PMID- 8340526
TI  - The health of our children and their use of medical services.

PMID- 8340527
TI  - Increasing enrollment of very young children in educational programs.

PMID- 8340528
TI  - Increased acidity in frozen fruit juices and dental implications.

PMID- 8340529
TI  - Autoantibodies in scleroderma.
AB  - Autoantibodies directed against nuclear, nucleolar, and a number of cytoplasmic
      components are described in the sera of scleroderma patients. Early studies of
      autoantibodies that relied on cryopreserved sections of rodent organ substrates
      showed that approximately 50% of scleroderma patients had anti-nuclear antibodies
      (ANA). More recent studies that have used tissue culture cell substrates have
      shown that up to 98% of scleroderma patients have a positive ANA. In all of these
      studies, the presence of different patterns of staining have suggested that
      scleroderma sera reacted with a variety of intracellular antigens. The use of
      molecular and immunochemical techniques has now shown that over 20 intracellular
      autoantigens are targets of autoantibodies in scleroderma sera. Clinical studies
      have shown that these autoantibodies are important diagnostic and prognostic
      markers in scleroderma. In the future, autoantibody testing may be used to
      monitor the patient's response to immunological therapies.

PMID- 8340530
TI  - Clinical criteria for differentiating between recessive and dominant forms of
      dystrophic epidermolysis bullosa, elaborated from an analysis of 119 cases.
AB  - We attempted to establish clinical criteria which differentiated between
      recessive dystrophic epidermolysis bullosa (RDEB) and dominant DEB (DDEB), since
      these two groups show prominent differences in prognosis, genetic recurrence risk
      and response to some types of treatment. The total of 119 cases examined
      consisted of our own 9 cases (2 of RDEB and 7 of DDEB) and 110 cases (26 of RDEB
      and 84 of DDEB) collected from the medical literature. They were analyzed by
      calculating the sensitivity and specificity of ten clinical features. We
      concluded that, syndactyly, presence of complications, dental lesions, remission
      less course, and oral lesions are strongly indicative of RDEB (more than 70%
      specific). Intractable skin ulcer is suggestive of RDEB (more than 55% specific).
      Nail lesions, scar and atrophy, milia and pigmentation are not helpful in the
      differentiation because of their commonality. The proposed criteria are simple,
      reliable, and practical, providing us with a useful tool for differentiation of
      RDEB and DDEB in daily practice.

PMID- 8340531
TI  - An analysis of 24 patients with IgA deposition at the BMZ.
AB  - A study of 24 patients with IgA deposition at the BMZ of the skin showed that
      five conditions could be recognized: 1) linear IgA bullous dermatosis in adults
      (LAD, 7 cases); 2) linear IgA and IgG bullous dermatosis in adults (LAGD, 10
      cases); 3) chronic bullous disease of childhood (CBDC, 3 cases); 4) dermatitis
      herpetiformis (DH, 1 case), and 5) systemic lupus erythematosus (SLE, 3 cases).
      Histopathologically, 5 of 7 patients with LAD were similar to the DH group, but 7
      of 10 patients with LAGD were similar to the BP group. Half the patients with LAD
      and LAGD had oral lesions, and most of them had excellent responses to dapsone
      and Tripterygium Wilfordii, but the patients with CBDC did not respond to these
      treatments. In the patients with LAD and LAGD, the positivity rates of IgA anti
      BMZ antibodies examined by indirect immunofluorescence (IIF) on intact skin and
      NaCl split skin were 41% and 64%, respectively. The heterogeneity of the
      histopathologic pictures of LAD and LAGD, the incidence of DH, and the value of
      using NaCl split skin for IIF are discussed.

PMID- 8340532
TI  - Cutaneous reactions induced by calcium channel blocker: high frequency of
      psoriasiform eruptions.
AB  - Fifteen cases with cutaneous reactions to calcium channel blockers (Ca
      antagonist), dihydropiridine (including nicardipine, nifedipine, nisoldipine),
      verapamil, and diltiazem are reported. The patients from Yokohama City University
      Hospital and affiliated hospitals included 4 males and 11 females with
      cardiovascular diseases. Their average age was 64.7 (54 to 82) years. They had
      been taking Ca-antagonists for an average of 95 days (7 days to 10 years) before
      they developed dermatitis. The frequency of reactions to Ca-antagonists was high
      with diltiazem (5/16:31.25%) and dihydropyridine (7/16:43.75%), including
      nifedipine (4/7), nisoldipine (1/7), and nicardipine (2/7). Stevens-Johnson
      syndrome (MCOS) was associated only with verapamil. A notable type of eruption
      was the psoriasiform type, including exacerbation of psoriasis, which was
      resolved or easily controlled after discontinuation of the drug. Provocation
      tests verified the Ca-antagonist as the cause in 7 cases of psoriasiform
      eruption. The frequency of positive patch tests to Ca-antagonists was low except
      for diltiazem. Patch tests with diltiazem showed positive reactions in 54% (7 of
      13 patients), based on our experience and papers published in Japan. Ca
      antagonists are occasional causes of a wide spectrum of cutaneous reactions and
      should also be considered as causative factors in patients who develop
      psoriasiform eruptions or in patients whose psoriasis is exacerbated while using
      these drugs.

PMID- 8340533
TI  - A correlation between carotenemia and biliary dyskinesia.
AB  - The interrelationship between carotenemia and biliary dyskinesia was studied in
      eighty-two biliary dyskinesia patients and twenty-seven normal subjects.
      Incidence of serum carotene levels of more than 300 micrograms/dl was more
      frequent in biliary dyskinesia patients without liver damage or hyperlipemia.
      Among the carotenemia patients, no dietary cases were found, but metabolic and
      hyperlipemic ones were observed. Significant relationships were found between
      gall bladder contraction rate and the levels of serum carotene, vitamin A, and
      lipids in metabolic carotenemia. A close relationship between metabolic
      carotenemia and biliary dyskinesia was strongly suggested.

PMID- 8340534
TI  - Association of generalized granuloma annulare with autoantibodies.
AB  - Granuloma annulare is a degenerative disease of the skin histopathologically
      characterized by focal degeneration of collagen with a surrounding infiltrate of
      lymphoid cells, histiocytic cells, and multinucleated giant cells. Immunological
      abnormalities such as delayed-type hypersensitivity and vasculitic origin are
      suspected in the pathogenesis. We describe three patients with generalized
      granuloma annulare, in whom autoantibodies, including antinuclear antibody,
      antithyroid stimulating hormone receptor antibody, and immune complex, were
      detected.

PMID- 8340535
TI  - A case of cutaneous B-cell lymphoma with a storiform stromal reaction.
AB  - A case of cutaneous B-cell lymphoma is described. The patient was treated only by
      surgical excision of the skin tumors five times during a period of about two
      years from February of 1984 to October of 1986. After the last surgical excision,
      a continuous disease-free period was achieved. Biopsy samples showed dense
      lymphocytic infiltrations with discrete masses in the dermis and subcutis; one of
      them showed a storiform pattern. At the time, the infiltrating cells were
      composed of medium and large lymphoid cells and spindle-shaped cells. The medium
      and large lymphoid cells were positive for CD20, CD22 and HLA-DR and negative for
      CD3, CD4, CD5, CD8, CD43, and kappa and lambda light chain. The spindle-shaped
      cells were negative for CD20, CD43, kappa and lambda light chain, lysozyme, and S
      100 protein.

PMID- 8340536
TI  - A case of necrobiosis lipoidica treated with systemic corticosteroid.
AB  - A 43-year-old woman had asymptomatic eruptions on the anterior sides of both legs
      for 5 years. Biopsy specimens revealed the typical findings of necrobiosis
      lipoidica. An immunofluorescence study demonstrated no deposits of
      immunoglobulins, complement, or fibrinogen in vessel walls. Immunohistochemical
      staining revealed CD4 positive lymphocytes dominating in the lesion and strong
      expression of ICAM-1 on the endothelial cells, giant cells, lymphocytes and
      dermal fibroblasts in the lesion. The eruptions resolved remarkably with oral
      corticosteroid therapy.

PMID- 8340537
TI  - Familial cases of psoriasis vulgaris and pustulosis palmaris et plantaris.
AB  - Two familial cases of psoriasis vulgaris and pustulosis palmaris et plantaris and
      their HLA types were examined. Our cases suggest a close genetic relationship
      between these two diseases.

PMID- 8340538
TI  - Papillary tubular adenoma of the skin.
AB  - A case of papillary tubular adenoma of the skin in a 31-year-old black man is
      reported. This lesion is also termed papillary eccrine adenoma, and it commonly
      occurs in the extremities.

PMID- 8340539
TI  - Effects of ultraviolet radiation on the alloreactivity of splenic T cells.

PMID- 8340540
TI  - Might does not equal right.

PMID- 8340541
TI  - Taking responsibility.

PMID- 8340542
TI  - Why no dental dam?

PMID- 8340543
TI  - Delegating duties.

PMID- 8340544
TI  - A timely report.

PMID- 8340545
TI  - Implant dentistry: where are we now?
AB  - Dental implants can dramatically change a patient's self-esteem and quality of
      life. But too few people receive implants because of the cost and lack of
      education in this growing field. More training, systems standardization and
      practice guidelines will improve implant treatment availability.

PMID- 8340546
TI  - The developing market for dental implants.
AB  - A survey of U.S. dentists showed that dental implant use increased 73 percent
      between 1986 and 1990. More than half of all implants are placed by oral and
      maxillofacial surgeons. Most dentists who place implants are not affiliated with
      professional implant organizations; training for implant placement varies widely.

PMID- 8340547
TI  - Evaluating CAD-CAM generated ceramic veneers.
AB  - As the CAD-CAM technique has been expanded to include porcelain facings, of
      particular interest is adapting the veneer to the prepared surface. In a
      comparison of the gap dimension of CAD-CAM generated veneers to those produced in
      the laboratory, no statistically significant differences were detected.

PMID- 8340548
TI  - Feeding patterns, water sources and fluoride exposures of infants and 1-year
      olds.
AB  - Concern about dental fluorosis prompted this study of feeding habits, water
      sources and fluoride exposures of about 100 children from birth to 18 months.
      Toothbrushing habits and dentrifice use, both at home and during child care, must
      be considered to estimate fluoride exposures and ingestion.

PMID- 8340549
TI  - The plaque fighters: choosing a weapon.
AB  - In recent years new head shapes and angles, bristle lengths and designs, have
      flooded the toothbrush market. Are these truly innovations or just gimmicks?
      Several comparative studies are reviewed.

PMID- 8340550
TI  - Possibility of cross-contamination between dental patients by means of the saliva
      ejector.
AB  - Concern about cross-contamination between dental patients prompted investigation
      of current suctioning practices. The possibility of the suck-back phenomenon and
      the presence of oral bacteria in vacuum lines were studied, and dental offices
      were surveyed concerning the use and disinfection of suction equipment.

PMID- 8340551
TI  - Guided tissue regeneration in oral reconstruction: surgical and restorative
      applications.

PMID- 8340552
TI  - Hastening the enamel microabrasion procedure eliminating defects, cutting
      treatment time.
AB  - Two cases illustrate the technique of treating enamel discoloration and
      decalcification by beginning with bur cutting and completing with microabrasion
      compound. This eliminates texture defects caused by bur cutting and reduces
      treatment time.

PMID- 8340553
TI  - Keeping interocclusal records: how to solve a common problem.

PMID- 8340554
TI  - Surviving practice downturn: a case study in dental marketing.
AB  - Unexplained downturns can destroy a healthy practice. This report details the
      warning signs and offers a blueprint for keeping your practice on track.

PMID- 8340555
TI  - Comparison of adaptations and compliance to exercise training between middle-aged
      and older men.
AB  - OBJECTIVE: To compare the rate and magnitude of physiologic and psychologic
      adaptations to aerobic training between middle-age and older men, to assess their
      interest in continued participation (> 6 months) in a supervised high-intensity
      training program, and to evaluate the safety of high-intensity training for older
      people. DESIGN: Before-after intervention trial. SETTING: Medical center in a
      Midwestern metropolitan city. PARTICIPANTS: Thirteen middle-age (35-50 years) and
      14 older (60-71 years) normal men. INTERVENTION: Subjects trained on treadmills
      and leg cycle ergometers for 40 minutes 3 times per week. The intensity was
      increased to 85% of peak heart rate (HR) within the first 3 weeks of training.
      MEASUREMENT: Peak oxygen consumption, HR at submaximal work rates, three
      psychological tests, and election to continue in the supervised program. RESULTS:
      At 6 months of training, peak oxygen consumption had increased by 12% and 11% in
      the middle-aged and older groups, respectively, with 86% and 100% of this
      increase occurring within the first 3 months. Both groups showed comparable
      decreases in HR at submaximal work rates after 3 months of training with no
      further significant change from 3 to 6 months. None of the psychologic parameters
      evaluated changed significantly with 3 or 6 months of training in either group.
      More of the older (71%) than middle-aged (45%) men elected to continue in the
      supervised program after 6 months. CONCLUSIONS: The results of this study
      involving small groups of carefully screened middle-aged and older men suggest
      that the time course and magnitude of physiologic adaptations to aerobic training
      are similar between age groups when the training regimen is the same. Neither age
      group showed alterations in psychologic parameters nor experienced orthopedic
      injuries with training. The older group showed greater interest in continued
      participation in a supervised exercise program.

PMID- 8340556
TI  - Characteristics and quality of prescribing by doctors practicing in nursing
      homes.
AB  - OBJECTIVES: To describe the professional characteristics of doctors practicing in
      nursing homes and to determine whether those characteristics correlate with
      quality of prescribing. DESIGN: A prospective, cohort study. PARTICIPANTS: 306
      physicians practicing in 12 nursing homes in greater Los Angeles. MEASUREMENTS:
      We surveyed doctors about their age, sex, education, credentials, and NH
      practice. We also determined medication orders for a 1-month period and evaluated
      them using explicit criteria for appropriateness developed by an expert panel.
      RESULTS: We obtained data from 72% of MDs. Respondents had a mean age of 53 years
      (29-78) and were 94% male. Fifty-seven percent trained in internal medicine, 20%
      graduated outside the US or Canada, 67% were board certified in their declared
      specialty, and 5% had a certificate of added qualification in geriatrics (CAQ).
      Sixteen percent spent > 10% of their professional time in NHs, and 46% had NH
      practices that were > 20% Medicaid; most did not consult psychiatrists when
      prescribing psychoactive drugs. Forty percent of residents had at least one
      inappropriate prescription. The characteristics of doctors associated with the
      best prescribing quartile were female sex, CAQ, no board certification, and
      frequent consultation with psychiatrists. The characteristics of doctors in the
      most inappropriate quartile were older age, graduation from medical school before
      1965, graduation from US medical school, small NH practice, and infrequent
      consultation with psychiatrists. CONCLUSIONS: Although the quality of prescribing
      in nursing homes is related to some physician characteristics, the relationships
      are not those most commonly stated.

PMID- 8340557
TI  - Disposition of intramuscular cefonicid in elderly patients.
AB  - OBJECTIVE: To examine the disposition of intramuscular (IM) cefonicid in elderly
      patients with bacterial pneumonia. DESIGN: Pharmacokinetic study. SETTING: A 620
      bed university-affiliated long-term care institution with its own 39-bed acute
      care unit. PATIENTS: Nine consecutive elderly patients with bacterial pneumonia
      treated with IM cefonicid. MEASUREMENTS: Blood samples were collected on the
      seventh day of therapy over a 24-hour period and analyzed by high performance
      liquid chromatography. Pharmacokinetics parameters (volume of distribution, half
      life, and clearance) and protein binding were calculated. Clinical outcome of IM
      cefonicid therapy was also noted. RESULTS: The estimated creatinine clearance
      (CIcr) ranged from 32 to 145 mL/min. Peak cefonicid serum concentrations occurred
      at 0.5-1.5 hours, with a mean value of 118 +/- 41 micrograms/mL. Cefonicid
      concentrations declined monoexponentially to 57 +/- 16 micrograms/mL at 12 hours
      and 28 +/- 14 micrograms/mL at 24 hours. The mean apparent distribution volume
      was 0.2 +/- 0.07 L/kg, and the mean apparent total clearance was 15 +/- 12
      mL/min. The half-life ranged from 3.1 to 38 hours. A linear correlation was noted
      between Clcr and cefonicid clearance (r = 0.99). CONCLUSIONS: Cefonicid
      absorption was variable among these patients, and the serum half-life was longer
      than previous values noted in younger patients with similar degree of renal
      dysfunction. Pharmacokinetic and clinical outcome data from our study group
      indicate the potential role of IM cefonicid in treating elderly patients with
      bacterial pneumonia.

PMID- 8340558
TI  - Screening elders for risk of hospital admission.
AB  - OBJECTIVE: To define a set of screening criteria that identifies elders who are
      at high risk for repeated hospital admission in the future. DESIGN: Longitudinal
      cohort study. Logistic regression analysis of data from half of the subjects was
      used to identify risk factors for repeated hospital admission. The ability of
      these risk factors to identify elders who are at high risk for repeated
      hospitalization in the future was then tested using data from the other half of
      the subjects. SETTING: United States. PARTICIPANTS: A subsample (n = 5876) of a
      multistage probability sample of all non-institutionalized U.S. civilians who
      were 70 years or older in 1984. MEASUREMENTS: At baseline (1984), elderly
      subjects were asked about their demographic, socioeconomic, medical, and
      functional characteristics and about their recent use of health services. Their
      subsequent hospital admissions and mortality were then monitored through the
      records of the Medicare program and the National Death Index (1985-88). RESULTS:
      Among the subjects in the first half of the sample, eight factors emerged as risk
      factors for repeated admission: older age, male sex, poor self-rated general
      health, availability of an informal caregiver, having ever had coronary artery
      disease, and having had, during the previous year, a hospital admission, more
      than six doctor visits, or diabetes. Based on the presence or absence of these
      factors in 1984, 7.2% of the subjects in the second half of the sample were
      estimated to have a high probability of repeated admission (Pra > or = 0.5)
      during 1985-1988. In comparison with subjects estimated to have a low risk (Pra <
      0.5), this high-risk group's actual experiences during 1985-1988 included a
      higher cumulative incidence of repeated admission (41.8% vs 26.2%, P < 0.0001), a
      higher cumulative rate of mortality (44.2% vs 19.0%, P < 0.0001), more hospital
      days per person-year survived (5.2 vs 2.6), and higher hospital charges per
      person-year survived ($3731 vs $1841). CONCLUSION: Eight easily ascertained risk
      factors affect elders' probability of being hospitalized repeatedly within four
      years. In the future, brief surveys about the presence of these factors could be
      used to estimate elders' risk of future hospitalization and, thereby, to identify
      some of those who may derive the greatest benefit from interventions designed to
      avert the need for hospitalization.

PMID- 8340559
TI  - The effects of thiazide diuretics on calcium metabolism in the aged.
AB  - OBJECTIVE: To determine the effects of long-term use of the thiazide diuretic
      chlorthalidone on serum bone-related biochemical variables in older persons.
      DESIGN: Cross-sectional comparison. SETTING: Community-dwelling subjects who had
      participated in the Systolic Hypertension in the Elderly (SHEP) program.
      PARTICIPANTS: Sixty-six Caucasians (36 male and 30 female), age range 70 to 89
      years, of whom 23 were taking a thiazide diuretic. MEASUREMENTS: 25
      hydroxyvitamin D (25OHD), parathyroid hormone, osteocalcin, calcitonin, and serum
      bioavailable testosterone. RESULTS: In both groups, there was a high prevalence
      of low 25 (OHD) levels (30%). Log 25OHD showed a significant inverse relationship
      to parathyroid hormone (r = .33, P < 0.05). Thiazide users had lower levels of
      osteocalcin (P < 0.05) and parathyroid hormone levels (P < 0.05) compared with
      non-thiazide users. Male thiazide users had decreased bioavailable testosterone
      levels compared with non-thiazide users (P < 0.05). Serum osteocalcin was
      significantly related to bioavailable testosterone in men not on thiazide (r =
      .43, P < 0.05). CONCLUSIONS: Hypovitaminosis D is a common finding in older
      individuals with associated elevations in parathyroid hormone. Parathyroid
      hormone and testosterone concentration (in men) are correlated with serum
      osteocalcin, a measure of osteoblastic activity. Long-term thiazide use alters
      these relationships and produces a biochemical profile suggestive of decreased
      bone formation. Reduced bioavailable testosterone may also play a role in these
      biochemical changes.

PMID- 8340560
TI  - Serum thyrotropin and thyroid hormone levels in elderly and middle-aged euthyroid
      persons.
AB  - OBJECTIVE: To determine whether serum thyrotropin (TSH) levels are altered in
      euthyroid older persons compared with middle-aged adults. DESIGN: Serum TSH and
      thyroid hormone levels were measured in a large group of older persons (> 70
      years old, n = 216) and their middle-aged offspring (40-60 years old, n = 211)
      after excluding those with clinical or historical evidence of thyroid disease or
      abnormal thyroid function. MEASUREMENTS: Serum TSH, thyroxine (T4), free T4
      index, estimated free T4, triiodothyronine (T3), estimated free T3, and ferritin
      levels were measured on the Abbott IMx instrument. Peroxidase and thyroglobulin
      antibodies were measured by radioimmunoassay using Kronus kits. MAIN RESULTS:
      Overall, serum TSH showed a log-normal distribution. The geometric mean TSH
      (mU/L) and 95% confidence limits in the older persons, 1.24 (0.29-5.4), did not
      differ significantly from that in the middle-aged, 1.45 (0.54-3.9). The mean TSH
      in the 264 women, 1.37 (0.34-5.5), was similar to that of the 163 men, 1.30 (0.48
      3.5). The mean TSH in older women, 1.21 (0.22-6.6), was slightly but
      significantly lower than that in middle-aged women, 1.52 (0.55-4.2). However,
      when euthyroid women with positive antibodies were excluded, this difference was
      not significant. Four of the 123 older women had TSH < 0.1 mU/L, but none of the
      men or middle-aged women had a suppressed serum TSH. The mean TSH in older men,
      1.28 (0.43-3.8), was similar to that in middle-aged men, 1.32 (0.55-3.2). Free T4
      was slightly higher in older women than middle-aged women. There were no
      significant correlations between TSH and any thyroid hormone level. Serum
      ferritin, measured as a potential marker for the action of thyroid hormone, did
      not correlate with any measure of thyroid function. At least one antibody level
      was > 10 U/mL in 14.6% of older women, 15.6% of middle-aged women, 4.3% of older
      men, and no middle-aged men. When those with milder elevations of antibody levels
      were included (at least one level > 1 U/mL), the prevalence was 32% of older
      women, 43.3% of middle-aged women, 15% of older men, and 11.4% of middle-aged
      men. CONCLUSIONS: Euthyroid older persons have about the same levels of serum TSH
      as younger ones, although older euthyroid women have a slightly lower serum TSH
      than middle-aged women. We recommend that the normal range of serum TSH in the
      elderly be considered to be the same as that in healthy middle-aged subjects.

PMID- 8340561
TI  - Alleviation of sleep maintenance insomnia with timed exposure to bright light.
AB  - OBJECTIVE: Half of the population over 65 suffers from chronic sleep disturbance.
      As a consequence, almost 40% of hypnotic medications are prescribed to people
      over age 60. Yet, hypnotics are often of little benefit in this population. As
      such, an effective non-drug alternative could prove important in the management
      of age-related sleep maintenance insomnia. The current study sought to evaluate
      the efficacy of bright light exposure in the treatment of sleep maintenance
      insomnia. DESIGN: Following baseline sleep and circadian rhythms assessment,
      subjects with sleep-maintenance insomnia were treated with timed exposure to
      either bright white light or dim red light for 12 consecutive days. Sleep and
      circadian rhythms recordings were subsequently obtained and measures of sleep
      quality were compared to assess efficacy of the treatments. SETTING: Baseline and
      post-treatment sleep and circadian rhythms assessments took place in the
      Laboratory of Human Chronobiology, Department of Psychiatry, Cornell University
      Medical College. The treatment phase of the study was conducted in participants'
      homes. PARTICIPANTS: Sixteen men and women between the ages of 62 and 81 years
      were studied. All subjects were free of hypnotic medication, and all had
      experienced sleep disturbance for at least 1 year prior to entering the study.
      RESULTS: Exposure to bright light resulted in substantial changes in sleep
      quality. Waking time within sleep was reduced by an hour, and sleep efficiency
      improved from 77.5% to 90%, without altering time spent in bed. Increased sleep
      time was in the form of Stage 2 sleep, REM sleep, and slow wave sleep. The
      effects were remarkably consistent across subjects. CONCLUSIONS: The findings
      demonstrate the effectiveness of timed exposure to bright light in the treatment
      of age-related sleep maintenance insomnia. With further refinement of treatment
      regimens, this non-drug intervention may prove useful in a large proportion of
      sleep disturbed elderly.

PMID- 8340562
TI  - Nocturnal activity and immobility across aging (50-98 years) in healthy persons.
AB  - OBJECTIVE: To measure the influence of age on measures of nocturnal activity and
      immobility in 100 healthy subjects aged 50 to 98 years. DESIGN: Cross-sectional
      study. SETTING: Urban population in Leiden. Recordings were performed at home
      while the subjects maintained their habitual 24-hour pattern of activities.
      PARTICIPANTS: 100 subjects without a history of major medical disorders and a
      normal neurological examination and performance-oriented assessment of gait
      (Tinetti). MEASUREMENTS: Motor activity was recorded during six successive nights
      with a wrist-worn activity monitor. The occurrence of supra-threshold motor
      activity was recorded over 15-second epochs. A questionnaire was used to evaluate
      sleep habits and the occurrence of sleep disturbances. Four mean measures
      reflecting activity or immobility during the nocturnal period were calculated for
      each subject. RESULTS: Only one out of four measures, (ie, the nocturnal
      proportion of time with movement, increased with age for females. For males, no
      age effects emerged. The mean duration of nocturnal immobility periods was higher
      in females than in males. Also, for females, the use of hypnotics increased with
      successive decades. Sex and the use of hypnotics were significantly related to
      the mean duration of immobility periods. CONCLUSION: If care is taken not to
      confound aging with illness, measures of nocturnal activity and immobility reveal
      only marginal effects of aging.

PMID- 8340563
TI  - Poisoning in the elderly: characterization of exposures reported to a poison
      control center.
AB  - OBJECTIVE: To determine the incidence of poison center calls involving the
      elderly, characterize these poisonings, and compare them with poisonings that
      occur in people younger than 60 years of age. DESIGN: Concurrent, observational
      survey. SETTING: The Virginia Poison Center in Richmond, Virginia. PARTICIPANTS:
      All persons 60 years of age and older who were involved in a poison exposure
      reported to the Virginia Poison Center from October 1, 1991 through March 31,
      1992. MEASUREMENTS: Incidence, type, route, location, management site, medical
      outcome of exposures and reasons for these exposures. RESULTS: Exposures in
      persons 60 years of age and older accounted for 2.3% of all poison center calls
      during the 6-month study period. These calls were most likely to involve women
      who unintentionally ingested extra doses of medications. The majority of these
      exposures occurred in the home and resulted in either no effect or minor effects.
      For those exposures that necessitated an emergency room visit, elderly persons
      were more likely to be admitted to the hospital than younger persons (P < 0.05).
      CONCLUSIONS: The majority of poisonings that occur in persons 60 years of age and
      older are unintentional and may be amenable to poison prevention education.

PMID- 8340564
TI  - Hospital resources used to treat the injured elderly at North Carolina trauma
      centers.
AB  - OBJECTIVE: The purpose of this paper is to compare the hospital resources used by
      elderly, adult, and pediatric patients treated in hospitals reporting to the
      North Carolina Trauma Registry (NCTR). DESIGN: We analyzed data on all patients
      entered into the NCTR from 1 January 1988 to 31 December 1990. SETTING: The NCTR
      is a statewide registry of all trauma patients admitted for at least 24 hours or
      dead on arrival at the eight Level I and II trauma center hospitals in North
      Carolina. PATIENTS: The total number of patients included in the study was
      21,214; elderly adults included those age 65 and older (n = 2808), adults
      included those 15 to 64 years old (n = 15,776), and pediatric patients included
      those 0 to 14 years old (n = 2630). MAIN OUTCOME MEASURES: We examined hospital
      resources using three measures: overall length of hospital stay in days,
      intensive care unit (ICU) length of stay in days for those admitted to the ICU,
      and total hospital charges billed during the hospitalization. RESULTS:
      Controlling for injury severity, we found that elderly adults had longer mean
      hospital and ICU lengths of stay and higher mean hospital charges than adults or
      children. Whereas only 22% of injuries to elderly adults were transportation
      related, transportation injuries generated 38% of their hospital charges. Sixty
      eight percent of their injuries were caused by falls, generating total hospital
      charges of $17.6 million, an average of 15 days in hospital stay and 9 days in
      ICU stay. CONCLUSION: A 10% reduction in both transportation injuries and falls
      among the elderly could save $3.5 million in this population over 3 years.

PMID- 8340565
TI  - Aggressive behaviors among the institutionalized elderly.
AB  - OBJECTIVE: To describe the incidence and characteristics of aggressive behaviors
      in a group of institutionalized elderly. DESIGN: Retrospective survey. SETTING:
      350-bed, urban skilled nursing facility. PATIENTS: All nursing home residents who
      had an incident report completed after an aggressive behavior. MEASUREMENTS:
      Examination of all incident reports of aggressive behavior for 1 year. RESULTS:
      There were 94 reports of aggressive behaviors. Twenty-nine residents exhibited
      one aggressive behavior, 12 residents two, and six residents exhibited three or
      more aggressive behaviors. These six residents accounted for 44% of all events.
      The incidence of aggressive behavior was 0.27 per resident per year for the
      entire facility; on the Alzheimer's unit the incidence was 0.75 per resident per
      year. Sixty-two percent of the victims of aggressive behavior were other nursing
      home residents, 37% were employees, and 1% were visitors. The charts of the six
      residents with three or more aggressive behaviors were reviewed. These residents
      received trials of multiple scheduled psychotropic medications, often exhibited
      several additional agitated behaviors around the time of the attack, were at risk
      for psychiatric hospitalizations during the study period, and often were noted to
      have underlying acute medical illnesses near the time of the attack. CONCLUSION:
      Approximately two aggressive behaviors per week occurred in a large nursing home.
      Residents and staff of Alzheimer's units have a higher risk of being victims of
      aggressive behavior. A small number of patients account for nearly half of the
      behaviors, even on the Alzheimer's unit. Aggressive behaviors may be clinical
      indicators of underlying acute medical illnesses.

PMID- 8340566
TI  - Acetazolamide and salicylate interaction in the elderly: a case report.

PMID- 8340567
TI  - Rhabdomyolysis in association with acute pressure sore.

PMID- 8340568
TI  - The older person and the emergency department.

PMID- 8340569
TI  - The American and Canadian consensus conferences on dementia: is there consensus?

PMID- 8340570
TI  - Age-related decline of influenza A virus-specific cytotoxic T lymphocyte
      activity.

PMID- 8340571
TI  - A more opportune description of the stages of aging.

PMID- 8340572
TI  - Characteristics of diabetic ketoacidosis in older patients.

PMID- 8340573
TI  - Health care for end-stage dementia.

PMID- 8340574
TI  - Physician-assisted suicide.

PMID- 8340575
TI  - Driving with cognitive impairment.

PMID- 8340576
TI  - Cobalamin deficiency in the elderly.

PMID- 8340577
TI  - Prehospital cardiac arrest survival and neurologic recovery.
AB  - Many studies of prehospital defibrillation have been conducted but the effects of
      airway intervention are unknown and neurologic follow-up has been incomplete. A
      non-randomized cohort prospective study was conducted to determine the
      effectiveness of defibrillation in prehospital cardiac arrest. Two ambulance
      companies in the study area developed a defibrillation protocol and they formed
      the experimental group. A subgroup of these patients received airway management
      with an esophageal obturator airway (EOA) or endotracheal intubation (ETT). The
      control group was composed of patients who suffered a prehospital cardiac arrest
      and did not receive prehospital defibrillation. All survivors were assessed for
      residual deficits using the Sickness Impact Profile (SIP) and the Dementia Rating
      Scale (DRS). A total of 221 patients were studied over a 32-month period. Both
      the experimental group (N = 161) and the control group (N = 60) were comparable
      with respect to age, sex distribution, and ambulance response time. Survival to
      hospital discharge was 2/60 (3.3%) in the control group and 12/161 (6.3%) in the
      experimental group. This difference is not statistically significant. Survival in
      the experimental group by airway management technique was basic airway support
      (3/76 3.9%), EOA (3/67 4.5%), and ETT (6/48 12.5%). The improved effect on
      survival by ETT management was statistically significant. Survivors had minor
      differences in memory, work, and recreation as compared to ischemic heart disease
      patients as measured by the SIP and DRS. No effect of defibrillation was found on
      survival to hospital discharge. However, endotracheal intubation improved
      survival in defibrillated patients. Survivors had a good functional outcome.

PMID- 8340578
TI  - Signs and symptoms of patients with brain tumors presenting to the emergency
      department.
AB  - This retrospective chart review was conducted to determine the presenting signs
      and symptoms of patients with primary brain tumors diagnosed in the emergency
      department. There were 101 patients (65 males and 36 females) identified with a
      hospital discharge diagnosis of primary brain tumor who were admitted through the
      emergency department. The presenting symptoms included headache (56 patients),
      altered mental status (51 patients), ataxia (41 patients), nausea or vomiting (37
      patients), weakness (27 patients), speech deficits (21 patients), and sensory
      abnormalities (18 patients). The presenting signs included motor weakness (37
      patients), ataxia (37 patients), papilledema (28 patients), cranial nerve palsies
      (26 patients), visual deficits (20 patients), and speech deficits (12 patients).
      The average age was 42.8 years, with a range of 3 days to 88 years. The majority
      of tumors were malignant astrocytomas. Tumor location was cortical in 68
      patients, subcortical in 9 patients, and brainstem or cerebellum in 24 patients.
      In conclusion, patients of all ages may present to the emergency department with
      a variety of symptoms resulting from a primary brain tumor. Headache and altered
      mental status were common in our series of patients, but symptoms will depend on
      the size, location, and type of tumor. A complete neurologic examination is
      essential, including evaluation for papilledema.

PMID- 8340579
TI  - Retained foreign body: a fingernail fragment?
AB  - A 19-year-old female presented four and one-half months after an occupational
      injury from a punch-type machine. Exploration revealed a large fragment of her
      fingernail embedded in the fingerpad. Foreign bodies are commonly encountered in
      the practice of emergency medicine and failure to localize and remove them can
      result in significant morbidity. We present a case of a fingernail as a foreign
      body. Foreign bodies may be difficult to detect despite sophisticated imaging
      techniques. Although not visualized often, a radiolucent foreign body may be
      inferred from boney changes. A thorough history regarding mechanism of injury and
      resultant wound exploration are required. When an adequate wound examination
      using digital tourniquet control and proper precautions is performed, the
      majority of foreign bodies will be detected.

PMID- 8340580
TI  - Acute management of glycogen storage disease type Ia.
AB  - Rapid metabolic deterioration may occur in patients with some glycogen storage
      diseases (GSDs) regardless of presenting complaint. Hepatic, renal, and
      hemostatic abnormalities may also complicate diagnosis and treatment of trauma
      victims. We report the case of a man presenting with an epidural hematoma and a
      history of GSD type Ia.

PMID- 8340581
TI  - A 33-year-old white female with abdominal pain, nausea, vomiting and hypotension.
AB  - A thirty-three year old female presented to our emergency department complaining
      of severe abdominal pain, nausea, and vomiting. On physical examination she was
      hypotensive with a firm, tender abdomen, cervical motion tenderness and a diffuse
      erythematous rash. A surgical diagnosis of Acute Pelvic Inflammatory Disease was
      made during laparoscopy. Coagulant studies, liver function tests, culture
      results, and the desquamation of the patient's palms led to the additional
      diagnosis of Toxic Shock Syndrome. A literature search failed to reveal any
      similar cases of Pelvic Inflammatory Disease (PID) and Toxic Shock Syndrome (TSS)
      occurring concomitantly. Patients may present severely ill with either of these
      disease entities but potential for serious illness is greater when both of these
      syndromes occur in the same patient. We conclude that in patients with a similar
      presentation, the symptoms should not be attributed completely to PID without
      further investigation and consideration of a concomitant disease process
      including TSS.

PMID- 8340582
TI  - Misdiagnosis of bilateral ectopic pregnancies: a caveat about operator expertise
      in the use of transvaginal ultrasound.
AB  - Reported is the case of a 24-year-old female who presented to the Emergency
      Department complaining of lower abdominal pain and vaginal bleeding, whose
      initial transvaginal ultrasound was interpreted as showing a viable intrauterine
      pregnancy (IUP) of 8 weeks gestation. Repeat transvaginal ultrasound during a
      subsequent Emergency Department (ED) visit 3 days later revealed bilateral
      ectopic pregnancies of 6.5 weeks gestation. ED physicians should be familiar with
      the limitations of transvaginal sonography, and should be wary of early
      "intrauterine" pregnancies that are diagnosed ultrasonographically by
      inexperienced operators.

PMID- 8340583
TI  - Delayed cardiotoxicity following quinine overdose: a case report.
AB  - Quinine poisoning typically results in a constellation of non-life threatening
      symptoms which include tinnitus, deafness, nausea, vomiting, vision changes,
      headache, and hypotension. Cardiac conduction defects, dysrhythmias, and
      cardiovascular collapse have all been reported after overdose and generally occur
      within 8 hours of ingestion. We report a unique case of delayed cardiotoxicity
      following quinine ingestion. Toxicity included marked ventricular conduction
      abnormalities for which serum alkalinization appeared to be therapeutically
      beneficial, and torsades de pointes requiring overdrive pacing for termination.

PMID- 8340584
TI  - Benign course after massive ingestion of yohimbine.
AB  - Yohimbine is an alpha 2 adrenoreceptor antagonist occasionally used in the
      treatment of impotence. Overdose of this drug is uncommon. We describe a 62-year
      old male who ingested 100, 2.0 mg tablets whose only adverse effects were
      tachycardia, hypertension, and anxiety of brief duration. The limited experience
      to date suggests a benign course even after massive overdose. Observation would
      seem to be the management of choice.

PMID- 8340585
TI  - Reevaluation of plain radiographic findings in the diagnosis of aortic rupture:
      the role of inspiration and positioning on mediastinal width.
AB  - Despite the advent of newer imaging modalities, conventional radiography and
      clinical examination remain the primary screening method in evaluation of the
      mediastinum following blunt thoracic trauma. Mediastinal width (MW) is generally
      considered an important finding in assessing for aortic rupture. The degree of
      inspiration and patient positioning clearly affects MW, but is largely ignored in
      the literature. This study investigates the mediastinal widths of normal
      volunteers with differing degrees of inspiration and positioning, and compares
      them to radiographs of patients with known aortic ruptures. Mediastinal widths
      were obtained from chest radiographs of 16 patients with known aortic rupture,
      and from 50 volunteers using AP-inspiratory-supine, AP-expiratory-supine, and PA
      inspiratory-upright technique. Upper 95% confidence limits were obtained for
      normals. A statistically significant difference in MW of normals was found
      between inspiratory-supine, expiratory-supine, and upright-inspiratory
      techniques. Compared to the same degree of inspiration in normals, 12 of 16
      patients with aortic rupture had a MW above the upper 95% confidence limits. It
      is concluded that mediastinal width in normals is significantly affected by the
      degree of inspiration and positioning. When comparing mediastinal widths for
      normals and ruptures, there was a significant difference in MW for most degrees
      of inspiration. As depth of inspiration increased, differences between MW in
      controls and rupture patients increased. We conclude that patient positioning and
      degree of inspiration are important factors in assessing the mediastinum, and
      every effort should thus be made to obtain an upright-inspiratory film if
      clinically feasible prior to declaring a mediastinum as abnormal.

PMID- 8340586
TI  - Recognition and management of sarcoidosis in the emergency department.
AB  - Sarcoidosis is a chronic granulomatous disease of uncertain etiology. It can
      affect essentially every organ system in the human body and its manifestations
      are protean. Sarcoidosis can present in the emergency department (ED) as de novo
      disease, as preexisting disease with acute exacerbations, or as chronic
      debilitation. The authors provide a review of the various manifestations of this
      disease with emphasis on ED presentation and evaluation.

PMID- 8340587
TI  - Electric shock, Part I: Physics and pathophysiology.
AB  - Electric shock causes injury and death through a variety of mechanisms. The
      proper treatment of a patient with electric shock depends upon the nature of the
      injuries sustained. The primary electric injuries to be expected depend in large
      part on the type of electric energy source, the amount and duration of current
      flow, and the parts of the body affected. Secondary injury can be caused by
      trauma associated with the electric accident such as falls and explosions.

PMID- 8340588
TI  - Austin Flint: on cardiac murmurs.
AB  - Austin Flint first ausculted the murmur associated with his name in 1859.
      Suspecting it to be of mitral origin, he identified it as occurring in aortic
      insufficiency three years later. Recent echocardiographic study has indicated
      that this murmur is produced by an aortic insufficiency jet colliding with the
      anterior mitral valve leaflet. Flint was among the first to recognize the
      importance of normal cardiac and respiratory sounds. He advocated routine
      auscultation on all patients, and had great influence in popularizing
      auscultation in American medicine.

PMID- 8340589
TI  - The role of emergency services in health care for the elderly: a review.
AB  - The hospital emergency department (ED) has become an important means of access to
      health care for the elderly. Inadequacies in the current health care system for
      the elderly are reflected in their high utilization rates of the ED, continuing
      questions about the appropriateness of elderly ED patients, differences in the ED
      care offered the elderly versus the young, and poor coordination of care to and
      from the ED. Evidence of potential misuse of emergency services exists for both
      the ED and the emergency medical transport (EMS) systems. The increasing number
      of nursing home patients sent to the ED with nonemergent problems further
      emphasizes inadequacies of primary care in the nursing home setting. Economic,
      legal, and ethical issues that have changed the way medicine is practiced in
      other settings are finally reaching the sector of emergency services. The current
      and future roles of emergency medicine services, and the impact these issues will
      have on the practice of emergency medicine, are discussed.

PMID- 8340590
TI  - Robert M. Berne, teacher, scientist, and inventor.

PMID- 8340591
TI  - Ethics and continuous quality improvement.

PMID- 8340592
TI  - Emergency department discharges against medical advice.

PMID- 8340593
TI  - Staph aureus sepsis following emergent nasal intubation.

PMID- 8340594
TI  - The English system.

PMID- 8340595
TI  - Akathisia causing suicide attempts in patients taking fluoxetine (Prozac)

PMID- 8340596
TI  - Objectives to direct the training of emergency medicine residents on off-service
      rotations: neurology.
AB  - This is the twenty-first article in a continuing series of objectives to direct
      resident training in emergency medicine. Presented is a set of objectives with
      references for curriculum goals in neurology. Knowledge of neurology and clinical
      skills in diagnosing neurological illness is important in the practice of
      emergency medicine. Not all emergency residents have adequate exposure to the
      subspecialty of neurology. Many residents who have exposure to a neurology
      elective often spend only two weeks on the service. Therefore, a clear set of
      goals and objectives is essential for the resident to obtain a comprehensive
      knowledge of this complex specialty.

PMID- 8340597
TI  - Health policy and quality: an ethical dilemma.
AB  - Emergency medicine is on the front line of many important health issues, such as
      access for the poor and uninsured, the AIDS epidemic, and domestic violence.
      Virtually all key policy issues relating to emergency medicine deal with the
      concept of quality. During the 1970s, quality issues dealt with issues of value.
      Interest in quality is now vested in the tradeoff between cost containment
      activities and preserving access to health care. Key definitions of efficacy,
      effectiveness, and efficiency are provided. A policy approach to quality
      definition and assessment is suggested based upon the concepts of continuous
      quality improvement. The role of emergency physicians in health policy and the
      future of emergency medicine are discussed.

PMID- 8340598
TI  - Edlich's academical village.
AB  - Dr. Richard F. Edlich, Distinguished Professor of Plastic Surgery and Biomedical
      Engineering, recently received the Thomas Jefferson Award, the highest honor that
      can be bestowed upon a faculty member at the University of Virginia. Reflections
      of his "Academical Village" are presented to share ideas from the teaching
      environment he has created.

PMID- 8340599
TI  - The Canadian Association of Emergency Physicians (CAEP/ACMU).
AB  - The Canadian Association of Emergency Physicians is a diverse group of 500
      practitioners providing emergency care to the ill and injured. The specialty
      section of the organization represents Royal College certificants and is 120
      strong. The Association, with headquarters in Ottawa, has a major interest in the
      continuing education of its members, policy development and the improvement of
      emergency health care in the country.

PMID- 8340600
TI  - New challenges in hepatic fibrosis.
AB  - Treatment of hepatic fibrosis by simple and inexpensive therapies is a new
      challenge for the near future. Hepatic fibrosis which may lead to cirrhosis, is
      indeed associated with most chronic liver diseases and affects millions of
      people. During the last decade, major breakthroughs have been accomplished in the
      field of hepatic fibrosis including the discovery of key components of the
      extracellular matrix, the cellular origin of most matrix proteins, the molecular
      mechanisms involved in their synthesis and degradation, and the role of cytokines
      in fibrogenesis. Most of this progress came from the development of new
      techniques including in vitro model systems which have proven useful for
      investigating the molecular bases of fibrogenesis. From basic research to
      clinical application, two major fields are now actively explored: the search for
      reliable serum markers of fibrogenesis and the discovery of drugs that prevent
      cirrhosis. A recent approach to treat hepatic fibrosis is to use cytokines, e.g.
      interferons, that modulate extracellular matrix synthesis.

PMID- 8340601
TI  - Changes of sex hormone levels in patients with hepatitis B virus-related
      postnecrotic cirrhosis: relationship to the severity of portal hypertension.
AB  - The effect of portal hypertension on plasma sex steroid levels was studied in 49
      patients with hepatitis B virus-related postnecrotic cirrhosis. In accordance
      with the Child-Pugh classification, 18 patients were classified as grade A, 15
      grade B and 16 grade C. At the same time, 25 males who were admitted for physical
      check-up served as normal controls. Serum testosterone levels decreased (3.31 +/-
      2.03 vs. 5.65 +/- 0.13 ng/ml) and estrone levels increased (0.16 +/- 0.08 vs.
      0.09 +/- 0.02 ng/ml) significantly in patients with cirrhosis compared to the
      levels obtained in the controls. Moreover, these changes were associated with an
      increased severity of cirrhosis (P < 0.05 when severity increased from grade A to
      C). Hemodynamic values regarding hepatic venous pressure gradient and cardiac
      output demonstrated significant differences in patients from grade A to C, but
      the correlation between these two parameters was poor (r = 0.3242). The hepatic
      venous pressure gradient, the only direct measurement of portal hypertension, did
      not correlate with any of the measured hormone levels in patients with cirrhosis.
      There was, however, a highly significant negative correlation between cardiac
      output and testosterone levels (r = -0.8754, P < 0.01) and a positive correlation
      between cardiac output and estrone levels (r = 0.7522, P < 0.05) in grade C
      patients. On the basis of these results, we concluded that gonadal dysfunction is
      a common finding in patients with hepatitis B related postnecrotic cirrhosis,
      especially in those with decompensated liver function. The relationship between
      cardiac output and severity of liver disease suggests that the degree of
      portosystemic shunting probably increases as liver disease worsens.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8340602
TI  - Splenic function, assessed by quantification of erythrocyte membrane pits, is
      normal in chronic active hepatitis and primary biliary cirrhosis.
AB  - Splenic hypofunction has been described in a number of diseases in which
      autoimmune mechanisms are believed to play a part. It has been reported in
      association with chronic active hepatitis although this relationship has not been
      systematically investigated. Twenty patients with chronic active hepatitis and 22
      patients with primary biliary cirrhosis, together with an equal number of age
      matched controls for each group, were studied. Splenic function was assessed by
      counting pits on erythrocytes viewed under differential interference contrast
      microscopy. There was no difference between splenic function in either chronic
      active hepatitis, or primary biliary cirrhosis, and normal controls. In both
      groups of patients splenic hypofunction was significantly related to age.

PMID- 8340603
TI  - alpha-Interferon in the treatment of chronic viral hepatitis: effects on
      fibrogenesis serum markers.
AB  - Forty patients with chronic viral hepatitis or active cirrhosis (33 anti-HCV
      positive) entered a recombinant human alpha 2A interferon randomized trial.
      Twenty-one subjects were treated with 6 million units (MU) three times per week
      for 6 months. Nineteen were not treated. Six months later in 12 patients of the
      treated group (60% of the evaluable 20) with normalized serum aminotransferases
      levels (responders), fibrogenesis serum markers (NPIIIP and laminin) were
      significantly lower than baseline. In the untreated patients and in non
      responders NPIIIP and laminin were unchanged. Semi quantitative histological
      evaluation (allotting scores for inflammation, necrosis and fibrosis) confirmed a
      significant improvement of necro-inflammation in the responders. These data
      suggest that alpha-IFN treatment may decrease stimuli for fibrogenesis by
      reducing liver inflammation and necrosis, thus preventing evolution to cirrhosis.

PMID- 8340604
TI  - Low prevalence of precore mutations in hepatitis B virus DNA in fulminant
      hepatitis type B in France.
AB  - The presence of mutants of the precore region of the hepatitis B virus genome was
      investigated in French patients with fulminant hepatitis. Only one of the 10
      subjects had a detectable mutation by direct sequencing. On the other hand, 2/10
      and 3/10 had evidence of coinfection by hepatitis D virus and hepatitis C virus.
      These results indicate that the precore stop mutation at codon 28 is not a
      general condition in fulminant hepatitis B and might reflect epidemiological
      factors.

PMID- 8340605
TI  - Preservation-induced liver injury. Clinical aspects, mechanisms and therapeutic
      approaches.

PMID- 8340606
TI  - Serum and salivary caffeine clearance in cirrhosis. Any role in selection for
      surgery and timing for transplantation?

PMID- 8340607
TI  - Acute cholestatic liver injury induced by enoxacin.

PMID- 8340608
TI  - The response of rat liver perisinusoidal lipocytes to polypeptide growth
      regulator changes with their transdifferentiation into myofibroblast-like cells
      in culture.
AB  - During culture on uncoated plastic wells rat liver perisinusoidal lipocytes
      change their differentiated phenotype (transdifferentiate) within 1-2 weeks and
      obtain a myofibroblast-like phenotype (myofibroblast-like cells). This
      transdifferentiation was documented by morphologic (loss of fat droplets, flat
      cell shape, cytoplasmic extensions, expression of iso-alpha smooth muscle actin)
      and biochemical criteria (loss of retinyl-palmitate, enhanced matrix synthesis).
      Whereas transforming growth factor alpha (TGF alpha) stimulated and transforming
      growth factor beta (TGF beta 1) inhibited the proliferation of perisinusoidal
      lipocytes (early culture) these cytokines did not effect the growth of the
      myofibroblast-like cells. Opposite effects were obtained with platelet-derived
      growth factor (PDGF) which stimulated the growth of myofibroblast-like cells
      only. Insulin-like growth factor (IGF1) was mitogenic in both perisinusoidal
      lipocytes and myofibroblast-like cells, respectively. Furthermore, whereas the
      expression of the mRNAs of decorin and biglycan was stimulated by TGF beta 1 in
      perisinusoidal lipocytes, the synthesis of these mRNAs was stimulated in
      myofibroblast-like cells predominantly by TGF alpha. Similar effects of TGF alpha
      and TGF beta 1 have been observed on the glycosaminoglycan-([35S]sulfate
      incorporation) and proteoglycan level ([3H]leucin incorporation into decorin and
      biglycan). Neither IGF1 and PDGF stimulated glycosaminoglycan synthesis in
      perisinusoidal lipocytes or in myofibroblast-like cells. The results demonstrate
      that the effects of the polypeptide growth regulators TGF alpha, TGF beta 1 and
      PDGF depend on the cell phenotype (stage of cell activation/transdifferentiation)
      and may be completely different in perisinusoidal lipocytes and its transformed
      counterpart the myofibroblast-like cells.

PMID- 8340609
TI  - Hepatitis B virus heterogeneity, one of many factors influencing the severity of
      hepatitis B.
AB  - The pathogenesis of hepatitis B can be subdivided into three sequentially
      correlated events: (a) loss of virus tolerance, (b) liver cell necrosis mediated
      by virus specific inflammatory response, (c) non-specific death of functionally
      compromised hepatocytes mediated by inflammatory cytochines released by virus
      specific inflammatory response. The severity of liver damage depends on the
      occurrence of these events as well as other factors. The HBeAg defective mutant
      appears to be involved in the loss of virus tolerance and therefore in the
      pathogenesis of acute hepatitis B. In addition it is positively selected by
      antiviral immunoreaction, behaves as an escape mutant, and it also contributes to
      the pathogenesis of chronic hepatitis B. The combination of these characteristics
      explains the relative prevalence of this mutant over wild-type HBV in patients
      with severe acute hepatitis B and in chronic HBsAg carriers during anti-HBe
      seroconversion and/or hepatitis B exacerbations. However, the absence of HBeAg
      defective mutants in some cases of severe and fulminant hepatitis B as well as
      its detection in asymptomatic carriers of HBsAg should not be surprising. The
      severity of hepatitis is influenced by many other factors: the number of virus
      infected cells, the competence and genetic heterogeneity of the immune system,
      the vigor and extent of non-specific inflammatory response and the killing of
      hepatocytes endangered by other diseases or infected with other hepatotropic
      viruses.

PMID- 8340610
TI  - Heterogeneity of hepatitis B virus C-gene sequences: implications for
      amplification and sequencing.
AB  - Occasionally direct sequencing of amplified hepatitis B virus DNA leads to weak
      signals on autoradiograms. Using amplified C-gene sequences we investigated
      whether this is due to sequence heterogeneity of virus populations and use of
      inappropriate primers for direct sequencing. High C-gene sequence heterogeneity
      (point mutations, stop codons and a one codon deletion) was observed in HBV
      genomes from serum of a chronic carrier who underwent interferon treatment. The
      type of C-gene mutations detected by direct sequencing depended on the type of
      primers used. Cloning and sequencing of amplified C-gene sequences demonstrated
      that this was due to mutations in the region complementary to the sequencing
      primer. These data demonstrate the existence of novel HBV C-gene mutants and
      imply that multiple or degenerate sequencing and amplification primers are
      essential for accurate evaluation of the extent of HBV C-gene heterogeneity.
      Based on comparative sequence analysis of all available completely or
      incompletely sequenced C-genes, guidelines for optimal primer design are proposed
      for similar studies.

PMID- 8340611
TI  - Prednisolone stimulates hepatic glutathione synthesis in mice. Protection by
      prednisolone against acetaminophen hepatotoxicity in vivo.
AB  - Mediators of inflammation modulate the extent of hepatocellular necrosis
      following the administration of hepatotoxins. Since corticosteroids interfere
      with the generation of some of these mediators they might thus protect against
      the hepatotoxicity of drugs such as acetaminophen. To test this hypothesis mice
      were pretreated with two doses of prednisolone (10 and 20 mg/kg i.p., 17 and 2 h,
      respectively) prior to a hepatotoxic dose of 375 mg/kg acetaminophen and the
      metabolism and toxicity of acetaminophen were assessed. Twenty-four hours after
      acetaminophen the activity of ALT in plasma (737 vs. 6775 U/l) and the extent of
      hepatocellular necrosis (4 vs. 45% necrotic hepatocytes) were significantly lower
      in prednisolone-pretreated mice. Prednisolone pretreatment resulted in decreased
      covalent binding of the toxic metabolite in vivo and an increased urinary
      excretion of glutathione-derived conjugates of acetaminophen, indicating an
      enhanced detoxification of the reactive metabolite by glutathione. Nevertheless,
      hepatic glutathione was less depleted by acetaminophen in the prednisolone group,
      indicating an increased capacity to resynthesize glutathione. This was confirmed
      in experiments with diethyl maleate which depletes hepatic glutathione without
      causing cell injury. Following the administration of diethyl maleate to fed and
      fasted mice, hepatic glutathione was depleted to the same extent after 45 min,
      but was significantly higher after 2.5 h in prednisolone-pretreated mice. The
      present results indicate that prednisolone increases the capacity to replete
      depleted hepatic glutathione stores in mice.

PMID- 8340612
TI  - Angiographically determined arteriopathy in liver graft dysfunction and survival.
AB  - We evaluated the contribution of flush and selective hepatic angiography in
      defining the extent and pattern of major vessel and microvascular arterial
      lesions and their significance in graft survival. The 50 consecutive patients
      investigated comprised three clinical groups: Group A (n = 18) were patients with
      severe graft dysfunction within the first seven days post-transplantation. In
      this group six of 18 angiograms demonstrated intrahepatic attenuation of the
      arterial tree suggestive of acute cellular rejection and four of these grafts
      were lost, compared to a 78% graft survival in the non-arteriopathic group. Group
      B (n = 16) comprised patients with clinically suspected hepatic arterial
      thrombosis or stenosis, these diagnoses were confirmed in all patients compared
      to only 10 positive findings with doppler ultrasonography. Graft survival was
      only 10% in those patients with artery thrombosis as compared to 100% in those
      with arterial anastomotic stenoses. Group C patients (n = 16) had histologically
      confirmed chronic allograft rejection and in ten of them (65%) evidence of
      arteriopathy was demonstrated despite histological evidence of arteriopathy being
      present in only 19% of patients. All patients in this group with arteriopathic
      changes lost their grafts with the exception of one successfully treated with
      FK506. In two other patients reversibility of chronic rejection was observed,
      neither of whom had evidence of an arteriopathy.

PMID- 8340613
TI  - Reversibility of cholestatic changes following experimental common bile duct
      obstruction: fact or fantasy?
AB  - In 36 male Wistar rats extrahepatic cholestasis was induced by ligation and
      transsection of the common bile duct. After 1, 2 and 3 weeks of cholestasis the
      bile flow was restored by means of a Roux-en-Y choledochojejunostomy. Plasma
      levels of bilirubin, alkaline phosphatase, GOT and clotting factor X were
      measured weekly. Liver biopsies were taken at the time of restored bile flow as
      well as 3 and 8 weeks thereafter. Histochemical reaction for lactate
      dehydrogenase activity and Sirius Red F3BA staining were used as measure for
      functional liver parenchyma and collagen, respectively. Acid phosphatase,
      alkaline phosphatase and 5'-nucleotidase activities as well as the glycogen
      content were demonstrated in cryostat sections of the same biopsies. After 1, 2
      and 3 weeks of common bile duct obstruction, levels of bilirubin, alkaline
      phosphatase and GOT significantly increased, whereas levels of clotting factor X
      decreased. RBF resulted in normalization of all these levels to control range.
      The volume density of functional parenchyma was found to be reduced to 90%, 73%
      and 64% of the control values following 1, 2 and 3 weeks of common bile duct
      obstruction respectively, returning to 96%, 94% and 88% at 8 weeks, respectively,
      after restored bile flow. The collagen content increased significantly during
      cholestasis up to 5-fold after 3 weeks of common bile duct obstruction. After
      restored bile flow, a slight decrease of collagen was measured in some animals
      but in none of the three groups a return to normal values appeared. Cholestasis
      induced an alteration in localization and/or activity of the three enzymes
      analyzed as well as a depletion of glycogen stores. All changes in activity and
      distribution pattern of the three enzymes, as well as the glycogen depletion
      during common bile duct obstruction normalised after restored bile flow was
      performed. However, the longer common bile duct obstruction had existed, the
      longer period was needed for full recovery. In conclusion, even after 3 weeks of
      common bile duct obstruction the parenchyma/stroma relationship grossly
      normalized after restored bile flow with an almost complete restoration of the
      parenchyma and a concomitant recovery of liver function. However, collagen once
      formed, did not disappear but remained as more condensed septa, which apparently
      did not interfere with normal function.

PMID- 8340614
TI  - Epidemiologic findings in congenital anemia, dyserythropoiesis, and dyskeratosis
      in polled Hereford calves.
AB  - Congenital dyserythropoiesis and dyskeratosis occur within certain lines of
      Polled Hereford cattle. Eighty-nine of 90 alleles in 45 affected calves had a
      mechanism in which they could be identical by descent from an identified common
      ancestor. The line allele may have been a recurrence of the mutation, or the
      mutation may have occurred earlier in the breed's history and been distributed
      throughout the breed by the extensive use of several ancestors. No evidence of
      disease has been identified in sire and dams of affected calves, suggesting that
      the allele is not acting in a dominant or incompletely dominant manner. Even
      distribution of cases between sexes suggests that the disease is not sex linked
      or sex influenced. A higher degree of inbreeding in the affected calves and
      temporal and spatial features that separated individual cases also suggest a
      genetic cause. Segregation ratios were not significantly different from those of
      the hypothesized simple autosomal recessive inheritance.

PMID- 8340615
TI  - Genetic analysis of evolutionary relationships among deer (subfamily Cervinae).
AB  - The evolutionary relationships among 10 taxa of deer from the four genera of the
      subfamily Cervinae (Cervus, Elaphurus, Axis, and Dama) were examined by a
      comparison of their electrophoretic types for 22 proteins. We analyzed the data
      using both phenetic and cladistic methods and found that the genera of the
      Cervinae were not monophyletic. The genus Cervus was split into two distinct
      groups with red deer, wapiti (C. elaphus ssp.), and sika (C. nippon) in one clade
      and sambar (C. unicolor) and rusa (C. timorensis) in another. There was a close
      genetic relationship between the genus Elaphurus and the red deer, wapiti, sika
      group, whereas sambar and rusa were more similar to members of the genera Dama
      and Axis than to the other members of their own genus. These findings contrast
      with the taxonomy of the species that is based largely on studies of comparative
      morphology. Our samples (n = 5) showed fixed allelic differences between wapiti
      and red, wapiti and sika, and red and sika samples at 3, 6, and 7 loci,
      respectively. Analysis of these protein loci in a wider range of C. elaphus and
      C. nippon subspecies could resolve debate over the evolutionary relationships of
      these taxa.

PMID- 8340616
TI  - Microsatellite repeats in pig (Sus domestica) and chicken (Gallus domesticus)
      genomes.
AB  - Separate databases were made for all pig and chicken sequences in the Genbank
      database, which were then systematically searched for all possible
      mononucleotide, dinucleotide, trinucleotide, and tetranucleotide repeats of about
      20 bp or greater in length. A total of 13% of pig genes and 10% of chicken genes
      contained one or more of these microsatellite-like repeats. There was a
      considerable difference in the frequency of dinucleotide repeats between pigs,
      where they comprised 30% of the repeats found, and chickens, where they comprised
      only 12%. The AC/GT category displayed the greatest difference: seven cases were
      found from 181 genes in pig (3.9%), whereas only five were found from 531 genes
      in chicken (0.9%). There appears to be a substantial difference in the spectrum
      of microsatellites between pigs and chickens. Primer sequences for amplifying
      these microsatellites are presented.

PMID- 8340617
TI  - Population characteristics of DNA fingerprints in humpback whales (Megaptera
      novaeangliae).
AB  - Humpback whales exhibit a remarkable social organization that is characterized by
      seasonal long-distance migration (> 10,000 km/year) between summer feeding
      grounds in high latitudes and winter calving and breeding grounds in tropical or
      near-tropical waters. All populations are currently considered endangered as a
      result of intensive commercial exploitation during the last 200 years. Using
      three hypervariable minisatellite DNA probes (33.15, 3'HVR, and M13) originally
      developed for studies of human genetic variation, we examined genetic variation
      within and among three regional subpopulations of humpback whales from the North
      Pacific and one from the North Atlantic oceans. Analysis of DNA extracted from
      skin tissues collected by biopsy darting from free-ranging whales revealed
      considerable variation in each subpopulation. The extent of this variation argues
      against a recent history of inbreeding among humpback whales as a result of
      nineteenth- and twentieth-century hunting. A canonical variate analysis suggested
      a relationship between scaled genetic distance, based on similarities of DNA
      fingerprints, and geographic distance (i.e., longitude of regional
      subpopulation). Significant categorical differences were found between the two
      oceanic populations using a multivariate analysis of variance (MANOVA) with a
      modification of the Mantel nonparametric permutation test. The relationship
      between DNA fingerprint similarities and geographic distance suggests that
      nuclear gene flow between regional subpopulations within the North Pacific is
      restricted by relatively low rates of migratory interchange between breeding
      grounds or assortative mating on common wintering grounds.

PMID- 8340618
TI  - Chromosomal localization of omega and trophoblast interferon genes in goat and
      sheep by fluorescent in situ hybridization.
AB  - Fluorescent in situ hybridization (FISH) of the cattle cDNA probe bTP-509 to goat
      (Capra hircus L.) and sheep (Ovis aries L.) R-banded metaphase chromosomes
      localized the omega (IFNW) and trophoblast (IFNT) interferon genes to goat
      chromosome 8q15 and sheep chromosome 2p15. Caprine chromosome 8 and ovine
      chromosome 2p are equivalent in banding pattern to cattle chromosome 8. Since
      FISH has previously localized IFNW and IFNT genes to cattle chromosome 8q15 and
      river buffalo 3q15, the localization of IFNW and IFNT genes in goat and sheep
      provides evidence in support of the hypothesis that chromosome-banding homology
      among these four species is indicative of underlying genetic homology.

PMID- 8340619
TI  - Coat color genetics of Peromyscus: II. Tan streak--a new recessive mutation in
      the deer mouse, P. maniculatus.
AB  - The first mutant tan streak deer mice appeared in the initial laboratory-bred
      generation of a stock of Peromyscus maniculatus nubiterrae collected in Macon
      County, North Carolina. Laboratory progeny from the original animals were bred
      and mated among themselves and to wild-type individuals. The tan streak phenotype
      is characterized by nearly complete absence of coat pigmentation, except for a
      pale tan patch or narrow stripe extending mid-dorsally posteriorly from the head.
      The band is frequently somewhat broader in the shoulder region, occasionally
      forming a cross-shaped pattern. There is no evidence of black eumelanin in any
      part of the coat. The eyes are fully pigmented, appearing black, and pigment is
      present in the skin of the ears and elsewhere. The trait is inherited as an
      autosomal recessive. The genetic locus is provisionally designated tns. Crosses
      between homozygous tan streak (tns/tns) animals and albino (c/c), ivory (i/i),
      non-agouti (a/a) and brown (b/b) deer mice produced only wild-type progeny,
      indicating that the tns mutation is not at any of these loci.

PMID- 8340620
TI  - Coat color genetics of Peromyscus: III. Golden-nugget--a recessive trait in the
      white-footed mouse, P. leucopus.
AB  - A novel pelage color variant appeared in a laboratory colony of white-footed mice
      (Peromyscus leucopus) from Massachusetts. The mature adult coat color of this
      variant exhibits a rich golden tan appearance on the dorsum with white
      underparts. The trait is inherited as an autosomal recessive. Phenotypic
      comparisons with other rodents suggest that the trait is attributable to an
      allele at the brown (b) locus. Under laboratory conditions homozygous or
      heterozygous golden-nugget Peromyscus do not differ significantly from the wild
      type in litter size, litter survival, nest defense, or body weight. The
      possibility that the allele confers some adaptive value in nature is considered.
      The trait is given the tentative designation bgn (golden-nugget).

PMID- 8340621
TI  - Alternative approaches to pterygomaxillary separation.
AB  - Pterygoid plate fractures, resulting from the pterygomaxillary separation in a Le
      Fort I osteotomy, may be associated with untoward fractures that extend to the
      base of the skull and orbit and which can lead to rare but significant
      complications. Five alternative approaches to the pterygomaxillary dysjunction
      were studied in 50 fresh cadavers. The results of this study show that the use of
      a curved Obwegeser osteotome to achieve the pterygomaxillary dysjunction should
      be abandoned, as it leads to an unacceptably high incidence of high-level
      pterygoid plate fractures at, or near, the base of the skull. The best results
      were obtained with a Stryker micro-oscillating saw.

PMID- 8340622
TI  - Bilateral coronoid process hyperplasia and short stature. A case report.
AB  - A 23-year-old man with bilateral coronoid process hyperplasia and short stature
      is presented. These findings are characteristic features of trismus
      pseudocampylodactyly syndrome. However, in this patient the pseudocampylodactyly
      component and family history were absent.

PMID- 8340623
TI  - Palatal opening of the nasopalatine duct. A case report.
AB  - An unusual case of patent nasopalatine duct appearing in the central region of
      the hard palate in a young adult is reported. The origin and clinical symptoms of
      this anomaly are discussed.

PMID- 8340624
TI  - Early results from reconstruction of severely atrophic (Class VI) maxillas by
      immediate endosseous implants in conjunction with bone grafting and Le Fort I
      osteotomy.
AB  - This report presents our experience with 12 consecutive patients treated by the
      method of SAILER19, comprising bone grafting to the floor of the nose and the
      maxillary sinus after a Le Fort I inferior repositioning of the maxilla followed
      by immediate implantation of endosseous implants. The corticocancellous grafts
      were harvested from the iliac crest. Fifty-nine implants were inserted in the
      bone grafts and eight in the adjacent nongrafted bone. Fourteen implants (21%)
      had to be removed because of nonintegration, of which 10 had been placed in two
      patients. The follow-up ranged from 11 to 24 months. No implants have been lost
      after loading. Six patients received fixed prostheses, and four overdentures. The
      importance of complete preoperative positional stability of the bone grafts and
      implants is emphasized.

PMID- 8340625
TI  - A comparison of morbidity following the removal of lower third molars by the
      lingual split and surgical bur methods.
AB  - Fifty-two consecutive healthy patients with bilateral, similarly impacted
      mandibular third molars were studied. For each patient, both third molars were
      removed at the same operation by the same experienced operator. On one side, the
      lingual split method by chisel was used; on the other, the buccal approach with
      surgical bur. Standard preoperative and postoperative drug regimens were used.
      Pain, facial swelling (visual analogue scales), and lingual and labial sensory
      disturbance were recorded for each side by the patients at home 6, 24, and 48 h
      and 7 days after surgery. Wound healing was assessed at 4 weeks. There were no
      statistically significant differences between methods in relation to pain, facial
      swelling, sensory loss, infection, or periodontal pocket depth distal to the
      second molar, although 2% of third molars removed by chisel had lingual sensory
      disturbance at 7 days, as compared with 8% where burs had been used. There were
      no statistically significant differences between duration of procedures; mean
      operating time with burs was 8.28 min (range 4-15 min) and with chisels 7.57 min
      (range 4-15 min). This study provided no evidence of difference in either
      efficiency or outcome between two standard methods of removing lower third
      molars.

PMID- 8340626
TI  - Giant cell lesions complicating fibro-osseous conditions of the jaws.
AB  - Three patients who presented with giant cell lesions complicating ossifying
      fibroma, Paget's disease, and cherubism are reported. The giant cell lesions
      complicating ossifying fibroma and cherubism were diagnosed as giant cell
      granuloma (GCG), whereas the lesion complicating Paget's disease demonstrated
      more aggressive clinical and histologic features. The possible therapeutic and
      prognostic implications of these findings are discussed.

PMID- 8340627
TI  - Surgical considerations in cases of large mandibular odontomas located in the
      mandibular angle.
AB  - The surgical treatment of two large, complex odontomas of the angle of the
      mandible is described. It is recommended that the surgeon consider excision by an
      intraoral, lingual approach when indicated. The advantages, indications, and
      possible complications of this approach are discussed.

PMID- 8340628
TI  - Central odontogenic fibroma. A case report.
AB  - A case of a central odontogenic fibroma in a 16-year-old boy is presented. The
      clinical appearance and surgical treatment are described; and the pathogenesis
      and histopathologic diagnosis are discussed.

PMID- 8340629
TI  - Nodular fasciitis in a temporomandibular joint.
AB  - A patient is presented with nodular fasciitis of the right temporomandibular
      joint. The clinical presentation and radiologic and light microscopic findings
      are described. Clinicians should be aware of this condition, particularly when
      there is a history of trauma.

PMID- 8340630
TI  - The de Lange syndrome in association with a bleeding tendency: oral surgical
      implications.
AB  - A patient with de Lange syndrome who also had a variant of von Willebrand's
      disease is reported. The problems with dental surgery, particularly with respect
      to difficulty of extraction and bleeding tendency, are discussed.

PMID- 8340631
TI  - Three-dimensional ultrasonography in maxillofacial surgery. A new diagnostic
      tool.
AB  - Three-dimensional (3-D) ultrasonography is introduced as a new diagnostic method
      for soft-tissue lesions. This method is based on the production of absolutely
      parallel brightness (B)-scan tomographies with constant intervals. After adequate
      preparation, the sonographic primaries are processed into 3-D graphs by a
      specialized program called EUCLID-IS. This method promises to be useful in the
      evaluation of tumor patients as well as in the follow-up examination of these
      patients. The main advantages of the presented method are the capacity to measure
      accurately the volume of regions of interest and the excellent visualization of
      the structures examined.

PMID- 8340632
TI  - The behaviour of mandibular condylar cartilage in cell culture.
AB  - This investigation aimed to identify the behaviour of primate mandibular condylar
      cartilage cells in an in vitro model. Cells were harvested from the mandibular
      condyles of 1-year-old marmosets and maintained in primary culture for up to 30
      d. Cell proliferation, structure, and phenotype were assessed at regular
      intervals by phase-contrast microscopy, cytologic staining, and
      immunocytochemistry. Cell growth increased progressively, and cultures reached
      confluence after 22 d. Cells were initially small and round but later became
      enlarged and heterogeneous in shape. Polygonal and hypertrophic chondroblast-like
      cells dominated the mature cultures. Glycosaminoglycan synthesis increased as
      cultures aged. Type I collagen was produced by early cultures, whereas type II
      collagen predominated in mature confluent monolayers. It is suggested that this
      mixed population of cells underwent phenotypic changes in primary cell culture
      that closely resemble the normal in vivo maturation process.

PMID- 8340633
TI  - Should titanium miniplates be removed after bone healing is complete?
AB  - A prospective study of 32 patients was performed to analyze black pigmentation in
      the soft tissue covering titanium miniplates. This soft tissue was compared with
      the soft tissue covering Champy stainless steel plates. All plates were removed 8
      months after application. Macroscopically visible pigmentation was found in 25.6%
      of the soft tissue covering titanium miniplates and in none of the soft tissue
      covering Champy stainless steel plates. Microscopically visible pigmentation was
      found in 71.8% of the soft tissue covering titanium miniplates and in 65.3% of
      the soft tissue covering Champy stainless steel plates. Energy-dispersive x-ray
      analysis of the soft tissue covering titanium miniplates revealed only the
      presence of titanium dioxide. In the soft tissue near Champy stainless steel
      plates, chromium, nickel, iron, and molybdenum were found. Electron microscopy
      showed titanium dioxide to be mainly deposited between the collagen fibers,
      whereas stainless steel particles were mainly found in giant cells.

PMID- 8340634
TI  - Let's be careful out there.

PMID- 8340635
TI  - The MMSE to assess the cognitive state of elders. Mini-Mental State Examination.
AB  - In both nursing practice and research settings, valid and accurate information on
      the cognitive function of elderly persons is necessary. However, methods and
      criteria for evaluating an elder's mental status are inconsistent. A formal
      screening tool such as the Mini Mental State Examination (MMSE) would enable
      nurse clinicians and researchers to use a common method for identifying cognitive
      impairment. In addition, the MMSE score can readily describe levels of impairment
      across settings. Although certain limitations exist when using this instrument,
      the MMSE has been successfully employed by some nurses in selected clinical and
      research settings as a brief but accurate screen of cognition in older persons.

PMID- 8340636
TI  - Enhancing recovery via neuro-rehab rounds.
AB  - The neurologically injured patient experiences physiological and psychological
      disruptions regardless of the type of severity of injury. Through increased
      knowledge, nurses planning care can minimize loss of functional ability,
      anticipate complications and enhance recovery. Neuro-rehab rounds were developed
      to increase the involvement of support therapies for the patient in the
      neurotrauma intensive care unit (ICU) of a particular hospital. Increasing the
      critical care nurses' awareness of rehabilitation principles was the secondary
      goal. This protocol decreased length of stay, increased mobilization of patients
      in the ICU and provided for continuity of care for the neurologically injured
      patient. Rounds also redirected and expanded the focus for critical care nurses
      from episodic to one more outcome related.

PMID- 8340637
TI  - Bacterial ventriculitis and duration of ventriculostomy catheter insertion.
AB  - Invasive monitoring of intracranial pressure (ICP) plays an important role in
      managing many neurosurgical patients. While there are several techniques
      available to monitor ICP, the ventricular catheter is most commonly used and the
      most accurate. ICP monitoring poses potential risks to the patient. The most
      common and one of the most devastating complications is infection. This research
      study examined the rate of bacterial ventriculitis in relation to duration of
      ventricular catheter insertion as well as other factors which may contribute to
      ventriculitis. Data were collected prospectively on 78 patients with a
      ventriculostomy who were 14 years of age or older and admitted to the
      neuroscience intensive care unit. Patients were followed from the time of
      ventricular catheter placement to two weeks after the catheter was removed or
      until the patient was discharged from the hospital. A significantly higher
      ventriculitis rate was found in patients with a mean catheter duration of 11 days
      or longer (p = .004). In the group that developed ventriculitis there was a
      significant rise (means = 6.03592, p = .014) in the cerebrospinal fluid (CSF)
      lactate prior to the onset of ventriculitis. Neuroscience nurses should be aware
      of the factors which may increase the rate of ventriculitis, such as duration of
      catheter placement and factors which may indicate impending infection such as a
      rise in the CSF lactate. Future studies should compare various methods of
      ventriculostomy site care for efficacy of infection prevention, cost and
      caregiver time.

PMID- 8340638
TI  - Investing in the comeback: parent's experience following traumatic brain injury.
AB  - The increasing incidence of survival following traumatic brain injury
      necessitates a closer examination of long-term care and caregiver issues. A
      sample of parents and brain-injured offspring from 20 families was explored to
      identify a qualitatively-generated theory describing the parent's experience
      following a brain-injured child's return to the home setting. The grounded theory
      methodology was used during data collection and analysis. All the brain-injured
      offspring had survived moderate to severe traumatic brain injury, were living
      with at least one parent, and were aged 17-34 years. Investing in the Comeback is
      the generated three-phase theory. These three phases--centering on, fostering
      independence and seeking stability describe the work of parents living with brain
      injured offspring.

PMID- 8340639
TI  - Multiple sclerosis: a literature review.
AB  - The pathology of multiple sclerosis (MS) was first described over 150 years ago.
      An estimated 250,000 to 350,000 people are affected with MS in this country.
      Young adults between the ages of 20 and 50 years are most commonly affected, with
      the majority of patients experiencing a relapsing course and progressive
      functional disability. To date, researchers have been unable to discover a
      precipitating cause. However, many now believe MS develops due to exposure to
      some unknown virus in a genetically predisposed individual. The incidence of
      disease is limited in temperate climates and higher in northern latitudes.
      Neuroscience nurses frequently care for individuals with MS and must, therefore,
      maintain a familiarity with the current literature and research.

PMID- 8340640
TI  - tPA in acute stroke--risk or reprieve?
AB  - Stroke outcome is measured by survival and disability. Since more patients are
      surviving stroke, researchers are pursuing ways to reduce the severity of
      neurological deficits. Anticoagulant treatment with heparin prevents, rather than
      treats, thrombotic or embolic occlusions; therefore, the search for safer
      thrombolytic preparations continues. Tissue plasminogen activator is currently
      under investigation as an effective, safe treatment for acute stroke patients.
      However, the administration of tPA carriers a risk of hemorrhage. Although this
      article discussed tPA administered with an arteriogram based protocol, tPA
      investigation occurs using other protocols. Once acute stroke patients receive
      tPA, then measures to prevent complications and manage the stroke symptoms
      determine the risks and benefits patients receive. Nursing management of these
      patients can contribute to these benefits.

PMID- 8340641
TI  - Issues related to the protection of human research participants.
AB  - Making ethical decisions related to the protection of human research participants
      is often complex and fraught with uncertainty and conflict. Awareness of the
      basic principles outlined in the Belmont Report as well as in federal regulations
      and guidelines can provide a useful framework for such decisions, although the
      ultimate responsibility for ensuring ethical research practices rests with the
      individual investigator. Ongoing dialogue and discussion about these ethical
      issues will provide a basis for strengthening nursing research and practice while
      ensuring the maximum protection for research participants who make possible the
      advancement of nursing science.

PMID- 8340642
TI  - Evaluating research findings for clinical applicability.
AB  - Despite the emphasis upon research and research-related activities in nursing
      practice, the evaluation and subsequent utilization of research findings by those
      in direct contact with patients is minimal. Reasons for limited use include
      educational level of nurses, lack of availability of research findings to nurses
      in the practice setting and inadequate communication between nurses in the
      educational and service settings. Prior to using the findings from any research
      study, the study's findings must be evaluated. This process includes
      identification of the researchable problem or question, exploration of available
      completed studies, determination of applicability, implementation, assessment and
      evaluation. The final step of the process is the dissemination of the findings of
      the evaluation through inservice or continuing education programs or local,
      regional or national conferences. Publications also provide an avenue by which
      findings can be disseminated.

PMID- 8340643
TI  - [A study on cervical cerclage for a dilated cervix or bulging membranes without
      rupture of membranes].
AB  - During the period January 1, 1989 through December 31, 1991, one hundred thirty
      six pregnant women with an effaced and widely dilated cervix or with bulging
      membranes were treated by emergent cervical cerclage. Suturing was carried out in
      16 women before 20 weeks gestation, in 86 women between 20 and 28 weeks and in 34
      women after 28 weeks. 16 patients in group A were those whose pregnancy was
      terminated with 3 days after operation and their tocolysis index was
      significantly higher than that of 69 patients in group D, whose pregnancy was
      prolonged move than two weeks. Clinical chorioamnionitis (WBC > 15,000/mm3 and
      CRP > 2mg/dl) was occurring in 43.7% of patients in group A, compared with 8.7%
      in group D at the time of operation. Vaginal delivery was accomplished in 38
      patients at between 24 and 36 weeks gestation in our hospital, while 41 cesarean
      sections were performed. On the basis of these results, we conclude that the
      emergency cerclage operation may improve the outcome of pregnancy but we have to
      pay special attention to premature rupture of membranes and chorioamnionitis.

PMID- 8340644
TI  - [Measurement and its fluctuation of urinary glucaric acid in newborns].
AB  - It is known that urinary excretion of glucaric acid(GA) is an indirect index of
      hepatic P-450 microenzyme induction. We measured and analyzed urinary excretion
      of GA in 56 newborns and 26 mothers by a new method for the inhibition of beta
      glucuronidase activity and obtained the following results. 1. The concentration
      of urinary GA was correlated with that of urinary creatinine and total bilirubin
      in newborns. 2. There were no significant correlations between gestational age,
      sex, body weight at birth, placental weight and the urinary GA concentration. 3.
      The urinary excretion of GA in newborns was decreased the in first few days after
      birth, but a transitional increase was observed on the fifth day after birth. 4.
      The concentration of urinary GA was correlated with that of direct bilirubin in
      serum on the fifth day after birth. 5. There was a negative correlation between
      the urinary GA concentration on the first day after birth and that of direct
      bilirubin in serum on the fifth day after birth. These results suggested that
      hepatic P-450 microsomal enzyme was induced by bilirubin in newborns and it was
      possible to estimate the clinical course of jaundice by measuring the urinary
      excretion of GA.

PMID- 8340645
TI  - [Doppler flow velocity waveforms in uteroplacental and fetal circulation in
      normal pregnancy and pregnancy-induced hypertension].
AB  - The present study was conducted to elucidate circulation dynamics in
      uteroplacental and fetal circulation in 130 normal pregnancies and in 40 patients
      with pregnancy-induced hypertension (PIH). A sector and pulsed Doppler system was
      employed to measure the uterine artery pulsatility index (UtA-PI), umbilical
      artery pulsatility index (UAPI), fetal middle cerebral artery pulsatility index
      (MCPI) and fetal descending aorta peak velocity (AoPV). Furthermore, peak
      velocity during early diastolic (E) and atrial contraction (A) periods through
      the mitral (M) and tricuspid (T) valves was measured to determine their ratios (M
      E/A and T-E/A). Twelve of the 40 PIH women had UtA-PIs of 95% or higher in normal
      pregnant women. Ten of the 12 fetuses in women with high UtA-PIs had high UAPIs,
      5 of whom demonstrated an MCPI decrease. Two of them represented an increase in M
      E/A and a decrease in T-E/A and AoPV, and the prognosis was poor. Only 2 of the
      PIH women with normal UtA-PIs had high UAPIs. The fact that both M-E/A and T-E/A
      were inversely correlated with MCPI and UAPI, respectively, suggests that these
      parameters could be used as indexes demonstrating cardiac afterload in fetuses.
      UtA-PI measurement in combination with fetal circulation indexes could predict
      fetal and neonatal well-being.

PMID- 8340646
TI  - [Biopsy of mouse embryo fertilized in vitro as a preclinical model for
      preimplantation genetic diagnosis].
AB  - In preimplantation genetic diagnosis, it is vital that the biopsy method does not
      affect embryonic development and yet provides a suitable specimen for genetic
      diagnosis. This study investigated whether the expulsion method, a modification
      of the displacement and extrusion methods, could satisfy the above mentioned
      conditions. Mouse embryos fertilized in vitro were biopsied at the 4, 8 and 16
      cell stages, and were subsequently observed for in vitro and in vivo development.
      The rates of blastocyst formation, implantation, and fetal growth in the 8- and
      16-cell biopsy groups were not significantly different from those in the control
      groups, but all 3 parameters were significantly reduced in the 4-cell group.
      Fetal and placental development was similar to the control group when embryos
      were biopsied at all three stages. Single blastomeres obtained by expulsion
      biopsy were subjected to DNA amplification by dual PCR, and Sry and myogenin
      sequences were amplified. In conclusion, expulsion biopsy did not affect the
      development of 8- and 16-cell embryos, and the specimens obtained were adequate
      for DNA amplification.

PMID- 8340647
TI  - [Treatment of ovarian cancer at FIGO stage III and IV--prognostic factors for
      patients receiving neoadjuvant chemotherapy].
AB  - Among 165 patients with stage III and IV ovarian cancer, 74 received neoadjuvant
      (NA) chemotherapy. The response to NA chemotherapy was 85% (17/20) for CP, 79%
      (26/33) for CAP, and 33% (7/21) for FAMT. Following NA chemotherapy, 43 patients
      received debulking surgery, of whom 34 received optimal debulking (OD: residuum <
      2cm). The remaining 31 patients did not receive debulking, of whom 18 responded
      to NA chemotherapy. The rate of OD was significantly higher in patients with
      CAP/CP than in those with FAMT. There was a tendency for the OD rate to be higher
      in patients with the serous or endometrioid type than in those with the clear
      cell or mucinous type. The procedures employed in 34 patients receiving OD
      following NA chemotherapy included basic surgery for 24 patients and more
      extensive surgery for 10 patients. Significant prognostic factors for patients
      receiving NA chemotherapy were, 1) response to NA chemotherapy, 2) radicality of
      debulking following NA chemotherapy, 3) regimen of NA chemotherapy (CAP/CP), and
      4) histologic type (serous, endometrioid).

PMID- 8340648
TI  - [Effects of human macrophage-colony stimulating factor (hM-CSF) on the secretion
      of human placental lactogen in human chorionic villous cells].

PMID- 8340649
TI  - [Induction of M-CSF and G-CSF receptor mRNA in peripheral blood mononuclear cells
      of gynecological cancer by sizofiran].

PMID- 8340650
TI  - [A surgical correction of urinary stress incontinence by vaginal route--midline
      plication of urethral supports].

PMID- 8340651
TI  - [A case of embryonal rhabdomyosarcoma (sarcoma botryoides) of in adult woman
      vagina].

PMID- 8340652
TI  - [A case of transient fetal hydrops which would be caused by parvovirus B19
      infection].

PMID- 8340653
TI  - [Laparoscopy-assisted vaginal hysterectomy].

PMID- 8340654
TI  - [Bone metabolism in patients with physiological menopause and oophorectomy--cross
      sectional study].

PMID- 8340655
TI  - [Trend of clinical pathology tests and the effective usage for diagnosis].

PMID- 8340656
TI  - [Reading of normal value and abnormal value in clinical tests].

PMID- 8340657
TI  - [Factors influencing the results of clinical tests and need for careful handling
      of specimens].

PMID- 8340658
TI  - [International system of units].

PMID- 8340659
TI  - [New clinical tests in diagnosis of respiratory system diseases].

PMID- 8340660
TI  - [New clinical tests in diagnosis of cardiovascular system diseases].

PMID- 8340661
TI  - [New clinical tests in diagnosis of kidney and urologic diseases].

PMID- 8340662
TI  - [New clinical tests in diagnosis of hematologic diseases].

PMID- 8340663
TI  - [New clinical tests in diagnosis of endocrine and metabolic diseases].

PMID- 8340664
TI  - [New clinical tests in diagnosis of infectious diseases].

PMID- 8340665
TI  - [Present status of clinical pathology tests and the skillful usage for diagnosis
      (discussion)].

PMID- 8340666
TI  - [A case of systematic lupus erythematosus with autoimmune hypophysitis].

PMID- 8340667
TI  - [A case of empty sella syndrome and pan-hypopituitarism associated with acute
      suppurative paranasal sinusitis].

PMID- 8340668
TI  - [A case of acute intermittent porphyria treated with cimetidine].

PMID- 8340669
TI  - [A case of wallenberg's syndrome with systemic lupus erythematosus and
      antiphospholipid syndrome].

PMID- 8340670
TI  - [Double-chambered right ventricle without other heart anomaly in the aged].

PMID- 8340671
TI  - [Therapy of hypertension with kidney diseases].

PMID- 8340672
TI  - [Gene diagnosis and gene therapy].

PMID- 8340673
TI  - Introduction: genetic deficiencies of complement proteins--consequences and
      molecular basis.

PMID- 8340674
TI  - C1-inhibitor and its genetic alterations in hereditary angioneurotic edema.

PMID- 8340675
TI  - Genetic deficiencies of the complement system and association with disease--early
      components.
AB  - Genetic deficiency of one of the early components of the classical pathway of
      complement (C1q, C1r, C1s, C4 and C2) is often associated with clinical symptoms
      and immunochemical abnormalities common in idiopathic autoimmune diseases, such
      as lupus erythematosus, but also with an increased incidence of various, local
      and generalized infections. These observations are consistent with the current
      view of the complement system's role in handling immune complexes and combating
      microbial invasion. However, the absence of absolute correlations in these
      experiments of nature suggests that genetic defects of the classical pathway act
      only epistatically to other host factors and the primary etiologies of the
      associated diseases. In contrast, the strong association of properdin and factor
      D deficiency with serious infections caused by encapsulated Gram-negative
      bacteria suggests a more immediate involvement of the alternative pathway in a
      specific segment of immunity and its pathology. This concept is also supported by
      the primordial role of the alternative pathway in the evolution of the complement
      system and the apparent lethality of factor B deficiency. The gene structures of
      most of these early components have now been elucidated providing the basis for
      detailed analyses of the defective alleles, the determination of carrier status,
      and prenatal diagnosis.

PMID- 8340676
TI  - Hereditary deficiency of C3 in animals and humans.
AB  - Inherited deficiency of complement C3 has been described in guinea pigs, dogs and
      20 humans. Homozygous deficiency of C3 is associated with recurrent pyogenic
      infections by encapsulated bacteria, especially H. influenzae, S. pneumoniae and
      N. meningitidis. In dogs and humans there is also an association with development
      of glomerulonephritis of the mesangiocapillary type. Some patients also develop
      transient erythematous rashes in association with pyogenic infections, with
      histology showing predominantly neutrophil infiltration and small vessel
      vasculitis. Studies of antibody responses, mainly in experimental animals have
      shown impaired primary and secondary responses to both thymus-dependent and 
      independent antigens at low immunizing doses, with a reduced switch from IgM to
      IgG production. The molecular basis of C3 deficiency has been established in two
      humans with C3 deficiency. In one it was due to a splice junction mutation and in
      another, to a partial gene deletion. These mutations are not compatible with the
      production of functional C3 in any tissue. Such patients with absolute C3
      deficiency are a valid model for understanding the physiological role of C3 in
      vivo.

PMID- 8340677
TI  - Inherited deficiencies of the terminal complement components.

PMID- 8340678
TI  - Genetics and deficiencies of the soluble regulatory proteins of the complement
      system.

PMID- 8340679
TI  - ECG of the month. Rise and fall. Narrow-QRS tachycardia with electrical
      alternans.

PMID- 8340680
TI  - Vestibular rehabilitation.
AB  - Vestibular dysfunction has many etiologies. Symptoms including vertigo and
      imbalance may severely hamper life-style, causing the afflicted individual to
      seek medical attention. For many patients with vestibular complaints a cure is
      not available. However, the physician is often called upon to relieve
      incapacitating symptoms. The purpose of this article is to discuss vestibular
      rehabilitation as a therapeutic modality for patients with chronic vestibular
      dysfunction.

PMID- 8340681
TI  - Cardiac transplantation, 1993.

PMID- 8340682
TI  - Cardiac transplantation: role of endomyocardial biopsy and immunosuppressive
      agents.
AB  - The field of cardiac transplantation has made tremendous strides since the first
      transplant procedure in 1967. This paper reviews the role of endomyocardial
      biopsy to diagnose and follow rejection as well as the standard immunosuppressive
      regimens employed. With continued refinements in immunosuppressive therapy,
      further improvements in mortality and morbidity rates should be realized.

PMID- 8340683
TI  - Medical choices in the 90s: transplantation and donation.
AB  - Heart transplantation is a growing field that offers the promise of meaningful
      life extension to individuals in end-stage organ failure. This technology is not
      only costly but dependent on limited access to cadaveric donor organs. Although
      advances in transplantation biology may someday allow for reduced cost and easy
      access to organs from nonhuman sources, today the "most readily available" source
      remains those organs which are donated by human donors. But despite the fact of
      being the "most readily available" they are far from being readily accessible.
      Due to these advances in transplantation, physicians are able to offer the
      "choice" of transplantation to their patients in whom end-stage organ failure
      exists. As more patients are referred for transplantation, the need for donor
      organs grows. And because of this need, physicians must begin to consider how to
      offer another choice, the "choice" of organ donation. In order to offer this
      option, knowledge of patient selection, evaluation, and suitable time of referral
      is important if the practitioner is to counsel potential donor families. This
      article provides a background and brief description of the Louisiana donor
      process.

PMID- 8340684
TI  - Cardiac transplantation: an overview of recipient selection.
AB  - Cardiac transplantation is an accepted treatment for end-stage heart disease.
      Potential recipients are carefully screened in order to best place the short
      supply of donor organs with the best recipient. The success of heart
      transplantation in the United States today is directly related to careful donor
      and recipient selection criteria and improvements in immunosuppression.

PMID- 8340685
TI  - Long-term follow-up and complications after cardiac transplantation.
AB  - Cardiac transplantation has become an established therapy for cardiomyopathy and
      other irreversible cardiac diseases. Improvements in immunosuppression and
      management of infections has improved long-term survival following
      transplantation. The role of the primary care physician in the care of recipients
      will be expanding. Transplant recipients receive close outpatient follow-up after
      discharge, primarily to monitor immunosuppression through laboratory evaluation
      and drug levels, monitor for rejection through endomyocardial biopsy, and to
      assess for any signs of opportunistic infection. The foundation for long-term
      immunosuppression is administration of cyclosporin, azathioprine and
      corticosteroids. Antibiotic prophylaxis is used to decrease the chance of
      infection with cytomegalovirus, Pneumocystis, Candida, Toxoplasma, and other
      opportunistic organisms. The major long-term complications include rejection,
      infection, hypertension, renal dysfunction, lipid abnormalities, and accelerated
      coronary atherosclerosis. This review provides an overview of the short- and long
      term follow-up of the cardiac transplant recipient, including routine care as
      well as detection and management of the common complications.

PMID- 8340686
TI  - Cardiac assist devices: bridging and beyond.
AB  - Due to the high incidence of death while awaiting cardiac transplantation today,
      most major transplant centers have adopted the use of left ventricular assist
      devices in order to stave off the complications of end-stage heart failure and
      allow patients to maintain a good physiologic state going into heart
      transplantation. These devices are safe and may one day prove to be a substitute
      for the short supply of donor organs.

PMID- 8340687
TI  - Heart transplantation: operative techniques and postoperative management.
AB  - Heart transplantation has become an established therapeutic option for some
      patients with end stage heart failure. The technique of heart transplantation
      involves excision of the diseased heart leaving behind cuffs of the right and
      left atria, pulmonary artery and aorta, which are subsequently attached to their
      counterparts in the procured donor heart. In most cases donor and recipient
      operations are carried out in two different hospitals which can be hundreds of
      miles apart. Careful coordination and timing of the donor and recipient
      operations is fundamental to keep the ischemic time (ie, the time taken to remove
      the donor heart, transport to the transplant center and implant in the recipient)
      to a minimum. Ischemic time longer than 4 hours carries a significantly higher
      operative mortality. Preservation of the donor heart during the period of
      ischemia is achieved using a potassium based cardioplegic solution which arrests
      the heart in diastole, and is supplemented with topical cooling to keep the
      myocardial temperature at 4 degrees C. Due to cardiac denervation and impaired
      ability to respond to high filling pressures, maintaining a fast heart rate is
      essential to maximize cardiac output during the early postoperative period. High
      pulmonary vascular resistance can occur postoperatively and can result in failure
      of the donor heart. This may require the use of vasodilators and mechanical right
      heart assistance. In addition to the use of immunosuppressive agents to prevent
      rejection of the donor heart, careful attention should be given to renal function
      and to prophylaxis against infection. The overall 30-day survival (ie, operative
      survival) currently exceeds 95%.

PMID- 8340688
TI  - A modest proposal: universal access to appropriate medical care as a means of
      cost reduction.

PMID- 8340689
TI  - ECG of the month. Benevolent rhythm. Escape impulses; escape rhythm.

PMID- 8340690
TI  - Head and neck manifestations of sarcoidosis.
AB  - Sarcoidosis is a multisystem granulomatous disease of unknown etiology affecting
      young adults and presenting most commonly with bilateral hilar lymphadenopathy,
      pulmonary infiltrates, and skin or eye lesions. The manifestations of this
      disease are protean and its clinical course is variable. Often the mode of onset
      correlates with the natural course and prognosis of the disease. Acute onset
      usually leads to remission within 12 to 18 months. Insidious, chronic disease
      often results in fibrotic sequelae. The treatment of choice for sarcoidosis is
      systemic corticosteroids.

PMID- 8340691
TI  - What is medical ethics?
AB  - This article is the first of a series on medical ethics which will appear at
      irregular intervals in the JOURNAL of the Louisiana State Medical Society. The
      ethical issues which will cover many of the problems encountered in clinical
      practice that cause a dilemma for physicians and patients. In these cases a
      choice usually exists and one describes the situation with words such as "should"
      or "ought." The author will write about current issues in medical ethics. His
      goal will be to describe a problem and to present the arguments for and against
      various solutions. He does not intend to tell you how you should react to ethical
      issues; that is each person's judgment. On the other hand, he will try to give
      you the arguments and hopes to help you to see the issue from several
      perspectives.

PMID- 8340692
TI  - How to interpret fish consumption advisories.
AB  - The goal of this paper is to explain the guidelines used in Louisiana to issue
      advisories against consumption of chemically contaminated seafood or fish and
      explain some of the uncertainties encountered. In the absence of federal
      regulations the State had to develop its own approach. The concentrations
      resulting from Louisiana policies are generally low in comparison with the FDA
      tolerances and, thereby, well within reasonable limits justified by the need to
      protect populations with high fish consumption.

PMID- 8340693
TI  - Outpatient anesthesia in the pediatric patient: a review.
AB  - Outpatient or ambulatory surgery has become one of the fastest growing
      subspecialties. The practice of outpatient pediatric surgery has numerous
      advantages. One of the main advantages is the shortened length of time the child
      is hospitalized. Careful selection of pediatric patients for outpatient surgical
      procedures is the best way to avoid problems and complications. The most anxiety
      producing aspect of the operation itself, that of parent separation, is also
      lessened by outpatient pediatric surgery. Preoperative evaluation and assessment
      is just as crucial in outpatient surgery as in all other surgical procedures. It
      is even more important in outpatient pediatric surgery to establish rapport with
      the parent and child and get a sense of the psychological needs of the patient.
      Pediatric outpatient surgery is still a relatively new subspecialty and from an
      anesthetic standpoint, the preoperative assessment is the anesthesiologist's main
      tool in getting to know his or her patient.

PMID- 8340694
TI  - Nonspecificity of meningeal enhancement in craniospinal magnetic resonance
      imaging.
AB  - Magnetic resonance imaging contrast agents are exquisitely sensitive in detecting
      meningeal abnormalities, which almost invariably manifest as abnormal
      enhancement. This property of the contrast agents is not accompanied by an equal
      degree of specificity, but as shown by the two case reports, contrast agents are
      still helpful to detect and define the extent of the meningeal abnormality, and
      to document its resolution, or the lack thereof.

PMID- 8340695
TI  - New medical/legal interprofessional code for Louisiana undergoing
      development.[The Medical-Legal Interprofessional Committee. The Louisiana State
      Medical Society and The Louisiana Bar Association].
AB  - The Medical/Legal Interprofessional Committee is a cooperative committee
      involving representatives of the Louisiana State Medical Society and the
      Louisiana Bar Association. The committee is currently re-examining its
      Interprofessional Code and its Advisory Opinion with the intent of combining the
      documents into a new, concise Code designed to promote cooperation and limit
      conflicts between the two professions. The precepts of this Code will also guide
      the Committee in deciding issues and disputes between physicians and attorneys.
      Reprinted in this issue is the original Interprofessional Code for Physicians and
      Attorneys of the State of Louisiana and the Advisory Opinion of the Medical/Legal
      Interprofessional Committee. The Committee encourages all physicians to review
      these documents and to contribute their thoughts and suggestions on what should
      be included in the new Code and how the relationships between the two professions
      can be improved. Please send comments to: Louisiana State Medical Society,
      Medical/Legal Interprofessional Committee, 3501 N Causeway Blvd, Suite 800,
      Metairie, LA 70002.

PMID- 8340696
TI  - Endothelin: a new role for an old friend?

PMID- 8340697
TI  - Cocaine and reproductive cardiology.

PMID- 8340698
TI  - The right to participate in research studies.
AB  - Institutional review boards for the use of human subjects in scientific studies
      were initially established to focus on protection of human subjects from the
      risks of research. It has become evident in recent years, however, that it is
      also important to protect the rights of individuals to have access to the
      benefits of research participation. These include, but are not limited to,
      certain experimental drugs or treatments, closer monitoring, free care or direct
      remuneration, and societal benefits of results of studies on specific
      populations. Researchers, so long sensitized by their respective institutional
      review boards to the need for protection of the subjects, now must also focus on
      the added burden of efforts to include individuals and the increased efforts it
      may take to protect the safety and rights of certain populations, including
      patients with AIDS, women, minorities, children, and the elderly. Additional care
      must be taken to design appropriate studies, recruit an appropriate spectrum of
      the population, craft a complete yet understandable and nondeterent informed
      consent form, and make efforts to assure that participants are informed.

PMID- 8340699
TI  - Gene expression for endothelins and their receptors in glomeruli of diabetic
      rats.
AB  - The present study was designed to assess levels of messenger RNA encoding for
      endothelin-1, endothelin-3, and endothelin receptors A and B in glomeruli of rats
      with streptozotocin-induced diabetes at 4, 12, and 24 weeks of age. In addition,
      streptozotocin-induced rats with diabetes were either treated with 8 to 14 units
      neutral protamine Hagedorn insulin daily to maintain moderate hyperglycemia
      (approximately 200 mg/dl) or left untreated to produce severe hyperglycemia (more
      than 400 mg/dl) during the 4-week study period. The messenger RNA levels for
      endothelin-1 in glomeruli of diabetic rats increased with the progression of
      diabetic nephropathy (4 weeks, 2.5 times control level, p < 0.01; 12 weeks, 3.8
      times, p < 0.01; and 24 weeks, 5.3 times, p < 0.001. In contrast, messenger RNA
      levels for endothelin receptors A and B were not altered in glomeruli from
      diabetic and control rats throughout the experimental period. Messenger RNA for
      endothelin-3 in glomeruli from diabetic and control rats was not detected until
      24 weeks of age. Insulin treatment partially ameliorated the increase in
      messenger RNA for endothelin-1 in the glomeruli of diabetic rats (0.3 times
      compared with diabetic rats without insulin treatment, p < 0.01), whereas insulin
      treatment did not affect messenger RNA for endothelin receptors A and B in
      diabetic glomeruli. These findings indicate that increased endothelin-1 messenger
      RNA in glomeruli may be a manifestation of diabetic nephropathy, and
      hyperglycemia or insulin-deficiency may play a role in abnormal endothelin-1 gene
      regulation.

PMID- 8340700
TI  - Gender-related differences in cocaine toxicity in the rat.
AB  - To test our hypotheses that gender-related differences in cocaine toxicity exist
      in the rat, cocaine (2 mg/kg/min) was infused intravenously in chronically
      catheterized male and ovariectomized or intact female rats until the onset of
      circulatory collapse. Sequential manifestations of cocaine toxicity from mild
      central nervous stimulation to fatal cardiovascular collapse were observed.
      Arterial blood was withdrawn at the onset of the toxic signs or symptoms for
      determination of cocaine concentrations. Dosages and plasma concentrations of
      cocaine required to produce cardiovascular toxic manifestations were
      significantly lower in male and ovariectomized rats than in intact females.
      Plasma cholinesterase activity was lowest in the male animals and highest in
      intact females. These data suggest that systemic toxicity of cocaine is enhanced
      in male rats, because lower doses and plasma concentrations are required to
      induce toxic signs and symptoms.

PMID- 8340701
TI  - Tumor necrosis factor-induced contraction of cultured rat mesangial cells:
      interaction with angiotensin II.
AB  - The role of tumor necrosis factor alpha in the regulation of renal function,
      particularly glomerular filtration rate, has not been completely defined. This
      study was designed to assess the intrinsic role of this cytokine on glomerular
      filtration rate by analyzing its short-term effect on the degree of contraction
      in cultured rat mesangial cells, not only directly but also in the presence of
      angiotensin II. Contraction was evaluated both morphologically--by measuring
      planar cell surface area of cultured rat mesangial cells and glomerular cross
      sectional area of isolated rat glomeruli--and biochemically--by analyzing myosin
      light-chain phosphorylation in cells. Tumor necrosis factor alpha significantly
      decreased planar cell surface area in a dose-dependent and time-dependent manner,
      an effect completely abolished by preincubation of the cells with platelet
      activating factor receptor antagonists BN 52021 and alprazolam. This effect was
      also observed in the presence of angiotensin II, whether tumor necrosis factor
      alpha was added before or after angiotensin II, increasing the reduction in
      planar cell surface area induced by angiotensin II in both cases. Changes in
      planar cell surface area were evident not only when the absolute values of this
      parameter were considered but also when the percentage of contracted cells (cells
      with a planar cell surface area reduction > 10%) was analyzed. Tumor necrosis
      factor alpha also induced a significant reduction of glomerular cross-sectional
      area in isolated rat glomeruli. The results of the morphologic studies were
      supported by myosin light-chain phosphorylation experiments.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8340702
TI  - Investigations on the role of hemopexin and albumin in plasma clearance and
      tissue distribution of Sn-protoporphyrin.
AB  - The mechanism of the clearance of circulating tin-protoporphyrin (Sn-PP), a
      competitive inhibitor of heme oxygenase in the degradation of heme to bilirubin,
      is unknown. Two serum proteins, albumin and hemopexin, which are instrumental in
      the delivery of iron-protoporphyrin (heme) to the liver, also bind
      metalloporphyrins with high affinity and may aid in targeting their tissue
      distribution. After intravenous injection of 1 mumol Sn-PP/kg, the serum
      concentration of hemopexin decreased in human subjects, rats, and rabbits within
      24 hours to a similar extent (30% to 50%). This finding suggested that hemopexin
      may have a role in the tissue distribution of Sn-PP. However, when rats were
      injected with Sn-PP in saline solution or complexed with albumin, more Sn-PP was
      taken up by the liver and testes than when Sn-PP was complexed with hemopexin.
      These results indicate that hemopexin does not preferentially target Sn-PP to the
      liver and may not be the preferred vehicle for clearance of circulating Sn-PP.

PMID- 8340703
TI  - Glucocorticoid metabolism in the cardiac interstitium: 11 beta-hydroxysteroid
      dehydrogenase activity in cardiac fibroblasts.
AB  - The interstitial fibrosis seen in the heart and systemic organs in states of
      primary or secondary mineralocorticoid excess suggests that fibroblasts are
      responsive to mineralocorticoid. In vitro studies demonstrating increased
      fibroblast collagen synthesis in response to MC are consonant with this view. The
      nicotinamide-adenine dinucleotide phosphate(+)-dependent enzyme 11 beta
      hydroxysteroid dehydrogenase converts the glucocorticoids corticosterone and
      cortisol to the inactive metabolites 11-dehydrocorticosterone and cortisone,
      respectively, conferring mineralocorticoid specificity to the cells within which
      it is active. We investigated the presence of 11 beta-hydroxysteroid
      dehydrogenase in sonicates of cultured vascular endothelial cells and cardiac
      fibroblasts by incubating sonicates for 1 hour in the presence of 5 x 10(-9)
      mol/L tritiated corticosterone or tritiated cortisol (1 microCi) and using
      reverse-phase high-performance liquid chromatography coupled to an on-line
      radioisotope detector for steroid separation and quantitation. Extracts of bovine
      endothelial cells showed no enzymatic activity with either substrate, whereas
      extracts of rat cardiac fibroblasts readily converted corticosterone to 11
      dehydrocorticosterone, even in the absence of exogenous nicotinamide-adenine
      dinucleotide phosphate+ (10% conversion). When 5 x 10(-4) mol/L nicotinamide
      adenine dinucleotide phosphate+ was added to sonicated fibroblasts, conversion
      increased to 50%, corresponding to 12 pmol 11-dehydrocorticosterone formed/mg
      protein. Conversion of cortisol to cortisone was not observed in fibroblast or
      endothelial cell extracts. Significant levels of corticosterone to 11
      dehydrocorticosterone conversion (0.14 pmol/10(6) cells/hour) were detected in
      intact fibroblasts, but no 11-dehydrogenation of corticosterone was observed in
      intact endothelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8340704
TI  - The effects of inhibition of plasma cholinesterase activity on systemic toxicity
      and blood catecholamine levels from cocaine infusion in pigs.
AB  - We investigated systemic effects and possible mechanisms for lethality of
      intravenously infused cocaine in spontaneously breathing and mechanically
      ventilated unconscious Landrace male pigs weighing about 26 kg (25.75 +/- 0.25
      kg) that were pretreated with either saline solution (groups 1 and 3) or iso-ompa
      (tetraisopropyl pyrophosphoramide), a specific plasma cholinesterase inhibitor
      (groups 2 and 4). Pigs were made unconscious with sodium thiopental and
      ventilated with 70% nitrous oxide and 30% oxygen. A carotid arterial cannula and
      a Swan-Ganz catheter were inserted for hemodynamic monitoring. Pigs in groups 1
      and 2 were then allowed to breathe spontaneously and groups 3 and 4 were
      mechanically ventilated. After obtaining a stable state, as judged by
      cardiovascular and respiratory parameters, the pigs were infused intravenously
      with cocaine hydrochloride (0.8 mg/kg/min) until the time of cardiac arrest.
      Respiratory and cardiovascular parameters, blood temperature, and sodium and
      potassium levels were monitored. The times of occurrence of respiratory arrests
      (RA), cardiac arrests (CA), and convulsions were recorded. Our results showed
      that RA is the primary cause of death in spontaneously breathing pigs and that
      mechanical ventilation significantly delayed the occurrence of CA (p < 0.05).
      Significant decreases in cardiac output, mean blood pressure, and heart rate as
      well as significant increases in systemic and pulmonary vascular resistances,
      central venous and pulmonary wedge pressures, and blood K+ levels were noted in
      mechanically ventilated pigs (p < 0.05). Variable hemodynamic responses were
      noticed in spontaneously breathing pigs. Our results also showed that no
      significant changes occurred in blood catecholamine levels when compared with
      baseline values associated with the infusion of toxic doses of cocaine.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8340705
TI  - Creatine kinase isoenzyme MB may be elevated in healthy young women after
      submaximal eccentric exercise.
AB  - Elevations in serum creatine kinase isoenzyme MB (CK MB) after exercise may be of
      clinical importance for the diagnosis of myocardial infarction. However, CK MB
      has been observed to increase after exercise in highly trained endurance runners.
      No data exist relating to the effect of exercise in a heterogeneous female
      population with regard to CK MB. The purpose of the present investigation was to
      determine whether an elevation in serum CK MB can be measured in women
      (heterogeneous for aerobic capacity, estradiol, and lean body mass) and to make a
      preliminary analysis of the relationships of postexercise serum CK MB
      concentration and CK activity, estradiol, lean body mass, and peak oxygen
      consumption. Lean body mass and peak oxygen consumption were measured for 15
      college-age women (19 to 29 years) after the performance of a stepping exercise
      for 40 minutes at 70% of peak oxygen consumption to elicit the efflux of
      intramuscular enzymes. Serum CK MB concentration, CK activity, and estradiol
      level were measured before exercise and 24 and 48 hours after exercise. Serum
      estradiol level was also measured immediately after exercise. Four of the 15
      subjects had elevations in CK MB concentrations ranging from 18.4 to 101.2
      micrograms/L, many times the upper normal limit (4.7 micrograms/L). All subjects
      with high serum CK MB concentrations had high CK activity, and the two measures
      were significantly related (p < 0.01) in the postexercise period. It was
      concluded that exercise can cause large elevations in serum CK MB in some
      women.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8340706
TI  - Plasma defensin concentrations are elevated in patients with septicemia or
      bacterial meningitis.
AB  - We measured concentrations of defensins (human neutrophil peptides) in the plasma
      of healthy volunteers and patients with sepsis and meningitis. When a sensitive
      enzyme immunoassay was used, defensins were detected in plasma samples from 13 of
      24 healthy blood donors, with a mean +/- SD of 42 +/- 53 ng/ml. Defensin levels
      in plasma samples from seven patients with sepsis at the onset of disease ranged
      from 900 ng/ml to 170,000 ng/ml. In 10 patients with meningitis in the initial
      phase of disease, plasma defensin concentrations ranged from 120 ng/ml to 910
      ng/ml. Defensin concentrations in the plasma of both patient groups were
      significantly higher than those in healthy blood donors (p << 0.01), and patients
      with sepsis had higher defensin levels than patients with meningitis (p < 0.01).
      Defensin levels were significantly (p < 0.01) lower after the beginning of
      specific antibiotic therapy. Defensin concentrations in the plasma of patients
      with sepsis and meningitis correlated only weakly (r = 0.38) with blood
      neutrophil count. In vitro studies of defensin added to plasma indicated that all
      defensin was bound to plasma proteins. At high concentrations (1000
      micrograms/ml), defensins caused precipitation of plasma proteins. Because plasma
      defensin levels may reflect neutrophil activation at sites of infection and
      inflammation, studies of the clinical utility of defensin ELISA are indicated.

PMID- 8340707
TI  - Gender differences in hepatic induction and inhibition of theophylline
      pharmacokinetics and metabolism.
AB  - This investigation examined whether or not a gender-related effect on
      theophylline pharmacokinetics and metabolism exists in smoking and nonsmoking
      subjects with and without the concurrent administration of cimetidine. With a
      crossover design, 28 healthy men and premenopausal women (14 in each group) were
      administered intravenous aminophylline before (phase 1) and during (phase 2) a 10
      day course of cimetidine, 300 mg four times a day. Statistically significant
      gender- and smoking-related effects were seen for theophylline half-life and
      clearance in phase 1, but only the smoking effect was statistically significant
      for these pharmacokinetic parameters in phase 2. Urinary metabolite excretion
      patterns demonstrated a greater percentage of excretion of 3-methylxanthine in
      female smokers than in male smokers in phase 1. Time-averaged urinary clearance
      of 1,3-dimethyluric acid was greater in female smokers than in male smokers. In
      phase 2, a significant reduction in the clearance of 1,3-dimethyluric acid was
      noted in female smokers but not in any other group. The results of our
      investigation suggest that a significant difference in the pharmacokinetics of
      theophylline exists that is related to gender and smoking status. Theophylline
      metabolism also seems to vary according to these factors. Administration of
      cimetidine results in a significant reduction in clearance of theophylline and
      abolishes the gender differences but not the smoking differences.

PMID- 8340708
TI  - Do antiphospholipid autoantibodies modulate the physiological function of cell
      membrane phospholipids?

PMID- 8340709
TI  - Protecting the rights of conscience of health care providers.

PMID- 8340711
TI  - Qui tam litigation. A new forum for prosecuting false claims against the
      government.

PMID- 8340710
TI  - On a decision-making paradigm of medical informed consent.

PMID- 8340712
TI  - Qui tam actions. Are government employees proper qui tam plaintiffs?

PMID- 8340713
TI  - Application of qui tam to the quality of health care.

PMID- 8340714
TI  - RU-486: legal and policy issues confronting the Food and Drug Administration.

PMID- 8340715
TI  - A randomized clinical trial of manual therapy and physiotherapy for persistent
      back and neck complaints: subgroup analysis and relationship between outcome
      measures.
AB  - OBJECTIVE: To study the efficacy of manual therapy and physiotherapy in subgroups
      of patients with persistent back and neck complaints. The second objective was to
      determine the correlation between three important outcome measures used in this
      trial. DESIGN: Randomized clinical trial (subgroup analysis). SETTING: Primary
      health care in the Netherlands. PATIENTS: Two hundred fifty-six patients with
      nonspecific back and neck complaints of at least 6 wk duration who had not
      received physiotherapy or manual therapy in the past 2 yr. INTERVENTIONS: At the
      discretion of the manual therapists, physiotherapists and general practitioners.
      Physiotherapy consisted of exercises, massage and physical therapy (heat,
      electrotherapy, ultrasound, shortwave diathermy). Manual therapy consisted of
      manipulation and mobilization of the spine. Treatment by the general practitioner
      consisted of drugs (e.g., analgesics), advice about posture, home exercises and
      (bed)rest. Placebo treatment consisted of detuned shortwave diathermy (10 min)
      and detuned ultrasound (10 min). MAIN OUTCOME MEASURES: Changes in severity of
      the main complaint and limitation of physical functioning measured on 10-point
      scales by a blinded research assistant and global perceived effect measured on a
      6-point scale by the patients. RESULTS: Improvement in the main complaint was
      larger with manual therapy (4.3) than with physiotherapy (2.5) for patients with
      chronic conditions (duration complaint of 1 yr or longer). Also, improvement in
      the main complaint was larger with manual therapy (5.5) than with physiotherapy
      (4.0) for patients younger than 40 yr (both were measured after 12-mo follow-up).
      Labeling of patients by the treating manual therapists as "suitable" or "not
      suitable" for treatment with manual therapy did not predict differences in
      outcomes. Generally, there was a moderate to strong correlation between the three
      outcome measures, although a considerable number of patients gave a relatively
      low score for perceived benefit, while the research assistant gave a high
      improvement score for the main complaint and physical functioning. CONCLUSIONS:
      The subgroup analysis suggests better results of manual therapy compared to
      physiotherapy in chronic patients (duration of present complaints of 1 yr or
      longer) and in patients younger than 40 yr old). Differences for other subgroups
      were less clear. The explorative findings of these subgroup analyses have to be
      investigated in future research.

PMID- 8340716
TI  - Reactivity of leg alignment to articular pressure testing: evaluation of a
      diagnostic test using a randomized crossover clinical trial approach.
AB  - OBJECTIVE: A study was undertaken to assess the reliability of detecting leg
      alignment changes (reactivity) and to determine if the observed leg alignment
      reactivity can be attributed to a rotatory articular pressure challenge. DESIGN:
      Prospective double-blind crossover trial of a diagnostic test. SETTING:
      Laboratory: Center for Technique Research. PARTICIPANTS: Forty-two chiropractic
      college students, faculty and staff. INTERVENTIONS: A standardized force of 2 or
      3 kg was applied with a 1 cm2 rubber-tipped pressure algometer on the lateral
      aspect of the T3-T7 spinous processes and the posterior aspect of the lateral
      masses of C1. MAIN OUTCOME MEASURES: Leg alignment reactivity: an increase in leg
      alignment discrepancy (yes or no) following a diagnostic intervention. RESULTS:
      The reliability for detecting leg alignment reactivity was poor: on average,
      Kappa = 0.05 in the thoracics and 0.06 at C1. On average, the attributable risk
      of leg alignment reactivity (pressure test risk--sham test risk) was less than
      4%. In many cases, the sham rate was greater than the pressure test rate.
      CONCLUSIONS: For the population investigated, leg alignment reactivity to
      rotatory pressure testing can, in the majority of cases, be attributable to
      background noise. This procedure was not found to be viable for identifying
      vertebrae for adjustment. Further research with different subject populations,
      regions of investigation, leg alignment measurement techniques and vertebral
      challenge techniques are indicated.

PMID- 8340717
TI  - A model for developing standards of care of the chiropractic paraprofessional by
      task analysis.
AB  - BACKGROUND: This report is an examination of the demographics of currently
      employed chiropractic paraprofessionals, including a compilation and verification
      of a job analysis. Despite the increasing sophistication and accountability of
      the chiropractic practice, the chiropractic assistant has not maintained a
      parallel level of maturity. METHODS: Three data-gathering instruments were
      employed: a) a general survey was used to gather demographics; b) a program for
      developing a curriculum (DACUM) was used to develop a job analysis; and c) a
      survey was used to verify tasks and duty areas developed by the DACUM meetings.
      RESULTS: Demographically, chiropractic paraprofessionals are people with a wide
      variety of training and duties. Verification surveys of the DACUM model yielded
      no new tasks or duty areas and assigned relevance to all the tasks listed in the
      DACUM grid. CONCLUSIONS: No uniform standard of training or competency testing
      now exists for the chiropractic paraprofessional. The DACUM grid may serve as a
      useful model for developing a standard of training or competency.

PMID- 8340718
TI  - Interrelationship between plasma potassium concentration, pulmonary ventilation
      and electrocardiographic change during and after highly intense exercise.
AB  - OBJECTIVE: The purpose of this investigation was to induce elevated plasma
      concentrations of potassium (K+) efflux from active muscle cells during intense
      muscular exercise. The relationship between K+, pulmonary ventilation (VE) and
      EKG changes, specifically T-wave amplitude, is presently controversial. DESIGN:
      Repeated measures design. SETTING: Human performance laboratory. PARTICIPANTS:
      Twelve volunteer trained recreational cyclists (10 males, mean age 31.9 +/- 7.4,
      and 2 females, mean age 27.5 +/- 0.7, mean VO2max 571.2 +/- 6.4 ml.kg.min-1).
      OUTCOME MEASURE: Subjects performed 10 min of pedaling at 90 rpm, yielding a
      power output of 45 W.min-1 on a mechanically braked cycle ergometer as a warm-up.
      Each exercise stage was 2 min in duration, beginning at 135 W and increased by 45
      W thereafter until voluntary exhaustion. Respiratory gas exchange measures were
      obtained every 10 sec. Venous blood samples for K+ and lactate (LA-)
      determination were drawn at rest, at the end of stage 2, all subsequent stages,
      and during 3 and 10 min of recovery. EKG recordings were concurrent with venous
      sampling. RESULTS: Statistical analyses for VE vs. K+, respiratory exchange ratio
      (RER) vs. K+ and RER vs. LA- revealed neither significant change nor an
      associative relationship from stages 1-3. However, stages 4-8 were statistically
      significant (p < .05) and highly correlated. No relationship was found between K+
      change and T-wave amplitude during exercise or recovery. CONCLUSION: These data
      indicate a strong relationship between selected respiratory gas exchange measures
      and K+ during intermediate to highly intense exercise.

PMID- 8340719
TI  - Compartment syndrome and shin splints of the lower leg.
AB  - OBJECTIVES: The objective of this article is to review and categorize the current
      knowledge on compartment syndromes (CS) and shin splints (SS), with specific
      importance relegated to the diagnosis, differential diagnosis and management of
      these conditions. DATA SOURCES: The bibliographic data sources reviewed are
      limited to the English language and human content and are from medical and
      scientific journals, as well as chiropractic and medical texts. A mini-Medline
      version of Index Medicus was utilized. Terms for indexing included compartment
      syndromes, shin splints and stress fractures. The bibliographies of the journals
      selected were then evaluated and, where appropriate, the specific journal or text
      references regarding diagnosis and management were then reviewed. This
      information was then included in this article, where useful, to further clarify
      or reference statements made. CONCLUSION: Differential diagnosis of the acute CS
      from chronic CS and SS requires clinical methods and imaging procedures. The
      pathogenesis of the acute CS of the lower leg is associated with external
      pressure or internal hemorrhage. If the tissue pressure were to rise above 30-40
      mm Hg for 4-12 h, irreversible muscular damage would result. Emergency surgical
      intervention is the only appropriate form of treatment in acute CS. In chronic
      CS, where elevated pressures exist on a transient basis, influenced by activity,
      conservative management procedures are felt to be effective. However, if these
      methods are not helpful, surgical intervention may be necessary. The etiology of
      pain associated with SS is not associated with compartmental pressure elevations,
      but rather, results from periostitis occurring along the tibia caused by muscular
      and tendinous strain associated with inflammation. Conservative management is
      most appropriate for this disorder, with surgical intervention being an uncommon
      treatment approach. Although clinical findings are useful in the diagnosis of
      these disorders, fluid pressure findings may be necessary to fully differentiate
      acute CS from other disorders. Up until recently, common methods of obtaining
      pressure measurements of compartments included the use of a needle manometer.
      More recently, however, a hand-held miniature fluid pressure monitor has been
      developed that produces reproducible measurements of interstitial fluid, making
      testing potentially practical for the clinician.

PMID- 8340720
TI  - Osteochondroma of the knee.
AB  - This article discusses a case of osteochondroma suffered by a female patient. The
      typical clinical and radiographic signs and symptoms are presented.
      Osteochondromas may be pedunculated or sessile. Malignant transformation ranges
      from 1% for solitary lesions to 20% for hereditary multiple exostoses. If
      transformation occurs, chondrosarcoma usually develops. Most lesions are
      asymptomatic and require no treatment.

PMID- 8340721
TI  - Temporomandibular disorder associated with sacroiliac sprain.
AB  - A case of the external derangement-type temporomandibular disorder (TMD),
      temporarily relieved following chiropractic sacro-occipital technique (SOT)
      treatment, including SOT category II blocking to reduce sacroiliac sprain, is
      presented. Symptom exacerbation midway through the course of treatment followed
      additional dental work; symptom remission followed additional SOT treatment.
      Freedom from symptoms is maintained with a 3-wk treatment interval. There appears
      to be a cause-effect relationship between external derangement-type TMD and
      sacroiliac sprain. Concurrent, coordinated chiropractic and dental treatments may
      improve the success rate of TMD resolution.

PMID- 8340722
TI  - Administration in chiropractic education.

PMID- 8340723
TI  - Muscle scanning: the 18% solution.

PMID- 8340724
TI  - Metastatic testicular seminoma of the cervicothoracic spine.

PMID- 8340725
TI  - The effect of spinal manipulation on pain and prostaglandin levels in women with
      primary dysmenorrhea.

PMID- 8340726
TI  - Line drawing analyses of static cervical x ray used in chiropractic.

PMID- 8340727
TI  - Editorial: chiropractic magazines.

PMID- 8340728
TI  - Respiratory and cardiovascular adjustments during exercise of increasing
      intensity and during recovery in thoroughbred racehorses.
AB  - A new design of flowmeter is described and used in a comprehensive study of the
      respiratory and cardiovascular adjustments that occur during a standardised
      exercise test in Thoroughbred horses. The flowmeter system and associated
      lightweight, fibreglass mask (total mass, 0.7 kg) have a maximum dead space of
      500 ml and negligible resistance to airflow. They have no systematic effect on
      blood gases and, together with a rapidly responding mass spectrometer, enable an
      accurate computation of gas exchange to be performed together with breath-by
      breath determination of other respiratory variables. At the highest level of
      exercise (12 ms-1 on a 3 degrees incline), the rate of oxygen uptake (VO2) and
      carbon dioxide production (VCO2) increased to 29.4 times and 36.8 times their
      resting values, respectively. Respiratory minute volume (VE) increased to 27.0
      times its resting value, with respiratory frequency (fR) making the major
      contribution at the walk and trot. However, with increasing cantering speeds, fR
      changed little as it was locked in a 1:1 fashion to stride frequency, and tidal
      volume (VT) then made the major contribution to the increase in VE. The ratio of
      ventilatory dead space (VD) to VT in resting horses was lower than that
      previously reported in the literature and this could be the result of the
      different respiratory recording systems that were used. There was a close
      relationship between VT and stride length at increasing cantering speeds. Despite
      the fact that alveolar ventilation (VA) was well matched to VO2, there was a
      significant reduction in arterial PO2 (PaO2) when the horses cantered at 8 ms-1
      and this eventually fell to 34% below the resting value. The present data tend to
      support the idea that VA/Vb (where Vb is cardiac output) inequalities are
      important in causing this hypoxaemia. However, the reduction in PaO2 was more
      than compensated for by an increase in haemoglobin concentration, [Hb], so the
      concentration of oxygen in the arterial blood (CaO2) was significantly above the
      resting value at all levels of exercise. Both lactate concentration and PaCO2
      increased during exercise, causing substantial reductions in pH of both arterial
      and mixed venous blood. This would have inevitably shifted the oxygen equilibrium
      curve of the Hb to the right, desaturating the arterial blood and thus
      exacerbating the effect of the hypoxaemia, as would the almost 4 degrees C rise
      in blood temperature. The tight respiratory/locomotor linkage might prevent the
      acidosis and hyperthermia having the stimulatory effects on VE that they have in
      humans at high work loads.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8340729
TI  - Bioenergetic and kinematic consequences of limblessness in larval Diptera.
AB  - We report the cost of transport and kinematics of terrestrial locomotion by
      larval blowflies (Protophormia terraenovae, Diptera: Calliphoridae). We contrast
      inter- and intra-individual methods for estimating minimum cost of transport
      (MCOT) and the relationship between speed, contraction frequency and distance
      traveled per contraction. The minimum cost of transport calculated from intra
      individual data is 2297 +/- 317 J kg-1 m-1 (S.E.M.) and the MCOT calculated from
      inter-individual comparisons is statistically indistinguishable at 1910 +/- 327 J
      kg-1 m-1. These values are almost ten times higher than the predicted value for a
      similar-sized limbed arthropod. Fly larvae travel by repeated peristaltic
      contractions and individual contractions cost about the same amount as individual
      strides in limbed insects. Both contraction frequency and distance traveled per
      contraction increase linearly with speed. Doubling the contraction frequency or
      the distance traveled per contraction approximately doubles speed. The cost of
      transport in fly larvae is among the highest recorded for terrestrial locomotion,
      confirming the suggestion that biomechanical and kinematic properties of limbless
      organisms with hydraulic skeletons lead to very high costs of transport.

PMID- 8340730
TI  - Effect of temperature on central chemical control of ventilation in the alligator
      Alligator mississippiensis.
AB  - Central chemoreceptor function was assessed in unanesthetized alligators,
      Alligator mississippiensis, at body temperatures of 15, 25 and 35 degrees C. Two
      experiments were performed. In the first experiment, the fourth ventricle was
      perfused with mock cerebrospinal fluid (CSF) solutions of different pH values
      (7.1-7.9). Changes in pulmonary ventilation were evaluated with a
      pneumotachograph and arterial pH (pHa) was measured. Perfusion with low-pH
      solutions increased ventilation and arterial pH. Perfusion with high-pH solutions
      decreased ventilation and arterial pH. Mock CSF pH had a greater effect at higher
      temperatures. In the second experiment, the relative contributions of central and
      peripheral chemoreceptor drive to breathing were evaluated using hypercapnic gas
      mixtures to stimulate both central and peripheral chemoreceptors. Hypercapnia
      caused an increase in ventilation which was larger at higher temperatures. To
      stimulate only the peripheral chemoreceptors, the same hypercapnic gas mixtures
      were applied while the CSF pH of the fourth ventricle was kept constant by
      perfusion with a mock CSF solution. This reduced significantly the ventilatory
      response induced by hypercapnia. These data indicate that, regardless of the
      temperature, central chemoreceptors play a major role in the ventilatory
      regulation of the alligator. The change in pHa with temperature is compatible
      with the alphastat hypothesis.

PMID- 8340731
TI  - The physiology of bottlenose dolphins (Tursiops truncatus): heart rate, metabolic
      rate and plasma lactate concentration during exercise.
AB  - Despite speculation about the swimming efficiency of cetaceans, few studies have
      investigated the exercise physiology of these mammals. In view of this, we
      examined the physiological responses and locomotor energetics of two exercising
      adult Tursiops truncatus. Oxygen consumption, heart rate, respiratory rate and
      post-exercise blood lactate concentration were determined for animals either
      pushing against a load cell or swimming next to a boat. Many of the energetic and
      cardiorespiratory responses of exercising dolphins were similar to those of
      terrestrial mammals. Average heart rate, respiratory rate and oxygen consumption
      for dolphins pushing against a load cell increased linearly with exercise levels
      up to 58 kg for a female dolphin and 85 kg for a male. Oxygen consumption did not
      increase with higher loads. Maximum rate of oxygen consumption (VO2max) ranged
      from 19.8 to 29.4 ml O2 kg-1 min-1, which was 7-11 times the calculated standard
      metabolic rate (VO2std) of the dolphins. Blood lactate concentration increased
      with exercise loads that exceeded VO2max. The maximum lactate concentration was
      101.4 mg dl-1 (11.3 mmol l-1) for the male, and 120.6 mg dl-1 (13.6 mmol l-1) for
      the female. When swimming at 2.1 m s-1, heart rate, respiratory rate and post
      exercise blood lactate concentration of the dolphins were not significantly
      different from values at rest. The cost of transport at this speed was 1.29 +/-
      0.05 J kg-1 min-1. The energetic profile of the exercising bottlenose dolphin
      resembles that of a relatively sedentary mammal if the exercise variables defined
      for terrestrial mammals are used. However, the energetic cost of swimming for
      this cetacean is low in comparison to that of other aquatic and semi-aquatic
      mammals.

PMID- 8340732
TI  - Sun and skin damage.

PMID- 8340733
TI  - Scleroderma--clinical aspects.

PMID- 8340734
TI  - Intravenous immunoglobulin treatment in cytopenic haematological disorders.

PMID- 8340735
TI  - Anaphylatoxins in dilated cardiomyopathy.
AB  - OBJECTS: The aim of the study was to investigate the possible relationship
      between activation of complement system and thromboembolic complications in
      dilated cardiomyopathy (DCMP). METHODS: The plasma C3a and C5a concentrations
      were determined by radioimmunoassay measurement (Amersham International, UK) in
      23 patients with DCMP, 9 with hypertrophic cardiomyopathy (HCMP) and 11 healthy
      volunteers. RESULTS: The mean C3a concentration was significantly higher in DCMP
      patients (572 +/- 55 ng ml-1) compared with hypertrophic cardiomyopathy (344 +/-
      30 ng ml-1) and with healthy controls (294 +/- 43 ng ml-1) (P < 0.001). There
      were no significant correlations for C5a concentrations in this group. Mean C3a
      concentration in DCMP patients with thromboembolic complications (736 +/- 95 ng
      ml-1) was also significantly higher compared with DCMP patients without these
      complications (344 +/- 14 ng ml-1) (P < 0.001). CONCLUSIONS: We conclude that
      anaphylatoxins may play a role in the pathogenesis of thromboembolic
      complications.

PMID- 8340736
TI  - Effect of promethazine on lumbar vertebral bone mass in postmenopausal women.
AB  - OBJECTIVES: Work in mice suggests that the age-related loss of bone mineral noted
      in that species is caused by an intrinsic defect in a haematopoietic cell
      population which results directly or indirectly in increased bone resorption.
      This age-related loss of bone mineral is prevented or reversed by well-tolerated
      doses of promethazine HCL. The present study was undertaken to determine if
      promethazine would retard or reverse bone loss in postmenopausal women. DESIGN:
      Postmenopausal women whose spine (L2 to L4) bone mineral content (BMC) was two
      standard deviations below young normal values were assigned randomly to receive
      calcium or promethazine and calcium daily. Subjects who had been taking oral
      oestrogen for more than 4 years also were assigned randomly but independently to
      the calcium or promethazine groups. SETTING: All subjects were seen in the out
      patient clinic of the Department of Medicine, School of Medicine, University of
      California, Los Angeles. SUBJECTS: Healthy, ambulatory postmenopausal females
      were recruited by word of mouth and by advertisement from the local community.
      Fifty-four subjects completed the first 6 months of the study and 43 completed 30
      months. INTERVENTIONS: The subjects were assigned randomly to receive 1000 mg
      calcium daily or promethazine 50 mg and calcium 1000 mg daily throughout the
      period of the study. MAIN OUTCOME MEASURES: Bone mineral content of the lumbar
      vertebrae (L2 to L4) was determined by dual photon densitometry every 6 months.
      Dorsolumbar spine X-rays were obtained yearly and at the completion of the study
      to detect new compression fractures. RESULTS: In the groups not taking oestrogen,
      BMC decreased at the rate of 1.53% year-1 in the group given only calcium; in
      contrast, BMC increased at 3.22% year-1 in the group given promethazine and
      calcium (P < 0.001). Among the women taking oestrogen, increases in mean BMC were
      noted in both groups, but those taking promethazine and calcium had a greater
      rate of increase than observed in the group taking only calcium (5.62% vs. 1.97%
      per year-1, P < 0.001). CONCLUSIONS: These results suggest that promethazine can
      induce a modest increase in vertebral BMC in postmenopausal women who are not
      taking oestrogen and greater increases in those who are.

PMID- 8340737
TI  - No evidence of mitochondrial abnormality in skeletal muscle of patients with iron
      deficient anaemia.
AB  - OBJECTIVES: Patients with iron deficiency anaemia complain of decreased exercise
      capacity. We asked whether this is due to defective oxidative ATP synthesis in
      skeletal muscle as a consequence of reduced blood oxygen content and/or intrinsic
      mitochondrial abnormalities. DESIGN: We used 31P magnetic resonance spectroscopy
      to examine skeletal muscle bioenergetics in iron-deficient patients and in age-
      and sex-matched controls. SETTING: The patients were recruited from the primary
      care population. SUBJECTS: We studied seven symptomatic female iron-deficient
      patients (aged 32-70 years) with haemoglobin (Hb) concentration, [Hb], 8.0 g dl
      1. Six had menorrhagia, the cause in the seventh patient remained undiagnosed.
      Results were compared with those of 8 healthy female controls (aged 25-48 years)
      with mean [Hb] 13.7 g dl-1. RESULTS: The right calf muscle was by studied 31P
      magnetic resonance spectroscopy in a 1.9 T super-conducting magnet. We measured
      the intracellular concentrations of phosphocreatine (PCr), inorganic phosphate
      (Pi), adenosine triphosphate (ATP) and the intracellular pH at rest, during
      plantar flexion exercise and during recovery from exercise. Exercise duration was
      reduced in the patients, yet end-exercise PCr/(PCr+Pi) was higher and adenosine
      diphosphate (ADP) lower than in controls. After exercise, initial PCr recovery
      was slowed but this was probably because of the lower cytosolic ADP
      concentration. CONCLUSIONS: Mitochondrial ATP synthesis was not limited by oxygen
      supply or an intrinsic mitochondrial defect. Therefore, the reduced exercise
      capacity seen in iron deficiency could be due to central causes and not to
      skeletal muscle metabolic abnormalities.

PMID- 8340738
TI  - Drug expectations and drug choices of hospital physicians.
AB  - OBJECTIVES: To assess whether differences in drug choices of hospital physicians
      are related to differences in the underlying decision-making process. DESIGN: A
      survey study was conducted addressing drug choices in six therapeutic fields with
      existing interprescriber variations; prescribers and non-prescribers of drugs of
      which the merits were not sufficiently proven (i.e. the 'target drugs') were
      compared. SETTING: A 1000-bed university hospital in The Netherlands. SUBJECTS:
      All 85 hospital physicians working in specialities involving one of the selected
      fields were asked to participate; 72 physicians completed the interviews. MAIN
      OUTCOME MEASURES: Comparisons were made regarding three elements of the decision
      making process: (1) the physicians' expectations of the target drugs and
      frequently used alternatives, (2) the weights attached to the principal treatment
      aspects, and (3) the extent to which their actual choice is based on these
      expectations and weights. RESULTS: In three fields, i.e. anti-emetics,
      vasodilators, and platelet inhibitors, the prescribers of the less desirable
      target drugs had higher expectations of these drugs in comparison to the non
      prescribers. In the other therapeutic fields, choosing target drugs was related
      either to attaching less importance to side-effects and costs, or to attaching
      less importance to reports from clinical trials. Twenty of the 46 treatment
      choices of the prescribers of target drugs could not be predicted from their
      expressed views as opposed to 5 of the 36 choices of the non-prescribers (P <
      0.05). CONCLUSIONS: Choosing less desirable drugs is not always related to having
      too high expectations of the drug. Assigning a different importance to certain
      aspects of the drug and resorting to decision strategies that do not include the
      weighing of all pros and cons provide alternative explanations for such treatment
      choices.

PMID- 8340739
TI  - Presenting features of monoclonal gammopathies: an analysis of 684 newly
      diagnosed cases. Cooperative Group for the Study and Treatment of Multiple
      Myeloma.
AB  - OBJECTIVES: The clinical, laboratory and radiologic features at diagnosis of 684
      newly diagnosed patients with monoclonal gammopathy were revised in order to
      underline the differences between monoclonal gammopathies of undetermined
      significance (MGUS) and stage I multiple myeloma (MM). DESIGN: Patients were
      screened for inclusion in a prospective controlled protocol for treatment of MM.
      Those having serum or urine monoclonal component (MC) were diagnosed as MM when
      they demonstrated osteolysis and/or bone marrow plasma cells (BMPC) > 20%;
      patients not fulfilling these criteria were considered MGUS. SETTING: Patients
      were recruited from 24 general or university hospitals from the departments of
      internal medicine, haematology and medical oncology. SUBJECTS: Seven-hundred-and
      fifty were enrolled between January 1986 and March 1990; 684 (343 MGUS and 341
      MM) were able to be evaluated for this study and 78 were stage I MM.
      INTERVENTIONS: Complete clinical, radiologic and laboratory work-up was carried
      out at the referral centres. MAIN OUTCOME MEASURES: The main outcome expected was
      the confirmation that BMPC > 20% could reliably differentiate stage I MM from
      MGUS. RESULTS: At a median follow-up of 36 months (minimum follow-up: 18 months),
      MGUS had a lower progression rate to overt MM, longer overall survival and
      different causes of death than stage I MM. Further differences concerned
      erythrocyte sedimentation rate (28 vs. 47, P < 0.001), per cent reduction of
      normal immunoglobulin (86 vs. 60%, P < 0.001), serum MC (1.6 vs. 2.2 g dl-1, P <
      0.001) and thymidine kinase level (3.3 vs. 4.5 mU ml-1, P < 0.05). CONCLUSIONS:
      The study suggests that 20% BMPC can be taken as a safe cut-off point at which to
      differentiate MGUS from early MM and outlines a few simple parameters which can
      be of diagnostic aid.

PMID- 8340740
TI  - Diurnal blood pressure variations in normoalbuminuric type 1 diabetic patients.
AB  - OBJECTIVE: To test the hypothesis that normoalbuminuric type 1 diabetic patients
      segregate into groups with normal and elevated ambulatory blood pressure. To
      evaluate diurnal variation of blood pressure assessed by individual or fixed
      night-time periods. DESIGN: Cross-sectional study. SETTING: Tertiary referral
      centre. SUBJECTS: Inclusion criteria for type 1 diabetic patients (n = 33):
      normal urinary albumin excretion (UAE age < 45 < 20 micrograms min-1), diabetes
      duration < or = 20 years, age 45 years. Healthy controls (n = 33) were matched
      for sex and age. MAIN OUTCOME MEASURE: Twenty-four hour, day-time, night-time and
      night/day ratio of ambulatory blood pressure. RESULTS: Twenty-four-hour blood
      pressure in diabetic patients did not differ significantly from a normal
      distribution. The 24-h systolic blood pressure was higher in diabetic patients
      than in healthy controls (difference: 6 mmHg, 95% confidence interval (CI) from 1
      to 10 mmHg, P < 0.05), while no significant differences were found for diastolic
      values. The 24-h systolic blood pressure in diabetic patients with UAE above the
      median value (5.8 micrograms min-1) was higher than for those with lower UAE
      (difference: 7 mmHg, 95% CI from 0.5 to 13 mmHg, P < 0.05). The night/day ratio
      of diastolic blood pressure based on individual informations of the night period
      was (mean +/- SD) 80 +/- 6% in diabetic patients and 78 +/- 8% in controls
      (difference: 2%, 95% CI from -1 to 5%, not significant [NS]). This ratio increase
      significantly (P < 0.00001) to 90 +/- 5% in diabetes and to 84 +/- 7% in controls
      if a fixed night period from 22.30 hours to 06.30 hours was assumed. CONCLUSIONS:
      It was not possible to identify a well-separated group of normoalbuminuric type 1
      diabetic patients with elevated ambulatory blood pressure. Values of UAE above
      the median in diabetic patients are associated with higher ambulatory blood
      pressure. Assessment of the night/day variation from fixed time-points should be
      abandoned because this leads to a serious underestimation of the nocturnal
      reduction in blood pressure.

PMID- 8340741
TI  - Accuracy of clinical diagnoses in a teaching hospital: a review of 997 autopsies.
AB  - OBJECTIVES: To analyse the concordance between clinical and autopsy diagnoses.
      DESIGN: Nine-hundred-and-ninety-seven autopsies were studied comparing the
      diagnoses of the autopsy requests with those of the death certificates and
      autopsy reports. The cases were grouped according to the 17 categories of
      diseases of the International Classification of Diseases (ICD) and the
      concordance was analysed with the kappa (kappa) coefficient of concordance.
      SETTING: The Hospital da Clinicas da Faculdade de Medicina de Ribeirao Preto da
      Universidade de Sao Paulo (HCFMRPUSP), Ribeirao Preto, SP, Brazil. SUBJECTS: The
      patients autopsied at HCFMRPUSP during the period between 1978 and 1980. MAIN
      OUTCOME MEASURES: kappa statistics offer an alternative approach to measuring the
      concordance between clinical and autopsy diagnoses. RESULTS: The kappa-value
      obtained was equal to 0.601 with a variance of 1.545 x 10(-4) when comparing the
      clinical diagnoses and the autopsy diagnoses, and equal to 0.661 with a variance
      of 1.531 x 10(-4) comparing the clinical diagnoses with those obtained after the
      gross examination. These values are significant at the level of 5%, i.e. there is
      an overall statistical concordance between clinical and autopsy diagnoses
      although the value is not absolute (kappa = 1.00). CONCLUSIONS: If autopsies are
      heeded without bias, they will continue to give important feedback concerning
      medical diagnosis.

PMID- 8340742
TI  - Hand abnormalities are strongly associated with the duration of diabetes
      mellitus.
AB  - OBJECTIVES: To study the prevalence of hand abnormalities in diabetic patients
      and to evaluate associations between the hand abnormalities and diabetic
      variables, ergonomic factors and smoking habits. DESIGN: Cross-sectional study of
      100 patients selected at random. Setting. Out-patient clinic, Department of
      Internal Medicine, Orebro Medical Centre Hospital in Sweden. MAIN OUTCOME
      MEASURES: Presence and extent of carpal tunnel syndrome (CTS), Dupuytren's
      contracture (DC), flexor tenosynovitis (FTS), and limited joint mobility (LJM).
      Duration of diabetes, metabolic control, chronic diabetic complications, blood
      pressure, ergonomic factors and smoking habits. RESULTS: Carpal tunnel syndrome,
      DC, FTS and LJM were each present in about 20% of the patients. Hand
      abnormalities were observed in 50 patients and more than one abnormality was
      found in 26 of the patients. The hand abnormalities were associated with the
      duration of diabetes but not with the metabolic control or with other diabetic
      complications. However, the diabetic complications were associated with bad
      metabolic control and with the duration of diabetes. Hand abnormalities
      correlated with heavy manual work but not with smoking habits. Twenty-five of the
      50 patients with hand syndromes were disabled to such an extent that surgery was
      recommended. CONCLUSION: The prevalence of hand abnormalities in diabetic
      patients is high and increases with the duration of diabetes. In many cases
      patients with hand abnormalities can be helped by surgery.

PMID- 8340744
TI  - Correspondence between screening and intra-arterial blood pressures in young men
      with borderline hypertension.
AB  - OBJECTIVES: To evaluate the screening blood pressure (BP) for identification of
      individuals with a mild but persistent elevation of BP referred to as borderline
      hypertension (BH). DESIGN: Based on screening data from approximately 10,500 men
      at a military enlistment centre in 1987; an unbiased population sample of young
      men were recruited. Blood pressure follow-up and investigation of anthropometric
      and metabolic data were made at Ostra Hospital. SUBJECTS: Men aged 19.8 years
      (range 17-28) were screened. Three hundred and six were found to have elevated BP
      (systolic BP (SBP) > 145 mmHg and/or diastolic BP (DBP) > or = 85 mmHg). Of
      these, 179 were re-examined after 1-3 years, by which time three individuals
      exceeded the limits for established hypertension and 80 fulfilled the BP criteria
      for BH (in two out of two blood pressure measurements). Fifty-four of these BH
      individuals were investigated with intra-arterial (i.a.) BP measurements. A
      normotensive control (NC) group (SBP 110-130 and DBP 60-80 mmHg; n = 20) from the
      same population was examined concomitantly. RESULTS: At screening, at the 2-year
      clinic follow-up and again during the intra-arterial recording, SBP was
      significantly different in BH vs. NC. With DBP an increasing difference between
      the groups was observed with time. There were highly significant correlations
      between screening and 2-year clinic BP (r = 0.72, P < 0.001; n = 74) and
      screening and i.a. BP (r = 0.57, P < 0.001; n = 74). CONCLUSIONS: These data show
      that there is a correspondence between BP at the screening procedure and i.a. BP
      measured 2 years later, indicating that the screening procedure is a useful way
      of identifying young men with mild but persistent BP elevation. This
      interpretation is supported by metabolic and biochemical differences between the
      groups.

PMID- 8340743
TI  - Effects of age, sex, season and diet on serum ionized calcium, parathyroid
      hormone and vitamin D in a random population.
AB  - OBJECTIVES: To study the influence of age, sex, season and diet on calcium status
      in normal subjects. DESIGN: A random population study. Setting. Institutional
      clinic for large population studies. SUBJECTS: The subjects were drawn randomly
      from the Danish Civil Registration System and represented a random sample of the
      background population in the area. The sample comprised 127 subjects (54 men and
      73 women, aged 35-65 years). MAIN OUTCOME MEASURES: The effects of age, sex,
      season and diet on parathyroid hormone (PTH),1,25-dihydroxyvitamin D (1,25(OH)2D)
      and 25-hydroxyvitamin D (25-OHD). RESULTS: There was no statistical significant
      difference for the serum concentrations of ionized calcium, PTH, 1,25(OH)2D and
      25-OHD between the two sexes, nor any influence by age in either sex, in contrast
      to serum phosphate, which declined significantly in men (P < 0.05), but tended to
      increase in women. Serum PTH (P < 0.009) showed seasonal fluctuations, whereas
      serum concentrations of 1,25(OH)2D, 25-OHD, ionized calcium, phosphate and
      magnesium remained stable throughout the year. Dietary intake of calcium and
      vitamin D were not related to any serum variables. CONCLUSIONS: In healthy
      subjects differences between the two sexes exist regarding phosphate metabolism.
      Serum PTH shows seasonal fluctuations.

PMID- 8340745
TI  - Lipoprotein abnormalities in hypertriglyceridaemic patients on long-term
      haemodialysis.
AB  - OBJECTIVES: To analyse by ultracentrifugation in a zonal rotor the plasma
      lipoproteins in hypertriglyceridaemic patients on long-term haemodialysis.
      DESIGN: Case-control study. SETTING: Tertiary referred care centre. SUBJECTS: Ten
      consecutive hypertriglyceridaemic patients on haemodialysis and 12 consecutive
      healthy controls. MAIN OUTCOME MEASURES: Plasma lipid and lipoprotein cholesterol
      concentrations, lipoprotein physical properties and compositions, apolipoprotein
      concentrations. RESULTS: Hypertriglyceridaemia in patients undergoing
      haemodialysis is characterized by an increased amount of small and slow floating
      very-low density lipoproteins (VLDL), higher concentrations of intermediate
      density lipoproteins (IDL) and small and dense low-density lipoprotein (LDL)
      particles; reduced levels of high-density lipoproteins (HDL), in particular of
      HDL2. The lipoprotein composition of such patients indicates reduced cholesterol
      ester and increased triglyceride content. Compared to controls, they have lower
      levels of plasma apolipoprotein A-I and A-II and higher B, C-II, C-III and E
      values. CONCLUSIONS: The lipoprotein abnormalities observed in
      hypertriglyceridaemic patients undergoing haemodialysis have recently been
      associated with an increased incidence of vascular complications and may in part
      explain the high incidence of vascular disease reported in these subjects.

PMID- 8340746
TI  - Reactivation of chronic hepatitis C after withdrawal of immunosuppressive
      therapy.
AB  - A patient with immune-mediated thrombocytopenia (ITP) and chronic hepatitis C
      virus (HCV) infection for 11 years was given immunosuppressive treatment because
      of an activation of his ITP. After 6 weeks of treatment with cyclophosphamide,
      cyclosporin A and cortisone the patient decided not to continue taking his
      medication. One month later he was readmitted to hospital due to fever, cough and
      jaundice. Clinical investigation revealed his condition to be caused by an
      activation of his HCV infection. It is concluded that, in parallel to the
      situation in hepatitis B, immunosuppressive treatment of patients with HCV
      infection may lead to increased viral replication, resulting in severe liver
      damage when immunocompetence is regained.

PMID- 8340747
TI  - Long QT syndrome with insulin-dependent diabetes mellitus: contiguous gene
      syndrome on chromosome 11p.
AB  - Long QT syndrome (Romano-Ward syndrome) and insulin-dependent diabetes mellitus
      (IDDM) have been documented as being linked with gene(s) on chromosome 11p
      although concurrence of the two disorders has not been reported. Our case is a 13
      year-old boy with Romano-Ward syndrome accompanied by IDDM. The long QT syndrome
      seemed to be transmitted in an autosomal-dominant mode because the Q-T intervals
      of his father and paternal grandfather were longer than normal. There was no
      family member with an abnormally high level of blood glucose except the patient.
      The human leucocyte antigen (HLA) haplotypes of the patient and the father were
      DR4/DR9 and DR2/DR9, respectively. This study suggests that in our patient IDDM,
      as well as Romano-Ward syndrome, is linked with chromosome 11p in the presence of
      HLA-DR4. The results support the previous study that chromosome 11p encodes a
      gene implicated in HLA-DR4-dependent diabetes susceptibility.

PMID- 8340748
TI  - Disseminated Mycobacterium malmoense infection in a patient with chronic
      granulocytic leukaemia.
AB  - Mycobacterium malmoense is an atypical mycobacterium previously isolated from
      lymph nodes in children and from adults with pulmonary disease. Disseminated
      infection is extremely rare and bone marrow involvement has never previously been
      described. We report a patient with chronic granulocytic leukaemia and persistent
      fever with granuloma in the bone marrow due to disseminated M. malmoense
      infection. The patient initially received treatment with isoniazid, ethambutol
      and rifampicin with clearance of mycobacteria in the bone marrow and clinical
      improvement. Sensitivity in vitro was established for streptomycin, amikacin,
      ethambutol and rifabutin. The patient eventually expired as a result of
      progressive respiratory failure from other opportunistic infections. At autopsy
      staining of samples from lung parenchyma revealed fungal hyphi but staining for
      Pneumocystis carinii and myobacteria were negative.

PMID- 8340749
TI  - C1 esterase inhibitor gene expression in rat Kupffer cells, peritoneal
      macrophages and blood monocytes: modulation by interferon gamma.
AB  - Kupffer cells (KC) represent the main part of the tissue macrophages. Beside
      phagocytosis of particulate material, involvement of KC in immunological and
      inflammatory reactions has been supposed. As C1 esterase inhibitor (C1-INH) is a
      serine protease inhibitor involved in such processes, the aim of this work was to
      study C1-INH synthesis in KC and, by comparison, in peritoneal macrophages (PM)
      and blood monocytes (MC) of the rat. C1-INH synthesis was studied on the protein
      level by biosynthetic labeling, immunoprecipitation, and sodium dodecyl sulfate
      polyacrylamide gel electrophoresis analysis, and on the RNA level by Northern
      blotting of total RNA or by in situ hybridization. KC were found to express C1
      INH gene spontaneously. C1-INH synthesis represents 1.3 +/- 0.2% of total protein
      synthesis at day 1 of culture and the absolute amount each cell synthesis remains
      constant during the whole time in culture. Transcripts of C1-INH were detected
      both in freshly isolated and in cultured KC. In contrast, spontaneous C1-INH gene
      expression was not detectable in freshly isolated PM, but only in cultured PM. In
      MC, C1-INH was not detectable at any time, whatever. Treatment of the cells with
      interferon gamma increased C1-INH synthesis in KC and in PM and caused an
      induction of C1-INH synthesis in MC. The results suggest that constitutive C1-INH
      synthesis is a functional marker for mature tissue macrophages.

PMID- 8340750
TI  - Inhibition of c-fes expression by an antisense oligomer causes apoptosis of HL60
      cells induced to granulocytic differentiation.
AB  - The c-fes protooncogene is expressed at high levels in the terminal stages of
      granulocytic differentiation, but so far no definite function has been attributed
      to the product of this oncogene. To tackle this problem, the c-fes protooncogene
      expression has been inhibited in HL60 cells, and fresh leukemic promyelocytes of
      acute promyelocytic leukemia have been induced to differentiate with retinoic
      acid (RA) and dimethylsulfoxide (DMSO). Inhibition was obtained by incubating the
      cells with a specific c-fes antisense oligodeoxynucleotide. It was observed that
      the cells, rather than differentiating, underwent premature cell death showing
      the morphological and molecular characteristics of apoptosis. This process was
      inhibited by granulocyte and granulocyte/macrophage colony-stimulating factor,
      but not by interleukin 3 (IL-3), IL-6, or stem cell factor. Our present results
      demonstrate that the loss of cell viability that occurs during the in vitro
      differentiation of myeloid cells, after the complete inhibition of the c-fes gene
      product and treatment with RA-DMSO, is due to activation of programmed cell
      death. It is concluded that a possible role of the c-fes gene product is to exert
      an antiapoptotic effect during granulocytic differentiation.

PMID- 8340751
TI  - Suppressible and nonsuppressible autocrine mast cell tumors are distinguished by
      insertion of an endogenous retroviral element (IAP) into the interleukin 3 gene.
AB  - After v-H-ras expression, the interleukin 3 (IL-3)-dependent PB-3c mast cells
      progress in vivo to two different classes of IL-3 autocrine tumors. Class I
      tumors show a germline configuration of the IL-3 gene and represent more than 90%
      of tumors analyzed so far. Somatic cell fusion of class I tumor lines with the
      nontumorigenic parental PB-3c resulted in loss of oncogenic IL-3 expression by a
      posttranscriptional mechanism with concomitant tumor suppression. Class II tumors
      arise rarely and contain an insertion in one IL-3 allele. This alteration was
      linked to enhanced IL-3 gene transcription. For one tumor, the insertion was
      shown to be an endogenous retroviral element (intracisternal A-particle). Cell
      hybrids of class II tumors with PB-3c remained IL-3 independent, expressed IL-3,
      and formed tumors rapidly. These results suggest that the v-H-ras oncogene
      synergizes with a recessive and a dominant lesion in class I and II tumors,
      respectively, both of which lead to the autocrine production of IL-3.

PMID- 8340752
TI  - The significance of low bcl-2 expression by CD45RO T cells in normal individuals
      and patients with acute viral infections. The role of apoptosis in T cell memory.
AB  - The bcl-2 gene product has been shown to prevent apoptotic cell death. We have
      now investigated the bcl-2 protein expression by resting and activated mature T
      cell populations. Freshly isolated CD45RO+ T cells within CD4+ and CD8+ subsets
      expressed significantly less bcl-2 than CD45RO- (CD45RA+) T cells (p < 0.001).
      When CD45RA+ T cells within both CD4+ and CD8+ subsets were activated in vitro,
      the transition to CD45RO phenotype was associated with a decrease in bcl-2
      expression. Patients with acute viral infections such as infectious mononucleosis
      caused by Epstein-Barr virus infections or chickenpox, resulting from varicella
      zoster virus infection, had circulating populations of activated CD45RO+ T cells
      which also showed low bcl-2 expression. In these patients, a significant
      correlation was seen between low bcl-2 expression by activated T cells and their
      apoptosis in culture (r = 0.94, p < 0.001). These results suggest that the
      primary activation of T cells leads to the expansion of a population that is
      destined to perish unless rescued by some extrinsic event. Thus the suicide of
      CD45RO+ T cells could be prevented by the addition of interleukin 2 to the
      culture medium which resulted in a concomitant increase in the bcl-2 expression
      of these cells. Alternatively, apoptosis was also prevented by coculturing the
      activated T lymphocytes with fibroblasts, which maintained the viability of
      lymphoid cells in a restinglike state but with low bcl-2 expression. The paradox
      that the CD45RO+ population contains the primed/memory T cell pool yet expresses
      low bcl-2 and is susceptible to apoptosis can be reconciled by the observations
      that maintenance of T cell memory may be dependent on the continuous
      restimulation of T cells, which increases their bcl-2 expression. Furthermore,
      the propensity of CD45RO+ T cells to extravasate may facilitate encounter with
      fibroblast-like cells in tissue stroma and thus be an important additional factor
      which promotes the survival of selected primed/memory T cells in vivo.

PMID- 8340753
TI  - PECAM-1 is required for transendothelial migration of leukocytes.
AB  - Platelet/endothelial cell adhesion molecule 1 (PECAM-1; CD31) is crucial to the
      process of leukocyte transmigration through intercellular junctions of vascular
      endothelial cells. A monoclonal antibody to PECAM, or recombinant soluble PECAM,
      blocks transendothelial migration of monocytes by 70-90%. Pretreating either the
      monocytes or the endothelial junctions with antibody blocks transmigration. If
      the endothelium is first activated by cytokines, anti-PECAM antibody or soluble
      recombinant PECAM again block transmigration of both monocytes and neutrophils.
      Anti-PECAM does not block chemotaxis of either cell type. Light and electron
      microscopy reveal that leukocytes blocked in transmigration remain tightly bound
      to the apical surface of the endothelial cell, precisely over the intercellular
      junction. Thus, the process of leukocyte emigration can be dissected into three
      successive stages: rolling, mediated by the selectin class of adhesion molecules;
      tight adhesion, mediated by the leukocyte integrins and their endothelial cell
      counter-receptors; and now transmigration, which, based on these studies,
      requires PECAM-1.

PMID- 8340754
TI  - A complex of glycoproteins is associated with VpreB/lambda 5 surrogate light
      chain on the surface of mu heavy chain-negative early precursor B cell lines.
AB  - Monoclonal antibodies (mAbs) have been made specific for the pre-B cell-specific
      proteins VpreB and lambda 5 which together form the surrogate light (L) chain.
      mAbs specific for VpreB protein identified the 16-kD molecule associated on
      precursor B cell lines with lambda 5 protein as the product of the VpreB gene.
      Surrogate L chain was detectable even in the absence of mu heavy (H) chain on the
      surface of early precursor cell lines such as pro-B cell lines where all
      immunoglobulin (Ig) loci are in the germline configuration, as well as early pre
      B cell lines where Ig H chain loci are DHJH rearranged in reading frame I or III,
      which does not allow the expression of a DHJHC mu protein. A complex of
      glycoproteins (200, 130, 105, and 65-35 kD) was identified as coprecipitated with
      the Vpreb/lamba 5 surrogate L chain in mu H chain-negative precursor B cell
      lines. The 130-kD protein was most strongly labeled with iodine and most
      consistently detected in noncovalent association with surrogate L chain. This
      protein turned out to be a N-linked glycoprotein with a 100-kD protein core and
      isoelectric point 5.8, indicating that it is distinct from CD43 and the BP-1/6C3
      antigen. The surface deposition of the surrogate L chain in association with the
      newly identified glycoproteins suggests that the surrogate L chain may function
      as a receptor even before the association with mu H chain in early precursor B
      cells.

PMID- 8340755
TI  - The tyrosinase gene codes for an antigen recognized by autologous cytolytic T
      lymphocytes on HLA-A2 melanomas.
AB  - Lymphocytes of melanoma patients can be restimulated in vitro with autologous
      tumor cells to generate antitumor cytolytic T lymphocytes (CTL). Previous reports
      have indicated that, when such CTL are obtained from HLA-A2 melanoma patients,
      they often display broad reactivity on A2 melanoma cell lines. Such antitumor CTL
      clones, which appeared to recognize the same antigen, were isolated from two
      patients. We report here the cloning of a cDNA that directs the expression of the
      antigen recognized by these CTL. This cDNA corresponds to the transcript of the
      tyrosinase gene. The gene was found to be active in all tested melanoma samples
      and in most melanoma cell lines. Among normal cells, only melanocytes appear to
      express the gene. The tyrosinase antigen presented by HLA-A2 may therefore
      constitute a useful target for specific immunotherapy of melanoma. But possible
      adverse effects of antityrosinase immunization, such as the destruction of normal
      melanocytes and its consequences, will have to be examined before clinical pilot
      studies can be undertaken.

PMID- 8340756
TI  - CD44 is necessary for optimal contact allergic responses but is not required for
      normal leukocyte extravasation.
AB  - The in vivo administration of certain monoclonal antibodies (mAbs) against the
      adhesion receptor, CD44, into normal mice induces both a modulation of CD44 from
      the surface of peripheral lymphocytes, and a concomitant increase in the amount
      of soluble CD44 in the serum. CD44-negative lymphocytes isolated from anti-CD44
      treated mice exhibit normal homing patterns upon adoptive transfer, and are
      capable of reexpressing CD44 upon activation. The treatment of haptensensitized
      mice with anti-CD44 mAb inhibits their ability to mount a cutaneous delayed-type
      hypersensitivity (DTH) response within the first 24 h after hapten challenge.
      This inhibition reflects a block in both the edema and leukocyte infiltration of
      the cutaneous site of DTH, whereas the extravasation and accumulation of
      leukocytes in the draining lymph nodes progress normally. After 72 h, the
      leukocytes that extravasate into the site of antigen challenge express CD44.
      These results indicate that CD44 is not necessary for normal leukocyte
      circulation but is required for leukocyte extravasation into an inflammatory site
      involving nonlymphoid tissue.

PMID- 8340757
TI  - Human cord blood cells as targets for gene transfer: potential use in genetic
      therapies of severe combined immunodeficiency disease.
AB  - Human cord blood (CB) contains large numbers of both committed and primitive
      hematopoietic progenitor cells and has been shown to have the capacity to
      reconstitute the lympho-hematopoietic system in transplant protocols. To
      investigate the potential usefulness of CB stem and progenitor cell populations
      to deliver new genetic material into the blood and immune systems, we have
      transduced these cells using retroviral technology and compared the efficiency of
      gene transfer into CB cells with normal adult human bone marrow cells using a
      variety of infection protocols. Using two retroviral vectors which differ
      significantly in both recombinant viral titers and vector design, low density CB
      or adult bone marrow (ABM) cells were infected, and committed progenitor and more
      primitive hematopoietic cells were analyzed for gene expression by G418 drug
      resistance (G418r) of neophosphotransferase and protein analysis for murine
      adenosine deaminase (mADA). Standard methylcellulose progenitor assays were used
      to quantitate transduction efficiency of committed progenitor cells, and the long
      term culture-initiating cell (LTC-IC) assay was used to quantitate transduction
      efficiency of more primitive cells. Our results indicate that CB cells were more
      efficiently transduced via retroviral-mediated gene transfer as compared with ABM
      derived cells. In addition, stable expression of the introduced gene sequences,
      including the ADA cDNA, was demonstrated in the progeny of infected LTC-ICs after
      5 wk in long-term marrow cultures. Expression of the introduced ADA cDNA was
      higher than the endogenous human ADA gene in the LTC-IC-derived colonies
      examined. These studies demonstrate that CB progenitor and stem cells can be
      efficiently infected using retroviral vectors and suggest that CB cells may
      provide a suitable target population in gene transfer protocols for some genetic
      diseases.

PMID- 8340758
TI  - Molecular cloning, expression, and chromosomal localization of the human earliest
      lymphocyte activation antigen AIM/CD69, a new member of the C-type animal lectin
      superfamily of signal-transmitting receptors.
AB  - The activation of T lymphocytes, both in vivo and in vitro, induces the
      expression of CD69. This molecule, which appears to be the earliest inducible
      cell surface glycoprotein acquired during lymphoid activation, is involved in
      lymphocyte proliferation and functions as a signal transmitting receptor in
      lymphocytes, natural killer (NK) cells, and platelets. To determine the
      structural basis for CD69 function, the cDNA coding for CD69 was isolated by a
      polymerase chain reaction-based strategy using oligonucleotides deduced from
      peptide sequences of the purified protein. The isolated cDNA exhibited a single
      open reading frame of 597 bp coding for CD69, and predicted a 199-amino acid
      protein of type II membrane topology, with extracellular (COOH-terminal),
      transmembrane, and intracellular domains. The CD69 clone hybridized to a 1.7-kb
      mRNA species, which was rapidly induced and degraded after lymphocyte
      stimulation, consistent with the presence of rapid degradation signals at the 3'
      untranslated region. Transient expression of the polypeptide encoded by CD69 cDNA
      in COS-7 cells demonstrated that it presented properties comparable to native
      CD69 protein. The CD69 gene was regionally mapped to chromosome 12 p13-p12 by
      both somatic cell hybrid DNA analysis and fluorescence in situ hybridization
      coupled with GTG banding (G bands by trypsin using Giemsa). Protein sequence
      homology search revealed that CD69 is a new member of the Ca(2+)-dependent (C
      type) lectin superfamily of type II transmembrane receptors, which includes the
      human NKG2, the rat NKR-P1, and the mouse NKR-P1 families of NK cell-specific
      genes. CD69 also has a structural homology with other type II lectin cell surface
      receptors, such as the T cell antigen Ly49, the low avidity immunoglobulin E
      receptor (CD23), and the hepatic asialoglycoprotein receptors. The CD69 protein
      also shares functional characteristics with most members of this superfamily,
      which act as transmembrane signaling receptors in early phases of cellular
      activation.

PMID- 8340759
TI  - P58 molecules as putative receptors for major histocompatibility complex (MHC)
      class I molecules in human natural killer (NK) cells. Anti-p58 antibodies
      reconstitute lysis of MHC class I-protected cells in NK clones displaying
      different specificities.
AB  - Human CD3-16+56+ natural killer (NK) cells have been shown to display a clonally
      distributed ability to recognize major histocompatibility complex (MHC) class I
      alleles. Opposite to T lymphocytes, in NK cells, specific recognition of MHC
      class I molecules appears to induce inhibition of cytolytic activity and, thus,
      to protect target cells. Since a precise correlation has been established between
      the expression of the NK-specific GL183 and EB6 surface molecules (belonging to
      the novel p58 molecular family) and the specificity of NK clones, we analyzed
      whether p58 molecules could function as receptors for MHC in human NK cells. NK
      clones displaying the previously defined "specificity 2" and characterized by the
      GL183+EB6+ phenotype, specifically recognize the Cw3 allele and thus fail to lyse
      the Fc gamma R+ P815 target cells transfected with Cw3. On the other hand, NK
      clones displaying "specificity 1" and expressing the GL183-EB6+ phenotype failed
      to lyse Cw4+ target cells. Addition of the F(ab')2 fragments of either GL183 or
      EB6 mAb as well as the XA141 mAb of IgM isotype (specific for the EB6 molecules)
      completely restored the lysis of Cw3-transfected P815 cells by the Cw3-specific
      NK clones EX2 and EX4. Similarly, both the entire EB6 mAb, its F(ab')2 fragment
      and the XA141 mAb reconstituted the lysis of C1R, a Fc gamma R- target cell
      expressing Cw4 as the only serologically detected class I antigen. Thus, it
      appears that masking of different members of p58 molecules prevents recognition
      of "protective" MHC class I alleles and thus the delivering of inhibitory
      signals. Further support to the concept that p58 molecules represent a NK
      receptor delivering a negative signal was provided by experiments in which the
      entire anti-p58 mAbs (of IgG isotype) could inhibit the lysis of unprotected Fc
      gamma R+ P815 target cells, thus mimicking the inhibitory effect of MHC class I
      molecules.

PMID- 8340760
TI  - Small amounts of superantigen, when presented on dendritic cells, are sufficient
      to initiate T cell responses.
AB  - Dendritic cells are potent antigen-presenting cells for several primary immune
      responses and therefore provide an opportunity for evaluating the amounts of cell
      associated antigens that are required for inducing T cell-mediated immunity.
      Because dendritic cells express very high levels of major histocompatibility
      complex (MHC) class II products, it has been assumed that high levels of ligands
      bound to MHC products ("signal one") are needed to stimulate quiescent T cells.
      Here we describe quantitative aspects underlying the stimulation of human blood T
      cells by a bacterial superantigen, staphylococcal enterotoxin A (SEA). The
      advantages of superantigens for quantitative studies of signal one are that these
      ligands: (a) engage MHC class II and the T cell receptor but do not require
      processing; (b) are efficiently presented to large numbers of quiescent T cells;
      and (c) can be pulsed onto dendritic cells before their application to T cells.
      Thus one can relate amounts of dendritic cell-associated SEA to subsequent
      lymphocyte stimulation. Using radioiodinated SEA, we noted that dendritic cells
      can bind 30-200 times more superantigen than B cells and monocytes. Nevertheless,
      this high SEA binding does not underlie the strong potency of dendritic cells to
      present antigen to T cells. Dendritic cells can sensitize quiescent T cells,
      isolated using monoclonals to appropriate CD45R epitopes, after a pulse of SEA
      that occupies a maximum of 0.1% of surface MHC class II molecules. This
      corresponds to an average of 2,000 molecules per dendritic cell. At these low
      doses of bound SEA, monoclonal antibodies to CD3, CD4, and CD28 almost completely
      block T cell proliferation. In addition to suggesting new roles for MHC class II
      on dendritic cells, especially the capture and retention of ligands at low
      external concentrations, the data reveal that primary T cells can generate a
      response to exceptionally low levels of signal one as long as these are delivered
      on dendritic cells.

PMID- 8340761
TI  - Structural features of human immunoglobulin G that determine isotype-specific
      differences in complement activation.
AB  - Although very similar in sequence, the four subclasses of human immunoglobulin G
      (IgG) differ markedly in their ability to activate complement. Glu318-Lys320
      Lys322 has been identified as a key binding motif for the first component of
      complement, C1q, and is present in all isotypes of Ig capable of activating
      complement. This motif, however, is present in all subclasses of human IgG,
      including those that show little (IgG2) or even no (IgG4) complement activity.
      Using point mutants of chimeric antibodies, we have identified specific residues
      responsible for the differing ability of the IgG subclasses to fix complement. In
      particular, we show that Ser at position 331 in gamma 4 is critical for
      determining the inability of that isotype to bind C1q and activate complement.
      Additionally, we provide further evidence that levels of C1q binding do not
      necessarily correlate with levels of complement activity, and that C1q binding
      alone is not sufficient for complement activation.

PMID- 8340762
TI  - Anhydroretinol: a naturally occurring inhibitor of lymphocyte physiology.
AB  - Vitamin A (retinol) is an essential cofactor for growth of B lymphocytes in
      culture and for activation of T lymphocytes by antigen receptor-mediated signals.
      14-hydroxy-4,14-retro-retinol (14-HRR) a metabolite of retinol, has been
      implicated as the intracellular mediator of this effect. Anhydroretinol (AR) is a
      retinol derivative with retro structure produced in activated human B lymphocytes
      and the insect cell lines SF 21 and Schneider S2. AR reversibly inhibits retinol-
      and 14-HRR-dependent effects and blocks B lymphocyte proliferation as well as
      activation of resting T lymphocytes. The intracellular signaling pathway blocked
      by AR in T cell activation is distinct from the calcineurin/interleukin 2 pathway
      inhibitable by cyclosporine A or FK-506.

PMID- 8340763
TI  - Cell surface expression and function of an HLA class II molecule with class I
      domain configuration.
AB  - Recombinant major histocompatibility complex (MHC) class II molecules were
      expressed with extracellular polypeptide domains reorganized to form heavy (H)
      and light (L) chains (alpha 1-beta 1-beta 2 and alpha 2) analogous to class I.
      Accurate protein folding and dimerization is demonstrated by the ability of this
      3+1-DR1 construct to bind class II-restricted peptides and stimulate CD4+ T
      cells. Cell surface expression of a functional class II molecule consisting of H
      and L chains supports the validity of current class II models and affirms the
      evolutionary relatedness of class I/II. MHC functions that differ between class
      I/II may be influenced by domain configuration, and the use of domain-shifted
      constructs will allow examination of this possibility.

PMID- 8340764
TI  - Protection against antigenically variable Borrelia burgdorferi conferred by
      recombinant vaccines.
AB  - Due to local variation in the antigenicity of the agent of Lyme disease (Borrelia
      burgdorferi), a vaccine derived from any one isolate of this spirochete may fail
      to protect against the heterogeneous population of organisms that may be present
      in an enzootic focus. Accordingly, we determined whether antigenically variable
      spirochetes delivered by naturally infected ticks, collected from a site where
      transmission is intense, may fail to infect mice actively immunized with
      recombinant glutathione transferase outer surface fusion proteins A or B (OspA
      and OspB). Virtually all mice vaccinated by either immunogen appeared not to
      become infected, as determined by culture or histopathology of their tissues. We
      conclude that Osp vaccination of mice effectively prevents infection by the agent
      of Lyme disease in a simulated natural cycle of transmission.

PMID- 8340765
TI  - Identification of an extracellular plasmin binding protein from nephritogenic
      streptococci.
AB  - Examination of the extracellular products of nephritis(+) and nephritis(-) group
      A streptococci revealed the presence of a 46-kD protein secreted by nephritogenic
      strains that binds to human plasmin. Immunological data revealed that this
      protein, called nephritis plasmin binding protein (NPBP), is not related to group
      A streptokinase nor to a recently described streptococcal dehydrogenase protein.
      The binding of human plasmin to this protein can be blocked by epsilon-amino
      caproic acid, indicating the importance of lysine groups in the binding process.
      Mutanolysin extracts of cell walls from these nephritogenic strains probed with
      anti-NPBP antibody were negative for cell wall-bound NPBP. Serological data with
      acute poststreptococcal glomerulonephritis (APSGN) and acute rheumatic fever sera
      indicated that the protein reacts preferentially with APSGN sera. Amino acid
      sequence analysis and immunological reactivity suggest NPBP is the streptococcal
      pyrogenic exotoxin B precursor, also previously described as zymogen
      (streptococcal proteinase precursor). The secretion of both group A streptokinase
      and a secreted plasmin binding protein in the same nephritogenic strain raises an
      intriguing hypothesis of the mechanisms of action of this protein in APSGN.

PMID- 8340766
TI  - Spatial guidance of choice behavior in the radial-arm maze.
AB  - In 6 experiments, the performance of male rats in a 12-arm radial maze was
      examined. The focus of study was the extent to which the spatial location of
      individual baited maze arms was determined before the rat was exposed to the
      extramaze visual cues corresponding to the arm, and thereby guided the rat toward
      the location of baited arms. Such spatial guidance of choice behavior implies a
      spatially organized cognitive representation of maze arms (i.e., a cognitive
      map). A higher level of spatial guidance was found when visual access to
      extramaze cues was restricted than when it was unrestricted. There was no
      evidence of a difference between the level of spatial guidance in the context of
      working memory performance and reference memory performance. Some evidence that
      intramaze cues contributed to microchoice guidance was found. However, spatial
      guidance, under at least some conditions, is best explained in terms of cognitive
      mapping.

PMID- 8340767
TI  - Local time horizons in Pavlovian learning.
AB  - Responding to a conditioned stimulus (CS) is impaired if the CS is trained in the
      presence of excitatory local context cues. Four lick suppression experiments with
      rats explored whether this local context effect arises from the influence of
      excitatory cues that precede or that follow a reinforced target CS. Pretrained
      nontarget stimuli served as local context cues that occurred (a) immediately
      before and after the target CS trial, (b) immediately before or after the target
      CS trial, or (c) only before or after the target CS trial with varying intervals
      between the nontarget stimulus and target CS. Results indicated similar control
      over responding to the target CS by the preceding and following nontarget cues.
      This outcome implies a symmetrical window of memory integration (local time
      horizon) for a Pavlovian CS. Possible mechanisms underlying the detrimental
      effect of embedding a CS in an excitatory local context are discussed.

PMID- 8340768
TI  - Extending continuous versus discontinuous conditioned stimuli before versus after
      unconditioned stimuli.
AB  - Conditioned suppression was used with rats to study the effects of extending
      conditioned stimuli (CSs) before versus after the delivery of unconditioned
      stimuli. These extensions are termed B and A extensions, respectively. Within
      group designs were used to compare the effects of extending CSs when 2-min parts
      of those CSs were separated by temporal gaps of 6 min versus a separation of no
      gap. The results were as follows: (a) B extensions weakened conditioning more
      than did A extensions, with or without gaps; (b) under some conditions, this
      asymmetrical effect persisted with extended training; (c) gaps between 2-min
      parts of a B extension had no detectable effect; and (d) under some parameter
      values, gaps between 2-min parts of an A extension weakened conditioning
      significantly. These results are better predicted by the Sometimes Opponent
      Process model (SOP; A. R. Wagner, 1981) than by the Rescorla-Wagner-Frey-Sears
      real-time model (J. J. B. Ayres, M. Albert, & J. C. Bombace, 1987).

PMID- 8340769
TI  - Real-time processing of serial stimuli in classical conditioning of the rabbit's
      nictitating membrane response.
AB  - Real-time models contend that a conditioned stimulus (CS) gives rise to a cascade
      of hypothetical stimuli that govern conditioned responses (CRs) on a moment-by
      moment basis. Experiments with the rabbit nictitating membrane response
      successfully extended these models to external stimuli. CSs were trained in
      sequence with an unconditioned stimulus (CSA-CSB-US). When the CSA-CSB interval
      was shortened, the CR was compressed; when the CSA-CSB interval was lengthened,
      the CR was broadened. Peaks appeared at 2 places, namely, 1 following CSA by a
      period equal to its CS-US interval and another following CSB by its CS-US
      interval. Outside the sequence, the individual CSs evoked CRs located between
      their respective CS-US intervals. When, however, the 2 CSs were trained
      separately, the CRs were appropriate to their respective CS-US intervals when
      tested alone or in sequence. The results are discussed in terms of the J.E.
      Desmond and J.W. Moore (1988) and S. Grossberg and N.A. Schmajuk (1989) models.

PMID- 8340770
TI  - Single-incentive selective associations produced solely as a function of compound
      stimulus conditioning context.
AB  - Barpressing was maintained in a tone-plus-light (TL) condition in 2 groups of
      rats by shock-related contingencies and in 2 other groups by food-related
      contingencies. Responding ceased in TL absence (TL). Contingency arrangements
      made TL hedonically positive, relative to TL, for 1 shock group and for 1 food
      group and hedonically negative for 1 shock group and for 1 food group. In a
      stimulus-element test, the visual modality was dominant when TL was hedonically
      positive, whereas auditory control increased when TL was negative, irrespective
      of the reinforcers involved. Within-incentive contingency manipulations produced
      selective associations hitherto ascribed to stimulus-reinforcer interactions,
      suggesting that biological constraints on learning may operate at the level of
      conditioned psychological states.

PMID- 8340771
TI  - Cost-effectiveness of alcohol and drug treatment programs.

PMID- 8340772
TI  - The health-care revolution begins at home.

PMID- 8340773
TI  - While we're at it....

PMID- 8340774
TI  - Kyrle's disease. Effectively treated with isotretinoin.
AB  - Kyrle's disease is an uncommon dermatologic entity with characteristic clinical
      and histopathologic features. A case is recorded in a 63-year-old man undergoing
      hemodialysis for chronic renal failure. Systemic isotretinoin treatment for 13
      weeks resulted in a complete clearance of the cutaneous lesions. Systemic
      treatment is effective and could be considered preferred therapy.

PMID- 8340775
TI  - Clinical privileges for laparoscopic surgery.
AB  - Laparoscopic cholecystectomy has undergone an explosive growth. Its benefits to
      patients--shortened recovery time and less pain--became immediately obvious. The
      procedure's development and adaptation have largely been devised and implemented
      by ingenious and creative private practitioners, not the typical mode of
      introduction. Most or many new procedures in the past evolved from academic
      institutions after laboratory and then clinical trials. With rapid development
      and acceptance has come an additional new burden among medical practitioners:
      credentialing and granting clinical privileges.

PMID- 8340776
TI  - Benlate. A medical and scientific controversy.
AB  - Benlate, a fungicide, has been used for over 20 years in Florida to treat
      agricultural crops and ornamentals. In the past few years, there have been
      reports of crop damage and health effects from exposure. Physicians should be
      aware of research findings regarding these effects.

PMID- 8340777
TI  - The future ain't what it used to be.

PMID- 8340778
TI  - Stress and infections.
AB  - Neurotransmitters and neuroendocrine hormones can modify the functioning of
      immune cells and conversely cytokines produced by immune cells can alter brain
      homeostasis. This connection is further manifested by experimental studies
      showing a relationship between stress and resistance to infection. Human subjects
      with a high stress index were shown to be more susceptible to infection with
      common cold viruses. Furthermore, a diversity of experimental animal paradigms
      show that laboratory stressors such as forced exercise, avoidance learning,
      restraint, isolation, and cold exposure make animals more susceptible to primary
      infection with a variety of viruses and bacteria. The cellular and molecular
      basis for the observed modulation of host resistance is not fully understood but
      involves altered functioning of both T lymphocytes and cells of the hypothalamic
      pituitary adrenal axis. Also involved is the altered production of cytokines and
      hormones produced by the immune system and brain.

PMID- 8340779
TI  - Applying for medical staff membership. Peer review. Part I.

PMID- 8340780
TI  - And justice for all.

PMID- 8340781
TI  - In remembrance Anton Mark Krone, M.D.

PMID- 8340782
TI  - Access, cost and quality.

PMID- 8340783
TI  - The activity-stress paradigm: possible mechanisms and applications.
AB  - The mechanisms and applications of the activity-stress (A-S) research paradigm
      are examined in this article. Past research has reflected the value of this
      paradigm in the investigation of ulcerogenesis. Evidence is offered to support a
      theory explaining the excessive running observed in the A-S animals, according to
      which, animals commence running to increase body temperature after failing to
      adapt to the restricted feeding regime. Further, excessive running levels are
      hypothesized to be sustained by reinforcement resulting from increased mesolimbic
      dopaminergic activity. Finally, parallels between the behavior observed in the A
      S animals and some forms of maladaptive behavior observed in humans are
      discussed.

PMID- 8340784
TI  - Psychological studies in nonionizing electromagnetic energy research.
AB  - Research on nonionizing electromagnetic (NIEM) energy has focused on potential
      hazards, and to a lesser degree beneficial applications, of radiofrequency (RF)
      fields and extremely low frequency (ELF) fields. The history of research on the
      potential biological effects of NIEM contains many psychological investigations.
      These psychological investigations were conducted primarily in the discipline of
      biopsychology and included interdisciplinary cooperation with engineering,
      physical sciences, and other disciplines not routinely associated with
      psychology. The current recommended exposure level for RF is based on behavioral
      observations of laboratory animals. Psychology has been and continues to be in
      the midst of controversy regarding the ability of low-frequency, low-level
      electromagnetic energy or electric and magnetic fields to affect living
      organisms.

PMID- 8340785
TI  - The effects of chronic prenatal exposure to nicotine on the behavior of guinea
      pigs (Cavia porcellus).
AB  - Three groups of 15 offspring from guinea pig dams were injected twice daily
      throughout gestation with one of three doses (0.5, 1.5 or 2.5 mg/kg) of nicotine
      hydrogen tartrate. These offspring and 15 saline-exposed offspring were tested on
      several behavioral measures. Offspring of nicotine-treated dams had significantly
      lower rates of spontaneous alternation as neonates. The 1.5 and 2.5 mg/kg
      nicotine-exposed offspring also alternated less at puberty than control offspring
      and would not enter an unfamiliar stimulus alley that a majority of controls
      entered. Nicotine offspring, as adults, performed significantly poorer than their
      controls on errors and trials to criterion on a discrimination and reversal task.
      Prenatal nicotine treatment resulted in performance deficits on both learned and
      innate behavioral measures throughout development and adulthood.

PMID- 8340786
TI  - Keeping an eye on the brain: the role of visual experience in monkeys and
      children.
AB  - The quality of visual experience during infancy determines the functional
      sensitivity and precision of the mature primate visual system. Infant monkeys
      subjected to monocular form deprivation show a period of critical visual
      development that, though decreasing in sensitivity, lasts throughout the first 2
      years of life. Photopic threshold spectral sensitivity appears to have a briefer
      critical period, which is essentially complete by 6 months old, whereas scotopic
      visual functions appear well developed by 3 months old. Binocular visual
      functions seem to have the longest period of sensitivity to abnormal visual
      experience because periods of monocular form deprivation initiated during the
      first 2 years affect visual functions. Viewing the world through prisms, which
      mimics the condition of strabismus, causes a permanent loss of cortical binocular
      cells and stereopsis in monkeys. This result explains stereoblindness in children
      having equivalent clinical histories.

PMID- 8340787
TI  - A note on the early history of electrical stimulation of the human brain.
AB  - We address inconsistencies in two areas concerning who was first to electrically
      stimulate a human's brain. First, Boring (1950) and others attributed priority to
      Eduard Hitzig based on information mentioned somewhat incidentally in Fritsch and
      Hitzig's (1870) classic work using dogs. Others cited Fritsch and Hitzig but
      attributed priority to Roberts Bartholow (1874). Second, our examination of
      translations of Fritsch and Hitzig, especially of footnote 16 in Hitzig's report
      (1870) of a human case, revealed errors, omissions, and inconsistencies. To aid
      our inquiry, we requested and received new translations of footnote 16 and of
      Hitzig's report.

PMID- 8340788
TI  - Multiple sclerosis: does epidemiology contribute to providing etiological clues?
AB  - The epidemiological approach has undoubtedly contributed to our knowledge of
      Multiple Sclerosis (MS) by providing some etiological hypotheses in spite of the
      fact that a definitive basis for the conclusive resolution of its enigma is still
      lacking. Epidemiological studies have indicated that MS has an uneven
      geographical distribution and a changing incidence over time at least in several
      areas of the world: this suggests an etiological role of both genetic and
      environmental factors. The racial difference in disease risk, the results of
      familial and twin studies as well as the association between MS and some HLA
      markers, support the great importance of genetic factors. On the other hand, the
      evidence of temporal trends and the data from migrant studies seem to underline
      the etiological contribution of environmental factors. In the light of these
      results much of the present views have emerged interpreting the disease as caused
      by multiple factors acting at a susceptible age in genetically predisposed
      subjects.

PMID- 8340789
TI  - Generation of effector cytotoxic T cells from cytotoxic T cell precursors: role
      of soluble factors.
AB  - Cytotoxic T lymphocytes (CTL) have long been recognized as playing a major role
      in the immune response to alloantigens and viral antigens as well as tumor
      antigens. The progress of the last decade in the identification and
      characterization of soluble factors involved in the regulation of the immune
      response has greatly improved our knowledge of the mechanisms of CTL activation
      and regulation. This review will summarize the data available in the literature
      regarding different lymphokines and their specific activity on CTL. In addition
      it will point out a few of the elements of the systems that hamper its full
      understanding and it will suggest possible directions for future research.

PMID- 8340790
TI  - Multiple sclerosis: from immunogenetics to immunotherapy.

PMID- 8340791
TI  - Memory and "frontal lobe" dysfunction in multiple sclerosis.
AB  - The characteristics of memory disturbance in multiple sclerosis (MS) are briefly
      reviewed and the interactions of conceptual and memory dysfunction in MS are
      considered. Although conceptual functions such as abstraction and problem solving
      traditionally have been considered to be frontal lobe functions, there is now
      convincing evidence from studies of patients with focal brain lesions that these
      capacities are not localized to the frontal lobes. Thus, the concept of frontal
      lobe dysfunction in MS is without empirical support. Nevertheless, studies
      examining the relationship between memory and conceptual impairment in MS have
      value for both basic and clinical neuroscience.

PMID- 8340792
TI  - Frontal lobe dysfunction in multiple sclerosis as assessed by means of Lurian
      tasks: effect of age at onset.
AB  - We investigated frontal cognitive function in a group of 153 patients with
      multiple sclerosis and 100 healthy controls using a global scale composed by a
      set of items from the Luria-Nebraska Neuropsychological Battery (LNNB) which has
      been validated by Malloy and colleagues on frontally damaged patients. A second
      scale was built with LNNB items tapping parietal lobes function. Patients who
      were specifically impaired on the frontal scale (12%) had a shorter disease
      duration and were less physically disabled than those failing on the parietal
      tasks (8.5%) or those showing combined deficits (21.5%). Sixty-four patients were
      also tested on the Wisconsin Card Sorting Test (WCST). Twenty-seven (37.5%)
      patients were found to be impaired on the WCST, but the latter could not predict
      reliably their performance on the LNNB frontal scale. We also examined whether
      age of onset and disease duration could have had any effect on the cognitive
      performance of selected groups of patients. We found that relative to normals,
      deficits on the frontal scale were more severe in patients with a clinical onset
      around age 20 than in patients with a later onset (i.e., around 35), the two
      groups being comparable for duration and degree of disability. Furthermore,
      patients with a longstanding illness (> 10 years) were more affected on
      visuospatial processing and frontal control of language than those with a short
      duration (1.5 yrs). We propose that a greater disease activity interacting with
      contingent (developmental?) factors is responsible for the appearance of
      transient frontal deficits in several young MS patients.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8340793
TI  - Neuropsychology and multiple sclerosis: diagnostic and rehabilitative approaches.
AB  - The frequency of cognitive deficits in multiple sclerosis (MS) patients is rather
      high and the estimates vary between 43% and 72% depending on the patient samples
      studied as well as on the methods of cognitive assessment. Despite the great
      impact of cognitive dysfunction on several aspects of the quality of life, the
      importance of accurate assessment and rehabilitation of neuropsychological
      deficits in MS patients has long been ignored. In this article, we first describe
      tests for the assessment of impairments, disabilities and handicaps. We emphasize
      that after screening with brief assessment instruments, detailed testing of the
      basic target deficits is mandatory for the planning of special cognitive training
      programs. Second, the correlation of certain cognitive deficit patterns with
      important magnetic resonance imaging (MRI) variables such as total lesion area,
      size of the corpus callosum and specific lesion location is outlined in detail.
      Third, some recommendations are made with regard to general rehabilitation
      principles such as restitution, compensation and adaptation as well as for
      special rehabilitation techniques including cognitive retraining of basic
      deficits and/or training of activities of daily living. Finally, we emphasize
      that there is a need for the development of tailor-made neuropsychological
      rehabilitation techniques for MS patients, which take into account the course and
      stage of the disease as well as the specific psychosocial problems of the
      individual patient.

PMID- 8340794
TI  - Anatomical and functional correlates of cognitive deficit in multiple sclerosis.
AB  - This brief article reviews the present state of knowledge concerning the
      relationship between structural and functional cerebral abnormalities and the
      cognitive deficits associated with multiple sclerosis. Currently available
      neuroimaging techniques have substantially contributed to a better understanding
      of the latter, suggesting that cortical-subcortical disconnection is the most
      likely cause of the cognitive disturbance. Longitudinal studies are needed to
      determine the natural history of the cognitive deficit and its relationship to
      the cerebral changes detected by neuroimaging techniques.

PMID- 8340795
TI  - MRI and cognitive patterns in relapsing-remitting multiple sclerosis.
AB  - We studied the relationships between magnetic resonance imaging (MRI) and the
      Luria-Nebraska Neuropsychological Battery (LNNB) in 64 patients with relapsing
      remitting multiple sclerosis (MS). MRI films were scored according to arbitrary
      descriptive criteria designed to emphasize patterns of alterations. Five groups
      were created: group 1 and 2 had typical discrete white matter lesions, group 3
      had confluent lesions, group 4 had large discrete lesions and group 5 had only
      few small lesions. In addition, groups 2 and 3 had evidence of parenchymal
      atrophy. Groups 2 and 3 were the most impaired on the LNNB, but none of these
      patients was actually demented. Groups 1 and 5 were globally intact in spite of
      very different mean age and MRI pattern. Group 4 was composed of younger subjects
      with a shorter disease duration; they showed mild loss of attentive and
      abstracting abilities. We suggest that since their MRI was showing greater signs
      of local biological activity their mental deficits may be a transitory condition
      capable of two distinct outcomes: a favorable one as in groups 1 and 5, and a
      slowly progressive one associated with loss of brain tissue as in groups 2 and 3.

PMID- 8340796
TI  - Brain magnetic resonance imaging correlates of cognitive impairment in multiple
      sclerosis.
AB  - We evaluated the correlations between cognitive impairment, clinical and brain
      magnetic resonance imaging (MRI) findings in 100 patients with multiple sclerosis
      (MS). The performance on one or more neuropsychological tests was abnormal in 47%
      of the 64 patients who completed the entire neuropsychological battery; the
      cognitive impairment was mild in 14 (22%) and severe in 16 (25%). Performance on
      any single neuropsychological test was unrelated to clinical parameters (age,
      duration of the disease, disability). The neuropsychological performance of
      relapsing-remitting patients was better than in patients with a chronic
      progressive disease. The mean scores for almost all the neuropsychological tests
      were significantly lower in patients with severe ventricular dilatation and
      corpus callosum atrophy than in patients in whom these structures were little
      affected. Mean scores for WMS, performance Intelligence Quotient (IQ), total IQ
      and Token Test (TT) were also significantly correlated with the widening of
      cortical sulci and total lesional scores. Our data support the contention that
      the involvement of pathways that are critical for a given cognitive process as
      well as the progression of the axonal degeneration and sclerosis seem to play
      important roles in the pathophysiology of cognitive dysfunction in MS.

PMID- 8340797
TI  - Health Status of American Men--a study of post-vasectomy sequelae.

PMID- 8340798
TI  - Community services in the 1990s: are they meeting the needs of caregivers?
AB  - The community-based, long-term care system not only sustains the older person in
      the community but also helps to maintain him or her at the highest level of
      functioning possible. A broad spectrum of services exists, including personal
      care, transportation, home-delivered meals, adult day care, and respite care. One
      hundred sixty-eight primary caregivers were were interviewed regarding awareness
      of, inquiry into, utilization of, and satisfaction with community services during
      the caregiving period. The majority of caregivers were aware of and utilized 7 of
      the 15 services listed, including personal care services, home-delivered meals,
      rehabilitation services, housekeeping services, nursing services, and information
      referral services. Nurses remain the key individuals in providing linkages among
      elderly and their families and community-based services. One of the key roles
      that nurses can play is to inform caregivers about available community services,
      to help caregivers recognize the need for these services, to assist them in
      accessing these services, and to recognize their need for support during this
      process. Finally, the community nurse can also provide support to the caregiver
      when institutionalization of the older family member becomes a reality.

PMID- 8340800
TI  - Client satisfaction with home health care nursing.
AB  - Client satisfaction can serve as an outcome indicator of the quality of nursing
      care received, yet there is a paucity of literature and research describing
      client satisfaction within the home health care arena. This descriptive study
      explores the domain of client satisfaction with home health nursing as assessed
      by the Client Satisfaction Survey (CSS) developed by Reeder and Chen (1990). The
      overall mean response for surveyed clients is 1.6966, indicating satisfaction
      with the nursing services received. Through factor analysis, four factors were
      identified as dimensions of client satisfaction: (a) Technical Quality of Care,
      (b) Communication, (c) Personal Relationships Between Client and Provider, and
      (d) Delivery of Services. This study validates that consumer clients can
      willingly participate in the objective evaluation of the nursing care they
      receive. In addition, the measurement of satisfaction using instruments with
      established reliability and validity can contribute to the advancement of the
      definition of client satisfaction of the home care client.

PMID- 8340799
TI  - An assessment of diabetes self-care barriers in older adults.

PMID- 8340801
TI  - Developing and implementing a community intergenerational program.
AB  - Although intergenerational programs are becoming increasingly popular, there has
      been little documentation linking independent yet isolated seniors with children.
      This article discusses the development and implementation of a community
      intergenerational program. Elementary school students interacted with seniors at
      a nearby senior citizen apartment complex during eight 2-hr after-school
      meetings. Various recruitment strategies were needed to reach this vulnerable
      senior population, and activities had to be carefully monitored to promote
      intergenerational exchange. Evaluation of the program showed both the value of
      such interaction to the students and seniors and the importance of the nurse's
      role in ensuring that the program's benefits were realized.

PMID- 8340802
TI  - Training imperatives for volunteers caring for high-risk, vulnerable populations.
AB  - Today, vulnerable populations expand as the threats of homelessness and
      communicable diseases continue to grow. Volunteers are moved to serve in areas in
      which they may not be well prepared. We identify the caring needs of high-risk,
      vulnerable populations and the needs of volunteers; we also conceptualize,
      develop, implement, and evaluate a training program for volunteers who serve
      homeless persons and families. This training program and the imperatives that
      undergird it are presented as a model applicable to the training of volunteers
      serving high-risk, vulnerable populations.

PMID- 8340803
TI  - Glenridge: a partnership for eldercare.
AB  - Societal trends of rising health care costs and changing elder demographics
      dictate the need for new and innovative approaches to cost-effective health care
      and other services for this age group. As individuals age, their need for
      assistive services increases, and access becomes a priority. Housing models that
      provide an environment which facilitates independent living are very desirable
      and usually cost-containing by postponing and/or preventing institutionalization.
      Through access to health promotion and maintenance services, residents are
      enabled to stay in their preferred home environments as long as possible (Zink &
      Bissonnette, 1990, p. 70). A major obstacle to these models is a clear definition
      of the elder population's needs and a coordinated effort to meet these needs
      (Little, 1980). An innovative partnership involving nursing education, an area
      agency on aging, and a developer provided a unique opportunity for a school of
      nursing to play a pivotal role in the coordination of health care for "well"
      older adults.

PMID- 8340804
TI  - The retinal fate of Xenopus cleavage stage progenitors is dependent upon
      blastomere position and competence: studies of normal and regulated clones.
AB  - The clonal origin of the stage 43-44 Xenopus retina from cleavage stage
      precursors was quantitatively assessed with lineage tracing techniques. The
      retina descends from a specific subset of those blastomeres that form forebrain.
      The most animal dorsal midline cell (D1.1.1) produced about half of the retina,
      the three other dorsal ipsilateral blastomeres each produce about an eighth of
      the retina, and the four contralateral dorsal blastomeres and an ipsilateral
      ventral-animal cell together produce the remaining eighth of the retina. There
      was no significant spatial segregation of the clones derived from different
      progenitors in either the anterior-posterior or dorsal-ventral axes of the retina
      and no boundaries between clones were observed. Instead, the clones intermixed to
      form multiple radial subclones that were equivalent to those demonstrated by
      marking optic vesicle progenitor cells (Holt et al., 1988; Wetts and Fraser,
      1988). This mosaic pattern was initiated by the beginning of gastrulation,
      advanced in the neural plate, and virtually complete in the optic vesicle. At
      optic vesicle stages cell movement within subclones was restricted, resulting in
      the formation of lineally related columns of cells in the mature retina. To
      determine if the blastomere progenitors are determined to produce these retinal
      lineage patterns, the major retinal progenitor (D1.1.1) was deleted bilaterally.
      About 60% of the tadpoles developed normal-appearing eyes; of these the retinas
      in two-thirds were normal in size and the rest were smaller. The blastomeres
      surrounding the deleted D1.1.1 progenitors changed their contributions to retina
      in different ways to effect a complete or partial restoration. Ventral
      blastomeres, which normally contribute mainly to the tail, produced substantial
      amounts of the retina while dorsal blastomeres, which normally contribute mainly
      to the head, decreased their contribution to the retina. To determine whether
      these changes in retinal lineage were due to changes in blastomere position after
      the surgery, various other blastomeres were deleted prior to lineage mapping.
      Dorsal-animal blastomeres took over the retinal fate of their dorsal-vegetal
      neighbors after those neighbors were deleted, but did not change fate after the
      deletion of their ventral-animal neighbors. This result suggests that dorsal
      animal blastomeres change positional values in only one direction (dorsal to
      vegetal) after neighbor cell deletion, and that retinal fate is dictated by
      blastomere position. To test this hypothesis directly, different ventral and
      vegetal blastomeres, which normally do not produce retina, were transplanted to
      the position of D1.1.1.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8340805
TI  - Targeted ablation of diverse cell classes in the nervous system in vivo.
AB  - The study of both the function and development of complex neural systems would be
      greatly facilitated by a means for systematically blocking intercell
      communication. One way of preventing cells from signaling each other is to remove
      them from the system by ablation. Here we present a general technique for
      visualizing and ablating selected cell classes in vivo. The cells of interest are
      genetically engineered so that they can be selectively labeled with a
      photoactivatable dye and visualized in living preparations; the dye-labeled cells
      can then be photoablated. This approach is applicable to a broad range of cell
      types, in organisms amenable to gene transfer, and permits ablations to be
      performed at different developmental stages or in the adult. We demonstrate the
      use of this technique on several cell types in the mouse retina and cerebral
      cortex, and in the zebrafish embryo.

PMID- 8340806
TI  - A novel slow (< 1 Hz) oscillation of neocortical neurons in vivo: depolarizing
      and hyperpolarizing components.
AB  - We describe a novel slow oscillation in intracellular recordings from cortical
      association areas 5 and 7, motor areas 4 and 6, and visual areas 17 and 18 of
      cats under various anesthetics. The recorded neurons (n = 254) were
      antidromically and orthodromically identified as corticothalamic or callosal
      elements receiving projections from appropriate thalamic nuclei as well as from
      homotopic foci in the contralateral cortex. Two major types of cells were
      recorded: regular-spiking (mainly slow-adapting, but also fast-adapting) neurons
      and intrinsically bursting cells. A group of slowly oscillating neurons (n = 21)
      were intracellularly stained and found to be pyramidal-shaped cells in layers III
      VI, with luxuriant basal dendritic arbors. The slow rhythm appeared in 88% of
      recorded neurons. It consisted of slow depolarizing envelopes (lasting for 0.8
      1.5 sec) with superimposed full action potentials or presumed dendritic spikes,
      followed by long-lasting hyperpolarizations. Such sequences recurred rhythmically
      at less than 1 Hz, with a prevailing oscillation between 0.3 and 0.4 Hz in 67% of
      urethane-anesthetized animals. While in most neurons (approximately 70%) the
      repetitive spikes superimposed on the slow depolarization were completely blocked
      by slight DC hyperpolarization, 30% of cells were found to display relatively
      small (3-12 mV), rapid, all-or-none potentials after obliteration of full action
      potentials. These fast spikes were suppressed in an all-or-none fashion at Vm
      more negative than -90 mV. The depolarizing envelope of the slow rhythm was
      reduced or suppressed at a Vm of -90 to -100 mV and its duration was greatly
      reduced by administration of the NMDA blocker ketamine. In keeping with this
      action, most (56%) neurons recorded in animals under ketamine and nitrous oxide
      or ketamine and xylazine anesthesia displayed the slow oscillation at higher
      frequencies (0.6-1 Hz) than under urethane anesthesia (0.3-0.4 Hz). In 18% of the
      oscillating cells, the slow rhythm mainly consisted of repetitive (15-30 Hz),
      relatively short-lasting (15-25 msec) IPSPs that could be revealed by bringing
      the Vm at more positive values than -70 mV. The long-lasting (approximately 1
      sec) hyperpolarizing phase of the slow oscillation was best observed at the
      resting Vm and was reduced at about -100 mV. Simultaneous recording of another
      cell across the membrane demonstrated synchronous inhibitory periods in both
      neurons. Intracellular diffusion of Cl- or Cs+ reduced the amplitude and/or
      duration of cyclic long-lasting hyperpolaryzations.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8340807
TI  - Intracellular analysis of relations between the slow (< 1 Hz) neocortical
      oscillation and other sleep rhythms of the electroencephalogram.
AB  - The newly described slow cortical rhythm (approximately 0.3 Hz), whose
      depolarizing-hyperpolarizing components are analyzed in the preceding article, is
      now investigated from the standpoint of its relations with delta (1-4 Hz) and
      spindle (7-14 Hz) rhythmicity. Regular-spiking and intrinsically bursting
      cortical neurons were mostly recorded from association suprasylvian areas 5 and
      7; fewer neurons were also recorded from pericruciate motor and posterolateral
      visual areas. Although most cells were investigated under various anesthetics, a
      similar slow cortical rhythm was found in animals with brainstem transection at
      the low- or high-collicular levels. These cerveau isole (isolated forebrain)
      preparations display the major sleep rhythms of the EEG in the absence of general
      anesthetics. In 38% of recorded cortical neurons (n = 105), the slow rhythm was
      combined with delta oscillation. Both cellular rhythms were phase locked to the
      slow and delta oscillations in the surface- and depth-recorded EEG. In a group of
      this cell sample (n = 47), delta activity occurred as stereotyped, clock-like
      action potentials during the interdepolarization lulls of the slow rhythm. In
      another neuronal subsample (n = 58), delta events were grouped in sequences
      superimposed upon the depolarizing envelope of the slow rhythm, with such
      sequences recurring rhythmically at approximately 0.3-0.4 Hz. The associations
      between the two cellular and EEG rhythms (1-4 Hz and 0.3-0.4 Hz) were quantified
      by means of autocorrelograms, cross-correlograms, and spike-triggered averages.
      In 26% of recorded neurons (n = 72), the slow rhythm was combined with spindle
      oscillations. Regular-spiking cortical neurons fully reflected the whole
      frequency range of thalamically generated spindles (7-14 Hz). However, during
      similar patterns of EEG spindling, intrinsically bursting cells fired grouped
      action potentials (with intraburst frequencies of 100-200 Hz) at only 2-4 Hz. The
      dependence of the slow cortical oscillation upon the thalamus was studied by
      lesions and stimulation. The slow rhythm survived extensive ipsilateral thalamic
      destruction by means of electrolytic lesions or kainate-induced loss of perikarya
      in thalamic nuclei that were input sources to the recorded cortical neurons. To
      further prevent the possibility of a thalamic role in the genesis of the slow
      rhythm, through the contralateral thalamocortical systems and callosal
      projections, we also transected the corpus callosum in thalamically lesioned
      animals, and still recorded the slow rhythm in cortical neurons. These data
      indicate that the thalamus is not essentially implicated in the genesis of the
      slow rhythm.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8340808
TI  - The slow (< 1 Hz) oscillation in reticular thalamic and thalamocortical neurons:
      scenario of sleep rhythm generation in interacting thalamic and neocortical
      networks.
AB  - As most afferent axons to the thalamus originate in the cerebral cortex, we
      assumed that the slow (< 1 Hz) cortical oscillation described in the two
      companion articles is reflected in reticular (RE) thalamic and thalamocortical
      cells. We hypothesized that the cortically generated slow rhythm would appear in
      the thalamus in conjunction with delta and spindle oscillations arising from
      intrinsic and network properties of thalamic neurons. Intracellular recordings
      have been obtained in anesthetized cats from RE (n = 51) and cortically
      projecting (n = 240) thalamic neurons. RE cells were physiologically identified
      by cortically evoked high-frequency spike bursts and depolarizing spindle
      oscillations. Thalamocortical cells were recognized by backfiring from
      appropriate neocortical areas, spindle-related cyclic IPSPs, and
      hyperpolarization-activated delta oscillation consisting of rhythmic low
      threshold spikes (LTSs) alternating with afterhyperpolarizing potentials (AHPs).
      The slow rhythm (0.3-0.5 Hz) was recorded in 65% of RE neurons. In approximately
      90% of oscillating cells, the rhythm consisted of prolonged depolarizations
      giving rise to trains of single action potentials. DC hyperpolarization increased
      the synaptic noise and, in a few cells, suppressed the long-lasting depolarizing
      phase of the slow rhythm, without blocking the fast EPSPs. In approximately 10%
      of oscillating neurons, the hyperpolarizing phase of the oscillation was much
      more pronounced, thus suggesting that the slow rhythm was produced by inhibitory
      sculpturing of the background firing. The slow oscillation was associated with
      faster rhythms (4-8 Hz) in the same RE neuron. The slow rhythm of RE neurons was
      closely related to EEG wave complexes recurring with the same frequency, and its
      strong dependency upon a synchronized state of cortical EEG was observed during
      shifts in EEG patterns at different levels of anesthesia. In 44% of
      thalamocortical cells the slow rhythm of depolarizing sequences was apparent and
      it could coexist with delta or spindle oscillations in the same neuron. The
      occurrence of the slowly recurring depolarizing envelopes was delayed by the
      hyperpolarizing spindle sequences or by the LTS-AHP sequences of delta
      oscillation. The hyperpolarization-activated delta potentials that tended to
      dampen after a few cycles were grouped in sequences recurring with the slow
      rhythm. We finally propose a unified scenario of the genesis of the three major
      sleep rhythms: slow, delta, and spindle oscillations.

PMID- 8340809
TI  - Development of segment specificity in identified lineages of the grasshopper CNS.
AB  - The purpose of this study was to determine the factors underlying differences in
      population size and composition between segmentally homologous neuronal lineages.
      The segmental median neuroblasts (MNBs) of grasshoppers are identified stem cells
      that each produce a midline group of neurons. We traced the embryonic development
      of the group in two disparate segments, counting MNB progeny and profiles of
      dying cells in fixed and stained preparations of staged embryos. In the
      metathoracic segment (T3), about 95 MNB progeny survive embryonic development,
      whereas in the next posterior segment, the first abdominal (A1), only about 60
      survive. In T3, the MNB arises at 29% of embryogenesis and dies at 78%, whereas
      in A1 the MNB arises at 30% and dies at 73%. In T3, the number of MNB progeny
      initially increases at a steady rate, 10 cells being added per 5% of
      embryogenesis. Between 70% and 78% growth tapers off; although the T3 MNB
      continues to divide, cells die at the same time, specifically removing last-born
      progeny. By contrast, in A1 the MNB progeny increase in two phases, one from 30%
      to 45% and the other from 60% to 73%, again at the rate of 10 cells per 5%.
      Between the two phases, the number of A1 progeny is stable. The A1 MNB continues
      to divide, but cells die at the same time, specifically removing earlier-born
      progeny. The episodes of cell death in A1 and T3 coincide with embryonic molts,
      and thus may be hormonally triggered. Cell death is greater in A1 than T3,
      accounting for most of the difference in population size. The difference in MNB
      longevity makes a lesser contribution. The present data, together with corollary
      anatomical data (Thompson and Siegler, 1991), support the hypothesis that progeny
      fated to become certain neuronal types are selectively removed from the two MNB
      lineages: intersegmental interneurons from T3 and efferent neurons and local
      interneurons from A1.

PMID- 8340810
TI  - Specific induction of intracellular calcium oscillations by complement membrane
      attack on oligodendroglia.
AB  - Oligodendroglia (ODG) are unique among glial cell types in their capacity to
      activate complement in the absence of antibody, causing insertion of the
      potentially damaging membrane attack complex (MAC) into the plasma membrane.
      Using microfluorimetry of indo-1 fluorescence we have detected a complex
      oscillatory [Ca2+]i response in ODG following exposure to sublethal dilutions of
      serum-derived complement. Oscillations were transitory and preceded complete and
      stable return to resting [Ca2+]i levels, whereas nonoscillating ODG underwent
      rapid lysis. Depletion of the terminal complement component C9 from serum removed
      the oscillatory stimulus, which could be restored by reconstitution with purified
      C9. Exposure to the C9-homologous peptide melittin produced [Ca2+]i oscillations
      similar in pattern to those induced by whole serum. However, this type of
      response could not be reproduced by Ca2+ ionophores or mechanical wounding,
      suggesting that oscillations cannot be provoked by Ca2+ influx alone and depend
      on the presence of the MAC or a pore-forming lesion. Oscillations were not
      prevented in the continuous presence of caffeine, demonstrating independence from
      caffeine-releasable intracellular stores. Inhibition of the endoplasmic reticular
      Ca(2+)-ATPase with thapsigargin produced an abrupt elevation in [Ca2+]i but did
      not alter the latency between exposure to serum and the initial complement
      induced transient. However, the slope of this initial transient was considerably
      reduced and oscillations suppressed, demonstrating dependence of the oscillatory
      mechanism on functional endoplasmic reticular Ca2+ stores. The coincidence of ODG
      recovery with oscillating [Ca2+]i suggests that the complex calcium signal that
      follows MAC attack may stimulate repair or protective mechanisms.

PMID- 8340811
TI  - Inward-rectifying potassium channels in retinal glial (Muller) cells.
AB  - The voltage- and K(+)-dependent properties of Muller cell currents and channels
      were characterized in freshly dissociated salamander Muller cells. In whole-cell
      voltage-clamp experiments, cells with endfeet intact and cells missing endfeet
      both displayed strong inward rectification. The rectification was similar in
      shape in both groups of cells but currents were 9.2 times larger in cells with
      endfeet. Ba2+ at 100 microM reduced the inward current to 6.8% of control
      amplitude. Decreasing external K+ concentration shifted the cell current-voltage
      (I-V) relation in a hyperpolarizing direction and reduced current magnitude. In
      multichannel, cell-attached patch-clamp experiments, patches from both endfoot
      and soma membrane displayed strong inward rectification. Currents were 38 times
      larger in endfoot patches. In single-channel, cell-attached patch-clamp
      experiments, inward-rectifying K+ channels were, in almost all cases, the only
      channels present in patches of endfoot, proximal process, and soma membrane.
      Channel conductance was 27.8 pS in 98 mM external K+. Reducing external K+
      shifted the channel reversal potential in a hyperpolarizing direction and reduced
      channel conductance. Channel open probability varied as a function of voltage,
      being reduced at more negative potentials. Together, these observations
      demonstrate that the principal ion channel in all Muller cell regions is an
      inward-rectifying K+ channel. Channel density is far higher on the cell endfoot
      than in other cell regions. Whole-cell I-V plots of cells bathed in 12, 7, 4, and
      2.5 mM K+ were fit by an equation including Boltzmann relation terms representing
      channel rectification and channel open probability. This equation was
      incorporated into a model of K+ dynamics in the retina to evaluate the
      significance of inward-rectifying channels to the spatial buffering/K+ siphoning
      mechanism of K+ regulation. Compared with ohmic channels, inward-rectifying
      channels increased the rate of K+ clearance from the retina by 23% for a 1 mM K+
      increase and by 137% for a 9.5 mM K+ increase, demonstrating that Muller cell
      inward-rectifying channels enhance K+ regulation in the retina.

PMID- 8340812
TI  - The myomodulin-related neuropeptides: characterization of a gene encoding a
      family of peptide cotransmitters in Aplysia.
AB  - The myomodulin-related peptides comprise a family of cotransmitters that modulate
      neuromuscular signaling in the feeding system of Aplysia. In this study, cDNA
      clones encoding a myomodulin precursor polypeptide were isolated and
      characterized. This precursor contains seven different myomodulin-related
      peptides, one of which, myomodulin A, is present in 10 contiguous copies. The
      sequence of a myomodulin genomic clone indicates that all of these myomodulin
      related peptides are encoded on a single exon. The myomodulin gene is expressed
      in a tissue-specific manner and myomodulin mRNA is localized to specific neurons
      in the Aplysia CNS. The presence of multiple related neuropeptides can greatly
      increase the range and precision of signaling at synapses where they act as
      modulator cotransmitters.

PMID- 8340813
TI  - Modulation of hippocampal acetylcholine release: a potent central action of
      interleukin-2.
AB  - The potential of the T-cell growth factor interleukin-2 (IL-2) to modulate the
      release of ACh from rat hippocampus was studied in vitro, as a means to
      investigate the possible functional significance of this cytokine in the CNS.
      Hippocampal slices were superfused with Krebs' buffer medium, and endogenous ACh
      released into the superfusate was measured using a radioenzymatic assay.
      Recombinant human IL-2 present during a stimulation with 25 mM KCl altered, in a
      concentration-dependent manner, the evoked transmitter release. At a
      concentration of 15 U/ml (< or = 1 nM), IL-2 inhibited ACh release by more than
      50% of the control level (evoked ACh release from the untreated contralateral
      hemispheres). Inhibition was observed within 20 min of tissue exposure to IL-2
      and lasted for up to 1 hr. The inhibitory effect of IL-2 was reversible since
      transient tissue exposure to IL-2 did not affect subsequent evoked ACh release.
      IL-2 at this concentration also significantly decreased evoked ACh in frontal
      cortical slices, but was ineffective in the parietal cortex and striatum,
      revealing that IL-2 selectively modulates the release of ACh from certain, but
      not all, cholinergic nerve terminals in the CNS. At very low concentrations (1.5
      mU/ml, < or = 0.1 pM), IL-2 transiently increased hippocampal evoked ACh release,
      resulting in a biphasic dose-response profile with no significant effect observed
      at 0.015 mU/ml (< or = 1 fM). Other cytokines (IL-1 alpha, IL-3, IL-5, IL-6,
      interferon alpha), tested in hippocampal slice incubations, failed to modulate
      ACh release.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8340814
TI  - Vacuole dynamics in growth cones: correlated EM and video observations.
AB  - The neuronal growth cone is a major site of surface membrane dynamics associated
      with uptake and release of materials, motility, and axon extension. Although
      intracellular membrane organelles are thought to mediate surface membrane
      addition and retrieval at the growth cone, membrane events are fleeting and
      therefore difficult to study directly. In an effort to capture transient
      interactions between intracellular membrane organelles and the plasmalemma at the
      growth cone, embryonic rat sympathetic neuron cultures were prepared for whole
      mount electron microscopy (EM) by rapid freezing and freeze substitution. We
      identified a set of vacuole-like organelles (> or = 150 nm in diameter) that
      appeared to interact directly with the plasmalemma. In stereo-pair EM images the
      bounding membrane of some of these vacuoles had an orifice at sites where the
      organelle was adjoining the plasmalemma, suggesting that the organelle and
      surface membranes were confluent. Since this population of organelles could be
      labeled with cationized ferritin or HRP when added to living cultures just prior
      to freezing or chemical fixation, they were probably derived from the
      plasmalemma. Combined light microscopy and EM of individual growth cones showed
      that these same vacuoles had a conspicuous reverse shadowcast appearance in
      differential interference contrast images. Thus, we used real-time video
      microscopy to follow these organelles in living growth cones. Many of these
      vacuoles spontaneously appeared, remained visible for several minutes, and then
      disappeared. Reverse shadowcast vacuoles were formed at various sites throughout
      the growth cone, including surface membrane ruffles at the leading edge [P
      (peripheral)-domain] as well as quiescent and retracting regions at the growth
      cone base [C (central)-domain]. Vacuoles in the P-domain moved centripetally and
      rarely grew in size. In contrast, those in the C-domain exhibited Brownian-like
      movements and sometimes appeared to increase in size, raising the possibility
      that new membrane may be added to these organelles. Vacuoles within both the P-
      and C-domains shrank before rapidly disappearing, but rarely vesiculated,
      suggesting that they had fused with the plasmalemma. The results indicate that
      vacuoles are a highly dynamic population of organelles that directly communicate
      with the plasma membrane at the growth cone; they provide a major route of
      surface membrane uptake and may also play a role in membrane recycling.

PMID- 8340815
TI  - A spiking network model of short-term active memory.
AB  - Studies of cortical neurons in monkeys performing short-term memory tasks have
      shown that information about a stimulus can be maintained by persistent neuron
      firing for periods of many seconds after removal of the stimulus. The mechanism
      by which this sustained activity is initiated and maintained is unknown. In this
      article we present a spiking neural network model of short-term memory and use it
      to investigate the hypothesis that recurrent, or "re-entrant," networks with
      constant connection strengths are sufficient to store graded information
      temporarily. The synaptic weights that enable the network to mimic the input
      output characteristics of an active memory module are computed using an
      optimization procedure for recurrent networks with non-spiking neurons. This
      network is then transformed into one with spiking neurons by interpreting the
      continuous output values of the nonspiking model neurons as spiking
      probabilities. The behavior of the model neurons in this spiking network is
      compared with that of 179 single units previously recorded in monkey
      inferotemporal (IT) cortex during the performance of a short-term memory task.
      The spiking patterns of almost every model neuron are found to resemble closely
      those of IT neurons. About 40% of the IT neuron firing patterns are also found to
      be of the same types as those of model neurons. A property of the spiking model
      is that the neurons cannot maintain precise graded activity levels indefinitely,
      but eventually relax to one of a few constant activities called fixed-point
      attractors. The noise introduced into the model by the randomness of spiking
      causes the network to jump between these attractors. This switching between
      attractor states generates spike trains with a characteristic statistical
      temporal structure. We found evidence for the same kind of structure in the spike
      trains from about half of the IT neurons in our test set. These results show that
      the behavior of many real cortical memory neurons is consistent with an active
      storage mechanism based on recurrent activity in networks with fixed synaptic
      strengths.

PMID- 8340816
TI  - Degradation of two AChR populations at rat neuromuscular junctions: regulation in
      vivo by electrical stimulation.
AB  - The effect of electrical stimulation on the stability of junctional ACh receptors
      (AChR) on soleus muscles of Wistar rats was compared to that of denervation and
      reinnervation. Denervation causes the degradation rate of the slowly degrading
      AChRs (Rs) at the neuromuscular junction to accelerate and be replaced by rapidly
      degrading AChRs (Rr), while reinnervation restabilizes the accelerated Rs.
      Electrical stimulation initiated at the time of denervation prevented the
      acceleration of the Rs. It could not, however, reverse the effect of denervation
      if initiated after the AChRs became destabilized, nor could it slow the
      degradation rate of the Rr. We conclude that electrical stimulation of denervated
      muscle downregulates the expression of the Rr and prevents the destabilization of
      Rs.

PMID- 8340817
TI  - Dopaminergic modulation of dye coupling between neurons in the core and shell
      regions of the nucleus accumbens.
AB  - The presence of dye coupling and electrotonic coupling within the nucleus
      accumbens was examined using intracellular recording and staining in rat brain
      slices. In 24% of the cells examined, injection of single accumbens neurons with
      the dye Lucifer yellow resulted in the complete labeling of more than one cell.
      To examine whether this coupling is regulated by dopamine (DA), the extent of dye
      coupling was assessed in the presence of dopaminergic agonists and antagonists.
      In the core region of the accumbens, D1 receptor stimulation induced a decrease
      in the incidence of dye coupling; this effect could be blocked by the D1
      antagonists SCH 23,390 and SCH 39,166, by the D2 antagonist sulpiride, or by
      depletion of DA by reserpine and alpha-methyl-p-tyrosine coadministration, but
      not by the atypical antipsychotic drug clozapine. In contrast, in the posterior
      part of the shell region, D2 receptor stimulation increased the incidence of
      coupling independent of the state of D1 receptor activation. Fast spikelets
      resembling coupling potentials were found to occur only in neurons that also
      showed dye coupling, and could be attenuated in core neurons by D1 receptor
      stimulation. These findings suggest that DA, in addition to its actions on the
      membrane of single neurons, may also affect neuronal integration on a network
      level by regulating the transfer of information between adjacent neurons within
      the nucleus accumbens.

PMID- 8340818
TI  - Process outgrowth and synaptic varicosity formation by adult photoreceptors in
      vitro.
AB  - To assess the regenerative capability of the photoreceptor synapse, we have
      isolated and cultured photoreceptors from the mature salamander retina. Both rod
      and cone photoreceptors were able to regenerate processes within 3 d of plating.
      Cells extended numerous actin-containing filopodia as well as a few neuritic
      processes. The neurites contained microtubules and formed synaptic vesicle-filled
      varicosities, as shown by immunostaining for tubulin and synaptic vesicle
      proteins and by electron microscopy. Furthermore, regenerated varicosities were
      capable of depolarization-induced vesicle labeling, suggesting that they can
      recycle synaptic vesicles and release neurotransmitter by synaptic vesicle
      exocytosis. Differences were observed between rod and cone cell synaptic
      regeneration in vitro, which resembled structural differences between their
      synaptic terminals in situ: rod cells formed multiple synaptic vesicle-filled
      varicosities along neurites at a distance from the soma, whereas cone cells
      tended to accumulate synaptic vesicles within the soma. The regeneration of
      neurites and synaptic vesicle-filled varicosities was abolished by microtubule
      depolymerizing agents, suggesting a role for microtubule-based vesicle transport
      in the formation of varicosities. Finally, process outgrowth and varicosity
      formation were independent of cell-cell contact and, indeed, proceeded in the
      complete absence of other cells. These findings suggest not only that
      differentiated photoreceptors are capable of synaptic renewal but that the
      regeneration of presynaptic-like terminals is an intrinsic ability of rod and
      cone cells.

PMID- 8340819
TI  - Development of individual geniculocortical arbors in cat striate cortex and
      effects of binocular impulse blockade.
AB  - This study analyzes the morphological changes in geniculocortical axons
      terminating in the primary visual cortex of the cat, during the period in which,
      in normal development, the terminals in layer IV undergo an eye-specific
      segregation. Geniculocortical afferent fibers were filled anterogradely by the
      Phaseolus lectin (PHA-L) injected into the main laminae of the LGN. After
      standard immunohistochemical procedures, single axons were serially reconstructed
      in two or three dimensions. Experiments were performed in normal kittens and in
      kittens in which retinal activity was continuously blocked by repeated
      intraocular injections of TTX. In normal kittens, arbors were reconstructed at
      four different ages (19, 23, 30-31, and 39 days postnatally) spanning the period
      during which the geniculocortical projection segregates into eye-specific columns
      in layer IV (LeVay et al., 1978). Results reveal that sparse but widely extending
      branches characteristic of young arbors are eliminated during normal development
      at the same time as selected portions of the arbor grow considerably in length
      and complexity. The terminal arborizations also subdivide into distinct patches
      of terminals, consistent with the segregation of left and right eye afferents. In
      TTX-treated animals, axonal arbors reconstructed at postnatal days 23, 29, and 39
      show a complexity and extent of terminal arborization similar to that of normal
      animals, though more variable in size and degree of elaboration. No progressive
      changes are evident with age. Further, the majority of arbors reconstructed from
      TTX-treated animals lack the patchy organization typical of normal animals.

PMID- 8340820
TI  - Diffusion of small solutes in cartilage as measured by nuclear magnetic resonance
      (NMR) spectroscopy and imaging.
AB  - The ability of water and solutes to move through the cartilage matrix is
      important to the normal function of cartilage and is presumed to be altered in
      degenerative diseases of cartilage such as osteoarthritis and rheumatoid
      arthritis. Nuclear magnetic resonance (NMR) spectroscopy and magnetic resonance
      imaging (MRI) techniques were used to measure a self diffusion coefficient (D)
      for small solutes in samples of explanted cartilage for diffusion times ranging
      from 13 ms to 2 s. With a diffusion time of 13 ms, the intratissue diffusivity of
      several small solutes (water, Na+, Li+, and CF3CO2-) was found consistently to be
      about 60% of the diffusivity of the same species in free solution. Equilibration
      of the samples at low pH (which titrates the charge groups so that the net matrix
      charge of -300 mM at pH 8 becomes approximately -50 mM at pH 2) did not affect
      the diffusivity of water or Na+. These data, and the similarity between the D in
      cartilage relative to free solution for water, anions, and cations, are
      consistent with the view that charge is not an important determinant of the
      intratissue diffusivity of small solutes in cartilage. With 35% compression, the
      diffusivity of water and Li+ dropped by 19 and 39%, respectively. In contrast,
      the diffusivity of water increased by 20% after treatment with trypsin (to remove
      the proteoglycans and noncollagenous proteins). These data and the lack of an
      effect of charge on diffusivity are consistent with D being dependent on the
      composition and density of the solid tissue matrix. A series of diffusion
      weighted proton images demonstrated that D could be measured on a localized basis
      and that changes in D associated with an enzymatically depleted matrix could be
      clearly observed. Finally, evidence of restriction to diffusion within the tissue
      was found with studies in which D was measured as a function of diffusion time.
      The measured D for water in cartilage decreased with diffusion times ranging from
      25 ms to 2 s, at which point the measured D was roughly 40% of the diffusivity in
      free solution. Although changes in matrix density by compression or digestion
      with trypsin led to a decrease or increase, respectively, in the measured D, the
      functional change in measured diffusivity with diffusion time remained
      essentially unchanged. In a different type of study, in which bulk transport
      could be observed over long periods of time, cartilage was submerged in 99% D2O
      and MRI studies were performed to demonstrate the bulk movement of water out of
      the cartilage matrix.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8340821
TI  - Pleiotrophin is an abundant protein in dissociative extracts of bovine fetal
      epiphyseal cartilage and nasal cartilage from newborns.
AB  - An abundant protein that is identical to the growth-associated protein
      pleiotrophin (PTN) has been isolated from dissociative extracts of bovine nasal
      and fetal epiphyseal cartilage. The yield from these tissues was at least 15
      micrograms/g wet weight of cartilage. PTN was absent or was present only in trace
      amounts in mature articular cartilage. An analysis of tryptic fragments of PTN,
      held together with disulfide bonds, did not indicate any set pattern of cystine
      cross-links, which suggests a propensity for rapid refolding of the protein. PTN
      could not be isolated from thin (10 microns) slices of nasal cartilage in
      physiological extraction buffers, which indicates that it was tightly associated
      with the cell surface, was tightly associated with nonextractable matrix, or was
      an intracellular protein. Its appearance in various extraction media parallels
      that of histone H2b, a nucleosomal protein; this suggests a possible
      intracellular location for the protein. Immunohistochemical analysis of its
      distribution in fetal epiphysis indicated that it is associated with
      chondrocytes.

PMID- 8340822
TI  - In vivo quantification of proteoglycan synthesis in articular cartilage of
      different topographical areas in the murine knee joint.
AB  - We developed a method of quantitative measurement of the synthesis of
      proteoglycans in different areas of the patella and the tibial plateau of the
      mouse. After incorporation of radioactive sulfate in vivo, the patella was
      divided with a punch into a central and a peripheral part. A central medial and a
      central lateral part were taken from the tibial plateau to measure the synthesis
      of proteoglycans. The synthesis was determined in normal joints and at different
      intervals after intra-articular injection of sodium iodoacetate and was compared
      with autoradiographs of whole joint sections. Although considerable variation in
      sulfate incorporation was found within a group on particular days after induction
      of osteoarthritis, the variation among experiments was low. Comparison with
      autoradiographs showed that this new method makes it possible to quantify
      proteoglycan synthesis by incorporation of radioactive sulfate in different
      topographical areas of the murine knee joint.

PMID- 8340823
TI  - Adaptive bone remodeling around bonded noncemented total hip arthroplasty: a
      comparison between animal experiments and computer simulation.
AB  - Severe loss of bone related to stress-shielding is one problem threatening the
      long-term integrity of noncemented total hip arthroplasty. It is widely accepted
      that this phenomenon is caused by adaptive bone remodeling according to Wolff's
      law. Recently, quantitative bone-remodeling theories have been proposed, suitable
      for use in computer-simulation models in combination with finite-element codes,
      which can be applied to simulate the long-term effect of the remodeling process.
      In the present paper, the results of such a computer simulation are compared with
      those in an animal experiment. A three-dimensional finite-element model was
      constructed from an animal experimental configuration concerning the implantation
      of a fully coated femoral hip prosthesis in dogs. The simulation results of the
      adaptive bone-remodeling process (geometric adaptations at the periosteal surface
      and density adaptations within the cancellous bone) were compared with cross
      sectional measurements of the canine femurs after 2 years of follow-up. The
      detailed comparison showed that long-term changes in the morphology of bone
      around femoral components of total hip replacements can be fully explained with
      the present quantitative adaptive bone-remodeling theory.

PMID- 8340824
TI  - Evaluation of bone-grafting materials in a new canine segmental spinal fusion
      model.
AB  - This paper describes a new canine segmental spinal fusion model for the
      comparison of bone-grafting materials. The test sites in the model are three
      separate posterior interfacet-interlaminar fusion sites in the lumbar spine (L1
      2, L3-4, and L5-6). The outcome was assessed by scoring of the fusion sites for
      union and by mechanical testing of fused segments. The results from two
      experiments are presented. Autogenous cancellous bone was the most effective
      material tested and had a statistically superior score for union compared with
      all other materials (p = 0.01). The results with an osteoconductive matrix of
      collagen and ceramic alone were no better than those with the controls (no
      graft). However, addition of an extract of matrix-derived proteins (15-30 kDa) to
      the collagen-ceramic carrier appeared to improve the score for union. The
      inclusion of nonresorbed ceramic granules had no evident effect on the mechanical
      properties of fusions, with a comparable score for union. This model appears to
      be a sensitive and efficient method for the comparison of graft materials.
      Advantages over previously described models are discussed.

PMID- 8340825
TI  - Posture affects motion coupling patterns of the upper cervical spine.
AB  - Measurements of motions of the cervical spine are used to help diagnose the
      problems of clinical instability due to degenerative changes and trauma. For a
      better interpretation of the three-dimensional motions of the upper cervical
      spine, knowledge of the effects of posture on these motions is necessary. Seven
      fresh human cadaveric C0-C3 spinal specimens were utilized. Each specimen was put
      in three distinct sagittal plane postures: full flexion, neutral, and full
      extension. At each posture, two load types were applied: left and right axial
      torques, and left and right lateral bending moments up to 1.5 Nm. The resulting
      three-dimensional relative motions of C0-C1 and C1-C2 were measured, with use of
      nonconstraining stereophotogrammetry, in the form of load-displacement curves. We
      found that the curves were nonlinear. The most dramatic change due to
      modification in posture was found in coupled sagittal plane rotation, which
      changed from extension at extended posture to flexion at flexed posture at both
      levels and in response to both load types. For the axial torque, the main axial
      rotation and coupled lateral bending changed little with posture. For the lateral
      bending moment, the main lateral bending rotation and coupled axial rotation
      decreased; the latter changed direction at C1-C2 as the spine was put into flexed
      posture. The motions for the right and left load applications generally were
      mirror images, except for the coupled sagittal plane rotations, which did not
      change with the direction of the load.

PMID- 8340826
TI  - Changes in bone in a model of spinal cord injury.
AB  - Bone calcium, histomorphometry, and mechanical strength were evaluated in a model
      of spinal cord injury. Cortical bone area and rates of formation and apposition
      at the tibiofibular junction (TFJ) and midshaft of the humerus were measured at
      35-42, 42-77, and 77-94 days after transection of the spinal cord. All
      comparisons were between the animals with a spinal lesion and control animals. A
      0.34% difference in the length of the tibia of the two groups of animals was
      observed, the dry weight of the tibia was 28.4% less in rats with a lesion, and
      there was no significant difference in the amount of calcium per milligram of
      bone. At 35 days after surgery, the cortical area in the midshaft of the humerus
      was slightly less (11%) in rats with a lesion, but by 94 days there was no
      difference in cortical or medullary area. The final (day 94) cortical area at the
      TFJ in rats with a lesion was less than that in the controls. Bone formation at
      the TFJ was similar in both groups in the period of 35-42 days and was similar at
      77-94 days in the animals with a lesion, and rates of formation and apposition
      were greater in the humerus of rats with a lesion; the rates did not differ
      significantly between groups at either site. At 94 days, trabecular bone area in
      the tibial metaphysis was 41% less in rats with a lesion. Mechanical parameters
      were significantly less in the femora, but not the humeri, of rats with a lesion.

PMID- 8340827
TI  - Effect of controlled local release of sodium fluoride on bone formation: filling
      a defect in the proximal femoral cortex.
AB  - To assess the effect of sodium fluoride (NaF) in the healing of a defect in
      cortical bone, an experimental model was created by the drilling of 5.0 mm holes
      in the proximal ends of both femora of 12 adult male New Zealand White rabbits.
      An interlocking intramedullary implant constructed of poly(d,l-lactic acid)
      containing NaF was placed in the right femur and an identical implant without NaF
      (sham), in the left. The implant in the right femur was designed to release NaF
      in a controlled manner over the duration of the experiment. Ten weeks after
      implantation, the specimens were removed and were tested in torsion. The
      mechanical properties were not significantly different between the groups. The
      femora exposed to NaF had an 18.6% increase in intact cortex near the defect (p =
      0.023), however, the deposition of mineralized bone within the defect was not
      significantly greater. In fact, healing appeared to be impaired by the presence
      of NaF. There was complete closure of the defect in all but one of the femora
      with a sham implant, but the tissue had not yet calcified. In contrast, only one
      femoral defect exposed to NaF had closed. Examination of the material filling the
      defects of the femora exposed to NaF showed that it was predominantly uncalcified
      osteogenic mesenchymal tissue.

PMID- 8340828
TI  - Effects of transforming growth factor beta on cells derived from bone and callus
      of patients with osteogenesis imperfecta.
AB  - We studied the influence of transforming growth factor beta (TGF-beta) on
      cultured bone cells derived from two patients with osteogenesis imperfecta (OI)
      and from human controls. Additionally, cells from a hyperplastic callus that had
      developed spontaneously at the femur of the patient in Case 1 and cells from a
      normal fracture callus were included in the study. TGF-beta increased the
      synthesis of total protein and collagen of all cells without changing the pattern
      of interstitial collagens. Proliferation was stimulated by TGF-beta in the OI
      bone cells from Case 1, in cells from the central part of the hyperplastic
      callus, and in cells from the fracture callus. In Case 2, proliferation of bone
      cells was decreased by low concentrations of TGF-beta. Alkaline phosphatase (AP)
      activity was enhanced by TGF-beta in normal human bone cells, not affected in
      bone cells from the patient in Case 2 or in cells from the central part of the
      hyperplastic callus, and inhibited in bone cells and cells from the peripheral
      part of the hyperplastic callus of Case 1 and in cells from the fracture callus.
      We conclude that TGF-beta has common and specific effects on cultured human cells
      derived from different types of skeletal tissues. Simultaneous stimulation of
      collagen synthesis and AP activity by TGF-beta was restricted to normal human
      bone cells and might reflect their mature state of osteoblastic differentiation.
      Cells derived from bone of both patients with OI, from the hyperplastic callus,
      and from the fracture callus showed a different response pattern to TGF
      beta.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8340829
TI  - Laser Doppler flowmetry for estimation of bone blood flow: studies of
      reproducibility and correlation with microsphere technique.
AB  - The blood flow in the femoral condyles of six pigs was measured by the
      microsphere technique and by laser Doppler flowmetry (LDF) before and after
      clamping of the external iliac artery. A significant decrease in the bone blood
      flow was found with both microsphere and LDF measurements, and a high correlation
      was found between the two methods. After release of the arterial clamp, the LDF
      values rapidly returned to approximately the same values as before clamping. In a
      second part of the study, the LDF output signal was studied in the
      intertrochanteric area of eight patients. The reproducibility of two LDF
      measurements at the same location was within 15%. The temporal variability of the
      LDF signal during 10 min of recording showed only slight variations. It is
      concluded that LDF is relative in nature and that the mean LDF output signal is
      suitable for monitoring dynamic responses of the bone blood flow to various
      stimuli. Several consecutive measurements have to be performed if the blood flow
      at different locations of a specific bone are to be compared with each other.

PMID- 8340830
TI  - Cellular shape and pressure may mediate mechanical control of tissue composition
      in tendons.
AB  - In vivo studies have suggested that mechanical factors are involved in the
      regulation of the morphology and biochemical composition of tendons that wrap
      around bones. In these tendons, fibrocartilage is found in the segment wrapped
      around the bone, and tendon far from the bone displays normal tendon
      histomorphology. Recent in vitro studies have shown that intermittently loaded
      connective tissue cells are sensitive to changes in cellular shape and
      hydrostatic pressure: stretching and distortion of the cells enhances production
      of fibrous matrix and hydrostatic pressure enhances production of cartilaginous
      matrix. We used finite-element analysis to determine whether the regions of
      increased development of cartilaginous matrix in tendons that wrap around bones
      correspond to regions in which tendon cells are subjected to higher pressures,
      and whether the maintenance and rearrangement of fibrous extracellular matrix in
      these tendons is associated with regions of stretching and distortion of cells.
      We found that regions of cartilaginous matrix and fibrous matrix formation and
      turnover correlate well with patterns of hydrostatic compressive stress and
      distortional strain in the tendon. Although further experiments clearly are
      needed to establish the predictive value of our approach, hydrostatic stress and
      distortional strain history--parameters intimately related to changes in cellular
      pressure and shape, respectively--appear to be important tissue-level mechanical
      stimuli that regulate cartilaginous and fibrous matrix composition of connective
      tissues.

PMID- 8340831
TI  - Effects of complete stress-shielding on the mechanical properties and histology
      of in situ frozen patellar tendon.
AB  - The effects of freezing and stress-shielding on the mechanical properties and
      histology of the patellar tendon (PT) were studied with the use of 28 mature
      Japanese white rabbits. The PT was frozen in situ by liquid nitrogen to kill the
      fibroblasts and then, for stress-shielding, a stainless-steel wire, installed
      between the patella and the tibial tubercle, was stretched to release all tension
      in the PT. After being allowed unrestricted activity in their cages for 1, 2, 3,
      or 6 weeks, the animals were killed, and the PTs were excised for mechanical and
      histological study. The cross-sectional area of the frozen and stress-shielded PT
      started to increase significantly 1 week after the treatment and leveled off at 3
      weeks. In contrast, the tensile strength and elastic modulus began to decrease
      significantly at 1 week, falling to 15% of the control values at 6 weeks.
      Histologically, cells were absent until 2 weeks after freezing and stress
      shielding, although new cells appeared by 3 weeks. Splitting and fragmentation of
      collagen bundles were observed beginning at 2 weeks. These results indicate that
      complete stress-shielding led to substantial changes in the mechanical properties
      of the once-frozen PT, even in the absence of the tissue remodeling process by
      fibroblasts.

PMID- 8340832
TI  - In vitro biomechanical analysis of suture methods for flexor tendon repair.
AB  - This study was designed to compare five different suture methods that are used
      clinically for tendon repair. The flexor digitorum profundus tendons from the
      digits of adult mongrel dogs and adult human cadavers were used as models. The
      tendons in zone II of the hand, defined as the region from the distal palmar
      crease to the insertion of the flexor digitorum superficialis tendon at the
      middle phalanx, were transected and then were repaired by one of the suture
      methods developed by Kessler, Tsuge, Tajima, Savage, or Lee. The gliding function
      and tensile properties of the repaired tendons were evaluated biomechanically at
      time zero. The Tajima and Savage methods produced better gliding function than
      the other techniques. In the canine specimens that had been repaired by one of
      these two methods, the rotation of the distal interphalangeal joint was more than
      60% of the rotation of the canine control specimens; only the Savage technique
      produced a rotation 124% that of the human control specimens. After the Tajima
      repair, the rotation of the proximal interphalangeal joint was 113% that of the
      canine control specimens and 157% that of the human controls. In the canine
      specimens that had had the Tajima or Savage repair, excursion of the tendon was
      greater than 55% that of the controls. The tendons repaired by the Savage method
      tolerated a significantly higher ultimate load to failure (14 and 25% that of the
      canine and human control specimens, respectively) than the other
      methods.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8340833
TI  - Method to determine collagen density distributions in fibrous tissues.
AB  - We present a method for the measurement of hydroxyproline density distributions,
      as an estimate for collagen density distributions, in fibrous tissues such as
      ligaments and tendons. To evaluate this method, a single flexor tendon of a human
      hand was divided into seven tissue locations. Triplicate determinations of the
      dry weight tissue mass, volume, and hydroxyproline mass were made at each
      location: two samples were analyzed at the same time (a and b) and one was
      analyzed later (c). The intralocation variation is an estimate for the
      measurement error variance, which indicates both the precision (a compared with
      b) and the repeatability (b compared with c) of the technique for determination
      of volume, dry weight tissue mass, hydroxyproline concentration, and
      hydroxyproline density. The precision was about 5% for all variables, and the
      repeatability ranged from 1.5-4.3%. In comparison with the interlocation
      variations, the error variances were small, except for collagen concentration.
      This indicates that despite the measurement errors, differences in hydroxyproline
      density can be detected within fibrous tissues with the proposed method. The use
      of only a single tendon is adequate to evaluate the measurement error of the
      method, but more tendons should be measured to generalize the absolute values of
      the variables.

PMID- 8340834
TI  - Declining drug use in relation to increased drug education: a trend study 1979
      1991.
AB  - During the 1980s alcohol and drug education increased in Ontario schools,
      especially at the Grade 7 level. This article reports aggregate relationships
      between increased levels of exposure to classroom alcohol, tobacco, and cannabis
      education, and the use of alcohol, tobacco, and cannabis by students in Ontario
      schools. The data were derived from repeated cross-sectional probability surveys
      of alcohol and drug use conducted every two years since 1979. There were strong
      inverse associations between increases in exposure to alcohol and drug education
      and reported levels of use of these substances, especially for alcohol and for
      Grade 7 students.

PMID- 8340835
TI  - Who receives drug education in our schools?: a paradox.
AB  - Data from a national survey by the United States Department of Justice of 47,000
      households reveals a paradox regarding who receives drug education in primary and
      secondary schools. Those who would seem to need it the most are least likely to
      receive it. Thus, blacks receive drug education classes less often than whites,
      students in central city classes less often than those in other regions, and
      students who report that drugs are available are also less likely to receive drug
      education classes than students who report that drugs are not available. The
      results are paradoxical, but consistent with a study by Denson, Voight, and
      Eisenman which found that predominantly black schools in Louisiana provided less
      AIDS education than predominantly white schools.

PMID- 8340836
TI  - Reducing substance abuse risk factors among children through a teacher as
      facilitator program.
AB  - A Teachers as Facilitators (TAF) Program used classroom teachers as leaders of
      small groups that promoted social, emotional, and academic development of
      children at high risk of adopting potentially destructive substance abuse
      patterns. The program was intended to increase participating students' positive
      socialization experiences and academic achievement by successfully integrating
      these students into the school's social system. A longer-range goal was to
      increase students' sense of worth as it affects their attitudes toward
      relationships with other people and academic demands. Program results were: 1)
      school personnel were found capable of accurately identifying and referring to
      the TAF Program children who were at risk of substance usage and in need of
      assistance; 2) the TAF Program was effective in improving at-risk students'
      perceived academic self-concept, but was less effective in increasing students'
      perceived sense of social support; and 3) the program was endorsed by
      participating teachers, counselors, and administrators.

PMID- 8340837
TI  - Two-step drug education in Norway.
AB  - A survey of drug education in Norwegian lower secondary schools showed that
      almost one-fourth of the programs were based on a two-step model, which is
      described in this article. The intensive courses were socially successful, and
      created motivation, enthusiasm, and changes of attitudes. More than 90 percent of
      the participants carried out the second step of the teaching. There were
      important differences from one school to another in regard to how the pilot
      pupils, and their teaching program, were received. They found it difficult to
      find sufficient time for their programs, and sometimes hard to keep their
      classmates in order. Most of the classmates found the teaching in the second step
      interesting, but they had little belief in the preventive effect.

PMID- 8340838
TI  - Sexual abuse and drinking and drug use: implications for prevention.
AB  - Based on a survey of adolescent females in grades seven through twelve in a
      suburban school system, the relationship between drinking, drug use, and sexual
      abuse is examined. Using a holistic approach to adolescent deviant behavior,
      connections between family, peer, psychosocial factors and drug use and
      delinquency are explored. Girls who report sexual molestation are more likely to
      have used a number of drugs, different from the prevalence profile of the larger
      sample. Significant correlations for younger girls between sexual molestation and
      delinquency are also reported. Implications for school based drug prevention
      programs are discussed.

PMID- 8340839
TI  - Social bonds, early trauma and smoking: evidence of the group specific relevance
      of control theory.
AB  - This study analyzes data from a national sample of 595 adults to simultaneously
      evaluate the potential effects of social bonds and childhood trauma on tobacco
      smoking. Although both control factors and childhood experiences were found to
      affect smoking, religious belief and belief in the importance of conforming to
      moral and social norms had more important and robust negative relationships to
      smoking than commitment, attachment, or involvement social bonds. But, whereas
      childhood trauma appeared to promote smoking among both college educated and less
      educated persons, control factors significantly inhibited smoking only among the
      less educated. Implications for future drug research as well as anti-smoking
      campaigns and other anti-drug programs are discussed.

PMID- 8340840
TI  - On the role of patient.
AB  - Modern, highly technical health care systems increasingly remove patients from
      active participation in managing their own medical treatment. This is
      particularly true when serious or life-challenging illness occurs. Health
      psychology has much to contribute in the debate over the degree of patient self
      determination necessary to achieve optimal treatment outcomes. Psychologists may
      directly influence this process through their professional contact with medical
      patients and their families. Through researching the behavioral skills of medical
      consumership, identifying the elements of effective patient-physician
      interaction, and encouraging physicians-in-training to adopt a propatient
      partnership attitude, psychology adds new dimensions to the provision of health
      care. This paper reviews some of the issues faced by patients with life
      challenging illnesses through the writer's personal experience, and seeks to
      identify the requisite actions for informed, participatory involvement on the
      part of patients.

PMID- 8340841
TI  - Psychological research in pediatric oncology.

PMID- 8340842
TI  - Neuropsychological effects of central nervous system prophylactic treatment in
      childhood leukemia: methodological considerations.
AB  - Reviewed 53 studies on the effects of central nervous system prophylactic
      treatment (CNSPT) on cognition and neuropsychological functioning. CNSPT involves
      irradiation and/or chemotherapy directed to the brain, and is frequently
      administered to children who have leukemia. The effects of CNSPT on
      neuropsychological functioning in long-term cancer survivors remains
      controversial. A number of studies failed to identify any neuropsychological
      impact secondary to CNSPT, whereas others reported deficits that appear to be a
      function of CNSPT. Several methodological issues that make it difficult to draw
      meaningful conclusions from this research literature are identified and
      discussed. Specific recommendations are made for improvements in research on
      CNSPT in children.

PMID- 8340843
TI  - Factors associated with social and behavioral problems among children recently
      diagnosed with brain tumor.
AB  - Compared the psychological adjustment of 81 children with brain tumors to that of
      31 control children with various malignancies not involving the central nervous
      system. Both groups exhibited significantly increased frequencies of elevations
      on one or more age- and gender-corrected Social Competence and Behavior Problems
      scales of the Child Behavior Checklist (CBCL) relative to normative expectations.
      Comparison of the Brain Tumor and Cancer Control groups revealed no significant
      differences on any CBCL scale. Among children diagnosed with brain tumors,
      stepwise multiple regression analyses revealed that low child IQ, residence in a
      single-parent family, moderate to severe disfigurement, low SES, tumor location,
      and severe functional impairment were associated with decreased Social Competence
      scores. Elevated Behavior Problems scores were associated with younger maternal
      age at the child's birth, tumor location, and residence in a single-parent
      family. Results reinforce the need to consider complex relationships between
      demographic characteristics of the child's family, type of brain damage, and the
      cosmetic and functional status of the child in determining acute psychological
      adjustment of brain-damaged children.

PMID- 8340844
TI  - Adjustment in the peer system of adolescents with cancer: a two-year study.
AB  - Evaluated the psychosocial adaptations of adolescents with cancer who were
      primarily off treatment (n = 19, ages 11-18) as compared with matched classroom
      controls in a 2-year longitudinal study on indices of (a) teacher, peer, and self
      perceptions of social reputation; (b) multiple measures of popularity and
      friendships; and (c) self-reported feelings of loneliness, depression, and self
      concept. Adolescents with cancer continued to have a social reputation as being
      more socially isolated, but no significant differences were identified on
      multiple measures of social acceptance or the self-reported feelings. In general,
      adolescents with cancer were similar to peers on numerous dimensions of
      psychological functioning manifesting minimal discernable psychosocial late
      effects.

PMID- 8340845
TI  - Parents of children newly diagnosed with cancer: anxiety, coping, and marital
      distress.
AB  - Evaluated anxiety, approach-avoidance coping style, and marital distress in 134
      parents of children with cancer shortly after diagnosis. Of the 67 marital pairs
      studied, approximately 25% of the mothers and 28% of the fathers reported
      significant marital distress. Regression analyses revealed that marital distress
      was predicted by a combination of general emotional distress, the discrepancy
      between the couple's state anxiety levels, and the couple's use of sensitizing
      coping strategies. Greater differences in anxiety levels between the parents and
      greater stimulus approach coping activity in the marriage were associated with
      greater reported marital distress.

PMID- 8340846
TI  - Goal-directed behavior and perception of self-competence in children with spina
      bifida.
AB  - Compared a group of school-age children with spina bifida (n = 15) between the
      ages of 6 and 12 years with an age- and IQ-matched control group of normal
      children (n = 15). As predicted, the spina bifida children spent less time using
      goal-directed behaviors and more time in simple manipulation of the toys compared
      to the normal children. There were no group differences between the spina bifida
      and normal children's perceived competence but parents of the spina bifida
      children rated their children as having lower cognitive and physical competence.
      Associations were found between goal-directed behaviors and perceived self
      competence for children in the spina bifida group but not the normal group.

PMID- 8340847
TI  - Parental anxiety and response to symptoms of minor illness in infants.
AB  - Examined the relationship between parental anxiety and parental contact with the
      clinic following a child's initial DPT immunization. The subjects were 80
      volunteer mothers who brought their 8-week-old infants to an outpatient clinic
      for a well-child visit. At the time of the visit, maternal anxiety, anxiety
      proneness, perception of the infant as fussy or difficult, and demographic
      information were assessed. Seventy-two hours after the immunization, subjects
      reported DPT side effects and physician contacts. Discriminant function analysis
      found that mothers who were anxious prior to DPT administration and who had
      infant girls were more likely to contact the clinic by telephone. This
      relationship was independent of prior maternal experience with DPT immunization,
      maternal perception of the infant's general fussiness, and maternal Trait
      anxiety.

PMID- 8340848
TI  - Neonatal surgery: intensive care unit versus operating room.
AB  - The critically ill neonate with a surgical condition requires transfer to an
      operating room (OR), a process which may be associated with significant
      morbidity. In an effort to reduce such morbidity, we performed surgery on
      critically ill neonates in a designated area of our neonatal intensive care unit
      (NICU) over the past 4 years and have compared the outcome for infants operated
      on within the NICU with infants operated on in the OR over the same period. There
      were 81 procedures performed in the NICU compared with 112 in the OR. Infants
      operated on in the NICU had lower birthweights (1,758 g v 2,457 g), lower
      gestational ages (31.3 weeks v 35.8 weeks), and lower presurgical weights (2,118
      g v 2,922 g) (all P < .0001). In addition, infants operated on in the NICU had a
      greater severity of illness with 78% requiring mechanical ventilation versus 26%
      for the OR group (P < .0001) with a higher presurgical FiO2 (.43 v .31, P =
      .005), and a higher presurgical mean airway pressure (8.0 cm H2O v 6.2 cm H2O)
      for infants requiring mechanical ventilation. The overall mortality was higher in
      the NICU group (14% v 2%), reflecting their underlying prematurity, illness, and
      anomalies. There was only one surgically related death, which occurred in the
      NICU group. There was no significant difference in culture-proven sepsis, length
      of surgery, change in weight, temperature, blood pressure, heart rate, FiO2, mean
      airway pressure, or oxygen index associated with surgery, but there was a
      significantly higher incidence of hyperthermia with a temperature of greater than
      37.5 degrees C in the OR group (17.8% v 3.7%, P = .002). Our experience suggests
      that surgical procedures can be performed in the NICU for the unstable critically
      ill neonate with a morbidity comparable to that seen in the OR. Further
      experience is needed to compare the risks and benefits of this approach.

PMID- 8340849
TI  - Gastroschisis: an 18-year review.
AB  - From 1972 to 1990, 69 cases of gastroschisis were treated at Akron Children's
      Hospital Medical Center. Eighty-one percent of these patients underwent primary
      closure of their abdominal wall defect. Thirteen of 69 patients (19%) required
      Silastic silos with final closure in an average of 7.8 days. There was no sex
      predilection, the average birth weight was 2,473 g, and the mean gestational age
      was 36.3 weeks. Twenty-six percent had associated anomalies, the majority were
      intestinal atresia, volvulus, and/or undescended testicles. Seventy-seven percent
      of the infants were delivered vaginally. Fourteen children were delivered via
      cesarean section. Seven cesarean sections were done solely for prenatal
      ultrasonic identification of an abdominal wall defect. There was no improvement
      in hospital stay, complications, days until enteral feeds were tolerated, days
      intubated, or number of surgical procedures in this group. In 14 patients, mesh
      sheeting (Marlex, Silastic) was used in the final closure. Sixty-four percent of
      these incurred wound breakdown necessitating removal of the mesh. This compares
      with a 3.2% wound breakdown in the nonmesh group. The average hospital stay was
      43.9 days and the average time to enteral feeds 20.2 days. Sixty-four percent of
      the patients required postoperative intubation for an average of 5.5 days. The
      overall mortality rate was 4.3%. The present data do not support gastroschisis
      alone as an indication for cesarean section. The data indicate that mesh be
      avoided in the final closure if possible and support a favorable prognosis for
      most babies.

PMID- 8340850
TI  - Large gastroschisis: primary repair with Gore-Tex patch.
AB  - The author reports four newborns with large gastroschisis, in whom primary
      fascial closure could not be accomplished. They were successfully treated by
      primary repair with Gore-Tex patch. Gore-Tex patch closure is a safe and good
      alternative in large abdominal wall defects when primary fascial repair is not
      feasible.

PMID- 8340851
TI  - Gastroschisis in the partially extraamniotic fetus: experimental study.
AB  - The short, thick, matted bowel, often found in gastroschisis, has been attributed
      to a variety of factors. We designed an original animal model in order to isolate
      the effect of amniotic fluid on the fetal bowel. We created experimental
      gastroschisis in fetal rabbits. Extruded bowel was kept out of the amniotic sac
      in half of the operated fetuses. At term, 7 days after surgery, 21 surviving
      fetuses (12 intraamniotic gastroschisis [IAG] and 9 extraamniotic gastroschisis
      [EAG]) and 16 control littermates were collected for study. Five parameters were
      measured in each animal: body weight, intestinal weight, intestinal length, bowel
      diameter, and bowel wall thickness. Fetal mortality due to the extraamniotic
      fixation technique was 25%. We found no statistically significant difference in
      body weight, intestinal weight, or bowel wall thickness. An enormous difference
      was found in intestinal length (P < .0001 among the three groups). Bowel diameter
      was significantly different (P = .02) in the extreme groups (IAG and controls),
      with the intestine being more dilated in IAG than in EAG and controls.
      Gastroschisis in the absence of amniotic fluid was not as damaging to the fetal
      intestine as "natural" intraamniotic gastroschisis.

PMID- 8340852
TI  - A new bioprosthesis in large abdominal wall defects.
AB  - A collagen-coated Vicryl mesh bioprosthesis was used to repair a 4 x 4 cm full
      thickness abdominal wall defect, created in experimental rats. The tensile
      strength of the repair at 6 months reached 70% of the original abdominal wall.
      Implant collagen could not be differentiated from host collagen after 2 weeks.
      The increase in collagen content of the repair was responsible for the increasing
      tensile strength of the wound with time. All histological sections showed good
      tolerance of the implant. These results support the use of collagen Vicryl
      membrane to repair large abdominal wall defects. Clinical trials are indicated.

PMID- 8340853
TI  - Impaired respiratory function in infants with anterior abdominal wall defects.
AB  - Respiratory function at follow-up was assessed in 13 infants who had undergone
      surgical repair of an anterior abdominal wall defect. Six infants had exomphalos
      and seven had gastroschisis. The infants were delivered at a median gestational
      age of 36 weeks (range, 32 to 38 weeks). Respiratory function was assessed by
      measurement of functional residual capacity (FRC) at a median postnatal age of 5
      months (range, 1 to 10 months). Although there was no significant difference in
      the FRC of the infants with gastroschisis compared with those with exomphalos,
      the study group's mean FRC (25 mL/kg) was significantly lower than that of 50
      healthy control infants (mean, 30 mL/kg; 95% CI, +/- 6 mL/kg). Five infants had
      an FRC below the 95% confidence limit of the normal range. These data suggest
      that infants with anterior abdominal wall defects may have impaired antenatal
      lung growth.

PMID- 8340854
TI  - Lyophylized dura patch repair of congenital diaphragmatic hernia: occurrence of
      relapses.
AB  - During an 8-year period, 71 neonates with congenital diaphragmatic hernia were
      admitted to the Sophia Children's Hospital. Seventeen patients died before
      surgery. The other 54 patients underwent either direct suture (18) or patch
      closure with lyophylized dura (36), depending on the size of the defect. Forty
      patients survived. In 16 of them the defect was closed by direct suturing. In the
      other 24 patients a patch was used. Five recurrences of the defect occurred, all
      of them among the latter group.

PMID- 8340855
TI  - Extracorporeal membrane oxygenation in the management of cardiac failure
      secondary to myocarditis.
AB  - While most patients with viral myocarditis have a relatively uncomplicated
      clinical course, a small number of patients will present with cardiogenic shock
      unresponsive to standard medical therapy. We describe the clinical course of
      three patients who developed profound cardiac failure secondary to a documented
      viral myocarditis. Each patient was managed using venoarterial (VA)
      extracorporeal membrane oxygenation (ECMO) support using the right common carotid
      artery/internal jugular vein for cannulation. While undergoing ECMO support, each
      patient developed elevated left-sided cardiac chamber pressures with resultant
      pulmonary edema. This was managed by balloon atrial septostomy in two cases and
      combined blade/balloon atrial septostomy in one case. Excellent decompression of
      the left heart was achieved in each patient. Two patients were successfully
      weaned from ECMO and are currently alive, with one demonstrating residual cardiac
      dysfunction. One patient developed global myocardial necrosis and ultimately
      died. This small series demonstrates a role for ECMO in the management of cardiac
      failure due to acute viral myocarditis unresponsive to medical therapy. Our
      experience also suggests that balloon atrial septostomy may be useful to
      decompress the left atrium and ventricle of patients with acute myocarditis while
      on ECMO.

PMID- 8340856
TI  - Motility function of the esophagus before primary anastomosis in esophageal
      atresia.
AB  - Two patients with a long gap esophageal atresia without tracheoesophageal fistula
      underwent an esophageal manometric study before primary anastomosis and one of
      them underwent an identical study after operation. Before operation both patients
      showed peristaltic contraction in the proximal esophagus when swallowing which
      was always followed by a coordinated contraction of the distal esophagus the same
      as in that of the normal esophagus. These peristaltic contractions induced a
      reflex relaxation of the lower esophageal sphincter (LES). After operation the
      manometric studies of the repaired esophagus demonstrated an abnormal esophageal
      motility, with simultaneous contractions occurring when swallowing in the
      proximal to the distal esophagus. In addition, the reflex relaxation of LES was
      incomplete. These data suggest that even if the intraluminal continuity is
      defective, the esophageal motility function is not disturbed in the proximal to
      distal esophagus in preoperative esophageal atresia, and that intraoperative
      mobilization and denervation may be suggested to be an important factor in
      esophageal dysmotility even when esophageal atresia is successfully repaired.

PMID- 8340857
TI  - Emergency center arteriography in the evaluation of suspected peripheral vascular
      injuries in children.
AB  - During the 6-year period from 1983 to 1989, 109 children aged 3 to 18 years
      (mean, 16) with suspected peripheral vascular injuries underwent 113 emergency
      center arteriograms (ECA) performed by hand injection of contrast material using
      a single roentgenographic film. The most common indication for ECA was the
      proximity of the injury in 93 (82.3%) of the cases as penetrating injury
      accounted for 106 (94%) of the cases. There were 89 true-negative, 14 true
      positive, 1 false-negative, and no false-positive arteriograms. The remaining 9
      arteriograms were either equivocal or technically inadequate. The sensitivity,
      specificity, and diagnostic accuracy of this procedure were 98.9%, 100%, and
      91.2%, respectively. Operative intervention was required for 9 (64.2%) injuries
      detected by emergency arteriography. The remaining 5 injuries were considered
      minor and were observed with no complications during a period of 21 months. Sixty
      eight children (76.4%) with negative ECA were followed for a mean of 12 months
      with no vascular complications or growth abnormalities noted. ECA is a rapid,
      accurate, and cost-effective technique. It is of particular value in detecting
      the presence of occult arterial injuries that might have deleterious effects in
      the growing child.

PMID- 8340858
TI  - Elective surgery in children with sickle cell disease without preoperative blood
      transfusion.
AB  - It is generally recommended that patients with sickle cell disease receive red
      blood cell (RBC) transfusions before undergoing general anesthesia and surgery.
      Since RBC transfusions are costly, inconvenient, and may cause serious
      complications, it might be useful to identify groups of patients for whom they
      are not absolutely necessary. We report our experience with 54 pediatric patients
      undergoing 66 elective surgical procedures without preoperative transfusion
      preparation. All patients were felt to be clinically and hematologically stable
      in the immediate preoperative period. For the majority of procedures (57/66, 86%)
      no transfusions were administered at any time during the perioperative course.
      There were no intraoperative complications or postoperative deaths. Overall, some
      type of postoperative complication was encountered after 17 procedures (26%).
      Complications were usually minor and were more likely to occur after procedures
      involving thoracotomy or laparotomy (10/20, 50%) and tonsillectomy/adenoidectomy
      (T&A) (5/9, 56%) than other procedures (2/37, 5%; P < .001). Pulmonary
      complications were especially more prevalent in the group undergoing thoracotomy,
      laparatomy, or T&A (9/29 v 0/37 for all other procedures, P < .001). We conclude
      that preoperative transfusions might be avoided in children with sickle cell
      disease who undergo most minor surgical procedures on an elective basis. Patients
      undergoing thoracotomy, laparotomy, or T&A are at a relatively higher risk of
      developing postoperative complications and would comprise ideal groups for
      evaluation of preoperative transfusion regimens in prospective carefully
      controlled, randomized studies.

PMID- 8340859
TI  - Partial splenectomy in Gaucher's disease: follow-up report.
AB  - This is a follow-up report of three children who had partial splenectomy and are
      suffering from Gaucher's disease. A few years following partial splenectomy in
      every patient, the remaining spleen enlarged and hypersplenism reappeared;
      partial splenectomy did not prevent bone destruction if it already existed before
      partial splenectomy. Treatment with Ceredase parallel with partial splenectomy
      may have theoretical and practical advantages.

PMID- 8340860
TI  - Pediatric laparoscopic splenectomy.
AB  - We report our initial experience and describe the operative technique used in
      three patients who underwent laparoscopic splenectomy for hematologic disorders
      between September 1991 and February 1992. No early or late complications have
      been found at an average follow-up of 9 months. All have remained asymptomatic
      and continue to have normal cell counts. We believe that splenectomy is a
      feasible extension of minimally invasive surgery in the hands of experienced
      surgeons. However, recognition of its limitations and ability to convert to the
      open procedure to assure safe excision is essential.

PMID- 8340861
TI  - Laparoscopic nephrectomy in the first year of life.
AB  - A child was found antenatally to have a cystic right kidney on maternal
      ultrasound. This was evaluated in the immediate postnatal period with imaging
      studies and confirmed to be a multicystic, dysplastic kidney. Expectant
      management was followed; however, the kidney was found to be unchanged in size on
      a 6-month ultrasound and the parents elected surgical removal rather than
      continued medical surveillance. A nephrectomy was performed using laparoscopic
      techniques rather than standard open surgery. Operating time was less than 1
      hour. The patient's recovery was unremarkable.

PMID- 8340862
TI  - Abnormal aorta and iliac arteries in children with urogenital abnormalities.
AB  - Retroiliac ureters have been found in association with a variety of urogenital
      abnormalities but the iliac artery usually retains a retroperitoneal position. We
      report 7 children with various urogenital abnormalities (cloacal malformation 4,
      bladder agenesis 1, urogenital sinus 1, neuropathic bladder 1) in whom the lower
      aorta and iliac arteries were so distorted as to pose a significant operative
      hazard. In all cases the distal aorta and/or iliac arteries lay within the
      peritoneal cavity, often anterior to the bladder. In 3 cases the aorta was fixed
      by a short ligament to the umbilicus, and in 3 patients one of the iliac arteries
      ran across the pelvis behind the pubic bones before entering the leg. In one
      patient an anomalous iliac artery was inadvertently divided during reconstruction
      of a cloaca; when recognized, the vessel was rejoined. Recognition of an
      association between urogenital or cloacal malformations and a major vascular
      anomaly is of great importance to reconstructive surgeons who, if not forewarned,
      could unintentionally compromise the arterial supply to one or both lower limbs.

PMID- 8340863
TI  - The mild end of the clinical spectrum of posterior urethral valves.
AB  - Posterior urethral valves have a broad clinical spectrum. In this series of 87
      patients, 36 had mild valvular obstruction, the most common clinical variety.
      Boys with mild valves had a greater frequency of diurnal and nocturnal enuresis,
      super-imposed infection, and a poor stream. The diagnosis was established by a
      very strict correlation of the radiological and endoscopic findings. Urodynamic
      studies, although performed in a limited number of patients, add validity to the
      diagnosis of mild valves. A classification based on the secondary anatomical
      changes and functional damage, which divides the valves in mild, moderate, and
      severe is recommended. Results of the endoscopic fulguration were excellent and
      without complications; 34 of 36 patients were improved or cured of their
      disturbing symptoms.

PMID- 8340864
TI  - University of Wisconsin preservation solution compared with Euro Collins
      preservation solution in pediatric liver transplantation.
AB  - Orthotopic liver transplantation has become the accepted treatment for end-stage
      liver disease in children. To evaluate the efficacy of the University of
      Wisconsin (UW) preservation solution in pediatric liver transplantation, a group
      of 34 livers preserved with UW solution was compared in a nonrandomized fashion
      with a historical control group of 34 livers preserved with Euro Collins (EC)
      solution. Primary graft nonfunction did not occur in either group. Both groups
      were similar with respect to age, sex, weight, diagnosis, severity of the
      recipient's condition, donor condition at harvest, donor/recipient blood type
      match, and immunosuppressive management. The UW group had a significantly higher
      bilirubin, AST, ALT, and GGT during the first week after transplantation when
      compared with the EC group but no significant differences were noted after the
      ninth post-transplant day. No differences were noted when the groups were
      compared as to surgery time (9.1 v 8.4 hours), blood volumes replaced (1.8 v
      2.0), number of ICU days (5.0 v 6.5), total number of infections per graft (1.0 v
      0.8), total hospital days (31 v 30), and hospital cost ($134,000 v $126,000). The
      total preservation time was improved from 7 hours (range, 3.2 to 9.9) in the EC
      group to 13.9 hours (range, 6.9 to 22.3) in the UW group (P < .001). UW solution
      allows a significant increase in cold ischemic time in liver transplantation when
      compared with EC. This increase in preservation time resulted in no detrimental
      effect when compared with EC and potentially led to milder episodes of rejection
      in the postoperative period.

PMID- 8340865
TI  - Pancreatic anatomy in children: emphasis on its importance to pancreatectomy.
AB  - The literature is riddled with misconceptions concerning the landmarks and the
      actual amount of pancreatic tissue resected in "subtotal" 60% to 90%
      pancreatectomies. In order to clarify the surgical anatomy of the pancreas, 13
      autopsy specimens from children aged 2 days to 15 years were carefully examined.
      Pancreata were serially removed from the in situ position in four sections and
      weighed. Section 1 included pancreatic tissue from the tail to the left of the
      superior mesenteric vessels (SMV); section 2 included all tissue from the tail to
      the right of the SMV; section 3 contained tissue up to the left of the
      pancreaticoduodenal vessels in the head of the pancreas; and section 4 included
      the remainder of the pancreatic head within the duodenal sweep and the uncinate
      process. Results showed that section 1 weighed 47.5% +/- 9.7% (mean +/- SD) of
      the total pancreatic weight with a wide range of 32.3% to 67.3%; section 2
      weighed 53.5% +/- 9.0% (range, 38.7% to 72.2%); section 3 weighed 69.1% +/- 15.6%
      (range, 43.5% to 95.8%); and section 4 weighed 31.6% +/- 14.6% (range, 4.2% to
      56.5%). As noted, pancreatic anatomy was extremely variable in relation to the
      percent of tissue to either side of the SMV and the proportion of tissue
      contained within the uncinate process. Resections historically reported to result
      in a "75%" pancreatectomy (section 2) were demonstrated to contain a mean of only
      53.5% +/- 9.0% of the pancreas. Less tissue than expected would be resected by
      using the SMV as landmarks for a 75% resection. The wide variation in anatomy
      also has important clinical implications in performing "subtotal"
      pancreatectomies in infants with nesidioblastosis in whom the amount of tissue
      resected is critical to the patient's postoperative clinical course. This study
      demonstrates that a subtotal pancreatectomy should not be based upon the presumed
      relation of the pancreatic substance to the SMV. The entire gland including the
      uncinate process should be visualized at operation in order that a proper
      pancreatectomy is performed.

PMID- 8340866
TI  - Surgical treatment of intractable cholestasis associated with total parenteral
      nutrition in premature infants.
AB  - We report surgical reversal of intractable total parenteral nutrition (TPN)
      associated cholestasis refractory to conservative treatment in 9 premature
      infants. Indications for TPN were poorly tolerated enteral feedings in all
      patients. Five patients had undergone gastrointestinal operations; in addition, 7
      of the 9 patients had had bacterial sepsis. The median duration of TPN was 28
      days (range, 20 to 50 days). The median duration of preoperative full enteral
      nutrition after weaning from TPN was 34 days (range, 16 to 95 days). All patients
      had progressive conjugated hyperbilirubinemia, no excretion of Tc-labeled HIDA to
      the biliary tree and duodenum, and markedly elevated liver enzyme values.
      Intraoperative cholangiography showed normal biliary anatomy in all cases; in
      addition, 2 patients had gallbladder stones. Bile was hyperviscous in all
      patients and contained biliary sludge in 4. The biliary tree was irrigated and
      the liver biopsied in all patients. The gallbladder was removed from 2 patients
      who had stones in the gallbladder. Liver histology was consistent with TPN
      associated cholestasis in all cases, and in addition, 4 cases showed significant
      destruction of intrahepatic bile ducts. One patient died 2 weeks postoperatively
      from intracerebral hemorrhage. Jaundice completely resolved in other patients
      within 2 weeks. HIDA-biligraphy performed 1 to 2 months postoperatively showed
      normal excretion of the radioactive marker to the biliary tree and duodenum in
      all cases. The functional abnormality in bile excretion and bile duct motility in
      TPN-associated cholestasis may be reversed by irrigation of the biliary tree.
      Surgical intervention should be considered when cholestasis is progressive and
      refractory to medical management.

PMID- 8340867
TI  - Problems with intestinal lengthening.
AB  - The surgical problems encountered in treating three infants with short-bowel
      syndrome are reported. The two survivors demonstrate many of the problems
      associated with the very short-bowel syndrome and both are dependent on
      parenteral nutrition despite undergoing intestinal lengthening.

PMID- 8340868
TI  - Epigastric heteropagus.
AB  - Incomplete parasitic twinning with the parasite attached at the host's
      epigastrium is extremely rare. We report a case of epigastric parasitic twinning
      where the parasite with a well-developed pelvis and lower limbs had accessory
      pelvic organs and was attached to the host above an omphalocele. The parasite was
      excised and the omphalocele managed conservatively by mercurochrome application.
      A review of the four previously reported cases is presented along with a
      discussion of the possible etiopathogenesis and nomenclature of this condition.

PMID- 8340869
TI  - An unusual form of caudal duplication (dipygus).
AB  - An unusual case of caudal duplication is presented in which the infant had an
      extra lower limb with 14 digits attached to an accessory parasitic pelvis
      situated in the midline subpubic area. Duplication of the external genitalia was
      also present. Successful excision of the accessory limb and reconstruction of the
      genitalia was performed in the neonatal period.

PMID- 8340870
TI  - Reconstruction of hypoplastic aortic arch and coarctation in a 720-gram premature
      infant.
AB  - The case of a 720-g infant born at 29 weeks of gestation who underwent successful
      surgical correction of a hypoplastic aortic arch and aortic coarctation is
      presented. The infant was initially brought to surgery with an echocardiographic
      diagnosis of patent ductus arteriosus with left to right shunt unresponsive to
      indomethacin therapy. The correct diagnosis of hypoplastic aortic arch and severe
      coarctation with ductal dependent blood flow to the lower body was made
      intraoperatively. This case illustrates the danger of limited diagnostic testing
      in premature infants assumed to have isolated patent ductus arteriosus, and also
      that these small infants can undergo successful surgical repair of complex aortic
      arch lesions.

PMID- 8340871
TI  - Primary occlusion of the iliac and femoral artery in two newborn infants:
      efficacy of medical treatment.
AB  - Arterial occlusion not associated with umbilical artery catheterization is a rare
      condition in the newborn period. Two neonates with femoral and iliac artery
      occlusion in the first days of life are presented. While almost all the cases
      described in the literature underwent surgical treatment, these two infants
      received only pharmacological treatment with good results. Although angiography
      remains the examination of choice for the diagnosis, noninvasive angiologic
      evaluations such as oscillometry and Doppler flow examination have been used for
      both diagnosis and follow-up. The etiology in these two cases remains unknown.
      The results obtained with these two neonates suggest that with prompt recognition
      of this disorder and an aggressive medical treatment, a complete recovery could
      be achieved.

PMID- 8340872
TI  - Osteoid osteoma of the rib: a case report.
AB  - A case of a 6-year-old boy with a painful dorsal scoliosis secondary to an
      osteoid osteoma in a rib is described. Surgical excision was performed and the
      scoliosis decreased. Such cases are very rare.

PMID- 8340873
TI  - Infantile hemangiopericytoma: a rare cause of a soft tissue mass.
AB  - A case of infantile hemangiopericytoma in a neonate is presented. The
      clinicopathologic characteristics of this tumor are described. This tumor is
      often confused for other more aggressive malignant tumors and, thus, is likely
      under-reported and overtreated. These tumors exhibit features suggestive of
      malignancy such as increased mitotic activity, nuclear pleomorphism, and
      increased cellularity, yet are clinically unpredictable. A conservative surgical
      approach is advocated.

PMID- 8340874
TI  - Rapid decompression of chronic hydrocephalus resulting in bilateral extradural
      hematomas; a general surgical complication.

PMID- 8340875
TI  - Opening of both vasa into a mullerian duct cyst.

PMID- 8340876
TI  - Nitrofen-induced diaphragmatic hernias in rats: an animal model.

PMID- 8340877
TI  - Pediatric community needs.

PMID- 8340878
TI  - The development of a comprehensive bereavement program to assist families
      experiencing pediatric loss.
AB  - One of the most difficult situations encountered by pediatric nurses is dealing
      with families experiencing the death of a child. This article describes the
      development of the H.O.P.E.S. Program (Healing of Parents Experiencing Sorrow), a
      comprehensive bereavement program designed to assist families who have
      experienced pediatric loss. This program has been well-received by both families
      and staff and has enabled staff to interact more confidently with families at a
      very difficult time in their lives.

PMID- 8340879
TI  - The effect of the sight of blood and use of decorative adhesive bandages on pain
      intensity ratings by preschool children.
AB  - A total of 70 children between the ages of 3 and 6 years participated in two
      studies that tested the effect of (a) the sight of blood and (b) the application
      of a decorated adhesive bandage on pain intensity ratings following a
      fingerstick. In both studies, children were randomly assigned to one of four
      groups. These groups allowed for the combinations of testing blood or no blood
      and the application of a decorated adhesive bandage or plain adhesive bandage.
      The Oucher (Beyer, 1984) and the Poker Chip Tool (Hester, 1979) were used as self
      report measures of pain intensity at the time of the fingerstick and immediately
      after the application of the adhesive bandage. The pilot study recruited 20
      children from two day care centers and subjected them to sham fingersticks.
      Results indicated that there were no differences across the groups in pain
      intensity ratings. However, there was a trend for the sight of blood to increase
      the child's pain intensity rating. Age was a significant covariate across all
      groups, with younger children reporting higher levels of pain intensity. The
      second study took place in a pediatric test center of a metropolitan children's
      hospital. Fifty outpatient children who were receiving fingersticks for
      preoperative or diagnostic testing were enrolled. Results indicated that there
      were no differences across groups, and age was only significant on the Poker Chip
      Tool. These results suggest that simple interventions and distractions are not
      sufficient to decrease perceived pain intensity ratings in young children.

PMID- 8340880
TI  - Prevalence study of substance abuse in a midwestern city.
AB  - Illicit substance abuse among pregnant women has been documented in many large
      metropolitan areas. However, there has been limited documentation in smaller,
      more traditional cities of America. The urine of 105 viable newborns delivered
      within a 30-day period was tested for illicit drugs in a blind study. Positive
      results were obtained in 9.5% of the subjects. The following demographic data
      were compiled about the subjects: (a) type of identified substance; (b) age of
      mother; (c) timing of mother's entry into prenatal care; (d) maternal
      complications; (e) newborn complications; (f) newborn gestational age; and (g)
      mother's economic status.

PMID- 8340881
TI  - Survey of nursing research programs in children's hospitals.
AB  - Available published literature describing successfully implemented research
      programs is relatively limited, particularly within children's hospitals. In
      order to determine the status of research program development within children's
      hospitals, a mailed survey was sent to 108 free-standing children's hospitals in
      the United States and Canada. The questionnaire was comprised of questions
      pertaining to five general sections: (a) institutional demographics; (b)
      organizational structure for research; (c) research activities; (d) relationship
      to other agency research; and (e) demographic characteristics of the individual
      completing the survey. Findings indicated that nursing research within children's
      hospitals is in an early development state, but that it is recognized as a
      necessary and credible component of nursing. Differences were noted between the
      groups of hospitals with the most research activity and those with no research
      activity. Hospitals were in various stages of research development, a sequential
      process characterized by a sequential pattern comprised of two phases.

PMID- 8340882
TI  - Acute rheumatic fever revisited.
AB  - Acute rheumatic fever, often believed to have been eradicated, has shown an
      increase in prevalence and virulence within the past few years. This article
      discusses current epidemiology, assessment findings, medical treatment, and
      nursing interventions for the child with rheumatic fever. Principles of
      prevention and implications for health teaching are included.

PMID- 8340883
TI  - Sources of Family Annoyance (SOFA): development, reliability, and validity.
AB  - The Sources of Family Annoyance (SOFA) is a brief questionnaire intended to
      measure chronic stressors experienced by fathers and mothers in the home. Two
      scales, Household Negatives and Child Negatives, were derived from factor
      analysis. Experiment 1 demonstrated that the instrument discriminated a group of
      parents of psychiatric clinic-referred children from nonreferred parents.
      Experiment 2 demonstrated that the instrument discriminated mothers who were
      receiving public assistance from mothers in a community sample. Results suggest
      that the SOFA is a reliable and valid brief parent stress assessment instrument
      that may be useful in family-based interventions to reduce stress and improve the
      course of pediatric illness.

PMID- 8340884
TI  - The emerging need for a SIDS support group for family child care providers in
      Minnesota.
AB  - In Minnesota, 37% of all deaths due to Sudden Infant Death Syndrome (SIDS) in
      1989 occurred in a family child care home. An ongoing monthly support group was
      developed for child care providers who experienced a SIDS-related death in their
      homes. This was developed in response to a desire to have a support group
      specifically for providers and separate from parent support groups. Evaluation by
      group participants indicated that such a group was effective in helping them work
      through the grief process.

PMID- 8340885
TI  - Homeless children and their families, Part II: Federal programs and alternative
      health care delivery systems.

PMID- 8340887
TI  - Creative approaches to promoting parent-infant bonding.

PMID- 8340886
TI  - Glucometers: accuracy and precision, Part II. Selection of a blood glucose
      monitor for standard hospital use.

PMID- 8340888
TI  - A trip to the Australian Outback.

PMID- 8340889
TI  - HIV infection in 567 active pulmonary tuberculosis patients in Brazil.
AB  - We studied 567 patients with active pulmonary tuberculosis (APT) in Rio de
      Janeiro, Brazil, by using a standardized questionnaire and by testing blood for
      HIV antibodies. The rate of HIV infection was 3.9% in 1987, 4.8% in 1988, and
      5.2% in 1989, and did not differ by sex. It was highest (7.4%) in the 15- to 39
      year age group. There was no difference between patients infected and not
      infected by HIV with regard to education, income, housing, or employment. Among
      all patients with definite HIV risk behavior, the HIV infection rate was 23.3%,
      rising to 31.2% among homo/bisexual men and 36.4% among intravenous drug users,
      and the rate was 6.5% for blood-transfusion recipients. Among patients who denied
      risk behavior, the rate was 1.2%. Generalized lymphadenopathy and oral
      candidiasis occurred with greater frequency among HIV-infected patients (p <
      0.0001). Applying the World Health Organization 1985 clinical criteria and
      revised case definition for AIDS, we found, respectively, sensitivities of 34%
      and 76.9% and specificities of 31% and 26.3%; in the Rio de Janeiro environment,
      these clinical criteria without HIV serology should not be adopted for
      tuberculosis patients. For chest radiographs, a significant association was found
      between HIV infection and the occurrence of atypical images (p = 0.0001), and
      hilar and/or mediastinal adenopathy (p = 0.0002) and absence of cavities (p =
      0.0003). A PPD (purified protein derivative) skin test induration of < 5 mm was
      identified in 53% of the HIV-positive cases and in 31.3% of the HIV-negative
      cases. Only 11.5% of HIV-infected APT patients met the Centers for Disease
      Control 1987 AIDS criteria.

PMID- 8340890
TI  - Response of human immunodeficiency virus-infected adults to measles-rubella
      vaccination.
AB  - Measles-mumps-rubella vaccine (MMR) is recommended for human immunodeficiency
      virus-infected (HIV+) adults. Data concerning MMR vaccination of HIV+ patients
      are limited to children. We evaluated 39 HIV+ (97% with > 200 CD4+ lymphocytes)
      and 17 non-HIV+ control adults receiving measles-rubella vaccine (MR). Clinical
      adverse events did not differ between groups. Prevaccination, three HIV+ and two
      control vaccinees were measles seronegative; no HIV+ and one control vaccinee
      seroconverted. No initially measles-seropositive vaccinee had a significant
      antibody elevation. Four HIV+ and three control vaccinees were rubella
      seronegative prevaccination; three HIV+ and two control vaccinees seroconverted.
      Among those initially rubella seropositive, two HIV+ and one control vaccinee had
      significant antibody elevations. There were no significant percentage CD4+ or
      CD8+ lymphocyte changes between groups. Three HIV+ vaccinees were p24 antigen
      positive pre- and postvaccination. Although MR vaccination appears safe in HIV+
      adults, questions remain about the response of measles and rubella antibody
      negative HIV+ adults and those with < 200 CD4+ lymphocytes.

PMID- 8340891
TI  - Altered production of PGE2, IL-1 beta and TNF-alpha by peripheral blood monocytes
      from HIV-positive individuals at early stages of HIV infection.
AB  - We analyzed the in vitro synthesis and release of PGE2, IL-1 beta, and TNF-alpha
      by peripheral blood monocytes from HIV-infected injection drug users at the early
      clinical stages of HIV infection. We investigated whether there is a concomitant
      altered production of PGE2 and proinflammatory cytokines by HIV-positive
      monocytes. We also evaluated T-cell subsets and lymphocyte transformation
      response to pokeweed mitogen (PWM) in HIV-positive patients and healthy controls.
      PGE2 and IL-1 beta levels in supernatants from monocyte cultures were determined
      by radioimmunoassay (RIA), and TNF-alpha by enzyme immunoassay (EIA). Monocytes
      from asymptomatic HIV-positive individuals produced spontaneous and significantly
      increased quantities of PGE2, IL-1 beta, and TNF-alpha. Concomitant increased
      production of PGE2 and IL-1 beta by monocytes from HIV-positive asymptomatic
      patients was significantly associated with low CD4+ T-cell numbers (< 500
      cells/mm3). We also found a strong association between spontaneous and
      concomitantly increased production of PGE2 and cytokines by monocytes from
      asymptomatic HIV-positive individuals and a low lymphocyte transformation
      response to PWM. Further studies are necessary to establish whether this altered
      production of PGE2 and proinflammatory cytokines by monocytes from HIV-positive
      individuals might play a role in the mechanisms involved in the progressive
      impairment of cell-mediated immunity in HIV infection.

PMID- 8340892
TI  - Prevalence of intestinal protozoans in French patients infected with HIV.
AB  - To assess the prevalence of intestinal protozoans in French HIV-infected
      patients, stool samples, duodenojejunal biopsies, and/or colorectal biopsies from
      81 patients were studied for parasites, viruses, and bacteria. Pathogens were
      found in 70.6% of AIDS patients with diarrhea or malabsorption. The respective
      prevalence of protozoa in AIDS patients with diarrhea was Cryptosporidium sp.:
      37.3%, Blastocystis hominis: 13.7%, Giardia intestinalis: 5.8%, Isospora belli:
      2%, Enterocytozoon bieneusi: 2%. Microsporidia were noted in one patient with
      severe malabsorption but no diarrhea. Other pathogens included cytomegalovirus in
      27.4% and Mycobacterium avium in 5.8%. Patients with identified pathogens were
      more immunosuppressed and more severely malnourished than those with unexplained
      diarrhea. Multiple pathogens were found in 13 of 81 patients (16%). Twenty-six of
      66 identified pathogens (40%) were diagnosed only on biopsy specimens. Chronic
      diarrhea in HIV patients could be explained in the vast majority by appropriate
      gastrointestinal investigations. Cryptosporidia played a major role, while
      microsporidia appeared to be less common.

PMID- 8340893
TI  - The initial detection of human immunodeficiency virus 1 and its subsequent spread
      in prostitutes in Tamil Nadu, India.
AB  - To determine the prevalence of HIV-1 antibody and risk factors associated with a
      positive test in a heterosexually promiscuous female population, we initially
      screened 412 prostitutes in remand homes in three cites and three towns in Tamil
      Nadu state (southern India) and then tested all new entrants to one home in
      Vellore from 1986 to 1990. The proportion of women infected (10 of 102) from the
      port city of Madras was greater than from all other cities or towns combined
      (four of 310, p = 0.0002). The only significant risk factor for development of
      HIV-1 antibody was exposure to foreigners (odds ratio: 7.71; 95% confidence
      interval 4.2-11.2; p = 0.0004), after correcting for the influence of city. In
      Vellore the prevalence of HIV-1 antibody increased from 1.8% in 1986 to 28.6% in
      1990, with a doubling time of 0.95 years. We hypothesize that HIV-1 infection has
      been introduced into India relatively recently into the heterosexually
      promiscuous population, where there has been some spread. Preventive measures
      should be urgently directed toward this population to prevent spread in the
      general population.

PMID- 8340894
TI  - Urban-nonurban distribution of HIV infection in childbearing women in the United
      States.
AB  - Women account for an increasing proportion of AIDS cases in the United States,
      and the number reported from small cities and rural areas is growing. To better
      describe the geographic characteristics of the human immunodeficiency virus (HIV)
      epidemic in women, we analyzed data for more than 1.6 million newborn specimens
      tested for maternal antibody to HIV-1 in 35 states in 1989. To provide comparable
      geographic units for analysis, seroprevalence rates were calculated for state
      designated health districts, which are groups of counties defined for the
      planning and delivery of health services. Health districts with > or = 75% of the
      population residing in urban areas as defined by the 1990 census were considered
      urban. Prevalence of HIV infection ranged from 0 to 12.2 per 1,000, with the
      highest rates found in urban health districts, primarily those on the East coast;
      however, high rates were also found in some nonurban districts, particularly in
      the South. Rates among black women were three to 35 times higher than in white
      women in nine states, regardless of urbanicity. These findings should be used to
      focus prevention activities and direct health care planners to urban and rural
      areas in need of HIV-related services for women.

PMID- 8340895
TI  - Prevention of heterosexual transmission of human immunodeficiency virus through
      couple counseling.
AB  - In the absence of an effective vaccine, behavior change remains the most
      effective means to prevent the spread of HIV. We examined behavior change over
      time and rates of HIV seroconversion in a cohort of HIV individuals and their
      heterosexual partners recruited since 1985. Participants were recruited from
      various HIV counseling and testing sources throughout California and were usually
      interviewed and tested in their own homes. Couple counseling and risk assessments
      were conducted at average intervals of six months. Data from 144 couples who were
      discordant for HIV serostatus are reported. Of the index cases, 78% were men.
      Most male index cases were bisexuals, and most female index cases were infected
      through heterosexual intercourse with a previous sexual partner. The mean
      duration of the relationship for the couple at intake was 5.6 years. Both condom
      use and sexual abstinence increased over time (p < 0.001 for both), and most
      behavior change occurred between intake and first follow-up visit. We observed no
      seroconversion after 193 couple-years of follow-up. Couple counseling in
      combination with social support appears to be an effective means to promote and
      sustain behavior change among HIV-infected individuals and their heterosexual
      partners.

PMID- 8340896
TI  - Human immunodeficiency virus seroconversion among intravenous drug users in- and
      out-of-treatment: an 18-month prospective follow-up.
AB  - Our objective was to determine the prevalence and incidence of human
      immunodeficiency virus (HIV) infection and related risk behaviors among opiate
      abusing intravenous drug users (IVDUs) either in or out of methadone treatment.
      The subjects, 152 in-treatment and 103 out-of-treatment intravenous opiate users,
      were followed prospectively for 18 months. Behavioral and serologic assessments
      were made at 6-month intervals, with complete information available on 89% of the
      sample. Subjects were recruited from a single methadone maintenance program and
      the surrounding neighborhood in north-central Philadelphia. At baseline, the HIV
      seroprevalence rate for the total sample was 12%: 10% for the methadone
      maintained group and 16% for the out-of-treatment group. Out-of-treatment
      subjects were injecting drugs, sharing needles, visiting shooting galleries, and
      practicing unsafe sex at significantly higher rates than in-treatment subjects.
      Follow-up of HIV-negative subjects over the next 18 months showed conversion
      rates of 3.5% for those who remained in methadone maintenance versus 22% for
      those who remained out of treatment. The sixfold difference in rate of
      seroconversion between the two groups suggests that although rapid transmission
      of HIV still occurs, opiate-abusing IVDUs who enter methadone treatment are
      significantly less likely to become infected. In contrast, those opiate addicts
      who do not enter treatment are at significantly higher risk of contracting and
      spreading the disease. Implications for developing additional risk interventions
      for out-of-treatment IVDUs are discussed.

PMID- 8340897
TI  - Laboratory-based reporting of AIDS.
AB  - To improve the speed and completeness of AIDS reporting, the Philadelphia Board
      of Health adopted regulations requiring medical laboratories to report directly
      to the Department of Public Health all results indicative of AIDS-defining
      diagnoses. Reports were used to focus active AIDS surveillance on physicians who
      had requested laboratory reports whose results were likely to have diagnosed AIDS
      recently. One year after implementation, laboratories provided the first lead to
      20% of all AIDS reports. Reports originating with laboratories reach our data
      base sooner after diagnosis and ascertain a slightly higher proportion of women
      than do other reports. Laboratory-based reporting offers a practical way to focus
      the limited resources available for active surveillance on health providers
      likely to have an AIDS diagnosis to report.

PMID- 8340898
TI  - Human T lymphotropic virus type I/II in Lake Lindu Valley, Central Sulawesi,
      Indonesia.

PMID- 8340899
TI  - Attitudes to euthanasia and assisted suicide in a group of homosexual men with
      advanced HIV disease.

PMID- 8340900
TI  - Cellular immune response to SIVmac and HIV-2 in macaques: model for the human HIV
      1 infection.
AB  - SIV and HIV-2 infection of macaques has become a widely used model to study human
      HIV infection because the pathogenicity of, as well as the immune responses to,
      the viruses can be examined conveniently. In particular, the cellular immune
      responses to SIV or HIV-2 have been investigated thoroughly. This review
      summarizes the knowledge about helper and cytotoxic T-cell immunity in macaques,
      and it discusses the relevance and applications of this primate animal model for
      AIDS research.

PMID- 8340901
TI  - Serum inhibitors precede the development of SAIDS.
AB  - Rhesus macaque monkeys infected with the simian immunodeficiency virus develop a
      syndrome mimicking AIDS in humans. We have demonstrated previously that sera from
      individuals infected with human immunodeficiency virus type 1 inhibit the
      proliferation of lymphocytes from healthy noninfected subjects and that this
      phenomenon is associated with the development of clinical AIDS. We have also
      shown that sera from monkeys infected with SIV also have such inhibitors. In this
      body of work, we attempted to document the onset of these inhibitors in relation
      to the time of SIV infection. Twenty rhesus macaques were injected with one of
      two tissue strains of SIV or media. Blood was drawn on a set schedule and the
      serum samples frozen at -70 degrees C. The animals were monitored and observed
      for up to 42 weeks. All test animals were autopsied. Sera from all the draws were
      assayed against the same populations of human peripheral blood mononuclear cells
      in the same experiment using suboptimal amounts of phytohemagglutinin (PHA). Sera
      from those animals that subsequently developed SAIDS were more likely to
      demonstrate serum inhibition. This inhibition could be seen as early as 8-10
      weeks after infection. By week 14, the assay could differentiate animals into
      SAIDS or healthy groups with a sensitivity of 67% and a specificity of 89%.

PMID- 8340902
TI  - Tots and teens: similarities in behavior and interventions for pediatric and
      psychiatric nurses.
AB  - The separation-individuation process is played out in similar ways by toddlers
      and teenagers. Child and adolescent psychiatric nurses may have a better
      appreciation of the subtleties and complexities in dealing with behaviors of
      these patients with a comparison of the two groups. This paper discusses
      similarities in behaviors of toddlers and teens and presents theory-based
      guidelines for interventions with clients in these age groups.

PMID- 8340903
TI  - Sexually abused boys: awareness, assessment, and intervention.
AB  - The prevalence and consequences of the sexual victimization of young boys is
      tragically underestimated. The author provides data on the incidence of sexual
      abuse in boys and girls, ages 3-10, in an inpatient psychiatric children's unit.
      A retrospective chart review is presented including variables of coexisting
      maltreatment and symptomatology. Commonly found nursing diagnoses are identified
      with appropriate nursing interventions. Assessing a sexually abused boy,
      developing a comprehensive nursing care plan, and intervening effectively in
      assisting a child to assimilate and cope with his abuse experience are discussed
      in depth.

PMID- 8340904
TI  - A letter to Hillary Rodham Clinton.

PMID- 8340905
TI  - Attending nurses.

PMID- 8340906
TI  - Growth and development of the brain.

PMID- 8340908
TI  - The sicker get healthier and the healthier get sicker; eventually the twain shall
      meet.

PMID- 8340907
TI  - The first 100 days and hopes for children.

PMID- 8340909
TI  - Excursions in drug discovery.

PMID- 8340910
TI  - (S)- and (R)-8-(di-n-propylamino)-6,7,8,9-tetrahydro-3H-benz[e]indole-1-
      carbaldehyde: a new class of orally active 5-HT1A-receptor agonists.
AB  - The enantiomers of 6,7,8,9-tetrahydro-N,N-di-n-propyl-3H-benz[e]indol-8- amine (S
      (-)-2b and R-(+)-2b) and their corresponding 1-formyl analogs (S-(-)-6 and R-(+)
      6) were prepared and evaluated pharmacologically for serotonergic and
      dopaminergic activity. The introduction of a formyl group in the 1-position
      shifted the pharmacological profile of 2b from a mixed D2/5-HT1A agonists to a
      selective 5-HT1A agonist (6). The enantiomers of 6 were agonists with full
      intrinsic activity and had an affinity comparable to that of 8-hydroxy-2-(di-n
      propylamino)tetrahydronaphthalene (8-OH-DPAT). In contrast to 8-OH-DPAT, the
      enantiomers of compound 6 were found to have good oral availability.

PMID- 8340911
TI  - Synthesis and antitumor properties of an anthraquinone bisubstituted by the
      copper chelating peptide Gly-Gly-L-His.
AB  - A new molecule 4 [(GGH-DAE)2DHQ] associating the 1,4,5,8
      tetrahydroxyanthraquinone ring (DHQ) of the antitumor drug mitoxantrone (2), two
      diaminoethylene chains (DAE), and the metal-chelating peptide Gly-Gly-His (GGH)
      has been synthesized. Such a molecule presents characteristics able to induce
      antitumor activity: compound 4 intercalates into DNA as measured by delta Tm,
      fluorescence quenching, and viscometry; ESR studies demonstrate that several
      types of Cu complexes are formed depending on pH; and the production of free
      radicals, as evidenced by spin-trapping, is enhanced by 4. In vitro, in leukemia
      cells L1210 and mammary cells MCF7, 4 is slightly less cytostatic than
      mitoxantrone, but substantially less toxic. In vivo, in leukemia P388 on mice, a
      T/C value of 230 is obtained at 25 mg/kg, higher than the one of mitoxantrone,
      which is toxic at the same dose.

PMID- 8340912
TI  - Reductive activation of potential antitumor mitosene compounds.
AB  - The reductive activation of mitosene compounds was studied with cyclic
      voltammetry and HPLC analysis. Reduction of mitosenes, possessing good leaving
      groups at C-1 and C-10, was shown to result in loss of these groups at pH 7.0 and
      pH 6.0. The loss of leaving groups from mitosenes occurred faster at lower pH.
      Mitosenes without good leaving groups were found to be stable upon reduction. In
      the presence of acetoxy groups at C-1 and C-10, the C-10 site is the most
      reactive site upon reductive activation. This is opposite to the case of
      mitomycin C, where the C-1 site is the first to react upon reduction. At pH 6.0
      without reduction, acid degradation also caused the loss of leaving groups of
      mitosenes, although at a very slow rate. In contrast to reductive activation,
      upon acid degradation of a diacetoxymitosene the C-1 group appeared to be lost
      faster. Electrochemical as well as dithionite reduction of a bifunctional
      (diacetoxy) mitosene compound in the presence of calf thymus DNA at pH 5.5
      resulted in the formation of DNA interstrand cross-links. Depending on activation
      method, this diacetoxymitosene was at least as efficient in DNA cross-linking as
      mitomycin C under comparable conditions.

PMID- 8340913
TI  - N-phosphoryl derivatives of bisantrene. Antitumor prodrugs with enhanced
      solubility and reduced potential for toxicity.
AB  - The selective phosphorylation of bisantrene (1) affords bis(phosphonoguanidinic
      acid) 6, a prodrug with enhanced aqueous solubility (as sodium salt 7) at
      physiological pH. Unlike 1, in a rat tail vein model, no precipitation was
      observed when bis(phosphonoguanidinic acid) 6 was injected. While in rats 6
      hydrolyzed to monophosphonoguanidinic acid 9 with a half-life of ca. 12 min.,
      complete hydrolysis to bisantrene required several hours. The corresponding
      monophosphonoguanidinic acid 9 was synthesized from bisantrene and also showed
      good solubility and antitumor activity. While the antitumor activities of 6 in
      mice were comparable to bisantrene against B-16 melanoma and P-388 and L-1210
      leukemias, it was inactive in vitro vs several tumor cell types. Thus, its
      activity in vivo resulted from its ability to serve as a prodrug for bisantrene.

PMID- 8340914
TI  - Syntheses of 5'-substituted analogues of carbocyclic 3-deazaadenosine as
      potential antivirals.
AB  - Various 5'-substituted derivatives (2, 3, 6a, 6b, 9a, 9b, 12, 13b, and 15) of
      carbocyclic 3-deazaadenosine (3-deaza CAdo, 1) were prepared from 3-deaza CAdo
      (1) and evaluated as antiviral agents against a number of viruses, including HIV
      1. Several of the compounds had moderate to good antiviral activity against
      vaccinia (VV) and vesicular stomatitis (VSV) viruses; however, the antiviral
      activity of the analogues did not exceed that of the parent compound. No anti-HIV
      activity was detected.

PMID- 8340915
TI  - Synthesis and structure-activity relationships of phenyl-substituted benzylamine
      antimycotics: a novel benzylbenzylamine antifungal agent for systemic treatment.
AB  - Derivatives of the benzylamine antimycotics with an extra phenyl ring
      incorporated in the side chain have been prepared and their antifungal activity
      evaluated. The potency is strongly dependent on the distance between the two
      phenyl groups and the type of spacer. Linking the aryl rings with a quaternary
      carbon atom resulted in the identification of highly active compounds 7f and 12a,
      having a novel 4-benzylbenzylamine side chain. Compound 7f and its 7
      benzo[b]thienyl analogue 12a show significantly enhanced efficacy, in particular
      against Candida albicans, and are among the most potent allyl/benzylamine
      antimycotics identified so far. Extended investigations with the
      benzylbenzylamine derivative 7f revealed that, in addition to the enhanced
      antimycotic profile, the compound is the first representative of the benzylamine
      antimycotics suitable for systemic treatment.

PMID- 8340916
TI  - 2,2-Dialkylnaphthalen-1-ones as new potassium channel activators.
AB  - A new series of 2,2-dialkylnaphthalen-1-one potassium channel activators has been
      prepared, and their in vitro relaxant activities in isolated rat portal vein and
      guinea pig tracheal spirals as well as their oral antihypertensive effect in
      spontaneously hypertensive rats have been evaluated. The group of 1,2-dihydro-4
      (1,2-dihydro-2-oxo-1-pyridyl)-2,2-dimethylnaphthalen -1- ones with an electron
      withdrawing substituent at the 6-position contain the most active compounds and
      1,2-dihydro-4-(1,2-dihydro-2-oxo-1-pyridyl)-2,2-dimethyl-1-oxonaphtha lene-6-
      carbonitrile, 17f (UR-8225), has been selected for further pharmacological
      development.

PMID- 8340917
TI  - Sulfonylmethanesulfonamide inhibitors of carbonic anhydrase.
AB  - A series of sulfonylmethanesulfonamide derivatives is described, which are
      inhibitors of carbonic anhydrase (CA). The most potent of these is the racemic
      fluoro sulfone 9, which inhibits carbon dioxide hydration catalyzed by human CA
      II (CA-II) with an IC50 of 3 nM. Binding competition studies versus dansylamide
      indicate that the enantiomers of 9 have different affinities for CA-II, with
      equilibrium dissociation constants of 3.6 and 0.6 nM. QSAR analysis suggests that
      the key factors involved in achieving high affinity in this series are
      sulfonamide acidity, hydrophobicity, and minimization of steric demands at the
      carbon atom adjacent to the sulfonamide group.

PMID- 8340918
TI  - Multiple copy simultaneous search and construction of ligands in binding sites:
      application to inhibitors of HIV-1 aspartic proteinase.
AB  - Rational ligand design is a complex problem that can be divided into three parts:
      the search for optimal positions and orientations of functional groups in the
      binding site, the connection of such positions to form candidate ligands, and the
      estimation of their binding constants. Approaches for addressing the first two
      parts of the problem are described in the present work. They are applied to the
      construction of peptide ligands in the binding site of the human immunodeficiency
      virus 1 (HIV-1) proteinase. The primary objective is to test the method by
      comparison of the results with the MVT-101 complex structure for which
      coordinates are available; the results obtained with the liganded and unliganded
      proteinase structure are used to examine the utility of the latter for binding
      studies. A secondary objective is to show how to find new inhibitor candidates.
      The multiple copy simultaneous search (MCSS) method is utilized to search for
      optimal positions and orientations of a set of functional groups. For peptide
      ligands, functional groups corresponding to the protein main chain (N
      methylacetamide) and to protein side chains (e.g., methanol, ethyl guanidinium)
      are used. The resulting N-methylacetamide minima are connected to form
      hexapeptide main chains with a simple pseudoenergy function that permits a
      complete search of all possible ways of connecting the minima. Side chains are
      added to the main-chain candidates by application of the same pseudoenergy
      function to the appropriate functional group minima. A set of 15 hexapeptides
      with the sequence of MVT-101 is then minimized by a Monte Carlo scheme, which
      allows for escape from local minima. Comparison of the MCSS results with the
      structure of MVT-101 in the HIV-1 binding site showed that all of its functional
      group positions correspond (within 2.4 A) to some (usually more than one) MCSS
      minima. There were also many other low-energy MCSS minima which do not appear in
      any known inhibitors, e.g., methyl ammonium minima in the neighborhood of the
      catalytic aspartates. Among the 15 lowest minima are seven hexapeptides with the
      same main-chain orientation as the one found by X-ray crystallography for the
      inhibitor MVT-101 in the binding site and eight with the main chain oriented in
      the opposite direction; the latter tend to be more stable. [Addendum: These
      results are in agreement with recent high-resolution crystallographic data
      provided after the study was completed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8340919
TI  - 4-Amidinoindan-1-one 2'-amidinohydrazone: a new potent and selective inhibitor of
      S-Adenosylmethionine decarboxylase.
AB  - Two isomeric amidino-2-acetylpyridine amidinohydrazones, 11 and 12, and 4
      amidinoindanone amidinohydrazone, 17, have been synthesized and tested for
      inhibition of S-adenosylmethionine decarboxylase (SAMDC) and diamine oxidase and
      for antiproliferative activity against T24 human bladder carcinoma cells.
      Compound 11 inhibited SAMDC with an IC50 of 10 nM and was 140- and > 500-fold
      more potent than methylglyoxal bis(guanylhydrazone) (MGBG) and 12, respectively.
      The difference in potency between 11 and 12 was interpreted with the help of
      molecular modeling and appeared to be associated with two different low-energy
      conformations of the compounds. Compound 17 which represents a conformationally
      constrained analogue of 11, was superior to the latter and MGBG with respect to
      selective inhibition of SAMDC and antiproliferative activity, and is of interest
      as a potential anticancer agent and a drug for the treatment of protozoal and
      Pneumocystis carinii infections.

PMID- 8340920
TI  - Synthesis and structure-activity relationships of nonpeptide, potent triazolone
      based angiotensin II receptor antagonists.
AB  - 2,5-Dibutyl-2,4-dihydro-4-[[2-(1H-tetrazol-5-yl)[1,1'-biphenyl]-4' - yl]methyl]
      3H-1,2,4-triazol-3-one, SC-51316, was synthesized as a potent and orally active
      angiotensin II (AII) receptor antagonist with a long duration of action. To
      explore the lipophilic pocket in the AII receptor interacting with the
      substituent at the 2-position of triazolone-based antagonists, a series of
      compounds were prepared and evaluated for receptor binding affinity and
      antagonism of AII-contracted rabbit aortic rings. It has been found that the
      pocket is very spacious and can accommodate different sizes of lipophilic groups
      and various functionalities. Acidic groups generally result in a slight decrease
      in binding affinity. Branched chains are unfavorable. The freedom of rotation
      around C2-C3 in the flexible side chain is crucial for good binding. The 2
      phenylethyl-substituted triazolone analogue exhibits the highest in vitro potency
      among all compounds that have been synthesized.

PMID- 8340921
TI  - Nonpeptide angiotensin II receptor antagonists. Synthesis and biological activity
      of benzimidazolecarboxylic acids.
AB  - A series of 2-substituted-1-[(biphenyl-4-yl)methyl]-1H-benzimidazole-7-
      carboxylic acids was prepared from the key intermediate 3-amino-2-[[(biphenyl-4-
      yl)methyl]amino]benzoate (6a-c) in order to clarify the structure-activity
      relationships of various analogues of 2-butyl-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4
      yl]methyl]-1H-ben zimidazole- 7-carboxylic acid (CV-11194), a potent and long
      acting angiotensin II (AII) receptor antagonist. The AII antagonistic activity of
      the benzimidazoles was investigated by in vitro assays, which included an AII
      receptor binding assay and AII-induced vasocontraction assay, as well as by in
      vivo assays such as an AII-induced pressor response in rats. Most of the
      benzimidazoles showed high affinity for the AII receptor (IC50 value, 10(-6)-10(
      7) M) and inhibited the AII-induced pressor response at 1 or 3 mg/kg po, and the
      effects were more potent than those of CV-11194 and DuP 753. The structure
      activity relationship studies on the binding affinity and the inhibition of AII
      induced pressor response suggested that straight chains of a certain length
      (e.g., ethoxy groups, ethyl groups) were the best as substituents at the 2
      position and that their steric factors, lipophilicity, and electronic effects
      affected the potency of the AII antagonistic action. Both a carboxyl group at the
      7-position and a tetrazole ring at the 2'-position were particularly important
      for potent and orally active AII antagonistic activity and a long-acting
      hypotensive effect. The representative compound, 2-ethoxy-1-[[2'-(1H-tetrazol-5
      yl)biphenyl-4-yl]methyl]-1H- benzimidazole-7-carboxylic acid (26b, CV-11974),
      inhibited the specific binding of [125I]AII to bovine adrenal cortical membrane
      with an IC50 value of 1.1 x 10(-7) M. The AII-induced contraction of rabbit
      aortic strips was antagonized by CV-11974 (IC50 value, 3.0 x 10(-10) M). Oral
      administration of CV-11974 to conscious normotensive rats at 1 mg/kg resulted in
      long-lasting inhibition of the AII-induced pressor response. CV-11974 at 0.1-1
      mg/kg iv reduced blood pressure dose-dependently in spontaneously hypertensive
      rats.

PMID- 8340922
TI  - Synthesis and biological activity of cis-(3aR)-(-)-2,3,3a,4,5,9b-hexahydro- 3
      propyl-1H-benz[e]indole-9-carboxamide: a potent and selective 5-HT1A receptor
      agonist with good oral availability.
AB  - The synthesis and biological activity of cis-(3aR)-(-)-2,3,3a,4,5,9b- hexahydro-3
      propyl-1H-benz[e]indole-9-carboxamide ((-)-3a), U93385, is described. The cis
      racemate and its enantiomer as well as the corresponding trans enantiomers were
      also synthesized and evaluated. The synthesis of these analogs was achieved via
      either a four-step conversion of the 9-hydroxy precursor into 9-carboxamide or an
      alternative synthesis using the (R)-alpha-methylbenzyl group as the chiral
      auxiliary. The cis racemate (+/-)-3a, was found to be a selective and potent 5
      HT1A receptor agonist with the activity residing in the cis-(3aR)-enantiomer, (-)
      3a. The cis-(3aS)-enantiomer (+)-3a and trans-(3aR)-enantiomer (-)-3b displayed
      partial 5-HT1A agonist activity whereas the other trans-(3aS)-enantiomer (+)-3b
      showed no activity. The enantiomer (-)-3a was found to be selective in both in
      vitro and in vivo biochemical/behavioral assays. This compound potently reduced
      rectal temperature in mice, decreased the firing rate of rat midbrain
      serotonergic neurons, and suppressed rat brain 5-HT synthesis. This compound also
      reduced sympathetic nerve discharge and blood pressure in the anesthetized cat
      and showed activity in the forced swim assay in mice. It exhibited good oral
      activity in behavioral and biochemical assays and, in fact, had a 46% oral
      availability in the rat when comparing blood levels of parent drug after iv and
      po administration. This compound has demonstrated a potential for anxiolytic and
      antidepressant activity and is currently undergoing clinical evaluation.

PMID- 8340923
TI  - Synthesis and antitumor activity of 10-propargyl-10-deazaaminopterin.
AB  - Successive alkylation of dimethyl homoterephthalate with propargyl bromide and
      2,4-diamino-6-(bromomethyl)pteridine followed by ester saponification at room
      temperature afforded 2,4-diamino-4-deoxy-10-carboxy-10-propargyl-10-deazapteroic
      acid. The 10-COOH was readily decarboxylated by heating in DMSO at a temperature
      of only 120 degrees C to yield the diamino-10-propargyl-10-deazapteroic acid
      intermediate. Coupling with diethyl L-glutamate and ester hydrolysis gave the
      title compound. The 10-propargyl analogue was about 5 times more potent than MTX
      as an inhibitor of growth in L1210 cells, but was only one-third as potent as an
      inhibitor of DHFR from L1210. The analogue was transported inward very
      effectively in L1210 cells showing a 10-fold advantage over MTX. At a dose of 36
      mg/kg the 10-propargyl compound caused shrinkage of the E0771 solid murine
      mammary tumor to only 1% of untreated controls.

PMID- 8340924
TI  - 1-Carboranyl-3-(2-methylaziridino)-2-propanol. Synthesis, selective uptake by B
      16 melanoma, and selective cytotoxicity toward cancer cells.
AB  - 1-Carboranyl-3-(2-methylaziridino)-2-propanol (MACB) was prepared from the
      reaction of 1-carboranyl-2,3-epoxypropane with metalated methylaziridines having
      copper [Cu(CN)Li2]1/2 or lead (PbBu3) as the metal. MACB exhibited relatively
      high growth inhibition toward some cancer cells, and selective uptake of MACB by
      B-16 melanoma was accomplished.

PMID- 8340925
TI  - Selective inhibition of mammalian lanosterol 14 alpha-demethylase: a possible
      strategy for cholesterol lowering.

PMID- 8340926
TI  - Hydroxyurea derivatives as hypoglycemic agents.

PMID- 8340927
TI  - Triggered exocytosis and endocytosis have different requirements for calcium and
      nucleotides in permeabilized bovine chromaffin cells.
AB  - The intracellular requirements for membrane recapture in permeabilized chromaffin
      cells were compared to the requirements for exocytosis from the same cells. In
      permeabilized bovine chromaffin cells, calcium-driven exocytosis also triggers,
      with a short delay, uptake of extracellular horseradish peroxidase (HRP). This
      internalized HRP remains compartmentalized within the cell and migrates to a low
      density band on a Percoll gradient which is distinct from the heavier chromaffin
      granules. The amount of horseradish peroxidase internalized is similar in intact
      and leaky cells and is approximately equivalent to the volumes secreted.
      Endocytosis in both preparations is blocked by botulinum toxin, operates in a
      collapsed membrane potential, and is inhibited by low temperature. In
      permeabilized cells, exocytosis and coupled endocytosis are activated by the same
      concentrations of Ca2+ and MgATP. Although secretion requires Ca2+ and MgATP,
      once exocytosis has occurred the subsequent endocytosis can proceed in the
      virtual absence of Ca2+ or MgATP, and is largely unaffected by a variety of
      nucleotide triphosphates (including nonhydrolyzable analogues), and cyclic
      nucleotides. These data suggest that endocytosis can proceed, once exocytosis has
      been triggered, under conditions that are quite different from those necessary to
      support exocytosis, and that the specific requirements for Ca2+ and MgATP in
      secretion are for the exocytotic limb of the secretory cycle rather than for the
      associated endocytotic pathway.

PMID- 8340929
TI  - Fatty acid transfer across the myocardial capillary wall.
AB  - Interstitial transudate of isolated isometrically working perfused rat hearts was
      analyzed to investigate fatty acid (FA) release and transfer across the capillary
      wall. Unsaturated FA were released under certain conditions. Lowering medium FA
      (16:0) with constant or varying FA/A-ratio (A: albumin) decreased interstitial FA
      concentration down to 17% of arterial FA-concentration. This was accompanied by
      reduced uptake-rate. Transcapillary diffusion-resistance, unless markedly
      altering, cannot be responsible for this observation. Calculated diffusion-rates
      of FA and FA* protein-complexes in the endothelial cytoplasm and interstitium
      indicate that FA-transfer takes place almost exclusively bound to carrier
      proteins. The apparent permeability surface-area-values of FA for
      transendothelial FA-transfer are three orders of magnitude higher than those for
      sucrose; diffusion-coefficients for FA across the endothelium are close to those
      in water, excluding substantial diffusion-barrier of the capillary wall.
      Dissociation-rate-constants calculated from experimental data are in the range of
      those reported for FA* albumin-complexes in vitro. Thus the observed
      transcapillary FA-gradients are apparently due to the limited dissociation-rate
      of the FA*albumin-complex in the intravascular space.

PMID- 8340928
TI  - Effects of anions and/or cell volume on the permeance of an apical water pathway
      induced by Hg in toad skin epithelium.
AB  - Hg compounds block membrane transport units behaving as water channels. Here we
      show that Hg induces an apical water pathway in toad skins pretreated with 10(-3)
      M CH3ClHg or HgCl2, added to the outer bathing medium. Washing with SO4-Ringer
      caused a several-fold increase in net water flow (Jw) and osmotic permeability
      coefficient (Pf) that was reversed by re-exposure to Cl- or NO3-Ringer and
      mimicked by gluconate-Ringer. These Pf changes could be elicited repeatedly and
      were present if, and only if, anion replacements took place in the inner bathing
      solution. Such inner polarity was related to the anion permeability of the
      epidermal basolateral membrane: impermeant anions (SO4, gluconate) increased Pf;
      permeant anions (Cl, NO3) did not change basal Pf but reversed the high Pf
      induced by impermeant anions. Hg induced the appearance of aggregates that
      persisted despite repeated washings of the skins during 4-5 h, and whether Pf was
      high (SO4-Ringer) or low (Cl-Ringer) before skin fixation. The Hg-induced apical
      water pathway in toad skin appears to be a unique model for studying the
      interplay between cell volume, cell ionic composition and water permeability.

PMID- 8340930
TI  - Superoxide dismutase plus catalase therapy delays neither cell death nor the loss
      of the TTC reaction in experimental myocardial infarction in dogs.
AB  - Studies to test whether superoxide dismutase (SOD), with or without catalase,
      limits myocardial infarct size have produced conflicting results. Positive
      results following short periods of reperfusion vs negative results following
      longer periods of reperfusion could be explained if either: (1) myocytes,
      initially salvaged by SOD, are killed by continued production of free radicals
      after the administered SOD have been excreted, or (2) false positive results
      occur because SOD transiently preserves the TTC reaction, despite loss of
      cellular viability. To evaluate these two possibilities, we measured infarct size
      after 90 min of ischemia and 4 h of reperfusion in SOD+catalase treated and
      untreated dogs. Treated dogs received a 60 min intra-arterial infusion of SOD
      (15,000 U/kg) plus catalase (CAT) (55,000 U/kg) beginning 25 min before
      reperfusion. Infarct size was measured using triphenyl tetrazolium (TTC)
      macrochemistry and was compared with the extent of necrosis assessed semi
      quantitatively by light microscopy. Mean infarct size was similar in the control
      and treated groups. In addition, there was a positive linear correlation (r =
      0.95) between the extent of necrosis estimated by microscopy and that estimated
      by TTC in both groups, and treatment did not alter the regression line. These
      current results were compared with results from the control dogs from our
      previous study (Richard et al., 1988) in which 90 min of ischemia was followed by
      4 days of reperfusion. TTC-based infarct size at 4 days of reperfusion was
      similar to that observed in both groups at 4 h. These data indicate that oxygen
      free radicals, accessible to intravascular SOD and catalase, are not a cause of
      myocyte death detectable by measurement of infarct size after 4 h of reperfusion.
      Moreover, neither an "early protection, delayed death" hypothesis nor a specific
      preservation of the TTC reaction explain the positive results of other studies.
      TTC macrochemistry provides reliable estimates of myocardial infarct size,
      provided that sufficient magnification is used to permit resolution of
      interdigitating peninsulas of viable and necrotic tissue.

PMID- 8340931
TI  - Effect of transforming growth factor-beta 1 on myocardial stunning in the intact
      dog.
AB  - Previous studies have demonstrated that transforming growth factor-beta (TGF
      beta) can accelerate wound healing, inhibit free radical formation and limit
      myocardial ischemia/reperfusion injury in a variety of experimental models.
      However, it is unknown whether exogenous TGF-beta 1 can attenuate the prolonged
      contractile dysfunction that is observed after a brief, reversible ischemic
      insult (myocardial stunning). Thus, open-chest dogs undergoing a 15-min left
      anterior descending coronary artery occlusion and 4 h of reperfusion were given
      TGF-beta 1 as an intravenous bolus (250 micrograms) at 24 h and again at 1 h
      before coronary occlusion (n = 5). Control dogs (n = 7) received equivalent
      amounts of vehicle. The two groups were similar with respect to occluded bed
      size, collateral blood flow and rate-pressure product. Fundamental physiological
      parameters, such as body temperature, arterial pH, PO2 and hematocrit, were
      within normal limits throughout the experiment. In control dogs, regional
      myocardial function (assessed as systolic thickening fraction) remained depressed
      throughout the 4 h reperfusion period, indicating severe myocardial stunning. TGF
      beta 1 did not produce any significant improvement in the recovery of regional
      function; 4 h after reperfusion, paradoxical systolic thinning was still present
      in both treated and control groups, with thickening fraction being -22.5 +/- 6.1%
      and -31.0 +/- 5.3% of baseline, respectively (P = N.S.). These results
      demonstrate that a large dose of TGF-beta 1 given before ischemia fails to
      attenuate myocardial stunning in the open-chest dog, suggesting that this growth
      factor does not exert protective effects in the setting of reversible myocardial
      ischemia/reperfusion injury.

PMID- 8340932
TI  - Influence of congestive heart failure on endothelin levels and receptors in
      rabbits.
AB  - Congestive heart failure, both in man and in animals is associated with an
      increased plasma level of endothelin. To investigate further the potential role
      of the endothelin system, we designed a study to determine the effect of
      experimental congestive heart failure (CHF) on plasma and tissue immunoreactive
      endothelin (irET) and on the density and affinity of endothelin-1 receptors in
      the heart and kidney. For this purpose, CHF was induced in rabbits by combined
      aortic valvular insufficiency and stenosis. When CHF was established, plasma and
      tissue irET levels were measured by radioimmunoassay and density and affinity of
      endothelin-1 receptors were measured by binding assay on tissue homogenates.
      Compared to control rabbits, plasma irET was significantly elevated in rabbits
      with CHF [1.04 +/- 0.15 vs. 0.04 +/- 0.01 fmol/ml, P < 0.001]. Tissue irET
      concentrations in ventricles and kidney were roughly 4 orders of magnitude higher
      than plasma concentrations. CHF decreased the tissue irET levels in left
      ventricle and kidney by 32 and 46%, respectively (P < 0.01), whereas CHF
      increased it by 58% in the right ventricle (P < 0.005). The density of ET-1
      receptors was decreased in the right and left ventricles and in kidneys by 26,
      36, and 61%, respectively (P < 0.05). Receptor affinity remained unchanged in
      response to CHF in both ventricles, whereas it increased in kidney [Kd (pM); 154
      +/- 17 vs. 99 +/- 9, P < 0.01]. Thus, this study demonstrates that experimental
      CHF is not only characterized by elevated plasma irET levels but also by a
      decrease in tissue irET concentrations in the left ventricle and kidney, and by a
      down-regulation of ET-1 receptors both in the heart and kidney. Functional
      consequences of these changes need to be determined.

PMID- 8340933
TI  - A clathrin-coated vesicle-mediated pathway in atrial natriuretic peptide (ANP)
      secretion.
AB  - Atrial Natriuretic Peptide (ANP), produced by atrial cardiomyocytes, is an
      endogenous hypotensive agent that brings about vasodilation and diuresis. Similar
      to other polypeptide hormones, ANP is synthesized as a precursor, preproANP. The
      preprohormone is processed intracellularly and is stored in secretory granules as
      the prohormone. During the events of exocytosis, the prohormone is converted to
      its active form, ANP. In this study, a double-label immunocytochemistry
      experiment was performed using ANP and clathrin antibodies to determine if the
      transport of this hormone is mediated by clathrin-coated vesicles. Additionally,
      we have isolated clathrin-coated vesicles (CVs) from adult rat atria using
      immunoadsorption, and have characterized the fraction by using SDS PAGE, TEM, and
      Western blot analysis. The data demonstrate that: (1) ANP and clathrin co
      localize in myocardial tissue, (2) clathrin-coated vesicles can be isolated from
      adult rat atria, and (3) clathrin-coated vesicles isolated from adult atrial
      myocardium contain predominantly proANP. The presence of proANP in clathrin
      coated vesicles suggests that this polypeptide hormone is transported
      intracellularly via a clathrin-mediated pathway and during transit the prohormone
      is not significantly converted to its active form.

PMID- 8340934
TI  - Simple 24-hour preservation of rabbit hearts with hexanol and pyruvate
      cardioplegia.
AB  - The effectiveness of a newly developed crystalloid cardioplegic solution
      containing 4 mM 1-hexanol and 10 mM pyruvate was compared with St Thomas'
      Hospital solution. After control perfusion with a Langendorff method, rabbit
      hearts (n = 7 for each group) were arrested and stored in these solutions (4
      degrees C) for 24 h and subsequently reperfused for 45 min. The hexanol solution
      preserved both left ventricular systolic and diastolic function significantly
      better than St Thomas' Hospital solution. Developed pressure was significantly
      higher after preservation with the hexanol solution than with the St Thomas'
      Hospital solution at left ventricular balloon volumes larger than the mid volume
      (P < 0.05). The maximum developed pressure values after storage with the hexanol
      and St Thomas' Hospital solution were 77% and 42% of the maximum control values,
      respectively. Values for end-diastolic pressure at the maximum ventricular volume
      were 26.1 +/- 9.8 and 66.7 +/- 24.6 mmHg for the hexanol and St Thomas' Hospital
      solution, respectively (P < 0.05). Creatine kinase release during the first 15
      min of reperfusion was significantly lower with the hexanol solution as compared
      to St Thomas's Hospital solution (28.3 +/- 8.3 vs 92.9 +/- 52.6 IU/g wet weight,
      P < 0.05). In conclusion, a hexanol cardioplegic solution may be suitable for
      long-term cardiac preservation. Further evaluation of the effectiveness and
      safety of this solution is warranted.

PMID- 8340935
TI  - Detection of low molecular weight GTP-binding proteins associated with rat atrial
      secretory granules.
AB  - Recent studies suggest that low molecular weight (LMW) GTP-binding proteins are
      involved in the vesicular transport of proteins along the secretory pathway. In
      order to determine whether LMW GTP-binding proteins are potentially involved in
      the regulated secretion of atrial natriuretic factor (ANF) from the atrial
      myocyte, rat atrial secretory granules were purified and the LMW GTP-binding
      proteins associated with these granules were detected in [alpha-32P]GTP-blotting
      experiments. Three LMW GTP-binding proteins, displaying molecular weights of
      23,000, 25,000 and 29,000, were usually observed in atrial secretory granule
      preparations. The 29 kDa GTP-binding protein (G29), however, was typically the
      predominantly labelled band. The binding of [alpha-32P]GTP to G29 was guanine
      nucleotide specific and magnesium-dependent. Trypsin treatment of intact
      secretory granules markedly reduced the binding of [alpha-32P]GTP to G29. G29 is
      tightly associated with the granule membrane, as evidenced by its resistance to
      solubilization by high ionic strength buffers but its sensitivity to
      solubilization with sodium cholate. When secretory granule preparations of rat
      anterior pituitary glands were examined for the presence of LMW GTP-binding
      proteins, a different pattern of LMW GTP-binding proteins was observed which did
      not include a predominantly labelled 29 kDa protein. The results of this study
      indicate that: (1) LMW GTP-binding proteins are present on atrial secretory
      granules and may therefore be involved in the regulated secretion of ANF and (2)
      tissue-specific differences exist between the LMW GTP-binding proteins associated
      with secretory granules.

PMID- 8340936
TI  - Effect of a monoclonal antibody to VLA-4 on lymphocyte adherence to microvascular
      and aortic endothelial cells.
AB  - Lymphocyte migration out of the blood to inflammatory sites is preceded by the
      adherence of lymphocytes to the vascular endothelium. This lymphocyte binding is
      enhanced by cytokine activation of the endothelial cells (EC). Small peritoneal
      exudate lymphocytes (sPEL) migrate preferentially into cutaneous inflammation and
      to skin injected with INF gamma, TNF alpha or LPS. These cells adhere also to rat
      microvascular EC and this adherence correlates well with migratory properties of
      sPEL. Lymphocyte EC adhesion is in part mediated by the VLA-4 molecule on the
      lymphocytes. Since differences between microvascular and large vessel EC have
      been described, we investigated whether sPEL adherence to both types of EC is
      governed by similar molecular mechanisms. Lymphocyte adhesion was low to
      unstimulated microvascular EC and augmented by pretreatment of EC with INF gamma,
      TNF alpha and LPS. In contrast, lymphocyte adhesion to unstimulated large vessel
      (aortic) EC was higher than to microvascular EC and could not be increased by
      cytokine or LPS treatment. Anti VLA-4 mAb inhibited the enhanced cytokine
      stimulated adhesion to microvascular EC without affecting adhesion of sPEL to
      unstimulated EC. Anti VLA-4 mAb inhibited the high spontaneous adhesion to aortic
      EC, suggesting that with both EC, adhesion is in part VLA-4 dependent.

PMID- 8340937
TI  - Strategies for suppressing the function of oncogenic Ras protein in tumors.

PMID- 8340939
TI  - Imprinted genes play role, change rules, in cancer.

PMID- 8340940
TI  - Treating cancer pain in kids gets new attention.

PMID- 8340938
TI  - Gastric cancer following peptic ulcer surgery.

PMID- 8340941
TI  - Cytotoxic T-cell response and in vivo protection against tumor cells harboring
      activated ras proto-oncogenes.
AB  - BACKGROUND: Activated forms of the ras proto-oncogene have been found in
      approximately 30% of human malignancies, including pancreatic, colon, and lung
      adenocarcinomas. Ras oncoproteins arise by somatic mutation and contain amino
      acid changes at residues 12, 13, or 61, thus generating unique tumor-specific
      proteins that are attractive targets for cancer therapy. PURPOSE: The goal of
      this study was to determine whether vaccination with mutant Ras protein could
      lead to the generation of cytotoxic T lymphocytes (CTLs) specific for the mutant
      epitope and to protection against challenge with tumor cells expressing the
      mutant oncoprotein. METHODS: To determine a methodology for generating CTL
      responses following immunization with soluble protein, ovalbumin was used as a
      model tumor antigen. C57BL/6 mice were immunized with soluble ovalbumin
      administered intraperitoneally at 2-week intervals or with intravenous injection
      of ovalbumin or osmotically loaded splenocytes. Immunized mice were challenged
      with E.G7 cells (which express a transfected ovalbumin gene), and tumor growth
      was monitored. Generation of ovalbumin-specific CTLs was determined by 51Cr
      release assays. Purified wild-type or mutant H-Ras proteins (containing single
      amino acid substitutions at position 12 converting Gly to Arg or Val) were used
      to immunize BALB/c mice intraperitoneally. Ras-immunized mice were challenged
      with tumor cells containing Arg 12 or Val 12 mutations or not harboring mutant
      forms of Ras. Cytolytic and proliferative responses to mutant forms of Ras were
      studied, and the effects of in vivo depletion of CD4+ or CD8+ T lymphocytes were
      determined. RESULTS: In vivo challenge with E.G7 showed that intraperitoneal
      immunization with soluble ovalbumin was as effective as osmotic loading,
      resulting in long-term disease-free survival of some mice and the development of
      ovalbumin-specific CTLs. Immunization with Arg 12 Ras led to disease-free
      survival in nine of 10 animals challenged with tumor cells containing an Arg 12
      mutation, while no protection was afforded against tumors expressing other forms
      of Ras or other oncogenes. Splenocytes from BALB/c mice immunized with Arg 12 Ras
      demonstrated cytolytic activity specific against tumor cells expressing Arg 12
      Ras, with most of this activity residing in the CD8+ subset. Mutation-specific
      proliferation to Arg 12 Ras peptides was also observed. Immunization with Val 12
      Ras did not elicit detectable Val 12-specific immunity. CONCLUSIONS: Antigen
      specific CTLs can be induced following intraperitoneal immunization of mice with
      purified, soluble proteins. For both ovalbumin and Arg 12 Ras, specific in vivo
      protection against tumor cell challenge was observed.

PMID- 8340942
TI  - A cohort study of stomach cancer risk in men after gastric surgery for benign
      disease.
AB  - BACKGROUND: For the past 40 years, investigators have suggested that there exists
      an increased risk of stomach cancer following gastric surgery for benign disease.
      Recent cohort studies have consistently identified an increased risk of stomach
      cancer beginning 20 years or more following gastric surgery. Validation of this
      association and elucidation of risk factors related to gastric cancer have been
      complicated by variability in study designs. PURPOSE: This cohort study was
      designed to investigate the risk of stomach cancer following gastric surgery and
      to identify patient and treatment characteristics that may alter this risk.
      METHODS: Medical admission records of 17077 male military veterans hospitalized
      during 1970-1971 in U.S. Department of Veterans Affairs (VA) hospitals were
      examined. From this initial cohort, 1094 patients who died within the 1st year
      following gastric surgery were excluded. Data analysis was performed on the final
      cohort consisting of 15,983 patients divided into the following two groups: 1) an
      exposed group (gastric surgery group) that included 7609 patients receiving
      gastric surgery for a documented benign disorder and 2) an unexposed group
      (comparison group) that included 8374 male patients randomly selected from all
      other hospitalized male patients in the patient database. The comparison group
      was matched to the gastric surgery group by age (within 10 years), race,
      hospital, and year of admission. Mortality follow-up utilized the following three
      sources to identify vital status: 1) the VA Patient Treatment File (1970-1988),
      2) the VA Beneficiary Identification Record Linkage System (1970-1989), and 3)
      the National Death Index (1979-1988). Death certificates were obtained for 99% of
      the deceased patients. Analyses included estimations of risk using standardized
      rate ratios (SRRs) and proportional hazards techniques. RESULTS: A statistically
      significant increase in risk of stomach cancer was demonstrated among males
      during the 20 years following gastric surgery (SRR = 1.9; 95% confidence interval
      [CI] = 1.3-2.4; P = .0001). The risk of developing gastric cancer was greatest
      during the 2nd to 5th postoperative years (SRR = 2.8; 95% CI = 1.6-4.5; P < .01)
      and during years 11-15 (SRR = 2.5; 95% CI = 1.2-4.8; P < .01). Also, the risk of
      developing gastric cancer was greatest among those treated by gastrectomy for any
      type of ulcer (SRR = 2.6; 95% CI = 1.2-4.9; P < .01) and those having any type of
      gastric surgery when the primary diagnosis was gastric ulcer (SRR = 2.9, 95% CI =
      1.4-5.3; P < .01). CONCLUSIONS: This study confirms that men undergoing
      gastrectomy for benign disease and men receiving any gastric surgery for gastric
      ulcer are at increased risk for developing gastric cancer. Unlike earlier
      studies, we find that the increased risk is not delayed for 20 years.

PMID- 8340943
TI  - Screening for colorectal cancer with fecal occult blood testing and
      sigmoidoscopy.
AB  - BACKGROUND: The high incidence of and mortality from colorectal cancer (160,000
      new cases and 60,000 deaths in the United States each year) are compelling public
      health concerns. Following the evolution of effective surgery for this disease
      since the 1960s, the focus has been on improving methods of detection and
      integrating them into effective screening programs. PURPOSE: This was the first
      study to evaluate the effectiveness, in a setting of comprehensive medical
      examinations, of using the fecal occult blood test in conjunction with
      sigmoidoscopy, rather than sigmoidoscopy alone, to screen for colorectal cancer.
      Our end points were extent of compliance with fecal occult blood test and
      sigmoidoscopy, numbers of cancers detected, and mortality rate. METHODS: From
      1975 through 1979, a total of 21,756 patients (aged 40 and older) who presented
      at the Preventive Medicine Institute-Strang Clinic for routine medical
      examinations were enrolled by calendar period into study and control groups.
      Study patients were offered annually both rigid sigmoidoscopy examinations and
      fecal occult blood tests requiring two stool specimens per day for 3 days, while
      control patients were offered only annual sigmoidoscopy. The majority of fecal
      occult blood test cards were not rehydrated before assay. Patients with positive
      tests were referred for double-contrast barium enema and colonoscopy. Two
      distinct trials were carried out. Trial I was primarily a demonstration of
      feasibility of using the fecal occult blood test as a supplemental screening
      method. Of the 9277 participants, 7168 (77%) were assigned to the study group and
      offered the fecal occult blood test. In trial II, approximately half of the
      12,479 patients were assigned to each group. Patients in both trials had follow
      up through 1984. RESULTS: Compliance with the fecal occult blood test was
      initially high in both trials, but diminished such that only 56% of study
      patients in trial I and 20% of those in trial II returned for second tests. On
      the initial (prevalence) screen, a substantial number of early-stage cancers were
      detected by the fecal occult blood test, primarily in trial II. In trial II,
      survival probability was significantly greater (P < .001) in the study group than
      in the controls (70% versus 48%), and colorectal cancer mortality was lower (0.36
      versus 0.63) with borderline significance (P = .053, one-sided). CONCLUSIONS AND
      IMPLICATIONS: The screening of average-risk individuals (aged 50 and older) for
      colorectal cancer through use of the fecal occult blood test in conjunction with
      sigmoidoscopy can increase the likelihood of early detection of this disease.
      This practice, coupled with prompt diagnostic work-up following positive tests,
      will result in treatment of earlier stage cancers and increased survival after
      treatment.

PMID- 8340944
TI  - Phase I trial of granulocyte-macrophage colony-stimulating factor plus high-dose
      cyclophosphamide given every 2 weeks: a Cancer and Leukemia Group B study.
AB  - BACKGROUND: Chemotherapy-induced myelosuppression often limits escalation of
      cancer chemotherapy doses. Cyclophosphamide, an alkylating agent, is an ideal
      candidate for dose escalation: A log-linear relationship between cell kill and
      dose has been demonstrated, and the drug spares hematopoietic stem cells. In
      addition, studies suggest that granulocyte-macrophage colony-stimulating factor
      (GM-CSF) can enhance the ability to achieve optimal dose intensity as well as
      ameliorating chemotherapy-induced myelosuppression. PURPOSE: The purpose of this
      study was to determine the maximum tolerated dose and the toxic effects of
      cyclophosphamide administered every 2 weeks with GM-CSF support. METHODS: For
      this trial by the Cancer and Leukemia Group B (CALGB), cohorts of patients were
      treated with cyclophosphamide as a 1-hour intravenous infusion every 14 days; GM
      CSF was given subcutaneously on days 3-10. Four dose levels of cyclophosphamide
      (1.5, 3.0, 4.5, and 6.0 g/m2) and three dose levels of GM-CSF (2.5, 5.0, and 10.0
      micrograms/kg per day) were evaluated. There was no dose escalation in individual
      patients. Fifty-one patients with solid tumors who had CALGB performance status 0
      or 1 and minimal prior radiotherapy were eligible for analysis. Drug clearance
      and area under the curve for plasma drug concentration x time (AUC) were
      estimated at completion of the infusion and at 4 and 24 hours after the start of
      the infusion. RESULTS: Ninety-five courses of therapy were analyzed. Treatment
      with cyclophosphamide at 3.0 g/m2 or more resulted in neutropenia (absolute
      neutrophil counts < 100/microL) in all cycles of therapy. At those doses, blood
      cell count recovery adequate for re-treatment occurred in 67%-85% of cycles
      (median, 16 days). Doses of 6.0 g/m2 were associated with the greatest degree of
      myelosuppression and frequent hospitalization (88% of cycles); requirements for
      blood transfusion prohibited further dose escalation. Nonhematologic toxic
      effects were tolerable, with two episodes of reversible cardiotoxicity and four
      episodes of hemorrhagic cystitis that precluded further therapy. Degree of
      myelosuppression was not correlated with cyclophosphamide AUC or clearance.
      CONCLUSIONS: The recommended phase II dose of cyclophosphamide is 4.5 g/m2
      administered every 2 weeks with GM-CSF given at 5.0 micrograms/kg per day of GM
      CSF. Our results suggest that, with GM-CSF support, high cumulative doses of
      cyclophosphamide can be given to achieve optimal dose intensity, with
      reproducible blood cell count recovery and without the need for autologous bone
      marrow transplantation. IMPLICATIONS: Phase II studies of this intensive regimen
      in malignant diseases sensitive to alkylating agents are currently being done in
      CALGB.

PMID- 8340945
TI  - Antitumor effects of doxorubicin in combination with anti-epidermal growth factor
      receptor monoclonal antibodies.
AB  - BACKGROUND: A variety of human tumors frequently express high levels of epidermal
      growth factor (EGF) receptor and its ligand, transforming growth factor alpha
      (TGF-alpha), which in some tumors is associated with poor prognosis. Monoclonal
      antibodies (MAbs) that block the binding of TGF-alpha or EGF to the receptor can
      inhibit proliferation of tumor cells that express the receptor. Studies suggest
      that these MAbs may enhance the antitumor effects of chemotherapy. PURPOSE: Our
      purpose was to study, in vitro and in vivo, the antitumor effects of doxorubicin
      in combination with anti-EGF receptor MAbs against tumor cells expressing high
      levels of EGF receptor. Our goal was to achieve maximum initial cytoreduction
      with high-dose doxorubicin in association with prolonged blockade of EGF receptor
      with MAbs. METHODS: Anti-EGF receptor MAbs 528 (isotype IgG2a) and 225 (isotype
      IgG1) were used in combination with doxorubicin against cells from human A431
      squamous cell carcinoma and human MDA-468 breast adenocarcinoma. Both A431 and
      MDA-468 cells express high levels of EGF receptors and TGF-alpha. Cultured cells
      were treated with doxorubicin (range, 0-10 nM) in the presence or absence of MAb
      528 or 225 (range, 0-30 nM). At 48 hours, doxorubicin-containing medium was
      removed, and treatment with antibody was continued for 5 days, when cell
      proliferation assays were performed. The activity of the agents and the
      combinations against well-established xenografts in BALB/c nude mice was also
      studied. In nude mice, doxorubicin was given at doses of 50-100 micrograms/20 g
      body weight on 2 successive days, and MAbs 528 and 225 were given at a dose range
      of 0-2 mg intraperitoneally twice a week. RESULTS: MAbs 528 and 225 both enhanced
      the antitumor effects of doxorubicin against A431 and MDA-468 tumor cells,
      producing additive growth suppression in cell cultures. MAb 528 increased the
      antitumor effects of doxorubicin by 32%-42%, and similar results were obtained
      with MAb 225. In BALB/c athymic mice, the treatment of well-established
      xenografts with either doxorubicin or anti-EGF receptor MAb alone temporarily
      inhibited growth, but the combination of both agents substantially enhanced
      antitumor activity over that of doxorubicin alone in A431 and MDA-468 cell
      xenografts. The combination treatment of mice bearing A431 xenografts resulted in
      tumor eradication of 40%-100% in the surviving mice in several independent
      experiments. The enhanced antitumor activity was dose dependent. CONCLUSIONS: Our
      results suggest that anti-EGF receptor MAbs substantially enhance the effects of
      doxorubicin against well-established xenografts of tumor cells expressing high
      levels of EGF receptors. IMPLICATIONS: Clinical trials with anti-EGF receptor
      MAbs are being conducted, and trials with anti-EGF receptor MAbs combined with
      doxorubicin are planned.

PMID- 8340946
TI  - Effects of tumor necrosis factor-alpha on muscle-protein turnover in female
      Wistar rats.
AB  - BACKGROUND: Many cancer patients experience a wasting syndrome (cachexia)
      characterized by weight loss and abnormalities in carbohydrate, protein, and
      lipid metabolism. Recent experimental studies suggest that the development of
      cancer cachexia involves the host's production of inflammatory cytokines such as
      tumor necrosis factor-alpha (TNF-alpha). PURPOSE: Our goal was to evaluate in
      rats the effects of an 8-day TNF-alpha treatment on overall protein metabolism in
      the liver, diaphragm, heart, and hind-leg muscles. METHODS: Four experimental
      groups corresponding to specific tissues (liver, diaphragm, heart, and hind-leg
      muscles) in female Wistar rats (100-150 g) were studied. Each group consisted of
      25 TNF-alpha-treated and 25 control female Wistar rats. The TNF-alpha-treated
      rats were given intraperitoneal injections of recombinant-derived human TNF-alpha
      (0.5 mL) that was administered in two daily injections of 50 micrograms/kg (total
      dose of 100 micrograms/kg per day) for 8 days. Control animals followed the same
      injection schedule as the treatment group and received 0.5 mL of physiological
      saline instead of TNF-alpha. All rats were radioactively labeled with NaH14CO3 24
      hours prior to TNF-alpha treatment. At 0, 1, 2, 4, and 8 days during TNF-alpha
      treatment, five rats per group were killed to measure the radioactive decay of
      labeled protein in specific tissues in order to estimate fractional protein
      turnover. During necropsy, the liver, hind-leg muscles (soleus muscle analyzed
      separately on 8th day only), heart, and diaphragm were rapidly weighed, and each
      was homogenized. Total protein content and total DNA were also determined. Total
      protein radioactivity and specific protein radioactivity (per milligram of
      protein) were evaluated for liver, diaphragm, heart, and hind-leg muscles.
      Radioactivity was counted in a liquid scintillation counter. Fractional rates of
      protein synthesis, protein degradation, total protein, and protein accumulation
      or loss were calculated. RESULTS: The TNF-alpha treatment administered to female
      Wistar rats for 8 days resulted in a transient decrease in food intake and body
      weight 24 hours after the beginning of the TNF-alpha treatment. In all types of
      tissues studied, TNF-alpha treatment resulted in increases in both the protein
      synthesis and protein degradation, with a greater increase in the protein
      degradation that resulted in a reduced protein accumulation following TNF-alpha
      treatment. This reduction in protein accumulation was directly associated with a
      decreased soleus muscle mass on day 8 of the treatment. CONCLUSIONS: Data suggest
      that TNF-alpha enhances muscle degradation in experimental situations where body
      weight loss is not apparent.

PMID- 8340947
TI  - Cancer breakthroughs require mavericks.

PMID- 8340948
TI  - Tamoxifen-induced decreases in total cholesterol with 2 weeks of treatment.

PMID- 8340949
TI  - The effects of hyperthyroidism on MIBG uptakes in the human heart--preliminary
      report.
AB  - Twelve cases of hyperthyroidism with cardiac manifestations (4 males, 8 females,
      ages: 20 to 70 years) and 12 normal controls of euthyroidism (6 males, 6 females,
      ages: 27 to 70 years) were included in our study. Each case accepted an I.V.
      injection of I-131 MIBG (I.R.E., Belgium) with 0.5mCi/1.7m2 of body surface area.
      The 24 and 48 hr imagings of the anterior chest, including total heart and lungs,
      were used to estimate cardiac sympathetic nerve innervation by the following
      formula: H/L = (the mean counts of pixels in the regions of interest (ROI) over
      the heart)/(the mean counts of pixels in the ROI over the lungs). The results
      showed that the 24 and 48 hr H/L values in euthyroidism were a little higher than
      those in hyperthyroidism, but the differences were not significant by a Wilcoxon
      rank sum test. The correlation between H/L and 24 hr I-131 thyroid uptake in
      patients with hyperthyroidism were also evaluated and the results showed no
      significant correlation between the H/L and uptake. In conclusion, we consider
      that the clinical manifestations concerning the heart in hyperthyroidism may not
      totally depend on the effects of increased cardiac sympathetic nerve innervation.

PMID- 8340950
TI  - Bilateral simultaneous hypertensive intracerebral hemorrhages.
AB  - Bilateral simultaneous hypertensive intracerebral hemorrhages (HICH) are a rare
      occurrence. Computed tomography (CT) enables us to diagnose such a condition
      which is difficult to recognize clinically. In the series, six patients (2.6%)
      from a series of 553 HICH cases had suffered from simultaneous rehemorrhage in
      the contralateral hemisphere. It comprised four males and two females. Their ages
      ranged from 54 to 64 years with a mean age of 58 years. The clinical symptoms
      were excessively sever and were characterized by severe consciousness disturbance
      (semicoma to coma, 6 cases), aphasia (5 cases) and bilateral paresis (3 cases).
      CT density profiles were identical, implying that the hematomas were of similar
      age but located areas; two were bilateral basal ganglia, one was bilateral
      specular thalamus, pontine-ganglia (right), thalamo (left)-ganglia (right) and
      occipito (right)-thalamus (left) individually. All of the hematomas had ruptured
      into the ventricles. The predominant sites of hemorrhage were in the putamen
      (50%, 6/12) and the thalamus (33%, 4/12). Two patients received emergency
      craniotomy for evacuation of the hematomas. However, they died soon after the
      operations. In the remaining four non-surgical cases, two died of central
      failure, another died of pneumonia and the remain one survived but retained
      hemiplegia sequelae. The serious surgical results and outcome in bilateral HICH
      was compared that of unilateral HICH. Hemodynamically, poor cerebral blood flow
      and diaschisis phenomenon may contribute to the poor prognosis in these patients.

PMID- 8340951
TI  - A study of hospital nurses' attitudes toward continuing education in Kaohsiung
      City, Taiwan.
AB  - The purpose of this study was to investigate hospital nurses' attitudes toward
      continuing education. Continuing education was defined as non-credit organized
      educational programs designed for nurses by hospitals, nursing institutions, or
      other related organizations to maintain or improve professional competence. It
      included "in-service education", "on-the-job training", and other synonymous
      educational activities. Six hundred and seventy-four randomly selected hospital
      nurses in Kaohsiung City participated in this study. The data was collected by
      delivering a 34-statement questionnaire through the directors of nursing.
      Cronbach's Alpha Coefficient was applied to determine the reliability with a
      value of 0.79. Factor analysis and a group of experts' suggestions were applied
      to determine the validity. Frequency distribution, Analysis of Variance, Scheffe'
      test, and Multiple Regression Analysis were conducted to analyze the research
      questions. The level of significance was set at 0.05 or less. The results
      indicated that the majority of nurses (92.65%) hold positive attitudes toward
      continuing education (M = 86.32). Nurses' attitudes toward continuing education
      were related to selected personal and professional characteristics, and hospital
      policies regarding continuing education. To maintain nurses' positive attitudes
      and to develop positive attitudes for those who hold negative attitudes, some
      strategies for continuing education should be considered by nursing
      administrators.

PMID- 8340952
TI  - [A preliminary report about body shape and composition of 300 citizens in
      Kaohsiung City].
AB  - We studied 300 healthy citizen of Kaohsiung City, Taiwan, to discover factors
      that affect body shape, and especially body weight. It's our hope that we could
      find an objective evaluative index to assess obesity that would be suitable for
      use in out-patient clinics. During the study period, 300 healthy, under 50 years
      old volunteers were participated in our study. All the participant were asked to
      completed a questionnaire and anthropometric measures for analysis. The result of
      our study showed that age, sex and drinking habit all were significantly affected
      body shape. We also found that relative body weight and subscapular skinfold
      thickness are best predictor of body fat composition. Therefore, we suggest the
      combined use relative body weight and subscapular skinfold thickness as an index
      for assessing obesity in out-patient clinics.

PMID- 8340953
TI  - [Factors affecting stroke patients' motivations for rehabilitation].
AB  - Factors correlated to the motivation for rehabilitation in stroke patients were
      studied. Thirty patients who had had only one stroke were recruited between
      December 1991 and April 1992 for our study. Several assessment tools including
      the Motivational scale, the Health Locus of Control scale and a questionnaire
      were used. According to the results of the assessment, the stroke patients'
      motivation remained stable when assessed two to three times during the hospital
      stay, whereas their UE/LE Brunnstrom stage scores and activities of daily living
      skill (ADL) improved significantly. The motivation of the patients was closely
      correlated with the degree of education, the internal scores and ADL performance:
      patients with education level higher than primary school, higher internal scores,
      or better ADL performance had stronger motivation for rehabilitation. On the
      other hand, motivational assessments between the nursing staff and the therapists
      were not completely in agreement. The ADL performance was better correlated with
      the degree of motivation on the nursing assessment, whereas the Brunnstrom stage
      scores of UE/LE were more closely correlated with the therapists' assessment.
      Items on the motivational questionnaire such as "eagerness to recover earlier",
      "recognition of the effectiveness of rehabilitation", "support of spouse" and
      "homesickness" were commonly considered to be positive factors. However, the
      other factors such as "being in bad mood", "lack of family cooperation",
      "worrying about things other than finances" and "lack of family support" were
      commonly considered to be negative factors on motivation. In the comparison
      between high and low motivation groups, the high motivation group payed more
      attention to the positive factors such as "eagerness to be independent" and such
      negative factors as "lack of understanding of illness" as well as "poor appetite
      and fatigue". The low motivation group was considered to be more affected by such
      negative factors as "worrying about things other than finances", "not good enough
      facilities" and "homesickness" which resulted in lessening the motivation for
      rehabilitation.

PMID- 8340954
TI  - Metastatic brain tumor manifesting as lacunar syndrome in adults.
AB  - Lacunar syndrome can be an initial manifestation of the metastatic brain tumor in
      young adults. Two patients were encountered with previously undiagnosed lung
      cancer, one with anaplastic carcinoma and the other with adenocarcinoma. A
      neurologic syndrome occurred in the morning with unusual headache and stroke-like
      episodes, presenting an acute ataxic hemiparesis and a pure motor hemiparesis,
      respectively. Papilloedema was a universal finding. The headache and neurologic
      deficits responded rapidly to glucocorticoid. A preexisting intracranial mass
      with an outburst of brain edema is thought to be the mechanism in this situation.

PMID- 8340955
TI  - Extracranial internal carotid artery dissection secondary to neck massage:
      visualization of mural hematoma by MRI.
AB  - A 52-year-old man was admitted due to a severe pain in the right side of the neck
      and a progressive weakness of the left-side extremities. One week prior to
      admission, the patient began to use massage balls to relieve his long-lasting
      nuchal soreness. Carotid arteriography revealed a segment of tapered stenosis of
      the extracranial internal carotid artery with distal occlusion at the proximal
      middle cerebral artery. Magnetic resonance imaging (MRI) demonstrated a well
      defined mural hematoma which is a distinctive feature of arterial dissection.

PMID- 8340956
TI  - Cast-model and scanning electron microscopy of the rat brain ventricular system.
AB  - In order to establish a good experimental model for comparative studies of the
      brain ventricular system in mammals, a resin-cast model and scanning electron
      microscopy were employed to examine the rat brain ventricular system. From the
      resin-cast model, we found that the gross morphology of the brain ventricular
      systems of rats is simpler than that of humans. From scanning electron
      microscopy, local variations of ependymal cells lining the rat brain ventricle
      were noted. Most areas of the ventricles were lined by ciliated ependymal cells
      arranged in regular rows, whereas in some other areas non-ciliated ependymal
      cells were also observed. Epiplexus cells and supraependymal cells were also
      encountered on the top surface of the choroid epithelium, and ependymal cells in
      certain area such as the pineal recess.

PMID- 8340957
TI  - Solid phase radionuclide esophageal motility in polymyositis and dermatomyositis.
AB  - Polymyositis (PM) and dermatomyositis (DM) may be associated with motor
      dysfunction of the entire gastrointestinal tract. Abnormal esophageal motor
      function is a well-recognized complication of these diseases. In this study, we
      used a solid phase esophageal study to evaluate the motor function in patients
      with PM or DM. Twenty-three patients and 36 age-matched normal volunteers were
      studied. Each subject was placed in a supine position above a gamma camera linked
      to a computer and was given a 4-ml bolus of solid gelatin containing 1 mCi of Tc
      99m phytate. Data were acquired in the list mode. A computer method modified from
      Kelim and Wald and Russell et al. was used to calculate the following: A) total
      mean transit time (MTT); B) residual fraction after the first swallow (RF); and
      C) retrograde index (RI). All values are presented as mean +/- standard deviation
      (SD). The Student's t-test was used to test statistical significance. Our
      preliminary results suggest: 1) delayed esophageal emptying is common (17/23) in
      PM/DM, indicating frequent malfunction of the smooth muscle of the upper
      gastrointestinal tract in PM/DM and 2) measurement of esophageal motility may
      monitor disease activity in PM/DM.

PMID- 8340958
TI  - [Value of fine needle aspiration cytology in the diagnosis and management of
      fibroadenoma of the breast].
AB  - Cytological and histopathological biopsies were obtained from 121 breast lumps
      clinically diagnosed as fibroadenomas. Of these 98.3 percent of the lesions were
      benign. The cytological diagnosis was benign in 95.1 percent of 101 (83.4% of
      total) cases confirmed as fibroadenomas, histopathologically, but inadequate for
      diagnosis in 4.9 percent. The remaining 20 lesions included one breast cancer and
      one primary malignant lymphoma. In this group aspiration cytology was inadequate
      for diagnosis in 20 percent of the cases (P < 0.05). The cytological reports cast
      suspicion in the two malignant cases. No lesion with benign cytology was
      subsequently shown to be malignant. Ninety-five (78.5%) cases of the lesions,
      representing 72 women under 35 years of age, which has been clinically diagnosed
      as fibroadenomas, showed fibroadenoma, histopathologically, in 89.5% of these
      cases. The other 26 (21.5%) lesions in 21 patients, who were over 35 years in
      age, had 61.5 percent fibroadenomas, cytological results cast suspicion of
      fibroadenoma in 87.1 percent of these cases. The other 16 histopathologically
      diagnosed fibroadenomas in patients over 35 years of age showed 62.5% were
      cytologically suspected of being fibroadenomas (P < 0.025). As a result of this
      study it is reasonable to suggest that a typical clinical fibroadenoma can be
      treated conservatively in women under 35 years, but only if an adequate
      cytological smear obtained by fine needle aspiration does not show malignant of
      suspicious cells.

PMID- 8340959
TI  - [Investigation of activity of daily living performance in patients with Duchenne
      muscular dystrophy].
AB  - The purpose of this study was to reach a better understanding the deficits of
      activity of daily living (ADL) skills in patients with Duchenne muscular
      dystrophy (DMD), and their influencing factors. Our samples consisted of 35 male
      DMD patients, aged 3-24 years. The Barthel index was used to assess daily living
      abilities. Besides ten different motor abilities, muscle strengths of both upper
      and lower extremities and joint contractures were also included in each patient's
      evaluation. The results of degree of severity in ADL performance showed that
      21.1% of patients were classified as totally dependent, 48.5% were severely
      dependent, 12.1% moderately dependent, 9.1% mildly dependent and 9.1% totally
      independent. Among the ADL skills, the bathing needed most assistance whereas
      feeding required the least. Two of the sixteen factors influencing ADL
      performance was calculated to be significant after stepwise multiple regression
      analysis. They were hip contracture and static sitting balance. In conclusion, we
      find that DMD patients are highly dependent in carrying out ADL tasks. Therefore,
      it is very important to avoid contracture, to increase static sitting balance and
      to use appropriate devices to improve their daily living abilities. Finally, the
      Barthel index proved acceptable in evaluating Taiwanese children over six years
      of age.

PMID- 8340960
TI  - [Staffing levels and patient needs in the intensive care unit].
AB  - The current study sought to utilize a patient classification system to
      investigate staffing and patient needs along with nursing care distribution in
      our intensive care units. The study employed a factor type analysis to design a
      patient need checklist (for our six ICUs) in order to determine staff load and
      nursing requirements. Snapshot observations were also taken to survey the
      distribution of nursing care time. The results of the two methods provide an
      estimate of current staffing needs, they also show that there is no significant
      difference between our surgical and internal medicine wards. On average, direct
      care accounts for 40.1% of the time schedule; indirect care, 37.3%; related care,
      6.0%; and individual time, 16.6%. The average patient grade lies between I and
      III; and workload index, between 4.4 and 11.5. The average nursing time per
      patient per shift is 2.88 hours, and the average workload per person is estimated
      at 5.7-5.8 hours. By comparing the number of personnel currently employed and the
      estimated number needed, we discovered that two units are understaffed, and three
      are overstaffed. The understaffed units are all surgical units; the overstaffed
      ones, internal medicine units. To conclude the study, we examined the nature and
      complexity of nursing duties in the hopes of returning non-nursing
      responsibilities to the proper medical organizations. Our ultimate goal is to
      realize the full potential and improve the quality of our nursing personnel.

PMID- 8340961
TI  - Unilateral symptomatic palatal myoclonus: MRI evidence of contralateral inferior
      olivary lesion.
AB  - Symptomatic palatal myoclonus is a rare syndrome of segmental myoclonus which is
      thought to occur after damage to certain brainstem or cerebellar structures. We
      report two patients with unilateral PM, who showed hypertrophy of the inferior
      olivary nucleus on magnetic resonance imaging. In the first patient this was due
      to a left pontine tegmental hemorrhage, and a right-sided oculo-palato-facial
      myoclonus developed one month after the episode. The second one had a basilar
      artery occlusion with ischemic infarcts at the basis pontis, dorso-lateral
      aspects of the left pons, and left cerebellar dentate nucleus, as well as the
      occipital lobe. A delayed left oculopalatal myoclonus was recognized 3 months
      later. Interruption of the "dentato-rubro-olivary pathway" by the lesion with
      ensuing neuronal loss, cytoplasmic vacuolation, and astrocytic proliferation in
      the inferior olive, together with an increase of water content as mobile proton
      may cause the MR signal abnormalities in patients with unilateral symptomatic
      palatal myoclonus.

PMID- 8340963
TI  - [Stress fracture of the ribs in amateur golfers diagnosed by Tc-99m MDP
      scintigraphy].
AB  - Golf has become a popular sport in Taiwan recently. Some amateur golfers suffer
      from back or chest pain, and a few of them have stress fractures of the ribs. Six
      amateur golfers suffering from back pain or chest pain, all male and right-handed
      players, aged from 28 to 39, were included in our study. The initial chest
      roentgenograms, including special views focusing on ribs, were all negative. Tc
      99m MDP bone scan confirmed the diagnosis of stress fractures of the ribs. The
      intervals between playing golf and time of diagnosis were from 1 month to 5
      months. In five cases, fracture sites in the left side were prominently located
      in the posterior aspect, a condition which may result from traction of the
      serratus anterior. Three cases with fracture sites in the right side had
      fractures prominently located in the lateral aspect, which may result from the
      repercussive force produced by the clubhead hitting the ground. Tc-99m MDP bone
      scan, with its high sensitivity, is useful in establishing the diagnosis of
      stress fracture.

PMID- 8340962
TI  - [Teratoma of testis--a case report].
AB  - A case of mature testicular teratoma in a 5-year-old child is presented. The
      level of serum beta-human chorionic gonadotropin (beta-HCG), alpha-fetoprotein
      (alpha-AFP), and carcinoembryonic antigen (CEA) were all within normal limit one
      year post-operatively. We discussed the clinical features, treatment and the
      result of this patient and reviewed the literature.

PMID- 8340964
TI  - Rational suicide: no longer 'crazy'?

PMID- 8340965
TI  - Studies raise doubts about benefit of athletics in reducing unhealthy behavior
      among adolescents.

PMID- 8340966
TI  - World Bank report says reallocate resources.

PMID- 8340967
TI  - Pesticides pose concern about children's diet.

PMID- 8340968
TI  - From the Surgeon General, US Public Health Service.

PMID- 8340969
TI  - From the Centers for Disease Control and Prevention. Lead poisoning associated
      with use of traditional ethnic remedies--California, 1991-1992.

PMID- 8340970
TI  - From the Centers for Disease Control and Prevention. Severe isoniazid-associated
      hepatitis--New York, 1991-1993.

PMID- 8340971
TI  - From the Centers for Disease Control and Prevention. Heat-related deaths--United
      States, 1993.

PMID- 8340972
TI  - Declining blood lead levels and cognitive change in children.

PMID- 8340973
TI  - Declining blood lead levels and cognitive change in children.

PMID- 8340974
TI  - Declining blood lead levels and cognitive change in children.

PMID- 8340975
TI  - Soil abatement and lead levels in children.

PMID- 8340976
TI  - Breast-feeding: time to teach what we preach.

PMID- 8340977
TI  - Breast-feeding: time to teach what we preach.

PMID- 8340978
TI  - Breast-feeding: time to teach what we preach.

PMID- 8340979
TI  - Ethnicity and emergency department analgesia.

PMID- 8340980
TI  - Ethnicity and emergency department analgesia.

PMID- 8340981
TI  - Controlling the tuberculosis epidemic: the analogy with mental illness.

PMID- 8340982
TI  - Patients' ratings of outpatient visits in different practice settings. Results
      from the Medical Outcomes Study.
AB  - OBJECTIVE: To determine how patients in different kinds of practices--solo or
      single specialty (SOLO), multispecialty group (MSG), or health maintenance
      organizations (HMOs)--and with fee-for-service (FFS) or prepaid physician payment
      arrangements evaluate their medical care. DESIGN: Survey of adult outpatients
      after office visits, with sample weighted to represent population of patients
      visiting physicians in each practice type. SETTING: Offices of 367 internists,
      family practitioners, endocrinologists, cardiologists, and nurse practitioners,
      in HMOs (prepaid only), MSGs (prepaid and FFS), and SOLO practices (prepaid and
      FFS). PATIENTS: Adults (N = 17,671) at start of the Medical Outcomes Study.
      OUTCOME MEASURES: Overall rating of the visit (five choices from excellent to
      poor). A random half of the sample also rated the provider's technical skills,
      personal manner, and explanations of care as well as time spent during the visit,
      the appointment wait, the office wait, the convenience of the office location,
      and telephone access. RESULTS: Fifty-five percent of patients rated their visit
      overall as excellent, 32% very good, 11% good, and 2% fair or poor. Patients of
      SOLO practitioners were more likely (64%) to rate their visit excellent than MSG
      (48%) or HMO (49%) patients (P < .001). Patients of SOLO practitioners rated all
      aspects of care better than HMO patients did, most markedly appointment waits
      (64% vs 40% excellent; P < .0001) and telephone access (64% vs 33% excellent; P <
      .0001). Within SOLO and MSG practices, FFS patients rated most specific aspects
      better than prepaid patients, but these differences were not statistically
      significant and were inconsistent across cities. Adjusting for patients'
      demographics, diagnoses and self-rated health did not change results. Physicians
      with visit ratings in the lowest 20% were nearly four times as likely to be left
      by patients within 6 months than physicians in the highest 20% (16.7% vs 4.6%; P
      < .001). CONCLUSION: Of the five practice type and payment method combinations,
      SOLO FFS patients rated their visits best and HMO patients worst. Whether FFS or
      prepaid, care was rated better in small than in large practices. Our study shows
      that a brief visit rating form can be used to compare practice settings and
      health plans, and that patient ratings predict what proportion of patients, on
      average, will leave their physicians in the next several months.

PMID- 8340983
TI  - Calcium supplementation and bone mineral density in adolescent girls.
AB  - OBJECTIVE: To evaluate the effect of calcium supplementation on bone acquisition
      in adolescent white girls. DESIGN: A randomized, double-blind, placebo-controlled
      trial of the effect of 18 months of calcium supplementation on bone density and
      bone mass. SUBJECTS: Ninety-four girls with a mean age of 11.9 + 0.5 years at
      study entry. SETTING: University hospital in a small town. INTERVENTIONS: Calcium
      supplementation, 500 mg/d calcium as calcium citrate malate; controls received
      placebo pills. MAIN OUTCOME MEASURES: Bone mineral density and bone mineral
      content of the lumbar spine and total body were measured by dual-energy x-ray
      absorptiometry and calcium excretion from 24-hour urine specimens. RESULTS:
      Calcium intake from dietary sources averaged 960 mg/d for the entire study group.
      The supplemented group received, on average, an additional 354 mg/d of calcium.
      The supplemented group compared with the placebo group had greater increases of
      lumbar spine bone density (18.7% vs 15.8%; P = .03), lumbar spine bone mineral
      content (39.4% vs 34.7%; P = .06), total body bone mineral density (9.6% vs 8.3%;
      P = .05), and 24-hour urinary calcium excretion (90.4 vs 72.9 mg/d; P = .02),
      respectively. CONCLUSIONS: Increasing daily calcium intake from 80% of the
      recommended daily allowance to 110% via supplementation with calcium citrate
      malate resulted in significant increases in total body and spinal bone density in
      adolescent girls. The increase of 24 g of bone gain per year among the
      supplemented group translates to an additional 1.3% skeletal mass per year during
      adolescent growth, which may provide protection against future osteoporotic
      fracture.

PMID- 8340984
TI  - The effect of hospital financial characteristics on quality of care.
AB  - OBJECTIVE: To assess the relationship among hospital financial characteristics,
      patient payer mix, and the incidence of negligent medical injuries. DESIGN:
      Retrospective medical record review linked to hospital financial reports.
      SETTING: Acute care hospitals in New York State in 1984. POPULATION: Stratified,
      random sample of 30,195 medical records from 51 acute care hospitals. MAIN
      OUTCOME MEASURES: Hospital rates of medical injury and substandard care were
      developed from reviews of 30,195 medical records at 51 acute care hospitals in
      New York in 1984. Hospital-level variables representing financial status,
      hospital staffing, and the proportion of self-pay and Medicaid hospital
      discharges were compiled from a variety of secondary sources. RESULTS: The
      likelihood of negligent medical injury was highest in those hospitals with the
      lowest inpatient operating costs per hospital discharge (odds ratio, 2.8; 95%
      confidence interval, 1.5 to 5.5). The effect of low inpatient operating costs was
      marked among hospitals in financial distress, many of which served indigent
      populations. CONCLUSIONS: Patients admitted to hospitals that are unable to
      expend sufficient resources on patient care may be at higher risk of substandard
      care. Further study of the effect of hospital financial status on quality of care
      appears to be warranted.

PMID- 8340985
TI  - Topical anesthesia during circumcision in newborn infants.
AB  - OBJECTIVE: To determine the efficacy of topical anesthetic cream, eutectic
      mixture of local anesthetics (EMLA), in alleviating pain from neonatal
      circumcision. DESIGN: Randomized, controlled trial. SETTING: Normal newborn
      nursery in a university teaching hospital. PATIENTS: Twenty-seven newborn, full
      term male neonates, aged 1 to 3 days. OUTCOME MEASURES: Heart rate,
      transcutaneous oxygen saturation, facial activity, and crying. RESULTS: Compared
      with baseline, all newborns experienced pain as evidenced by increased heart rate
      of an average of 40 beats per minute (F [8, 25] = 14.12; P < .0001), decreased
      oxygen saturation of 3% (F [8, 25] = 15.02; P < .0001), and more facial actions
      indicative of pain (F [8, 25] = 5.25; P < .002) during all phases of the
      procedure. Compared with placebo, EMLA significantly attenuated the pain response
      as shown by lower heart rate of an average of 25 beats per minute (F [1, 25] =
      14.92; P < .001), higher oxygen saturation of 5%, particularly during the
      clamping and lysis phases (F [1, 25] = 19.83; P < .0001), 20% less facial
      activity (F [1, 25] = 12.01; P < .002), and 15% less crying during the clamping,
      Gomco clamp application, and incision of the foreskin. There were no differences
      between groups in the spectral crying parameters. CONCLUSIONS: Circumcision
      procedure produces pain responses that EMLA diminishes. Thus, EMLA may be a
      useful agent for pain management in neonatal circumcision.

PMID- 8340986
TI  - Treatment of convulsive status epilepticus. Recommendations of the Epilepsy
      Foundation of America's Working Group on Status Epilepticus.
AB  - Convulsive status epilepticus is an emergency that is associated with high
      morbidity and mortality. The outcome largely depends on etiology, but prompt and
      appropriate pharmacological therapy can reduce morbidity and mortality. Etiology
      varies in children and adults and reflects the distribution of disease in these
      age groups. Antiepileptic drug administration should be initiated whenever a
      seizure has lasted 10 minutes. Immediate concerns include supporting respiration,
      maintaining blood pressure, gaining intravenous access, and identifying and
      treating the underlying cause. Initial therapeutic and diagnostic measures are
      conducted simultaneously. The goal of therapy is rapid termination of clinical
      and electrical seizure activity; the longer a seizure continues, the greater the
      likelihood of an adverse outcome. Several drug protocols now in use will
      terminate status epilepticus. Common to all patients is the need for a clear
      plan, prompt administration of appropriate drugs in adequate doses, and attention
      to the possibility of apnea, hypoventilation, or other metabolic abnormalities.

PMID- 8340987
TI  - Abetalipoproteinemia. New insights into lipoprotein assembly and vitamin E
      metabolism from a rare genetic disease.
AB  - Abetalipoproteinemia is a rare genetic disease that has provided important new
      insights into the physiology of lipoprotein assembly and vitamin E metabolism.
      Forty-two years after its initial description, a molecular etiology of ABL has
      been reported to be a deficiency of a microsomal transfer protein, thus
      suggesting that this protein plays a key role in lipoprotein particle assembly
      and secretion both in the intestine and in the liver. Furthermore, studies in
      patients with ABL have established the critical role of hepatic secretion of VLDL
      in the delivery of vitamin E to peripheral tissues and the essential role of
      vitamin E in the maintenance of normal physiological function of multiple
      tissues. The systematic investigation of this rare genetic disease has provided
      insights that have substantially enhanced our understanding of human physiology.

PMID- 8340988
TI  - Doctor, I want to die. Will you help me?

PMID- 8340989
TI  - Compassion needs reason too.

PMID- 8340990
TI  - Self-determined death, the physician, and medical priorities. Is there time to
      talk?

PMID- 8340991
TI  - Radiation from digital clocks.

PMID- 8340992
TI  - Treatment for cramping of peripheral vascular occlusive disease.

PMID- 8340993
TI  - Does recombinant human erythropoietin accelerate erythropoiesis for predonation
      before cardiac surgery?
AB  - This study was performed to determine the effect of recombinant human
      erythropoietin (rEPO) on preoperative autologous blood donation in patients
      undergoing elective coronary bypass or valvular operations. Nineteen patients
      received 200 u/kg of rEPO intravenously 3 times a week, and 210 mg/day of iron
      sulfate orally, for 2 weeks before surgery (EPO group). Seven matched patients
      only took the same dose of iron sulfate (control group). Bone marrow was
      aspirated from the sternum during surgery, and the Myeloids/Erythroids ratio was
      calculated in 13 patients of the EPO group. The total donated blood mass was 853
      +/- 231 g in the EPO group, and 657 +/- 140 g in the control group (p < 0.05).
      The average increase in hemoglobin (Hb) mass from admission to the day before
      surgery was 87 +/- 33 g in the EPO group, and 24 +/- 13 g in the control group (p
      < 0.001). Furthermore, the logarithm of the ratio of "increased Hb mass/Hb mass
      at admission" was significantly correlated to the Myeloids/Erythroids ratio (r = 
      0.9130, p < 0.01). These results strongly indicate that rEPO is a very useful
      agent for predonation of autologous blood for cardiac operations.

PMID- 8340994
TI  - Abnormal postexercise systolic blood pressure response is a good indicator of
      impaired left ventricular filling during supine cycle ergometer exercise in
      patients with coronary artery disease.
AB  - To determine whether the postexercise systolic blood pressure (SBP) response is a
      useful marker of left ventricular filling abnormalities, supine leg exercise
      testing was conducted in 14 control subjects and 70 patients with coronary artery
      disease (CAD). An abnormal postexercise SBP response (the ratio of SBP after 3
      min of recovery to the peak exercise SBP) was defined as 0.85 or more, which
      represented the cutoff point with the highest sensitivity and specificity for
      prediction of pulmonary artery wedge pressure (PAWP) of at least 20 mmHg at peak
      exercise in CAD patients. There was a significant difference between the SBP
      ratios of the two groups (Control, 0.72 +/- 0.05; CAD, 0.86 +/- 0.13; p < 0.01).
      There was no significant difference between the PAWP of the two groups at rest,
      but the PAWP at peak exercise was significantly higher in the CAD group (20.2 +/-
      8.9 mmHg) than in the control group (11.5 +/- 4.0 mmHg)(p < 0.01). PAWP at peak
      exercise was > or = 20 mmHg in 35 (50%) of the 70 CAD subjects. The SBP ratio was
      significantly correlated with PAWP at peak exercise (r = 0.67, p < 0.01) in the
      CAD group, but not in the control group. An SBP ratio of > or = 0.85 showed a
      sensitivity of 80% and a specificity of 80% for predicting a peak exercise PAWP
      of > or = 20 mmHg in CAD patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8340995
TI  - Usefulness of serum CA125 measurement for monitoring pericardial effusion.
AB  - To investigate the clinical significance of carbohydrate antigen 125 (CA125), an
      antigen related to ovarian cancer, in patients with pericardial effusion, we
      examined the relationship between serum levels of CA125 and the presence or
      severity of pericardial effusion. Fifty-seven patients (25 with heart failure, 22
      with pericardial metastasis, 4 with hypothyroidism, 4 with renal failure, and 2
      with other diseases) in whom pericardial effusion was confirmed by
      echocardiography or autopsy, were used as subjects. Thirty-seven of these
      patients (65%) tested positive for CA125 in the serum. Of these, no significant
      differences in serum levels of CA125 were found between patients with benign and
      those with malignant underlying diseases or between those with, or without,
      pericarditis. However, CA125 values were higher in the patients with larger
      pericardial effusions and the serum level decreased when the pericardial effusion
      reduced. In some cases, the serum level normalized before the effusion resolved.
      Pericardial drainage was performed on 6 patients with cardiac tamponade. Four of
      these 6 patients had high serum CA125 levels and recurrent pericardial effusion.
      The other 2 patients had normal serum CA125 levels and no recurrence of effusion.
      An immunohistological study showed that a positive stain of pericardial tissues
      reacting to CA125 antibodies correlated to higher serum and pericardial fluid
      levels of CA125 than the levels of groups staining negative to the antibody.
      These results suggest that CA125 can be useful in assessing the status and
      clinical course of this disease.

PMID- 8340996
TI  - Effects of volume and pressure overloads and myocardial hypertrophy on exercise
      induced changes in electrocardiographic QRS amplitude.
AB  - To investigate the effects of volume and pressure overloads and myocardial
      hypertrophy on exercise-induced changes in QRS amplitude, we reviewed treadmill
      exercise electrocardiograms. In 10 normal young men, Rv5 amplitude decreased and
      Sv1 amplitude increased at peak exercise, and returned to the resting value in
      the recovery period. In 10 patients with aortic regurgitation, Rv5 and Sv1
      amplitudes increased after 5 min of recovery. In 12 patients with essential
      hypertension and 10 with idiopathic hypertrophic non-obstructive cardiomyopathy,
      Rv5 amplitude remained unchanged or higher at peak exercise compared with the
      resting value, but patterns of serial changes were similar to that of normal
      subjects. In 9 patients with atrial septal defect, R'v1 amplitude increased with
      exercise, whereas it remained unchanged in 12 with isolated complete right bundle
      branch block. In 5 patients with mitral stenosis, Sv1 amplitude decreased at peak
      exercise. In conclusion, changes in QRS amplitude with exercise are influenced by
      hemodynamic abnormality and myocardial hypertrophy, and a major determinant of
      these serial changes seems to be the change in ventricular volume.

PMID- 8340997
TI  - Cumulative effects of heart beat on ventricular premature contractions suggesting
      possible involvement of triggered activity.
AB  - We analyzed 24 h ECG recordings of 29 patients with frequent (> 2000/day)
      ventricular premature contractions (VPCs) to evaluate: 1) the relationship
      between VPC frequency and heart rate (HR); 2) the relationship between the
      coupling interval (CI) of VPCs and HR; 3) the time course of changes in VPC
      frequency following an abrupt and sustained increase in HR; and 4) the effect of
      oral diltiazem (90 or 180 mg/day for 4 weeks) on VPCs. Based on the patterns of
      relationship between VPC frequency and HR, patients were divided into 2 groups:
      1) 17 patients with a positive correlation, the P group (a linear increase in
      VPCs with increasing HRs); and 2) 12 patients with a non-positive correlation,
      the NP group. The NP group showed either a linear decrease in VPCs with increased
      HRs (4 patients) or an increase in VPCs at low HRs and a decrease at high HRs (8
      patients). In all cases, an increased HR was associated with a shortening of CI.
      In the P group, changes in VPCs after an abrupt increase in HR showed 2 types: 1)
      delayed-ascent type, in which VPCs increased as the duration of HR increase was
      prolonged (cumulative effects of heart beat) (7 patients); and non-delayed-ascent
      type (10 patients). Diltiazem reduced VPCs > or = 75% in all of the 7 delayed
      ascent-type patients, compared with 3 of the 10 non-delayed-ascent-type patients
      (p < 0.05) and none of the 12 patients in the NP group (p < 0.001).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8340998
TI  - Assessment of ejection fraction of the right and left ventricles in patients with
      acute myocardial infarction by magnetic resonance imaging.
AB  - Right and left ventricular function in acute myocardial infarction (AMI) was
      assessed by ECG-gated magnetic resonance imagine (MRI) in 64 patients and 8
      volunteers. Five short axis images for intrinsic cardiac long-axis of the left
      ventricle were obtained at 9 msec and 309 msec after the R wave as end-diastole
      and end-systole. Right and left ventricular volumes were measured by Simpson's
      rule. The intraobserver variabilities in right and left ventricular ejection
      fraction (RVEF: r = 0.94, LVEF: 0.89) were excellent. The interobserver
      variabilities in RVEF (r = 0.61) and LVEF (r = 0.77) were fair. LVEF, but not
      RVEF, was significantly reduced in patients with AMI. Among left ventricular
      dysfunction (LVEF < or = 40%) patients, 50% exhibited right ventricular
      dysfunction (RVEF < or = 40%). Among patients without left ventricular
      dysfunction, only 12% exhibited right ventricular dysfunction. In left
      ventricular and biventricular dysfunction compared with control, the left
      ventricular end-diastolic volume index increased (65 +/- 10 ml/m2, 68 +/- 12
      ml/m2 vs 54 +/- 8 ml/m2), the end-systolic volume index increased (40 +/- 16
      ml/m2, 43 +/- 7 ml/m2 vs 18 +/- 1 ml/m2), and the right ventricular end-diastolic
      volume index decreased (52 +/- 13 ml/m2, 53 +/- 20 ml/m2 vs 65 +/- 8 ml/m2). MRI
      can thus be used to assess ventricular systolic function. Since patients with
      left ventricular dysfunction revealed a high incidence of right ventricular
      dysfunction, an interaction between the left and right ventricles may occur in
      ventricular dysfunction.

PMID- 8340999
TI  - Effects of propranolol and diltiazem on the rate of high-energy phosphate
      metabolism in reperfused rat hearts--31P-NMR saturation transfer study.
AB  - The relationships between pressure rate product (PRP) and flux (PCr-->ATP) or
      flux (Pi-->ATP) were studied in isolated perfused rat hearts by the saturation
      transfer method using 31P-NMR. The effects of propranolol and diltiazem on
      phosphate metabolism were also studied. After a 40 min preischemic period, the
      hearts were subjected to a 15 min period of ischemia, followed by 60 min of
      reperfusion. Propranolol (0.4-1.2 microM) or diltiazem (3.0-6.0 microM) was
      infused for 30 min before ischemia and reinfused after reperfusion for 60 min.
      The flux (PCr-->ATP)/PRP ratio at reperfusion did not differ from that at
      preischemia. This value was also not affected by propranolol or diltiazem
      treatment. However, the flux (Pi-->ATP)/PRP ratio at reperfusion was
      significantly less than that at preischemia. Moreover, this value was
      significantly improved by propranolol or diltiazem treatment. This study
      demonstrates that 1) flux (PCr-->ATP) has a good correlation with cardiac
      performance, 2) stunned myocardium needs less ATP turnover for survival of its
      depressed contractile activity, and 3) flux (Pi-->ATP) can limit recovery of
      postischemic performance. Protective effects of propranolol and diltiazem are
      exerted on the flux (Pi-->ATP), i.e. ATP derived from glycolytic flux, in the
      reperfused heart.

PMID- 8341000
TI  - Relationship between pressure-rate product and myocardial oxygen consumption of
      normal and hypertrophic right ventricles in open-chest dogs.
AB  - There are few reports on the relationship between right ventricular performance
      and its myocardial oxygen consumption (RVMVO2). The present study was conducted
      to investigate the relationship between RVMVO2 and the mechanical performance of
      normal and hypertrophic right ventricles in open-chest dogs. Right ventricular
      hypertrophy (RVH) was induced by producing chronic right ventricular pressure
      overload by banding the pulmonary arteries of 8 puppies for 6 months. The
      experiment was performed under basal conditions and after increasing the RVMVO2
      in the eight dogs with RVH as well as in 20 normal dogs. The RVMVO2 showed
      significant positive relationships with right coronary (RCA) flow, right
      ventricular systolic pressure, and right ventricular pressure-rate product (PRP)
      in both the normal right ventricle and RVH hearts. However, the slope between the
      PRP and RVMVO2 was significantly steeper in the normal right ventricle (RV) than
      in the hypertrophic RV. When the PRP was normalized for the thickness of the
      right ventricular free wall, the slope of the two regression lines merged into a
      single line of fit. These results suggest that the pressure-rate product can be
      used to predict myocardial oxygen demand not only in the normal RV but also in
      well-compensated, hypertrophic RV. Isoproterenol induced smaller increases in
      cardiac output in the dogs with RVH than in those with normal RV. It also appears
      that the cardiac output of the hypertrophic RV is less sensitive to beta
      adrenoceptor stimulation than that of the normal RV.

PMID- 8341001
TI  - The relationship between early afterdepolarization and the occurrence of torsades
      de pointes--an in vivo canine model study.
AB  - The relationship between early afterdepolarization (EAD) and the occurrence of
      torsades de pointes (TdP) was studied in a canine model. Twelve dogs of both
      sexes, weighing 9.9-16 Kg, were studied. After reducing the concentration of
      serum potassium to 3.0-4.0 mEq/l, by administration of calcium polystyrene
      sulfonate at 15-20 g/day for 1 or 2 weeks, a 6F electrode catheter was introduced
      via the femoral vein and positioned at the atrioventricular (AV) junction.
      Complete AV block was produced by catheter ablation using a high frequency
      current. A Franz 6F catheter was introduced into the right ventricle to record
      monophasic action potentials (MAPs) using the contact electrode technique. After
      a stable recording of the MAPs was achieved, cesium chloride (CsCl; 1 mM/Kg) was
      administered as an intravenous bolus over 15 sec. The MAPs and electrocardiogram
      (ECG) changes were simultaneously recorded for 30 min after the administration of
      CsCl. The administration was repeated several times at intervals 30 min.
      Sustained or non-sustained ventricular tachycardia was produced in all dogs. EAD
      appeared in 8 of 12 dogs. When EAD developed sufficiently high amplitude,
      ventricular premature beats occurred near the peak of EAD and TdP was induced in
      3 of 8 EAD-positive dogs. TdP was not induced in EAD-negative dogs. Although TdP
      was comparatively difficult to induce, EAD-triggered activity was suggested to be
      one of the necessary conditions for TdP, because TdP occurred only when EAD
      reached a sufficiently high amplitude to produce ventricular premature beats.

PMID- 8341002
TI  - Beneficial effect of the addition of nitroglycerin to the cardioplegic solution
      on the cold-stored reperfused isolated rat heart.
AB  - We discuss here the effect of the addition of trinitroglycerin to the
      cardioplegic solution on the isolated rat heart after eight hours of storage.
      This effect was evaluated by measuring cardiac function as well as myocardial
      calcium and enzymes. Male Wistar rats were divided into three groups based on the
      concentration of trinitroglycerine in the cardioplegic solution. In the control
      group, the fluid used was a crystalloid cardioplegic solution (K+ 25 mEq/L)
      without trinitroglycerin and for groups I and II, trinitroglycerin was added at
      concentrations of 2 micrograms/ml and 5 micrograms/ml, respectively. All hearts
      were arrested with the cardioplegic solution at 4 degrees C and then immersed for
      eight hours in Euro-Collins' solution at 4 degrees C. The postperfusion coronary
      flow showed higher rates for groups I and II than for the control group (p <
      0.05), while the difference between groups I and II was not significant. In group
      I, the total concentrations of creatine kinase-MB, lactate and malondialdehyde
      after reperfusion showed the lowest levels; this group also had the lowest
      content of myocardial calcium. These results indicate that the addition of
      nitroglycerin, especially at a concentration of 2 micrograms/ml, to the
      cardioplegic solution elicits better cardiac function for immersed rat heart.

PMID- 8341003
TI  - Ischemic heart disease showing unusual angiographic findings.
AB  - Atherosclerotic lesions usually occur in the proximal and middle portion of the
      coronary arteries. Multiple obstructive lesions appearing only in the peripheral
      branches without lesions in the proximal or distal portion have not been
      reported. We encountered a patient with ischemic heart disease showing multiple
      obstruction in the peripheral branches of the right and left coronary arteries
      without significant stenotic lesions in the proximal or middle portion. This 49
      year-old male was admitted to Yamada Red Cross Hospital due to angina pectoris.
      Coronary risk factors for him included hypertension, abnormal glucose tolerance,
      smoking habit, and obesity. Laboratory studies showed a complete blood count and
      normal blood chemistries, as well as thromboplastin and prothrombin times.
      Coronary angiography showed multiple obstruction or marked stenosis in the distal
      portion and peripheral branches; there was no stenosis in the proximal and middle
      portions. Left ventriculography showed severe hypokinesis in the diaphragmatic
      segment. Biopsy of the left ventricular endocardium showed interstitial fibrosis
      but showed no abnormalities in the myocardial fibers or cell infiltration to
      perivascular areas and vascular walls. Coronary angiography after two months
      showed multiple lesions, as previously observed. Although ischemic heart disease
      is caused by various types of vasculitis, embolism, coronary spasm, and
      fibromuscular dysplasia, in this patient, there were no findings suggestive of
      causes other than atherosclerosis. This case is interesting in terms of rare
      angiographic findings and its cause.

PMID- 8341004
TI  - Massive myocardial calcification of right and left ventricles following acute
      myocarditis complicated with rhabdomyolysis-induced acute renal failure.
AB  - A 26-year-old man was admitted with a high fever, oliguria, skeletal muscle
      weakness, and cardiogenic shock which led to a diagnosis of acute myocarditis and
      acute rhabdomyolysis. During treatment with hemodialysis and calcium
      supplementation, because of severe hypocalcemia, a massive calcification of both
      right and left ventricular myocardium gradually became apparent with repeated
      computed tomographic (CT) examinations. Technetium-99m scannings more clearly
      delineated the markedly accumulated calcium in the myocardium, while significant
      activity was not detected in other soft tissues. Histopathological examinations
      by myocardial biopsy revealed a large amount of fibrosis and calcium deposits,
      and serial CT scans showed a gradual regression of the calcium deposition,
      suggesting that this rare form of massive dystrophic calcification may parallel
      changes in the severity of myocarditis, and may be associated with abnormalities
      in calcium metabolism secondary to rhabdomyolysis-induced acute renal failure.

PMID- 8341005
TI  - A case of dilated cardiomyopathy manifested by exercise-induced left bundle
      branch block.
AB  - We report an extremely rare case of dilated cardiomyopathy manifested by exercise
      induced left bundle branch block. A 63-year-old female came to our hospital
      because supraventricular arrhythmia had been detected at a check-up. A treadmill
      exercise test induced left bundle branch block. However, chest X-ray and
      echocardiography revealed no abnormal finding. Two years later, the patient
      experienced exertional dyspnea. A chest X-ray examination showed cardiomegaly,
      and echocardiography showed a moderate impairment of left ventricular function
      with left ventricular dilatation. The diagnosis of dilated cardiomyopathy was
      made by left ventricular myocardial biopsy. No previous cases have initially
      shown exercise-induced left bundle branch block which was followed by left
      ventricular dysfunction due to dilated cardiomyopathy. Careful long-term
      observation of the clinical course is necessary in patients with exercise-induced
      left bundle branch block which shows no significant underlying disease.

PMID- 8341006
TI  - Effect of transforming growth factor-beta on extracellular matrix production by
      cultured rat mesangial cells.
AB  - The effects of transforming growth factor-beta (TGF-beta) on the protein
      synthesis and gene expression of collagen I (CI), III (CIII), IV (CIV) and
      laminin (LM) in cultured rat mesangial cells (MCs) were examined to determine
      whether or not TGF-beta could modulate the formation of extracellular matrix
      (ECM) constituents, employing immunocytochemistry, enzyme-linked immunoadsorbent
      assay (ELISA) and Northern blotting. Although TGF-beta did not modulate MC
      proliferation, it induced slight enhancement of immunoperoxidase staining for CIV
      in the cytoplasm. ELISA demonstrated a significant increase in the amounts of CIV
      and LM, a tendency for CIII to increase, and a significantly lower amount of CI
      at 4 days after TGF-beta administration. Northern blotting showed that the mRNA
      expression displayed different patterns among the 4 matrix components during a 24
      hr period. These findings suggest that a single growth factor, TGF-beta, in vitro
      modulates the synthesis of individual ECM constituents in MCs differently at the
      level of both genetic expression and protein production. The specific effects of
      TGF-beta on the increase in amounts of CIV and LM indicate that TGF-beta may
      contribute to glomerular remodeling and ECM accumulation in various kinds of
      glomerular injuries.

PMID- 8341007
TI  - Inhibitory effects of crude drug components on the proliferation of cultured
      human mesangial cells.
AB  - The effects of a component of an Oriental medicine and green tea plants utilized
      for the traditional beverage on the proliferation of mesangial cells were
      determined in terms of the 3H-thymidine uptake. When magnesium lithospermate B
      was added to the medium of the mesangial cell culture, it suppressed the
      proliferation of mesangial cells at a concentration of 50 micrograms/ml. The 3H
      thymidine uptake began to display an inhibitory action from the 6.25
      micrograms/ml (-)-epicatechin 3-O-gallate, (-)-epigallocatechin 3-O-gallate or
      green tea tannin mixture, showing a more conspicuous inhibition at 50
      micrograms/ml that did the magnesium lithospermate B at the corresponding
      concentration. In particular, (-)-epigallocatechin 3-O-gallate, the predominant
      component of the green tea tannin mixture, exerted an inhibitory effect at a
      relatively low concentration.

PMID- 8341008
TI  - Dilazep prevents glomerulosclerosis in accelerated Masugi nephritis in the rat.
AB  - The effects of Dilazep on immunologically induced glomerular injuries were
      examined. Accelerated Masugi nephritis in rats produced glomerulosclerosis with
      proteinuria following administration of a single dose of nephrotoxic serum (NTS).
      When 5 mg/kg/day of Dilazep had been administered prior to the NTS injection, the
      proteinuria was resolved rapidly after reaching a maximum level. The glomeruli 3
      months later showed significant suppression of glomerulosclerosis and lesser
      adhesive lesions as compared to those in control rats with Masugi nephritis. On
      the other hand, when Dilazep was administered from 2 weeks after the injection of
      NTS, the rats displayed persistent proteinuria and glomerulosclerosis at similar
      levels to those in the Masugi group. Dilazep appears to exert some protective
      effects in the early stages of glomerular injuries induced by immunological
      mechanisms.

PMID- 8341009
TI  - Effect of magnesium lithospermate B on the renal and urinary kallikrein
      activities in rats with adenine-induced renal failure.
AB  - A study was conducted to examine the effect of magnesium lithospermate B on both
      the urinary and renal total and active kallikrein and prokallikrein in rats with
      adenine-induced renal failure. In rats given magnesium lithospermate B at a dose
      of 10 mg/kg body weight/day for 12 days, significant increases of urinary total
      and active kallikrein were associated with significant increases of urine volume
      and urinary total and active kallikrein were associated with significant
      increases of urine volume and urinary creatinine excretion. The renal total and
      active kallikrein levels were also significantly elevated by the treatment with
      magnesium lithospermate B. On day 24, the urinary excretion of total and active
      kallikrein and prokallikrein was significantly increased. Concomitantly, a
      significant increase in renal kallikrein (total, active and pro-) was found in
      the rats given magnesium lithospermate B. A significant relationship existed
      between the urinary creatinine and active kallikrein excretion. These results
      suggest that magnesium lithospermate B may stimulate the synthesis of kallikrein
      and/or conversion to active kallikrein, thus improving renal function.

PMID- 8341010
TI  - Effect of chronic central alpha-hANP administration on blood pressure, water and
      electrolyte balance in rats.
AB  - Relatively few studies have evaluated the chronic effects of atrial natriuretic
      polypeptide (ANP) administration into the central nervous system on peripheral
      cardiovascular and renal function under conditions of expanded extracellular
      fluid volume. The present investigation examined the effects of synthetic alpha
      human atrial natriuretic polypeptide (alpha-hANP) chronically infused into the
      cerebroventriculum of rats loaded with 0.9% saline. Measurements of the arterial
      blood pressure, water and electrolyte balances were carried out during a 4-day
      central ventricular infusion of alpha-hANP. Significant increases in daily urine
      volume and urinary sodium and chloride excretion were observed, but no changes of
      arterial blood pressure occurred. These results indicate that elevated levels of
      ANP in the CSF can influence sodium and water excretion, but do not appear to
      influence arterial pressure.

PMID- 8341011
TI  - A new murine model of autosomal recessive polycystic kidney disease.
AB  - We describe the renal cystic disease occurring in a new inbred strain of mice
      which developed as a spontaneous mutation in otherwise healthy Balb/c mice. The
      disease displays characteristics of an autosomal recessive polycystic kidney
      disease. Affected animals develop massive cystic enlargement of the kidneys and
      die of renal failure at the age of 4 weeks. During postnatal development, there
      is a gradual shift in site of the lesions. At birth, cystic dilations are
      localized almost exclusively in proximal tubular segments, whereas in the
      terminal stages of the disease, 80% of the cysts are localized in collecting
      tubular segments as defined by segment specific lectin binding. The composition
      of the basement membrane of the cystic tubular walls during postnatal development
      as analyzed by immunocytochemistry is essentially normal during the earliest
      stage of cyst formation. However, with disease progression, the cystic tubular
      basement membrane demonstrates a decreased immunoreactivity to anti-laminin and
      anti-entactin antibodies. This indicates a shift in cyst localization during
      disease progression in this model, and suggests that basement membrane
      abnormalities are not a primary feature of the early cyst formation and
      progressive enlargement.

PMID- 8341012
TI  - Page kidney with constrictive perinephritis.
AB  - We describe a case of Page kidney following an infectious urinoma complicated by
      a pyelolithotomy. The most characteristic finding was the fact that this case
      resulted from constrictive perinephritis, not from any usual etiology such as
      perirenal hematoma. Knowledge of the patient's medical history and split venous
      renin measurements were helpful in making a diagnosis. She had refractory
      hypertension during conservative medical therapy. Finally, a nephrectomy improved
      her hypertension. The value of venous renin sampling for reaching a diagnosis,
      and the medical and surgical therapeutic options are discussed. This report also
      reviews all previously described cases of Page kidney without hematomas.

PMID- 8341013
TI  - Investigation of the clinical value of assessing renal size on computed
      tomography in autosomal dominant polycystic kidney disease.
AB  - We examined relationship between serum creatinine concentration (Scr) and renal
      size on CT scans on 32 occasions in 25 patients with autosomal dominant
      polycystic kidney disease (ADPKD). As a result, a significant correlation was
      observed when the Scr was less than 5 mg/dl, as shown by the correlation
      coefficient (r) and P values of 0.803 and 0.0001, respectively. However, these
      values changed to 0.482 and 0.0093, respectively when 2 cases with Scr 6.2 and
      6.4 mg/dl were included, and further changed to 0.005 and 0.9775 when an
      additional 4 cases with Scr 7.8, 9.9, 11.1 and 20.1 mg/dl were included. Renal
      size is therefore thought to be a useful parameter of renal function when the Scr
      is less than 5 mg/dl in ADPKD, but not when the Scr exceeds 6 mg/dl, and is
      regarded as useless for predicting the time at which dialysis would be required.

PMID- 8341014
TI  - Clinico-pathological studies of Amyloid-P component in human glomerulopathies.
AB  - Renal tissues from 171 patients with different glomerulopathies and 6 normal
      controls were examined by an immunofluorescent technique. Specimens were stained
      in particular with anti-Amyloid P (AP) antisera, and were also stained for
      immunoglobulins and complement. The intensity and distribution pattern of AP
      staining were studied. The AP staining revealed a faint/linear pattern in normal
      controls, and was granular and linear in pathological specimens. The distribution
      of AP was found to be mesangial, capillary and mesangiocapillary. According to
      the degree of AP intensity, the patients were divided into two groups: group I
      (56 patients) exhibiting a faint intensity as seen in the normal controls, and
      group II (115 patients) with a strong intensity. The histological findings and
      laboratory data were compared between the two groups as well as among patients
      with different diseases. The incidence of sclerotic lesions and the amount of
      proteinuria were significantly higher in group II than in group I. Increased
      amounts of AP deposition in different glomerular diseases thus appear to be
      related to a diminished renal function or glomerular damage.

PMID- 8341015
TI  - Plasma levels of superoxide dismutase and its isomers in patients with chronic
      renal disease.
AB  - To evaluate the significance of Cu,Zn-superoxide dismutase (SOD) in chronic renal
      disease, we evaluated the plasma SOD activity and analyzed the plasma Cu,Zn-SOD
      isomers employing gel column chromatography. The plasma SOD activity was
      determined as the biological activity using the nitrite method and the Cu,Zn-SOD
      concentration was assayed from the immunological activity using enzyme-linked
      immunosorbent assay (ELISA). The subjects comprised 185 patients with chronic
      glomerular disease and 20 hemodialysis patients. Plasma from 170 healthy persons
      was employed as a control. Both the plasma biological activity and plasma level
      of Cu,Zn-SOD determined by ELISA were elevated in patients with chronic
      glomerular disease. In hemodialysis patients, a marked increase in Cu,Zn-SOD
      level (ELISA) was noted in comparison with the increase in SOD biological
      activities. Gel column chromatography demonstrated a marked increase in Cu,Zn-SOD
      monomer which was enzymatically inactive. From these results, we conclude that a
      marked elevation of the plasma level of Cu,Zn-SOD in hemodialysis patients was
      caused by an increase in the enzymatically inactive Cu,Zn-SOD monomer.

PMID- 8341016
TI  - Oral 1,25(OH)2D3 pulse therapy for the treatment of secondary
      hyperparathyroidism.
AB  - We examined the effect of oral 1,25(OH)2D3 pulse therapy in hemodialyzed patients
      with secondary hyperparthyroidism (2 degrees HPT). Prescription of 6.0 micrograms
      1,25(OH)2D3 once a week combined with calcium carbonate as a phosphate binder
      during the last 5 days a week for 12 weeks resulted in improvement of mild to
      moderate 2 degrees HPT despite no significant differences in serum total calcium
      and phosphate concentration. In addition, the effect was greater in cases with
      mild 2 degrees HPT. A single administration of 6 micrograms 1,25(OH)2D3 reduced
      the parathyroid hormone concentration in patients with mild 2 degrees HPT or with
      a short duration of hemodialysis. Tmax of the serum 1,25(OH)2D3 after single
      administration of 6.0 micrograms 1,25(OH)2D3 was individually different (range,
      0.4-20.9 hrs). It is recommended that early employment of oral 1,25(OH)2D3 pulse
      therapy be undertaken once a week combined with prescription of calcium salt as a
      phosphate binder during the last 5 days a week for the treatment of 2 degrees HPT
      refractory to conventional therapy, since there is no risk of aluminum
      accumulation with satisfactory control of the serum total calcium and phosphate
      concentration.

PMID- 8341017
TI  - Autosomal dominant polycystic kidney disease in a child diagnosed by
      ultrasonography.
AB  - A 10-year-old boy with a chief complaint of nocturnal enuresis was identified as
      having three cysts in each kidney on ultrasonographic examination. These findings
      together with a positive family history for renal failure prompted us to examine
      his father ultrasonographically on the same day, resulting in the identification
      of multiple large cysts in both kidneys. These observations supported a diagnosis
      of autosomal dominant polycystic kidney disease. Enhanced X-ray CT demonstrated
      more sensitively the presence of renal cysts in the boy. He had a normal urinary
      concentrating ability and no other abnormalities except for mild hypertension,
      which was successfully treated only by salt restriction. Ultrasonography thus
      appears to be a valuable tool for diagnosing polycystic kidney diseases.

PMID- 8341018
TI  - A case of minimal change nephrotic syndrome associated with acute renal failure
      after excessive exercise.
AB  - A case of minimal change nephrotic syndrome associated with acute oliguric renal
      failure after exercise is reported. Renal function returned to normal after the
      patient underwent hemodialysis, and the nephrotic state was improved by
      administration of prednisolone. Adequate supportive management of the renal
      failure and early administration of corticosteroids for nephrotic syndrome are
      important therapeutic procedures in such a situation.

PMID- 8341019
TI  - Inhibitory effect of FUT-175 on complement activation and its application for
      glomerulonephritis with hypocomplementemia.
AB  - FUT-175 (6-amidino-2-naphthyl p-guanidinobenzoate dimethane-sulphonate), a potent
      serine protease inhibitor, has been reported to inhibit complement activity in
      vitro, and especially the classical complement pathway effectively. In the
      present study, we examined the inhibitory effect of FUT-175 on the classical
      complement pathway components by hemolytic assay using purified human complement
      components. As a result, 50% inhibition of the C1 protease activity for classical
      C3 convertase formation and for C2 was obtained with 3.0 x 10(-8) M and 7.0 x 10(
      8) M of FUT-175, respectively. FUT-175 did not inhibit the C2 protease activity
      at all. We then administered FUT-175 to 5 glomerulonephritic patients with
      hypocomplementemia and proteinuria in order to assess the clinical effectiveness
      of this drug. When FUT-175 was administered intravenously and continuously at a
      rate of 0.1 to 0.2 mg/kg/hr for 2 weeks, the urinary protein excretion decreased
      significantly from 2.9 +/- 0.8 to 1.4 +/- 0.5 g/day (P < 0.025). In these
      patients, some of the serum complement markers (serum C3, C4 level and the
      hemolytic activity via the classical complement pathway (CH50)) were increased
      after FUT-175 administration. The above findings suggests that FUT-175 can exert
      beneficial effects on glomerulonephritis with hypocomplementemia by inhibiting
      complement activation.

PMID- 8341020
TI  - A clinico-pathological study on progress factors in lupus nephritis.
AB  - The prognosis of lupus nephritis was investigated in 147 patients who underwent
      renal biopsy, in an attempt to elucidate the progress factors of this disease
      clinico-pathologically. Twenty-two patients received a follow-up biopsy and were
      observed for time-related histopathological changes. At the first examination,
      only the serum creatinine and mean blood pressure were correlated with prognosis.
      The anti-DNA antibody and serum complement titer measured at the same time did
      not correlate with prognosis, and neither showed a significant improvement in the
      poor prognosis group. Profuse proteinuria tended to last longer in the poor
      prognosis group. The renal biopsy findings were found to correlate with
      prognosis. The prognosis was especially poor in patients exhibiting marked
      mesangial cell proliferation, glomerulosclerosis and interstitial lesions.

PMID- 8341021
TI  - Hypersensitivity to heparin; a case report.
AB  - Hypersensitivity reactions to heparin are very rare. A generalized
      hypersensitivity reaction including as fever and skin rash to a porcine- and
      bovine-derived heparin preparation was observed in a hemodialysis patient due to
      the nephrotic syndrome. The patient revealed peripheral eosinophilia and normal
      serum IgE. The results of a drug lymphocyte stimulating test on heparin were
      positive. Following prednisolone administration and infusion of nafamostat
      mesilate as anticoagulant therapy during hemodialysis, the high fever and
      generalized urticaria disappeared. Caution is required when conducting heparin
      therapy on hemodialysis patients.

PMID- 8341022
TI  - A case complicated with SLE during maintenance hemodialysis.
AB  - A 40-year-old woman suffered from toxemia of pregnancy in 1977 and was admitted
      to hospital. Thereafter, she developed nephrotic syndrome, underwent a renal
      biopsy, and a diagnosis of membranoproliferative glomerulonephritis (MPGN) was
      made. She received steroid therapy, immunosuppressive drug and anticoagulant
      therapy, and recovered sufficiently to be discharged from hospital in April,
      1979. During subsequent ambulatory treatment at our outpatient department, her
      renal function deteriorated gradually, and maintenance hemodialysis was started
      from June, 1990. In July, 1991, she was admitted to our hospital with pleurisy
      and pericarditis. There was no improvement despite antibiotic treatments.
      Laboratory data revealed leukopenia and lymphopenia. Under suspicion of systemic
      lupus erythematosus (SLE), relevant tests were carried out. Immunological
      abnormalities such as positive LE cells and the presence of various
      autoantibodies, together with clinical signs of hypersensitivity to sunlight,
      stomatitis and serositis, satisfied the diagnostic criteria of the ARA and a
      diagnosis of SLE was made. This case did not exhibit any clinical or serological
      abnormalities except for the renal disorder for a 10-year period after the
      histological diagnosis of MPGN, but was eventually diagnosed as SLE as a result
      of the manifestation of SLE symptoms for the first time after one year of
      maintenance hemodialysis. Immunological abnormalities and SLE during maintenance
      hemodialysis are discussed in relation to other reports.

PMID- 8341023
TI  - Improvement of ischemic myocardial dysfunction by nisoldipine in relation to its
      coronary vasodilating action.
AB  - We examined the cardioprotective effect of nisoldipine against myocardial
      dysfunction during ischemia and reperfusion in comparison with those of diltiazem
      and nifedipine in rabbit hearts perfused at constant pressure. These calcium
      antagonists were administered to the hearts before 60 min of ischemia. They
      inhibited the increase of end-diastolic pressure during ischemia in a dose
      dependent manner. Diltiazem at 1.0 microM, nifedipine at 3.0 microM and
      nisoldipine at 0.01 microM produced the maximal cardioprotective effect.
      Nisoldipine had a beneficial effect with less negative inotropic effect than
      those of diltiazem and nifedipine and it produced a significant increase of
      coronary flow during reperfusion. When the vascular component was eliminated
      under constant flow perfusion, nisoldipine also showed the cardioprotective
      effect. Nisoldipine did not produce any beneficial effect without the inhibition
      of the increase in end-diastolic pressure during ischemia nor did it do so
      without the increase of reperfusion flow. Therefore, the nisoldipine-increased
      coronary flow during reperfusion as well as the inhibition of ischemic
      contracture by nisoldipine seems to play a crucial role in improving the
      myocardial dysfunction of ischemic-reperfused hearts.

PMID- 8341024
TI  - G protein beta gamma-subunits inhibit purified adenylate cyclase independent of
      the activation by Ca2+ and calmodulin.
AB  - Adenylate cyclase purified by affinity chromatography was activated about 2.5
      fold in a Ca(2+)- and calmodulin-dependent fashion. G protein beta gamma
      subunits, an inhibitor in the receptor-mediated inhibition of adenylate cyclase,
      inhibited the purified cyclase by more than 80%. The extent of beta gamma-induced
      inhibition was not affected by the activation with Ca2+ and calmodulin. Moreover,
      the prior addition of the beta gamma-subunits to the cyclase did not prevent the
      subsequent activation of the enzyme by Ca2+ and calmodulin. We conclude that the
      beta gamma-subunits inhibit adenylate cyclase activity in a calmodulin
      independent mode.

PMID- 8341025
TI  - Effects of heparin on the inhibitory activities of human urinary trypsin
      inhibitor (ulinastatin) on trypsin, chymotrypsin and leukocyte elastase.
AB  - Effects of heparin on the inhibitory activities of human urinary trypsin
      inhibitor (ulinastatin) on trypsin, chymotrypsin and leukocyte elastase were
      studied. Heparin per se neither influenced the enzymatic activities nor changed
      the mode of inhibition of ulinastatin on the enzymes. In the presence of heparin,
      inhibitory effects of ulinastatin on trypsin were enhanced, whereas its effects
      on chymotrypsin and elastase were attenuated. These results suggest that the two
      functional domains in ulinastatin are differently affected by heparin.

PMID- 8341026
TI  - Effect of NC-1300-O-3 on healing of acetic acid-induced gastric ulcers in rats.
AB  - We examined the effect of NC-1300-O-3 on the healing of acetic acid-induced
      gastric ulcers in male Donryu rats. NC-1300-O-3, administered orally once daily
      for 2, 4 or 8 weeks after ulceration, significantly accelerated the spontaneous
      healing of both fresh and unhealed ulcers (induced by pretreatment with
      indomethacin). The delay in ulcer healing caused by indomethacin was markedly
      prevented by concurrent administration of NC-1300-O-3 once daily for 4 weeks in a
      dose-related manner. A bolus administration of NC-1300-O-3 to rats with 5-day-old
      ulcers potently and persistently (> 48 hr) inhibited both the basal and histamine
      stimulated gastric secretion. However, the potency and duration of the anti
      secretory activity of the compound, with or without indomethacin, gradually
      decreased with the period of treatment. After an 8-week treatment with NC-1300-O
      3 alone, the volume of the gastric contents was markedly increased, resulting in
      an increased acid output. Administration of the compound together with
      indomethacin for 8 weeks resulted in a significant increase in the volume, no
      change in acid output and a significant increase in the pH. The spontaneous or
      delayed healing of gastric ulcers induced 4 weeks after pretreatment with NC-1300
      O-3 was also significantly enhanced or prevented with NC-1300-O-3, with a
      weakened antisecretory activity. Therefore, NC-1300-O-3 seems to promote ulcer
      healing or prevents delayed healing by its potential antisecretory and/or ulcer
      healing activities.

PMID- 8341027
TI  - Streptozocin-diabetes modifies acetylcholine release from mouse phrenic nerve
      terminal and presynaptic sensitivity to succinylcholine.
AB  - Acetylcholine (ACh) release from the motor nerve terminal in the streptozocin
      induced diabetic state was studied in mouse phrenic nerve-diaphragm muscle
      preparations. Electrically evoked release of 3H-ACh from the preparation
      preloaded with 3H-choline was measured during two consecutive periods of
      stimulation (S1 and S2). In diabetic mice, the amount of 3H-ACh release during S2
      was decreased, and the evoked ACh release declined more steeply with successive
      stimulation periods than in normal ddY mice. The decrease in release was restored
      when the presynaptic autoreceptors were stimulated by accumulating ACh under the
      irreversible inhibition of junctional cholinesterase by methanesulfonyl fluoride.
      This effect was abolished by the administration of (+)-tubocurarine (5 microM).
      In diabetic mice, the biphasic (acceleration and suppression) effect by
      succinylcholine on evoked ACh release was caused at 3- to 10-fold lower
      concentrations than in normal mice. The degree of enhancement of resting 3H
      overflow by succinylcholine (10 and 30 microM) was greater in the diabetic state.
      These results indicated that in the diabetic state, the decrease in evoked ACh
      release interferes with its presynaptic action on inducing further release
      (positive feedback modulation) via the presynaptic nicotinic ACh receptor (n
      AChR). The presynaptic hypersensitivity to succinylcholine may be due to the
      augmentation of presynaptic n-AChR sensitivity caused by the reduction of evoked
      ACh release in the diabetic state.

PMID- 8341028
TI  - Mechanisms of the hypolipidemic effect of NIP-200 in rats.
AB  - We studied the mechanisms of hypolipidemic effects of NIP-200 (3,5-dimethyl-4,6
      diphenyltetrahydro-2H-1,3,5-thiadiazine- 2-thione), a potent hypolipidemic
      compound, in cholesterol biosynthesis in the liver, cholesterol absorption in
      small intestine, and cholesterol catabolism and excretion in rats. NIP-200 did
      not reduce cholesterol biosynthesis and had no effects on cholesterol absorption
      in the small intestine. In the cholesterol catabolism and excretion, NIP-200
      induced increases in cholesterol and bile acids levels in the bile and acidic
      steroids in the feces, and it enhanced cholesterol 7 alpha-hydroxylase activity
      in the liver. These results suggest that NIP-200 increases the synthesis of bile
      acids as a result of the activation of cholesterol 7 alpha-hydroxylase, the rate
      limiting enzyme in the conversion of cholesterol to bile acids. Therefore, it is
      considered that one of the probable mechanisms of the serum total cholesterol
      lowering action of NIP-200 involves the enhancement of catabolism and excretion
      of cholesterol in the liver.

PMID- 8341029
TI  - Organic hydroperoxide-induced activation of liver microsomal glutathione S
      transferase of rats in vitro.
AB  - The effect of t-butyl hydroperoxide (t-BuOOH), cumene hydroperoxide (CuOOH) or
      linoleic acid hydroperoxide (linoleic-OOH) on liver microsomal glutathione S
      transferase of rats was studied in vitro. When microsomes were incubated with
      either 100 microM t-BuOOH or 25 microM CuOOH, glutathione S-transferase activity
      was increased 1.5-fold; activity was further increased to 2.2-fold in the
      presence of small amounts of glutathione. The same amounts of dithiothreitol or
      cysteine did not enhance the t-BuOOH or CuOOH-induced increase in transferase
      activity. The transferase activity was also increased 1.4-fold by 10 microM
      linoleic-OOH plus 1 microM glutathione. The increase in microsomal glutathione S
      transferase activity after treatment of microsomes with t-BuOOH in the presence
      of glutathione was completely reversed by addition of dithiothreitol, whereas the
      activation of the transferase caused by t-BuOOH in the absence of glutathione was
      not reversed. Although microsomal glutathione S-transferase also possesses
      glutathione peroxidase activity, only transferase activity was increased by t
      BuOOH in either the presence or absence of glutathione. These data indicate that
      microsomal glutathione S-transferase is activated by organic hydroperoxides in
      either the absence or presence of small amounts of glutathione, suggesting an
      activation of the transferase by thiol oxidation of the cysteine residue.

PMID- 8341030
TI  - Pharmacological properties of blood pressure and heart rate control in suncus.
AB  - Blood pressure and heart rate and responses to various physiological substances
      in suncus were characterized and compared with those in mice. The blood pressures
      of the two species were similar, but the heart rate of suncus (about 400
      beat/min) was significantly lower than that of mice. Norepinephrine increased the
      blood pressure but decreased the heart rate in suncus. The latter was blocked by
      cervical vagotomy. Sensitivities to acetylcholine and isoproterenol were lower in
      suncus. These results suggest that regulation of blood pressure and heart rate in
      suncus is very unique and different from the well-defined system of the rodents.

PMID- 8341031
TI  - Effects of OM-853, a novel indolonaphthyridine derivative, on behavioral
      responses in the forced swim test in rats.
AB  - Effects of OM-853 on behavioral responses in the forced swim test were studied.
      OM-853 significantly reduced the duration of immobility without any change in the
      exploratory activity. Imipramine also reduced the duration of immobility, but
      idebenone did not. On the other hand, vinpocetine enhanced the duration with a
      suppressive effect on ambulation. The anti-immobility effect of OM-853 was
      reversed by pretreatment with haloperidol. These results demonstrate that the
      effect of OM-853 on the swim test is different from that of idebenone and
      vinpocetine. Furthermore, the present results suggest that OM-853 may exert its
      anti-immobility activity through facilitated transmission of the dopaminergic
      and/or adrenergic systems.

PMID- 8341032
TI  - The self-locking Balgrist hip socket for cementless fixation: biomechanical
      principles and clinical results.
AB  - The Balgrist hip socket, initially made entirely of HDPE (high molecular weight
      polyethylene), now made of outer titanium alloy shell that faces the bone of the
      acetabulum has been in clinical use for 10 years. The purpose of this
      presentation is to illustrate the biomechanical principles that have governed
      this unique design and to present the clinical results that we have obtained
      until the end of 1991 with 717 implants. From 1982 to 1987 Balgrist HDPE sockets
      had been implanted for 346 hips, from 1984 to 1991 Balgrist Titanium alloy
      sockets have been implanted for 371 hips. The number of revision are 55 of 717
      hips. 48 hips out of 55 were with Balgrist HDPE sockets. On the contrary, only 7
      hips were with Balgrist titanium socket. The greatest benefit of Balgrist
      Titanium socket is the excellent mechanical lock with subchondral bone of the
      acetabulum.

PMID- 8341033
TI  - Alpha-adrenergic blockade with phenoxybenzamine enhances cerebrovascular CO2
      reactivity.
AB  - The influence of sympathetic nervous activity on cerebral circulation and
      cerebrovascular CO2 reactivity was investigated by an alpha-adrenergic blockade
      with phenoxybenzamine (PBZ). Cerebral oxygen and carbon dioxide tension (BrPo2,
      BrPco2) and arterial blood pressure were continuously recorded before, during and
      after intracarotid infusion of 5 mg/kg of PBZ. The effects of 5% CO2 inhalation
      were measured before and after the infusion of PBZ. Following the intracarotid
      infusion of PBZ, BrPo2 and BrPco2 did not change significantly. After the alpha
      adrenergic blockade the degree of the increase in BrPo2 during 5% CO2 inhalation
      was significantly enhanced. The increase in the cerebrovascular CO2 reactivity
      produced by low dose PBZ suggests that the sympathetic nervous system modifies
      cerebrovascular CO2 reactivity.

PMID- 8341034
TI  - Effect of clonidine on the cerebrovascular system in cats.
AB  - The effects of clonidine, a potent alpha 2 adrenergic agonist and an
      imidazole/imidazoline receptor agonist, were examined in the cat cerebrovascular
      system, measuring cerebral oxygen and carbon dioxide tension (BrPo2, BrPco2) and
      arterial blood pressure. Intracarotid injection of clonidine (2 micrograms/kg)
      produced a gradual decrease in systemic blood pressure without initial
      hypertension, while BrPo2 decreased slightly but significantly. Before and after
      intracarotid administration of clonidine, cerebrovascular reactivity to carbon
      dioxide was estimated by changes in BrPo2 and BrPco2 during and after 3 min
      inhalation of 5% CO2. Clonidine significantly enhanced cerebrovascular reactivity
      to carbon dioxide. The data suggest that the alpha 2-adrenoceptor and/or
      imidazoline receptor play an important role in the regulation of cerebral
      circulation.

PMID- 8341035
TI  - The dramatic change from empirical to scientific technology in medicine:
      computerized imaging, communications and holography.
AB  - Perhaps the single most important element in the rapid development of
      contemporary diagnostic imaging is simply its feasibility that results from the
      deliberate use of complicated, but powerful, mathematical formulation.
      Implemented with various types of computers, today mostly digital, in such
      applications at CT (computerized tomography), MRI (magnetic resonance imaging)
      and others, the underlying principles of the 3-D (three-dimensional) image
      recording and reconstruction can all be traced back to the principles of
      "holography". Further improvements in image communications and processing, for
      example in view of robotized "Imaging-guided Stereotactic Diagnosis and
      Treatment" in high-field MRI is likely to result from suitable use of "Fuzzy
      Logic".

PMID- 8341036
TI  - A female infant with DiGeorge syndrome.

PMID- 8341037
TI  - [A study of knowledge, attitude and health behavior toward tuberculosis among non
      immigrant Korean people in Japan].
AB  - Knowledge, attitude and health behavior toward tuberculosis among Non-immigrant
      Korean people in Japan was researched by using questionnaire because of
      increasing the number of the tuberculosis patients among those group. The Korean
      member of protestant churches in Tokyo were subjects for the survey. Immigrant
      Korean people and their descendants were excluded. The questionnaire form was
      written in Korean language under the guidance of native Korean tuberculosis
      specialists. Proportion of Response was 53.1%, or 251 among 473 from 10th January
      to 30th June in 1992. The knowledge of tuberculosis among them was revealed to be
      higher than among ordinary native Korean people. It was different statistically
      by generation, namely, younger subjects aged less than 40 years old tended to
      answer that tuberculosis was a minor illness. The mass screening system in Japan
      was well known by the subjects, as shown by the fact that 72.4% of them answered
      that they knew about it. But only 56.6% of them replied that they actually took
      the mass screening. The source of its information was different statistically by
      sex, occupation, and generation. As for their health behavior, nearly two third
      (63.7%) of them visited the hospital or dispensary quickly when they fell sick. A
      small number of them answered that they could not visit a doctor because of their
      problems with the Japanese language. More than 80% of them possessed a National
      Health Insurance certificate. This proportion varied according to the period of
      stay in Japan. That is to say, The group which stayed in Japan less than one year
      was significantly the lowest because they were limited in their ability to enter
      National Health Insurance.

PMID- 8341038
TI  - [INH preventive therapy in Chiba Prefecture--before and after the renewal of the
      guideline].
AB  - To prescribe or withhold isoniazid (INH) for tuberculin skin test reactors is a
      difficult question in our country where BCG coverage rate is high. The guideline
      for INH preventive therapy renewed in 1989 says that the decision should be made
      according to the maximum erythema diameter of tuberculin skin test considering if
      the patient is a contact or non-contact, BCG vaccinated or non-vaccinated. In
      addition, evidence of recent infection is also important. We reported the INH
      preventive therapy in Chiba prefecture before and after the renewal of the
      guideline. There were 347 cases before and 571 after the renewal of the
      guideline. The cases of which maximum erythema diameter were coincided with the
      recommendation of the guideline were 50.2% and 78.6% respectively. Close contacts
      of infectious tuberculosis, i.e. cases founded out in extraordinary health
      examination and household contacts examination, showed high coincidence rate. On
      the contrary, tuberculin-positive infants found in routine health examination,
      who are neither contacts nor BCG vaccinated, showed low coincidence rate and
      seemed to be administered INH by their home- or school-doctors' own standards.
      These trends were the same before and after the renewal of the guideline.

PMID- 8341039
TI  - [HIV-infection, AIDS and BCG vaccination].
AB  - Bacille Calmette-Guerin (BCG) has been widely used as a safe and effective
      vaccine for the protection of tuberculosis, but recent epidemic of human
      immunodeficiency virus (HIV) infection evoked serious concerns about the safety
      of BCG when vaccinated to HIV-infected persons: that is, because BCG is a live,
      though avirulent, bacterial vaccine, it might grow in immuncompromised host and
      might cause dissemination and/or exacerbated local adverse reactions. In fact,
      during the decade since the first report on AIDS in 1981, several reports were
      published on the adverse reactions, systemic or local, induced by BCG in HIV
      infected persons. In this paper, the present author attempted to review such
      reports as comprehensively as possible. From critical examinations of the
      literatures, it was concluded that: 1) None of the reports dealing with
      dissemination of BCG provided satisfactorily enough evidence to identify the
      isolated mycobacteria as Mycobacterium bovis BCG. In some cases, infection with
      wild strain of M. bovis, instead of BCG, should be considered as more plausible
      pathogen. Especially, two reports, which suggested the late reactivation and
      dissemination of BCG vaccinated 30 years ago, could not be accepted without more
      detailed description of the procedures and results of the identification tests.
      In some cases, application of BCG were considered to be inappropriate. According
      to the present author's judgement, when BCG was applied appropriately as an anti
      tuberculosis vaccine, generalized infections were most plausively induced by BCG
      only in 4 cases during this decade. 2) As for the local adverse reactions, many
      reported cases of outbreak of local adverse reactions, such as local ulceration
      and supprative lymphadenitis, were not related to HIV-infection at all, but were
      due to the usage of an inferior vaccine produced by a specified manufacturer
      (Pasteur Institute, Paris). Conclusion was that BCG could be safely vaccinated to
      children born from HIV-seropositive mothers, even if children themselves were
      also infected with HIV, so long as BCG vaccine of good quality was used. 3)
      Positive conversion rate of post-vaccination tuberculin skin-test seemed to be
      lower in HIV-infected children than in children born from HIV-seronegative
      mothers. But, about 30% of the HIV-infected children converted to tuberculin
      positive after BCG vaccination suggesting the effectiveness of the vaccination
      for the considerable fraction of the babies at the highest risk of tuberculosis
      infection. Positive conversion rate was much higher in HIV-noninfected children
      born from HIV-seropositive mothers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341040
TI  - Chronic neuropsychological impairment resulting from disulfiram overdose.
AB  - The present case study examines the sequelae of disulfiram overdose and resulting
      chronic organic brain syndrome, with a 45-year-old, white, male alcoholic.
      Previous reports have discussed acute organic brain syndromes that are reversed
      after discontinuance of the drug. This particular case, however, resulted in
      significant cerebral impairment that was irreversible. Full neuropsychological
      testing which describes the extent of these neurologic deficits is presented,
      along with some possible reasons for these chronic sequelae.

PMID- 8341041
TI  - Attenuated cortisol response to biobehavioral stressors in sober alcoholics.
AB  - Sober alcoholics show an attenuated hormonal response to pharmacological agents
      that normally stimulate the hypothalamic-pituitary-adrenocortical (HPAC) axis. To
      determine if this same result would be found using biobehavioral stressors, 52
      detoxified (mean = 32 days) male alcoholics and 30 male nonalcoholic controls
      were given two moderately aversive tasks (mental arithmetic and cold pressor
      test). Three samples of blood were drawn during a 2.5-hour prestressor baseline,
      a fourth immediately following the stressors and a fifth, 20 minutes later. At
      each of these times, subjects were asked to report their degree of distress.
      Serum cortisol concentrations did not differ between groups at baseline or
      immediately following the stressors, but 20 minutes later alcoholics had
      significantly lower concentrations than controls. The groups did not differ on
      their degree of self-reported distress in response to the stressors. Thus, while
      alcoholics appeared to affectively experience stressful events in a manner
      similar to that of controls, they had an attenuated cortisol response. A possible
      pathophysiological mechanism for this dysregulation is discussed in addition to
      the potential existence of a premorbid condition.

PMID- 8341042
TI  - Alcohol and aggression: a social information processing analysis.
AB  - The present study represents a preliminary exploration of the effects of alcohol
      on aggression (a hypothetical response to a videotaped provocation), using a
      social information processing model. Subjects were male social drinkers who
      received either a control beverage (ginger ale), placebo, .45 g/kg alcohol or .85
      g/kg alcohol. Subjects observed a series of videotaped scenes of potential
      conflict occurring in the lounge of a college dormitory. In these scenes, an
      intruder switched the channel on a television set without asking the person
      watching for permission. The four groups were similar in their ability to encode
      and interpret social cues. Subjects in the 0.85 g/kg group were less able to
      generate competent (nonaggressive) solutions and were less likely than controls
      to select adaptive (nonaggressive) solutions. Subjects in the .85 g/kg group were
      more likely than control subjects to respond aggressively after being frustrated
      by the intruder's negative reaction to the initial attempt to resolve the
      conflict.

PMID- 8341043
TI  - Auditory event-related potentials in children at high risk for alcoholism.
AB  - To determine if P300 and other event-related potentials (ERP) could serve as
      markers for risk of developing alcoholism, two groups of children (8-18 years
      old) were tested. The high-risk (HR) group consisted of 51 children with an
      average of 4.1 first- and second-degree relatives who were alcoholic. The low
      risk group (LR) consisted of 42 children who had no first- or second-degree
      relatives who were alcoholic or met criteria for DSM-III Axis I psychopathology.
      Auditory stimuli varying in conditional probability were presented during a
      silent counting task, and during a choice reaction task. P300 amplitude was
      smaller in high-risk than low-risk children. When grouped according to gender and
      developmental status (8-12 and 13-18 year olds), P300 showed the greatest
      reduction for the older high-risk males compared to low-risk males. In addition,
      a previous finding was replicated: the prolonged centro-frontal negativity (232
      352 msec), which decreased with age in low-risk children, showed significantly
      less reduction for high-risk children. Risk status was not related to either
      amplitudes of the N100 and P200 components of the ERP, or to latencies of any
      components. Decreases in P300 amplitude and delayed reduction of anterior
      negativity appear related to developmental processes in high-risk children.

PMID- 8341044
TI  - A retrospective measure of childhood behavior problems and its use in predicting
      adolescent problem behaviors.
AB  - Confirmatory factor analysis was used to support the dimensional structure of a
      four-factor retrospective measure of childhood behavior problems with a large,
      nonclinical adolescent sample. Acceptable levels of internal consistency and low
      to-moderate levels of parent-adolescent interrater agreement were indicated for
      the four factors of attentional deficit/hyperactivity, oppositional behavior,
      conduct disorder symptoms and avoidance behaviors. The externalizing childhood
      problems (i.e., attentional deficit/hyperactivity, oppositional behavior, conduct
      disorder) were associated significantly with both internalizing (depression) and
      externalizing (e.g., alcohol consumption, delinquent activity) adolescent problem
      behaviors, as well as with an earlier age of onset for substance use. Avoidant
      behaviors in childhood were associated specifically with depressive
      symptomatology in adolescence. Results are discussed with regard to the role of
      childhood problems as precursors to adolescent/adult disorders.

PMID- 8341045
TI  - Alcohol consumption among emergency room patients: comparison of county/community
      hospitals and an HMO.
AB  - This study examines the associations of drinking patterns and problems to injury
      vs noninjury status among emergency room (ER) patients. Data come from two
      distinctly different health care systems in the same county: (1) the county
      hospital and three community hospitals (N = 2,626) and (2) the three health
      maintenance organization (HMO) hospitals (N = 1,102). Results indicate that
      alcohol's role in injury cases seen in the ER differs from its contribution to
      noninjury cases. Further, the demographic characteristics of ER populations--and
      the associated drinking patterns--also vary from site to site, and these also
      affect the contribution of alcohol to events requiring ER treatment. Both studies
      used similar methods and data collection instruments. Probability samples of
      patients were breath analyzed and interviewed regarding self-reported consumption
      (within 6 hours prior to the injury or illness), usual drinking patterns and
      alcohol-related problems. In both samples injured were more likely than
      noninjured to have positive breath-analyzer readings and to report heavy
      drinking, more frequent drunkenness, prior alcohol-related accidents and prior
      treatment for an alcohol-related problem, but were no more likely to report
      harmful consequences of drinking or alcohol dependence experiences during the
      last year. Both injured and noninjured in the county/community sample reported
      higher rates of heavy and problem drinking than their counterparts in the HMO
      sample, while those in the HMO sample reported rates for heavy and problem
      drinking similar to those found in the general population of the county.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8341046
TI  - Alcohol's effect on fatality risk from a physical insult.
AB  - Although alcohol's effect on the risk of being involved in a traffic crash is
      well known, its influence on the risk of death, given that a crash has occurred,
      is more uncertain. One study published a few years ago finds that alcohol
      increases such risk. The present study examines alcohol's effect on fatality risk
      in a crash using data and methods independent of the previous study, and provides
      estimates as a function of blood alcohol concentration (BAC). Data for drivers
      with measured BAC who were fatally injured in a two-car crash were selected from
      the Fatal Accident Reporting System (FARS). The study uses two sets of fatal
      crashes. For one, the probability that a BAC = 0 driver was killed is low, so
      that if alcohol increased fatality risk, this would generate additional
      fatalities at higher BAC levels. For the other set of crashes, fatality risk was
      sufficiently close to 100% that other factors had little opportunity to influence
      it. Dividing the fatalities that can be affected by alcohol by those that cannot
      measures alcohol's influence on fatality risk, and gives that a driver with BAC =
      0.1% is 1.9 +/- 0.2 times as likely as is a BAC = 0 driver to be killed in the
      same crash. The corresponding ratio for a BAC = 0.25% driver is 3.3 +/- 0.5.
      While derived using the "laboratory" of traffic, there does not appear to be any
      obvious reason why the results should not apply to physical trauma in general, so
      a BAC of 0.1% doubles the risk of death from a given impact, and a BAC of 0.25%
      triples the risk.

PMID- 8341047
TI  - Average daily alcohol consumption during adult life among decedents with and
      without cirrhosis: the 1986 National Mortality Followback Survey.
AB  - The relationship of alcohol consumption and cirrhosis mortality was examined by
      sampling 1% of deaths in the U.S. using the 1986 National Mortality Followback
      Survey. Quantity and frequency of decedent's alcohol consumption was obtained
      from next of kin through mailed questionnaire. The percentage of decedents with
      cirrhosis increased sharply with the increasing number of drinks per day. Three
      drinks per day was associated with a significantly higher percentage of cirrhosis
      deaths compared with lifetime abstainers for both whites and blacks. Although
      blacks had a significantly higher percentage of abstainers than whites, of those
      persons who were reported to drink every day, blacks were more likely to be
      heavier drinkers (5 or more drinks per day). Blacks did not have a higher risk of
      cirrhosis mortality than whites for each drinking category. Although Native
      Americans were oversampled, the number of deaths was too small for statistical
      comparisons.

PMID- 8341048
TI  - Important characteristics of warning displays on alcohol containers.
AB  - Four studies examined the federally mandated warning on alcohol containers, which
      is required by law to be "located in a conspicuous and prominent place." In all
      four studies few of the drinkers could recall the main parts of the warnings,
      even though the warning had been required on all alcohol containers for over two
      years. In Study 1, 44 adults looked at the warning on various beer containers and
      77% thought that the warning was not conspicuous but could be made conspicuous
      through various changes, such as by printing the warning horizontally (parallel
      to the brand name) rather than vertically. In Study 2, 50 adults looked at the
      warning placed horizontally on one beer can and vertically on a similar can and
      rated the horizontal warning significantly more conspicuous. In Study 3, 44
      adults spent several minutes in a simulated drinking atmosphere. Half the
      subjects had beer cans with a horizontal warning and half had a vertical warning.
      The subjects with the horizontal warning later showed significantly better
      awareness/recall of the warning. In Study 4, with 75 adult subjects in a bar, the
      half of the subjects prompted to notice the alcohol warning drank less thereafter
      in the bar than the other subjects. The findings of the series of studies suggest
      that the conspicuousness of health warnings on alcohol containers tends to
      influence their possible effectiveness.

PMID- 8341049
TI  - Privatization, price and cross-border liquor purchases.
AB  - Self-report survey data were used to investigate the effects of liquor sales
      privatization on cross-border liquor purchases. A state survey sample
      representing the Iowa age 18+ noninstitutionalized population was interviewed in
      April 1989, some 25 months after retail spirits sales were privatized. Despite a
      privatization induced 6.1% increase in retail liquor prices, there was little, if
      any, change in the self-reported amount of liquor purchased outside the state of
      Iowa.

PMID- 8341050
TI  - The effect of social investment on treatment outcome.
AB  - Social support is associated with better response to treatment. Treatments
      focused on relationships, such as marital and family therapy, are directed in
      part at promoting this support. However, the strength of the relationship between
      support and abstinence is modest, as is the demonstrated incremental
      effectiveness of treatments focused on relationships. Treatment-matching research
      needs to determine under what set of conditions treatments focused on
      relationships will enhance abstinence. The primary aim of this study was to
      determine whether the relationship between alcohol involvement and alcohol
      specific social support is moderated by a person's social investment. The second
      aim was to determine the set of circumstances under which extended individually
      focused cognitive behavioral (CB) treatment and a relationship enhancement (RE)
      of brief cognitive behavioral treatments would improve outcomes. Patients were
      randomly assigned to individual or relationship-enhanced outpatient treatment and
      followed for 12 months. Results indicated that a patient's social investment did
      moderate the strength of the relationship between support and posttreatment
      alcohol involvement: Among high investors, there was a strong positive
      relationship, while the association was weak for low investors. A hypothesized
      triple-order interaction between social investment, posttreatment support and
      treatment did not materialize. However, an interaction between support and
      treatment showed that those with high support did equally well in either
      treatment, while those posttreatment support was low benefited from CB, but
      experienced poor outcomes when treated in relationship enhancement of CB. Further
      analyses indicated that increasing alcohol-specific support for low investors was
      probably contraindicated. We suggest that patients with low investment should be
      treated in an extended cognitive behavioral modality, while relationally enhanced
      CB treatment should be limited to high investors who are likely to experience
      support for their abstinence following treatment.

PMID- 8341051
TI  - Differences among AA groups: implications for research.
AB  - Clinical writings and research often imply the homogeneity of Alcoholics
      Anonymous. Survey data from four groups reflected some consistencies as well as
      substantial variation in group environment that could have an important impact on
      outcomes and research.

PMID- 8341052
TI  - Why not breast conservation?

PMID- 8341053
TI  - Immunohistochemical study of estrogen receptor and estradiol on papillary thyroid
      carcinoma in young patients.
AB  - We have immunohistochemically examined estrogen receptors (ER) and estradiol (E2)
      on papillary thyroid carcinoma in young females under the age of 25 years. The 10
      young females in this study were compared with 64 females 30 years of age or
      older who underwent surgery for treatment of papillary thyroid carcinoma. We did
      not find any significant difference in the incidences of positive staining for E2
      between the two groups. Of the specimens obtained from the young patients, 80%
      (8/10) showed positive staining for ER; this was significantly higher (P < 0.01)
      than that observed in patients 30 years of age or older (25%). We think that,
      especially in youth, estrogen may play an important role as a promoting factor.
      This indication needs further study.

PMID- 8341054
TI  - Carcinoembryonic antigen (CEA) in stage IV gastric cancer as a risk factor for
      liver metastasis: a univariate and multivariate analysis.
AB  - Serum carcinoembryonic antigen (CEA) levels were determined in 68 patients with
      Stage IV gastric cancers, the objective being to examine the clinicopathological
      relationship between the metastatic patterns of gastric cancer and the serum CEA
      level. Of the 68 patients, 31 were diagnosed as cases of liver metastases and 37
      as cases of peritoneal dissemination. Serum CEA levels were elevated in 21 of 31
      patients (67.8%) with liver metastases and in 7 of 37 patients (18.9%) with
      peritoneal dissemination (P < 0.01). A univariate analysis showed that liver
      metastasis correlated with a young age (P < 0.01), the lower portion of stomach
      (P < 0.05), Borrmann types 1 and 2 (P < 0.01), differentiated type (P < 0.01),
      and nonserosal involvement (P < 0.05) more than did peritoneal dissemination. A
      multivariate analysis showed that in addition to Borrmann type 1 and 2, elevated
      CEA levels (> 2.5 ng/ml) is an independent risk factor involved in liver
      metastasis. Thus careful follow-up and postoperative adjuvant therapy are
      required for patients with elevated CEA levels, even with "curative" resection.

PMID- 8341055
TI  - Pulmonary metastases from adrenal cortical carcinoma: results of resection.
AB  - Adrenal cortical carcinoma is uncommon. There is little controversy concerning
      treatment of the primary tumor. However, data concerning the treatment of
      pulmonary metastases are sparse. In order to assess the results of therapy, we
      reviewed our 14-year experience. Records of 24 patients admitted to our
      institution from 1973 to 1991 with the diagnosis of adrenal cortical carcinoma
      and pulmonary metastases were reviewed. Ten patients underwent pulmonary
      resection, 12 received chemotherapy, and 2 no therapy. In the pulmonary resection
      group, treatment consisted of wedge resection in 8 patients and lobectomy in 2.
      For the 10 patients undergoing resection of their pulmonary metastases, the 5
      year survival was 71% (median not reached at 5 years). This was significantly
      longer than those not resected, with no one alive at 3 years (median survival 11
      months). Our data suggest that those patients who are able to have their
      pulmonary metastases resected survive significantly longer than those who do not.

PMID- 8341056
TI  - Prognostic value of the number of metastatic lymph nodes in gastric cancer with
      radical surgery.
AB  - To evaluate the effectiveness of extended lymph node dissection in gastric
      cancer, the relationship between the number of lymph nodes with metastasis and
      the long-term outcome was studied retrospectively in 761 patients who underwent
      curative resection with extensive lymph node dissection. The cumulative 5-year
      survival rate was 85.8% in patients without lymph node metastasis, 60.2% in those
      with 1-4 lymph nodes, 35.6% with 5-10 nodes, and 12.3% with 11 or more nodes
      involved. Concerning N2 or N3 patients in whom metastatic lymph nodes would have
      remained without extensive dissection, the 5-year survival rate was 70.5% in
      those with 1-4 lymph nodes involved and 44.0% with 5 or more lymph nodes involved
      when no serosal invasion was observed. It was 38.5% with 1-4 lymph nodes and 5%
      with 5 or more lymph nodes involved when serosal invasion was observed. These
      results suggest that extensive lymph node dissection is effective in gastric
      cancer patients without serosal invasion and, when only a few lymph nodes are
      involved, also in those with serosal invasion. However, it is not considered to
      be effective in patients with serosal invasion and metastasis to many lymph
      nodes. Combination therapies are thought to be required in such patients.

PMID- 8341057
TI  - Flow cytometric DNA analysis of interleukin-2 responsive renal cell carcinoma.
AB  - Adoptive immunotherapy using interleukin-2 (IL-2) based therapy can result in
      marked tumor regression in some patients with metastatic renal cell carcinoma.
      DNA flow cytometry has not been previously studied as a predictor of outcome of
      this therapy. Archival paraffin embedded tumors were studied in 23 IL-2 treated
      patients with metastatic renal cell carcinoma. Eleven patients were complete
      responders (CR) and 12 were nonresponders (NR). In the CR group, 4/11 (40%) were
      diploid and 7/11 (60%) were aneuploid. In the NR group, 9/12 (75%) were diploid
      and 3/12 (25%) were aneuploid. Although there was a trend that patients with an
      aneuploid DNA pattern were more likely to undergo a complete response, ploidy
      pattern alone was not significantly predictive of response (p2 = 0.10, Fischer's
      exact test). When combining ploidy pattern with other variables that were
      predictive for complete response, such as good performance status and a higher
      pretreatment weight, prediction of complete response was not improved by
      including ploidy. This preliminary report suggests that DNA ploidy does not
      appear to provide any additional information concerning responsiveness to IL-2
      based immunotherapy beyond that obtained by performance status and pretreatment
      weight in this patient population.

PMID- 8341058
TI  - Changes in histopathological features of gastric carcinoma over a 26-year period
      (1965-1990).
AB  - Epidemiological study has shown that the incidence rate of gastric carcinoma in
      Japan has declined recently. To explore the factors that have influenced this
      decrease, the changing pattern in clinico-pathological features of gastric
      carcinoma was studied from the epidemiological point of view. The 5,015 cases of
      gastric carcinoma treated with gastrectomy at Aichi Cancer Center Hospital from
      1965-1990 were divided into two histopathological types: the well-differentiated
      and other types. Proportional distribution was compared over the three different
      periods (1965-1973, 1974-1982, 1983-1990) according to the clinico-pathological
      features of the gastric carcinoma, i.e., sex, age, lesional location, etc. The
      recent relative decline of gastric carcinoma is due mainly to the decline of
      carcinoma of the well-differentiated type. This decline has been highly
      correlated to the decline in carcinoma of the antrum, which has been the most
      common in Japan. This changing pattern of clinicopathological features of
      Japanese gastric carcinoma might be affected by the change of exposure patterns
      to epidemiological factors, i.e., a Westernizing diet.

PMID- 8341059
TI  - Total pelvic exenteration with preservation of fecal continence.
AB  - Total pelvic exenteration may be required in the management of locally advanced
      or recurrent pelvic malignancy. Although prolonged survival may be achieved, the
      morbidity of this procedure is substantial. Many of the complications associated
      with total pelvic exenteration are related to the perineal wound, the necessity
      for two cutaneous stomas, and the creation of a empty pelvis that often has been
      previously irradiated. In selected cases, perineal preservation with restoration
      of coloanal continuity may significantly reduce postoperative morbidity. We
      report four cases of recurrent pelvic malignancy treated by total pelvic
      exenteration with preservation of fecal continence.

PMID- 8341060
TI  - In memoriam Hiram Thomas Langston (1912-1992).

PMID- 8341061
TI  - Comparison of open versus thoracoscopic lung biopsy for diffuse infiltrative
      pulmonary disease.
AB  - BACKGROUND: Patients with diffuse pulmonary infiltrates often require biopsy for
      a diagnosis. Standard operative therapy, open wedge resection via thoracotomy, is
      associated with known morbidity. We hypothesized that closed thoracoscopic wedge
      resection may result in reduced morbidity and decreased duration of hospital
      stay. This retrospective study compares open resection with thoracoscopic wedge
      resection in patients with diffuse pulmonary infiltrates. METHODS: Seventy-five
      patients with diffuse pulmonary infiltrates underwent diagnostic lung biopsy.
      Patients requiring mechanical ventilation and high levels of pressure support
      before biopsy were excluded from the study. Between March 1987 and September
      1991, a total of 28 patients underwent open wedge resection via lateral
      thoracotomy. Since April 1991, a total of 47 patients underwent thoracoscopic
      resection. RESULTS: There was no difference between the groups in age, sex,
      presence of immunosuppression, or final pathologic diagnosis. Adequate tissue was
      obtained for pathologic diagnosis in all patients of both groups. All surgeons
      believed that thoracoscopic biopsy provided better visualization of the entire
      lung than did a limited thoracotomy. Mean operative time was 69 minutes for open
      biopsies and 93 minutes for thoracoscopic biopsies [p = 0.038]. Mean duration of
      chest tube drainage was not significantly different between the two groups.
      Duration of hospital stay was significantly less for thoracoscopic biopsy (4.9
      days) than for open biopsy (12.2 days) (p = 0.018). Fourteen of 28 open biopsies
      resulted in complications compared with 9 of 47 closed biopsies (p = 0.009).
      There were 6 deaths among patients having open biopsies and 3 deaths among those
      having closed biopsies (p = not significant). CONCLUSION: A significant decrease
      in hospital stay was noted with thoracoscopic biopsy when compared with lung
      biopsy via the standard open approaches. Thoracoscopy provided excellent
      visualization and allowed for wedge resection that provided adequate tissue for
      diagnosis in patients with diffuse pulmonary interstitial disease.

PMID- 8341062
TI  - Transhiatal versus transthoracic esophagectomy for esophageal cancer.
AB  - We retrospectively analyzed 238 patients with esophageal carcinoma treated
      between 1983 and 1991; 120 underwent transthoracic esophagectomy, and 118
      underwent transhiatal esophagectomy. The two groups were statistically similar in
      preoperative characteristics, except that upper esophageal cancer was more
      frequent in the transhiatal esophagectomy group than in the transthoracic
      esophagectomy group (p < 0.01). The rate of postoperative complications differed
      significantly in wound infection (21% in patients who underwent transthoracic
      esophagectomy, 10% in those who underwent transhiatal esophagectomy; p < 0.05)
      and empyema (11% with transthoracic esophagectomy, 1% with transhiatal
      esophagectomy; p < 0.01). Pneumothorax was detected in 24% of the transhiatal
      esophagectomy cases. Intraoperative blood loss was 1340 +/- 490 ml in the
      transthoracic esophagectomy group and 930 +/- 340 ml in the transhiatal
      esophagectomy group (p < 0.001). Hospital mortality was 11% in the transthoracic
      esophagectomy group and 6.7% in the transhiatal esophagectomy group. Late
      complication rate was lower with transhiatal esophagectomy than with
      transthoracic esophagectomy (11% and 51%, respectively). There was no significant
      difference in actuarial survival of patients in both groups. Transhiatal
      esophagectomy, which can be performed in almost all levels of the esophagus, is
      the safer of the two operations.

PMID- 8341063
TI  - Conduit reconstruction of the right ventricular outflow tract. Lessons learned in
      a twelve-year experience.
AB  - From September 1979 to July 1991, a total of 163 patients have undergone valved
      conduit reconstruction of the right ventricular outflow tract when a right
      ventricle-pulmonary artery connection was absent or right ventricular outflow
      tract enlargement was required. From September 1979 through October 1984, 24
      porcine valved conduits were implanted with an operative mortality of 38% (9/24).
      There were no early failures, but by 9 years after the operation 9 of 15
      survivors (60%) had severe conduit obstruction, which resulted in death in 2
      patients and reoperation in 6. From May 1985 to June 1991, 24 patients received
      cryopreserved aortic allografts to correct congenital anomalies. Operative
      mortality was 25% (6/24) and, again, early conduit function was good. There were
      4 (22%) late deaths that were not related to the aortic allograft. At a mean
      follow-up of 3.4 years, 11 of the 13 survivors (85%) had allograft calcification
      and 8 of the 13 (62%) had mild to moderate conduit stenosis or regurgitation, or
      both; two of them required conduit replacement. Distal anastomotic problems that
      might have been avoided with bifurcated pulmonary allografts were apparent in 4
      (36%) patients. Cryopreserved pulmonary allografts were placed in 115 patients
      between April 1985 and January 1991, with 18 (16%) operative deaths. Late deaths
      that were not allograft related occurred in 7 of 97 surviving patients (7%). Six
      patients (6%) underwent reoperation, 2 because of primary pulmonary allograft
      failure. The 84 remaining patients are free of symptoms with little or no
      allograft calcification or echocardiographic evidence of significant conduit
      stenosis or regurgitation. Experience with porcine valved conduits and aortic and
      pulmonary allografts suggests that pulmonary allografts are the conduit of choice
      for right ventricular outflow tract reconstruction.

PMID- 8341064
TI  - Primary unifocalization for the absence of intrapericardial pulmonary arteries in
      the neonate.
AB  - The management of the neonate with absence of intrapericardial pulmonary arteries
      in association with complex intracardiac anomalies presents a challenging
      surgical problem. The more traditional approach of palliation with unilateral or
      bilateral systemic-pulmonary artery shunts may result in peripheral pulmonary
      artery stenoses and uneven distribution of pulmonary blood flow. In addition,
      this approach may lead to complicated reconstructive procedures necessitating
      reconstruction of the branch pulmonary artery with prosthetic material, which
      restricts pulmonary artery growth and often complicates reoperation. To avoid
      these potential limitations, we have performed primary unifocalization for
      absence of intrapericardial pulmonary arteries in eight consecutive neonates
      (median age 9 days) between May 1990 and December 1991. Absence of
      intrapericardial pulmonary arteries occurred in association with tetralogy of
      Fallot (n = 4), truncus arteriosus (n = 2), and transposition of the great
      arteries with pulmonary atresia (n = 2). Four patients had unilateral absence of
      the right (n = 1) or left (n = 3) intrapericardial pulmonary artery. In the
      remaining four patients, there was complete absence of both intrapericardial
      pulmonary arteries. Wide mobilization and excision of all ductal tissue before
      anastomosis was performed from a midline approach in seven patients. In one
      patient, a preliminary right thoracotomy was required. Primary unifocalization
      was performed simultaneously with complete repair in five patients. In the
      remaining three patients, unifocalization was part of a staged repair and
      included insertion of a systemic-pulmonary artery shunt to the reconstructed
      central pulmonary artery confluence. No operative or late cardiac deaths
      occurred, although one death occurred during subsequent repair of a
      tracheoesophageal fistula. Three patients underwent reoperation, and only one
      patient required revision of an anastomotic pulmonary artery stenosis. All
      survivors were growing normally at 2 to 22 months after operation (mean follow-up
      10 months). Our experience suggests that primary reconstruction for the absence
      of intrapericardial pulmonary arteries can be successfully accomplished in the
      neonate. This approach provides uniform bilateral pulmonary blood flow, avoids
      prosthetic material in the branch pulmonary arteries, and may eliminate, or at
      least simplify, future reconstructive procedures.

PMID- 8341065
TI  - Biventricular repair of cardiac isomerism with common atrioventricular canal with
      the aid of an endocardial cushion prosthesis.
AB  - Between 1983 and 1990, six patients with atrial isomerism associated with common
      atrioventricular canal and double-outlet right ventricle were operated on with
      the aid of an endocardial cushion prosthesis. This prosthesis, which has been
      used for the repair of common atrioventricular canal since 1975, is composed of a
      vertical Dacron patch and "wings" constructed from the patient's own pericardium,
      which are attached to both sides of the patch to compensate for the defective
      atrioventricular valve tissue. The ventricular portion of the patch was extended
      anteriorly to construct the route for blood flow from the left ventricle to the
      aorta. Intraventricular repair was performed through the common atrioventricular
      orifice in all patients and also through an additional right ventriculotomy in
      one patient. The complex systemic and pulmonary venous return was separated by
      use of the atrial part of the endocardial cushion prosthesis together with
      additional prosthetic materials. All patients survived the operation and were
      followed up from 1 to 9 years. All of them are doing well, although one patient
      has a significant interventricular residual shunt. Repair of atrial isomerism
      with common atrioventricular canal and double-outlet right ventricle with an
      endocardial cushion prosthesis was performed with satisfactory immediate and
      intermediate-term postoperative results.

PMID- 8341066
TI  - Pulmonary atresia, intact ventricular septum, and Ebstein anomaly of the
      tricuspid valve. Anatomic and surgical considerations.
AB  - Pulmonary atresia with intact ventricular septum is a disorder that involves the
      whole right ventricle. An associated Ebstein deformity of the tricuspid valve is
      found in 10% of the cases, further complicating the anatomy and the function of
      the right ventricle. From January 1966 to December 1990, pulmonary atresia,
      intact ventricular septum, and Ebstein deformity of the tricuspid valve were
      observed in 11 cases in our institution; four of them were necropsy findings and
      the remaining seven were patients treated surgically. Of the latter, two were
      boys and five were girls (age range 1 day to 18 days). Two patients were managed
      by pulmonary valvotomy, three by systemic-pulmonary artery shunt, and two had a
      combination of the two. Operative mortality was 57%. Eight hearts were available
      for morphologic study. All had viscero-atrial situs solitus, D-loop ventricular
      structure, and normally related great arteries. A correlation between the degree
      of tricuspid valve dysplasia and right ventricular cavity size was observed in
      all. Furthermore, in five cases the anterior leaflet of the tricuspid valve
      obstructed the right ventricle at the ostium infundibuli level. In two of our
      surgical patients, a protruding anterior tricuspid valve leaflet was identified
      and excised and both patients survived. Ebstein anomaly of the tricuspid valve
      further complicates surgical management and outcome of pulmonary atresia and
      intact ventricular septum. Potential obstruction at the ostium infundibuli level
      should always be considered during repair. Various degrees of right ventricular
      inlet dysplasia, always present in this complex, may contraindicate an anatomic
      correction. In these cases a modified Fontan-type procedure should be considered
      as a valid surgical option.

PMID- 8341067
TI  - Lipid peroxidation and changes in vitamin E levels during coronary artery bypass
      grafting.
AB  - The effects of ischemia and reperfusion on arterial and coronary sinus vitamin E
      and thiobarbituric acid reactive substance levels were investigated in 10
      patients undergoing routine coronary artery bypass grafting. Serial sampling was
      performed during bypass operations, before the initial period of crossclamping
      and at 30 seconds and 2, 5, and 10 minutes after final crossclamp removal. A net
      myocardial loss of vitamin E occurred in the first 5 minutes of myocardial
      reperfusion (0.84 +/- 0.21 mumol/mmol cholesterol; p < 0.01). Myocardial vitamin
      E loss correlated positively with the total crossclamp time (rho = -0.695; p <
      0.05) but was independent of cardiac enzyme release and duration of
      cardiopulmonary bypass. The concentration of thiobarbituric acid reactive
      substance rose significantly in the systemic circulation (+14 nmol/gm albumin; F
      > 17; p < 0.002) at 2 and 5 minutes after crossclamp removal. A significant
      increase of thiobarbituric acid reactive substance levels was also found in the
      coronary sinus blood 10 minutes after crossclamp removal (+8 nmol/gm albumin; F >
      14; p < 0.004). However, there was no net arterial-coronary sinus difference in
      thiobarbituric acid reactive substance levels. The change in arterial
      thiobarbituric acid reactive substance levels in each patient was inversely
      correlated with their control vitamin E level (F = 9.53; p < 0.01). Our findings
      suggest that systemic lipid peroxidation occurs during bypass and that vitamin E
      may play a protective role during routine bypass grafting by attenuating the
      degree of peroxidative damage.

PMID- 8341068
TI  - Transcaval liver resection with hepatoatrial anastomosis for treatment of
      patients with the Budd-Chiari syndrome. Late results.
AB  - Between 1980 and 1990 transcaval liver resection with hepatoatrial anastomosis
      was performed in 17 patients with the Budd-Chiari syndrome. There were two early
      deaths (early mortality 11.7%). Hepatic function returned to normal and
      hepatosplenomegaly disappeared in all but two patients with preexisting
      cirrhosis. All survivors regained normal working capacity after the operation.
      During an average follow-up of 6 years (7 months to 11 years) there were three
      late deaths due to progression of the underlying disease. The actuarial 1-, 5-,
      and 10-year survivals were 82%, 76%, and 57%, respectively. Hepatoatrial
      anastomosis represents an optimal treatment for patients with the Budd-Chiari
      syndrome and obstruction of major hepatic veins. Patients with compression of the
      inferior vena cava, very common in this disease, were treated by simultaneous
      transcaval stenting. The late results are very satisfactory, with excellent
      quality of life. With adequate hepatic function, results of hepatoatrial
      anastomosis are superior to those of liver transplantation, which represents the
      only alternative for patients with the advanced form of the Budd-Chiari syndrome.

PMID- 8341069
TI  - Experience with four surgical techniques to repair traumatic aortic
      pseudoaneurysm.
AB  - We report our experience with 27 (22 male and 5 female) patients who were from 16
      to 82 years of age (median 29 years) who underwent surgical repair for traumatic
      pseudoaneurysm of the thoracic aorta. The cause of injury in all cases was blunt
      trauma. Repair was accomplished with partial bypass by means of a roller pump
      with systemic heparinization in 6 (23%), Gott shunt in 7 (27%), clamp-and-sew
      technique in 6 (23%), and centrifugal pump without systemic heparinization in 8
      (30%). Significant postoperative complications occurred in 12 patients.
      Paraplegia occurred in 1 patient (clamp and sew), anterior spinal cord syndrome
      in 1 (clamp and sew), renal failure in 1 (Gott shunt), temporary vocal cord
      paralysis in 2 (Gott shunt, centrifugal pump), permanent vocal cord paralysis in
      1 (roller pump), and coagulopathy in 2 (centrifugal pump, Gott shunt). Hospital
      mortality occurred in 5 of 27 (19%), (1 clamp and sew, 1 Gott shunt, 1
      centrifugal pump, 2 roller pump). Follow-up of survivors (1 week to 20 years,
      median 2.1 years) revealed no further problems from either aortic graft or
      primary repair. Although patient numbers are small, evaluation of each of the
      four surgical techniques leads us to favor repair with shunting with a
      centrifugal pump without heparin. The potential advantage of left atrial-left
      femoral artery shunt with centrifugal pump support was evident in operative field
      exposure, afterload reduction, avoidance of clamp injury, and maintenance of
      stable distal aortic perfusion without heparin.

PMID- 8341070
TI  - Is zero-pressure fixation of bioprosthetic valves truly stress free?
AB  - Zero-pressure fixation has often been referred to as stress-free fixation, which
      implies that no leaflet stresses exist during the fixation process. The two
      aortic valve cusp layers, the fibrosa and the ventricularis, however, are
      believed to produce mutually opposing forces within the valve cusps. Residual
      stresses may therefore exist even during zero-pressure fixation. We first
      verified the presence of such internal stresses by separating the layers of pig
      aortic valve leaflets and measuring dimensional changes. In the 11 specimens
      examined, the fibrosa expanded radially by 30% +/- 13% (mean +/- standard
      deviation), whereas the ventricularis contracted by 12% +/- 4%. The ventricularis
      also contracted circumferentially by 13% +/- 3%. We measured the extensibility of
      120 fresh and glutaraldehyde-fixed fibrosa and ventricularis components to
      investigate the mechanical effects of glutaraldehyde fixation under such internal
      stresses. We also tested the layers from leaflets that were fixed whole. We
      compared the extensibility of the fibrosa and the ventricularis, each fixed in
      the presence and absence of residual stresses, and found that, in the radial
      directions, the ventricularis from valve cusps that were fixed whole was less
      extensible than fresh ventricularis (35.4% versus 63.7% strain to high-modulus
      phase, p < 0.00001). The fibrosa from cusps that were fixed whole, however, was
      more extensible than fresh fibrosa (39.2% versus 29.5% strain, p < 0.0122
      radially; 12.8% versus 8.2% strain, p < 0.0001 circumferentially). The
      ventricularis became less extensible because it was fixed under tension, and the
      fibrosa became more extensible because it was fixed under compression. This study
      therefore demonstrates the presence of residual tensile and compressive stresses
      in the ventricularis and fibrosa, even when the leaflets are relaxed. Zero
      pressure fixation cannot therefore be considered truly stress free, in the
      engineering sense, because residual internal stresses affect collagen fiber crimp
      and change the extensibility of the fibrosa and the ventricularis.

PMID- 8341071
TI  - Comparative outcome of heart-lung and lung transplantation for pulmonary
      hypertension.
AB  - Despite the development of several lung transplantation procedures, the most
      advantageous for pulmonary hypertension remains controversial. Between 1986 and
      February 1992, 30 patients with end-stage primary pulmonary hypertension (n =
      24), chronic pulmonary embolism (n = 4), and hystiocytosis X (n = 2) underwent
      heart-lung (n = 21), double lung (n = 8), or single lung (n = 1) transplantation.
      Indications for double lung transplantation were similar to those for heart-lung
      transplantation, and the preoperative clinical and hemodynamic parameters were
      not significantly different between the two groups. There were no intraoperative
      deaths, but two reoperations were needed for pleural hematoma. Five early deaths
      were related to graft failure (two heart-lung transplantations), mediastinitis
      (one heart-lung transplantation), multiorgan failure (one double lung
      transplantation), and aspergillosis (one double lung transplantation). There was
      a similar improvement in early (days 0 and 2) and late (6 months postoperatively)
      right-sided hemodynamic function in patients undergoing heart-lung and double
      lung transplantation. Three double lung transplant recipients had early and
      reversible left ventricular-failure. The early postoperative course of the one
      patient who had single lung transplantation was characterized by severe pulmonary
      edema, left ventricular failure, and persistent desaturation and later on by
      moderate pulmonary hypertension and an important ventilation/perfusion mismatch.
      The pulmonary function results were also similar in the heart-lung and double
      lung transplantation groups. The overall projected 2- and 4-year survivals were
      49% and 41%, respectively, and were not significantly different between the heart
      lung and double lung recipients. Results demonstrate that heart-lung and double
      lung transplantation are equally effective in obtaining early and durable right
      sided hemodynamic and respiratory improvement and similar respiratory function.
      In patients with pulmonary hypertension, double lung transplantation should be
      preferred to single lung transplantation because of the critical postoperative
      course and the uncertain long-term results of single lung transplantation.

PMID- 8341072
TI  - A technique for perfusion of an isolated working heart to investigate hyperacute
      discordant xenograft rejection.
AB  - We developed an isolated working heart preparation to investigate hyperacute
      rejection of discordant xenografts. It is possible to correlate organ failure
      with the rejection process, and end points of rejection are easily identified.
      This unique model permits easy sampling of perfusates and examination of the
      rejected organ. The perfusate may be modified in ways not possible in in vivo
      preparations. Investigation of the discordant rabbit-to-pig combination with the
      technique has confirmed that hyperacute xenograft rejection can be reproduced.
      Rejection appears to be a complement-mediated immunologic phenomenon rather than
      the consequence of a nonspecific physical incompatibility. Hyperacute xenograft
      rejection can be prevented by depletion of C3 from the perfusing blood by
      treatment with cobra venom factor.

PMID- 8341073
TI  - Venovenous compares favorably with venoarterial access for extracorporeal
      membrane oxygenation in neonatal respiratory failure.
AB  - Traditional extracorporeal membrane oxygenation via the venoarterial route
      requires cannulation and ligation of the internal jugular vein and common carotid
      artery. Concerns about ligation of the common carotid artery prompted development
      of a 14F double-lumen internal jugular vein cannula for venovenous oxygenation
      for neonates with respiratory failure. We retrospectively compared 22 patients
      supported by venovenous bypass and 20 patients supported with traditional
      venoarterial bypass. The two groups of patients were selected to be comparable in
      terms of diagnosis and severity of respiratory insufficiency. The diagnoses in
      both groups were limited to meconium aspiration syndrome or persistent pulmonary
      hypertension of the newborn. The average oxygenation indexes in the two groups
      were similar (46.6 venovenous, 47.2 venoarterial, p = not significant).
      Venovenous access allowed flow rates of more than 100 ml/kg per minute, which
      were adequate for gas exchange support. One patient required conversion from
      venovenous to venoarterial bypass because of hemodynamic instability. The average
      time of bypass support was 115 hours (range 24 to 338 hours) for venovenous
      bypass and 134 hours (range 47 to 361 hours) for venoarterial bypass (p < 0.05).
      The time to extubation after decannulation from extracorporeal membrane
      oxygenation was 133 hours (range 38 to 720 hours) for venovenous support and 100
      hours (range 27 to 192 hours) for venoarterial support (p = not significant). One
      patient supported with venoarterial bypass had an intracranial hemorrhage. There
      were no documented neurologic injuries in the patients managed with venovenous
      bypass. There were no deaths in either group. Venovenous extracorporeal membrane
      oxygenation through a double-lumen cannula can adequately provide respiratory
      support for neonates with pulmonary failure and effectively avoids ligation of
      the common carotid artery.

PMID- 8341074
TI  - Changes in pericardial morphology and fibrinolytic activity during
      cardiopulmonary bypass.
AB  - The presence of pericardial adhesions at resternotomy not only increases the
      operation time but also increases the risk of serious damage to the heart, great
      vessels, and extracardiac grafts. The reported prevalence of damage is 2% to 6%.
      The fibrinolytic activity of pericardial tissue may be a crucial factor in
      determining the extent of adhesion formation following primary operation. Ten
      patients undergoing cardiac operations were studied to assess the plasminogen
      activating activity of homogenates of pericardial tissue samples. Samples were
      taken at three times during the operation and the plasminogen activating activity
      was measured by means of a standard fibrin plate technique. Tissue-type
      plasminogen activator, urokinase-type plasminogen activator, plasminogen
      activator inhibitor-1, and plasminogen activator inhibitor-2 were also measured
      by means of enzyme-linked immunosorbent assays. Compared with its initial levels
      (median 2.06 IU/cm2, range 1.28 to 6.48 IU/cm2), the plasminogen activating
      activity of pericardial biopsy tissue was significantly reduced at 75 minutes
      (median 0.64 IU/cm2, range 0.12 to 2.44 IU/cm2, p < 0.01) and at 135 minutes
      (median 1.45 IU/cm2, range 0.12 to 4.39 IU/cm2, p < 0.05). The major plasminogen
      activator present was tissue-type plasminogen activator. Compared with its
      initial levels (median 2.34 ng/ml, range 1.03 to 6.42 ng/ml), subsequent tissue
      type plasminogen activator values were also significantly reduced at 75 minutes
      (median 0.83 ng/ml, range 0.75 to 5.13 ng/ml, p < 0.005) and at 135 minutes
      (median 1.24 ng/ml, range 0.75 to 6.67 ng/ml, p < 0.05). Low levels of urokinase
      type plasminogen activator were found in 5 of 10 patients. However, neither
      plasminogen activator inhibitor-1 nor plasminogen activator inhibitor-2 was
      detected. Examination with a light microscope showed both increasing pericardial
      mesothelial damage and increasing features of acute inflammatory changes with
      time. This study shows that plasminogen activating activity is present in
      pericardial tissue and that tissue-type plasminogen activator is the major
      plasminogen activator. The observed inflammatory changes and concomitant damage
      to the pericardial mesothelium, and the significant reductions in pericardial
      tissue-type plasminogen activator and plasminogen activating activity seen during
      cardiac operations, may be important factors contributing to the early
      development of pericardial adhesions.

PMID- 8341075
TI  - Effects of crossclamping the descending aorta on the high-energy phosphates of
      myocardium and skeletal muscle. A phosphorus 31-nuclear magnetic resonance study.
AB  - The study was designed to test the hypothesis that a moderate decrease in upper
      body oxygen consumption observed during crossclamping of the thoracic aorta
      represents tissue hypoxia (possibly as a result of microcirculatory disorders)
      and results in adenosine triphosphate homeostasis disturbances. We averaged
      phosphorus 31-nuclear magnetic resonance spectroscopy measurements for 10 minutes
      with the use of a surface coil on the left ventricle and on the deltoid muscle
      during a 1-hour period before aortic crossclamping, during aortic crossclamping,
      and after aortic unclamping. Skeletal muscle creatine phosphate levels decreased
      3.1% (p < 0.01), whereas the ratio of creatine phosphate to adenosine
      triphosphate decreased 2.2% (p < 0.05); glycolytic intermediates increased 70% (p
      < 0.01) and intracellular inorganic phosphate decreased 9% (p < 0.01). Myocardial
      creatine phosphate decreased 15% (p < 0.01), whereas the ratio of creatine
      phosphate to adenosine triphosphate decreased 5.3% (p < 0.01); glycolytic
      intermediates did not change, but intracellular inorganic phosphate almost
      doubled (p < 0.05). These data suggest that observations of reduced upper body
      oxygen consumption after aortic crossclamping are consistent with the effects of
      skeletal muscle hypoxia. Changes in myocardial metabolites may result from
      transient ischemia caused by the increased wall stress.

PMID- 8341076
TI  - Detrimental effects of interrupting warm blood cardioplegia during coronary
      revascularization.
AB  - Warm blood cardioplegia has emerged as a substitute for cold blood cardioplegia
      as a method of myocardial protection. However, the continuous infusion of blood
      in this technique may obscure the operative field and necessitate interruption of
      warm blood cardioplegia. This experimental study was therefore undertaken to
      determine whether interrupting warm blood cardioplegia during coronary
      revascularization would increase myocardial damage. In 30 adult pigs, the second
      and third diagonal vessels were occluded with snares for 90 minutes. All animals
      underwent cardiopulmonary bypass and 45 minutes of cardioplegic arrest. During
      the period of cardioplegic arrest, 10 pigs received intermittent
      antegrade/retrograde infusion of cold blood cardioplegic solution (4 degrees C)
      10 pigs received continuous retrograde infusion of warm blood cardioplegic
      solution (37 degrees C) at 100 ml/min, and 10 pigs received retrograde infusion
      of warm blood cardioplegic solution that was interrupted for three 7-minute
      periods. After aortic unclamping, the coronary snares were released and all
      hearts were reperfused for 180 minutes. Interrupting retrograde warm blood
      cardioplegia resulted in more tissue acidosis during cardioplegic arrest (6.20 +/
      0.16 interrupted retrograde warm blood cardioplegia and 6.45 +/- 0.12 continuous
      retrograde warm blood cardioplegia, both p < 0.05 compared with 6.98 +/- 0.17
      intermittent antegrade and retrograde cold blood cardioplegia), decreased
      echocardiographic wall-motion scores (4 [normal] to -1 [dyskinesis]; 2.06 +/-
      0.30 interrupted retrograde warm blood cardioplegia, p < 0.05 compared with 3.30
      +/- 0.40 intermittent antegrade and retrograde cold blood cardioplegia, 2.80 +/-
      0.40 continuous retrograde warm blood cardioplegia), and increased tissue
      necrosis as measured by the area of necrosis/area at risk (38% +/- 5% interrupted
      retrograde warm blood cardioplegia, p < 0.05 compared with 21% +/- 2%
      intermittent antegrade and retrograde cold blood cardioplegia; 25% +/- 2%
      continuous retrograde warm blood cardioplegia). We concluded that interrupting
      warm blood cardioplegia during coronary revascularization diminishes the
      effectiveness of warm blood cardioplegia and results in increased ischemic
      damage.

PMID- 8341077
TI  - Relation of pH strategy and developmental outcome after hypothermic circulatory
      arrest.
AB  - To examine whether pH management during core cooling is a risk factor for adverse
      developmental outcome, we studied 16 children with transposition of the great
      arteries and intact ventricular septum who underwent a Senning procedure in
      infancy (median age 32 days, range 2 to 154 days) between 1983 and 1988.
      Information was collected retrospectively on many aspects of perfusion, including
      lowest carbon dioxide tension during core cooling, duration of core cooling, and
      duration of circulatory arrest. The pH strategy changed from pH-stat to alpha
      stat in 1985, resulting in a wide range of pH values and carbon dioxide tension
      (34 to 76 mm Hg) during the study period. All children had rapid core cooling to
      a rectal temperature of 19.8 degrees +/- 2.7 degrees C (mean +/- standard
      deviation) and a tympanic temperature of 16.6 degrees +/- 3.0 degrees C.
      Development was assessed at median age 48.0 (11 to 79) months with the Bayley
      Scales (n = 4, children younger than 30 months) or the McCarthy Scales (n = 12,
      children older than 30 months). The mean core-cooling duration was 14.5 +/- 6.2
      minutes, circulatory arrest time was 43.4 +/- 6.6 minutes, and total bypass plus
      circulatory arrest time was 89.7 +/- 12.7 minutes. Lower carbon dioxide tension
      (alpha-stat) before onset of circulatory arrest was associated with worse
      developmental outcome (r = 0.71, p = 0.002). This relationship remained highly
      significant when we controlled for sociodemographic and intraoperative variables.
      including core-cooling time, circulatory arrest time, and total elapsed time.
      Duration of circulatory arrest was not associated with developmental outcome. We
      conclude that when relatively rapid core cooling is used to achieve hypothermia
      before circulatory arrest in young infants, a more alkaline pH strategy such as
      alpha-stat may result in less effective cerebral protection.

PMID- 8341078
TI  - Inhaled nitric oxide in pulmonary hypertension after total repair of total
      anomalous pulmonary venous return.

PMID- 8341079
TI  - Retrograde cardioplegia and aortic valve replacement.

PMID- 8341080
TI  - Warm retrograde cardioplegia: protection of the right ventricle in mitral valve
      operations.

PMID- 8341081
TI  - Aortic valve rupture in closed trauma: the extent of the damage.

PMID- 8341082
TI  - Atresia of left atrioventricular valve and intact atrial septum with multiple
      congenital defects corrected by total cavopulmonary connection.

PMID- 8341083
TI  - Is two-dimensional echocardiography reliable in identifying cardiac injury?

PMID- 8341084
TI  - Controlled limb reperfusion as a new surgical technique to reduce postischemic
      syndrome.

PMID- 8341085
TI  - Simulated left ventricular aneurysm and aneurysm repair in swine.

PMID- 8341086
TI  - Inflammatory response of the lung to tungsten particles: an experimental study in
      mice submitted to intratracheal instillation of a calcium tungstate powder.
AB  - Tungsten has been implicated as a cause of a severe form of pneumoconiosis in
      humans, the so-called "hard metal" lung disease. We have investigated the effect
      of intratracheal instillation of a powder of calcium tungstate on the pulmonary
      tissue of CD-1 mice. The tungsten-induced alterations were studied using 3
      microanatomical methods: cytologic study of exudates obtained by bronchoalveolar
      lavage (BAL); histologic examination of paraffin-embedded sections of the lung;
      and scanning electron microscopic (SEM) examination of lung samples using x-ray
      microanalysis to detect tungsten in situ. The animals were sacrificed 1, 3, 7, 14
      and 21 days after a single intratracheal instillation of 250 micrograms calcium
      tungstate particles suspended in 100 microliters of saline. We found that the
      metal particles induced a marked inflammatory response in the bronchoalveolar
      space characterized by a biphasic attraction of leukocytes with cellular peaks
      observed at day 1 and 14. More than 50% of the BAL macrophages showed ingested
      tungsten. In the lung parenchyma, the inflammatory infiltrates were predominantly
      located at the periphery of the bronchiolar walls. From 7 days on after the
      tungsten deposition, large inflammatory exudates were seen invading focal areas
      of the alveolar domain of the lung. SEM views revealed that the tungsten
      particles could be inside alveolar macrophages, in cells making up the alveolar
      wall, or inside periacinar lymphatics. Our data document that tungsten particles
      cause a marked inflammatory response in the lung tissue and that the leukocyte
      exudates may invade alveolar areas of the lung.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341087
TI  - Aging, respiratory efforts during sleep, and pulsus paradoxus.
AB  - Forty patients with either obstructive sleep apnea syndrome or a clinical
      complaint of daytime sleepiness with measured nocturnal increase in upper airway
      resistance and snoring were investigated during sleep for the presence of pulsus
      paradoxus, which is defined as a decrease in systolic blood pressure (SBP) of at
      least 10 mmHg during inspiration. Two thirds of the subjects presented pulsus
      paradoxus. Age, lowest oxygen saturation (SaO2), and negative inspiratory
      esophageal pressure nadir (an index of inspiratory effort) were the only studied
      variables which could statistically dissociate patients presenting pulsus
      paradoxus. We then divided the patient population into three different subgroups
      of equal number based upon the degree of decrease in SBP (i.e., > 20 mmHg, < 20
      but > 10 mmHg, and < 10 mmHg). In this second analysis, age was the only
      significant variable that separated the three groups. Lowest SaO2 could not be
      used to statistically separate subjects with mild to moderate pulsus paradoxus
      from those without it; and negative inspiratory esophageal pressure measurements
      could only significantly identify subjects with severe pulsus paradoxus (i.e., >
      20 mmHg) from those without any pulsus paradoxus. The variable which correlated
      best with age was negative inspiratory esophageal pressure nadir (R = 0.83). Our
      interpretation is that as age increased, negative inspiratory esophageal pressure
      became less negative, due to the known impact of aging on muscles, and pulsus
      paradoxus was no longer observed.

PMID- 8341088
TI  - Airflow obstruction in nonsmoking, asbestos- and mixed dust-exposed workers.
AB  - Obstructive changes in small airways have been described in patients exposed to
      asbestos and other mineral dusts. The physiologic significance of these small
      airways abnormalities and their relationship to dust burden and alveolitis remain
      unclear. We performed bronchoalveolar lavage (BAL) in 30 nonsmoking and 30 age
      matched smoking subjects, all with mild asbestos and mixed dust exposure, to
      determine if parameters of lung dust burden correlated with spirometric evidence
      of airflow obstruction. Seventeen of 30 nonsmoking subjects and 24 of 30 smoking
      subjects met spirometric criteria for airflow obstruction. There were
      significantly more obstructed subjects in both dust exposed groups (P < 0.05)
      than in an age-matched nondust exposed group. There was, however, no significant
      difference in the number of obstructed subjects between the smoking and
      nonsmoking groups. There was no correlation in either group between airflow
      obstruction and total or differential cell counts, ferruginous bodies, total
      asbestos fibers, or the percent of free silica in the particulate fraction
      recovered by BAL. We conclude that evidence of small airways obstruction occurs
      commonly in occupationally dust exposed subjects and appears to be related to
      dust exposure per se and not to alveolar inflammation or fiber retention,
      important factors in the development of alveolitis and interstitial lung disease.

PMID- 8341090
TI  - A pulmonary rehabilitation program for patients with asthma and mild chronic
      obstructive pulmonary diseases (COPD).
AB  - The effects of a pulmonary rehabilitation program on 44 patients with chronic
      obstructive pulmonary disease (COPD) were compared to a control group. The
      treated group was admitted to the program for a period of three months. The
      program consisted of several parts, such as physical training, health education,
      and psychological and social matters. Before participation, the patients were
      thoroughly examined and provided with optimal medical treatment. Both groups were
      assessed by means of biometrical tests and questionnaires for a period of 2
      years. The rehabilitation group improved significantly in endurance,
      psychological parameters, and consumption of medical care. Working days increased
      and their way of life became more active. Smoking habits and body fat percentage
      decreased. Bronchial hyperreactivity, need for pulmonary drugs, and coughing and
      sputum production did not improve in the rehabilitation group compared to the
      control group. Airway obstruction, expressed as forced expiratory volume in one
      second, and complaints of dyspnea, allergy and hyperreactivity scores on
      questionnaires improved only in the short term (< 1 year), but did not improve
      significantly in the long term. This study shows that pulmonary rehabilitation
      can result in improvements in patients with asthma or COPD who have many
      complaints despite the fact that their pulmonary function is not severely
      disturbed.

PMID- 8341089
TI  - Studies of phagocytic and killing activities of alveolar macrophages in patients
      with sarcoidosis.
AB  - Phagocytosis and killing activities of alveolar macrophages were compared in 17
      patients with stage 1 sarcoidosis and 6 healthy controls. The average total cell
      count of bronchoalveolar lavage fluid from patients with sarcoidosis was 7.8 +/-
      7.5 x 10(6) cells; 70.4 +/- 15% of these cells were alveolar macrophages and 25.9
      +/- 16.2% lymphocytes. Average total cell count from controls was 8.33 +/- 8.6 x
      10(6) cells, with 92.7 +/- 5.9% alveolar macrophages and 6.6 +/- 4.4%
      lymphocytes. Purified alveolar macrophages were tested in in vitro antibacterial
      assays using S. aureus as a test microbe. Moderate decreases in the kinetics of
      staphylococcal ingestion were detected in the sarcoidosis group. The
      intracellular killing activity of macrophages was much lower in the patients with
      sarcoid than in control subjects. In a pilot study, intracellular killing
      activity of macrophages from 1 patient with sarcoidosis was greatly enhanced by
      24 hr treatment with transfer factor. In summary, alveolar macrophages from
      patients with radiographic stage 1 sarcoidosis have decreased bacterial ingestion
      and intracellular killing activities. These results suggest that macrophages
      undergo complex functional changes in sarcoidosis that may influence both disease
      development and host defenses.

PMID- 8341091
TI  - Breastfeeders versus bottlefeeders: differences in femininity perceptions.
AB  - Fifty-eight primiparous women were studied to explore perceived differences in
      femininity between women who chose to breastfeed and women who chose to
      bottlefeed. A demographic questionnaire and a sex role inventory were
      administered to the sample. Although breast and bottlefeeders did not differ
      significantly in their perceived levels of femininity, analysis of the data
      revealed that women who had no clear cut sense of identity were more likely to
      bottlefeed.

PMID- 8341092
TI  - Coping behaviors of children hospitalized for cardiac surgery: a secondary
      analysis.
AB  - While the coping behaviors of hospitalized children continue to be an area of
      interest for researchers, systematic documentation in the literature concerning
      children's coping remains limited. In this descriptive secondary analysis, 23
      master's thesis case studies were analyzed to determine how researchers described
      the range of coping behaviors that children used while hospitalized for cardiac
      surgery. The analysis sought to determine patterns of coping in both preschool
      and school-age children. A second aim was to validate further and refine the
      dimensions and items of the Children's Coping Behaviors Category System developed
      by Ritchie, Caty, and Ellerton in 1987. Results revealed that a broad range of
      names and labels of behavior was used to describe children's coping. The
      predominant patterns of behavior that emerged were direct action and information
      seeking. Differences between preschool and school-age children's reported
      behaviors were evident. The coping category system was validated further and
      refinements are suggested.

PMID- 8341093
TI  - Pain in the infant: theoretical and conceptual issues.
AB  - Existing theories of pain are individually inadequate to explain pain in infants.
      There is limited understanding of how the physiological response to pain
      (nociception) relates to the cognitive and behavioral response of infants. Little
      knowledge exists on how the context in which pain is experienced affects
      physiological and behavioral responses. Lack of a clear conceptualization of pain
      in infants has implications for nursing practice and research, most notably in
      the area of pain assessment and management. Several theories must be considered
      to address the complexity and multidimensionality of pain in infants.

PMID- 8341094
TI  - Clinical comparisons of posturography and electronystagmography.
AB  - A retrospective study was conducted of 103 balance-disturbed patients of mixed
      etiologies tested with electronystagmography (ENG) and computerized dynamic
      posturography (CDP). CDP was abnormal for 83% of the group as compared to 42%
      abnormal ENG results. In cases of otolithic dysfunction, ENG was more sensitive
      and gave specific information. Results of this preliminary study indicate that
      CDP has merit when used in the evaluation of patients with undifferentiated
      balance complaints. ENG testing is still needed in cases of vestibular
      dysfunction to establish anatomic level and laterality as well as for lesions
      involving the otolith. Additional study will be needed to verify these findings
      and to develop a means of detecting otolith dysfunction with CDP.

PMID- 8341095
TI  - Evidence of IgE-mediated hypersensitivity in allergic fungal sinusitis.
AB  - Despite documentation of specific immunologic hypersensitivity in a few case
      reports, controversy continues as to the role of allergy versus true infection in
      the clinical entity of allergic fungal sinusitis (AFS). Using a modified
      radioallergosorbent test (RAST) to multiple fungal antigens, 16 patients meeting
      the histologic criteria of AFS and with positive fungal cultures were compared to
      5 control patients with similar preoperative clinical findings but without
      histologic or culture evidence of AFS. All patients were immunocompetent and none
      demonstrated histologic evidence of tissue invasion. All AFS patients were RAST
      positive to at least one fungal antigen in the family of their cultured organism
      with positive defined as class 2 or greater. No control patient was RAST-positive
      to either dematiaceous or Aspergillus fungal antigens. Thus, modified RAST
      testing can aid in the routine clinical diagnosis of AFS, and it provides further
      serologic evidence for a type I hypersensitivity in the pathogenesis of AFS.

PMID- 8341096
TI  - Magnetic resonance imaging of perilymphatic fistula.
AB  - Perilymphatic fistula (PLF) is considered to be a most challenging otologic
      issue. There are no currently agreed upon objective tests for the diagnosis of
      PLF. In an effort to improve diagnostic accuracy in patients with suspected PLF,
      a novel diagnostic test involving magnetic resonance (MR) contrast imaging was
      designed. An experimental PLF was created in the cochlear round window membrane
      of healthy adult cats. Since cochlear perilymph is thought to be an ultrafiltrate
      of cerebral spinal fluid, gadodiamide (gadolinium-diethylenetriamine penta-acetic
      acid [DTPA] bismethylamide), a nonionic paramagnetic contrast agent, was injected
      intrathecally in an attempt to enhance imaging of the created fistula. Post
      contrast images of the fistualized cochlea demonstrate a significant increase in
      the signal intensity of the cochlear perilymph with pooling of enhanced perilymph
      observed in the ipsilateral mastoid bulla. Magnetic resonance contrast imaging
      may prove to be a valuable technique in human studies involving perilymphatic
      fistula.

PMID- 8341097
TI  - Electronic control of laryngeal spasm. II. Selective blockage of glottic
      adduction by a closed-loop circuit in the canine.
AB  - This work is the continuation of an earlier pilot study in which specially
      designed electrodes were used to block their own induced action potentials to
      restrain spasticity. In the current series of experiments, strap muscle and
      thyroarytenoid contraction (glottic closure) elicited by supramaximal ansa
      hypoglossi (N = 6) and recurrent laryngeal nerve (N = 4) stimulation (30 to 50
      Hz, 0.1 to 6 mA, 0.1 to 1 msec), respectively, allowed afferent information via
      intramuscular sonomicrometer crystals to trigger a circuit that, in turn,
      stimulated blocking electrodes passed around the nerves downstream. Simultaneous
      videorecording of strap and vocal cord motion during direct laryngoscopy with
      their corresponding excursion tracings demonstrated near-total suppression of
      contractions within given stimulation "windows." These encouraging results may
      eventually permit selective restraint of erratic contractions involving laryngeal
      and other cervical musculatures in the human.

PMID- 8341098
TI  - Surgical pitfalls in cochlear implantation.
AB  - Increasing experience with cochlear implantation has led to the identification of
      potential surgical pitfalls: improper patient selection, poor flap design and
      handling, facial nerve injury, improper electrode placement, and improper seating
      of the receiver stimulator. Each of these areas of potential difficulty are
      reviewed, emphasizing methods of avoidance and management of adverse outcome.

PMID- 8341099
TI  - Irritative spontaneous nystagmus following intratympanic gentamicin for Meniere's
      disease.
AB  - Intratympanic aminoglycosides were first used to treat unilateral intractable
      Meniere's disease over 30 years ago. Gentamicin, the current drug of choice,
      provides excellent vertigo control with a low incidence of hearing loss. Its
      salutory effect results from direct damage to both the sensory neuroepithelium
      and the dark cells of the labyrinth. This latter effect may reverse the degree of
      endolymphatic hydrops. Twelve patients with unilateral Meniere's disease were
      treated and prospectively studied. Although further follow-up is necessary, 10
      patients have complete vertigo control, while 2 remain significantly improved.
      Three patients developed a spontaneous "irritative" nystagmus during the early
      post-treatment period. This new unique finding may represent a recovery
      phenomenon resulting from a temporary reversible ototoxic effect in the treatment
      ear. Despite our patients having a somewhat higher incidence of hearing loss
      compared to the reported rate, the results of this treatment are encouraging.

PMID- 8341100
TI  - Otolaryngology manpower in the year 2010.
AB  - The number of otolaryngologists practicing in the future is particularly
      pertinent in light of the changes taking place in American medicine today. A
      mathematical model is presented which projects the growth of otolaryngology
      manpower in the year 2010, taking into consideration the age distribution of
      practicing otolaryngologists, death rates, and the current production of
      residents. This model suggests that there will be a 21% increase in the number of
      otolaryngologists from 1990 to 2010. The main reason for the increase is the
      uneven distribution of otolaryngologists by age at the present time, with 49% of
      otolaryngologists being less than 45 years of age. There is concern that the
      American medical community is populated with too many specialists and that more
      emphasis should be placed on training generalists. The manpower issue should be
      studied in more detail, and future societal needs should be determined so that a
      rational policy on the growth of otolaryngology can be developed.

PMID- 8341101
TI  - Neurologic paraneoplastic syndromes with neurotologic manifestations.
AB  - Evidence supports the hypothesis that autoimmune mechanisms are operational in
      the etiopathogenesis of certain neurologic paraneoplastic syndromes (PNSs),
      including paraneoplastic encephalomyelitis (PEM) and paraneoplastic cerebellar
      degeneration (PCD). The antibodies (Anti-Hu and Anti-Yo), the antigens (Hu and
      Yo), and complementary DNA clones encoding Hu and Yo, central to PEM and PCD,
      respectively, have been isolated. In contrast, the antigens, and antibodies if
      any, involved in autoimmune cochleovestibular dysfunction remain unknown. The
      temporal bone histopathology and neuropathology of 2 patients, 1 with PEM and 1
      with PCD, who developed signs and symptoms of cochleovestibular dysfunction, are
      reviewed and contrasted to the literature. It is concluded that both auditory and
      vestibular symptomatology and pathologic alterations can be seen in association
      with neurologic PNSs and that studies using the antigens and antibodies involved
      in neurologic PNSs may provide a new perspective on the investigation of
      autoimmune cochleovestibular dysfunction.

PMID- 8341102
TI  - Morphometric analysis of the vestibular complex in the rat.
AB  - The characteristics of the four major vestibular nuclei and accessory cell groups
      in the rat have been studied in serially cut horizontal sections. Camera lucida
      drawings of the vestibular nuclei and their neurons were made in these sections
      and subjected to a computerized image analysis. The dimensions (volume and
      length) and the number of cells of each vestibular nucleus were obtained, as well
      as morphometric parameters of their neurons (cross-sectional area, maximum and
      minimum diameter, and shape). These parameters were statistically analyzed by
      comparing the cell population from different nuclei and different parts of each
      nucleus. Of the major nuclei, the medial, which is the largest, has the greatest
      number of cells, its neurons being the smallest of all the nuclei, with the size
      of cells decreasing in a rostrocaudal direction. In contrast, the lateral nucleus
      contains the fewest cells but also the largest ones. Neurons of the superior and
      descending nuclei are of an intermediate size and number, with a rostrocaudal
      decrease in the size of the descending nucleus cells. In addition, minor nuclei
      are identified and described in their relationship to the other structures in the
      brain stem. The relevant aspects of the anatomical information in regard to
      functional roles are reviewed.

PMID- 8341103
TI  - In search of missing links in otology. III. Development of a new animal model for
      cholesteatoma.
AB  - An experimental study was conducted in chinchillas regarding the pathogenesis of
      acquired cholesteatoma (keratoma). The placement of a chemically modified gelatin
      membrane from the external auditory canal to the promontory through a tympanic
      membrane perforation stimulated squamous epithelial cell migration. Cholesteatoma
      formation with the presence of keratin debris and inflammatory reactions was
      observed in the middle ear and anterior bulla in 53.5% of the experimental
      animals. These experimental findings show for the first time the presence of
      epithelial migration and true cholesteatoma formation in the middle ear of
      chinchillas in an experimental model with deliberate perforation of the tympanic
      membrane. Erosion of the cochlear walls was observed in areas with granulation
      tissue and cholesteatoma. The importance and significance of the migration of
      squamous epithelium and of the middle ear inflammatory reaction in the genesis of
      acquired cholesteatomas are discussed.

PMID- 8341104
TI  - Laryngeal resistance to respiratory airflow in humans.
AB  - Although vocal cord adduction has been observed during expiration, measurements
      of absolute values of resistance changes in man have not been reported in the
      literature. The authors measured resistance to translaryngeal respiratory airflow
      in inspiratory and expiratory phases of the respiratory cycle of four healthy,
      awake men during nasal breathing. It was found that, during quiet breathing
      through a decongested nose, translaryngeal resistance was 1.245 cm H2O/L per
      second in expiration and 0.354 cm H2O/L per second in inspiration (.005 < P < or
      = .01), for a percentage of approximately 25% and 50% of extrathoracic expiratory
      and inspiratory resistances, respectively. Voluntary hyperventilation decreased
      expiratory resistance, and a partial nasal obstruction abolished the statistical
      difference between translaryngeal inspiratory and expiratory resistance. These
      results are in agreement with previous observations of vocal cord movement and
      are consistent with an expiratory braking effect on airflow.

PMID- 8341105
TI  - Vestibular decruitment: an indicator of central pathology?
AB  - Torok studied the ratio obtained between the responses to two different heat
      stimulation intensities of the same temperature. A decrease in response to the
      strong stimulus (i.e., a diminished ratio) was called "vestibular decruitment,"
      and was regarded as a topodiagnostic indicator of central vestibular lesion,
      reflecting "adaptation" or "fatigue." The authors studied the reliability of
      vestibular decruitment obtained by Torok's technique in the indication of central
      vestibular pathology. Twenty-eight normal individuals and 30 patients previously
      diagnosed by other methods with diffuse pathology of the central nervous system
      were evaluated. The results obtained show that the two stimuli used are both
      supraliminal and of different intensity regarding the labyrinth. In no case was
      vestibular recruitment obtained. In view of the high percentage of normal
      individuals (57.14%) who presented vestibular decruitment, we consider the latter
      to lack topodiagnostic value as an indicator of either central or vestibular
      pathology; the smaller response to the mass stimulus might be explained by the
      vestibular habituation phenomenon that occurs on applying Torok's technique in
      both normal individuals and in patients with central vestibular pathology.

PMID- 8341106
TI  - Effects of cyanoacrylate tissue adhesives on cartilage graft viability.
AB  - Cartilage graft fixation using cyanoacrylate tissue adhesives has aided in the
      accuracy and stability of these grafts in facial reconstructive procedures. To
      objectively determine how these adhesives affect cartilage viability, freshly
      harvested cartilage from septoplasty procedures was bonded in vitro with one of
      four cyanoacrylate adhesives: Histoacryl, Bucrylate, Krazy Glue, or Eastman 910
      monomer. Viable chondrocytes will incorporate the sulfur-35 (35S) isotope in the
      synthesis of chondroitin sulfate, and is therefore a reliable test of cartilage
      viability. The bonded cartilage specimens were stored from 3 days to 4 weeks at 4
      degrees C and then were incubated with the 35S isotope. Autoradiographs were made
      and the sections were counterstained. Throughout the study period, there was no
      statistical difference in the viability of Histoacryl-bonded specimens as
      compared to the controls. Specimens bonded with Bucrylate, Krazy Glue, and
      Eastman 910 monomer statistically demonstrated markedly less viability compared
      to those bonded with Histoacryl at the P = .01 level of significance. Further,
      the cartilage separated from these latter adhesives at the longer study times,
      most likely secondary to cartilage devitalization. Histoacryl optimizes graft
      viability as compared to these other available cyanoacrylate tissue adhesives in
      vitro.

PMID- 8341107
TI  - Direct application of basic fibroblast growth factor improves tympanic membrane
      perforation healing.
AB  - Topical application of basic fibroblast growth factor (b-FGF) on tympanic
      membrane (TM) perforations was studied in guinea pigs. One-millimeter simple
      round TM perforations or 2-mm TM perforations with medially flapped borders were
      performed. Either b-FGF or placebo was instilled in each ear on the day of
      surgery and daily thereafter. Treatment was applied either directly to the
      perforation or to a Gelfoam pledget over the defect. When no scaffolding material
      was interposed, b-FGF induced a faster healing response characterized by a
      hyperplastic but linear subepidermal connective tissue reaction compared to the
      control. When Gelfoam was interposed as a scaffold, a voluminous scar protruding
      into the middle ear cavity and involving the ossicles was observed in both b-FGF
      and control animals. Gelfoam-induced scars did not decrease after long-term
      observation, therefore discouraging its use.

PMID- 8341108
TI  - Endoscopic 'second look' mastoidoscopy to rule out residual epitympanic/mastoid
      cholesteatoma.
AB  - Endoscopic mastoidoscopy is ideally suited for patients who have undergone an
      intact canal wall mastoidectomy for primary acquired cholesteatoma confined to
      the epitympanum and mastoid. The use of an endoscopic technique significantly
      decreases the morbidity of the second-look procedure. Visualization of the
      pertinent anatomy can be reliably, quickly, and safely accomplished.

PMID- 8341109
TI  - Endoscopic human olfactory biopsy technique: a preliminary report.

PMID- 8341110
TI  - Revision surgery for Sedlacek-Kambic-Tucker epiglottic laryngoplasty.

PMID- 8341111
TI  - Decreasing the risk of implantation of cancer cells intraoperatively.
AB  - Maneuvers are suggested to decrease the likelihood of disseminating and
      implanting cancer cells in wounds during head and neck oncologic surgery, and
      thereby the risk of local-regional recurrence. These include occlusive covering
      of fresh tracheotomy sites and areas of skin ulceration, excising the primary
      tumor before performing neck dissection(s) to avoid contamination of uninvolved
      tissue planes, irrigation of the field with hypotonic solution after removal of
      the primary tumor, and using clean instruments and apparel when moving between
      anatomical sites (e.g., donor flaps/grafts, skull base extensions, percutaneous
      or standard gastrostomies, etc.).

PMID- 8341112
TI  - In leprosy the presence of mycobacteria in the nerve is an essential factor in
      the cycle and spectrum of Mycobacterium leprae infection.
AB  - A total of 220 untreated leprosy patients who underwent parallel skin and nerve
      biopsies are included in this study, which is intended to evaluate the extent of
      previously reported differences in bacillary load between skin and nerve lesions
      in leprosy and to describe the response of peripheral blood lymphocytes to
      Mycobacterium leprae antigens in such patients. In 161 patients out of the 220,
      the skin and nerve biopsies were diagnostic for leprosy. When patients were
      grouped according their skin and nerve lesions, the 3 groups observed were (1)
      paucibacillary skin and nerve lesions; (2) multibacillary skin and nerve lesions,
      and (3) paucibacillary skin and multibacillary nerve lesions. There was no
      observation of a group of patients with multibacillary skin and paucibacillary
      nerve lesions. In all patients with multibacillary nerve lesions, regardless of
      the type of skin lesions, a low response of peripheral blood lymphocytes to M.
      leprae was consistently noted. These results suggest that the bacillary load in
      the nerve is certainly one of the factors determining the immunological spectrum
      observed in leprosy.

PMID- 8341113
TI  - Concurrent skin and nerve histology in leprosy and its role in the classification
      of leprosy.
AB  - Concurrent skin and nerve histology was evaluated in 60 leprosy patients (25 BT,
      28 BL and 7 LL). The twin aims were to study the comparative histology and the
      usefulness of nerve histology in the classification of the disease. In BT
      patients, clinical and histological classification was in agreement in 11 (44%)
      skin and 17 (68%) nerve biopsies. Concurrent skin and nerve histology was in
      consonance in 14 (56%) BT patients, while in 6 (24%) patients, only nerve
      histology was helpful in the classification of the disease, the skin histology
      being non-specific. Nerve histology was classified as BL in 3 (12%) BT patients,
      the skin histology was non-specific. In the BL group, the histology of 23 (82.4%)
      nerve biopsies correlated with the clinical classification, in contrast to skin
      histology which correlated with clinical assessment in 19 (68%) patients only. In
      the LL patients, the histology of nerve correlated with the clinical
      classification in 5 patients (71.4%), compared to histology of the skin in 4
      (57%) patients only. The GF was higher in the nerves than in the skin throughout
      the leprosy spectrum (BT, BL, LL); the difference was, however, marginal in BL
      leprosy. The average bacteriological index (BI) was higher in nerves (4+)
      compared to that of skin histology and slit skin smears (3+) in BL leprosy. There
      was, however, no difference in the BI of the slit skin smears, skin and nerve
      biopsies in lepromatous leprosy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341114
TI  - Pilot study to determine acceptability and ability of heat-killed Mycobacterium
      leprae plus BCG (HKML+BCG) vaccine to induce skin test conversion.
AB  - Although local reactions, including erythema, induration and ulcers, appeared in
      every patient after the injection of the combined HKML+BCG vaccine, they were
      accepted by the patients. There was no tendency for the local reaction to become
      aggravated after repeated vaccination. However, systemic reactions, mainly
      iridocyclitis and complaint of numbness of the fingers and toes, became quite
      common after the 5th vaccination and therefore significantly reduced the
      acceptability of vaccine by injection. It seems that repeated vaccination might
      activate the iridocyclitis, but the relationship between the complaint of
      numbness and vaccination has not been well established. Neither typical ENL nor
      reversal reaction had been observed throughout the trial. A significant
      proportion of patients converted to SMLA positivity after repeated vaccination.
      However, it seems the positive status was not stable as many of them reverted to
      negative after the following vaccination. After the 7th vaccination, the positive
      conversion rate to SMLA-I was 45% and to SMLA-II was 35%. After the 8th
      vaccination, 66.7% of patients converted to Mitsuda reaction positive, which has
      been confirmed by histopathological examination. Nevertheless, further follow-up
      is required in order to determine whether or not such conversion will be of a
      long duration. The reactions to SMLA-I and SMLA-II were associated but only
      correlated at a moderate level. Overall, the positive conversion rate to SMLA-I
      was significantly higher than that to SMLA-II after repeated vaccination. Neither
      the early reaction nor the late (Mitsuda) reaction of the lepromin test were
      correlated to either SMLA reaction. The repeated vaccination of HKML+BCG vaccine
      did not affect the weakly-positive anti-PGL-1 Mycobacterium leprae antibody level
      seen in the skin-smear negative lepromatous patients participating in this study.

PMID- 8341115
TI  - Survey for secondary dapsone and rifampicin resistance in Cuba.
AB  - A total of 1211 Cuban multibacillary leprosy patients treated for at least 5
      years were clinically and bacteriologically examined. They were being treated
      according to a 2-phase monotherapy regimen with RMP first and DADDS afterwards.
      On skin-smear examination 50 patients were found positive, of which 9 showed a BI
      of 3+ or higher at any site. With regard to the clinical status the only cases
      found with clinical signs of relapse were 5 out of 7 long-standing patients with
      BI of 4+ and 5+. A 6th patient of this high BI group who showed a good clinical
      condition, except for a heavy infiltration of both earlobes, was receiving a
      second RMP course when examined and biopsied for this research. These 9 patients
      were biopsied and susceptibility tests to RMP and DDS performed. The results
      showed that in 1 case the Mycobacterium leprae were resistant to both drugs; the
      organisms from 2 other patients were susceptible to RMP but low-grade resistant
      to DDS. Those from another patient were susceptible to RMP and fully resistant to
      DDS. In 3 other cases the bacilli did not multiply in any of the mice but 1 of
      these strains was from the patient taking a second RMP course, therefore this
      strain might also be susceptible to RMP and resistant to DDS. In the last 2 cases
      multiplication was only observed in 2 of the controls and in 1 of the 0.0001% DDS
      treated mice; therefore, these experiments were not conclusive, and the AFB
      recovered were inoculated into fresh mice to repeat the tests but these failed to
      multiply.

PMID- 8341116
TI  - Efficacy and safety of multidrug therapy in paucibacillary leprosy in Singapore.
AB  - A total of 49 patients with paucibacillary leprosy (PB) who completed multidrug
      therapy (MDT) between 1985 and 1990 were analysed retrospectively for efficacy
      and complications; 20 (40.8%) patients had borderline-tuberculoid (BT), 13
      (26.5%) had tuberculoid (TT), 1 (2.1%) had indeterminate (I) and 15 (30.0%) had
      pure neural (N) leprosy; 26 patients (76.5% of 34 non-neural leprosy) were skin
      biopsied for histological cure before MDT was stopped. Of these 26 patients, 19
      had histological clearance at 6 months while the remaining 7 cleared beyond 1
      year (18-36 months). The remaining 8 non-neural patients who refused rebiopsy had
      MDT for 6-8 months and the MDT was stopped when there was clinical clearance. Of
      the 15 neural (N) leprosy patients, 11 were given MDT for 6 months while the rest
      had 12-18 months of treatment; 1 patient with neural leprosy, who was treated for
      6 months, relapsed with BT leprosy 18 months post-treatment. There were few
      complications among the 49 patients-4 (8.2%) patients developed reaction to
      dapsone, 1 (2.0%) had the dapsone syndrome, 2 (4.1%) had haemolytic anaemia and 1
      (2.0%) had dapsone hepatitis; 7 (14.3%) patients had type I reaction.

PMID- 8341117
TI  - An epidemiological survey of deformities and disabilities among 14,257 cases of
      leprosy in 11 counties.
AB  - This study was planned and conducted in Yang Zhou Prefecture, covering 11
      counties that were formerly areas with a high prevalence of leprosy. Out of
      14,257 leprosy patients, 8122 (56.97%) cases with deformities and disabilities
      were found. The disability rate is much higher in patients with MB leprosy
      (81.15%) than in PB leprosy (53.04%). The statistical data and the type of
      deformities and disabilities are presented. The influences of various host
      factors and disease factor which cause disability and deformity are discussed.

PMID- 8341118
TI  - Inventory of skin smear practices in 6 leprosy control programmes in Nigeria.
AB  - A study of slit skin smear (SSS) examination practices in 6 Nigerian Leprosy
      Control Programmes was undertaken to assess the quality of smearing, staining and
      reading. Results indicated that the standard of SSS practices fall below the
      ideal. There is a great need for training as well as supervision and support of
      laboratory staff if this deplorable situation is to be improved.

PMID- 8341119
TI  - Borderline-tuberculoid relapse in lepromatous leprosy.
AB  - We report details of 2 patients who had been treated for a long time by dapsone
      monotherapy and who had remained smear negative for over 10 years, but were found
      to have relapsed with borderline-tuberculoid (BT) leprosy.

PMID- 8341120
TI  - Divorce among Saudi female leprotic patients: an experience at Ibn Sina Hospital.

PMID- 8341121
TI  - Tuberculoid relapse in lepromatous leprosy.

PMID- 8341122
TI  - Disappointing experiences with blister-calendar packs.

PMID- 8341123
TI  - Comment: nasal myiasis in leprosy.

PMID- 8341124
TI  - Reply: treatment of smear negative MB patients who had received previous dapsone
      monotherapy.

PMID- 8341125
TI  - Current global situation on the HIV/AIDS pandemic: WHO.

PMID- 8341126
TI  - Leprosy control through general health services and/or combined programmes.

PMID- 8341127
TI  - Human immunodeficiency virus and leprosy.
AB  - In summary, clinical leprosy does not appear to be more frequent in HIV-positive
      than in HIV-negative people in areas where both infections are endemic. There is
      no evidence that the paucibacillary to multibacillary distribution of patients is
      altered by HIV infection. There are reports that neuritis is more severe in co
      infected people, and that reversal reactions (or, at least, new lesions) may be
      more frequent after therapy; but these reports are either poorly documented or
      poorly controlled. In several ways, this lack of expected leprosy is similar to
      the patterns of other low-virulent infections in HIV-positive patients in the
      tropics, such as MAC infection, Pneumocystis carinii and cytomegalovirus
      infection. Despite the presence of the agents in the environment and/or in the
      human host, they are infrequently encountered clinicopathologically. This is in
      marked contrast to their importance in industrialized countries. One explanation,
      as yet unproven, is that HIV-positive patients in the tropics do not live long
      enough in states of severe immunosuppression to develop these infections. Perhaps
      the same applies to M. leprae infection, whose incubation period can be measured
      in decades and whose clinical course may evolve over years, in contrast to the
      common reactivation of latent, virulent M. tuberculosis infection with its high
      morbidity. There may also be an analogy between leprosy and infection with
      Plasmodium falciparum, Strongyloides stercoralis and Entamoeba histolytica: these
      infections are controlled (or at least influenced) by cell-mediated immunity and,
      theoretically, should be more frequent in HIV-positive people than HIV-negatives.
      In fact they are not, and leprosy may be regarded as another 'missing infection
      in AIDS'.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341128
TI  - Further evidence for the involvement of prolactin in the inflammatory response.
AB  - The pro-inflammatory activity of prolactin (PRL) was clearly demonstrated in our
      previous research on rat paw oedema. In the present study we report our results
      on the activity of PRL on other animal models of acute and chronic inflammation.
      Repeated administration of ovine PRL provoked a significant increase in the
      inflammatory parameters in experimental carrageenan pleurisy (leukocytes number
      and prostaglandin E2 concentration in the exudate). A pro-inflammatory effect was
      also present after a hyperprolactinaemia induced by pituitary gland graft.
      Moreover, the inflammatory response to polyester sponge implantation was
      significantly potentiated by oPRL, whereas the hormone was completely inactive on
      cotton pellet granuloma test. A possible involvement of prostaglandins in the pro
      inflammatory activity of PRL is suggested.

PMID- 8341129
TI  - Analysis of vasocontractile responses to endothelin-1 in rabbit retinal vessels
      using an ETA receptor antagonist and an ETB receptor agonist.
AB  - To study the role of endothelin receptor subtypes in rabbit retinal arteries,
      endothelin-1 (ET-1)-induced vasoconstriction was analyzed using the ETA receptor
      antagonist BQ-123 and the ETB receptor agonist BQ-3020. A cumulative injection of
      ET-1 (1 approximately 100 pmole) into the posterior vitreous body in anesthetized
      rabbits caused dose-dependent vasoconstriction in the retinal arteries, and
      ultimately caused complete obstruction. Fifteen minutes after BQ-123 (1 mumole)
      was injected into the posterior vitreous body, the dose-response curve of ET-1
      was significantly shifted to the right. Intravitreal injection of BQ-3020 caused
      a significant retinal vasoconstriction only at the highest dose (1000 pmole).
      Therefore, in rabbit retinal arteries, ET-1-induced vasoconstriction appears to
      be mediated mainly through ETA receptors.

PMID- 8341130
TI  - Concanavalin A enhances ATP resynthesis via de novo pathway in postischemic rat
      hearts.
AB  - Acute post-ischemic cardiac failure was studied in isolated rat hearts. Xylitol,
      glutamine, aspartic acid and glycine were added during reperfusion, resulting in
      no inotropic effect. Concanavalin A had a moderate inotropic effect. When
      concanavalin A added with xylitol, glutamine, aspartic acid and glycine, a rapid
      recovery of myocardial function and high-energy phosphate was achieved.

PMID- 8341131
TI  - Neuroendocrine probes of serotonergic function: a critical review.
AB  - Neuroendocrine probes of serotonergic function are based on the premise that
      serotonin (5-HT) exhibits an excitory influence on the release of certain
      anterior pituitary hormones and that the extent of release of these hormones
      following a challenge with a 5-HT agonist would provide an index of central 5-HT
      activity. This paper critically reviews studies published to date on healthy
      volunteers to assess the validity of tests of serotonergic function. Using
      standardized criteria, it is concluded that although extensive data is available
      on 5-HT-neuroendocrine probes, there is no test that is currently available that
      would fulfil all the proposed requirements for a test to be acceptable, although
      ipsapirone, m-chlorophenylpiperazine (m-CPP), and possibly fenfluramine challenge
      tests come very close. The rapid development and availability of more specific
      and stereo-selective 5-HT agonists/antagonists seem to indicate that it will not
      be too long before a valid neuroendocrine test for the assessment of serotonergic
      function emerges.

PMID- 8341132
TI  - Phosphoramidon-sensitive endothelin converting enzyme in cultured vascular smooth
      muscle cells converts big endothelin-3 to endothelin-3.
AB  - Incubation of big endothelin-3 (big ET-3, 1-41) with the membrane fraction
      obtained from cultured vascular smooth muscle cells (VSMCs) resulted in time
      dependent increases in immunoreactive-ET (IR-ET), which were suppressed by
      phosphoramidon. Analysis of the incubation mixture by reverse-phase high
      performance liquid chromatography (RP-HPLC) confirmed that the IR-ET was due to
      the mature ET-3 (1-21). ET-1 (1-21) generated during incubation of big ET-1 (1
      39) with the membrane fraction was markedly suppressed by the addition of big ET
      3 into the incubation mixture. When the cultured VSMCs were incubated with big ET
      3, a conversion to the mature ET-3 was observed. This ET-3 generation from
      exogenously applied big ET-3 was also suppressed by phosphoramidon. We conclude
      that the phosphoramidon-sensitive ET converting enzyme in VSMCs converts big ET-1
      and big ET-3 to their mature form.

PMID- 8341133
TI  - Effect of systemic interleukin-3 administration on epithelial cell proliferation
      in mouse intestine.
AB  - The effect of interleukin-3 (IL-3) on the crypt cell production rate (CCPR) in
      the intestine of mice was studied using a stathmokinetic technique combined with
      crypt microdissection. Interleukin-3 (0.71 micrograms/injection) was administered
      subcutaneously (s.c.) as two injections per day for 7 successive days and small
      mucosal pieces (duodenum, jejunum, ileum and colon) removed at necropsy were
      organ cultured in the presence of the metaphase arrest agent vincristine sulfate
      for two hours. The number of metaphases was enumerated in dissected crypts and
      CCPR calculated. The results demonstrated that the CCPR was significantly
      increased in all mucosal segments in the IL-3 treated animals compared to saline
      injected controls. These results suggest that the growth promoting properties of
      IL-3 are not restricted to hematopoietic cells when used in vivo and may directly
      or indirectly increase epithelial cell turnover in gut mucosa.

PMID- 8341134
TI  - Delayed matching-to-sample performance during a double-blind trial of tacrine
      (THA) and lecithin in patients with Alzheimer's disease.
AB  - During a double blind, inpatient-outpatient study of THA (tacrine) and lecithin
      in Alzheimer's disease, data on a laboratory-based delayed-matching-to-sample
      (DMS) test was collected on six of 10 subjects. DMS measures proved more
      sensitive to drug effects than clinical measures of cognitive performance. Both
      clinical and DMS measures suggest that patients with mild to moderate impairment
      are more likely to show modest improvement in performance than advanced cases.
      Outcome measures are related to possible mechanisms of attention and memory.

PMID- 8341135
TI  - Influence of calcium on the release of endogenous adenosine from spinal cord
      synaptosomes.
AB  - Intrathecal administration of Ca2+ has been shown to produce antinociception
      which is thought to be partially mediated by the release of adenosine. In the
      present study we have examined directly the effects of varying Ca2+
      concentrations on the release of endogenous adenosine, measured by HPLC with
      fluorescence detection, from rat spinal cord synaptosomes. Although increasing
      the concentration of extracellular Ca2+ reduces the total amount of adenosine
      detected extrasynaptosomally, the component derived from the release of adenosine
      per se is actually augmented. This release of adenosine occurs from dorsal but
      not ventral spinal cord synaptosomes and appears to originate from capsaicin
      sensitive nerve terminals. The Ca2+ ionophore A23187 also releases adenosine, but
      this release is due to the extrasynaptosomal conversion of released nucleotide(s)
      to adenosine, as it is markedly reduced by ecto-5'-nucleotidase inhibitors.
      Release of adenosine by A23187 occurs from both the dorsal and ventral spinal
      cord, and is not capsaicin-sensitive. Ethanol, used as a vehicle for the
      ionophore, releases adenosine which is a mixture of adenosine and nucleotide from
      both dorsal and ventral spinal cord synaptosomes. These observations provide
      direct support for behavioural studies which demonstrate that methylxanthines
      block antinociception produced by intrathecal administration of Ca2+.

PMID- 8341136
TI  - The adenosine kinase inhibitor, 5-iodotubercidin, is not protective against
      cerebral ischemic injury in the gerbil.
AB  - 5-Iodotubercidin is a potent inhibitor of the enzyme adenosine kinase. It has a
      recognized ability to enhance interstitial fluid levels of the cerebroprotective
      purine, adenosine, in the hypoxic brain, and an anticonvulsant action, which is
      thought to be a consequence of its ability to increase extracellular adenosine
      levels. 5-Iodotubercidin (1 mg/kg, i.p.) was therefore tested for its ability to
      reduce cerebral ischemic injury in a gerbil model. Unanesthetized gerbils were
      subjected to a 5 min period of bilateral carotid artery occlusion and then
      maintained in an environmental chamber at 30 degrees C for 5 hr to counteract the
      hypothermia-inducing action of 5-iodotubercidin. As estimated from the extent of
      the increases in locomotor activity and the magnitude of hippocampal CAI layer
      pyramidal cell loss, 5-iodotubercidin (1 mg/kg) failed to have a
      cerebroprotective effect against ischemic injury.

PMID- 8341138
TI  - SDZ CO 611: a highly potent glycated analog of somatostatin with improved oral
      activity.
AB  - To obtain orally active octreotide (Sandostatin, SMS 201-995) analogs a new class
      of glycated somatostatin derivatives were synthesized by the Amadori reaction
      (Maillard reaction). The synthesis, chemical and biological characterization of a
      series of new compounds is described. These oligopeptides bind with high affinity
      to somatostatin receptors and retain full biological activity. Whereas generally
      polypeptide hormones are almost completely inactive after oral administration, we
      report here for the first time that these analogs show remarkably high activity
      by the oral route. Thus for example SDZ CO 611, the D(+)-maltose Amadori
      derivative of octreotide, has about 10 times higher oral effect bioavailability
      than octreotide while maintaining the selectivity, metabolic stability and long
      duration of action of the parent compound.

PMID- 8341137
TI  - The phenytoin metabolite p-HPPH upregulates prostaglandin biosynthesis in human
      gingival fibroblasts challenged to interleukin-1.
AB  - The effects of and interactions between the major phenytoin (PHT) metabolite 5
      parahydroxyphenyl-5-phenylhydantoin (p-HPPH) and interleukin-1 (IL-1 alpha, IL-1
      beta) or tumor necrosis factor alpha (TNF alpha) on prostaglandin biosynthesis in
      human gingival fibroblasts were studied. IL-1 alpha, IL-1 beta and TNF alpha,
      dose-dependently, stimulated PGE2 formation in gingival fibroblasts. The
      metabolite, p-HPPH (1.2-2.4 micrograms/ml), did not induce PGE2 formation itself
      but potentiated IL-1 alpha and IL1 beta induced PGE2 formation in the gingival
      fibroblasts in a manner dependent on the concentration of both IL-1 and p-HPPH.
      The metabolite also stimulated IL-1 induced formation of 6-Keto PGF1 alpha, the
      stable breakdown product of PGI2, in a dose dependent manner. IL-1 beta induces
      release of [3H]-arachidonic acid ([3H]-AA) from prelabelled fibroblasts, which
      was potentiated by p-HPPH (> or = 1.2 micrograms/ml). TNF alpha (> or = 1 ng/ml)
      significantly stimulated the biosynthesis of PGE2 by a process that was also
      potentiated by p-HPPH. Addition of exogenous, unlabelled AA (10 microM) caused an
      increase of PGE2 formation in the fibroblasts that was not potentiated by p-HPPH
      (1.6 micrograms/ml). The results indicate that treatment with p-HPPH results in
      upregulation of prostaglandin synthesis in gingival fibroblasts challenged to IL
      1 or TNF alpha at the level of phospholipase A2.

PMID- 8341139
TI  - Catastrophic visual loss due to Cryptococcus neoformans meningitis.
AB  - We have reviewed our experience with 17 of our own patients with cryptococcal
      meningitis and 32 cases from the literature. Although this complication is an
      uncommon event, patients with cryptococcal meningitis may develop visual loss in
      the absence of other ocular lesions (endophthalmitis or cryptococcomas in the
      visual pathway) that could explain the visual symptoms. There are 2 distinct
      patterns of visual loss: rapid visual loss and slow visual loss. Rapid visual
      loss is characterized by onset of profound visual loss over a period as short as
      12 hours before or early in the course of therapy and a clinical syndrome that is
      strongly suggestive of optic neuritis. Direct invasion of the optic nerve by C.
      neoformans is demonstrated by cases in this and other reports. Slow visual loss
      is characterized by slow but progressive visual loss which typically begins later
      during therapy and may be due to the effects of increased intracranial pressure.
      While the initial deficit may be mild, patients with slow visual loss can
      progress to severe visual loss over weeks to months. The only factors that appear
      to predict either pattern of visual loss are the presence of papilledema, an
      elevated CSF opening pressure, and a positive CSF India ink preparation. In the
      25 visual loss patients for whom data were available for all 3 items, 10 (40%)
      were positive for all 3, as opposed to only 4 of 114 (3.5%) from a reference
      group of cryptococcal meningitis patients without visual loss (p < 0.00001). The
      only therapeutic measures with any degree of consistent success were those
      directed at reducing intracranial pressure. When begun early and used
      aggressively, such therapy halted and sometimes even reversed the course of
      visual loss, particularly in the slow visual loss group. Corticosteroids did not
      appear to be of value in the small number of patients who received them.

PMID- 8341140
TI  - Clinical expression of systemic lupus erythematosus in patients with C4A
      deficiency.
AB  - We studied 121 patients with systemic lupus erythematosus (SLE), of whom 119 were
      complement typed. Both black and white patients with SLE were more likely than
      racially matched controls to have a C4A null allotype. Patients with homozygous
      C4A deficiency had less proteinuria than other patients (p = 0.02) and both
      homozygous and heterozygous C4A-deficient patients (p = 0.05) had fewer seizures
      than other patients. Anti-dsDNA, anti-Sm, anti-Ro, and anticardiolipin antibodies
      were less common in patients with homozygous C4A deficiency, with heterozygous
      C4A-deficient patients intermediate in frequency between homozygous C4A-deficient
      and normal patients with SLE. Both homozygous and heterozygous C4A-deficient
      patients (p < 0.005) had higher C3 levels than other patients, and heterozygous
      C4A-deficient patients had higher, not lower, C4 levels (p < 0.002), compared
      with non-C4A-deficient patients. C4A gene deletion was found in 23.4% of
      patients. C4A gene deletion was associated with subacute cutaneous lupus
      erythematosus (p = 0.04) and Sjogren syndrome (p = 0.02) in patients with SLE.
      Both anti-dsDNA (p = 0.04) and anticardiolipin (p = 0.04) were found less
      frequently in patients with C4A gene deletion. Patients with C4A gene deletion
      had lower C4 levels than patients with C4A deficiency from other mechanisms. We
      conclude that the presence of 1 or 2 C4A null allotypes and the presence of a C4A
      gene deletion identify subgroups of patients with SLE that differ in clinical,
      laboratory, and autoantibody characteristics from other patients with SLE.

PMID- 8341141
TI  - Kaposi sarcoma.

PMID- 8341142
TI  - The etiology of rheumatic fever: A review of theories and evidence. 1949.

PMID- 8341143
TI  - The etiology of rheumatic fever: a review of theories and evidence. 1949.

PMID- 8341144
TI  - The clinical patterns of acute rheumatic fever: a reappraisal. 1962.

PMID- 8341145
TI  - Preventive medical informatics for office practice.

PMID- 8341146
TI  - Checkup interval and cancers in automated multiphasic health testing and
      services.
AB  - The purpose of this study was to disclose which types of cancer and how many
      persons with cancer were detected among the AMHTS examinees of our AMHTS center
      by using the hospital information retrieval system, and to study the relationship
      between cancer and the number of examinees, checkup intervals, and frequency in
      AMHTS. The examinees who had checkups more than twice were divided into three
      groups based on their checkup intervals: within one year, one to two years, and
      over two years. The relationship between cancer ratios and checkup intervals was
      evaluated in each group of examinees. In those having checkups within one year
      and from one to two years the cancer rate was 2.9 patients per 1,000 persons.
      However, in those having checkups after a two-year period or longer, the cancer
      rate was 4.3, clearly greater than the rate of the other two groups.

PMID- 8341147
TI  - Repeated multiphasic screening examinations: evaluating the process.
AB  - There are sound clinical and epidemiological reasons to promote and emphasize
      early detection efforts and disease prevention services. A large body of
      scientific literature supports the notion that detection and intervention early
      in the course of many diseases is beneficial both to the afflicted individual and
      to society at large. Several publications deal with the evaluation of multiphasic
      screening examinations (MSE) as a tool for simultaneous early detection and
      prevention of multiple risk factors and various diseases. Usually, this
      technology is evaluated based on data from a single (cross-sectional)
      comprehensive screening study. However, frequently MSE are performed
      periodically, resulting in repeated test results of the same individuals. The
      health impact of such repeated (longitudinal) MSE has not been studied
      extensively. Similarly, many of the unique theoretical, technical, and
      epidemiological features characteristic of consecutive (periodical) comprehensive
      screening examinations are not well-documented. The purpose of this study was to
      compare the test results of two MSE, performed 3.5 years apart, in order to
      demonstrate certain characteristics of multiphasic health testing (MHT)
      technology related to repeated (longitudinal) multiphasic examination of the same
      individuals.

PMID- 8341148
TI  - Economic evaluation of a Ninngen-dokku (medical checkup).
AB  - An economic evaluation of a medical checkup center (Ninngen-dokku, "human dry
      dock") was conducted from two perspectives: the cost for cancer checkup, and the
      cost for medical treatment after a diagnosis was obtained. We studied the cost of
      diagnosing cancer, compared with the cost required when cancer of an individual
      organ was detected through mass health testing, and studied the economics of a
      Ninngen-dokku according to Kawai's method of medical judgment. Assuming that the
      cost of death is more than the cost of saving the lives of persons who undergo
      the Ninngen-dokku, the Ninngen-dokku will be affordable. In the group undergoing
      the Ninngen-dokku compared with the group which did not, the estimated cost of
      medical treatment was reduced. The Ninngen-dokku carries advantages that cannot
      be quantified in financial terms; therefore, a multi-layered economic analysis of
      the Ninngen-dokku was required.

PMID- 8341149
TI  - Fitness in a U.K. screening sample--a comparison with the Canadian population.
AB  - Fitness measurements were compared from approximately 12,000 men and 5,000 women
      attending the BUPA Health Screening Centre, London, with published Canadian
      levels. The mean (+/- SD) predicted VO2-max values in the BUPA group were 35.1
      (+/- 9.2) and 30.0 (+/- 8.4) ml/kg/min for men and women aged 15-64 years,
      respectively. These compare with means of 44.1 and 34.3 in men and women of the
      same age in Canada. A comparison of flexibility measurements showed that in all
      age groups the BUPA subjects were less flexible than their Canadian counterparts,
      on average 28.7% and 25.1% lower for men and women, respectively. Comparison of
      grip strength showed BUPA values to be on average 8.1% lower in men and 9.5%
      lower in women than the Canadian levels. Analysis of variance showed that the
      fitness measurements reflect the recorded physical activity in the BUPA sample,
      and in particular the predicted VO2-max and flexibility exhibit linear
      relationships with age and exercise levels.

PMID- 8341150
TI  - Heart rate response to exercise in normal women.
AB  - Heart rate is known to increase under the influence of increased sympathetic
      stimulation rates during exertion or stress. Few data are available regarding the
      rate response to exercise near the fatigue limit, for normal women. The effects
      on heart rate were studied of fatigue limiting exercise in 87 asymptomatic,
      normal female subjects employing a bicycle ergometer exercise protocol. The heart
      rate response to imposed exercise power closely followed a monotonic increasing,
      negative exponential function. Different age groups followed the same form of
      function but differed in parameter values. Group fitting was useful to develop
      parameters with which one group may be compared to another, establish referent
      ranges, and gain insight into cardiovascular models of exercise physiology.

PMID- 8341151
TI  - Athletes as health testing examinees.
AB  - Health-testing examination data of 91 male and 54 female athletes were studied,
      together with age-matched controls, on serum biochemistry, ECG findings,
      hematology, and some data on gynecological physiology. Analysis of serum
      biochemical values revealed statistically significant differences in 14 of 18
      routine test items as compared with the age-matched controls. In ECG findings,
      the combination of bradycardia and left ventricular hypertrophy was most
      frequently found in male athletes, whereas that of bradycardia and sinus
      arrhythmia was observed predominantly in female athletes. The incidence of anemia
      and menstrual dysfunction was higher in female athletes than in controls,
      especially in the basketball team. In the same team, a high rate of deviant ECG
      records and a different distribution of the age at menarche were also observed.

PMID- 8341152
TI  - Significant left ventricular hypertrophy in subjects with normal resting
      pressures but exaggerated pressure response during light exertion.
AB  - Concentric left ventricular hypertrophy (LVH) frequently occurs in subjects with
      normal resting systolic and diastolic pressures (SP and DP, respectively). LVH in
      this normotensive-hypertrophic group (NH) may be due to an abnormally exaggerated
      pressure response to exercise. The SP and DP responses to exercise were studied
      in 130 subjects free from coronary artery disease or cardiomyopathy. The NH
      subjects (n = 35) had normal resting pressure (SP < or = 140 and DP < or = 85
      mmHg) and increased LV wall thickness (T) by echocardiography (T > 1.1 cm). A
      normal control group (NN) (n = 57) and a hypertensive control group (HH) (n = 23)
      were simultaneously evaluated. The original groups, subgroups censored for age
      and weight, and matched-pair subgroups demonstrated greater exercise SP for NH
      than for NN (p < 0.005). Moreover, the rate of SP increase with exercise was
      greater for NH than for NN or HH (p < 0.05). Hence, an exaggerated exercise SP
      response may have been the stimulus for LVH in these NH subjects.

PMID- 8341153
TI  - Serum lipid values and age in healthy women: a preliminary report on cholesterol.
AB  - In a 20-year prospective study of the influence of lifestyle and age on health
      parameters in men's and women's serum cholesterol, triglycerides and high density
      and low density lipoproteins were measured periodically to determine each
      person's longitudinal profile. The accumulated data for 1008 women of 20 to 70
      years is averaged by five-year age brackets. Scatter plots and simple regression
      of these five-year group means for ages 20 to 45 years, reveals a gradual
      increase in serum cholesterol, increasing from 176 mg/dl to 196 with a slope of
      0.61 mg/dl per year. Between ages 45 and 70, the slope increases substantially to
      1.91 mg/dl per year, and the five-year group means rise from 196 at age 45 to 239
      at age 70 in rather uniform increments. The data have been analyzed for the other
      lipids and the relationship to estrogen replacement, nutritional, and exercise
      habits.

PMID- 8341154
TI  - Benefits and risks of combined oral contraceptives.
AB  - The use of combined oral contraceptives carries a number of well-established
      major non-contraceptive benefits. Of these, the most important protective effects
      are suppression of the risk of epithelial cancer of the ovary and cancer of the
      endometrium. Also of great importance is a reduction in the risk of pelvic
      inflammatory disease. Needless to say, there are also some established risks of
      combined oral contraceptives. The most important of these are the vascular ones,
      comprising effects on acute myocardial infarction, thrombotic stroke,
      haemorrhagic stroke, and venous thrombosis and embolism. Possible risks which are
      still under evaluation include an adverse effect on breast cancer and, likewise,
      on carcinoma of the cervix. More information is needed about both these
      conditions. A number of authors have provided analyses of varying degrees of
      complexity in which they have attempted to weigh the benefits and risks of
      combined oral contraceptives. Results from some of these studies are presented in
      the paper. On the whole, the findings are reasonably reassuring.

PMID- 8341155
TI  - Defining normality--art or science?
AB  - The problem of defining normality, and in particular the establishment of
      reference ranges, is discussed. A so-called "objective" method of determining
      such ranges is described. It is suggested, however, that all currently used
      methods for defining "normal" ranges rely ultimately on a subjective choice. We
      propose the use of "How Often That Happens" (HOTH) graphs as an alternative to
      the conventional reference range. Such graphs show the frequency of results at
      least as extreme as any observed value. We have used such graphs, along with
      computer simulation models, in an attempt to describe how the frequency
      distribution of a given parameter changes as a population ages. Finally, an
      analogy is drawn between the states of "health", "illness" and "death", and the
      attractors which arise in non-linear dynamic systems. We conclude that the
      definition of normality is in fact more of an art than a science.

PMID- 8341156
TI  - Probability graphics support for medical reasoning.
AB  - Graphic displays of data from clinical observations and laboratory testing
      provide important support to the health practitioner in managing an increasing
      amount of complex information. A graphic display program is described that
      preserves much of the context of data that is important to their evaluation, and
      that maintains a sense of the strength of the signal when aberrant data are
      encountered.

PMID- 8341157
TI  - Bone density, biochemistry and life-style.
AB  - We have assessed the relationship between bone density, biochemistry and life
      style factors in a cross-sectional study of 434 pre- and 357 postmenopausal
      women. Bone-mineral content (BMC) was measured in the non-dominant forearm using
      single-photon densitometry. Bone mass was corrected for bone size (BMC2) in a sub
      set of 263 subjects. Correlation statistics and multiple regression analyses were
      used to identify physical and biochemical measurements that could be used to best
      predict BMC or BMC2. These were combined with lifestyle factors, using multiple
      logistic regression analysis, to identify women at risk of low bone density. Cut
      off values were taken as the 5th percentile of the bone density distributions in
      pre-menopausal women. In postmenopausal women, using BMC2 values to define
      "risk", and using age, creatinine, alkaline phosphatase, thyroxine treatment, and
      calcium supplementation as predictors, a sensitivity of 73% and a specificity of
      95% were achieved. Such a model may be of use as a "first pass" screening test
      for osteoporosis.

PMID- 8341158
TI  - Criteria for screening diabetes mellitus using serum fructosamine level and
      fasting plasma glucose level. The Japanese Society of Multiphasic Health Testing
      and Services (JMHT), Fructosamine Working Committee.
AB  - A screening method using serum fructosamine level and the fasting plasma glucose
      level was used for screening patients with diabetes mellitus. The criteria for
      positive tests recommended by the Japanese Society of Multiphasic Health Testing
      and Services were evaluated. It was found that levels for the serum fructosamine
      of 290 mumol/l or higher (or, for the fasting plasma glucose of 110 mg/dl or
      higher) agreed with the standard oral glucose tolerance test in identifying
      patients with diabetes mellitus in 96.7% of cases, and the serum fructosamine
      test was simpler and less expensive.

PMID- 8341159
TI  - George Zur Williams, MD, DSc, FCAP, FASCP--biographical description.

PMID- 8341160
TI  - HEALTH WATCH: health promotion and disease prevention in primary care.
AB  - HEALTH WATCH, a longitudinal prospective study of healthy aging, was designed to
      characterize a healthy population of 2,200 men and women, ages 20-80 years in
      1970. Biochemical, hematological, and physiological tests are performed annually
      over three weekly visits, combined with a self-administered HEALTH WATCH
      questionnaire to measure health status and behaviors in seven areas (with over
      1,330 variables). In 1988, the HEALTH WATCH study was modified to assess
      characteristics of an oldest old "productive aging" cohort in Kauai, Hawaii.
      Nutrition, physical activity, extended family, and spirituality were found to be
      major health determinants. During 1989 to 1991 a controlled intervention study
      (ten local primary care physicians and their patients, aged 65-89 years) was
      completed in the Sun Cities, Arizona. These studies provide evidence that primary
      care physicians can promote positive health outcomes in patients of any
      chronological age and baseline health status through active healthy aging
      interventions.

PMID- 8341161
TI  - Cerebral and functional aging: first results on prevalence and incidence of the
      Paquid cohort.
AB  - Paquid is an interdisciplinary study designed to investigate cerebral and
      functional aging. A cohort of 3,777 community residents living in two
      administrative areas of South-Western France was selected. A standardized
      questionnaire was administered at home by trained psychologists. The same
      procedure was applied one and three years after the baseline data collection. The
      identification of demented subjects was made with a two-step procedure. The first
      step is a systematic screening by the psychologists using the DSM-III criteria
      for dementia. Subjects who fulfilled the DSM-III criteria were examined by a
      neurologist. Diagnosis of dementia is confirmed according to the NINCDS-ADRDA
      criteria. The Paquid cohort is complemented by a random sample of 357
      institutionalized subjects. First results of prevalence and incidence rates show
      an exponential increase of dementia with age.

PMID- 8341162
TI  - Physiological age-related changes: cross-sectional and longitudinal studies.
AB  - Physiological age-related changes were investigated by cross-sectional and
      longitudinal studies. The data of the study were derived from volunteers admitted
      to the Gerontology Center in Budapest. In the follow-up study 864 subjects took
      part, and in the cross-sectional study 2,281 individuals. The 20-year
      longitudinal study and the cross-sectional examination showed that from a
      clinical standpoint the most important observation is that several biochemical
      data do not change with age. No changes were found in the values in erythrocyte
      sedimentation, hemoglobin, hematocrit, serum total protein, albumin, liver
      function, glucose, creatinine, triglyceride, and HDL-cholesterol levels. Changes
      were observed in the levels of HDL-cholesterol, immunoglobulins, rheumatoid
      factors, antinuclear factors, morphology of lymphocytes, serum TSH and T3
      concentration, and systolic blood pressures.

PMID- 8341163
TI  - The role of genetics in defining reference values and health status.
AB  - Since its establishment, the Center for Preventive Medicine in Vandoeuvre-les
      Nancy, France, performed specific studies on healthy humans, and its approach was
      very useful for defining reference values. Prevention should extend its interest
      to chronic diseases. The majority of important adult disorders are partially
      genetically determined. Genetic markers are also useful as exclusion or as
      partition criteria in the production of reference values. Results are presented
      that were obtained for apolipoproteins E, B and AIV, frequencies of these
      polymorphisms in the Lorraine population, and relationships between these
      polymorphisms and lipid metabolism-related parameters. Health checkup centers, in
      particular those involved in family screening, are well suited for resembling
      many data concerning environmental factors: tobacco consumption, alimentation
      habits, or alcohol and drug consumption. Simultaneous determination of genetic
      markers could allow the determination of an individual's susceptibility or
      resistance to developing a disease and to prepare a preventive action.

PMID- 8341164
TI  - Health-risk appraisal applied to ordinary AMHTS.
AB  - The main purpose of an automatic health testing system (AMHTS) has changed from
      early detection to primary prevention. Health-risk appraisal is now widely
      available as a tool of health education aiming at the modification of unhealthy
      lifestyles. However, the opportunity to offer appropriate health education was
      less frequent for those who had no particular findings during AMHTS. The results
      of an AMHTS should be evaluated from the viewpoint of health-risk appraisal,
      because the system is expected to supply useful information regarding one's
      lifestyle. Our system consists of two health-risk appraisal subsystems. One
      subsystem estimates the degree of improvement in medical indicators after a
      patient's lifestyle has been modified. The other subsystem predicts the
      occurrence of abnormal findings in medical indicators. These health-risk
      appraisal subsystems provide patients with information about their health-risks,
      based on their AMHTS results. Our health-risk appraisal subsystems should play an
      important role in future health education through the application of ordinary
      AMHTS.

PMID- 8341165
TI  - Computers, personal health management and aging tomorrow.

PMID- 8341166
TI  - Cholera--still a major health problem.

PMID- 8341167
TI  - Blood cholesterol screening: influence of fasting state, biological variation and
      the single cholesterol assay on total cholesterol level.
AB  - Postprandial changes in plasma total cholesterol (TC) are minimal and there is
      essentially no difference between fasting vs random TC concentrations, as
      reflected in the small diurnal coefficient of variation (CV) for TC of 2.5%.
      Similarly, a cholesterol-rich meal within the last 24 hours lacked an impact on
      plasma TC. Thus, random specimens are acceptable in blood cholesterol screening.
      The intraindividual biological CV (CVb) for plasma TC as measured over a long
      period was estimated from the data of several published studies to be 6.0%,
      which, when combined with a probable analytical CV (CVa) of 5% during screening,
      gave a total intraindividual CV (CVt) of about 8% for the single cholesterol
      assay. There is consensus that 'high TC values' acquired during screening should
      be confirmed under the conventional laboratory setting capable of CVa of 3% or
      less.

PMID- 8341168
TI  - Acute appendicitis--the University Hospital experience.
AB  - A 1 year review of 529 cases of acute appendicitis, treated at the University
      Hospital in 1990, was performed. Perforation rate was 23.7% and delay in
      diagnosis was found to be significant. Patients above 50 years of age were
      particularly at risk. Diagnostic error was 19.3% and it was a problem not only in
      young women but also in children. Temperature and rectal examinations were not
      found to be helpful in the diagnosis in contrast to leukocytosis. Waiting time
      for operation was long (median 7 hours), be it for a perforated or a
      nonperforated appendicitis.

PMID- 8341169
TI  - A review of acute appendicitis seen in the Taiping District Hospital from July to
      December, 1990.
AB  - In a retrospective study, 455 people were found to have been admitted to the
      Surgical Unit of the Taiping District Hospital, suspected of acute appendicitis
      in the study period from 1 July to 31 December 1990. However, only 147 (32.3%)
      were clinically confirmed to have appendicitis and underwent appendicectomy. Out
      of these, 120 (81.6%) cases were subjected to detailed analysis. The study showed
      that the commonest age group affected was the 10 to 20 year old. Males were
      slightly more often affected but there seemed to be an equal distribution among
      the major races. The diagnostic accuracy, that is the operated cases that were
      actually acute appendicitis, was 92.5%. The perforation rate was 31.5%. Fifty
      five percent of patients developed some post-operative complications, of which
      the commonest was fever.

PMID- 8341170
TI  - Gas-containing liver abscesses: assessment by ultrasound (US) and computed
      tomography (CT).
AB  - Single gas-containing pyogenic liver abscesses in 11 patients were studied by
      ultrasound and computed tomography (CT). On ultrasound, all abscesses were
      predominantly echogenic compared to the normal liver parenchyma. The gas
      collections appeared as hyperreflective areas arranged in clusters associated
      with acoustic shadowing and ring-down artifacts. Ten abscesses (90%) had ill
      defined margins on ultrasound, causing underestimation of their sizes in these
      patients. All abscesses were shown to be multiloculated and had clearly defined
      borders on CT, not appreciated or mistaken for multiplicity of abscesses on
      ultrasound. Ultrasound may be inadequate in the evaluation of gas-containing
      liver abscesses, as they have complex echotexture in addition to ring-down
      artifacts, acoustic shadows and poorly-defined margins; leading to
      underestimation of abscess size, difficulty in identifying loculations and
      erroneous interpretation of multiplicity of abscess cavities.

PMID- 8341171
TI  - Detection of gene deletions by PCR analysis in a Malaysian patient with Duchenne
      muscular dystrophy.
AB  - Duchenne muscular dystrophy (DMD), the commonest X-linked disorder, is a
      progressive, eventually fatal disease. With the advent of molecular genetics, the
      Duchenne gene and its protein product, dystrophin, have been characterised.
      Molecular diagnosis of DMD, identification of carriers and antenatal diagnosis
      are now possible. We describe here the use, in a Malaysian boy with DMD, of a
      recent innovation, multiplex polymerase chain reaction (PCR), to obtain molecular
      diagnosis by detection of dystrophin gene deletions.

PMID- 8341172
TI  - Profile of extracranial cerebrovascular disease in Kelantan: a study by
      continuous wave Doppler ultrasonography.
AB  - The present study outlines the clinical profile and patterns of extracranial
      vascular abnormalities detected by continuous wave doppler ultrasonography (CWDU)
      in 100 patients with cerebrovascular insufficiency states. Males outnumbered
      females (65:35); completed stroke (CS) was a more common mode of presentation
      than transient ischaemic attacks (TIA); carotid strokes were more common than
      vertebro-basilar ones; and hypertension was the most common predisposing factor.
      The CWDU evaluation revealed extracranial vascular disease in 73% of patients.
      Vascular occlusions were more common in patients with TIA. Overall, 33% of the
      patients had evidence of proximal obstruction of the cerebral vessels below the
      neck. The clinical prediction of vascular territory (carotid or vertebro-basilar)
      matched with the findings on CWDU, but evidence of subclinical multiple-vessel
      involvement could be detected in 48% of the patients.

PMID- 8341173
TI  - Response of ovary in young women experiencing laparoscopy under general
      anaesthesia.
AB  - This study investigated whether changes in circulating levels of immunoreactive
      oestradiol-17 beta (E2), progesterone (P) and testosterone (T) occur in women at
      follicular (n = 18, age 25 to 39 years) and luteal (n = 17, 25 to 39 years)
      phases of the normal menstrual cycles, experiencing laparoscopy after intravenous
      sedation with general anaesthesia. The pre- and intra-operative follicular phase
      plasma steroid hormone concentrations were 153.5 +/- 84.3 vs 297.4 +/- 220.8
      pg/ml for E2, 2.0 +/- 3.2 vs 3.3 +/- 3.8 ng/ml for P and 746.6 +/- 415.9 vs
      1325.8 +/- 535.1 pg/ml for T, respectively. The corresponding luteal phase
      steroid levels were 259.7 +/- 120.2 vs 382.7 +/- 188.7 pg/ml, 7.0 +/- 4.8 vs 9.9
      +/- 6.1 ng/ml and 819.4 +/- 355.7 vs 1703.5 +/- 1058.1 pg/ml. Using the Wilcoxon
      rank sum test, intra-operative hormone levels with the exception of P in the
      luteal phase were found to be significantly elevated (p < 0.05). The results
      suggest that laparoscopy under general anaesthesia evokes increased secretion of
      ovarian hormones, possibly via the activation of hypothalamo-pituitary-ovarian
      axis.

PMID- 8341174
TI  - The prevalence of endemic goitre in Kelantan, Malaysia.
AB  - A large-scale study was undertaken in the state of Kelantan, to determine the
      prevalence of goitre. A total of 2,450 subjects above the age of 15 years were
      selected from 31 localities in the state and examination for goitre was done
      using the technique of Perez. The state was divided into 3 areas--coastal area
      (area 1), inland area (area 2) and the area in between the coast and the inland
      area (area 3). The overall prevalence of goitre was 36.8% and the prevalence in
      areas 1, 2 and 3 were 23.0%, 35.9% and 44.9% respectively and ranged from 6.9% in
      a locality in area 1 to 59.7% in a locality in area 3. In all areas, the
      prevalence was higher in females than in males. The prevalence of grades I, II
      and III goitres were 21.5%, 1.0% and 0.5% respectively in area 1, 33.6%, 1.5% and
      0.7% respectively in area 2 and 41.7%, 2.2% and 1.0% respectively in area 3.
      Amongst age groups, goitre prevalence was highest in the 36 to 45 years age group
      in area 1 (33.9%), in the 15 to 25 years age group in area 2 (39.6%) and in the
      26 to 35 years age group in area 3 (54.3%). In all the areas, goitre prevalence
      was lowest in the above 56 years age group. We concluded that the prevalence of
      goitre was high in Kelantan and there were regional differences in the prevalence
      rate within the state.

PMID- 8341175
TI  - Comparison of the efficacy of single and multiple regimens of carbimazole in the
      treatment of thyrotoxicosis.
AB  - Carbimazole, in 3 divided daily doses, is commonly prescribed for the treatment
      of thyrotoxicosis. However, based on its long intra-thyroid half-life, the drug
      may be effective when used as a single or twice daily dose. This study was
      undertaken to determine the effect of once, twice or thrice daily doses of
      carbimazole on thyroid function in patients with thyrotoxicosis. Seventy
      previously untreated thyrotoxic patients were randomly allocated to receive
      carbimazole 30 mg once (group 1), 15 mg twice (group 2) and 10 mg thrice (group
      3) daily. All patients were also prescribed propranolol 20 mg thrice daily for
      the first 4 weeks. Blood was taken for total T3, T4, TSH, blood counts and liver
      enzymes determinations at the beginning and at 6 weeks of treatment. Only 48
      (68.6%) patients were included in the analysis, as the rest defaulted follow-up
      (20.0%) or blood samples were not available at review (11.4%). Of the 48
      patients, 17 were in group 1, 16 in group 2 and 15 in group 3. Following 6 weeks
      of treatment, there was no significant difference in the mean serum levels of
      total T3 and T4 between the 3 groups. However, there was a significant decrease
      in the mean serum levels of total T3 and T4 as compared to the start of the
      treatment. Four patients (23.5%) in group 1, 4 patients (25%) in group 2 and 3
      patients (20%) in group 3 were still thyrotoxic at 6 weeks of treatment, whilst
      10 patients (58.8%) in group 1, 6 patients (37.5%) in group 2 and 3 (20%) in
      group 3 were biochemically hypothyroid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341176
TI  - [Anthropometric measurements in Malay children from upper class families in Kuala
      Lumpur].
AB  - This study was done to determine the anthropometric measurement patterns of Malay
      children from wealthy families in Malaysia and to make a comparison with NCHS
      reference population. A population of 900 children aged between 3-12 years old
      from Taman Tun Dr Ismail, Kuala Lumpur (TDI), were examined but only 871 of them
      were eligible for the study. Weight, height, mid-arm circumference and skin fold
      thickness were measured. The increment pattern of anthropometric measurements of
      TDI children was quite similar to NCHS except for having a lower median weight
      for age and height for age. There was prepubescent increase in skin folds
      thickness in both sexes, followed by a midpubescent decrease and a late pubescent
      increase. The study indicated that Malay children from a wealthy background have
      growth rates comparable to children in the West, hence NCHS percentile charts are
      suitable as a reference for comparing the nutritional status of Malay children in
      Malaysia.

PMID- 8341177
TI  - Painful thyroiditis in postpartum period.
AB  - Destructive thyroiditis commonly occurs during the postpartum period, with a
      prevalence rate of 5% to 16%, and is mainly due to postpartum autoimmune
      thyroiditis (PPT) and, very rarely, to subacute thyroiditis. The thyroiditis is
      similar to Hashimoto's thyroiditis and is generally painless in nature, although
      cases with painful thyroiditis have been described. We report a case of painful
      destructive thyroiditis occurring during the postpartum period, which was
      clinically and biochemically indistinguishable from the variant of painful PPT or
      subacute thyroiditis. Fine needle aspiration cytology showed multi-nucleated
      giant cells diagnostic of subacute thyroiditis.

PMID- 8341178
TI  - Skin cancer caused by chronic arsenical poisoning--a report of three cases.
AB  - The association of arsenical poisoning with the development of skin cancer is
      well-known. In Malaysia, arsenic has been shown to coexist with tin in tin-mining
      land. Our preliminary investigation has shown that the level of arsenic in well
      water from a tin-mining area is high. We report 3 patients with cutaneous lesions
      typical of chronic arsenical poisoning such as hyperpigmentation, keratoses and
      skin cancer. These patients have positive histories of previous domicility in tin
      mining areas. We conclude that these patients developed chronic arsenical
      poisoning from drinking well water polluted with arsenic from the tin-mining
      soil.

PMID- 8341179
TI  - Cytokines in infection.
AB  - Cytokines are central to the development of effective immunity against microbial
      pathogens and their beneficial effects in the control of a variety of infections
      of man and animals are well-documented. However, it appears that cytokines may
      also have detrimental effects in infections by actually enhancing microbial
      growth. These observations emphasise the fact that many successful pathogens
      possess mechanisms enabling them to evade the immune response and that caution
      needs to be exercised in using cytokines as therapeutic agents to control
      infections in various human diseases.

PMID- 8341180
TI  - AIDS presenting as unresolved pneumonia in a 9 year old boy.

PMID- 8341181
TI  - Tetracycline-resistant vibrio cholerae El Tor.

PMID- 8341182
TI  - Health care research in the developing world: a successful educational
      experiment.

PMID- 8341183
TI  - Primary aldosteronism: a new understanding.

PMID- 8341184
TI  - Class III antiarrhythmic action: the way forward?

PMID- 8341185
TI  - Extrapulmonary tuberculosis in children.
AB  - OBJECTIVE: To investigate an apparent increase in the number of children admitted
      to the Royal Alexandra Hospital for Children with extrapulmonary tuberculosis
      (TB). Further, to highlight both the seriousness of this disease and the
      difficulty of its diagnosis, and to draw attention to factors such as ethnic
      origin in identifying children at risk. DESIGN: Clinical and microbiological data
      were collected for all children admitted to the hospital with a confirmed
      diagnosis of TB. A standardised incidence ratio (SIR) was used to analyse the
      number of children admitted with extrapulmonary TB in 1990-1991 compared with
      1982-1989, and in 1987-1991 compared with 1982-1986. RESULTS: Eleven children
      (five of these in 1990 and 1991) had extrapulmonary TB (4, central nervous
      system; 3, osteomyelitis; 2, cervical lymphadenitis; 2, abdominal). One was
      Aboriginal and 10 were from families of overseas origin. Twenty-one others had
      pulmonary TB and 17 of these were from families of overseas origin. The apparent
      increase in the number of admissions for extrapulmonary TB was not statistically
      significant. CONCLUSION: There has been a recent increase in the number of
      children hospitalised with extrapulmonary TB but when this is compared with the
      increase in children hospitalised for all causes, the increase is not
      significant. Immigration and the continuing contact of children with infected
      adults appear to account for most cases of TB in this series.

PMID- 8341186
TI  - Evaluation of a community-based asthma management program in a population sample
      of schoolchildren.
AB  - OBJECTIVE: To assess the effect of a community-based management program,
      incorporating both education and treatment directed at children, parents,
      doctors, pharmacists, community nurses and school teachers. DESIGN: The effect of
      this intervention in a population sample of 65 children with a wide range of
      morbidity due to asthma was compared with a control group of 55 children living
      in a different area. Both groups were re-evaluated concurrently after three and
      six months. MAIN OUTCOME MEASURES: Forced expiratory volume in one second (FEV1);
      bronchial responsiveness to histamine measured as the provoking dose causing a
      20% fall in FEV1 (PD20FEV1) and as dose-response ratio (DRR); Airflometer
      variability; symptom frequency; and knowledge of asthma. Morbidity was measured
      by parents using a self-administered questionnaire and included days absent from
      school and unscheduled doctor or emergency room visits. RESULTS: At three months,
      the intervention group had a significant improvement in knowledge of asthma
      compared with both their baseline and the control group's change in knowledge.
      Also, FEV1 improved in this group and symptoms which limit activity decreased
      significantly. However, the largest improvements were recorded at the six-month
      follow up. In the intervention group, bronchial responsiveness and night cough
      were reduced significantly and FEV1 was improved, compared with both baseline
      measurements and the control group. Knowledge of asthma also improved
      significantly from baseline, and unscheduled doctor or emergency room visits were
      reduced. CONCLUSION: These improvements in this group of children, many of whom
      had mild asthma, verify that community-based management programs can be effective
      in treating childhood asthma.

PMID- 8341187
TI  - On our selection: predictors of medical school success.
AB  - OBJECTIVE: To review predictors of academic success in one Australian medical
      students with predictors rated retrospectively. PREDICTORS: Success and
      involvement in academic and non-academic pursuits over the final two school years
      and at university, as well as study and external employment variables. RESULTS:
      Superior performance over the medical course was predicted by younger age and by
      being involved in debating in the final school year, immediate entry to the
      course, having English as a first language, completing school in Australia,
      having a higher Higher School Certificate (or equivalent) English score, as well
      as leadership responsibilities in the last year at school, with the first two
      variables remaining significant in a multiple regression analysis. English and
      communication skills were two of the five predictors of success for students who
      did not have English as their first language. For students who had English as
      their first language, the important predictors were younger age and having
      debated in the final high school year. CONCLUSIONS: These results, considered
      with some other recent reports, suggest that academic success in a medical course
      is predicted to a surprisingly high level by competence in English. Both the
      importance of communication skills to the practice of medicine, and their
      assessment in those seeking entry to medical schools, are considered.

PMID- 8341188
TI  - A comparison of a bodyweight dose versus a fixed dose of nebulised salbutamol in
      acute asthma in children.
AB  - OBJECTIVE: To compare the efficacy of salbutamol as a fixed dose Ventolin Nebule
      (2.5 mg) and as variable dose respirator solution (0.1 mg/kg bodyweight). DESIGN:
      Multicentre, randomised, double-blind, parallel group comparison. SETTING: The
      Emergency Departments of the Royal Children's Hospital, Melbourne, Victoria;
      Princess Margaret Hospital for Children, Perth, Western Australia; and The
      Children's Hospital, Sydney, New South Wales. PATIENTS: Ninety-nine children
      between four and 12 years of age who presented to the Emergency Departments with
      mild to moderate acute asthma from May to December 1990. INTERVENTIONS: Children
      enrolled in the study were randomly allocated to one of two groups. Group 1
      received one Nebule (2.5 mg salbutamol in 2.5 mL aqueous solution) delivered by
      wet nebulisation. Group 2 received salbutamol (approximately 0.1 mg/kg
      bodyweight) diluted with saline to 2.5 mL, delivered by identical wet
      nebulisation. MAIN OUTCOME MEASURES: (i) Clinical score; (ii) pulse oximetry; and
      (iii) peak expiratory flow rate (PEFR) where possible--measured before, and at 15
      and 30 minutes after treatment with salbutamol. RESULTS: The clinical score
      significantly improved in both treatment groups after 15 minutes (P < 0.001), but
      the difference between the two treatments (adjusted for covariates) was not
      significant (P = 0.97). Both preparations of salbutamol produced a significant
      increase in oxygen saturation after 15 minutes (P < 0.05), while the difference
      between the two treatments (adjusted means) was not significant (P = 0.46). Peak
      flow measurements were available for 65 of the 99 patients. Both preparations of
      salbutamol produced highly significant (P < 0.001) improvements in PEFR at 15
      minutes after treatment. The difference in peak flow rates between the two
      treatment groups (adjusted means) was not significant (P = 0.89). The study had a
      power of 0.8 to detect differences between treatments of 9% PEFR (percentage
      predicted), 0.8% oxygen saturation and 0.77 units of clinical score. CONCLUSIONS:
      A fixed dose of nebulised salbutamol is as efficacious as a salbutamol dose
      calculated for bodyweight in children with mild to moderate acute asthma.

PMID- 8341189
TI  - Viral zoonoses.
AB  - Viral zoonoses cause overt disease in humans and other animals or silent
      infections in animals and overt disease in unnatural hosts such as humans. Often
      the virus and its animal host have evolved together and learned to live together.
      Infection may spread freely between the natural host animals and cause no signs
      of disease, but this balance may be upset by many factors, including stress,
      changing environmental conditions and mutations in both viruses and hosts.
      Infection of an unnatural host may cause clinical disease but no further spread
      of the virus. Examples of viral zoonoses both old and new are used to illustrate
      some of these points, and two will be described in detail--Rift Valley fever and
      influenza.

PMID- 8341190
TI  - Treatment of asthma in children and adolescents: the need for a different
      approach.
AB  - OBJECTIVE: To provide a concise, balanced summary of the principles of management
      of asthma in children and adolescents. DATA SOURCES: Current medical literature
      and the clinical experience considered during the deliberations of the Australian
      Paediatric Asthma Special Interest Group. KEY ISSUES: There is evidence of both
      under-treatment and over-treatment of childhood asthma in Australia. The spectrum
      of asthma severity is very broad, most children with asthma having mild
      infrequent episodes that do not require regular preventive therapy. The
      guidelines presented here provide a framework for accurately assessing the
      pattern and severity of asthma, identifying those children who require preventive
      therapy and making a rational decision about the appropriate preventive agent and
      delivery device. CONCLUSIONS: When prescribing preventive therapy, a careful
      assessment of the relative risks and benefits should be made in the light of the
      underlying asthma severity. The level of therapy should be reconsidered regularly
      to ensure control is maintained with minimum dosages, particularly for inhaled
      corticosteroids. Recommendations are provided to ensure a normal quality of life
      for children with asthma, with guidelines to minimise adverse effects of therapy.

PMID- 8341191
TI  - Asthma management in general practice.
AB  - OBJECTIVE: To provide guidelines for management of asthma in general practice.
      DATA SOURCES: Selected articles, particularly those relating to general practice.
      CONCLUSION: Better management of asthma requires strategies for dealing with long
      term management as well as acute attacks. Planning such strategies and
      implementing personal management plans for each patient requires assessment of
      asthma severity; determination and maintenance of best achievable lung function,
      with avoidance of trigger factors, regular monitoring, and appropriate drug
      therapy; a written self-management plan as a basis for patient and family
      education; and regular review.

PMID- 8341192
TI  - Thyroid disease.
AB  - Hyperthyroidism and hypothyroidism are common disorders in the elderly and may
      remain unrecognised until a patient presents with an apparently unrelated
      problem. The finding of an elevated level of thyroid stimulating hormone (TSH)
      with a normal serum thyroxine (T4) level represents "subclinical hypothyroidism",
      which does not necessarily require treatment. Iodine can precipitate
      hyperthyroidism in patients with autonomous thyroid tissue and the iodine-rich
      antiarrhythmic agent, amiodarone, may cause either hyperthyroidism or
      hypothyroidism. The metabolism and clearance of numerous therapeutic agents is
      altered when thyroid status is abnormal, so that dose adjustment may be
      necessary. In cardiac failure secondary to hyperthyroidism, great care must be
      taken in prescribing beta-blockers and diuretics; dosage of digitalis
      preparations may need to be increased. Thyroid replacement therapy can aggravate
      myocardial ischaemia and it may be appropriate to consider coronary artery bypass
      grafting before hypothyroidism is fully corrected. Antithyroid drugs, surgery and
      radioactive iodine all have a place in the treatment of hyperthyroidism in the
      elderly, depending on factors such as disease severity and the characteristics of
      the goitre. T4 may be given together with an antithyroid drug in a "block
      replace" regimen.

PMID- 8341193
TI  - A prospective audit of asthma management following emergency asthma treatment at
      a teaching hospital.
AB  - OBJECTIVE: To audit the assessment and treatment of acute asthma and the
      subsequent application of the Australian Asthma Management Plan. DESIGN:
      Prospective audit of case notes with follow-up telephone questionnaire and
      clinical assessment at 8-12 weeks after discharge. SETTING: Tertiary-level
      teaching hospital. MAIN OUTCOME MEASURES: Comparison with published guidelines
      for acute and ongoing asthma management. RESULTS: Asthma severity was objectively
      assessed in the Primary and Emergency Care Department, with lung function
      performed in 95% of acute presentations. Clinical history and examination were
      documented completely in 28% of presentations. Corticosteroids were underused and
      there was inappropriate use of ipratropium bromide. At 8-12 weeks follow-up most
      patients were symptomatic with limited activity due to asthma (46%) and impaired
      lung function (66%). One-third of patients were undertreated. Asthma management
      skills were seriously inadequate: only 20% of patients were performing peak flow
      monitoring, and only 21% recalled receiving specific instructions for the
      management of future exacerbations. Inhaler technique was inadequate in one-third
      of patients and asthma knowledge was poor. These deficits were more frequent in
      patients not admitted to hospital. CONCLUSION: This audit identified suboptimal
      assessment and treatment of acute asthma, and deficits in the implementation of
      the Australian Asthma Management Plan following discharge. Patients in this audit
      were undertreated and not provided with the skills to manage future attacks of
      asthma.

PMID- 8341194
TI  - New developments in anti-asthma drugs.
AB  - OBJECTIVE: To review the current approach to the management of bronchial asthma
      with particular reference to drug therapy. DATA SOURCES: All significant English
      language journals were searched for current studies, particularly controlled
      clinical trials, in the management of asthma. STUDY SELECTION: Sixty articles
      were reviewed. They were selected on the basis of the known reputation of the
      author or the unit from which the study emanated, the place that the study has
      assumed in academic respiratory circles, and whether the study contributed
      something new to our understanding of drug therapy in asthma. Review articles
      from eminent scientific bodies were also analysed. CONCLUSIONS: Asthma is an
      inflammatory disease and therapy must be directed towards this as well as to
      bronchoconstriction. Inhaled corticosteroids are the mainstay of treatment and
      inhaled beta-agonists are best used on an as needed basis. Regular objective
      assessments of patients' progress are essential, as are written, individualised
      action plans. The adjunctive use of other drugs is discussed and new therapies
      which may prove useful in the future are reviewed.

PMID- 8341195
TI  - Genetic susceptibility to common diseases.

PMID- 8341197
TI  - Planning bedside teaching--7. Explication of the clinical experience.

PMID- 8341196
TI  - Hypothermia, hyperhidrosis, myokymia and increased urinary excretion of
      catecholamines associated with a thymoma.
AB  - OBJECTIVE: To report a rare syndrome associated with a thymoma and its first
      successful treatment with gammaglobulin. CLINICAL FEATURES: A 49-year-old white
      male presented with marked hypothermia, hyperhidrosis, myokymia and increased
      urinary excretion of catecholamines four weeks after complete excision of a
      malignant thymoma. He became increasingly drowsy, obtunded and required
      ventilatory support. INTERVENTION AND OUTCOME: A catecholamine secreting tumour
      was excluded and he was treated with intravenous gammaglobulin for five days,
      with dramatic improvement in his condition. Six months later he remains in
      remission. CONCLUSION: The response to treatment in this patient suggests an
      immunological pathogenesis for this rare group of symptoms associated with a
      thymoma.

PMID- 8341198
TI  - Mohs surgery explained.

PMID- 8341199
TI  - Mohs surgery explained.

PMID- 8341200
TI  - The acceptability of personal invitations to a mammographic screening program.

PMID- 8341201
TI  - Illness associated with blue-green algae.

PMID- 8341203
TI  - Anabolic steroid use and cerebellar haemorrhage.

PMID- 8341202
TI  - Rheumatic fever and chronic rheumatic heart disease in Yarrabah aboriginal
      community, north Queensland.

PMID- 8341204
TI  - Non-pharmacological treatment of cramps.

PMID- 8341205
TI  - Homelessness and mental illness in rural New South Wales.

PMID- 8341206
TI  - Perspectives on tropical health.

PMID- 8341207
TI  - Topical terbinafine for tinea infections.

PMID- 8341208
TI  - Malnutrition of children in developing countries: what can we do?
AB  - This informal paper is a personal account of the development of my work on
      malnourished children, starting with clinical studies in Jamaica and the
      challenge of an unacceptably high mortality rate; moving on to the problem of how
      to define less severe malnutrition in the community; and ending with some
      reflections on the enormously difficult question of prevention and the
      contribution that richer countries such as the UK could make.

PMID- 8341209
TI  - A time of hate and suffering.

PMID- 8341210
TI  - Eighth international conference on radiation and health.

PMID- 8341211
TI  - Violence: a public health concern.

PMID- 8341212
TI  - When is the optimum time to harvest peripheral blood stem cells in children
      following standard dose chemotherapy?
AB  - The optimal time for peripheral stem cell harvest may be predicted by recovery of
      blood count following priming doses of chemotherapy. Bone marrow growth factors
      have also been used to enhance yield. Both these manoeuvres may necessitate
      alterations to standard treatment programmes. In order to determine whether
      adequate peripheral stem cell yields could be obtained without altering
      chemotherapy regimens, 18 children with either leukaemia or solid tumours were
      studied. Circulating bone marrow progenitor cells were estimated by CFU-GM
      cultures in soft agar. There were 8 males and 10 females, median age 5.6 years
      (range 2-13 years). Six out of 13 studies in leukaemia patients were done when
      the bone marrow contained significant leukaemic blasts, and in 2 of 9 studies in
      patients with solid tumours, there was active infiltration of the bone marrow. In
      15 of 23 studies, a rise in CFU-GM levels to greater than 1,000 x 10(3)/l were
      observed following postchemotherapy aplasia. Maximum CFU-GM levels were
      maintained for only 1-2 days and could be predicted by the achievement of a total
      white cell count in the region of 2 x 10(9)/l and platelet count around 100 x
      10(9)/l. Neutrophil recovery did not predict the rise in CFU-GM levels. A rapid
      rise in monocyte levels also preceded maximum CFU-GM levels. Predictably, the CFU
      GM counts were lower in patients who were heavily pretreated, but in several
      children, the counts were sufficient to predict an adequate harvest to be used in
      conjunction with bone marrow autotransplantation. It is concluded that in
      children with active bone marrow recovery, chemotherapy priming or the use of
      bone marrow growth factors may not be necessary to achieve useful stem cell
      harvests.

PMID- 8341213
TI  - Superior prognosis in combined compared to isolated bone marrow relapses in
      salvage therapy of childhood acute lymphoblastic leukemia.
AB  - Three hundred twenty-six children with bone marrow (BM) relapse of non-B acute
      lymphoblastic leukemia (ALL) were stratified according to the time of relapse in
      three consecutive multicenter trials--ALL-REZ BFM 83, 85, and 87. Employing an
      intensive polychemotherapy regimen, extramedullary involvement appeared to be
      predictive of superior outcome in both strata as well as in the whole group
      (probability of 7-year event-free survival (EFS) 42% in combined vs. 15% in
      isolated BM relapse, P = 0.015). Children with combined BM relapse occurring
      later than 6 months after completion of front-line therapy reached EFS estimates
      of 60%. We conclude that results of conventional polychemotherapy with BFM
      relapse protocols are equivalent to those achieved by bone marrow transplantation
      in children with late combined BM relapse.

PMID- 8341214
TI  - Increased risk of cardiac dysfunction after anthracyclines in girls.

PMID- 8341215
TI  - Carcinoma of the choroid plexus: a pediatric experience.
AB  - Carcinoma of the choroid plexus (CCP) is a rare tumor of the central nervous
      system which occurs more frequently in patients under 3 years of age. We report
      10 cases of CCP in children. There were 5 males and 5 females, aged 5 to 84
      months at diagnosis (median 32 months). Eight CCP were located in the lateral
      ventricle and 2 in the fourth ventricle. All patients underwent initial surgery,
      with complete resection in 5 cases. Postoperative treatment included radiotherapy
      alone in 4 patients, chemotherapy alone in 4, both in 1 patient, and no further
      treatment in one patient. Six patients remain in first continuous complete
      remission with a follow-up of 12 to 156 months (mean 34 months). Five of these
      six patients had a complete surgical resection of their tumor and 4 of them
      received chemotherapy alone. A comparison with the series in the literature
      suggests that total resection of the tumors is the major prognostic factor for
      survival. Recourse to additional treatments to prevent local relapses and CNS
      dissemination seems necessary. In our opinion, radiotherapy should be avoided as
      far as possible because of its deleterious effect in very young children. As some
      of the long term survivors did not receive radiation treatment, we conclude that
      CCP can be treated post operatively using chemotherapy protocols designed for
      infants with malignant brain tumors.

PMID- 8341216
TI  - Chemotherapy in the management of infantile fibrosarcoma.
AB  - Infantile fibrosarcoma (IF) has traditionally been treated with surgery, which
      may have considerable morbidity. Chemotherapy has been suggested in order to
      reduce the need for extensive surgery. Nine children with histologically
      confirmed IF who received chemotherapy are described. Six children were treated
      with chemotherapy initially, two following conservative surgery, and one
      following recurrence after surgery. All received vincristine (V) and actinomycin
      D (A), and six received additional drugs including ifosfamide (I),
      cyclophosphamide (C), adriamycin (Ad), etoposide (E), and cisplatinum (CDDP).
      Objective responses were achieved in eight: three responded completely (CR), two
      responded partially (PR), which allowed conservative surgery, one had stable
      disease, one had an initial PR, but subsequently had tumour recurrence 1 month
      after cessation of treatment, necessitating further surgery and chemotherapy, and
      one had an initial PR but died following local and regional metastases. One child
      had no response to chemotherapy but is alive with stable residual disease. Thus,
      five of nine children achieved a CR--three with chemotherapy alone. With the
      inclusion of chemotherapy as part of their treatment, five children, for whom
      curative surgery may have resulted in amputation, remain alive with limbs intact.
      Chemotherapy including V and A should be given to infants with fibrosarcoma in
      whom curative surgery would be mutilating.

PMID- 8341217
TI  - Low dose continuous infusion doxorubicin in children and young adults.
AB  - Ten patients (age range 3.2-26.3 yrs) with relapsed or resistant malignancies
      received a total of 20 courses of low dose continuous infusion doxorubicin (3
      mg/m2/day for 28 days) delivered by portable Graseby infusion pumps via central
      venous catheters. Each patient received a median dose of 144 mg/m2 (range 87
      261). Four patients responded to treatment (1 complete response (CR) and 3
      partial response (PR)) and performance status improved in seven patients. Overall
      toxicity was minimal: WHO Grade 4 anaemia in 2/18 courses, Grade 4 neutropenia in
      1/18, Grade 3-4 thrombocytopenia in 3/18, nausea and vomiting of Grades 2 and 4
      in 4/20 and 1/20 respectively, and mucositis of Grades 2 and 4 in 2/20 courses
      each. Cardiac toxicity was assessed using echocardiography, and fractional
      shortening remained within normal limits in all patients. Low dose continuous
      infusion doxorubicin is a feasible, well tolerated, ambulatory therapy in
      children and may be an effective way of delivering doxorubicin with less
      toxicity, thus enabling the development of more dose intensive regimens.

PMID- 8341218
TI  - N-myc oncogene and urinary catecholamines in children with neuroblastoma.
AB  - This paper reports the analysis of N-myc amplification, urinary vanillylmandelic
      acid (VMA), and norepinephrine (NE) excretion and survival in 22 children with
      neuroblastoma and 7 with ganglio-neuroblastoma. Five patients had N-myc
      amplification (from 30 to more than 200 copies), all of whom had advanced-stage
      disease. The urinary excretion of VMA was normal in all of them, only one showed
      increased NE excretion. All patients with stage C-D disease and one copy of N-myc
      had increased VMA urinary excretion and increased (9/14) or normal (5/14) NE
      urinary excretion. All patients with stage A or B disease had one copy of N-myc.
      Half of them showed increased VMA urinary levels, while only 3/10 showed
      increased NE urinary values. Comparison of cumulative survival curves in relation
      to N-myc amplification and to VMA and NE urinary excretion showed a clear
      parallelism. Amplification of N-myc corresponded to normal VMA and NE urinary
      excretion, and was associated with the worst prognosis (P < 0.01), while
      increased VMA and/or NE excretion was found in patients with only one copy of N
      myc.

PMID- 8341219
TI  - James Ewing (1866-1943): "the chief".
AB  - "It is a growing conviction that to know cancer in man, one must study the
      disease most carefully in the human subject. Personally, I do not look for any
      startling advances or sensational discoveries, since it is much more likely that
      a steady reduction in the mortality from cancer will come chiefly from a large
      number of separate factors, of which the most significant appear to be increased
      control of the conditions leading to cancer, more general recognition of the
      preliminary stages of the disease, early diagnosis, and treatment of the
      established disease. From the consideration of these various functions of the
      modern cancer research hospital, I think that it must be evident that such an
      institution not only can justify its existence, but fills a very urgent need
      without which, progress of cancer research would be handicapped, and much relief
      that might early be extended to cancer victims would be unavailable. Nor is there
      any doubt that the function of supporting such an institution is properly
      exercised by the State, which support should be continuous and liberal"--James
      Ewing [2].

PMID- 8341220
TI  - Ganglioglioma.

PMID- 8341222
TI  - Clear cell sarcoma of the kidney in a 4-month-old infant: a case report.
AB  - A case of clear cell sarcoma of the kidney is described in a 4-month-old male
      infant. The tumor had a typical histological pattern, consisting of sheets of
      tumor cells possessing "empty" nuclei set within a delicate capillary network.
      There was extensive necrosis and tumor cell cytoplasm contained vimentin. This
      tumor occurs only rarely in infants less than six months of age. The different
      renal neoplasms of childhood have diverse prognoses and demand specific therapy
      so that accurate diagnosis is mandatory. The present case illustrates that clear
      cell sarcoma, a highly malignant neoplasm, must be considered in the differential
      diagnosis of a renal mass occurring in this age group.

PMID- 8341221
TI  - Tumor lysis syndrome after combination chemotherapy for ovarian cancer.
AB  - Tumor lysis syndrome is infrequently encountered following the treatment of solid
      tumors. A 47-year-old woman developed this syndrome after receiving combination
      chemotherapy for ovarian cancer. The levels of serum lactate dehydrogenase, uric
      acid, phosphate, and creatinine increased, whereas the serum calcium level
      decreased. These metabolic abnormalities were treated successfully using a
      combination of vigorous intravenous hydration, parenteral bicarbonate to keep
      urinary pH > 7, furosemide, and allopurinol. This unusual and easily treatable
      complication should be anticipated in patients with rapidly growing ovarian
      cancer undergoing aggressive treatment.

PMID- 8341223
TI  - [Varicella: how and when to start antiviral treatment].
AB  - The Meeting "An Update on Chickenpox" (Florence, 19-3-1993) has contributed to
      verify, in the light of the most recent acquisitions, the new guidelines for a
      correct rationale in the diagnosis and therapy of chickenpox. The present
      availability of an effective specific antiviral therapy for chickenpox
      (acyclovir) leads to a careful selection of patients to be treated. The high
      incidence of chickenpox morbidity keeps long unaltered and, beyond the usually
      benign onset of the primary infection in the child, the severity of this
      pathology in particular subjects and situations at risk is to be certainly
      underlined. Treatment is suggested for cases of chickenpox contracted inside the
      family. Generally, boys are at higher risk. Adolescents and adults, usually with
      a lower incidence, report a much higher severity of the acute onset and
      complications. Another category to be certainly treated is the one--in constant
      increase--of immunocompromised subjects. In any case, acyclovir treatment
      improves the symptomatologic evolution (pruritus and fever) and duration of
      clinical course. Among the progenitors of acyclovir, Valacyclovir seems to have
      the best prospects of success for the immediate future of antiviral therapy.

PMID- 8341224
TI  - [L-T4 malabsorption determined by intolerance to cow's milk proteins and celiac
      disease in a patient with congenital hypothyroidism. A clinical case].
AB  - An infant with congenital hypothyroidism (CH) is described who in the course of
      thyroxin replacement therapy developed cow's milk protein intolerance (CMPI) and
      subsequently coeliac disease (CD). The presence of these two pathologies
      interfered with the intestinal absorption of L-thyroxin (L-T4) and made the
      appropriate management of CH difficult. A male patient, formula fed from birth,
      was screened for CH at 5 days of age. CH was confirmed and L-T4 treatment (6.8
      micrograms/kg/day per os) begun at 35 days of age. Seen after 3 weeks because of
      feeding problems and impaired growth and with a serum T4 concentration of 4.7
      micrograms/dl and a TSH of 56 mU/ml, his replacement dose was increased to 12
      micrograms/kg/day. One week later, the child was hospitalized because of
      vomiting, acidosis and shock. CMPI was diagnosed and the child began a diet with
      a hydrolyzed milk protein food. After 7 weeks the serum T4 improved to 11
      micrograms/dl, the TSH decreased to 10 mU/ml, while maintaining the 12
      micrograms/kg dose. After 2 months an oral challenge with cow's milk confirmed
      the diagnosis of CMPI with a concomitant decrease in serum T4 to 6.4
      micrograms/dl, while TSH rose to 64 mU/ml. Weight and T4 levels normalised with
      CMPI diet. At 12 months of age the patient presented anorexia and impaired
      growth.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341225
TI  - [Chondrodysplasia punctata (the Conradi-Hunermann syndrome). A clinical case
      report and review of the literature].
AB  - A case of chondrodysplasia punctata (CDP) a mild form of Conradi-Huenermann type
      in a male newborn is presented. CDP is a bone dysplasia with the hallmark of
      stippling of the epiphyses. Although stippling of the epiphyses can be seen in
      several disorders and syndromes such as Zellweger sy., trisomy 21 sy., trisomy 18
      sy., fetal alcohol syndrome, following ingestion of warfarin or phenytoin during
      pregnancy, the term describes a group of different clinical features involving
      the bones, skin and eyes with different inheritance transmission: autosomal
      dominant type, autosomal recessive type, X-linked dominant type, X-linked
      recessive type with deletion of terminal short arm, duplication of short arm of
      chromosome 16. The rhizomelic form of CDP is considered a peroxisomal disorder,
      due to reduced activity of some enzymes: DHAP-AT, phytanic acid oxidase, alkil
      DHAP synthase. The Conradi-Huenermann syndrome has also been considered by some
      authors as a peroxisomal disorder. A brief description of these disorders and
      their classification in groups will follow.

PMID- 8341226
TI  - [The persistence after clinical recovery and the suspension of therapy of altered
      ESR values in a case of meningococcal sepsis and septic shock].
AB  - The paper describes a case of meningococcal sepsis and septic shock treated with
      Ceftriazone, Dexamethosone, plasma and heparin. It was observed that contrary to
      other hematological parameters, ESR levels remained high for one month after the
      suspension of antibiotic therapy and complete clinical recovery. The authors
      relate this alteration of ESR values to the administration of plasma during the
      acute phase of the disease.

PMID- 8341227
TI  - [The efficacy of aztreonam in a "bolus dose" in the therapy of urinary tract
      infections in neonates].
AB  - A "bolus dose" of aztreonam was used to treat a sample group of 46 neonates
      suffering from urinary tract infections caused by bacteria thought to be
      sensitive to aztreonam. This treatment proved efficacious in approximately 80% of
      cases.

PMID- 8341228
TI  - [To pediatricians who care for infants with Wolman's disease. Advice for an
      efficacious treatment].

PMID- 8341229
TI  - [The international nomenclature of so-called "constitutional bone diseases"].

PMID- 8341230
TI  - [The growth of the low-birth-weight neonate: assessment at 3 years].
AB  - Follow-up studies of low-birth-weight (LBW) neonates have shown a high incidence
      of growth failure in the first years of life. We evaluated the growth attainment
      (weight, length and head circumference) in 182 LBW neonates discharged from our
      Intensive Care Unit between 1982-84 and included in a 3 years follow-up program.
      The aim of the study is to analyze the correlation between gestational age (GA)
      and subsequent growth failure. Neonates included in the study were divided in 4
      groups (G) according to GA: I G < or = 30 weeks GA; II G = 31-33 weeks GA; III G
      = 34-36 weeks GA; IV G > or = 37 weeks of gestational age. Growth was evaluated
      at 40 weeks GA on the basis of Lubchenco and Battaglia centiles, and thereafter
      at 12, 24 and 36 months according to Scalamandre greeds. Subnormal weight (< 10
      degrees centile) was still evident at 3 years of age in 16.7% of the most
      premature babies (group I), in 6.2% of babies born between 31 and 33 weeks GA
      (group II), in 7.1% of babies in group III and in 16.6% of LBW babies born at
      term of gestation (group IV). Length measurements were satisfactory in PT babies
      as none of them showed a length < 10 degrees centile by 24 months of age. On the
      contrary, in the term LBW neonates group 15.6% of babies still showed subnormal
      length at 3 years of age. Head circumference remained < 10 degrees centile in
      16.6% in the I group, in 6.2% in the II group, 21% in the III group and 30% in
      the IV group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341231
TI  - [The clinical evaluation and immunological response of a new measles vaccine].
AB  - For a number of years the measles vaccine has been tabled to be included among
      the compulsory vaccines with the not impossible aim of wiping out this disease.
      In practice, however, there have been isolated attempts to impose mass
      vaccination but, given that it is not compulsory, there has been a certain degree
      of resistance to the vaccine. In an attempt to interpret the reasons for this
      resistance we have identified three main causes: cultural heritage by family
      doctors and sometimes pediatricians ("a disease which is important to have had").
      Limited information with underestimation of damaging effects of disease
      overemphasis of side-effects of vaccine and, among these, in particular fever
      which 30-35% of vaccinated children present between day 8-10, and the possible
      allergic reaction (chicken embryos-antibiotics). Using the latter as a starting
      point, we assessed the efficacy and tolerability of the Moraten Berna vaccine on
      165 children aged between 10 months and 8 years. This vaccine is prepared using
      the Edmonston Zagreb strain cultured in diploid human cells, and does not
      therefore contain heterologous proteins, seroconversion was assessed in 54 of the
      vaccinated children (aged 10 months--3 years) by blood sample collected following
      an interval of between 40 and 120 days after vaccination. Anti-measles antibody
      titering was assayed using a neutralisation test on plates of cellular monostrate
      by assessing the titer (starting dilution of serum in test: 1:8). Seroconversion,
      as shown in table I, was obtained for all vaccinated subjects who presented a
      mean antibody titer of 916 mUI/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341232
TI  - [Cranial fractures during growth. An analysis of the authors' personal cases and
      therapeutic management of such childhood pathology].
AB  - Growing skull fractures are a rare complication of head injury with a dome
      fracture. The cases described in literature highlight a higher frequency of this
      pathology in children under than over three years of age. The authors describe 4
      personal cases, underlying the clinical, diagnostic and therapeutic aspects. The
      aetiological hypothesis of a dural tear and its anatomic-pathological evolution
      are investigated. The surgical technique of dural and bony repair is also
      discussed. The authors conclude that this complication must be recognized early
      in order to obtain very good results after surgical therapy.

PMID- 8341233
TI  - [The predictive value of antigliadin antibodies (AGA) in the diagnosis of non
      celiac gastrointestinal disease in children].
AB  - Recent antigliadin antibody (AGA) determination has become an important
      diagnostic tool in coeliac disease (CD). Although this test has high sensibility
      for the disease, it is less specific, especially for IgG class, because of its
      having been found in some acute and chronic common intestinal childhood diseases.
      We studied the behaviour of AGA, IgA and IgG, in 234 children affected by various
      gastrointestinal diseases, comparing the results with those obtained in 125
      coeliac children and 788 normal children. The intestinal diseases were as
      follows: irritable bowel syndrome, cow's milk protein intolerance, acute
      infectious diarrhoea, parasitosis, lactase deficiency, recurrent abdominal pain,
      cystic fibrosis, chronic constipation, gastroesophageal reflux, intestinal
      lymphangiectasia, chronic intractable diarrhoea and nodular lymphoid hyperplasia.
      Our results showed that while AGA-IgA were absent in all children studied, with
      the exception of 3 cases of acute diarrhoea, a moderate percentage of AGA-IgG was
      observed in subjects with cow's milk protein intolerance, acute diarrhoea,
      irritable bowel syndrome, lactase deficiency, chronic intractable diarrhoea and
      in a low percentage of children with parasitosis, intestinal lymphangiectasia and
      nodular lymphoid hyperplasia. There was no antibody movement in subjects with
      cystic fibrosis, gastroesophageal reflux, recurrent abdominal pains and chronic
      constipation. The different behaviour of the two antibody classes could be
      explained by the fact that AGA-IgG were detected in diseases where scattered
      areas of mucosal damage could allow the permeability of the macromolecules
      inducing passage of gliadin through the mucosal barrier and immune system-induced
      antibody stimulation.

PMID- 8341234
TI  - [A critical review of the problem of children at audiological and phoniatric risk
      in the first year of life].
AB  - The "M. L. Marenzi" Centre of Infantile Otophoniatrics, in collaboration with the
      Department of Neonatal Pathology of the Fatebenefratelli Hospital in Milan,
      performed longitudinal controls of an audiological and phoniatric type in 252
      children. In the present study attention is focused in particular on audiological
      evaluations made in a group of 71 infants aged from 6-9 months old. During
      audiological tests the evaluation of auditory capacity and the type of response
      to acoustic stimulus were taken into account. The behavioural observation of
      selective attention to sound is a very important index of the maturity of
      sensorial patterns. The retarded development of response to an acoustic stimulus
      may indicate future communication disorders. The type of response to acoustic
      stimulus obtained in 71 infants were compared with those in a further two groups
      of children: the first comprised 3822 children with no audiological risk, and the
      second 3755 children at audiological risk according to Feinmeser and Telly's
      expanded list. This comparison highlighted a significant persistence of an
      archaic-type response in the group of infants from the Department of Neonatal
      Pathology. It is therefore essential that these children are examined further
      from a phoniatric point of view.

PMID- 8341235
TI  - Emergency department response to domestic violence--California, 1992.
AB  - A 1993 national poll found that 34% of adults in the United States report having
      witnessed a man beating his wife or girlfriend and that 14% of women report that
      a husband or boyfriend has been violent with them (1). Studies suggest that as
      many as 30% of women treated in emergency departments (EDs) have injuries or
      symptoms related to physical abuse (2). A national health objective for the year
      2000 is for at least 90% of hospital EDs to have protocols for routinely
      identifying, treating, and referring victims of sexual assault and spouse abuse
      (objective 7.12) (3). The Joint Commission on Accreditation of Healthcare
      Organizations (JCAHO) has also recommended that accredited EDs have policies,
      procedures, and education in place to guide staff in the treatment of battered
      adults (4). To assess progress toward the national health objective for the year
      2000 and the JCAHO standards, all active EDs in California were surveyed during
      November-December 1992 about their policies and practices for the treatment of
      battered adults. This report presents findings of this survey.

PMID- 8341236
TI  - Radical prostatectomies--Wisconsin, 1982-1992.
AB  - Prostate cancer incidence and death rates have increased during the past decade
      in the United States (1). In addition, a recent study of the Medicare population
      indicated that the rate of radical prostatectomies (the removal of the prostate
      gland, ejaculatory ducts, and seminal vesicles) increased nearly sixfold from
      1984 through 1990 (2). To examine trends in prostate cancer incidence and
      surgical treatment in Wisconsin, the Wisconsin Division of Health assessed data
      from 1982 through 1992. This report summarizes the results of this study.

PMID- 8341237
TI  - Tuberculosis--Western Europe, 1974-1991.
AB  - In several industrialized countries, declines in trends in reported tuberculosis
      (TB) have stabilized or reversed. This phenomenon was first recognized in the
      United States and subsequently observed in Western European countries. This
      report summarizes a 1992 assessment of trends in TB morbidity and mortality in 15
      countries of Western Europe (Table 1) by the Tuberculosis Program of the World
      Health Organization (WHO).

PMID- 8341238
TI  - [Stimuli from surgical stress and epidural anesthesia].

PMID- 8341239
TI  - [Treatment of recurrent laryngeal nerve paralysis by several types of nerve
      suture].
AB  - Although simple neurorrhaphy of the injured recurrent laryngeal nerve usually
      results in impaired movements of the vocal cord because of misdirected
      regeneration, phonation recovers because the vocal cord maintains tension during
      phonation. Simple neurorrhaphy is possible in only a few of patients who have had
      their nerve severed because of thyroid surgery for thyroid cancer. We tried free
      nerve grafting, vagus nerve-recurrent nerve suture and ansa cervicalis-recurrent
      nerve suture as well as the simple neurorrhaphy in 3, 1, 1 and 3 patients,
      respectively. All of the 8 patients who had repair of the recurrent nerve
      recovered from hoarseness. Maximum phonation times of these patients ranged from
      17 to 41 sec with a mean of 26.5 +/- 9.6 sec, which were significantly longer
      than those of 23 patients without nerve repair. Each modality of the repair
      obtained similar good results, although the patient who underwent vagus-recurrent
      suture required a longer period for recovery. These results indicate that not
      only simple neurorrhaphy of the recurrent nerve but also free nerve grafting,
      vagus nerve-recurrent nerve suture, or ansa cervicalis-recurrent suture are
      effective in recovery of the phonation in patients with peripheral and unilateral
      recurrent nerve paralysis.

PMID- 8341240
TI  - [Tissue oxygen metabolism and cellular injury in patients with septic multiple
      organ failure (SMOF)].
AB  - The present study was undertaken to study the pathophysiology of SMOF from the
      aspect of tissue hypoxia. Seventeen postoperative SMOF patients (9 survivors, 8
      non-survivors) and 14 control ICU patients were evaluated their oxygen delivery
      (DO2I) and oxygen consumption (VO2I) in relation to cellular injury score (CIS)
      derived from 3 different intracellular metabolic indices, arterial ketone body
      ratio (AKBR), osmolality gap (OG) and blood lactate. In the early stage, SMOF
      patients showed hyperdynamic state and increased VO2I, reflecting increased
      oxygen demand in tissue. However, CIS of SMOF was significantly higher than that
      of control in spite of increased VO2I, indicating relative tissue hypoxia might
      exist in vital organs resulting in cellular injury. Further deterioration of CIS
      was accompanied with decreased VO2I. These data suggest that impaired tissue
      oxygen metabolism correlates with cellular injury and might be one of mechanisms
      of organ failure in SMOF patients.

PMID- 8341241
TI  - [Surgical stress induces the secretion of alpha human atrial natriuretic
      peptide].
AB  - The changes in plasma alpha-hANP level and the factors affecting its secretion
      were studied in 35 patients treated by surgery for gastrointestinal disease
      (laparotomy group, 17) and (non-laparotomy group, 18). They did not have any
      particular complication during the study period. alpha-hANP, catecholamine (CA),
      antidiuretic hormone (ADH), aldosterone and plasma renin activity (PRA) were
      determined serially before and after the surgery. Plasma alpha-hANP level
      elevated on the post-operative day 1 and dropped to the upper limit of the normal
      range by the day 3, then gradually recovered to the level of before surgery. This
      early elevation of alpha-hANP was more marked in the laparotomy group than in the
      non-laparotomy group. These change in alpha-hANP level correlated well to those
      of CA, but not to those of ADH, aldosterone, and PRA. Age, sex, duration of
      surgery, bleeding and infusion volume during surgery did not affect the
      difference in alpha-hANP secretion between the two groups. In conclusion, the
      early elevation of plasma alpha-hANP level was correlated well to the surgical
      stress, and that this alpha-hANP secretion might be induced by CA secretion.

PMID- 8341242
TI  - [The surgical management of blunt liver trauma].
AB  - One hundred and sixty-six consecutive patients with closed hepatic injury
      admitted to Osaka University Hospital from 1966 to 1990 were reviewed to evaluate
      the surgical procedures for injured liver. Of the 166 patients, 37 died within 24
      hours of initial management. Thirteen (35%) of the 37 died related to
      exsanguinating hemorrhage of liver injury. Emergency laparotomy required hepatic
      resection in all and revealed hepatic vein or retrohepatic caval injuries in 9.
      Eighty-nine of 129 patients who survived over 24 hours of initial management
      underwent emergency laparotomy. Twenty-two of the 129 died thereafter. Five (3
      underwent lobectomy and 2 simple suture) died of liver injury-related
      complications. Perihepatic packing was performed in 5 and all except for 2 of
      brain death were alive. Most complications except for hemobilia were well
      resolved. CT scan study revealed profoundly radiating injuries closed to spine in
      63% and suggested existence of hepatic vein or caval injury. Especially, 20 of 31
      CT studies (65%) in conservative management of liver injury showed the same
      findings with intact capsule. These results support that exsanguinating
      hemorrhage from deep injury including hepatic vein or vena cava is the most
      lethal but can be controlled with liver packing in a similar mechanism to liver
      trauma in conservative management.

PMID- 8341243
TI  - [Outcome of surgical treatment for Graves's disease and a correlation between its
      clinical course and values of TSH receptor antibodies (TRAb)].
AB  - Two hundreds and sixteen patients with Graves' disease who underwent subtotal
      thyroidectomy at Ito Hospital during 1983 and 1984 were studied in order to known
      about the relationship between the prognosis and preoperative values of TRAb.
      There were 65 euthyroid patients (30.1%), 112 hypothyroid (51.8%), and 39
      hyperthyroid (18.1%). No relationship between postoperative thyroid function and
      preoperative values of TRAb was observed. Postoperative values of TRAb were
      significantly higher in hyperthyroid group than in euthyroid group and
      hypothyroid group at any period. Postoperative values of TRAb were negative in
      about 90% of the patients of euthyroid group. On the other hand, negative
      postoperative values of TRAb were also observed in about 40% patients of
      hyperthyroid group. It is concluded that postoperative thyroid function could not
      be estimated from preoperative values of TRAb and much care is thought to be
      necessary to estimate the prognosis from postoperative values of TRAb.

PMID- 8341244
TI  - [Peri- and postoperative management in one staged operation of cardiac disease
      combined with pectus excavatum].
AB  - Patients with pectus excavatum occasionally have coexisting surgical heart
      disease. During a 10-year period up to the end of 1988, we surgically treated a
      total of 2015 cases of pectus excavatum, including 12 cases with one staged
      operation for pectus excavatum and heart disease. Proving the advantage of our
      one staged operation for the coexisting diseases we studied data resulting from
      the perioperative management in the group of one staged operations (n = 5), and
      in the other group of single valve replacement (n = 10). Operative time, amount
      of operative blood loss and total amount of transfused blood, were 433 +/- 66
      min. (mean +/- SD), 3180 +/- 1867 ml and 4836 +/- 2247 ml, in the former group (n
      = 5), respectively. These data were almost similar to those in the latter group
      (n = 10). Postoperative ventilatory support time and ICU stay time also showed
      little difference between two groups. We conclude these data supports our
      previous report that one staged operation has no perioperative disadvantage in
      the surgical treatment of patients with both cardiac disease and pectus
      excavatum.

PMID- 8341245
TI  - [Intraoperative assessment of left ventricular function with left ventricular
      pressure-volume relationships in patients with open heart surgery].
AB  - There are few reports on the assessment of the left ventricular function from
      left pressure-volume relationships intraoperatively in open heart surgery. LV
      Emax, Ea/Ees and EW/PVA efficiency were assessed intraoperatively by using a left
      ventricular conductance catheter in patients with aortocoronary bypass. After
      dobutamine administration (DOB, 10 micrograms/kg/min), LV Emax was increased by
      33 +/- 23% during cardiopulmonary bypass (CPB) and 60 +/- 38% after weaning from
      CPB. Ea/Ees changed from 2.14 +/- 1.36 to 1.08 +/- 0.47 after weaning from CPB
      with dobutamine administration. EW/PVA efficiency changed from 52 +/- 12% to 66
      +/- 10%. The change of LV Emax after dobutamine administration was correlated
      with the change of LV Emax after weaning from CPB and was correlated with Ea/Ees
      and EW/PVA efficiency after weaning from CPB. We concluded that measuring LV Emax
      before and after dobutamine administration during CPB is useful to assess left
      ventricular contraction clinically.

PMID- 8341246
TI  - [Resected roentgenographically occult bronchogenic squamous cell carcinoma tumor
      size, survival and recurrence].
AB  - The relationship between tumor size and nodal involvement of resected
      roentgenographically occult squamous cell carcinoma in 127 cases was documented.
      Survival and recurrent patterns were analyzed. Intrabronchial invasion was
      observed in 103 cases and extrabronchial invasion in 24 cases. One hundred and
      nineteen cases (94%) had N0 diseases, six (5%) N1 diseases and two (2%) N2
      diseases. One hundred and one cases were in early stage and 26 in non-early
      stage. Nodal involvement was observed in two (2%) of the 103 cases with
      intrabronchial invasion and in six (25%) of the 24 cases with extrabronchial
      invasion. Nodal involvement was noted in none (0%) of 55 cases in whom
      longitudinal extension of tumors was within 10mm, but was noted in four (9%) of
      46 cases in whom it was 11 to 20mm and in four (15%) of 26 cases in whom it was
      21 to 55mm. Death from primary lung cancer occurred in three (12%) of the non
      early cases, but in none (0%) of the early cases. Death from multiple
      metachronous lung cancer occurred in one (4%) of the non-early cases and in three
      (3%) of the early cases. Nodal and extrabronchial involvement reduced survival.
      Recurrence often involved hilar, mediastinal, supraclavicular nodes, and surgical
      margin of bronchus.

PMID- 8341247
TI  - [The influence of cholesterol feeding on the anastomotic region of the induced
      atherosclerotic rabbit vessels--especially on the late occlusive process].
AB  - Late occlusive complication of implanted graft may occur 6 months to 5 years
      after operation. The most frequent cause of this condition is considered to be an
      intimal thickening at the anastomotic sites. The relationship between this
      intimal thickening and cholesterol feeding in rabbits was investigated. Twenty
      eight male New Zealand White Rabbits were assigned following 4 groups. Group 1:
      given 0.1% cholesterol containing rabbit pellets after denudation of endothelium
      Group 2: given standard laboratory rabbit pellets after denudation Group 3: given
      0.1% cholesterol rabbit pellets without denudation Group 4: given standard rabbit
      pellets without denudation Anterior half of infrarenal abdominal aorta of all
      rabbits was incised and then continuous over and over suture was carried out.
      Three months later, rabbits were killed and specimens were obtained. In group 1,
      3 specimens out of 7 were found significant intimal thickening near anastomosis,
      whereas, in group 2 specimens showed regular thickening which seemed to be
      affected by denudation of endothelium. In group 3, intimal thickening localized
      only near anastomosis was found. From these results, we concluded intimal
      thickening at the anastomotic sites can be considered as the initial stage of
      atherosclerosis and cholesterol would be one of the important factors which
      promote this thickening.

PMID- 8341248
TI  - [A case of postpartum silent thyroiditis misapprehended as malignant lymphoma of
      the thyroid].
AB  - A case of postpartum silent thyroiditis misapprehended as malignant lymphoma of
      the thyroid is reported. The patient was a 30-year-old female who had received
      irradiation therapy to the neck for malignant lymphoma 9 years ago. She was
      referred to our department owing to a struma accompanying rapid aggravation of
      chronic thyroiditis after delivery. The mechanism of this case was possible to be
      explained by immune rebound theory. It was difficult to make differential
      diagnosis of this case from malignant lymphoma of the thyroid clinically and
      cytologically when immune rebound phenomena with invasion of lymphocyte and
      appearance of lymph follicle were the strongest. Immune state of the patients
      with chronic thyroiditis accompanied by morphological change should be taken into
      consideration in the process of making diagnosis of malignant lymphoma of the
      thyroid.

PMID- 8341249
TI  - [Successful operation for two cases of an aneurysmal bone cyst of the rib].
AB  - An aneurysmal bone cyst involving the rib is very rare. A 43-year-old man and 49
      year-old woman complained of pain and swelling on the chest. X-ray and CT
      revealed a local expansion and honeycomb lesion of the right 9th rib. Surgical
      excision of the rib were performed to remove the tumor completely. The
      histopathological examination revealed that the lesion consisted of many cavities
      filled with blood and trabecullae containing osteoid tissue and giant cells,
      showing it to be an aneurysmal bone cyst. Because of the potential for the rapid
      growth and difficulty in differentiation between benign and malignant rib tumor,
      an excisional biopsy should be considered for the treatment of an aneurysmal bone
      cyst of the rib.

PMID- 8341250
TI  - [Delayed surgical treatment of traumatic injury of the thoracic aorta].
AB  - A 55-year-old male, who had fallen down from a tree, was brought into the
      emergency room. The initial roentogenogram of the chest showed widening of the
      mediastinum, but CT study did not give the blood leaking out of the aorta. Thus
      the patient was managed in ICU. An aortography showed an aneurysmal dilatation of
      the descending aorta on ninth day after the injury, but we interpreted it may not
      proceed to the free rupture. Therefore we postponed the operation of the aortic
      injury until 41 days after the trauma. Immediate repair may be thought to be the
      first choice for acute traumatic injury of the thoracic aorta, but delayed
      surgery can be achieved safely on selective patients.

PMID- 8341251
TI  - [A case of venous aneurysm].
AB  - A 70-year-old woman was referred to our hospital with a complaint of a soft mass
      at the right elbow. Venography demonstrated that the mass was connected with
      vein. This mass was surgically removed and histologically a marked reduction of
      both elastic fibers and the adventitia were observed in the aneurysmal wall.
      Venous aneurysm (VA) is different form varicose veins by many features. It was
      considered that congenital fragility of the venous walls was associated with the
      onset of VA. We classified VA into type-I VA (cystic ectasia) and type II
      (fusiform ectasia).

PMID- 8341252
TI  - [Three dimensional cholangiography with spiral CT for analysis of biliary tract:
      preliminary report].

PMID- 8341253
TI  - [Modulation by 1-leucovorin of 5-fluorouracil antitumor activity on human gastric
      carcinoma xenograft in nude mouse: preliminary report].

PMID- 8341254
TI  - [Immunohistochemical investigations of proliferating tissues at anastomotic sites
      in saphenous vein grafts: preliminary report].

PMID- 8341255
TI  - Low-temperature-dependent expression of a rice gene encoding a protein with a
      leucine-zipper motif.
AB  - We have isolated from rice suspension cells three non-sequence-related cDNAs the
      expression of which is markedly induced by low, non-freezing temperature. Here we
      further characterize one of the cDNA clones, lip19. Expression of lip19 is
      positively regulated by low temperature, but not affected by high (40 degrees C)
      temperature. Sequencing and primer extension analyses showed that lip19 has a
      long (552 bp) 5' non-coding sequence followed by a single open reading frame
      specifying a protein of 148 amino acids. The deduced amino acid sequence of the
      protein, Lip19, shows at its amino-terminus a conserved basic region followed by
      a "leucine-zipper" domain. The reported sequence most similar to Lip19 is maize
      OCSBF-1, which is a bZip-type DNA binding protein. The possibility is suggested
      that Lip19 is a transcriptional factor that is positively controlled by low
      temperature.

PMID- 8341256
TI  - Domains of colicin M involved in uptake and activity.
AB  - Colicin M inhibits murein biosynthesis by interfering with bactoprenyl phosphate
      carrier regeneration. It belongs to the group B colicins the uptake of which
      through the outer membrane depends on the TonB, ExbB and ExbD proteins. These
      colicins contain a sequence, called the TonB box, which has been implicated in
      transport via TonB. Point mutations were introduced by PCR into the TonB box of
      the structural gene for colicin M, cma, resulting in derivatives that no longer
      killed cells. Mutations in the tonB gene suppressed, in an allele-specific
      manner, some of the cma mutations, suggesting that interaction of colicin M with
      TonB may be required for colicin M uptake. Among the hydroxylamine-generated
      colicin M-inactive cma mutants was one which carried cysteine in place of
      arginine at position 115. This colicin derivative still bound to the FhuA
      receptor and killed cells when translocated across the outer membrane by osmotic
      shock treatment. It apparently represents a new type of transport-deficient
      colicin M. Additional hydroxylamine-generated inactive derivatives of colicin M
      carried mutations centered on residues 193-197 and 223-252. Since these did not
      kill osmotically shocked cells the mutations must be located in a region which is
      important for colicin M activity. It is concluded that the TonB box at the N
      terminal end of colicin M must be involved in colicin uptake via TonB across the
      outer membrane and that the C-terminal portion of the molecule is likely to
      contain the activity domain.

PMID- 8341257
TI  - Promoter specificity and deletion analysis of three heat stress transcription
      factors of tomato.
AB  - Transient expression assays in transformed tobacco (Nicotiana plumbaginifolia)
      mesophyll protoplasts were used to test the activity of three tomato heat stress
      transcription factors, HSF24, HSF8 and HSF30, in a trans-activation and a trans
      repression assay. The results document differences between the three HSFs with
      respect to their response to the configuration of heat stress promoter elements
      (HSEs) in the reporter construct (promoter specificity) and to the stress regime
      used for activation. Analysis of C-terminal deletions identified acidic sequence
      elements with a central tryptophan residue, which are important for HSF activity
      control. Surprisingly, heterologous HSFs from Drosophila and human cells, but not
      from yeast, were also functional as heat stress-induced transcription factors in
      this tobacco protoplast system.

PMID- 8341258
TI  - A family of serine protease genes expressed in adult buffalo fly (Haematobia
      irritans exigua).
AB  - Gene fragments encoding serine proteases expressed in adult buffalo fly
      (Haematobia irritans exigua) were amplified from cDNA using generic
      oligonucleotide PCR primers, based on conserved residues surrounding the active
      site His and Ser amino acids found in all serine proteases. The PCR product
      consisted of a broad band extending from about 450 bp to 520 bp, which suggested
      that the PCR product actually consisted of numerous DNA fragments of slightly
      variable sizes. Seventeen independent clones of these fragments, each with an
      insert of approximately 480 bp, were digested with HaeIII. Comparison of
      restriction fragment patterns indicated that 13 of these clones harboured
      different PCR products. This was confirmed by DNA sequence analysis of 9 clones.
      Each of the sequenced clones contained an open reading frame which included
      structurally conserved regions characteristic of the serine protease superfamily.
      This study reveals the expression of a large and highly variable repertoire of
      serine proteases in adult buffalo fly. Importantly, these data also demonstrate
      the utility of such an approach in obtaining DNA probes for use in further
      investigations of gene family organization and expression, as well as providing
      recombinant antigens in the form of fusion proteins which may be used as
      candidates for vaccine production.

PMID- 8341259
TI  - The heterodimeric protease clostripain from Clostridium histolyticum is encoded
      by a single gene.
AB  - Clostripain (EC 3.4.22.8) is a heterodimeric cysteine endopeptidase with strict
      specificity for Arg-Xaa peptidyl bonds. It is secreted by Clostridium
      histolyticum strains. For the first time we present evidence that both
      polypeptide chains of native clostripain are encoded by a single gene. DNA
      sequencing of two overlapping genomic DNA fragments revealed a single open
      reading frame (ORF) of 1581 nucleotides encoding a polypeptide of 526 amino acid
      residues. The ORF is preceded by canonical transcription signals and both chains
      of the clostripain heterodimer are completely represented by the deduced coding
      sequence. Most interestingly, the sequences coding for the light and the heavy
      chain are joined by a DNA stretch coding for a linker nonapeptide that is
      preceded by the C-terminal arginyl residue of the light chain and also ends with
      an arginyl residue. Heterologous expression of the gene in Escherichia coli
      yielded an enzyme capable of hydrolyzing the clostripain substrates N alpha
      benzoyl-L-arginine ethyl ester (BAEE) and N-carbobenzoxy-L-arginine p
      nitroanilide (Z-Arg-pNA).

PMID- 8341260
TI  - Saccharopolyspora hirsuta 367 encodes clustered genes similar to ketoacyl
      synthase, ketoacyl reductase, acyl carrier protein, and biotin carboxyl carrier
      protein.
AB  - The actI gene, encoding a component of the actinorhodin polyketide synthase of
      Streptomyces coelicolor, was used to identify and clone a homologous 11.7 kb
      BamHI DNA fragment from Saccharopolyspora hirsuta 367. The cloned fragment
      complemented actinorhodin production in a strain of Streptomyces coelicolor
      bearing a mutant actI gene. The DNA sequence of a 5.1 kb fragment revealed 6 open
      reading frames (ORF). ORF1 does not resemble any known DNA or deduced protein
      sequence, while the deduced protein sequence of ORF2 resembles that of biotin
      carboxyl carrier proteins. Based on the similarity to deduced protein sequences
      from cloned genes of polyketide producers, ORF3 would code for a ketoreductase,
      ORF4 and ORF5 for the putative heterodimeric beta-ketoacyl synthase, and ORF6 for
      an acyl carrier protein.

PMID- 8341261
TI  - Isolation and characterization of mutants with impaired regulation of rpsA, the
      gene encoding ribosomal protein S1 of Escherichia coli.
AB  - In order to select mutants that would help to characterize the post
      transcriptional regulation of rpsA, we constructed a strain in which the growth
      rate on lactose minimal medium is determined by the amount of an rpsA-lacZ' alpha
      fragment fusion protein produced, even when this is encoded by a high-copy-number
      plasmid. In the parental strain, synthesis of the fusion protein is repressed by
      a wild-type rpsA gene, present on a compatible plasmid. Twenty-eight spontaneous
      and independent mutants, all of them mapping in the rpsA leader region, were
      isolated as strains that showed higher growth rates, on lactose medium, due to
      increased synthesis of the rpsA-lacZ' fusion protein. Among these mutants only
      three sequence changes were found, mapping 9, 10 and 27 bases upstream of the
      rpsA start codon. At both the -9 and -10 positions an A to G transition and at 
      27 a C to G transversion all resulted in a sequence with better complementarity
      to the 3' end of 16S rRNA. We also isolated two mutations mapping in the plasmid
      encoded rpsA structural gene: an ochre nonsense mutation in codon 15 of the rpsA
      gene and a frameshift mutation, deleting the T residue at position +1186. To
      facilitate the in vitro assay of alpha-fragment activity we also constructed a
      strain that overproduces the alpha-acceptor fragment four-fold relative to a
      strain that is diploid for this lacZ delta M15 allele.

PMID- 8341262
TI  - Cloning and characterization of the gamma-glutamyl phosphate reductase gene of
      Campylobacter jejuni.
AB  - The gamma-glutamyl phosphate reductase gene, proA, of Campylobacter jejuni was
      isolated from a recombinant pBR322 clone. A HindIII fragment of the insert
      containing the gene was subcloned into pUC19 and sequenced in both orientations.
      The deduced amino acid sequence of gamma-glutamyl phosphate reductase (EC
      1.2.1.41) of C. jejuni exhibits 36.4% identity to that of Escherichia coli and
      36.0% identity to Serratia marcescens. Two highly conserved regions in the amino
      acid sequence were identified from the alignment of the three available gamma
      glutamyl phosphate reductase gene sequences. The gene was expressed from its own
      promoter and the transcription start site was mapped. The proline biosynthetic
      genes of C. jejuni are not located tandemly and thus differ in this respect from
      those of E. coli and S. marcescens, where gamma-glutamyl phosphate reductase and
      gamma-glutamyl kinase (proB) are located in a single operon.

PMID- 8341263
TI  - Budding yeast mutants showing constitutive basal levels of expression of DNA
      synthesis genes.
AB  - Two mutants have been isolated in Saccharomyces cerevisiae in which transcripts
      from at least CDC8, CDC9, CDC21 (TMP1) and POL1 genes are expressed
      constitutively in cells blocked at START by use of either alpha-pheromone or the
      cdc28 mutation. The transcripts from these genes also persist in mutant
      stationary phase cells; however, cell cycle regulation of these four DNA
      synthesis genes occurs normally in late G1. The mutation therefore does not
      appear to lie in the MCB-DSC1 (MBF) system that controls the periodic regulation
      of the genes, but must affect some control mechanism regulating basal levels of
      expression.

PMID- 8341264
TI  - A nucleotide substitution in one of the beta-tubulin genes of Trichoderma viride
      confers resistance to the antimitotic drug methyl benzimidazole-2-yl-carbamate.
AB  - We characterized a Trichoderma viride strain that is resistant to the antimitotic
      drug methyl benzimidazole-2-yl-carbamate (MBC). This species has two beta-tubulin
      genes (tub1 and tub2) and by reverse genetics we showed that a mutation in the
      tub2 gene confers MBC resistance in this strain. Comparison of the tub2 sequence
      of the mutant strain with that of the wild type revealed that a single amino acid
      substitution of tyrosine for histidine at a position 6 is responsible for the MBC
      tolerance. Furthermore, we showed that this gene can be used as a homologous
      dominant selectable marker in T. viride transformation. Both tubulin genes were
      completely sequenced. They differ by 48 residues and the degree of identity
      between their deduced amino acid sequences is 86.3%.

PMID- 8341265
TI  - Chitin synthetase mutants of Phycomyces blakesleeanus.
AB  - Mutants resistant to nikkomycin, an inhibitor of chitin biosynthesis, were
      isolated after exposure of wild-type spores of the fungus Phycomyces
      blakesleeanus to N-methyl-N'-nitro-N-nitrosoguanidine. Genetic analysis revealed
      that nikkomycin resistance was due to mutations in a single gene, chsA. Mutants
      and wild type grew equally well in the absence of nikkomycin. In contrast to the
      wild type, whose spore germination and mycelial growth were inhibited by 5 microM
      nikkomycin, chsA mutants grew reasonably well in the presence of 50 microM
      nikkomycin. Chitin synthesis in vivo was much less affected by the drug in the
      mutants than in the wild type. Resistance was not due to impaired uptake or
      detoxification of the drug. Analysis of the kinetics of chitin synthesis in vitro
      showed that the mutants had a decreased Ka for the allosteric activator, N
      acetylglucosamine, and gross alterations in nikkomycin inhibition kinetics. These
      results indicate that chsA is the structural gene for chitin synthetase, or at
      least for the polypeptide that bears the catalytic and allosteric sites.

PMID- 8341266
TI  - A cloned angiotensin receptor isoform from the turkey adrenal gland is
      pharmacologically distinct from mammalian angiotensin receptors.
AB  - A 2046-base pair cDNA clone, homologous to mammalian angiotensin (AT) AT1
      receptors, was isolated from a library prepared from adrenal glands of the
      domestic turkey (Meleagris gallopavo). Sequence analysis of the cDNA insert in
      clone pTAT2' reveals a 1077-base pair open reading frame predicting a 359-amino
      acid protein approximately 75% homologous to mammalian AT1 receptors. Saturation
      radioligand binding studies performed in membranes of COS-7 cells transfected
      with pTAT2' show high affinity specific binding of 125I-angiotensin II, with a Kd
      of 172 pM. The rank order of affinities for a series of ligands determined by
      competition binding studies is angiotensin II > or = [Sar1,Ile8]-angiotensin II >
      angiotensin III approximately [Sar1,Ala8]-angiotensin II approximately CGP42112A
      > angiotensin I > Dup753 > PD123177. This rank order of affinity series differs
      substantially from that for mammalian AT1 receptors and AT2 binding sites.
      Angiotensin II (100 nM) can stimulate inositol phosphate production similarly in
      COS-7 cells transfected with pTAT2' and in COS-7 cells transfected with the AT1a
      receptor cDNA pCa18b. This response in pTAT2'-transfected cells is not attenuated
      in the presence of 30 microM Dup753. In contrast, this concentration of
      antagonist attenuates > 90% of the inositol phosphate response to angiotensin II
      in COS-7 cells transfected with the rat AT1a receptor cDNA. These results
      demonstrate an avian structural homologue of mammalian AT1 receptors possessing
      distinct pharmacological properties with both peptide and nonpeptide AT receptor
      ligands.

PMID- 8341267
TI  - Measurement of guanine nucleotide-binding protein activation by A1 adenosine
      receptor agonists in bovine brain membranes: stimulation of guanosine-5'-O-(3
      [35S]thio)triphosphate binding.
AB  - Signal transduction by A1 adenosine receptors was investigated by measuring the
      modulation by adenosine agonists of guanosine-5'-O-(3-[35S]thio)triphosphate
      ([35S]GTP[S]) binding to guanine nucleotide-binding proteins (G proteins). The
      extent of stimulation of [35S]GTP[S] binding was dependent on the presence of
      high concentrations of Mg2+ (1-10 mM), GDP (10 microM), and NaCl (100 mM). Under
      optimal conditions, the agonist (R)-N6-phenylisopropyladenosine [(R)-PIA]
      stimulated binding of [35S]GTP[S] to G proteins approximately 2.3-fold. All
      adenosine receptor agonists tested stimulated the binding of [35S]GTP[S] with a
      rank order of potency typical of A1 adenosine receptors in bovine tissues, (R)
      PIA > 2-chloro-N6-cyclopentyladenosine > (S)-PIA > 5'-N-ethylcarboxamidoadenosine
      > 2-[4-(2-carboxyethyl)phenethylamino]-5'-N-ethylcarboxamidoadenosin e. The EC50
      values for G protein activation correlated with the Ki value of agonists for
      inhibition of radioligand binding to the high affinity state of the A1 adenosine
      receptor. The inclusion of 100 mM NaCl as well as increasing GDP concentrations
      led to a parallel increase of Ki values and EC50 values. In addition, both
      compounds induced a shift of A1 adenosine receptors from the high affinity state
      for agonists to the low affinity state.

PMID- 8341268
TI  - Mutations leading to antifolate resistance in Chinese hamster ovary cells after
      exposure to the alkylating agent ethylmethanesulfonate.
AB  - Chinese hamster ovary cells with a single allele for dihydrofolate reductase were
      used as a model system to study the effect of exposure to an alkylating agent,
      ethylmethanesulfonate, on rates and types of mutations at the dihydrofolate
      reductase locus leading to antifolate resistance. After overnight exposure to 400
      micrograms/ml ethylmethanesulfonate, cells were allowed to recover for 3 days,
      and resistant colonies were selected in 8 x 10(-8) M trimetrexate. Trimetrexate,
      rather than methotrexate, was used as the selecting agent to increase the
      probability of obtaining mutations in dihydrofolate reductase, rather than in the
      reduced folate transport carrier protein. Seven of several hundred surviving
      colonies were selected at random, and cell lines were established. Cell lines 1-3
      were maintained in culture in the presence of 8 x 10(-8) M trimetrexate and were
      66-170-fold resistant to the drug. Cell lines 4-7 were initially expanded in 8 x
      10(-8) M trimetrexate but were then maintained in the absence of the drug. These
      cell lines were 4.4-26-fold resistant to the drug, compared with the parental
      cell line. Cell line 1 was found to have an increase in dihydrofolate reductase
      activity, a corresponding increase in mRNA for dihydrofolate reductase, and
      amplification of this gene. Cell lines 2 and 6 had a mutated dihydrofolate
      reductase with altered trimetrexate- and methotrexate-binding properties. Cell
      line 3 had a 3-fold increase in dihydrofolate reductase activity. In cell lines
      4, 5, and 7 the mechanisms of resistance to trimetrexate remain unknown.

PMID- 8341269
TI  - Novel endothelin receptors in the follicular membranes of Xenopus laevis oocytes
      mediate calcium responses by signal transduction through gap junctions.
AB  - Follicular oocytes from Xenopus laevis display saturable and high affinity
      endothelin (ET)-1 binding sites. Competition binding experiments using unlabeled
      ET-1, ET-3, and sarafotoxin 6c indicated that these ET receptors belong to the
      ETA receptor subtype. However, the ETA receptor-selective antagonist BQ123
      [cyclo(D-Trp,D-Asp,L-Pro,D-Val,L-Leu)] failed to inhibit 125I-ET-1 binding to
      these receptors, suggesting that these receptors belong to a novel subtype of ETA
      receptors (ETAX) distinct from the human ETA receptors. These endogenous
      receptors are present in the follicular layer, because defolliculated oocytes did
      not show any 125I-ET-1 binding. Addition of ET-1 to follicular oocytes led to
      Ca2+ mobilization, which was reversibly blocked by treatments that uncouple gap
      junctions, suggesting that these ETAX receptors mediate their response by
      transferring signals through gap junctions. On the other hand, the expressed
      human ETA receptor-mediated Ca2+ mobilization was not blocked by inhibitors of
      gap junctions. In agreement with the binding data, the endogenous ETAX receptor
      mediated response was not inhibited by BQ123 even at 100 nM, whereas the
      expressed human ETA receptor-mediated response was inhibited by 50% at
      concentrations as low as 10 nM. This further confirms that the amphibian ETAX
      receptors are different from mammalian ETA receptors. Finally, ET-1 enhanced the
      rate of progesterone-induced maturation of follicular oocytes, implying the
      involvement of these endogenous ETAX receptors in an in vivo maturation process.

PMID- 8341270
TI  - Endothelin- and ATP-induced inhibition of adenylyl cyclase activity in C6 glioma
      cells: role of Gi and calcium.
AB  - Endothelin-1 (ET) and ATP mobilize Ca2+ in rat C6 glioma cells by stimulating
      phosphoinositide turnover. Both agents also inhibit adenylyl cyclase (AC)
      activity in C6 glioma cells. The goal of this study was to characterize the
      molecular mechanisms responsible for the inhibition of AC activity. The
      administration of either ET, ATP, A23187, or thapsigargin to cells simultaneously
      with isoproterenol for 5 min inhibited isoproterenol-stimulated cAMP synthesis by
      a maximum of 60%, 91%, 65%, and 68%, respectively. Pretreatment of cells with
      pertussis toxin (PTX) did not alter the inhibitory effects of A23187 or
      thapsigargin, whereas the inhibitory effects of ET or ATP were completely
      eliminated. Removal of extracellular Ca2+ and 1,2-bis(2-aminophenoxy)ethane
      N,N,N',N'- tetraacetic acid acetoxymethyl ester treatment failed to affect the
      inhibition caused by ET or ATP, whereas the inhibition caused by A23187 or
      thapsigargin was completely eliminated in Ca(2+)-free medium and was attenuated
      by 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid acetoxymethyl ester
      treatment. The inhibition by both receptor agonists in the earlier phase (30 sec)
      of the AC reaction was, however, reduced by using either Ca(2+)-free medium or
      PTX pretreatment. The administration of 3-isobutyl-1-methylxanthine or Ro 20-1724
      suggested that the inhibitory effects of A23187 and thapsigargin were partially
      due to Ca(2+)-dependent stimulation of PDE activity. Short term treatment with
      phorbol-12-myristate-13-acetate (PMA) had no effect on isoproterenol-stimulated
      AC activity. However, the inhibition of cAMP induced by ET or ATP, but not by
      A23187 or thapsigargin, was diminished by PMA, suggesting that the receptor
      signal via Gi was blocked by PMA treatment. The antagonistic effect of PMA was
      blocked by staurosporine. All four agents still inhibited AC activity in cells
      that had been treated with PMA for 24 hr to deplete protein kinase C. ET produced
      an additional decrease in AC activity in cells that had been treated with a
      maximally effective concentration of A23187 or thapsigargin. The ET- or ATP
      induced decrease in cAMP levels showed homologous desensitization. These results
      demonstrate that ETZ receptors and ATP receptors in C6 glioma cells inhibit AC
      activity primarily by interaction with a PTX-sensitive G(i) and partially by
      elevation of [Ca(2+)]. Protein kinase C activation is not responsible for agonist
      induced inhibition of AC but appears to uncouple the G(i)/AC system activated by
      ET or ATP.

PMID- 8341271
TI  - Barium blockade of a clonal potassium channel and its regulation by a critical
      pore residue.
AB  - Barium ion (Ba2+) has the same crystal radius as potassium ion but blocks rather
      than permeates the ion-conducting pore of K+ channels. Ba2+ ion may therefore be
      used as a probe of residues lining the pore of K+ channels, and we applied it to
      test the position and function of a residue crucial for K+/Rb+ selectivity and
      blockade by internal tetraethylammonium. We examined blockade by internal and
      external Ba2+ of the delayed rectifier K+ channel DRK1 (Kv2.1) and tested the
      effects of point mutations at pore residue 374. Internal Ba2+ blocked the wild
      type open channel with high affinity (Kd = 13 microM). Blockade involved more
      than one site, was voltage dependent, and increased at more positive potentials.
      Mutation of V374 to threonine or serine produced a significant decrease in the
      rate of dissociation of internal Ba2+ from the pore, whereas mutation of V374 to
      isoleucine produced no change. For wild-type channels, external Ba2+ decreased
      the rate of activation of the K+ current, suggesting that Ba2+ can interact with
      closed DRK1 channels. This result was unaffected by the V374T substitution.
      Furthermore, external Ba2+ also caused a very low affinity (Kd approximately 30
      mM) and voltage-independent block of the open DRK1 channel. Thus, Ba2+ blocked
      the pore at internal and external sites, which were clearly distinguishable. The
      effects of substitution at position 374 with residues having polar hydroxyls are
      consistent with position 374 being at a surface position critical for ion
      permeation, near the inner mouth of the pore.

PMID- 8341272
TI  - Transport of (2-chloroethyl)-3-sarcosinamide-1-nitrosourea in the human glioma
      cell line SK-MG-1 is mediated by an epinephrine-sensitive carrier system.
AB  - The transport of (2-chloroethyl)-3-sarcosinamide-1-nitrosourea (SarCNU), an
      experimental anticancer compound, was investigated in the human glioma cell line
      SK-MG-1. The transport of [3H]SarCNU was examined in suspension. The uptake of
      [3H] SarCNU was found to be temperature dependent, with influx being linear to 4
      sec at 37 degrees. Equilibrium was reached after 1 min at 22 degrees and 37
      degrees, with accumulation slightly above unity. SarCNU was not significantly
      metabolized in the cells after a 60-min incubation at 37 degrees, as shown by
      thin layer chromatography. At 37 degrees, uptake of [3H]SarCNU was found to be
      saturable, sodium independent, and energy independent. Previous work demonstrated
      that SarCNU was able to inhibit the uptake of sarcosinamide, which is transported
      by the catecholamine uptake 2 system. This catecholamine system mediates the
      physiological transport of epinephrine. Epinephrine was able to significantly
      inhibit the uptake of [3H]SarCNU, at a concentration of 50 microM, by 40%.
      Additionally, several amino acids were unable to inhibit the uptake of SarCNU.
      The initial rate of SarCNU influx is mediated by both facilitated and
      nonfacilitated diffusion. The nonfacilitated diffusion rate could be estimated
      from the linear concentration dependence of the residual influx rate for SarCNU,
      which was not inhibited by the presence of excess co-permeant (epinephrine).
      Dixon plot analysis, corrected for nonfacilitated diffusion of SarCNU, revealed
      that epinephrine inhibited the uptake of SarCNU competitively, with a Ki of 163
      +/- 15 microM, a value similar to the Km value for epinephrine influx in SK-MG-1
      cells. Additionally, after appropriate corrections for nonfacilitated diffusion
      in the influx rates observed for SarCNU, it was revealed that SarCNU influx
      obeyed Michaelis-Menten kinetics over a 200-fold range of concentrations, with a
      Km of 2.39 +/- 0.37 mM and a Vmax of 236 +/- 53 pmol/microliters of intracellular
      water/sec. Metabolic poisons (2,4-dinitrophenol, iodoacetate, NaCN, NaF, or
      ouabain) were unable to inhibit the influx of SarCNU, suggesting that the carrier
      mediated uptake of SarCNU is energy independent and mediated by facilitated
      diffusion. These findings indicate that SarCNU uptake in SK-MG-1 cells is
      mediated both by nonfacilitated diffusion and by facilitated diffusion via the
      catecholamine uptake 2 carrier system. SarCNU is the first chloroethylnitrosourea
      that has been demonstrated to have carrier-mediated uptake. Moreover, this
      carrier-mediated uptake may play a role in the increased cytotoxicity of SarCNU
      against gliomas, compared with that of 1,3-bis(2,-chloroethyl)-1-nitrosourea,
      which enters cells primarily by passive diffusion.

PMID- 8341273
TI  - Role of NAD(P)H:(quinone acceptor) oxidoreductase (DT-diaphorase) in activation
      of mitomycin C under acidic conditions.
AB  - The quinone antitumor agent mitomycin C is preferentially toxic to some cells
      under hypoxic and acidic conditions. The two-electron reducing enzyme DT
      diaphorase may be a major contributor to mitomycin C activation under aerobic
      conditions, but its role in drug activation under hypoxic and acidic conditions
      is unclear. In this study, we observed that mitomycin C produced increased DNA
      cross-linking and cytotoxicity in Chinese hamster ovary cells at pH 6.6, compared
      with pH 7.2, under aerobic conditions, but drug activity was similar at these pH
      values under hypoxic conditions. The DT-diaphorase inhibitor dicoumarol
      completely inhibited the enhanced activity of mitomycin C at acidic pH under
      aerobic conditions but had no effect on DNA cross-linking or cytotoxicity under
      hypoxic conditions. These finding suggest that the enhanced activity of mitomycin
      C at acidic pH, in air, is due to increased drug activation by DT-diaphorase.
      However, the role of DT-diaphorase in activating mitomycin C under hypoxic
      conditions appears to be limited, even at acidic pH.

PMID- 8341274
TI  - Characterization of human liver microsomal cytochrome P450 involved in the
      reductive metabolism of zonisamide.
AB  - Zonisamide (1,2-benzisoxazole-3-methanesulfonamide) was metabolized to 2
      sulfamoylacetylphenol (SMAP) in human liver microsomes under anaerobic
      conditions. The formation of SMAP was remarkably inhibited by cimetidine, n
      octylamine, ketoconazole, and carbon monoxide, indicating that a cytochrome P450
      is involved in the metabolism of zonisamide to SMAP in human liver microsomes.
      The SMAP-producing activity did not correlate with the spectrally determined
      amount of cytochrome P450. In contrast, the SMAP-producing activity from
      zonisamide correlated closely with the activity of testosterone 6 beta
      hydroxylase (r2 = 0.96) and correlated slightly but significantly with the
      activity of imipramine 2-hydroxylase (r2 = 0.28), but not with those of aniline
      hydroxylase (r2 = 0.09) or benzphetamine N-demethylase (r2 = 0.20). In addition,
      immunoquantitation of cytochrome P450 enzymes in 21 human liver microsomal
      samples revealed that SMAP formation correlated closely with the amount of P450
      3A enzyme and correlated moderately well with that of P450 2D6 but not with that
      of P450 2C enzyme in human liver microsomes. P450 3A4 exhibited SMAP-producing
      activity in a reconstituted monooxygenase system. The metabolism of zonisamide to
      SMAP was almost completely inhibited by anti-P450 3A4 antibody but not by anti
      P450 2C9 or anti-P450 2D6 antibodies, suggesting that the amount of P450 3A
      enzyme may be a major factor influencing the level of metabolism of zonisamide to
      SMAP in human liver microsomes.

PMID- 8341275
TI  - 5-Fluorouracil alters dihydrofolate reductase pre-mRNA splicing as determined by
      quantitative polymerase chain reaction.
AB  - A quantitative polymerase chain reaction (PCR) assay has been developed to
      determine the absolute and relative amounts of each dihydrofolate reductase RNA
      species present at different stages of splicing (i.e., pre-mRNA, splicing
      intermediate, and mRNA). The ratios of each RNA species as measured by
      quantitative PCR have been confirmed by S1 nuclease mapping analysis.
      Quantitative PCR studies reveal a concentration-dependent decrease in the levels
      of dihydrofolate reductase mRNA and a splicing intermediate but little change in
      pre-mRNA levels after long term exposure of cells to 5-fluorouracil (FUra). The
      observed changes correlate with the extent of FUra incorporation into RNA and
      with cytotoxicity. These results, together with previous data from our
      laboratory, provide the first direct evidence that FUra incorporation into RNA
      can cause inhibition of pre-mRNA splicing in vivo. Inhibition of pre-mRNA
      splicing is thus a likely additional mechanism by which FUra incorporation into
      RNA may lead to growth inhibition and cell death.

PMID- 8341276
TI  - 5-Amino-4-imidazolecarboxamide riboside potentiates the metabolism and anti-human
      immunodeficiency virus activity of 2',3'-dideoxyinosine.
AB  - The antiviral activity of the purine dideoxynucleosides 2',3'-dideoxyadenosine
      (ddA) and 2',3'-dideoxyinosine (ddI) is dependent on their conversion into ddA
      triphosphate in vivo. 5-Amino-4-imidazolecarboxamide riboside (AICA riboside), a
      natural metabolite in purine biosynthetic pathways, is converted into IMP, a
      substrate for the biosynthesis of adenine and guanine nucleotides, and enhances
      the intracellular purine nucleotide pools. Because IMP also serves as a phosphate
      donor in the anabolic phosphorylation of ddI (and ddA) into ddI monophosphate by
      the cytosolic enzyme 5'-nucleotidase, we investigated the effects of AICA
      riboside on the phosphorylation and antiretroviral activity of these purine
      nucleoside analogs. At an AICA riboside concentration of 0.5 mM, there was a
      approximately 2-fold increase in the intracellular ATP and GTP levels, whereas a
      nearly 8-fold increase was observed for the phosphorylation of ddA (or ddI). A
      marked reduction in intracellular pools of the pyrimidine nucleotides CTP and UTP
      was observed in AICA riboside-treated cells and inhibited cell proliferation.
      However, this growth inhibition was prevented by the addition of uridine to the
      cultures. Cells pretreated with AICA riboside and ddI were less susceptible to
      human immunodeficiency virus (HIV) infection and synthesized reduced levels of
      HIV proviral DNA. A 10-fold potentiation of the effectiveness of ddI against both
      wild-type HIV (HIVIIIB) and a ddI-resistant variant HIV was observed in the
      presence of 0.5 mM AICA riboside. These results show that AICA riboside modulates
      the anabolism and antiviral activity of ddI, and they have implications for
      possible therapies with dideoxynucleosides.

PMID- 8341277
TI  - Commonly occurring plant flavonoids have estrogenic activity.
AB  - A remarkable diversity of naturally occurring and synthetic compounds have been
      shown to mimic the biological effects of 17 beta-estradiol by virtue of their
      ability to bind to and activate the nuclear estrogen receptor. This report
      extends the family of nonsteroidal estrogens to include several multiply
      hydroxylated chalcones, flavanones, and flavones. The hormone-like activity of
      these natural plant products is indicated by their ability to stimulate an
      estrogen receptor-dependent transcriptional response and to promote growth of
      estrogen-dependent MCF7 cells in culture. The transcriptional response can be
      inhibited by the steroidal estrogen antagonist ICI-164,384 and is specific for
      the estrogen receptor. Evidence is presented to show that selected hydroxylated
      flavonoids interact directly with the estrogen receptor, based on their ability
      to compete for the binding of 17 beta-[3H]estradiol to the receptor in cell-free
      extracts. These compounds are less active, on a molar basis, than 17 beta
      estradiol or the synthetic dihydroxystilbene estrogens, but they have potencies
      comparable to those of other known phytoestrogens. Together, these findings
      broaden our understanding of the structure-activity relationships for
      nonsteroidal estrogens and present a series of new chemical prototypes for the
      future development of potentially useful agonists and antagonists for this
      nuclear receptor. The wide distribution of weakly estrogenic flavonoid pigments
      in food crops and medicinal plants raises additional questions about the possible
      health risks and benefits of these compounds, meriting closer examination of
      their presence in the human diet.

PMID- 8341278
TI  - Altered cisplatin and cadmium resistance and cell survival in Chinese hamster
      ovary cells expressing mouse metallothionein.
AB  - Metallothionein (MT) proteins are associated with resistance to the toxic effects
      of heavy metals, chemotherapeutic drugs, and alkylating agents. It has been
      suggested that MT may mediate both resistance to toxic agents and cellular metal
      homeostasis. To study the role of MT, we obtained cells expressing a range of MT
      levels in the absence of heavy metal induction. We cotransfected the eukaryotic
      G418 resistance vector pSV2neo and mouse MT-1 cDNA in a pBR322 vector into
      Chinese hamster ovary cells. Of 200 transfected clonal cell populations, five had
      constitutive MT expression ranging from 31 to 87 ng of MT/mg of protein. All five
      populations had increased resistance to cadmium but were less resistant to
      cisplatin than control cells. On the other hand, the level of foreign MT
      expression correlated well with the degree of cisplatin resistance among the five
      clones. Resistance to ionizing radiation and growth rate in the absence of drug
      or radiation treatment were not affected. However, transfected MT gene expression
      inhibited the ability of Chinese hamster ovary cells to form colonies in the
      absence of toxic drug treatment (r = -0.95). The perturbation of cisplatin
      sensitivity after genetic alteration of MT expression indicates a role for MT in
      drug resistance: however, the fact that transfected MT gene expression decreased
      rather than increased drug resistance and decreased plating efficiency in the
      absence of drug implies that the role of MT may not be one of simply "scavenging"
      toxic molecules. These data suggest a role for MT in homeostatic cellular
      processes that, when distributed by transfection of active MT genes, have an
      effect on cellular drug resistance.

PMID- 8341279
TI  - Postnatal changes in the expression and distribution of pulmonary cytochrome P450
      monooxygenases during Clara cell differentiation in rabbits.
AB  - Previous studies have indicated that both cytodifferentiation of Clara cells and
      the onset of pulmonary cytochrome P450 activity are postnatal events. However,
      the relationship between these two events during lung development remains poorly
      understood. To determine how these events interrelate, we examined rabbit Clara
      cells during postnatal differentiation, with the following goals in mind: 1) to
      identify the patterns of intracellular expression of cytochrome P450
      monooxygenase isozymes 2B and 4B and cytochrome P450 reductase, 2) to describe
      the biogenesis of the organelles with which these isozymes are associated, namely
      smooth and rough endoplasmic reticulum, and 3) to compare the patterns of
      expression with cytochrome P450 activity in the whole lung over the same period.
      Lungs of rabbits ranging in age from 24 days gestational age (DGA) to 25 weeks
      postnatally were studied. Ultrastructural morphometry showed that smooth
      endoplasmic reticulum averaged < 5% of the Clara cell volume in late gestational
      (24-30 DGA) and neonatal rabbits [0-7 days postnatally (DPN)], grew to 20-30% of
      the cell volume in 14-21-DPN animals, and approximated adult levels (> 40%) in 28
      DPN rabbits. In contrast, rough endoplasmic reticulum decreased from > 10% of the
      cell volume at 27 DGA to < 5% in adults. All postnatal animals showed
      considerable heterogeneity in the abundance of smooth endoplasmic reticulum among
      individual cells. Immunohistochemistry revealed that cytochrome P450 reductase
      appeared in Clara cells earlier (28 DGA) than did either isozyme 2B or 4B (1
      DPN). Each antigen was detected first in the apical borders of the cells, then
      throughout the cytoplasm in a few cells by 7 DPN, and finally in adult abundance
      by 28 DPN. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western
      blotting showed that cytochrome P450 protein concentrations increased
      postnatally. Cytochrome P450 heme protein was not detected spectrophotometrically
      in the lungs of animals younger than 3 DPN but increased to approximately 70% of
      adult levels by 28 DPN. Likewise, cytochrome P450 activity (measured as ethoxy-
      and pentoxyresorufin O-dealkylation) was not detected in animals younger than 2
      DPN but increased to approximately 75% of adult levels by 28 DPN.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8341280
TI  - Associated complement C3b. Towards an understanding of its intracellular
      modifications.
AB  - Covalent Superose microspheres-bound C3b was used as a model system to simplify
      the analysis of antigen-bound C3b modifications during antigen processing. The
      model was set up using purified C3 and Superose-bound trypsin. C3b was covalently
      bound to Superose through an ester link, as indicated by lability to
      hydroxylamine treatment at alkaline pH. C3b-Superose was incubated with L
      subcellular fraction, enriched in endosomes/lysosomes, purified from U937 cell
      line. Two types of limited activities on the C3b-Superose model system were
      detected: (i) a proteolytic activity cleaving C3b into mainly a C3c-like fragment
      which was released and a C3d-like fragment of apparent M(r) 32 kDa which remained
      bound to Superose through the original ester link; (ii) an esterolytic activity
      cleaving the ester bond and releasing C3b. Inhibition experiments pointed to the
      involvement of serine, aspartyl and cysteine proteases. Cathepsin B appeared most
      probably as one of the major proteases of L fraction catalysing the proteolysis
      of the C3b-bound. Kinetic studies were in favour of a good stability on the ester
      bond, supporting an effective role of C3b as a chaperone during the extracellular
      and intracellular travel of C3b-bound antigen.

PMID- 8341281
TI  - Development and functional characterization of a murine/human chimeric antibody
      with specificity for the human interleukin-2 receptor.
AB  - A murine/human chimeric antibody, with specificity for the human interleukin-2
      receptor, was developed by genetic engineering. For this purpose, the light and
      heavy chain variable region exons encoding the murine monoclonal antibody 2C8
      were isolated and inserted into expression vectors containing the human kappa and
      gamma-1 constant regions. After transfection by electroporation of the chimeric
      genes into murine Sp 2/0 hybridoma cells, transfectomas secreting the complete
      chimeric antibody were selected. The chimeric antibody has similar binding
      properties as the original murine antibody. The in vitro cytotoxic effects of the
      murine and the chimeric antibodies were compared.

PMID- 8341282
TI  - An alternative method for T-cell receptor repertoire analysis: clustering of
      human V-beta subfamilies selected in responses to staphylococcal enterotoxins B
      and E.
AB  - We have designed a convenient procedure for the analysis of V beta repertoire
      expression in polyclonal T-cell populations. In this procedure T-cell RNA is
      converted to cDNA, polydC-tailed with terminal deoxynucleotidyl transferase and
      submitted to one-side specificity PCR amplification with a constant region
      oligonucleotide primer. The amplified material is then analysed by reverse spot
      test hybridization: after 32P-labelling, the amplification product is put to
      hybridize on a membrane where specially designed V beta subfamily-specific probes
      are immobilized. The radioactivity fixed on each probe can then be easily
      quantified and the signal obtained is directly proportional to the initial amount
      of homologous RNA. We applied this technique to the study of V beta gene
      selection following T-cell stimulation by staphylococcal enterotoxins B and E. We
      show that with these toxins two almost non-overlapping sets of T-cells are
      recruited and that this selection is likely to be dependent on specific amino
      acid residues shaping the fourth complementarity determining region of the TCR
      beta chain. These residues constitute two tandemly-conserved tripeptide sequences
      (Asp39Pro40Gly41)-(Val69Ser70Arg71) and (Arg66Phe67Ser68)-(Asp88Ser89Ala90) in
      the SEB- and the SEE-responsive V beta gene clusters respectively.

PMID- 8341284
TI  - Proteins separated from human IgG molecules.
AB  - Immunoglobulin G binding proteins were separated from human IgG molecules using 1
      N acetic acid followed by 5 M guanidinium chloride in 0.1 M acetic acid. The
      proteins thus obtained were heterogeneous as demonstrated by SDS-PAGE and reverse
      phase HPLC. The isolated proteins consisted of two types: the C3a and C4a
      complement fragments (anaphylatoxins) and immunoglobulin peptide chain fragments
      V kappa I and C gamma 3. Both anaphylatoxins immobilized on cellulose nitrate
      membranes could reassociate with intact IgG molecules. The ubiquitous presence of
      C3a in IgG preparations was demonstrated using monoclonal antibodies specific for
      C3a. Nearly all of the bound anaphylatoxin molecules were found in the Fab
      fragment. These findings suggest that IgG molecules can eliminate anaphylatoxins
      from the circulation, and thus prevent harmful effects due to these active
      complement components.

PMID- 8341283
TI  - Tumor-induced modulation of macrophage class II MHC molecule mRNA expression.
AB  - Class II MHC protein expression in macrophages (M phi) is reduced during tumor
      growth. Because regulation of class II MHC proteins occurs during transcription,
      tumor growth may suppress class II MHC protein expression by suppressing mRNA.
      The decrease in class II mRNA may result from (i) a decrease in M phi
      responsiveness to an inducing agent, such as interferon-gamma (IFN-gamma), or
      (ii) an increase in M phi sensitivity to suppressing agents, such as
      prostaglandin E2 (PGE2). To determine how tumors induce suppression of class II
      mRNA, M phi were cultured in the presence of IFN-gamma with or without other
      factors, and Northern blot analyses were performed. Unstimulated normal host (NH)
      or tumor-bearing host (TBH) M phi do not express detectable class II mRNA. The
      addition of IFN-gamma induces class II mRNA expression in NH and TBH M phi, but
      class II mRNA expression is significantly lower in TBH M phi. Kinetic studies
      suggested that NH M phi class II mRNA is induced faster and in greater amounts
      than TBH M phi class II mRNA. There is a decrease in M phi class II mRNA
      stability during tumor growth that may account for the decreased induction by IFN
      gamma. Lipopolysaccharide (LPS) suppresses class II mRNA induction in both NH and
      TBH IFN-gamma-treated M phi, but TBH M phi are more sensitive to its suppression.
      PGE2 and tumor-necrosis factor-alpha (TNF-alpha), two factors produced by LPS
      stimulated M phi, were tested for their ability to modulate class II mRNA
      expression in NH and TBH IFN-gamma-treated M phi. PGE2 suppressed class II mRNA
      expression in both NH and TBH M phi. The addition of TNF-alpha to IFN-gamma
      treated M phi suppressed class II mRNA in NH M phi but, surprisingly, had an
      additive effect on IFN-gamma-induced class II mRNA expression. TNF-alpha did not
      induce class II mRNA expression in TBH M phi in the absence of IFN-gamma. The
      cause of the reduced class II mRNA expression during tumor growth is a decreased
      response to IFN-gamma and an increased sensitivity to PGE2. This change may cause
      the observed suppression mediated by TBH M phi.

PMID- 8341285
TI  - Cellular recognition and HLA restriction of a midsequence HBsAg peptide in
      hepatitis B vaccinated individuals.
AB  - Vaccination with native HBsAg results in both a humoral and a cellular immune
      response in humans. In individuals who responded to vaccination, the HBsAg (S
      region) specific response, as measured by cell proliferation, diminished
      significantly after 12 weeks, a time when the antibody response was still
      vigorous. Reduced and nonreduced HBsAg were equivalent in eliciting lymphocyte
      proliferation. Anti-MHC class II monoclonal antibodies were used in blocking
      studies to demonstrate that anti-HLA-DR but not anti-HLA-DQ or anti-HLA-DP
      inhibited specific lymphocyte proliferation to HBsAg. Both the monomer (reduced)
      and dimer (nonreduced) forms of an immunodominant midsequence HBsAg peptide
      (amino acid residues 139-146) produced lymphocyte proliferation roughly
      comparable to that induced by whole HBsAg in 6 of 7 responders immunized with
      whole HBsAg and the peptide-induced proliferation was blocked by anti-HLA-DR but
      not by anti-HLA-DP antibodies. These results suggest that HBsAg p 139-146 is a
      major immunodominant peptide of HBsAg and is restricted by HLA-DR.

PMID- 8341286
TI  - Significance and properties of the autoanti-metatype immune response.

PMID- 8341287
TI  - An anti-lipid A antibody obtained from the human fetal repertoire is encoded by
      VH6-V lambda 1 genes.
AB  - The human hybridoma cell line CB-201 has been obtained from a fusion of fetal
      spleen lymphocytes (31st gestational week) with heteromyeloma cells. The IgM
      (lambda) secreted was found to bind to lipid A, whereas other endogenous and
      exogenous antigens were not recognized. The CB-201 antibody is encoded by the
      unmutated VH6 gene recombined with DN4 and JH3 elements and a V lambda subgroup 1
      gene. Therefore, a VH gene, which was previously described to be over-represented
      in the fetal repertoire and to be expressed in autoantibody-producing B cells,
      may encode an anti-bacterial specificity.

PMID- 8341288
TI  - Affinity of monoclonal antibodies to large multivalent antigens: influence of
      steric hindrance on antibody affinity constants calculated from Scatchard plots.

PMID- 8341289
TI  - Early combination therapy with bromocriptine and levodopa in Parkinson's disease.
AB  - The use of early combination therapy with bromocriptine (Br) and levodopa (LD) in
      Parkinson's disease is controversial. It has been suggested that treatment with
      this regimen would prevent or delay the onset of motor fluctuations and
      dyskinesia. Thus, some have recommended it as a standard of care. This
      recommendation is based on the theory that LD may accelerate the progression of
      PD and clinical experience using Br monotherapy in early Parkinson's disease,
      which suggested that Br causes fewer late complications. This article reviews
      these arguments and shows that the theories are unproven. A single, uncontrolled
      trial is often referred to as evidence for efficacy of early combination therapy.
      We critically review this and five other studies which have evaluated the
      treatment strategy. We show that the literature is often misleading and that
      these trials do not support the efficacy of early combination therapy. We
      conclude that there is no justifiable reason to use a combination of Br and LD in
      early parkinsonian patients.

PMID- 8341290
TI  - The detection of preclinical Parkinson's disease: what is the role of positron
      emission tomography?
AB  - On clinical criteria alone, the diagnosis of early Parkinson's disease can be
      difficult and, by definition, the prospective recognition of preclinical
      Parkinson's disease is impossible. Positron emission tomography (PET) using
      [18F]dopa as tracer has been proposed as a means of identifying patients with
      preclinical disease. The number of subjects detected to date has been few; most
      have been identified by serendipity or during the course of family studies. This
      review examines the significance of a single abnormal scan in an apparently
      healthy subject in terms of the relationship between normal and abnormal values
      and the time course of the disease.

PMID- 8341291
TI  - Ascorbic acid protects against levodopa-induced neurotoxicity on a catecholamine
      rich human neuroblastoma cell line.
AB  - Levodopa, at concentrations of 0.25 x 10(-4) M or larger, is toxic for the human
      neuroblastoma cell NB69. Toxicity is associated with high levels of quinones,
      increased activity of complex II-III, and lack of changes of complex I of the
      mitochondrial respiratory chain. Deprenyl, which does not alter the production of
      quinones, has a partial protective effect. Tocopherol, 23 or 115 x 10(-6) M,
      lacks significant preventive effect on levodopa toxicity, but ascorbic acid, 10(
      3) M, prevents levodopa toxicity and quinone formation. Deprenyl, 10(-4) M,
      provides additional protection in cultures treated with levodopa and ascorbic
      acid. Our results indicate that ascorbic acid and deprenyl prevent levodopa
      neurotoxicity by unrelated mechanisms. Both compounds should be considered as
      complementary drugs to test for slowing the progression of Parkinson's disease.

PMID- 8341292
TI  - The syndrome of gait ignition failure: a report of six cases.
AB  - The syndrome of gait ignition failure is described in six patients in whom
      difficulty initiating walking was the major symptom. The gait had elements of
      parkinsonism with start and turn hesitation, shuffling, and freezing. Unlike
      parkinsonism, however, the gait was relatively normal once entrained; the posture
      was upright, and good arm swing, a normal stride length, and no festination were
      seen. Equilibrium was normal or near normal, and when seated or lying, rhythmic
      leg movements were generated normally. Facial expression, upper limb mobility,
      and whole body movements were well-preserved. This gait disorder differed from
      that seen in Parkinson's disease and the so-called "frontal" or "senile"
      disorders of gait and gait "apraxia." The causes of this gait syndrome are not
      clear but it may be due to frontal lobe vascular disease and/or focal
      degeneration of the frontal lobes.

PMID- 8341293
TI  - Primary progressive freezing gait.
AB  - Freezing gait is an incapacitating symptom often observed in patients with
      Parkinson's disease. It has been less frequently described in association with
      multi-infarct state, multisystem atrophies, and normotensive hydrocephalus. In
      our movement disorder clinic, we have diagnosed (and followed up to 3 years;
      median, 16 months), 18 patients in whom progressive freezing gait was the sole
      neurological dysfunction. These 15 men and 3 women (aged 60-82 years; 74 +/- 6)
      were subjected to an extensive neurological workup that included clinical
      evaluation, videotaping for grading of gait disability, comprehensive blood and
      cerebrospinal fluid (CSF) analysis, and brain computed tomography (CT) and
      magnetic resonance imaging (MRI). Mean disease duration was 2.5 +/- 1.9 years
      (range, 0.5-6). Neurological examination disclosed freezing gait, often
      associated with varying degrees of postural instability. The degree of freezing
      gait ranged from sudden motor blocks only when confronted with obstacles to
      severe disability with total inability to start walking requiring a walker,
      massive assistance, or a wheelchair. However, patients could mimic gait movements
      with absolutely no freezing when seated or lying prone, and most of them could
      overcome arrests by the "walking-over-lines" maneuver. Otherwise, neurological
      examination was normal with no signs of bradykinesia, rigidity, or tremor. Blood
      chemistry and CSF analysis were normal. Brain CT and MRI were normal or showed
      mild cortical atrophy in 12 and putative lacunes in 6 patients. Therapy with
      levodopa or dopamine agonists was ineffective. During the follow-up period, a
      gradual progression of the freezing gait was observed. However, it remained
      unaccompanied by any other neurological findings.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8341294
TI  - Administration of the new COMT inhibitor OR-611 increases striatal uptake of
      fluorodopa.
AB  - L-Dopa is metabolized to 3-O-methyldopa (3OMD) by catechol-O-methyltransferase
      (COMT). This reduces the amount of L-dopa available for entry into brain. We
      studied the effect of OR-611, a new COMT inhibitor, on plasma and brain 6-[18F]
      fluoro-L-dopa (6FD) metabolism in cynomolgus monkeys with positron emission
      tomography (PET). OR-611 pretreatment substantially reduced plasma 6FD metabolism
      to 3-O-methylfluorodopa (3OMFD). PET measurements of striatal 6FD concentrations
      showed an average 2.3-fold increase following OR-611 pretreatment, compared to
      the same animals in the control state. OR-611 inhibits plasma metabolism of 6FD
      and increases brain uptake of this L-dopa analog. OR-611 appears to be a
      promising agent as an adjunct to L-dopa for the treatment of patients with
      Parkinson's disease.

PMID- 8341295
TI  - Lewy bodies in the lateral hypothalamus: do they imply neuronal loss?
AB  - Lewy bodies have been found in the hypothalamic lateral tuberal nucleus (NTL) and
      the adjoining tuberomammillary nucleus (TM) in Parkinson's disease (PD). The NTL
      is severely atrophic in Huntington's disease; the TM seems unaffected. In this
      study, we examined the NTL and the TM of seven PD patients and one patient with
      presumed PD to assess whether the presence of Lewy bodies indicated neuronal
      loss. Most Lewy bodies were found in the TM, but they were also present in the
      NTL of seven of the eight patients. The number of NTL neurons in the PD patients
      was similar to a group of 14 nonneurological controls, seven Alzheimer's disease
      (AD) patients, and two AIDS patients with dementia. This challenges the
      hypothesis that Lewy bodies are a sign of significant cell death. The TM, whose
      cells could not be counted, did not seem depleted in neuronal numbers, although
      occasional neuronophagia was observed.

PMID- 8341296
TI  - Axial motor disturbances after hypoxic lesions of the globus pallidus.
AB  - Four subjects aged between 29 and 60 years were examined because of axial motor
      impairment after hypoxic brain injury. Magnetic resonance imaging revealed
      circumscribed lesions of the globus pallidus in every case. The association of
      freezing of the gait, speech disorders, axial bradykinesia, and postural
      disturbances, with no rigidity or tremor and little or no distal akinesia,
      suggests a role of the globus pallidus in controlling axial motion.

PMID- 8341297
TI  - Laterality of onset in idiopathic torsion dystonia.
AB  - Idiopathic torsion dystonia (ITD) is a dominantly inherited disorder with
      incomplete penetrance. It is important to identify factors that may cause
      dystonia or prevent its occurrence in a genetically predisposed individual.
      Because dystonia may be precipitated by peripheral triggers, we have investigated
      whether the preferential use of a limb affects the development of dystonia.
      Analysis of the correlation between the side of motor dominance and the limbs in
      which dystonic symptoms first appeared was performed in 49 patients with ITD
      ascertained in a country-wide survey in Israel. The dominant motor side was
      determined in 45 cases (92%). Among 29 patients with lateralized limb onset, 24
      showed right-side motor dominance, of whom 21 had dystonia onset in a right limb.
      The first sign was in a left limb for all five cases with left-side motor
      dominance (90% coincidence). The pattern of limb involvement was studied.
      Detection bias could be ruled out. The highly significant relationship between
      the motor dominance and the laterality of limb onset in ITD patients suggests
      that the preferred use of a limb may trigger the onset of dystonia.

PMID- 8341298
TI  - Geniospasm: hereditary chin trembling.
AB  - Geniospasm is a hereditary disorder characterized by episodic, usually stress
      induced involuntary trembling of the chin. Nineteen families from Europe and the
      U.S.A. suffering from this disorder have been described since 1894. We present
      three cases from two newly detected families. There was no evidence of any other
      nervous system abnormality, although abnormal EEG, sleep disorders, and
      involvement of other facial muscles have been described in rare cases. Geniospasm
      is transmitted as an autosomal-dominant trait with high penetrance. It must be
      differentiated from facial myokymia, palatal tremor, and essential tremor
      affecting facial muscles. Neurophysiological and molecular mechanisms of this
      peculiar disorder are unknown.

PMID- 8341299
TI  - Cisapride treatment of constipation in Parkinson's disease.
AB  - Constipation, a frequent symptom in Parkinson's disease (PD), is probably caused
      by degeneration of the autonomic nervous system, particularly the myenteric
      plexus. Cisapride is a drug that causes increased release of acetylcholine in the
      myenteric plexus. In a pilot study, cisapride therapy was investigated in 20 PD
      patients, 10 women and 10 men, who suffered from delayed intestinal transit. In
      all cases, cisapride therapy was associated with a significant acceleration of
      colonic transit, as measured by radioopaque pellets viewed on radiographs. Pellet
      count fell from a mean of 53.8 pretreatment to 30.4 after cisapride treatment. No
      adverse reaction and no "overshoot affects," such as diarrhea, were seen. Our
      findings suggest that cisapride may alleviate the constipation associated with
      Parkinson's disease.

PMID- 8341300
TI  - Modulatory effect of clozapine on levodopa response in Parkinson's disease: a
      preliminary study.
AB  - Clozapine has been shown not only to be effective in ameliorating dopaminomimetic
      psychosis but to improve parkinsonian symptomatology. Six parkinsonian patients
      with motor fluctuations under levodopa treatment and severe interdose "off"
      periods (believed to be mediated by an inhibitory effect of subthreshold levels
      of levodopa) underwent a trial of clozapine. The effects of this drug on levodopa
      response were measured by means of an acute levodopa test both before and after
      receiving clozapine. After 1 month of treatment, clozapine 25 mg/day reduced
      parkinsonian scores at all stages of the evaluation (pre-levodopa "off," "on,"
      and interdose "off"). The effect was consistently more significant for the
      interdose "off." Clozapine could be exerting its beneficial effects through the
      inhibition of an inhibitory effect mediated by low-level dopaminergic
      stimulation, thus behaving as an apparent anti-parkinsonian drug.

PMID- 8341301
TI  - Reversible striatal hypermetabolism in a case of Sydenham's chorea.
AB  - We studied a 10-year-old girl with Sydenham's chorea (SC) using positron emission
      tomography (PET) with fluorodeoxyglucose (FDG). Choreic movements involved the
      head and the left side of her body. PET showed increased glucose metabolism in
      the right caudate nucleus and putamen. Three months after complete recovery,
      striatal glucose metabolism had returned to normal in the caudate nucleus. In the
      right putamen, glucose metabolism had decreased compared to that in the first
      study but remained elevated compared to that of normal young adults. We propose
      that the transient striatal hypermetabolism may have been due to increased
      afferent inputs to the striatum as a consequence of striatal or subthalamic
      nucleus dysfunction.

PMID- 8341302
TI  - Inverse masticatory muscle activity due to syringobulbia.
AB  - The clinical, radiological, and electrophysiological data of a 25-year-old woman
      with "inverse masticatory muscle activity" due to syringobulbia is presented.
      This uncommon brain stem syndrome may be due to a disturbance in central
      programming of mastication.

PMID- 8341303
TI  - Orofacial dystonia and rest tremor in a patient with normal brain pathology.
AB  - We report a patient with cranial dystonia who also had rest tremor of one arm and
      who developed drug-induced parkinsonism on treatment. The patient's brain was
      normal on autopsy. We also review the findings in the few reported cases of
      cranial dystonia with pathology.

PMID- 8341304
TI  - Cerebellar ataxia in ataxic hemiparesis? A kinematic and EMG analysis.
AB  - It has recently been proposed that the ataxia in ataxic hemiparesis is a
      clumsiness common to all patients with hemiparesis and not indicative of any
      involvement of corticopontocerebellar or cerebellocortical pathways. In
      disagreement with this view, we report here that a patient with ataxic
      hemiparesis, following a lesion of the corona radiata, showed the disorders in
      kinematic and electromyographic (EMG) parameters of goal-directed movements that
      have recently been demonstrated to be characteristic of patients with cerebellar
      lesions. This suggests involvement of corticopontocerebellar or cerebellocortical
      pathways in ataxic hemiparesis.

PMID- 8341305
TI  - Significant improvement of stiff-person syndrome after paraspinal injection of
      botulinum toxin A.
AB  - Following several months of low back pain, a 36-year-old man developed
      progressive stiffness of the abdominal, low back, and thigh muscles. On
      examination, these muscles demonstrated marked hypertonia consistent with the
      clinical diagnosis of stiff-person syndrome. The patient demonstrated increased
      lumbar lordosis and had focal hyperhidrosis at different sites. Electromyography
      showed continuous activity of the paraspinal and thigh muscles, and serum and
      cerebrospinal fluid antibodies to glutamic acid decarboxylase (GAD) were markedly
      elevated. Diazepam and Lioresal offered partial pain relief. Paraspinal muscle
      administration of botulinum toxin A reduced the tone of paraspinal and thigh
      muscles significantly and resulted in marked improvement of ambulation and
      cessation of pain.

PMID- 8341306
TI  - Linkage analysis with chromosome 9 markers in hereditary essential tremor.
AB  - Hereditary essential tremor (ET) is an autosomal dominant disorder with variable
      expression and reduced penetrance. A tremor indistinguishable from ET may be
      observed in patients with autosomal dominant idiopathic torsion dystonia (ITD),
      in which the disease locus has been mapped to 9q32-34 in some kindreds, tightly
      linked to the argininosuccinate synthetase (ASS) locus. We performed linkage
      analysis in 15 families with ET containing 60 definitely affected individuals,
      using dinucleotide repeat polymorphisms at the ASS locus and the Abelson locus
      (ABL). Cumulative lod scores were -19.5 for ASS and -10.8 for ABL at a
      recombination fraction of 0.01, and tight linkage to ASS was excluded
      individually in 11 of the families. These data indicate that the ET gene is not
      allelic to that causing ITD.

PMID- 8341307
TI  - Painless legs and moving toes: a syndrome related to painful legs and moving
      toes?
AB  - The syndrome of painful legs and moving toes consists of continuous or
      semicontinuous involuntary writhing movements of the toes associated with pain in
      the affected extremity. We report a 57-year-old man with a 33-year history of
      painless and semicontinuous involuntary movements of the toes of the left foot
      similar to those seen in painful legs and moving toes. There was no family
      history of movement disorder. The history and physical examination were negative
      for significant trauma, radiculopathy, or peripheral neuropathy. There were no
      other neurological findings or involuntary movements. It is unlikely that the
      involuntary movements were precipitated by neuroleptics or psychosis. CT scan of
      the head; EEG, CT, and MRI scans of the lumbosacral spine; and EMG and nerve
      conduction studies of the legs showed no significant abnormalities except for a
      predominant cocontraction of the left foot flexors and extensors at 0.6-1.2 Hz in
      a pattern sometimes seen in painful legs and moving toes. We conclude that there
      is a condition clinically and electrophysiologically similar to painful legs and
      moving toes that we call painless legs and moving toes, the etiology of which
      remains undetermined.

PMID- 8341308
TI  - Interactive video conferencing: a means of providing interim care to Parkinson's
      disease patients.
AB  - Inequity in health care delivery is attributable to a variety of factors
      including geographic isolation. Patients living far from major urban centers have
      limited access to medical specialists. In the instance of Parkinson's disease
      (PD), optimal assessment and care may depend upon availability of specialty
      health care providers. In order to broaden health care access, interactive video
      conference (IVC) units are being developed for medical use. IVC allows a patient
      at a distant site to be "seen and heard" by a hospital-based physician;
      simultaneously, the patient can "see and hear" the doctor. To establish the
      validity of this technology in the evaluation of PD, nine patients were
      independently examined and scored (UPDRS) by two movement disorder specialists.
      One examination was performed in-person by the usual physician. The other
      examination was performed on the same day via IVC over a distance of 350 miles by
      an examiner previously unfamiliar with the patients. Individual patient scores
      did not differ based on examiner (Spearman Rho Correlation Coefficients: UPDRS
      total scores r = 0.933, p < 0.0002; Hoehn and Yahr Scale r = 0.883, p < 0.001). A
      standardized exit interview was conducted to assess patients' perceptions of this
      application of video technology. Responses were favorable and virtually all
      patients viewed this as a means of accessing better health care. We conclude that
      valid motor assessments of PD patients can be made via IVC.

PMID- 8341309
TI  - Hemidystonia symptomatic of primary antiphospholipid syndrome in childhood.
AB  - We report three children with hemidystonia in whom anti-cardiolipin (aCL)
      antibodies were demonstrated. Systemic lupus erythematosus was excluded on the
      basis of both clinical and serological criteria, and the diagnosis of primary
      antiphospholipid syndrome (PAPS) was made. In two cases, aCL antibodies could be
      causally related to a presumed immune-mediated thrombotic event involving the
      basal ganglia as shown by magnetic resonance imaging (MRI). In the remaining
      patient the finding of white matter alteration on NMR might be due to cross
      reactivity of anti-phospholipid (aPL) antibodies with cerebral phospholipids,
      resulting in demyelination. We suggest that PAPS must always be considered when
      isolated or recurrent focal cerebral ischaemia, and particularly hemidystonia,
      occur in childhood.

PMID- 8341310
TI  - Neuropathology of lubag (x-linked dystonia parkinsonism).
AB  - Lubag is an x-linked recessive dystonia parkinsonism that affects Filipino men
      originating principally from the Panay Island. Linkage analysis has confirmed the
      mode of inheritance and localized the disease gene to the proximal long arm of
      the x-chromosome. We studied the brain of a 34 year old Filipino man affected
      with lubag. He developed truncal dystonia at age 30, which subsequently
      generalized. With disease progression, he also presented with parkinsonism
      including, rigidity, bradykinesia, and impaired balance. His symptoms were
      largely unaffected by medication and, at age 34, he underwent a right
      cryothalamotomy. He died suddenly 2 days after the procedure. The principal
      neuropathological findings were neuronal loss and a multifocal mosaic pattern of
      astrocytosis restricted to the caudate and lateral putamen. Similar findings have
      been reported in two other men with dystonia--one Filipino and the other non
      Filipino. The similar pathology of the two Filipino men suggests that this is the
      pathology of lubag. Recognition of this pathology in a non-Filipino man suggests
      that the mutation causing lubag may not be restricted to the Filipino population.

PMID- 8341311
TI  - Brain glucose metabolism and dopamine D2 receptor analysis in a patient with
      hemiparkinsonism-hemiatrophy syndrome.
AB  - We report findings on brain glucose metabolism and dopamine D2 receptors
      generated by positron emission tomography (PET) in a 67-year-old woman with right
      hemiparkinsonism-hemiatrophy syndrome (HP-HA). PET with [18F]-fluorodeoxyglucose
      (FDG) showed marked glucose metabolism asymmetry. There were significant
      reductions in glucose uptake at the level of the basal ganglia and, to lesser
      extent, in the fronto-parietal cortex contralateral to the clinically involved
      side. These changes were different from those found in a patient with hemi
      Parkinson's disease who was scanned under similar conditions. Because the patient
      with HP-HA had only minimal response to levodopa therapy, we evaluated post
      synaptic dopaminergic structures using PET with [18F]-fluoroethylspiperone
      (FESP). No striatal binding asymmetry was found in FESP/PET, which suggests a
      sparing of striatal dopamine D2 receptors. The changes in FDG uptake which we
      found were in brain areas relevant to the clinical features of HP-HA syndrome. In
      addition, our study provides evidence that FDG/PET may help to differentiate HP
      HA syndrome from hemi-Parkinson's disease. In most instances, since HP-HA is
      associated with a more benign clinical course than Parkinson's disease, this
      distinction is of clinical important.

PMID- 8341312
TI  - Developmental stuttering followed by intermittent jaw opening dystonia.

PMID- 8341313
TI  - Leg tremor mimicking orthostatic tremor as an initial manifestation of
      Parkinson's disease.

PMID- 8341314
TI  - Levodopa-responsive parkinsonism associated with basal ganglia calcification and
      primary hypoparathyroidism.

PMID- 8341315
TI  - Involuntary humming in autopsy-proven Parkinson's disease.

PMID- 8341316
TI  - Benign hereditary chorea or hereditary idiopathic dystonia?

PMID- 8341317
TI  - Cloning and characterisation of cDNA clones encoding two Babesia bovis proteins
      with homologous amino- and carboxy-terminal domains.
AB  - A dextran sulphate protein (DSP) fraction derived from Babesia bovis has
      previously been shown to induce a protective immune response in cattle. A B.
      bovis cDNA library was screened with both the complete anti-DSP serum and a
      subfraction of the anti-DSP serum affinity purified on a native B. bovis protein
      of approx. 80 kDa. cDNA clones encoding two different B. bovis proteins were
      identified. The product of one gene, Bv80, has a single divergent copy of a
      sequence of 149 amino acids (approx. 30% amino acid identity) in both the amino-
      and carboxy-terminal domains. These domains are separated by an array of short
      variant repeat sequences rich in proline and glutamic acid. The product of the
      other gene, BvVAl (homologous to the previously described 225-kDa B. bovis
      protein)[19], is predicted to have a single divergent copy of a sequence of 170
      171 amino acids (approx. 35% amino acid identity) in both the amino- and carboxy
      terminal domains. These domains are also separated by an array of repeats. The 73
      amino acid repeat unit of this array is composed of a number of variant
      derivatives of shorter repeat units. Detailed analysis of genomic clones flanking
      two alleles of the gene encoding BvVAl/225 kDa identified further members of a
      multi-gene family. This region of the genome of B. bovis has been subject to a
      large number of amplification processes.

PMID- 8341318
TI  - A mitochondrial heat shock protein from Crithidia fasciculata.
AB  - MCP72 is a mitochondrial hsp70 protein from the trypanosomatid Crithidia
      fasciculata. An MCP72 cDNA clone was isolated from a C. fasciculata cDNA library
      by screening with antiserum specific for the homologous protein of Trypanosoma
      cruzi [9]. The MCP72 cDNA encodes a polypeptide of 663 amino acids which is 84%
      identical to the Trypanosoma cruzi protein and 56% identical to the Escherichia
      coli hsp70 protein DnaK. MCP72 is less similar to other hsp70 proteins. Native
      MCP72 was purified to homogeneity by ATP-agarose affinity chromatography.
      Comparison of its N-terminal amino acid sequence with that deduced from the cDNA
      sequence shows that 20 amino acid residues had been cleaved from the N-terminus;
      this sequence probably represents a mitochondrial import signal which is cleaved
      during translocation into the mitochondrion. Fluorescence microscopy, using
      antibodies specific for MCP72, indicates that the protein is concentrated in a
      region of the mitochondrial matrix which surrounds the kinetoplast.

PMID- 8341319
TI  - Synthesis and activity of inhibitors highly specific for the glycolytic enzymes
      from Trypanosoma brucei.
AB  - Most glycosomal enzymes of Trypanosoma brucei carry a relatively high number of
      positive charges. In at least 3 of the enzymes some of the charges unique to
      these enzymes are concentrated in 2 distinct areas on the enzymes' surface, about
      4 nm apart [4] and these positively charged structural elements have been
      suggested to be the site of interaction with the trypanocidal drug Suramin. We
      have synthesized a series of symmetrical long chain molecules with negative
      charges or strong dipoles at each end. Several of these compounds inhibited the
      glycosomal enzymes more strongly than Suramin. They also exhibited a specificity
      for the trypanosome enzymes, when compared with homologous enzymes from other
      organisms. By varying the chain length of the active compounds, a 4-nm distance
      between the molecules' extremes proved optimal for inhibition. Tetra-substituted
      compounds were better than di-substituted. Modifications introduced at the two
      ends indicated that a planar orientation, with an amide bond linking a phenyl
      ring to the chain, is preferred. Inhibition kinetics for some of the enzymes
      indicated the existence of multi-site interactions with the inhibitors.

PMID- 8341320
TI  - Genetic variability and evolution of the Schistosoma genome analysed by using
      random amplified polymorphic DNA markers.
AB  - The usefulness of random amplified polymorphic DNA markers (RAPD) was assayed in
      an attempt to discriminate among species, strains and individuals within the
      genus Schistosoma. Depending on the species, 40-50 arbitrary decamer
      oligonucleotides were used as primers to amplify total DNA by the polymerase
      chain reaction (PCR). An important polymorphism was observed among 5 species,
      allowing a phylogenetic tree to be outlined. These differences can be used for
      rapid and accurate identification. A limited but easily detectable polymorphism
      was revealed among 3 strains of a single species (Schistosoma mansoni). Minor
      differences were observed among individuals of a single strain. A RAPD marker
      allows sexual discrimination between individuals from the terminal spined-egg
      species group. Although a limited number of strains have been examined, the
      results already indicate clearly that RAPD markers constitute a powerful tool for
      the analysis of genetic variability. This new tool will considerably extend the
      information available from morphology, isozyme and limited restriction fragment
      length polymorphism data and opens the way to genetic analysis of these species.

PMID- 8341321
TI  - Molecular cloning and localization of an abundant novel protein of Plasmodium
      berghei.
AB  - Screening of Plasmodium berghei genomic libraries using DNA insert corresponding
      to the 3' half of P. falciparum 70-kDa heat shock protein gene identified several
      abundant clones which represent a novel gene in the parasite. The complete
      sequence was obtained using an approach based on inverse polymerase chain
      reaction. Analysis of the deduced amino acid sequence revealed the presence of 19
      imperfect repeats of the sequence Gly-Gly-Met-Pro toward the carboxy terminus.
      Except for the similar sequence repeated seven times in the malarial 70-kDa heat
      shock protein, the sequence of the cloned gene product is very different.
      Moreover, the sequence also revealed acidic and basic domains in the protein
      which are more than 60% similar in sequence to functional domains present in
      numerous DNA binding transcription factors. A 56-kDa protein was identified by
      immunoprecipitation from labeled P. berghei extract using antisera raised in mice
      against gene products expressed in Escherichia coli. The protein is present in
      all the different life cycle stages of the parasites as revealed by
      immunoelectron microscopy.

PMID- 8341322
TI  - Characterization of the Schistosoma mansoni gene encoding the glycolytic enzyme,
      triosephosphate isomerase.
AB  - The complete gene encoding Schistosoma mansoni triosephosphate isomerase (TPI)
      was isolated from a lambda phage genomic library on 2 overlapping clones. These
      genomic clones have been characterized by restriction mapping and DNA sequencing
      of the 5' flanking region, the exons, the intron boundaries and the
      polyadenylation addition site. S. mansoni TPI is encoded by 6 exons spanning a
      region of about 12 kb. The 5 introns are located at positions precisely analogous
      to those of mammalian TPI genes but one of the 6 mammalian TPI introns is missing
      in S. mansoni. We find no evidence of spliced leader involvement in TPI gene
      expression. The gene is preceded by at least 4 tandem copies of a 2.5-kb
      repetitive sequence. While the 12-kb size for the S. mansoni TPI gene is much
      larger than the 3-4 kb typical of mammalian TPI genes, the 42-bp first intron is
      unusually short. The transcription initiation site for the S. mansoni TPI gene is
      heterogeneous. Genomic Southern blot analysis suggests that TPI is expressed from
      a single copy gene.

PMID- 8341323
TI  - Mediation of Trypanosoma cruzi invasion by sialic acid on the host cell and trans
      sialidase on the trypanosome.
AB  - Trypanosoma cruzi attaches and invades a large variety of mammalian cells. The
      nature of the cell receptors and of the corresponding parasite counter-receptors
      that mediate T. cruzi-host cell interaction are not known. Three sialic acid
      deficient mutants of Chinese hamster ovary (CHO) cells were used to probe the
      role of host sialyl residues in T. cruzi infection. All three mutants supported
      adhesion and infection to a much lower extent than the parental CHO cells. One of
      the mutants, Lec2, contains sugar chains terminating in non-reducing beta Gal
      residues, which are acceptors for sialylation by the T. cruzi trans-sialidase. Re
      sialylation of Lec2 cells restored T. cruzi adhesion and invasion to about the
      same extent as wild-type cells. Digestion of wild-type cells with bacterial
      sialidase reduced T. cruzi interaction but after re-sialylation, the cells were
      almost as good as control, naturally sialylated parental cells. These results
      suggest that T. cruzi recognizes sialyl residues on the surface of host cells
      during invasion. On the other hand, affinity-purified trans-sialidase blocked T.
      cruzi adherence and invasion of sialylated cells, and had no effect on parasite
      interaction with sialic acid-deficient Lec2 mutant. Furthermore, 2,3
      sialyllactose, a substrate for the trans-sialidase, competitively inhibited T.
      cruzi invasion of sialylated parental K1 cells, but 2,6-sialyllactose, which does
      not react with the trans-sialidase, was without effect, as were other sugars that
      do not contain alpha 2,3 sialyl residues. These results suggest that the trans
      sialidase functions as a counter-receptor for trypomastigote binding to alpha 2,3
      sialyl receptors on host cells as a prelude to T. cruzi invasion.

PMID- 8341324
TI  - Structure and expression of a post-transcriptionally regulated malaria gene
      encoding a surface protein from the sexual stages of Plasmodium berghei.
AB  - The sexual stage-specific protein Pbs21 of the rodent malaria parasite Plasmodium
      berghei, expressed on the surface of zygotes and ookinetes, has been shown to
      induce an effective and long-lasting transmission blocking immunity. The gene
      encoding Pbs21 was cloned by screening a cDNA library prepared from enriched
      zygotes and ookinetes using the monoclonal antibody 13.1.15, which is capable of
      blocking subsequent parasite sexual development in the mosquito vector. The Pbs21
      gene encoded a protein of 213 amino acids which contained a putative amino
      terminal signal sequence and a putative carboxy-terminal hydrophobic membrane
      anchor. The amino-acid sequence was characterised by a large number of cysteine
      residues which were organized into 4 epidermal growth factor-like domains. The
      spacing of the cysteine residues was highly conserved when compared to the 25-kDa
      ookinete proteins of Plasmodium falciparum (Pfs25), Plasmodium reichenowi (Prs25)
      and Plasmodium gallinaceum (Pgs25) which were approximately 45%, 45% and 40%
      homologous to Pbs21 respectively. The gene is located on chromosome 5 and cross
      hybridizes to a similarly defined gene unit in the other rodent malaria species
      Plasmodium chabaudi, Plasmodium vinckei and Plasmodium yoelii. The gene is
      internally disposed and not in the subtelomeric region of chromosome 5. The gene
      is transcribed in a stage-specific manner giving rise to an abundant 1.5-kb
      transcript. This mRNA is synthesised in the precursor cells to female gametes
      (gametocytes) however the protein is observed only after activation of the
      gametes, suggesting that translation of the mRNA is controlled by a post
      transcriptional process. The Pbs21 gene and the P. berghei parasite system
      provide an excellent vehicle for the study of stage-specific transcriptional and
      post-transcriptional control in malaria.

PMID- 8341325
TI  - Characterization of mevalonate-labeled lipids isolated from parasite proteins in
      Schistosoma mansoni.
AB  - Adult paired schistosomes incubated for 3 days in radiolabeled mevalonate can
      effectively label at least 2 major proteins with apparent sizes of 25 and 43 kDa.
      The 25-kDa mevalonate-labeled proteins comigrated with proteins that could be
      labeled with GTP. The lipids attached to these proteins were removed and resolved
      by HPLC and found to comigrate with known samples of farnesol and
      geranylgeraniol. Homogenates of the schistosome when incubated with labeled
      farnesol pyrophosphate effectively labeled a protein(s) with an apparent
      molecular weight of 43 kDa while homogenates incubated in the presence of labeled
      geranylgeranyl pyrophosphate-labeled schistosome proteins with an apparent
      molecular weight of 25 kDa. Our results demonstrate that Schistosoma mansoni has
      the ability to covalently attach farnesol and geranylgeranyl to low-molecular
      weight proteins.

PMID- 8341326
TI  - Mucin-like glycoproteins linked to the membrane by glycosylphosphatidylinositol
      anchor are the major acceptors of sialic acid in a reaction catalyzed by trans
      sialidase in metacyclic forms of Trypanosoma cruzi.
AB  - We have previously shown that 35- and 50-kDa glycoconjugates of cultured
      metacyclic trypomastigotes participate in the attachment of parasites to
      mammalian cells. Here we show that when metacyclic trypomastigotes are incubated
      with [3H]sialyllactose, most of the sialic acid is transferred to these 35/50-kDa
      molecules in a reaction catalyzed by a parasite transsialidase. The sialic acid
      is incorporated in oligosaccharides of about 10 glucose units in size that are
      released from the glycoconjugate by mild alkaline hydrolysis. Compositional
      analysis reveals that the 35/50-kDa molecules are highly glycosylated proteins
      rich in threonine, galactose, N-acetyl-glucosamine and sialic acid. These
      glycoproteins can be labeled in vivo with [3H]palmitate, and the labeled fatty
      acid is released by glycosylphosphatidylinositol specific phospholipases C. This
      result, associated with the fact that they contain mannose, ethanolamine, myo
      inositol, and lipid, indicate that these glycoproteins are anchored to the
      membrane by glycosylphosphatidylinositol. During cell invasion, these molecules
      appear to be capped and locally released by the parasite.

PMID- 8341328
TI  - Pathogenic Entamoeba histolytica: cDNA cloning of a histone H3 with a divergent
      primary structure.
AB  - Entamoeba histolytica has an unusual nuclear structure characterized by a low
      degree of chromatin condensation and the absence of stainable metaphase
      chromosomes. Although nucleosome-like particles were observed, no information
      about histones was available so far. In this paper we describe a cDNA clone with
      significant homology to H3 histones that was isolated from a library of
      pathogenic E. histolytica. The complete cDNA encodes a 15-kDa polypeptide, which
      like the histone sequence from Volvox carteri is shorter by one residue than the
      human homologue. The amino acid sequence has only 69% identity with human H3.3
      histone and 67% identity with the human H3.1 histone. This is the highest degree
      of sequence divergence observed for any eukaryote H3 histone sequence. Our
      results indicate that this divergence may contribute to the unusual chromatin
      structure of E. histolytica.

PMID- 8341327
TI  - Effect of thapsigargin on calcium homeostasis in Trypanosoma cruzi
      trypomastigotes and epimastigotes.
AB  - By using the fluorescent calcium indicator fura-2, it was found that the
      concentration of free Ca2+ in the cytoplasm of Trypanosoma cruzi trypomastigotes
      incubated in the presence or absence of external calcium was maintained at very
      low levels (10-20 nM). When trypomastigotes were incubated in the presence of
      succinate and ATP and permeabilized with digitonin, they lowered the medium
      calcium concentration to a submicromolar level. In the presence of 1 microM FCCP
      the initial rate of Ca2+ sequestration by these permeabilized cells was very
      slow. When succinate alone was present, the initial rate of Ca2+ accumulation was
      slower than with ATP plus succinate, and the calcium set point was about 0.6
      microM. The succinate dependence and FCCP sensitivity of the later Ca2+ uptake
      indicate that it may be exerted by the mitochondria. High concentrations of the
      tumor promoter thapsigargin slightly increased cytosolic Ca2+ in the presence of
      extracellular Ca2+ but had no effect on the FCCP- and oligomycin/antimycin A
      insensitive Ca2+ pool. In addition, when used at those concentrations (4-20
      microM), thapsigargin was shown to release Ca2+ from the mitochondria and to
      decrease the inner mitochondrial membrane potential of trypomastigotes and
      epimastigotes as measured using safranine O. Despite the presence of inositol
      phosphates as determined by [3H]inositol incorporation, no IP3-sensitive Ca2+
      release could be detected in trypomastigotes.

PMID- 8341329
TI  - Rapid isolation of DNA from trypanosomatid protozoa using a simple 'mini-prep'
      procedure.
AB  - Although several methods for isolating genomic DNA from trypanosomatid protozoa
      exist, all are time-consuming and cumbersome. Faster, simpler and efficient
      protocols for preparation of DNA from these protozoa are needed to ease the
      screening of mutants and transfectants. We describe the use of a bacterial lysis
      method to isolate chromosomal DNA from a wide range of trypanosomatids. The
      method is based on the finding reported by He et al., who noticed that
      phenol/chloroform treatment of Escherichia coli cells in the presence of LiCl and
      Triton X-100 solubilizes plasmid DNA, while precipitating unwanted chromosomal
      DNA and denatured cellular proteins. In applying this lysis method to the
      isolation of episomal DNA from transfected trypanosomatids, we found that, unlike
      bacterial genomic DNA, chromosomal DNA of trypanosomatids was soluble in the
      phenol/chloroform/Triton/LiCl mixture. This observation prompted us to use the
      bacterial lysis method as a routine protocol for extraction of DNA from
      trypanosomatids.

PMID- 8341330
TI  - Isolation from a Plasmodium chabaudi chromosome 7 specific library of a novel
      gene encoding a protein with multiple GGMP repeats homologous to hsp70.

PMID- 8341331
TI  - Isolation and characterization of a middle repetitive DNA element from
      Echinococcus granulosus.

PMID- 8341332
TI  - Sequence of a cDNA encoding beta-tubulin from Babesia bovis.

PMID- 8341333
TI  - Racial differences in the incidence of cardiac arrest and subsequent survival.
      The CPR Chicago Project.
AB  - BACKGROUND: Differences between blacks and whites have been reported in the
      incidence of several forms of cardiovascular disease, including hypertension and
      stroke. We examined racial differences in the incidence of cardiac arrest in a
      large urban population and in subsequent survival. METHODS: We collected data on
      all nontraumatic, out-of-hospital cardiac arrests in Chicago from January 1,
      1987, through December 31, 1988, and compared the incidence and survival rates
      for blacks and whites. We examined the association between survival and race and
      seven other known risk factors by logistic-regression analysis. We computed
      incidence rates by coupling our data with U.S. Census population data. RESULTS:
      Our study population comprised 6451 patients: 3207 whites, 2910 blacks, and 334
      persons of other races. The incidence of cardiac arrest was significantly higher
      for blacks than for whites in every age group. The survival rate after cardiac
      arrest was 2.6 percent in whites, as compared with 0.8 percent in blacks (P <
      0.001). Blacks were significantly less likely to have a witnessed cardiac arrest,
      bystander-initiated cardiopulmonary resuscitation, or a "favorable" initial
      rhythm or to be admitted to the hospital. When they were admitted, blacks were
      half as likely to survive. The association between race and survival persisted
      even when other recognized risk factors were taken into account. We did not find
      important differences between blacks and whites in the response times of the
      emergency medical services. CONCLUSIONS: The black community in our study was at
      higher risk for cardiac arrest and subsequent death than the white community,
      even after we controlled for other variables.

PMID- 8341334
TI  - Prenatal determination of fetal RhD type by DNA amplification.
AB  - BACKGROUND: An RhD-negative woman whose partner is heterozygous may have
      preexisting anti-RhD antibodies that may or may not affect a subsequent fetus,
      depending on whether it is heterozygous. A safe method of determining fetal RhD
      type early in pregnancy would eliminate the risks to an RhD-negative fetus of
      fetal-blood sampling or serial amniocenteses. METHODS: We determined the RhD type
      in 15 fetuses using the polymerase chain reaction in amniotic cells and serologic
      methods in fetal blood collected simultaneously. In another 15 fetuses, the RhD
      type determined from chorionic-villus samples was compared with that identified
      by typing of DNA from the fetus itself. RESULTS: RhD typing of DNA from amniotic
      cells correctly indicated the serologic type in every fetus. Of 10 fetuses with
      RhD-negative mothers, 4 were identified as RhD-negative and 6 as RhD-positive. Of
      five fetuses with RhD-positive mothers, four were identified as RhD-positive and
      one as RhD-negative. There was also complete agreement between the results of RhD
      typing of DNA from chorionic-villus samples and the results of typing of DNA from
      fetal tissue. Eleven fetuses were RhD-positive, and 4 were RhD-negative. Four RhD
      positive fetuses had RhD-negative mothers. Three RhD-negative fetuses had RhD
      positive mothers. There was no contamination by maternal RhD-positive DNA of the
      samples from RhD-negative fetuses. CONCLUSIONS: Determining fetal RhD type in
      amniotic cells without invading the fetomaternal circulation is a reliable method
      that will be valuable in the management of Rh alloimmunization.

PMID- 8341335
TI  - Treatment of orthostatic hypotension with erythropoietin.
AB  - BACKGROUND AND METHODS: Patients with orthostatic hypotension caused by autonomic
      neuropathy frequently have a decreased red-cell mass. This would be expected to
      compromise their effective circulating blood volume and aggravate the orthostatic
      hypotension. We studied the effect of increasing the red-cell mass with
      erythropoietin, given subcutaneously in a dose of 50 U per kilogram of body
      weight three times a week for 6 to 10 weeks to eight patients with orthostatic
      hypotension--four men, one teenage boy, and three women (age range, 17 to 68
      years). Four patients had type I diabetes mellitus and autonomic neuropathy,
      three patients had pure autonomic failure, and one patient had sympathotonic
      orthostatic hypotension. Seven patients received fludrocortisone (0.1 or 0.2 mg
      per day) before, during, and after the trial of erythropoietin. The red-cell
      volume, plasma volume, and hemodynamic response to orthostatic stress were
      measured before and after therapy. RESULTS: Erythropoietin increased the mean (+/
      SD) hematocrit from 0.34 +/- 0.04 to 0.45 +/- 0.04 (P < 0.005) and increased the
      red-cell volume from 16.8 +/- 3.9 to 25.3 +/- 3.1 ml per kilogram (P < 0.005),
      but had no effect on plasma volume. The systolic blood pressure increased from 81
      +/- 11 to 100 +/- 24 mm Hg (P < 0.01) and the diastolic blood pressure increased
      from 46 +/- 10 to 63 +/- 18 mm Hg (P < 0.01) while the patients were standing.
      The average systolic and diastolic blood pressure while the patients were supine
      did not increase significantly, although hypertension in the supine position
      developed in three patients. Orthostatic dizziness improved during treatment in
      six of the eight patients. CONCLUSIONS: In patients with orthostatic hypotension,
      increasing the red-cell volume with erythropoietin elevates blood pressure while
      standing. Possible long-term adverse effects are not known.

PMID- 8341336
TI  - Plasma renin activity and ischemic heart disease.
AB  - BACKGROUND: An earlier prospective study reported an association between high
      levels of plasma renin activity (as measured by the renin-sodium profile) and the
      incidence of myocardial infarction in patients with hypertension. We have
      investigated the relation between plasma renin activity and ischemic heart
      disease in the Northwick Park Heart Study. METHODS: The study included 803 white
      men 40 to 64 years of age selected from industrial workers in London. Plasma
      renin activity and established risk factors for ischemic heart disease were
      measured at entry, which was between 1972 and 1978. Ascertainment of the primary
      clinical end points of fatal or nonfatal myocardial infarction and sudden death
      from coronary causes was carried out until the end of 1991. RESULTS: In an
      analysis of the 86 first coronary events, we found an independent relation
      between higher systolic blood pressure and coronary end points (relative risk per
      1 SD increase in blood pressure, 1.47; 95 percent confidence interval, 1.16 to
      1.85; P < 0.001), but no relation between plasma renin activity and coronary end
      points (relative risk per 1 SD increase in the level of plasma renin activity,
      1.04; 95 percent confidence interval, 0.84 to 1.30). In the 242 men who had
      hypertension of a degree similar to that of the subjects in the earlier
      prospective study of the renin profile, and in whom 44 of the 86 coronary events
      occurred, the relative risk of those in the highest as compared with the lowest
      third for plasma renin activity was 1.26 (95 percent confidence interval, 0.63 to
      2.56). CONCLUSIONS: Our results suggest that there is no association between
      plasma renin activity and myocardial infarction or sudden death from coronary
      causes, at least in normotensive men.

PMID- 8341337
TI  - Images in clinical medicine. Endovascular stents for iliac arterial disease.

PMID- 8341338
TI  - Racial differences in the use of invasive cardiovascular procedures in the
      Department of Veterans Affairs medical system.
AB  - BACKGROUND: Previous studies have found racial differences in the use of invasive
      cardiovascular procedures, which may be due in part to the greater financial
      incentives to perform such procedures in white patients. In Department of
      Veterans Affairs hospitals, direct financial incentives affecting use of the
      procedures are minimized for both patients and physicians. METHODS: We conducted
      a retrospective analysis of the use of cardiovascular procedures among black and
      white male veterans discharged from Veterans Affairs hospitals with primary
      diagnoses of cardiovascular disease or chest pain during fiscal years 1987
      through 1991. We used coded discharge data to determine whether cardiac
      catheterization, percutaneous transluminal coronary angioplasty, or coronary
      artery bypass grafting was performed during or immediately after such admissions.
      We used logistic-regression analysis to adjust for the primary discharge
      diagnosis, the presence of coexisting conditions, age, marital status, type of
      eligibility to receive care at Veterans Affairs hospitals, geographic region, and
      whether the hospital was equipped to perform bypass surgery. We classified the
      primary diagnosis as myocardial infarction, unstable angina, angina, chronic
      ischemia, chest pain, or "other" cardiovascular diagnosis. RESULTS: After we
      adjusted for all the potential confounders, we found that white veterans were
      more likely than black veterans to undergo cardiac catheterization (odds ratio,
      1.38; 95 percent confidence interval, 1.34 to 1.42), angioplasty (odds ratio,
      1.50; 95 percent confidence interval, 1.38 to 1.64), and coronary artery bypass
      surgery (odds ratio, 2.22; 95 percent confidence interval, 2.09 to 2.36).
      CONCLUSIONS: Even when financial incentives are absent, whites are more likely
      than blacks to undergo invasive cardiac procedures. These findings suggest that
      social or clinical factors affect the use of these procedures in blacks and
      whites.

PMID- 8341339
TI  - American trypanosomiasis (Chagas' disease)--a tropical disease now in the United
      States.

PMID- 8341340
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 34-1993. A 36-year-old man with AIDS and respiratory failure.

PMID- 8341341
TI  - Adults with tetralogy of Fallot--repaired, yes; cured, no.

PMID- 8341342
TI  - Heart disease in black and white.

PMID- 8341343
TI  - The new and the old--molecular diagnostics and hemolytic disease of the newborn.

PMID- 8341344
TI  - Sexual harassment in medical training.

PMID- 8341345
TI  - Sexual harassment in medical training.

PMID- 8341346
TI  - Sexual harassment in medical training.

PMID- 8341347
TI  - Sexual harassment in medical training.

PMID- 8341348
TI  - Life support for patients with cervical-level quadriplegia.

PMID- 8341349
TI  - Life support for patients with cervical-level quadriplegia.

PMID- 8341351
TI  - Life support for patients with cervical-level quadriplegia.

PMID- 8341350
TI  - Life support for patients with cervical-level quadriplegia.

PMID- 8341352
TI  - Life support for patients with cervical-level quadriplegia.

PMID- 8341353
TI  - Graft-versus-host disease.

PMID- 8341354
TI  - Growth hormone, insulin-like growth factor I, and benign intracranial
      hypertension.

PMID- 8341355
TI  - Geographic variations in payments to physicians.

PMID- 8341356
TI  - Geographic variations in payments to physicians.

PMID- 8341357
TI  - Geographic variations in payments to physicians.

PMID- 8341358
TI  - Geographic variations in payments to physicians.

PMID- 8341359
TI  - Use of cocaine during pregnancy.

PMID- 8341360
TI  - Activation of Immediate Early Genes by Drugs of Abuse. Technical review.
      Rockville, Maryland, June 3-4, 1991.

PMID- 8341362
TI  - Mechanisms of opioid-mediated antinociception: correlation of Fos expression and
      behavior.

PMID- 8341361
TI  - c-Fos and Fos-related antigens as markers for neuronal activity: perspectives
      from neuroendocrine systems.

PMID- 8341363
TI  - The ontogeny of immediate early gene response to cocaine: a molecular analysis of
      the effects of cocaine on developing rat brain.

PMID- 8341364
TI  - NMDA receptor blockade prevents translation, but not transcription, of the c-fos
      gene following stimulation with multiple extracellular signals in cultured
      cortical neurons: implications for plasticity and molecular memory.

PMID- 8341366
TI  - Everything activates c-fos--how can it matter?
AB  - It is probably safe to say that the regulation of c-fos expression by drug
      treatment and other stimulus paradigms has biological specificity and mechanistic
      significance. However, as this brief essay makes clear, the immunohistochemical
      detection of c-fos is only the tip of the biological iceberg. IEGs deserve to be
      studied as critical components of the intracellular signaling machinery that may
      transduce intercellular signals, including those produced by drugs of abuse, into
      longer term changes in cellular function. However, the study of IEG expression
      must be related to biologically significant target genes and must be complemented
      by the study of phosphorylation of constitutively expressed transcription
      factors. Moreover, as illustrated by the proenkephalin gene, the regulation of
      genes that play important roles in differentiated cell function may differ
      depending on which cell types and stimulus conditions are investigated. Finally,
      attention must be paid to the complexities of gene regulation under conditions of
      repetitive and chronic stimulation if phenomena such as the neural substrates of
      drug dependence are to be understood.

PMID- 8341365
TI  - Induction and suppression of proto-oncogenes in rat striatum after single or
      multiple treatments with cocaine or GBR-12909.

PMID- 8341367
TI  - Regulation of immediate early gene expression.
AB  - From this brief overview of the regulation of the c-fos promoter, it can be seen
      that the regulation of early-response genes is a complex affair. Therefore, it is
      not easy to predict from the upstream sequence of a given early-response gene
      exactly which elements are responsible for responding to what signals in a given
      cell type. However, from studies of other early-response genes, it is clear that
      several of the elements found upstream of c-fos appear frequently and are
      important in the regulation of other early-response genes. For instance, the
      zif/268 gene has four separate CArG boxes that are similar to fos. These CArG
      boxes can function in the serum and TPA response, but interestingly, they are not
      imbedded in a region of dyad symmetry as in c-fos (Christy and Nathans 1989).
      Upstream of the c-jun oncogene is an AP-1 site that can modulate the expression
      and induction of this gene and is responsive to TPA (Angel et al. 1988).
      Moreover, other studies suggest that cAMP-mediated signals can repress induction
      of c-jun through this element (de Groot et al. 1991; Mechta et al. 1989). This
      would explain why in certain circumstances, such as depolarization of PC12 cells
      or in the striatum in response to cocaine, there is an uncoupling of the
      induction of c-jun and jun-B. Depolarization induces c-fos and jun-B but not c
      jun; however, growth factors such as NGF can induce all three genes in the same
      cell (Bartel et al. 1989). Upstream of the jun-B gene there does not appear to be
      an SRE, but there is a new element that can be responsive to both cAMP and
      phorbol esters (de Groot et al. 1991). Genes such as c-myc, JE, and KC have no
      consensus SREs upstream, and the regulatory elements responsible for the
      induction of these genes have not been clearly identified (Rollins et al. 1988).
      However, there is some evidence from the c-myc gene that the E2F binding sites
      are important for its regulation by serum (Mudryj et al. 1990; Sacca and Cochran
      1990). In addition, there are two SIF sites upstream of the c-myc proto-oncogene
      (B.H. Cochran and T.E. Hayes, unpublished results). Upstream of the nur-77 gene
      there are no SREs, but there are four potential calcium/CRE-like elements (Watson
      and Milbrandt 1989).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8341368
TI  - Immediate early genes: their involvement in physiological and pathological
      responses in the nervous system.

PMID- 8341369
TI  - Immediate early gene activation and long-term changes in neural function: a
      possible role in addiction?

PMID- 8341371
TI  - Presentation of the Morrison Award.

PMID- 8341370
TI  - Regulation of neural gene expression in opiate and cocaine addiction.

PMID- 8341372
TI  - What's a radical behaviorist like you doing in a nice pharmacology club like
      C.P.D.D.?

PMID- 8341373
TI  - Dependence studies of new compounds in the rhesus monkey, rat and mouse (1992).

PMID- 8341374
TI  - Genetic approaches to understanding the actions of drugs of abuse.

PMID- 8341375
TI  - The National Institute on Drug Abuse 1992--focus on the future: a steadfast
      commitment to research.

PMID- 8341376
TI  - Credentials committee--"get involved".
AB  - The purpose of this information is to make a plea to physicians to get involved
      with your Credentials Committee. Your active interest and participation will help
      physicians maintain control of this important process. If you are not able to be
      an active member of the committee, be sure that there is someone on the committee
      who is looking our for your interests.

PMID- 8341377
TI  - Neonatal group B streptococcal infections: case report and review of the
      literature.

PMID- 8341378
TI  - Update on neonatal blood transfusions.

PMID- 8341379
TI  - Serum lipids predict cardiac death in diabetic patients on maintenance
      hemodialysis. Results of a prospective study. The German Study Group Diabetes and
      Uremia.
AB  - The objective of this study was to measure cholesterol concentrations in diabetic
      patients at the beginning of maintenance hemodialysis treatment and to define
      their role as predictors of subsequent cardiac death on maintenance hemodialysis.
      The design of this study consisted of a prospective study of all consecutive
      diabetic patients newly admitted to 28 German dialysis centers between January
      1985 and October 1987. The patients were examined on admission and subsequently
      followed for 45 months on dialysis. This study included 196 patients, 67 type I
      (43 male, 24 female, median age 49 years, range 22-73) and 129 type II (54 male,
      75 female, aged 64 years, range 37-82). Lipids (total cholesterol, triglycerides
      low-density lipoprotein (LDL) cholesterol high-density lipoprotein (HDL)
      cholesterol apolipoprotein B and A and anthropometric indices (body mass index,
      triceps skinfold thickness) were measured. The outcome was death, i.e.,
      cardiovascular (myocardial infarction, sudden death, other cardiac causes,
      stroke) and noncardiovascular death during a 45-month follow-up. At the start of
      treatment, total cholesterol, triglycerides LDL cholesterol, LDL/HDL ratio and
      apolipoprotein B were significantly higher in diabetics than in healthy controls
      or patients with standard primary renal disease starting dialysis. Only minor
      differences were found between males and females and type I and type II
      diabetics. Fourty-three percent of type I and 50% of type II diabetics died, 61%
      from cardiovascular causes, mostly myocardial infarction (in 40% reinfarction)
      and sudden death. On admission, diabetics subsequently dying from myocardial
      infarction had significantly higher median cholesterol than survivors, i.e., 259
      versus 222 mg/dl, and higher LDL cholesterol, LDL/HDL ratio and apolipoprotein
      B.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341380
TI  - Cigarette-smoking affects platelets and endothelium in chronic hemodialysis
      patients.
AB  - Previous work has shown that cigarette-smoking affects platelets and endothelium
      in men and women without renal failure. The present study compared 10 male
      habitual smokers receiving maintenance hemodialysis for chronic renal failure
      with 11 healthy male habitual smokers before and after controlled cigarette
      smoking after a 12-hour period of abstinence. Collagen-induced platelet
      aggregation was not significantly different in the two groups of men before
      smoking. The platelet aggregate ratio was lower and the plasma concentration of
      platelet factor 4 was higher in the dialysis patients than in the healthy men (p
      < 0.05). Mean or median values before and after cigarette smoking by the dialysis
      patients were 42 and 62 chart units for collagen-induced platelet aggregation,
      0.88 and 0.77 for the platelet aggregate ratio, 6.2 and 8.5 ng/ml for the plasma
      concentration of platelet factor 4, 0.8 and 1.7 per counting chamber for the
      endothelial cell count and 4 and 37 ng/ml for the plasma nicotine concentration
      (each p < 0.01). None of the changes which occurred in the dialysis patients was
      statistically significantly different from those in the healthy men. We conclude
      that cigarette-smoking has similar effects on platelets and endothelium in
      patients receiving maintenance hemodialysis and in healthy controls.

PMID- 8341381
TI  - Compliance in hemodialysis patients: a multivariate regression analysis.
AB  - Successful treatment of patients with end-stage renal failure requires, in
      addition to dialysis, strict control of dietary, fluid and medication intake. In
      the present study we measured, in 50 chronic hemodialysis patients, serum
      potassium (K), serum phosphate (PO4) and interdialytic weight gain as indices of
      diet, medication and fluid compliance, respectively. Dietary compliance did not
      correlate with fluid or medication compliance, whereas fluid intake and
      medication compliance were related (p = 0.01). Age, time on dialysis, place of
      birth and whether the patient came accompanied or not to the dialysis unit were
      the main variables affecting serum K levels. Sex, ethnic origin and education
      significantly affected serum PO4. Sex, place of birth, marital status, number of
      children and years of education affected fluid intake. The compliance of the
      hemodialysis patient with different aspects of his regimen is thus
      multifactorial. Attempts to improve compliance and thus reduce morbidity and
      mortality should be aimed at identifying the population with low compliance and
      exposing them to educational programs.

PMID- 8341382
TI  - Nafamostat mesilate: a regional anticoagulant for hemodialysis in patients at
      high risk for bleeding.
AB  - 107 hemodialysis patients at high risk for intradialytic bleeding due to previous
      surgery or active bleeding from other sites were treated with nafamostat mesilate
      (FUT-175; FUT) as hemodialysis anticoagulant for 2 weeks. In contrast to heparin.
      FUT prolonged clotting times only in the extracorporeal circuit. Clotting times
      were not prolonged even at the conclusion of the treatment, and bleeding from the
      puncture site after removal of the needle was shorter than with heparin. The
      exacerbation of bleeding by hemodialysis was noted in only 21 out of 573
      hemodialysis procedures (3.7%), and 134 of 145 hemodialysis procedures (92.4%)
      with active bleeding were successfully completed without increasing the bleeding.
      Adverse effects of FUT were noted in only 6 cases (5.6%) or 1.2% of HD
      procedures. These results indicate that FUT is a very useful anticoagulant for
      HD, especially in patients with high risk of bleeding.

PMID- 8341383
TI  - Serum vanadium levels in chronic hemodialysis patients.
AB  - Serum vanadium, aluminum, silicon and beta 2-microglobulin levels as well as the
      red cell count, hemoglobin and systolic blood pressure were simultaneously
      measured in 80 chronic hemodialysis patients. The serum vanadium level was
      positively correlated with the serum levels of aluminum, silicon and beta 2
      microglobulin as well as the systolic blood pressure, and was inversely
      correlated with the red cell count and hemoglobin. The mean serum vanadium level
      was 18.4 +/- 7.6 ng/ml before hemodialysis and decreased to 13.0 +/- 5.30 ng/ml
      at the completion of dialysis. The dialysate vanadium level increased from 0.4 +/
      0.2 (inflow) to 1.0 +/- 0.4 ng/ml (outflow). It was concluded that vanadium was
      transferred from blood to dialysate when purified water was used in the
      preparation of the dialysate.

PMID- 8341384
TI  - Questionable role of soy protein in childhood IgA nephropathy.
AB  - By means of indirect immunofluorescence, the glomerular deposition of soy protein
      was studied in renal biopsy specimens from 16 children (aged 4-18 years) with IgA
      nephropathy. In addition, serum anti-soy protein IgA antibody was measured by
      enzyme-linked immunosorbent assay. Glomerular immunofluorescence for soy protein
      was not found in any of the preparations studied, both without and with citrate
      buffer treatment, and there was no significant difference in the concentration of
      serum anti-soy protein IgA antibody between the 13 patients studied and 13 age-
      and sex-matched controls. It is thus unlikely that soy protein plays a crucial
      role in the pathogenesis of childhood IgA nephropathy.

PMID- 8341385
TI  - Prognosis of children with acute renal failure: a study of 138 cases.
AB  - Acute renal failure (ARF) in children has a poor prognosis in spite of modern
      therapeutic techniques. For this reason, it would be useful to have prognostic
      indicators early in the course of the disease, in order to identify those
      patients that could benefit most from aggressive treatment. In an attempt to
      establish valid prognostic factors, we prospectively studied 138 cases of ARF in
      children. We examined age, sex, etiology of ARF, previous surgery, prerenal
      origin, clinical situation of the patient when first seen by the nephrologist and
      complications. All these variables were statistically analyzed individually by
      univariate tests and, except for sex and complications, also by multiple
      regression analysis. Median age of the patients was 26 months. The etiology of
      ARF was nephropathy in 16, tumor in 14, cardiopathy in 85 and other causes in 23
      cases. For analysis, patients were divided into patients with and without
      prerenal ARF. In the prerenal group, mortality-related factors were hypotension,
      need for ventilatory support, age less than 1 month and serum values of
      creatinine. In the nonprerenal ARF group, the need for assisted ventilation and
      the need for dialysis correlate positively with the mortality, while an exclusive
      nephrological etiology was associated with less probability of death.

PMID- 8341386
TI  - Altered metabolism in the ex vivo remnant kidney. I. Effects of time, substrate
      and perfusion pressure.
AB  - Oxygen consumption is increased in the rat remnant kidney (RK), but the basis of
      this enhanced metabolic activity has not been defined fully. To characterize the
      hypermetabolism further, isolated RK and normal kidneys (NK) were perfused using
      a range of perfusion pressures and substrates, and at varying times after 5/6
      nephrectomy. Altered and increased RK metabolism was found as early as 1 week
      after 5/6 nephrectomy. The rate of net glucose consumption was higher in RK than
      NK (e.g., 0-30 min, 2.42 +/- 0.28 vs. 1.21 +/- 0.33 mumol.min-1 x g-1), a
      difference not explained by changes in oxygen delivery or glycosuria. Ammonia
      production was significantly greater early in perfusion in RK than NK. Calculated
      nephron oxygen consumption (QO2) was greater in RK than NK for all substrates
      tested (e.g., pyruvate 5 mM: 552.3 +/- 43.1 vs. 173.3 +/- 25.6 pmol.min-1, p <
      0.001). When considered together, site I mitochondrial substrates supported QO2
      and net sodium reabsorption (TNa+) better than site II substrates. In RK, QO2 did
      not change with increasing perfusion pressure, and TNa+ rose only slightly for
      pressures > or = 120 mm Hg. In summary, RK hypermetabolism is characterized by
      increased oxygen consumption, glycolysis and ammoniagenesis, is not substrate
      specific and does not appear to be an artefact of the altered physiology of
      remnant perfusion.

PMID- 8341388
TI  - Comparison of renal effects of creatinine, creatol and methylguanidine in rats
      with adenine-induced chronic renal failure.
AB  - Creatinine (Cr), creatol and methylguanidine (MG), which accumulate in the body
      with the progress of renal failure after adenine administration, were given
      separately to rats in order to compare their toxicities. Food containing adenine
      was given to rats for 20 days to induce renal failure. Then each of the test
      substances was administered intraperitoneally, and renal function of the rats was
      determined. The changes in glomerular filtration rate, renal plasma flow and
      renal blood flow after administration of Cr were only slight in comparison with
      those of the control group. Creatol or MG administration induced a significant
      decrease in renal function. In addition, the level of MG in serum, liver and
      kidney was extraordinarily high in rats given creatol or MG. The toxic effects
      are discussed on the basis of these results.

PMID- 8341387
TI  - Altered metabolism in the ex vivo remnant kidney. II. Effects of metabolic
      inhibitors and dietary protein.
AB  - To understand further the contribution of heightened net sodium reabsorption
      (TNa+) and other nontransport processes to increased and altered metabolic
      activity of the rat remnant kidney (RK), isolated RK and normal kidneys (NK) were
      perfused with and without metabolic inhibitors and following 4 weeks of low (12%)
      or high (40%)-protein diet. 3-Mercaptopicolinate (200 microM) and 2-deoxyglucose
      (200 microM) reduced glucose production and consumption, respectively, without
      altering oxygen consumption (QO2). Ouabain reduced TNa+ and QO2 in NK but not RK,
      and increased glucose consumption in RK (by 67%, p < 0.02, n = 12) and NK (by
      54%, p < 0.05, n = 12). Raising perfusate pH by 0.3 U to 7.65 increased glucose
      production in RK but not NK and reduced TNa+ in NK but not RK. Dietary protein
      restriction reduced QO2 (2.18 +/- 0.29 vs. 4.13 +/- 0.20 mumol-1 x min-1 x g-1, p
      < 0.001), TNa+ (8.74 +/- 4.39 vs. 38.83 +/- 8.32, p < 0.01) and ammoniagenesis (0
      30 min, 0.16 +/- 0.05 vs. 0.32 +/- 0.10, p < 0.05) in RK, but not NK. In summary:
      (1) responses to ouabain and alkalosis, but not other metabolic inhibitors, were
      quite distinct in remnant versus normal kidneys, and (2) protein restriction
      limited sodium-transport-dependent and -independent hypermetabolism in RK.

PMID- 8341389
TI  - Castration attenuates proteinuria and glomerular injury in hyperlipidemic male
      Imai rats.
AB  - Hyperlipidemic Imai rats spontaneously develop proteinuria and
      glomerulosclerosis, especially in males. We investigated the effect of castration
      on spontaneous proteinuria and progressive renal injury in male Imai ats. Male
      Imai rats (n = 16) were castrated at 5 weeks of age. Body weight, blood pressure,
      urinary protein excretion and serum constituents were checked and compared with
      sham-operated control rats (n = 16) up to 24 weeks. Sham-operated group 1 (n = 5)
      and castrated group 2 (n = 6) underwent morphological study after 16 weeks of
      observation and sham-operated group 3 (n = 11) and castrated group 4 (n = 10)
      were followed for an additional 8 weeks and used for morphological study. Growth
      rate was significantly stunted in castrated rats as compared with the controls.
      Castration significantly reduced proteinuria almost throughout the experiment
      (167 +/- 84 vs. 46 +/- 24 mg/kg/day, p < 0.001, at 8 weeks and 688 +/- 211 vs.
      458 +/- 97, p < 0.01, at 20 weeks). The glomerulosclerosis index was
      significantly higher in sham-operated control rats than in castrated rats (28.8
      +/- 18.0 vs. 7.3 +/- 3.1, p < 0.01, at 16 weeks, and 92.1 +/- 35.5 vs. 39.5 +/-
      8.9, p < 0.001, at 24 weeks). There were no significant differences in blood
      pressure, serum cholesterol, plasma renin activity, plasma somatomedin C levels
      between the two groups. These results raise the possibility that sex hormones may
      partly contribute to spontaneous proteinuria and progressive renal injury in male
      Imai rats.

PMID- 8341390
TI  - Effects of furosemide on renal oxygen consumption after ischemia in normal and
      streptozotocin diabetic rats.
AB  - Normal and streptozotocin diabetic rats were subjected to ischemic injury by
      unilateral renal artery occlusion for 60 min. The cortical and the medullary
      oxygen consumption (QO2) in the postischemic and the control, contralateral
      nonischemic, kidneys were measured 1 h, 1 day, and 1, 2 and 4 weeks for normal
      rats and 1 day, and 1 and 4 weeks for diabetic rats after ischemia. The effects
      of furosemide on QO2 of the cortex and the medulla of normal and diabetic rats
      were studied. The diabetic kidney was more vulnerable to ischemic injury than the
      normal kidney. Furosemide-sensitive active transport function in the medulla of
      the diabetic kidney was higher than that of the normal kidney. Furosemide did not
      decrease the cortical QO2 significantly in the control and the postischemic
      kidneys of normal and diabetic rats. In contrast, the medullary QO2 of the
      control kidney in both rats was significantly reduced by furosemide at every
      period after ischemia. In the medullary QO2 of the postischemic kidney, there
      were no significant decreases at any period after ischemia in the diabetic rats
      and only after a 1-hour period for normal rats. However, 4 weeks after ischemia,
      there was no statistically significant difference in the medullary QO2 inhibition
      by furosemide between the control and the postischemic kidneys in both normal and
      diabetic rats. We conclude that the furosemide-sensitive active transport
      function in the medulla recovers by the 4th week after ischemia in normal and
      diabetic rats.

PMID- 8341391
TI  - A case of pheochromocytoma of the urinary bladder in a long-term hemodialysis
      patient.
AB  - The development is reported of a pheochromocytoma of the urinary bladder in a 33
      year-old patient with systemic lupus erythematosus who had undergone long-term
      hemodialysis. A hypertensive episode followed by defecation was demonstrated by
      the monitoring of blood pressure with a portable automated sphygmomanometer
      without elevation of plasma catecholamines. The tumor was surgically removed and
      normalization of the patient's blood pressure followed. Thus, monitoring of blood
      pressure for 24 h proved useful for the diagnosis of pheochromocytoma and, in
      particular, of paroxysmal hypertension.

PMID- 8341392
TI  - Renal hypouricemia with both drug-insensitive secretion and defective
      reabsorption of urate: a novel type of renal hypouricemia.
AB  - Renal handling of urate in the hypouricemic patient with increase in both urate
      clearance (Cur) and Cur/creatinine clearance (Ccr) and normal urinary excretion
      of urate was studied according to the pharmacological evaluation. In the present
      case there was no response of urate excretion to either pyrazinamide or
      probenecid. Both furosemide and prednisolone could not alter Cur and Cur/Ccr.
      Administration of inosine could have increased Cur, which was greater than Ccr.
      These results suggest that the present case had the defect of both pre- and
      postsecretory reabsorption of urate, accompanied by the existence of drug
      insensitive secretion of urate, which is different from hitherto known types of
      renal hypouricemia, i.e. a novel type of renal hypouricemia.

PMID- 8341393
TI  - Chronic renal insufficiency after an episode of macroscopic hematuria in IgA
      nephropathy.
AB  - Several cases of acute renal failure associated with episodes of macroscopic
      hematuria (EMH) in IgA nephropathy (IgAN) have been reported; in every case renal
      function returned to normal. We report 2 cases with previous normal renal
      function that developed acute renal failure during EMH of 17 and 30 days
      duration, respectively. Renal biopsies showed mesangial proliferation with IgA
      deposits, crescents in 10-15% of glomeruli and a marked tubular necrosis with red
      blood cell casts obstructing the lumen in 30-45% of tubules. Although renal
      function improved after EMH cessation, it did not recover previous normal values.
      Thus, EMH can produce permanent loss of renal function in patients with IgAN.

PMID- 8341394
TI  - Wegener's granulomatosis with antiproteinase-3 antibodies occurring after
      Hodgkin's disease.
AB  - We describe the first association between Hodgkin's lymphoma and Wegener's
      granulomatosis, heralded by renal involvement. A 43-year-old man developed
      rapidly progressive glomerulonephritis requiring chronic hemodialysis 8 months
      after remission of Hodgkin's lymphoma. At that moment, no extrarenal involvement
      was found, despite extensive investigation. Antineutrophil cytoplasm antibodies
      were positive, without specificity for proteinase-3 or myeloperoxydase. Six
      months after beginning hemodialysis, multiple pulmonary nodules appeared, along
      with rapid clinical worsening. A surgical biopsy was performed which disclosed a
      giant cell granuloma. Antimyeloperoxydase antibodies remained negative, whereas
      proteinase-3 antibodies became positive. Wegener's granulomatosis was diagnosed
      and treatment with cyclophosphamide and steroids was started. Clinical and
      radiological improvement occurred promptly. Eleven months after treatment, both
      Wegener's disease and Hodgkin's lymphoma remained in remission.

PMID- 8341396
TI  - Use of tissue plasminogen activator for reopening of clotted dialysis catheters.
AB  - The use of central venous catheters as permanent vascular access in chronic
      hemodialysis is complicated by clotting. We have tried a nonallergenic
      thrombolytic agent, tissue plasminogen activator (t-PA), to dissolve catheter
      luminal thrombosis. Eight patients, 7 in chronic hemodialysis and 1 treated by
      immune adsorption had 18 treatments with locally applied t-PA (2 mg/2 cm3).
      Fifteen out of 16 treatments with longer bolus dwell than 60 min were successful.
      No side effects occurred. t-PA dissolves clot formation efficiently and safely,
      the drug is nonallergenic and can therefore be given repeatedly.

PMID- 8341395
TI  - Partial correction of dialysis-associated anaemia does not reduce erythropoietin
      dose or the incidence of side effects.
AB  - We examined the hypothesis that administering epoetin to maintain a lower target
      haemoglobin (Hb) results in a reduced side effect profile and a lower maintenance
      epoetin dose. We report a prospective study of 14 haemodialysis patients
      assessing epoetin dose efficiency and side effect profile of partially correcting
      dialysis-associated anaemia. Initial Hb was 6.2 +/- 0.6 g/dl (mean +/- 1 SD).
      Intravenous epoetin was commenced at 120 IU/kg/week in 3 divided doses and
      titrated to achieve a target Hb of 8 g/dl. Follow-up was 24 weeks. The final Hb
      was 8.7 +/- 0.8 g/dl. The peak epoetin dose was 196 +/- 86 IU/kg/week with a
      maintenance dose of 141 +/- 71 IU/kg/week. Therapy was associated with
      hypertension--5 patients (32%); seizures--1 patient (6%) (withdrawn from
      therapy), and temporary iron deficiency--4 patients (35%). Iron deficiency was
      corrected with oral therapy. There was 1 treatment failure. Comparable
      conventional regimens use 100-200 IU/kg to maintain the Hb at 10-13 g/dl and have
      a similar incidence of side effects. We concluded that reducing the target Hb in
      order to decrease epoetin requirements is not justified as it offers no benefit
      over conventional Hb targets in terms of dose requirements or side effects.

PMID- 8341397
TI  - Vesicoureteric reflux in a grafted kidney as a cause of massive hematuria: a case
      report.

PMID- 8341398
TI  - Acute renal failure as first clinical manifestation of the primary
      antiphospholipid syndrome.

PMID- 8341400
TI  - Maxillary brown tumor as manifestation of renal osteodystrophy.

PMID- 8341401
TI  - Spontaneous retropharyngeal bleeding in a patient on chronic hemodialysis.

PMID- 8341399
TI  - Excess purine degradation in muscle of chronic hemodialysis patients.

PMID- 8341402
TI  - Glomerulosclerosis and lipid peroxidation.

PMID- 8341404
TI  - Parenteral iron during hemodialysis.

PMID- 8341403
TI  - A case of crescentic glomerulonephritis associated with polymyositis.

PMID- 8341405
TI  - Long-term evolution of erythropoietin after successful renal transplantation.

PMID- 8341406
TI  - Angiographically demonstrable bilateral renal aneurysms in a patient with
      diabetic nephropathy.

PMID- 8341407
TI  - Concurrent renal sarcoidosis and lupus nephritis.

PMID- 8341408
TI  - Elevated circulating levels of hyaluronan in long-term hemodialysis patients with
      dialysis-associated arthropathy: what does it mean?

PMID- 8341409
TI  - Lymphorrhea following percutaneous right supraclavicular hemodialysis catheter
      placement.

PMID- 8341410
TI  - Radial arterial spasm in uremic patients undergoing construction of arteriovenous
      hemodialysis fistulas: diagnosis and prophylaxis with intravenous nicardipine.
AB  - Radial arterial spasm in uremic patients undergoing construction of internal
      arteriovenous (AV) dialysis fistulas was investigated transcutaneously using
      ultrasonic Doppler flowmetry. In 5 of 15 patients, radial arterial blood flow was
      significantly decreased 5 min after anastomosing the radial cephalic vein with
      the radial artery (14.3 +/- 4.5%, mean +/- SE, of the initial value; p < 0.001
      vs. the initial blood flow), indicating vasospasm. Vasospasm disappeared 20 min
      after anastomosing. In 10 patients who were continuously given nicardipine
      intravenously (1 microgram/kg/min) during surgery, vasospasm did not occur.
      Arterial blood flow was significantly increased in patients who received
      nicardipine as compared with patients who did not receive nicardipine and did not
      have vasospasm, both at 10 min (171.2 +/- 16.2 vs. 124.3 +/- 11.9%, p < 0.05) and
      at 20 min (176.5 +/- 17.6 vs. 130.2 +/- 11.2%, p < 0.05) after anastomosing. Mean
      blood pressure was significantly reduced without causing hypotensive symptoms in
      patients who received nicardipine as compared with patients who did not receive
      nicardipine and did not have vasospasm. Our study suggests that ultrasonic
      Doppler flowmetry is useful for diagnosing vasospasm in patients undergoing the
      creation of AV fistulas and that nicardipine may be effective in preventing
      vasospasm safely.

PMID- 8341412
TI  - Target detection in left and right hemispace: effects of positional pre-cuing and
      type of background.
AB  - The two experiments reported here examined the degree to which detection of
      targets by the right hemisphere can be characterized as occurring at the global
      level and detection by the left hemisphere can be characterized as occurring at
      the local level. Although the results provided some evidence for such a
      dichotomy, these hemispheric differences in processing were modified by the
      overall configuration in which the item is embedded, the nature of the
      background, and whether a precue indicates the probable location of the target.
      The findings are discussed in relation to current theories of hemispheric
      differences in spatial processing.

PMID- 8341411
TI  - Strategic search and retrieval inhibition: the role of the frontal lobes.
AB  - Recall of words from categorised lists was examined in 77 patients and 12 normal
      control subjects. In Experiment 1, both left temporal-lobe excisions that
      included the hippocampus (LTH) and left frontal-lobe removals (LF) impaired free
      recall, but the LF group performed normally when encoding and retrieval
      strategies were supplied. In Experiment 2, experimentally induced interference
      during cued recall abnormally hampered performance for the LF, but not for the
      LTH group. Subsequent removal of the interfering cues resulted in improved
      performance for the LF group. Thus, the integrity of the left frontal lobe seems
      indispensable for normal strategic retrieval and for the suppression of
      potentially interfering items in verbal memory.

PMID- 8341413
TI  - Corpus callosum morphometry and dichotic listening performance: individual
      differences in functional interhemispheric inhibition?
AB  - We examined the relationship between midsagittal corpus callosum area, as seen by
      magnetic resonance imaging, and behavioral laterality effects from a dichotic
      listening task requiring cross-callosal relay of an auditory signal, in 60
      healthy young adults. Four patients with complete forebrain commissurotomy were
      also given the dichotic listening task, confirming that in this task, the report
      of left ear items is dependent on callosal pathways. Contrary to our predictions,
      callosum measures were unrelated to either a laterality measure or to inferior
      (typically left) ear performance. Surprisingly, superior (typically right) ear
      accuracies, which do not depend on cross-callosal sensory transfer, were
      significantly and negatively correlated with callosum size. These findings show
      that normal variations in callosum size do not appear to contribute significantly
      to individual differences in hemispheric specialization. Callosum size may,
      instead, be associated with degree of functional interhemispheric inhibition.

PMID- 8341414
TI  - A material-control single-case study of the efficacy of treatment for written and
      oral naming difficulties.
AB  - Twenty-two right-handed aphasics with written and/or oral naming difficulties
      were treated with a traditional language therapy: copying and repetition of
      words. The efficacy and maintainability of the treatment were evaluated using a
      variation of the single-case design, which was termed the material-control single
      case design. Effectiveness of the treatment for written naming difficulty was
      demonstrated for 9 of 21 subjects in a first treatment and 3 of 14 subjects in a
      second treatment. Three of the 14 subjects benefitted overall from both
      treatments in written naming. In oral naming, 2 of 18 subjects responded well to
      the first treatment while 2 of 16 responded well to the second treatment. One of
      the 16 subjects showed benefits from both the first and second treatments in oral
      naming. Although written and oral naming disturbances were difficult to improve
      using ordinary language treatment, a small proportion of subjects clearly showed
      effectiveness of the therapy. Maintenance of the effects of treatment was
      observed in all of the improvers.

PMID- 8341415
TI  - Visual object agnosia, prosopagnosia, achromatopsia, loss of visual imagery, and
      autobiographical amnesia following recovery from cortical blindness: case M.H.
AB  - A number of higher visual deficits accompanied by severe retrograde
      autobiographical memory loss following bilateral medial occipital infarctions are
      described in case M.H. Assessment of M.H.'s visual object agnosia and
      prospagnosia suggested that he was unable to integrate the elements of a percept
      to form a meaningful whole. This deficit may occur at the level the percept is
      encoded into the visual buffer and inspected. M.H. also describes a loss of
      visual memories, and it is hypothesized that this may similarly be a result of an
      inability to integrate the elements of the visual representation (e.g. of an
      object or face) following its generation from long-term visual memory store into
      the visual buffer. M.H.'s retrograde autobiographical memory loss is postulated
      to be a consequence of the severe impoverishment of episodic memories that must
      occur when events originally stored multimodally, must be recalled without any
      visual component.

PMID- 8341416
TI  - Neuroendocrine brain asymmetry and physical complaints.
AB  - It was examined whether there is an association between physical health and
      alterations of normal brain asymmetry in cerebral control of neuroendocrine
      activity. In particular, it was studied whether right-handed subjects showing a
      high amount of physical complaints and recurrent diseases differ in direction and
      degree of brain asymmetry in cerebral control of cortisol secretion from subjects
      with only few physical complaints. Lateralized brain activation was achieved by
      presenting an emotionally aversive film to the subjects' left or right visual
      hemifield, using a technique for lateralizing visual input that allows prolonged
      viewing while permitting free ocular scanning. Results revealed a clear
      association between a high degree of physical complaints and altered brain
      asymmetry in cerebral control of neuroendocrine activity.

PMID- 8341418
TI  - Equivalent perceptual asymmetries for free viewing of positive and negative
      emotional expressions in chimeric faces.
AB  - Research employing chimeric stimuli (in which smiling and neutral half-faces are
      paired) has demonstrated greater influence of the left half-face in determining
      perceived intensity of expression. To date, no studies have examined how
      emotional expressions other than happiness are perceived in this format. Right
      handed subjects viewed chimeric faces depicting both positive (happiness,
      pleasant surprise) and negative (sadness, anger) emotions in a free vision task.
      Results indicated a left half-face bias for all four emotions, supporting the
      hypothesis of a greater right hemisphere role in emotional perception. The lack
      of differences in strength of left half-face bias as a function of the specific
      emotion depicted suggests that results obtained with typical chimeric half-face
      paradigms can be generalized to emotions other than happiness.

PMID- 8341417
TI  - Visual discrimination impairments following lesions of the superior temporal
      sulcus are not specific for facial stimuli.
AB  - Six rhesus monkeys took part in an experiment on visual learning. In three of the
      monkeys the part of the superior temporal sulcus in which many of the cells
      respond selectively to some aspect of faces was removed, while the remaining
      three animals served as unoperated controls. In Experiment 1 they learned a
      series of two-choice visual discriminations between patterns. The animals with
      lesions of the superior temporal sulcus were markedly impaired. The
      discriminations were of two types: in the first, the discriminanda differed in
      shape (e.g. Y and 3), while in the second they differed only in their orientation
      (e.g. <and>). Unlike animals with lesions to the neighbouring inferior temporal
      cortex who are impaired on shape but not orientation discriminations, animals
      with lesions of the superior temporal sulcus were equally impaired on both types
      of discrimination. In Experiment 2 the same six animals learned a series of
      discriminations between discriminanda which consisted of photographs of pairs of
      eyes. Each discrimination was between a set of eyes which looked directly at the
      viewer and a set in which the gaze was laterally averted to varying degrees.
      Again, animals with lesions of the superior temporal sulcus showed a marked
      impairment. We conclude that this impairment may be a general impairment in two
      choice visual discrimination learning, rather than a selective impairment in
      discrimination of eye gaze. This result warns against a simple interpretation of
      the function of this area as a "face area", concerned only, or chiefly, with the
      perception and significance of parts of the body, notably faces, and their
      movements.

PMID- 8341420
TI  - Ankyrin immunoreactivity in adult rat cerebellum.
AB  - An antibody recognizing all ankyrin isoforms was employed to localize ankyrin in
      the cerebellum by light and electron microscopy. White matter (myelinated fiber
      tracts) did not contain ankyrin. Granule cell bodies and axons contained ankyrin
      which extended into the parallel fibers and their synapses. Purkinje cells
      contained a nearly uniform plasma membrane undercoating of ankyrin in the cell
      body. However, in both of these cell types ankyrin was not detected in dendrites.
      Basket and stellate cells did not contain detectable ankyrin. Golgi
      neuroepithelial cell bodies and processes contained ankyrin while myelin and
      myelinated axons did not. These results indicate that the membrane skeletal
      protein ankyrin occurs in some, but not all, neuronal and glial cell types in the
      cerebellum. For the neurons in which it does occur its distribution is polarized,
      being limited to cell bodies and axons while not occurring in dendrites.

PMID- 8341419
TI  - Neuropeptide co-expression in the magnocellular neurosecretory system of the
      female rat: evidence for differential modulation by estrogen.
AB  - Single- and double-immunohistochemical staining methods were used to assay the
      effect of estrogen on the expression of co-existing peptides in the magnocellular
      neurosecretory system of the female rat. It was confirmed in colchicine-treated,
      ovariectomized animals that immunoreactive corticotropin-releasing factor and
      cholecystokinin co-exist in subsets of oxytocinergic neurons; in addition,
      dynorphin immunoreactivity was detected in a substantial majority of oxytocin
      containing magnocellular neurons. Consistent with previous studies, magnocellular
      vasopressinergic cells were found to display angiotensin II-, dynorphin- and
      galanin-immunoreactivities. Comparable results occurred in colchicine-treated
      ovariectomized rats independent of whether or not the animals received
      replacement injections of estradiol benzoate or vehicle. Ovariectomized rats that
      were not pretreated with colchicine showed enhanced staining (increased cell
      number and staining intensity of both cell bodies and terminals in the posterior
      pituitary) for each of the peptides that was found to co-exist in
      vasopressinergic neurons after treatment with estradiol; staining for vasopressin
      was similar in steroid- and oil-treated animals. Perikaryal staining for peptides
      co-localized with oxytocin was not discernibly different in estradiol- vs vehicle
      treated animals, while in the posterior lobe, differential effects of hormone
      replacement on oxytocin, cholecystokinin, and corticotropin-releasing factor
      immunostaining of terminals were apparent. Perikaryal staining for co-existing
      peptides in gonadally intact animals killed at the estrus or the diestrus II
      phases of the estrous cycle provided a pattern of results compatible with those
      seen in ovariectomized animals treated with estradiol or oil, respectively. These
      observations suggest that circulating gonadal steroids affect co-existing peptide
      expression differentially in oxytocinergic vs vasopressinergic neurons. All
      peptides examined that could be co-localized in vasopressinergic cells showed
      evidence of enhanced expression in the presence of estrogen, while at least two
      of these co-localized with oxytocin appeared driven in the opposite direction.
      The results in normally cycling rats indicate that this kind of influence may be
      manifest under normal physiological conditions.

PMID- 8341421
TI  - Synaptic contacts of serotonin-like immunoreactive and 5,7-dihydroxytryptamine
      accumulating neurons in the anuran retina.
AB  - The synapses of serotonin-like immunoreactive retinal neurons were studied in
      Bufo marinus and Xenopus laevis and those of 5,7-dihydroxytryptamine-labelled
      cells in Xenopus. Immunoreactivity to serotonin was mostly confined to amacrine
      cells. Synapses formed by profiles of labelled cells were almost uniformly
      distributed in the inner plexiform layer in both species. Interamacrine synapses
      were the most frequent, and in some cases two labelled amacrine cell profiles
      made a gap junction. Some of the labelled amacrine cells synapsed on to presumed
      ganglion cell dendrites and onto bipolar cell terminals. Labelled bipolar cell
      terminals synapsed on to non-labelled amacrine cell dendrites and received inputs
      both from labelled and non-labelled amacrine cells. Labelled bipolar cell
      profiles were not observed in the outer plexiform layer. After preloading and
      photoconversion of 5,7-dihydroxytryptamine in the Xenopus retina, labelled
      bipolar cell dendrites in the outer plexiform layer were observed to be
      postsynaptic to cone pedicles and less frequently to rods and horizontal cells.
      In the inner plexiform layer, synapse types formed by labelled bipolar cells were
      similar to those with serotonin immunoreactivity. The frequency of synapses
      formed by 5,7-dihydroxytryptamine-labelled amacrine cells increased, compared
      with serotonin immunocytochemistry. Labelled amacrine cells synapsed mostly with
      non-labelled amacrine cells, although the ratio of contacts formed by two
      labelled profiles increased. Synapses from labelled amacrine cell dendrites to
      non-labelled bipolar cell terminals and from non-labelled bipolar cell terminals
      to labelled amacrine cell profiles increased in number, while those from labelled
      amacrine cells to presumed ganglion cell dendrites decreased. The quantitative
      data obtained by the two approaches enabled us to propose different neuronal
      circuits for serotonin-synthesizing and -accumulating neurons of the Xenopus
      retina.

PMID- 8341422
TI  - The low molecular weight form of microtubule-associated protein 2 is transported
      into both axons and dendrites.
AB  - In the developing brain microtubule-associated protein MAP2 occurs as both a high
      molecular weight form, MAP2b, which is present only in dendrites, and a low
      molecular weight form, MAP2c, which is also present in axons. Because the MAP2c
      amino acid sequence is entirely contained within that of MAP2b it is not possible
      to raise a MAP2c-specific antibody, so that it has been impossible to determine
      whether MAP2c is present in dendrites along with MAP2b. To answer this question
      we have generated a MAP2c cDNA clone tagged with a 10 amino acid epitope from
      human c-myc. This additional sequence does not alter either the binding of MAP2c
      to microtubules or its effects on microtubules in non-neuronal cells. When
      expressed in cultured primary neurons by transfection, the myc tag allowed the
      distribution of MAP2c to be determined independently of endogenous MAP2 protein
      by immunostaining with an anti-myc antibody. This showed that MAP2c is present in
      all processes, indicating that it can enter all kinds of processes and is stable
      in their cytoplasm. The results further suggest that the selective association of
      high molecular weight MAP2 with dendrites depends on a mechanism that prevents
      either its entrance or survival in the axonal compartment.

PMID- 8341424
TI  - Adrenalectomy attenuates kainic acid-elicited increases of messenger RNAs for
      neurotrophins and their receptors in the rat brain.
AB  - Treatment with excitotoxin kainic acid is known to increase the level of
      messenger RNAs for nerve growth factor and brain-derived neurotrophic factor in
      the brain. In this study we have used quantitative in situ hybridization to
      analyse the effect of glucocorticoids on kainic acid-induced increase of nerve
      growth factor and brain-derived neurotrophic factor messenger RNA in the rat
      brain. In adrenalectomized animals, the kainic acid-mediated increase of brain
      derived neurotrophic factor messenger RNA in the hippocampus and the cerebral
      cortex was reduced by 50% compared to sham-operated animals. The increase of
      nerve growth factor messenger RNA elicited by kainic acid in the dentate gyrus
      was almost completely abolished in adrenalectomized animals. No significant
      change was seen in c-fos messenger RNA in the hippocampus of adrenalectomized rat
      after kainic acid injection compared to sham-operated kainic acid-treated rats,
      while a three-fold reduction was seen in the cerebral cortex. Dexamethasone
      injection prior to kainic acid administration potentiated the kainic acid-induced
      increase of nerve growth factor messenger RNA in the dentate gyrus and the
      piriform cortex. In contrast, dexamethasone pretreatment did not potentiate the
      kainic acid-mediated increase of brain-derived neurotrophic factor messenger RNA.
      We also examined the effect of adrenalectomy and kainic acid injection on
      tropomyosin receptor kinase B and C messenger RNA, encoding essential components
      of high-affinity receptor for brain-derived neurotrophic factor/neurotrophin-4
      and neurotrophin-3, respectively. Following adrenalectomy no change of
      tropomyosin receptor kinase B or C messenger RNA was detected in any of the brain
      regions studied compared to sham-operated animals. The injection of kainic acid
      caused four-fold and two-fold increases of tropomyosin receptor kinase B
      messenger RNA in the dentate gyrus and cerebral cortex, respectively, but no
      change in tropomyosin receptor kinase C messenger RNA in any of these regions. In
      adrenalectomized animals receiving kainic acid, the level of tropomyosin receptor
      kinase B messenger RNA was decreased both in the dentate gyrus and cerebral
      cortex as compared to sham animals treated with kainic acid. Taken together, the
      data suggest that excitotoxins and glucocorticoids both influence expression of
      brain-derived neurotrophic factor and nerve growth factor messenger RNA in the
      brain, but by two different mechanisms, where the effect of excitotoxin-evoked
      seizures is modulated by glucocorticoids.

PMID- 8341423
TI  - Transforming growth factor beta 1 and fibronectin messenger RNA in rat brain:
      responses to injury and cell-type localization.
AB  - Transforming growth factor-beta 1 rapidly increases in adult rat brain in
      response to experimental lesions. This study characterized the schedule of
      changes, regional distribution, and cellular localization of striatal
      transforming growth factor-beta 1 messenger RNA and fibronectin messenger RNA
      following partial striatal deafferentation by frontal cortex ablation. Frontal
      cortex ablation induced striatal transforming growth factor-beta 1 messenger RNA
      elevations that coincided temporally and overlapped anatomically with the course
      of degeneration of cortico-striatal afferent fibers. Within three days post
      lesioning, transforming growth factor-beta 1 messenger RNA was localized at the
      cortical wound. By 10 days, the anatomical site of transforming growth factor
      beta 1 messenger RNA expression shifted to the dorsal half of the deafferented
      striatum and co-localized with OX-42+ immunostained microglia-macrophage at the
      site of degenerating afferent terminals. Similarly, fibronectin messenger RNA
      also shifted from the cortical wound to the deafferented striatum by 10 days post
      lesioning. Fibronectin messenger RNA was localized to glial fibrillary acidic
      protein+ immunostained astrocytes surrounding degenerating corticostriatal
      afferents. Infusion of transforming growth factor-beta 1 peptide elevated
      striatal and cortical fibronectin messenger RNA. These findings suggest that
      microglia-macrophage associated with degenerating afferent fibres can upregulate
      transforming growth factor-beta 1 messenger RNA and may influence fibronectin
      messenger RNA synthesis in reactive astrocytes. This study suggests that
      transforming growth factor-beta 1 has a role in controlling extracellular matrix
      synthesis following brain injury, which is analogous to that in peripheral wound
      healing.

PMID- 8341425
TI  - Distribution of secretoneurin, a peptide derived from secretogranin II, in rat
      brain: an immunocytochemical and radioimmunological study.
AB  - The distribution of secretoneurin, a peptide derived from its precursor
      secretogranin II by proteolytic processing, was studied in the central nervous
      system of the rat by immunocytochemistry and radioimmunoassay and compared to the
      distribution of secretogranin II messenger RNA by using in situ hybridization.
      With a specific antiserum a distinct staining of fibers and to a lesser extent
      also of perikarya was observed throughout the central nervous system. A high
      density of immunoreactive fibers and terminals was found in several brain areas,
      i.e. the lateral septum, the medial parts of the amygdala, some medial thalamic
      nuclei, the hypothalamus, habenula, nucleus interpeduncularis, locus coeruleus,
      nucleus tractus solitarii, the substantiae gelatinosae of the caudal trigeminal
      nucleus and of the spinal cord. The quantitative distribution as measured by a
      radioimmunoassay agreed well with the varying densities of immunoreactivity found
      by immunocytochemistry. The highest concentrations of this peptide were present
      in the hypothalamus, in particular, in the median eminence and are comparable to
      those of the most highly concentrated neuropeptides. The distribution of
      immunopositive perikarya corresponded well with that of secretogranin II
      messenger RNA obtained by in situ hybridization. The pattern of secretoneurin
      expression in rat brain was widespread and unique, partially overlapping with
      established chemical transmitters and neuropeptides. The functional significance
      of this new brain peptide remains to be established.

PMID- 8341426
TI  - Sensory integration by the dorsal spinocerebellar tract circuitry.
AB  - Monosynaptic connections from sensory receptors to the dorsal spinocerebellar
      tract are believed to have a significant role in the transmission of sensory
      information to the cerebellum. However, predominant polysynaptic connections with
      highly convergent afferent input suggest a functional organization based on
      integrated sensory representations. We explored this possibility by examining the
      responses of dorsal spinocerebellar tract neurons to inputs from muscle
      receptors. We compared results from two sets of experiments designed to activate
      receptors in the gastrocnemius-soleus muscles. In one set (135 cells) we
      stimulated muscle receptors by stretching the isolated muscles and in the other
      set (194 cells) the muscle receptors were activated by passive foot flexion,
      which concurrently activated cutaneous and joint receptors as well. Population
      responses of the spinocerebellar neurons were quite different for the two types
      of stimuli. Foot flexion elicited long-latency excitatory responses in a majority
      (53%) of the cells, while muscle stretch elicited a large fraction of early
      peaking excitatory responses (28%) and inhibitory responses (38%). The long
      latency responses to flexion could not be accounted for by specific cutaneous
      inputs or by possible delayed reflex contractions. We concluded that both types
      of population response resulted from the muscle stretch and therefore the
      responses of dorsal spinocerebellar tract cells to these stimuli do not simply
      reflect the activity in specific classes of sensory receptors.

PMID- 8341428
TI  - Perinatal and adult factors responsible for the sexually dimorphic calcitonin
      gene-related peptide-containing cell population in the rat preoptic area.
AB  - Neurons containing calcitonin gene-related peptide in the medial preoptic nucleus
      exhibit the largest neurochemically defined sex difference in the rat preoptic
      area with a 20-fold difference in cell numbers. The gonadal steroid hormones
      responsible for this sexual dimorphism have been investigated by examining
      calcitonin gene-related peptide immunoreactivity in the preoptic area of adult
      rats receiving a variety of perinatal and adult gonadal steroid manipulations.
      Cells immunoreactive for calcitonin gene-related peptide were examined in two
      populations within the preoptic area, one in its ventrolateral aspect and the
      other located in the lateral division of the medial preoptic nucleus. Cell
      profile counts estimate numbers of calcitonin gene-related peptide-containing
      cells in the medial preoptic nucleus of the female to be 22.2 +/- 3.0
      cells/section compared with 1.0 +/- 0.2 in the male (P < 0.01). No sex
      differences existed in the preoptic ventrolateral population of calcitonin gene
      related peptide cells (males 4.3 +/- 0.2, females 4.4 +/- 0.6 cells/section).
      Gonadectomy of male rats on postnatal day 2 resulted in the appearance of a
      calcitonin gene-related peptide-containing cell population in the medial preoptic
      nucleus which was indistinguishable from intact female rats (19.3 +/- 2.2
      cells/section). Gonadectomy of adult male rats resulted in a modest increase in
      calcitonin gene-related peptide cell numbers within the medial preoptic nucleus
      (8.8 +/- 0.4 cells/section) and this was fully reversed by replacement of
      testosterone (0.7 +/- 0.2 cells/section).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341427
TI  - Rapid proliferation of calcitonin gene-related peptide-immunoreactive nerves
      during healing of rat tibial fracture suggests neural involvement in bone growth
      and remodelling.
AB  - The nervous system may be actively involved in bone repair and in remodelling of
      callous tissue in bone fractures, as well as in the regulation of nociceptive
      impulses from the site of the trauma. The aim of this study was to assess the
      distribution and nature of the periosteal innervation of normal control bone and
      during bone healing subsequent to fracture of rat tibiae at seven, 14 and 21 days
      after experimental fracture using immunocytochemistry and image analysis
      quantification of the neuronal marker protein gene product 9.5 and sensory
      neuropeptide calcitonin gene-related peptide. At seven days, periosteal protein
      gene product 9.5- and calcitonin gene-related peptide-immunoreactive fibres
      showed dense ramifications and terminal sprouting. In addition to periosteum, the
      nerve fibres were found in the middle of the callus interspersed with
      inflammatory cells and penetrating into secondary minor fractures. At days 14 and
      21 many tortuous nerves were found in the periosteum but not in mid callus. Image
      analysis quantification revealed a uniform increased proliferation of nerves
      after seven days. At 21 days, the intercept countings showed in excess of a three
      fold increase of calcitonin gene-related peptide-immunoreactive nerve fibres
      compared with the normal control group (P > or = 0.0001) and were almost as
      numerous as protein gene product 9.5-immunoreactive fibres (P < 0.005). It is
      postulated that calcitonin gene-related peptide-containing sensory innervation
      may have a potential importance in the fracture vascular control, angiogenesis
      and osteogenesis in addition to a protective role against excessive fracture
      movement. The results are consistent with the neural involvement in bone growth
      and remodelling.

PMID- 8341429
TI  - Health risks associated with mercury from dental amalgams.

PMID- 8341430
TI  - The incidence, benefits and variables associated with breastfeeding: implications
      for practice.
AB  - The health, nutritional and psychological benefits of breastfeeding are widely
      acknowledged. Breastfeeding is the recommended infant-feeding method for the
      first four to six months of life. Despite the well-documented benefits of
      breastfeeding, researchers in the United States have noted a decline in its
      incidence and duration over the last several years. In order to address this
      decline, clinicians need to be familiar with what is currently known about
      breastfeeding trends and benefits, as well as variables associated with infant
      feeding choices and reasons for premature weaning. Current breastfeeding research
      and implications for nursing practice are the focus of this article.
      Specifically, health practitioners are encouraged to develop a prolactation
      protocol for their practice. This involves development and/or utilization of
      educational and support services that span the prenatal period and continue until
      the child is weaned.

PMID- 8341431
TI  - Assessment and management of galactorrhea.
AB  - Galactorrhea, inappropriate lactation, is a relatively common clinical sign
      encountered by primary health care providers. However, this physical sign is not
      synonymous with life-threatening breast or intracranial malignancy; rather, it
      may be physiologic, drug-induced or idiopathic. Given the 20 percent prevalence
      of pituitary adenomas in women with galactorrhea, the primary health care
      provider must rule out, in every case, intracranial causes for galactorrhea. This
      article reviews relevant physiopathology and develops an assessment and
      diagnostic protocol, which includes indications for urgent referral. It concludes
      with summaries of treatment modalities, outlining the role of the primary care
      provider throughout the diagnostic and treatment processes.

PMID- 8341432
TI  - Management strategies for promoting successful breastfeeding.
AB  - Clinicians can promote a successful breastfeeding experience by providing
      support, anticipatory guidance and practical information. This article presents
      the components of early follow-up and guidelines for assessment. Management
      strategies for common problems are discussed, such as nipple soreness, cracked
      nipples, plugged ducts and mastitis, insufficient infant weight gain, perceived
      inadequacy of milk supply, breast-milk jaundice, sexual adjustment and failure at
      breastfeeding. Breastfeeding guidelines for employed mothers and adoptive mothers
      are indicated.

PMID- 8341433
TI  - The delivery of Early and Periodic Screening, Diagnosis and Treatment Program
      services by NPs in a nursing center.
AB  - Enacted in 1967 as a required component of the Medicaid program, the Early and
      Periodic Screening, Diagnosis and Treatment Program combines outreach, health
      screening, follow-up care for detected conditions, and case management. This
      article describes the delivery of this program's services by nurse practitioners
      in an academic nursing center. Detailed are the Nursing Center's activities to
      develop a services contract for the Early and Periodic Screening, Diagnosis and
      Treatment Program and to improve client access. Issues discussed include protocol
      development, prescriptive authority and referral to health care providers
      accepting Medicaid. Services are evaluated by auditors, faculty, students and
      clients. The article concludes with suggestions for other providers or potential
      providers of the program.

PMID- 8341434
TI  - Three (or four?) options for doctors.

PMID- 8341435
TI  - Draconian powers in Health Commissioner Bill.

PMID- 8341436
TI  - Public health spending is down.

PMID- 8341437
TI  - Mortality and social class in Maori and nonMaori New Zealand men: changes between
      1975-7 and 1985-7.
AB  - AIMS: Social class mortality differences in Maori and nonMaori New Zealand men
      aged 15-64 years have previously been examined for the period 1975-7. The
      analysis has now been repeated for the period 1985-7 in order to examine changes
      over time. METHODS: Numerator data were obtained from national death
      registrations and denominator data were obtained from the 1976 and 1986 censuses.
      These were used to calculate age-standardized death rates in Maori and nonMaori.
      RESULTS: Mortality declined by 28% in Maori and 14% in nonMaori between 1975-7
      and 1985-7. The death rate for diseases amenable to medical intervention fell by
      54% in Maori and 23% in nonMaori, but the Maori death rate was still 2.8 times
      the nonMaori death rate, whereas the relative risk for nonamenable causes was
      only 1.4. CONCLUSIONS: Some progress has been achieved in reducing ethnic
      differences in mortality in New Zealand men, but substantial differences remain
      for diseases which are amenable to medical intervention (including chronic
      rheumatic heart disease, hypertensive heart disease, and tuberculosis). It is
      likely that these differences reflect poor access to culturally safe and
      appropriate health care in Maori people.

PMID- 8341438
TI  - New coronary intervention devices: needed skills or useless frills.

PMID- 8341439
TI  - Mometasone versus betamethasone creams: a trial in dermatoses.
AB  - AIM: To compare the efficacy and safety of mometasone furoate cream 0.1% applied
      daily versus betamethasone valerate cream 0.1% applied twice daily in a variety
      of dermatoses. METHODS: A 4 week study was undertaken of patients with at least
      moderately severe dermatoses as judged by scoring of a target lesion. Weekly
      global improvement was assessed, as well as change in target lesion scores. Local
      side effects were noted including observation of atrophy. RESULTS: Fifty eight
      patients in three centres completed the study, 30 in the betamethasone group and
      28 in the mometasone. There was no difference in demographic variables or disease
      severity in each group or any difference between the three investigator gradings
      of initial severity. There was a rapid onset of improvement in both groups by day
      seven (scores being reduced by 72% in the betamethasone group and 65% in the
      mometasone group). By the fourth week visit there was 90% reduction in the
      betamethasone group score and 93% in the mometasone. There was no significant
      difference between the groups. CONCLUSION: Mometasone furoate cream 0.1% applied
      daily in dermatoses is as effective as betamethasone valerate 0.1% cream. Both
      creams had rapid onset of action and had no signs of atrophy. Better patient
      compliance could be expected with the convenience of mometasone cream being
      applied daily.

PMID- 8341440
TI  - Parental perceptions of information about medication prescribed for their
      children.
AB  - AIMS: The study aimed to examine parents' perceptions of the information provided
      to them on prescribed medication; how it might be improved and; parental level of
      knowledge of medication administration. METHODS: 245 parents completed a
      questionnaire at a preschool health day. The questionnaire covered parental
      opinion on whether the doctor provided enough information about illness and
      medication, recall of pharmacist's instructions on medication, parental general
      knowledge of medication and what parents wanted to know about medication for
      their children. RESULTS: The findings indicated there was an overall lack of
      information from the doctor on side effects and what to do if problems occurred
      with medication. Furthermore, half (49%) of the parents did not recall receiving
      any information from the pharmacist. Parents appeared to understand the basics of
      medication administration. CONCLUSIONS: It is suggested that improvements should
      be made regarding the information given to parents on prescribed medication. This
      may improve satisfaction with the service received from health professionals,
      such as doctors and pharmacists, and increase patient compliance with treatment
      regimes.

PMID- 8341442
TI  - NZMA dissent.

PMID- 8341441
TI  - Drug treatment of depression.

PMID- 8341443
TI  - Side effects of acipimox (Olbetam)

PMID- 8341444
TI  - The patient with haematuria.

PMID- 8341445
TI  - Chronic fatigue syndrome.

PMID- 8341446
TI  - A need for critical analysis, not confused criticism.

PMID- 8341447
TI  - Medical Council defends its questions.

PMID- 8341448
TI  - Ethics in the new environment.

PMID- 8341449
TI  - Computer column: patient numbering v privacy.

PMID- 8341450
TI  - Measuring quality.

PMID- 8341451
TI  - Transcatheter closure of patent ductus arteriosus in children and adults.
AB  - AIM: To describe the initial New Zealand experience of transcatheter patent
      ductus arteriosus closure in adults and children. METHODS: Twenty-three children
      beyond infancy and four adults with isolated patent ductus arteriosus were
      selected for transcatheter umbrella closure. Rashkind umbrellas were placed
      across the patent ductus arteriosus through a percutaneously inserted long venous
      sheath using the Mullins technique. RESULTS: In 25 of the 27 patients a Rashkind
      umbrella was placed accurately. In two patients the umbrella could not be placed
      accurately: in one the procedure was abandoned uneventfully and in one the
      umbrella embolised to the right pulmonary artery necessitating surgical removal
      of the device and patent ductus arteriosus closure. There were no other
      significant complications. A second umbrella insertion is planned in two children
      for a significant residual leak at 1-year follow up. CONCLUSIONS: Transcatheter
      patent ductus arteriosus closure is a low risk and usually effective alternative
      to surgical closure for the majority of patients beyond infancy.

PMID- 8341453
TI  - Prescription for increasing cooperation between clinicians and managers in public
      hospitals.

PMID- 8341452
TI  - Neuropsychological impairment and return to work following severe closed head
      injury: implications for clinical management.
AB  - AIMS: To study the rate and timing of return to work following severe closed head
      injury, and to compare the neuropsychological functioning of patients who
      successfully return to work with that of patients who fail to return to work.
      METHODS: The vocational status, level of cognitive functioning and personality
      functioning of a consecutive series of 66 patients who survived severe closed
      head injury was assessed between six months and three years postinjury. The level
      of cognitive and personality functioning of patients who returned to work were
      compared with that of patients who failed to return to work. RESULTS: Twenty five
      percent of patients failed to return to work, and a further 17% returned to work
      under special conditions of employment. Failure to return to work was related to
      the degree of neuropsychological impairment (cognitive deficit and adverse
      personality change), injury severity (duration of posttraumatic amnesia), and
      age. Multiple regression analysis found the total number of neuropsychological
      symptoms to be the strongest predictor of the patients' return to work.
      CONCLUSIONS: These findings suggest that neuropsychological symptoms are the main
      mechanism through which severe brain injury affects the ability to return to
      work. It is recommended that vocational rehabilitation of severe closed head
      injury patients be based on a comprehensive neuropsychological assessment.

PMID- 8341454
TI  - Demographic variables in Auckland medical students.
AB  - AIMS: To review the important background details of students admitted to the
      Auckland School of Medicine over its 25 years. METHODS: Data collected at the
      time of application on 2448 students who successfully gained entry to the course
      has been analysed and compared with similar demographic variables in the New
      Zealand population as a whole, and with some of the findings from a survey
      performed on the total student population enrolling at Auckland University during
      1990. RESULTS: Successful applicants had a mean age of 18.6 years, 39.7% were
      females and 77% were born in New Zealand. Eighty-three percent were European,
      3.6% Maori, 2.4% Pacific Islanders and 10.8% Chinese, Indian or other Asian.
      Sixty-three percent came from cities over 100,000, 16% being from towns less than
      20,000 people. State schools were attended by 77% of entrants and 55% went to
      single sex schools. University students enrolling in 1990 came from affluent
      backgrounds with 70% of medical students that year being from socioeconomic
      levels one and two. Parental occupation was found to clearly influence the career
      choice of students. CONCLUSIONS: Auckland medical students are predominantly from
      large cities and affluent backgrounds with only those of European origin being
      admitted in the same proportion as they occupy in the New Zealand population. The
      high ratio of Asian students reflects their commitment to senior secondary school
      studies while the lower admission rate for Maori and Polynesian students is due
      in part to the large number who leave school without completing their secondary
      education. The possible impact of these demographic variables on recruitment and
      loss from the course and on the choice and location of practice is discussed.

PMID- 8341455
TI  - Primary nonHodgkins lymphoma of kidney with humoral hypercalcaemia: case report.

PMID- 8341456
TI  - Establishment of a registry for hereditary nonpolyposis colorectal cancer in New
      Zealand.

PMID- 8341457
TI  - Therapeutic recommendations for common sexually transmitted diseases; Part 2.

PMID- 8341458
TI  - Resource constraints--what do we tell our patients?

PMID- 8341459
TI  - The Health Research Council and diabetes mellitus prevention.

PMID- 8341460
TI  - Failure of scabies treatment.

PMID- 8341461
TI  - Nonfluoridation in Oamaru and Timaru.

PMID- 8341462
TI  - Pharmaceutical company sponsorship.

PMID- 8341463
TI  - Antenatal self care.

PMID- 8341465
TI  - Hormone replacement therapy.

PMID- 8341464
TI  - Computerised age-sex registers.

PMID- 8341466
TI  - Serum methadone concentrations.

PMID- 8341467
TI  - Maternity benefits: the continuing saga.

PMID- 8341468
TI  - Core health services--a fiction?

PMID- 8341469
TI  - Minister says HUHC review unlikely.

PMID- 8341470
TI  - Unlinked anonymous monitoring of HIV prevalence at sexually transmitted disease
      clinics.
AB  - AIM: To determine the prevalence of HIV infection among patients attending the
      four sexually transmitted disease (STD) clinics in two metropolitan areas of New
      Zealand. METHODS: The population studied comprised everyone who attended between
      August 1991 and August 1992 because of concern about a possible new episode of an
      STD and who had a blood specimen taken for hepatitis B (or syphilis) serology.
      The study involved unlinked anonymous testing of left-over blood specimens,
      following ethical guidelines that have been proposed internationally. RESULTS:
      Among 8478 specimens tested, 23 (2.7 per 1000) were found to be HIV positive. The
      seroprevalence rates per 1000 among women, heterosexual men, and homosexual or
      bisexual men were 1.1, 1.3, and 44, respectively. All but five of the infected
      people were either known to be HIV positive or had an identifiable test during
      their clinic attendance. CONCLUSIONS: The seroprevalence rates are similar to
      those reported from STD clinics in England, and suggest that heterosexual
      transmission of HIV infection has not yet been extensive in New Zealand.

PMID- 8341471
TI  - Male cancer mortality by occupation: 1973-86.
AB  - AIM: To identify male occupational groups with increased risk of death from
      cancer in 1973-86. METHOD: Age and social class standardised mortality ratios
      were calculated for males 15-64 years for all cancers combined and for site
      specific cancers by occupational group. RESULTS: In general, higher socio
      economic groups had a lower all cancer mortality and lower socio-economic groups
      a higher mortality. After standardisation for age and social class, mortality
      ratios were increased for lung cancer in bricklayers and carpenters (SMR = 125;
      95% CI: 110-141), machine tool operators (SMR = 218; 95% CI: 131-342), and
      welders (SMR = 140; 95% CI: 120-161), with the first group also having an
      increased risk for pleural mesothelioma (SMR = 222; 95% CI: 70-522). Malignant
      melanoma risk was increased in clerical workers (SMR = 147; 95% CI: 106-199) and
      not in outdoor occupations. Colon cancer mortality risk was increased in managers
      (SMR = 125; 95% CI: 104-148), and woodworkers (SMR = 147; 95% CI: 115-186).
      Stomach cancer mortality risk was raised for machine tool operators (SMR = 357;
      95% CI: 128-782). Painters had an increased ratio for multiple myeloma (SMR =
      352; 95% CI: 140-729) and machine tool operators an increase for leukaemia (SMR =
      172; 95% CI: 45-446). CONCLUSIONS: The use of routinely collected data to examine
      cancer mortality by occupation is a useful method to identify groups with
      increased risks and provide information for hypothesis generation. Further
      research may be warranted to investigate lung and digestive cancers in
      woodworkers and machine tool operators, and cancer of the haemopoietic and
      lymphatic systems in painters and machine tool operators.

PMID- 8341472
TI  - Informed consent.

PMID- 8341473
TI  - Hepatitis C virus infections in oral and injectable drug users.
AB  - AIM: To assess the frequency of hepatitis C virus antibodies (anti HCV) and
      exposure to hepatitis B virus in injectable and oral drug users in Auckland.
      METHODS: Sera from 110 injectable drug users and 154 oral drug users were tested
      for anti HCV as well as hepatitis B and D virus markers. Liver function tests
      were also performed. RESULTS: 73% of injectable drug using persons and 4% of oral
      drug using persons were positive for anti HCV. Over half of persons with a
      positive anti HCV result had an abnormal elevation of the liver enzyme alanine
      aminotransferase (ALT). Total HBV exposure was similar in both injectable drug
      user and oral drug user groups at approximately 30%, with little difference
      between ethnic groups. There were no positive results for hepatitis D virus
      infection. CONCLUSIONS: Injectable drug users who are anti HCV positive may
      represent a potential source of HCV infection in the community. An upgraded
      educational programme, perhaps in conjunction with the needle/syringe exchange
      programme, may be required to ensure drug users are aware of the risks of HCV
      infection to both themselves and the community.

PMID- 8341474
TI  - An analysis of unscheduled return visits to an urban emergency department.
AB  - AIM: This study was undertaken to identify the reasons for unscheduled return
      visits to an urban emergency department, particularly those relating to physician
      errors in diagnosis and management, and, where possible, to identify strategies
      to reduce unscheduled return visits. METHOD: All patients returning to the
      Emergency Department, Christchurch Hospital, within seven calendar days of
      initial visit were identified. These cases were reviewed to identify reasons for
      return visit. RESULTS: Unscheduled return visits accounted for 2% of patient
      encounters. Sixty one per cent were due to illness related factors, 27% to
      patient related factors, 11% to physician related factors and 1% to system
      related factors. Significant management errors occurred in nine patients (4.4% of
      unscheduled return visits), three of whom were admitted. There were no ICU or CCU
      admissions and no deaths. CONCLUSIONS: Significant physician errors were a minor
      reason for reattendance at the emergency department and no specific areas of
      deficiency were identified. These might be further reduced by increasing the
      seniority and experience of staff and by the introduction of regular audit,
      continuing medical education and vocational training programmes. Interventions to
      reduce patient related unscheduled return visits might include better explanation
      of the role of the emergency department and better communication with patients
      about their illness and treatment.

PMID- 8341475
TI  - Trial of an asthma action plan in the Maori community of the Wairarapa.
AB  - AIMS: An asthma action plan has been tested in a study conducted by Wairarapa
      Maori community health workers and the Wellington asthma research group. There
      were several distinctive features of the project, including the programme of
      marae-based asthma clinics, and the partnership between the researchers and the
      Maori community groups. This paper describes the process by which the study was
      conducted since this experience may be relevant to future Maori health research
      projects. METHODS: The programme was launched with a series of hui at marae in
      the Wairarapa, and marae-based clinics were set up. These were followed up by
      further support from the Maori community health workers who helped people to keep
      diaries to monitor their asthma, and generally maintained contact. The severity
      of asthma in the participants was compared for a two-month period before the
      action plan was introduced, and for a four-month period after the plan was
      introduced. RESULTS: There was a high participation rate, with 91% (63/69) of
      participants finishing the programme, 75% of whom adequately completed their
      daily asthma diaries. Asthma control improved significantly in the participants.
      They commented positively on the programme, and particularly on the marae-based
      clinics. CONCLUSIONS: The study was successful in terms of participation in the
      marae-based clinics, acceptance and use of the plan, and improvement in asthma
      control of the participants. The findings indicate what can be achieved when
      researchers and Maori community groups work in partnership.

PMID- 8341477
TI  - Hypercalcaemia of malignancy.

PMID- 8341476
TI  - Use of hormonal contraceptives in an institutional setting: reasons for use,
      consent and safety in women with psychiatric and intellectual disabilities.
AB  - AIM: To describe the use of hormonal contraceptives in institutionalised women
      with psychiatric and/or intellectual disabilities. METHODS: Women who had been
      disability or mental health service inpatients for six months or more and were
      prescribed hormonal contraceptives were included. Data were collected from their
      clinical files and from structured interviews of the women and of their primary
      care givers. RESULTS: Forty two women were prescribed contraceptives, of whom 23
      were intellectually disabled and 28 had mental illnesses. Most women had no
      children; four had had one child and two, two children. Thirteen were not
      sexually active. Depot medroxyprogesterone acetate (Depo Provera) was prescribed
      for 69%, combined oral contraceptive agents for 14% and progestin-only oral
      contraceptives for 17%. Contraceptives were initially prescribed by hospital
      staff for all but 1 woman, and were administered without consent for over half
      the group, including 11 women for whom this administration was not legally
      authorized. Less than half the group had blood pressure measured within the
      previous 12 months and only a third had a cervical smear within the previous 3
      years. Of the women who were sexually active, less than half knew how to protect
      themselves from sexually transmitted diseases and less than 10% regularly used
      condoms. CONCLUSIONS: Improvements in reproductive health care for these women
      are needed, in particular attention to education and client participation in
      decisions about contraceptive treatment. It is suggested that gynaecological and
      family planning services be provided separately from psychiatric services.

PMID- 8341478
TI  - Health provisions for the elderly.

PMID- 8341479
TI  - Fluoridation.

PMID- 8341480
TI  - Fluoridation.

PMID- 8341481
TI  - The relevance of gluten in pharmaceutical products.

PMID- 8341482
TI  - Cannabis use among New Zealand adolescents.

PMID- 8341484
TI  - Munchausen syndrome by proxy.

PMID- 8341485
TI  - Blood transfusion trust.

PMID- 8341483
TI  - Occupational overuse syndrome (OOS)

PMID- 8341486
TI  - Medical milestone.

PMID- 8341487
TI  - Botulinum treatment of congenital esotropia.

PMID- 8341488
TI  - Cardiovascular risk factors and ARM.

PMID- 8341489
TI  - Cardiovascular risk factors and ARM.

PMID- 8341490
TI  - Why payment settings can influence practice guidelines.

PMID- 8341491
TI  - Glycemic control and development of retinopathy in youth-onset insulin-dependent
      diabetes mellitus. Results of a 12-year longitudinal study.
AB  - BACKGROUND: In 1979, the authors began a prospective study of the natural history
      of retinopathy in youth-onset insulin-dependent diabetes mellitus (IDDM). Their
      major goal was to determine if there was an association between glycemic control
      and the development and progression of retinopathy. METHODS: The study consisted
      of 420 individuals with IDDM (onset younger than 20 years of age) and no
      retinopathy at baseline. Study subjects were enrolled between 1979 and 1988.
      Stereo color fundus photographs were obtained annually. Two eye endpoints were
      recorded: duration when retinopathy was first detected, and when proliferative
      retinopathy was detected. Glycemic control was assessed by quarterly
      determinations of glycohemoglobin (GHb). Life-table analyses were performed
      relating duration of diabetes, sex, GHb, and age of diabetes onset to development
      of retinopathy. RESULTS: Retinopathy did not develop before 2 years' duration or
      before puberty. The prevalence of retinopathy was 50% by 9 years' duration and
      100% by 20 years' duration. Retinopathy developed in females approximately 2
      years sooner than in males, but plotting duration as postpubertal years resulted
      in nearly identical rates. Retinopathy developed significantly earlier in
      subjects with prepubertal onset of diabetes than in subjects with postpubertal
      onset if duration was plotted as postpubertal years. When separated into three
      groups based on GHb levels (< 7.5%, 7.5%-9%, > 9%), retinopathy developed
      approximately 2 years later in subjects in the less than 7.5% GHb group than
      those in the higher GHb groups. Proliferative retinopathy developed in 11
      subjects. Their mean GHb level was higher than the mean GHb for those without
      proliferative retinopathy (10.9 versus 8.6%; P < 0.01). The higher the level of
      GHb, the sooner proliferative changes were detected. CONCLUSION: Long-term
      glycemic control is significantly related to both development and progression of
      retinopathy. Prepubertal duration of diabetes is a significant risk factor for
      the development of retinopathy.

PMID- 8341492
TI  - Factors influencing the onset and progression of diabetic retinopathy in subjects
      with insulin-dependent diabetes mellitus.
AB  - BACKGROUND: The etiology of diabetic retinopathy is poorly understood. In the
      current study, factor associated with the onset and the progression or regression
      of retinopathy are evaluated. METHODS: Two hundred seventy-seven subjects with
      insulin-dependent (type I) diabetes mellitus (IDDM) were evaluated longitudinally
      for retinal changes over a mean of 2.7 years. The multistate Markov model was
      used to analyze the influences of the duration of diabetes, a family history of
      hypertension, age, sex, cigarette smoking, systolic blood pressure, diastolic
      blood pressure, cholesterol levels, and longitudinal glycohemoglobin (GHb) values
      on the development and the progression or regression of retinopathy. RESULTS:
      Univariate analysis confirmed that four factors were significantly associated
      with the etiology and the progression or regression of diabetic retinopathy: age,
      duration of diabetes, mean longitudinal GHb levels (all at P < 0.01), and
      diastolic blood pressure (P < 0.04). However, age was no longer significant when
      controlled by duration of diabetes. Cigarette smoking was only associated
      significantly with background retinopathy (stages 2 and 3). Systolic blood
      pressure, sex, a family history of hypertension, and cholesterol levels were not
      significantly associated with retinopathy. CONCLUSIONS: The onset of diabetic
      retinopathy is associated with the duration of diabetes, mean longitudinal GHb
      levels, smoking, and diastolic blood pressure. A longer duration of diabetes,
      higher GHb values, and higher diastolic blood pressure levels are associated with
      an increased risk of progression and a decreased chance of regression of diabetic
      retinopathy.

PMID- 8341493
TI  - Is gross proteinuria a risk factor for the incidence of proliferative diabetic
      retinopathy?
AB  - PURPOSE: To examine the relationship between gross proteinuria, measured at the
      initial examination, and the 4-year incidence of proliferative diabetic
      retinopathy (PDR) in a population-based study in Wisconsin. METHODS: Gross
      proteinuria was measured by reagent strip. Diabetic retinopathy was determined
      from stereoscopic fundus photographs in a masked fashion using the modified
      Airlie House classification scheme. RESULTS: In the younger-onset group taking
      insulin (n = 693), the relative risk of proliferative retinopathy developing in
      those with gross proteinuria at baseline was 2.32 (95% confidence interval [CI]:
      1.40,3.83) compared with those without gross proteinuria. For the older-onset
      group taking insulin, the relative risk was 2.02 (95% CI: 0.91,4.44), and for
      those not taking insulin it was 1.13 (95% CI: 0.15,8.50). After controlling for
      other risk variables, the relationship was of borderline statistical significance
      (P = 0.052) in the younger-onset group with no or early nonproliferative
      retinopathy at baseline. CONCLUSION: These data suggest that gross proteinuria is
      a risk indicator for proliferative retinopathy in younger-onset patients with
      diabetes. These patients might benefit from having regular ophthalmologic
      evaluation.

PMID- 8341494
TI  - Retinal nerve fiber layer defect as an early manifestation of diabetic
      retinopathy.
AB  - PURPOSE: An incidence of and risk factors for retinal nerve fiber layer defect
      were investigated in patients with type II diabetes mellitus and compared with
      that of age-matched control subjects. METHODS: The authors photographed the
      retinal nerve fiber layer of the right eye in each of 137 patients with diabetes
      and 144 healthy control subjects. The level of diabetic retinopathy ranged from
      levels 1 (no microaneurysm) to 4 (eyes with localized intra-retinal microvascular
      abnormalities or venous beading). Risk factors for the nerve fiber layer defect
      analyzed were age of patients, visual acuity, axial length, optic disc size,
      glycosylated hemoglobin, systolic blood pressure, and level of diabetic
      retinopathy. RESULTS: Defects of the retinal nerve fiber layer were found in 6/30
      (20%) eyes with level 1 retinopathy, 8/14 (57%) eyes with level 2 retinopathy,
      24/47 (51%) eyes with level 3 retinopathy, and 36/46 (78%) eyes with level 4
      retinopathy. These defect incidences were significantly higher than that of the
      control group, which had 5/144 (3.5%) defects (P < or = 0.001). Risk factors for
      this nerve defect were level of diabetic retinopathy (P = 0.002), high systolic
      blood pressure (P = 0.0232), and patient's age (P = 0.0478). Not correlated with
      the incidence of the retinal nerve fiber layer defect were visual acuity, disc
      size, axial length, and glycosylated hemoglobin level at the time of examination.
      CONCLUSION: These findings suggest that the retinal nerve fiber layer defect is
      common in patients with early diabetic retinopathy. Risk factors for this defect
      were higher level of diabetic retinopathy, systemic hypertension, and advanced
      age.

PMID- 8341495
TI  - An evaluation of the influence of reproductive factors on the risk of metastases
      from uveal melanoma.
AB  - BACKGROUND: There is a paucity of data concerning the possible role played by
      hormonal factors in the risk of metastases from intraocular melanomas. METHODS:
      The authors studied the influence of post-diagnosis pregnancy and oral
      contraceptive use in a group of women of reproductive age (45 or younger) who
      were treated for uveal melanoma by proton beam irradiation. A baseline
      reproductive history had been collected before irradiation for all women, and
      interim reproductive data were collected by mailed questionnaire. RESULTS: In
      this age group, the overall rate of metastasis among women was similar to that of
      men treated during the same interval (adjusted rate ratio: 1.28; 95% confidence
      interval: 0.62-2.67). A total of 24 full-term pregnancies were reported among the
      139 women still menstruating at diagnosis. Twenty-three women reported regular
      oral contraceptive use. Metastases developed in 15 of the 139 women. Compared
      with other women in the series, rates of metastases were not higher among the
      women who reported pregnancies (P = 0.932) or oral contraceptive use (P = 0.424)
      after diagnosis. CONCLUSION: Although based on limited numbers, results suggest
      that the hormonal environment has no appreciable influence on risk of metastases
      in younger women with uveal melanoma.

PMID- 8341496
TI  - Intraoperative fluorescein angiography.
AB  - BACKGROUND: Fluorescein angiography is often beneficial in the evaluation and
      management of many retinal vascular diseases. However, vitreous blood or
      opacities may prevent fluorescein studies before pars plana vitrectomy. After
      vitrectomy, fluorescein angiography may be delayed, creating uncertainty over
      differentiation of preoperative, intraoperative, and postoperative findings.
      METHODS: The authors have modified an intraocular light source and operating
      microscope to perform intraoperative fluorescein angiography easily. Twenty-five
      patients underwent fluorescein angiography during pars plana vitrectomy. All
      studies were recorded using a microscope-mounted video camera for intraoperative
      and postoperative evaluation. RESULTS: In all cases, intraoperative angiography
      was performed without complication. Indications for intraoperative studies
      included confirmation of macular edema, delineation of avascular retina, and
      localization of retinal and choroidal neovascularization. All videotape
      recordings of procedures were of high quality, allowing easy review and
      interpretation. CONCLUSION: Intraoperative fluorescein angiography is an easily
      performed adjunctive diagnostic procedure that can aid intraoperative evaluation
      and treatment of selected retinal vascular disorders.

PMID- 8341497
TI  - Hemodynamic alterations in the acute retinal necrosis syndrome.
AB  - BACKGROUND: Clinical and histopathologic observations suggest a role for ischemia
      in the pathogenesis of the acute retinal necrosis (ARN) syndrome. Disruption of
      blood flow appears to occur at some level in the retina or choroid and may
      account for some of the major features of the syndrome. METHODS: To investigate
      these potential circulatory changes, color Doppler imaging (CDI) was used to
      quantitate blood flow velocities and vascular resistance in the central retinal,
      ophthalmic, and short posterior ciliary arteries in ten consecutive patients with
      unilateral ARN syndrome. Data were analyzed with a paired Student's t test. The
      unaffected fellow eyes served as controls. RESULTS: Blood flow velocities within
      the central retinal artery were significantly reduced in eyes with ARN syndrome
      compared with control eyes. In affected eyes, there was a mean reduction of 55%,
      60%, and 72% in peak systolic, average, and end-diastolic velocities,
      respectively (P < 0.01). The calculated vascular resistance of the central
      retinal artery showed an upward trend, but the data fell short of statistical
      significance. Blood flow velocities from the ophthalmic and short posterior
      ciliary arteries were not significantly different compared with controls.
      CONCLUSIONS: This study demonstrates marked circulatory changes in the central
      retinal artery of eyes involved with the ARN syndrome. Although the exact
      mechanism and clinical significance are yet to be determined, the data support
      the presence of retinal arterial hemodynamic compromise in this condition.

PMID- 8341498
TI  - Toxoplasmosis neuroretinitis.
AB  - BACKGROUND: Neuroretinitis is a distinct clinical entity consisting of moderate
      to severe visual loss, optic nerve head edema, macular exudate in a stellate
      pattern, and variable vitreous inflammation. Although the etiology is usually
      postviral or idiopathic, an acute infectious cause occasionally is demonstrated.
      METHODS: Five juvenile or young adult patients with neuroretinitis are presented
      with serologic evidence of Toxoplasma gondii infection. Four of the five patients
      were treated with systemic antibiotics and corticosteroids; one patient was not
      treated. RESULTS: With a mean follow-up period of 50 months, visual acuity
      returned to 20/25 or better in four patients, with one patient regaining visual
      acuity of 20/60. Two patients had one or more recurrent episodes of
      neuroretinitis, distinguishing toxoplasmosis from idiopathic neuroretinitis,
      which is usually a monophasic illness. CONCLUSION: Toxoplasmosis infection is a
      rare, but potentially treatable, form of neuroretinitis and should be included in
      the differential diagnosis of "Leber's idiopathic stellate retinopathy."

PMID- 8341499
TI  - The diagnostic histopathologic features of ocular malaria.
AB  - BACKGROUND: The ocular complications in patients with malaria have been studied
      clinically by many investigators, but the histopathologic changes were rarely
      described and generally regarded as nonspecific. METHODS: The eye of a 53-year
      old man who died of chloroquine-resistant Plasmodium falciparum malaria was
      studied by brightfield and polarized light microscopy. FINDINGS: An epibulbar
      hemorrhage that involved the conjunctiva, episclera, and tendinous insertion of
      the medial rectus muscle was present. Cytoadherence and rosetting of the
      parasitized erythrocytes were observed within the partially occluded lumens of
      small retinal and uveal blood vessels. The birefringence of hemozoin (malarial
      pigment) within the lumens of small ocular blood vessels and in the hemorrhagic
      epibulbar area was demonstrated by polarized light. CONCLUSION: Birefringent
      hemozoinemia in vascular lumens of ocular tissues indicates systemic malarial
      infestation by any of the four species of malaria. Cytoadherence and rosetting of
      the parasitized erythrocytes inside ocular capillaries and venules is diagnostic
      of P. falciparum and is an important cause of ocular hemorrhage.

PMID- 8341500
TI  - Retinal folds in Terson syndrome.
AB  - BACKGROUND: Perimacular retinal folds have been reported in the shaken baby
      syndrome, but have not been described in adults with Terson syndrome. METHODS:
      The authors present two patients with perimacular retinal folds in adults with
      Terson syndrome. In one patient, electron microscopy was used to examine the
      membrane spanning the fold. RESULTS: The membrane spanning the perimacular fold
      was found to be internal limiting membrane. The pathogenesis of these perimacular
      folds found in adults sustaining direct head trauma is probably different from
      that previously described for folds seen in infant eyes with shaken baby
      syndrome. CONCLUSION: Retinal folds occurring in Terson syndrome are clinically
      similar to those seen in the shaken baby syndrome.

PMID- 8341501
TI  - Immunocytologic findings in a case of Vogt-Koyanagi-Harada syndrome.
AB  - BACKGROUND: Vogt-Koyanagi-Harada (VKH) syndrome is a form of chronic panuveitis
      that often has a poor long-term visual outcome. To the authors' knowledge, there
      have been only two previous reports describing immunocytologic findings in the
      eyes of patients with VKH syndrome, all studied in relatively late stages of the
      disease. METHODS: The authors performed immunocytologic studies on the enucleated
      eyes of a patient with active VKH syndrome, using monoclonal antibodies to
      mononuclear subsets, major histocompatibility antigens, and viral and treponemal
      agents, to better understand the pathophysiologic mechanisms underlying the
      disease. Emulsified chorioretinal tissue also was processed for viral isolation
      in tissue culture and for Treponema pallidum by rabbit inoculation studies.
      RESULTS: The dense uveal infiltrates in active VKH syndrome are composed
      predominantly of T lymphocytes and HLA-DR+ macrophages. Scattered T cells and
      plasma cells were present in the retina. In addition, nondendritic-appearing CD1
      (Leu-6) positive cells were localized in the choroid, in close proximity to
      choroidal melanocytes. No microbial agents were identified. CONCLUSION: Whereas
      the etiology of the VKH syndrome remains an enigma, the authors' immunocytologic
      findings are consistent with a T-cell-mediated disorder. In demonstrating CD1
      (Leu-6) positive cells in the infiltrates, the authors propose a potential role
      for these cells in the etiology of VKH syndrome.

PMID- 8341502
TI  - The association of HLA-B8, B51, DR2, and multiple sclerosis in pars planitis.
AB  - PURPOSE: To establish a human leukocyte antigen (HLA) association in a
      homogeneous population of patients with pars planitis. METHODS: A strict set of
      inclusion parameters was established for the diagnosis of pars planitis. Forty
      patients with pars planitis who met these criteria underwent HLA analysis of
      class I and II phenotypes. RESULTS: HLA-B8 was present in 15 (37.5%) of 40
      patients versus 85 (19.7%) of 431 controls (relative risk, 2.44; P = 0.011). HLA
      B51 was present in 9 (22.5%) of 40 patients versus 51 (11.8%) of 431 controls
      (relative risk, 2.16; P = 0.049). HLA-DR2 was present in 27 (67.5%) of 40
      patients versus 121 (28.0%) of 431 controls (relative risk, 5.32; P < 0.0001).
      HLA-DR2 has been associated with multiple sclerosis (MS). Exclusion of five
      patients with pars planitis in whom MS subsequently developed did not change the
      significance of these findings. CONCLUSIONS: The strongest association of pars
      planitis with HLA-DR2 and the temporal development of MS in some patients with
      pars planitis further supports an association between pars planitis and MS.

PMID- 8341503
TI  - Intraocular lens implantation versus no intraocular lens implantation in patients
      with chronic iridocyclitis and pars planitis. A randomized prospective study.
AB  - PURPOSE: The authors studied the safety of intraocular lens (IOL) implantation in
      patients with uveitis. METHODS: The authors prospectively randomized 26 patients
      with chronic iridocyclitis (22 patients) or pars planitis (4 patients) to undergo
      IOL implantation or no IOL implantation at the time of cataract surgery. RESULTS:
      There was no statistical difference in visual acuity results at 1 year between
      the two groups. There was a trend toward better visual acuity in patients with
      chronic iridocyclitis without IOLs. Cocoon-like dense fibrous membranes enveloped
      the IOL in two patients. CONCLUSION: The authors conclude that IOLs are
      relatively safe in patients with chronic iridocyclitis but that only a much
      larger study could determine if the trend toward better visual acuity without an
      IOL was real.

PMID- 8341504
TI  - Cataract extraction in patients with pars planitis.
AB  - BACKGROUND: The authors analyzed the results of cataract surgery performed on
      patients with pars planitis from January 1985 through August 1992. METHODS: One
      hundred twenty-six patients with pars planitis were evaluated and treated during
      this period. Cataracts that warranted surgery developed in 12 patients (18 eyes)
      from this tertiary referral population. These 12 patients were evaluated with
      respect to pars planitis duration, systemic disease association, treatment
      regimens, macular and disc pathology, and final visual result. RESULTS: The
      average final visual acuity of these 18 eyes was 20/38, and 83% of the patients
      achieved a final visual acuity better than or equal to 20/40. The factors that
      limited visual recovery to this level were primarily macular and optic nerve
      pathology (cystoid macular edema [CME], macular epiretinal membrane, and optic
      atrophy). Control of inflammation required regional steroids in all patients,
      systemic steroids in ten patients, and immunosuppression in four patients.
      Posterior chamber lens implantation accompanied the surgery in 14 eyes (10
      patients). Recurrent episodes of inflammation in two patients (3 eyes) resulted
      in accumulation of deposits on the posterior chamber intraocular lens (IOL)
      surface. Deposits were removed by a YAG laser lens "polishing" session.
      CONCLUSION: Absolute control of inflammation in patients with pars planitis
      through a stepladder approach may reduce the incidence of cataract development,
      and can certainly improve visual rehabilitation after cataract extraction.
      Implantation of a posterior chamber lens can be well tolerated in selected cases.

PMID- 8341505
TI  - Pseudophakia for traumatic cataracts in children.
AB  - PURPOSE: The purpose of this prospective study is to evaluate the postoperative
      visual acuity, refractive error, intraocular pressure, and status of the
      posterior capsule in children with traumatic cataracts who undergo extracapsular
      cataract extraction and insertion of a posterior chamber lens. METHODS:
      Extracapsular cataract extraction and primary endocapsular fixation of a
      posterior chamber lens implant were performed in eight children (age range, 4-17
      years) with unilateral traumatic cataracts. RESULTS: There were no intraoperative
      complications, and seven of eight eyes achieved 20/40 or greater spectacle visual
      acuity during an average follow-up interval of 10 months (range, 5-20 months).
      The average postoperative spherical equivalent refractive error was +0.33 diopter
      (D) (range, -2.25 to +2.12 D); the average postoperative anisometropia was
      approximately 1 D (range, 0-2.25 D). In one patient, a coagulase-negative
      staphylococcal endophthalmitis developed 10 days after surgery. In three eyes
      that had opacified posterior capsules, YAG laser capsulotomy was performed.
      CONCLUSIONS: These preliminary results suggest that intraocular lens (IOL)
      implantation may be a safe and effective method of optical correction for
      children with traumatic cataracts.

PMID- 8341506
TI  - Epithelial interface cysts after epikeratophakia.
AB  - BACKGROUND: Epithelial interface cysts have been occasionally observed after
      lamellar keratoplasty. The authors report the incidence, clinical significance,
      and management of this complication in epikeratophakia patients. METHODS: From
      August 1987 to January 1991, 108 consecutive patients undergoing epikeratophakia
      entered a prospective study aimed at evaluating both clinical results and changes
      in corneal physiologic parameters. After an average hospitalization of 6 days,
      all patients underwent complete ophthalmologic examinations at regular intervals
      after surgery. All postoperative complications, including the development of
      epithelial interface cysts, were recorded and photographed. RESULTS: Over a 3
      year period, epithelial interface cysts were observed in 8 eyes, with an overall
      incidence of 7.4%. All cysts originated under the periphery of the epilens. In
      five patients, the cysts enlarged centripetally but eventually ceased to grow,
      causing no visual impairment. In two patients, after an initial increase in size
      the cysts slowly regressed and finally disappeared. In only one patient, a cyst
      migrated over the visual axis, thus necessitating surgical removal. The cyst did
      not recur during an observation time of 18 months after debridement, allowing
      full recovery of visual acuity. CONCLUSION: The incidence of epithelial interface
      cysts after epikeratophakia is relatively high. Because of their peripheral
      location and self-limited growth, the clinical significance of this complication
      is low. The possibility of spontaneous regression of the cysts supports a
      conservative approach, as long as the visual axis is not affected. Surgical
      removal is possible without compromising the epi-lens and is compatible with an
      excellent visual outcome.

PMID- 8341507
TI  - Optical zone centration in keratorefractive surgery. Entrance pupil center,
      visual axis, coaxially sighted corneal reflex, or geometric corneal center?
AB  - PURPOSE: To study the differences in optical zone marking using the geometric
      corneal center, entrance pupil center, visual axis, and the coaxially sighted
      corneal reflex as centration points. METHODS: A modified autokeratometer was used
      to photograph the cornea in 50 volunteers under standardized levels of
      illumination, with the subject fixing on the keratometer target. These
      photographs enabled us to mark the above-mentioned centration points and measure
      the direction and degree of decentration. RESULTS: From the corneal intercept of
      the visual axis, the entrance pupil center was found up to 0.75 mm (mean, 0.34
      mm) temporally, the corneal reflex was found up to 0.62 mm (mean, 0.02 mm)
      nasally, and the geometric corneal center was found up to 1.06 mm (mean, 0.55 mm)
      temporally. CONCLUSION: The ideal physiologic centration point is the corneal
      intercept of the visual axis. The decentration from the visual axis was least if
      the coaxially sighted corneal reflex was used for centration.

PMID- 8341508
TI  - Acanthamoeba keratitis. The value of early diagnosis.
AB  - BACKGROUND: The treatment of Acanthamoeba keratitis has been increasingly
      successful as diagnoses are made earlier. The authors investigated features of
      the disease and prognosis in a consecutive series of 15 patients who were treated
      within 1 month of initial symptoms. METHODS: A database of patients with
      Acanthamoeba infection presenting between March 1984 and March 1992 was analyzed.
      The recognition, presenting features, culture methods, results, and treatment of
      the early cases were reviewed to determine the reasons for a good outcome.
      RESULTS: Recognition depended on perineural infiltrates (11/15), uveitis (10/15),
      limbitis (14/15), and infiltrated epithelium; 6 of 15 patients had epithelial
      defects, but only 3 of 15 had ring infiltrates or ulcers. Epithelial biopsy was
      culture-positive in 12 of 15 patients. Most (11/15) patients needed only two anti
      amebal drugs. One patient only required penetrating keratoplasty for uncontrolled
      disease. The final visual acuity was at least 6/12 in all patients who had been
      treated within 1 month of first symptoms, whereas only 17 (53%) of 32 eyes of
      patients who presented after 1 month achieved a visual acuity of 6/12.
      CONCLUSIONS: Subtle diagnostic signs, supported by comprehensive microbiologic
      investigation, justify the immediate instigation of specific antiamebal therapy.
      Treatment within 1 month of onset results in a lower morbidity and a good visual
      outcome.

PMID- 8341509
TI  - Invasive squamous cell carcinoma arising from asymptomatic choristomatous cysts
      of the orbit. Two cases and a review of the literature.
AB  - BACKGROUND: Epithelial choristomatous cysts are common orbital lesions, the most
      frequent of which are dermoid or epidermoid tumors. Massive enlargement or
      extraorbital extension of these benign lesions may occur. Malignant
      transformation of the epithelial lining of epidermoid cysts is rarely reported.
      METHODS: Two patients are presented in whom the epithelial lining of a previously
      asymptomatic choristomatous cyst of the orbit underwent malignant transformation
      to produce invasive squamous cell carcinoma. The unusual origin and clinical
      presentation of the lesions caused a delay in the diagnosis and therapy in both
      patients. Metastatic workup was negative in both patients, who underwent
      resection of their tumors via orbital exenteration with craniofacial resection.
      Reported cases of malignant transformation in analogous choristomatous cysts
      elsewhere in the cranium are reviewed. RESULTS: One patient is alive and well
      without recurrent disease 40 months postoperatively. The second patient died of a
      pulmonary embolus 2 months postoperatively. Autopsy showed no residual tumor.
      Overall, only 3 of 18 reported patients with epidermoid choristoma of the head
      and orbit with malignant transformation were alive when reported. CONCLUSIONS:
      Malignant squamous metaplasia is believed to be a rare complication of orbital
      dermoid or epidermoid cysts, with only two previously reported cases. However,
      malignant transformation is relatively frequent in analogous epidermoid cysts
      found elsewhere in the cranial vault, especially after incomplete excision. These
      reports encourage the complete removal of epithelial choristomas of the orbit.

PMID- 8341510
TI  - Changes in retinal nerve fiber layer thickness after reduction of intraocular
      pressure in chronic open-angle glaucoma.
AB  - PURPOSE: The authors evaluated the relative nerve fiber layer height changes in
      glaucomatous eyes after reduction of intraocular pressure (IOP) after
      trabeculectomy using image analysis techniques. METHODS: Optic disc topography
      and relative nerve fiber layer height of 12 eyes of 12 patients with chronic open
      angle glaucoma were measured using a Rodenstock optic nerve head analyzer and
      Caprioli's program for nerve fiber layer height determination before
      trabeculectomy and at 2 or more months after surgery. RESULTS: Changes in
      relative nerve fiber layer height after surgery, as well as those in cup volume
      and rim area, showed statistically significant correlation with the degree of
      reduction of IOP (Spearman's correlation coefficient = 0.66; P < 0.05). Changes
      in the mean deviation of Humphrey visual field showed a slight correlation with
      IOP reduction (Spearman's correlation coefficient = 0.55; P < 0.1). CONCLUSION:
      Nerve fiber layer height changes that may occur after trabeculectomy are pressure
      dependent.

PMID- 8341511
TI  - Can the concentration of timolol or the frequency of its administration be
      reduced?
AB  - BACKGROUND: There is evidence that the ocular hypotensive effect of topical beta
      blockers persists for at least 24 hours once beta-blockade has been achieved. In
      previous studies, the highest concentration of drug generally has been used for
      this purpose. METHOD: Home tonometry was performed with a self-tonometer by 14
      patients to study the intraocular pressure (IOP) reduction of 0.5% timolol
      administered once daily in the morning or in the evening and of 0.25% timolol
      administered in the morning. The study was masked and included washout periods
      before and between the different regimens. At the end of each treatment period,
      the IOP was monitored five times daily for 3 days. RESULTS: No significant
      difference in mean reduction of IOP was found between the morning instillation of
      once daily 0.5% timolol compared with evening instillation of 0.5% timolol. In
      addition, there was no statistically significant difference in the mean IOP
      reduction between once daily administration of 0.25% versus 0.5% timolol.
      CONCLUSION: This study indicates that a lower concentration of timolol maleate
      used once daily may achieve maximum IOP reduction. The time of the single
      administration appears not to make any difference.

PMID- 8341512
TI  - Comparison of the anterior chamber inflammatory response to diode and argon laser
      trabeculoplasty using a laser flare meter.
AB  - BACKGROUND: Diode laser trabeculoplasty (DLT) has a similar hypotensive action to
      argon laser trabeculoplasty (ALT). However, anterior chamber inflammatory
      response and laser-induced discomfort are less pronounced with DLT. The authors
      compared the breakdown of the blood-aqueous barrier after DLT and ALT over the
      time course of 1 week and the hypotensive action over 8 weeks. METHODS: Twenty
      five patients with uncontrolled intraocular pressure (IOP) were randomized to
      either DLT or ALT. If two eyes required treatment, then the second eye would be
      treated with the alternative laser to the first. Flare values were measured at 1,
      3, 24, 48, 72, 96, and 168 hours using a laser flare and cell meter. Intraocular
      pressures were measured at similar intervals and at 8 weeks. RESULTS: Of 38 eyes
      treated, 21 underwent ALT and 17 DLT. Both forms of treatment induced a similar
      hypotensive effect with a significant reduction in IOP at 8 weeks compared with
      initial IOP (P < 0.01) (paired Student's t test). However, there was a
      significantly greater disruption of the blood-aqueous barrier with ALT when
      compared with DLT at 1, 3, and 24 hours (P < 0.001) and at 48, 72, and 96 hours
      (P < 0.01) (unpaired Student's t test). By 1 week, however, there was no
      significant difference in flare values between the two groups. Postlaser pain
      occurred in seven eyes treated with ALT but in no eyes treated with DLT. In
      addition, peripheral anterior synechiae occurred in four eyes after ALT by 8
      weeks but none occurred in the DLT group. CONCLUSION: Argon laser trabeculoplasty
      produces a greater disruption of the blood-aqueous barrier than DLT. This may be
      associated with the development of complications in the anterior segment.

PMID- 8341513
TI  - Late argon laser suture lysis after mitomycin C trabeculectomy.
AB  - BACKGROUND: Argon laser suture lysis has been effectively used in the early post
      operative period to enhance filtration after trabeculectomy. The most substantial
      reductions in intraocular pressure (IOP) occur when laser suture lysis is
      performed during the first 2 postoperative weeks, and virtually no effect has
      been reported after the fourth postoperative week. Mitomycin C, used as adjunct
      therapy, improves the success rate of trabeculectomy in high-risk eyes and may
      change the time course for effective suture lysis. METHODS: The authors used late
      laser suture lysis in five high-risk patients after mitomycin C trabeculectomy.
      The mean patient age was 66.8 +/- 15.7 years, and laser suture lysis was
      performed an average of 13 +/- 5.8 weeks (range, 7-21 weeks) after surgery.
      RESULTS: The mean IOP before suture lysis was 20.2 +/- 3.8 mmHg. The average IOP
      reduction immediately after suture lysis was 11.4 +/- 3.9 mmHg. The average IOP 3
      to 4 months after laser suture lysis was 9.4 +/- 3.4 mmHg. CONCLUSION: The
      authors postulate that adjunctive mitomycin C therapy markedly delays wound
      healing and appears to extend the period that laser suture lysis is clinically
      effective.

PMID- 8341514
TI  - Management of functional impairment due to cataract in adults. Cataract
      Management Guideline Panel.

PMID- 8341515
TI  - The classification of flaps.
AB  - The history of flap surgery originated several thousands of years ago. As each
      era of humans learned to apply the principles of anatomy, progress was made in
      the coverage of difficult and complex wounds. A classification scheme is
      important not only to organize our thinking, but also to logically plan an
      operation based on reconstructive requirements. The most important factor in the
      safe design of flaps is a fundamental understanding of the anatomy based on the
      arterial supply.

PMID- 8341516
TI  - Soft tissue reconstruction. Coverage of hand injuries.
AB  - The complexity of the hand necessitates careful assessment of an injury. Wound
      coverage requires careful appraisal of the tissue available for coverage and
      consideration of its functional and cosmetic aspects. The simplest yet most
      appropriate flap should be chosen. Local flaps can cover many wounds. Larger
      wounds may require significant debridement, which should be performed early using
      the pseudotumor technique. Free flap coverage is then indicated and should be
      completed within 3 days of injury if no extenuating circumstances exist.

PMID- 8341517
TI  - Soft tissue reconstruction. Coverage of the elbow and forearm.
AB  - Soft-tissue loss around the elbow can occur from trauma, burn injury, or tumor
      resection. Several factors, including the patient's age, sex, occupation, and
      general health status before injury or an operation, should be considered before
      choosing the method of wound closure. The surgical procedure must be tailored to
      the needs of the wound and the patient. This article discusses primary wound
      management and closure, flap coverage, and free-tissue transfer.

PMID- 8341518
TI  - Soft-tissue coverage of the shoulder and brachium.
AB  - Injuries to the upper extremity often involve bone and soft-tissue elements, as
      do injuries to the lower extremity. Proper reconstruction of the soft-tissue
      deficits in concert with bone restoration is essential to final recovery. Better
      understanding of the blood supply and newer concepts of managing severely injured
      limbs has improved the ability to manage these challenging problems.

PMID- 8341519
TI  - Soft tissue reconstruction. Coverage of the chest wall and spine.
AB  - Advances in reconstructive surgery achieved during the past decade have
      considerably broadened the range of options available for coverage of the chest
      wall and spine. Flaps can be designed to maximize function and provide bulk, bony
      rigidity, sensation, or function, when needed. Local musculocutaneous and muscle
      flaps are preferred, but, at times, a free flap is more appropriate, either
      because the local tissue is inadequate or because a free flap best meets the
      needs of the recipient site. With current techniques, donor-site morbidity, flap
      survival, and, ultimately, patient outcome can be optimized to a much greater
      extent than in years past.

PMID- 8341520
TI  - Soft tissue reconstruction. Coverage of hips, pelvis, and femur.
AB  - This article discusses coverage of the posterior and inferior pelvis, coverage of
      the anterolateral pelvis and hip, and coverage of the femur. Special problems
      associated with these procedures are addressed also.

PMID- 8341521
TI  - Soft tissue reconstruction. Coverage of lower leg. Rotational flap.
AB  - The combined orthopedic and plastic surgical approach to the injured lower
      extremity has permitted successful salvage of otherwise severely injured limbs.
      Although numerous muscle and fascial flaps have been described for all regions of
      the leg between the knee and foot, specific treatment regimens have become
      popular based on the location of the wound. Refinements in flap surgery have
      permitted the approach discussed in this article to become standard in the care
      of patients with either chronic osteomyelitis or acutely injured limbs. This
      article delineates the muscle and fascial flaps that are used to reconstruct
      these defects.

PMID- 8341523
TI  - Reconstructive considerations for limb salvage surgery.
AB  - Tumors in the musculoskeletal system are generally treated surgically, although
      radiation therapy and chemotherapy have greatly improved survival statistics of
      patients with high-grade sarcomas of the musculoskeletal system. The mainstay in
      treatment of nearly every primary tumor of the musculoskeletal system is surgical
      resection for cure. Radiation therapy and chemotherapy continue to be important
      adjuvants in the overall management of musculoskeletal tumors. Functional limb
      salvage following radical resection is now possible in most resectable cases by
      placement of an alloplastic prosthesis, homograft, or autogenous bone for
      skeletal reconstitution, followed by well-vascularized soft-tissue coverage.

PMID- 8341522
TI  - Treatment of chronic osteomyelitis with muscle flaps.
AB  - This article discusses a study of 36 patients with chronic osteomyelitis that had
      local or free muscle flaps. Reconstruction of chronic osteomyelitis requires
      infection control and assessment of soft tissue and bone. In patients with
      osteomyelitis with an ununited fracture or nonunion, stabilization of the
      fracture is needed.

PMID- 8341524
TI  - Coverage strategies in total joint replacement.
AB  - The strategy for soft-tissue management following total joint arthroplasty begins
      with prevention. The medical status of the patient is optimized preoperatively.
      Meticulous surgical technique with liberalized indication for flap closure
      primarily will reduce soft-tissue failures. Early identification and aggressive
      team management of complications are critical to decrease long-term morbidity and
      to obtain a good functional result.

PMID- 8341525
TI  - Soft tissue reconstruction.  Monitoring.
AB  - Despite recent advances in technology, no safe and completely reliable monitoring
      device is available for clinical use. As a result, direct clinical evaluation
      remains the mainstay of post-operative monitoring efforts. Although we have found
      this technique to be reliable, we tend to supplement it with Doppler
      ultrasonography, particularly in those patients in whom the flap remains buried
      beneath the skin. In patients with replants, we use pulse oximetry as an adjunct
      to clinical findings. This has proved to be reliable in our experience. However,
      should any question arise concerning altered tissue perfusion, we remain liberal
      in our indications for reexploration. The old adage of "better safe than sorry"
      certainly applies, for it is much easier to reexplore a flap than to lose a
      potentially salvageable reconstruction. The future remains promising for
      techniques such as laser Doppler study and various methods of measuring
      transcutaneous oxygen. However, further experimental and clinical trials are
      necessary to determine the efficacy of these methods.

PMID- 8341526
TI  - Soft-tissue reconstruction in orthopedic surgery. Secondary procedures.
AB  - The original consulting microsurgeon should be present to assist in the
      identification and protection of the vascular pedicle during secondary procedures
      on microvascular transplants. Flap elevation, trimming, and bone graft placement
      should be completed during a single tourniquet time, whenever possible. Flaps can
      easily be resutured on the original bed while the tourniquet is still inflated.
      Although proximal pedicle transection is possible, it should be avoided by
      careful planning, because the transplanted tissue cannot be predictably expected
      to survive, especially with muscle transplants. The distal muscle should be
      transected only in situations in which the muscle inset is extremely complex.
      Transection in the extramuscular portion of the main pedicle may require prompt
      microsurgical repair in immature muscle transplants. The safest approach is to
      avoid the pedicle whenever additional secondary procedures are necessary
      following free microvascular tissue transplantation. Placement of vascular
      pedicles such that the anterior crest of the tibia is avoided if the Ilizarov
      technique is required permit uncomplicated distraction osteosynthesis.
      Simultaneous Ilizarov fixation and microvascular tissue transfer are safe,
      practical procedures for limb salvage. Placement of the Ilizarov fixator at the
      time of microvascular transplantation provides stable fixation and eliminates the
      need for a subsequent anesthetic for fixator placement. This form of
      stabilization, when performed at the time of microvascular tissue transfer,
      allows the orthopedic surgeon direct visualization of the fracture site as the
      fixator is placed and eliminates the need for placement of the fixation device
      through the transplanted tissue. Tissue expansion or suction lipectomy are
      sometimes needed to optimize the clinical result.

PMID- 8341527
TI  - External skeletal fixation and rectus abdominis free-tissue transfer in the
      management of severe open fractures of the tibia.
AB  - The management of severe open fractures of the tibia remains one of the more
      challenging problems facing the orthopedic surgeon. Patients who sustain high
      energy injuries with loss of soft tissue in conjunction with displaced comminuted
      fractures face high rates of delayed union, nonunion, infection, and in some
      instances, amputation. This article discusses materials, methods, and surgical
      techniques.

PMID- 8341528
TI  - Vascular considerations in extremity trauma.
AB  - Effective diagnosis and management of associated vascular injuries is imperative
      to minimize morbidity after extremity trauma. An algorithm is presented for the
      diagnostic evaluation of patients with extremity trauma. The value of physical
      examination and Doppler indices in identifying occult injuries is discussed. The
      natural history of certain occult, nonocclusive injuries suggests that
      nonoperative management may be considered. The intraoperative management of major
      arterial and venous injuries, including current controversies, is addressed also.

PMID- 8341529
TI  - [Experience with the screening of pregnant women for hepatitis B virus and the
      vertical transmission of the virus].
AB  - The authors started the checking for the hepatitis B virus in pregnant women of
      the town Ajka and its surroundings 10 years ago and then they extended it over
      the whole county. They examined 33,433 pregnant women from 1980 to 1990 and found
      that 0.5% of them were HBV carrier state (that is 169 persons), while in endemic
      territories they found a higher rate (0.74%). The existence of vertical
      transmission can be proved by the positive data of 120 infancy born to 72
      symptomless HBV carrier mothers. The frequency of transmission is 4%. At the
      beginning of the check-up they gave passive then active-passive immunisation to
      the children born to carrier mothers. The results of immunisation were controlled
      by clinical and laboratory tests. They suggest that their worked-out check-up and
      care model--which is unique in Hungary in its kind and is also a part of the
      programme to prevent cancer--should be introduced all over the country.

PMID- 8341530
TI  - [Pulsatile gonadotropin releasing hormone treatment following previous ovarian
      hyperstimulation].
AB  - Physiological follicular maturation was achieved by pulsatile gonadotrophin
      releasing hormone treatment in ovarian hyperstimulatory cases induced previously
      by other ovulation induction methods (clomiphene, clomiphene + hCG, clomiphene +
      hMG + hCG). The follicular development was detected by vaginal ultrasound
      examination (Hitachi-3000, 6.5 MHz) in 8 cycles treated with gonadotrophin
      releasing hormone. During the pulsatile gonadotrophin releasing hormone treatment
      ovulation was found in all cases and 2 pregnancies occurred. Ovarian
      hyperstimulation was not noticed. Physiological follicular maturation can be
      induced with the pulsatile administration of gonadotrophin releasing hormone
      after previous ovarian hyperstimulation because using this method the hypophyseal
      ovarian steroid feed back mechanism remains unchanged.

PMID- 8341531
TI  - [Clinical significance of incomplete right bundle branch block].
AB  - In authors' opinion the majority of the physicians speak about an incomplete
      right bundle branch block in cases of a terminal r'wave in lead V1 of the ECG,
      when the QRS complex is not wider than 0.12 sec. These ECG anomalies are not
      properly separated in the literature, either. Authors define 4 groups whose
      separation is possible by the analysis of leads V1 and V2. 1. Right ventricular
      conduction defect--the ECG width is 0.09-0.13 sec. This picture generally signs
      normal or only slight higher right ventricular pressure. 2. Real incomplete right
      bundle branch block--the terminal vector directs forward only in this group and
      it causes also an r' in V2 next to the high R' in lead V1. This group can be
      harmless, only a conduction defect, but it can mean an advanced stadium of
      serious right ventricular systolic or diastolic overloading, too. 3. Right
      ventricular diastolic overloading--the QRS width is normal. We saw this picture
      in slight forms of atrial septal defect. One of our conclusions was that in case
      of normal V1 a haemodynamic significant ASD I or ASD II can be excluded. 4.
      Normal variant: normal QRS width and only a very low r' in lead V1. It was seen
      in young patients or in patients with flat chest. Authors remark that this
      pattern can possibly be seen in childhood or in case of inexact ECG (V1)
      registration.

PMID- 8341532
TI  - [Pellagra--a forgotten disease].
AB  - In the civilized world the traditional causes of pellagra such as hunger,
      malnutrition are disappeared, but the disease has not disappeared after all. In
      the well developed countries the current etiologic causes are the following:
      alcoholism, psychiatric disorders, diseases causing cachexy, malabsorption and
      some drugs. In the case reported by the authors the malnutrition, accompanying
      the chronic alcoholism was the cause of the diarrhoea, dementia and dermatitis.
      The correct diagnosis was established after four years of repeated psychiatrical
      and medical treatment.

PMID- 8341533
TI  - [Janos Foldi, public health officer, polyhistor].

PMID- 8341534
TI  - [Self-performed cesarean section].

PMID- 8341535
TI  - [Portrait of Laszlo Nemeth in numismatic art].

PMID- 8341536
TI  - [Problems of translation].

PMID- 8341537
TI  - [Zitazonium therapy in breast cancer].

PMID- 8341538
TI  - [In defense of the Latin language].

PMID- 8341539
TI  - [Endoscopic study of the small intestine].
AB  - The author summarises the possibilities of small bowel endoscopy. In case of
      haemorrhage of unknown origin, enteroscopy may be helpful. Sonde type fiber- or
      video-enteroscopes can be used. This procedure is time-consuming and needs an
      experienced team. In case of life-threatening bleeding intraoperative enteroscopy
      is recommended. "Push" enteroscopy is the best, rapid method in the diagnostics
      of suspected diffuse intestinal diseases or circumscript lesions of the proximal
      small bowel. Adult or pediatric colonoscopies or jejunoscopes are available for
      this investigation. Endoscopic biopsy specimens are suitable for histological
      examination and for enzyme assay as well. Aspiration of jejunal fluid for
      bacteriological culture is a way for revealing of bacterial overgrowth. The
      author emphasises the importance of the deep duodenoscopy made by an upper
      panendoscope in the diagnostics of villous atrophy.

PMID- 8341541
TI  - [Measurement of bone mineral content by single-photon absorptiometry in
      children].
AB  - Bone mineral content (BMC) was measured in 64 children (33 boys [aged 4-17] and
      31 girls [aged 2-12]) having no signs of metabolic bone disease, at the distal
      third of their radius using single photon absorptiometry (SPA), to establish
      normative data. Relationships were studied between the obtained bone mineral
      content and the age, weight, as well as height of children. The obtained BMC
      values were compared with that of healthy Swedish and American children. Authors
      suggest the routine use of SPA in home children suffering from metabolic bone
      diseases.

PMID- 8341540
TI  - [Clinical picture of slow-evolving insulin-dependent diabetes mellitus]("1
      1/2")].
AB  - The authors investigated the difficulties of differential diagnosis in diabetes,
      beginning in young age. They analysed the case records of fifteen young
      diabetics. The authors pointed out, that clinical diagnosis, carried out early,
      has utmost importance both of theoretical and practical significance, for correct
      classification according to the type of diabetes determines the therapy. In
      building the diagnosis, the clinician needs correct anamnestical, clinical data,
      immunogenetic markers (ICA, HLA), and the capacity of endogenous insulin
      secretion as well. In three patients they have observed a long period without
      insulin treatment that could be classified as remission phase. In eleven cases
      the treatment has started with oral antidiabetic drugs, one patient has got at he
      very beginning insulin treatment. At present, there is only one patient, still
      taking oral drugs. This diabetics has an ICA positivity in high titer, but he is
      refusing the recommended exogenous insulin treatment. In all of their cases the
      amount of injected daily insulin is low (0.3-0.6 IU/body weight/24 hours).
      Authors state by their careful analysis, that in all of their 15 diabetics there
      is existing a slowly developing type I IDDM, I/b, or very recently 1 1/2 diabetes
      form. The so called autoimmune form--described originally by Bottazzo--could have
      been disclosed in all of their cases.

PMID- 8341542
TI  - [Risk of premature rupture of the fetal membranes in cases of fetal maturity].
AB  - In this study data of labour, delivery and neonatal outcome were compared in term
      pregnancies in 100 patients with premature rupture of the membranes (PROM)
      amniotomy. According to the data in cases of PROM there are more unfavourable
      cervix findings at the beginning of labour (54%), more pathologic cardiotocograms
      in the first stage (14% vs. 12%), more prolonged first stages (21.5 vs 14.5
      hours) more caesarean section (9% vs 7%) and more newborns were born with a 5
      minute Apgar score below 8 than in the control group. Intrauterine infection was
      detected in 1% of all cases. The authors conclude, that careful monitoring of the
      fetal state and with no signs of intrauterine infection expectant management of
      delivery is advisable to improve to improve perinatal mortality and morbidity.

PMID- 8341543
TI  - [The use of a nitinol (nickel-titanium) prosthesis in the management of malignant
      esophageal stenosis (preliminary report)].
AB  - The authors present the case of an 81-year-old male patient with cardia
      adenocarcinoma. The patient underwent a surgical resection. Due to local
      recurrence Gianturco prosthesis implantation was performed. After 5 months of
      unimpeded swallowing, the patient gradually lost his ability to swallow. This was
      caused by tumor overgrowth. The serious condition was managed by nitinol
      (Ultraflex) metallic prosthesis. This reticular, compressed stent is a nickel
      titanium based alloy. After implantation, as a result of the body temperature it
      assumes its original shape. After the twofold prosthesis implantation the patient
      had no complaints. The authors found the case worthy of presentation because of
      the new method and the originality of the new design.

PMID- 8341544
TI  - [Zoltan Ernst, pioneer of diabetology in Hungary].

PMID- 8341545
TI  - [Remembering Lajos Makara].

PMID- 8341546
TI  - [Management of foreign bodies in the esophagus].

PMID- 8341547
TI  - [Rights of the patient].

PMID- 8341548
TI  - [HIV-1 infection in cell culture].

PMID- 8341549
TI  - [Current data on the pathogenesis of neurodegenerative diseases and some muscular
      disorders: therapeutic prospectives].
AB  - Recent findings suggest that damaged mitochondrial DNA (mtDNA) may play a role in
      the development of Leber's hereditary optic neuropathy, Huntington's, Parkinson's
      and Alzheimer's disorders, as well as in that of encephalomyopathies. The mtDNA
      consist of 16,569 base pair and encodes 13 polypeptides, 2 ribosomal RNAs and 22
      transfer RNAs. It is much more injurable than the nuclear DNA (nDNA) and since
      mtDNA participates in the synthesis of respiratory chain enzymes, therefore, its
      damage may result in neuronal cell death. The present paper summarizes these
      novel mechanisms and potential therapeutic strategies with regard to neurological
      disorders.

PMID- 8341550
TI  - [The role of two-dimensional echocardiography in the detection of pacemaker
      induced endocarditis].
AB  - The authors analysed the data of eight patients who had to undergo open heart
      surgery because of pacemaker endocarditis in the last four years. Repeated
      surgical interventions on the pacemaker system was the most predisposing factor.
      The most common causative organisms were Staphylococcus aureus and Staphylococcus
      epidermidis. Two-dimensional echocardiography (2DE) had a decision making role in
      the diagnosis beside the clinical picture and blood culture. CONCLUSIONS: 1. Each
      pacemaker patient with fever must be considered to have a pacemaker endocarditis;
      2. All these patients must be examined by two-dimensional echocardiography.

PMID- 8341551
TI  - [Economic glossary: pitfalls of interpretation].
AB  - Sharp discrepancy exists between the concepts declared and the measures
      introduced with urgency by the government and the real praxis of the health-care
      institutions, which are delivered to and suffer from the heaviest financial
      economical restrictions. The situation may partly be attributed to the missing
      system-specific interpretation of some leading categories. Attempts were made to
      point at some harmful consequences of this failure and to reinterpret basic
      categories, so as to contribute to a better agreement of the participants in
      favour of our patients' welfare.

PMID- 8341552
TI  - [Congenital absence of the left pericardium. Case report and review of the
      literature].
AB  - Congenital absence of the pericardium, whether partial or total, is a rare
      abnormality. If suspicion of such a malformation arises it should be classified
      because of possible herniation of the atrium or ventricle. The authors report the
      case of an asymptomatic young male patient in whom the diagnosis was suggested
      radiographically, electrocardiographically (total electrical alternans has been
      noticed) and confirmed by cross-sectional echocardiography, computed tomography
      and magnetic resonance imaging. Only in exceptional cases should it be necessary
      to perform an exploratory thoracotomy. In patients with complete pericardial
      defects no specific therapy is indicated, however, in patients with partial
      defects surgical treatment is indicated. Congenital pericardial defects are not
      completely benign, as has been suggested before.

PMID- 8341553
TI  - [Gyula Varannai, M.D. (1905-1993)].

PMID- 8341554
TI  - [Pentoxyphylline and lymphocyte migration].

PMID- 8341555
TI  - [Fresh osteochondral transplants in the treatment of advanced giant cell tumors].
AB  - Eighteen patients with advanced giant cell tumors were treated with complete
      tumor resection and reconstruction using fresh osteochondral allografts. All
      patients had one or more of the following indications for tumor resection (as
      opposed to curettage): tumor recurrence, pathological fracture, or destruction of
      the subchondral bone plate. At the 4- to 16-year follow-up (mean 9 years), two
      grafts were revised to a second fresh graft because of fracture, one graft was
      converted to an allograft implant composite and two joints were fused because of
      infection. The functional results were assessed in 14 patients: 9 were good or
      excellent, 4 fair and 1 poor. We conclude that the fresh osteochondral allograft
      is a viable treatment alternative to prosthetic replacement in advanced benign,
      aggressive bone tumors.

PMID- 8341556
TI  - [Rotation grafts].
AB  - Nowadays rotationplasty is well established as an acceptable procedure for limb
      salvage in patients who have a malignant tumor in the femur or tibia. The main
      indication is that it is the alternative to amputation. Rotationplasty should be
      used in very young children because of the growth-dependent complications that
      can be expected after tumor resection. The different types of rotationplasty, the
      operative technique, prosthetic care, and the results of 104 patients are shown.

PMID- 8341557
TI  - [Tumor endoprosthesis in malignant bone tumors].
AB  - In the Department of Orthopedics at the University of Vienna, tumor
      endoprostheses have been implanted after resections of tumors of the upper
      extremities since 1974 and of the knee joint since 1976. For replacement of the
      humerus after tumor resection, a system of modular tumor endoprostheses was
      developed very early. Initially, it was ceramic and later on made of titanium
      alloys, which were also implanted in combination with custom-made prostheses with
      cementless stem-plate fixation in 57 patients until February 1990. In 43 of these
      patients (75.4%) adequate resection (2 radical and 41 wide) had been performed.
      Of 49 patients with a follow-up period of at least 24 months, 36 patients had a
      mean disease-free survival time of 106.1 months. Between 1976 and 1981, 16 custom
      made endoprostheses were used after tumor resection of the knee joint. Since 1982
      we have used a modular system of tumor endoprostheses suitable for replacement of
      the proximal and distal femur, proximal tibia, total femur and total knee joint.
      Of 75 patients who had been operated on up to February 1990, 67 patients (89.3%)
      had undergone adequate resection (2 radical and 65 wide). Out of 32 of these
      patients, 24 (75%) exhibited a disease-free survival time of at least 24 months
      (mean 48.2 months). Out of 213 patients with resection/reconstruction (160
      endoprostheses), 77.8% had a survival time of at least 24 months, a results which
      is considerably better than in 146 patients with amputation in which case the
      respective value was 69.4%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341558
TI  - [Partial endoprosthetic reconstruction of the pelvis in malignant tumors].
AB  - Twenty-five patients underwent an internal hemipelvectomy with endoprosthetic
      reconstruction of the pelvis for primary bone tumor (n = 17) or bone metastasis
      in the pelvis (n = 8). According to the Enneking tumor classification system,
      there were 9 stage II B tumors and 16 stage III. Conventional metal or polyacetal
      prostheses were used in 5 cases, and in 20 anatomically adaptable modular
      prostheses with intramedullary anchorage were implanted. In the last 11 cases a
      3D CT-controlled manufactured model of the pelvis was used. The functional
      results according to Enneking were good in 5 cases, fair in 11, and poor in 7.
      The last endoprosthetic system showed better results, because it is easier to
      implant and the possibility failure is reduced. The learning curve of the surgeon
      is important, too.

PMID- 8341559
TI  - [Resection of pelvic sarcomas. Reconstruction techniques without use of
      endoprostheses].
AB  - Advances in preoperative imaging techniques and surgical expertise now permit
      limb sparing resections of pelvic sarcomas to be performed in appropriate
      patients with an acceptable risk of local recurrence. Reconstruction of the
      skeletal defect remains, however, problematic. Many techniques have been
      employed, all with advantages and disadvantages. Arthrodesis for the unstable
      pelvis has been our preferred reconstructive procedure. When successful, we find
      this a durable and pain-free reconstruction for the young, active patient.

PMID- 8341561
TI  - [Resection arthrodesis of the proximal ankle joint in Ewing's sarcoma.
      Maintenance of leg length using distraction osteogenesis].
AB  - The technique of segmental transport of the tibia according to Ilzarov is a well
      known procedure in pediatric orthopedics, but in the treatment of bone tumors it
      has not yet been established. The method is also applicable for filling a large
      gap after tumor resection in the distal tibia. A case history is presented in
      which Ewing's sarcoma localized in the distal tibia was removed surgically after
      multiagent chemotherapy. The ankle joint was successfully fused after bone
      transport of the tibia 5 cm distal to the talus.

PMID- 8341560
TI  - [Intraoperative radiotherapy in malignant bone tumors].
AB  - When a bone tumor is confirmed to be malignant by biopsy and has not expanded
      into the soft tissue, intraoperative radiation therapy (IORT) is indicated for
      most parts of the four extremities. The irradiation area is exposed through an
      extensive skin incision, and the soft tissues are opened and retracted away from
      the irradiation area, leaving a layer of normal tissue directly covering the
      tumor. The irradiation is performed with 12-26 MeV electron beams from a betatron
      at a dose of 50-100 Gy, depending on the radiosensitivity of each tumor. The
      multifocal bilateral irradiation method is the best for minimizing complications
      of the soft tissues. Since 1978, we have performed IORT in combination with
      chemotherapy in 41 cases of malignant bone tumors and experienced only five cases
      of tumor recurrence one in the irradiated area and four in the non-irradiated
      area. Joint function in the irradiated limb was excellent. However, due to the
      high incidence of pathological fracture after IORT in osteolytic tumors, the limb
      eventually had to be replaced by a prosthesis. After 1984 when cisplatinum was
      introduced to our chemotherapy protocol, the cumulative 5 year survival rate
      increased to 81%, with the irradiated lesion preserved in situ in osteoblastic
      tumors and replaced with a prosthesis in osteolytic tumors.

PMID- 8341562
TI  - [Tumor resection and reconstructive intervention in spinal tumors].
AB  - Modern techniques of resection and reconstructive surgery in patients with
      primary and metastatic spine tumors are presented. These techniques are
      delineated along an algorithm that allows us to develop an adequate oncological
      protocol, find a rational approach for preoperative embolization and for tumor
      resection and choose the proper materials and implants for bridging bone defects.
      The aim is to achieve short-term and long-term stability, respectively. These
      principles are illustrated by different examples and our own results in spinal
      metastasis surgery.

PMID- 8341563
TI  - Should intravenous therapy teams be responsible for peripheral venous access?

PMID- 8341564
TI  - Long-term care a priority issue for patients with cancer.

PMID- 8341565
TI  - The evolution of otosclerosis surgery.
AB  - This article reviews the development of surgical methods over the centuries to
      improve hearing loss due to otosclerosis. Pioneers in the development of surgical
      techniques for otosclerosis discussed in this article include Holmgren, Lempert,
      Rosen, and Shea. Also discussed are the personal experiences of the author,
      witness to many of this century's technologic developments and founder of the
      House Ear Institute in Los Angeles, California.

PMID- 8341566
TI  - Histopathology of otosclerosis.
AB  - This histopathologic review illustrates that otosclerosis is a very pleomorphic
      bone dyscrasia. It may fix the stapes by a tiny bridge of abnormal bone or may
      totally obliterate it. It may spread to the cochlea to produce either a
      sensorineural loss of varying degree or deafness. Lesions may be sclerotic,
      spongiotic, or fibrous but usually comprise all these histologic types. This
      diversity of size and anatomic distribution coincides with the variable types of
      hearing loss, from a mild conductive deficit to a total loss. In spite of more
      than a century of investigation of otosclerosis, an etiologic agent other than
      heredity has not been established.

PMID- 8341567
TI  - Physical examination and clinical evaluation of the patient with otosclerosis.
AB  - A detailed history, otoscopic examination, and testing with tuning forks are
      essential to the diagnosis of otosclerosis. These steps, including a differential
      diagnosis to rule out those middle ear conditions that can masquerade as
      otosclerosis, can help the examining physician make the presumptive diagnosis of
      otosclerosis.

PMID- 8341568
TI  - Imaging of otosclerosis.
AB  - Imaging studies play an important role in the diagnosis of otosclerosis and in
      the clinical management of this disease. CT scanning at present is the tool of
      choice for the assessment of the labyrinthine windows and cochlear capsules. MR
      imaging thus far has had limited applications in the examination of the cochlear
      capsules but has been more useful in the assessment of the cochlear lumen prior
      to cochlear implant in patients with profound bilateral hearing loss.

PMID- 8341569
TI  - Audiologic characteristics of the patient with otosclerosis.
AB  - The audiologic manifestations of otosclerosis are as distinctive as they are
      varied. When pure stapedial otosclerosis is present, the most prominent
      audiologic signs are elicited in response to the use of low-frequency stimuli,
      reflecting the effect that increased stiffness has on the transfer function of
      the middle ear. Characteristic abnormalities appear on tympanometry, acoustic
      reflexes, and the pure-tone audiogram. When the disease process extends into the
      cochlea, a sensorineural hearing loss develops, which may be accompanied by
      vestibular symptoms and/or tinnitus. Complete audiologic evaluation may prove to
      be uniquely helpful both in establishing a diagnosis by recognizing the
      characteristic patterns of stapes fixation and in planning for the surgical,
      medical, or hearing aid management of the patient with otosclerosis.

PMID- 8341570
TI  - Stapedectomy technique.
AB  - This article reviews the evolution of the author's stapedectomy technique from
      total footplate removal with single loop wire prosthesis and Gelfoam seal to
      small fenestra stapedectomy with platinum ribbon piston prosthesis and blood
      seal. The author concludes that the microdrill is effective, safe, and cost
      effective for performing this procedure. Since using this technique, the author
      has had no cases of sensorineural hearing loss and few complaints of dizziness or
      vertigo.

PMID- 8341571
TI  - Surgical treatment of stapes fixation by fiberoptic argon laser stapedotomy with
      reconstruction of the annular ligament.
AB  - The goal of surgical treatment of stapes fixation is to restore the impedance
      transfer of the ossicular chain and the acoustic impedance of the annular
      ligament of the stapes footplate to achieve normal physiologic vibration of the
      inner ear fluids. Advances in instrumentation, particularly the introduction of
      fiberoptic laser handpieces and microdrills, have enabled surgeons to approach
      this goal in a more precise and delicate fashion. In this article, the authors
      review their surgical techniques, the biophysics involved, the physics of
      fiberoptic handpieces for the delivery of argon laser energy, and their results.

PMID- 8341572
TI  - Carbon dioxide lasers for otosclerosis.
AB  - Over the past eight years, the senior author (SGL) has sought the ideal
      microsurgical laser for otosclerosis surgery. This quest required learning the
      principles of laser physics and of the interactions of light with matter. Rather
      simple thermocouple experiments were performed in the laboratories of the Midwest
      Ear Foundation (MEF) to confirm some of what was predicted from these principles.
      More sophisticated transmission spectroscopy experiments were performed at the
      Massachusetts Institute of Technology (MIT) to evaluate which electromagnetic
      wavelengths are best absorbed by collagen and bone. MIT's spectroscopy studies
      paralleled MEF's thermocouple data. CO2 laser energy (10.6 microns) is nearly
      completely absorbed by collagen and bone, whereas visible argon and KTP laser
      energy (0.5 micron) is poorly absorbed. Despite the better optical precision of
      visible lasers, the author chose the CO2 laser for stapedectomy revision and
      stapedotomy, because long infrared electromagnetic energy has vastly superior
      tissue absorption characteristics for these procedures. With the development of
      I. L. Med's Unilase, the otologic surgeon now has a CO2 laser with optical
      precision and convenience approaching that of visible lasers. Clinical studies of
      102 consecutive CO2 laser stapedectomy revisions show that in 92% of patients,
      hearing was significantly improved with the new CO2 laser revision techniques.
      Nearly half of these patients had undergone one or more previous, unsuccessful,
      nonlaser revisions. For primary otosclerosis, CO2 laser stapedotomy has
      simplified a technically difficult operation while significantly reducing
      mechanical trauma to the inner ear. Most gratifying to the senior author is that
      after approximately 450 consecutive CO2 laser operations for otosclerosis, no
      patient has experienced significant postoperative sensorineural hearing loss
      (greater than 15 dB; mean 500, 1000, 2000, 3000 Hz). This fact alone has
      justified our theoretical and laboratory efforts to find the safest laser for
      otosclerosis surgery.

PMID- 8341573
TI  - Evolution of techniques of stapedectomy from the total stapedectomy to the small
      fenestra stapedectomy.
AB  - No consensus exists among surgeons about how much of the footplate to remove in
      stapes surgery. By comparing ideal cases with identical surgical techniques, it
      may be possible to select an optimal amount of the stapes footplate to remove.
      This article details the evolution of techniques of stapedectomy from the total
      stapedectomy to the small fenestra stapedectomy.

PMID- 8341574
TI  - Stapedectomy. Causes of failure and revision surgery in otosclerosis.
AB  - The greatest chance of success in stapedectomy is at the time of the initial
      procedure. Complications are compounded and successes markedly decreased when
      revision surgery is attempted. The most common pitfalls encountered in
      stapedectomy are reviewed in this article. Principles of surgery that have
      minimized complications and decreased the need for revision procedures in the
      authors' practices are outlined. Guidelines helpful when considering revision
      surgery also are presented and specific indications are addressed.

PMID- 8341575
TI  - Complications in stapes surgery. Options for prevention and management.
AB  - Although successful stapedectomy is very gratifying for both the patient and
      surgeon, complications can arise, often with disastrous results. Certain clues
      may alert the surgeon to risk prevention or possible complications, allowing
      early definitive management. This assumes critical importance today as fewer
      younger surgeons acquire extensive experience in stapedectomy. A thorough
      knowledge of possible problems and their management is mandatory for the
      otologist who undertakes this most challenging of operations.

PMID- 8341576
TI  - Hearing aids and otosclerosis.
AB  - The purpose of this article on the use of hearing aids in patients with
      otosclerosis is to emphasize that all otosclerosis patients cannot be assumed to
      be good users of hearing aid amplification. Patients with losses of 60 dB or less
      and with purely conductive lesions may be able to use aids well. Individuals with
      mixed-type impairments due to otosclerosis may have significant problems
      utilizing amplification. These cases demonstrate the use of hearing aid
      amplification in patients with mixed-type hearing impairment due to otosclerosis.
      This is a very different group of patients from the group with a pure conductive
      lesion, in which there is little problem in fitting a hearing aid, provided that
      the instrument has sufficient power and gain to override the loss. A special
      subgroup of patients who have far-advanced otosclerosis and have successful
      stapes surgery to correct the conductive component of their hearing loss present
      a unique problem. They may initially suffer from severe recruitment requiring
      patience, special training and compression-type hearing aids.

PMID- 8341577
TI  - Early identification of hearing impairment in infants and young children. Summary
      of the NIH Consensus.

PMID- 8341578
TI  - Empowering women for the future.

PMID- 8341579
TI  - Heterogeneity in patterns of malarial oocyst infections in the mosquito vector.
AB  - Oocyst prevalence and intensity have been recorded in 349 laboratory infections
      of Anopheles stephensi with Plasmodium berghei. Intensity and prevalence of
      infection are shown to be predictably related. The structure and heterogeneity in
      the infections has been analysed with the objective of describing the biological
      mechanisms by which the observed negative binomial oocyst distributions are
      generated. The analysis has revealed that the most likely processes lie within
      the population dynamic events of malaria within the mosquito, namely
      gametogenesis, fertilization and mortality. The distribution is similar in all
      Plasmodium-mosquito combinations examined so far, whether they are of laboratory
      (P. gallinaceum in Aedes aegypti) or field (P. vivax in An. albimanus and P.
      falciparum in An. gambiae s.l. and An. funestus) origin. Further we conclude that
      there is competition between parasites in the vector. Oocyst frequency
      distribution analysis shows that under natural conditions of transmission
      intensity, and even under the best laboratory conditions, significant numbers (>
      10%) of fully susceptible mosquitoes will not be infected under conditions where
      the mean infection is as high as 250 oocysts. Failure to infect is not therefore
      an absolute indicator of refractoriness. In assessing transmission data it is
      shown that sample sizes should not be less than 50, and ideally 100 mosquitoes,
      if reliable data are to be obtained. In field it is suggested that difficulties
      in determining the low natural intensity of oocyst infections indicate that
      prevalence estimates are a useful and accessible parameter to measure.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8341580
TI  - Immunogenicity of a hybrid Plasmodium falciparum malaria antigen.
AB  - A recombinant baculovirus-expressed hybrid protein containing epitopes for the C
      terminal fragment of the Plasmodium falciparum precursor to the major merozoite
      surface antigens (PMMSA) and the tetrapeptide repeats of the circumsporozoite
      protein (CSP) was assessed for its immunogenicity. Murine MHC-II restriction of
      the antibody response to the CSP repeats was not overcome by the PMMSA component,
      the response to which showed no restriction. In an adjuvant trial the highest
      antibody titres in rabbits to both components of the hybrid were obtained using
      Freund's adjuvant. Lack of a boosting antibody response to the CSP repeats
      appeared to be linked to the conformation of the PMMSA component. Formulation of
      the hybrid protein into Iscoms gave antibody titres of only short duration to
      both components.

PMID- 8341581
TI  - Immunization of pigs against infection with Schistosoma japonicum using
      ultraviolet-attenuated cercariae.
AB  - Since pigs are important in the zoonotic transmission of schistosomiasis japonica
      in China, a veterinary vaccine might contribute to the control of the disease in
      humans. Pigs were immunized with three doses each of 10,000 cercariae of
      Schistosoma japonicum attenuated with ultraviolet light (400 microWatt.min/cm2).
      The experiment was performed with portable irradiation equipment in a rural area
      of the Hubei Province (P.R. China). A challenge infection of 1,000 untreated
      cercariae was given 2.5 or 6 months after the last immunization, and age-matched
      naive pigs were challenged as a control. Immunized pigs developed about 90%
      resistance against the challenge. The liver egg load of these animals was reduced
      by over 90%. Less than 0.01% of the immunizing cercariae developed to adult
      parasites and the vaccination had no apparent adverse influence on the pigs'
      health.

PMID- 8341583
TI  - Voltage-gated currents in muscle cells of Schistosoma mansoni.
AB  - Three morphologically distinct types of muscle fibres isolated from the
      platyhelminth Schistosoma mansoni have been studied with whole cell current- and
      voltage-clamp techniques. Fibres showed a marked time-dependent decrease in
      membrane resistance in response to depolarizing current injections. Voltage-clamp
      experiments revealed the presence of two distinct voltage-gated outward currents.
      The most prominent current is a slowly activating, slowly and incompletely
      inactivating potassium current similar to delayed rectifier currents which have
      been described in a variety of cell types from a variety of organisms. Also
      present is a faster activating, quickly and completely inactivating potassium
      current that shares functional characteristics with 'A'-currents. All three of
      the cell types studied possess a delayed rectifier current, but only two of the
      three types have 'A'-currents. Though depolarization with high K+ leads to
      contraction of the dispersed fibres, no voltage-gated inward currents could be
      detected by whole cell voltage-clamp under any of our conditions.

PMID- 8341582
TI  - Mechanisms involved in the loss of antibody-mediated adherence of macrophages to
      lung-stage schistosomula of Schistosoma mansoni in vitro.
AB  - Sera from rabbits vaccinated with irradiated cercariae mediated cell (P388D1 or
      mouse peritoneal macrophage) adherence to lung-stage schistosomula (LS) but such
      antibody-mediated cell adherence was short-lived in contrast to cell adherence to
      mechanically transformed schistosomula (MS). Thus LS lost 50% of their adherent
      cells within 3-6 h in culture and up to 90% by 24 h, whereas adherence to MS was
      undiminished during this time. Rapid loss of adherent cells was unique to
      schistosomula that had developed to the lung stage because schistosomula
      recovered from the skin up to 3 days post-infection did not exhibit the rapid
      cell loss shown by 3-day LS. To determine whether cell loss was caused by loss of
      surface antigenicity during culture LS were cultured on their own for up to 24 h
      and at various intervals samples of schistosomula were tested for antigenicity by
      addition of immune serum and cells. Levels of adherence to both MS and LS were
      maintained throughout the incubation period. When antibody-opsonized
      schistosomula were washed and indicator cells added at progressive intervals,
      persistence of adherence was again demonstrated, showing that antibody binding to
      LS had not promoted surface antigen loss or degradation of bound antibody. It was
      then shown, by adding fresh macrophages to cultures up to 24 h old that LS which
      had lost their adherent cells nevertheless retained bound antibody, and
      comparison of adherence of 'used' and 'fresh' cells to MS and LS showed that the
      cytoadherence properties of macrophages were not significantly reduced during
      their culture with LS from which cells had been lost.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8341584
TI  - Epidemiology of trypanosome infections of the tsetse fly Glossina pallidipes in
      the Zambezi Valley.
AB  - The epidemiology of trypanosome infections of Glossina pallidipes was studied at
      a riverine site in the Zambezi Valley, Zimbabwe for a period of 13 months. Over
      9000 flies were captured using a single trap. These flies were dissected,
      screened for trypanosome infection, sexed, and aged using both wing fray and (for
      females) ovarian category indices. Midgut infections were identified to species
      using recently developed DNA probes. The overall prevalence of mature infections
      was 5.5%, comprising 3.1% Trypanosoma vivax-type and 2.4% T. congolense-type
      (which included very low prevalences of T. brucei, T. simiae and another
      Nannomonas species). The prevalence of infection increased with age. For T. vivax
      type infections in flies aged by ovarian category this relationship could be
      described by a simple 'catalytic' model assuming a constant per capita rate of
      infection. For T. congolense-type infections this model tended to over-estimate
      prevalence in older age classes, implying that the rate of infection decreases
      with age, and/or that infected flies have higher mortality rates, and/or that a
      significant fraction of the population is resistant to infection. Prevalences of
      infection also varied between months. This variation was more marked for T. vivax
      type infections and was negatively correlated with both temperature and rainfall.
      The shape of the age-prevalence relationship, however, did not vary significantly
      between months. These observations are not fully explained by variation in the
      age-structure of the tsetse population and are consistent with temporal variation
      in the rate of infection (rather than in the trypanosome developmental period or
      in effects of infection on fly mortality). Possible causes of this variation are
      discussed.

PMID- 8341585
TI  - Characterization of the cysteine proteinases of the common liver fluke Fasciola
      hepatica using novel, active-site directed affinity labels.
AB  - The excreted/secreted proteinases of adult and juvenile Fasciola hepatica
      maintained in vitro were found to hydrolyse the fluorogenic substrates Cbz-Phe
      Arg- and Cbz-Arg-Arg-NHMec. This activity was demonstrated to have a classical
      cysteine proteinase inhibitor profile, with turn-over of both substrates being
      blocked by pre-incubation with E64 and peptidyl diazomethanes. The Cbz-Arg-Arg
      NHMec hydrolysing activity of the mature fluke exhibited an alkaline stability
      not characteristic of its mammalian lysosomal counterparts. Further, the
      biotinylated affinity reagents biotin-Phe-Ala-CHN2 and biotin-Phe-Cys(SBzyl)-CHN2
      were used to label and characterize these cysteine proteinases in terms of
      apparent molecular weight and subsite specificity. Adult fluke media were found
      to contain four species of molecular weights 66, 58, 50 and 25-26 kDa; juvenile
      media contained three species of molecular weights 66, 54 and 25-26 kDa. The
      major 25-26 kDa cysteine proteinase common to both stages was shown to have a
      subsite specificity similar to that of mammalian cathepsin B.

PMID- 8341586
TI  - Establishment, survival, site selection and development of Leptorhynchoides
      thecatus in largemouth bass, Micropterus salmoides.
AB  - Establishment, survival and distribution of Leptorhynchoides thecatus
      (Acanthocephala) were investigated in largemouth bass, Micropterus salmoides, fed
      10, 25, or 40 cystacanths and examined at 1, 3 or 5 weeks post-infection. Worms
      established widely in the alimentary tracts of bass but by 5 weeks post-infection
      had localized in the pyloric caeca and intercaecal region. Other individuals
      moved to parenteral sites where they remained immature, though viable. In the 10-
      and 25-level exposures, establishment and survivorship in the alimentary tract
      were roughly proportional to the dose of cystacanths. After 1 week post-infection
      in the 40-level exposure class, numbers of worms in the alimentary tract
      decreased significantly and parenteral occurrence increased significantly. Total
      survival of L. thecatus appeared to be density-independent. Maturation of worms
      was retarded temporarily as intensity of infection increased, but by 5 weeks post
      infection worms from all doses were at roughly the same stage of development
      within sex. The caeca and intercaecal area apparently did not differ in their
      suitability for maturation.

PMID- 8341587
TI  - The potential of vervet monkeys (Cercopithecus aethiops) and baboons (Papio
      anubis) as models for the study of the immunology of Echinococcus granulosus
      infections.
AB  - Nine vervet monkeys and nine baboons were infected with eggs of Echinococcus
      granulosus per os. Six of the vervets and one of the baboons possessed hydatid
      cysts at autopsy, 15-28 months post-infection. The sequential IgG response to
      hydatid fluid and protoscolex antigens showed considerable inter-animal
      variation. Infected vervets and baboons became seropositive after an average of 8
      months post-infection. Considerable fluctuation in the IgG response was observed,
      particularly to the hydatid fluid antigen which, in humans, may contribute to the
      existence of a significant proportion of seronegative individuals. Vervets, in
      particular, may be useful to study immunological events associated with exposure,
      development and resolution of hydatid disease in outbred human populations.

PMID- 8341588
TI  - Spatio-temporal structure of the communities of helminths in the digestive tract
      of Sciaena umbra L. 1758 (Teleostei).
AB  - The helminth community in the digestive tract of the sedentary predatory fish,
      Sciaena umbra, near the Scandola Nature Reserve, Corsica, consists of 5 species
      of digeneans. Anoiktostoma coronatum (in the rectum) and Metadena pauli (in the
      intestine) were found in almost all the fish, and in high numbers; they are
      considered core species. Distomum aloysiae, Pleorchis polyorchis (both in the
      intestine), and Stephanostomum bicoronatum (in the rectum) were relatively
      uncommon, usually found in small numbers, and are considered satellite species.
      The two core species were very abundant in June, when the size of their
      populations was strongly correlated with the size of the host fish. At this time,
      M. pauli was found mainly in the duodenum, but in high populations was spread
      throughout the intestine (s. strict.). Both species were much less abundant in
      October, their populations were less dependent on host size, and M. pauli was
      more limited to the anterior intestine. Pleorchis polyorchis and Distomum
      aloysiae were more frequent in October, were found predominantly in fish with few
      M. pauli, and were found posterior to M. pauli, suggesting some interactions
      between these species. Stephanostomum bicoronatum showed no seasonal patterns,
      and no apparent interactions with A. coronatum.

PMID- 8341589
TI  - Detection of density-dependent growth and fecundity of helminths in natural
      infections.
AB  - Density-dependent constraints on parasite growth, survival or reproduction are
      thought to be important in preventing the unchecked increase in parasite numbers
      within individual hosts or host populations. While it is important to know where,
      and with what severity, density dependence is acting within the parasite life
      cycle, interpretation of data from natural infections is difficult. In this
      paper, we present a Monte Carlo simulation technique for examining such data for
      evidence of density dependence. We also describe how this technique may be used
      to distinguish among mechanisms hypothesized to generate density-dependent
      phenomena.

PMID- 8341590
TI  - Activation of the cryptic DNA binding function of mutant forms of p53.
AB  - Wild type p53 assembles into a latent multiprotein complex which can be activated
      for sequence-specific DNA binding in vitro by proteins targeting the carboxy
      terminal domain. Using an optimized system coupling the post-translational
      modification of wild type p53 to activation of sequence specific DNA binding, we
      examined the affects of common mutations on the cryptic DNA binding function of
      p53. Two mutant forms of p53 were shown to be efficiently converted from the
      latent state by PAb421 and DnaK, but were defective in activation by casein
      kinase II, indicating that mutant p53 may not be receptive to allosteric
      regulation by casein kinase II phosphorylation. A reactive sulfhydryl group is
      absolutely required for DNA binding by wild type and mutant forms of p53 once
      converted to the activated state. Together, these data show that some mutant
      forms of p53 harbour the wild-type machinery required to engage in sequence
      specific DNA binding and define a signalling pathway whose inactivation may
      directly result in a loss of p53 function.

PMID- 8341591
TI  - A novel Brn3-like POU transcription factor expressed in subsets of rat sensory
      and spinal cord neurons.
AB  - Brn3a and Brn3b are mammalian members of the POU class of transcription factors.
      They are closely related to each other and to Unc86, which determines the normal
      development of certain cells, including mechanoreceptive sensory neurons in
      Caenorhabditis elegans. We screened a rat dorsal root ganglion (DRG) cDNA library
      at moderate stringency with a Brn3a POU-domain probe and identified a novel
      transcript encoding a POU protein that we have named Brn3c. Brn3c closely
      resembles Brn3a and Brn3b in its POU-domain and thus helps define a family of
      Unc86-related mammalian POU factors. Both Brn3a and Brn3c are expressed only in
      the central and peripheral nervous systems. In the neonatal rat, northern blots
      revealed a 3.6 kb Brn3a transcript in DRG, spinal cord and hindbrain, and a 2.6
      kb Brn3c transcript in DRG and spinal cord. In situ hybridization showed that
      most DRG neurons express Brn3a whereas only a small subset of neurons expresses
      Brn3c. In the spinal cord, Brn3a is expressed by many dorsal horn neurons. In
      contrast, Brn3c is expressed by a very small number of cells in laminae 4/5 of
      the dorsal horn. These data suggest that Brn3-related POU factors may be involved
      in the development or function of particular subclasses of sensory and spinal
      cord neurons.

PMID- 8341592
TI  - The role of the preserved sequences of Dam methylase.
AB  - We have undertaken a site directed mutational analysis of two of the preserved
      regions in the amino acid sequence of Dam methylase in order to characterize
      their role. Mutations in region IV (sequence DPPY) abolish catalytic activity and
      greatly affect AdoMet crosslinking. Mutants in region III display a lowered
      specific activity with an unchanged AdoMet crosslinking capacity. We have also
      made a series of deletions both at the N and C terminal parts of the protein,
      which have been found to provide inactive enzyme. We discuss the significance of
      these results for the understanding of the functional properties of the enzyme.

PMID- 8341593
TI  - Matrix-assisted laser desorption ionization time-of-flight mass spectrometry: a
      powerful tool for the mass and sequence analysis of natural and modified
      oligonucleotides.
AB  - We report the analysis and characterization of natural and modified
      oligonucleotides by matrix-assisted laser desorption ionization time-of-flight
      mass spectrometry (MALDI-TOF MS). The present technology was highly improved for
      this class of compounds by using a new matrix, 2,4,6-trihydroxy acetophenone,
      together with di- and triammonium salts of organic or inorganic acids to suppress
      peak broadening due to multiple ion adducts. This methodology can be used in
      combination with time dependent degradation of oligonucleotides by exonucleases
      as powerful tool to determine sequence compositions.

PMID- 8341594
TI  - Antipairing and strand transferase activities of E. coli helicase II (UvrD).
AB  - The product of the uvrD gene of Escherichia coli, UvrD (helicase II), is known to
      be involved in methyl-directed mismatch repair, transposon excision and uvrABC
      excision repair. In conjugational crosses, various uvrD mutants have been
      reported to result in higher, lower or unaffected recombination frequencies. In
      an attempt to clarify the role of UvrD in recombination, we have studied in vitro
      its effects on two key reactions driven by RecA, homologous pairing and strand
      exchange. We show here that UvrD efficiently prevents or reverses RecA-mediated
      homologous pairing. Unexpectedly, we also found that it can stimulate RecA-driven
      branch migration and even catalyze strand exchange in the absence of RecA. A
      possible in vivo role for these antagonistic activities is discussed.

PMID- 8341595
TI  - A protein containing conserved RNA-recognition motifs is associated with
      ribosomal subunits in Saccharomyces cerevisiae.
AB  - Using PCR cloning techniques, we have isolated a Saccharomyces cerevisiae gene
      encoding a protein that contains two highly conserved RNA-recognition motifs.
      This gene, designated RNP1, encodes an acidic protein that is similar in sequence
      to a variety of previously isolated RNA binding proteins, including nucleolin,
      poly (A) binding protein, and small nuclear ribonucleoproteins. The RNP1 gene
      maps to the left arm of chromosome XIV centromere distal to SUF10. Haploid yeast
      containing a null allele of RNP1 are viable, indicating that RNP1 is dispensible
      for mitotic growth. However genomic Southern blot analysis indicated that several
      other loci in the S. cerevisiae genome appear to contain sequences similar to
      those in the RNP1 gene. The majority of the Rnp1 protein is cytoplasmic. Extra
      copies of RNP1 cause a decrease in levels of 80S monoribosomes. A fraction of
      Rnp1 protein cosediments on sucrose gradients with 40S and 60S ribosomal subunits
      and 80S monosomes, but not with polyribosomes.

PMID- 8341596
TI  - Interlocked circle formation by group I introns: structural requirements and
      mechanism.
AB  - Precursor RNA transcribed from the yeast mitochondrial gene coding for the large
      ribosomal RNA contains a group I intron that can excise itself in vitro. Apart
      from group I specific sequence elements the intron also contains a gene encoding
      a DNA endonuclease involved in intron dispersal. A precursor RNA derivative from
      which this gene has been removed self-splices efficiently, but due to activation
      of cryptic opening sites located in the 5' exon, the 3' part of this exon is
      sometimes co-excised with the intron. Upon further reaction, this enlarged intron
      molecules give rise to interlocked circles, comprising small circles derived from
      5' exon parts and large circles of the intron. Sequence comparison between
      cryptic opening sites and authentic splice sites reveals in most cases homology
      with the 3' exon part that is capable of interacting with the Internal Guide
      Sequence. The role of the IGS was further substantiated by replacing the cryptic
      opening sites with well defined sequences of authentic splice sites: one
      corresponding to the 3' splice site and its mutant derivatives, the other to a
      fragment containing the natural 5'-3' exon junction. Precursor RNAs derived from
      these constructs give rise to interlocked circles, and mutation studies confirm
      that the 3' exon nucleotides flanking a 3' splice site are essential for their
      formation. The results underline the crucial role of the IGS in interlocked
      circle formation which behaves similarly as in the normal self-splicing
      reactions. It has been proposed that the two short helices formed by basepairing
      of the IGS with the 5' and 3' exon can co-axially stack on top of each other
      forming a quasi continuous RNA double helix or pseudoknot. We present a model
      explaining how transesterification reactions of a mutant precursor RNA in such a
      pseudoknot can lead to interlocked circles. The experiments support the notion
      that a similar structure is also operative in splicing of wild type precursor
      RNA.

PMID- 8341598
TI  - Synthesis of (3'-5'),(2'-5')-linked di- and tri-adenylyl methylphosphonate
      analogs.
AB  - Stereoselectivity was found during the coupling reaction, to form 2',5'- and
      3',5'-linked di- and triadenylyl methylphosphonate. The configuration of
      phosphorus was determined by 1HNMR NOE.

PMID- 8341597
TI  - Determination of DNA replication kinetics in synchronized human cells using a PCR
      based assay.
AB  - Studies on the temporal order of DNA replication are difficult due to the lack of
      sensitivity of methods available for replication kinetic analysis. To overcome
      problems associated with the current techniques, we propose a PCR-based assay to
      determine the replication time of any single-copy DNA sequence in complex
      genomes. Human cells labeled with 5-bromodeoxyuridine (BrdU) were flow sorted,
      according to their DNA content, at different times after synchronous release from
      the G1/S phase boundary. The selective removal of newly-replicated BrdU
      substituted DNA was achieved by UV light irradiation followed by S1 nuclease
      treatment. The timing of replication of selected DNA sequences (housekeeping,
      tissue-specific, and non-coding loci) was determined by polymerase chain reaction
      (PCR) amplification using appropriate primers. DNA sequences localized in
      inactive replication units allowed amplification whereas those that have
      replicated will not be amplified by PCR. Using this sensitive and quantitative
      assay the replication kinetic analysis of a number of different DNA sequences can
      be performed from a single sorting experiment.

PMID- 8341599
TI  - Activation of HIV-specific ribozyme activity by self-cleavage.
AB  - A hammerhead ribozyme designed to cleave in trans the R region of HIV-1 RNA was
      inserted into a eukaryotic expression vector. This ribozyme was studied in vitro
      using the T3 RNA polymerase promoter located upstream of the eukaryotic promoter.
      The ribozyme showed no activity against its specific target sequence under any
      condition tested. To decrease the influence of potential cis inhibitory sequences
      in such a ribozyme transcript, a specific target sequence was inserted upstream
      of the ribozyme-coding sequence. This insertion allowed the release by cis
      cleavage of a short RNA bearing ribozyme activity and able to cleave in trans an
      external RNA target. The cis cleavage reaction generated two RNA molecules: the
      shorter RNA species, which included the catalytic domain, showed a trans cleavage
      reaction. This self-cleavable ribozyme was active in vitro at 37 degrees C
      against three distinct HIV-1 transcripts sharing the specific target sequence.
      Ribozyme activity was thus attained by self-cleavage of the ribozyme-containing
      sequence from the longer vector transcript.

PMID- 8341601
TI  - Distribution and cloning of eukaryotic mRNAs by means of differential display:
      refinements and optimization.
AB  - Differential display has been developed as a tool to detect and characterize
      altered gene expression in eukaryotic cells. The basic principle is to
      systematically amplify messenger RNAs and then distribute their 3' termini on a
      denaturing polyacrylamide gel. Here we provide methodological details and examine
      in depth the specificity, sensitivity and reproducibility of the method. We show
      that the number of anchored oligo-dT primers can be reduced from twelve to four
      that are degenerate at the penultimate base from the 3' end. We also demonstrate
      that using optimized conditions described here, multiple RNA samples from related
      cells can be displayed simultaneously. Therefore process-specific rather than
      cell-specific genes could be more accurately identified. These results enable
      further streamlining of the technique and make it readily applicable to a broad
      spectrum of biological systems.

PMID- 8341600
TI  - Interactions of USF and Ku antigen with a human DNA region containing a
      replication origin.
AB  - By means of a combination of ion-exchange and sequence-specific affinity
      chromatography techniques, we have purified to homogeneity two protein complexes
      binding in a human DNA region (B48) previously recognized to contain a DNA
      replication origin. The DNA sequence used for the protein purification (B48
      binding site) contains a binding site for basic-helix-loop-helix DNA binding
      proteins. The first complex is composed of two polypeptides of 42- and 44-kDa;
      its size, heat stability, and target DNA sequence suggest that it corresponds to
      transcription factor USF; furthermore, the 42-kDa polypeptide is recognized by
      antibodies raised against 43-kDa-USF. The second complex is represented by
      equimolar amounts of two proteins of 72 and 87 kDa; microsequencing of the two
      species indicated that they correspond to the human Ku antigen. In analogy with
      Ku, they produce a regular pattern of footprints without an apparent sequence
      specificity, and their binding can be competed by unspecific DNA provided that it
      contains free ends. The potential role of B48 binding site and of these cognate
      proteins in origin activation is discussed.

PMID- 8341602
TI  - Self-cleavage activity of the genomic HDV ribozyme in the presence of various
      divalent metal ions.
AB  - To identify the divalent metal ions that can support the self-cleavage activity
      of the genomic ribozyme of human hepatitis delta virus (HDV), we tested the
      activity of various divalent metal ions in the ribozyme reactions catalyzed by
      HDV88 (683-770 nt) and 88DI3 (HDV88 with the sequence from 740-752 nt deleted).
      Among various metal ions tested, Mg2+, Mn2+, Ca2+ and Sr2+ efficiently supported
      the self-cleavage reactions of the HDV88 and 88DI3 ribozymes. In the case of the
      88DI3 ribozyme, other divalent metal ions, such as Cd2+, Ba2+, Co2+, Pb2+ and
      Zn2+, were also able to support the self-cleavage reaction to some extent (<
      10%). In the presence of spermidine (0.5 mM), the cleavage reaction was promoted
      at lower concentrations of effective divalent metal ions. The HDV ribozyme
      represents the only example of ribozyme to date of a ribozyme that catalyzes the
      self-cleavage reaction in the presence of Ca2+ ions as efficiently as it does in
      the presence of Mg2+ ions.

PMID- 8341603
TI  - Isolation, sequencing and overexpression of the gene encoding the theta subunit
      of DNA polymerase III holoenzyme.
AB  - The gene encoding the theta subunit of DNA polymerase III holoenzyme, designated
      holE, was isolated using a strategy in which peptide sequence was used to derive
      a DNA hybridization probe. Sequencing of the gene, which maps to 41.43 centisomes
      of the chromosome, revealed a 76-codon open reading frame predicted to produce a
      protein of 8,846 Da. When placed in a tac promoter expression vector, the open
      reading frame directed expression of a protein, that comigrated with authentic
      theta subunit from purified holoenzyme, to 6% of total soluble protein.

PMID- 8341604
TI  - DNA-protein interactions at the S.cerevisiae alpha 2 operator in vivo.
AB  - Two homodimeric proteins, alpha 2 and MCM1, are required to repress transcription
      of a-cell type specific genes in haploid yeast alpha-cells. In vitro studies by
      others of the interactions of these proteins with operator DNA have suggested
      that MCM1 binds to the middle and alpha 2 to the ends of the 31 bp operator. We
      have previously shown that alpha 2 organizes chromatin structure adjacent to the
      operator; in the presence of alpha 2 repressor, a precisely positioned nucleosome
      abuts the operator in both minichromosomes and the genome. We present in vivo
      footprinting evidence consistent with occupancy of the operator by MCM1 in both a
      and alpha-cells and by alpha 2 repressor in alpha-cells. Interestingly, our in
      vivo results differ from previous in vitro work in detail. In contrast to the
      broad block of reagent accessibility to DNA by the factors seen in vitro, we find
      a pattern of strand-specific protection or augmented reactivity in vivo. The in
      vivo results are consistent with genetic data concerning transcriptional
      regulation of a-cell specific genes and corroborate the crystallographic data of
      others.

PMID- 8341605
TI  - The importance of downstream delta-factor binding elements for the activity of
      the rpL32 promoter.
AB  - A salient feature of mammalian ribosomal protein genes is the location of
      promoter elements downstream, as well as upstream, of the transcriptional start
      point. Previous functional studies of the mouse rpL32 gene (Chung and Perry, Mol.
      Cell. Biol. 9, 2075; 1989) indicated that the first intron of this gene contains
      such an element. We show here that this element encompasses a binding site for a
      zinc finger nuclear protein known as delta (YY-1, muE1, UCRBP). The intronic
      delta site (delta i) is located 32 bp downstream of another delta site in the
      first exon (delta e). Transfection experiments with genes containing deleterious
      mutations in one or both delta sites or having alterations in the spacing between
      the sites indicate that the two delta elements function independently and
      contribute additively to the overall strength of the rpL32 promoter. Moreover,
      the contribution of the delta i element is the same whether it is oriented
      parallel or antiparallel to the delta e element. Together, the two delta elements
      raise the expression level about 10-fold over that attained by the upstream and
      initiator portions of the promoter. The positive role of the delta factor in
      rpL32 expression contrasts strikingly with its repressive role in various other
      genes.

PMID- 8341606
TI  - Primary structure of Trichoderma harzianum ribosomal protein L32.

PMID- 8341607
TI  - Isolation of CENIX and CENXII from Saccharomyces cerevisiae.

PMID- 8341608
TI  - Nucleotide sequence of the Schizosaccharomyces pombe 25S ribosomal RNA and its
      phylogenetic implications.

PMID- 8341609
TI  - Nucleotide sequence of the Borrelia burgdorferi dnaN gene encoding the beta
      subunit of DNA polymerase III.

PMID- 8341610
TI  - Capsid protein gene sequences of four tobacco mosaic virus strains defective for
      virus assembly.

PMID- 8341611
TI  - Nucleotide sequence of Salmonella bacteriophage P22 head completion genes 10 and
      26.

PMID- 8341612
TI  - Nucleotide sequence of Mycobacterium leprae elongation factor (EF-Tu) gene.

PMID- 8341613
TI  - Midiprep method for isolation of DNA from plants with a high content of
      polyphenolics.

PMID- 8341614
TI  - A simple and efficient method for direct gene deletion in Saccharomyces
      cerevisiae.

PMID- 8341615
TI  - Fluorescence-based DNA sequencing with hexamer primers.

PMID- 8341616
TI  - Rapid sequencing of unpurified PCR products by thermal asymmetric PCR cycle
      sequencing using unlabeled sequencing primers.

PMID- 8341617
TI  - An EMSA-based method for determining the molecular weight of a protein--DNA
      complex.

PMID- 8341619
TI  - Gonorrhea. Finding and treating a moving target.
AB  - Gonorrhea is the most common reportable disease in the United States. In recent
      years, the epidemiology of this infection has changed as a result of increasing
      drug abuse, exchange of money and drugs for sex, and sexual promiscuity among
      teenagers, particularly blacks. Significant numbers of asymptomatic male carriers
      have been identified, which presents an additional challenge to disease control.
      Gonococcal infection has become increasingly resistant to traditional antibiotic
      therapy and now requires the use of newer, more expensive agents. Single-dose
      oral treatment with cefixime (Suprax) or a quinolone appears to be effective,
      safe, and practical for patients with uncomplicated gonorrhea. Serious infection
      and new syndromes caused by gonococci continue to be reported. Because
      disseminated infections can be fatal, hospitalization and treatment with
      intravenous antibiotics such as ceftriaxone sodium (Rocephin) or cefotaxime
      sodium (Claforan) are required.

PMID- 8341618
TI  - Simplified high throughput protocol for northern hybridization.

PMID- 8341620
TI  - Scary quotes about healthcare that may go down in history.

PMID- 8341621
TI  - Chronic obstructive pulmonary disease. Major objectives of management.
AB  - The successful management of chronic obstructive pulmonary disease (COPD) depends
      on achieving three major goals: reduction of airflow obstruction, prevention or
      management of complications, and improvement in the patient's quality of life.
      Exercise training is effective in improving the patient's performance; breathing
      training and education regarding smoking cessation and use of a peak flow meter
      are also vital to management. Some COPD patients may be suitable candidates for
      long-term oxygen therapy.

PMID- 8341622
TI  - Popliteal artery aneurysm. Prompt intervention prevents tragic consequences.
AB  - Popliteal artery aneurysm is an important, if uncommon, cause of lower extremity
      ischemia. About half of cases are asymptomatic. Untreated aneurysms may lead to
      embolization, rupture, thrombosis, and amputation. Diagnosis involves careful
      physical examination and use of ultrasound and arteriography. Prompt surgical
      intervention is essential.

PMID- 8341623
TI  - Modern coronary rehabilitation. New concepts in care.
AB  - Contemporary rehabilitative care for coronary patients involves individualized
      recommendations and applications. The challenge to the physician is to select
      those services that are appropriate for a given patient, on the basis of both
      medical recommendations and patient preferences, so as to encourage progressive
      independence in rehabilitative care. The physician, patient, and rehabilitation
      professional can then define the desired outcome of each intervention, in both a
      quantitative and a time-based format. Physical activity goals can often be
      rapidly met, whereas risk reduction addresses longer-term outcomes. Exercise test
      based risk stratification can identify the high-risk subset of coronary patients,
      who require supervision of exercise testing, often with ECG monitoring. Low-risk
      patients can exercise independently. Modest-intensity dynamic exercise is
      beneficial and has greater adherence and safety than high-intensity exercise.
      Isometric exercise is recommended once patients attain a reasonable dynamic
      (aerobic) exercise capacity. Education and counseling are necessary to implement
      reduction of coronary risk factors. Technological advances that may help in
      delivery of educational services include videocassettes and computer interactive
      programs for home use. Information shared with family members has added benefit,
      because they may also have coronary risk attributes. Innovative approaches may
      improve the effectiveness and efficiency of long-term rehabilitative care.

PMID- 8341624
TI  - Systolic hypertension in the elderly. Safe treatment with low-dose thiazide
      diuretics.
AB  - Low doses of thiazide diuretics are effective in controlling isolated systolic
      hypertension in most elderly patients. These agents are well tolerated and do not
      appear to adversely affect quality of life. Biochemical adverse effects are
      minimal with low doses. Of greatest importance, thiazide diuretics are the only
      class of antihypertensives that has been shown to reduce risk of cardiovascular
      events in patients with isolated systolic hypertension. Recent studies showed all
      these advantages with both chlorthalidone and hydrochlorothiazide therapy,
      although low-dose hydrochlorothiazide may cause less hypokalemia in the elderly
      than does chlorthalidone.

PMID- 8341625
TI  - Entrapment neuropathies. A guide to avoiding misdiagnoses.
AB  - Nerve entrapment has many possible causes and can mimic a broad range of
      disorders. A carefully taken history and thorough neurologic examination are the
      most important parts of evaluation, and plain radiography, electromyography, and
      nerve conduction velocity studies are useful adjuncts. Treatment options include
      correction of underlying causes; reduction in activity; exercise programs;
      wearing of splints, arch supports, or foot braces; local injections of
      corticosteroids and/or anesthetics; use of nonsteroidal anti-inflammatory drugs;
      and surgical decompression. Early, appropriate therapy ensures a good outcome.

PMID- 8341626
TI  - The antinuclear antibody test. When is a positive result clinically relevant?
AB  - The antinuclear antibody (ANA) test is sensitive but not specific. Many
      nonrheumatic diseases and conditions can cause positive results, and some healthy
      persons have positive results. ANA testing should not be used to evaluate
      patients who have vague complaints or symptoms. Rather, it is best used in
      patients with signs or symptoms of rheumatic disease to justify further specific
      investigation aimed at confirming a diagnosis.

PMID- 8341627
TI  - Acute gouty arthritis. Modern approaches to an ancient disease.
AB  - The principles governing the pathogenesis and treatment of gout have been
      established with greater clarity than those for almost any other rheumatic
      disease. The benefits of treatment include the virtual cure of a disabling and
      deforming disease. Adherence to proper management guidelines provides predictable
      relief of symptoms for patients and great satisfaction for the treating
      physician.

PMID- 8341628
TI  - Invasion of the 'killer' bees. Separating fact from fiction.
AB  - Even a single honeybee sting can lead to anaphylaxis in a susceptible person, but
      severe reactions can result from multiple stings, particularly if stings are from
      the fast-spreading Africanized honeybees, sometimes called "killer" bees. Signs
      and symptoms of multiple stings may include urticaria, nausea, vomiting,
      diarrhea, hypotension, confusion, seizures, and renal failure. Treatment is
      entirely supportive and requires special attention to airway patency, blood
      pressure, and renal function. Patients with more than 50 stings are at a higher
      risk of toxicity. Stingers should be removed by scraping gently to prevent
      further venom injection. Smoke or aerosolized deet (diethyl-toluamide) may thwart
      attacking bees, but avoidance is the best line of defense.

PMID- 8341629
TI  - Cytogenetic analysis of human oocytes after subzonal insemination.
AB  - Subzonal insemination has been proposed to achieve fertilization in cases where
      standard in vitro fertilization has failed. We present the results of chromosome
      analysis of oocytes after subzonal insemination. Our data suggest that the main
      cause (76 per cent) of the absence of cleavage after subzonal insemination is the
      total absence of sperm nucleus evolution of the injected spermatozoa. Our results
      also suggest that spermatozoa chromatin development is normal after subzonal
      insemination. Aneuploidy does not seem to be increased in zygotes after subzonal
      insemination. However, polyploidy was often more important than predicted by the
      observation of pronuclei (PN). Pronucleus development might be asynchronous and
      can appear earlier or later than after standard IVF. The cytogenetic risk after
      subzonal insemination might therefore be triploidy (if a triploid egg is
      transferred, because only 2 PN were seen) rather than aneuploidy or structural
      abnormalities.

PMID- 8341630
TI  - Applicability of DNA isolated from syncytiotrophoblast vesicles to gene
      amplification and molecular analysis.
AB  - Maternal contamination of fetal DNA represents a major problem when highly
      sensitive molecular techniques are used in the prenatal diagnosis of genetic
      diseases. For this reason, we have studied the possibility of using DNA isolated
      from syncytiotrophoblast vesicles as a target of gene amplification (PCR). Three
      PCR systems were selected which included a repetitive 149 bp fragment of the Y
      chromosome, the VNTR locus D1S80, and a portion of the beta-globin gene. The
      results of these experiments indicate that DNA isolated from syncytiotrophoblast
      vesicles is free of maternal contamination and is suitable for gene amplification
      and DNA analysis.

PMID- 8341631
TI  - Grief and mid-trimester fetal loss.
AB  - Fetal loss through miscarriage or termination of pregnancy for genetic reasons
      often provokes the grief of bereavement. This is not fully understood, and the
      extent of the distress is often underestimated by professionals and family alike.
      We have examined elements of the normal bereavement process and have found that
      they may occur in specific and accentuated forms in mid-trimester fetal loss. We
      discuss our findings in the light of the attachment theory--a psychodynamic model
      for understanding grief reactions.

PMID- 8341632
TI  - Rapid karyotyping in ectopic pregnancies.
AB  - The aim of this study was to determine the feasibility of karyotyping ectopic
      Fallopian tube pregnancies utilizing dividing cytotrophoblast cells. Villi from
      78 ectopic conceptuses were processed by the direct chromosome technique and
      cytogenetic diagnosis was successful in 60 cases (76.9 per cent). The amount of
      villi obtained, as well as villus morphology, was correlated with cytogenetic
      success rate. Histological examination of the Fallopian tube was also carried
      out. A total of 47 cases were chromosomally abnormal (78.3 per cent), which is
      the highest frequency of cytogenetic abnormalities reported to date.

PMID- 8341633
TI  - Characterization of i(18p) in prenatal diagnosis by fluorescence in situ
      hybridization.
AB  - A case is presented in which chorionic villus direct preparation and cultured
      chorionic villus cells revealed a 47,XX+mar karyotype. The marker was a small
      metacentric chromosome and appeared to be i(18p)--isochromosome 18p. Follow-up
      studies in both amniotic fluid and fetal fibroblasts confirmed the karyotype. In
      order to characterize the marker, a panel of biotinylated DNA probes was used,
      including a whole chromosome 18 probe, chromosome 18-specific alpha satellite
      DNA, Yac clones, and a pan-telomeric probe. These studies show that the marker is
      a monocentric i(18p) in which about 80 per cent of chromosome 18 alpha satellite
      DNA has been lost.

PMID- 8341634
TI  - False-positive amniotic fluid acetylcholinesterase analysis in the third
      trimester.
AB  - Thirty-two third-trimester amniotic fluid samples were studied according to the
      indication for amniocentesis, result of acetylcholinesterase (AChE) analysis, and
      outcome, in order to address the issue of the effectiveness of AChE testing late
      in gestation. The results indicate that third-trimester AChE analysis is less
      effective than second trimester in distinguishing open neural tube defects
      (ONTDs) and ventral wall defects (VWDs) from other abnormalities. False-positive
      results occurred in cases of isolated hydrocephaly (four of seven cases),
      polyhydramnios, and intrauterine growth retardation (IUGR). Caution is
      recommended in interpreting third-trimester AChE tests, particularly when neither
      an ONTD nor a VWD is observed by ultrasound.

PMID- 8341635
TI  - First-trimester diagnosis of duodenal stenosis associated with oesophageal
      atresia.
AB  - Duodenal stenosis associated with oesophageal atresia was diagnosed by ultrasound
      at 12 weeks' gestation. The diagnosis was made by recognition of a double bubble
      sign which was more pronounced when a vaginal transducer was used. Post-abortion
      autopsy confirmed the diagnosis. Oesophageal and duodenal obstruction in this
      case had no effect on the amount of amniotic fluid or the alpha-fetoprotein
      concentration since swallowing and subsequent utilization of amniotic fluid do
      not occur before 12 weeks of gestation.

PMID- 8341636
TI  - A large retinoblastoma detected in a fetus at 21 weeks of gestation.
AB  - The facial tumour described here is the first reported case of a large
      retinoblastoma detected early in pregnancy and adds another item to the
      differential diagnosis of facial tumours visualized by prenatal ultrasound
      examination. Ultrasound examination of the fetal eyes can be offered in cases of
      retinoblastomas where prenatal DNA diagnosis is otherwise impossible.

PMID- 8341637
TI  - Molecular cytogenetic characterization of marker chromosomes found at prenatal
      diagnosis.
AB  - The nature and origin of two de novo small marker chromosomes found at prenatal
      diagnosis were determined by fluorescence in situ hybridization using chromosome
      centromere-specific probes and chromosome-specific plasmid libraries. One marker
      was found in a mosaic state and was shown to be an i(18p). The second marker was
      characterized as an inv dup(22). We conclude that molecular cytogenetic analysis
      contributes to the identification of marker chromosomes and therefore facilitates
      genetic counselling and decision-making for the parents.

PMID- 8341638
TI  - Ultrasonographic features in a case of heterozygous achondroplasia at 25 weeks'
      gestation.
AB  - Prenatal diagnosis of heterozygous achondroplasia at 25 weeks is described. First
      level fetal ultrasonography demonstrated short long bones of the lower limbs.
      Second-level examination showed a large head; shortened femur, fibula, and tibia;
      a 'trident'-shaped hand; and an abnormal facial profile.

PMID- 8341639
TI  - Prenatal diagnosis of isolated bilateral microphthalmia with confirmation by
      evaluation of products of conception obtained by dilation and evacuation.
AB  - We describe the prenatal diagnosis of isolated bilateral fetal microphthalmia in
      a woman at increased risk of having a fetus with microphthalmia. Ultrasound
      examinations at 16.1 and 19.5 weeks' gestation demonstrated bilateral fetal
      microphthalmia with no other associated structural defects. The patient elected
      to terminate her pregnancy at 19.5 weeks. Pathological evaluation of the products
      of conception obtained by dilation and evacuation confirmed the prenatal
      diagnosis of isolated bilateral fetal microphthalmia.

PMID- 8341640
TI  - Early prenatal sonographic diagnosis of neuropathic arthrogryposis multiplex
      congenita with osseous heterotopia.
AB  - A prenatal diagnosis of arthrogryposis multiplex congenita (AMC) has been carried
      out on a 19-week-old fetus by means of echography. The ultrasonographic
      characteristics were unnatural position of the four limbs associated with
      articular anomalies together with absence of active fetal movements. A
      therapeutic interruption of pregnancy was performed and the diagnosis was
      confirmed. At autopsy, architectural disorder of the motor neurons of the
      anterior medullary horn revealed a neuropathic pathogenesis of the
      arthrogryposis. Moreover, at the lumbar level the spinal cord was progressively
      replaced by heterotopic bony tissue which caused a more severe deformity of the
      lower limbs compared with the upper. The aspects of anatomo-pathological,
      genetic, and differential diagnosis are discussed showing the precocity of the
      prenatal diagnosis and the peculiarity of the aetiology of our case.

PMID- 8341641
TI  - Prenatal diagnosis of exencephaly.
AB  - This paper presents a sonographic diagnosis of exencephaly made during the last
      trimester of gestation. The sonogram showed the absence of bones in the cranial
      vault together with the presence of a disorganized cerebral mass, with loss of
      its normal anatomy. Post-partum examination of the newborn confirmed the findings
      of the sonogram. We briefly review the characteristics of exencephaly, its
      aetiology, and its relationship to anencephaly.

PMID- 8341642
TI  - Direct selection of antibodies that coordinate metals from semisynthetic
      combinatorial libraries.
AB  - An iterative strategy for the selection of catalytic metalloantibodies is
      described. The first stage of this strategy is validated by the selection of
      semisynthetic antibodies that coordinate a variety of different metal ions and
      the metal oxide magnetite. These results have implications not only for the
      development of catalytic metalloantibodies but also for the development of
      reagents for magnetic resonance imaging, delivery of radioisotopes, and
      purification of recombinant proteins.

PMID- 8341643
TI  - Targeting the site of RNA-RNA recombination in brome mosaic virus with antisense
      sequences.
AB  - It has been postulated that local hybridizations between viral RNAs can mediate
      recombination in brome mosaic virus (BMV) and in poliovirus. To test this model,
      a 3' fragment of BMV RNA1 was inserted into the 3' noncoding sequence of BMV RNA3
      in an antisense orientation. This resulted in high-frequency nonhomologous
      crossovers at or near the hybridized region. Insertion of the same RNA1 fragment
      in a positive-sense orientation did not promote recombination. Modification of
      the antisense insert by deletion of 3' portions did not affect the sites of
      crossover. However, modification of the 5' portion shifted the crossovers toward
      the central part of the heteroduplex region. Our results provide experimental
      evidence that recombinant crosses can be primed by hybridization between viral
      RNA molecules.

PMID- 8341644
TI  - Inhibition of type 1 human immunodeficiency virus replication by a tat antagonist
      to which the virus remains sensitive after prolonged exposure in vitro.
AB  - The transactivator of transcription, Tat, of human immunodeficiency virus type 1
      (HIV-1) is required for viral replication. Inhibition of Tat function could have
      the potential to keep integrated provirus in dormancy. In the presence of Tat, Ro
      24-7429, an analog of Ro 5-3335, inhibited expression of indicator genes
      controlled by the HIV-1 long terminal repeat promoter in transient transfection
      assays and in a constitutive cell line at noncytotoxic concentrations. Reduction
      of steady-state mRNA of the indicator gene by the compound correlated with
      reduction of the gene product in the constitutive cell line. Ro 24-7429 has broad
      activity against several strains of HIV-1 in different cell lines, peripheral
      blood lymphocytes, and macrophages (IC90 = 1-3 microM). Importantly, Ro 24-7429
      inhibited viral replication in both acute and chronic infection in vitro, a
      characteristic expected of a Tat antagonist and not shared by viral reverse
      transcriptase inhibitors. Consistent with this, the compound reduced cell
      associated viral RNA and proteins and partially restored cell-surface CD4 in
      chronically infected cells. After 2 years of continued weekly passage of the
      virus in fresh CEM cells grown in the presence of the compound at 1 or 10 microM,
      the virus did not develop resistance to the drug. These results indicate that the
      compound's action might involve a cellular factor.

PMID- 8341645
TI  - Treatment of chronic-relapsing experimental autoimmune encephalomyelitis with the
      synthetic immunomodulator linomide (quinoline-3-carboxamide).
AB  - Linomide is a synthetic immunomodulator that enhances natural killer cell
      activity and significantly activates several lymphocytic cell subpopulations in
      both experimental animals and humans. In this study we examined the effect of
      linomide (80 mg per kg per day in drinking water) on mice with chronic-relapsing
      experimental autoimmune encephalomyelitis (CR-EAE), a T-cell-mediated organ
      specific autoimmune disease that resembles human multiple sclerosis. None of the
      mice (n = 17) that were treated with linomide from day 7 after disease induction
      developed any clinical or histopathological signs of CR-EAE, as compared to 19 of
      20 untreated controls that were severely paralyzed and had extensive
      demyelinating lesions in the central nervous system. Linomide-treated animals
      were also resistant to an induced attack by a booster injection with a murine
      spinal cord homogenate. When administered to mice exhibiting severe clinical
      signs of paralysis, linomide inhibited both spontaneous and induced relapses.
      Linomide treatment protected mice from passively induced CR-EAE as well, when
      given from the day of injection with myelin-basic-protein-specific lymphocytes.
      Lymphocytes obtained from linomide-treated mice had a reduced in vitro
      proliferative response to the myelin basic protein and to the tuberculin purified
      protein derivative, whereas the mitogenic response to concanavalin A was not
      affected. Natural killer cell and lymphokine-activated killer cell activities
      were enhanced. These results suggest that linomide regulates autoimmunity in the
      absence of systemic immunosuppression. Since linomide is very well tolerated in
      experimental animals and humans, it might be used in the treatment of multiple
      sclerosis.

PMID- 8341646
TI  - Kinetics of human immunodeficiency virus type 1 (HIV-1) DNA and RNA synthesis
      during primary HIV-1 infection.
AB  - HIV-1 replication and viral burden in peripheral blood mononuclear cells (PBMC)
      have been reported to be high in primary infection but generally very low during
      the prolonged period of clinical latency. It is uncertain precisely when this
      transition occurs during the HIV-1 infection and what the relationship is between
      the changes in HIV-1 replication versus the clearance of infected cells in the
      overall control of viral replication. In the present study, the kinetics of viral
      burden (i.e., frequency of HIV-1-infected cells) and replication during primary
      and early-chronic infection were analyzed in PBMC of four acutely infected
      individuals. High frequencies of HIV-1-infected cells and high levels of virus
      replication were observed in PBMC after primary HIV-1 infection. Down-regulation
      of virus replication in PBMC was observed in all four patients coincident with
      the emergence of HIV-1-specific immune responses. Other parameters of virus
      replication, such as circulating plasma p24 antigen and plasma viremia showed
      similar kinetics. In contrast, a significant decline in viral burden in PBMC was
      observed in only one of four patients. These results indicate that the down
      regulation in the levels of virus replication associated with the clinical
      transition from acute to chronic infection does not necessarily reflect a
      reduction in viral burden, thus suggesting the involvement of additional factors.
      Identification of these factors will be important in elucidating the host
      mechanisms involved in the early control of HIV-1 infection and disease.

PMID- 8341647
TI  - Neurexin III alpha: extensive alternative splicing generates membrane-bound and
      soluble forms.
AB  - The structure of neurexin III alpha was elucidated from overlapping cDNA clones.
      Neurexin III alpha is highly homologous to neurexins I alpha and II alpha and
      shares with them a distinctive domain structure that resembles a cell surface
      receptor. cDNA cloning and PCR experiments revealed alternative splicing at four
      positions in the mRNA for neurexin III alpha. Alternative splicing was previously
      observed at the same positions in either neurexin I alpha or neurexin II alpha or
      both, suggesting that the three neurexins are subject to extensive alternative
      splicing. This results in hundreds of different neurexins with variations in
      small sequences at similar positions in the proteins. The most extensive
      alternative splicing of neurexin III alpha was detected at its C-terminal site,
      which exhibits a minimum of 12 variants. Some of the alternatively spliced
      sequences at this position contain in-frame stop codons, suggesting the synthesis
      of secreted proteins. None of the sequences of the other splice sites in this or
      the other two neurexins include stop codons. RNA blot analysis demonstrate that
      neurexin III alpha is expressed in a brain-specific pattern. Our results suggest
      that the neurexins constitute a large family of polymorphic cell surface proteins
      that includes secreted variants, indicating a possible role as signaling
      molecules.

PMID- 8341648
TI  - Preferential and asymmetric interaction of linker histones with 5S DNA in the
      nucleosome.
AB  - We establish that linker histones H1 and H5 bind preferentially to a Xenopus
      borealis somatic 5S RNA gene associated with an octamer of core histones rather
      than to naked 5S DNA. This preferential binding requires free linker DNA to
      either side of the nucleosome core. Incorporation of a single linker histone
      molecule into the nucleosome protects an additional 20 bp of linker DNA from
      micrococcal nuclease digestion. This additional DNA is asymmetrically distributed
      with respect to the nucleosome core. Incorporation of linker histones causes no
      change to the cleavage of DNA in the nucleosome by hydroxyl radical or DNase I.

PMID- 8341649
TI  - An alkylation-tolerant, mutator human cell line is deficient in strand-specific
      mismatch repair.
AB  - The human lymphoblastoid MT1 B-cell line was previously isolated as one of a
      series of mutant cells able to survive the cytotoxic effects of N-methyl-N'-nitro
      N-nitrosoguanidine (MNNG). MT1 cells nevertheless remain sensitive to mutagenesis
      by MNNG and display a mutator phenotype. These phenotypes have been attributed to
      a single genetic alteration postulated to confer a defect in strand-specific
      mismatch repair, a proposal that attributes the cytotoxic effect of DNA
      alkylation in wild-type cells to futile attempts to correct mispairs that arise
      during replication of alkylated template strands. Our results support this view.
      MNNG-induced mutations in the HPRT gene of MT1 cells are almost exclusively G.C-
      >A.T transitions, while spontaneous mutations observed in this mutator cell line
      are single-nucleotide insertions, transversions, and A.T-->G.C transitions. In
      vitro assay has demonstrated that the MT1 line is in fact deficient in strand
      specific correction of all eight base-base mispairs. This defect, which is
      manifest at or prior to the excision stage of the reaction, is due to simple
      deficiency of a required activity because MT1 nuclear extracts can be
      complemented by a partially purified HeLa fraction to restore in vitro repair.
      These findings substantiate the idea that strand-specific mismatch repair
      contributes to alkylation-induced cytotoxicity and imply that this process serves
      as a barrier to spontaneous transition, transversion, and insertion/deletion
      mutations in mammalian cells.

PMID- 8341650
TI  - Differentiation and characterization of B-cell precursors detected in the yolk
      sac and embryo body of embryos beginning at the 10- to 12-somite stage.
AB  - The embryonic sites in which progenitors of the hematopoietic lineages first
      emerge are ideal regions to characterize both the cells and environment needed to
      initiate blood cell development. For a number of years both the murine yolk sac
      and embryo have been recognized to contain progenitors of B lymphocytes. However,
      clonal, quantitative in vitro assays, which allow precise observation of
      precursors and their progeny, have been lacking. Moreover, the site of origin of
      the initial events remains controversial. In this report we document the presence
      of B-cell progenitors in yolk sac and embryonic tissue obtained from mouse
      fetuses beginning at the 10-somite stage, day 8.5. We determine the frequency,
      cell-surface phenotype, and growth properties of these progenitors. We show that
      these cells can differentiate into immunoglobulin-secreting cells and that the
      progeny derived from single progenitors are diverse with respect to
      immunoglobulin heavy-chain allotype expression, diversity-joining region use, and
      heavy-chain variable-region utilization.

PMID- 8341651
TI  - Lipid advanced glycosylation: pathway for lipid oxidation in vivo.
AB  - To address potential mechanisms for oxidative modification of lipids in vivo, we
      investigated the possibility that phospholipids react directly with glucose to
      form advanced glycosylation end products (AGEs) that then initiate lipid
      oxidation. Phospholipid-linked AGEs formed readily in vitro, mimicking the
      absorbance, fluorescence, and immunochemical properties of AGEs that result from
      advanced glycosylation of proteins. Oxidation of unsaturated fatty acid residues,
      as assessed by reactive aldehyde formation, occurred at a rate that paralleled
      the rate of lipid advanced glycosylation. Aminoguanidine, an agent that prevents
      protein advanced glycosylation, inhibited both lipid advanced glycosylation and
      oxidative modification. Incubation of low density lipoprotein (LDL) with glucose
      produced AGE moieties that were attached to both the lipid and the apoprotein
      components. Oxidized LDL formed concomitantly with AGE-modified LDL. Of
      significance, AGE ELISA analysis of LDL specimens isolated from diabetic
      individuals revealed increased levels of both apoprotein- and lipid-linked AGEs
      when compared to specimens obtained from normal, nondiabetic controls.
      Circulating levels of oxidized LDL were elevated in diabetic patients and
      correlated significantly with lipid AGE levels. These data support the concept
      that AGE oxidation plays an important and perhaps primary role in initiating
      lipid oxidation in vivo.

PMID- 8341652
TI  - Neuronal colocalization of mRNAs for neurotrophins and their receptors in the
      developing central nervous system suggests a potential for autocrine
      interactions.
AB  - Development and survival of neurons in the central nervous system are dependent
      on the activity of a variety of endogenous neurotrophic agents. Using combined
      isotopic and nonisotopic in situ hybridization histochemistry, we have found that
      subsets of neurons within the developing forebrain coexpress the mRNAs for both
      neurotrophins (nerve growth factor, brain-derived neurotrophic factor, and
      neurotrophin 3) and their receptors (p75NGFR, TrkA, and TrkB). The colocalization
      of mRNA for neurotrophin receptors and their ligands in presumptive neurotrophin
      target neurons suggests the potential for autocrine and paracrine mechanisms of
      action during development. Such mechanisms may ensure the onset of
      differentiation and survival of specific subsets of neurons prior to and
      following target innervation.

PMID- 8341654
TI  - Loss of erythropoietin responsiveness in erythroid progenitors due to expression
      of the Evi-1 myeloid-transforming gene.
AB  - Inappropriate expression of the Evi-1 zinc-finger gene in hematopoietic cells has
      been associated with acute myelogenous leukemia and myelodysplastic syndromes in
      murine models and in humans. Consistent with this, previous studies have shown
      that aberrant expression of the Evi-1 gene in a myeloid progenitor cell line
      blocks granulocytic differentiation. Here we demonstrate that the aberrant
      expression of the Evi-1 gene impairs the normal response of erythroid cells or
      bone-marrow progenitors to erythropoietin. Erythroid differentiation has been
      shown to require the GATA-1 transcription factor that binds to a sequence
      contained within the consensus binding sequence identified for Evi-1. In the
      studies presented here we also show that Evi-1 can repress GATA-1-dependent
      transactivation in transient chloramphenicol acetyltransferase assays. Together
      the data support the hypothesis that inappropriate expression of the Evi-1 gene
      blocks erythropoiesis by repressing the transcription of a subset of GATA-1
      target genes.

PMID- 8341653
TI  - "Diabodies": small bivalent and bispecific antibody fragments.
AB  - Bivalent and bispecific antibodies and their fragments have immense potential for
      practical application. Here we describe the design of small antibody fragments
      with two antigen-binding sites. The fragments comprise a heavy-chain variable
      domain (VH) connected to a light-chain variable domain (VL) on the same
      polypeptide chain (VH-VL). By using a linker that is too short to allow pairing
      between the two domains on the same chain, the domains are forced to pair with
      the complementary domains of another chain and create two antigen-binding sites.
      As indicated by a computer graphic model of the dimers, the two pairs of domains
      can pack together with the antigen-binding sites pointing in opposite directions.
      The dimeric antibody fragments, or "diabodies," can be designed for bivalent or
      bispecific interactions. Starting from the monoclonal antibodies NQ11.7.22 (NQ11)
      and D1.3 directed against the hapten phenyloxazolone and hen egg lysozyme,
      respectively, we built bivalent fragments (VHNQ11-VLNQ11)2 and (VHD1.3-VLD1.3)2
      and bispecific fragments VHNQ11-VLD1.3 and VHD1.3-VLNQ11. The fragments were
      expressed by secretion from bacteria and shown to bind specifically to the hapten
      and/or antigen. Those with 5- and 15-residue linkers had similar binding
      affinities to the parent antibodies, but a fragment with the VH domain joined
      directly to the VL domain was found to have slower dissociation kinetics and an
      improved affinity for hapten. Diabodies offer a ready means of constructing small
      bivalent and bispecific antibody fragments in bacteria.

PMID- 8341655
TI  - Cell cycle regulation of nuclear localization of hepatitis B virus core protein.
AB  - The hepatitis B virus (HBV) core protein has been found in the nucleus, the
      cytoplasm, or both of HBV-infected hepatocytes. However, the mechanism that
      regulates the subcellular localization of the HBV core protein is still unclear.
      In this report, we demonstrate that nuclear localization of the HBV core protein
      is cell cycle-regulated in two different cell lines. The amount of the core
      protein in the nucleus was increased during the G1 phase, reduced to an
      undetectable level during the S phase, and increased again when the cells were
      confluent and ceased to grow. Thus, the nuclear localization of the core protein
      during HBV infection can be at least partially attributed to liver injury and
      regeneration, which cause the hepatocytes to enter cell cycles. Based on the
      observation that the cytoplasmic core protein was phosphorylated and the nuclear
      core protein was not, we speculate that nuclear localization of the HBV core
      protein is negatively regulated by phosphorylation during the cell cycle.

PMID- 8341656
TI  - Anti-cardiolipin antibodies induce pregnancy failure by impairing embryonic
      implantation.
AB  - The antiphospholipid syndrome is characterized by thrombocytopenia, thrombosis,
      and recurrent fetal loss in association with anti-cardiolipin antibodies (ACAs)
      or lupus anti-coagulants. However, the causal role of these antibodies in the
      disease and the mechanisms by which the ACA may induce the syndrome are not
      clear. Recently, we have established an experimental mouse antiphospholipid
      syndrome induced by the mouse IgM monoclonal ACA designated 2C4C2. In the present
      study, we focused on the effects of immunization with the monoclonal ACA 2C4C2 on
      the outcome of pregnancies in BALB/c female mice. Four weeks after active
      immunization with the monoclonal ACA, a severe gestational failure with low
      pregnancy rates, low number of fetuses, and a high rate of resorptions was
      observed. Moreover, embryos obtained from the ACA-immunized females on day 3.5 of
      pregnancy were severely impaired, demonstrating developmental delay and abnormal
      morphology. These abnormal embryos failed also to develop in an in vitro
      implantation model. Furthermore, specific binding of the 2C4C2 ACA to the
      trophectoderm cell lineage of in vitro implanting normal embryos was observed.
      Thus, our studies demonstrate that the severe ACA-induced gestational failure
      results from an impairment of implantation and suggest that the ACA may react
      directly with the preimplantation embryos.

PMID- 8341657
TI  - O6-methylguanine-DNA methyltransferase protects against nitrosamine-induced
      hepatocarcinogenesis.
AB  - We previously generated transgenic C3H/HeN mice by introducing the Escherichia
      coli O6-methylguanine-DNA methyltransferase (MGMT, DNA-O6-methylguanine:protein-L
      cysteine S-methyltransferase, EC2.1.1.63) gene, ada, attached to the Chinese
      hamster metallothionein I gene promoter. One transgenic mouse line expressing
      both ada-specific mRNA and Ada protein could be propagated over many generations
      in a homozygous state with respect to the integrated DNA. Liver extracts from
      transgenic homozygous mice have consistently demonstrated about 3 times the
      control activity of normal mice. Furthermore, in the transgenic homozygotes
      treated with ZnSO4, activity is increased to 6-8 times the normal level in mice
      and is equivalent to that for man. To examine whether these increased levels of
      MGMT activity can actually decrease the susceptibility of animals to N-nitroso
      compounds, we studied liver carcinogenesis in our transgenic mice expressing high
      amounts of MGMT. Groups of transgenic and nontransgenic mice, each comprising
      about 200 suckling animals (14 +/- 1 days old), were divided each into eight
      subgroups, providing paired groups of transgenic and nontransgenic mice. They
      received an i.p. injection of ZnSO4 to induce MGMT, and 10 hr thereafter were
      given an i.p. injection of either dimethylnitrosamine or diethylnitrosamine.
      Liver tumor development was quantitatively assessed at 7-11 months. Here, we
      report statistically significant reduction of tumor formation in transgenic mice
      of four of the six paired groups that received treatment. The remaining two
      demonstrated results in line with dose dependence. Therefore, our data indicate
      that MGMT can indeed protect animals from low-dose exposure to environmental
      alkylating carcinogens.

PMID- 8341658
TI  - Yersinia enterocolitica invasin: a primary role in the initiation of infection.
AB  - The ability to invade the intestinal epithelium of mammals is an essential
      virulence determinant of Yersinia enterocolitica. The chromosomally encoded Y.
      enterocolitica 8081v invasion gene, inv, was disrupted to assess its role in
      pathogenesis. The inv mutant (JP273v) was approximately 80-fold less invasive
      than wild type for cultured epithelial cells. When mice were infected
      intragastrically, up to 10(7) fewer JP273v were recovered from Peyer's patches
      early (6-18 hr) after infection compared with wild type. Analysis of the course
      of infection revealed that the inv mutant had distinct differences relative to
      wild type in the distribution of visible infectious foci and in tissue
      colonization; however, the mutant and wild-type strains had similar LD50 values
      for both orally and intraperitoneally infected mice. The invasion defect of the
      inv mutant was fully complemented in vitro and in vivo by introduction of the
      wild-type inv gene in trans. The inv gene product, invasin, appears to play a
      vital role in promoting entry during the initial stage of infection. During the
      subsequent establishment of a systemic infection, invasin may be of secondary
      importance, since the Y. enterocolitica inv mutant was as proficient as wild type
      at causing a fatal infection in mice. Based on these data, we discuss the role of
      invasin in a naturally occurring Y. enterocolitica infection.

PMID- 8341659
TI  - Volatile anesthetics compete for common binding sites on bovine serum albumin: a
      19F-NMR study.
AB  - There is controversy as to the molecular nature of volatile anesthetic target
      sites. One proposal is that volatile anesthetics bind directly to hydrophobic
      binding sites on certain sensitive target proteins. Consistent with this
      hypothesis, we have previously shown that a fluorinated volatile anesthetic,
      isoflurane, binds saturably [Kd (dissociation constant) = 1.4 +/- 0.2 mM, Bmax =
      4.2 +/- 0.3 sites] to fatty acid-displaceable domains on serum albumin. In the
      current study, we used 19F-NMR T2 relaxation to examine whether other volatile
      anesthetics bind to the same sites on albumin and, if so, whether they vary in
      their affinity for these sites. We show that three other fluorinated volatile
      anesthetics bind with varying affinity to fatty acid-displaceable domains on
      serum albumin: halothane, Kd = 1.3 +/- 0.2 mM; methoxyflurane, Kd = 2.6 +/- 0.3
      mM; and sevoflurane, Kd = 4.5 +/- 0.6 mM. These three anesthetics inhibit
      isoflurane binding in a competitive manner: halothane, K(i) (inhibition constant)
      = 1.3 +/- 0.2 mM; methoxyflurane, K(i) = 2.5 +/- 0.4 mM; and sevoflurane, K(i) =
      5.4 +/- 0.7 mM--similar to each anesthetic's respective Kd of binding to fatty
      acid displaceable sites. These results illustrate that a variety of volatile
      anesthetics can compete for binding to specific sites on a protein.

PMID- 8341660
TI  - Kinetic control of Ca(II) signaling: tuning the ion dissociation rates of EF-hand
      Ca(II) binding sites.
AB  - EF-hand Ca(II) binding sites share a conserved architecture and are prevalent in
      Ca(II) signaling pathways. The ion binding kinetics of these sites are carefully
      tuned to provide the physiologically appropriate activation and inactivation time
      scales. Here we examine kinetic tuning by the side chain at the ninth position of
      the EF-loop. A model is proposed in which both the size and charge of the side
      chain contribute to kinetic tuning. To test this model, the ninth loop position
      of the EF-hand-like site in the Escherichia coli D-galactose binding protein has
      been engineered and the Tb(III) dissociation kinetics of the resulting sites have
      been analyzed. Substitutions at this position are observed to generate up to
      10(4)-fold changes in Tb(III) dissociation rates, with little effect on Tb(III)
      affinity. Furthermore, the observed pattern of rate changes confirm the model's
      predictions; long side chains at the ninth loop position yield slow dissociation
      kinetics as predicted for a steric block, whereas acidic side chains yield slow
      dissociation kinetics as expected for an electrostatic barrier.

PMID- 8341661
TI  - A general two-metal-ion mechanism for catalytic RNA.
AB  - A mechanism is proposed for the RNA-catalyzed reactions involved in RNA splicing
      and RNase P hydrolysis of precursor tRNA. The mechanism postulates that chemical
      catalysis is facilitated by two divalent metal ions 3.9 A apart, as in phosphoryl
      transfer reactions catalyzed by protein enzymes, such as the 3',5'-exonuclease of
      Escherichia coli DNA polymerase I. One metal ion activates the attacking water or
      sugar hydroxyl, while the other coordinates and stabilizes the oxyanion leaving
      group. Both ions act as Lewis acids and stabilize the expected pentacovalent
      transition state. The symmetry of a two-metal-ion catalytic site fits well with
      the known reaction pathway of group I self-splicing introns and can also be
      reconciled with emerging data on group II self-splicing introns, the spliceosome,
      and RNase P. The role of the RNA is to position the two catalytic metal ions and
      properly orient the substrates via three specific binding sites.

PMID- 8341662
TI  - Single kinesin molecules crossbridge microtubules in vitro.
AB  - Kinesin is a cytoplasmic motor protein that moves along microtubules and can
      induce microtubule bundling and sliding in vitro. To determine how kinesin
      mediates microtubule interactions, we determined the shapes and mass
      distributions of squid brain kinesin, taxol-stabilized microtubules (squid and
      bovine), and adenosine 5'-[beta, gamma-imido]triphosphate-stabilized kinesin
      microtubule complexes by high-resolution metal replication and by low
      temperature, low-dose dark-field scanning transmission electron microscopy of
      unfixed, directly frozen preparations. Mass mapping by electron microscopy
      revealed kinesins loosely attached to the carbon support as asymmetrical dumbbell
      shaped molecules, 40-52 nm long, with a mass of 379 +/- 15 kDa. The mass
      distribution and shape of these molecules suggest that these images represent
      kinesin in a shortened conformation. Kinesin-microtubule complexes were organized
      as bundles of linearly arrayed microtubules, stitched together at irregular
      intervals by cross-bridges typically < or = 25 nm long. The crossbridges had a
      mass of 360 +/- 15 kDa, consistent with one kinesin per crossbridge. These
      results suggest that kinesin has a second microtubule binding site in addition to
      the known site on the motor domain of the heavy chain; this second site may be
      located near the C terminus of the heavy chains or on the associated light
      chains. Thus, kinesin could play a role in either crosslinking or sliding
      microtubules.

PMID- 8341663
TI  - Short DNA sequences from the cytoplasm of mouse tumor cells induce
      immortalization of human lymphocytes in vitro.
AB  - Cytoplasts of mouse L929 and Ehrlich ascites tumor cells harbor DNA sequences
      that induce unlimited proliferation ("immortalization") of human lymphocytes
      after transfection in vitro. By equilibrium centrifugation of cytoplasmic lysates
      in a neutral CsCl gradient, the immortalizing activity was recovered together
      with extramitochondrial fractions at high salt densities (1.85-1.87 g/cm3).
      Unexpectedly, these fractions contain linear DNA molecules of 50-500 bp in
      length. In contrast, cytoplasts of primary, senescent cells (mouse embryo
      fibroblasts, human lymphocytes) do not harbor DNA in the corresponding fractions.
      Cytoplasmic DNA isolated from high-density fractions of mouse tumor cells was
      cloned in subset libraries, and of 45 DNA sequences we identified 2 clones--one
      from L929 cytoplasts (203 bp) and another one from the cytoplasm of Ehrlich
      ascites cells (372 bp)--that induce unlimited proliferation of human lymphocytes
      in vitro. Immortalized lymphoid cells harbor 1-5 copies of transfected DNA
      integrated into chromosomal DNA, whereas about 100 copies were found as episomal
      DNA in the cytoplasmic fraction. No immortalization could be induced by
      transfection of nuclear DNA randomly fragmented to 200-500 bp. Although the
      cloned DNA sedimented at 1.70 g/cm3, after transient transfection into
      lymphocytes, these DNA sequences form salt-stable complexes that sediment in
      fractions at the same high density (1.82-1.88 g/cm3) from which they were
      originally cloned. The high-density banding of these cytoplasmic DNA sequences
      may be due to association with RNA and/or with (metallo-) proteins in vivo. Since
      both cloned DNA sequences with immortalizing activity have stop codons for
      protein translation in all possible reading frames, immortalization may be
      induced by insertional inactivation or functional suppression of genes that are
      needed to be expressed during cellular senescence or programmed cell death.

PMID- 8341665
TI  - Milk and fat yields decline in bovine leukemia virus-infected Holstein cattle
      with persistent lymphocytosis.
AB  - Effects of bovine leukemia virus (BLV) infection on milk and fat yields were
      studied by using data collected from Holstein cows over a 6-year period. Milk and
      fat yields in BLV-infected cows with persistent lymphocytosis (PL) declined
      significantly relative to their BLV-infected non-PL herdmates. Declines were most
      pronounced in cows older than 6 years. The estimated loss to the dairy industry
      due to PL is more than $42 million annually. A major histocompatibility complex
      class I (BoLA-A) allele that has been previously associated with resistance to PL
      was associated with longevity and realization of milk production potentials,
      indicating that genetic resistance to PL will have an economic benefit in herds
      where BLV is endemic.

PMID- 8341664
TI  - Metastatic conversion of cells by expression of human papillomavirus type 16 E6
      and E7 genes.
AB  - The human papillomavirus type 16 (HPV-16) is a DNA tumor virus highly associated
      with cervical carcinoma. Viral DNA from HPV-16 is found in primary tumors and
      their metastatic lesions. To investigate the role of HPV-16 oncoproteins in the
      development of cancer metastasis, the E6 and E7 genes from HPV-16 were inserted
      into retrovirus and introduced into nonmetastatic mouse cell lines. Expression of
      either of the viral genes from HPV-16 made the cells metastatic in nude mice. In
      contrast, expression of the E6 and E7 genes of HPV type 6 (HPV-6b), which is
      frequently found in nonmalignant HPV-associated diseases, did not. The metastatic
      ability of cells transduced with viral genes of HPV-16 did not correlate with
      their growth rate or sensitivity to destruction by natural killer cells. Our
      results demonstrate that expression of oncogenic proteins of HPV-16 can cause
      tumor metastasis and implicate HPV-16 in an important role regarding the
      progression of HPV-associated human cancers.

PMID- 8341666
TI  - Transmutation of a heme protein.
AB  - Residue Asn57 of bovine liver cytochrome b5 has been replaced with a cysteine
      residue, and the resulting variant has been isolated from recombinant Escherichia
      coli as a mixture of four major species: A, BI, BII, and C. A combination of
      electronic spectroscopy, 1H NMR spectroscopy, resonance Raman spectroscopy,
      electrospray mass spectrometry, and direct electrochemistry has been used to
      characterize these four major cytochrome derivatives. The red form A (E(m) = -19
      mV) is found to possess a heme group bound covalently through a thioether linkage
      involving Cys57 and the alpha carbon of the heme 4-vinyl group. Form BI has a
      covalently bound heme group coupled through a thioether linkage involving the
      beta carbon of the heme 4-vinyl group. Form BII is similar to BI except that the
      sulfur involved in the thioether linkage is oxidized to a sulfoxide. The green
      form C (E(m) = 175 mV) possesses a noncovalently bound prosthetic group with
      spectroscopic properties characteristic of a chlorin. A mechanism is proposed for
      the generation of these derivatives, and the implications of these observations
      for the biosynthesis of cytochrome c and naturally occurring chlorin prosthetic
      groups are discussed.

PMID- 8341667
TI  - Six S100 genes are clustered on human chromosome 1q21: identification of two
      genes coding for the two previously unreported calcium-binding proteins S100D and
      S100E.
AB  - The human genome contains large regions that are highly structured. Sequence
      related members of multigene families are often found in a clustered
      organization. Here we describe a previously unrecognized gene cluster composed of
      genes coding for calcium-binding proteins of the S100 family. The linkage of six
      S100 genes was established by pulsed-field gel electrophoresis, and a contiguous
      DNA sequence of 15 kilobases containing the full coding region of four different
      S100 genes was characterized. This is the tightest mammalian gene cluster
      discovered so far to our knowledge. Two additional S100 genes are located within
      the cluster, both of which exhibit unique structural features when compared with
      other S100 genes. The product of S100E is cysteine-rich, whereas that of S100D
      contains a long hydrophobic N-terminal tail. The gene cluster was assigned to
      chromosome 1q21, one of the bands showing rearrangements in neoplasms at high
      frequency. The deregulated expression of some S100 genes in the cluster during
      tumor progression suggests that chromosomal abnormalities may influence the
      expression of S100 genes in late stages of cancer, particularly in association
      with the formation of metastases.

PMID- 8341668
TI  - Stimulus-induced dissociation of alpha subunits of heterotrimeric GTP-binding
      proteins from the cytoskeleton of human neutrophils.
AB  - Previous studies on the mechanism responsible for terminating the generation of
      second messengers induced by chemotactic factor-receptor complexes have, on one
      hand, suggested a direct role of a GTP-binding protein(s) (G protein), and, on
      the other hand, proposed that there is a lateral segregation of the ligand
      receptor complexes into G protein-depleted domains of the plasma membrane. In the
      present investigation, which addresses these apparently contradictory findings,
      we found that a substantial part of the alpha subunits of the Gn protein (Gn
      alpha) in unstimulated neutrophils were associated with a cytoskeletal fraction
      and that release of these subunits occurred upon stimulation with the chemotactic
      factor fMet-Leu-Phe. An identical Gn alpha release could also be induced by
      direct activation of G proteins with guanosine 5'-[gamma-thio]triphosphate or
      AIF4-. In contrast, the alpha subunits of the stimulatory G protein (Gs alpha)
      also found associated with the cytoskeletal fraction of unstimulated cells were
      not released by fMet-Leu-Phe stimulation. However, they were effectively released
      by direct G-protein activation with guanosine 5'-[gamma-thio]triphosphate. In
      addition, inhibition of the fMet-Leu-Phe-stimulated modulation of the actin
      network by pertussis toxin did not affect the fMet-Leu-Phe-induced release of Gn
      alpha from the cytoskeletal fraction. These observations indicate that fMet-Leu
      Phe-induced activation of neutrophils involves a specific dissociation of Gn
      alpha from the cytoskeleton and that this release is not a consequence of the
      well-known effect of fMet-Leu-Phe on the cytoskeleton of neutrophils. The present
      data contribute ideas concerning the transducing properties of G proteins in
      cellular signaling and seem to reconcile the apparently contradictory concepts of
      how the cytoskeleton participates in the termination of the chemotactic-factor
      induced generation of second messengers in human neutrophils.

PMID- 8341669
TI  - Molecular characterization of a short interspersed repetitive element from
      tobacco that exhibits sequence homology to specific tRNAs.
AB  - We have characterized a family of tRNA-derived short interspersed repetitive
      elements (SINEs) in the tobacco genome. Members of this family of SINEs,
      designated TS, have a composite structure and include a region structurally
      similar to a rabbit tRNA(Lys), a tRNA-unrelated region, and a TTG repeat of
      variable length at the 3' end. Southern blot hybridization, together with a
      search of the GenBank data base, showed that various plants belonging to the
      families Solanaceae and Convolvulaceae contain sequences homologous to the TS
      family in the introns and flanking regions of many genes, whereas Arabidopsis in
      the family Cruciferae and several species of monocoytledonous plants do not. The
      TS family is widely involved in structural and genetic variations in the genomes
      of many plants that belong to the order Tubiflorae. All of nine sequences
      identified in a data base search are truncated at their 5' regions and lack the
      tRNA-related region of the TS family. We characterized the entire sequence of the
      members of the TS family and found that this family can be categorized as a
      member of a group of SINEs with a tRNA(Lys)-like structure, as can several animal
      SINEs. The TS family can be divided into two major subfamilies by analysis of
      diagnostic positions, and one of the subfamilies is clearly younger than the
      other. Amplification of many copies of the full sequence of the younger subfamily
      occurred during the recent evolution of the tobacco lineage. We also discuss
      mechanisms that could be involved in the generation of SINEs in animals and also
      in plants.

PMID- 8341670
TI  - Local sources of retinoic acid coincide with retinoid-mediated transgene activity
      during embryonic development.
AB  - We have assessed whether retinoic acid (RA) comes from local sources or is
      available widely to activate gene expression in embryos. We used an RA-responsive
      indicator cell line, L-C2A5, to localize RA sources. In these cells, an RA
      sensitive promoter/lacZ reporter construct used previously by us to produce
      indicator transgenic mice is induced globally by RA in medium or locally by RA
      released at physiological concentrations (1 nM) from AG-1X2 resin beads.
      Furthermore, the cells are differentially responsive to the 9-cis and all-trans
      isomers of RA at low concentrations. Indicator transgenic mice with the same
      promoter/reporter construct were used to identify regions of RA-mediated gene
      activation. There are distinct domains of lacZ expression in the cervical and
      lumbar spinal cords of embryonic indicator mice. This pattern might reflect
      localized RA sources or restricted spatial and temporal expression of RA
      receptors, binding proteins, or other factors. To resolve this issue we compared
      the pattern of transgene activation in indicator cell monolayers cocultured with
      normal embryonic spinal cords with that in transgenic spinal cords. The explants
      induced reporter gene expression in L-C2A5 monolayers in a pattern identical to
      that in transgenic mice: alar regions of the cervical and lumbar cord were
      positive whereas those in the thoracic and sacral regions were not. We conclude
      that restricted sources of RA in the developing spinal cord mediate the local
      activation of RA-inducible genes. Thus, region-specific gene activation in
      embryos can be mediated by precisely localized sources of inductive molecules
      like RA.

PMID- 8341671
TI  - A mouse homolog of the Escherichia coli recA and Saccharomyces cerevisiae RAD51
      genes.
AB  - Analysis of mitotic and meiotic recombination in mammalian cells has been
      hampered by the complexity of the reactions involved as well as lack of mutants.
      Furthermore, none of the genes involved in the process has yet been identified.
      In budding yeast, Saccharomyces cerevisiae, the RAD51 gene is essential along
      with other genes of the RAD52 epistasis group for mitotic and meiotic
      recombination and DNA repair. The Rad51 protein is structurally similar to
      Escherichia coli RecA protein, which is required in homologous recombination and
      SOS responses in bacteria. Here we report the isolation of a mouse homolog of the
      yeast RAD51 gene. The amino acid sequence predicted from the gene shows 83% and
      55% homology with those of the yeast RAD51 and the E. coli recA product,
      respectively. The mouse gene complemented a rad51 mutation of S. cerevisiae with
      sensitivity to methyl-methanesulfonate, which produces double-strand breaks of
      DNA. This gene is expressed in the thymus, testis, ovary, spleen, and intestine,
      suggesting that its product is involved in mitotic and meiotic recombination in
      addition to DNA repair.

PMID- 8341672
TI  - At day 8-8.5 of mouse development the yolk sac, not the embryo proper, has
      lymphoid precursor potential in vivo and in vitro.
AB  - We have studied both in vitro and in vivo the formation of lymphocyte progenitors
      before blood circulation (day 9 of gestation) has started in the mouse embryo,
      and we have determined the tissue where this occurs. The results demonstrate that
      the yolk sac of embryos at day 8 and day 8.5 of gestation contains precursor
      cells that can give rise, in vivo and in vitro, to mature T and B lymphocytes. No
      lymphoid precursors were found in the embryo proper at this stage of mouse
      development. The yolk sac cells with lymphocyte precursor potential are most
      likely multipotent stem cells rather than cell-lineage-determined T- and/or B
      lymphocyte progenitors. The defined in vitro assays described here that support
      differentiation of yolk sac stem cells along the T- or B-lymphocyte pathways also
      may now facilitate the study of the molecular events leading to cell-lineage
      commitment of lymphocyte progenitors in the mouse embryo.

PMID- 8341673
TI  - Expression of an atrial G-protein-activated potassium channel in Xenopus oocytes.
AB  - Injection of rat atrial RNA into Xenopus oocytes resulted in the expression of
      guanine nucleotide binding (G) protein-activated K+ channel. Current through the
      channel could be activated by acetylcholine or, if RNA encoding a neuronal 5HT1A
      receptor was coinjected with atrial RNA, by serotonin (5HT). A 5HT-evoked current
      (I5HT) was observed in oocytes injected with ventricle RNA fractions (of 2.5-5.5
      kb) and 5HT1A receptor RNA. I5HT displayed strong inward rectification with very
      little conductance above the K+ equilibrium potential, was highly selective for
      K+ over Na+, and was blocked by 5-300 microM Ba2+. I5HT was suppressed by
      intracellular injection of the nonhydrolyzable analog of GDP, guanosine 5'-[beta
      thio]diphosphate, but not by treatment with pertussis toxin (PTX), suggesting
      coupling of the receptor to the G-protein-activated K+ channel via a PTX
      insensitive G protein, possibly endogenously present in the oocyte. Coexpression
      of the alpha subunit of a PTX-sensitive G protein, G(i2), rendered I5HT sensitive
      to PTX inhibition. Native oocytes displayed a constitutively active inwardly
      rectifying K+ current with a lower sensitivity to Ba2+ block; expression of a
      similar current was also directed by atrial or ventricle RNA of 1.5-3 kb. Xenopus
      oocytes may be employed for cloning of the G-protein-activated K+ channel cDNA
      and for studying the coupling between this channel and G proteins.

PMID- 8341674
TI  - Effects of abasic sites and DNA single-strand breaks on prokaryotic RNA
      polymerases.
AB  - Abasic sites are thought to be the most frequently occurring cellular DNA damage
      and are generated spontaneously or as the result of chemical or radiation damage
      to DNA. In contrast to the wealth of information that exists on the effects of
      abasic sites on DNA polymerases, very little is known about how these lesions
      interact with RNA polymerases. An in vitro transcription system was used to
      determine the effects of abasic sites and single-strand breaks on transcriptional
      elongation. DNA templates were constructed containing single abasic sites or
      nicks placed at unique locations downstream from two different promoters and were
      transcribed by SP6 and Escherichia coli RNA polymerases. SP6 RNA polymerase is
      initially stalled at abasic sites with subsequent, efficient bypass of these
      lesions. E. coli RNA polymerase also bypassed abasic sites. In contrast, single
      strand breaks introduced at abasic sites completely blocked the progression of
      both RNA polymerases. Sequence analysis of full-length transcripts revealed that
      SP6 and E. coli RNA polymerases insert primarily, if not exclusively, adenine
      residues opposite to abasic sites. This finding suggests that abasic sites may be
      highly mutagenic in vivo at the level of transcription.

PMID- 8341675
TI  - Transcriptional arrest of yeast RNA polymerase II by Escherichia coli rho protein
      in vitro.
AB  - A promoter-independent assay utilizing poly(dC)-tailed DNA templates has revealed
      that Saccharomyces cerevisiae whole-cell extracts can be proficient for
      transcription by the endogenous yeast RNA polymerase II as well as for correct 3'
      end RNA processing. Our attempts to examine the fate of polymerase II itself were
      inconclusive, because only trace transcription products corresponded to the
      expected size of terminated RNA species. Transcription in our processing
      proficient extract was thus insufficient to cause termination. To test our system
      with a known, albeit heterologous, signal, we examined a dC-tailed template
      carrying the E. coli rho-dependent termination signal trp t' in the yeast
      extract. Transcripts from this template were not susceptible to processing, but
      addition of rho protein resulted in two distinct truncated transcripts that could
      not be chased by excess unlabeled nucleotides. These RNA species thus represented
      stably paused or terminated polymerase II products, and their absence when a
      mutated unresponsive trp t' template was used affirmed that they were due to the
      effects of rho. E. coli RNA polymerase added to a yeast extract pretreated with
      alpha-amanitin was also halted by rho at these same two sites. A mutated rho
      protein, while only partly defective with E. coli polymerase, failed to provoke
      arrest when transcription was carried out by RNA polymerase II. Thus, functional
      rho and its cognate site, trp t', appear necessary and sufficient to elicit the
      production of truncated transcripts by RNA polymerase II in a yeast whole-cell
      extract. The ability of rho to halt the eukaryotic enzyme strengthens the
      likelihood that a rho-like helicase may be involved in RNA polymerase II
      transcription termination.

PMID- 8341676
TI  - Inhibition of anaphase spindle elongation in vitro by a peptide antibody that
      recognizes kinesin motor domain.
AB  - Isolated central spindles or spindles in detergent-permeabilized cells from the
      diatom Cylindrotheca fusiformis can undergo ATP-dependent reactivation of spindle
      elongation in vitro. We have used a peptide antibody raised against a 10-amino
      acid portion common to the kinesin superfamily motor domain to look for kinesin
      like motor activity during anaphase B of mitosis. The peptide antibody localizes
      to central spindles. Upon ATP reactivation of spindle elongation, antigens
      recognized by the antibody are associated exclusively with the central spindle
      midzone where antiparallel microtubules of each half-spindle overlap. The
      antibody recognizes several polypeptides by immunoblot using isolated spindle
      extracts. One of these polypeptides behaves like kinesin with respect to
      nucleotide-specific binding to and release from taxol-stabilized microtubules.
      Preincubation of the spindle model with the peptide antibody inhibits subsequent
      ATP reactivation of spindle elongation. Coincubation of the peptide antibody with
      peptide antigen rescues spindle function. These results support a role for
      kinesin-related protein(s) in spindle elongation (anaphase B) of mitosis and
      suggest that one or several polypeptides that we have identified in spindle
      extracts may fulfill this function.

PMID- 8341677
TI  - Heterologous expression of mating-type genes in filamentous fungi.
AB  - Podospora anserina and Neurospora crassa, two filamentous heterothallic
      ascomycetes, have a single mating-type locus with two alternate forms called mat+
      and mat- and A and a, respectively. Mating type controls entry into the sexual
      cycle, events subsequent to fertilization, and, in N. crassa, prevents the
      formation of mixed mating-type heterokaryons. The mating types of these two
      organisms display similarity in their DNA structure and in the encoded
      polypeptides involved in fertilization. Here we show that this molecular
      similarity reflects a functional homology with respect to mating identity.
      Transformation experiments show that the N. crassa mating-type genes can provide
      the fertilization functions in P. anserina strains devoid of mating specificity
      as well as in mat+ and mat- strains. Reciprocally, the introduction of P.
      anserina mating-type genes confers mating activity in N. crassa. Functional
      identity between the mating types is not observed for vegetative incompatibility
      or for post-fertilization events such as meiosis and ascosporogenesis.

PMID- 8341678
TI  - Transcription factors are required for the meiotic recombination hotspot at the
      HIS4 locus in Saccharomyces cerevisiae.
AB  - The full activity of a recombination initiation site located 5' of HIS4 requires
      the binding of the transcription factors RAP1, BAS1, and BAS2. Two RAP1 binding
      sites can substitute for the wild-type initiation site. A 51-bp region of
      telomeric DNA inserted upstream of either HIS4 or ARG4 very strongly stimulates
      recombination. We suggest that the ability of transcription factors to induce
      recombination is a consequence of an altered chromatin structure that favors the
      entry of proteins that initiate recombination, rather than an effect of these
      factors on transcription.

PMID- 8341679
TI  - Generation of nitric oxide and induction of major histocompatibility complex
      class II antigen in macrophages from mice lacking the interferon gamma receptor.
AB  - Availability of mice with a targeted disruption of the interferon gamma (IFN
      gamma) receptor gene (IFN-gamma R0/0 mice) made it possible to examine parameters
      of macrophage activation in the absence of a functional IFN-gamma receptor. We
      asked to what extent other cytokines could replace IFN-gamma in the induction of
      nitric oxide or major histocompatibility complex class II antigen (Ia) expression
      in peritoneal macrophages. In thioglycollate-elicited macrophages from wild-type
      mice, tumor necrosis factor (TNF) alone was virtually ineffective in inducing
      release of NO2- (the endproduct of nitric oxide generation), but TNF enhanced NO2
      release in the presence of IFN-gamma. In macrophages from IFN-gamma R0/0 mice,
      which were unresponsive to IFN-gamma, TNF completely failed to stimulate NO2-
      release. The stimulatory actions of IFN-alpha/beta on NO2- release were
      indistinguishable in wild-type and IFN-gamma R0/0 macrophages: IFN-alpha/beta was
      ineffective on its own, showed marginal stimulation of NO2- release in
      combination with TNF, and was moderately effective in the presence of
      lipopolysaccharide. The level of constitutive Ia antigen expression was not
      significantly different in peritoneal macrophages from wild-type and IFN-gamma
      R0/0 mice. An increased Ia expression was induced by IL-4 and granulocyte
      macrophage colony-stimulating factor in both wild-type and IFN-gamma R0/0
      macrophages, but the magnitude of this induction was less than with optimal
      concentrations of IFN-gamma in macrophages from wild-type mice. IFN-alpha/beta
      showed only a minor stimulatory effect on Ia expression in both wild-type and IFN
      gamma R0/0 macrophages. Simultaneous treatment of wild-type macrophages with IFN
      alpha/beta and IFN-gamma reduced the IFN-gamma-induced Ia expression in wild-type
      macrophages, but IFN-alpha/beta did not show an inhibitory effect on IL-4- or
      granulocyte-macrophage-colony-stimulating factor-induced Ia expression in either
      wild-type or IFN-gamma R0/0 macrophages. The important role of IFN-gamma in the
      regulation of the induced expression of major histocompatibility complex class II
      antigen was confirmed by showing that after systemic infection with the BCG
      strain of Mycobacterium bovis resident peritoneal macrophages from IFN-gamma R0/0
      mice had a lower level of Ia expression than macrophages from wild-type mice. The
      inability of other cytokines to substitute fully for IFN-gamma in macrophage
      activation helps to explain the earlier observed decreased resistance of IFN
      gamma R0/0 mice to some infections.

PMID- 8341680
TI  - Oxidative tyrosylation of high density lipoprotein by peroxidase enhances
      cholesterol removal from cultured fibroblasts and macrophage foam cells.
AB  - Lipoprotein oxidation is thought to play a pivotal role in atherogenesis, yet the
      underlying reaction mechanisms remain poorly understood. We have explored the
      possibility that high density lipoprotein (HDL) might be oxidized by peroxidase
      generated tyrosyl radical. Exposure of HDL to L-tyrosine, H2O2, and horseradish
      peroxidase crosslinked its apolipoproteins and strikingly increased protein
      associated fluorescence. The reaction required L-tyrosine but was independent of
      free metal ions; it was blocked by either catalase or the heme poison
      aminotriazole. Dityrosine and other tyrosine oxidation products were detected in
      the apolipoproteins of HDL modified by the peroxidase/L-tyrosine/H2O2 system,
      implicating tyrosyl radical in the reaction pathway. Further evidence suggests
      that tyrosylated HDL removes cholesterol from cultured cells more effectively
      than does HDL. Tyrosylated HDL was more potent than HDL at inhibiting cholesterol
      esterification by the acyl-CoA:cholesterol acyltransferase reaction, stimulating
      the incorporation of [14C]acetate into [14C]cholesterol, and depleting
      cholesteryl ester stores in human skin fibroblasts. Moreover, exposure of mouse
      macrophage foam cells to tyrosylated HDL markedly diminished cholesteryl ester
      and free cholesterol mass. We have recently found that myeloperoxidase, a heme
      protein secreted by activated phagocytes, can also convert L-tyrosine to o,o'
      dityrosine. This raises the possibility that myeloperoxidase-generated tyrosyl
      radical may modify HDL, enabling the lipoprotein to protect the artery wall
      against pathological cholesterol accumulation.

PMID- 8341681
TI  - Homologous recognition promoted by RecA protein via non-Watson-Crick bonds
      between identical DNA strands.
AB  - The RecA protein of Escherichia coli forms a nucleoprotein filament that promotes
      homologous recognition and subsequent strand exchange between a single strand and
      duplex DNA via a three-stranded intermediate. Recognition of homology within
      three-stranded nucleoprotein complexes, which is probably central to genetic
      recombination, is not well understood as compared with the mutual recognition of
      complementary single strands by Watson-Crick base pairing. Using
      oligonucleotides, we examined the determinants of homologous recognition within
      RecA nucleoprotein filaments. Filaments that contained a single strand of DNA
      recognized homology not only in a complementary oligonucleotide but also in an
      identical oligonucleotide, whether their respective sugar-phosphate backbones
      were antiparallel or parallel, and a filament that contained duplex DNA showed
      the same polymorphic versatility in the recognition of homology. Recognition of
      self by a filament that contains a single strand reveals that RecA filaments can
      recognize homology via non-Watson-Crick hydrogen bonds. Recognition of multiple
      forms of the same sequence by duplex DNA in the filament shows that it primarily
      senses base-sequence homology, and suggests that recognition can be accomplished
      prior to the establishment of new Watson-Crick base pairs in heteroduplex
      products. However, unlike the initial recognition of homology, strand exchange is
      stereospecific, requiring the proper antiparallel orientation of complementary
      strands.

PMID- 8341682
TI  - Cloning of human erythroid dematin reveals another member of the villin family.
AB  - Dematin is an actin-bundling protein originally identified in the human erythroid
      membrane skeleton. Its actin-bundling activity is abolished upon phosphorylation
      by the cAMP-dependent protein kinase and is restored after dephosphorylation.
      Here we report the complete primary structure of human erythroid dematin, whose
      sequence includes a homologue of the "headpiece" sequence found at the C terminus
      of villin. This headpiece is essential for villin function in inducing
      microvillar development and actin redistribution. The widespread expression of
      dematin transcripts in human tissues suggests that dematin and its homologues may
      substitute for villin in villin-negative tissues to regulate actin reorganization
      by a phosphorylation-regulated mechanism.

PMID- 8341683
TI  - VH gene organization in a relict species, the coelacanth Latimeria chalumnae:
      evolutionary implications.
AB  - The living coelacanth Latimeria chalumnae is a relict species whose higher-level
      phylogenetic relationships have not been resolved clearly by traditional
      systematic approaches. Previous studies show that major differences in
      immunoglobulin gene structure and organization typify different phylogenetic
      lineages. To date, mammalian-, avian-, and elasmobranch-type gene organizations
      have been identified in representatives of these different phylads. A fourth form
      or organization is found in Latimeria, which possesses immunoglobulin heavy-chain
      variable region (VH) elements separated by approximately 190 nucleotides from
      diversity (D) elements. Adjacency of VH and D elements is characteristic of the
      elasmobranch "clustered" arrangement, although many other features of coelacanth
      VH gene organization and structure are more similar to those of bony fishes and
      tetrapods. These observations strongly support a phylogenetic hypothesis in which
      Latimeria occupies a sister-group relationship with teleosts and tetrapods.

PMID- 8341684
TI  - Wavelengths effective in induction of malignant melanoma.
AB  - It is generally agreed that sunlight exposure is one of the etiologic agents in
      malignant melanoma of fair-skinned individuals. However, the wavelengths
      responsible for tumorigenesis are not known, although DNA is assumed to be the
      target because individuals defective in the repair of UV damage to DNA are
      several thousandfold more prone to the disease than the average population.
      Heavily pigmented backcross hybrids of the genus Xiphophorus (platyfish and
      swordtails) are very sensitive to melanoma induction by single exposures to UV.
      We irradiated groups of five 6-day-old fish with narrow wavelength bands at 302,
      313, 365, 405, and 436 nm and scored the irradiated animals for melanomas 4
      months later. We used several exposures at each wavelength to obtain estimates of
      the sensitivity for melanoma induction as a function of exposure and wavelength.
      The action spectrum (sensitivity per incident photon as a function of wavelength)
      for melanoma induction shows appreciable sensitivity at 365, 405, and probably
      436 nm, suggesting that wavelengths not absorbed directly in DNA are effective in
      induction. We interpret the results as indicating that light energy absorbed in
      melanin is effective in inducing melanomas in this animal model and that, in
      natural sunlight, 90-95% of melanoma induction may be attributed to wavelengths >
      320 nm--the UV-A and visible spectral regions.

PMID- 8341685
TI  - A soluble divalent class I major histocompatibility complex molecule inhibits
      alloreactive T cells at nanomolar concentrations.
AB  - Genetically engineered or chemically purified soluble monovalent major
      histocompatibility complex (MHC) molecules, which have previously been used to
      study T cells, have not blocked cytotoxic T-cell responses. Here we describe a
      genetically engineered divalent class I MHC molecule which inhibits lysis of
      target cells by alloreactive cytotoxic T cells. This protein, H-2Kb/IgG, was
      generated as a fusion protein between the extracellular domains of a murine class
      I polypeptide, H-2Kb, and an immunoglobulin heavy chain polypeptide. The chimeric
      protein has serological and biochemical characteristics of both the MHC and IgG
      polypeptides. Nanomolar concentrations of H-2Kb/IgG inhibited lysis of H-2Kb
      expressing target cells not only by alloreactive H-2Kb-specific T-cell clones but
      also by alloreactive H-2Kb-specific primary T-cell cultures. A direct binding
      assay showed high-affinity binding between the H-2Kb/IgG molecule and an H-2Kb
      specific alloreactive T-cell clone. Unlabeled H-2Kb/IgG displaced 125I-labeled H
      2Kb/IgG from T cells with an IC50 of 1.2 nM.

PMID- 8341686
TI  - Differential organ-specific expression of three poly(A)-binding-protein genes
      from Arabidopsis thaliana.
AB  - Poly(A)-binding protein (PABP) is considered an essential component of a
      eukaryotic cell; deletion of the PABP-coding gene in yeast leads to a lethal
      phenotype. PABP is implicated in numerous aspects of posttranscriptional
      regulation, including mRNA turnover and translational initiation. A nested set of
      degenerate PCR primers designed from regions conserved among yeast, Xenopus, and
      human PABP sequences was used to amplify genomic DNA fragments from Arabidopsis
      thaliana. Hybridization screening of genomic and cDNA libraries with a genomic
      PCR probe led to the isolation of three diverse Arabidopsis genes encoding PABPs,
      PAB1, PAB3, and PAB5. All three sequences contain the expected four RNA
      recognition motifs. Sequence diversity between these genes equals or exceeds the
      diversity among animal and fungal sequences. One of the genes, PAB5, and its cDNA
      were completely sequenced. Its open reading frame encodes a 73.2-kDa protein
      containing a number of amino acid motifs characteristic of PABPs from different
      species. Moreover, in vitro synthesized PAB5 protein bound to poly(A)-Sepharose
      with high specificity. All three genes isolated showed organ-specific patterns of
      expression. PAB5 and PAB3 RNAs were detected only in floral organs, with the
      highest level of expression in immature flowers. PAB1 RNA was observed
      predominantly in roots, was less abundant in immature flowers, and was not
      detected in any other organ examined (stems, leaves, mature flowers, siliques).
      This suggests a potentially unique role for PABPs in organ-specific
      posttranscriptional regulation in plants.

PMID- 8341687
TI  - cDNA structure of the mouse and rat subtilisin/kexin-like PC5: a candidate
      proprotein convertase expressed in endocrine and nonendocrine cells.
AB  - By using reverse transcriptase/PCR and oligonucleotide sequences derived from
      conserved segments (including the conserved RRGDL sequence) of the known
      proprotein convertases (PCs) PC1, PC2, furin, and PC4, we identified a
      subtilisin/kexin-like PC called PC5 in both mouse and rat tissues. The composite
      structure (2.85 kb) was deduced from the analysis of the reverse
      transcription/PCR products combined with the sequence from a clone isolated from
      a cDNA library made from corticotropin-activated mouse adrenocortical Y1 cells.
      The deduced cDNA structures of mouse PC5 and rat PC5 showed that the closest
      homologue is PACE4. Furthermore, like furin, Drosophila melanogaster (d) dfurin2,
      and PACE4, PC5 shows the presence of a C-terminal Cys-rich domain containing
      either 5 (PC5 and PACE4) or 10 (dfurin2) repeats of the consensus motif Cys-Xaa2
      Cys-Xaa3-Cys-Xaa(5-7)-Cys-Xaa2-Cys-Xaa (8-15)-Cys-Xaa3-Cys-Xaa(9-16). The richest
      sources of rat PC5 mRNA (3.8 kb) are the adrenal and gut, but it can also be
      detected in many endocrine and nonendocrine tissues. Corticotropin-stimulated
      adrenocortical Y1 cells showed an increased expression of PC5 mRNA, suggesting an
      upregulation by cAMP. In situ hybridization of rat brain sections demonstrated a
      unique distribution of PC5 compared to PC1, PC2, and furin.

PMID- 8341688
TI  - Suppression of oncogenic Ras by mutant neurofibromatosis type 1 genes with single
      amino acid substitutions.
AB  - NF1 was first identified as the gene responsible for the pathogenesis of the
      human genetic disorder neurofibromatosis type 1. cDNA cloning revealed that its
      putative protein product has a domain showing significant sequence homology with
      the mammalian Ras GTPase activating protein and two yeast Saccharomyces
      cerevisiae proteins, Ira1 and Ira2. The Ras GTPase activating protein-related
      domain of the NF1 gene product (NF1-GRD) stimulates GTPase activity of normal Ras
      proteins but not of oncogenic mutant Ras from both mammalian and yeast cells.
      Thus, in yeast, NF1-GRD can suppress the heat-shock-sensitive phenotype of ira-
      cells but not the same phenotype of activated RAS such as RAS2Val19 and
      RAS2Leu68. We have screened a pool of mutagenized NF1 expression plasmids and
      obtained two mutant NF1 cDNA clones that can suppress the heat-shock-sensitive
      phenotype of RAS2Val19 cells. One clone (NF201) suppressed RAS2Leu68, RAS2Ser41,
      and RAS2Val19, whereas another clone (NF204) preferentially suppressed RAS2Val19.
      When expressed in mammalian cells, these mutant NF1-GRDs were able to induce the
      morphological reversion of v-ras-transformed NIH 3T3 cells. Both wild-type and
      mutant NF1-GRDs can stimulate the GTPase activity of normal but not transforming
      Ras. We suggest that mutant NF1-GRDs may bind tightly to transforming Ras, which
      stays in GTP-bound conformation, thus preventing the interaction with the
      putative effector molecule. On the other hand, normal Ras cannot be sequestered
      since the bound GTP is rapidly hydrolyzed upon interaction with mutant NF1-GRD to
      yield Ras-GDP, which is readily released from the NF1-GRD and recycled.

PMID- 8341689
TI  - Coexpression of neurotrophins and their receptors in neurons of the central
      nervous system.
AB  - Nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) are
      neuronal survival molecules which utilize the Trk family of tyrosine kinase
      receptors. Using double-label in situ hybridization, we demonstrate that mRNAs
      for BDNF and its high-affinity receptor TrkB are coexpressed in hippocampal and
      cortical neurons. Also, a large number of neurons in these areas coexpress NGF
      and BDNF mRNAs. Epileptic seizures lead to increased levels of both BDNF/TrkB and
      NGF/BDNF mRNAs in double-labeled cells. Our results show that individual neurons
      of the central nervous system can coexpress neurotrophins and their receptors and
      produce two neurotrophic factors. These factors could support neuronal survival
      after brain insults, not only via retrograde transport but also through autocrine
      mechanisms.

PMID- 8341690
TI  - The serum response element can mediate induction of c-fos by growth hormone.
AB  - The c-fos protooncogene is transcriptionally activated by a wide variety of
      agents including serum, growth factors, and phorbol esters. This induction is
      rapid and transient and is mediated through a number of identified promoter
      elements. Growth hormone (GH) is also known to induce transcription of c-fos in a
      variety of cell types including NIH 3T3 fibroblasts and 3T3-F442A preadipocytes.
      To identify DNA sequences in the c-fos gene regulated by GH, this study sought to
      determine whether induction of c-fos by GH involves previously identified c-fos
      promoter elements. A plasmid containing a growth factor-sensitive fragment of the
      upstream region of the c-fos promoter from -361 to -264 bp was tested for GH
      sensitivity. The fragment was cloned upstream of a human c-fos reporter
      [designated FOS by Human Gene Mapping 11 (1991)], which included basal promoter
      elements. In transiently transfected mouse NIH 3T3 fibroblasts, the promoter
      fragment conferred GH sensitivity on the human c-fos reporter. To identify a
      specific GH-sensitive DNA sequence in this promoter, a serum response element
      (SRE)-reporter plasmid was tested and found to be stimulated by GH. GH was
      effective in inducing expression through the SRE over a range of physiological GH
      concentrations. Since GH was recently found to synergize with serum factors in
      inducing c-fos transcription, the effect of GH and serum on SRE function was
      examined for insight into the mechanism for such synergism. The combined effect
      of GH and serum to induce reporter expression through the SRE was greater than
      the added effects of GH and serum, indicating that the synergism between GH and
      serum in inducing c-fos involves the SRE sequence. These studies identify the SRE
      as one specific DNA sequence in the c-fos promoter functionally regulated by GH.
      It is notable that GH is effective at physiological concentrations. Furthermore,
      synergism in c-fos induction between GH and serum factors is evident through the
      SRE.

PMID- 8341691
TI  - A Jun-binding protein related to a putative tumor suppressor.
AB  - A lambda gt11 cDNA library of chicken embryo fibroblasts was screened with
      biotinylated Jun protein to identify Jun-binding clones. Eight such clones were
      isolated; one contains a gene referred to as jif-1 that is homologous to the
      putative tumor suppressor gene QM. jif-1 codes for a protein of 25 kDa that binds
      to the leucine zipper of viral and cellular Jun. The Jif-1 protein also binds to
      itself. Jif-1 does not contain a leucine zipper, and it does not bind to the 12-O
      tetradecanoylphorbol 13-acetate response element DNA sequence. Complex formation
      of Jif-1 with Jun inhibits DNA binding and reduces transactivation by Jun.
      Addition of Fos protein to Jun-Jif-1 complexes restores DNA-binding activity.
      These observations suggest that Jif-1 is a negative regulator of Jun.

PMID- 8341692
TI  - Splice variants of the N-methyl-D-aspartate receptor NR1 identify domains
      involved in regulation by polyamines and protein kinase C.
AB  - The N-methyl-D-aspartate (NMDA) receptor NR1 gene encodes RNA that is
      alternatively spliced to generate at least seven variants. The variants arise
      from splicing in or out of three exons; one encodes a 21-amino acid insert in the
      N-terminal domain, and two encode adjacent sequences of 37 and 38 amino acids in
      the C-terminal domain. Splicing out of the second C-terminal exon deletes a stop
      codon and results in an additional open reading frame encoding an unrelated
      sequence of 22 amino acids before arriving at a second stop codon. We denote the
      NR1 variants by the presence or absence of the three alternatively spliced exons
      (from 5' to 3'); thus, NR1(111) has all three exons, NR1(000) has none, and
      NR1(100) has only the N-terminal exon. We report here electrophysiological
      characterization of six splice variants of the NR1 receptor expressed in Xenopus
      oocytes. NR1 receptors that lacked the N-terminal exon (NR1(000), NR1(010), and
      NR1(011)) exhibited a relatively high affinity for NMDA (EC50 approximately 13
      microM) and marked potentiation by spermine. In contrast, those receptor variants
      with the N-terminal insert (NR1(100), NR1(101), and NR1(111)) showed a lower
      agonist affinity and little or no spermine potentiation at saturating glycine.
      All six variants showed spermine potentiation at low glycine and inhibition by
      spermine at more negative potentials. Variants differing only in the C-terminal
      domain differed little in agonist affinity and spermine potentiation. These
      findings indicate that the N-terminal insert either participates in agonist and
      polyamine binding domains or indirectly modifies their conformations. The splice
      variants differed in the extent to which they could be potentiated by activators
      of protein kinase C (PKC) from 3- to 20-fold. Presence of the N-terminal insert
      and absence of the C-terminal sequences increased potentiation by PKC. These
      findings identify the contributions of the separate polypeptide domains to
      modulation by polyamines and PKC and provide further support for the concept that
      subunit composition determines functional properties of NMDA receptors.

PMID- 8341693
TI  - Hexamethylenebisacetamide-induced erythroleukemia cell differentiation involves
      modulation of events required for cell cycle progression through G1.
AB  - Hexamethylenebisacetamide (HMBA), a potent inducer of differentiation of
      transformed cells such as murine erythroleukemia cells, causes a prolongation of
      the G1 phase of the cell cycle during which commitment to terminal
      differentiation is first detected. Removal of HMBA prior to the G1 phase aborts
      commitment. To further define the relationship between the G1 phase and
      commitment to differentiation, we used two inhibitors of cell cycle progression:
      aphidicolin, which blocks cells at the G1/S interphase, and deferoxamine, which
      blocks cells at an earlier stage during G1. HMBA-induced prolongation of G1 is
      associated with the accumulation of underphosphorylated retinoblastoma protein,
      decrease in cyclin A protein levels, and commitment to differentiation. G1 arrest
      of murine erythroleukemia cells induced by aphidicolin or deferoxamine is not
      associated with accumulation of under-phosphorylated retinoblastoma protein,
      suppression of cyclin A protein, or commitment of cells to terminal
      differentiation. Neither of the cell cycle inhibitors alters the effect of HMBA
      in inducing the G1-associated changes or commitment to differentiation. Taken
      together, the present findings indicate that the site of action of HMBA which
      leads to commitment is in a stage of the G1 phase prior to the point of cell
      cycle block caused by deferoxamine or aphidicolin. HMBA appears to cause cell
      differentiation with suppression of cell cycle progression by an action that
      affects events required for cell progression through G1, including accumulation
      of underphosphorylated retinoblastoma protein and changes in regulation of cyclin
      levels.

PMID- 8341694
TI  - Sequence analysis of the beta-N-acetylhexosaminidase gene of Vibrio vulnificus:
      evidence for a common evolutionary origin of hexosaminidases.
AB  - DNA cloned from the marine bacterium Vibrio vulnificus into Escherichia coli
      HB101 can hydrolyze chitin oligomer analogs in the recipient. The nucleotide
      sequence of the cloned DNA was determined and a single long open reading frame of
      2541 base pairs (initiation codon through termination codon) was found. The
      nucleotide sequence predicts a gene product of 847 amino acids and a molecular
      mass of 94.3 kDa. In vitro transcription and translation analyses indicated a
      single protein of 94 kDa encoded by the cloned DNA. The gene product hydrolyzes
      methylumbelliferyl beta-D conjugates of chitotriose, chitobiose, N
      acetylglucosamine, and N-acetylgalactosamine and has, therefore, been termed a
      beta-N-acetylhexosaminidase. The predicted protein shares a high degree of
      sequence similarity with the chitobiase of Vibrio harveyi and limited similarity
      with the alpha chain of human beta-hexosaminidase. Cluster analyses suggest a
      common evolutionary ancestor for all known hexosaminidase enzymes, with no
      detectable relationship to known chitinases.

PMID- 8341695
TI  - Primary structure elements responsible for the conformational switch in the
      envelope glycoprotein gp120 from human immunodeficiency virus type 1: LPCR is a
      motif governing folding.
AB  - The ability to undergo a particular conformational switch on moving from a polar
      to a less polar environment has been shown to be conserved at the CD4-binding
      domain of the envelope glycoprotein gp120 from human immunodeficiency virus type
      1 despite considerable variability in primary structure and is essential for the
      process of binding to the T-cell receptor CD4. The elements necessary to the
      expression of this behavior have been examined in synthetic peptides using
      circular dichroism and have been found to include a tetrad, LPCR, plus a
      tryptophan at a position 8 residues C-terminal to it. In the absence of the
      tryptophan the conformational change from beta-sheet to alpha-helix as medium
      polarity decreases does not occur abruptly but, rather, in a linear fashion. In
      the absence of the LPCR tetrad, no transition to alpha-helix occurs even at 100%
      trifluoroethanol. These two domains interact to control not only the beta-->alpha
      transition but also both its cooperativity and the critical point on the polar-
      >apolar gradient at which it occurs. Sequence similarity searches of the protein
      data banks suggest that an LPCR tetrad, governing the folding behavior of
      subsequent residues, may occur as a conserved motif in proteins in general.
      Synthetic peptides with the sequence of non-gp120 proteins that contain the
      tetrad do in fact display a similar pattern of folding response to decreasing
      polarity, with a sharp, cooperative transition from beta-sheet to alpha-helix.
      The LPCR tetrad appears to be a motif that controls secondary structure in a
      manner supplementary to that predicted by folding algorithms.

PMID- 8341696
TI  - Dimerization and DNA binding alter phosphorylation of Fos and Jun.
AB  - Fos and Jun form dimeric complexes that bind to activator protein 1 (AP-1) DNA
      sequences and regulate gene expression. The levels of expression and activities
      of these proteins are regulated by a variety of extracellular stimuli. They are
      thought to function in nuclear signal transduction processes in many different
      cell types. The role of Fos and Jun in gene transcription is complex and may be
      regulated in several ways including association with different dimerization
      partners, interactions with other transcriptional factors, effects on DNA
      topology, and reduction/oxidation of a conserved cysteine residue in the DNA
      binding domain. In addition, phosphorylation has been suggested to control the
      activity of Fos and Jun. Here we show that phosphorylation of Fos and Jun by
      several protein kinases is affected by dimerization and binding to DNA. Jun
      homodimers are phosphorylated efficiently by casein kinase II, whereas Fos-Jun
      heterodimers are not. DNA binding also reduces phosphorylation of Jun by casein
      kinase II, p34cdc2 (cdc2) kinase, and protein kinase C. Phosphorylation of Fos by
      cAMP-dependent protein kinase and cdc2 is relatively insensitive to dimerization
      and DNA binding, whereas phosphorylation of Fos and Jun by DNA-dependent protein
      kinase is dramatically stimulated by binding to the AP-1 site. These results
      imply that different protein kinases can distinguish among Fos and Jun proteins
      in the form of monomers, homodimers, and heterodimers and between DNA-bound and
      non-DNA-bound proteins. Thus, potentially, these different states of Fos and Jun
      can be recognized and regulated independently by phosphorylation.

PMID- 8341697
TI  - The Saccharomyces cerevisiae PRP21 gene product is an integral component of the
      prespliceosome.
AB  - In Saccharomyces cerevisiae, the prp21 mutation causes accumulation of unspliced
      pre-mRNA at the nonpermissive temperature. We have cloned the PRP21 gene by
      complementation of its temperature-sensitive phenotype and found it to be the
      same as SPP91, an extragenic suppressor of the prp9 mutation previously studied
      in vivo by Chapon and Legrain [Chapon, C. & Legrain, P. (1992) EMBO J. 11, 3279
      3288]. We have analyzed the effects of the prp21 mutation on splicing in vitro
      and have found that PRP21 is a splicing factor required for prespliceosome
      assembly. We also have analyzed the interaction of PRP21 with splicing complexes
      using anti-PRP21 antibodies and found that the RNA components of the
      prespliceosome--U1 and U2 small nuclear RNA (snRNA) particles and pre-mRNA--are
      specifically coimmunoprecipitated under splicing conditions in the presence of
      0.2 M KCl. At higher KCl concentrations, U1 snRNP dissociates from splicing
      complexes; nevertheless, U2 snRNA and pre-mRNA are still efficiently
      immunoprecipitated. Immunoprecipitation of both U1 and U2 snRNA as well as pre
      mRNA is ATP-dependent and requires a pre-mRNA capable of supporting
      prespliceosome assembly. Analysis of the unbound complexes in native gels
      confirmed that prespliceosomes are specifically immunoprecipitated by anti-PRP21
      antibodies. These results demonstrate that PRP21 is an integral component of the
      prespliceosome and establishes a stable interaction with U2 snRNP and/or pre-mRNA
      in that complex.

PMID- 8341698
TI  - An unusual RNA tertiary interaction has a role for the specific aminoacylation of
      a transfer RNA.
AB  - The nucleotides in a tRNA that specifically interact with the cognate aminoacyl
      tRNA synthetase have been found largely located in the helical stems, the
      anticodon, or the discriminator base, where they vary from one tRNA to another.
      The conserved and semiconserved nucleotides that are responsible for the tRNA
      tertiary structure have been shown to have little role in synthetase recognition.
      Here we report that aminoacylation of Escherichia coli tRNA(Cys) depends on the
      anticodon, the discriminator base, and a tertiary interaction between the
      semiconserved nucleotides at positions 15 and 48. While all other tRNAs contain a
      purine at position 15 and a complementary pyrimidine at position 48 that
      establish the tertiary interaction known as the Levitt pair, E. coli tRNA(Cys)
      has guanosine -15 and -48. Replacement of guanosine -15 or -48 with cytidine
      virtually eliminates aminoacylation. Structural analyses with chemical probes
      suggest that guanosine -15 and -48 interact through hydrogen bonds between the
      exocyclic N-2 and ring N-3 to stabilize the joining of the two long helical stems
      of the tRNA. This tertiary interaction is different from the traditional base
      pairing scheme in the Levitt pair, where hydrogen bonds would form between N-1
      and O-6. Our results provide evidence for a role of RNA tertiary structure in
      synthetase recognition.

PMID- 8341699
TI  - Rare scleroderma autoantibodies to the U11 small nuclear ribonucleoprotein and to
      the trimethylguanosine cap of U small nuclear RNAs.
AB  - We have identified a scleroderma serum (Ru) with a previously undescribed
      specificity to protein components of the U11 small nuclear ribonucleoprotein
      particle (snRNP), a low-abundance member of the Sm class of U RNPs. The U11 RNP
      can be specifically immunoprecipitated from sonicated HeLa cells with Ru serum.
      In nuclear extracts, a fraction of the U11 particle is found complexed to the U12
      RNP, an even lower abundance Sm snRNP. In glycerol gradient fractions, Ru serum
      identifies a 65-kDa protein that cosediments with the U11-U12 complex and is
      shifted upon targeted degradation of the U12 RNA. The 65-kDa protein therefore
      appears to be a component of the U11-U12 snRNP complex, whereas another Ru
      reactive (140 kDa) protein may be associated with the free U11 RNP. The Ru serum
      also contains autoantibodies directed against the trimethylguanosine cap of U
      RNAs. This rare specificity has been described previously in only three other
      scleroderma patients.

PMID- 8341700
TI  - On how a myosin tryptophan may be perturbed.
AB  - A well-known indication that a nucleotide has bound to myosin is the enhancement
      of the fluorescence of a specific tryptophan in the "subfragment 1" segment of
      the protein. Empirically the effect has been enormously useful in myosin
      enzymology. But beyond an early suggestion that it arises from a purine
      tryptophan charge-transfer complex, the mechanism of the effect has not been
      considered. Here we consider the alternative that it arises from an ionizable
      group (either another residue or the phosphate of the nucleotide) whose proximity
      to the tryptophan is altered by substrate binding. We study this possibility by
      studying the interaction of an ionizable residue and tryptophan when both are
      incorporated in a diketopiperazine structure. The geometry of the situation is
      inferred from molecular mechanics simulations. Unexpectedly, the best explanation
      seems to be that the field of the imposed charge, acting across space, affects
      events in the excited state of the indole.

PMID- 8341701
TI  - Construction of a yeast artificial chromosome contig spanning the spinal muscular
      atrophy disease gene region.
AB  - The childhood spinal muscular atrophies (SMAs) are the most common, serious
      neuromuscular disorders of childhood second to Duchenne muscular dystrophy. A
      single locus for these disorders has been mapped by recombination events to a
      region of 0.7 centimorgan (range, 0.1-2.1 centimorgans) between loci D5S435 and
      MAP1B on chromosome 5q11.2-13.3. By using PCR amplification to screen yeast
      artificial chromosome (YAC) DNA pools and the PCR-vectorette method to amplify
      YAC ends, a YAC contig was constructed across the disease gene region. Nine walk
      steps identified 32 YACs, including a minimum of seven overlapping YAC clones
      (average size, 460 kb) that span the SMA region. The contig is characterized by a
      collection of 30 YAC-end sequence tag sites together with seven genetic markers.
      The entire YAC contig spans a minimum of 3.2 Mb; the SMA locus is confined to
      roughly half of this region. Microsatellite markers generated along the YAC
      contig segregate with the SMA locus in all families where the flanking markers
      (D5S435 and MAP1B) recombine. Construction of a YAC contig across the disease
      gene region is an essential step in isolation of the SMA-encoding gene.

PMID- 8341702
TI  - Conserved structure of amphibian T-cell antigen receptor beta chain.
AB  - All jawed vertebrates possess well-differentiated thymuses and elicit T-cell-like
      cell-mediated responses; however, no surface T-cell receptor (TCR) molecules or
      TCR genes have been identified in ectothermic vertebrate species. Here we
      describe cDNA clones from an amphibian species, Ambystoma mexicanum (the Mexican
      axolotl), that have sequences highly homologous to the avian and mammalian TCR
      beta chains. The cloned amphibian beta chain variable region (V beta) shares most
      of the structural characteristics with the more evolved vertebrate V beta and
      presents approximately 56% amino acid identities with the murine V beta 14 and
      human V beta 18 families. The two different cloned axolotl beta chain joining
      regions (J beta) were found to have conserved all the invariant mammalian J beta
      residues, and in addition, the presence of a conserved glycine at the V beta-J
      beta junction suggests the existence of diversity elements. The extracellular
      domains of the two axolotl beta chain constant region isotypes C beta 1 and C
      beta 2 show an impressively high degree of identity, thus suggesting that a very
      efficient mechanism of gene correction has been in operation to preserve this
      structure at least from the early tetrapod evolution. The transmembrane axolotl C
      beta domains have been less well conserved when compared to the mammalian C beta
      but they do maintain the lysine residue that is thought to be involved in the
      charged interaction between the TCR alpha beta heterodimer and the CD3 complex.

PMID- 8341703
TI  - Cloning and characterization of cyclophilin C-associated protein: a candidate
      natural cellular ligand for cyclophilin C.
AB  - We report the protein purification and the cloning and characterization of a cDNA
      encoding the proteins that bind with high affinity to cyclophilin C (Cyp-C) in
      the absence of cyclosporin A. Transfection of this cDNA into COS cells directs
      the production of a glycoprotein of 77 kDa that binds to Cyp-C in the absence,
      but not the presence, of cyclosporin A. Homology comparisons reveal that this
      protein and gene, termed CyCAP for Cyp-C-associated protein, possess a cysteine
      rich domain (scavenger receptor cysteine-rich domain) found in a variety of cell
      surface molecules; the rest of the sequence is apparently specific. This result
      raises the possibility that Cyp-C serves as a mediator or regulator of an as-yet
      unidentified signal or cellular process initiated via the Cyp-C-associated
      protein.

PMID- 8341704
TI  - Even in culture, oligodendrocytes myelinate solely axons.
AB  - Cerebral hemispheres from mouse embryos at 15 days of gestation were dissociated
      and maintained in culture for several weeks in a medium which permitted
      homochronic and homotypic oligodendrocytes and neurons to interact in the
      presence of other central nervous system cells. After 13-14 days in culture a few
      oligodendrocytes changed from highly branched, "sun-like," nonmyelinating cells
      to sparcely branched myelinating cells. The number of fibers myelinated per
      oligodendrocyte ranged from 1 to 10, similar to that described previously in vivo
      in the corpus callosum. When an oligodendrocyte began to myelinate, it
      immediately myelinated a maximum number of fibers, suggesting that the number of
      axons to be myelinated by the oligodendrocyte was predetermined. When only one
      fiber was in the vicinity of a myelinating oligodendrocyte, whorls of myelin-like
      figures were seen at the tip of oligodendrocyte processes that had not reached an
      axon. Myelinated fibers were unambiguously identified as axons both by
      immunostaining and by electron microscopy. Myelin was not observed around
      astrocyte processes or around dendrites. The exclusive myelination of axons
      suggests the existence of a specific axonal recognition signal which attracts
      oligodendrocyte processes.

PMID- 8341705
TI  - A tobacco gene family for flower cell wall proteins with a proline-rich domain
      and a cysteine-rich domain.
AB  - Flowering is known to be associated with the induction of many cell wall
      proteins. We report here five members of a tobacco gene family (CELP, Cys-rich
      extensin-like protein) whose mRNAs are found predominantly in flowers and encode
      extensin-like Pro-rich proteins. CELP mRNAs accumulate most abundantly in
      vascular and epidermal tissues of floral organs. In the pistil, CELP mRNAs also
      accumulate in a thin layer of cells between the transmitting tissue and the
      cortex of the style and in a surface layer of cells of the placenta in the ovary.
      This unique accumulation pattern of CELP mRNAs in the pistil suggests a possible
      role in pollination and fertilization processes. CELP genes encode a class of
      plant extracellular matrix proteins that have several distinct structural
      features: a Pro-rich extensin-like domain with Xaa-Pro3-7 motifs and Xaa-Pro
      doublets, a Cys-rich region, and a highly charged C terminus. The extensin-like
      domains in these proteins differ significantly in their length and these
      differences appear to be results of both long and short deletions within the
      coding regions of their genes. Furthermore, the number of charged amino acid
      residues in the C-terminal region varies among the CELPs. These structural
      differences may contribute to functional versatility in the CELPs. On the other
      hand, the Cys-rich domain is highly conserved among CELPs and the positions of
      the Cys residues are conserved, suggesting that this region may have a common
      functional role. The presence of a Pro-rich domain and a Cys-rich domain in these
      CELPs is reminiscent of a class of hydroxyproline-rich glycoproteins, solanaceous
      lectins, that are believed to be important in cell-cell recognition. The
      structure of these CELPs indicates that they may be multifunctional and that
      their genes may have arisen from recombinational events.

PMID- 8341706
TI  - Overexpression, characterization, and purification of a recombinant mouse
      immunophilin FKBP-52 and identification of an associated phosphoprotein.
AB  - To gain insight into the structure and function of the immunophilin FKBP-52, a
      mouse FKBP-52 was overexpressed in Spodoptera frugiperda insect cells (Sf9 cells)
      with the baculovirus expression system. The purification and characterization of
      the recombinant FKBP-52 (rFKBP-52) was facilitated by incorporating a histidine 6
      mer domain at its N terminus. The rFKBP-52 was highly purified on a N(i)2+
      affinity resin with an estimated recovery of 10 mg of pure protein from 1 liter
      of Sf9 cell culture. Subcellular fractionation revealed that the rFKBP-52 is
      expressed predominantly in the nuclei of infected Sf9 cells maximally at 48 hr
      after infection, consistent with the nuclear localization of FKBP-52 in mammalian
      cells. The rFKBP-52 can be assembled in vitro with the glucocorticoid receptor
      complex, establishing its functionality and confirming that it is a component of
      the unactivated glucocorticoid receptor complex. The rFKBP-52 possesses an
      ATP/GTP binding activity that is stimulated by divalent cations. Furthermore,
      incubation of purified rFKBP-52 with [gamma-32P]ATP and MgCl2 resulted in the
      phosphorylation of a 59-kDa nuclear protein. Amino acid sequence analysis of this
      protein revealed that it is a phosphoprotein or kinase that is associated with
      the rFKBP-52.

PMID- 8341707
TI  - cdc2-like kinase from rat spinal cord specifically phosphorylates KSPXK motifs in
      neurofilament proteins: isolation and characterization.
AB  - A protein kinase that phosphorylates a specific KSP sequence [K(S/T)PXK], which
      is abundant in high molecular weight neurofilament (NF) proteins, was identified
      and isolated from rat spinal cord. Characterization of this enzyme activity
      revealed a close relationship with p34cdc2 kinase with respect to its molecular
      mass (32.5 kDa by SDS/PAGE) and substrate specificities. It could phosphorylate a
      synthetic peptide analog of the simian virus 40 large tumor antigen, reportedly a
      specific substrate for p34cdc2 kinase. Histone (H1) and peptide analogs of the
      KSP sequence present in the C-terminal end of rat and mouse neurofilament
      proteins were phosphorylated. This kinase did not phosphorylate alpha-casein and
      peptide substrates of other known second messenger-dependent or -independent
      kinases. Dephosphorylated rat NF protein NF-H was strongly phosphorylated by the
      purified enzyme; NF proteins NF-M and native NF-H, but not NF-L, were slightly
      phosphorylated. Studies on synthetic peptide analogs of KSP repeats with
      substitution of specific residues, known to be present in the C-terminal regions
      of NF-H, revealed a consensus sequence of X(S/T)PXK, characteristic of the
      p34cdc2 kinase substrate. On Western blots, the enzyme was immunoreactive with
      antibody against the C-terminal end of cdc2 kinase (mouse) and neuronal cdc2-like
      kinase from rat but not with an antibody against the conserved PSTAIRE region of
      the p34cdc2 kinase. The antibody against the C-terminal end of cdc2 kinase could
      immunoprecipitate (immunodeplete) the purified kinase activity. Since the adult
      nervous system is composed primarily of postmitotic cells, the present
      observations indicate a nonmitotic role for this cdc2-like kinase activity. The
      effective phosphorylation of NF-H by this kinase suggests a function in axonal
      structure.

PMID- 8341708
TI  - The functional form of the erythropoietin receptor is a 78-kDa protein:
      correlation with cell surface expression, endocytosis, and phosphorylation.
AB  - An abundant 70- to 78-kDa form of the erythropoietin receptor (EPOR) was observed
      in HC-D57 murine erythroleukemia cells deprived of erythropoietin (EPO). In
      contrast to the 64- and 66-kDa EPOR proteins, these high molecular mass forms of
      EPOR (hmm-EPOR) correlated well with the number of binding sites and endocytosis
      of EPO. The hypothesis that hmm-EPOR are more highly glycosylated forms of the
      EPOR, appear on the cell surface, and represent at least one component of the
      biologically active EPOR was tested. Consistent findings were as follows. (i)
      Only hmm-EPOR increased following withdrawal of EPO from HC-D57 cells,
      correlating with a 10-fold increase in binding of 125I-labeled EPO. In addition,
      the EPO-dependent downregulation of 125I-EPO binding and disappearance of hmm
      EPOR occurred in parallel while the amount of 66-kDa EPOR did not change. (ii)
      The 78-kDa EPOR was detected in COS cells expressing EPOR cDNA. (iii) Probing of
      the intact surface of these cells with anti-NH2-terminal antibody recovered only
      the 78-kDa EPOR. (iv) Enzymatic deglycosylation and dephosphorylation showed that
      hmm-EPOR apparently resulted from additional N-linked glycosylation of a 62-kDa
      EPOR. (v) The hmm-EPOR turnover in HC-D57 cells was accelerated 12-fold in the
      presence of EPO (half-life changed from 3 hr to 15 min). (vi) Anti
      phosphotyrosine antiserum detected an EPO-dependent phosphorylation of the 78-kDa
      EPOR. The kinetics of tyrosine phosphorylation of a 97-kDa protein correlated
      with the occupancy and internalization of hmm-EPOR. In summary, we suggest that
      the 78-kDa EPOR is directly involved in the initial biological actions of EPO.

PMID- 8341709
TI  - Sea urchin early histone H2A modulator binding factor 1 is a positive
      transcription factor also for the early histone H3 gene.
AB  - To shed some light on the mechanisms involved in the coordinate regulation of the
      early histone gene set during sea urchin development, we tested the hypothesis
      that the upstream sequence element USE1, previously identified in the early H2A
      modulator, could also participate in the transcription of the early histone H3
      gene. We found by DNAse I protection analysis and by competition in
      electrophoretic mobility-shift experiments that two sequence elements of the H3
      promoter closely resembled the USE1-H2A sequence in their binding activity for
      nuclear factors from 64-cell stage embryos. These modulator binding factor 1 (MBF
      1)-related factors seem to recognize the ACAGA motif that is conserved between
      the USE1-like sequences of both H2A and H3 promoters. In fact, excess
      oligonucleotide containing a mutated USE1-H2A element in which the ACAGA sequence
      was mutated to AGTCA failed to compete with the USE1 sites of both H2A and H3
      genes for interaction with MBF-1. Finally, in vivo transcriptional analysis in
      both Xenopus and sea urchin showed that an excess of USE1-H2A element efficiently
      competed for the activity of the H3 promoter. From these results we conclude that
      MBF-1 is a transcription factor conserved between sea urchin and frog and that
      MBF-1 or related transcription factors are involved in the coordinate expression
      of both H2A and H3 early histone genes.

PMID- 8341710
TI  - PEBP2/PEA2 represents a family of transcription factors homologous to the
      products of the Drosophila runt gene and the human AML1 gene.
AB  - cDNAs representing the alpha subunit of polyomavirus enhancer binding protein 2
      (PEBP2; also called PEA2) were isolated. The products of the cDNAs are highly
      homologous to that of Drosophila segmentation gene runt (run) for an N-proximal
      128-amino acid region showing 66% identity. The run homology region encompasses
      the domain capable of binding to a specific nucleotide sequence motif and of
      dimerizing with the companion beta subunit. The human AML1 gene related to
      t(8;21) acute myeloid leukemia also had a run homology region. Together with the
      beta subunit, which increases the affinity of the alpha subunit to DNA without
      binding to DNA by itself, PEBP2 represents a newly discovered family of
      transcription factor. The major species of PEBP2 alpha mRNA was expressed in T
      cell lines but not in B-cell lines tested. Evidence indicated that PEBP2
      functions as a transcriptional activator and is involved in regulation of T-cell
      specific gene expression.

PMID- 8341712
TI  - The linker of des-Glu84-calmodulin is bent.
AB  - The crystal structure of a mutant calmodulin (CaM) lacking Glu-84 has been
      refined to R = 0.23 using data measured to 2.9-A resolution. In native CaM the
      central helix is fully extended, and the molecule is dumbbell shaped. In
      contrast, the deletion of Glu-84 causes a bend of 95 degrees in the linker region
      of the central helix at Ile-85. However, EF-hand domains 1 and 2 (lobe 1,2) do
      not touch lobe 3,4. The length, by alpha-carbon separation, of des-Glu84-CaM is
      56 A; that of native CaM is 64 A. The shape of des-Glu84-CaM is similar to that
      of native CaM, as it is bound to the target peptide of myosin light-chain kinase.
      This result supports the proposal that the linker region of the central helix of
      CaM functions as a flexible tether.

PMID- 8341711
TI  - Intervening sequence with conserved open reading frame in eubacterial 23S rRNA
      genes.
AB  - An intervening sequence (IVS) occurred in the 23S rRNA genes (rrl) of some, but
      not all, strains of four species of the spirochete genus Leptospira and was
      absent from strains in three other species. The IVS varied in size from 485 to
      759 base pairs and replaced bases 1224-1245 in both copies of rrl. The two ends
      of each IVS shared 22-35 bases of complementarity that could form a stable double
      helix. The presence of an IVS correlated with a cleaved mature 23S rRNA that
      probably results from removal of the IVS without religation. The 3' site of
      cleavage was mapped within the inverted repeat of the IVS. An open reading frame
      of 121-133 amino acids was conserved in the IVS in all four species, oriented so
      that the sense strand was in the rRNA transcript. When the open reading frames
      were compared between species, they predicted polypeptides that showed between
      51% and 78% amino acid conservation and similar DNA sequence conservation,
      indicating selection for protein function.

PMID- 8341713
TI  - Genomic mapping with I-Ceu I, an intron-encoded endonuclease specific for genes
      for ribosomal RNA, in Salmonella spp., Escherichia coli, and other bacteria.
AB  - Construction of physical maps of genomes by pulsed-field gel electrophoresis
      requires enzymes which cut the genome into an analyzable number of fragments;
      most produce too many fragments. The enzyme I-Ceu I, encoded by a mobile intron
      in the chloroplast 23S ribosomal RNA (rrl) gene of Chlamydomonas eugametos, cuts
      a 26-bp site in the rrl gene. This enzyme digests DNA of Salmonella typhimurium
      at seven sites, each corresponding to one of the rrl genes of the rrn operons,
      but at no other site. These seven fragments were located on the previously
      determined Xba I physical map, and the I-Ceu I sites, and thus the rrn genes of
      S. typhimurium, were mapped on the 4800-kb chromosome. Escherichia coli K-12 also
      yields seven fragments of sizes similar to those of S. typhimurium, indicating
      conservation of rrn genes and their location, and a chromosome size of 4600 kb.
      The sizes of the E. coli fragments are close to the size predicted from
      restriction maps and nucleotide sequence. The I-Ceu I maps of Salmonella
      enteritidis, Salmonella paratyphi A, B, C, and Salmonella typhi were deduced
      after digesting genomic DNA and I-Ceu I and probing with DNA of S. typhimurium;
      the data indicated strong conservation of rrn gene number and position and genome
      sizes up to 4950 kb. Digestion of DNA of other bacteria (species of Haemophilus,
      Neisseria, Proteus, and Pasteurella) suggested that only rrn genes are cut in all
      these species. I-Ceu I digestion followed by pulsed-field gel electrophoresis is
      a powerful tool for determining genome structure and evolution.

PMID- 8341714
TI  - Unusual microtubule-dependent endocytosis mechanisms triggered by Campylobacter
      jejuni and Citrobacter freundii.
AB  - Bacterial invasion of six different human epithelial cell lines showed that some
      strains of the intestinal pathogen Campylobacter jejuni invaded intestinal cell
      lines at a level 10(2)-10(4) times higher than reported previously for other
      Campylobacter strains. Separately, urinary tract isolates of Citrobacter freundii
      triggered a high-efficiency invasion of bladder cells. Use of multiple inhibitors
      with known effects on eukaryotic cell structures/processes allowed us to define
      in these genetically distinct bacterial genera unusual bacterial invasion
      mechanisms that uniquely require microtubules but not microfilaments.
      Campylobacter jejuni strain 81-176 uptake into 407 intestinal cells and
      Citrobacter entry into T24 bladder cells was blocked by microtubule
      depolymerization and inhibitors of coated-pit formation but not by microfilament
      depolymerization. Inhibitors of endosome acidification had no significant impact
      on intracellular survival of Campylobacter jejuni or Citrobacter freundii, but
      monensin markedly reduced Citrobacter uptake. Epithelial cell invasion by both of
      these bacterial genera was dependent upon de novo bacterial protein synthesis but
      not upon de novo eukaryotic cell protein synthesis. In contrast to the T24 cell
      line-specific, strict microtubule-dependent uptake, Citrobacter entry into other
      cell lines was inhibited by both microtubule- and microfilament-depolymerization,
      suggesting that these bacteria encode two separate pathways for uptake (i,
      microtubule-dependent; ii, microfilament-dependent) that are cell line-specific
      and are recognized perhaps depending on the presence and abundance of appropriate
      eukaryotic receptors.

PMID- 8341716
TI  - Monthly prostaglandin bibliography prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 8341715
TI  - Diazepam dependence prevented by glutamate antagonists.
AB  - Long-term treatment leads to tolerance to and dependence on benzodiazepines.
      Abrupt termination of benzodiazepine administration triggers the expression of
      signs of dependence. Mice withdrawn from chronic treatment with diazepam showed a
      time-related evolution of anxiety, muscle rigidity, and seizures between days 4
      and 21 after treatment discontinuation. A period between withdrawal days 1 and 3
      was symptom-free. Surprisingly, during this "silent phase" the susceptibility of
      mice to alpha-amino-3-hydroxy-5-tert-butyl-4-isoxazolepropionate (ATPA) and
      kainate seizures and the magnitude of monosynaptic reflexes mediated by non-N
      methyl-D-aspartate (NMDA) mechanisms were enhanced. In apparent contrast, the
      "active phase", between withdrawal days 4 and 21, was characterized by increased
      susceptibility to NMDA seizures and enhanced magnitude of polysynaptic reflexes,
      which are NMDA dependent. Treatment of mice with alpha-amino-3-hydroxy-5-methyl-4
      isoxazolepropionate (AMPA) antagonists 1-(4-aminophenyl)-4-methyl-7,8
      methylenedioxy-5H-2,3-benzodiazepine (GYKI 52466) or 2,3-dihydroxy-6-nitro-7
      sulfamoylbenzo(f)quinoxaline but not with the NMDA antagonist 3-[(+/-)-2
      carboxypiperazin-4-yl]-propyl-1-phosphonate (CPP) during the silent phase
      prevented signs of dependence. In contrast, treatment with CPP but not with GYKI
      52466 during the active phase prevented the symptoms. The development of
      tolerance to and dependence on diazepam was prevented by concurrent treatment of
      mice with CPP but was not prevented by GYKI 52466. These data indicate that NMDA
      dependent mechanisms contribute to the development of tolerance to diazepam and
      to the expression of signs of dependence in mice after termination of long-term
      treatment with diazepam. Nevertheless, the non-NMDA-mediated silent phase is
      essential for triggering the symptoms. Therefore, AMPA antagonists may offer a
      therapeutic approach for preventing dependence on benzodiazepines that is an
      alternative to NMDA antagonism.

PMID- 8341717
TI  - Role of eicosanoids in the pathogenesis of atopic dermatitis.

PMID- 8341719
TI  - The effect of 16,16-dimethyl prostaglandin E2 on proliferation of an intestinal
      goblet cell line and its synthesis and secretion of mucin glycoproteins.
AB  - The effect of 16,16'-dimethyl prostaglandin E2 (dmPGE2) on the human colonic
      adenocarcinoma derived mucus-secreting goblet cell line HT29-18N2 was
      investigated. The proliferation rate of HT29-18N2 was increased by exposure to 10
      or 100 microM dmPGE2. Exposure to 10 or 100 microM dmPGE2 caused a significant
      decrease in the rate of radiolabeled glucosamine incorporation into newly
      synthesized glycoproteins during an 8 or 24 h exposure. At concentrations as low
      as 1 microM, dmPGE2 accelerated the secretion of mucin glycoproteins as assessed
      by the release of newly synthesized radiolabeled glycoproteins, a mucin-specific
      enzyme-linked immunoassay and a whole-mount immunofluorescence assay. A 1 h
      exposure to dmPGE2 did not, however, result in a morphometrically detectable
      decrease in intracellular mucous granule stores or elicit any other readily
      detectable morphological change. The experimental results suggest elevated levels
      of PGs may contribute to the previously recognized decreases in intracellular
      mucin stores and shifts in the types of mucins species present at sites of
      mucosal inflammation in ulcerative colitis patients.

PMID- 8341718
TI  - The effects of prostacyclin analog OP-41483 on normothermic liver ischemia and
      reperfusion injury in rats.
AB  - To estimate the effects of the prostacyclin analog (OP-41483) on normothermic
      liver ischemia and reperfusion injury, saline (Group 1, N = 8), heparin (group 2,
      N = 8, 100 u/kg) or OP-41483 (group 3, N = 8, 400 ng/kg/min) was infused
      intravenously for 30 min before and after liver ischemia in rats. There were no
      significant differences in survival, or transaminase at 30 min after reperfusion
      among the three groups. Hepatic vessel flow and tissue flow were measured for the
      first 30 min after reperfusion. Hepatic tissue flow increased for the first 30
      min after reperfusion in the group 3 rats, but not in the groups 2 and 3 rats.
      There were significant differences in hepatic tissue flow between the groups 1
      and 3 rats at 20 min (p < 0.05), as well as significant differences between the
      groups 1 and 3 rats (p < 0.01) and the groups 1 and 2 rats (p < 0.05) at 30 min
      after reperfusion. There were no significant differences in total hepatic inflow
      among the three groups. Our data suggest that OP-41483 exerts beneficial effects
      by improving the microcirculation and increasing the effective hepatic blood flow
      in the ischemically injured liver after reperfusion.

PMID- 8341720
TI  - Isolation, identification and synthesis of an endogenous arachidonic amide that
      inhibits calcium channel antagonist 1,4-dihydropyridine binding.
AB  - This study was part of a broad search for endogenous regulators of L-type calcium
      channels. The screening for active fractions was done by measuring inhibition
      [3H]1,4-dihydropyridine (DHP) binding to rat cardiac and cortex membranes. An
      inhibitory fraction, termed lyophilized brain hexane-extractable inhibitor
      (LBHI), was isolated from hexane extracts of lyophilized calf brain. The active
      substance was purified by a series of chromatographic steps. 13C nuclear magnetic
      resonance (NMR), 1H coherence spectroscopy (COSY) NMR and fast atom bombardment
      (FAB) mass spectroscopy suggested that LBHI was N-arachidonic acid-2
      hydroxyethylamide. Synthesis of this substance and subsequent high performance
      liquid chromatography (HPLC) and NMR analysis confirmed this structure. Synthetic
      LBHI (SLBHI) inhibited [3H]DHP binding to rat cortex membranes with an IC50 value
      of congruent to 15 microM and a Hill coefficient of congruent to 2. Saturation
      analysis in the presence of SLBHI showed a change in KD (equilibrium dissociation
      constant), but not maximal binding capacity (Bmax). SLBHI produced an increased
      dissociation rate, which, along with the Hill slope of > 1, suggested a non
      competitive interaction with the DHP binding site. The results suggest that
      arachidonic acid derivatives may be endogenous modifiers of the DHP calcium
      antagonist binding site.

PMID- 8341721
TI  - Characterization of (5Z)-7-[3-endo-[(4-iodophenylsulfonyl) amino] 
      bicyclo[2.2.1]hep-2-exo-yl]heptenoic acid (IS-145) as an antagonist for the study
      of thromboxane A2 receptor.
AB  - (5Z)-7-[3-endo-[(4-iodophenylsulfonyl) amino]bicyclo[2.2.1]-hep-2-exo-yl]
      heptenoic acid (IS-145) was characterized on its suitability for the study of
      thromboxane A2 (TXA2) receptor. Both the I-125 and I-127 analogs are very potent
      TXA2 antagonist. The I-127 analog interacted with the receptor specifically as
      shown by the displacement of [3H]-SQ29548 from its binding sites on human
      platelet membranes in a dose dependent manner. It also elicited specific
      biological responses by inhibiting I-BOP induced platelet aggregation. However,
      they failed to inhibit those induced by platelet activating factor. Moreover, it
      interfered with the TXA2 receptor activated signal transduction system by
      inhibiting I-BOP induced increase in GTP-gamma-[35S] binding and GTPase activity.
      These data indicated that IS-145 was indeed a specific antagonist. The I-125
      analog was used as a radioactive ligand to characterize TXA2 receptor in human
      platelet membranes. The binding was found to be saturable, reversible and
      specific with a KD of 5.8 nM and a Bmax of 1.9 pmol/mg protein.

PMID- 8341722
TI  - Pharmacological model for airway hypersensitivity produced by propranolol and
      reserpine in guinea pigs.
AB  - Combined treatment with propranolol and reserpine enhanced acetylcholine-induced
      dose-response curves for bronchoconstriction in guinea pigs in vivo. This airway
      hyperreactivity model was investigated pharmacologically. (1) Increased capillary
      permeability and increases in leukocytes in bronchoalveolar lavage fluid (BALF)
      were not observed after this combined treatment. (2) The increased airway
      sensitivity to acetylcholine produced by propranolol and reserpine was inhibited
      by ketotifen and theophylline, reported in clinical studies to inhibit airway
      hyperreactivity. (3) Two leukotriene (LT) receptor antagonists, MCI-826 and FPL
      55712, clearly inhibited this increased airway reactivity. (4) A thromboxane A2
      (TXA2) receptor antagonist, ONO-3708, and TXA2 synthetase inhibitor, OKY-046,
      also inhibited this increased airway reactivity. These results suggest that the
      airway hyperreactivity model produced by propranolol and reserpine in guinea pigs
      is a valuable pharmacological tool for investigating a remedy and LT and TXA2 may
      be involved in the onset of this airway hyperreactivity.

PMID- 8341723
TI  - Hyperoxia decreases cyclooxygenase activity in endothelial cells.
AB  - We examined the effect of hyperoxia on arachidonic acid (AA) metabolism in bovine
      carotid artery endothelial cells (CAEC) and pulmonary artery endothelial cells
      (PAEC). Confluent monolayers were exposed to hyperoxic gases (95% O2 or 60% O2)
      from 12-72 h. Control cells were incubated under normoxic condition (air-5% CO2).
      After exposure of the cells to normoxic or hyperoxic conditions, prostaglandin
      (PG) synthesis activity was analyzed in cell homogenates using thin layer
      chromatography; release of 6-keto-PGF1 alpha, a stable metabolite of PGI2, into
      the culture medium was measured using a radioimmunoassay. The major metabolites
      formed from exogenously supplied 14C-AA were 6-keto-PGF1 alpha and a small amount
      of PGE2. Hyperoxia (95% O2) decreased the synthesis of these cyclooxygenase
      products beginning at 24 h; moderate hyperoxia (60% O2) had no such effect. There
      was no significant difference between CAEC and PAEC with respect to the depletion
      effect of hyperoxia. After 72 h of exposure to 95% O2, endothelial injury was
      observed in CAEC but not in PAEC. We conclude that hyperoxia decreases
      cyclooxygenase activity in endothelial cells, and that this decrease is dependent
      on the severity of the hyperoxia. In addition, CAEC are more susceptible to
      hyperoxia-induced injury than PAEC. The depletion of cyclooxygenase activity and
      the resultant effect on PGI2 and PGE2 production may be a factor in the
      development of hyperoxia-induced endothelial injury.

PMID- 8341724
TI  - Eicosapentaenoic acid abolishes the proatherogenic effects of cholesterol:
      effects on migration of bovine smooth muscle and endothelial cells in vitro.
AB  - It is well known that vascular endothelial cell (EC) migration plays a major role
      in regeneration of the injured endothelium and also that smooth muscle cell (SMC)
      migration is the important step for atheromatous plaque formation. In the present
      study, we investigated the effects of cholesterol and eicosapentaenoic acid (EPA)
      on bovine carotid artery EC and SMC migration using the modified Boyden chamber
      technique. The migration activity of the cholesterol-enriched ECs loaded with
      cholesterol-rich liposomes was significantly suppressed, whereas that of the
      cholesterol-enriched SMCs was enhanced. Next, we examined the effects of EPA
      pretreatment on the migration of both cell types. When ECs and SMCs were treated
      with EPA (5 micrograms/ml) for 2 days, the EPA content increased from 0.55 +/-
      0.04% to 11.72 +/- 0.19% and 1.22 +/- 0.09% to 9.69 +/- 0.07% in cellular
      phospholipids, respectively. Although pretreatment of the ECs with EPA caused a
      significant increase in serum-induced cell migration, pretreatment of SMCs had no
      effect. If both cell types were concomitantly pretreated with EPA and cholesterol
      rich liposomes, EPA abolished the effects of cholesterol on the migration of both
      cell types, but did not affect the content of cholesterol in both cells. These
      data indicate the possibility that EPA counteracts the atherogenic effect of
      cholesterol on EC and SMC migration.

PMID- 8341725
TI  - U 46619 induces different blood pressure effects in male and female spontaneously
      hypertensive rats (SHR).
AB  - The effect of U 46619 (5 micrograms/kg i.v.) alone or in combination with
      acetylsalicylic acid (ASA) (100 mg/kg po.) on mean arterial blood pressure (MABP)
      was investigated in male and female spontaneously hypertensive rats (SHR). In
      male SHR, a significant increase of MABP was observed 1 min after administration
      of U 46619. Pretreatment of male SHR with ASA delayed the increase of MABP after
      intravenous injection of U 46619 compared to U 46619 alone. Whereas in control
      animals the elevated MABP returned to baseline values 5 min after intravenous
      application of U 46619, the MABP of ASA-pretreated male SHR remained
      significantly increased by about 30 mmHg. In contrast, the MABP of female SHR did
      not respond to U 46619 alone or to the combination of U 46619 and ASA. Sex
      differences were further shown by the vascular formation of thromboxane B2
      (TXB2). Whereas in male SHR the vascular formation of TXB2 was increased by U
      46619, the TXB2 formation of female SHR was decreased. The vascular formation of
      6-keto-PGF1 alpha of male and female SHR was not influenced by U 46619 alone or a
      combination of U 46619 and ASA. In conclusion, our results demonstrate that the
      blood pressure of SHR respond differently to the TXA2 mimetic U 46619 in the two
      sexes. Furthermore, by modulating blood pressure response to TXA2, vasoactive
      prostanoids may be significantly involved in the maintenance of hypertension with
      male SHR.

PMID- 8341726
TI  - Lipoproteins from normolipidemic and dyslipidemic subjects modify the thromboxane
      A2 generation by platelets in clotting human blood.
AB  - The study was performed to investigate the influence of lipoproteins (LP) on the
      thromboxane (TX) A2 formation capacity of platelets in clotting whole blood in
      vitro. The different lipoprotein fractions VLDL, LDL, HDL2 and HDL3 were isolated
      from blood of normo- or dyslipidemic volunteers by ultracentrifugation. These
      lipoproteins were incubated in blood with different levels of serum total
      cholesterol (TC) taken from normolipidemics (TC < 200 mg/dl), moderate
      hypercholesterolemics (TC: 200-250 mg/dl) or subjects with high cholesterol level
      (TC > 250 mg/dl), respectively. The amount of serum TXA2 formed within 60 min at
      37 degrees C was measured by enzyme immunoassay. The results obtained show that
      the efficacy of separate LP fractions to influence the TXA2 production depends
      not only on the type of LP fraction but also on the source of plasma used for
      isolation of LP and on the cholesterol level in the blood for incubation: LDL
      taken from normolipidemics or moderate hyperlipidemics inhibited the TXA2
      formation in blood from normolipidemics (P < 0.02, respectively), but enhanced it
      in blood from persons with moderate hypercholesterolemia (P < 0.05). LDL from
      hyperlipidemics enhanced TXA2 production in blood from hyperlipidemics (P <
      0.05). The HDL2 fractions inhibited the TXA2 formation in blood from normo- and
      hypercholesterolemics (P < 0.02, resp.), but there was no effect of HDL2 in
      clotting blood from persons with moderate hypercholesterolemia. All HDL3
      fractions tested inhibited the TXA2 formation in all types of blood used for
      clotting (P < 0.02, resp.), probably due to their great cholesterol accepting
      capacity.

PMID- 8341727
TI  - [Interaction of NO-generators with thioles].

PMID- 8341728
TI  - Bridged bis(4-thiazolidinones) and related compounds with antibacterial activity.
AB  - Condensation of 4,4'-diaminobiphenyl ether (1) and 4,4'-diaminobiphenyl methane
      (6) with various aldehydes gave diarylidenebiphenyl ethers 2a-d and
      diarylidenebiphenyl methanes 7a-c, respectively, which on cyclocondensation with
      merceptoacetic acid yielded 3,3'-[oxy-bis(4,1-phenylene)]-bis[(2-substituted
      phenyl)-4- thiazolidinones] 3a-d and 3,3'-[methylene-bis(4,1-phneylene)]-bis[2
      substituted phenyl)-4-thiazolidinones] 8a-c. A series of 2,2'-[oxy-bis(4,1
      phenylenenitrilo)]-bis[3- (substituted)-4-thiazolidinones] 5a and b and 2,2'
      [methylene-bis(4,1-phnylenenitrilo)]-bis[3-(substituted)-4- thiazolidinones] 10a
      and b were synthesized from 4,4'-diaminobiphenyl ether (1) and 4,4'
      diaminobiphenyl methane (6) via the corresponding dithiocarbamide biphenyl ethers
      4a and b and dithiocarbamide biphenyl methanes 9a and b by cyclocondensation with
      monochloroacetic acid. The structures of compounds 2-10 are supported by
      elemental analysis and spectral data (IR, 1H NMR, 13C NMR). The specific rotation
      of compounds 3c, 8b and 8c was measured.

PMID- 8341729
TI  - Synthesis and biological activity of mono- and bis-hydrazones of cyclic
      aminoguanidines.

PMID- 8341730
TI  - Mathematical model of the cut-off effect in the homologous series of tertiary
      amine local anesthetics.
AB  - It is proposed a simple mathematical model explaining the quasi parabolic
      dependence of the local anesthetic activity on the length of hydrophobic
      substituent in the homologous series of tertiary amines (TA). It is suggested
      that the molecules of TA intercalate between the lipid molecules in bilayers. Due
      to the mismatch between the lengths of lipid and TA hydrocarbon chains the
      intercalation results in a decrease in the bilayer thickness. The quasi parabolic
      dependence is the result of combination of partition equilibria and of
      geometrical parameters of interacting molecules in the bilayer. The model
      predicts that the TA chain length at which the maximum activity is observed
      should be dependent on the lipid: aqueous phase volume ratio. The empirical
      parameters used in the model are obtained from the X-ray diffraction on
      multilamellar egg yolk phosphatidylcholine (EYPC) dispersions with the
      monohydrochloride of [2-(heptyloxy)phenyl]-2-(1-piperidinyl)ethyl ester of
      carbamic acid and from the partition equilibria of its alkyloxy homologs with
      unilamellar EYPC liposomes.

PMID- 8341731
TI  - Synthesis and local anaesthetic activities of 3-(2
      alkoxyphenylcarbamoyloxy)chinuclidinium chlorides.

PMID- 8341732
TI  - [The penetration of liposomal encapsulated vitamin A and E in the skin].

PMID- 8341733
TI  - Transport of testosterone through rat skin from transdermal patch formulations.

PMID- 8341734
TI  - [Skin pH value on hands after application of soap, cleaners and hand
      disinfectants].

PMID- 8341735
TI  - Influence of propranolol enantiomers on the pentetrazol kindling development in
      rats.

PMID- 8341736
TI  - Correlation between log k', C, pi, RF, RM, Pex, Pcal and values of surface and
      infiltration anaesthesia for piperidinoethylesters of alkoxy substituted
      phenylcarbamic acid series. Part 109(3): Study of local anaesthetices.

PMID- 8341737
TI  - The anatomy of Cupid's bow in normal and cleft lip.
AB  - This is a gross and microscopic examination of the cutaneous-vermilion-mucosal
      region (Cupid's bow) in infants with normal lip as compared to cleft lip.
      Morphologic observations of lips in situ were made with magnification. Specimens
      for histology were from the normal upper lip of infants (n = 3) and adults (n =
      4), and from redundant tissue made available during primary repair of cleft lip
      (n = 13) and cleft lip revision (n = 4). Tissues were analyzed with hematoxylin
      and eosin, Gomori trichrome, and Fontana-Masson stains. Immunoperoxidase stains
      were used to emphasize vascular endothelium and epithelial cytokeratins. Our
      observations support the hypothesis that the anterior projection of the pars
      marginalis of the musculus orbicularis oris gives rise to the normal cutaneous
      vermilion junction ("white skin roll" of Gillies-Millard). The band of vellus
      hairs, found atop the vermilion-cutaneous junction, also highlights the rim of
      Cupid's bow. There was no abrupt alteration in vasculature, melanin, or
      cytokeratin content in the white roll. Proceeding caudally, the vermilion-mucosal
      region was characterized by progressively increasing epidermal thickness and size
      of rete ridges, decreasing melanin, more superficial capillaries, and an abrupt
      transition from keratinized to nonkeratinized squamous epithelium ("red line" of
      Noordhoff). In the cleft lip specimens, where white roll was absent, there was
      hypoplasia and disorientation of the underlying pars marginalis component of m.
      orbicularis oris. Vellus hair follicles were seen in the zone of presumptive
      white roll in clefts, just as in normal lip. Frequently, these pilar units
      contained disproportionately large sebaceous glands. In some cleft lip specimens,
      ectopic sebaceous glands were noted in the oral mucosa. We also observed a
      deficiency of vermilion width on the medial side of unilateral cleft lip, whereas
      the width of the vermilion at the crest of the bow was normal or slightly
      increased in the lateral cleft segment. A narrow vermilion band and exposed
      hypoplastic mucosa were characteristic of the prolabium in the bilateral complete
      cleft deformity. The findings of this study are pertinent to technical details
      for construction of the Cupid's bow and vermilion in unilateral and bilateral
      cleft lip.

PMID- 8341738
TI  - The role of the dura in cranial bone regeneration in the immature animal.
AB  - In an animal model, the effect of transferring mature pericranial tissues to
      immature animals with cranial bone defects was tested. Isogeneic guinea pigs of
      different ages were used: "infants" (3-4 weeks) and "adults" (> 18 months).
      Bilateral parietal cranial defects were made in infant guinea pigs and the guinea
      pigs were divided into three groups. In group 1 (n = 6), the infant periosteum
      was resected and replaced as an autograft on one side (control), and adult
      periosteum was transplanted as an isograft on the other (experiment). In group 2
      (n = 5), dura was used as the variable. In group 3 (n = 5), combined dura and
      periosteum were the variables. After 8 weeks, there was complete or near complete
      bone regeneration in all animals in which infant dura was present. There was
      minimal to no bone regeneration in defects in which adult dura was present.
      Unlike dura, periosteum had little influence on the capacity of the bone to
      regenerate.

PMID- 8341740
TI  - Free anterolateral thigh flaps for reconstruction of head and neck defects.
AB  - The anterolateral thigh flap is a septocutaneous artery flap based on the
      septocutaneous or muscle perforators of the lateral circumflex femoral system.
      Little has been reported about the variations in its vascular anatomy and its
      application for head and neck reconstruction. We report 22 cases in which this
      flap was used for the reconstruction of head and neck defects. Based on our
      clinical and cadevaric experiences, the derivation of the vascular pedicle of
      this flap has four variations by which the septocutaneous perforators are derived
      from the descending branch of the lateral circumflex femoral system and/or from
      the transverse branch of that system, or for which there are no septocutaneous
      perforators but there are muscle perforators originating from the lateral
      circumflex femoral system. Clinically, the vascular variations and the locations
      of perforators of this system can be determined preoperatively with
      stereoangiograms or simple angiograms and Doppler audiometry. The anterolateral
      thigh fasciocutaneous flap is suitable for reconstruction of defects in an oral
      floor with tongue and esophageal deficits, scalp defects with dural defects, and
      for large full thickness defects of the lip. The advantages of this flap are safe
      elevation, a long and wide vascular pedicle, skin that is generally thin, and
      good pliability. Even if the skin is thick, a thinner flap can be created by
      sacrificing a large amount of fatty tissue. Furthermore, the skin territory is
      very wide and long. The donor defect can often be closed directly with its scar
      being less noticeable. The disadvantage of this flap is that the anatomy of the
      pedicle vessels has irregular derivation from the main vessels. This can be
      overcome, however, by employing preoperative stereoangiograms.

PMID- 8341739
TI  - Free combined composite flaps using the lateral circumflex femoral system for
      repair of massive defects of the head and neck regions: an introduction to the
      chimeric flap principle.
AB  - Chimeric composite flaps combined using microanastomoses consist of two or more
      flaps or tissues, each with an isolated pedicle and a single vascular source.
      Free combined chimeric flaps using the lateral circumflex femoral system were
      used to treat massive composite defects of the head and neck in 10 cases. A
      combined anterolateral thigh flap and vascularized iliac bone graft based on the
      lateral circumflex femoral system and the deep circumflex iliac system was the
      most commonly used combination. An anteromedial thigh flap and a paraumbilical
      perforator-based flap were also combined with this principal combination. The
      advantages of this chimeric flap over other osteocutaneous flaps are: (1) The
      flap is relatively thin and the pedicle vessels are up to 10 cm longer and are
      wider than those of other flaps for easier harvesting of the flap. (2) It is
      unnecessary to reposition the patient. (3) The vascular pedicle to the skin can
      be separated from that of the bone. (4) The donor site is not close to the
      recipient site. (5) The donor scar is in an unexposed area. (6) The skin
      territory of this flap is extremely wide. (7) A combined anterolateral and
      anteromedial thigh flap and vascularized iliac bone graft can be easily obtained
      as an extended combined osteocutaneous flap. (8) Other neighboring skin flaps,
      such as a groin flap, a paraumbilical perforator-based flap, or a medial thigh
      flap, can be combined with this chimeric flap because several major muscle
      branches to be anastomosed derive from the lateral circumflex femoral system.
      Chimeric composite flaps using the lateral circumflex femoral system are
      considered suitable for the repair of massive composite defects of the head and
      neck.

PMID- 8341741
TI  - Osteocartilaginous flap technique for acquired and congenital saddle nose
      deformities.
AB  - This paper illustrates the objective possible applications of the
      osteocartilaginous flap technique in solving the functional and aesthetic
      problems associated with saddle nose deformities, the pathogenesis of which
      essentially relates to: (1) congenital saddle noses; (2) post-traumatic saddle
      noses; and (3) saddle noses resulting from previous surgery on the septum. This
      technique is suggested as an alternative to a combination of other methods (such
      as septoplasty, bone, or cartilage grafts) to restore the inhalatory function of
      the internal nasal valve and the integrity of the nasal support structures using
      locally available tissues. The authors prefer to use this technique in the
      treatment of serious congenital or acquired saddle nose deformities and to assign
      composite grafts a supplementary function only. The different stages of this
      surgical procedure are analyzed and the results are assessed during short- and
      medium-term follow-up.

PMID- 8341742
TI  - Submental lipectomy with skin excision.
AB  - A new method of excision of submental skin and fat with modified Z-incision
      affords easy excision, wide exposure, and simple closure. Thirty-two patients
      over an 18-year period have had satisfactory results with inconspicuous scars.
      Modification of platysma muscles and subplatysmal fat excision are facilitated by
      the wide exposure. Use of this method has been limited to those cases in which a
      large submental fold is present in a patient who declines to have a regular
      rhytidectomy or in cases of residual submental redundancy after a complete
      rhytidectomy. Occasionally, a rhytidectomy is not sufficient.

PMID- 8341743
TI  - Osseointegrated implants: a comparative study of bone thickness in four
      vascularized bone flaps.
AB  - Primary and secondary reconstruction of mandibular continuity defects with
      vascularized bone is currently the standard of care at many institutions. The
      most commonly utilized donor sites for such bone flaps include the scapula, iliac
      crest, fibula, and radius. Recently, interest has grown in the placement of
      osseointegrated implants into these flaps to facilitate functional dental
      rehabilitation. There are no studies comparing the bone available from each of
      these flaps into which osseointegrated implants can be placed. In this cadaver
      study, the dimensions of bone available for implant placement from the iliac
      crest, scapula, fibula, and radius osseous flaps were measured. The iliac crest
      and fibula flaps had bone dimensions consistently adequate for implant placement.
      Bone available for the safe placement of implants into the scapula flap was found
      in the majority of specimens. The radius flap group had the highest number of
      specimens that were inadequate for implant placement. The majority of the
      specimens with bone inadequate for implantation were from females. Clinical
      implications of this study regarding flap selection are discussed.

PMID- 8341744
TI  - Dermatofibrosarcoma protuberans of the chest and the shoulder: wide and deep
      excisions with immediate reconstruction.
AB  - Dermatofibrosarcoma protuberans is a rare malignant tumor of the skin. The only
      satisfactory treatment is surgical and consists of a wide excision. In our
      department, we have established the limits of the excision required to be a
      margin of 5 cm on the surface, whereas in the depth, we excise the first healthy
      anatomical structure encountered. Latissimus dorsi flap reconstruction was used
      for the major tissue deficit for 15 patients with dermatofibrosarcoma protuberans
      of the chest and the shoulder. When compared to skin grafting, this technique
      results in an improved aesthetic appearance and a stable cover for the
      periosteumless clavicle. Fourteen patients were followed for an average of 37.6
      months and all remained free of disease.

PMID- 8341745
TI  - A new approach to the study of skin vascularization.
AB  - There are several methods of quantifying the vascularization of tissues,
      including the skin, but they are imprecise in terms of quantification of the
      complexity and structure of vascular networks. Fractal analysis can quantify the
      complexity of any structure existing in nature by using fractional dimension.
      This study makes a case for this approach by demonstrating the fractal structure
      of the skin vascular network in the mouse. The skin was removed from the
      posterior face of the thigh, which is supplied by a musculocutaneous perforator
      system. Twenty arterial vascular networks were investigated by image analysis and
      the fractal dimension was determined by the box counting method. Statistical
      analysis revealed an average mean of fractal dimension D = 1.256 (SD = 0.086),
      indicating low to intermediate complexity with a narrow distribution of results.
      D should logically fluctuate within a certain limit, depending on the anatomical
      structure investigated and its physiological function. These results demonstrate
      the ability of fractal analysis to quantify the vascular pattern of the skin.
      Fractal analysis opens a new field of investigation in the study of
      vascularization patterns and possible vascular modification by different
      physiological or pathological conditions (flap-delay techniques, tobacco use,
      diabetes mellitus, classification of diabetic retinopathies).

PMID- 8341746
TI  - Adjuvanticity and arthritogenicity of silicone.
AB  - Potential adjuvanticity and arthritogenicity of silicone obtained from a mammary
      implant were investigated. Silicone, injected intraperitoneally in conjunction
      with heat-killed Mycobacterium tuberculosis and EL4 cells (mouse tumor cell, H
      2b), failed to enhance the development of immune response directed toward EL4
      cells in Lewis rats. Subplantar injection of silicone, alone or in combination
      with heat-killed M. tuberculosis, also failed to induce adjuvant arthritis in
      Lewis rats. These findings suggest that silicone has neither adjuvant activity
      nor arthritogenic property and is not an effective substitute for the mineral oil
      component of Freund's adjuvant.

PMID- 8341747
TI  - Soft tissue response to textured silicone implants in an animal experiment.
AB  - In a study on rats to assess soft tissue response to textured silicone implants,
      ellipsoid 15 x 20 mm pieces from the bag of a Biocell breast prosthesis were
      implanted under the dorsal skin. Histological examinations including
      immunohistochemical detection of myofibroblasts were made 2 weeks and 1, 3, 6,
      and 8 months after implantation (12 specimens for each time interval). On the
      smooth side of the implant, which served as a control, the thin connective tissue
      capsule characteristically seen with silicone elastomer implants developed within
      a month. Myofibroblasts were present after the first month and appeared to reach
      a peak 3 months after implantation, after which they showed marked regression. On
      the textured side of the implant, villous processes were a characteristic feature
      of the capsules; originating in a common basal layer, they penetrated into the
      cavities of the implant. Collagen deposits and myofibroblasts only became more
      evident during the third month after implantation; they were limited to the
      common basal layer of the capsule, though foreign body reaction persisted in the
      villous processes until the end of the experiment. The experimental study,
      limited to an 8-month period after implantation, showed that texturing of the
      implant surface prevents compact capsule development and considerably delays or
      inhibits the maturation process.

PMID- 8341748
TI  - Ultraviolet-A induced delayed wound contraction and decreased collagen content in
      healing wounds and implant capsules.
AB  - Chronic exposure to ultraviolet-A radiation causes changes in the biochemistry of
      dermal connective tissue. To investigate its effects on wound healing, we
      irradiated Sprague-Dawley rats for 4 months using a black ray ultraviolet-A
      radiation source (560 J/cm2). Full thickness skin wounds of 2 cm in diameter were
      then created on the back of each animal and silicone cubes were implanted
      subcutaneously into the irradiated area of the back. Wound contraction in the
      irradiated animals (n = 28) was significantly slower than that of the controls (n
      = 29) (p < 0.001). Postoperatively, the hydroxyproline content of the contracted
      wounds and the implant capsules was assessed at 6 and 12 weeks, respectively. In
      the irradiated animals, it was found to be significantly less than that of the
      controls (p < 0.001). A delay in wound contraction and a decrease in
      hydroxyproline content of healing wounds and implant capsules, reflecting an
      alteration in collagen metabolism, are two effects of prolonged intermittent
      ultraviolet-A radiation pretreatment.

PMID- 8341749
TI  - Microsurgical management of extremity wounds in diabetics with peripheral
      vascular disease.
AB  - Plastic surgeons are frequently called upon to evaluate wounds in diabetic
      patients with compromised vascular inflow. Although a few authors have reported
      success in coverage of such wounds with microsurgical techniques, enthusiasm for
      this procedure has remained low due to concerns about flap viability, occlusion
      of flow to the distal limb, and the usually poor systemic status of such
      patients. We report here on our experience with 19 diabetic patients with
      peripheral vascular disease and a nonhealing wound of the lower extremity treated
      over the last 4 years with microvascular tissue transfer. Two patients (10.5
      percent) suffered anastomotic difficulties and there was one flap loss (5
      percent). Major morbidity rates were acceptable, with only one perioperative
      death (5 percent) and three cases of nonfatal major systemic difficulties in the
      immediate postoperative period (16 percent). Despite the importation of well
      vascularized tissue, local morbidity at the recipient site was seen in nine
      patients (47 percent). The overall limb salvage rate was 72 percent during the
      period of follow-up, which averaged 22 months. Despite this loss of five limbs,
      all but three of the patients eventually returned to ambulation. The overall
      death rate in our series was only 2/19 (10.5 percent) over the period of follow
      up. Although further work needs to be done in this difficult group of patients to
      ascertain the long-term benefit (especially relative to the cost/benefit ratio),
      we feel that this series confirms the safety and short-term efficacy of
      microsurgical treatment of such individuals.

PMID- 8341750
TI  - Selection of topical antimicrobial agents for cultured skin for burns by combined
      assessment of cellular cytotoxicity and antimicrobial activity.
AB  - Cultured epidermal skin has become an adjunctive therapy for treatment of major
      burn injuries, but its effectiveness is greatly limited due to destruction by
      microbial contamination. To evaluate candidate drugs for use with cultured skin,
      a combined cytotoxicity-antimicrobial assay system was developed for
      determination of toxicity to cultured human keratinocytes and fibroblasts, and to
      common burn wound organisms (20 bacterial and 4 fungal strains). Candidate agents
      including Hibiclens (n = 3), amikacin, piperacillin, norfloxacin, and nystatin
      were tested separately and in combination (n = 6 each) for inhibition of growth
      of human cells and lytic activity on microorganisms in the wet disc assay. The
      data showed that: (1) Hibiclens was uniformly toxic to both cultured human cells
      and microorganisms; (2) norfloxacin had dose-dependent toxicity to human cells
      and broad effectiveness against microorganisms; and (3) norfloxacin (25
      micrograms/mL) plus nystatin (100 U/mL) had low toxicity to human cells and high
      toxicity to both Gram-positive and Gram-negative bacteria (20 of 20) and fungi (4
      of 4). Selection of topical antimicrobial drugs by these assays may improve
      effectiveness of cultured skin for burns and may be extended to the control of
      other surgical wound infections.

PMID- 8341752
TI  - Extensor digiti minimi tendon transfer to prevent recurrent ulnar drift.
AB  - Thirty percent of patients with rheumatoid arthritis develop ulnar drift.
      Although numerous operations have been described, recurrence of the deformity is
      frequent. We recommend use of the extensor digiti minimi tendon transfer to
      prevent recurrent ulnar deviation. The tendon insertion is moved from a dorsal
      location to a dorsal-radial position. In this new location, the tendon produces
      both extension and radial deviation. Moreover, this transfer is maximally
      effective in extension when ulnar drift is greatest. We have used this transfer
      28 times during the past 6 years. In evaluating patients more than 1 year after
      surgery, metacarpal phalangeal joint extension averaged 52 degrees and there was
      no evidence of recurrent ulnar drift of the little finger. The only problem was
      slight hyperextension of less than 5 degrees in approximately half of the
      patients. However, in no patient was this functionally a problem. We recommend
      the use of this tendon transfer in all patients with ulnar drift undergoing
      metacarpal phalangeal joint replacement for rheumatoid arthritis.

PMID- 8341751
TI  - The second dorsal metacarpal flap with vascular pedicle composed of the second
      dorsal metacarpal artery and the dorsal carpal branch of radial artery.
AB  - A pedicle second dorsal metacarpal flap, comprising the second dorsal metacarpal
      artery, the partial carpal arterial arch of the dorsal hand, and the dorsal
      carpal branch of radial artery, was designed. The flap may be rotated through two
      axes of rotation, one at the entry of carpal branch of radial artery into the
      first dorsal interosseous muscle and one at the entry of the recurrent cutaneous
      branch arising from the second dorsal metacarpal artery into the skin. The method
      introduced can increase as much as possible the length of the vascular pedicle of
      the second dorsal metacarpal flap. Thus, it can cover a small defect at a more
      distant area. If the width of this flap is not more than 3 cm, the donor site can
      be closed directly. The flap had been used in five cases with no necrosis of the
      flap or complication of the donor site. In further investigation of the
      postoperative patients, no stiffness and tightness have been observed through a
      short period of rehabilitation of the hand. The results are satisfactory. The
      anatomy, the operative technique, and three selective cases are described here.

PMID- 8341753
TI  - Verification of a free vascularized nerve graft model in the rat with application
      to the peripheral nerve allograft.
AB  - We report a vascularized sciatic nerve graft in the rat, based upon the femoral
      popliteal superior muscular artery pedicle. The pedicle may be raised from the
      common femoral artery via the popliteal artery, with accompanying venous drainage
      to the femoral vein. We have characterized two vessels: the middle tibial artery
      to the posterior tibial nerve and the arteria comitas nervus peroneus to the
      peroneal nerve. Plastic monomer and Evans blue labeled albumin injections
      established the anatomic model. The graft was reliably perfused at the time of
      isolation and 24 hours post-transplantation. The model was used to evaluate
      regeneration across allogeneic (ACI to Lewis, n = 12) versus syngeneic (Lewis to
      Lewis, n = 6) nerve grafts. Electrophysiologic and histomorphometric assessments
      demonstrated that the vascularized immunosuppressed allograft was similar to the
      vascularized syngeneic graft. Both were superior to the vascularized allograft
      without immunosuppression.

PMID- 8341754
TI  - The law poster and what it has done for me.

PMID- 8341755
TI  - Familial subungual keratoacanthoma in association with ectodermal dysplasia.
AB  - Described is the first report of familial SUKA, occurring in two of three sisters
      with ectodermal dysplasia, a rare, hereditary disorder involving ectodermally
      derived organ systems. Although rare, SUKA should be considered when assessing
      rapidly growing nailbed lesions. Differentiation from subungual squamous cell
      carcinoma is essential. Tumor excision and curettage and close postoperative
      follow-up are recommended, with conservative amputation reserved for tumor
      recurrences. If the diagnosis of SUKA is confirmed in a female, an association
      with ectodermal dysplasia should be sought.

PMID- 8341756
TI  - Aspergillosis complicating the grafted skin and free muscle flap in a diabetic.
AB  - A case of infected diabetic foot ulcer was reconstructed by a free muscle flap
      overlaid with a skin graft. Primary cutaneous aspergillosis involving the grafted
      skin and the transplanted muscle was described. The patient presented with an
      indurated grey-yellow plaque or black eschar in the wound without purulent
      discharge. Biopsies and cultures demonstrated A. flavus as the etiologic agent
      without evidence of systemic dissemination. Early diagnosis necessitates a high
      index of suspicion in immunocompromised patients with unusual cutaneous
      manifestation. Treatment consisted of aggressive debridement, systemic and local
      antifungal therapy, and delayed grafting. We concluded that primary cutaneous
      aspergillosis may occur at the reconstructed wound in an immunocompromised
      diabetic, and that it is a rare complication requiring prompt diagnosis and
      treatment.

PMID- 8341757
TI  - Replantation of the heel pad.
AB  - A heel microvascular replantation was done to a 17-year-old patient. The
      replanted heel survived completely. A year after the operation, the patient is
      working in agriculture and has no problem walking.

PMID- 8341758
TI  - The lines and grooves of the face: a suggested nomenclature.
AB  - The lines and grooves of the face commonly recognized and used by plastic
      surgeons, biological anthropologists, forensic medicine specialists, artists, and
      others are described. Proper Latin anatomical names for them are suggested. It is
      hoped that eventually these will be adopted by those who use them and published
      by the International Anatomical Nomenclature Committee.

PMID- 8341759
TI  - Paired five-flap Z-plasty.
AB  - Web-like contractures may occur along both the outer borders of joints, creating
      double-parallel contracture bands that turn into webs during movements. A
      combination of two "five-flap z-plasties" lying in confrontation to each other
      was used to release such contractures. The two Vs face each other and meet at
      their upper ends, forming a rhomboid (Fig. 1, a and b) or hexagon (Fig. 1, c and
      d) whose position remains unchanged after the contractures have been released and
      all the flaps transferred or advanced. This method has been used to release a
      total of seven double-parallel web-like linear contractures with very
      satisfactory results. Paired five-flap z-plasty seems to be superior when release
      of double web-like contractures, with the presence of sufficient spared skin, is
      contemplated.

PMID- 8341760
TI  - Recurrence of leukemia cutis within a cutaneous microvascular transplant.

PMID- 8341761
TI  - Elevator modification: enhancement for safety and confidence during orbital
      exploration.

PMID- 8341762
TI  - Dealing with the ruptured silicone gel breast implant.

PMID- 8341763
TI  - Could tight breast capsules "squeeze" a significant amount of silicone gel out of
      an implant?

PMID- 8341764
TI  - Serotonin2 receptor binding in blood platelets of schizophrenic patients.
AB  - Platelet serotonin2 (5-HT2) binding was determined in 47 neuroleptic-free
      schizophrenic patients and 42 normal control subjects. Although the maximum
      number of 5-HT2 binding sites (Bmax) was significantly higher in the blood
      platelets of schizophrenic patients than in those of the normal control subjects,
      the difference disappeared after correction for age and sex effects. However, the
      Bmax of schizophrenic patients who had made suicide attempts was significantly
      greater than that of schizophrenic patients who had not, as well as that of
      normal controls. There was no difference in Kd between the schizophrenic patients
      and control subjects, and no relation between Kd and suicide attempts. The
      importance of serotonin in schizophrenia and suicide attempts is discussed.

PMID- 8341766
TI  - Association of levels of N-acetyl-beta-glucosaminidase with specific psychiatric
      symptoms in bipolar patients.
AB  - The levels of N-acetyl-beta-glucosaminidase (NAG) in urine from 35 patients with
      bipolar affective disorder were compared with scores for the 90 items (symptoms)
      of the Symptom Checklist (SCL-90). There were significant negative correlations
      between NAG levels and 23 of the SCL-90 variables (symptoms). These symptoms
      could be grouped into the following categories: anxiety, unusual or psychotic
      thinking, suicidal thinking, dysphoria, irritability, nausea, headaches, memory
      problems, and loss of interest. Serotonin abnormalities may play a role in the
      production of many of these symptoms. The hypothesis that NAG could be a marker
      for a serotonin activity is discussed.

PMID- 8341765
TI  - Further evidence for the existence of endogenous serotonin uptake inhibitors and
      their purification by calmodulin affinity chromatography.
AB  - Experimental evidence suggests the occurrence of endogenous antidepressant-like
      compounds in the brain, blood plasma, and urine. After extensive purification by
      calmodulin-sepharose affinity chromatography, and further purification of the
      urine-derived sample by exclusion chromatography, at least three distinctive
      fractions have been identified. These fractions effectively inhibited serotonin
      uptake, imipramine, and/or paroxetine binding, and they apparently contained some
      compounds that were recognized by the anti-imipramine or anti-paroxetine
      antibodies. Their identification may have significant implications for studies of
      affective illness.

PMID- 8341767
TI  - Effects of single dose haloperidol administration on plasma homovanillic acid
      levels in normal subjects.
AB  - Homovanillic acid (HVA), an oxidative metabolite of dopamine, has been shown in a
      number of studies to reflect severity of symptoms and to predict response to
      neuroleptic treatment in schizophrenic patients. In several clinical studies, HVA
      levels have been shown to have a positive relationship with symptom severity and
      to decline over time upon treatment with antipsychotic agents. The magnitude of
      this decline appears to be related to the degree of symptom reduction in patients
      so treated. However, administration of dopamine postsynaptic antagonists should
      be expected to increase synaptic dopamine availability, thereby increasing HVA
      concentrations, according to traditional models of drug action. While in some
      studies, this appears to be the case, we saw no evidence of an early phase of HVA
      elevation after administration of 4- and 10-milligram doses of haloperidol to
      human volunteers. Rather, HVA levels declined during the period of absorption and
      attainment of peak haloperidol levels. Baseline HVA levels of 51.6 +/- 3.83
      pmoles/ml and 56.8 +/- 5.70 pmoles/ml (after 4 mg and 10 mg., respectively)
      declined to minima of 35.6 +/- 1.67 pmoles/ml and 26.3 +/- 5.34 pmoles/ml
      respectively, at 3-4 hours after haloperidol administration. A trend was noted
      for the 10-mg dose to produce a greater decline than the 4-mg dose, which was
      most apparent at 4 hours after drug administration. The shape of both curves did
      not appear to be substantially different than expected on the basis of diurnal
      variation. These preliminary findings support the concept that dopamine turnover
      in humans is not increased and may be decreased by short-term administration of
      conventional neuroleptics.

PMID- 8341768
TI  - Personality and benzodiazepine sensitivity in anxious patients and control
      subjects.
AB  - Cloninger has recently proposed a model of personality variability that is based
      on three independent heritable traits of harm avoidance, novelty seeking, and
      reward dependence, each of which is thought to be mediated by a separate
      neurochemical and neuroanatomic mechanism. The current study tested hypotheses
      generated on the basis of this theory in anxious patients and control subjects.
      Eighteen patients with panic disorder, 12 patients with generalized anxiety
      disorder, and 21 control subjects underwent both personality testing and
      assessment of their sensitivity to diazepam, as measured by slowing of saccadic
      eye movement velocity. As expected, anxious patients displayed higher harm
      avoidance scores than controls. Although an inverse correlation between harm
      avoidance and benzodiazepine sensitivity was predicted, no relationship between
      these variables was found in any diagnostic group. However, a significant
      correlation was found between novelty-seeking scores and sensitivity to diazepam.
      This finding, although not predicted by Cloninger's theory, is consistent with
      prior preclinical and human studies.

PMID- 8341769
TI  - Hypercortisolemia and hippocampal changes in depression.
AB  - Hypercortisolemia is a frequently observed abnormality in patients with major
      depression. It has been hypothesized that the hippocampus, as a major feedback
      site for glucocorticoids, is involved in the pathophysiology of
      hypercortisolemia. Some have in fact posited that the hippocampus is marked by
      diminished size in depressed patients with hypercortisolemia. We tested this
      hypothesis by examining the relationship between hippocampal volume, assessed
      with magnetic resonance imaging, and hypercortisolemia using the dexamethasone
      suppression test (DST) in a group of 19 depressed patients. No differences in
      hippocampal volume were observed between patients and control subjects (n = 30).
      Within the patient group, DST suppressors did not differ from DST nonsuppressors
      in hippocampal volume. However, a relationship between hippocampal volume and 11
      p.m. cortisol concentration was observed after covariance adjustment for age and
      sex. Furthermore, significant negative correlations were observed between
      hippocampal volume and both age of depressive onset and number of
      hospitalizations. The results of this study therefore provide limited support for
      the hypothesis regarding an essential role of the hippocampus in the
      neuroendocrine elevation of glucocorticoids in depression.

PMID- 8341770
TI  - Magnetic resonance abnormalities in HIV infection: a study in the drug-user risk
      group.
AB  - Cognitive impairment is a frequent complication of advanced human
      immunodeficiency virus-1 (HIV-1) infection. However, structural imaging of the
      brain has not revealed abnormalities that precede the onset of clinical
      abnormalities. Cranial magnetic resonance (MR) studies were performed in 28 male
      subjects with intravenous drug use histories; nine were HIV-1 seronegative, 11
      were HIV-1 seropositive but asymptomatic, and eight were seropositive and met
      symptomatic criteria for acquired immune deficiency syndrome (AIDS). Cortical
      atrophy, but not the degree of ventricular enlargement or signal abnormalities,
      was increased in the seropositive group compared with the seronegative group and
      also differed between asymptomatic seropositive and seronegative patients. An
      increased level of cortical atrophy may reflect the early impact of HIV-1
      infection on the brain.

PMID- 8341771
TI  - Hyperdopaminergia in schizophreniform psychosis: a chronobiological study.
AB  - Circadian rhythm abnormalities have been described in various psychiatric
      disorders, but they have not received much attention in studies of schizophrenia
      and schizophreniform psychosis. The present study used the cosine model to
      determine the circadian patterns of amino acids, dopamine, and prolactin
      concentrations, which were analyzed over a 24-hour period in serum of healthy
      subjects, drug-free schizophrenic patients, and neuroleptic-treated schizophrenic
      patients. The mesor (the daily mean) of phenylalanine was lower in drug-free
      schizophrenic women than in healthy women. The mesors of the ratio of
      phenylalanine or tyrosine to competing amino acids were similar in healthy
      subjects and patients. The ratio of phenylalanine/competing amino acids showed a
      phase advance (i.e., earlier onset of the time of highest concentration) in drug
      free patients compared with healthy subjects. Schizophrenic patients displayed a
      higher dopamine mesor than healthy subjects. Female drug-free schizophrenic
      patients had lower prolactin mesors and lower amplitudes (i.e., half of the total
      predictable change in rhythm) than healthy women. Compared with healthy subjects,
      schizophrenic patients showed a phase advance of circadian prolactin
      concentrations. Neuroleptics raised the prolactin mesor and amplitudes but did
      not elicit any phase change in amino acids, dopamine, or prolactin. These data
      confirm the indirect pharmacologic evidence of increased dopaminergic activity in
      schizophrenic patients that relates to dopamine's precursors and to the
      neuroendocrine regulation of prolactin.

PMID- 8341772
TI  - Disease prevention through immunization: the beginning of health care reform.

PMID- 8341773
TI  - The president's child immunization initiative--a summary of the problem and the
      response.
AB  - After only 24 days in office, President Bill Clinton announced a comprehensive
      childhood immunization initiative designed to assure that all children in the
      United States lead healthier lives by receiving age-appropriate immunizations
      against preventable diseases such as polio, mumps, measles, whooping cough, and
      diphtheria. As part of his economic stimulus proposal, the President requested
      $300 million for Fiscal Year 1993 to reinforce the nation's immunization
      infrastructure by providing funding for communities to extend clinic hours,
      provide more staff, and increase information and education efforts and for the
      planning and implementation of a national immunization tracking system. In its
      Fiscal 1994 budget request, the Administration asked for a doubling of the
      Centers for Disease Control and Prevention's immunization program funding to $667
      million. In cooperation with key congressional committees, the Administration has
      also prepared legislation that would provide recommended childhood vaccines to
      States for free distribution to health care providers who serve children enrolled
      in Medicaid or who don't have health insurance that covers immunization services.
      Providers could not charge for the vaccine but could charge a fee for
      administration. State Medicaid programs would also be required to reimburse
      providers reasonably for vaccine administration. This measure is designed to
      improve universal access to immunization services by helping to remove financial
      barriers that impede children from being immunized at the appropriate age.

PMID- 8341774
TI  - Evaluation of telephoned computer-generated reminders to improve immunization
      coverage at inner-city clinics.
AB  - The authors evaluated the effectiveness of computer-generated telephoned
      reminders used to raise the rates of on-time immunization among preschool-age
      children in two public clinics in Atlanta, GA. The overall effect of the
      intervention on immunization levels appeared to be minimal (crude relative risk =
      1.07, 95 percent confidence interval = 0.78, 1.46), in part because only about 80
      percent of children in both the randomly selected intervention group and in the
      control group were members of a household with a telephone number listed in
      clinic records. However, logistic regression analysis indicated that 36 of 68
      children (52.9 percent) in the intervention group whose households were reached
      were vaccinated within 30 days of their due dates, compared to 31 of 75 children
      (41.3 percent) in the control group whose household telephone numbers were
      recorded but not called (adjusted odds ratio = 2.12, 95 percent confidence
      interval = 1.01, 4.46). This analysis indicates that telephoned reminders
      demonstrated a level of effectiveness in improving immunization levels at inner
      city clinics that recommends further trial and study.

PMID- 8341775
TI  - Evaluation of a two-dose measles, mumps, and rubella vaccination schedule in a
      cohort of college athletes.
AB  - Despite high vaccination levels, measles outbreaks continue to occur among
      vaccinated adults. In response, new guidelines call for two doses of measles
      vaccine. To determine seroprevalence and response to vaccination in seronegative
      persons, we tested serums from 256 college athletes at a Maryland State college
      by enzyme-linked immunosorbent assay, vaccinated seronegatives, then re-tested
      vaccinees. High school records were obtained for persons seronegative to measles.
      Of 256 students, 53 (21 percent) were seronegative to measles alone, 13 (5
      percent) were seronegative to rubella alone, and 5 (2 percent) were seronegative
      to both. Among those seronegative to measles, 86 percent had previously received
      a dose of measles vaccine. After vaccination, 37 persons initially seronegative
      to measles and 9 seronegative to rubella were 97 percent and 100 percent
      seropositive, respectively. The high measles seroconversion rate suggests that
      the two-dose vaccine schedule should effectively control campus measles outbreaks
      and, if given as measles-mumps-rubella vaccine, will also improve immunity to
      rubella and mumps.

PMID- 8341776
TI  - An epidemiologic investigation of a rubella outbreak among the Amish of
      northeastern Ohio.
AB  - From April 1990 to April 1991, 278 cases of rubella were reported to the Ohio
      Department of Health. Of these, 276 (99 percent) were among the Amish of
      northeastern Ohio. The outbreak involved eight counties in an area that contains
      large settlements of Old Order Amish. Members of this community of Amish
      frequently take religious exemption from recommended immunization practices and
      are believed to represent a high proportion of Ohio's rubella-susceptible
      persons. Vaccination history was known only for 146 of the Amish people. Of
      those, only four had a positive history of rubella vaccination. Of the 276 Amish
      with cases of rubella, 65 (24 percent) were younger than age 5 years, 104 (38
      percent) were ages 5-14, 46 (17 percent) were ages 15-19, 32 (12 percent) were
      ages 20-29, 6 (2 percent) were ages 30 or older, and age was not reported for 23
      (8 percent). The ratio of males to females with rubella was 1:1. Five women of
      the Amish community were pregnant; four had been ill with symptoms consistent
      with rubella. Three were in their first trimester. Congenital rubella syndrome
      did not occur in any of the four live births. Serology was available for only the
      two non-Amish people, and both were acute phase serum-positive for Immunoglobulin
      M.

PMID- 8341777
TI  - Pneumococcal vaccination in a remote population of high-risk Alaska Natives.
AB  - In response to an increasing prevalence of serious pneumococcal disease among
      adult Alaska Natives of northwest Alaska, a 3-year program was begun in 1987 to
      identify residents of that remote region who were at high risk for developing
      invasive pneumococcal disease, to determine their pneumococcal vaccination
      status, and to deliver vaccine to at least 80 percent of those at risk. After
      reviewing public health nursing and Indian Health Service data bases, the authors
      identified 1,337 persons, 20 percent of the 6,692 residents of the region, at
      high risk for invasive pneumococcal infection, defined either by having a
      specific chronic disease or by age criteria. Cardiovascular disease and
      alcoholism were the two most common chronic diseases. Only 30 percent of those
      determined to be at high risk had received one or more doses of pneumococcal
      vaccine previously. Half of those persons had received their most recent
      vaccination 6 or more years earlier. The program used both customary and
      innovative methods to deliver 23-valent polysaccharide vaccine to 1,046 of those
      at high risk (78 percent), including 388 persons who were revaccinated. At the
      completion of the project, 1,123 persons, 84 percent of those at high risk, had
      received at least 1 dose. They included 1,088 persons, 81 percent of those at
      high risk, with vaccination within the previous 5 years as a result of the
      project, compared with a 15-percent rate prior to the vaccination phase of the
      project. The program demonstrated that high levels of vaccination against
      pneumococcal disease, exceeding Year 2000 objectives of 60 percent, are
      attainable in a remote rural Alaskan population.

PMID- 8341778
TI  - Risk factors for septicemia-associated mortality in older adults.
AB  - Septicemia is the 10th leading cause of death among older adults in the United
      States; its mortality rate has steadily increased over the past decades. Little
      is known about factors which predispose to septicemia mortality in the elderly.
      The authors investigated risk factors for septicemia-associated mortality in
      10,269 older adults as part of a longitudinal study of three communities (East
      Boston, MA; New Haven, CT; and Iowa and Washington Counties, IA). During 6 years
      of followup, 177 persons (3.2 per 1,000 person-years) had septicemia ICD9 038
      (International Classification of Diseases, ninth revision) reported on their
      death certificate. In a multivariate proportional-hazards model, septicemia
      mortality was significantly (P < 0.05) and independently associated with age,
      male sex, history of diabetes, history of cancer requiring hospitalization,
      smoking one pack of cigarettes per day or more, not drinking alcohol in the year
      prior to baseline, disability in activities of daily living, cognitive
      impairment, and missing cognitive testing score. These factors might be useful in
      developing an at-risk population for testing septicemia treatment or prevention
      strategies in a community setting. Further investigation is needed to explain
      underlying mechanisms of increased risk of subsequent septicemia.

PMID- 8341779
TI  - Stroke mortality and its socioeconomic, racial, and behavioral correlates in
      Florida.
AB  - Stroke mortality is associated both with being black and with having low
      socioeconomic status. However, it is uncertain to what extent that increased risk
      is related to rates of behavior-related risk factors, such as hypertension,
      cigarette smoking, obesity, or alcohol consumption. The investigators performed
      an ecologic analysis to estimate the contributions of behavioral risks,
      socioeconomic status, and black race to regional variations in stroke mortality
      rates among persons 55-84 years of age in Florida. They used data from the 1980
      census and from the Behavioral Risk Factor Surveillance System (BRFSS) for 1986
      through 1988. Weighted multiple linear regression models indicated that regions
      in Florida with high stroke mortality rates were characterized by high
      prevalences of poverty, obesity, and hypertension. Although limited by its
      ecologic design, this study suggests that socioeconomic status and prevalence of
      behavioral risks contribute independently to interregional disparities in stroke
      mortality rates in Florida. BRFSS data, now available for more than 45 States,
      can be used to help clarify the relative contributions of behavioral and other
      risks to population-based mortality rates.

PMID- 8341780
TI  - Where and how adolescents obtain alcoholic beverages.
AB  - Patterns of acquisition of alcoholic beverages by underage youth were studied,
      using focus group methods with a sample of midwestern youth. Results showed that
      the alcohol initially used by those in their early teens is obtained from
      parents' stocks or from older siblings and friends. By the midteens, parties at
      which alcohol (usually beer) is readily available become the major source. In the
      mid to late teens, young people purchase alcohol from commercial alcohol outlets,
      despite the fact that 21 is the legal age for purchasing alcohol. Factors
      reported to increase the rate of successful alcohol purchases include female
      buyer, male seller, young seller, and convenience store outlet. Results of focus
      group interviews revealed the easy accessibility of alcoholic beverages to
      underage youth. Further investigation into patterns of underage access to alcohol
      is recommended, with results from the focus group study guiding the design of
      probability sample studies to assess their generalizability.

PMID- 8341781
TI  - Self-reported frequency of serum cholesterol testing, awareness of test results,
      and laboratory cholesterol values in two South Carolina communities.
AB  - Self-reported frequency of cholesterol testing and awareness of test results were
      collected from 5,246 adults 18 years and older in two semirural communities in
      South Carolina. Serum cholesterol was also measured for about 60 percent of this
      group. More than half of these persons had serum cholesterol values greater than
      200 milligrams per deciliter (mg per dL) and 21 percent had values greater than
      240 mg per dL. One-third of the population had had their cholesterol level
      measured within the past year; 40 percent reported that their cholesterol level
      had never been measured. Among persons whose cholesterol was 240 mg per dL or
      more, 39 percent reported that their cholesterol had never been measured or that
      they did not know if it had been measured, 37 percent reported that their
      cholesterol had been measured but that they were not told that it was high, and
      18 percent reported that their cholesterol had been measured and that they were
      advised to reduce it. Among persons whose cholesterol was 200 mg per dL or more,
      and who reported that they had cardiovascular disease, 25 percent reported that
      they were advised to reduce their cholesterol. These results emphasize the need
      to increase the proportion of the population who have had their cholesterol level
      measured, who know their test results, and who have been properly counseled about
      the results.

PMID- 8341782
TI  - Lung cancer rates in the Hispanic population of Connecticut, 1980-88.
AB  - To identify lung cancer patients of Hispanic ethnicity, surnames in the
      Connecticut Tumor Registry were matched with the 1980 Spanish surname list of the
      U.S. Bureau of the Census. Also death certificates for women with lung cancer in
      the registry were examined to ascertain maiden names. For women Hispanic surnames
      in the registry were not good indicators of ethnicity; their sensitivity was only
      58 percent when compared with the decedent's maiden name. Estimated age-specific
      incidence rates for lung cancer during the 1980-88 period among Hispanic men,
      using surnames in the registry, were lower than the rates for non-Hispanic men,
      as expected from studies of Hispanic mortality in the Northeast. The distribution
      of histologic types, including those most strongly associated with smoking, was
      similar for Hispanic and non-Hispanic men. Although estimated lung cancer
      mortality rates were low for Hispanic men defined by surname, higher standard
      mortality ratios for Puerto Rican-born versus other Hispanic men suggested
      heterogeneity in lung cancer death rates of the Hispanic population of
      Connecticut. Lung cancer incidence and mortality rates should continue to be
      monitored in the Hispanic population of Connecticut, in view of anticipated
      increases attributable to trends in smoking behavior, and interventions should be
      planned to counteract anticipated increases.

PMID- 8341783
TI  - Local health departments implement a theory-based model to increase breast and
      cervical cancer screening.
AB  - Su Vida, Su Salud/Your Life, Your Health is a community program to increase
      participation in breast and cervical cancer screening. This program illustrates
      the diffusion of an innovative outreach strategy from a research environment to
      two local health departments. The program uses A Su Salud, the communication
      model in which positive role models are featured in the media, and community
      volunteers who give positive social reinforcement. Local health departments in
      Galveston and Corpus Christi, TX, were selected to implement the model because of
      excessive mortality rates in the region and the departments' adequate level of
      resources and commitment. Over an 18-month period, 54 stories of role models
      appeared in the media in Corpus Christi, and 60 appeared in Galveston. There were
      490 volunteers active in Corpus Christi and 279 in Galveston. Of 365 inquiries to
      the Corpus Christi program, 35 percent were from the Mexican American target
      group of women ages 40-70. Of 1,457 women who contacted the Galveston program, 9
      percent were from the African American target group ages 40-70. Local health
      departments are well-suited to participation in cancer control research
      applications because they have direct access to high-risk populations and have
      the authority to institutionalize effective interventions.

PMID- 8341784
TI  - Traumatic occupational fatalities in South Carolina, 1989-90.
AB  - Death certificates for South Carolina for 1989 and 1990 were examined to identify
      deaths resulting from injury incurred in the workplace. There were 277 deaths in
      that category in the 2-year period, an average yearly rate for traumatic
      occupational fatalities of 8.84 per 100,000 workers. The groups of industries
      with the highest fatality rates were transportation-communication-utilities,
      construction, and agriculture-fishing-forestry. The leading causes of death were
      injuries from motor vehicle crash, homicide, and falls. The traumatic
      occupational fatality rate for men was about 13 times greater than that for
      women; however, a much higher proportion of women died from homicide on the job.
      The findings in general reflect trends reported in other studies. The death rates
      for workers in South Carolina for 1989-90, however, were higher than national
      averages for 1980-88. National data for 1989-90 were not available for
      comparison. The data suggest that more effective injury prevention efforts need
      to be applied to such causes of on-the-job injury as motor vehicle crash,
      homicide, and falls. Those three categories accounted for more than 56 percent of
      all traumatic occupational fatalities in South Carolina in 1989 and 1990. Motor
      vehicle crash prevention efforts particularly are needed in the transportation
      communication-utilities industries. The findings show that particular efforts
      need to be directed to the retail trade category for prevention of homicide and
      to the construction industry for prevention of falls.

PMID- 8341785
TI  - Deaths among the homeless in Fulton County, GA, 1988-90.
AB  - The circumstances surrounding the deaths of 128 homeless persons investigated by
      the Fulton County, GA, Medical Examiner's Office during the period 1988-90 and
      the demographic characteristics of the deceased were studied and analyzed.
      Emphasis was placed on cause and manner of death, unintentional injuries, and
      alcohol-related mortality. Ninety-eight percent of those who died were men, 55
      percent occurred outdoors, 55 percent were due to natural causes, and 42 percent
      resulted from injuries, most of which were unintentional. The average age at
      death was 46 years, and 80 percent of those who died were found dead. Nearly half
      of the deaths (47 percent) were related to the acute or chronic effects of
      alcohol; the blood of 45 percent tested positive for ethanol; of that 45 percent,
      75 percent had a blood ethanol concentration that exceeded 0.1 grams per
      deciliter. Mortality patterns among the homeless persons in the study were
      similar to those previously reported in Fulton County and in San Francisco, CA.
      Available data indicate that mortality prevention strategies for the homeless in
      Fulton County should target alcohol abuse and unintentional injuries. Further
      studies are needed to document regional mortality patterns of the homeless.

PMID- 8341786
TI  - Birth outcomes of Korean women in Hawaii.
AB  - Since the end of the Korean War, immigration of Koreans to the United States has
      increased rapidly. In 1990, 11.6 percent of all Asians in the United States were
      of Korean ethnicity, and it is projected that Koreans will outnumber all other
      Asian groups, except Filipinos, in the United States by the year 2030. Despite
      the growing size of this population, very little is known about their health
      status. This study, using 1979-89 Hawaii vital record data, investigates the
      relationship between maternal sociodemographic characteristics, prenatal care
      utilization factors, and birth outcomes among Koreans as compared with
      Caucasians. The ethnic term "Caucasian" is used in Hawaii's vital records and is
      synonymous with non-Hispanic whites. Korean mothers were more likely to be older
      and have lower educational attainment, and less likely to be adolescent, single,
      or to have received adequate prenatal care than Caucasian mothers. More than 80
      percent of the Korean mothers were foreign born. Significantly higher risks for
      very preterm delivery (less than 33 weeks) and very low birth weight births were
      observed for Koreans as compared with Caucasians. Nativity had no effect on birth
      outcome in this population. The results of this study suggest that prevention of
      preterm birth is an important focus for improving pregnancy outcomes in this
      growing ethnic group.

PMID- 8341787
TI  - Prevalence of aortic aneurysms in the Twin Cities metropolitan area, 1979-84.
AB  - The discharge summaries for Minneapolis-St. Paul metropolitan area residents
      hospitalized during 1979-84 were reviewed for diagnoses of aortic aneurysms.
      Annual age-specific and age-adjusted sex-specific hospital discharge diagnosis
      rates were calculated for all aortic aneurysms, dissecting aortic aneurysms,
      thoracic aortic aneurysms (nondissecting), and abdominal aortic aneurysms
      (nondissecting). For each aortic aneurysm type, hospital discharge diagnosis
      rates were found to increase with age for both men and women. Abdominal aortic
      aneurysms were the most common type reported (age-adjusted annual rates for men
      varied between 40.6 and 49.3 per 100,000 population; for women, between 6.8 and
      12.0 per 100,000 population). Men were noted to have higher rates for each
      aneurysm type. An increasing temporal trend was observed for all aortic aneurysms
      and abdominal aortic aneurysms among men. These findings are reviewed in light of
      recent data on mortality from aortic aneurysms in the United States.

PMID- 8341788
TI  - Do anti-smoking media campaigns help smokers quit?
AB  - As part of an evaluation of the 1990-91 anti-tobacco media campaign carried out
      by the California Department of Health Services, a study was conducted among 417
      regular smokers who had quit during the period of the media campaign. In brief
      telephone interviews, all respondents identified up to three events or
      experiences that had influenced them to quit. In response to uncued questions,
      6.7 percent of those interviewed indicated that they had been influenced to quit
      by an advertisement they had seen or heard on radio, television, or billboards.
      In response to direct questions about the media campaign, 34.3 percent of the
      respondents indicated that the media campaign's advertisement had played a part
      in their decision to quit. Applying the 6.7 percentage to the number of
      Californians who quit smoking in 1990-91, it can be estimated that for 33,000
      former smokers, the anti-tobacco media advertisements were an important stimulus
      in their quit decision. Multiplying the 34.3 percent by the number of former
      California smokers who quit in 1990-91, the estimate of former smokers for whom
      the media campaign's advertisements played at least some part in their decision
      to quit rises to 173,000 persons. While causal attributions from such
      investigations should be made with caution, the evidence suggests that the 1990
      91 campaign did influence substantial number of smokers in California to quit.

PMID- 8341789
TI  - Variability and consistency of rates of primary and repeat cesarean sections
      among hospitals in two states.
AB  - Hospitals in New York and Illinois have wide variations in their primary and
      repeat cesarean section rates. A number of factors account for these differences.
      To investigate whether hospitals with higher or lower rates tend to continue
      these patterns over time, their rates in 1988 were compared with those in 1983.
      It was found that a hospital's cesarean section rate was consistent, but some
      regression to the mean process did occur. By 1988, teaching hospitals had lower
      rates than nonteaching hospitals; this difference is likely due to the greater
      response to calls for increasing trials of vaginal birth after a previous
      cesarean section by teaching hospitals. Over time this should contribute to
      further moderating of the rates. Data were from the Illinois and New York State
      Departments of Health.

PMID- 8341790
TI  - NIAID mounts nationwide HIV-TB treatment study.

PMID- 8341791
TI  - NIAID to test new AIDS vaccines on pregnant women with HIV.

PMID- 8341792
TI  - AIDS history conference set for Oct. 28-29 at NIH.

PMID- 8341793
TI  - FDA clears the way for ending shortage of TB treatment drug.

PMID- 8341794
TI  - Nurses insist "fetus dead": "fetus alive" & catastrophe.

PMID- 8341795
TI  - Dr. improperly orders discharge: should nurse intervene? Case in point: NKC
      Hospitals, Inc. v. Anthony 849 S.W. 2d 564 KY (1993).

PMID- 8341796
TI  - MI: expert testimony--$1.3 million judgment: expert's qualifications issue.

PMID- 8341797
TI  - NY: siderails down--patient injured: hospital failed to comply with own rules.

PMID- 8341798
TI  - Loose "screw" left in patient: vicarious liability issue. Case in point:
      Hunnicutt v. Wright 986 F. 2d 119 MS (1993).

PMID- 8341799
TI  - Analysis of rice genes in transgenic plants.

PMID- 8341800
TI  - tRNA structure and aminoacylation efficiency.

PMID- 8341801
TI  - Evolution of Ca(2+)-dependent animal lectins.

PMID- 8341802
TI  - Immunoglobulin gene diversification by gene conversion.

PMID- 8341803
TI  - ADP-ribosylation factors: protein activators of cholera toxin.

PMID- 8341804
TI  - Molecular biology in the eicosanoid field.

PMID- 8341805
TI  - How tautological are interspecies correlations of carcinogenic potencies?
AB  - Crouch and Wilson demonstrated a strong correlation between carcinogenic
      potencies in rats and mice, supporting the extrapolation from mouse to man.
      Bernstein et al., however, show that the observed correlation is mainly a
      statistical artifact of bioassay design. Crouch et al. have a comeback. This
      paper will review the arguments and present some new data. The correlation is
      largely (but not totally) tautological, confirming results in Bernstein et al.

PMID- 8341806
TI  - Armitage-Doll two-stage model: implications and extension.
AB  - The objective of this paper is twofold: (1) to provide insight on the simplified
      MVK model of carcinogenesis (a model proposed by Moolgavkar and colleagues) by
      revealing the relationship between the Armitage-Doll two-stage model and the
      simplified MVK model; and (2) to extend the Armitage-Doll two-stage model to one
      with time-varying (piece-wise constant) parameters. It is shown that the
      simplified MVK model is a special case of the Armitage-Doll two-stage model, and
      many applications of the simplified MVK model involving intermittent exposures or
      exposures to different compounds in different time periods can be derived easily
      from the Armitage-Doll two-stage model with piece-wise constant parameters. The
      limitations of the Armitage-Doll two-stage model are discussed.

PMID- 8341807
TI  - The risks of licensing persons with diabetes to drive trucks.
AB  - The 1990 Americans with Disabilities Act forbids employers to bar disabled
      persons from jobs unless employers can show the disabled person cannot perform
      the tasks. The Federal Highway Administration will not license persons with
      diabetes mellitus to drive commercial motor vehicles in interstate commerce.
      These individuals may experience severe hypoglycemia, greatly increasing their
      risk of losing control of the truck. This prohibition is currently being
      reexamined. We describe the disease process leading to severe hypoglycemia and
      its physical manifestations. To quantify the risks of licensing persons with
      diabetes to use insulin, we first estimate the number of potential insulin-using
      drivers. We estimate that 1420 insulin-using persons would seek licenses in the
      United States if they were permitted to do so (920 noninsulin dependent and 500
      insulin dependent). Next, we estimate the annual incidence of mild and severe
      hypoglycemia in these populations. The third step is to estimate the number of
      hypoglycemic episodes while driving. Estimating the likelihood of a crash due to
      a mild or severe hypoglycemic episode is the fourth step. We estimate that an
      additional 42 crashes each year would occur if insulin using persons were
      licensed to drive commercial motor vehicles in interstate commerce (20 from
      insulin dependent and 22 from non-insulin dependent drivers).

PMID- 8341808
TI  - Should persons with diabetes be licensed to drive trucks?--Risk management.
AB  - How should a regulatory agency interpret a risk analysis that concludes there is
      a small increase in risk? The agency must decide on behalf of society whether the
      increased risk is large enough to justify banning the risky activity or taking
      some other step to lessen the risks. In a companion paper (Songer et al.), we
      conclude that licensing insulin using persons to drive commercial motor vehicles
      in interstate commerce would result in 42 additional crashes each year. Here we
      address risk management issues by interpreting the number of additional crashes
      and the relative risks of the prospective handicapped drivers. Are the number of
      additional crashes (42) significant? Is the increase in the annual crash risk
      (from 0.00785 to 0.032 for non-insulin dependent and 0.048 for insulin dependent
      persons) significant? Are the relative risks significant for all insulin using
      drivers (4.7)? For drivers with a history of severe hypoglycemic reactions
      (19.8)? How should society tradeoff risk increases for increases in opportunity
      for these handicapped persons? We review other social decisions concerning
      highway safety: Accepting the increasing risks of letting 16 year olds drive,
      allowing extremely light cars, allowing some unsafe highways, and allowing
      extremely unsafe driving conditions at some times of day. We conclude that the
      additional risks from insulin using persons are well within the current accepted
      range of risks.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341810
TI  - Re-evaluation of the reference dose for methylmercury and assessment of current
      exposure levels.
AB  - Methylmercury (Me-Hg) is widely distributed through freshwater and saltwater food
      chains and human consumption of fish and shellfish has lead to widespread
      exposure. Both the U.S. EPA Reference Dose (0.3 micrograms/kg/day) and the
      FAO/WHO Permissible Tolerable Weekly Intake (3.3 micrograms/kg/week) are
      currently based on the prevention of paraesthesia in adult and older children.
      However, Me-Hg exposure in utero is known to result in a range of developmental
      neurologic effects including clinical CNS symptoms and delayed onset of walking.
      Based on a critical review of developmental toxicity data from human and animal
      studies, it is concluded that current guidelines for the prevention of
      paraesthesia are not adequate to address developmental effects. A dose of 0.07
      micrograms/kg/day is suggested as the best estimate of a potential reference dose
      for developmental effects. Data on nationwide fish consumption rates and Me-Hg
      levels in fish/seafood weighted by proportion of the catch intended for human
      consumption are analyzed in a Monte Carlo simulation to derive a probability
      distribution of background Me-Hg exposure. While various uncertainties in the
      toxicologic and exposure data limit the precision with which health risk can be
      estimated, this analysis suggests that at current levels of Me-Hg exposure, a
      significant fraction of women of childbearing age have exposures above this
      suggested reference dose.

PMID- 8341809
TI  - An investigation of indoor air contamination in residences above dry cleaners.
AB  - An investigation of residences located above dry cleaning facilities was
      conducted to determine whether indoor and outdoor air concentrations of the dry
      cleaning solvent tetrachloroethene (perchloroethylene, PCE) were elevated
      compared to residences not near a dry cleaning facility. Data were also collected
      on the dry cleaners' operating conditions and equipment. Significantly elevated
      levels of PCE were found in the indoor air of each of six apartments located
      above dry cleaners compared to control residences for both day and night samples.
      The PCE concentrations in outdoor air near the dry cleaners were also
      significantly elevated compared to control locations and were lower than the
      concentrations measured indoors. The type of dry cleaning machine was
      significantly associated with the concentration of PCE found in the apartment
      above. A strong correlation was also found between the day and night PCE levels
      in the study apartments.

PMID- 8341811
TI  - [Serum ferritin and Still's disease in adults].

PMID- 8341812
TI  - [Candidiasis in high-risk units. A pending problem].

PMID- 8341813
TI  - [Candidiasis in an intensive care unit].
AB  - The risk of being infected by candidiasis in an Intensive Care Unit (ICU) is
      evaluated, using an algorithm which allows the establishment of an early
      fungicidal treatment. This is a study which includes 34 patients with a mortality
      of 35%. Yeasts are detected from the second week at ICU, related with the long
      stay of patients at ICU and the relationship between mortality and age. The first
      positive sample usually does not indicate disseminate candidiasis (9%) or a
      positive blood culture (6%). Population defined as high risk for disseminated
      candidiasis (HRDC) with a negative blood culture has the worst prognosis (18
      cases, 50% mortality rate). The six cases with HRDC with positive blood culture
      showed a mortality of 17%. In seven cases there were no HRDC criteria (mortality
      of 14%). With said study the existence or not of a HRDC could be determined,
      establishing the adequate antifungal treatment.

PMID- 8341814
TI  - [Disorders secondary to iodine deficiency in the autonomous community of the
      Murcia area].
AB  - Hypothesis. To know goiter prevalence, iodine excretion and disorders associated
      to iodine deficiency in the region of Murcia, with the aim to define the need for
      establishing iodine prophylaxis programs. Method. Transversal study on 1956
      pupils of the region of Murcia, with an age between four and seventeen years old,
      stratified by sex, age and area of origin, evaluating thyroid size, grade,
      weight, height, school performance and problems, menarche age, fish and iodine
      salt intake and iodine excretion. Results. Global prevalence of goiter was 29%,
      we found a mean ioduria of 93.92 +/- 56.83 micrograms/l. Anthropometric mean
      values for each age group did not differ between pupils affected by the lack of
      iodine and the others. A lower school performance was found in pupils with iodine
      deficit. Fish intake did not play a role in goiter prevalence. Conclusions.
      Murcia is an area affected by disorders derived from mild iodine deficiency,
      which implies the need to establish a continuous plan of effective prophylaxis
      with iodine salt.

PMID- 8341815
TI  - [Oxidative hepatic metabolism in chronic alcoholics during the acute abstinence
      period: evaluation with antipyrine elimination].
AB  - In chronic alcoholics, while they consume ethanol, an increase in the oxidative
      hepatic metabolism is produced by means of an increment of microsomal enzymes
      induced by ethanol. In our study we have appraised this hepatic metabolism during
      the period of acute ethilic abstinence. This study has been performed in 20
      chronic alcoholics without clinical symptoms, after five days free of ethanol
      drinks. The assessment of oxidative hepatic metabolism was realized by means of
      the measuring of corporal antipyrine clearance (by saliva elimination), being
      compared to those performed in a control group of ten healthy adults. Antipyrine
      clearance (5.5 +/- 2 l/h) is increased significatively in chronic alcoholics
      respect to the control group value (3.4 +/- 1 l/h) (p < 0.01). Elimination half
      life of antipyrine in chronic alcoholic groups (7.6 +/- 3 h) is decreased
      significatively respect to the control group value (11.2 +/- 2 h) (p < 0.01).
      During the period of acute abstinence, the oxidative hepatic metabolism persists
      increased. In these patients, when we administer drugs with hepatic metabolism
      following the same metabolic way that antipyrine, it will be necessary to
      readjust the maintenance dose to attain its therapeutic effect.

PMID- 8341816
TI  - [Paroxysmal dystonia as the first manifestation of multiple sclerosis].
AB  - We discuss the case of a patient with episodes of left unilateral paroxysmal
      dystonia as first manifestation of multiple sclerosis, secondary to a
      demyelinization lesion in posterior arm of right internal capsule, detected by
      nuclear magnetic resonance (NMR). These episodes diminished with carbamazepine at
      low doses.

PMID- 8341818
TI  - [Epidermoid carcinoma of the pancreas associated with malignant humoral
      hypercalcemia].
AB  - Pure squamous carcinoma is a rare pancreas cancer histological variety. Moreover
      the association of malign humoral hypercalcemia and neoplasia of the pancreas
      exocrine portion is extremely rare. The case of a patient with pure squamous
      pancreas carcinoma and hypercalcemia is discussed. The absence of bone metastasis
      allowed to classify it within the malign humoral hypercalcemia syndrome. It is
      the first case described in the spanish scientific literature and the third in
      the international literature of an epidermoid pancreas carcinoma associated to
      malign humoral hypercalcemia.

PMID- 8341817
TI  - [Usefulness of serology in the diagnosis of Candida tropicalis septicemia].
AB  - In this study, we have evaluated the usefulness of eight serologic tests in the
      diagnosis of a Candida tropicalis septicaemia in a patient with acute myeloid
      leukaemia. Among the tests used, detection of mannose and candida antigen in
      serum allowed a high degree of suspicion of infection, earlier than the isolation
      of this species on mycological cultures from blood or oesophagic samples.
      Detection of anti-C. albicans antibodies was useless but low titres of anti-C.
      tropicalis antibodies were observed. In spite of early diagnosis and antifungal
      treatment, the complication of the disseminated candidiasis with a Pseudomonas
      aeruginosa septicaemia, concluded with the patient's exitus.

PMID- 8341819
TI  - [Intake of pollutants (heavy metals) via total diet at the national level as a
      whole and in autonomous communities: a new approach].
AB  - As an answer to the request of information on the real intake of pollutants, both
      WHO and FAO recommend its study through the study of total diet. Following their
      criteria we have determined the contents of arsenic, cadmium, mercury and lead in
      the total mean spanish diet and in the seventeen Autonomous Regions, comparing
      them with the acceptable daily intakes (ADI). At the same time it is studied the
      contribution of the different groups of nutrients to the total pollutant charge.
      There is no detectable health risk due to the intake through the total diet of
      arsenic, mercury or lead. However the intake of cadmium from the total national
      reaches 85% of ADI, which is higher in Galicia (153%), Canary Islands (129%) and
      Cantabria (103%) and is very close in Murcia (97%), Asturias (92%) and the
      Balearic Islands (85%).

PMID- 8341820
TI  - [Gestational diabetes: new approaches to an old and growing problem].
AB  - Gestational diabetes is defined as glucose intolerance of variable severity with
      onset or first recognition during pregnancy. Gestational Diabetes generally
      disappears as soon as the pregnancy is terminated. The prevalence of gestational
      diabetes is 2% to 13%, depending on the genetic characteristics and environment
      of the population under study. Classic risk factors identify a population of
      women at risk of gestational diabetes (obesity, family history of diabetes, or
      previous poor obstetric history); however, these risk factors identify only 60%
      of women diagnosed as having gestational diabetes. Therefore, it is necessary to
      screen all pregnant women, regardless of history, for gestational diabetes. The
      optimal time to screen for gestational diabetes in pregnancy is between 24 and 28
      weeks of gestation. The screening test consist of 50 g of oral glucose followed
      by a plasma determination at 1 hour. If the plasma glucose 1 hour after the oral
      load is > or = 140 mg/dl, a glucose tolerance test is indicated. The goal of
      management (diet, insulin and exercise) of the gestational diabetic women is to
      maintain normoglycemia, needed to avoid complications for the fetus and mother.

PMID- 8341821
TI  - [Current status of thrombolysis. The need for coadjuvant antithrombotic therapy].
AB  - Thrombolytic therapy yields a 80% repermeabilitation in the acute myocardium
      infarct if applied soon. In other thrombotic sites such as deep venous
      thrombosis, pulmonary thromboembolism and peripheral arterial thrombosis, with no
      large cooperative randomized clinical trials, its usefulness is clear, tough
      selectively. The high rethrombosis frequency is the major drawback of this
      therapy. The concomitant use of an anti-thrombotic and/or anti-aggregant agent,
      even tough the possible higher risks of hemorrhages, seems a key element to
      improve the results obtained with thrombolysis.

PMID- 8341822
TI  - [Female with chronic lymphocytic leukemia with fast general deterioration,
      increase and fistulization of adenopathies and bone involvement].

PMID- 8341823
TI  - [Supra-diaphragmatic primary amyloidosis diagnosed with oral biopsy].

PMID- 8341824
TI  - [Round pneumonia and solitary nodule].

PMID- 8341825
TI  - [Heart transplantation in Spain. The Official Report of the National
      Transplantation Organization on its activities in 1992].

PMID- 8341826
TI  - [The usefulness of transesophageal echocardiography in assessing mechanical
      mitral prostheses. A comparison with transthoracic echocardiography].
AB  - One hundred and sixty mechanical mitral prostheses were studied by
      transoesophageal echocardiography to ascertain the role of this technique in
      their functional assessment. All patients underwent transoesophageal
      echocardiogram, and, in 83, transthoracic Doppler-echocardiogram had already been
      performed immediately prior to transoesophageal echocardiogram. Prostheses
      presenting structural anomaly on bidimensional image and/or areas of
      regurgitation with predominantly turbulent flow on colour Doppler were considered
      to be dysfunctional. Of the 160 prostheses, 115 were considered normofunctional,
      and regurgitation was detected in 85 (94%) by transoesophageal echocardiogram and
      10 (9%) by transthoracic echocardiogram; haemodynamic and/or surgical
      confirmation was obtained in 6 of these prostheses and all proved to be
      functioning normally. Of the 45 remaining prostheses considered to be
      dysfunctional, haemodynamic and/or surgical confirmation was obtained in 21 (the
      non-confirmed 24 were excluded from the study). Seventeen of the dysfunctional
      prostheses presented with areas of regurgitation of 3.9-24 cm2 (mean: 9.21 +
      5.36); in one case, the degree of regurgitation with respect haemodynamic study
      was over-assessed; transthoracic echocardiogram detected only periprosthetic
      leaks in 38% of cases, with areas of regurgitation of 1.8-6.3 cm2 (mean: 1.87 +
      2.02). The other 4 dysfunctional prostheses presented dysfunction due to
      thrombosis; all 4 were diagnosed by both transthoracic and transoesophageal
      echocardiogram. Transoesophageal echocardiogram detected 12 structural anomalies
      (1 vegetations, 4 thromboses and 7 dehiscencies), whereas transthoracic
      echocardiogram only detected these anomalies in five of the cases (1 vegetations
      and 4 thromboses). Transoesophageal echocardiography surpasses transthoracic
      echocardiography in the assessment of mechanical mitral prostheses and
      dysfunction diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341827
TI  - [Transposition of the great arteries. Its anatomical correction. Our initial
      experience].
AB  - Arterial switch correction of transposition of the great arteries has been
      performed without mortality on 8 children, 7 neonates and one 6 years old child,
      at our institution. One infant and the 6 year old child has previous pulmonary
      artery banding and modified Blalock-Taussig shunts. The coronary cuffs were
      anastomosed to the neo-aorta using the "trap-door" technique described by Mee and
      in seven the Lecompte manoeuvre was used. Postoperative management included
      treatment for persistent pulmonary hypertension and left ventricular dysfunction.
      All patients were discharged in satisfactory condition, and continue to do so at
      a maximum follow-up of ten months. These results encourage us to elect the
      arterial switch procedure as the primary treatment of transposition of the great
      arteries.

PMID- 8341828
TI  - [Transposition of the great arteries. Its arterial correction. The treatment of
      choice?].

PMID- 8341829
TI  - [The development of the atrioventricular node and bundle of His in the human
      embryonic period].
AB  - To study the development of the atrioventricular specific system, together with
      the closely related mesenchymal tissue (from which the fibrous skeleton of the
      heart later develops). Thirty human embryos ranging from 3 mm to 30 mm crown-rump
      length (Carnegie stages 10-23) were used. The primordium of the atrioventricular
      specific system was observed for the first time in human embryos of 10 mm Crown
      Rump length (Carnegie stage 16) as a cellular aggregate located below the
      inferior endocardial cushion. The primordium cells originate from the myocardium
      of the posterior wall of the atrioventricular canal. The primordium later forms
      both the atrioventricular node and the His bundle. The mesenchymal tissue which
      surrounds these features originates from the endocardial cushions (particularly
      from the inferior endocardial cushion). Todaro's tendon and the central fibrous
      body are later formed from the inferior endocardial cushion. The atrioventricular
      node and His bundle are both formed from the primordium of the atrioventricular
      specific system. The node is produced from the cranial-dorsal extension of the
      primordium while the His bundle is produced from the growth of the primordium in
      a ventral-caudal direction. The central fibrous body is anatomically defined in
      the stages post-dating morphogenesis of the atrioventricular specific system.

PMID- 8341830
TI  - [Transcatheter ablation with high-frequency currents as a method for creating
      useful experimental models in the study of cardiac conduction and automatism].
AB  - PURPOSE: analyze the utility of transcatheter ablation with high-frequency
      currents to create different experimental models of altered cardiac automatism
      and conduction. METHOD: the results were obtained in six anesthetized dogs
      subjected to electrophysiological study after selectively applying transcatheter
      radiofrequency ablation to different zones of the specific cardiac conduction
      system. Ablation was carried out using conventional bipolar 7F catheter
      electrodes. High-frequency currents (0.7 MHz) were emitted through the distal
      electrode, with variable intensity and duration according to the aim of the
      experiment. Anatomic (fluoroscopic) and electrophysiological criteria were used
      to position the electrode within the ablation zone. RESULTS: selective
      radiofrequency application to the atrioventricular junction zone affords complete
      A-V blocks with escape rhythms located in the A-V node or His-Purkinje system,
      together with different degrees of infra- and intra-hisian and intranodal blocks.
      The modification of intranodal refractoriness and conduction without interrupting
      atrial pulse transmission may manifest atypical patterns with truncated nodal
      conduction curves. The abolition of sinus function through ablation in the zone
      of the sulcus terminalis makes it possible to obtain supraventricular subsidiary
      rhythms. The obtaining of intranodal complete blocks with supra-Hisian escape
      rhythms demonstrates phenomena such as the modulation of subsidiary automatism by
      non-transmitted atrial pulses, analyzed by constructing phase-response curves.
      CONCLUSION: transcatheter ablation using high-frequency currents is useful in
      demonstrating phenomena related to intranodal and His-Purkinje conduction,
      subsidiary pacemaker automatism or the modulation of automatism and conduction
      via non-transmitted pulses.

PMID- 8341831
TI  - [Cardiac arrhythmias (VII). Supraventricular tachycardias: the selection of the
      therapeutic options in the radiofrequency decade].

PMID- 8341832
TI  - [The echocardiography of 10 cardiac myxomas with successful surgical treatment].
AB  - Fifteen thousand patients were studied consecutively at the Echocardiographic
      Laboratory in the University Hospital Calixto Garcia. We found that one out of
      1,500 patients studied (0.07%) presented a cardiac myxoma. Average age 40.8
      years. Male sex was mainly (60%), and the interval between the onset of the
      symptoms and the diagnosis was 22.8 months. A previous diagnosis to Echo was
      performed in 30% of the patients despite of the recurrency and refractory
      therapeutics of symptoms. The echocardiographic data showed that left atrium and
      right ventricle dilatation were proportionally related to the tumor size and its
      mitral obstruction degree since 90% was localized at the left interatrial septum,
      and was presented at right ventricle septum and in both auricles in 2 patients.
      All the patients were successfully surgical treated and the 4-year Echo 2D study
      showed no tumoral recurrency.

PMID- 8341833
TI  - [The VVI pacemaker in the treatment of hypertrophic obstructive myocardiopathy in
      atrial fibrillation].

PMID- 8341834
TI  - [Cerebral embolism as the first manifestation of Staphylococcus aureus
      endocarditis: the role of transesophageal echocardiography in the therapeutic
      decision].
AB  - In patients with endocarditis due to Staphylococcus aureus, the issue of medical
      or surgical treatment still remains controversial. Likewise, there is no
      agreement in the management of those patients who have suffered cerebral embolism
      and show large vegetations in echocardiography. Moreover, transthoracic
      echocardiography not always disclose endocarditis vegetations as accurately as
      transesophageal echocardiography. We describe a patient with cerebral embolism
      due to Staphylococcus aureus endocarditis in which adequate medical diagnosis and
      management was achieved by means of transesophageal echocardiography.

PMID- 8341835
TI  - Observations on physical activity in physical locations: age, gender, ethnicity,
      and month effects.
AB  - The level of physical activity of 3- and 4-year-old children was assessed in
      alternative physical locations by month and time of day and by age, gender, and
      ethnicity. Physical activity was assessed by observation with the Children's
      Activity Rating Scale (CARS) for up to 12 hours from 7:00 am to 7:00 pm. A sample
      of 191 three- and four-year-old children was observed for up to four times in the
      course of a year. The sample was tri-ethnic. Boys were significantly more active
      than girls. Activity was consistently higher outside than inside. There were
      significant differences in the amount of time children in this age group spent
      inside versus outside by time of year; the activity levels of boys and girls
      differed by time of year, particularly when outside. A model including gender,
      month, and location terms accounted for 75% of the variance in physical activity.
      These data further documented gender differences in physical activity among very
      young children using measures not subject to self-report biases but did not
      explain or clarify the gender differences. The substantial differences by
      physical location and time of year deserve future attention, but more refined
      methods will be needed to balance data by location and important seasonal times.
      An inference from these results is that activity levels among young children may
      be increased by encouraging them to spend more time outdoors.

PMID- 8341836
TI  - The development of an instrument to measure motivation for marathon running: the
      Motivations of Marathoners Scales (MOMS).
AB  - This study reports the development of an instrument to assess the motives of
      marathon runners. The Motivations of Marathoners Scales (MOMS) contains 56 items
      distributed across nine scales. Content areas covered included health
      orientation, weight concern, self-esteem, life meaning, psychological coping,
      affiliation, recognition, competition, and personal goal achievement. Adequate
      internal consistency (Cronbach's alpha range .80 to .93), retest reliability
      (intraclass Rs range .71 to .90), and factorial validity of the scales were
      demonstrated. Assessment of the relationship between individual MOMS scales and
      other variables of conceptual relevance documents early evidence for the
      convergent and discriminant validity of the instrument. Future uses of the MOMS
      are discussed in light of theoretical, empirical, and practical considerations.

PMID- 8341837
TI  - Age and physical activity effects on reaction time and digit symbol substitution
      performance in cognitively active adults.
AB  - University professors (N = 56), divided into two age groups (< 50 years and > 50
      years) and two physical activity level groups (high and low), were tested on
      three tasks requiring increasingly complex cognitive processing--simple reaction
      time (SRT), choice reaction time (CRT), and on a digit symbol substitution test
      (DSST). A significant main effect for exercise, with high active subjects
      performing better than low active subjects, was found for SRT (p < .001) and CRT
      (p < .01) but not for DSST (p < .09). Significant main effects for age, with
      younger subjects performing better than older subjects, were found on DSST (p <
      .01) and CRT (p < .05) but not for SRT (p < .09). The observation that the effect
      of age was more pronounced with increasing task complexity is consistent with
      previous research. However, the tendency for exercise effects to decrease with
      increasing task complexity is not consistent with former findings, suggesting
      that perhaps the controlled high level of cognitive activity of subjects in this
      study may have offset the usual effects of exercise on information processing
      speed. No significant Age x Activity Level interactions were found on any of the
      dependent raw score data. However, compared to normative scores of the population
      at large, there was a slight increase in DSST percentile ranks with age for the
      older aerobically active professors, whereas a decrease occurred for the inactive
      subjects.

PMID- 8341838
TI  - The influence of proficiency level, transfer distality, and gender on the
      contextual interference effect.
AB  - This study examined the impact of high and low proficiency level, transfer
      distality, and gender on the contextual interference effect with an open skill.
      Subjects were separated into two levels of proficiency based on performance on a
      pretest similar to the experimental task. Analysis of error scores during
      acquisition indicated that the partitioning of subjects according to ability
      level had been successful. Transfer distality was varied by presenting subjects
      with two tasks varying in similarity to the acquisition task. Analysis of
      absolute constant, constant, variable, and total error scores in transfer
      strongly suggested that subjects' consistency rather than response bias was
      affected by the experimental variables. The findings suggested that, for the task
      used in this study, proficiency level does not account for gender differences in
      the contextual interference effect, as the effect was only reliably found for
      females. For coincident timing skills, it appears that there may be two distinct
      conclusions drawn from the results of this study: contextual interference only
      benefits female subjects' consistency and the effect of contextual interference
      increases with the distality of transfer, regardless of the subjects' proficiency
      level.

PMID- 8341839
TI  - Players' perceptions of accountability factors in secondary school sports
      settings.
AB  - The purpose of this study was to gauge the extent to which students believed that
      the accountability strategies employed by their coaches had significant effects
      on their involvement in sports training sessions. Questionnaire data from 235
      secondary school athletes were analyzed using linear structural relations to test
      a model of accountability hypothesized as operating in these coaching settings.
      The accountability strategy of active instruction was found to be a variable that
      significantly affected the students' valuing of their coaches as well as their
      task involvement. However, the rewards/consequences variable was not found to be
      a predictor of valuing or task involvement, suggesting that these athletes seemed
      more task oriented than reliant on external sanctions. The results of this study
      can only be generalized to team sport settings. Detailed examination needs to be
      made of the processes through which accountability factors operate for other
      contexts, including individual sports and competitive levels. Further research
      could also be undertaken into gender differences, especially in relation to the
      gender of coaches.

PMID- 8341840
TI  - Pedagogical knowledge structures in prospective teachers: relationships to
      performance in a teaching methodology course.
AB  - The purpose of the article is to describe the relationships of prospective
      teachers' pedagogical knowledge structures to performance in a physical education
      teaching methods class. The Pathfinder network scaling algorithm was used to
      elicit knowledge structures prior to and after the prospective teachers completed
      the class. The findings indicated that their knowledge of key pedagogical
      concepts was more coherent and corresponded more closely to the instructor's
      following the courses. Student measures of correspondence and coherence before
      the class were not significantly correlated with course performance; however,
      following the class, correlations between these measures and course performance
      were significant. Additionally, university grade point average (GPA) was highly
      related to course performance variables and knowledge measures, whereas American
      College Test (ACT) scores were not. A follow-up investigation of a subset of
      students indicated that key pedagogical concepts were retained over a 6-month
      period of time. However, performance on a semantic classification task provided
      little evidence that students with knowledge structures similar to that of the
      instructor organized knowledge at a more semantic level than students who were
      less similar. Future directions for the study of pedagogical knowledge
      acquisition in physical education are discussed.

PMID- 8341841
TI  - Effects of a curriculum and inservice program on the quantity and quality of
      elementary physical education classes.
AB  - The primary responsibility for engaging children in opportunities to be
      physically active and learn physical skills rests with school physical education.
      This study evaluated the effects of a combined health-related curriculum and
      inservice program on the quantity and quality of elementary school physical
      education lessons. Seven schools (N = 28 fourth-grade classes) in one district
      were randomly assigned to one of three conditions: 10 classes were taught in
      their usual manner by classroom teachers (Control [CO]); 10 classes were taught
      by trained classroom teachers (TT) who received inservice training and follow-up
      consultations; and 8 classes were taught by physical education specialists (PES)
      hired by the research project. Student activity level, curriculum context, and
      teacher behavior were directly observed and coded during a sample of 112 lessons
      over an 8-month period. Results indicated significant differences in both the
      frequency and mean length of classes (PES, 26.7 min; TT, 23.4 min; CO, 18.9 min).
      Additionally, the curriculum and inservice program equipped trained classroom
      teachers to provide significantly better classes than were provided by controls
      in terms of student activity engagement, lesson context, and active instructional
      behavior, though their classes did not match the quality of those taught by the
      physical education specialists. This study is unique in its use of direct
      observation of lessons to assess a curriculum and inservice intervention.

PMID- 8341842
TI  - A qualitative study on the socialization of beginning physical education teacher
      educators.
AB  - Few studies have focused on how university faculty learn and understand
      expectations of their professional role. The purpose of this study was to
      describe the experiences of five female physical education teacher educators in
      their first positions as assistant professors in research oriented universities.
      Data were collected using primarily qualitative methods--weekly journals and in
      depth interviews. Quantitative data were gathered to compare organizational
      factors such as salary, load allocation, equipment, and travel funds. Data
      yielded five main categories concerning how and what participants learned about
      their faculty roles. These categories included participants' perceptions of (a)
      organizational structure and job facilitation, (b) work tasks, (c) support
      systems, (d) evaluation and feedback, and (e) participants' psychological states.
      All participants reported experiencing role ambiguity and stress. Clear criteria
      for job performance, collegial support and mentoring, and regular evaluation and
      feedback were cited by all participants as important factors for reducing stress
      and facilitating their roles as faculty.

PMID- 8341843
TI  - Aerobic capacity in black adolescent girls.
AB  - Our purpose was to determine the aerobic capacities (VO2max) of a group of black
      female adolescents (age = 11.4-15.8 years) randomly chosen from a single urban
      school. Of 91 girls selected, 64 performed an incremental treadmill running test
      to volitional exhaustion and achieved VO2max as determined from expired gas
      measures. Other measures included height (m), weight (kg), and calf and triceps
      skinfolds (for % fat estimates). Girls were also asked whether they had achieved
      menarche. VO2max averaged 37.3 +/- 6.2 ml.kg-1 x min-1 and was significantly
      correlated (r[62]) with height (-.32, p < .01), body mass index (-.63, p < .001),
      and % fat (-.65, p < .001) but not with age (-.16, p > .10). Postmenarchal girls
      were significantly taller and older than premenarchal girls. Contrary to previous
      studies, the girls' VO2max values were not related to biological age. Our
      subjects' aerobic capacity values averaged 14% less than those of nonblack U.S.
      female adolescents previously reported in the literature. This difference in
      VO2max was primarily a function of body weight. Study implications support the
      possibility that overweight in adult black women may originate prior to or during
      early adolescence. Future longitudinal studies should be designed to investigate
      the effects of aerobic fitness on cardiovascular risk factor reduction in black
      adolescent girls.

PMID- 8341844
TI  - The effects of conceptually based physical education programs on attitudes and
      exercise habits of college alumni after 2 to 11 years of follow-up.

PMID- 8341845
TI  - Graphic versus numeric knowledge of results: which mode?

PMID- 8341846
TI  - More on assessing the retention of motor learning based on restricted
      information.

PMID- 8341847
TI  - Determination of the aerobic benefit of selected physical education activities.

PMID- 8341848
TI  - The effects of experience on the detection and location of performance
      differences in a gymnastic technique.

PMID- 8341849
TI  - The effects of variable practice on the performance of a basketball skill.

PMID- 8341850
TI  - The incidence of bulimia nervosa and pathogenic weight control behaviors in
      female collegiate gymnasts.

PMID- 8341851
TI  - Predicting the presence of pulmonary function impairment in adult respiratory
      distress syndrome survivors.
AB  - Varying degrees of impairment in pulmonary function in survivors of adult
      respiratory distress syndrome (ARDS) have been reported. Physiologic indices of
      the severity of disease have been associated with impaired pulmonary function
      after ARDS, including duration of exposure to FIO2 > 0.6, AaDO2, maximal mean
      pulmonary artery pressure, lowest total static thoracic compliance, and peak
      airway pressure. Prediction of impairment following ARDS is difficult because
      clinical observations may reflect reversible lung injury (e.g. lung edema) and
      clinical features of ARDS do not predict subsequent function reliably. We
      developed a severity score to predict the presence of impairment of pulmonary
      function in 51 ARDS survivors, by examining the following clinical variables: (1)
      predisposing factor for ARDS; (2) age; (3) sex; (4) severity of hypoxemia; (5)
      smoking history; (6) number of days of positive pressure ventilation; (7) lowest
      total static thoracic compliance; (8) maximal mean pulmonary artery pressure, and
      (9) presence of barotrauma. Pulmonary function studies were performed at least 1
      year after ARDS onset. The ARDSscore developed required only two variables:
      ARDSscorce = duration of positive pressure ventilation (days) minus lowest static
      thoracic compliance (ml/cm H2O). Significant correlations (p < 0.001) were found
      between linear regressions of percent predicted FEV1, FVC, TLC and DLCO against
      ARDSscore. ARDSscore > +20 predicted an 82% probability of impaired FEV1, FVC or
      TLC and a 100% probability of an impaired DLCO. We conclude that a score based
      upon duration of positive pressure ventilation and lowest static thoracic
      compliance predicts impaired pulmonary function more than 1 year after ARDS.

PMID- 8341852
TI  - Bronchiolitis obliterans after bone marrow transplantation: the effect of
      preconditioning.
AB  - While half of all patients receiving bone marrow transplantation (BMT) for
      malignancies and related diseases may achieve prolonged disease-free survival, 2
      10% of patients undergoing allogeneic transplantation develop bronchiolitis
      obliterans (BrOb). We have hypothesized that total body irradiation (TBI) which
      has been used for pretreatment may influence the subsequent development of BrOb
      in patients undergoing allogeneic BMT. Since 1976, we have treated 104 patients
      undergoing allogeneic BMT with non-TBI preconditioning. Of 60 patients that
      survived and were evaluable for chronic graft versus host disease (GVHD) 26
      developed chronic GVHD (43%). Four of 104 patients (3.9%) developed BrOb by
      clinical and/or pathologic findings. Four of 4 patients (100%) with BrOb had
      chronic GVHD. Two of these 4 patients (50%) were alive at the end of 2 years.
      These data demonstrate that chronic GVHD is a risk factor for BrOb in patients
      receiving non-TBI preconditioning regimens. The similar incidence of BrOb in this
      population compared to other studies using TBI suggest that the preconditioning
      regimen is not a factor in the development of BrOb. Further study is needed to
      confirm these findings. Allogeneic bone marrow transplantation (BMT) has
      revolutionized the therapeutic approach toward acute and chronic leukemias,
      aplastic anemia and rare immunodeficiency disorders. Half of all patients that
      undergo BMT achieve long-term disease-free survival but a similar number develop
      significant complications [1].(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341853
TI  - Pulmonary manifestations in adult T-cell leukemia at the time of diagnosis.
AB  - Adult T-cell leukemia (ATL) is an underlying immunodeficient condition which
      often leads to various kinds of pulmonary diseases. We have analyzed 35
      consecutive patients (18 male, 17 female) with ATL to see to what extent
      pulmonary complications were involved at the time of diagnosis. Over one-third
      presented with respiratory symptoms and 14 (40%) patients had significant
      findings on chest radiographs on the first admission in which reticulo-nodular
      shadows were predominant in 10 patients, suggesting that overt ATL is preceded by
      interstitial pulmonary disease. In addition, bacterial pneumonia and
      pneumocystosis were experienced in over two-thirds of the patients during the
      clinical course, and more than half of the patients subsequently died of
      pulmonary complications suggesting that early institution of diagnostic
      procedures and treatment for pulmonary conditions is needed in ATL patients.

PMID- 8341854
TI  - Diffuse interstitial fibrosis in nonasbestos pneumoconiosis--a pathological
      study.
AB  - Pathological examinations of 233 consecutive autopsy cases with nonasbestos
      pneumonconiosis revealed evidence of diffuse interstitial fibrosis (DIF) in 64
      (27.5%), among whom 45 (19.3%) showed bilateral involvement and 9 (3.9%)
      extensive disease closely resembling usual interstitial pneumonia. The patients
      with DIF were significantly older and had longer occupational histories as
      compared with those without DIF. There was no correlation between the occurrence
      of DIF and the type of the underlying disease (silicosis or mixed dust
      pneumoconiosis) except that an extensive DIF was more frequently associated with
      mixed dust pneumoconiosis. The extensive DIF developed an in situ malignancy much
      more frequently (33.3%) than the focal disease (2.6%).

PMID- 8341855
TI  - Obstructive sleep apnea in the Rubinstein-Taybi syndrome.
AB  - The Rubinstein-Taybi syndrome is characterized by a pattern of malformations
      including broad thumbs and big toes, microcephaly, facial dysmorphism, small
      stature, and mental retardation. Obstructive sleep apnea (OSA), has been
      described in several facial or skeletal malformations, but never in the
      Rubinstein-Taybi syndrome. We studied a 9-year-old boy, previously diagnosed as
      having the Rubinstein-Taybi syndrome and affected by severe OSA, as documented by
      polysomnography. He manifested the habitual and heavy snoring with breathing
      difficulties at night, and excessive daytime sleepiness. Short neck and obesity
      were important factors for the severity of the syndrome. Continuous positive
      airway pressure was not tolerated and weight loss was the only possible
      treatment, as upper airway surgery was not indicated by cephalometric,
      otolaryngologic or clinical results.

PMID- 8341856
TI  - Sarcoid reactions in regional lymph nodes of primary lung cancer.
AB  - A 66-year-old woman diagnosed as having primary lung cancer with an enlargement
      of the mediastinal, subcarinal and bilateral hilar lymph nodes underwent a
      thoracotomy after preoperative chemotherapy. The histological examination showed
      a moderately differentiated papillary adenocarcinoma in the left upper lobe
      without any metastases to the regional lymph nodes; however, non-caseous
      epithelioid granulomas without necrosis were observed in the nodes. These changes
      were considered to be sarcoid reactions, since no other physiological and
      laboratory findings compatible with systemic sarcoidosis were observed. The
      histological findings suggested the possibility that the regional lymph nodes
      were not involved with the tumor cells at the time of lung cancer diagnosis.
      Despite the rarity of this condition, sarcoid reactions in the regional lymph
      nodes must be kept in mind when an enlargement of bilateral hilar lymph nodes is
      detected in patients with lung cancer, and a good prognosis may be expected in
      cases with sarcoid reactions in the regional lymph nodes.

PMID- 8341857
TI  - Two-dimensional echocardiographic assessment of right cardiac pressure overload
      in patients with chronic obstructive airway disease.
AB  - Two-dimensional echocardiography was used to estimate right cardiac pressure
      overload in patients with chronic obstructive airway disease. Area measurements
      of the four heart chambers were carried out from the apical four-chamber view.
      Additionally, the respiratory behaviour of the inferior vena cava was examined
      from the subcostal view. A good apical imaging of the four-chamber view for area
      measurement was obtained in 44 out of 48 patients with chronic obstructive airway
      disease. The respiratory behaviour of the inferior vena cava was investigated
      from the subcostal view in 38 patients. Within 8 days after echocardiography,
      right cardiac catheterization was carried out in order to measure pulmonary
      artery and right atrial mean pressures and to determine pulmonary vascular
      resistance. A good correlation was found between pulmonary artery mean pressure
      and the following echocardiographic parameters: area index (area/body surface) of
      the two right heart cavities (r = 0.83), right-to-left ventricular area ratio (r
      = 0.82) and right-to-left cardiac area ratio (ratio between the added areas of
      both right heart cavities on the one side and the added areas of both left heart
      cavities on the other; r = 0.82). Correlation between these parameters and
      pulmonary vascular resistance (r = 0.71, 0.66 and 0.71, respectively) and between
      the right atrial mean pressure and the right atrial area index was less close (r
      = 0.64). On the other hand, the respiratory behaviour of the inferior vena cava
      proved to be highly specific but not very sensitive in predicting a pathological
      right atrial pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341858
TI  - Atrial natriuretic peptide and bronchial hyperresponsiveness in patients with
      mitral stenosis.
AB  - Atrial natriuretic peptide (ANP) has been reported to have protective effects
      against methacholine-induced bronchoconstriction in asthmatics. The aim of the
      study was to evaluate the relationship between plasma ANP levels and bronchial
      responsiveness to methacholine in patients with mitral stenosis. In 12 patients
      with moderate mitral stenosis, age 35-58 years, 9 female, 8 in NYHA class 2, 4 in
      NYHA class 3 for symptoms, plasma ANP and bronchial threshold to methacholine
      (PD20FEV1) were determined. The same measurements were performed in 10 asthmatic
      patients, hyperresponsive to methacholine, and in 10 normal subjects,
      nonresponsive to methacholine. Mean +/- SE plasma ANP levels were significantly
      higher in patients with mitral stenosis in comparison with asthmatics and normals
      (159 +/- 41.8, 7.3 +/- 0.98, 7.6 +/- 1.3, respectively, p < 0.01). In patients
      with mitral stenosis there was a significant relationship between plasma ANP and
      PD20FEV1 (r = 0.81, p < 0.01). No relationship was found between ANP and PD20FEV1
      in asthmatics. In conclusion, in patients with mitral stenosis ANP seems to play
      a protective role against bronchial hyperresponsiveness to methacholine.

PMID- 8341860
TI  - Increased endothelin-like immunoreactive material on bronchoalveolar lavage fluid
      from patients with bronchial asthma and patients with interstitial lung disease.
AB  - Endothelin (ET) is an endothelial regulatory peptide present also in pulmonary
      tissue where it exerts several biological actions both on bronchial and vascular
      smooth muscle cells. It has been shown to increase in bronchoalveolar lavage
      fluid (BALF) from asthmatic patients; but changes in other chronic respiratory
      disease have not been well studied. We measured by a radioimmunoassay (RIA) ET
      immunoreactive (IR) levels on BALF (BALF-ETIR, pg/ml) from 5 normal subjects
      (NS), 5 patients with chronic extrapulmonary disease (ED) without signs of lung
      involvement, 5 patients with allergic bronchial asthma (BA), 10 patients with
      idiopathic lung fibrosis (ILF) and 9 patients with miscellaneous interstitial
      lung disease (MILD). In 5/5 NS and 4/5 ED BALF-ETIR was lower than sensibility of
      RIA test used (0.8 pg/ml). BALF-ETIR was dosable in all patients with
      bronchopulmonary disease; means were 2.45 pg/ml in BA, 12.37 pg/ml in ILF, 2.90
      pg/ml in MILD--Wilcoxon's rank test (two tailed) versus NS, p < 0.05. There was
      an inverse correlation between BALF-ETIR values and the degree of ventilatory
      impairment (forced vital capacity % of predicted value, r = -0.61 p < 0.01;
      forced expiratory volume in 1 s % of predicted value, r = -0.71 p < 0.01) and the
      level of arterial pressure of O2 (PaO2; r = -0.75 p < 0.01); a positive
      correlation was found with number of neutrophils/ml of BALF (r = 0.52 p < 0.01)-
      Spearman's rank correlation. Though rarely detected on BALF from normal lungs, ET
      increases on BALF in patients with bronchopulmonary disease, raising the question
      of its involvement in pathogenic mechanisms or evolution of bronchial asthma and
      interstitial lung disease.

PMID- 8341859
TI  - Comparison of bronchodilator effects of fenoterol/ipratropium bromide and
      salbutamol in patients with chronic obstructive lung disease.
AB  - A double-blind, randomized cross-over trial was carried out in 24 patients with
      chronic airflow obstruction. The patients were required to demonstrate a minimum
      15% absolute increase in forced expiratory volume (FEV1) after a standard dose
      (0.4 mg) of fenoterol (F). On a separate occasion the effect of ipratropium
      bromide (IB; 0.04 mg) on FEV1 was tested also; according to the increase in FEV1
      the patients were grouped into IB responders (delta FEV1 > 15%) and IB
      nonresponders (delta FEV1 < 15%). Two puffs of F/IB (0.1 mg/0.04 mg), salbutamol
      (S; 0.2 mg) and placebo (P) were given by metered-dose inhaler at the same time
      of the day on three different occasions. FEV1 and specific airway resistance
      (sRaw) were assessed before and at specific intervals following inhalation. The
      results showed that F/IB and S produced similar maximal increases in FEV1 (delta
      FEV1 32% for F/IB and 31% for S) and decreases in sRaw (delta sRaw 24% for F/IB
      and 21% for S). These effects were significantly different both from baseline
      values and from P. FEV1 was still significantly different 8 h after inhalation
      from P in the F/IB group, but not in the group that received S. The effect of IB
      on FEV1 in the pretest was compared with the subsequent response to F/IB. In IB
      responders F/IB seemed to produce slightly more effective bronchodilation. Side
      effects were minimal and clinically insignificant. In conclusion, F/IB, with its
      ability to effect sustained bronchodilation without adverse side effects, is a
      viable alternative to a monotherapy in chronic obstructive pulmonary disease.

PMID- 8341861
TI  - Psychosocial changes in patients participating in a chronic obstructive pulmonary
      disease rehabilitation program.
AB  - Changes in physical competence, respiratory symptoms, well-being, emotional
      state, level of depression, every-day coping skills, and general activity and
      independence were studied in 40 chronic obstructive pulmonary disease patients
      participating in an intensive 3-week rehabilitation program. Both patient and
      staff ratings were used. Expectations and attitudes prior to rehabilitation were
      also measured. The study design included a 3-week basal period, a 3-week
      rehabilitation period and a 6-month follow-up. The immediate effects of
      rehabilitation on the variables which described subjective experiences were
      positive: well-being, emotional state and respiratory symptoms improved
      significantly (p < 0.001, p < 0.01 and p < 0.01, respectively). By the end of the
      follow-up period, however, all the treatment effects had dissipated. No
      significant effects of rehabilitation could be seen in every-day coping skills,
      general activity and independence or level of depression. It was not possible to
      predict the rehabilitation response on the basis of the patients' attitudes,
      expectations, level of depression or age. We conclude that pulmonary
      rehabilitation causes transient improvement in respiratory symptoms and some
      subjectively characterized psychosocial variables and that this improvement is
      unpredictable by attitude and expectation variables.

PMID- 8341862
TI  - Reducing attrition bias with an instrumental variable in a regression model:
      results from a panel of rheumatoid arthritis patients.
AB  - This study proposes an econometric technique to reduce attrition bias in panel
      data. In the simplest case, one estimates two regressions. The first is a probit
      regression based on sociodemographic and clinical characteristics measured at
      baseline. The probit regression estimates the probability that subjects stay or
      leave over the duration of the study. We insert the predicted probabilities from
      the probit regression into an inverse Mills ratio (IMR) or hazard rate to form an
      instrumental variable. We use this instrumental variable subsequently as an
      additional covariate in a second regression model that attempts to explain
      fluctuations in the dependent variable. The second regression, which is linear,
      includes only subjects who remained in the study. In alternative models,
      instrumental variables are created using predicted values from least squares and
      logit regressions estimating the probability that subjects stay or leave. The use
      of the instrumental variables reduces the effects of attrition bias in the linear
      regression model. We applied the technique to a panel of patients with rheumatoid
      arthritis (RA) enrolled in 1981 and followed through 1990. We attempted to
      predict values for a measure of functional disability recorded in 1990 with use
      of covariates measured in 1981. The dependent variable was an index of disability
      in 1990 and the independent variables (covariates) included the disability index
      from 1981, the years of duration of RA, gender, marital status, education, and
      age in 1981. The correction technique suggested that ignoring attrition bias
      would underestimate the strength of associations between being female and the
      subsequent disability index, and overestimate the strength of associations
      between being married spouse present, age, and the initial disability index on
      the one hand and the subsequent disability index on the other.

PMID- 8341863
TI  - Robust inference for multivariate survival data.
AB  - Multivariate survival data arise when an individual records multiple survival
      events or when individuals recording single survival events are grouped into
      clusters. In this paper we propose a new method for the analysis of multivariate
      survival data. The technique is a synthesis of the Poisson regression formulation
      for univariate censored survival analysis and the generalized estimating equation
      approach for obtaining valid variance estimates for generalized linear models in
      the presence of clustering. When the survival data are clustered, combining the
      methods provides not only valid estimates for the variances of regression
      parameters but also estimates of the dependence between survival times. The
      approach entails specifying parametric models for the marginal hazards and a
      dependence structure, but does not require specification of the joint
      multivariate survival distribution. Properties of the methodology are
      investigated by simulation and through an illustrative example.

PMID- 8341864
TI  - Tests for qualitative treatment-by-centre interaction using a 'pushback'
      procedure.
AB  - In multicentre clinical trials using a common protocol, the centres are usually
      regarded as being a fixed factor, thus allowing any treatment-by-centre
      interaction to be omitted from the error term for the effect of treatment.
      However, we feel it necessary to use the treatment-by-centre interaction as the
      error term if there is substantial evidence that the interaction with centres is
      qualitative instead of quantitative. To make allowance for the estimated
      uncertainties of the centre means, we propose choosing a reference value (for
      example, the median of the ordered array of centre means) and converting the
      individual centre results into standardized deviations from the reference value.
      The deviations are then reordered, and the results 'pushed back' by amounts
      appropriate for the corresponding order statistics in a sample from the relevant
      distribution. The pushed-back standardized deviations are then restored to the
      original scale. The appearance of opposite signs among the destandardized values
      for the various centres is then taken as 'substantial evidence' of qualitative
      interaction. Procedures are presented using, in any combination: (i) Gaussian, or
      Student's t-distribution; (ii) order-statistic medians or outward 90 per cent
      points of the corresponding order statistic distributions; (iii) pooling or
      grouping and pooling the internally estimated standard deviations of the centre
      means. The use of the least conservative combination--Student's t, outward 90 per
      cent points, grouping and pooling--is recommended.

PMID- 8341865
TI  - Evaluation of multicentre clinical trial data using adaptations of the Mosteller
      Tukey procedure.
AB  - Two procedures, based on proposals discussed by Mosteller and Tukey, are
      described for obtaining a combined estimate of the difference between two
      treatment means and its confidence interval from multicentre clinical trial data.
      Both procedures provide estimates in the possible presence of heteroscedasticity.
      The first procedure is designated the primary analysis for efficacy assessment.
      It omits treatment-by-centre interaction from the error term for treatment,
      unless there is substantial evidence of qualitative interaction (Ciminera et al.)
      or other special circumstances. The second procedure is the primary analysis
      whenever there is substantial evidence of qualitative interaction, and can be
      used whenever there are other reasons to make an analysis allowing for
      interaction.

PMID- 8341866
TI  - Calculation of power and sample size with bounded outcome scores.
AB  - The two-sample Wilcoxon rank sum test is the most popular non-parametric test for
      the comparison of two samples when the underlying distributions are not normal.
      Although the underlying distributions need not be known in detail to calculate
      the null distribution of the test statistic, parametric assumptions are often
      made to determine the power of the test or the sample size. We encountered
      difficulties with this approach in the planning of a recent clinical trial in
      stroke patients. It is shown that, for power and sample size estimation, it can
      be dangerous to apply the classical formulae routinely, especially with outcome
      scores having a U-shaped or a J-shaped distribution. As an example we have taken
      the Barthel index, a quality-of-life outcome measure in stroke patients. Further,
      we have investigated alternative methods by means of Monte Carlo simulation. The
      distributional characteristics of the estimated powers were compared. Our
      findings suggest more appropriate computer software is necessary for the
      calculation of power and sample size when efficacy is measured by a non
      parametric method.

PMID- 8341867
TI  - Sample size determinations using logistic regression with pilot data.
AB  - Suppose the goal of a projected study is to estimate accurately the value of a
      'prediction' proportion p that is specific to a given set of covariates.
      Available pilot data show that (1) the covariates are influential in determining
      the value of p and (2) their relationship to p can be modelled as a logistic
      regression. A sample size justification for the projected study can be based on
      the logistic model; the resulting sample sizes not only are more reasonable than
      the usual binomial sample size values from a scientific standpoint (since they
      are based on a model that is more realistic), but also give smaller prediction
      standard errors than the binomial approach with the same sample size. In
      appropriate situations, the logistic-based sample sizes could make the difference
      between a feasible proposal and an unfeasible, binomial-based proposal. An
      example using pilot study data of dental radiographs demonstrates the methods.

PMID- 8341868
TI  - International Collaborative Group on Clinical Trial Registries (ICG-CTR)
      consensus recommendations.

PMID- 8341869
TI  - A comparison of different matching designs in case-control studies: an empirical
      example using continuous exposures, continuous confounders and incidence of
      myocardial infarction.
AB  - The paper presents a case-control study involving a disease, exposures and
      several continuous confounders. The relative efficiency and validity of a fully
      matched design is compared with random sampling of controls. We test a viable
      option of a partially matched design when inability to match all study subjects
      on all confounders occurs. The degree of bias in the odds ratios introduced by
      the different designs and by the different analytic models is assessed in
      comparison with the estimates obtained from a total cohort, from which both cases
      and controls were selected. Matched designs and analytic strategies are also
      evaluated in terms of the variances of the odds ratios. The results indicate that
      matching on continuous variables may lead to a more precise estimate of odds
      ratio than statistical control of confounding in unmatched designs. Partial
      selection of controls by matching may be a useful strategy when complete matching
      cannot be achieved; in practice, partial matching achieves most of the benefits
      of full matching.

PMID- 8341871
TI  - Physical allergies and exercise. Clinical implications for those engaged in
      sports activities.
AB  - There are several allergic responses that may occur in susceptible individuals as
      a result of exposure to physical stimuli. Most of these conditions are mediated
      by vasoactive substances and usually result in symptoms of urticaria and/or
      angioedema. There are 2 such conditions that may occur as a direct result from
      exercise. The first of these is cholinergic urticaria. Patients with cholinergic
      urticaria experience punctate (2 to 4mm) hives which occur reproducibly with
      exercise or with passive warming, such as might occur in a steam bath or hot
      pool. Life-threatening hypotension or angioedema usually do not occur with
      cholinergic urticaria. This condition usually responds well to oral hydroxyzine.
      Exercise-induced anaphylaxis (EIA) is a form of physical allergy that has been
      recognised with increasing frequency in recent years. This syndrome typically
      presents with generalised pruritus, a flushing sensation, a feeling of warmth and
      the development of conventional (10 to 15mm) urticaria in association with
      vigorous physical exertion only. Symptoms tend to occur variably with exposure to
      exercise and do not typically occur with passive warming. During symptomatic
      attacks, cutaneous mast cells degranulate and serum histamine levels increase.
      Treatment is problematic. Cessation of exercise with onset of symptoms and self
      administration of epinephrine (adrenaline) are recommended. Other physical
      allergies that may affect exercising individuals include cold urticaria,
      localised heat urticaria, symptomatic dermatographism (dermographism), delayed
      pressure urticaria (angioedema), solar urticaria and aquagenic urticaria.
      Management of these conditions may include patient education, selective
      avoidance, antihistamines and, in some cases, induction of tolerance.

PMID- 8341870
TI  - Physical activity in older adults. An overview of health benefits.

PMID- 8341873
TI  - Resistance training during preadolescence. Issues and controversies.
AB  - High intensity resistance training appears to be effective in increasing strength
      in preadolescents. Children make similar relative (percentage improvement), but
      smaller absolute, strength gains compared with adolescents and young adults in
      response to similar resistance training programmes. Resistance training appears
      to have little if any effect on muscle size, and strength gains during training
      have been associated with increases in levels of neuromuscular activation and
      changes in intrinsic contractile characteristics of muscle. Although
      unsubstantiated, improved motor coordination probably also contributes to the
      increase in strength, especially for more complex strength manoeuvres. On the
      basis of limited information, training-induced strength gains are lost during
      detraining, and the decay in strength has been associated with a reduction in
      neuromuscular activation. Short term resistance training appears to have no
      effect on somatic growth (height or weight) and body composition, and no proven
      positive influence on sports performance, injury rate or recovery from injury
      during preadolescence. Weightlifting has proved injurious to some children,
      especially when unsupervised and without instruction in proper weightlifting
      technique and load selection. In contrast, the risk of injury from prudently
      prescribed and closely supervised resistance training appears to be low during
      preadolescence. Lastly, short term resistance training appears to have no
      detrimental effect during preadolescence on either cardiorespiratory fitness or
      resting blood pressure.

PMID- 8341875
TI  - [Role of the radiologist in the resection of suspect, non-palpable breast
      lesions].

PMID- 8341874
TI  - Current concepts in the treatment of common compartment syndromes in athletes.
AB  - Compartment syndromes of the leg, and to a lesser extent the forearm and other
      areas, occur in both acute and chronic exertional forms. Similar inciting events
      may precipitate either form, with different presentations, prognoses and
      implications for treatment. A complete knowledge of the anatomy and
      pathophysiology of these syndromes is essential for diagnosis. Measurement of
      compartment pressures is a valuable tool in the diagnosis of chronic exertional
      compartment syndrome. In our experience, athletes who desire to return to the
      same level of exercise will require fascial release, although symptoms may
      improve if the intensity or duration of the activity is decreased. Fascial
      release is the treatment of choice in acute compartment syndrome and in chronic
      exertional compartment syndrome unresponsive to nonoperative treatment.

PMID- 8341872
TI  - Velocity specificity of resistance training.
AB  - Velocity specificity of resistance training has demonstrated that the greatest
      strength gains occur at or near the training velocity. There is also evidence
      that the intent to make a high speed contraction may be the most crucial factor
      in velocity specificity. The mechanisms underlying the velocity-specific training
      effect may reside in both neural and muscular components. Muscular adaptations
      such as hypertrophy may inhibit high velocity strength adaptations due to changes
      in muscle architecture. However, some studies have reported velocity-specific
      contractile property adaptations suggesting changes in muscle kinetics. There is
      evidence to suggest velocity-specific electromyographic (EMG) adaptations with
      explosive jump training. Other researchers have hypothesised neural adaptations
      because of a lack of electrically evoked changes in relation to significant
      voluntary improvements. These neural adaptations may include the selective
      activation of motor units and/or muscles, especially with high velocity
      alternating contractions. Although the incidence of motor unit synchronisation
      increases with training, its contribution to velocity-specific strength gains is
      unclear. However, increased synchronisation may occur more frequently with the
      premovement silent period before ballistic contractions. The preprogrammed neural
      circuitry of ballistic contractions suggests that high velocity training
      adaptations may involve significant neural adaptations. The unique firing
      frequency associated with ballistic contractions would suggest possible
      adaptations in the frequency of motor unit discharge. Although co-contraction of
      antagonists increases with training and high velocity movement, its contribution
      is probably related more to joint protection than the velocity-specific training
      effect.

PMID- 8341876
TI  - [The role of ultrasonography in non-palpable lesions of the breast].

PMID- 8341877
TI  - [Non-palpable lesions of the breast: biopsy techniques].

PMID- 8341878
TI  - [Perioperative risk: evaluation methods].

PMID- 8341879
TI  - [Celioscopy and abdominal surgery of adnexitis].

PMID- 8341880
TI  - [Review of methotrexate treatment of persistent extrauterine pregnancy].

PMID- 8341881
TI  - [Vaginal hysterectomy assisted by laparoscopy--experiences in Vaud].

PMID- 8341882
TI  - [Contribution of nuclear magnetic resonance imaging in the diagnosis and
      pathogenesis of brain stem and cerebellar infarction].

PMID- 8341883
TI  - [Contribution of magnetic resonance to the diagnosis of multiple sclerosis].

PMID- 8341885
TI  - [Pulmonary opacity in a 47-year-old crane operator].

PMID- 8341884
TI  - [Allergic asthma and environment--effect of atmospheric pollution].

PMID- 8341886
TI  - [Homage to Professor Julian de Ajuriaguerra].

PMID- 8341887
TI  - [Trauma pathology of the wrist in the general practitioner's office].

PMID- 8341888
TI  - [The pulverisator of Just Lucas-Champonniere, according to Lister (1876)].

PMID- 8341889
TI  - [The drug addict: the ideal consumer, the most accomplished.... Apropos of Jean
      Martin's article].

PMID- 8341890
TI  - Sedative effects and plasma concentrations following single doses of triazolam,
      diphenhydramine, ethanol and placebo.
AB  - Twelve, healthy, young men received 0.25 mg triazolam and ethanol placebo, 50 mg
      diphenhydramine and ethanol placebo, 0.6 g/kg ethanol and placebo pill and
      ethanol placebo and placebo pill in a double-blind Latin Square design. Each of
      the four treatments were administered for 2 days at 0900 hours with blood samples
      drawn on day one at 0830, 1030, 1230, 1430 and 1630 hours, and sleep latency and
      performance assessed on day two at 1000, 1200, 1400 and 1600 hours. Significant
      sedative effects of ethanol, triazolam and diphenhydramine relative to placebo
      were observed on the sleep latency and performance measures with the effects
      being detected over the full 6.5 hours of assessment. Among the active drugs,
      triazolam and diphenhydramine had similar sedative effects which differed from
      that of ethanol. Plasma concentration of each drug declined significantly over
      the 6.5 hours. Ethanol reached zero, but triazolam and diphenhydramine did not.
      Continued sedation (sedative effects after plasma concentration reached zero) was
      observed with ethanol.

PMID- 8341891
TI  - Treatment of narcolepsy with methamphetamine.
AB  - Eight pairs of subjects (each consisting of a narcoleptic and a control matched
      on the basis of age, sex, educational background and job) were evaluated under
      the following double-blind, randomized treatment conditions: baseline, placebo,
      low dose and high dose methamphetamine. Subjects were drug-free for 2 weeks prior
      to beginning the protocol. Methamphetamine was the only drug taken during the
      protocol and was given in a single morning dose of 0, 20 or 40-60 mg to
      narcoleptics and 0, 5 or 10 mg to controls. The protocol was 28 days long, with
      each of the four treatment conditions lasting 4 days followed by 3 days of
      washout. Nighttime polysomnography and daytime testing were done during the last
      24 hours of each treatment condition. Daytime sleep tendency was assessed with
      the multiple sleep latency test (MSLT). Daytime performance was assessed with
      performance tests including a simple, computer-based driving task. Narcoleptics'
      mean MSLT sleep latency increased from 4.3 minutes on placebo to 9.3 minutes on
      high dose, compared with an increase from 10.4 to 17.1 minutes for controls.
      Narcoleptics' error rate on the driving task decreased from 2.53% on placebo to
      0.33% on high dose, compared with a decrease from 0.22% to 0.16% for controls.
      The effects of methamphetamine on nocturnal sleep were generally dose-dependent
      and affected sleep continuity and rapid eye movement (REM) sleep. Elimination
      half life was estimated to be between 15.9 and 22.0 hours. Mild side effects
      emerged in a dose-dependent fashion and most often involved the central nervous
      system and gastrointestinal tract. We concluded that methamphetamine caused a
      dose-dependent decrease in daytime sleep tendency and improvement in performance
      in both narcoleptics and controls. Methamphetamine at doses of 40-60 mg allowed
      narcoleptics to function at levels comparable to those of unmedicated controls.

PMID- 8341892
TI  - Effects of zolpidem and triazolam on sleep and respiration in mild to moderate
      chronic obstructive pulmonary disease.
AB  - Sleep problems and nocturnal arterial oxygen desaturation are common in patients
      with chronic obstructive pulmonary disease (COPD). Hence, the safety and efficacy
      of new hypnotic agents must be ascertained in this group of patients. We
      performed a double-blind, randomized, single-dose, placebo and active drug
      controlled, crossover study in 24 patients with insomnia (subjective sleep
      latency > 30 minutes and sleep duration 4-6 hours) and mild to moderate COPD
      (mean FEV1 61 +/- 12(SD)% predicted) in order to establish the effects of
      zolpidem 5 mg and 10 mg on sleep and respiration and to compare these effects
      with triazolam 0.25 mg. Arterial oxygen saturation for the entire night, by hour
      and stage, and the apnea-hypopnea index for the entire night were not
      significantly different with placebo and the various drug conditions. Total sleep
      time and sleep efficiency were increased over placebo by all three drug
      conditions. Triazolam was more effective than zolpidem 5 mg but not zolpidem 10
      mg, and there was no significant difference between zolpidem 5 mg and zolpidem 10
      mg. Zolpidem 10 mg and triazolam both reduced the number of awakenings (> 15
      seconds duration) per hour of sleep. Although there was a trend for triazolam to
      be more efficacious than zolpidem 10 mg, no statistically significant difference
      was found for any objective or subjective sleep variable. Likewise, zolpidem 10
      mg tended to be more efficacious than zolpidem 5 mg, but the difference was only
      significant in terms of perceived sleep quality and ease of falling
      asleep.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341893
TI  - Successful treatment of the idiopathic restless legs syndrome in a randomized
      double-blind trial of oxycodone versus placebo.
AB  - In a double-blind randomized crossover trial, oxycodone or placebo was given in
      divided night-time doses to 11 patients with idiopathic restless legs syndrome
      (RLS) for 2 weeks prior to appropriate polysomnographic studies. Under double
      blinded conditions, patients were asked to do daily ratings of their leg
      sensations, motor restlessness and daytime alertness on a 1-4 scale for the 2
      weeks prior to the polysomnographic studies and for the nights of the
      polysomnographic studies as well. Leg sensations (p < 0.009), motor restlessness
      (p < 0.006) and daytime alertness (p < 0.03) were significantly improved on
      oxycodone as compared to baseline or placebo. Patients were studied
      polysomnographically under double-blinded conditions for 2 nights in each phase
      of the protocol. On an average dose of 15.9 mg oxycodone (equivalent to
      approximately three 5-mg tablets of commercial preparation), there was a
      statistically significant reduction in the number of periodic limb movements in
      sleep [(PLMS)/hour sleep (p < 0.004)] and in the number of arousals/hour sleep (p
      < 0.009) on drugs as compared to baseline or placebo. A statistically significant
      improvement was also noted in sleep efficiency (p < 0.006) and 10 of the 11
      patients preferred oxycodone over placebo. We conclude that oxycodone is an
      effective treatment for RLS and PLMS.

PMID- 8341894
TI  - Circadian sleep regulation in the absence of light perception: chronic non-24
      hour circadian rhythm sleep disorder in a blind man with a regular 24-hour sleep
      wake schedule.
AB  - Sleep disturbances and the failure to entrain circadian rhythms to the 24-hour
      day have been reported in the majority of totally blind subjects. The present
      case study of a totally blind man with a well-documented recurring sleep
      disturbance was designed to investigate the mutual relationship between sleep and
      the circadian timing system. The 63-year-old subject, a high school teacher with
      a regular work schedule, had suffered from cyclically recurring insomnia for the
      past 28 years. Analysis of a sleep log that he had kept for the past 15 years
      suggested that his circadian rhythms were not entrained to the 24-hour day.
      During a 3-month inpatient study, the period of the endogenous circadian
      pacemaker was assessed by analysis of ambulatory core body temperature, urinary
      excretion and a series of estimates of the phase of core body temperature cycles
      and plasma cortisol levels during constant routines. All circadian markers
      revealed periods in the range of 24.22-24.27 hours, with no evidence for a
      modulation of the observed periods by the sleep-wake cycle. During this 3-month
      inpatient study, a complete cycle of the subject's sleep disturbance and
      remission was polysomnographically documented while the subject lived on a
      regular 24-hour schedule. Because the subject's circadian rhythms were free
      running and his sleep times were fixed, sleep occurred at virtually all circadian
      phases. Analysis of sleep latency, REM sleep latency, sleep duration, wake in
      sleep episode and REM sleep during sleep episode revealed a strong modulation by
      circadian phase. These findings in this blind man suggest that: 1) the period of
      his cyclically recurring sleep disturbance is directly related to the
      nonentrained period of an endogenous circadian pacemaker that drives circadian
      variation in core body temperature, urinary excretion, plasma cortisol and sleep
      propensity; 2) both his sleep structure and the severity of his daily sleep
      disruption are directly related to circadian phase and 3) his circadian
      pacemaker, which has an endogenous period that deviates only 0.2-0.3 hours from
      24 hours, cannot be entrained by periodic daily exposure to nonphotic time cues,
      including a very regular 24-hour sleep-wake schedule.

PMID- 8341895
TI  - Consulting about insomnia: a method and some preliminary data.
AB  - Sleep specialists are increasingly asked to advise other health care workers and
      patients about specific cases of insomnia, even when the patients do not plan to
      seek actual treatment of their insomnia at a sleep center. This paper describes a
      procedure for such one-time consultations. It also provides some preliminary data
      on the subjective efficacy of such insomnia consultations by reporting data from
      follow-up telephone calls placed 1, 3 and 12 months after the interview. The
      patients' estimates of their sleep seemed significantly improved on all three
      follow-up contacts, and the telephone calls also provided information on what
      type of recommendations were actually tried by the insomniacs and which ones
      seemed beneficial. Acceptance of individual sleep hygiene suggestions ranged
      between 68 percent and 11 percent, but those who tried a given suggestion
      generally reported its usefulness to be about 70 percent. Advice to seek
      relaxation or behavioral therapy and suggestions for various medication changes
      were accepted by about half of those insomniacs who received such advice, and
      about two-thirds of those who tried them reported them as being helpful. Advice
      to seek psychotherapy--although quite carefully given--typically was tried by
      only one-third of those who received it. Overall, the survey shows good patient
      acceptance of once-only insomnia consultations.

PMID- 8341896
TI  - Aerobic fitness, acute exercise and sleep in older men.
AB  - In the current study 12 aerobically fit and 12 sedentary older men underwent two
      nocturnal polysomnographic (PSG) studies. A control PSG was conducted following a
      day without aerobic activity, whereas a postexercise PSG study was conducted
      following an afternoon session of exhaustive aerobic exercise. In addition to
      deriving usual sleep parameters, a computer scoring program was used to count the
      number of individual electroencephalographic (EEG) slow waves in each PSG
      tracing. Multivariate and univariate analyses showed that the fit subjects had
      shorter sleep onset latencies, less wake time after onset, fewer discrete sleep
      episodes, fewer sleep stage shifts during the initial portion of the night, less
      stage 1 sleep, a higher sleep efficiency and more total slow waves during both
      PSGs than did the sedentary subjects. Although no main effects were found for the
      acute exercise challenge, post hoc analyses showed that high levels of body
      heating during exercise predicted increased sleep fragmentation for both fit and
      sedentary subjects. These findings provide initial support for the contention
      that exercise and fitness may have significant effects on the sleep of older men.
      However, results also suggest that high levels of body heating resulting from a
      single exercise challenge may have adverse effects. Implications of the study are
      discussed and suggestions for future research are provided.

PMID- 8341897
TI  - Sleep and breathing patterns in patients with Prader Willi syndrome (PWS):
      effects of age and gender.
AB  - Patients with Prader Willi syndrome (PWS) often complain of daytime
      hypersomnolence. Because of reported daytime sleepiness and high prevalence of
      morbid obesity, these patients have been considered at risk for sleep related
      disordered breathing, but polysomnographic studies have been limited. We
      evaluated sleep and breathing polysomnographically in 24 PWS patients including
      15 adults and 9 children. All adult patients completed MSLT testing on the day
      following the nocturnal sleep study. Both adult and children groups showed little
      or no sleep apnea, but REM related oxygen desaturation was quite common, its
      severity significantly correlated with increased obesity. Sleep patterns in both
      groups showed abnormal REM sleep cycles with variable REM latency (at times
      significantly shortened) and fragmented REM sleep with multiple brief REM
      periods. REM sleep abnormalities were still present in some patients without REM
      related desaturation. As a group, patients with PWS demonstrated pathological
      somnolence as measured by MSLT, which correlated with nocturnal sleep efficiency
      but not with nocturnal REM latency. It is hypothesized that the abnormal sleep
      findings in PWS reflect an underlying hypothalamic dysfunction characteristic of
      this syndrome.

PMID- 8341898
TI  - Sleep and mammalian hibernation: homologous adaptations and homologous processes?
AB  - Evidence from electroencephalographic, thermoregulatory and cellular
      neurophysiological studies suggests that sleep and hibernation may be homologous
      adaptations for energy conservation. However, despite the similarities between
      non-rapid eye movement (NREM) sleep and hibernation, the restorative function
      normally associated with slow wave sleep appears not to occur during hibernation,
      perhaps because of the low body temperature (Tb). Cellular neurophysiological
      studies also suggest that a bout of hibernation is not exclusively NREM sleep but
      is punctuated by periods of wakefulness. The entrance to hibernation involves
      both an inhibition of cortical activity and activation of hypothalamic regions,
      whereas the arousal from hibernation is primarily a hypothalamic function.
      Multiple neurochemical systems are affected by the arousal state change that
      occurs in hibernation, and a serotonergic-opiatergic interaction, in particular,
      may be important in regulating these events. Among regulated physiological
      systems affected by arousal state changes, the episodic respiration evident in
      hibernation shows striking similarities to the apneas observed during sleep in
      both humans and other mammals. Although the slight down-regulation of Tb and
      metabolism that accompanies the transition from wakefulness to NREM sleep may
      have served as a preadaptation for the evolution of hibernation among the
      mammals, increasing consideration must be given to the possibility that
      hibernation represents an arousal state distinct from any known normothermic
      arousal state.

PMID- 8341899
TI  - Are infants sharing a bed with another person at increased risk of sudden infant
      death syndrome?

PMID- 8341901
TI  - Bibliography of recent literature in sleep research.

PMID- 8341900
TI  - Respiratory problems during sleep in infants and the elderly and possible
      relation to mattress compression.

PMID- 8341902
TI  - [Schistosoma, water and man].
AB  - The biology of schistosomes is increasingly better known due to the research
      works conducted since the early 1980s. Numerous data have been collected on: the
      structure of the genome; the genetic variability of natural populations; the
      causes of geographical distribution of Schistosoma species; the acquisition,
      probably recent, of the parasite as by modern man's ancestors; and even some
      aspects of development, such as the behaviour of larvae and the migrations in the
      circulatory system. Substantial advances have also been made in the maintenance
      of laboratory strains. Yet, multiple and fascinating problems are still raised by
      schistosomes. In the present state of our knowledge the origin and relationship
      of human parasitizing species are still hypothetical. Several features of
      reproduction, such as the existence of separate sexes and permanent couples
      cannot be explained. Quantitative data concerning the dynamics of transmission
      are much too vague to establish satisfactory mathematical models and to
      contribute usefully to strategies of control. Finally, the fact that schistosomes
      can develop either in man alone or in numerous mammals remain a mystery for
      immunologists and specialists of evolution.

PMID- 8341903
TI  - [Epidemiology of human bilharziasis].
AB  - Schistosomiasis is endemic in three continents: Africa, where Schistosoma
      haematobium, S. mansoni and S. intercalatum are present; tropical America and
      some of the the Caribbean islands, where the only parasite of this type is S.
      mansoni; Mediterranean Asia (S. haematobium, S. mansoni) and the Far-East (S.
      japonicum, S. mekongi). Schistosomal infestation is distributed in foci of
      warying size and significantly differs in prevalence, intensity and therefore
      morbidity from one region to another. Despite the successes obtained in the
      neutralization of certain foci, the great plasticity of the hosts-parasites
      molluscs relations and the huge displacements of human populations in the poorer
      countries explain why the epidemiology of schistosomiasis is constantly changing
      and the disease is far from disappearing.

PMID- 8341904
TI  - [Symptoms and development of Schistosoma mansoni infestation].
AB  - Schistosoma mansoni schistosomiasis is widespread in Latin America and Black
      Africa. Infestation is through the skin where it produces erythema with pruritus.
      Invasion is manifested by mild or sometimes fairly marked systemic disorders. The
      gastrointestinal disorders observed in the established phase have no
      characteristic features. The major complication is portal hypertension due to the
      portal vein fibrosis provoked by schistosomatic granules with an egg at their
      centre. The diagnosis rests on the finding of eggs in the faeces and on biopsy of
      the rectal mucosa. The present treatments are effective and well tolerated, but a
      portocaval anastomosis may be necessary.

PMID- 8341905
TI  - [Symptoms and development of Schistosoma haematobium infestation seen in a
      metropolis].
AB  - Urogenital schistosomiasis is often diagnosed in France where, contrary to its
      severity, its initial presentation (mainly haematuria) has not changed. The
      frequency of major renal abnormalities seems to have diminished since 1965, but
      above all cystoscopy and intravenous urography have been superseded by
      ultrasonography, a totally harmless and painless method which provides the same
      information as that obtained with the previous two methods, except as regards the
      ureters. In particular, cystoscopy is now indicated only when tumours of the
      bladder are suspected at ultrasonography. Cutaneous schistosomiasis, with its
      characteristic features, deserves to be known and recognized.

PMID- 8341906
TI  - [Bilharziasis caused by Schistosoma intercalatum, a recent and forgotten form of
      schistosomiasis].
AB  - Schistosoma intercalatum schistosomiasis is confined to the western regions of
      equatorial Africa. It is often asymptomatic but it produces microscopic lesions
      in the intestine (mainly the rectum), the liver and the genital organs of both
      men and women, the latter lesions being more insidious and insufficiently
      explored. Its treatment, like that of other schistosomiases, consists of one
      course of praziquantel. Naturally, S. intercalatum may be hybridized with S.
      haematobium in Gabon and Cameroun which are the two countries where the two
      parasites coexist.

PMID- 8341907
TI  - [Acute form of primary bilharziasis].
AB  - Acute schistosomiasis is observed in subjects with primary infestation,
      Schistosoma mansoni and S. japonicum being the responsible parasites in the vast
      majority of cases. The disease occurs between 2 weeks and 6 months from the first
      infesting bath and presents as fever with cutaneous, pulmonary and
      gastrointestinal manifestations. Eosinophilia is frequent. The diagnosis is made
      by serological tests. Myelopathies are rare and may leave severe sequelae.
      Treatment rests on praziquantel combined with a short course of corticosteroid
      therapy.

PMID- 8341908
TI  - [Biological diagnosis of Schistosoma infestation].
AB  - For general practitioners the most important step towards the clinical and
      laboratory diagnosis of infestation with Schistosoma spp. is to think of it.
      Although schistosomiasis is the world's most frequent parasitosis after malaria,
      it is found in France only as imported cases (immigrants, tourists, etc.) with
      clinical signs that are not always very suggestive at the stage of invasion. The
      laboratory examinations requested can then make the diagnosis, irrespective of
      the time elapsed since infestation. In the early invasion stage, only the
      indirect serological methods (ELISA, IFI, precipitation techniques) are
      appropriate. The direct methods are not always informative since the parasites
      are still immature and do not lay eggs. But when the disease is established the
      diagnosis rests essentially on direct examination of urine and faeces which
      discloses schistosoma eggs the morphology of which varies from one species to the
      other.

PMID- 8341909
TI  - [Salmonella-Schistosoma interactions].
AB  - Prolonged or recurrent typhoid fever and mainly salmonella septicaemia usually
      regarded as minor, or even episodes of salmonelluria are not uncommon in patients
      infested with Schistosoma spp. In such cases the salmonella infection is often
      apparently resistant to antibiotic therapy. Schistosoma-salmonella interactions
      have been described with all species of schistosoma, notably S. haematobium, S.
      mansoni, S. intercalatum and S. japonicum. The adult worms of schistosoma live in
      the mesenteric venous plexuses and, in some particular sites, salmonellas are
      electively stuck onto the outer wall of adult schistosomas. As a result of this,
      salmonella septicaemia is facilitated and sustained by the schistosomal
      infestation, and several varieties of salmonella may be involved. These
      salmonella infections cannot be cured without treatment of the associated
      schistosomiasis.

PMID- 8341910
TI  - [Treatment of bilharziasis].
AB  - Specific treatment of bilharziosis is obviously simplified by praziquantel which,
      unfortunately, is not easily available in endemic areas. Nevertheless, the major
      problem is an early treatment before the occurrence of severe sequellae. Mass
      chemoprophylaxis remains needed and, if possible, with praziquantel. For economic
      purposes, we have often to use either oxamniquine or niridazole-metrifonate
      combination.

PMID- 8341911
TI  - [Vaccine against bilharziasis. Strategies and perspectives].
AB  - Due to the determination of immunity acquisition mechanisms, a number of studies
      on experimental models and human populations has made it possible to devise a
      strategy of vaccination against schistosomiasis, a major worldwide parasitic
      disease affecting 200 million people. A schistosomial protein, identified as
      glutathione-S-transferase (SM28GST) has been cloned and expressed in various
      vectors. Immunization with the recumbent protein results in a significant
      reduction of the parasitic load, while the fertility of schistosoma and the
      viability of its eggs are markedly inhibited. Recent experiments performed in
      primates and bovines have shown that a more than 90% inhibition of the
      schistosoma's transmission potential can be induced by this vaccine. The
      important role played by IgA antibodies in the inhibition of the parasite's
      fertility has led to the development of an oral immunization strategy. In view of
      the results obtained, the availability, in the near future, of a vaccine
      protecting human beings against this scourge can be considered realistic.

PMID- 8341912
TI  - [The campaign against schistosomiasis].
AB  - Like other diseases linked to environment from where men look for supplies of
      goods, schistosomiases are difficult to control. Means of control are existing
      (mass treatment, selective treatment, with well tolerated drugs) but to insure
      the decrease of the prevalence over a long period of time, the strategies are
      sophisticated and often expensive. Therefore, today the objectives of
      schistosomiasis control are focused on the prevention and decrease of morbidity
      rather than on the decrease of transmission. Especially so when the economic,
      social and cultural levels do not permit to avoid the "pathogenic" behaviours.

PMID- 8341913
TI  - [Preoperative cardiologic evaluation. More limited indications, for more useful
      results].

PMID- 8341914
TI  - [Modern identification principles in forensic medicine. Major progress through
      informatics and molecular genetics].

PMID- 8341915
TI  - [Treatment of pneumonia in a community].

PMID- 8341916
TI  - [Heredity and cancers].
AB  - Cancer is a disease at the DNA level, originating from mutations of genes
      involved in the regulation of cell proliferation and differentiation: oncogenes
      and tumor suppressor genes. Only a few proportion of tumors, resulting mainly
      from germ-line anti-oncogene inactivation, arise in the frame of inherited cancer
      syndromes with mendelian mode of transmission. There may also be a much larger
      number of cases who are less strongly predisposed, without evident familial
      clustering. Genes involved in DNA repair process and in metabolism of
      carcinogenesis may be responsible. Study of genetic predisposition to cancer have
      important implications for screening individuals at high-risk in families.

PMID- 8341917
TI  - [Wounds of the hand. Diagnosis, treatment in the first 24 hours].

PMID- 8341918
TI  - [Functional intestinal disorders. Diagnosis, treatment].

PMID- 8341919
TI  - [Shoulder injury. Diagnostic orientation].

PMID- 8341920
TI  - [Dermatophyte infections of the hairless skin and folds. Diagnosis and
      treatment].

PMID- 8341921
TI  - [Pneumothorax. Principles of emergency treatment].

PMID- 8341922
TI  - [Deficiency rickets. Physiopathology, diagnosis, preventive and curative
      treatment].

PMID- 8341923
TI  - [Foreign bodies in the airways. Diagnosis and treatment].

PMID- 8341924
TI  - [Cytokines and inflammation].
AB  - Numerous cytokines are present in inflammatory foci. Two of them, interleukin-1
      (IL-1) and tumour necrosis factor (TNF), play a major role in coordinating
      mechanisms which command inflammation. Under their action many cells produce
      lipidic mediators, proteolytic enzymes or free radicals, all factors that are
      directly responsible for the noxious effects observed. IL-1 and/or TNF exert
      cytotoxic activities on vascular epithelium, cartilage, bone, muscle or beta
      cells of pancreatic islets. Such cytokines as interferon gamma (IFN gamma), IL-3
      or granulocyte-macrophage colony stimulating factor (GM-CSF) amplify the
      inflammatory response by increasing the production of IL-1 and TNF by
      macrophages. GM-CSF also produces other cytokines, such as IL-8 and the
      macrophage chemoattractant protein 1 (MCP-1), the chemotactic properties of which
      participate in the recruitment of leucocytes within the focus of inflammation. IL
      6 abounds in inflammatory processes and induces the production by hepatocytes of
      acute inflammation phase proteins. The same applies to IL-1, TNF, IL-11, the
      leukaemia inhibitory factor (LIF) or the transforming growth factor beta (TGF
      beta). The latter also possesses a number of anti-inflammatory activities and,
      like IL-4 and IL-10, can inhibit IL-1 and TNF production. Glucocorticoids have
      this potential activity, and they may be produced by a cascade of events
      initiated by IL-1, TNF and IL-6, involving the neuroendocrine system. The concept
      of "cytokine network", therefore, perfectly illustrates the participation of
      these mediators in inflammatory mechanisms.

PMID- 8341925
TI  - [Cytokines and hematopoiesis].
AB  - The identification and purification of haemopoietic growth regulators have
      resulted in a better understanding of control mechanisms. Cloning and expression
      of the corresponding genes have shown that most of the activities observed
      correspond to specific glycoproteins produced by cells from numerous tissues,
      including those of bone marrow stroma and immune system. These cytokines activate
      the responsive cells through specific receptors expressed on their membranes.
      They exert an accurate control of haematopoiesis in a network of synergistic and
      antagonistic factors. The exact identification of their biological activities,
      together with the possibility of producing them in large amounts by genetic
      recombination, have already resulted in their therapeutic use with, in certain
      cases, a remarkable efficiency.

PMID- 8341926
TI  - [Cytokines and severe sepsis].
AB  - During severe sepsis syndromes, almost every gene coding for cytokines may be
      activated. The primary purpose of this activation is to defend the organism
      against infection, but sometimes these inflammatory mediators go out of control.
      The reasons why this may occur is unclear because the regulation of cytokines
      production is still poorly understood. Metabolic effects, production of
      endothelial adhesion molecules and triggering of neutrophils are some important
      consequences of cytokine overstimulation which may lead to the clinical picture
      of septic shock. The major cytokines involved in septic shock are tumor necrosis
      factor alpha (TNF) and interleukin-1 (IL-1). Both may induce lethal shock in
      experimental models. The effects of these 2 cytokines are difficult to
      differentiate from one another because they share many similar biological
      effects, one can induce the synthesis of the other, and they are strikingly
      synergistic with each other. gamma-interferon may amplify the inflammatory
      response by stimulating the cells of monocytic lineage and by increasing TNF
      receptor expression, thus participating in the pathogenesis of the septic
      syndrome. The role of other cytokines is still poorly known. Clinical studies
      with anti-TNF monoclonal antibodies or with an IL-1 receptor antagonist are under
      way.

PMID- 8341927
TI  - [Cytokines and malignant hemopathies: leukemias and bone marrow graft].
AB  - Cytokines are now part of the modern armentarium utilized against malignant blood
      diseases. The essentially lymphocytic haematopoietic growth factors (G-CSF, GM
      CSF, IL-3) reduce the infectious morbidity associated with the deep and prolonged
      neuropoenia induced by the myelo-ablative conditioning for autologous or
      allogeneic bone marrow transplantations, and widening their indications is
      tempting. The reluctance expressed about their use in chemotherapy of acute
      myeloid leukaemia is abating now that controlled studies have shown that they
      preserve the complete response rate and shorten the duration of leucopoenia.
      Moreover, they modify the leukaemia biological response, which makes it possible
      to increase the cytotoxicity of certain drugs and constitutes a new approach to
      drug-resistant leukaemias. Immuno-modulating cytokines (interferon alpha,
      interferon gamma, interleukin-2) act through mechanisms that are still ill
      defined: antitumoral activity, modification of biological responses,
      immunoactivation. Nevertheless, interferon alpha has revolutionized the treatment
      of hairy cell leukaemia and myeloid leukaemia, with a 70% remission rate. The
      scarcity of complete responses (10% of hairy cell leukaemias) or cytogenetic
      responses (20% of chronic myeloid leukaemias) justifies a combined treatment
      (chemotherapy+immunotherapy?) to improve these patients' cure rate. The anti
      leukaemic activity of interleukin-2, observed in patients with refractory
      relapses, produces 33% of responses, including 10% of complete responses, and it
      is tempting to test the impact of this immunotherapy on the control of residual
      leukaemia as adjuvant of complete remission using randomized trials.

PMID- 8341928
TI  - [Anti-cytokines and anti-cytokine receptors].
AB  - Cytokines play a key-role in the immune response. The best known of them is
      interleukin-2 and its specific receptors. Monoclonal antibodies directed against
      the interleukin-2 receptor have initially enabled this receptor to be
      characterized; then they served to confirm the major role played by this cytokine
      in immune responses, where it proved effective in many animal models such as
      allograft reaction, delayed hypersensitivity reaction and some experimental auto
      immune diseases. These results have been confirmed in man, particularly in kidney
      transplantation (but also in bone marrow transplantation), and they encourage to
      develop new bioreagents (chimeral antibodies, "humanized" antibodies, fusion
      proteins). Some of these reagents are now undergoing evaluation in renal
      transplantation. The principles of these bioreagents, issued from molecular
      biology, can be applied to other cytokines involved in the immunopathological
      mechanisms of certain diseases such as, for example, IL-6 and its role in the
      development of myeloma. Data from immune intervention directed against other
      cytokines are, for the moment, preliminary, but many potential targets (IL-1, IL
      4, TNF alpha, INF gamma) are emerging.

PMID- 8341929
TI  - [Cytokine assay: value and limitations].
AB  - Cytokines are proteins with multiple functions indispensable to body homeostasis.
      They are also good indicators of certain diseases which they are sometimes
      suspected to induce (e.g. septic shock, allograft rejection). Making cytokine
      assay methods available to scientists and clinicians has been a notable step
      forward in the understanding of numerous illnesses. However, these quantitative
      assays create more problems than they solve, and although reliable and easy tests
      exist we cannot recommend their use in routine clinical practice. In 1992,
      cytokine assays must be reserved for research studies where their results in
      patient populations are meaningful and where they can usefully be completed by
      other detection methods, such as amplification by polymerase chain reaction or
      hybridization in situ. Nevertheless, the constant improvement of assay kits, the
      ever increasing number of cytokines that can be quantified by simple laboratory
      tests and a better study of interactions between cytokines, their soluble
      receptors and their natural inhibitors will perhaps make it possible, in the near
      future, to analyse finely the immune response in not very invasive samplings.
      Moreover, there are hopes that modern molecular biology tools will soon be
      available in daily clinical practice. For instance, the development of automated
      methods for amplification by polymerase chain reaction will provide useful
      information on the activation of the immune system in various clinical
      situations. Such techniques, combined with measurements of local or circulating
      cytokine concentrations are undoubtedly promising tools. Finally, cytokine assays
      are essential to research workers who can study, within well-defined systems, the
      kinetics of production and the respective role played by these mediators.

PMID- 8341930
TI  - [The cost of cytokines].
AB  - The use of cytokines (interferons, interleukin-2, growth factors) is in full
      development, but the new drugs issued from biotechnology are costly. In order to
      control consumption, these products are made available only to hospital
      pharmacists, and they are paid by the prescribing establishments from global
      funds. This results in an ever growing financial burden on the hospital
      pharmaceutical budget. Physicians will have to conciliate 2 objectives: make the
      patients benefit from the new drugs, and control the expenses by using these
      drugs only when necessary.

PMID- 8341931
TI  - [Congestive outbreak of osteoarthritis. Chondrolysis and cartilage repair].

PMID- 8341932
TI  - [Management of acute carbon monoxide poisoning. Normobaric or hyperbaric oxygen].

PMID- 8341933
TI  - [Endovascular ultrasonography. A technology with a promising future].

PMID- 8341934
TI  - [Treatment of infections developing on catheters].

PMID- 8341935
TI  - [Contact dermatitis. Etiology, physiopathology, diagnosis, treatment].

PMID- 8341936
TI  - [Acute metabolic complications of diabetes (ketoacidosis, hypoglycemia,
      hyperosmolarity). Etiology, physiopathology, diagnosis, emergency treatment of
      ketoacidosis with posology].

PMID- 8341937
TI  - [Epistaxis. Diagnostic orientation and principles of the emergency treatment].

PMID- 8341939
TI  - [Nephrotic syndromes. Physiopathology, diagnosis, clinical course and treatment
      of lipoid nephrosis].

PMID- 8341938
TI  - [Malignant tumors of the larynx and the hypopharynx. Epidemiology, diagnosis,
      treatment].

PMID- 8341940
TI  - [Lithium. Principles and rules of use].

PMID- 8341941
TI  - [Ascites. Diagnostic orientation].

PMID- 8341942
TI  - [Physiopathology and principles of intensive care in intestinal obstructions].
AB  - The physiopathology of intestinal obstruction consists of increased intestinal
      peristaltis, distension by gas and fluids, contraction of the extracellular fluid
      volumes (plasma and interstitial sectors) and bacterial proliferation. To this
      must be added, in obstruction by strangulation, the passage of bacteria and
      bacterial products into the general circulation and the peritoneal cavity through
      an ischaemic or necrotic intestinal wall. Metabolic disorders consist of water,
      sodium and potassium deficits and acid-base disturbances. Water and electrolyte
      replacement should take into account the deficits that existed at the beginning
      of treatment, the additional losses expected during treatment and the needs for
      daily maintenance of water and electrolyte balance. The therapeutic procedure is
      simple provided it is systematized.

PMID- 8341943
TI  - [Acute intestinal obstructions in adults: quantified semiology (signs and their
      value) and surgical treatment].
AB  - The prevalence of signs and symptoms of acute intestinal obstruction in the adult
      was studied in a prospective study of 600 cases extracted from a data base on
      acute abdomen in 7,000 patients. This study of prevalence allows a precise
      definition of intestinal obstruction syndrome and to differentiate two types of
      presentations according to the site of obstruction on the small bowel or the
      colon. However, it is more difficult to differentiate simple bowel obturation
      from vascular strangulation. Surgical treatment depends mainly on the cause of
      obstruction.

PMID- 8341944
TI  - [Chronic small intestine obstructions].
AB  - Chronic small bowel obstruction may be related either to disordered motility or
      to progressive chronic stenoses. Disordered motility (or intestinal pseudo
      obstruction) is the consequence for muscular and/or intrinsic nerve impairment
      with 2 main types, one of which is primary (including so-called visceral
      myopathies and visceral neuropathies), the other one being secondary (generally
      due to systemic, or sometimes immunologic disease). Chronic stenoses have a
      different pathophysiology and occur in the setting of chronic inflammatory bowel
      disease or of systemic diseases such as vasculities. Chronic stenoses lead to
      intestinal stasis and in fine to mechanical obstruction. In any case, chronic
      obstruction poses difficult diagnostic and therapeutic problems. Management calls
      for tight medico-surgical cooperation. Atypical surgical operations may be
      warranted, and specific, sometimes aggressive medical care is mandatory. Moreover
      the nutritional consequences of chronic small bowel obstruction may become highly
      disabling due to alimentary restriction, disordered transit, bacterial overgrowth
      and malabsorption. In this setting nutritional support should be a matter of
      prime concern.

PMID- 8341945
TI  - [Imaging of intestinal obstructions].
AB  - The diagnosis of intestinal obstruction still rests on radiography of the abdomen
      without preparation. Three X-ray films must systematically be taken: a general
      film and a film centred on the diaphragmatic domes with the subject standing;
      another general film with the subject lying on his back. It is relatively easy to
      identify the obstructed segment, but the cause of obstruction remains difficult
      to determine. For small bowel obstruction, emergency surgery is often necessary.
      If the patient's condition permits, it may be useful to opacify the dilated
      segment in order to study the nature of the obstacle. Colonic obstruction is
      opacified through the anus, this route being more informative. There are two
      types of acute obstruction: by occlusion and by strangulation. The various causes
      are considered, but there are also incomplete obstructions and dilatations
      without obstruction.

PMID- 8341946
TI  - [Postoperative obstructions].
AB  - The intestinal obstructions after a laparotomy in adult may be caused by an
      inflammatory or a mechanic pathology; the incidence of the bowel obstruction in
      the early postoperative period is about 0.5 to 2% of all surgical procedures;
      these obstructions are often related to the degree of contamination or infection;
      contrary to postoperative paralytic ileus, they result in a reoperation, so as a
      peritonitis may be associated. In the later postoperative period intestinal
      obstructions may be caused by adhesions, internal strangulation or fibrosis
      bridles; these obstructions are frequent and they affect especially the small
      intestine (5% of laparotomies will be complicated by small bowel obstruction).
      The intestine volvulus due to bridles or adhesions is observed in approximately
      10% of cases and the diagnosis must be conjured up in principle because it
      necessities an operation immediately; it's the same for the strangulation by
      incarceration. The absence of classic indicators of gangrene permits a non
      operative treatment using a naso-gastric tube decompression during 24 to 48
      hours: generally the causes of obstruction are small bowel adhesions,
      nevertheless it's important to eliminate a colonic obstruction. The management of
      chronic postoperative adherences is a difficult problem because the iterative
      operations increase the risk of intestinal obstructions; the video-laparoscopic
      surgery seems to be a promising technique to prevent and to treat (laparoscopic
      adhesiolysis) the post-operative adherences; its results are not evaluated.

PMID- 8341947
TI  - [Obstructions in children].
AB  - In matters of intestinal obstruction the younger the child, the clearer the
      features of this condition. As in adults, obstruction reveals an intestinal
      blockage related to multiple and varied origins. Neonatal obstruction deserves
      special attention, as it often reveals a digestive tract abnormality with
      interrupted continuity which is incompatible with life unless the appropriate
      surgical treatment is carried out. Constant advances in intensive care and
      nutritional care of these infants result in increasingly "borderline" digestive
      situations, but certain situations have not yet been solved in the absence of
      success of intestinal transplantation.

PMID- 8341948
TI  - [Ogilvie's syndrome and non-mechanical obstructions].
AB  - Ogilvie's syndrome and chronic intestinal pseudo-obstructions are two aspects of
      non-mechanical obstruction. The syndrome consists of acute colonic obstruction
      due to multiple causes and is characterized by passive dilatation of the colon
      without downstream obstacle. Treatment is primarily medical, except in cases with
      complications such as perforation by symptomatic treatment and, sometimes, by
      decompression colonoscopy. The most severe complication is perforation of the
      colon which may require colonic excision. Chronic intestinal pseudo-obstruction
      is characterized by chronic disorders mostly due to abnormalities of nervous
      plexuses and smooth muscle of the small and large bowels. It occurs in children
      and surgical abstention may lead to repeated but unfortunately ineffective
      operations. The only treatment recognized is digestive tract bypass combined with
      total parenteral feeding.

PMID- 8341949
TI  - [Strangulated hernia and eventration].
AB  - Incarcerated hernia or wound dehiscence are responsible for more than 10% of
      small bowel obstructions. The complication is easily recognized when hernia or
      wound dehiscence was previously diagnosed. Difficulties occur when mass is deeply
      located in a thick abdominal wall or inside the inguinal canal. Femoral hernias
      and direct inguinal hernias are those which strangulate the most. Strangulation
      in wound dehiscence is the most severe. Strangulated hernia should be routinely
      excluded in patient with intestinal obstruction, to avoid inappropriate surgical
      approach.

PMID- 8341950
TI  - [Tetrahydroaminoacridine or THA. Disputed value in Alzheimer's type dementia].

PMID- 8341951
TI  - [Pubalgia. A syndrome in of sport injury, corresponding to locoregional
      pathology].

PMID- 8341952
TI  - [Acquired facts on the treatment of colonic and rectal cancers].

PMID- 8341953
TI  - [Role of cyclosporin in renal transplantation].
AB  - The cyclosporine era started 10 years ago in organ transplantation, especially in
      renal transplantation. Following the pioneering works showing the efficacy and
      its synergism with other immunosuppressors, a second step consisted in a better
      use by decreasing the induction dose and a closer definition of its side effects.
      A major improvement in the results (increase of 5 to 10% in patient survival and
      of 10 to 20% in graft survival), a decrease in the number of acute rejection
      episodes, in the cumulative doses of steroids, in the duration of hospitalization
      and in the total cost of transplantation made this drug as the worldwide used
      agent, now considered as the milestone in immunosuppression. Over all, organ
      transplantation is needing a more specific immunological agent, deprived if
      possible of major side effects. In these regards, each new agent should be
      considered only if compared to the "gold standard", namely cyclosporine.

PMID- 8341954
TI  - [Segalen and Chabaneix in China during the Manchurian plague].

PMID- 8341955
TI  - [Bacterial cutaneous infections: impetigo. Etiology, diagnosis, development,
      treatment].

PMID- 8341956
TI  - [Painful shoulder. Diagnostic orientation].

PMID- 8341957
TI  - [Leukorrhea. Diagnostic orientation].

PMID- 8341958
TI  - [Typhoid and paratyphoid fever. Epidemiology, etiology, physiopathology,
      diagnosis, development, prognosis, treatment].

PMID- 8341959
TI  - [Closed injuries of the abdomen. Physiopathology, diagnosis, treatment].

PMID- 8341960
TI  - [Statural growth retardation. Diagnostic orientation].

PMID- 8341961
TI  - [Pelvic rheumatic spondylitis. Etiology, diagnosis, development, prognosis,
      treatment].

PMID- 8341962
TI  - [Cancer of the tongue. Epidemiology, diagnosis, treatment].

PMID- 8341963
TI  - [Procurement and transplantation of organs. Legal and ethical aspects].

PMID- 8341964
TI  - [Antiemetics during cytotoxic treatments].

PMID- 8341965
TI  - [Inguinal, crural and umbilical hernia. Physiopathology, diagnosis,
      complications, treatment].

PMID- 8341966
TI  - [Recent brain injury. Diagnostic orientation].

PMID- 8341967
TI  - [Cutaneo-mucous herpes. Epidemiology, physiopathology, diagnosis, development,
      treatment].

PMID- 8341968
TI  - [Chickenpox and herpes zoster. Epidemiology, physiopathology, diagnosis,
      development, treatment].

PMID- 8341969
TI  - [Severe acute asthma. Diagnosis and emergency treatment with posology].

PMID- 8341970
TI  - [Cancers of the stomach. Diagnosis, development, treatment].

PMID- 8341971
TI  - [Intrapulmonary solitary round opacity. Diagnostic orientation].

PMID- 8341972
TI  - [Paranoid personality. Diagnosis].

PMID- 8341973
TI  - [Normal sperm].
AB  - The evaluation of male infertility rationally begins with a study of the
      characteristics of the semen, notably sperm count and motility assessment.
      However, this examination is difficult to interpret due to the important intra-
      and interindividual variability of these parameters, making it impossible to
      determine accurately the criteria of "normality". In each given subject the
      characteristics of semen can be influenced by the conditions of sample
      collection, the length of abstinence, and any disease that may have occurred in
      the 3 months preceding the examination. To draw firm conclusions from one single
      examination would be misleading and a second examination is advised. The criteria
      of normality laid down by WHO are not very useful to determine the degree of
      fertility in males: one may speak of oligozoospermia when the sperm count is
      below 20 million/ml, but several recent prospective studies have shown that
      fertility significantly falls only below 5 million/ml. A threshold value
      concerning the percentage of normal forms has been established at 30-40%, whereas
      teratozoospermia has been defined by the WHO as from 50% onwards. Sperm count can
      be completed by a fine analysis of sperm motions, and this has been made possible
      by the development of digital microvideographic analysis techniques. However,
      defining norms for the main parameters of sperm motility is delicate and can only
      be done by teams of specialists.

PMID- 8341974
TI  - [Epidemiology of male infertility].
AB  - The responsibility of the male in the infertility of the couple has been ignored
      for long time; it is now universally recognized and obliges general practitioners
      to explore the possibility of male infertility. Clinical and laboratory
      examinations must be carried out simultaneously, with a systematic search for the
      major risk factors of male infertility, such as varicocele and history of genital
      infection or injury to the testis. The practitioner must also investigate the
      working conditions and the environment of the infertile male in search for
      occupational risk factors which are frequently overlooked but often have severe
      consequences.

PMID- 8341975
TI  - [How to recognize and classify male infertility].
AB  - Infertility of the couple affects 19% of the general population, 4% of which are
      infertile. Almost 50% of infertilities are ascribable to the male partner. Male
      infertility is determined by a preliminary clinical and biological evaluation
      which consists of full examination of the semen, with sperm and spermocyte counts
      and cultures. Further examinations depend on the data provided by this
      evaluation. The causes of human infertility can be classified as follows: 1.
      Abnormalities of the spermatozoa which may be of testicular origin (defect of
      gonadal maturation, genetic of genic congenital anomalies, varicocele) or of post
      testicular origin (acquired or congenital excretory obstacle to be located by
      surgery and treated whenever possible. 2. Abnormalities of seminal plasma
      (seminal infections, autoimmunization, isoimmunization). 3. Abnormalities of
      ejaculation (pathogenic or iatrogenic retrograde ejaculation, organic or psychic
      anejaculation). 4. Unknown cause requiring more sophisticated sperm examinations,
      such as microvideography of the flagellum, exploration of the acrosome and of
      nuclear maturation.

PMID- 8341976
TI  - [Exploration of pathological sperm and its fertilizing power].
AB  - The exploration of human sperms has considerably progressed during the last few
      years, side by side with the development of medically assisted procreation
      techniques. The sperms are explored by a battery of techniques which evaluate
      their functional state and the expression of their fertilizing power. Sperm count
      and motility assessment remain the basic examination in the exploration of
      couples' infertilities but other more sophisticated techniques can be used to
      evaluate certain stages in the fertilization process, including the recognition
      by, and attachment of the sperm to the zona pellucida of the oocyte, its
      penetration into this zone, the fusion of sperm and oocyte membranes and the
      transformation of the nucleus into a male protonucleus in the cytoplasm of the
      oocyte. Up to now, however, most of the techniques that evaluate the functional
      state of the sperm cell have not been predictive, and the only feasible and
      repeatable means of evaluating the fertilizing power of a semen is fertilization
      in vitro.

PMID- 8341977
TI  - [Male infertility of immunologic origin and its treatment].
AB  - Antibodies against sperm surface antigens may be responsible for 3 to 20% of
      idiopathic male infertility cases. Antisperm immunisation may be suspected in
      view of a clinical suggestive history, a spontaneous sperm-agglutination and an
      inability of spermatozoa to penetrate a normal cervical mucus. The responsibility
      of antisperm antibodies in the infertility state could be demonstrated in vitro
      by their effects on several sperm functions. An inverse correlation between
      antibodies titres and conception rates has been demonstrated and it justifies a
      therapeutical approach in the presence of high levels of antibodies.
      Corticosteroids must not be used as the results obtained did not justify the side
      effects observed. Intra-uterine insemination as well as in vitro fecundation can
      help some of these couples but results must be improved by better methods of
      selection of motile sperm populations devoid of antibodies.

PMID- 8341978
TI  - [Genetic aspects of male infertility].
AB  - Cytogenetic investigations in sterile males showed that autosomal and sex
      chromosome anomalies can be responsible of the defect of spermatogenesis.
      Specific alteration of genes controlling spermatogenesis is excluded because all
      chromosomes are involved in the anomaly and breakpoints are distributed at
      random. In the aim to explain the spermatogenic failure, three mechanisms are
      proposed: X-autosome interaction, asynapsis, somatic lesion of the gonad, each
      mechanism might act alone or with the other. Beside chromosomal infertility,
      meiotic or sperm anomalies suggest the presence of gene mutations which interfere
      with the evolution of spermatogenesis or lead to the formation of abnormal
      spermatozoa. Insertion of technics of molecular biology in our researches could
      demonstrate the existence of these mutations; the same technics will allow to
      resolve the problem of the failure of a germ cell bearing a chromosomal anomaly
      particularly when this anomaly is balanced and involves the autosomes and not the
      sex chromosomes.

PMID- 8341979
TI  - [Medical treatment of male infertility].
AB  - The opinions of specialists on the medical treatment of male infertility has been
      altered by two events: the advent of epidemiology, which demands studies with
      control cases, and the advances achieved in in vitro fertilization. Apart from
      cases of hypogonadotropic hypogonadism, no type of male hypofertility has found
      an unquestionably effective treatment. Yet it is probable that varicocelectomy,
      treatment of genital infection and, in rare cases of hormonal deficiency,
      hormonal treatments that stimulate Leydig and Sertoli cells may have positive
      effects. In idiopathic oligo-astheno-teratospermia, which is the most frequently
      encountered type of infertility, several treatments are currently being tested
      but have not been fully evaluated. Quite recently, attempts at treating patients
      immediately before in vitro fertilization have started, but the results are not
      yet available.

PMID- 8341980
TI  - [Psychological approach of the infertile male].
AB  - Male infertility is usually anxiogenic, and it is often responsible for sexual
      dysfunctions due to the cultural indissociability of the virility and fertility
      concepts on the one hand, and to the timing of sexual intercourse in the
      ovulation period on the other hand. The intrusion of medicine in the life of the
      infertile couple frequently amplifies the existing psychological problems and
      discloses other problems by questioning the representation systems of identity,
      procreation and filiation.

PMID- 8341982
TI  - [Future of the treatment of male infertility].
AB  - The aim of this paper is to introduce inherent difficulties leading to relative
      delay in the field of male infecundity treatment. Four theoretical possibilities
      are exposed: infertility prevention improvement, qualitative or quantitative
      improvement of spermatogenesis, spermatozoa fecundity ability improvement and
      micro-fertilization procedures. These methods are exposed in their technical
      aspects and in their results. Critical analysis is conducted about some
      impressive reported series. Basic knowledge improvement seems to be necessary to
      explore new therapeutic ways.

PMID- 8341981
TI  - [Assisted procreation for male indication].
AB  - Strategy for male infertility looks like a compromise between diagnosis methods
      with their efficacy and complexity and treatment with their own risks, cost,
      efficacy. Infertility duration as well as woman's fertility play a key role for
      such a strategy. Definitive infertility without any correction (secretory
      azoospermia) will be proposed for alternate projects. Some situations may benefit
      from specific therapy (hypogonadotropic hypogonadism, anejaculations or
      retrograde ejaculation). More frequently male hypofertility is suspected with non
      specific sperm alterations, then assisted reproductive technologies will be
      discussed. Intra-cervical way artificial insemination with husband semen may be
      proposed in case of hypospadias, anejaculation, retrograde ejaculation, small
      volume ejaculate or self-cryostored semen, however negative post-coital test,
      positive crossed penetration test and positive post-insemination test need to be
      confirmed. Intrauterine way enhance fertilizing probability by discarding
      cervical step. It will be justified in case of negative post-coital test as well
      as crossed penetration test except that sperm preparation allowed to inseminate
      500,000 to 1 million motile spermatozoa. Both rigorous monitoring and synchronism
      between insemination and ovulation enhance the efficacy of IU AIH which allowed a
      two to four fold increase in the pregnancy rate on a total of six cycles. In
      vitro fertilization for male factor represent around 15% of all IVF attempts.
      Both decrease in the fertilization rate and the increase in the pregnancy rate by
      transfer as compared with tubal factor are well accepted. The fertilization
      failure remain difficult to explain and need to be cautiously confirmed. Thus IVF
      represent an actual fertilization test but remain limited by the heterogeneity of
      parameters under "male factor".(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341983
TI  - [Sodium and arterial hypertension. Mythic or real relations?].

PMID- 8341984
TI  - [MRI in the exploration of tendon diseases. An irreplaceable tool with still
      limited indications].

PMID- 8341985
TI  - Role of acid inhibition in the management of Helicobacter pylori infection:
      chairmen's introduction.

PMID- 8341986
TI  - Hp and pH: implications for the eradication of Helicobacter pylori.
AB  - Helicobacter pylori infection causes inflammation of the gastric and duodenal
      mucosae, which results in a disturbance of the regulatory mechanisms for gastrin,
      gastric acid and pepsin secretion. Acid secretion may be decreased, normal or
      increased, depending on the stage of infection, although the meal-stimulated
      gastrin response is invariably elevated. The exact mechanisms involved are not
      known but may be due to the release of cytokines in response to bacterial toxins.
      H. pylori colonization is reduced by effective acid suppression with proton pump
      inhibitors, although it is not eradicated. In combination with amoxycillin,
      omeprazole, up to 40 mg twice daily, eradicated the organism in up to 82% of
      cases. This synergistic effect may be due to a direct effect of omeprazole on the
      organism, the protection of amoxycillin from acid degradation, or enhancement of
      host defence mechanisms accompanying acid suppression.

PMID- 8341987
TI  - Long-term follow-up after eradication of Helicobacter pylori with a combination
      of omeprazole and amoxycillin.
AB  - Early studies have suggested that omeprazole may facilitate the eradication of
      Helicobacter pylori. Sixty patients with duodenal ulcer and H. pylori
      colonization were randomly assigned to receive either omeprazole monotherapy (n =
      30) or combination therapy with omeprazole and amoxycillin (n = 30) for a total
      duration of 6 weeks. Four patients receiving monotherapy and three receiving
      combination therapy had to be withdrawn from the study. All (100%) duodenal
      ulcers healed in patients receiving combination therapy, and 25 out of 26 (96%)
      healed in the group receiving monotherapy. H. pylori was eradicated in 22 out of
      27 (82%) patients receiving combination therapy; only two ulcer relapses (9%)
      occurred within 18 months in these 22 patients. Of the five patients who remained
      H. pylori-positive after combination therapy, two relapsed during the 18-month
      follow-up. In the monotherapy group, all patients remained H. pylori-positive
      after treatment, and duodenal ulcer relapsed in 16 out of 25 (64%) patients
      within the median follow-up of 18 months. Adverse events were not reported in the
      group treated with combination therapy; one patient receiving monotherapy
      reported severe headache. These results lend further support to existing data
      that H. pylori eradication prevents duodenal ulcer relapse and show that
      combination therapy with omeprazole and amoxycillin is effective and well
      tolerated.

PMID- 8341988
TI  - Role of Helicobacter pylori in the pathogenesis of gastritis, peptic ulcer and
      gastric cancer.
AB  - Helicobacter pylori is the major causal factor in chronic gastritis. Its
      acquisition leads to a chronic, usually lifelong, inflammation of the gastric
      mucosa, which may gradually progress to atrophy (with intestinal metaplasia) in a
      significant proportion of infected individuals. This progression is probably
      multifactorial, being influenced by genetic or environmental factors in addition
      to H. pylori infection. The pathogenesis of peptic ulcer and gastric cancer is
      closely associated with H. pylori gastritis and its subsequent atrophic sequelae
      (atrophic gastritis). H. pylori-induced gastritis is an important risk factor in
      the multifactorial aetiology of these diseases. It causes a cascade of reactions
      that damage the gastric mucosa and epithelium in various ways. The specific
      mechanisms involved are largely unknown. Some are probably bacterium-related
      reactions, which are influenced by various virulence factors, and others are
      consequences of the mucosal inflammation and atrophy. The risk of peptic ulcer
      and gastric cancer in patients with H. pylori gastritis can be summarized as
      follows: i) the risk of both peptic ulcer and gastric cancer is low in
      individuals with a normal stomach; ii) the risk of peptic ulcer is approximately
      ten times higher and the risk of gastric cancer approximately twice as high in
      patients with non-atrophic H. pylori-positive gastritis as in those with a normal
      stomach; iii) these risks are further increased (twofold to threefold) when there
      is antral atrophy; whereas iv) in the presence of corpus atrophy the risk of
      gastric cancer remains high, but that of peptic ulcer decreases gradually to zero
      with increasing severity of corpus atrophy.

PMID- 8341989
TI  - Compliance, adverse events and antibiotic resistance in Helicobacter pylori
      treatment.
AB  - The highest H. pylori eradication rates have been reported with triple therapy,
      using metronidazole with amoxycillin or tetracycline, and colloidal bismuth
      subcitrate or bismuth subsalicylate. The use of such therapies, however, may be
      impeded by a number of major disadvantages, including reduced patient compliance,
      the incidence of adverse events and primary or acquired antibiotic resistance.
      Patient compliance is a particular problem with triple therapy owing to the
      quantity of drugs taken, treatment duration and regimen complexity; the
      eradication rate is reduced from 96% to 69% when only 60% of the medication is
      taken. The risk of adverse events resulting from the inclusion of antibiotics in
      the regimen is increased in triple therapy, and this generates reluctance in many
      practitioners to prescribe such therapy despite its well-documented efficacy. An
      important cause of antibiotic failure lies in the development of H. pylori
      resistance; between 6% and 27% of H. pylori strains are primarily resistant to
      the 5-nitroimidazoles--metronidazole and tinidazole--both of which are used in
      triple therapy. In contrast, no resistance of H. pylori to amoxycillin has been
      reported. The combination of an acid pump inhibitor with a single antibiotic
      represents a promising novel therapy for H. pylori-associated peptic ulcer
      disease. Treatment with omeprazole and amoxycillin could provide both rapid
      healing of ulcers and eradication of H. pylori, coupled with few adverse events,
      good drug compliance and low ulcer relapse rates, and may replace triple therapy
      as first-line medication.

PMID- 8341990
TI  - Eradication of Helicobacter pylori and its effect in peptic ulcer disease.
AB  - Since Helicobacter pylori was first cultured 10 years ago, there have been
      remarkable changes in our approach to the therapy of peptic ulcer disease. We now
      know that 90% of duodenal ulcer patients and 70% of all gastric ulcer patients
      are infected with H. pylori. Evidence is presented that the relapse rate of both
      duodenal and gastric ulcers can be substantially reduced if the bacterium is
      eradicated from the patient's stomach. Some of the anti-H. pylori eradication
      regimens currently available are discussed, with particular emphasis on the
      relative merits of standard triple therapy and an omeprazole/amoxycillin
      combination.

PMID- 8341991
TI  - Kinematic gait analysis in hemiplegic patients.
AB  - Temporal-distance variables of gait were investigated in 8 female and 23 male
      hemiplegic patients in order to assess the distribution of these variables
      according to functional ambulation category and to evaluate their validity. Video
      recording technique was used for obtaining the temporal-distance values.
      Velocity, step-time, stride length and stride length in relation to lower
      extremity length proved to be valuable measures in the gait analysis, while
      cadence, step-time and step-time differential values seemed to be less important.

PMID- 8341992
TI  - The influence of isometric hip adduction on quadriceps femoris activity.
AB  - In the treatment of muscle imbalances around the knee, hip adduction and the
      contraction of adductor magnus have been used to facilitate vastus medialis
      obliquus (VMO) to a greater extent than vastus lateralis (VL). This study was
      conducted to investigate the effectiveness of this technique. Hip adduction was
      superimposed onto the contraction of quadriceps femoris in a weight bearing (WB)
      and a non-weight bearing (NWB) position at three levels of hip adduction force.
      The muscle activity of VMO and VL was recorded using electromyography with the
      ratio of the recordings of VMO to VL used for comparison. The activity of VMO
      compared with VL was greater in WB than NWB without hip adduction. VMO activity
      increased relatively more than VL with the addition of each level of hip
      adduction in WB and only with maximal hip adduction in NWB. The results provide
      support for the use of this technique.

PMID- 8341993
TI  - Impact of knee extensor strength deficits on stair ascent performance in patients
      after medial meniscectomy.
AB  - After arthroscopic meniscectomy the relationship between the magnitude of knee
      extensor strength deficits and locomotor performance during stair ascent unloaded
      and when carrying a 22 kg load has been tested in 31 patients. The specific
      locomotor adaptations related to large strength deficits were also studied. The
      results indicate that large deficits were significantly associated to: 1) reduced
      activation of the knee extensor muscles (vastus medialis and lateralis) during
      the first double leg support and single leg support phases, and of the hip
      extensors (medial hamstrings) during the second double leg support of stair
      ascent, 2) overactivations of the hip extensors (gluteus maximus and medial
      hamstrings) during single leg support, and 3) longer cycle and step durations and
      lower cadences. Locomotor abnormalities in movements and muscle activations were
      generally found in patients with strength deficits greater than 25% while
      patients with smaller strength deficits (less than 25%) usually could climb
      stairs with normal performance. These results support the use of knee extensor
      strength measures to predict locomotor capacities, and also highlight the
      importance of postoperative knee strength rehabilitation.

PMID- 8341994
TI  - Lung volumes in tetraplegic patients according to cervical spinal cord injury
      level.
AB  - Fifty-six tetraplegic patients with motor complete lesions (Frankel A and B)
      underwent spirometric measurements more than 6 months after injury. The results
      were evaluated according to the level of transection of the cervical cord. A
      pronounced restrictive respiratory dysfunction was demonstrated in all patients.
      The expiratory reserve volume (ERV) was zero or markedly reduced in patients at
      all lesion levels. Systematic increases in both ERV and vital capacity (VC) were
      found with lower lesion level. The inspiratory capacity (IC) was reduced at all
      injury levels, but there were no systematic differences in IC between injury
      levels C4-C8. The total lung capacity (TLC) was reduced and the ratio residual
      volume/total lung capacity (RV/TLC) was increased in patients at all injury
      levels. The lung function of patients tested > 12 months after injury was not
      significantly different from the function in those tested 6-12 months after
      injury. A respiratory rehabilitation programme for tetraplegic patients should
      take into account the fact that the respiratory function, especially the forced
      expiration, is dependent upon injury level.

PMID- 8341995
TI  - Lymphoedema post-mastectomy: is elevation alone an effective treatment?
AB  - In an attempt to obtain information about the efficacy of arm elevation on the
      reduction of lymphoedema following mastectomy, a study on 33 patients was carried
      out in which both the control, contralateral and lymphoedematous arms were
      elevated for periods of 1 and 5 h. There were statistically significant (p <
      0.05) reductions in the volumes of the control and lymphoedematous arms after 1
      and 5 h of elevation. After 1 h of elevation, significantly more fluid was
      removed from the control arm (2.7%) than the lymphoedematous one (1.3%). At 5 h
      there was no significant difference in the volume of fluid removed from the
      control arm (3.3%) compared with the lymphoedematous one (3.1%).

PMID- 8341996
TI  - Rehabilitation after coronary bypass surgery: coping strategies predict metabolic
      improvement and return to work.
AB  - Thirty-six consecutive male patients who underwent coronary bypass surgery were
      investigated before and repeatedly up to 5 years after surgery. We followed the
      patients' physical capacity, dietary and exercise habits, mood, perception of
      health and return to work. Discriminant analysis identified four variables from
      the preoperative interview and the psychological tests which correctly classified
      22 out of 24 patients into either metabolic responders--who were characterized by
      favourable changes in their lipoprotein profile, related to a successful clinical
      outcome--or non-responders. Responders were found to acknowledge subjective,
      emotional aspects of their situation whereas non-responders minimised their
      disease. Six preoperative variables successfully predicted the classification of
      all but one patient into full-time workers or not, one year after surgery. Full
      time workers were more frequent among minimizers. The results suggest that
      whereas minimising of disease is adaptive in a short-term perspective,
      acknowledgement may be successful in the long run.

PMID- 8341997
TI  - [Late sequelae in a group of children and adolescents treated for cancer between
      1981 and 1986 in Switzerland].
AB  - An ever-growing number of children with malignant diseases can today be cured and
      will have prolonged survival. Their quality of life, which can be altered by a
      substantial number of late effects of the disease or its treatment, is a
      prominent field of long-term assessment. In a cross-sectional study based on
      clinical and paraclinical parameters and covering 59 children and young adults
      treated between 1981 and 1986 for a childhood malignant disease, we investigated
      late effects in the long-term survivors. Late effects were found in 36 (61%) of
      these patients; their spectrum is wide, but most often affected are the CNS and
      the musculoskeletal system. Two thirds of the patients have mild or moderate and
      one third severe problems. The frequency of the late effects and the type of
      problem vary greatly according to the initial diagnosis; our results show a
      significant difference of severity according to the number of affected systems (p
      < 0.05). The results of our study match those of other similar reports and
      confirm the high frequency of late effects in survivors of pediatric cancer. A
      prospective study, assessing a large population of patients, is needed to
      determine the underlying causes and to develop primary and secondary prevention
      strategies.

PMID- 8341998
TI  - [Results of short-term tuberculosis therapy with isoniazid, rifampicin and
      pyrazinamide].
AB  - Short-course chemotherapy of six-month duration with an initial combination of
      three drugs (isoniazid [H], rifampin [R] and pyrazinamide [Z]) is recommended as
      the treatment of choice in tuberculosis today. Use of fixed-combination tablet
      (Rifater) prevents prescription errors by physicians and selective intake by
      noncompliant patients. It should therefore assist in the prevention of emergence
      of drug resistance. In a controlled study at a chest hospital in Switzerland
      involving 261 patients with culture proven tuberculosis, the following two
      regimens were compared: 1) Six-month therapy (n = 128) with daily Rifater for two
      months, followed by H and R for four months. 2) Nine-month therapy (n = 133) with
      H and R daily for nine months, supplemented by ethambutol for the first two
      months. The two patient groups were comparable except for initial drug resistance
      (16% vs 8%, p < 0.05). Overall resistance to H was 10%. Five patients had initial
      resistance to two or more drugs. 227 patients were re-examined 1-8, and on
      average 4 years after therapy: four patients relapsed after 12, 20, 36 and 90
      months. Two patients with initial drug resistance to H later developed resistance
      to R; both of these, as well as a third relapse patient, were cured with
      subsequent multi-drug therapy. Despite two and a half years of chemotherapy and
      repeated surgery, the fourth patient with initial resistance to H and R could not
      be cured. All relapse patients with initial drug resistance were randomized into
      the six-month therapy group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8341999
TI  - [Mesenteric panniculitis].
AB  - A 70-year-old patient with a 6 x 6 x 12 cm mass involving the mesentery root is
      discussed. The pseudotumorous infiltration was detected by ultrasound done
      because of nonspecific abdominal symptoms and weight loss. Laparoscopic biopsy
      confirmed the diagnosis of mesenteric panniculitis. The primary histologic
      criterion is infiltration of the mesenterium by foamy lipid-laden macrophages,
      clusters of lymphocytes and fibrosis. The majority of cases follow a benign
      course and need no therapy, but co-existence of lymphoma has been reported. There
      have been few cases where panniculitis with progressive fibrosis changed into
      retractile mesenteritis with shortening of the mesenterium and compression of
      mesenteric vessels with partial or complete intestinal obstruction or ischemia
      requiring surgery. Few reported cases of severe and progressive disease have been
      treated with prednisone and azathioprine or cyclophosphamide.

PMID- 8342000
TI  - [Are there antidepressants specially indicated in certain depressive disorders?].
AB  - Treatment for depression has improved and several well tolerated antidepressants
      have been developed. The diagnosis is less important for the choice of treatment
      than the severity of the symptoms. Antidepressants are indicated if a depression
      is of at least moderate severity. For many years attempt has been made to find
      specific criteria for the choice of the "right" antidepressant. At present the
      scientific results do not allow unequivocal formulation of criteria for the
      differential indication of antidepressants. When treating patients we have
      nevertheless to decide which antidepressants to prescribe. Based on scientific
      results and long therapeutic experience, the author indicates which
      antidepressants may be more successful in which depression (retarded depression,
      agitated depression, delusional depression, suicidal ideas, anxiety, obsessive
      compulsive symptoms, eating disorders and atypical depression).

PMID- 8342001
TI  - [Vertigo and migraine].
AB  - Vertigo consists of a variety of syndromes and can be due to many etiologies. One
      of these causes is migraine, which in our experience is often overlooked,
      although migrainous vertigo is well known in the literature. Vertigo in migraine
      can occur as aura or during the headache phase, or independent of the attacks as
      aura without headache. The aim of this retrospective study was to analyze cases
      with vertigo and migraine: 23 (8%) of 298 patients with migraine examined in a
      neurological outpatient department also had rotational vertigo. 48% of these
      patients had vertigo independent from typical migraine headache. Two types of
      vertigo were found: permanent vertigo, and vertigo with the characteristics of
      paroxysmal positional vertigo. 57% of the vertiginous attacks lasted hours, 26%
      even days, and 17% minutes. Most of the patients had several attacks of vertigo,
      some involving up to 30 episodes. To recognize migraine as a cause of vertigo has
      therapeutic implications. Most of our patients with vertigo and migraine showed a
      good response to antimigraine therapy.

PMID- 8342002
TI  - [Partial kidney resection in renal cell carcinoma].
AB  - In 18 patients with renal cell carcinoma in anatomical or functional single
      kidneys, with limited renal function or bilateral tumors, partial renal resection
      was absolutely indicated to preserve renal function. In 17 patients with small
      peripheral tumors and intact contralateral kidney, partial renal resection was
      performed electively. One patient of each group died during postoperative care.
      During follow-up, 4 patients with absolute indication for partial renal resection
      showed progression of the disease. Three developed distant metastases, and in one
      patient local relapse with infiltration of the inferior cava vein occurred. These
      4 patients had had a bilateral synchronous or asynchronous stage pT2 or pT3 renal
      cell carcinoma and died from the neoplasm within 10-36 months postoperatively. 13
      of 18 patients with absolute indication remained tumorfree during a median follow
      up period of 57 months. Partial renal resection saved 15 of these 17 patients
      from dialysis. Sixteen of 17 patients in whom partial renal resection was
      performed electively remained tumorfree during a median follow-up period of 28
      months. The results suggest that, given an absolute indication to prevent
      dialysis, partial renal resection should be performed whenever technically
      possible. In patients with small peripherally located tumors and intact
      contralateral kidney, partial renal resection as an elective procedure must be
      considered a genuine alternative to radical nephrectomy.

PMID- 8342003
TI  - [Villous adenoma of Vater's papilla. Problems in diagnosis and therapy].
AB  - Adenomas of the ampulla of Vater are rare tumors which cause the same diagnostic
      problems as adenomas of the colon and rectum. From 1984 to 1991 we treated 5
      patients with adenomas of the ampulla of Vater verified by endoscopy and biopsy.
      All 5 patients underwent transduodenal papillectomy and reimplantation of the
      common bile duct and pancreatic duct with intraoperative frozen section
      examination of the specimen. In 2 out of the 5 cases, the definitive diagnosis
      was invasive carcinoma undetected by frozen section examination. Both patients
      subsequently underwent partial duodenopancreatectomy with preservation of the
      pylorus. In one of our patients villous adenoma was detected six years after the
      insertion of a biliary endoprosthesis for alveolar echinococcus infiltrating the
      bifurcation of the hepatic ducts, a finding which raises the question as to an
      etiologic role of long-time biliary duct stenting. We discuss the diagnostic
      problems of the adenoma-carcinoma sequence and the therapeutic options.

PMID- 8342004
TI  - [Post-cholestatic hypercholeresis in a patient with malignant obstruction of the
      bile ducts].
AB  - Increased choleresis of up to 4950 ml per day was observed after positioning of a
      PTCD in a patient with complete biliary obstruction due to a malignant tumor.
      Bile secretion could be temporarily reduced to 15% of the initial flow rate by
      intravenous administration of somatostatin. Simultaneously, the concentration of
      bile acids increased from 1.2 to 6.2 mmol/l, whereas the concentrations of
      electrolytes remained constant. Cholic acid had no influence on bile secretion.
      To safeguard the patient from excessive loss of fluid and electrolytes, the
      drained bile was reinfused into the duodenum via a PEG.

PMID- 8342005
TI  - [Malignant neuroleptic syndrome under metoclopramide and neuroleptics in anuria].
AB  - A patient with myeloma nephropathy and acute, probably diclofenac-induced renal
      failure developed a neuroleptic malignant syndrome (NMS) during treatment with
      metoclopramide and neuroleptics. These drugs were withdrawn, symptomatic
      treatment of NMS was started and the patient was hemodialyzed because of uremia.
      During hemodialysis, the patient's condition improved dramatically and NMS did
      not recur during her further stay in the hospital. The temporal relationship
      between metoclopramide administration and the development of NMS, as well as the
      rapid reversal of NMS, suggest that NMS in this patient was caused by
      metoclopramide and not by neuroleptic drugs. Thus, metoclopramide should be used
      with caution in patients with renal failure and patients should be monitored
      closely for the development of neuroleptic malignant syndrome. Hemodialysis may
      be therapeutically effective in certain patients with metoclopramide-induced NMS.

PMID- 8342006
TI  - [Statistical deviations in high-performance athletes].
AB  - Between 1978 and 1984, 1323 high level athletes were tested at the Sports
      sciences institute of the Swiss federal sports school. During these
      investigations, several characteristic variations of body statics were measured.
      Analysis of the pooled data reveal a link of statistical significance between
      certain sports and several abnormalities of lower limbs static. As it was a
      retrospective investigation, we cannot be sure of a causal relationship between
      the reported effects. Our principal aim however was to publish this somewhat
      extensive set of data, in view of the general dearth of such scientific results.
      In addition to the type of movement the athletes perform during their sports
      activity, it is the duration of the exertion which seems to be an important
      determinant for the presence of an increased number of static abnormalities in
      certain sports. Endurance running presents an elevated risk of developing both
      flat foot and splay foot. For football (soccer) and tennis players however, only
      a subnormal transverse foot arch appears frequently. Alpine skiers on the other
      hand have an increased risk of longitudinal foot arch insufficiency. The
      knowledge as to which abnormalities are increasingly present in a given sport is
      instrumental to enabling an early detection and prophylaxis of these ailments.

PMID- 8342007
TI  - [Neuroradiological studies in diving accidents].
AB  - In case of a type II decompression sickness (with cerebrospinal injury), the
      decision on how to structure a prompt hyperbaric treatment rests on an anamnesis
      and the clinical investigation. In looking for an associated contingent
      barotrauma, one has to be satisfied with an X-ray of thorax and abdomen. The
      myelopathy which results from a decompression mishap with medullary involvement
      forms a very peculiar clinical entity defined by a fascicular injury at several
      levels. For several years now, clinical radiologists resort to a new medical
      imaging technique: Nuclear Magnetic Resonance (NMR-)Imaging. For the first time,
      this technique allows the imaging of intramedullary lesions due to a
      decompression accident. Other neuroradiological investigations (such as
      myelography, spinal tomodensitometry, medullary angiography, isotopic tests) are
      without merit for evaluating decompression accidents with medullary involvement.
      NMR-Imaging has the potential too, of revealing ischemic cerebral injuries, even
      if the clinical brain impairment is often silent and therefore overlooked. The
      role of NMR-Imaging for evaluating cerebrospinal aspect of decompression
      accidents is not yet finalized. However, NMR-Imaging will give without any doubt
      a boost to the pathophysiological knowledge of decompression mishaps.

PMID- 8342008
TI  - [Sports anthropological knowledge of relationships between individual hormone
      levels and anthropometric measuring values].
AB  - As a tentative investigation of morpho-endocrinology, 92 male and 18 female long
      distance runners (ages 21 to 72) were measured according to the standard
      anthropological techniques. 66 anthropometric parameters, the colours of hair and
      eyes were recorded. Seven growth factors were derived by means of factor
      analysis. The levels of 13 hormones were measured and morphological and
      endocrinological parameters were compared by means of correlation coefficients.
      So human growth hormone showed correlations to macrosomia and hyperplastic
      robustness. Estradiol was primarily related to the more feminine features of men,
      but also to leanness and slenderness of women. Testosterone exhibited significant
      correlations to mesomorphy and masculinity of males and leptomorphism and
      strength of females. Both sexes with higher insulin levels seemed to be more fat.
      Thyroxine (T4) showed a relation to endomorphy and leptomorphism of face, whereas
      Triiodothyronine (T3) exhibited correlations to ectomorphy. Thyroid stimulating
      hormone (TSH) was paralleling mesomorphy of males and hyperplastic robustness of
      females. Luteinizing hormone (LH), Follicle-stimulating hormone (FSH) and
      Prolactin were related to microsomia and hypoplasia. The T4 levels of the dark
      haired athletes were significantly higher than the levels of the bright-haired.
      Several correlations between morphology and hormonal status have been shown,
      which may be interpreted as a permanent endocrine constitution paralleling the
      somatotypical body shape, outlasting growth. These correlations however should
      not be interpreted as causal, as further experimental studies are needed to
      ascertain such a link.

PMID- 8342009
TI  - [Why L-carnitine works in sports inspite of everything].

PMID- 8342010
TI  - [Does L-carnitine really not work?].

PMID- 8342011
TI  - Dental institute report.

PMID- 8342012
TI  - Dingell pursues AIDS patent 'cover-up'.

PMID- 8342013
TI  - Human growth hormone. French scientists may face charges over CJD outbreak.

PMID- 8342014
TI  - AZT patent. Court favors drug 'concept' over proof.

PMID- 8342015
TI  - Bacteria may provide access to the tsetse fly.

PMID- 8342016
TI  - Biomedicine in the age of imaging.

PMID- 8342017
TI  - OCT: images of coherence.

PMID- 8342018
TI  - Echo-planar MRI: learning to read minds.

PMID- 8342019
TI  - EEG + MRI: a sum greater than the parts.

PMID- 8342020
TI  - Transillumination: looking right through you.

PMID- 8342021
TI  - Direct colorimetric detection of a receptor-ligand interaction by a polymerized
      bilayer assembly.
AB  - Detection of receptor-ligand interactions is generally accomplished by indirect
      assays such as enzyme-linked immunosorbent assay. A direct colorimetric detection
      method based on a polydiacetylene bilayer assembled on glass microscope slides
      has been developed. The bilayer is composed of a self-assembled monolayer of
      octadecylsilane and a Langmuir-Blodgett monolayer of polydiacetylene. The
      polydiacetylene layer is functionalized with an analog of sialic acid, the
      receptor-specific ligand for the influenza virus hemagglutinin. The sialic acid
      ligand serves as a molecular recognition element and the conjugated polymer
      backbone signals binding at the surface by a chromatic transition. The color
      transition is readily visible to the naked eye as a blue to red color change and
      can be quantified by visible absorption spectroscopy. Direct colorimetric
      detection by polydiacetylene films offers new possibilities for diagnostic
      applications and screening for new drug candidates or binding ligands.

PMID- 8342022
TI  - Greater susceptibility to mutations in lagging strand of DNA replication in
      Escherichia coli than in leading strand.
AB  - Models of DNA replication in Escherichia coli involve an asymmetric DNA
      polymerase complex that replicates concurrently the leading and the lagging
      strands of double-stranded DNA. The effect of asymmetry on mutagenesis was tested
      with pairs of plasmids containing the unidirectional ColE1 origin of replication
      and a single lesion located in the leading or lagging strand. The lesion used was
      the covalent adduct that the chemical carcinogen N-2-acetylaminofluorene (AAF)
      forms with the C-8 position of guanine. Whether SOS was induced or not, mutations
      arose at about a 20-fold higher frequency when the AAF adduct was located in the
      lagging strand than when in the leading strand.

PMID- 8342023
TI  - Signal sequence trap: a cloning strategy for secreted proteins and type I
      membrane proteins.
AB  - A method was developed to clone, without the use of specific functional assays,
      complementary DNAs (cDNAs) that carry specific amino-terminal signal sequences,
      such as those encoding intercellular signal-transducing molecules and receptors.
      The vector used in this system directed the cell surface expression of
      interleukin-2 receptor fusion proteins when inserts with signal sequences were
      cloned in-frame with the correct orientation. An expression cDNA library was
      constructed from a bone marrow stromal cell line, which contained 5' portion
      enriched cDNAs (the average size was 400 base pairs). Two cDNAs that encoded
      putative cytokine molecules, stromal cell-derived factor-1 alpha (SDF-1 alpha)
      and SDF-1 beta, which belong to the intercrine-macrophage inflammatory protein
      superfamily, were cloned.

PMID- 8342024
TI  - Ixr1, a yeast protein that binds to platinated DNA and confers sensitivity to
      cisplatin.
AB  - Structure-specific recognition proteins (SSRPs) bind to DNA containing
      intrastrand cross-links formed by the anticancer drug cisplatin. A yeast gene
      encoding an SSRP, designated IXR1, was cloned and sequenced. The Ixr1 protein, a
      member of the high mobility group-box protein family, bound specifically to DNA
      modified with cisplatin but not inactive platinum compounds. A yeast strain with
      an inactivated IXR1 gene was half as sensitive to cisplatin and accumulated one
      third as many platinum-DNA lesions after treatment with cisplatin as the parental
      strain. These findings suggest that SSRPs play a role in mediating the
      cytotoxicity of cisplatin.

PMID- 8342025
TI  - A detailed genetic map for the X chromosome of the malaria vector, Anopheles
      gambiae.
AB  - Anopheles gambiae, the primary vector of human malaria in Africa, is responsible
      for approximately a million deaths per year, mostly of children. Despite its
      significance in disease transmission, this mosquito has not been studied
      extensively by genetic or molecular techniques. To facilitate studies on this
      vector, a genetic map has been developed that covers the X chromosome at an
      average resolution of 2 centimorgans. This map has been integrated with the
      chromosome banding pattern and used to localize a recessive, sex-linked mutation
      (white eye) to within 1 centimorgan of flanking markers.

PMID- 8342026
TI  - Interaction of activated EGF receptors with coated pit adaptins.
AB  - The epidermal growth factor (EGF) receptor interacts with plasma membrane
      associated adapter proteins during endocytosis through coated pits. Almost 50
      percent of the total pool of alpha-adaptins was coimmunoprecipitated with the EGF
      receptor when A-431 cells were treated with EGF at 37 degrees C, but not at 4
      degrees C. Partial proteolysis of alpha-adaptin suggested that the amino-terminal
      domain is the region that associates with the EGF receptor. The extent of
      receptor-adaptin association was increased in cells depleted of potassium to
      block endocytosis. These data suggest that receptor-adaptin association occurs in
      intact cells before coated pits are fully assembled.

PMID- 8342027
TI  - Functional magnetic resonance imaging of motor cortex: hemispheric asymmetry and
      handedness.
AB  - A hemispheric asymmetry in the functional activation of the human motor cortex
      during contralateral (C) and ipsilateral (I) finger movements, especially in
      right-handed subjects, was documented with nuclear magnetic resonance imaging at
      high field strength (4 tesla). Whereas the right motor cortex was activated
      mostly during contralateral finger movements in both right-handed (C/I mean area
      of activation = 36.8) and left-handed (C/I = 29.9) subjects, the left motor
      cortex was activated substantially during ipsilateral movements in left-handed
      subjects (C/I = 5.4) and even more so in right-handed subjects (C/I = 1.3).

PMID- 8342028
TI  - The Caenorhabditis elegans unc-17 gene: a putative vesicular acetylcholine
      transporter.
AB  - Mutations in the unc-17 gene of the nematode Caenorhabditis elegans produce
      deficits in neuromuscular function. This gene was cloned and complementary DNAs
      were sequenced. On the basis of sequence similarity to mammalian vesicular
      transporters of biogenic amines and of localization to synaptic vesicles of
      cholinergic neurons in C. elegans, unc-17 likely encodes the vesicular
      transporter of acetylcholine. Mutations that eliminated all unc-17 gene function
      were lethal, suggesting that the acetylcholine transporter is essential.
      Molecular analysis of unc-17 mutations will allow the correlation of specific
      parts of the gene (and the protein) with observed functional defects. The mutants
      will also be useful for the isolation of extragenic suppressors, which could
      identify genes encoding proteins that interact with UNC-17.

PMID- 8342029
TI  - Locating the catalytic water molecule in serine proteases.

PMID- 8342030
TI  - Bioinorganic chemistry.

PMID- 8342031
TI  - The missing AIDS science.

PMID- 8342032
TI  - Marine lab weathers a storm.

PMID- 8342033
TI  - PCR enzyme. The more you use, the cheaper it gets.

PMID- 8342034
TI  - French AIDS tests get the hook.

PMID- 8342035
TI  - Where are 'new' diseases born?

PMID- 8342036
TI  - Australian pest control by virus causes concern.

PMID- 8342037
TI  - Bioinorganic chemistry: a maturing frontier.

PMID- 8342038
TI  - Transition metals in control of gene expression.
AB  - Metalloproteins play structural and catalytic roles in gene expression. The
      metalloregulatory proteins are a subclass that exerts metal-responsive control of
      genes involved in respiration, metabolism, and metal-specific homeostasis or
      stress-response systems, such as iron uptake and storage, copper efflux, and
      mercury detoxification. Two allosteric mechanisms for control of gene expression
      were first discovered in metalloregulatory systems: an iron-responsive
      translational control mechanism for ferritin production and a mercury-responsive
      DNA-distortion mechanism for transcriptional control of detoxification genes.
      These otherwise unrelated mechanisms give rise to a rapid physiological response
      when metal ion concentrations exceed a dangerous threshold. Molecular recognition
      in these allosteric metal ion receptors is achieved through atypical coordination
      geometries, cluster formation, or complexes with prosthetic groups, such as
      sulfide and heme. Thus, many of the inorganic assemblies that otherwise buttress
      the structure of biopolymers or catalyze substrate transformation in active sites
      of enzymes have also been adapted to serve sensor functions in the
      metalloregulatory proteins. Mechanistic studies of these metal-sensor protein
      interactions are providing new insights into fundamental aspects of inorganic
      chemistry, molecular biology, and cellular physiology.

PMID- 8342039
TI  - Crystal structure of hemoprotein domain of P450BM-3, a prototype for microsomal
      P450's.
AB  - Cytochrome P450BM-3, a bacterial fatty acid monoxygenase, resembles the
      eukaryotic microsomal P450's and their flavoprotein reductase in primary
      structure and function. The three-dimensional structure of the hemoprotein domain
      of P450BM-3 was determined by x-ray diffraction and refined to an R factor of
      16.9 percent at 2.0 angstrom resolution. The structure consists of an alph and a
      beta domain. The active site heme is accessible through a long hydrophobic
      channel formed primarily by the beta domain and the B' and F helices of the alpha
      domain. The two molecules in the asymmetric unit differ in conformation around
      the substrate binding pocket. Substantial differences between P450BM-3 and
      P450cam, the only other P450 structure available, are observed around the
      substrate binding pocket and the regions important for redox partner binding. A
      general mechanism for proton transfer in P450's is also proposed.

PMID- 8342040
TI  - Dialkylglycine decarboxylase structure: bifunctional active site and alkali metal
      sites.
AB  - The structure of the bifunctional, pyridoxal phosphate-dependent enzyme
      dialkylglycine decarboxylase was determined to 2.1-angstrom resolution. Model
      building suggests that a single cleavage site catalyzes both decarboxylation and
      transamination by maximizing stereoelectronic advantages and providing
      electrostatic and general base catalysis. The enzyme contains two binding sites
      for alkali metal ions. One is located near the active site and accounts for the
      dependence of activity on potassium ions. The other is located at the carboxyl
      terminus of an alpha helix. These sites help show how proteins can specifically
      bind alkali metals and how these ions can exert functional effects.

PMID- 8342041
TI  - DNA melting on yeast RNA polymerase II promoters.
AB  - Transcription-dependent DNA melting on the yeast GAL1 and GAL10 promoters was
      found to be more closely correlated with the TATA box than the transcription
      start site. On both these genes, melting begins about 20 base pairs downstream of
      the TATA box. Physical and genetic analyses suggest that RNA polymerase II
      associates with this region. Thus, the distance between promoter melting and the
      TATA box in yeast may be similar to that in higher eukaryotes, even though
      transcription initiates in a region about 10 to 90 base pairs farther downstream
      in yeast.

PMID- 8342042
TI  - Selective and ATP-dependent translocation of peptides by the MHC-encoded
      transporter.
AB  - Major histocompatibility complex (MHC) class I molecules present peptides derived
      from nuclear and cytosolic proteins to CD8+ T cells. These peptides are
      translocated into the lumen of the endoplasmic reticulum (ER) to associate with
      class I molecules. Two MHC-encoded putative transporter proteins, TAP1 and TAP2,
      are required for efficient assembly of class I molecules and presentation of
      endogenous peptides. Expression of TAP1 and TAP2 in a mutant cell line resulted
      in the delivery of an 11-amino acid oligomer model peptide to the ER. Peptide
      translocation depended on the sequence of the peptide, was adenosine triphosphate
      (ATP)-dependent, required ATP hydrolysis, and was inhibited in a concentration
      dependent manner.

PMID- 8342043
TI  - Heat shock (stress) proteins and autoimmunity in rheumatic diseases.
AB  - The rheumatic diseases (RDs) are characterized by acute and chronic inflammation,
      and autoimmunity plays a major role in their pathogenesis. RDs are for the most
      part of unknown etiology, but recent evidence indicates that heat shock or stress
      proteins (HSPs) may have an important role in the etiology/pathogenesis of RDs.
      HSPs are produced by prokaryotic and eukaryotic cells and are grouped according
      to molecular weight. Phylogenetically, HSPs are very old and are remarkably
      conserved molecules in evolution from bacteria to humans. HSPs are induced by a
      variety of cellular stresses in addition to heat; cognates are expressed
      constitutively and are essential in a number of normal functions. Some HSPs serve
      as molecular chaperones, the latter defined as proteins that mediate folding of
      other polypeptides and either promote their assembly into oligomeric structures
      or disassemble the final product. Conservation of structure and function of many
      HSPs may provide a link between immunity to infection and the autoimmune features
      of RDs. Evidence is reviewed from clinical and laboratory observations that
      diverse microbial agents, including viruses, bacteria, and parasites, may have
      putative roles in the development and pathogenesis of some RDs. HSPs also are
      discussed in relation to the major histocompatibility complex, HLA antigens, and
      disease associations and how they may alter the balance between tolerance and
      autoimmunity. Studies are reviewed that are supportive or nonsupportive of the
      concept of microbial infection associated with autoimmunity; individuals first
      react to microbial immunizations or infections with enhanced cellular/humoral
      responses to the agent's HSPs. With the enhanced immune response, cross
      reactivity may occur with an HSP of the stressed host because of structural
      similarities to the microbial HSP. If all of these events occur, the host's
      homologous HSP or stressed cells now become true autoantigen(s). This sequence
      has implications for the etiology of immune-mediated RDs, the concept of epitope
      sharing, and the accompanying autoimmunity. A recurring theme emphasized in some
      reports to understand better the role of HSPs in autoimmunity is the need to
      select patients with early-onset disease. A minor subpopulation of T lymphocytes
      express a CD3-associated T-cell receptor (TCR) heterodimer composed of gamma and
      delta polypeptide chains. The gamma delta + T cells have several unique features.
      When analyzed by the polymerase chain reaction, lymphocytes with TCR-gamma delta
      appear to reflect the polyclonal expansion of preexisting gamma delta clones.
      They are found in peripheral lymphoid tissue in very low percentage (< 5%) but
      may represent the majority of T cells within epithelial tissue.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8342044
TI  - Corticosteroid-induced osteoporosis.
AB  - Corticosteroid-induced osteoporosis is a major problem faced by rheumatologists,
      with up to 50% of patients at increased risk for vertebral fractures. Our current
      understanding of the pathophysiology of corticosteroid-induced osteoporosis
      suggests two basic problems: a reduction in bone formation and an increase in
      bone resorption leading to an overall reduction in bone mass. Adequate calcium
      and vitamin D intake, calcitonin, hormone-replacement therapy, and thiazide
      diuretics are of benefit in preventing corticosteroid-induced bone loss. Other
      therapies such as the bisphosphonates, fluoride, and anabolic steroids should be
      considered when fractures occur or ongoing bone loss is evident. A review of the
      literature outlining the pathophysiology, clinical features, assessment, and
      treatment is presented.

PMID- 8342045
TI  - Antilipoprotein antibodies in rheumatoid arthritis.
AB  - Antibodies against very low-density lipoproteins and low-density lipoproteins
      (aLA) were found in 26 of 69 (38%) patients with active rheumatoid arthritis (RA)
      but not in any control subjects (ie, 40 patients with psoriatic arthritis, 21
      patients with osteoarthritis, and 65 healthy blood donors). In 21 RA patients
      (30%), lipoproteins were found in the dissociated components of circulating
      immune complexes. RA patients with aLA had significantly decreased cholesterol
      levels in all lipoprotein fractions and total serum lipids, while serum
      triglycerides were significantly increased compared with RA patients without aLA.
      Anticardiolipin antibodies as measured by the Venereal Disease Research
      Laboratory test were not found in any subject in this study. These findings
      suggest a possible autoimmune origin of dyslipoproteinemia in some patients with
      active RA.

PMID- 8342046
TI  - Lymphatic disorders in rheumatoid arthritis.
AB  - Lymphedema is a rare complication of rheumatoid arthritis (RA). Diagnosis is
      clinical: long-standing, painful swelling of a whole limb in association with RA.
      Cases described in the literature are predominantly of the upper limbs, sometimes
      bilateral. Diagnosis can be confirmed by biopsy of lymph nodes, lymphography, or
      preferably lymphoscintigraphy. The etiology of the edema is unknown. Mechanical
      obstruction and lymphangitis have been suggested. Pharmacological and surgical
      treatment of the edema have been disappointing, and treatment of the underlying
      RA does not improve the lymphedema. Physical treatment of the affected limb, such
      as massage, manual drainage techniques, light compression bandaging, and
      exercise, has been moderately effective.

PMID- 8342047
TI  - Autoimmunity and selected environmental factors of disease induction.
AB  - Autoimmune diseases may be induced by physical and/or chemical environmental
      factors. A review of the available literature on mercuric chloride, iodine,
      silicone, anilides, L-tryptophan, vinyl chloride, and canavanine suggests three
      general mechanisms by which they may induce disease. First, oxidative damage
      probably is a frequent process involved in disease induction and pathogenesis.
      Second, certain compounds also may generate antigen-specific immune responses
      that could then cross-react with self-tissues. Other xenobiotics might bind to
      self-tissues and increase self-tissue immunogenicity. Third, physical and
      chemical agents may also modulate the immune system. Finally, in response to
      controversies surrounding the influence of human activities on global climate
      changes, the immunosuppressive effects of ozone and ultraviolet radiation are
      discussed.

PMID- 8342048
TI  - Reactive arthritis associated with Clostridium difficile pseudomembranous
      colitis.
AB  - Reactive arthritis is associated with several gastrointestinal pathogens,
      particularly Shigella, Salmonella, Campylobacter, and Yersinia. Another, less
      well recognized bowel infection leading to reactive arthritis is pseudomembranous
      colitis, caused by Clostridium difficile. An illustrative case is presented, and
      the clinical features and characteristics of all reported patients with this
      association are reviewed. The pathogenesis of the reactive arthritis seems to be
      related to an immunological response in joints and other tissues against
      bacterial antigens, which gain access to the systemic circulation through
      increased intestinal permeability. Therapy with nonspecific antiinflammatory
      drugs, anticlostridial agents, or a combination of the above is effective.
      Despite the possibility of persistent articular involvement after
      gastrointestinal symptoms have subsided, the long-term prognosis seems to be
      excellent.

PMID- 8342049
TI  - Osteoarthritis and hyaluronan--palliative or disease-modifying treatment?

PMID- 8342050
TI  - The effects of intraarticular administration of hyaluronan in a model of early
      osteoarthritis in sheep. I. Gait analysis and radiological and morphological
      studies.
AB  - Using a model of early osteoarthritis (OA) induced in ovine joints by medial
      meniscectomy, the intraarticular effects of two hyaluronic acid (HA) preparations
      (AHA and DHA) were investigated. DHA was an HA preparation with an average
      molecular weight (MW) of approximately 2.0 x 10(6) d, and AHA had a MW of
      approximately 8 x 10(5) d. Animals (n = 5) were injected intraarticularly with 1
      mL (10 mg/mL) of either HA preparation once a week for 5 weeks beginning 16 weeks
      after initiation of arthropathy. Meniscectomized, saline (1.0 mL)-injected
      animals (n = 5) and nonoperated sheep (n = 5) were used for controls. Force-plate
      analysis of gait and radiographic changes in joints were evaluated in these
      groups before and after intraarticular treatment. At necropsy, cartilage gross
      morphology, osteophyte development, and cartilage histopathology were examined.
      Meniscectomized joints were characterized by erosions and fissuring of cartilage
      of the medial compartment with areas of decreased matrix staining for
      proteoglycans. Osteophytes were present at the medial joint margins. Saline
      treated meniscectomized animals showed reduced loading of the operated limb using
      the force plate. Force-plate analysis of walking animals before and after
      treatment with either AHA or DHA indicated some normalization of joint loading.
      However, osteophyte scores for meniscectomized joints injected with AHA and DHA
      were higher after treatment than those of the corresponding saline-treated group.
      Although the gross cartilage damage was lower than in saline-treated controls for
      both the HA-treated groups, the histological scores did not support this
      conclusion. Indeed, the tibial score for the DHA group was higher than for the
      AHA group (P < .05). These studies confirmed previous reports that meniscectomy
      of sheep stifle (knee) joints resulted in matrix changes similar to those
      described for early OA in humans. Both HA preparations appeared to improve gait,
      suggesting decreased lameness. Increased joint loading associated with gait
      improvement may account for the higher osteophyte scores in the treated groups.
      However, cartilage damage with DHA was found to be higher than when the lower-MW
      HA preparation (AHA) was used.

PMID- 8342051
TI  - The effects of intraarticular administration of hyaluronan in a model of early
      osteoarthritis in sheep. II. Cartilage composition and proteoglycan metabolism.
AB  - A model of early osteoarthritis (OA) induced in ovine joints by medial
      meniscectomy was used to study the effects of two hyaluronan (HA) preparations
      (AHA and DHA) on cartilage composition and proteoglycan (PG) metabolism. DHA was
      an HA preparation with an average molecular weight (MW) of approximately 2.0 x
      10(6) d, and AHA had an MW of approximately 8.0 x 10(5) d. Both preparations were
      administered intraarticularly once a week for 5 weeks starting 16 weeks after
      meniscectomy, and animals (n = 5) were killed 5 weeks after the last injection.
      Meniscectomized, saline-injected (n = 5) and nonoperated (n = 5) animals were
      used for controls. At necropsy, 3-mm-diameter full-depth cartilage plugs were
      sampled under sterile conditions from specific locations on the medial and
      lateral femoral condyles, tibial plateaus, patella, and trochlear groove. The
      cartilage plugs were cultured in Hams-F12 medium supplemented with 10% fetal calf
      serum for 24 hours, then for a further 48 hours in the presence of H2(35)SO4 to
      determine the biosynthesis of PGs. The percentage of 35S-PGs and sulfated
      glycosaminoglycans released into the media was also ascertained. The cartilage
      adjacent to the plugs was analyzed for collagen and proteoglycan content and
      differential extractability with guanidine hydrochloride (GuHCl) solutions. The
      extractability of PGs with 0.4 mol/L GuHCl (nondissociative conditions) was lower
      from the medial femoral cartilages of the DHA-treated group than from the
      corresponding saline-treated group. In contrast, the release of 35S-PGs from the
      tibial cartilages of the DHA-treated animals was higher than in the saline
      treated group. The biosynthesis of 35S-PGs, determined in vitro, for cartilage
      derived from the medial compartment was generally lower than for the lateral
      regions of the meniscectomized joints. The biosynthetic activity was further
      reduced in joints injected with the two HA preparations, but DHA reduced 35SO4
      incorporation into PGs more than AHA. It was concluded that reduced biosynthesis
      of 35S-PGs and secretion into media was a consequence of increased loading of
      joints in the HA-treated animals rather than a direct effect of these
      preparations on chondrocyte metabolism.

PMID- 8342052
TI  - Effects of intraarticular hyaluronan on matrix changes induced in the lateral
      meniscus by total medial meniscectomy and exercise.
AB  - Total medial meniscectomy was performed in 12 adult merino sheep. Immediately
      after surgery, 8 animals received high-molecular-weight hyaluronan (HA) (1 mL, 10
      mg/mL) and 4 were given sterile saline (1 mL) intraarticularly. Injections were
      given for 5 more weeks. In week 3 an exercise program, consisting of walking 24
      km/wk, was initiated. This program was continued until the animals were killed at
      week 26 postmeniscectomy. At necropsy the lateral menisci were removed and
      divided into three concentric zones--inner, middle, and outer. Powdered aliquots
      of tissues from each zone were analyzed for collagen and hexuronate contents
      using colormetric methods. The glycosaminoglycans (GAGs)--chondroitin-O-sulfate
      (C-O-S), chondroitin-4-sulfate (C-4-S), chondroitin-6-sulfate (C-6-S), and
      dermatan sulfate (DS)--were determined using a high-performance liquid
      chromatography method. The lateral menisci from the joints of animals injected
      with HA showed higher hexuronate and GAG levels than those of controls. This
      increase was mainly due to C-6-S, which had highest levels in the inner and
      middle meniscal zones. In addition, dermatan sulfate levels increased
      significantly in the middle and outer zones of the lateral menisci compared with
      the same zones of the meniscus from the saline-treated group. Collagen and C-O-S
      levels were not statistically different from those of controls. These data
      suggest that intraarticular administration of high-molecular-weight HA
      immediately after open total medial meniscectomy may help preserve the
      proteoglycans in the lateral meniscus remaining in the joint.

PMID- 8342053
TI  - The kinetics of hyaluronan in normal and acutely inflamed synovial joints:
      observations with experimental arthritis in sheep.
AB  - The metabolic half-life of hyaluronan (HA) in synovial fluid was estimated in
      sheep from the rate of appearance of 3H2O in plasma after injection of highly
      polymerized labeled HA. This material is substituted with 3H in its acetyl group
      and is rapidly and almost completely degraded in sheep and other species to yield
      3H2O. Previously sensitized sheep were studied before and after induction of
      acute monoarticular arthritis by intraarticular challenge with type II collagen.
      In both circumstances 3H was released from the joint in a monophasic exponential
      pattern and appeared in plasma only as 3H2O. Before challenge, the mean metabolic
      half-life of [3H]HA was 20.8 hours (range, 15.8 to 27.9 hours, n = 5); an
      estimate in a single unsensitized sheep (27.0 hours) fell within this range.
      After challenge, swelling occurred around the joint without frankly increased
      synovial fluid. The mean half-life fell to 11.5 hours (range, 9.0 to 16.8 hours),
      with a corresponding increase in mean fractional turnover from 3.5%/h to 6.3%/h;
      an increased amount of the label was also retained within the peripheral tissues.
      It is concluded that a relatively mild acute inflammation can induce major
      changes in the metabolic turnover of synovial HA without the development of gross
      effusions. In the course of this study, mean synovial fluid volume in the normal
      sheep hock joint was estimated to be 1.54 mL; the concentration and content of HA
      were 0.54 mg/mL and 0.84 mg, respectively. These data add to other evidence that
      the volume and HA content of normal synovial fluid vary widely in different
      joints and species.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342054
TI  - [Quality assurance in trauma surgery--what does the TRISS method offer ?].
AB  - The TRISS method offers a standard approach for evaluating the outcome of trauma
      care. Based on the data of more than 150,000 patients, TRISS offers a method of
      calculating the individual probability of survival of trauma patients. The
      calculation is based on anatomical, physiological data and the age of the
      patient. The basic scores for using TRISS are the Revised Trauma Score and the
      Injury Severity Score. Recent analyses demonstrate for blunt trauma patients a
      sensitivity of 60.9% and a specificity of 99.2%. What does TRISS offer in
      comparison to other trauma scores? TRISS offers a valid approach for the
      screening of trauma patients regarding unexpected survival/death. Based on the
      largest database of trauma patients, TRISS represents a method of maintaining
      quality assurance for prehospital and hospital trauma patient care; it also
      allows comparison with international standards of trauma care.

PMID- 8342055
TI  - [Primary management of polytrauma. Comparison of a German and American air rescue
      unit].
AB  - Hospital-based helicopter services from German and American university-affiliated
      trauma centers were reviewed. All multitrauma patients transported via helicopter
      from the scene of the accident to the trauma center during a 1-year period were
      included. The patients were comparable regarding mechanism of injury, age, flight
      times, mean ISS, ISS distribution, and number of severe injuries per body region
      (patients with AIS > 3 for head, thorax and abdomen). Overall mortality for the
      German system was 21/221 (9.5%) and 21/186 (11.3%) for the American system (not
      significant). Survivor-based TRISS analysis yielded Z-statistics of +2.459 for
      the German, and +1.049 for the American system. There were 9 unexpected survivors
      (Ps < 0.5) in the German, 6 in the American system. There was a significant
      higher (P < 0.01) number of early deaths (< 6 h) in the American population (12,
      ISS 56) than in the German (4, ISS 64). Analysis of the prehospital data
      demonstrated significant differences in the mean volume of IV fluids infused:
      1800 cc German, 825 cc American (P < 0.05); rate of intubation: 82/221 (37.1%)
      German, 24/186 (13.4%) American (P < 0.001); and thoracic decompressions: 20/221
      (9.1%) German, 1/186 (0.5%) American (P < 0.001). Pre-hospital care in the German
      system is directed on-scene by a trauma surgeon member of the flight crew,
      compared to a nurse/paramedic team with remote medical control in the American
      system. Compared to an American trauma system, the German system demonstrates
      improved overall outcome as measured by survivor-based TRISS Z-statistics. More
      favorable German Z-statistics are in part related to fewer early deaths.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8342056
TI  - [Biochemical wound monitoring. PMN elastase in different healing stages after
      trauma surgery-orthopedic interventions].
AB  - Laboratory parameters are of proven value in the diagnosis of early postsurgical
      infections, since clinical aspects cannot always be clearly defined. Neutrophil
      granulocytes (PMN) are major inflammatory cells taking effect following ingestion
      and degradation of foreign material, such as bacteria and cell debris, for
      example after mechanical trauma. In patients who had undergone surgery we
      monitored the course of plasma PMN elastase in uncomplicated wound healing (n =
      22), in uncomplicated wound healing associated with secondary infections (n = 6),
      and in defective wound healing (manifestation of a bacterial wound infection: n =
      3; wound infection already manifest at the time of entry on study: n = 11).
      Surgical trauma was accompanied by an increase in PMN elastase and C-reactive
      protein (CRP) in all patients studied, reaching a maximum within the first 3
      postsurgical days. When a bacterial wound infection became manifest during the
      course of healing there was a highly significant difference on the 4th
      postsurgical day (p < 0.01) compared with the group with uncomplicated healing.
      Since PMN elastase can now be determined automatically with an autoanalyser and a
      commercial kit and its discriminatory time point is as soon as 4-5 days after
      surgery, it is suggested that this marker should be determined routinely together
      with CRP in traumatology.

PMID- 8342057
TI  - [Severe parachuting accident. Analysis of 122 cases].
AB  - Based on a population of 122 severely injured patients the causes of paragliding
      accidents and the patterns of injury are analyzed. A questionnaire is used to
      establish a sport-specific profile for the paragliding pilot. The lower limbs
      (55.7%) and the lower parts of the spine (45.9%) are the most frequently injured
      parts of the body. There is a high risk of multiple injuries after a single
      accident because of the tremendous axial power. The standard of equipment is good
      in over 90% of the cases. Insufficient training and failure to take account of
      geographical and meteorological conditions are the main determinants of accidents
      sustained by paragliders, most of whom are young. Nevertheless, 80% of our
      patients want to continue paragliding. Finally some advice is given on how to
      prevent paragliding accidents and injuries.

PMID- 8342058
TI  - [Long-term results of surgical management of patellar fractures].
AB  - Between 1973 and 1989, 129 patients with 135 fractures of the patella were
      treated operatively. More than two-thirds of these patients were younger than 40
      years at the time of the accident. The main cause of trauma was a traffic
      accident in 65.9%. Sixty patients had polytraumata. There were 74 comminuted, 28
      transverse, 17 starlike, 10 longitudinal and 6 fractures with one large fragment.
      Eighty-two patients with 85 fractures were followed up after 8.4 years on average
      (1.2-16.3 years). The overall results were excellent or good in 64.7%, fair in
      18.8% and poor in 16.5%. The best results were seen in transverse fractures after
      modified tension-band wiring using two longitudinal K wires, and in longitudinal
      fractures applying screws. Sixty-three percent of the fair and poor results were
      seen after osteosynthesis of comminuted fractures. In these cases primarily
      partial or complete patellectomy seems to be indicated instead of just
      insufficient reconstruction of the retropatellar face. Early functional
      physiotherapy is very important for all kinds of patellar fractures to gain full
      range of motion.

PMID- 8342059
TI  - [Follow-up and prognosis of neurologic sequelae of pelvic ring fractures with
      involvement of the sacrum and/or the iliosacral joint].
AB  - The extent of neurological lesions following an injury of the pelvic ring is
      often not initially recognized, as interest is then focused on the treatment of
      the pelvic ring fracture. Once the fracture has healed, the patient suffers from
      the sequelae of the neurological injury. Our series of 323 pelvic ring injuries
      includes 161 sacral fractures and 12 complete disruptions of the sacroiliac
      joint. Twenty-three patients sustained an injury of the lumbosacral plexus, and
      20 patients were examined retrospectively. The different parts of the lumbosacral
      plexus showed variable recovery potential. An important or complete recovery was
      noted in 8 of 9 patients suffering from a motor deficit of the lumbar plexus, the
      obturator nerve, the superior gluteal nerve or the inferior gluteal nerve. Four
      out of 8 patients with a motor deficit of the sacral plexus had an important or
      complete improvement. In contrast to these results was the poor recovery of
      lesions of the lumbosacral trunk. Eight out of 11 patients showed no or only
      minor recovery, although the pelvic ring was stabilized by operative means in 9
      patients. In 2 patients the lumbosacral trunk was directly decompressed by a
      dorsal approach. In both cases the recovery was complete. In 6 patients the
      sphincter function was damaged. Recovery was dependent on the localization of the
      sacral fracture. If the fracture traversed the sacral canal, no neurological
      improvement was noted.

PMID- 8342060
TI  - [Case histories of therapy of traumatic knee joint dislocation].
AB  - The records of eight patients with traumatic knee dislocation and operative
      treatment in 1981-1991 were reviewed. In this retrospective study the average
      follow-up was 6 years and indicated good results concerning stability and
      functional use of the knee. The vascular complications, especially the ischemic
      syndrome are associated with an emergency situation that requires immediate
      reduction.

PMID- 8342061
TI  - [Interlocking nailing of the humerus].
AB  - Within a 3-year period a total of 42 humeral fractures were treated. Nineteen of
      these were operated on with the Seidel intramullary interlocking nail. Most of
      the fractures could be classified into group A (AO classification); three type B
      and four type C fractures occurred. Two patients had pathological fractures due
      to bone metastases. Mean hospital inpatient treatment was 24 days. Besides two
      infections seven system-specific complications occurred. A discrepancy between
      the diameter of the nail and the width of medullary cavity was the reason in one
      case for an additional fracture and in another case for nonunion because of
      loosening of the nail tip in the distal fragment. Three further intraoperative
      fractures occurred during impaction of the nail, the reasons are also device
      specific and are carefully analyzed. In two cases we were forced to remove the
      nail because of subacromial impingement due to an overranging proximal nail end.
      Finally, a normal intraoperative and postoperative course with good functional
      results could only be observed in approximately half the cases. Thus, our initial
      optimism with respect to the outstanding theoretical concept was dampened, so
      that the interlocking humerus nail is now just applied in pathological shaft
      fractures.

PMID- 8342062
TI  - [Reconstruction of foot arteries after injury in arterial occlusive disease].
AB  - At the Maribor Teaching Hospital two elderly with progressive atherosclerotic
      disease below the knee were treated between 1986-1992 for open fracture of ankle
      joint and pedal arterial trauma. The only patent atherosclerotic vessel (dorsal
      artery of the foot) that was disrupted was reconstructed in both cases by
      interposition of a part of the great and small saphenous vein in one case each. A
      termino-terminal anastomosis with a long, triangular patch was used, fixed with
      interrupted sutures. The fractures were stabilized with external fixators. Both
      extremities were saved.

PMID- 8342063
TI  - [Experiences with closed irrigation-suction drainage and simultaneous
      administration of an antiseptic].
AB  - In 47 patients a closed instillation drainage system was used with concomitant
      systemic antibiotic therapy. The schedule was strictly followed and is described
      in detail in the text. Prerequisites for a successful therapy are thorough
      surgical debridement, good coverage with soft tissue and a very careful skin
      closure. We propose a shortened duration of instillation of 3 to a maximum of 5
      days. The Draintec suction pumps now used evidently create less problems than the
      classic pumps. During a mean follow-up of 3 years a definite recurrence was
      observed in two cases and a possible recurrence in one. In view of these results
      we consider this mode of treatment is still valid. Lavasept was added as an
      antiseptic drug in three quarters of the cases and was tolerated well. In view of
      the low rate of recurrence in all cases its potential cannot yet be fully
      estimated. We recommend the instillation-drainage system for use in thigh, upper
      arm and pelvic areas in the hands of a fully cooperating management team with
      some experience in the application of instillation-drainage systems.

PMID- 8342064
TI  - Immunotherapy of lung cancer.
AB  - Review of the literature on immunotherapies in lung cancer provides hope that an
      impact on the natural history of this disease can be achieved. Although the
      various trials of adjuvant nonspecific immunostimulation with BCG, levamisole,
      and C parvum are not sufficiently detailed to permit meta-analysis, in aggregate
      the data suggest a slight improvement in disease-free survival for treated
      patients. Perhaps these adjuvants combined with more immunogenic TAAs could be
      formulated into a vaccine that would be effective in preventing recurrence of
      lung cancer after surgical excision. Ongoing research in molecular technology may
      provide adequate quantities of such products so that this hypothesis can be
      tested in appropriate patient populations.

PMID- 8342065
TI  - Biological markers in smoking cessation treatment.

PMID- 8342066
TI  - Potential application of gene therapy to lung cancer.

PMID- 8342067
TI  - Early detection of lung cancer.

PMID- 8342068
TI  - Lung cancer: recent changes and expectations of improvements.

PMID- 8342069
TI  - Preparative Regimens in Bone Marrow Transplantation. Proceedings of a symposium.
      Anaheim, California, December 4, 1992.

PMID- 8342070
TI  - The development of busulfan/cyclophosphamide preparative regimens.
AB  - Bone marrow transplantation (BMT) preparative regimens consisting of busulfan
      (Bu) and cyclophosphamide (Cy) were developed as an alternative to preparative
      regimens based on total body irradiation (TBI). Animal studies demonstrated that
      Bu had a high level of myeloablative and antileukemic activity, but little
      immunosuppressive effect. In contrast, Cy was sufficiently immunosuppressive to
      allow allogeneic marrow engraftment in animal systems. In both animals and
      humans, the combination of Bu and Cy results in effective eradication of the
      host's bone marrow and suppression of the immune response, thus allowing
      engraftment by either allogeneic or autologous marrow. A number of BMT
      preparative regimens have been developed for use in leukemic patients. These
      regimens differ primarily in the myeloablative agent used (Bu or TBI) and the
      dose of Cy. Although few comparative studies have been conducted, BuCy regimens
      appear to be similar in efficacy to those containing Cy and TBI. In addition to
      its use in leukemic patients, BuCy BMT preparative regimens also have been used
      in patients with nonmalignant lymphohematopoietic disorders or other malignant
      diseases.

PMID- 8342071
TI  - Busulfan disposition: the role of therapeutic monitoring in bone marrow
      transplantation induction regimens.
AB  - High-dose busulfan is an important component of many bone marrow transplantation
      (BMT) preparative regimens. The dose-limiting toxicity of busulfan in BMT
      regimens is hepatic veno-occlusive disease (VOD), which occurs in approximately
      20% to 40% of patients. We used a gas chromatography-electron capture detection
      assay and pharmacokinetic models to examine busulfan disposition in adults and
      children. Marked interpatient and intrapatient variability in busulfan
      disposition was observed in both patient populations. Part of the intrapatient
      variation appeared to be due to circadian changes in busulfan disposition. We
      also used gas chromatography-electron capture detection and pharmacokinetic
      models to assess whether excessive exposure to busulfan correlates with an
      increased risk of VOD. The area under the curve of time versus concentration
      (AUC) after the first dose of busulfan was measured in patients receiving a 16
      dose course of busulfan as part of a BMT preparative regimen. In 27 patients who
      showed high AUCs (> 1,500 mumol.min/L) after the first dose, the fifth through
      16th doses of busulfan were decreased. Patients with high AUCs who did not
      receive dose adjustments had a 75% incidence of VOD. The incidence of VOD was
      only 18% in patients with high AUCs whose dose was adjusted on the basis of
      therapeutic monitoring. 5% for those not needing adjustment. These studies
      suggest that therapeutic monitoring can play an important role in decreasing the
      toxicity of BMT preparative regimens. Therapeutic monitoring also may improve
      treatment efficacy by identifying patients who are not receiving adequate drug
      exposure.

PMID- 8342072
TI  - Treatment of chronic myelogenous leukemia with allogeneic bone marrow
      transplantation after preparation with busulfan and cyclophosphamide (BuCy2): an
      update.
AB  - Allogeneic bone marrow transplantation (BMT) has been shown to result in long
      term disease-free survival in patients with leukemia. However, the utility of
      this treatment approach is limited by treatment-related morbidity and mortality.
      We present an update of a study in which a BMT preparative regimen consisting of
      a 4-day course of busulfan and a 2-day course of cyclophosphamide (BuCy2) was
      used in patients with chronic myelogenous leukemia. Patient survival depended on
      disease stage, with a 58% survival rate for patients in first chronic phase, 41%
      for those in accelerated phase, and 25% for those in the blast transformation
      stage. There was a significant difference in patient survival between those who
      received transplants within 1 year of diagnosis and those who received
      transplants more than 1 year after diagnosis (70% v 40%). This difference
      appeared to be due to the extent of previous exposure to busulfan. The overall
      mortality rate in this study was 46%. We conclude that the BuCy2 preparative
      regimen is similar in effectiveness to regimens that include total body
      irradiation and results in comparable levels of transplant-related mortality. Our
      results strongly indicate that patients with chronic myelogenous leukemia who
      receive BMT within the first year after diagnosis have a significantly better
      clinical outcome than those who receive BMT later in the course of the disease.

PMID- 8342073
TI  - The influence of total dose, fractionation, dose rate, and distribution of total
      body irradiation on bone marrow transplantation.
AB  - Total body irradiation (TBI) is a common component of many preparative regimens
      used prior to bone marrow transplantation. The biologic effects of TBI are
      influenced by a number of factors, including total dose, dose fractionation, dose
      rate, and dose distribution. Higher doses of TBI result in greater antileukemic
      activity, but this effect may be offset by concomitant increases in treatment
      related toxicities. Increased doses of TBI also produce a greater degree of
      immunosuppression. Fractionated TBI results in decreased late toxicities and
      immunosuppressive effects when compared with single-dose TBI, yet the extent of
      marrow ablation seems to be similar. For both single-dose and fractionated TBI,
      higher dose rates produce increased treatment-related toxicities. Dose rates also
      may affect marrow ablation and immunosuppression. By targeting radiation to
      leukemic or immunocompetent cells, alterations in dose distribution have the
      potential to significantly improve the clinical benefits of TBI. Directed
      external beam irradiation is one approach to achieving the goal of targeted
      therapy. Other approaches involve the conjugation of radionuclides to antibodies
      that recognize specific cell-surface antigens or to aminophosphonic acid
      compounds that bind to bone. Such specific targeting of radiation could lead to
      significant increases in the intensity of therapy without resulting in greater
      treatment-related toxicities.

PMID- 8342074
TI  - Allogeneic bone marrow transplantation for acute myelogenous leukemia, acute
      lymphocytic leukemia, and multiple myeloma following preparation with busulfan
      and cyclophosphamide (BuCy2).
AB  - The combination of busulfan (Bu) and cyclophosphamide (Cy) has been found to be
      effective preparative therapy for patients treated with allogeneic bone marrow
      transplantation (BMT). We developed the BuCy2 regimen, which contains a lower
      dose of cyclophosphamide than the original BuCy regimen, in the hope of reducing
      regimen-related toxicities. We have studied the use of BuCy2 as preparation for
      allogeneic BMT in patients with acute myelogenous leukemia, acute lymphocytic
      leukemia, and multiple myeloma. In patients with acute myelogenous leukemia, the
      leukemia-free survival and regimen-related toxicity rates obtained in our study
      appear similar to those achieved with other preparative regimens, including those
      containing Cy and total body irradiation (TBI). BuCy2 is also an effective BMT
      preparative regimen in patients with acute lymphocytic leukemia and multiple
      myeloma. Treatment with BuCy2 results in a lower incidence of severe stomatitis
      and probably of interstitial pneumonia than does treatment with Cy/TBI, but
      hepatic veno-occlusive disease occurs more frequently in BuCy-treated patients.
      The incidence of veno-occlusive disease appears to be affected by agents used as
      prophylaxis for graft-versus-host disease. Compared with Cy/TBI regimens, BuCy
      treatment is likely to result in fewer delayed effects of treatment, such as
      impairment of fertility and second malignancies. Current clinical efforts are
      focusing on ways to improve the antileukemic activity of the BuCy preparative
      regimen and to reduce regimen-related toxicities.

PMID- 8342075
TI  - Busulfan plus etoposide as a preparative regimen for autologous bone marrow
      transplantation for acute myelogenous leukemia: an update.
AB  - We have used a new preparative regimen prior to autologous bone marrow
      transplantation in patients in remission of acute myelogenous leukemia (AML).
      Sixty-two patients were treated with preparative chemotherapy consisting of 1
      mg/kg of busulfan every 6 hours for 4 days (total dose 16 mg/kg) on days -7 to -4
      followed by an intravenous infusion of 60 mg/kg of etoposide on day -3.
      Autologous bone marrow that had been purged with 4-hydroperoxycyclophosphamide
      was infused on day 0. Thirty-five of the treated patients were in first
      remission, 21 were in second or third remission, and six had primary refractory
      AML and required aggressive salvage regimens to achieve remission. Among patients
      in first remission, one treatment-related death and five relapses have occurred.
      With a median follow-up of 25 months, the actuarial relapse rate is 19% +/- 8%
      and the disease-free survival rate is 79% +/- 8% at 3 years. The 16 patients with
      favorable FAB subtypes (M3 or M4E0) showed an excellent response to this
      treatment protocol, with no relapses after median follow-up of 35 months. Among
      patients in second or third remission, there were five treatment-related deaths
      and five relapses. With a median follow-up of 41 months, the actuarial relapse
      rate is 30% +/- 11% and the disease-free survival rate is 52% +/- 11% at 3 years.
      Four of six primary refractory patients died during treatment and one remains in
      remission with short follow-up. These preliminary data indicate that aggressive
      preparative regimens followed by the infusion of purged autologous bone marrow
      may be a promising approach to improving the clinical outcome of adult patients
      with AML.

PMID- 8342076
TI  - Comparison of preparative transplantation regimens using
      carmustine/etoposide/cisplatin or busulfan/etoposide/cyclophosphamide in lymphoid
      malignancies.
AB  - Most bone marrow transplantation preparative regimens use total body irradiation
      as one component. Recently, however, two non-total body irradiation containing
      autologous bone marrow transplantation preparative regimens have been evaluated
      in patients with lymphoid malignancies. The first regimen consisted of
      carmustine, etoposide, and cisplatin; some patients also received involved-field
      radiotherapy to sites of prior disease. Of the 79 patients with relapsed or
      refractory lymphoma who participated in this study, 57 (72%) achieved a complete
      remission and 40 (51%) remain in complete remission. Treatment-related deaths
      occurred in five patients (6%). The second preparative regimen evaluated
      consisted of busulfan, etoposide, and cyclophosphamide and included 21 patients
      with Hodgkin's lymphoma, non-Hodgkin's lymphoma, or acute lymphocytic leukemia.
      Sixteen patients (76%) achieved complete remission and 12 (57%) remain disease
      free. The regimen-related mortality rate in this study was 14%. The three
      treatment-related deaths were all due to pulmonary toxicity. The results of these
      clinical trials indicate that both the carmustine/etoposide/cisplatin regimen and
      the busulfan/etoposide/cyclophosphamide regimen are effective in treating
      lymphoid malignancies. Treatment-related toxicities and deaths are significant,
      but not prohibitive. Accordingly, these new preparative regimens deserve further
      evaluation in the treatment of patients with lymphoma or leukemia.

PMID- 8342077
TI  - New preparative regimens with diaziquone or cytarabine in combination with
      busulfan and cyclophosphamide.
AB  - Preparative regimens used prior to bone marrow transplantation (BMT) in patients
      with malignancies must mediate engraftment and eradicate malignant cells without
      producing significant extramedullary toxicities. The first agents to be tested in
      BMT preparative regimens, total body irradiation (TBI) and cyclophosphamide (Cy),
      were ineffective as single agents, but resulted in long-term disease-free
      survival in some leukemic patients when combined. However, Cy/TBI regimens are
      associated with significant acute and chronic toxicities as well as technical
      constraints involving the administration of radiation. Accordingly, a
      nonradiation-based regimen consisting of Cy and busulfan (Bu) was developed.
      Regimens using either a 4-day course (BuCy4) or a 2-day course (BuCy2) of Cy have
      been shown to have significant antileukemic effects. In general, however, BuCy
      regimens do not appear to result in greater antileukemic activity or lower
      treatment-related toxicity than Cy/TBI regimens. New preparative regimens are
      currently being developed to lower the incidence of disease recurrence after BMT.
      One such regimen consists of BuCy plus etoposide. At our institution, we are
      currently testing the efficacy and toxicity of regimens in which cytarabine or
      diaziquone are administered in combination with Bu and Cy. It is hoped that these
      new preparative regimens will enhance the antileukemic effects of BMT without
      significantly increasing treatment-related toxicity.

PMID- 8342078
TI  - [Research in health policy].

PMID- 8342079
TI  - [The seroepidemiology of rubella in a female population of reproductive age in
      Leon, Guanajuato].
AB  - In order to assess the seroepidemiology of protective antibodies against rubella
      among women from Leon, Guanajuato, Mexico, a prospective study was done. The
      sample consisted in 176 serum samples from urban and rural women at reproductive
      age, drawn from June 1990 to June 1991. Samples were tested by the classic
      hemagglutination inhibition method, titers of 1:8 or higher were considered as
      positive. Global positivity was 71 per cent (125 sera). Seropositivity did not
      increase with women's age; the lowest values were seen at the rural zones
      (58.9%). This survey showed a lower seropositivity than the previously reported
      in Mexico, and confirms data from new official studies. With this information
      authors suggest that the utility and viability of a national vaccination program
      should be reviewed and propose that it could be risky that individual clinicians
      to recommend children vaccination because the lack of coordination could increase
      adult cases of rubella.

PMID- 8342080
TI  - [Leishmaniasis: a preliminary epidemiological study in a locality of the endemic
      area in the state of the Tabasco].
AB  - The state of Tabasco is localized in the endemic area of cutaneous leishmaniasis
      where both diffuse cutaneous leishmaniasis and mucocutaneous leishmaniasis have
      recently been reported. The objective of the present study was to obtain reliable
      information of the situation of this disease--which has a great relevance as a
      worldwide public health problem--through determination of the allergic index in a
      randomized sample from Rancheria Miguel Hidalgo, Comalcalco Municipality,
      Tabasco, Mexico. We found an allergic index of 56 per cent. Farmers and
      housewives had the highest positive responses to the Montenegro skin test. We
      found no statistical differences between males and females. Moreover, 3 patients
      with active lesions and people with scars suggestive of prior leishmaniasis were
      detected during the study. This village should be considered a high endemic
      focus.

PMID- 8342081
TI  - [Blood transfusion-associated AIDS].
AB  - OBJECTIVE: To know the prevalence and epidemiologic characteristics of AIDS
      related to blood transfusion. DESIGN: This is a retrospective study, conducted
      from January 1988 to August 1992. PLACE: General Regional Hospital of Mexican
      Institute for Social Security in Puebla, Mexico. PARTICIPANTS: Inpatients and
      outpatients attending the hospital and in whom the diagnosis of AIDS stage IV,
      according to the criteria by the Centers for Disease control, Atlanta, USA, was
      made. The following criteria were used: age, sex, marital status, date of blood
      transfusion, amount of blood units transfused, incubation period and course of
      the disease. STATISTICAL METHODS: The mean, standard deviation, the correlation
      coefficient and Student t-test were used. RESULTS: Two hundred and forty-seven
      cases of AIDS were found, 61 of then were related to blood transfusion (24.7%).
      The mean age was 30 years (SD +/- 9). Thirty-nine out of 61 cases were females
      (63.9%). The incubation period was 48 months (SD +/- 16) and was shorter in those
      subjects who received more units of blood, however, this was not statistically
      significant (P > 0.20). Transmission of the infection to the sexual partner was
      observed in 6 cases, and perinatal transmission in 2 cases. CONCLUSION: AIDS
      transmitted by blood transfusion is important; it is more common in females and
      it is related to the high incidence of HIV infection among commercial donors.
      Nowadays this mode of transmission is considered virtually absent and a great
      decrease in transfusion-related AIDS cases is expected in the future.

PMID- 8342082
TI  - [The prevalence of caries in marginal rural and peripheral urban areas].
AB  - A descriptive study of caries prevalence in peripheral urban and rural
      underprivileged groups was undertaken in self-selected populations demanding
      basic dental therapy in seven states of Mexico. Dental therapy services were
      delivered as part of a mobile oral health care program in the Mexican countryside
      implemented by the Dental School of Universidad Nacional Autonoma de Mexico,
      during 1990 and 1991. Partial examination of clinical histories of 2,596 patients
      (mean age 21.8 years) revealed a mean DMFT (the sum of decayed, missing and
      filled teeth) of 9.21. Only 6.3 per cent of patients had DMFT = 0 and 10.7 per
      cent were caries-free. The largest component of DMFT were decayed teeth and the
      smallest one filled teeth. In general, results suggested that caries prevalence
      was high within the study populations, highlighting the little restorative
      treatment previously undertaken. The convenience of implementing oral health care
      schemes to deal with caries morbidity is discussed from the perspective of both
      the traditional dental treatment approach and preventive public health policies,
      taking into account the background of complex treatment needs present in these
      population groups.

PMID- 8342083
TI  - [Mortality in geriatric patients in the Hospital General of Mexico].
AB  - In order to define the main diseases of the elderly and a possible changes of
      mortality causes at Hospital General of Mexico, SSA, the authors studied 586
      autopsy reports of individuals over sixty years old, deceased between 1960 and
      1965 and of 625 individuals of similar characteristics deceased between 1981 and
      1985. The analysis of diseases showed qualitative and quantitative changes in the
      ten principal causes of death at each period: some of the most frequent diseases
      in the 60's, for instance, amebiasis, were not included among the then principal
      causes of death in the 80's. On the other hand, malignant neoplasms persisted as
      one of the principal death causes in both periods, but the most frequent
      carcinoma in the 60's, gastric carcinoma, was substituted in the 80's by
      bronchogenic carcinoma. This study suggests that great technical and sanitary
      interventions are necessary to promote health of third age persons, an increasing
      but poorly protected population in our country.

PMID- 8342084
TI  - [The opinions of the different participants on community participation in family
      health and planning].
AB  - Community participation constitutes a central strategy in the provision of health
      services, particularly in poor communities in this country. Little is known,
      however, about the different actors's point of view regarding this strategy. This
      is true particularly for female community members and community workers. In this
      paper, historical antecedents of community participation are discussed and some
      results of a research work are presented, which explored attitudes and opinions
      of different groups of interviewees, regarding the idea of community
      participation in health and family planning. The involved groups are: female
      community members, community workers, community leaders, medical supervisors
      which control community workers, and medical executives which control those
      supervisors. It is emphasized that medical executives are the strongest
      supporters of community participation, while community members are the weakest.
      The importance of taking into account the community members' position on matters
      such as community participation in family planning is stressed.

PMID- 8342085
TI  - [The construction of a sociocultural epidemiological profile of a rural
      community].
AB  - This study combines two methodological approaches in order to assess morbidity
      just as it is conceived by the population: the first approach--an anthropological
      perspective--is a qualitative study of focal groups; the second approach is a
      sociological study that draws upon participatory research proposals, and intends
      to related academic interest with the concerns that arise in the population. This
      research work was conducted with the Health Commission of the main peasant
      organization in the zone, as part of a health education program working with
      female peasants who also participated in an ethnobotanical participatory study
      and in health workshops. The information produced by these women in the two
      analytical space aforementioned, allowed the indirect conformation of a
      sociocultural morbidity profile for the zone. Participatory research, focal
      groups and ethnobotanical studies are useful in the characterization of an
      epidemiological profile of the sociocultural nature of diseases. In order to
      conform a synthetic epidemiology, it is necessary to take into account these
      diseases as health problems that generate poor performance at work, suffering and
      that deserve to be considered in local health systems (SILOS).

PMID- 8342086
TI  - [Education by correspondence: a strategy for training and instruction in health
      services administration].
AB  - The training of health services administration professionals in Mexico has faced
      two main challenges. One the one hand, the need to have recognition as
      professionals, and on the other hand the difficulty to train individuals that are
      currently working as health care administrators. This article emphasizes a
      distance education strategy as an alternative to provide training to these type
      of personnel. A proposal developed as the second phase of the Advance Education
      Program on Health Administration (PROASA-II) is presented. It has the objective
      to strengthen local institutions to take responsibility for the future training
      of their professional administration staff. Once that this is started, we can
      begin to talk about the creation of a national system of manpower training in
      health administration and public health, that will support the decentralization
      and the appropriate training of the different levels of health administration in
      the country.

PMID- 8342087
TI  - [Razon de posibilidades: a proposed translation of the term odds ratio].
AB  - In English, odds ratio is a basic epidemiological measure approximating the
      relative risk. Odds ratio has been translated into Spanish in several ways, which
      has produced great terminological confusion. On the other hand, the English word
      odds is often used in epidemiology or statistics English textbooks, alone or as
      part of other expressions, but always keeping a definite mathematical meaning,
      which calls for a similarly definite term in Spanish. We discuss several
      translations of odds ratio found in the literature and propose the Spanish word
      "posibilidades" as a translation of odds and "razon de posibilidades" as a
      translation of odds ratio.

PMID- 8342088
TI  - [Rice and beriberi. A preliminary report on an experiment performed in the Asylum
      for the Insane of Kuala Lumpur. 1907].

PMID- 8342089
TI  - Bone marrow toxicity by silver sulfadiazine.
AB  - The effect of silver sulfadiazine (SSD) on the production of granulocytes and
      macrophages was studied in a murine model of cutaneous injury. Application of SSD
      daily to mice receiving a 10 percent full-thickness total body surface area burn
      injury failed to demonstrate consistent suppression of the bone marrow at one,
      four or seven days postinjury. Mice undergoing a 10 percent full-thickness skin
      excision (SE) and daily SSD application (SE plus SSD) had a near 50 percent
      reduction in total peripheral blood leukocyte counts in comparison with a control
      group and untreated mice that were skin-excised (SE-U) (p < 0.03) to 0.002) on
      day one postinjury and maintained this reduction compared with SE-U at days four
      and seven postinjury. The absolute number of granulocytes in SE plus SSD was only
      10 percent of control or SE-U (p < 0.04 to 0.002) at day one postinjury and
      remained less than SE-U at four and seven days postinjury. Femoral bone marrow
      assay of granulocyte-macrophage progenitor cells (GM-CFC) revealed a marked
      reduction in nucleated bone marrow cells for SE plus SSD compared with respect to
      control at days one and seven and SE-U at days four and seven (p < 0.02 to
      0.001). GM-CFC were significantly depressed in SE plus SSD on day one compared
      with C and SE-U and day four compared with SE-U (p < 0.01 to 0.001), but returned
      to control values by day seven. When SSD (0.5 to 500.0 micrograms per milliliter)
      was added to culture plates containing maximally stimulated normal murine or
      human bone marrow cells, the colony count was depressed in a dose-dependent
      manner. In vitro SSD is directly cytotoxic to myelopoietic tissue, and in vivo,
      alters the myeloid cell compartment. These observations in combination may
      explain the transient leukopenia frequently observed in patients receiving
      topical chemoprophylaxis with SSD.

PMID- 8342090
TI  - Surgical bleeding in microgravity.
AB  - A surgical procedure performed during space flight would occur in a unique
      microgravity environment. Several experiments performed during weightlessness in
      parabolic flight were reviewed to ascertain the behavior of surgical bleeding in
      microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood,
      as well as actual arterial and venous bleeding in rabbits, were examined. The
      high surface tension property of blood promotes the formation of large fluid
      domes, which have a tendency to adhere to the wound. The use of sponges and
      suction will be adequate to prevent cabin atmosphere contamination with all
      bleeding, with the exception of temporary arterial droplet streams. The control
      of the bleeding with standard surgical techniques should not be difficult.

PMID- 8342091
TI  - Mediastinal drainage prevents fatal pyothorax from anastomotic leakage after
      intrathoracic anastomosis in reconstruction for carcinoma of the esophagus.
AB  - In our experience, anastomotic leakage occurred in five of 69 patients with
      intrathoracic anastomosis after resection of carcinoma of the esophagus. In the
      early period, only an ordinary right thoracic drain was put in place, and when
      leakage occurred, two patients died because of pyothorax, while one patient was
      saved by surgical drainage. However, in the recent period, in addition to the
      ordinary right thoracic drain, another drain has also been placed just distal to
      the anastomosis through the esophageal hiatus through the abdominal cavity,
      exiting the abdominal wall. After such procedure, drainage has been adequate
      without any occurrence of pyothorax, even when anastomotic leakage occurred, as
      in the two most recent instances. Therefore, unless drainage is inadequate and
      surgical drainage is indicated, as in instances of necrosis of substitutes,
      mediastinoabdominal drainage seems to be effective in the treatment of
      intrathoracic anastomotic leakage.

PMID- 8342092
TI  - Microsurgery alone or with INTERCEED Absorbable Adhesion Barrier for pelvic
      sidewall adhesion re-formation. The INTERCEED (TC7) Adhesion Barrier Study Group
      II.
AB  - Adhesion re-formation after a reproductive operation, particularly involving the
      pelvic sidewall, is a prominent cause of failure in the surgical treatment of
      infertility. This study was done to evaluate the impact of standard microsurgery
      through laparotomy and the additional benefit of an oxidized regenerated
      cellulose adhesion barrier (INTERCEED [TC7] Absorbable Adhesion Barrier [Ethicon
      Inc.]), in reducing pelvic sidewall adhesion re-formation. One hundred and thirty
      four patients with bilateral pelvic sidewall adhesions undergoing adhesiolysis by
      standard microsurgical techniques through laparotomy were treated during a
      prospective randomized trial involving 13 centers. After adhesiolysis, the
      deperitonealized surface of one pelvic sidewall was randomly assigned to be
      covered with INTERCEED Barrier, the contralateral sidewall serving as control. A
      second-look laparoscopy was performed ten days to 14 weeks postoperatively.
      Microsurgical adhesiolysis alone resulted in 24 percent of the sidewalls becoming
      free of adhesions and a 55.6 percent reduction in the area of adherent
      peritoneum. With microsurgery alone, 60 and 39 percent of adhesions initially
      characterized as filmy or severe, respectively, were not seen at second-look
      laparoscopy. The use of INTERCEED Barrier increased the incidence of adhesion
      free sidewalls twofold. The treatment was also associated with a statistically
      significant reduction in the area of peritoneum affected by adhesion re
      formation, compared with the control wall. Of the adhesions originally graded as
      severe, 61 percent of those treated with INTERCEED Barrier did not re-form at
      all. When evaluated on filmy adhesions, the use of the barrier was associated
      with a 72 percent reduction in adhesion re-formation. A measurable reduction in
      adhesion re-formation was found, depending on the initial adhesion type, with
      microsurgery alone. The addition of INTERCEED Barrier further reduced the
      incidence, extent and severity of postoperative adhesion re-formation. In this
      study, 90 percent of the patients benefited from the use of INTERCEED Barrier.

PMID- 8342093
TI  - Helium insufflation for laparoscopic operation.
AB  - Laparoscopic surgical procedures are becoming simultaneously more commonplace and
      complex. However, carbon dioxide (CO2) pneumoperitoneum required for these
      procedures causes a respiratory acidosis. We undertook this study to determine if
      an alternate insufflating gas, such as helium, prevents this sequelae. Twenty
      patients undergoing elective laparoscopic cholecystectomy were randomized to
      receive either CO2 or helium insufflation. Intraoperative parameters, including
      arterial CO2 (PaCO2), end-tidal CO2, pH, bicarbonate (HCO3-), cardiac output and
      blood pressure were obtained before, during and at the conclusion of
      pneumoperitoneum. Effects of the two gases on these variables were compared. The
      average CO2 rose significantly from 35.7 +/- 1.0 to 50.4 +/- 3.2 (p < 0.0001),
      while pH decreased from 7.434 +/- 0.014 to 7.286 +/- 0.018 (p < 0.0001) in those
      who received CO2. No change in PaCO2 was observed in those who received He,
      although a small decrease in pH from 7.428 +/- 0.011 to 7.392 +/- 0.012 (p <
      0.05) was observed. HCO3- decreased slightly in both groups. Increases in blood
      pressure and pulse rate were independent of the gas received. The cardiac output
      did not change. Helium insufflation for laparoscopic cholecystectomy does not
      produce the respiratory acidosis caused by CO2 and, therefore, merits further
      investigation for use, particularly in patients with underlying respiratory
      disease.

PMID- 8342094
TI  - Intraoperative fine needle aspiration of pancreatic and extrahepatic biliary
      masses.
AB  - Intraoperative fine needle aspiration (IFNA) of masses of the pancreas and
      extrahepatic biliary system provides a method of rapid tissue diagnosis with a
      much lower complication rate than either wedge or large bore needle biopsies. Few
      series include IFNA of extrahepatic biliary system masses in their analyses. We
      retrospectively evaluated all IFNA of pancreatic, extrahepatic biliary and
      ampullary masses at the University of Virginia from March 1981 to December 1991
      to assess the diagnostic accuracy of this procedure. Ninety-nine IFNA were
      performed--75 of the pancreas, 17 of the extrahepatic biliary system and seven of
      the ampulla. All aspirations were performed with direct visualization or
      palpation of the tumor, or both, using several passes with a 22 gauge needle. A
      diagnostic "positive" or "negative" reading was rendered in 90 of 99 IFNA.
      Carcinoma was confirmed by positive tissue diagnosis or clinical course
      consistent with cancer. Benign disease was confirmed by negative pathologic
      factors from a resected specimen or confirmatory clinical course of at least 18
      months. Diagnosis was confirmed by these criteria in 82 patients. Thirty-four of
      43 patients with confirmed carcinoma of the pancreas had positive cytologic
      factors by IFNA. Three pancreas IFNA were deemed as "suspicious" and six as
      "unsatisfactory." Two patients with "suspicious" findings had pathologically
      confirmed well-differentiated carcinoma. Carcinoma of the ampulla and
      extrahepatic biliary tract was detected by IFNA in 17 of 18 confirmed patients.
      The overall sensitivity of positive or negative IFNA in this series in 90
      percent, with 100 percent specificity and 92 percent accuracy. IFNA has a
      positive predictive value of 100 percent and negative predictive value of 74
      percent. We conclude that IFNA is a highly accurate diagnostic procedure and
      represents the preferred technique of obtaining an intraoperative tissue
      diagnosis in masses of the pancreas, extrahepatic biliary tract and ampulla.
      Positive IFNA may definitively guide surgical decision-making; however, we
      caution that negative IFNA cannot be relied on definitively to exclude the
      diagnosis of carcinoma.

PMID- 8342095
TI  - Outcome of surgical treatment for extrapancreatic gastrinomas.
AB  - Since the availability of the H2-receptor antagonists (1978), seven patients
      admitted to the Department of Emergency Surgery, University of Pisa, with
      Zollinger-Ellison syndrome (ZES) sustained by extrapancreatic gastrinomas
      underwent elective surgical treatment. There were four women and three men, with
      a mean age of 37.3 years (16 to 67 years of age). Preoperative localization
      studies included endoscopy of the upper part of the gastrointestinal tract,
      computed axial tomography, ultrasound, selective angiography and transhepatic
      portal vein sampling for gastrin and were effective in four patients. In the
      other three patients, the localization of the gastrinoma was made at laparotomy.
      Four patients had gastrinomas of the duodenal and jejunal wall. Three underwent
      excisional operations, whereas the remnant was treated with
      pancreatoduodenectomy. In three of the patients, the location of the gastrinoma
      was extrapancreatic and extraintestinal, and surgical treatment consisted of
      nodal excision (two patients) and hepatectomy. None of the patients had undergone
      a gastric operation in addition to tumorectomy procedures. Soon after excisional
      operation, ZES recurred in one patient and a second laparotomy with nodal
      excision resulted in a cure. On long term follow-up evaluation, ranging from 15
      to 136 months (mean of 85.1 divided by 37.3 months), no patients showed a
      recurrence of ZES. The possibility of extrapancreatic gastrinoma should be
      suspected in patients with sporadic ZES. The need for emergency surgical
      treatment in these patients is minimized by the medical control of the gastric
      secretion that consents diagnostic studies for the preoperative localization of
      the gastrinoma. Even if only suspected, the site of the extrapancreatic
      gastrinoma has an increased chance to be identified at operation. This consents
      to remove gastrinomas mostly by a minimal excisional procedure resulting in the
      normalization of gastric secretion and the prevention of malignant evolution of
      these tumors.

PMID- 8342096
TI  - Surgical treatment for congenital absence of the vagina using tissue expansion.
AB  - A modification of the Abbe-McIndoe technique for the treatment of congenital
      absence of the vagina, using a cylindrical tissue expander wrapped in a mesh
      split-thickness skin graft, instead of a rigid silicone mold, is presented. The
      expander was kept in place for a period of two to six months and the functional
      result was 100 percent in all the six patients treated. Our experience led us to
      change the design of the expander (cylindrical, without ring, 10X4 centimeters)
      and to place the valve in the inner thigh as the best site for the valve. The age
      range of the patients was 18 to 27 years, and the final result was good or very
      good in five of the six women. Only one patient has occasional dyspareunia, which
      does not prevent sexual intercourse.

PMID- 8342097
TI  - The analysis of benefit and risk of combined pancreatic and renal transplantation
      versus renal transplantation alone.
AB  - Currently, diabetes mellitus is the most common cause of renal failure in adults.
      However, combined pancreatic and renal transplantation (PRT) remains
      controversial when compared with renal transplantation alone (RTA) in diabetic
      recipients. We analyzed the results and morbidity in four age-matched groups--31
      patients with Type I diabetes undergoing PRT before dialysis, 30 patients with
      diabetes who are dependent of dialysis undergoing PRT, 31 concurrent and historic
      patients with Type I diabetes undergoing RTA and 31 concurrent patients without
      diabetes undergoing RTA. All patients received cadaver donor organs and were
      managed with cyclosporine and prednisone immunosuppression with selective OKT3
      induction. The four groups were comparable with respect to age, weight, gender,
      duration and severity of diabetes, dialysis type, number of retransplants, degree
      of sensitization, preservation time and matching. The groups differed with regard
      to duration of dialysis and period of follow-up evaluation, pretransplant blood
      transfusions, racial distribution and OKT3 induction therapy. PRT was associated
      with a greater morbidity rate as evidenced by a slightly higher incidence of
      rejection, infections and reoperations. The number of readmissions and
      hospitalization period during the first 12 months was also greater after PRT
      versus RTA. However, none of these differences were significant. No detrimental
      effect was noted on renal allograft function at one year; patient and graft
      survival was actually higher in the PRT groups. Quality of life was improved in
      nearly 90 percent of PRT recipients. Although the improved results after PRT may
      be attributed to selection bias, only lesser differences were noted among the
      four study groups. The aforementioned data suggest that appropriate patient
      selection can overcome the morbidity associated with PRT, resulting in excellent
      patient and graft survival with the potential for complete rehabilitation.

PMID- 8342098
TI  - Patient-controlled analgesia and postoperative urinary retention after open
      appendectomy.
AB  - We retrospectively studied 279 patients who had undergone uncomplicated open
      appendectomy for acute appendicitis to determine risk factors for postoperative
      urinary retention. The gender of the patients, the operating time and the amount
      of fluid given perioperatively had no influence on the occurrence of retention.
      The amount of analgesic agent administered postoperatively and the age of the
      patient were significantly associated with urinary retention (p = 0.01 and p <
      0.0001, respectively, after adjustment for potential confounding factors). The
      use of meperidine hydrochloride as compared with morphine and of patient
      controlled analgesia as compared with intramuscular delivery were initially found
      to be significantly related to retention (p = 0.014 and p < 0.0001,
      respectively). After the effects of the age of the patient, the drug type and the
      amount of fluid and analgesic agent administered were controlled for, patient
      controlled analgesia remained significantly associated with retention (p <
      0.0001), whereas the type of drug given was no longer significant after
      controlling for potential confounding factors. Because we found that urinary
      retention was 13 times more likely to occur in the patients who had patient
      controlled analgesia, we recommend that the use of this form of analgesia
      delivery be avoided after open appendectomy.

PMID- 8342099
TI  - An inexpensive and versatile intraluminal shunt for vascular operations.
AB  - An inexpensive and versatile intraluminal shunt for vascular operation is
      presented. The shunt is created using two urinary catheters and a three-way
      stopcock. This shunt can be used for perfusion in patients with trauma and
      prolonged revascularization in the lower part of the limb. Various procedures are
      easy to perform using this shunt without any manipulation of the vessel or shunt.
      Furthermore, and more importantly, this shunt can be created and used in any
      hospital.

PMID- 8342100
TI  - Cystopancreaticostomy and longitudinal pancreaticojejunostomy as a simpler
      technique of combined drainage operation for chronic pancreatitis with
      pancreatitis with pancreatic pseudocyst causing persistent cholestasis.
AB  - A simpler combined drainage operation for a patient with chronic pancreatitis and
      chronic pseudocyst is described in the following conditions: the pancreatic duct
      was markedly dilated, the cyst was located directly behind the main pancreatic
      duct in the head of the pancreas and separate from the duodenum and the cyst
      caused persistent CBD stricture and cholestasis mainly by its compressive effect.
      The pancreatic duct was opened anteriorly throughout its length. A second
      incision was made in the posterior wall of the main pancreatic duct into the cyst
      and the edge of the opening was sutured for hemostasis. The opened pancreas was
      anastomosed to a Roux-en-Y jejunal limb according to the ordinary method of
      longitudinal pancreaticojejunostomy. This technique, cystopancreaticostomy and
      pancreaticojejunostomy, may provide a simpler and effective operative strategy
      for patients with chronic pancreatitis and pseudocyst in similar conditions.

PMID- 8342101
TI  - Internal marsupialization after laparoscopy for lymphoceles after renal
      transplantation.

PMID- 8342102
TI  - Gastrojejunal disconnection in the presence of purulent peritonitis as an
      alternative approach in gastroduodenal operations.
AB  - A two stage operation is presented, for example, a life-saving procedure that
      halts further leakage and drainage of abscess by a modification of the
      gastrojejunal disconnection and reconstruction. It may be considered as an
      alternative approach in gastroduodenal operations in the presence of purulent
      peritonitis, especially in delayed surgical treatment.

PMID- 8342103
TI  - A technique for securing transperitoneal tubes.
AB  - A simple technique for securing transperitoneal tubes is described. We believe
      this technique results in a tube fixation that is less traumatic to the
      surrounding skin, is difficult to remove accidentally and is easier to replace.

PMID- 8342104
TI  - The life of Joseph Colt Bloodgood, M.D., public surgeon.

PMID- 8342105
TI  - The surgical management of obstruction and perforation of the left colon.
AB  - Patients requiring emergency surgical treatment of the left side of the colon
      have a poor prognosis. Age, advanced malignant disease and systemic sepsis are
      contributory factors to the high morbidity and mortality rates, but making
      surgical decisions is also important. Any surgeon is likely to encounter only a
      few such patients per year and this adds to the uncertainty regarding management.
      Although the traditional three-staged approach was based on safety, it has been
      demonstrated that immediate resection is feasible and beneficial in most
      patients. This should be accompanied by primary anastomosis in all instances
      except in the presence of generalized peritonitis or a large abscess cavity
      causing severe systemic sepsis. When such circumstances occur, resection with
      terminal colostomy is the safest policy. We conclude that multicenter randomized
      prospective clinical trials should be initiated to establish the optimum and most
      economic method of resection and primary anastomosis for emergency operation of
      the left side of the colon.

PMID- 8342106
TI  - Prostate surgery expenses, 1991.
AB  - During 1991, average total charges for a radical prostatectomy among MetLife
      group health policy holders and dependents averaged $18,140; comparable charges
      for a transurethral resection of the prostate (TURP) were $7,970. The Pacific
      area reported the highest average total charges for both procedures--charges 25
      percent above the U.S. average for both surgeries. Among the 14 states with 10 or
      more radical prostatectomies reported to MetLife, California led with total
      charges of $24,850 (37 percent above the U.S. average) and Minnesota reported the
      lowest average total charges ($12,480, 31 percent lower than the norm). In the 32
      states with 10 or more TURPs during 1991, the charges ranged from the highest in
      Massachusetts ($11,250, 41 percent above average) to the lowest in Washington
      ($5,170,35 percent below the United States). Just over two-thirds of the total
      charges for each surgical procedure was due to the hospital portion of the bill.
      Physician charges were more than twice as high for a radical prostatectomy than
      for a TURP, e.g., $5,730 versus $2,630. Hospital stays averaged 7.5 days for a
      radical prostatectomy and 4.3 days for a TURP. The stays were longest in New
      Jersey for both procedures.

PMID- 8342107
TI  - The evolving American family.
AB  - The American family is undergoing profound changes. In the past few decades the
      traditional two-parent family has dramatically decreased while the one-parent
      family has become more prevalent. Currently, just seven out of 10 children under
      18 years of age live with both mother and father; in 1960 the ratio was nearly
      nine out of 10. During this interval, premarital childbearing, separation and
      divorce increased rapidly, with the result that the percentage of children
      residing with just one parent virtually tripled--from 9 percent to 26 percent.
      Parental characteristics of single- and two-parent families with children under
      18 showed significant differences among racial groups.

PMID- 8342108
TI  - Trends in urinary tract cancer deaths.
AB  - Death from cancer of the urinary tract (bladder, kidney and renal pelvis)
      continues to be the fourth leading cause of cancer mortality among U.S. men. In
      1988-89, 21,834 deaths from urinary tract cancer occurred among men aged 45-84
      years, resulting in an age-adjusted mortality rate of 25.9 per 100,000. This rate
      was 7.2 lower than that reported for 1979-81 and all but 16 states had lower
      rates in 1988-89 than in 1979-81. The rates decreased or remained the same in all
      but the West South Central area of the country where there was a 2.5 percent
      increase in 1988-89. In states with 200 or more deaths from urinary tract cancer,
      the largest decrease in the age-adjusted mortality rate for men 45-84 was evident
      in New York and Virginia. The 16 rate increases ranged from 24 percent in Wyoming
      with 44 cases to 0.4 percent in Minnesota with 393 cases and 0.3 percent in
      Indian with 529 cases.

PMID- 8342109
TI  - International death rates compared.
AB  - Since 1950 substantial progress has been made in reducing mortality in the United
      States. The decline in age-adjusted death rates was especially notable among
      women and among nonwhite persons. In particular, women of all other races
      recorded a precipitous reduction in death rates. Notwithstanding, age-adjusted
      death rates in the United States are still higher than those in other countries
      with traditionally low mortality. Moreover, very little progress has been
      achieved in the past decade in narrowing the international mortality gap.
      Currently, the United States ranks eleventh out of 15 countries under review. Men
      and women in Japan have the best mortality record.

PMID- 8342110
TI  - [Radiosynoviorthesis].
AB  - Intraarticular therapy using radionuclides seems to be the best conservative
      local treatment of chronic synovitis as a generally accepted alternative to
      surgical synovectomy. If the indication is carefully considered and the technique
      properly applied, the success rate of treatment is as high as it is with surgery,
      whereas the risk involved is comparatively low.

PMID- 8342111
TI  - [The primary radiotherapy of inoperable or recurrent pancreatic carcinoma-
      Heidelberg patients from 1982 to 1992].
AB  - Between 1982 and 1992, 34 patients with locally advanced or relapsed
      adenocarcinoma of the pancreas were treated at the Department of Radiotherapy in
      Heidelberg. 14 patients were treated with a combined radiochemotherapy with 5-FU,
      the other patients were irradiated alone. In all cases irradiation was done with
      high energy photons. 15 patients received an irradiation with doses between 30
      and 44 Gy, and twelve patients between 45 and 66 Gy (median 50 Gy). Seven
      patients were treated intraoperatively during an exploration laparotomy with fast
      electrons (10 to 18 MeV, 15 to 20 Gy) and postoperatively with additional 30 to
      41 Gy. The median survival of the patients treated with the higher doses or in
      combination with the IORT showed a significant advantage of nine vs. 2.9 months.
      There was no benefit in median survival for the patients treated with
      radiochemotherapy. In retrospective analysis of the percutaneous treated patient
      collective a pain relief was observed in nine patients. In the prospective
      treatment protocol of the IORT in 4/4 patients a pain relief was rapidly reached.

PMID- 8342112
TI  - The RBE of negative pions in the treatment of tumors with different volumes.
AB  - For negative pions, large differences exist between experimental RBE values
      obtained by in vivo investigations with animals and corresponding data being used
      in clinical tumor therapy. Therefore, the influence of the treatment volume on
      the radiation quality and respectively on the RBE is examined. The RBE for euoxic
      mammalian cells is measured with high precision in different volumes irradiated
      in the spot-scan mode with the PIOTRON at the Paul Scherrer Institute. It is
      shown experimentally that the RBE is reduced if the radius of the irradiation
      volume is increased. Using a simple mathematical approximation for the spot-scan
      technique this relation can be understood quantitatively. The same approximation
      is also used to calculate dose mean values for the lineal energy yD present in
      different irradiated volumes. The good agreement with existing experimental data
      for yD indicates that the approximation used is adequate and the main physical
      parameters have been taken into consideration. The above mentioned differences
      between animal experiments and treatment of patients can be explained by changes
      in the effective radiation quality due to the scanning procedure used in the
      clinical treatments.

PMID- 8342113
TI  - Tumor response to ionizing radiation and combined 2-deoxy-D-glucose application
      in EATC tumor bearing mice: monitoring of tumor size and microscopic
      observations.
AB  - The present study deals with the changes induced by two fractionation schedules
      (5 x 9 Gy and 10 x 4.5 Gy; 30 MeV-electrons) of ionizing radiations and 2-deoxy-D
      glucose (2-DG) application on EATC tumor bearing swiss albino mice. The
      monitoring of tumor response was carried out by means of caliper measurement on
      the macroscopic level and by histopathological examination of tumor preparations
      stained with hematoxiline and eosine on the microscopic level. The tumor material
      was assessed at suitable intervals after treatment by killing the animals. The
      tumor response was analysed in the histological preparations and the thickness of
      the tumor band was determined quantitatively by an ocular micrometric technique.
      Tumor damage was most extensive in the combined treated animals (5 x 9 Gy + 2
      DG). Only in this group local tumor control was achievable. The histological
      analysis of tumor preparations revealed additional data about treatment-induced
      changes in the tumor compared to the measurement of the tumor volume with
      mechanical calipers. We also found that the treatment outcome could be predicted
      from the histopathological analysis. It is concluded that studies involving
      histopathological examinations may give some insight into the way cancer is
      controlled by radiotherapy and may be of value in prognosis and selection of
      treatment in patients.

PMID- 8342114
TI  - [The relative biological effectiveness (RBE) of fast neutrons on the Dunning rat
      prostate carcinoma R3327-HI].
AB  - Human prostate tumors are known to be good candidates for neutron therapy. The
      Dunning rat prostate tumor system R3327 was found in many studies to be an
      excellent model for human prostate tumors. There is still a paucity of studies on
      the response of the Dunning tumors to fast neutrons. Tumors of the R3327-HI
      subline are moderately well differentiated and mucin producing. They show one
      euploid cell population, a bromodeoxyuridine labelling index of 5%, a potential
      doubling time of 8.9 days, a volume doubling time of about ten days and a cell
      loss rate of 10%. Tumors were transplanted s.c. in the distal thigh of Copenhagen
      rats and treated with 60Co-photons (10, 20, 30, 40 Gy, 45 cGy/min) and 14-MeV
      neutrons (8, 10, 12 Gy, 7 to 11 cGy/min). Tumor volumes were measured twice
      weekly. Growth delay was defined as time in days until the tumors reached twice
      their treatment volume. Linear regressions on the median growth delays of the
      different treatment groups were calculated. The ratio of the neutron- and photon
      slopes yielded an RBE of 3.1 +/- 0.3. Additionally isoeffect-RBE values between
      2.3 and 2.6 were graphically estimated.

PMID- 8342115
TI  - Effect of whole-body irradiation on phagocytic cells in mouse blood measured by
      chemiluminescence.
AB  - In investigations with mice the influence of an X-irradiation on the
      chemiluminescence yield of granulocytes from the peripheral blood was measured.
      The measurements were carried out with diluted freshly drawn blood by adding
      luminol as chemiluminogenic substance. The granulocytes were stimulated by
      zymosan. The following dependencies were investigated: dose from 1 to 8 Gy and
      time twelve hours to 32 days after a whole-body irradiation. In general the
      chemiluminescence yields from blood of irradiated animals are reduced in
      dependence of dose compared with the findings in controls. In unirradiated
      animals (controls) there exists a good correlation between the numbers of
      granulocytes and the chemiluminescence. This correlation is diminished after an
      irradiation. For the fourth day after a whole-body irradiation the
      chemiluminescence shows an exponential dose dependence. If chemiluminescence
      counts are related to the number of granulocytes (relative chemiluminescence) an
      increased chemiluminescence per single granulocyte is recorded up to the eighth
      day after an irradiation with 1 Gy. It may be assumed that subpopulations of
      granulocytes with enhanced ability to form oxidative metabolic products are
      responsible for this effect.

PMID- 8342116
TI  - Linear quadratic model--estimation of alpha/beta ratio for mucosal reaction.
AB  - In radiotherapy to ensure that appropriate tumor lethal dose is delivered without
      exceeding normal tissue tolerance, concepts like NSD and its derivatives were
      used in the past. Due to their short coming these concepts are now replaced by a
      linear quadratic model. As this model is based on the recent radiobiological
      data, it is claimed to be able to predict the biological responses of tumors as
      well as normal tissues more accurately. However, the accuracy of prediction
      depends on the precise values of various parameters such as alpha/beta, repair
      constant mu and repopulation factor that are involved in the linear quadratic
      model. For most of the tumors and normal tissues, values of the parameters are
      not yet accurately known. We have estimated alpha/beta value for mucosal
      reactions, i.e. normal tissue early reactions in head neck cases treated with
      twice daily fractionation schedules and observed it to be 7.90 Gy for slight
      mucositis whereas it is 7.68 and 8.11 Gy for patchy and confluent mucositis,
      respectively.

PMID- 8342117
TI  - Systemic radiotherapy with monoclonal antibodies. An experimental study with
      human neuroblastoma xenografts in nude mice.
AB  - In this experimental study, feasibility and efficiency of systemic radiotherapy
      with the I-131 labelled monoclonal antibody BW575/9 (radioimmunotherapy) are
      investigated using human SK-N-SH neuroblastoma transplanted into nude mice.
      Series of six nude mice were treated with intravenous application of 400 microCi
      (group 1), 700 microCi (group 2) of the I-131 labelled and of the unlabelled MAb
      (group 3). An untreated group (group 4) served as control. Tumors of group (3)
      and (4) showed an identical growth. In group (1), tumor growth was arrested for
      seven days. In group (2), the tumor showed complete regression after eight days
      which lasted for 55 days. Thereafter, the tumor started to regrow. This growth
      characteristics are correlated with the doses achieved in the tumor using a
      medical internal radiation dose (MIRD) formulation. The biodistribution data
      necessary for MIRD calculation were obtained by previously performed experiments
      with the I-125 labelled MAb. The doses assessed in the tumor turned out to be
      five to ten times greater than those in normal tissues (liver, bone, etc.) These
      results confirm feasibility, selectivity and efficiency of radioimmunotherapy in
      the above described model. Moreover, this in vivo model seems suitable for
      further investigations concerning fundamental issues of radioimmunotherapy.

PMID- 8342119
TI  - Zen and the art of surgery.

PMID- 8342118
TI  - Measurement of the proliferative activity of three different sublines of the
      Dunning rat prostate tumor R3327.
AB  - The development of the BrdUrd assay has greatly facilitated the measurement of
      proliferation in both human and experimental tumors. The potential doubling time
      (Tpot) was reported to be the most promising parameter to serve as a predictive
      assay to select patients for new treatment modalities such as accelerated
      fractionation and fast neutrons. We compared flow cytometry and immunochemistry
      applied to three sublines of the Dunning rat prostate tumor with differing
      differentiation. The anaplastic R3327-AT subline has a labeling index (LI) of 7
      +/- 0.5% and 8.8 +/- 3.7 measured with flow cytometry and histology respectively,
      S-phase duration (Ts) of 8 h, a Tpot of 4.7 days and a cell loss factors (phi) of
      15%. Proliferating cells are homogeneously distributed. The moderately well
      differentiated R3327-HI subline shows a LI of 5% (flow cytometry 5 +/- 0.5%,
      immunohistochemistry 5 +/- 2%), Ts of 10.7 h, Tpot of 8.9 days and phi of 10%.
      The well differentiated subline R3327-H has two cell populations (DNA-index 1.6)
      and a labeling index of 3.7 +/- 0.5% measured with flow cytometry and 2.2 +/-
      0.4% with immunochemistry.

PMID- 8342121
TI  - Arginine stimulates wound healing and immune function in elderly human beings.
AB  - BACKGROUND: Experimentally, arginine enhances immune function and promotes wound
      healing. In this randomized double-blind study we investigated the effect of oral
      arginine supplementation on wound healing and T-cell function in elderly human
      beings (more than 65 years of age). METHODS: Thirty elderly, healthy, human
      volunteers (15 men and 15 women) received daily supplements of 30 gm arginine
      aspartate (17 gm free arginine). Fifteen volunteers (nine men and six women)
      received a placebo syrup. Fibroplastic wound responses were assessed by inserting
      a polytetrafluoroethylene catheter subcutaneously into the right deltoid region.
      Epithelialization was examined by creating a 2 x 2 cm split thickness wound on
      the lateral aspect of the upper thigh. Mitogenic response of peripheral blood
      lymphocytes to concanavalin A, phytohemagglutinin, pokeweed mitogen, and
      allogeneic stimuli was assayed at the beginning and end of supplementation.
      Polytetrafluoroethylene catheters were analyzed for alpha-amino nitrogen
      (assessment of total protein accumulation), hydroxyproline (index of reparative
      collagen synthesis), and DNA accumulation (index of cellular infiltration).
      RESULTS: Arginine supplementation for 2 weeks significantly enhanced wound
      catheter hydroxyproline accumulation (26.49 +/- 2.39 nmol/cm vs 17.41 +/- 2.04
      nmol/cm) and total protein content (43.47 +/- 3.85 micrograms/cm vs 21.95 +/- 2.5
      micrograms/cm). Arginine did not influence the DNA content of the catheters or
      the rate of epithelialization of the skin defect. Peripheral blood lymphocyte
      responses to mitogenic and allogenic stimulation were greater in the arginine
      supplemented group. Serum insulin-like growth factor-1 levels were significantly
      elevated in the arginine group. CONCLUSIONS: The data suggest that arginine
      supplementation may improve wound healing and immune responses in the elderly.

PMID- 8342120
TI  - Role of bactericidal permeability-increasing protein in the treatment of gram
      negative pneumonia.
AB  - BACKGROUND: Gram-negative infections are a major cause of morbidity and death.
      Bactericidal permeability-increasing protein (BPI) is an endotoxin-neutralizing
      protein that also exhibits potent bactericidal activity. This study compared the
      efficacy of a 23 kd recombinant N-terminal fragment of BPI (rBPI23) with that of
      antiendotoxin antibody E5 in a model of gram-negative sepsis. METHODS: Sixty
      Swiss-Webster mice (Carworth farm) received an intratracheal inoculation of
      Escherichia coli (7 x 10(6) colony-forming units) and were randomized to three
      groups (20 per group). Starting immediately after inoculation, the groups
      received either rBPI23 (4 mg/kg intravenously every 2 hours for four doses), E5
      (11 mg/kg intravenously every 24 hours for two doses), or an isotype control
      antibody B55 (11 mg/kg intravenously every 24 hours for two doses) and were
      followed up for survival. In a second survival study, 40 mice received the same
      intratracheal inoculation of E. coli and were randomized to two groups. Starting
      2 hours after inoculation, the groups received either rBPI23 (4 mg/kg
      intravenously every 2 hours for four doses) or E5 (8 mg/kg intravenously every 12
      hours for four doses) and were followed up for survival. In a third study, mice
      received an intratracheal inoculation of 3 x 10(6) colony-forming units E. coli,
      a sublethal dose, and were killed to determine pulmonary and blood clearance of
      bacteria. RESULTS: rBPI23 conferred significantly greater protection from death
      than either E5 or B55 when started immediately (95% survival vs 20% and 10%,
      respectively; p < 0.001) or 2 hours after inoculation (65% survival vs 25% for
      E5; p < 0.05). Both pulmonary and vascular clearance of bacteria was enhanced
      significantly by treatment with rBPI23. CONCLUSIONS: rBPI23 may be a novel
      therapeutic agent in the management of gram-negative sepsis.

PMID- 8342122
TI  - Extracorporeal life support for adult cardiorespiratory failure.
AB  - BACKGROUND: Extracorporeal membrane oxygenation is routinely used for neonatal
      respiratory failure but is considered unsuccessful in adults based on old studies
      and old methods. We conducted a new phase 1 trial of modern extracorporeal life
      support (ECLS) in moribund adults with cardiorespiratory failure. METHODS:
      Criteria for initiation of ECLS were 90% mortality risk despite maximal
      conventional care, good potential for recovery, age < 60 years, and no
      contraindication to anticoagulation. Vascular access for ECLS was performed by
      operative or percutaneous cannulation. Continuous systemic heparinization was
      used, maintaining whole blood activated clotting time between 160 to 180 seconds.
      Blood components were transfused as necessary. Lung management included low rate
      and low pressure ventilation with an inspired oxygen fraction 0.5 or less.
      RESULTS: Forty patients were treated with ECLS, 30 with primary respiratory
      failure and 10 with primary cardiac failure. Twenty-two patients recovered lung
      or heart function, and 18 patients survived and were discharged from the hospital
      (14 with respiratory failure and four with cardiac failure, overall survival
      45%). The major complication of ECLS was bleeding. CONCLUSIONS: With modern
      techniques, ECLS can be lifesaving in adult cardiorespiratory failure when
      conventional therapy has failed.

PMID- 8342123
TI  - Use of gene therapy to induce human-mouse xenogeneic chimerism.
AB  - BACKGROUND: Bone marrow transplantation (BMT) has been used in the laboratory to
      overcome the immunologic barriers to xenotransplantation and results in chimerism
      and specific tolerance to donor antigens in lethally irradiated mice. Clinically,
      BMT carries the considerable risks of graft-versus-host disease and graft
      failure. Retrovirus-mediated gene transfer could provide a means of introducing
      foreign major histocompatibility (MHC) genes into host bone marrow cells (BMC)
      and thus accomplish the immunologic goals of BMT, without the associated risks.
      METHODS: Using a Moloney virus-based vector, a replication defective retrovirus
      was constructed that contained a complementary DNA encoding the human MHC antigen
      HLA-A2. Three million C57BL/6 mouse BMC were cocultured for 48 hours with 1 x
      10(6) HLA-A2 virus "producer" cells in the presence of 15% WEHI supernatant
      (interleukin-3) and 200 units/ml interleukin-6. Putatively infected BMC were then
      used at 2 to 3 x 10(6) BMC/animal to reconstitute lethally irradiated syngeneic
      mice. RESULTS: Twelve days after reconstitution, spleen colonies were found to
      have integrated the full-length retroviral sequences. Thirty days after BMT, the
      introduced DNA could be found in the bone marrow, thymus, and spleen, and
      approximately 5% of T cells in the spleen expressed the HLA-A2 surface antigen.
      CONCLUSIONS: These data show that xenogeneic MHC genes can be introduced and
      expressed in mouse hematopoietic cells in vivo and indicate that gene therapy
      potentially may be used in the future to manipulate the immune system to induce
      transplantation tolerance.

PMID- 8342124
TI  - Prevention by thymectomy of tolerance induced by intrathymic injection of donor
      splenocytes.
AB  - BACKGROUND: We have recently demonstrated indefinite donor-specific cardiac
      allograft survival after the intrathymic injection of donor splenocytes and
      simultaneous injection of antilymphocyte serum (ALS) in a fully major
      histocompatibility complex-mismatched rat combination. In this study we performed
      thymectomy to determine the length of time required for donor alloantigen to be
      present in the recipient thymus to induce tolerance. METHODS: Male Buffalo (BUF;
      RT1b) rats at 4 to 8 weeks of age underwent intrathymic injection of 25 x 10(6)
      Lewis (LEW; RT1(1)) splenocytes and simultaneously received an intraperitoneal
      injection of 1 ml ALS. To determine the kinetics of tolerance induction, the BUF
      recipients underwent thymectomy on days 1, 3, or 7 after the initial intrathymic
      injection of alloantigen and intraperitoneal ALS. Twenty-one days after
      intrathymic alloantigen injection and ALS, all rats underwent transplantation
      with a heterotopic LEW cardiac allograft. RESULTS: Thymectomy performed 1 (mean
      survival time, 6.8 days) and 3 (mean survival time, 8.0 days) days after donor
      alloantigen injection and ALS did not affect the normal rejection of LEW cardiac
      allografts. In contrast, thymectomy 7 days after intrathymic alloantigen
      injection and ALS resulted in indefinite survival of cardiac allografts in 75% of
      recipients (mean survival time > 77.0 days). In addition, allospecific cytotoxic
      T lymphocyte activity and interleukin-2 production were markedly decreased in
      those recipients undergoing thymectomy after 7 days compared with untreated
      control rats and recipients undergoing thymectomy 1 and 3 days after alloantigen
      injection. CONCLUSIONS: The presence of the thymus for at least 7 days after
      intrathymic alloantigen injection and intraperitoneal ALS allows the development
      of indefinite donor-specific cardiac allograft tolerance.

PMID- 8342126
TI  - Biochemical detection of small intestinal allograft rejection by elevated
      circulating levels of serum intestinal fatty acid binding protein.
AB  - BACKGROUND: Intestinal fatty acid binding protein (I-FABP) was investigated as a
      serum marker for acute intestinal allograft rejection. Its behavior was compared
      with that of another putative marker of intestinal damage, hexosaminidase.
      METHODS: Transplants were performed in three groups of rats: group 1, Lewis to
      Lewis; group 2, ACI to Lewis, no immunosuppression; and group 3, ACI to Lewis
      with cyclosporine given on posttransplant days 0 through 5. Daily serum I-FABP
      and hexosaminidase levels were quantitated and serial graft biopsy specimens were
      obtained. RESULTS: Serum I-FABP levels fell to 20 ng/ml or less in all animals
      between posttransplant days 3 and 4. In group 1, I-FABP levels remained at
      baseline throughout the experiment. In group 2, I-FABP levels rose dramatically
      on either day 6 or 7 and declined to baseline within 4 days of the peak. On the
      day that I-FABP levels increased, findings of biopsy specimens were consistent
      with early rejection. In group 3 the rise in serum I-FABP levels was delayed 2 to
      10 days. Hexosaminidase did not correlate with rejection. CONCLUSIONS: Serum I
      FABP content correlated with early histologic manifestations of rejection.
      Hexosaminidase was insensitive as a marker in this model. I-FABP, which has a
      human analog, has potential as a biochemical marker for early intestinal
      allograft rejection.

PMID- 8342125
TI  - Endotoxin stimulates arginine transport in pulmonary artery endothelial cells.
AB  - BACKGROUND: The pulmonary endothelium plays an important role in the metabolism
      of the amino acid arginine, the exclusive precursor molecule for nitric oxide
      (NO). Despite decreased circulating arginine levels, endothelial NO production is
      elevated during endotoxemia. However, the regulation of pulmonary artery
      endothelial arginine transport has not been studied. We hypothesized that
      endotoxin stimulates carrier-mediated arginine transport by the pulmonary
      endothelium. METHODS: The relative contributions of the various transport systems
      to total arginine transport by porcine pulmonary artery endothelial cells (PAECs)
      was determined by assaying the uptake of 3H-L-arginine in the presence or absence
      of Na+. PAECs were then incubated with various concentrations of Escherichia coli
      endotoxin, and y(+)-mediated arginine transport was measured at different time
      points thereafter. Kinetic studies were performed over a range of arginine
      concentrations to determine changes in transport affinity and maximum rate of
      metabolism. To address the role of RNA and protein synthesis in the increased
      transport, uptake was measured after exposure of cells to the transcriptional
      inhibitor actinomycin D and the protein synthesis inhibitor cycloheximide.
      RESULTS: Most (75%) of arginine transport by PAECs was mediated by the high
      affinity Na(+)-independent transport system y+. Endotoxin stimulated y(+)
      mediated arginine transport by PAECs twofold to fivefold, a response that was
      time and dose dependent. The accelerated transport was detectable within 2 hours
      and maximal at 12 hours. Kinetic studies revealed that the accelerated arginine
      transport was the result of a 68% increase in the maximal transport velocity
      (1519 +/- 65 pmol/mg protein/30 sec in endotoxin-treated cells vs 903 +/- 96 in
      control cells; p < 0.01) without a change in transport affinity. The endotoxin
      mediated increase in arginine uptake was abrogated by actinomycin D and
      cycloheximide. CONCLUSIONS: Endotoxin stimulates Na(+)-independent arginine
      transport by PAECs through a process that requires de novo RNA and protein
      synthesis, possibly of the transporter itself. This response may be designed to
      support arginine-dependent biosynthetic pathways in the lung during septic
      states.

PMID- 8342127
TI  - Composite kidney-islet transplantation prevents recurrent autoimmune beta-cell
      destruction.
AB  - BACKGROUND: Clinically successful islet transplantation has been rare despite
      adequate isolation techniques. Reenactment of the original autoimmune beta-cell
      destruction may contribute to the poor results. Distinguishing autoimmune effects
      from rejection can be accomplished with isogeneic transplants exchanged between
      diabetes-prone (BB-DP) and diabetes-resistant (BB-DR) rats. These experiments
      determine the relative sensitivity of islet, whole pancreas, and composite kidney
      islet transplants to recurrent autoimmunity. METHODS: Acutely diabetic (BB-Ac) BB
      rats served as recipients of vascularized pancreas, intraportal (IPo) or renal
      capsular (KC) islet transplants, or vascularized composite kidney-islet grafts
      from BB-DR or BB-DP donors. Graft function was assessed by daily blood glucose
      level, and the outcome was confirmed on histologic examination. Cyclosporine 5
      mg/kg/day intramuscularly was administered to assess its effect on recurrent beta
      cell injury. RESULTS: BB-DP pancreases developed recurrent autoimmunity in 55% of
      cases; cyclosporine afforded complete protection if maintained. Diabetes
      resistance was transplanted with 23 of 23 BB-DR pancreas grafts; however, islet
      isolation led to a loss of diabetes resistance for islet grafts to the KC and
      IPo. Cyclosporine protected KC but not IPo islets. Composite BB-DR kidney-islet
      transplants functioned indefinitely in all cases. CONCLUSIONS: Transplanted
      islets initially survive by passive diffusion but are ultimately revascularized
      by capillary ingrowth. The finding that composite kidney-islet transplants
      function indefinitely suggests that the revascularizing endothelium may play a
      role in resistance or susceptibility to autoimmune beta-cell destruction.

PMID- 8342128
TI  - T-cell recognition of ovarian cancer.
AB  - BACKGROUND: The existence of a tumor-specific T-cell immune response to human
      malignant melanoma has been well documented. In contrast, the existence of tumor
      specific cytotoxic T lymphocyte to ovarian cancer remains controversial despite
      the abundant lymphocytic infiltrates in the malignant ascites and solid tumor of
      these patients. METHODS: Tumor-associated lymphocytes (TAL) from the malignant
      ascites and tumor-infiltrating lymphocytes (TIL) from the solid tumors were
      isolated from six untreated patients with ovarian cancer. TAL and TIL were grown
      with initial anti-cluster of differentiation of T cells (CD3), low-dose
      interleukin-2, and tumor stimulation. T-cell lines were analyzed in functional
      studies. RESULTS: At 5 weeks, TAL and TIL from five of six patients were > 50%
      CD8+, and one of six was > 70% CD4+. In all five pairs of CD8 positive cultures,
      both TAL and TIL exhibited high levels of tumor-specific cytotoxicity for ascite
      and solid tumor, respectively. T-cell recognition of tumor was mediated through
      the T-cell receptor-CD3 complex and was human leukocyte antigen class I
      restricted. TAL and TIL lysed autologous ascitic tumor equally well; however, TAL
      mediated tumoricidal activity against autologous solid tumor was consistently and
      significantly poorer than TIL-mediated killing. CONCLUSIONS: Tumor-specific
      cytotoxic T lymphocytes can be expanded from both TAL and TIL. However, TAL do
      not kill solid tumor as efficiently as TIL. This suggests the requirement of TIL,
      or a combination of TIL and TAL, for effective immunotherapy.

PMID- 8342129
TI  - Soluble factors modulate changes in collagen gene expression in abdominal aortic
      aneurysms.
AB  - BACKGROUND: Although increased procollagen gene expression and synthesis have
      been implicated in the progression of abdominal aortic aneurysms (AAA), factors
      modulating this change have not been identified. Furthermore, it is not known
      whether the increase in AAA procollagen expression is specific to this disease or
      also occurs in tissue affected by atherosclerotic occlusive disease (AOD). If
      paracrine rather than autocrine factors are responsible for increased gene
      expression in AAA, this effect should be transferable to target smooth muscle
      cells through conditioned media. Our objectives were to determine 1 alpha (I)
      procollagen messenger RNA levels in AOD tissue compared with normal and AAA and
      to determine whether differences noted in tissue procollagen gene expression
      could be transferred through conditioned media from normal, AOD, and AAA tissues
      to target smooth muscle cells in primary culture. METHODS: Normal, AOD, and AAA
      tissue was used for tissue RNA extraction or was minced and washed with serum
      free media (4 degrees C) x 30 minutes and the media applied to human aortic
      smooth muscle cells (SMC) in primary culture for 36 hours. Total RNA from tissue
      and SMC exposed to conditioned media was analyzed by Northern and dot blot
      analysis for 1 alpha (I) procollagen. RESULTS: Relative tissue 1 alpha (I)
      procollagen levels were not increased in AOD (0.23 +/- 0.05) as compared with
      normal (0.17 +/- 0.03); both were decreased compared with AAA (0.53 +/- 0.07; p <
      0.01). The 1 alpha (I) procollagen levels in SMC exposed to conditioned media
      from AAA (1.73 +/- 0.15) were increased (p < 0.05) compared with AOD (1.10 +/-
      0.12) and normal (1.16 +/- 0.16). CONCLUSIONS: There is no increase in tissue AOD
      procollagen gene expression. The ability to transfer the same relative patterns
      of gene expression from tissue to target SMC with conditioned media suggests that
      paracrine, rather than autocrine, factors modulate procollagen expression in AAA
      tissues.

PMID- 8342130
TI  - Regression of intimal hyperplasia with restoration of endothelium-dependent
      relaxing factor-mediated relaxation in experimental vein grafts.
AB  - BACKGROUND: The reversibility of the morphologic and functional alterations that
      occur in veins transplanted into the arterial circulation was examined in this
      study. METHODS: Common carotid vein bypass grafts (VG) were performed in 20 male
      New Zealand White rabbits. Ten VG and jugular veins (CV) were harvested after 14
      days, and ten VG were reimplanted as venovenous bypass grafts (REV) and harvested
      after an additional 14 days. Vessels were taken for structural or isometric
      tension studies to norepinephrine, serotonin, and bradykinin and to acetylcholine
      and sodium nitroprusside after precontraction. RESULTS: There was a decrease in
      the thickness of the intima (p = 0.02) and the media (p = 0.002) in REV compared
      with VG. In REV, sensitivity to norepinephrine decreased (p = 0.0007) with a
      reduced maximal tension to norepinephrine (p = 0.02) and to serotonin (p =
      0.0001). Bradykinin sensitivity increased in REV (p = 0.003 vs VG) and was
      greater than in CV. Only the precontracted CV and REV relaxed to acetylcholine.
      All tissues relaxed to sodium nitroprusside. CONCLUSIONS: This study suggests
      that intimal hyperplasia can be reversed with restoration of endothelium
      dependent relaxing factor-mediated relaxation but that only a partial regression
      of the contractile abnormalities can be achieved.

PMID- 8342131
TI  - Interleukin-1 receptor antagonist improves survival and preserves organ adenosine
      5'-triphosphate after hemorrhagic shock.
AB  - BACKGROUND: This study was designed to determine the role of interleukin-1 (IL-1)
      in hemorrhagic shock death. METHODS: Pentobarbital anesthetized C3H/HeN mice (n =
      59) were prepared with a femoral arterial catheter and were randomized to
      treatment with an IL-1 receptor antagonist (IL-1ra, 10 mg/kg, n = 29) or an equal
      volume of phosphate-buffered saline solution (vehicle, n = 30) by subcutaneous
      bolus injection at 15 minutes before hemorrhage and again at 120 minutes.
      Continuous posthemorrhage delivery of IL-1ra or vehicle was performed in each
      group (1.5 mg IL-1ra in 30 microliters/day) through a subcutaneous osmotic pump.
      Rapid hemorrhage of 4 ml/100 gm weight was followed by normal saline
      resuscitation of 12 ml/100 gm 60 minutes later. RESULTS: Survival analysis by
      Wilcoxon rank sum analysis revealed a significantly improved 5-day survival in IL
      1ra-treated mice (n = 15, 20%) as compared with vehicle-treated mice (n = 14, 6%,
      p < 0.001). To determine a possible mechanism of this survival advantage, the
      remaining mice in each treatment group were killed at 30 minutes to obtain blood
      and tissue samples from the heart, liver, and kidney for measurement of adenosine
      5'-triphosphate (ATP). No difference in hematocrit, circulating neutrophils, or
      levels of glucose, lactate, or tumor necrosis factor was identified between
      groups to explain the improved outcome. IL-1ra prevented hemorrhage-induced ATP
      depletion observed in vital organs of vehicle-treated mice. CONCLUSIONS: The data
      implicate IL-1 in shock-induced ATP depletion and suggest IL-1ra may improve
      hemorrhagic shock survival by preventing ATP depletion in vital organs.

PMID- 8342132
TI  - Erythromycin, motilin, and the esophagus.
AB  - BACKGROUND: Motilin induces phase III activity of the gastroesophageal tract.
      Erythromycin has a motilin-like effect on the stomach, but possible esophageal
      effects have not been evaluated and are the focus of our investigation. METHODS:
      Esophageal manometry was performed in 11 healthy volunteers before and after
      intravenous infusion of 500 mg erythromycin. Values are expressed as means +/-
      SEM. RESULTS: Lower esophageal sphincter (LES) pressure increased from 21.1 +/-
      2.6 mm Hg at baseline to 37.5 +/- 3.8 mm Hg after erythromycin infusion (p <
      0.0001). Erythromycin did not affect LES length, esophageal body contraction
      amplitude, duration or velocity, or the upper esophageal sphincter. Serum motilin
      levels decreased from 96.4 +/- 10.9 pmol/L to 81.8 +/- 10.9 pmol/L (p < 0.01)
      after erythromycin administration. CONCLUSIONS: Erythromycin profoundly
      stimulates the normal human LES. This is a direct motilin agonist-like effect and
      is not mediated by release of endogenous motilin. Erythromycin has no important
      effect on the esophageal body or the upper esophageal sphincter.

PMID- 8342133
TI  - Ca2+ calmodulin regulates basal gallbladder absorption.
AB  - BACKGROUND: Gallbladder absorption is altered during gallstone formation, a
      phenomenon that may be partly the result of elevated biliary Ca2+ levels. Recent
      studies suggest that changes in gallbladder absorption are mediated by
      intracellular Ca2+ ([Ca2+]ic). However, the mechanisms by which [Ca2+]ic
      regulates gallbladder ion transport are not known. Calmodulin is a Ca2+ receptor
      protein in the Ca2+ messenger system that modulates ion transport in the small
      intestine. We hypothesized that Ca(2+)-calmodulin mediates the effects of
      [Ca2+]ic on gallbladder absorption. METHODS: Prairie dog gallbladders were
      mounted in Ussing chambers, and standard electrophysiologic parameters were
      recorded. Unidirectional Na+, Cl-, and water fluxes were measured before and
      after mucosal exposure to 5 x 10(-5) mol/L trifluoperazine, a potent calmodulin
      antagonist. In addition, the ion transport effects of increased extracellular
      calcium and theophylline were determined in the presence of calmodulin
      inhibition. RESULTS: Inhibition of calmodulin resulted in an increase in net Na+
      and water absorption and converted the gallbladder from a Cl- absorptive state.
      Similar results were obtained during exposure to two other calmodulin antagonists
      that differ only in their affinity for calmodulin but not in their
      hydrophobicity, suggesting that the observed changes were caused by specific
      calmodulin inhibition. Effects of trifluoperazine were reversed by increasing
      luminal [Ca2+] or theophylline exposure. CONCLUSIONS: The effects of calmodulin
      inhibition are directly opposite of the effects of the Ca2+ ionophore. We
      conclude that Ca(2+)-calmodulin regulates gallbladder absorption at basal
      [Ca2+]ic. Further studies are needed to determine whether altered calmodulin
      activity is responsible for increased gallbladder absorption during gallstone
      formation.

PMID- 8342134
TI  - Platelet-activating factor-induced polymorphonuclear neutrophil priming
      independent of CD11b adhesion.
AB  - BACKGROUND: Our previous studies have implicated phospholipase A2-dependent
      platelet-activating factor (PAF) production in the genesis of polymorphonuclear
      neutrophil (PMN)-mediated tissue injury after gut ischemia-reperfusion. Further,
      these studies have suggested a discordance of PMN sequestration and tissue
      injury. CD11B-dependent PMN-endothelial cell adhesion has been purported to play
      a dominant role in PMN-mediated tissue injury. We therefore undertook this study
      with the hypothesis that PAF-induced PMN superoxide production requires CD11B
      mediated PMN-endothelial cell adherence. METHODS: Human PMNs, isolated by Percoll
      gradient centrifugation, were exposed to PAF (10 ng/ml). At fixed times of
      exposure during 120 minutes, (1) superoxide production, (2) CD11B receptor
      expression, and (3) PMN adhesion to unstimulated human umbilical vein endothelial
      cell cultures were assayed. RESULTS: PAF induced prompt changes in PMN priming
      (increased superoxide production after N-formyl-methyl-leucyl-phenylalanine
      activation), adhesion to unstimulated endothelial cells, and CD11B receptor
      expression. Priming was temporally concordant with the rise and fall of CD11B
      expression but appeared to precede adhesion. CD11B blockade (F(Ab') 2 anti-CD11B
      [60.1] antibodies), before or at maximal PAF priming, reduced PMN adhesion but
      had no effect on superoxide production. CONCLUSIONS: In summary, PAF-induced PMN
      priming occurs in temporal concordance with the expression of CD11B and
      subsequent endothelial cell adherence, but CD11B-mediated adherence is not
      essential for this process.

PMID- 8342135
TI  - Use of an Objective Structured Clinical Examination (OSCE) to measure improvement
      in clinical competence during the surgical internship.
AB  - BACKGROUND: Traditional ward ratings and multiple-choice tests do not reliably
      assess clinical competence. This study determined the reliability of the
      Objective Structured Clinical Examination (OSCE) and its sensitivity in detecting
      the performance gains and deficits in surgical interns. METHODS: A comprehensive
      35-station OSCE was administered to 23 incoming interns and seven outgoing
      interns. The OSCE comprised 17 two-part clinical problems, relying primarily on
      actual or simulated patients. The reliability of the examination was assessed by
      coefficient alpha. Significant differences in performance between the two intern
      groups, between parts A and B, and among the 17 problems were determined by a
      three-way ANOVA: OSCE performance was also correlated with National Board of
      Medical Examiners Part II scores. RESULTS: The reliabilities of part A, part B,
      and parts A and B combined were 0.72, 0.70, and 0.82, respectively. Overall, the
      outgoing interns performed significantly better than the incoming interns: 58% +/
      1% mean OSCE score versus 47% +/- 1% (p = 0.0001). The 17 clinical problems
      differed significantly in difficulty; major performance deficits were seen in
      both groups of trainees. The correlation of OSCE scores with National Board of
      Medical Examiners Part II scores was not significant (r = 0.11, p = 0.633).
      CONCLUSIONS: We conclude that the OSCE is an innovative, reliable tool for
      evaluating resident competence. Although outgoing interns performed better than
      did incoming interns, the OSCE scores clearly indicated major performance
      deficits in all interns.

PMID- 8342137
TI  - PDGF and FGF reverse the healing impairment in protein-malnourished diabetic
      mice.
AB  - BACKGROUND: Growth factors have been shown to improve healing in impaired models
      but not after malnutrition. The effects of growth factors on altered tissue
      repair caused by malnutrition were examined. METHODS: Nondiabetic and diabetic
      mice fed a 1% protein diet received full-thickness skin wounds. Wounds were
      treated topically with vehicle, platelet-derived growth factor (PDGF, 10
      micrograms) or basic fibroblast growth factor (bFGF, 1 microgram), for 5 days.
      RESULTS: Malnourished animals developed significantly impaired wound closure.
      PDGF or bFGF did not enhance closure in nondiabetic C57BL/KsJ-db/m mice, whether
      fed normal or restricted diets. The same treatment regimen was effective in
      reversing the delayed wound closure in their genetically diabetic C57BL/KsJ-db/db
      littermates. The growth factors significantly enhanced tissue repair in diabetic
      mice fed a 1% protein diet starting as early as day 15 and continuing until day
      21. Protein-depleted diabetic wounds had significantly decreased cellularity and
      granulation tissue formation. These deficiencies were reversed with growth factor
      treatment. CONCLUSIONS: Despite the lack of effects in nondiabetic animals,
      growth factors improve healing in diabetic mice with restricted protein intake.
      The differential effects may result from different healing mechanisms:
      nondiabetic animals heal mainly by contraction; diabetic animals require
      granulation tissue formation and reepithelialization.

PMID- 8342136
TI  - Pentoxifylline restores cardiac output and tissue perfusion after trauma
      hemorrhage and decreases susceptibility to sepsis.
AB  - BACKGROUND: Although pentoxifylline produces various beneficial effects in a
      preheparinized model of hemorrhagic shock, it was unknown whether this agent
      restores the depressed cardiac output (CO) and tissue perfusion in a
      nonheparinized model of trauma-hemorrhage and resuscitation and, if so, whether
      it decreases the susceptibility to sepsis after hemorrhage. METHODS: After
      laparotomy (i.e., induction of trauma), rats were bled to and maintained at a
      mean arterial pressure of 40 mm Hg until 40% of the maximum shed blood volume was
      returned in the form of Ringer's lactate. The animals were then resuscitated with
      Ringer's lactate, four times the volume of shed blood. Pentoxifylline (50 mg/kg
      body weight) or normal saline solution was infused intravenously more than 95
      minutes during and after resuscitation. At 1.5 and 4 hours after resuscitation,
      CO, tissue perfusion, and plasma liver enzyme levels were determined. Sepsis was
      induced by cecal ligation and puncture at 20 hours after hemorrhage, and the
      necrotic cecum was excised 10 hours thereafter. RESULTS: CO and tissue perfusion
      in the liver, kidney, spleen, and small intestine decreased significantly after
      hemorrhage and resuscitation. Pentoxifylline treatment, however, restored the
      depressed CO and tissue perfusion. The elevated liver enzyme levels were also
      significantly reduced by pentoxifylline treatment. Moreover, pentoxifylline
      prevented the increased mortality of posthemorrhaged rats subjected to sepsis.
      CONCLUSIONS: Because pentoxifylline restored the depressed CO and tissue
      perfusion and decreased the susceptibility to sepsis, this agent appears to be a
      useful adjunct to crystalloid resuscitation after trauma and hemorrhage, even in
      the absence of blood resuscitation.

PMID- 8342138
TI  - Tissue generation with growth factors.
AB  - BACKGROUND: An in vivo experimental model was introduced to determine whether the
      mitogenic effect of recombinant platelet-derived growth factor (rPDGF) could be
      used to generate potentially useful tissue. METHODS: In Lewis rats, the extended
      femoral arteriovenous bundle was placed within silicone chambers containing
      collagen disks. The disks could deliver their content of rPDGF-BB (125 to 131
      micrograms/disk) either as a rapid pulse or as a slow release. The time course of
      tissue generation was determined by harvesting the specimens at various
      postoperative days. The effect of continuous versus pulsed delivery was
      determined at 30 days. Analysis of the generated tissue was performed by use of
      histomorphometry. RESULTS: Pulsed delivery of rPDGF-BB induced the formation of a
      substantial amount of tissue that peaked at 10 to 15 days (145.9 +/- 13.8 vs 35.0
      +/- 6.8 mm3, p < 0.0001); however, the generated tissue completely subsided by
      day 30. Sustained delivery of rPDGF-BB caused continuous growth of the tissue and
      was more effective than pulsed delivery. CONCLUSIONS: In an experimental model
      that approximates an in vivo tissue culture system, rPDGF-BB can induce a tenfold
      increase in tissue within the chamber. However, that tissue is labile and its
      survival necessitates continuous rPDGF-BB delivery. To become useful for
      reconstructive purposes, means to stabilize this new tissue growth are needed.

PMID- 8342139
TI  - The effects of CO2 pneumoperitoneum on hemodynamics in hemorrhaged animals.
AB  - BACKGROUND: Carbon dioxide (CO2), the primary gas currently used for
      pneumoperitoneum, has been known to cause systemic effects on acid-base balance
      and hemodynamic stability. We studied the hemodynamic effects of CO2
      pneumoperitoneum in a hemorrhagic shock model to assess the safety of
      laparoscopic procedures in acute trauma patients. METHODS: After 1 hour of
      baseline, 32 anesthetized adult pigs were randomized into four groups. Group 1
      animals had no hemorrhage, serving as a control group. Group 2 animals had a mild
      hemorrhage of 10 ml/kg/hr. Group 3 animals had a moderate hemorrhage of 20
      ml/kg/hr. Group 4 animals had a moderate hemorrhage but were resuscitated with 40
      ml/kg of lactated Ringer's solution. All animals were then insufflated to an
      intraabdominal pressure of 15 mm Hg with CO2 gas for 1 hour. The abdomen was then
      decompressed, and the animals were observed for another hour. All animals
      survived hemorrhage. One death each occurred in moderate hemorrhage groups, both
      near the end of CO2 pneumoperitoneum. These animals were not included in
      statistical analysis. RESULTS: In euvolemic animals, CO2 pneumoperitoneum induced
      hypercapnia (from 34 +/- 1 mm Hg to 48 +/- 1 mm Hg), acidemia (from 7.45 +/- 0.02
      to 7.36 +/- 0.02), and a 20% reduction in stroke volume. Mild hemorrhage and CO2
      insufflation resulted in a similar degree of acidemia (7.35 +/- 0.01), but
      moderate hemorrhage and CO2 insufflation led to more severe acidemia (7.26 +/-
      0.02). Fluid resuscitation failed to prevent this severe fall in pH (7.30 +/-
      0.03) for group 4. PaCO2 was not affected by hemorrhage, but CO2 pneumoperitoneum
      induced significant hypercapnia in all groups, ranging from 48 +/- 1 mm Hg for
      euvolemic animals to 52 +/- 1 mm Hg for moderate hemorrhage animals. Stroke
      volume declined as a function of blood loss, and it was further depressed by CO2
      insufflation, to as low as 75% of baseline in mild hemorrhage and 55% of baseline
      in moderate hemorrhage. Both stroke volume and cardiac index initially responded
      to large-volume fluid replacement after moderate hemorrhage but quickly decreased
      to levels comparable to those of unresuscitated animals when CO2 pneumoperitoneum
      was created. CONCLUSIONS: Intraperitoneal insufflation with CO2 for diagnostic
      laparoscopy may be hazardous in acute hypovolemic trauma patients.

PMID- 8342140
TI  - Pulmonary function after laparoscopic cholecystectomy.
AB  - BACKGROUND: The purpose of this study was to prospectively compare the effect of
      laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) on
      postoperative pulmonary function. METHODS: Forty consecutive patients (20 in each
      group) who were evenly matched in terms of pulmonary risk factors were assigned
      to either elective LC or OC. Pulmonary function studies, oxygen saturation, and
      chest radiography were performed on both groups before and after the operation
      until baseline levels were reached. Narcotic requirements and pulmonary
      complications were compared. The t test, ANOVA, and chi-squared analysis were
      used. RESULTS: Compared to the patients who underwent OC, patients who underwent
      LC had a significant reduction in postoperative pulmonary impairment (30% to 38%)
      in all areas studied including forced vital capacity; forced expiratory volume in
      1 second; forced expiratory flow, mid-expiratory phase; maximum forced expiratory
      flow; maximum voluntary ventilation; total lung capacity; and oxygen saturation.
      Pulmonary function returned to baseline levels 4 to 10 days sooner after LC.
      Pulmonary complications including atelectasis and hypoxia were less frequent
      after LC. An eight-fold decrease was noted in postoperative pain medication
      requirement in the LC group. CONCLUSIONS: Compared to OC, laparoscopic
      cholecystectomy results in a significantly reduced compromise in pulmonary
      function and narcotic requirement leading to fewer postoperative pulmonary
      complications. Laparoscopic cholecystectomy should be considered the procedure of
      choice for elective cholecystectomy.

PMID- 8342141
TI  - Lateral hypothalamic dopaminergic neural activity in response to total parenteral
      nutrition.
AB  - BACKGROUND: The lateral hypothalamic dopaminergic neurons dominate modulation of
      food intake. Changes in lateral hypothalamic synaptic dopaminergic release before
      and during total parenteral nutrition (TPN) and its components were measured in
      vivo with microdialysis probes. METHODS: Rats had an intracerebral guide cannula
      and an internal jugular catheter placed. Ten days after recovery, rats were
      fasted for 24 hours. A 2 mm microdialysis probe was inserted into the lateral
      hypothalamus neurons via the guide cannula. Dopamine level was measured by high
      performance liquid chromatography in three 60-minute baseline dialysis samples.
      TPN, glucose, fat, or amino acid was then infused via the internal jugular
      catheter, and dopamine level was measured in three more 60-minute dialysate
      samples. Single nutrients were infused for 24 hours, and dopamine was measured
      during the 3 hours after the infusions were stopped. Data were analyzed by paired
      t test (mean +/- standard error) and represented percentage change from baseline.
      RESULTS: Dopamine levels rose significantly (p < 0.05) and remained so during
      infusions in TPN (26% +/- 3%), glucose (26.5% +/- 4.6%), fat (36.2% +/- 6.7%),
      and amino acids (9.6% +/- 4.2%). After infusions were stopped, dopamine levels
      decreased to -35.4% +/- 1.5% in glucose but remained unchanged with fat and amino
      acids. CONCLUSIONS: Increase in lateral hypothalamic dopamine level occurs with
      TPN and its components, and changes persist temporarily after stopping the
      infusions, explaining in part the slow recovery of food intake after TPN is
      stopped.

PMID- 8342142
TI  - Molecular mechanisms of decreased interleukin-2 production after thermal injury.
AB  - BACKGROUND: Among the fundamental immunologic abnormalities induced by serious
      traumatic or thermal injury are alterations in T cell activation, reduced
      lymphocyte interleukin-2 (IL-2) production, and associated depression of T
      lymphocyte proliferation. This study attempts to localize the cellular mechanisms
      underlying abnormal IL-2 production in thermal injury. METHODS: Following
      National Institutes of Health guidelines, 150 A/J mice were anesthetized,
      subjected to a 20% full-thickness scald burn injury or sham burn, and killed at
      intervals from 4 to 21 days later; splenocytes were harvested for in vitro
      studies. For measurement of IL-2 production, cells were cultured with either
      concanavalin A or a combination of the phorbol ester PMA, which directly
      activates protein kinase C, and the calcium ionophore A23187, which increases
      intracellular calcium. Cytokine mRNA expression was measured by Northern blot
      analysis and IL-2 production by bioassay. RESULTS: Both IL-2 production and IL-2
      mRNA expression were consistently suppressed in concanavalin A-stimulated cells
      from burned mice compared with sham burns. This suppression of IL-2 and IL-2 mRNA
      also occurred when T cells were activated with PMA and A23187, bypassing the
      earlier stages of the signal transduction mechanism. IL-1 beta and tumor necrosis
      factor-alpha mRNA expression were consistently increased in burned animals,
      indicating that decreased IL-2 mRNA expression was specific to IL-2 and not
      representative of a global decrease in cytokine mRNA expression. CONCLUSIONS:
      These results suggest that the principal cellular abnormalities that result in
      altered T cell activation and IL-2 production after thermal injury lie downstream
      of the initiating signal transduction events and before IL-2 gene transcription.

PMID- 8342143
TI  - Cultured keratinocyte allografts fail to induce sensitization in vivo.
AB  - BACKGROUND: The use of cultured keratinocyte (CK) allografts for burn wounds
      offers a potentially unlimited supply of skin. It is unknown, however, whether CK
      allografts induce rejection in vivo. This study investigated the induction of
      immune responsiveness to CK allografts as measured by mixed lymphocyte response
      and serum cytotoxic antibody. METHODS: Female CBA mice (n = 160) were randomized
      to four equal groups, each receiving a 3 cm2 flank graft of autologous CBA CK
      (Auto CK), allogeneic C57BL/6 CK (Allo CK), C57BL/6 full thickness skin (Allo
      FT), or Sham. Graft take was assessed by gross and histologic examinations.
      Unidirectional mixed lymphocyte response was measured with graft recipient and
      donor splenocytes by use of tritiated thymidine uptake. Stimulation indexes were
      calculated. Serum cytotoxic antibody was measured by coculturing graft recipient
      serum with donor splenocytes and rabbit complement and assessing resultant cell
      killing. RESULTS: Overall graft take was 50% for Allo CK and 74% for Auto CK,
      Allo FT, but not Allo CK, were associated with significantly increased
      stimulation indexes compared with Auto CK and Sham (p < 0.01). Allo FT, but not
      Allo CK, resulted in elevated titers of alloantibody, reaching significant levels
      10 days after grafting (p < 0.05). CONCLUSIONS: CK allografts do not result in
      increased in vitro T cell responses or enhanced alloantibody formation,
      indicating that sensitization to major histocompatibility antigens by CK does not
      occur. These data suggest that CK allografts may provide a possible source of
      grafts for victims of large burn wounds.

PMID- 8342144
TI  - Intercellular communication and maintenance of islet cell mass--implications for
      islet transplantation.
AB  - BACKGROUND: The major emphasis in islet transplantation has been the development
      of methods to enhance islet purity. This focus assumes that islets do not require
      support from other cellular elements of the pancreas. We chose to examine a
      possible duct-islet interaction because of the embryologic origin of islets from
      ductal epithelium. METHODS: Duct and islet cells were prepared by collagenization
      of hamster pancreas and purified on a bovine serum albumin gradient. Primary duct
      cultures were passaged twice. Duct-conditioned medium was collected from the
      tertiary cultures. Three groups of cultures were established: group 1, 100
      islets/plate in minimal medium (Dulbecco's modified Eagle medium/F12); group 2,
      100 islets + 40 duct fragments/plate in Dulbecco's modified Eagle medium/F12; and
      group 3, 100 islets/plate+duct-conditioned medium. After a 3-day incubation,
      tritiated thymidine (1 microCi/ml) was added for 24 hours. The islets were
      separated from the ducts by handpicking and then sonicated. DNA was measured
      (microgram) fluorometrically and tritiated thymidine incorporation, a measure of
      cell proliferation, was determined in trichloroacetic acid-precipitated material
      by liquid scintillation. Data (mean +/- SEM) were compared by two-tailed
      Student's t test. RESULTS: Tritiated thymidine incorporation into islet cells in
      minimal medium (81.1 +/- 24.6 disintegrations per minute [dpm]/microgram DNA [n =
      8 plates]) was less than 25% (p < 0.001) of that of islet cells cocultured with
      ducts (323.2 +/- 54.5 dpm/micrograms DNA [n = 6]) or with duct-conditioned medium
      (389.7 +/- 27.6 dpm/micrograms DNA [n = 5]). CONCLUSIONS: Pancreatic duct
      epithelium can stimulate islet cell proliferation in a paracrine manner.

PMID- 8342145
TI  - The effect of cocaine on the physiologic response to hemorrhagic shock.
AB  - BACKGROUND: Bradycardia is thought to be an uncommon and abnormal response to
      acute blood loss. A review of trauma patients (n = 84) admitted during a 1-year
      period with a systolic blood pressure of less than 100 mm Hg revealed that 45%
      had relative bradycardia (heart rate < 100 beats/minute). Cocaine use was
      recorded more often in this group (76% versus 26%; p < 0.05) compared with
      patients with tachycardia (heart rate > or = 100 beats/minute). We investigated
      the effect of cocaine use on the response to acute blood loss in an animal model
      of hemorrhagic shock. METHODS: Rats were given intraperitoneal cocaine 20
      mg/kg/day for 14 days (n = 10) or saline solution (n = 10). The rats were bled
      until 30% of their blood volume was shed; they were resuscitated 30 minutes
      later. RESULTS: Cocaine-treated rats showed a decreased 24-hour survival rate
      (50% versus 100%; p < 0.05), a relative bradycardic response compared to baseline
      heart rate (-8.9% +/- 6.4% versus 7.5% +/- 3.5%; p < 0.05), and a greater drop in
      mean arterial blood pressure (-55.5% +/- 4.8% versus -37.0% +/- 5.5%; p < 0.05)
      by 5 minutes of shock. Cocaine-treated rats were more acidotic after shock
      compared to controls (pH 7.36 +/- 0.03 versus 7.44 +/- 0.02; p < 0.05).
      CONCLUSIONS: Cocaine had a deleterious effect on experimental hemorrhage. The
      bradycardic response observed in our trauma patients may be due, in part, to
      cocaine abuse, and we postulate that chronic cocaine use alters the normal
      adrenergic response to blood loss.

PMID- 8342146
TI  - The ivory tower from outside and in: a survey of Minnesota surgeons.
AB  - BACKGROUND: Increasing competition has eroded the patient base of many university
      hospitals and may jeopardize their teaching programs. METHODS: We questioned all
      private surgeons (PS), university surgeons (US), and resident surgeons (RS) in
      our state. Chi-squared analysis was used. RESULTS: Most PS, US, and RS,
      respectively, answered "yes" when asked to respond to the following items:
      whether teaching hospitals were the best way to educate new surgeons (77% versus
      96% versus 87%), whether surgery residencies should be based at a university
      hospital (72% versus 96% versus 91%), and whether PS should refer complicated
      clinical cases for teaching purposes (75% versus 87% versus 68%). Differences
      appeared when the groups were asked whether the university should take the lead
      in guaranteeing the quality of surgical care in the state (67% versus 100% versus
      77%, p = 0.002) and whether PS are better teachers of surgery than US (40% versus
      4% versus 59%, p = 0.0001). An unexpected and disturbing trend was observed in RS
      when groups were asked whether practicing surgeons had any obligation to the
      state's university (57% versus 74% versus 22%, p = 0.0001) and whether surgeons
      had an obligation to repay society for their education (77% versus 83% versus
      56%, p = 0.005). CONCLUSIONS: Despite recent changes in medical economics, most
      PS still feel residency programs should be university based. A significantly
      smaller percentage of RS feel an obligation to their university and to society
      than do either PS or US.

PMID- 8342147
TI  - Small bowel transplantation and chronic rejection alter rat intestinal smooth
      muscle structure and function.
AB  - BACKGROUND: The purpose of this study was to determine whether morphologic and
      functional changes in intestinal smooth muscle occur after small bowel
      transplantation (SBTx) and during chronic rejection. METHODS: Orthotopic SBTx was
      performed in syngeneic (ACI-ACI, n = 6) and allogeneic (ACI-Lewis, n = 6) rat
      strain combinations. The latter received temporary immunosuppression
      (cyclosporine 15 mg/kg/body weight on postoperative days 0 to 6 once a day,
      postoperative days 7 to 28 every other day), which led to clinically quiescent
      chronic rejection of the graft by 90 days after SBTx. At that time structure and
      function of the jejunal muscularis externa were evaluated with histochemistry,
      mechanical organ bath, and intracellular electrical recording techniques.
      RESULTS: Histochemistry showed a 1.5-fold thickening of the intestinal muscularis
      externa of syngeneic grafts, although contractile properties and intracellular
      electrical activity were not significantly different from controls. Allogeneic,
      chronically rejecting grafts showed a threefold increase in the thickness of the
      muscularis externa as a result of both smooth muscle hyperplasia and hypertrophy.
      Muscle strips from chronically rejecting grafts generated only 23% of the maximal
      contractile force generated by controls (bethanechol 300 mumol/L). Median
      effective concentration and threshold values were not significantly different.
      Intracellular electrical activity of circular smooth muscle cells revealed a
      significantly more depolarized resting membrane potential and a reduction in slow
      wave amplitude compared with controls. CONCLUSIONS: Syngeneic SBTx resulted in a
      significant thickening of the muscularis externa with an apparent adaptation to
      control in vitro physiologic function. Allogeneic SBTx subject to chronic
      rejection leads to profound morphologic changes and functional impairments.
      Changes in muscle structure and function evolve before the clinical signs of
      graft rejection.

PMID- 8342148
TI  - Gs alpha--identification of a gene highly expressed by insulinoma and other
      endocrine tumors.
AB  - BACKGROUND: The isolation of mRNA molecules that are either uniquely or more
      highly expressed by tumor and not normal tissue is a powerful tool in the study
      of cell regulation and growth. To this end we constructed a complementary DNA
      (cDNA) library from messenger RNA (mRNA) isolated from a human insulinoma and, by
      differential hybridization with cDNA from both normal pancreas and insulinoma,
      isolated clones more highly expressed by insulinoma. METHODS: Total RNA was
      isolated from human insulinoma and normal pancreas and purified to mRNA by oligo
      (dT) column. An insulinoma cDNA library was constructed and screened with 32P
      labeled cDNA from pancreas and insulinoma. Northern blots from insulinoma,
      pancreas, carcinomas, normal endocrine tissues, and endocrine tumors were then
      probed with the 32P-labeled inserts. RESULTS: Two clones that consistently
      hybridized with 32P cDNA from insulinoma and not pancreas proved to represent
      mRNAs for insulin and the alpha subunit of the Gs protein. There was a markedly
      higher expression (30-fold) of the gene for Gs alpha in mRNA from insulinoma
      compared with normal pancreas by Northern blot analysis. We found Gs alpha to be
      more highly expressed by a pheochromocytoma, a corticotropin-producing islet cell
      tumor of the pancreas, and a corticotropin-producing thymic carcinoid (up to 35
      fold) compared with normal pancreas, whereas normal endocrine tissues, a
      parathyroid adenoma, thyroid follicular adenoma, gastrinoma, and several
      carcinomas showed no expression. CONCLUSIONS: This study showed that Gs alpha is
      highly expressed in insulinoma and certain endocrine tumors. It is not expressed
      in several cancers or normal endocrine tissues. Others have implicated mutated Gs
      proteins in the tumorigenesis of pituitary and thyroid tumors. G proteins are
      also known to mediate hormonal transmembrane signaling. Its overexpression in
      four of seven endocrine tumors tested suggests that it may have a role in the
      unregulated hormone secretion and/or a role in the tumorigenesis of
      differentiated endocrine tumors.

PMID- 8342149
TI  - Endotoxin-exposed atria exhibit G protein-based deficits in inotropic regulation.
AB  - BACKGROUND: Diminished response at the myocardial beta 1-adrenoceptor is
      established in endotoxemia. The myocardial muscarinic-2 acetylcholine receptor
      (M2ACHR) has not been investigated in endotoxemia, although it shares a G protein
      mediated link to adenyl cyclase (AC). This study aimed to assess the contractile
      responses elicited at the M2ACH and beta 1 receptors, their respective G
      proteins, and the AC unit in endotoxemia. METHODS: Isometric force and rate of
      contraction were measured in atria from Sprague-Dawley rats after exposure to 24
      hour continuous intravenous infusion of 0.2 mg/kg endotoxin or vehicle. The
      responses to isoproterenol, acetylcholine, sodium fluoride (NaF), and forskolin
      were studied. RESULTS: In a comparison of endotoxic versus control atria,
      diminished force response at the beta 1-adrenoceptor was confirmed (4.98 +/-
      1.343 vs 7.26 +/- 1.568 gx10 [gx10 is unit of measure used for force], p =
      0.0006, n = 10), and an analogous defect at the M2ACHR was identified (6.66 +/-
      0.906 vs 8.16 +/- 1.307 gx10, p = 0.009, n = 10). NaF was able to directly
      activate Gs and G(i) in a dose-dependent differential manner. Both Gs (5.40 +/-
      0.795 vs 7.81 +/- 1.057 gx10, p = 0.0015, n = 6) and G(i) (2.73 +/- 0.528 vs 3.76
      +/- 0.332 gx10, p = 0.003) force responses were diminished in endotoxic atria.
      Stimulus of AC by forskolin yielded similar force increases (3.15 +/- 0.731 vs
      3.21 +/- 0.667 gx10, p = 0.89, n = 9). CONCLUSIONS: In this model only
      contractile responses were altered by endotoxemia. The use of NaF revealed
      dysfunction distal to agonist receptor interaction and with the data from M2ACHR
      activation confirmed that this defect is not adrenergic specific. The preserved
      response at AC localized the site of this myocardial receptor dysfunction to the
      G proteins.

PMID- 8342150
TI  - Acute cyclosporine-induced renal vasoconstriction is mediated by endothelin-1.
AB  - BACKGROUND: Cyclosporine causes intrarenal vasoconstriction, which may account
      for its nephrotoxic side effects. Plasma levels of the vasoconstrictor peptide
      endothelin-1 are increased after cyclosporine administration, and endothelin-1
      has been shown to cause renal vasoconstriction. In this study we used in vivo
      microscopy to investigate the role of endothelin-1 in cyclosporine-induced
      vasoconstriction. METHODS: Hydronephrotic kidneys in decerebrate rats were
      suspended in an environmentally controlled tissue bath with neurovascular supply
      intact. Interlobular, afferent, and efferent arteriolar diameters and flow were
      measured by videomicroscopy and Doppler velocimetry. Cyclosporine was added to
      the tissue bath, and measurements were repeated for 60 minutes. In study groups
      endogenous endothelin-1 was blocked by infusion of either specific endothelin
      antiserum or an endothelin-1 receptor antagonist. RESULTS: Cyclosporine caused
      constriction of the interlobular artery by 20% +/- 2% and a corresponding
      decrease in blood flow by 66% +/- 4%. The afferent and efferent arterioles
      constricted to a similar degree. This vasoconstriction was entirely prevented by
      infusion of either the endothelin antiserum or the receptor antagonist. The
      antagonist reagents alone had no effect on hemodynamic parameters or renal
      microvessel diameters. CONCLUSIONS: The acute renal vasoconstriction induced by
      cyclosporine is mediated by endothelin-1. Endogenous endothelin-1 has little role
      in maintaining basal vascular tone.

PMID- 8342151
TI  - 'You will be affected by AIDS, even if you are not infected'.

PMID- 8342152
TI  - AIDS chairman: epidemic prompts slow response from physicians.

PMID- 8342153
TI  - Survey reveals physicians are treating inquisitive patients.

PMID- 8342154
TI  - What is the national commission on AIDS?

PMID- 8342155
TI  - Firearms are leading cause of injury mortality in Texas ... again.

PMID- 8342156
TI  - TMA takes decisive steps towards leadership role in health-care reform.

PMID- 8342157
TI  - Council on socioeconomics studies low-cost electronic claims clearinghouse.

PMID- 8342158
TI  - The down-to-earth side of space medicine.

PMID- 8342159
TI  - Council on medical education studies medical examiners, other issues.

PMID- 8342160
TI  - Chiropractic board may adopt 'worrisome' rules.

PMID- 8342161
TI  - Navigating the Board of Medical Examiners system.

PMID- 8342162
TI  - Electroconvulsive therapy.
AB  - Electroconvulsive therapy (ECT) is a safe, effective, valuable treatment for
      serious affective disorders (eg, major depression). Sometimes indicated for
      other, occasionally nonpsychiatric, medical conditions, ECT is a moderately
      complex procedure for which training is provided routinely during psychiatric
      residency. Although temporary confusion and amnesia are expected immediately
      after treatment, no reliable data suggest that permanent memory loss or cognitive
      deficit is caused by modern ECT. Indeed, because severe depression itself often
      causes both memory and cognitive deficits, ECT's remarkable therapeutic
      effectiveness is associated with long-term improvement in cognition, learning
      ability, and memory for many patients. Controversy over safety and effect on
      memory is fueled largely by public misinformation.

PMID- 8342163
TI  - Carotid endarterectomy: a review of surgical practice in a community hospital.
AB  - That a specified number of vascular surgery procedures must be performed annually
      to maintain competence and that these procedures require a specialized center
      have been suggested repeatedly. Recent national guidelines admonish us to check
      our own experience with carotid surgery. In our 10-year review of 215 operations
      performed for carotid stenosis and/or ulceration by two surgeons in a relatively
      small community, the combined major morbidity/mortality rate of 2.8% compares
      favorably to many other series. Our experience suggests that if done judiciously,
      gently, and with universal shunting, the operation can be accomplished safely in
      the community hospital setting.

PMID- 8342164
TI  - PCRM reiterates stance on cow's milk.

PMID- 8342165
TI  - Growing RN layoffs. Does Texas mirror the national trend?

PMID- 8342166
TI  - Legal issues for nurses. Overview of professional liability insurance.

PMID- 8342167
TI  - THA says: nurses still in demand in Texas.

PMID- 8342168
TI  - Possible mechanisms of action of cobra snake venom cardiotoxins and bee venom
      melittin.
AB  - Cobra snake venom cardiotoxins and bee venom melittin share a number of
      pharmacological properties in intact tissues including hemolysis, cytolysis,
      contractures of muscle, membrane depolarization and activation of tissue
      phospholipase C and, to a far lesser extent, an arachidonic acid-associated
      phospholipase A2. The toxins have also been demonstrated to open the Ca2+ release
      channel (ryanodine receptor) and alter the activity of the Ca(2+)+Mg(2+)-ATPase
      in isolated sarcoplasmic reticulum preparations derived from cardiac or skeletal
      muscle. However, a relationship of these actions in isolated organelles to
      contracture induction has not yet been established. The toxins also bind to and,
      in some cases, alter the function of a number of other proteins in disrupted
      tissues. The most difficult tasks in understanding the mechanism of action of
      these toxins have been dissociating the primary from secondary effects and
      distinguishing between effects that only occur in disrupted tissues and those
      that occur in intact tissue. The use of cardiotoxin and melittin fractions
      contaminated with trace ('undetectable') amounts of venom-derived phospholipases
      A2 has continued to be common practice, despite the problems associated with the
      synergism between the toxins and enzymes and the availability of methods to
      overcome this problem. With adequate precautions taken with regard to methodology
      and interpretation of results, the cobra venom cardiotoxins and bee venom
      melittin may prove to be useful probes of a number of cell processes, including
      lipid metabolism and Ca2+ regulation in skeletal and cardiac muscle.

PMID- 8342169
TI  - Cardiotoxin 1 from cobra (Naja naja atra) venom causes necrosis of skeletal
      muscle in vivo.
AB  - Cardiotoxin 1 from cobra (Naja naja atra) venom was tested for its ability to
      cause necrosis of skeletal muscle cells after i.m. injection into mice. Light and
      electron microscopic examination of tissue indicated that the toxin caused
      necrosis of skeletal muscle as early as 30 min after injection. The plasma
      membranes of affected cells were ruptured in the area of delta lesions, and the
      myofibrils were condensed into dense clumps alternating with clear areas
      containing elements of the sarcotubular system and damaged mitochondria. By 24 hr
      the affected cells appeared as empty 'bags' containing only remnants of
      myofibrils and swollen mitochondria. To eliminate the possibility that the
      necrosis was due to contaminating phospholipase A2 (PLA2) activity of the sample,
      the sample was treated with p-bromophenacyl bromide (p-BPB), a known inhibitor of
      PLA2 activity. The p-BPB-treated preparation caused myonecrosis in vivo in mice,
      and the treatment caused a significant decrease in the release of fatty acids and
      no detectable lysophospholipid in human muscle cell cultures treated in vitro
      with the preparation, indicating the lack of PLA2 activity. Additionally,
      purified PLA2 from the same venom failed to cause myonecrosis in vivo at doses
      equal to or ten times the estimated contaminating concentration. Thus, it is
      concluded that cardiotoxin 1 from Naja naja atra venom causes necrosis of
      skeletal muscle cells in vivo upon i.m. injection.

PMID- 8342170
TI  - Variation in the toxins present in ciguateric narrow-barred Spanish mackerel,
      Scomberomorus commersoni.
AB  - Water-soluble and lipid-soluble toxins present in six specimens of Scomberomorus
      commersoni captured in subtropical Queensland were compared with those detected
      in a specimen studied earlier. All specimens were from batches that had been
      involved in human poisonings. All specimens contained significant amounts of
      potent water-soluble toxins, the most important of which in terms of contribution
      to the lethal potency of fish flesh was unidentified toxic material which tested
      positively for alkaloids. All specimens contained lipid-soluble toxins including
      ciguatoxin-like and scaritoxin-like material, the latter usually predominating.
      Amounts of water-soluble toxins with lethal potencies ranging from 14.9 MU to 115
      MU/100 g of flesh and of lipid-soluble toxins with lethal potencies ranging from
      8.8 MU to 39.9 MU/100 g of flesh were found. (A mouse unit, MU, is the minimum
      amount of toxic material expressed in g required to kill a 20 g mouse within 24
      hr following i.p. injection.) The lethal potency of water-soluble toxins per g of
      fish exceeded that of lipid-soluble toxins per g of fish for five of the seven
      specimens of S. commersoni now investigated. Based on a lethal dose to humans of
      2500 MU all fishes contained lethal amounts of toxic material. The relative
      amounts of water-soluble and lipid-soluble toxins present in the flesh of a
      specimen of S. commersoni were altered by different cooking procedures.

PMID- 8342171
TI  - Different clotting mechanisms of Bothrops jararaca snake venom on human and
      rabbit plasmas.
AB  - Bothrops jararaca venom is approximately 3.5 times more effective at coagulating
      rabbit plasma than human plasma. To investigate this difference B. jararaca venom
      was treated with several enzymatic inhibitors and the minimum coagulant dose was
      determined both on plasma anticoagulated with sodium citrate or a mixture of
      sodium citrate and heparin, and on fibrinogen (both human and rabbit). On human
      plasma, the thrombin-like component of the venom accounted for c. 60% of the
      coagulant activity, such activity was negligible on rabbit plasma. The venom had
      little clotting activity on rabbit fibrinogen. The factor II- and X-activator
      components could be inhibited by EDTA, EGTA and 2-mercaptoethanol, whereas the
      thrombin-like activity was inhibited by PMSF. These differences show that (using
      human plasma) B. jararaca clotting activity is mainly due to the thrombin-like
      component, whereas the factor II- and X-activator components are more important
      on rabbit plasma. The delayed action of the thrombin-like enzyme on rabbit
      fibrinogen may be attributed to the difference between rabbit and human
      fibrinopeptide A. Thus, the increased coagulant activity on rabbit plasma may be
      due to a faster rate of activation of factor X, V or II by snake venom enzymes.

PMID- 8342172
TI  - Biological and biochemical activities of Vipera berus (European viper) venom.
AB  - Vipera berus is widely distributed throughout the northern part of Europe and
      Asia. Characterization of several toxic effects of its venom in the mouse, as
      well as of in vitro enzymatic activities was performed. Vipera berus venom
      displayed in vitro proteolytic, fibrinolytic, anticoagulant, and phospholipase A2
      activities. The i.p. LD50 of the venom for Swiss mice was 0.86 micrograms/g (95%
      confidence limits 0.71-1.01 microgram/g). Significant local tissue-damaging
      effects, including edema, hemorrhage and myonecrosis, were observed. The local
      edema was characterized by rapid onset, reaching a maximum after 0.5-1 hr, and
      with dose-dependent persistence. The hemorrhagic potency was measured by a skin
      test, giving a minimum hemorrhagic dose value of 3.2 micrograms. The venom also
      induced a moderate local myonecrosis, evidenced by histological evaluation of
      injected tissue (gastrocnemius), and by biochemical parameters (increase of
      plasma creatine kinase activity, and decrease of muscle residual MTT (3-[4,5
      dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium bromide)-reducing activity).
      Characterization of the venom by SDS-polyacrylamide gel electrophoresis revealed
      10 (reduced) or 11 (unreduced) main protein bands, which were further analyzed in
      relation to mol. wt and relative concentration by densitometry. A rabbit
      antiserum to V. berus venom recognized all main venom bands by immunoblotting.
      This antiserum cross-reacted to a variable extent with several crotaline venoms,
      as assessed by enzyme immunoassay.

PMID- 8342173
TI  - Toxicity of the venom from Nasonia vitripennis (Hymenoptera: Pteromalidae) toward
      fly hosts, nontarget insects, different developmental stages, and cultured insect
      cells.
AB  - A venom preparation from Nasonia vitripennis, a wasp ectoparasitoid of fly pupae,
      was assayed for lethality in different stages of insects representing ten
      different orders and in cultured insect cells. In most cases, the motor activity
      of the injected insects remained completely normal for 1-2 days after the
      injection and displayed none of the symptoms of paralysis commonly reported for
      venoms of the Hymenoptera. A natural host, the flesh fly Sarcophaga bullata, was
      highly sensitive in the pupal stage (LD50 = 5.4 and 5.5 VRE/g for nondiapausing
      and diapausing pupae, respectively), the stage that is normally parasitized, and
      larvae and adults were as susceptible to the venom as the pupae. Adults of
      another fly host, Phaenicia sericata, were nearly as sensitive (LD50 = 6.5
      VRE/g), but nonhost adult flies were more tolerant. Among the other orders
      tested, pupae of several species (Plodia interpunctella, Trichoplusia ni,
      Tenebrio molitor) were more susceptible to envenomation than larval or adult
      stages. In fact, the highest sensitivity observed in this study (LD50 = 0.58
      VRE/g) was with pupae of the cabbage looper, T. ni, a species that is not a
      natural host. In contrast, the larvae (LD50 = 7.23 VRE/g) and adults (LD50 =
      7.48) of T. ni were far less sensitive. Adults of Nasonia vitripennis were not
      sensitive to their own venom (LD50 = > 533 VRE/g), although adults of another
      hymenopteran, Apis mellifera, were suceptible (4.62 VRE/g). Adults of Lymantria
      dispar, Oncopeltus fasciatus, Aphis nerii, Euborellia annulipes, Diapheromera
      femorata, Blattella germanica, Periplaneta americana, and Reticulitermes flavipes
      demonstrated a high tolerance to Nasonia venom. When tested in vitro, the venom
      caused cultured Lepidoptera (TN-368) and Diptera (NIH SaPe4) cells to round up,
      swell, and eventually die. The LC50S were 0.0014 and 0.0010 VRE/microliters for
      TN-368 and SaPe4 cells, respectively. Cytotoxicity was observed within 10 min
      after exposure to LC99 levels of venom, with 100% cell mortality at 100 min for
      the NIH SaPe4 cells and 24 hr for TN-368 cells. It is possible that the venom
      component responsible for in vivo and in vitro activities may be different, but
      results from the cell culture work suggest that this method offers a promising
      assay for quickly screening venom samples. The high susceptibility of flies and
      pupae of other insects to the venom, as well as its novel (nonparalytic) action
      suggest that it may have considerable potential for development as a
      biopesticide.

PMID- 8342174
TI  - Evidence for a fast-exchange conformational process in alpha-bungarotoxin.
AB  - Anomalous behavior of the post-synaptic protein neurotoxin, alpha-bungarotoxin
      (alpha-bgt), has been observed during reverse-phase HPLC. Purified samples of
      this toxin from two distinct sources elute from reverse-phase columns as two
      separate peaks. The protein species represented by these two peaks are in rapid
      equilibrium, the relative ratio of which displays a pH dependency with a pKa of
      approximately 3. This equilibrium does not involve the dimerization or
      aggregation of the toxin and appears to be relatively unique to alpha
      bungarotoxin in that similar behavior is not displayed by several other available
      alpha-neurotoxins. pH-dependent conformational changes have been documented for
      several alpha-neurotoxins whose crystal structures have been determined (alpha
      bungarotoxin, alpha-cobratoxin, and erabutoxin b). One or more of these may
      account for the observed behavior of alpha-bungarotoxin on reverse-phase HPLC.

PMID- 8342175
TI  - Severity rating scales for ciguatera fish poisoning.
AB  - Severity of ciguatera fish poisoning is often quite variable. Two symptom check
      list rating scales were developed for quantifying illness severity and for
      selectively monitoring response to therapy in patients with chronic toxicity.
      Content validity was ascertained, and internal consistency reliability was
      demonstrated by means of the Cronbach alpha correlation coefficient (alpha =
      0.9475). It was concluded that these instruments were valid and reliable, and
      that they conveniently and accurately recorded illness severity and treatment
      efficacy. They should prove useful in clinical settings and epidemiologic
      investigations.

PMID- 8342176
TI  - Structural modifications imparting reduced toxicity in microcystins from
      Microcystis spp.
AB  - A cyanobacterial (blue-green algal) bloom containing Microcystis aeruginosa
      (dominant), M. viridis, and M. wesenbergii, was collected from Homer Lake
      (Illinois, U.S.A.) in the summer of 1988 and microcystins were isolated. One
      microcystin of substantially reduced toxicity was isolated, together with ten
      hepatotoxic microcystins. The compound with reduced toxicity was nonlethal at 1
      mg/kg (i.p. mouse) and was determined to have a (C3H7O2) mono-ester of the alpha
      carboxyl on the Glu unit of microcystin-LR. The other nine microcystins apart
      from MCLR had approximate LD50S ranging from 97 micrograms/kg to 750
      micrograms/kg.

PMID- 8342177
TI  - The effect of the viper Cerastes cerastes cerastes venom and venom fractions on
      carbohydrate metabolism.
AB  - The effect of the viper Cerastes cerastes cerastes venom and venom fractions on
      carbohydrate metabolism. Toxicon 31, 791-801, 1993.--I.p. injection of a
      sublethal dose of Cerastes cerastes cerastes venom into white rats induced a
      marked hypoglycemia after 15 min. This hypoglycemia continued for at least 24 hr.
      Hypoglycemia was accompanied by a significant increase of liver and muscle
      glycogen at 15-30 min and 8 hr. Plasma lactate levels were significantly
      increased for most of the 24 hr test period, and was accompanied by a marked
      decrease of liver lactate levels. Levels of skeletal muscle lactate increased
      significantly. Viper venom significantly increased levels of plasma, liver and
      skeletal muscle pyruvate for most of the 24 hr test period. Cerastes cerastes
      cerastes venom was fractionated using gel filtration into six fractions. Each of
      the first four fractions caused a significant hypoglycemic effect at some point
      of the 6 hr test period, while fraction I also produced a hyperglycemia 30 min
      after administration. Fraction III, the only fraction to show a continuous
      hypoglycemic effect during the 6 hr test period, significantly increased plasma
      insulin levels 30 min after treatment. It is suggested that the hypoglycemia may
      be due to a direct effect of venom components on plasma insulin levels.

PMID- 8342178
TI  - Toxin content, phallotoxin and amatoxin composition of Amanita phalloides
      tissues.
AB  - The toxin content and composition of Amanita phalloides tissues were determined
      in three specimens at two carpophore development stages. The carpophore was
      subdivided into six parts, namely, the cap, gills, ring, stipe, volva and bulb.
      To our knowledge, this is the first report of such an investigation on the ring
      and the bulb. Substantial differences in the tissue toxin content were revealed.
      The ring displayed a very high amount of toxins, whereas the bulb had the lowest
      toxin content. Compositional differences in relation to the nature of the tissue
      were also noted. The highest amatoxin content was found in the ring, gills and
      cap, whereas the bulb and volva were the richest in phallotoxins. Furthermore,
      variability in the toxin composition was observed. The differences in the
      distribution of individual toxins in the tissues might be related to the
      carpophore developmental stage.

PMID- 8342179
TI  - Is Nai Habarala (Alocasia cucullata) a poisonous plant?
AB  - Nai Habarala is not documented as a poisonous plant. However, we report two cases
      of fatal poisoning following ingestion of its fruit. The clinical manifestations
      have a similarity to cyanogenic glycoside poisoning.

PMID- 8342180
TI  - Bibliography of toxinology.

PMID- 8342181
TI  - Public health nurses--a century of caring (1893-1993).

PMID- 8342182
TI  - Carotid stenosis and perioperative stroke risk in symptomatic and asymptomatic
      patients undergoing vascular or coronary surgery.
AB  - BACKGROUND AND PURPOSE: The management of asymptomatic carotid stenosis found
      before vascular or coronary surgery is unclear from the literature. We aimed to
      define the relation of carotid stenosis to perioperative stroke in all patients,
      symptomatic and asymptomatic, and so determine a policy for the management of
      asymptomatic carotid stenosis in patients requiring major surgery. METHODS: We
      conducted a prospective clinical and Duplex ultrasound study of 358 consecutive
      noncarotid major vascular or coronary artery bypass operations, with a moratorium
      on endarterectomy for asymptomatic carotid stenosis. RESULTS: There were 145
      vascular and 213 coronary bypass operations. Ten of the 49 cases with prior
      symptoms of cerebral ischemia (38 carotid, 11 vertebrobasilar) had symptomatic
      stenosis of 50% or greater or occlusion, and 3 of these (30%) had ipsilateral
      perioperative cerebral infarction (95% confidence interval, 6.67% to 65.25%). Two
      of these occurred ipsilateral to symptomatic carotid occlusions, and 1 occurred
      ipsilateral to an 80% symptomatic stenosis. One symptomatic patient with
      bilateral 30% stenosis had a perioperative infarct in the asymptomatic
      hemisphere. Among the 309 asymptomatic patients, 1 perioperative infarct occurred
      ipsilateral to carotid stenosis of 30%. In all there were 5 (1.4%) perioperative
      (within 72 hours) and 2 late (after 18 days) strokes. All strokes were hemisphere
      infarcts confirmed by computed tomography. There were 53 cases with 50% or
      greater asymptomatic carotid stenosis or occlusion, including 28 with 80% or
      greater stenosis or occlusion. None had an ipsilateral perioperative stroke (95%
      confidence interval, 0% to 6.72%). CONCLUSIONS: We conclude that the risk of
      perioperative stroke related to symptomatic carotid stenosis may be high, but for
      asymptomatic carotid stenosis the risk is low and does not justify preoperative
      prophylactic carotid endarterectomy.

PMID- 8342183
TI  - Treatment of acute cortical infarct with intravenous glycerol. A double-blind,
      placebo-controlled randomized trial.
AB  - BACKGROUND AND PURPOSE: This clinical trial investigates the effectiveness of
      intravenous glycerol therapy in patients with acute cortical infarction in whom
      intracerebral hemorrhage was rigorously excluded. METHODS: Within 48 hours of
      symptoms from their first ischemic stroke, 113 hospital inpatients were
      randomized into the trial, provided that hemorrhage was excluded by computed
      tomography and informed consent was obtained. Patients were stratified into
      alert, semicoma, and coma groups using the Glasgow Coma Scale. Treatment was
      allocated according to a double-blind, randomized protocol; 56 patients received
      500 mL of 10% glycerol in saline over 4 hours on 6 consecutive days, and 57
      patients received corresponding placebo treatment with saline. Using a variety of
      objective scoring systems, patient follow-up was up to 6 months. RESULTS:
      Corresponding measures of outcome in the glycerol and placebo groups were
      similar. At 6 months, respective mortality rates were 17 of 56 and 16 of 57, and
      mean +/- SD improvements in scores were 9.98 +/- 14.40 vs 10.51 +/- 12.68 (long
      term), 1.12 +/- 7.20 vs 1.57 +/- 6.30 (prognostic), -1.94 +/- 5.53 vs -2.06 +/-
      5.34 (Glasgow Coma Scale), and 21.72 +/- 23.40 vs 11.94 +/- 18.10 (Barthel Index
      rating in survivors). Hemolysis (generally subclinical) was the only adverse
      effect. CONCLUSIONS: There was no clinically or statistically significant
      difference in outcome between the groups; a trend toward greater functional
      recovery among survivors was evident after treatment with glycerol.

PMID- 8342185
TI  - Hyperglycemia in the acute phase of stroke is not caused by stress.
AB  - BACKGROUND AND PURPOSE: Hyperglycemia in the acute phase of stroke is associated
      with poor outcome. Whether hyperglycemia in nondiabetic stroke patients is caused
      by stress is controversial. METHODS: We studied glucose levels and glycosylated
      hemoglobin in 91 consecutive patients with acute stroke admitted within 24 hours
      after onset of symptoms. In 27 unselected patients we also measured
      catecholamines on days 1 and 3 after onset. RESULTS: Hyperglycemia was found in
      39 (43%) of the patients, 55% of whom either had diabetes mellitus or latent
      diabetes; the others had idiopathic hyperglycemia. Norepinephrine levels were
      associated with the severity of the stroke (P = .005) and with hypertension (P =
      .03) but not with glucose levels, irrespective of whether or not the patients had
      diabetes. CONCLUSIONS: We conclude that hyperglycemia in the acute phase of
      stroke cannot be explained by increased stress.

PMID- 8342184
TI  - Does low-dose acetylsalicylic acid prevent stroke after carotid surgery? A double
      blind, placebo-controlled randomized trial.
AB  - BACKGROUND AND PURPOSE: The aim of this randomized double-blind, placebo
      controlled trial was to evaluate whether neurological deficits could be prevented
      with low-dose acetylsalicylic acid (ASA) as an adjunct to carotid endarterectomy.
      METHODS: A total of 232 patients were randomized to two groups, 75 mg/d ASA
      starting preoperatively and continued for 6 months (n = 117) or placebo
      (identical tablets) (n = 115). The patients were followed up regularly for 1
      year. RESULTS: The groups were well matched regarding laboratory data and
      indication for operation. The number of patients with intraoperative or
      postoperative stroke without complete recovery within 1 week were 0 and 2 at 30
      days and 6 months, respectively, in the ASA group, compared with 7 and 11 in the
      placebo group (P = .01). Including all neurological events within 6 months, this
      was found in 15 patients in the ASA group compared with 24 in the placebo group
      (P = .12). Mortality was 0.8% and 3.4% at 30 days and 6 months, respectively, in
      the ASA group. In the placebo group, the corresponding figures were 4.3% and
      6.0%, respectively (P = .12). The intraoperative bleeding did not differ between
      the groups nor did the number of reoperations due to bleeding or other
      complications related to pharmacology. CONCLUSIONS: This study indicates that low
      dose ASA (75 mg/d) reduces the number of postoperative strokes without complete
      recovery within 1 week. Overall neurological events are insignificantly reduced,
      as also mortality. The use of low-dose ASA (75 mg) seems safe and effective in
      reducing cerebrovascular events after carotid endarterectomy.

PMID- 8342186
TI  - Fibrinogen and the albumin-globulin ratio in recurrent stroke.
AB  - BACKGROUND AND PURPOSE: In following patients initially recruited for a cross
      sectional study of blood viscosity in ischemic cerebrovascular disease, it was
      noted that those having a low albumin-globulin ratio appeared to experience the
      majority of subsequent vascular events. Accordingly, a prospective study in which
      subjects were assigned to a high or low albumin-globulin cohort was undertaken to
      examine the relation between a low albumin-globulin ratio, the presence of
      clinical risk factors for stroke, and the occurrence of subsequent stroke,
      myocardial infarction, or vascular death. METHODS: Three groups of subjects were
      followed for an average of 1.5 +/- 0.8 years to ascertain vascular end points.
      Group 1 consisted of 126 patients with acute ischemic stroke; group 2 included
      109 subjects matched with group 1 for age, medications, and recognized clinical
      risk factors for stroke; and group 3 was composed of 84 healthy volunteers,
      matched for age with groups 1 and 2. The median albumin-globulin ratio for group
      1 at enrollment, 1.45, was used to dichotomize patients into two cohorts: all
      subjects with an albumin-globulin ratio of 1.45 or less were assigned to the
      "low" albumin-globulin cohort; those whose ratio was greater than 1.45 were
      assigned to the "high" albumin-globulin cohort. The occurrence of vascular end
      points was verified during subsequent hospitalizations and outpatient clinic
      visits and by telephone interviews of patients and providers. RESULTS: A total of
      51 vascular events occurred, including 39 in group 1, 8 in group 2, and 4 in
      group 3. Subjects in either group 1 or 2 who were in the low albumin-globulin
      cohort had at least double the risk for a subsequent vascular event compared with
      their counterparts in the high albumin-globulin cohort (P < .01 and P < .03,
      respectively). In comparison with the high albumin-globulin cohort, significantly
      more patients in the low albumin-globulin cohort in group 1 had a history of
      prior stroke (P < .03). When groups 1 and 2 were combined, both a low albumin
      globulin ratio and diabetes had a significant independent association with
      increased risk for subsequent vascular events in a Cox proportional-hazards model
      (P < .01 and P < .03, respectively). CONCLUSIONS: The results of this study
      indicate that significantly increased risk for subsequent vascular events in
      stroke patients and in subjects with clinical risk factors for stroke is
      associated with a shift in the concentrations of blood proteins to a
      prothrombotic environment characterized by lower levels of albumin and an
      increased concentration of globulins and fibrinogen.

PMID- 8342187
TI  - Stroke mortality and case-fatality rates in three geographic areas of Finland
      from 1983 to 1986.
AB  - BACKGROUND AND PURPOSE: Our aim was to describe the mortality and early case
      fatality rates of stroke in three geographic areas of Finland during 1983 to 1986
      by means of a community-based stroke register and to estimate the accuracy of
      registration of stroke deaths in the official statistics compared with the
      FINMONICA stroke register. METHODS: Annual and average mortality and case
      fatality rates of stroke were derived from data collected in the FINMONICA stroke
      register during 1983 to 1986. Age-specific and age-standardized rates were
      calculated for the three areas, and the results were compared with the official
      mortality statistics and with the case-fatality figures published previously in
      the literature for Finland and elsewhere. RESULTS: Mortality from stroke in the
      three FINMONICA areas was between 73 and 90 per 100,000 per year among men aged
      25 to 74 years and between 42 and 55 per 100,000 per year among women in the same
      age group. Average case-fatality was similar in the three areas and globally
      high: 20% to 27% in men and 24% to 28% in women. Approximately half of the fatal
      strokes occurred within less than 2 days from the onset of the attack, and a
      further 25% within the first week. Hemorrhagic strokes accounted for 54% to 81%
      of all fatal strokes occurring in less than 2 days among men, while among women
      the corresponding proportions varied in the three areas between 35% and 74%. Of
      cerebral infarctions, approximately 28% to 37% among men and 19% to 20% among
      women were fatal within less than 2 days. Although the number of fatal strokes
      was similar in both the FINMONICA register and official mortality statistics,
      only 82% to 85% of the stroke cases were common in both registers; a further 13%
      to 14% of the cases classified as stroke deaths in the FINMONICA register could
      also be found in the official mortality statistics, but the underlying cause of
      death was something other than stroke. CONCLUSIONS: The reliability of the
      Finnish official mortality statistics with regard to stroke deaths is reasonably
      good in aggregate numbers, but at the individual level considerable discrepancies
      seem to occur. Mortality from stroke in Finland has not declined further after
      1979 and remains high internationally. Early case-fatality of stroke also seems
      higher in Finland than in most other countries. We believe that both the high
      incidence of stroke and the severity of the attacks are contributing to mortality
      and case-fatality rates of stroke in Finland.

PMID- 8342188
TI  - Regional cerebral blood flow in chronic hypertension. A correlative study.
AB  - BACKGROUND AND PURPOSE: Cerebral hypoperfusion has occasionally been reported
      during essential hypertension. We explored regional cerebral blood flow in a
      large series of neurologically asymptomatic hypertensive patients to determine
      relations among cerebral blood flow, concomitant main vascular risk factors, and
      the most common signs of end-organ damage. METHODS: Regional cerebral blood flow
      was measured by the 133Xe inhalation method in 101 hypertensive patients without
      clinically apparent central nervous system involvement, including 39 mild to
      moderate untreated and 62 mild to severe treated patients. RESULTS: Compared with
      age- and sex-matched normal control subjects, cerebral blood flow was
      significantly reduced in untreated hypertensive patients (P < .01) and to a
      lesser extent in treated patients (P = .047). Both regional and global cerebral
      blood flow reductions were observed in approximately one third of patients in
      both groups. Analysis of variance failed to show significant correlations between
      cerebral blood flow and total cholesterol concentration, mean arterial blood
      pressure, duration of disease, or the presence of retinopathy or left ventricular
      hypertrophy. In the treated group, the quality of control of hypertension
      significantly influenced both global cerebral blood flow (P = .007) and
      cerebrovascular resistance (P < .0001). CONCLUSIONS: Focal or diffuse cerebral
      hypoperfusion is present even in neurologically asymptomatic hypertensive
      patients, especially when untreated; good control of blood pressure may preserve
      cerebral perfusion and reduce cerebrovascular resistance. Regional cerebral blood
      flow examination represents a relatively simple and low-cost technique to explore
      the perfusional condition of the brain, one of the main target organs of
      hypertensive disease.

PMID- 8342189
TI  - Cerebral blood flow velocity and systemic vascular resistance after acute
      reduction of low-density lipoprotein in familial hypercholesterolemia.
AB  - BACKGROUND AND PURPOSE: Low-density lipoprotein apheresis is currently used for
      the treatment of familial hypercholesterolemia, an inherited disorder of
      metabolism associated with premature development of cardiovascular disease. We
      wanted to evaluate cerebral blood flow velocity, cardiac output, and systemic
      vascular resistance in patients with familial hypercholesterolemia before and
      after low-density lipoprotein apheresis. METHODS: Ten patients (age range, 14 to
      46 years; 4 males, 6 females) with familial hypercholesterolemia (8 homozygotes,
      2 heterozygotes) and 10 healthy control subjects of comparable age and sex
      distribution participated in the study. Low-density lipoprotein apheresis by
      dextran sulfate was performed in 8 patients (7 homozygotes, 1 heterozygote). Six
      patients (4 homozygotes, 2 heterozygotes) underwent a procedure of extracorporeal
      erythrocyte filtration with the same extracorporeal volume as for low-density
      lipoprotein apheresis, but with the exclusion of the passage of plasma through
      the dextran sulfate column. Cerebral blood flow velocity (transcranial Doppler),
      cardiac output, and systemic vascular resistance (electric bioimpedance
      cardiography) were determined by noninvasive techniques before and 1 day and 7
      days after low-density lipoprotein apheresis or extracorporeal erythrocyte
      filtration. Plasma and blood viscosities were measured at the same time. RESULTS:
      Before apheresis, mean and diastolic cerebral flow velocities were abnormally low
      in hypercholesterolemic patients (P < .01 and P < .02 vs healthy control
      subjects, respectively). After apheresis, low-density lipoprotein cholesterol was
      lowered by 40% to 60% from baseline, and cerebral blood flow velocities (mean,
      systolic, and diastolic velocities) were increased (P < .01). Cardiac output,
      systemic vascular resistance, and viscosity values were not significantly
      modified. Extracorporeal erythrocyte filtration (without passage of plasma
      through the dextran sulfate column) did not modify serum lipids, hemodynamic
      parameters, or viscosity values. CONCLUSIONS: Low-density lipoprotein apheresis
      produces potentially useful hemodynamic effects. They are not adequately
      explained by changes in blood viscosity alone and might reflect a restoration of
      endothelium-mediated vasodilation, which is inhibited by high concentrations of
      low-density lipoprotein.

PMID- 8342190
TI  - Brain stem infarction and diaschisis. A SPECT cerebral perfusion study.
AB  - BACKGROUND AND PURPOSE: We studied six patients suffering from pure, unilateral
      brain stem infarction to explore the association of remote cerebral and
      cerebellar blood flow changes with damage at different sites of this region of
      the brain. METHODS: We used single-photon emission computed tomography and
      [123I]iodoamphetamine to measure regional differences in tracer uptake.
      Qualitative image analysis and calculated asymmetry indexes were correlated to
      the location of the infarcted area on magnetic resonance imaging and to the
      patients' clinical findings. RESULTS: Significant perfusion asymmetries were
      noted in the two patients with infarction in the upper pons but not in those with
      lesions below this level. They comprised a contralateral cerebellar and
      ipsilateral supratentorial hypoactivity that was most marked in the
      frontoparietal cortex. There was no clear relation between the patterns of
      cerebral or cerebellar tracer uptake and specific neurological findings.
      CONCLUSIONS: Remote perfusion changes after pure brain stem infarction may be
      seen both infratentorially and supratentorially and depend on the lesion site
      rather than on the neurological deficit. In this context, our study confirmed
      damage to the corticopontocerebellar pathways as the key event in the genesis of
      a crossed cerebellar diaschisis. The exact mechanisms causing ipsilateral
      cerebral hemispheric diaschisis await further clarification.

PMID- 8342191
TI  - Regional cerebral blood flow measured with N-isopropyl-p-[123I]iodoamphetamine
      and its redistribution in ischemic cerebrovascular disease.
AB  - BACKGROUND AND PURPOSE: The relation between the redistribution phenomenon and
      regional cerebral blood flow and its clinical significance were investigated in
      stroke patients. METHODS: Single-photon emission computed tomography studies
      using N-isopropyl-p-[123I]iodoamphetamine were performed on 16 patients (26 to 77
      years old) with chronic infarction and 10 age-matched normal control subjects.
      Regional cerebral blood flow was quantitatively measured by a microsphere model,
      and the redistribution on delayed images was analyzed in ischemic lesions.
      RESULTS: Supratentorial mean cerebral blood flow and the ratio of gray matter to
      white matter in normal subjects were 52.7 +/- 5.0 mL/100 g per minute and 2.34,
      respectively. Low-activity areas of ischemic lesions on early images were
      classified into two abnormal zones, an infarct area and a peri-infarct area.
      These regions were characterized by regional blood flow averaging 9 to 20 mL/100
      g per minute and 22 to 41 mL/100 g per minute, respectively. Redistribution,
      which was minimally present in the infarct area, was markedly enhanced in the
      peri-infarct area. After bypass surgery, we observed a significant increase of
      blood flow (+22%) in the peri-infarct area. CONCLUSIONS: The data indicate that
      the redistribution phenomenon depends on the maintenance of a minimal blood flow
      that would sustain cellular function and that this phenomenon is useful to
      evaluate bypass surgery in patients with chronic infarction.

PMID- 8342192
TI  - The Frenchay Activities Index. Assessment of functional status in stroke
      patients.
AB  - BACKGROUND AND PURPOSE: Assessment of functional status in stroke patients is of
      major importance in both clinical practice and outcome studies. The Frenchay
      Activities Index has been developed specifically for measuring disability and
      handicap in stroke patients. The purpose of the study was to evaluate the metric
      properties of this instrument and to obtain normal values in a group of
      unselected elderly subjects. METHODS: The Frenchay Activities Index was tested in
      a group of stroke patients and a group of unselected subjects aged 65 or older.
      The functional status of the stroke patients was measured 26 weeks after stroke.
      Their prestroke status was registered retrospectively. Reliability and validity
      of the instrument were assessed. RESULTS: The mean scores in the prestroke,
      poststroke, and control group demonstrated differences in functional status. The
      reliability of unweighted scores (range of Cronbach's alpha-coefficients, 0.78 to
      0.87) was sufficient. The construct validity was supported by meaningful
      correlations between the Frenchay Activities Index and scores on the Barthel
      Index and Sickness Impact Profile. Principal-components analysis indicated that
      the Frenchay Activities Index showed two traits: instrumental disability and some
      aspects of handicap. The reliability of the instrument could be improved by
      deleting two items and by creating two subscale scores: domestic and outdoors
      activities. CONCLUSIONS: The Frenchay Activities Index is a useful stroke
      specific instrument to assess functional status. Completion of the questionnaire
      is easy and takes only a few minutes. Currently, the instrument is suitable for
      use in patient care and cross-sectional, descriptive studies.

PMID- 8342193
TI  - A comparison of five stroke scales with measures of disability, handicap, and
      quality of life.
AB  - BACKGROUND AND PURPOSE: Recently much debate has arisen on the appropriateness of
      assessing stroke outcomes with stroke impairment scales. Our purpose was to study
      the relationship between long-term impairments and functional outcomes in terms
      of disability, handicap, and quality of life. METHODS: We studied 87 patients who
      had a stroke 6 months earlier. Impairments were scored on five stroke scales: the
      Orgogozo Scale, the National Institutes of Health scale, the Canadian
      Neurological Scale, the Mathew scale, and the Scandinavian Stroke Scale.
      Disability was assessed with the Barthel Index, handicap with the Rankin scale,
      and quality of life with the Sickness Impact Profile. The linear relationship
      between stroke scales and functional scales was assessed with correlation
      coefficients. We used regression analyses to explain functional health. RESULTS:
      The stroke scales were highly related to one another (range, r = -.85 to .92).
      The correlation between stroke scales and functional scales was < .70 and
      decreased from Barthel (mean r2 = 47.5%) to Rankin (mean r2 = 36.5%) to Sickness
      Impact Profile (mean r2 = 33%). Stroke scales were rather poorly correlated with
      patients' psychosocial conditions (mean r2 = 11.5%). Functional health status was
      mainly related to leg power and orientation. The standardized stroke scale
      weights of the explanatory items were lower than their standardized regression
      weights. CONCLUSIONS: Stroke scales only partly explain functional health. The
      impact of impairments on functional outcomes seems to be underestimated by the
      stroke scale weights. The correlation patterns give empirical support to the
      hierarchical structure of the International Classification of Impairments,
      Disabilities and Handicaps.

PMID- 8342194
TI  - Factors influencing return to work after stroke in Japan.
AB  - BACKGROUND AND PURPOSE: Few studies have identified factors that predict return
      to work after stroke in Japan. Our aim in this study was to determine the
      predictors of return to work after stroke in Japan. METHODS: We performed a
      retrospective cohort study on the association between patients' characteristics
      at admission and return to work in 230 first-stroke patients, adjusting for
      potential confounding factors. The patients were all aged younger than 65 years
      and were working, students, or housewives at the time of their stroke. Return to
      work was evaluated by a follow-up questionnaire. Data were analyzed using forward
      logistic regression analysis to compute odds ratios of return to work. RESULTS:
      The adjusted odds ratios (and 95% confidence intervals) for patients with normal
      muscle strength vs severe muscle weakness, without apraxia vs with apraxia, and
      with white-collar vs blue-collar occupation were 4.50 (1.04 to 19.42), 4.87 (1.28
      to 18.54), and 3.33 (1.34 to 8.30), respectively. CONCLUSIONS: Significant
      predictors of return to work after stroke were no muscle weakness, absence of
      apraxia, and white-collar occupation.

PMID- 8342195
TI  - The effects of long-term rehabilitation therapy on poststroke hemiplegic
      patients.
AB  - BACKGROUND AND PURPOSE: Rehabilitation therapy is believed to be useful during
      the first few months after stroke when recovery usually takes place. However,
      evidence exists that this may not be the rule for all stroke victims. Therefore,
      we investigated, in a selected group of poststroke patients, the profile of
      recovery in response to long-term rehabilitation therapy. METHODS: Fifty-one
      hemiplegic subjects unable to walk 3 months after stroke were enrolled in this
      study. Patients underwent consecutive periods of rehabilitation up to 2 years
      after the cerebrovascular accident. Autonomy in daily living activities and the
      degree of neurological compromission were periodically assessed with the Barthel
      Index and a neurological scale designed for hemiplegic subjects. The main
      features of the patients were also evaluated as a possible predictor of outcome.
      RESULTS: In a consistent percentage of the patients, significant gains in gait
      and daily living abilities were observed during the first year and, in individual
      cases, during the second year after stroke. At the end of the study, 74% of the
      patients regained their capacity to walk without assistance, and up to 79% had a
      Barthel Index score above 70. Sphincter function, level of neurological
      impairments, and capacity in daily living activities are significantly related to
      the outcome of the patients as a whole but were not useful to anticipate the
      outcome of each patient. CONCLUSIONS: These results suggest that disabled
      poststroke subjects may attain significative functional improvements in response
      to prolonged restorative therapy. However, the possibility of predicting the
      outcome of individual patients appears the major problem to solve in order to
      assign to long-term rehabilitation programs only patients who will benefit from
      the therapy.

PMID- 8342196
TI  - Rate of successful recording of blood flow signals in the middle cerebral artery
      using transcranial Doppler sonography.
AB  - BACKGROUND AND PURPOSE: To assess the usefulness of transcranial Doppler
      sonography, we investigated the rate of blood flow signal recording failure in
      the middle cerebral artery in Japanese subjects. Furthermore, we studied the
      effect of increased emitted power on the rate of successful recording in some of
      the patients in whom recording failure had been detected at the standard
      transducer power of 100 mW/cm2. METHODS: To evaluate the rate of successful
      recording, we measured blood flow signals in 597 patients (age range, 16 to 89
      years) for screening of cerebrovascular disease by using a 2-MHz range-gated,
      pulsed-wave Doppler instrument at the standard transducer power. In 18 elderly
      patients with recording failure at the standard power, we assessed the effect of
      increased emitted power of 400 mW/cm2 on flow signal recording. RESULTS: Blood
      flow signals were recorded in 920 (77.1%) of the 1194 middle cerebral arteries of
      the 597 patients studied. The rate of successful recording of bilateral middle
      cerebral artery flow signals (70.9%; 423 of 597 patients) decreased with age,
      especially in females (17.0% in women aged 70 years or older). In 12 of 18
      elderly patients with recording failure at the standard power, blood flow signals
      could be detected at the increased emitted power of 400 mW/cm2. CONCLUSIONS: The
      rate of successful recording of blood flow signals in Japanese subjects decreases
      with advancing age, especially in females. Increasing the emitted power markedly
      improves the successful recording rate.

PMID- 8342197
TI  - Color Doppler imaging of orbital arteries for detection of carotid occlusive
      disease.
AB  - BACKGROUND AND PURPOSE: Distal to a hemodynamically significant stenosis, the
      Doppler effect becomes dampened. Thus, measuring the flow profile in the
      ophthalmic artery and the central retinal artery with color Doppler imaging may
      provide hemodynamic information about the carotid circulation. METHODS: To
      validate the flow profile measurement with color Doppler imaging in the
      ophthalmic and central retinal arteries and to determine the sensitivity and
      specificity of this examination in the detection of hemodynamically significant
      carotid stenosis, we compared color Doppler imaging examinations with ocular
      pneumoplethysmography and ophthalmodynamometry examinations in 66 patients with
      atherothrombotic ischemic cerebrovascular disease. The degree of carotid stenosis
      in these patients was determined by a duplex scan with color Doppler imaging, and
      57 patients underwent angiography to verify the stenosis. RESULTS: The flow
      velocities (systolic peak velocity and end-diastolic velocity) and pulsatility
      indices (A/B ratio and resistance index) in the ophthalmic and central retinal
      arteries decreased as the degree of carotid stenosis increased. There is a
      statistically significant difference in the mean of systolic peak velocity and
      the mean of end-diastolic velocity of the ophthalmic and central retinal arteries
      among groups with various degrees of carotid stenosis (P < .02). Using the flow
      velocities of the ophthalmic and central retinal arteries to diagnose carotid
      stenosis (> or = 75% stenosis and occlusion), 8 cm/s for systolic peak velocity
      in the central retinal artery and 29 cm/s for systolic peak velocity plus flow
      direction reversal in the ophthalmic artery gave the maximum accuracy
      (sensitivities, 84% and 85.7% and specificities, 89.6% and 81.7%, respectively).
      The systolic peak velocity in the central retinal artery varied directly with the
      systolic pressure of the ophthalmic and central retinal arteries. CONCLUSIONS:
      The flow velocity and pulsatility in orbital arteries examined by color Doppler
      imaging provide further hemodynamic information; this test can be used to
      complement current sonographic examination of carotid disease.

PMID- 8342198
TI  - Use of neuroanesthesia adjuncts (hyperventilation and mannitol administration)
      improves neurological outcome after thoracic aortic cross-clamping in dogs.
AB  - BACKGROUND AND PURPOSE: Using a canine model of thoracic aortic cross-clamping,
      we compared the incidence and severity of paraplegia with and without standard
      neuroanesthesia adjuncts (mannitol administration and deliberate
      hyperventilation). Better outcome was predicted for animals treated with mannitol
      and hyperventilation. METHODS: Nineteen dogs (mean +/- SD weight, 21 +/- 3 kg)
      were anesthetized with methohexital to an isoelectric electroencephalogram.
      Animals were randomized to group C (control; n = 9) or group M (mannitol
      administration and deliberate hyperventilation; n = 10). In group C, animals were
      maintained normocapnic (PaCO2, 38 to 42 mm Hg). In group M, animals were
      hyperventilated to a PaCO2 of 28 to 32 mm Hg and received mannitol 2 g.kg-1
      during surgical preparation, then 1 g.kg-1.h-1 by continuous infusion. The
      thoracic aorta was cross-clamped for 30 minutes. Systemic hemodynamics,
      cerebrospinal fluid pressure, and arterial blood gases were measured at (1)
      baseline, (2) 2 minutes after cross-clamp, (3) 20 minutes after cross-clamp, (4)
      5 minutes after cross-clamp release, and (5) 30 minutes after resuscitation. No
      attempt was made to control the hemodynamic consequences of cross-clamping in
      either group. With release of the cross-clamp, PaCO2 was not controlled in group
      C; in group M the minute ventilation was further increased to maintain PaCO2
      constant. At precisely 24 hours after cross-clamp the animals were assessed for
      incidence and severity of paraplegia, using the Tarlov score, by an observer
      unaware of the experimental protocol. The animals were killed, and the entire
      spinal cord was removed for histological assessment. Multiple sections of the
      lumbar spinal cord were processed and stained with hematoxylin and eosin.
      RESULTS: With application of the cross-clamp, cerebrospinal fluid pressure and
      central venous pressure increased significantly in both groups. However, in group
      M the maximal mean cerebrospinal fluid pressure never exceeded baseline values in
      group C. With cross-clamp release, spinal cord perfusion pressure (distal mean
      aortic pressure minus mean cerebrospinal fluid pressure) was significantly
      greater in group M (86 +/- 23 vs 65 +/- 17 mm Hg; P = .0017 between groups). Acid
      base balance was better maintained in group M. The incidence and severity of
      paraplegia were significantly lower in group M (P = .043; Mann-Whitney rank-sums
      test, two-tailed). In this group 10 of 10 animals could walk and 4 of 10 had
      complete recovery. In group C 4 of 9 animals were paraplegic. There was a strong
      negative correlation between the Tarlov score and the ratio of dead to total
      anterior spinal cord neurons in the lumbar region as assessed by light microscopy
      (P = .0004; Spearman's rank test). CONCLUSIONS: We conclude that a protocol using
      standard neuroanesthesia adjuncts (mannitol administration and deliberate
      hyperventilation) is associated with improved neurological outcome after thoracic
      aortic cross-clamping of 30 minutes' duration in dogs anesthetized with
      methohexital.

PMID- 8342199
TI  - The effects of hypertension on cerebral atherosclerosis in the cynomolgus monkey.
AB  - BACKGROUND AND PURPOSE: There is substantial clinical, pathological, and
      experimental evidence that hypertension aggravates atherosclerosis of the
      extracranial vessels. The present study assesses the effects of hypertension on
      the development of cerebral atherosclerosis in nonhuman primates fed an
      atherogenic diet. METHODS: The extent and severity of cerebral atherosclerosis
      were evaluated morphologically, morphometrically, and biochemically in
      atherosclerotic monkeys with and without hypertension. Atherosclerosis was
      induced by feeding a hypercholesterolemic diet for 12 months; hypertension was
      produced by surgical coarctation of the thoracic aorta. RESULTS: At autopsy,
      gross atherosclerotic lesions of the major cerebral arteries were observed in 15
      of 16 atherosclerotic monkeys with hypertension compared with 5 of 16
      atherosclerotic animals without hypertension. In the hypertensive-atherosclerotic
      group, 38.5% of the vessels examined showed gross involvement compared with only
      3.4% of the vessels involved in the atherosclerotic group (P < .001). The lesions
      in the atherosclerotic group were generally mild, whereas those in the
      hypertensive-atherosclerotic group were severe and resulted in significant
      luminal narrowing and occlusion of vessels (P < .001). The small branches of the
      cerebral arteries also showed severe disease with luminal obstruction in the
      hypertensive-atherosclerotic group. The extent and severity of cerebral
      atherosclerosis were significantly related to the severity of the hypertension (P
      < .05). CONCLUSIONS: Hypertension is an important factor in cerebral
      atherosclerosis because of its accelerating effect on the disease. Nonhuman
      primate models may be useful in clarifying the role of hypertension and
      atherosclerosis in cerebral vascular disease.

PMID- 8342200
TI  - Postischemic (1 hour) hypothermia significantly reduces ischemic cell damage in
      rats subjected to 2 hours of middle cerebral artery occlusion.
AB  - BACKGROUND AND PURPOSE: We investigated the effect of hypothermia induced 1 hour
      after transient (2-hour) middle cerebral artery occlusion on the extent of
      ischemic cell damage in the rat. METHODS: Middle cerebral artery occlusion was
      induced extracranially by insertion of a nylon filament into the right internal
      carotid artery. Two groups of rats were investigated: (1) rats (n = 10) subjected
      to normothermic (37 degrees C) ischemia and normothermic reperfusion; and (2)
      rats (n = 10) subjected to normothermic ischemia and 1 hour of normothermic
      reperfusion followed by 3 hours of hypothermia (30 degrees C). All rats were
      killed 1 week after the experiment, and brain sections were stained with
      hematoxylin and eosin for evaluation of ischemic cell damage. RESULTS: Infarct
      volume in normothermic rats involved 20.9 +/- 4.6% of the hemisphere, whereas
      hypothermic rats exhibited a significantly smaller (P < .001) infarct volume of
      11.1 +/- 2.7%. The numbers of surviving (or structurally intact) neurons within
      large sections of the cortex and striatum were significantly greater for
      hypothermic compared with normothermic rats (P < .01). CONCLUSIONS: Our data
      suggest that postischemic induction of hypothermia significantly reduces ischemic
      cell damage after 2 hours of middle cerebral artery occlusion in the rat, and
      that an interval of time of at least 1 hour after ischemia exists in which
      hypothermic intervention is effective in either salvaging or postponing
      irreversible neuronal injury.

PMID- 8342201
TI  - Bilirubin levels in subarachnoid clot and effects on canine arterial smooth
      muscle cells.
AB  - BACKGROUND AND PURPOSE: Previous studies have suggested that bilirubin is a
      potential contributor to cerebral vasospasm. The purpose of this investigation
      was to determine whether bilirubin accrues in subarachnoid clot, whether its
      vasoconstrictive effect could involve a direct action on arterial smooth muscle
      cells, and, if so, whether bilirubin affects their Ca2+ uptake. METHODS:
      Subarachnoid clots were analyzed for bilirubin using high-performance liquid
      chromatography. The length and 45Ca2+ uptake of vascular smooth muscle cells
      enzymatically dissociated from canine carotid arteries were measured before and
      after exposure to bilirubin solution. Additional experiments were conducted on
      cultured smooth muscle cells from canine basilar artery and on ATP-depleted
      cardiac myocytes. RESULTS: Mean +/- SE bilirubin concentration in experimental
      clot was 263 +/- 35.7 mumol/L. Vascular smooth muscle cells exposed to bilirubin
      showed progressive shortening (P < .01) and an increased uptake of 45Ca2+ (P <
      .001). Contraction was prevented by Ca(2+)-free media but not by verapamil.
      Experiments with heart myocytes showed that bilirubin caused an increased uptake
      of 45Ca2+ but not of [14C]sucrose. CONCLUSIONS: The results indicate that
      bilirubin accrues in subarachnoid clot, that it exerts a direct constrictive
      effect on arterial smooth muscle cells, and that this effect is associated with
      an increased uptake of Ca2+. Studies on heart myocytes suggest that the Ca2+
      uptake induced by bilirubin could be due to a selective increase in membrane
      permeability to Ca2+.

PMID- 8342202
TI  - Transcranial Doppler detection of circulating cerebral emboli. A review.
AB  - BACKGROUND: The identification of gaseous emboli using Doppler ultrasound was
      described as early as the 1960s. Recently it has been demonstrated that this
      method can also detect solid emboli such as thrombi and platelet aggregates. This
      may make this technology useful in a large number of patients with, or at risk
      of, embolic stroke. SUMMARY OF REVIEW: Emboli appear as short-duration, high
      intensity signals in the Doppler spectrum. The intensity of the Doppler signal
      from an artery containing an embolus depends on the density difference between
      the embolic material and blood. This difference is greatest for gaseous emboli,
      which are therefore the most easy to detect. Gaseous emboli have been
      demonstrated during deep-sea diving, and their presence correlates with the
      occurrence of decompression sickness. Similar signals have been detected during
      cardiopulmonary bypass. A relation has been demonstrated between the number of
      emboli detected by transcranial Doppler and a decline in neuropsychological
      function after cardiopulmonary bypass. Solid emboli such as thrombi and platelet
      aggregates result in less intense signals than air emboli. Their detection, using
      Doppler ultrasound, has recently been described in patients with prosthetic heart
      valves, atrial fibrillation, and carotid artery disease. It may also help in the
      detection and localization of embolic sources in patients with stroke. Studies in
      in vitro and in vivo models demonstrate that this technique provides information
      on the size and type of emboli. Larger emboli produce signals of greater
      intensity and duration. Practical patient monitoring will require automatic
      emboli detectors incorporated into the Doppler machine; such programs are being
      developed. CONCLUSIONS: Detection of solid emboli using Doppler techniques offers
      an exciting new diagnostic tool. It has been demonstrated that the technique can
      detect solid emboli. The prognostic significance of such emboli remains to be
      determined. It is hoped that the technique will allow detection of patients at
      high risk of embolic stroke in whom appropriate prophylactic treatment can then
      be instituted.

PMID- 8342203
TI  - Aspirin: optimal dose in stroke prevention.

PMID- 8342205
TI  - Stroke triggered by an asthma attack.

PMID- 8342204
TI  - Increased 99mTc-HMPAO uptake in ischemic stroke.

PMID- 8342206
TI  - Chorea in a child with Churg-Strauss syndrome.

PMID- 8342207
TI  - Cerebrovascular events in cardiac catheterization.

PMID- 8342208
TI  - Magnetic resonance imaging in basilar artery dissection.

PMID- 8342209
TI  - An evaluation of postvention following adolescent suicide.
AB  - This study sought to evaluate postvention provided to two schools following
      student suicides. A risk index for suicidal behavior among exposed adolescents
      was devised. The index clearly differentiated high (n = 272) and low (n = 534)
      scorers on a range of outcome variables. While two-thirds of students attending
      postvention counselling had two or more putative risk factors for suicidal
      behavior, a further 231 uncounselled students had similar risk scores. Counselled
      students (n = 63) did not differ from matched controls (n = 63) at 8-month follow
      up on a range of outcome variables. Measures to improve future postvention are
      discussed.

PMID- 8342210
TI  - The relationship of drug use to suicide ideation and attempts among African
      American, Hispanic, and white non-Hispanic male adolescents.
AB  - This study presents self-report cross-sectional and longitudinal data on
      associations between drug use, suicide ideation, and attempts in a multiethnic
      sample of seventh- and eighth-grade male adolescents attending school in the
      greater Miami, Florida, area. African Americans had the highest prevalence of 6
      month ideation (20.5%), and Haitians had the highest attempts (11.4%). For the
      total sample, tranquilizers had the highest odds ratio for ideation (3.4), and
      PCP for attempts (6.2). Psychoactive drug-use was consistently related to
      attempts among Hispanics, white non-Hispanics, and African Americans.
      Acculturation strains interacted with cocaine and crack to predict suicide
      attempts among Hispanic respondents.

PMID- 8342211
TI  - The impact of a suicide prevention program for adolescents on suicidal
      tendencies, hopelessness, ego identity, and coping.
AB  - Three-hundred ninety-three adolescents from six schools participated in a study
      aimed at examining the effectiveness of an experiential suicide prevention
      program with regard to suicidal tendencies, hopelessness, ego identity, and
      coping ability. The subjects were randomly divided into experimental (n = 215)
      and control (n = 178) groups. The experimental groups took part in seven weekly 2
      hour meetings. The program was based on the notion that a gradual, controlled
      confrontation and exploration of inner experiences and life difficulties related
      to suicidal behavior accompanied by an emphasis on coping strategies can immunize
      against self-destructive feelings. In this pretest-posttest design, the students
      completed questionnaires of suicidal tendencies, hopelessness, ego identity, and
      coping ability before and after the program. The statistical analyses showed that
      the experimental groups were superior to the controls, with at least some of the
      dependent measures pointing out the effectiveness of the program.

PMID- 8342212
TI  - Double jeopardy: suicide rates in forensic hospitals.
AB  - While a number of studies have described high and increasing rates of completed
      suicide among psychiatric patients, the suicide risk of forensic hospital
      patients is virtually unknown. This paper reports on the suicides that have taken
      place in the country's oldest continually operating institution housing persons
      formerly labeled "criminally insane," the Bridgewater State Hospital. The results
      show considerable variation in the suicide rate by historical period, with
      suicide prior to 1968 a considerably more infrequent event. By contrast, the post
      '68 rate of 232 per 100,000 is comparable to data reported in a series of studies
      of psychiatric suicides, and significantly higher than that found in U.S. studies
      of correctional populations. These differences are discussed. The results
      strongly suggest that forensic hospital populations have suicide rates broadly
      comparable to other psychiatric populations.

PMID- 8342213
TI  - Hopelessness, depression, suicidal ideation, and clinical diagnosis of
      depression.
AB  - The relevance of a clinical diagnosis of depression for explaining the discrepant
      relationships of hopelessness and depression with suicidal ideation was studied.
      The Beck Depression Inventory (BDI), Hopelessness Scale (BHS), and the Scale for
      Suicide Ideation (SSI) were administered to 1,306 (72.8%) patients with at least
      one DSM-III-R mood disorder and 488 (27.3%) patients without any mood disorders.
      A multiple regression analysis was conducted, and hopelessness was 1.3 times more
      important than depression was for explaining suicidal ideation. The interactions
      of the BDI and BHS with diagnostic group were not significant.

PMID- 8342214
TI  - Control group studies of suicide survivors: a review and critique.
AB  - Empirical studies of suicide survivors with designs that include control groups
      are reviewed. Investigations are discussed individually with respect to those in
      which participating survivors are friends or a combination of many different
      relationships to the deceased, parents of the deceased child, and spouses.
      Following the review is a brief discussion of the commonalities of the findings
      and the most frequent methodological difficulties. Concluding comments suggest
      methodological improvements as well as issues and groups for which additional
      investigations are needed.

PMID- 8342215
TI  - Inpatient treatment planning.

PMID- 8342216
TI  - Characteristics of completed suicides: implications of differences among methods.
AB  - Approximately 30% of suicides in New York City are the result of jumping from a
      height. After describing jumping suicides and jumping sites, we used
      polychotomous logistic regression to compare the characteristics of suicides by
      jumping to those of individuals committing suicide by hanging, ingestion, or
      shooting. Method used was significantly associated with sociodemographics,
      occupation, and mental health status, even after adjustment for individual access
      to the means of committing suicide. Our finding of an independent association
      between personal characteristics and method used provides strong evidence for the
      hypothesis that controlling access to an agent of suicide can influence overall
      suicide rates, at least in the short term. Study results support the introduction
      of preventive programs to control access to commonly employed agents of suicide.

PMID- 8342217
TI  - Head trauma. Perioperative nursing implications.
AB  - 1. The highest mortality rate in the adult trauma patient population is among
      those presenting with acute head trauma and associated multiple trauma. 2. Motor
      vehicle crashes are the leading cause of head trauma, with alcohol being a
      primary associated factor. The other major mechanisms of head trauma are falls
      and assaults. 3. Secondary brain injury is a result of brain swelling and
      intracranial hemorrhage causing hypoxia and ischemia of the brain tissue. 4. The
      goals of surgical intervention are to evacuate intracranial hematoma and prevent
      increases in intracranial pressure.

PMID- 8342218
TI  - Orthopedic trauma: pelvic fracture.
AB  - 1. The incidence of pelvic fractures has greatly increased; automobile and
      motorcycle crashes, pedestrian accidents, and falls from great height are the
      most common causes. Pelvic fractures caused by high-energy trauma often result in
      significant morbidity and mortality with mortality rates variously reported at
      10% to 50%, dependent upon fracture classification and associated injuries.
      Mortality occurs from associated trauma to viscera, abdominal organs, and
      abdominal vessels, and from early complications of hemorrhage. 2. The difficulty
      in management of patients with pelvic fractures is determining whether fractures
      are stable or unstable. Single breaks with no displacement in the pelvic ring,
      which includes injuries to the ischium, ilium, pubis, and sacrum, are stable
      fractures and account for one third of all pelvic fractures. 3. Increasingly
      widespread use of surgical stabilization internally via rigid fixation of pelvic
      fractures has helped reduce the morbidity and mortality related to these
      fractures. Other benefits that have resulted include shortened hospitalization,
      decreased complications, and earlier mobility.

PMID- 8342219
TI  - Admission surgery: the patient with abdominal and thoracic trauma.
AB  - 1. Epidemiology may affect admission. It is essential to know what types of
      trauma patients are typically admitted, at what time of day, and on which day of
      the week. Within trauma systems, one of the major determinants of patient
      survival is the adequacy of surgical personnel and equipment resources. 2.
      Assessment of the abdominal and thoracic trauma patient is an active process,
      requiring constant curious attention. Due to the time-critical nature of these
      injuries, effective communication is paramount. There may be little or no
      documentation, and minimal verbal report, consisting of mechanism of injury and
      vital signs. A stable patient may rapidly deteriorate. 3. Injury severity and
      location are key in patients' mortality and morbidity. Outcomes for vascular
      injury surgeries depend on time lag, differences in surgeons' experience,
      associated injury, site of wounds, type of arterial lesions, and infection.

PMID- 8342220
TI  - Pediatric trauma: preparation and management.
AB  - 1. Trauma causes more than 50% of the deaths in children. The leading cause of
      pediatric injury is motor vehicle accidents involving children as passengers,
      pedestrians, or bicycle riders. 2. Trauma is always unexpected; therefore, the
      most vital aspect of any trauma system is that the system itself never be caught
      unprepared. Anticipation and preparation are the best first-line defenses against
      traumatic injury. 3. Because of a child's smaller size, vital organs are in close
      proximity to one another; multiple organ injuries are common. 4. The team who
      responds to a pediatric trauma should include nurses and physicians trained in
      principles of pediatric resuscitation.

PMID- 8342221
TI  - Microsurgical instrument handling systems. A new approach to instrument budget
      control.
AB  - 1. Large portion of a hospital's supply budget is allocated for repair and
      replacement of surgical instruments. Microsurgical instrumentation can account
      for 18% or more of a total OR budget. 2. Managing the surgical instrument repair
      and replacement budgets with greater emphasis on accountability can help
      demonstrate effective cost containment. Cost savings may be experienced through
      appropriate use of surgical instrument management systems for handling,
      sterilization, and storage of microsurgical instruments. 3. Many facilities are
      implementing quality control programs to minimize replacement and repair costs,
      to ensure surgical instrument integrity, and to extend the life of their
      investment. Education, management information systems, improved communication,
      and appropriate use of instrument handling systems are some components of budget
      accountability in the operating room.

PMID- 8342222
TI  - A perioperative nursing challenge: trauma in the OR.

PMID- 8342224
TI  - Business and nursing: interdependence?

PMID- 8342223
TI  - Preparing a nursing department for downshifting.
AB  - 1. Downshifting is a movement away from intense job attention and a focus toward
      the family. Many individuals in all parts of America are shifting their focus
      away from materialism and financial prosperity, and toward a simpler lifestyle
      and homelier values. This increasing focus on family--rather than career--can
      also be seen in nursing. 2. Motivation to downshift because of decreasing
      interest in career is less likely when the employee is a nurse. However, rising
      emphasis on the hazards of latchkey children and the need for quality parenting
      have increased nurses' concerns about the effect of being out of the home for
      extended periods. 3. With today's nursing shortage, personnel policies must be
      responsive to the priorities of the prospective job applicant. To be desirable,
      an employer must appear responsive to personal needs. The national trend to make
      positions more compatible with home responsibilities must be incorporated in
      personnel strategies if nurses are to remain in nursing positions and be
      satisfied.

PMID- 8342225
TI  - Safe practices key to preventing fires in the OR.

PMID- 8342226
TI  - When the manager shares work responsibility.
AB  - Delegation can be an effective tool for the OR manager in completing work
      activities in a more timely manner. A manager with skill in delegation can make
      the work environment a more positive and enjoyable place in which to work, while
      at the same time increasing productivity.

PMID- 8342227
TI  - OR resuscitation for trauma patients.
AB  - 1. The results of multiple studies have shown evidence that immediate access to
      the operating room has significantly contributed to improved outcome in several
      categories of trauma patients. 2. "Walk through" table top exercises were held in
      the OR suite to identify problems. These mock resuscitations were particularly
      helpful in solving logistical and equipment problems. 3. Prehospital care
      providers were given classes regarding triage criteria and operating room
      logistics. 4. Continuing education for OR and trauma nurses included videotape
      review and critique of ORR, trauma-specific inservice programs presented by the
      trauma coordinators and physicians, and attendance at weekly videotape review and
      trauma conference presented by the Division of Trauma. Easy recognition of
      individual team members, an important issue, required the use of name badges.

PMID- 8342228
TI  - Is white cell reduction cost-effective?

PMID- 8342229
TI  - Column agglutination technology: the antiglobulin test.
AB  - A new system for typing and screening blood, based on the sieving effect of glass
      bead microparticles, has been developed. The test is performed in a microcolumn
      in which the red cell agglutinates are trapped in the glass bead matrix during
      centrifugation, and unagglutinated cells form a pellet at the bottom of the
      column. Anti-human globulin reagents were incorporated in the diluent and the new
      test system, column agglutination technology, was compared to conventional tube
      tests and low-ionic-strength method. Sera and plasmas (228 samples) were screened
      for red cell antibodies with two anti-human globulin reagents: one containing
      only anti-IgG and the other containing both anti-IgG and anti-C3b, -C3d. After
      initial testing, there was 94-percent agreement between column agglutination
      technology and tube tests, and after repeat testing, there was 97-percent
      agreement. The column agglutination technology anti-human globulin test
      eliminates the need to wash red cells, which decreases the overall test time. The
      test is easy to perform, and the results are more objective than those with tube
      and microplate methods.

PMID- 8342230
TI  - Platelet crossmatches of single-donor platelet concentrates using a latex
      agglutination assay.
AB  - A latex agglutination assay was evaluated for the purpose of identifying
      compatible platelet donors for alloimmunized recipients. Assay reagents were
      prepared by adsorbing detergent-solubilized, donor-specific platelets to
      polystyrene latex beads. Semiquantitative results for up to 30 donors can be
      completed in less than 1 hour. These reagents retained their immunoreactivity for
      at least 3.5 months. A retrospective study has established the assay's upper
      limit of compatibility. The prospective study evaluated transfusions to a group
      of multiply transfused patients. Part I evaluated 143 crossmatched, single-donor
      platelet transfusions given to 50 patients. In 96 percent of the cases, a
      positive crossmatch was associated with an unsuccessful transfusion outcome; in
      84 percent of the transfusions, a negative crossmatch predicted a satisfactory
      platelet increment. The overall predictability, sensitivity, and specificity were
      87, 62, and 99 percent, respectively. Part II evaluated 105 transfusions given to
      the 43 patients (of 50) in whom no incidence of fever, sepsis, or bleeding could
      be documented. A positive crossmatch was 96-percent efficient in predicting an
      unsuccessful transfusion, whereas a negative crossmatch was associated with an
      adequate platelet increment following 89 percent of the transfusions. The overall
      predictability was 91 percent, the sensitivity was 72 percent, and the
      specificity was 99 percent. Within-run and between-run variations were 6.3 and
      6.2 percent, respectively. These results demonstrate that detergent-solubilized
      platelet antigens, immobilized on latex particles, can be used in a cost
      effective crossmatching procedure.

PMID- 8342231
TI  - Differential effect of cryopreservation on natural killer cell and lymphokine
      activated killer cell activities.
AB  - The use of lymphokine-activated killer (LAK) cell therapy in delayed treatment
      requires the use of cryopreserved effector cells. The purpose of this study was
      to determine the optimal cryopreservation protocol for the maintenance of
      cytotoxic activity in mononuclear cells (MNCs). MNCs were cryopreserved with
      dimethyl sulfoxide or 1,2-propanediol before and after 3 days of culture with
      recombinant interleukin 2. The effects of cryopreservation on cell recovery, LAK
      cell and natural killer (NK) cell cytotoxic activities, and surface antigen
      markers were studied. Recovery of nonactivated MNCs was higher with 1,2
      propanediol than with dimethyl sulfoxide (p < 0.05). Cytotoxic activities,
      measured with a 51Cr release assay, significantly decreased after thawing, on
      both activated cells (76.3%; range, 35.8-92.2%) and fresh cells (54.6%; range,
      17.5-75.4%). A 6-day kinetic test was used to compare the cytotoxic activity of
      cryopreserved and fresh cells. The results showed different patterns for NK cells
      (cryopreserved cells had lower levels of activity than fresh cells) and LAK cells
      (cryopreserved cells had higher levels of activity than fresh cells). Phenotype
      changes of effector cells in culture, with and without cryopreservation, were
      monitored by flow cytometry using monoclonal antibodies. These results were
      compared with changes in the cytotoxicity of cells with and without
      cryopreservation. After thawing, there was a decrease in MNCs expressing CD14 and
      CD56. Recovery of the CD56 marker correlates with increased cytotoxic activity.
      Despite some loss of NK cell activity, it is concluded that MNCs may be
      successfully cryopreserved before their use in immunotherapeutic treatment.

PMID- 8342232
TI  - Analysis of the expression of neutrophil-specific antigen NB1: characterization
      of neutrophils that react with but are not agglutinated by anti-NB1.
AB  - The neutrophil-specific NB antigen system has been serologically characterized
      with human alloantisera. Two alleles, NB1 and NB2, have been described. NB1 is
      expressed on a subpopulation of peripheral blood neutrophils in 97 percent of
      healthy donors. Human alloantibodies have been used to identify the 58- to 64-kDa
      glycoprotein (GP) on which NB1 is located. NB1 can usually be detected by both a
      granulocyte immunofluorescence (GIF) assay and a granulocyte agglutination (GA)
      assay, but neutrophils from some donors have been found to react with anti-NB1 in
      GIF but not in GA assays. To determine if the latter neutrophils express NB1 and
      the corresponding 58- to 64-kDa GP, these neutrophils were probed with rabbit and
      human sera specific for NB1. First, the proportion of neutrophils that express
      NB1 was quantitated. Neutrophils from donors that typed as NB1-positive in both
      GA and GIF assays were analyzed by flow cytometry with antisera to NB1. Human and
      rabbit anti-NB1 reacted with 71 +/- 17 percent and 70 +/- 17 percent of
      neutrophils, respectively. There was no difference in the expression of NB1 in
      NB1-homozygous and NB1-heterozygous individuals. In contrast, significantly fewer
      neutrophils from four donors that typed as NB1-positive in GIF assay but not GA
      assay reacted with human (27 +/- 12%; p < 0.001) and rabbit (26 +/- 12%; p <
      0.001) anti-NB1. When neutrophils from these same four donors were probed with
      rabbit and human anti-NB1 by immunoblotting and immunoprecipitation, the 58- to
      64-kDa GP was identified.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342233
TI  - Effect of storage time on clinical efficacy of single-donor platelet units.
AB  - Decrements in platelet function and recovery are known to accumulate during the 5
      day storage period, and the clinical response to platelets transfused after
      several days' storage has been suggested by some researchers to be less than that
      seen with platelets stored for shorter periods. The clinical response to single
      donor platelet (SDP) units (as measured by corrected count increments [CCIs] and
      intertransfusion intervals) was investigated in autologous bone marrow transplant
      patients. Twenty-seven consecutive autologous bone marrow transplant patients
      with a variety of hematologic and solid organ malignancies were evaluated for
      posttransfusion CCIs after 419 SDP transfusions of units stored for 1 to 5 days.
      Patients were not excluded from the study because of clinical condition, such as
      fever or sepsis. The mean 15-minute posttransfusion CCI for SDP units stored for
      only 1 day (11,006 +/- 5,157) was no different than that for units stored for 5
      days (10,225 +/- 4,481; p > 0.05); 24-hour posttransfusion CCIs were also not
      different if the SDP unit had been stored for 1 day or 5 days (6229 +/- 4489 vs.
      4786 +/- 2759; p > 0.05) or for any intermediate period. Nor were
      intertransfusion intervals affected by storage time. While platelets may exhibit
      a progressive lesion during the 5-day storage period, these changes do not result
      in a decreased clinical response.

PMID- 8342234
TI  - Cost-effectiveness of white cell-reduction filters in treatment of adult acute
      myelogenous leukemia.
AB  - The objective of this study was to compare the cost and cost-effectiveness of
      three transfusion strategies in the treatment of acute myelogenous leukemia: 1)
      the use of unfiltered pooled platelets until alloimmunization developed and of
      crossmatch-compatible single-donor platelets thereafter; 2) the use of filtered
      blood components until alloimmunization occurred and of crossmatch-compatible
      single-donor platelets thereafter; and 3) the use of single-donor platelets from
      the beginning. The data sources were English language articles on transfusion
      medicine in acute leukemia and the management of acute leukemia and review of the
      transfusion experience at the H. Lee Moffitt Cancer Center. The method was
      decision analysis with a software program for cost-effectiveness, sensitivity
      analysis, threshold evaluation, and Monte Carlo sensitivity analysis. In the
      basic models, the total costs of the first, second, and third strategies are,
      respectively, $12,557.14, $11,406.17, and $13,016.16 without bone marrow
      transplant and $14,002.72, $12,281.89, and $13,727.48 with bone marrow
      transplant. The threshold between the first and second strategies in regard to
      risk of refractoriness to filtered blood components and pooled platelets was 0.30
      and 0.27, respectively, without bone marrow transplant and 0.28 and 0.40 with
      bone marrow transplant. According to a Monte Carlo sensitivity analysis of 500
      samples, the second strategy is more cost-effective than the first in 76 percent
      of cases. It is concluded that the use of filtered blood components is unlikely
      to increase the cost of treatment.

PMID- 8342235
TI  - Changes in intention to donate blood under a hypothetical condition of reduced
      confidentiality.
AB  - Lawsuits related to transfusion-associated human immunodeficiency virus
      infections have increasingly resulted in requests for the release of confidential
      information about volunteer blood donors. Concern that loss of confidentiality
      might change blood donor behavior led to a survey of donors at collection sites
      within an American Red Cross Blood Services Region. Of the 361 respondents, 50.3
      percent (181) indicated reduced intent to provide accurate medical and personal
      history information under conditions of reduced confidentiality. Ten percent (34)
      indicated that they were not sure whether they would or would not donate blood in
      the future under this condition. The results indicate that the possibility of
      release of donors' medical and personal information may have a negative effect on
      the safety and adequacy of the nation's volunteer blood supply.

PMID- 8342236
TI  - Strategies to recruit plateletpheresis donors from a registry of HLA-typed,
      unrelated, bone marrow donors.
AB  - Rising demand for single-donor platelet components--from random donors, to
      maintain platelet inventories, or from HLA-compatible donors, to support
      alloimmune platelet-refractory patients--necessitated increasing the size of a
      community plateletpheresis donor registry. This study compares two strategies for
      recruiting whole-blood donors into a plateletpheresis program. The whole-blood
      donors who were asked to participate in this study had recently joined an
      unrelated bone marrow donor registry and had been HLA-typed as part of that
      process. An in-person recruitment strategy, which was time-intensive for the
      apheresis donor coordinator, served as the standard. A by-mail strategy involved
      the mailing of recruitment materials to marrow-donor registry participants.
      Marrow-donor registry participants were approached about apheresis participation
      after they had indicated an interest in the plateletpheresis program by returning
      a tear-off section of an informational brochure that was sent to them along with
      their marrow-donor registry materials. A total of 852 marrow-donor registry
      participants were randomly assigned to one of two recruitment strategies, and the
      recruitment rates were the same (46%) for both methods. In addition, levels of
      apheresis participation and attrition rates of donors recruited by either
      strategy were comparable. Thus, the simple strategy of mailing information about
      a plateletpheresis program is a very cost-effective method of recruiting donors.

PMID- 8342237
TI  - The effect of sterilization on transforming growth factor beta isolated from
      demineralized human bone.
AB  - Growth factors have been identified as the primary cause of osteoinduction in
      bone healing. Transforming growth factor beta (TGF-beta) has been shown to
      promote bone formation and is present in bone in high quantities. The aims of the
      present study were to isolate TGF-beta from human bone, demonstrate its biologic
      activity, and analyze the effects of conventional sterilization techniques on
      activity. Bone, obtained from femoral heads of five patients (mean age, 70 years)
      was ground, demineralized, and freeze-dried, and samples from each patient were
      divided into three groups: no treatment, sterilization with 1.60 to 1.94 Mrad of
      60Co irradiation, and sterilization with ethylene oxide (ETO). Carrier-free
      recombinant TGF-beta control was also treated and was totally inactivated by ETO
      but not by irradiation (p < 0.01). TGF-beta activity in demineralized bone was
      not significantly diminished (p > 0.1) by either sterilization procedure, and
      substantial amounts of active TGF-beta were recovered in all bone samples: 1.04
      +/- 0.77 ng per mg of protein in irradiated samples, 0.67 +/- 0.26 ng per mg in
      ETO-treated samples, and 1.04 +/- 0.33 in untreated samples, respectively (mean
      +/- SD). Although a recent report demonstrated that the osteoinductive activity
      of bone morphogenetic protein in bone powder is diminished considerably by ETO
      and by 2.5 Mrad of irradiation sterilization of bone powder, these data
      demonstrate that TGF-beta activity, with its osteoinductive properties, was not
      destroyed in more coarsely ground, demineralized bone by ETO or by lower doses of
      irradiation. These findings support the use of human bone allografts in clinical
      instances involving impaired bone formation.

PMID- 8342239
TI  - Hemolytic anemia associated with injection of fluorescein.
AB  - A 49-year-old woman presented with a hemoglobin level of 9.5 g per dL (95 g/L),
      reticulocyte count of 6.7 percent (0.067), and hemoglobinuria. The next day, the
      hemoglobin had dropped to 5.8 g per dL (58 g/L), and total bilirubin was 8.8 mg
      per dL (150 mumol/L). The serum reacted 2+ with all red cells (RBCs). The direct
      antiglobulin test (DAT) was 3+ with anti-IgG and 1+ with anti-C3, but eluates
      prepared by two different methods did not react with untreated RBCs. The eluate
      reacted 2+ with amoxicillin-coated RBCs; amoxicillin had been listed in the
      patient's record as a previous medication. The patient denied recent ingestion of
      amoxicillin. Further investigation documented the injection of a dye, fluorescein
      sodium (AK-FLUOR-25%), for a ophthalmologic fluorescein angiographic study 2 days
      before admission. RBCs coated with AK-FLUOR reacted with the eluate. Controls
      consisting of normal serum, an eluate prepared from DAT-negative RBCs, and a
      serum known to contain anti-penicillin did not react with AK-FLUOR-coated RBCs.
      Nine days later, the DAT was negative and the serum did not react with untreated
      RBCs. In the presence of AK-FLUOR (1-in-125) or amoxicillin (1 mg/mL), the serum
      reacted 2+ in the antiglobulin test. Antibodies to AK-FLUOR and amoxicillin
      appeared to react by two mechanisms, which is similar to results in recent
      reports of other drugs associated with hemolytic anemia. AK-FLUOR has not
      previously been reported to be associated with hemolytic anemia.

PMID- 8342238
TI  - Antibodies to hydrocortisone in reagent red cells causing positive antibody
      screening tests.
AB  - When a patient's serum contains a temperature-independent antibody reacting with
      all antibody screening and antibody identification panel cells but with few or no
      units of blood used for crossmatching, one should suspect an antibody against a
      constituent of the suspension medium of the reagent blood cells. This observation
      is confirmed by negative reactions with a) washed reagent cells or b) another
      manufacturer's cells that do not contain the same additives. Two patients are
      described with antibodies to hydrocortisone that are present in one
      manufacturer's antibody screening cells and identification panels. The
      hydrocortisone was added by the manufacturer to prevent hemolysis of the reagent
      red cells. The patient's antibodies were IgM, complement independent, and
      nonneutralizable by prior incubation with hydrocortisone. The addition of
      hydrocortisone to other manufacturers' reagents converted previously negative
      reactions to the same level of positivity as was seen with the reagent from the
      index manufacturer. Antibodies to reagent constituents can cause delays in
      finding compatible blood. It is suggested that manufacturers delete irrelevant
      additives or those of questionable necessity from their reagents.

PMID- 8342240
TI  - The specificity of enzyme immunoassays for antibodies to human immunodeficiency
      virus: impact on record and donor management.

PMID- 8342241
TI  - Guidelines for counseling human T-lymphotropic virus type I (HTLV-I)- and HTLV
      type II-infected persons.

PMID- 8342242
TI  - Ursodeoxycholic acid--new drug for liver diseases.

PMID- 8342243
TI  - Hydatid jaundice--an overview.

PMID- 8342244
TI  - Outcome of patients with pre-existing hepatitis B virus infection following renal
      transplant.
AB  - Twenty four patients who were HBsAg positive prior to renal transplantation were
      studied with respect to their hepatic and renal outcome. The kidneys in all
      patients were obtained from living related donors. The standard immunosuppressive
      therapy consisted of azathioprine and prednisolone. Post-renal transplant follow
      up varied from 32-86 months (mean 55 +/- 9). Renal functions, liver functions,
      HBsAg and HBsAb status was closely monitored during follow-up. One patient
      developed acute hepatitis four months after transplantation; this resolved in 10
      weeks. Four patients showed transient elevations of liver enzymes. The results of
      liver biopsy in 16 cases revealed, normal histology (8), virus in hepatocytes
      (5), and acute hepatitis (3). None of the patients had evidence of chronic liver
      disease. Two patients died due to chronic rejection/chronic renal failure and two
      patients died due to septicaemia. Five living patients have mild to moderate
      chronic rejection. It was concluded that pre-existing HBsAg carrier state in
      transplant patients had no deteriorating effect on the liver. The mortality was
      related to chronic rejection and septicaemia.

PMID- 8342245
TI  - The anatomy of an epidemic (the final report on an epidemic of multidrug
      resistant enteric fever in eastern India).
AB  - Two hundred and forty two patients of enteric fever were treated at Command
      Hospital (EC) Calcutta, during the period 1989-90. The mean age of the patients
      was 28.4 (range 2-60) years and 119 (49.2%) of them were males. Fever (100%),
      headache (55%), diarrhoea (25.2%), intestinal bleeding (2.9%) and icterus (3.7%)
      were the main presenting features. Blood cultures were positive in 216 (%)
      patients. A majority of the isolates were found to be resistant to all four
      commonly used drugs for enteric fever i.e. chloramphenicol, ampicillin,
      cotrimoxazole and furazolidone. The commonest phage type found in the resistant
      strains was 51 (biotype-1). Two plasmids of 14 and 120 kd size were detected in
      the resistant strains but not in the sensitive strains. Clinical response to
      gentamicin was not satisfactory in spite of all strains showing in vitro
      sensitivity. Ciprofloxacin proved to be a safe and effective drug for the
      treatment of multidrug resistant enteric fever.

PMID- 8342246
TI  - Pancreatic abscess: is there a role for conservative therapy?
AB  - Pancreatic abscess is a serious complication of acute pancreatitis and non
      operative management has been reported to carry a mortality of nearly 100%. We
      present five patients with pancreatic abscess, who were successfully treated with
      antibiotics alone. All 5 patients had acute pancreatitis followed by prolonged
      fever and development of an abdominal mass. The diagnosis was confirmed in each
      of them by a contrast enhanced CT scan and an ultrasound guided aspiration of pus
      from the pancreatic mass. The choice of antibiotics was decided by the culture
      reports in two cases and by Gram's staining in the remaining three patients. We
      attribute the success of antibiotic therapy in our patients to early diagnosis by
      CT scan and guided aspiration as well as the absence of any unfavourable risk
      factors. This study suggests that a select group of patients with pancreatic
      abscess may be managed conservatively with antibiotics.

PMID- 8342247
TI  - Amoebic liver abscess.
AB  - Sonography is a major advance in the diagnosis of ALA. Identification of amoebic
      antigen in the pus is a specific immunodiagnostic test. Medical therapy with a
      single drug (metronidazole) is adequate in most instances. Routine needle
      aspiration or surgical drainage are not indicated. The abscess cavity may take up
      to 18 months for resolution and demonstration of such a lesion does not warrant
      repeated therapy unless clinical evidence of recurrence is present. Recurrences
      are rare. Clinical and laboratory evidences of poor prognosis are being
      identified, and may guide the treatment modality to be selected.

PMID- 8342248
TI  - Long common channel syndrome as etiology of choledochal cysts and pancreatitis-
      two instructive cases.
AB  - The aetiology of choledochal cysts is controversial. The authors report two cases
      of Type I C and Type IV B choledochal cysts; both showing axial dilatation of the
      common bile duct and common hepatic ducts, single fusiform (Type IC) and multiple
      cysts of extrahepatic ducts only (Type IVB). Both had anomalous junction of the
      pancreaticobiliary ductal system as delineated on ERCP leading to the formation
      of a long common channel. Both these female patients presented in the third
      decade of life with 7-8 years history of repeated episodes of right upper
      abdominal and epigastric pain suggestive of pancreatitis. Similar pain was
      precipitated in both patients following ERCP with raised serum amylase. Hepatico
      enterostomy gave lasting relief in both these patients.

PMID- 8342249
TI  - Can DNA aneuploidy study make surveillance colonoscopy more cost effective.

PMID- 8342250
TI  - Pathophysiology of incomplete renal tubular acidosis in recurrent renal stone
      formers: evidence of disturbed calcium, bone and citrate metabolism.
AB  - Urinary acidification, bone metabolism and urinary excretion of calcium and
      citrate were evaluated in 10 recurrent stone formers with incomplete renal
      tubular acidosis (iRTA), 10 recurrent stone formers with normal urinary
      acidification (NUA) and 10 normal controls (NC). Patients with iRTA had lower
      plasma standard bicarbonate after fasting (P < 0.01) and lower urinary excretion
      of titratable acid (P < 0.05) and citrate (P < 0.01) compared with NUA patients
      and NC, and higher urinary excretion of ammonia (P < 0.05) compared with NC (P <
      0.05). Hypercalciuria was found in 6 of 10 patients with iRTA compared with 3 of
      10 with NUA, and 0 of 10 NC. The citrate/calcium ratio in urine was significantly
      reduced in iRTA compared with the value in NUA (P < 0.01), and in NUA compared
      with NC (P < 0.05). Biochemical markers of bone formation (serum osteocalcin) and
      bone resorption (urinary hydroxyproline) were significantly increased in iRTA
      compared with NUA and NC (P < 0.01), indicating increased bone turnover in stone
      formers with iRTA. Stone formers with iRTA thus presented with disturbed calcium,
      bone and citrate metabolism--the same metabolic abnormalities which characterize
      classic type 1 RTA. Mild non-carbonic acidosis during fasting may be a
      pathophysilogical factor of both nephrolithiasis and disturbed bone metabolism in
      stone formers with iRTA.

PMID- 8342251
TI  - Calcium phosphate: an important crystal phase in patients with recurrent calcium
      stone formation?
AB  - Stone and urine composition were analysed in 75 men and 40 women with recurrent
      calcium oxalate stone disease (group R) and in 48 men and 19 women who had formed
      only one calcium-oxalate-containing stone (group S). Patients who had developed
      stones with a large fraction of calcium phosphate were significantly more
      frequent in group R than in group S. There was furthermore a higher excretion of
      calcium and higher calcium oxalate supersaturation levels in patients with stones
      containing more than 25% calcium phosphate. It was concluded from these
      observations that the calcium phosphate content of renal stones might be a useful
      factor in predicting the future course of the disease.

PMID- 8342252
TI  - Solubility, inhibited growth and dissolution kinetics of calcium oxalate crystals
      in solutions, containing hippuric acid.
AB  - An analysis of crystal growth and dissolution of slightly soluble salts in
      physiological solutions in the presence of complexing ions was carried out,
      simulating conditions typical in human urine. It was found that hippuric acid, a
      normal physiological constituent of urine, acts at increased concentrations as a
      dissolving agent with respect to calcium oxalate (CaOx) and CaOx calculi. The
      kinetics of dissolution of crystalline CaOx calculi in physiological solutions
      containing hippuric acid at different concentrations were studied, using the
      change in the Archimedean weight of samples immersed in the solution. Analysis of
      the experimental results enabled the determination of the increased solubility of
      CaOx in the presence of hippuric acid and the quantitative characterization of
      this substance as a new and promising agent for dissolving CaOx calculi in human
      urine. The possible effect of hippuric acid as a natural regulator of CaOx
      supersaturation and crystallization in human and mammalian urine is also
      discussed.

PMID- 8342253
TI  - Heparin sulfate in the stone matrix and its inhibitory effect on calcium oxalate
      crystallization.
AB  - The nature of the soluble stone matrix and its possible role in urinary stone
      formation was studied. For this purpose we performed two-dimensional cellulose
      acetate membrane electrophoresis of the glycosaminoglycans (GAGs) which were
      contained in the soluble stone matrix, substances adsorbed onto calcium oxalate
      crystals in vitro (crystal surface binding substances, CSBS) and urinary
      macromolecules (UMMs). The main GAG in the soluble stone matrix and CSBS was
      found to be heparan sulfate, whereas the UMMs contained various GAGs usually seen
      in urine. An inhibition assay showed the soluble stone matrix to have the
      strongest inhibitory activity among these macromolecular substances when
      inhibitory activity was expressed in terms of uronic acid concentration. It is
      suggested that the main GAG in the soluble stone matrix consists of heparan
      sulfate, which has a strong inhibitory activity on calcium oxalate crystal growth
      and aggregation and constitutes part of the CSBS.

PMID- 8342255
TI  - Urodynamic evaluation and electrical and pharmacologic neurostimulation. The rat
      model.
AB  - We introduce a rat model that allows simultaneous or independent recording of
      bladder and sphincteric activity. Via a polyethylene tube inserted into the
      bladder dome, bladder pressure is measured in response to constant intravesical
      saline perfusion. The electrical activity of the intra-abdominal urethra (a well
      defined striated muscular tube which, in the rat, constitutes the external
      urethral sphincter) is recorded simultaneously with an electromyography needle
      electrode. Thus, precise statements can be made about detrusor/sphincter
      interrelationships. Changes in urodynamic parameters with the anesthetics
      urethane, methoxyflurane (Metofane), and thiobutabarbital sodium (Inactin) were
      investigated. High-frequency oscillations in intraluminal bladder pressure could
      be demonstrated during micturition cycles only in rats anesthetized with urethane
      or Metofane. As this high-frequency activity is generated by the striated muscle
      of the intra-abdominal urethra, the external sphincter of the rat is the force
      behind urine expulsion. The anesthetic Inactin combined with a low intravesical
      perfusion rate attenuated spontaneous bladder and sphincteric activity and
      abolished micturition cycles. This rat model can provide accurate and
      reproducible measurements of urodynamic changes in response to electrical
      stimulation of the pelvic and pudendal nerves and pharmacologic stimulation with
      neuropeptides at the lumbosacral spinal cord level. We recommend using this model
      with urethane or Metofane for physiologic studies of micturition and with Inactin
      for meticulous neuropharmacologic and electrostimulatory evaluation of urodynamic
      parameters.

PMID- 8342254
TI  - Assessment of high-energy phosphorus compounds in the rat kidney by in situ 31P
      nuclear magnetic resonance spectroscopy: effect of ischemia and furosemide.
AB  - 31P nuclear magnetic resonance (NMR) spectroscopy of the in situ rat kidney was
      performed by a surface coil method, and the effects of ischemia and furosemide
      infusion were assessed. 31P NMR spectra of the kidney subjected to 30 min of
      ischemia returned completely to the pre-ischemic level after 60 min of
      reperfusion. But the 31P NMR spectra after 60 min of ischemia did not recover,
      even after 120 min of reperfusion. Levels of beta-ATP and inorganic phosphate
      (Pi) decreased and the chemical shift of Pi increased after intravenous infusion
      of furosemide. This increase in chemical shift might signal an alkalotic change
      in intracellular pH. Furosemide infusion prior to ischemia is thought to protect
      the kidney from injury induced by 60 min of warm ischemia. The chemical shift of
      Pi returned to the pre-ischemic level earlier than beta-ATP and Pi. In
      conclusion, according to the findings of 31P NMR spectroscopy, furosemide
      infusion prior to ischemia may be effective in protecting the kidney against
      ischemic injury. But the change in Pi peak and the causes of the dissociation of
      Pi and beta-ATP should be examined further.

PMID- 8342256
TI  - Inhibitory effects on in vitro cell growth of human urothelial tumor cell lines
      under the combined administration of hematopoietic growth factors and clinically
      relevant antineoplastic agents.
AB  - In five of eight human transitional carcinoma cell (TCC) lines a proliferative
      response has been reported during exposure to interleukin-3 (IL-3), granulocyte
      macrophage colony stimulating factor (GM-CSF) and granulocyte colony stimulating
      factor (G-CSF). To elucidate possible growth-modulating effects of these factors
      combined with clinically relevant antineoplastic agents, cells of the human TCC
      lines EJ28 and T24 were exposed to methotrexate (MTX), vinblastine (VBL),
      doxorubicin (DXR) and cisplating (CDDP) with and without single or continuous
      exposure to IL-3, GM-CSF and G-CSF at concentrations of 1-100 ng/ml. Compared
      with cells exposed only to chemotherapy, significant inhibitory effects occurred
      as a result of continuous exposure to IL-3 or GM-CSF at the highest activities
      with CDDP and MTX in the T24 and EJ28 lines; continuous G-CSF administration (100
      ng/ml) in combination with MTX led to significant growth inhibition in the EJ28
      line. In contrast, no significant growth modulation was found on combined
      administration of DXR or VBL with any one of the three colony stimulating factors
      tested.

PMID- 8342257
TI  - A bioresorbable urethral stent. An experimental study.
AB  - The aim of the present study was to examine the suitability of biodegradable
      polymers as materials for a urethral stent. A new urethral stent made of
      biodegradable self-reinforced poly-L-lactide (SR-PLLA) was implanted in 16 male
      rabbits after urethrotomy. Seven stents of stainless steel served as controls.
      The dimensions of the two types of stents were identical: length 15 mm, diameter
      8.2 mm. The mechanical construction was a helical spiral. The SR-PLLA spiral was
      sustained with three microspirals, and the whole device was coated with DL
      lactide to achieve an active initial tissue reaction and better tissue
      penetration. The SR-PLLA stent showed more favourable implantation properties
      than the steel one. Within 6 months all PLLA stents had implanted, and the tissue
      reaction around the stent material was minimal. The helical spiral of stainless
      steel induced a remarkable inflammatory reaction due to poor implantation
      properties. We suggest that biodegradable SR-PLLA is a promising material for a
      urethral stent to prevent re-stenosis of urethral strictures.

PMID- 8342258
TI  - Isolation and in vitro translation of messenger RNA encoding allergens of the cat
      flea, Ctenocephalides felis.
AB  - Polyadenylated [poly(A)+] mRNA was isolated from the cat flea, Ctenocephalides
      felis by oligothymidylic acid-cellulose spin column chromatography and translated
      in vitro using a cell-free rabbit reticulocyte system. The relative incorporation
      of 35S-methionine into trichloroacetic acid-precipitable translation products
      obtained using poly (A+) mRNA was 48.5-fold over control translations performed
      without added mRNA. SDS-PAGE analysis of the translation products in combination
      with autoradiography showed that many proteins with apparent molecular weights in
      the range 14-90 K were synthesized. Immunoprecipitation studies performed using
      flea-allergic dog sera showed that several of the synthesized proteins
      corresponded with flea allergens. The allergenicity of the lysates was also
      confirmed by skin testing.

PMID- 8342259
TI  - Immune cell distribution in the small intestine of the pig: immunohistological
      evidence for an organized compartmentalization in the lamina propria.
AB  - Using monoclonal antibodies in immunohistochemistry, the distribution of the
      cells with the following surface antigens was studied in samples of proximal and
      distal small intestine of five 6-month-old pigs: CD2, CD4 (helper/inducer T
      cells), CD8 (suppressor/cytotoxic T cells), accessory cell marker
      (monocyte/granulocyte), MHC Class II (DRw), and interleukin 2 (IL-2) receptor.
      CD2+ cells were found in high numbers in both the epithelium and the lamina
      propria. More cells were demonstrated in villis than in crypts (proportion
      approximately 4:1). At least two subpopulations of intraepithelial lymphocytes
      were identified: apically in the epithelium there were CD2+CD4-CD8- (double
      negative) cells, whereas cells expressing CD8 marker were concentrated around the
      basement membrane. CD4+ cells were localized in the lamina propria towards the
      villus core. Accessory cells were distributed in crypts and the villus base and
      more cells were found in ileum than in duodenum. In contrast, MHC Class II+ cells
      were located predominantly in villi, just underneath the basement membrane,
      forming a sheath of cells between the CD8+ and the CD4+ cells. Cells expressing
      IL-2 receptor were sparse but widely distributed in both the lamina propria and
      the epithelium. This organized cell distribution may be related to the physiology
      of the mucosal immune system in the gut.

PMID- 8342260
TI  - Purification and characterization of IgG1 and IgG2 from buffalo (Bubalus bubalis)
      serum and colostrum.
AB  - Buffalo IgG1 and IgG2 were purified from serum and colostrum using salt
      precipitation, dialysis, gel filtration and ion-exchange chromatography. Their
      purity was monitored by immunodiffusion and immunoelectrophoresis using anti
      heavy chain specific sera and SDS-PAGE. Selective binding of IgG2 to protein-A
      was used to remove IgG2 from IgG1 preparations. The IgG1 and IgG2 had a molecular
      mass (Mr) of 162.0 and 161.5 kD, respectively and were found to consist of heavy
      (H) and light (L) chains. The H and L chains had Mr of 58 and 24 kD,
      respectively. Reduction-alkylation followed by gel filtration was used for the
      isolation of H and L chains. While intact H chains were obtained, the L chains
      appeared to be cleaved into 14 kD molecules and smaller fragments. The mean
      hexoses content of the serum IgG1 and IgG2 was 1.81 +/- 0.02% and 0.70 +/- 0.02%,
      respectively. The corresponding values for colostral IgG1 and IgG2 were 1.76 +/-
      0.01% and 0.78 +/- 0.08%. Both the IgG subclasses activated homologous
      complement. These results suggest that buffalo and cattle IgG subclasses have
      many common characteristics and minor differences.

PMID- 8342261
TI  - Quantification of antibody secreting cells to Yersinia ruckeri by ELISPOT assay
      after in vivo and in vitro immunization of rainbow trout (Oncorhynchus mykiss).
AB  - The ELISPOT assay was applied for the quantification of total and specific
      antibody secreting cells (ASC) in spleen after in vitro immunization and in head
      kidney and blood after in vivo immunization of rainbow trout with Yersivax
      vaccine. The highest number of total and specific anti-Yersinia ruckeri ASC was
      obtained on Day 21 after in vivo immunization and on Day 10 after in vitro
      immunization of spleen.

PMID- 8342262
TI  - Treatment of B-cell lymphoma using peptides. A novel concept.
AB  - Combination chemotherapy remains the major current treatment of non-Hodgkin's
      lymphoma. B-cell lymphoma often has tumor-specific surface immunoglobulins called
      idiotypes. Clinical trials using murine monoclonal anti-idiotype antibodies as a
      targeting approach have shown some success. I describe a novel concept of using
      idiotype-specific peptides as an alternative targeting approach for the treatment
      of B-cell lymphoma. In brief, octapeptides that bind to the surface idiotype of
      the B-cell lymphoma are isolated from a large synthetic peptide library (10(6) to
      10(7) peptides). Once the sequence of a tumor-specific octapeptide ligand is
      defined, large quantities can be synthesized and conjugated with a radionuclide
      (such as iodine 131). This should permit highly specific destruction of lymphoma
      cells that bind the labeled peptide. The theoretic advantages of this approach
      over the previous use of anti-idiotype antibodies are addressed.

PMID- 8342263
TI  - Human T-lymphotropic virus type I seroprevalence among Japanese Americans.
AB  - The epidemiology of human T-lymphotropic virus type I (HTLV-I) infection is not
      well defined in Japanese Americans. This impairs using approaches that could
      reduce viral transmission and monitor carriers for the disease. Using enzyme
      linked immunosorbent assay and p21e recombinant Western blot testing, HTLV-I
      antibody was measured in unlinked samples from Japanese-American patients at 4
      physicians' offices in San Francisco, California. Of 442 patients, 4 (0.9%; 95%
      confidence interval 0.25%, 2.3%) were confirmed seropositive, all with an HTLV-I
      rather than an HTLV-II pattern on Western blot. Seroprevalence was highest among
      the issei or immigrant generation (3/230 or 1.3%) compared with the second
      generation nisei (1/191 or 0.5%) or third-generation sansei (0 of 17). Prevalence
      did not differ by age or sex, although the number of positive subjects in each
      subgroup was small. Of 88 patients with familial origins in endemic areas of
      southern Japan, none were seropositive. In this sample of Japanese Americans,
      HTLV-I seroprevalence was lower than in residents of endemic southern Japan but
      higher than among American blood donors. The prevalence was most similar to that
      in nonendemic areas of Japan. The public health implications of HTLV-I infection
      among Japanese Americans are discussed.

PMID- 8342264
TI  - Effect of preoperative suggestion on postoperative gastrointestinal motility.
AB  - Autonomic behavior is subject to direct suggestion. We found that patients
      undergoing major operations benefit more from instruction than from information
      and reassurance. We compared the return of intestinal function after intra
      abdominal operations in 2 groups of patients: the suggestion group received
      specific instructions for the early return of gastrointestinal motility, and the
      control group received an equal-length interview offering reassurance and
      nonspecific instructions. The suggestion group had a significantly shorter
      average time to the return of intestinal motility, 2.6 versus 4.1 days. Time to
      discharge was 6.5 versus 8.1 days. Covariates including duration of operation,
      amount of intraoperative bowel manipulation, and amount of postoperative
      narcotics were also examined using the statistical model analysis of covariance.
      An average savings of $1,200 per patient resulted from this simple 5-minute
      intervention. In summary, the use of specific physiologically active suggestions
      given preoperatively in a beleivable manner can reduce the morbidity associated
      with an intra-abdominal operation by reducing the duration of ileus.

PMID- 8342266
TI  - 34-year-old woman with hypotension, respiratory failure, fever, and an abdominal
      mass.

PMID- 8342265
TI  - Barriers to prenatal care for low-income women.
AB  - Inadequate prenatal care is associated with poor birth outcomes. Recognizing
      barriers to care is necessary to improve results. Postpartum in-hospital
      interviews were conducted with women admitted through emergency departments with
      no physician of record (n = 69) in 8 Sacramento hospitals during April and May
      1991. A focus group of local obstetrician-gynecologists was used to determine
      physicians' attitudes about caring for low-income women. We undertook the study
      in response to an increased number of "no doc" births. The inability to find a
      physician willing to accept them was reported by the women as the single largest
      barrier to obtaining care, cited by 64% of women overall and 96% of those who
      tried but were unable to obtain care. Transportation difficulties were a problem
      regardless of women's success in obtaining care and were ranked as the top
      barrier by women who never tried to obtain care. Physicians cited administrative
      difficulties and reimbursement levels of Medi-Cal plus extra care requirements
      and resource dependency of low-income patients as barriers to caring for this
      population. The value ascribed to prenatal care by women and physicians'
      perceptions of women's attitudes about care contrasted sharply. The link between
      poor women and physicians providing obstetric services can be fragile. The
      difficulty finding physicians willing to take them indicates that these women
      need special support services to ensure adequate care during pregnancy.

PMID- 8342268
TI  - Estrogen replacement therapy for reducing cardiovascular disease.
AB  - The Council on Scientific Affairs of the California Medical Association presents
      the following inventory of items of progress in general and family practice. Each
      item, in the judgment of a panel of knowledgeable physicians, has recently become
      reasonably firmly established, both as to scientific fact and important clinical
      significance. 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
      these items of progress in general and family practice that have recently
      achieved a substantial degree of authoritative acceptance, whether in their own
      field of special interest or another. The items of progress listed below were
      selected by the Advisory Panel to the Section on General and Family Practice of
      the California Medical Association, and the summaries were prepared under its
      direction.

PMID- 8342267
TI  - Antiplatelet therapy--Part II.
AB  - We summarize current information about aspirin and other antiplatelet drugs in
      patients with cardiac and vascular disease. For each indication, we briefly
      summarize the rationale for the use of antiplatelet therapy and describe the
      findings of relevant clinical trials. We propose recommendations for the use of
      these agents in clinical practice. In Part 2, we discuss the use of antiplatelet
      agents in coronary angioplasty, atrial fibrillation, artificial cardiac valves,
      stroke, and peripheral vascular disease. In Part 1, we reviewed the use of
      antiplatelet therapy for the primary and secondary prevention of myocardial
      infarction, in conjunction with coronary thrombolysis, in patients with unstable
      and chronic stable angina, and following coronary artery-saphenous vein bypass
      grafting.

PMID- 8342269
TI  - Sleeping position and sudden infant death syndrome.

PMID- 8342270
TI  - Outpatient management of asthma.

PMID- 8342271
TI  - Practical approach to diagnosing and treating sinusitis.

PMID- 8342272
TI  - Health and medical care of homeless persons.

PMID- 8342273
TI  - Practice guidelines movement.

PMID- 8342274
TI  - Universal hepatitis B childhood vaccinations.

PMID- 8342275
TI  - Increased surgical options for dysfunctional uterine bleeding.

PMID- 8342276
TI  - Changing guidelines for screening mammography.

PMID- 8342277
TI  - Acute dilated cardiomyopathy as a cluster in children.

PMID- 8342278
TI  - Overcoming the limitations of chemotherapy in the treatment of B-cell non
      Hodgkin's lymphomas--an approach using radiolabeled peptide ligands.

PMID- 8342279
TI  - Ileus and ignorance.

PMID- 8342280
TI  - Reserpine and thiazide for hypertension--an inexpensive therapy for older
      patients.

PMID- 8342281
TI  - Assessing CME needs assessment.

PMID- 8342282
TI  - Otitis externa and facial cellulitis from Oriental ear cleaners.

PMID- 8342283
TI  - Future directions in sickle cell disease.

PMID- 8342284
TI  - Singapore's solution to health care costs.

PMID- 8342285
TI  - The burden of reform falls again to the states.

PMID- 8342286
TI  - Leadership or lordship?

PMID- 8342287
TI  - Medical billing system.

PMID- 8342288
TI  - Suicide among Wisconsin elderly.
AB  - Suicide can be one of the most tragic events possible for an individual and
      family. Suicide, especially among the elderly, evokes very strong sentiments.
      "Assisted death," "death with dignity," "rational suicide for reasons of age," "a
      person's right to die," "euthanasia," and "mercy killing" are some of the phrases
      used to characterize one's own position or the position of those with opposing
      opinions. This article examines Wisconsin death certificate data for the years
      1985 through 1990.

PMID- 8342289
TI  - Verbal communication with cuffed tracheotomy.

PMID- 8342290
TI  - White House meeting 'positive for physicians'.

PMID- 8342291
TI  - Trends in stroke mortality in Wisconsin: progress toward achieving the year 2000
      objective.

PMID- 8342292
TI  - The effects of Medicare and Medicaid reimbursement on the financial viability of
      clinics and physician practices in medically under-served areas of Wisconsin.
AB  - A survey of 21 physicians and clinic managers located in Health Professional
      Shortage Areas (HPSAs) and other under-served areas in Wisconsin found that to
      combat increasing costs, Medicare and Medicaid discounts, charity care demands
      and physician recruitment difficulty, several practices rely on outside sources
      of funding to remain financially viable. Also, the financial viability of
      physician practices in under-served areas of Wisconsin is threatened more by the
      reimbursement rates of Medicaid and Medicare than by the provision of charity
      care. Though few are limiting the number of Medicare and uninsured patients they
      will treat, many practices have begun implementing cost-containment measures,
      including more strict collection policies. There are also indications of
      restricted access for Medicaid patients at some sites.

PMID- 8342293
TI  - Wisconsin physicians reach out to Nicaraguan children.

PMID- 8342294
TI  - John Randolph Currens, MD: 1855-1921.

PMID- 8342295
TI  - Metabolism of thiodiglycol (2,2'-thiobis-ethanol): isolation and identification
      of urinary metabolites following intraperitoneal administration to rat.
AB  - 1. The metabolism of thiodiglycol, 2,2'-thiobis-ethanol, was investigated
      following i.p. administration to rat. 2. Approximately 90% of the administered
      dose was excreted in the 0-24-h urine. Four metabolites were isolated by h.p.l.c.
      and identified by mass spectrometry. Structural assignments were confirmed by
      comparison with authentic synthetic standards. 3. Thiodiglycol sulphoxide was the
      major metabolite accounting for approximately > or = 90% of the excreted
      radioactivity following i.p. injection of 13C4, 35S-thiodiglycol. Thiodiglycol
      sulphone, S-(2-hydroxyethylthio)acetic acid and S-(2-hydroxy
      ethylsulphinyl)acetic acid were identified as minor metabolites. 4. Analysis for
      thiodiglycol by GC-MS indicated approximately 0.5-1% of the applied dose was
      excreted unmetabolized.

PMID- 8342296
TI  - Disposition of prednisolone in the course of subclinical fascioliasis in sheep.
AB  - 1. The in vivo disposition of prednisolone in sheep was studied before, during
      and after recovery from experimental hepatitis of parasitical origin
      (fascioliasis). 2. After i.v. administration, plasma clearance of prednisolone
      was increased from 0.93 +/- 0.13 l/kg per h before infection to 1.73 +/- 0.50
      l/kg per h at week 21 post-infection. The steady state volume of distribution was
      increased from 0.45 +/- 0.08 l/kg during the control period to 1.26 +/- 0.44 l/kg
      at week 5 post-infection. 3. None of the prednisolone binding parameters
      (specific and non-specific sites) was modified, and the overall mean unbound
      fraction was 24%. 4. Urinary excretion of unchanged prednisolone was low and only
      a trace of 6 beta-hydroxy-prednisolone was identified.

PMID- 8342297
TI  - On the metabolism of haloperidol.
AB  - 1. p-Fluorobenzoyl-propionic acid, 4-(4-chlorophenyl)-4-hydroxy-piperidine, and
      reduced haloperidol were confirmed as metabolites of haloperidol. Their formation
      was catalysed by hepatic microsomes and was NADPH dependent. 2. The pyridinium
      metabolite of haloperidol (HP+) was identified. It is proposed that haloperidol
      first undergoes dehydration to form its 1,2,3,6-tetrahydropyridine analogue
      (HTP). HTP is then further metabolized to HP+, HTP N-oxide and its N-dealkylated
      product, 4-chlorophenyl-1,2,3,6-tetrahydropyridine (CPTP). HTPN-oxide was
      metabolized to CPTP and HTP. All these metabolites were confirmed by comparison
      with synthesized compounds using h.p.l.c. and h.p.l.c.-mass spectrometry. 3.
      Three unknown metabolites were present in microsomal metabolic incubations of
      haloperidol. One of them was tentatively characterized by h.p.l.c.-mass
      spectrometry as an oxygenated product of haloperidol, another appears to be the 2
      pyridine analogue of haloperidol. The third metabolite was shown to be a neutral
      compound of unknown structure, which was not haloperidol N-oxide nor 4-hydroxy-4'
      fluorobutyrophenone. In addition, HTP was metabolized to a further unknown
      product with a similar u.v. spectrum to that of HTP. 4. The identification of
      these metabolites led to the hypothesis that the metabolism of haloperidol is
      similar to that of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and may
      therefore produce motor neurone toxicity by a similar mechanism.

PMID- 8342298
TI  - Studies on the metabolism of a monoterpene ketone, R-(+)-pulegone--a hepatotoxin
      in rat: isolation and characterization of new metabolites.
AB  - 1. The metabolic disposition of R-(+)-pulegone (I) was examined in rats following
      four daily oral doses (250 mg/kg). 2. Six metabolites, namely pulegol (II), 2
      hydroxy-2-(1-hydroxy-1-methylethyl)-5-methylcyclohexanone (III), 3,6-dimethyl-7a
      hydroxy-5,6,7,7a-tetrahydro-2(4H)-benzofuranone (IV), menthofuran (V), 5-methyl-2
      (1-methyl-1-carboxyethylidene)cyclohexanone (VI), and 5-methyl-5-hydroxy-2-(1
      hydroxy-1-carboxyethyl)cyclohexanone (VII) have previously been isolated from rat
      urine, and identified (Moorthy et al. (1989a). Eight new metabolites have now
      been isolated from rat urine, namely, 5-hydroxy-pulegone (VIII), piperitone (IX),
      piperitenone (X), 7-hydroxy-piperitone (XI), 8-hydroxy piperitone (XII), p-cresol
      (XIII), geranic acid (XIV) and neronic acid (XV). These were identified by
      n.m.r., i.r. and mass spectrometry. 3. Based on these results, metabolic pathways
      for the biotransformation of R-(+)-pulegone in rat have been proposed.

PMID- 8342299
TI  - Fungal biotransformation of organophosphines.
AB  - 1. The biotransformations of triphenyl phosphite and of triphenyl-, tri-n.-butyl
      , diethylphenyl-, and ethylmethylphenyl-phosphines by the fungi Mortierella
      isabellina ATCC 42613, Helminthosporium species NRRL 4671, and Aspergillus
      foetidus ATCC 10254, have been examined. 2. The triaryl and tri-n.-butyl
      substrates underwent oxidation at phosphorus in low yield, a process attributed
      largely to auto-oxidation under the experimental conditions used. 3. The alkyl
      aryl phosphines were enzymically oxidized at phosphorus, but concurrent auto
      oxidation also occurred. 4. Incubation of ethylmethylphenyl phosphine with M.
      isabellina gave the corresponding S(-) phosphine oxide in a 92% yield with an
      enantiomeric purity of 13%.

PMID- 8342300
TI  - Enantiomer-enantiomer interaction of a uricosuric antihypertensive diuretic
      (DBCA) in renal tubular secretion and stereoselective inhibition by probenecid in
      the cynomolgus monkey.
AB  - 1. Enantiomer-enantiomer interaction of 5-dimethylsulphamoyl-6,7-dichloro-2,3
      dihydrobenzofuran-2-carboxyl ic acid (DBCA), a uricosuric, diuretic and
      antihypertensive agent, was studied from the pharmacokinetics of the enantiomers
      following intravenous injection of individual enantiomers and racemate into male
      cynomolgus monkeys. Also studied was the involvement of the anion transport
      system in the renal excretion of DBCA by comparison of the pharmacokinetics in
      probenecid-treated and non-treated animals. 2. Separate administration of
      individual enantiomers showed higher plasma concentrations of (S)(-)-DBCA than
      those of the antipode, at an early period after dosing. Both enantiomers
      disappeared rapidly from plasma with an elimination half-life (t1/2 beta) of 0.35
      0.38 h. Unbound fractions were 18.9% for the (R)(+)-enantiomer and 10.2% for the
      (S)(-)-enantiomer. The major portion of both enantiomers was excreted by 6 h
      after dosing and 77-78% of the dose was recovered within 48 h, principally as the
      unchanged drug. Tubular secretion contributed significantly to the renal
      excretion of DBCA, because tubular secretion clearance values of unbound drug
      (CLrf,s) were 14- to 29-fold greater than creatinine clearance. 3. The presence
      of the antipode decreased the tubular secretion clearance (CLrf,s) value of
      unbound (S)(-)-enantiomer by 30%, and tended to decrease that for the unbound
      (R)(+)-enantiomer, although not significantly. This indicates the occurrence of
      enantiomer-enantiomer interaction in the process of renal tubular secretion, and
      the inhibition of (S)(-)-DBCA renal excretion in the presence of the antipode. 4.
      Probenecid treatment significantly decreased the CLrf,s of both enantiomers, and
      the extent of inhibition for the (S)(-)-enantiomer (53%) was significantly higher
      than that for the antipode (14%). These results show that renal tubular secretion
      of DBCA involves an anion transport system which prefers the (S)(-)-enantiomer,
      and that probenecid can preferentially inhibit (S)(-)-enantiomer secretion.

PMID- 8342301
TI  - Biological fate of sulphur mustard (1,1'-thiobis(2-chloroethane)): uptake,
      distribution and retention of 35S in skin and in blood after cutaneous
      application of 35S-sulphur mustard in rat and comparison with human blood in
      vitro.
AB  - 1. During the 6-h occluded cutaneous application of 35S-sulphur mustard vapour to
      rat, most of the dose, approximately 75%, passed through the skin and was
      systemically-distributed. Up to 25% of the 35S was retained in the skin, up to
      30% was excreted in the urine and 5-8% was present in the blood, by the end of
      the application. 2. 35S initially declined rapidly in skin and then more slowly
      with a half-life of approximately 7.4 days. Some of the early loss was as sulphur
      mustard vapour from a possible depot of this compound which was larger with
      increase in dose. There was some apparent continuing uptake from such a depot
      into the systemic circulation. 3. The decline of 35S in blood was much slower
      than that from skin. About one-fifth of the original post-exposure level in the
      blood still present 6 weeks later. 4. The 35S in blood was mainly in the red cell
      contents as reaction products of haemoglobin with sulphur mustard. Its
      persistence in the systemic circulation, after an initial rapid decline due to
      its removal from the plasma, reflected the 65 day life span of these cells.
      Significant levels of 35S were found in the plasma only for a few days (t1/2 =
      2.4 days). 5. Uptake and subsequent distribution of 35S in rat and human blood in
      vitro during gradual exposure to 35S-sulphur mustard using a novel method were
      similar. 35S in the red cells was associated mainly with the haemoglobin protein,
      but slightly greater binding with human, rather than with rat, plasma components
      was indicated.

PMID- 8342302
TI  - Report of the Validation and Technology Transfer Committee of the Johns Hopkins
      Center for Alternatives to Animal Testing. Framework for validation and
      implementation of in vitro toxicity tests.
AB  - The development and application of in vitro alternatives designed to reduce or
      replace the use of animals, or to lessen the distress and discomfort of
      laboratory animals, is a rapidly developing trend in toxicology. However, at
      present there is no formal administrative process to organize, coordinate, or
      evaluate validation activities. A framework capable of fostering the validation
      of new methods is essential for the effective transfer of new technological
      developments from the research laboratory into practical use. This committee has
      identified four essential validation resources: chemical bank(s), cell and tissue
      banks, a data bank, and reference laboratories. The creation of a Scientific
      Advisory Board composed of experts in the various aspects and endpoints of
      toxicity testing, and representing the academic, industrial and regulatory
      communities, is recommended. Test validation acceptance is contingent upon broad
      buy-in by disparate groups in the scientific community-academics, industry and
      government. This is best achieved by early and frequent communication among
      parties and agreement upon common goals. It is hoped that the creation of a
      validation infrastructure composed of the elements described in this report will
      facilitate scientific acceptance and utilization of alternative methodologies and
      speed implementation of replacement, reduction and refinement alternatives in
      toxicity testing.

PMID- 8342303
TI  - [100 years of Zeitschrift fur Orthopadie].
AB  - The article affords insight into the one hundred years' history of the Journal of
      Orthopedics. The existing 130 volumes reflect the change in the orthopedic
      spectrum of illness, diagnostic investigation and treatment. Already in its first
      few years of existence, the journal was a forum for international exchange.
      Investigation of various epochs showed that the editors applied strict scientific
      standards in selecting the publication, despite basis changing historical
      conditions. They were able to prevent political interventions appreciably
      influencing the character of the journal. At the same time, the negative effects
      which the two world wars and National Socialism had on the further development of
      orthopedics become evident. The extent to which, as a result of these, the
      development of orthopedics fell behind international development could only be
      overcome in the last few decades.

PMID- 8342304
TI  - [Ultrasonography of the spine in infancy].
AB  - QUESTION: Based on a standardized technic and reliable attachment of the
      presented structures the suitability of spinal sonography as a screening-method
      in newborns and infants should be estimated. METHODS: Enabled by the comparison
      of sonographic transverse and sagittal plains with identical anatomic sections of
      an infant corpse the anatomic structures of an healthy spine were associated,
      which was verified in the clinical use later on. RESULTS: Exemplary photographs
      of a collective of 50 newborns and infants reproduce the presentation of the
      spine found in the preparation of the corpse. The technical practicability of
      such an examination in clinical use was confirmed herein and it became clear that
      the application of this method is limited from the 6.-8. months of living on
      because of the increasing ossification which involves a reduction of the image
      quality. The deviations from the spine presentation in normal relations were
      shown by some ultrasound examples of malformed spines (spinal dysraphism,
      hemivertebrae). CONCLUSION: Reproducible attachment of the structures obviously
      seen with ultrasound and the clear demarcation of deformations as well as the
      simply practicable examination make evident the suitability of spinal sonography
      in newborns and infants as a noninvasive screening for the exclusion of spine
      malformations.

PMID- 8342305
TI  - [Dysphagia as a symptom of a ventral cervical prolapsed disk].
AB  - Ventral osteophytes, which occur frequently, usually cause no symptoms. They are
      sometimes identified as the cause of dysphagia. Cervical disc prolapses which
      cause symptoms of dysphagia are far less common. This paper describes a patient
      with dysphagia in whom ventral cervical disc prolapse was finally diagnosed by MR
      tomography, after she had been through a "diagnostic odyssey". The result was
      subsequently confirmed at surgery. The relevant literature is also reviewed.

PMID- 8342306
TI  - [The value of diskography in disk-related pain syndrome of the cervical spine for
      evaluation of indications for spondylodesis].
AB  - In this study the postoperative results of patients with cervical spondylodesis
      for "discogenic pain syndrome" were evaluated. The diagnosis "discogenic pain
      syndrome" as well as the pathologic segments were confirmed by cervical
      discography. However interpretation of the discogram as "positive" was only
      considered reliable when typical pain provocation through discography correlated
      with pathologic disc pattern ("functional test"). 38 cervical segments have been
      found to fulfill these criteria and were fused in 29 operative procedures (21
      unisegmental, 7 bisegmental, one trisegmental). The patients were evaluated
      postoperative for change of symptoms, pain character and intensity, neurological
      deficits, working and sporting disability and mobility of cervical spine.
      According to the criteria of Simmons and Segil 73% of the patients showed a good
      to excellent result. A fair result was found in 23.2% and an unsatisfactory
      result was seen in 3.8%. In the literature a good to excellent outcome is seen in
      30 to 46% in similar patients groups after cervical fusion without preoperative
      assessment by discography.

PMID- 8342307
TI  - [10-year follow-up of C3-C7 cervical laminectomy for intramedullary grade I
      astrocytoma].
AB  - In an eight years old boy we operated an intramedullary astrocytoma grade I and
      reimplanted the laminae C4-7 en bloc. A good stability was achieved. Ten years
      later only one segment remained intact, the others showing spontaneous fusion as
      a major draw back. This is possibly due to subperiostal dissection and bracing.
      No spinal stenosis occurred. An overuse of the remaining disc C4/5 might lead to
      a secondary degenerative stenosis. The operation is simple and might avoid swan
      neck deformity in children after large decompression of dorsal structures.

PMID- 8342308
TI  - [Initial experiences with subcutaneous Harrington distraction without
      spondylodesis in scoliosis].
AB  - We report on a special method in the treatment of scoliosis using subcutaneous
      Harrington-distraction without spondylodesis. We operated 14 patients in all who
      were between 7 and 12 years old, in average 10 2/12 years Indication is made if
      scoliosis is extremely progressive, if Cobb's measure is above 50 degrees, after
      unsuccessful conservative treatment also including orthosis and physiotherapy, or
      if patients appeared to late in our department. In this technique only two
      incisions to make are necessary to place the Harrington roots to the cranial and
      caudal end of the scoliosis curve. The Harrington root can be 'needled' in
      subcutaneously. When in times of further growth the amount of correction gets
      noticeably lost the cranial hook could be tightened or the Harrington root could
      be changed easily. We need an orthosis (Cheneau or Milwaukee) for after treatment
      until in a final operation with spinal fusion is made. This method has showed
      good results although we had to cope with a bad prognostic starting position.

PMID- 8342309
TI  - [Comparative biomechanical studies following automated percutaneous nucleotomy
      and diskotomy].
AB  - APLD is considered as the last step of conservative treatment for lumbar disc
      herniation assuming that a negative biomechanical effect of APLD is not expected.
      Biomechanical effects of APLD were investigated in comparison to open discectomy.
      APLD decreased disc height less than open discectomy and increased instability
      and flexibility less. The position of the center of rotation was not
      significantly altered.

PMID- 8342310
TI  - [Long-term results following percutaneous facet coagulation].
AB  - 93 patients with a mean follow up of 73 months (30-133 months) after lumbar
      percutaneous radiofrequency denervation (PRFD) were evaluated. Mean age of the
      patients at time of surgery was 47 years (18-76 years). 54 patients had no lumbar
      spine surgery prior to facet denervation, 32 patients had one or multiple disc
      surgery prior to denervation, and 7 patients had spinal fusions. 51 patients were
      in the process of early retirement or already retired at time of surgery. Out of
      all 93 patients only 50% had significant pain relief immediately after PRFD. 3
      months after PRFD the success rate dropped down to 38%. 6 years after surgery
      only 25% of all patients had long lasting good results. Patients who were pain
      free after facet infiltration had significant better initial results, but were
      similar to the others after 6 years. 6 out of 7 patients after lumbar spinal
      fusions demonstrated bad results. The worst results had those patients who had
      applied for early retirement (workmens compensation cases). In this group the
      recurrence rate was 74% 6 years after surgery. We found no correlation between
      the surgeon and the outcome. CLINICAL RELEVANCE: Without pain reduction after
      facet infiltration the success rate after PRFD is low. Spinal surgery prior to
      PRFD significantly reduces the success rate. The worst prognosis have workmans
      compensation cases. The recurrence rate is high within the first 6 months after
      PRDF.

PMID- 8342311
TI  - [Effects of inflammation-induced spinal fusion of the lumbar area on movement of
      the lumbar spine].
AB  - Lateral x-rays of the lumbar spine in standing position and functional flexion
      extension roentgenograms of 21 patients with spontaneous fusion within the lumbar
      area after spondylitis were checked related to kyphosis of the block, lordosis
      and mobility of the lumbar spine and the single discs, and the appearance of
      degenerative spondylolisthesis. 76% demonstrated degenerative spondylolisthesis
      of the neighbouring discs, the half of them more than 5 mm with a significant
      higher number of segmental loosening of the disc caudal to the fusion. The kind
      of instability is a pseudo-spondylolisthesis (Junghans 1930) above and a
      retrolisthesis below the fused area. No higher mobility (no significant
      difference of mobility between the two cranial and the two caudal discs) can be
      seen as cause of this behaviour. The increased lordosis of the caudal segments is
      discussed to be the cause of the retrolisthesis distal the fusion. Altogether,
      kyphosis of the fused area leeds compensatory to a higher grade of lordosis in
      the mobile part of the lumbar spine without reaching the physiological lordosis
      of total lumbar spine. Kyphosis of the block does not influence mobility of the
      discs or the total lumbar spine, but increases significantly the rate of
      degenerative spondylolisthesis in the vicinal segments. These results suggest the
      operative reduction of lumbar lordosis in cases of kyphotic spondylitic
      destruction within the lumbar or thoracolumbar region in younger patients.

PMID- 8342312
TI  - [Spinal surgery on patients with myelomeningocele. Results 1971-1990].
AB  - Between 1971 and 1990 33 kyphectomies were performed at the Orthopaedic Hospital,
      University of Heidelberg. The average age at time of surgery was 5 years/5
      months; the follow-up period was 5 years. The best results were obtained in the
      group with congenital rigid kyphosis. A marked postoperative deterioration was
      considered in patients with a flexible paralytic kyphosis, probably due to a too
      short area of fusion. In 19 patients the correction of the kyphotic deformity was
      the prerequisite for being provided with orthotic devices. The most serious
      complication was the intraoperative death of 3 patients. It can be presumed, that
      after transection of the spinal cord a non-functioning CSF-shunt lead to an acute
      elevation of the intracranial pressure. Therefore an adequately functioning shunt
      must be secured preoperatively.

PMID- 8342313
TI  - [Does geometry of the lumbosacral inclination have an effect on the etiology of
      isolated osteochondrosis of L5/S1?].
AB  - Men and women with isolated osteochondrosis L5/S1 (excluding transitional
      anomalies) were compared against a corresponding group of healthy volunteers to
      see whether there is any geometric or statistical evidence that might constitute
      predisposing factors for isolated osteochondrosis L5/S1. Arithmetic means,
      variances, standard deviations, and correlation coefficients were calculated for
      all the characteristics determined for the two groups. Multiple linear
      discriminant analysis was used to try to reproduce any classifications our
      groupings of the characteristic bearers on the basis of their characteristics. It
      was found that the position of the sacrum in the pelvis and the extent of lumbar
      lordosis play a major role. To detect a predisposition for isolated
      osteochondrosis L5/S1, it is thus necessary to evaluate: the position of the
      sacrum with regard to the pelvis and the degree of lumbar lordosis-excluding that
      of the fifth lumbar vertebra-in the angle system. This evaluation can be
      performed by measuring the dorsal inclination of the sacrum (the delta angle) and
      the Albrecht inclination.

PMID- 8342314
TI  - [Assessment of surgically treated vertebral fractures of the thoracic and lumbar
      spine without neurological complications].
AB  - The progress of surgical treatment of spine fractures leads to new problems in
      the assessment of these patients. Possible consequences of this treatment are
      discussed (especially approach-caused faults in muscle or pulmonary function).
      Beside the length and localisation of the fusion the strain on the adjacent
      movement segments have to be considered. The different function of the different
      regions of the spine is also represented. The possible "MdE" is discussed under
      consideration of the above criteria.

PMID- 8342315
TI  - [A case of bilateral isolated talonavicular synostosis in childhood--observations
      of tarsal joint function and functional adaptation of the proximal ankle joint].
AB  - A rare case of bilateral isolated coalition of the talonavicular joint with ball
      and socket ankle joint is presented. Range of motion of the subtalar joint and
      hindfoot mobility were measured intraoperatively. The following conclusions may
      be drawn on development and function of the ankle joint complex: Isolated
      talonavicular synostosis in the growing foot results in marked impairment of
      subtalar range of motion. The development of a ball and socket ankle joint may be
      caused thereby, if tarsal hypomobility becomes effective at an early stage of
      growth.

PMID- 8342316
TI  - [The tripod support of the foot. An analysis of pressure distribution under
      static and dynamic loading].
AB  - A "tripod" loading of the human foot, as it is mentioned in some textbooks, was
      not found in a pressure distribution study with 111 adults. For bipedal standing
      as well as walking peak pressures beneath the 3rd metatarsal head were
      substantially higher than under the metatarsal heads I and V. Correlation
      analyses demonstrated that the pressure distribution during standing reveals only
      little information about the dynamic loads under the foot during gait. Gender
      differences in the load bearing behavior of the foot as well as significant
      correlations of peak pressures towards body weight and foot contact area were
      found.

PMID- 8342317
TI  - [Assessment of congenital foot deformities].
AB  - The assessment of congenital foot deformities is only relevant in the context of
      German legislation (SchwbG) defining disability and fitness for military service.
      All assessments of congenital foot deformities should be based on the twin
      concepts of function and capacity to withstand stress. However, assessments with
      regard to the degree of disability and fitness for military service will
      occasionally differ. This article discusses the various congenital foot
      deformities individually, allocating them to the respective degrees of disability
      [as laid down in German law]. The classification may serve as a guide for
      consultants within the context of disability legislation and for ascertaining
      fitness for military service in accordance with the "Central Standing Orders" of
      the Federal German armed forces.

PMID- 8342318
TI  - Comparison of humoral immune responses to trivalent influenza split vaccine in
      young, middle-aged and elderly people.
AB  - A total of 296 volunteers in five different groups were immunized with one dose
      of the commercial 1991-1992 trivalent split influenza vaccine formulation
      A/Singapore/6/86 (H1N1), A/Beijing/353/89 (H3N2) and B/Yamagata/16/88. The groups
      differed in age (young adults, middle-aged and elderly) and history of previous
      vaccination. Antibodies were determined in pre- and postvaccination sera by
      haemagglutination inhibition assay and the results were evaluated as geometric
      mean titre, mean fold antibody increase, protection and response rates. No
      significant age-related differences among the protection rates were found. The
      proportion of vaccinees with antibodies > or = 40 ranged between 70 and 95%.
      Compared with the H3N2 and B components the antibody response to the H1N1
      component was low. Residents of a nursing home fully vaccinated the previous year
      developed 7.6-8.4-fold antibody increases and showed 96-100% protection rates.

PMID- 8342319
TI  - Studies on reactogenicity and immunogenicity of attenuated bivalent cold
      recombinant influenza type A (CRA) and inactivated trivalent influenza virus (TI)
      vaccines in infants and young children.
AB  - Fifty-two infants seronegative to or without prior infection with influenza type
      A viruses were enrolled in a study to evaluate reactogenicity and immunogenicity
      of three bivalent cold recombinant type A (CRA) and two trivalent inactivated
      influenza (TI) vaccines. Controls consisted of infants receiving normal saline by
      nose drops (Pli.n.) or intramuscularly (Pli.m.). CRA and TI vaccines were
      monitored for local and systemic reactions after vaccination. Serum specimens
      obtained prior to and 6 weeks postvaccination were analysed for neutralizing
      antibody to influenza H1N1 and H3N2 viruses. CRA vaccines and Pli.n. recipients
      had similar numbers of acute respiratory infections and comparable rates of
      illnesses during the trial. Significantly fewer CRA vaccinees without an
      intercurrent viral infection had fever (0/16 versus 4/10, p = 0.04) and cough
      (4/16 versus 9/10, p = 0.002) than CRA vaccinees with a confirmed intercurrent
      viral infection. Recipients of TI vaccine and Pli.m. did not develop reactions at
      the injection site. For each of the CRA vaccines tested, a dominant CRA virus was
      identified. The dominant CRA viruses were isolated from a greater number of
      infants or for a longer duration than the non-dominant CRA viruses. All 14 non
      dominant CRA viruses were recovered from infants within the first week after
      vaccination; 24 of 77 dominant CRA viruses were recovered more than 7 days after
      vaccination. The immunogenicity of CRA vaccines was not affected by a confirmed
      intercurrent viral infection or low titres of influenza-specific
      antibody.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342320
TI  - Correlation of antibody titres induced by vaccination with protection in mouse
      typhoid.
AB  - The ELISA method was used to titrate the humoral immune response in vaccinated
      mice. When mice were given two doses of a heat-killed salmonella vaccine 6 days
      apart, there was a steady but low-level increase of antibody synthesis. In
      contrast, if a booster vaccination was administered 21 days after the primary
      inoculation, the anamnestic response produced a significantly greater antibody
      titre, rapidly reaching its peak within 10 days. Such a heightened humoral
      response induced in the genetically susceptible C57BL/6J mice also coincided with
      effective protection against an otherwise lethal challenge with Salmonella
      typhimurium.

PMID- 8342321
TI  - Single capripoxvirus recombinant vaccine for the protection of cattle against
      rinderpest and lumpy skin disease.
AB  - A recombinant capripoxvirus has been constructed containing a full-length cDNA of
      the fusion protein gene of rinderpest virus. The gene was inserted in the
      thymidine kinase gene of the capripox genome under the control of the vaccinia
      virus major late promoter p11 together with the Escherichia coli gpt gene in the
      opposite orientation under the control of the vaccinia early/late promoter p7.5.
      A vaccine prepared from this recombinant virus protected cattle against clinical
      rinderpest after a lethal challenge with a virulent virus isolate. In addition,
      the vaccine protected the cattle against lumpy skin disease.

PMID- 8342322
TI  - Protection of mice from inhaled ricin by vaccination with ricin or by passive
      treatment with heterologous antibody.
AB  - Mice were vaccinated subcutaneously with 25 micrograms kg-1 of ricin in the
      presence of Freund's complete adjuvant or Ribi adjuvant, followed by a boost 14
      days later with 50 micrograms kg-1 ricin in Freund's incomplete adjuvant or Ribi
      adjuvant, respectively. Three subsequent boosts at 28-day intervals with 25
      micrograms kg-1 ricin yielded high anti-ricin antibody titres as determined by
      ELISA. Vaccinated animals were exposed to an aerosolized LD99 dose of ricin. With
      the exception of one death not attributable to ricin intoxication, all vaccinated
      mice survived the lethal aerosol exposure. In addition, a passive protection
      regimen was evaluated in mice pretreated with 100 micrograms purified goat anti
      ricin IgG administered intravenously, and then challenged with ricin
      intravenously. All were resistant to 125 micrograms kg-1 of ricin, a dose greater
      than 25 times the intravenous lethal dose. Mice injected intravenously with 5 mg
      of the same IgG were protected from a lethal aerosol challenge. These results
      indicated that it is possible to protect animals from inhaled ricin by
      vaccination or passive administration of specific antibodies.

PMID- 8342323
TI  - Immunogenicity of wild-type and vaccine strains of Japanese encephalitis virus
      and the effect of haplotype restriction on murine immune responses.
AB  - The Chinese live attenuated Japanese encephalitis (JE) virus vaccine clone SA14
      14-2 produced in primary hamster kidney (PHK) cells has been adapted to primary
      dog kidney cells (PDK) for use as a live attenuated human vaccine. In this study
      we have compared the immunogenicity in mice of SA14-14-2 (PDK) and SA14-14-2
      (PHK); also included was the wild-type parent to the vaccine clones, SA14, and
      another wild-type JE virus strain Nakayama (original). It was found that Balb/c
      (H-2d) mice given a single dose of 10(3) or 10(6) p.f.u. of live SA14-14-2 (PHK)
      virus elicited a superior neutralizing (N) antibody response as compared to the
      same dosages of live SA14-14-2 (PDK) virus. However, if the vaccine clones were
      inactivated and administered in a two-dose regime the N antibody response
      elicited was similar for the two viruses. This observation may be explained by
      differences in the replication efficiency in vivo of the respective vaccine
      clones. The humoral immune response to all the virus strains in this study
      elicited by different inbred mouse strains each carrying a discrete haplotype
      (Balb/c (H-2d), C3H (H-2k), C57BL/6 (H-2b)) were also assessed using
      haemagglutination inhibition (HAI) and N assays. Viruses were shown to elicit
      patterns of high and low N-antibody response depending on the major
      histocompatibility complex (MHC) make-up of the mouse strains. However, the
      patterns did not necessarily coincide when HAI and N titre reactivity patterns
      were compared for the same virus strain.

PMID- 8342324
TI  - Clinical and serological evaluation of a Pasteurella haemolytica A1 capsular
      polysaccharide vaccine.
AB  - The purified capsular polysaccharide (CPS) of Pasteurella haemolytica A1 was
      examined for its ability to protect cattle from experimental challenge with
      logarithmic-phase P. haemolytica. Several preparations of P. haemolytica antigens
      were utilized in the experiment including CPS, log-phase P. haemolytica culture
      supernatant, P. haemolytica recombinant leucotoxin (rLKt) and various
      combinations of the above. CPS alone or in combination with culture supernatant
      or rLkt elicited no protection; rather, administration of CPS was associated with
      a high incidence of anaphylaxis (36% of calves). Although a classical biphasic
      humoral immune response to CPS could be detected in all calves that received this
      compound, this T-dependent response was not correlated with resistance to
      experimental challenge. The complexity of protective immunity in pneumonic
      pasteurellosis is emphasized by this study, and clinical anaphylaxis associated
      with response to CPS may be implicated in the pathogenesis of disease.

PMID- 8342325
TI  - Expression of a recombinant Entamoeba histolytica antigen in a Salmonella
      typhimurium vaccine strain.
AB  - The expression of a major surface antigen of the intestinal protozoal parasite
      Entamoeba histolytica in an attenuated Salmonella typhimurium vaccine strain is
      described. A polymerase chain reaction fragment derived from cDNA encoding the
      serine-rich Entamoeba histolytica protein, SREHP, was introduced into S.
      typhimurium chi 3987 (delta cya delta crp delta asd) using a plasmid expression
      vector (pYA292) containing the aspartate semialdehyde (asd) gene. S. typhimurium
      expressing recombinant SREHP as a SREHP/maltose binding protein fusion protein
      was administered orally to mice and gerbils (an important animal model for E.
      histolytica infection) and was recovered from splenic tissue in both species. Our
      study demonstrates the feasibility of expressing recombinant amoebic proteins in
      attenuated S. typhimurium strains, and shows that vaccine strains of S.
      typhimurium can successfully infect the gerbil, a widely used model for amoebic
      liver abscess and intestinal amoebiasis.

PMID- 8342326
TI  - Immunoadjuvant activity of a liposomal IL-6 formulation.
AB  - The adjuvant effect of interleukin 6 (IL-6) entrapped in liposomes was evaluated
      using a 65 kDa heat shock protein as a model antigen. The secondary humoral
      immune response either to antigen alone, or incorporated into liposomes, and the
      effect of IL-6 entrapped in liposomes, on this response were studied in Balb/c
      mice. The adjuvanticity of these formulations was compared with that of potent
      adjuvants such as Ribi and dimethyldioctadecylammoniumbromide (DDA). The
      importance of IL-6 during adjuvant activity was supported by the observation that
      high serum IL-6 levels were induced in Balb/c mice by all members of a panel of
      adjuvants tested. Following incorporation into liposomes, IL-6 retained its full
      biological activity, as shown by its capacity to sustain growth of the IL-6
      dependent B9 cell line. At antigen dosages where Ribi and DDA gave minimal or no
      secondary antibody titres, incorporation of antigen into liposomes resulted in
      measurable secondary antibody titres. Interestingly, this adjuvant activity was
      significantly enhanced when liposomes containing IL-6 were co-injected with the
      liposomal antigen formulation. These results illustrate the potential adjuvant
      properties of this formulation, which seem especially useful for vaccines
      containing weak or non-immunogenic antigens.

PMID- 8342327
TI  - [Perinatology. Fetal origin of diseases in adults].
AB  - Perinatal medicine is mostly interested in the normal development of the growing
      fetus. Perinatal care is becoming even more important, since a disorder in fetal
      development, due to an abnormal intrauterine milieu, results in problems during
      infancy and adult age. There is clear evidence that this is the case in diabetes
      and pregnancy and in intrauterine growth retardation.

PMID- 8342328
TI  - [The serological diagnosis of gastrointestinal nematode infections in cattle].
AB  - Ostertagia ostertagi and Cooperia oncophora are widely distributed and are the
      most important parasites affecting young bovine livestock. Therefore, there is a
      substantial need for sensitive and specific parameters in support of their
      diagnosis, especially for sub-clinical disease correlated to production loss. In
      this review, the value and the application as a diagnostic tool of pepsinogen,
      gastrin and antibody response are discussed. An increase in pepsinogen or gastrin
      reflects mucosal damage caused by an Ostertagia infection. Some controversy
      exists about the level of pepsinogen and gastrin, which may be considered
      indicative for the diagnosis of clinical and sub-clinical ostertagiasis.
      Pepsinogen levels between 3,000 tot 4,000 mU tyrosine are regarded indicative for
      subclinical disease, values in excess of 5,000 mU tyrosine are considered
      significant for diagnosing clinical disease. For gastrin, it is suggested that
      based on group means, values of 400 pg/ml are indicative for subclinical
      parasitic disease in calves with reduced daily weight gain, while threshold
      levels of > or = 1000 pg/ml gastrin are representative for clinical
      ostertagiasis. Antibody responses to Ostertagia and Cooperia can be assessed
      using the enzyme immunoassay (EIA). Until now, mainly crude worm extracts have
      been used as antigen source in the EIA. They are not species-specific as
      discussed experiments provide evidence of a close relationship between the onset
      of parasitic disease and the evolution of the group mean parameters. However,
      data demonstrate serious variations between animals, which impede a reliable
      individual diagnosis. For longitudinal epidemiological studies especially
      pepsinogen and gastrin have proven their value, exhibiting fast fluctuations
      induced by infection or as a result of treatment. Conversely antibody levels were
      found to be more stable and therefore are useful in large cross-sectional
      studies, enabling a rough assessment of the degree of infection.

PMID- 8342329
TI  - [Theory and practice of medicine: levels of knowledge and clinical medicine as a
      cultural institution].
AB  - The author discusses the contents of his book "The inside of medicine" which
      appeared at the end of 1990 (it is written in dutch). The book aims to acquire a
      view how the metamorphosis of theory and practice of medicine as to size and
      diversity in the past fifty years came about. Also health care developed into a
      social right, and became a cultural institution. The book is not meant as a
      history of medicine of that period, but rather as a history of ideas illustrated
      with examples. The author feels qualified to do so, because he was actively
      involved with research during those years. Before World War II his activities
      were during ten years limited to laboratory research (biomedical) in the
      Netherlands, U.S.A. and finally at the Pasteur Institute in Paris. Residencies in
      internal medicine followed and qualification for this specialty. From 1948-1983
      he held a chair at Leiden University in Internal medicine and concentrated his
      research on endocrinology and metabolic diseases (patient centered research). He
      was Founding Dean of the Rotterdam Medical Faculty for 5 years. Since the
      beginning of the 20th century it is accepted that illness in general is
      multifactorially determined. However research about illness is still dominated by
      the Newtonian unidirectional paradigm of cause to effect, which leads to
      mechanistic thinking. Obtained data are followed further by the same method,
      through different levels of knowledge from symptom to morphology and to
      pathophysiology, and finally to the molecular level. Undoubtedly much has been
      achieved. The integrated approach, reflecting reality, often characterized by the
      term of the bio-psycho-social view, was hardly used. It is frequently suspected
      that advances are disappointing in diseases like atherosclerosis, or the
      deviating course of disease and recovery in advanced age etc. because of that
      reason. Molecular biology is at a too early stage of development that reasoning
      upwards to the "lived human body" is possible. The author feels that there are
      signs of changing the approach and paradigm at present. Some examples will be
      discussed.

PMID- 8342330
TI  - On the regulation of the plasminogen activator inhibitor-1 gene expression.
AB  - Plasminogen activators and their inhibitors play a pivotal role in maintaining
      the hemostatic balance in blood and also in other proteolytic processes such as
      cell migration and tumor invasion. The main physiological inhibitor of the
      plasminogen activators is plasminogen activator inhibitor-1 (PAI-1). The effect
      of PMA on the endogenous PAI-1 production and on the expression of transfected
      promoter/reporter gene constructs was studied in HUVEC and in the HT1080 and HeLa
      cell lines. Addition of PMA (> or = 10 nM) to monolayer cell cultures induced a 2
      to 5.5-fold increase of PAI-1 antigen production within 8-24 h. In HUVEC, PMA
      (160 nM) induced both the 2.4 kb and 3.4 kb mRNA species of PAI-1: 3.1 +/- 1.1
      and 1.7 +/- 0.8-fold (n = 6), respectively, within 8 h. Run-on experiments
      confirmed that this increase is at least partially mediated by increased gene
      transcription. When HUVEC, HT1080 and HeLa, transfected with an 826 bp or a 336
      bp PAI-1 gene promoter fragment, were stimulated with 160 nM phorbol 12-myristate
      13-acetate (PMA), the CAT activity was induced 4-, 3.5- and 10-fold respectively
      for both constructs, revealing that PMA responsive sequences are present in the
      proximal 336 bp of the PAI-1 promoter. Substitution mutations in the regions
      encompassing nucleotides -78 to -69 (TGGGTGGGGC) or -61 to -54 (TGAGTTCA), but
      not in the regions -155 to -149 (TGCCTCA) or -84 to -76 (AGTGAGTGG) reduced this
      induction. Gel electrophoresis of double stranded -65 to -50 oligonucleotides of
      the PAI-1 promoter region and nuclear extracts from HeLa cells produced a gel
      shift pattern, similar to that obtained with a AP-1 consensus oligomer, and
      excess unlabeled AP-1 oligomer reverted binding suggesting that this region of
      the PAI-1 promoter is an AP-1-like binding site. Gel electrophoresis of double
      stranded -82 to -65 oligonucleotide with HeLa nuclear extracts revealed a gel
      shift pattern of three bands. Sp1 consensus oligomer competed with the binding of
      two of these bands and AP-2 consensus sequence oligomer with the binding to the
      third band. The -82 to -65 oligomer also bound to purified AP-2 and Sp1 proteins.
      Southwestern blotting of HeLa nuclear extracts revealed that the labeled oligomer
      covering region -82 to -65 bound the proteins with molecular weights of 52 kD and
      72 kD.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8342331
TI  - [Reliability of the Child Behavior Checklist in a population of 6 to 8-year-old
      special education students].
AB  - 66 children attending first grade at a special school for educationally subnormal
      children were examined medically and psychologically. Classification was done
      according to ICD-10. In addition, the parents were asked to rate their children's
      behavior with the "Child Behavior Checklist" by Achenbach and Edelbrock. The most
      common symptoms rated in this group of 6- to 8-year-old children were lack of
      concentration, speech and language problems, hyperactivity, demand for attention
      and arguing. The mean total score (cut-off score: 30) and the number of crucial
      items (cut-off score: at least two crucial items) differed significantly between
      the children with and those without psychiatric disorders. No significant
      correlation was found between the mean total score or the number of crucial items
      and the sex of the children or the other axes of the Multi-axial Classification
      of Child Psychiatric Disorders.

PMID- 8342332
TI  - [Overprotectiveness as a coping reaction in intensive physical therapy].
AB  - 25 mothers of children with cerebral palsy who were doing daily intensive
      physical therapy (Vojta) completed questionnaires concerning their child's
      temperament, parental attitudes and how they coped with everyday problems. Their
      responses were compared to those given by mothers who were not under the stress
      of conducting therapy. The results revealed compensatory coping processes:
      Mothers doing therapy try to compensate for their child's stress by being
      overprotective in ambiguous everyday situations.

PMID- 8342333
TI  - [Dyssocial disorders of adopted adolescents--a clinical, empirical study].
AB  - The literature indicates that adopted adolescents with conduct disorders are
      overrepresented in psychiatric treatment facilities for children and adolescents.
      In the present study adopted adolescents with conduct disorders and non-adopted
      adolescents with conduct disorders were compared with regard to biological and
      psychosocial risk factors known to play a role in the development of such
      disorders. The groups were carefully matched for age and sex. The results showed
      that the adopted subjects were a distinct group with a significantly lower number
      of risk factors for the development of conduct disorders. This suggests that the
      adoptive situation has a role in pathogenesis.

PMID- 8342334
TI  - [Psychoneuroimmunology].

PMID- 8342335
TI  - [Formation of self concept in the transition from adolescence to adulthood. An
      empirical comparative study of psychiatric patients and healthy control
      probands].
AB  - The psychosocial development of psychiatrically ill and mentally healthy young
      adults is being explored in a series of comparative studies based on
      developmental tasks typical of this age. In a first study a patient group was
      compared with a control group with the Offer Self-Image Questionnaire as an
      indicator of patterns of psychosocial adaptation thus far. The patients showed
      significantly poorer adaptation on 10 dimensions of psychosocial life. In
      relation to a representative sample of young adults they especially reported
      disturbances in their own personality development and in family relations, but
      judged their adaptation to norms for behavior in public as less impaired. The
      nonpsychotic patients had a significantly less favorable pattern of self-concepts
      than the psychotic patients. The patients with affective disorders had a
      relatively healthy profile of psychosocial development compared with the
      schizophrenic patients. There was no significant difference between patients with
      schizophrenia of the disorganized type and other schizophrenic patients. There
      was a close relationship between subjective measures of self-concept and
      objective measures of psychosocial development, e.g. premorbid adaptation and
      current psychosocial development, e.g. premorbid adaptation and current
      psychosocial competence, in the different subgroups. The findings on self-concept
      seemed to be largely independent of the present severity of psychopathology.

PMID- 8342336
TI  - [Effect of timing and chronicity of stressors on the emotional development of
      children and adolescents. Results of a prospective epidemiologic longitudinal
      study of 8 to 18 years].
AB  - In a prospective epidemiological study with assessments at ages 8, 13 and 18 it
      could be demonstrated that if all risk factors are analyzed at the same time
      recent stressors are more important than stressors and disturbances in early
      childhood. But from a chronological point of view early stressors were found to
      be at least as important as later ones because the early stressors play a role in
      the development of some of the later ones. The effects of stressors were sex
      specific to some extent: Boys were more seriously affected when of elementary
      school age, whereas girls were more affected in early childhood and in
      adolescence. Chronic stress proved to be more important than acute life events,
      the later being not only a cause but also a consequence of emotional
      disturbances. Children with early disturbances sometimes even had lower rates of
      disorders in adolescence if they had been brought up in an overprotective manner.

PMID- 8342337
TI  - [Documentation of psychopathologic findings: a procedure for the evaluation of
      psychological disorders in children and adolescents].
AB  - A standardized documentation system for psychopathological findings allowing an
      assessment of psychiatric disorders in children and adolescents after clinical
      evaluation of the patient and his or her caregivers is presented. The
      symptomatology during the previous few months and the symptoms seen during the
      examination are rated separately. Altogether 113 items in 16 areas are assessed.
      In addition, motivation to participate in treatment is judged and a global
      assessment is made of symptom severity. A number of facilities are already
      employing this documentation system in their routine clinical work. In a first
      study 597 patients from a routine clinical population seen consecutively were
      assessed at the start of treatment. As expected, the most commonly recorded
      symptoms were those of expansive behavior. Such symptoms were seen much more
      rarely during the evaluation than outside this situation. The documentation
      system for psychopathological findings complements diagnosis by category
      according to ICD with a phenomenological description of psychiatric disturbances
      on the level of single symptoms. It enables simple and economical documentation
      of clinical findings after evaluation of the patient and his or her caregivers.

PMID- 8342338
TI  - [Peripheral neurogenic tumors--surgical therapy of neuroblastoma. Review and
      personal results].
AB  - From January 1, 1982 to November 1, 1992 24 patients suffering from neuroblastoma
      were operated in the course of a neuroblastoma study at the Department of
      Surgery, Cologne University. 23 patients were in advanced stages 3, 4 and 4s. In
      13 cases the initial operation was prior to applying chemotherapy, whereas in 10
      cases chemotherapeutical treatment had taken place before. As a result of
      preoperative chemotherapy operation time and blood loss could be reduced,
      respectively, and despite delayed operative treatment a better demarcation of the
      tumor and an easier preparation were seen. Due to the preoperative treatment,
      tumors could be operated on more radically without increasing the rate of
      complications. Utilizing all possible surgical means, secondary and tertiary
      operative procedures and chemotherapeutical treatment. all patients in stage 2, 3
      and 4s survived with safe remission. Nine of the fifteen patients in stage 4 died
      due to side effects from bone marrow transplantation or from recurrent
      neuroblastomas and not because of the surgical procedures. In the light of
      existing current multicenter neuroblastoma studies stage oriented surgical and
      chemotherapeutical concepts were developed, that are presented in this paper.

PMID- 8342339
TI  - [Thoracoscopic interventions].
AB  - The technique of minimal invasive surgery has successfully been introduced into
      the area of thoracic surgery. Surgery of the intrathoracic organs may now be
      performed without compromise of respiratory mechanics, thus allowing the
      operative treatment of an ever widening range of pathological conditions. An
      analysis of our experience (287 thoracoscopic interventions in the last three
      years) reveals that the diverse procedures performed on the pleura (pleurectomy
      and pleurodesis), on the lung (wedge resection, fistula closure and ligature of
      parenchymatous leaks) and on other defined anatomical structures such as the
      sympathetic nerves or the thoracic duct, are effective in the therapy of
      intrathoracic disease. The most important pathological conditions which may be
      treated by thoracoscopy are listed. The range of complications and their causes,
      which developed in 8% of all procedures, are discussed. The current limitations
      of this method are defined in the context of the situations where thoracoscopy
      was discontinued (9 times), a thoracotomy performed (17 times) or a further
      procedure became necessary (14 times). Current developments and innovations are
      summarized by a short review of the literature.

PMID- 8342340
TI  - [Laparoscopic operations of the bile duct].
AB  - Laparoscopic common bile duct exploration offers the possibility of complete
      minimal invasive therapy of biliary stone disease with respect to the anatomical
      structures of the papilla Vateri. In spite of generously indicated preoperative
      ERC, we found in 23 of 376 laparoscopic cholecystectomies unsuspected common bile
      duct stones by intraoperative in principle cholangiography. 8 patients with known
      common bile duct stones got a complete laparoscopic therapy. Balloon-dilatation
      of the ductus cysticus up to 5 mm is followed by laparoscopic choledochoscopy via
      the cystic duct. Small stones are washed into the duodenum or extraced
      retrogradely via the cystic duct. For bigger stones the intracorporeal
      lithotripsy is available, the stone scrap is washed either into the duodenum or
      is sucked off via the cystic duct. Laparoscopic choledochotomy is indicated for
      multiple big or proximally fixed stones. In this way stone extraction can be
      effectively performed, incarcerated stones are treated by additional lithotripsy.
      A microdrainage of the common bile duct or a T-tube drainage secures the bile
      flow until restitution of papillary function. The common bile duct is sewn by
      running suture. In the case of regular cholangiography the microdrainage can be
      removed on the third postoperative day. In 96% of the laparoscopic
      cholecystectomies intraoperative cholangiography was possible. 3 of 21 patients
      with transductus cysticus-exploration had to undergo postoperative EPT due to
      residual stone fragments. 6 laparoscopic choledochotomies showed the efficacy of
      the endoscopic operation technique, demonstrating the probability of
      complications in the postoperative period to be equivalent to that of
      conventional operations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342341
TI  - [Sequelae of cholecystectomy--a prospective study].
AB  - In a prospective study designed to assess the situation following cholecystectomy
      carried out at the Department of Surgery of the University of Freiburg, 105
      patients were examined between August, 1988 and December, 1989. Out of 80
      patients who were followed up, 64 had undergone cholecystectomy alone and the
      remaining 16 had been additionally subjected to exploration of the common bile
      duct. 80% of the patients reported that their preoperative symptoms had
      disappeared altogether, 8% admitted some improvement and 10% complained that
      their condition was unchanged. Specific questioning resulted in the reporting of
      persistent symptoms in 54%, and these consisted mostly of general complaints such
      as dyspepsia, flatulence, food intolerance and dull upper abdominal pain. These
      complaints were vanished or appeared with equal frequency following operation.
      Objective clinical findings could not be confirmed. Comparison between the pre-
      and postoperative signs in these patients established a statistically significant
      correlation (p < 0.05) between the patient's age and the severity of the
      preoperative symptoms on the one hand and a satisfactory postoperative outcome on
      the other. This also applied to patients for whom an examination of the bile duct
      was necessary.

PMID- 8342342
TI  - [Complications of intramedullary nailing and their prevention].
AB  - Interlocking nailing technique offers a wide variety of indications which are
      associated with an increased risk of complications. A consecutive series of 208
      cases were analyzed and possible complications, how to avoid them and
      recommendations for treatment are given. The complications were divided into
      common complications--like infection, pseudarthrosis, malrotation, compartment
      syndrome, disorders of the arterial and venous system, neurological deficts and
      fat embolism--as well as into specific complications--like malreduction of the
      fracture, malpositioning of the guide wire, splitting fragments and problems with
      nail insertion and with the locking bolts. There was a 8.7% common complication
      rate. Specific complications occurred intraoperatively in 3.5% and
      postoperatively in 11% of call cases. This seems to be a high rate which is
      decreasing by progressive experience of the surgeon. In many cases of shaft
      fractures interlocking nailing technique is the method of choice.

PMID- 8342343
TI  - [Eight years experience with the "Erlangen Model" titanium prosthesis--results of
      cementless implantation of 250 hip prostheses].
AB  - Between March 13, 1984 and March 28, 1988, 233 patients (age range from 21 to 73
      years) with osteoarthritis of one or both hips were treated with the uncemented
      hip replacement "Erlanger Modell" (Prof. H. Beck/P. Brehm Chirurgie-Mechanik
      GmbH). The cause of the osteoarthritis was variable. Hip replacement was carried
      out for the following conditions: rheumatoid arthritis including ankylosing
      spondylits (n = 29), aseptic necrosis of the femoral head including posttraumatic
      and idiopathic forms (n = 17), osteoarthritis of unknown origin (n = 111),
      osteoarthritis following dysplasia or subluxation of the hips (n = 56) and
      loosened cemented hip prostheses (n = 37). Full weight bearing was not permitted
      for 50 days postoperatively, but mobilization and isometric exercises began 2
      days after operation and isotonic exercises are introduced later. Complications
      included fracture of the femoral shaft during operation (3.3%), fracture of the
      femoral shaft postoperative (1.6%), dislocation (0.8) and infection early after
      operation (0.4%) and aseptic loosening (3.7%). Our results of 233 patients (250
      joints), ranging from 4 to 8 postoperative years giving an average of 5.3 years,
      are encouraging. Good results based on patients satisfaction were obtained in
      95.2% (83.8% after revision) and poor results in 1.0% (2.7% after revision). 3.8%
      (13.5 after revision) judged their situation as unchanged. 93.3% of the patients
      can walk without hooked stick (53.3% after revision), 90.2% of the patients can
      walk more than 1000m (69.4% after revision).

PMID- 8342344
TI  - [Osteosynthesis of subtrochanteric femoral fractures with the dynamic condyle
      screw].
AB  - The dynamic condyle screw was originally designed for osteosynthesis of distal
      femoral fractures. Because of more favourable biomechanical facilities compared
      with the condyle plate we have been used the implant since 1987. This
      investigation is based on 40 patients with pertrochanteric, subtrochanteric as
      well as proximal diaphyseal fractures. The majority of the patients were
      mobilized early and reached full weight bearing latest after 3 months according
      to the fracture type. The most severe complications appeared with subtrochanteric
      fractures with lack of medial cortical support. There was a broken plate in 2
      cases and a secondary spongiosa plastic was necessary in 3 cases to ensure bony
      consolidation. As the point of this investigation we will see a wider indication
      for primary spongiosa plastic and early secondary spongiosa plastic.

PMID- 8342345
TI  - [Stabilization of 150 unstable spinal injuries with the Cotrel-Dubousset
      instrument--analysis of results].
AB  - The present study is a retrospective analysis of spinal fracture treatment with
      the Cotrel-Dubousset instrumentation technique. 150 unstable injuries of the
      spine were treated with the CD implant at the University of Louisville--Level I
      Trauma Center--between February 1985 and March 1989. There were 67 burst
      fractures, 48 compression fractures and 21 fracture dislocations, 8 flexion
      distraction fractures and 6 flexion rotation injuries. Ninety-three patients
      underwent anterior cord decompression and strut grafting followed by posterior CD
      instrumentation and posterolateral fusion. Fifty-seven patients had posterior CD
      instrumentation and fusion alone. No neurological deterioration after the
      procedure was observed, 33 patients improved neurologically. Hospital stay ranged
      between 7 and 60 days (mean 20 days). 114 patients had a minimum follow up of 6
      months (range 6-52 months). The mean follow up was 17.7 months. At final follow
      up 77.8% of the patients had returned to work and 84.2% of the patients were
      almost painfree. The mean loss of correction in the sagittal plane was 6.2
      degrees (range: 0 and 42 degrees) at final follow up. As technical complications
      there were four hook cut outs (2.6%) of which two underwent reosteosynthesis and
      two did not effect the clinical or radiographic result. The high stability of the
      device provides a decreased risk of neurological deterioration, a decreased risk
      of posttraumatic kyphosis and early rehabilitation.

PMID- 8342346
TI  - [Bilateral rupture of the quadriceps tendon--case report and review of the
      literature].
AB  - We report a very rare case of bilateral simultaneous rupture of the quadriceps
      tendons in a 64-year-old patient following a minor trauma. The reconstruction of
      the ruptured tendons was achieved by intertwined PDS-sutures which were
      supportively fixed in the patellae. After wound healing, the patient was
      mobilized in his two casts which were applied for 6 weeks. After the period of
      one year, a satisfactory result could be seen. We report the etiology,
      pathogenesis, diagnosis, therapy and postoperative treatment which are described
      in the literature.

PMID- 8342347
TI  - [The incidence of abortions of viable pregnancies in the first trimester].
AB  - The spontaneous abortion rate in singleton pregnancies with sonographically
      proven heart activity between 5 and 13 weeks was analysed. Up to 15 weeks 8.6% of
      395 patients miscarried. The abortion rate was higher in pregnancies with a
      gestational age < 9 weeks (12.5%), a maternal age > or = 35 years (15.5%) and
      vaginal bleeding (16.3%). The correlation of the abortion rate with these factors
      has to be taken into account when the prognosis of an individual gestation or the
      risk of invasive procedures is determined.

PMID- 8342348
TI  - [Cellular lymphatic tissue of the endometrium and uterine tube].
AB  - The presence of T-lymphocyte subsets in human endometrium and tubal mucosa in
      correlation to the menstrual cycle was investigated by the immunoperoxidase
      technique. The main cell populations were the pan T-cells (CD 3) and T-suppressor
      cells (CD 8). The T-helper cells (CD 4) and the B-lymphocytes (CD 22) were
      sparsely distributed. Significant differences between the phases of menstrual
      cycle could not be observed.

PMID- 8342349
TI  - [Echinococcosis in pregnancy. A rare differential diagnosis in cystic intra
      abdominal tumors in pregnancy].
AB  - Pregnancy and intraabdominal masses rarely cointcidate. Therapeutical
      consequences are associated with possible complications such as intraabdominal
      pain, torquation of cystic tumors, rupture of cystic masses and pelvic
      inflammation. In less than 5% of the cases a malignant process during pregnancy
      can be expected. Prior to therapy of intraabdominal masses patients from typical
      endemic areas ought to be checked up for parasitic infections such as cystic
      echinococcosis treated specifically. Based on the following case report we
      present the epidemiology, diagnosis and therapy of cystics echinococcosis in
      pregnancy.

PMID- 8342350
TI  - [Femoral nerve paralysis after vaginal hysterectomy and its forensic importance].
AB  - Paresis of the femoral nerve following vaginal hysterectomy is a rare event, only
      21 cases have been reported in the literature. This lesion is caused by pressure
      of the femoral nerve through the ligamentum inguinale during extreme flection and
      abduction of the thigh when vaginal surgery is done in lithotomy position. To
      avoid this femoral nerve lesion during vaginal hysterectomy the inclination angle
      between thigh and body should not be smaller than 45 degrees and the abduction
      angle should not exceed 45 degrees in relation to a vertical midline. The correct
      positioning of the patients has to be checked and documented by the gynecologist
      performing the operation. The operating gynecologist is responsible for injuries
      and damages by incorrect positioning of the patient.

PMID- 8342352
TI  - [Congress of the Netherlands Society of Obstetrics and Gynecology, Amsterdam, 20
      21 November 1992].

PMID- 8342351
TI  - [Simultaneous occurrence of a squamous epithelial and adenocarcinoma of the
      endometrium].

PMID- 8342353
TI  - [Our gynecologic heritage. Robert von Olshausen (1835-1915), pioneer in surgical
      gynecology. 5th contribution on the history of the Berlin Society of Obstetrics
      and Gynecology].
AB  - Robert von Olshausen was an outstanding German gynecologist at the turn of the
      century and a pioneer of operative gynaecology. His fields of excellency were
      ovarotomy, the problems of asepsis, carcinoma therapy and the development of
      obstetrics in general. Under his chairmansship, the Berlin Department of
      Obstetrics and Gynecology (Universitats-Frauenklinik) became the leading Clinic
      in Germany. For many years Olshausen was the chairman of the Berlin Society of
      Obstetrics and Gynecology, since 1894 as honorary chairman. The present paper is
      a biography of Robert von Olshausen, showing his importance for the development
      of the modern gynaecology in Berlin and Germany.

PMID- 8342354
TI  - [Cardiotocography practice case no. 24].

PMID- 8342355
TI  - Induction of serotonin-S2 receptor blockade during early or late stage of acute
      respiratory distress syndrome in double-muscled calves: a comparative study.
AB  - Ninety-four Belgian White and Blue double-muscled calves were involved in this
      study which aimed to compare the efficacy of a serotonin-S2 receptor blockade at
      two different stages of an acute respiratory distress syndrome (ARDS), i.e. at
      the occurrence of first clinical signs or when another anti-inflammatory compound
      was clinically shown to be ineffective. Metrenperone, a 5-hydroxytryptamine (5
      HT2) blocker, was injected (intramuscularly, 5 times, at 12 hourly intervals,
      dose rate: 0.1 mg/kg) to (1) 58 calves referred to our laboratory after a
      treatment (group I) which lasted from 3 to 5 days and which did not improve the
      clinical status of the animals and (2) 36 calves investigated as soon as first
      clinical signs occurred (group II). Following the severity of the ARDS, the
      animals from group I needed to be classified into 2 groups: group IA (moderate
      ARDS - n = 45) and group IB (severe ARDS - n = 13). For animals in group I, the
      antibacterial compound previously used was maintained and administered during 4
      more days whilst the previous anti-inflammatory drug was suppressed and replaced
      by metrenperone administered as mentioned above. In group II, each animal was
      treated with ceftiofur sodium as an antibacterial agent. A clinical score and a
      breathing score were calculated at each step of the investigation period, i.e.
      before (T0) and 1 hour (T1) after the first treatment, during the interval 12H
      48H (T2) which followed this treatment and 168 H (T3) after this treatment. Four
      clinical parameters were also taken into account separately: rectal and cutaneous
      temperatures, respiratory and heart rates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342356
TI  - Body weight loss during lactation in relation to energy and protein metabolism in
      standard-fed primiparous sows.
AB  - After 5 weeks of lactation 14 standard-fed primiparous sows were divided into a
      low weight-loss group (L-gr, loss < 25 kg, n = 7) and a high weight-loss group (H
      gr, loss > or = 25 kg, n = 7). Body weights of the sows and their litters were
      recorded on days 2, 7, 14, 21, 28 and 35 of lactation. Blood samples were
      collected before the morning feeding on each weighing day. Samples were analysed
      to determine concentrations of insulin, glucagon, glucose, triglycerides, non
      esterified fatty acids (NEFA), urea and creatinine. The H-gr sows lost weight
      throughout lactation, whereas the L-gr sows gained weight during the last week.
      Weight loss was higher in the H-gr than in the L-gr during weeks 2, 3 and 5 of
      lactation. Litter size and litter weight gain were higher in the H-gr than in the
      L-gr. Significant changes in levels of insulin, glucagon, glucose, triglycerides
      and creatinine were observed over lactation. No significant differences in
      concentrations of any of the parameters were found between the two groups, except
      for insulin and cholesterol which were higher in the L-gr. Catabolism of adipose
      tissue and muscle protein was observed in both groups during the first week of
      lactation. This catabolic state was more pronounced and tended to be prolonged in
      the H-gr. Concentrations of all parameters seemed to be stable in both groups
      during the last two weeks of lactation.

PMID- 8342357
TI  - Effect of storage of blood on the osmotic fragility of mammalian erythrocytes.
AB  - The osmotic fragility of mammalian erythrocytes during blood storage was
      determined. Significant changes were observed in the fragility of goat, cattle,
      pig, mouse, rat and rabbit erythrocytes but not in sheep erythrocytes during the
      storage of blood for 24 hours at 10 degrees C.

PMID- 8342358
TI  - Stress induced gizzard erosion in chicks. I. Gross and histopathological
      findings.
AB  - A model of stress induced gizzard erosions is described. Three day old chickens
      were deprived of food for 24 h, and after that they were immersed in tap water
      (17 degrees C) for five seconds. Group A was sacrificed immediately before being
      subjected to stress, group B one hour, group C two hours and group D three hours
      after water immersion stress. Each group consisted of 10 animals. Gizzard lesions
      in group A were very mild and the main feature was discoloration of the gizzard
      lining. In groups B, C, and D the lesions were more severe and they were
      characterised by gizzard erosions, ulcerations and hemorrhages especially
      pronounced in group D. This model produced lesions in all stressed animals.

PMID- 8342359
TI  - Combining two independent indirect methods as a new possibility for screening the
      illegal use of growth promotants.
AB  - In this study the possibilities of combined indirect screening methods for the
      growth promotants clenbuterol and estradiol-17 beta benzoate and the combination
      of both these agents were investigated. Three groups of 5 male goat kids (two
      months of age) were treated for 4 weeks; clenbuterol per os, 10 micrograms/day/kg
      body weight via milkreplacer twice a day; 2 mg estradiol-17 beta benzoate weekly
      per i.m. injection; combined clenbuterol per os+estradiol-17 beta benzoate per
      injection. Five animals were not treated and served as controls. Nuclear Magnetic
      Resonance (NMR) was used as an initial tool to monitor the urine composition. The
      analysis of NMR spectra showed, that most treated animals had increased L
      lactate/creatine ratios (L/C-ratio) in their urine, compared to control animals.
      For screening, L-lactate/creatine ratios could be determined directly in urine-
      in a simple, quick and inexpensive manner--by using enzymatic methods and an
      autoanalyzer. Histologically clenbuterol induced degenerative changes in the
      urethral and glandular epithelium of the prostate. Changes consisted of
      vacuolization of the epithelium and necrosis with nuclear pyknosis and
      fragmentation. Estradiol-17 beta benzoate induced metaplastic changes in the
      glandular tissue of the goat prostate. In combination with estradiol-17 beta
      benzoate, characteristics of both agents could be observed. The histological
      methods and observed effects can be used directly for screening. The combination
      of independent histological and L/C-ratio methods looks very promising with
      respect to screening of growth promotants. Since in both cases effects of growth
      promotants are detected, it may be expected that this approach is not limited to
      goats or clenbuterol and estradiol alone.

PMID- 8342360
TI  - Cation-induced aggregation of cat Tamm-Horsfall glycoprotein and its possible
      role in feline urolithiasis.
AB  - The in vitro cation-induced aggregation properties of cat Tamm-Horsfall protein
      (cTHP), a urinary glycoprotein, were examined and related to the potential role
      of cTHP in feline urolithiasis. The aggregation assay involved adding either
      CaCl2, MgCl2, or NaCl to solutions containing purified cTHP, and then separating
      the aggregated cTHP by centrifugation. The concentration of cTHP remaining in the
      supernatant was quantified using a previously developed enzyme-linked
      immunosorbent assay (ELISA). The effect that buffer pH, cTHP concentration, and
      urea concentration had on cTHP aggregation also were examined. Of the three
      salts, CaCl2 consistently was most efficient at precipitating cTHP, while MgCl2
      was slightly less efficient. At least ten times more NaCl than CaCl2 or MgCl2 was
      required for comparable cTHP aggregation. As the pH decreased, increasing
      concentrations of the salts were required to aggregate cTHP. Increased amounts of
      CaCl2 and MgCl2 also were required to aggregate cTHP when the urea concentration
      was increased. As cTHP concentration increased within the physiological range,
      lower concentrations of CaCl2 and MgCl2 were required to precipitate 50% of the
      cTHP. Several aspects of the in vitro aggregation properties of cTHP correlate
      closely with previously identified risk factors for feline urolithiasis,
      strengthening the theory that cTHP aggregation may be important in this disease.

PMID- 8342361
TI  - [M-mode echocardiography in dressage horses, class S jumping horses and untrained
      horses].
AB  - Heart structures of 45 warmblooded horses were measured by M-mode
      echocardiography. The current training level of 15 dressage horses (group I) and
      15 show-jumping horses (group II) was category "S". In the third group were 15
      untrained horses. Four standardized transducer positions were determined for the
      m-mode echobeam, calibrated according to the two-dimensional real time technique.
      End systolic and end diastolic diameters of left ventricle, right ventricle,
      aortic root, interventricular septum and left ventricular wall, as well as motion
      pattern of heart wall, mitral valve and aortic valve of all horses were measured.
      The dressage horses showed a significant thickening of interventricular septum
      and left-ventricular wall compared with the show-jumping horses and the untrained
      horses. The end diastolic left ventricle diameter of the show-jumping horses was
      significantly larger than in the other groups. Compared to the untrained horses
      the show-jumping horses showed a significantly larger end systolic left
      ventricular wall diameter measured at the level of papillary muscle. It can be
      concluded, that an increase in heart mass in category "S" sport horses is
      attributed to their level of training.

PMID- 8342362
TI  - Simultaneous genotyping of sex and kappa-casein of bovine in vitro fertilized
      embryos by the PCR technique.
AB  - Sex and the kappa-casein genotype of in vitro produced cattle demiembryos was
      identified by simultaneous PCR-genotyping using polymorphic sites in ZFY/ZFX and
      kappa-casein genes. We obtained PCR products of 530 bp (kappa-casein) and of
      445/447 bp (sex). Sex and the two kappa-casein alleles could be identified after
      digestion of the PCR products with Pstl and simultaneous separation of the
      restriction fragments on one step, allowing a rapid and efficient analyses of
      embryos.

PMID- 8342363
TI  - Effect of various dietary selenium (Se) intakes on tissue Se levels and
      glutathione peroxidase activities in lambs.
AB  - Experiments were conducted to examine selenium (Se) metabolism in tissues of
      lambs following Se supplementation at varying doses. For three months four groups
      of lambs were fed either a basal diet (group A) containing 0.082 mg Se per kg dry
      matter (ppm) or the same diet plus mineral mixture with Se (as selenite) so that
      the total diet contained 0.25, 0.41 and 0.58 ppm Se (groups B, C and D,
      respectively). After three months six lambs of each group were slaughtered and
      tissues were removed for Se level and GSH-Px activity determinations. Among the
      tissues of lambs fed the basal diet the highest Se concentration was found in the
      kidney (1.32 micrograms/g wet weight), and the lowest in the skeletal muscle
      (0.030 micrograms/g wet weight). In the liver, heart, lung and spleen Se
      concentrations were almost at the same level and varied in the range of 0.14 to
      0.18 micrograms/g wet weight tissue. No increase in Se concentration was found in
      the kidneys of Se-supplemented animals. Se concentration in the liver and lung
      increased linearly with the Se level in the diet. In the spleen, heart and
      skeletal muscle the highest Se concentrations were found in lambs fed 0.41 ppm
      Se. Tissue GSH-Px activities (calculated on the per g protein basis) increased
      significantly in Se-treated animals. In the tissues of lambs fed 0.25 ppm Se the
      enzyme activities were higher in a range of 1.8 to 3.5 as compared to the group
      fed the basal diet. Higher doses of dietary Se had much smaller effect on the
      tissues GSH-Px activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342364
TI  - Control of infections with Mycoplasma hyopneumoniae in swine herds by disrupting
      the chain of infection, disinfection of buildings and strategic medical
      treatment.
AB  - A program with the aim to eliminate infections with Mycoplasma hyopneumoniae was
      applied in 4 herds selling breeding pigs. A "fast" (1 month) variant of the
      program was applied in one herd selling young gilts (30 kg body weight) and in
      one herd selling adult breeding stock, and a "slow" (> or = 3.5 months) variant
      was applied in two corresponding herds. In both variants, the spread of
      infections was prevented by isolating the breeding stock. These animals were
      treated with tiamulin before being reintroduced to the original, but emptied and
      disinfected units. Further, the rearing of pigs born before and after initiating
      the program was separated. In both herds selling young gilts, no antibodies to
      Mycoplasma hyopneumoniae were detected in sera collected for at least 40 months
      after finishing the program. In the herds selling adult breeding pigs,
      elimination of infections with Mycoplasma hyopneumoniae was only achieved by the
      "fast" variant, while the infections still were present in the breeding herd
      using the "slow" variant of the program. The failure of the program in the latter
      herd was probably due to turbulent air flows between ventilation systems of units
      situated close to each other and simultaneously housing uninfected and infected
      pigs.

PMID- 8342365
TI  - Dose-dependent pathophysiological changes in cattle experimentally infected
      Dictyocaulus viviparus.
AB  - In two trials five calves were each experimentally infected on three consecutive
      days with a total number of either 30 Dictyocaulus viviparus larvae per kg body
      weight (trial A) or 3 larvae/kg body weight (trial B). Five calves served as non
      infected controls. Infected cattle in trial A developed severe clinical signs of
      dictyocaulosis and one calf died 37 days post infection (p.i.), whereas all
      cattle in trial B remained clinically healthy. Weight gains in both trials were
      not statistically different. Haemoglobin concentrations, packed cell volume
      (PCV), number of erythrocytes and leucocytes, blood pH and albumin concentrations
      were in the physiological range in all groups. Infected cattle in trial A showed
      increases in respiratory rates, body temperature, serum protein concentrations,
      and blood eosinophil counts and decreases in oxygen partial pressure. Infected
      cattle in trial B showed increased blood eosinophil counts. Antibody formation in
      infected cattle of both trials showed a similar pattern. Excretion of larvae from
      infected cattle reflected the different infection doses. Microbiological
      examinations showed an increase of facultatively pathogenic bacteria in the lung
      fluid.

PMID- 8342366
TI  - Experimental cerebrospinal elaphostrongylosis (Elaphostrongylus rangiferi) in
      sheep.
AB  - Seven lambs were inoculated with 150-3,000 infective larvae of Elaphostrongylus
      rangiferi and subsequently killed for autopsy. From one week post inoculation
      (p.i.), a marked eosinophilia was found, and one of the lambs showed signs of
      coughing, increased respiratory frequency and elevated body temperature. Pruritus
      was observed in three lambs during the period 5-10 weeks p.i. Gross and
      microscopic lesions were found in the liver, lungs, myocardium, kidneys, spinal
      nerve roots and in the central nervous system (CNS). The lesions resembled those
      previously reported in experimentally infected goat kids. The migratory route of
      the infective larvae seemed to be haematogenous. Developing nematodes were
      sectioned in the CNS of a lamb killed at day 30 p.i. The nematodes found in the
      brain of this lamb were significantly thicker than those observed in the spinal
      cord. Intact nematodes were not detected in the remaining lambs which were all
      killed 149-151 days p.i. None of the experimental lambs shed E. rangiferi first
      stage larvae in the faeces. These findings indicate that E. rangiferi gradually
      dies out in sheep and will not complete its life cycle in this animal species.

PMID- 8342368
TI  - The development of pulmonary lesions associated with dead adult D. immitis in
      naive dogs.
AB  - The sequential response of the lung to the death of adult D. immitis has not been
      reported. To determine the time sequence and severity of pulmonary lesions
      following the death of D. immitis, light microscopy was used to follow 36 dogs,
      detailing the respective lesions 1-35 days after insertion of dead D. immitis or
      of control polyvinyl chloride threads. Results showed that dogs exposed to dead
      filariae developed more severe pulmonary arterial disease than did those exposed
      to inert threads. Severe pulmonary lesions occurred at 5-9 days post insertion
      with the right caudal lobes being the most affected, both macro and
      microscopically. These findings suggest that this was a suitable model for the
      study of this parasite-host interaction and that 5-9 days following insertion of
      dead D. immitis was the most intensive period of host reactivity.

PMID- 8342367
TI  - Research on the presence of porcine enterovirus serotype 1 in north-eastern
      Italy.
AB  - The liquid-phase blocking sandwich ELISA, already developed for foot-and-mouth
      disease and swine vesicular disease serology, has been employed in pig sera for
      the antibody detection against porcine enterovirus serotype 1. ELISA-titers
      correlate positively with virus neutralization and their distribution show a high
      prevalence among the sampled pigs. The serological findings are confirmed by the
      isolation of a field strain of porcine enterovirus belonging to the serotype 1.

PMID- 8342369
TI  - Staphylococcus intermedius: current knowledge on a pathogen of veterinary
      importance.
AB  - It has been 16 years since the identification of S. intermedius as a new species.
      Numerous investigations using cell wall and DNA analytic methods have now clearly
      demonstrated significant differences to warrant the creation of this new species.
      However, studies investigating virulence factors associated with S. intermedius
      have not uncovered evidence that differentiates virulent from non-virulent
      isolates. Therefore, at the present time, it is difficult for veterinary
      clinicians and microbiologists to determine the clinical significance of many S.
      intermedius isolates. Host-bacterial interactions and the hosts' immune status
      appear to be the factors most crucial in determining the outcome of infections,
      not the virulence of the organism. Continued research in the virulence factor
      field will hopefully lead to a better understanding on how we can differentiate
      virulent from nonvirulent isolates of S. intermedius.

PMID- 8342370
TI  - Antigenicity of Dermatophilus congolensis hemolysin.
AB  - The separated cell-free form of hemolytic exosubstance was obtained from five
      strains of Dermatophilus congolensis. Three strains produced exosubstance with
      high activity, two strains produced exosubstance with lower intensity of
      activity. The separated forms exhibited the same hemolytic interactions as the
      native forms produced by growing strains, namely the antagonism with
      staphylococcal beta hemolysin and the synergism with staphylococcal delta
      hemolysin, streptococcal CAMP factor and rhodococcal equi factor. Rabbit sera
      obtained after intravenous or intraperitoneal application of the separated forms
      contained precipitation and neutralization antibodies. Cross tests of
      precipitation and neutralization proved antigen identity of hemolysins of
      different D. congolensis, strains which makes the serodiagnostics of this species
      possible.

PMID- 8342371
TI  - Intestinal carriage of Clostridium difficile in neonate dogs.
AB  - A total of 70 puppies and their dams, distributed in 14 litters, were submitted
      to weekly fecal examinations for C. difficile during the first 10 weeks after
      birth. During the study, 94.3% of the puppies and 42.9% of the dams harboured C.
      difficile at least once in their feces. We calculated that 58% of the puppies
      carried toxigenic C. difficile at least once during the survey. In the puppies,
      C. difficile carriage rates ranging from 3.1% to 67.1% were observed at different
      moments of the observation period. In comparison, C. difficile carriage rate was
      1.4% in a control group of healthy dogs more than 3 months old. Discrepancies in
      the toxigenic phenotype of the C. difficile strains isolated in the same litter
      showed that the neonate dogs were transiently infected with different strains,
      and that the dam is often not the source of infection with C. difficile. We could
      not demonstrate any pathogenicity of C. difficile for neonate dogs.

PMID- 8342372
TI  - [Basic indicators of cellular immunity in patients with chronic staphylococcal
      osteomyelitis].
AB  - The objective of the presented work is to compare the state of the immune system
      in patients with chronic osteomyelitis with a group of the healthy population.
      The authors followed up on a long-term basis a group of 24 patients with chronic
      osteomyelitis of staphylococcal origin; they completed immunological examinations
      comprising cellular and humoral immunity (in particular assessment of T
      lymphocytes and their sub-populations by means of monoclonal antibodies,
      examination of phagocytic capacities of blood elements, assessment of selected
      plasma protein and immunoglobulin levels). Comparison of results of these
      examinations in patients with chronic osteomyelitis and the healthy population
      proved statistically very significant differences in particular in the number of
      T-lymphocytes (reduction of T-lymphocytes CD 4+, i.e. helpers, immunity
      stimulating cells and reduction of the ratio of immunity promoting lymphocytes
      and immunity inhibiting lymphocytes). The authors found also significant
      differences in the levels of plasma proteins and immunoglobulins.

PMID- 8342373
TI  - [The closed method of intramedullary fixation of forearm fractures].
AB  - The authors demonstrate a group of 27 patients subjected to intramedullary
      osteosynthesis of the forearm by means of Kirschner wires, using closed surgery.
      They prefer the described method in patients suffering from multiple injuries who
      have devastated soft parts of the forearm and in unstable fractures in children.
      The authors draw attention to the fact that they have achieved very good results
      by the simple surgical method they described.

PMID- 8342374
TI  - [Personal experience with treatment of Pipkin fractures of the femoral head].
AB  - In the introduction the authors analyze the classification and incidence of
      fractures of the Pipkin type. This is a rare injury which develops as a rule in
      10% of posterior type dislocations during motor car crashes. The authors present
      a theoretical review of all therapeutic possibilities in specific types of
      fractures. The group comprises 17 patients during a follow-up period of 16 years,
      mean age of the patients 39.6 years. In 82% the cause of the injury was a car
      accident. Type IV fractures were most frequent, consistent with data in the
      literature only one type III fracture was recorded. Sixteen patients were
      operated incl. three operated after a long time interval following the injury.
      The authors evaluate nine patients who were at least one year past the injury.
      The average period which had elapsed since the injury was 7.3 years. From the
      evaluation patients were eliminated who had primary or secondary prostheses of
      the hip joint. According to the score based on modified evaluation of Thompson,
      Epstein and Motta 44 excellent and very good results were achieved, one poor
      result. Two patients were granted full invalid pensions. In the discussion the
      authors compare their views and results with those reported in the literature. In
      the conclusion the authors state that treatment of these fractures should be
      provided at highly specialized departments.

PMID- 8342375
TI  - [Possibilities of using the sartorius muscle in the treatment of chronic
      osteoarticular infections].
AB  - In a group of 17 patients with chronic osteoarticular infection for filling of
      the chronic cavity the sartorius muscle was used. In eight instances chronic
      osteomyelitis of the distal femur was involved, in nine instances by means of the
      sartorius muscle the acetabulum was filled (after removal of an infected total
      endoprosthesis or after resection of the hip joint on account of purulent
      coxitis). In the first group the authors recorded 75% satisfactory results and
      therefore they recommend to use the sartorius muscle for filling chronic
      osteomyelitic cavities in the distal part of the femur with a fistula on the
      inner side of the thigh. In the second group of patients, where the sartorius
      muscle was used to fill the acetabulum, poor results were recorded in 55.5%. This
      is obviously associated with the blood supply of the muscle used, which does not
      permit such an extensive mobilization and rotation of the muscle without
      jeopardizing its nutrition. Therefore the authors do not recommend the use of the
      sartorius muscle for filling the acetabulum and propose other muscle flaps which
      gave preliminary, satisfactory results.

PMID- 8342376
TI  - [The role of pharmacology in the comprehensive prophylaxis of post-traumatic fat
      embolism].
AB  - Immediate high-standard provisions implemented as soon as possible after serious
      injuries with the aim to prevent the development of shock or to treat incipient
      and developing shock is one of the most important aspects of prophylaxis of the
      syndrome of traumatic fat embolism (FE). An important place is held by the
      rostoration of normal microcirculation, replacement of blood losses and the
      control of hypoxia, in particular by artificial pulmonary ventilation. A high
      caloric intake both by the parenteral and enteral route has among others the
      objective to prevent excessive development of lipolysis. Surgical operations with
      the exception of urgent ones which must not be delayed should be postponed till
      complete regression of clinical manifestations of traumatic shock. The group of
      comprehensive provisions comprises pharmacological provisions against traumatic
      shock and pharmacological participation in the prophylaxis of the FE syndrome:
      Lipostabil; Trasylol; heparin and other anticoagulants in small doses;
      hydrocortisone; dextrans, CaCl2 and possibly other effective substances or drugs
      in rational individually recommended doses and expedient combinations.

PMID- 8342377
TI  - [Amputation and prosthesis design in severe congenital defects of the lower
      extremity (case reports)].
AB  - The author presents an account of three patients with severe congenital defects
      of the lower extremities who relied on a long-term basis on complex prosthetic
      appliances. In the mentioned patients the author amputated part of the malformed
      extremity in such a way as to preserve the "plantar" stump and it was thus
      possible, when solving the technical aspects of the appliance, to improve also
      the cosmetic covering of the defect.

PMID- 8342378
TI  - [Leg lengthening using callotasis. I. History of lengthening of extremities and
      surgical technics].
AB  - In the first part of the article divided into two sections the authors describe
      the history of approaches to limb length discrepancy and they compare several
      methods and discuss their advantages and disadvantages. The surgical method
      proper used at the clinic is described incl. preoperative preparation and
      deliberations as used at the clinic up to the procedure used for removing the
      fixator after completion of the lengthening of long bones. The operation proper
      is described in detail from application of the apparatus to performance of
      osteotomy. The lengthening process is also described.

PMID- 8342379
TI  - [Factors affecting the development of para-articular ossification in total hip
      replacement].
AB  - The authors evaluated the prevalence of paraarticular ossifications in three
      groups of patients after a minimum interval of one year following the
      administration of a total prosthesis. For evaluation they used Brooker's
      classification. The first group comprised 40 patients who during the first six
      weeks after administration of a cemented prosthesis of the hip joint took 75 mg
      of Indomethacin per day in three doses. The second control group comprised 50
      patients, i.e. 61 operated hip joints (11 bilateral prostheses) to whom
      Indomethacin was not administered during the postoperative period, nor any other
      antiphlogistic preparations. The third group comprised 40 patients to whom a non
      cemented prosthesis of the hip joint was implanted and who did not use any
      antiphlogistic preparations after operation. In the first group, i.e. patients
      after total endoprostheses of the hip joint with preventive administration of
      Indomethacin, ectopic ossifications were recorded in 32.5% of the operated
      patients. In the second group, i.e. without preventive Indomethacin
      administration, ectopic ossifications of various grades were recorded in 51%. In
      patients with non-cemented prostheses of the hip joint the prevalence of ectopic
      ossifications was only 18%. The authors selected from the control group a sub
      group with bilateral prostheses of the hip joint where an ectopic bone was found.
      This sub-group comprised 9 operated patients and bilateral ectopic ossifications
      developed only in 33.3%. From the results ensues that Indomethacin administration
      is an expedient prevention of development of paraarticular ossifications. Marked
      reduction of development of ectopic bone formation occurs when bone cement is not
      used as a fixation medium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342380
TI  - [Personal experience with the use of the Herbert screw in orthopedics and
      traumatology].
AB  - The authors present in the submitted paper their initial experience as well as
      theoretical possibilities of using Herbert's screw. This is a relatively new type
      of implant developed originally for stable compressive osteosynthesis of small
      bones. This screw is made from a titanium alloy in sizes of 16-32 mm and is based
      on the principle of traction screws. It has, however, compared with the latter
      some advantages and thus makes a reduction of the period of postoperative
      fixation possible. It is supplied along with the insertion instruments which
      facilitate peroperative reposition and retention of fragments for easier
      insertion of the screw. In the authors' department this screw was used in 1988
      1991 for osteosynthesis in 18 patients incl. 12 with fractures of the navicular
      bone, head of the radius, the patella, Bennett's fracture, osteochondral
      fractures of the femoral condyle and it was also used for osteosynthesis of
      scapholunatal desis and desis of the interphalangeal articulations of the hand.
      In the authors' so far not very numerous group Herbert's screw proved useful-
      only in one patient the X-ray and clinical finding was not satisfactory and
      called for further surgical operation. It is, of course, essential to respect the
      surgical principles for its application, in particular in fractures of the
      navicular bone. The implant is an advance in the treatment of selected recent
      injuries as well as their late sequelae.

PMID- 8342381
TI  - Secondary intramedullary nailing of complicated fractures of lower extremities.
AB  - Between 1984 and 1991, 16 patients with 23 fractures of the lower extremities
      were treated with external skeletal fixation and subsequent intramedullary
      nailing. There were 7 closed fractures, 1 closed fracture with vascular injury, 2
      Grade I, 3 Grade II and 10 Grade III injuries, sansistiny of 5 Grade IIIA, 2
      Grade IIIB and 3 Grade IIIC fractures. The fractures were maintained in external
      fixation for an average of 14 days (range 4 to 32 days) after which the fixateur
      was removed and an intramedullary nail placed during the same procedure in all
      cases. Two of the twenty-three fractures, 9%, subsequently developed deep
      infections involving the intramedullary canal, both of which resolved with
      antibiotics while retaining the nail. Thus we were able to place intramedullary
      fixation in these difficult and often contaminated injuries in less than one
      month with a relatively low incidence of complications.

PMID- 8342382
TI  - [Initial experience with peroperative autotransfusion in spinal surgery].
AB  - The authors describe combinations of anaesthesiological methods which enabled
      them during extensive spondylosurgical operations in 66 patients to reduce the
      consumption of homologous blood during operation to 90 ml, on the first day after
      operation to 300 ml and on the second day after operation to 120 ml. In six
      patients they used preoperative collection of the patient's own blood, in 45
      patients acute normovolaemic haemodilution, in all patients controlled
      hypotension with sodium nitroprusside to a mean arterial pressure of 8-9 kPa and
      peroperative collection of blood by means of an autotransfusion apparatus Dideco
      Stat with a standard programme and yield higher than 50%. During and after
      peroperative collection they did not record any complications. Lower haemoglobin
      and haematocrit values and a reduced number of erythrocytes, lower than the lower
      normal range, during and after operation did not threaten the postoperative
      course in these patients. The authors draw, however, attention to the rise of the
      number of leucocytes immediately after operation to 19.7 x 10(9). 1(-1) which is
      due to their shift into the final product. Solution of this phenomenon which can
      produce ARDS is according to the authors the use of a programme different from
      the standard one.

PMID- 8342383
TI  - [Arthroscopic meniscopexy].
AB  - The author analyses indications and therapeutic possibilities of arthroscopic
      meniscopexy and presents his own results assembled at the First Orthopaedic
      Clinic of the Masaryk University in Brno. He describes the surgical technique
      used, i.e. OUTSIDE-IN, in treatment of recent paracapsular ruptures of the
      meniscus, postoperative fixation and the rehabilitation programme. The author
      discusses also the necessity of a rigid plaster fixation and advocates fixation
      of the knee joint by a bandage as proposed by R. Jones with elimination of
      burdening for a period of eight weeks.

PMID- 8342384
TI  - Non-conventional growth hormone treatment in short children.
AB  - Despite the fact that GH has been available in sufficient amounts to allow
      treatment in non-conventional indications during childhood, results on final
      height are not available or are available in only very small groups of patients.
      Much has to be done to answer the question of how to optimize GH treatment, with
      respect not only to final height, but also to normal psychosocial development.

PMID- 8342385
TI  - Growth hormone and bone metabolism.
AB  - GH is a potent anabolic hormone for bone and calcium metabolism, not only via
      direct effects but also mediated through other systems. The individual effects on
      bone metabolism are summarized in Table 1. Some of the signs (low BMD and low
      serum osteocalcin) and symptoms (increased prevalence of vertebral fractures)
      seen in patients with GHD may be due to the lack of GH itself, others may be due
      to secondary hormone deficiencies or changes in body composition induced by GHD.
      GH treatment can reverse changes of calcium metabolism. Whether it is able to
      increase bone mass still needs to be determined in larger and longer studies.
      Some patients with established osteoporosis and vertebral fractures seem to
      suffer from GHD. Treatment of osteoporosis with GH has not previously been
      successful, but studies with more patients over several years to investigate the
      effects of GH treatment on vertebral fracture rates are lacking. As GH seems to
      reverse some signs of old age, such as muscle weakness and reduced exercise
      capacity, it is possible to speculate that GH could prevent the occurrence of hip
      fractures in elderly people.

PMID- 8342386
TI  - Effect of growth hormone on muscle and protein in critically ill patients.
AB  - In summary, the effects of protein metabolism of the provision of additional GH
      are well documented in critically ill patients. Nitrogen balance improves as urea
      production is diminished. The crucial question is whether this lowers the
      availability of glutamine for cells dependent on it in critical illness. In
      parallel, muscle protein synthesis is stimulated by GH and the free glutamine
      content of muscle is maintained in situations when a depletion of muscle
      glutamine is otherwise seen. Another consistent finding in most clinical studies
      is the pronounced interindividual variability in the response to GH. So far, no
      marker has been identified to predict an individual patient's sensitivity to GH,
      but the identification of individuals who are likely to benefit from GH treatment
      during critical illness should be a priority in future clinical research on GH.

PMID- 8342387
TI  - The consequences of growth hormone deficiency in adults.

PMID- 8342388
TI  - Effects of growth hormone on reproduction.

PMID- 8342389
TI  - Growth hormone and low-density lipoproteins.

PMID- 8342390
TI  - Evaluation of different methods of determining body composition, with special
      reference to growth hormone-related disorders.

PMID- 8342391
TI  - Preliminary report on the development of a disease-specific instrument for
      assessing quality of life of adults with growth hormone deficiency.
AB  - It is notable that many of the feelings described by the people in the sample are
      similar to those experienced at times by people who do not suffer from GHD, that
      is, lapses of memory, feeling drained of energy, loss of temper, loss of
      motivation, difficulty in concentrating, forgetfulness and having a tendency to
      gain weight. Adults with GHD, however, appear to suffer these problems more
      frequently and to a more extreme degree than other people. It is clear that the
      range of problems that afflict people with GHD is great, and that the
      repercussions affect virtually all aspects of their lives. The results from these
      interviews will form the basis of a measure designed specifically to assess the
      quality of life of patients with GHD, and to determine the changes in quality of
      life after treatment with GH.

PMID- 8342392
TI  - Preliminary study of the effects of growth hormone substitution therapy on bone
      mineral density and serum osteocalcin levels in adults with growth hormone
      deficiency.
AB  - In order to evaluate the consequences of pituitary insufficiency on bone mineral
      status, bone mineral density (BMD) was measured by dual-energy X-ray
      absorptiometry in 33 patients (aged 22-65 years) with pituitary insufficiency.
      BMD of the lumbar spine and femoral neck was decreased. Twenty of the patients
      were randomized to receive either recombinant human growth hormone (GH), 0.25
      IU/kg/week for 6 months (0.125 IU/kg/week during the first month), or placebo.
      Serum osteocalcin levels increased significantly during GH administration. In the
      GH-treated group, there was no change in lumbar spine BMD and a small but
      significant decrease in femoral neck BMD (p < 0.05) after 6 months. Treatment
      periods longer than 6 months are needed to evaluate the potential beneficial
      effect of GH on BMD. This is in accordance with our previous findings of an
      increase in forearm BMD after 12 months of GH substitution therapy.

PMID- 8342393
TI  - Protein metabolism in growth hormone deficiency, and effects of growth hormone
      replacement therapy.
AB  - The effects of growth hormone (GH) treatment on protein metabolism were studied
      in adults with GH deficiency (GHD). A double-blind, placebo-controlled trial of
      recombinant human GH, 0.018 IU/kg/day for 1 month followed by 0.036 IU/kg/day for
      1 month, was performed with isotopic whole-body protein turnover studies at 0 and
      2 months. In all, 18 adults with GHD (9 men, 9 women; mean age, 46.6 years;
      range, 30-56 years) were studied. Whole-body isotopic leucine turnover using L-[1
      13C]leucine was assessed by measuring leucine Ra (a measure of protein
      degradation), non-oxidative leucine Rd (a measure of protein synthesis) and
      leucine oxidation rate. Lean body mass and circulating insulin-like growth factor
      I were significantly (p < 0.02) increased at 2 months in the GH-treated group,
      but not in the placebo group. There was no change in leucine Ra in either the
      placebo or GH-treated groups at 2 months. Leucine oxidation decreased (p < 0.01)
      and non-oxidative leucine Rd increased (p < 0.02) in the GH-treated group at 2
      months. There was no significant change in either leucine oxidation or non
      oxidative leucine Rd in the placebo group at 2 months. These results indicate
      that the increase in lean body mass resulting from GH treatment in adults with
      GHD is due to an increase in protein synthesis.

PMID- 8342394
TI  - Economic evaluation of health care technologies.
AB  - Despite two decades of developments, economic evaluation of medical therapies is
      still in its infancy. The first decade was mainly a search for a relevant
      methodology, a period when it was important to establish that new medical
      technologies carried not only costs but also economic benefits. The costs-of
      illness methodology was the most convenient to use and served well to show that
      new medical technology produced economic benefits. It was obvious, however, that
      the method had its limitations, particularly in health care systems devoting more
      and more resources to the elderly, not an economically active part of the
      population. For other people also, health per se is more important than health as
      a human capital that improves work capacity. The studies undertaken in the 1970s
      were mainly based on epidemiological data and undertaken at arms' length from
      clinical activities in hospitals and in general practice. At the beginning of the
      1980s, it became clear that in order to become more relevant, economic
      evaluations have to be linked much more closely to the clinical evaluation of new
      technologies. Clinicians and economists have to work together to produce good and
      relevant studies. The beginning of the 1980s saw such an increase in
      collaboration between economists and clinicians, and some important studies were
      undertaken. These studies were mainly concerned with calculating costs for
      different clinical actions and determining cost-effectiveness using, for example,
      number of life-years gained. During the last 5 years, interest has been focused
      on the problems and opportunities of including quality of life and utility
      estimates in economic evaluations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342395
TI  - Long-term consequences of growth hormone deficiency acquired in childhood.

PMID- 8342396
TI  - Workshop report: protein metabolism and muscles. The effects of growth hormone
      and growth hormone deficiency.

PMID- 8342397
TI  - [Current contribution of molecular biology in the diagnosis of hepatitis B].
AB  - Recent advances in molecular biology had led to a better understanding of the
      pathology of hepatitis B virus. The polymerase chain reaction technique has shown
      that the genome of hepatitis B virus is highly variable. Mutations in the pre
      core region are associated with HBe Ag negative chronic hepatitis and fulminant
      hepatitis B; moreover, rare cases of hepatitis due to HBV with mutations within
      the S gene have been reported in HBV-vaccinated patients. The aim of this paper
      is to assess the clinical, serological and therapeutic features of hepatitis B
      variants.

PMID- 8342398
TI  - Georges Brohee Prize. Oestrogen-progesterone, a new therapy of bleeding
      gastrointestinal vascular malformations.
AB  - Gastrointestinal vascular malformations can cause haemorrhage requiring multiple
      transfusions. Surgical or endoscopic therapy are ineffective when the vascular
      malformations are spread diffusely over the gastrointestinal tract, when lesions
      escape identification or are not accessible for treatment. Several reports
      suggest that oestrogen-progesterone therapy is effective in the treatment of
      epistaxis in hereditary haemorrhagic telangiectasia. The aim of our studies is to
      test the hypothesis that oestrogen-progesterone is an effective treatment for
      bleeding gastrointestinal vascular malformations in patients with a very high
      transfusion need and in whom surgical or endoscopic treatment failed or could not
      be performed. The mean transfusion requirement prior to entering the studies
      amounted to 35.4 units packed per patient. In an uncontrolled trial oestrogen
      progesterone therapy diminished significantly transfusion requirements from 3.4
      units packed cells per patient per month to 0.1 units packed cells (p = 0.02).
      Haemorrhage ceased totally in 3 of 7 patients. A double-blind randomized placebo
      controlled, cross-over trial shows that therapy with 0.050 mg ethinyloestradiol
      and 1 mg norethisterone is very effective in reducing transfusion requirements:
      2.8 versus 11.2 units packed cells over a 6 month treatment period (p = 0.002).
      Only 3 of 13 patients treated with ethinyloestradiol and norethisterone required
      transfusions for persistent bleeding, while 12 of 13 patients in the placebo
      group had transfusion requirements (p = 0.001). After stopping hormonal therapy,
      no transfusions were needed for a mean of 10 months. This indicates a long
      lasting effect of ethinyloestradiol and norethisterone on bleeding and
      transfusion requirements.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342399
TI  - Intravenous clonidine does not promote hypoxemia or platelet aggregation in man.
AB  - This study was designed to evaluate hypoxemia and platelet aggregation in man
      following intravenous administration of clonidine. With Institutional approval
      and following informed consent, 20 patients (ASA I-II) without spontaneous or
      drug-induced coagulation disorder undergoing elective total hip replacement were
      studied. They were randomly divided into two groups. Group A (n = 10) received an
      IV loading dose of 4 micrograms/kg of clonidine in 30 minutes followed by an
      infusion of 1 microgram/kg/h till the end of the procedure. Group B (n = 10)
      received saline. Platelet aggregation was assessed before infusion and at the end
      of both the loading dose and the infusion. PaO2 was measured before anesthesia
      (FIO2 = 0.21), before femoral cementation (FIO2 = 0.40), 2 min. after prosthesis
      implantation (FIO2 = 1), before the end of the procedure (FIO2 = 0.40) and in the
      recovery room (spontaneous breathing with FIO2 = 0.21). Plasma clonidine levels
      were assessed at the end of both the loading dose and the infusion. At any time
      considered, no statistical differences were noted between the groups for platelet
      aggregation and PaO2. We conclude that intravenous clonidine does not clinically
      promote platelet aggregation nor hypoxemia in man.

PMID- 8342400
TI  - Pulmonary function tests predict outcome after cardiac surgery.
AB  - The aim of this study was to examine the value of systematic preoperative
      pulmonary function tests (PFTs) in order to reliably predict prolonged stay in
      I.C.U., prolonged mechanical ventilation and mortality in elective cardiac
      surgical patients. 149 consecutive adult patients (valvular replacement or
      coronary bypass graft) were studied retrospectively. We examined the preoperative
      respiratory data: vital capacity (VC), first second forced expired volume (FEV1),
      PaCO2 and PO2. Length of stay in I.C.U. (LICU), duration of mechanical
      ventilation (DMV), incidence of reintubation and survival rate were used as
      indices of respiratory morbidity. The results of the present study clearly
      indicate that patients with impaired airway flow rates had a prolonged
      postoperative recovery following cardiac surgery. Mortality, ICV and DMV
      increased when FEV1 was less than 1.5 L, VC was less than 2.5 L, or PaO2 was less
      than 8.5 kPa. Reintubation was associated with impaired flow rates. Pulmonary
      function tests appeared effective in predicting postoperative complications and
      the need for prolonged ventilatory support.

PMID- 8342402
TI  - Open placebo controlled comparison of the antiemetic effect of droperidol,
      metoclopramide or a combination of both in pediatric strabismus surgery.
AB  - In children, strabismus surgery is frequently followed by vomiting. The present
      study compares the antiemetic effects of droperidol (10 micrograms/kg) and/or
      metoclopramide (0.1 mg/kg) in 104 children undergoing strabismus surgery. The
      patients were randomly divided into four groups. Group I (n = 28) received
      placebo (saline), Group II (n = 26) droperidol 10 micrograms/kg, Group III (n =
      25) metoclopramide 0.1 mg/kg and Group IV (n = 25) droperidol 10 micrograms/kg
      and metoclopramide 0.1 mg/kg. Droperidol was given just after induction and
      metoclopramide at the end of surgery, just before recovery. The technique of
      anesthesia involved an anticholinergic premedication, IV fentanyl (2
      micrograms/kg), controlled ventilation using isoflurance and N2O in oxygen and
      systematic gastric emptying before extubation. Vomiting, retching and nausea were
      noted at 5 different moments: in the Post Anesthetic Care Unit, when arriving on
      the ward (= after carriage by lift), during the first hour following the return
      in the ward, from the 6th to the 12th postoperative hour and on the morning of
      day 1. There was no statistically significant difference in the incidence of
      vomiting among these four groups. Moreover, the incidence of vomiting in the
      placebo group was much lower (17.9% in the recovery room, 3.6% at return in the
      ward, 25% during the first hour, 7.1% from 6 to 12 hours and 3.6% the next day)
      than that reported in previous studies. We think that this could result from the
      additive effects of some aspects of the technique of anesthesia described and
      discussed in this paper.

PMID- 8342401
TI  - Total intravenous anesthesia in South-African genetic porphyria (variegate
      porphyria).
AB  - The authors report the case of a female patient with South-African genetic
      porphyria who had to undergo hepatic tumorectomy under general anesthesia. The
      choice for propofol as the induction and maintenance agent using a balanced
      anesthetic technique led to a significant rise in urinary excretion of porphyrins
      without associated clinical manifestations. A short review of the literature on
      physiopathology of porphyrias and medicinal agents, susceptible to induce acute
      porphyric crisis follows. The authors conclude that the innocuity of propofol as
      induction and maintaining agent in the porphyric patient cannot be yet
      established without further studies.

PMID- 8342403
TI  - The fit of Procera titanium crowns. An in vitro and clinical study.
AB  - In contrast to conventional casting methods for the production of a metallic
      crown the Procera process is based on precision machine duplication of models
      combined with spark erosion of the metal frame. Some of the steps in the manual
      handling procedure are thereby excluded. The present study evaluated, by means of
      a replica technique, the fit or adaptation of Procera titanium crowns to the
      stone die and in vivo to the tooth before cementation. For any combination, the
      marginal adaptation was superior to and significantly better than the occlusal
      areas and axial surfaces, respectively. In addition, the crowns had a
      significantly better fit to the stone die than to the tooth. The marginal
      discrepancy was approximately 60 microns in vitro and 70 microns in vivo, with a
      range of 3-205 microns.

PMID- 8342404
TI  - The amelocemental junction in young premolar teeth. A replica study by scanning
      electron microscopy.
AB  - To investigate the validity of traditional data on the frequency of various
      relationships of root cementum to coronal enamel at the amelocemental junction,
      the relationship in 50 young premolar teeth extracted on orthodontic indications
      was documented, using replica techniques for scanning electron microscopy (SEM),
      combined with polarization microscopy of thin ground sections (< 40 microns). Of
      200 surfaces, 30 were excluded because of damage during specimen preparation.
      Replicas of the other 170 surfaces were photographed at 20x and 80x in SEM and
      classified as having an edge-to-edge relationship of enamel to cementum in 76%
      and an overlap of cementum onto the cervical enamel in 14%. What appeared to be a
      gap between enamel and cementum at low magnification (10%) was seen at high
      magnification to be a ditch or trough in the cementum: no gaps with exposed
      dentin were observed in SEM. Polarization microscopy of ground sections of the
      original specimens confirmed the SEM classification. In this material, the edge
      to-edge relationship of enamel to cementum predominated: overlapping of cementum
      onto the enamel was less prevalent than previously reported. The methods applied
      in this study circumvented some major sources of artefact formation due to
      shrinkage during specimen preparation, which may previously have caused
      misinterpretation of 'gap' relationships.

PMID- 8342405
TI  - The human incisal suture and premaxillary area studied on archaeologic material.
AB  - The purpose of this study was to investigate the extent of the incisal suture,
      the size of the premaxillary area, and the developmental status of the dentition.
      Sixty-three medieval crania were examined: 30 from children and 33 from adults,
      including 5 cases with tooth deviations. All crania were photographed at a 1:1
      scale. From the photographs the size of the premaxilla and the length of the
      incisal suture were measured. In addition, the spatial conditions in the anterior
      region were recorded. The study showed that the main closure of the suture takes
      place shortly after the crowns of the permanent incisors have attained their
      final width size. The mean size of the premaxillary area was larger in
      individuals with interincisal spacing and smaller in individuals with crowding
      when comparing with normal spatial conditions. In the cases of tooth agenesis the
      premaxillary areas were markedly reduced.

PMID- 8342406
TI  - On functional strain in some fixed and removable partial dentures. An
      experimental in vitro study.
AB  - An 11-unit fixed maxillary reconstruction with 2 bilateral cantilever pontics in
      combination with a removable partial denture (RPD) with a palatal bar was
      fabricated. The RPD was retained to the fixed reconstruction with precision
      attachments. A laboratory model system was constructed in such a manner that the
      mechanical properties of the biologic supporting tissues involved were simulated
      by artificial materials. By means of a strain-gauge technique the deformation was
      studied in both the fixed and the removable partial denture. In different
      laboratory loading situations with and without the RPD the deformation in the
      fixed dental appliance was more extensive and more complex when the RPD was
      excluded.

PMID- 8342407
TI  - Office and ambulatory blood pressure in patients with craniomandibular disorders.
AB  - To assess the physiologic response to daily life stress in patients with
      craniomandibular disorders (CMD), office and ambulatory blood pressure and heart
      rate were studied in 25 female patients and 25 controls. Significant differences
      (p < 0.05) were found between the groups for heart rate before the clinical
      examination and that in the patient group when compared before and after the
      clinical examination. Higher values were found for mean daytime systolic and
      diastolic blood pressure in the control group compared with the patient group (p
      < 0.05). The mean number of systolic blood pressure > or = 140 mmHg during 24 h
      and daytime was significantly higher (p < 0.05) in the control group than in the
      patient group. In this study the CMD patients with muscular diagnosis were not
      more stressed than healthy subjects in the daily activities as evaluated by
      ambulatory blood pressure measurements.

PMID- 8342408
TI  - General practitioners' and dental students' decisions on third-molar diagnoses,
      treatment, and referrals.
AB  - A questionnaire on third-molar problems was mailed to a systematic random sample
      of 200 Norwegian general dental practitioners in November 1991. The return rate
      was 88%. Similar questions were given to 59 5th-year dental students, with a
      return rate of 83%. Ten third-molar cases were presented by means of copies of
      radiographs and written information. The following conclusions were drawn: Apart
      from a terminology problem consisting of lack of discrimination between the terms
      retention and impaction, overall good diagnostic abilities were shown by both
      practitioners and students. Receiver operating characteristic analysis of
      treatment decisions indicated that students were more radical than practitioners.
      The students had an increased referral rate for third-molar surgery, whereas the
      practitioners indicated a more selective practice of referring advanced cases.

PMID- 8342409
TI  - Calcified cartilage zone and its dimensional relationship to the articular
      cartilage in the human temporomandibular joint of elderly individuals.
AB  - The aim was to describe the appearance of the calcified cartilage zone (CCZ) and
      to determine its dimensional relationship to the articular cartilage thickness in
      the normal human temporomandibular joint. An autopsy material comprising 21
      joints from 12 elderly individuals was examined microscopically. The appearance
      of the CCZ was examined, and the thickness of the CCZ and of the total articular
      cartilage was measured in 18 different positions in each joint. The CCZ was
      outlined by a flat or gently undulating tidemark and an irregular osteochondral
      junction. The cellularity of the CCZ varied extensively. The cells were numerous
      in the CCZ when the overlying articular cartilage displayed high cellularity.
      Statistical analysis of the measurements demonstrated a relationship (p < 0.001)
      between the thickness of the CCZ and of the articular cartilage. Our findings,
      both qualitative and quantitative, indicate a close relationship between the
      physiology of the CCZ and of the overlying articular cartilage.

PMID- 8342410
TI  - Visual selective attention: a theoretical analysis.
AB  - The present paper outlines a framework which allows a consistent interpretation
      of data regarding visual selection in visual search tasks. It organizes and
      reviews visual search tasks in which the target is defined by primitive features,
      by conjunctions of features and when the target is categorically different from
      non-targets. The special role of spatial attention is reviewed and different
      theoretical accounts are discussed. Because visual selection depends principally
      on the outcome of the early parallel preattentive stage of processing, the main
      focus will be on this stage. It is concluded that visual selection is to a large
      extent determined by the physical characteristics of the stimuli present in the
      visual field. The early preattentive parallel process computes how different each
      object is from each of the other objects within a particular stimulus dimension.
      Attention is automatically drawn to the location having the highest activation,
      implying that the object at that location is automatically selected irrespective
      of the intentions of the subject. The model also assumes some top-down control.
      It is well known that attention can be voluntarily directed to nonfixated
      locations in visual space, varying from a uniform distribution over the visual
      field to a highly focused concentration. The model assumes that the endogenous
      direction of attention to an area in the visual field is the only top-down manner
      of affecting visual selection. Within the area of directed attention, no top-down
      control is possible: selection is completely determined by the physical
      properties of the stimuli.

PMID- 8342411
TI  - [Transurethral echography in the staging of bladder neoplasms].
AB  - Forty vesical neoplasias in various stages and which were treated through
      transurethral resection followed by chemotherapy, in accordance to the currently
      accepted approach, were studied using transurethral ultrasound techniques. A
      histochemical correlation is established based on the proposed U.I.C.C. grading
      (T.N.M.). Such correlation coincides in 88.2% of cases for the "unified" Ta-T1
      stage; 70% for T2; 88.8% for T3; and 100% for T4.

PMID- 8342412
TI  - [Urologic specialization of the Bachelor Andres de Tamayo, famous surgeon and
      writer of the 17th century].
AB  - During the second half of the 15th century and beginning of the 16th century, the
      problem of "carnosities" and "urine passion" aroused an enormous concern within
      the social and courtesan environments. The Monarchy, participating in this
      concern and confronted with a lack of specialized surgeons, fostered the massive
      hiring of non-college professionals who demonstrated to be knowledgeable in the
      treatment and cure of this conditions, granting them degrees and nominations so
      that they could teach and spread their techniques. One of this practical men was
      the graduate Andres de Tamayo, famous surgeon who worked for Philip II and Philip
      III, acclaimed writer and poet who in 1617 obtained the degree of surgeon and
      "urologist" of the Royal Family for his dedication and specialization in "urine
      passions and carnosities".

PMID- 8342413
TI  - [Prophylaxis of superficial bladder cancer with 1 mg of intravesical BCG:
      comparison with other doses].
AB  - Presentation of results obtained in 171 evaluable patients from a series of 181,
      presenting surface vesical cancer in Tis, Ta and T1 stages, treated with 3
      different dosages of endovesical BCG as prophylaxis for tumour relapse: a) high
      dose, 100 to 120 mg, 72 patients; b) intermediate dose, 20 to 50 mg, 39 patients;
      and, c) minidose of 1 mg, 60 patients. Complications and adverse reactions were
      seen to be dose-dependent, also percentage of patients free of disease both after
      treatment and following addition of retreatment in several patients was similar
      in all the dosages used. It is thus concluded that endovesical BCG 1 mg, would be
      an optimal dosage for the prophylaxis of surface vesical cancer relapse.

PMID- 8342414
TI  - [Microdoses of BCG vaccine for prophylaxis in bladder cancer stage T1].
AB  - A prophylaxis with a minidose of BCG Vaccine (1 mgr.) is performed in vesical
      instillation during one year, to 108 patients bearing bladder cancer in the stage
      T1. In the first month the instillations are once a week, each fifteen days the
      second and third month and then, once a month for one year. An 19.4% of
      recurrences is obtained with an general average observation time of 37.3 months
      as well as an important increase of muster populations of T lymphocytes and a
      positive test of dinitroclorobenzene. As complications we have obtained an
      inguinal BCG adenitis and in a few cases disury and frequency for two or three
      days. We conclude that the doses of the BCG vaccine used during the period of one
      year, is satisfactory in the reduction of recurrences and without important
      complications.

PMID- 8342415
TI  - [Our experience in the treatment of cystine lithiasis].
AB  - Contribution of six cases of patients with cystinic lithiasis, diagnosed and
      treated at our centre. Analysis of pathophysiological mechanisms, key data for
      their diagnosis and current aspects of treatment, as well as a review on past and
      recent literature on this disease.

PMID- 8342416
TI  - [Vesico-intestinal fistulae].
AB  - Review of vesicointestinal fistulae cases treated in the Urology Unit at our
      hospital over the last few years. Most frequently seen cause was colorectal
      cancer (66%) and most frequent location was vesicosigmoideal (50%). Clinical
      signs and symptoms were varied, mainly urinary infection in 100% cases,
      pneumaturia in 66% and fecaluria in 50%. Opaque enema and cystography were great
      diagnostic aids as complementary methods. Also U.I.V., cystoscopy, rectoscopy and
      C.A.T. were used. Treatment was surgical in all cases where the patient's general
      health status allowed it.

PMID- 8342418
TI  - [Synergistic necrotizing fasciitis of genitalia and perineum. Our experience].
AB  - Presentation of 9 cases of synergistic genitalia and perineum necrosing fascitis
      treated in our service over the last 5 years. The contents of the disease and its
      terminology has been reviewed by the light of the existing literature. In our
      series, patients mean age was 65 years. Three of our 9 patients had diabetes
      mellitus, and also 3 had liver disease due to alcohol. The initial septic focus
      was found in 8 cases, and in 4 it was urological, basically urethra's stricture.
      The most frequently involved germs were aerobe-anaerobe associations. Mortality
      was 11%.

PMID- 8342417
TI  - [Prognostic value of the tissue expression of human chorionic gonadotropin (beta
      HCG) in infiltrating transitional carcinoma of the bladder].
AB  - Study of the ectopic secretion of Human Chorionic Gonadotrophin (beta-HCG) in the
      tumoral tissue of 62 patients diagnosed with infiltrant transitional carcinoma of
      the bladder. The inmunohistochemical tests showed specific stains in 15/62
      patients. Bi-varied analysis showed that vesical tumours with beta-HCG ectopic
      expression present associated nodular disease with a significantly higher
      prevalence (p = 0.02). Survival of patients with beta-HCG+ tumours was overall
      lower that of patients with beta-HCG-tumours, but this difference did not reach
      statistical significance. Multivariate analysis of survival showed no prognostic
      value for the tissue expression of beta-HCG, when it is considered as an isolated
      variable. Complete local response was seen in 5/6 beta-HCG+ patients treated with
      pre-operative chemo and radiotherapy and in 1/4 patients treated with pre
      operative radiotherapy. Tissular expression of beta-HCG is a poor prognostic
      factor due to its relationship with another 2 variables of larger predictive
      capability: the presence of metastatic nodular disease and the infiltration of
      venous and/or lymphatic structures of the vesical wall.

PMID- 8342419
TI  - [Vesiculography with echo-guided transperineal puncture: a complement to
      intracavitary transrectal echography].
AB  - The present paper is a presentation of our experience in the study of seminal
      vesicles through transperineal ultrasound-guided puncture vesiculography
      (T.U.P.V.). Explanation of the technical procedure, performance of an analysis of
      indications and evaluation of its advantages and disadvantages. We consider that
      T.U.P.V. is another technique to further study the processes affecting the
      seminal vesicles.

PMID- 8342420
TI  - [Obstruction caused by anterior urethral valves in childhood].
AB  - Presentation of 3 patients (aged 11 years, 9 months and 9 years old) with
      diaphragm-like valves in the anterior urethra. Haematuria, urinary tract
      infection and thin voiding stream were the most common symptoms. Transurethral
      endoscopic resection with cold blade solved the problem appropriately in two
      cases, though the youngest patient required resection of stenotic area and end
      terminal by-pass of the urethra.

PMID- 8342421
TI  - [Associated renal malformations. Renal agenesis and ectopy].
AB  - The association of ectopia and renal agenesis is not a common occurrence.
      Incidence is variable although in the clinical practice it usually represents
      1/900-1500 visits, and occurs in the absence of one kidney in 10% of pelvic
      ectopias and accompanied by genital deformations in 50% of cases. A large number
      of cases present no symptoms and the diagnosis happens by chance during an X-ray
      examination for other reasons. In further occasions other urological
      manifestations lead to the discovery. Treatment is usually conservative and
      expectant, and surgery becomes necessary only when is inductive of infectious and
      obstructive symptoms that might compromise the organ's viability and the
      patient's life.

PMID- 8342422
TI  - [Diagnosis of prostatic abscess with echography].
AB  - Report of our experience in 15 cases of prostatic abscess where diagnosis was
      established by ultrasound techniques. Most frequent images were: irregular and
      heterogenical hyperchoic areas.

PMID- 8342424
TI  - [National uro-oncologic registry].

PMID- 8342423
TI  - [Arteriovenous fistulae following percutaneous renal biopsy in renal
      transplantation. Selective arterial embolization].
AB  - Five cases of clinically severe arteriovenous fistulae (AVF) secondary to
      percutaneous renal biopsy in patients carrying a functional renal graft were
      diagnosed and treated in our centre. Occlusion via superselective intraarterial
      embolization accomplished successful control in every case. We insist on the
      therapeutical value of this minimally invasive technique, which furnish it with a
      particularly relevant role in renal transplantation.

PMID- 8342425
TI  - [The diagnosis of infravesical obstruction].

PMID- 8342426
TI  - [Conceptual review of oncocytic lesions].
AB  - Updating of a series of entities which significance is not always pathological,
      or it is poorly known, and which are related to oxyphilic transformation of
      epithelial cells. Review of concepts such as "oncocytosis", "oncocytic
      hyperplasia" and "oncocytoma", establishing a hypothetical continuum of damage
      which could actually be contemplated within the evolution spectrum of hyperplasia
      adenoma-carcinoma. Also, both the changes occurring at subcellular level and the
      hypothesis considered to explain them are commented.

PMID- 8342428
TI  - [Multivariate analysis of local response to preoperative treatment in patients
      with infiltrating carcinoma of the bladder].
AB  - The article presents a multivariate study carried out by means of a logistic
      regression of local responses (reduction to stage p0, p1 or p 'in situ') in 82
      patients with transitional infiltrant carcinoma of the bladder, undergoing 3
      different types of radical therapy: 25 patients treated with TUR and radical
      cystectomy; 33 patients treated with TUR, pre-operative radiotherapy (45-60 Gy)
      and radical cystectomy; and 24 patients treated with TUR, intra-operative
      radiotherapy (15 Gy), external radiotherapy (46 Gy), neo-adjuvant chemotherapy
      and radical cystectomy. Local response increased with the intensity of pre
      operative therapy, there being a better relationship with this approach than with
      the initial clinical stage of the tumour. The factors which better explain the
      prospect of an objective local response are the use of radiotherapy associated to
      chemotherapy and the absence of metastatic lymphatic nodes. These 2 variables can
      adequately predict the local response in 87% of patients.

PMID- 8342427
TI  - [Response of superficial bladder carcinoma to prophylacit treatment with
      mitomycin-C versus interferon. Preliminary study].
AB  - The efficacy of two protocols for the prevention of relapse using Mitomycin-C and
      alpha-Interferon in 56 patients with surface bladder carcinoma (stages Ta-T1)
      treated with TUR was compared in a prospective study. Relapse percentages and
      rates, related to the tumours' presentation characteristics (single, multiple,
      primary, recurrent), as well as their systemic and local toxicity, were
      evaluated. The study of statistical significance is made using the squared-chi
      test, and it is completed with a Fisher's test for groups containing few elements
      for accuracy. The results show no statistical differences (log rank p = 0.313)
      between the two groups of endovesical therapy, both confirming to be effective as
      adjuvant therapy to TUR in surface bladder tumours.

PMID- 8342429
TI  - [Endoscopic trigono-cervico-prostatotomy: our experience].
AB  - Presentation of our experience in treating the disease of the vesical neck
      through longitudinal endoscopic transurethral incisions in 24 patients following
      the Orandi procedure. Of the 24 patients seen in our service, 21 showed a clear
      clinical and urodynamic improvement. Complications were 2 cases of
      epididimorchitis and 1 iatrogenic stenosis of the anterior urethra. There were no
      major haemorrhages, urinary incontinence, or retrograde ejaculation except for an
      obvious decrease of ejaculate volume in 2 cases.

PMID- 8342430
TI  - [Primary Kaposi's sarcoma of the penis in a patient with acquired
      immunodeficiency syndrome].
AB  - Presentation of one case of a 40 year-old, homosexual, AIDS diagnosed male with
      extrapulmonary tuberculosis (lymphatic nodes) and prior history of gonococcal
      urethritis, brain toxoplasmosis, molluscum contagiosum and pneumonia by
      Pneumocystis carinii. A purpura-type lesion with inflammatory features appeared
      in the foreskin which was diagnosed as primary Kaposi's sarcoma of the penis. The
      article explains the clinical signs and symptoms, laboratory data, histological
      findings, and it reviews the literature.

PMID- 8342431
TI  - [Ureteral obstruction secondary to endometriosis. Report of a case].
AB  - The urinary tract is rarely affected by endometriosis, urinary bladder being the
      most common location. This paper presents one case of advanced extrinsic
      endometriosis which initially presented as obstructive pyelonephritis. The
      diagnostic methodology, including uro-tomographic imaging, is evaluated. Although
      good results have been reported with hormone-therapy, we support the surgical
      approach sanctioned by the patho-anatomical findings.

PMID- 8342432
TI  - [Conservative treatment of Wunderlich syndrome in a functional monorenal
      patient].
AB  - Presentation of one case of Wunderlich's syndrome secondary to spontaneous
      mesorenal fracture due to renal angiomyolipoma. In our case, the therapeutical
      approach is based in the need to preserve the functional renal unit. Wunderlich's
      syndrome or spontaneous perirenal haematoma can occur for a variety of causes,
      the most frequent ones being renal adenocarcinoma and renal angiomyolipoma. The
      latter is a hamartoma made up of three different tissue lines: smooth muscle
      cells, blood vessels and adipose tissue. Based on our case, we discuss the
      clinical, prognostic and therapeutical aspects related to renal angiomyolipomes.

PMID- 8342433
TI  - [Synchronous and bilateral inverted papilloma of the kidney pelvis. Conservative
      treatment].
AB  - Contribution of a new case of inverted papilloma (IP) of the upper urinary tract
      (UUT) with the idiosyncrasy of being bilateral and synchronic, a fact not found
      in the reviewed literature, treated with radical surgery on the left side and
      conservatively on the right one. Discussion on this pathology is addressed,
      emphasising its benign biological behaviour, which does not eliminate some cases
      of malignization. Treatment has to be conservative, and so we stress the
      relevance of defining a suspicion state to make pre- and peri- operative
      diagnosis in which endourological methods, that allow both direct visualization
      and the taking of a biopsy, play a preeminent role. Subsequent strict monitoring
      is essential due to the likelihood of relapse and malignant changes.

PMID- 8342435
TI  - [Spontaneous bladder rupture: report of a case].
AB  - Contribution of one case of spontaneous vesical fracture in a patient with no
      urinary pathological background. Presentation of this picture is highly uncommon.
      In this case, a major alcoholic intake stands out as the unleashing factor which
      provoked vesical overdistension with an intraperitoneal posterior fracture. A
      review is made of the various etio-pathogenic mechanisms which can originate this
      pathology, as well as the diagnostic and therapeutic methodology.

PMID- 8342434
TI  - [Renal oncocytoma in acquired cystic diseases].
AB  - The authors report a case of renal oncocytoma associated with acquired renal
      cystic disease and we comment on its pathogenesis and course. This case responds
      a patient with chronic end renal insufficiency, included in a maintenance
      hemodialysis program for the two previous years nefrectomy. The association of
      oncocytoma with acquired renal cystic disease has been previously described only
      twice; both patients have been hemodialyzed for a long time.

PMID- 8342436
TI  - Fascism and the eye of the beholder: a reply to J. S. Searles on the controlled
      intoxication issue.

PMID- 8342437
TI  - Smoking in pregnancy: a follow-up study of women unwilling to quit.
AB  - During a smoking intervention trial at Buskerud Central Hospital in Norway in
      1988-1989, 79 out of 279 smoking pregnant women refused any form of intervention.
      Thirty-five of the women (44%) expressed a negative attitude to quit smoking and
      insisted on continuing their smoking habits. Forty-four (56%) indicated a
      positive interest in quitting, but refused advice and assistance from the health
      service. The smoking pattern of the 79 women was followed during 12 months. In
      spite of their stated unwillingness to change their smoking habits, or their
      refusal of advice, no difference was observed in their quitting or reduction rate
      during pregnancy compared to a control group of women with a positive interest in
      quitting. In addition, significantly more women in the latter group actually
      increased their smoking. The quitting rate of the negatively motivated women also
      proved similar to that obtained in a stop-smoking intervention used among
      positively motivated women who also had received additional information. Hence,
      the negatively motivated do not appear to represent a graver risk group than
      other pregnant women.

PMID- 8342438
TI  - In search of an alternative placebo: estimating alcohol content of nonalcoholic,
      light, and regular beer.
AB  - Alcohol research has demonstrated that expectancies about what one has consumed
      may supercede pharmacological effects of the drink. The present study sought to
      expand the scope of the placebo designs by examining an alternative manipulation,
      using widely available nonalcoholic beverages. The nonalcoholic beers used in
      this study have recently become marketed and made available to consumers by two
      major breweries. Subjects were provided with a total of four beer samples: two
      nonalcoholic samples ("O'Doul's" and "Sharp's"), one light sample ("Busch
      Light"), and one regular sample ("Busch"). Results indicated that subjects
      estimated the alcohol content in "O'Doul's" as significantly lower than that of
      the light and regular beers; the estimate of alcohol content in Sharp's was not
      significantly lower than either the light or regular beers. In addition, the mean
      alcohol estimates for both nonalcoholic beers approximated the actual alcohol
      content of a light beer (roughly 3%). These results indicate that nonalcoholic
      beers may provide a viable alternative to the placebo manipulations currently in
      vogue.

PMID- 8342439
TI  - Morphine and human aggression.
AB  - Twenty-eight male undergraduates received either 45 mg of immediate-release oral
      morphine tablets or a placebo. Subjects were then given the opportunity to
      administer electric shocks to an increasingly aggressive bogus opponent during a
      competitive reaction-time task. Subjects in the morphine condition were more
      willing to initiate attacks against their opponent than subjects in the placebo
      condition, and reacted more aggressively at all levels of provocation.

PMID- 8342440
TI  - An expert system intervention for smoking cessation.
AB  - Intervention efficacy can be increased when the treatment is maximally matched to
      the needs of the client. One means of achieving such matching is through use of
      an expert system, a computer-based decision-making system designed to utilize
      client information to produce unique, matched information and interventions. An
      expert system can combine the individual matching possible in a clinic-based
      intervention and the low cost associated with a public health approach. This
      paper begins by discussing several alternative implementations of the expert
      system approach within the general context of communication theory. Second, the
      theoretical model and related empirical evidence which form the basis of the
      expert system is described briefly. Third, the details of a computer-driven,
      expert system intervention specifically developed for smoking cessation is
      described. Finally, empirical results from a study comparing the expert system
      intervention to three alternative interventions for smoking cessation are
      presented. In general, the expert system approach can provide a cost effective,
      viable, and efficacious means of intervening in a specific problem behavior area.
      Implications and potential areas of development are discussed.

PMID- 8342441
TI  - Hangover moderates the association between personality and drinking problems.
AB  - This study investigated hangover as a potential mediator or moderator of the
      relation between personality and drinking problems. Hangover did not appear to
      mediate the relation, suggesting that the link between personality and drinking
      problems does not stem from an indirect effect via hangover. Hangover did appear
      to moderate the relation. Personality and drinking problems correlated
      significantly for subjects who reported experiencing severe hangovers, but not
      for those who reported mild hangovers. Those who experience greater hangover may
      choose to drink more alcohol in order to relieve these adverse effects, and this
      choice may vary with personality. The theoretical and conceptual implications of
      mediators and moderators are also discussed.

PMID- 8342442
TI  - Additive effects of mood and eating forbidden foods upon the perceptions of
      overeating and binging in bulimia nervosa.
AB  - We examined the relationship between actual caloric intake and subjective
      perceptions of amount eaten using self-monitoring data. Forty subjects
      participated in the study: 20 bulimia nervosa patients and 20 normal controls.
      All subjects monitored their eating for a 2-week period and rated each eating
      episode on a Likert-type scale ranging from an undereat to a binge. Estimates of
      actual caloric intake were compared with these subjective ratings. Bulimics were
      found to overrate the amount consumed, relative to controls. The effect increased
      as caloric intake increased. Bulimics' ratings of amount eaten and binging were
      found to be predicted by the estimate of the actual amount eaten, the type of
      foods eaten, and the subjects' mood prior to eating, while nonbulimics' ratings
      were predicted only by the estimated actual amount. Subjective ratings of amount
      were found to be the best predictor of purgative activity. The results are
      discussed in terms of a perceptual bias theory, treatment implications, and
      possible revisions to the current DSM criteria for bulimia nervosa.

PMID- 8342443
TI  - Attributional correlates of cessation self-efficacy among smokers.
AB  - Male and female smokers (N = 121) stated the most important cause of previous
      abstinence failure and rated this attribution along the dimensions of
      internality, stability, globality, and controllability. Respondents also
      estimated their ability to abstain from smoking in a variety of hypothetical
      situations (i.e., cessation self-efficacy). Results indicated that high self
      efficacy smokers attributed prior abstinence failure to motivational and
      situational factors more frequently than low self-efficacy smokers. Significant
      correlates of cessation self-efficacy included perceived success of prior quits
      (r = .26), percent of family/friends who smoke (r = -.21), causal stability (r = 
      .18) and causal control (r = .21). Composite attributional indices of behavioral
      self-blame and the abstinence violation effect also correlated significantly with
      cessation self-efficacy (rs = .21 and .22, respectively). Consistent with self
      efficacy theory, these findings suggest that personal experience, vicarious
      experience, and attributional processes play a role in one's perceived ability to
      refrain from smoking.

PMID- 8342444
TI  - Reasons for smoking or not smoking in early adolescence.
AB  - Previous studies of smokers' and nonsmokers' reasons have not compared their
      reasons for smoking and their reasons for not smoking, or examined the extent of
      change or stability in these reasons over time. We examined reasons for smoking
      and not smoking in a large sample of 13-year-olds from the general population.
      Factor structures of reasons differed according to whether adolescents were
      smokers or nonsmokers. Nonsmokers were found to be less discriminating than
      smokers about the reasons for smoking. Smokers and nonsmokers tended to show more
      agreement about the reasons for not smoking. Recency of smoking was
      differentially related to the factors for smoking and the factors for not
      smoking. "Image" was a more important reason for smoking at age 11 than at age
      13. "Friends" as a reason for smoking showed a small degree of consistency across
      age, whereas reasons involving relaxation and pleasure showed a relatively higher
      degree of consistency. Health, as a reason not to smoke, showed only a small
      degree of consistency, while social context, effects and access were moderately
      consistent as reasons not to smoke at ages 11 and 13.

PMID- 8342445
TI  - Disinhibition and negative affectivity in substance abusers with and without a
      gambling problem.
AB  - A cohort of 2,171 substance abusers were assessed for their gambling behavior,
      and divided into three groups: those with no significant gambling problem (87%);
      those with a probable problem (7.2%); and those with a severe problem (5.8%).
      Substance abusers with a gambling problem scored significantly higher on measures
      of: impulsivity; disinhibition of aggressive/hostile responses; and negative
      affectivity. They also abused more substances than the nongamblers. The results
      underscore the importance of assessing a wide range of impulsive behaviors in
      substance abusers and the potential for subtyping substance abusers based on
      psychological traits.

PMID- 8342446
TI  - The cast-6: development of a short-form of the Children of Alcoholics Screening
      Test.
AB  - The 30-item Children of Alcoholics Screening Test (CAST) is shortened to a 6-item
      scale (CAST-6) using Principal Components Analysis of CAST responses for three
      distinct samples: outpatient substance abusers, outpatient psychiatric patients,
      and medical students. The face validity, internal consistency, and discriminatory
      ability of the CAST-6 are examined. The CAST-6 is judged to compare favorably
      with the full CAST and to provide a more efficient way to identify adult children
      of alcoholics.

PMID- 8342447
TI  - Changes in family functioning during treatment and drinking outcomes for high and
      low autonomy alcoholics.
AB  - Alcoholics' level of autonomy was hypothesized to have a moderating effect on the
      relationship between changes in family functioning and subsequent drinking
      behavior. Functioning of families of patients in outpatient alcoholism treatment
      was assessed prior to the onset of treatment and again 6 months later. For
      alcoholics who were low in autonomy, perceptions of improvements in functioning
      predicted better drinking outcomes during a subsequent 6-month follow-up, while
      changes in family functioning were unrelated to drinking behavior in high
      autonomy alcoholics. The areas of family functioning in which change was a
      significant predictor of later drinking primarily concerned the quality of
      interactions between family members. Alcoholics' gender, psychiatric comorbidity,
      and the type of treatment they received did not moderate the relationship between
      changes in family functioning and drinking outcomes. Implications for the
      treatment of alcoholic patients and the limitations of the research are
      discussed.

PMID- 8342448
TI  - Tolerance in gambling: an objective measure using the psychophysiological
      analysis of male fruit machine gamblers.
AB  - "Excitement" has often been referred to as the gambler's drug although until
      recently there was little evidence to substantiate such claims. This study
      involved the systematic monitoring of the psychophysiology of fruit machine
      gambling using heart rate measures in 30 adolescent male gamblers. The study was
      designed to test heart rate differences between regular and nonregular fruit
      machine gamblers (i.e., between subjects) and differences against the players'
      own baseline rates (i.e., within subjects). Results showed that there were no
      heart rate differences between regular and nonregular gamblers although during
      gambling, both groups' heart rates increased by approximately 22 beats per
      minute. It was also found that nonregular gamblers' heart rates did not decrease
      significantly after gambling whereas regular gamblers did. This finding could be
      argued as the first study to demonstrate an objective measure of gambling
      tolerance.

PMID- 8342449
TI  - Evaluation of the effect of contraceptive prices on demand in eight Western
      European countries.
AB  - Wide differences exist among European countries as regards national reimbursement
      schemes and the resulting individual expenditure on contraception. In this
      current research project annual expenditure and costs in the first year of use
      were calculated, taking into account existing reimbursement levels, for oral
      contraceptives, intrauterine devices, condoms, and sterilization in eight Western
      European countries: Italy, France, United Kingdom, Spain, West Germany, Austria,
      Sweden and Denmark. The costs were expressed in Swiss francs. For users of oral
      contraceptives it emerged that the annual expenditure on contraception ranged
      from nil in the United Kingdom to 172.32 Swiss francs in Austria. In the case of
      condoms, the cost to users was lowest in the United Kingdom (57.44 Swiss francs)
      and highest in Spain (105.95 Swiss francs). Expenditure on the use of an
      intrauterine device in the first year ranged from nil in the United Kingdom and
      Sweden to 449.87 Swiss francs in Austria, while sterilization was carried out
      free of charge in France, West Germany and Denmark, as compared with a cost of
      677.57 Swiss francs in Italy. The variation in expenditure was largely explained
      by the extent to which contraception costs are reimbursed in the respective
      countries. Correlation of the calculated expenditure on a method and its use did
      not show any statistically significant trend. This suggests that the wide
      differences in the choice of contraceptive methods between countries are not
      related to differences in national reimbursement schemes and resulting costs to
      users, and that other factors must be involved.

PMID- 8342450
TI  - Contraceptive practice and attitudes in former Soviet women.
AB  - For decades, abortion has been the principal birth control method for Soviet
      women. As indicated by some earlier local surveys, most couples use unreliable
      methods. Little is known about the latest trends in contraceptive use affected by
      the recent general liberalization of Soviet society, including more open
      attitudes about sex. A survey was conducted in 1991 via a questionnaire in the
      popular 'Health' magazine with national circulation. A total of 8059 women
      returned the questionnaire. The sample is selective with an overrepresentation of
      young and better educated urban residents, mostly from Russia and the Ukraine.
      Some 81% reported use of a contraceptive method during the last 5 years.
      Traditional methods still prevail (41% used withdrawal, rhythm and douche). Among
      women younger than 25 years there is a clear trend toward use of modern methods
      (IUD 35% and the pill 10%), although their notion of the 'pros" and 'cons' is
      biased. Of the respondents, 20% used a barrier method, mainly condom. The
      preferred method is the IUD (51%) and the pill (18%). Abortions resulting from
      contraceptive failure were reported by 60% of women. Eighty-nine percent
      considered pregnancy termination more dangerous than its prevention. For only 12%
      of respondents, a physician was the main source of contraceptive information,
      although 49% addressed him for advice. The results indicate a gap between
      conservative birth control practice and preferences of Russian women, with a
      positive general trend in the near future.

PMID- 8342451
TI  - A multicenter clinical trial in Nigeria with a low-dose oral contraceptive,
      Marvelon.
AB  - The monophasic combination preparation, Marvelon, is a modern, technically
      improved oral contraceptive. It was tested for contraceptive reliability, cycle
      control and acceptability in 4 clinical centers in Nigeria for a period of one
      year. A total of 408 women was included in these studies, and 3102 cycles were
      monitored. The results showed a high contraceptive reliability and an excellent
      cycle-control. It was well tolerated. There were very few side-effects and the
      symptoms during medication were minor and hardly needed any treatment. At 12
      months, 43.1% of the acceptors were still in the trial. Seventy-nine women
      (19.4%) discontinued before the end of the study for any reason. Drop-out reasons
      of these women were mainly non-medical. For the remainder of drop-outs no reason
      was given. This study suggests that this new oral contraceptive adequately
      satisfies the contraceptive needs of modern women.

PMID- 8342452
TI  - Introductory trial of the once-a-month injectable contraceptive, Cyclofem, in
      Indonesia.
AB  - Cyclofem, a once-a-month injectable hormone contraceptive, contains
      medroxyprogesterone acetate, 25 mg and estradiol cypionate, 5 mg. Indonesia is
      one of the countries participating in an introductory trial in collaboration with
      the World Health Organization (WHO) under the Human Reproduction Program (HRP).
      The main purpose of the trial is to assess, through a limited cohort of users,
      both problems and user needs in the program situation with regard to safety,
      efficacy, acceptability, and causes of discontinuation in the Indonesian context.
      Data based on the trial (March 1990-February 1992) indicate that the Cyclofem
      women complained of dizziness, nausea, bleeding problems, migraine, vomiting,
      amenorrhea, allergies and hypertension during the use of Cyclofem. However, it
      was found that the complaint rates decreased with increased duration of use. The
      life table continuation rates indicate that about 80% and 66% continued use at
      the end of 6 months and 12 months, respectively. Personal reasons account for the
      highest proportion of discontinuation, followed by desire for pregnancy and lost
      to-follow-up.

PMID- 8342453
TI  - Evaluation of liver function and lipid metabolism following Norplant implant
      removal.
AB  - A final evaluation of this longitudinal study involving 100 Singaporean women
      shows that, besides a significantly elevated bilirubin level, there is no other
      evidence of hepatocellular dysfunction with the use of Norplant implants. The
      elevated bilirubin levels remained significantly elevated six months after
      removal of the implant. Despite this, all values of bilirubin remained within the
      clinical range for the population studies. As regards lipid metabolism, total
      cholesterol, LDL-cholesterol and total triglycerides continued to remain below
      the pre-insertion mean at six months post-removal. The HDL-cholesterol showed a
      significant increase following removal of the implants. As a result, the HDL
      cholesterol/(total cholesterol-HDL-cholesterol) ratio continued to remain above
      0.200. This indicates that Norplant implants are not directly contributory to
      cardiovascular risk.

PMID- 8342454
TI  - Evaluation of hemostatic function following Norplant implant removal.
AB  - Norplant implant use in Singapore showed a decrease in vitamin K-dependent
      Factors II, V, VII and reduction in fibrinolytic activity at the end of 5 years
      of use. Increased platelet numbers and accelerated platelet aggregation were also
      found throughout the 5 years of Norplant use. It thus appears that unlike the
      combined pill, prolonged Norplant use does not activate the coagulation system
      and does not enhance a state of hypercoagulation. On removal of the Norplant
      implants at the end of 5 years, the significant changes seen in hemostatic
      function observed with Norplant use remained.

PMID- 8342456
TI  - Intracervical anchoring: a new approach to intrauterine contraception.
AB  - The intracervical device described in this paper consists of copper wire around a
      small plastic frame that is anchored to the inner wall of the cervix, at about
      1.5 cm from the external os. The device represents a radical departure from
      conventional intrauterine contraception and 'frameless' IUDs, which are anchored
      to the uterine fundus. The device was evaluated in a preliminary study of 11
      women. During the 3-month evaluation period, there were no expulsions or removals
      for any reason. The device was well tolerated. Expanded clinical trials are
      planned.

PMID- 8342455
TI  - A multicenter study of the clinical performance of the Ortho Gyne-T380 Slimline
      intrauterine device in routine use in general practice and family planning
      clinics. UK Family Planning Research Network.
AB  - In a multiclinic use-effectiveness study, 505 parous women were fitted with an
      Ortho Gyne-T380 Slimline intrauterine device (IUD). Gross cumulative event rates,
      calculated by the Tietze-Potter life-table method, show the device to have a very
      low pregnancy rate and a low expulsion rate. The rate of removal following
      complaints of bleeding and/or pain was high. The incidence of infection was low
      and more likely to occur among younger users. The older parous women were more
      likely to have a satisfactory experience of IUD use than younger users. In
      accordance with current advice, and following a full discussion with the client,
      long-term use of the device beyond the manufacturer's recommended time period
      will continue among satisfied users.

PMID- 8342457
TI  - Ovarian function during hormonal replacement therapy in perimenopausal women.
AB  - To determine the need for contraception during Hormonal Replacement Therapy (HRT)
      in perimenopausal women, ultrasound monitoring of ovarian function was performed
      on 10 perimenopausal women in the second month of treatment. All patients were
      not at risk of unwanted pregnancy during the study period and had last regular
      menses at least three months before starting HRT. All of them received
      transdermal implants of 50 mg of estrogen, twice per week, and 10 mg of oral
      dydrogesterone on the fourth week. Ultrasound performed at treatment days 7, 14
      and 21 of the second month revealed follicular development and rupture in 5 out
      of the 10 patients. Contraceptive implications are discussed.

PMID- 8342459
TI  - The new intrauterine contraceptive devices: safe and effective.
AB  - Reviews of the safety of intrauterine contraception usually are based on studies
      that do not reflect changes in clinical practice that have occurred over time,
      and that include many types of IUDs that are no longer used. Studies of
      insertions of the Multiload 375 and Copper T 380 performed since 1980, which more
      accurately reflect current clinical practice, show that these IUDs provide a high
      level of protection against pregnancy and are associated with low rates of
      complications. Current clinical opinion regarding the safety of IUDs needs to be
      reassessed in light of the positive safety record of these IUDs.

PMID- 8342458
TI  - Clotting factors after emergency contraception.
AB  - Women with a previous history of thromboembolic disease have often been denied
      oral emergency contraception because of a theoretical concern about increasing
      their risk of thrombosis. METHODS: Eleven healthy volunteers with regular periods
      were recruited to the study. A thrombophilia screen was done at the first visit
      and they each had four measurements of Factor VII and antithrombin III taken at
      mid-cycle for two cycles. In the third cycle, emergency contraception was given
      mid-cycle and blood samples were taken 1, 3 and 7 days later. A further four
      samples were taken during the following cycle and, where the cycle had been
      significantly foreshortened due to the emergency contraception, a fifth cycle was
      monitored. The treatment given during the third cycle was the standard Yuzpe
      regimen of emergency contraception, which consists of 100 micrograms of
      ethinylestradiol and 500 micrograms of levonorgestrel repeated after twelve
      hours. RESULTS: There was a wide inter- and intra-subject variation in clotting
      factors in the observation months. There was no obvious effect noted in the
      levels of the factors measured after treatment, either in the first week or in
      the subsequent month(s) of follow-up. CONCLUSIONS: The dosage of ethinylestradiol
      used in emergency contraception is very shortlived and this study shows no effect
      on clotting factors. This suggests that ethinylestradiol should not be
      automatically dismissed in women with previous thromboembolic disease.

PMID- 8342460
TI  - Rapid absorption and local redistribution of progesterone after vaginal
      application in gilts.
AB  - Catheters were implanted in 6 anaesthetized gilts (3 animals in the follicular
      phase, 3 in the luteal phase) into a carotid artery and into the utero-ovarian
      vein and uterine artery on both sides. The uterine lumina were closed by a
      suture. Further, a catheter was inserted into the vagina after which the animals
      were allowed to recover. Tritiated progesterone was infused into vagina the
      following day during a 2 min period and simultaneous blood samples collected from
      the 5 catheters every 10 min for 2 h after which the animals were sacrificed.
      Tissue samples were obtained from the genital organs. The results showed a rapid
      absorption of progesterone from the vaginal lumen and a marked redistribution to
      the genital organs. The increased level of radioactivity in the plasma samples
      collected from the uterine arteries compared to the simultaneous samples from the
      carotid artery in 2 of the 3 animals in the luteal phase indicates the existence
      of a local redistribution system.

PMID- 8342461
TI  - Clinically diseased cats with non-suppurative meningoencephalomyelitis have Borna
      disease virus-specific antibodies.

PMID- 8342462
TI  - Aerobic bacteria occurring in the vagina of bitches with reproductive disorders.
AB  - A retrospective survey was performed of aerobic bacterial species found in the
      vagina of 203 bitches with genital disorders, e.g. infertility, vaginitis,
      pyometra and puppy death. Escherichia coli, beta-hemolytic streptococci,
      Staphylococcus intermedius and Pasteurella multocida were the species most often
      isolated. From bitches with pyometra E. coli in pure culture was the most
      frequent isolate. In contrast, the majority of infertile bitches gave rise to
      mixed cultures, and no specific bacterial species was consistently associated
      with infertility. Thus, bacterial sampling from infertile bitches was concluded
      to be of low diagnostic value. Bacterial species isolated from the bitches having
      vaginitis were present in pure culture in 26.9% of the samples while nonspecific
      mixed cultures were obtained from 34.6% of the samples from these bitches. E.
      coli was the most frequently isolated bacterial species from bitches with dead
      puppies. However, in such cases it is important to relate the vaginal bacterial
      findings to autopsy findings and the results of bacteriological cultures of the
      pups.

PMID- 8342463
TI  - Bovine uterine, cervical and ovarian cytosol estrogen and progesterone receptor
      concentrations in cystic ovarian disease.
AB  - Bovine cytosol estrogen (ERC) and progesterone receptor (PRC) concentrations were
      measured simultaneously in various regions of the uterus and in ovarian stromal
      tissue in cows with cystic ovarian disease (follicular cysts), and the
      concentrations compared with those in animals with normal cycles. In cystic
      ovarian disease, ERC concentrations in endometrium (550 fmol/mg cytosol protein
      (c.p.)) and in myometrium (405) were significantly higher than in control
      animals. Very high PRC contents were measured in the endometrium (3115) and
      myometrium (2761) of cows with cystic ovarian disease. In control animals, PRC
      concentrations in the endometrium and myometrium were significantly lower than in
      diseased animals. No statistical differences were observed in ERC or PRC contents
      between the endometrium and the myometrium in cows with cystic ovarian disease.
      ERC and PRC concentrations in the uterine cervix and ovaries were low compared to
      those detected in the uterus. Bovine serum estradiol-17 beta concentrations were
      higher (p < 0.001) in cows with cystic ovarian disease than in control animals in
      postpartum anestrus or during the normal estrous cycle. Serum sex hormone-binding
      globulin (SHBG) concentrations were of the same magnitude as in control cows
      during their estrous cycles. These findings show that long standing low
      endogenous progesterone and elevated estradiol concentrations in serum are
      associated with elevated ERC and PRC concentrations in bovine uterus.

PMID- 8342464
TI  - Tick-borne fever in lambs of different ages.
AB  - Four groups of lambs aged 1 week, 4 weeks, 1/2 year and 1 year old respectively
      were inoculated with Ehrlichia phagocytophila infected blood. Clinical signs,
      temperature reactions, haematological changes and parasitaemia were more moderate
      in lambs inoculated with E. phagocytophila at the age of 1 week than those
      recorded in the older animals. The clinical response to tick-borne fever (TBF)
      appears to be more severe with increasing age of the lambs. The lymphocyte
      reactivity to mitogens was reduced in the TBF infected lambs, and was most
      pronounced in lambs in the 3 older age groups.

PMID- 8342465
TI  - Vitamin D status and hypocalcemic response to protamine in exercised and non
      exercised dairy cows.
AB  - Bone resorption was studied in post parturient cows using intravenous injection
      of protamine. Protamine inhibits bone resorption and the protamine-induced
      hypocalcemia can be taken as a measure of this process. The studies were
      performed in a herd where half of the cows had been tied indoors for 2 1/2 years,
      the other half had been given daily exercise during the same period. All animals
      were fed in the same way. The hypocalcemic response to protamine was the same in
      both groups, which indicates that exercise did not change bone resorption. The
      serum levels of calcium, inorganic phosphorus and magnesium around parturition
      did not differ. The daily exposure to daylight increased the serum level of 25
      (OH)-cholecalciferol in late summer in the exercised group.

PMID- 8342466
TI  - The effect of transport stress on plasma levels of catecholamines, cortisol,
      corticosteroid-binding globulin, blood cell count, and lymphocyte proliferation
      in pigs.
AB  - The effect of transport stress on the plasma levels of catecholamines, cortisol,
      and corticosteroid-binding globulin were studied in 6 gilts. To assess the effect
      on immune status, white blood cells were also counted and the cell-mediated
      immunity was estimated. The adrenaline level increased significantly during
      transport, from a basal mean level of 0.03 ng/ml to a plateau level of 0.11 to
      0.12 ng/ml. The noradrenaline level fluctuated, but not constantly, during
      transport. The mean plasma cortisol level before loading was approximately 40
      nmol/l and rose immediately after the start of transport to 70 nmol/l (p < 0.05)
      and to 87 nmol/l (p < 0.01) within 10 and 30 min, respectively. After unloading
      the cortisol level rapidly decreased and a minimum level was seen 4 h after the
      transport, whereafter the diurnal rhythm was resumed. The plasma corticosteroid
      binding globulin level increased nonsignificantly during the day of transport,
      from 25 nmol/l to a level of 34 nmol/l, and it continued to increase until a
      plateau level was reached on the second day after transportation. The total white
      blood cell number increased significantly (from 13.7 to 15.5 x 10(9) cells/l),
      the number of lymphocytes decreased significantly (from 8.4 to 7.0 x 10(9)
      cells/l), and the number of polymorphonuclear neutrophils increased significantly
      (from 4.3 to 7.2 x 10(9) cells/l) during transport. No significant variation in
      the proliferation response was seen in the whole blood cell cultures. The main
      results were the significant signs of simultaneous activity of both the adrenal
      cortex and the adrenal medulla during transport.

PMID- 8342467
TI  - Mesangioproliferative glomerulonephritis in mink with encephalitozoonosis.
AB  - Renal specimens from 6 mink with encephalitozoonosis were studied by light and
      electron microscopy and immunohistochemistry. The glomeruli of affected kidneys
      had a mesangioproliferative glomerulonephritis which was characterized by an
      increase in mesangial cells and matrix in most glomeruli. Some glomeruli were
      partially or completely sclerosed. There were protein or granular casts in the
      cortical and medullary tubules. Interstitial nephritis, vasculitis and tubular
      cysts were found. Electron microscopy demonstrated extensive matrix and increased
      cellularity in the mesangial areas. Glomeruli showed segmentally thickened or
      wrinkled capillary basement membranes. Electron dense deposits were found in the
      glomerular basement membranes and mesangium. Peroxidase-anti-peroxidase
      immunohistochemistry demonstrated that IgG and IgM positive material was present
      as granular deposits in the glomerular basement membrane and occasionally in the
      mesangium.

PMID- 8342468
TI  - Peripartal excretion of Eimeria oocyst by cows on Swedish dairy farms and the age
      of calves at first excretion.
AB  - Faecal samples were collected 3 times a week for 6 weeks from 22 paripartal cows
      and for up to 15 weeks after birth from 27 calves in 3 herds, to determine the
      numbers of Eimeria oocysts excreted and the age at which the calves first
      excreted oocysts. Only low numbers of oocysts were excreted by the cows and no
      oocysts were detected in 93% of the samples. However, half the cows excreted
      oocysts at least once. The age at which the calves first excreted oocysts ranged
      from 2.5 to at least 15 weeks, and there was a significant difference between the
      herds in their mean age at first excretion. Oocysts of Eimeria alabamensis, E.
      auburnensis, E. bovis and E. ellipsoidalis were found in numbers ranging from 7
      to 8450 oocysts per gram faeces. About 50% of the calves excreted oocysts before
      they were transferred to group pens. The primary source of infection of the
      calves was probably their penmates or the previous occupants of the pens, and the
      cows probably played a subsidiary role.

PMID- 8342469
TI  - Variations during lactation in total and differential leukocyte counts, N-acetyl
      beta-D-glucosaminidase, antitrypsin and serum albumin in foremilk and residual
      milk from non-infected quarters in the bovine.
AB  - Quarter samples of foremilk and residual milk were taken approximately every
      second week from 2 days post partum (pp) throughout lactation month 9, from 5
      dairy cows in their second lactation period. Bacteriologically positive milk
      samples were excluded. The aim was to study the variation in total and
      differential leukocyte counts, N-acetyl-beta-D-glucosaminidase (NAGase),
      antitrypsin (ATR) and serum albumin (BSA) in milk during the lactation period and
      different stages of oestrous cycle. Also the between milkings variation was
      studied from lactation month 4 to 9. At 2 days pp, each fraction of milk
      contained significantly higher numbers of leukocytes and had a higher activity of
      NAGase and ATR than later in the lactation period. In foremilk the highest
      content of BSA was also recorded at 2 days pp. From lactation month 2 to 9, stage
      of lactation had, in general, a slight effect on the variation in the variables
      measured. The total leukocyte count in residual milk tended to increase as
      lactation proceeded. The proportion of monocyte-macrophages in foremilk was
      significantly decreased during the last 4 months. NAGase and BSA in both
      fractions and ATR in residual milk increased significantly towards the end of the
      lactation period. From lactation month 4 to 9 the highest recorded ranges of
      variation between milkings, within quarter and stage of lactation, in the total
      leukocyte count, proportions of neutrophils, lymphocytes, monocyte-macrophages,
      NAGase, ATR and BSA in foremilk were 215 x 10(3)/ml, 42%, 34%, 54%, 6.68 units,
      0.36 units and 0.14 mg/ml respectively. The corresponding figures in residual
      milk were higher except for the variation in BSA which was slightly lower in
      residual milk than in foremilk. In residual milk there was a positive correlation
      between the proportion of neutrophils and the total leukocyte count, when
      calculated on data from all cows and the entire experimental period. During the
      oestrous periods, the proportion of neutrophils in residual milk was higher than
      during the dioestrous periods. Foremilk and residual milk differed in the total
      as well as the differential leukocyte counts in all the various stages of
      lactation, whereas the contents of NAGase, ATR and BSA were equal in both
      fractions. The exception was 2 days pp when the proportions of lymphocytes were
      equal in both fractions and BSA-significantly higher in foremilk than in residual
      milk.

PMID- 8342470
TI  - Energy metabolism during late gestation and lactation in multiparous sows in
      relation to backfat thickness and the interval from weaning to first oestrus.
AB  - Ten crossbred, fourth or fifth parity sows were divided into 2 groups - high (H)
      and low (L)- according to their backfat thickness 9 days before parturition. Body
      weight, backfat thickness and litter weight were recorded repeatedly during a 5
      week lactation period. The length of the interval from weaning to first oestrus
      was also noted. All sows were fed a commercial diet (11.9 MJ/kg, 14.5% crude
      protein). During gestation, daily food intake was 2.2 kg/sow, while during
      lactation it was 3.0 kg/sow plus 0.4 kg/piglet. Blood samples were drawn on day 9
      before parturition and on days 2, 7, 14 and 21 of lactation. The samples were
      analysed to determine concentrations of glucose, urea nitrogen, creatinine,
      triglycerides, free fatty acids and beta-hydroxybutyric acid. In both groups,
      concentrations of free fatty acids and urea nitrogen were low on day 9 before
      parturition while those of triglycerides were high, indicating anabolism
      regardless of backfat thickness. During the first week of lactation,
      concentrations of free fatty acids increased in the H-group but not in the L
      group, and concentrations of urea nitrogen were higher in the H-group. These
      differences, together with the greater loss of weight observed in the H-group,
      indicate that catabolism of maternal fat and protein depots was more pronounced
      in the H-group than in the L-group during this time. On day 14 of lactation, both
      groups showed equally low concentrations of free fatty acids, decreasing
      creatinine concentrations and stable triglyceride and urea nitrogen
      concentrations. Furthermore, weight loss during the second and third weeks of
      lactation was low in both groups. These facts, taken together, indicate that the
      catabolic rate was decreasing in both groups during this period. No differences
      in return to oestrus interval were noted between the groups. The present study
      indicates that under a restricted feeding regime the catabolic rate during the
      first week of lactation is higher in sows with higher backfat thickness in late
      gestation. As lactation progresses, a more balanced metabolism is achieved
      regardless of backfat thickness, which may tend to reduce differences in return
      to oestrous interval.

PMID- 8342471
TI  - Patterns of plasma oestradiol-17 beta in relation to the interval from weaning to
      oestrus in sows.

PMID- 8342472
TI  - A case of bovine spongiform encephalopathy in Denmark.

PMID- 8342473
TI  - Disseminated gonococcal infection vs. meningococcal infection.

PMID- 8342474
TI  - Difficult doctor-patient relationships.

PMID- 8342475
TI  - How to avoid decortication in childhood empyema.

PMID- 8342476
TI  - Getting more out of athletic examinations.

PMID- 8342477
TI  - Oral cancer screening in the elderly.

PMID- 8342478
TI  - Diary from a week in practice.

PMID- 8342479
TI  - Superficial tinea infections.
AB  - Dermatophytes commonly cause superficial dermatoses, especially in children, but
      these infections are frequently misdiagnosed as nonfungal disease. Superficial
      tinea infections can vary widely in appearance, ranging from a single, small,
      circular lesion with mild erythema and a scaling active border to multiple large
      areas of marked inflammation with vesicle formation. Therefore, laboratory tests,
      particularly the potassium hydroxide slide preparation, are often necessary to
      establish the diagnosis. The culture becomes particularly important if the smear
      is negative but a superficial dermatosis is strongly suspected. Tinea capitis is
      frequently diagnosed only by culture. Since many agents are available to treat
      superficial dermatoses, cost should be an important consideration in the
      selection of a topical antifungal agent. Oral agents are recommended for scalp
      and nail infections, as well as extensive body infections. Griseofulvin is the
      oral agent of choice because of its efficacy and low toxicity.

PMID- 8342480
TI  - Neuroimaging evaluation in multiple sclerosis.
AB  - Although clinical evaluation remains the cornerstone in the diagnosis of multiple
      sclerosis, magnetic resonance imaging (MRI) has emerged as the ancillary study of
      choice. An important diagnostic tool, MRI can also be used to assess disease
      load, activity and progression, and distinguish between acute and chronic
      lesions. As technology advances, it will play an essential role in monitoring
      disease progression and assessing the results of therapy.

PMID- 8342481
TI  - Tennis elbow.
AB  - The term "tennis elbow" usually refers to lateral epicondylitis, but the same
      symptoms can be caused by pathologic processes in the elbow. In fact, most cases
      of this common condition are caused by occupational stress rather than racket
      sports. Patients complain of elbow pain when the wrist is extended against
      resistance or during repetitive actions with the wrist and elbow extended. The
      condition is thought to be caused by a lesion at the origin of the common wrist
      extensor mechanism, at or very near the lateral epicondyle of the humerus.
      Differential diagnosis includes inflammatory, arthritic and nerve entrapment
      syndromes. Prompt conservative treatment has a high success rate. Patient
      education, use of a tennis-elbow band and physical therapy play key roles in the
      management of acute symptoms and in the prevention of recurrence. Surgical
      intervention is required only when other treatment fails.

PMID- 8342482
TI  - Sertraline: a new antidepressant.
AB  - Sertraline is a serotonin reuptake inhibitor that has been approved for use in
      the treatment of depression. Its side-effect profile is similar to that of
      fluoxetine, a drug of the same class. The side effects of these drugs most often
      affect the gastrointestinal tract. Serotonin reuptake inhibitors are nonsedating
      and free of cardiac effects; they do not cause hypotension, urinary retention or
      blurred vision. Sertraline, like fluoxetine, appears to be safer than tricyclic
      antidepressants in overdose. However, no clinical studies comparing sertraline
      and fluoxetine have been published. The wholesale cost of a month's supply of
      sertraline is about $50, compared with about $5 for a generic tricyclic
      antidepressant. Despite their cost, serotonin uptake inhibitors may be the
      initial drugs of choice in depressed elderly patients, because these patients are
      at increased risk for suicide and have a low tolerance for the side effects of
      tricyclic antidepressants.

PMID- 8342483
TI  - AIDS survival time has nearly doubled since 1984.

PMID- 8342484
TI  - HIV infection rate remains high in young homosexuals.

PMID- 8342485
TI  - Maternal cocaine use harms infants more than HIV infection.

PMID- 8342487
TI  - AAP statement on adolescents and HIV. American Academy of Pediatrics.

PMID- 8342486
TI  - ACIP issues recommendations for vaccines and immune globulins in
      immunocompromised persons. Advisory Committee on Immunization Practices.

PMID- 8342488
TI  - Reimbursement for outpatient biotech drugs, Part 1.

PMID- 8342489
TI  - Errors caused by medical office personnel.

PMID- 8342490
TI  - Are chemical sunscreens beneficial for lupus patients who experience
      photosensitivity?

PMID- 8342491
TI  - Can nitric oxide be used to treat impotence?

PMID- 8342492
TI  - New guidelines for managing hypercholesterolemia. National Cholesterol Education
      Program.

PMID- 8342494
TI  - Make patients equal partners in health care.

PMID- 8342493
TI  - An evaluation of cholesterol screening in community pharmacies.

PMID- 8342495
TI  - Medication errors.

PMID- 8342496
TI  - Drug abuse is learned behavior.

PMID- 8342497
TI  - National health care.

PMID- 8342498
TI  - Quebec turnaround.

PMID- 8342499
TI  - Pharmacy-based therapeutic drug monitoring.

PMID- 8342500
TI  - Differences in prevalence and extent of coronary artery calcium detected by
      ultrafast computed tomography in asymptomatic men and women.
AB  - Coronary artery calcium is a marker of atherosclerosis in asymptomatic subjects.
      Ultrafast computed tomography (CT) can detect and quantify coronary calcium,
      simply and noninvasively, with greater sensitivity than can other techniques. The
      prevalence and extent of coronary calcium in a large population of asymptomatic
      men and women were measured and compared. Coronary calcium studies were performed
      in an asymptomatic population of 1,396 male and 502 female subjects (age range 14
      to 88 years). The prevalence of calcium, and the distribution of total calcium
      scores (which reflect the amount of calcium present) were determined and compared
      for men and women at 5- and 10-year intervals. The prevalence of calcium in women
      was half that of men, until the age of 60 years when the difference diminished.
      The mean total calcium score distributions of men between the ages of 40 and 69
      years were virtually identical to those of women between the ages of 50 and 79.
      The quantitative data obtained by Ultrafast CT showed very close agreement with
      autopsy studies of coronary calcium. Ultrafast CT is a sensitive technique to
      measure coronary calcium in both men and women. The differences in prevalence and
      extent of coronary calcium appear to be parallel to those observed in the
      clinical incidence of coronary artery disease in men and women. Ultrafast CT may
      have a greater impact on the treatment of women than of men, because it can be
      used to provide objective evidence of coronary atherosclerosis.

PMID- 8342501
TI  - Prognostic value of plasma atrial natriuretic factor, norepinephrine and
      epinephrine in acute myocardial infarction.
AB  - Neurohumoral activation in acute myocardial infarction (AMI) may reflect the
      degree of hemodynamic compromise, contribute to the progression of heart failure
      and augment to the risk of serious ventricular arrhythmias. Consequently,
      assessment of neurohumoral variables may provide an index of prognostic value in
      AMI. Plasma levels of atrial natriuretic factor (ANF), norepinephrine and
      epinephrine were determined in 145 patients on day 3 after AMI. During the 360
      day follow-up period 17 patients died. In univariate analysis, all 3
      neurohormones were significantly related to 1-year mortality rates (ANF, p <
      0.001; norepinephrine, p = 0.009; epinephrine, p = 0.048). After correction for
      age, sex, anamnestic, biochemical and clinical variables including signs of
      clinical heart failure in a multivariate model, ANF remained independently
      related to mortality. The association between plasma norepinephrine and survival
      failed to reach statistical significance after introduction of clinical heart
      failure in the model. Comparison of patients subdivided according to median
      hormone levels (ANF, 30.3 pmol/liter; norepinephrine, 2.29 nmol/liter)
      demonstrated a significantly increased mortality rate in patients with elevated
      ANF (p < 0.001), but not elevated norepinephrine levels. These results suggest
      that early plasma ANF levels are related to survival in patients with AMI,
      independently of signs of clinical heart failure.

PMID- 8342502
TI  - Noninvasive computerized assessment of left ventricular performance and systemic
      hemodynamics by study of aortic root pressure and flow estimates in healthy men,
      and men with acute and healed myocardial infarction.
AB  - Aortic root pressure and flow data can be used to assess left ventricular (LV)
      performance and properties of the systemic arterial tree. The calibrated
      subclavian arterial pulse trace was combined with echocardiographic imaging and
      Doppler velocity recordings to obtain noninvasive estimates of aortic root
      pressure and flow in 8 healthy subjects (group A), 12 patients with recent
      myocardial infarction (group B), and 8 with healed myocardial infarction and a
      dilated left ventricle (group C). The pressure and flow data were transferred to
      a computer and processed in specially designed software, including a new
      procedure for estimation of 3-element windkessel model parameters. There were no
      significant group differences for either aortic root pressure estimates or heart
      rate. In groups B and C, stroke and cardiac indexes were lower and total
      peripheral resistance higher than in group A. There were no group differences in
      the model estimates of total arterial compliance, whereas the characteristic
      impedance was greater in group C than in A, indicating a less compliant aorta in
      C. Both LV total and steady power were less in groups B and C than in A, whereas
      no group difference was found for percent oscillatory power. The reproducibility
      for recording was good for the aortic root pressure estimates, and lower for the
      derived parameters (stroke and cardiac indexes, windkessel model parameters and
      LV power), whereas that for interpretation was generally good. This method
      provides a unique noninvasive access to important parameters of LV function and
      the systemic circulation.

PMID- 8342503
TI  - Wall motion asynchrony is a major determinant of impaired left ventricular
      filling in patients with healed myocardial infarction.
AB  - Left ventricular (LV) diastolic filling is impaired in hearts with healed
      myocardial infarction. Possible hemodynamic parameters related to impaired LV
      filling include left atrial pressure, time constant of isovolumic relaxation,
      chamber stiffness and wall motion asynchrony. Previous studies demonstrated
      univariate correlations between each of these parameters and LV filling. The
      current study was designed to compare relative importance of these parameters in
      patients with a myocardial infarction. Left ventriculograms with simultaneous LV
      pressure measurement were analyzed in 15 patients with a myocardial infarction
      and in 10 control subjects. Every frame of the left ventriculogram was divided
      into 8 segments and the volume of each segment was obtained frame-by-frame by
      planimetry and area-length method. Asynchrony was quantitated as the sum of areas
      of discrepancy between each segmental and global volume-time curve. Patients with
      myocardial infarction had greater asynchrony (20 +/- 2 vs 10 +/- 1%, p < 0.01),
      greater atrial filling fraction (46 +/- 4 vs 35 +/- 5%, p < 0.05) and slower peak
      early filling rate (2.5 +/- 0.1 vs 4.1 +/- 0.4 end-diastolic volume/s, p < 0.01)
      than the control subjects. Multiple regression analyses with hemodynamic
      variables (asynchrony, LV pressure at mitral valve opening, time constant of LV
      isovolumic pressure decrease and LV chamber stiffness constant) showed that
      asynchrony and LV pressure at mitral valve opening were significant determinants
      of LV filling in patients with myocardial infarction, whereas LV pressure at
      mitral valve opening was the only significant determinant in control subjects.

PMID- 8342504
TI  - Quantitative severity of stress thallium-201 myocardial perfusion single-photon
      emission computed tomography defects in one-vessel coronary artery disease.
AB  - The relation between the quantitative myocardial perfusion defect severity of
      exercise thallium-201 single-photon emission computed tomography (SPECT) and the
      quantitative degree of coronary stenosis was examined in 18 patients with 1
      vessel disease (> or = 50% diameter stenosis), and abnormal thallium-201 SPECT. A
      total of 26 vessels were analyzed. Thallium-201 SPECT quantitative defect
      severity score was derived by summing the number of pixels in a coronary
      territory in which counts fell below the normal mean and multiplied by the number
      of SDs by which they fell below the normal mean. The thallium-201 defect severity
      score was significantly (p < 0.001) related to the maximal percent luminal
      diameter narrowing (r = 0.93), percent area narrowing (r = 0.89), absolute
      stenotic area (r = 0.79), and absolute stenotic diameter (r = 0.81). As expected,
      the strongest relation between thallium-201 defect severity and quantitative
      angiographic indexes was in the low and high ranges of coronary stenosis, with
      more variability and lower correlation coefficients (percent diameter: r = 0.75,
      p < 0.02, percent area stenosis: r = 0.63, p < 0.05) in the middle ranges (50 to
      80% diameter stenosis). This observation is likely to be due to the complex flow
      characteristics across stenotic lesions. The findings suggest that in a select
      population, thallium-201 defect severity is potentially useful for noninvasive
      characterization of the functional severity of coronary artery stenosis and may
      complement coronary angiography in predicting functionally significant stenosis.

PMID- 8342505
TI  - Randomized antiarrhythmic drug therapy in survivors of cardiac arrest (the
      CASCADE Study). The CASCADE Investigators.
AB  - The Cardiac Arrest in Seattle: Conventional Versus Amiodarone Drug Evaluation
      (CASCADE) study evaluated antiarrhythmic drug treatment of survivors of out-of
      hospital ventricular fibrillation (VF) not associated with a Q-wave myocardial
      infarction who were at especially high risk of recurrence of VF. Therapy was
      randomized to empiric treatment with amiodarone versus treatment with other
      antiarrhythmic drugs guided by electrophysiologic testing, Holter recording, or
      both (conventional therapy). The primary end points of the study were cardiac
      mortality, resuscitated cardiac arrest due to documented VF, or complete syncope
      followed by a shock from an implanted automatic defibrillator. Two hundred twenty
      eight patients were enrolled in the study, and baseline characteristics were
      similar in the patients treated with amiodarone and with conventional therapy.
      Two hundred two patients (89%) were men with an average age of 62 years. Coronary
      artery disease was the most common underlying condition (188 of 228, 82%), and in
      coronary patients, 153 of 188 (81%) had experienced a prior myocardial infarction
      before the index VF event. Mean left ventricular ejection fraction was 0.35, and
      102 patients (45%) had a prior history of congestive heart failure. Survival free
      of cardiac death, resuscitated VF, or syncopal defibrillator shock for the entire
      population was 75% at 2 years (amiodarone, 82%; conventional, 69%), 59% at 4
      years (amiodarone, 66%; conventional, 52%), and 46% at 6 years (amiodarone, 53%;
      conventional, 40%); p = 0.007. The survival free of cardiac death and sustained
      ventricular arrhythmias was 65% at 2 years (amiodarone, 78%; conventional, 52%),
      43% at 4 years (amiodarone, 52%; conventional, 36%), and 30% at 6 years
      (amiodarone, 41%; conventional, 20%); p < 0.001.

PMID- 8342506
TI  - Noninvasive prediction of efficacy of type IA antiarrhythmic drugs by the signal
      averaged electrocardiogram in patients with coronary artery disease and sustained
      ventricular tachycardia.
AB  - This study attempted to determine if specific changes on the signal-averaged
      electrocardiogram (ECG) after type IA antiarrhythmic therapy are predictive of
      efficacy in the treatment of ventricular tachycardia (VT). Scalar and signal
      averaged ECGs were obtained at baseline and after type IA drug therapy in 15
      patients with coronary artery disease and inducible VT at baseline
      electrophysiologic testing. Signal-averaged QRS duration, root-mean-square
      amplitude in the last 40 ms of signal-averaged QRS, and the duration under 40 mu
      v of the signal-averaged QRS (low-amplitude signal), as well as ventricular
      effective refractory period at electrophysiologic study, and QTc on the scalar
      ECG were compared. At drug study, 6 patients (group A) had persistent but slower
      VT, whereas 9 (group B) had VT rendered noninducible. The baseline signal
      averaged QRS duration was longer in group A than in B (136 +/- 10 vs 115 +/- 13
      ms; p < 0.05), as was the scalar QRS (115 +/- 19 vs 98 +/- 11 ms; p < 0.05).
      After antiarrhythmic therapy, group A had a greater prolongation of both signal
      averaged QRS (24 +/- 10 vs 8 +/- 3 ms; p < 0.05) and low-amplitude signal (31 +/-
      13 vs 3 +/- 7 ms; p < 0.05), whereas group B had a greater increase in
      ventricular effective refractory period (49 +/- 20 vs 20 +/- 13 ms; p < 0.05) and
      corrected QT interval (100 +/- 39 vs 43 +/- 23 ms; p < 0.05).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8342507
TI  - Usefulness of propafenone for supraventricular arrhythmias in infants and
      children.
AB  - The relation between propafenone dose, serum level, electrocardiographic
      parameters, antiarrhythmic drug efficacy and adverse effects was studied in 47
      children with symptomatic supraventricular arrhythmias aged 1 day to 10.3 years
      (median 2.2 months) with a mean follow-up of 14.3 months. Propafenone trough
      serum levels were measured using gas chromatography. Oral propafenone (mean dose
      353 mg/m2/day) was effective in 41 of the 47 patients (87.2%). Serum levels did
      not differ between patients responding and not responding to propafenone (0.45 +/
      0.40 vs 0.36 +/- 0.41 mg/liter). PR interval and QRS complex duration increased
      more significantly with propafenone dose increments (p < 0.001), than with
      propafenone serum levels (p < 0.05). At successful treatment PR interval and QRS
      complex were prolonged by a mean of 19.2 and 20.5% compared with pretreatment
      status. Five patients exhibited unexpected marked QRS complex prolongation (50 to
      200%) despite low propafenone dosage (< 300 mg/m2/day) and level ranging from
      0.05 to 1.33 mg/liter. Three patients (6.1%) were suspected of being "poor"
      metabolizers of propafenone. Mild chronic elevation of serum liver enzymes was
      observed in 5 patients treated with a larger dose (mean 448 mg/m2/day, p <
      0.001). No proarrhythmia was noted on serial Holter monitors. One patient with
      Wolff-Parkinson-White syndrome and a normal heart had cardiac arrest after
      aspiration. Serial monitoring of PR interval and QRS complex duration was more
      useful for proper dosage adjustment than propafenone serum levels. Serum liver
      enzymes should be closely monitored when using higher propafenone doses.
      Malignant proarrhythmia could not be excluded in the 1 patient with cardiac
      arrest.

PMID- 8342508
TI  - Experience with three different third-generation cardioverter-defibrillators in
      patients with coronary artery disease or cardiomyopathy.
AB  - Clinical investigations are being performed in multiprogrammable devices whose
      therapeutic options include antitachycardia pacing, cardioversion, defibrillation
      and bradycardia pacing. Three different third-generation devices were implanted
      in 46 research patients at 1 clinical center to document their safety and
      efficacy for the treatment of malignant ventricular arrhythmias. Additionally,
      the purpose of the study was to determine if antitachycardia pacing is a
      desirable and frequently used feature of tiered devices. The Medtronic PCD was
      implanted in 15 patients (12 men, mean age 60 +/- 13 years, mean ejection
      fraction 40 +/- 15%), the Ventritex Cadence in 21 patients (17 men, mean age 65
      +/- 10 years, mean ejection fraction 38 +/- 12%), and the CPI VENTAK PRx in 10
      patients (8 men, mean age 63 +/- 14 years, mean ejection fraction 31 +/- 8%). All
      patients presented with cardiac arrest or ventricular tachycardia. During follow
      up of 10 +/- 6 months (range 1 to 19), 70% of the 20 patients with
      antitachycardia pacing activated used the feature for spontaneous ventricular
      tachycardia. The antitachycardia pacing parameters were reprogrammed 20 times in
      15 patients. Two thousand six hundred thirty-eight of 2,675 (98%) antitachycardia
      pacing attempts successfully terminated spontaneous tachyarrhythmias. Low-energy
      cardioversion or defibrillation terminated tachyarrhythmias in patients where
      pacing was unsuccessful. One hundred forty-eight episodes of tachycardia were
      successfully treated directly by shocks in 16 of 46 patients (35%). There were no
      deaths due to device failure. This initial single-center clinical experience
      suggests that the PCD, Cadence and VENTAK PRx are all safe and effective tiered
      therapy devices for the treatment of malignant ventricular arrhythmias.
      Antitachycardia pacing successfully terminated most episodes of ventricular
      tachycardia; in patients with this feature activated, it was used frequently but
      required reprogramming to achieve high levels of success.

PMID- 8342509
TI  - Information on type 1 diabetes mellitus and QT interval from identical twins.
AB  - To determine whether QT interval is influenced by genetic factors and whether QT
      interval prolongation occurs in type 1 diabetes or is related to diabetic
      autonomic neuropathy, QT intervals were measured, and autonomic function was
      assessed in 44 pairs of identical twins who were discordant for type 1 diabetes.
      Twins were compared with 44 normal control subjects of similar age and sex. QT
      intervals were corrected for heart rate (QTc). QTc in diabetic twins correlated
      with that in their nondiabetic co-twins (r = 0.41; p = 0.006). Diabetic twins had
      significantly longer QTc than did their nondiabetic co-twins and control subjects
      (416 +/- 18 vs 407 +/- 16 and 403 +/- 19 ms, respectively; p < 0.005). A greater
      number of abnormal autonomic function tests were detected in diabetic twins than
      in their nondiabetic co-twins and control subjects (8 vs 2 and 0%, respectively;
      p < 0.01). Diabetic twins with disease duration > 14 years (n = 22) had longer
      QTc than did their nondiabetic co-twins (420 +/- 17 vs 402 +/- 14 ms; p <
      0.0005). Twins with diabetes for > 14 years had a greater frequency of abnormal
      autonomic function tests than did those with diabetes < 14 years (15 vs 2%; p <
      0.001). QTc did not correlate with autonomic function in diabetic twins. It is
      concluded that QT interval is influenced by genetic factors, and in type 1
      diabetes, QTc can be prolonged independently of autonomic neuropathy.

PMID- 8342510
TI  - Sex differences in cardiac adaptation to isolated systolic hypertension.
AB  - This study examines the association of isolated systolic hypertension with left
      ventricular (LV) mass and geometry in men and women. The subjects of this study
      were surviving members of the Framingham Heart Study and the Framingham Offspring
      Study who attended the index examination (between 1979 and 1983) and were aged >
      or = 50 years, free of clinically apparent cardiovascular disease, not taking
      antihypertensive medication and without diastolic hypertension (diastolic blood
      pressure < 90 mm Hg), and in whom LV mass could be determined by
      echocardiography. Examinations routinely included 12-lead resting
      electrocardiography, measurements of resting blood pressure, anthropometry, blood
      glucose levels, and M-mode echocardiography. M-mode echocardiograms adequate to
      assess LV hypertrophy were obtained for 1,282 normotensive subjects (538 men and
      744 women) and 79 subjects with isolated systolic hypertension (26 men and 53
      women). Adjusting for age, body mass index and diastolic blood pressure, the
      relative odds of LV hypertrophy associated with isolated systolic hypertension
      were 2.58 (95% confidence interval 0.97 to 6.86) in men and 5.94 (95% confidence
      interval 3.06 to 11.53) in women. Women with isolated systolic hypertension had
      increased LV wall thickness and mass without LV chamber enlargement, but men had
      LV dilation and increased LV mass without increased wall thickness. In
      conclusion, although isolated systolic hypertension was associated with increased
      LV mass in men and women, the geometric pattern of increased LV mass differed by
      sex; although women demonstrated a pattern of concentric hypertrophy, an
      eccentric pattern was observed in men.

PMID- 8342511
TI  - Frequency of ring abscess and cuspal infection in active infective endocarditis
      involving bioprosthetic valves.
AB  - When active infective endocarditis (IE) involves a bioprosthetic valve, the
      infective process may involve only the cusps or sewing ring or both. We studied
      34 patients with infected bioprostheses to determine whether the infection
      involved the cusps or ring, or both, because these locations could affect
      prognosis. In the 5 patients in whom active IE began < 60 days after operation,
      the infection involved the cusps only in 2, the ring only in 2, and both in 1.
      The 29 patients in whom signs and symptoms of active IE appeared > 60 days after
      valve replacement were subdivided into 3 categories based on the valve or valves
      replaced. In the 16 patients with isolated aortic valve replacement, the
      infection involved the cusps only in 6, the ring only in 4, and both in 6. In the
      6 patients with isolated mitral valve replacement, the infection involved the
      cusps only in 2, the ring only in 1, and both in 3. In the remaining 7 patients,
      15 native valves were replaced with bioprostheses, and 10 of them were infected.
      The infection involved the cusps only in 7, and both the cusps and ring in 3. Of
      all 34 patients, 13 had operative excision of the infected bioprosthesis: 1 died
      within 60 days of the bioprosthetic excision, and 1 was lost to follow-up; of the
      remaining 11 patients, 4 died late (1.5, 3, 5 and 14 years), and the other 7 are
      alive 5 to 10 years after bioprosthetic excision (all in New York Heart
      Association functional class I or II). Thus, although infection limited to the
      bioprosthetic cusps may reasonably allow a better outlook, reoperation with
      infection involving the annular ring (8 of 13 reoperation patients) does not
      prevent successful outcome.

PMID- 8342512
TI  - Percutaneous mitral valvuloplasty with severe pulmonary artery hypertension.
AB  - The aim of this study was to assess the initial and midterm outcome of patients
      with severe pulmonary hypertension undergoing percutaneous mitral valvuloplasty
      (PMV). Accordingly, the baseline characteristics, immediate results and follow-up
      of 64 consecutive patients with severe pulmonary artery hypertension (systolic
      pulmonary artery pressure > or = 60 mm Hg on cardiac catheterization) (group I)
      were analyzed and compared with those of 194 consecutive patients with lower
      pulmonary pressures (group II). Patients in group I were more symptomatic (New
      York Heart Association functional class > or = III, 72 vs 40%, p < 0.001) and had
      higher echocardiographic scores (8.6 +/- 2 vs 7.4 +/- 1, p < 0.05). Before PMV,
      mitral gradient was higher (17 +/- 6 vs 13 +/- 5 mm Hg, p < 0.025) and mitral
      valve area smaller (0.79 +/- 0.2 vs 0.96 +/- 0.2 cm2, p < 0.005) in group I
      patients, who also had higher pulmonary vascular resistances (469 +/- 299 vs 157
      +/- 125 dynes s-1 cm-5, p < 0.005). On multivariate analysis patients in group I
      were more symptomatic, had smaller mitral valve areas and higher mitral
      gradients. PMV success (area gain > 50% without complications) was similar (89 vs
      87%) in both groups. After PMV final mitral gradient (5 +/- 2 vs 4 +/- 2 mm Hg)
      and area (1.82 +/- 0.5 vs 1.87 +/- 0.5 cm2) were similar in both groups.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8342513
TI  - Effects of serotonin on coronary arteries of cardiac transplant recipients.
AB  - Serotonin constricts coronary arteries with endothelial dysfunction. To detect
      early graft artery disease, the responses to intracoronary serotonin were studied
      1 month (group A, 14 patients) and 1 year (group B, 13 patients) after orthotopic
      cardiac transplantation. No patient had evidence of rejection and all had
      angiographically normal coronary arteries. Serotonin in increasing doses (1, 10
      and 20 micrograms/min for 2.5 minutes each) was infused into the coronary
      circulation. Diameters of proximal, middle and distal segments were measured by
      quantitative angiography. At the maximal concentration of serotonin, the
      diameters of the proximal segments decreased to 73 +/- 4% (percentage of the
      baseline) in group A; the diameters of the middle and distal segments decreased
      to 67 +/- 5 and 63 +/- 4%, whereas in group B, the diameters of the proximal,
      middle and distal segments were 90 +/- 6% (p < 0.02 vs group A value), 88 +/- 5%
      (p < 0.01 vs group A value) and 84 +/- 4% (p < 0.01 vs group A value),
      respectively. These changes were significantly (p < 0.02) different from those
      observed in 6 control patients in whom no constriction was induced by
      intracoronary serotonin. Moreover, coronary plasma endothelin levels were
      significantly higher in group A than in group B and control patients (5.6 +/- 0.3
      vs 4.3 +/- 0.2 fmol/ml in group B and 3.9 +/- 0.3 fmol/ml in control patients).
      Thus, an abnormal response to intracoronary serotonin seems to occur often in
      transplant patients, and this abnormality is unexpectedly more pronounced in the
      early weeks after transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342514
TI  - Spa therapy for heart disease Bad Nauheim (circa 1900).
AB  - The development of Bad Nauheim, a German spa that over 2 centuries became
      dominant in the attraction of patients with heart disease is described. Here,
      patients experienced a regimen of saline baths and mostly static exercises
      developed by the Schotts, 2 physician brothers. Concomitant with the bathing and
      exercises, there was a social atmosphere conducive to relaxation. Many visiting
      physicians were impressed that there were improvements in the patients' cardiac
      status. One skeptical exception was Sir James Mackenzie, whose views are
      synopsized. The reported improvements may have had a modicum of a physiologic
      base, from recent investigations on the nature of heart failure, and may have
      anticipated the current use of exercise in cardiac rehabilitation.

PMID- 8342515
TI  - The paradox of nitrates in patients with angina pectoris and angiographically
      normal coronary arteries.

PMID- 8342516
TI  - Serum ferritin is not a risk factor for coronary artery disease in men and women
      aged > or = 62 years.

PMID- 8342517
TI  - Value of clinical variables for risk stratification in patients with sustained
      ventricular tachycardia and history of myocardial infarction.

PMID- 8342518
TI  - Impact of directional atherectomy on adjacent branch vessels.

PMID- 8342519
TI  - Catheter creation of an open outflow tract in previously atretic right
      ventricular outflow tract associated with ventricular septal defect.

PMID- 8342520
TI  - Quantitation of left ventricular volumes and ejection fraction by biplane
      transesophageal echocardiography.

PMID- 8342521
TI  - On-line quantification of left ventricular function by automatic boundary
      detection and ultrasonic backscatter imaging.

PMID- 8342522
TI  - Both aborted sudden cardiac death and end-stage phase in hypertrophic
      cardiomyopathy.

PMID- 8342524
TI  - Sudden death, right ventricular infarction, and abnormal right ventricular
      intramural coronary arteries in isolated congenital valvular pulmonic stenosis.

PMID- 8342523
TI  - Congestive heart failure, dilated cardiac ventricles, and sudden death in
      hyperthyroidism.

PMID- 8342525
TI  - Triglycerides, high-density lipoproteins and the Framingham Heart Study.

PMID- 8342526
TI  - Are autopsies still useful? Thank goodness we didn't know. Not all tumors are bad
      tumors. Most of the cavity has to be filled before trouble occurs.

PMID- 8342527
TI  - Great expectations and disappointment with laser angioplasty.

PMID- 8342528
TI  - Accuracy of recall of hip fracture, heart attack, and cancer: a comparison of
      postal survey data and medical records.
AB  - Accuracy of recall of hip fracture, heart attack, and cancer was evaluated by
      comparing data obtained from postal surveys and medical records of participants
      in the Leisure World Disease Prevention Study. The study cohort comprised 13,897
      residents of Leisure World Laguna Hills who responded to a questionnaire first
      mailed in 1981. Follow-up questionnaires requesting information on recent disease
      history were mailed in 1983 and 1985 to all living cohort members and were
      returned by 9,734 (86%) and 8,884 (82%) persons, respectively. The proportion of
      false-positive answers was about 40% for acute myocardial infarction, but less
      than 10% for hip fracture and cancer. Many of those who gave a false-positive
      answer on the questionnaire had a condition that the lay population might easily
      confuse with the condition of interest (e.g., heart attack vs. other
      cardiovascular disease). Among persons with the disease of interest recorded in
      the medical record, the percentage who failed to report their events on the
      questionnaires was highest for those who had an acute myocardial infarction,
      followed by those who had cancer and those who had hip fracture. The highest
      rates of confirmation of cancer were for cancers of the breast, bladder,
      prostate, and uterus. For closely related sites (e.g., colon and rectum), the
      reliability of reports decreased. The amount of information obtained varied
      according to the wording of the questionnaire and the specificity of the
      questions asked. Improved accuracy of recall was observed when the occurrence of
      specific diseases was asked in addition to a general question about recent
      hospitalizations.

PMID- 8342529
TI  - Past and recent physical activity and risk of hip fracture.
AB  - A population-based case-control study was conducted to examine the effects of
      past and recent physical activity on the risk of hip fracture in women. Cases
      included females aged 55-84 years with a first diagnosis of hip fracture in 1989
      in metropolitan Toronto, Canada. Controls were a population-based random sample
      frequency matched by 5-year age groups. Data were collected on 381 cases and
      1,138 controls by self-administered mailed questionnaires or telephone
      interviews. Past activity was calculated as a compilation of activity scores at
      ages 16, 30, and 50 years. Recent activity was defined as activity in the past
      year for controls and activity in the year before fracture for cases. Multiple
      logistic regression was used to control for age, previous fracture, obesity,
      smoking, osteoporosis, epilepsy, stroke or Parkinson's disease, daily intake of
      dietary calcium, and duration of use of supplemental calcium, fluoride, and
      estrogen. After recent activity was adjusted for, statistically significant
      effects were found for women who in the past had been active (odds ratio estimate
      (OR) = 0.66, 95% confidence interval (CI) 0.45-0.96) or very active (OR = 0.54,
      95% CI 0.33-0.88). After past activity was adjusted for, a similar protective
      effect was found for women who were moderately active recently (OR = 0.61, 95% CI
      0.41-0.90), but women who were very active recently were not protected from hip
      fracture (OR = 1.15, 95% CI 0.72-1.83). This study showed evidence of independent
      protective effects of past physical activity and of moderate levels of recent
      physical activity on the risk of hip fracture in postmenopausal women.

PMID- 8342530
TI  - Variations in the accuracy of obstetric procedures and diagnoses on birth records
      in Washington State, 1989.
AB  - The authors abstracted a sample of 7,536 hospital medical records to validate the
      accuracy of the coding of obstetric information on 1) birth certificates, 2) a
      statewide computerized hospital discharge abstract data system, and 3) a linked
      file merging birth certificates and the hospital abstract data for Washington
      State deliveries occurring in 1989. Measures of accuracy of coding of delivery
      method and obstetric procedures varied greatly among the 23 hospitals that
      participated in the study. Computerized hospital discharge data were generally
      more complete and accurate than were birth certificate data. The linked file was
      more likely to identify obstetric procedures than was either source alone. For
      example, only 84.1% of cesarean deliveries noted in the hospital charts were
      identified on birth certificates (range among hospitals, 37-100%). Using the
      linked file, the authors identified 99.8% of cesarean deliveries (range, 97
      100%). Linked birth certificate-hospital abstract files may become an excellent
      source of data for epidemiologic and health care studies; however, further
      training of medical record personnel and standardization of coding are needed to
      improve the quality of computerized data on obstetric events.

PMID- 8342531
TI  - Risk attribution and tobacco-related deaths.
AB  - The number of deaths that would not have occurred had an exposure or trait been
      absent is generally estimated by observing mortality rates in sample populations
      of exposed and nonexposed persons and applying them to the population of
      interest. Three methods used to estimate deaths due to tobacco use are evaluated.
      Each method requires estimates of certain absolute and relative risks, and the
      published estimates based on them assume that the absolute and relative risks
      observed in the two large American Cancer Society prospective studies can be
      applied to the US population or to populations in developed countries.
      Computations using large representative samples of US decedents and of the entire
      US population for these methods result in estimated numbers of deaths for the US
      population that are substantially lower than those based on Cancer Prevention
      Survey-I or Cancer Prevention Survey-II. Computations also showed that
      controlling for confounding from two smoking-related variables results in still
      lower estimates of the number of excess deaths. Consequently, published results
      that ignore confounding and are based on nonrepresentative data overstate the
      contribution of smoking. It is imperative that estimates of excess deaths be
      based on representative data and control for relevant confounders.

PMID- 8342532
TI  - Relation between anthropometric indicators and risk of breast cancer among
      Australian women.
AB  - Associations between various anthropometric indicators and breast cancer were
      investigated in a community-based case-control study conducted among 456
      premenopausal women (135 cases) and 656 women who were at least 10 years past
      menopause (185 cases) in Brisbane, Australia, from 1981 to 1985. Among
      postmenopausal women, increased risk was associated with greater weight at age 25
      years (p trend = 0.002) and with a heavier maximum weight (p trend = 0.003), but
      not with recent weight. Results were similar for relative weight (weight
      (kg)/height (m)1.5). Overall, weight gain was unrelated to the occurrence of
      breast cancer, although risks were elevated among postmenopausal women who
      weighed less at age 25 (< 54 kg) and subsequently experienced a large weight gain
      (> 13 kg). Among premenopausal women, there was little indication that body size
      or change in weight was related to breast cancer. These results suggest that both
      heaviness in early adulthood and a large maximum weight at any time are
      associated with elevated risks for postmenopausal breast cancer.

PMID- 8342533
TI  - Is ovarian cancer associated with an increased frequency of germinal inclusion
      cysts?
AB  - It has been proposed that epithelial ovarian cancers arise in germinal inclusion
      cysts of the ovary, which are thought to form as stigmata of ovulation. To
      evaluate whether the frequency of germinal inclusion cysts is associated with
      ovarian cancer, the authors counted the germinal inclusion cysts in single slides
      of sections from ovaries of 148 women who underwent incidental oophorectomy and
      from the contralateral ovaries of 37 women with unilateral ovarian cancer at
      Columbia-Presbyterian Medical Center, New York, New York, in 1985-1991. The mean
      number of germinal inclusion cysts was 2.7 for cases and 3.6 for controls.
      Conditional logistic regression analysis showed that germinal inclusion cysts
      were not associated with ovarian cancer (odds ratio = 0.98, 95% confidence
      interval 0.92-1.04). These findings do not support the hypothesis that increased
      formation of inclusion cysts is a risk factor for ovarian cancer.

PMID- 8342534
TI  - Relation of caffeine intake to blood lipids in elderly women.
AB  - The relation of the consumption of caffeine from coffee, tea, and all caffeine
      containing soft drinks (hereafter referred to as "cola") to blood lipid levels
      was studied in 1,035 white women ranging in age from 65 to 90 years (mean, 71.2
      years) from October 1986 through October 1988. All study subjects were
      participants in the Pittsburgh, Pennsylvania, clinic of the Study of Osteoporotic
      Fractures. Fasting blood samples were tested for total cholesterol,
      triglycerides, apolipoproteins A-I and B-100, total high-density lipoprotein
      (HDL) cholesterol, and the HDL2 and HDL3 subfractions. Low-density lipoprotein
      (LDL) cholesterol was calculated using the Friedewald equation. Current
      consumption of coffee, tea, and cola was assessed by means of a self-administered
      personal habits questionnaire. Potential confounders, such as body mass index
      (weight (kg)/height (m)2), waist/hip ratio, smoking status, and alcohol intake
      were also measured for each woman. Analyses of variance and tests for mean
      differences revealed an inverse relation between the consumption of tea and
      apolipoprotein B-100 and a positive association between the consumption of cola
      and apolipoprotein B-100. Apolipoprotein A-I levels were found to be positively
      related to coffee consumption and negatively related to tea consumption. There
      was no consistent relation between caffeine consumption and total cholesterol,
      LDL cholesterol, total HDL cholesterol and its subfractions, or apolipoprotein B
      100. Adjustment for potential confounders yielded no remaining significant
      associations between caffeine from any of the major beverage sources and any of
      the lipid fractions. In conclusion, the inconsistent relations between caffeine
      from various sources and blood lipids do not support a significant association of
      blood lipid levels with caffeine consumption in elderly women.

PMID- 8342535
TI  - A simple, practical model for reducing alloimmunization in patients with sickle
      cell disease.
AB  - Patients with sickle cell disease (SCD) form immune alloantibodies more
      frequently than other transfused populations because red cells (RBCs) from white
      donors (with a higher incidence of certain Rh, Duffy, Kell, and Kidd blood group
      antigens) are transfused to black patients often lacking these antigens. We
      propose a model to reduce alloimmunization in patients with SCD by providing them
      with blood from only black random donors. Rationale is shown by examining
      calculations based on the phenotype E-, C-, Fy(a-), K-, and Jk(b-). There is a 7%
      probability that this phenotype belongs to a white donor, while there is a 93%
      probability that this phenotype belongs to a black donor. The probability of
      selecting blood from a black donor identical with the above phenotype for black
      recipients from an all black population and from a typical urban blood inventory
      population (90% white, 10% black) is 1/4 and 1/33, respectively. Therefore, an 8
      fold greater chance of selecting antigen non-identical blood occurs if blood is
      obtained from a typical urban donor population as compared to a black population.
      Based on these calculations, alloimmunization can be reduced prospectively in
      patients with SCD by meeting their transfusion requirements with blood selected
      from random black blood donors.

PMID- 8342536
TI  - Comparison of buffy coat preparation to direct method for the evaluation and
      interpretation of bone marrow aspirates.
AB  - Bone marrow differential and French, American, British (FAB) classification of
      buffy coat preparation (BCP) was compared to direct method (DM) in 69 pediatric
      patients with various hematologic and oncologic disorders. The marrow evaluation
      differed significantly in 12 of 69 patients (17.4%). The differential counts were
      discordant in 9 out of 69 patients (13%), and the FAB classifications were
      discordant in 3 out of 25 patients (12%) with acute lymphoblastic leukemia (ALL).
      Underestimation of the percent blasts occurred with buffy coat preparation in
      patients with acute non-lymphoblastic leukemia (ANLL). While buffy coat
      preparations can facilitate morphologic evaluation in marrow malignancies,
      significant errors can occur in determination of the differential count. Direct
      smear should be used in conjunction with buffy coat smears in the evaluation of
      bone marrow aspirates.

PMID- 8342537
TI  - DNA diagnosis for the detection of sickle hemoglobinopathies.
AB  - At this time, the sole generally accepted use for DNA diagnosis in the
      hemoglobinopathies is for the prenatal detection of disease, which can be
      identified by these means early in the first trimester of pregnancy. By
      ascertaining genotype rather than phenotype, the confusion that results from
      diagnostic errors should be diminished. DNA diagnostics are the future of all
      genetic disease detection and this future will soon be upon us.

PMID- 8342538
TI  - Lymphoproliferative disease of "LAK cell" precursor large granular lymphocytes in
      association with celiac disease.
AB  - We have investigated a case of lymphoproliferative disease of large granular
      lymphocytes (LDGL) occurring in association with celiac disease, anemia,
      neutropenia, and carcinomas of the endometrium, breast, and skin. The large
      granular lymphocyte (LGL) proliferation was monoclonal, T cell in origin, with T
      cell receptor beta-chain gene rearrangement, and a CD3+, CD8+, CD16+/- phenotype.
      In spite of the high frequency of LGL, natural killer (NK) cell activity was
      absent. Stimulation with interleukin-2 in vitro, however, resulted in high
      lymphokine-activated killer (LAK) cell activity against NK-resistant targets. The
      T-cell nature of the LAK precursor cells is in contrast to the majority seen in
      normal peripheral blood. Therapeutic trials of cyclosporin A, low-dose
      cyclophosphamide, and levamisole were unsuccessful in reducing transfusion
      requirements. This case is unique in the association of LDGL with celiac disease.
      It is also unique in that the patient had been followed for several years prior
      to the onset of the LDGL. The case extends the list of lymphoproliferative
      disorders documented to be associated with celiac disease and, conversely, adds
      to our knowledge of lymphoproliferative disorder of LGL and its "dysimmune"
      manifestations.

PMID- 8342539
TI  - Chronic myelogenous leukemia and acute lymphoblastic leukemia occurring in the
      course of polycythemia vera.
AB  - We are reporting an unusual case of a 54-year-old woman with polycythemia vera
      (PV) who developed Ph chromosome positive chronic myelogenous leukemia (CML) 8
      years after the initial diagnosis of PV, and terminating in acute lymphoblastic
      leukemia (ALL), 11 years after the initial diagnosis. Cytogenetic studies
      revealed a normal female karyotype at the time of diagnosis of PV and the
      presence of a Ph chromosome at the time of appearance of CML. Southern blot
      hybridization revealed a bcr rearrangement in both mononuclear cells and
      granulocytes. The diagnosis of ALL was established on the basis of morphology,
      positive TdT staining, and monoclonal antibody studies positive for 12, B4, and
      J5. This case demonstrates the transition of PV into CML, followed by a blastic
      transformation into acute lymphocytic leukemia. At termination of her disease
      there were findings compatible with bi-phenotypic leukemia. These findings would
      suggest that the disease arose in a primitive multipotential stem cell.

PMID- 8342540
TI  - Reactivation and dissemination of blastomycosis complicating Hodgkin's disease: a
      case report and review of the literature.
AB  - Patients presenting with Hodgkin's disease (HD) may show lung involvement
      characterized by contiguous spread from ipsilateral hilar lymph nodes. Lung
      consolidation or noncontiguous pulmonary involvement makes an alternative
      diagnosis more likely. This report describes a patient with HD in whom concurrent
      pulmonary blastomycosis was recognized only after chemotherapy had started and
      dissemination had occurred. Although Blastomyces dermatitidis may behave as an
      opportunist pathogen, there are no previous reports of blastomycosis in patients
      with HD. Undiagnosed active opportunistic infection at the time of diagnosis of
      HD may complicate staging as well as treatment. Biopsy of lung lesions with stain
      and culture for opportunistic pathogens should be considered in patients with
      newly diagnosed HD disease and atypical patterns of lung involvement.

PMID- 8342541
TI  - Terminal acute myelogenous leukemia in a patient with congenital agranulocytosis.
AB  - Congenital agranulocytosis terminating in acute myelogenous leukemia has been
      previously reported in only two cases of adolescent males. We describe the
      clinical and laboratory features of a 13-year-old male with congenital
      agranulocytosis, treated with G-CSF with initial good neutrophil response, who
      subsequently developed acute myeloid leukemia. This rare complication may define
      a preleukemic subset of patients for whom G-CSF therapy is ineffective. The
      diagnostic challenges of this case are presented.

PMID- 8342542
TI  - A new alpha-thalassemia-2 deletion resulting in microcytosis and hypochromia and
      in vitro chain imbalance in the heterozygote.
AB  - We have detected a novel alpha-thalassemia-2 with a large (18+ kb) deletion
      involving the alpha 1- and theta 1-globin genes and the 3' hypervariable region
      sequence. Unexpectedly, the heterozygote had a mild anemia with a marked
      microcytosis and hypochromia, and an in vitro alpha/beta chain synthesis ratio of
      0.62-0.66. It is suggested that the deletion includes a sequence that is involved
      in the in cis regulation of the alpha 2-globin gene.

PMID- 8342543
TI  - Measurement of beta 2-glycoprotein I (apolipoprotein H)-independent
      anticardiolipin antibody in human immunodeficiency virus-1-positive and -negative
      hemophiliacs.
AB  - The authors studied whether or not anticardiolipin antibody (aCL), which is
      frequently detected in hemophiliacs with human immunodeficiency virus-1 (HIV-1)
      infection, is dependent on beta 2-glycoprotein I (GPI), a cofactor of cardiolipin
      (CL). GPI-independent aCL was positive in 27 of 36 hemophiliacs with HIV-1
      antibody (75%) and in 23 of 29 patients without HIV-1 antibody (79%). However,
      only six HIV-1-positive and four HIV-1-negative patients were positive for GPI
      dependent aCL. Thus the aCL in these hemophiliacs was GPI independent and
      therefore different from the aCL found in autoimmune diseases, such as systemic
      lupus erythematosus.

PMID- 8342544
TI  - Ultrastructure of neutrophilic phagosome of autologous platelet in vivo in
      specific granule deficiency.
AB  - The ultrastructure of neutrophilic phagosomes containing autologous platelets in
      vivo from a woman with specific granule deficiency is described. This phagosome
      formation was observed only when she had developed pneumonia due to
      Staphylococcus aureus. Therefore, the phenomenon might be induced by severe
      bacterial infection under an abnormal neutrophilic condition accompanied by
      specific granule deficiency.

PMID- 8342545
TI  - Treatment options in primary erythermalgia?

PMID- 8342546
TI  - Treatment of myelofibrosis and primary erythermalgia.

PMID- 8342547
TI  - Malnutrition is a prognostic factor in childhood lymphoblastic leukemia.

PMID- 8342548
TI  - B-cell malignancy associated with disseminated herpes simplex and a large
      granular lymphocyte response.

PMID- 8342549
TI  - Intraperitoneal chemotherapy with cytosine arabinoside in agnogenic myelofibrosis
      with myeloid metaplasia and ascites due to peritoneal extramedullary
      hematopoiesis.

PMID- 8342550
TI  - Case of Crohn's disease in bone marrow transplantation.

PMID- 8342551
TI  - Pregnancy-associated factor VIII inhibitor: treatment with intravenous high-dose
      immunoglobulin.

PMID- 8342552
TI  - Jehovah's Witnesses and acute leukemia.

PMID- 8342553
TI  - Ciprofloxacin-induced neutropenia and erythema multiforme.

PMID- 8342554
TI  - Lymphoma of large granular lymphocytes.

PMID- 8342555
TI  - Heterogeneous proliferative effect of tumor necrosis factor-alpha and lymphotoxin
      on mitogen-activated B cells from B-chronic lymphocytic leukemia.
AB  - The proliferative effect of tumor necrosis factor-alpha (TNF-alpha) and
      lymphotoxin on B cells from patients with B-chronic lymphocytic leukemia (B-CLL)
      was studied. Fresh purified B-CLL lymphocytes showed no proliferative response to
      either recombinant (r) TNF-alpha or r-lymphotoxin. However, after "in vitro"
      activation of B-CLL lymphocytes for 2 days with Staphylococcus aureus Cowan 1
      (SAC), four of seven patients showed enhanced blastogenic response in the
      presence of either rTNF-alpha or r-lymphotoxin. We also found that the
      proliferative response of SAC-activated B-CLL lymphocytes to the two cytokines
      was independent of that found in the presence of interleukin-2. These results
      demonstrate that TNF-alpha and lymphotoxin can heterogeneously support the
      proliferation of in vitro activated B cells from B-CLL patients and may reflect
      the biological heterogeneity of B-CLL disease.

PMID- 8342556
TI  - Increase of hemoglobin A2 in human immunodeficiency virus-1-infected patients
      treated with zidovudine.
AB  - We observed increased hemoglobin A2 (HbA2) levels in an asymptomatic human
      immunodeficiency virus-1 (HIV1) patient with no previous history of beta
      thalassemia. He was treated only with zidovudine (AZT). In an attempt to
      understand this observation, a retrospective study was initiated to determine
      whether mean HbA2 levels are higher in AZT-treated patients than in subjects not
      receiving this drug and to assess if other hematologic alterations are associated
      with elevated HbA2. One hundred fifty-one HIV-positive cases were investigated;
      AZT was administered to 81 of them. The mean value of HbA2 was 0.032 (SD +/-
      0.005) for the treated group vs. 0.027 (SD +/- 0.004) for the controls. This
      difference was highly significant (P < 0.001). Twenty-four patients (31%) in the
      treated group had elevated HbA2 levels vs. none in the controls. Bone marrow
      toxicity seemed to be more significant in patients with heightened HbA2 values,
      and HbA2 levels did not increase with CDC clinical stage. We conclude that AZT
      may be linked to high HbA2 levels in some patients.

PMID- 8342557
TI  - Coagulation system activation and increase of D-dimer levels in peripheral
      arterial occlusive disease.
AB  - The aim of the present study was to document coagulation system activation and
      basal fibrinolysis in peripheral arterial occlusive disease (PAOD) at stage II of
      Fontaine's classification. In 34 patients, prothrombin fragment (F1 + 2),
      thrombin-antithrombin III complexes (TAT), and D-dimer concentrations were
      evaluated before and after a standard treadmill test. Basal levels in PAOD of F1
      + 2 (1.25 +/- 0.19 nmol/liter) and of TAT (3.34 +/- 0.35 micrograms/liter) were
      significantly increased compared to those obtained in age- and sex-matched
      healthy controls (0.68 +/- 0.06 nmol/liter and 2.30 +/- 0.33 micrograms/liter,
      respectively), showing baseline activation of the clotting cascade. A secondary
      activation of the fibrinolytic system was evidenced by the highly significant
      increase of basal D-dimers (719 +/- 99 ng/dl in PAOD vs. 229 +/- 37 ng/dl in
      controls). Treadmill exercise failed to increase the study parameters
      significantly further. Walking distance (583 +/- 40 m) was correlated with the
      preexercise ankle to brachial systolic blood pressure ratio (r = 0.485, P <
      0.005) and inversely with the level of D-dimers (r = -0.425, P < 0.02). Under
      baseline conditions, the latter parameter was correlated as well with the antigen
      concentration of urokinase-type plasminogen activator (u-PA; r = 0.503, P <
      0.002). These results indicate that stage II PAOD is characterized by an
      activation of the clotting cascade in baseline conditions evidenced by increased
      F1 + 2 and TAT. A secondary activation of the fibrinolytic system with increased
      u-PA antigen levels accounts for the elevated D-dimers. Treadmill exercise was
      unable to increase these parameters further.

PMID- 8342558
TI  - Hematologic remission and cytogenetic improvement after treatment of stable-phase
      chronic myelogenous leukemia with continuous infusion of low-dose cytarabine.
AB  - Prolonged exposure to low concentrations of cytarabine preferentially inhibits in
      vitro growth of neoplastic myeloid progenitors from patients with chronic
      myelogenous leukemia (CML) compared to that of normal myeloid progenitors.
      Continuous infusions of cytarabine in doses of 15-30 mg/m2/day were therefore
      administered for extended periods to patients with CML in stable phase to
      determine if this treatment could achieve selective cytoreduction of Philadelphia
      chromosome (Ph)-positive cells. Five patients demonstrating > 90% Ph-positive
      metaphases before treatment received a total of 43 cycles of cytarabine
      infusional therapy. Cytarabine was administered on an outpatient basis using a
      portable, battery-operated syringe pump until the total leukocyte count reached
      2500/microliters or the platelet count reached 75,000/microliters. A new cycle
      was begun when the total leukocyte count exceeded 4,000/microliters and the
      platelet count exceeded 100,000/microliters. The median duration of cytarabine
      administration per cycle was 29 days (range 15-72 days). Leukocytosis was readily
      controlled by low-dose cytarabine therapy in all patients. All five patients
      experienced complete hematologic responses during cytarabine therapy. The
      fraction of Ph-positive metaphases in the marrow of the five patients was reduced
      to 0, 10%, 43%, 72%, and 84%, respectively, during therapy. The median time to
      achieve optimal cytogenetic response was 4.8 months (range 2.8-8.6 months). One
      patient demonstrated a complete cytogenetic response after three cycles of
      cytarabine. Another patient demonstrated persistent cytogenetic improvement
      during 20 cycles of cytarabine, with a median 38% Ph-positive marrow metaphases
      (range 10-53%) over 32 months. Cytarabine therapy was generally well-tolerated,
      but was discontinued in one patient because of persistent asymptomatic elevations
      in hepatic enzymes, which resolved within 2 months after discontinuing therapy.
      There were no episodes of fever during neutropenia, and platelet transfusions
      were not required. However, symptomatic anemia requiring transfusion of red cells
      occurred during most cycles of treatment. In summary, treatment of CML with low
      dose cytarabine can induce prolonged cytogenetic improvement in some patients
      with acceptable toxicity. Further evaluation is needed to ascertain the effect of
      this treatment on duration of stable phase and overall survival.

PMID- 8342559
TI  - Significant hyponatremia following DDAVP administration in a healthy adult.
AB  - We report the development of significant hyponatremia (121 mEq/L) following three
      daily intravenous doses of desmopressin acetate (DDAVP; 18 micrograms; 0.3
      micrograms/kg) in a healthy adult with moderate von Willebrand's disease.
      Previous reports suggest that clinically important hyponatremia due to DDAVP
      administration only occurs in the very young, those receiving hypotonic
      intravenous fluids or those given multiple frequent (e.g., every 8-12 hours)
      doses of DDAVP. None of these conditions was present in this case. Consideration
      should be given to monitoring serum sodium levels and fluid balance in patients
      receiving more than a single dose of DDAVP, even in the absence of previously
      reported risk factors for the development of hyponatremia.

PMID- 8342560
TI  - Hb Saint Nazaire (beta 103[G5]Phe-->Ile): a new example of polycythemia due to a
      hemoglobin variant with increased oxygen affinity.
AB  - Hb Saint Nazaire [beta 103 (G5) Phe-->Ile] was found in four apparently unrelated
      French families. The five patients carrying this hemoglobin have been detected
      because of a moderate erythrocytosis. The structural abnormality of Hb Saint
      Nazaire concerns the same residue as in Hb Heathrow [beta 103 (G5) Phe-->Leu). A
      comparative functional study between these two variants showed that the increase
      in oxygen affinity is much lower in Hb Saint Nazaire than in Hb Heathrow. The
      replacement of phenylalanine G5, which is localized within the heme pocket, by a
      leucine abolishes several contacts between the heme and the globin and leads to
      an environment of the heme having some similarities with that observed in
      myoglobin. In contrast, the replacement of G5 by an isoleucine is likely to
      introduce less structural modifications.

PMID- 8342561
TI  - Detection of the (--SEA) double alpha-globin gene deletion by a simple
      immunologic assay for embryonic zeta-globin chains.
AB  - Homozygous alpha-thalassemia [alpha-thal-1], with loss of all four alpha-globin
      genes, causes lethal hydrops fetalis. The most common mutation producing this
      syndrome is the Southeast Asian (--SEA) double alpha-globin gene deletion.
      Erythrocytes from adults heterozygous for the (--SEA) deletion have minute
      amounts of embryonic zeta-globin chains detectable by anti-zeta-globin monoclonal
      antibodies. Among 225 peripheral blood samples tested by a simple anti-zeta
      immunobinding tetrazolium dye test, 81 were positive and 144 were negative. The
      majority of subjects were of Filipino, Chinese, or Laotian ancestry. All 81
      positive samples were confirmed by Bam HI digests and a zeta-cDNA probe to have
      the (--SEA) mutation. The (--SEA) double alpha-deletion was the only abnormality
      in 58. In the others, it was combined with alpha-globin or beta-globin mutations,
      or coincidental iron deficiency. Four other samples from (--SEA) heterozygotes
      were negative by this immunologic assay. Anti-zeta negative samples included 78
      deletions of the total alpha-globin region, (--Tot), 23 single alpha-globin
      deletions, and a variety of beta-globin mutations; 16 normocytic samples with
      normal alpha-genes were also negative. Ten anti-zeta positive and 25 anti-zeta
      negative samples had benign triplicated zeta-globin genes. In this population,
      the sensitivity of this test was 95%; and specificity for the (--SEA) mutation
      was 100%. Anti-zeta immunobinding testing provides rapid, simple, and reliable
      screening for the (--SEA) double alpha-globin deletion, although it does not
      detect the (--Tot) total alpha-deletions.

PMID- 8342562
TI  - Consequences of chronic hepatitis C: a review article for the hematologist.
AB  - The hepatitis C virus (HCV) has been cloned, and assays capable of detecting
      antibody to HCV recombinant proteins (anti-HCV) have been developed. Concurrent
      with the cloning and development of the anti-HCV screening tests, trials with
      interferon alfa-2b have documented biochemical and histologic improvement in the
      indices of hepatitis C and non-A, non-B (NANB) in patients who were chronically
      infected. Subsequently, the anti-HCV assays and interferon alfa-2b have become
      clinically available. These new detection and treatment modalities can now be
      used in the management of hemophilics and other chronically transfused patients
      who bear great risk for blood-borne infections and manifest signs of chronic
      hepatitis.

PMID- 8342563
TI  - 10(6) Depletion of WBC with CF-2, a new leukocyte removal filter.
AB  - A new leukocyte removal filter, Nipro CF-2, was evaluated. A non-woven polyester
      filter, gravity flow device that does not require priming and rinsing after use
      was developed to remove white blood cells from 400 ml of whole blood or
      concentrates of 400 ml of whole blood. A flow cytometric technique was developed
      to measure extremely low WBC counts. To evaluate the efficiency of this filter,
      leukocyte counts were measured by flow cytometry using a Coulter EPIC-C
      cytometer. After filtration through a CF-2 filter, more than 99.9999% of WBCs
      were depleted from 6 of 17 samples. The mean value of WBC depletion was 99.9994%.
      The CF-2 filter achieved nearly a million-fold depletion of WBCs from whole blood
      concentrates.

PMID- 8342564
TI  - Adoptive chemoimmunotherapy using ex vivo activated memory T-cells and
      cyclophosphamide: tumor lysis syndrome of a metastatic soft tissue sarcoma.
AB  - Adoptively transferred immune cells in combination with chemotherapeutic agents
      form the basis for adoptive chemoimmunotherapy (ACIT) of neoplastic disease.
      Autolymphocytes (ALT-cells) are ex vivo activated peripheral blood lymphocytes
      (PBL) from tumor-bearing hosts (TBH) that consist primarily of tumor-specific
      CD45RO+ (memory) T-cells. These ALT-cells combined with cimetidine (CIM) as
      autolymphocyte therapy (ALT), have previously been demonstrated to be a safe and
      active form of outpatient adoptive immunotherapy (AIT) in human TBH with
      metastatic renal cell cancer (RCC). We have previously described an effective
      ACIT protocol using ALT and cyclophosphamide (CY) for patients with relapsed and
      refractory non-RCC solid tumors. We now report a case of a patient with a
      metastatic gastric leiomyosarcoma to the liver, who developed a clinical picture
      consistent with a tumor-lysis syndrome (TLS), following salvage therapy for his
      tumor with ACIT using ALT and CY. TLS is a well-known complication resulting from
      the treatment of rapidly proliferating hematopoietic tumors such as Burkitt's
      lymphoma and acute lymphocytic leukemia. TLS has also been rarely described in
      chronic lymphocytic leukemia, as well as certain solid tumors such as breast
      cancer, small cell lung cancer, and medulloblastoma. However, there have been no
      previous reports of TLS occurring either secondary to immunotherapy or in
      sarcomas. The nature of these unusual findings is discussed.

PMID- 8342565
TI  - Presence of serum antibodies to coagulation protein C in patients with systemic
      lupus erythematosus is not associated with antigenic or functional protein C
      deficiencies.
AB  - Antibodies directed to immunopurified coagulation protein C (PC) were
      investigated in serum samples from 108 patients with systemic lupus erythematosus
      (SLE) and found in 12 of them. However, their presence was not associated with
      antigenic or functional deficiencies of PC, which were documented in 6 and 17
      patients, respectively.

PMID- 8342566
TI  - Phosphatidylserine in the outer leaflet of red blood cells from beta-thalassemia
      patients may explain the chronic hypercoagulable state and thrombotic episodes.
AB  - Investigation of red blood cells from beta-thalassemia patients by means of
      prothrombinase assay reveals phosphatidylserine in the outer leaflet of the
      plasma membrane. This might explain their elevated susceptibility to phagocytosis
      by macrophages and the chronic hypercoagulable state, frequent thrombotic events,
      and life-long platelet activation that are found in thalassemic patients.

PMID- 8342567
TI  - Hemolytic uremic syndrome developing during remission of acute myelomonocytic
      leukemia.
AB  - A 47-year-old woman was diagnosed with acute myelomonocytic leukemia (AMMoL) and
      was treated with combination chemotherapy. After one cycle of remission induction
      therapy, she entered into complete remission and then received three cycles of
      consolidation therapy. A month after the last consolidation therapy, she was
      diagnosed with having the complication of chemotherapy-related HUS (C-HUS). The C
      HUS improved after initiation of plasma exchange and antiplatelet therapy. In the
      present case, it seems that the antileukemic agents might play an important role
      in the development of C-HUS.

PMID- 8342568
TI  - Amegakaryocytic thrombocytopenia with a positive direct Coombs' test.
AB  - A 50-year-old previously well woman developed a sudden onset of ecchymoses and
      petechiae over the trunk and extremities and gum bleeding. There was no history
      of alcohol use or drug ingestion. Physical examination was normal except for the
      ecchymoses, purpuric rash, and gum bleeding. Complete blood count showed Hb 8.0
      g/dl, leucocytes 10.9 x 10(9)/L with a normal differential, platelets 8 x 10(9)/L
      and reticulocytes, 4%. The bone marrow was normocellular and showed absence of
      megakaryocytes; there was normoblastic erythroid hyperplasia and the myelopoiesis
      was normal. The direct Coombs test result was positive. There was poor response
      to treatment with prednisone and bolus doses of vincristine. Therapy with danazol
      resulted in the complete normalization of the blood counts, and the patient
      remains well 32 months after diagnosis and is currently taking 100 mg danazol
      daily.

PMID- 8342569
TI  - Dapsone for autoimmune thrombocytopenic purpura.
AB  - Twenty-one human immunodeficiency virus (HIV)-free and six HIV-infected adults
      with autoimmune thrombocytopenic purpura (AITP) were treated with dapsone (100
      mg/day). A response was observed in 13 patients (median platelet count before 25
      x 10(9)/L, range 3-49; after 109 x 10(9)/L, range 69-241). Thrombocytopenia
      recurred in four of the responders in whom dapsone was discontinued. No response
      was observed in 12 patients. Dapsone had to be withdrawn after two weeks of
      treatment in the remaining two patients and after six to eight weeks in three
      other patients due to intolerance. No serious hematological complications were
      observed. These results confirm that dapsone is a safe, inexpensive, and
      effective treatment of AITP.

PMID- 8342570
TI  - Translocation (14;15) (q32;q13) in B cell chronic lymphocytic leukemia.

PMID- 8342572
TI  - Pleural blast crisis in chronic myelogenous leukemia.

PMID- 8342571
TI  - Successful arthroscopic synovectomy using holmium: Yag laser and FEIBA in a high
      responder hemophiliac.

PMID- 8342573
TI  - Familial lupoid thrombocytopenia.
AB  - Familial lupoid thrombocytopenia affecting three subjects in three generations is
      reported. All subjects had antinuclear antibodies with or without antibodies to
      single-stranded DNA, an increase in platelet-associated IgG, and a family member
      with an autoimmune disease. These findings implicate a genetic contribution. All
      subjects shared a common HLA haplotype.

PMID- 8342574
TI  - Recombinant granulocyte-macrophage colony-stimulating factor modulates in vitro
      function of the peripheral blood mononuclear cells in lipoid nephrosis.
AB  - The effect of recombinant human granulocyte-macrophage colony-stimulating factor
      (GM-CSF) on the in vitro proliferation of peripheral blood lymphocytes (PBL) was
      evaluated in patients with lipoid nephrosis (LN). The cytokine increased the
      proliferation of LN PBL in response to phytohemagglutinin (PHA), measured by the
      [3H]thymidine uptake. The effects were abrogated by antibody against human GM
      CSF. We then investigated the effect of GM-CSF on the release of interleukin-1
      (IL-1) from peripheral blood monocytes (PBM) in LN patients and normals. In vitro
      IL-1 production by LN PBM treated with lipopolysaccharide (LPS) was enhanced by
      coculture with GM-CSF. Potentiation was approximately 2-fold. The immunological
      identity of the thymocyte comitogenic activity as IL-1 was confirmed by
      neutralization with a specific rabbit antihuman IL-1 antiserum. Taken together,
      these observations suggest that one mechanism by which GM-CSF acts to restore
      immune responses in LN patients may be enhancing the signals which enable
      activated monocytes/macrophages to secrete IL-1.

PMID- 8342575
TI  - Urinary acidification response to furosemide administration in patients on low
      dose cyclosporine therapy.
AB  - The response of urinary acidification parameters and electrolytes to furosemide
      administration was prospectively studied in 9 psoriatic patients treated with a
      low-dose cyclosporine A schedule (initial dose: 5 mg/kg body weight) before
      beginning cyclosporine A, after 3 months on cyclosporine A and 1 month after
      cyclosporine A withdrawal. The test was also performed in 29 psoriatic patients
      after 3 months on 5 mg/kg body weight cyclosporine A treatment. There were no
      significant differences between before and after cyclosporine A treatment
      regarding furosemide-induced changes in urinary volume, sodium or potassium
      excretion. Contrarily, the post-furosemide urinary pH decrease and ammonium and
      titrable acid increase were significantly lower in cyclosporine-A-treated
      patients. Five of the 29 studied patients showed abnormal furosemide tests (17%).
      These patients had lower total serum CO2, urea and creatinine but similar serum
      potassium and fractional potassium excretion. We conclude that some patients
      treated with low-dose cyclosporine A therapy develop an abnormal tubular distal
      response to furosemide administration, suggesting an alteration in the H(+)
      ATPase pump or a voltage-dependent mechanism.

PMID- 8342576
TI  - Bone mineral density in patients with end-stage renal failure.
AB  - Renal osteodystrophy is a well-recognized complication of chronic renal failure
      (CRF) and is associated with a marked morbidity. Bone mineral density (BMD) has
      been shown to be the best predictor of fracture risk in different circumstances.
      In this cross-sectional study, we measured BMD using dual photon absorptiometry
      at three skeletal sites of functional importance such as the lumbar spine (LS),
      the femoral shaft (FS) and the femoral neck (FN) in 106 patients with end-stage
      renal failure (11 predialysis patients and 95 patients on maintenance dialysis).
      These skeletal sites are characterized by various relative amounts of trabecular
      and cortical bone. The results indicate that decreased bone mass was detectable
      in all skeletal sites before the beginning of dialysis and that BMD was
      negatively related to dialysis duration in LS and FS. Nevertheless, the
      deleterious effects of renal osteodystrophy were more pronounced at the FS level,
      where cortical bone is predominant. A separate analysis of BMD in both sexes
      revealed that females presented a more important bone loss in both cortical and
      trabecular bone than males. We did not find any significant difference in BMD at
      the three measured sites between patients on continuous ambulatory peritoneal
      dialysis and on regular hemodialysis. This study emphasizes the need to pay more
      attention to the prevention of bone loss in patients on CRF before the start of
      dialysis therapy, and to the fact that the female population might display a more
      pronounced susceptibility to bone loss.

PMID- 8342577
TI  - Acute nephropathy of organotin compounds.
AB  - Three patients who developed acute nephropathy following ingestion of
      triphenyltin acetate (TPTA) are described. All of them had significant
      proteinuria, azotemia, and polyuria. Mild neurological manifestations in all
      patients were also noted. Hematuria and pyuria were noted in 1 severely poisoned
      patient. Evidence for hepatitis was present in 2 patients, and for pancreatitis
      in 1. Renal biopsy showed focal fusion of glomerular cell processes and proximal
      tubular damage with cellular necrosis. Two patients survived with complete
      recovery of renal functions. One old patient died of aspiration pneumonia. Acute
      nephropathy following organotin intoxication appears to result mainly from
      proximal renal tubular damage with a benign and reversible clinical course.

PMID- 8342578
TI  - Renal concentrating capacity test by desmopressin in children: intranasal or
      intravenous route?
AB  - Intranasal administration of desmopressin (dDAVP) is frequently used to test
      renal concentrating capacity in children. However, the bioavailability of
      intranasal dDAVP is about 10% and may be modified by nasal congestion. The study
      aimed to compare the efficacy of intranasal dDAVP with an equivalent dose of
      intravenous dDAVP for a renal concentrating capacity test in children. We studied
      18 children aged 12.6 +/- 3.8 years weighing more than 20 kg in whom a dDAVP test
      was indicated as part of global renal function evaluation. Spray applicator
      (Minirin Spray) was used for intranasal administration (20-40 micrograms
      according to BW); the dose of intravenous dDAVP (Minirin IV) was reduced to 10%
      (2-4 micrograms according to BW). A randomized sequence was used for the first
      intranasal or intravenous dDAVP test; the second alternate test was repeated in
      the same children in a time interval ranging from 1 to 3 weeks. Osmolality of the
      urine (Uosm, mosm/kg) was determined before (T0), then 2 (T2) and 4 (T4) h after
      dDAVP administration. There was no significant difference in Uosm at T0
      (intranasal = 480 +/- 212, intravenous = 443 +/- 168 mosm/kg), T2 (604 +/- 226
      and 542 +/- 173 mosm/kg, respectively), and T4 (657 +/- 206 and 629 +/- 190
      mosm/kg, respectively). There was an obvious correlation between intranasal and
      intravenous Uosm at T4 (r2 = 0.826; p = 0.001). Even if intravenous dDAVP is of
      theoretical interest, intranasal administration of dDAVP using a spray applicator
      can be considered as first-choice method for a renal concentrating capacity test
      in children weighing more than 20 kg.

PMID- 8342579
TI  - Difference between renal failure associated with methylprednisolone pulse therapy
      and deterioration of renal function unrelated to methylprednisolone therapy.
AB  - In this study, we attempted to analyze the differences between renal failure
      associated with methylprednisolone (MP) pulse therapy and natural deterioration
      of renal function that was unrelated to MP administration. Of 80 patients with
      renal or collagen disease who received MP pulse therapy at our hospitals, 13 were
      selected for the study whose serum creatinine levels increased more than 0.5
      mg/dl from baseline values following therapy. Somewhat arbitrarily, 7 patients
      were placed in an MP-associated renal deterioration group (group 1) in which
      serum creatinine levels returned naturally, or following induced diuresis, to
      baseline levels, and 6 patients in an MP-independent natural deterioration group
      (group 2) in which renal function progressively deteriorated. Renal function
      similarly deteriorated in the two groups following pulse therapy, irrespective of
      the degree of crescent formation. Our data suggested that hypoproteinemia is the
      most important index for differentiating MP-associated renal failure from natural
      deterioration of renal function unrelated to MP pulse therapy. In patients that
      are nephrotic and have impaired renal function, worsening of renal function
      following pulse therapy may partly be due to transient MP-associated renal
      failure. On the other hand, in patients without hypoproteinemia, worsening of
      renal function is most likely due to active primary disease and is probably not
      associated with MP pulse therapy.

PMID- 8342580
TI  - Mineralocorticoid therapy lowers serum potassium in patients with end-stage renal
      disease.
AB  - Hyperkalemia is a commonly encountered problem in dialysis patients with end
      stage renal disease. In this study we evaluated the effect of mineralocorticoid
      therapy (MCT; fludrocortisone 0.1-0.3 mg per os daily) on serum potassium of
      hyperkalemic end-stage renal disease patients. Consecutive monthly clinical and
      biochemical profiles 3-6 months before and after MCT were compared. Twenty-one
      patients with a mean age (+/- SE) of 54 +/- 4 years (11 male and 10 female) were
      studied. Two patients were dropped from this study because they required a change
      in prescription of dialysis after starting MCT. Mean serum potassium levels
      significantly fell (p < 0.001) during the post-MCT period (4.9 +/- 0.1 mEq/l)
      compared with potassium levels during the pre-MCT (5.6 +/- 0.1 mEq/l) period. All
      patients except 1 showed a reduction in serum potassium levels after MCT. Pre-
      and post-MCT values were not different for body weight, mean blood pressure,
      blood urea nitrogen, serum glutamic-oxaloacetic transaminase, lactate
      dehydrogenase, sodium, chloride, bicarbonate, creatinine and albumin. Since the
      majority of the patients were anuric (n = 15), a decrease in serum potassium
      values in the post-MCT period was not due to loss of potassium in the urine. MCT
      appears to decrease serum potassium values in patients with end-stage renal
      disease by extrarenal mechanisms. We conclude that MCT can be used safely to
      lower serum potassium in patients with end-stage renal disease.

PMID- 8342581
TI  - Influence of thalassemia on the response to recombinant human erythropoietin in
      dialysis patients.
AB  - Thalassemia is a common genetic disorder among the South Chinese. To see if
      thalassemia would adversely affect the erythrocyte response to recombinant human
      erythropoietin (rHuEPO, Epogen) in dialysis patients, the response to rHuEPO in 4
      dialysis patients with thalassemic traits (thal-t) was compared with that of 4
      control patients who were matched for age, sex, mode of dialysis and baseline
      hemoglobin levels over a 6-month period. Patients with thal-t showed a reduced
      erythrocyte response to rHuEPO compared to control dialysis patients as reflected
      by a reduced reticulocyte index, a slower rise in hemoglobin or hematocrit
      levels, requirement of a higher cumulated dose of rHuEPO to achieve a target
      hemoglobin of 10 g/dl and a higher maintenance dose of rHuEPO. A dialysis patient
      with hemoglobin H disease (HbHD) was also studied. He failed to respond to rHuEPO
      despite that the dose was increased to 250 U/kg/week. In contrast, his matched
      control dialysis patient, despite a lower baseline hemoglobin level (6.1 versus
      8.8 g/dl), was able to reach a target hemoglobin level of 10 g/dl by 6 weeks and
      could be maintained at this level with 50 U/kg/week. The patient with HbHD had
      splenomegaly and a higher baseline serum erythropoietin level, reticulocyte
      count, serum bilirubin, serum ferritin and serum iron saturation than control
      patients and patients with thal-t. It was concluded that thal-t reduces the
      erythrocyte response to rHuEPO in dialysis patients and that in the presence of
      active hemolysis and enhanced endogenous erythropoietin secretion, dialysis
      patients with HbHD are resistant to treatment with rHuEPO.

PMID- 8342582
TI  - Treatment of severe secondary hyperparathyroidism with administration of calcium
      carbonate, intermittent high oral doses of 1,25-dihydroxyvitamin D3 and dialysate
      with 3 mEq/1 calcium concentration.
AB  - In this study, we evaluated the effect of long-term administration of daily
      calcium carbonate (2-4 g/day) and intermittent high oral doses of 1,25
      dihydroxyvitamin D3 [1,25-(OH)2D3, 3-4 micrograms, given twice a week] in
      conjunction with a 3-mEq/1 calcium concentration in the dialysate for the
      treatment of severe secondary hyperparathyroidism in 6 hemodialysis patients. All
      patients had reduced serum levels of 1,25-(OH)2D3, which increased significantly
      (p < 0.005) reaching the maximum level in the 4th month. Serum total and ionized
      calcium levels significantly increased also, in relation to those before
      treatment. No patients developed hypercalcemia. Serum phosphorus did not
      significantly change during the study. Initial serum intact parathyroid hormone
      (PTH) (1,241 +/- 233 pg/ml, mean +/- SEM) markedly decreased after starting
      treatment with 1,25-(OH)2D3, being 542 +/- 174 pg/ml in the 5th month and 477 +/-
      174 pg/ml in the 8th month. These changes are statistically significant (p < 0.05
      and < 0.007, respectively). Alkaline phosphatase behavior was similar to that of
      intact PTH. A constant direct correlation between intact PTH and alkaline
      phosphatase and an inverse significant correlation between intact PTH and 1,25
      (OH)2D3 was evidenced by us. We conclude that oral 1,25-(OH)2D3 pulse therapy is
      very effective in suppressing PTH secretion. The administration of calcium
      carbonate and the use of dialysate with a reduced calcium concentration would
      allow to prevent hyperphosphatemia and the administration of high oral doses of
      1,25-(OH)2D3 without concomitant hypercalcemia.

PMID- 8342583
TI  - Elevated basal levels of cytosolic calcium of thymocytes in chronic renal
      failure.
AB  - The basal levels of cytosolic calcium ([Ca2+]i) in rats and/or humans with
      chronic renal failure (CRF) are elevated in many cells including brain
      synaptosomes, pancreatic islets, polymorphonuclear leukocytes, platelets and B
      and T cells. This rise in [Ca2+]i has been attributed to the state of secondary
      hyperparathyroidism of CRF. These observations have led to the proposition that
      CRF is a state of cellular calcium intoxication mediated by excess parathyroid
      hormone (PTH). The documentation of a high basal level of [Ca2+]i in other cells
      is needed to provide further support for this postulate. The present study
      evaluated the basal levels of [Ca2+]i of thymocyte, which are targets for PTH
      action, in normal, CRF, and CRF parathyroidectomized (CRF-PTX) rats. We also
      examined whether CRF affects the phenotype expression (Thy-1, CD4 and CD8) in
      thymocytes. The results showed that the basal levels of [Ca2+]i in thymocytes
      from CRF rats (81 +/- 3.7 nM) are significantly (p < 0.01) higher than those in
      normal animals (60 +/- 2.9 nM). PTX of CRF animals prevented the elevation in the
      basal levels of [Ca2+]i of thymocytes; in these animals, the levels were 59 +/-
      2.8 nM. Neither CRF nor the elevation in [Ca2+]i of thymocytes affected their
      phenotype expression.

PMID- 8342584
TI  - A case of Guillain-Barre syndrome with focal segmental glomerulosclerosis.
AB  - Acute inflammatory polyneuropathy or Guillain-Barre syndrome may be associated
      with glomerulonephritis, especially membranous nephropathy. This paper details
      the case of a 73-year-old woman presenting with acute onset of Guillain-Barre
      syndrome associated with an abnormal urinary sediment and significant
      proteinuria. Renal biopsy was consistent with focal segmental glomerulosclerosis.
      Despite an initial response to plasmapheresis, the patient's polyneuropathy
      deteriorated and subsequently improved with corticosteroid therapy.
      Simultaneously, her proteinuria and urinary sediment also improved. This implies
      that this was not a chance association. A brief discussion of the association
      between Guillain-Barre syndrome and glomerulopathies is undertaken.

PMID- 8342585
TI  - Steroid-responsive renal insufficiency due to idiopathic granulomatous
      tubulointerstitial nephritis.
AB  - A 26-year-old male was admitted to our hospital having suffered from subfever,
      sterile pyuria and renal insufficiency for 1 year. There had been no apparent
      hematuria/proteinuria, and evidence of infection, allergy or intoxication was not
      demonstrated. Open renal biopsy revealed severe tubulointerstitial changes with
      granuloma accompanied by neither caseous necrosis nor giant cells. Infiltrating
      cells mostly consisted of CD4 and CD8 T cells, and some proximal tubular cells
      presented MHC class II antigen. Following the negative culture of biopsied
      specimen for acid-fast bacilli, diagnosis of idiopathic granulomatous
      tubulointerstitial nephritis was made, and steroid therapy was started. Two
      months later, pyuria disappeared and renal function improved significantly,
      proving the effectiveness of steroid on idiopathic granulomatous
      tubulointerstitial nephritis.

PMID- 8342586
TI  - Transplantation of kidneys from a donor with Neisseria meningitidis infection.

PMID- 8342587
TI  - Immunocytochemical localization of ProANF 1-30, ProANF 31-67, atrial natriuretic
      factor and urodilatin in the human kidney.
AB  - Whether ProANF 1-30 [first 30 amino acids (a.a.) of the 126-a.a. atrial
      natriuretic factor (ANF) prohormone] and ProANF 31-67 (a.a. 31-67 of this
      prohormone) with their natriuretic and diuretic properties are present within the
      human kidney is unknown. In the present investigation, ProANFs 1-30 and 31-67 as
      well as ANF (a.a. 99-126) of the ANF prohormone localized to the subbrush border
      of the pars convoluta and pars recta of the proximal tubules of the human kidney
      with immunoperoxidase staining. Immunofluorescent studies revealed that each of
      these peptides had a strong inclination for the perinuclear region in the
      proximal and distal tubules. ProANFs 1-30, 31-67 and 99-126 (i.e. ANF) also
      localized with both immunoperoxidase and immunofluorescent staining to the
      coritcal collecting ducts, glomeruli, and peritubular and interstitial blood
      vessels. ANF immunoperoxidase staining was particularly striking in the
      endothelium of interstitial arteries and vasa recta. In the glomeruli, prominent
      staining was noted in the peripheral glomerular capillary wall and in some of the
      visceral epithelial cells. In contrast, urodilatin (i.e. a.a. 95-126 of the ANF
      prohormone) was not found in the proximal tubules, but weak staining was found in
      the distal tubules and interstitial vessels with some but not all glomeruli,
      peritubular vessels, cortical collecting tubules and outer medullary nephrons
      weakly staining by immunoperoxidase and immunofluorescent methods. The whole
      prohormone being present in the kidney was suggested by immunological recognition
      of both the N- and C-termini of the ANF prohormone by radioimmunoassays.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8342588
TI  - Acute effects of furosemide on blood pressure in functionally anephric, volume
      expanded rats.
AB  - The hypotensive effect of loop diuretics is primarily mediated by a decrease in
      extracellular fluid volume that follows the intense diuresis. In the present
      study we investigated whether furosemide (1.25 mg/kg i.v.) can acutely lower
      blood pressure independently of its diuretic action. The experiments were
      performed in four groups of male Wistar rats: (a) rats in which furosemide was
      administered after bilateral ligation of renal vessels and saline (0.9% NaCl at a
      rate of 0.25 ml/min to a final volume of 1% of body weight) infusion; (b) rats in
      which furosemide was injected after bilateral ligation of ureters and saline
      infusion; (c) rats pretreated with indomethacin (3 mg/kg i.p. for 4 days) in
      which furosemide was injected after bilateral ligation of ureters and saline
      infusion; (d) sham-operated rats with intact kidneys. All the groups were
      compared with appropriate time controls. After furosemide injection, heart rate
      and blood pressure were serially recorded for 30 min by plethysmography.
      Hematocrit, plasma 6-keto-prostaglandin F1 alpha levels and plasma renin activity
      were measured at baseline and 20 min after furosemide injection. No change in
      blood pressure followed furosemide administration in rats with ligation of the
      renal vessels. Conversely, furosemide induced a rapid and significant fall in
      blood pressure associated with a significant increase in heart rate in rats with
      ligation of the ureters and rats with intact kidneys. Indomethacin pretreatment
      prevented the furosemide-induced decrease in blood pressure in rats with ligation
      of the ureters. Hematocrit and plasma 6-keto-prostaglandin F1 alpha levels were
      not affected by furosemide in either group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342589
TI  - Keratinocytes: key immunocytes of the integument.

PMID- 8342590
TI  - The placenta revealed.

PMID- 8342591
TI  - Interleukin-4 down-regulates adult human astrocyte DNA synthesis and
      proliferation.
AB  - The T lymphocyte-derived cytokine, interleukin-4 (IL-4), was found to inhibit
      dose dependently basal DNA synthesis of cultured non-neoplastic human astrocytes
      isolated from epilepsy white matter tissue. The mitogenic effect of tumor
      necrosis factor on astrocytes was also inhibited by IL-4, and the inhibitory
      effect was abrogated by anti-IL-4 antibody but not by irrelevant IgG.
      Immunofluorescent analysis indicated significantly reduced numbers of glial
      fibrillary acidic protein-positive astrocytes incorporating nuclear
      bromodeoxyuridine in IL-4-treated cultures compared to control. These findings
      indicate that human adult astrocyte proliferation, in contrast to that reported
      for endothelial cells or fibroblasts, is sensitive to down-regulation by IL-4.

PMID- 8342592
TI  - Cytotoxic potential of intraepithelial lymphocytes (IELs). Presence of TIA-1, the
      cytolytic granule-associated protein, in human IELs in normal and diseased
      intestine.
AB  - Human intestinal intraepithelial lymphocytes (IELs) have phenotypic
      characteristics of cytotoxic T cells, yet a cytotoxic function has not been
      demonstrated in redirected lysis assays. A monoclonal antibody that reacts with a
      cytotoxic granule-associated protein, TIA-1, was used in this study to identify
      this protein in many, but not all, IELs of normal human proximal small intestine.
      Furthermore, in active celiac disease, in which the number of IELs is
      significantly increased, a corresponding increase in the number of TIA-1 cells
      was found. These results indicate that whereas cytotoxicity of human IELs has
      been difficult to demonstrate, they contain at least one of the proteins
      associated with cytotoxicity, and a failure to demonstrate this function may be
      related to the in vitro assay system used.

PMID- 8342593
TI  - Spatial and temporal patterns of immunoreactive transforming growth factor beta
      1, beta 2, and beta 3 during excisional wound repair.
AB  - Transforming growth factor beta (TGF-beta) regulates cellular growth and
      differentiation and stimulates the synthesis and secretion of protein
      constituents of the extracellular matrix. Three isoforms of TGF-beta have been
      found in mammals. Although the biological activities of TGF-beta 1, TGF-beta 2,
      and TGF-beta 3 are similar at the level of cell culture, distinct in vivo
      functions for these molecules are emerging. To gain insight into the role of each
      isoform in wound repair, antibodies specific for each isoform of TGF-beta were
      used to examine excisional wound repair. Marked differences in the temporal and
      spatial relationships for immunoreactive TGF-beta 1, -beta 2, and -beta 3 were
      noted throughout the repair process. TGF-beta 2 and TGF-beta 3 were prevalent by
      24 hours after excisional wounding, and strong immunoreactivity was observed in
      the migrating epidermis. Subtle changes in immunoreactivity occurred for TGF-beta
      2 and TGF-beta 3 in cells of the epidermal appendages, mesenchymal derivatives,
      granulation tissue, and the underlying dermis throughout wound repair. In
      contrast, TGF-beta 1 was not associated with any undifferentiated cells and was
      not present in the dermis and most dermal structures in both nonwounded skin or
      wounds until day 5 after wounding, when re-epithelialization was complete.
      Following re-epithelialization, TGF-beta 2 and TGF-beta 3 were present in all
      four layers of stratum corneum of the differentiating epidermis. All three TGF
      beta isoforms were present in mesenchymal cells and basal lamina, suggesting
      their role in the modulation of dermal-epidermal interaction during wound repair.
      Our observations support individual in vivo function for TGF-beta isoforms in
      cutaneous wound repair.

PMID- 8342594
TI  - Effects of late reperfusion on infarct expansion and infarct healing in conscious
      rats.
AB  - We examined the effects of late reperfusion on infarct expansion and infarct
      healing process in conscious rats. Coronary occlusion and reperfusion were
      carried out in conscious rats 1 week after appropriate surgical preparations. The
      rats were randomized into the following four groups: sham operated, permanent
      occlusion, early reperfusion (i.e., reperfusion performed 1 hour after
      occlusion), and late reperfusion (i.e., reperfusion performed 6 hours after
      occlusion). Histological examination was performed 7 days after coronary
      occlusion. In the early reperfusion group, infarct size and expansion were
      reduced when compared to the permanent occlusion group. In rats subjected to late
      reperfusion, infarct size and expansion were not different from those in the
      permanent occlusion group. The extent of unresorbed necrotic myocardium in areas
      of infarcted scar was reduced in both early and late reperfusion groups.
      Infiltration by neutrophilic cells into areas of necrotic myocardium 16 hours
      after myocardial infarction was increased in both reperfusion groups.
      Infiltration by macrophages 3 days after infarction was also increased in both
      reperfusion groups. Late reperfusion, therefore, does not affect infarct
      expansion, but does contribute to the acceleration of the infarct healing
      process.

PMID- 8342595
TI  - Apoptosis of T lymphocytes in experimental autoimmune encephalomyelitis. Evidence
      for programmed cell death as a mechanism to control inflammation in the brain.
AB  - In experimental autoimmune encephalomyelitis (EAE) myelin-specific T lymphocytes
      attack the myelinated tissue of the central nervous system (CNS). In the Lewis
      rat, EAE as a rule has an acute, monophasic course. With spontaneous clinical
      recovery the inflammatory CNS infiltrates are cleared from the nervous tissue
      within a few days. This is well in line with the remarkably low incidence of
      myelin-specific T cells present in EAE infiltrate. Combining immunocytochemical
      techniques, ultrastructural criteria and in situ nick translation we found up to
      49% of T lymphocytes in EAE lesions showing signs of apoptosis at the time of
      recovery from disease. Our results suggest that apoptosis of T lymphocytes may be
      one possible mechanism to eliminate T lymphocytes from inflammatory brain
      lesions.

PMID- 8342596
TI  - Villitis of unknown etiology is associated with major infiltration of fetal
      tissue by maternal inflammatory cells.
AB  - Villitis of unknown etiology (VUE) is a common placental lesion and an important
      cause of intrauterine growth retardation and recurrent reproductive failure. Two
      theories have been proposed to explain VUE. One proposes that VUE is an
      exclusively fetal immune response to microbial antigen, whereas the other
      suggests that maternal cells cross the maternal-fetal interface and mount an
      immune response to fetal antigens. To differentiate between these alternatives,
      we performed in situ hybridization using X and Y chromosome-specific probes and
      immunostaining for CD3 and CD45 on VUE placentas from male infants. A total of
      eight foci and 40 villi were studied from four male VUE placentas. Controls
      included nonaffected villi from each male VUE placenta, a female VUE placenta,
      and male and female tonsils. Affected villi showed a major proportion of XX
      (maternal) cells (range 30 to 54%). An appropriate percentage of the remaining
      (fetal) cells contained Y chromosomes. The fraction of cells within the eight
      foci staining for CD3 (T lymphocytes) ranged from 34 to 57%, whereas the fraction
      staining for CD45/LCA (total leukocytes) ranged from 45 to 74%. The proportion of
      maternal cells within each focus was significantly correlated with the number of
      CD3-positive T lymphocytes but not with the number of CD3-negative leukocytes. We
      conclude that maternal cells, probably CD3-positive T cells, cross the
      maternofetal barrier and participate in VUE.

PMID- 8342597
TI  - Expression of tumor necrosis factor-alpha and its mRNA in the endometrial mucosa
      during the menstrual cycle.
AB  - Endometrial biopsies, collected at various phases of the menstrual cycle, were
      examined for the presence of tumor necrosis factor-alpha (TNF-alpha) by
      histochemistry, and TNF-alpha mRNA by in situ hybridization and Northern
      blotting. During the proliferative phase, TNF-alpha and TNF-alpha mRNA were not
      detected or were at low levels. During the secretory phase, the TNF-alpha mRNA
      level was increased and observed in the wall of coiled arteries. TNF-alpha was
      detected both in the wall of the coiled arteries and, in highest concentration,
      within the epithelial cells. In regard to the capacity of TNF-alpha to induce a
      hemorrhagic necrosis in various tissues, this study suggests that an
      overproduction of TNF-alpha within the small arteries of the endometrial mucosa
      might be responsible for menstruation.

PMID- 8342598
TI  - Plasma protein insudation as an index of early coronary atherogenesis.
AB  - Two hundred ninety-nine paraffin-embedded coronary artery blocks from 68 autopsy
      cases were serially sectioned. The blocks were selected to provide a range from
      normal through various stages of atherosclerosis, and sections were examined with
      the indirect immunofluorescence technique for intramural distribution of plasma
      albumin, fibrinogen, and immunoglobulin gamma (IgG). Cryostat-sections of 44
      blocks from 22 of the same cases were examined with the same technique for
      distribution of apolipoprotein B. Alteration of protein insudation in the artery
      wall was a sensitive index of coronary atherogenesis. The sequence in which these
      proteins were involved in the initiation and development of early atherosclerotic
      lesions was analyzed by determining the average relative intimal thickness and
      relative lumen size that was associated with the first occurrence of altered
      insudation of each of these proteins. Results indicate that changed plasma
      albumin insudation is the earliest sign of a focal intimal lesion, and increasing
      albumin insudation shows the strongest association with intimal plaque growth.
      The other proteins tested showed altered insudation, in the order IgG,
      fibrinogen, apolipoprotein B. The results indicate that a progressive increase in
      permeability of the coronary artery endothelium occurs in the early stages of
      atherogenesis. Patterns of IgG localization provide evidence of both early
      systemic and subsequent local immune reactions being involved in atherogenesis.
      Altered albumin and apolipoprotein B insudation levels have stronger correlation
      coefficients with relative intimal thickness and relative lumen size than do
      those IgG and fibrinogen. The extremely high correlation coefficients shown by
      albumin emphasizes the importance of edema in determining plaque size and lumen
      stenosis.

PMID- 8342599
TI  - Elevated expression of basic fibroblast growth factor in an immortalized rabbit
      smooth muscle cell line.
AB  - Intimal smooth muscle cell accumulation is regarded as an important component of
      atherosclerotic plaque formation, angioplasty-induced restenosis, and vascular
      graft occlusion. Vascular smooth muscle cells can both express and respond to
      acidic fibroblast growth factor (aFGF) and basic fibroblast growth factor (bFGF);
      therefore, under certain conditions these polypeptides may regulate smooth muscle
      cell growth in an autocrine manner. Previous studies using smooth muscle cells
      cultured in vitro have identified factors that can enhance aFGF and bFGF gene
      expression. In this study, we assayed fibroblast growth factor gene expression in
      a spontaneously immortalized rabbit smooth muscle cell line. In contrast to
      "normal" rabbit smooth muscle cells, these immortalized cells acquire an altered
      morphology and enhanced proliferative rate during; cell passaging in vitro. Both
      "normal" and immortalized rabbit smooth muscle cells express bFGF but not aFGF
      transcripts. RNA gel blot hybridization, reverse transcription/polymerase chain
      reaction amplification, and Western blotting techniques demonstrate that bFGF
      expression in the immortalized smooth muscle cell line increases as a function of
      passage level. This continuous cell line should prove valuable for studying both
      the regulation of bFGF synthesis and the control of vascular smooth muscle cell
      proliferation.

PMID- 8342600
TI  - Growth and invasion of human melanomas in human skin grafted to immunodeficient
      mice.
AB  - An orthotopic model of human melanoma was developed in which malignant cells were
      injected into human skin grafted to nude and SCID mice. Melanoma cells
      proliferated and invaded the human skin grafts with characteristic patterns.
      Three of six melanomas grew as multiple nodules and infiltered the grafts without
      major architectural changes in the dermis, whereas the others invaded the dermis
      along collagen fibers with prominent endothelial vessels. By contrast, melanoma
      cells inoculated into mouse skin grew as diffusely expanding nodules that did not
      invade the murine dermis. In human skin grafts, human melanoma cells were
      angiogenic for human blood vessels, and murine vessels were only found at the
      periphery of grafts. Tumor cells invaded the human vessels, and four out of seven
      cell lines metastasized to lungs, suggesting that this model is useful to
      determine in vivo the interactions between normal and malignant human cells.

PMID- 8342601
TI  - Cooperation of Ito cells and hepatocytes in the deposition of an extracellular
      matrix in vitro.
AB  - Cellular and molecular mechanisms involved in the deposition of extracellular
      matrix components in both normal and fibrotic liver are still poorly understood.
      We have investigated the influence of cooperation between Ito cells and
      hepatocytes in matrix deposition in vitro. Immunoprecipitation of radiolabeled
      proteins from media of 5-day-old Ito cell primary cultures showed that these
      cells secreted high levels of the major basement membrane components, ie,
      collagen IV, laminin, and entactin/nidogen. By immunocytochemistry, precursors of
      basement membrane components were found intracellularly, but only scarce deposits
      were seen around the cells. When hepatocytes were added to 2-day-old Ito cell
      primary cultures, they established close contacts with Ito cells in less than 24
      hours and expressed ZO-1, a tight junction-associated protein not detectable in
      standard hepatocyte culture. Cytochemistry analysis revealed an abundant
      extracellular matrix deposited over hepatocyte cords and between hepatocytes and
      Ito cells. Immunocytochemistry studies showed that this matrix contained laminin,
      fibronectin, and collagens proIII and IV. These data indicate that a high level
      of matrix protein synthesis by liver cells in vitro is not sufficient to induce
      extracellular matrix deposition, and that cell-cell interactions are strongly
      involved in this process. Hepatocyte/Ito cell co-culture, which may reflect the
      actual situation in vivo, represents a useful tool for studying liver
      fibrogenesis.

PMID- 8342602
TI  - K-ras oncogene activation in adenocarcinoma of the human pancreas. A study of 82
      carcinomas using a combination of mutant-enriched polymerase chain reaction
      analysis and allele-specific oligonucleotide hybridization.
AB  - We examined 82 surgically resected or biopsied, formalin-fixed, paraffin-embedded
      primary adenocarcinomas of the pancreas for the presence of activating point
      mutations in codon 12 of the K-ras oncogene. Mutations were detected using primer
      mediated, mutant-enriched, polymerase chain reaction-restriction fragment length
      polymorphism analysis and characterized further by allele-specific
      oligonucleotide hybridization. This combination of mutant-enriched polymerase
      chain reaction-restriction fragment length polymorphism analysis and allele
      specific oligonucleotide hybridization results in a rapid and sensitive
      characterization of the mutations in codon 12 of K-ras. Sixty-eight (83%) of the
      82 carcinomas examined harbored a point mutation. Of the 68 mutations, 33 (49%)
      were guanine to adenine transitions, 27 (39%) were guanine to thymine
      transversions, and eight (12%) were guanine to cytosine transversions. Mutations
      were found in carcinomas of the head (61 of 75, 81%) as well as in carcinomas of
      the body or tail (seven of seven, 100%) of the pancreas. The overall prevalence
      of K-ras point mutations in adenocarcinomas of the pancreas obtained from
      patients who smoked cigarettes at some point during their lives (88%; 86% in
      current smokers and 89% in ex-smokers) was greater than that seen in pancreatic
      adenocarcinomas from patients who never smoked cigarettes (68%, P = 0.046). The
      presence of K-ras point mutations did not correlate with tumor ploidy, tumor
      proliferating index, or patient survival. These results demonstrate that primer
      mediated, mutant-enriched polymerase chain reaction-restriction fragment length
      polymorphism analysis combined with allele-specific oligonucleotide hybridization
      can be used to detect and characterize mutations in codon 12 of the K-ras
      oncogene in formalin-fixed, paraffin-embedded tissues, and the results confirm
      that activating point mutations in codon 12 of the K-ras oncogene occur
      frequently in adenocarcinomas of the pancreas.

PMID- 8342603
TI  - Biochemical and anatomical redistribution of tau protein in Alzheimer's disease.
AB  - We have developed assays that distinguish tau protein incorporated into the core
      structure of the paired helical filament (PHF) from non-PHF tau protein in brain
      tissue, whether soluble or insoluble. The PHF content was 19-fold greater in
      Alzheimer's disease cases compared with cognitively intact controls, and in
      temporal cortex the difference was 40-fold. There was a threefold decrease in
      soluble tau protein in Alzheimer's disease cases compared with normal age-matched
      controls, the decrease being greatest in frontal cortex. The PHF content was
      closely correlated with the number of tau-immunoreactive dystrophic neurites in
      plaques and throughout the neuropil, whereas counts of neurofibrillary tangles
      were poorer predictors of PHF content. beta-Amyloid deposits correlated neither
      with PHF content nor with neurofibrillary pathology. These findings suggest that
      Alzheimer's disease is characterized by a substantial redistribution of available
      tau protein from free to PHF-incorporated fractions and that PHF accumulation may
      be important in neurites as well as tangles in predicting the extent of cognitive
      impairment in Alzheimer's disease.

PMID- 8342604
TI  - Development of functional diversity in mouse macrophages. Mutual exclusion of two
      phenotypic states.
AB  - The objective of this study was to investigate the mechanisms that contribute to
      the generation of macrophage functional diversity. Exposure of mouse bone marrow
      derived macrophages to beta-1,3-glucan, a particulate inflammatory stimulus, or
      polyinosinate-polycytidylate (poly[I:C]), a stimulus of macrophage cytocidal
      activation, induced distinct and stimulus-specific patterns of gene expression.
      These changes were characterized by an up-regulation of the expression of the
      acid hydrolase beta-glucuronidase and platelet-derived growth factor B following
      incubation with beta-1,3-glucan and a stimulation of the expression of the
      complement component Bf, beta-interferon, and the reactive nitrogen intermediates
      NO2/NO3 during incubation with poly[I:C]. The induction of Bf expression by
      poly[I:C] could not be explained on the basis of distinct subpopulations of cells
      since in situ hybridization with a mouse Bf cRNA probe revealed a uniform and
      substantial increase in Bf expression by the entire population of cells.
      Incubation of macrophages with beta-1,3-glucan before stimulation with poly[I:C]
      was found to strongly attenuate the expression of Bf and beta-interferon.
      Conversely, incubation with poly[I:C] prior to exposure to beta-1,3-glucan
      substantially blocked the stimulation of beta-glucuronidase and platelet-derived
      growth factor B expression, indicating that these two responses were expressed in
      a mutually antagonistic fashion. However, after removal of either stimulus and
      following a period in which the primary response was allowed to decay, the cells
      regained their capacity to subsequently respond to either the same stimulus or to
      a different stimulus. Collectively, these findings indicate, first, that the
      heterogeneity of gene expression seen in response to poly[I:C] represents an
      adaptive response of the entire macrophage population rather than the restricted
      responses of distinct subpopulations of cells. Second, macrophages respond to
      these stimuli in a sequential fashion. These findings thus have a significant
      bearing on our understanding of the regulation of macrophage heterogeneity in
      host defense.

PMID- 8342605
TI  - Detection of two forms of GP330. Their role in Heymann nephritis.
AB  - Heymann nephritis is characterized by glomerular immune deposits that contain a
      glycoprotein called gp330. The deposits are believed to result from shedding of
      immune complexes formed on podocytes. Complexes are also shed from proximal
      tubule cells, when antibodies combine with gp330 on the cell surface. We
      performed the present study to investigate what portion of the gp330 molecule is
      shed, using a rabbit antiserum against a peptide deduced to be in the cytoplasmic
      domain of gp330, as well as a rabbit antiserum and two monoclonal antibodies that
      recognize extracellular epitopes of gp330. The anti-cytoplasmic peptide antiserum
      precipitated from Fx1A (a crude renal cortical membrane preparation), a protein
      with a mass of about 440 kd that was reactive with two monoclonal anti-gp330
      antibodies. (In our experiments, the protein called gp330 generally has a mass
      estimated to be about 440 kd.) The anti-cytoplasmic peptide antiserum also
      reacted with a truncated gp330 protein produced in transfected COS cells.
      Immunohistochemical studies showed that all the antibodies recognized the same
      group of epithelial cells. However, as seen in immunoultrastructural studies of
      proximal tubules, the anti-cytoplasmic peptide antiserum reacted only with
      components at the base of microvilli, whereas the anti-gp330 ectodomain
      antibodies identified material not only at the base, but over the surface of
      microvilli as well. In rats with Heymann nephritis, glomerular deposits and
      material shed into tubule lumens reacted with antibodies against extracellular
      epitopes of gp330, but not with the anti-cytoplasmic peptide antiserum. We
      propose that there are two forms of gp330 on the cell surface of proximal renal
      tubules. One form is restricted to coated pit regions at the base of microvilli
      and has a cytoplasmic domain containing a sequence deduced from a partial
      complementary DNA encoding gp330. The other form is present over microvilli (and
      possibly at the base of microvilli as well) and lacks the cytoplasmic domain
      deduced from the complementary DNA. The complexes that are shed in Heymann
      nephritis contain either a portion of gp330 cleaved from the full-length molecule
      or a form of gp330 that lacks the cytoplasmic domain.

PMID- 8342607
TI  - Immotile cilia syndrome in pigs. A model for human disease.
AB  - This paper describes the ultrastructural alterations observed in the tracheal
      epithelium of six sibling swine suffering from porcine immotile cilia syndrome
      (PICS) compared with those in human immotile cilia syndrome (HICS). As in some
      human cases, the tracheal epithelium of these pigs was lined by cilia-lacking
      cells. A variety of dynein defects in other pigs suffering from PICS have been
      previously observed. The spectrum of defects affords evidence that the PICS is
      genetically heterogeneous. Available data suggests that there are many
      similarities between HICS and PICS. Therefore, it is proposed that PICS may prove
      to be a useful animal model for the human disease.

PMID- 8342608
TI  - Source of kidney determines blood pressure in young renal transplanted rats.
AB  - Recipients of a renal graft from adult stroke-prone spontaneously hypertensive
      rat (SHRSP) but not normotensive Wistar-Kyoto rat (WKY) donors have been shown to
      develop posttransplantation hypertension. To investigate whether hypertension
      would also travel with the kidneys from young prehypertensive SHRSP and whether
      the age-related increase in blood pressure in F1 hybrids (F1H) bred from SHRSP
      and WKY parents was attenuated by early bilateral nephrectomy and transplantation
      of a WKY kidney, we transplanted kidneys from 14 male SHRSP and 16 WKY donors
      aged 35-42 days to young male F1H. Recipients had both native kidneys removed.
      Fifteen unilaterally nephrectomized nontransplanted F1H served as controls. At
      the time when kidneys were harvested for transplantation, systolic blood
      pressures in young SHRSP and WKY donors were not significantly different (114 +/-
      5 vs. 113 +/- 3 mmHg). After transplantation, recipients of an SHRSP kidney
      rapidly developed posttransplantation hypertension with systolic blood pressures
      above 180 mmHg at 3 mo after transplantation. In contrast, systolic blood
      pressure in recipients of a WKY kidney rose only slightly with increasing age and
      remained significantly lower than in non-transplanted controls. Transplanted rats
      exhibited normal weight gain, and renal function (glomerular filtration rate,
      renal blood flow) in grafted kidneys was well preserved; plasma renin activity
      was reduced compared with nontransplanted controls. These data demonstrate that
      1) hypertension can be transmitted to normotensive recipients by transplantation
      of a kidney from young prehypertensive SHRSP donors and 2) the age-related
      increase in arterial pressure in F1H is attenuated by early bilateral nephrectomy
      and transplantation of a WKY kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342606
TI  - Rabbit models of arthritis: immunolocalization of matrix metalloproteinases and
      tissue inhibitor of metalloproteinase in synovium and cartilage.
AB  - The distribution of the matrix metalloproteinases, collagenase, stromelysin,
      gelatinases A and B, and the tissue inhibitor of metalloproteinases in cartilage
      and synovium removed from rabbits up to 27 days after induction of two models of
      arthritis was investigated by immunolocalization. Following intra-articular
      injection of poly-D-lysine/hyaluronic acid coacervate, collagenase and
      stromelysin were found bound to cartilage matrix, but there was little increase
      in chondrocyte synthesis of these enzymes. The synovium underwent a complex wound
      healing response involving invagination and encapsulation of the coacervate and
      inflammatory cell debris, during which all four metalloproteinases and tissue
      inhibitor of metalloproteinase could be immunolocalized. The second model, intra
      articular injection of ovalbumin into sensitized rabbits, caused considerable
      chondrocyte necrosis; collagenase was found bound to cartilage matrix on day 13,
      although again there was little evidence of synthesis by chondrocytes.
      Inflammatory cell infiltration of meniscoid synovia took place initially,
      followed by fibrosis involving macrophagelike cells secreting gelatinase A. In
      both models there was rapid loss of glycosaminoglycan metachromasia from the
      cartilage matrix. These results are discussed in relation to current knowledge of
      metalloproteinase involvement in the chronic rheumatoid synovial pannus erosion
      of cartilage in humans. The data suggest that there are considerable differences
      between rheumatoid arthritis and these models, and their use must therefore be
      carefully defined.

PMID- 8342609
TI  - Regulation of renal glomerular and papillary ANP receptors in rats with
      experimental heart failure.
AB  - Rats with aortocaval (A-V) fistula, an experimental model of congestive heart
      failure (CHF), display high circulating atrial natriuretic peptide (ANP) levels
      and a markedly blunted natriuretic response to ANP infusion. The present study
      was designed to evaluate whether alterations in renal ANP receptors may
      contribute to renal hyporesponsiveness to ANP in experimental CHF. Densities
      (Bmax) and dissociation constants (Kd) of both the biologically active (ANPA) and
      clearance receptors (ANPC) were evaluated in glomerular and papillary membranes
      from A-V fistula rats (n = 18) and sham-operated controls (n = 20). ANPA and ANPC
      receptor subtypes were assayed by displacement of 125I-ANP-(99-126) bound to
      glomerular or papillary membranes by increasing concentrations of unlabeled ANP
      (99-126) or des-(18-22)-ANP-(4-23), an analogue which binds only to ANPC. Seven
      days after the operation, rats with A-V fistula displayed avid sodium retention,
      elevated plasma renin activity, and approximately a 10-fold increase in plasma
      ANP levels. Bmax of total ANP binding sites was significantly decreased in rats
      with A-V fistula compared with controls (220 +/- 61 vs. 399 +/- 88 fmol/mg
      protein, P < 0.05). The decrease was mainly due to a reduction in ANPA receptor
      density (51 +/- 10 vs. 110 +/- 15 fmol/mg protein, P < 0.05) with no change in
      receptor affinity. Likewise, a significant reduction in the density of ANPA (23
      +/- 5 vs. 64 +/- 10 fmol/mg protein, P < 0.05) with no change in receptor
      affinity was observed in papillary membranes of rats with A-V fistula.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8342610
TI  - Sodium azide protects against ischemia-induced acute renal failure in rats.
AB  - Sodium azide (AZ) is a nitrovasodilator with diverse biochemical properties. We
      found that low doses of AZ led to a profound protective effect against
      postischemic, acute renal failure (ARF) in rats. AZ, given at 250 micrograms/kg
      iv, before 25 min of renal artery occlusion (RAO) and again before reperfusion,
      conferred almost complete protection against loss of kidney function determined
      18 h after RAO. The effect of AZ was evidenced by a higher creatinine clearance
      (+348%) and lower levels of blood urea nitrogen (-69%) and histological renal
      damage (-50%) compared with ischemic control animals. Indexes of kidney function
      in AZ-treated animals subjected to RAO were not significantly different from
      those of nonischemic control animals. Two other nitrovasodilators, sodium
      nitroprusside and hydralazine, at doses which produced decreases in blood
      pressure similar to that of AZ, were ineffective at preventing ARF. The
      beneficial effect of AZ may be due to its known ability to inhibit one or more
      enzymes including adenosinetriphosphatase, cytochrome-c oxidase, and
      myeloperoxidase.

PMID- 8342611
TI  - Polarity of taurine transport in cultured renal epithelial cell lines: LLC-PK1
      and MDCK.
AB  - We characterized taurine transport in two continuous renal epithelial cell lines:
      LLC-PK1, derived from the proximal tubule of the pig, and the Madin-Darby canine
      kidney (MDCK), which was originated from the distal tubule of the dog. In the LLC
      PK1 cell line, taurine transport is greatest at the apical surface of the cell,
      whereas in the MDCK cell line taurine transport is greatest at the basolateral
      surface. Both apical and basolateral surfaces of LLC-PK1 and MDCK cells exhibit
      an adaptive response to the extracellular taurine concentration (medium taurine
      concentration). Only the basolateral surface of the MDCK cell responded to
      hyperosmolality with increased taurine accumulation. This indicates differential
      control of the beta-amino acid transport system by substrate and external
      tonicity. The function of the beta-amino acid transport system may be different
      depending on the cell. In the LLC-PK1 cell, there is net transepithelial movement
      of taurine and changes in transporter activity in response to supply of
      substrate. In contrast, taurine accumulation by the MDCK cell appears to be a
      mechanism for adaptation to osmotic stress.

PMID- 8342612
TI  - Developmentally regulated kallikrein enzymatic activity and gene transcription
      rate in maturing rat kidneys.
AB  - Kinins are paracrine vasoactive and growth-modulating peptides. Kidney maturation
      is accompanied by enhanced accumulation of the mRNA encoding tissue (renal)
      kallikrein, a serine protease, and a key component of the kallikrein-kinin
      system. To further delineate the developmental regulation of renal kallikrein, we
      measured tissue kallikrein activity and gene transcription rate during the latter
      stages of metanephrogenesis. Active tissue kallikrein was measured in renal
      homogenates by the amidolytic assay using the fluorogenic substrate D-Val-Leu-Arg
      7-amino-4-methylcoumarin (D-VLR-AMC) in the presence or absence of soybean
      trypsin inhibitor (SBTI). Kallikrein activity was detectable at very low levels
      in the near-term fetal metanephros. Postnatally, renal kallikrein activity peaked
      immediately after birth and again at the time of weaning (P < 0.05 vs. other age
      groups) and remained high in the adult. Mature female rat kidneys contained 30%
      more active kallikrein than male kidneys (P < 0.05). The SBTI-sensitive D-VLR-AMC
      hydrolytic activity (due to serine proteases other than tissue kallikrein)
      accounted for 36-53% of the total renal amidolytic activity. Compared with the 5
      day-old newborn, steady-state renal kallikrein mRNA levels increased threefold by
      day 12 and sixfold by adulthood. Run-on transcription analysis of renal cell
      nuclei revealed a significant increase in kallikrein gene transcription rate of
      80% on day 12 (P < 0.05) and 480% in the adult (P < 0.001). The presence of
      active kallikrein in the developing kidney and the upregulation of its synthesis
      at specific time points during postnatal development implicate intrarenal kinins
      as potential modulators of renal growth and functional maturation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8342613
TI  - V2-like vasopressin receptor mobilizes intracellular Ca2+ in rat medullary
      collecting tubules.
AB  - Cytosolic free calcium concentration ([Ca2+]i) was measured in single
      microdissected rat medullary collecting tubules [outer (OMCD) and inner (IMCD)]
      to identify receptors involved in vasopressin (AVP)-induced [Ca2+]i increases. In
      both segments, [Phe2,Orn8]vasotocin ([Phe2,Orn8]VT), a specific V1 agonist, as
      well as the V2 agonist 1-desamino-8-D-AVP (dDAVP) triggered [Ca2+]i variations.
      In OMCD, the mean response to 10 nM AVP roughly corresponded to the sum of V1 and
      V2 agonists effects. In IMCD, dDAVP (10 nM) alone reproduced the calcium response
      to AVP (delta[Ca2+]i = 243 +/- 34 nM, n = 6, and 248 +/- 27 nM, n = 8, with dDAVP
      and AVP, respectively). Furthermore, in the same experiments V1 and V2 maximal
      effects were not additive ([Phe2,Orn8]VT = 154 +/- 21 nM, n = 6; dDAVP +
      [Phe2,Orn8]VT = 233 +/- 23 nM, n = 9). As AVP, dDAVP released intracellular
      calcium (delta[Ca2+]i in calcium-free medium = 182 +/- 24 nM, n = 8, vs. 182 +/-
      14 nM, n = 6 with 10 nM dDAVP and AVP, respectively). Neither 8-(4-chlorophenyl
      thio)-adenosine 3',5'-cyclic monophosphate nor forskolin modified [Ca2+]i. A
      cross-reaction of dDAVP with an oxytocin (OT) receptor can be excluded since 1)
      the specific OT agonist [Thr4,Gly7]OT (10 nM) increased only slightly [Ca2+]i
      (delta-[Ca2+]i = 20 +/- 5 nM, n = 11); 2) the dDAVP response was not altered by
      the specific OT antagonist [1-(beta-mercapto-beta,beta-cyclopentamethylene
      propionic acid),2-(O-methyl)tyrosine,4-threonine, 8-ornithine,9
      tyrosylamide]vasotocin [d(CH2)5(1),O-Me-Tyr2,Thr4,Tyr-NH2(9)]OVT; 3) it was
      insensitive to V1 antagonists but was totally blocked by the V1/V2 antagonist
      [d(CH2)5(1),O-Et-Tyr2,Val4]AVP ([delta[Ca2+]i = 18 +/- 4 nM, n = 6). These
      results indicate that in IMCD AVP increases [Ca2+]i via both V1 and V2 receptors.
      [Ca2+]i variations due to V2 receptors involve a mechanism independent of
      adenylate cyclase and coupled to the same intracellular calcium pool as V1 and V2
      receptors.

PMID- 8342614
TI  - Role of muscarinic receptors in renal response to acetylcholine.
AB  - Renal arterial infusion of acetylcholine (ACh) (40 micrograms/min) in control
      dogs produced an ipsilateral increase in renal plasma flow (RPF) and in sodium
      excretion (UNaV) without a change in glomerular filtration rate (GFR). The
      increase in RPF and UNaV was maintained during the infusion of ACh. In
      indomethacin (Indo)-treated dogs (5 mg/kg) ACh produced a transient rise in RPF
      and UNaV, followed by a progressive decline in RPF and UNaV. The profound renal
      vasoconstriction was accompanied by a decline in GFR. To determine the role of
      the muscarinic receptor in the renal vasodilation and in vasoconstriction
      produced by ACh in Indo-treated dogs, atropine at 6, 60, and 600 micrograms/min
      was infused into the renal artery before and during the infusion of ACh. In Indo
      treated dogs, all dosages of atropine prevented renal vasoconstriction by ACh.
      Renal arterial infusion of atropine at 600 micrograms/min completely inhibited
      the renal vasodilation produced by ACh. Atropine infused at 60 micrograms/min
      partially inhibited, whereas 6 micrograms/min atropine failed to inhibit, the
      renal vasodilation produced by ACh. Our data suggest that the renal vasodilator
      and vasoconstrictor effects of ACh in Indo-treated dogs are mediated by two
      separate types of muscarinic receptors.

PMID- 8342615
TI  - Hepatocyte growth factor may function as a renotropic factor for regeneration in
      rats with acute renal injury.
AB  - Hepatocyte growth factor (HGF), a potent mitogen for mature hepatocytes,
      possesses mitogenic and morphogenic activities for renal epithelial cells. To
      examine the renotropic function of HGF, we investigated the expression of HGF
      mRNA and HGF activity in the rat kidney after acute renal failure. When acute
      renal failure was induced by ischemia or by HgCl2 administration, a DNA synthesis
      occurred predominantly in the renal tubular cells located in the outer medulla
      with a peak at 48 h after the treatments. In both renal injuries, HGF mRNA in the
      kidney increased markedly, reaching a maximum 6 to 12 h after the treatments. HGF
      activity in the kidney also increased to three- to fourfold higher level than the
      normal level at 12 h after ischemic treatment or HgCl2 administration. In situ
      hybridization and immunohistochemical analysis indicated that both HGF mRNA and
      HGF protein were expressed in renal interstitial cells, presumably endothelial
      cells and macrophages, but not in tubular epithelial cells. In addition, HGF
      activity in the plasma of rats with renal ischemia or HgCl2 administration
      rapidly increased, reaching a maximum at 6 h after the treatment. One week after
      these injuries, HGF mRNA and HGF activity reverted to normal levels, and renal
      tubular cell regeneration ceased. Moreover, intravenous injection of human
      recombinant HGF into mice with acute renal failure caused by HgCl2 administration
      stimulated DNA synthesis of renal tubular cells in vivo.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8342616
TI  - Extrahepatic lipogenesis contributes to hyperlipidemia in the analbuminemic rat.
AB  - Hepatic lipid and apolipoprotein synthesis is increased in the nephrotic
      syndrome. Catabolism of triglyceride-rich lipoproteins is impaired in nephrotic
      syndrome but not in rats with hereditary analbuminemia (NA), suggesting that
      lipid synthesis should be increased by analbuminemia in the absence of
      proteinuria. In this study the rate of cholesterol and fatty acid synthesis in
      liver and extrahepatic tissue was measured in female NA and control Sprague
      Dawley (SD) rats to determine whether lipid synthesis was indeed increased in
      isolated analbuminemia and to identify the site(s) of increased lipogenesis. We
      also measured the concentrations of apolipoproteins (apo) AI, B, and E in plasma,
      as well as the levels of the respective mRNAs in liver. Plasma cholesterol,
      triglycerides, and apo AI, B, and E were all increased severalfold in the NA rat
      (P < 0.001). Although liver apolipoprotein mRNA content was significantly
      increased (P < 0.001) for apo AI (643%), B (273%), and E (299%), 3-hydroxy-3
      methylglutaryl-coenzyme A reductase activity in liver microsomes and hepatic
      cholesterol synthesis were not significantly increased in the NA rats. Hepatic
      fatty acid synthesis and intestinal cholesterol synthesis were not increased in
      the NA rats. Surprisingly, intestinal fatty acid synthesis was elevated by 60% (P
      < 0.01). The NA rats demonstrated approximately fourfold increases in the
      incorporation of 3H2O into circulating cholesterol and fatty acids (P < 0.001). A
      56% increase in the synthesis of total nonsaponifiable lipid was found in the
      extravisceral carcass (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342617
TI  - Ion concentration changes in renal cells during regulatory volume decrease.
AB  - Electron-probe microanalysis was employed to follow ion concentration changes
      during regulatory volume decrease. The measurements were performed on isolated
      tubule bundles, which were dissected from medullary rays of New Zealand White
      rabbit kidneys. Cell swelling and subsequent regulatory volume decrease were
      induced by incubating the bundles in 190 mosM medium; control bundles were
      incubated in 290 mosM medium. Under both conditions, the detectable ions
      accounted for approximately 80% of the intracellular osmolarity. All cells lost
      significant amounts of Na, K, and Cl during cell volume regulation. While in the
      proximal straight tubule more than one-half of the ions lost were Na and Cl, in
      principal and intercalated cells of the cortical collecting duct and in the thick
      ascending limb the losses of Na and Cl played only a minor role. The efflux of Na
      and K greatly exceeded the Cl efflux, suggesting the loss of an additional
      undetectable anion (bicarbonate). Separate measurements in the nucleus,
      cytoplasm, and several cellular organelles revealed some inhomogeneity of the
      subcellular ion distribution.

PMID- 8342618
TI  - Osmotically sensitive renin release from permeabilized juxtaglomerular cells.
AB  - Renin secretion from juxtaglomerular (JG) cells is sensitive to external
      osmolality in a way that has been suggested to depend either on cellular volume
      or on effects on secretory granules. To distinguish between these possibilities,
      a technique for permeabilization of JG cell membranes was developed. Rat
      glomeruli with attached JG cells were isolated and permeabilized by 20 microM
      digitonin for 12 min and followed by continuous exposure to 2 microM digitonin.
      Experiments on proximal tubules showed that cellular volume was unaffected by
      changes in external sucrose concentration after a similar permeabilization
      procedure. With permeabilized JG cells the following changes in osmolality were
      tested (in mM sucrose): +90 (n = 6), +60 (n = 5), +30 (n = 6), +15 (n = 6), -15
      (n = 5), -30 (n = 6), -60 (n = 6), and -90 (n = 6). With nonpermeabilized cells
      similar experiments were done with changes of +90 (n = 7), +30 (n = 4), -30 (n =
      4), and -90 (n = 6) mM sucrose. Increases in osmolality caused inhibition of
      renin release, whereas decreases stimulated secretion. Within +/- 10% variations
      in osmolality there were no differences between the responses in permeabilized
      and intact cells, whereas the responses with larger changes were less in the
      permeabilized cells. Increase or decrease in urea concentration by 30 mM did not
      affect renin release. Thus water fluxes can influence renin release by a
      mechanism that is independent of cell volume.

PMID- 8342619
TI  - Effects of rC5a on the circulation of normal and split hydronephrotic rat
      kidneys.
AB  - Systemic release of complement-derived anaphylatoxin C5a is suggested to be
      involved in the pathogenesis of renal failure during endotoxic or severe
      traumatic shock. In the present study we analyzed renal hemodynamic effects of
      recombinant human complement 5a (rC5a) and examined whether these effects are
      mediated by the secondary release of other inflammatory mediators. Intravenous
      infusion of rC5a (0.5 micrograms/min) in thiobarbital-anesthetized rats decreased
      renal blood flow (RBF) by 20 and 34% after 20 and 60 min, respectively.
      Glomerular filtration rate (GFR) was reduced by 45%, whereas filtration fraction
      and blood pressure were not significantly changed by rC5a. Hematocrit (Hct)
      increased by 11%, whereas white blood cell count decreased by 40%. Renal rC5a
      effects were completely inhibited by the competitive leukotriene D4/E4 antagonist
      ICI-198615, whereas the competitive thromboxane A2 (TxA2) antagonist daltroban
      only partly reversed rC5a effects on RBF and GFR. The competitive platelet
      activating factor (PAF) antagonist L-695989 did not influence renal or systemic
      rC5a effects. These results point to an rC5a-mediated synthesis and release of
      cysteinyl leukotrienes and TxA2, whereas PAF does not seem to be released after
      intravenous rC5a in rats. To determine the cellular source of cysteinyl
      leukotriene synthesis, rats were depleted of polymorphonuclear cells (PMN) by
      intraperitoneal injection of anti-rat PMN antibodies, which abrogated renal and
      systemic hemodynamic rC5a effects, suggesting that PMN participate in the
      synthesis and release of cysteinyl leukotrienes. The exact localization of
      renovascular rC5a effects was performed on the model of the split hydronephrotic
      rat kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342620
TI  - Neural mechanism underlying basilar arterial constriction by intracisternal L-NNA
      in anesthetized dogs.
AB  - Basilar arterial diameters were angiographically measured in anesthetized dogs in
      which systemic blood pressure and heart rate were also monitored. Injections of
      NG-nitro-L-arginine (L-NNA), a NO synthase inhibitor, into the cisterna magna
      produced a significant, persistent decrease in arterial diameter, the effect
      being reversed by intracisternal injections of L-arginine. The vasoconstrictor
      effect of L-NNA was diminished in dogs treated with hexamethonium. On the other
      hand, treatment with phentolamine in a dose sufficient to lower blood pressure to
      a level similar to that attained with hexamethonium did not inhibit, but rather
      potentiated, the effect of intracisternal L-NNA. Nicotine injected into the
      vertebral artery significantly dilated the basilar artery. The effect was
      abolished by treatment with L-NNA applied intracisternally, the inhibition being
      reversed by the addition of L-arginine. Systemic blood pressure and heart rate
      were not altered by intracisternally applied L-NNA and L-arginine. These findings
      support the hypothesis that basilar arterial constriction caused by
      intracisternal L-NNA is associated with a suppression of NO synthesis in
      nitroxidergic nerves innervating the cerebroarterial wall rather than an
      elimination of basal release of NO from the endothelium. Functional importance of
      nitroxidergic vasodilator innervation in cerebral arteries in vivo is thus
      clarified.

PMID- 8342621
TI  - Endotoxin induces metabolic dysregulation of vascular tone.
AB  - The goals of this study were to determine 1) if endotoxin alters vascular
      responsiveness to metabolic stimuli and 2) if the decompensatory loss of skeletal
      muscle vascular tone that occurs during endotoxemia is induced by increased
      muscle metabolism. Vascularly isolated and denervated canine gracilis muscles
      were perfused in situ at a constant flow. In the first set of experiments,
      gracilis muscle O2 extraction (MVO2) and perfusion pressure were continuously
      measured during direct electrical stimulation of the muscle mass. Endotoxemia was
      induced by a 30-min intravenous infusion of Escherichia coli endotoxin (2 mg/kg),
      and the stimulations were repeated 60 min postendotoxemia. Compared with the
      nonendotoxic control, the endotoxemic muscle stimulation resulted in a decreased
      MVO2, and the vascular response (dilation) was potentiated. In the second set of
      experiments, the MVO2 of the experimental muscle (GMe) was lowered by cooling the
      temperature of the blood perfusing the muscle to 22-24 degrees C while
      maintaining the temperature of the contralateral control muscle (GMc) at 34-35
      degrees C. After the administration of endotoxin, arterial pressure fell and the
      GMc showed a progressive increase in MVO2 and loss of vascular tone
      (decompensation). Coincidently, the GMe showed no significant change in MVO2 and
      did not vasodilate. The major findings of this study are 1) endotoxin induces the
      vasculature to become more reactive to metabolic vasodilation, and 2) the
      decompensatory vasodilation typically observed during endotoxemia can be
      abolished if MVO2 (i.e., metabolism) is kept low by cooling the muscle. The data
      suggest that endotoxemia increases vascular sensitivity to vasodilatory
      metabolites, which allows local mechanisms to dominate extrinsic nonneural forces
      and control vascular tone, thus inducing vasodilation.

PMID- 8342622
TI  - Ca(2+)-dependent fluorescence transients and phosphate metabolism during low-flow
      ischemia in rat hearts.
AB  - To determine whether cytosolic free calcium ([Ca2+]i) rises during low-flow
      ischemia and to determine the mechanisms responsible for contractile dysfunction,
      isolated rat hearts were studied during graded reductions of coronary flow. Indo1
      fluorescence at 385- and 456-nm wave-lengths (F385/456) was used as an index of
      [Ca2+]i. 31P-magnetic resonance spectroscopy (MRS) was used to measure free
      energy of ATP hydrolysis (delta GATP), intracellular pH (pHi), and Pi in parallel
      experiments to determine whether these factors may be responsible for increasing
      diastolic [Ca2+]i or altering the [Ca2+]i-pressure relationship. When coronary
      flow was reduced to 20 and 10% of control, diastolic F385/456 increased by 14 +/-
      3 and 39 +/- 5%, respectively. Although developed pressure markedly decreased
      when coronary flow was reduced, there was no change of the F385/456 transient
      amplitude (systolic minus diastolic). During low-flow ischemia there was a
      significant decrease of delta GATP and increase of Pi that may lead to increased
      [Ca2+]i. Furthermore, there was a close inverse relationship between Pi and
      developed pressure, suggesting that Pi is an important regulator of
      contractility.

PMID- 8342623
TI  - Regulation of diaphragmatic oxygen uptake by endothelium-derived relaxing factor.
AB  - The role of endogenous nitric oxide (NO) in the regulation of phrenic blood flow
      (Qphr) and O2 consumption (VO2) of the in situ isolated left hemidiaphragms was
      assessed in two groups of anesthetized, mechanically ventilated dogs. Saline was
      infused into the phrenic artery for 20 min in one group, whereas N omega-nitro-L
      arginine (L-NNA, 6 x 10(-4) M) was infused in the other (L-NNA) group. Qphr and
      diaphragmatic VO2 were measured at rest and during 2 min of continuous 3-Hz
      stimulation of the left phrenic nerve. The animals were progressively
      hemorrhaged, and the measurements were repeated at various arterial pressures
      (Pa). For the resting diaphragm, Qphr at a mean Pa of 145 mmHg was lower in the L
      NNA group than in the saline group; however, diaphragmatic VO2 values were
      similar in both groups. Qphr decreased with the decline in Pa in both groups, but
      O2 extraction ratios obtained at mean Pa of 25-45 mmHg were similar in both
      groups (71 vs. 73%). For the contracting diaphragm, Qphr and diaphragmatic VO2
      values at a given Pa were lower in the L-NNA group than in the saline group
      (except at mean Pa < 75 mmHg). O2 extraction ratios obtained at a given Pa were
      similar in both groups. We concluded that 1) EDRF inhibition limits diaphragmatic
      blood flow both at rest and during 3-Hz stimulation; 2) diaphragmatic O2
      extraction is unaffected by EDRF inhibition; and 3) the effect of EDRF release on
      diaphragmatic VO2 is dependent on the level of metabolic demands.

PMID- 8342624
TI  - Adenosine stimulates proliferation of human endothelial cells in culture.
AB  - The effect of adenosine on proliferation of human endothelial cells was
      investigated by adding adenosine to the medium of cultures derived from human
      umbilical veins. Cell counts on cultures grown in 10 microM adenosine for 4-7
      days were 41-53% greater than counts from control cultures. In contrast, 10
      microM adenosine had no effect on growth of a human fibroblast cell strain (IMR
      90). Neither inosine nor 2',5'-dideoxyadenosine influenced endothelial cell
      growth at concentrations of 0.1 or 10 microM. Addition of adenosine deaminase
      abolished the proliferative effect of added adenosine and inhibited proliferation
      by 16% in control cultures, suggesting that endogenous adenosine may enhance
      proliferation in culture. The adenosine receptor antagonist, 8
      phenyltheophylline, at 0.1 and 1.0 microM blocked the enhanced proliferation
      caused by 10 microM adenosine. Addition of 10 microM adenosine enhanced DNA
      synthesis in endothelial cell cultures as indicated by an increased incorporation
      of [3H]thymidine into acid-insoluble cell material. The results indicate that
      addition of physiological concentrations of adenosine to human umbilical vein
      endothelial cell cultures stimulates proliferation, possibly via a surface
      receptor, and suggest that adenosine may be a factor for human endothelial cell
      growth and possibly angiogenesis.

PMID- 8342625
TI  - Ontogeny of Big endothelin-1 effects in newborn piglet pulmonary vasculature.
AB  - Endothelin-1 (ET-1), a 21-amino acid peptide produced by endothelial cells,
      results from the cleavage of preproendothelin, generating Big ET-1, which is then
      cleaved by the ET-converting enzyme (ECE) to form ET-1. Big ET-1, like ET-1, is
      released by endothelial cells. Big ET-1 is equipotent to ET-1 in vivo, whereas
      its vasoactive effects are less in vitro. It has been suggested that the effects
      of Big ET-1 depend on its conversion to ET-1. ET-1 has potent vasoactive effects
      in the newborn pig pulmonary circulation, however, the effects of Big ET-1 remain
      unknown. Therefore, we studied the effects of Big ET-1 in isolated perfused lungs
      from 1- and 7-day-old piglets using the ECE inhibitor, phosphoramidon, and the
      ETA receptor antagonist, BQ-123Na. The rate of conversion of Big ET-1 to ET-1 was
      measured using radioimmunoassay. ET-1 (10(-13) to 10(-8) M) produced an initial
      vasodilation, followed by a dose-dependent potent vasoconstriction (P < 0.001),
      which was equal at both ages. Big ET-1 (10(-11) to 10(-8) M) also produced a dose
      dependent vasoconstriction (P < 0.001). The constrictor effects of Big ET-1 and
      ET-1 were similar in the 1-day-old, whereas in the 7-day-old, the constrictor
      effect of Big ET-1 was less than that of ET-1 (P < 0.017).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8342626
TI  - Differences in EDNO contribution to arteriolar diameters at rest and during
      functional dilation in striated muscle.
AB  - This study was designed to determine the physiological role of endothelium
      dependent nitric oxide (EDNO) in the control of arteriolar diameter during rest
      and muscle stimulation. Diameters of first-, second-, and third-order arterioles
      in the superfused hamster cremaster muscle were measured before and throughout 1
      min of field stimulation before and after inhibition of EDNO release. ENDO
      inhibition by intravenous N omega-nitro-L-arginine methyl ester (L-NAME)
      significantly attenuated the arteriolar vasodilation in response to 1 microM
      acetylcholine. First-order arterioles averaged 65 +/- 5 microns at rest and
      dilated to 86 +/- 6 microns during muscle stimulation (n = 9), second-order
      arterioles averaged 45 +/- 6 microns and dilated to 72 +/- 3 microns during
      muscle stimulation (n = 6), with third-order arterioles averaging 29 +/- 2
      microns, and dilating to 53 +/- 3 microns during muscle stimulation (n = 7). EDNO
      inhibition significantly decreased both the resting diameter of first-order
      arterioles (57 +/- 4 microns) and functional dilation (68 +/- 3 microns; P <
      0.05). EDNO inhibition had no effect on the resting diameter of second-order
      arterioles (45 +/- 5 microns) yet significantly attenuated the functional
      dilation (64 +/- 4 microns; P < 0.05). EDNO inhibition had no effect on either
      the resting diameter of third-order arterioles (30 +/- 2 microns) or the
      functional dilation (49 +/- 2 microns).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342628
TI  - Responses of cerebral arterioles in diabetic rats to activation of ATP-sensitive
      potassium channels.
AB  - The goal of this study was to determine whether responses of pial arterioles to
      activation of ATP-sensitive potassium channels are altered during diabetes
      mellitus. We measured changes in diameter of pial arterioles in vivo in
      nondiabetic and diabetic rats (streptozotocin; 50-60 mg/kg ip; studied 3-4 mo
      after streptozotocin) in response to RP52891, an activator of ATP-sensitive
      potassium channels. RP52891 (1.0 microM) dilated pial arterioles in nondiabetic
      rats by 16 +/- 1% but constricted pial arterioles in diabetic rats by 2 +/- 2%
      (means +/- SE; P < 0.05 vs. response in nondiabetic rats). Dilatation of pial
      arterioles in nondiabetic rats in response to RP52891 was inhibited by
      glibenclamide (1.0 microM) but was not altered by NG-monomethyl-L-arginine (1.0
      microM), apamin (0.1 microM), or charybdotoxin (50 nM). Thus dilatation of pial
      arterioles in response to RP52891 appears to be due to activation of ATP
      sensitive potassium channels and does not involve nitric oxide or calcium
      activated potassium channels. To determine whether impaired dilatation of pial
      arterioles in response to RP52891 in diabetic rats was related to a nonspecific
      effect of diabetes mellitus on vasodilatation, we measured diameter of pial
      arterioles in nondiabetic and diabetic rats in response to nitroglycerin.
      Nitroglycerin (1.0 microM) dilated pial arterioles by 12 +/- 1% in nondiabetic
      rats and 16 +/- 2% in diabetic rats (P > 0.05). Thus impaired dilatation of pial
      arterioles in diabetic rats in response to RP52891 also is not related to a
      nonspecific effect of diabetes mellitus on vasodilatation.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8342627
TI  - Endothelium, vasopressin receptors, and resistance to DOCA-salt hypertension.
AB  - Mesenteric artery rings from Wistar and Wistar-Furth rats subcutaneously treated
      with deoxycorticosterone acetate (DOCA) and 1% NaCl drinking water were used to
      measure endothelial modulation of contractile sensitivity and vasopressin
      receptor function and affinity. DOCA-salt hypertension reduced contractile
      sensitivity to arginine vasopressin (AVP) and did not affect contractile
      sensitivity to norepinephrine in arteries from Wistar rats. Endothelial removal
      caused a threefold increase in contractile sensitivity to AVP and norepinephrine
      in DOCA-salt hypertensive Wistar rats. In Wistar-Furth rats, DOCA-salt treatment
      did not affect contractile sensitivity to AVP, lysine vasopressin, oxytocin, and
      norepinephrine or the affinity of the vasopressin receptor for agonists or
      antagonists. Removal of endothelium did not affect vasopressin contractile
      sensitivity but caused a 15-fold increase in contractile sensitivity to
      norepinephrine in untreated or DOCA-salt-treated Wistar-Furth rats. These data
      show that reduced vasopressin receptor function and increased endothelial
      function that compensate for increased contractile sensitivity in arteries from
      DOCA-salt hypertensive Wistar rats are not the cause of resistance of DOCA-salt
      treated Wistar-Furth rats to the development of enhanced contractile sensitivity
      and hypertension.

PMID- 8342629
TI  - 5-Hydroxytryptamine dominates over thromboxane A2 in reducing collateral blood
      flow by activated platelets.
AB  - Intra-aortic infusion of collagen (100 micrograms/kg in 1 min) elicited an
      extensive platelet activation and transient but marked reductions of blood flow
      and increases of peripheral vascular resistance, both responses being more
      pronounced in collaterals than in normal arterial beds in feline hind legs.
      Blockade of 5-hydroxytryptamine (5-HT) subtype 2 (5-HT2) receptors for 5-HT
      (ketanserin or ritanserin, 0.63 mg/kg iv, -10 min) or amine depletion (reserpine,
      0.1 mg/kg im, -10 days, + parachlorophenylalanine 100 mg/kg sc daily for 3 days),
      but not cyclooxygenase inhibition (indomethacin, 5 mg/kg iv) or thromboxane (Tx)
      A2/prostaglandin endoperoxide receptor antagonism (sulotroban, 2.5 mg/kg iv),
      largely prevented the collagen-induced perfusion defect without interfering
      substantially with the platelet activation process. TxA2 synthase inhibition,
      alone (dazoxiben, 5 mg/kg iv) or combined with TxA2-prostaglandin endoperoxide
      receptor antagonism (ridogrel, 2.5 mg/kg iv), partially reduced the collagen
      induced perfusion defect and limited to a similar extent the initial platelet
      aggregation and release of 5-hydroxyindoles and TxB2 while increasing plasma
      levels of prostacyclin. These results suggest that platelet-derived 5-HT
      dominates over TxA2 in reducing blood flow in collateral-dependent tissue of the
      cat hindlimb.

PMID- 8342630
TI  - Induction of heat shock response leads to apoptosis in endothelial cells
      previously exposed to endotoxin.
AB  - The homeostatic response of complex eukaryotes to the challenge of environmental
      stress includes the induction of several programs of gene expression; among them
      are those for the acute phase genes and those for the heat shock genes. In some
      systems, the heat shock response, which is often elicited by more severe stimuli,
      preempts the acute phase response, which is seen in response to less severe
      challenges, as well as constitutive gene expression. Nevertheless, each response
      appears to provide a natural selective advantage for survival of the organism in
      a toxic environment. However, when cultured porcine endothelial cells were
      exposed first to a nonlethal level of bacterial endotoxin lipopolysaccharide
      (LPS), an inducer of the acute phase response, and then, simultaneously to
      standard stimuli, which normally elicit a salutary heat shock response, the cells
      died manifesting a pattern of DNA fragmentation (nucleolysis) characteristic of
      programmed cell death (apoptosis). The treatment of LPS-exposed cells with
      cycloheximide to block protein synthesis reproduced the lethal apoptosis that had
      been elicited by the induction of heat shock gene expression. Therefore, the
      preemption of other programs of stress gene expression by the prioritized
      expression of heat shock genes is associated with apoptosis.

PMID- 8342631
TI  - Contribution of prostaglandins to exercise-induced vasodilation in humans.
AB  - It has been postulated that endothelial release of prostaglandins contributes to
      exercise-induced vasodilation of skeletal muscle arterioles. To test this
      hypothesis, 12 normal subjects underwent brachial arterial and venous catheter
      insertion and instrumentation of their forearm to measure plethysmographic
      forearm blood flow. Forearm blood flow and arterial and venous 6
      ketoprostaglandin F1 alpha (PGF1 alpha) and prostaglandin E2 (PGE2) were then
      measured during two levels of wrist flexion exercise (0.2 and 0.4 W). In nine of
      the subjects, exercise was repeated after intra-arterial infusion of indomethacin
      (0.3 mg/100 ml forearm vol). Exercise increased forearm blood flow (2.0 +/- 0.2
      to 12.1 +/- 1.1 ml.min-1.100 ml-1) and forearm release of PGF1 alpha (162 +/- 28
      to 766 +/- 193 pg.min-1.100 ml-1) and PGE2 (26 +/- 6 to 125 +/- 46 pg.min-1.100
      ml-1) (all P < 0.05). Indomethacin virtually abolished forearm prostaglandin
      release and reduced forearm blood flow at rest (2.2 +/- 0.2 to 1.7 +/- 0.2 ml.min
      1.100 ml-1), at 0.2 W (6.3 +/- 0.7 to 5.4 +/- 0.7 ml.min-1.100 ml-1), and at 0.4
      W (12.2 +/- 1.5 to 10.3 +/- 1.3 ml.min-1.100 ml-1) (all P < 0.02). These data
      suggest that release of vasodilatory prostaglandins contributes to exercise
      induced arteriolar vasodilation and hyperemia in skeletal muscle.

PMID- 8342632
TI  - Nitric oxide attenuates cardiac myocyte contraction.
AB  - Cardiac muscle fibers have microvessels in close proximity, the distance from the
      nearest capillary being no greater than 8 microns. We performed experiments on
      isolated, electrically stimulated, contracting guinea pig cardiac myocytes to
      test whether NO from endothelium or nitrovasodilators or directly superfused in
      solution might affect myocyte contractility. In endothelium-myocyte coculture
      experiments, 10(-7) M bradykinin reduced myocyte shortening by 11 +/- 3.5%. This
      effect was abolished in the presence of NG-nitro-L-arginine methyl ester and was
      unaffected by indomethacin. Sodium nitroprusside, but not organic
      nitrovasodilators, reduced myocyte contraction amplitude by 23% at 3 x 10(-5) M.
      This effect was reversed by methylene blue. Superfusion with NO solution had an
      effect similar to sodium nitroprusside, as did exposure to 8-bromoguanosine 3',5'
      cyclic monophosphate. Thus the present study shows that cardiac myocyte
      contraction is attenuated by NO, which appears to act via production of guanosine
      3',5'-cyclic monophosphate within the myocytes. Because cardiac myocytes in vivo
      are in such close proximity to endothelium, the effects of endothelial products
      on cardiac myocyte contractility may be important in myocardial function.

PMID- 8342633
TI  - Normal and hypertrophied senescent rat heart: mechanical and molecular
      characteristics.
AB  - The energetics of the senescent (S) rat heart and the mechanisms by which it
      adapts to pressure overload have been investigated by simultaneous cardiac
      mechanical, energetic, and molecular biological studies. Compared with young
      adult (YA), S papillary muscles had an improved economy of contraction since the
      curvature (G) of Hill's (Proc. R. Soc. Lond. B. Biol. Sci. 126:136-195, 1938)
      hyperbola was increased (S, 1.93 +/- 0.13; YA, 1.60 +/- 0.07, P < 0.05). In
      addition, the maximum unloaded shortening (Vmax) and relengthening velocities
      were both reduced in S. In parallel, both alpha-myosin heavy chain (MHC) and
      sarcoplasmic reticulum (SR) Ca(2+)-adenosinetriphosphatase (ATPase) mRNA contents
      were reduced (-30 and -28%, respectively), whereas beta-MHC mRNA was increased
      (+91%). The active tension (S, 40.0 +/- 2.6; YA, 50.1 +/- 2.5 mN/mm2, P < 0.01)
      was depressed although the active force remained unchanged (S, 52.0 +/- 4.0; YA,
      47.5 +/- 2.5 mN). Pressure overload in senescent deoxycorticosterone acetate
      (DOCA)-salt rats induced a left ventricular hypertrophy (+43%) and a further
      decrease in both Vmax (S, 2.81 +/- 0.10; DOCA-salt, 2.55 +/- 0.13 initial length
      corresponding to peak of length-active curve/s, P < 0.05) and alpha-MHC mRNA (
      30%) content. Senescence modifies mechanics and gene expression in a way similar
      to pressure overload. During senescence, an additional overload induces left
      ventricular hypertrophy and attenuates Vmax without worsening the economy of the
      contraction.

PMID- 8342634
TI  - Presynaptic effects of epinephrine on norepinephrine release from cardiac
      sympathetic nerves in dogs.
AB  - The possible functional role of tissue epinephrine in the modulation of
      norepinephrine release from cardiac sympathetic nerve endings in anesthetized dog
      was investigated. Observations were carried out under control conditions and
      after a short- (10 min) and long-term (180 min) epinephrine infusion (92 ng.kg
      1.min-1). An increase in the stimulation-induced release of norepinephrine after
      intravenous administration of a selective beta 2-agonist (fenoterol, 0.5
      micrograms/kg) indicated the presence of the beta 2-facilitatory mechanism.
      Furthermore, the facilitatory effect of fenoterol was inhibited by intravenous
      administration of a selective beta 2-antagonist (ICI 118551, 1 mg/kg). Short-term
      epinephrine infusion did not facilitate the stimulation-induced release of
      norepinephrine, when tissue epinephrine content in the left ventricle was
      increased 1.5-fold, without, as well as with, alpha 2-blockade (yohimbine, 0.3
      mg/kg). However, stimulation-induced release of norepinephrine from the
      myocardium was significantly potentiated in animals in which tissue epinephrine
      in the left ventricle was greatly increased (5.6-fold) by a prolonged infusion of
      epinephrine (180 min). It is concluded that a facilitatory mechanism mediated by
      presynaptic beta 2-adrenoceptors is present in cardiac sympathetic nerve endings
      of the dog. Some of our observations support the hypothesis that this mechanism
      may be influenced by locally released epinephrine and, thus, by tissue
      epinephrine content.

PMID- 8342635
TI  - Age-associated increase in rat cardiac opioid production.
AB  - Several lines of evidence suggest that opioid peptide production in the heart may
      increase during aging from adulthood through senescence. We tested the hypothesis
      that cardiac opioid peptides and preproenkephalin (PNK) mRNA would increase with
      advancing age. Ventricles and atria from male Wistar rats, aged 2, 6, 18, and 22
      24 mo of age, were acid extracted and assayed for methionine enkephalin (ME) and
      leucine enkephalin (LE). Total RNA was extracted from hearts of age-matched rats
      and probed for PNK mRNA by Northern blot analysis using a cDNA probe. ME and LE
      peptides were significantly elevated with advancing age in both ventricles [P <
      0.001; by analysis of variance (ANOVA)]. Ventricular ME concentration exhibited a
      biphasic increase with approximately twofold higher peaks at 6 and 22-24 mo of
      age compared with the 2 mo value of 1.04 +/- 0.05 (SE) pmol/g wet wt. In
      contrast, ventricular LE concentration was largely unchanged until 22-24 mo of
      age when it increased approximately threefold over the 2-mo value of 2.19 +/-
      0.14 pmol/g wet wt. Left ventricular PNK mRNA increased approximately fivefold
      between 2 and 18 mo of age (P < 0.01; ANOVA). Thus both enkephalins and the mRNA
      coding for them were increased in hearts of older vs. younger rats. Because
      opioid receptor stimulation can negatively modulate several characteristics of
      cardiac myocyte contraction, these results may have important functional
      implications for the senescent heart.

PMID- 8342636
TI  - Topical hyperglycemia rapidly suppresses EDRF-mediated vasodilation of normal rat
      arterioles.
AB  - Arteriolar dilation to endothelium-derived relaxing factor (EDRF) is suppressed
      early in diabetes mellitus. The purpose of this study was to determine whether
      acute exposure to a hyperglycemic media can suppress EDRF function of normal
      arterioles. Dilation of intestinal arterioles to iontophoretically applied
      acetylcholine (ACh) and nitroprusside was measured in normoglycemic rats before
      and after 1 h of topical exposure to isotonic solutions containing D-glucose
      concentrations of 200, 300, and 500 mg/100 ml. Exposure to a D-glucose
      concentration of 200 mg/100 ml had no effect on vasodilation to ACh. D-Glucose
      concentrations of both 300 and 500 mg/100 ml caused significant suppression of
      the responses: for example, at the approximate 50% effective dosage (100 nA), the
      dilatory response was decreased by 60% at a D-glucose concentration of 300 mg/100
      ml and 55% at a D-glucose concentration of 500 mg/100 ml. Responses to
      nitroprusside were not significantly (P < 0.05) impaired after exposure to D
      glucose concentrations of 200, 300, or 500 mg/100 ml. Exposure to an isotonic L
      glucose concentration of 500 mg/100 ml for 1 h had no significant (P > 0.05)
      effect on responses to ACh. Pretreatment with superoxide dismutase, catalase,
      indomethacin, or meclofenamic acid preserved EDRF-mediated vasodilation during
      exposure to a D-glucose concentration of 500 mg/100 ml at almost all the ACh
      dosages tested. These results indicate that oxygen radicals formed in part by
      increased eicosanoid synthesis during exposure to D-glucose hyperglycemia
      interfere with the EDRF mechanism before its action on the microvascular smooth
      muscle.

PMID- 8342638
TI  - Relationship of arterial compliance to baroreflex function in hypertensive
      patients.
AB  - The objectives of this study were to determine whether carotid arterial
      compliance is reduced in patients with hypertension and to assess whether reduced
      arterial compliance is related to abnormal arterial baroreflex function.
      Accordingly, concurrent measurements of carotid arterial diameter (via
      computerized high resolution B-mode ultrasonography) and blood pressure were made
      to determine carotid arterial compliance in 23 normotensive and 16 age-matched
      hypertensive patients. In addition, arterial baroreflex function was assessed in
      12 of the normal subjects and nine of the hypertensive patients by measuring the
      infusions of nitroprusside and phenylephrine. Compared with the normotensive
      subjects, the patients with hypertension had reduced compliance (5.9 +/- 0.7 vs.
      16.6 +/- 1.8 10(-7) m2/kPa, mean +/- SE, P < 0.001). The baroreflex slope
      relating the change in R-R interval to the change in systolic blood pressure
      during the drug infusions was less in the hypertensive than normotensive subjects
      (12.3 +/- 2 vs. 18.9 +/- 2 ms/mmHg, P < 0.05). Consequently, when both
      normotensive and hypertensive subjects were considered, there was a significant
      correlation between the baroreflex slope and compliance (r = 0.53, P < 0.05).
      However, there was no correlation between the baroreflex slope and compliance
      within either the normotensive group (r = 0.04, P = NS) or the hypertensive group
      (r = 0.43, P = NS) when analyzed separately. There was a significant correlation
      between age and compliance (r = -0.48, P < 0.01) but not between age and
      baroreflex function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342637
TI  - Differential blockade of central effects of angiotensin II by AT2-receptor
      antagonists.
AB  - In conscious, chronically instrumented, male Long-Evans rats, we showed
      previously that central administration (intracerebroventricular) of the AT1
      receptor antagonist EXP-3174 (1 microgram) caused a rapid-onset marked, but
      transient, blockade of the regional hemodynamic responses to
      intracerebroventricular angiotensin II (ANG II). In contrast, the AT2-receptor
      antagonist PD-123319 (80 micrograms) caused a slow-onset, but marked and
      persistent, antagonism of the effects of intracerebroventricular ANG II. In the
      present study we attempted to mimic the actions of PD-123319 by giving a
      supramaximal dose of EXP-3174 (10 micrograms), and we also assessed the effects
      of PD-123177 (80 micrograms), an AT2-receptor antagonist that differs from PD
      123319 only by a dimethyl group. The higher dose of EXP-3174 did not exert
      prolonged antagonistic effects against responses to intracerebroventricular ANG
      II, and PD-123177 was without inhibitory effects in this model. The results
      indicate important functional differences between putative AT2-receptor
      antagonists, when assessed in vivo, that are not apparent from binding studies.

PMID- 8342639
TI  - Angiotensin II increases cardiac protein synthesis in adult rat heart.
AB  - This study examined the direct effect of angiotensin II (ANG II) on cardiac
      muscle atrophy previously observed in the denervated rat heart. Rats with
      transplanted hearts were infused with normal saline (1 microliter/h) or a
      subpressor dose of ANG II dissolved in saline (3 micrograms.kg-1.h-1) for 1 wk.
      Left ventricular (LV) mass of transplanted hearts decreased by 29 and 18% in the
      saline-infused and ANG II-infused groups, respectively (P < 0.05). Total LV
      protein synthesis of the transplanted heart was 1.4 +/- 0.1 mg.LV-1.day-1 in the
      saline compared with 2.2 +/- 0.2 mg.LV-1.day-1 in the ANG II (P < 0.05) group.
      Heart rate and carotid systolic arterial pressures were not affected by ANG II
      infusion, and the decrease in alpha-myosin heavy chain normally observed in this
      model was unchanged between the two groups (61 +/- 3 and 66 +/- 1%, saline vs.
      ANG II). These data demonstrate that ANG II increases total cardiac protein
      synthesis in the adult heart, leading to an attenuation in cardiac atrophy. The
      failure of ANG II to prevent the shift from alpha- to beta-myosin heavy chain may
      be related to its lack of an effect on heart rate, since other interventions that
      affect myosin isoenzyme distribution also increase heart rate.

PMID- 8342640
TI  - Effect of upright tilt on ventricular/vascular coupling in chronically
      instrumented primates.
AB  - Studies of the hydraulic loading conditions on the heart in humans, especially
      pulsatile load, have primarily been limited to the supine state. Therefore, we
      have chosen a nonhuman primate model, the baboon, to assess left
      ventricular/vascular coupling in both supine and upright positions. Primate
      subjects were studied by catheterization under sedation and then after surgical
      implantation of transducers. This allowed the evaluation of postural stress in
      the chronically instrumented conscious baboon and then after light dissociative
      doses of ketamine. Basic hemodynamic variables were evaluated for baboons in
      supine and upright positions. Fourier analysis was applied to aortic pressure and
      flow to obtain input and characteristic impedance and the ratio of pulsatile (Wp)
      to total (Wt) left ventricular power (Wp/Wt). The aortic reflected, or backward,
      pressure was also calculated. Peripheral resistance increased (P = 0.01) and
      reflected pressure decreased (17.74 +/- 1.50 vs. 15.21 +/- 2 mmHg; P < 0.01) in
      upright subjects. Characteristic impedance and Wp/Wt were unchanged.
      Postoperatively, peripheral resistance increased (2,651 +/- 311 vs. 3,667 +/-
      276; P < 0.05) and mean power and Wt decreased (P < 0.01) without changes in
      reflected pressure. All variables were unchanged after light dissociative doses
      of ketamine. Thus there is no significant change in efficiency of left
      ventricular/vascular coupling formulated in terms of Wp/Wt or input impedance
      with postural stress.

PMID- 8342641
TI  - Polyethylene glycol-conjugated superoxide dismutase in focal cerebral ischemia
      reperfusion.
AB  - Generation of free radicals during reperfusion after organ ischemia has been
      implicated in the pathogenesis of ischemic injury. We have previously shown that
      a combination of intravenous polyethylene glycol-conjugated superoxide dismutase
      (PEG-SOD) and catalase (PEG-CAT), at a dose of 10,000 U/kg each, is effective in
      reducing infarct size in a focal cerebral ischemia model in the rat. It is not
      clear whether PEG-SOD alone is sufficient to reduce ischemic brain injury. In
      this study we determined the therapeutic efficacy of PEG-SOD and its dose
      response curve. In a range of 1,000-30,000 U/kg, PEG-SOD exhibited a U-shaped
      dose-response curve. Only 10,000 U/kg significantly reduced infarct size [control
      121 +/- 12 mm3 (mean +/- SE), n = 35; PEG-SOD 95 +/- 10 mm3, n = 36, P < 0.05].
      PEG-SOD at the doses tested did not have significant acute hemodynamic effects
      but had a tendency to improve postischemic hypotension. This beneficial effect of
      PEG-SOD on blood pressure did not appear to fully account for the treatment
      effect of PEG-SOD on infarct size. The narrow therapeutic dose range of PEG-SOD
      in this study and similar findings of SOD in other investigations may contribute
      to the inconsistent protective effects of SOD preparations in ischemia
      reperfusion injury in the literature.

PMID- 8342642
TI  - Activated complement directly modifies the performance of isolated heart muscle
      cells from guinea pig and rat.
AB  - The complement system has been implicated in the pathogenesis of cardiovascular
      disorders including ischemia and atherosclerosis. Selective deposition of C5b-9,
      the membrane attack complex of complement, has been histochemically documented in
      human myocardium early after reperfusion of ischemic areas and in infarcted
      zones. However, functional sequelae of the C5b-9 complex binding to myocardial
      cells have not been identified. Insertion of C5b-9 complexes into the membrane of
      other cell types can generate transient changes in membrane permeability in the
      absence of cell lysis. We demonstrate in beating isolated adult guinea pig and
      rat cardiac myocytes that human derived C5b-9 can transiently augment in a dose
      dependent manner both basal cytosolic calcium concentration and calcium
      transients, resulting in a temporary increase in contractility. If similar
      changes occur in human heart cells in vivo, they could significantly affect
      myocardial performance and contribute to functional abnormalities seen in
      ischemia and other pathological conditions associated with complement activation.

PMID- 8342643
TI  - Effects of collagenase, elastase, and hyaluronidase on mechanical properties of
      isolated dog jugular veins.
AB  - To study the contribution of tissue components to the mechanical properties of
      veins, pressure-volume relationships were obtained with the cylindrical segments
      of isolated dog external jugular veins at several levels of longitudinal
      extension. At each length, the transmural pressure of the segment was raised up
      to 20 cmH2O and then reduced to 0 cmH2O by increasing and decreasing the
      intraluminal volume at a constant rate. The longitudinal extension of the venous
      segments caused a significant reduction in the incremental volume elasticity
      within the pressure range of 0-2 cmH2O (E0-2) as well as a significant increase
      of the incremental volume elasticity within 10-20 cmH2O (E10-20). The pressure
      volume relationships of venous segments were also constructed in the same way
      after treatment with 1 mg/ml collagenase for 30 min, 0.1 mg/ml elastase for 5
      min, or 1 mg/ml hyaluronidase for 60 min. Treatment with collagenase or elastase
      produced a significant increase of the E0-2. The treatment, however, caused no
      effect on E10-20. Treatment with hyaluronidase induced no effect on these
      mechanical parameters but produced a significant attenuation of the extension
      induced decrease in E0-2. Activation of the venous smooth muscles induced by
      norepinephrine (10(-4) M) or high-potassium Krebs solution caused a significant
      decrease of E0-2 as well as a significant increase of E10-20. A complete
      relaxation of the smooth muscles elicited by Ca(2+)-free Krebs solution
      containing ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid
      (2 mM) caused an increase of E0-2. Mechanical rubbing of the endothelium caused
      no significant effect on E0-2 and E10-20.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342644
TI  - Dynamics of intracellular free Mg2+ changes in a vascular smooth muscle cell
      line.
AB  - Intracellular free Mg2+ concentration ([Mg2+]i) has been implicated in the
      pathogenesis of hypertension. It has been postulated that Mg2+ through its
      antagonistic effects on intracellular Ca2+ concentration may affect tension and
      contractility of vascular smooth muscle cells. An established cell line of rat
      thoracic aorta cells (A10) was cultured on glass cover slips, and [Mg2+]i was
      determined by fluorescent techniques on single cells with the use of mag-fura-2.
      Basal [Mg2+]i was 0.52 +/- 0.02 mM (n = 15). Vascular smooth muscle cells were
      challenged with A23187 plus 5 mM MgCl2 to rapidly elevate [Mg2+]i. [Mg2+]i
      increased to a peak of 1.03 +/- 0.09 mM within 1-2 s and then quickly declined to
      below basal levels, 0.30 +/- 0.03 mM, within 45-60 s despite the continued
      presence of A23187 and external Mg2+. The rapid removal of the Mg2+ challenge to
      below basal levels suggests the presence of intracellular transport mechanisms,
      likely in intracellular compartments or organelles. Spatial imaging studies
      indicated that Mg2+ is heterogeneously distributed within the cell with the
      greatest variations in the perinuclear region, the area of most cytosolic
      organelles. Vanadate, an inhibitor of P-type adenosinetriphosphatases, inhibited
      the removal rate from 10.2 +/- 0.9 to 6.8 +/- 1.0 microM/s. Inhibitors of
      intracellular Ca2+ mobilization, thapsigargin, dantrolene, and 3,4,5
      trimethoxybenzoic acid 8-(diethylamino)octyl ester, inhibited Mg2+ sequestration.
      Ryanodine and caffeine had no effect on Mg2+ removal. Ruthenium red did not
      inhibit Mg2+ sequestration, but oligomycin B slowed its removal. These studies
      demonstrated that [Mg2+]i in vascular smooth muscle cells is carefully controlled
      by active mechanisms involving intracellular and plasma membrane
      transporters.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342645
TI  - Dependence of endothelium-mediated relaxation on oxygen and metabolism in porcine
      coronary arteries.
AB  - Hypoxia has major effects on endothelium-dependent relaxation. To further
      understand the underlying mechanism(s), we investigated the O2 dependence of the
      endothelium-dependent relaxations elicited by ionophore A-23187 or agonists
      substance P (SP) or thrombin (TB) in porcine coronary arteries. A-23187 elicits
      an endothelium-dependent relaxation of KCl- or U-46619-induced contractures that
      can be described in terms of a rapid and slow phase. The duration of the
      relaxation was dose dependent. SP (10 nM) and TB (0.1 U/ml) also elicited
      endothelium-dependent relaxations that were rapid but transient. Hypoxic
      conditions (95% N2-5% CO2 instead of 95% O2-5% CO2; PO2 < 1%) abolished the A
      23187 rapid phase and the SP and TB transient relaxation but not the A-23187 slow
      phase. Threshold PO2 for the rapid phase was approximately 35 mmHg. Pretreatment
      with cyanide (5 mM), to inhibit respiration, or 2-deoxy-D-glucose, to inhibit
      glycolysis, had little effect. Similarly, propranolol (10 microM) or indomethacin
      (10 microM) had no effect on the relaxation to A-23187, TB, or SP. In contrast,
      both NO synthesis inhibitors and ouabain blunted all endothelium-dependent
      relaxations studied. Our results suggest that the rapid relaxations to A-23187,
      SP, and TB are sensitive to O2 but not mitochondrial respiration. The slow
      sustained relaxation induced by A-23187, however, is characterized by a
      sensitivity to O2 that is distinct from that of the rapid phase, yet is dependent
      on an intact endothelium and is affected by NO synthesis inhibitors. Thus the
      endothelium-dependent relaxation to A-23187 is probably mediated by NO, but its
      sensitivity to O2 suggests that two distinct mechanisms may be involved.

PMID- 8342646
TI  - Fluid shear stress stimulates platelet-derived growth factor expression in
      endothelial cells.
AB  - Fluid flow and the associated shear stress play a critical role in vascular
      growth and remodeling. Recent data suggest that increased endothelial cell
      expression of platelet-derived growth factor (PDGF) A- and B-chain by flow may
      participate in these events. In the present study, we examined the mechanism for
      flow-induced PDGF expression, focusing on protein kinase C (PKC). Bovine aortic
      endothelial cells were exposed to flow (shear stress = 30 dyn/cm2) in a parallel
      plate flow chamber. Increases in PDGF B-chain, but not PDGF A-chain, were
      observed within 3 h, maximal within 6 h (13-fold increase), and sustained for 24
      h. PKC appeared to be involved because phorbol 12-myristate 13-acetate induced
      PDGF B-chain mRNA. Activation of PKC alone, however, was insufficient to induce
      PDGF mRNA because the selective PKC activator, 1-oleoyl-2-acetyl-sn-glycerol, did
      not induce PDGF expression. A PKC-independent pathway was suggested by the fact
      that inhibition of PKC (downregulation with phorbol 12,13-dibutyrate or exposure
      to staurosporine) failed to block PMA or flow-induced PDGF B-chain expression.
      These results demonstrate flow-induced PDGF B-chain expression in endothelial
      cells that appears to be mediated, in part, by a PKC-independent pathway.

PMID- 8342647
TI  - Effect of adenosine on heart rate in isolated muskrat and guinea pig hearts.
AB  - The purpose of this study was to compare the responses of isolated hearts of the
      diving muskrat with the nondividing guinea pig (GP) to determine the contribution
      of adenosine (ADO) to the profound bradycardia that was seen in isolated muskrat
      hearts during exposure to hypoxia. Muskrat hearts were more sensitive than GP
      hearts to the heart rate-lowering effects of exogenously applied ADO or a stable
      ADO analogue, (R)-N6-(phenylisopropyl)adenosine. The hearts of both species were
      unpaced, and the bradycardia appeared to be due to high degree of
      atrioventricular block. Radioligand binding with 8-cyclopentyl-1,3
      [3H]dipropylxanthine to A1-ADO receptors was greater in cardiac membranes
      prepared from GP hearts than from muskrat hearts. Nucleoside transporter
      antagonist binding was also greater in GP hearts compared with muskrats. This was
      determined by membrane binding of [3H]-nitrobenzylthioinosine, an antagonist of
      nucleoside transport. Both muskrat and GP hearts responded to 30 min of hypoxic
      perfusion by releasing ADO into the coronary effluent; however, the muskrat
      hearts released approximately five times more than the GP hearts. When hearts
      were subjected to hypoxia in the presence of ADO deaminase, theophylline, or 8-(p
      sulfophenyl)theophylline, the hypoxia-induced bradycardia was blocked in the GP
      hearts and either slightly reduced or not affected in muskrat hearts. In contrast
      to GP hearts, muskrat hearts release larger amounts of ADO during hypoxia and are
      more sensitive to the negative chronotropic effects of exogenously administered
      ADO; yet the hypoxia-induced bradycardia does not appear to be exclusively
      mediated by ADO in the muskrat as it is in the isolated GP heart.

PMID- 8342648
TI  - Dependence of cardiac filling pressure on cardiac output during rest and dynamic
      exercise in dogs.
AB  - At rest, central venous pressure (CVP) falls when cardiac output (CO) rises. This
      can be attributed to flow-dependent redistribution of blood volume from central
      to peripheral blood vessels. In contrast, CVP rises during dynamic exercise
      despite a rise in CO. Therefore peripheral circulatory changes during exercise
      must counteract the factors that lower CVP when CO rises during rest. Our
      objectives were to determine the importance of blood flow, the muscle pump, and
      reflexes on changes in ventricular filling pressure during dynamic exercise. In
      seven dogs with a surgically produced atrioventricular (AV) block, normal
      relationships between CO and CVP were established by AV-linked pacing (normal
      heart rates) during rest and exercise. Cardiac output was altered during rest and
      treadmill exercise (4 miles/h at 0, 10, or 20% grade) by changing ventricular
      pacing rate to establish curves relating delta CVP to delta CO. These curves were
      displaced rightward (higher CO) and upward (higher CVP) by exercise because of
      the muscle pump. Changing CO by pacing during rest and exercise revealed a
      constant slope for delta CVP/delta CO of -2.7 mmHg.l-1.min-1. Blockade of reflex
      vasoconstriction and venoconstriction with hexamethonium at rest and during mild
      exercise (to isolate effects of the muscle pump) did not alter these slopes or
      the displacement of the curves by exercise, although CVP was 4.3 mmHg lower at a
      given CO after blockade.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342649
TI  - Sodium hyperosmolarity of intestinal lymph causes arteriolar vasodilation in part
      mediated by EDRF.
AB  - This study evaluated 1) the effect of increased submucosal lymph osmolarity on
      the regulation of first-order (1A) and second-order (2A) intestinal arterioles
      and 2) the role of endothelium-derived relaxing factor (EDRF) in hypertonic
      induced vasodilation. Increasing the submucosal lymph osmolarity from 280 to 400
      mosM, in increments of 30 mosM, resulted in a dose-dependent dilation of 1A and
      2A. A submucosal lymph tonicity of 340 mosM, as occurs during glucose and oleic
      acid absorption, caused dilation of 1A (118%) and 2A (124%) equivalent to that
      during absorptive hyperemia. The dilation caused by 400 mosM mannitol (137%) was
      similar to that with 340 mosM NaCl (131%) and approximately 70% of that with 400
      mosM NaCl (152%). After EDRF blockade, the responses to sodium hypertonicity
      decreased by about one-half; blockade reduced mannitol-induced dilation by 22%.
      These results indicate that sodium hypertonicity, as occurs during absorption,
      can play a major role in absorptive hyperemia, and about one-half of the dilation
      is related to a sodium-coupled release of EDRF.

PMID- 8342650
TI  - Catecholamines modulate protein turnover in cultured, quiescent rabbit cardiac
      myocytes.
AB  - When rabbit ventricular myocytes were cultured for 1 wk and then exposed to alpha
      and/or beta-adrenergic agonists, such nonbeating heart cell preparations
      disclosed increased protein-to-DNA ratios and elevated RNA content, indicative of
      cellular hypertrophy. Norepinephrine, isoproterenol, and phenylephrine provoked
      hypertrophy with norepinephrine eliciting a greater response than isoproterenol
      or phenylephrine. Specific alpha- and beta-antagonists blocked growth by
      inhibiting catecholamine-induced changes in protein turnover. Each catecholamine
      enhanced the fractional rate of protein synthesis within 48 h; however, changes
      in growth rates appeared to be modulated, in part, by alterations in protein
      degradation. Even though rates of total protein and actin synthesis resembled
      values measured in vivo, myosin heavy chain fractional rate of synthesis was only
      22% of in vivo levels. Double label immunofluorescence microscopy further
      illustrated that catecholamine treatment accelerated myofibrillar disruption in
      these quiescent heart cells. These observations suggested that in the absence of
      beating, neurohumoral modulation of contractile protein turnover was not
      associated with the maintenance of myofibrillar integrity even though
      catecholamines induced cellular hypertrophy.

PMID- 8342651
TI  - Limit to cardiac compensation during acute isovolemic hemodilution: influence of
      coronary stenosis.
AB  - We assessed limit to cardiac compensation during isovolemic hemodilution (HD) in
      14 anesthetized dogs. Radioactive microspheres were used to evaluate myocardial
      blood flow (MBF) and its transmural distribution (endo/epi). Myocardial O2
      consumption (MVO2) and percent lactate extraction were determined. Coronary
      vasodilator reserve was assessed from reactive hyperemic responses. Dogs were
      divided into group 1, with intact left anterior descending coronary artery (LAD),
      and group 2, with critical stenosis of LAD. Measurements were obtained at
      baseline and during graded HD (Hespan) until cardiac failure (CF). CF occurred at
      lower hematocrit in group 1 compared with group 2 (9 +/- 1 vs. 17 +/- 1%). In
      group 1, MBF increased during HD to maintain MVO2 constant; increases in MBF were
      transmurally uniform until CF, when decreased endo/epi and lactate production
      suggested subendocardial ischemia. Coronary vasodilator reserve decreased
      progressively during HD and was absent at CF. In group 2, stenotic LAD
      demonstrated constant MBF (resulting in decreased MVO2) during HD. At CF, these
      responses along with reduced endo/epi and lactate production indicated local
      myocardial ischemia. We conclude that 1) with normal coronary circulation,
      cardiac function was well maintained over a wide range of hematocrits because
      increases in MBF were transmurally uniform and sufficient to maintain myocardial
      oxygenation: CF occurred during extreme HD when MBF became maldistributed,
      resulting in subendocardial ischemia; 2) critical coronary stenosis impaired
      coronary vascular adjustment to HD and reduced significantly tolerance of left
      ventricle to HD; and 3) present findings underscore the importance of recruitment
      of coronary vasodilator reserve in preserving total and regional myocardial
      oxygenation during HD.

PMID- 8342653
TI  - Coronary arterial tree remodeling in right ventricular hypertrophy.
AB  - We investigated coronary vascular adaptations occurring in right ventricular
      hypertrophy (RVH). Six pigs had RVH induced by pulmonary artery stenosis for 5
      wk. Three pigs served as controls. At autopsy we made silicone elastomer casts of
      the right coronary arteries (RCA) and collected morphometric data. We organized
      the segments and their diameters and lengths into a framework of a modified
      Strahler's ordering scheme in which the order number of an offspring is increased
      only if its diameter is greater than the diameters of its parents by a specific
      amount. The segments of the same order arranged in series are combined into
      elements. In RVH the total number of orders of vessels was larger than the
      control by 1; the total number of elements in each order increased greatly,
      whereas the diameters and lengths of each order decreased somewhat. The total RCA
      resistance decreased in RVH mainly because the total cross-sectional area (CSA)
      of every order was increased. Because the diameters of the resistance vessels
      decreased, this decrease in total RCA resistance was due to a numerical increase
      in resistance vessels. These findings indicate that new flow channels have been
      established. In contrast, the RCA was remodeled in that the lumen diameter
      increased. Pressure-flow curves showed a decrease of coronary resistance in RVH,
      in agreement with the morphometric findings. We conclude that there is
      significant remodeling of the coronary arterial vasculature in RVH, and any
      future analysis of coronary hemodynamics of the right ventricle in hypertrophy
      must take the morphometric remodeling into account.

PMID- 8342652
TI  - Morphometry of pig coronary arterial trees.
AB  - To establish a mathematical model of the tree like arteries for the purpose of
      hemodynamic analysis, a complete set of morphometric data of pig coronary
      arteries is presented. For the purpose of mathematical modeling, three
      innovations in morphometry are introduced: 1) a rule for assigning the order
      numbers of the vessels on the basis of diameter ranges, 2) a connectivity matrix
      to describe asymmetric branching, and 3) a measurement of the fraction of vessel
      segments connected in series. The morphometric measurements were made with the
      silicone elastomer-casting method. Data on smaller vessels were obtained from
      histological specimens by optical sectioning. Data on larger vessels were
      obtained from vascular casts. The order number, diameter, length, connectivity
      matrix, and fractions of the vessels of a given order connected in series were
      measured for all orders of vessels of the right coronary artery and the left
      anterior descending and left circumflex branches. The data can be used to analyze
      the longitudinal distribution of blood pressure and volume and spatial
      distribution of perfusion in myocardium.

PMID- 8342654
TI  - Increasing oxygen tension dilates fetal pulmonary circulation via endothelium
      derived relaxing factor.
AB  - We examined the role of endothelium-derived relaxing factor (EDRF) in the
      increase in pulmonary blood flow caused by increasing oxygen tension in the lungs
      of the fetus. Fetal lambs at 133 days of gestation were instrumented for
      intrauterine measurement of pulmonary arterial, left atrial, and amniotic fluid
      pressure and pulmonary blood flow. Three days later oxygen tension in the
      pulmonary arterial blood of the fetus was doubled by having the ewe breathe 100%
      oxygen at 3 atm absolute pressure. In the control fetuses (n = 5), hyperbaric
      oxygenation increased pulmonary blood flow eightfold. Blocking EDRF production by
      infusing 45 mg of NG-monomethyl-L-arginine into the superior vena cava of the
      fetus over 5 min starting 30 min after the beginning of hyperbaric oxygen
      reversed the increase in pulmonary blood flow (n = 5). Blocking EDRF production
      by infusing NG-nitro-L-arginine at 1 mg/min for 60 min starting 30 min before
      hyperbaric oxygen blunted the initial increase in pulmonary blood flow and
      eliminated it by the end of the experiment (n = 5). As hyperbaric oxygen did not
      significantly alter pulmonary arterial or left atrial pressure, changes in
      pulmonary vascular conductance paralleled those in pulmonary blood flow. We
      conclude that the majority of the vasodilation of the fetal pulmonary circulation
      caused by increasing oxygen tension is mediated by EDRF. We speculate that EDRF
      is involved in maintaining low vascular tone at the relatively high oxygen
      tension of the postnatal lung.

PMID- 8342655
TI  - Pressure-related capillary leukostasis following ischemia-reperfusion and
      hemorrhagic shock.
AB  - Although the receptor-dependent venular adhesion of leukocyte adherence has been
      relatively well characterized, less is known about capillary leukostasis. With
      the use of fluorescence intravital microscopy, leukocyte behavior in the
      capillaries of rabbit tenuissimus muscle was evaluated after ischemia-reperfusion
      or hemorrhage. After fixed volume hemorrhage or 4 h of total ischemia,
      inflammatory injury was manifest by broken fibrils, edema, leukocyte
      infiltration, and margination along the postcapillary venular walls.
      Nevertheless, as long as arterial perfusion pressure was between 27 and 72 mmHg,
      the frequency of capillary leukostasis was low (4-8 cells/mm2) and similar in all
      groups, including animals treated with the antiadhesion antibody IB4. In
      contrast, when perfusion pressure decreased to 20 mmHg, capillary leukostasis
      increased similarly (to 16-21 cells/mm2) in controls (with or without IB4) and in
      those subjected to ischemia. Furthermore, when perfusion pressure was increased
      to more than 27 mmHg, (27-72 mmHg) stationary leukocytes returned to the original
      low level (4-5 cells/mm2). These results are consistent with the conclusion that
      during some inflammatory injuries, capillary leukostasis is a pressure-related
      phenomena that is not receptor dependent and is freely reversible with the early
      restoration of perfusion pressure.

PMID- 8342656
TI  - Altered cerebrovascular responsiveness to N-methyl-D-aspartate after asphyxia in
      piglets.
AB  - We examined effects of prior asphyxia and reventilation on pial arteriolar
      responses to arterial hypercapnia, topical application of forskolin, and topical
      application of N-methyl-D-aspartate (NMDA) in newborn pigs. Piglets were
      anesthetized and ventilated with a respirator. Pial arteriolar diameter was
      determined using a closed cranial window and intravital microscopy. After
      baseline diameter was determined, the respirator was turned off for 10 min. Then
      the respirator was turned on, and the piglet was ventilated for 4 h. At 1, 2, and
      4 h after asphyxia, arteriolar diameter was determined during control conditions
      and during arterial hypercapnia (inspiration of 10% CO2 in air; n = 4), topical
      application of 2.4 x 10(-8) M forskolin (n = 6), and topical application of 10(
      5) M NMDA (n = 6). At 1 h after asphyxia, arterial hypercapnia dilated pial
      arterioles by 39 +/- 3%, topical forskolin dilated pial arterioles by 24 +/- 3%,
      and NMDA dilated pial arterioles by 10 +/- 1%. For arterial hypercapnia and
      forskolin application, arteriolar responses were not different from 1 h at 2 and
      4 h postasphyxia. In contrast, for NMDA, arteriolar responses were greater at 2 h
      (23 +/- 6%) and 4 h (30 +/- 5%) than at 1 h. In time-control animals, NMDA
      dilated arterioles by 20 +/- 5% at 1 h, by 24 +/- 8% at 2 h, and by 21 +/- 4% at
      4 h (n = 5). Indomethacin administration (5 mg/kg iv) before asphyxia resulted in
      a 23 +/- 3% arteriolar dilation in response to NMDA at 1 h (n = 7).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8342657
TI  - Age-dependent overflow of endogenous norepinephrine from paraventricular
      hypothalamic nucleus of hypertensive rats.
AB  - The relationship between age and central noradrenergic neuronal activity of the
      paraventricular hypothalamic nucleus (PVH) was examined in 7- to 10-, 12- to 14-,
      and 30- to 36-wk-old Sprague-Dawley (SD), Wistar-Kyoto (WKY), and spontaneously
      hypertensive rats (SHR). As an index of noradrenergic activity, endogenous
      norepinephrine (NE) overflow was assessed utilizing a miniaturized push-pull
      cannula assembly in unanesthetized freely moving rats. NE overlow under basal, 56
      mM K+ stimulation, and in response to pressor/depressor drugs, were examined in
      all three strains at all ages. Significant increases in basal and K(+)-stimulated
      overflow of endogenous NE from the PVH were observed in all ages of SHR compared
      with normotensive controls with the greatest percent increase occurring during
      the development of hypertension in SHR. In addition, a reciprocal relationship
      exists with respect to blood pressure and overflow of NE from the PVH such that
      increases/decreases in blood pressure elicit decreases/increases in NE overflow
      in all strains at all ages examined. However, developing hypertensive SHR
      exhibited attenuated decreases in overflow of NE from the PVH compared with age
      matched controls and established hypertensive SHR. These results suggest that
      noradrenergic pathways of the PVH contribute to the development and maintenance
      of arterial pressure hemostasis and that enhanced central noradrenergic neuronal
      activity is greatest during the development of hypertension in SHR.

PMID- 8342658
TI  - Activation of cardiac sympathetic afferents: effects of exogenous adenosine and
      adenosine analogues.
AB  - Adenosine is released during myocardial ischemia and can cause angina-like chest
      pain when given by intracoronary administration. We tested the hypothesis that
      intracoronary adenosine activates cardiac sympathetic afferent fibers and results
      in reflex sympathoexcitation. In dogs with sinoaortic denervation and vagotomy,
      we administered 2 mg of adenosine into the left anterior descending artery over 2
      min. Before dipyridamole infusion, intracoronary adenosine resulted in no change
      in blood pressure or renal sympathetic nerve activity. After dipyridamole
      infusion, which blocks adenosine uptake, intracoronary adenosine resulted in a
      peak increase in sympathetic activity of 34 +/- 7%. We also investigated the
      adenosine-receptor subtype responsible for this sympathoexcitatory response. We
      found that the adenosine1 agonist N6-cyclopentyladenosine elicited a dose
      dependent sympathoexcitatory response similar to adenosine but that the
      adenosine2 agonist 5'-(N-cyclopropyl)carboxamidoadenosine failed to elicit a
      sympathoexcitatory response. We conclude that adenosine activates cardiac
      sympathetic afferent fibers and leads to a sympathoexcitatory response due to
      activation of adenosine1 receptors.

PMID- 8342659
TI  - Biologic role of atrial natriuretic factor clearance receptor in congestive heart
      failure.
AB  - Atrial natriuretic factor (ANF) is a circulating 28-amino acid peptide that
      functions in the regulation of sodium homeostasis and vascular tone. ANF
      metabolism occurs via degradation by neutral endopeptidase 24.11 and binding to
      the ANF clearance receptor (ANFR-C). The present study was performed on
      anesthetized dogs, normal (control) and with experimental congestive heart
      failure (CHF), and was designed to investigate the ability of an ANF ligand
      specific for ANFR-C [C-ANF-(4-23)] to increase plasma ANF and also to evaluate
      the influence of ANFR-C on regional pulmonary and renal ANF clearances. C-ANF-(4
      23) increased plasma ANF in controls (51 +/- 15 to 123 +/- 39 pg/ml; P < 0.05)
      and further increased plasma ANF in CHF dogs (242 +/- 30 to 327 +/- 34; P <
      0.05), demonstrating that ANFR-C plays a significant role in the overall
      metabolism and clearance of ANF, even with chronically elevated ANF. Infusion of
      C-ANF-(4-23) produced a marked decrease in ANF pulmonary clearance (PCLANF) in
      controls (1,018 +/- 405 to -286 +/- 383 ml/min; P < 0.05); however, PCLANF was
      not altered by the ANF ligand in CHF dogs [-137 +/- 174 to -106 +/- 226 ml/min;
      not significant (NS)], suggesting an occupancy of ANFR-C or a downregulation of
      this receptor with chronically elevated plasma ANF. ANF renal clearance (RCLANF)
      was not altered in either group by C-ANF-(4-23) infusion.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8342660
TI  - Role of nitric oxide in leukotriene C4-induced increases in microvascular
      transport.
AB  - The goal of this study was to determine the role of nitric oxide in alterations
      in macromolecular transport of the hamster cheek pouch in vivo in response to
      leukotriene C4. We used intravital fluorescent microscopy to examine the
      transport of macromolecules across the hamster cheek pouch in response to
      leukotriene C4 before and after application of an enzymatic inhibitor of nitric
      oxide, NG-monomethyl-L-arginine (L-NMMA; 1.0 microM). Increases in transport of
      macromolecules across the hamster cheek pouch were quantitated by the formation
      of venular leaky sites and clearance of fluorescein isothiocyanate-dextran (FITC
      dextran; mol wt = 70 K). Leukotriene C4 (1.0 and 3.0 nM) produced an increase in
      the number of venular leaky sites and clearance of FITC-dextran-70K. Superfusion
      of L-NMMA (1.0 microM) significantly decreased leukotriene C4-induced increases
      in venular leaky sites and clearance of FITC-dextran-70K. In addition,
      superfusion of LY-83583 (10 microM) significantly decreased leukotriene C4
      induced increases in venular leaky sites. In contrast, superfusion of NG
      monomethyl-D-arginine (D-NMMA; 1.0 microM), indomethacin (10 mg/kg iv), or
      diphenhydramine hydrochloride; 15-20 mg/kg iv) did not significantly alter
      leukotriene C4-induced increases in venular leaky sites. Thus these findings
      suggest that production of nitric oxide and subsequent activation of guanylate
      cyclase play an important role in formation of venular leaky sites and clearance
      of FITC-dextran-70K in response to application of leukotriene C4.

PMID- 8342661
TI  - Myogenic tone is coupled to phospholipase C and G protein activation in small
      cerebral arteries.
AB  - The cellular transduction mechanisms underlying the response of blood vessels to
      mechanical forces such as pressure or stretch are largely unknown. In this report
      we test the hypothesis that myogenic tone in the cerebral circulation is coupled
      to activation of phospholipase C (PLC) and G proteins. Rat posterior cerebral
      arteries (luminal diam 189 +/- 4 microns) were cannulated in an arteriograph and
      allowed to develop myogenic tone at 75 mmHg (122 +/- 6 microns; P < 0.01).
      Exposure to U-73122, an inhibitor of PLC, produced concentration-dependent
      vasodilation, with near-maximal (> 90%) inhibition at concentrations > 3 microM
      (50% inhibitory concentration = 0.8 +/- 0.04 microM). The action of U-73122 was
      confirmed by demonstrating that constrictor responses to serotonin (PLC mediated)
      could be significantly attenuated or abolished at concentrations (0.5-1 microM)
      that were ineffective in antagonizing potassium depolarization or indolactam
      induced constrictions (both PLC independent). Incubation in pertussis toxin (100
      ng/ml, 2-2.5 h), an inhibitor of some G protein subtypes, reduced myogenic tone
      by 74 +/- 12%, with luminal diameters increasing from 129 +/- 7 to 160 +/- 7
      microns. Conversely, nonspecific G protein activation using AlF-4 (NaF+AlCl3, 0.5
      5 mM) significantly increased myogenic tone by 86 +/- 9%, reducing luminal
      diameters from 132 +/- 6 to 88 +/- 8 microns (P < 0.01). Together, these findings
      suggest that 1) PLC is activated in arteries that possess myogenic tone, 2)
      pharmacological inhibition of PLC results in a virtual loss of pressure-induced
      constriction, and 3) G proteins may modulate mechanotransduction through pathways
      superimposed on basal myogenic tone.

PMID- 8342662
TI  - Dietary sodium stimulates ouabainlike activity in adrenalectomized spontaneously
      hypertensive rats.
AB  - Both the adrenal glands and the hypothalamus have been proposed to produce
      compound(s) with ouabainlike activity (OLA). To evaluate the contribution of the
      adrenal glands, 4-wk-old spontaneously hypertensive rats (SHR) were sham operated
      or adrenalectomized. The adrenalectomized SHR were given daily injections of
      corticosterone and aldosterone. Subsequently, rats were randomized to control or
      high (8%) dietary Na+, and after 2.5 wk, blood pressure and OLA in plasma,
      hypothalamus, and pituitary were evaluated. Hypertension developed somewhat less
      in adrenalectomized vs. sham-operated SHR. On control Na+ intake, adrenalectomy
      caused only minor decreases in circulating and central OLA. Adrenalectomy did not
      prevent the 50-90% increases in plasma, hypothalamus, and pituitary OLA caused by
      high Na+ intake for 2.5 wk. These findings are consistent with the concept that,
      at least in SHR, the central nervous system may represent the major source of
      both central and peripheral OLA.

PMID- 8342663
TI  - Microvascular volume shift and fluid restitution induced by lower-body suction.

PMID- 8342664
TI  - Neutral axis location in bending and Young's modulus of different layers of
      arterial wall.
AB  - With few exceptions, experimental results on the blood vessel elasticity have
      been analyzed with the blood vessel wall treated as a homogeneous material,
      probably because the experiments have been limited to inflation and stretching.
      To advance the subject, we must evaluate the force-deformation relationship of
      different layers of the vessel. A key strategy to do this is to study
      nonaxisymmetric deformation of the vessel wall so that the different layers of
      the vessel may deform in different amounts at different places. One of the most
      effective nonaxisymmetric deformations that can be imposed on the vessel wall is
      bending. The first important question to ask about bending is, Where is the
      neutral axis? In this study, a method to determine the neutral axis is presented.
      We found that the neutral axis of the aorta of the pig lies in the medial layer
      about one-third of the wall thickness from the endothelium. We measured the
      strain distribution in the vessel wall by optical methods. Using the load
      deflection relationship, we evaluated the Young's modulus of the intima-media
      layer and that of the adventitia. They differ by an order of magnitude. Our
      results show that the Young's modulus of the intima-media layer of the pig
      thoracic aorta is 43.2 +/- 15.8 kPa, whereas the Young's modulus of the
      adventitial layer is 4.70 +/- 1.72 kPa, in a linear range of the stress-strain
      relationship including the zero-stress state and the no-load state.

PMID- 8342665
TI  - Myocardial capillary diffusion capacity in rat hearts with cardiac hypertrophy
      due to pressure and volume overload.
AB  - The functional adaptation of the myocardial capillary bed in response to cardiac
      hypertrophy was studied in one volume overload (aortocaval fistula, ACF) and in
      one pressure overload model [left renal arterial stenosis, two-kidney, one-clip
      (2K,1C)]. Furthermore, a group where renal hypertension was reversed 1 wk before
      experimentation (UC-2K,1C) and a sham-operated (Sham) group were studied.
      Functional estimations of myocardial capillary diffusion capacity in terms of
      permeability surface area products (PS) per 100 g of myocardium were obtained by
      the single-injection indicator dilution technique in a Langendorff preparation.
      After 4 wk, ACF hearts, with 72% hypertrophy and normal minimal coronary vascular
      resistance (CVR), displayed an unchanged diffusion capacity, i.e., PS for Cr-EDTA
      and vitamin B12. This indicates a structural out-growth of the coronary vascular
      bed to match the increased demand of the tissue. 2K,1C hearts with marked
      elevations of minimal coronary vascular resistance and left ventricular
      hypertrophy (65%) showed higher PS values than Sham, implying that diffusion
      capacity was enhanced despite structural coronary vascular changes. These changes
      were completely reversed in UC-2K,1C. Thus the present data imply that myocardial
      capillary diffusion capacity was well maintained in volume overloaded cardiac
      hypertrophy and in contrast with earlier morphometric estimations, even enhanced
      in pressure overload hypertrophy.

PMID- 8342666
TI  - Hemodynamic responses to graded lower body positive pressure.
AB  - Fourteen healthy young men were exposed to progressive increases in lower body
      positive pressure (LBPP) from 0 to 40 Torr in the supine position. Central venous
      pressure (CVP) increased 1.09 mmHg (P < 0.05) at 5 Torr LBPP. Between 20 and 40
      Torr LBPP CVP increased 0.85 mmHg, resulting in a total increase of 2.06 mmHg (P
      < 0.05). During 0-20 Torr LBPP mean arterial pressure (MAP) increased from 86 to
      89 mmHg with a slope of 0.15 mmHg/Torr LBPP. Stroke volume and cardiac output
      were significantly increased at 20 Torr LBPP. Beyond 20 Torr LBPP, MAP increased
      to 95 mmHg at 40 Torr (P < 0.05) with a slope of 0.32 mmHg/Torr LBPP. Forearm
      blood flow increased above rest at 40 Torr LBPP (P < 0.05). However, neither
      peripheral nor forearm vascular resistance decreased significantly from rest.
      Despite the significant increases in MAP, heart rate was unchanged above 20 Torr
      LBPP. These data suggest that LBPP produces increases in CVP at 0-20 Torr by
      translocation of blood volume from the legs to the thorax. At LBPP > 20 Torr,
      further increases in CVP and MAP were produced by other mechanisms possibly
      related to an activation of intramuscular pressure-sensitive receptors.

PMID- 8342667
TI  - Albumin modulation of capillary permeability: role of endothelial cell [Ca2+]i.
AB  - Albumin is required in vascular perfusates to maintain the normal permeability of
      microvessel walls. The most common mechanism proposed for action of albumin
      involves binding to the endothelial cell surface to increase the resistance to
      water and solute flows through hydraulic pathways across the capillary wall. The
      results of the present experiments do not conform to this simple adsorption
      model. Ringer perfusion increased the hydraulic conductivity (Lp) of the wall of
      single perfused frog mesenteric microvessels by 4.0 +/- 0.5-fold. The increase in
      Lp was associated with an increase of cytoplasmic calcium concentration ([Ca2+]i)
      from 59 +/- 5 nM when albumin was in the perfusate to a transient peak of 181 +/-
      13 nM, 1-2 min after Ringer perfusion. [Ca2+]i then fell back to close to 100 nM.
      Processes that reduced Ca2+ influx into endothelial cells (removal of
      extracellular Ca2+, membrane depolarization) reduced Ca2+ influx and attenuated
      the increase in [Ca2+]i. The same processes abolished the increase in Lp after
      Ringer perfusion and restored Lp to close to control values during Ringer
      perfusion. Thus Ca2+ entry into endothelial cells is required to initiate and
      maintain the increased permeability during Ringer perfusion.

PMID- 8342668
TI  - Magnesium influences incorporation of [3H]arachidonic acid in perfused rabbits
      hearts.
AB  - Ca(2+)-free perfusion of rabbit hearts produces a 50% loss of tissue Ca2+ and
      Mg2+ and results in reduced incorporation of arachidonic acid into tissue lipids.
      This work was undertaken to determine whether the reduced incorporation was
      specific for arachidonic acid and whether it was correlated to the loss of either
      (or both) cation(s). Single 170-pmol bolus doses of [3H]arachidonic or [3H]oleic
      acid were given to perfused hearts with or without Ca2+ in the perfusate. The
      experiment was terminated, and the lipids were extracted 1-15 min after
      administration of label. At all time points, significantly less arachidonate was
      incorporated into total tissue lipids in the absence of than in the presence of
      Ca2+. The presence or absence of Ca2+ had no effect on the incorporation of
      oleate. When [3H]arachidonate was administered to hearts perfused with buffer
      containing 104 mM Li+ and 35 mM Na+ (which reduces tissue Mg2+ by approximately
      25% and increases tissue Ca2+ by approximately 35%), the incorporation into
      lipids was reduced from 0.882 +/- 0.0739 to 0.598 +/- 0.0722 pmol/mg lipid (P <
      0.05; n = 6). The incorporation of [3H]oleate during 104 mM Li+ and 35 mM Na+ was
      not different from control. These data suggest that the incorporation of
      arachidonic, but not oleic, acid into tissue lipids is dependent on the tissue
      Mg2+ content.

PMID- 8342669
TI  - Fetal responses to acute maternal cocaine injection in sheep.
AB  - Maternal cocaine abuse has been associated with neonatal neurological and
      neurobehavioral problems of unknown pathogenesis. We administered a single
      intravenous dose of cocaine (2 mg/kg) to 12 unanesthetized pregnant sheep; their
      fetuses had been catheterized in utero 2 days before the study. We measured fetal
      cerebral blood flow (CBF), cerebral metabolic rate of O2 (CMRO2), mean arterial
      blood pressure (MAP), and blood gases before and 2, 5, 15, and 30 min after
      maternal cocaine injection. Fetal CBF increased by 37 +/- 33% (mean +/- SD) at 5
      min and returned to baseline by 15 min. Regional brain blood flow changes
      paralleled CBF changes with the greatest increases occurring in cerebellum (54 +/
      43%) and brain stem (54 +/- 52%). Cerebral vascular resistance was decreased for
      cerebellum (22%) and brain stem (19%) but was unchanged for cerebral hemispheres
      and caudate. Increased CBF at 5 min was associated with a 20 +/- 9% increase in
      fetal MAP and a 38 +/- 13% decrease in fetal arterial O2 content. Fetal CMRO2 was
      unchanged. There was a decrease in fetal intestinal blood flow at 2 min, an
      increase in myocardial, adrenal, and renal blood flow at 5 min, and no change in
      placental blood flow. Maternal cocaine injection causes fetal hypoxemia,
      hypertension, and increased CBF. Possible mechanisms for cerebral vasodilation
      (in some areas) include hypoxemia, impaired autoregulatory response to increased
      blood pressure, and/or direct or indirect vascular effects of cocaine or its
      metabolites.

PMID- 8342670
TI  - VIP and NPY in canine hearts. Distribution and effect of total and selective
      parasympathetic denervation.
AB  - The hypotheses that vasoactive intestinal peptide (VIP) is evenly distributed
      throughout atrial and ventricular myocardium and is present in postganglionic
      parasympathetic neurons in the regions of the sinoatrial and atrioventricular
      nodes were tested in three groups of dogs. Neuropeptide Y (NPY) tissue
      concentrations were determined in each group. In six sham dogs VIP and NPY
      concentrations were evenly distributed and were higher in atria compared with
      ventricles. In nine parasympathectomized dogs, VIP concentrations in sample sites
      from regions of the sinoatrial and atrioventricular nodes were comparable to
      those in sham-operated controls. In nine denervated dogs VIP concentrations were
      significantly decreased in three adjacent sample sites along the atrioventricular
      groove. In these dogs NPY concentrations were not detectable or were
      significantly decreased at all sample sites of both atria and ventricles. These
      data suggest that VIP neurons are evenly distributed in atrial and ventricular
      myocardium but do not originate in parasympathetic ganglia supplying the
      sinoatrial and atrioventricular nodes. The data also demonstrate the possible
      presence of extrinsic VIP neurons in the canine right ventricle and indicate that
      NPY may be a useful marker of myocardial adrenergic innervation.

PMID- 8342671
TI  - Baroreflex control of arterial and venous compliances and vascular capacity in
      hypertensive dogs.
AB  - The ability of the carotid sinus baroreflex to elicit reflex changes in vascular
      capacity was studied in chronically hypertensive (one-kidney, one-clip) and sham
      operated normotensive dogs under pentobarbital sodium anesthesia. Vascular
      compliances and reflex-induced changes in external reservoir volume were measured
      in response to changes in isolated carotid sinus pressure (CSP). The mean
      arterial pressure-CSP reflex characteristic curve was shifted to a higher
      arterial pressure with hypertension with no change in maximum reflex gains.
      Arterial compliance in both groups increased significantly (P < 0.01) when CSP
      was increased from 50 to 200 mmHg. Total, arterial, and venous vascular
      compliances were not different in normotensive and hypertensive groups. Changes
      in CSP caused no significant changes in either total systemic vascular or
      calculated venous compliances. A decrease in CSP from 250 to 50 mmHg resulted in
      an increase in external reservoir volume of 8.02 +/- 1.03 and 7.44 +/- 1.33 ml/kg
      in normotensive and hypertensive groups, respectively, with changes in venous
      volume of 11.99 +/- 1.39 and 12.58 +/- 1.52 ml/kg (NS). We conclude that despite
      the increase in arterial resistance, Goldblatt hypertensive dogs retain the
      ability to make short-term reflex adjustments in both arterial pressure and
      venous blood volume.

PMID- 8342672
TI  - Adrenal medulla as a mediator of diet-induced hypertension.
AB  - Male Sprague-Dawley rats fed either a high-fat or glucose-enriched diet for 10 wk
      developed higher blood pressure (BP) and higher urinary catecholamine excretion
      than rats fed a control diet. After 10 wk of diet treatment, systolic BP was 164
      +/- 3, 156 +/- 2, and 145 +/- 4 mmHg in rats fed the high-fat, glucose, and
      control diets, respectively (P < 0.02 vs. control). During weeks 7-9 of diet
      treatment, excretion of epinephrine and norepinephrine was increased in
      hypertensive rats (those fed the high-fat or glucose diet) when compared with
      rats fed the control diet (P < 0.001). The purpose of this study was to determine
      whether the hypertensive response to nutrients could be prevented by prior
      surgical removal of the adrenal medulla. Adrenal demedullation nearly abolished
      epinephrine excretion, attenuated norepinephrine excretion, and completely
      blocked the hypertensive response to dietary fat and glucose. These findings
      suggest that adrenal medullary catecholamines play a role in the hypertensive
      response to nutrients.

PMID- 8342673
TI  - Norepinephrine does not stimulate protein and UCP synthesis in brown adipocytes
      of golden Syrian hamsters.
AB  - Hamster brown adipocytes were incubated for up to 24 h with or without
      norepinephrine (NE) in Dulbecco's modified Eagle's medium supplemented with
      bovine serum albumin, calf serum, and antibiotics. Brown fat cells were viable
      for 24 h as defined by their ability to respond to NE by a 10-fold increase in
      oxygen consumption. However, prolonged exposure of the cells to NE led to a
      decline in NE-stimulated rates of O2 consumption, which was not the result of
      loss of cell thermogenic capacity. Brown fat cells incubated for 24 h with or
      without NE showed no significant change in succinate dehydrogenase activity or
      uncoupling protein (UCP) content. However, cell recovery after 24 h was
      significantly reduced in the absence of NE. In brown adipocytes isolated from
      rat, NE increased [35S]methionine incorporation into cell proteins and UCP. In
      contrast, [35S]methionine incorporation in hamster brown adipocyte proteins and
      UCP was greater than in rat brown fat cells and was not increased by NE. These
      results indicate that although NE may be required for cell survival, it does not
      stimulate protein and UCP synthesis in hamster brown fat cells.

PMID- 8342674
TI  - Supramedullary inputs to cardiovascular neurons of rostral ventrolateral medulla
      in rats.
AB  - Experiments were done to test the hypothesis that selective activation of cell
      bodies in different nuclei known to be involved in central cardiovascular control
      could excite or inhibit the discharge of neurons in the rostral ventrolateral
      medulla (RVLM). It is known that chemical stimulation of the lateral parabrachial
      nucleus (LPBN), locus ceruleus (LC), and lateral hypothalamic area (LHA) in
      anesthetized animals elicits increases (LPBN) or decreases (LC and LHA) in
      arterial pressure. We therefore recorded extracellularly spontaneous activity
      from RVLM units in urethan-anesthetized rats and monitored the changes in firing
      frequency of these neurons during chemical stimulation of one of LPBN, LC, and
      LHA. Thirty-two units were classified as cardiovascular neurons because their
      activity was inhibited by baroreceptor activation (1-3 micrograms phenylephrine
      iv) and displayed a cardiac cycle-related rhythmicity. Chemical stimulation with
      sodium glutamate of arterial pressor sites in the ipsilateral LPBN increased the
      firing frequency (40.3 +/- 1.3%) of 11 cardiovascular neurons. Activation of cell
      bodies in arterial depressor sites in the ipsilateral LC inhibited the firing
      rate (59.1 +/- 7.1%) of 10 cardiovascular neurons and excited 1 unit. Activation
      of cell bodies in arterial depressor sites in the ipsilateral LHA inhibited the
      discharge rate (25.4 +/- 4.7%) of six cardiovascular neurons, excited one unit,
      and did not alter the rate of the remaining three units. These results provide
      direct evidence for the existence of excitatory and inhibitory pathways from
      neurons located in the LPBN, LC, and LHA to cardiovascular neurons in the RVLM.

PMID- 8342675
TI  - Responses to catecholamines in perfused livers of hypothalamic-lesioned rats.
AB  - The responses of hepatic glycogenolysis to catecholamines in ventromedial
      hypothalamus (VMH)-lesioned male rats were examined in perfused livers. Seven
      days after bilateral electrical lesioning of the VMH, the livers were perfused.
      Isoproterenol, a beta-agonist, stimulated greater glucose production in VMH
      lesioned rats than in controls (32.8 vs. 5.6 mumol glucose.h-1.g liver-1), while
      responses to phenylephrine, an alpha-agonist, decreased significantly compared
      with controls (44.4 vs. 69.8 mumol glucose.h-1.g liver-1). There were no
      significant differences in responses of livers to glucagon and vasopressin
      between control and VMH-lesioned rats. Adrenodemedullation showed the same effect
      on beta-responses as lesions in the VMH, but no effect on alpha-responses. Plasma
      epinephrine levels were not detectable with the high-performance liquid
      chromatography analysis in VMH-lesioned rats. The periodicity of plasma
      corticosterone levels was observed in both VMH-lesioned and control rats,
      although daytime increases in plasma corticosterone were blocked by VMH lesions.
      These results suggest that the lesions in the VMH cause changes in the levels of
      adrenergic receptor and that the increase in beta-responses is caused mostly by
      the reduction of plasma epinephrine.

PMID- 8342676
TI  - Single-pass gill extraction and tissue distribution of atrial natriuretic peptide
      in trout.
AB  - A new method is described in the present experiments to quantify atrial
      natriuretic peptide (125I-ANP) extraction from plasma in a single transit through
      the gill vasculature of an unanesthetized trout. Tissue distribution of 125I
      relative to an inert extracellular space marker, 58Co-EDTA, was also measured 1 h
      after injection of 125I-ANP. Single-pass extraction of 125I-ANP by the gill was
      60% in control fish; it fell to 18% in fish previously injected with saline and
      became negative (relative to 58Co-EDTA) after treatment with the clearance (C
      type) receptor inhibitor SC 46542. Approximately 90% of a 125I-ANP bolus injected
      into control trout is removed from the circulation within 2 min. 125I
      concentration in gill tissue was nearly seven times greater than that predicted
      by the 58Co-EDTA space. 125I was also concentrated in brain (2X), gallbladder,
      gastrointestinal tract, and eye (all 1X). SC 46542 decreased gill 125I binding
      from seven times to one times the 58Co-EDTA space and increased 125I accumulation
      in heart, kidney, fat, and skeletal muscle. Extraction of 125I-ANP by the
      isolated perfused gill was 53%, similar to that observed in vivo. These results
      show that the gill is a major site for ANP removal from trout plasma and that C
      type receptors are predominant in this process.

PMID- 8342677
TI  - Effects of capsaicin on micturition and associated reflexes in rats.
AB  - The effect of capsaicin on micturition and associated reflexes was studied in
      urethan-anesthetized female rats. Capsaicin or vehicle solution were administered
      4 days before the experiment in a dose of 125 mg/kg sc or during the experiment
      in a dose of 50-100 mg/kg sc. Activity of the urinary bladder was recorded by
      measuring intravesical pressure via a urethral catheter while slowly filling
      (0.052 ml/min) the bladder or when the bladder was distended beyond the
      micturition threshold and maintained at a constant volume. Pretreatment with
      capsaicin did not significantly change various parameters of urinary bladder
      function including micturition volume threshold or the amplitude, duration, and
      interval between reflex bladder contractions. However, capsaicin pretreatment
      significantly reduced (80% decrease) the arterial pressor responses accompanying
      reflex bladder contractions and reduced by approximately one-half the percentage
      of animals in which bladder activity was inhibited by stimulation of the uterine
      cervix. A large dose of capsaicin (50 mg/kg sc) elicited an acute block of
      bladder activity that persisted for 8-15 h. This effect is attributable to an
      action on myelinated afferent or efferent components of the micturition reflex
      pathway. It is concluded that capsaicin-sensitive afferents are not essential for
      the performance of micturition in the rat. However, these afferents are involved
      in cervicovesical reflex mechanisms that modulate bladder activity and in
      vascular reflexes triggered by isometric bladder contractions.

PMID- 8342678
TI  - Fate of circulating amino-terminal propeptide of type III procollagen in
      conscious pigs.
AB  - The amino-terminal propeptide of type III procollagen (PIIINP, M(r) 42,000) is a
      promising marker for the formation of type III collagen of granulation tissue in
      experimental and clinical studies. The disposal kinetics of circulating PIIINP
      is, however, almost unknown. In conscious pigs with a thoracic duct-venous shunt,
      125I-labeled PIIINP was injected intravenously. The initial distribution volume
      was 2.2 liters, which was 1.7 times the plasma volume (P < 0.01). The
      disappearance curve was three-phased, with an initial steep decline (t1/2 58
      min), followed by two slower phases (t1/2 239 min and 289 h). Consecutive gel
      filtrations showed that the initial slope of the plasma disappearance curve
      corresponded to the plasma clearance of the intact PIIINP. The initial plasma
      clearance was 26.5 ml plasma/min, whereas the urinary clearance was 8.7 ml
      plasma/min (P < 0.01). The other components of the plasma disappearance curve
      originated from the formation and disappearance of a high and a low molecular
      weight (MW) fraction as part of the degradation of PIIINP. The high MW fraction
      (approximately M(r) 90,000) was similar to a previously described, but not
      further characterized, PIIINP immunoreactive component. The existence of the low
      MW fraction (approximately M(r) 20,000) has not been reported before. The
      lymphatic recirculation of intact PIIINP was rapid, and the lymph-serum ratio was
      almost constant within 1 h of injection. We conclude that the t1/2 of circulating
      PIIINP is 58 min, that PIIINP escapes the circulation very quickly, and that the
      degradation of PIIINP includes at least two intermediary steps.

PMID- 8342679
TI  - Inhibition of chemoreceptor inputs to nucleus of tractus solitarius neurons
      during baroreceptor stimulation.
AB  - The reflex effects of arterial chemoreceptor activation are attenuated as
      arterial pressure is elevated and augmented as arterial pressure is decreased.
      This study was designed to test the hypothesis that excitatory arterial
      chemoreceptor inputs to neurons in the nucleus tractus solitarius (NTS) are
      inhibited by arterial baroreceptors. In pentobarbital sodium-anesthetized,
      mechanically ventilated, paralyzed cats, extracellular recordings were obtained
      from NTS neurons, which were excited after brief activation of ipsilateral
      carotid body chemoreceptors. During increases in arterial pressure, carotid sinus
      nerve (CSN)-evoked discharge was 45-112% of the control-evoked discharge at the
      prevailing level of arterial pressure (n = 70). Inhibition of CSN-evoked
      discharge during increased arterial pressure was significant when evoked
      discharge was < 90% of control (n = 31; 67 +/- 2%, mean percent of control-evoked
      discharge +/- SE; P < 0.01, Wilcoxon signed-rank test). The inhibition of CSN
      evoked discharge was reduced after section of both vagi, both aortic nerves, and
      the contralateral CSN (n = 5, P < 0.05). These results demonstrate that
      activation of arterial baroreceptors attenuates excitatory chemoreceptor inputs
      to a subpopulation of NTS neurons. The inhibition appears to be mediated by
      disfacilitation. The results indicate that baroreceptor modulation of arterial
      chemoreflexes occurs at an early stage of the reflex arc, within the NTS. The
      results also suggest that sympathoinhibition evoked by baroreceptors might
      include, as a component, reduced sympathoexcitatory, i.e., chemoreceptor, drive.

PMID- 8342680
TI  - Energy balance and lipid metabolism in transgenic mice bearing an antisense GCR
      gene construct.
AB  - Energy balance and lipid metabolism were investigated in transgenic mice bearing
      an antisense glucocorticoid receptor (GCR) gene construct that impairs the normal
      expression of the GCR gene. Food intake was recorded during the 15 days preceding
      decapitation of adult normal and transgenic mice, and feces were collected to
      derive the digestible energy intake. Body composition measurements consisted of
      the determination of energy, protein, and fat content of the carcass. Carcass
      energy was determined by bomb calorimetry, whereas carcass protein was measured
      by the Kjeldahl procedure. Energy expenditure was estimated from the continuous
      oxygen consumption (VO2) monitoring over a 24-h period. Lipoprotein lipase (LPL)
      activity was quantified in epididymal white adipose tissue (WAT), heart, and
      vastus lateralis muscle (VLM) by measuring the in vitro hydrolysis of labeled
      triolein in the presence of tissue homogenates. Norepinephrine (NE) content of
      both interscapular brown adipose tissue (BAT) and heart were determined by high
      performance liquid chromatography (HPLC). Energy intake and expenditure were
      significantly lower in transgenic mice than in controls. Concurrently, both fat
      content and total energy of the carcasses were significantly higher in the
      transgenic animals. In comparison with normal mice, heart and VLM LPL activity
      was significantly reduced in transgenic mutants. There was no difference between
      groups in LPL activity in WAT. Finally, heart and BAT NE contents were lower in
      transgenic animals than in control mice. These results suggest that a defective
      GCR system may affect energy balance through increasing energetic efficiency, and
      they emphasize the modulatory effects of hypothalamic-pituitary-adrenal axis
      changes on muscle LPL activity.

PMID- 8342681
TI  - Possible involvement of brain oxytocin in modulating vasopressin antipyretic
      action.
AB  - Experiments were undertaken to test whether oxytocin (OT) may modulate the
      antipyretic action of arginine vasopressin (AVP) and to determine whether the
      action of endogenously released OT and/or AVP evoked by fever may modulate the
      motor actions of exogenous AVP. Intracerebroventricular (icv) injection of
      interleukin-1 alpha (IL-1 alpha, 40 ng) elicited a significantly attenuated rise
      in body temperature during the 2nd h of the febrile responses in OT-pretreated
      (0.1-10 pmol icv, 24 h earlier) rats. At the end of the 2nd h, administration of
      AVP (1 pmol icv), but not OT (10 pmol icv), significantly suppressed the febrile
      response in OT-pretreated but not in saline-pretreated rats. In nonfebrile OT
      pretreated rats, 10 but not 1 pmol of AVP (icv) caused a significant decrease in
      body temperature. In rats pretreated with IL-1 alpha (40 ng icv) injection of AVP
      (100 pmol icv) induced enhanced motor responses. In summary, the ability of OT
      pretreatment to alter the febrile response to IL-1 alpha and the antipyretic
      action of AVP suggests a role for this peptide in fever. Furthermore, the
      observation that fever pretreatment can lower the threshold for convulsive-like
      behavior evoked by subsequent exposure to AVP raises the possibility that central
      OT and/or AVP released during fever could play a role in the genesis of febrile
      convulsions.

PMID- 8342682
TI  - Metabolism and energetics in squid (Illex illecebrosus, Loligo pealei) during
      muscular fatigue and recovery.
AB  - The concentrations of intermediate and end products of anaerobic energy
      metabolism and of free amino acids were determined in mantle musculature and
      blood sampled from cannulated, unrestrained squid (Loligo pealei, Illex
      illecebrosus) under control conditions, after fatigue from increasing levels of
      exercise, and during postexercise recovery. Phosphagen depletion, accumulation of
      octopine (more so in Illex than in Loligo), and accumulation of succinate
      indicate that anaerobic metabolism contributes to energy production before
      fatigue. Proline was a substrate of metabolism in Loligo, as indicated by its
      depletion in the mantle. In both species, there was no evidence of catabolism of
      ATP beyond AMP. A comparison of the changes in the free and total levels of
      adenylates and the phosphagen indicates an earlier detrimental effect of fatigue
      on the energy status in Loligo. The acidosis provoked by octopine formation in
      Illex was demonstrated to promote the use of the phosphagen and to protect the
      free energy change of ATP such that the anaerobic scope of metabolism during
      swimming is extended and expressed more in Illex than in Loligo. In both species,
      there was no decrease in the sum of phospho-L-arginine, octopine, and L-arginine,
      and thus no release of octopine from the mantle, thereby supporting our earlier
      claim that octopine and associated protons are recycled in the mantle tissue.
      Overall, the metabolic strategy of Loligo is much less disturbing for the acid
      base status. This strategy and the alternative strategy of Illex to keep
      acidifying protons in the tissue may be important for the protection of
      hemocyanin function in the two species.

PMID- 8342683
TI  - Acute phase response in exercise. III. Neutrophil and IL-1 beta accumulation in
      skeletal muscle.
AB  - Nine untrained men (22-29 yr) performed 45 min of downhill running (16% incline,
      70% of maximum heart rate). Needle biopsies of the vastus lateralis were
      performed before, 45 min after, and 5 days after exercise. Immunohistochemical
      staining of muscle cross sections revealed a 135% increase in muscle interleukin
      1 beta (IL-1 beta) immediately after and a 250% increase (P < 0.03) 5 days after
      exercise. Using a rating scale (0-3) for the presence of neutrophils, light
      microscopic examination showed a significant accumulation of neutrophils in
      muscle biopsies taken 45 min after and 5 days after exercise [before: 0.5 +/-
      0.2, 45 min after: 1.5 +/- 0.3 (P < 0.01), and 5 days after: 1.2 +/- 0.2 (P <
      0.04)]. In addition, electron microscopic analysis showed an increase in the
      percentage of damaged Z-bands relative to total Z-bands [before: 4.8 +/- 3.5%, 45
      min after: 32.5 +/- 8.6% (P < 0.05), and 5 days after: 14.1 +/- 3.2%]. Neutrophil
      accumulation was positively correlated to intracellular Z-band damage (rho =
      0.66, P < 0.001). Immunohistochemical staining for IL-1 beta was related to
      neutrophil accumulation in muscle (rho = 0.38, P < 0.06) and to plasma creatine
      kinase levels (rho = 0.416, P < 0.04). These data indicate that after eccentric
      exercise ultrastructural damage to skeletal muscle is associated with neutrophil
      infiltration and muscle IL-1 beta accumulation.

PMID- 8342684
TI  - Volume-regulatory amino acid transport in erythrocytes of the little skate, Raja
      erinacea.
AB  - Skate erythrocytes swell in a hypotonic medium and then reduce their volume
      mainly by releasing the beta-amino acids taurine and beta-alanine. Although these
      amino acids exhibit a net efflux, Na(+)-independent influx is also increased.
      Both the reduction in cell volume and increase in amino acid transport are
      inhibited by several inhibitors of band 3-mediated anion transport, including
      4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS) [L. Goldstein and S. R.
      Brill, Am. J. Physiol. 260 (Regulatory Integrative Comp. Physiol. 29): R1014
      R1020, 1991]. The objective of the present investigation was to further
      characterize the mechanism of volume-activated amino acid transport. Na(+)
      independent amino acid uptake was studied because of the ease in controlling
      amino acid concentrations. Na(+)-independent taurine uptake was observed to be
      linear over a range of 0.1-15 mM and was not inhibited by 10 mM beta-alanine,
      suggesting that the transporter may be a channel rather than a carrier. The
      uptake of a variety of amino acids was examined to characterize the size of the
      putative channel. Glycine, beta-alanine, taurine, proline, gamma-aminobutyric
      acid (GABA), and threonine exhibited volume-activated transport that was DIDS
      inhibited, whereas aspartic acid, leucine, methionine, and ornithine were not
      transported. On the basis of the size of these amino acids, it appears that
      molecules containing eight or fewer major atoms and having a molecular mass of <
      125-131 Da are transported during volume activation but larger molecules are not.
      We estimate the size of the channel to be 5.7-6.3 A in diameter.

PMID- 8342685
TI  - High blood pressure maintenance in transgenic mRen-2 vs. Lyon genetically
      hypertensive rats.
AB  - The present work was aimed to assess the factors involved in the maintenance of
      hypertension in adult transgenic mRen-2 (TG) rats. Special attention was paid to
      the renal handling of sodium, the sympathetic, and the renin-angiotensin system
      (RAS) activity. TG rats were compared with age-matched Lyon genetically
      hypertensive rats (LH), as both are of Sprague-Dawley origin. Blood pressure
      (BP), heart rate, and renal sympathetic nerve activity (RSNA) were recorded in
      conscious freely moving animals. Kidneys were isolated and single-pass perfused
      at different pressure levels. It was observed that the peripheral sympathetic
      drive was identical in TG and LH rats as indicated by their similar 24-h urinary
      excretion of catecholamines and methoxylated metabolites, baseline RSNA and its
      control by the baroreflex, and hypotensive response to ganglion-blockade. On the
      contrary, TG rats differed from LH rats by a more rapid excretion of an oral
      isotonic sodium load, a greater hypotensive and natriuretic response to
      furosemide, and a more marked BP response to acute RAS blockade. The TG kidney
      responses to stepwise changes in renal perfusion pressure (RPP) differed from
      those of LH rats by significantly higher perfusate flow and glomerular filtration
      rate. However, the pressure natriuresis curve of TG kidneys did not differ from
      that of LH rats because of an elevated tubular sodium reabsorption rate. These
      results suggest that adult TG rats, compared with LH rats, exhibit a tendency
      toward sodium and water retention, which may explain that despite low renal and
      circulating renin levels, the RAS remains involved in the maintenance of high BP
      in that model.

PMID- 8342686
TI  - Cerebrovasodilation elicited by fastigial stimulation is preserved under deep
      halothane anesthesia.
AB  - We studied the effect of halothane anesthesia on the increases in cerebral blood
      flow (CBF) and arterial pressure (AP) elicited by electrical stimulation of the
      cerebellar fastigial nucleus (FN). Rats were anesthetized (0.75-2% halothane),
      instrumented for continuous recording of AP, and ventilated. The FN was
      stimulated through stereotaxically implanted microelectrodes. In CBF experiments
      the elevations in AP resulting from FN stimulation were eliminated by spinal cord
      transection at C1. After cord transection AP was maintained by intravenous
      phenylephrine. CBF or cerebral glucose utilization (CGU) was measured by laser
      Doppler flowmetry or the 2-deoxyglucose method, respectively. FN stimulation
      produced increases in CBF that were graded with the intensity (10-150 microA) or
      frequency (10-150 Hz) of stimulation. At 1% halothane, FN stimulation (100
      microA; 75 Hz; n = 8) increased CBF by 123 +/- 16%. The elevations in CBF were
      attenuated by increasing levels of halothane anesthesia in a dose-dependent
      manner. At halothane concentrations of 1.5 and 2% the CBF response to FN
      stimulation (100 microA; 75 Hz) was reduced by 58 +/- 6 and 77 +/- 4%,
      respectively (p < 0.05 from 0.75% halothane; analysis of variance and Tukey's
      test). In contrast, the increases in CBF elicited by hypercapnia were not
      attenuated (P > 0.05 from 0.75% halothane). At 1% halothane, FN stimulation did
      not change CGU in neocortex (frontal cortex: unstimulated 48 +/- 6, mumol.100 g
      1.min-1, FN stimulation: 47 +/- 11; P > 0.05; n = 5/group). In the group of rats
      in which the pressor response was studied (n = 7), halothane produced a dose
      dependent attenuation of the elevations in AP. The degree of attenuation of the
      AP response was comparable to that of the CBF response (P > 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8342687
TI  - Carotid baroreflex control during hemorrhage in conscious and anesthetized dogs.
AB  - The hypothesis was tested that carotid baroreflex gain is increased after 20%
      hemorrhage. The baroreceptor reflex responses to changes in carotid sinus
      pressure (CSP) were measured in control, 20% hemorrhage, and reinfusion
      conditions in three experimental groups: conscious intact (n = 7), anesthetized
      intact (n = 8), and anesthetized vagotomized (n = 8) dogs. Mean arterial pressure
      (MAP), heart rate (HR), cardiac output (CO), stroke volume (SV), and calculated
      total peripheral resistance (TPR) responses to changes in CSP were measured. At
      any given CSP, MAP, CO, and SV all decreased significantly with the 20%
      hemorrhage, as reflected by a downward shift in the reflex characteristic curve
      with no change in overall reflex range or gain. In contrast, TPR and HR responses
      to CSP were not significantly altered by 20% hemorrhage; reflex curves and gains
      were comparable to control conditions. In the conscious intact dogs, the maximal
      reflex gain, Gmax, for the MAP response was -1.365 +/- 0.25, -1.298 +/- 0.33, and
      -1.324 +/- 0.25 in control, 20% hemorrhage, and reinfusion conditions,
      respectively, and was not significantly altered by hemorrhage. In the same group,
      the Gmax for the HR response was -1.792 +/- 0.65, -1.709 +/- 0.33, and -1.986 +/-
      0.67 in control, 20% hemorrhage, and reinfusion conditions, respectively;
      baroreflex gain on HR was not increased with hemorrhage. Plasma arginine
      vasopressin (AVP), an increase in which has been proposed to augment baroreflex
      gain, increased from a control level of 0.98 +/- 0.27 to 9.66 +/- 2.67 pg/ml
      during 20% hemorrhage in the conscious intact dogs; despite the increase in
      plasma AVP during hemorrhage, augmentation of baroreflex gain was not
      observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342688
TI  - Hormonal, fluid, and electrolyte responses of sheep during chronic intravenous
      infusion of epidermal growth factor.
AB  - Epidermal growth factor (EGF) has been shown to increase water intake and urine
      volume. To further characterize these responses the effects of EGF on fluid
      balance, electrolyte, and hormone profiles were examined. After an 8-day control
      period, ewes received intravenous EGF at doses of 0 (n = 6), 2 (low dose, n = 6),
      10 (medium dose, n = 6), or 20 micrograms/h (high dose, n = 5) for 4 days. During
      EGF treatment, water intake and urine volume increased (both P < 0.001) in a dose
      related fashion, although fluid balance was unaffected. Feed intake and fecal dry
      matter output were reduced (both P < 0.001) by the two higher doses of EGF. EGF
      had no effect on plasma potassium, sodium, or osmolality, but there was a dose
      related natriuresis (P < 0.001). Treatment with EGF increased plasma renin
      activity and aldosterone in the medium and high dose groups (both P < 0.001).
      Thus chronic intravenous infusion of 10-20 micrograms EGF/h into sheep caused
      polydipsia, polyuria, and natriuresis with neutral fluid balance. Whether the
      resultant polydipsia or polyuria was the primary response to EGF remains unclear.

PMID- 8342689
TI  - Chronic alcohol consumption increases sensitivity to the anorexic effect of
      cholecystokinin.
AB  - In this study we examined the ability of intraperitoneal cholecystokinin COOH
      terminal octapeptide (CCK-8; 0.2, 0.6, and 2.0 micrograms/kg) to suppress food
      intake in rats that had consumed a control diet, 6-8 g.kg-1.day-1 of ethanol
      (EtOH) in sucrose, or sucrose alone for 6 mo. Both the EtOH- and sucrose-fed rats
      developed significant dietary obesity. After 3 mo, the EtOH group was
      significantly more sensitive to CCK-8 than the sucrose and control groups, while
      the responses of the sucrose and control groups were comparable. In contrast,
      after 6 mo the EtOH and sucrose groups' response to CCK-8 was no longer
      significantly different. After 6 mo there were no significant differences in
      basal or postprandial plasma CCK-8 levels. The sucrose group had significantly
      higher basal insulin levels than the control and EtOH groups, and postprandial
      insulin levels, relative to basal, were significantly elevated in the EtOH group.
      Basal glucose levels did not differ among groups. Postprandial glucose levels
      (relative to baseline) were significantly lower in the EtOH group compared with
      the other groups and in fact never rose above baseline levels. These results are
      consistent with the hypothesis that EtOH, when taken on a chronic basis,
      increases the sensitivity to CCK-8.

PMID- 8342690
TI  - Integration of oral habituation and gastric signals in decerebrate rat pups.
AB  - During a series of oral infusions of a sweet solution, the ingestive responses of
      young rat pups habituate; pups stop responding to the infusions even when their
      stomachs are empty and the infused diet is nonnutritive. The rate of this oral
      habituation is enhanced by the addition of gastric fill signals, even in
      decerebrate pups. In intact but not in decerebrate pups, prior deprivation gates
      out the influence of gastric fill on habituation. This oral habituation system,
      responsive to multiple ingestion-related signals, may serve as the elemental
      process that integrates physiological state with ongoing behavior to control
      ingestion.

PMID- 8342691
TI  - Vasopressin, renin, and cortisol responses to hemorrhage during acute blockade of
      cardiac nerves in conscious dogs.
AB  - The effect of acute cardiac nerve blockade (CNB) on the increases in plasma renin
      activity (PRA), arginine vasopressin (AVP), and cortisol in response to a 30
      ml/kg hemorrhage was determined in conscious dogs (n = 9). Procaine was infused
      into the pericardial space to produce acute reversible CNB, or saline was infused
      in the control hemorrhage. Blood was removed from the inferior vena cava at a
      rate of 1 ml.kg-1.min-1. In the control hemorrhage, plasma AVP increased from 1.8
      +/- 0.3 to 219 +/- 66 pg/ml, PRA increased from 0.63 +/- 0.20 to 3.08 +/- 0.91 ng
      angiotensin I (ANG I).ml-1.3 h-1, and cortisol increased from 1.4 +/- 0.2 to 4.0
      +/- 0.7 micrograms/dl. When the hemorrhage was repeated during acute CNB, plasma
      AVP increased from 2.8 +/- 1.6 to 185 +/- 59 pg/ml, PRA increased from 0.44 +/-
      0.14 to 2.24 +/- 0.27 ng ANG I.ml-1.3 h-1, and cortisol increased from 1.9 +/-
      0.3 to 5.4 +/- 0.6 micrograms/dl, and none of the increases differed
      significantly from the responses during the control hemorrhage. Left atrial
      pressure fell significantly after removal of 6 ml/kg of blood, but mean arterial
      pressure was maintained at control levels until blood loss reached 20 ml/kg
      during pericardial infusion of either saline or procaine. The declines in MAP at
      the 30 ml/kg level of hemorrhage in both treatments were similar. These results
      demonstrate that acutely blocking input from cardiac receptors does not reduce
      the increases in plasma AVP, cortisol, and PRA in response to a 30 ml/kg
      hemorrhage. The results of this study do not support the hypothesis that input
      from cardiac receptors is required for a normal AVP response to hemorrhage and
      suggest that other receptors, presumably arterial baroreceptors, can stimulate
      AVP and cortisol secretion in the absence of signals from the heart.

PMID- 8342692
TI  - Effects of centrally and systemically administered indomethacin on body
      temperature in exercising rats.
AB  - Subcutaneous and intracerebroventricular (icv) injections of indomethacin were
      used to test whether prostaglandin synthesis is essential for the exercise
      induced increase in a rat's body temperature. At an air temperature of 24 degrees
      C, male Wistar rats ran on a treadmill at 10-15 m/min 20 min after 300-micrograms
      icv injection or 60 min after 15-mg/kg sc injection of indomethacin or of control
      vehicle. The rectal temperature (Tre) of control rats in 17 control experiments
      increased by 1.0 degree C during exercise, whereas the Tre of the rats pretreated
      with intracerebroventricular indomethacin increased by only 0.4 degrees C.
      Threshold Tre for tail vasodilation was significantly lower in rats pretreated
      with indomethacin than the control rats (38.4 +/- 0.1 vs. 38.9 +/- 0.1 degrees
      C), but O2 uptake did not differ between indomethacin-pretreated and control
      rats. Subcutaneous injection of indomethacin did not affect the body temperature,
      tail vasomotor activity, or O2 uptake of exercising rats. Intracerebroventricular
      indomethacin did not affect Tre or tail vasomotor activity of rats resting at
      ambient temperatures of 24 and 28 degrees C. Present results suggest that
      prostaglandin synthesis is required for the vasoconstrictive effect of exercise
      on skin blood vessels and thus for the exercise-induced elevation of body
      temperature.

PMID- 8342693
TI  - Meal-induced c-fos expression in brain stem is not dependent on cholecystokinin
      release.
AB  - Sprague-Dawley rats injected with a "physiological" dose of cholecystokinin
      octapeptide (CCK-8; 6 micrograms/kg ip) expressed c-fos immunoreactivity in the
      nucleus of the tractus solitarius (NTS) and the area postrema (AP) of the brain
      stem. Injection of the CCK-A antagonist L-364,718 30 min before CCK-8 injection
      eliminated c-fos expression in these regions. These findings support the
      hypothesis that CCK-8 induced c-fos expression is mediated by CCK-A receptors. We
      then tested whether a meal (Isocal) could activate c-fos, and, if so, whether
      this response could be eliminated by L-364,718. Ingestion of Isocal induced c-fos
      immunoreactivity in the NTS and AP. Meal-induced c-fos expression was not blocked
      by the CCK-A antagonist L-364,718. These findings demonstrate for the first time
      that a purely physiological nonnoxious stimulus, a meal, induces c-fos in the rat
      brain stem and indicate that feeding induces c-fos expression by a pathway that
      is largely, if not entirely, independent of CCK release.

PMID- 8342695
TI  - Glucagon and insulin regulate lipolysis in trout liver by altering
      phosphorylation of triacylglycerol lipase.
AB  - Rainbow trout were used to investigate the hormonal regulation by glucagon and
      insulin of hepatic triacylglycerol (TG) lipase activation. Two purified
      preparations of the trout hepatic TG lipase enzyme, the 110,000-g preparation and
      the resuspended ammonium sulfate fraction (ASF), were activated up to 58% with
      (in mM) 0.5 ATP, 0.01 cAMP, 5 MgCl2, and exogenous protein kinase over control
      levels. ATP or cAMP alone had no effect on activation. Activation of the trout
      hepatic lipase was reversible; complete inactivation of the ASF was obtained
      within 3 h in the presence of exogenous phosphorylase phosphatase. Adenosine
      3',5'-cyclic monophosphate (cAMP)/ATP-dependent 32P-phosphorylation of trout
      hepatic lipase was observed within 5 min of incubation with the cAMP/ATP-Mg2+
      activation system and 25 microCi [32P]ATP. Hormonal modulation of trout hepatic
      lipase phosphorylation was studied in isolated hepatocytes. Hepatocytes were
      incubated with [32P]-monopotassium phosphate for 3 h, then exposed to mammalian
      glucagon (GLU). Within 5 min, increased lipolysis was accompanied by a 95%
      increase in phosphorylation of the enzyme. Mammalian insulin (INS) depressed GLU
      stimulated phosphorylation by 56% and inhibited GLU-stimulated lipolysis. These
      results indicate that GLU and INS modulate lipolysis in trout liver by altering
      phosphorylation of the TG lipase enzyme.

PMID- 8342694
TI  - Reanalysis of the rat proestrous LH surge by deconvolution analysis.
AB  - To evaluate the temporal mechanisms that give rise to the spontaneous proestrous
      surge of luteinizing hormone (LH) in the rat, we have applied deconvolution
      analysis to earlier immunoreactive LH concentration vs. time profiles obtained by
      sampling blood in proestrus at 2- to 3-min intervals in 10 animals over a span of
      160-300 min. Six other animals were bled in 6-min intervals on day 1 of diestrus.
      Deconvolution analysis permitted us to calculate the number, duration, amplitude
      (maximal release rates), and mass of underlying LH secretory bursts and to
      simultaneously estimate basal secretion and the half-life of endogenous LH in
      each animal. Proestrus rats exhibited a significant increase in the number of
      computer-identified LH secretory bursts per hour (1.8 +/- 0.2 vs. 1.1 +/- 0.01 on
      diestrus, P < 0.01), with a corresponding reduction in the LH intersecretory
      burst interval from 61 +/- 6.4 min (diestrus) to 25 +/- 2.7 min (proestrus, P <
      0.01). There was a remarkable 16-fold increase in the mass of LH secreted per
      burst, which rose from 72 +/- 5.2 to 1,230 +/- 200 ng/ml (P < 0.01). This
      resulted from a sixfold increase in LH secretory burst amplitude and a doubling
      of burst duration. The total amount of LH released in a burstlike fashion during
      the proestrous LH surge rose 20-fold, and calculated basal LH secretion increased
      to approximately 25% of this value. Of interest, the computed half-life of
      endogenous LH also increased from 10 +/- 1.1 to 19 +/- 3.7 min (P <
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342696
TI  - The circadian melatonin and cortisol secretion pattern in permanent night shift
      workers.
AB  - In permanent night shift workers the impact of environmental time cues on the
      circadian system is conflicting. Rhythm adjustments to the nocturnal work
      schedule have been described, and their significance for tolerance to shift work
      is under discussion. Reports concerning the effect of this work situation on the
      setting of the endogenous clock are, however, inconsistent. We examined nine
      healthy young male permanent shift workers with high work satisfaction at the end
      of a week on night work and seven male controls with normal diurnal working
      hours. All subjects were admitted to a research facility for 28 h, and blood was
      collected with a continuous-withdrawal pump in portions taken hourly for the
      estimation of the circadian melatonin (MT) and cortisol secretion pattern. One
      control did not exhibit a circadian secretion pattern. When compared with the
      other controls (n = 6), all except one of the shift workers showed no difference
      in the phase or phase relationship of their hormonal profiles. In the shift
      workers, a minor trend toward elevation of the MT amplitude and an increase in
      two indicators for the amount of MT secreted were noticed. One individual
      displayed inverse hormone rhythms with an undisturbed phase relationship of MT
      and cortisol and inconspicuous hormone amplitudes. He showed, however, an inverse
      day-night rhythm in his private life, too. The data collected suggest that even
      permanent night workers with a high degree of work satisfaction do not usually
      lose the diurnal orientation of their endogenous clock. Factors other than
      reorientation of the circadian system may be more important for high tolerance to
      shift work.

PMID- 8342697
TI  - Somatic and visceral inputs to neurons of the rostral ventrolateral medulla.
AB  - Sympathoexcitatory neurons in the rostral ventrolateral medulla (RVLM) play an
      essential role in the generation of basal sympathetic tone and in the reflex
      regulation of blood pressure. In this study responses of RVLM "cardiovascular"
      neurons to somatic and visceral afferent stimulation were investigated. The
      activity of 34 RVLM neurons was recorded in urethan-anesthetized paralyzed and
      artificially ventilated rats. These neurons were identified as cardiovascular
      based on their baroreceptor sensitivity and their pulse-synchronous discharge.
      Electrical stimulation of the sciatic nerve excited 31 of the 34 RVLM units
      (91%). Renal nerve stimulation inhibited firing of 14 of 22 RVLM neurons tested
      (64%), not affecting the remaining 8 units. Stimulation of splenic nerves
      inhibited the discharge of 7 of 12 RVLM neurons tested (58%), whereas the
      remaining 5 units were not affected. All RVLM units responsive to visceral
      afferent stimulation were also responsive to sciatic nerve stimulation. These
      results indicate that RVLM cardiovascular neurons receive somatic and visceral
      inputs, suggesting an involvement of these units in the integration of
      homeostatic responses to changes in the internal and external environment.

PMID- 8342699
TI  - Anoxia-tolerant hepatocytes: model system for study of reversible metabolic
      suppression.
AB  - Chrysemys picta bellii is well known for its ability to survive extended anoxic
      periods and has been widely used as a model system to study anoxic metabolism.
      Described here is a method for the isolation of anoxia-tolerant hepatocytes from
      this species. Freshly isolated hepatocytes were determined to be viable based on
      trypan blue exclusion, gluconeogenic capacity from [14C]lactate, responsiveness
      to epinephrine and glucagon, and maintenance of cellular adenylate
      concentrations. Under anoxic conditions for 10 h there was no significant
      increase in cell staining and no decrease in cellular ATP concentration.
      Furthermore, the addition of cyanide at the 5-h mark did not result in any
      significant differences in these parameters; however, iodoacetate added at this
      time caused trypan blue staining to increase and ATP concentrations to fall. The
      rate of glucose production from the cells was threefold greater under anoxic than
      normoxic conditions, underscoring the important role of the liver in supplying
      substrate during anoxia. From the rate of O2 consumption and rate of lactate
      production under anaerobic conditions, ATP turnover rates were calculated to be
      68.4 +/- 7.2 and 6.5 +/- 0.43 mumol ATP.g-1.h-1, respectively; this corresponds
      to a 90% decrease in metabolic rate during anoxia. Within a cellular system such
      as this the more complex regulatory mechanisms involved in a large coordinated
      reduction in metabolism can be probed.

PMID- 8342698
TI  - Response of protein synthesis to anoxia and recovery in anoxia-tolerant
      hepatocytes.
AB  - Hepatocytes from the western painted turtle (Chrysemys picta bellii) display a
      profound metabolic suppression under anoxia. Fractional rates of protein
      synthesis fell by 92% during 12 h anoxia at 25 degrees C and were
      indistinguishable from the rate obtained with cycloheximide. Normoxic recovery
      saw protein synthesis increase to 160% of control values and return to normal
      after 2 h. The GTP-to-GDP ratio, implicated in the control of translation, fell
      threefold during anoxia. Purine nucleotide phosphate profiles suggest that this
      change occurs through increasing concentrations of ADP and GDP, with
      concentrations of ATP and GTP and total purines remaining constant. The normoxic
      cost for protein synthesis was calculated at 47.6 +/- 6.8 mmol ATP/g protein.
      Normoxic protein synthesis accounted for 36% of overall ATP turnover rates, close
      to the extent of O2 consumption inhibitable by cycloheximide (28%). Under anoxia,
      the proportion of ATP turnover utilized by protein synthesis did not change
      significantly. ATP turnover rates for urea synthesis reflected a similar pattern,
      falling 72% under anoxia. These results reflect the cell's ability to suppress
      protein synthesis under anoxia in a manner that is coordinated with the reduction
      in total metabolic rate.

PMID- 8342700
TI  - Angiotensin-converting enzyme inhibition and Na appetite: microbehavioral
      analysis and nycthemeral physiology.
AB  - The present experiments describe a marked nycthemeral rhythm in both the appetite
      for 0.3 M NaCl solution and components of the renin-angiotensin-aldosterone axis
      stimulated in Sprague-Dawley rats by chronic administration of enalapril, an
      angiotensin I-converting enzyme inhibitor. Continuous recording of water, NaCl,
      and food intakes shows that the sodium appetite is manifest as discrete bouts of
      salt ingestion in temporal proximity to meals and is partially independent of
      water bouts. In particular, salt bouts occur without water bouts in the late
      afternoon of a 12:12-h light-dark cycle and continue periprandially with water
      bouts during the night. Intake of all three commodities is minimal in the
      morning. In a second experiment, it was determined that plasma renin activity
      (PRA) was maximally elevated by chronic enalapril in the daytime and that plasma
      aldosterone was reduced by enalapril but continued to show nycthemeral rhythm
      peaking in the afternoon. The concurrent maxima in PRA and aldosterone in the
      afternoon in enalapril-treated rats thus coincides with NaCl intake in the
      absence of water intake.

PMID- 8342701
TI  - Effect of elevated atrial pressure on plasma renin activity in hypotensive fetal
      lambs.
AB  - In adults, renin secretion is stimulated by reductions in arterial pressure and
      inhibited by increases in atrial pressure. In the late gestation fetus, a fall in
      arterial pressure stimulates renin secretion, but it is unknown whether elevation
      of atrial pressure will alter such an increase. Therefore we studied the effect
      of elevated atrial pressure on renin secretion in the presence of nitroprusside
      induced arterial hypotension. Thirteen fetal lambs at 127.9 +/- 0.9 days of
      gestation were prepared 5 days before study with inflatable pulmonary artery
      occluders and right atrial, vascular, and amniotic catheters. Each fetus
      underwent two protocols (hypotension and hypotension with occlusion) using a
      randomized block design. Nitroprusside reduced arterial pressure by 34% in both
      groups. Right atrial pressure during the course of hypotension was significantly
      higher in the occlusion group (F = 14.2, P = 0.001). Plasma renin activity
      increased similarly in both groups during hypotension (F = 6.0, P = 0.003).
      Elevated right atrial pressure did not alter hypotension-induced renin secretion
      in the fetus.

PMID- 8342702
TI  - Endothelin-induced natriuresis and diuresis are pressure-dependent events in the
      rat.
AB  - The goal of the current study was to determine the mechanism by which doses of
      endothelin (ET) that do not markedly affect the glomerular filtration rate (GFR)
      cause a natriuresis and diuresis. ET was infused into pentobarbital-anesthetized
      female rats at 50 ng.kg-1.min-1 iv for 30 min. In controls (n = 6 rats; n = 5 in
      all other groups), ET increased mean arterial blood pressure (MAP) from 95 +/- 2
      to 131 +/- 2 (SE) mmHg, Na excretion (UNa V) from 0.34 +/- 0.07 to 1.83 +/- 0.2
      meq/min, and urine flow rate (V) from 13 +/- 1 to 24 +/- 3 ml/min (all P < 0.01
      vs. baseline). At 15 min during infusion of ET, the GFR was not affected (2.1 +/-
      0.1 to 2.2 +/- 0.1 ml/min) but modestly decreased to 1.8 +/- 0.1 ml/min at 30 min
      (P < 0.05 vs. baseline). Either removing the capsule from both kidneys during
      surgery or maintaining renal arterial pressure at baseline values with an
      adjustable clamp on the aorta above the right renal artery abolished the ET
      induced increase in UNa V and V. Meclofenamate also did not alter the ET-induced
      increase in MAP, V, or UNa V. To determine the intrarenal site of action of ET,
      experiments were conducted with ET plus amiloride or with a combination of
      amiloride plus furosemide; there was a larger ET-induced diuresis and natriuresis
      in amiloride-treated rats and an even larger response with amiloride plus
      furosemide compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342703
TI  - Effect of outflow pressure on lymphatic pumping in vitro.
AB  - The objective of this study was to determine how lymphatic vessels responded to
      outflow pressure changes in vitro. Bovine mesenteric lymphatics were suspended in
      an organ bath preparation with both inflow and outflow ends cannulated. Input to
      the duct was provided from a reservoir filled with Krebs solution. To initiate
      pumping, a transmural pressure was applied to the ducts by elevating the fluid
      reservoir and outflow catheters and making their heights equal to one another.
      The outflow catheter was then elevated above the liquid in the reservoir in 2
      cmH2O increments, and pumping activity was monitored for 10 min at each outflow
      pressure. Outflow pressures were calculated as the product of the flow rate and
      outflow cannula resistance plus the height of the tip of the outflow catheter
      above the liquid in the organ bath. At low transmural pressures (2-4 cmH2O),
      elevations in outflow pressure often had little effect on flow rates until high
      outflow pressures had been attained. In contrast, elevations in outflow pressures
      resulted in an increasingly rapid decline in flow rates as transmural pressures
      were incrementally increased. The mean power (in mu W) required to produce the
      observed flow rate was estimated at each outflow pressure as the product of the
      flow rate and the pressure across the lymphatic vessel. The ability of the
      lymphatics to generate sustained or enhanced power output in response to an
      increasing outflow pressure challenge was most pronounced at lower transmural
      pressures. As transmural pressures were increased, the range of outflow pressures
      that stimulated increased power production was diminished. We conclude that
      elevations in outflow pressure in an in vitro preparation result in a nonlinear
      decline in flow rates. This nonlinearity is due to an active lymphatic pump
      mechanism.

PMID- 8342704
TI  - On the site of loss: a response to Antokeletz's paper on cross-cultural
      transformation.

PMID- 8342705
TI  - The psychoanalysis of ethnicity and the ethnicity of psychoanalysis. I.

PMID- 8342706
TI  - The negative therapeutic reaction, maternal transference, and obsessions.

PMID- 8342707
TI  - Occupational hazards and characterological vulnerability: the problem of
      "burnout".

PMID- 8342708
TI  - An alternative to the "traumatizing" vacation: the enriching, expansive vacation.

PMID- 8342709
TI  - Analysis interminable reconsidered.

PMID- 8342710
TI  - Prenatal weight gain and postpartum weight retention: a delicate balance.

PMID- 8342711
TI  - Improving cause-of-death statistics: the case of fetal deaths.

PMID- 8342712
TI  - Analyzing socioeconomic and racial/ethnic patterns in health and health care.

PMID- 8342713
TI  - The coding of underlying cause of death from fetal death certificates: issues and
      policy considerations.
AB  - Recently, plans to implement nationwide coding of underlying cause of fetal death
      have been promulgated. To examine the validity and potential utility of
      nationwide coding, this paper presents data from a five-state (Wisconsin,
      Arkansas, Maine, North Carolina, California) analysis of underlying causes of
      fetal death from vital records for 1985 through 1987. Nosological coding rules
      varied somewhat from state to state. Underlying causes were grouped into
      categories; distributions were similar for each state. Many deaths (20.3% to
      32.9%) were coded as unspecified conditions. Congenital anomalies accounted for
      only 6.9% to 10.3% of fetal deaths, including implausible and nonspecific causes.
      In total, 29.5% to 42.8% of the reports were not valid or useful. To obtain
      better data, researchers must focus on improving fetal death reporting, which
      will entail the promotion of comprehensive autopsy, placental and laboratory
      evaluation, systematic vital records query procedures, and implementation of
      multiple-cause-of-fetal-death coding.

PMID- 8342714
TI  - Over-the-counter oral contraceptives--an immodest proposal?

PMID- 8342715
TI  - Should oral contraceptives be available without prescription?
AB  - In this paper, it is argued that oral contraceptives should be available without
      prescription. Prescription status entails heavy costs, including the dollar,
      time, and psychological costs of visiting a physician to obtain a prescription,
      the financial and human costs of unintended pregnancies that result from the
      obstacle to access caused by medicalization of oral contraceptives, and
      administrative costs to the health care system. After a review and evaluation of
      the reasons for strict medical control of oral contraceptives in the United
      States, safety concerns anticipated in response to the proposal discussed here
      are addressed. Also, concerns that prescription status is necessary for
      efficacious use are evaluated. It is concluded that neither safety nor efficacy
      considerations justify prescription status for oral contraceptives. Revised
      package design and patient labeling could allow women to screen themselves for
      contraindications, to educate themselves about danger signs, and to use oral
      contraceptives safely and successfully. Several alternatives to providing oral
      contraceptives by prescription with current package design and labeling and
      selling them over the counter are suggested; the proposals discussed would make
      these safe and effective contraceptives easier to obtain and to use.

PMID- 8342716
TI  - Pregnancy-related weight gain and retention: implications of the 1990 Institute
      of Medicine guidelines.
AB  - OBJECTIVES: Guidelines from the Institute of Medicine's 1990 report call for
      weight gains during pregnancy that are higher than those previously recommended.
      This study examines the potential implications of compliance with these
      guidelines for postpartum weight retention. METHODS: Weight retention 10 to 18
      months following delivery was examined for selected women who had live births in
      the 1988 National Maternal and Infant Health Survey. Women's actual weight gains
      during pregnancy were retrospectively classified according to the Institute of
      Medicine's guidelines. RESULTS: Weight retention following delivery increased as
      weight gain increased, and Black women retained more weight than White women with
      comparable weight gain. The median retained weight for White women who gained the
      amount now being recommended was 1.6 lb whereas that for Black women was 7.2 lb.
      CONCLUSIONS: If pregnant White women gain weight according to the institute's
      guidelines, they need not be concerned about retaining a substantial amount of
      weight postpartum. Our findings suggest, however, that Black women are in need of
      advice about how to lose weight following delivery.

PMID- 8342717
TI  - Factors influencing the practice of vaginal birth after cesarean section.
AB  - OBJECTIVES: Vaginal birth after cesarean has been recommended for most women with
      previous cesarean sections for the past 10 years. This practice, however, has not
      yet been generalized because high variations can still be observed among
      countries, hospitals, and physicians. METHODS: A case-control study involving 635
      case patients and 2593 control patients was carried out to determine which
      characteristics of the physician, the patient, or the hospital were important in
      the adoption of this practice. RESULTS: The results of the multiple stepwise
      logistic regression analysis indicate a higher likelihood that women will
      experience vaginal birth after cesarean if their physicians had cesarean rates
      under 20%, had less than 5% of their patients considered at risk, and were
      younger than 54 years old. Vaginal birth after cesarean was also favored by
      hospitals characterized by a high degree of neonatal and obstetrical
      specialization, and a patient population with a low level of education.
      CONCLUSIONS: This policy is still in the developmental stage, as evidenced by the
      great variability between hospitals and physicians in rates of vaginal birth
      after cesarean. Further efforts are required for this policy to become the norm.

PMID- 8342718
TI  - Variation in cesarean section rates among hospitals in Washington State.
AB  - OBJECTIVES: This study examined hospital characteristics and hospital population
      risk factors and their associations with hospital-specific cesarean section rates
      in Washington State. METHODS: Data were obtained from 1987 birth certificates.
      The study population included all hospitals that had 12 or more singleton live
      births. RESULTS: Hospital-specific cesarean section rates varied from 0% to 43%
      and were positively associated with proprietary ownership, size of delivery
      service, and the proportions of women who had complications or high-birthweight
      infants. The proportion of women who had late prenatal care was inversely
      associated with cesarean section rates. Although proprietary hospitals had higher
      cesarean section rates, their patient populations were lower risk than patients
      of public or teaching hospitals. CONCLUSIONS: Variation in cesarean section rates
      among hospitals cannot be fully explained by either hospital or patient
      population characteristics. A combined strategy may be necessary to lower
      unjustifiably high cesarean section rates.

PMID- 8342719
TI  - Oral contraceptives and the risk of gallbladder disease: a meta-analysis.
AB  - OBJECTIVES: This study was designed to assess the risk of gallbladder disease due
      to oral contraceptive use by conducting a thorough literature review. METHODS:
      Controlled epidemiologic studies published through March 1992 were systematically
      searched and evaluated. Of 25 studies (27 publications), 9 could stand the test
      of critical appraisal with respect to validity. Restriction to these studies was
      judged to circumvent publication bias at the same time. RESULTS: Oral
      contraceptive use is associated with a slightly and transiently increased rate of
      gallbladder disease. The results of six selected studies in which asymptomatic
      women were screened for gallstones were strikingly similar. Pooling of these
      results yielded an odds ratio, for ever vs never oral contraceptive use, of 1.36.
      A dose-effect relationship was indicated, suggesting that modern low-dose oral
      contraceptives are safer than older formulas, but an effect cannot be excluded.
      CONCLUSIONS: Considering the large efforts already devoted to this exposure
      disease relationship, the probably weak effect, and the rapidly changing formulas
      of oral contraceptives, the authors suggest that the safety of new oral
      contraceptives be evaluated by studying bile saturation and biliary function
      rather than by waiting for gallbladder disease to develop.

PMID- 8342720
TI  - Smoking and pregnancy outcome: trends among black teenage mothers in Missouri.
AB  - OBJECTIVES: The purpose of this study is to analyze the smoking changes that have
      occurred among pregnant Black teenagers in Missouri. The study also examines
      changes in Black teenage pregnancy outcomes in relation to smoking behavior
      changes. METHODS: This analysis used computerized data files from the 1978 to
      1990 Missouri birth certificates to acquire information on smoking during
      pregnancy for 41,544 Black teenagers and 105,170 White teenagers. All Missouri
      births with smoking history were included in the study. RESULTS: During the study
      period, the rate for Blacks who smoked during pregnancy decreased from 37% in
      1978 to less than 22% in 1990. A large part of this reduction is attributable to
      Black teenagers, whose smoking-during-pregnancy rate declined from 35.8% to 7.2%.
      Additionally, the Black teenage-specific low-birthweight rate decreased by 13.6%
      over the study period, possibly influenced by the decrease in smoking.
      CONCLUSIONS: The results indicate that a major norm has changed in smoking status
      among pregnant Black teenagers. Understanding the reasons behind this change
      could assist smoking cessation and other health promotion efforts.

PMID- 8342721
TI  - Epidemiologic evidence for a potentiating effect of malnutrition on child
      mortality.
AB  - OBJECTIVES: Despite broad agreement that severe malnutrition contributes to child
      mortality in developing countries and that malnutrition has a physiologically
      synergistic relationship with morbidity, evidence of an epidemiologic synergism
      has been lacking. Also, the literature provides conflicting evidence concerning
      the existence of elevated mortality among children with mild to moderate
      malnutrition. A review of published population-based studies of anthropometry
      mortality relationships was undertaken to clarify these relationships. METHODS:
      Six studies with the relevant data were reanalyzed to test for synergism and
      elevated mortality in mild to moderate malnutrition. RESULTS: The results
      demonstrate that mortality increases exponentially with declining weight for age.
      This effect is consistent across studies and there is no apparent threshold
      effect on mortality. The primary difference across studies is in baseline levels
      of mortality, which determine the quantitative impact of malnutrition on
      mortality in a population. CONCLUSIONS: These results indicate that mild to
      moderate malnutrition is associated with elevated mortality and that there is an
      epidemiologic synergism between malnutrition and morbidity. This previously
      undemonstrated finding has significant implications for child survival policies
      and research.

PMID- 8342722
TI  - Vietnamese infant and childhood mortality in relation to the Vietnam War.
AB  - OBJECTIVES: There is obvious potential for war to adversely affect infant and
      childhood mortality through direct trauma and disruption of the societal
      infrastructure. This study examined trends in Vietnam through the period of the
      war. METHODS: The 1988 Vietnam Demographic and Health Survey collected data on
      reproductive history and family planning from 4172 women aged 15 through 49 years
      in 12 selected provinces of Vietnam. The 13,137 births and 737 deaths to children
      younger than age 6 reported by the respondents were analyzed. RESULTS: For the
      country as a whole, infant and childhood mortality dropped by 30% to 80% from the
      prewar period to the wartime period and was stable thereafter. In provinces in
      which the war was most intense, mortality did not decline from the prewar period
      to the wartime period but declined after the war, consistent with an adverse
      effect during the wartime period. CONCLUSIONS: The data are limited by assignment
      of birth location on the basis of mother's current residence and by inadequate
      information on areas of war activity. Nonetheless, the data do not indicate a
      widespread, sizable adverse effect of the war on national infant and childhood
      mortality in Vietnam but suggest detrimental effects in selected provinces.

PMID- 8342723
TI  - Sexual behavior and exposure to HIV infection: estimates from a general
      population risk index.
AB  - OBJECTIVES: The spread of the human immunodeficiency virus (HIV) in the general
      population has been a much debated topic in the mass media. The aim of this study
      was to create an approach to estimating the risk of exposure to HIV resulting
      from sexual behaviors. METHODS: A theoretical estimate was applied to data
      obtained from a large-scale risk factor survey carried out in Britain. An HIV
      infection-exposure risk index was constructed by ranking different sex-related
      categorizations derived from variables in the survey. RESULTS: The risk index
      involved a Delphi-based assessment of self-reported behavioral factors associated
      with HIV exposure and subsequent transmission. Roughly 85% of the adult
      population aged 18 to 50 were estimated to be at some risk for behavioral
      exposure to HIV virus with regard to reported sexual behavior. Over time, those
      who could be considered at no risk have declined as a proportion of the
      population. CONCLUSIONS: The estimates appear to refute commonplace assertions
      that exposure to HIV through sexual behavior is not a problem for general
      populations.

PMID- 8342724
TI  - HIV risk-related sex behaviors among injection drug users, crack smokers, and
      injection drug users who smoke crack.
AB  - OBJECTIVES: This study was designed to assess and compare sex risk behaviors for
      human immunodeficiency virus (HIV) transmission of three drug user groups:
      injectors who do not smoke crack, crack smokers who do not inject, and injectors
      who also smoke crack. METHODS: Sexual risk behaviors for HIV were assessed among
      246 drug users from Denver, Miami, and San Francisco. Respondents were classified
      into the three drug groups based on self-report and verified through urinalysis
      and physical inspection. RESULTS: An increased risk for HIV through sexual
      transmission was associated with crack cocaine use, particularly among those who
      also injected. Crack smoking injectors were more likely to report sex with an
      injector, exchanging sex for drugs and/or money, drug use before or during sex,
      and unprotected sexual intercourse. They also injected more than injectors only,
      smoked crack as often as smokers only, and reported higher overall frequencies of
      drug use. CONCLUSIONS: These findings, together with the higher rates of
      gonorrhea and syphilis reported by smokers and injectors/smokers, are indicators
      of the risk crack poses for the heterosexual transmission of HIV.

PMID- 8342725
TI  - Frequent cocaine users and their use of treatment.
AB  - OBJECTIVES: Despite decreases in the number of cocaine users since 1985, the
      consequences of cocaine use continue to rise. This paper provides descriptive
      data on frequent cocaine users that will help to explain these diverging trends
      and enable treatment planners to better predict the types of cocaine users who
      are likely to seek treatment. METHODS: Data from the National Household Survey on
      Drug Abuse were used to study the characteristics of frequent cocaine users since
      1985. The 1991 data were used to compare frequent users with infrequent users and
      nonusers. RESULTS: Since 1985, frequent cocaine users have become older. In 1991,
      they were likely to be unemployed (32.4%), unmarried (82.3%), and without health
      insurance (39.4%). Most were cigarette smokers (86.8%) and marijuana users
      (88.4%), and 32.0% reported getting drunk weekly. Criminal behavior was more
      likely among frequent cocaine users than among frequent cocaine users than among
      infrequent users and nonusers. Almost a third (30.0%) reported drug abuse
      treatment experience in the past year. CONCLUSIONS: Despite the recent decreases
      in overall prevalence of cocaine use, the need for treatment of cocaine abusers
      will continue. Treatment must address multiple problems that occur in conjunction
      with cocaine abuse.

PMID- 8342726
TI  - Lead content in 70 brands of dietary calcium supplements.
AB  - OBJECTIVES: Elevated lead levels in calcium supplements may pose a health risk,
      particularly to children with milk intolerance who rely on these products to meet
      their calcium requirement. Earlier reports chiefly focused on the lead content in
      supplements derived from bonemeal and dolomite. This study undertook to determine
      the lead levels in the major forms of calcium supplements currently available.
      METHODS: The lead content was measured in 70 brands of calcium supplements
      grouped in the following five categories: dolomite, bonemeal, refined and natural
      source calcium carbonate, and calcium chelates. RESULTS: The lead levels measured
      in the supplements ranged from 0.03 microgram/g to 8.83 micrograms/g. Daily lead
      ingestion rates revealed that about 25% of the products exceeded the US Food and
      Drug Administration's "provisional" total tolerable daily intake of lead for
      children aged 6 years and under. Less than 20% of the supplements had
      "normalized" lead levels comparable to or lower than that reported for cow's
      milk. CONCLUSIONS: Children are the most sensitive to the low-level effects of
      lead. If calcium supplements are to provide an alternate source of calcium to
      some of these individuals, they should also deliver concomitant lead dosages no
      greater than those obtained from milk products themselves.

PMID- 8342727
TI  - Changes in energy intakes during pregnancy and lactation in a national sample of
      US women.
AB  - Increases in energy intakes during pregnancy and lactation were evaluated by
      examining dietary data for 458 pregnant women who participated in the Continuing
      Surveys of Food Intakes by Individuals conducted in 1985 and 1986. Energy intakes
      were well below recommendations during all reproductive states; however,
      increases during pregnancy approximated recommendations, while increases during
      lactation were low. Postpartum non-lactating intakes did not return to
      prepregnancy levels for Black women or women with lower incomes.

PMID- 8342728
TI  - The quality of the new birth certificate data: a validation study in North
      Carolina.
AB  - A random sample of 395 December 1989 North Carolina birth certificates and the
      corresponding maternal hospital medical records were examined to validate
      selected items. Reporting was very accurate for birth-weight, Apgar score, and
      method of delivery; fair to good for tobacco use, prenatal care, weight gain
      during pregnancy, obstetrical procedures, and events of labor and delivery; and
      poor for medical history and alcohol use. This study suggests that many of the
      new birth certificate items will support valid aggregate analyses for maternal
      and child health research and evaluation.

PMID- 8342730
TI  - Fatal car fires from rear-end crashes: the effects of fuel tank placement before
      and after regulation.
AB  - A federal standard for fuel tank integrity in cars was applied to 1977 and
      subsequent models. National data indicate that fatalities per 10,000 occupants in
      rear-end crashes of small cars, where fire was the most harmful event, were
      reduced by approximately 57% if the fuel tank was located behind the rear axle
      and 77% if the tank was situated directly above or in front of the rear axle.

PMID- 8342729
TI  - Mandating vitamin K prophylaxis for newborns in New York State.
AB  - New York State's infant deaths and hospitalizations attributed to hemorrhagic
      disease of the newborn and other neonatal hemorrhagic conditions were reviewed.
      In 65% of 34 deaths reviewed, vitamin K was not documented as given or was given
      only after the onset of hemorrhage. Vitamin K was not included in standing orders
      in any of 22 hospitals contacted. As a result of this review, vitamin K
      prophylaxis was made a mandatory newborn care procedure in the State Public
      Health Code.

PMID- 8342731
TI  - Black leaders' perceptions of the year 2000 public health goals for black
      Americans.
AB  - We surveyed 1196 Black health and political leaders on their perceptions about
      the US Department of Health and Human Services' Healthy People 2000 public health
      goals. Respondents identified reducing the incidence of acquired immunodeficiency
      syndrome, improving maternal and infant health, and controlling sexually
      transmitted diseases as the three most important public health goals for Black
      Americans that are amenable to intervention. The leaders assigned nearly all
      responsibility for prevention efforts to the federal government and the
      individual. With the American health care system now in flux, Black leaders need
      to organize to see that these priority issues are addressed.

PMID- 8342732
TI  - Community hospitals can increase staff influenza vaccination rates.

PMID- 8342733
TI  - The Hawaii pneumococcal disease initiative.

PMID- 8342734
TI  - Maternal reporting of birthweight in a Peruvian shanty town.

PMID- 8342735
TI  - Socioeconomic and racial differences in obstetric procedures.

PMID- 8342736
TI  - The ramifications of induced abortion. 1. The unbroken chain of life.

PMID- 8342737
TI  - Abortion in the Eastern Bloc, then and now.

PMID- 8342738
TI  - How safe is the consumption of trona?

PMID- 8342739
TI  - Position paper: Immunotherapy with hymenoptera venoms. (EAACI) The European
      Academy of Allergology and Clinical Immunology.

PMID- 8342740
TI  - Position paper: Allergen standardization and skin tests. The European Academy of
      Allergology and Clinical Immunology.

PMID- 8342741
TI  - Position paper: Immunotherapy.

PMID- 8342742
TI  - [Interleukin-1 beta and interleukin-6-plasma concentrations in laparotomies.
      Interaction with neuroendocrine secretion and postoperative temperature
      regulation?].
AB  - Elevated body temperature, increased plasma cortisol concentrations, and loss of
      the circadian secretory pattern are typical changes observed after trauma and
      surgery. We investigated the hypothesis that the interleukins IL-1 beta and IL-6
      are involved in these phenomena, since both are endogenous pyrogens and can
      induce ACTH and cortisol secretion. METHODS. Eight healthy women undergoing
      hysterectomy for non-malignant diseases participated in the study after having
      given written consent. The study had the approval of our institution's ethics
      committee. Anaesthesia was induced with fentanyl 0.1 mg and methohexitone 1.5
      mg/kg and maintained with isoflurane in 60% N2O and 40% O2. Blood samples were
      drawn before induction, before incision, during surgery, at the end of surgery,
      and 30, 60, 120, 240 and 360 min after surgery. Cortisol, prolactin, IL-1 beta,
      and IL-6 concentrations were determined with commercially available ELISAs.
      Statistical analysis was performed with non-parametric methods. RESULTS. IL-6
      increased significantly from 15 (4.3-23) to 68 (18-107) pg/ml (medians and range)
      at the end of surgery and peaked at 128 (52-214) pg/ml 60 min postoperatively (p
      < 0.01, Table 2). Baseline IL-1 beta concentrations were 20 (1-35) pg/ml with a
      significant increase in median postoperative concentrations in the postoperative
      period (p < 0.001). Prolactin increased from 22 (13-43) to 210 (115-291) ng/ml
      immediately after induction of anaesthesia (p < 0.001) and remained elevated
      until 240 min after surgery. Cortisol increased from 99 (26-167) to 384 (241-553)
      ng/ml during surgery and reached a maximum of 475 (246-597) ng/ml 30 min
      postoperatively (Table 3). Rectal and mean body temperatures increased
      significantly in the postoperative period (Table 1). There was a significant
      correlation between IL-6 and cortisol concentrations (r = 0.468; p < 0.001), but
      none was found between IL-6 and temperature or between IL-1 beta and cortisol or
      temperature. CONCLUSIONS. Surgical trauma markedly stimulates the secretion of IL
      6, and to a lesser extent that of IL-1 beta. The data do not yield any evidence
      indicating an effect of IL-1 beta or IL-6 on body temperature. Postoperative
      prolactin concentrations might be influenced by IL-6. The positive correlation
      between plasma concentrations of IL-6 and cortisol may be coincidental, but could
      reflect a causal relationship, particularly in the postoperative period during
      which time the circadian pattern of cortisol secretion is disturbed.

PMID- 8342743
TI  - [The cardiotoxicity of bupivacaine during pacemaker stimulation is dependent on
      the stimulation frequency. Results of an experimental study].
AB  - The cardiotoxic effects of bupivacaine are related to the temporal dispersion of
      effective refractory periods in different parts of the cardiac conduction system.
      This effect facilitates the occurrence of re-entry arrhythmias under burst
      stimulation [4, 8]. In this study physiological increments in heart rate were
      simulated by cardiac pacing, and the electrophysiological and haemodynamic
      effects under the influence of cardiotoxic concentrations of bupivacaine were
      measured. METHODS. After institutional approval we generated cardiotoxic arterial
      plasma concentrations of bupivacaine (6.9 +/- 1.6 micrograms/ml) in pigs (n = 8;
      15-22 kg) by i.v. injection of 4 mg bupivacaine/kg, followed by a constant rate
      infusion of 0.2 mg/kg per min [8]. The pigs were anaesthetized with midazolam,
      fentanyl and pancuronium and normoventilated with a FiO2 of 0.4. Internal right
      atrial and right ventricular pacing was performed with increasing frequencies of
      20, 40, 60, 80 and 100 stimulations/min above individual spontaneous heart rates
      (AL) before (control) and after the administration of bupivacaine. ECG, MAP,
      LVSP, dp/dtmax and stimulation thresholds were recorded. Student's t-test, and
      the U-test of Wilcoxon, Mann and Whitney were used for statistical testing with a
      significance level of 0.05. RESULTS. By inducing a frequency-dependent increase
      in stimulation threshold, bupivacaine prevented regular atrial pacing with
      frequencies higher than AL + 60. Ventricular pacing with a frequency of AL+40
      induced a lethal arrhythmia in 1 animal. In the remaining 7 pigs ventricular
      pacing showed a frequency-dependent increase in stimulation thresholds (Fig. 1)
      and stimulus-QRS intervals (Fig. 5). MAP (Fig. 2), LVSP (Fig. 3) and cardiac
      inotropy (Fig. 4) showed frequency-dependent decreases under ventricular pacing.
      CONCLUSIONS. The toxic effects of bupivacaine on pacing thresholds, av
      conduction, intraventricular conduction, cardiac inotropy, and blood pressure are
      modulated by the stimulation frequency of a cardiac pacemaker. The cardiotoxic
      effects of bupivacaine seem to be use dependent. Even minor increments in heart
      rate can induce malignant arrhythmias. Cardiac pacing can be difficult in the
      presence of toxic bupivacaine concentrations, and high-frequency pacing should be
      avoided. It has to be verified whether higher heart rates generated by the
      physiological pacemakers of the heart do also increase the cardio-circulatory
      toxicity of bupivacaine. If that holds true, drugs that can induce tachycardias
      should be avoided in the treatment of bupivacaine toxicity.

PMID- 8342744
TI  - [Emesis and the oculocardiac reflex. Drug prophylaxis with droperidol and
      atropine in children undergoing strabismus surgery].
AB  - Although droperidol is often used to prevent emesis, vomiting is still common in
      children undergoing strabismus surgery. METHODS. One hundred children aged 3 to
      12 years admitted for strabismus surgery were enrolled in a randomised, double
      blind study to investigate the influence of the timing of the administration of
      droperidol (75 micrograms/kg i.v.) and the effect of atropine (10 micrograms/kg
      i.v.) on postoperative vomiting and the occurrence of the oculocardiac reflex
      (OCR). Each child was prospectively assigned to one of the following groups:
      Group A: atropine and droperidol before the beginning of surgery (n = 25); Group
      B: atropine before the beginning, droperidol after completion of surgery (n =
      25); Group C: no atropine, droperidol before the beginning of surgery (n = 25);
      Group D: no atropine, droperidol after completion of surgery (n = 25). After oral
      premedication with 0.4 mg/kg midazolam, anaesthesia was induced via a face mask
      by inhalation of halothane, nitrous oxide, and oxygen and 1 mg/kg succinylcholine
      was given to facilitate tracheal intubation. Gastric contents were aspirated by a
      gastric tube at the end of the operation. Vomiting and retching were recorded for
      24 h; recovery from anaesthesia was assessed by a modified Steward score.
      RESULTS. The four groups were comparable regarding age, sex, body weight,
      duration of anaesthesia, and number of repaired eye muscles. Patients receiving
      droperidol before and after the end of surgery had a similar incidence of
      vomiting (groups A and C 60% vs. groups B and D 50%). There was no significant
      difference in the number of patients vomiting between groups A and B (58%) and
      groups C and D (52%). The incidence of the OCR was lower in the patients
      premedicated with atropine (18% vs. 60%, P < 0.01). There was no statistical
      relationship between the occurrence of the OCR and post-operative emesis. Younger
      children (3 to 6 years) vomited more often than older ones (7 to 12 years). The
      incidence of the OCR was higher in patients with more than two eye muscles
      repaired than in others. Recovery scores were slightly lower in patients with
      droperidol after completion of surgery; postoperative recovery times did not
      differ significantly between the study groups. CONCLUSIONS. The timing of the
      administration of droperidol (75 micrograms/kg) had no influence on postoperative
      vomiting. The application of atropine (10 micrograms/kg) prior to surgery did not
      influence vomiting after strabismus surgery. Atropine (10 micrograms/kg) reduced
      the incidence of the OCR significantly. There was no statistical relationship
      between the occurrence of the OCR and postoperative vomiting.

PMID- 8342745
TI  - [Extracorporeal shock-wave therapy (ESWT) for pseudoarthrosis. A new indication
      for regional anesthesia].
AB  - Extracorporeal shock-wave therapy for the treatment of pseudarthrosis is a new
      indication for anaesthesia. In a clinical trial of 65 treatments in 53 patients,
      the anaesthetic procedure is shown. Regional anaesthesia, mainly plexus blocks of
      the upper and lower extremities, was performed in nearly all cases. The various
      localisations of the pseudarthroses and the types of anaesthetic techniques used
      are shown in Table 1. In all, we performed 9 epidural blocks, 2 spinal blocks, 29
      axillary blocks, 3 supraclavicular perivascular blocks (Winnie), 1 psoas
      compartment block, and 20 sciatic/femoral 3-in-1 blocks. The shock waves used for
      this therapy are several times stronger than those used for nephrolithotripsy.
      Furthermore, the shockwaves are focused on bone and periosteum, which is
      abundantly innervated. Therefore, in contrast to nephro-lithotripsy with second
      generation lithotripters, anaesthesia must be performed for this therapy. We
      chose regional anaesthesia for several reasons: the procedures are located in the
      arms or legs, which can readily be anaesthetised by regional blocks. The duration
      of treatment ranged up to several hours. By using regional anaesthesia, we were
      able to avoid unnecessary exposure to general anaesthetics. Finally, most of the
      patients wanted to stay awake during the new treatment and therefore opted for
      regional techniques. A typical set-up for the treatment is shown in Fig 1. In 67%
      of the patients fracture healing was significantly improved by the new therapy.
      Acceptance of therapy and anaesthesia by the patients was very good.

PMID- 8342746
TI  - [The performance of respirator alarms during simulated critical events in
      CMV/IPPV artificial respiration].
AB  - Alarm systems of ventilators enhance detection of possible critical events during
      artificial ventilation. Due to their significance, in some countries the alarm
      detection of ventilators is regulated by federal law. Up to now, no
      recommendations for the adjustment of alarm limits exist and only a few detailed
      investigations of the accuracy of alarm detection are available. METHODS. The
      response of four commercially available ventilators (Servoventilator 900C,
      Siemens, Inc.; Bennett 7200a, Hoyer, Inc.; Veolar, Hamilton, Inc.; EVITA, Drager,
      Inc.) to critical events during artificial ventilation of a test lung were
      evaluated. We measured the alarm time (the time between event creation and alarm
      response) of ten different simulated critical events including disconnection,
      differentisized leaks, failure of the gas supply, and obstruction at different
      places in the artificial airway. DISCUSSION. All respirators were able to
      recognise severe critical situations such as hose disconnection, failure of gas
      supply, and total airway obstruction within a short time (< 15 s). The
      recognition of small airway leaks was more difficult for the ventilators even
      when the alarm thresholds were close. The alarm detection of the EVITA (software
      10.0 or less) under conditions of partial airway obstruction may be a source of
      risk for the patient as the machine continued supplying inspiration with pressure
      limited ventilation even when the pressure threshold was reached.

PMID- 8342747
TI  - [Perioperative cardiovascular reactions and the noradrenaline plasma level in
      patients on chronic antidepressant medication].
AB  - It is still controversial whether the perioperative incidence of cardiovascular
      complications is increased in patients on chronic treatment with cyclic
      antidepressants (AD) and whether AD medication should be discontinued prior to
      surgery. METHODS. We measured perioperative cardiovascular variables in 31
      patients on chronic treatment with tri- and tetracyclic AD and 31 patients
      without AD medication. Heart rate, blood pressure, and noradrenaline plasma
      concentrations were compared between the two groups at nine points in time.
      During induction of anaesthesia, the ECG was recorded continuously. After the
      administration of 0.01 mg/kg atropine i.v., all patients received opiate
      supplemented enflurane anaesthesia. RESULTS: Re-uptake inhibition of
      noradrenaline by AD resulted in significantly higher noradrenaline plasma
      concentrations before and during anaesthesia in the AD-treated group. The
      incidence of arrhythmias, blood pressure elevations, and tachycardia was not
      increased in patients in AD treatment. Arrhythmias during induction of
      anaesthesia were seen in 6 of the AD-treated patients and 5 of the controls.
      Blood pressure elevations by more than 35% were seen in 10 patients on AD
      treatment and 8 controls. The heart rate prior to induction of anaesthesia and 2
      h after the end of surgery was significantly higher in the AD-treated group.
      During anaesthesia the heart rate was higher at two points in time only. The
      incidence of tachycardia was similar in both groups. Intravenous administration
      of 0.01 mg/kg atropine prior to induction of anaesthesia increased the heart rate
      of the patients on chronic AD medication by 11.4%. This increase was
      significantly higher in the control group (16.2%), suggesting that patients with
      chronic AD treatment do not have a higher sensitivity to atropine. CONCLUSION:
      The elevated noradrenaline plasma levels in patients on chronic AD treatment did
      not result in a higher incidence of arrhythmias, blood pressure elevations, or
      tachycardia perioperatively. Taking these results into account, we do not
      consider it necessary to discontinue chronic AD medication prior to surgery in
      patients without cardiovascular disease.

PMID- 8342748
TI  - [Damage to a stent caused by a Shaldon catheter].
AB  - Recently, stent implantation has been used with increasing frequency in the
      treatment of central venous stenoses in patients undergoing chronic
      haemodialysis. Stent localisation may interfere with central venous
      catheterisation. CASE REPORT. In a 57-year-old female haemodialysis patient, a
      filiform stenosis of the right subclavian vein was treated by percutaneous
      transvenous angioplasty and stent implantation. Five weeks later, she presented
      with a thrombosed dialysis shunt. A Shaldon catheter was implanted via the right
      internal jugular vein. Post-procedure radiographs showed extensive stent damage
      without stent dislocation or thrombosis. CONCLUSION. Stent localisation has to be
      considered in the event of later central venous catheterisation. Venous puncture
      should be carried out under fluoroscopic control if catheter placement on the
      side of the stent is inevitable.

PMID- 8342749
TI  - [A difficult intubation: prolapse of the epiglottis into the trachea in an
      infant].
AB  - Luxation of the epiglottic cartilage is a very uncommon complication of
      endotracheal intubation in paediatric anaesthesia. We report on a case of
      prolapse of the epiglottic cartilage into the trachea in a 4-month-old child who
      had been anaesthetized for palliative banding of the pulmonary artery and
      correction of a coarctation of the aorta. Further malformations included a single
      ventricle combined with an ASD II and VSD. The first intubation (ID 3.5 mm) via
      the nasopharyngeal route seemed not to involve any problems; breathing pressure,
      however, increased to 25 cm H2O. Direct laryngoscopy after extubation of the
      smaller tube and insertion of another one (ID 4.0 mm) demonstrated a completely
      blocked trachea. The epiglottidean cartilage had prolapsed into the tracheal
      lumen and excluded any possibility of ventilating the patient. After seizing the
      epiglottic cartilage with a Magill forceps it was possible to pull the cartilage
      out of the trachea and to intubate again with the 4.0 mm tube. There were no
      complications in the postoperative period.

PMID- 8342750
TI  - [Fulminant pulmonary embolism in the 35th gestational week. Sonographic detection
      of a thrombus in the inferior vena cava with normal cavography].
AB  - Pulmonary embolism is the most common cause of maternal death during pregnancy.
      CASE REPORT. We report a 28-year-old obstetric patient (35th gestational week)
      who was admitted to the hospital because of intermittent vaginal bleeding caused
      by placenta totalis et accreta. Eleven days after admission she suffered a
      cardiac arrest. After cardiopulmonary resuscitation, an emergency caesarian
      section was performed and a healthy child was delivered. Abdominal sonography (B
      mode) showed a floating thrombus in the inferior vena cava. Perfusion
      scintigraphy and cavography were normal; a computed tomography i.v. contrast
      medium study confirmed the presence of the thrombus. An open thrombectomy was
      performed to protect the patient from further pulmonary emboli. After 8 days she
      left the intensive care unit without residual complications. CONCLUSION. This
      case emphasises the importance of bedside sonography as a diagnostic method of
      identifying the source of a thrombus in patients with suspected pulmonary
      embolism.

PMID- 8342751
TI  - [The effect of sedation on oxygen uptake during spontaneous breathing].
AB  - Sedation may be used in intensive care and emergency medicine to improve the
      oxygen demand/delivery ratio. The influence of sedation has most frequently been
      investigated in a dose-related manner. The aim of the present study was to
      determine the effect-related influence of different sedatives on oxygen uptake
      (VO2) in relation to defined resting conditions. METHODS. Forty ASA I patients
      who had to undergo a minor surgical procedure were investigated 1.5 h before
      surgery at basal energy-expenditure measurement conditions. One of the following
      substances was given with a preset bolus rate in a double-blind, randomised order
      until a defined level of sleep or side effects was encountered: propofol (n = 8),
      midazolam (n = 8), thiopentone (n = 8), sodium chloride (n = 8), and fentanyl (n
      = 8). The sleep level was defined as sluggish response to a loud voice or tapping
      on the forearm. The variables VO2, carbon dioxide elimination (VCO2), end tidal
      CO2 (p(et)CO2), oxygen saturation (SaO2), heart rate, systemic blood pressure,
      skin temperature, and skin resistance on the sole of the foot were documented on
      line on a computer. All variables were compared using differences of averages
      from 10-min periods before and after sedation during which the VO2 was minimal.
      RESULTS. The mean VO2 before sedation was 264 +/- 60 ml/min, and the measured
      energy expenditure did differ by -0.2% (+/- 14%) from mean predicted values using
      the Harris-Benedict equation. The VO2 was reduced by 15 +/- 2% with propofol, by
      12 +/- 8% with midazolam, and by 10 +/- 5% with thiopentone. This was
      statistically significant compared to placebo treatment, as was the difference
      between propofol and thiopentone effects. All patients in these groups reached
      the defined sleep level, which was not achieved by the placebo and fentanyl
      groups. Placebo treatment changed the VO2 by 0.1% (+/- 2%). Fentanyl increased
      the VO2 by 5% (+/- 8%), which did not reach significance. In the fentanyl group
      the bolus application had to be stopped at a p(et)CO2 of 50 mm Hg in all
      patients. In the propofol, midazolam, and thiopentone groups the phasic changes
      of skin resistance were reduced to zero and the skin temperature increased from
      27 +/- 2 degrees C to 32 +/- 2 degrees C. The fentanyl group showed an increase
      in changes of skin resistance without changes in temperature. CONCLUSIONS. Sleep
      induced by propofol, midazolam, or thiopentone to a clinically maximal desirable
      level in spontaneously breathing patients reduced VO2 by 10% to 15%. This level
      of sedation did not induce a relevant change in P(et)CO2 or SaO2. The effect of
      propofol appeared to be the most pronounced and least variable. This may be
      attributable to a more pronounced reduction in single-organ VO2 or to an
      undetected difference in level of sedation. Fentanyl did, in contrast to most
      publications on opioid effects, seem to increase VO2. Underlying mechanisms may
      be sought in an increased rate-pressure product and sympathetic activity on the
      basis of hypercapnia and changes in muscle tension.

PMID- 8342752
TI  - [Respirators in intensive care medicine. Fundamentals].
AB  - Microprocessor-controlled intensive care ventilators combine controls of
      pressure, flow, volume, and timing to generate various breathing modes and
      differentiated breathing patterns that will meet the respiratory needs of the
      patient. This is essential when respirator-supported ventilation is performed.
      Graphic representation of ventilatory parameters is another important feature,
      facilitating subtle adjustments. The future may bring even more desirable options
      to improve monitoring of respiratory mechanics and make management easier. Modern
      ventilators differ less in technical features than do the accessories with
      different options. Most of these options are costly without any corresponding
      benefit in terms of treatment or diagnosis; nevertheless, future upgrading
      possibilities should be borne in mind when hardware is purchased. There is no
      ideal ventilator, and the success of respiratory treatment will therefore
      continue to be dependent on the patient's underlying disease and the therapist's
      level of training and experience rather than on the choice of respirator.

PMID- 8342754
TI  - Disk submissions.

PMID- 8342753
TI  - Clover's nitrous oxide/ether inhaler 1876.

PMID- 8342755
TI  - The Sprotte needle and post dural puncture headache following caesarean section.
AB  - One hundred and forty-four patients receiving subarachnoid anaesthesia for
      caesarean section were prospectively analysed for quality of anaesthesia and the
      occurrence of post dural puncture headache (PDPH). Anaesthesia was administered
      via 24 gauge Sprotte (n = 104) and 26 gauge Quincke (n = 40) needles using
      hyperbaric bupivacaine 0.5% with morphine 0.2 mg. Anaesthesia was successful in
      103 patients with the Sprotte needle and 38 patients with the Quincke needle, and
      the operating conditions were considered to be excellent. Of the 104 patients in
      the Sprotte needle group there were ten with PDPH (9.6%), two of which were
      considered severe. Of the 40 patients in the Quincke needle group there were
      eight with PDPH (20%), three of which were considered severe. Despite the lower
      incidence of headache in the Sprotte needle group, this was not statistically
      significant (P > 0.05), due to the difference in population size. We conclude
      that the 24 gauge Sprotte needle is associated with a comparatively low but
      clinically relevant incidence of headache in the obstetric population.

PMID- 8342756
TI  - Epidural catheter insertion: the effect of saline prior to threading in non
      obstetric patients.
AB  - The effects of injecting normal saline 4 ml through the epidural needle before
      catheter passage on ease of catheterisation and incidence of certain
      complications were investigated in 189 non-obstetric patients. The use of saline
      had no effect on ease of catheterisation, with 84.2% of Group S patients (saline,
      n = 95) and 88.3% of Group C patients (control, n = 94) having the difficulty of
      passing the catheter rated as "easy" (P = 0.31). The incidence of complications
      was not affected by the use of saline. Paraesthesia occurred in 27.4% of Group S
      patients compared with 16.0% of Group C patients (P = 0.08). Epidural venous
      cannulation occurred in 6.3% of Group S patients versus 11.7% of Group C patients
      (P = 0.30). We conclude that the use of 5 ml of normal saline prior to catheter
      threading provides no significant benefit in improving the ease of
      catheterisation or decreasing the incidence of catheter complications.

PMID- 8342757
TI  - Apnoea and oximetric desaturation in patients receiving epidural morphine after
      gastrectomy: a comparison of intermittent bolus and patient controlled
      administration.
AB  - The number of apnoeic episodes and arterial oxygen desaturations were measured
      preoperatively and for sixty hours postoperatively in twenty ASA status 1-2
      patients scheduled for elective gastrectomy. Monitoring included continuous pulse
      oximetry, respiratory inductive plethysmography and repeated arterial blood gas
      analysis. The number and magnitude of apnoeas and desaturation episodes were
      compared between two postoperative analgesic regimens of epidural morphine;
      intermittent bolus injection (Group B, n = 10), and patient controlled
      administration with continuous infusion (Group P, n = 10). Morphine dose, P(a)CO2
      and mean SpO2 values were similar between the two groups. Although the number of
      central apnoeas with SpO2 < 90% was greater in Group B, other episodes of apnoea
      or desaturation were similarly seen preoperatively. In the postoperative period,
      central apnoeas with SpO2 < 90% were significantly increased in Group B, while no
      change was seen in Group P. Apnoeas with SpO2 < 80% were only seen in Group B. We
      conclude from these results that postoperative apnoeas and episodic desaturations
      are greatly influenced by the different modes of opioid administration.

PMID- 8342758
TI  - A rabbit model for the evaluation of epidurally administered local anaesthetic
      agents.
AB  - A rabbit model is described for the evaluation of epidurally administered local
      anaesthetic agents. The technique involves a single injection via the readily
      identified lumbosacral space in conscious rabbits, with the epidural space being
      identified by a modified loss-of-resistance technique. The endpoints used to
      assess pharmacodynamic responses of the rabbit model were (1) sensory loss, (2)
      loss of weight-bearing ability, and (3) flaccid paresis. The model was further
      characterised by investigation of endpoint responses to changes in injection
      volume (0.1-0.25 ml/kg) and concentration of administered lignocaine solutions
      (0.5 to 2%). From these studies, a volume of 0.2 ml/kg was chosen as a standard
      dose and a subsequent comparison between different agents undertaken. The rank
      order for the onset of action, duration of effect and the observed
      pharmacokinetic profiles after epidural administration of 2% lignocaine, 2%
      lignocaine with adrenaline (1:200,000) or 0.5% bupivacaine solutions are broadly
      consistent with human clinical data. These data indicate that the rabbit is a
      simple (albeit limited) model for the screening evaluation of epidurally
      administered local anaesthetic agents.

PMID- 8342760
TI  - The influence of obesity on the relationship between body mass index and the
      distance to the epidural space from the skin.
AB  - This study confirms that distance to the epidural space from the skin at the L3-4
      interspace is only moderately correlated with body mass index in obstetric
      patients. A similar moderate linear correlation was found in the non-obstetric
      patients. However, in obese patients (BMI > 25), distance to epidural space from
      the skin correlated poorly with body mass index.

PMID- 8342759
TI  - A comparison of effects of fixed and tailored cardiopulmonary bypass flowrates on
      renal function.
AB  - Cardiopulmonary bypass may result in renal impairment but there is little
      investigative data on the effect of differing flowrates on postoperative renal
      function. One hundred and twenty-two patients presenting for cardiac surgery were
      randomly assigned to receive either a fixed CPB flow of 2.4 l.m-2 or a bypass
      flow tailored to maintain a venous return oxygen saturation of 75-80%. Vasoactive
      drugs were given to maintain a perfusion pressure of 50 to 80 mmHg. Patients were
      assessed by serum creatinine, creatinine clearance, arterial blood gases, serum
      lactates and electrolytes. The results show an overall decline in postoperative
      renal function compared with preoperative levels, with no significant differences
      between the two groups.

PMID- 8342761
TI  - A review of anaesthesia for ruptured abdominal aortic aneurysm with special
      emphasis on preclamping fluid resuscitation.
AB  - Ruptured abdominal aortic aneurysm (RAAA) remains a critical emergency with an
      average hospital mortality of 50%. There has been no significant improvement in
      survival despite advances in anaesthesia, surgery and intensive care over the
      last 30 years. It is believed that early diagnosis, aggressive surgical
      management and meticulous attention to haemodynamic status and coagulation may
      improve survival, but this is unsubstantiated. Mortality is closely linked to the
      degree of preoperative hypotension and other related factors such as massive
      blood transfusion and cardiac arrest. Survival depends not only on the severity
      of rupture, but also the ability to compensate physiologically, and is linked to
      the premorbid state of the patient. Management priorities are dictated chiefly by
      the clinical signs and symptoms at presentation. There is controversy regarding
      the appropriate preoperative fluid regimen for RAAA.

PMID- 8342762
TI  - Parental attitudes to presence at induction of paediatric anaesthesia.
AB  - Previous studies of parental presence at induction of anaesthesia in children
      have examined parental reaction to being present and the benefits gained from
      their presence. This study was undertaken specifically to assess parents'
      attitudes to being present at induction of their child's anaesthetic. A total of
      154 questionnaires were distributed over a two-week period to parents of children
      presenting to the Day Stay Unit for procedures requiring general anaesthesia.
      Eighty-eight percent would have liked to be present at induction. Only 41% of
      parents expected to be present and only 40% of parents were actually present for
      their child's induction. Of those parents present, 94% felt it helpful to their
      child, 65% helpful to themselves and 41% helpful to the anaesthetist. No-one felt
      their presence to have been unhelpful. These results may provide an incentive for
      anaesthetists to review their current paediatric anaesthetic practices.

PMID- 8342763
TI  - "Don't turn the needle!".
AB  - Accidental dural puncture is a well-recognised complication of epidural
      anaesthesia. The technique of inserting the epidural needle with the bevel
      parallel to the spinal ligaments is still taught in some centres. Evidence is
      presented that the subsequent turning of the needle to allow passage of the
      epidural catheter may increase the likelihood of dural puncture. There would also
      appear to be a greater chance of subdural catheterisation. The epidural needle
      should be introduced with the bevel in the direction in which the catheter is to
      go and not moved once the epidural space is located.

PMID- 8342764
TI  - Quality assessment in personal anaesthetic practice.
AB  - Continuing education can improve anaesthetic practice if it is relevant to an
      individual's work and complications. A practice profile delineates the
      significance of untoward events. A personal audit of consecutive anaesthetics and
      associated complications is presented as a first step to checking one's
      competence over the course of years.

PMID- 8342765
TI  - A fatal reaction following scavenged autologous blood transfusion.

PMID- 8342766
TI  - A comparison of three ported cannulae available in New Zealand.
AB  - A comparison was made of the three 22-gauge ported intravenous cannulae available
      in New Zealand--Venflon 2, Vasofix Braunule and Insyte. All cannulae performed
      satisfactorily in terms of overall success of cannulation although significant
      differences were apparent in both clinical and laboratory performance.
      Anaesthetists' clinical preference was for Insyte and Venflon 2 brands,
      perceiving these to have greater ease of handling and better packaging. In a
      series of laboratory studies, Vasofix was found to have the highest flowrate, the
      fastest time to flashback and the lowest valve opening pressure. Insyte required
      the least force of penetration. Venflon 2 had the greatest margin of safety
      between pressure to inject through the port and pressure required to blow the
      syringe/port assembly apart. Potential problems were identified with the Insyte
      port valve mechanism.

PMID- 8342767
TI  - Massive intraoperative pulmonary thromboembolism treated by pulmonary
      embolectomy.

PMID- 8342768
TI  - Sudden onset unilateral pulmonary oedema during thoracotomy.

PMID- 8342769
TI  - Transoesophageal echocardiography aids insertion and management of the "Thoratec"
      ventricular assist device.

PMID- 8342770
TI  - Acute dapsone poisoning.

PMID- 8342771
TI  - Upper limb amputation following radial artery cannulation.

PMID- 8342773
TI  - Clinical prediction of a difficult intubation.

PMID- 8342772
TI  - The diagnosis of fatal anaphylactic reactions during anaesthesia: employment of
      immunoassays for mast cell tryptase and drug-reactive IgE antibodies.

PMID- 8342774
TI  - Postoperative amiodarone pulmonary toxicity.

PMID- 8342775
TI  - Central anticholinergic syndrome following reversal of neuromuscular blockade.

PMID- 8342776
TI  - Cardiac and respiratory complications of mediastinal lymphomas.

PMID- 8342777
TI  - Airway obstruction with a cuffed single-use plastic endotracheal tube.

PMID- 8342778
TI  - Total oesophageal obstruction in association with combined enteral feed and
      sucralfate therapy.

PMID- 8342780
TI  - Eye movement during cataract surgery.

PMID- 8342779
TI  - Artefact with rate-responsive pacemaker.

PMID- 8342781
TI  - Failure of insulin mixing in 10% glucose.

PMID- 8342782
TI  - Phantom sensation.

PMID- 8342784
TI  - The flexible, reinforced tube LMA--initial experience.

PMID- 8342783
TI  - Ephedrine and caesarean section.

PMID- 8342785
TI  - Taping ETT connectors.

PMID- 8342786
TI  - Flow injection chemiluminometric determination of epinephrine, norepinephrine,
      dopamine and L-dopa.
AB  - A method is proposed for the determination of 0.0500-1.00 microgram ml-1 of
      epinephrine and L-dopa and 0.100-1.00 micrograms ml-1 of norepinephrine and
      dopamine by their chemiluminogenic oxidation with potassium permanganate in
      acidic medium, in the presence of formaldehyde, which greatly improves the
      sensitivity. Flow injection allows the measurement of 80 solutions per hour. The
      method was also optimized for a continuous-flow system. Comparative results from
      numerous organic compounds proved the necessity for electron-donating groups on
      the benzene ring for sensitive chemiluminescent characteristics.

PMID- 8342787
TI  - Continuous-flow chemiluminometric determination of tetracyclines in
      pharmaceutical preparations and honey by oxidation with N-bromosuccinimide.
AB  - A continuous flow chemiluminometric method for determining 0.050-3.00 micrograms
      cm-3 of tetracycline, 0.50-5.00 micrograms cm-3 of oxytetracycline, 0.50-7.00
      micrograms cm-3 of doxycycline and chlorotetracycline and 0.30-3.00 micrograms cm
      3 of demeclocycline in pharmaceutical preparations and honey is described. The
      method is based on the chemiluminescence produced by the action of N
      bromosuccinimide on tetracyclines in alkaline solution. The emission intensity is
      greatly enhanced by the presence of ammonia. The procedure is automated and
      solutions can be analysed at a rate of 130 h-1 with a relative error of about 2%.
      During evaluation of possible interferences of the method, recoveries from
      solutions with common excipients and other concomitant compounds were in the
      ranges 97.8-104.0 and 96.6-109.4%, respectively. Recoveries of various
      tetracyclines from commerical formulations and honey samples were in the ranges
      95.2-103.7 and 89.2-106.6%, respectively. The results obtained for the assay of
      commerical pharmaceutical preparations compared well with those obtained by an
      official method and demonstrated accuracy and precision (< or = 5%).

PMID- 8342788
TI  - Expression of alkaline phosphatase in the mature mouse placenta visualized by in
      situ hybridization and enzyme histochemistry.
AB  - Alkaline phosphatases (APs) are a family of cell surface glycoproteins that are
      expressed in a variety of tissues. Their physiological functions are still
      unclear. Three different AP genes have been found to be expressed in mice, and AP
      cloned from the placenta is of the tissue non-specific (TNAP) type. We have in
      investigated the location of TNAP mRNA and active AP in mature mouse placenta,
      using in situ hybridization and enzyme histochemistry on serial sections. Digital
      image analysis was used to estimate relative amounts of TNAP mRNA. Tissue non
      specific alkaline phosphatase messenger was detected only in the placental
      labyrinth, whereas active AP was present both in the labyrinth and in a zone of
      cells at the margin of the decidua basalis, bordering the myometrium and the
      metrial gland. This latter location of AP activity has not been described
      previously. The AP-positive zone of the decidua had a condensed appearance and a
      central defect in the zone was visible on sections taken from the middle of the
      placenta. No TNAP messenger was found in the zone of AP-positive decidual cells.

PMID- 8342789
TI  - An immunohistochemical study of basic fibroblast growth factor in the developing
      chick.
AB  - An antiserum against basic fibroblast growth factor (bFGF) was characterized by
      immunoblot experiments and used to investigate immunohistochemically the
      appearance of bFGF-like immunoreactivity in the developing chick. Crude
      homogenates of chick embryos at every developmental stage, when subjected to
      immunoblotting with the use of bFGF antiserum, exhibited a main band with the
      same molecular weight (18 kDa) as bovine bFGF. With immunohistochemistry, bFGF
      immunoreactivity (bFGF-IR) was detected exclusively in intracellular components
      of various tissues at different stages of development; bFGF-IR appeared initially
      on embryonic (incubation) day 3 (E3) in the myotome, on E12 in the spinal cord
      and ganglia, on E8 in chondrocytes and osteoblasts of the vertebrae, and on E10
      in the esophageal epithelium. Immunoreaction products were present either in the
      cytoplasm or in the nuclei, depending on the types of individual bFGF-containing
      cells; developing chondrocytes and cells in the stratum basale of the esophagus
      exhibited intense immunoreactions exclusively within the nuclei, and the other
      cells mainly within the cytoplasm. Moreover, bFGF-IR was observed in discrete
      regions of these tissues at different stages; the epithelium of the esophagus
      contained bFGF-IR in all layers on E10 to E18 with a superficial-to-basal
      gradient, but it began to exhibit bFGF-IR only in the stratum basale after E20;
      and bFGF-IR was more abundant in hypertrophic chondrocytes than in proliferating
      ones. As chicks aged, bFGF-IR decreased or disappeared in the muscles, vertebrae
      and esophageal epithelium, but neuronal bFGF increased in intensity until the
      perinatal period and thereafter remained unchanged.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8342791
TI  - Dorsal rhizotomy does not alter rat estrous cycles or ovarian compensatory
      responses.
AB  - Rats were subjected to right side dorsal rhizotomy of spinal nerves T12-L2 and
      ipsi- or contralateral unilateral ovariectomy at estrus (day 1). Estrous cycles
      were recorded daily, and on day 15 the remaining ovary was removed and weighed.
      Antral follicles were counted in representative day 1 and day 15 ovaries. Dorsal
      rhizotomy did not affect estrous cycles during the period after surgery. Also
      dorsal rhizotomy did not alter ipsilateral ovarian hypertrophy or follicular
      activation following unilateral ovariectomy. Thus, although the major portion of
      the ovarian sensory innervation is via the lesioned segments, interruption of
      these segments centrally does not alter compensatory ovarian responses subsequent
      to unilateral ovariectomy.

PMID- 8342790
TI  - Tissue variation of two large chondroitin sulfate proteoglycans (PG-M/versican
      and PG-H/aggrecan) in chick embryos.
AB  - PG-M and PG-H, chick large chondroitin sulfate proteoglycans corresponding to
      versican (fibroblast-type proteoglycan) and aggrecan (cartilage-characteristic
      proteoglycan), respectively, which are found in mammals, have been characterized
      in various tissues of chick embryos. Their distribution and the compositions of
      the core molecules were analyzed by immunofluorescence staining and
      immunoblotting, respectively, using various monospecific antibodies. Molecules
      reactive to a monoclonal antibody to the PG-M core protein (designated MY-174)
      were distributed in various tissues, including aorta, lung, cornea, brain,
      skeletal muscle and dermis. Immunoblotting with MY-174 of the chondroitinase ABC
      digested tissue extracts showed a tissue variation of MY-174-reactive core
      molecules (550-kD, 500-kD, 450-kD, and 350-300-kD). In contrast, PG-H, besides
      massive occurrence in cartilage, was only found in a few tissues such as aorta
      and brain. In addition, PG-H in aorta, cornea, and skin was atypical in
      structure, because it lacked keratan sulfate. The expression of PG-M in
      developing chick embryos was then examined. PG-M was found in some
      developmentally active areas, such as the perinotochordal mesenchyme between
      notochord and neural tube, the basement membranes facing neuroepithelial cells,
      and condensing mesenchymal cells in limb buds, suggesting some functions
      distinctive of the developing tissues.

PMID- 8342792
TI  - Visualization of lectin-like proteins in human placenta by means of anti-plant
      lectin antibodies.
AB  - Proteins antigenically cross-reactive with lectins were sought in the placenta by
      immunohistochemistry using polyclonal antibodies raised in rabbit against four
      well-known lectins: Concanavalin A, Wheat germ agglutinin, Ulex europaeus
      agglutinin, and Phaseolus vulgaris leukoagglutinin (PHA-L), as well as one
      antibody raised in goat against PHA-L. Even at high dilutions of the primary
      antibody, strong staining was obtained after short incubations, in patterns
      generally resembling those obtained for placental lectins by other means, such as
      those based on binding capacity for glycosylated probes. One of the
      immunohistochemical patterns distinguishes with great clarity between the
      trophoblast cell layers, thus relating to developmental and functional
      parameters; another localises PHA-L-immunoreactivity to the syncytiotrophoblast.
      These results underline the validity of the immunohistochemical screening as an
      approach in its own right. Both positive and negative controls were applied to
      the immunohistochemical methodology. These controls showed that the staining
      patterns obtained relate to the specificities of the primary antibodies employed;
      i.e. to lectins. The PHA-L-like cross-reactivity was analysed immunochemically.
      In electrophoretically separated and Western-blotted placental extracts there
      were found anti-PHA-L-binding fractions of apparent molecular weights 30 kDa, 58
      kDa and 67 kDa. Control studies of the PHA-L antigen showed anti-PHA-L-binding
      fractions of approximate molecular weights 32 kDa and 60 kDa. The 30 kDa fraction
      from placenta and the 32 kDa fraction from PHA-L antigen bound lactosylated BSA
      but not fucosylated BSA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342793
TI  - Differentiation of the gonads and initiation of mammary gland and scrotum
      development in the brushtail possum Trichosurus vulpecula (Marsupialia).
AB  - The first appearance of the mammary and scrotal primordia and the sexual
      differentiation of the gonads of the brushtail possum, Trichosurus vulpecula, are
      described. Primordial germ cells were first observed, in fetuses of 7.5 mm crown
      rump length, in the gonadal ridges and migrating up the dorsal mesentery. Mammary
      primordia were first observed in fetuses of 11 mm, and scrotal primordia in those
      of 12 mm crown-rump length. These structures were diagnostic of female and male
      brushtail possums respectively. Processus vaginales and gubernacula showed sexual
      dimorphism, being better developed and appearing earlier in males than in
      females. Sexual differentiation of the gonads occurred after the appearance of
      mammary and scrotal primordia, the testes being first recognisable in a 14.5-mm
      fetus and the ovaries postnatally. Birth occurred between the stages of 14 and 15
      mm crown-rump length. These observations appear to indicate that the development
      of mammary and scrotal primordia are not under gonadal hormonal control, but
      under direct genetic control, as suggested for the tammar wallaby by previous
      authors.

PMID- 8342794
TI  - Onset of gastrulation, morphogenesis and somitogenesis in mouse embryos
      displaying compensatory growth.
AB  - This is a study on the ability of mouse embryos to compensate for a loss of cells
      and to develop with body parts of normal size and normal proportions during post
      implantation development. Micro-manipulations were performed on 4-cell pre
      implantation mouse embryos to reduce the number of cells by 25% (3/4 embryos) or
      50% (2/4 embryos). Blastocysts developed from these embryos showed a preferential
      loss of inner cell mass population, and fewer of them formed viable embryos after
      implantation. The size of post-implantation 3/4 embryos was initially smaller
      than controls of the same gestational age, but compensatory growth, achieved by
      increasing cell numbers at above the normal rate and beyond the normal duration,
      took place between 6.5 and 11.5 days, resulting in a complete restoration of body
      size. During compensatory growth the 3/4 embryos rescheduled events of
      gastrulation and morphogenesis in keeping with cell number or body size
      appropriate for each developmental stage. The formation of the correct number of
      somites was accomplished by changing the rate of somite segmentation and by an
      adjustment of the size of individual somites and somitomeres proportional to the
      available amount of precursor tissues. Morphogenesis and pattern formation in
      embryos recovering from earlier cell losses are therefore regulated in accordance
      to tissue volume (or cell number) instead of chronological age or some intrinsic
      cellular clock.

PMID- 8342796
TI  - Should we use muscle biopsy to diagnose malignant hyperthermia susceptibility?

PMID- 8342795
TI  - Tissue culture of bovine subcommissural organ.
AB  - Tissue of the secretory, glial subcommissural organ (SCO) of adult, male cattle
      was cultured in serum-free medium for 70 days in vitro. Only minor alterations in
      the histoarchitecture and the cytology of the explanted SCOs could be observed by
      light and electron microscopy. Light- and electron-microscopic immunocytochemical
      investigations with an antiserum raised against bovine SCO secretory proteins
      revealed intra- and extra-cellularly localized immunoreactive material in tissue
      sections of SCO explants cultured up to 69 days in vitro. An indirect competition
      enzyme-linked immunosorbent assay (ELISA) was developed to detect minor
      quantities of SCO secretory products. By means of this assay, approximately 35 ng
      RF protein per ml was detected in culture medium supernatants conditioned for 3
      days in SCO tissue cultures at 3, 38, and 69 days in vitro. These studies
      demonstrate that the bovine SCO can maintain its secretory activity throughout
      long periods in vitro.

PMID- 8342797
TI  - Intraoperative transesophageal echocardiography for the detection of cardiac
      preload changes induced by transfusion and phlebotomy in pediatric patients.
AB  - BACKGROUND: Intraoperative blood volume changes are difficult to monitor in
      pediatric patients. The authors tested the hypothesis that transesophageal
      echocardiography would identify changes in cardiac filling resulting from
      manipulations of blood volume. METHODS: Eleven patients (3-15 kg) were studied
      following sternal closure after repair of congenital heart lesions.
      Transesophageal echocardiography of the midpapillary left ventricular short axis
      view and hemodynamics were recorded at baseline (T1), during withdrawal of blood
      until the systolic blood pressure decreased by 5 mmHg (T2) and 10 mmHg (T3), and
      after reinfusion of the blood (T4). The identical cycle of blood withdrawal and
      reinfusion was repeated after administration of calcium chloride (10 mg/kg; T5
      T8). RESULTS: Manually traced transesophageal echocardiography images of the left
      ventricular end-diastolic area decreased from 4.64 +/- 1.50 cm2 at T1 to 4.03 +/-
      1.25 cm2 at T2 to 3.78 +/- 1.35 cm2 at T3, and increased to 4.42 +/- 1.75 cm2 at
      T4. Nearly identical results were obtained at T5-T8. End-systolic areas
      significantly decreased from 1.96 +/- 0.86 cm2 at T1 to 1.52 +/- 0.73 cm2 at T2
      to 1.41 +/- 0.62 cm2 at T3, and increased to 1.87 +/- 0.88 cm2 at T4. An
      experienced anesthesiologist-echocardiographer blinded to study events was able
      to identify mild reductions in blood volume (T2, T3, T6, T7) from recorded cine
      loop video recordings with high sensitivity (80-95%) and specificity (80%).
      CONCLUSIONS: Transesophageal echocardiography is a potentially useful monitor of
      cardiac filling changes in pediatric patients.

PMID- 8342798
TI  - Effects of remifentanil, a new short-acting opioid, on cerebral blood flow, brain
      electrical activity, and intracranial pressure in dogs anesthetized with
      isoflurane and nitrous oxide.
AB  - BACKGROUND: A new short-acting opioid, remifentanil, is metabolized by esterase
      activity in blood and tissue. It is important to know whether remifentanil may
      decrease the time to recovery of opioid-induced cardiovascular and cerebral
      effects compared to that of other short-acting agents such as alfentanil.
      METHODS: Baseline measures were made during 1% end-tidal isoflurane and 50% N2O
      in oxygen in dogs. Approximately equipotent low- and high-dose remifentanil (0.5
      and 1.0 micrograms.kg-1.min-1) or alfentanil (1.6 and 3.2 micrograms.kg-1.min-1)
      were infused for 30 min each (total infusion time 60 min) followed by a 30-min
      recovery period. Blood pressure, heart rate, and intracranial pressure were
      recorded continuously. Electroencephalogram measurements were made using
      aperiodic analysis, and regional cerebral blood flow using radioactive
      microspheres. RESULTS: Both remifentanil and alfentanil decreased blood pressure
      and heart rate 25-30%. Cortex, hippocampus, and caudate blood flow decreased 40
      50% during opioid infusion, but flow changes in lower brain regions were modest
      or absent. The electroencephalogram showed a shift from low-amplitude, high
      frequency activity during baseline to high-amplitude, low-frequency activity
      during opioid infusion. During a 30-min recovery period, heart rate,
      electroencephalogram, and regional cerebral blood flow recovered to baseline
      levels in remifentanil--but not in alfentanil--treated dogs. Blood pressure and
      intracranial pressure decreased during opioid infusion and increased above
      baseline levels during the recovery period in remifentanil-treated dogs.
      CONCLUSIONS: These results show that the cardiovascular and cerebral effects of
      remifentanil and alfentanil are similar but that recovery of these parameters
      occurs sooner following remifentanil.

PMID- 8342799
TI  - Halothane-oxidant interactions in the ex vivo perfused rabbit lung. Fluid
      conductance and eicosanoid production.
AB  - BACKGROUND: The present studies were undertaken to determine the interactions
      between halothane and oxidative injury with respect to endothelial integrity, as
      measured by pulmonary capillary filtration coefficient (Kfc), and production of
      arachidonic acid-derived mediators, in perfused rabbit lungs challenged with the
      oxidant tert-butyl-hydroperoxide (t-bu-OOH). METHODS: Isolated lungs were
      prepared from 27 New Zealand white rabbits (2-3 kg) and were perfused with Ca(2+)
      free Krebs-Henseleit buffer solution. In group A (n = 9), lungs were ventilated
      with halothane 2.5% in carrier gas (5% CO2 in air); in group B (n = 9), with
      carrier gas alone; and in group C (n = 9), with carrier gas, but without injury.
      The lungs in the two injury groups (A and B) received four infusions of t-bu-OOH,
      200 microM, over 1 min, directly into the pulmonary artery. The uninjured lungs
      received four infusions of vehicle (normal saline). Kfc was determined after each
      t-bu-OOH infusion. Concentrations of thromboxane B2 (TxB2) and 6-keto
      prostaglandin F1 alpha were measured in samples of effluent perfusate obtained
      before and 30 s after the end of each infusion of t-bu-OOH. The wet/dry weight
      ratio of each pair of lungs was determined at the end of each experiment.
      RESULTS: Kfc progressively increased after each infusion of oxidant in group A
      when compared with the other two groups. Lung wet/dry ratios were elevated in
      group A (14.3 +/- 0.7) and group B (13.2 +/- 0.2) compared with group C (12.1 +/-
      1.1). TxB2 production in group A (2206 +/- 263 pg.min-1.g-1 dry lung tissue) was
      greater than in group B (1413 +/- 127) by the final infusion of t-bu-OOH.
      CONCLUSIONS: Ex vivo perfused rabbit lungs ventilated with halothane exhibited,
      simultaneously, evidence of greater fluid conductance across the pulmonary
      capillary bed and production of thromboxane A2 when challenged with oxidant than
      did lungs ventilated with carrier gas. Both of these effects may be mediated by
      halothane-related enhancement of intracellular endothelial Ca2+ mobilization
      stimulated by intrapulmonary infusion of oxidant.

PMID- 8342800
TI  - A focal cryogenic brain lesion does not reduce the minimum alveolar concentration
      for halothane in rats.
AB  - BACKGROUND: A focal cortical cryogenic brain injury has been reported to reduce
      the brain pentobarbital concentrations needed to prevent movement in response to
      pain in rats. This occurred despite any apparent behavioral changes in the awake
      animals. To determine whether this was true with other anesthetics, the authors
      determined the minimum alveolar concentration (MAC) for halothane in
      normothermic, normocarbic ventilated Sprague-Dawley rats previously subjected to
      a freezing injury of the parietal cortex. METHODS: Injury was produced in
      halothane-anesthetized rats by applying a cold (-70 degrees C), 4-mm-diameter
      brass rod to the exposed dura for 5 or 15 s. Animals then were studied 3 days
      after injury, a time when cerebral metabolism in the ipsilateral hemisphere
      reaches a minimum. Minimum alveolar concentration was determined using a tail
      clamp stimulus, combined with end-tidal anesthetic sampling. In addition,
      exploratory activity was measured by the open field test just before MAC
      determination, and spontaneous nocturnal motility was monitored by an electronic
      motion sensor during the night before testing. RESULTS: In normal animals
      subjected only to preparatory surgery, MAC was 1.10 +/- 0.07% (mean +/- SD).
      Almost identical values were found in rats subjected to 5- and 15-s cryogenic
      injuries (1.11 +/- 0.07% and 1.08 +/- 0.06%, respectively). There were no
      intergroup differences in open field test results or in spontaneous nocturnal
      activity. CONCLUSIONS: These results indicate that a focal cortical brain injury
      that has no obvious neurologic or behavioral effects in the awake rat does not
      alter halothane requirements.

PMID- 8342802
TI  - Severe burn caused by an operating room light.

PMID- 8342801
TI  - Subanesthetic concentrations of isoflurane suppress learning as defined by the
      category-example task.
AB  - BACKGROUND: Previously, we found unconscious (implicit) learning in subjects
      given subanesthetic, but not anesthetic, concentrations of isoflurane. Other
      investigators, using different learning tasks, have reported implicit learning at
      anesthetic concentrations. We investigated whether one of these tasks might
      provide a more sensitive test of implicit learning. In addition, to determine
      whether suppression of explicit or implicit learning is dose-dependent, we
      studied one of the tasks at three subanesthetic concentrations. METHODS: We
      applied a category-example task at 0.15, 0.28, and 0.4 minimum alveolar
      concentration (MAC) of isoflurane, and a behavior task only at 0.4 MAC. After
      anesthesia, we determined whether volunteers more frequently listed an example of
      a category (e.g., flute as an example of musical instrument) presented during
      anesthesia and/or demonstrated a behavior (touching ear, chin, or knee) suggested
      to them at 0.4 MAC. RESULTS: Results from the category task indicated implicit
      learning only at 0.15 MAC, a concentration that also permitted significant
      explicit learning. Explicit learning was demonstrated at 0.28 but not at 0.4 MAC
      (ED50 of 0.20 MAC and ED95 of 0.4 MAC). Results from the behavior task revealed
      neither implicit nor explicit learning. CONCLUSIONS: The ED50 that suppressed
      explicit learning in our volunteers equaled that previously reported (0.2 MAC)
      for implicit learning in volunteers measured using a different task. Combined,
      these results suggest that less than 0.45 MAC isoflurane suppresses learning in
      volunteers.

PMID- 8342803
TI  - Profound hypercarbia late in the course of laparoscopic cholecystectomy:
      detection by continuous capnometry.

PMID- 8342804
TI  - Maternal masseter muscle rigidity and neonatal fasciculations after induction for
      emergency cesarean section.

PMID- 8342805
TI  - Paradoxical vocal cord motion: an unusual cause of stridor in the recovery room.

PMID- 8342806
TI  - Cold-induced bronchospasm during coronary artery bypass surgery.

PMID- 8342807
TI  - Laryngeal mask airway and pulmonary edema.

PMID- 8342808
TI  - Laryngeal mask airway and pulmonary edema.

PMID- 8342809
TI  - Laryngeal mask airway and pulmonary edema.

PMID- 8342810
TI  - Cerebrovascular autoregulation may be the probable mechanism responsible for
      fentanyl- and sufentanil-induced increases in intracranial pressure in patients
      with head trauma.

PMID- 8342811
TI  - Organ perfusion during deliberate hypotension and superimposed hemorrhage.

PMID- 8342812
TI  - Spinal anesthesia for a former premature infant undergoing upper abdominal
      surgery.

PMID- 8342813
TI  - Injection of pancuronium into the masseter muscle for difficult reduction of
      mandibular dislocation.

PMID- 8342814
TI  - Ipsilateral shoulder pain following thoracic operations.

PMID- 8342815
TI  - Ipsilateral shoulder pain following thoracic operations.

PMID- 8342816
TI  - Henry Ruth, T. Drysdale Buchanan, and history of anesthesia.

PMID- 8342817
TI  - Henry Ruth and history: his rightful place?

PMID- 8342818
TI  - Anesthesia studies should include costs.

PMID- 8342819
TI  - Intrathecal baclofen in tetanus: alternative methods of administration.

PMID- 8342821
TI  - The safety of sevoflurane in humans.

PMID- 8342820
TI  - The safety of sevoflurane in humans.

PMID- 8342822
TI  - Epidural anesthesia and anticoagulation.

PMID- 8342823
TI  - Epidural anesthesia and anticoagulation.

PMID- 8342824
TI  - The pupillary light reflex. Effects of anesthetics and hyperthermia.
AB  - BACKGROUND: The pupillary light reflex often is evaluated in the perianesthetic
      period to assess drug effects and brainstem function. Mild hypothermia alone or
      combined with isoflurane does not impair pupillary responses. Although
      perioperative hyperthermia is less common than hypothermia, abnormal increases in
      core temperature remain an important thermal disturbance. Accordingly, the
      pupillary effects of hyperthermia alone and hyperthermia combined with isoflurane
      and enflurane were evaluated. Additionally, the effects of nitrous oxide on
      pupillary responses were determined. METHODS: The pupillary light reflex was
      evaluated in 31 non-surgical volunteers participating in concurrent
      thermoregulatory studies. Pupillary reflexes were quantified using a portable
      infrared pupillometer during (1) hyperthermia alone (n = 9), (2) hyperthermia
      with 0.8% and 1.2% end-tidal isoflurane (n = 8), (3) hyperthermia with 1.7% end
      tidal enflurane (n = 5), and (4) inhalation of 60% N2O (n = 9). RESULTS: Mild
      hyperthermia alone (core temperature 38.5 +/- 0.3 degrees C) produced no
      clinically significant change in the pupillary light reflex. Pupillary responses
      were decreased markedly with 0.8% isoflurane, 1.2% isoflurane, and 1.7% enflurane
      when the volunteers were normothermic. Mild hyperthermia combined with isoflurane
      or enflurane dilated the pupil and increased the amplitude of the light reflex.
      Sixty-percent nitrous oxide decreased the pupillary reflex only 26 +/- 4%.
      CONCLUSIONS: Anesthetic-induced inhibition of the pupillary response to light is
      reversed partially by core hyperthermia. In contrast to enflurane and isoflurane,
      60% N2O has little effect on the pupil.

PMID- 8342825
TI  - The interaction between alcohol and the residual effects of thiopental
      anesthesia.
AB  - BACKGROUND: During ambulatory surgery, barbiturates, such as thiopental, may
      impair psychomotor performance several hours after administration. It was
      hypothesized that if patients drink alcohol 4 h after thiopental injection, the
      increase in psychomotor impairment would be greater than that seen after alcohol
      ingestion alone. METHODS: Twelve healthy men volunteered to participate in a
      double-blind, placebo-controlled, crossover study with a Latin square design. On
      each testing day, the subjects received intravenous injections of either 5 mg/kg
      of 2.5% thiopental or an equal volume of saline for 30 s. Four hours after
      injection, the subjects consumed a beverage with or without 0.7 g/kg alcohol.
      Psychomotor performance and mood were assessed at five times: prior to injection,
      at 1 h and 3 h after injection, and at 1 h and 3 h after consumption of beverage.
      RESULTS: Both thiopental and alcohol had strong independent effects on the
      dependent measures in this study. In addition, body sway, one of the nine
      psychomotor tests used to assess impairment, was greater after thiopental and
      alcohol than after alcohol alone. Of eleven adjectives used to assess mood,
      lightheadedness was cited most frequently after a combination of thiopental and
      alcohol than after each alone. CONCLUSIONS: Based on our tests of performance and
      mood, an interaction between thiopental and alcohol is evident; in addition, the
      interaction between both drugs may exert deleterious effects on higher levels of
      central nervous system integration.

PMID- 8342826
TI  - Cardiac performance preserved despite thiopental loading.
AB  - BACKGROUND: Some cerebral artery aneurysms require cardiopulmonary bypass and
      deep hypothermic circulatory arrest to be clipped safely. During bypass these
      neurosurgical patients often are given large doses of thiopental in the hope that
      additional cerebral protection will be provided. However, thiopental loading
      during bypass has been associated with subsequent cardiac dysfunction in patients
      with heart disease. This study was undertaken to determine how patients without
      concomitant heart disease would respond to thiopental loading. METHODS: Twenty
      four neurosurgical patients with giant cerebral aneurysms and little or no
      cardiac disease were anesthetized with fentanyl, nitrous oxide, and isoflurane.
      Thiopental was titrated to achieve electroencephalographic burst-suppression
      before bypass, and the infusion was continued until after separation. Prebypass
      hemodynamic and echocardiographic measurements were obtained during a stable
      baseline and 15 min after thiopental loading began. They were repeated after
      bypass. RESULTS: Prebypass thiopental loading increased heart rate from 61 +/- 11
      to 72 +/- 13 beats/min and decreased stroke volume from 43 +/- 10 to 38 +/- 8
      ml.beat-1.m-2, but arterial and filling pressures, vascular resistance, cardiac
      index, and ejection fraction remained the same. Before bypass, thiopental plasma
      concentration measured 28 +/- 8 micrograms/ml. Loading continued for 2-3 h until
      after bypass was terminated, and the overall infusion rate was 18 +/- 5 mg.kg-1.h
      1. All patients were easily separated from bypass without inotropic support.
      Following bypass, vascular resistance was decreased; heart rate, filling
      pressures, and cardiac index were increased; stroke volume had returned to its
      baseline; and ejection fraction was unchanged. CONCLUSIONS: It was concluded that
      if preoperative ventricular function is good, thiopental loading to
      electroencephalographic burst-suppression causes negligible cardiac impairment
      and does not impede separation from cardiopulmonary bypass.

PMID- 8342827
TI  - Pupillary assessment of sensory block level during combined epidural/general
      anesthesia.
AB  - BACKGROUND: Currently, no reliable method exists to determine the level of
      sensory block during combined epidural/general anesthesia. However, the pupil
      dilates markedly in response to noxious electrical stimulation during general
      anesthesia. Presumably, sensory block produced by epidural anesthesia decreases
      or obliterates this autonomic response. Accordingly, we tested the hypothesis
      that pupillary dilation in response to noxious stimulation would predict the
      level of sensory block achieved during combined epidural/general anesthesia.
      METHODS: We studied eight volunteers and ten patients during combined
      epidural/general anesthesia. The volunteers were given an epidural infusion of 2%
      2-chloroprocaine while general anesthesia was maintained with 0.8% isoflurane and
      60% N2O. In the patients, an epidural infusion of 0.25% bupivacaine was combined
      with isoflurane and vecuronium. Noxious electrical stimulation was administered
      to dermatomal segments in a caudal-to-rostral progression. A twofold increase in
      pupil size following electrical stimulation was considered the predicted block
      level in volunteers. In patients, an increase in pupil size exceeding 50% was
      considered the predicted level. After general anesthesia was discontinued,
      observers blinded to the pupillary measurements independently determined the
      actual epidural block level using pain in response to a pinprick as the
      criterion. RESULTS: The level predicted by pupillary responses was within two
      dermatomal segments of the actual level in all the volunteers. The predicted and
      actual block levels were within two segments in eight of the ten patients and
      never differed by more than four dermatomes. CONCLUSIONS: We conclude that
      dilation of the pupil in response to electrical stimulation is an accurate test
      of the sensory block level during combined epidural/general anesthesia.

PMID- 8342828
TI  - Dose-response pharmacology of intrathecal morphine in human volunteers.
AB  - BACKGROUND: Intrathecal morphine sulfate (ITMS) administration was introduced
      into clinical practice in 1979. Inadequate information exists delineating ITMS
      respiratory effects in the dosage range most frequently employed today. This
      study evaluated 0.2, 0.4, and 0.6 mg ITMS in male volunteers. METHODS: Twenty
      healthy, young, adult male volunteers received 0.0, 0.2, 0.4, or 0.6 mg
      preservative-free ITMS in an isobaric solution administered at the L3-L4
      interspace in a double-blind randomized fashion. Respiratory function was
      assessed by finger pulse oximetry (SpO2), respiratory rate, and arterial blood
      gas analysis via an indwelling arterial catheter and the slope of the ventilatory
      response to carbon dioxide (VE/CO2). Analgesia was assessed by the effect of ITMS
      on moderate pain produced by pressure algometry at the tibia. The need for
      supplemental oxygen, 2 L/min via nasal cannulae, was determined by the failure of
      verbal and tactile prompts to maintain subjects' SpO2 > or = 85% on more than two
      occasions. Heart rate, arterial blood pressure, sedation level, pupil size, and
      the incidence of adverse effects also were documented. All the above measurements
      were made before and 30 min after ITMS, hourly for 11 h, and then every 2 h for
      12 more h. RESULTS: ITMS produced significant dose-related decreases in SpO2.
      Mild desaturations (SpO2 > or = 85 and < 90%) occurred in 2 of 5, 3 of 5, and 4
      of 5 subjects receiving 0.2, 0.4, and 0.6 mg ITMS, respectively. Moderate to
      severe desaturations (SpO2 < 85%) occurred in 0 of 5, 2 of 5, and 4 of 5 subjects
      receiving 0.2, 0.4, and 0.6 mg ITMS, respectively. The need for supplemental
      oxygen also was significantly related to ITMS dose, with 0 of 5, 1 of 5, and 4 of
      5 subjects requiring oxygen after 0.2, 0.4, and 0.6 mg ITMS, respectively. Nasal
      oxygen administration consistently alleviated hypoxemia. Increases in arterial
      carbon dioxide tension (PaCO2) and decreases in pH were significantly related to
      ITMS dose. Peak mean PaCO2s were 42.4, 44.9, and 50.7 mmHg in the 0.2-, 0.4-, and
      0.6-mg groups, respectively. These peaks occurred 6.5-7.5 h after ITMS injection.
      ITMS produced significant dose-related depression of VE/CO2. Maximum mean
      depressions of VE/CO2 were to 61%, 63%, and 32% of baseline in the 0.2-, 0.4-,
      and 0.6-mg groups, respectively. These nadirs occurred 3.5-7.5 h after ITMS
      injection. Some subjects receiving 0.6 mg ITMS experienced profound (< 20% of
      baseline) and prolonged (< 50% of baseline for up to 20 h) VE/CO2 depression.
      Magnitude and duration of analgesia after ITMS were dose-related. Changes in
      heart rate, systolic blood pressure, and respiratory rate were not significantly
      related to ITMS dose. Hypoxemia was not related to respiratory rate. Although
      ITMS produced statistically significant dose-related increases in sedation and
      decreases in pupil size, these changes were small and did not coincide with
      hypoxemia. ITMS caused dose-related increases in emesis, but the severity of
      pruritus and urinary retention was unrelated to dose. CONCLUSION: ITMS produced
      dose-related analgesia and respiratory depression in nonsurgical healthy, young,
      adult male volunteers. Respiratory depression was significant after 0.2 or 0.4 mg
      and profound and prolonged after 0.6 mg. No clinical signs or symptoms, including
      respiratory rate, reliably indicated hypoxemia. Pulse oximetry reliably detected
      hypoxemia after ITMS, and supplemental nasal oxygen (2 L/min) effectively
      corrected this hypoxemia.

PMID- 8342829
TI  - False-negative results with muscle caffeine halothane contracture testing for
      malignant hyperthermia.
AB  - BACKGROUND: During the period 1985-1991, 350 muscle contracture studies have been
      performed in the authors' laboratory, and during this period, they became aware
      of an occasional false-negative result. The findings pertaining to the four cases
      so classified are presented in detail. METHODS: In 1985 the protocol for the
      muscle strip caffeine halothane testing procedure adopted was that of the
      European Malignant Hyperthermia Society. RESULTS: Thirty-six percent of the cases
      tested susceptible for malignant hyperthermia, 15% tested equivocal in that they
      responded either to halothane or to caffeine singularly, and 49% gave a normal
      response. In this latter group, the authors believe they identified four false
      negative results. CONCLUSIONS: This study documents the rarity of false-negative
      results and substantiates the reliability of caffeine halothane testing as a
      biologic test in diagnosing the presence of a potentially serious problem.

PMID- 8342830
TI  - Hemodilution with oxyhemoglobin. Mechanism of oxygen delivery and its
      superaugmentation with a nitric oxide donor (sodium nitroprusside).
AB  - BACKGROUND: Hemodilution (HD) with oxyhemoglobin colloid (oxyHb) provides a
      greater arterial oxygen content (CaO2) than HD with conventional colloids;
      however, oxygen delivery (DO2) is essentially the same, because, in contrast to
      conventional HD, cardiac output (CO) is not augmented. This study seeks to
      elucidate the mechanism that limits CO during oxyHb-HD and to test whether
      infusion of a nitric oxide (NO) donor would augment DO2, because oxyHb is known
      to inactivate in vitro endothelial-derived NO. METHODS: Anesthetized dogs were
      isovolemically hemodiluted with 10% oxyHb, 8% albumin, or 10% methemoglobin (weak
      NO inactivator) to 20% hematocrit. After HD, sodium nitroprusside (SNP) was
      titrated intravenously until decreases (> 10 mmHg) in mean aortic pressure (Pao)
      indicated the presence of exogenous NO. Systemic hemodynamics and regional blood
      flows (microsphere method) were measured. RESULTS: Albumin-HD and metHb-HD
      produced typical HD-mediated responses: increased CO (63-65%), slight decreases
      (13-15%) in DO2, decreases in systemic vascular resistance (SVR) proportional to
      the decreases (49-52%) in blood viscosity of all three groups, and increased
      regional blood flows (RBF). Responses to oxyHb-HD were atypical: CO and its
      determinants were not changed, DO2 decreased (23%) proportional to CaO2, and SVR
      and most RBF were not changed except for a net redistribution of CO to myocardium
      and skeletal muscle. In albumin-HD or metHb-HD, SNP (2-5 micrograms.kg-1.min-1)
      induced comparable decreases in mean Pao (29-37%) and SVR (39-41%); however, CO,
      RBF, and DO2 were not affected. In oxyHb-HD, exceptionally large doses of SNP (54
      +/- 5 micrograms.kg-1.min-1) decreased mean Pao only 19 +/- 1%; however, CO
      increased 78 +/- 5% and decreases (61 +/- 3%) in SVR were slightly greater than
      viscosity reductions. Other determinants of CO were not affected. Most RBF
      increased proportional to CO; there was, however, preferential distribution to
      myocardium and skeletal muscle. Consequently, the augmented CO, and CaO2 of oxyHb
      HD, produced large increases in DO2, 77 +/- 5% from HD alone and 43 +/- 3% from
      prehemodilution values. CONCLUSIONS: This study indicates that the limited CO and
      DO2 of oxyHb-HD resulted from opposing changes in two determinants of flow, i.e.,
      reduced blood viscosity and increased arterial resistance (vasoconstriction). The
      vasoconstriction was not evident with metHb-HD and was reversed by the SNP
      infusion, indicating that oxyHb inactivated in vivo endothelial-derived NO. The
      ability of the NO donor (SNP) to facilitate large viscosity-mediated increases in
      DO2 during oxyHb-HD is an important finding that could potentially render oxyHb
      colloids more useful than conventional colloids, particularly for the individual
      with a compromised circulation who would benefit from an increased oxygen supply.

PMID- 8342832
TI  - Tomorrow.

PMID- 8342833
TI  - Aspirin, the miracle drug: spinally, too?

PMID- 8342831
TI  - Positive end-expiratory pressure lowers the risk of laser-induced
      polyvinylchloride tracheal-tube fires.
AB  - BACKGROUND: The possibility of ignition of polyvinylchloride (PVC) tracheal tubes
      by a CO2 laser is of concern in patients undergoing CO2 laser surgery of the
      airway. The authors analyzed the ignition of PVC tracheal tubes by a CO2 laser
      beam to determine what variables were involved, and then designed a study to
      determine how they affect the incidence of such fires. METHODS: For the analysis,
      PVC tracheal tubes were enclosed in a clear plexiglass enclosure and a laser beam
      was focused on the tubes. The enclosure contained one of three different gas
      combinations. A high-speed camera photographed the tubes during the analysis and
      showed that tracheal tube perforation always preceded ignition in all three gas
      combinations. These results led to the hypothesis that intraluminal gauge
      pressure (IGP) may be an important variable, because it would affect the flow of
      O2 across the perforation. This hypothesis was tested by aiming a CO2 laser beam
      at PVC tracheal tubes and varying IGP in 0.25-cm H2O increments, from 0.25 to 28
      cm H2O, while nitrogen or helium containing O2 at 40, 50, or 60% flowed through
      the tubes. To simulate the clinical effect of IGP on PVC tracheal tube ignition,
      we used a mechanical lung model connected to an anesthesia breathing circuit with
      a standing bellows ventilator in which 60% He and 40% O2 flowed through a PVC
      tracheal tube. Laser beam exposure was started at three different times during
      the respiratory cycle: at the start of inspiration, at the end of inspiration, or
      at the end of expiration. Also, for each condition, trials were made at baseline
      circuit pressure (2.5 cm H2O) and at 5.0 cm H2O by the addition of 2.5 cm H2O
      positive end-expiratory pressure (PEEP) applied to the circuit. RESULTS: The
      incidence of tracheal tube ignition decreased as IGP increased. The IGP at which
      ignition did not occur (which increased as O2 concentration increased) did not
      differ between N2 and He at 40% O2, but was twice as high with N2 as with He at
      O2 of 50% and 60%. Fires never occurred when PEEP was added to the system and,
      when PEEP was not added, always started during the last 2 s of end expiration
      (when airway pressure is lowest), regardless of when the laser beam was
      activated. CONCLUSIONS: It is recommended that, in addition to other safety
      practices, PEEP be added to the breathing circuit during CO2 laser operations on
      the airway in which PVC tracheal tubes or laser-resistant tracheal tubes with PVC
      components are used.

PMID- 8342834
TI  - The effects of preinduction warming on temperature and blood pressure during
      propofol/nitrous oxide anesthesia.
AB  - BACKGROUND: Core temperature decreases rapidly after induction of anesthesia,
      largely because heat is redistributed to peripheral tissues. The hypothesis that
      warming peripheral tissues before induction of general anesthesia (prewarming)
      minimizes hypothermia was tested. Because circulating blood volume may be greater
      during exposure to heat compared to cold, the hypothesis that prewarming
      decreases the amount of hypotension associated with induction of anesthesia was
      tested also. Finally, the hypothesis that the difference between direct radial
      arterial blood pressure and blood pressure measured oscillometrically at the
      brachial artery depends on thermoregulatory and anesthetic conditions was tested.
      METHODS: Each of six volunteers underwent general anesthesia (propofol and
      nitrous oxide) twice on the same day. Each anesthetic lasted 1 h and was preceded
      by either 2 h of active warming with forced air or 2 h of passive cooling by
      exposure to a typical operating room environment. After induction of each
      anesthetic, volunteers were fully exposed to the ambient environment. Volunteers
      recovered for 2 h before starting the second preinduction treatment. RESULTS:
      Initial tympanic membrane temperatures were similar before each preinduction
      treatment: 36.7 +/- 0.4 degrees C when volunteers were not warmed and 36.7 +/-
      0.6 degrees C when volunteers were warmed. Tympanic membrane temperature did not
      change during the preinduction period without warming but increased slightly
      (delta T = 0.4 +/- 0.2 degree C) during warming. After induction of anesthesia,
      core temperatures decreased to 36.1 +/- 0.4 degree C over 1 h when volunteers
      were prewarmed but decreased to 34.9 +/- 0.4 degrees C when they were not. Radial
      arterial systolic, diastolic, and mean blood pressures were lower before
      induction of anesthesia when volunteers were warmed compared to when no warming
      was given. Oscillometric diastolic and mean pressures also were lower during
      prewarming; however, oscillometric systolic pressure did not differ
      significantly. Prewarming did not result in less hypotension after induction.
      Without warming, the difference (radial arterial minus oscillometric) in systolic
      blood pressure measurements was approximately 17 mmHg. Warming was associated
      with a reversal of the systolic pressure difference to approximately -6 mmHg.
      After induction of anesthesia, the differences in systolic and mean pressure
      measurements became more negative with respect to the preinduction values
      regardless of preinduction warming treatment. CONCLUSIONS: These data confirm our
      hypothesis that redistribution hypothermia can be minimized by preinduction
      warming of peripheral tissues. Prewarming decreases blood pressure but does not
      prevent subsequent hypotension after induction. The difference between radical
      arterial blood pressure and oscillometric blood pressure depends on
      thermoregulatory vasomotor changes but also may be influenced by vasodilation
      associated with administration of propofol and nitrous oxide.

PMID- 8342835
TI  - Comparison of effects of sevoflurane/nitrous oxide and enflurane/nitrous oxide on
      myocardial contractility in humans. Load-independent and noninvasive assessment
      with transesophageal echocardiography.
AB  - BACKGROUND: Few studies have been reported on the direct depressive effects of
      sevoflurane on myocardial contractility in humans. Direct assessment of
      contractile state is possible by examining the slope of left ventricular end
      systolic wall stress (LVESWS) versus velocity of circumferential fiber shortening
      with heart rate corrected (Vcfc) relationship with echocardiography. Using this
      contractile index, the effects of sevoflurane/nitrous oxide were compared with
      that of enflurane/nitrous oxide on myocardia contractility in humans. METHODS:
      Twenty-eight subjects were studied during either sevoflurane/nitrous oxide or
      enflurane/nitrous oxide anesthesia. Systolic, diastolic, and mean arterial blood
      pressure, heart rate, and transesophageal echocardiographic data were determined
      at 0.9 MAC and 1.35 MAC of sevoflurane or enflurane, both with 60% N2O, and at
      1.6 MAC of sevoflurane with 60% N2O. Furthermore, another 28 awake subjects were
      studied with transthoracic echocardiography to examine the contractile state at
      awake state, and echocardiograms, heart rate, and arterial blood pressure were
      recorded. RESULTS: Heart rate did not changed significantly in either group.
      Enflurane/nitrous oxide produced significantly greater decrease in arterial blood
      pressure than did sevoflurane/nitrous oxide. The Vcfc at each anesthetic dose in
      both anesthetic groups was significantly less than that in the awake subjects
      group. Sevoflurane/nitrous oxide produced no significant change in Vcfc at 1.5
      MAC, whereas enflurane/nitrous oxide caused significant dose-related decrease in
      Vcfc. Vcfc produced by sevoflurane/nitrous oxide was significantly greater than
      that produced by enflurane/nitrous oxide. There was no significant difference in
      LVESWS (index of afterload) between the groups. With respect to the LVESWS-Vcfc
      relationship, myocardial contractility was significantly depressed in both the
      sevoflurane and the enflurane groups compared to the awake subjects group.
      However, myocardial contractility produced by enflurane/nitrous oxide was
      significantly less than that by sevoflurane/nitrous oxide at equiMAC
      concentration. CONCLUSIONS: The results of the present study suggest that
      sevoflurane has fewer depressant effects on cardiac function than does enflurane.

PMID- 8342836
TI  - The esophageal detector device. Does it work?
AB  - BACKGROUND: The esophageal detector device (EDD) is a diagnostic tool for
      confirmation of tracheal intubation. Capnography is the accepted standard for
      such confirmation. The purpose of this investigation was to determine whether
      results using the EDD and capnography agree. METHODS: Five hundred patients were
      divided into three separate studies. In study 1, with 300 consecutive patients,
      tracheal intubation was performed and tested with the EDD followed by
      capnography. In study 2, 100 patients had the esophagus intentionally intubated,
      and confirmation was tested similarly. The tube was then removed and the trachea
      intubated, and testing followed. Study 3 involved 100 patients and used a double
      blind, randomized design. The tube was intentionally inserted into either the
      esophagus (n = 5) or trachea (n = 49), and testing followed. RESULTS: In study 1,
      the compressed EDD bulb reinflated 270 times and always agreed with capnography;
      in 20 of the 270 subjects (7%) bulb reinflation was delayed, taking from 5-30 s.
      In 30 instances, the bulb remained compressed, and there was no capnogram
      indicating esophageal intubation. In study 2, regardless of esophageal or
      tracheal intubation, agreement between EDD and capnogram was 100%. In study 3,
      the agreement between the two detecting instruments was 100%, but reinflation of
      the EDD bulb was delayed in 4% of tracheal intubations. In the 500 patients
      studied, results from the EDD and capnogram always agreed, but in 6% of all
      tracheal intubations, the EDD bulb inflated slowly. Of 181 esophageal
      intubations, the results from the EDD and capnogram always agreed, i.e., there
      was no reinflation or capnogram. The sensitivity, specificity, and predictive
      value for the EDD in all of these studies was 100%. CONCLUSIONS: The EDD is a
      valuable diagnostic technique for confirming tracheal intubation. Results using
      EDD agree with results using capnography; in 6% of instances there is a slow
      reinflation; and where there is no capnography, such as on hospital wards, EDD
      may be a useful diagnostic tool.

PMID- 8342837
TI  - The effect of sensor malpositioning on pulse oximeter accuracy during hypoxemia.
AB  - BACKGROUND: Previous studies have shown that pulse oximeters whose sensors are
      positioned improperly may yield erroneously low saturation (SpO2) values on
      normoxemic subjects. The behavior of oximeters with malpositioned sensors during
      hypoxemia has not been studied. The current study is aimed at determining the
      behavior of several different pulse oximeters over a wide range of arterial
      oxygen saturation (SaO2). METHODS: In each of 12 healthy volunteers, a radial
      artery cannula was inserted, and eight different pulse oximeters, five of which
      had malpositioned sensors, were applied. Subjects breathed controlled mixtures of
      nitrogen and oxygen to slowly vary their SaO2 from 100% to 70%. Arterial blood
      samples were analyzed and pulse oximeter data were recorded at five stable SaO2
      values for each subject. RESULTS: The oximeters with malpositioned sensors vary
      greatly in their behavior, depending on both the actual SaO2 and the manufacturer
      and model. One oximeter underestimated saturation at all SaO2 values, while three
      others underestimated at high SaO2 and overestimated at low SaO2. Linear
      regression analysis shows a decrease in the slope of SpO2 versus SaO2 in most
      cases, indicating a loss of sensitivity to SaO2 changes. Between-subject
      variation in response curves was significant. CONCLUSIONS: The calibration curves
      of the pulse oximeters studied were changed greatly by sensor malpositioning. At
      low SaO2 values, these changes could cause the oximeter to indicate that a
      patient was only mildly hypoxemic when, in fact, hypoxemia was profound. It is
      recommended that sensor position be checked frequently and that inaccessible
      sensor locations be avoided whenever possible.

PMID- 8342838
TI  - Perioperative platelet reactivity and the effects of clonidine.
AB  - BACKGROUND: Increased postoperative platelet reactivity may contribute to
      arterial thrombotic complications following surgery. alpha 2 Agonists, which are
      being used increasingly to blunt the stress response of surgery, increase
      platelet aggregation in vitro. We compared perioperative changes in platelet
      reactivity in 21 patients receiving either clonidine or placebo. METHODS:
      Patients undergoing major abdominal surgery were randomized to receive oral and
      transdermal clonidine (n = 11) or placebo (n = 10). All patients received similar
      perioperative management, including preoperative sedation, general anesthesia
      without neuraxial opioids, or local anesthetics and postoperative patient
      controlled intravenous morphine. Blood was obtained for measurement of clonidine
      level, fibrinogen concentration, platelet count, and platelet reactivity
      (impedance aggregometry and dense granule release) before induction and 24, 48,
      and 72 h postoperatively. RESULTS: Thirteen of the 21 patients had biopsy-proven
      cancer at surgery, 5 of 11 received clonidine and 8 of 10 received placebo (NS).
      Clonidine levels were therapeutic (1-2 ng/ml) throughout the study period.
      Clonidine administration had no effect on platelet count or platelet reactivity.
      Therefore, the groups were combined for further analysis. In this group (n = 21),
      compared to preoperative values, fibrinogen levels rose maximally (36%) at 72 h
      postoperatively and platelet counts decreased 22% at 48 h. Platelet reactivity
      (aggregation and degranulation) to collagen, adenosine diphosphate, arachidonic
      acid, and ristocetin, increased at 24, 48, and 72 h postoperatively. Thrombin
      induced (supramaximal stimulus) dense granule release did not change from
      preoperative values. CONCLUSIONS: These data indicate that major abdominal
      surgery causes increased platelet reactivity postoperatively but does not effect
      maximal degranulation. This increased platelet reactivity occurs within 48 h of
      surgery, coinciding with the peak incidence of postoperative arterial thrombotic
      complications. Clonidine administration has no effect on surgically induced
      changes in platelet reactivity. In this surgical patient population, the use of
      clonidine should not increase the risk of platelet-induced perioperative arterial
      thrombosis.

PMID- 8342839
TI  - Clonidine pretreatment reduces the systemic toxicity of intravenous bupivacaine
      in rats.
AB  - BACKGROUND: Clonidine prolongs the duration of sensory and motor block induced by
      bupivacaine, and this association, in constant infusion by the epidural route, is
      used for postoperative analgesia. After a near-fatal intravenous bolus of
      bupivacaine in dogs, clonidine improves ventricular electrophysiologic
      parameters, but probably worsens bupivacaine-induced bradycardia and depression
      of the myocardial contractility. The current study, using a rodent animal model,
      evaluated the influence of clonidine pretreatment on the systemic toxic effects
      of bupivacaine overdose induced by a constant intravenous infusion. METHODS:
      Twenty Wistar male rats were anesthetized with thiopental, and controlled
      ventilation was started with an equal mixture of O2 and N2O. Electrocardiogram
      (ECG), electroencephalogram (EEG), and invasive arterial blood pressure were
      continuously recorded. Clonidine (5 micrograms/kg) or saline was injected
      intravenously in a randomized fashion. After 15 min, an intravenous infusion of
      bupivacaine was started at 2 mg.kg-1 x min-1. The time of occurrence of the
      bupivacaine-induced toxic events was recorded and the doses were calculated. Ten
      (five in each group) additional rats, pretreated according to the same protocol,
      were killed at the time of the first dysrhythmia, for blood sampling and plasma
      bupivacaine concentration measurement. RESULTS: Clonidine reduced heart rate and
      arterial blood pressure before bupivacaine infusion (P < 0.05). The threshold
      doses at the first QRS modification (11.3 +/- 5.6 vs. 2.1 +/- 0.9 mg/kg) and the
      first dysrhythmia (40.6 +/- 15.3 vs. 8.48 +/- 3.7 mg/kg), the increase in EEG
      total spectral power (33.3 +/- 21.9 vs. 8.2 +/- 5.1 mg/kg), the 25 and 50%
      reduction in baseline mean arterial pressure and heart rate, the isoelectric EEG
      (58.6 +/- 14 vs. 22 +/- 6.6 mg/kg), and the final systole (99 +/- 16 vs. 51.8 +/-
      14.5 mg/kg) were significantly greater in the clonidine group than in the saline
      group (P < 0.01). The time between the first dysrhythmia and 50% reduction of
      baseline mean arterial blood pressure was not different between the groups. In
      the additional series, the first dysrhythmia occurred later (10.9 +/- 4.5 vs. 3.2
      +/- 1.0 min, P < 0.01) and plasma bupivacaine levels were greater (18.7 +/- 8.0
      vs. 7.8 +/- 3.2 micrograms/ml, P < 0.01) in the clonidine group than in the
      saline group. CONCLUSIONS: In this model, clonidine given prophylactically delays
      the toxic manifestations of bupivacaine overdose and does not accentuate the
      subsequent hypotension.

PMID- 8342840
TI  - Effects of halothane, propofol, and thiopental on peripheral airway reactivity.
AB  - BACKGROUND: General anesthetics modify airway responsiveness by several
      mechanisms, including direct effects on airway smooth muscle and reductions in
      neural reflex activity. Halothane has been shown to reduce responsiveness through
      both of these mechanisms. The airway effects of barbiturates are controversial,
      and the effects of propofol are unknown. METHODS: To compare the direct effects
      of halothane, thiopental, and propofol in vivo, canine peripheral airways were
      constricted with two stimuli, histamine and hypocapnia, which are thought to
      directly contract smooth muscle. The authors then investigated the role of ATP
      sensitive potassium (KATP) channels as a mechanism for attenuating these
      responses. Basenji-Greyhound (BG) dogs were anesthetized with either halothane
      (1.5 MAC), thiopental (7.5 mg.kg-1 x min-1 intravenously) plus fentanyl (25
      micrograms intravenously every 20-30 min), or propofol (0.6 mg.kg-1 x min-1
      intravenously). A wedged bronchoscope technique was used to measure peripheral
      airway resistance (RP). After a stable baseline was obtained, dose-response
      curves to histamine (50, 100, or 200 micrograms intravenous bolus) or hypocapnia
      (0% CO2 for 2 min with 100, 200, or 400 ml/min collateral flow) were constructed.
      On separate occasions, the same sublobar segments were pretreated with
      glibenclamide (2 mg/ml aerosol), a KATP channel blocker, and dose-response curves
      to hypocapnia were repeated. RESULTS: Dose-response curves to histamine were
      similar during all three anesthetics. Halothane decreased airway responsiveness
      to hypocapnia, compared with either thiopental or propofol (P < 0.05).
      Pretreatment with glibenclamide abolished the effect of halothane on hypocapnia
      induced airway constriction. CONCLUSIONS: These results indicate that propofol
      afforded no benefit over thiopental or halothane in reducing peripheral airway
      responsiveness. Furthermore, the beneficial effects of halothane in reducing
      responsiveness to hypocapnia appear to be mediated by the opening of KATP
      channels.

PMID- 8342841
TI  - Effects of pentobarbital and isoflurane on regional cerebral oxygen extraction
      and consumption with middle cerebral artery occlusion in rats.
AB  - BACKGROUND: When compared with barbiturates, isoflurane may lack protective
      effects during focal cerebral ischemia. The reason for this difference is not
      clear. In this study, regional cerebral blood flow (rCBF), arterial and venous O2
      saturation, and O2 extraction were compared in the ischemic cortex and in the
      nonischemic brain regions of rats anesthetized with isoflurane or pentobarbital
      using a microspectrophotometric technique that directly measures the O2
      saturation of blood in the small arteries and veins. METHODS: Twenty-eight rats
      were anesthetized with 1.4% isoflurane or 50 mg/kg pentobarbital. One hour after
      a middle cerebral artery (MCA) occlusion, rCBF was measured in the ischemic
      cortex and in the nonischemic brain regions using 14C-iodoantipyrine in one-half
      of each group of animals. Regional arterial and venous O2 saturation were
      determined using microspectrophotometry in the other one-half of each group.
      RESULTS: The rCBF of the ischemic cortex (IC) and the non-ischemic contralateral
      cortex (CC) of the isoflurane group were significantly higher than those of the
      pentobarbital group. The venous O2 saturation was significantly less, and the O2
      extraction was significantly higher, in the IC than in the nonischemic regions in
      both groups of animals (pentobarbital group, IC 10.5 +/- 1.1 ml O2.100 ml blood
      1, CC 6.3 +/- 0.7; isoflurane group, IC 10.8 +/- 0.6, CC 5.9 +/- 0.2). There was
      no significant difference between the two groups. CONCLUSIONS: Because the rCBF
      was less and the O2 extraction was similar, O2 consumption in the focal ischemic
      area of the brain during pentobarbital anesthesia must have been less than that
      during isoflurane anesthesia.

PMID- 8342842
TI  - Mechanism of the direct, negative inotropic effect of ketamine in isolated ferret
      and frog ventricular myocardium.
AB  - BACKGROUND: Ketamine exerts both an indirect, positive inotropic effect and a
      direct, negative inotropic effect in isolated ferret ventricular myocardium. This
      negative inotropic effect becomes apparent after inactivation of the sympathetic
      neuroeffector junction. The aim of this study was to investigate the mechanisms
      of ketamine's intrinsic negative inotropic effect. METHODS: The authors analyzed
      the effects of ketamine after beta-adrenoceptor blockade on variables of
      contractility and relaxation, and on the free intracellular Ca++ transient
      detected with the Ca(++)-regulated photoprotein aequorin. Ketamine's effects were
      also evaluated in a preparation in which the sarcoplasmic reticulum (SR) function
      was impaired by ryanodine, and in frog ventricular myocardium in which the SR is
      poorly developed. RESULTS: Ketamine at concentrations > or = 3.3 x 10(-5) M
      decreased contractility and the amplitude of the intracellular Ca++ transient.
      After inactivation of sarcoplasmic reticulum Ca++ release with 10(-6) M
      ryanodine, a condition in which myofibrillar activation depends almost
      exclusively on transsarcolemmal Ca++ influx, ketamine caused a decrease in
      contractility and in the amplitude of the intracellular Ca++ transient, and
      ketamine's relative negative inotropic effect was not different from that in
      control muscles not exposed to ryanodine. Furthermore, > or = 10(-4) M ketamine
      decreased contractility in frog ventricular myocardium, a species that is almost
      entirely dependent on transsarcolemmal Ca++ influx for its myofibrillar
      activation. CONCLUSIONS: These findings indicate that the direct negative
      inotropic effect of ketamine results from a decrease in intracellular Ca++
      availability with no changes in myofibrillar Ca++ sensitivity. At least part of
      ketamine's action is caused by inhibition of transsarcolemmal Ca++ influx.

PMID- 8342843
TI  - Prolonged regional nerve blockade by controlled release of local anesthetic from
      a biodegradable polymer matrix.
AB  - BACKGROUND: Prolonged nerve blockade is potentially useful in the management of
      many acute and chronic pain problems. Aside from infusions via an indwelling
      catheter, most currently available nondestructive techniques for prolonging local
      anesthetic action cannot provide more than 1-2 days of blockade. Bioerodible
      polymer matrixes have been used to deliver a variety of drugs in patients and
      animals for periods lasting weeks to years. Previously, dibucaine and bupivacaine
      were incorporated into copolymers of 1,3 bis(p-carboxyphenoxy) propane-sebacic
      acid anhydride (1:4), and demonstrated sustained release in vitro following
      incubation of the drug-polymer matrixes in phosphate-buffered solution (pH 7.4,
      37 degrees C). METHODS: In the present study, cylindrical pellets made from
      polymer matrixes incorporated with bupivacaine-HCl were implanted surgically
      along the sciatic nerves of rats. Neural block was assessed by direct observation
      of motor skills and by leg-withdrawal latency to a hot surface. Biochemical and
      histologic examinations were performed 2 weeks after implantation. RESULTS:
      Sensory and motor blockade was produced for periods ranging from 2 to 6 days.
      Contralateral control legs receiving polymer implants without drug showed no
      block. Blockade was reversible, and animals appeared to recover sensory and motor
      function normally. Biochemical indexes of nerve and muscle function were
      indistinguishable from contralateral controls. CONCLUSIONS: This biodegradable
      polymer system provides a promising new alternative for the delivery of local
      anesthetics to peripheral nerves to produce prolonged blockade for the management
      of acute and chronic pain.

PMID- 8342844
TI  - The effect of a platelet activating factor antagonist (BN 52021) on neurologic
      outcome and histopathology in a canine model of complete cerebral ischemia.
AB  - BACKGROUND: Research has demonstrated that platelet activating factor may
      modulate, in part, the severity of postischemic neurologic injury. The proposed
      mechanism involves a platelet activating factor-mediated release of cerebral
      cellular lipids and free fatty acids, resulting in increased cerebral edema and
      cell injury. The present study tested the hypothesis that a specific platelet
      activating factor antagonist, BN 52021, would improve neurologic outcome after 12
      min of complete global cerebral ischemia in a canine model. METHODS: Using an
      established canine model of complete cerebral ischemia, dogs were assigned
      randomly to receive, in a blinded fashion, either 20 mg/kg BN 52021 intravenously
      (N = 8) or placebo (N = 7) 5 min before cerebral ischemia. After cerebral
      ischemia and recovery, neurologic assessment was performed by a blinded observer
      for 72 h. Immediately thereafter, the brains were harvested and later were
      evaluated histologically by a neuropathologist blinded to the treatment groups.
      RESULTS: Dogs were well matched for systemic physiologic variables during all
      portions of the study. One placebo-treated dog and one BN 52021-treated dog were
      not included in the statistical analysis because of failure to meet
      preestablished protocol criteria. BN 52021, when compared to placebo, affected
      neither neurologic functional recovery nor overall histopathology scores.
      Regional histopathology was improved in BN 52021-treated dogs in only 1 of 18
      brain regions studied (i.e., the parietal cortex). When both treatment groups
      were combined, there was a significant correlation between neurologic function
      rank and histopathology rank. CONCLUSIONS: The present data demonstrate that the
      platelet activating factor antagonist BN 52021, at a dose of 20 mg/kg
      intravenously given 5 min before cerebral ischemia, did not protect the brain
      from injury in this canine model of complete global ischemia.

PMID- 8342845
TI  - Evaluation of central spinal cord injury pain with diagnostic spinal anesthesia.

PMID- 8342846
TI  - Indigo carmine-induced severe hypotension in patients undergoing radical
      prostatectomy.

PMID- 8342847
TI  - Is it time to correct the dermatome chart of the anterior scrotal region?

PMID- 8342848
TI  - Diagnosis of myocardial injury by real-time recording of ST segments of the
      electrocardiogram in a patient receiving general anesthesia for electroconvulsive
      therapy.

PMID- 8342849
TI  - Intraarterial vasodilator administration to restore pulse oximeter function.

PMID- 8342850
TI  - Pacemaker interactions with transcutaneous cardiac pacing.

PMID- 8342851
TI  - Electrocardiographic and hemodynamic changes associated with unintentional
      intravascular injection of bupivacaine with epinephrine in infants.

PMID- 8342852
TI  - A simple technique for placement of the Univent bronchial blocker.

PMID- 8342853
TI  - Needleless intravenous administration system.

PMID- 8342854
TI  - Barrier flaps for continuous caudal anesthesia in pediatric patients.

PMID- 8342855
TI  - Succinylcholine and Duchenne muscular dystrophy.

PMID- 8342856
TI  - Euthanasia and anesthesiologists.

PMID- 8342857
TI  - Euthanasia: wisdom or folly?

PMID- 8342859
TI  - Pitfalls in performing meta-analysis: I.

PMID- 8342858
TI  - Euthanasia in the intensive care unit.

PMID- 8342860
TI  - Anesthetic care and management of patients who are deaf and mute.

PMID- 8342861
TI  - Believe your monitors.

PMID- 8342862
TI  - Periarterial lidocaine/hydralazine aids arterial catheter insertion in patients
      with preeclampsia.

PMID- 8342863
TI  - Research and the laryngeal mask airway.

PMID- 8342864
TI  - Defining the difficult airway.

PMID- 8342865
TI  - Severity of illness classification for infection control departments: a study in
      nosocomial pneumonia.
AB  - BACKGROUND: A subjective severity of illness classification was evaluated in a
      study of nosocomial pneumonia. This is a 5-category system based on the
      determination of the control of underlying illness and the risk of death during
      current hospital admission. METHODS: A case-control study was performed with 128
      cases of nosocomial pneumonia and 252 control patients. An additional 60 case and
      90 control patients were used to compare this classification with APACHE II
      scoring in intensive care unit patients. RESULTS: In univariate analysis, the
      severity illness classification was significantly associated with nosocomial
      pneumonia risk (p < 0.01). APACHE II adequately predicted mortality rate but was
      not statistically significantly associated with nosocomial pneumonia risk among
      intensive care unit patients. In logistic regression analysis, the severity of
      illness classification, surgery, age, nasogastric tube placement, and histamine
      blockers each showed significant independent association with nosocomial
      pneumonia. CONCLUSIONS: The role of the severity of illness classification for
      risk stratification in nosocomial pneumonia is valid. Its roles in the evaluation
      of surgical wound infection, nosocomial bacteremia, and quality of care remain to
      be determined in subsequent studies.

PMID- 8342867
TI  - Infection control and bone marrow transplantation.
AB  - BACKGROUND: Bone marrow transplantation for the treatment of malignancies is on
      the increase. Unfortunately, there are no well-validated infection control
      guidelines for this highly susceptible population. METHODS: Literature was
      reviewed concerning infection risks and interventions to decrease risks for bone
      marrow transplant recipients. RESULTS: Definitive information was generally
      lacking. However, basic "common sense" infection control recommendations for bone
      marrow transplantation were made in the following areas: air ventilation systems,
      design issues, environmental services, patient care issues, barrier precautions,
      nosocomial surveillance, and discharge planning. Recommendations must be tailored
      to each facility or setting. CONCLUSION: We conclude that validation of many of
      these recommendations is necessary to provide optimum care for bone marrow
      transplant recipients.

PMID- 8342866
TI  - Measles susceptibility and immunization: experiences in a forensic psychiatric
      hospital.
AB  - BACKGROUND: In response to a measles outbreak in the community, a measles
      immunization program was developed at our hospital for forensic psychiatric
      patients. METHODS: Measles antibody screening of all employees and patients by
      means of an enzyme-linked immunosorbent assay was followed by vaccination of
      susceptible persons. RESULTS: Serum samples from 813 employees and 868 patients
      during a 6-month period were analyzed. The susceptibility rate was 16.15% for
      employees and 13.60% for patients born in or after 1957. It was 4.67% for
      employees and 5.40% for patients born before 1957. The overall rate was 7.38% for
      employees and 8.53% for patients. A rate of 5% is known to be sufficient for
      transmission in institutions. Vaccine was given to 84.51% of susceptible
      patients. Vaccine failure occurred in 8.33%. Residual susceptibility rate was
      1.84%. CONCLUSIONS: Cost analysis showed that screening of all individuals and
      immunization of susceptible persons was the most cost-effective method for
      measles control in our institutional setting.

PMID- 8342868
TI  - A Flavobacterium meningosepticum outbreak among intensive care patients.
AB  - A Flavobacterium meningosepticum outbreak, involving 12 infected and 47 colonized
      intensive care patients during the months of February through July 1990, was
      investigated. F. meningosepticum was isolated from tap water and ice, but these
      environmental strains eventually proved to be distinct from those colonizing
      patients. A review of newly colonized patients' charts revealed that a common
      factor among the patients was daily changes of ventilator tubing pasteurized in
      the hospital's central sterile department. More than 90% of patients in the
      outbreak had been on ventilators that used the pasteurized tubing. An
      investigation of the pasteurization process found that two pasteurizer tanks had
      been operating at suboptimal temperatures (< 62 degrees C). Cultures of water
      from the tanks and droplets of water found in the pasteurized tubing grew species
      of Acinetobacter, Moraxella, and Pseudomonas but did not grow F. meningosepticum.
      After deficiencies in the pasteurization process were corrected, the outbreak
      terminated. Despite the failure to culture F. meningosepticum, an analysis of
      gram-negative bacillary isolates showed that the deficiency in the pasteurization
      process was a major contributor to colonization of ventilated patients by
      bacteria ubiquitous in tap water.

PMID- 8342869
TI  - Infection control in home care agencies.
AB  - BACKGROUND: The purpose of this study was to describe the characteristics of home
      care agencies, including the nature of care provided and the presence of
      infection control standards and education. METHODS: Study design was cross
      sectional and descriptive; the survey of home health agencies included questions
      about agency type, nature of care delivered, and infection control policies and
      educational programs. The sample included all directors of home care agencies in
      northern California. RESULTS: The response rate was 33.5%. Agency directors
      reported that 15.3% of their clients required high-technology nursing care; in
      response to a list of invasive procedures generally considered high in infection
      risk, more than 90% cared for urinary drainage devices, some categories of wound
      care, and intravenous management. Of those performing high-risk procedures, more
      than 75% had policies covering the procedures. Nearly all (87.7% to 100%) had
      policies on universal precautions, handwashing, handling of needles and sharps,
      and the cleaning and disinfection of equipment; however, nearly a quarter (24.6%)
      had no education program regarding the handling of contaminated equipment.
      CONCLUSIONS: Among agencies responding to this survey, care that is considered
      high risk for infection is delivered and the agencies for the most part have
      infection control policies and educational programs. Research is needed to define
      more clearly infection control efforts in home health care. More work is needed
      to adapt the knowledge of infection control in hospitals to the home setting.

PMID- 8342870
TI  - The numbers game: sample-size determination.
AB  - Sample-size determination is a crucial component of study design. Estimates of
      sample size are influenced by the amount of change that must occur between study
      groups and the degree of risk that the investigator is willing to accept in
      evaluating the null hypothesis. A complete understanding of the impact of sample
      size on the interpretation of study data is therefore a prerequisite for quality,
      innovative, valid research.

PMID- 8342871
TI  - Use of the total quality process in an infection control program: a surprising
      customer-needs assessment.
AB  - The University of Michigan Hospitals began a quality management and improvement
      process in 1987 as the framework for all of its quality-related efforts and
      activities. The Infection Control Services department used total quality
      techniques to develop its mission statement, identify customers, identify
      customer requirements, and develop quality improvement objectives to meet the
      requirements. A service evaluation of customers resulted in specific improvement
      activities. An unexpected result of this evaluation was the difference noted
      between the Infection Control Services staff members' perception of customer
      requirements and these customers' actual needs. ICPs should use the continuous
      quality improvement tools and techniques to enhance their activities within their
      institutions, to better meet their customer needs, and to make sure that they are
      complementing their institution's mission.

PMID- 8342872
TI  - Prospective, randomized trial of barrier isolation versus universal precautions
      during medical intensive care.

PMID- 8342873
TI  - Draft APIC guideline for infection prevention and control in flexible endoscopy.
      Association for Practitioners in Infection Control, Inc.

PMID- 8342875
TI  - Analysis of familial and individual risk factors among patients with ischemic
      vascular dementia and Alzheimer's disease.
AB  - The purpose of this study was to determine relative contributions of first-degree
      familial and individual risk factors to clinical manifestations of two major age
      related dementias. The authors interviewed 183 patients with dementia of the
      Alzheimer's type (DAT) and 137 patients with ischemic vascular dementia (IVD)
      together with family members and caregivers. Information was also obtained from
      medical records and collateral sources as required. Risk factor data within a
      predictive model for differentiating the two dementias were evaluated. There was
      a greater incidence of family history of degenerative and dementing neurologic
      disorders in DAT than in IVD. Both groups were equivalent for family histories of
      cerebrovascular disease. Despite familial equivalence, patients with IVD had a
      greater individual incidence of risk factors for cerebrovascular disease.
      Analysis by gender revealed three observations. Among DAT patients, family
      history for degenerative and dementing neurologic disorders proved to be
      significantly greater among women than among men. This risk factor did not,
      however, predict individual diagnoses for DAT. Women with IVD were more likely to
      have a family history of cancer than men. Multiple regression analyses revealed
      that reduced educational levels in women predicted greater liability for IVD than
      for DAT. Hypertension, heart disease, and diabetes mellitus were all risk factors
      for IVD, but not for DAT. CONCLUSIONS: Individual and familial historical data
      provide useful information concerning identification, pathogenesis, prevention,
      and treatments for vascular dementia but little predictive information for
      identifying patients with Alzheimer's disease.

PMID- 8342874
TI  - Features of coronary artery lesions related to left ventricular aneurysm
      formation in anterior myocardial infarction.
AB  - To determine the factors of left ventricular aneurysm formation in acute
      myocardial infarction, the authors studied the distribution of coronary artery
      lesions and the left ventricular wall motion of 43 patients with anterior
      myocardial infarction. Of 15 patients with aneurysm, 9 (60%) showed a single
      vessel disease with severe stenosis of the proximal left anterior descending
      artery. Of 9 patients with triple-vessel disease, 8 (89%) had no aneurysm. In
      patients with the aneurysm, the Gensini score of the culprit lesion was
      significantly higher (p < 0.05) and the score except for the culprit lesion was
      less (chi 2 = 5.7, p < 0.05). In 23 patients with single-vessel disease, the
      collateral score was significantly less (p < 0.05) in patients with the aneurysm.
      The systolic wall motion on the ventriculogram appeared more impaired in the
      anterior infarct area but well maintained in the posterior noninfarct area in
      patients with the aneurysm. In conclusion, the important factors of left
      ventricular aneurysm formation were as follows: (1) A culprit lesion of the
      myocardial infarction was severe, but other coronary artery lesions were mild.
      (2) Collateral vessels were poor. (3) The left ventricular wall motion of the
      infarct area was impaired, but that of the noninfarct area was relatively good.

PMID- 8342876
TI  - Carotid ultrasonographic findings in intracranial internal carotid artery
      occlusion.
AB  - Five cases of unilateral intracranial internal carotid artery (ICA) occlusion
      received both carotid angiographic and ultrasonographic studies. The Doppler
      examination showed that the resistive index (RI) of the common carotid artery
      (CCA) and ICA was higher but the peak systolic velocity was lower on the diseased
      side as compared with the normal side. Absence of the diastolic phase was found
      in the CCA flow in 2 cases and in the ICA flow in 3 cases on the diseased side.
      The mean CCA flow volume on the diseased side (271 +/- 82 mL/min) was half or
      less than that on the normal side (680 +/- 86 mL/min) (P < 0.01). The flow volume
      of the diseased ICA (49 +/- 20 mL/min) was markedly lower than that of the normal
      side (344 +/- 49 mL/min) (P < 0.01) and was also less than that of the
      ipsilateral external carotid artery (ECA) (129 +/- 43 mL/min). The Doppler
      ophthalmic artery flow all showed a forward direction. The authors propose that
      the following extracranial carotid ultrasonographic findings may be helpful in
      the prediction of intracranial carotid artery occlusion: (1) diminished
      frequencies, increased RI, and a more than 50% reduction of flow volume in the
      CCA as compared with the opposite side; (2) diminished frequencies to loss of the
      diastolic phase, a more than 50% reduction of the flow volume, and reversed
      ICA/ECA flow volume in the ICA as compared with the opposite side; and (3) a
      forward Doppler ophthalmic artery flow.

PMID- 8342877
TI  - Simultaneous recording of blood volume shifts in different vascular beds in man
      by a versatile scintigraphic method.
AB  - A device was developed to record the blood volume changes occurring in the lung
      and calf during postural changes, physical exercise, and the Valsalva maneuver in
      man. The changes in regional counting rates from the right middle lung and the
      calf mirrored the well-known changes in venous return that are expected to occur
      in response to the above-mentioned external stimuli. Thus a sustained decrease in
      lung blood volume was noted on assumption of the erect posture as well as during
      the forced expiration of the Valsalva maneuver. In addition a rapid increase and
      a sharp decrease in lung blood volume took place at the very onset and at the
      very end of walking, respectively. The calf blood volume declined immediately at
      the onset of walking, increased slightly in the ensuing two minutes, and returned
      to baseline quickly at the termination of walking. The authors' method enables
      real-time equilibrium blood pool scintigraphy to be recorded continuously and
      simultaneously from different districts over sustained periods of time
      irrespective of the posture and the physical activity performed by the patient.
      Their method might improve knowledge of the systemic circulatory responses to
      selective physiologic and therapeutic interventions in health and disease.

PMID- 8342878
TI  - Hemorheologic approach in the treatment of diabetic foot ulcers.
AB  - Pentoxifylline, a new trisubstituted methylxanthine derivative, is the most well
      known of a new group of hemorheologic agents. It has been shown to improve
      hemorheologic abnormalities associated with diabetes and atherosclerosis. The
      authors examined the role of pentoxifylline in the treatment of diabetic foot
      ulcers. Forty diabetic patients with foot ulcerations were included in the study,
      20 of whom received conventional therapy and 20 received pentoxifylline (400 mg
      three times a day) in addition. Healing of ulcers after eight weeks of treatment
      was significantly higher in those on pentoxifylline, and the patients needed less
      mutilating surgery. Administration of pentoxifylline in addition to conventional
      therapy was significantly superior in the management of diabetic foot ulcers.

PMID- 8342879
TI  - Effect of ticlopidine on the cutaneous circulation in peripheral vascular
      disease.
AB  - To assess the effect of ticlopidine on the cutaneous circulation, 25 patients
      with lower limb ischemia were investigated just before and at two hours after
      being given a 200 mg oral dose of ticlopidine. The transcutaneous partial
      pressure of oxygen (PtcO2) and the skin temperature were determined at 35 limb
      sites and 9 chest walls sites. Both the PtcO2 and the skin temperature were
      significantly increased at two hours after the administration of ticlopidine (p <
      0.01). The findings suggest that ticlopidine can improve the cutaneous
      microcirculation in patients with peripheral vascular disease.

PMID- 8342880
TI  - Platelet-derived growth factor release and antiplatelet treatment with low-dose
      acetylsalicylic acid.
AB  - Platelet-derived growth factor (PDGF) and beta-thromboglobulin (beta-TG) are
      released from alpha granules during platelet activation. PDGF may play a role in
      the development of atherosclerosis and the late restenosis after percutaneous
      transluminal coronary angioplasty (PTCA). The effect of acetylsalicylic acid
      (ASA) on PDGF release was studied in healthy volunteers before and twelve hours
      after ingestion of 300 mg ASA. PDGF, beta-TG, and thromboxane B2(TxB2) were
      measured by radioimmunoassay (RIA) in serum and in platelet rich plasma (PRP)
      after submaximal stimulation with collagen. TxB2 decreased significantly from 0.9
      +/- 0.3 ng/(mL x 10(6) platelets) to 0.006 +/- 0.005 ng/(mL x 10(6) platelets)
      (mean +/- SD) in serum after ASA ingestion while PDGF and beta-TG remained
      unchanged. Measurements in PRP after stimulation with collagen showed a
      significant decrease in PDGF (from 21.5 +/- 1.4 pg/(mL x 10(6) platelets) to 1.8
      +/- 4.1 (pg/mL x 10(6) platelets), in beta-TG (from 21.0 +/- 13.3 ng/(mL x 10(6)
      platelets) to 2.2 +/- 1.4 ng/(mL x 10(6) platelets)) and in TxB2 (from 143.6 +/-
      80.7 pg/(mL x 10(6) platelets) to 0.5 +/- 0.6 pg/(mL x 10(6) platelets)) after
      treatment with ASA. In conclusion low-dose ASA inhibits collagen-induced release
      of both beta-TG and PDGF in PRP and TxB2-synthesis in PRP and serum.

PMID- 8342881
TI  - Hypoxia-induced activation of endothelial cells as a possible cause of venous
      diseases: hypothesis.
AB  - Blood stasis in leg veins is a situation commonly linked to the development of
      venous diseases such as varicoses. Such a stasis will provoke an ischemia, thus
      decreasing oxygen availability to tissues. Owing to its localization between
      blood and tissue, endothelium is the first target of this insult. The authors
      develop here a hypothesis in which the effect of oxygen deprivation on the
      functional state of the endothelium is the starting point of a cascade of events
      leading to the disorganization of the vessel wall typical of these pathologies.
      When venous human endothelial cells obtained from umbilical cords (HUVEC) are
      exposed to hypoxic conditions they become activated without change in their
      viability. The synthesis of a proinflammatory molecule (PAF, platelet-activating
      factor) and the adhesion of human polymorphonuclear neutrophils (PMN) on HUVEC
      are markedly increased during hypoxia incubation. These two processes are related
      to a calcium-dependent activation of endothelial cells due to a decrease of
      adenosine triphosphate (ATP) availability during hypoxia. Adherence of
      neutrophils to endothelial cells is the first step of diapedesis, which leads to
      the infiltration of these cells in the media of the veins, where they affect the
      smooth muscle cells and the connective tissue, leading to tissue alterations
      typical of the venous pathologies. The authors propose that this sequential
      process which originates from a reduction in oxygen availability and which
      involves different cell type as one main cause of the venous disorders, in
      addition to genetic, hormonal, and mechanical factors.

PMID- 8342882
TI  - Absence of enhancement of spontaneous echocardiographic contrast by
      thrombocytosis in a patient with left ventricular aneurysm, primary
      thrombocythemia, and von Recklinghausen neurofibromatosis: a case report.
AB  - A thirty-eight-year-old man with primary thrombocythemia, von Recklinghausen
      neurofibromatosis, and myocardial-infarction-related left ventricular aneurysm
      with spontaneous echocardiographic contrast was followed up, suggesting that: 1.
      Neurofibromatosis may promote silent myocardial infarction or ischemia. Whether
      involvement of cardiac sensory nerves is a possible underlying mechanism remains
      nevertheless uncertain. 2. Platelets, whose role in the genesis of spontaneous
      echocardiographic contrast has been advocated, are probably not involved in this
      phenomenon, even in large numbers.

PMID- 8342883
TI  - Mobile string-like thrombus on the calcified aortic valve in cardioembolic stroke
      -a case report.
AB  - The calcified aortic valve has been associated with being a possible source of
      emboli in cardioembolic stroke. However, thrombus on the calcified aortic valve
      has not been identified with two-dimensional echocardiography. A seventy-two-year
      old woman with calcified aortic stenosis was admitted with brain embolism. She
      had not previously received any platelet antiaggregant or anticoagulant. At
      admission, two-dimensional echocardiography demonstrated a mobile string-like
      abnormal echo attached to the calcified aortic valve, which showed regression and
      enlargement repeatedly during admission. No symptoms or clinical data suggested
      infective endocarditis or nonbacterial thrombotic endocarditis. After
      commencement of antiplatelet therapy, the abnormal echo regressed and
      disappeared. She continued to take the medication for seven months and then
      discontinued. Three months later, she developed recurrence of stroke, and an
      abnormal echo on the calcified aortic valve was again detected by two-dimensional
      echocardiography. The authors believe that the abnormal echo on the calcified
      aortic valve was thrombus and that it was the embolic source. Calcified aortic
      valve may thus be a causative lesion for mobile string-like thrombus. Two
      dimensional echocardiography should be performed repeatedly in patients with
      calcified aortic valve and brain embolism.

PMID- 8342884
TI  - Forward Doppler ophthalmic artery flow in patients with extracranial carotid
      artery occlusion--a case report.
AB  - The authors report 2 cases of common carotid artery (CCA) occlusion and 4 cases
      of extracranial internal carotid artery (ICA) occlusion with forward Doppler
      ophthalmic artery flow. The compression test during Doppler study showed that the
      ophthalmic artery flow was reduced to zero when compressed contralateral to the
      CCA in 1 case of CCA occlusion and when compressed ipsilateral to the CCA in all
      4 cases of ICA occlusion. The angiograms showed that in the 2 cases of CCA
      occlusion, 1 had the ophthalmic artery originating from the anterior
      communicating artery, and the other had subclavian steal syndrome with a reversed
      vertebral flow. In 3 of the 4 cases of ICA occlusion, the ophthalmic artery was
      found to originate from the ipsilateral middle meningeal artery. Their findings
      suggest that in cases of extracranial carotid artery occlusion, the forward
      ophthalmic artery flow is supplied from the contralateral CCA in cases of CCA
      occlusion and from the branches of the ipsilateral external carotid artery in
      cases of ICA occlusion, and the vertebrobasilar system plays a less important
      role.

PMID- 8342885
TI  - Isolated tuberculous pericarditis still exists: a case history.
AB  - A fifty-four-year-old woman from a high socioeconomic class developed acute
      isolated tuberculous pericarditis, three years after her sister had recovered
      from such disease. She was treated successfully by a triple drug regimen
      including isoniazid, rifampin, and ethambutol.

PMID- 8342886
TI  - Leiomyosarcoma of the inferior vena cava causing Budd-Chiari syndrome--a case
      report.
AB  - A forty-eight-year-old Japanese woman with leiomyosarcoma of the inferior vena
      cava presenting as Budd-Chiari syndrome is reported. A large tumor originating
      from the venous wall grew into the lumen, obstructing the hepatic vein, and
      extended up to the right atrium. Although this is a very rare tumor, care should
      be taken in order to make an early diagnosis and manage the condition
      effectively.

PMID- 8342887
TI  - Can we relax during spirometry?

PMID- 8342888
TI  - Trial of standard versus modified expiration to achieve end-of-test spirometry
      criteria.
AB  - To assess whether satisfying American Thoracic Society (ATS) end-of-test
      spirometry criteria can be enhanced by modifying the patient's expiratory
      technique, we conducted a cross-over trial of two expiratory techniques in 48
      patients with a range of pulmonary functions (Group 1, n = 12: FEV1/FVC < 0.45;
      Group 2, n = 11: FEV1/FVC, 0.45 to 0.60; Group 3, n = 16: FEV1/FVC, 0.61 to 0.74;
      Group 4, n = 9: FEV1/FVC > or = 0.75). After randomizing the order of testing,
      each patient performed three exhalations using a "standard" forced expiratory
      maneuver and a modified expiratory technique consisting of an initial maximal
      expiratory effort followed by a "relaxed expiration" for as long as possible.
      Patients initiated "relaxed expiration" when instructed by the supervising
      technician, who issued the instruction to relax when expiratory airflow fell to <
      or = 200 ml/s (as determined by flow-volume loop analysis). ATS end-of-test
      criteria were satisfied significantly more often using the modified expiratory
      technique (58.3% of testing sessions) than using the standard technique (18.7% of
      sessions, p = 0.001) because of prolongation of the forced expiratory time (FET)
      with the modified technique in all patient groups. In the 38 patients with
      FEV1/FVC < or = 0.75, the largest FVC and FET rose significantly using the
      modified expiratory technique, without compromising the largest FEV1 in any
      group. In patients with FEV1/FVC > or = 0.75, FET increased without concomitant
      changes in FVC or FEV1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342889
TI  - Tumor necrosis factor and endotoxin do not directly affect in vitro diaphragm
      function.
AB  - Ventilatory pump failure can occur in the setting of severe infection. Recent in
      vivo studies have shown a significant decrease in diaphragm force production in
      rats with pneumococcal sepsis and sepsis secondary to Escherichia coli endotoxin.
      We hypothesized that diaphragm impairment during sepsis may be mediated by a
      direct effect of tumor necrosis factor-alpha (TNF) or endotoxin. To test this
      hypothesis we studied the mechanical characteristics of isolated rat diaphragm
      strips in tissue baths containing rTNF-alpha or endotoxin and compared the
      results with control strips. The strips were stimulated to contract isometrically
      in the tissue baths that were aerated with 95% O2-5% CO2. Baseline force
      frequency determinations were made at 60 min. Following this, the strips were
      fatigued over a 4-min period (20 Hz, 0.33-s trains, 1 train/s) and force
      frequency relationships determined 30 s, 10 min, and 60 min post-fatigue. There
      were no significant differences found between control and experimental strips in
      any aspect of contractile function tested, including force-frequency
      characteristics, fatiguability, and recovery from fatigue. Using an isolated cell
      line assay (L929), we found evidence of attenuated cytotoxicity of TNF at 26
      degrees C compared with 37 degrees C. Therefore, we repeated the experiments
      studying the effects of TNF on in vitro muscle at 37 degrees C. We once again
      found no effect of TNF on contractile function. We conclude that the impairment
      of diaphragm function during sepsis is not mediated by a direct effect of TNF or
      endotoxin.

PMID- 8342890
TI  - Factors determining pulmonary function in adolescent idiopathic thoracic
      scoliosis.
AB  - Adolescent idiopathic thoracic scoliosis may lead to severe pulmonary impairment
      and early death, but the responsible factors are poorly understood; pulmonary
      function is only weakly related to the angle of scoliosis. We performed a cross
      sectional study using multivariate analysis to identify the individual and
      additive influence of different features of spinal deformity and nonstructural
      factors on pulmonary impairment. Pulmonary function was assessed by measuring
      lung volumes and diffusing capacity, with a priori selection of vital capacity
      (expressed as percentage of predicted, % VC) as the primary index of pulmonary
      impairment. Radiologic and physiologic measurements were made independently in 66
      subjects who had not previously had spinal surgery. Angle of scoliosis (p = 0.01)
      was one of four features of spinal deformity associated with reduced % VC;
      greater number of vertebrae involved (p = 0.007), cephadal location of the curve
      (p = 0.04), and loss of the normal thoracic kyphosis (p = 0.002) made an equal
      and additive contribution to pulmonary impairment. Spinal deformity led to
      reductions in VC, primarily by reducing TLC. Spinal column rotation, respiratory
      muscle strength, and duration of the curvature were not related to pulmonary
      function (p > 0.05). We conclude that features of the spinal deformity are the
      major determinants of pulmonary impairment in idiopathic thoracic scoliosis but
      that the relationship between deformity and impairment is complex. The severity
      of pulmonary impairment cannot be inferred to a clinically useful extent from the
      angle of scoliosis alone.

PMID- 8342891
TI  - Factors influencing work capacity in adolescent idiopathic thoracic scoliosis.
AB  - The factors contributing to reduced work capacity (disability) in adolescent
      idiopathic thoracic scoliosis are poorly understood. We performed a cross
      sectional study using multivariate analysis to identify the individual and
      additive influence of spinal deformity, pulmonary impairment, and muscular
      function on work capacity in 79 subjects with idiopathic scoliosis (angle of
      scoliosis 45 +/- 18.5 degrees, SD). Work capacity was measured using an
      incremental cycle test, and the cardiorespiratory response to exercise was
      compared with that of normal subjects. Work capacity was reduced (% Wcap, 86%;
      95% CI 81.9 to 89.7), indicating significant disability. The % Wcap was unrelated
      to the nature and extent of spinal deformity (p > 0.05). Leg muscularity and
      pulmonary impairment had an additive influence on work capacity, the relationship
      with muscularity being the stronger of the two. Independently of muscularity and
      pulmonary impairment, a high heart rate response at submaximal work rates was
      also associated with a reduced work capacity. Ventilation was normal for
      metabolic demands. During exercise, the tidal volumes of scoliotic subjects were
      reduced in proportion to the vital capacity. We conclude that disability occurs
      with mild to moderate idiopathic scoliosis and appears to be related to a
      combination of reduced ventilatory capacity, reduced muscularity, and
      cardiovascular deconditioning. These findings suggest that physical activity
      should be encouraged in subjects with idiopathic scoliosis to maintain peripheral
      muscle and cardiovascular conditioning, thereby minimizing disability.

PMID- 8342892
TI  - Hemodynamic and gas exchange responses to infusion of acetylcholine and
      inhalation of nitric oxide in patients with chronic obstructive lung disease and
      pulmonary hypertension.
AB  - To investigate endothelium-dependent and endothelium-independent nitric oxide
      (NO) mediated pulmonary vasodilation in patients with chronic obstructive lung
      disease (COLD), we examined the responses to incremental infusion rates of
      acetylcholine (ACh) or inhaled NO on hemodynamic and gas exchange. In 13
      patients, ACh (15 mg/min) decreased pulmonary artery pressure (Ppa) from 31 +/- 1
      to 28 +/- 1 mm Hg (p < 0.01) and systemic arterial pressure while increasing
      cardiac index from 3.7 +/- 0.4 to 4.7 +/- 0.4 L/min/m2 (p < 0.01). Inhaling 40
      parts per million (ppm) NO decreased Ppa from 32 +/- 1 to 26 +/- 1 mm Hg (p <
      0.001) with no associated hemodynamic change. ACh reduced PaO2 from 57 +/- 3 to
      48 +/- 2 mm Hg (p < 0.01) and increased venous admixture (QVA/QT) from 35 +/- 3
      to 45 +/- 3% (p < 0.01). Inhaling 40 ppm NO increased PaO2 from 57 +/- 3 to 60 +/
      3 mm Hg (p < 0.01) and decreased QVA/QT from 36 +/- 3 to 32 +/- 3% (p < 0.01).
      Pulmonary vascular resistance changes were similar in response to 40 ppm NO or 15
      mg/min ACh. In COLD patients, ACh produces both pulmonary and systemic
      vasodilation but impairs arterial oxygenation whereas inhaled NO induces
      selective pulmonary vasodilation while improving gas exchange. The resistance to
      ACh in some patients could be related to pulmonary endothelial dysfunction.

PMID- 8342893
TI  - Bicarbonate does not increase left ventricular contractility during L-lactic
      acidemia in pigs.
AB  - Lactic acidosis decreases left ventricular contractility, but whether bicarbonate
      increases left ventricular contractility during lactic acidosis in vivo is
      controversial. Therefore, we measured hemodynamics and left ventricular mechanics
      before and after bicarbonate administration during L-lactic acid infusion in 15
      anesthetized pigs. The pigs were beta-blocked and atrially paced to minimize
      indirect effects of acidosis on contractility. We measured mean arterial
      pressure, left ventricular end-diastolic pressure, thermodilution cardiac output,
      left ventricular pressure (Miller catheter), and left ventricular volume (three
      orthogonal pairs of ultrasonic crystals). Left ventricular contractility was
      assessed primarily using the slope (Emax) of the end-systolic pressure-volume
      relationship. While PCO2 was kept constant, 0.2 M L-lactic acid was infused,
      which reduced arterial pH to 7.05 +/- 0.06. Animals were then randomized to
      receive either 1 M NaHCO3 (n = 8), which increased pH to 7.45 +/- 0.11, or an
      equivalent amount of 1 M NaCl (n = 7). Bicarbonate decreased mean arterial
      pressure (105 +/- 20 to 95 +/- 39 mm Hg, p < 0.05) but did not increase cardiac
      output. These effects were not significantly different from the effects of
      saline. Bicarbonate did not significantly increase Emax (4.2 +/- 0.8 to 4.9 +/-
      0.8 mm Hg/ml) and was indistinguishable from saline (5.0 +/- 0.7 to 5.2 +/- 0.7
      mm Hg/ml). We conclude that bicarbonate infusion does not directly increase left
      ventricular contractility during lactic acidemia in pigs within this pH range.

PMID- 8342894
TI  - Effects of periodic obstructive apneas on venous return in closed-chest dogs.
AB  - With sleep apnea syndrome, mean cardiac output (CO) may fall. This implies a fall
      in venous return (VR) that is equal to the product of the pressure gradient for
      VR (GVR)--mean circulatory pressure (MCP)--right ventricular end-diastolic
      pressure and the conductance for VR (Gv). During airway obstruction there could
      also be shifts of blood volume between central and peripheral circulatory
      compartments. We studied these parameters in anesthetized closed-chest,
      spontaneously breathing dogs when hypoxia occurred (room air [RA] breathing) and
      when hypoxia was prevented (100% O2 breathing). Obstructive apneas were induced
      by completely occluding the endotracheal tube at end expiration for 1 min and
      allowing 1 min of spontaneous ventilation. During RA apneas, arterial PO2
      decreased to 32.7 +/- 6.1 mm Hg (p < 0.01). Apnea reduced respiratory effort rate
      by 22.0 to 37.0% and was associated with inspiratory airway pressure swings in
      both RA and O2 of approximately -16.0 mm Hg. During apnea, on RA and O2 heart
      rate and mean arterial pressure decreased by 20 to 30 beats/min and by 8 to 12 mm
      Hg, respectively. On RA, CO decreased by 7.0% (not significant). In contrast, on
      O2, CO increased by 21.0% (p < 0.01). With RA apneas, GVR and MCP increased by
      55% (p < 0.05) and Gv decreased by 63% (p < 0.05). On O2, there were no changes
      in GVR or Gv, and changes in CO were predictable from the baseline VR curve. With
      O2 there was an increase in central blood volume by 21.0% (p < 0.01) during the
      apneic phase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342895
TI  - Role of hyperventilation in the pathogenesis of central sleep apneas in patients
      with congestive heart failure.
AB  - Periodic breathing with central apneas during sleep is typically triggered by
      hypocapnia resulting from hyperventilation. We therefore hypothesized that
      hypocapnia would be an important determinant of Cheyne-Stokes respiration with
      central sleep apnea (CSR-CSA) in patients with congestive heart failure (CHF). To
      test this hypothesis, 24 male patients with CHF underwent overnight
      polysomnography during which transcutaneous PCO2 (PtcCO2) was measured. Lung to
      ear circulation time (LECT), derived from an ear oximeter as an estimate of
      circulatory delay, and CSR-CSA cycle length were determined. Patients were
      divided into a CSR-CSA group (n = 12, mean +/- SEM of 49.2 +/- 6.3 central apneas
      and hypopneas per h sleep) and a control group without CSR-CSA (n = 12, 4.9 +/-
      0.8 central apneas and hypopneas per h sleep). There were no significant
      differences in left ventricular ejection fraction, awake PaO2, mean nocturnal
      SaO2, or LECT between the two groups. In contrast, the awake PaCO2 and mean sleep
      PtcCO2 were significantly lower in the CSR-CSA group than in the control group
      (33.0 +/- 1.2 versus 37.5 +/- 1.0 mm Hg, p < 0.01, and 33.2 +/- 1.2 versus 42.5
      +/- 1.2 mm Hg, p < 0.0001, respectively). Neither group had significant awake or
      sleep-related hypoxemia. In addition, CSR-CSA cycle length correlated with LECT
      (r = 0.939, p < 0.001). We conclude that (1) hypocapnia is an important
      determinant of CSR-CSA in CHF and (2) circulatory delay plays an important role
      in determining CSR-CSA cycle length.

PMID- 8342896
TI  - Use of capnography for assessment of the adequacy of alveolar ventilation during
      weaning from mechanical ventilation.
AB  - A prospective study was conducted to determine the reliability of noninvasive end
      tidal CO2 (PETCO2) monitoring as a reflection of arterial CO2 tension (PaCO2)
      during weaning from mechanical ventilation (MV). Simultaneous PaCO2 and PETCO2
      determinations were compared during MV and again during a spontaneous breathing
      trial just before returning the patient to MV. Three groups of patients
      recovering from acute respiratory failure were evaluated. Group 1 consisted of 16
      patients (28 observations) without parenchymal lung disease. Group 2 consisted of
      22 patients (31 observations) with alveolar filling diseases. Group 3 was
      composed of 13 patients (22 observations) with emphysema. Significant Pearson
      correlation coefficients were demonstrated between PaCO2 and PETCO2 during both
      MV and spontaneous breathing in all three groups. Significant correlation was
      also demonstrated between the change in PaCO2 and the change in PETCO2 associated
      with weaning for each group; however, the degree of correlation varied between
      groups. Our data suggest that capnography offers a reasonable estimate of PaCO2
      and changes in PaCO2 during weaning in patients without parenchymal lung disease.
      However, PETCO2 is less sensitive to changes in PaCO2 for patients with
      parenchymal lung disease, particularly patients with emphysema. Interpretation of
      capnographic data requires a full understanding of its limitations. An approach
      to capnographic monitoring during weaning is discussed.

PMID- 8342897
TI  - Tracheal gas insufflation augments CO2 clearance during mechanical ventilation.
AB  - A technique that improves the efficiency of alveolar ventilation should decrease
      the pressure required and reduce the potential for lung injury during mechanical
      ventilation. Alveolar ventilation may be improved by replacing a portion of the
      anatomic dead space with fresh gas via an intratracheal catheter. We studied the
      effect of intratracheal gas insufflation as an adjunct to volume cycled
      ventilation in eight sedated, paralyzed patients with a variety of lung
      disorders. Continuous flows of 2, 4, and 6 L/min were delivered through a
      catheter positioned 1 or 10 cm above the carina. Carbon dioxide production,
      inspiratory minute ventilation, and peak and mean airway pressures did not change
      over the range of flows tested. PaCO2 and dead space volume/tidal volume
      decreased significantly as joint functions of catheter flow and position (p <
      0.001). The highest catheter flow (6 L/min) and most distal catheter position (1
      cm above the carina) were the most effective combination tested, averaging a 15%
      reduction in PaCO2 (range 9 to 23%). Certain characteristics of the expiratory
      capnogram were helpful in predicting the observed reduction in PaCO2. Tracheal
      gas insufflation may eventually prove a useful adjunct to a pressure-targeted
      strategy of ventilatory management (in either volume-cycled or pressure
      controlled modes), particularly when the total dead space is heavily influenced
      by its anatomic component.

PMID- 8342898
TI  - Gastric and pharyngeal flora in nosocomial pneumonia acquired during mechanical
      ventilation.
AB  - We studied the interrelations between gastric, pharyngeal, proximal, and distal
      airway bacterial flora in ventilator-associated pneumonia (VAP) on 36 patients
      with nosocomial pneumonia acquired during mechanical ventilation (MV) and 27
      mechanically ventilated control subjects without pulmonary infection. Gastric,
      pharyngeal, and endotracheal (EA) sampling for quantitative cultures were
      performed upon all patients, as well as fiberoptic bronchoscopy with protected
      specimen brush (PSB) sampling. Mean bacterial and fungi colony counts were
      significantly increased in pharyngeal, EA, and PSB samples in patients with VAP
      compared with control subjects. The overall increase in colonization was due to
      gram-positive cocci in all samples. In addition, gram-negative bacilli and fungi
      mean counts increased significantly in PSB pneumonia samples versus control
      samples. However, mean gastric colonization was similar in both patients with VAP
      and control subjects. In the former group there was an increase in coincident
      microorganisms isolated from gastric, pharyngeal, and EA samples in relation to
      PSB samples compared with control samples. Among the different quantitative
      cultures analyzed, only those obtained from EA significantly correlated with PSB
      cultures in patients with pneumonia (r = 0.67, p = 0.001). In summary, the
      present study shows that the coincidence between microorganisms isolated in PSB
      cultures and those from gastric and oropharynx increase in MV patients with
      pneumonia, indicating that both reservoirs play a key role in the pathogenesis of
      pneumonia. Conceivably, preventing both gastric and pharyngeal colonization may
      reduce the incidence of ventilator-associated pneumonia. From all the noninvasive
      samples studied only endotracheal aspirate cultures were useful for inferring the
      etiology of some VAP pneumonias.

PMID- 8342899
TI  - Response time and reliability of three neonatal patient-triggered ventilators.
AB  - We studied the response time (RT) and reliability of three neonatal patient
      triggered ventilator (PTV) systems: the Draeger Babylog 8000, the Bear Cub
      enhancement module (CEM), and the Infrasonics Star Sync. In 10 adult rabbits,
      airway flow and pressure recordings showed the RT of the Star Sync to be shorter
      than that of the Bear CEM (53 +/- 13 versus 65 +/- 15 ms, p < 0.05), and both
      were shorter than that of the Babylog (95 +/- 24 ms, p < 0.01) by ANOVA. The RT
      of the Bear CEM and the Babylog increased significantly at decreased trigger
      sensitivity settings. All ventilators triggered successfully on assist-control
      (A/C). However, the Babylog had a higher rate of asynchrony on SIMV (30 +/- 25%)
      than the Bear CEM (1.1 +/- 0.3%) and the Star Sync (1.2 +/- 0.4%), p < 0.01. In
      10 infants with respiratory failure, recordings of airway flow and pressure were
      made at ventilator inspiratory time (Ti) settings of 0.3, 0.4, and 0.5 s on
      assist-control and on SIMV at rates of 15, 30, 45, and 60 breaths/min. The Star
      Sync and Bear CEM triggered successfully on A/C (100%) and had low rates of
      asynchrony on SIMV (1 to 3%). The Babylog had a lower success rate on A/C (70 +/-
      12%) and a higher rate of asynchrony on SIMV (29 +/- 30%) than the other two
      ventilators; p < 0.01. The lower reliability of the Babylog was due to its
      variable refractory period (0.2 to 0.5 s, to equal the set Ti).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8342900
TI  - Increased adherence of Staphylococcus aureus from cystic fibrosis lungs to airway
      epithelial cells.
AB  - Airway colonization by Staphylococcus aureus is a frequent feature of cystic
      fibrosis (CF). To assess the pathogenesis of selective colonization with this
      organism, we compared the capacity of S. aureus isolated from the respiratory
      tract of CF and non-CF patients to adhere to epithelial cells from the upper and
      lower airways of CF and control subjects. Bacterial adherence to bronchial
      epithelial cell lines was significantly greater for CF than for non-CF isolates
      (p < 0.001). Of 17 CF S. aureus isolates 12 adhered at a level > 1 bacterium per
      cell; this was true for only 1 of 14 non-CF isolates. CF S. aureus isolates also
      bound more avidly than non-CF isolates to ciliated (p < 0.05) and squamous nasal
      cells (p < 0.02) and buccal epithelial cells (p < 0.005) freshly harvested by
      scraping. Each S. aureus isolate bound with equal avidity to epithelial cells
      from CF patients and healthy individuals. Adherence was not related to sex, age,
      severity of pulmonary disease, presence of other microorganisms in the airways,
      or genotype of the CF hosts. Binding of S. aureus was blocked by proteinase
      treatment of organisms, suggesting that adherence is mediated by one or more
      peptide adhesins. We propose that the high prevalence of adherent S. aureus is
      due either to selection of adherent strains by CF airways or to induction of an
      adherent phenotype by factors residing at the CF airways surface.

PMID- 8342901
TI  - Bronchoscopy versus empirical therapy in HIV-infected patients with presumptive
      Pneumocystis carinii pneumonia. A decision analysis.
AB  - The outcomes of alternative strategies for the management of pulmonary
      complications in patients infected with the human immunodeficiency virus (HIV)
      and with suspected Pneumocystis carinii pneumonia were compared using a decision
      analysis model. A decision tree was constructed using baseline probabilities
      derived from published data and expert opinion. The case scenario analyzed was
      that of a patient not currently receiving anti-Pneumocystis prophylaxis who
      presents with moderate pulmonary symptoms and fulfills the Centers for Disease
      Control (CDC) criteria for presumptive P. carinii pneumonia. Two strategies were
      compared: (1) early bronchoscopy with appropriate therapy based on the results,
      and (2) empiric treatment for P. carinii (trimethoprim/sulfamethoxazole or
      pentamidine, and steroids) with delayed bronchoscopy in those not responding to 5
      days of empiric therapy. The expected 1-month survival rate (with and without
      quality of life adjustment) was found to be essentially the same for the two
      strategies using the baseline probabilities, and the decision remained a toss-up
      within the clinically relevant range of published probabilities for P. carinii
      pneumonia in patients fulfilling the CDC criteria. Because early bronchoscopy
      does not offer any additional survival benefits and is associated with greater
      costs and disutility, empiric therapy would appear to be the superior management
      strategy in this scenario.

PMID- 8342902
TI  - Elevated levels of serum mucin-associated antigen in adult patients with cystic
      fibrosis.
AB  - Previous studies using the CA 19-9 antibody have demonstrated that serum mucin
      levels in patients with cystic fibrosis (CF) are elevated and that the degree of
      elevation relates to the age of the patient and possibly to his or her clinical
      status. However, CA 19-9 only recognizes the mucin-associated blood group sialyl
      Le(a+) antigen, so mucin levels cannot be measured in patients without Lewis
      antigens. The present study used the 17B1 monoclonal antibody to measure serum
      mucin levels in normal subjects, and in patients with CF, patients with chronic
      obstructive pulmonary disease (COPD), and patients with lung transplants. Serum
      mucin levels were 25 ng/ml (+/- 1 SEM, n = 8) in normal subjects, 13,853 ng/ml
      (+/- 1,281, n = 25) in patients with CF, and 25.5 ng/ml (+/- 1.9, n = 17) in
      patients with COPD. Patients with CF who were sialyl Le(a-b-) also had elevated
      serum mucin levels (715 +/- 152, n = 2). Serum mucin levels of six lung
      transplant recipients with CF were elevated compared with those in normal
      subjects (4,621 +/- 765 ng/ml), but they were not different from serum mucin
      levels in six lung transplant recipients without CF (5,307 +/- 1.677 ng/ml).
      Preliminary characterization of the serum mucin antigen showed that: (1) in CF
      sera, the antigen is polydisperse and smaller than the antigen in normal sera;
      (2) the mucin antigen is distinct from ABO blood group antigens. Serum mucin
      levels may be a useful marker to follow a specific patient's response to therapy.

PMID- 8342903
TI  - Activation of blood neutrophils in acute episodes of farmer's lung.
AB  - Farmer's lung often presents clinically as recurring acute episodes several hours
      after exposure to moldy hay. During these episodes the blood neutrophil count
      increases. Because activated neutrophils release toxic oxygen metabolites and
      proteinases, we hypothesized that the pulmonary reaction in farmer's lung may be
      induced by the secretory products of activated neutrophils. To evaluate this
      concept, we quantified the respiratory burst of separated blood neutrophils from
      patients with farmer's lung (n = 12) during standardized exposure tests with
      moldy hay. The respiratory burst of these cells was evaluated by measuring
      zymosan-stimulated and lucigenin-amplified chemiluminescence (CL). Asymptomatic
      farmers (n = 12) and normal volunteers with no prior exposure to moldy hay (n =
      15) were used as control subjects. As expected, following exposure in the group
      of patients with farmer's lung, striking changes in VC, TLCO, and PaO2 were
      observed, whereas there were only minor changes in these parameters in both
      control groups. In all three groups a considerable increase in the blood
      leukocyte count was observed. The CL response of the blood neutrophils from
      patients with farmer's lung 6 h after exposure was significantly higher than
      before or 1 h after exposure (p < 0.05 for both comparisons), whereas there was
      no significant change in the CL response in either control group during the
      observation period. Our results indicate that antigen inhalation induces an
      increase in the number of circulating neutrophils in patients and controls, but
      in patients with an acute episode of farmer's lung the neutrophils are primed for
      an enhanced respiratory burst and may thereby damage the lung.

PMID- 8342904
TI  - Prednisolone treatment in asthma is associated with modulation of bronchoalveolar
      lavage cell interleukin-4, interleukin-5, and interferon-gamma cytokine gene
      expression.
AB  - Although corticosteroids are effective in improving asthma symptoms and bronchial
      responsiveness, their mechanism of action is unknown. We examined whether changes
      in bronchial responsiveness with corticosteroid therapy of asthma are accompanied
      by a reduction in cytokine gene expression and eosinophil infiltration in the
      airways. Bronchoalveolar lavage (BAL) was performed in 18 patients with moderate
      asthma before and after 2 wk of treatment with prednisolone, 0.6 mg/kg/day, or
      matched placebo in a randomized double-blind parallel group study. Cells were
      counted in BAL cytocentrifuge preparations, and the numbers of cells expressing
      cytokine mRNA were assessed by in situ hybridization using 35S-labeled RNA
      probes. When the actively treated and placebo groups were compared, there was a
      decrease in airway methacholine responsiveness (p < 0.01) after prednisolone.
      This was accompanied by a decrease in bronchoalveolar lavage eosinophils (p <
      0.05), a reduction in the numbers of BAL cells per 1,000 expressing mRNA for
      interleukin-4 (IL-4, p < 0.01) and interleukin-5 (IL-5, p < 0.005), and an
      increase in numbers of cells expressing mRNA for interferon-gamma (p < 0.005).
      These results are compatible with the hypothesis that the beneficial effects of
      corticosteroids in asthma may result from modulation of cytokine production, with
      consequent inhibition of local bronchial eosinophilia.

PMID- 8342905
TI  - Role of leukotriene D4 in allergen-induced increases in airway smooth muscle in
      the rat.
AB  - The purpose of the study was to investigate whether allergen-induced
      hyperresponsiveness to methacholine and an increase in airway smooth muscle (ASM)
      in Brown Norway (BN) rats could be mediated by LTD4, an important mediator of
      allergic airway responses. Male BN rats, 8 to 12 wk of age, were sensitized with
      ovalbumin (OA). Rats were exposed 2 wk later to aerosols of saline (n = 6), OA (n
      = 8), or OA after pretreatment with the LTD4 antagonist MK-571 (2 mg/kg
      intraperitoneally, n = 9), on six occasions at 5-day intervals. Airway
      responsiveness to methacholine (the concentration required to double pulmonary
      resistance, EC200 RL) was measured immediately before the first aerosol exposure
      and 2 days after the last exposure. ASM was quantitated by morphometry, and areas
      were standardized for size using the epithelial basement membrane length (BM).
      Following OA challenges EC200 RL decreased from 6.5 to 3.1 mg/ml (p < 0.05) but
      did not change significantly after saline or OA exposures in MK-571-pretreated
      animals. ASM/BM2 in the large airways was significantly greater, 3.41 +/- 0.19 x
      10(-3), after OA compared with 2.35 +/- 0.22 x 10(-3) for saline exposures (p <
      0.01). The ASM/BM2 after OA exposures but with MK-571 pretreatment (2.75 +/- 0.25
      x 10(-3)) was intermediate in value. The results indicate that both the increase
      in airway responsiveness and the increase in ASM following repeated antigen
      exposures appear to be mediated predominantly by LTD4.

PMID- 8342906
TI  - Chronic obstructive pulmonary disease. An original model of cognitive decline.
AB  - In order to characterize the neuropsychologic profile of patients with hypoxic
      hypercapnic chronic obstructive pulmonary disease (COPD), the performance of 36
      patients with COPD 69 +/- 10 yr of age (mean +/- SD) on 19 tests exploring eight
      cognitive domains was compared with those of 29 normal adults (69 +/- 7 yr of
      age), 20 normal elderly adults (78 +/- 2 yr of age), 26 patients with Alzheimer
      type dementia (72 +/- 6 yr of age), and 28 with multi-infarct dementia (MID) (70
      +/- 8 yr of age). The discriminant analysis of cognitive test scores showed that
      48.5% of patients with COPD had a specific pattern of cognitive deterioration
      characterized by a dramatic impairment in verbal and verbal memory tasks, well
      preserved visual attention, and diffuse worsening of the other functions. The
      remaining patients with COPD were functionally classified as normal adults
      (12.1%), normal elderly adults (15.2%), those with MID (12.1%), and those with
      Alzheimer-type dementia (12.1%) according to discriminant analysis. Cognitive
      impairment was significantly and positively correlated with age (p < 0.05) and
      duration of hypoxic-hypercapnic chronic respiratory failure (p < 0.05). Because
      patients with COPD were receiving oxygen therapy from the beginning of
      oxyhemoglobin desaturation, results suggest that continuous oxygen therapy does
      not prevent or only partly prevents cognitive decline in COPD. Although some
      analogies between age-related and COPD-related cognitive decline are evident, a
      distinct cognitive profile was found in a large fraction of patients with COPD
      and it differs in several aspects from those of both normal and demented
      subjects.

PMID- 8342907
TI  - Inhibitory effect of staurosporine on protein kinase C stimulation of airway
      smooth muscle cells.
AB  - Phospholipid/calcium-dependent protein kinase (protein kinase C [PKC]) is a
      critical system in signal transduction of many different cells including airway
      smooth muscle (ASM) cells. We have previously shown that after administration of
      different phorbol esters, specific activators of PKC, characteristic electrical
      and contractile changes of ASM cells can be demonstrated. Similarly, our data
      showed that stimulation of PKC is implicated in the process of sensitization and
      the specific antigen challenge response of ASM cells. In this study we examined
      the effect of staurosporine, a microbial alkaloid, which has been reported to be
      a specific inhibitor of PKC, on sensitization- and specific antigen challenge
      induced electrical and contractile changes of ASM cells. The effect of
      staurosporine was compared with those of amiloride, furosemide, and compounds NA
      0345 and H-7, both synthetic PKC inhibitors. We used ASM preparations isolated
      from adult male guinea pigs (Camm-Hartley strain). Changes in both membrane
      potential (Em), measured by a glass microelectrode technique, and isometric
      force, measured by copper-beryllium strain gauge, were continuously monitored.
      Experiments were conducted with optimal length (Lmax) of ASM preparations and at
      37 degrees C. We found that the exposure of ASM preparations to staurosporine, NA
      0345, H-7, amiloride, and furosemide (all in 10(-12) to 10(-4) M) had no
      measurable effect on the resting membrane potential or isometric force of ASM
      preparations. In contrast, pretreatment of ASM preparations with staurosporine,
      NA-0345, H-7, amiloride, or furosemide significantly attenuated (p < 0.001)
      phorbol myristate acetate-induced changes of ASM preparations.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8342908
TI  - Antiasthma drug, ibudilast, inhibits neurogenic plasma extravasation in guinea
      pig airways.
AB  - We examined the effect of ibudilast, an antiasthma drug, on neurogenic
      microvascular leakage in guinea-pig airways by measuring extravasation of Evans
      blue dye. After intravenous pretreatment with atropine (1 mg/kg) and propranolol
      (1 mg/kg), bilateral vagal stimulation significantly increased nonadrenergic
      noncholinergic (NANC)-mediated leakage of dye in the trachea (Tr), the main
      bronchi (MB), and the central (cIPA) and peripheral (pIPA) intrapulmonary
      airways. Ibudilast (1.0 to 100 micrograms/kg given intravenously) did not affect
      basal leakage, but it significantly inhibited NANC-mediated plasma extravasation
      in a dose-dependent manner, with a maximal inhibition of 74.0% (Tr, p < 0.05),
      89.1% (MB, p < 0.05), 91.4% (cIPA, p < 0.01), and 84.3% (pIPA, p < 0.05) at 100
      micrograms/kg. Plasma extravasation induced by exogenous substance P (1
      microgram/kg given intravenously) was not inhibited by ibudilast. Glibenclamide,
      an inhibitor of ATP-sensitive potassium channels, blocked the inhibitory effect
      of ibudilast. We conclude that ibudilast inhibits neurogenic leakage by
      prejunctional inhibition of neuropeptide release from airway sensory nerve
      terminals via an ATP-sensitive potassium channel.

PMID- 8342909
TI  - Cigarette yields of tar and nicotine and markers of exposure to tobacco smoke.
AB  - Although cigarette yields of tar and nicotine have been declining since the early
      1970s, little information is available for the general population on the
      consequences of their use on exposure to tobacco combustion products. In a
      population-based sample of 298 smokers, the majority of whom were Hispanic, we
      examined the relationships between yields of cigarettes currently smoked and
      levels of salivary cotinine and end-expired carbon monoxide. Spearman correlation
      coefficients between the current number of cigarettes smoked and cotinine (r =
      0.52) or carbon monoxide (r = 0.51) were higher than correlations between the
      Federal Trade Commission (FTC) nicotine data and these same markers, 0.12 and
      0.05, respectively. Correlations between FTC tar and carbon monoxide yields and
      the biologic markers were similarly weak. In multiple linear regression models,
      the current number of cigarettes smoked was the most important predictor of
      cotinine and carbon monoxide levels (p < 0.0001). The addition of FTC tar,
      nicotine, or carbon monoxide to the models explained little of the variability in
      cotinine or carbon monoxide levels. Because FTC yields of tar and nicotine are
      poor predictors of exposure to tobacco combustion products, subjects' reports of
      cigarette brand should not be used as a primary marker of exposure in
      epidemiologic investigations. Furthermore, smokers need to be advised about the
      limitations of cigarette yield information for predicting the potential for
      adverse health effects of smoking.

PMID- 8342910
TI  - Comparability of parent reports of respiratory illnesses with clinical diagnoses
      in infants.
AB  - In a cohort study of respiratory illnesses from birth through age 18 months, the
      investigators assessed the occurrence of illness by telephone reports of
      respiratory symptoms. To assess the comparability of illness events based on
      symptom reports with usual clinical modalities, a nurse practitioner examined
      children during illnesses, and office and clinic records of outpatient visits
      were reviewed. Respiratory illnesses were defined as symptom episodes of at least
      2 days; lower respiratory illnesses included at least 1 day of either wet cough
      or wheeze. This report is based on 10,771 illnesses in the 1,315 subjects
      enrolled. Runny or stuffy nose was reported for most (93%) illnesses, wet cough
      in 33%, and wheeze in 6%. In comparison with the diagnoses made by a nurse
      practitioner, parent report of wet cough or wheeze was sensitive (93.4%) for
      detecting lower respiratory illnesses, but nonspecific with specificity of only
      24.2%. The majority of the false-positive lower respiratory illnesses had the
      symptom of wet cough. The comparison of parent reports with outpatient records
      provided similar findings. Standardized reporting of respiratory illnesses can be
      achieved with a telephone surveillance system but classification of specific
      illnesses from the surveillance information may differ from diagnoses made by
      clinicians.

PMID- 8342911
TI  - Nasal secretion of the ozone scavenger uric acid.
AB  - Uric acid, an important scavenger of ozone, has been identified as the major low
      molecular weight antioxidant in baseline and cholinergically induced nasal
      secretions. The purpose of this study was to determine the specific tissue source
      of uric acid in airway secretions. The secretion of uric acid is increased by
      cholinergic stimulation and correlates closely with the secretion of lactoferrin
      (a nasal glandular protein), suggesting that submucosal glands are involved.
      Indeed, nasal turbinate tissue was found to contain uric acid. However, careful
      analysis of nasal turbinate tissue failed to reveal the presence of xanthine
      oxidase, the enzyme responsible for uric acid synthesis. These data suggest that
      uric acid might be taken up secondarily by glands from plasma. This possibility
      was strengthened by the observation that lowering the plasma urate level with
      probenecid concomitantly lowered urate secretion. These findings are consistent
      with the hypotheses that the principal source of uric acid in nasal secretions is
      plasma and that uric acid is taken up, concentrated, and secreted by nasal
      glands.

PMID- 8342912
TI  - Pharyngeal fat in obstructive sleep apnea.
AB  - Although most patients with obstructive sleep apnea (OSA) are obese, it is not
      known how obesity contributes to airway collapse during sleep. The purpose of
      this study was to determine whether the volume of adipose tissue adjacent to the
      pharyngeal airway in humans is related to the degree of OSA. We studied 30
      subjects, nine without OSA and 21 with OSA; two subjects were studied before and
      after weight loss. Adipose tissue was detected with magnetic resonance imaging
      using T1-weighted spin echo sequences. The volume of adipose tissue adjacent to
      the upper airway was determined by measuring the volume of all pixels in the
      intensity range of adipose tissue within the region bounded by the ramus of the
      mandible, the spine, the anterior border of the soft palate, and the hard palate.
      Polysomnography was performed with conventional techniques. All subjects had a
      collection of adipose tissue adjacent to the upper airway; the volume of this
      adipose tissue correlated with the number of apneas plus hypopneas per hour of
      sleep (r = 0.59, p < 0.001). Both patients who lost weight and had fewer apneas
      and hypopneas had a marked decrease in the pharyngeal adipose tissue volume. We
      conclude that adipose tissue is deposited adjacent to the pharyngeal airway in
      patients with OSA and that the volume of this tissue is related to the presence
      and degree of OSA.

PMID- 8342913
TI  - Immunofluorescent analysis of plasma fibronectin incorporation into the lung
      during acute inflammatory vascular injury.
AB  - Incorporation of plasma fibronectin into tissues is believed to influence
      endothelial cell-cell interaction, as well as endothelial cell adhesion to
      matrix. We used immunofluorescent microscopy coupled with tissue extraction of
      noncovalently incorporated fibronectin to delineate the time course for matrix
      incorporation of soluble plasma-derived fibronectin into the lung of sheep during
      postoperative bacteremia. Adult sheep were surgically prepared with both lung and
      peripheral lymph fistulas. Sheep were anesthetized 2 days following surgery and
      injected intravenously with a sublethal dose of live Pseudomonas aeruginosa,
      which consisted of 5 x 10(8) live organisms suspended in 0.9% saline. Bacterial
      infusion elicited a 300% increase in lung transvascular protein clearance but no
      increase in peripheral transvascular protein clearance. Purified dimeric human
      plasma fibronectin (hFn), used as an "immunologic marker," was then infused
      intravenously (100 mg/sheep) into two additional groups of sheep (nonbacteremic
      control group and bacteremic experimental group) and allowed to mix with the
      plasma pool of endogenous soluble sheep fibronectin (sFn). Incorporation of the
      plasma-derived hFn into the lung matrix and its distribution in relation to
      endogenous sheep fibronectin in the matrix was assessed by dual-label
      immunofluorescence using antibodies specific to either sFn or hFn. Human
      fibronectin from the vascular compartment codistributed with endogenous sheep
      fibronectin in the lung matrix. Moreover, its deposition into the lung was
      markedly increased in postoperative bacteremic sheep compared with nonbacteremic
      control sheep. Increased hFn deposition in the lung with bacteremia was clearly
      apparent within 2 h. The hFn deposited in the lung was nonextractable using a
      heparin-urea tissue extraction buffer, suggesting its rapid covalent cross
      linking and incorporation into the lung matrix. Microscopic analysis of serial
      lung biopsies revealed focal areas of inflammation with an intense mononuclear
      infiltrate into the lungs by 2 h in the bacteremic sheep. Interstitial edema and
      vascular endothelial injury were observed by 4 h, with alveolar edema apparent
      over 6 to 8 h. Thus, postoperative bacteremia results in a rapid incorporation of
      plasma fibronectin into the lung matrix. This may be a physiologic mechanisms to
      stabilize the integrity of the lung vascular barrier.

PMID- 8342914
TI  - A new model of progressive pulmonary fibrosis in rats.
AB  - Sprague-Dawley rats were exposed for 6 h daily to 0.8 ppm of ozone and 14.4 ppm
      of nitrogen dioxide. Approximately 7 to 10 wk after the initiation of exposure,
      animals began to demonstrate respiratory insufficiency and severe weight loss.
      About half of the rats died between Days 55 and 78 of exposure; no overt ill
      effects were observed in animals exposed to filtered air, to ozone alone, or to
      nitrogen dioxide. Biochemical findings in animals exposed to ozone and nitrogen
      dioxide included increased lung content of DNA, protein, collagen, and elastin,
      which was about 300% higher than the control values. The collagen-specific
      crosslink hydroxy-pyridinium, a biomarker for mature collagen in the lung, was
      decreased by about 40%. These results are consistent with extensive breakdown and
      remodeling of the lung parenchyma and its associated vasculature. Histopathologic
      evaluation showed severe fibrosis, alveolar collapse, honeycombing, macrophage
      and mast cell accumulation, vascular smooth muscle hypertrophy, and other
      indications of severe progressive interstitial pulmonary fibrosis and end-stage
      lung disease. This unique animal model of progressive pulmonary fibrosis
      resembles the final stages of human idiopathic pulmonary fibrosis and should
      facilitate studying underlying mechanisms and potential therapy of progressive
      pulmonary fibrosis.

PMID- 8342915
TI  - Enhanced production of IL-1 receptor antagonist by alveolar macrophages from
      patients with interstitial lung disease.
AB  - Alveolar macrophages (AM) produce various inflammatory and immunomodulatory
      cytokines. The objective of these experiments was to evaluate the production of
      IL-1ra, a specific receptor antagonist of IL-1, by AM from nonsmoking control
      subjects (n = 9), smoking control subjects (n = 6), and patients with
      interstitial lung disease (ILD) (n = 9). IL-1ra protein levels in cultured AM
      lysates and supernatants were determined by a specific ELISA; relative steady
      state IL-1ra mRNA levels were measured using a specific cDNA probe. Before
      culture the isolated AM from all subject groups contained undetectable IL-1ra
      mRNA and no IL-1ra protein in the cell lysates as determined by ELISA. AM from
      nonsmoking control subjects spontaneously produced IL-1ra protein after a 20 h
      culture in medium, approximately 12 ng/ml with around half in cell lysates. AM
      from smoking control subjects produced levels of IL-1ra that were similar to the
      levels in AM from nonsmokers. In contrast, AM from nonsmoking ILD patients (n =
      6) produced high levels of IL-1ra spontaneously (approximately 28 ng/ml), with no
      enhancement observed when cultured on adherent IgG. Interestingly, AM from
      smoking ILD patients (n = 3) produced lower levels of IL-1ra protein
      (approximately 11 ng/ml) that were comparable to levels noted in smoking control
      subjects. AM from all three types of subjects produced decreased amounts of IL
      1ra in response to LPS and enhanced amounts in response to GM-CSF. In general, IL
      1ra steady-state mRNA levels correlated with protein production.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8342916
TI  - Severe hemolysis due to a donor anti-D antibody after heart-lung transplantation.
      Association with lung and blood chimerism.
AB  - Hemolysis due to donor-derived red cell antibodies is a potential complication
      after minor ABO-mismatched solid organ transplantation. It has also been
      described in Rh-positive recipients receiving organs from previously isoimmunized
      Rh-negative donors. We report on a group O, Rh(D)-positive patient who received a
      heart-lung transplant from a group O, Rh(D)-negative donor presenting an anti-D
      antibody. Severe hemolytic anemia developed in the early postoperative period and
      lasted for 3 mo. Anti-D antibodies that were of donor origin were found in
      bronchoalveolar lavage fluid and serum. In addition, using the polymerase chain
      reaction for human leukocyte antigen class II genotyping, we were able to
      demonstrate the presence of a mixed population of donor and recipient cells in
      the lungs and the peripheral blood of the recipient. The chimeric state in the
      blood persisted until at least the fifty-seventh postoperative day. This first
      case report of hemolysis due to Rh(D) antibody after heart-lung transplantation
      emphasizes the need for routine red cell antibody screening of donors and for
      close monitoring of signs of red cell destruction in the recipient in cases of
      pretransplant donor isoimmunization.

PMID- 8342917
TI  - Paradoxical bronchoconstriction with nebulized albuterol but not with
      terbutaline.
AB  - A 40-yr-old woman with severe chronic asthma complained that her regular
      nebulized albuterol was exacerbating her symptoms. Changing to regular nebulized
      terbutaline resulted in a marked improvement in her peak flow readings. Double
      blind challenge with nebulized albuterol and terbutaline confirmed paradoxical
      bronchoconstriction with albuterol but not with terbutaline. This indicates that
      paradoxical bronchoconstriction to beta 2-agonists can be specific to the drug
      preparation used rather than a class effect, as has previously been suggested.

PMID- 8342918
TI  - Perception of breathlessness during early and late asthmatic responses.
AB  - We looked at the perception of breathlessness associated with bronchoconstriction
      during early (EAR) and late (LAR) asthmatic responses to inhaled antigens and its
      correlation with the rate of fall of expiratory flows. Twenty-eight asthmatics
      were studied (12 male, 16 female, 18 to 38 yr of age). Breathlessness was
      evaluated on a modified Borg scale (0 to 10) before each FEV1 measurement,
      obtained at regular intervals for as long as 8 h after the antigen challenge. The
      rate of the fall in FEV1 was calculated from the maximal percent fall obtained
      during the EAR or the LAR and the time lapse from the onset of the reaction to
      the maximal fall in FEV1. Ten subjects had an isolated early and 18 had a dual
      asthmatic response after allergen challenge. Dual responders perceived a similar
      percent fall in FEV1 (mean percent fall: EAR, 20.7 +/- 1.6%; LAR, 21.5 +/- 1.6%)
      more intensely during the EAR than during the LAR, with median Borg scores
      (range) of, respectively, 2.0 (0.5 to 4) and 0.5 (0 to 3.0) (n = 18, p < 0.001).
      The median rate of the fall in FEV1 was: EAR, 2.09 (0.77 to 6.6) %/min; LAR, 0.11
      (0.05 to 0.36) %/min (n = 18, p < 0.001). The rate of the fall in FEV1 during
      either EAR or LAR was strongly correlated with the Borg scores; the slower the
      fall, the weaker the perception (p < 0.001). We conclude that LAR are poorly
      perceived compared with EAR and that this may be due to the temporal adaptation
      to the slow and progressive bronchoconstriction in LAR.

PMID- 8342920
TI  - Bronchoalveolar lavage in asthma. An update and perspective.

PMID- 8342919
TI  - Circulating immunoreactive endothelin-1 in children with pulmonary hypertension.
      Association with acute hypoxic pulmonary vasoreactivity.
AB  - To determine whether circulating levels of endothelin-1 (ET-1), a potent
      vasoconstrictor peptide, are elevated in children with pulmonary hypertension and
      related to the degree of hypoxic pulmonary vasoconstriction, we measured arterial
      and mixed venous plasma concentrations of immunoreactive ET-1 (irET-1) in 13
      children during cardiac catheterization. Clinical diagnoses in seven children
      with pulmonary hypertension (PH) included chronic lung disease (four children),
      congenital heart disease after surgical repair (two children), and primary
      ("reactive") pulmonary hypertension (one child). Blood samples were
      simultaneously obtained from pulmonary artery (venous) and systemic arterial
      sites during baseline conditions. Plasma irET-1 was elevated in children with PH
      (12.3 +/- 3.4 versus 3.6 +/- 0.7 pg/ml, PH versus non-PH; p < 0.01).
      Arterial/venous irET-1 ratios in the PH group (1.1 +/- 0.2) were not different
      from those in the non-PH group. During acute hypoxia, mean Ppa increased from 27
      +/- 3 to 40 +/- 5 mm Hg. Basal irET-1 correlated strongly with the degree of
      elevation of mean Ppa during acute hypoxia (r = 0.69; p < 0.02). We conclude that
      irET-1 levels are often elevated in children with PH, and they are strongly
      correlated with pulmonary vasoreactivity during acute hypoxia. Whether elevated
      irET-1 levels contribute directly to or are markers of altered pulmonary vascular
      tone and reactivity in children with PH remains speculative.

PMID- 8342921
TI  - Diaphragmatic pacing.

PMID- 8342922
TI  - Microfixation of acute orbital fractures.
AB  - Microfixation techniques were used as an adjunct to the use of miniplates and
      screws in the acute treatment of fractures involving the orbit in 42 patients
      over a 2-year period. Miniplates were used in all fractures at the Le Fort I
      level and at the zygomatic-frontal suture in high-energy injuries. Microfixation
      was used to stabilize all other fractures of the zygomatic, nasoethmoid, and
      frontal areas. Problems with plate visibility and objectionable palpability
      through thin periorbital skin were eliminated. The use of microplates allowed
      more precise positioning of small fragments than possible with miniplates or
      interfragmentary wires. Fracture reduction remained clinically stable in the
      frontal and nasoethmoid areas. Microplates were inadequate to resist soft tissue
      deforming forces along the infraorbital rim and the zygomatic arch in high-energy
      injuries.

PMID- 8342923
TI  - Prevention of thrombosis by topical application of tissue factor pathway
      inhibitor in a rabbit model of vascular trauma.
AB  - The extrinsic pathway of coagulation is initiated when tissue factor complexes
      with factor VII. A naturally occurring protein inhibitor of this complex, tissue
      factor pathway inhibitor (TFPI), has recently been isolated and the cDNA coding
      for this protein cloned. We used a rabbit ear artery model of crush/avulsion
      injury and microvascular repair to investigate the efficacy of TFPI as a
      topically applied antithrombotic agent. Traumatized arteries treated through
      lumenal irrigation with normal saline vehicle (controls) achieved patency rates
      of 8% and 0% at 1 and 7 postoperative days, respectively. Heparin irrigation (10
      U/ml) resulted in patencies of 40% at both evaluation times. In contrast, TFPI at
      a dose of 20 micrograms/ml (0.2 ml total volume; 10 minute exposure) yielded a
      91% patency rate at 1 day and 73% at 7 days postoperatively (p < 0.0005 vs
      controls). Prothrombin time and activated partial thromboplastin time values were
      not altered after topical treatment with TFPI. Scanning electron microscopy
      revealed dramatically inhibited thrombogenesis upon the injured surfaces of TFPI
      treated vessels. These results suggest that TFPI used as a topically applied
      antithrombotic agent is effective for the prevention of thrombosis in
      microvascular anastomoses.

PMID- 8342924
TI  - The extended deep inferior epigastric pedicle flap for lower extremity
      reconstruction.
AB  - Large soft-tissue defects of the lower extremity can present a challenging
      reconstructive problem. The extended deep inferior epigastric pedicle flap is a
      versatile and reliable flap that can be used for the coverage of complex lower
      extremity soft-tissue defects as far distal as the knee. We reviewed our 5-year
      experience with 20 consecutive extended deep inferior epigastric pedicle flaps
      used to cover lower extremity defects. All wounds, including 4 soft-tissue
      defects of the knee, were successfully covered. Two minor complications occurred.
      Flap anatomy, surgical approach, and new refinements in flap design are
      presented. The indications for the flap and its role in ablative tumor surgery
      are discussed. This flap has proved to be versatile, easy to raise, and extremely
      hardy. The ample skin island with its large arc of rotation is well vascularized,
      healing well even in irradiated wounds, and the flap tolerates both postoperative
      pressure and radiation.

PMID- 8342925
TI  - The expanded forehead flap for nasal reconstruction.
AB  - A 3-year experience using forehead tissue expansion for nasal reconstruction is
      presented. The series includes 7 expansions in 6 patients with different degrees
      of nasal loss due to either cancer, trauma, or avascular necrosis. Balloon tissue
      expansion minimizes the well-known limitations and drawbacks found in using
      forehead flaps for nasal reconstruction. Technique, timing, and sequencing of
      procedures are discussed and compared with those of other authors. The
      complications of tissue expansion are few, but obtaining a satisfactory nasal
      reconstruction requires multiple operations over a period of time. A learning
      curve is necessary due to inadequate previous experience and new developments in
      tissue expanders. The results obtained were possible due to the excellent tissue
      provided by forehead expansion.

PMID- 8342926
TI  - Facial injuries from falling: age-dependent characteristics.
AB  - A retrospective analysis was undertaken of 108 patients with facial injuries from
      falling who presented at the Plastic Surgery Unit of the Toyo-oka Public Hospital
      from 1988 to 1990. Facial injuries from falling were common in little children,
      in those < 6 years of age comprising 45.4% of injuries. Age-dependent
      characteristic injury sites were found (i.e., in those < 2 years old, the
      forehead; in small children, the chin; in students, the lip; and in older
      persons, the cheek); this disparity can be explained by the mechanism of injury.
      The injury pattern also depended on age, varying activities, and tissue strength.
      In children of < 6 years of age, small lacerations on the forehead or chin were
      most common, but even conservative treatment could achieve good results. On the
      other hand, inadequate suturing by emergency room physicians brought on poor
      results. In adults, abrasions and traumatic tattoos occurring with late-night
      inebriation tended to develop some sequelae.

PMID- 8342927
TI  - Quantitative monitoring of capsular contraction around smooth and textured
      implants.
AB  - The purpose of this study was to assess the efficacy of textured silicone
      implants in reducing the incidence of capsular contracture. Each of 10 female New
      Zealand, albino rabbits received 2 saline-filled implants, 1 on either side of
      the lateral chest wall. The surface of 1 implant was smooth silicone, whereas the
      other implant's surface was textured silicone. Magnetic resonance imaging (MRI)
      scans of the implants were performed at 0, 9, 17, 26, 34, and 40 weeks after
      implantation. Data from the MRI scans were used to calculate the effective
      surface area of implants at each analysis interval. This technique provided a
      noninvasive method of monitoring implant contraction as a function of time. Eight
      rabbits completed the study. Four of 8 smooth implants developed contractures,
      whereas none of the textured implants developed contracture. For the 4 smooth
      implants that developed contractures, MRI scans calculated 72 +/- 12% contraction
      at 17 weeks, but the Baker palpation test detected only mild firmness. From 17 to
      40 weeks, the mean percentage of contraction for these implants changed
      minimally, but their mean Baker score increased from mild to severe (II to IV).
      Quantitative data from MRI scans were much more predictive of final implant
      contraction than palpation (Baker test), applanation tonometry, or indentation
      tonometry. The latter two tests only detected the final stages of severe implant
      contraction.

PMID- 8342928
TI  - Irradiation effects on wound contraction using a connective tissue model.
AB  - To analyze irradiation effects on wound contraction, fibroblasts harvested from
      human oral mucosa were irradiated (single 2-, 4-, 6-, 8-, and 10-Gy exposures of
      x-rays). The irradiated fibroblasts were examined for growth ability, and they
      were cultured three-dimensionally in hydrated collagen gels. The irradiation
      inhibited growth of fibroblasts and contraction of collagen gels in a dose
      dependent manner. In addition, inhibition depended on the duration after
      exposure. The organization of actin filaments of fibroblasts in this model was
      examined with fluorescent dye-conjugated phalloidin. Many elongated cell
      projections were formed in cells of the control group, but the cell projections
      were almost disrupted in the irradiated cells. X-ray irradiation is thus shown to
      inhibit wound contraction by affecting the organization of actin filaments in
      fibroblasts.

PMID- 8342929
TI  - Tissue oxygenation and blood flow on specialized and conventional hospital beds.
AB  - Despite the widespread use of specialty bed products, the physiological mechanism
      of their benefit has not been evaluated. In this study, healthy subjects were
      used to study transcutaneous oxygen tension (TcPo2) and laser Doppler blood flow
      in pressure sore-prone areas on air-fluidized, low-air-loss, and adjustable air
      mattress beds relative to a standard hospital mattress with and without an egg
      crate mattress overlay. Measurements were obtained over the sacrum with the
      subject in the prone and supine positions, and over a greater trochanter with the
      subject in the prone and 90-degree lateral positions. Our results on healthy
      volunteers suggest that the specialty bed products maintain TcPo2 better than a
      standard bed when tissue is weighted. Further, the Clinitron had significantly
      higher TcPo2 when weighted than each of the other beds. Laser Doppler blood flow
      was much more variable. The weighted trochanter on the standard bed had the
      lowest blood flow, which is consistent with the TcPo2 readings. However, the
      variability made the laser Doppler flow data less valuable than the TcPo2. In
      conclusion, these data indicate that several products, particularly the
      Clinitron, maintain TcPo2 of weight-bearing tissue, which may be an important
      mechanism in protecting against pressure sores.

PMID- 8342930
TI  - Marginal eyelid reconstruction with a composite skin-muscle-mucosa graft from the
      lower lip.
AB  - Marginal defects of the eyelid were repaired using skin-muscle-mucosa composite
      grafts from the lower lip without cartilage support in 2 patients. The method is
      a simple one-stage procedure and takes little time to perform. Because of the
      wide contact between the grafts and the recipient sites, grafting was successful.
      Texture and color match is not too problematic in elderly persons.

PMID- 8342931
TI  - Asymmetrical hypersensitivity to bovine collagen.
AB  - We report a unique patient with true asymmetrical hypersensitivity to bovine
      collagen. Hypersensitivity is the development of an inflammatory response at a
      treatment site after a negative skin test. She developed an inflammatory response
      in only one of two simultaneously injected sites. About 1.5% of patients with a
      negative skin test have a hypersensitivity reaction consisting of firmness,
      erythema, and swelling. The signs and symptoms generally resolve spontaneously in
      a few months.

PMID- 8342932
TI  - Scalp flap rotation with primary donor site closure.
AB  - A 57-year-old man with a 7-cm defect of the left temple underwent reconstruction
      with a large scalp rotation flap that shifted the donor defect to the back of the
      neck so that it could be closed primarily. This approach, also used successfully
      in 7 other patients with similar defects, avoided the need for an unsightly skin
      graft in the donor site while providing tissue with a color and texture that
      blended well with the surrounding forehead and facial skin. Primary closure of
      the donor site reduces scalp flap morbidity and improves the overall aesthetic
      outcome.

PMID- 8342933
TI  - Myonecrosis as a sequela of calf implants.
AB  - Calf augmentation using alloplastic implants primarily is intended to enhance
      body contour. Usually this is a safe and efficacious procedure. However, in this
      unique report, significant myonecrosis occurred as a direct consequence of calf
      implantation, which resulted in a residual functional disability as well as
      aesthetic deformity. An awareness of the potential for a similar catastrophe
      hopefully will mitigate against future overzealous attempts at augmentation.

PMID- 8342934
TI  - Successful treatment of coccidioidomycosis osteomyelitis in an infant.
AB  - A 10-month-old Hispanic male infant with expansile lesions of the third
      metacarpal and proximal phalanx positively diagnosed as Coccidioides immitis
      osteomyelitis is presented. Treatment consisted of combined surgical debridement
      and systemic antifungal therapy and resulted in complete resolution of the
      lesions. Treatment was guided by clinical response and complement fixation
      titers. Osteomyelitis is a relatively infrequent manifestation of disseminated
      coccidioidomycosis. Neonates and infants appear to be more susceptible to the
      development of dissemination, but less likely to develop toxicity due to systemic
      therapy. Current therapy consists of concomitant surgical excision of involved
      lesions and systemic antifungal therapy. Complement fixation titers correlate
      closely with clinical response to therapy and are useful in detecting subclinical
      recurrences.

PMID- 8342935
TI  - Neovaginal procidentia.
AB  - Split-thickness skin grafts combined with an omental pedicle is a popular method
      of vaginal reconstruction. An unusual case of neovaginal prolapse presenting 3
      months after construction is presented. Sacral colpopexy using autogenous fascial
      tissue allowed for both anatomical and functional correction of this neovagina.

PMID- 8342936
TI  - A reconstructive surgeon's taste in art: Dr Peter Parker and the Lam Qua oil
      paintings.
AB  - Hidden within the basement archives of Yale University's Historical Medical
      Library lie the original oil painting collection and personal papers of the first
      American surgeon to practice in China. The Reverend Dr Peter Parker, a graduate
      of Yale, established the first American hospital in Guangzhou (formerly Canton)
      in 1835 and successfully introduced Western surgical techniques including
      amputation, anesthesia, and reconstructive surgery. In addition to this
      distinguished career of medical missionary service, Parker commissioned the
      Chinese artist Lam Qua to paint a fascinating series of portraits depicting
      patients with extreme tumor growths. In this article, Parker's own journals are
      examined to reveal both his missionary zeal and his frustrations working in
      China. Selected examples of the Lam Qua paintings are presented along with
      Parker's corresponding patient descriptions. These detailed patient reports give
      insight into the extent of surgical pathology as well as the relative brutality
      of surgical techniques in the early to mid-1800s. The historical significance of
      the Peter Parker-Lam Qua collaboration within the context of the Western
      transformation of Chinese art and medicine is also discussed.

PMID- 8342938
TI  - The best and the brightest.

PMID- 8342937
TI  - The cleft palate gag line: connect the Dotts.
AB  - The origin of the Dott mouth gag is discussed and the various modifications of
      this instrument are listed chronologically. A personal modification to allow
      surgery of the tongue is described.

PMID- 8342939
TI  - Re: Accessory abductor digiti minimi muscle originating proximal to the wrist
      causing symptomatic ulnar nerve compression.

PMID- 8342940
TI  - Re: The subcutaneous forehead lift with an anterior hairline incision.

PMID- 8342941
TI  - Re: The transverse gracilis musculocutaneous flap.

PMID- 8342942
TI  - Identification and localization of a novel cathepsin S-like proteinase in guinea
      pig spermatozoa.
AB  - Guinea pig spermatozoa were found to contain a novel cysteine proteinase that
      most closely resembled lysosomal cathepsin S. The responsible enzyme was shown to
      have an acrosomal localization. Like the cathepsin S of lymphocyte-rich tissues,
      e.g., lymph nodes and spleen, the spermatozoal enzyme digested protein substrates
      such as hemoglobin and Azocoll optimally at about pH 3.5 in the presence of
      pepstatin. No appreciable action was manifested in the range of pH 5-6 on protein
      substrates nor on the 7-(4-methyl)coumarylamide (NMec) derivatives of peptides
      commonly employed for the fluorometric assay of cathepsins B (benzyloxycarbonyl
      (Z)-Arg-Arg-NMec), H (Arg-NMec), and L (Z-Phe-Arg-NMec). Like spleen cathepsin S,
      the sperm enzyme selectively hydrolyzed Z-Phe-Arg-NMec, but its activity was
      uncharacteristically limited to a pH range of 3.0-3.5, where it displayed a
      typical high sensitivity to sulfhydryl reagents (HgCl2, mersalyl acid,
      iodoacetate), leupeptin, Z-Phe-Phe-CHN2, and L-trans-epoxysuccinylleucylamido(3
      methyl)butane. Gossypol (a male antifertility agent) was also inhibitory.
      Inhibition by the mercurial sulfhydryl reagents was completely reversible with
      dithiothreitol. Pepstatin, a potent inhibitor of aspartic proteinases, and serine
      proteinase inhibitors (phenylmethylsulfonyl fluoride, benzamidine) were
      ineffective. Other properties displayed by the sperm extract that were uniquely
      characteristic of cathepsin S included stability under alkaline conditions, and a
      greater rate of hydrolysis when the P2-phenylalanine of the assay substrate was
      replaced by two aliphatic residues, as in Z-Leu-Leu-Arg-NMec.

PMID- 8342943
TI  - Characterization of glutathione transferase from Xanthomonas campestris.
AB  - A single form of glutathione transferase (Xc-GST-4.5) having an isoelectric point
      at pH 4.5 was resolved from Xanthomonas campestris cytosol by affinity
      chromatography and isoelectric focusing. HPLC,N-terminal amino acid sequence, and
      SDS-PAGE analyses indicate that Xc-GST-4.5 is composed of two identical subunits,
      each with a molecular mass of 22 kDa. As indicated by its substrate specificity,
      immunological reactivity, and CD spectra, as well as by its N-terminal amino acid
      sequence, Xc-GST-4.5 appears to be distinct from the other bacterial glutathione
      transferases, Pm-GST-6.0 and Sm-GST-7.3, previously purified from the cytosolic
      fraction of Proteus mirabilis and Serratia marcescens. Xc-GST-4.5 also appears to
      be distinct from the GST so far purified from other sources.

PMID- 8342944
TI  - Biosynthesis of vicinal dihydroxy fatty acids in the red alga Gracilariopsis
      lemaneiformis: identification of a sodium-dependent 12-lipoxygenase and a
      hydroperoxide isomerase.
AB  - Biosynthesis of the vicinal diol fatty acid (12R,13S)-dihydroxy-(5Z,8Z,10E,14Z)
      eicosatetrae noic acid from arachidonic acid was studied in preparations of the
      red alga Gracilariopsis lemaneiformis. The transformation consisted of initial 12
      lipoxygenase-catalyzed oxygenation of arachidonic acid into (12S)-hydroperoxy
      (5Z,8Z,10E,14Z)-eicosatetraeno ic acid followed by hydroperoxide isomerase
      catalyzed conversion of the hydroperoxide into (12R,13S)
      dihydroxyeicosatetraenoic acid. Short time incubations and trapping experiments
      with glutathione peroxidase revealed that (12S)-hydroperoxyeicosatetraenoic acid
      existed as a free intermediate in the overall conversion. The 12-lipoxygenase was
      mainly present in the soluble fraction of homogenate of G. lemaneiformis.
      Further, gel filtration experiments showed that the soluble 12-lipoxygenase was a
      protein having a molecular weight of 84,000-89,000. The enzymatic activity of 12
      lipoxygenase isolated by gel filtration was weak; however, addition of 0.8-1 M
      sodium chloride to such desalted enzyme increased the activity 20-fold.
      Experiments with different salts revealed that sodium ion was specifically
      responsible for the stimulatory effect. Hydroperoxide isomerase was about equally
      distributed between the high speed supernatant and particulate fractions. Gel
      filtration of hydroperoxide isomerase present in the soluble fraction showed two
      peaks of activity corresponding to proteins having molecular weights of 220,000
      or greater, and 40,000-45,000. The stereochemical course of the biosynthesis of
      vicinal diol fatty acids was determined using stereospecifically deuterated
      6,9,12-octadecatrienoic acids. The 12-lipoxygenase-catalyzed reaction consisted
      of antarafacial hydrogen removal and oxygen insertion, whereas the hydroperoxide
      isomerase catalyzed an intramolecular oxygenation which occurred with retention
      of the configuration of the carbon atom hydroxylated.

PMID- 8342945
TI  - Expression of modified human cytochrome P450 3A4 in Escherichia coli and
      purification and reconstitution of the enzyme.
AB  - A full-length human cytochrome P450 (P450) 3A4 cDNA clone and four derivatives in
      which the N-terminus was modified were inserted into a pCW vector and used to
      transform Escherichia coli DH5 alpha cells. Little expression was seen with the
      native sequence; the highest level of expression (range of 40-110 membrane-bound
      nmol P450 liter-1) was achieved with a construct (NF14) in which residues 3-12
      were deleted. In all of the constructs P450 was found primarily in the membranes.
      The modified P450 3A4 (construct NF14) showed typical P450 hemoprotein spectra.
      The protein was purified to electrophoretic homogeneity in a five-step procedure
      [nominally 23 nmol P450 (mg protein)-1]. For most purposes it was found to be
      more practical to purify the modified P450 3A4 to approximately 70% homogeneity
      [nominally 15 nmol P450 (mg protein)-1] in a simple two-step process. The
      modified P450 3A4 (NF14) or P450 3A4 purified from human liver could be mixed
      with rabbit liver NADPH-P450 reductase to achieve catalytic activities nearly as
      high as those found in human liver microsomes (on a nmol P450 basis), but the
      optimal reconstitution conditions included not only a mixture of
      phosphatidylserine, L-alpha-dilauroyl- and L-alpha-dioleoyl-sn-glycero-3
      phosphocholines, cholate, and cytochrome b5 suggested by others but also
      glutathione during the preincubation. Several other thiols were found not to
      substitute in this role. Good catalytic activity was seen for nifedipine
      oxidation, testosterone 6 beta-hydroxylation, and the 8,9-epoxidation and 3 alpha
      hydroxylation of aflatoxin B1, reactions previously ascribed to the enzyme. These
      procedures provide a relatively convenient and reliable means of producing,
      purifying, and reconstituting a catalytically active and useful derivative of
      P450 3A4, a human P450 enzyme that has many roles in the oxidation of drugs and
      other xenobiotic chemicals.

PMID- 8342946
TI  - Free radical reductive degradation of vic-dibromoalkanes and reaction of bromine
      atoms with polyunsaturated fatty acids: possible involvement of Br(.) in the 1,2
      dibromoethane-induced lipid peroxidation.
AB  - Bromine atoms generated upon reductive degradation of 1,2-dibromoethane and
      various other vic-dibromoalkanes have been shown to react with polyunsaturated
      fatty acids via both abstraction of bisallylic hydrogen and addition to the
      double bonds. The abstraction process occurs with 53, 68, and 77% efficiency from
      linoleic (18:2), linolenic (18:3), and arachidonic acid (20:4), respectively. The
      corresponding absolute rate constants have been evaluated to be 1.2 x 10(9), 1.8
      x 10(9), and 5.1 x 10(9) M-1 s-1 for these three polyunsaturated fatty acids
      (PUFAs). The rate constants for the bromine atom addition reaction appear to be
      very similar for all PUFAs and have been determined to (1.2 +/- 0.3) x 10(9) M-1
      s-1. Absolute rate constants in the order of 10(5)-10(6) s-1 have also been
      measured for the bromine atom elimination from various beta-bromoalkyl radicals.
      The results render bromine atoms a potential initiator for lipid peroxidation,
      and their reactions may well provide an important chemical basis for the overall
      toxic action of 1,2-dibromoethane and related substrates.

PMID- 8342947
TI  - Molluscan chymotrypsin-like protease: structure, localization, and substrate
      specificity.
AB  - A messenger RNA encoding a chymotrypsin-like preproprotease is expressed
      abundantly and specifically in the distal quarter of the intestine of the mollusc
      Haliotis rufescens (red abalone). Consistent with this finding, a chymotrypsin
      like activity was detected at highest concentration in the lumen of this segment
      of the intestine. Because the complexity of total protein in the distal
      intestinal fluid was low and the chymotrypsin-like protease was highly expressed,
      purification of the enzyme to near homogeneity was achieved by a single passage
      over an anion-exchange resin. The primary specificity of the protease, predicted
      from homology of the key amino acid residues (Ser189, Gly216, and Ser226) in the
      substrate binding site with similar residues lining the S1 subsites of other
      chymotrypsin-like enzymes, was confirmed by hydrolysis of a family of
      tetrapeptide substrates with different P1 amino acids. The optimal P1 residues
      include those with bulky, gamma-branched side chains (phenylalanine and leucine)
      similar to the side chain of the asparagine residue at P1 of the activation
      peptide of the proenzyme. Thus, unlike zymogens of the pancreatic serine
      proteases, which are activated by the common tryptic mechanism, the zymogen of
      the molluscan enzyme appears to be activated by an autocatalytic mechanism, i.e.,
      by cleavage with active chymotrypsin-like protease. Additional unique properties
      of the enzyme predicted from the primary sequence include an unpaired cysteine,
      with the potential for internal thiol-disulfide isomerization between two
      different conformers of the protease.

PMID- 8342948
TI  - Further approaches to the quaternary structure of octopus hemocyanin: a model
      based on immunoelectron microscopy and image processing.
AB  - The direction of the polypeptide chains and the location of the functional units
      in Octopus vulgaris hemocyanin were studied by various methods. Monoclonal
      antibodies specific for the Ovc (clone Ov409) and Ovg (clone Ov315) functional
      units produced immunocomplex strings which were examined in the electron
      microscope. In both cases the immunocomplexes contained more than two hemocyanin
      molecules in their side view, demonstrating that in the whole hemocyanin
      neighboring polypeptide chains run in antiparallel directions. The
      interhemocyanin distances in the immunocomplexes also indicated that Ovg is
      located inside the cylinder, while Ovc is located in the external layers of
      functional units. In addition, the fact that the binding point of the Fab arm to
      the hemocyanin molecule was occasionally visible confirmed the external location
      of functional unit Ovc. Image processing of the whole hemocyanin cross-linked
      with dimethyl suberimidate showed that the end-on view is not a perfect cylinder
      but a regular pentahedron and that the five-arch collar is probably composed of
      five pairs of functional unit Ovg located inside the cylinder. The accessibility
      of cross-linked hemocyanin to functional unit-specific polyclonal antibodies,
      studied in immunoelectrophoresis, showed that Ovb and Ove are highly accessible,
      while Ovd, Ovf, and Ovg are not. The low accessibility of Ovd may be at least
      partially explained by its high sugar content which could hamper the
      accessibility of the antibody to the antigen.

PMID- 8342949
TI  - Hyperexpression of catalase in selenium-deprived murine L1210 cells.
AB  - Murine leukemia L1210 cells grown for 2-3 weeks in the presence of 1% serum
      without selenium supplementation [L.Se(-) cells] typically exhibited < 10% of the
      glutathione peroxidase (GPX) and phospholipid hydroperoxide glutathione
      peroxidase (PHGPX) activity of selenium-satisfied controls [L.Se(+) cells].
      Concomitant with diminished GPX and PHGPX activity was a 1.5- to 2.0-fold
      increase in catalase (CAT) activity, which reverted to control levels when L.Se(
      ) cells were given sufficient Se for full expression of selenoperoxidase
      activity. Selenium manipulation affected total glutathione content similarly, but
      had no effect on glutathione-S-transferase or superoxide dismutase activity. Long
      term growth under Se-deficient conditions resulted in a progressive additional
      increase in CAT activity, which maximized after ca. 5 months. These cells
      [referred to as L'.Se(-)] attained CAT activity levels at least 100-times greater
      than those of Se-supplemented [L'.Se(+)] controls, whereas their glutathione
      content remained elevated by approximately 70%. Supplying L'.Se(-) cells with Se
      resulted in a rapid elevation to full GPX activity; however, CAT failed to
      decline in this case, suggesting that a selection for stable CAT hyperexpressing
      variants had been accomplished. Quantitative immunoblot analysis indicated that
      the high CAT activity of L'.Se(-) cells is accounted for by an elevated level of
      enzyme protein. Induction of CAT and selection for CAT-rich phenotypes, as
      apparent for Se-starved L1210 cells, was not observed in human K562 counterparts,
      which lack GPX and express only a low level of PHGPX. L.Se(-) cells were found to
      be more sensitive to H2O2-induced killing than L.Se(+) controls, whereas L'.Se(-)
      cells were exceedingly more resistant to H2O2 than L'.Se(+) counterparts. By
      contrast, L.Se(-) and L'.Se(-) cells were both more sensitive to t-butyl
      hydroperoxide than Se(+) controls, consistent with CAT being unimportant in the
      detoxification of this peroxide compared with GPX. This appears to be the first
      reported evidence for CAT hyperexpression in response to selenium deprivation.

PMID- 8342950
TI  - Kinetics of the "on-off" change in regulatory state of the muscle thin filament.
AB  - The excimer fluorescence of pyrene iodoacetamide-labeled tropomyosin bound to
      actin is a probe of the regulatory state change of the muscle thin filament
      associated with the cooperative binding of myosin subfragment 1 (S1) (Y. Ishii
      and S. S. Lehrer, Biochemistry 29, 1160, 1990). In this study, the excimer
      fluorescence was used to monitor the kinetics of the "on-off" state change due to
      the ATP-induced dissociation of S1 from actin-tropomyosin. A lag in the
      fluorescence change indicated that the thin filament was maintained in the "on
      state" until more than half of the S1s dissociate. The on-off transition rate was
      slower than the dissociation of the remaining S1s. These delays in relaxation to
      the "off-state" may explain some observed kinetic and cooperative effects during
      tension measurements.

PMID- 8342952
TI  - Dissociation of relaxation and myosin light chain dephosphorylation in porcine
      uterine muscle.

PMID- 8342951
TI  - cDNA cloning and expression of a soluble epoxide hydrolase from human liver.
AB  - We report the cloning and expression of a cDNA that encodes a soluble epoxide
      hydrolase from human liver. The 2101-base clone predicts a 554-residue protein
      (M(r) 62,640) with an apparently imperfect peroxisomal targeting signal of Ser
      Lys-Met at the carboxy terminus. The cDNA was expressed in the baculovirus system
      in the Spodoptera frugiperda 21 cell line. The recombinant protein was similar to
      soluble epoxide hydrolase isolated from human liver in terms of molecular weight,
      hydrolytic activity, inhibition, and immunoreactivity.

PMID- 8342953
TI  - Plant dnaj homologue: molecular cloning, bacterial expression, and expression
      analysis in tissues of cucumber seedlings.
AB  - Proteins homologous to the bacterial dnaJ protein have been implicated as
      molecular chaperones in different compartments of eukaryotes. A plant equivalent
      is now described in various cucumber tissues. Using a cDNA library constructed
      from poly(A)-rich RNA of cotyledons of etiolated seedlings and dnaJ-specific
      probes, we isolated clones encoding full-length cDNAs: clone CSDNAJ-1 contained a
      1.7-kb insert with a single open reading frame of 413 amino acid residues
      encoding a protein of M(r) 46, 012; pCSDNAJ-2 differed from pCSDNAJ-1 by an
      additional nucleotide and predicted a protein of M(r) 26, 104. Peptides of
      similar sizes were observed when the cDNA information was expressed by in vitro
      transcription and translation or expressed in vivo in bacteria. Using mRNA
      isolated by hybrid selection for in vitro translation we observed the formation
      of CSDNAJ-1 protein. Comparisons revealed that the similarity in primary
      structure between CSDNAJ-1 protein and dnaJ homologues in eukaryotes is most
      pronounced in the N-terminal region. The high degree of identity (39%) of CSDNAJ
      1 protein with the yeast dnaJ homologue YDJ1 protein suggests that csdnaJ
      proteins assist intracellular protein transfer. The predicted CSDNAJ-1 protein is
      characterized by a fourfold repetition of the motif CXXCXGX(G) and by a C
      terminus -QCAQQ. Analysis of gene expression at the level of mRNA showed that the
      putative dnaJ protein is expressed in cucumber seedlings in all tissues, but
      exceedingly high in hypocotyledons and roots. The level of dnaJ mRNA was
      transiently increased by a factor of 1.5-2.0 when heat shock was applied to the
      seedlings.

PMID- 8342954
TI  - Hepatic effects of endothelin: metabolism of [125I]endothelin-1 by liver-derived
      cells.
AB  - Endothelin, a potent vasoactive peptide originally isolated from cultured porcine
      endothelial cells, (1) elicits hemodynamic and glycogenolytic actions in perfused
      rat liver; (2) evokes phosphoinositide signaling in hepatic cells; and (3)
      stimulates synthesis of mediators in Kupffer cells and glucose production in
      hepatocytes. Recently, we characterized receptor(s) for endothelin on hepatocytes
      (C. R. Gandhi, R. H. Behal, S. A. K. Harvey, T. Nouchi, and M. S. Olson, Biochem.
      J. 287, 897-904, 1992). Both hepatocytes and Kupffer cells rapidly internalize
      [125I]endothelin-1 ([125I]ET-1). In the present study we exposed primary cultures
      of hepatocytes or Kupffer cells to [125I]ET-1 and analyzed the radiolabeled
      metabolites which appeared in the cell medium. Six metabolites were separated by
      high-performance liquid chromatography (HPLC) from hepatocyte medium; these peaks
      had approximate elution times of 5 (free iodide), 22, 35, 37, 38, and 41 min,
      respectively, whereas the elution time for [125I]ET-1 was 43 min. The kinetics of
      formation of the metabolites, and experiments using excess unlabeled ET-1, both
      showed that internalization of the native peptide by hepatocytes is required for
      the metabolism of [125I]ET-1 into metabolite, and for the subsequent deiodination
      of metabolite. The formation of metabolites does not require internalization of
      the native peptide. In Kupffer cells, the cell medium contained only metabolite
      and metabolite. Internalization of the native peptide was required for the
      formation of metabolite but not for metabolite. Three classes of [125I]ET-1
      metabolites from hepatic cells also were separated by sequential precipitation
      with trichloroacetic acid (TCA) and with silver nitrate. This procedure
      facilitated multiple rapid assays of [125I]ET-1 metabolism. Phosphoramidon, an
      inhibitor of neutral metalloendopeptidases, did not affect significantly the
      binding or the metabolism of [125I]ET-1 by hepatocytes or Kupffer cells. The
      aminopeptidase inhibitor bacitracin strongly attenuated [125I]ET-1 metabolism by
      hepatocytes, with a concomitant increase in the intracellular content of [125I]ET
      1. These data suggest that enzymes capable of endothelin degradation are present
      both on the surface and in the intracellular compartment of hepatic cells, and
      that endothelin is not metabolized by neutral endopeptidase 24.11 in the liver.

PMID- 8342955
TI  - Isolation and properties of YCK2, a Saccharomyces cerevisiae homolog of casein
      kinase-1.
AB  - A soluble fragment of YCK2, a casein kinase-1 isoform from Saccharomyces
      cerevisiae, has been purified and characterized in vitro. The procedure enriches
      enzyme activity to a final specific activity of 4.7 mumol min-1 mg-1 (when
      assayed with casein as substrate). Structural analysis reveals that the
      preparation arises from N-terminal modification and C-terminal proteolysis of the
      initially synthesized 546-residue protein, consisting of residues 2-495 +/- 1.
      Kinetic analysis demonstrates that YCK2 is similar to casein kinase-1 isolated
      from other organisms in its inability to use GTP as nucleotide substrate, in its
      sensitivity to heparin and ribofuranosyl-benzimidazole inhibitors, and in its
      peptide substrate selectivity. The enzyme is unusual, however, in that it is
      insensitive to the potent mammalian casein kinase-1 inhibitor N-(2-aminoethyl)-5
      chloroisoquinoline-8-sulfonamide.

PMID- 8342956
TI  - Accumulation of intermediates and isotopically sensitive enolization distinguish
      between aromatase (cytochrome P450 CYP19) from rat ovary and human placenta.
AB  - Aromatase activity in microsomes from human placenta (HPM) and rat ovary (ROM)
      was compared by measuring the accumulation of 19-oxygenated intermediates, the
      effect of tritium substitution upon rates, and the distribution of tritium in
      products. A considerable accumulation of intermediates (19-hydroxyandrogen and 19
      al-androgen) and a lag in product formation (estrogen and water) was observed
      with ROM but not HPM. Addition of purified NADPH-cytochrome P450 reductase to ROM
      decreased the accumulation of 19-hydroxyandrostenedione and increased the rate of
      estrone formation. This difference could not be attributed to the microsomal
      reductase concentration since its concentration was similar in both tissues.
      Estrogen formation by aromatase from these tissues was not associated with a
      significant kinetic isotope effect when androstenedione was labeled with tritium
      at C-1 and C-2. Isotopically sensitive switching (branching) from the 19-al
      androstenedione enzyme complex to form free 19-al-androstenedione rather than
      estrogen was not observed. These data suggest that for aromatase in both tissues,
      an enzymatic step exists between the 19-al-androstenedione intermediate and
      hydrogen abstraction or enolization that has a large commitment to catalysis. The
      distribution of tritium into the products, water and estrogen, was dependent upon
      substrate, enzyme source, and position of the label. Incubation of 1 beta, 2 beta
      [3H]androstenedione and testosterone with ROM and 1 beta,2 beta-[3H]testosterone
      with HPM resulted in approximately 50% of the label being retained in the
      estrogen and 50% being lost in water. The majority of the label was lost in water
      upon incubation of 1 beta-labeled substrates with microsomes from both sources.
      Unexpectedly, no label was lost to water upon incubation of the specifically 1
      alpha,2 alpha-labeled substrates with either enzyme source. Only incubation of 1
      beta,2 beta-[3H]androstenedione with HPM resulted in loss of tritium from the 2
      position. These data were interpreted to indicate that, for androstenedione
      metabolism by ROM and testosterone metabolism by both ROM and HPM, enolization
      occurs nonspecifically in an isotopically sensitive manner following
      deformylation, but for HPM metabolism of androstenedione enolization occurs in an
      enzyme-assisted manner. The studies show that aromatase located in ROM differs
      from that in HPM by its accumulation of intermediates and inability to
      selectively remove the 2 beta-tritium from androstenedione.

PMID- 8342957
TI  - Differential solubilization of membrane lipids by detergents: coenrichment of the
      sheep brain serotonin 5-HT1A receptor with phospholipids containing predominantly
      saturated fatty acids.
AB  - Most membrane receptors lose binding activity during purification and we studied
      the correlation between this event and differential solubilization of membrane
      lipids by detergents. Both 3-[(3-cholamidopropyl)dimethylammonio]-1
      propanesulfonate [Chaps; high critical micellar concentration (cmc) approximately
      0.5%] and n-dodecyl beta-D-maltoside (DDM; low cmc approximately 0.009%)
      solubilized the 8-[3H]hydroxy-2-(di-n-propylamino)tetralin ([3H]8-OH-DPAT)
      binding serotonin 5-HT1A receptor (5-HT1A-R) optimally at 2% (w/v) detergent
      concentration despite the widely differing cmc of the two detergents. In
      contrast, n-octyl-beta-D-glucopyranoside (octyl glucoside; high cmc approximately
      0.7%), Thesit (low cmc approximately 0.005%), and Triton X-100 (low cmc
      approximately 0.013%) solubilized virtually no [3H]8-OH-DPAT-binding activity.
      The total mass of solubilized lipids was always low at 0.5% detergent
      concentration and attained a plateau between 1 and 2.5% for all detergents except
      octyl glucoside. The mass of octyl glucoside-solubilized lipids showed an
      increasing trend even at 3.0% detergent concentration. The total amount of
      solubilized lipid is unrelated to the amount of 5-HT1A-R solubilized but the
      species of lipid is important. Thus Chaps and DDM, with diverse structures and
      cmc, both preferentially solubilized phospholipids enriched in saturated fatty
      acids (67 and 72%, respectively). In contrast, octyl glucoside, Triton X-100, and
      Thesit showed no preference in solubilizing phospholipids. Octyl glucoside, which
      solubilized significantly higher proportions of saturated fatty-acid-containing
      phosphatidylethanolamine (slightly higher saturated fatty acids in total
      phospholipids), also produced more (twofold higher) solubilized 5-HT1A sites than
      Triton X-100 and Thesit. This suggests an optimum involvement of saturated fatty
      acid side chains in forming tightly packed vesicles which stabilize the 5-HT1A-R
      more than the vesicles of higher fluidity formed by phospholipids containing
      higher proportions of cis-double-bonded unsaturated fatty acids. Indeed,
      delipidation of the 1.5% Chaps-solubilized receptor preparations by Sephacryl S
      200 column chromatography eliminated essentially all [3H]8-OH-DPAT-binding
      activity. Therefore, for efficient recovery during solubilization and
      reconstitution of a prototypic heptahelical receptor (5-HT1A), it is essential to
      stabilize the receptor protein through association with saturated phospholipids.

PMID- 8342958
TI  - Protein-lipid interactions of the proteolipid c subunit of the Escherichia coli
      proton-translocating adenosinetriphosphatase.
AB  - Interactions between Escherichia coli membrane phospholipids and the hydrophobic
      c subunit of the F1F0 proton-translocating ATPase were characterized. Extraction
      of E. coli membranes with a neutral mixture of chloroform and methanol and
      subsequent separation steps produced several protein-containing fractions. The
      protein-containing fraction most soluble in organic solvents contained subunit c
      and a lipid fraction enriched in phosphatidylglycerol compared to total E. coli
      membrane phospholipids. Other ATPase subunits and some additional proteins
      extracted from the membranes by this procedure could be separated from the c
      subunit by subsequent extraction. The purified and delipidated c subunit
      contained fatty acids which were released upon treatment with boron trifluoride
      methanol. Furthermore, deleting and restoring the genes for the F0 subunits
      changed the composition of extractable membrane phospholipid and fatty acids,
      indicating that the F0 plays a significant structural role in the membrane.

PMID- 8342959
TI  - Oxidation of pyruvate, malate, citrate, and cytosolic reducing equivalents by AS
      30D hepatoma mitochondria.
AB  - Mitochondria isolated from normal rat liver and AS-30D hepatoma were concurrently
      evaluated with regard to their bioenergetic and metabolic properties. AS-30D
      mitochondria oxidized many NAD-linked respiratory substrates at rates 1.5-4 times
      faster than those from liver, a fact which contributes to their diminished
      membrane depolarization on conversion from state 4 to state 3 respiration. AS-30D
      mitochondria exhibited no signs of a "truncated" Krebs cycle, nor did they
      oxidize malate preferentially based upon its origin in the cytosol or the
      mitochondrial matrix. In addition, beta-oxidation in AS-30D mitochondria was not
      sufficient to suppress respiratory CO2 production and induce pyruvate
      carboxylation to the extent observed in liver. Finally, AS-30D mitochondria were
      able to oxidize externally generated NADH in a reconstituted system, but in a
      manner independent of the transmembrane electrical potential (delta psi),
      suggesting that the malate-aspartate shuttle is not operable in vivo. This fact
      may necessitate the adaptations tumor cells make to reoxidize cytosolic NADH
      through glycolysis even in the presence of adequate oxygen.

PMID- 8342960
TI  - Skin-homing T lymphocytes: detection of cutaneous lymphocyte-associated antigen
      (CLA) by HECA-452 in normal human skin.
AB  - The immigration of circulating T cells into specific tissues is directed by the
      interaction between adhesion molecules on lymphocyte subpopulations and their
      ligands on vascular endothelium. Of these, endothelial leucocyte adhesion
      molecule (ELAM-1), weakly expressed in normal human skin (NHS), seems to be the
      counter-structure for cutaneous lymphocyte-associated antigen (CLA). CLA is a 200
      kDa cell-surface glycoprotein of which the sugar moieties sialyl Le(a) and sialyl
      Le(x) are the possible epitopes recognized by the monoclonal antibody HECA-452.
      HECA-452 was originally described as a marker for lymphoid organ high endothelial
      cells, but 16% of peripheral-blood-derived T cells react with this antibody. We
      studied the expression of CLA on the cellular constituents of the skin immune
      system (SIS). By applying immunohistochemical double staining, 41% of CD3+ T
      cells, 44% of CD4+ T cells and 31% of CD8+ T cells were found to express CLA.
      Keratinocytes, CD1a+ Langerhans cells (LC) and endothelial cells did not express
      HECA-452 in significant numbers in NHS. Monocytes were found to express HECA-452
      in 14% of CD68+ cells. CLA expression was present on a relatively low percentage
      of T cells and subsets localized distant from NHS vessels, suggesting loss of the
      molecule during further migration after transendothelial passage. However,
      intraepidermal T cells expressed CLA in similar percentages to T cells localized
      directly perivascularly. Our findings support the notion that CLA expression by T
      cells is associated with their homing into cutaneous structures.

PMID- 8342961
TI  - Mast cell tryptase and chymase in developing and mature psoriatic lesions.
AB  - The number and distribution of mast cells in non-lesional and lesional skin
      samples from 13 psoriatic patients were analyzed enzyme- and
      immunohistochemically. Mast cell tryptase was stained with the sensitive
      substrate Z-Gly-Pro-Arg-4-methoxy-2-naphthylamide, and chymase with Suc-Val-Pro
      Phe-MNA and monoclonal B7 anti-chymase antibody. In addition, healthy-looking
      skin from 27 psoriatic patients was tape-stripped resulting in induction of the
      Kobner response in 9 patients. Sequential biopsies were taken before and after
      (7, 14 and 21 days) tape-stripping, and both tryptase and chymase were stained
      enzyme-histochemically. In non-lesional psoriatic skin, 70 +/- 24% (mean +/- SD)
      of the mast cells contained chymase enzyme activity, and 78 +/- 18% chymase
      immunoreactivity. About 10% of the chymase-immunoreactive cells lacked chymase
      activity. In lesional psoriatic skin, tryptase-positive cells were increased in
      number throughout the dermis but especially beneath the epidermis. Chymase
      immunoreactivity paralleled the tryptase activity, whereas chymase activity was
      strongly diminished both in terms of mast cell numbers and in staining intensity
      in the papillary dermis. The apparent inactivation of chymase may be due to the
      action of the chymase inhibitors, alpha 1-antitrypsin and alpha 1
      antichymotrypsin, localized immunohistochemically in mast cells of lesional and
      non-lesional psoriatic skin. In the developing psoriatic lesion, mast cells
      displaying chymase activity were already 27-38% decreased in number in the upper
      dermis on day 7 after tape-stripping, along with the first clinical signs of
      psoriasis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8342962
TI  - The herpes-specific immune response of individuals with herpes-associated
      erythema multiforme compared with that of individuals with recurrent herpes
      labialis.
AB  - Infection with herpes simplex virus (HSV) is the most common precipitating factor
      in the development of erythema multiforme (EM). It is not known why only a few of
      the many individuals who experience recurrent HSV infection also develop herpes
      associated EM (HAEM), although a difference in the HSV-specific immune response
      has been postulated. The purpose of this study was to compare the HSV-specific
      immune response of individuals with HSV infection alone with that of individuals
      with HAEM. There were 21 patients in each of the two groups. Four parameters of
      the HSV-specific immune response were examined: (1) anti-HSV IgG titers were
      measured by ELISA; (2) antibody neutralization was assessed using a plaque assay;
      and (3) antibody-dependent complement-mediated cytotoxicity, and (4) antibody
      dependent cellular cytotoxicity were investigated using a previously described in
      vitro HSV-specific cytotoxicity assay. No statistically significant differences
      were detected between the two patient groups. Thus, a difference in these HSV
      specific immune mechanisms does not explain the development of HAEM in some
      individuals with recurrent HSV infection.

PMID- 8342963
TI  - Epidermis reconstructed from the outer root sheath of human hair follicle. Effect
      of retinoic acid.
AB  - In the present paper, we show that a multilayered and well-differentiated
      epidermis can easily and rapidly be generated in vitro from the outer root sheath
      of human hair follicles deposited on de-epidermized demis. Histologically, this
      epidermis presented characteristic features of normal human epidermis in vivo.
      Moreover, markers specific for interfollicular keratinocyte terminal
      differentiation, such as the K10 keratin, involucrin, membrane-bound
      transglutaminase, filaggrin and loricrin, were expressed in the reconstructed
      tissue. By in situ hybridization, keratin K5 and K10 mRNAs were detected in the
      basal and suprabasal cells, respectively, as in normal human epidermis. The
      differentiation pattern achieved in this reconstructed epidermis confirms the
      already reported phenotypical shift from outer root sheath cells to
      interfollicular keratinocytes and shows that this transition takes place in the
      absence of living fibroblasts. The differentiation of the reconstructed epidermis
      thus obtained was modulated by retinoic acid in a dose-dependent manner. This
      culture system on dead dermis is easier to handle than similar cultures on
      collagen-fibroblast lattices because of the resistance of dermis to mechanical
      forces and to collagenolysis. It could represent a valuable wound-healing model
      and a promising tool for pharmacological studies on in vitro reconstructed skin.

PMID- 8342964
TI  - Soluble factors from human hair papilla cells and dermal fibroblasts dramatically
      increase the clonal growth of outer root sheath cells.
AB  - Depending on environmental influences, follicular outer root sheath (ORS) cells
      in vivo can differentiate either towards interfollicular keratinocytes or, as
      demonstrated in the rat vibrissa, hair matrix cells. Crucial regulators of both
      their proliferation and differentiation are the mesenchymal cells of the
      respective tissues. The interactions of human ORS cells with human hair papilla
      cells (HPC) or human dermal fibroblasts (HDF) were studied using a two-chamber
      model separating the two cell types either by a microporous membrane or
      additionally by a medium layer. The results of 3H-thymidine incorporation studies
      indicated that ORS cell growth was markedly enhanced in co-culture with either
      HPC or HDF, the highest stimulatory effect resulting when ORS cells were in close
      association with the mesenchymal cells. No correlation was found between ORS cell
      proliferation and IL-6 production in the co-culture system, thus pointing to the
      secretion by HPC and HDF of growth-promoting soluble factors that are different
      form IL-6 as well as from EGF, bFGF and insulin present in the culture medium.

PMID- 8342965
TI  - Modified epidermal lipid composition in air-exposed culture of non-bullous
      congenital ichthyotic erythroderma (NBCIE) keratinocytes.
AB  - Emerged epidermal cultures on dead de-epidermized dermis (DED) constitute an
      excellent model for in vitro reproduction of dermatoses linked to a keratinocyte
      defect. We used such cultures for studies of non-bullous congenital ichthyotic
      erythroderma (NBCIE). Keratinocytes of normal and pathological origin were
      expanded in submerged cell cultures and frozen keratinocytes from the resulting
      cell bank were subsequently used for seeding on DED. Lipid extracts from 14 day
      emerged cell cultures were assayed qualitatively and quantitatively using thin
      layer chromatography and compared with the neutral and non-polar lipid profiles
      obtained from normal epidermis extracts and with those from the plantar stratum
      corneum of healthy donors and untreated NBCIE patients. The ichthyotic cultures
      were found to contain significantly elevated levels of n-alkanes, as were the
      lipid extracts from the patients' plantar horny layer. Our results demonstrate
      that a major marker of the NBCIE epidermis can be reproduced under the emerged
      culture conditions. They also indicate that the characteristic n-alkane increase
      in NBCIE is indeed endogenous and not merely related to possible contamination
      from topical treatments.

PMID- 8342966
TI  - Antibody titers to an oxidized thymidine moiety are altered by systemic
      pharmacotherapy and by ultraviolet B phototherapy.

PMID- 8342967
TI  - EGF induces ornithine decarboxylase transcription in Balb/MK keratinocytes: a
      proposed mechanism for the TGF alpha autocrine loop.

PMID- 8342968
TI  - Quantitative evaluation of urea in stratum corneum of human skin.

PMID- 8342969
TI  - [The physician and the interview].

PMID- 8342970
TI  - [Transcatheter arterial embolization in the hemorrhagic complications of kidney
      trauma].
AB  - Transcatheter arterial embolization is a nonsurgical alternative for the
      complications arising from biopsy, surgery and blunt or penetrating renal trauma.
      Fourteen transcatheter embolization procedures were performed in 13 patients for
      hemorrhage following biopsy of the native kidney (3 cases) biopsy of the
      transplanted kidney graft (3 cases), stone surgery (3 cases), blunt abdominal
      trauma (2 cases), a stab wound (1 case) and an A-V fistula (1 case). The bleeding
      was effectively controlled in all cases. Nephrectomy was required in 3 cases
      (21.4%) whose kidneys were not viable and cannot be ascribed to a complication of
      the embolization procedure. The diagnostic aspects of hemorrhage arising from
      renal trauma, the embolization technique and its indications are discussed. In
      our view, transcatheter arterial embolization is the technique of choice for the
      hemorrhagic complications of blunt or penetrating renal trauma or those caused by
      biopsy or surgery.

PMID- 8342971
TI  - [Renal angiomyolipoma. Our case histories].
AB  - We reviewed the cases of angiomyolipoma that had been diagnosed and treated in
      our urology services from 1978 to 1991. The study showed a higher incidence in
      the females; it frequently presented as a solitary tumor; a high specificity was
      found for the US (hyperechoic mass) and CT (areas of low attenuation ratio)
      findings. Owing to these diagnostic techniques, conventional surgery is no longer
      the only treatment. Embolization is considered to be the first therapeutic
      approach.

PMID- 8342972
TI  - [A prospective and randomized study of the complete response, index of
      recurrences and progression in superficial bladder carcinoma treated with
      mitomycin C alone versus mitomycin C and BCG alternatively].
AB  - The results of a comparative randomized study on intravesical chemoprophylaxis
      are presented. The study comprised 66 patients; one group of 29 patients received
      mitomycin C alone, while another group of 37 patients received mitomycin C and
      alternating BCG therapy. This latter treatment modality was found to achieve a
      slightly higher complete response rate and a much lower tumor progression rate.
      Although these results were not statistically significant (p > 0.05), they
      indicate that if the study were comprised of a larger series, the combined
      modality may be shown to achieve better results than the other modalities
      currently used.

PMID- 8342973
TI  - [The usefulness of computerized axial tomography (CT) in establishing the
      composition of calculi].
AB  - Determining stone composition before extracorporeal lithotripsy can be
      potentially useful. A total of 90 calculi of 6 different chemical composition
      (calcium oxalate monohydrate, calcium oxalate dihydrate, magnesium ammonium
      phosphate, phosphate carbonate, uric acid and phosphate oxalate) were analyzed in
      vitro using computed tomography (CT). The mean, central, peripheral, maximum,
      minimum stone density and stone morphology were determined. At least in vitro,
      the serial analyses of the mean, minimum, central stone density and stone
      morphology permitted distinguishing these 6 types of calculi, although 53% of the
      calcium oxalate dihydrate calculi could not be distinguished from the phosphate
      oxalate stones.

PMID- 8342974
TI  - [The usefulness of dual-energy radiographic densitometry (DO) in establishing the
      composition of calculi].
AB  - Dual-energy radiographic bone densitometry is utilized to determine the bone
      mineral content in patients with osteoporosis. The present in vitro experimental
      study investigated the usefulness of densitometry in determining stone
      composition and in evaluating the mineral and non mineral phases of the calculus.
      For the study we analyzed 114 calculi of 6 different chemical composition
      (calcium oxalate monohydrate, calcium oxalate dihydrate, magnesium ammonium
      phosphate, phosphate carbonate, uric acid and phosphate oxalate). The phosphate
      carbonate calculi had the highest mineral density, whereas the uric acid calculi
      had the lowest and contained more water. Although densitometry appears to be of
      little value in determining stone composition, it provides information on the
      mineral and non mineral phases of the calculus.

PMID- 8342975
TI  - [The therapeutic approach in vascular damage from pyelocaliceal endoscopic
      urology].
AB  - Six cases of vascular lesion associated with percutaneous removal of renal
      calculi are described. The lesions had been caused during percutaneous access or
      ultrasound fragmentation of the stone. Those that had resolved spontaneously have
      not been included. When vascular injury is suspected during the procedure, the
      appropriate measures must be taken to resolve the different complications, such
      as arteriovenous, arteriocaliceal or venocaliceal fistula. Since there is little
      reference to this subject in the Spanish literature, the experience described
      herein may be of interest to the urologist who has only recently begun to perform
      this technique.

PMID- 8342976
TI  - [Ureteroscopy. Our results and complications].
AB  - From November, 1987 to December, 1990, 399 cases of ureteral calculi were treated
      by rigid ureteroscopy (URS). Our success and complication rates are presented. Of
      these, 99 (25%) had a calculus in the pelvis (78/99), iliac (15/99) or lumbar
      (6/99) ureter, and 300 (75%) had Sandstrasse in the distal ureter. The cases with
      Sandstrasse were submitted to ureteroscopy within the first 48-72 hours to remove
      the ureteral obstruction, prevent hydronephrosis or sepsis and to expedite
      treatment. If symptomatic, obstructive and/or 7 mm or more in diameter, a
      nephrostomy tube was placed first whenever there was sepsis [23/300 (7%) of those
      with Sandstrasse and 3/99 (3%) of those with a ureteral calculus] or marked
      dilatation of the renal cavities [29/300 (9%) and 6/99 (6%), respectively]. The
      success rate was 93% for the cases with Sandstrasse versus 85% for those with a
      ureteral calculus, and the complication rates were 5.7% versus 9%, respectively.
      The foregoing results confirm the high success rate and scant morbidity of
      ureteroscopy in the treatment of ureteral calculus and Sandstrasse.

PMID- 8342977
TI  - [The percutaneous management of stenosis in uretero-intestinal diversions].
AB  - Five patients with a stenotic uretero-intestinal diversion were submitted to
      percutaneous balloon dilatation. The stricture was successfully dilated without
      complications in all cases. One case, however, required another dilatation
      procedure due to restenosis 30 days later. The low cost, short hospital stay,
      absence of important complications and low recurrence rate make percutaneous
      balloon dilatation the procedure of choice in these patients.

PMID- 8342978
TI  - [Primary choriocarcinoma of the bladder. A case report with immunohistochemical
      and ultrastructural study].
AB  - Some tumors frequently encountered in other organs and usually with a high grade
      of malignancy and a poor prognosis have been recently described in the urinary
      bladder, very often in close relationship with a pre-existing transitional cell
      carcinoma. Of these, primary choriocarcinoma of the urinary bladder is one of the
      most uncommon and its histogenesis much discussed. It is important to identify
      this tumor type, since a change in the oncologic treatment may be warranted. We
      report an additional case of this rare bladder tumor with clinicopathologic study
      and discuss the histogenetic and therapeutic aspects.

PMID- 8342979
TI  - [The infected solitary renal cyst. A case review and review of the literature].
AB  - A case of solitary infected renal cyst is presented. The clinical features,
      diagnosis and treatment of this disease entity are discussed and the literature
      reviewed. Less than thirty cases have been reported until the last decade.

PMID- 8342980
TI  - [Renal-cell adenocarcinoma and massive retroperitoneal hemorrhage during
      pregnancy].
AB  - We report a case of renal cell carcinoma that had manifested as massive
      retroperitoneal hemorrhage in the second trimester of pregnancy. The diagnosis
      was made on the basis of the clinical and ultrasound findings. The patient was
      submitted to unilateral nephrectomy at 27 wk of gestation and she delivered by
      cesarean section at 35 wk gestation. Both mother and infant are well 1 year
      postoperatively.

PMID- 8342981
TI  - [Hematuria due to polypoid cystitis. Its differential diagnosis from bladder
      carcinoma].
AB  - Polypoid cystitis is not uncommon in patients with a permanent urethral catheter.
      In some cases difficulties are encountered when making the differential or
      anatomopathological diagnosis from transitional cell carcinoma of the bladder. We
      report a case of polypoid cystitis mimicking bladder carcinoma in a patient with
      a permanent urethral catheter.

PMID- 8342982
TI  - [The cutaneous metastasis of prostatic adenocarcinoma. Apropos a case].
AB  - An additional case of prostatic adenocarcinoma metastasizing to the skin is
      described. The metastatic lesions appeared late and despite surgical and hormonal
      castration. To our knowledge only 5 cases have been reported in the Spanish
      literature. Cutaneous metastasis originating from adenocarcinoma of the prostate
      is a sign of poor prognosis and patients die within 6 months after the appearance
      of the metastatic lesions. The site and route of tumor dissemination in the
      present case coincide with those reported in the literature.

PMID- 8342983
TI  - [A xanthogranulomatous psoas abscess 4 years after nephrectomy for
      xanthogranulomatous pyelonephritis].
AB  - We report a case of xanthogranulomatous abscess of the left psoas muscle in a
      patient who underwent nephrectomy for xanthogranulomatous pyelonephritis four
      years earlier. Pathogens unlike those usually found in this type of inflammatory
      reaction were grown on culture. The possible relationship between the two
      infectious disease processes is analyzed.

PMID- 8342984
TI  - [A chronic intrascrotal inflammation secondary to free foreign bodies in the
      tunica vaginalis].
AB  - We report a case of granulomatous reaction to intrascrotal foreign body
      (vegetable fibers) that presented as an inguinal mass in a patient who had been
      treated for perforation of the jejunum loop incarcerated in inguinal hernia. To
      our knowledge a similar case has not been reported in the literature.

PMID- 8342985
TI  - [Adenocarcinoma in addition to bladder exstrophy. Apropos a case and a review of
      the literature].
AB  - Herein we describe a case of adenocarcinoma complicating exstrophy of the bladder
      in a 59-year-old patient. The morphologic, histochemical and immunohistochemical
      analyses revealed a colonic glandular adenocarcinoma. The two hypotheses relative
      to its pathogenesis are briefly discussed. To date, 106 cases have been reported
      in the literature.

PMID- 8342986
TI  - [The recent appearance of the journal Current Opinion in Urology].

PMID- 8342987
TI  - The electromechanical impactor: a new device for intracorporeal stone
      fragmentation.
AB  - The Electromechanical Impactor was conceived as a safe and effective device for
      intracorporeal stone fragmentation. It is a 3 French EHL electrode enclosed
      within a stainless steel sheath. The interior is irrigated with saline. Discharge
      of the system causes an EHL spark which vaporizes saline and produces a
      cavitation bubble and subsequent shock wave. The shock wave propels a conical
      titanium tip forward for a distance of 2.7 mm with an impact pressure of 900 bar.
      Bench and animal testing has proven its effectiveness for stone fragmentation and
      safety for use within the ureter. The mean lifetime of each probe is
      approximately 700 pulses. It is used under direct vision through the straight
      operating port of a rigid or semi-rigid 9.5 French ureteroscope. Clinical studies
      at the Massachusetts General Hospital (reported herein) and the Mayo Clinic
      demonstrate approximately 90% efficacy. It is especially effective on cystine,
      calcium oxalate dihydrate, struvite and mixed calcium oxalate monohydrate
      calculi. Shiny-smooth black calcium oxalate monohydrate calculi will fragment but
      are more resistant. There has been no evidence of ureteral wall injury. The EMI
      is currently 5 French and is used both safely and effectively under direct vision
      of fragment ureteral calculi. Larger sizes are designed for percutaneous use and
      for bladder stone fragmentation.

PMID- 8342988
TI  - Primary benign vesical teratoma. A case report.
AB  - Primary benign vesical teratomas are rare. Most of the cases reported are
      paravesical teratomas rupturing into the bladder. A case of primary benign
      vesical teratoma suspected preoperatively and later confirmed at histopathology
      is reported.

PMID- 8342989
TI  - The elusive pathophysiology of the multiple organ failure syndrome.

PMID- 8342990
TI  - The gastrointestinal tract. The "undrained abscess" of multiple organ failure.
AB  - OBJECTIVE: This study determined the association between proximal
      gastrointestinal (GI) colonization and the development of intensive care unit
      (ICU)-acquired infection and multiple organ failure (MOF) in a population of
      critically ill surgical patients. SUMMARY BACKGROUND DATA: ICU-acquired infection
      in association with progressive organ system dysfunction is an important cause of
      morbidity and mortality in critical surgical illness. Oropharyngeal and gastric
      colonization with the characteristic infecting species is common, but its
      association with ICU morbidity is poorly defined. METHODS: A prospective cohort
      study of 41 surgical ICU patients was undertaken. Specimens of gastric and upper
      small bowel fluid were obtained for quantitative culture; the severity of organ
      dysfunction was quantitated by a numeric score. RESULTS: One or more episodes of
      ICU-acquired infection developed in 33 patients and involved at least one
      organism concomitantly cultured from the upper GI tract in all but 3. The most
      common organisms causing ICU-acquired infection--Candida, Streptococcus faecalis,
      Pseudomonas, and coagulase-negative Staphylococci--were also the most common
      species colonizing the proximal GI tract. Gut colonization correlated with the
      development of invasive infection within 1 week of culture for Pseudomonas (90%
      vs. 13% in noncolonized patients, p < 0.0001) or Staphylococcus epidermidis (80%
      vs. 6%, p < 0.0001); a weaker association was seen for colonization with Candida.
      Infections associated with GI colonization included pneumonia (16 patients),
      wound infection (12 patients), urinary tract infection (11 patients), recurrent
      (tertiary) peritonitis (11 patients), and bacteremia (10 patients). ICU mortality
      was greater for patients colonized with Pseudomonas (70% vs. 26%, p = 0.03);
      organ dysfunction was most marked in patients colonized with one or more of the
      following: Candida, Pseudomonas, or S. epidermidis. CONCLUSIONS: The upper GI
      tract is an important reservoir of the organisms causing ICU-acquired infection.
      Pathologic GI colonization is associated with the development of MOF in the
      critically ill surgical patient.

PMID- 8342991
TI  - Hepatocyte injury by activated neutrophils in vitro is mediated by proteases.
AB  - OBJECTIVE: This study determined the mechanism used by neutrophils (PMNs) to
      induce hepatocellular injury. SUMMARY BACKGROUND DATA: Neutrophils have been
      shown to be potent mediators of cell and tissue injury and have been hypothesized
      to contribute to the hepatic injury that occurs after trauma and infection.
      Oxygen radical scavengers protect the liver in vivo from inflammatory injury and
      it has been suggested that PMNs are the source of these toxic oxygen radicals.
      The specific mechanism used by PMNs to produce hepatocellular damage, however,
      has not been determined. METHODS: Neutrophils were cultured in vitro with
      hepatocytes (HCs) and stimulated with phorbol 12-myristate 13-acetate (PMA) to
      induce HC injury in the presence of oxygen radical scavengers and protease
      inhibitors. RESULTS: PMA induced a PMN-mediated HC injury that was dependent on
      the number of PMNs present and the concentration of PMA. Protease inhibitors
      reduced the extent of HC injury, while oxygen radical scavengers had no effect.
      Hydrogen peroxide, directly applied, was able to injure HCs, but only at
      concentrations greater than those that could be produced by PMA-stimulated PMNs.
      CONCLUSIONS: PMNs are cytotoxic to cultured HCs, predominantly due to the release
      of proteolytic enzymes, while HCs appear relatively resistant to oxidative
      injury. Involvement of neutrophil toxic oxygen radicals in hepatic damage in vivo
      may require impairment of HC antioxidant defenses or may involve injury to
      nonparenchymal liver cells with secondary effects on HCs.

PMID- 8342992
TI  - Open cholecystectomy. A contemporary analysis of 42,474 patients.
AB  - OBJECTIVE: This study evaluated, in a large, heterogeneous population, the
      outcome of open cholecystectomy as it is currently practiced. SUMMARY BACKGROUND
      AND DATA: Although cholecystectomy has been the gold standard of treatment for
      cholelithiasis for more than 100 years, it has recently been challenged by the
      introduction of several new modalities including laparoscopic cholecystectomy.
      Efforts to define the role of these alternative treatments have been hampered by
      the lack of contemporary data regarding open cholecystectomy. METHODS: A
      population-based study was performed examining all open cholecystectomies
      performed by surgeons in an eastern and western state during a recent 12-month
      period. Data compiled consisted of a computerized analysis of Uniformed Billing
      (UB-82) discharge analysis information from all non-Veterans Administration (VA),
      acute care hospitals in California (Office of Statewide Planning and Development
      [OSHPD]) and in Maryland (Health Services Cost Review Commission [HSCRC]) between
      January 1, 1989, and December 31, 1989. This data base was supplemented with a 5%
      random sample of Medicare UB-82 data from patients who were discharged between
      October 1, 1988, and September 30, 1989. Patients undergoing cholecystectomy were
      identified based on diagnosis-related groups (DRG-197 and DRG-198), and then
      classified by Principal Diagnosis and divided into three clinically homogeneous
      subgroups: acute cholecystitis, chronic cholecystitis, and complicated
      cholecystitis. RESULTS: A total of 42,474 patients were analyzed, which
      represents approximately 8% of all patients undergoing cholecystectomy in the
      United States in any recent 12-month period. The overall mortality rate was 0.17%
      and the incidence rate of bile duct injuries was approximately 0.2%. The
      mortality rate was 0.03% in patients younger than 65 years of age and 0.5% in
      those older than 65 years of age. Mortality rate, length of hospital stay, and
      charges were all significantly correlated (p < 0.001) with age, admission status
      (elective, urgent, or emergent), and disease status. CONCLUSIONS: These data
      indicate that open cholecystectomy currently is a very safe, effective treatment
      for cholelithiasis and is being performed with near zero mortality. The ultimate
      role of laparoscopic cholecystectomy needs to be defined in the context of
      current and contemporary data regarding open cholecystectomy.

PMID- 8342993
TI  - A prospective study of intraoperative methods to diagnose and resect duodenal
      gastrinomas.
AB  - OBJECTIVE: This study determined, prospectively, whether duodenotomy (DX) should
      be routinely performed in explorations for patients with Zollinger-Ellison
      syndrome (ZES). SUMMARY BACKGROUND DATA: Duodenal gastrinomas are now being found
      with increasing frequency in patients with Zollinger-Ellison syndrome. The
      surgical approach used to detect these tumors is controversial. Some recommend
      intraoperative endoscopy with transillumination (IOE) at surgery, while others
      recommend routine DX. METHODS: Beginning in 1989, the authors prospectively
      compared the ability of palpation, intraoperative ultrasound (IOUS), IOE, and DX
      (in that sequence) to detect gastrinomas in 35 consecutive patients with ZES.
      Each patient also underwent preoperative localization studies. RESULTS: Thirty
      three of 35 patients (94%) had tumor detected and excised; duodenal gastrinomas
      were excised in 27 patients (77%). The average size of the duodenal tumors was
      0.8 cm, significantly smaller (p < 0.005) than the pancreatic and lymph node
      tumors in this series. Standard palpation after a Kocher maneuver identified 19
      of the 31 duodenal tumors (61%) in the 27 patients. IOUS revealed only eight
      duodenal tumors (26%) and no new lesions. IOE identified 20 duodenal gastrinomas
      (64%) and 6 new lesions. DX identified 31 duodenal tumors (100%) and 5 additional
      tumors. The morbidity rate was 17%. One patient had a duodenal fistula after
      operation (2.8%) and subsequently recovered. No patient died. CONCLUSIONS: These
      results demonstrate that the duodenum is the most common location for gastrinoma
      in patients with ZES (77%) and that DX to detect and remove duodenal gastrinomas
      should be routinely performed in all explorations for patients with ZES.

PMID- 8342994
TI  - Increased bile duct complications in liver transplantation across the ABO
      barrier.
AB  - OBJECTIVE: This study evaluated the outcome of liver grafts from ABO incompatible
      donors, focusing on biliary complications, and compared the results to an ABO
      compatible control group. Also, the expression of donor ABH antigens in the liver
      graft was analyzed. SUMMARY BACKGROUND DATA: The outcome of liver transplantation
      using an ABO incompatible graft is still debated. These blood group related (ABH)
      antigens are known to be expressed not only on the surface of the erythrocytes,
      but also on the epithelial cells of large bile ducts. Because the biliary
      epithelium of hepatic allografts may continue to express donor ABH antigens, it
      may be more susceptible to immunologic bile duct injury after transplantation
      across the ABO barrier. METHODS: Eighteen ABO incompatible grafts were compared
      with 18 ABO compatible grafts in patients who were matched according to medical
      urgency, primary liver disease (PLD), and recipient age. After transplantation,
      the grafts were analyzed with cholangiography, Doppler ultrasound, or
      arteriography and liver histology according to protocol. Immunoperoxidase
      staining for ABH antigens was performed on hepatic tissue. RESULTS: Biliary
      complications developed in 82% of the ABO incompatible donors, compared to 6% of
      the ABO matched controls. Hepatic artery thrombosis occurred in 24%. Cellular
      rejection was diagnosed in 65% versus only 28% in the control group. The 1-year
      actuarial graft survival rate was 44% versus 78% in the control group. ABH
      antigens of the donor were expressed on vascular endothelium and bile duct
      epithelial cells as long as 150 days after transplant. CONCLUSIONS: Using ABO
      incompatible allografts, a high incidence of biliary and hepatic artery
      complications and decreased graft survival in liver transplantation were found.
      An immunologic injury to the bile duct epithelium and/or to vascular endothelium
      is suspected.

PMID- 8342996
TI  - Endoscopic management of biliary fistulas complicating liver transplantation and
      other hepatobiliary operations.
AB  - OBJECTIVE: This study was undertaken to prospectively evaluate the efficacy and
      safety of endoscopic management of biliary fistulas complicating liver
      transplantation and other hepatobiliary operations. SUMMARY BACKGROUND DATA:
      Surgical therapy has been the traditional approach to large or unresolving
      biliary fistulas complicating liver transplantation. Although endoscopic
      management is rapidly becoming an acceptable alternative to surgery for the
      treatment of biliary fistulas complicating non-liver transplant hepatobiliary
      operations, it has received limited attention in the liver transplant setting.
      METHODS: During a 15-month period, 146 adults underwent liver transplantation
      with biliary reconstruction by end-to-end choledochocholedochostomy over a T
      tube. Inadvertent T-tube migration or intentional T-tube removal resulted in bile
      peritonitis in 18 patients. The patients were treated with a nasobiliary tube (n
      = 13), internal stent plus endoscopic sphincterotomy (n = 3), or internal stent
      alone (n = 2). Thirteen patients had a biliary fistula after other hepatobiliary
      operations and underwent endoscopic therapy during a similar period. All 13 had
      an endoscopic sphincterotomy with removal of obstructing stones when present (n =
      6). Twelve patients also had stents placed. All patients were prospectively
      followed after hospital discharge and assessed for recurrent symptoms suggestive
      of biliary tract disease and procedure-related complications. RESULTS: Endoscopic
      retrograde cholangiopancreatography (ERCP) identified a biliary fistula at the T
      tube insertion site into the bile duct in all 18 liver transplant patients.
      Seventeen patients had resolution of their symptoms within 12 hours of therapy.
      The fistula sealed in 94.4%. In the other hepatobiliary operation group, ERCP
      demonstrated contrast extravasation from the biliary tree in 12 of 13. The
      biliary fistula closure rate was 92.3%. The endoscopic complication rate for the
      two groups was 3.2%. During a mean follow-up of 9 months, recurrent biliary tract
      complications occurred in 11.1% of the liver transplant group and 0% in the other
      hepatobiliary operation group (p > 0.05). The 30-day mortality rate was 0%.
      CONCLUSIONS: The results of this study support the application of endoscopic
      management of biliary fistulas complicating orthotopic liver transplantation and
      other hepatobiliary operations. This approach was relatively safe and obviated
      the need for surgical intervention.

PMID- 8342995
TI  - Macrophages produce nitric oxide at allograft sites.
AB  - OBJECTIVE: The current study was designed to determine which cytokines produced
      during an alloimmune response stimulate macrophage nitric oxide (.N = O)
      production at allograft sites. SUMMARY BACKGROUND DATA: Previous work has
      demonstrated that rat sponge matrix allograft infiltrating cells produce more .N
      = O on stimulation with alloantigen than syngeneic graft-infiltrating cells.
      Addition of NG-monomethyl-L-arginine (NMA), an inhibitor of .N = O synthesis,
      promotes allospecific cytolytic T-lymphocyte effector function. METHODS:
      Polyurethane sponges were implanted subcutaneously in recipient Lewis rats and
      injected with 10 x 10(6) ACl splenocytes. On various days after grafting, graft
      infiltrating cells were harvested for in vitro study. Adherent macrophages from
      the graft infiltrating cell population were obtained by a 2- to 3-hour incubation
      to plastic dishes with subsequent washing to remove nonadherent cells. RESULTS:
      Stimulation of unseparated graft-infiltrating cell populations with
      lipopolysaccharide or interferon-tau resulted in enhanced .N = O synthesis by
      allograft infiltrating cells compared with syngeneic graft-infiltrating cells,
      early after grafting. Macrophages recovered from an allograft site spontaneously
      produce more .N = O than macrophages recovered from syngeneic grafts (p < 0.001).
      Significantly enhanced levels of .N = O were produced by allograft macrophages
      compared with syngeneic graft macrophages on stimulation with lipopolysaccharide
      or interferon-tau (p < or = 0.025). CONCLUSIONS: Nitric oxide appears to be
      produced in response to the local cytokines secreted by an ongoing rejection
      reaction. Nitric oxide serves under these circumstances to modulate the
      alloimmune response.

PMID- 8342997
TI  - Bile secretion and liver regeneration in partially hepatectomized rats.
AB  - OBJECTIVE: The purpose of this research was to study the correlation between bile
      secretion and the liver regeneration in the partially hepatectomized rat. SUMMARY
      BACKGROUND DATA: Significant alteration in bile formation and secretion is
      expected in the liver after hepatectomy. There is scant literature, however,
      about the effects of liver regeneration in bile secretion. METHODS: The work was
      done in rats with 50% hepatectomy, 75% hepatectomy, and sham operation as the
      control. A chronic common bile duct fistula and a duodenal cannula were
      established for bile collection and the sample analysis on days 1, 3, 5, 7, and
      9. RESULTS: With size reduced in the liver after 50% and 75% hepatectomy, the
      total bile volume decreased 45.9% and 51.5%, bile salt independent flow decreased
      59.3% and 64.9%, bile salt secretion rate decreased 36.1% and 43.4%, bile salt
      basal synthesis rate decreased 52.3% and 56.4%, phospholipid secretion rate
      decreased 52.6% and 68.0%, and cholesterol secretion rate decreased 54.3% and
      72.4% from control on day 1, respectively. All changes returned to the control
      level in 3 to 9 days with accompanying increasing liver size during regeneration.
      CONCLUSION: Alterations of total bile flow, bile salt independent flow, bile salt
      secretion rate, bile salt basal synthesis rate, and biliary lipid secretion after
      partial hepatectomy correlate with the liver regeneration rate in rats. Partial
      hepatectomy reduces the bile salt independent fraction calculated as per 100 g
      body weight rather than the dependent fraction. The study of bile salt and
      biliary lipid secretion is a useful method for monitoring synthetic function in
      liver regeneration in vivo.

PMID- 8343000
TI  - Are adults content or continent after repair for high anal atresia? A long-term
      follow-up study in patients 18 years of age and older.
AB  - OBJECTIVE: This study investigated the current state of fecal and urinary
      continence in an extensive group of adults after operative correction for high
      anorectal malformations and how they cope with their incontinence. SUMMARY
      BACKGROUND DATA: Normal fecal continence is hardly to be expected after
      correction for high anorectal malformation; despite this, it is commonly accepted
      that for most patients fecal continence improves with growing age and that most
      adult patients have no problems. Until now, however, few long-term follow-up
      studies in small groups of adults have been performed to assess continence after
      operative repair for high anorectal malformation. METHODS: Fifty-eight adult
      patients (median age, 26.0 years; range, 18.1 to 56.9 years) with an operatively
      corrected high anorectal malformation were evaluated by questionnaire with
      respect to their current state of fecal and urinary continence and mode of
      control of defecation. RESULTS: Seven patients have a permanent ileostoma or
      colostoma. Of the 51 patients with anal defecation, 61% control defecation by
      themselves, whereas 35% control defecation by using enemas or bowel irrigations,
      and 4% do not have any control at all. Besides medical therapy, 65% take dietary
      measures to influence defecation. According to existing scoring methods, 41%
      reached good and 49% fair control of defecation, whereas only 10% had poor
      control. Current control of defecation was reached from a median age of 15.0
      years (range, 5 to 31 years). CONCLUSION: Conclusively, the authors can say that
      after correction for high anorectal malformation nobody reached normal fecal
      continence. Most patients with anal defecation reached good and fair control of
      defecation, however. Of all 58 patients, 84% are satisfied with their level of
      cleanliness.

PMID- 8342999
TI  - Survival with colorectal cancer in ulcerative colitis. A study of 102 cases.
AB  - OBJECTIVE: This study was undertaken to correlate postoperative survival of
      patients with ulcerative colitis-associated colorectal cancer with the stage,
      configuration, size, and mucin content of the tumor. SUMMARY BACKGROUND DATA: The
      factors influencing prognosis in colorectal cancer in the general population are
      well accepted, but less is known about their influence in cases of colorectal
      cancer associated with ulcerative colitis. METHODS: The authors reviewed the
      records of 102 patients with ulcerative colitis-associated colorectal cancer
      admitted to The Mount Sinai Hospital between 1959 and 1988. Tumors were
      classified on independent pathologic review according to histologic stage,
      configuration, size, and mucin content. Comparisons among survival curves were
      tested by the generalized Wilcoxon test. Cox regression models were used to
      examine the joint effects of selected clinicopathologic features on postoperative
      survival rates. RESULTS: Complete follow-up was obtained for 93 patients (92%).
      Overall 5-year actuarial survival was 52%. When factors were analyzed one at a
      time, survival was significantly poorer among patients with advanced cancer
      stage, larger tumor size, infiltrating and ulcerating configuration, and high
      mucin concentration. On multivariate analysis by the Cox regression model,
      however, only cancer stage emerged as a factor independently predicting survival.
      CONCLUSIONS: For colitis-associated colorectal cancers, as for noncolitic
      cancers, histologic stage is the most important variable determining
      postoperative survival. The distribution of stages in our series and the survival
      rates within each stage did not differ appreciably from the distributions and
      survival rates reported for noncolitic colorectal cancers.

PMID- 8342998
TI  - Developmental expression of the neurotensin gene in the rat liver.
AB  - OBJECTIVE: This study determined whether the neurotensin gene is expressed during
      early development of the liver. SUMMARY BACKGROUND DATA: Neurotensin (NT), a gut
      tridecapeptide localized mainly to the distal small bowel and brain of adults, is
      an important hormone regulating gut motility, secretion and mucosal growth.
      Expression of NT peptide and the gene is found in fibrolamellar hepatocarcinomas,
      a variant of hepatocellular carcinoma, but not in the normal adult liver.
      METHODS: Northern and in situ hybridization techniques were used to determine
      expression of the neurotensin gene (NT/N) in the normal developing liver.
      RESULTS: NT/N is expressed in the fetal and early postnatal rat liver, but
      expression is repressed in the liver of the adult. In situ hybridization confirms
      the authors' Northern data and demonstrates a random distribution of NT/N
      expression in the fetal and 3-day postnatal liver. CONCLUSIONS: The authors
      conclude from this study that NT/N is expressed during early development of the
      rat liver with subsequent repression in the adult. NT/N may be reexpressed with
      malignant transformation of the liver.

PMID- 8343001
TI  - Anal sphincter defects. Correlation between endoanal ultrasound and surgery.
AB  - OBJECTIVE: This study was performed to (1) correlate and sphincter defects,
      identified by endoanal ultrasound with operative findings, and (2) define the
      appearance of such sphincter defects as seen at operation. SUMMARY BACKGROUND
      DATA: Endoanal ultrasonography is a minimally invasive method of imaging the anal
      sphincter complex and enables identification of anal sphincter defects. Little is
      known about the accuracy and limitations of endoanal ultrasound in identifying
      such defects. Furthermore, there are no data about the appearances of these
      endosonic sphincter defects as seen at operation. METHODS: Forty-four patients
      (40 women; age range, 26 to 80 years; mean age, 56 years) with fecal
      incontinence, undergoing pelvic floor repair, were investigated by endoanal
      ultrasound before operation. Endosonic findings were correlated with the
      appearances of external anal sphincter, internal anal sphincter, and
      intersphincteric space, at operation. Diagnosis of the site and type of defect
      was made by macroscopic appearances. Uncertainty about the type of sphincter
      defect was resolved by obtaining muscle biopsies for histology. RESULTS: All
      external sphincter defects seen by endoanal ultrasound (n = 23) were confirmed at
      operation. Twenty-one of 22 internal sphincter defects identified by
      endosonography also were confirmed at operation. In ten patients with a
      neuropathic anal sphincter complex, the morphology was normal on endosonography,
      and this was confirmed at operation. (Sensitivity and specificity of 100% for
      external anal sphincter; 100% and 95.5%, respectively, for internal and
      sphincter) CONCLUSIONS: These data show that endoanal ultrasound is an accurate
      method of identifying anal sphincter defects.

PMID- 8343003
TI  - Surgical strategy of extended lymphadenectomy for esophageal carcinoma.

PMID- 8343002
TI  - A prospective, randomized evaluation of the effect of silver impregnated
      subcutaneous cuffs for preventing tunneled chronic venous access catheter
      infections in cancer patients.
AB  - OBJECTIVE: This study was performed to evaluate the effect of a silver
      impregnated cuff on the incidence of catheter-related bacteremia/fungemia or
      tunnel tract infection in cancer patients with chronic dual-lumen tunneled venous
      access catheters. SUMMARY BACKGROUND DATA: Infection is a frequent and
      potentially life-threatening complication of tunneled chronic cuffed silastic
      central venous access catheters in cancer patients. Recent experience with
      antimicrobial silver-impregnated cuffs placed on nontunneled percutaneously
      inserted central venous catheters suggests that such a cuff may render the
      catheter less prone to infection. METHODS: The authors prospectively randomized
      200 cancer patients to receive either a dual-lumen 10 French tunneled cuffed
      silastic central venous access catheter or the same catheter with a second more
      proximal subcutaneous silver-impregnated cuff. All patients then were followed
      prospectively for infectious morbidity until the device was removed or the
      patient died. RESULTS: The hazard rate for infection/day (95% confidence limits)
      was 0.0022 (0.0015 to 0.0030) for standard catheters compared with 0.0027 (0.0019
      to 0.0037) for catheters with silver-impregnated cuffs (p = not significant).
      Regression analysis of infection-free interval of both catheter types shows no
      difference over the lifetime of catheter as well as the over the first 48 days
      after insertion. CONCLUSIONS: The study indicated no effect of a silver
      impregnated cuff in decreasing the incidence of catheter-related
      bacteremias/fungemias, tunnel infections, or the spectrum of causative
      microorganisms involved in cancer patients with tunneled chronic venous access
      catheters.

PMID- 8343004
TI  - Laparoscopic bile duct injuries.

PMID- 8343005
TI  - Routine operative cholangiography in patients undergoing laparoscopic
      cholecystectomy.

PMID- 8343006
TI  - Multiple (systems) organ failure [M(S)OF] is an unbridled inflammatory response.

PMID- 8343007
TI  - Multiple (systems) organ failure [M(S)OF] is an unbridled inflammatory response.

PMID- 8343008
TI  - Computerized morphometric analysis of the chick embryo esophagus.
AB  - By means of a computerized morphometric system and a semiautomatic digital system
      (videoplan II), the quantitative aspects of the organogenesis of the chick embryo
      esophagus were investigated from the 6th to the 15th day of incubation. The area
      of the total section, of the lumen, of the wall and its components (subserous
      stratum, muscle layer, lamina propria and epithelium) and the thickness of the
      epithelium and the muscle layer were measured. The mean area +/- S.E.M. of the
      values obtained was calculated. The percentage of shrinkage, due to the
      histological procedures, was calculated for each day. The mean values for each
      day of incubation were modified on the basis of the shrinkage percentage.
      Exponential curves and r coefficient were determined to evaluate the growing
      pattern of the mean area of the esophageal wall components as a function of age.
      The main results are the following: 1) From the 6th to the 10th day of incubation
      the areas of all the wall components show an increase. 2) From the 11th day
      onwards, the wall components undergo a different growth pattern; in fact, the
      area of the subserous stratum decreases from the 11th to the 13th day, the muscle
      layer and the lamina propria show a decrease on the 12th day, while the growing
      pattern of the epithelium area appears irregular from the 12th day onwards. 3)
      The lamina propria results to be the component of the wall that shows the highest
      growth rate. Moreover, the esophageal anlage shows different developmental
      behaviour compared with that of the other intestinal tracts previously examined
      (ileum, duodenum, colon, caeca) in the same chick embryo.

PMID- 8343009
TI  - Further observations on the morphology and sensitive innervation of the retractor
      penis muscle in several species of ungulates.
AB  - The retractor penis muscle originates from the vertebrae in pigs, horses, cattle
      and goats; it arises from the rectum in sheep. In all the species considered,
      sensitive innervation was found. This was represented by encapsulated receptors.
      Nervous vegetative supply, made up of isolated or assembled ganglion cells, was
      also present. Among the numerous sensory nerve endings found in pigs, goats and
      sheep were Pacinian, Pacinian-like, Golgi-Mazzoni corpuscles and Krause's end
      bulbs (genital corpuscles). Few Pacinian and Pacinian-like corpuscles were found
      in cattle and horses. A hypothesis on the probable functional role of the
      observed receptorial apparatus was formulated.

PMID- 8343010
TI  - The anatomy and clinical significance of the collateral circulation between the
      internal and external carotid arteries through the ophthalmic artery.
AB  - Complete occlusion of the internal carotid artery is not necessarily associated
      with total disruption of cerebral blood flow distal to the site of the arterial
      obstruction. In fact, the flow of blood may be sufficient to maintain cerebral
      perfusion. This is accomplished by the shunting of blood from the external to the
      internal carotid artery by means of collateral circuits. While several major
      branch arteries of the external carotid artery may be recruited in this process,
      the ophthalmic artery is often the final common pathway before the anastomosis
      with the internal carotid artery. With the aim of elucidating these collateral
      circles, digital subtraction angiography was used to examine 100 patients with
      total occlusion of the internal carotid artery. These data were compared with
      those obtained using Doppler ultrasound, duplex scanning, and transcranial
      Doppler. Forty patients were excluded because there was no demonstrable
      collateral circulation, because the collateral circulation used the communicating
      arteries, or because the ophthalmic artery arose from the middle meningeal
      artery. Dynamic data were obtained by compressing the branches of the two
      external and common carotid arteries, and the blood vessels were identified by
      comparison with previous anatomic studies. We have constructed a precise map of
      the intra- and extracranial circles that connect the internal and external
      carotid arteries through the pathways that include the ophthalmic artery. This
      map demonstrates why apparently identical vascular occlusions may have divergent
      symptomatologies and clinical outcomes, which may range from the complete absence
      of symptoms to cerebral infarction.

PMID- 8343011
TI  - Interaction between keratinocytes and fibroblasts cultured in vitro: morphology,
      morphometry and growth.
AB  - In order to elucidate the interactions between fibroblasts and keratinocytes co
      cultured in vitro, the morphology and growth of rat keratinocytes cultured with
      and without a feeder layer were compared. Morphological analysis was coupled with
      a simple morphometric method of image analysis performed with a computer aided
      system to demonstrate statistically significant differences between keratinocyte
      cultures obtained with and without a feeder layer. Epidermal cells cultured
      without fibroblasts but with a conditioning medium showed a slower growth rate
      and significant a greater cellular dimensions in comparison with cells grown in
      the presence of a feeder layer. These results suggest that the conditioning
      medium induces a morphological change of keratinocytes. The electrophoretic
      patterns of proteins extracted from cells cultured with and without a feeder
      layer were identical, whereas densitometric analysis revealed that the
      quantitative expression of proteins was clearly different. These data confirm
      that of keratinocyte growth is dependent on fibroblasts or fibroblast products.

PMID- 8343012
TI  - The sulci of the cuneus of the human cerebrum.
AB  - The limiting and internal sulci of the cuneus of the occipital lobe of 80 cerebri
      of Brazilians of either sex (24 females and 56 males) were studied and findings
      were correlated with each hemisphere and the sex of the individuals. The
      distribution of the material was 39 Caucasians (11 females and 18 males) and 41
      non-Caucasians (13 females and 28 males). The limiting sulci, namely parieto
      occipital and calcarine, were found in all cases. The internal sulci were
      classified in horizontal, oblique, vertical and cuneolingual. The cuneus of the
      right cerebral hemisphere had more sulci than that of the left. The cuneus had
      also more sulci in males than in females.

PMID- 8343013
TI  - [Oral rice-based rehydration solution (SRO), alternative of SRO of WHO in acute
      diarrhea in malnourished patients].
AB  - BACKGROUND: Although malnutrition is frequently associated with diarrhea, most
      oral rehydration solutions have been tested in well-nourished children. The study
      tests efficacy of rice, a traditional treatment for diarrhea in Madagascar.
      PATIENTS AND METHODS: 150 severely malnourished children, aged 6 months to 3
      years, took part in this randomized trial. All the children were given oral
      rehydration solution, (100 ml/kg) in the first 6 hours. The first group (68
      children) was given a solution containing glucose, (20 g/l). The second group (82
      children) was given a solution containing rice powder (50 g/l). Treatment was
      then continued according to WHO recommendations, including feeding after
      rehydration (mixture of milk, oil and sugar). RESULTS: The age, weight, height,
      duration of diarrhea before admission, degree of dehydration and pathogens in
      stools of the two groups were comparable on admission. Only 2 patients were
      withdrawn from the trial. The percentage of death was the same in both groups:
      16% of those given glucose and 15% of those given rice-based rehydration
      solution. The weight gains were similar in both groups; the duration of diarrhea
      was 89 +/- 6 hours in the glucose-fed groups and 68 +/- 4 hours for those given
      the rice-based rehydration solution (p < 0.02). CONCLUSIONS: Both glucose and
      rice-based rehydration solutions are equally effective for rehydrating severely
      malnourished children with acute diarrhea. The rice-based rehydration solution
      also reduces the duration of diarrhea.

PMID- 8343014
TI  - [Congenital obstruction of lacrimal ducts in 578 children].
AB  - BACKGROUND: Congenital obstruction of the nasa lacrimal ducts is a frequent
      problem in infancy. Its management is still controversial. REPORT: 578 children
      aged 6 weeks to 3 years were treated in our department between 1980 and 1987.
      Congenital obstruction of the nasa lacrimal ducts was bilateral in 172 of them,
      so that a total of 750 ducts were obstructed. All the infants were treated with
      antibiotics until they are 2 months old. Permeability was obtained in 97% of the
      750 obstructed ducts: this was spontaneous in 38.7%, after a single wash in 3%,
      and by probing under general anesthesia in 55.3%. The percentage of cases
      requiring surgery increased with age at time of diagnosis. CONCLUSIONS: The best
      results are obtained in infants 2 to 4 months old.

PMID- 8343015
TI  - [Value of dexamethasone in purulent meningitis in children. Apropos of a
      comparative study of 85 children].
AB  - BACKGROUND: The beneficial effect of dexamethasone plus antibiotic therapy in
      bacterial meningitis is still controversial. PATIENTS AND METHODS: Eighty-five
      children, aged 1 month to 14 years, were admitted between 1987 and 1990 for
      bacterial meningitis. They received the same antibiotic therapy for 10 days (7
      days in meningococcal meningitis). The 44 children admitted since March 1989 were
      also given dexamethasone (0.15 mg/kg/6 hours for 4 days); the first injection was
      given before antibiotic therapy. Clinical (fever, neurological findings,
      audition) and laboratory data [CSF proteins, glucose, lactate, cell and bacterial
      counts; blood C-reactive protein (CRP), hemoglobin, leukocytes and platelets]
      were analyzed statistically. RESULTS: The group treated with antibiotics plus
      dexamethasone showed decreases significantly greater in CSF protein and lactate
      levels after 48 hours than the children given antibiotics alone and an early (6
      hours after the start of treatment) increase in CSF glucose. The blood CRP level
      of the dexamethasone plus antibiotics group decreased significantly within 48
      hours. The numbers of neurological sequelae and deaths in this group were clearly
      lower than for the antibiotic group, but the risk of deafness did not appear to
      be altered. CONCLUSIONS: These results confirm the beneficial effect of
      dexamethasone reported earlier. The relatively frequent transient recurrences of
      fever and increased CRP when dexamethasone was interrupted suggest that the dose
      and/or duration of dexamethasone treatment should be modified.

PMID- 8343016
TI  - [Huntington chorea in children].
AB  - BACKGROUND: The onset of Huntington's disease, a dominantly inherited
      degeneration of the basal ganglia, usually occurs in middle age; cases of
      childhood onset are rare. CASE REPORTS: Case 1. A boy from a family including
      several cases of Huntington's disease gradually developed behavior disorders from
      the age of 5 years. He had learning and language disorders at 7 years of age and
      at 11 years he suffered from generalized seizures and progressive rigidity. The
      disease led to dementia at 17 years and the patient died a few months later. CT
      scan showed diffuse cortical atrophy. Case 2. A girl aged 5 years, was first
      examined for gait disorders. At that time she had dystonia and spasticity.
      Rigidity gradually developed, and 2 months later several cases of Huntington's
      disease were identified in her father's family. Case 3. A boy developed gait
      disorders from the age of 5 years. He gradually developed dystonia, rigidity,
      learning disorders, and finally mental retardation. The CT scan showed cortical
      atrophy and atrophy of the caudate nucleus. His father and others members of the
      paternal family had Huntington's disease that appeared in the adulthood.
      CONCLUSION: The clinical manifestations of Huntington's disease in childhood are
      different from those seen in adults. Progressive alteration of mental development
      and dementia can occur. Diagnosis may be difficult except when a parent has the
      fully developed disease.

PMID- 8343017
TI  - [Unusual intrathoracic tumor in children: lipoma].
AB  - BACKGROUND: Intrathoracic lipomas are rare, often asymptomatic and, in this case,
      discovered by chance on X-ray. CASE REPORT: A 3 year-old girl was admitted
      because chest X-rays prescribed for a persistent cough showed a mass in the right
      axillary area. The CT scan showed a mass with density of -80 Hounsfield units,
      characteristic of adipose tissue. There was a slight rib change in contact with
      the mass, but radionuclide bone scan showed no area of increased uptake. A chest
      X-ray performed 3 years earlier had shown such a mass, but it was not recognized
      at that time. Surgery demonstrated that the mass was extrapleural in location and
      adhering to the rib which was partly excised. Histologic examination showed the
      presence of mature adipocytes, but no malignant cells. CONCLUSION: The fatty
      component of an intrathoracic tumor is easily recognized with CT scan. Erosion of
      bone in contact with it has been reported.

PMID- 8343019
TI  - [Neonatal septicemia due to Pneumococcus resistant to beta-lactam antibiotics].
AB  - BACKGROUND: Neonatal sepsis due to Streptococcus pneumoniae is relatively rare.
      The increasing risk that this bacterium is resistant to betalactam antibiotics
      worsens its prognosis. CASE REPORT: A newborn was delivered by cesarean section
      because of an abnormal fetal heart rate pattern. Despite intubation, respiratory
      support and correction of acidosis, the baby remained cyanotic and displayed
      signs of shock. Neutropenia, increased percentage of immature neutrophils, high C
      reactive protein levels and an X-ray pattern of pneumonia also indicated an
      infection. The child was given symptomatic therapy, and amoxicillin, cefotaxime
      and amikacin. Pneumococci type 9 were isolated from peripheral secretions and
      from the blood. Deterioration of the respiratory condition required higher doses
      of amoxicillin and cefotaxime on day 2 pending the results of antibiotic
      sensitivity testing. This test showed that the strains were resistant to beta
      lactam antibiotics. On day 3, the treatment was replaced by a combination of
      vancomycin, rifampicin, amikacin and cefotaxime. This treatment was pursued for 2
      weeks, except for rifampicin which was stopped after 2 days. The follow-up was
      uneventful. A search for pneumococci in the mother was negative. CONCLUSIONS:
      Streptococcus pneumoniae should always be considered as a cause of neonatal
      sepsis. Poor therapeutic control indicates resistance to beta-lactam antibiotics.
      This patient may be the first reported case of maternal-fetal infection with this
      resistant strain.

PMID- 8343018
TI  - [Dwarfism, arterial hypertension and hyperkalemic acidosis corrected with
      thiazides. A case of type II pseudohypoaldosteronism].
AB  - BACKGROUND: Type II pseudohypoaldosteronism is a rare tubulopathy defined by
      abnormal renal potassium excretion. CASE REPORT: A 12 1/2 year-old girl, was
      admitted for dwarfism. Her parents were not consanguineous and her 5 living sibs
      were normal. At admission, she had moderate hypertension: systolic 130-150 mmHg;
      diastolic 80-100 mmHg and no pubertal development. LABORATORY DATA: pH
      (arterial): 7.34; bicarbonates: 18-20 mEq/l; chloride: 112-120 mEq/l; potassium:
      5.6-7 mEq/l; aldosterone: 200-700 pg/ml (N < 60); plasma renin activity: 0.4
      ng/ml/hr (N 2.2 +/- 0.2). The bone maturation was 8 1/2 years. All the other
      renal function tests were normal. The titratable acidity was 22 mEq/day (N 20-40)
      and the ammonia excretion 15.2 mEq/l (N 44-61). The fractional excretion of
      potassium was 6.5% (N 11.8 +/- 1.9). This girl was given polystyrene sulfonate
      resin followed by hydrochlorothiazide (1 to 3 mg/kg/day). There was a subsequent
      improvement in all data, a growth spurt and pubertal development. CONCLUSION:
      This is the fifth case of type II pseudohypoaldosteronism reported in childhood
      and the first one with hypertension. The beneficial effect of hydrochlorothiazide
      is underlined.

PMID- 8343020
TI  - [Stark-Kaeser type scapulo-peroneal amyotrophy of neurogenic origin. Study of a
      familial case].
AB  - BACKGROUND: There are several types of the rare syndrome, scapuloperoneal
      atrophy; the report deals with a familial case of the Stark-Kaeser type. CASE
      REPORT: A 16 year-old Tunisian boy was admitted for "steppage" gait. His mother
      had distal myoatrophy of four limbs and pes cavus. His sister, aged 8 years, also
      had pes cavus. She had no tendon reflexes and electromyography showed evidence of
      muscular denervation with normal nerve conduction velocity. The "steppage" gait
      in our patient began when he was 6 years old. When he was examined at 16 years,
      there were bilateral atrophy of the sternocleidomastoid muscle, and atrophy of
      the scapular girdle and the peroneal muscles with loss of tendon reflexes; there
      was no sensory involvement. Nerve conduction velocity was normal and
      electromyography showed fibrillation and pseudomyotonia potentials. Creatine
      kinase activities were moderately increased. Muscle biopsy showed significant
      neurogenic type changes. CONCLUSION: This patient has a Stark-Kaeser type spinal
      amyotrophy, a well-individualized entity due to progressive degeneration of the
      anterior horn cells.

PMID- 8343021
TI  - [C2 deficiency discovered in pneumococcal meningitis].
AB  - BACKGROUND: Congenital deficiencies of complement system proteins are rare.
      Patients with C2 deficiency have a high incidence of vascularitis syndromes. Most
      patients with this deficiency have no problems with increased susceptibility to
      infection, most commonly due to pneumococci, presumably because of the protective
      function of the alternative pathway. CASE REPORT: A 22 month-old girl was
      admitted because of acute meningitis and otitis. She had had 2 episodes of otitis
      media at the age of 1 year. Analysis of the CSF showed that this meningitis was
      due to pneumococcal infection. Recovery was complete after 15 days of antibiotic
      therapy. Total hemolytic complement activity (CH50) was low during the infection;
      one month later, the CH50 value was about zero as was C2, while C3 and C4 were
      normal. The patient was given polyvalent pneumococcal and anti-Haemophilus
      vaccines plus prophylactic penicillin G. Laboratory tests for systemic lupus
      erythematosus were negative. CONCLUSION: A defect of complement function should
      be suspected in any patient with severe of recurring pyogenic infections.
      Complement disorders can be detected one month later by means of the relatively
      simple hemolytic complement assay.

PMID- 8343022
TI  - [Iconographic rubric. Metastatic pulmonary calcifications in a child].

PMID- 8343023
TI  - [Behcet disease in children].

PMID- 8343024
TI  - [Development of body image in adolescents. Psychosocial determinants and
      behavioral effects].

PMID- 8343025
TI  - [Recent progresses in neonatology].

PMID- 8343026
TI  - [Flow rate through Vialon peripheral catheters, after used in children].

PMID- 8343027
TI  - [Catheter breakage at the point of insertion into a pediatric implantable
      system].

PMID- 8343028
TI  - [A case of peritoneal tuberculosis].

PMID- 8343029
TI  - [Digestive form of Langerhans cell histiocytosis].

PMID- 8343030
TI  - [Peanut allergy, iatrogenic disease?].

PMID- 8343031
TI  - [Massive feto-maternal hemorrhage and prevention of Rhesus feto-maternal
      incompatibility].

PMID- 8343032
TI  - [Plea for a specialty of medical genetics].

PMID- 8343033
TI  - [Manner of birth and otitis media].
AB  - BACKGROUND: There are many risk factors associated with the occurrence of otitis
      media; cesarean section could be one of them. REPORT: Two hundred and eighty four
      children were treated during the first three years of life by the same pediatric
      service. 47% of these children were treated for otitis media and 53% were not.
      41% were delivered by cesarean section, and 59% were vaginal births. The
      incidence of otitis media in the cesarean section group was 0.504, versus 0.449
      in the vaginal birth group. RESULTS: These data indicate that the fraction of
      risk of having otitis media that is attributable to cesarean section is 11%; the
      relative risk is 1.12. CONCLUSION: The observed effect is not large enough to
      confirm that cesarean section is a risk factor, but suggests that a carefully
      controlled prospective study should be conducted.

PMID- 8343034
TI  - Effects of clozapine and fluphenazine treatment on responses to m
      chlorophenylpiperazine infusions in schizophrenia.
AB  - OBJECTIVE: To explore serotonin function in patients with schizophrenia during
      typical and atypical neuroleptic treatment. We hypothesized that clinically
      relevant doses of the atypical neuroleptic clozapine would attenuate responses to
      the serotonin agonist m-chlorophenylpiperazine (m-CPP). DESIGN AND INTERVENTIONS:
      m-CPP or placebo was administered intravenously over 90 seconds to patients who
      had been receiving no medications for at least 3 weeks. m-CPP was also
      administered during treatment with the typical neuroleptic fluphenazine and the
      atypical neuroleptic clozapine. PATIENTS: Fifteen inpatients (two women and 13
      men) who met DSM-III-R criteria for chronic schizophrenia (n = 13) or
      schizoaffective disorder (n = 2) participated in the study. Mean age (+/- SD) was
      33.8 +/- 8.0 years. MAIN OUTCOME MEASURES: Measures of m-CPP effects included
      plasma cortisol and prolactin, body temperature, and the Brief Psychiatric Rating
      Scale (BPRS). The final BPRS total score at approximately 12 weeks of treatment
      was used to assess response to clozapine. RESULTS: m-CPP infusion significantly
      increased plasma cortisol and prolactin levels in drug-free patients. There was a
      range of behavioral responses while drug-free, but no statistically significant
      effects on BPRS total or BPRS factor scores. Clozapine treatment significantly
      blocked neuroendocrine responses to m-CPP, whereas fluphenazine had no effect.
      Clozapine also appeared to attenuate behavioral responses. CONCLUSIONS: These
      results demonstrate that clozapine treatment has potent serotonin antagonist
      effects in patients with schizophrenia. This may be related to clozapine's
      therapeutic effects since patients with greater cortisol response to m-CPP while
      drug-free had a better subsequent response to clozapine.

PMID- 8343035
TI  - The Roscommon Family Study. II. The risk of nonschizophrenic nonaffective
      psychoses in relatives.
AB  - OBJECTIVE: We sought to clarify the familial relationship between the
      nonschizophrenic, nonaffective psychoses (schizoaffective disorder [SAD],
      schizophreniform disorder, delusional disorder, and atypical psychosis) and
      schizophrenia and affective illness (AI). DESIGN: A case-controlled epidemiologic
      family study using DSM-III-R criteria. RESULTS: Compared with relatives of
      unscreened controls, the risk of nonschizophrenic, nonaffective psychoses was
      significantly elevated in relatives of probands with schizophrenia, SAD,
      schizotypal personality disorder, and psychotic AI. No significant elevation in
      risk to these disorders was seen in relatives of probands with nonpsychotic AI.
      The risk for SAD alone was significantly increased in relatives of probands with
      psychotic or bipolar AI. CONCLUSIONS: The nonschizophrenic, nonaffective
      psychoses have a significant familial relationship with both schizophrenia and
      schizotypical personality disorder. Schizoaffective disorder, as defined by DSM
      III-R, shares familial etiologic factors with at least some forms of AI.

PMID- 8343036
TI  - Research activities of full-time faculty in academic departments of psychiatry.
AB  - Using data collected by a 1989 American Psychiatric Association survey of full
      time, salaried faculty in departments of psychiatry at US medical schools, we
      examined the number of faculty engaged in research, their levels of involvement
      in research, distribution, sources of funding, fields and topics studied, and
      training. Using a three-level measure of research involvement, we categorized
      39.1% of the respondents as "researchers," 36% as "limited commitment
      researchers," and 25.1% as not involved in research. In a pattern similar to that
      observed for research funding in other studies, half of the researchers were
      concentrated in the top 15 of the 116 responding departments. Level of research
      involvement varied by degree type (joint-program MD/PhDs were most involved),
      sources of funding, fields, and topics. Among faculty with MDs, having had
      research experiences in medical school or postdoctoral research training was
      associated with a higher level of research involvement. The findings underscore
      the need to expand and improve postdoctoral research training--especially for MDs
      -and programs to recruit college and medical students into psychiatric research.

PMID- 8343037
TI  - In memoriam Daniel X. Freedman, MD August 17, 1921, to June 3, 1993.

PMID- 8343038
TI  - Alfred Adler's description of the case of Vaslav Nijinsky in light of current
      diagnostic standards.

PMID- 8343039
TI  - Low-grade B-cell lymphoma of mucosa-associated lymphoid tissue and monocytoid B
      cell lymphoma. Related entities that are distinct from other low-grade B-cell
      lymphomas.

PMID- 8343040
TI  - Proficiency testing in clinical cytogenetics. A 6-year experience with
      photographs, fixed cells, and fresh blood.
AB  - The College of American Pathologists and the American Society of Human Genetics
      offer a proficiency testing program in clinical cytogenetics. Two hundred twenty
      five laboratories now provide data for this survey, which was begun in 1986.
      Challenges have consisted of photographed metaphases, fixed lymphoblastoid cell
      suspensions, fresh peripheral blood, and disarranged karyotypes. The "correct"
      response was based on 80% or greater consensus among either the referees or the
      participants. Referee laboratories performed better than participants. More
      laboratories were able to report accurate recognition of abnormalities by using a
      coded list than could write the interpretation in standardized nomenclature.
      Deletions, unbalanced translocations, and inversions were more difficult
      challenges than balanced translocations or trisomies. Prenatal and lymphocyte
      challenges were more likely to result in consensus than were bone marrow
      challenges. Participants performed best on whole-blood challenges. Fixed cell
      suspensions were less satisfactory. Excellent quality case material is essential
      for a successful challenge. A grading system has been devised to separate
      artifacts of the survey process from proficiency variables.

PMID- 8343041
TI  - Detecting semen antisperm antibodies in the clinical laboratory.
AB  - Although antisperm antibodies are associated with infertility, many hospital
      laboratories do not test for these antibodies. This study included 520 males who
      were referred for infertility evaluation. Semen samples from all patients were
      tested for antisperm antibodies by using the mixed antiglobulin reaction and
      immunobead binding tests. These results were correlated with the findings of
      semen analyses, postcoital tests, and sperm penetration assays. Eighty-eight men
      (16.9%) tested positive for IgG, IgA, or IgM antisperm antibodies. More samples
      tested positive for IgG antibodies by the mixed antiglobulin reaction than by the
      immunobead test (n = 71 vs n = 42); 57 samples tested IgA positive. Both methods
      showed good reproducibility (97.6%). Antibody-positive males had a higher
      incidence of abnormal semen analyses (92% vs 74%) and other immune-related
      fertility test results (94.2% vs 38.4%). The presence of antisperm antibodies
      correlates with other abnormal semen parameters. Testing for these antibodies
      should be included in an infertility evaluation and could be readily implemented
      in a clinical laboratory.

PMID- 8343043
TI  - Adenoid cyst-like carcinoma of the prostate gland.
AB  - Adenoid cyst-like carcinoma of the prostate is a rare but distinctive variant of
      prostatic adenocarcinoma. Adenoid cystic carcinoma is most commonly encountered
      in the salivary glands, and the cell of origin is thought to be the myoepithelial
      cell. Electron microscopic studies of the human prostate have not revealed
      myoepithelial differentiation. Myoepithelial cells of the human prostate are
      thought to arise in seromucinous ectopic glands. A case of adenoid cyst-like
      carcinoma of the prostate gland is documented, and the histological,
      immunohistochemical, and electron microscopic features of this tumor are
      discussed. These features are compared with five cases of classic salivary gland
      adenoid cystic carcinoma. To define the myoepithelial cell population of the
      prostate gland, 12 normal prostate glands were studied. Prostatic adenoid cyst
      like carcinoma differs from adenoid cystic carcinoma of salivary gland origin,
      and it is therefore postulated that the behavior of these tumors may likewise
      differ.

PMID- 8343042
TI  - Computerized static DNA ploidy analysis of prostatic intraepithelial neoplasia.
AB  - The microscopic features of prostatic intraepithelial neoplasia (PIN) are said to
      identify a precursor of prostatic adenocarcinoma (PC). We investigated this
      sequence of neoplastic progression by studying the relationship of PIN and PC by
      static ploidy analysis so that PIN and PC nuclei could be distinguished
      morphologically from each other and separately analyzed. From 51 archival cases
      of PC with coexistent high-grade PIN (PIN grades II and III) 50 control nuclei,
      100 PIN nuclei, and 100 carcinoma nuclei per case were identified and digitized
      in corresponding Feulgen-stained slides. Control and PIN ploidy histograms fit a
      log-normal distribution, whereas malignant nuclei fit a rectangular distribution.
      When the histogram patterns were classified, the incidence of aneuploidy was 25%
      in PIN and 41% in PC. By case, the concordance of ploidy between PIN and PC was
      heterogeneous, yet the DNA ploidy of PIN and the corresponding PC was
      significantly associated. In four cases, PIN was DNA aneuploid while the
      associated PC was DNA diploid. These results support the hypothesis that high
      grade PIN is a neoplastic precursor of prostatic adenocarcinoma and suggest that
      further karyotypic instability may result in invasive adenocarcinoma with
      different DNA content detectable by image analysis.

PMID- 8343044
TI  - Succinylated wheat germ agglutinin lectin binding in intrahepatic vessels. A new
      histochemical tool.
AB  - Succinylated wheat germ agglutinin, specified by the amino sugar beta(4)-N
      acetylglucosamine, bound frequently to the endothelial cells of the hepatic
      arterial branches and small vessels of the peribiliary capillary plexus, while it
      did not bind to the endothelial cells of venous vessels such as portal vein
      branches and hepatic venous radicles, nor to lymphatic vessels. Sinusoidal
      endothelial cells were also negative for succinylated wheat germ agglutinin.
      Proliferating small vessels in the enlarged portal tracts and fibrous septa in
      patients with extrahepatic biliary obstruction or chronic active hepatitis with
      or without cirrhosis tended to be positive for succinylated wheat germ
      agglutinin. Such findings have not been previously reported, to the best of our
      knowledge. Thus, succinylated wheat germ agglutinin may be a new and useful
      histochemical tool in routinely processed tissue sections to discriminate
      intrahepatic vessels into several categories, particularly into two categories
      (arterial and other vessels), in normal as well as diseased livers.

PMID- 8343046
TI  - Gastric syphilis. Primary diagnosis by gastric biopsy: report of four cases.
AB  - Gastric involvement in secondary or tertiary syphilis is rarely recognized
      clinically, and its diagnosis by examination of endoscopic biopsy specimens has
      been reported infrequently. We report four cases of gastric syphilis with the
      primary diagnosis made by gastric biopsy. The patients, all male, ranged in age
      from 38 to 78 years and presented with gastric complaints, the most common being
      upper gastrointestinal tract bleeding (three of four). Gastroscopy showed either
      erosive gastritis or gastric ulcers with heaped, nodular edges. The clinical
      diagnoses ranged from benign ulcer disease to infiltrating carcinoma and
      lymphoma. Gastric biopsy specimens in all cases showed a severe gastritis with
      dense plasmacytic infiltration, associated with varying numbers of
      polymorphonuclear leukocytes and lymphocytes, variable degrees of glandular
      destruction and reactive atypia, and a vasculitis without proliferative changes.
      Modified Steiner silver impregnation stain revealed numerous spirochetes in all
      four cases and associated Helicobacter pylori infection in one case. Serologic
      studies for syphilis were positive in all four cases (rapid plasma reagin test,
      fluorescent treponemal antibody absorption test). None of the patients were
      seroreactive for antibodies to human immunodeficiency virus. These recent cases
      of gastric syphilis emphasize the importance of remaining alert to the protean
      clinical manifestations of syphilis and aware of the histopathologic patterns of
      this disease.

PMID- 8343045
TI  - Diffuse lymphoplasmacytic infiltration of the small intestine with damage to
      nerve plexus. A cause of intestinal pseudo-obstruction.
AB  - We describe the clinicopathologic characteristics of three patients with chronic
      intestinal pseudo-obstruction and malabsorption. The patients were young women
      (average age, 25 years) who presented with abdominal pain, nausea, vomiting,
      diarrhea, and weight loss that led to extreme inanition and death in two patients
      despite multiple treatment schemes. The evolution of the process averaged 8
      years. No case manifested evidence of malignant lymphoproliferative progression.
      Histologically, a diffuse lymphoplasmacytic infiltrate that affected all the
      layers of the intestinal wall was observed in full-thickness biopsy specimens.
      The proliferating lymphocytes were small and mixed with mature plasma cells that
      proved to be polyclonal on immunohistochemical analysis. An outstanding finding
      in all three cases was extensive damage to submucosal and myenteric nerve plexus
      associated with a lymphoid infiltrate. Quantification of the myenteric plexus by
      using immunohistochemical and morphometric techniques also revealed a marked
      reduction in their number. We concluded that diffuse lymphoplasmacytic
      infiltration of the small intestine associated with damage to the intestinal
      nerve plexus constitutes a specific disorder that is different from other
      diseases that produce intestinal pseudo-obstruction.

PMID- 8343047
TI  - The prognostic value of human chorionic gonadotropin expression in colorectal
      adenocarcinomas. An immunohistochemical study of 102 stage B2 and C2 nonmucinous
      adenocarcinomas.
AB  - Several recent studies have detected human chorionic gonadotropin (hCG)
      expression in colorectal adenocarcinomas and have concluded that its expression
      is an adverse prognostic indicator. The patient population and length of follow
      up has varied. Therefore, we reviewed a defined group of cases with long-term (>
      5 years) follow-up. We studied 102 stage B2 and C2 nonmucinous adenocarcinomas
      immunohistochemically for the production of hCG. Expression of hCG was detected
      in paraffin sections, including tumor and adjacent mucosa, using immunolabeling
      with a polyclonal rabbit antibody and the avidin-biotin-peroxidase complex
      technique. Cytoplasmic positive staining was evaluated semiquantitatively in
      every low-power microscopic field containing tumor. Expression of hCG was noted
      in at least one field in 42% (43/102) of the carcinomas. There was no expression
      in adjacent mucosa. Although the staining was usually focal (< 5% of tumor
      cells), some cases did stain diffusely. There was no significant correlation of
      hCG expression with survival, stage, differentiation, age, race, sex, or site of
      tumor. We therefore conclude that hCG expression is not a significant prognostic
      indicator in stage B2 and C2 colorectal carcinomas.

PMID- 8343048
TI  - Pulmonary tumor embolism to arterial vessels and carcinomatous lymphangitis. A
      comparative clinicopathological study.
AB  - A prospective study of 222 consecutive autopsies of cancer cases was undertaken
      to investigate whether carcinomatous lymphangitis and pure arterial tumor
      embolism of the lungs are different clinicopathological entities. The lungs were
      removed as a block and 15 sections (three from each lobe) were analyzed. A
      protocol containing clinical (ie, dyspnea, cyanosis, right ventricular failure,
      engorgement of jugular veins, and peripheral edema as main cause of death) and
      morphological (ie, right ventricle thickness and dilatation, vascular sclerosis,
      pulmonary infarct) data were carefully recorded in each case. Arterial tumor
      embolism was detected in 19 cases (8.5%) and carcinomatous lymphangitis in 44
      cases (19.8%). We found no differences in relation to signs and symptoms of
      arterial tumor embolism and carcinomatous lymphangitis, but respiratory distress
      as the main cause of death was significantly more frequent in the cases with
      arterial involvement by tumor emboli. Morphologically, however, right ventricular
      hypertrophy-dilatation, histological signs of pulmonary hypertension, and
      hemorrhagic infarcts were more prevalent in the cases with arterial tumor
      embolism. This study permits us to conclude that although arterial tumor embolism
      and carcinomatous lymphangitis are clinically similar diseases, they are
      morphologically different entities. Our results suggest that the most probable
      pathogenesis of pulmonary endarteritis and subsequent pulmonary hypertension is
      the injury to the vascular endothelium caused by the arrest of tumor emboli.

PMID- 8343049
TI  - Development of chronic renal failure in patients with multiple myeloma.
AB  - Glomerulotubular disconnections at the immediate postglomerular segment of the
      proximal tubules, accounting for an impaired renal function, were demonstrated
      recently in several chronic nonglomerular renal disorders. To analyze the
      glomerulotubular junctions in Bence Jones cast nephropathy, paraffin blocks from
      the kidneys of nine deceased patients with myeloma and chronic renal failure on
      whom autopsies were performed were studied in serial sections. Kidneys from seven
      deceased patients without renal disease on whom autopsies also were done served
      as controls. For stereological estimations, the percentages of patent and
      sclerosed glomerular profiles, the relative volume fractions, and the absolute
      volumes of the interstitium, tubules, and glomeruli were determined. In Bence
      Jones cast nephropathy, 96% of the glomerular profiles were patent, and the
      reconstruction of randomly chosen glomerulotubular junctions revealed that 84% of
      the patent glomeruli had normal tubular connections. There was an increased
      relative interstitial volume (fibrous tissue) and a decreased relative tubular
      volume. The absolute values indicated severe interstitial fibrosis, but not
      tubular atrophy. The results show that in contrast with other chronic
      nonglomerular nephropathies, chronic renal failure in Bence Jones cast
      nephropathy does not result from nephron disconnection at the immediate
      postglomerular segment of the proximal tubules. The main factor responsible for
      the decrease in renal function appears to be the progressive severe fibrosis of
      the interstitium.

PMID- 8343050
TI  - Osteolytic phaeohyphomycosis caused by Phialemonium obovatum.
AB  - Phialemonium obovatum was found to be the cause of nosocomial osteomyelitis in a
      41-year-old man after sustaining a nonpenetrating injury to his lumbar and
      cervical region. Histologic examination of fragments of disk and bone from L3-4
      hemilaminectomy showed multiple fragments of fibrocartilage with focal necrosis,
      chronic inflammation, and granulation tissue formation. Sections stained with
      Gomori's methenamine silver procedure showed multiple fungal elements in necrotic
      areas consisting of irregularly branched, hyaline septate hyphae having swollen
      cells, and occasional yeastlike cells. The use of Fontana-Masson silver stain
      showed the presence of melanin in cells walls and septa of the hyphae.
      Phialemonium obovatum was isolated when the ground tissue from disk and bone from
      L3-4 was cultured on biphasic brain-heart infusion medium. Colonies were moist,
      off-white to ochraceous with a characteristic green, diffusible pigment on the
      reverse side. The isolate grew well up to 40 degrees C. It formed characteristic
      adelophialides without conspicuous collarettes and basal septa and produced
      smooth, one-celled, hyaline, and obovate conidia.

PMID- 8343051
TI  - Plasma cell leukemia presenting as a pancreatic mass.
AB  - A 62-year-old woman presented with a 3-week history of obstructive jaundice.
      Computed tomography of the abdomen showed marked enlargement of the head of the
      pancreas and a prominent pancreatic body, suggestive of a neoplasm with
      associated pancreatitis. The peripheral blood showed an increased number of
      plasma cells accounting for 50% of the leukocytes. Biopsy specimens of the
      pancreas, liver, and a peritoneal lymph node showed a diffuse infiltrate of
      typical and atypical plasma cells (50% of which had cytoplasmic IgG-lambda).
      Serum and urine protein electrophoresis revealed a monoclonal IgG-lambda spike
      and Bence Jones-lambda protein, respectively. The bone marrow was diffusely
      infiltrated by plasma cells. To our knowledge, this is the first reported case of
      a plasma cell leukemia presenting as a pancreatic mass producing extrahepatic
      biliary obstruction.

PMID- 8343052
TI  - Adnexal tumor and a pigmented nevoid lesion in a benign cystic ovarian teratoma.
AB  - We describe a case of an unusual adnexal lesion and concurrent collections of
      dendritic melanocytes of the type occurring in a blue nevus in a mature cystic
      teratoma of the ovary. To our knowledge, there have been no previous reports of
      benign skin adnexal tumors in an ovarian dermoid cyst. This rarity would indicate
      that the cutaneous adnexal tissue in a benign teratoma is not unduly prone to
      undergo further more-specialized secondary tumorigenesis. The combination of the
      three benign lesions is therefore probably purely coincidental.

PMID- 8343053
TI  - Fusiform dilatations of the esophagus secondary to protracted distention and
      emetogenic injury.
AB  - We report the case of a 74-year-old woman who presented with a 2-year history of
      dysphagia, weight loss, nausea, and vomiting. She was diagnosed as having
      secondary achalasia due to external compression probably by a tumor of the lower
      part of the esophagus. At autopsy, however, no tumor was found at that site,
      whereas a pancreatic microcystic serous adenoma and multiple gastric leiomyomata-
      one of which occupied the pyloric sphincter area leading to gastric outlet
      obstruction--were noted. The esophagus displayed two fusiform dilatations located
      at the lower and midportions, the latter being associated with rupture and
      necrosis of the muscularis and adventitial wall layers. The lower dilatation
      showed only attenuation of the muscularis, without necrosis. The epithelium was
      intact in both dilatations. This was an unusual series of pathogenetic events,
      leading from gastric outlet obstruction to secondary achalasia and protracted
      vomiting, followed by spontaneous partial esophageal wall rupture (a variant of
      intramural hematoma) or atrophy of the muscularis, morphologically evident as
      fusiform dilatations.

PMID- 8343054
TI  - Lymphoproliferative process with natural killer cell phenotype. Histopathologic,
      ultrastructural, and surface marker observations.
AB  - We describe the clinical, structural, and immunophenotypic characteristics of a
      lymphoproliferative process characterized by persistent thrombocytopenia and
      prominent involvement of the spleen and, to a lesser degree, the liver. The
      proliferating cells lacked cytoplasmic azurophilic granules by light microscopy
      and on ultrastructural examination displayed prominent interdigitating cell
      processes and did not contain parallel tubular arrays. Immunophenotypically, the
      cells displayed markers of true natural killer cells (positive CD2, CD56, CD45,
      CD7, CD16, and CD33). No involvement of peripheral blood or bone marrow was
      detected. This case represents a proliferation of true natural killer cells
      probably arising in the spleen. The relationship of this process to other
      lymphoid proliferations at different sites with true natural killer cell or
      natural killer-like activity is unknown.

PMID- 8343055
TI  - Delayed sequelae of penetrating cardiac injury.
AB  - OBJECTIVE: We studied delayed or residual manifestations of penetrating cardiac
      injury in patients to determine the incidence, type, management, and outcome.
      BACKGROUND: Penetrating cardiac injury is associated with a high mortality
      despite improvement in management in recent years. Secondary lesions that are
      usually not looked for at the time of initial surgery are diagnosed and repaired
      postoperatively. DESIGN: Retrospective study. SETTING: The study was conducted at
      a major urban trauma center. PATIENTS: Forty-eight survivors of 71 penetrating
      cardiac injuries were treated during a 10-year period from 1980 to 1990. RESULTS:
      Delayed sequelae were diagnosed in 11 patients (23%) during the postoperative
      period. There were five ventricular septal defects, two aortic valvular injuries,
      one atrial septal defect, two conduction defects, and one tricuspid valvular
      lesion. All lesions were repaired electively with 100% survival. CONCLUSION: We
      found residual or delayed sequelae in 23% of our patients. Close follow-up and
      utilization of diagnostic studies, including two-dimensional echocardiography
      during the early postoperative period, can identify late sequelae and allow
      elective repair.

PMID- 8343056
TI  - Splenic abscess in the intensive care unit.
AB  - BACKGROUND AND METHODS: From 1980 through 1990, nine patients developed de novo
      splenic abscess during their stay in our intensive care unit (ICU), representing
      the first series of such reported cases. RESULTS: All nine patients were septic
      prior to the diagnosis of splenic abscess. The signs and symptoms of splenic
      abscess commonly described in the literature were of little help in detecting
      this pathology in ICU patients. Mean +/- SD platelet count, however, increased
      significantly, from 274 x 10(9)/L +/- 50 x 10(9)/L at admission to 647 x 10(9)/L
      +/- 94 x 10(9)/L at diagnosis. At diagnosis, left pleural effusion was present in
      all patients. Only three patients had detectable left upper quadrant tenderness.
      Abdominal computed tomographic scans, when used, were diagnostic in all cases.
      All patients were treated by splenectomy; eight had a solitary abscess. Six
      abscesses were caused by enteric organisms, two by Staphylococcus aureus, and one
      by Streptococcus epidermidis. Eight patients (89%) had had the offending organism
      previously isolated from their blood or from another infected site. Mortality was
      45%. CONCLUSIONS: Splenic abscess, although a rare clinical entity, does occur de
      novo in ICU patients and is associated with significant mortality. Unexplained
      thrombocytosis in a septic ICU patient with persistent left pleural effusion is
      suggestive of splenic abscess. Previous culture and sensitivity results are
      useful in guiding perioperative antibiotic choices.

PMID- 8343057
TI  - Ovarian neoplasms in children.
AB  - OBJECTIVE: To review the clinical presentation, treatment, and outcome in a
      series of children with ovarian neoplasms. DESIGN: A retrospective review of the
      medical records in a case series of 29 girls with ovarian neoplasms. The length
      of follow-up ranged from 6 months to 7 1/2 years and averaged 3.0 years in the
      girls with malignant tumors. SETTING: The patients were treated at a large
      referral children's hospital. PATIENTS: Twenty-nine girls with ovarian neoplasms
      were treated from 1976 to 1992. The average age of the patients was 10 years and
      ranged from 2 to 16 years. MAIN OUTCOME MEASURES: The principal outcomes examined
      were mortality and surgical morbidity. RESULTS: The most common presenting
      symptoms for these ovarian tumors in pediatric patients included chronic
      abdominal pain, an abdominal mass, or distention. Three girls presented with
      precocious puberty or hirsutism. In 27 cases, the tumor was a primary ovarian
      lesion. In two patients, the ovarian mass was the presenting finding for a stage
      IV non-Hodgkin's lymphoma. Seventeen tumors were benign and 12 were malignant.
      Tumors originating from the germ-cell line predominated (n = 17). Seven of the 10
      ovarian malignant neoplasms were stage I at the time of diagnosis. All but one of
      the girls with malignant tumors received either adjunctive radiation therapy or
      multiple-agent chemotherapy. Two girls with sex cord/stromal cell tumors who
      presented with stage I disease ultimately developed widespread metastases. Both
      girls with large epithelial tumors survived. All of the girls with benign tumors
      and seven (70%) of 10 with malignant lesions survived. CONCLUSION: Ovarian tumors
      are unusual lesions in the pediatric population. Unlike in adults, such neoplasms
      generally originate from the germ-cell line. Whereas most ovarian tumors in girls
      are benign, some children have malignant tumors that are very aggressive and do
      not respond well to adjuvant therapy. In particular, malignant sex cord/stromal
      cell tumors, even when they present at an early stage, may behave unpredictably.

PMID- 8343058
TI  - Thymectomy for myasthenia gravis.
AB  - OBJECTIVES: To assess the change in clinical status of patients with generalized
      myasthenia gravis treated with thymectomy and to identify prognostic variables
      that may be of significance in optimizing patient selection. DESIGN:
      Retrospective review. Mean follow-up period was 41 months. SETTING: Large
      community hospital. PATIENTS: Thirty-seven patients (11 male and 26 female) with
      generalized myasthenia gravis who were referred for thymectomy if they were
      refractory to medical treatment or had a thymoma. This represents all patients
      undergoing thymectomy for myasthenia gravis between January 1982 and December
      1991. INTERVENTIONS: Each patient underwent staging before and after thymectomy
      using a modified Osserman classification. Medication requirements were also
      recorded. All patients underwent transsternal thymectomy and complete mediastinal
      dissection. MAIN OUTCOME MEASURES: Changes in clinical stage and medication
      requirement before and after thymectomy; effect of patient age, sex, duration of
      disease, stage of disease, antibody status, histologic characteristics of the
      thymus, and duration of follow-up on outcome. RESULTS: Improvement after
      thymectomy was noted in all 37 patients. Complete remission was achieved in three
      patients (8%) and pharmacologic remission in 23 (62%). The remainder improved in
      stage, medication requirement, or both. Patients in preoperative stages IIb and
      IIc showed the greatest improvement. Age, sex, duration of disease, antibody
      status, histologic characteristics of the thymus, and duration of follow-up were
      not significant factors in assessing improvement. CONCLUSIONS: Transsternal
      thymectomy was found to be beneficial to all patients with generalized myasthenia
      gravis. Complete or pharmacologic remission was achieved in most patients (70%)
      following the procedure. Patients in preoperative stages IIb and IIc showed the
      greatest degree of postoperative improvement.

PMID- 8343059
TI  - Effect of lithium on incorporation of bromodeoxyuridine and tritiated thymidine
      into human parathyroid cells.
AB  - OBJECTIVE: To measure lithium chloride-stimulated incorporation of tritiated
      thymidine (3H-TdR) and bromodeoxyuridine (BrdU) by human parathyroid cells as an
      indicator of lithium's growth-promoting properties. DESIGN: Cell suspensions
      derived from abnormal human parathyroid tissue were incubated for 5 days with
      graded concentrations of lithium and pulsed with either 0.074 MBq of 3H-TdR or
      0.6 microgram of BrdU. The 3H-TdR incorporation was measured by counting cell
      filtrates in a beta counter, and nuclear BrdU incorporation was determined by
      counting nuclei positively stained by an antibody to BrdU. Counts of BrdU
      positive cells by two observers unaware of incubation conditions were correlated
      with 3H-TdR counts. RESULTS: Cell suspensions derived from adenomatous and
      hyperplastic parathyroid glands demonstrated a dose-related increase in 3H-TdR
      incorporation. There was close correlation between the two observers' counts of
      BrdU-positive cells (r = 0.70, P = .01) and between each observer's counts and 3H
      TdR counts (r = 0.70, P = .02, and r = 0.90, P = .01, respectively). CONCLUSIONS:
      Lithium stimulates in vitro incorporation of 3H-TdR and BrdU by abnormal human
      parathyroid cells, consistent with a growth-promoting effect.

PMID- 8343060
TI  - Preoperative pulmonary function evaluation for laparoscopic cholecystectomy.
AB  - OBJECTIVE: Hypercarbia with respiratory acidosis is a recognized complication of
      laparoscopic cholecystectomy. This study was performed to identify preoperatively
      those patients who may develop hypercarbia and acidosis during the procedure.
      DESIGN: Retrospective analysis of preoperative variables. PATIENTS: Thirty-one
      consecutive patients underwent laparoscopic cholecystectomy at one institution
      who were receiving both preoperative pulmonary function tests and arterial blood
      gas analysis. RESULTS: More than 80 demographic, laboratory, and perioperative
      variables were entered into a univariate analysis to identify predictors of
      intraoperative acidosis (pH, < 7.35). Patient age, duration of the procedure, and
      preoperative blood gas values were not predictors of intraoperative acidosis.
      Several univariant predictors for patients experiencing carbon dioxide
      pneumoperitoneum-induced hypercarbia were identified; these included an elevated
      American Society of Anesthesiologists classification and significant decreases in
      forced expiratory flow at 25% of maximum, maximal forced expiratory flow, maximal
      voluntary ventilation, vital capacity, inspiratory capacity, and diffusing
      capacity of the lung for carbon monoxide. CONCLUSIONS: This study suggests that
      neither age nor preoperative arterial blood gas values are predictive of
      intraoperative hypercarbia and acidosis during periods of carbon dioxide
      pneumoperitoneum. However, preoperative pulmonary function measures of decreased
      flow, limited capacity, and compromised diffusion do correspond to the
      development of intraoperative acidosis. Preoperative evaluation with pulmonary
      function tests demonstrating forced expiratory volumes less than 70% of predicted
      values and diffusion defects less than 80% of predicted values can identify those
      patients who are at risk of developing hypercarbia and acidosis.

PMID- 8343061
TI  - Prospective assessment of functional results after ileal J pouch-anal restorative
      proctocolectomy.
AB  - OBJECTIVE: To document the functional results of 50 consecutive patients who
      underwent hand-sewn ileal J pouch-anal restorative proctocolectomy for ulcerative
      colitis between 1988 and 1991 (mean follow-up, 18.1 months; range, 6 to 48
      months). DESIGN: Patients recorded their observations daily over 1 week. The
      patients completed these weekly diaries every 3 months for the first year and
      then at 18, 24, 36, and 48 months after ileostomy closure. STUDY PARTICIPANTS:
      Fifty patients (mean age, 31 years; 24 males). SETTING: The University of Chicago
      (Ill). RESULTS: Stool frequency at 3, 6, 12, and 24 months was 6.3 +/- 2.1, 5.5
      +/- 2.4, and 5.1 +/- 1.9, and 5.9 +/- 1.6 per day, respectively, without urgency.
      Fifty-four percent were perfectly continent; 18% had occasional spotting (one or
      two leaks per week); 12% had minor leakage (three to seven per week); and 16% had
      major leakage (more than seven per week). In these three groups, loss of solid
      feces never occurred in 84%, 88%, and 65% of patients, respectively. Females had
      more severe incontinence than males, but continence improved over time for both
      sexes. Twenty-two percent of female patients developed dyspareunia; no males
      developed impotence, but 19% had retrograde ejaculation. The probability of
      experiencing pouchitis increased with time from 15% at 6 months to 40% at 12
      months, and 50% after 24 months. CONCLUSIONS: These results represent an accurate
      assessment of patient function after ileal J pouch-anal anastomosis. We encourage
      the use of a prospective, patient-completed protocol to obtain a realistic
      assessment of functional results.

PMID- 8343062
TI  - Transdiaphragmatic approach to the posterior mediastinum and thoracic esophagus.
AB  - OBJECTIVE: Complex operations involving the lower esophagus and posterior
      mediastinum are frequently compromised by poor exposure, thereby requiring
      combined thoracic and abdominal incisions. We describe our technique and report
      our experience with a transdiaphragmatic approach to the posterior mediastinum
      that improves exposure and eliminates the need for thoracotomies. PATIENTS: The
      lower thoracic esophagus and posterior mediastinum were exposed through a
      semicircular incision in the central tendon of the diaphragm. The indications for
      operation in 14 patients were benign conditions of the lower esophagus (reflux
      esophagitis, lye stricture, scleroderma, and achalasia) (n = 8), malignant
      neoplasm of the lower esophagus (n = 3), and revagotomy (n = 3). RESULTS: All
      indicated procedures, resections, and esophagogastric, esophagojejunal, or
      esophagocolonic anastomoses were completed through abdominal and/or cervical
      incisions. There were no thoracotomies performed. CONCLUSIONS: We believe this
      transdiaphragmatic approach greatly improves exposure to the lower and middle
      esophagus and posterior mediastinum compared with transhiatal approaches;
      preserves the integrity of the gastroesophageal junction; allows easy access to
      the vagus nerves without risking esophageal injury in patients who had undergone
      surgery previously; shortens operative time; and lessens pulmonary morbidity and
      decreases patients' pain and recovery time when compared with thoracotomy.

PMID- 8343063
TI  - Orotracheal intubation in trauma patients with cervical fractures.
AB  - OBJECTIVE: To evaluate orotracheal intubation with in-line stabilization of the
      cervical spine for emergency airway treatment of trauma patients with cervical
      spine injuries. DESIGN: Of 7518 trauma patients examined, 81 patients with
      cervical spine injuries received emergency orotracheal intubation. All
      intubations were performed by experienced anesthesiologists, with a separate
      individual maintaining in-line stabilization. Neurologic examination was
      documented before and after intubation. RESULTS: Peripheral neurologic deficit
      was present from the outset in 20 patients. There were unstable cervical
      fractures in 38 patients with no neurologic deficit. Twenty-three patients were
      neurologically intact with fractures that were later judged stable. In no
      instance was there a deterioration of neurologic status following intubation.
      Peripheral neurologic deficits improved after intubation in four patients.
      CONCLUSION: Orotracheal intubation, performed with manual in-line stabilization
      by trained and experienced personnel, is a safe emergency procedure in patients
      with cervical fractures.

PMID- 8343064
TI  - Intermittent sequential pneumatic compression in prevention of venous stasis
      associated with pneumoperitoneum during laparoscopic cholecystectomy.
AB  - OBJECTIVES: To determine whether pneumoperitoneum and reverse Trendelenburg's
      position used during laparoscopy impede common femoral venous flow and whether
      calf-length intermittent sequential pneumatic compression (ISPC) overcomes this
      impedance. DESIGN: Using Doppler ultrasonography, peak systolic velocities in the
      common femoral vein were measured in patients undergoing laparoscopic
      cholecystectomy with peritoneal insufflation of carbon dioxide. Measurements were
      obtained during three intervals: preoperatively with the patients in the supine
      position; after induction of general anesthesia with the patients in the supine
      position; and after insufflation to 13 to 15 mm Hg with the patients in the 30
      degrees reverse Trendelenburg position (both with and without ISPC). Mean
      arterial pressure and heart rate were obtained concurrently. Measurements of
      preoperative and postoperative calf and thigh circumferences were obtained.
      SETTING: A tertiary care center. PATIENT PARTICIPANTS: A consecutive sample of 20
      patients 30 to 70 years of age (15 women and five men) who underwent laparoscopic
      cholecystectomy and met the inclusion criteria. MAIN OUTCOME MEASURES: Peak
      systolic velocity, mean arterial pressure, heart rate, and calf and thigh
      circumferences. RESULTS: The combination of pneumoperitoneum to 13 to 15 mm Hg
      and a 30 degrees reverse Trendelenburg position significantly decreased peak
      systolic velocity in the common femoral vein from a preoperative mean of 0.24 +/-
      0.025 m/s to 0.14 +/- 0.011 m/s, or a 42% decrease. Intermittent sequential
      pneumatic compression reversed that effect, returning peak systolic velocity to
      0.27 +/- 0.021 m/s. The mean difference between preoperative peak systolic
      velocity and peak systolic velocity with a combination of pneumoperitoneum,
      reverse Trendelenburg's position, and ISPC was 0.03 +/- 0.03 m/s but was not
      significant. Anesthesia alone caused a mean increase in preoperative peak
      systolic velocity from 0.24 +/- 0.025 m/s to 0.3 +/- 0.032 m/s. Mean arterial
      pressure levels, heart rate, and calf and thigh circumferences did not change
      significantly. CONCLUSIONS: This study demonstrated a significant reduction in
      common femoral venous flow during laparoscopic cholecystectomy coincident with
      pneumoperitoneum and reverse Trendelenburg's position. Intermittent sequential
      pneumatic compression reversed that effect, returning peak systolic velocity to
      normal.

PMID- 8343065
TI  - Endotoxin stimulates lymphocyte glutaminase expression.
AB  - BACKGROUND/HYPOTHESIS: Glutamine is the principal fuel used by lymphocytes. It is
      hydrolyzed by the glutaminase enzyme, which regulates the rate of intracellular
      glutamine metabolism. Since lymphocyte glutamine utilization is increased during
      infection to support cellular proliferation, we hypothesized that endotoxin
      regulates lymphocyte glutaminase expression at the molecular level. METHODS:
      Adult rats received Escherichia coli endotoxin (one dose of 7.5 mg/kg) or saline.
      Total RNA from lymphocytes in the ileocolic lymph node chain was extracted for
      Northern hybridization and labeled with an alpha-phosphorus 32 rat glutaminase
      cDNA probe. The mRNA of the constitutively expressed gene beta-actin was the
      control for RNA loading. Quantitation of glutaminase transcripts was determined
      by densitometric scanning and values were normalized to actin. Glutaminase
      specific activity (nanomoles per milligram of protein per hour) and glutaminase
      kinetic parameters were also determined. RESULTS: Treatment with a single dose of
      endotoxin resulted in a 53% increase in glutaminase activity at 4 hours. Kinetic
      analysis showed that the increase in glutaminase activity was due to an 84%
      increase in Vmax (maximal enzyme velocity) with no change in Km (enzyme
      affinity). Endotoxin increased glutaminase mRNA twofold at 2 hours and more than
      fourfold at 4 hours. The increase in message preceded the increase in activity
      consistent with gene transcription prior to enzyme biosynthesis.
      CONCLUSION/CLINICAL RELEVANCE: The increase in glutaminase activity provides
      lymphocytes in the mesenteric lymph nodes with more glutamine for energy and
      cellular proliferation during times of infection when the gut mucosal barrier may
      become compromised.

PMID- 8343066
TI  - The history of the surgical treatment of portal hypertension.

PMID- 8343067
TI  - Suppression of proliferation of a human B-cell leukaemic cell line derived from
      acute lymphoblastic leukaemia by soluble factor(s) from Campylobacter rectus.
AB  - Soluble sonic extracts of several strains were examined for their ability to
      alter proliferation of a cell line derived from acute lymphoblastic leukaemia
      (BALL-1). Extracts of all strains tested caused dose-dependent suppression of
      proliferation when assessed by DNA (tritiated thymidine incorporation), RNA
      (tritiated uridine incorporation) and protein (tritiated leucine incorporation)
      synthesis. There was no effect on the viability of BALL-1 as measured by either
      trypan-blue exclusion or extracellular release of the cytoplasmic enzyme lactate
      dehydrogenase. The suppressive factor(s) was separated in a well-defined peak by
      high-pressure liquid DEAE ion-exchange chromatography, which revealed a single
      active peak with a molecular mass of 48 kDa. Characterization of the peak
      indicated that the suppressive factor(s) was heat labile (activity destroyed at
      80 degrees C) and sensitive to the proteolytic enzyme pronase P. The soluble
      suppressive factor(s) from Campylobacter rectus thus has protein-like properties
      and no cytotoxicity to a human B-cell leukaemic cell line.

PMID- 8343068
TI  - The effect of growth on collagen and glycosaminoglycans in the articular disc of
      the rat temporomandibular joint.
AB  - Newly synthesized collagen and glycosaminoglycans (GAG) were studied in the
      temporomandibular discs of male Sprague-Dawley rats of 3-13 weeks of age. Each
      age group had eight animals and [14C]glycine or [3H]glucosamine were used to
      determine the proportion of newly synthesized type III to type I collagens or the
      proportion of different types of newly synthesized GAGs during 4 h of labelling
      in organ culture. Separation of newly synthesized collagen bands from rat disc by
      sodium dodecyl sulphate-polyacrylamide gel electrophoresis showed a peak in type
      III at the ages of 7 and 8 weeks. Type III collagen synthesis and the rate of
      mandibular growth were strongly related through all ages studied. GAG chains were
      separated by cellulose-acetate electrophoresis. Calculation of
      disintegrations/min per mg of wet disc tissue for each GAG peak showed that
      hyaluronic acid (HA), chondroitin-6-sulphate and keratan sulphate/chondroitin-4
      sulphate (KS/C4S) were the predominant molecules synthesized in the disc. There
      was also a steady increase in newly synthesized HA and C6S synthesis up to 6 and
      7 weeks respectively. Proportions of newly synthesized C4S/KS, HA and C6S were
      significantly higher than those of other GAGs with respect to ageing. From these
      observations it appears that the articular disc shows more of the characteristics
      of cartilage, as evidenced by the increased amounts of C6S and KS/C4S during the
      mandibular growth spurt at the ages of 6 and 7 weeks, similar to that of type III
      collagen. There were also increased amounts of HA, suggesting that during 5-7
      weeks of age the rat disc is undergoing more active remodelling. This study
      provides baseline data for further analysis of the effects of mechanical loading
      and trauma on articular disc responses.

PMID- 8343069
TI  - Difference in chewing patterns between involved and opposite sides in patients
      with unilateral temporomandibular joint and myofascial pain-dysfunction.
AB  - Surface electromyograms (EMG) during maximal clenching and gum and peanut chewing
      were recorded from the temporal and masseter muscles of 30 patients with
      unilateral temporomandibular joint and myofascial pain-dysfunction (TMD). The gum
      chewing integrated EMGs were transformed to a differential Lissajous EMG figure
      (DL-EMG) to facilitate comparison of mastication on the dysfunctional and
      opposite side. Variables, mainly those in the gum-chewing DL-EMG, were
      statistically analysed, and were compared with those of normal subjects. Patients
      were then classified into three types: (1) same side, (2) opposite side and (3)
      intermediate side. Same-side patients chewed peanuts on the dysfunctional side,
      although this side did not necessarily show abnormal behaviour during gum
      chewing. Opposite-side patients chewed peanuts by avoiding the dysfunctional side
      and showed excellent chewing activity on the side opposite the dysfunction.
      Intermediate-side patients had a chewing pattern that was a combination of the
      first two types. The relation between the pain side, the preferred or habitual
      mastication side, and the side showing better mastication in the EMG pattern was
      shown to be important in research on the origin of TMD syndromes. It was
      speculated that in the same-side patients, overwork on the side with the better
      dental condition for chewing was the main cause of the dysfunction, and that so
      called hyperactivity on the dysfunctional side in TMD patients may result from
      habitual unilateral mastication.

PMID- 8343070
TI  - Glucose clearance from different surfaces of human central incisors and first
      molars.
AB  - The study examined the glucose clearance (retention) in saliva at different
      surfaces of these teeth in 23 subjects. The mouth was thoroughly rinsed for 15 s
      with 20 ml of a 0.5 M glucose solution. The concentrations of glucose absorbed by
      small pieces of paper, placed on the mesial, distal, labial (buccal), lingual and
      occlusal surfaces 3 min after rinsing, were measured using an immobilized enzyme
      system and an electrochemical sensor. On the maxillary and mandibular central
      incisors, the glucose concentrations on the labial surfaces were significantly
      higher than on all other surfaces and lowest on the lingual surfaces. In the
      mandibular molars, glucose concentrations were significantly higher on the buccal
      surfaces than on the lingual surfaces. Clear site-specific differences in glucose
      clearance were thus observed at the different tooth surfaces. It is considered
      that the differences in the glucose retention rate might be indicative of factors
      important for the site specificity of dental caries.

PMID- 8343071
TI  - A three-dimensional, finite-element analysis of bone around dental implants in an
      edentulous human mandible.
AB  - The design of dental superstructures influences the loading on dental implants
      and the deformation of the anterior interforaminal bone in an edentulous
      mandible. This deformation causes stress in the bone around the implants and may
      lead to bone resorption and loss of the implant. The stress distribution around
      dental implants in an edentulous mandible was calculated by means of a three
      dimensional, finite-element model of an entire lower jaw. This model was built
      from data obtained from slices of a single human mandible and was provided with
      two endosseous implants in the interforaminal region. The implants were either
      connected with a bar or remained solitary, and were loaded with a horizontal bite
      force of 10 N, a vertical bite force of 35 N, or an oblique bite force of 70 N.
      The most extreme principal stresses in the bone were always located around the
      neck of the implant. Stress around the implant was, therefore, not only caused by
      the local deformation of the bone due to movement of the implant and interface
      relative to the surrounding bone but also by the bending of the mandible. The
      most extreme principal stress was found with oblique bite forces. The highest
      maximum and lowest minimum principal stresses were 7.4 and -16.2 MPa in the model
      without the bar and 6.5 and -16.5 MPa in the model with the bar. When differences
      in the amount of bite force were eliminated, the vertical bite force resulted in
      the lowest stress.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343072
TI  - An electromyographic study of whether the digastric muscles are controlled by jaw
      closing proprioceptors in man.
AB  - Whether in the oral system the digastric muscles (which lack muscle spindles) are
      under the control of proprioceptive information from the masseter muscles (which
      contain muscle spindles) was investigated by analysing whether and how the
      masseters and digastrics showed coordinated behaviour during a static, forceful
      bite. Subjects were asked to maintain a 100-N force for 15 s with and without
      visual guidance; bite force exerted, and masseter and digastric electromyograms
      (EMGs) were recorded. Under visual guidance all subjects co-contracted their
      digastric muscles during the isometric bite. They held the force for a short
      time, followed by periods with fluctuations (peak-to-peak force amplitude about
      15-20 N). Fluctuations in bite force correlated with the masseter EMGs, the
      maximum in the correlogram occurring at about -50 ms with the force lagging the
      masseter. In 75% of the subjects a significant periodic component in the masseter
      and in the force spectra was found at about 4 Hz. This was also seen in the
      amplitude spectra of the forces, which showed in 80% of the subjects a
      significant elevation between 7-10 Hz as well. No correlation between the
      digastric EMGs and the bite forces, and between the EMGs of masseter and
      digastric could be detected. Spectra of digastric EMGs showed no prominent
      maxima. When subjects were deprived of visual feedback, maxima at -50 ms in the
      cross-correlation functions of the masseters and the forces were reduced
      considerably; periodicities of +/- 250 ms disappeared.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8343073
TI  - Urease activity in Streptococcus salivarius at low pH.
AB  - Arginine metabolism to alkali by the arginine deiminase system in oral bacteria
      increases their acid tolerance. The potential of urease activity in Streptococcus
      salivarius to fulfil a similar role was examined. In cell extracts between pH 5.0
      and 8.0, urease activity was over 80% the maximal rate. The urease rate was zero
      at pH 4.3, and at pH 3.6 the enzyme was rapidly inactivated (t 1/2 of 0.6 min).
      The pH range of intact cells was broader. In Strep. salivarius cells acidified to
      pH 2.6 for 5 min, urease was completely retained and the ureolytic pH rise was
      rapid. There was no urease activity after acidification to pH 2. In cells
      acidified to maintain the pH between 3.3 and 4, viability was maintained for a
      short period (extrapolation indicated 20 min) and then decreased. This
      acidification induced alkali generation or acid removal that decreased in
      parallel to loss of viability. A small fraction (10%) of the urease was rapidly
      inactivated, after which both the remaining urease and pH response decreased at a
      similar rate to cell viability (t 1/2 of 15-20 min), but for at least 1 h
      following acidification, a rapid ureolysis induced rise in pH to above 7. In
      cells held at pH 3.6 and treated to compromise their membranes by freeze-thawing
      or transient acidification to pH 2.3, 70-80% of the urease was lost rapidly and
      the remainder inactivated at a rate similar to that in intact cells. Therefore,
      although at pH below 4, S. salivarius urease is outside its pH activity range and
      the free enzyme is rapidly inactivated, intact cells the urease is protected and
      ureolytic generation of ammonia is capable of substantially raising the pH for at
      least 1 h while the cell population is being progressively killed by acid.

PMID- 8343074
TI  - Air blast-induced evaporative water loss from human dentine, in vitro.
AB  - Short air blasts are commonly used to test for dentine sensitivity but their
      mechanism of action is poorly understood. In this study, evaporative water loss
      of teeth in vitro was measured under spontaneous conditions and during air blasts
      from three-way dental air syringes. Air blasts induced a 15-30-fold increase in
      evaporative water loss, which varied inversely with distance from the tooth and
      directly with air temperature. As water evaporation occurs readily across smear
      layers, which greatly impede bulk fluid movement, the use of air blasts may
      overestimate dentine sensitivity. Sustained air blasts may remove enough fluid
      from the pulp-dentine complex to cause disruption of odontoblasts and changes in
      pulpal blood flow.

PMID- 8343075
TI  - Presence but not synthesis of thyrotrophin-releasing hormone in rat salivary
      glands detected by radioimmunoassay and northern blot analysis.
AB  - Thyrotrophin-releasing hormone (TRH) is one of the ubiquitous peptides first
      isolated from hypothalamus. This study sought to examine if it could also be
      detected in rat submandibular salivary glands, as can other neurogastrointestinal
      peptides. Radioimmunoassay of submandibular gland homogenates revealed TRH-like
      immunoreactivity in all samples from male rats (637.34 pg/gland +/- 166.17, n =
      15). In contrast, Northern blot analysis to determine whether the peptide was
      locally synthesized in the glands failed to detect TRH mRNA. Consequently, the
      presence of TRH in the glands (as revealed by radioimmunoassay) could be
      associated with binding to presumptive TRH receptors in the mediation of
      physiological activities.

PMID- 8343076
TI  - Effect of tooth temperature on activities of slowly adapting periodontal
      mechanoreceptors during or after long-lasting strong pressure applied to the cat
      upper canine tooth.
AB  - Periodontal mechanosensitive units (PM units) responsive to mechanical
      stimulation of this tooth were recorded from single fibres isolated from the
      superior alveolar nerve. Mechanical stimulation was applied in a sequence of long
      lasting strong pressure followed by a train of weak stimuli. Temperature was
      changed by perfusing the pulpal cavity of the stimulated tooth with saline
      solution at a temperature of 5-45 degrees C. The response of the PM units
      elicited by strong pressure was initially dynamic and subsequently static. The
      dynamic response was little affected by tooth temperature whereas, the static
      response increased with the rise in temperature. After strong pressure the
      excitability of the PM units was depressed transiently, followed by gradual
      recovery; this depression was especially prominent when tooth temperature was
      high.

PMID- 8343077
TI  - Absence of interaction between the 165-kDa fibronectin-binding protein involved
      in mouse odontoblast differentiation and vinculin.
AB  - Previous data suggested that matrix could control the organization of
      microfilaments in differentiating odontoblasts and that this process involved a
      complex of fibronectin-165-kDa membrane protein-vinculin. The use of two
      different gel systems and microsequence analysis demonstrated that two distinct
      165-kDa proteins interact, one with fibronectin and the other with vinculin.

PMID- 8343078
TI  - Click-evoked oto-acoustic emissions in 1036 ears of healthy newborns.
AB  - Click-evoked oto-acoustic emissions (EOAEs) were recorded in 1036 ears of healthy
      newborns and in 71 normal-hearing adult ears. Newborns aged between 3 and 238 h
      were examined in a separate but not silent room of the obstetric ward. The adults
      were tested in a quiet but not sound-treated room. The recordings were more
      difficult in the newborn than in the adult, which was mirrored in recording
      parameters such as the time required for measurement (up to 7 min in newborns vs.
      1-2 min in adult ears). Recording was always successful in adults, while retests
      were necessary in 4% of newborns. Also the artefact-rejection level and the
      stimulus stability were more favourable in adults. Still, EOAE recording for
      screening purposes in newborns seems feasible. Response levels in newborns (range
      1.6-38.6; mean 20.2 dB SPL) appear to be higher than in adults (range 2.7-20.6;
      mean 12.8 dB SPL). The overall prevalence of EOAEs in newborns amounted to 93.4%
      and appeared to be age related. It rises from 78% in ears from newborns younger
      than 36 h to 99% in ears of newborns older than 108 h. This rise may be related
      to the middle ear clearance of amniotic fluid in the first days post partum. The
      prevalence in newborns older than 3-4 days is comparable with the prevalence of
      97.2% in adults. Therefore, newborns should not be screened before the age of 4
      days. In search of an objective EOAE detection variable, the prevalence of EOAEs
      for different age groups was calculated for various criterion values of
      reproducibility. These prevalences were compared to subjectively scored EOAE
      prevalences in the same age groups. A reproducibility criterion of about 50%
      appears to be useful for mass screening in newborns.

PMID- 8343079
TI  - Effects of noise burst rise time and level on the human brainstem auditory evoked
      response.
AB  - An experiment was conducted to examine the effects of noise burst rise time and
      level on the human BAER. Noise burst levels included 15, 30, 45 and 60 dB nHL,
      with linear rise times of 0, 0.5, 1.25 and 2.5 ms. With increasing noise burst
      level, there is a decrease in wave V latency and an increase in peak amplitude.
      With increasing noise burst rise time, there is an increase in wave V latency and
      a decrease in wave V amplitude. The slope of the latency/intensity function
      increases with increasing rise time. The slope of the latency/rise time function
      increases with decreasing noise burst level. The change in wave V latency
      associated with changing rise time is less than the change in rise time for all
      experimental conditions.

PMID- 8343080
TI  - Correlations between presbyacusis and extrinsic noxious factors.
AB  - As part of the longitudinal gerontological and geriatric population study of 70
      year-olds in Goteborg, Sweden, the possible correlation between presbyacusis and
      extrinsic factors affecting health in elderly persons was investigated.
      Participants from one cohort (F 01) were studied longitudinally at ages 70, 75,
      79 and 85 years, and from another cohort (F 06) at age 70 years. A weak
      correlation between hearing loss and smoking, alcohol abuse and head trauma was
      found for men and between hearing loss and intake of pharmaceutical agents
      (especially salicylates) for women.

PMID- 8343081
TI  - The role of tuning curve variables and threshold measures in the estimation of
      sensory cell loss.
AB  - Auditory-evoked potential tuning curves were collected at six frequencies before
      and 30 days after various noise exposures in 363 chinchillas using a simultaneous
      masking paradigm. Traditional bivariate and multiple linear
      regression/correlation analyses were performed in an effort to determine the
      extent to which sensory cell damage could be estimated from a knowledge of
      audiometric and tuning curve variables. The results showed strong correlations
      between percent outer hair cell (%OHC) loss and permanent threshold shift (PTS)
      and between %OHC loss and the tuning curve variables Q10 dB and high- and low
      frequency slopes (SHF, SLF). The correlations were strongest between PTS and %OHC
      loss. However, the proportion of variability (r2) in %OHC loss attributable to
      variability in the predictor variable(s) (i.e., PTS) could be increased
      significantly by adding the Q10 dB of the tuning curve whose probe frequency was
      centered in the octave band length of the cochlea corresponding to the frequency
      at which the PTS occurred. The r2 values could be further increased by including
      audiometric and tuning curve variables from frequencies adjacent to the octave
      band being evaluated.

PMID- 8343082
TI  - Age-associated degeneration of backward masking task performance: evidence of
      declining temporal resolution abilities in normal listeners.
AB  - A backward masking paradigm was employed to investigate temporal resolution
      capabilities in normal-hearing subjects of increasing chronological age. Results
      have documented: (1) a 2-, 4-, 8-, and 11-fold decibel magnitude difference for
      averaged psychoacoustic functions when comparing data obtained from young adults
      to those of elderly listeners; (2) that backward masking function slopes become
      significantly steeper with age, especially at very short interstimulus intervals;
      (3) a significant interaction between age and target frequency; (4) a linear age
      associated decrement in presumed temporal resolution abilities, and (5) no
      significant target frequency difference nor any ear differences existed. Both end
      organ and central nervous system mechanisms were considered in explaining these
      findings.

PMID- 8343083
TI  - Recent developments in diagnosis of exotic disease at the Australian Animal
      Health Laboratory.

PMID- 8343084
TI  - Nutrient intake of horses in thoroughbred and standardbred stables.
AB  - Twenty-five Thoroughbred (TB) and 25 Standardbred (SB) stables were visited to
      determine their feeding practices. The ingredients of the main feed of the day
      for a mature gelding of average size in full training were weighted at each
      stable. Nutrient content of diets was calculated using published data for the
      individual ingredients. Results are expressed as mean +/- sd. The estimated body
      weight of TB horses was 493 +/- 34 kg and 437 +/- 32 kg for SB horses. There was
      considerable variation in diet composition and nutrient intake between stables.
      The TB trainers fed 11.0 +/- 2.4 kg and SB trainers 11.8 +/- 2.5 kg per day. The
      concentrate component of the diet weighed 7.8 +/- 1.6 and 7.7 +/- 2.3 kg for TB
      and SB stables, respectively, and the roughage component for TB horses 3.3 +/-
      1.4 and SB horses 4.1 +/- 1.4 kg per day. The digestible energy intake of horses
      at TB stables was 129 +/- 29 MJ per day and at SB stables 132 +/- 31 MJ per day.
      Crude protein intake of TB horses was 1452 +/- 363 g and SB horses 1442 +/- 338 g
      per day. There were differences in some feeding practices at TB and SB stables.
      Standardbred trainers fed more roughage than TB trainers. Standardbred trainers
      fed chaffed lucerne (alfalfa) and cereal hays as the major roughage, whereas TB
      trainers fed more hay. The major hay type fed by TB trainers was lucerne, whereas
      many SB trainers preferred clover hay. Both trainers fed oats as the major grain,
      but TB trainers fed slightly more maize (corn) than SB trainers.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8343085
TI  - Identification of galegine, an isoprenyl guanidine, as the toxic principle of
      Schoenus asperocarpus (poison sedge).
AB  - An isoprenyl guanidine, galegine, was isolated from the Western Australian sedge
      Schoenus asperocarpus (Cyperaceae). Synthetic galegine was shown to reproduce the
      clinical and pathological features of poisoning by this plant. Preliminary
      results suggest that the massive thoracic effusion observed in sedge poisoning is
      the result of a direct effect on pulmonary vascular permeability.

PMID- 8343086
TI  - Treatment with vitamins A, D and E did not reduce weight loss in transported
      cattle.
AB  - Two field trials using an injectable vitamin A, D and E solution conducted in the
      pastoral environment of northern Australia are described. It was found that
      treatment of lighter (< 150 kg) or heavier (> 372 kg) weight cattle did not
      reduce weight loss during road transport. These findings contradict anecdotal
      evidence of reduced weight loss during transport with the use of vitamins A, D
      and E. The lack of scientific basis for their use is discussed.

PMID- 8343087
TI  - Chlamydiosis in workers at a duck farm and processing plant.
AB  - An outbreak of chlamydiosis was investigated in workers at a duck farm and
      processing plant during winter 1989. Chlamydia psittaci was isolated from ducks,
      but there was little evidence of clinical chlamydiosis in the ducks. Serological
      tests showed that 76% of workers had been exposed to infection, 12% recently, 16%
      had not been exposed and 8% had inconclusive test results. There was a strong
      association (P < 0.05) between years of employment and exposure to infection.
      Infection appeared to be contracted during the first year of employment. Measures
      were implemented to reduce shed contamination and control rodents and wild birds.
      At the same time, ducks were medicated, the processing plant was modified, work
      practices were altered and workers were advised about chlamydiosis to reduce the
      risk of human infection.

PMID- 8343088
TI  - Efficacy of ivermectin jetting fluid against strike by some primary and secondary
      blowflies of sheep.
AB  - Merino sheep, which were hand jetted with ivermectin jetting fluid, and untreated
      sheep were challenged with larval implants of Lucilia cuprina, Lucilia sericata,
      Calliphora nociva and Chrysomya rufifacies at intervals of about 2 weeks from 6
      to 16 weeks after treatment. Both Lucilia species produced strike rates of about
      90% in untreated sheep; the respective rates were lower for Chr rufifacies (55%)
      and C nociva (60%). Strike rates for the treated group were about 17, 11, and 9%
      for L cuprina, L sericata, and Chr rufifacies, respectively. Only 1 implant site
      in the treated group was struck by C nociva. Treated sheep had significantly (P <
      0.01) longer time to first strike than did untreated ones for each species of
      fly. L sericata, Chr rufifacies, and C nociva larvae implanted on treated animals
      had significantly (P < 0.05) longer time to first strike than did L cuprina
      larvae.

PMID- 8343089
TI  - Efficacy of ivermectin as a pour-on formulation for control of buffalo fly.

PMID- 8343090
TI  - Feeding practices in thoroughbred and standardbred racehorse stables.

PMID- 8343091
TI  - Anthelmintic activity of milbemycin oxime against adult and immature Uncinaria
      stenocephala in dogs.

PMID- 8343092
TI  - Experimental tunicamycin toxicity in cattle, sheep and pigs.

PMID- 8343093
TI  - Susceptibility of freshly-mulesed lambs to flystrike and the effectiveness of
      propetamphos as a wound dressing.

PMID- 8343094
TI  - Sheep-adapted Anaplasma marginale maintains virulence for cattle.

PMID- 8343095
TI  - Spironucleus muris in laboratory mice.

PMID- 8343096
TI  - Lack of association between abortion and blood ammonia and methaemoglobin
      concentrations in dairy cows grazing improved pastures on the Atherton Tableland.

PMID- 8343097
TI  - The efficacy of ivermectin topically applied to cattle for control of adult
      buffalo flies (Haematobia irritans exigua).

PMID- 8343098
TI  - Developmental issues in social-skills assessment and intervention with children
      and adolescents.
AB  - In recent years, social-skills training has become an increasingly common
      intervention. Recipients of skill training programs have included children of all
      ages as well as adults, yet relatively few systematic attempts have been made to
      incorporate developmental considerations into program design and evaluation.
      Developmental research indicates that significant normative changes take place
      during the preschool, grade school, and adolescent years in domains such as the
      complexity of children's social reasoning, the focus and duration of their peer
      interactions, the nature of peer-approved (and disapproved) behaviors, the
      organization of the peer group, and the extent and nature of peer influence.
      Although a full understanding of the impact that these developmental changes may
      have on the effectiveness of various social-skills interventions awaits future
      research, the potential implications are numerous. In this article, developmental
      changes in children's peer relationships are reviewed. The implications that
      these changes may have for the assessment of social skills, for the design of
      skill training programs, and for future research are discussed.

PMID- 8343099
TI  - Assessing acceptance and social skills with peers in childhood. Current issues.
AB  - This article reviews current strategies for assessing social skills with peers in
      childhood, highlighting contemporary unresolved issues in identifying children
      who need intervention, selecting target behaviors, and assessing treatment
      outcome. Sociometric measures of peer acceptance are also considered. Although
      many current measures of social skills have adequate evidence of reliability and
      convergent validity, assessment could benefit from (a) increased documentation
      that the content of measures assesses important skills in relating to peers, (b)
      improved methods for assessing social behavior in specific interpersonal
      situations, and (c) more empirical evidence that indirect assessment methods
      (self-report, peer assessment, and teacher report) and analogue observations
      reflect in vivo behavior.

PMID- 8343100
TI  - Social skills interventions for children.
AB  - Children who exhibit social skills deficits experience short-term, and often long
      term, negative consequences. Reasons for such deficits, which have treatment
      utility, are reviewed and a number of procedures for treating children's social
      skills deficits are examined. In this article, these procedures are categorized
      into one of three broad and somewhat overlapping treatment approaches: operant
      conditioning, social learning, or cognitive-behavioral procedures. Descriptions
      of specific treatment procedures are provided, along with an examination of the
      effectiveness data, to support the various approaches to enhancing children's
      social behavior. The research literature provides strong support for the use of
      operant and social learning techniques, particularly with preschool and
      elementary school children.

PMID- 8343101
TI  - Social-skills interventions with adolescents. Current issues and procedures.
AB  - During adolescence, the interpersonal interactions and behaviors necessary for
      successful social functioning become increasingly complex. In recent years,
      social-skills training with adolescents has made a variety of advances beyond
      basic skill acquisition toward techniques designed to promote generalization and
      maintenance of an effective interpersonal repertoire. This article reviews
      relevant empirical literature for current issues and procedures in social-skills
      training with adolescents, including use of social-skills interventions for a
      variety of adolescent populations and problems, use of innovative and promising
      intervention procedures, and issues regarding generalization and social validity
      of intervention procedures.

PMID- 8343102
TI  - Assessing and enhancing generalization and social validity of social-skills
      interventions with children and adolescents.
AB  - Generalization and social validity are necessary aspects of any applied behavior
      analytic endeavor. They are especially critical to social-skills training
      research and practice. Investigators have demonstrated the effectiveness of
      various learning theory-based interventions in teaching social skills to and
      increasing peer interactions of children with and without disabilities. However,
      development of a technology for reliably transferring these changes across
      different situations or ensuring their persistence over time has proven to be
      more problematic. From both a conceptual and empirical standpoint, this article
      reviews progress in and barriers to assessing and enhancing generality of social
      behavior change and its relationship to social validity. If progress is to be
      made, then it will be necessary to (a) distinguish between generalization and
      generality in developing and evaluating social-skills interventions; (b) expand
      the concept of social validity to give more emphasis to objective measurement of
      social skills, interventions, and outcomes; and (c) pursue a systematic analysis
      of generality- and durability-programming tactics.

PMID- 8343103
TI  - [Immunology of the mammary gland of cattle].
AB  - A successful control of udder diseases in dairy cattle widely depends on the
      knowledge of the mammary gland immune functions. They are responsible not only
      for the self-protection of this organ but also for the supply of the newborn with
      immunoprotective substances of humoral and cellular character. In the mammary
      gland, selected immunology methods may be used in the diagnosis of both local and
      systemic function disorders. Such evaluation represents a necessary prerequisite
      for a possible treatment by immunomodulators.

PMID- 8343104
TI  - [The effect of parenteral administration of 25-hydroxycholecalciferol and 1 alpha
      hydroxycholecalciferol on the mineral concentrations in the blood of cows in late
      pregnancy].
AB  - The effect of 1 - 3 intramuscular injections of the vitamin D3 metabolite 25
      OHD3, synthetic 1 alpha-OHD3, and a combination of both on the plasma
      concentrations of calcium (Ca), inorganic phosphate (P(i)) and magnesium (Mg) was
      tested in 67 older dry dairy cows. Administering 4,0 mg 25-OHD3 reduced Ca and
      P(i) for some time while Mg blood levels remained constant. Injecting 210
      micrograms 1 alpha-OHD3 plus 2.0 mg 25-OHD3 only brought a marked increase in
      P(i) concentrations, whereas 420 micrograms 1 alpha-OHD3 plus 4.0 mg 25-OHD3, and
      350 micrograms 1 alpha-OHD3 alone significantly raised Ca and P(i) levels
      beginning on the 2nd day after injection and lasting for at least 6 days. These
      higher levels can be maintained by repeated injections. Another effect of
      injecting 1 alpha-OHD3 was to depress Mg blood levels, and a negative effect on
      the Ca and vitamin D3 metabolism is suggested which may cause hypocalcaemia when
      the effect of 1 alpha-OHD3 subsides. Metastatic calcifications of soft tissues
      were observed in some 1 alpha-OHD3-treated cows.

PMID- 8343105
TI  - [Does the administration of derivatives of vitamin D to dairy cows in late
      pregnancy for the prevention of parturient paresis affect the maternal-fetal
      mineral metabolism?].
AB  - Intramuscular injection of 1 alpha-hydroxyvitamin D3 (with or without 25
      hydroxyvitamin D3) to highly pregnant dairy cows caused a significant increase of
      ionized calcium in blood and of total calcium and inorganic phosphate with a
      concomitant decrease of magnesium in blood plasma 3,5 +/- 1,9 days later (resp.
      12-48 h a.p.). This brought about a higher Ca level at parturition preventing
      parturient paresis. The changes of maternal mineral and vitamin D status had no
      effect on the mineral concentrations of blood in newborn calves. However, the
      increase in calcium and phosphate concentrations in maternal blood after
      injection was accompanied by an increase of the minerals in the amniotic fluid
      reflecting their strong reciprocal exchange. On the other hand, the composition
      of allantoic fluid showed no significant changes. Therefore, analysis of both
      fetal fluids does not refer to disorders of fetal mineral metabolism. As a
      consequence, there seems to be no potential risk of intoxication after a
      prepartal injection of the substances to the mother for their offspring.

PMID- 8343106
TI  - [Detection of toxin-producing types of Pasteurella multocida--a comparison of
      methods].
AB  - 28 Pasteurella multocida strains were examined for production of toxin by 6
      different methods. Identical results were obtained using a mice lethality test, a
      tissue cell culture assay and an ELISA. Different results were received with a
      dot-blot-immunoassay (1 strain), using a gene probe (6 strains) and a guinea pig
      skin test (8 strains). Corresponding differences were detected with 2 strains
      only. Tissue culture, ELISA and dot-blot-immunoassay are effective methods for
      the diagnosis of toxin-producing Pasteurella multocida strains. Animal
      experiments should be an exception.

PMID- 8343107
TI  - [The effect of different biotechnical measures on live and stillborn piglets of
      sows of different body condition and parity].
AB  - In a single large pig production unit of 6000 breeding sows, seven groups of 100
      sows each were formed at random on the 110th day of pregnancy. Each group was
      evaluated and divided according to body condition in three subgroups. The average
      parity in each subgroup was recorded. The groups were treated as follows: Group 1
      received on the 113th day of pregnancy a 3 mg single intramuscular dose of
      alfaprostol. Group 2 received on the 113th day of pregnancy a 3 mg single
      intramuscular dose of alfaprostol, 24 hours later a single intramuscular dose of
      10 IU of oxytocin. Group 3 received a single intramuscular dose of 10 IU of
      oxytocin after the birth of the first piglet. Group 4 received on the 113th day
      of pregnancy a 100 mg single intramuscular dose of prednisolone. Group 5 received
      on the 113th day of pregnancy a 0.2 mg single intramuscular dose of
      carbamylcholine. Group 6 received from the 110th day of pregnancy food consisting
      of 12% fiber, 3 kg per sow per day. Group 7 (control) received a 3 ml physiologic
      NaCl solution on the 114th day of pregnancy. The following parameter were
      evaluated: A: Number of live born piglets B: Number of intrapartum stillborn
      piglets As regard number of live born piglets no significant difference was seen
      between the experimental groups (1-6) and the control group (7). On the other
      hand showed the experimental group 1, 2, 5 and 6 significant lower incidence of
      intrapartum stillbirth when compared to the control (group 7). Within the groups
      the tendency was seen, that the sows with higher parity and body condition
      produced less numbers of live born and higher numbers of intrapartum stillborn
      piglets.

PMID- 8343108
TI  - [The helminth fauna of wild boars of the west Berlin forests].
AB  - Samples of muscles and internal organs obtained from 96 wild boars in the forests
      of West Berlin between September 1989 and August 1990, were examined for
      helminths. Nine nematode species, Metastrongylus pudendotectus, M. salmi, M.
      confusus, M. apri, Physocephalus sexalatus, Ascarops strongylina, Globocephalus
      urosubulatus, Ascaris suum and Trichuris suis belonging to five families could be
      found. Larvae of Toxocara spp. were isolated from most of the enzymatically
      digested samples of the gastrointestinal tract. In a few cases juvenile forms of
      Cysticercus tenuicollis could be identified. Trichinella spiralis and trematodes
      were not found. The correlation between helminth infection and age and sex of the
      wild boars as well as time and site of shooting are discussed.

PMID- 8343110
TI  - Band 3 HT, a human red-cell variant associated with acanthocytosis and increased
      anion transport, carries the mutation Pro-868-->Leu in the membrane domain of
      band 3.
AB  - 1. We have studied band 3 HT, a human red-cell band 3 variant with increased
      M(r), which is associated with abnormal red-cell shape (acanthocytosis) and
      increased anion-transport activity. 2. We have shown that the increased M(r) does
      not result from the presence of the band 3 Memphis mutation, and that the variant
      band 3 is covalently labelled by 4,4'-di-isothiocyanato-1,2-diphenylethane-2,2'
      disulphonic acid (H2DIDS) less readily than normal. 3. cDNA cloning studies show
      that band 3 HT results from the mutation Pro-868-->Leu, and the possible
      significance of the mutation in the altered anion-transport activity and
      cytoskeleton binding properties of band 3 HT is discussed.

PMID- 8343111
TI  - Peptide glyoxals: a novel class of inhibitor for serine and cysteine proteinases.
AB  - A series of novel synthetic dipeptides, containing a C-terminal glyoxal grouping
      (-COCHO), have been tested as inhibitors against typical members of the serine-
      and cysteine-proteinase families. For example, the sequences benzyloxycarbonyl
      (Cbz)-Pro-Phe-CHO (I) and Cbz-Phe-Ala-CHO (II), which fulfil the known primary
      and secondary specificity requirements of chymotrypsin and cathepsin B
      respectively, have been found to be potent reversible inhibitors of their
      respective target proteinase. Thus I was found to inhibit chymotrypsin with a Ki
      of approximately 0.8 microM, whereas II exhibits a Ki of approximately 80 nm
      against cathepsin B. These Ki values are some 10-fold and 3-fold lower than those
      reported for the corresponding peptide-aldehyde inhibitors of chymotrypsin and
      cathepsin B upon which the peptidyl-glyoxals were fashioned. Unexpectedly, the
      sequence Cbz-Pro-Ala-CHO, which was designed to inhibit elastase-like
      proteinases, exhibited no inhibitory activity towards porcine pancreatic
      elastase, even when used at concentrations as high as 200 microM.

PMID- 8343109
TI  - Regulated exocytosis.

PMID- 8343113
TI  - Influence of Mg2+ on detection of somatogenic and lactogenic components of growth
      hormone-binding protein in mammalian sera.
AB  - We recently classified the growth-hormone (GH)-binding protein (GH-BP) in a wide
      range of mammalian [including human (h)] sera and reported the existence of a
      major lactogenic component in GH-BP of type-III sera (rabbit, horse, dog, pig and
      cat), based on the capacity of bovine (b) and ovine prolactin (PRL) to displace
      125I-labelled human growth hormone (hGH) binding and on direct 125I-bPRL binding
      studies. In this study, we demonstrate the high degree of Mg2+ dependence of the
      binding of the classically lactogenic hGH and bPRL, but not that of the
      somatogenic bGH to various mammalian sera (types I-IV). Serum GH-BP was assayed
      using a previously described and validated charcoal-separation assay. 125I-hGH
      binding to rat, ovine, bovine, rabbit, horse, dog and human sera was enhanced 1.5
      2.5-fold in the presence of 70 mM Mg2+. The Mg2+ effect was concentration
      dependent between 3.7 mM and 70 mM, causing a significant and proportional
      increase in 125I-hGH binding to serum. Like 125I-hGH, 125I-bPRL binding to type
      III sera was also Mg(2+)-dependent. In contrast, 125I-bGH binding to all types of
      serum GH-BP was not affected by Mg2+ concentrations of up to 35 mM, while 70 mM
      Mg2+ slightly, but significantly, reduced (by approx. 15%) bGH binding to rabbit
      serum. In keeping with the Mg(2+)-dependent stimulation of lactogenic hormone
      binding to GH-BP, 70 mM Mg2+ caused a shift to the left in the displacement
      curves of hGH and bPRL competing with 125I-hGH binding to rabbit, dog, horse and
      human sera, while the effects of the somatogens bGH and rabbit GH were shifted to
      the right. Scatchard analysis of hGH displacement curves with sera from various
      species yielded linear plots and revealed that Mg2+ significantly increased (2.3
      3.0-fold) the affinity constants, but not the binding capacities. These results
      demonstrate the ability of changes in Mg2+ concentration to determine the degree
      of differential recognition of somatogens versus lactogens by serum GH-BP. It
      remains to be determined whether such bivalent cation effects may account, at
      least in part, for the growth retardation seen in Zn2+ or Mg2+ ion deficiencies.

PMID- 8343112
TI  - Rapid activation of hepatic glutaminase in rats fed on a single high-protein
      meal.
AB  - We report that hepatic glutaminase is rapidly activated in rats fed on a single
      high-protein (60% casein) meal. Rats previously fed on a normal-protein (15%
      casein) diet for 3-4 days were given a high-protein meal for 2 h. The high
      protein meal increased the rate of flux through glutaminase in intact liver
      mitochondria nearly 3-fold (20.6 +/- 1.7 nmol/min per mg of protein versus 7.5 +/
      2.9 nmol/min per mg of protein) at a P(i) concentration of 10 mM. The activation
      of flux through glutaminase by a high-protein meal involved an increased
      sensitivity of glutaminase to P(i), an activator of the enzyme. The Ka for P(i)
      was 1.0 mM and 24.1 mM in mitochondria from rats fed on the high-protein and
      normal-protein meals respectively. We measured the concentration of P(i) in the
      mitochondrial matrix and found that it did not differ in mitochondria from rats
      fed on the high-protein and normal-protein meals, suggesting that the effect of
      the high-protein meal on the P(i)-sensitivity of glutaminase was not due to a
      change in the distribution of P(i) across the mitochondrial inner membrane.
      Glutaminase activity was measured by using mitochondrial membranes from frozen
      thawed mitochondria. Glutaminase activity and its dependence on P(i) were similar
      for preparations from rats fed on high-protein and normal-protein meals. These
      findings show that hepatic glutaminase is stimulated rapidly by a high-protein
      meal. This is part of the physiological hepatic response to increased protein
      intake which permits the liver to cope with the influx of glutamine occurring at
      this time.

PMID- 8343114
TI  - Unusual reactivity of Tyr-7 of GSH transferase P1-1.
AB  - Reaction of human GSH transferase P1-1 (GSTP1-1) with diethylpyrocarbonate (DEPC)
      at pH 7.0 and 4 degrees C resulted in covalent modification of an equivalent of
      one histidine and one tyrosine residue per subunit, with loss of activity.
      Sequence analysis showed that His-71 and Tyr-7 were modified. Reference to the
      three-dimensional structure of GSTP1-1 [Reinemer, Dirr, Ladenstein, Huber, Lo
      Bello, Frederici and Parker (1992) J. Mol. Biol. 227, 214-226] shows that the
      modification of Tyr-7 is most likely to affect enzyme activity. Kinetic analysis
      of the DEPC modification of Tyr-7 in GSTP1-1 gave a k2 approx. 150 times that of
      a peptide comprising residues 1-11 of GSTP1-1. The reaction of Tyr-7 of GSTP1-1
      with DEPC was poorly inhibited by 1 mM GSH (14%) or 10 microM S-hexylglutathione
      (18%). DEPC treatment of the enzyme altered the absorbance at 290 nm in second
      derivative spectra, suggesting that a significant amount of tyrosinate ion occurs
      in the enzyme. GSH, however, did not significantly alter the A290. The data
      provide the first evidence of unusual chemical reactivity of Tyr-7 and are
      consistent with its proposed role as a proton acceptor during catalysis.

PMID- 8343115
TI  - Chemical modification of GSH transferase P1-1 confirms the presence of Arg-13,
      Lys-44 and one carboxylate group in the GSH-binding domain of the active site.
AB  - GSH transferase P1-1 (GSTP1-1) was modified with group-specific reagents. Kinetic
      experiments demonstrated that inactivation of GSTP1-1 occurred upon reaction of
      one arginine residue per subunit with diacetyl, one lysine residue per subunit
      with 2,4,6-trinitrobenzene sulphonate, or one carboxylate group per subunit with
      1-ethyl-3-(3-dimethylaminopropyl)carbodiimide. All three inactivation reactions
      were inhibited by compounds known to bind at the GSH site of the enzyme but were
      unaffected by the electrophile 1-chloro-2,4-dinitrobenzene. N-terminal sequence
      analysis showed that Arg-13 was modified by diacetyl and that this modification
      was inhibited by GSH. Arg-11 was not modified. The lysine residue modified by
      2,4,6-trinitrobenzene sulphonate and protected by S-octylglutathione was
      identified as Lys-44 by sequencing of tryptic peptides. The findings are in
      agreement with the involvement of Arg-13 and Lys-44 in binding of GSH, as
      determined from the crystal structure [Reinemer, Dirr, Ladenstein, Huber, Lo
      Bello, Frederici and Parker (1992) J. Mol. Biol. 227, 214-226]. The present data
      also implicate a single carboxylate in GSH binding, consistent with the
      involvement of Asp-98 of subunit B determined from the crystallographic study.
      The GSH-binding determinants of GSTP1-1 are compared using sequence similarity
      with those of GSTs of Alpha, Mu and Theta classes.

PMID- 8343116
TI  - Studies on secondary structure of caldesmon and its C-terminal fragments.
AB  - Evaluation of the secondary structure of caldesmon from c.d. spectra revealed
      that it contains 51% helix, 9% beta-strand and 40% of remainder structures. These
      values agree well with the predicted ones from amino acid sequence, assuming an
      extended chain structure for caldesmon. The estimates of the secondary-structure
      elements in C-terminal 34 kDa and 19 kDa fragments are: 11 and 12% helix, 22 and
      20% beta-strand, 13 and 17% beta-turns and loops, and 54 and 50% of remainder
      structure respectively. The best fit of experimental data was obtained assuming
      the globular state of the fragments. On the basis of structural analysis and
      fragmentation by proteolytic and chemical cleavages the six-domain model of
      caldesmon is proposed.

PMID- 8343117
TI  - Parathyroid hormone transport effects and hormonal processing in primary cultured
      rat proximal tubular cells.
AB  - The development of satisfactory cell culture models for the study of parathyroid
      hormone (PTH)-induced inhibition of Pi transport has proven difficult. Using
      subcellular fractionation techniques we investigated the response of primary
      cultures of rat proximal tubular cells to PTH-(1-34). Specific binding of 125I
      bPTH-(1-34) occurred at 2 degrees C. After 5 min of rewarming, trypsin-releasable
      radioactivity decreased from 90 to 50%, indicating internalization of the ligand.
      Cell disruption, followed by density centrifugation with 17% Percoll either
      directly after binding at 2 degrees C or post-rewarming for 20 min, showed a
      shift of 125I label from the plasma membrane (5'-nucleotidase) to lysosomal
      fractions (beta-D-glucosaminidase), confirming the sequential occurrence of cell
      surface binding, internalization and transport to lysosomes of 125I-bPTH-(1-34).
      Reculture at 37 degrees C revealed steady accumulation of trichloroacetic acid
      soluble radioactivity in the medium, indicating degradation of 125I-bPTH-(1-34).
      Phosphate transport in the absence of sodium was minimal. Incubation of the cells
      with bPTH-(1-34) resulted in up to 50% inhibition of sodium-dependent phosphate
      transport. Prior phosphate depletion abrogated the response to PTH.

PMID- 8343118
TI  - Endothelins stimulate tyrosine phosphorylation and activity of p42/mitogen
      activated protein kinase in astrocytes.
AB  - Endothelins (ET-1, -2, -3) display pleiotropic activities, by signalling through
      G-protein-coupled membrane receptors. We show here that ET-1 and ET-3 stimulate
      within minutes the tyrosine phosphorylation of a 42 kDa protein (p42) in primary
      cultures of mouse embryo astrocytes, but not in any of two subclones of rat
      astrocytoma C6 cells. This effect, measured by anti-phosphotyrosine
      immunoblotting of cell extracts, was also observed in response to bradykinin,
      platelet-derived growth factor, the phorbol ester phorbol 12-myristate 13-acetate
      and the G-protein activator fluoroaluminate. Pretreatment of cells with pertussis
      toxin, which inactivates Gi/G(o) proteins, did not affect these responses.
      However, down-regulation of protein kinase C completely blocked the response to
      phorbol ester and fluoroaluminate and at least partially impaired the ET-1
      stimulated phosphorylation of p42. We have identified p42 as p42mapk, a mitogen
      activated protein (MAP) kinase, on the basis of the following data: by sequential
      immunoblotting with antiphosphotyrosine and anti-MAP kinase antibodies, (i)
      similar kinetics are observed for p42 phosphorylation and the decrease in p42mapk
      electrophoretic mobility, likely corresponding to its tyrosine/threonine
      phosphorylation [de Vries-Smits, Boudewijn, Burgering, Leevers, Marshall and Bos
      (1992) Nature (London) 357, 602-604]; (ii) p42 and the shifted form of p42mapk co
      migrate on SDS/PAGE; (iii) the myelin-basic-protein kinase activity of p42mapk is
      stimulated by ET-1, in parallel with the tyrosine phosphorylation of p42. In
      conclusion, these findings strongly suggest that endothelins can stimulate the
      tyrosine phosphorylation and activation of p42mapk in astrocytes, via pertussis
      toxin-insensitive G protein and protein kinase C-dependent and -independent
      pathways.

PMID- 8343119
TI  - A type I collagen reporter gene construct for protein engineering studies.
      Functional equivalence of transfected reporter COL1A1 and endogenous gene
      products during biosynthesis and in vitro extracellular matrix accumulation.
AB  - A type I collagen reporter gene construct, designed to facilitate detailed
      analysis of the consequences of introduced structural and regulatory mutations on
      collagen biosynthesis and participation in the extracellular matrix, was produced
      by site-directed mutagenesis of the mouse COL1A1 gene. The reporter construct,
      pWTCI-Ile822, carried a single base change which converted the codon for amino
      acid 822 of the triple helix from methionine to isoleucine. This change allowed
      the reporter protein, [Ile822]alpha 1(I), to be distinguished from the wild-type
      alpha 1(I), and quantified, by its altered CNBr cleavage pattern. In mouse Mov13
      cells, which synthesize no endogenous pro alpha 1(I), reporter chains associated
      with endogenous pro alpha 2(I), formed pepsin-stable triple helices and were
      secreted efficiently from the cell. The thermal stability of wild-type molecules
      and molecules containing the reporter [Ile822]alpha 1(I) chains was identical.
      The biosynthetic characteristics of wild-type and reporter chains were directly
      compared in stably transfected 3T6 cells. These cells did not make a distinction
      between reporter and endogenous alpha 1(I) chains, which were secreted from the
      cells at the same rate and were processed and deposited into the 3T6 cell in
      vitro accumulated extracellular matrix with equal efficiency. These data
      demonstrate that the helical sequence alteration in the reporter protein is
      functionally neutral and that the reporter construct, pWTCI-Ile822, is a suitable
      vector for the analysis of the biochemical effects of site-directed mutations in
      the putative COL1A1 functional domains.

PMID- 8343120
TI  - Two independently regulated Ca2+ entry mechanisms coexist in Jurkat T cells
      during T cell receptor antigen activation.
AB  - Receptor-mediated Ca2+ influx was studied in the human leukaemic T cell line,
      Jurkat. Stimulation of these cells through the T cell antigen-receptor complex
      with OKT3 (an antibody against the CD3 molecules of the T cell antigen-receptor
      complex), or inhibition of the endoplasmic reticular Ca(2+)-ATPase with
      thapsigargin, resulted in Ca2+ mobilization from intracellular stores and the
      activation of Ca2+ and Mn2+ entry. The rates of thapsigargin-induced Ca2+ and
      Mn2+ entry in Jurkat cells were 76% and 64% respectively of those observed after
      treatment of these cells with OKT3. The combined addition of thapsigargin plus
      OKT3 to Jurkat cells produced an enhanced effect on the sustained increase in the
      cytosolic free Ca2+ concentration that was greater than that obtained by addition
      of thapsigargin or OKT3 alone. The rates of Ca2+ and Mn2+ entry were increased to
      119% and 112% respectively of the OKT3-induced rates. Taken together, these
      results suggest that the inositol 1,4,5-trisphosphate-sensitive Ca(2+)-pool
      dependent bivalent cation entry only accounts for 57% and 52% respectively of the
      total OKT3-dependent Ca2+ and Mn2+ entry, and that the rest is mediated by second
      messenger(s). Thus two separate pathways coexist in regulating Ca2+ entry in
      Jurkat cells during activation mediated through the T cell receptor.

PMID- 8343121
TI  - Use of superfused rat skeletal muscle for metabolic studies: assessment of pH by
      31P n.m.r.
AB  - We developed a muscle superfusion system suitable for metabolic studies of small
      isolated rat muscle ex vivo in real time and in a non-destructive manner by
      n.m.r. spectroscopy. In order to determine biochemical stability of superfused
      extensor digitorum longus (EDL) muscle (from fasted 45 and 100 g rats), the
      energy state and the pH of muscle were continuously monitored by 31P n.m.r.
      spectroscopy. ATP and phosphocreatine remained stable during 2 h whatever the
      muscle size (20 or 45 mg). Neither metabolite was a sensitive probe of possible
      metabolic compartmentation within muscle under our experimental conditions. By
      contrast, the chemical shift of Pi by its sensitivity to pH was a discriminant
      factor in the assessment of muscle stability. Indeed, heterogeneity of pH was
      observed only in the 45 mg EDL muscle resulting from a core region with loss of
      glycogen. Together, these observations suggest deviations of energy metabolism to
      supply ATP. Consequently, pH may be considered as a new real-time criterion for
      monitoring a metabolic heterogeneity due to changes in energy metabolism of
      muscle preparations ex vivo.

PMID- 8343122
TI  - Calcium measurements with a new high-affinity n.m.r. indicator in the isolated
      perfused heart.
AB  - A new n.m.r. indicator, 1,2-bis-(2-[1-(hydroxycarbony)ethyl-
      (hydroxycarbonylmethyl)]amino-5-fluorophenoxy)ethane (DiMe-5FBAPTA), with a
      higher affinity for calcium (apparent Kd 46 nM, pH 7.2, 30 degrees C) than the
      parent 5FBAPTA chelator (Kd 537 nM, pH 7.1, 30 degrees C) has been used to
      measure the cardiac intracellular free Ca2+ ([Ca2+]i). DiMe-5FBAPTA was loaded
      into Langendorff-perfused ferret hearts maintained at 30 degrees C using the
      acetoxymethyl ester (AM) derivative. The intracellular concentration required to
      achieve an adequate signal-to-noise (S/N) ratio (> 10:1) for the n.m.r. spectra
      caused a similar reduction in developed pressure to that obtained using 5FBAPTA
      AM. The DiMe-5FBAPTA was used to estimate [Ca2+]i in diastole, through the
      calcium transient and at rest in the presence of the slow calcium channel blocker
      diltiazem. At a pacing frequency of 1.0 Hz, end-diastolic [Ca2+]i was 198 +/- 30
      nM (n = 9), and reducing the pacing frequency to 0.2 Hz lowered [Ca2+]i to 89 +/-
      13 nM (n = 5). Perfusion with diltiazem (100 microM) for 60 min lowered [Ca2+]i
      to 10 +/- 1 nM (n = 4) in unpaced hearts and to 94 +/- 24 nM (n = 4) in hearts
      paced at 1.0 Hz. The [Ca2+]i transient measured with DiMe-5FBAPTA was sharper and
      delayed compared with the transient measured previously with 5FBAPTA. Co-loading
      the two indicators provided evidence that the indicator with the higher Kd had a
      dominant effect on the end-diastolic [Ca2+]i. The lower values for end-diastolic
      [Ca2+]i obtained with DiMe-5FBAPTA are consistent with fluorescent indicator
      measurements. These observations suggest that perturbations of [Ca2+]i caused by
      the new indicator are less than those induced by 5FBAPTA. DiMe-5FBAPTA therefore
      represents a useful step in the development of 19F-n.m.r. calcium indicators.

PMID- 8343124
TI  - Digestion of damaged DNA by the T7 DNA polymerase-exonuclease.
AB  - We have investigated the 3'-5'-exonuclease activity of phage T7 DNA polymerase
      for its usefulness as an approach for the detection of lesions in DNA. Unlike the
      T4 DNA polymerase-exonuclease, which is commonly used to map the position and
      frequency of lesions in very small DNA fragments, T7 DNA polymerase-exonuclease
      is able to hydrolyse almost completely the large fragments from KpnI-restricted
      mammalian DNA. However, we found that the exonuclease was also able to hydrolyse
      DNA containing several kinds of lesions: cyclobutane pyrimidine dimers, thymine
      glycols, and mono-adducts of 4'-hydroxymethyl-4,5',8-trimethylpsoralen and 5'
      methyl-isopsoralen. Modifications of the reaction conditions did not
      significantly alter the extent of hydrolysis. These properties distinguish the T7
      DNA polymerase-exonuclease from the T4 DNA polymerase-exonuclease and make the T7
      DNA polymerase-exonuclease unsuitable for detecting several types of lesions in
      DNA.

PMID- 8343123
TI  - Mobilization of Ca2+ by thapsigargin and 2,5-di-(t-butyl)-1,4-benzohydroquinone
      in permeabilized insulin-secreting RINm5F cells: evidence for separate uptake and
      release compartments in inositol 1,4,5-trisphosphate-sensitive Ca2+ pool.
AB  - We characterized and directly compared the Ca(2+)-releasing actions of two
      inhibitors of endoplasmic-reticulum (ER) Ca(2+)-ATPase, thapsigargin and 2,5-di
      (t-butyl)-1,4-benzohydroquinone (tBuBHQ), in electropermeabilized insulin
      secreting RINm5F cells. Ambient free calcium concentration ([Ca2+]) was monitored
      by Ca(2+)-selective mini-electrodes. After ATP-dependent Ca2+ uptake,
      thapsigargin and tBuBHQ released Ca2+ with and EC50 of approximately 37 nM and
      approximately 2 microM respectively. Both agents mobilized Ca2+ predominantly
      from the Ins(1,4,5)P3-sensitive Ca2+ pool, and in this respect thapsigargin was
      more specific than tBuBHQ. The total increase in [Ca2+] obtained with
      thapsigargin and Ins(1,4,5)P3 was, on the average, only 7% greater than that with
      Ins(1,4,5)P3 alone. In contrast, the total increase in [Ca2+] obtained with
      tBuBHQ and Ins(1,4,5)P3 was 33% greater than that obtained with only InsP3 (P <
      0.05). Although Ca2+ was rapidly mobilized by thapsigargin and tBuBHQ, complete
      depletion of the Ins(1,4,5)P3-sensitive Ca2+ pool was difficult to achieve. After
      the release by thapsigargin or tBuBHQ, Ins(1,4,5)P3 induced additional Ca2+
      release. The additional Ins(1,4,5)P3-induced Ca2+ release was not altered by
      supramaximal concentrations of thapsigargin and tBuBHQ, or by Bafilomycin A1, an
      inhibitor of V-type ATPases, but was decreased by prolonged treatment with the ER
      Ca(2+)-ATPase inhibitors. These results suggest the existence of distinct uptake
      and release compartments within the Ins(1,4,5)P3-sensitive Ca2+ pool. When
      treated with the inhibitors, the two compartments became distinguishable on the
      basis of their Ca2+ permeability. Apparently, thapsigargin and tBuBHQ readily
      mobilized Ca2+ from the uptake compartment, whereas Ca2+ from the release
      compartment could be mobilized only very slowly, in the absence of Ins(1,4,5)P3.

PMID- 8343125
TI  - L(+)-Mandelate dehydrogenase from Rhodotorula graminis: purification, partial
      characterization and identification as a flavocytochrome b.
AB  - L(+)-Mandelate dehydrogenase was purified to homogeneity from the yeast
      Rhodotorula graminis KGX 39 by a combination of (NH4)2SO4 fractionation, ion
      exchange and hydrophobic-interaction chromatography and gel filtration. The amino
      acid composition and the N-terminal sequence of the enzyme were determined.
      Comprehensive details of the sequence determinations have been deposited as
      Supplementary Publication SUP 50172 (4 pages) at the British Library Document
      Supply Centre, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom
      copies can be obtained on the terms indicated in Biochem. J. (1993) 289, 9. The
      enzyme is a tetramer as judged by comparison of its subunit M(r) value of 59,100
      and native M(r) of 239,900, estimated by SDS/PAGE and gel filtration
      respectively. There is one molecule of haem and approx. one molecule of non
      covalently bound FMN per subunit. 2,6-Dichloroindophenol, cytochrome c and
      ferricyanide can all serve as electron acceptors. L(+)-Mandelate dehydrogenase is
      stereospecific for its substrate. D(-)-Mandelate and L(+)-hexahydromandelate are
      competitive inhibitors. The enzyme has maximum activity at pH 7.9 and it has a pI
      value of 4.4. HgCl2 and 4-chloromercuribenzoate are potent inhibitors, but there
      is no evidence that the enzyme is subject to feedback inhibition by potential
      metabolic effectors. The evidence suggests that L(+)-mandelate dehydrogenase from
      R. graminis is a flavocytochrome b which is very similar to, and probably (at
      least so far as the haem domain is concerned) homologous with, certain well
      characterized yeast L(+)-lactate dehydrogenases, and that the chief difference
      between them is their mutually exclusive substrate specificities.

PMID- 8343126
TI  - The Ca(2+)-transporting ATPases of rabbit and trout exhibit different pH- and
      temperature-dependences.
AB  - The phosphorylation of the trout sarcoplasmic-reticulum Ca(2+)-ATPase by Pi
      differs in its temperature- and pH-dependence from the rabbit ATPase. In the
      trout enzyme, the apparent affinity for Pi and maximum phosphoenzyme values do
      not vary over a pH and temperature ranges that have a pronounced effect on the
      rabbit enzyme. The lack of temperature-dependence for phosphorylation is observed
      at pH 6.8. At pH 8.0, the temperature profile for phosphorylation of the trout
      enzyme resembles that of the rabbit at pH 6.8. The rabbit ATPase is no longer
      phosphorylated by Pi after solubilization with the detergent C12E9. In contrast,
      the trout enzyme can be phosphorylated by Pi after solubilization with C12E9, and
      the same levels of phosphoenzyme were obtained with the soluble and membrane
      bound ATPase at both 0 degrees and 25 degrees C. In the range of 0-20 degrees C,
      the rates of ATP synthesis and of Ca2+ uptake by the trout ATPase are less
      temperature-dependent than for the rabbit enzyme. However, both isoenzymes
      catalyse ATP hydrolysis with similar temperature-dependences. The results raise
      the possibility that protonation of specific amino acid residues may contribute
      to the lack of temperature-dependence for phosphorylation of the trout Ca(2+)
      ATPase.

PMID- 8343127
TI  - Cytosolic and nuclear spermidine acetyltransferases in growing NIH 3T3
      fibroblasts stimulated with serum or polyamines: relationship to polyamine
      biosynthetic decarboxylases and histone acetyltransferase.
AB  - The expression (mRNA level of enzymic activity) of cytosolic and nuclear
      spermidine acetyltransferases was studied in NIH 3T3 fibroblasts, either (1)
      serum-starved and stimulated to grow by serum refeeding, or (2) treated with
      inhibitors of ornithine decarboxylase (ODC) (MDL 72.175) and S-adenosylmethionine
      decarboxylase (AdoMetDC) (MDL 73.811) and stimulated to grow by spermidine.
      Expression of the known growth-regulated genes for ODC, AdoMetDC and histone
      acetyltransferase was also examined. The mRNA for spermidine/spermine N1
      acetyltransferase (SAT) accumulated after serum refeeding (between 6 and 16 h)
      and even more after spermidine addition (16 h). Histone acetyltransferase
      activity increased after both growth stimuli, whereas spermidine N8
      acetyltransferase activity remained unchanged. After serum stimulation, the ODC
      mRNA level and activity rose between 6 and 16 h, whereas AdoMetDC mRNA
      accumulation occurred later (16 h) than the increase in enzyme activity (6 h).
      Stimulation of ODC and AdoMetDC activities was suppressed by the inhibitors added
      alone or in combination with spermidine, whereas mRNA accumulation was down
      regulated by spermidine. These results indicate that the expression of SAT was
      growth-controlled and that SAT mRNA level was regulated by polyamines.

PMID- 8343128
TI  - Trichomonas vaginalis: characterization of ornithine decarboxylase.
AB  - Ornithine decarboxylase (ODC), the lead enzyme in polyamine biosynthesis, was
      partially purified from Trichomonas vaginalis and its kinetic properties were
      studied. The enzyme appears to be of special significance in this anaerobic
      parasite, since the arginine dihydrolase pathway generates ATP as well as
      putrescine from arginine. ODC from T. vaginalis had a broad substrate
      specificity, decarboxylating ornithine (100%), lysine (1.0%) and arginine (0.1%).
      The enzyme had a pH optimum of 6.5, a temperature optimum of 37 degrees C and was
      pyridoxal 5'-phosphate-dependent. Attempts to separate ornithine- from lysine
      decarboxylating activity by thermal-stability and pH-optima curves were not
      successful. Although Km values for ornithine and lysine were 109 and 91 microM
      respectively, and the Vmax values for these substrates were 1282 and 13 nmol/min
      per mg of protein respectively, the most important intracellular substrate is
      ornithine, since intracellular ornithine levels are 3.5 times those of lysine and
      extracellular putrescine levels are 7.5 times those of cadaverine. Ornithine was
      also an effective inhibitor of lysine-decarboxylating activity (Ki 150 microM),
      whereas lysine was relatively ineffective as inhibitor of ornithine
      decarboxylating activity (Ki 14.5 mM). Crude ODC activity was localized (86%) in
      the 43,000 g supernatant and 3303-fold purification was obtained by (NH4)2SO4
      salting and DEAE-Sephacel, agarose-gel and hydroxyapatite chromatography steps.
      The enzyme bound difluoro[3H]methylornithine ([3H]DFMO) with a ratio of drug
      bound to activity of 2500 fmol/unit, where 1 unit corresponds to 1 nmol of CO2
      released from ornithine/min. The enzyme had a native M(r) of 210000 (gel
      filtration), with a subunit M(r) of 55,000 (by SDS/PAGE), suggesting that the
      trichomonad enzyme is a tetramer. From the subunit M(r) and binding ratio of
      DFMO, there is about 137 ng of ODC per mg of T. vaginalis protein (0.013%). The
      significant amount of ODC protein present supports the view that putrescine
      synthesis in T. vaginalis plays an important role in the metabolism of the
      parasite.

PMID- 8343129
TI  - Cloning, in vitro mitochondrial import and membrane assembly of the 17.8 kDa
      subunit of complex I from Neurospora crassa.
AB  - We have cloned and sequenced a cDNA encoding a 17.8 kDa subunit of the
      hydrophobic fragment of complex I from Neurospora crassa. The deduced primary
      structure of this subunit was partially confirmed by automated Edman degradation
      of the isolated polypeptide. The sequence data obtained indicate that the 17.8
      kDa subunit is made as an extended precursor of 20.8 kDa. Resistance of the
      polypeptide to alkaline extraction from mitochondrial membranes and the existence
      of a putative membrane-spanning domain suggests that the 17.8 kDa subunit is an
      intrinsic (bitopic) membrane protein. The in vitro synthesized precursor of the
      17.8 kDa subunit can be efficiently imported into isolated mitochondria, where it
      is cleaved to the mature species by the metal-dependent matrix-processing
      peptidase. The in vitro imported mature subunit is found mainly exposed to the
      mitochondrial intermembrane space. However, a significant fraction of the
      imported polypeptide acquires the same membrane topology as the endogenous
      subunit, indicating that correct assembly in the mitochondrial inner membrane did
      occur.

PMID- 8343130
TI  - Non-catalytic activation of phospholipase C-gamma 1 in vitro by epidermal growth
      factor receptor.
AB  - To investigate the possible functional role of epidermal growth factor (EGF)
      receptor-phospholipase C-gamma 1 (PLC-gamma 1) complexes, we have measured PLC
      gamma 1 activity in vitro in the absence or presence of purified EGF receptor.
      Immunoprecipitates of PLC-gamma 1 from control A-431 cells were incubated without
      or with purified EGF receptor in the absence or presence of ATP. Under these
      conditions the EGF receptor increased non-tyrosine-phosphorylated PLC-gamma 1
      activity 3-4-fold in the absence or presence of ATP, but increased tyrosine
      phosphorylated and activated PLC-gamma 1 by only 20-50%. Both basal and
      autophosphorylated forms of the purified EGF receptor increased the activity of
      the non-tyrosine-phosphorylated PLC-gamma 1, and stoichiometric levels of
      purified receptor were required to increase PLC activity. Other tyrosine kinases
      such as the platelet-derived growth factor receptor and erbB-2, but not the
      insulin receptor, also stimulated PLC-gamma 1 activity. PLC-gamma 1 activity
      could be activated with the kinase-negative EGF receptor, but a C-terminal
      truncated receptor was much less effective. Purified EGF receptor could also
      activate PLC-beta 1, but with a much decreased potency compared with PLC-gamma 1.
      Our results suggest that in vitro the EGF receptor can increase PLC-gamma 1
      activity independently of tyrosine phosphorylation.

PMID- 8343131
TI  - Transgenic mice over-expressing the human spermidine synthase gene.
AB  - We have generated a transgenic mouse line harbouring the functional (chromosome-1
      derived) human spermidine synthase (EC 2.5.1.16) gene in their genome. The
      transgenic animals expressed the human gene-derived mRNA, as revealed by reverse
      transcriptase/PCR analysis, in all tissues studied and displayed tissue
      spermidine synthase activity that was 2-6 times that in their syngenic
      littermates. The elevated spermidine synthase activity, however, had virtually no
      effect on tissue putrescine, spermidine or spermine levels. The view that the
      accumulation of spermidine and spermine is possibly controlled by S
      adenosylmethionine decarboxylase was further supported by the finding that tissue
      spermidine and spermine contents also remained practically normal in hybrid
      transgenic mice over-expressing both human ornithine decarboxylase and spermidine
      synthase genes.

PMID- 8343132
TI  - Calorimetric studies of the N-terminal half-molecule of transferrin and mutant
      forms modified near the Fe(3+)-binding site.
AB  - The effects of single amino acid substitution on the thermal stability of the N
      terminal half-molecule of human transferrin and its iron-binding affinity have
      been studied by high-sensitivity scanning calorimetry. All site-directed
      mutations are located on the surface of the binding cleft, and they are D63-->S,
      D63-->C, G65-->R, H207-->E and K206-->Q. Differential scanning calorimetry
      results show that the mutations do not significantly alter the conformational
      stability of the apo-forms of the proteins. The changes in free energy of
      unfolding relative to the wild-type protein range from 0.83 to -2.4 kJ/mol. The
      D63-->S, G54-->R and H207-->E mutations slightly destabilize the apo-protein,
      while the D63-->C and K206-->Q mutations increase its stability by a small
      amount. However, there are large compensating enthalpy-entropy changes caused by
      all mutations. All mutants bind ferric ion, but with different affinities.
      Replacement of Asp-63 by either Ser or Cys decreases the apparent binding
      constant by 5-6 orders of magnitude. The G65-->R mutation also decreases the
      apparent binding constant by 5 orders of magnitude. The K206-->Q mutation
      increases the apparent binding constant by 20-fold, while the H207-->E mutation
      does not significantly change the apparent iron-binding affinity of the half
      molecule.

PMID- 8343133
TI  - Inactivation of the endogenous argininosuccinate lyase activity of duck delta
      crystallin by modification of an essential histidine residue with diethyl
      pyrocarbonate.
AB  - The argininosuccinate lyase activity of duck delta-crystallin was inactivated by
      diethyl pyrocarbonate at 0 degrees C and pH 7.5. The inactivation followed pseudo
      first-order kinetics after appropriate correction for the decomposition of the
      reagent during the modification period. The plot of the observed pseudo-first
      order rate constant versus diethyl pyrocarbonate concentration in the range of
      0.17-1.7 mM was linear and went through the origin with a second-order rate
      constant of 1.45 +/- 0.1 M-1.s-1. The double-logarithmic plot was also linear,
      with slope of 1.13, which suggested a 1:1 stoichiometry for the reaction between
      diethyl pyrocarbonate and delta-crystallin. L-Arginine, L-norvaline or L
      citrulline protected the argininosuccinate lyase activity of delta-crystallin
      from diethyl pyrocarbonate inactivation. The dissociation constants for the delta
      crystallin-L-arginine and delta-crystallin-L-citrulline binary complexes,
      determined by the protection experiments, were 4.2 +/- 0.2 and 0.12 +/- 0.04 mM
      respectively. Fumarate alone had no protective effect. However, fumarate plus L
      arginine gave synergistic protection with a ligand binding interacting factor of
      0.12 +/- 0.02. The double-protection data conformed to a random Uni Bi kinetic
      mechanism. Fluorescence-quenching studies indicated that the modified delta
      crystallin had minimum, if any, conformational changes as compared with the
      native delta-crystallin. Inactivation of the enzyme activity was accompanied by
      an increasing absorbance at 240 nm of the protein. The absorption near 280 nm did
      not change. Treatment of the modified protein with hydroxylamine regenerated the
      enzyme activity to the original level. These results strongly indicated the
      modification of an essential histidine residue. Calculation from the 240 nm
      absorption changes indicated that only one histidine residue per subunit was
      modified by the reagent. This super-active histidine residue has a pKa value of
      approximately 6.8 and acts as a general acid-base catalyst in the enzyme reaction
      mechanism. Our experimental data are compatible with an E1cB mechanism [Raushel
      (1984) Arch. Biochem. Biophys. 232, 520-525] for the argininosuccinate lyase with
      the essential histidine residue close to the arginine-binding domain of delta
      crystallin. L-Citrulline, after binding to this domain, might form an extra
      hydrogen bond with the essential histidine residue.

PMID- 8343134
TI  - Effect of betaine on HSP70 expression and cell survival during adaptation to
      osmotic stress.
AB  - Induced expression of the HSP70 gene in 3T3 and SV-3T3 cells was monitored by
      measurements of the synthesis of HSP70 and of the cellular contents of both HSP70
      and its mRNA. The presence of betaine (N-trimethylglycine) at concentrations of
      2.5-25 mM decreased the induction of HSP70 gene expression caused by incubation
      of 3T3 and SV-3T3 cells in hypertonic (0.5 osM) medium. This effect was
      accompanied by an enhancement of SV-3T3 cell adaptation, assayed by colony
      formation, to the hyperosmotic conditions. In contrast, the presence of betaine
      did not affect HSP70 gene expression induced in these cells by heat shock. After
      6 h incubation with 25 mM betaine under hypertonic (0.5 osM) conditions the
      intracellular concentration of betaine in SV-3T3 cells was about 195 mM, compared
      with about 70 mM under isotonic (0.3 osM) conditions. Hence, with this
      concentration of extracellular betaine, the marked increase in the accumulation
      of betaine within the cells presumably counteracts the imposed osmotic pressure
      and eliminates the signal that otherwise initiates increased expression of the
      HSP70 gene.

PMID- 8343135
TI  - Purification, characterization and binding interactions of the Chinese-cobra
      (Naja naja atra) serum antitoxic protein CSAP.
AB  - The characterization of the single-chain protein in Chinese-cobra (Naja naja
      atra) blood serum, which yields strong specific protection against the venom of
      the same snake, is reported. The protein, CSAP (cobra serum antitoxic protein),
      was purified to electrophoretic homogeneity. Over the pH range 5-9 it formed
      stable complexes with the neuro- and the cardio-toxin of the snake. The molecular
      size of the CSAP was estimated to be 70.3 +/- 0.3 kDa. Tryptic hydrolysis of CSAP
      yielded several peptides that were able to bind to the toxin. The native CSAP
      maximally bound 8 +/- 1 toxin molecules/molecule. Six tryptic fragments,
      containing 5-39 residues, were sequenced. The longest of these displayed sequence
      similarity to rat serum albumin. The protective effect of the CSAP was
      demonstrated in vivo on mice and in vitro by measurement of the rate of
      haemolysis. Kinetic and thermodynamic parameters of the binding interactions of
      the neurotoxin and the CSAP were determined from the rates of displacement of
      125I-labelled toxin from its complexes with the CSAP by unlabelled toxin by using
      a DEAE-cellulose filter assay for CSAP-toxin complexes. The toxin molecules
      rapidly dissociated from one type of site and slowly from a second. The binding
      capacity and concentration of the CSAP suffice to explain the protective effect
      of the latter against the toxin.

PMID- 8343136
TI  - Binding of a substrate analogue can induce co-operative structure in the plasmin
      serine-proteinase domain.
AB  - Human miniplasminogen and miniplasmin were studied by n.m.r. spectroscopy and
      differential scanning calorimetry (d.s.c.) in order to investigate the structural
      properties of the serine-proteinase domain. The d.s.c. thermograms of both
      miniplasminogen and non-inactivated miniplasmin at pH 4.0 can be closely fitted
      to two transitions, at 62 +/- 2 and 72 +/- 2 degrees C, corresponding to
      unfolding of the kringle 5 and proteinase domains respectively. No evidence was
      found, under these conditions, for non-co-operative unfolding of the proteinase
      domain. On inactivation of miniplasmin with an affinity label, a number of
      additional resonances arising from residues of the proteinase domain are observed
      in resolved regions of the n.m.r. spectrum. A combination of variable-temperature
      n.m.r. and d.s.c. has shown that part of the proteinase domain undergoes a major
      conformational transition on heating which is distinct from the unfolding of the
      remainder of the proteinase domain or the kringle 5 domain. This additional
      transition occurs at a temperature that depends on the nature of the affinity
      label present and is not observed in the absence of an inactivating agent. These
      results provide direct evidence for the existence of a region of the proteinase
      domain which, under these conditions, becomes structured only in the presence of
      a bound substrate.

PMID- 8343137
TI  - Turnover of inositol pentakisphosphates, inositol hexakisphosphate and
      diphosphoinositol polyphosphates in primary cultured hepatocytes.
AB  - We have used a non-transformed cell model, the primary cultured hepatocyte, to
      explore the turnover of inositol hexakisphosphate, multiple isomers of inositol
      pentakisphosphate and two novel diphosphoinositol polyphosphates. All of these
      compounds gradually accumulated radioactivity throughout a 70 h period of
      labelling with [3H]inositol. However, a rapid metabolic rate was revealed upon
      inhibition of diphosphoinositol polyphosphate biphosphatase(s) with 1 mM fluoride
      for 40 min: this treatment elevated levels of [3H]diphosphoinositol
      polyphosphates up to 10-fold, indicating that their cellular pools were normally
      turning over at least 10 times every 40 min. This was accompanied by a turnover
      of about 10% of the pool of inositol hexakisphosphate. Control experiments
      established that 200 nM vasopressin brought about a typical activation of
      phospholipase C in hepatocytes after 62 h of primary culture. This agonist
      treatment did not affect steady-state levels of [3H]inositol pentakisphosphates,
      [3H]inositol hexakisphosphate or [3H]diphosphoinositol polyphosphates. However,
      prolonged treatment of hepatocytes with 2 microM thapsigargin reduced steady
      state levels of [3H]diphosphoinositol polyphosphates by 50-70%. This effect of
      thapsigargin was also observed in the presence of fluoride, indicating that
      thapsigargin inhibited the rate of synthesis of diphosphoinositol polyphosphates.

PMID- 8343138
TI  - Polarimetry and 13C n.m.r. show that the hydrolyses of beta-D-glucopyranosyl
      fluoride by beta(1-->3)-glucanases from Phanerochaete chrysosporium and
      Sporotrichum dimorphosporum have opposite stereochemistries.
AB  - The time courses of optical rotation and fluoride ion release during hydrolysis
      of beta-D-glucopyranosyl fluoride by the beta(1-->3)-glucanase of Phanerochaete
      chrysosporium (J. L. Copa-Patino and P. Broda, unpublished work) indicated that
      the initial sugar product was beta-D-glucopyranose. This was confirmed by
      monitoring the hydrolysis of 1-[13C]beta-D-glucopyranosyl fluoride by this enzyme
      with 13C n.m.r. (without proton decoupling). The same two techniques were used to
      confirm that hydrolysis of beta-D-glucopyranosyl fluoride by the exo beta(-->3)
      glucanase of 'Basidiomycete QM 806' (identified as Sporotrichum dimorphosporum)
      yielded alpha-glucopyranose as first sugar product, in accordance with previous
      results using laminarin as substrate [Parrish and Reese (1963) Carbohydr. Res. 3,
      424-429; Nelson (1970) J. Biol. Chem. 245, 869-872].

PMID- 8343140
TI  - The specification of sensory neuron identity in Drosophila.
AB  - Different types of sense organs are present on the larva of Drosophila. Several
      genes that specify the type of sense organ that will form at a particular
      position have been recently identified. Here we review the functional and
      molecular analyses of these genes, and summarize the evidence which supports a
      role in the choice of which type of organ will be formed. Most or all of these
      genes are required for the appropriate specification of adult as well as larval
      sense organs, suggesting that the larval and adult systems share many gene
      requirements. Interestingly, the specifying genes identified so far in the
      peripheral nervous system are also expressed in subsets of cells in the central
      nervous system, where they might have similar roles.

PMID- 8343139
TI  - Mg2+ affects the binding of ADP but not ATP to 3-phosphoglycerate kinase.
      Correlation between equilibrium dialysis binding and enzyme kinetic data.
AB  - The role of Mg2+ in the binding of ADP and ATP to pig muscle and yeast 3
      phosphoglycerate kinases has been studied by equilibrium dialysis. Whereas the Kd
      of ATP binding varies between 0.17 and 0.23 mM (S.E.M. 0.03 mM) for both enzymes,
      independently of the presence of Mg2+, the Kd values for ADP and MgADP binding
      are in the range 0.18-0.27 mM (S.E.M. 0.04 mM) and 0.05-0.06 mM (S.E.M. 0.01 mM)
      respectively. Thus Mg2+ exclusively tightens the interaction of ADP, but not of
      ATP, with the protein molecule. Although the equilibrium dialysis data are
      consistent with a model possessing a single site for nucleotides, the existence
      of a much weaker secondary site (with a Kd value at least two orders of magnitude
      larger) cannot be excluded. The binding of AMP and adenosine to pig muscle 3
      phosphoglycerate kinase is weaker than binding of MgATP; the respective Kd values
      are 0.36 +/- 0.05 mM and 0.65 +/- 0.05 mM. Thus, in addition to the interaction
      of the alpha-phosphate that is detectable by crystallography [Banks, Blake,
      Evans, Haser, Rice, Hardy, Merrett and Phillips (1979) Nature (London) 279, 773
      777], the beta- and/or gamma-phosphate(s) of MgATP may also interact with the
      enzyme molecule. The fact that MgADP binds more tightly than ADP is consistent
      with its stronger inhibition of the reaction catalysed by the enzyme between 3
      phosphoglycerate and MgATP. MgADP is a product of this reaction, and inhibits it
      competitively with both substrates; as an inhibitor its KI is comparable with the
      Kd found in binding studies. At the same time, the Km value for MgADP in the
      reverse reaction (0.18 +/- 0.05 mM; mean +/- S.E.M.) is higher than these
      constants; this may be due either to a different kinetic mechanism in this
      direction of the enzymic reaction, or to different binding modes of MgADP as
      inhibitor and as substrate. The reason why inhibition by MgADP is competitive
      with 3-phosphoglycerate may be that its binding prevents the specific change in
      conformation that the enzyme undergoes [Harlos, Vas and Blake (1992) Proteins 12,
      133-144] when it binds 3-phosphoglycerate.

PMID- 8343141
TI  - RNA as a catalyst: natural and designed ribozymes.
AB  - RNA can catalyse chemical reactions through its ability to fold into complex
      three-dimensional structures and to specifically bind small molecules and
      divalent metal ions. The 2'-hydroxyl groups of the ribose moieties contribute to
      this exceptional reactivity of RNA, compared to DNA. RNA is not only able to
      catalyse phosphate ester transfer reactions in ribonucleic acids, but can also
      show amino-acyl esterase activity, and is probably able to promote peptide bond
      formation. Bearing its potential for functioning both as a genome and as a gene
      product, RNA is suitable for in vitro evolution experiments enabling the
      selection of molecules with new properties. The growing repertoire of RNA
      catalysed reactions will establish RNA as a primordial molecule in the evolution
      of life.

PMID- 8343142
TI  - Protein targeting to dense-core secretory granules.
AB  - Regulated secretory proteins are stored within specialized vesicles known as
      secretory granules. It is not known how proteins are sorted into these
      organelles. Regulated proteins may possess targeting signals which interact with
      specific sorting receptors in the lumen of the trans-Golgi network (TGN) prior to
      their aggregation to form the characteristic dense-core of the granule.
      Alternatively, sorting may occur as the result of specific aggregation of
      regulated proteins in the TGN. Aggregates may be directed to secretory granules
      by interaction of a targeting signal on the surface with a sorting receptor.
      Novel targeting signals which confer on regulated proteins a tendency to
      aggregate under certain conditions, and in so doing cause them to be incorporated
      into secretory granules, have been implicated. Specific targeting signals may
      also play a role in directing membrane proteins to secretory granules.

PMID- 8343143
TI  - DNA damage and cell cycle regulation of ribonucleotide reductase.
AB  - Ribonucleotide reductase (RNR) catalyzes the rate limiting step in the production
      of deoxyribonucleotides needed for DNA synthesis. In addition to the well
      documented allosteric regulation, the synthesis of the enzyme is also tightly
      regulated at the level of transcription. mRNAs for both subunits are cell cycle
      regulated and inducible by DNA damage in all organisms examined, including E.
      coli, S. cerevisiae and H. sapiens. This DNA damage regulation is thought to
      provide a metabolic state that facilitates DNA replicational repair processes. S.
      cerevisiae also encodes a second large subunit gene, RNR3, that is expressed only
      in the presence of DNA damage. Genetic analysis of the DNA damage response in S.
      cerevisiae has shown that RNR expression is under both positive and negative
      control. Among mutants constitutive for RNR expression are the general
      transcriptional repression genes, SSN6 and TUP1. Mutations in POL1 and POL3 also
      activate RNR expression, indicating that the DNA damage sensory network may
      respond directly to blocks in DNA synthesis. A protein kinase, Dun1, has been
      identified that controls inducibility of RNR1, RNR2 and RNR3 in response to DNA
      damage and replication blocks. This result suggests that the RNR genes in S.
      cerevisiae form a regulon that is coordinately regulated by protein
      phosphorylation in response to DNA damage.

PMID- 8343144
TI  - Mammalian cells can trans-splice. But do they?

PMID- 8343145
TI  - Chromosome bands--flavours to savour.
AB  - The mammalian chromosome is longitudinally heterogeneous in structure and
      function and this is the basis for the specific banding patterns produced by
      various chromosome staining techniques. The two most frequently used techniques
      are G, or Giemsa banding and R, or reverse banding. Each type of stained band is
      characterised by variations in gene density, time of replication, base
      composition, density of repeat sequences, and chromatin packaging. It is
      increasingly apparent that R and G bands, which are complementary to each other,
      represent separate compartments of the euchromatic human genome, with R bands
      containing the vast majority of genes. R bands are also more GC-rich, contain a
      higher density of Alu repeats, and replicate earlier in S phase, than G bands.
      These properties may be interdependent and may have coevolved.

PMID- 8343146
TI  - The inhibition of HIV-1 protease by interface peptides.
AB  - Previous studies have shown that some peptides derived from one of the terminal
      amino acid segments of the homodimeric HIV-1 protease show moderate inhibition of
      this enzyme probably by interfering with the "interface" structure formed by the
      four terminal segments of the dimer. Different peptides, with improved inhibitory
      potency, were devised by computer modelling, synthesized, and tested. Ac-TVSFNF,
      the short peptide with the best inhibition so far (IC50 = 80 microM) is identical
      with the C-terminal part of the gag-pol frame shift protein p6*. This suggests a
      regulatory function of p6* as a dimerization inhibitor of HIV protease in the
      virion. Peptides derived from the active site sequence of PR are inactive. The
      two terminal hexapeptides of reverse transcriptase are also inactive in the HIV-1
      PR activity assay.

PMID- 8343147
TI  - Increase in albumin mRNA by repeated intrahepatic transplantation of F344 rat
      hepatocytes into the liver of congenic analbuminemic rats.
AB  - Hepatocytes of F344 rat were transplanted into the liver of congenic
      analbuminemic rats by infusion into the mesenteric vein from once to four times
      at one-week intervals. The transplantability was confirmed by the increase in the
      number of albumin-positive cells and appearance of normal albumin mRNA within the
      recipient liver, and the elevated serum albumin level. When the normal albumin
      mRNA was quantitated by reverse transcriptase polymerase chain reaction (RT-PCR)
      using the abnormally spliced albumin mRNA of analbuminemic rats as an internal
      standard, the increase in normal mRNA was in good agreement with the serum
      albumin level and the number of albumin positive hepatocytes within the liver.
      These three markers proportionally increased with the number of infusion times.
      Our results demonstrate that the number of intrahepatically transplanted
      hepatocytes is able to be increased by repeated infusion.

PMID- 8343148
TI  - Allyl compounds selectively killed human immunodeficiency virus (type 1)-infected
      cells.
AB  - Various allyl compounds were tested as anti-HIV reagents. Of all the allyl
      compounds tested, allyl disulfide (CH2 = CH-CH2-S-S-CH2-CH = CH2), allyl alcohol
      (CH2 = CH-CH2-OH), and its ester strongly depressed cell proliferation of HIV-1
      infected cells. KC50 (50% killing concentration) of the allyl disulfide and the
      allyl alcohol were 34 microM and 10 microM, respectively. The allyl alcohol, in
      particular, completely inhibited cell growth of HIV-1-infected cells by a single
      injection at a concentration of 40 microM, ultimately killing the viable CEM/LAV
      1 cells within 96 hr cultivation. No effect of the allyl alcohol and its esters
      on cell proliferation of CEM cells, which are a HIV-1 noninfected human T-cell
      cell line, was observed at the concentration range of 20 to 200 microM under the
      same experimental conditions. The results suggest that the effect of the allyl
      alcohol and its esters resulted in remarkable promotion of the cytopathic effect
      induced by HIV-1 virus.

PMID- 8343149
TI  - Molecular identification of onchocerciasis vector sibling species in black flies
      (Diptera: Simuliidae).
AB  - A number of sibling species in the Simulium damnosum species complex transmit
      River Blindness (onchocerciasis) in tropical Africa. Black fly sibling species
      can be reliably recognized only through analysis of the larval polytene
      chromosomes. The routine, unambiguous assignment of the potentially disease
      transmitting adult females to a particular species is virtually impossible. Two
      molecular assays to identify the sibling species of biting female flies are
      presented. The first relies on PCR-mediated amplification of internal transcribed
      spacers of the nuclear rDNA loci while the second involves immunoblotting of silk
      proteins which are expressed in both larvae and adult females. Both assays yield
      sibling-specific size markers that can be used to identify the sibling species of
      biting adult females. To illustrate the use of these assays, a molecular
      characterization is given for two S. damnosum siblings (squamosum, sirbanum)
      collected from cytologically verified populations, and a partial characterization
      of a third sibling (damnosum s. str.) found as a contaminant in these samples.

PMID- 8343150
TI  - Modulation of rat liver protein kinase C during "in vivo" CC14-induced oxidative
      stress.
AB  - Rat intoxication with a single dose of the hepatotoxin carbon tetrachloride
      induces a significant modification of liver protein kinase C total activity which
      depends on the degree of the intrahepatocyte oxidative unbalance provoked by
      various concentrations of the haloalkane. Low carbon tetrachloride amounts
      stimulate total protein kinase C activity, while one order of magnitude higher
      amounts exert strong enzyme inhibition. The latter effect is due to an early
      inactivation followed with progress of time by a proteolytic degradation of the
      enzyme. A pathological recruitment of the calcium-dependent protein kinase C
      regulatory enzymes calpain and calpastatin appears responsible for protein kinase
      C loss. The prolonged excess of cytosolic calcium which characterizes the single
      high dose carbon tetrachloride poisoning also leads to inactivation of calpain II
      and calpastatin in a time-dependent manner.

PMID- 8343151
TI  - Hyperosmotic stress induces immediate-early gene expression in ventricular adult
      cardiomyocytes.
AB  - Mammalian cells possessing osmosensors have long been described in brain and
      kidney. The genetic basis of the response to hyperosmotic stress has been well
      characterized in prokaryotes. In contrast, the genetic response of eukaryotic
      cells is poorly understood. Therefore we investigated the effect of hypertonic
      NaCl and sucrose solutions on the transcriptional activation of the immediate
      early genes (IEGs) egr-1 and c-fos in isolated ventricular adult rat
      cardiomyocytes. We observed that even small increases in osmolarity to 315 +/- 5
      mosmol/l and 370 +/- 8 mosmol/l by hypertonic NaCl solution resulted in dose
      dependent induction of egr-1 (4-and 5-fold) and c-fos (3-and 4-fold),
      respectively. Hypertonic sucrose solution had the same effect on egr-1 and c-fos
      mRNA levels while increased sucrose concentration under isotonic conditions had
      no effect. Cardiomyocytes exposed to hypertonic media did not significantly
      shrink as shown by a cell length measurement. We conclude that isolated adult
      cardiomyocytes possess an osmoreceptor mechanism which is able to sense even
      slight changes in osmolarity and to translate these into a transcriptional
      response of the myocardial IEG program.

PMID- 8343152
TI  - S1 nuclease-sensitive sites in the bithoraxoid region of the Drosophila
      Ultrabithorax gene.
AB  - The Ultrabithorax gene is required to specify the third thoracic and first
      abdominal segments of Drosophila melanogaster. Mutations in the bithoraxoid
      region, a 40 kb DNA stretch upstream of the Ultrabithorax promoter, affect cis
      regulatory elements of the Ultrabithorax gene. We now have identified specific
      sites in the bithoraxoid region that exhibit S1 nuclease sensitivity in vitro.
      These sites are not scattered along the DNA but are grouped instead in specific
      domains. Some of these S1-sensitive sites correlate with known breakpoint or
      insertional mutations. Others correspond to putative binding sites for
      transcription factors. The results suggest that unusual secondary structure might
      be important in chromosomal translocation within regulatory sequences of the
      Ultrabithorax product or its transcriptional regulation.

PMID- 8343153
TI  - Chromosomal localization of angiotensin II type 1 receptor isoforms in the rat.
AB  - The cDNA sequences of two different isoforms of the rat angiotensin II type 1
      receptors, AT1A and AT1B, have been reported. A single set of polymerase chain
      reaction primers was used to amplify sequence from both AT1A and AT1B from rat
      genomic DNA. Genomic DNA from a panel of rat x mouse somatic hybrid cell lines
      which had been characterized as to the rat chromosomal content was then amplified
      with these primers. The amplified products from rat AT1A and AT1B were
      distinguished from each other and those of the mouse by the use of differential
      restriction patterns. Using this method, AT1A was localized to rat chromosome 17
      and AT1B to rat chromosome 2.

PMID- 8343154
TI  - trk immunoreactivity at neuronal dendrite and cell body.
AB  - Neurotrophins homologous to the nerve growth factor (NGF) bind the neurotrophic
      receptors of the trk gene family. Since the target tissues release these
      neurotrophic factors to the neuron, it has been believed that their trophic
      effects are mediated by the retrograde axonal transport. However it remains an
      open question whether the neurotrophins act through the autocrine or the
      paracrine mechanisms, since the protein-level expression of trk has not been
      studied so far. We have made polyclonal antibodies against the recombinant
      proteins of chicken trkC and rat trkB. These antibodies showed immunoreactivity
      at the dendrite and the cell body of neuron. This subcellular localization
      strongly suggests the autocrine or the paracrine mechanism of the neurotrophic
      factors. At the same time, our data provide basic knowledge to decide where to
      deliver these neurotrophic factors in the therapy of neurodegenerative diseases.

PMID- 8343155
TI  - Isolation and identification of an endogenous inhibitor of enkephalin-degrading
      enzymes from bovine spinal cord.
AB  - We isolated a potent inhibitor of enkephalin-degrading enzymes from bovine spinal
      cord and determined its amino-acid sequence and inhibitory activity toward
      enkephalin-degrading enzymes. This new substance, designated spinorphin, is
      composed of a heptapeptide (Leu-Val-Val-Tyr-Pro-Trp-Thr). The inhibitory activity
      (IC50) of this new substance toward enkephalin-degrading enzymes, purified from
      monkey brain, was found to be 3.3 micrograms/ml against aminopeptidase, 1.4
      micrograms/ml against dipeptidyl aminopeptidase, 2.4 micrograms/ml against
      angiotensin-converting enzyme, and 10 micrograms/ml against enkephalinase. This
      new substance did not show inhibitory activity toward enkephalin degrading
      enzymes purified from kidney and blood. Above results suggest that this substance
      is a new neuromodulator in the spinal cord.

PMID- 8343156
TI  - Caffeine inhibits Ca(2+)-mediated potentiation of inositol 1,4,5-trisphosphate
      induced Ca2+ release in permeabilized vascular smooth muscle cells.
AB  - We studied the effects of caffeine on inositol 1,4,5-trisphosphate (IP3)-induced
      Ca2+ release in saponin-permeabilized smooth muscle cells. The Ca2+ concentration
      in the vicinity of the Ca2+ store was strongly buffered to exclude the secondary
      effect of Ca2+ on the Ca2+ release. 2 mM caffeine shifted the IP3 concentration
      Ca2+ release relation at 100 nM Ca2+ to the higher IP3 concentration without
      decreasing the steepness of the relation. The ascending limb of the biphasic Ca2+
      dependence of IP3-induced Ca2+ release was shifted to the higher Ca2+
      concentration by 2 mM caffeine. However, caffeine showed little inhibitory effect
      in the absence of Ca2+. These results indicate that caffeine inhibits IP3-induced
      Ca2+ release only when the Ca2+ release is potentiated by Ca2+.

PMID- 8343157
TI  - Cloning of gene responsible for tributyltin chloride (TBTC1) resistance in TBTC1
      resistant marine bacterium, Alteromonas sp. M-1.
AB  - A genetic library of tributyltin chloride (TBTC1)-resistant marine bacterium,
      Alteromonas sp. M-1, was constructed using plasmid vector pUC 19. Three positive
      clones were obtained from E. coli JM 109 transformed with the plasmids by the
      method of replica plating to LB medium containing 1 mM TBTC1. These clones could
      grow in LB liquid medium containing 100 microM TBTC1. Plasmids harbouring genes
      of Alteromonas sp. M-1 were designated pTBT1, pTBT2 and pTBT3 which contain 1.8
      kb Hind III-fragment, 4.8 kb Pst I-fragment and 7.8 kb Pst I-fragment,
      respectively. Nucleotide sequence of the shortest fragment, 1.8 kb Hind III
      fragment was determined, revealing an open reading frame (ORF) was contained in
      the fragment. The ORF was 324 bp (108 amino acids). The 48.5% of the amino acids
      encoded was hydrophobic, suggesting that the product relating to TBTC1 resistance
      might be membrane related protein. Homology search in amino acids alignment
      indicated that the product has homology with transport proteins.

PMID- 8343158
TI  - Vascular myocyte-derived nitric oxide is an autocrine that limits
      vasoconstriction.
AB  - Vascular myocytes and endothelial cells possess the enzymatic machinery to
      generate nitric oxide from L-arginine. This study tests the hypothesis that
      myocyte-derived nitric oxide has an autocrine function to inhibit contraction.
      Rat aortic rings were placed in muscle baths for isometric force measurement.
      Denuded and intact rings contracted to N omega nitro-L-arginine; L-arginine
      reversed these contractions. Compared to intact rings, contractile sensitivity to
      phenylephrine was increased in denuded rings; N omega nitro-L-arginine caused a
      further enhancement of phenylephrine sensitivity. Acetylcholine contracted
      denuded rings but not intact rings; these contractions were also potentiated by N
      omega nitro-L-arginine. In intact rings contracted with phenylephrine,
      acetylcholine caused relaxation that was inhibited by N omega nitro-L-arginine.
      Denuded rings did not relax to acetylcholine. In summary, contractile responses
      of rat aortae to interventions that alter nitric oxide production are the
      composite of enzymatic activity in both the endothelial cells and myocytes. Thus,
      myocyte-derived nitric oxide modulates vascular tone.

PMID- 8343159
TI  - Lipoprotein lipase facilitates very low density lipoprotein binding to the
      subendothelial cell matrix.
AB  - The effect of bovine lipoprotein lipase (LPL) on very low density lipoprotein
      (VLDL) binding to subendothelial matrix was studied. Without LPL, VLDL bound
      poorly to the matrix. However, decreasing NaCl or elevating Ca++ concentration
      increased matrix VLDL binding. With LPL, VLDL binding was markedly increased.
      Since LPL is a normal constituent of the artery wall and is elevated in
      atherosclerotic lesions, we postulate two potential mechanisms for the
      involvement of VLDL and LPL in atherogenesis. First, VLDL acquisition is
      attenuated by the increased matrix LPL content in the developing atheroma.
      Secondly, elevated plasma levels of VLDL (and VLDL remnants) such as in Type II
      or III dyslipidemia could enhance such interactions. These events likely
      accelerate the rate of atherosclerosis lesion development.

PMID- 8343160
TI  - A characterization of the H3 and H4 histone genes from the ascidian Styela
      plicata.
AB  - Information about histone sequences and histone gene organization from
      invertebrate chordates is completely lacking. A genomic clone containing linked
      H3 and H4 histone genes from the urochordate Styela plicata was analyzed. The
      nucleotide sequence indicates that the two genes are transcribed in opposite
      directions and have structural similarities to cell cycle-dependent histones.
      Unique amino acid replacements occur in H3 at positions 88 (serine) and 98
      (arginine). In H4, the methionine at position 84 is replaced by a leucine, a
      replacement found only in fungi. Codon usage patterns are nonrandom and resemble
      invertebrate patterns. The H3 and H4 genes are polymorphic and are represented
      five times per haploid genome.

PMID- 8343161
TI  - Biosynthesis and oligosaccharide processing of human Tamm-Horsfall glycoprotein
      permanently expressed in HeLa cells.
AB  - Human Tamm-Horsfall glycoprotein (T-H) is produced by renal cells of ascending
      limb of loop of Henle and is largely excreted in urine. N-linked glycans account
      for close to 30% of the weight of T-H. We studied the biosynthesis of recombinant
      T-H permanently expressed in HeLa cells. The conversion from the precursor (84
      kDa) to the mature form (97 kDa) mainly depends on the processing of glycans from
      the high-mannose to polyantennary type. The conversion from precursor to mature
      form is very slow and the glycan structure of precursor appears to be that of a
      glycoprotein not yet processed by Golgi alpha 1,2 mannosidase. Since T-H has a
      very high number of disulfide bridges (more than 50 cysteine residues/mol) one
      may infer that the rate limiting step for the precursor export out of ER is the
      formation of a correct set of disulfide bonds. Mature T-H isolated from HeLa
      cells retained one N-linked chain with the high-mannose structure similarly to
      urinary T-H. This result indicates that the occurrence of one unprocessed high
      mannose chain in mature T-H is host-cell independent and very likely related to
      the T-H primary structure.

PMID- 8343162
TI  - A missense mutation of cardiac beta-myosin heavy chain gene linked to familial
      hypertrophic cardiomyopathy in affected Japanese families.
AB  - A novel missense mutation of the cardiac beta-myosin heavy chain gene was
      detected in five unrelated Japanese patients and their affected family members
      with hypertrophic cardiomyopathy (HCM) by using the polymerase chain reaction
      (PCR)-DNA conformation polymorphism (DCP) analysis. Sequencing analysis revealed
      an A to G transition at codon 778 leading to replacement of the Asp residue,
      which is adjacent to the interaction sites of myosin heavy chain (MHC) with actin
      and is a conserved amino acid residue in various MHC across species, to the Gly
      residue. Linkage study of the mutation and two dinucleotides repeat markers of
      the cardiac beta-MHC gene in three affected families showed that the mutation was
      on the same haplotype of the cardiac beta-MHC gene and linked to HCM. These
      observations strongly suggest that the 778Asp to Gly mutation is the cause of HCM
      in these affected individuals.

PMID- 8343163
TI  - Expression of vascular endothelial growth factor by cultured endothelial cells
      from brain microvessels.
AB  - Vascular endothelial growth factor (VEGF) is a potent and specific mitogen for
      vascular endothelial cells that may be involved in tumor angiogenesis. Cultured
      capillary endothelial cells from rat brain (BCEC) express transcripts for VEGF as
      assayed by Northern blots and polymerase chain reaction analysis. The three forms
      of VEGF (VEGF120, VEGF164 and VEGF188) are produced, VEGF188 being detected in
      lower amounts. The sequence of rat VEGF188 was determined. Rat and human exons 6
      differ at only one position (human Tyr134-->rat Phe133). Transcripts for VEGF
      were observed in different clones of rat BCEC, in bovine BCEC but not in bovine
      aortic endothelial cells.

PMID- 8343164
TI  - Conformational states of human placental glutathione transferase as probed by
      limited proteolysis.
AB  - Limited proteolysis experiments have been carried out on human placental
      glutathione transferase in its different forms. The reduced enzyme, as well as
      the oxidized form and that inactivated with cystamine were all sensitive to 10%
      (w/w) trypsin, under nondenaturing conditions. The proteolytic cleavage was
      accompanied by a concomitant loss of enzymatic activity. On the contrary, the
      presence of glutathione or glutathione conjugates strongly protected the reduced
      enzyme against inactivation and from the proteolytic attack. Sodium dodecyl
      sulphate-polyacrylamide gel electrophoresis and peptide sequence analysis showed
      that only the peptide bond between Lys 44 and Ala 45 was cleaved. Since Lys 44
      has been demonstrated to be involved in the glutathione binding, it is suggested
      that the region surrounding this amino acid residue (alpha B helix) could be more
      exposed to the solvent, in the absence of glutathione. Crystallographic data also
      indicated that this region is flexible, supporting the idea that it may be
      involved in the observed conformational change upon glutathione binding.

PMID- 8343165
TI  - Molecular cloning, functional expression and chromosomal localization of the
      human cholecystokinin type A receptor.
AB  - The cholecystokinin (CCK) family of peptides and receptors are present throughout
      the brain and gastrointestinal tract and can be pharmacologically subdivided into
      two subtypes: CCKA and CCKB. Little is known about the localization, pharmacology
      and function of CCKA receptors (CCKAR) in humans. We used the rat CCKAR cDNA to
      isolate the human CCK receptor cDNA homologue from human gallbladder which
      encodes a unique 428 amino acid protein having > 90% homology to the rat and
      guinea pig CCKAR. Expression of the recombinant CCKAR in COS-7 cells displayed a
      pharmacological profile characteristic of a CCKAR subtype and mediated agonist
      stimulated increase in total inositol phosphates. Northern hybridization
      identified a transcript measuring 6 Kb. The human CCKAR gene maps to chromosome
      4. These results describe for the first time the molecular cloning, expression
      and chromosomal localization of the human CCKA receptor.

PMID- 8343166
TI  - Expression and cloning of migration inhibitory factor-related protein (MRP)8 and
      MRP14 in arthritis-susceptible rats.
AB  - Rat migration inhibitory factor-related protein 8 (MRP8) and MRP14 were
      identified during screening of a subtracted cDNA library generated to identify
      differences in gene expression between LEW/N and F344/N rats. The predicted amino
      acid sequence of rat MRP8 and MRP14 is 60-80% identical with that from human and
      mouse. Expression of these genes correlated with chronic inflammation in LEW/N
      rats, but were absent in F344/N rats which do not develop arthritis in response
      to streptococcal cell wall peptidoglycan-polysaccharide complexes (SCW). These
      differences suggest a role for MRP8 and MRP14 in susceptibility to SCW-induced
      chronic disease.

PMID- 8343167
TI  - Spontaneous nucleosomal DNA fragmentation in murine leukemic L1210 cells.
AB  - Spontaneous nucleosomal DNA fragmentation (SNDF), characteristic of apoptotic
      cell death was observed in a murine leukemic cell line grown to high density.
      This effect was eliminated by permitting free diffusional exchange with a large
      amount of complete medium. Cells seeded at low density did not show SNDF in a
      conditioned medium that had been used to culture cells with severe SNDF. Cells
      seeded at high density in the same conditioned medium showed pronounced SNDF, but
      addition of 10% fetal bovine serum to such a medium significantly reduced SNDF.
      These observations indicate that neither physical contact among cells in high
      density culture per se nor secretion of a death factor by the high density
      culture could account for the induction of SNDF. The results support a model in
      which the gradual depletion of a serum factor(s) leads to the activation of a
      cell death program that is manifested as SNDF.

PMID- 8343168
TI  - Exogenous phospholipase C specifically inhibits apoE expression in mouse
      peritoneal macrophages.
AB  - Treatment of cholesterol-loaded mouse peritoneal macrophages with exogenous
      phospholipase C results in a specific and dose-dependent inhibition of apoE
      secretion. The inhibition of apoE secretion is secondary to the rapid and
      specific inhibition of its synthesis. The profound changes in rates of apoE
      synthesis are not accompanied by changes in the levels of apoE mRNA, an
      observation strongly suggestive of translational regulation of expression. The
      changes in apoE expression coincide with, or are preceded by a three-fold
      increase in membrane-bound protein kinase C activity, pointing out the potential
      importance of this signal transduction pathway in regulating apoE expression at a
      posttranscriptional locus.

PMID- 8343169
TI  - Retinoblastoma gene product-associated proteins in human colon cancer cell lines.
AB  - The expression of cellular proteins that associate with the human retinoblastoma
      (RB1) gene protein was examined in three colorectal carcinoma cell lines (SW480,
      SW403, DiFi) by immunoprecipitation analysis, using the mouse monoclonal antibody
      (RB-MAb-1) directed against the RB1 gene product (RB). The potential of RB-MAb-1
      to detect RB-associated proteins by immunoprecipitation analysis was confirmed
      using three control cell lines (WI-38, J82, T24) known to express RB and/or RB
      associated proteins. In all colon cancer cell lines tested, multiple RB
      associated protein (RAP) bands were found with molecular weights of 30-50 kDa.
      Because involvement of the RB1 gene in colorectal tumorigenesis appears to differ
      from its role in other cancer types (wherein RB1 is lost or inactivated), it will
      be important to characterize the role of RAPs in RB growth regulatory mechanisms
      of colonic epithelial cells.

PMID- 8343170
TI  - Tumor cell retention of antibody Fab fragments is enhanced by an attached HIV TAT
      protein-derived peptide.
AB  - Two peptide analogs of the 37-62 sequence region of the HIV TAT protein bind
      tightly to the surface of A431 breast carcinoma cells. After conjugation to
      either of two poorly internalized anti-tumor antibody Fab fragments, the analogs
      enhanced the in vitro cell surface retention and internalization of the Fab
      fragments to the level of the whole antibodies. This was at the expense of some
      binding specificity in the case of 1.6 peptides/NRLU-10 Fab, but not in the case
      of 1.1 peptides/Fab. Enhanced retention may occur by enhanced bivalent binding of
      the Fab fragments. The internalized fraction of free peptide, but not of the Fab
      conjugates, is enhanced by chloroquine. The conjugates which were less specific
      for tumor cell binding may be useful for enhanced retention/internalization of
      specifically acting agents, for use at specific sites of injection, or against
      pre-separated target cell populations, while the more specific conjugate may be
      of interest for further development.

PMID- 8343171
TI  - Double-stranded RNA triggers generalized translational arrest in Xenopus oocytes.
AB  - Controls of gene expression which act at the translational level can be rapidly
      activated and readily reversed. The impact of double-stranded RNA on
      translational control is of significant interest as a number of studies point to
      its ability to directly activate generalized translational arrest. This activity
      is observed in in vitro systems stimulated by native double-stranded RNAs or
      synthetic homopolymers and is inferred in virally infected cells in tissue
      culture. Significantly, however, this activity has never been studied in an
      intact cell system using RNAs of known secondary structure. In this study we
      arrest total cellular translation in intact Xenopus oocytes by micro-injecting
      them with alpha-globin-derivative mRNAs containing defined double-stranded
      segments. The ability of these mRNAs to directly activate translational arrest in
      oocytes substantiates the potential role for this activity in vivo and
      establishes a well-characterized whole cell system for its further study.

PMID- 8343172
TI  - Newly established murine pituitary folliculo-stellate-like cell line (TtT/GF)
      secretes potent pituitary glandular cell survival factors, one of which
      corresponds to metalloproteinase inhibitor.
AB  - A mouse folliculo-stellate cell (FS cell) line, TtT/GF, was found to secrete a
      potent survival factor influencing a somatotropic cell line (MtT/S) in serum-free
      medium. A three-step chromatography purification procedure using heparin-affinity
      chromatography, anion-exchange chromatography and gel-filtration chromatography
      revealed that the factor was a 27 kDa protein. Amino-terminal sequence analysis
      showed that the N-terminal 20 amino acids of the 27 kDa protein corresponded to
      those of human tissue inhibitor of metalloproteinase-II (TIMP-II). These results
      indicate that FS cells secrete TIMP-II, which probably protects the composition
      of the extracellular matrix and acts as a cell survival factor for endocrine
      cells in the anterior pituitary gland.

PMID- 8343173
TI  - ADP-ribosylation of neurofilaments by a cytoplasmic ADP-ribose transferase
      associated with free mRNP.
AB  - ADP-ribosylation of neurofilaments by an ADP-ribose transferase isolated from
      cytoplasmic ribonucleoprotein particles is demonstrated. The 150 kDa
      neurofilament subunit appears to be the main ADP-ribose acceptor with the
      transfer of ADP-ribose dimers or monomers. A binding of about 1 mole ADP-ribose
      per 8 moles of neurofilament subunits has been recorded. An interaction between
      neurofilaments' ADP-ribosylation and their phosphorylation state is demonstrated.

PMID- 8343175
TI  - Direct electrochemical measurement of nitric oxide released from human platelets.
AB  - A porphyrinic microsensor has been used to investigate the release of nitric
      oxide (NO) from human platelets in whole blood and in washed platelet
      suspensions. Basal release of NO was not detectable. Aggregation of platelets by
      collagen (1-15 micrograms/ml) but not by thrombin (0.1 U/ml) resulted in a
      concentration-dependent release of NO. This release was prolonged and potentiated
      by L-arginine (100-1000 microM) and inhibited by NG-monomethyl-L-arginine (300
      microM). These data support our previous findings that human platelets generate
      NO during aggregation.

PMID- 8343174
TI  - Analysis of cleavage-site patterns in protein precursor sequences with a
      perceptron-type neural network.
AB  - A method for feature extraction from protein sequences has been developed which
      is based on an artificial neural filter system. Amino acid sequences are analyzed
      with regard to physicochemical residue properties. This alternative
      representation of a sequence allows an interpretation of the networks' weight
      values in a comprehensive and biochemically meaningful way by displaying the
      optimized network weights in Hinton diagrams. Signal peptidase cleavage sites of
      E.coli periplasmic proteins, human mitochondrial precursors and chloroplast
      precursors from spinach have been investigated. The network for E.coli
      periplasmic protein precursors classified both training and test data with 100%
      accuracy. The interpretation of its network weights clearly confirms the "-3,-1
      rule" and the existence of a hydrophobic core region starting at position -6.
      Further striking features and dominant positions can be found for all three types
      of cleavage sites.

PMID- 8343176
TI  - Deoxyribocytidine is salvaged not only into DNA but also into phospholipid
      precursors. IV. Exogenous deoxyribocytidine can be used with the same efficacy as
      (ribo)cytidine for lipid activation.
AB  - Utilisation of exogenous (ribo)cytidine (3H-CR) and deoxyribocytidine (3H-CdR)
      for DNA/RNA synthesis and for activation of phospholipid intermediates was
      compared in human tonsillar lymphocytes. Incorporation of 3H-CdR into dCDP
      choline and into dCDP-DAG was similar or even higher than labelling of CDP
      choline and CDP-DAG from 3H-CR. No interconversion was found between CDP-DAG and
      dCDP-DAG, as shown by TLC separation of the ribo- and deoxyribocytidine
      derivatives. Moreover, a strict separation was found between the salvage pathways
      of deoxyribocytidine and (ribo)cytidine, as 4000-fold excess of non labelled
      (ribo)cytidine did not show any specific effect on 3H-dCDP-DAG labelling from
      exogenous 3H-CdR.

PMID- 8343177
TI  - Scanning tunnelling microscopy of collagen I reveals filament bundles to be
      arranged in a left-handed helix.
AB  - Collagen I is the most abundant protein found in the body. Its quaternary
      structure has been extensively characterised and consists of filaments arranged
      into bundles. In this study we used scanning tunnelling microscopy to image the
      collagen I filaments and fibrils directly. The images suggested that filaments
      are arranged into a left-handed helical structure with a periodicity of about
      10nm. Such a structure potentially adds increased tensile strength to the
      collagen fibrils.

PMID- 8343178
TI  - Implication of cysteine residues in the activity of single-chain urokinase
      plasminogen activator.
AB  - Single-chain urokinase-plasminogen activator contains 24 cysteine residues
      involved in 12 disulfide bonds and distributed all along the three domains of the
      protein. In order to investigate the role of these disulfide bridges in the
      catalytic activities of scu-PA, we used site-specific mutagenesis to construct 10
      mutants in which some cysteine residues were changed to serine residues. Each
      mutated DNA fragment was cloned into a procaryotic expression vector and the
      protein expressed in E. coli. Mutant proteins of the expected size were produced
      and analyzed for amidolytic and fibrinolytic activities. From this, it is shown
      that: i) the disulfide bonds in the epidermal growth factor (EGF)-like and in the
      kringle domains are not necessary. Moreover, disulfide bond deletion in the
      kringle domain improves those catalytic activities; ii) on the contrary, the
      disulfide bridges in the catalytic domain are essential for maintaining both
      activities.

PMID- 8343179
TI  - Geriatric rheumatology.

PMID- 8343180
TI  - Nitric oxide and arthritis.

PMID- 8343182
TI  - Antineutrophil cytoplasmic antibodies in rheumatoid arthritis. Characterization
      and clinical correlations.
AB  - OBJECTIVE: To study the prevalence, interrelationships, and target antigens of
      antineutrophil cytoplasmic antibodies (ANCA) in rheumatoid arthritis (RA) and to
      relate their presence to disease duration and to the occurrence of extraarticular
      manifestations, including vasculitis. METHODS: Sera from 94 patients with RA (31
      with recent-onset disease, 35 with longstanding disease but without
      extraarticular manifestations, and 28 with extraarticular disease) were studied
      for the presence of ANCA by indirect immunofluorescence. All sera were tested by
      enzyme-linked immunosorbent assay (ELISA) for the presence of antibodies to
      proteinase 3, myeloperoxidase (MPO), elastase, lactoferrin (LF), and cathepsin G
      (CG), and by Western blotting for antibodies to neutrophil proteins. RESULTS:
      Seventy percent of the 94 sera showed staining of the nuclei of ethanol-fixed
      neutrophils; 32% of the 94 were proven to have ANCA, as manifested by their
      cytoplasmic staining pattern on paraformaldehyde-fixed neutrophils. In the ELISA,
      19 sera reacted with LF, 1 with MPO, and 1 with CG. By Western blotting, 21 sera
      reacted with LF, and 15 reacted with previously unknown polypeptides (7 sera with
      a 67/66-kd doublet and 8 with a 63/54-kd doublet). Neither of these antibodies
      was associated with a particular subset of the disease, but the prevalence of the
      antibodies tended to increase among patients with longstanding disease.
      CONCLUSION: ANCA in RA patients are directed toward diverse cytoplasmic antigens
      of the neutrophil, in particular, LF and other, not yet fully characterized
      polypeptides. The antibodies are not a marker for a disease subset, but are
      probably a corollary of chronic inflammation.

PMID- 8343181
TI  - Rheumatoid arthritis and mortality. A longitudinal study in Pima Indians.
AB  - OBJECTIVE: To determine the effect of rheumatoid arthritis (RA) on mortality
      rates. METHODS: Longitudinal analyses of data from a cohort of Pima Indians from
      the Gila River Indian Community in Arizona, who were followed up during the
      period February 1965 through December 1989. RESULTS: Among 2,979 study subjects
      aged > or = 25 years, there were 858 deaths, 79 of which occurred in subjects
      with RA (36 men, 43 women). Age- and sex-adjusted mortality rates were slightly
      higher in subjects with RA than in those without (mortality rate ratio 1.28, 95%
      confidence interval [95% CI] 1.01-1.62). Among those with RA, mortality rates
      were higher in older subjects (mortality rate ratio 1.51 per 10-year increase in
      age, 95% CI 1.22-1.88), in male subjects (mortality rate ratio 2.23, 95% CI 1.44
      3.45, adjusted for age), and in subjects with proteinuria (mortality rate ratio
      1.88, 95% CI 1.02-3.46, adjusted for age and sex). Mortality rate ratios for
      these risk factors were similar in subjects without RA. In addition, among
      subjects with RA, rheumatoid factor (RF) positivity was predictive of death
      (mortality rate ratio 1.94, 95% CI 1.10-3.43), and the excess mortality was found
      primarily among subjects who were seropositive. The death rate from
      cardiovascular disease (mortality rate ratio 1.77, 95% CI 1.10-2.84) and from
      liver cirrhosis or other alcohol-related disease (mortality rate ratio 2.52, 95%
      CI 1.06-6.01) was increased in persons with RA. CONCLUSION: The results of this
      population-based study suggest that although the risk of mortality in subjects
      with RA is significantly higher than in those without RA, the risk ratio is in
      the lower range of that described previously in studies of clinic-based cohorts.
      RF positivity as a predictor of early death among subjects with RA indicates that
      the immunologic processes in seropositive RA may contribute to the events that
      eventually lead to early death.

PMID- 8343183
TI  - The repertoire of rheumatoid factor-producing B cells in normal subjects and
      patients with rheumatoid arthritis.
AB  - OBJECTIVE: To compare the B cell repertoire of normal individuals and patients
      with rheumatoid arthritis (RA) and, specifically, to identify precursor B cells
      with the potential to secrete rheumatoid factor (RF) and to understand the T
      helper cell requirements for the production of this autoantibody. METHODS:
      Frequencies of precursors of IgM-, IgG-, and RF-producing B cells were measured
      in a limiting-dilution system. Two distinct sources of T cell help were compared.
      T cell help was provided by anti-CD3-activated CD4+ human T cell clones, or T
      cell-B cell interaction was facilitated by the bacterial super-antigen
      staphylococcal enterotoxin D (SED). RESULTS: A subset of 2-14% of peripheral
      blood B cells secreted IgM and IgG in SED-driven cultures. The SED-responsive B
      cell subpopulation was present at 10 times higher frequency in normal donors
      compared with RA patients. However, the repertoires were very similar,
      particularly for RF+ precursors, which represented approximately one-third of all
      SED-responsive B cells. In normal individuals, most of these RF+ precursor B
      cells did not respond to anti-CD3-activated T helper cells, with only a very
      small fraction of B cells activated by anti-CD3-driven helper cells maturing into
      RF-secreting B cells (from 1 of 182 to 1 of 889 IgM-producing B cells). This
      subset was expanded approximately 50-fold in RA patients. CONCLUSION: Normal
      subjects and RA patients share a pool of B cells which secrete RF when activated
      in the presence of SED and T helper cells. These B cells are frequent and
      obviously anergic in normal individuals. The B cell subset with the potential to
      produce RF when help is provided in noncognate T-B interaction (anti-CD3-driven T
      cells) is considerably expanded in RA patients, probably reflecting an increased
      responsiveness of such B cells to helper signals.

PMID- 8343184
TI  - Detection of herpesviruses by polymerase chain reaction in lymphocytes from
      patients with rheumatoid arthritis.
AB  - OBJECTIVE: To investigate the occurrence of herpesviruses, including Epstein-Barr
      virus (EBV), herpes simplex viruses types 1 and 2 (HSV-1; HSV-2), and human
      herpesvirus 6 (HHV-6), in lymphocytes from patients with rheumatoid arthritis
      (RA) of less than 1 year's duration. METHODS: The polymerase chain reaction was
      applied to cells isolated from synovial fluid and peripheral blood. Indirect
      immunofluorescence and enzyme immunoassay techniques were used to detect
      antibodies against EBV and HSV, respectively. RESULTS: EBV DNA was present in
      synovial fluid lymphocytes from 19% (7 of 37) of the RA patients and 33% (5 of
      15) of the patients with reactive arthritis (ReA). Peripheral blood lymphocytes
      harbored EBV DNA in 39% of the RA patients, 39% of the ReA patients, 27% of the
      patients with other arthropathies, and in 31% of the healthy control subjects.
      HSV-1, HSV-2, and HHV-6 viral DNA was not detected in cells from the synovial
      fluid or peripheral blood. CONCLUSION: Our findings do not support the
      participation of EBV, HSV-1, HSV-2, or HHV-6 in the pathogenesis of RA. A role
      for the highly prevalent EBV cannot be excluded, however, since potential
      contributions may become manifest only when other necessary factors are involved.
      RA pathogenesis caused by an overproduction of the EBV virus is nevertheless
      highly unlikely.

PMID- 8343185
TI  - Presence of estrogen-binding sites on macrophage-like synoviocytes and CD8+,
      CD29+, CD45RO+ T lymphocytes in normal and rheumatoid synovium.
AB  - OBJECTIVE: To study the presence of estrogen-binding sites (EBS) in the synovial
      tissues of male and female patients with rheumatoid arthritis (RA) and in age-
      and sex-matched healthy controls. METHODS: Both type 1 (high affinity, low
      binding capacity) and type 2 (reduced affinity, higher binding capacity) EBS were
      investigated in both soluble and nuclear fractions of homogenized synovial tissue
      samples by a dextran-coated charcoal method. To determine what type of synovial
      cell was positive for EBS, cryosections of synovial tissues were immunostained
      with a specific monoclonal anti-estrogen receptor antibody (anti-ER MAb) using
      both immunofluorescence and immunoperoxidase techniques. Double immunostaining
      with the anti-ER MAb and with specific MAb to detect different macrophage
      antigens (Ber-MAC3, MAC387, CD68) and CD8+ T cell subsets (CD29+, CD45RO+ and
      CD29-, CD45RO-) was performed. RESULTS: Higher affinity EBS were found mostly in
      nuclear cell fractions of either RA or control synovial tissues (28 of the 33).
      These EBS were present to a lesser extent in soluble cell fractions (11 of the
      33). Immunostaining showed the estrogen receptor-positive cells to be the
      macrophage-like synoviocytes and the CD8+, CD29+ T cells both in RA and in
      control synovial tissues. Higher nuclear content of EBS was consistent with more
      intense nuclear staining of synoviocytes and T cells. CONCLUSION: It is
      conceivable that the immunomodulatory activity exerted by estrogens is at least
      partly mediated through their interaction with EBS that are present on macrophage
      like synoviocytes, functioning as antigen-processing and antigen-presenting
      cells, and on antigen-experienced (memory) CD8+ T lymphocytes (CD29+, CD45RO+).

PMID- 8343186
TI  - Integrin-mediated attachment of articular chondrocytes to extracellular matrix
      proteins.
AB  - OBJECTIVE: To investigate the interactions between chondrocytes and their
      extracellular matrix (ECM). An attachment assay was used to determine the extent
      of integrin-mediated attachment of chondrocytes to a variety of ECM proteins and
      the effect of monolayer culturing on attachment activity. METHODS: Bovine and
      human articular cartilage chondrocytes were grown in high-density monolayer
      cultures for 3-21 days and used in the assays. Cell shape and production of 3H
      proline-labeled collagen were monitored to assess phenotypic changes with time in
      culture. Cultured chondrocytes were incubated in wells coated with purified
      proteins, with and without specific inhibitors of integrin-mediated attachment,
      and cell attachment was determined. RESULTS: Compared with bovine serum albumin,
      chondrocytes showed significant attachment to fibronectin, matrix Gla protein
      (MGP), osteopontin, bone sialoprotein II (BSP II), vitronectin, and types II and
      VI collagen. A synthetic peptide containing the integrin-recognition sequence Arg
      Gly-Asp inhibited attachment to all the proteins tested, except types II and VI
      collagen. A monoclonal antibody (MAb) to the beta 1-integrin subunit inhibited
      attachment to fibronectin, MGP, and type II collagen, and a MAb to the beta 3
      integrin subunit inhibited attachment to BSP II and osteopontin. An increase in
      cell attachment was seen with time in culture, and this increase was followed by
      a change in the chondrocytes to flattened, type I collagen-producing cells.
      CONCLUSION: Chondrocytes can attach to a variety of cartilage and bone proteins;
      this attachment is mediated via integrins, including members of both the beta 1
      and beta 3 subunit families. The modulation of the chondrocyte phenotype during
      monolayer culture may be related to activation or increased expression of
      integrins.

PMID- 8343187
TI  - Comparative studies of the major histocompatibility complex in French Canadian
      and non-French Canadian Caucasians with systemic lupus erythematosus.
AB  - OBJECTIVE: To investigate and compare the predisposing role of major
      histocompatibility complex (MHC) genes in systemic lupus erythematosus (SLE) in
      French Canadian and non-French Canadian (mainly Anglo-Saxon descent) Caucasian
      subjects. METHODS: HLA-A, B, C (serology), DR, and DQ (restriction fragment
      length polymorphism [RFLP] typing) were determined. RFLP defining a large C4A,21
      OHA deletion (Taq I C4) and an Nco I tumor necrosis factor alpha (TNF alpha) RFLP
      were analyzed in 91 Caucasian Canadians and 91 ethnically matched control
      subjects. RESULTS: In the total SLE and non-French Canadian SLE populations, HLA
      B8, DR3(DR17), Dw24, DQ2, and the C4A gene deletion were associated with SLE.
      These HLA specificities and the C4A gene deletion were not significantly
      increased in French Canadian SLE patients compared with ethnically matched
      controls. When present in French Canadians, the C4A gene deletion was less
      closely associated with HLA-DR3(DR17), Dw24, DQ2 than in other Caucasians. HLA
      DQ6 was associated with SLE in French Canadians. No association of the 2-allele
      Nco I TNF alpha RFLP with SLE was found in this population, in either ethnic
      group. CONCLUSION: These results support the importance of ethnic background in
      the study of MHC genes and SLE. The extended HLA-B8,DR3,C4A null haplotype is
      found mainly in SLE patients of Anglo-Saxon descent, while the DQ6 specificity is
      associated with SLE in French Canadians. This relatively genetically homogeneous
      Caucasian population offers the opportunity to study non-HLA-B8,DR3-linked MHC
      influence in SLE.

PMID- 8343188
TI  - Lymphoproliferation in primary Sjogren's syndrome. Evidence of selective
      expansion of a B cell subset characterized by the expression of cross-reactive
      idiotypes.
AB  - OBJECTIVE: To evaluate the possibility that lymphoproliferation in primary
      Sjogren's syndrome (SS) arises within a subset of B cells. METHODS: A panel of
      monoclonal antibodies (MAb) specific for rheumatoid factor (RF)-associated cross
      reactive idiotypes (CRI) and anti-V kappa and anti-VH subgroup antibodies were
      used to define the clonality of B lymphocytes undergoing neoplastic
      transformation in 5 patients with primary SS. Anti-CRI antibodies were also used
      to study longitudinal variations in serum paraprotein levels and in vitro
      regulation of IgM and IgM-RF production by peripheral blood lymphocytes. The
      levels of CRI, IgM, and IgM-RF were quantitated in serum and culture supernatants
      by enzyme-linked immunosorbent assay. Heavy and light chain isotypes and VH
      subgroups of the paraproteins were determined by immunoelectrophoresis,
      immunofixation, and Western blotting. RESULTS: Paraproteins from all patients
      expressed an epitope associated with V kappa IIIb sub-subgroup of light chains.
      Three of the paraproteins were cryoglobulins with RF activity, all of which
      expressed the V kappa IIIb-associated CRI (detected by MAb 17-109) and the VHI
      associated CRI (detected by MAb G6 and G8). None of the paraproteins expressed
      the VHIII-associated CRI (detected by MAb B6 and D12). The CRI were consistently
      expressed over a period of 5-6 years. The anti-CRI and anti-subgroup antibodies
      substantially inhibited spontaneous production of IgM-RF and IgM by peripheral
      blood B lymphocytes from 3 of the SS patients. CONCLUSION: These results suggest
      that lymphoproliferation in primary SS is highly selective, and that the anti-CRI
      antibodies can be used as an aid to early diagnosis as well as for monitoring and
      modulating the lymphoproliferative process in primary SS.

PMID- 8343189
TI  - Antihistone antibodies in patients with localized scleroderma.
AB  - OBJECTIVE: To study the prevalence and antigen specificity of antihistone
      antibodies (AHA) in localized scleroderma. METHODS: Forty-nine serum samples from
      patients with localized scleroderma were examined by an enzyme-linked
      immunosorbent assay (ELISA) and by immunoblotting. RESULTS: By ELISA, AHA were
      demonstrated in 47% (23 of 49) of patients with localized scleroderma and in 87%
      (13 of 15) of patients with generalized morphea. Immunoblotting revealed that the
      predominant antigens were histones H1 and H3. The presence of AHA correlated with
      that of anti-single-stranded DNA antibody. CONCLUSION: Some of the major antigens
      for antinuclear antibodies in patients with localized scleroderma are histones.

PMID- 8343190
TI  - Connective tissue activation. XXXVI. The origin, variety, distribution, and
      biologic fate of connective tissue activating peptide-III isoforms:
      characteristics in patients with rheumatic, renal, and arterial disease.
AB  - OBJECTIVE: To determine the origin, distribution, and biologic fate of platelet
      derived connective tissue activating peptide-III (CTAP-III), to define the
      relative amounts of the antigen forms (CTAP-III, beta-thromboglobulin [beta-TG],
      neutrophil activating peptide-2 [NAP-2]) in plasma of normal persons and those
      with rheumatic or end-stage renal disease, and to define the isoforms of CTAP-III
      in platelets, plasma, transudates, and tissue deposits. METHODS: CTAP-III in
      plasma was measured by enzyme-linked immunosorbent assay, and growth promoting
      activity of CTAP-III isoforms was tested in synovial and peritoneal cell cultures
      by measuring increased synthesis of 14C-glycosaminoglycan (14C-GAG) and 3H-DNA.
      Isolated CTAP-III was characterized by Western blotting, microsequencing, and
      mass spectrometry. RESULTS: CTAP-III was the primary isoform of this antigen
      family in normal platelets and platelet-rich plasma; beta-TG and NAP-2 accounted
      for < 1% of CTAP-III isoforms. Previously undescribed isoforms, i.e., CTAP-III
      des 1, des 1-2, des 1-3, and a phosphate adduct of CTAP-III, were observed in
      varying amounts. Elevated plasma levels of CTAP-III antigen were found in a
      substantial fraction of rheumatic disease patients: 24% of those with rheumatoid
      arthritis, 36% of those with systemic sclerosis, and 15% of those with systemic
      lupus erythematosus. All 10 patients with end-stage kidney disease had marked
      elevations of plasma CTAP-III levels, which stimulated DNA and GAG synthesis by
      peritoneal cells in culture. Only large isoforms (such as CTAP-III) were detected
      in venous plasma of normal subjects, rheumatic disease patients, and patients
      receiving long-term dialysis. Normal human spleen and kidney contained
      substantial (micrograms/gm) amounts of CTAP-III and traces of an isoform with the
      electrophoretic mobility of CTAP-III des 1-15/NAP-2. Liver, lung, and urine
      contained lesser (ng/gm) amounts of CTAP-III. CONCLUSION: These data show that,
      among the 10 known isoforms, intact CTAP-III itself was the major circulating
      isoform (> 90%), and beta-TG was the most rare (0-1%). Deposition of CTAP-III in
      tissues, such as synovium, spleen, and kidney, is associated with partial
      processing to NAP-2-like isoforms and the potential to induce neutrophil and
      fibroblast activation in patients with rheumatic or end-stage renal disease.

PMID- 8343192
TI  - The spectrum of vasculitis in human immunodeficiency virus-infected patients. A
      clinicopathologic evaluation.
AB  - OBJECTIVE: To delineate the different types of inflammatory vascular diseases
      (IVD) occurring in patients with human immunodeficiency virus (HIV) infection.
      METHODS: Muscle, nerve, or skin biopsy specimens from 148 symptomatic HIV
      infected individuals were reviewed, and subgroups of vasculitis were identified
      using the American College of Rheumatology (ACR) 1990 clinicopathologic criteria
      for the classification of vasculitis. RESULTS: IVD was documented in 34 patients
      (23%) and included necrotizing arteritis (3 patients), non-necrotizing arteritis
      (1 patient), neutrophilic IVD (7 patients), mononuclear IVD (17 patients), and
      other small vessel inflammatory changes (6 patients). According to the ACR
      criteria, 11 patients could be classified as having a distinct category of
      vasculitis, including polyarteritis nodosa (4 patients), Henoch-Schonlein purpura
      (1 patient), and drug-induced hypersensitivity vasculitis (6 patients), and 23
      were classified in the group "other vasculitis, type unspecified." One patient
      had hepatitis B virus surface antigenemia, 2 had cryoglobulinemia, and 2 were
      coinfected by human T lymphotropic virus type I. Cytomegalovirus inclusions and
      antigens were found in endothelial cells in 1 patient. HIV antigens and genome
      were detected in perivascular cells of 2 of the 3 patients with necrotizing
      arteritis; in 1, HIV-like particles were seen by electron microscopy. Immune
      deposits were found in small vessel walls in 5 skin biopsy samples showing small
      vessel vasculitis and in the muscle of the 3 patients with necrotizing arteritis.
      CONCLUSION: A wide range of inflammatory vascular diseases may occur in HIV
      infected individuals. Vascular inflammation appears multifactorial and may result
      from HIV-induced immunologic abnormalities and exposure to a variety of
      xenoantigens, such as HIV itself, other infectious agents, and drugs.

PMID- 8343191
TI  - Sensory nerves only temporarily protect the unstable canine knee joint from
      osteoarthritis. Evidence that sensory nerves reprogram the central nervous system
      after cruciate ligament transection.
AB  - OBJECTIVE: The slow rate at which articular cartilage degrades in dogs after
      transection of the anterior cruciate ligament (ACLT) has been attributed to
      capsular thickening and buttressing by osteophytes. We investigated the roles of
      the peripheral and central nervous systems in protecting knee joints with chronic
      ACL deficiency from breakdown. METHODS: Five groups of dogs were studied; all
      were killed 72 weeks after left knee surgery. Group A had ACLT, group B had ACLT
      followed 52 weeks later by ipsilateral L4-S1 dorsal root ganglionectomy (DRG),
      group C had DRG followed 2 weeks later by ACLT, group D had sham DRG followed 2
      weeks later by ACLT, and group E had DRG followed 2 weeks later by sham ACTL.
      RESULTS: Group E dogs did not develop knee pathology. All cruciate-deficient
      knees were lax at the end of the study. The osteoarthritis (OA) that developed in
      groups A, B, and D was comparable (P > 0.05), and was significantly greater than
      that in group E (P < 0.05). Group C developed much more severe OA than any of the
      other groups (P < 0.05). CONCLUSION: Ipsilateral sensory input is temporarily
      important in protecting the unstable joint from rapid breakdown. Over time, the
      central nervous system apparently acquires the ability to protect the unstable
      joint without continued ipsilateral sensory input.

PMID- 8343193
TI  - The Chronic Arthritis Systemic Index: a nomogram to assess the activity and
      severity of chronic arthritis.

PMID- 8343194
TI  - Proteinuria associated with tolmetin treatment in a patient with systemic lupus
      erythematosus.

PMID- 8343195
TI  - Issues in the study of azathioprine, methotrexate, and combination therapy:
      comment on the article by Willkens et al.

PMID- 8343197
TI  - Food labeling: definition of the term 'healthy'. American Dietetic Association.

PMID- 8343196
TI  - In vitro phagocytosis inhibition assay for the screening of potential candidate
      antigens for sub-unit vaccines against the asexual blood stage of Plasmodium
      falciparum.
AB  - We have previously established a direct correlation between immune protection
      against the asexual blood stage Plasmodium falciparum infection and the presence
      of opsonizing antibodies promoting phagocytosis of parasitized red blood cells.
      In the present communication we describe an in vitro assay for measuring
      phagocytosis inhibition (PIA) specific for P. falciparum-infected erythrocytes.
      The phagocytosis inhibition assay is a simple procedure for screening potential
      candidates for sub-unit vaccines against P. falciparum based on the correlation
      between opsonizing antibodies and immunoprotection. The assay was used to analyse
      18 recombinant molecules, corresponding to 11 distinct antigens of P. falciparum.
      Pre-incubation and selective antibody depletion experiments demonstrate the
      antigen-antibody specificity of the PIA. The presence of epitopes participating
      as targets of opsonic antibodies were demonstrated in six distinct polypeptide
      antigens.

PMID- 8343198
TI  - Clinical pharmacokinetics and practical applications of simvastatin.
AB  - Simvastatin is a methyl analogue of lovastatin and acts as an HMG-CoA reductase
      inhibitor effective in the treatment of hypercholesterolaemia. Like lovastatin,
      it is an inactive hydrophobic lactone prodrug which is metabolised in vivo to
      several more polar, pharmacologically active compounds, most notably the
      corresponding hydroxy acid form, simvastatin acid. HPLC techniques have been
      developed to assay simvastatin and its metabolites. In addition, a
      pharmacodynamic assay has been developed that measures HMG-CoA reductase
      inhibitory activity. This latter assay may be more applicable to clinical
      situations since simvastatin is not active, while its metabolites are.
      Simvastatin is well absorbed from the gastrointestinal tract but is highly
      extracted by the liver and only 7% of the dose reaches the general circulation
      intact. The peak inhibition of HMG-CoA reductase activity occurs within 2 to 4
      hours. Increasing the dose of simvastatin from 5 to 120 mg increases the
      pharmacological activity in a linear fashion. The several metabolites tend to
      remain within the liver and the intestines (via biliary excretion). Some
      gastrointestinal reabsorption of metabolites may occur. Simvastatin is eliminated
      mainly in the faeces due to biliary excretion but only a small percentage of the
      dose is found in the stool in the form of the parent compound or simvastatin
      acid. Since simvastatin is metabolised by the cytochrome P450 system, a potential
      for drug interactions exists. Elevated HMG-CoA reductase inhibitory activity has
      been observed when simvastatin was administered concurrently with cyclosporin,
      possibly increasing the risk of myopathy and subsequent rhabdomyolysis which are
      associated with simvastatin use. Simvastatin has also been shown to potentiate
      the effects of warfarin [corrected].(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343199
TI  - Aluminum and hepatobiliary complications of total parenteral nutrition.

PMID- 8343200
TI  - Obesity experts say less weight still best.

PMID- 8343201
TI  - Laparoscopic surgery: more facts, less fancy.

PMID- 8343202
TI  - Functional interactions of the retinoblastoma protein with mammalian D-type
      cyclins.
AB  - The retinoblastoma gene product (Rb) can interact efficiently with two of three D
      type G1 cyclins (D2 and D3) in vitro. Binding depended upon the minimal regions
      of Rb necessary for its growth-suppressive activity, as well as upon the D-type
      cyclin sequence motif shared with Rb-binding DNA tumor virus oncoproteins.
      Coexpression of the three D-type cyclins with the cyclin-dependent kinase (cdk4)
      in insect cells generated Rb kinase activity. By contrast, cyclins D2 and D3, but
      not D1, activated another such kinase, cdk2. Introduction of cyclin D2 and Rb
      into the Rb-deficient cell line SAOS-2 led to overt Rb hyperphosphorylation,
      whereas Rb, expressed alone or together with cyclin D1, remained
      unphosphorylated. Cyclin D2-dependent phosphorylation inhibited its binding to
      the transcription factor E2F and reversed the Rb G1 exit block in the cell cycle.
      Thus, all D-type cyclins do not function equivalently, and one of them plays a
      major role in reversing the cycle-blocking function of a known tumor suppressor.

PMID- 8343204
TI  - Every six hours a patient waiting for an organ dies.

PMID- 8343203
TI  - Three-dimensional structure of omega-conotoxin GVIA determined by 1H NMR.
AB  - omega-Conotoxin GVIA, a peptide of 27 amino acid residues and three disulfide
      bridges, has been studied by NMR techniques. The complete assignment of the
      corresponding proton NMR spectra was performed by two-dimensional sequence
      specific methods at 288 K and pH 3.5. On the basis of 169 distance restraints
      derived from this analysis, the three-dimensional structure was obtained. A total
      of 30 initial structures were generated by distance geometry methods and further
      refined by restrained energy minimization techniques yielding a final set of 8
      structures. The mean root-mean-square deviation between each of the 8 structures
      and the mean atomic coordinates for all residues is 0.82 +/- 0.06 A for the
      backbone atoms and 1.45 +/- 0.18 A for all non-H atoms. The structure shows a
      globular folding pattern that is stabilized by the three disulfide linkages and a
      number of intramolecular hydrogen bonds. A total of 14 hydroxyl groups are found
      at the periphery fully exposed to the solvent. These groups, together with the
      charged side chains of Lys and Arg residues emerging radially from the peptide
      core, provide specific recognition elements for the interaction of this toxin
      with neuronal calcium channels.

PMID- 8343205
TI  - Immunosuppressive medications.

PMID- 8343206
TI  - Adult renal transplantation.

PMID- 8343207
TI  - Pancreas transplantation.

PMID- 8343208
TI  - Medical University of South Carolina Pediatric Renal Transplant Program.

PMID- 8343209
TI  - Chiral PAF agonists: synthesis, theoretical analysis of their stereoelectronic
      properties and structure activity relationships.
AB  - A series of chiral PAF agonists were synthesized. Modifications at the PAF
      structure were undertaken as far as the C2 substituents and the onium head groups
      are concerned. In parallel, molecular modelling studies including a MOPAC
      geometry optimization and the analysis of the electrostatic potential were
      performed on the newly synthesized and on already known PAF agonists, in order to
      gain a better insight into the stereoelectronic features required for interaction
      with the PAF receptor.

PMID- 8343210
TI  - Cinnamamide analogs as inhibitors of protein tyrosine kinases.
AB  - Protein tyrosine kinases (PTK) are important signal transducing enzymes involved
      in the modulation of normal cellular growth and differentiation and have been
      associated with the etiology of various human cancers. The development of
      properly designed inhibitors, which block their function by interfering with the
      substrate binding, may therefore offer an unique target for selective anticancer
      chemotherapy. Here we describe synthesis and biochemical testing of a novel
      series of non-peptide PTK inhibitors which have as characteristic active
      pharmacophore the cinnamamide moiety. For testing we used an exogenous substrate
      kinase assay based on the phosphorylation of (Val5)-angiotensin II with
      radiolabelled ATP by the catalytic domain of the PTK encoded by the v-abl
      oncogene (p45 v-abl). The most potent compounds were found in the class of 3
      arylidene-2-oxindoles (II) with IC50 values in the 1 microM range. Among these
      the 2-tetralylmethylene-, 4-quinolylmethylene-, 5-quinolylmethylene- and 3
      indolylmethylene-2-oxindole compounds of formulae 16, 20, 21 and 24 respectively
      were selected for further investigation.

PMID- 8343211
TI  - Chemical modifications of the antibiotic purpuromycin.
AB  - Purpuromycin, isolated in our laboratories from the culture broth of Actinoplanes
      ianthinogenes, is very active in vitro against Gram-positive bacteria and fungi
      and shows variable activity against Gram-negative bacteria. Its poor
      bioavailability, probably due to its insolubility in aqueous media at
      physiological pH's, and the fact that its activity is antagonized by serum, led
      us to plan a chemical program with the aim of understanding the relevance of the
      substituents for the antibiotic activity. The original 7-methoxycarbonyl group
      was transformed into more hydrophilic groups by hydrolysis, by reduction and by
      ammonolysis or in esters with different degree of lipophilicity and steric
      hindrance. Almost all of the derivatives retained activity against Gram-positive
      bacteria but lost activity against Escherichia coli and Trichophyton
      mentagrophytes. Like purpuromycin, all of the derivatives show a reduced activity
      in the presence of serum.

PMID- 8343212
TI  - Studies on annelated 1,4-benzothiazines and 1,5-benzothiazepines. VI. Synthesis
      and preliminary pharmacological evaluation of 1-alkylaminomethyl-4,5-dihydro-s
      triazolo[3,4-d]-1,5-benzothiazepines.
AB  - A series of new 1-alkylaminomethyl derivatives of 4,5-dihydro-s- triazolo[3,4-d]
      1,5-benzothiazepines has been prepared using chloromethyltriazolobenzothiazepines
      4a-g as key intermediates. The 1-alkylaminomethyl derivatives were tested for CNS
      activity on mice and some of them caused remarkable decrease of spontaneous motor
      activity.

PMID- 8343213
TI  - In vitro metabolism of 1,3-dioxane, 1,3-oxathiolane, and 1,3-dithiane derivatives
      of theophylline: a structure-metabolism correlation study.
AB  - Correlation between structure and metabolism was studied within a series of
      cyclic acetal and thioacetal theophylline derivatives. All the compounds showed
      marked regioselectivity in in vitro metabolism, the metabolites arising only from
      7-cycloalkyl side chain transformation. The 1,3-dioxane derivative, besides N
      dealkylation to theophylline, underwent enzymatic ring cleavage, through the
      oxidation of the acetal carbon and subsequent rearrangement. Thus the acetal
      group was converted enzymatically to an ester. A similar transformation,
      catalyzed by cytochrome P450-dependent monooxygenases, was previously found for
      the 1,3-dioxolane ring of doxophylline. The cyclic thioacetal derivatives (i.e.
      1,3-oxathiolane and 1,3-dithiane) were not cleaved during oxidative metabolism.
      The metabolites arise only from the oxidation of the sulfur atom, the major
      nucleophilic center in the molecule. No N-dealkylation to theophylline was
      observed. Enzymatic sulfoxidation proceeded diastereoselectively in both the 1,3
      oxathiolane and 1,3-dithiane rings, the trans isomers being the major ones with a
      ratio trans: cis 75:25 and 60:40 respectively. The sulfoxides were stable to
      hydrolysis and were not further metabolized. Neither disulfoxides nor sulfones
      were detected in the incubations.

PMID- 8343214
TI  - Synthesis and vasodilatory activity of some thiazolo-triazole derivative.
AB  - In this study, some thiazolo[3,2-b]-1,2,4-triazole derivatives were synthesized.
      Their vasodilatory activities were examined in vitro. All examined compounds
      showed appreciable activity.

PMID- 8343215
TI  - Coexistence of amyloid beta-protein precursor and basic fibroblast growth factor
      in single cells of the rat parietal cortex, hippocampus and basal magnocellular
      nucleus.
AB  - The coexistence of amyloid beta-protein precursor (APP) and basic fibroblast
      growth factor (basic FGF) in single cells of the parietal cortex, hippocampus and
      basal magnocellular nucleus was investigated immunohistochemically in adult rats.
      A monoclonal antibody directed against human recombinant APP and a polyclonal
      antibody against a synthetic fragment of basic FGF (the N-terminal 12 residues)
      were used. APP and basic FGF were frequently colocalized in the pyramidal cells
      of layers III and V of the parietal cortex, in the pyramidal and extrapyramidal
      cells of the hippocampus, and in large cells of the medial septal nucleus and the
      horizontal limb of the diagonal band of Broca. Such a frequent colocalization
      suggests a close functional relationship between APP and basic FGF in the
      neuronal cells.

PMID- 8343216
TI  - PPD-specific IgG and IgG subclasses in the sera of pulmonary tuberculosis
      patients.
AB  - This study was performed to characterize the humoral immune responses with
      isotype profiles in Mycobacterium tuberculosis infection. PPD-Specific IgG and
      IgG subclasses were measured using ELISA in 212 patients with pulmonary
      tuberculosis. The values of PPD-specific IgG were significantly higher in
      pulmonary tuberculosis patients than those in the control group, and were
      correlated to the severity of illness (P < 0.01). The specificity and sensitivity
      of ELISA for IgG antibodies were 1.0 and 0.81, respectively as determined in 212
      sera from tuberculosis patients and 44 from healthy controls. The positive
      predictive value was 1.0 (171/171), while negative predictive value was 0.52
      (44/85). The values of PPD-specific IgG were significantly decreased after 2-4
      months of treatment. Among the moderately and far advanced pulmonary tuberculosis
      patients, the values of PPD-specific IgG were significantly decreased in
      responders after 6 months of treatment. However, PPD-specific IgG in
      nonresponders was increased (P < 0.01). PPD-specific IgG subclass responses were
      evident to all four IgG subclasses. No changes of isotype response according to
      the severity of the disease were observed.

PMID- 8343217
TI  - Impaired homeostatic mechanism of potassium handling after acute oral potassium
      load in diabetes mellitus.
AB  - Chronic stable diabetic patients (n = 6) were compared with healthy control
      subjects (n = 5) after acute oral intake of 50 mEq of potassium chloride (KCl) to
      investigate for possible derangements of homeostatic responses for acute term (3
      hrs) to acute potassium load. Plasma renin activity (PRA), plasma aldosterone
      (PA), and transtubular potassium concentration gradient (TTKG) known as a useful
      semiquantative index of distal nephron potassium secretion were measured. All the
      baseline parameters were comparable between diabetic and non-diabetic subjects
      except for significantly reduced creatinine clearance in diabetics (mean +/- SEM,
      105 +/- 4 vs. 85 +/- 5 ml/min, p < 0.05). Following acute oral KCl load, the peak
      increases of serum potassium changes from basal levels were noted at 2 hours in
      both groups, but were higher in diabetic subjects (mean +/- SEM, 0.42 +/- 0.06
      vs. 0.62 +/- 0.09 mEq/L). Also, 4 out of 6 diabetic subjects but none of the
      control subjects at 2 hours after oral KCl load became hyperkalemic ( > 5.0
      mEq/L). PRA did not show any significant changes, whereas PA was increased
      simultaneously with increments in serum potassium in both groups, with blunted
      increases in the diabetics. However, TTKG was increased prominently in control
      subjects (8.18 from 4.98), but only slightly in diabetic subjects (4.55 from
      4.18), with statistical difference between the two groups (p < 0.01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8343218
TI  - Histological and immunohistochemical studies on primary gastrointestinal
      lymphomas.
AB  - To study the characteristics and histogenesis of the malignant lymphomas derived
      from the gastrointestinal mucosa, histologic and immunohistochemical analyses
      were performed on a series of 28 malignant lymphomas of the gastrointestinal
      tract. By cytomorphologic classification, there were two small lymphocytic
      lymphomas, one small cleaved cell lymphoma, two mixed small cleaved and large
      cell lymphomas, 17 large cell lymphomas, one small noncleaved cell lymphoma,
      three immunoblastic lymphomas, and two lymphoblastic lymphomas. This distribution
      of histologic types was compatible with that of nodal lymphoma. The lymphomas
      with poor prognostic histology (23 cases) outnumbered those with favorable
      prognosis (five cases). Three of 28 cases (one in the stomach and two in the
      small intestine) had cytologic features consistent with centrocytoid cell
      lymphoma of the mucosa associated lymphoid tissue and were large cell lymphomas.
      Immunophenotypically, 23 cases expressed B-cell markers (82.1%) and three cases
      reacted with T-cell markers. Two cases did not react with either T-cell or B-cell
      markers. True histiocytic lymphomas were not identified. Gastric lymphomas (nine
      cases) and colorectal lymphomas (three cases) were of B-lymphocyte origin whereas
      T-cell lymphomas were noted in the small intestine (two cases) and ileocecal
      region (one case). Three cases of centrocytoid lymphoma were of B-lymphocyte
      origin. Histologically B-cell lineage lymphomas were evenly distributed on
      various histologic subtypes but all T-lineage lymphomas belonged to the large
      cell type. The two cases with undetermined phenotype were lymphoblastic lymphomas
      histologically. This study showed that the primary GIT lymphomas, mostly of B
      cell lineage, were not cytomorphologically distinctive from the nodal
      lymphomas.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343219
TI  - Immunoelectron-microscopic localization of IgE binding site of mugwort pollen.
AB  - To elucidate the IgE binding site of mugwort (Artemisia vulgaris r.) pollen,
      pollen grains were frozen and fixed using a cryocut. They were incubated with
      antibodies according to the following sequence: Sera pool of individuals who
      showed mugwort-RAST class 3 or 4, biotin-labeled goat anti-human IgE antibody,
      streptavidin-peroxidase and diaminobenzidine. Then, they were observed under
      electron microscopy. The control section was incubated with the sera pool from
      individuals who showed a negative result on a skin prick test to mugwort pollen.
      Antigenic activity (electrondense line) was noted on the surface of the exine.
      There was no activity in cytoplasm or the intine layer. The control section was
      completely free of activity. It was suggested that the IgE binding site of
      mugwort pollen was present on the surface of the exine.

PMID- 8343220
TI  - Prevalence of otitis media and allied diseases in Korea--results of a nation-wide
      survey, 1991.
AB  - A nation-wide survey was conducted to estimate the prevalence of otitis media and
      allied diseases through physical examination by otolaryngologic doctors from July
      to October, 1991. A sample study population was selected from a panel to be
      representative of the Korean population by multistage clustered and stratified
      random sampling method based on the National Census Data, 1990. Total number of
      subjects undertaken were 9,321, Which were drawn from 2,899 households residing
      in 60 different areas throughout the country. The overall prevalence of otitis
      media was 2.85% (3.10% of males and 2.61% of females). Prevalence of each subtype
      was as follows; acute otitis media, 0.02%; middle ear effusion, 0.60%; chronic
      otitis media, 2.19%, respectively. The prevalence of otitis media did not vary by
      sex, nor by urban-rural difference. There was an increasing tendency of the
      prevalence of otitis media by age. However, the prevalence of both middle ear
      effusion and acute otitis media showed a decreasing pattern by age. Particularly
      noteworthy was a significant geographic variation in the prevalence of otitis
      media by provinces. The prevalence rate of septal deviation was 21.93% and the
      presence of septal deviation was significantly related to that of otitis media (p
      < 0.05). The prevalence rates of nasal allergic symptoms, nasal polyposis and
      evident cleft palate were 1.14%, 1.00% and 0.07%, respectively. The presence of
      otitis media was significantly correlated with both nasal allergic symptoms (P <
      0.1) and evident cleft palate (P < 0.05), but not with that of nasal polyposis.

PMID- 8343221
TI  - Actions of potassium channel openers in rat detrusor urinae.
AB  - This study was performed to investigate the action of potassium channel openers
      on the mechanical activity of detrusor muscle isolated from rats. Detrusor muscle
      strips, 15 mm in length, were myographied isometrically in an isolated organ
      bath. P 1060, RP 49356 and BRL 38277, potassium channel activators, reduced the
      basal tone and diminished the phasic activity of detrusor concentration
      dependently. P 1060, RP 49356 and BRL 38227 suppressed the maximal responses to
      bethanechol and shifted the concentration-response curves of bethanechol-induced
      contraction to the right. RP 49356 and BRL 38227 reduced the contraction by low
      (20 mM) concentration of potassium. P 1060, however, diminished the high (80 mM)
      and low (20 mM) concentration of potassium-induced contraction. Glibenclamide, an
      inhibitor of ATP-dependent potassium channel, antagonized the suppressive action
      of P 1060, RP 49356 and BRL 38227 on the basal tone. Apamin or procaine did not
      antagonize it significantly. Based on these results, it is suggested that the
      relaxation of detrusor muscle strip caused by P 1060, RP 49356 and BRL 38227 may
      predominantly involve opening of the same potassium channel, i.e., the ATP
      dependent potassium channel.

PMID- 8343222
TI  - Enhanced expression of the c-myc protooncogene in human intracranial meningiomas.
AB  - We examined the alteration and expression of c-myc protooncogene in 11 human
      intracranial meningiomas using Southern blot, Northern blot and
      immunohistochemical techniques. Southern blot showed neither amplification nor
      rearrangement but Northern blot and immunohistochemical study revealed enhanced
      expression of the c-myc gene. Immunohistochemically, c-myc product was found in
      all of the 11 cases and seven of these cases showed an above moderate degree of
      immunoreaction in semiquantitative analysis. Loss of heterozygosity at IGLC2
      locus on chromosome 22 was detected in four of the 8 informative cases. But
      extent and intensity of immunoreactivity did not correlated with loss of
      heterozygosity on chromosome 22. These genetic changes may play important roles
      in the pathogenesis of human intracranial meningioma.

PMID- 8343223
TI  - Loss of retinoblastoma gene and amplification of N-myc gene in retinoblastoma.
AB  - We have analyzed paired samples of genomic DNA from peripheral leukocyte and
      primary tumor tissue from nine patients with retinoblastoma (RB) and from two RB
      cell lines, WERI-Rb-1 and Y79, to detect the molecular alterations of the
      retinoblastoma susceptibility gene (RB-1) and N-myc gene. In Southern analysis,
      RB-1 deletions in tumor tissues were detected in five patients (56%), one of
      these revealed a total loss of RB-1. N-myc amplification was found only in one
      (11.1%) out of nine patients. We also observed a total loss of RB-1 in WERI-Rb-1,
      and a more than 100-fold amplification of N-myc in Y79. The analysis of the
      relationship between molecular events and clinical characteristics such as age,
      sex, tumor laterality did not reveal any specific correlation. These results
      suggest that genetic backgrounds of RB in Korean patients are quite similar to
      those of reported cases elsewhere. The high sensitivity of our method in
      detecting the RB-1 loss indicates that this method can be a useful tool for
      initially screening a large number of tumors.

PMID- 8343224
TI  - Evaluation of outcome after acute carbon monoxide poisoning by brain CT.
AB  - Of 129 patients with carbon monoxide (CO) poisoning, 62(48.0%) had characteristic
      computed tomographic (CT) findings. The most common finding, seen in 42 patients,
      was low-density in the cerebral white matter, and the second characteristic
      feature, seen in 33 patients, was low-density in both globus pallidi. Abnormal CT
      findings tended to increase in accordance with the duration of unconsciousness
      during acute CO poisoning, but such findings occurred even when the mental state
      was clear during acute illness. The prognosis of acute CO poisoning depended on
      low-density lesions of the cerebral white matter rather than those of the globus
      pallidus. There also seemed to be a significant correlation between the cerebral
      white matter changes in the initial CT scan and the development of delayed
      neurologic sequelae after acute CO poisoning, particularly in middle age or older
      patients, but no correlation between the CT findings and the clinical outcome of
      delayed neurologic sequelae.

PMID- 8343225
TI  - Comparison of enzyme and DNA analysis in a Tay-Sachs disease carrier screening
      program.
AB  - Tay-Sachs disease (GM2 gangliosidosis, type 1; TSD) is an autosomal recessive GM2
      gangliosidosis resulting from the deficient activity of the lysosomal hydrolase
      beta-hexosaminidase A (Hex A). With a carrier frequency estimated at 1 in 25, it
      is a common lysosomal disorder in the Ashkenazi Jewish population. Tay-Sachs
      disease has provided the prototype for the prevention of severe recessive genetic
      diseases. Molecular analysis of the Hex A gene (HEXA) of Ashkenazi Jewish
      individuals affected with Tay-Sachs disease revealed that three common mutations
      cause the infantile and adult onset forms of the disease; a four base insertion
      in exon 11, a splice junction mutation in intron 12 and a point mutation in exon
      7 (G269S). A study was undertaken to determine whether mutation analysis would be
      useful in TSD screening programs in identifying carriers and clarifying the
      status of individuals whose enzyme assays are inconclusive. Ashkenazi Jewish
      individuals who had been diagnosed as carriers, inconclusives by enzyme assay and
      non-carriers with low normal enzyme levels in the Mount Sinai Tay-Sachs Disease
      Prevention Program were examined for the presence of the three mutations using
      polymerase chain reaction (PCR) and allele specific oligonucleotide (ASO)
      hybridization. The insertion mutation was present in 29 of 34 carriers and 2 of
      36 inconclusive individuals, the splice junction mutation was found in 4 of 34
      carriers and the G269S mutation was found in 1 of 34 carriers. Of the 313 non
      carrier individuals with normal enzyme activity in the lower normal range, one
      was positive for the splice junction mutation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343226
TI  - Regulation of the urinary excretion of endothelin in the rat.
AB  - The regulation of the urinary excretion of endothelin (UETV) and its clinical
      significance has not yet been established. The present study was designed to
      examine the effect of angiotensin II (A-II), arginine vasopressin (AVP), and
      nifedipine on UETV. Anesthetized Munich-Wistar rats were infused with low (50
      ng/kg/min) and high (500 ng/kg/min) doses of A-II for 30 min. Both doses
      significantly increased UETV, from nondetectable (ND) levels to 155 +/- 54 (P <
      .03) and 450 +/- 86 fg/min (P < .001), respectively. This effect was accompanied
      by a significant increase in urine flow (UV), from 6 +/- 1 to 67 +/- 12 and 89 +/
      10 microL/min, and in mean arterial pressure (MAP), from 139 +/- 4 to 187 +/- 5
      and 217 +/- 3 mm Hg. Infusions of A-II with its nonspecific antagonist,
      saralasin, resulted in a further increase in UETV to 647 +/- 126 and 782 +/- 117
      fg/min (P < .002), respectively. However, infusion of A-II with its specific
      antagonist, losartan, completely blocked its stimulatory effect on UETV. Infusion
      of AVP, 10 or 100 mU/kg/h, produced increases in MAP, from 134 +/- 3 to 165 +/- 7
      and 203 +/- 4 mm Hg, and in UV from 6 +/- 1 to 37 +/- 6 and 97 +/- 17 microL/min,
      comparable to A-II, but AVP did not have a marked effect on UETV.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8343227
TI  - Abnormalities in dihomo-gamma-linolenic acid release in the pathogenesis of
      hypertension.
AB  - Spontaneously hypertensive rats (SHR) respond to angiotensin and norepinephrine
      with an exaggerated pressor response. We have investigated the possibility that
      increased vascular reactivity in SHR may be related to a reduced synthesis of
      prostaglandin E1 (PGE1) resulting from a defect in the release of its precursor,
      dihomo-gamma-linoleic acid (DGLA). Isolated perfused mesenteric vascular beds of
      SHR and age matched Wistar-Kyoto rats (WKY) were perfused with Kreb's bicarbonate
      buffer. The effluent was collected and the fatty acid composition determined by
      gas chromatography. In SHR the release of DGLA, arachidonic acid,
      eicosapentaenoic acid, and virtually all other fatty acids detected in the
      effluent were reduced when compared to their normotensive controls. This
      difference could not be explained by low tissue fatty acid levels because these
      were higher in SHR. Evening primrose oil (EPO) when added to the diet increased
      the release of DGLA but not of other prostanoid precursors. EPO also reduced
      vascular reactivity and reduced blood pressure in SHR. It is suggested that the
      defect in the release of DGLA may be involved in the pathogenesis of hypertension
      because it occurs early before hypertension has actually occurred.

PMID- 8343229
TI  - Effects of neurotensin on norepinephrine release in blood vessels of
      spontaneously hypertensive rats.
AB  - The present study was performed to investigate the effects of neurotensin on
      noradrenergic transmission in blood vessels of hypertension. In the perfused
      mesenteric vasculatures prepared from spontaneously hypertensive rats (SHR) and
      age-matched Wistar-Kyoto (WKY) rats, we examined the influences of neurotensin on
      vascular responsiveness and norepinephrine release from adrenergic neurons. In
      studies with male standard Wistar rats, endogenous norepinephrine release during
      periarterial nerve stimulation was inhibited by neurotensin in a dose-dependent
      manner. Vasoconstrictor responses to electrical nerve stimulation were also
      inhibited by neurotensin. In SHR, the stimulation-evoked pressor responses and
      norepinephrine release were enhanced compared with WKY rats. The suppression of
      these responses by neurotensin was significantly less in SHR than in WKY rats.
      These results show that neurotensin could have a modulatory effect on
      noradrenergic activity and cause a decrease in stimulation-evoked norepinephrine
      release from vascular adrenergic neurons. The lesser reduction of pressor
      responses and norepinephrine release by neurotensin in SHR might suggest an
      insufficient regulation of vascular adrenergic transmission by the peptide
      hormone in hypertension.

PMID- 8343228
TI  - Possible radical scavenging properties of cicletanine and renal protection in
      Dahl salt sensitive rats.
AB  - Much interest in cicletanine, a novel antihypertensive drug, has grown because it
      uniquely stimulates prostacyclin (PGI2) production and may, thereby, provide
      further cardiovascular protection. We postulated that cicletanine may be an
      antioxidant, and assessed its ability to protect the kidney in Dahl salt
      sensitive (Dahl S) rats on a high salt diet. Cicletanine eradicated in vitro a
      stable radical, DPPH, and decreased the lipid peroxidation both in rat brain
      homogenate and in a xanthine-xanthine oxidase (X-XOD) superoxide generating
      system. Furthermore, cicletanine attenuated the inhibition of PGI2 synthase
      activity by 15HPETE. However, cicletanine did not exhibit superoxide dismutase
      like activity in X-XOD system, suggesting that it behaves primarily as a hydroxy
      radical scavenger. A 6 week cicletanine treatment reduced blood pressure in Dahl
      S rats fed a high salt diet, and ameliorated functional and morphological injury
      to the kidney. This attenuation of glomerular sclerosis correlated with the
      attenuation of lipid peroxidation in the kidney homogenate. These data indicate
      that cicletanine is an antioxidant that protects the kidney from salt-induced
      hypertension in Dahl salt-sensitive strain rats.

PMID- 8343230
TI  - Blood pressure variability and urinary electrolyte excretion in normotensive
      adults.
AB  - The principal aim of the present study was to determine the relationship of
      ambulatory blood pressure (BP) to urinary electrolyte excretion in normotensives.
      Twenty-five young adults underwent ambulatory BP and heart rate monitoring while
      collecting urine over 24 h. The correlations of 24 h urine sodium excretion and
      the ratio of sodium/potassium excretion with systolic BP in the laboratory (r =
      0.12 and 0.24), ambulatory awake (r = 0.11 and 0.24), and ambulatory asleep (r =
      0.24 and 0.31) settings were all in the positive direction but not significant.
      However, 24 h sodium excretion did correlate significantly and positively with
      awake and asleep ambulatory systolic (r = 0.45 and 0.41, P < .05) and diastolic
      (r = 0.42 and 0.43, P < .05) coefficients of variability. Thus, in normotensives
      on an unlimited diet, 24 h urinary sodium was more closely related to ambulatory
      BP variability than to BP level.

PMID- 8343231
TI  - Myocardial fibrosis in the rat with mineralocorticoid excess. Prevention of
      scarring by amiloride.
AB  - In both humans and experimental animals, mineralocorticoid (MC)-induced
      hypertension is associated with myocardial fibrosis. We have shown that this
      fibrous tissue response includes a reactive interstitial fibrosis not initiated
      by parenchymal cell loss, and a reparative fibrosis or scarring, occurring in
      response to cardiac myocyte necrosis. The reactive fibrosis is thought to be
      related to MC excess, while cell loss and microscopic scarring may be secondary
      to enhanced potassium excretion or a cytotoxic effect of aldosterone. This
      histologic study was undertaken to determine whether or not the potassium sparing
      diuretic amiloride would be effective in preventing the appearance of either form
      of fibrosis. Uninephrectomized male Sprague Dawley rats received either
      aldosterone (AL; 0.75 microgram/h), amiloride (AMC; 1 mg/kg/day),
      aldosterone+amiloride (ALAM), or vehicle (ALC) alone via subcutaneous osmotic
      minipumps for 8 weeks. All rats received 1% NaCl in their drinking water. Hearts
      were recovered, immersion-fixed, and tissue sections from both left and right
      ventricles stained with the collagen specific stain Sirius Red F3BA were
      morphometrically analyzed. The interstitial collagen volume fraction was elevated
      in AL and ALAM groups compared to ALC and AMC, but did not differ between AL and
      ALAM. Microscopic scarring, found in both ventricles, was evident in AL animals,
      but was not found in the ALAM, AMC, or ALC groups. These data suggest that
      chronic elevations in plasma aldosterone, relative to dietary sodium intake, do
      not have a direct cytotoxic effect on cardiac myocytes, but they are associated
      with a reactive interstitial fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343232
TI  - Synergistic action of angiotensin II, insulin-like growth factor-I, and
      transforming growth factor-beta on platelet-derived growth factor-BB, basic
      fibroblastic growth factor, and epidermal growth factor-induced DNA synthesis in
      vascular smooth muscle cells.
AB  - The effect of angiotensin II (AII), transforming growth factor-beta (TGF-beta),
      and insulin-like growth factor-I (IGF-I) on platelet-derived growth factor (PDGF)
      BB-, basic fibroblastic growth factor (bFGF)-, and epidermal growth factor (EGF)
      induced DNA synthesis in vascular smooth muscle cells (VSMCs) was investigated.
      TGF-beta, AII, IGF-I increased concentration-dependent cell protein. No increase
      in [3H]thymidine incorporation could be detected. TGF-beta, AII, and IGF-I
      enhanced PDGF-BB-, bFGF-, and EGF-induced DNA synthesis. Our results suggest that
      growth factors that possess a weak mitogenic effect on vascular smooth muscle
      cells such as TGF-beta, AII, and IGF-I may enhance the mitogenicity of PDGF-BB,
      bFGF, and EGF.

PMID- 8343233
TI  - Impaired recovery of vascular smooth muscle intracellular calcium following
      agonist stimulation in insulin resistant (Zucker obese) rats.
AB  - We have previously shown that insulin attenuates vasoconstrictor responses to
      pressor agonists and accelerates vascular smooth muscle cell (VSMC) Ca(2+)-ATPase
      mediated Ca2+ efflux and vascular relaxation. We have now sought to determine if
      VSMC from insulin resistant (Zucker Obese, ZO) rats manifest exaggerated [Ca2+]i
      responses to pressor agonists and impaired [Ca2+]i recovery (rate of [Ca2+]i
      return to baseline) compared to their lean controls (ZL). Thoracic aortae from ZO
      and ZL were enzymatically digested to release VSMC (n = 16 animals/group and 8
      determinations/group). Freshly dispersed cells were washed, counted, and loaded
      with Fura-2-AM. The [Ca2+]i responses to and rate of recovery from angiotensin II
      (AII; 200 nmol/L) and arginine vasopressin (AVP; 10 mumol/L) were studied
      fluorometrically in stirred suspension (10(6) cells/mL). Peak [Ca2+]i responses
      to AVP were not significantly different in ZO v ZL, while responses to AII were
      higher in ZL ([Ca2+]i, 180 +/- 7 v 160 +/- 4% of baseline in ZL and ZO, P < .02).
      Since we have recently shown insulin to increase AII-releasable Ca2+ stores in
      sarcoplasmic reticulum, this increase in peak [Ca2+]i response to AII in ZL may
      reflect relative VSMC insulin resistance in ZO. Despite their increased peak AII
      response, ZL exhibited a more rapid recovery from both the AII-stimulated load
      (recovery rate, 66.1 +/- 8.9 v 42.1 +/- 9.0 nmol/L/min in ZL and ZO, P < .02) and
      the AVP-stimulated [Ca2+]i load (22.2 +/- 2.3 v 18.4 +/- 4.6
      nmol/L/min).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343234
TI  - Determinants of left ventricular mass in normotensive children.
AB  - Left ventricular hypertrophy has been shown to be an independent predictor of
      cardiovascular morbidity and mortality. Few studies have examined the
      determinants of left ventricular mass (LVM) in normotensive children. Eight-four
      healthy children, blacks and whites, girls and boys, between 6 and 18 years of
      age, all with positive family histories of essential hypertension, participated
      in the study. Demographic and anthropometric characteristics, physical activity,
      and hemodynamic responses at rest and in response to the stress of forehead cold
      stimulation and a challenging video game were related to M-mode echocardiographic
      determined LVM indexed by two indices of body habitus. Hierarchical stepwise
      multiple regression analysis indicated that the significant independent
      correlates of LVM per body surface area were gender (boys were greater), baseline
      systolic blood pressure and heart rate, a physical activity index (sweat episodes
      per week) and peak systolic blood pressure responses to the forehead cold
      stressor (final model r2 = 0.49). For LVM/height2.7 significant independent
      correlates were adiposity index (weight z score--height z score), gender (boys
      were greater), age, resting systolic pressure, and systemic vascular resistance
      reactivity to forehead cold stimulation (final model r2 = 0.42). These findings
      with normotensive children corroborate other findings that have typically
      involved hypertensive children, indicating that resting heart rate and systolic
      pressure, gender, and adiposity are early determinants of LVM indices in
      children. In addition, the current findings indicate that hemodynamic responses
      to stress also appear to play a role in the early development of LVM.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8343235
TI  - Effects of renin inhibitor A-72517 on hemodynamics and cardiac function in sodium
      depleted dogs.
AB  - A-72517 is a potent inhibitor of human renin (IC50 = 1.0 nmol/L, pH 7.4 in
      plasma) and, aside from displaying modest activity against canine plasma renin
      (IC50 = 110 nmol/L), has been shown to be orally active in the dog and other
      animals. Renin inhibitors, in general, are presumed to exert their hypotensive
      effect through a reduction in total peripheral resistance. To elucidate the
      hemodynamic mechanism of action of this new dipeptidic renin inhibitor, the
      cardiac and systemic hemodynamic effects of A-72517 were studied in sodium
      depleted, pentobarbital-anesthetized dogs. Each dog received either vehicle (n =
      8) or a single dose (n = 8/dose) of A-72517 administered intravenously as a
      priming bolus followed by a 30 min constant infusion; infusion doses were 0.01,
      0.05, and 0.1 mg/kg/min. A-72517 elicited significant (P < .05) dose-related
      reductions in mean arterial pressure (MAP) and systemic vascular resistance (SVR)
      compared to baseline values and the vehicle-treated group, and the recoveries of
      MAP and SVR were also dose-related. Plasma renin activity, measured by
      radioimmunoassay, was nearly completely suppressed during drug infusion at all
      doses. The hypotensive responses did not alter cardiac output nor did they induce
      reflex tachycardia at any dose. Left ventricular dP/dtmax did not change during
      infusion of A-72517, but, when corrected for changes in afterload, showed dose
      related increases with drug treatment. Moreover, left ventricular end-diastolic
      pressure and pulmonary arterial wedge pressure were significantly reduced at the
      high dose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343236
TI  - Calcium metabolism, plasma parathyroid hormone, and calcitriol in transient
      hypertension of pregnancy.
AB  - In order to know if abnormalities of calcium metabolism may be involved in the
      pathophysiology of pregnancy-induced hypertension (PIH), as it has been
      incriminated in essential hypertension, we measured plasma and urinary calcium
      and phosphate as well as plasma PTH and free calcitriol index (ratio of total
      calcitriol on the D binding protein) in normotensive pregnant women (n = 25), in
      women with PIH after the same duration of amenorrhea (> 28 wk, n =
      21:preeclampsia and 20 transient hypertensions), and in age-matched nonpregnant
      women (n = 15). The severity of PIH was mild since blood uric acid was not
      increased and plasma volume, measured with the Evans blue technique, was found
      only moderately decreased (-10.5 +/- 3.1% of normal value). The results show that
      normotensive pregnant women showed the expected increase of the vitamin D
      parameters in comparison to nonpregnant controls. Hypertensive pregnant women
      were not different from the normotensive ones regarding plasma corrected calcium
      and phosphate and urinary excretion of calcium and phosphate, but had higher
      plasma PTH (13 +/- 1 v 8.8 +/- 1.6 pg/mL) and lower total and free calcitriol
      index (86 +/- 7 v 110 +/- 6 pg/mL and 1.72 +/- 0.10 v 2.25 +/- 0.13 x 10(-5)).
      Correlative studies showed PIH having a negative correlation between blood
      pressure and plasma corrected calcium (r = -0.43, P < .05), which is in agreement
      with epidemiological studies of essential hypertension. In conclusion,
      disturbances of calcium regulating hormones do exist in transient forms of
      pregnancy-induced hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343237
TI  - Potassium channel antagonists and vascular reactivity in stroke-prone
      spontaneously hypertensive rats.
AB  - The goal of this study was to characterize differences in contractile
      responsiveness to several potassium channel antagonists in vascular smooth muscle
      from stroke-prone spontaneously hypertensive rats (SHRSP) and Wistar-Kyoto
      normotensive rats (WKY). Helically-cut strips of carotid arteries (endothelium
      removed) from SHRSP and WKY were mounted in muscle baths for measurement of
      isometric force generation. Contractile responses to tetraethylammonium (10(-4)
      to 3 x 10(-2) mol/L) and barium (3 x 10(-5) mol/L), blockers of the voltage
      dependent and large conductance, calcium activated potassium channels, were
      greater in carotid arteries from SHRSP than in those from WKY. In contrast,
      contractile responses to the voltage-dependent potassium channel blockers 3,4
      diamino-pyridine (10(-6) to 3 x 10(-3) mol/L) and sparteine (10(-6) to 3 x 10(-2)
      mol/L) in arteries from SHRSP did not differ from WKY values. Carotid arteries
      from SHRSP and WKY did not contract to apamin (10(-9) to 10(-6) mol/L), an
      antagonist of the small conductance, calcium activated potassium channel.
      Furthermore, relaxation responses to diazoxide (3 x 10(-4) mol/L), an activator
      of the ATP-sensitive potassium channel, and subsequent contractions to the ATP
      sensitive potassium channel blocker glyburide (10(-8) to 3 x 10(-6) mol/L) in
      arteries from SHRSP did not differ from WKY values. Carotid artery segments from
      SHRSP were more sensitive to the contractile effects of elevated potassium than
      those from WKY. We conclude that altered activity of the large conductance,
      calcium activated potassium channel may play a role in the increased
      responsiveness observed in arteries from SHRSP.

PMID- 8343238
TI  - Erythrocyte Na+/Li+ countertransport and glomerular hyperfiltration in insulin
      dependent diabetics.
AB  - Erythrocyte Na+/Li+ countertransport activity was investigated in 11 controls and
      22 recent onset type I (insulin-dependent) diabetic patients with normal and high
      glomerular filtration rates. No differences in Vmax were observed in
      hyperfiltering compared to normofiltering patients or controls. The Na+/Li+
      activity was correlated with blood glucose levels in insulin-dependent diabetics
      showing good glycemic control. Total cholesterol and triglyceride concentrations
      were similar among the three groups. In conclusion, enhanced Na+/Li+
      countertransport activity is not associated, in our case, with diabetic condition
      per se and with early glomerular hyperfiltration and cannot be used as a marker
      of renal involvement in recent onset insulin-dependent diabetics.

PMID- 8343239
TI  - Differential regulation of ANF-R2 receptors coupled to adenylyl cyclase in
      cardiovascular tissues in hypertension.
AB  - We have recently shown that ANF-R2 receptors are coupled to the adenylyl
      cyclase/cAMP system through inhibitory guanine nucleotide regulatory protein
      (Gi). The present studies were undertaken to investigate the regulation of ANF-R2
      receptor-mediated inhibition of adenylyl cyclase in spontaneously hypertensive
      rats (SHR) which have been reported to have high plasma ANF levels. ANF99-126
      inhibited adenylyl cyclase activity in a concentration dependent manner in both
      aorta and heart sarcolemma from SHR and age-matched Wistar-Kyoto (WKY) rats,
      however, the extent of inhibition was greater in SHR as compared to WKY. On the
      other hand, ANF99-126 also inhibited the adenylyl cyclase activity in rat
      platelets from WKY rats in a concentration dependent manner, however, the
      inhibition in SHR was completely attenuated. In addition GTP gamma S stimulated
      adenylyl cyclase activity by about 600% in aorta from WKY rats and about 300% in
      SHR. On the other hand, the GTP gamma S-stimulated adenylyl cyclase activity was
      higher in platelets from SHR as compared to WKY. The observed difference may be
      attributed to the differential alterations in ANF-R2 receptor number or
      postreceptor events or both. Nonetheless, these results indicate that ANF-R2
      receptors in platelets from SHR are differentially regulated than those in heart
      and aorta.

PMID- 8343240
TI  - Ionized magnesium and calcium levels in umbilical cord serum of pregnant women
      with transient hypertension during labor.
AB  - Using a new ion selective electrode (ISE) to measure ionized magnesium (IMg2+),
      we compared levels of IMg2+ with total magnesium (TMg) and serum ionized calcium
      levels (ICa2+) in umbilical arterial and venous serum of 13 parturients who
      developed transient hypertension in labor with levels in 38 who remained
      normotensive. Ionized, but not total magnesium levels were significantly lower in
      the umbilical veins of the hypertensive compared to the normotensive subjects
      (0.46 +/- 0.01 v 0.51 +/- 0.01 mmol/L), and these were at least 15% lower than
      maternal levels found in nonpregnant women (0.60 +/- 0.005 mmol/L, P < .001). If
      umbilical vein samples reflect maternal levels as well, then these results
      suggest that lower IMg2+ levels may play a role in the development of transient
      hypertension in labor, and the potential utility of an ion selective electrode
      for ionized magnesium in the diagnosis of subtle magnesium deficient states.

PMID- 8343241
TI  - Size of endotracheal tube and neonatal acquired subglottic stenosis. Study Group
      for Neonatology and Pediatric Emergencies in the Parisian Area.
AB  - OBJECTIVE: Risk factors for acquired laryngotracheal stenosis in newborn infants
      are poorly known. The extreme scarcity of acquired laryngotracheal stenosis in
      young infants in France, compared with the published rate in the English
      literature, suggested that these patients may be treated in a different way in
      France. A prospective study was performed to analyze local features. DESIGN: Six
      month multicenter inception cohort study. SETTING: Seven neonatal intensive care
      units of referral centers in the area of Paris, France. PATIENTS: A total of 247
      intubated surviving neonates in a consecutive sample during 6 months.
      INTERVENTION: A file was completed with sex, birth weight, gestational age,
      underlying disease, and every feature concerning the intubation period and the
      outcome. MAIN OUTCOME MEASURES: All the collected data were compared with those
      available from previous studies in the English literature. RESULTS: After
      extubation, respiratory outcome was uncomplicated in 242 cases. The five patients
      with dyspnea were treated medically and recovered. A much higher rate of
      extubation difficulties was reported in the English literature. The rate of
      stenosis in this series was significantly lower than in previously reported
      studies. The differences between this and other series seem to be higher birth
      weights, shorter duration of intubation, and, most important, a smaller tube size
      (2.5 mm in neonates weighing less than 2500 g and 3.0 mm in those weighing 2500 g
      or more). CONCLUSIONS: Although this is a limited series and many unknown
      variables can differ from those in previous studies, the size of the endotracheal
      tube appears to be a major risk factor for acquired laryngotracheal stenosis in
      the neonate. Further studies seem necessary to point out additional factors.

PMID- 8343242
TI  - Bacteriology and immunology of normal and diseased adenoids in children.
AB  - Adenoid physiology as reflected in the qualitative and quantitative bacteriology
      and immune cell distribution was correlated with clinical presentation in 69
      children (16 to 130 months of age) undergoing adenoidectomy for obstructive
      adenoid hyperplasia (n = 38) or chronic adenoid infection (n = 31) and in 16
      adenoid core biopsy specimens from 16 nondiseased controls. In the control
      adenoids, few potentially pathogenic bacteria were found as the dominant bacteria
      in the adenoid core (25%), and significantly greater concentrations of
      nonpathogens (commensals) were isolated (P < .01). Potential pathogens as the
      dominant bacteria were found twice as often in obstructive adenoid hyperplasia
      (62%) and in chronic adenoid infection (55%) (P < .05). Haemophilus influenzae
      was most common in the diseased adenoids, 53% in obstructive adenoid hyperplasia
      and 48% in chronic adenoid infection, compared with only 19% in the controls (P <
      .05). No significant differences in lymphocyte density, B and T cells, as well as
      T-helper subsets, were found between clinical classifications. However, T
      suppressor cells, monocytes-macrophages, and natural killer cells were
      significantly increased in chronic adenoid infection only (P < .05). The findings
      in this study support roles for both alterations in bacterial homeostasis and an
      altered immune profile in the etiology of chronic adenoid disease in children.

PMID- 8343243
TI  - Bacterial allergy in nasal polyposis. A new method for quantifying specific IgE.
AB  - OBJECTIVES: To determine (1) if bacteria-specific serum IgE levels can be more
      effectively measured by first absorbing competing IgG antibodies from serum and
      (2) if patients with chronic paranasal sinus disease exhibit a high positive
      prevalence of bacteria-specific serum IgE. DESIGN: A modified radioallergosorbent
      test method was employed wherein each serum sample was absorbed with recProtein A
      to remove competing non-IgE antibodies, and purified proteins extracted from 16
      individual bacteria were used as potential allergens. PARTICIPANTS: Twenty-four
      patients with nasal polyposis and 14 with chronic sinusitis, all refractory to
      conventional medical therapy and requiring endoscopic sinusotomies, were tested.
      Tested as controls were 10 subjects with chronic allergic rhinitis, without a
      history of chronic sinus disease, and possessing total serum IgE and inhalant
      specific IgE levels equal to or higher than the patient group. RESULTS: (1)
      Pretreatment of serum samples with recProtein A resulted in an increase of
      bacteria-specific radioallergosorbent test sensitivity. (2) Seventeen of 24
      patients with polyps, eight of 14 with chronic sinusitis, and one of 10 with
      chronic allergic rhinitis were determined to be IgE positive when tested with
      this assay. CONCLUSIONS: (1) Bacteria-specific serum IgE can be quantified; (2)
      most patients with nasal polyposis and/or chronic sinusitis possess bacteria
      specific IgE in their serum, while subjects with only allergic rhinitis do not;
      and (3) multiple bacterial species isolated from chronically infected sinuses are
      capable of inducing IgE-mediated sensitization.

PMID- 8343244
TI  - Embolization for the treatment of posterior epistaxis. An analysis of 31 cases.
AB  - Thirty-one patients with posterior epistaxis refractory to nasal packing alone or
      in combination with surgical ligation (n = 8) underwent diagnostic angiography
      and therapeutic embolization of the internal maxillary artery. Embolization
      resulted in the cure of epistaxis in 22 cases (71.0%). Of the nine failures
      (29.0%), seven underwent successful surgical clipping of the ethmoid arteries,
      and two were treated conservatively and died of their primary hematologic disease
      within 33 days. Late rebleeding occurred in two patients: one underwent re
      embolization and the other was treated surgically. No severe or permanent
      complications occurred. The results indicate that embolization is a feasible
      alternative to surgical intervention for patients with posterior epistaxis, and
      we recommend it as the treatment of choice in cases with high surgical risk or
      failure of prior arterial ligation.

PMID- 8343245
TI  - Use of alprazolam for relief of tinnitus. A double-blind study.
AB  - OBJECTIVE: To systematically test the effectiveness of alprazolam as a
      pharmacological agent for patients with tinnitus. DESIGN: Prospective, placebo
      controlled, double-blind study. PATIENTS: Forty adult patients with constant
      tinnitus who had experienced their tinnitus for a minimum of 1 year and who
      resided in the Portland, Ore, metropolitan area. Twenty patients were randomly
      assigned to the experimental group and 20 to the control group. RESULTS:
      Seventeen of 20 patients in the experimental (alprazolam) group and 19 of the 20
      in the placebo (lactose) group completed the study. Of the 17 patients receiving
      alprazolam, 13 (76%) had a reduction in the loudness of their tinnitus when
      measurements were made using a tinnitus synthesizer and a visual analog scale.
      Only one of the 19 who received the placebo showed any improvement in the
      loudness of their tinnitus. No changes were observed in the audiometric data or
      in tinnitus masking levels for either group. Individuals differed in the dosages
      required to achieve benefit from the alprazolam, and the side effects were
      minimal for this 12-week study. CONCLUSIONS: Alprazolam is a drug that will
      provide therapeutic relief for some patients with tinnitus. Regulation of the
      prescribed dosage of alprazolam is important since individuals differ
      considerably in sensitivity to this medication.

PMID- 8343246
TI  - The National Temporal Bone, Hearing, and Balance Pathology Resource Registry.
AB  - The National Temporal Bone, Hearing, and Balance Pathology Resource Registry has
      been established with funding provided by the National Institute on Deafness and
      Other Communication Disorders of the National Institutes of Health. The registry
      is meant to serve as a national resource for researchers and the public to
      stimulate and facilitate human otopathologic research. It will maintain a
      computerized database of currently active and inactive temporal bone and auditory
      brain-stem collections throughout the United States. In addition, it will
      encourage human temporal bone research by disseminating pertinent information,
      developing and fostering temporal bone professional educational activities,
      implementing a national temporal bone acquisition network, and encouraging
      investigative collaborations in the study of the human temporal bone and brain
      structures. It will also identify otopathologic collections at risk of being
      discarded or lost and will develop mechanisms and strategies to conserve them.

PMID- 8343247
TI  - The concept of transtympanic injection of fibrin caulk.
AB  - Cerebrospinal fluid otorhinorrhea after basilar skull trauma poses a difficult
      management problem. When conservative techniques fail, more aggressive
      neurosurgical and otologic procedures are required to control cerebrospinal fluid
      leakage. We assessed a less invasive method for the repair of traumatic
      cerebrospinal fluid fistulas. Thirty-one adult Sprague-Dawley rats were used to
      develop an animal model for the treatment of cerebrospinal fluid leakage. A
      fistula was created by removing a thin plate of bone from the superior aspect of
      the rat bulla. The bulla was then plugged with a transtympanic injection of
      fibrin caulk. Otoscopic and histologic data were collected at selected intervals.
      Transtympanic injection of fibrin caulk failed to alter significantly the rate of
      healing of cerebrospinal fluid fistulas. Coagulum retraction, rapid fibrinolysis,
      and other reasons for failure are explored.

PMID- 8343248
TI  - Transiently evoked and distortion-product otoacoustic emissions. Comparison of
      results from normally hearing and hearing-impaired human ears.
AB  - Evoked otoacoustic emissions can be measured after a transient stimulus or as
      distortion products of two pure tones. Measurements of both emission types are
      being used more frequently as the techniques become easier to implement and the
      clinical benefits are realized. In addition, comparisons between the two types of
      emissions from the same ear provide information about cochlear mechanisms. We
      have measured transiently evoked otoacoustic emissions (TEOAEs) stimulated with
      clicks and distortion-product otoacoustic emissions (DPOAEs) from 166 ears of
      individuals with and without hearing impairment. The TEOAE and DPOAE amplitudes
      were compared with each other and with corresponding audiometric thresholds by
      frequency. Results revealed a high correspondence between the two emission types
      (r = .78) and between the distribution of the energy for each emission and
      audiometric threshold levels at corresponding frequencies (DPOAE, Spearman p = 
      .84; TEOAE, p = -.77). The DPOAEs were present more often than were TEOAEs when
      hearing levels across frequency were greater than 30-dB hearing level. The
      results suggest that both TEOAEs and DPOAEs are derived largely from similar
      mechanisms. The differences between the occurrence of the two emissions by
      audiometric threshold level would suggest that TEOAEs may be preferable for
      screening purposes, whereas DPOAEs may be more valuable for monitoring cochlear
      changes clinically.

PMID- 8343249
TI  - Identifying high-risk patients before head and neck oncologic surgery.
AB  - Patients from the Comprehensive Cancer Center of the Arthur G. James Cancer
      Hospital and Research Institute, Ohio State University, Columbus, who were
      undergoing major head and neck oncologic surgery were prospectively studied to
      determine predictors of postoperative medical complications and wound infection.
      Of 119 patients studied, 28 (24%) had at least one postoperative medical
      complication. The strongest predictors of medical complication were poor
      functional capacity as assessed by the Specific Activity Scale questionnaire and
      alcohol abuse. Thirteen patients (11%) developed wound infections. The strongest
      predictors of wound infection were an elevated preoperative platelet count and
      prolonged surgery. Wound infection was the strongest correlate of prolonged
      hospital stay. These findings suggest that the Specific Activity Scale
      questionnaire identifies patients at risk for medical complication, that alcohol
      abuse should be managed aggressively, and that thrombocytosis identifies patients
      at risk for wound infection.

PMID- 8343250
TI  - DNA analysis as a predictor of the outcome of induction chemotherapy in advanced
      head and neck carcinomas.
AB  - We investigated whether flow cytometric DNA index and/or ploidy status are
      predictors of response to chemotherapy and survival. Fifty consecutive patients
      with previously untreated locally advanced squamous cell carcinomas of the head
      and neck received induction chemotherapy consisting of three courses of cisplatin
      (100 mg/m2) and a subsequent 120-hour infusion of fluorouracil (1000 mg/m2 per 24
      hours) repeated every 3 weeks. Chemotherapy was followed by radiotherapy to a
      median target dose of 65 Gy and subsequent surgery for residual tumor. The median
      observation time was 27 months (range, 24 to 57 months). Flow cytometric DNA
      analysis was based on formalin-fixed and paraffin-embedded tissue from
      pretreatment tumor biopsy specimens. Complete response after induction
      chemotherapy was achieved in only 12% (2/17) of patients with diploid tumors
      compared with 39% (13/33) of those with nondiploid tumors. Among patients with
      nondiploid tumors, DNA index was higher for those responding to chemotherapy
      compared with the nonresponders. Complete response to chemotherapy was apparently
      a prerequisite for survival in the nondiploid group. Of the patients not
      responding to chemotherapy but responding to subsequent radiotherapy, survival
      was better among those with diploid tumors than among those with nondiploid
      tumors.

PMID- 8343251
TI  - Cricohyoidopexy in selected infrahyoid epiglottic carcinomas presenting with
      pathological preepiglottic space invasion.
AB  - Nineteen patients who presented with infrahyoid epiglottic squamous cell
      carcinoma with gross pathological preepiglottic space invasion, not amenable to a
      partial horizontal supraglottic laryngectomy, were offered a supracricoid partial
      laryngectomy with a cricohyoidopexy technique; this was an attempt to preserve
      physiological phonation, respiration, and deglutition while achieving the same
      local control rate as with a total laryngectomy. Preoperative chemotherapy and
      bilateral jugulocarotid lymph node dissection were performed in all cases.
      Patients were monitored for at least 5 years or until death. No patients were
      unavailable for follow-up. The 5-year actuarial survival (Kaplan-Meier method)
      was 84.2%. Local recurrence, nodal recurrence, and distant metastasis occurred
      once in our series, while six patients presented with a second primary tumor. We
      present, analyze, and compare functional results with those of the previously
      reported series. Our experience with the supracricoid partial laryngectomy with a
      cricohyoidopexy, in the face of selected infrahyoid epiglottic squamous cell
      carcinoma invading the preepiglottic space, not amenable to a partial horizontal
      supraglottic laryngectomy, suggested that a total laryngectomy might be avoided
      without decreasing the cure rate.

PMID- 8343252
TI  - Dermatofibrosarcoma protuberans of the head and neck. A report of 16 cases.
AB  - Dermatofibrosarcoma protuberans of the head and neck is a rare neoplasm. Overall,
      sarcomas account for less than 1% of all head and neck malignancies. Of 229
      patients with sarcomas of the head and neck seen at our institution between 1955
      and 1988, 14 (7%) were assigned the diagnosis of dermatofibrosarcoma protuberans
      after pathologic review. Two additional cases have been seen since 1988, bringing
      the total to 16. All cases were low-grade lesions. Follow-up ranged from 36 to
      198 months, with a median of 114 months. Fifteen patients were managed with
      surgery alone, and nine (60%) developed local recurrence. Eight were salvaged
      with further surgery. There were no regional lymph node recurrences or distant
      metastases. One patient was judged to be a poor surgical candidate and received
      primary radiation therapy. He died disease free 3 years after treatment. At last
      follow-up, 15 (94%) of 16 patients were ultimately disease free after salvage
      treatment. The overall 5-year survival rate was 93% (13/14). We conclude from
      this series, and from a review of the literature, that wide surgical resection
      achieving good margins offers excellent probability of cure, and that radiation
      therapy is a reasonable alternative in patients who have unresectable lesions or
      who are medically inoperable.

PMID- 8343253
TI  - The effect of an acute fast on human head and neck carcinoma xenograft. Growth
      effects on an 'isolated tumor vascular pedicle' in the nude rat.
AB  - The effects of nutritional state on tumor growth are poorly understood. Most
      animal studies to date suggest an inhibitory effect of nutritional depletion on
      tumor growth and a stimulatory effect of nutritional repletion or overfeeding. We
      have modified an "isolated tumor vascular pedicle" model in the nude rat to study
      the growth and tumor-specific nutrient utilization of the FaDu cell line of human
      hypopharyngeal squamous carcinoma. Two weeks after tumor implantation, rats were
      randomized to either a fed or fasted study group for an additional 7 days. Tumors
      were significantly larger in the fasted group (0.602 +/- 0.215 g vs 0.362 +/-
      0.104 g; P < .02). Whole blood nutrient gradients were determined across the
      tumor and systemic tissues in both groups. The nutrient gradients across these
      tissues were significantly different in the fed animals and approached
      statistical significance in the fasted animals. In addition, there appeared to be
      a greater utilization of glucose in the fed group (-0.401 +/- 0.904 mmol/L vs 
      0.298 +/- 0.589 mmol/L), while there was a greater production of lactate in the
      fasted group (0.798 +/- 0.518 mmol/L vs 0.046 +/- 0.639 mmol/L; P < .1). Flow
      cytometric analysis revealed no difference in the percentage of cells in any
      particular stage of the cell cycle between the two groups. These results suggest
      that the maintenance of adequate body weight may be beneficial not only to the
      nutrition of the cachectic tumor-bearing host but may also prevent a ketotic
      state or state of lipolysis that may be preferential to the tumor.

PMID- 8343254
TI  - Pathologic quiz case 1. Cutaneous angiosarcoma.

PMID- 8343255
TI  - Validation of personal exposure models for sulfate and aerosol strong acidity.
AB  - Personal exposure models for sulfates (SO4 =) and aerosol strong acidity (H+)
      were previously developed using concentration and activity pattern data collected
      from a personal monitoring study conducted in Uniontown, Pennsylvania, during the
      summer of 1990. Models were constructed based on time-weighted micro
      environmental exposures. For SO4 =, the "best-fit" model included a correction
      factor, while for H+, it included both a correction factor and a neutralization
      term. In this paper, we present the validation of these models using data
      collected in a personal monitoring study conducted in State College,
      Pennsylvania, during the summer of 1991. Indoor and outdoor concentration and
      activity pattern data collected in this study were used as inputs for the "best
      fit" models for SO4 = and H+. Predicted personal exposures subsequently were
      compared to the measured personal exposures from State College to determine their
      accuracy and precision. Predicted personal exposures for both SO4 = and H+ were
      in excellent agreement with measured personal exposures from State College. The
      models explained 91 and 62 percent of the variability in personal SO4 = and H+
      exposures, respectively, and were able to estimate personal exposures
      substantially better than outdoor concentrations alone. Validation results
      suggest that the models' correction and neutralization factors are not site
      specific and support the models' future application as a technique to assess the
      personal acid aerosol exposures of children living in similar rural and semi
      rural communities.

PMID- 8343256
TI  - Do dead batteries cause cancer?

PMID- 8343257
TI  - Salvage intraperitoneal chemotherapy for ovarian cancer: a possible role for
      mitoxantrone?

PMID- 8343258
TI  - Mechanisms of carcinogenesis and molecular epidemiology.

PMID- 8343259
TI  - Carcinoma of the cervical stump: a review of 213 cases.
AB  - From 1970 to 1987, 213 cases of carcinoma of the cervical stump were accrued in a
      multi-institutional prospective cooperative study. This group accounted for 5.5%
      of cervical carcinoma diagnosed during the same period. 13 had in situ carcinoma
      and 200 had invasive carcinoma (96% squamous cell carcinoma, 4% adenocarcinoma).
      Radiotherapy alone (external and brachytherapy) was given to 77%, brachytherapy
      and surgery to 15% and surgery alone to 8%). FIGO stage distribution was: I
      (31%), IIa (15%), IIb (27%), IIIa (5%), IIIb (17%) and IV (5%). Five-year
      locoregional control per stage was 100% in Ia, 85% in Ib, 82% in IIa, 71% in IIb,
      45% in IIIa, 54% in IIIb and 30% in IV. Corrected 5-year survival per stage was
      82% in Ib, 78% in IIa, 73% in IIb, 69% in IIIa, 38% in IIIb and 0% in IV. The
      diameter of disease in stage II strongly influenced the 5-year locoregional
      control (81% for tumours of less than 3 cm vs. 68% for tumours more than 3 cm).
      Lymphangiogram was associated with a 44.5% 5-year locoregional control when
      positive vs. 74% when non-positive. Brachytherapy was advantageous in obtaining
      locoregional control in patients receiving external irradiation and
      brachytherapy: 81.5% vs. 38.5% in patients treated with external radiotherapy
      alone. Surgery was performed only for in situ carcinoma and for part of stages
      Ia, Ib and IIa. There is no significant difference in locoregional control at
      equal stage between radiotherapy alone and treatment schemes including surgery.
      However, lethal complications were observed in 6% of the patients of the surgical
      group as compared to 0.6% of the patients treated with radiotherapy alone.
      Radical radiotherapy seems to provide similar results of locoregional control and
      survival at equal stages in carcinoma of the cervical stump compared to carcinoma
      developed on an intact uterus. The rate of severe complications reported with the
      French-Italian glossary is 13% for G3 and 3% for G4, which is close to the
      observed rate during the same period in our series of radical radiotherapy to the
      intact uterus.

PMID- 8343260
TI  - Long-term adjuvant immunotherapy in stage I high risk malignant melanoma,
      comparing two BCG preparations versus non-treatment in a randomised multicentre
      study (EORTC Protocol 18781).
AB  - The present study reports the results of a multicentre adjuvant trial with BCG
      (Bacillus Calmette-Guerin) in high risk patients (Breslow thickness > or = 1.5
      mm, Clark level > or = III) with malignant melanoma, after surgical removal of
      their primary tumour. The trial was specifically designed in order to resolve the
      controversy and to provide some definite answers regarding the value of adjuvant
      BCG treatment in stage I malignant melanoma. Patients were randomised to either
      BCG RIV (108 patients) or BCG Pasteur (109 patients) for 3 years or to follow-up
      only (110 patients). The two vaccines used had greatly divergent properties
      regarding their mode of preparation, their composition and their immunomodulating
      activities. Of the 353 randomised patients, 23 were ineligible, 3 refused
      participation after randomisation and 327 were evaluable for final analysis.
      Median follow-up time was 6 years (range 0-10 years). The log-rank test
      comparison showed no statistical difference between the three arms regarding time
      to progression (P = 0.55) and duration of survival (P = 0.82). Treatment was
      generally well tolerated, with no major adverse events in either treatment arm.
      These findings confirm data with different BCG preparations and with stage II
      melanoma which also demonstrated no benefit regarding patient survival and time
      to relapse.

PMID- 8343261
TI  - Phase I-II intraperitoneal mitoxantrone in advanced pretreated ovarian cancer.
AB  - 36 previously treated patients (25 with anthracyclines) with advanced epithelial
      ovarian cancer have been treated with intraperitoneal (i.p.) mitoxantrone (M) at
      increasing doses. The response was evaluated through repeated laparoscopy with
      multiple biopsies and serial measurement of Ovarian Cancer Antigen 125 (CA 125);
      11/36 patients had a complete (6 patients) or partial (5 patients) response.
      Toxicity (both local and general) was observed starting from 25 mg/m2 of M per
      cycle. The amount of drug reaching systemic circulation was monitored by
      measuring M plasma value after i.p. treatment. This study showed wide variations
      in serum levels obtained after i.p. doses ranging from 23 to 36 mg/m2. The area
      under the curve (AUC) of mitoxantrone plasma samples, did not correlate with the
      i.p. administered dose. Conversely, a correlation seems to exist between the
      plasma AUC and the responder status. Patients who showed clinical responses to
      i.p. treatment with mitoxantrone had AUCs and plasma peak levels of the drug that
      were significantly higher than those in non-responders (P = 0.03, Fisher's exact
      test).

PMID- 8343262
TI  - Immunoradiometric assay of pro-cathepsin D in breast cancer cytosol: relative
      prognostic value versus total cathepsin D.
AB  - In breast cancer cell lines, the maturation of pro-cathepsin D into enzymatically
      active cathepsin D is altered, leading to its increased secretion. In order to
      specifically assay pro-cathepsin D (52 kD form) in breast cancer cytosol, we
      monitored a solid phase sandwich radioimmunoassay using D9H8 and D7E3 monoclonal
      antibodies raised against human pro-cathepsin D from MCF7 cells. Pro-cathepsin D
      was assayed in 108 primary breast cancer cytosols in which total cathepsin D was
      previously found to be correlated with metastasis. Pro-cathepsin D concentrations
      were found to be correlated with total cathepsin D and with lymph node invasion,
      and was slightly higher in premenopausal patients. By contrast, Cox
      multiparametric analysis showed that pro-cathepsin D status had no prognostic
      value for survival, or metastasis free survival contrary to total cathepsin D
      status. This first study shows the technical validity of the pro-cathepsin D
      assay but indicates that it has less value as a prognostic marker than total
      cathepsin D. This study also shows that the proportion of pro-cathepsin D
      recovered in vivo (1-6%) is much less than that produced in cell lines and
      suggests that the secreted pro-enzyme might be activated in the tumour
      extracellularly or following its reinternalisation.

PMID- 8343263
TI  - Zn-alpha 2-glycoprotein levels in breast cancer cytosols and correlation with
      clinical, histological and biochemical parameters.
AB  - Zn-alpha 2-glycoprotein (Zn-alpha 2-gp), a protein present at high levels in
      breast cyst fluid, has been measured in 104 breast tumour cytosols by using an
      immunoenzymatic assay. Concentrations of Zn-alpha 2-gp ranged from 0 to 23.5
      micrograms/mg of total soluble protein, with an average value of 2.4
      micrograms/mg. There was no significant correlation between Zn-alpha 2-gp and
      menopausal status, tumour size or lymph node involvement, or between this protein
      and biochemical parameters such as oestrogen receptor, cathepsin D or pS2 levels.
      However, there was a significant association between Zn-alpha 2-gp and
      histological grade of tumours, with higher Zn-alpha 2-gp levels in well
      differentiated tumours (mean 4.6 micrograms/mg) than in moderately (1.8
      micrograms/mg) or poorly (0.9 micrograms/mg) differentiated tumours. On the basis
      of these results, we propose that Zn-alpha 2-gp may be considered as a
      biochemical marker of differentiation in breast cancer.

PMID- 8343264
TI  - The changing importance of prognostic factors in bladder cancer during a long
      term follow-up.
AB  - A cohort of 505 patients with a transitional cell bladder cancer were followed up
      for over 9 years and clinical, histological and morphometric factors were related
      to survival. Several survival analyses were done by moving the start of the
      follow-up so that the first analysis started at the time of primary therapy and
      the last one after 9 years follow-up. T-category, WHO grade, papillary status and
      the density of tumour infiltrating lymphocytes had independent short-term
      prognostic value whereas mitotic index and standard deviation (S.D.) of nuclear
      area were independent long-term predictors up to 7 years after diagnosis. In
      papillary tumours S.D. of nuclear area and mitotic index were independent long
      term predictors in contrast to T-category and WHO grade which were both short
      term prognostic factors. In superficial tumours only mitotic index had
      independent long-term prognostic value. The results show that the prognostic
      information from the primary tumour biopsy specimen has long-term prognostic
      significance in transitional cell bladder cancer. The results particularly
      emphasize the importance of factors related to cancer cell proliferation as long
      term predictors.

PMID- 8343265
TI  - Neuropsychological and neurophysiological assessment of the central effects of
      interleukin-2 administration.
AB  - Neuropsychiatric disturbances may occur following interleukin-2 (IL2)
      administration. We studied the effects of IL2 infusion on cerebral functions in 7
      patients with neuropsychological tests and event-related evoked potentials
      (P300). We observed a failure in the cognitive performances, an increase in
      latency, and a decrease in amplitude of P300. These effects followed IL2
      administration and were reversible.

PMID- 8343266
TI  - Karyotype in multiple myeloma and plasma cell leukaemia.
AB  - Between October 1988 and October 1991, 104 patients with multiple myeloma and 6
      with plasma cell leukaemia were studied cytogenetically. Abnormal karyotypes were
      found in bone marrow cells of 33 patients (30%). Most pathological karyotypes
      were complex with numerous modal and structural anomalies. Numerical anomalies
      most frequently involved chromosome 11 and structural aberrations occurred most
      often in chromosomes 1, 11 and 14. The most consistent structural aberration was
      a 14q+ chromosome (10 patients) resulting from a t(11;14)(q13;q32) in 4 patients
      and a t(8;14)(q24;q32) in 1 patient. Sequential cytogenetic studies were
      performed in 15 patients. In 5 of 8 cases with a normal karyotype at diagnosis,
      chromosomal anomalies were detected when disease progressed. In concomitant
      cytogenetic/cytological studies it was found that in the majority of patients
      with normal karyotype the mitoses originated from contaminating normal bone
      marrow cells. Pathological karyotypes were detected more frequently in pretreated
      than in untreated patients, in patients with plasma cell leukaemia than in
      patients with multiple myeloma, in patients with stage III and dense bone marrow
      infiltration than in patients with stage I. Patients with abnormal karyotype,
      irrespective if pretreated or not, had a significantly shorter median survival
      than those with normal karyotype. These findings suggest that karyotype is an
      independent prognostic factor in multiple myeloma.

PMID- 8343267
TI  - Ceftriaxone versus latamoxef in febrile neutropenic patients: empirical
      monotherapy in patients with solid tumours.
AB  - 121 patients with 132 febrile episodes were randomised to ceftriaxone or
      latamoxef monotherapy in order to compare antibiotic efficacy in neutropenic
      patients treated with cytotoxic chemotherapy for solid tumours. In 80 evaluable
      episodes no significant differences were observed between the two groups with
      respect to efficacy and fatal failure rates. Of episodes treated with
      ceftriaxone, 67% showed a favourable clinical response vs. 61% in the latamoxef
      group. The clinical response rates in episodes with documented bacterial
      infections were 67 and 56% in the two treatment groups. In 18% of the episodes
      with documented initial infections the patients died of presumably uncontrolled
      infection. The convenient once daily dosage schedule combined with fewer severe
      adverse reactions favours the use of ceftriaxone instead of latamoxef. Although a
      relative high degree of response was seen, empirical antibiotic monotherapy
      apparently does not offer a sufficient antibacterial cover in infections in this
      type of patient with defective host immunity.

PMID- 8343268
TI  - Oxaliplatin activity against metastatic colorectal cancer. A phase II study of 5
      day continuous venous infusion at circadian rhythm modulated rate.
AB  - Oxaliplatin (L-OHP) is a non-nephrotoxic third generation platinum complex with
      proven antitumoral activity and minimal haematological toxicity. Circadian
      scheduling has allowed significant increases in L-OHP dosage and dose intensity
      and decreases in its toxicities. This phase II trial has tested the antitumour
      activity of a 5-day circadian schedule of continuous venous infusion of L-OHP
      against metastatic colorectal cancer. Initial dose was 150 mg/m2/course. An
      intrapatient dose escalation scheme by 25 mg/m2/course was planned up to 200
      mg/m2/course, according to toxicity criteria. The delivery rate of L-OHP was
      sinusoidally modulated along the 24-h time scale, and was highest at 1600 h. A
      programmable-in-time ambulatory pump was used, so that all patients could receive
      their treatment at home. 29 of 30 patients registered were eligible. 25 had
      failed previous chemotherapy. Three objective responses were observed (response
      rate: 10%), in patients progressive while on chemotherapy with 5-fluorouracil and
      folinic acid. Toxicity was moderate. Dose-limiting toxicities were diarrhoea and
      peripheral sensitive neuropathy. The latter adverse effect appeared to be
      cumulative. L-OHP, as delivered under this circadian schedule, exhibits clinical
      antitumour activity against metastatic colorectal cancer. These results, which
      await further confirmation, support the place of L-OHP in combination regimens
      including 5-fluorouracil.

PMID- 8343269
TI  - DNA pattern and dietary habits in patients with breast cancer.
AB  - An association between dietary fat, micronutrients and breast cancer aetiology
      and prognosis has been found in studies of experimental animals and in
      epidemiological studies. The relationship between dietary habits and the nuclear
      DNA content of breast cancer cells was studied in 82 women aged 50-65 years. A
      dietary history interview was conducted within 4 months following surgery.
      Patients having tumours with euploid DNA pattern reported lower mean intake of
      saturated fatty acids (FA) in absolute terms, lower mean intake of total fat,
      saturated FA, and monounsaturated FA, in percentage of total energy intake (E%),
      a higher E% from protein, and a higher intake of vitamin D, and selenium per 10
      MJ than did patients having tumours with aneuploid DNA pattern. In the stepwise
      logistic regression analysis, the multivariate odds ratios (OR) for having a
      tumour with aneuploid DNA pattern was 1.16 (95% confidence interval, 1.04-1.28)
      for each 1 g increase in intake of total fat (E%) and 0.95 (95% confidence
      interval, 0.92-0.99) for each mg increase in selenium intake per 10 MJ. When
      total fat was substituted with types of fat, the OR for having a tumour with
      aneuploid DNA pattern was 1.30 (95% confidence interval, 1.07-1.59) for each 1 g
      increase in intake of saturated FA (E%). These results suggest a correlation
      between a diet rich in fat and protein and the DNA content of breast cancer
      cells.

PMID- 8343270
TI  - Trends in lung cancer mortality in three broad Italian geographical areas between
      1969 and 1987.
AB  - Trends in death certification rates from lung cancer in broad Italian
      geographical areas (north/centre/south) were analysed over the period 1969-1987.
      In northern Italy, lung cancer rates in young and middle-aged males reached a
      peak between the mid and late 1970s, and tended to decline afterwards; only above
      age 60 was mortality still rising in the 1980s. A similar pattern of age-specific
      rates was observed in central areas, while in the South rates tended to level off
      in the early 1980s only below age 55, but were still upwards in subsequent age
      groups. Consequently, the north/south ratio for the overall age-standard rate
      increased slightly between the late 1960s and mid 1970s, from 1.68 (corresponding
      to a world standardised rate of 47.1/100,000 in the north vs. 28.1 in the south)
      to 1.73, but declined to 1.55 between 1985 and 1987 (for a rate of 69.1/100,000
      males in the north vs. 44.6 in south). In the younger age groups a diverging
      pattern was observed: at ages of 25-34 rates in 1985 and 1987 were apparently
      higher in the south (1.0 vs. 0.9/100,000 in the north), and in the 35-44 age
      group the north/south ratio decreased from 1.7 to 1.2 (with rates of 12.9 and
      10.7, respectively, in 1985 and 1987). Among females, lung cancer rates increased
      in all geographical areas and age groups except the youngest (25-34 years). Under
      the age of 50, the rises were proportionally similar in various geographical
      areas, thus widening the north/south difference in absolute terms. Above the age
      of 50, the north/south difference tended to be wider in relative terms too,
      reaching a factor of 2 in the 65-74 age group. The overall age-standardised
      north/south ratio for females increased from 1.51 in 1969-1974 (5.6 vs.
      3.7/100,000) to 1.87 in 1985-1987 (8.4 vs. 4.5/100,000). These trends reflect
      changes in smoking habits in subsequent generations of Italian males and females
      from different areas of the country, and confirm the central role of cigarette
      smoking in lung cancer rates in various populations, although this does not
      exclude some influence by other, mainly occupational, lung carcinogens on the
      substantial differences in lung cancer rates in various Italian geographical
      areas.

PMID- 8343271
TI  - Evidence for bimodal distribution of breast carcinoma ER and PgR values
      quantitated by enzyme immunoassay.
AB  - Breast carcinoma oestrogen receptor (ER) and progesterone receptor (PgR) values
      obtained by radioligand binding assays have commonly been observed to have
      approximate log-normal distributions. We examined the distribution of log
      transformed receptor values obtained by enzyme immunoassay for 5468 primary
      breast carcinomas in five Ontario laboratories. In each laboratory, it was found
      that the frequency histograms for the log transformed receptor values were not
      unimodal, and generally were suggestive of bimodality. This was not affected by
      stratification by age or inferred menopausal status (< or = 49, > or = 50 years),
      and could not be explained by kit characteristics. However, the low point in the
      distribution varied from 5 to 63 fmol/mg cytosol protein, depending on the
      receptor, patient age and laboratory. The tendency towards biomodality was more
      distinct for ER than for PgR. It remains to be determined whether the low points
      on the frequency histograms have clinical relevance for discriminating between
      hormone-sensitive and hormone-insensitive tumours.

PMID- 8343272
TI  - Risk factors for epithelial ovarian cancer in women under age 45.
AB  - Risk factors for ovarian cancer in young women were investigated using data from
      a case-control study conducted between 1983 and 1992 in Milan, northern Italy, on
      194 women below age 45 with histologically confirmed incident cancers of the
      ovary and 710 controls admitted to the same network of hospitals for acute non
      gynecological, nonhormonal and non-neoplastic diseases. An elevated relative risk
      (RR) of ovarian cancer was found among women reporting 12 or more years of
      education [RR 1.6, 95% confidence intervals (CI) 1.0-2.03] and belonging to the
      highest social class (RR 1.8, 95% CI 1.1-3.0). Women whose mothers had had
      ovarian cancer had a multivariate RR of 2.7 (95% CI 0.7-10.5) compared to those
      with no family history. Menarche above age 13 and irregular menstrual cycles were
      significantly protective against ovarian cancer (RR 0.6 for both risk factors).
      There was a significant inverse relationship with abortions, the RR being 0.6
      both for spontaneous and for induced abortions, while protection of parity was
      not significant. Higher risks of ovarian cancer were observed in women having
      first or last birth when older than 30 years (RR 2.0 and 2.4, respectively,
      compared to those delivering under age 25). A significant trend toward an
      increased risk of ovarian cancer was also observed with decreasing time since
      last birth. Compared with women whose last birth occurred 10 or more years before
      diagnosis, the RR was 2.1 (95% CI 1.1-3.9) for those reporting a birth during the
      last 5 years. The RR for oral contraceptive users was 0.7 (95% CI 0.5-1.0) and
      the protection increased with duration, with RR of 0.3 (95% CI 0.1-0.7) for 5 or
      more years of use. This study indicates that, although the incidence of ovarian
      cancer is higher in older women, recognised risk and protective factors are
      similar below age 45. An excess risk in the few years after a term delivery is
      also suggested.

PMID- 8343273
TI  - Characterisation of muscarinic cholinergic receptors in human ovaries, ovarian
      tumours and tumour cell lines.
AB  - Using [3H]quinuclidinyl benzilate (QNB) as radioligand, muscarinic cholinergic
      receptor sites in isolated plasma membrane fractions from human ovarian tumours,
      cultured tumour cells, and normal ovarian tissue were characterised. QNB binding
      to all preparations, except from poorly differentiated tumour, was specific,
      saturable, and of high affinity. In contrast to normal ovaries, benign tumours,
      well differentiated adenocarcinoma and OVCAR-3 cells, the poorly differentiated
      adenocarcinoma and SKOV-3 cells completely lacked specific QNB binding. The
      muscarinic receptor densities and the Kd values in preparation from ovaries,
      receptor-positive tumours and OVCAR-3 cells were similar. QNB binding was
      strongly inhibited by the classical muscarinic receptor antagonist atropine, but
      poorly by the agonist carbachol. In contrast to atropine, inhibition by
      pirenzepine and AF-DX 116 was relatively low. These data suggest that muscarinic
      receptors in ovaries and ovarian tumours are of m3 type.

PMID- 8343274
TI  - Expression of O6-alkylguanine-DNA-alkyltransferase in situ in ovarian and
      Hodgkin's tumours.
AB  - The cellular expression of O6-alkylguanine-DNA-alkyltransferase (ATase) may be an
      important factor in determining tumour sensitivity to certain alkylating agents.
      In a comparative study, we have examined the inter- and intracellular
      distribution of ATase in tumour biopsies of a series of patients with Hodgkin's
      disease and ovarian cancer using a rabbit antihuman ATase antiserum. The antibody
      recognises the ATase protein on western blots of cell-free extracts of a number
      of ovarian tumours with ATase activities varying from 20 to 420 fmol/mg protein
      as determined by in vitro assay and there was a linear correlation between ATase
      activity and the intensity of the band on western blots (r = 0.993).
      Immunohistochemical staining was seen in all of the ovarian tumours examined and
      was confined to the nucleus. This is in contrast to the Hodgkin's tissue, where
      staining was much reduced and present in both nuclei and cytoplasm. The results
      suggest that in ovarian tumours the general resistance to nitrosourea
      chemotherapy may be related to the high cellular expression of ATase protein:
      this is in contrast to the more chemosensitive Hodgkin's disease. This raises the
      possibility that it might be feasible to predict sensitivity or resistance to
      these alkylating agents by immunohistochemical staining of tumour or tissue
      specimens.

PMID- 8343275
TI  - Continuous intravenous interleukin-2 infusion and subcutaneous interferon-alpha
      in metastatic renal cell carcinoma.
AB  - In a phase II trial patients with metastatic renal cell carcinoma (MRCC) received
      two induction cycles each consisting of 24-h intravenous infusions of interleukin
      2 (IL-2) 18 x 10(6) U/m2/day and interferon (IFN) 3 x 10(6) U/m2/day given
      subcutaneously on days 1-5 and 8-12 of a 2-week cycle. Between cycles 1 and 2
      there was a 3-week treatment-free interval. Maintenance therapy consisted of four
      monthly cycles of IL-2 and IFN. Due to considerable toxicity the trial was
      prematurely closed after inclusion of 16 of 23 scheduled patients. Three partial
      responses were observed. Nine events of severe or life-threatening side-effects
      occurred and 8 patients were transferred to the intensive care unit. The
      combination of continuous intravenous high-dose infusions of IL-2 and
      subcutaneously given IFN is moderately effective, but too toxic for routine
      treatment of MRCC.

PMID- 8343276
TI  - De novo cisplatinum resistance does not influence cellular radiosensitivity.
AB  - The intrinsic sensitivity to 4 MeV photons, and 62.5 MeV (p-->Be+) neutrons has
      been examined in a panel of 11 cultured human cell lines exhibiting a wide
      spectrum of inherent cisplatinum sensitivity. Irrespective of whether cellular
      sensitivities to these therapeutic agents were compared at the 10% survival
      level, relative to the initial portion of the cell survival curves, or to their
      relative rank order of response, there were no significant correlations between
      inherent cisplatinum sensitivity and sensitivity to either 4 MeV photon, or 62.5
      MeV neutron irradiation. This data raises the possibility that the previously
      reported decreased radiosensitivity of human tumour cell lines with acquired
      cisplatinum resistance may be due to the induction of cellular processes which
      confer resistance to both cisplatinum and ionising radiation, rather than the
      selection of innately cisplatinum-resistant cells, which are collaterally
      radioresistant.

PMID- 8343277
TI  - Vinca alkaloids: anti-vascular effects in a murine tumour.
AB  - We have investigated the blood flow modifying effects of the vinca alkaloids,
      vincristine and vinblastine in the murine carcinoma CaNT. Vinblastine at doses of
      7.5 or 10 mg/kg induced profound and chronic reductions in tumour blood flow as
      measured by 86RbCl extraction. Following the maximum tolerated dose of 10 mg/kg,
      blood flow was reduced to 10% of pretreatment values after 2 h and remained below
      20% of pretreatment values 24 h after drug administration. These findings are
      consistent with the early induction of necrosis by vinblastine and suggest that
      vascular-mediated cell death may account for a large part of the 11 day growth
      delay induced by this drug dose. In contrast to the large reductions in tumour
      blood flow, in skin, kidney, liver and muscle, blood flow reductions did not, at
      any time examined, exceed 40%. In all the normal tissues studied, blood flow had
      fully recovered by 6 h after vinblastine administration. Similar results, albeit
      less pronounced, have been obtained with vincristine at the maximum tolerated
      dose of 3 mg/kg. The results clearly show that both vinblastine and vincristine
      can induce, with some selectivity, a dramatic and prolonged reduction in tumour
      blood flow and that this may contribute to the anti-tumour effects against the
      CaNT tumour.

PMID- 8343278
TI  - Lack of correlation between anxiety parameters and oestrogen receptor status in
      early breast cancer.
AB  - Correlation between anxiety parameters and oestrogen receptor levels (ER) were
      investigated in 89 patients with primary breast cancer. Patients were divided
      into two groups, ER poor (< 0.05 fmol/microgram DNA) and ER rich (> 0.05
      fmol/microgram DNA). No differences were found between anxiety levels, determined
      by a modified Hospital Anxiety and Depression (HAD) scale, in the two groups.
      This report does not support the findings from other studies, claiming an
      association between psychological parameters and oestrogen receptor status, which
      is believed to be a prognostic predictor.

PMID- 8343279
TI  - CEA-immunoscintigraphy with 99m-technetium correlates with tumour cell
      differentiation in colorectal cancer.
AB  - The clinical usefulness of immunoscintigraphy with the monoclonal anti-CEA
      (carcinoembryonic antigen) antibody BW431/26, directly labelled with 99m
      Technetium in targeting colorectal carcinomas was investigated in 43 patients. In
      addition, tumour cell grading and CEA-expression were examined
      immunohistochemically. Best imaging results were obtained in pelvic tumour
      lesions (sensitivity 80%). Tumour grading correlated with radioimmunoimaging,
      well differentiated tumours being detectable at a higher rate (P = 0.09).
      Immunoscintigraphy preceded the findings of conventional diagnostic methods in 3
      patients. In 4 cases immunoscintigraphy was decisive for patients management.
      Therefore, immunoscintigraphy with 99m-Technetium is valuable in directing
      patients management if conventional diagnostic methods remain undecisive.

PMID- 8343280
TI  - Carboplatin in patients with advanced colorectal cancer pretreated with
      fluoropyrimidines.
AB  - The activity of carboplatin (CBDCA) was tested in 21 consecutive patients with
      advanced colorectal cancer that had progressed during fluoropyrimidine therapy.
      CBDCA was chosen in view of the favourable results obtained in previous phase II
      studies. We were unable to find any activity of the agent which was given every
      21 days at a dose of 400 mg/m2. The main toxicity was haematological. CBDCA is
      not recommended in pretreated patients with colorectal cancer.

PMID- 8343281
TI  - Black (air-cured) and blond (flue-cured) tobacco and cancer risk. V: Oral cavity
      cancer.

PMID- 8343282
TI  - Carotenoids and cancer: an update with emphasis on human intervention studies.
AB  - This article gives an overview of the current state of knowledge on the cancer
      preventive potential of carotenoids. Numerous retrospective and prospective
      epidemiological studies have shown that a high intake of carotenoid-rich fruits
      and vegetables is associated with a decreased risk of cancer at a number of
      common sites. For several other cancer sites, however, the epidemiological
      evidence is not very consistent. A number of mechanisms for the cancer preventive
      properties of carotenoids have been proposed. Conversion to retinol, possibly in
      posthepatic tissues, would allow an effect on cellular differentiation and
      proliferation, and on cell-to-cell communication. Antioxidant functions could
      prevent free radical-induced damage to cellular DNA and other macromolecules.
      Immunomodulatory effects could enhance immune surveillance in tumorigenesis. In
      addition, non-retinol-mediated effects of carotenoids on metabolism of
      carcinogens and cell-to-cell communication have been shown. Observational
      epidemiology cannot resolve whether associations are due to a specific
      carotenoid, or to an associated factor in fruits and vegetables, whereas
      interpretation of animal studies is hampered by uncertainties in extrapolation
      between species, more so because the metabolism of carotenoids in most animals
      differs notably from that in humans. Human intervention studies on biomarkers
      related to cancer risk and on cancer incidence are, therefore, necessary. Human
      intervention studies performed so far suggest that beta-carotene can affect
      carcinogenesis, though not at all stages and not at all cancer sites.
      Implications for future human intervention research are discussed.

PMID- 8343283
TI  - Mechanisms of carcinogenesis: chemical exposure and molecular changes.

PMID- 8343284
TI  - Report of an international workshop on perspectives on secondary prevention of
      laryngeal cancer.

PMID- 8343285
TI  - Phase II study of oral ftorafur and uracil in patients with advanced renal cell
      carcinoma.

PMID- 8343286
TI  - A phase II study of etoposide, cisplatin plus methotrexate in patients with
      advanced refractory breast cancer.

PMID- 8343287
TI  - Carboplatin hypersensitivity: case reports and review of the literature.

PMID- 8343288
TI  - Meningeal tumour infiltration in hormone resistant prostate cancer demonstrated
      with magnetic resonance.

PMID- 8343289
TI  - A pilot study of vinorelbine on a weekly schedule in recurrent and/or metastatic
      squamous cell carcinoma of the head and neck.

PMID- 8343290
TI  - [The endovascular surgery of the cerebral arteriovenous malformations].

PMID- 8343291
TI  - [Balloon angioplasty for high grade vasospasm after subarachnoid hemorrhage].

PMID- 8343292
TI  - [Intravascular surgery for brain tumors].

PMID- 8343293
TI  - [Intravascular surgery for spinal AVM].

PMID- 8343294
TI  - [A study on the prediction of long-term prognosis of adulthood epilepsy].
AB  - We report results of a study on the relation between the clinical findings 2
      years after initiation of the therapy and the long-term prognosis of seizure
      control, and discuss the possibility of predicting the prognosis in the early
      stage of therapy. The subjects consisted of 141 patients, observed for 10 to 20
      years at Hirosaki University Hospital. Regarding the epilepsy type, the prognosis
      of temporal lobe epilepsy was unfavorable. In temporal lobe epilepsy, only 21%
      were in remission (seizure-free for 3 years or more) at the time of the study.
      Also, the presence of organic brain lesions or neuropsychiatric complications at
      the early stage of treatment was associated with unfavorable prognosis. We are
      particularly interested in the possibility of predicting the long-term prognosis
      from the result of early response to anti-epileptic drug therapy. We found a
      significant correlation between the early excellent response to drug treatment
      and the good long-term prognosis. Using discriminant analysis (quantification
      theory II), we tried to find which factors would influence more to the long-term
      prognosis. As the result, an importance was found in the following order: (1)
      epilepsy type, (2) presence or absence of neuropsychiatric complications, (3) age
      at onset, (4) early response to treatment, (5) presence or absence of organic
      brain lesions and (6) the interval between the onset and the initiation of drug
      treatment. Correct identification rate by discriminant analysis was 73%.

PMID- 8343295
TI  - [A study of plasma atrial natriuretic peptide, antidiuretic hormone and cerebral
      vasospasms in patients with aneurysmal subarachnoid hemorrhage].
AB  - The relationship between plasma atrial natriuretic peptide (ANP) and antidiuretic
      hormone (ADH) both of which show high values after subarachnoid hemorrhage and
      cerebral vasospasm was studied. The subjects were 23 patients who were admitted
      because of aneurysmal subarachnoid hemorrhage during three years from March, 1989
      to March, 1992 and in whom plasma ANP and ADH levels could be determined over
      time. Cerebral vasospasm was evaluated by the finding of cerebral angiography,
      clinical symptoms, and presence or not of low density areas on CT. Hyponatremia
      was defined as the serum sodium level of 130 mEq/l or less for two days or more.
      Angiographical vasospasm was found in 17 patients (85%), symptomatic vasospasm in
      15 patients (65.2%), low density areas on CT in 9 patients (40.9%) and
      hyponatremia in 8 patients (34.8%). Symptomatic vasospasm was noted in 7 of the 8
      patients (87.5%) with hyponatremia, low density areas on CT in 4 patients (50%),
      the detection rate being high. The plasma ANP and ADH levels were 76.7 +/- 32.1
      pg/ml and 2.2 +/- 0.7 pg/ml respectively in the patients with symptomatic
      vasospasm against 38.3 +/- 21.3 pg/ml and 2.4 +/- 0.6 pg/ml respectively without
      symptomatic vasospasm, the plasma ANP level being significantly high in the
      patients with symptomatic vasospasm (p < 0.01). The plasma ANP and ADH were 71.2
      +/- 33.8 pg/ml and 2.0 +/- 1.1 pg/ml respectively in the patients with low
      density areas on CT against 51.2 +/- 31.3 pg/ml and 1.8 +/- 0.5 pg/ml
      respectively without low density areas on CT.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343296
TI  - [Evaluation of surgical treatment for chronic subdural hematoma in extremely aged
      (over 80 years old) patients].
AB  - A consecutive series of 76 aged (over 80 years old; 50 male, 26 female) patients
      with chronic subdural hematoma (CSDH) was studied. They were analyzed about
      interval form trauma, preoperative grade according to Bender scale, coexisting
      disease, volume and location of hematoma, surgical procedures, postoperative
      outcome and complications. Sixty-six% of patients had a history of trauma.
      Clinical findings at the time of admission were graded according to Bender scale.
      The majority of patients belonged to grade 2 (41 cases) and grade 3 (23 cases)
      followed by grade 1 (8 cases) and grade 4 (4 cases). The volume of CSDH was
      classified into three group; under 79 ml (21 cases), between 80 and 119 ml (28
      cases), over 120 ml (27 cases). Almost all of patients were operated by burr
      hole, irrigation with drainage or Ommaya's reservoir. Six cases needed
      reoperation. Six cases suffered from infections. Sixty-eight (89%) patients
      improved at the time of discharge. Surgical procedure is the best choice for CSDH
      even in extremely aged patients.

PMID- 8343297
TI  - [A case of atypical senile dementia of Alzheimer type].
AB  - We describe the autopsy finding in a male patient with senile dementia of
      unusually prolonged total duration, who had exhibited atypical neuropathologic
      findings. During clinical course, memory disturbance had been more prominent than
      deterioration of other cognitive functions. Neuropathologic examination revealed
      neurofibrillary changes which were prominent in the hippocampal region and
      scattered in the amygdala and in the predilection sites of the hypothalamus and
      brain stem. This distributional pattern was that in Alzheimer-type dementia. The
      most characteristic finding was scanty senile plaques, which were scattered
      predominantly in the basal and medial portion of the frontal lobe. Although the
      clinical course and pathological findings of this case were in slight degree and
      deviated from those in usual senile dementia, it is thought that the entity in
      this case was dementia of the Alzheimer-type.

PMID- 8343298
TI  - [A case report of Weber's syndrome associated with supranuclear vertical gaze
      palsy caused by the ipsilateral thalamomesencephalic lesion].
AB  - We report a rare case showing Weber's syndrome associated with supranuclear
      vertical gaze palsy caused by the ipsilateral lesion of the rostral interstitial
      nucleus of the medial longitudinal fasciculus (riMLF), which is regarded as the
      supranuclear control center of vertical gaze. To date, no literature concerning
      Weber's syndrome associated with the ipsilateral riMLF lesion was documented. The
      patient was a 53-year-old female, who suddenly developed unconsciousness and left
      sided weakness. Neurological findings on admission revealed right third nerve
      palsy, severe supranuclear vertical gaze palsy, almost complete convergence
      palsy, left hemiparesis and hyperreflexia with positive Babinski's sign on the
      left side. There was no sign of pupillary disturbance or no abnormality of the
      horizontal movements of the left eye. The vestibulo-ocular reflex of the left eye
      was preserved. There was no sensory disturbance. Cranial MRI had the advantages
      in demonstrating unilateral ischemic lesions at the cerebral peduncle and the
      thalamomesencephalic junction involving the unilateral riMLF on the right side.
      Recent reports have demonstrated that supranuclear vertical gaze palsy is caused
      by the unilateral riMLF lesion. We confirm that the unilateral riMLF lesion
      causes supranuclear vertical gaze palsy in our case and that cranial MRI has the
      advantages in demonstrating the specific lesion.

PMID- 8343299
TI  - [A case of selective short-term memory disturbance due to a glioma in the left
      temporo-parietal lobe].
AB  - We report a patient with selective short-term memory disturbance caused by a
      glioma in the left temporal-parietal lobe. The patient was a 40-year-old right
      handed housewife who complained of difficulty in memorizing series of numbers.
      She was working as a car dealer. She was well until 6 months prior to the present
      admission when she noted a difficulty in memorizing series of numbers such when
      telephone numbers and car registration numbers. She had to write them down as her
      customers told them to her. On admission, she was alert and oriented to all
      spheres. She was mentally sound without dementia. She did not show aphasia,
      apraxia, or agnosia, except for brief periods of seizures in which she became
      unable to speech. Neuropsychological examination revealed that she had difficulty
      in repeating and dictating series of numbers and meaningless kana words. However,
      she could easily pick up the correct series of numbers or kana words among
      multiple choices presented visually. Thus it was clear that her problem was not
      the disturbance of auditory input nor expression, but a selective impairment of
      short-term memory. She could memorize the same stimuli when visually presented.
      Therefore, her problem was thought to be a disturbance of auditory short-term
      memory of meaningless words. After resection of her tumor, she developed
      transient amnesic aphasia, which improved a year later. She was examined again in
      her memory function. In the task of visual stimuli, we presented her a card in
      which a series of numbers or a nonsense syllable was written for 5 seconds and
      asked her to remember them.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343300
TI  - [Thalamic infarction in young adult caused by embolism from an unruptured
      aneurysm of the posterior cerebral artery--a case report].
AB  - A 21-year-old man presented with sudden weakness and dysesthesia of his right
      limbs. Computerized tomography (CT) scan showed a low density area in the
      posterolateral part of the left thalamus. Right vertebral angiography revealed a
      small aneurysm at the P2 segment of the posterior cerebral artery. Magnetic
      resonance imaging (MRI) demonstrated intra-aneurysmal clot and signal void in the
      residual lumen. There were no other lesion and no predisposing risk factors that
      produced cerebral ischemia. It was thought that the aneurysm was the source of
      emboli resulting in thalamic infarction. The patient underwent a left subtemporal
      craniotomy, and the aneurysm was clipped. Following surgery, there has been no
      recurrence of ischemic attacks. The diagnosis and the therapy were discussed,
      with reference to the literature.

PMID- 8343301
TI  - [A large vertebrobasilar junction aneurysm grown at the proximal end of basilar
      artery fenestration--usefulness of balloon occlusion test with 99mTc-HMPAO SPECT
      under induced hypotension and consideration in therapeutic strategies].
AB  - A 48-year-old lady suffered a transient loss of consciousness. CT and MRI
      revealed a large vascular lesion compressing the left lower pons. Angiography
      revealed a large aneurysm at vertebro-basilar junction, dome of which projected
      anteriorly and left to midline. Her previous vertebral angiogram taken 10 years
      ago when she suffered a subarachnoid hemorrhage from the left MCA aneurysm, had
      showed a fenestration of lower basilar artery without apparent aneurysm.
      Bilateral super-selective vertebral angiograms revealed that the aneurysm arose
      at the proximal end of the fenestration, and vertebrobasilar junction was
      incorporated into the aneurysm indicating broad neck aneurysm. The left posterior
      communicating artery was well developed. Balloon test occlusion (BTO) of
      bilateral vertebral artery was performed under normotension and induced
      hypotension. 99mHM-PAO SPECT was used to examine cerebral blood flow (CBF) during
      hypotensive BTO. The patient tolerated the test and CBF imaging showed
      insignificant sight decrease in bilateral cerebellar hemispheres. Exploration of
      the aneurysm was carried out by the right far lateral suboccipital approach.
      Bilateral vertebral arteries and the right segment of the basilar artery
      fenestration were identified. Neck clipping of the aneurysm with reconstruction
      of the parent vessels were tried with fenestrate clip. However, narrow operative
      field and large dome of the aneurysm made it hard to identify the left segment of
      the fenestration. Neck clipping was given up and clipping of bilateral vertebral
      arteries were performed distal to posterior inferior cerebellar artery with three
      body clippings. The patient showed moderate postoperative left lower nerve palsy,
      which was gradually improved in several weeks. Follow-up angiography revealed no
      opacification of the aneurysm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343302
TI  - Self-scheduling guidelines. Pediatric unit. Mercy Hospital and Medical Center,
      San Diego, California.

PMID- 8343304
TI  - Nurse executives share their first class ideas. Outcome-based resource
      management.

PMID- 8343303
TI  - When patient classification systems fail.

PMID- 8343305
TI  - ANA blueprint for transition: the matrix plan for nursing initiatives in managed
      care.

PMID- 8343306
TI  - Partnering with your human resource department.

PMID- 8343307
TI  - Self-scheduling: a practical application of shared governance.

PMID- 8343308
TI  - Learned optimism.

PMID- 8343309
TI  - Insulin and atherosclerosis: villain, accomplice, or innocent bystander?

PMID- 8343310
TI  - Oxidised low density lipoproteins and atherogenesis.

PMID- 8343311
TI  - Radiation induced coronary heart disease.

PMID- 8343312
TI  - Radiotherapy, left-sided breast cancer, and ischaemic heart disease.

PMID- 8343313
TI  - Non-invasive diagnosis of arterial patency after thrombolytic treatment and its
      relation to prognosis.
AB  - OBJECTIVE: To validate a simple noninvasive method with serial creatine kinase
      measurements for diagnosis of early patency of the infarct related artery after
      thrombolytic treatment with streptokinase. To investigate the relation between
      early patency of the infarct related artery and prognosis. DESIGN: Patients under
      76 years of age and seen within six hours of the start of prolonged chest pain
      and ST segment elevation were treated with streptokinase (1.5 x 10(6) U)
      intravenously over 30-60 minutes. Blood for measurement of total creatine kinase
      activity was taken at baseline and at 1, 2, 3, 4, 8, 12, 16, 20, and 24 hours
      after starting treatment. The rise in enzyme activity at each time from baseline
      was expressed as a proportion of the total rise from baseline to peak. PATIENTS:
      Patients studied were in the following groups: (a) Sixty patients took part in a
      validation study with angiographic determination of patency of the infarct
      related coronary artery at 2.6 (0.3) hours (mean (SD)) after starting
      streptokinase. (b) A further 258 patients did not have early arteriography, but
      data were added to those from the 60 validation patients to find the relation
      between enzymatically determined early patency of the infarct related artery and
      30 day mortality. (c) A further subset of 232 patients with first infarctions
      (including patients from groups (a) and (b) had angiocardiography at three weeks
      after infarction, and data were used to investigate the relation between early
      patency of the infarct related artery and left ventricular function. MAIN OUTCOME
      MEASURES: Normalised rate of rise of creatine kinase activity at three hours
      after starting streptokinase in relation to angiographic patency of the infarct
      related coronary artery at 2.5 hours; 30 day cardiac mortality; and left
      ventricular function at three weeks in survivors of first infarction. RESULTS: In
      the validation study, a rise in three hour creatine kinase activity of > 20% of
      peak occurred in 34/37 patients with initially patent infarct related coronary
      arteries (sensitivity 92%), and a rise to < 20% of peak occurred in 21/23
      patients with initially occluded arteries (specificity 91%). In the prognostic
      study, 30 day mortality was 2.1% in the 191 patients with three hour creatine
      kinase > 20% of peak and 8.7% in the 127 patients with three hour creatine kinase
      < 20% of peak (p < 0.01). Angiocardiography in three week survivors of anterior
      infarction (n = 95) showed better left ventricular function when three hour
      creatine kinase was > or = 20% than when it was < 20% of peak (mean (SEM) end
      systolic volume 71 (5) v 96 (9) ml, p < 0.02; ejection fraction 56% (2%) v 51%
      (2%), NS). CONCLUSION: Non-invasive determination of early patency of the infarct
      related artery by the normalised rate of rise of creatine kinase activity at
      three hours seems to be reliable, and may be prognostically important and of
      value for use in clinical trials.

PMID- 8343314
TI  - Aspirin does not improve early arterial patency after streptokinase treatment for
      acute myocardial infarction.
AB  - OBJECTIVE: To investigate the hypothesis that the magnitude of the life saving
      effect of aspirin in the second international study of infarct survival (ISIS-2)
      trial cannot be explained solely by prevention of late reocclusion of the infarct
      related artery. The aim of this study was to discover whether or not aspirin in
      combination with streptokinase had an adjuvant thrombolytic effect. DESIGN:
      Aspirin (150 mg) or placebo was given at the start of streptokinase infusion to
      200 patients seen within six hours of the start of prolonged ischaemic cardiac
      pain and ST segment elevation. All patients received active aspirin at three
      hours. Patency of the infarct related artery was assessed non-invasively by the
      normalised rise of creatine kinase activity at three hours after starting
      streptokinase in these 200 patients and in a further 52 patients who had already
      taken aspirin within one week of the start of infarction. MAIN OUTCOME MEASURE:
      Rise in creatine kinase activity from baseline to > or = 20% or < 20% of the peak
      rise of activity in blood taken at three hours after starting infusion of
      streptokinase. This correlates with patency or occlusion of the infarct related
      coronary artery at about 2.5 hours after starting streptokinase. RESULTS:
      Assessed in this way, patency of the infarct related artery was 60% in patients
      given aspirin, 63% in those given placebo, and 62% in patients who had already
      taken aspirin within one week of infarction. CONCLUSION: The magnitude of the
      life saving effect of aspirin remains unexplained. Further investigation is
      needed into the mechanism of action of antiplatelet treatment in relation to
      thrombolytic treatment.

PMID- 8343315
TI  - Severe coronary artery disease after radiation therapy of the chest and
      mediastinum: clinical presentation and treatment.
AB  - OBJECTIVE: To define the clinical and angiographic features and the therapeutic
      problems in patients with coronary artery disease after therapeutic irradiation
      of the chest. DESIGN: An observational retrospective study. SETTING: The cardiac
      catheterisation laboratory, university medical school. PATIENTS: 15 subjects (8
      men and 7 women, aged 25-56 years, mean 44) examined in the cardiac
      catheterisation laboratory, who had significant coronary artery disease years
      after having radiation treatment to the chest and anterior mediastinum. In the
      early stages of the study angiography was performed because of typical symptoms
      of ischaemic heart disease. Later on it was performed because of a high index of
      suspicion in people with signs of extensive radiation heart damage. MAIN OUTCOME
      MEASURES: Clinical and electrocardiographic evidence of ischaemic heart disease;
      echocardiographic signs of pericardial, myocardial or valvar involvement;
      angiographic evidence of coronary arterial stenosis, with special attention to
      the ostia; haemodynamic and angiographic signs of pericardial, myocardial, and
      valvar disease. Survival and symptomatic and functional status were ascertained
      after medical or surgical treatment. RESULTS: The patients were relatively young
      and had no risk factors. Seven patients had no signs or symptoms of ischaemic
      heart disease. Ten patients had ostial stenosis, which was associated with
      extensive involvement of other cardiac structures in nine of them. Seven required
      surgical treatment for coronary artery disease. Two died, one at surgery and the
      other one six months later. Five patients had complications associated with
      irradiation. CONCLUSIONS: Coronary arterial disease can be reasonably ascribed to
      the effects of chest irradiation when the patients are young and free from risk
      factors, especially if the obstructions are ostial and there is important damage
      to other cardiac structures. In patients with damage to other cardiac structures
      angina and infarction are often absent and coronary angiography seems to be
      mandatory. Patients often require surgical treatment and postoperative
      complications are common.

PMID- 8343316
TI  - Early changes in left ventricular subendocardial function after successful
      coronary angioplasty.
AB  - OBJECTIVE: To study the early effects of coronary angioplasty on resting left
      ventricular long axis function, reflecting that of the subendocardium. DESIGN:
      Prospective echocardiographic and Doppler examination of patients with coronary
      artery disease, before and after single vessel coronary angioplasty. SETTING: A
      tertiary referral centre for cardiac diseases with facilities for invasive and
      non-invasive investigation. PATIENTS: 23 patients with significant left coronary
      disease being considered for coronary angioplasty. RESULTS: Before angioplasty
      the mean (SD) isovolumic relaxation time was longer than normal (75(19) ms v 55
      (10), p < 0.001) with a significant increase in transverse dimension change
      before mitral valve opening, and peak rate of early diastolic thinning (8(3) v
      10.4 (2.6) cm/s (p < 0.001)) was reduced. Long axis motion was frequently
      abnormal. The interval from the onset of the Q wave to the onset of shortening
      was prolonged (118 (30) ms v 90 (19) at the left site and 115 (26) ms v 81 (9) at
      the septal site, p < 0.001) and the onset of early diastolic rapid lengthening
      delayed with respect to the aortic valve closure sound (A2) by 85 (34) ms v 58
      (11) at the left site and 88 (33) ms v 60 (9) at the septal site (p < 0.001).
      Although overall amplitude was reduced at the septal site only (1.23 (0.3) cm v
      1.5 (0.4), p < 0.05), the extent (0.8 (0.2) cm v 1.04 (0.3) at the left site and
      0.66 (0.2) cm v 0.9 (0.3) at the septal site, p < 0.001) and peak rate (6.2 (2)
      cm/s v 10 (2.5) at the left site and 5.4 (2.3) cm/s v 8.5 (2) at the septal site,
      p < 001) of early diastolic lengthening were both much lower than normal. The E/A
      ratio on transmitral Doppler was modestly reduced (1.0 (0.7) v 1.4 (0.4), p <
      0.05). After angioplasty: isovolumic relaxation time shortened to 64 (18) ms (p <
      0.001) and left ventricular incoordination regressed. Long axis shortening with
      respect to Q (98 (32) ms v 118 (30) at the left site and 94 (23) ms v 115 (26) at
      the septal site, p < 0.01) and that of lengthening with respect to A2 both
      normalised. Early diastolic peak lengthening rate increased (7.5 (2.1) cm/s v 6.2
      (2) at the left site, and 6.3 (2.4) cm/s v 5.4 (2.3) at the septal site, p <
      0.001). The early diastolic peak thinning rate of the posterior wall
      significantly increased (10 (3.5) cm/s v 8 (3), p < 0.005) as did mitral E/A
      ratio 1.2 (0.7) v 1.0 (0.7), p < 0.05). CONCLUSION: Long axis motion,
      representing the function of longitudinally arranged subendocardial fibres, is
      consistently abnormal in the resting state in coronary artery disease. These
      systolic and diastolic abnormalities return towards normal after successful
      angioplasty, suggesting that they are the direct effect of coronary artery
      stenosis.

PMID- 8343317
TI  - Increased response of diastolic blood pressure to exercise in patients with
      coronary artery disease: an index of latent ventricular dysfunction?
AB  - OBJECTIVE: To determine whether an abnormal response of diastolic blood pressure
      during treadmill exercise stress testing correlated with the number of obstructed
      vessels and with left ventricular systolic function in patients with coronary
      artery disease. DESIGN: Diastolic blood pressure was measured invasively during
      exercise stress testing and coronary angiograms and left ventriculograms were
      obtained at rest in patients with coronary artery disease. The abnormal (> or =
      15 mm Hg) diastolic blood pressure response was compared with the number of
      obstructed coronary arteries and with left ventricular systolic function.
      SETTING: Two tertiary referral centres. PATIENTS: 50 consecutive patients (mean
      age 57 years) with coronary artery disease. MAIN OUTCOME MEASURES: The increase
      in diastolic blood pressure during exercise and its correlation with the
      appearance and disappearance of ST segment deviation, resting left ventricular
      systolic function, and the number of obstructed coronary arteries. RESULTS: Group
      1: 10 (20%) patients (three with one, four with two, and three with three vessel
      coronary artery disease) (mean (SD) age 54.7 (12) years) had an abnormal
      diastolic blood pressure response that appeared 1.2 (0.3) min before ST segment
      deviation and became normal 0.9 (0.3) min after the ST segment returned to
      normal. Group 2: 40 (80%) patients (12 with one, 16 with two, and 12 with three
      vessel coronary arteries disease) (aged 56.8 (8.2) years) had a normal diastolic
      blood pressure response to stress testing. The ejection fraction (46.3 (5)%) and
      cardiac index (2.6 (0.1) 1/min/m2) in group 1 were less than in group 2 (61.6
      (4.2)% and 3.8 (0.3) 1/min/m2 respectively, p < or = 0.001). The end systolic
      volume was greater in group 1 than in group 2: 38.7 (0.7 ml/m2 v 28.2 (2.1)
      ml/m2, p < or = 0.001. CONCLUSION: In patients with coronary artery disease an
      abnormal increase in diastolic blood pressure during exercise stress testing
      correlated well with left ventricular systolic function at rest but not with the
      number of obstructed coronary arteries. The abnormal response of diastolic blood
      pressure probably reflects deterioration of myocardial function.

PMID- 8343319
TI  - Maternal mortality from heart disease in pregnancy.

PMID- 8343318
TI  - Effect of hyperventilation and mental stress on coronary blood flow in syndrome
      X.
AB  - OBJECTIVES: To assess the effect of hyperventilation and mental stress on
      coronary blood flow and symptom production in patients with syndrome X. DESIGN: A
      prospective study. Hyperventilation and mental stress tests were performed on the
      ward and were repeated in the cardiac catheter laboratory where coronary blood
      flow velocity was also measured with an intracoronary Doppler catheter in the
      left anterior descending coronary artery. Oesophageal manometry studies were also
      performed. PATIENTS: 29 patients with syndrome X (typical anginal chest pain, a
      positive exercise test, and normal coronary angiogram). SETTING: A regional
      cardiothoracic centre. RESULTS: Hyperventilation produced typical chest pain in
      16 patients on the ward. 13 patients experienced their typical chest pain with
      mental stress test 5. Ten patients experienced chest pain with both
      hyperventilation and mental stress tests. This pattern was reproduced exactly
      when the tests were repeated in the cardiac catheter laboratory. Hyperventilation
      produced a significant increase in the rate-pressure product during ward and
      laboratory testing. There was, however, no significant change in the rate
      pressure product on mental stress tests. The mean (SEM) coronary flow velocity
      decreased significantly on hyperventilation in the catheter laboratory from 10.0
      (0.92) cm/s to 5.9 (0.72) cm/s (p < 0.001). There was also a significant
      reduction in the mean (SEM) coronary blood flow velocity on mental stress tests
      from 9.8 (0.86) cm/s to 7.4 (0.6) cm/s (p < 0.001). This reduction in flow
      velocity occurred in the absence of any changes in diameter of the left anterior
      descending artery. Further analysis showed that the coronary flow velocity was
      reduced significantly in only that group of patients in which hyperventilation
      and mental stress provoked chest pain. There was a significant increase in the
      arterial concentrations of noradrenaline on both hyperventilation and mental
      stress testing. Oesophageal manometry showed abnormalities in 17% of patients.
      CONCLUSIONS: Both hyperventilation and mental stress can produce chest pain in
      patients with syndrome X and this is associated with a reduction in coronary
      blood flow velocity. The results of this study suggests that this reduction in
      coronary flow occurs as a result of increased microvascular resistance.

PMID- 8343320
TI  - Autonomic function in hypertrophic cardiomyopathy.
AB  - BACKGROUND: Autonomic dysfunction has been found to be a powerful predictor of
      arrhythmic events and sudden death after myocardial infarction. Hypertrophic
      cardiomyopathy carries a risk of sudden death and this risk is increased by the
      occurrence of syncope. OBJECTIVES: To determine if autonomic dysfunction occurs
      in patients with hypertrophic cardiomyopathy and if it is associated with the
      occurrence of syncope. PATIENTS AND METHODS: Autonomic function was measured in
      30 patients with hypertrophic cardiomyopathy, 15 with and 15 without a history of
      syncope, and in 28 healthy volunteers. RESULTS: Tests of parasympathetic activity
      showed that the mean (SD) variation in heart rate during deep breathing was
      reduced in patients compared with controls, 17 (9) v 22 (9) beats/min, p = 0.03,
      the Valsalva ratio was also reduced in patients, 1.52 (0.33) v 1.70 (0.36), p =
      0.05 but the immediate heart rate response to standing, the 30:15 ratio, was
      similar in both groups. Tests of sympathetic activity--namely the diastolic blood
      pressure response to sustained handgrip and the change in systolic blood pressure
      on standing--did not differ between patients and controls. There was no
      significant difference in autonomic function between patients with and without a
      history of syncope. A secondary predetermined analysis showed that the degree of
      impairment in variation of heart rate with breathing was correlated with the
      severity of left ventricular hypertrophy, r = 0.39, p = 0.03. CONCLUSIONS:
      Patients with hypertrophic cardiomyopathy have a selective impairment of
      variability of heart rate with deep breathing and the Valsalva manoeuvre
      indicating decreased cardiac parasympathetic activity. The data suggest that the
      afferent limb of these reflexes is impaired and that the severity of impairment
      is related to the degree of left ventricular hypertrophy.

PMID- 8343321
TI  - A comparison of transoesophageal atrial pacing and direct current cardioversion
      for the termination of atrial flutter: a prospective, randomised clinical trial.
AB  - OBJECTIVE: To compare the safety and efficacy of transoesophageal atrial pacing
      (TAP) with an easily swallowed pill electrode and direct current cardioversion
      (DCC) in patients with atrial flutter that was refractory to appropriate medical
      treatment. DESIGN: Prospective, randomised clinical trial. SETTING: Community
      based United States naval hospital. SUBJECTS: Twenty one consecutive patients
      with refractory atrial flutter selected consecutively from the inpatient
      cardiology consultation service. All patients were haemodynamically stable and
      medical treatment with a class IA or IC antiarrhythmic agent had failed. Eleven
      patients were treated with TAP and 10 patients were treated with DCC.
      INTERVENTIONS: Digoxin was given to all patients to control the ventricular rate
      to < 100/minute. MAIN OUTCOME MEASURE: Conversion to normal sinus rhythm and
      arrhythmias after cardioversion. RESULTS: Conversion to normal sinus rhythm was
      similar in both groups (TAP 8/11, DCC 9/10, p = 0.31). Arrhythmias after
      cardioversion including third degree heart block and non-sustained ventricular
      tachycardia were more frequent in the DCC group (TAP 0/11, DCC 6/10, p = 0.02).
      CONCLUSION: Transoesophageal atrial pacing with an easily swallowed pill
      electrode is safe, well tolerated, and is as efficacious as DCC for refractory
      atrial flutter.

PMID- 8343322
TI  - Pulmonary artery pressure and the acute chest syndrome in homozygous sickle cell
      disease.
AB  - OBJECTIVE: To investigate whether attacks of acute chest syndrome affected
      pulmonary artery pressure in patients homozygous for sickle cell disease. MAIN
      OUTCOME MEASURES: Pulmonary artery pressure, assessed by non-invasive
      echocardiographic techniques. PATIENTS: 20 patients with homozygous sickle cell
      disease with a history of at least six episodes of acute chest syndrome and in 20
      age, sex, and height matched controls with homozygous sickle cell disease without
      a history of acute chest syndrome. RESULTS: There was no difference in any of the
      echocardiographic or Doppler indices between these two groups. CONCLUSIONS:
      Repeated attacks of acute chest syndrome by the mean age of 12 (range eight to
      16) years have not had a discernible effect upon pulmonary artery pressure.

PMID- 8343323
TI  - Employment and insurance for young adults with congenital heart disease.
AB  - OBJECTIVE: To determine the life and health insurability and employability of
      young adults with congenital heart disease. DESIGN: Questionnaire study. SETTING:
      Cardiac department of a tertiary referral hospital for children. PATIENTS: Young
      adults 18-30 years old with a variety of congenital heart defects, both simple
      and complex, including postoperative patients. MAIN OUTCOME MEASURES:
      Availability of insurance at normal or high rates, with or without special
      conditions or exclusions. Prospects for employment. RESULTS: Questionnaires were
      sent to eight large life insurance companies, five health insurance companies
      and, 15 employers, and 26 replies were received (93%). The consensus for life
      insurability was that young adults with mitral valve prolapse without
      regurgitation, postoperative ductus arteriosus, and aortic coarctation were
      insurable at standard rates. Those with any of the other heart defects listed
      were either insurable at high rates, or in the case of many lesions, not
      insurable at all. The consensus for health insurance was that insurance was
      available, but with complete exclusion of benefit for the cardiac disorder.
      Employment prospects were good for those with simple defects, but poorer for
      those with complex lesions. CONCLUSIONS: Prospects for insurance and employment
      for young adults with complex congenital heart lesions are poor. Inconsistencies
      found in insurance and job policies may be due to lack of appropriate guidelines
      for the outcome of young adults with corrected and uncorrected congenital heart
      disease.

PMID- 8343324
TI  - Use of a second transcatheter Rashkind arterial duct occluder for persistent flow
      after implantation of the first device: indications and results.
AB  - OBJECTIVE: To assess the efficacy, feasibility, and most appropriate timing of
      the implantation of a second Rashkind arterial duct occluder because of
      persistent flow after the first device. DESIGN: A prospective serial Doppler
      study of patients after the insertion of a Rashkind arterial duct occluder
      including a subgroup in whom a second device was implanted. SETTING: A tertiary
      referral centre for congenital heart disease. PATIENTS: 144 patients aged 7
      months to 67 years (median 3.38 years) who underwent transcatheter occlusion of
      patent arterial duct, 20 of whom had attempted implantation of a second device.
      INTERVENTIONS: Implantation of a second device alongside the first was attempted
      in 20 of the patients with persistent residual flow. MAIN OUTCOME MEASURES:
      Successful implantation of a second device, the incidence of complications, and
      the achievement of complete occlusion on follow up Doppler echocardiography. The
      time to complete occlusion in the whole group and factors predictive of
      persistent leak were also analysed. RESULTS: Second devices were successfully
      implanted in 19 of 20 first attempts and in the remaining patient at the second
      attempt. Complete occlusion was found in 19 patients at a mean follow up of eight
      months. The complications included fracture of a guidewire requiring femoral
      arteriotomy for its removal in one patient and embolisation of a device in
      another. With a single device, persistence of residual flow six months after
      implantation and malposition of the device on the aortogram after implantation
      were predictive of continuing residual patency. CONCLUSIONS: Implantation of a
      second device is safe, feasible, and effective and should be considered when
      residual flow persists beyond six months, or if malposition of the first device
      causes complications such as haemolysis.

PMID- 8343326
TI  - Increased expression of interleukin 6 mRNA in cardiac myxomas.
AB  - In three patients with cardiac myxoma increased expression of interleukin 6 (IL
      6) mRNA was found in the myxoma tissue by polymerase chain reaction (PCR) and in
      situ hybridisation. These cases suggest that IL-6 is overproduced in the myxoma
      tissue and secreted into the systemic circulatory system. This might contribute
      to the systemic inflammatory or autoimmune manifestations seen in cardiac myxoma.
      This study also showed the usefulness of PCR and in situ hybridisation for the
      evaluation of mRNA expression in small samples of tissue.

PMID- 8343325
TI  - Technique of percutaneous laser-assisted valve dilatation for valvar atresia in
      congenital heart disease.
AB  - OBJECTIVE: To investigate the efficacy and safety of transcatheter laser-assisted
      valve dilatation for atretic valves in children with congenital heart disease.
      DESIGN: Prospective clinical study. SETTING: Supraregional paediatric cardiology
      centre. SUBJECTS: Eleven children (aged 1 day-11 years; weight 2.1-35.7 kg) with
      atresia of pulmonary (10) or tricuspid (one) valve underwent attempted laser
      assisted valve dilatation as part of the staged treatment of their cyanotic heart
      disease. INTERVENTION: After delineating the atretic valve by angiography and/or
      echocardiography a 0.018 inch "hot tip" laser wire was used to perforate the
      atretic valve. Subsequently the valve was dilated with conventional balloon
      dilatation catheters up to the valve annulus diameter. RESULTS: Laser-assisted
      valve dilatation was successfully accomplished in nine children. In two neonates
      with pulmonary valve atresia, intact ventricular septum, and coexistent
      infundibular atresia the procedure resulted in cardiac tamponade: one died
      immediately and one later at surgery. During a follow up of 1-17 months (mean 11)
      two infants with pulmonary valve atresia and intact ventricular septum died (one
      with congestive cardiac failure). The remainder are either well palliated and do
      not require further procedures (three), or are awaiting further transcatheter or
      surgical procedures because of associated defects (four). CONCLUSIONS: Laser
      assisted valve dilatation is a promising adjunct to surgery in this high risk
      group of patients. It may avoid surgery in some patients, and may reduce the
      number of surgical procedures in those requiring staged operations.

PMID- 8343328
TI  - Coronary heart disease in Indians, Pakistanis, and Bangladeshis: aetiology and
      possible prevention.

PMID- 8343327
TI  - A patient in whom self-terminating ventricular fibrillation was a manifestation
      of myocardial reperfusion.
AB  - Self-terminating ventricular fibrillation was recorded in a 47 year old woman
      without coronary artery or other structural heart disease. Reperfusion was
      thought to be responsible for the ventricular fibrillation because the arrhythmia
      started while the ST segment was returning to the baseline during an episode of
      silent ischaemia that was probably caused by coronary spasm. This case shows that
      potentially lethal arrhythmias can arise during reperfusion and that ventricular
      fibrillation during reperfusion may be self-terminating.

PMID- 8343329
TI  - Early and late arrhythmias after the Fontan operation: predisposing factors and
      clinical consequences.

PMID- 8343330
TI  - Bedside APTT and PT monitoring.

PMID- 8343331
TI  - Respiratory depression after extradural fentanyl.

PMID- 8343332
TI  - Neuromuscular block and insertion of the laryngeal mask airway.

PMID- 8343333
TI  - Preoperative fasting guidelines for cataract surgery under regional anaesthesia.

PMID- 8343334
TI  - Anesthesia for nasotracheal intubation in dentistry.

PMID- 8343335
TI  - Thrombelastography in the management of cardiopulmonary bypass for a patient with
      reduced prothrombin conversion because of a rare familial haemostatic defect.

PMID- 8343336
TI  - Arterial pressure measurement in pregnancy.

PMID- 8343338
TI  - Long-term backache after extradural or general anaesthesia for manual removal of
      placenta.

PMID- 8343337
TI  - Thoracic electrical bioimpedance or thermodilution for measurement of cardiac
      index.

PMID- 8343339
TI  - Post-spinal headaches in parturient women.

PMID- 8343340
TI  - The reinforced laryngeal mask airway in paediatric radiotherapy.

PMID- 8343341
TI  - Use of the laryngeal mask airway in children with laryngotracheal pathology.

PMID- 8343342
TI  - Adrenoceptors as models for G protein-coupled receptors: structure, function and
      regulation.

PMID- 8343343
TI  - Influence of the route of administration on the pharmacokinetics of pirprofen
      enantiomers in the rat.
AB  - The pharmacokinetics of the enantiomers of the non-steroidal anti-inflammatory
      drug pirprofen were studied in male Sprague-Dawley rats after oral and
      intravenous (iv) doses of the racemate. No significant differences were detected
      between the enantiomers after oral or iv dosing in t1/2, Vd, or sigma Xu.
      However, the R:S area under the plasma concentration (AUC) ratio after oral doses
      (0.92 +/- 0.13) was slightly but significantly lower than after matching iv doses
      (1.05 +/- 0.036). The absolute bioavailability of the active S-enantiomer (78.5%)
      after oral doses was higher than the inactive R-enantiomer (69.3%). The plasma
      protein binding of both enantiomers was saturable over a fivefold range of plasma
      concentrations. At higher plasma concentrations, the S-enantiomer was less bound
      than the R-enantiomer. In an in vitro experiment using everted rat jejunum, no
      chiral inversion was discernible. The dependency of the AUC ratio of the
      enantiomers on the route of administration may be due to stereoselective first
      pass metabolism.

PMID- 8343344
TI  - Enantioselective determination of hydroxychloroquine and its major metabolites in
      urine and the observation of a reversal in the (+)/(-)-hydroxychloroquine ratio.
AB  - A sequential achiral-chiral high-performance liquid chromatographic system has
      been developed for the quantitation in urine of the enantiomers of
      hydroxychloroquine (HCQ), and of its 3 major metabolites,
      desethylhydroxychloroquine (DHCQ), desethylchloroquine (DCQ), and
      bisdesethylchloroquine (BDCQ). HCQ and its metabolites were separated and
      quantified on a cyano-bonded phase, and the enantiomeric ratios were determined
      using a Chiral-AGP chiral stationary phase. The assay validation and application
      of this method to a preliminary study in a human volunteer are presented. In this
      subject, the initial 0-4 h urine contained the 2 HCQ enantiomers in a ratio of
      (+)-HCQ:(-)-HCQ of 3:2; by the 2,064 h of the study, this ratio had reversed to
      (+)-HCQ:(-)-HCQ of 3:7.

PMID- 8343345
TI  - Testicular atrophy as a risk of inguinal hernioplasty.

PMID- 8343346
TI  - [Suppurative complications in acute pancreatitis].
AB  - The authors examining suppurative complications caused by acute necrotizing
      pancreatitis point out how such complications can arise early at the same time of
      acute pancreatitis with large spread in peripancreatic tissues and spaces and
      with worse prognosis or have a late appearance with a trend to localize and
      circumscribe. Four cases of pancreatic abscess, three of which largely diffused
      brought to death in spite of surgery, are reported.

PMID- 8343347
TI  - [The diagnostic and therapeutic problems of endocrine tumors of the digestive
      system: our experience].
AB  - The authors experience in the surgical treatment of endocrine tumours of the
      digestive tract is reported. Particularly, they emphasize that in spite of the
      several syndromes associated with these neoplasms, diagnostic and therapeutic
      concepts herein analyzed are similar.

PMID- 8343348
TI  - [Colorectal pathology: an analysis and comparison between patients of different
      ages].
AB  - The increasing incidence of large bowel diseases observed in the last years is
      age-related. The authors have analyzed 366 patients who underwent surgery for
      colorectal pathology, divided in two groups (> or < 65 years) considering sex,
      diagnosis, type of clinical presentation, incidence and type of associated
      pathology, and post-operative complications. The analysis of the series revealed
      that type of clinical presentation, surgical patterns, post-operative infections
      were the same in the two groups, as reported in the literature. The substantial
      differences were only due to the different incidence of colo-rectal pathology,
      associated pathology and cardiovascular complications, factors that become
      characteristic of the elderly patients.

PMID- 8343349
TI  - [A case of multiple intestinal perforations due to TBC in a female patient with
      HIV-1 infection].
AB  - The authors report a case of HIV-1 infection, primary miliary tuberculosis of the
      lung and secondary intestinal tuberculosis complicated with multiple intestinal
      perforations. The surgical emergency therapy, supported by specific
      antitubercular drugs, antibiotics, and total parenteral nutrition, consisted in
      suturing seven perforative sites of the small and large intestine. The Authors
      stress the possibility that in the future tubercular complications up till now
      considered atypical may become more and more frequent because of the HIV-1
      infection association.

PMID- 8343350
TI  - [Arteriomegaly: a clinical case report and review of the literature].
AB  - The authors report a case of arteriomegaly and underline the importance of a
      correct diagnosis. A review of the literature, in fact, confirms the incidence of
      the disease is higher than usually believed. Therefore, a complete diagnostic
      evaluation is necessary to recognize the disease and assure the adequate
      treatment.

PMID- 8343351
TI  - [The use of fibrin glue in the surgery of breast carcinoma].
AB  - Twenty-four patients operated on for breast carcinoma with associated axillary
      node dissection were randomly assigned to two protocols. In the first group
      fibrin glue was applied intraoperatively, in the second group no complementary
      treatment was accomplished. The aim of the study was to evaluate the effect of
      fibrin glue in reducing postoperative axillary sero-lymphatic secretion. In the
      fibrin glue group a significant reduction of postoperative axillary secretion was
      observed.

PMID- 8343352
TI  - [Mediastinoscopy in a general surgery department. The evaluation of 186 cases].
AB  - A series of 186 cases of mediastinoscopy performed in a department of general
      surgery is reported. The main indications for this procedure are: histological
      diagnosis of mediastinal masses, definition of bronchopulmonary neoplasms and
      thoracic esophagus ones with indication for surgery. The results obtained are:
      sensibility 90.3%, complications 3.7%, mortality rate 0%. The authors believe in
      the great utility of mediastinoscopy in case of unknown histotype of primary
      neoplasms and CT N2? involvement.

PMID- 8343353
TI  - [The use of scintigraphy with labelled leukocytes: our experience].
AB  - The authors describe various applications of scintigraphy with labeled leukocytes
      and its value in the diagnosis of gut diseases such as Crohn's disease,
      ulcerative colitis and related complications. Furthermore, the study of vascular
      prosthesis infection, cryptogenetic fever and abdominal sepsis, three cases of
      which are herein reported, is facilitated. The method, in conjunction with
      endoscopy and traditional radiology, revealed to be of great value in terms of
      sensitivity and specificity for the diagnosis of the aforementioned diseases.
      Therefore, the use of such method is encouraged in all those cases of abdominal
      sepsis of uncertain interpretation and in the evaluation of vascular prosthesis
      infection.

PMID- 8343354
TI  - [Anterograde laparoscopic cholecystectomy: when and why].
AB  - Today largely diffused is the concept that laparoscopic cholecystectomy (LC)
      represents the treatment of choice for symptomatic gallstones. Nonetheless some
      questions have been raised on the real safety of this new method in terms of
      procedure-related complications. On the basis of our experience with traditional
      open cholecystectomy, we have recently performed a prograde LC in those cases
      with difficulties in identifying the anatomical structures of the so called
      Calot's triangle. This alternative route can be easily performed laparoscopically
      and has been useful in reducing the time of the intervention in the most
      difficult setting and to increase the safety of the procedure. The technical
      details and the results are compared with those of the laparoscopic retrograde
      route.

PMID- 8343356
TI  - Rediscovering caring and healing arts. Interview by Alex Mathieson.

PMID- 8343355
TI  - Normothermic liver perfusion ex situ: a resuscitation tool for hepatic grafts
      damaged by warm ischemia.
AB  - Ex situ perfusion of the liver has been proposed as a preservation tool for
      organs to be grafted; in this study, we have investigated whether this procedure
      could help to reverse damage caused by prolonged ischaemia. The liver was
      explanted from 6 pigs under general anaesthesia. The organs were subject to warm
      ischaemia (37 degrees C) for 30 min., cooled in situ by portal infusion of Euro
      Collins, excised and maintained ischaemic at 4 degrees C for 30 min. more.
      Afterwards, normothermic perfusion was achieved through the portal vein and
      hepatic artery for 6 hrs. The parameters measured allowed to follow up the
      hemodynamic, metabolic and structural response of the liver to the experimental
      procedure. By electron microscopy, generalized hepatocyte damage was observed
      after ischaemia, but appeared to be reversed in most cells after ex situ
      perfusion. Wide areas of sinusoidal walls were devoid of endothelial lining;
      where this was present, however, it was normal in structure. Kupffer and Ito
      cells had normal structure whenever observed. Four livers were implanted
      orthotopically into recipient animals, which were monitored for hemodynamic and
      biochemical parameters during surgery and followed up to one week. Post mortem
      examination was performed on the animals which died before this end point. Two of
      them were alive after one week. Two animals died, one for a perforation of the
      right hepatic vein and the other for massive necrosis of the left lobe with
      sepsis and hemorrhage. These results indicate that normothermic ex situ perfusion
      of the liver has the potential to become a valuable tool to reverse ischaemic
      injury and monitor organ function before grafting.

PMID- 8343357
TI  - Nursing in Canada: researching nurses' work.

PMID- 8343358
TI  - Strategic thinking. The Royal College of Nursing Research Advisory Group.

PMID- 8343359
TI  - Mental health day units: users' views.
AB  - This article describes clients' perspectives on psychiatric day care units in an
      area in the South of England. The results of a small-scale research project show
      that clients from different localities have similar perspectives and feelings
      about the units. It is demonstrated that, in the clients' view, the units achieve
      many of their aims and fulfil needs that supersede the initial purpose.

PMID- 8343360
TI  - Health promotion: preventing unwanted teenage pregnancies.
AB  - In the second of two articles looking at health promotion projects addressing
      targets set out in the Health of the Nation White Paper (1), the author describes
      the work of a North Staffordshire family planning clinic which specifically
      targets young people with contraceptive advice and services including pregnancy
      testing, rubella vaccination and cervical cytology. Hundreds of young people have
      attended the clinic since it opened in 1990 and the scheme has been so successful
      that a similar clinic has been opened in another area.

PMID- 8343361
TI  - Bedside charts: how to introduce change.
AB  - This article describes the efforts of an orthopaedic nursing team to scrutinize
      and reform the charts used at bedside. A review of the process revealed a
      ritualistic system that was ill-defined and centered around nurses' work
      patterns. A new chart was designed incorporating features of the old, and adding
      new information that was considered useful. The author reports that staff
      preferred the new design and argues that nurses can initiate change at ward
      level.

PMID- 8343362
TI  - Portakabinly correct.

PMID- 8343363
TI  - Roger Dyson. Interview by Trevor Clay.

PMID- 8343364
TI  - Women's network. Rising stars.

PMID- 8343365
TI  - Never mind the quality.

PMID- 8343366
TI  - Misconduct allegations. Victim of false accusations.

PMID- 8343367
TI  - Government backing for HIV research.

PMID- 8343369
TI  - Speak up.

PMID- 8343368
TI  - Disappearance of hospital chaplains.

PMID- 8343370
TI  - Nursing unions slam MPs ignorance on AIDS issues.

PMID- 8343371
TI  - Prison nursing: doing time the hard way.

PMID- 8343372
TI  - Poll positions at the Palace.

PMID- 8343374
TI  - Shifting patterns of nurses' work.

PMID- 8343373
TI  - Books used on Project 2000 courses.

PMID- 8343375
TI  - Rheumatoid arthritis: effects on the family.
AB  - The impact of rheumatoid arthritis (RA) on the families of people with the
      disease is poorly understood. A qualitative study was undertaken on 22 patients
      with rheumatoid arthritis, their respective well partners and their 40 children.
      For most children the effect of living with a parent suffering from a painful,
      chronic illness was not detrimental, but a minority suffered verbal and physical
      abuse. The disease had wide-ranging effects on sexual and working relationships,
      but marriage to a partner with RA did not result in a threat to the relationship
      for the majority. Recommendations for future practice are made.

PMID- 8343376
TI  - 'Ordinariness' in nursing: a study (Part 1).
AB  - This is the first of two articles describing aspects of ordinariness in nursing
      as they were explored in a phenomenological study on clinical nursing. By way of
      introduction, it provides an overview of the first phase of the study in terms of
      its background and method, and describes aspects of ordinariness, showing their
      relevance to nursing practice. In exploring this phenomenon, this study affirmed
      a shared sense of humanity as a general group and the enhancing effect this
      affinity can have on interpersonal relationships.

PMID- 8343377
TI  - Workwise: they axed my ward.

PMID- 8343378
TI  - AIDS focus. Bereavement counselling in HIV disease.

PMID- 8343379
TI  - AIDS focus. 'How are you? I'm fine'.

PMID- 8343380
TI  - AIDS focus. HIV roundup.

PMID- 8343381
TI  - Pressure sores: a case to answer (continuing education credit).

PMID- 8343382
TI  - Health and safety. The back injury battle.

PMID- 8343383
TI  - Community care reforms: team spirit.

PMID- 8343384
TI  - Harvesting of organs: the nursing issues.
AB  - The RCN Congress of 1991 discussed the ethics of harvesting' organs from patients
      who are brainstem dead but whose organs are being kept viable (through
      technological means) to enable them to be removed for transplantation. This
      review of the legal, ethical and nursing implications of organ harvesting is
      intended to act as a framework for local discussion and policy formulation.

PMID- 8343385
TI  - Promoting continence in Denmark and UK.
AB  - This article compares nursing approaches to the promotion and management of
      continence in the UK and Denmark. Semi-structured interviews of key health
      professionals in Denmark were undertaken. The information collected forms the
      basis for a comparison of clinical practice, management, education and research.

PMID- 8343387
TI  - 'Ordinariness' in nursing: a study (Part 2).

PMID- 8343386
TI  - Bereavement counselling (continuing education credit).

PMID- 8343389
TI  - Information technology. Small is bountiful.

PMID- 8343388
TI  - Uniform thinking.

PMID- 8343390
TI  - Will to die.

PMID- 8343391
TI  - Professional accountability: too scared to care.

PMID- 8343392
TI  - Purchasing: never mind the quality.

PMID- 8343393
TI  - Workwise: a moving story.

PMID- 8343394
TI  - Fear for AIDS wards' future.

PMID- 8343395
TI  - Funds cut as AIDS increases.

PMID- 8343396
TI  - A call for mandatory HIV testing.

PMID- 8343397
TI  - Alcohol consumption and HIV/AIDS warning.

PMID- 8343398
TI  - Antigens might protect against HIV.

PMID- 8343399
TI  - The Allitt case: getting close to the facts?

PMID- 8343400
TI  - Whistleblowers: the end of the affair.

PMID- 8343401
TI  - Nurses' knowledge of infection control.
AB  - The article is based on a research study examining infection control in nurse
      education and practice. A survey of a large population was carried out to
      establish the perceived importance of microbiological knowledge to nurses and to
      ascertain whether this knowledge was present. The results suggest that although
      microbiological knowledge is considered necessary for safe infection control
      practice, nurses' actual knowledge falls far short of the level required for
      'informed' practice. What this implies in relation to patient care, and
      recommendations regarding education and practice, are discussed.

PMID- 8343402
TI  - Open learning in nurse education.
AB  - Much confusion surrounds the meanings of terms such as flexible learning,
      distance learning and open learning. In this article, the author highlights the
      difference between these types of learning and their advantages and
      disadvantages, and stresses the importance of all grades of nurses adopting the
      philosophy behind the initiative.

PMID- 8343403
TI  - When can nurses refuse to care?
AB  - At the RCN Congress in Blackpool last year, one of the key topics discussed was
      the policy and practice implications which arise if nurses refuse to care for
      certain patients or if patients refuse to be cared for by a particular nurse.
      This article outlines the guidance by the RCN Ethics and Nursing Committee on
      when patients and nurses can exercise a right to refuse to be cared for or
      provide care.

PMID- 8343404
TI  - Learning disabilities. Community homes: institutions in waiting?
AB  - This article explores the assumption that community care is better than care in
      an institution for people with learning disabilities. Parallels are also drawn
      with community provision of residential and nursing home accommodation for people
      who are elderly, those who have a physical handicap, and people with a mental
      illness. While community care is recognised as a valuable option, the authors
      argue that it must be correctly implemented, and identify the need to move
      further forward.

PMID- 8343405
TI  - Mental health: benefits of holidays for hostel ward residents.
AB  - This article describes a self-catering holiday in Ireland for a group of new
      'long-stay' hostel residents from a psychiatric hospital, and accompanying staff.
      It looks at the process of organising the trip, analyses the benefits and
      assesses the lessons learned.

PMID- 8343406
TI  - Computer reviews. Why pay more?

PMID- 8343409
TI  - Tradimus. Personal finance: the banks that like to mumble 'maybe'.

PMID- 8343407
TI  - Tradimus. Student power: any way--we're poor.

PMID- 8343408
TI  - Tradimus. Personal finance: not to be taken for granted.

PMID- 8343410
TI  - Tradimus. Examinations: examinations fail the test.

PMID- 8343411
TI  - Tradimus. Qualification: the right staff?

PMID- 8343412
TI  - Quality assurance. Setting new standards.

PMID- 8343413
TI  - Quality assurance. Talk about teaming up.

PMID- 8343414
TI  - Quality assurance. Unchartered initiatives at Cameron Hospital.

PMID- 8343415
TI  - Quality assurance. Quality control: is patient power the solution?

PMID- 8343416
TI  - Quality assurance. Getting some important heads together.

PMID- 8343417
TI  - Annual Scientific Meeting of the British Society for Haematology. Bournemouth, 20
      23 April 1993. Abstracts.

PMID- 8343418
TI  - Death rates of miners and ex-miners with and without coalworkers' pneumoconiosis
      in south Wales. 1955.

PMID- 8343419
TI  - Mortality among workers in the diatomaceous earth industry.
AB  - A cohort mortality study was conducted among workers from two plants in the
      diatomaceous earth mining and processing industry in California. Diatomaceous
      earth consists of the skeletal remains of diatoms. Exposure to amorphous (non
      crystalline) and crystalline silica in the form of quartz results from open pit
      mining and exposure to crystalline silica (principally cristobalite) occurs in
      the processing of the material. Lung cancer and non-malignant respiratory
      diseases have been the health outcomes of greatest concern. The main study cohort
      included 2570 white men (533 Hispanic and 2017 non-Hispanic workers) who were
      employed for at least 12 months cumulative service in the industry and who had
      worked for at least one day during the follow up period, 1942-87. Vital status
      was ascertained for 91% of the cohort and death certificate information was
      retrieved for 591 of 628 (94%) identified deaths. The all causes combined
      standardised mortality ratio (SMR) was slightly increased (SMR = 1.12; 628
      observed) compared with rates among US white males. The principal contributors to
      this excess were increased risks from lung cancer (SMR = 1.43; 59 observed) and
      non-malignant respiratory disease (NMRD) excluding infectious diseases and
      pneumonia (SMR = 2.59; 56 observed). The excess of lung cancer persisted when
      local county rates were used for comparison (SMR = 1.59). Internal rate
      comparisons by Poisson regression analysis were conducted to assess potential
      dose-response relations for lung cancer and NMRDs. Mortality trends were examined
      in relation to duration of employment in dust exposed jobs and with respect to an
      index of cumulative exposure to crystalline silica. The crystalline silica index
      was a semiquantitative measure that combined information on duration of exposure,
      differences in exposure intensity between jobs and calendar periods, the
      crystalline content of the various product mixes, and the use of respiratory
      protection devices. Increasing gradients of risk were detected for lung cancer
      and NMRD with both exposure indices. The relative risk trends for lung cancer and
      NMRD with crystalline silica exposure lagged 15 years were respectively: 1.00,
      1.19, 1.37, and 2.74, and 1.00, 1.13, 1.58, and 2.71. Based on a review of
      available but limited data on cigarette smoking in the cohort and from
      application of indirect methods for assessing confounding variables, it seems
      unlikely that smoking habits could account for all of the association between
      exposure to dust and lung cancer. The intense and poorly controlled dust
      exposures encountered before the 1950s were probably the most aetiologically
      significant contributors to risks from lung cancer and NMRDs. The absence of an
      excess of lung cancer among workers hired since 1960, and the finding of no
      deaths attributed to pneumoconiosis as an underlying cause of death among workers
      hired since 1950 indicate that exposure reductions in the industry during the
      past 40 years have been successful in reducing excess risks to workers. Further
      mortality follow up of the cohort and the analysis of radiographic data will be
      needed to determine conclusively the long term patterns of disease risks in this
      industry.

PMID- 8343420
TI  - Incidence of renal stones among cadmium exposed battery workers.
AB  - The health effects of occupational exposure to cadmium were studied in a group of
      902 workers employed for at least one year in a Swedish battery factory between
      1931 and 1982. Data on air cadmium concentrations for different periods were
      combined with company employment records to obtain individual cumulative exposure
      estimates. A questionnaire including questions on the occurrence of kidney stones
      was sent to all 601 living workers and to the next of kin of 267 of the deceased
      workers. The response rate was 88%. 73 workers reported renal calculi that
      appeared after initial employment. A dose-response relation was found between
      cumulative exposure to cadmium and age standardised cumulative incidence.
      Incidence rate ratios (IRRs) were then computed for three exposure categories (<
      250, 250- < 5000, and 5000 micrograms/m3 x years) standardised for calendar time,
      age, and smoking with the low exposure group as reference level. The IRRs were
      1.0, 1.6 [95% confidence interval (95% CI) 0.7-3.4], and 3.0 (95% CI 1.3-6.8)
      respectively. beta 2 Microglobulin measurements were available for 33 workers who
      formed stones; 13 of these workers had tubular proteinuria (beta 2 microglobulin
      > or = 34 micrograms/mmole creatinine)--that is, a prevalence of 39%. There was
      also an indication of a steeper dose-response relation among workers with tubular
      proteinuria.

PMID- 8343421
TI  - A nine year follow up study of renal effects in workers exposed to cadmium in a
      zinc ore refinery.
AB  - Renal changes with time have been studied in 14 workers engaged in the production
      of cadmium (Cd) in a zinc ore refinery. These workers were examined once a year
      in the period 1980 to 1985 and 13 of them also in 1989. Four of the workers
      (group A) had been employed in an old Cd plant before 1973 and had received
      higher exposures to Cd than the other workers (group B). Average urinary Cd
      concentrations over the whole study period in workers of group A ranged from 6.9
      to 9.2 micrograms/g creatinine (median 8.4 micrograms/g) and in workers of group
      B from 0.64 to 7.1 micrograms/g creatinine (median 1.9 micrograms/g). Renal
      effects were assessed by the determination of urinary N-acetyl-beta-D
      glucosaminidase (NAG), beta 2-microglobulin (beta 2-M), retinol binding protein,
      albumin, total protein, and serum creatinine concentrations and activity. Urinary
      beta 2-M concentrations in three of four workers of group A were close to or
      marginally above the upper normal limit during the study period. The beta 2
      microglobinuria was not, however, progressive. No values outside normal limits
      were detected for any of the other renal tests in workers of groups A and B,
      related to exposure to Cd. Dose-response relations showed that urinary Cd
      correlated significantly with urinary NAG activity and total protein and beta 2
      M. The earliest change induced by Cd was seen for urinary NAG activity within
      normal limits of NAG excretion. The regression lines were similar in the surveys
      between 1981 and 1989, indicative of no progression to higher values for any of
      the renal tests. The current biological exposure index (BEI) of 10 micrograms/g
      creatinine for workers exposed to Cd, set by the American Conference of
      Governmental Industrial Hygienists (ACGIH), therefore seems justified, although
      the safety margin is small. The World Health Organisation recommended limit and
      ACGIH (1992-3) proposed limit of 5 micrograms/g creatinine would provide a much
      larger safety margin, and could be regarded as an action point for increased
      health surveillance.

PMID- 8343422
TI  - Residual cognitive deficits 50 years after lead poisoning during childhood.
AB  - The long term neurobehavioural consequences of childhood lead poisoning are not
      known. In this study adult subjects with a documented history of lead poisoning
      before age 4 and matched controls were examined with an abbreviated battery of
      neuropsychological tests including measures of attention, reasoning, memory,
      motor speed, and current mood. The subjects exposed to lead were inferior to
      controls on almost all of the cognitive tasks. This pattern of widespread
      deficits resembles that found in children evaluated at the time of acute exposure
      to lead rather than the more circumscribed pattern typically seen in adults
      exposed to lead. Despite having completed as many years of schooling as controls,
      the subjects exposed to lead were lower in lifetime occupational status. Within
      the exposed group, performance on the neuropsychological battery and occupational
      status were related, consistent with the presumed impact of limitations in
      neuropsychological functioning on everyday life. The results suggest that many
      subjects exposed to lead suffered acute encephalopathy in childhood which
      resolved into a chronic subclinical encephalopathy with associated cognitive
      dysfunction still evident in adulthood. These findings lend support to efforts to
      limit exposure to lead in childhood.

PMID- 8343423
TI  - Estimation of individual dermal and respiratory uptake of polycyclic aromatic
      hydrocarbons in 12 coke oven workers.
AB  - Twelve workers from a coke plant in The Netherlands participated in an intensive
      skin monitoring programme combined with personal air sampling and biological
      monitoring during five consecutive eight hour workshifts. The purpose of the
      study was to make a quantitative assessment of both the dermal and respiratory
      intake of polycyclic aromatic hydrocarbons (PAHs). Pyrene was used as a marker
      compound for both dermal and respiratory exposure to PAHs. The biological measure
      for the internal exposure to PAHs was urinary 1-OH-pyrene concentration.
      Measurements on exposure pads at six skin sites showed that mean total skin
      contamination of the 12 workers ranged between 21 and 166 micrograms pyrene a
      day. The dermal uptake of pyrene ranged between 4 and 34 micrograms/day, which
      was about 20% of the pyrene contamination on skin. The mean concentration of
      total pyrene in the breathing zone air of the 12 coke oven workers ranged from
      0.1 to 5.4 micrograms/m3. The mean respiratory uptake of pyrene varied between
      0.5 and 32.2 micrograms/day. Based on the estimates of the dermal and respiratory
      pyrene uptake it is concluded that an average 75% (range 28%-95%, n = 12) of the
      total absorbed amount of pyrene enters the body through the skin. Because of the
      difference in the pyrene:benzo(a)pyrene ratio between the air samples and the
      skin contamination samples, the dermal uptake of benzo(a)pyrene was also
      estimated. This was about 51% of the total absorbed amount (range 8%-92%, n =
      12). The total excreted amount of urinary 1-OH-pyrene as a result of exposure to
      PAHs during the five consecutive workshifts varied between 36 and 239 nmol. A
      multiple regression model of the mass balance between pyrene dose (both dermal
      and respiratory) and 1-OH-pyrene excretion confirmed the relevance of the dermal
      exposure route. The variation in urinary 1-OH-pyrene excretion was determined
      more by the dermal pyrene dose than by the respiratory dose. The model showed an
      estimate of the percentage of the absorbed amount of pyrene that is metabolised
      and excreted as 1-OH-pyrene in urine. For the 12 workers this percentage varied
      between 13% and 49% depending on smoking habits and consumption of alcohol. The
      results of this study indicate that among coke oven workers, the skin is the main
      route of uptake of PAHs. Preventive measures to reduce exposure to PAHs should be
      focused more on the reduction of dermal contamination by PAHs than on the
      reduction of inhaled dose.

PMID- 8343424
TI  - Decreased glutathione content and glutathione S-transferase activity in red blood
      cells of coal miners with early stages of pneumoconiosis.
AB  - Blood samples of miners heavily exposed to coal dust were examined for changes in
      glutathione S-transferase (GST) activity. Decreased GST activity was found in red
      blood cells of subjects with early stages of coal workers' pneumoconiosis
      (International Labour Office classification 0/1-1/2) when compared with control
      miners. At further progression of coal workers' pneumoconiosis (> or = 2/1), the
      activity of GST was not different from controls. In the same group with moderate
      coal workers' pneumoconiosis a decrease in GSH in red blood cells occurred.
      Decreases in GST activity in early stages of coal workers' pneumoconiosis, as
      well as the decreases in glutathione peroxidase (GPx) activity and in GSH
      concentrations reported earlier, may originate from damage caused by reactive
      oxygen species. These changes might imply an impairment of the detoxification
      capacity for electrophilic and oxidative compounds during this stage of the
      disease.

PMID- 8343425
TI  - An improved instrument for the in vivo detection of lead in bone.
AB  - An improved instrument for the fluorescence excitation measurement of
      concentrations of lead in bone has been developed. This is based on a large area
      high purity germanium detector and a point source of 109Cd. The source is
      positioned in a tungsten shield at the centre of the detector face such that
      88keV photons cannot enter the detector directly. In vivo measurements are
      calibrated with plaster of Paris phantoms. Occupationally non-exposed men show a
      minimum detectable concentration of about 6 micrograms/g bone mineral.
      Measurements of tibia lead concentrations in 30 non-occupationally exposed men
      between the ages of 23 and 73 showed an annual increment of 0.46 microgram/g bone
      mineral/year. The mean deviation from the regression of tibia lead upon age was
      3.5 micrograms/g bone mineral. Tibia lead concentration in one subject with a
      history of exposure to lead was 69.6 (SD 3.5) micrograms/g bone mineral. The
      improved precision of the point source large detector system means that greater
      confidence can be placed on the results of in vivo measurements of lead
      concentration. This will allow studies of the natural history of non-occupational
      lead accumulation in normal subjects and should permit investigations of the
      efficacy of therapeutic interventions in subjects poisoned with lead.

PMID- 8343426
TI  - Melanoma and occupation: results of a case-control study in The Netherlands.
AB  - Several studies have reported excesses of risk of melanoma in specific
      industries. Data from a case-control study in The Netherlands, including 140
      cases with a cutaneous melanoma and 181 controls with other types of malignancy,
      were used to evaluate whether the reported associations with these specific
      industries could be reproduced. Adjustment for characteristics of pigmentation
      and exposure to sunlight was made. Increased risks of cutaneous melanoma were
      found for subjects who had ever worked in the electronics industry (odds ratio
      (OR) = 2.03, 95% confidence interval (95% CI) 0.63-6.62), in the metal industry
      (OR = 2.61, 95% CI 0.96-7.10), and in the transport and communication branch (OR
      = 1.92, 95% CI 0.84-4.35). These ORs were adjusted for age, sex, education, hair
      colour, tendency to burn, freckling, and exposure to sunlight. No increased risks
      were seen for workers in the chemical industry, the textile industry, and among
      health care workers. Analyses according to duration and latency of exposure did
      not give consistent results, but existing patterns may be obscured by the
      imprecision of the estimates.

PMID- 8343427
TI  - Mortality and incidence of cancer among sewage workers: a retrospective cohort
      study.
AB  - To study the incidence of and mortality from cancer among sewage workers a
      retrospective analysis was performed on a cohort of 656 men employed for at least
      one year at any one of 17 Swedish sewage plants during the years 1965-86.
      Assessment of exposure was done by classification of work tasks. Lower than
      expected total mortality (standardised mortality ratio (SMR) = 0.75, 95%
      confidence interval (95% CI) 0.58-0.97) and cardiovascular mortality (SMR = 0.61,
      95% CI 0.39-0.91) was found. This was interpreted as a result of the healthy
      worker effect. For all cancers combined the mortality (SMR = 1.08, 95% CI 0.68
      1.67) and morbidity (SMR = 1.02, 95% CI 0.72-1.38) were comparable with those of
      the general population. There were increased incidences for brain tumours (SMR =
      2.19, 95% CI 0.45-6.39), gastric cancers (SMR = 2.73, 95% CI, 1.00-5.94), and
      renal cancers (SMR = 1.68, 95% CI = 0.35-4.90). For lung cancer the risk was
      reduced (SMR = 0.70, 95% CI 0.15-2.05). Allowance for a latency period of 10
      years from the start of exposure did not change the pattern. Logistic modelling
      was used to search for exposure-response relations. In a logistic model with the
      confounder age forced in, renal cancer had a significant positive relation with a
      weighted sum of employment times, where the weights describe the classification
      of exposure. No exposure-response relations were found for brain tumors or
      gastric cancers. The increased risks are based on small numbers of cases. A
      future follow up will add more conclusive power to the study. Specific exposures
      need to be identified to allow for a better dose-response analysis.

PMID- 8343429
TI  - Seamstress's finger.

PMID- 8343428
TI  - Follow up study of workers exposed to man made mineral fibres.
AB  - A survey of workers in seven man made mineral fibre (MMMF) production plants, the
      subject of a previous report, was conducted, with other blue collar workers
      serving as regional comparisons. Based on the median reading of chest radiographs
      by five readers, a low prevalence of small opacities, all at the 1/0 and 1/1
      profusion levels, was again found: for workers with MMMFs, 23/1435 (1.6%); for
      comparison workers, 2/305 (0.7%). Spirometric measurements indicated generally
      healthy populations, and were not related to presence of opacities. Ninety three
      per cent (21/23) of MMMF workers with opacities worked at the two plants with the
      highest exposures to fine fibres, resulting in a dose-response relation across
      plants. For one location, the prevalences of opacities for the MMMF and
      comparison workers were not significantly different (5.9% (13/220) v 3.1%
      (2/65)). No comparison x ray films were obtained for the MMMF plant with the
      highest prevalence (6.6%), so a second phase of the study was conducted, with pre
      employment films from these two plants. On this second reading, the prevalence of
      opacities was lower; there were no significant differences between the two groups
      of films, and no relation between opacities and exposure indices. There was
      considerable inter and intrareader variability. These results indicate no adverse
      clinical, functional or radiographic signs of effects of exposure to MMMFs in
      these workers.

PMID- 8343430
TI  - Hexachlorophene exposure in a young patient with soft tissue sarcoma.

PMID- 8343431
TI  - Asbestos and cancer: history and public policy.

PMID- 8343432
TI  - Quantitative morphological assessment of erythroblastic differentiation induced,
      in vitro, in human K562 leukemic cells.
AB  - K562 human leukemia cell line undergoes in vitro terminal differentiation towards
      the erythroid pathway following treatments with appropriate chemical agents
      including aclacinomycin, fagaronine and hemin. These three drugs induced a
      different expression of phenotypic and functional characters associated with
      differentiation. The morphological characteristics of the differentiation
      sequences elicited by these agents were evaluated by image analysis using a SAMBA
      200 cell image processor. Multivariate statistical analyses of morphological data
      revealed that only aclacinomycin was able to induce significant modifications of
      the morphological parameters similar to those observed during the maturation of
      normal bone-marrow erythroblastic cells. These data correlate with the higher
      inductive potency of aclacinomycin as compared to hemin or fagaronine and suggest
      that quantitative cytology may be a useful adjunct to conventional tests for the
      selection of new drugs with differentiating potential.

PMID- 8343433
TI  - Effectiveness of pulse-shape criteria for the selection of dicentric chromosomes
      by slit-scan flow cytometry and sorting.
AB  - A method was developed to detect dicentric chromosomes by slit-scan flow
      cytometry. The two centromeres of dicentric chromosomes are represented by the
      two dips in the trimodal fluorescence profile. A trimodal profile can, however,
      also be generated by aggregates of chromosomes. We tested the effectiveness of
      slit-scan profile criteria that were applied to discriminate between trimodal
      profiles generated by dicentrics and trimodal profiles generated by artefacts. A
      Profile-Dip Counter (PDC) module was designed that can assess, in real time, the
      number of dips in slit-scan profiles. The PDC module was used in combination with
      a Cytofluorograph System 50 cell sorter for slit-scan sorting of chromosomes
      prepared from irradiated V79 cells. Chromosomes corresponding to trimodal
      profiles were sorted individually onto slides for subsequent visual inspection by
      fluorescence microscopy. The isolated chromosomes were stretched by treatment
      with trypsin to increase the efficiency for centromere detection. When fixed with
      glutaraldehyde, chromosomes could be sorted intact on slides. We found that
      trimodal profiles are generated by dicentric chromosomes as well as by
      monocentric and aggregated chromosomes. When stringent pulse-shape criteria were
      applied for the selection of profiles, the yield of dicentric chromosomes was 70%
      of the sorted chromosomes.

PMID- 8343434
TI  - Application of multivariate, fuzzy set and neural network analysis in
      quantitative cytological examinations.
AB  - Multivariate statistical methods have been used in several studies to increase
      the diagnostic reliability of TV image analyser systems. In recent years some
      algorithms for decision support (fuzzy logic) and for pattern recognition (neural
      nets), both non-linear, were developed. This paper reports on preliminary results
      obtained with these methods in quantitative cytology and compares them to the
      traditional classifiers. A total of 21 normal, 15 dysplastic and 23 malignant,
      gastric imprint smears were Feulgen stained and analysed on a Leitz Miamed DNA
      cytophotometer system. Mean DNA content, the 2c deviation index (2cDI), 5c
      exceeding rate (5cER), G1, S, G2 phase fraction ratios, cell nucleus area and
      form factor were determined. Diagnostic accuracy of the discriminant analysis was
      96% for the malignant cases, 87% for dysplasias and 81% for normal cases. Cluster
      analysis gave no significant result. Our diagnostic system utilizing fuzzy logic
      has made the diagnostic borders adjustable and reliable. The back-propagation
      neural net correctly classified the normal and malignant cases (100%) and all but
      one of the dysplasias (98%). The non-linear mathematical methods improved the
      reliability of the diagnostic system. These new algorithms gave results
      comparable to traditional classifiers. The application of these methods to
      clinical samples is encouraging.

PMID- 8343435
TI  - Normalization of the minimum spanning tree.
AB  - A problem of considerable interest in pattern recognition and data analysis is
      that of describing the spatial structure of a data set. In the field of biology
      this could be based on graph construction. Although the minimum spanning tree
      (MST), contains less information than the Relative Neighbourhood, Gabriel and
      Delaunay graphs [16], this graph has been frequently used [3-9]. The MST is a
      subgraph of all the preceding graphs. Two main types of parameters can be derived
      from a graph. Some of the parameters are derived from the structure of the graph
      (topological parameters), whereas others are based on the Euclidean metrics of
      the graph (edge lengths). Since these parameters are used to characterize the
      spatial structure of data sets, they have to be normalized so that different
      biological structures may be compared. A model for the normalization of the most
      common parameters derived from the MST is thus presented here. Two aspects of the
      problem are considered: (i) omission of the metrics associated dimension of the
      Euclidean parameters in order to compare biological structures at different scale
      factors and (ii) elimination of border effects to avoid border artefacts.

PMID- 8343436
TI  - Refractive laser sharing concepts proliferate.

PMID- 8343437
TI  - Aspheric photorefractive keratectomy with excimer laser.
AB  - BACKGROUND: Increased spherical aberration of the cornea is a common finding
      after excimer laser keratorefractive keratectomy. The shape of the paracentral
      cornea is probably related to the incidence of side effects like glare and halos
      at night depending on ablation zone size and pupil diameter. Aspheric curvature
      changes of the paracentral cornea at the edge of the ablation may decrease those
      side effects. MATERIALS AND METHODS: Fifteen patients were treated with
      photorefractive keratectomy for myopia correction with a Summit excimer laser
      (Summit Technology, Waltham, Mass), one eye using a standard spherical algorithm
      and the fellow eye using a new aspherical algorithm. Eyes were followed for 6 to
      18 months. RESULTS: None of 15 patients reported halos in the aspherically
      corrected eye stronger than in the fellow eye, whereas five patients claimed
      stronger halos in the spherically corrected eye. The effective clear zone size
      was 3.16 +/- 0.35 mm in the spherical cases compared to 3.43 +/- 0.31 in the
      aspherical cases, although the same ablation zone diameters of 5 mm were used.
      This difference is highly statistically significant. Effective spherical
      aberration based on raytracing analysis of the central 5 mm of the corneal
      topographic maps was significantly smaller in the corneas with aspheric
      correction than in those with spheric corrections. CONCLUSION: These results
      indicate better optical homogeneity in eyes after aspheric photorefractive
      keratectomy for myopia compared to standard spherical corrections.

PMID- 8343438
TI  - Shape and radius of posterior corneal surface.
AB  - BACKGROUND: The posterior corneal surface is often ignored in predictive models
      concerned with refractive surgery. In previous studies, the radius of this
      surface has been measured in a variety of ways, primarily over a large chord
      diameter of the surface, with the common assumption that the surface is
      spherical. The asphericity of this surface has not been adequately addressed in
      the past. METHODS: An algorithm is derived for the calculation of posterior
      corneal surface apical radius and using characteristics of the anterior corneal
      surface and topographic corneal thickness variation. Anterior corneal asphericity
      was measured using a commercially available photoelectric keratoscope. Using a
      marked soft contact lens, a simple method of locating noncentral corneal sites is
      described as an aid to ultrasonic pachometry. RESULTS: In a group of 20 normal
      subjects ranging in age from 19 to 23 years, the average posterior corneal
      surface apical radius and asphericity (p) was 5.80 mm (SD = +/- 0.42) and 0.64
      (SD = 0.37) for the vertical meridian, and 5.82 mm (SD = +/- 0.40) and 0.52 (SD =
      0.30) for the horizontal meridian. Average central corneal thickness was 533 mu
      (SD = +/- 19). CONCLUSIONS: The average asphericity values are below 1, hence the
      posterior corneal surface is described as a flattening ellipse. The rate of
      flattening of this surface is greater than the rate of flattening along the
      averaged anterior corneal surface.

PMID- 8343439
TI  - Proceedings of the 1st Keratoprosthesis Study Group Meeting. Miami, Florida,
      November 6, 1992. Abstracts.

PMID- 8343441
TI  - Nomenclature for keratoconus suspects.

PMID- 8343440
TI  - Combined epikeratoplasty and homoplastic keratophakia for correction of aphakia:
      double curve effect.
AB  - BACKGROUND: Having used the nonfreeze Barraquer-Krumeich-Swinger set for
      refractive lamellar keratoplasty since January 1987, the authors found the
      results of this procedure to be disappointing for correction of aphakia.
      Insufficient refractive gains for epikeratoplasty (+39% of initial refraction at
      12-month follow up) persuaded the authors to look for a more effective refractive
      corneal surgery technique for correcting aphakia. METHODS: We describe a new
      technique consisting of the insertion of a plano-convex homoplastic donor cornea
      meniscus between the patient's cornea and a hypermetropic epikeratoplasty. A
      nonfreeze Barraquer-Krumeich-Swinger set was used to fashion the two donor
      lenticules. This double surgery, called the "double curve effect," because it
      uses two convex surfaces to increase the converging power of the cornea, has been
      performed in 15 eyes. RESULTS: We report the results of 10 eyes with a 6-month
      follow up. The average refractive gain was +11.75 D, 90% of the needed
      correction. But there was a loss of approximately 46% of best spectacle-corrected
      visual acuity. CONCLUSION: Three problems should be emphasized: the existence of
      two interfaces, the difficulty of perfectly centering the two lenticules, and the
      induced irregular astigmatism. Despite these problems which can reduce the level
      of best spectacle-corrected visual acuity, the double curve effect may offer an
      effective solution for treating certain cases of unilateral aphakia.

PMID- 8343442
TI  - Should we consider clear lens extraction for routine refractive surgery?

PMID- 8343443
TI  - More radial keratotomy comments.

PMID- 8343444
TI  - Hexagonal keratotomy.

PMID- 8343445
TI  - [Autologous tumor killing (ATK) and tumor metastasis in human cancer patients].
AB  - The present study has demonstrates that the ability of blood lymphocytes to kill
      freshly isolated tumor cells tested at the time of surgery predicts a favorable
      clinical course in patients who have primary localized solid tumor and receive
      curative operation. The strong correlation of autologous tumor killing (ATK)
      activity with tumor-free interval and total survival indicates that ATK activity
      is a meaningful prognostic indicator and provides evidence for immunological
      control of tumor growth and metastasis. According to these data, it is unlikely
      that cancer patients who remain tumor-free after 5 years of follow-up will
      develop recurrence or die from the disease. While there is no direct evidence
      that ATK effector cells play a critical role in regression of tumor and
      prevention of tumor metastasis and regrowth, the lack of ATK activity in patients
      who relapsed and died after surgery may not result from factors related to their
      poor performance status and other immunological functions since no differences
      have been observed in background factors between ATK-positive and-negative
      groups. The prognostic value of ATK activity in patients with documented
      metastatic tumors has not been established yet. In this respect, however, the
      induction of ATK activity by biological therapy has positively correlated with
      prolonged survival time, while such a correlation is not observed with other
      parameters such as NK cells or LAK cell activity. Based on the clinical and
      biological significance of ATK activity, clinical trials have been conducted to
      determine whether the induction of ATK activity before surgery by administration
      of BRM could improve the clinical outcome in patients who naturally have no such
      potential.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343446
TI  - [The roles of cytokine in organ-specific tumor metastasis].
AB  - The production of cytokines by tumor cells has been suggested as the molecular
      perturbation responsible for the development of malignant tumors. The behavior of
      tumor cells in animals is presumed to be affected by these factors, which include
      such hematopoietic cytokines as GM-CSF, IL-1, and IL-6. Here, we report findings
      demonstrating that GM-CSF is produced by many murine transplantable tumors with
      metastatic ability in the lungs, and IL-6 and/or IL-1 are produced by the tumors
      metastatic in the liver. We discuss the notion that the particular organ or
      organs in which tumor cells metastasize may be associated with the type of
      cytokines produced by the tumors. Metastatic spread requires interactions of
      tumor cells with components of the extracellular matrix of host tissues or with
      other cells, almost all of which depend on cell surface determinants such as cell
      adhesion molecules. We also discuss the possibility that the expression and
      adhesive potentials of adhesive protein (CD44) may be regulated by the cytokine
      (GM-CSF) excreted from the tumor cells. We then emphasize the possibility that
      both gene expression of cytokines and adhesive proteins play a critical role in
      tumor metastasis and in determining organ specificity in metastasis.

PMID- 8343447
TI  - [Establishment and characterization of a cell line (H-1) from squamous cell
      carcinoma of human gingiva--effect of temperature].
AB  - We established a cell line (H-1) from human oral cancer. It was derived from a
      biopsy specimen of squamous cell carcinoma in the lower gingiva of a japanese
      man. The cell line has now been growing in vitro for more than 86 passages. The
      cells had an epithelial morphology and grew as adherent monolayers. PAS stain was
      positive and activity of ALP also was positive. They had a doubling time of 37
      hours and colony formation of 32%. Chromosomal numbers ranged from 49 to 75 and
      the modal number was 61. The cell line was tumorigenic in nude mice, its
      histologic examination showed identification with that from the original tumor.
      The cells were sensitive to hyperthermia.

PMID- 8343448
TI  - [Serum-free culture for leukemia cells].
AB  - Several human and murine acute myeloid leukemia cell lines growing in serum-free
      and protein-free culture medium are known to be established. In this paper,
      recent development of serum-free and protein-free culture methods for leukemia
      cells and the characteristics of the established cell lines are reviewed.
      Chemically defined culture medium is preferable as compared with serum-containing
      culture medium because the latter contains various, undefined factors which make
      it difficult to investigate the interactions between cell proliferation or
      differentiation and various growth factors. Investigations using leukemia cell
      lines which are maintained in a serum-free and protein-free chemically defined
      medium will provide the important information with respect to cell biology of
      leukemia cells and leukemia therapy.

PMID- 8343450
TI  - [Detection of chromosomal numerical aberration in glioma by FISH (fluorescence in
      situ hybridization)].
AB  - FISH method with chromosome specific DNA probe to interphase nuclei has been
      useful for the analysis of chromosomal numerical aberration in human brain tumor.
      We applied the FISH method to 9 gliomas and one glioma cell line (KMU-100) with 4
      kinds of chromosomes of number 7, 9, 10 and 17. The predominant specific
      aberration in glioma were revealed the increased signal numbers of chromosome
      7&17 and the decreased signal numbers of chromosome 9&10. The inactivation of
      tumor suppressor genes and the activation of oncogenes have been suggested as the
      principal mechanism of tumorigenesis in human cancer. The definite oncogenes have
      not still been identified on chromosome 7&17 and tumor suppressor genes on
      chromosome 9&10. We discussed the mechanism of tumorigenesis with one or more
      oncogenes on chromosome 7&17 and of one or more tumor suppressor genes on
      chromosome 9&10 in glioma.

PMID- 8343449
TI  - [Establishment and characterization of a human rectal cancer cell line, SRM from
      primary diffuse infiltrating type cancer].
AB  - Primary diffuse infiltrative cancer of the large bowel shows poor prognosis. A
      human rectal cancer cell line, designated as SRM, was established from the
      metastatic lymph node of a 35-year-old female patient. SRM cells have been
      cultured with RPMI-1640 medium supplemented with 10% fetal calf serum and grew as
      monolayers, showing a tendency to pile up. The doubling time of this cell line
      was 23.0 hours, and the modal number of chromosomes was 64 at passage 14. The
      cells produced CA19-9 and TPA in the spent medium and formed tumors in nude mice,
      the histology of which was similar to that of the primary tumor. CA19-9 in the
      cytoplasma of the transplanted tumor cells was demonstrated by the ABC method and
      the c-myc oncogene was amplified in the transplanted tumor in nude mice.

PMID- 8343451
TI  - [Regulation of tumor metastasis and invasion by fibroblasts].
AB  - Using immunodeficient mice human tumor cell lines, which metastasize to specific
      organs from orthotopic implantation sites but not from ectopic sites, have been
      established. We have been studying mechanisms of the regulation of tumor
      metastasis by organ specific microenvironments, and have recently found
      significant differences in interactions between metastatic tumor cells and
      fibroblasts from different tissues. Fibroblasts isolated from orthotopic organ
      tissues of nude mice enhanced invasion of metastatic human colon carcinoma cells.
      In contrast, fibroblasts derived from a subcutaneous tissue suppressed carcinoma
      cell invasion. These divergent effects were found in part due to differential
      expression of cytokines and growth factors by fibroblasts from different tissues.

PMID- 8343452
TI  - [Worm recovery rate and small intestinal lesions of albino rats coinfected with
      Fibricola seoulensis and Metagonimus yokogawai].
AB  - Worm recovery rates and pathologic changes in small intestine of albino rats were
      observed after concurrent and challenge infections with metacercariae (MC) of
      Fibricola seoulensis and Metagonimus yokogawai, and compared with those of single
      infection groups. Albino rats in concurrent infection group were killed 20 days
      after feeding with 1,000 MC of each fluke. Rats in challenge infection group were
      fed with 1,000 MC of F. seoulensis and challenged by 1,000 MC of M. yokogawai 10
      days after primary infection, then killed 10 days thereafter. In concurrent
      infection group, mean number of F. seoulensis and M. yokogawai recovered, 250 and
      118 respectively, were similar to those of single infection groups. However, more
      flukes were collected from the duodenum and less flukes were from the ileum than
      from single infection group. In challenge infection group, the recovery rate of
      F. seoulensis was similar to that of single infection group and the distribution
      of the flukes was similar to that of concurrent infection group. Mean number of
      M. yokogawai, 69, was significantly lower than that of single infection group.
      Its distribution, however, extended to the duodenum and most of the flukes were
      recovered from the jejunum. In concurrent infection group, villi of the duodenum
      were more markedly thickened, fused and shortened than those in F. seoulensis
      single infection group. The crypt epithelium appeared to be hyperplastic and
      inflammatory cell infiltration into the villous stroma was mild. Villous atrophy
      in the jejunum and ileum was milder than in M. yokogawai single infection group.
      In challenge infection group, the findings were similar to those of concurrent
      infection group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343453
TI  - [Proteinase activity in the isolates of Trichomonas vaginalis according to their
      pathogenicity].
AB  - Ten axenic isolates of Trichomonas vaginalis were subcutaneously injected to the
      BALB/c mice in order to assess their pathogenicity by means of so-called "mouse
      assay" method. All the isolates revealed neutral and acid proteinase activities
      both in their lysates and in culture media, but the specific activities of both
      proteinases in the severely pathogenic group were significantly higher than the
      mildly pathogenic group (p < 0.05). In the SDS-PAGE system in which the
      electrophoretic gels contained 0.4% gelatin as the substrate, five different
      banding patterns of trichomonal proteinases were detected, and the patterns were
      closely related with the pathogenicity of the isolates of T. vaginalis. All five
      bands might be regarded as cysteine proteinases group in the inhibitor assays.
      The cytotoxicity of the lysates of T. vaginalis to the target Chinese hamster
      ovarian (CHO) cell line was also significantly different according to the
      pathogenicity of the isolates, and generally lower in the lysates treated with
      cysteine proteinase inhibitors than in the control lysates. In summarizing the
      results, it might be considered that the proteinases of T. vaginalis showing five
      electrophoretic banding patterns are closely related with the pathogenicity and
      cytotoxicity of the isolates of T. vaginalis.

PMID- 8343454
TI  - Mucosal mast cell responses to experimental Metagonimus yokogawai infection in
      rats.
AB  - Intestinal mucosal mast cell (MMC) responses were studied in rats experimentally
      infected with Metagonimus yokogawai (Digenea: Heterophyidae). Twenty Sprague
      Dawley rats were fed each 2,500 metacercariae isolated from the sweetfish and
      sacrificed on the week 1, 2, 3 and 4 post-infection (PI). Recovery of worms was
      performed from the small intestine of each rat. To visualize the MMCs, duodenal
      and jejunal (upper, middle and lower) tissue sections were made and stained with
      alcian blue/safranine-0. The average worm recovery rates were 16.2% and 13.8% on
      the week 1 and week 2, respectively, but they decreased rapidly to 4.1% and 4.2%
      on the week 3 and week 4 PI, respectively, which indicate spontaneous worm
      expulsion after the week 2. The MMC number in the infected rats was, compared
      with uninfected controls, significantly increased in the whole small intestine,
      through the whole period of observation. The peak level of mastocytosis was
      observed on the week 3 PI. It is strongly suggested that MMCs might be involved
      in the expulsion process of flukes from the rat intestine.

PMID- 8343455
TI  - [Infectivity of the sparganum treated by praziquantel, gamma-irradiation and
      mechanical cutting].
AB  - An experimental study was performed to observe the infectivity of sparganum
      (plerocercoid of Spirometra erinacei) treated by praziquantel, gamma-irradiation
      and mechanical cutting. The spargana were obtained from the naturally infected
      European grass snake, Rhabdophis tigrina, or from the experimentally infected
      mice. A total of 83 mice (ICR strain) were divided into 3 experimental groups by
      the source of the damage, fed each with 5 spargana, and sacrificed 1 month later
      for worm recovery. In the praziquantel group, the worms were incubated in the
      concentration of 10 micrograms/ml (control: Tyrode for 4 hours) for 0.5, 1, 2 and
      4 hours at 36 degrees C, and fed to mice. The recovery rate from mice in
      praziquantel group was not different from that (80%) of control group and in the
      range of 76-100%. In the gamma-irradiation group, the worms were irradiated by 10
      1000 Gy with Cs137. The average recovery rates of 69-100% were not different from
      that of control up to 100 Gy. The rate was 56% under 150 Gy, and 5% by 1000 Gy.
      In the mechanical cutting group, the worms were cut at 0.5, 1, 2 and 3 mm from
      the anterior end of the scolex. The average recovery rates in each group were 70
      90% and that of control was 90%. The present finding suggests that the sparganum
      be highly resistant to praziquantel, gamma-irradiation and mechanical cutting.
      The vitality center of the sparganum must be at the anterior end of its scolex.

PMID- 8343456
TI  - Serodiagnosis of human paragonimiasis by ELISA-inhibition test using monoclonal
      antibodies.
AB  - ELISA-inhibition test using Paragonimus westermani specific monoclonal antibody
      (Mab) was investigated to improve the diagnostic specificity of paragonimiasis.
      By cell fusion, one hybridoma clone secreting anti-P. westermani specific Mab was
      selected (Pwa-14), which reacted on bands of 28 kDa, 42.5 kDa, 89 kDa and 120.5
      kDa. IFA showed Pwa-14 was located at the vitelline follicles. By micro-ELISA,
      100% of 22 paragonimiasis cases were found positive, but 5 of 40 clonorchiasis
      cases (12.5%), 3 of 26 cysticercosis cases (7.7%) showed false positive. None of
      10 sparganosis patients or 28 normal controls reacted positively. On the other
      hand, by ELISA-inhibition test using a P. westermani specific Mab, 100% of
      paragonimiasis cases were found positive, and there were no positive in
      cysticercosis, sparganosis cases or normal controls, except 2 (5.0%) false
      positive sera of 40 clonorchiasis cases. The ELISA-inhibition test using a Mab
      showed higher specificity in comparison with micro-ELISA for serodiagnosis of
      human paragonimiasis.

PMID- 8343457
TI  - Serodiagnosis of cysticercosis by ELISA-inhibition test using monoclonal
      antibodies.
AB  - Monoclonal antibodies (Mabs) were produced against crude scolex extract of T.
      solium metacestodes, and applied to ELISA-inhibition test for improving the
      specificity of serodiagnosis of human cysticercosis. Four hybridomas secreting
      species-specific anticysticercal Mabs (Cya-1, Cya-7, Cya-28 and Cya-31) were
      selected. Each Mab reacted on antigenic components of 25.5 kDa (Cya-1), 28 kDa
      (Cya-7), 87.5 kDa (Cya-28), and 12.5 kDa (Cya-31). IFA showed that Cya-1 was
      located at the calcium corpuscles, and Cya-7 at the loose connective tissue of T.
      solium metacestode scolex. Cya-28 and Cya-31 reacted on the tegument of the
      scolex. By conventional ELISA, 23 out of 28 (82.1%) cysticercosis patients were
      found serologically positive, but 1 out of 9 (11.1%) sparganosis cases and 6 out
      of 31 (19.4%) paragonimiasis cases showed false positives. By ELISA-inhibition
      test using species-specific anti-cysticercal Mab Cya-7, 19 out of 28 (67.9%)
      cysticercosis cases were found serologically positive, but there were no false
      positives in other parasitic infections.

PMID- 8343458
TI  - [The effect of active immunization with Acanthamoeba culbertsoni in mice born to
      immune mother].
AB  - Acanthamoeba culbertsoni is a pathogenic free-living amoeba causing primary
      amoebic meningoencephalitis (PAME) in human and mouse. Several reports on the
      immune responses in mice with this amoebic infection have been published, but the
      effects of transferred passive immunity on the active immunization in offspring
      mice have not been demonstrated. This experiment was done to observe the effect
      of active immunization with Acanthamoeba culbertsoni in mice born to immune
      mothers. Acanthamoeba culbertsoni was cultured in the CGV medium axenically.
      Female BALB/c mice weighing about 20g were immunized through the intraperitoneal
      injection of Acanthamoeba culbertsoni trophozoites 1 x 10(6) each three times at
      the interval of one week. Offspring mice were immunized two times. The mice were
      inoculated intranasally with 1 x 10(4) trophozoites under secobarbital
      anesthesia. There was a statistical difference in mortality between the
      transferred immunity group and the active immunization group. Statistical
      differences were not demonstrated in antibody titer between both groups. But
      L3T4+ T cell/Ly2+ T cell ratio was increased in the transferred immunity group
      more than active immunization group of the offspring mice at the age of 5 weeks.
      There was no differences statistically in mortality between both groups. It was
      recognized that active immunization in offspring mice born to immune mother could
      modulate the immune status according to the time of immunization.

PMID- 8343459
TI  - Activities of acid phosphatase and non-specific esterase are present in the
      tribocytic organ and the caecum of Fibricola seoulensis.
AB  - In order to know the enzyme activities of Fibricola seoulensis, an intestinal
      trematode of human and rodent in Korea, the enzyme histochemical method is
      applied. Activities of acid phosphatase (E.C.3.1.3.2) and non-specific esterase
      (E.C.3.1.1) were present in microvilli and glandular cells of tribocytic organ
      and the epithelium of the caecum.

PMID- 8343460
TI  - Turnover of biliary epithelial cells in Clonorchis sinensis infected rats.
AB  - We performed bromodeoxyuridine (BrdU) staining to observe the proliferation
      pattern of epithelial cells on the biliary mucosa in Clonorchis sinensis
      infection. Albino rats were infected with 100 metacercariae each and their livers
      were processed for histopathological observation after BrdU injection. Five to
      six sites in the liver of a rat were selected for paraffin section, and stained
      immunohistochemically to visualize BrdU incorporating cells. The flukes were
      mainly in the common bile duct and right or left hepatic bile ducts. The
      proportion of stained epithelial cells in the infected bile ducts where the worms
      were found on the section was 2.9-10.2% at 1 week after infection, 7.3-12.8% at 2
      weeks, 7.3-13.4% at 5 weeks, and 8.4-14.8% at 15 weeks while in the non-infected
      ducts 0 to 2.7% cells were stained. The stained cells were mainly at the base of
      the mucosal layer. It is suggested that mucosal epithelial cells of the bile
      ducts infected with C. sinensis become hyperplastic mainly by direct and local
      stimulation of the worms.

PMID- 8343461
TI  - Experimental infection of Paragonimus westermani in mice and rats.
AB  - To determine the infectivity and maturity of metacercariae of Paragonimus
      westermani after keeping at low temperature for a long period, 45 mice and 45
      rats were each infected with 20 metacercariae which were kept at 4 degrees C for
      8 to 234 days. The worm recovery in mice increased with age of worm and reached a
      peak of 32% at 41-50 days and then decreased with age. The rate in rats first
      decreased to a lowest point of 6% at 71-100 days and then increased with age. In
      42 infected mice and 41 infected rats, 187 immature worms (183 tiny and 4
      juvenile ones) and 190 worms (164 tiny, 19 juvenile and 7 mature ones) were
      recovered respectively. Two worm cysts with eggs only and 8 empty worm cysts were
      also found in the rats. In addition, the frozen metacercariae can still develop
      to mature worms in SD rats.

PMID- 8343462
TI  - An epidemiological study of metagonimiasis along the upper reaches of the Namhan
      River.
AB  - An epidemiological study of Metagonimus infection was undertaken along the upper
      reaches of the Namhan River, with special consideration on the species (type) of
      the worms collected from humans. Eggs of Metagonimus spp. were detected from 15
      (9.7%) of 154 people examined in Umsong-gun, and from each infected person (5
      cases) 6,015-24,060 worms (mean 13,233) were recovered after treatment with
      praziquantel (10 mg/kg). Eggs were also detected from 37 (48.1%) of 77 people in
      Yongwol-gun, from whom (27 cases) 1-4,965 worms (means 1,215) were collected. The
      worm from Umsong-gun consisted of both Metagonimus Miyata type and Metagonimus
      takahashii, whereas those from Yongwol-gun consisted of only Metagonimus Miyata
      type. When the uterine eggs of the two kinds and M. yokogawai (obtained from
      people in Tamjin River basin) were morphologically compared, it was suggested
      that the egg size should be a good indicator for discrimination of the species or
      type. The source of human infection was proved to be fresh water fishes; 49 of 52
      Zacco platypus examined, 6 of 8 Hemibarbus longirostris, 13 of 15 Pseudogobio
      esocinus, 4 of 6 Odontobutis obscura interrupta, and 17 of 18 Carassius carassius
      were found infected with Metagonimus metacercariae. From the results, it is
      concluded that the upper reaches of the Namhan River are endemic foci of
      Metagonimus Miyata type and M. takahashii.

PMID- 8343463
TI  - The evolving role of visual electrodiagnostics.

PMID- 8343464
TI  - Blindness in the developing world.

PMID- 8343465
TI  - Age-related Bruch's membrane change: a clinical study of the relative role of
      heredity and environment.
AB  - For many years there has been controversy concerning the role of genetic
      influences in the pathogenesis of age-related macular disease. It is widely
      believed that the lesions causing visual loss occur in response to age-related
      changes in Bruch's membrane which are recognised clinically as drusen. In this
      study the density, size, and confluence of drusen as shown on colour photographs
      were compared in eyes of 50 spouses and 53 sibling pairs ascertained during a
      prospective study of age-related macular disease. Concordance between pairs of
      drusen--number, size, and density-were determined by kappa statistic and chi 2
      test for trend. Drusen were absent in one sibling and 26 spouses of patients.
      There was a trend towards concordance of drusen characteristics between siblings
      but not between spouses, although the difference achieved 5% significance only
      for the number and density of drusen in the central macula. The difference of
      concordance between the probands and spouses and the probands and siblings was
      significant for all characteristics. These findings support the belief that
      genetic factors influence age-related changes in Bruch's membrane. They also
      imply that environmental factors are less important or alternatively that the
      environmental variation between households included in our study was not great
      enough to be evident.

PMID- 8343466
TI  - Cone dystrophies with negative photopic electroretinogram.
AB  - A scotopic electroretinogram with an a-wave amplitude larger than the b-wave
      amplitude traditionally is termed 'negative'. Six male patients with negative
      photopic electroretinograms were examined; three of them suffered from
      progressive cone dystrophy, in which negative electroretinograms are unusual.
      Another patient without symptoms was the brother of a patient with cone
      dystrophy. These patients are compared with others who characteristically have
      negative electroretinograms-one patient with incomplete congenital stationary
      night blindness and another with X linked congenital retinoschisis. Differential
      diagnosis between these unusual cases of cone dystrophies and X linked
      retinoschisis or congenital stationary night blindness was possible with
      funduscopy, adaptometry, and evaluation of progression, but not with the
      electroretinogram. Inner retinal defects may occur in cone dystrophies as
      indicated by the negative electroretinogram. The waveform variations between our
      patients may be due to different inner retinal defects. The findings in two
      brothers indicate that cone dystrophy and inner retinal defects may be inherited
      separately.

PMID- 8343467
TI  - Blindness in Africa: Zimbabwe schools for the blind survey.
AB  - An ophthalmic assessment survey of 430 students in Zimbabwe's two schools for the
      blind was conducted in 1988. Bilateral corneal opacity was found to be
      responsible for 75% of all blindness among institutionalised blind students.
      Thirteen per cent of the study patients could gain improved vision through either
      ocular surgical intervention or spectacle correction. Findings in this survey are
      similar to those from other schools for the blind elsewhere in Africa.

PMID- 8343468
TI  - Congenital glaucoma in the West Bank and Gaza Strip.
AB  - This study presents the results of all patients with congenital glaucoma who were
      managed at St John Ophthalmic Hospital, Jerusalem from 1981 to 1990. This
      involved 118 eyes, 174 surgical procedures, and 460 examinations under
      anaesthesia. All procedures showed decreasing success rates with time. However,
      trabeculectomy was clearly the most successful in the hands of general
      ophthalmologists. Careful, long term follow up with particular regard to both
      intraocular pressure and detection and treatment of amblyopia are emphasised.

PMID- 8343469
TI  - A population based, prospective study of the development of ROP in prematurely
      born children in the Stockholm area of Sweden.
AB  - A prospective population based study including 260 children with a birth weight
      of 1500 g or less was performed in the Stockholm county. The total incidence of
      retinopathy of prematurity (ROP) was 40.4%, while severe ROP--that is, stage 3 or
      more, was seen in 20.0%. Cryotherapy was performed in 10.8%. Logistic regression
      analysis revealed independent association of both gestational age and birth
      weight with ROP. The association of gestational age and ROP was significantly
      stronger, indicating that the degree of immaturity of the eye is a main
      predictive factor for the development of ROP. The purpose of a general screening
      for ROP is to identify children requiring cryotherapy. Based on these results it
      seems appropriate to include children with a gestational age of 32 weeks or less
      in such a programme and a first examination at 5-6 weeks of postnatal age is
      suggested.

PMID- 8343470
TI  - Monocular temporal hemianopia.
AB  - Monocular temporal hemianopia was identified in 24 patients. The field of the
      fellow eye was normal. Computed tomography or magnetic resonance imaging showed
      juxta-sellar lesions in 19 patients. Fifteen had pituitary adenomas, two had
      tuberculum sella meningiomas, one a craniopharyngioma, and one an astrocytoma.
      One patient had optic neuritis. A relative afferent pupillary defect (RAPD) was
      detected in most patients. Field loss was functional in two. Two had congenital
      optic disc dysversion with hemianopia which did not respect the vertical
      meridian. Monocular temporal hemianopia is attributed to involvement of the
      ipsilateral optic nerve close enough to the chiasm to selectively impair
      conduction in crossing nasal retinal fibres from the ipsilateral eye, but too
      anterior to affect crossing nasal retinal fibres from the contralateral eye. The
      combination of an RAPD, with or without optic disc pallor, on the side of
      monocular temporal field loss implicates compression of the optic nerve at its
      junction with the chiasm.

PMID- 8343471
TI  - Suture needle drainage of subretinal fluid.
AB  - A simple technique is described for the transcleral drainage of subretinal fluid
      during retinal detachment repair. In a prospective study of 94 consecutive suture
      needle drainage procedures subretinal fluid was successfully drained in 91 cases.
      There were six 'significant' subretinal haemorrhages associated with the
      procedure, but none was subfoveal in location or directly compromised the
      surgical outcome. In no case was retinal incarceration or retinotomy observed.

PMID- 8343472
TI  - Decreased choroidal thickness in eyes with secondary angle closure glaucoma. An
      aetiological factor for deep retinal changes in glaucoma?
AB  - A decreased count of retinal photoreceptors all over the fundus and a loss of
      retinal pigment epithelium cells mainly in the parapapillary region have been
      reported to be associated with glaucoma. This study addressed the question
      whether this cell loss in the deep retinal layers may be connected with a change
      of the choroidal thickness in glaucomatous eyes. Histological sections of 12 eyes
      with secondary angle closure glaucoma due to a malignant melanoma of the ciliary
      body and 20 eyes with a malignant choroidal melanoma and normal intraocular
      pressure were histomorphometrically evaluated. Before enucleation the intraocular
      pressure was significantly higher in the glaucoma group compared with the control
      group. Thickness of the choroid was measured at 12 locations from the posterior
      pole to the fundus periphery. The choroid was significantly thinner in the
      glaucoma group than in the control group. The decreased choroidal thickness was
      mainly due to a diminished choroidal vessel diameter. The differences were more
      marked at the optic disc border than in the fundus periphery. The decreased
      choroidal thickness in the glaucomatous eyes suggests a reduced choroidal
      perfusion. It fits with the reported lack of autoregulation of the choroidal
      blood circulation. Considering the diminished choroidal thickness especially in
      the parapapillary region, it may be one among other factors explaining the
      changes of the deep retinal layers in eyes with glaucoma. It indicates that
      thinning of the choroid, besides the chorioretinal atrophy in the parapapillary
      region, should be added to the panoply of histological changes in glaucoma.

PMID- 8343473
TI  - Role of mitomycin C in pterygium surgery.
AB  - Mitomycin C in the form of eye drops in a concentration of 0.4 mg/ml (0.04%) was
      used as adjunctive treatment for primary and recurrent pterygium after surgical
      excision. The study was concurrent in nature and consisted of 32 pterygia in 30
      patients and was done over a period of 36 months. The object was to observe the
      effect of mitomycin C drops on pterygium recurrence after surgical excision.
      Fifteen eyes of 15 patients were treated with 'bare sclera technique' for
      pterygium excision. Nine patients showed recurrence occurring within first 6
      months of surgery. On the other hand 17 eyes of 15 patients after bare sclera
      pterygium excision received mitomycin 0.4 mg/ml (0.04%) eye drops four times a
      day for 2 weeks from first postoperative day. There was no recurrence of
      pterygium in this group. Follow up time for these cases ranged from 13-19 months.

PMID- 8343475
TI  - Primary surgery for primary open angle glaucoma--justified or not?

PMID- 8343476
TI  - Adult nasolacrimal duct bypass tubes: where do they go?

PMID- 8343474
TI  - Does autoimmunity to S-antigen play a role in Fuchs' heterochromic cyclitis?
AB  - Autoimmunity directed against retinal or choroidal antigens has been suggested to
      play a role in the chorioretinal lesions observed in patients with Fuchs'
      heterochromic cyclitis. This hypothesis was addressed and patients with Fuchs'
      heterochromic cyclitis were tested for cellular immunity (migration inhibitory
      factor assay) against human retinal S-antigen. A significantly higher percentage
      of patients with Fuchs' heterochromic cyclitis had a positive cellular autoimmune
      response to S-antigen than healthy controls and other patients with anterior
      uveitis. This finding is remarkable since Fuchs' heterochromic cyclitis is
      generally classified as an anterior uveitis and patients with Fuchs'
      heterochromic cyclitis without chorioretinal lesions also had a positive test. In
      view of these results and a sensitisation against a corneal antigen reported
      earlier in Fuchs' heterochromic cyclitis, it is suggested that a chronic low
      grade grade anterior uveitis or chorioretinitis of unknown origin may cause the
      release of potent autoantigens in these patients.

PMID- 8343477
TI  - Simultaneous retinal and optic nerve lesions in toxoplasmosis: the advantages of
      magnetic resonance imaging.

PMID- 8343478
TI  - Focal electroretinogram and visual field defect in multiple evanescent white dot
      syndrome.

PMID- 8343479
TI  - Contralateral active ocular toxoplasmosis in Fuchs' heterochromic cyclitis.

PMID- 8343480
TI  - Resolution of an external layer macular hole associated with an optic nerve pit
      after laser photocoagulation.

PMID- 8343481
TI  - A case of presumed congenital herpes zoster ophthalmicus.

PMID- 8343482
TI  - Orbital multiple myeloma mimicking acquired angio-oedema.

PMID- 8343483
TI  - Amaurosis fugax in young adults.

PMID- 8343484
TI  - Glaucoma, ocular hypertension, cataract, and glucose tolerance.

PMID- 8343485
TI  - 5-Fluorouracil and ocular toxicity.

PMID- 8343486
TI  - Fractured laser fibreoptic cord.

PMID- 8343487
TI  - Iris crystals and uveitis.

PMID- 8343488
TI  - ACE inhibition with perindopril and atherogenesis-induced structural and
      functional changes in minipig arteries.
AB  - The effects of angiotensin-converting-enzyme (ACE) inhibition on atherosclerosis
      induced changes in arterial function are unknown, as well as whether they are
      coupled to improvements of structural alterations in the arterial wall. An
      atherogenic (A) diet and the ACE inhibitor perindopril (P) were given
      concomitantly for 4 months to seven adult Pitman-Moore minipigs (7 months of age;
      A+P animals), which were compared with seven A and seven control (C) animals.
      Perindopril, at a daily dose of 4 mg PO that is commonly used in the clinical
      setting, induced a continuous 70% inhibition of serum ACE activity. At the end of
      the study, the atherosclerosis-induced impairment of arterial flow was
      investigated via the hemodynamics and vascular rheology of hindlimb arteries in
      non-barbiturate-anesthetized pigs. Structural alterations were evaluated from the
      histopathology of lesions in the arterial tree (abdominal aorta, left
      interventricular coronary artery [LIVCA], and brachiocephalic trunk [BCT]), with
      particular attention given to the analysis of the structure and composition of
      aortic elastic fibers. Atherosclerosis impaired the function of both capacitance
      and resistance arteries. Blood pressure (BP) rose significantly because of
      increased hindlimb peripheral resistance (HPR) and aortic input impedance (Zc),
      although blood flow was not affected. Altered aortic stress and elastic responses
      revealed that the stiffness of the aorta was markedly increased because of
      increased wall tension and reduced viscoelasticity, the viscous component being
      blunted in the arterial wall. Perindopril significantly opposed these alterations
      by reducing BP, HPR, and Zc and by returning parietal stiffness values to C
      values by increasing aortic compliance. ACE inhibition prevented the alteration
      of both stress and elastic responses. Major fibroproliferative fatty lesions were
      observed in the aorta and LIVCA, while moderate fibrosclerotic lesions were found
      in the BCT. Computerized densitometric analysis of orcein-stained elastin showed
      that elastic laminae fragmentation was prominent in the abdominal aorta, less in
      the LIVCA, and moderate in the BCT. Furthermore, the elastin content was reduced
      in the atherosclerotic aorta, although this loss of elastin was not associated
      with changes in the biochemical nature of alkali-insoluble elastin. Perindopril
      significantly prevented the development of atherosclerosis in the abdominal
      aorta, LIVCA, and BCT by decreasing the cross-sectional area of lesions as well
      as the number of lipid-laden cells in the abdominal aorta and LIVCA. In the
      abdominal aorta, ACE inhibition significantly prevented the alteration of elastic
      laminae by specifically preventing elastolytic fragmentation of dense elastic
      laminae, but it didn ot modify elastin content.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8343489
TI  - Plasma lipid, lipoprotein cholesterol, and apoprotein distributions in selected
      US communities. The Atherosclerosis Risk in Communities (ARIC) Study.
AB  - The distributions of plasma lipids, lipoproteins, and apoproteins of 14,524
      female and male black and white participants 45 to 64 years old in the
      Atherosclerosis Risk in Communities (ARIC) Study are presented. All specimens
      were analyzed at a central laboratory. Mean total cholesterol levels increased
      with increasing age across all ages from 204 to 229 mg/dL (12%) in women and from
      208 to 213 mg/dL (2%) in men. Triglyceride levels increased with age in women,
      remained stable in men, and were higher in whites than blacks. High-density
      lipoprotein (HDL) cholesterol levels were higher in black and white women (range,
      57 to 59 mg/dL) compared with black men (49 to 52 mg/dL) or white men (42 to 43
      mg/dL). Cholesterol associated with HDL was distributed in a relatively constant
      proportion between HDL3 (70% to 76%) and HDL2 (24% to 30%) for all race/sex
      groups. Low-density lipoprotein (LDL) cholesterol levels increased with age in
      black (14.7%) and white (17.1%) women and in black (4.4%) and white (3.7%) men;
      more than 50% of all participants had LDL cholesterol levels > 130 mg/dL.
      Apoprotein A-I and B levels followed the same trends as HDL cholesterol and LDL
      cholesterol levels, respectively. Lipoprotein(a) [Lp(a)] levels were twice as
      high in blacks as in whites, and women's Lp(a) levels were higher than men's
      Lp(a) levels for each race. Menopause was associated with elevated total
      cholesterol, LDL cholesterol, apoprotein B, and Lp(a) levels, and hormone
      replacement medication use in postmenopausal subjects was associated with higher
      HDL cholesterol, triglyceride, and apoprotein A-I levels and lower LDL
      cholesterol, apoprotein B, and Lp(a) levels.

PMID- 8343490
TI  - Aggregate formation is more strongly inhibited at high shear rates by dRGDW, a
      synthetic RGD-containing peptide.
AB  - The effect of D-Arg-Gly-Asp-Trp (dRGDW), a synthetic RGD-containing peptide, on
      platelet adhesion and aggregate formation on various purified adhesive proteins
      and the extracellular matrix of endothelial cells was investigated with
      anticoagulated blood recirculating through a parallel-plate perfusion chamber.
      Aggregate formation on the extracellular matrix of phorbol myristate acetate
      (PMA)-stimulated endothelial cells and on collagen type I was more strongly
      inhibited by dRGDW at higher shear rates than at a low shear rate. Platelet
      adhesion to the extracellular matrix of nonactivated and PMA-stimulated
      endothelial cells was inhibited by dRGDW, especially at high shear rates,
      probably as a consequence of the inhibition of platelet spreading. Inhibition by
      dRGDW of platelet adhesion to von Willebrand factor, fibronectin, and fibrinogen
      was almost complete, indicating that platelet adhesion to these substrates is
      mediated through RGD-directed receptors. Platelet adhesion to laminin was not
      inhibited by the peptide, whereas platelet adhesion to collagen was increased as
      a consequence of the inhibition of aggregate formation. Our results show that
      dRGDW is a strong inhibitor of platelet adhesion and aggregate formation,
      especially at high shear rates.

PMID- 8343491
TI  - Inhibitory effect of clopidogrel on platelet adhesion and intimal proliferation
      after arterial injury in rabbits.
AB  - The possible activity of ticlopidine and its analogue clopidogrel in early
      atherogenesis was investigated. Incubation of rabbit platelets with the
      extracellular matrix produced by endothelial cells in culture induced massive
      platelet adherence in vitro. This phenomenon was strongly reduced when platelets
      were isolated from rabbits that had been treated with a single dose of
      clopidogrel (10 mg/kg PO) or three doses of ticlopidine (each 200 mg/kg PO) (94%
      and 56% inhibition of platelet adhesion, respectively). Three doses of aspirin
      (each 200 mg/kg PO) were ineffective. Air-drying injury of the rabbit carotid
      artery resulted in platelet adherence to the underlying subendothelium. This
      platelet accumulation on the damaged vessel wall was greatly reduced by
      clopidogrel: 95% (P < .001) inhibition of platelet adhesion after a single oral
      dose of 25 mg/kg. Ticlopidine (200 mg/kg) was also effective (71% inhibition; P <
      .001), whereas aspirin (100 mg/kg PO) failed to reduce platelet adhesion to the
      subendothelium. The effect of clopidogrel on intimal smooth muscle hyperplasia in
      rabbit carotid arteries subjected to air-drying endothelial injury was then
      investigated. After a 16-day treatment, clopidogrel (25 mg/kg per day PO)
      inhibited the development of intimal thickening (48% inhibition; P < .01). This
      effect was dose dependent and increased with the duration of the treatment. Under
      the same experimental conditions, ticlopidine (200 mg/kg per day PO) inhibited
      myointimal thickening (57%; P < .001), whereas aspirin was ineffective. These
      results show that clopidogrel and ticlopidine, two ADP-selective antiplatelet
      agents, can reduce myointimal thickening after endothelial injury. This effect
      can be due to the inhibition of platelet adhesion and aggregation to the exposed
      subendothelium.

PMID- 8343492
TI  - Noninvasive quantitative evaluation of atherosclerosis using MRI and image
      analysis.
AB  - A new medical image analysis system to quantify atherosclerosis in the lower
      abdominal aorta using magnetic resonance imaging is described. This medical image
      analysis and display system permits the quantification of the three-dimensional
      (3D) properties of the vessel wall and lumen cross-sectional area and volumes.
      Preliminary results of employing this medical image analysis capability on
      magnetic resonance images demonstrated a twofold increase in wall volume per unit
      vessel length, corresponding to intimal thickening, before luminal narrowing was
      detected. This work demonstrated the feasibility and usefulness of quantitatively
      evaluating the 3D properties of the vessel lumen and wall by using a combination
      of magnetic resonance imaging and image analysis. The demonstration that intimal
      wall thickening is observed in images before observable occlusion of the lumen
      can be expected to provide an important early indicator of the future development
      of atherosclerosis. Such capability will permit detailed and quantitative studies
      to assess the effectiveness of therapies, such as drug, exercise, and dietary
      regimens.

PMID- 8343493
TI  - Relation of plasma triglyceride and apoB levels to insulin-mediated suppression
      of nonesterified fatty acids. Possible explanation for sex differences in
      lipoprotein pattern.
AB  - To test whether a sex difference in insulin-mediated suppression of nonesterified
      fatty acids (NEFAs) could account for sex differences in plasma triglyceride
      levels, we studied 632 normoglycemic men and women of European and South Asian
      descent aged 40 to 69 years. Mean fasting NEFA levels were 19% higher in women
      than in men. Between fasting and 2 hours after a 75-g oral glucose load, NEFA
      levels fell by 69% in women and 55% in men, so that mean NEFA levels at 2 hours
      after loading were 19% lower in women than in men. Plasma triglyceride and
      apolipoprotein B levels were correlated with 2-hour NEFA levels in each sex and
      ethnic group, and these associations were independent of glucose, insulin, and
      central obesity. These results are consistent with experimental studies of the
      effects of insulin and NEFAs on hepatic production of triglycerides and
      apolipoprotein B. Suppression of NEFA levels in response to insulin is greater in
      women than in men, and this may account for some of the sex differences in
      lipoprotein pattern and coronary heart disease risk.

PMID- 8343494
TI  - Local intimal-medial uptakes of 125I-albumin, 125I-LDL, and parenteral Evans blue
      dye protein complex along the aortas of normocholesterolemic minipigs as
      predictors of subsequent hypercholesterolemic atherogenesis.
AB  - This report describes the normalized intimal-medial uptakes [uptake (M, mg.cm-2)
      divided serum concentration (c0, mg.cm-3)] of 125I-albumin, 125I-low-density
      lipoprotein (LDL), and in vivo Evans blue dye (EBD)-albumin complex as functions
      of pressure (P), time (t), molecular species (i), and location (z) along a
      ventral longitudinal z axis of the normal, intact, aortic endothelial surface in
      adult normocholesterolemic Sinclair Research Farm (SRF) minipigs and compares
      these uptake (M/c0) measurements with atherogenesis in hypercholesterolemic
      cohorts. Uptakes of porcine serum 125I-albumin (n = 21) and 125I-LDL (n = 10)
      were measured in freshly excised, metabolically supported aortas using a recently
      developed organ-support system. In vivo intimal-medial EBD uptake vs z data were
      measured photometrically on opened descending aortas from another group (n = 6)
      of normocholesterolemic, adult, SRF minipigs 18 hours after the intravenous
      administration of EBD. For comparison purposes, the corresponding incidence of
      atherosclerotic lesions along the aortic z axis was calculated using topographic
      data from hypercholesterolemic minipig cohorts (n = 39). The results showed that
      uptakes varied greatly with t, z, and macromolecule (i) but not with P. More
      specifically, the value of M/c0 at any location (z) rose with t, was insensitive
      to P, decreased with macromolecular (i) size, and varied with z in a pattern that
      "peaked" in the upstream region, decreased to a nadir in the downstream region,
      and then rose again as it approached the abdominal celiac orifice. The spatially
      z-averaged uptake rates for the three different labeled serum proteins were 0.31
      x 10(-3) cm.h-1 for 125I-albumin, 0.42 x 10(-3) cm.h-1 for EBD-albumin, and 0.04
      x 10(-3) cm.h-1 for 125I-LDL. Nondimensionalized analysis of the individual sets
      of uptake data indicated that the overall uptake relationship [M(t,P,z,i)/c(io),
      cm] could be characterized empirically by the simple product of two separate
      functions: one, a "scaling function" [m(z,i)], that described the uptake
      magnitude for a given i and z and appeared to be independent of t or P; the
      other, a "shape function" [s(t,P)], that described the shapes of the uptake vs t
      and P relationships and appeared to be independent of z or i. The "scaling
      function" [m(z,i)] vs z contour appeared to correlate well with the corresponding
      atherosclerotic lesion incidence vs z contour from the group of
      hypercholesterolemic minipig cohorts. Assuming passive transport, it was shown
      ("Appendix") that m(z,i) can be interpreted physically in terms of an endothelial
      diffusive permeability coefficient (P,cm.s-1).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8343495
TI  - Associations of fish intake and dietary n-3 polyunsaturated fatty acids with a
      hypocoagulable profile. The Atherosclerosis Risk in Communities (ARIC) Study.
AB  - Recent epidemiological evidence indicates that the hemostatic profile is an
      important predictor of cardiovascular disease, yet its dietary determinants are
      not well established. An important question is whether dietary fatty acid intake
      influences blood levels of coagulation proteins. We examined potential dietary
      determinants of six hemostatic factors--fibrinogen, factor VII, factor (vWF),
      protein C, and antithrombin III--in four population-based samples totaling over
      15,000 participants, blacks and whites, in the Atherosclerosis Risk in
      Communities (ARIC) Study. Usual dietary intake was assessed by a food frequency
      questionnaire. Cross-sectional associations were explored using multiple linear
      regression analysis, adjusting for gender, race, age, body mass index, smoking
      status, alcohol use, diabetes, and field center. Dietary intake of n-3
      polyunsaturated fatty acids (PUFAs) showed negative associations with fibrinogen,
      factor VIII, and vWF (blacks and whites) and a positive association with protein
      C (whites only). Fish intake, the major source of dietary n-3 PUFAs, was
      similarly related to the hemostatic profile: a 1 serving per day greater fish
      intake was associated with the following predicted differences (95% confidence
      interval): fibrinogen, -2.9 mg/dL (-6.3, 0.5); factor VIII, -3.3% (-5.4, -1.3);
      vWF, -2.7% (-5.2, -0.1) (blacks and whites); and protein C, +0.07 microgram/mL
      (0.03, 0.11) (whites only). Other nutrients or foods were variably associated
      with the hemostatic factors. These population-based associations, although cross
      sectional, suggest that increases in n-3 PUFA intake from fish may modify the
      blood levels of several coagulation factors.

PMID- 8343496
TI  - Dermatan sulfate inhibition of fibrin-rich thrombus formation in nonhuman
      primates.
AB  - Dermatan sulfate (DS), a factor that amplifies plasma heparin cofactor II
      antithrombin (HCII) activity, has been evaluated in baboons for its relative
      antithrombotic and antihemostatic effects by use of a model that combines both
      platelet-rich and fibrin-rich thrombus formation. Thrombus was generated in a two
      component thrombogenic device incorporated into exteriorized femoral
      arteriovenous shunts, in which a proximal segment of collagen-coated tubing
      induces platelet-rich arterial-type thrombus and distal expanded chambers with
      disturbed and static flow produce fibrin-rich venous-type thrombus. Thrombus
      formation was measured as the deposition of autologous 111In-platelets by imaging
      analysis and by the accumulation of 125I-fibrin. Intravenous infusion of DS at
      0.83, 8.3, and 42 mg/kg maintained plasma levels at approximately 7, 70, and 400
      micrograms/mL, respectively, throughout the period of study. By enhancing HCII
      dependent inactivation of soluble thrombin, DS prolonged the coagulation times,
      reduced plasma fibrinopeptide A levels, and decreased fibrin-rich thrombus
      formation in the chamber portion of the device in a dose-dependent manner, ie,
      the intermediate dose reduced fibrin accumulation by approximately 70% (P < .05).
      By contrast, neither platelet deposition on collagen nor platelet hemostatic
      function, assessed with bleeding time determinations, was significantly affected
      by DS at any dose studied (P > .2 and P > .1, respectively, for the high dose), a
      finding presumably explained by the resistance of immobilized thrombin to
      inactivation by DS.

PMID- 8343497
TI  - Role of endogenous platelet-derived growth factor in arterial smooth muscle cell
      migration after balloon catheter injury.
AB  - The process of intimal thickening after de-endothelializing injury to the rat
      carotid artery is dependent on the migration of smooth muscle cells from the
      media. Recent reports have suggested that platelet-derived growth factor may be
      an important mediator of migration after injury. We have addressed this issue by
      directly determining smooth muscle cell migration in injured arteries of animals
      depleted of platelets and after administration of an antibody that blocks
      platelet-derived growth factor. Because there is a reported association between
      plasminogen activator synthesis and smooth muscle cell migration, we assayed the
      activity levels of plasminogen activators after arterial injury and also assessed
      the effect of a plasmin inhibitor on migration. The data suggest that platelet
      derived growth factor, released by platelets at sites of arterial injury, is an
      endogenous mediator of smooth muscle cell migration; that plasmin generation,
      catalyzed by tissue-type plasminogen activator, is necessary for migration; and
      that one way in which platelet-derived growth factor may act is by stimulation of
      the synthesis of tissue-type plasminogen activator by smooth muscle cells.

PMID- 8343499
TI  - The GTP-binding regulatory proteins, Gs and G(i), are altered in erythrocyte
      membranes of patients with ischemic heart disease resulting from coronary
      atherosclerosis.
AB  - Acute ischemic heart disease is associated with alterations in the cardiac
      adenylate cyclase system response, although the specificity and mechanism of
      these events are unknown. We studied the characteristics of inhibitory (G(i)) and
      stimulatory (Gs) GTP-binding regulatory proteins (G proteins) of adenylate
      cyclase in erythrocyte membranes of patients (n = 16) with nonacute ischemic
      heart disease resulting from coronary atherosclerosis. Gs was measured by
      reconstitution with the resolved catalytic unit of adenylate cyclase and by
      cholera toxin-catalyzed ADP-ribosylation of a 42-kD protein; G(i) was tested as a
      41-kD substrate of pertussis toxin-catalyzed ADP-ribosylation. Gs activity was
      decreased by 27 +/- 2% in the cholate extract and by 25 +/- 3% in the supernatant
      of guanosine 5'-(gamma-thio)triphosphate-treated membranes. The amount of cholera
      toxin substrate was decreased by 33 +/- 3%, and the pertussis toxin substrate was
      increased by 27 +/- 5% compared with healthy subjects (n = 10). All changes in G
      protein characteristics appear to be specific relative to other erythrocyte
      membrane proteins and hemoglobin. Those patients who have a decreased Gs possess
      approximately normal Gi, and those with increased G(i) showed no change in Gs.
      Patients with increased G(i) (normal Gs) exhibited more severe deterioration of
      their coronary arteries than did patients with decreased Gs (normal G(i)) (P <
      .05), but these two groups did not differ significantly in serum lipids,
      hormones, drug therapy, historical data, or baseline assessment (P < 0.05).

PMID- 8343498
TI  - Activities of lipoprotein lipase and hepatic triglyceride lipase in postheparin
      plasma of patients with low concentrations of HDL cholesterol.
AB  - Previous investigations have shown that abnormalities in the postheparin plasma
      levels of the lipolytic enzymes, lipoprotein lipase (LPL) and hepatic
      triglyceride lipase (HTGL), are correlated with variations in plasma high-density
      lipoprotein cholesterol (HDL-C) levels. The present study was performed to
      determine correlations between the postheparin plasma activities of these two
      enzymes and HDL levels in a sizable number of subjects with low HDL-C levels. Two
      types of low-HDL subjects were investigated: 159 male subjects with low HDL-C (<
      40 mg/dL) and normal triglyceride (< 250 mg/dL) levels (the low-HDL group) and 80
      male subjects with low HDL-C (< 40 mg/dL) and elevated triglyceride (> or = 250
      mg/dL) levels (the low-HDL/high-TG group). Postheparin plasma activities of LPL
      and HTGL were determined in these two groups, and these levels were compared with
      those obtained from 51 normolipidemic (normal-HDL) male subjects. Postheparin LPL
      activities were significantly lower in the low-HDL and low-HDL/high-TG groups
      (mean +/- SD, 9.9 +/- 2.9 and 10.4 +/- 3.0 mmol/h per liter, respectively; P <
      .001 for both) compared with the normal-HDL group (12.5 +/- 3.7 mmol/h per
      liter). Conversely, postheparin HTGL activities were significantly higher in the
      low-HDL and low-HDL/high-TG groups (39.3 +/- 16.2 and 44.4 +/- 16.7 mmol/h per
      liter, respectively; P < .001 for both) compared with the normal-HDL group (29.7
      +/- 11.3 mmol/h per liter). Consequently, mean LPL/HTGL ratios were markedly
      lower in the two low-HDL groups compared with the normal-HDL group.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8343500
TI  - DNA photolyase repairs the trans-syn cyclobutane thymine dimer.
AB  - DNA photolyases catalyze the splitting of the cyclobutane ring joining the two
      dihydropyrimidines of a pyrimidine dimer by a photoinduced electron-transfer
      reaction. Previous studies concluded that photolyase repairs only the cis-syn
      form of the eight stereoisomers of the cyclobutane pyrimidine dimer (Pyr[ ]Pyr).
      In this study we found that Escherichia coli photolyase binds to the trans-syn-I
      isomer of T[ ]T with about 10(4)-fold lower affinity than the cis-syn isomer but
      it repairs it relatively efficiently.

PMID- 8343501
TI  - Comparison of sequence preference of tomaymycin- and anthramycin-DNA bonding by
      exonuclease III and lambda exonuclease digestion and UvrABC nuclease incision
      analysis.
AB  - The DNA bonding sites of two pyrrolo[1,4]benzodiazepine derivatives--tomaymycin
      (Tma) and anthramycin (Atm)--were identified by exonuclease III (exo III)
      digestion, lambda exonuclease (lambda exo) digestion, and UvrABC nuclease
      incision analysis. exo III digestion stalls 4-5 bases 3' to a drug-DNA adduct.
      While this method can recognize most of the Atm-and Tma-DNA modification sites,
      it is complicated in that exo III digestion is also stalled by certain unmodified
      sequences and by drug bound to the opposite strand. lambda exo digestion stalls 1
      2 bases 5' to a drug-DNA adduct. The lambda exo method also recognizes most of
      the drug-DNA bonding sites and renders a cleaner background; however, it is also
      affected by opposite-strand drug bonding. Due to their intrinsic digestion
      polarities, these two exonucleases tend to be stalled by the drug-DNA adduct at
      one end of the DNA molecule. Purified UvrA, UvrB, and UvrC proteins acting
      together make dual incisions 6-8 bases 5' and 4 bases 3' to a Atm- or Tma-DNA
      adduct. This nuclease complex recognizes all the Tma- and Atm-DNA bonding sites
      identified by exonuclease digestion methods, and all the UvrABC incisions can be
      attributed to drug modifications in the incised DNA strand. The degree of UvrABC
      nuclease incision increases with increasing drug concentrations for DNA
      modification. Using the UvrABC incision method, we have identified the sequence
      preference of Tma- and Atm-DNA adduct formation in three DNA fragments, and we
      have found that these two drugs have different preferred sites for adduction.
      Both Tma- and Atm-DNA bonding is strongly influenced by the 5' and 3' neighboring
      bases; the orders of preferred 5' and 3' bases for Tma are A > G, T > C, and A, C
      > G, T, and for Atm the orders are A > G > T > C and A > G > T, C. The preferred
      triplets for Tma bonding are -AGA- > -GGC-, -TGC-, and AGC- and for Atm are -AGA
      , -AGG- > -GGA-, -GGG-.

PMID- 8343502
TI  - Electronic nature of the transition state for nucleoside hydrolase. A blueprint
      for inhibitor design.
AB  - A new approach to understanding transition-state structure is presented which
      involves the sequential application of experimental and computational methods. A
      family of experimentally determined kinetic isotope effects is fit simultaneously
      in a vibrational analysis to provide a geometric model of the transition state.
      The electrostatic potential surface of the geometric model is defined by
      molecular orbital calculations to detail the electronic nature of the transition
      state. The method provides both geometric and charge information for the enzyme
      stabilized transition state. Electrostatic potential surface calculations were
      applied to the N-glycohydrolase reaction catalyzed by nucleoside hydrolase from
      the trypanosome Crithidia fasciculata. A geometric model of the transition-state
      structure for the enzymatic hydrolysis of inosine by nucleoside hydrolase has
      been established by the analysis of a family of kinetic isotope effects
      [Horenstein, B.A., Parkin, D.W., Estupinan, B., & Schramm, V.L. (1991)
      Biochemistry 30, 10788]. The transition state has substantial oxycarbonium ion
      character, but the results of electrostatic potential calculations indicate that
      the transition-state charge is distributed over the ribosyl ring rather than
      existing as a localized C+-O<==>C = O+ resonance pair. The electrostatic
      potential surfaces of the substrate and enzyme-bound products differ considerably
      from that of the transition state. At the transition state both hypoxanthine and
      ribose demonstrate regions of positive charge. The positive charge on the ribosyl
      oxycarbonium ion is moderated by association with an enzyme-directed water
      nucleophile. The enzyme-bound products contain adjacent areas of negative charge.
      The electrostatic potential surfaces provide novel insights into transition-state
      structure and the forces causing release of products.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8343503
TI  - Structures of thymidylate synthase with a C-terminal deletion: role of the C
      terminus in alignment of 2'-deoxyuridine 5'-monophosphate and 5,10
      methylenetetrahydrofolate.
AB  - Thymidylate synthase undergoes a major conformational change upon ligand binding,
      where the carboxyl terminus displays the largest movement (approximately 4 A).
      This movement from an "open" unliganded state to the "closed" complexed
      conformation plays a crucial role in the correct orientation of substrates and in
      product formation. The mutant lacking the C-terminal valine (V316Am) of the
      enzyme is inactive. X-ray crystal structures of V316Am and its complexes with
      dUMP, FdUMP, and both FdUMP and CH2H4folate are described. The structures show
      that ligands are bound within the active site, but in different modes than those
      in analogous, wild-type thymidylate synthase structures. The 2.7-A binary complex
      structures of V316Am with FdUMP and dUMP show that the pyrimidine and ribose
      moieties of the nucleotides are pivoted approximately 20 degrees around the 3'
      hydroxyl compared to dUMP in the wild-type enzyme. The 2.7-A crystal structure of
      V316Am complexed with cofactor, CH2H4folate, and the substrate analog, FdUMP,
      shows these ligands bound in an open conformation similar to that of the
      unliganded enzyme. In this ternary complex, the imidazolidine ring of the
      cofactor is open and has reacted with water to form 5-HOCH2H4folate. 5
      HOCH2H4folate is structural evidence for the 5-iminium ion intermediate, which is
      the proposed reactive form of CH2H4folate. The altered ligand binding modes
      observed in the three V316Am complex structures open new venues for the design of
      novel TS inhibitors.

PMID- 8343504
TI  - NMR solution structure of human parathyroid hormone(1-34).
AB  - The aqueous solution structure of the biologically-active N-terminal domain of
      human parathyroid hormone (residues 1-34) was studied by two-dimensional proton
      nuclear magnetic resonance (2D NMR) spectroscopy, distance geometry, and dynamic
      simulated annealing. Unambiguous NMR assignments of all backbone and side chain
      hydrogens were made with the aid of totally correlated spectroscopy experiments,
      which provided through-bond 1H-1H connectivities, and nuclear Overhauser effect
      spectroscopy, which provided through-space and sequential backbone
      connectivities. The NMR data acquired were utilized in a distance geometry
      algorithm to generate a family of structures which were then refined using
      dynamic simulated annealing. The major structural feature evident is alpha-helix
      extending from residues Glu4 to Lys13 and from Val21 to Gln29 with a turn
      incorporating Asn16-Glu19 resulting in a quite globular C-terminal domain with a
      hydrophobic core comprising Leu15, Leu18, Trp23, and Val31. Structure-activity
      studies are interpreted in terms of the deduced conformation of the PTH structure
      with particular reference to the likely PTH receptor binding site formed
      primarily by the bulk of the C-terminal helix.

PMID- 8343505
TI  - An elongated form of T4 glutaredoxin with four extra residues.
AB  - Two different forms of T4 glutaredoxin (thioredoxin) arising from the same gene
      on a multicopy plasmid in an Escherichia coli expression system have been
      isolated and characterized. Up to one-fourth of purified T4 glutaredoxin has an
      extension of four amino acids in the carboxy terminus, with the sequence
      aspartate, arginine, isoleucine, lysine. This four-residue extension may be
      caused by a translational +1 frameshift at the UGA terminator codon.

PMID- 8343506
TI  - Mode of formation and structural features of DNA-cationic liposome complexes used
      for transfection.
AB  - Complexes formed between cationic liposomes and nucleic acids represent a highly
      efficient vehicle for delivery of DNA and RNA molecules into a large variety of
      eukaryotic cells. By using fluorescence, gel electrophoresis, and metal-shadowing
      electron microscopy techniques, the factors that affect the, yet unclear,
      interactions between DNA and cationic liposomes as well as the structural
      features of the resulting complexes have been elucidated. A model is suggested
      according to which cationic liposomes bind initially to DNA molecules to form
      clusters of aggregated vesicles along the nucleic acids. At a critical liposome
      density, two processes occur, namely, DNA-induced membrane fusion, indicated by
      lipid mixing studies, and liposome-induced DNA collapse, pointed out by the
      marked cooperativity of the encapsulation processes, by their modulations by DNA
      condensing agents, and also by their conspicuous independence upon DNA length.
      The DNA collapse leads to the formation of condensed structures which can be
      completely encapsulated within the fused lipid bilayers in a fast, highly
      cooperative process since their exposed surface is substantially smaller than
      that of extended DNA molecules. The formation of the transfecting DNA-liposome
      complexes in which the nucleic acids are fully encapsulated within a positively
      charged lipid bilayer is proposed, consequently, to be dominated by mutual
      effects exerted by the DNA and the cationic liposomes, leading to interrelated
      lipid fusion and DNA collapse.

PMID- 8343507
TI  - Reorientation time of DNA molecules in pulsed-field gel electrophoresis.
AB  - The precise determination of the influence of an electric field strength E on the
      resolution of DNA molecules during a pulsed-field gel electrophoresis shows that
      the maximal molecular size Nmax of still resolved DNA molecules is described by
      the equation Nmax = k tau E alpha, where k is a coefficient, tau is a pulse time,
      and alpha is an exponent (calculated as approximately 3/2). We assume that the
      best estimation of the reorientation time tau R for each DNA fragment is such a
      pulse time in which this DNA molecule is the largest separated one.

PMID- 8343508
TI  - FT-IR studies on the triplet state of P680 in the photosystem II reaction center:
      triplet equilibrium within a chlorophyll dimer.
AB  - The structure and molecular interactions of the primary donor (P680) in the
      reaction center (D1-D2-cytochrome b-559 complex) of photosystem II (PS II) have
      been investigated by detecting light-induced FT-IR difference spectra upon the
      formation of its triplet state (3P680). The 3P680/P680 spectrum obtained was
      analyzed by comparing it with difference spectra between the ground and lowest
      triplet states of purified chlorophyll a (Chl) in organic solvents. The negative
      peaks at 1669 and 1707 cm-1 accompanied by the positive peaks at 1627 and 1659 cm
      1 in the 3P680/P680 spectrum were assigned to the keto C = O stretching mode, and
      the appearance of these two pairs of bands indicated that P680 has a dimeric
      structure analogous to that of the bacterial primary donor. From the band
      positions of the keto and carbomethoxy C = O stretches, the hydrogen-bonding
      properties of these two Chl molecules were found to be asymmetrical; in one Chl
      molecule both the keto and carbomethoxy C = O groups form hydrogen bonds, while
      in the other Chl molecule the keto C = O is not hydrogen-bonded whereas the
      carbomethoxy C = O probably is hydrogen-bonded. The temperature dependence of the
      intensity ratios of the keto C = O bands revealed that the triplet state is
      equilibrated between the two Chl molecules with an energy gap of 8.4 +/- 0.7 meV.
      Most of the triplet population was found to be localized on one Chl molecule (86%
      at 80 K), in which both of the two C = O groups are hydrogen-bonded, that is
      probably attached to the D1 subunit. Considering the structure of the bacterial
      reaction center determined by X-ray crystallography and the sequence homology
      between the D1 and D2 subunits of PS II and the L and M subunits of bacteria, a
      model of the P680 structure and its interactions with apoproteins has been
      proposed.

PMID- 8343509
TI  - Resonance Raman and optical transient studies on the light-induced proton pump of
      bacteriorhodopsin reveal parallel photocycles.
AB  - The photocycle of bacteriorhodopsin (bR) was studied at ambient temperature in
      aqueous suspensions of purple membranes using time-resolved resonance Raman (RR)
      and optical transient spectroscopy (OTS). The samples were photolyzed, and the
      fractional concentrations of the retinylidene chromophore in its parent state,
      BR570, and in the intermediate states L550, M412, N560, and O640 were determined
      in the time domain 20 microseconds-1 s and in the pH range 4-10.5. Two
      kinetically different L components could be identified. At pH 7 one fraction of L
      (approximately 65%) decays in 80 microseconds to M (deprotonation of the Schiff
      base), whereas the residual part is converted in approximately 0.5 ms to N. The
      RR spectra reveal only minor structural changes of the chromophore in the L-->N
      transition. These were attributed to a conformational change of the protein
      backbone [Ormos, P., Chu, K., & Mourant, J. (1992) Biochemistry 31, 6933]. With
      decreasing pH the L-->N transition is delayed to > 2 ms following a titration
      like function with pKa approximately 6.2. The decay of M412 monitored by OTS can
      be fitted for each pH value by two different amplitudes and time constants (Mf,
      tau f; Ms, tau s; f = fast, s = slow). Both Mf and Ms consist of subcomponents
      which can be distinguished by their different reaction pathways (but not by OTS).
      Mf occurs in the reaction sequences L-->Mf-->N-->BR and L-->Mf-->O-->BR. The
      population of the first sequence, in which N is formed with the time constant tau
      f (approximately 2-4 ms, pH 6-10.5), increases with pH. Ms is also found in two
      different reaction sequences of the form L-->Ms-->BR. The quantitative analysis
      reveals that each "titration effect" can be related to a certain fraction of bR.
      It is proposed that each fraction can be identified with a "subspecies" of bR
      which undergoes an independent and individual cyclic reaction. A complete
      reaction scheme is set up which represents the manifold of observed phenomena. It
      is concluded from the pH dependence of the lifetimes of Ms and N that the
      reconstitution of BR570 in the reaction steps Ms-->BR and N-->BR requires the
      uptake of a proton from the external phase. It is argued that this proton
      catalyzes the reisomerization of retinal, whereas the Schiff base is internally
      reprotonated from Asp-85. A model for proton pumping is proposed in which the
      proton taken up from the external phase to catalyze the reisomerization of
      retinal is the one which is pumped through the membrane during the photocycle of
      bR.

PMID- 8343510
TI  - Characterization of hemopexin and its interaction with heme by differential
      scanning calorimetry and circular dichroism.
AB  - Hemopexin is a plasma glycoprotein that has two structural domains (I and II) and
      binds and transports heme particularly to liver cells. Differential scanning
      calorimetry (DSC) studies show that hemopexin is largely stabilized by heme,
      which binds exclusively to domain I. The melting temperature (Tm) of heme
      hemopexin is 66.4 +/- 0.7 degrees C as compared with 53.9 +/- 0.3 degrees C for
      apohemopexin, and this Tm increase is accompanied by a 100 kcal increase in molar
      enthalpy. Heme stabilizes hemopexin by stabilizing domain I. This is demonstrated
      by the 26 degrees C increase in Tm from 51.9 +/- 0.3 to 77.6 +/- 0.6 degrees C
      and the over 3-fold increase in molar enthalpy when domain I associates with
      heme. A moderate change in domain I secondary structure is indicated by an
      increase in negative molar ellipticity at 206 nm. However, there is no net effect
      on the secondary structure of holo-hemopexin caused by heme binding as indicated
      by both far-UV circular dichroism (CD) and Fourier-transform infrared spectra.
      The characteristic positive ellipticity of hemopexin at 233 nm, ascribed to
      tryptophan residues in domain II, is dramatically increased, suggesting a change
      in teritary structure for domain II of hemopexin. DSC and CD results show that
      isolated domain I and domain II interact both in the presence and absence of
      heme. Moreover, domain II destabilizes heme-domain I, which may be an important
      factor in facilitating heme release to the hemopexin receptor.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8343511
TI  - The Schiff base bond configuration in bacteriorhodopsin and in model compounds.
AB  - The Schiff base linkage bond configuration of bacteriorhodopsin was studied using
      model compounds consisting of all-trans- and 13-cis-retinal-protonated Schiff
      bases bearing C = N anti and syn bond configurations. The C = N configuration was
      analyzed using a combination of Fourier transform infrared spectroscopy and
      isotopically labeled chromophores. It was found that, in the model compounds, the
      coupling between the C14--C15 stretching frequency and the N--H rock is weak in
      the all-trans-retinal-protonated Schiff base in both the anti and syn C = N
      configurations. However, this coupling is relatively strong in the 13-cis-retinal
      protonated Schiff base in both the anti and syn C = N configurations. Thus, it is
      concluded that, in model compounds, the C14--C15 mode can serve as a marker for
      the C13 = C14 bond configuration but not for the C = N. A different situation may
      prevail in bacteriorhodopsin due to different conformations of the retinal
      chromophore in the protein binding site and in solution. This difference suggests
      that the C14--C15/NH coupling in retinal-protonated Schiff bases is affected by
      the retinal conformation.

PMID- 8343512
TI  - Regulation of the rhodopsin-transducin interaction by a highly conserved
      carboxylic acid group.
AB  - Rhodopsin is a member of a family of G protein-coupled receptors which share
      structural and functional homologies. A tripeptide sequence (Glu or Asp/Arg/Tyr)
      at the cytoplasmic border of the third transmembrane segment is conserved among
      most of these receptors. This region is involved in G protein activation in
      rhodopsin as well as in other receptors. The role of the conserved Glu-134 was
      studied by site-specific mutagenesis of rhodopsin in combination with a real-time
      fluorescence assay of G protein (transducin) activation. Assay conditions were
      chosen under which the transducin activation rate was determined either by
      rhodopsin-transducin complex formation or by GTP gamma S-induced complex
      dissociation. Glu-134 was replaced by Gln in order to mimic the protonated state
      of the carboxylic acid group. This mutation caused the pH dependency of complex
      formation to extend to the alkaline range as compared with rhodopsin. Replacement
      of Glu-134 by Asp had an opposite but less pronounced effect on the pH dependency
      and lowered the overall efficiency of transducin activation. The acidity constant
      (pKa) of the residue at position 134 did not directly determine the pH
      sensitivity of complex formation, indicating that other amino acid residues
      contribute to a titratable binding domain that includes Glu-134. In contrast, the
      pH sensitivity of GTP gamma S-induced complex dissociation was not changed by the
      mutations, although absolute rates were affected. The data suggest that the
      protonated state of Glu-134 favors binding of rhodopsin to transducin and that
      Glu-134 is not titratable in the rhodopsin-transducin complex.

PMID- 8343513
TI  - Importance of main-chain flexibility and the insulin fold in insulin-receptor
      interactions.
AB  - We have investigated the effects of altering the disposition between the COOH
      terminal B chain domain of insulin and the core of the insulin molecule on ligand
      interactions with the hepatocyte insulin receptor. Analogues include those in
      which ArgB22 of des-octapeptide(B23-B30)-insulin is extended by one to three
      residues of glycine prior to termination in Phe-NH2, by one to five residues of
      glycine prior to termination in Phe-Phe-NH2, or by an additional residue of
      glycine prior to termination in more extended sequences derived from insulin or
      [GlyB24]insulin. Analogues were also examined with respect to their abilities to
      form hexamers in solution in the presence of Co2+, phenol, and NaSCN. Overall,
      our studies of ligand-receptor interactions identify that (a) the energetic
      penalty for the introduction of a single residue of glycine is uniform in all
      classes of analogues for up to three residues of glycine but diminishes somewhat
      for analogues with longer insertions and (b) the COOH-terminal residues of the B
      chain retain their importance for all classes of analogues, no matter the number
      of glycine residues introduced. Analogues with glycine insertions, but not those
      with glycine substitutions, readily form thiocyanate-stabilized complexes with
      Co2+ in the presence of phenol.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343514
TI  - A structural and kinetic study on myofibrils prevented from shortening by
      chemical cross-linking.
AB  - In previous work, we studied the early steps of the Mg(2+)-ATPase activity of
      Ca(2+)-activated myofibrils [Houadjeto, M., Travers, F., & Barman, T. (1992)
      Biochemistry 31, 1564-1569]. The myofibrils were free to contract, and the
      results obtained refer to the ATPase cycle of myofibrils contracting with no
      external load. Here we studied the ATPase of myofibrils contracting
      isometrically. To prevent shortening, we cross-linked them with 1-ethyl-3-[3
      (dimethylamino)propyl]carbodiimide (EDC). SDS-PAGE and Western blot analyses
      showed that the myosin rods were extensively cross-linked and that 8% of the
      myosin heads were cross-linked to the thin filament. The transient kinetics of
      the cross-linked myofibrils were studied in 0.1 M potassium acetate, pH 7.4 and 4
      degrees C, by the rapid-flow quench method. The ATP binding steps were studied by
      the cold ATP chase and the cleavage and release of products steps by the Pi burst
      method. In Pi burst experiments, the sizes of the bursts were equal within
      experimental error to the ATPase site concentrations (as determined by the cold
      ATP chase methods) for both cross-linked (isometric) and un-cross-linked
      (isotonic) myofibrils. This shows that in both cases the rate-limiting step is
      after the cleavage of ATP. When cross-linked, the kcat of Ca(2+)-activated
      myofibrils was reduced from 1.7 to 0.8 s-1. This is consistent with the
      observation that fibers shortening at moderate velocity have a higher ATPase
      activity than isometric fibers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343515
TI  - Modification of oligosaccharide antenna flexibility induced by exoglycosidase
      trimming.
AB  - We have investigated the solution conformation of a triantennary glycopeptide
      using resonance energy transfer [Rice et al. (1991) Biochemistry 30, 6646-6655].
      Triantennary glycopeptide was derivatized with a donor fluorophore on the N
      terminus and with an acceptor fluorophore attached individually to each terminal
      galactose residue, resulting in three isomeric donor-acceptor pairs. Time
      resolved energy-transfer experiments revealed two distinct donor-acceptor
      distance populations for two of the three antennae of the oligosaccharide. An
      extended conformation and a folded conformation were detected for the two
      flexible antennae whereas the third antenna on the oligosaccharide was rigid,
      containing only an extended conformer. The ratios of the extended to folded
      conformers of the two flexible antennae were reversibly modulated by temperature,
      allowing the calculation of delta H and delta S for the conformational change [Wu
      et al. (1991) Proc. Natl. Acad. Sci. U.S.A. 88, 9355-9359]. In the present study,
      we have trimmed the fluorescent glycopeptides with exoglycosidases which
      specifically removed the unmodified antennae of the oligosaccharide. The
      resulting single-chain isomeric glycopeptides each contained identical core sugar
      residues and a terminally located donor and acceptor, but differed only in the
      linkage configuration of the sugar residues. Analysis of these glycopeptides by
      time-resolved energy transfer indicated that each antenna of the oligosaccharide
      is, by itself, maintained exclusively in the extended conformation. Temperature
      modulation failed to induce antenna folding as was previously observed for the
      complete triantennary structure. These data suggest that interantenna
      interactions modulate the conformation of individual antenna of complex
      oligosaccharides.

PMID- 8343516
TI  - Purification of human thioredoxin reductase: properties and characterization by
      absorption and circular dichroism spectroscopy.
AB  - The flavoenzyme thioredoxin reductase (TR) and its natural substrate thioredoxin
      comprise a redox system generally found in all organisms. In order to better
      understand the biochemistry of this redox system, TR was purified (> 4000-fold)
      from human placenta as a dimer of 60-kDa subunits. The molecular size of native
      TR was determined to be 160 kDa by gel filtration chromatography whereas
      migration on a sucrose gradient gave a molecular mass of 130 kDa. The pI of TR
      was determined to be 4.85. The temperature optima for DTNB and insulin reduction
      by TR were 52 and 40 degrees C, respectively. Preincubation of TR at 60 degrees C
      for up to 1 h showed no decrease in the enzymatic rates when assayed at 28
      degrees C, while temperatures above 65 degrees C resulted in an irreversible loss
      of activity. Circular dichroism (CD) spectra of TR indicated that the secondary
      structural changes at 60 degrees C were only partly reversible at 28 degrees C.
      CD studies showed the flavoenzyme had a TM of 63 degrees C and above 45 degrees C
      began to exhibit changes in the secondary structure. Equilibrium denaturation of
      TR by temperature and guanidine hydrochloride suggested that FAD was not
      displaced during inactivation of TR and that the tertiary structure was primarily
      disrupted prior to denaturation of the secondary structure. The results of this
      study show that purified human TR is a relatively thermostable flavoenzyme whose
      tightly bound FAD group is not displaced by elevated temperatures up to 60
      degrees C or by relatively low concentrations of guanidine hydrochloride.

PMID- 8343517
TI  - A new kinetic mechanism for the concomitant hydrolysis and transfer reactions
      catalyzed by bacterial DD-peptidases.
AB  - In the presence of an adequate nucleophilic acceptor substrate (A) and ester and
      thiolester donor substrates (S), the Streptomyces R61 soluble DD-peptidase
      catalyzes both hydrolysis and acyl group transfer reactions. Simple bisubstrate
      models do not explain the variation of the transfer to hydrolysis ratios with the
      donor and acceptor concentrations. A new kinetic mechanism for the concomitant
      hydrolysis and transfer reactions is proposed which involves an acceptor and a
      second, nonproductive donor substrate binding site. In this model, the acceptor
      essentially binds to the acyl-enzyme, and the second donor molecule only binds to
      the ternary ES*A complex. Hydrolysis can then proceed from the quaternary ES*AS
      complex. The values of all of the parameters involved in the reaction of a
      thiolester substrate with D-alanine as the acceptor substrate were determined at
      15 and 37 degrees C. The results obtained with a protein modified by site
      directed mutagenesis, and with which the transpeptidation reaction appeared to be
      specifically impeded, are discussed on the basis of the new kinetic mechanism.
      The data obtained with the soluble form of the high molecular weight penicillin
      binding protein 2X from Streptococcus pneumoniae are also in agreement with this
      model.

PMID- 8343518
TI  - Heparin binding affinity of normal and genetically modified antithrombin III
      measured using a monoclonal antibody to the heparin binding site of antithrombin
      III.
AB  - The inhibitory activity of the plasma serine proteinase inhibitor antithrombin
      III (AT III) is enhanced about 1000-fold upon binding to heparin. We have
      determined the dissociation constants, Kd, of 48.8 nM for the heparin-AT III
      interaction, of 175 nM for the specific pentasaccharide-AT III interaction, and
      of 13 microM for the low-affinity heparin-AT III interaction, using a binding
      assay based on a monoclonal antibody (MAb) that recognizes an epitope at or close
      to the heparin binding site of AT III. The heparin binding affinities and
      proportions of normal and variant AT III in plasma from patients with mutations
      of AT III have been quantitated for the first time using the binding assay.
      Substitution mutations in three regions of AT III have been investigated: (i)
      mutations in the reactive site loop affecting Ala382, Arg393, and Ser394 have no
      discernible effect on heparin binding; (ii) mutations in the previously
      identified N-terminal heparin binding region, affecting Arg47, Leu99, and Arg129,
      produce variant AT III molecules with heparin affinities reduced 11-924-fold, the
      largest reduction being observed for the substitution mutation Arg47-Cys in Padua
      2, which has an affinity of 65.6 microM; (iii) mutations in the hydrophobic
      regions around strand 1C of the C terminus, affecting Phe402, Ala404, Asn405,
      Pro407, and Pro429, have pleiotropic effects that include the production of
      reduced amounts of low-affinity AT III with dissociation constants from 6 to 43
      microM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343519
TI  - Distinct metal binding configurations in ACE1.
AB  - The ACE1 protein of Saccharomyces cerevisiae mediates the metal-induced
      expression of the CUP1 metallothionein (MT) genes. Curiously, ACE1 resembles the
      MT protein in the types of metal complexes that form. ACE1 binds Cd(II) and Cu(I)
      ions in distinct configurations, but only the Cu(I) conformer of ACE1 forms a
      high-affinity and specific complex with DNA. Cu(I) ions associated with ACE1 are
      known to assemble in a polymetallic CuI-thiolate cluster that resembles Cu
      metallothionein in metal coordination properties [Dameron, C. T., Winge, D. R.,
      George, G. N., Sansone, M., Hu, S., & Hamer, D. (1991) Proc. Natl. Acad. Sci.
      U.S.A. 88, 6127-6131]. In contrast to the Cu(I) nuclearity of 6-7 mol equiv in
      ACE1 and 7 mol equiv in yeast MT, divalent ions, including Cd(II), Zn(II) and
      Co(II), bind with a maximal stoichiometry of near 4 mol equiv in ACE1 and 4 mol
      equiv in yeast MT. Charge-transfer bands consistent with metal:thiolate
      coordination were observed in CdACE1 and CoACE1. Spectroscopic studies of
      CoIIACE1 and EXAFS analysis of CdIIACE1 revealed tetrahedral coordination
      geometry in these complexes. Similar tetrahedral coordination complexes were
      observed with Co(II) and Cd(II) complexes of MT from S. cerevisiae. Metal binding
      in ACE1 is clearly similar to that in MT, and therefore the MT-metal clusters
      appear to be a good structural model of the metal center of ACE1.

PMID- 8343520
TI  - Thermodynamics of ligand binding to trp repressor.
AB  - The thermodynamics of L-tryptophan and operator DNA binding to the tryptophan
      repressor of Escherichia coli were analyzed by titration microcalorimetry and
      van't Hoff analysis of footprinting titrations, respectively. At 25 degrees C in
      10 mM sodium phosphate, pH 7.6, and 0.1 M NaCl, the binding of L-tryptophan to
      the repressor is characterized by values of delta G degrees = -6.04, delta H
      degree = -14.7, and T delta S degree = -8.67 kcal/mol. The temperature dependence
      of delta H degree yields delta Cp degree = -0.46 +/- 0.08 kcal/(mol.K) per dimer.
      The binding is noncooperative at all temperatures studied. At 23 degrees C in 2.5
      mM sodium phosphate, pH 7.6, and 25 mM NaCl, the binding of operator DNA to the
      repressor is characterized by values of delta G degree = -13.3 kcal/mol, delta H
      degree = -1.55 kcal/mol, T delta S degree = 11.8 kcal/mol, and delta Cp degree = 
      0.54 +/- 0.10 kcal/(mol.K). Changes in water-accessible surface areas upon
      binding of L-tryptophan or DNA were calculated from X-ray crystal structures. The
      experimentally observed delta Cp degree values were compared with delta Cp degree
      values calculated according to several methods based on various proposed
      relationships between surface area changes and heat capacity changes. Regardless
      of which method is used, we find poor agreement between the calorimetric results
      for L-tryptophan binding and the surface areas calculated from X-ray data; the
      direction of the discrepancy is that the X-ray data underestimate the value of
      delta Cp degree.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343521
TI  - Intramolecular electron transfer in single-site-mutated azurins.
AB  - Single-site mutants of the blue, single-copper protein, azurin, from Pseudomonas
      aeruginosa were reduced by CO2- radicals in pulse radiolysis experiments. The
      single disulfide group was reduced directly by CO2- with rates similar to those
      of the native protein [Farver, O., & Pecht, I. (1989) Proc. Natl. Acad. Sci.
      U.S.A. 86, 6968-6972]. The RSSR- radical produced in the above reaction was
      reoxidized in a slower intramolecular electron-transfer process (30-70 s-1 at 298
      K) concomitant with a further reduction of the Cu(II) ion. The temperature
      dependence of the latter rates was determined and used to derive information on
      the possible effects of the mutations. The substitution of residue Phe114,
      situated on the opposite side of Cu relative to the disulfide, by Ala resulted in
      a rate increase by a factor of almost 2. By assuming that this effect is only due
      to an increase in driving force, lambda = 135 kJ mol-1 for the reorganization
      energy was derived. When Trp48, situated midway between the donor and the
      acceptor, was replaced by Leu or Met, only a small change in the rate of
      intramolecular electron transfer was observed, indicating that the aromatic
      residue in this position is apparently only marginally involved in electron
      transfer in wild-type azurin. Pathway calculations also suggest that a longer,
      through-backbone path is more efficient than the shorter one involving Trp48. The
      former pathway yields an exponential decay factor, beta, of 6.6 nm-1. Another
      mutation, raising the electron-transfer driving force, was produced by changing
      the Cu ligand Met121 to Leu, which increases the reduction potential by 100
      mV.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343522
TI  - The properties of the secreted gamma-glutamyl hydrolases from H35 hepatoma cells.
AB  - gamma-Glutamyl hydrolase has been partially purified and characterized from
      conditioned culture medium of H35 hepatoma cells. Evidence for heterogeneity of
      the enzyme is derived from its elution as three distinct peaks of enzymatic
      activity when the enzyme is purified by TSK-butyl-Sepharose column
      chromatography. These three enzyme fractions appear to have identical catalytic
      properties but, as yet, the basis for their resolution is not understood. A
      rapid, sensitive and simple assay based on reverse-phase HPLC fluorescent
      detection with pre-column derivatization using o-phthalaldehyde (OPA) was
      developed to separate OPA-derivatives of poly-gamma-glutamates and glutamic acid.
      Using this assay and the standard HPLC assay for pteroylpolyglutamates, the
      enzyme appears to be an endopeptidase with respect to pteroylpenta-gamma
      glutamate (PteGlu5), methotrexate penta-gamma-glutamate (4-NH2-10-CH3PteGlu5) and
      p-aminobenzoyl-penta-gamma-glutamate (pABAGlu5). The initial products are PteGlu1
      (or 4-NH2-10-CH3PteGlu1 or pABAGlu1) and intact tetra-gamma-glutamate, which is
      subsequently degraded to glutamic acid. When penta-gamma-glutamate is the
      substrate, the cleavage of the gamma-bonds by the enzyme is less ordered, with
      the early appearance of mono-, di-, tri- and tetraglutamate. Poly-alpha-glutamate
      is not a substrate nor are pABA-gamma-Glu5 or penta-gamma-glutamate covalently
      linked to albumin. 4-NH2-10-CH3PteGlu2 or Glu5 bound to dihydrofolate reductase
      is not a substrate for the enzyme, offering further evidence that protein
      associated poly-gamma-glutamates are poor substrates for gamma-glutamyl hydrolase
      from H35 hepatoma cells.

PMID- 8343524
TI  - AMP-deaminase from human uterine smooth muscle: the effect of DTNB treatment on
      kinetic and regulatory properties of the enzyme.
AB  - Reactivity of sulfhydryl groups of human uterine smooth muscle AMP-deaminase with
      DTNB, and the effect of their chemical modification on kinetic and regulatory
      properties of the enzyme were investigated. (1), Approx. 7 and 5 sulfhydryl
      groups per mol of the enzyme have been shown to be accessible for DTNB (5,5'
      dithiobis(2-nitrobenzoic acid)) titration in denaturated and native AMP
      deaminase, respectively. (2), Titrated groups were not homogenous; some of them
      reacted with DTNB much faster than others. (3), The activity of the modified
      enzyme was very low, and the modified enzyme manifested unusual hyperbolic
      saturation kinetics with the substrate. (4), Exhaustive dialysis against a buffer
      containing 10 mM thioethanol reactivated the modified enzyme, and restored its
      original regulatory properties. Experimental results obtained indicate that
      modified sulfhydryl groups play a significant role in the maintenance of the
      proper, catalytically-efficient conformation of the enzyme.

PMID- 8343523
TI  - Local variations in protein structure in the human eye lens: a Raman
      microspectroscopic study.
AB  - Confocal Raman microspectroscopy was used to monitor local and age-related
      changes in protein conformation in human eye lenses. In clear human lenses of
      varying age (range 17-80 years) spectra were recorded along the visual axis,
      using laser light of 660 nm wavelength. The Raman vibrations in the 650-1750 cm-1
      spectral region were analyzed. Difference spectra between central core and
      different positions along the visual axis were calculated after calibration for
      protein content using the I(1450) cm-1 CH2/CH3 vibration peak. Tryptophan content
      was quantified using the peak at 760 cm-1 calibrated for protein. Changes in the
      'exposed' vs. 'buried' position of tryptophan were analyzed using the peak
      heights at I(880) and I(760) cm-1. The difference spectra revealed an excess of
      tryptophan, tyrosine, phenylalanine, beta-sheet conformation and molecules or
      molecular groups responsible for a 1425 cm-1 peak in the core region in all
      lenses investigated. The excess peaks disappeared at about 0.6-0.9 mm below the
      surface. The tryptophan content increased from superficial to deep layers,
      levelling off between 0.4-0.8 mm below the surface. Upon aging, the tryptophan
      content increases in the core not in the cortex. No changes in the 'exposed' vs.
      'buried' position of tryptophan were observed. Changes in tryptophan and tyrosine
      probably reflect the maturational shift from cortex to core in the relative
      content of alpha, beta and gamma crystallines. The age-related increase in
      tryptophan in the core may reflect the preferential breakdown by endo- and
      exopeptidases of alpha-crystallins damaged upon aging. The increase in beta-sheet
      conformation may indicate a post-translational shift in secondary conformation
      upon aging. These changes in protein conformation are largely completed in a
      small superficial zone, i.e., in the early life span of the crystallins.

PMID- 8343525
TI  - Identification of the reactive cysteine residue in human placenta aldose
      reductase.
AB  - Modification of human placental aldose reductase by iodoacetate (IAA) led to a
      mol/mol binding of IAA, a 40% decrease in the kcat, a 3-5-fold increase in the
      Km,NADPH and Km,glyceraldehyde and a 600-fold increase in the Ki,sorbinil;
      determined at pH 6.0. NADPH and 2'-monophosphoadenosine 5'-diphosphoribose but
      neither glyceraldehyde nor sorbinil, prevented carboxymethylation-induced
      changes. Cleavage of [14C]IAA-modified enzyme by trypsin resulted in two
      radiolabeled peptides: Val-297 to Lys-307 and Val-297 to Phe-315. In both these
      peptides Cys-298 was the only radiolabeled residue. It is suggested that Cys-298
      regulates the kinetic and inhibition properties of the enzyme, but does not
      participate in catalysis.

PMID- 8343526
TI  - Comparison of acyl-carrier protein and other protein structures in aqueous
      solutions by Fourier-transform infrared spectroscopy.
AB  - Protein solution structures were analyzed by horizontal attenuated total
      reflectance (ATR) FTIR spectroscopy. Secondary structure compositions determined
      from analyses of amide-I and II region and amide-III region difference spectra
      were compared. Data for proteins of known solution structure, cytochrome c,
      concanavalin A and lysozyme, were compared with those reported in the literature.
      Melittin, a peptide from bee venom whose secondary structural configuration
      varies depending upon solution conditions was also examined. Acyl-carrier protein
      (ACP) is a small protein of recognized dynamic structure that in its diverse
      physiologic roles interacts specifically with numerous different proteins.
      Horizontal ATR FTIR analysis of ACP's secondary structure indicated a
      predominantly helical structure best defined as a combination of ordered and
      disordered helices. The FTIR-derived structural composition agreed with those
      determined for ACP by other techniques. Comparison of independent analyses of the
      amide-I and III regions to determine protein configuration compositions was a
      useful method of verifying the internal consistency of the calculated structural
      compositions of dynamically-structured proteins.

PMID- 8343527
TI  - 3-(Alkylthio)-N-hydroxysuccinimide derivatives: potent inhibitors of human
      leukocyte elastase.
AB  - A series of 3-(alkylthio)-N-hydroxysuccinimide derivatives was synthesized and
      their inhibitory activity towards human leukocyte elastase (HLE) was
      investigated. The interaction of the compounds having a 3-alkylthioether side
      chain (compounds 1 and 2) with HLE was found to involve rapid acylation of the
      enzyme, followed by total regain of enzymatic activity within 3 h. Interestingly,
      compounds 3-8, having an oxidized thioether side chain, were found to be highly
      effective, time-dependent, irreversible inhibitors of the enzyme. The k(obs)/I
      values for compounds 3-8 ranged between 890 and 24,000 M-1 s-1. These findings
      demonstrate that, unlike the physiological inhibitor of HLE (alpha-1-proteinase
      inhibitor), which is inactivated upon oxidation, low-molecular-weight compounds
      retain and/or show enhanced inhibitory activity towards HLE upon oxidation of the
      thioether side chain and lay the groundwork for the development of compounds that
      embody proteinase inhibitory and antioxidant activity.

PMID- 8343528
TI  - Thiols, gold-thiols, zinc-thiols and the redox state of hemoglobin.
AB  - The beta subunit of human hemoglobin can be oxidized site-specifically through
      beta-Cys-93 by Cu(II)(His)2. A series of thiol ligands, gold thiols and zinc(II)
      inhibit this oxidation. The thiol inhibitors formed a transient ternary
      intermediate involving Cu(I) with consequent inhibition of electron transfer from
      the Fe(II)-heme. The intermediate led to the formation of a disulfide at the beta
      Cys-93 site. The most effective thiols achieved maximum inhibition at one
      equivalent per beta heme. Gold thiols and zinc complexes inhibited heme oxidation
      by competing with the Cu(II)(His)2 for the beta-Cys-93 site.

PMID- 8343529
TI  - Identity and some properties of the L-threonine aldolase activity manifested by
      pure 2-amino-3-ketobutyrate ligase of Escherichia coli.
AB  - 2-Amino-3-ketobutyrate ligase catalyzes the reversible, pyridoxal 5'-phosphate
      dependent condensation of glycine with acetyl CoA forming the unstable
      intermediate, 2-amino-3-ketobutyrate. Several independent lines of evidence
      indicate that the pure protein obtained in the purification of this ligase from
      Escherichia coli also has L-threonine aldolase activity. The evidence includes:
      (a), a constant ratio of specific activities (aldolase/ligase) at all stages of
      purifying 2-amino-3-ketobutyrate ligase to homogeneity; (b), the same rate of
      loss of aldolase and ligase activities during controlled heat inactivation of the
      pure protein at 60 degrees C in the absence, as well as in the presence of acetyl
      CoA, a protective substrate; (c), ratios of the two enzymatic activities that are
      not significantly different during slow inactivation by iodoacetamide, with and
      without L-threonine added; (d), coincident rates of loss and essentially
      identical rates of recovery of aldolase activity and ligase activity during
      resolution of the holoenzyme with hydroxylamine followed by reconstitution with
      pyridoxal 5'-phosphate. No aldolase activity is observed with D-threonine as
      substrate and L-allothreonine is about 25% as effective as L-threonine. Whereas
      ligase activity has a sharp pH optimum at 7.5, the aldolase activity of this pure
      protein is maximal at pH 9.0. Comparative apparent Km values for glycine (ligase)
      and L-threonine (aldolase) are 10 mM and 0.9 mM, respectively, whereas
      corresponding respective Vmax values were found to be 2.5 mumol of CoA
      released/min per mg vs. 0.014 mumol of acetaldehyde formed (NADH oxidized)/min
      per mg.

PMID- 8343530
TI  - Purification and properties of a flavodoxin from the heterocystous cyanobacterium
      Anabaena sphaerica.
AB  - A flavodoxin was purified to homogeneity from the nitrogen-fixing heterocystous
      cyanobacterium Anabaena sphaerica grown under iron-limited conditions. The
      protein has a molecular mass of 21 kDa, and its spectral properties and amino
      acid composition are very close to that of flavodoxins from other cyanobacteria.
      A. sphaerica flavodoxin supported the activities of A. sphaerica NADP reductase
      and Clostridium butyricum hydrogenase in reconstituted systems with illuminated
      plant chloroplasts as reductant. With the use of polyclonal anti-flavodoxin
      antiserum it was found that nitrogen-fixing cultures of A. sphaerica grown under
      iron-sufficient conditions contain low but significant amounts of flavodoxin (0.2
      0.6 micrograms/mg crude extract protein) which increased dramatically (to 8-15
      micrograms/mg crude extract protein) after the iron concentration in the medium
      was decreased to below 1 microM Fe. The flavodoxin content of both iron-limited
      and iron-sufficient. A. sphaerica was also shown to depend upon the growth phase
      of the (batch) cultures with a maximum at early exponential phase, coinciding
      with maximal in-vivo nitrogenase activity. These results suggest that A.
      sphaerica flavodoxin not only substitutes for ferredoxin under iron-limiting
      conditions, but also fulfills some specific role under iron-sufficient
      conditions.

PMID- 8343531
TI  - The in-vivo identification of the MoFe protein (FeMo cofactor) of nitrogenase in
      Klebsiella pneumoniae and of the Mo-storage protein in Azotobacter vinelandii via
      the nuclear quadrupole interaction of 99Mo(beta-)99Tc.
AB  - The expression of the MoFe protein of nitrogenase in Klebsiella pneumoniae was
      identified in vivo via the nuclear quadrupole interaction (NQI) of 99Mo(beta
      )99Tc using perturbed angular correlations of gamma-rays. The NQI parameters
      were: omega approx. 360 Mrad/s and eta approx. 1. In addition, the NQI of the 'Mo
      storage protein' in Azotobacter vinelandii cells which had been grown in the
      presence of NH4+ (13 mM), i.e. under conditions of strict repression of
      nitrogenase synthesis, was determined: omega approx. 190 Mrad/s, eta approx.
      0.25. Under these conditions, the characteristic signal of the MoFe protein (FeMo
      cofactor) was absent.

PMID- 8343532
TI  - Fluorometric analysis of native, urea-denatured and refolded human prostatic acid
      phosphatase.
AB  - Human prostatic acid phosphatase (EC 3.1.3.2) was denatured in 6 M urea at pH
      2.5, but was refolded by dilution at pH 7.0, as demonstrated by the recovery of
      nearly complete enzyme activity and dimeric structure. The conformational changes
      among the native, denatured and refolded states were monitored by means of steady
      state and nanosecond pulse fluorometry of tryptophan residues of the enzyme. The
      relative quantum yield of the fluorescence was highest in the native enzyme and
      lowest in the denatured one, and was intermediate in the refolded enzyme,
      although the emission peak was reproducible after refolding. The observed decay
      curves of tryptophan fluorescence of the native, denatured and refolded states
      were analyzed by decay functions of three lifetimes. The fluorescence lifetimes
      of the refolded enzyme were shorter than those of the native one. The
      fluorescence of the denatured enzyme decayed much faster than that of the other
      forms. The fluorescence excitation spectra revealed that the excitation energy of
      phenylalanine was transferred to tryptophan(s) in the native and refolded forms,
      but not in the denatured form. The efficiency of the energy transfer was higher
      in the native enzyme than in the refolded one. It was found by excitation
      polarization spectra that the freedom of internal motion of tryptophans was
      greater in the refolded enzyme than in the native enzyme. In the denatured enzyme
      the polarization anisotropies were very low. These results indicate that the
      higher structure with respect to tryptophans of the refolded enzyme is delicately
      but definitely different from that of the native enzyme and that local
      conformation of the active center is recovered upon refolding.

PMID- 8343533
TI  - Purification and immunohistochemical tissue localization of human xanthine
      oxidase.
AB  - Xanthine oxidase was purified 1600-fold from human liver cytosol. The purified
      enzyme was shown as a single band of 300 kDa on polyacrylamide gel
      electrophoresis and 150 kDa on SDS-PAGE. Using this purified enzyme, polyclonal
      antibody against xanthine oxidase was raised in a rabbit. On Ouchterlony's double
      immunodiffusion method, the raised antibody and the human liver cytosol made a
      precipitation line stained by activity stain and protein stain, respectively.
      With the raised anti-xanthine oxidase sera, the immunohistochemical localization
      of xanthine oxidase in human tissues was examined. Immunostaining of frozen
      hepatic tissue section showed that the cytoplasm of hepatocytes and endothelial
      lining cells were stained. In a number of other tissues, the xanthine oxidase
      antigen was detected only in the endothelial lining cells from heart, kidney,
      brain, aorta, lung and mesentery, except for the duodenal mucosa cells. A
      possible role for xanthine oxidase in the endothelial cells from various human
      tissues in the pathogenesis of reperfusion injury was suggested.

PMID- 8343534
TI  - Nucleation of the iron core occurs at the three-fold channels of horse spleen
      apoferritin: an EXAFS study on the native and chemically-modified protein.
AB  - Extended X-ray absorbance fine structure measurements have been carried out on
      the initial Fe(III)-apoferritin complex at a Fe/subunit ratio of 2 in native and
      modified horse spleen apoferritin. Analysis of the data indicates that in the
      native protein the iron forms a protein-bound polynuclear cluster (Fe-Fe distance
      3.4 A) with a first coordination sphere constituted by 5-6 low-Z atoms, e.g.,
      nitrogen atoms, carboxylate-like ligands or oxo bridges between the iron atoms.
      Modification of Cys-126, a residue localized on the outer surface of the
      hydrophilic three-fold channels, with p-chloromercuribenzoate (PMB) or
      phenylmercuric acetate (PMA) brings about distinctive differences. In particular,
      in the PMB-reacted protein the feature assigned to the iron-iron interaction
      disappears from the spectrum, whilst in the PMA-reacted protein the main
      differences with respect to the native protein are observed at the level of the
      first coordination sphere. These results confirm the formation of protein-Fe(III)
      clusters and localize these sites at the hydrophilic three-fold channels of horse
      spleen apoferritin.

PMID- 8343535
TI  - Lipoprotein lipase gene expression: physiological regulators at the
      transcriptional and post-transcriptional level.

PMID- 8343536
TI  - Dietary polyunsaturated fats suppress the high-sucrose-induced increase of rat
      liver pyruvate dehydrogenase levels.
AB  - Pyruvate dehydrogenase complex (PDC) has a key role in the regulation of hepatic
      lipogenesis by dietary factors. We have investigated the effects of dietary
      carbohydrate and fat on hepatic PDC. Sucrose-based or starch-based diets were
      administered for 15 days. A positive correlation between PDC activity and the
      lipogenic potential of the diet was found. A high-sucrose, fat-free diet caused a
      3-fold increase in total activity whereas a high-starch, fat-free diet caused a
      1.5-fold increase, as compared with chow-fed rats. Dietary polyunsaturated fat
      (PUF) caused a marked inhibitory effect on total and active PDC; fish oil being
      more effective than corn oil. Dietary saturated fat (butter) failed to inhibit
      the sucrose-induced elevation in total activity, but was almost as effective as
      fish oil in depressing percent active enzyme. Changes in total PDC activity
      closely correlated with modifications in the content of enzyme quantitated by
      immunoblotting, indicating that increased enzyme content and not activation is
      the predominant mechanism underlying the adaptive response to high-sucrose
      feeding. This response is suppressed by dietary PUF. Inhibition of hepatic
      lipogenesis by PUF involves a reduction of PDC content as well as that of several
      lipogenic enzymes. The relevant mechanisms remain to be established.

PMID- 8343537
TI  - Biosynthesis of a novel 3-oxo-2-tetradecyloctadecanoate-containing phospholipid
      by a cell-free extract of Corynebacterium diphtheriae.
AB  - We have isolated, purified, and identified by chemical analyses and mass
      spectrometry, a novel 3-oxo-2-tetradecyloctadecanoate (dehydrocorynomycolate)
      containing phospholipid (PL-1) from the chloroform-methanol extract of
      Corynebacterium diphtheriae. This phospholipid was separated from all of the
      other known dehydrocorynomycolate and 3-hydroxy-2-tetradecyloctadecanoate
      (corynomycolate)-containing lipids and found to be unstable even at -20 degrees
      C. It was present in trace amounts as a homologous series (molecular weights of
      1400 and 1404 as the methyl esters) and composed of a dehydrocorynomycolate, a
      phosphate group, a diacylglycerol, and an unidentified amine-containing
      component. Because of the complexity of these phospholipids, their complete
      structural determination is yet to be completed. A cell-free extract of C.
      diphtheriae catalyzed the incorporation of radiolabel from [14C]palmitic acid
      into PL-1. This incorporation was ATP-dependent, and the rate was linear with
      respect to both time and protein concentration. The radiolabel was incorporated
      primarily into the dehydrocorynomycoloyl moiety of PL-1. While avidin did not
      show any significant effect, cerulenin showed a marked inhibition of this
      reaction. Based on these results, we suggest that this dehydrocorynomycolate
      containing PL-1 may be the long-sought acyl carrier-containing product of a
      Claisen-type condensation.

PMID- 8343538
TI  - Exposure of rabbit fetal lung to glucocorticoids in vitro does not enhance
      transcription of the gene encoding pulmonary surfactant-associated protein-B (SP
      B).
AB  - We have investigated the ontogeny and hormonal regulation of both synthesis rates
      and cellular accumulation of the mRNA for surfactant-associated protein B (SP-B)
      in rabbit fetal lung. The developmental pattern for SP-B mRNA synthesis increased
      as a function of gestational age and paralleled that for SP-B mRNA levels except
      on days 22-26 of gestation where relatively higher levels of gene transcription
      were observed. Time-course studies with explants from 26- and 30-day fetal lung
      maintained in culture revealed a gradual increase in mRNA levels and a much
      smaller increase in gene transcription relative to adult values. Within 48 h of
      exposure of 26-day explants to dexamethasone at 10(-8) M there was a rapid
      increase in SP-B mRNA levels to 7-fold adult levels. A similar overall although
      somewhat slower and attenuated pattern was observed with 30-day explants.
      Dexamethasone at 10(-8) M had no effect on SP-B gene transcription with explants
      of either gestational age. We conclude that the major effect of dexamethasone
      treatment in vitro on SP-B mRNA levels appears to be post-transcriptional and
      there are small but distinct differences in the effects of glucocorticoids on SP
      B mRNA levels with explant cultures from early and late stages of fetal lung
      maturation.

PMID- 8343539
TI  - Purification and characterization of Pseudomonas fluorescens SIK W1 lipase
      expressed in Escherichia coli.
AB  - Pseudomonas fluorescens SIK W1 lipase was expressed as a form of inclusion bodies
      in Escherichia coli, which was equivalent to 46% of total cell protein. The
      inclusion bodies isolated from other cell components were solubilized in the
      buffer containing 8 M urea and then refolded by diluting urea. The lipase with
      active conformation was purified by hydrophobic interaction chromatography, gel
      filtration, anion-exchange chromatography and hydroxyapatite chromatography from
      the refolded sample. By these purification steps, a single band for active lipase
      was detected on non-reducing SDS-PAGE and 10-fold purification was attained on
      the basis of specific activity. Specific activity of the purified lipase toward
      olive oil emulsion was found to be 7395 units per mg protein. The optimum pH and
      temperature of the lipase were pH 8.5 and 45-55 degrees C, respectively. The
      lipase showed higher lipolytic activity toward tricaproin (C6) and tricaprylin
      (C8) among the triacylglycerols examined and preferentially hydrolyzed ester bond
      of 1- and 3-position of triolein. Lipase activity was greatly increased by
      approx. 6-fold and stability for pH was shifted to alkaline pH by Ca2+ ion. The
      lipase was inhibited by Hg2+, Ag2+, p-chloromercuribenzoate, diethylpyrocarbonate
      and sodium dodecyl sulfate.

PMID- 8343540
TI  - A convenient evaluation of the stereoselectivity of lipase-catalyzed hydrolysis
      of tri-O-acylglycerols on a chiral-phase liquid chromatography.
AB  - A general method was developed using chiral-phase chromatography in order to
      evaluate the stereoselectivities of lipases-catalyzed hydrolysis of tri-O
      acylglycerols independent of acyl groups. 1,2-Di-O-acyl-sn-glycerols or its
      enantiomer 2,3-di-O-acyl-sn-glycerols in the enzymatic reaction mixtures were
      derivatized to the key compound, 1,2-di-O-benzoyl-3-O-tert-butyldimethylsilyl-sn
      glycerol 2 (+) or its enantiomer 2' (-), respectively. The enantiomers were
      separated on a chiral-phase HPLC, and the method was highly sensitive to
      determine the stereoselectivities of lipases.

PMID- 8343541
TI  - 1H-NMR spectroscopy can accurately quantitate the lipolysis and oxidation of
      cardiac triacylglycerols.
AB  - Triacylglycerol metabolism in isolated, perfused hearts from rats fed a diet
      containing 20% rapeseed oil (RSO) was studied using 1H-NMR spectroscopy. RSO
      induced elevation in cardiac triacylglycerols is associated with an increase in
      the peak area of fatty acid 1H-NMR resonances. The ratio of methyl, gamma
      methylene or methylene protons adjacent to a carbon-carbon double bond to the
      number of methylene protons in these hearts measured by 1H-NMR spectroscopy gives
      values similar to those derived from previously reported chemical analyses. In
      addition, the triacylglycerol content of these hearts determined by chemical
      analysis directly correlates with their content of 1H-NMR visible fatty acid
      resonances. This quantitative relationship allows the real-time measurement of
      the rates of cardiac triacylglycerol lipolysis using 1H-NMR spectroscopy. Rates
      of triacylglycerol lipolysis measured using 1H-NMR spectroscopy are similar to
      those previously measured by chemical methods. Triacylglycerol lipolysis measured
      using 1H-NMR spectroscopy occurs at a significantly faster rate in hearts
      perfused in the presence or absence of glucose when compared to hearts perfused
      with glucose and acetate or medium-chain fatty acids. Finally, the rate of
      triacylglycerol lipolysis in glucose perfused hearts is linearly related to work
      output. These results demonstrate that 1H-NMR spectroscopy can accurately
      quantitate triacylglycerol content and metabolism in the rapeseed oil-fed rat
      model. 1H-NMR spectroscopic or imaging techniques may be useful in the real-time
      evaluation of cardiac triacylglycerol content and metabolism.

PMID- 8343542
TI  - Purification of human gastric lipase by immunoaffinity and quantification of this
      enzyme in the duodenal contents using a new ELISA procedure.
AB  - Human gastric lipase (HGL) is the first lipolytic enzyme involved in the
      digestion of dietary lipids along the gastrointestinal tract. We describe an
      improved procedure for isolating the enzyme using immunoaffinity chromatography
      in combination with ion-exchange chromatography. The purified enzyme, showing a
      single band on SDS-PAGE, expressed a specific activity of 1000 U/mg using
      tributyrin as the substrate. We also describe a specific enzyme-linked
      immunosorbent assay (ELISA) procedure for measuring duodenal HGL levels. The
      ELISA was performed using an anti-HGL polyclonal antibody (pAb) as the captor
      antibody and a biotinylated monoclonal antibody (mAb) as the detector antibody.
      With the double sandwich ELISA technique, HGL in the range of 1-60 ng/ml was
      measured in less than 5 h. Identical HGL concentrations were obtained using the
      above ELISA procedure when compared to those based on the enzymatic activity
      using the potentiometric method (correlation coefficient: r = 0.95). No
      significant interference from other duodenal components was observed, as proved
      by the quantitative HGL determinations performed on intestinal samples.

PMID- 8343543
TI  - Increased hepatic monoacylglycerol acyltransferase activity in streptozotocin
      induced diabetes: characterization and comparison with activities from adult and
      neonatal rat liver.
AB  - Hepatic monoacylglycerol acyltransferase (EC 2.3.1.22) (MGAT) is a
      developmentally-expressed activity associated with physiological periods
      characterized by high rates of lipolysis and dependence on fatty acids for energy
      production. During these periods, MGAT may help to retain essential fatty acids
      selectively. In streptozotocin-diabetes, mean MGAT-specific activity increased
      11.8-fold. We characterized microsomal MGAT activity from diabetic and control
      adult rats, and compared these adult activities with the high neonatal activity.
      Compared with the activity in neonatal liver, adult MGAT activity was more
      thermolabile, had a markedly different pH profile, and responded differently to
      incubation with bovine serum albumin, phospholipids, and MnCl2. Adult diabetic
      MGAT activity was also stimulated 2-fold by albumin and was markedly
      thermolabile, but was not inhibited by phospholipid. Diabetic MGAT activity had
      some properties that combined characteristics observed in adult and neonatal
      microsomes: a pH dependence that was optimal at pH 7.0 but that plateaued between
      pH 7.0 and 9.5, and neither stimulation nor inhibition after incubation with
      MnCl2. Diabetic MGAT acylated monoalkylglycerols more readily than did either the
      neonatal or the adult MGAT activities. The enhanced expression of hepatic MGAT
      activity in diabetes is consistent with its postulated role in retaining
      essential fatty acids during lipolysis.

PMID- 8343544
TI  - Comparison of the lipid and apolipoprotein composition of skeletal muscle and
      peripheral lymph in control dogs and in dogs fed a high fat, high cholesterol,
      hypothyroid-inducing diet.
AB  - Most studies of peripheral interstitial fluid lipoprotein composition have been
      made on interstitial fluid-derived from skin and connective tissue. We developed
      techniques which allowed simultaneous comparison of lymph (a model of
      interstitial fluid) from skeletal muscle and skin in control (C) and cholesterol
      fed (CF) dogs. Lipoprotein fractions were separated by ultracentrifugation.
      Skeletal muscle interstitial fluid HDL concentrations were approximately twice
      those of skin. However, the concentration of VLDL-LDL particles was similar in
      both interstitial spaces. HDL particles from both microvascular beds showed
      evidence of extensive remodelling when compared to plasma HDL from the same
      animal. Relative to apo A-I, skeletal muscle HDL was enriched in free cholesterol
      and apo E (C and CF dogs) and apo A-IV (CF dogs). Skin-derived HDL was
      consistently enriched in free cholesterol, apo E and A-IV in both C and CF dogs.
      These studies indicate that similar remodeling of plasma HDL occurs in widely
      different tissues which together constitute approximately 70% of the total
      interstitial space. The relatively high concentration of plasma-derived and
      remodeled HDL within the interstitial space of skeletal muscle is consistent with
      that tissue's importance in reverse cholesterol transport.

PMID- 8343545
TI  - Alterations by clofibric acid of glycerolipid metabolism in rat-kidney.
AB  - Alterations induced by p-chlorophenoxyisobutyric acid (clofibric acid) in
      glycerolipid metabolism in rat-kidney were studied. (1) The treatment of rats
      with clofibric acid markedly decreased renal level of triacylglycerol, which
      seemed to be due to a reduced formation of triacylglycerol, since the in vivo
      incorporation of [14C]oleic acid (18:1), [14C]linoleic acid (18:2) and
      [3H]glycerol into triacylglycerol was decreased in clofibric acid-fed rats. (2)
      The administration of clofibric acid to rats increased proportions of 18:1 and
      18:2 and decreased a proportion of arachidonic acid (20:4) in
      phosphatidylcholine; the contents of two major molecular species of renal
      diacylglycerophosphocholine (diacyl-GPC), palmitoyl-arachidonoyl (16:0-20:4) and
      stearoylarachidonoyl (18:0-20:4), were both decreased markedly. The treatment did
      not alter renal content of phosphatidylcholine. (3) By contrast, clofibric acid
      changed, to a lesser extent, the composition of molecular species of
      diacylphosphatidylethanolamine. (4) The decrease in the level of diacyl-GPC that
      contains 20:4 seemed to be due to the clofibric acid-caused reduction in the
      concentration of free 20:4 in kidney. The reduction in renal concentration of
      free 20:4 seemed to be caused by a decrease in serum concentration of lipids that
      contain 20:4, but not by a decrease in the activities of desaturation and chain
      elongation that participate in biosynthesis of 20:4. (5) The reduction by
      clofibric acid in the renal content of diacyl-GPC containing 20:4 resulted in the
      decrease in the formation of prostaglandin E2 in kidney.

PMID- 8343547
TI  - Whose interest should have priority? Phase II: society's challenge for the next
      decade.

PMID- 8343546
TI  - Questions about child abuse? Consultation line created for physicians.

PMID- 8343548
TI  - Changes in medical care.

PMID- 8343549
TI  - Candidates for governor discuss health care issues.

PMID- 8343550
TI  - Abdominal actinomycosis, a common presentation of an increasingly uncommon
      infection.

PMID- 8343551
TI  - Urinary incontinence.

PMID- 8343552
TI  - Nursing diagnosis: a professional challenge for ET nursing.
AB  - ET nursing has an exciting and challenging opportunity to contribute to the
      advancement of nursing knowledge by the development of new nursing diagnoses and
      the revision of diagnoses already approved by the North American Nursing
      Diagnosis Association. This article discusses the significance of nursing
      diagnosis for nursing in general and ET nursing practice in particular. It also
      promotes exploration of the contribution ET nursing can offer through the common
      language of nursing diagnosis.

PMID- 8343553
TI  - Survey of the degree to which ET nurses are performing current procedural
      terminology-coded services.
AB  - ET nurses practice in many different settings including hospitals, home health,
      independent practice, and contract services. Reimbursement for their services is
      widely varied. To contribute meaningfully to health care reform, the services
      being provided by ET nurses must be identified. Familiarity with how these
      services overlap with those provided by other health care providers is essential.
      Current Procedural Terminology (CPT) codes, the language of payment within the
      health care system, are prepared and published annually by the American Medical
      Association for purposes of physician payment. Physicians are being paid for
      services that are also performed by ET nurses. This study identifies the CPT
      coded services used in the practice of the ET nurse and also codes that overlap
      those for which physicians are paid. Identification of ET nurse-provided CPT
      coded services delineates the ET nursing scope of practice and may serve as a
      foundation to address other practice issues, including reimbursement.

PMID- 8343554
TI  - Collaborative nurse management of multifactorial moist desquamation in a patient
      undergoing radiotherapy.
AB  - Consultation and collaboration between health care professionals can facilitate
      and improve patient care. In this case, Radiation Oncology and ET nurses
      collaborated in the care of a patient undergoing radiotherapy for esophageal
      carcinoma and concomitant corticosteroid therapy for cicatricial pemphigoid. The
      patient had moist skin desquamation during radiotherapy and was successfully
      treated by moist wound healing techniques with a hydrogel (Vigilon, C.R. Bard,
      Inc., Murray Hill, N.J.). The clinical success of nursing collaboration in this
      case affected assessment and treatment of moist desquamation in the Radiation
      Oncology department at one institution.

PMID- 8343555
TI  - ET nurses: on the front line of health care reform.
AB  - The most important challenge at the forefront of the national agenda is the need
      for health care reform. Major concerns of the current system are cost and access
      to care. This article discusses numerous congressional proposals and strategies
      for addressing these concerns. ET nurses are in a unique position to influence
      health care delivery. The Wound Ostomy and Continence Nurses Society has
      implemented strategies that position ET nurses as part of the solution to the
      health care crisis. ET nurses must also market themselves in their individual
      settings as key players in health care reform.

PMID- 8343557
TI  - Management of perineal and genital burns.
AB  - Burn injuries to the perineum and genitals present the bedside care provider with
      a unique set of management problems. Traditionally, thermal injuries to these
      areas have been allowed to close by secondary intention, with epithelialization
      occurring from remnants protected within skin folds. Partial-thickness wounds of
      the perineum and genitals must be kept clean and free of bacterial infection to
      prevent necrosis and development of full-thickness injury. Although full
      thickness thermal injuries to the penis and vulva are rare, they require special
      attention during the immediate postgrafting period to ensure complete
      engraftment. Control of scarring in this area requires tailor-made pressure
      garments, with customized inserts to provide controlled pressure to the skin
      folds.

PMID- 8343556
TI  - Twenty four-hour monitoring of incontinence and bladder function in a community
      hospital.
AB  - We wished to determine whether 24-hour monitoring of urinary incontinence without
      video urodynamics would provide adequate information for treatment. Twelve
      subjects with urinary incontinence (seven women and five men) were investigated,
      average age 75 years (range 44 to 89 years). Setting was a community hospital (80
      beds), a nursing home, and a lodge, 60 miles from the nearest assessment center.
      Twenty four-hour monitoring consisted of 2 hourly preweighed pad changes,
      postchange weighing, Uroflow set-up in subject's bathroom, fluid intake record,
      and 1 postvoid residual ultrasonogram. All subjects had history and physical and
      evaluation of medications. Findings included probable urge incontinence, stress
      incontinence, chronic retention with overflow, and normal bladder function.
      Recommendations included oxybutynin chloride, timed toileting, timed fluid
      restriction, diuretic manipulation, intermittent catheterization, pessary, and
      surgery. At 6 weeks, 25% (4/12) were better (three with urge incontinence and one
      after operation for stress incontinence). Video urodynamics were conducted only
      for the patient with stress incontinence after operation. We suggest that 24-hour
      monitoring is noninvasive, is less disruptive and less expensive than video
      urodynamics, and provides adequate information for initial treatment in many
      patients with urinary incontinence.

PMID- 8343558
TI  - Options in practice: another option explored.

PMID- 8343559
TI  - In vitro tumour cell growth inhibition: a comparative study between
      allosensitized cytotoxic T lymphocytes and lymphokine activated killer cells.
AB  - There is general agreement that several distinct subpopulation of lymphocytes,
      including major histocompatibility complex (MHC)-restricted T lymphocytes and non
      restricted natural killer, or lymphokine-activated killer (LAK), cells are active
      in lysing neoplastic cells. In this study experiments were designed to compare
      the inhibitory effects of LAK cells and allosensitized cytotoxic T lymphocytes
      (CTL) on in vitro growth of an Epstein-Barr virus-transformed B-cell line (BSM)
      and of a HTLV-I producer T-cell line (MT-2). It was found that allosensitized CTL
      are more efficient at inducing BSM, or MT-2, cell growth inhibition than LAK
      cells. These results are consistent with the hypothesis that MHC-restricted T
      effector cells could mediate higher tumour suppressive effects than non-MHC
      restricted LAK cells.

PMID- 8343560
TI  - Characterization and enumeration of spontaneously proliferating human leucocytes
      by multiparameter flow cytometry.
AB  - Spontaneously proliferating human leucocytes have been characterized and
      enumerated using multiparameter flow cytometry. The frequency of spontaneously
      proliferating cells amongst human peripheral blood mononuclear cells, was
      determined on the basis of BrdUrd incorporation and total DNA content in samples
      of cells incubated in medium without added mitogen for several days. The
      frequency of proliferating cells decreased from an initial level of approximately
      6 x 10(-4) to 3 x 10(-4) after 30 h of incubation, and then rose to approximately
      2 x 10(-2) after 100 h of incubation. In one reference person, the frequency
      showed only minor variation in this pattern over a 1.5 year interval.
      Simultaneous measurement of proliferation and determination of immunological
      subclass, as indicated with Hoechst 33342 staining and surface markers, showed an
      over-representation of CD19-positive cells, compared with CD2-positive cells and
      subsets of CD2-positive cells (CD4-positives and CD8-positives). This method can
      be used as an indicator of exposure to agents when results from animal tests are
      to be compared with results from human populations. The advantages are that no
      cell culturing is needed to perform the test, it provides the possibility of
      further characterizing proliferating cells, and the rapid flow-cytometric
      enumeration.

PMID- 8343561
TI  - A simplified HPLC method for simultaneously quantifying ribonucleotides and
      deoxyribonucleotides in cell extracts or frozen tissues.
AB  - Agents and conditions that induce alterations in deoxyribonucleotide pools can
      have important regulatory effects on the rate of DNA synthesis as well as cell
      cycle progression. A simplified procedure for the separation of both
      ribonucleoside triphosphates (NTP) and deoxyribonucleoside triphosphates (dNTP)
      is presented which utilizes reversed phase high-performance liquid chromatography
      coupled with diode array detection. The simultaneous resolution of NTP and dNTP
      peaks within the same cell extract effectively eliminates the need for post
      extraction steps such as periodate oxidation and/or boronate affinity
      chromatography previously used to degrade or isolate co-eluting NTP from dNTP.
      The resolution of two nucleotides, dGTP and ADP, was found empirically to vary
      with the efficiency of the C18 column. High efficiency columns (> 90,000
      plates/m) provided good separation; however, less efficient columns resulted in
      co-elution of dGTP and ADP. These co-eluting nucleotides can be accurately
      quantified, if necessary, using diode array technology and a mathematical
      expression which incorporates molar peak coefficients and peak areas obtained by
      monitoring at dual wave-lengths. Tissue samples or single cell suspensions were
      extracted with trichloroacetic acid and the neutralized extract was injected
      directly into the column without prior lyophilization. The per cent recovery of
      standards was > or = 99% and replicate extractions within or between samples were
      highly reproducible (SD < 5%). The single step method described minimizes
      potential losses associated with post-extraction manipulation and provides the
      capability to examine alterations in nucleotide precursor-product metabolism
      under various physiological and pharmacological conditions.

PMID- 8343562
TI  - Flow cytometric BrdUrd-pulse-chase study of heat-induced cell-cycle progression
      delays.
AB  - The flow cytometric, bromodeoxyuridine (BrdUrd)-pulse-chase method was extended
      by analysing five kinetic parameters to study perturbed cell progression through
      the cell cycle. The method was used to analyse the cell-cycle perturbations
      induced by heat shock. Exponentially growing, asynchronous Chinese hamster ovary
      (CHO) cells were pulse labelled with BrdUrd and simultaneously heated at 43
      degrees C for 5, 10 or 15 min. The cells were then incubated in a BrdUrd-free
      medium and, at various times thereafter, were prepared for flow cytometry. Five
      compartments (BrdUrd-labelled divided and undivided, and unlabelled G1, G1S, and
      G2) were defined in the resulting dual-parameter histograms. The fraction of
      cells and the mean DNA content, when appropriate, were calculated for each
      compartment. The rates of cell-cycle progression were assessed as time-dependent
      changes in the fraction of cells in a given compartment and/or the relative DNA
      content of cells within a given compartment. Linear regression analysis of the
      data revealed two distinct modes of alteration in cell progression: 1 a delay in
      cell transit (either out of or into a given compartment), and 2 a decrease in the
      rate of cell transit. Hyperthermia produced a delay in the exit of cells from the
      G1 compartment of approximately 16 min per minute of heat at 43 degrees C with no
      threshold. In contrast, the delay in the exit of cells from all other
      compartments showed a threshold of from 3 to 5 min at 43 degrees C. Above this
      threshold the delay in exit of cells from the BrdUrd-labelled, undivided
      compartment was approximately 25 min per minute of heat at 43 degrees C. The more
      complex dose-response function of this latter compartment may reflect the fact
      that it includes two cell-cycle phases, S and G2 + M. The decrease in the rate of
      transit out of G2 for cells heated in G2 was significantly larger than that for
      any other compartment, consistent with previous studies, which showed a G2
      accumulation following hyperthermia. These results indicate that heat exposure
      induces very complex alterations in cell-cycle progression and that this flow
      cytometric method offers a straightforward approach for observing such
      alterations.

PMID- 8343563
TI  - Evidence for altered cell-cycle traverse of the non-modal cells of the
      heteroploid MCa-11 line.
AB  - Classic stem cell theory states that the growth of heteroploid cell populations
      is due to the proliferation of 'main stemline' cells with modal DNA content and
      chromosome number. Cells with non-modal DNA content and chromosome number are
      thought to be blocked and/or destroyed at mitosis. To test this, we studied two
      chromosomally stable cell populations (mouse bone marrow and WCHE-5 cells) and
      one heteroploid, chromosomally diverse cell line (MCa-11). The heteroploid MCa-11
      cells showed significant [3H]dT labelling for cells with DNA contents below the
      modal G0/G1 peak and above the modal G2 peaks (P < 0.001). This was consistent
      with the presence of cells with the non-modal DNA content that were engaged in
      replicative DNA synthesis. A percentage labelled mitosis analysis showed that MCa
      11 cells with non-modal DNA content and chromosome number were able to complete
      mitosis, although with prolonged pre-karyokinetic time. These results suggest
      that many non-modal cells present in heteroploid cell populations are capable of
      continued proliferation.

PMID- 8343564
TI  - The Safe Medical Devices Act.

PMID- 8343565
TI  - Shadows and light.

PMID- 8343566
TI  - Evaluating damages in malpractice cases.

PMID- 8343567
TI  - Making direct mail work.

PMID- 8343568
TI  - Medical-legal Q & A. Utilization review.

PMID- 8343569
TI  - The interaction of DAPI with phospholipid vesicles and micelles.
AB  - The interactions of the dye 4',6-diamidino-2-phenylindole (DAPI) with
      phospholipids ordered in single bilayer vesicles of dioleylphosphatidylserine
      (DOPS) or dimyristoylphosphatidylcholine (DMPC) or micelles of
      monomyristoylphosphatidylcholine (MPC) have been investigated. Somewhat
      unexpectedly, the binding of this dye to such ordered structures is not affected
      by the ionic strength of the external medium, which suggests an embedding of DAPI
      into the hydrocarbon phase. The fluorescence enhancement of DAPI bound can be
      accomodated within a model previously proposed for the behaviour of DAPI bound to
      proteins (Mazzini et al., Biophys. Chem. 42 (1992) 101). From both static and
      dynamic anisotropy measurements, bound DAPI results severely restricted in its
      rotational freedom but insensitive to the temperature dependent phase transition
      of the saturated DMPC vesicles. The considerable tightness and specificity of the
      interactions between DAPI and ordered phospholipids are also deduced from
      preliminary fluorescence quenching studies (reduced accessibility of iodide ions
      towards DAPI bound and quenching effects by the chaotrop Nonidet P-40).

PMID- 8343570
TI  - Tryptophan mutants of human C5a anaphylatoxin: a fluorescence anisotropy decay
      and energy transfer study.
AB  - Three mutants of the anaphylatoxin C5a were prepared with positions 2, 64 and 70,
      respectively, substituted by tryptophan. The last mutant was additionally
      labelled at Cys27 for fluorescence energy transfer (FET) measurements. The
      structural integrity and biological activity of the molecules were not affected.
      Fluorescence anisotropy decay (FAD) measurements showed that the rotational
      correlation time for tryptophan decreases in the order: [Trp2]rhC5a >
      [Trp64]rhC5a > [Trp70]rhC5a, indicating an increasing mobility of the side chain.
      Measurements of the fluorescence energy transfer from Trp70 to the 1,5-AEDANS
      group at Cys27 yielded a distance distribution of 2.4 +/- 0.8 nm. This value is
      compatible with the C-terminal chain being arranged as a slightly stretched helix
      pointing away from the body of the molecule.

PMID- 8343571
TI  - Effect of linear reinsertion of receptor on the distribution of receptors around
      coated pits.
AB  - We consider a linear receptor reinsertion step in our kinetic model of the
      primary steps occurring in receptor-mediated endocytosis. In contrast with our
      previous zeroth order receptor reinsertion assumption, here we consider a first
      order process, and we study the effect of receptor diffusion on the trapping rate
      constant (k+) and the radial distribution of receptors around coated pits (grp).
      Using experimental data for low density lipoproteins (LDL) receptors on
      fibroblast cells, we find that the trapping of receptors by coated pits is
      diffusion-controlled for any value of the escaping rate constant (k-). This
      result is significantly different from our previous findings. In fact, for a
      zeroth order process, we find that either diffusion has no effect on k+ or, at
      the most, receptor trapping is 84% diffusion-controlled. Moreover, we find values
      for the receptor reinsertion rate constant (kappa), which range between 15% of
      the pit's invagination rate constant, lambda, and three halves lambda. In
      addition, the ratio kappa/lambda is equal to the ratio of the concentration of
      receptors in pits with respect to the internalized receptors. Comparison between
      the experimental radial distribution of receptors around pits and the theoretical
      should provide an indication of the diffusion effect on k+.

PMID- 8343572
TI  - End-to-end diffusion coefficients and distance distributions from fluorescence
      energy transfer measurements: enhanced resolution by using multiple acceptors
      with different Forster distances.
AB  - We measured distance distributions and end-to-end diffusion coefficients of donor
      acceptor pairs linked by a flexible methylene chain using frequency-domain
      fluorescence energy transfer measurements. The donor was an indole group, and two
      acceptors with different Forster distances were used. The uncertainties in the
      recovered parameters describing the end-to-end distance distribution and
      diffusion coefficient were rather large when each donor-acceptor pair was
      analyzed separately. It was not possible to resolve distance distributions in the
      presence of intra-molecular diffusion when the Forster distance was comparable to
      the mean and half-width of the distribution. Global analysis using two acceptors
      dramatically improved the resolution. Surprisingly, the Forster distances need
      not be very different, and a 20% difference between the two R0 values resulted in
      substantial improvements in resolution. Both the simulations and the experiments
      suggest the benefit of using global analysis with different Forster distances to
      obtain reliable distance distribution parameters in the presence of diffusion.

PMID- 8343573
TI  - Structure and dynamics of peptide-polynucleotide complexes.
AB  - The mode and the dynamics of LysTrpLys-binding to double helical DNA and to
      single stranded poly(A) has been analyzed by measurements of the chemical
      relaxation detected by fluorescence and of the rotational diffusion using the
      electric dichroism. The chemical relaxation, induced by electric field pulses,
      requires two exponentials for a satisfactory representation, indicating a two
      step reaction mechanism. The data are consistent with a bimolecular reaction step
      followed by a relatively slow intramolecular transition, which is expected to
      reflect "insertion" of the Trp-indole residues between the nucleic acid bases.
      The experimental data are analyzed quantitatively by global fitting with exact
      correction of the convolution due to the experimental device. In this procedure a
      complete set of relaxation curves is fitted directly to the reaction model and,
      thus artifacts resulting from erroneous assignments of coupled modes are avoided.
      According to this analysis the bimolecular reaction step is controlled by
      diffusion. The intramolecular transition in adenylate chains is found to be
      dependent on the chain length and on the ionic strength I: at I = 2.5 mM the
      "insertion" rate constant is 3 x 10(4) s-1 for the polymer and 2 x 10(5) s-1 for
      A(pA)19; the rate constant for poly(A) increases with increasing salt
      concentration. The corresponding "insertion" rate constant for DNA double helices
      with 30 kbp is 2.5 x 10(4) s-1. For DNA double helices we find again an increase
      of the "insertion" rate with increasing salt concentration and with decreasing
      chain length. The mode of LysTrpLys-binding to double helical DNA is compared
      with that of LysTyrLys, LysLeuLys and LysGlyLys by measurements of the rotational
      diffusion of complexes with restriction fragments of different chain lengths. The
      persistence lengths derived from these measurements do not reveal any special
      effects resulting from insertion of aromatic residues. Apparently "insertion" of
      indole rings into double helical DNA does not increase the length of the double
      helix, which may be attributed to a special form of insertion, e.g. partial
      insertion. According to these results the interaction of the indole residues of
      LysTrpLys with DNA double helices is not equivalent to e.g. intercalation of
      aromatic residues like ethidium-neither with respect to structure nor to
      dynamics.

PMID- 8343574
TI  - Lattice vibrations in crystalline L-alanine.
AB  - Zwitterionic L-alanine forms crystals containing strong hydrogen-bonding and
      methylmethyl interactions. Well-defined low-frequency lattice vibrations exist in
      the crystals involving correlated intermolecular motions on the picosecond
      timescale. A characterization of these vibrations is expected to provide useful
      information on the nature of nonbonded interactions in peptides and proteins. We
      examine some of the vibrations using coherent inelastic neutron scattering and
      computer simulation techniques. The neutron scattering measurements are used to
      determine phonon dispersion relations for the acoustic and some low-frequency
      optic modes in the crystal. There is evidence for interaction between the two
      lowest frequency optical phonons and the longitudinal acoustic mode. The velocity
      of sound is anisotropic and can be correlated with the hydrogen-bonding
      arrangement in the crystal. Corresponding phonon dispersion relations are derived
      from normal mode analyses of the crystal using the program CHARMM. Although some
      calculated vibrational frequencies are somewhat too high, the form of the
      calculated dispersion relations are in good agreement with experiment.

PMID- 8343575
TI  - Molecular dynamics of sickle and normal hemoglobins.
AB  - Molecular dynamics (MD) simulations have been carried out for 62.5 ps on crystal
      structures of deoxy sickle cell hemoglobin (HbS) and normal deoxy hemoglobin
      (HbA) using the CHARMM MD algorithm, with a time step of 0.001 ps. In the
      trajectory analysis of the 12.5-62.5 (50 ps) simulation, oscillations of the
      radius of gyration and solvent-accessible surface area were calculated. HbS
      exhibited a general contraction during the simulation, while HbA exhibited a
      nearly constant size. The average deviations of simulated structures from the
      starting structures were found to be 1.8 A for HbA and 2.3 A for HbS. The average
      rms amplitudes of atomic motions (atomic flexibility) were about 0.7 A HbA and
      about 1.0 A for HbS. The amplitudes of backbone motion correlate well with
      temperature factors derived from x-ray crystallography. A comparison of
      flexibility between the alpha- and beta-chains in both HbA and HbS indicates that
      the beta-chains generally exhibited greater flexibility than the alpha-chains,
      and that the HbS beta-chains exhibit greater flexibility in the N-terminal and D-
      and F-helix regions than do those of HbA. The average amplitude of backbone
      torsional oscillations was about 9 degrees, a value comparable with that of other
      simulations, with enhanced torsional oscillation occurring primarily at the ends
      of helices or in loop regions between helices. Comparison of atomic flexibility
      and torsional oscillation results suggests that the increased beta-chain
      flexibility results from relatively concerted motions of secondary structure
      elements. The increased flexibility may play an important role in HbS
      polymerization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343576
TI  - Self-assembly of bioelastomeric structures from solutions: mean-field critical
      behavior and Flory-Huggins free energy of interactions.
AB  - Elastic and quasi-elastic light scattering studies were performed on aqueous
      solutions of poly(Val-Pro-Gly-Gly), a representative synthetic bioelastomer that
      differs from the previously studied poly(Val-Pro-Gly-Val-Gly) by the deletion of
      the hydrophobic Val in position four. When the spinodal line was approached from
      the region of thermodynamic stability, the intensity of light scattered by
      fluctuations, and the related lifetime and correlation length, were observed to
      diverge with mean-field critical exponents for both systems. Fitting of the
      experimental data allowed determining the spinodal and binodal (coexistence)
      lines that characterize the phase diagrams of the two systems, and it also
      allowed a quantitative sorting out of the enthalpic and entropic contributions to
      the Flory-Huggins interaction parameters. The contribution of valine is derived
      by comparison of the two cases. This can be viewed as sorting out the effect of a
      modulation of the solute. The same approach may allow sorting out the entropic
      and enthalpic effect of modulations of the solvent by cosolutes (or by
      cosolvents). This could be of particular interest in the case of small osmolytes,
      affording important adaptive roles in nature, at the cost of very limited changes
      in genetic information. Finally, the suggestion is further supported that
      statistical fluctuations of anomalous amplitude, such as those occurring in
      proximity of the spinodal line, have a role in promoting the process of self
      assembly of extended supramolecular structures. On the practical side, the
      present approach appears useful in the design of novel synthetic model systems
      for bioelastomers.

PMID- 8343577
TI  - Further characterization of the kinetic folding intermediate of alpha alpha
      tropomyosin and of its 142-281 subsequence.
AB  - The backbone CD spectrum from 250 to 212 nm for the kinetic folding intermediate
      of alpha alpha-tropomyosin (alpha alpha-Tm) and nonpolymerizable alpha alpha-Tm
      was obtained. The spectrum shows that the intermediate is indeed alpha-helical
      with about 70% of the equilibrium alpha-helix content. Subsequence 142Tm281 of
      the alpha-tropomyosin chain has five tyrosine residues (at positions 162, 214,
      221, 261, 267). Stopped flow CD at the negative peak in the tyrosine spectral
      region (280 nm) shows that any tyrosine residues that contribute to the spectrum
      in the region have already reached their final state in the fast phase of folding
      (< 0.04 s).

PMID- 8343578
TI  - Unfolding of an alpha-helix in peptide crystals by solvation: conformational
      fragility in a heptapeptide.
AB  - The structure of the peptide Boc-Val-Ala-Leu-Aib-Val-Ala-Leu-OMe has been
      determined in crystals obtained from a dimethylsulfoxide-isopropanol mixture.
      Crystal parameters are as follows: C38H69N7O10.H2O.2C3H7OH, space group P2(1), a
      = 10.350 (2) A b = 26.084 (4) A, c = 10.395 (2) A, beta = 96.87 (12), Z = 2, R =
      8.7% for 2686 reflections observed > 3.0 sigma (F). A single 5-->1 hydrogen bond
      is observed at the N-terminus, while two 4-->1 hydrogen bonds characteristic of a
      3(10)-helix are seen in the central segment. The C-terminus residues, Ala(6) and
      Leu(7) are extended, while Val(5) is considerably distorted from a helical
      conformation. Two isopropanol molecules make hydrogen bonds to the C-terminal
      segment, while a water molecule interacts with the N-terminus. The structure is
      in contrast to that obtained for the same peptide in crystals from methanol-water
      [I. L. Karle, J. L. Flippen-Anderson, K. Uma, and P. Balaram (1990) Proteins:
      Structure, Function and Genetics, Vol. 7, pp. 62-73] in which two independent
      molecules reveal an almost perfect alpha-helix and a helix penetrated by a water
      molecule. A comparison of the three structures provides a snapshot of the
      progressive effects of solvation leading to helix unwinding. The fragility of the
      heptapeptide helix in solution is demonstrated by nmr studies in CDCl3 and
      (CD3)2SO. A helical conformation is supported in the apolar solvent CDCl3,
      whereas almost complete unfolding is observed in the strongly solvating medium
      (CD3)2SO.

PMID- 8343579
TI  - Probing protein structure by solvent perturbation of NMR spectra. II.
      Determination of surface and buried residues in homologous proteins.
AB  - The experimental assignment of most residues in a protein to the surface or
      interior is in principle possible without prior solution of a complete three
      dimensional structure. The method described is based on nmr measurements that
      determine the amino acid composition of the surface of a protein [A. Petros, L.
      Mueller, and K.D. Kopple (1990) Biochemistry, Vol. 29, pp. 10041-10048; G.
      Esposito, A. M. Lesk, H. Molinari, A. Motta, N. Niccolai, and A. Pastore (1992)
      Journal of Molecular Biology, Vol. 224, pp. 659-670]. If these measurements are
      carried out on several homologous proteins of known sequence, it is possible to
      combine the results to determine, in most cases, which positions in the sequence
      contain exposed residues.

PMID- 8343580
TI  - A method for studying the structure of uniaxially aligned biopolymers using solid
      state 15N-nmr: application to Bombyx mori silk fibroin fibers.
AB  - Recent advances in the application of solid state nmr spectroscopy to uniformly
      aligned biopolymers have opened a window through which to view the detailed
      structure of biological macromolecules that are unable to be seen with standard
      techniques for structure determination such as x-ray diffraction. Atomic
      resolution structural details are obtained from solid state nmr data in the form
      of bond orientations, which yield the relative positions of specific atoms within
      the molecule. For static aligned systems such as fibers, in which rapid
      reorientation about the axis of alignment does not occur, it has generally been
      necessary to perform trial and error line-shape simulations to extract structural
      details from nmr spectra arising from a single type of nuclear spin interaction.
      In the present work, a new method is developed in which solid state 15N-nmr
      spectra obtained from uniaxially aligned molecules placed with the axis of
      alignment both parallel and perpendicular to the magnetic field are analyzed to
      yield the orientations of specific molecular bonds. Analytical expressions are
      derived that utilize spectral features read from 15N chemical shift anisotropy
      line shapes to calculate a discrete number of possible orientations for a
      specific site. The 15N-1H dipolar interaction is employed to further narrow the
      number of unique orientations possible for a given site. With this method, a
      neighborhood of possible orientations is quickly determined, and full line-shape
      simulations within this region of allowed space can be performed to refine the
      limits of orientation. This technique demonstrates the use of a single type of
      isotopic label to determine the orientation of a specific molecular group such as
      a peptide plane within a protein. Results from the application of this method to
      the Bombyx mori silk fibroin protein provide structural detail that is consistent
      with currently accepted structural models based on fiber diffraction studies.

PMID- 8343581
TI  - Special issue: 3rd Naples Workshop on Conformational Analysis of Peptides:
      Relationships and Interactions. Capri, May 24-27, 1992.

PMID- 8343582
TI  - Improved molecular dynamics simulations for the determination of peptide
      structures.
AB  - In this article a few methods or modifications proven to be useful in the
      conformational examination of peptides and related molecules by molecular
      dynamics are illustrated. The first is the explicit use of organic solvents in
      the simulations. For many cases such solvents are appropriate since the nmr
      measurements (or other experimental observations) were carried out in the same
      solvent. Here, the use of dimethylsulfoxide and chloroform in molecular dynamics
      is described, with some advantages of the use of these solvents high-lighted. A
      constant allowing for the scaling of the nonbonded interactions of the force
      field, an idea previously employed in distance geometry and simulated annealing,
      has been implemented. The usefulness of this method is that when the nonbonded
      term is turned to zero, atoms can pass through each other, while the connectivity
      of the molecule is maintained. It will be shown that such simulations, if a
      sufficient driving force is present (i.e., nuclear Overhauser effects
      restraints), can produce the correct stereoconfiguration (i.e., chiral center) as
      well as configurational isomer (i.e., cis/trans isomers). Lastly, a penalty term
      for coupling constants directly related to the Karplus curve has been implemented
      into the potential energy force field. The advantages of this method over the
      commonly used dihedral angle restraining are discussed. In particular, it is
      shown that with more than one coupling constant about a dihedral angle a great
      reduction of the allowed conformational space is obtained.

PMID- 8343584
TI  - Noncoded residues as building blocks in the design of specific secondary
      structures: symmetrically disubstituted glycines and beta-alanine.
AB  - Structural changes can be induced in a peptide by selective substitution of coded
      alpha-amino acid residues by noncoded alpha-amino acid residues and the
      consequent production of analogues with modified structure and conformational
      preferences. In this review article we summarize the solid state structural
      results and the conformational preferences of two classes of "building blocks":
      (a) the linear and cyclic symmetrically alpha, alpha-disubstituted glycines in
      which either two identical n-alkyl groups replace the hydrogen atoms of the
      glycine residue or a cyclic aliphatic side-chain system is formed by linking the
      two alpha-carbon side chains, respectively; and (b) the beta-alanine residue.
      Examples, whenever possible, of the use of these residues for the elucidation of
      the bioactive conformation in the appropriate biological systems will be given.

PMID- 8343583
TI  - CD of proline-rich polypeptides: application to the study of the repetitive
      domain of maize glutelin-2.
AB  - An overview of CD of proline-rich peptides is reported. First, structural
      characteristics, theoretical CD studies, and the biological relevance of
      polyproline II structure in such peptides are discussed. Second, a CD study of
      peptides belonging to the repetitive domain of maize glutelin-2, H-(Val-His-Leu
      Pro-Pro-Pro)n-OH (n = 3, 5, 8), is described. This series of peptides displayed
      the CD features of polyproline II structure in water (5 degrees C, pH 5).
      Moreover, it was shown that the addition of increasing amounts of the polyanionic
      molecule heparin forced a displacement of the conformational equilibrium of those
      peptides toward higher proportions of the polyproline II structure. In contrast,
      when the temperature is raised such a structure gradually disappears, leading to
      more disordered conformations.

PMID- 8343585
TI  - Structures of peptides from alpha-amino acids methylated at the alpha-carbon.
AB  - The structural preferences of peptides (and depsipeptides) from the achiral MeAib
      and Hib residues, and the chiral Iva, (alpha Me) Val, (alpha Me) Leu, and (alpha
      Me) Phe residues, as determined by conformational energy computations, x-ray
      diffraction analyses, and 1H-nmr and spectroscopic studies, are reviewed and
      compared with literature data on Aib-containing peptides. The results obtained
      indicate that helical structures are preferentially adopted by peptides rich in
      these alpha-amino acids methylated at the alpha-carbon. Intriguing experimental
      findings on the impact of the chirality of Iva, (alpha Me) Val, and (alpha Me)
      Phe residues on helix screw sense are illustrated.

PMID- 8343586
TI  - Bioactive peptides: conformational study of a cystinyl cycloheptapeptide in its
      free and calcium complexed forms.
AB  - The disulphide bridged heptapeptide Boc-Cys-Val-Pro-Pro-Phe-Phe-Cys-OMe has been
      synthesized by classical solution methods. An ion binding study showed the
      peptide's ability to complex calcium ions with definite stoichiometry. The
      solution conformation of the peptide in its free and calcium-complexed form has
      been investigated by CD and nmr. The model structure derived from nmr data has
      been energy minimized and the resulting structure investigated by molecular
      dynamics simulation in water. The structure of the equimolar peptide/Ca2+ complex
      in acetonitrile at room temperature shows the presence of two transannular
      hydrogen bonds, with the formation of two ring structures of the C10 (type VIa)
      and C14 type. One peptide unit (Pro-Pro) is cis, all others are trans.

PMID- 8343587
TI  - Crystal structures of two cyclic pseudopentapeptides containing psi[CH2S] and
      psi[CH2SO] backbone surrogates.
AB  - The solid state conformations of cyclo [Gly-Pro psi[CH2S] Gly-D-Phe-Pro] and
      cyclo [Gly-Pro psi[CH2-(S)-SO]Gly-D-Phe-Pro] have been characterized by X-ray
      diffraction analysis. Crystals of the sulfide trihydrate are orthorhombic,
      P2(1)2(1)2(1), with a = 10.156(3) A, b = 11.704(3) A, c = 21.913(4) A, and Z = 4.
      Crystals of the sulfoxide are monoclinic, P2(1) with a = 10.662(1) A, b =
      8.552(3) A, c = 12.947(2) A, beta = 94.28(2), and Z = 2. Unlike their all-amide
      parent, which adopts an all-trans backbone conformation and a type II beta-turn
      encompassing Gly-Pro-Gly-D-Phe, both of these peptides contain a cis Gly1-Pro2
      bond and form a novel turn structure, i.e., a type II' beta-turn consisting of
      Gly-D-Phe-Pro-Gly. The turn structure in each of these peptides is stabilized by
      an intramolecular H bond between the carbonyl oxygen of Gly1 and the amide proton
      of D-Phe4. In the cyclic sulfoxide, the sulfinyl group is not involved in H
      bonding despite its strong potential as a hydrogen-bond acceptor. The crystal
      structure made it possible to establish the absolute configuration of the
      sulfinyl group in this peptide. The two crystal structures also helped identify a
      type II' beta-turn in the DMSO-d6 solution conformers of these peptides.

PMID- 8343588
TI  - Solid state and solution structure of Boc-L-Ala-delta Phe-delta Phe-NHMe: a
      dehydropeptide showing propensity for 3(10)-helices of both screw senses.
AB  - The crystal and molecular structure of the peptide Boc-L-Ala-delta Phe-delta Phe
      NHMe, containing two consecutive dehydro-phenylalanine (delta Phe) residues, has
      been solved by x-ray diffraction. Two independent molecules, X and Y, are present
      in the crystallographic unit. Their conformation corresponds approximately to an
      incipient 3(10)-helix stabilized by two intramolecular hydrogen bonds. The (phi,
      psi) torsion angles, however, have negative and positive signs in the two
      molecules X and Y, respectively. Therefore, in spite of the presence of an amino
      acid residue of the L configuration, the two helical molecules have opposite
      screw senses, even though the right-handed helix is less distorted than the left
      handed one in correspondence of the L-Ala residue. The CD spectra in various
      solvents exhibit exciton bands originating from dipole-dipole interaction between
      the delta Phe side chains. Addition of DMSO to the chloroform solution produces,
      as a first step, a strong increasing of the CD bands, which are then
      progressively canceled by increasing DMSO concentration. The nmr data parallel
      the behavior observed in the CD spectra. In CDCl3 solution, the temperature
      coefficients of the NH resonances are consistent with the involvement of the last
      two amide protons of the sequence in intramolecular hydrogen bonds, but only
      negligibly small nuclear Overhauser effects (NOE) are observed. Addition of 5%
      DMSO-d6 allows the observation of diagnostic NOEs. CD and nmr data indicate that
      the solid state structure is retained in solution, and are consistent with the
      presence of right-handed and left-handed conformers, with a prevalence of the
      more stable right-handed one.

PMID- 8343590
TI  - The evaluation and interpretation of cervical cytology: application of the
      likelihood ratio concept.
AB  - The Papanicolaou smear (Pap test), used for the detection and prevention of
      neoplastic lesions of the cervix, is known to have both false negative and false
      positive results. Proper handling of the diagnostic uncertainty resulting from
      these errors demands quantification of flaws. Traditionally, sensitivity,
      specificity and predictive values are used for that aim. In this study another
      approach is advocated, namely the use of the likelihood ratio. For cervical
      cytology this ratio is the quotient of the probability of a Pap class within the
      diseased population to the probability of that same Pap class within the non
      diseased group. This approach enables the characterization of each Pap class
      separately, and is therefore much better for clinical interpretation of the
      result. It is also a superior approach for quality assessment.

PMID- 8343589
TI  - Conformational requirements for molecular recognition of acetylcholine receptor
      main immunogenic region (MIR) analogues by monoclonal anti-MIR antibody: a two
      dimensional nuclear magnetic resonance and molecular dynamics approach.
AB  - The conformational properties of two [D-A70, A76] and [Aib70, A76] analogues of
      the alpha 67-76 Torpedo acetylcholine receptor fragment, with low binding
      capacity for the anti main immunogenic region (MIR) antibodies, were studied in
      DMSO by two-dimensional nmr techniques and molecular dynamics simulations. The
      results were compared to the free and bound conformations of the [A76] analogue,
      which has twice more affinity for the anti-MIR monoclonal antibody 6 (mAb6), than
      the natural Torpedo sequence. It appeared that a single substitution of the A70,
      at a crucial position, by the D-A70 or Aib70, could modify completely the
      conformational behavior of the peptide and reduced its recognition by the anti
      MIR antibody. The WNPADY rigid structure at the N-terminal part was essential for
      antibody recognition. The adjacent more flexible C-terminal sequence (GGIK) gives
      additional stability to the monoclonal antibody-peptide complex probably due to
      an adequate orientation of the peptide side chains in the complex, by setting
      them in close contact with the antibody.

PMID- 8343591
TI  - Ciliary ultrastructure in nasal brushings.
AB  - Normal ciliary ultrastructure is thought to be necessary for effective function.
      There has been little or no attempt to quantify ultrastructural abnormalities in
      nasal disease and assess their significance. In this study we measured nasal
      ciliary function and examined ciliary ultrastructure in nasal brushings from 35
      patients with perennial nasal symptoms refractory to treatment. Ultrastructural
      defects included microtubular abnormalities, compound cilia and ciliary 'blebs'.
      The incidence of abnormal cilia was 16.7%, compared with 9% in controls, but
      there was only a poor correlation between ultrastructural defects and ciliary
      beat frequency. One patient had primary ciliary dyskinesia (PCD) with a typical
      clinical history and immotile cilia. However, only secondary ultrastructural
      abnormalities were seen. We have been unable to show that ciliary ultrastructural
      defects form the basis of impaired function. In patients with suspected PCD,
      nasal brushings should be taken for functional and ultrastructural studies;
      ideally, a further sample should be obtained for examination of possible primary
      ultrastructural abnormalities.

PMID- 8343592
TI  - Evidence that the sensitivity is increased and the inadequacy rate decreased when
      pathologists take aspirates for cytodiagnosis.
AB  - The results of the diagnostic accuracy of breast fine needle aspiration specimens
      taken by the pathologist in a joint surgical clinic are compared with those taken
      by a surgeon. In the joint clinic the complete sensitivity rose by 15% and the
      number of missed malignancies fell by half.

PMID- 8343593
TI  - A case of pilomatrixoma misdiagnosed as squamous cell carcinoma.

PMID- 8343594
TI  - Prolapsed fallopian tube after abdominal hysterectomy: a report of the
      cytological findings.

PMID- 8343595
TI  - A poplar tree proteinase inhibitor-like gene promoter is responsive to wounding
      in transgenic tobacco.
AB  - Wounding of poplar trees leads to the accumulation of several mRNA species that
      encode proteins with putative defensive function. One class of wound-induced
      poplar RNA (win3) has amino acid sequence similarity to Kunitz-type trypsin
      inhibitors. Northern blots and cDNA sequencing show that several win3 mRNAs
      accumulate in the uninjured leaves of wounded trees. We report further
      characterization of the win3 family including sequence comparisons, gene family
      organization, and the identification of one win3 member that is transcriptionally
      activated in response to mechanical wounding. We also show that 1.5 kb of 5'
      flanking sequence of one win3 member (win3.12) is sufficient to confer wound
      regulated expression of a beta-D-glucuronidase (GUS) reporter gene in transgenic
      tobacco. Annual herbaceous plants such as tobacco can thus be used to study the
      expression of genes from a perennial woody angiosperm.

PMID- 8343597
TI  - Identification and genetic analysis of normal and mutant phytoene synthase genes
      of tomato by sequencing, complementation and co-suppression.
AB  - A tomato phytoene synthase gene, Psy1, has recently been isolated as the clone
      GTOM5 and shown by sequence identity to be the gene from which the major fruit
      ripening cDNA clone TOM5 was derived. Sequence analysis of transcripts from two
      allelic yellow-fruited tomato mutants, mapped to chromosome 3, has shown the lack
      of carotenoids in fruit of these mutants to be due to the production of aberrant
      TOM5 transcripts which are unlikely to encode a functional phytoene synthase
      enzyme. In one mutant (yellow flesh) the aberrant transcript contained a sequence
      that, by its strong hybridization to a wide size range of genomic fragments,
      appeared to be repeated many times within the genome. Southern and PCR analysis
      of the phytoene synthase genes in the mutant revealed restriction fragment length
      polymorphisms, suggesting that the production of altered mRNAs was associated
      with specific genomic rearrangements. Constitutive over-expression of a TOM5 cDNA
      clone in transgenic mutant plants restored synthesis of the carotenoid lycopene
      in ripening fruit and also led to unscheduled pigment production in other cell
      types. In some mutant plants transformed with the TOM5 cDNA construct, inhibition
      of carotenoid production in immature green fruit, leaves and flowers was
      observed, due to the phenomenon of co-suppression, indicating that different
      insertion events with the same gene construct can lead to overexpression or co
      suppression in transgenic plants. Green organs of these plants were susceptible
      to photobleaching, due to the lack of carotenoids. These results suggest the
      existence of separate Psy genes for carotenoid synthesis in green organs.

PMID- 8343596
TI  - Systemic induction of a potato pin2 promoter by wounding, methyl jasmonate, and
      abscisic acid in transgenic rice plants.
AB  - To address the question whether common signal(s) and transduction pathways are
      used to mediate a systemic wound response in monocot and dicot plants, a fusion
      of the potato proteinase inhibitor II gene (pin2) promoter and the bacterial beta
      glucuronidase gene (Gus)-coding region was introduced into rice. In transgenic
      rice plants, the expression of the pin2-Gus fusion gene displays a systemic wound
      response, although the expression level is relatively low. Incorporation of the
      first intron from the rice actin 1 gene (Act1) into the 5'-untranslated region of
      the pin2-Gus construct results in high-level, systemically wound-inducible
      expression of the modified construct in transgenic rice plants. Histochemical
      analysis shows that this high-level, wound-inducible expression is associated
      with the vascular tissue in both leaves and roots. Furthermore, the expression of
      the pin2-Act1 intron-Gus fusion gene in transgenic rice plants can be
      systemically induced by both methyl jasmonate (MJ) and the phytohormone abscisic
      acid (ABA). These results suggest that the signal(s) mediating the observed
      systemic wound response and certain steps of the transduction pathways are
      conserved between dicot and monocot plants. Transient expression assays show that
      the pin2-Act1 intron-Gus construct is also actively expressed in transformed
      cells and tissues of several other monocot plants. Thus, the wound-inducible pin2
      promoter in combination with the rice Act1 intron 1 might be used as an efficient
      regulator for foreign gene expression in transgenic monocot plants.

PMID- 8343598
TI  - Chromosomal locations of the genes for histones and a histone gene-binding
      protein family HBP-1 in common wheat.
AB  - The chromosomal locations of the genes in common wheat that encode the five
      histones and five members of the HBP (histone gene-binding protein)-1 family were
      determined by hybridizing their cloned DNAs to genomic DNAs of nullitetrasomic
      and telosomic lines of common wheat, Triticum aestivum cv. Chinese Spring. The H1
      and H2a genes are located on different sets of homoeologous chromosomes or
      chromosome arms, namely, 5A, 5B and 5D, and 2AS, 2BS and 2DS, respectively. Genes
      for the other histones, H2b, H3 and H4, are found in high copy number and are
      dispersed among a large number of chromosomes. The genes for all members of the
      HBP-1 family are present in small copy numbers. Those for HBP-1a(1) are located
      on six chromosome arms, 3BL, 5AL, 5DL, 6AL, 6BS and 7DL, whereas those for each
      HBP-1a(c14), 1a(17), 1b(c1), and 1b(c38) are on a single set of homoeologous
      chromosome arms; 4AS, 4BL, 4DL; 6AS, 6BS, 6DS; 3AL, 3BL, 3DL; and 3AS, 3BS, 3DS,
      respectively. The genes for histones H1 and H2a, and for all members of the HBP-1
      family except HBP-1a(1) are assumed to have different phylogenetic origins. The
      genes for histone 2a and HBP-1a(17) are located in the RFLP maps of chromosomes
      2B and 6A, respectively. Gene symbols are proposed for all genes whose
      chromosomal locations have been determined.

PMID- 8343599
TI  - A structural and evolutionary analysis of a dispersed repetitive sequence.
AB  - A family of dispersed repetitive sequences (Hch1) which is present in the genome
      of the wild barley Hordeum chilense was studied in detail. Hch1 sequences are
      found both as part of short tandem arrays and dispersed throughout the H.
      chilense chromosomes. Subcloning of sections of the sequence reveals that it is
      composed of unrelated classes of sequences which can also be found separately in
      other genomic locations. Analysis of these sequences in the genomes of wheat and
      two other wild barley species strongly suggests that specific amplifications and
      arrangements of the repeated sequences have taken place during speciation.
      Nucleotide sequence analysis fails to detect, in their entirety, the features
      shown by plant transposons.

PMID- 8343600
TI  - The psbB gene cluster of the Chlamydomonas reinhardtii chloroplast: sequence and
      transcriptional analyses of psbN and psbH.
AB  - We have sequenced and characterized the complete psbB gene cluster of
      Chlamydomonas reinhardtii chloroplast DNA. Although the petB and petD genes are
      located elsewhere, the sequential order of psbB, ORF31, psbN and psbH is
      identical to that of the psbB operon in higher plants. Also, intergenic non
      coding regions are much larger in the Chlamydomonas gene cluster. Northern blot
      analyses indicate the formation of dicistronic transcripts of psbB and ORF31 and
      monocistronic transcripts of psbN and psbH. It is unclear whether a psbB operon
      is transcribed to yield a large polycistronic precursor but northern blot
      analysis with total RNA from cells grown at 15 degrees C does not detect an
      increased complexity of the transcripts, as has been found in studies of the psbB
      operon of higher plants. From primer extension and nuclease protection assays, it
      is apparent that 5' and 3' processing of the primary psbH transcript results in
      the accumulation of a heterogenous population of mRNAs. Northern blot analyses
      reveal transcription of Chlamydomonas psbN and show that its mRNA is much larger
      than that identified in liverwort and pea. The sequence identities of the PSII-H
      and PSII-N polypeptides as compared to their vascular plant counterparts is 50 to
      62%. While the amino acid sequences of PSII-H and PSII-N proteins are
      significantly conserved, the mass of PSII-H from Chlamydomonas is significantly
      larger.

PMID- 8343601
TI  - Differential expression of bean chitinase genes by virus infection, chemical
      treatment and UV irradiation.
AB  - Three chitinases have been shown previously to be induced upon various stresses
      of bean leaves. Time course studies of mRNA accumulation of two of them (P3- and
      P4-chitinases) have been studied upon virus infection, mercuric chloride
      treatment and UV irradiation. In alfalfa mosaic virus (AlMV)-infected plants both
      mRNAs, absent in uninfected bean leaves, become detectable 36 h after
      inoculation. A maximum level of mRNAs is reached 84 h after inoculation and,
      whereas the amount of P3-ch mRNA decreases soon after having reached the maximum,
      the amount of P4-ch mRNA remains at high levels for several days. In mercuric
      chloride-treated leaves P4-ch mRNA becomes detectable 1-1.5 h after onset of
      treatment and a maximum level is observed between 6 h and 24 h after treatment;
      P3-ch mRNA becomes detectable later than P4-ch mRNA in treated leaves and reaches
      a maximum as late as 18 h after treatment has been applied. UV light also induces
      the synthesis of both mRNAs but, here again, important differences are observed
      in the accumulation rate of the two transcripts. The relative amounts of each
      mRNA induced by the different stresses have been compared. The most effective
      inducer of P3-ch mRNA is AlMV. In contrast, mercuric chloride induces P4-ch mRNA
      more efficiently than AlMV or UV light. We have also determined the complete
      nucleotide sequence of the cDNA encoding P3-chitinase that has been isolated from
      a cDNA library by using the cucumber lysozyme-chitinase cDNA as a probe. The 1072
      bp P3-ch cDNA encodes a mature protein of 268 amino acid residues and the 25
      residue NH2-terminal signal peptide of the precursor. Because of its high
      structural homology to the cucumber and Arabidopsis acidic chitinases as well as
      to the N-terminal amino acid sequence of the bifunctional lysozyme-chitinase from
      P. quinquifolia, bean P3-chitinase can be considered to belong to the class III
      chitinases. Southern blot analysis of bean genomic DNA revealed that P3-chitinase
      is encoded by a single gene.

PMID- 8343602
TI  - A complex ensemble of cis-regulatory elements controls the expression of a Vicia
      faba non-storage seed protein gene.
AB  - We have identified cis-regulatory elements within the 5'-upstream region of a
      Vicia faba non-storage seed protein gene, called usp, by studying the expression
      of usp-promoter deletion fragments fused to reporter genes in transgenic tobacco
      seeds. 0.4 kb of usp upstream sequence contain at least six, but probably more,
      distinct cis-regulatory elements which are responsible for seemingly all
      quantitative, spatial and temporal aspects of expression. Expression-increasing
      and -decreasing elements are interspersed and include an AT-rich sequence, a G
      box element and a CATGCATG motif. The latter acts as a negative element in
      contrast to what has been found for the same motif in legumin- and vicilin-type
      seed storage protein gene promoters. Seed specificity of expression is mainly
      determined by the -68/+51 region which confers, however, only very low levels of
      expression. The data support the combinatorial model of promoter function.

PMID- 8343604
TI  - High evolutionary divergence of the 5.8S ribosomal DNA in Mimulus glaucescens
      (Scrophulariaceae).
AB  - Ribosomal DNA sequences for the ITS 1, 5.8S, ITS 2 and adjoining regions of the
      18S and 25S were obtained from Mimulus glaucescens (Scrophulariaceae) via cloned
      PCR products. The spacer sequences were completely unrelated to other plant taxa,
      although spacer lengths were approximately the same. Interestingly, the Mimulus
      5.8S sequence was much more divergent than other higher-plant rDNA sequences.
      Consideration of the secondary structure of the 5.8S rRNA shows that most of the
      changes in Mimulus are compensatory and preserve the basic secondary structure of
      the mature RNA molecule.

PMID- 8343603
TI  - Transfer RNA-mediated suppression of stop codons in protoplasts and transgenic
      plants.
AB  - We have developed a simple, rapid and sensitive assay for tRNA gene expression in
      plant cells. A plant tRNA(Leu) gene was site-specifically mutated to encode each
      of the three anticodon sequences (CUA, UUA and UCA) that recognize, respectively,
      the amber, ochre and opal stop codons. The suppression activity of these genes
      was detected by their ability to restore transient beta-glucuronidase (GUS)
      expression in tobacco protoplasts electroporated with GUS genes containing
      premature stop codons. Protoplasts co-electroporated with the amber suppressor
      tRNA gene and a GUS gene containing a premature amber stop codon showed up to 20
      25% of the activity found in protoplasts transfected with the functional control
      GUS gene. Ochre and opal suppressors presented maximum efficiencies of less than
      1%. This system could be adapted to examine transcription, processing or
      aminoacylation of tRNAs in plant cells. In addition, phenotypically normal,
      fertile tobacco plants expressing a stably incorporated amber suppressor tRNA
      gene have been obtained. This suppressor tRNA can be used to transactivate a
      target gene containing a premature amber stop codon by a factor of at least
      several hundred-fold.

PMID- 8343605
TI  - Inhibitory effects of human cystatin C on plum pox potyvirus proteases.
AB  - The effect of different protease inhibitors on the proteolytic processing of the
      plum pox potyvirus (PPV) polyprotein has been analyzed. Human cystatin C, an
      inhibitor of cysteine proteases, interfered with the autoprocessing of the viral
      papain-like cysteine protease HCPro. Unexpectedly, it also had an inhibitory
      effect on the autocatalytic cleavage of the Nla protease which, although it has a
      Cys residue in its active center, has been described as structurally related to
      serine proteases. Other protease inhibitors tested had no effect on any of the
      cleavage events analyzed.

PMID- 8343606
TI  - Isolation and characterization of cDNA clones encoding a 18.8 kDa polypeptide,
      the product of the gene psaL, associated with photosystem I reaction center from
      spinach.
AB  - Several cDNA clones encoding subunit XI of photosystem I reaction center (PSI-L)
      have been isolated from two lambda gt11 expression libraries based on
      polyadenylated RNA of spinach seedlings illuminated for 4 and 16 h, respectively.
      The precursor polypeptide made from these recombinant DNAs in vitro can be
      efficiently imported into isolated spinach chloroplasts. It is correctly
      processed to the size of the authentic polypeptide and integrates into the
      photosystem I assembly. The 834 nucleotide sequence of the longest cDNA insert
      encodes a precursor polypeptide of 24 kDa (216 residues) and a mature protein of
      probably 18.8 kDa (169 residues). Hydropathy analysis suggests that the
      polypeptide contains two transmembrane segments. The protein appears to originate
      in a single-copy gene in spinach and to be decoded from RNA species of ca. 900
      bases.

PMID- 8343607
TI  - RNA editing of the barley (Hordeum vulgare) mitochondrial ATP synthase subunit 9.
AB  - The barley (Hordeum vulgare) FO-ATP synthase subunit 9 (atp9) was isolated from
      the mitochondrial DNA. Two copies of atp9 are present in barley mitochondria and
      2 major transcripts of 2.7 kb and 1.2 kb were detected on RNA blots. RNA editing
      as C-to-U conversion occurs in barley atp9 in seven positions. Five of these
      seven positions lead to an amino acid change whereas two conversions are silent.
      The editing positions of barley were found to be identical to those of wheat.
      Whereas in wheat, Oenothera and Petunia all the atp9 transcripts were fully
      edited, 24% of the barley cDNA clones were partially edited as compared to 10%
      partially edited clones in wheat.

PMID- 8343608
TI  - Molecular cloning and sequencing analysis of a beta-tubulin gene from Lupinus
      albus.
AB  - Genomic lambda-Dash library constructed from Lupinus albus nuclear DNA was
      screened using a fragment of the beta-tubulin cDNA (beta 8-31) clone of
      Chlamydomonas reinhardtii as probe. One of the positive recombinant phages was
      isolated, subcloned and analysed by sequencing. We present here nucleotide and
      derived amino acid sequences of the beta-tubulin gene, designated as L beta 1 and
      identified by similarity with other beta-tubulins. The L beta 1-encoded protein
      reveals a very high degree of similarity with other plant tubulins and contains
      consensus sequences for binding guanine base, phosphate and Mg2+. Northern
      analysis of total RNA isolated from roots, leaves, flowers and pools revealed
      that Lupinus albus beta-tubulin genes are constitutively expressed in all studied
      plant tissues.

PMID- 8343609
TI  - Homology of the N-terminal domain of the petH gene product from Anabaena sp. PCC
      7119 to the CpcD phycobilisome linker polypeptide.
AB  - The complete nucleotide sequence of the petH gene encoding ferredoxin-NADP+
      reductase from the nitrogen-fixing cyanobacterium Anabaena sp. PCC 7119 has been
      determined. The encoded polypeptide is 136 amino acids longer than the enzyme
      obtained after purification to homogeneity. The extended N-terminal domain
      consists of 80 amino acids which shows homology to the CpcD phycobilisome linker
      polypeptide, through which FNR might be anchored to the thylakoid-bound
      phycobilisomes. A 56 amino acid interdomain fragment is found which could be a
      target for proteolysis.

PMID- 8343610
TI  - Effect of hyperglycemia and the aldose reductase inhibitor tolrestat on sural
      nerve biochemistry and morphometry in advanced diabetic peripheral
      polyneuropathy. The Tolrestat Study Group.
AB  - Tolrestat is a well tolerated nonhydantoin aldose reductase inhibitor that has
      been reported to improve nerve conduction in diabetic animals and humans. Its
      effects on nerve biochemistry and structure have not been studied in patients
      with diabetic neuropathy. Patients with advanced diabetic neuropathy treated with
      long-term open-label tolrestat were randomly assigned to continuation on drug
      treatment or to placebo-controlled drug withdrawal for 12 months. At the end of
      this period, sural nerve biopsies were obtained for measurement of glucose,
      sorbitol, and fructose content, and for detailed morphometric analysis. Tolrestat
      ameliorated the glucose-mediated increase in sorbitol and fructose in sural nerve
      tissue. No statistically significant differences in nerve morphometry emerged
      between the two groups; however, both treatment groups exhibited increased nerve
      fiber regeneration and normalization of axo-glial dysfunction and segmental
      demyelination following long-term tolrestat treatment. These findings are similar
      to those previously reported in a placebo-controlled sequential nerve biopsy
      study with the aldose reductase inhibitor sorbinil. Thus tolrestat is a
      biochemically effective aldose reductase inhibitor in human diabetic nerve with
      potential therapeutic efficacy for diabetic neuropathy.

PMID- 8343611
TI  - Withdrawal of the aldose reductase inhibitor tolrestat in patients with diabetic
      neuropathy: effect on nerve function. The Tolrestat Study Group.
AB  - A double-blind, placebo-controlled clinical trial was conducted to study the
      effects of discontinuing tolrestat, an aldose reductase inhibitor, on peripheral
      sensorimotor diabetic neuropathy. After an average of 4.2 years of continuous
      tolrestat use, 372 patients were randomly assigned to either placebo or continued
      tolrestat therapy and were followed for 52 weeks. After 3 months, patients who
      perceived worsening of symptoms of neuropathy were allowed to switch once to the
      alternate treatment group while maintaining the double-blind. Patients assigned
      to placebo had significant deterioration in motor nerve conduction velocity
      (MNCV) while those maintained on tolrestat did not (p < 0.05). The 28 patients
      who were randomly assigned to tolrestat and elected to switch to placebo had a
      significant deterioration in MNCV while the 36 assigned to placebo who switched
      to tolrestat had a significant improvement (p < 0.05). Treatment differences in
      favor of tolrestat were observed for sensation in the toes as well as for pain (p
      < 0.05). These data indicate that withdrawal from long-term treatment with
      tolrestat has a detrimental effect on several measures of diabetic neuropathy,
      whereas continuation of treatment is associated with stabilization of these
      measures, suggesting a continued role for polyol pathway activity in late
      neuropathy.

PMID- 8343612
TI  - Human kidney aldose and aldehyde reductases.
AB  - Mounting experimental evidence links increased aldose reductase activity with
      diabetes-related kidney functional changes. To investigate the interrelationship
      of NADPH-dependent reductases in the human kidney, both aldose reductase and
      aldehyde reductase were purified from human kidney by a series of chromatographic
      procedures, including gel filtration on Sephadex G-100, affinity chromatography
      on Matrex Gel Orange A, and chromatofocusing on Mono P. Each purified enzyme
      appeared as a single band on polyacrylamide gel after electrophoresis or
      isoelectric focusing. Aldose reductase has a pI of 5.7 and apparent molecular
      weight of 37 kDa, calculated from SDS-polyacrylamide gel electrophoresis, while
      aldehyde reductase has a pI of 5.2 and molecular weight of 39 kDa. Similar
      molecular weights were also obtained by gel filtration, indicating that both
      aldose and aldehyde reductases are present as monomers in the human kidney.
      Aldehyde reductase is primarily localized in the cortex, while the medulla
      contains aldose reductase. Both enzymes displayed properties consistent with the
      general characteristics of aldose and aldehyde reductases obtained from either
      rat or dog kidney. Purified aldose reductase utilizes aldose sugars such as D
      xylose, D-glucose, and D-galactose as substrates while aldehyde reductase
      preferentially reduces D-glucuronate and oxidizes L-gulonate to D-glucuronate.
      Despite the lower apparent affinity of aldehyde reductase for aldose sugars
      (approximately 20- to 100-fold less) both enzymes reduced D-xylose, D-glucose,
      and D-galactose to their respective sugar alcohols in in vitro incubation studies
      where the generated sugar alcohols were identified by gas chromatography. Both
      enzymes were also inhibited by aldose reductase inhibitors.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8343613
TI  - Dietary myo-inositol supplementation does not prevent retinal and glomerular
      vascular structural changes in chronically diabetic rats.
AB  - To assess effects of dietary myo-inositol supplementation on diabetes-induced
      vascular structural lesions, diabetes was induced in Sprague-Dawley rats with
      streptozotocin; one-third of these rats was fed a 2% myo-inositol diet for 9
      months, one-third was left untreated for 5 months then treated with myo-inositol
      for the last 4 months, and one-third was untreated for the entire 9 months.
      Controls included untreated and myo-inositol-treated groups. Weight gain was
      impaired and plasma glucose, glycosylated hemoglobin, food consumption, urine
      volume, and albuminuria were increased significantly in diabetic versus age
      matched control rats. Plasma myo-inositol levels were increased approximately
      fivefold in controls and approximately six- to eightfold in diabetic rats treated
      with myo-inositol. In general, myo-inositol did not affect any of the above
      parameters in control or diabetic rats. Retinal capillary basement membrane width
      (CBMW) was increased significantly (approximately 50% versus controls) after 9
      months of diabetes. In the control group myo-inositol increased CBMW to the level
      of untreated diabetic rats; myo-inositol had no effect on CBMW in each diabetic
      group. The number of retinal capillaries containing pericyte nuclei and pericyte
      capillary coverage were increased in untreated as well as myo-inositol-treated
      diabetic rats and in the myo-inositol-treated control group. Glomerular CBMW was
      increased after 5 and 9 months of diabetes versus age-matched controls, and was
      increased even more by myo-inositol. Mesangial fractional volume of the
      glomerulus was increased 36% by diabetes and was decreased slightly but
      significantly by myo-inositol. These results indicate that diets supplemented
      with 2% myo-inositol (1) cause capillary basement membrane (CBM) thickening and
      pericyte changes in retinal capillaries of normal rats, (2) are ineffective in
      preventing or reversing diabetes-induced retinal CBM thickening, and (3) cause
      further thickening of glomerular CBM in diabetic rats.

PMID- 8343614
TI  - Prospective study of the enzymatic activities in urine of N-acetyl-beta-D
      glucosaminidase, alpha-D-mannosidase, alpha- and beta-D-glucosidases, alpha-L-
      and beta-D-fucosidases, and beta-D-galactosidase in type I diabetes mellitus with
      early nephropathy.
AB  - Different surveys have been carried out on the plasma activities of different
      glycosidases in patients with insulin-dependent diabetes mellitus, but research
      on urinary glycosidases in this disease is scanty and incomplete. To elucidate
      the behavior of these lysosomal enzymes in the metabolic alterations occurring in
      the glomerular basal membrane during the initial stages of diabetic nephropathy,
      we conducted a prospective study to examine the urinary activities of N-acetyl
      beta-D-glucosaminidase (NAG), alpha-D-mannosidase, alpha- and beta-D-glucosidase,
      alpha-L- and beta-D-fucosidase, and beta-D-galactosidase in patients with type I
      insulin-dependent diabetes mellitus, surveyed over 18 months, whose early
      diabetic nephropathy was detected by the presence of microalbuminuria. The
      simultaneous determination of beta 2-microglobulin in urine confirmed the
      glomerular origin of the albuminuria. No statistically significant correlation
      was found between the levels of albuminuria and the activities of any of the
      glycosidases analyzed. In the diabetic patients, a significant decrease was
      observed in the activities of all the enzymes (p < 0.05), except NAG and alpha-D
      mannosidase, although the decrease in the latter was very close to statistical
      significance (p = 0.028, unilateral; p = 0.057 bilateral). Similarly, in the
      patients, there was a significant negative correlation (p < 0.05) with the serum
      levels of fructosamine, except with beta-D-galactosidase, which showed a positive
      correlation (p < 0.05) with fructosamine and blood HbA1c.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8343615
TI  - Diabetic embryopathy: a selective review of recent trends.

PMID- 8343616
TI  - The role of myoglobin in retarding oxygen depletion in skeletal muscle.
AB  - Myoglobin retards the development of anoxia in a poorly perfused region of
      skeletal muscle by facilitating diffusion into this region from adjacent normally
      perfused regions and by releasing bound oxygen directly into the tissue. We
      examine these phenomena by analyzing a mathematical model of time-dependent
      myoglobin-facilitated oxygen transport. The governing equations are solved using
      similarity transformations and multiple-scale techniques. We find that when
      perfusion of a region is suddenly decreased, oxygen depletion is significantly
      retarded by direct release of myoglobin-bound oxygen into the tissue and that
      myoglobin-facilitated diffusion of oxygen from adjacent regions becomes
      significant at very low oxygen concentration.

PMID- 8343617
TI  - On the distribution of vaccine protection under heterogeneous response.
AB  - We assume that individuals in a vaccinated cohort respond heterogeneously and
      acquire a continuous spectrum of effective protection against an environmental
      exposure to infection that can be varying in time. The notion of dynamical
      invariants is applied to a proportional hazard model with an unvaccinated or
      placebo cohort as baseline. The hazard is expressed as a susceptibility factor
      times a measure of environmental exposure to infection. Using the time-evolving
      information for the aggregated vaccinated cohort and the unvaccinated cohort, it
      is possible to reconstruct the distribution of effective protection imparted by
      the vaccination at the beginning of observation. Efficacy is defined in terms of
      the hazard ratio at the beginning of observation.

PMID- 8343618
TI  - Nonlinear control of biotechnological processes with growth-production
      decoupling.
AB  - Nonlinear control design techniques for a class of continuous biological
      processes with growth and production decoupling are investigated. We establish,
      under realistic assumptions on the kinetics, that though neither the inlet
      substrate concentration nor the dilution rate can achieve linearization of the
      global dynamics, we can maximize the dimension of the linear system obtained
      after feedback and get stable zero dynamics by choosing output functions having a
      physical meaning. More precisely, if the manipulated variable is the inlet
      substrate concentration, then the output can be chosen as the biomass
      concentration. But if the chosen input is the dilution rate, then a suitable
      output corresponds to yields.

PMID- 8343619
TI  - Conditioning a diffusion at first-passage and last-exit times, and a mirage
      arising in drug therapy for HIV.
AB  - Let X(t), t > or = 0, be a real-valued diffusion process, not necessarily time
      homogeneous. For a fixed z, let Tz be the first-passage time to z; and, under the
      assumption that z is a transient state, let Vz be the last-exit time from z. The
      main results of this work are a description of the structure of X(t), t > or = 0,
      upon conditioning by the values of Tz and Vz, and some of the characteristics of
      the conditioned process. The results are illustrated by application to Brownian
      motion with constant drift and also to the Ornstein-Uhlenbeck process augmented
      by a linear term representing a constant drift (a nonhomogeneous diffusion). The
      problem was motivated by the need to explain a possible mathematical mirage in
      the testing of antiviral drugs for HIV infection.

PMID- 8343621
TI  - The future of health care in the United Kingdom.

PMID- 8343620
TI  - Effect of red blood cell shape on oxygen transport in capillaries.
AB  - A mathematical model of oxygen (O2) transport within a capillary utilizes
      axisymmetric red blood cell (RBC) shapes that were predicted theoretically by
      Zarda et al. in 1977. Chemical kinetics and both free and facilitated diffusion
      of O2 are accounted for in this time-dependent model. The finite-element method
      is used to solve the governing partial differential equations. It is found that
      the shape of RBCs, characterized by the shape parameter theta adapted from Zarda
      et al., affects such important O2 transport characteristics as capillary wall O2
      flux and hemoglobin (Hb) saturation. At an RBC residence time (time for an RBC to
      travel from the capillary inlet to a given point) of 0.22 s, a change in the
      shape parameter theta from 0 (undeformed cell) to 26 (parachute-shaped cell)
      decreases the spatially averaged O2 flux by 26%. The dependence of O2 flux on RBC
      shape diminishes as the RBC residence time increases. The difference in Hb
      saturation at the RBC residence time of 0.22 s can be as large as 10% for
      different values of theta. The mass transfer Nusselt number, which is inversely
      proportional to transport resistance, decreases with increases in theta. The
      fractional transport resistance in the plasma region accounts for approximately
      65-80% of the total intracapillary resistance. Calculations show that local
      chemical equilibrium in the O2-Hb chemical reaction is attained everywhere except
      within a thin boundary layer adjacent to the erythrocyte membrane, where
      significant deviation from chemical equilibrium occurs.

PMID- 8343622
TI  - Sex selection.

PMID- 8343623
TI  - Biochemical screening for Down's syndrome.

PMID- 8343624
TI  - Trials and errors.

PMID- 8343626
TI  - London specialty reviews.

PMID- 8343625
TI  - How can doctors diagnose colorectal cancer earlier?

PMID- 8343627
TI  - Can paternal preconceptional radiation account for the increase of leukaemia and
      non-Hodgkin's lymphoma in Seascale?
AB  - OBJECTIVE: To determine if the excess of leukaemia and non-Hodgkin's lymphoma in
      Seascale is restricted to those born in the parish and whether it might be
      explained by the postulated relation with paternal preconceptional radiation.
      DESIGN: Comparison, separately for those born in the parish and those born
      elsewhere, of the numbers of these malignancies observed in Seascale with those
      expected on the basis of reference rates for England and Wales. Details of
      paternal radiation levels were sought for each case. SETTING: The parish of
      Seascale in west Cumbria. SUBJECTS: Residents of Seascale below age 25 years in
      the years 1951-91. MAIN OUTCOME MEASURES: The observed and expected numbers of
      cases of leukaemia and non-Hodgkin's lymphoma within Seascale among those born
      there and among those born elsewhere. Also, the levels of any paternal
      preconceptional radiation associated with each case. RESULTS: A significant
      excess of leukaemia and non-Hodgkin's lymphoma at ages 0-24 was found in Seascale
      in those who were born there (ratio of observed to expected cases 8.6 and 20.2
      respectively; p < 0.01). This also applied to those not born there (7.2 and 16.5;
      p < 0.01), a group often regarded as not showing an excess. The estimates were
      then conservatively recalculated so as to overestimate the risks among those born
      in Seascale and underestimate them among those born elsewhere. On this basis the
      six cases in those born in Seascale compare with 0.38 expected (15.8; p < 0.001),
      of which two were associated with paternal preconceptional life-time levels of
      100 mSv or greater and three others with levels of 90-99 mSv. Among those born
      elsewhere, there were five cases (expected 0.74; ratio 6.7, p < 0.01), of which
      only one was associated with a high level of such radiation. CONCLUSIONS:
      Paternal preconceptional radiation cannot be the sole cause of the excess in
      Seascale since it will not explain the excess among those born outside Seascale.
      It follows that, unless two causes are to be postulated, any single cause must be
      a factor other than paternal preconceptional radiation. On this basis, the
      association found among those born there, if not partly due to chance, may
      reflect an indirect relation with the true cause. The recent hypothesis about
      such paternal radiation has originated in a subgroup of the excess cases that
      have aroused concern.

PMID- 8343628
TI  - Is screening and intervention for microalbuminuria worthwhile in patients with
      insulin dependent diabetes?
AB  - OBJECTIVE: To analyse the cost-benefit of screening for and antihypertensive
      treatment of early renal disease indicated by microalbuminuria in patients with
      insulin dependent diabetes mellitus. DESIGN: Previously published data were used
      to estimate transition probabilities for each step from normoalbuminuria until
      death. The effect of intervention on urinary albumin excretion rate by
      antihypertensive treatment was arbitrarily set at three different levels. All
      direct costs (screening, antihypertensive treatment, treatment of end stage renal
      failure) were included in the cost-benefit analysis by using real discount rates
      of 2.5% and 6%. SETTING: Computer simulation. SUBJECTS: Simulated cohort of 8000
      patients. MAIN OUTCOME MEASURES: Mortality, incidence of diabetic nephropathy,
      incidence of end stage renal failure, and costs versus savings. RESULTS: Assuming
      treatment effects of 33% and 67% median life expectancy increased by four to 14
      years, respectively, and the need for dialysis or transplantation decreased by
      21% to 63%. Costs and savings would balance if the annual rate of increase of
      albuminuria was decreased from 20% to 18% a year. CONCLUSIONS: Screening and
      intervention programmes are likely to have life saving effects and lead to
      considerable economic savings.

PMID- 8343629
TI  - Site of principal metabolic defect in idiopathic haemochromatosis: insights from
      transplantation of an affected organ.

PMID- 8343630
TI  - Increased concentrations of serum lipoprotein (a) in response to growth hormone
      treatment.

PMID- 8343631
TI  - Explaining variations in prescribing costs across England.
AB  - OBJECTIVE: To derive a predictive model for national prescribing behaviour in
      terms of basic morbidity and demographic factors. DESIGN: 24 demographic,
      morbidity, and practice factors were entered into a multiple regression analysis
      to determine the net ingredient cost per patient. SETTING: The 90 family health
      service authorities in England for 1989. RESULTS: For net ingredient cost per
      patient only two demographic factors (numbers of pensioners and the mobility of
      the registered population measured by list inflation) and two morbidity related
      factors (standardised mortality ratios and numbers of prepayment certificates
      issued) significantly contributed to a multiple regression model. This model
      explained 81% of the variation in net ingredient cost per registered patient
      between family health services authorities. The model also enabled a weighting
      factor of 4.6 (95% confidence interval 3.2 to 6.7) to be derived for the net
      ingredient cost for elderly patients (compared with the existing prescribing unit
      factor of 3). CONCLUSIONS: The model shows that variations in prescribing costs
      essentially reflect demand. It also suggests that the current prescribing unit
      value of 3 for patients aged 65 or more underestimates the extra costs of
      prescribing for elderly patients.

PMID- 8343633
TI  - Leave practice.

PMID- 8343632
TI  - Contraceptives, counselling, and pregnancy in women with sickle cell disease.
AB  - Sickle cell disease is listed in the manufacturers' data sheets in the United
      Kingdom as a contraindication to the use of most combined contraceptive pills;
      the result is confused advice on family planning to a group of women who are at
      substantial risk from both planned and unplanned pregnancy. A study in north
      London on the use of contraceptives by women with sickle cell disease indicates
      that the use of combined oral contraceptives is common. Although medical staff
      usually advised against pregnancy, such advice was almost always ignored. Over
      half of the women surveyed had some knowledge about antenatal diagnosis. Family
      planning advice should be an integral part of the care of women with sickle cell
      disease. In the absence of specific data to the contrary all methods of
      contraception may be considered, although with appropriate caution.

PMID- 8343634
TI  - The first 15 cm are important in upper gastrointestinal endoscopy.

PMID- 8343635
TI  - Dispensing in general practice. Overhaul system of reimbursement.

PMID- 8343636
TI  - Dispensing in general practice. Criticisms unfounded.

PMID- 8343637
TI  - Dispensing in general practice. NHS regulations deny patients cheap drugs.

PMID- 8343638
TI  - Dispensing in general practice. Dispensing improves compliance.

PMID- 8343639
TI  - Teenage pregnancy. Give girls a motive for avoiding it.

PMID- 8343641
TI  - Teenage pregnancy. Seek the views of teenagers.

PMID- 8343640
TI  - Open access gastroscopy. Service is efficient and effective.

PMID- 8343642
TI  - Open access gastroscopy. GPs use gastroscopy appropriately.

PMID- 8343643
TI  - Accident and emergency in London. Patients' perceptions are the problem.

PMID- 8343644
TI  - Accident and emergency in London. Good primary care reduces workload.

PMID- 8343645
TI  - Treating hyperhidrosis. Complications of endoscopic sympathectomy.

PMID- 8343646
TI  - Treating hyperhidrosis. Reserve sympathectomy for palmar hyperhidrosis.

PMID- 8343647
TI  - Child health surveillance.

PMID- 8343648
TI  - Antenatal HIV testing may put pressure on women.

PMID- 8343649
TI  - Chickenpox in pregnancy.

PMID- 8343650
TI  - Reduction in infant mortality probably due to fall in cot deaths.

PMID- 8343651
TI  - Do we need more hospices?

PMID- 8343652
TI  - Infection control in dentistry.

PMID- 8343653
TI  - The new NHS. Britain hasn't learnt from America's mistakes.

PMID- 8343654
TI  - The Calman report and specialist training. More questions, no answers.

PMID- 8343655
TI  - The Calman report and specialist training. Calman report builds on the status
      quo.

PMID- 8343656
TI  - The Calman report and specialist training. Government must meet the cost.

PMID- 8343657
TI  - The Calman report and specialist training. European certificates don't mean the
      same.

PMID- 8343658
TI  - Subcortical dementia.

PMID- 8343659
TI  - Does routine ultrasound scanning improve outcome in pregnancy? Meta-analysis of
      various outcome measures.
AB  - OBJECTIVE: To evaluate the effectiveness of routine ultrasound scanning in
      pregnancy by a meta-analysis of various outcome measures. DESIGN: Meta-analysis
      of randomised controlled trials evaluating the effect of routine ultrasound
      scanning on perinatal mortality and morbidity. Live birth rate (that is, live
      births per pregnancy) is included as a measure of pregnancy outcome in addition
      to the conventional perinatal mortality. SUBJECTS: 15,935 pregnancies (7992 in
      which routine ultrasound scanning was used and 7943 controls with selective
      scanning) from four randomised controlled trials. MAIN OUTCOME MEASURES:
      Perinatal mortality, live birth rate, rate of miscarriage, Apgar score < 7 at 1
      minute, and number of induced labours. RESULTS: The live birth rate was identical
      in both screening and control groups (odds ratio = 0.99; 95% confidence interval
      0.88 to 1.12) although the perinatal mortality was significantly lower in the
      group who had routine ultrasonography (0.64, 0.43 to 0.97). Differences in
      perinatal morbidity between the two groups as measured by the proportion of
      newborn babies with Apgar score < 7 at 1 minute were not significant (1.05; 0.93
      to 1.19). CONCLUSION: Routine ultrasound scanning does not improve the outcome of
      pregnancy in terms of an increased number of live births or of reduced perinatal
      morbidity. Routine ultrasound scanning may be effective and useful as a screening
      for malformation. Its use for this purpose, however, should be made explicit and
      take into account the risk of false positive diagnosis in addition to ethical
      issues.

PMID- 8343660
TI  - Breast feeding and risk of breast cancer in young women. United Kingdom National
      Case-Control Study Group.
AB  - OBJECTIVE: To investigate whether breast feeding is related to subsequent risk of
      breast cancer. DESIGN: Population based case-control study designed primarily to
      investigate the relation between oral contraceptives and risk of breast cancer;
      data obtained from questionnaires administered by interviewers, general
      practitioner notes, and family planning clinic records. SETTING: 11 health
      regions in Britain. SUBJECTS: Women diagnosed with breast cancer before age 36
      living in the defined study areas. One control per case, matched for age, was
      selected from the list of the case's general practitioner. 755 case-control pairs
      were interviewed. MAIN OUTCOME MEASURES: Duration of breast feeding each liveborn
      infant; timing of return of menses; hormone use; other risk factors for breast
      cancer. RESULTS: Risk of breast cancer fell with increasing duration of breast
      feeding (relative risk = 0.94 per three months' breast feeding; test for trend p
      = 0.026) and with number of babies breast fed (relative risk = 0.86; test for
      trend, p = 0.017). Breast feeding each baby for longer than three months
      conferred no additional benefit. Breast feeding was more strongly negatively
      associated with risk of breast cancer than duration of postpartum amenorrhoea
      (chi 2 test for trend, p = 0.69). Hormonal suppression of lactation was unrelated
      to risk of breast cancer (relative risk = 0.96 per episode of suppressed
      lactation; test for trend, p = 0.72). CONCLUSIONS: These results suggest that
      breast feeding protects against the development of breast cancer in young women.

PMID- 8343661
TI  - Sex, pregnancy, hormones, and melanoma.

PMID- 8343662
TI  - Factors associated with lack of awareness of HIV infection before diagnosis of
      AIDS.
AB  - OBJECTIVE: To identify characteristics of people likely to be unaware of their
      HIV infection before diagnosis of AIDS defining disease. DESIGN: Survey of
      continuing surveillance of voluntarily reported AIDS cases. SUBJECTS: 4127 adults
      with AIDS diagnosed during 1989-92 and reported to the Public Health Laboratory
      Service AIDS Centre. SETTING: England and Wales. MAIN OUTCOME MEASURE: Lack of
      prolonged awareness of infection before diagnosis of AIDS, defined as an interval
      of nine months or less between first positive test result and diagnosis of AIDS.
      RESULTS: Of 3556 adults with known dates of first positive HIV test result and
      AIDS diagnosis, 1742 (49%) had been unaware of their infection for up to nine
      months before AIDS was diagnosed. Lack of awareness was independently and
      positively associated with infection through heterosexual contact (odds ratio
      4.46, 95% confidence interval 3.15 to 6.33), AIDS reported outside the Thames
      regions (1.64, 1.38 to 1.96), and being non-white (1.99, 1.51 to 2.61). Women
      were less likely to be unaware than men (0.50, 0.33 to 0.76), and people
      diagnosed in 1992 were least likely to be unaware (0.48, 0.39 to 0.60). Those
      aged 25-49 years at diagnosis were less likely to be unaware than those aged 15
      24 years and those aged 50 and over. CONCLUSIONS: People with certain
      characteristics are more likely than others to be unaware of their HIV infection
      before AIDS is diagnosed and are therefore less likely to receive prophylaxis.
      Methods for educating this heterogeneous group need to be investigated.

PMID- 8343663
TI  - Peak expiratory flow rate in schoolchildren living close to Braer oil spill.

PMID- 8343664
TI  - Teenagers, sex, and risk taking.

PMID- 8343665
TI  - Death from pulmonary microembolisation after intravenous injection of temazepam.

PMID- 8343666
TI  - Josamycin-induced pedal oedema.

PMID- 8343667
TI  - Taste disorders and terbinafine.

PMID- 8343668
TI  - Effects of preventive home visits to elderly people.
AB  - OBJECTIVES: To assess the effect of preventive home visits by public health
      nurses on the state of health of and use of services by elderly people living at
      home. DESIGN: Randomised controlled trial. SETTING: General population of elderly
      people in one of the southern regions of the Netherlands. SUBJECTS: 580 subjects
      aged between 75 and 84 years randomly allocated to intervention (292) or control
      (288) group. INTERVENTIONS: Four visits a year over three years in intervention
      group. Control group received no home visits. MAIN OUTCOME MEASURES: Self rated
      health, functional state, well being, loneliness, aspects of the mental state
      (depressive complaints, memory disturbances), and mortality. Use of services and
      costs. RESULTS: Visits had no effect on the health of the subjects. In the group
      visited no higher scores were seen on health related measures, fewer died (42
      (14%) v 50 (17%)), and community care increased slightly. In the control group
      more were referred to outpatient clinics (166 (66%) v 132 (55%)), and they had a
      40% increased risk of admission (incidence rate ratio 1.4; 90% confidence
      interval 1.2 to 1.6). No differences were found in long term institutional care,
      and overall expenditure per person in the intervention group exceeded that in the
      control group by 4%. Additional analyses showed that visits were effective for
      subjects who initially rated their health as poor. CONCLUSIONS: Preventive home
      visits are not beneficial for the general population of elderly people living at
      home but might be effective when restricted to subjects with poor health.

PMID- 8343670
TI  - Accuracy of diagnosis of psychosis on general practice computer system.
AB  - OBJECTIVES: To determine the accuracy of diagnoses of schizophrenia and non
      affective psychosis entered by general practitioners on a computer system. To
      compare recording of clinical events on computer with written records. DESIGN:
      Examination of case notes of all patients with a computer diagnosis of psychosis.
      Search of 8000 randomly selected patient records to identify patients with
      psychosis not recorded on computer and comparison of 141 computer and written
      entries for prescribing and consultation in each practice. SETTING: 13 London
      practices on the VAMP research bank. MAIN OUTCOME MEASURES: Accuracy of record of
      psychosis compared with ICD 9, American Psychiatric Association diagnostic
      manual, and syndrome checklist criteria. RESULTS: Computer search revealed 102
      patients with schizophrenia, 78 with other psychoses, and 71 with non-affective
      psychosis who had adequate case notes. The sensitivity and positive predictive
      value of the computer diagnosis of schizophrenia were 88% (95% confidence
      interval 62% to 98%) and 71% (48% to 88%). For all non-organic psychoses
      sensitivity was 91% (74% to 97%) and positive predictive value was 91% (74% to
      98%). On average 95% of all known prescriptions and 74% of all consultations were
      recorded on computer compared with 42% and 75% in written records. CONCLUSIONS:
      Recording of psychotic illness on the VAMP computer is accurate and complete.
      Prescribing was more fully recorded on the computer than on the written records.
      Computer databases of well motivated general practitioners could be used for
      research.

PMID- 8343669
TI  - Adhesion and the cancer jigsaw.

PMID- 8343671
TI  - Searching for gastrinomas.

PMID- 8343672
TI  - Structural adjustment: the wrong prescription for Africa?

PMID- 8343673
TI  - Health, humanitarian relief, and survival in former Yugoslavia.
AB  - Since the World Health Organisation's effort in former Yugoslavia started in July
      1992 it has been concerned with the public health policies of survival. It has
      provided advice to the United Nations High Commission for refugees, helped the
      voluntary agencies coordinate their work, assessed health needs, and provided
      practical help in the field to all parties to the conflict. Three features of the
      Bosnia war have particularly deplorable effects on health: ethnic cleansing,
      deliberate attacks on hospitals, and systematic rape. The WHO's response has
      included initiatives in nutrition, winter survival, and medical supplies. This
      experience shows that the WHO can have a useful role complementary to that of
      other agencies in situations where the basic elements for survival of the
      population are seriously compromised by war.

PMID- 8343675
TI  - Reviewing the NHS review.

PMID- 8343674
TI  - Chloroquine poisoning. Rapidly fatal without treatment.

PMID- 8343676
TI  - ABC of one to seven. Audit in primary care paediatrics.

PMID- 8343677
TI  - Caring for patients with brain injuries. ...and neuropsychiatrists.

PMID- 8343678
TI  - Caring for patients with brain injuries. The role of rehabilitation
      specialists...

PMID- 8343679
TI  - Caring for patients with brain injuries. Towards a better service.

PMID- 8343680
TI  - Control of communicable disease. A problem shared.

PMID- 8343681
TI  - Control of communicable disease. Compulsory removal powers inappropriate.

PMID- 8343682
TI  - Control of communicable disease. Misfits in the new NHS.

PMID- 8343683
TI  - Control of communicable disease. Tuberculosis screening falls foul of reforms.

PMID- 8343684
TI  - Control of communicable disease. Departments of microbiology are central to
      control of infection.

PMID- 8343685
TI  - Control of communicable disease. Government ignores control of viruses.

PMID- 8343686
TI  - Child health services. Should be combined.

PMID- 8343687
TI  - Homosexuality in the US.

PMID- 8343688
TI  - Use computers to detect inappropriate prescriptions.

PMID- 8343689
TI  - Residential and nursing care in London. Hampering discharge from acute units.

PMID- 8343690
TI  - Residential and nursing care in London. Number of places is decreasing...

PMID- 8343691
TI  - Chlamydial respiratory infections. Don't get bogged down by differentiating
      species.

PMID- 8343692
TI  - Tuberculosis is increasing in England and Wales.

PMID- 8343693
TI  - Epidural analgesia during childbirth. Minimising headache after dural puncture.

PMID- 8343694
TI  - Epidural analgesia during childbirth. Association with backache is real.

PMID- 8343695
TI  - Psychiatric services for elderly people. GPs happy with multidisciplinary teams.

PMID- 8343696
TI  - Psychiatric services for elderly people. Traditional model has limited scope.

PMID- 8343697
TI  - Hyponatraemia following desmopressin.

PMID- 8343698
TI  - Learning to cope with violence in the workplace.

PMID- 8343699
TI  - Screening for cardiovascular risk factors.

PMID- 8343701
TI  - Searching the literature. Be systematic in your searching.

PMID- 8343700
TI  - Neonatal intensive care. Staff must be experienced.

PMID- 8343702
TI  - Induction of labour.

PMID- 8343703
TI  - Will it hurt, doctor? Factors predicting patients' experience of pain during
      double contrast examination of the colon.

PMID- 8343704
TI  - Developing organisational vision in general practice.
AB  - Vision is a fashionable but ill defined term in management circles. Nevertheless,
      it embodies a significant concept related to guiding an organisation from present
      realities, through opportunities and hazards, to a viable future. Until recently
      a typical general practice could assume a stable external environment, but now it
      is caught up in the uncertainties stemming from the NHS reforms. For such a
      practice to undertake effective strategic planning it will have to develop a
      vision connecting the present with aspirations for the future. While vision is
      usually considered to be an individual talent, it is possible to develop a
      collective organisational vision within a general practice, and the small size of
      general practices makes this relatively easy. The vision needs to be broad; it
      needs to be continuous; and its capacity to predict the future needs to be
      monitored.

PMID- 8343705
TI  - Patients with fatigue in general practice: a prospective study.
AB  - OBJECTIVE: To describe the characteristics of patients attending their general
      practitioners and complaining of fatigue or being "tired all the time." DESIGN:
      Prospective study of cohort aged 16 years and older with follow up at two weeks
      and by questionnaires at two and six months. SUBJECTS: 220 patients (164 women)
      with mean age 43 years and an age-sex matched comparison group. SETTINGS: Doctors
      and patients in four practices in Lancashire, Mid Glamorgan, Suffolk, and Surrey.
      MAIN OUTCOME MEASURES: General clinical data, results from standard group of
      laboratory tests, fatigue questionnaire, and 12 item general health
      questionnaire. RESULTS: Over twice as many patients with fatigue had high scores
      on the health questionnaire compared with the comparison group (156 (75%) v 69
      (34%)). Results of laboratory tests were abnormal and contributed to the
      diagnosis in 19 patients. 59 out of 102 patients who responded had high fatigue
      scores six months later. Patients with persistent fatigue were more likely to
      have a history of anxiety or depression and to have had fatigue for more than
      three months on entry to the study. CONCLUSIONS: Women are particularly at risk
      of fatigue. The outcome is better if patients have had symptoms for three months
      or less or there is no history of emotional illness.

PMID- 8343706
TI  - Management of raised blood pressure in New Zealand: a discussion document.
AB  - A report to the National Advisory Committee on Core Health and Disability Support
      Services, New Zealand, on the management of raised blood pressure recommends that
      decisions to treat raised blood pressure should be based primarily on the
      estimated absolute risk of cardiovascular disease rather than on blood pressure
      alone. In general, patients with a blood pressure of 150-170 mm Hg systolic or 90
      100 mm Hg diastolic, or both, should be given treatment to lower blood pressure
      if the risk of a major cardiovascular disease event in 10 years is more than
      about 20%. The results of clinical trials indicate that, at this level of
      absolute risk, 150 people would require treatment to reduce the annual number of
      cardiovascular events by about one. Implementation of these recommendations may
      result in a smaller proportion of people aged under 60, particularly women,
      receiving treatment but an increased proportion of older people treated. In the
      absence of specific contraindications, low dose diuretics and low dose beta
      blockers should be considered for first line treatment, since for only these drug
      groups is there direct evidence of reduced risk of stroke and coronary disease in
      people with raised blood pressure.

PMID- 8343707
TI  - Health professionals and South Africa: supporting change in the health sector.
AB  - Now that political change is on the way in South Africa, what should be the
      position of doctors who are invited to visit the country? Does the "academic
      boycott" still have relevance? Waterston and Zwi review the case for and against
      an academic boycott policy, using evidence collected during the recent visit by
      Physicians for Human Rights (UK) and the Johannes Wier Foundation. The health
      system in South Africa is still inequitable, and despite progress towards
      desegregation in hospitals there is little momentum towards universal provision
      of primary health care, especially in the rapidly growing townships around big
      cities. The authors consider that pressure on the government should be maintained
      by outside organisations but that support directed towards appropriate health
      care should be encouraged, particularly in public health and primary health care.

PMID- 8343708
TI  - Guidelines for the management of spontaneous pneumothorax. Standards of Care
      Committee, British Thoracic Society.
AB  - Simple flow diagrams, with explanatory notes, have been devised to assist in the
      immediate and subsequent management of patients presenting to casualty
      departments with spontaneous pneumothorax. They cover decision making about which
      patients require admission; whether a drainage procedure is necessary; if so, the
      appropriate method, including technical details; inpatient treatment; referral of
      inpatients to a respiratory specialist; and follow up arrangements. The
      guidelines, designed for incorporation into casualty and ward handbooks, have
      already proved valuable in several district general hospitals, and can be used as
      a basis for audit.

PMID- 8343709
TI  - ABC of one to seven. Services for children: primary care.

PMID- 8343710
TI  - The Hawksley random zero sphygmomanometer. Manufacturer fights back.

PMID- 8343711
TI  - The Hawksley random zero sphygmomanometer. Should be abandoned.

PMID- 8343712
TI  - The Hawksley random zero sphygmomanometer. Don't condemn it without proper
      evidence.

PMID- 8343713
TI  - The Hawksley random zero sphygmomanometer. Instrument is accurate if used
      properly.

PMID- 8343714
TI  - The Hawksley random zero sphygmomanometer. Used in epidemiology, not individual
      people.

PMID- 8343715
TI  - Measuring patients' views of their health. SF 36 misses the mark.

PMID- 8343716
TI  - Reducing serum cholesterol. Confusion remains over whom to treat.

PMID- 8343717
TI  - Reducing serum cholesterol. Lower cholesterol of doubtful benefit to anyone.

PMID- 8343719
TI  - Measuring patients' views of their health. Definitions of health status should be
      rationalised.

PMID- 8343718
TI  - Measuring patients' views of their health. Reliability of SF 36 remains
      uncertain.

PMID- 8343720
TI  - Measuring patients' views of their health. The term outcome is ambiguous.

PMID- 8343721
TI  - Diagnosing meningococcal infection. Don't delay giving antibiotics.

PMID- 8343722
TI  - Medical angiologists. Europe already has them.

PMID- 8343723
TI  - Access to heart surgery for smokers. Persuade smokers to give up before surgery.

PMID- 8343724
TI  - Access to heart surgery for smokers. Rationed services should go to those who
      benefit.

PMID- 8343725
TI  - Patients' satisfaction with psychiatric care.

PMID- 8343726
TI  - Teaching communication skills. Putting it on paper helps patient understanding.

PMID- 8343727
TI  - The lasting trauma of the concentration camps.

PMID- 8343728
TI  - The health of the nation's research and development.

PMID- 8343729
TI  - Hand transmitted vibration.

PMID- 8343730
TI  - Nursing elderly patients out of bed.

PMID- 8343731
TI  - Private health care: patients' beliefs and practice.

PMID- 8343732
TI  - Whither health care in South Africa?

PMID- 8343733
TI  - US government is more giving on AIDS.

PMID- 8343734
TI  - Administration of vitamin K to newborn infants and childhood cancer.
AB  - OBJECTIVES: To investigate whether childhood cancer is associated with
      intramuscular administration of vitamin K to newborn infants. DESIGN: Routines
      for administration of vitamin K to infants born after normal deliveries during
      1973-89 were obtained from maternity hospitals. Occurrence of cancer up to the
      end of 1991 was identified by comparing these records with the national cancer
      registry. Adherence to the routine method of administering vitamin K was checked
      with the medical records of a sample of 396 infants (196 who had developed
      childhood cancer and 200 controls). SETTING: All maternity hospitals in Sweden.
      SUBJECTS: 1,384,424 full term infants born after non-instrumental deliveries,
      1,085,654 of whom were born in units where vitamin K was routinely given by
      intramuscular injection and 272,080 of whom were born where it was given orally.
      MAIN OUTCOME MEASURES: Odds ratios for cancer after intramuscular administration
      of vitamin K versus oral administration after stratification for year of birth.
      RESULTS: Adherence to routine method of administering vitamin K was 92% in the
      235 cases where individual information could be found. The risk of cancer after
      intramuscular administration of vitamin K was not elevated compared with that
      after oral administration: odds ratios of 1.01 (95% confidence interval 0.88 to
      1.17) for all childhood cancers and 0.90 (0.70 to 1.16) for childhood leukaemia.
      CONCLUSIONS: The alleged association between intramuscular vitamin K prophylaxis
      to newborn infants and childhood cancer could not be verified in the present
      study of full term infants born after non-instrumental delivery.

PMID- 8343735
TI  - Insulin resistance in offspring of hypertensive parents.
AB  - OBJECTIVE: To determine if insulin resistance is present in normotensive adults
      at increased risk of developing hypertension. DESIGN: Normotensive subjects with
      at least one hypertensive parent were paired with offspring of normotensive
      parents (controls), being matched for age, sex, social class, and physical
      activity. SETTING: Outpatient clinic. SUBJECTS: 30 paired subjects (16 men and 14
      women) with and without a family history of hypertension, aged 18-32, with a body
      mass index < 25 kg/m2, with blood pressure < 130/85 mm Hg, and not taking drugs.
      INTERVENTIONS: Euglycaemic glucose clamp (two hour infusion of insulin 1
      mU/kg/min) and intravenous glucose tolerance test (injection of 100 ml 20%
      glucose). MAIN OUTCOME MEASURES: Insulin mediated glucose disposal and insulin
      secretion. RESULTS: The offspring of hypertensive parents had slightly higher
      blood pressure than did the controls (mean 117 (SD 6) v 108 (5) mm Hg systolic, p
      = 0.013; 76 (7) v 67 (6) mm Hg diastolic, p = 0.017). Their insulin mediated
      glucose disposal was lower than that of controls (29.5 (6.5) v 40.1 (8.6)
      mumol/kg/min, p = 0.002), but, after adjustment for blood pressure, the
      difference was not significant (difference 6.9 (95% confidence interval -1.5 to
      15.3), p = 0.10). Insulin secretion in the first hour after injection of glucose
      was slightly but not significantly higher in the offspring of hypertensive
      patients (9320 (5484) v 6723 (3751) pmol.min/l). The two groups had similar
      concentrations of plasma glucose (5.2 (0.3) v 5.1 (0.4) mmol/l), serum
      cholesterol (4.4 (0.8) v 4.6 (0.8) mmol/l), serum triglyceride (0.89 (0.52) v
      0.68 (0.27) mmol/l), and serum low density lipoprotein cholesterol (2.81 (0.65) v
      2.79 (0.61) mmol/l). The offspring of hypertensive parents, however, had lower
      serum concentrations of high density lipoprotein cholesterol (1.24 (0.31) v 1.56
      (0.35) mmol/l, p = 0.002) and higher serum concentrations of non-esterified fatty
      acids (0.7 (0.4) v 0.4 (0.4) mmol/l, p = 0.039). CONCLUSIONS: Young normotensive
      subjects who are at increased risk of developing hypertension are insulin
      resistant.

PMID- 8343736
TI  - A decade of diabetes: keeping children out of hospital.
AB  - OBJECTIVES: To document the number of children aged less than 15 years who
      developed diabetes and were managed within one large health district, and to
      evaluate the outcome of those children managed without hospital admission at
      diagnosis. DESIGN: A retrospective study over 1979-88, when a paediatrician and a
      physician with special interests in childhood diabetes initiated joint clinics.
      Data collected from the district diabetes register and files of consultants and
      health visitors specialising in diabetes. SETTING: Referral of children to
      consultants in Leicestershire (total population 863,000). MAIN OUTCOME MEASURES:
      The proportion of children managed without hospital admission, comparison of
      readmission rates and glycated haemoglobin concentrations between children
      admitted and those not admitted. RESULTS: Over 10 years 236 children aged 10-14
      years developed diabetes (annual incidence rate 12.8/100,000 child population
      (95% confidence interval 11.3 to 14.7)). In total 138 were not admitted to
      hospital but received supervised management based at home. Admitted children were
      younger or acidotic or their family doctors did not contact the diabetes team.
      Duration of admission declined from seven days in 1979-80 to three days in 1987
      8. Ninety two were not admitted to hospital during the 10 years for any reason.
      Significantly fewer children who received management at home were readmitted for
      reasons related to diabetes than the group treated in hospital (30 (22%) v 40
      (41%); p = 0.004). Concentrations of glycated haemoglobin were no different
      between the two groups. CONCLUSIONS: Children with newly diagnosed diabetes may
      be safely and effectively managed out of hospital. Domiciliary or community based
      management depends on the commitment of consultants specialising in diabetes
      working in close cooperation with general practitioners, specialist nurses in
      diabetes, and dietitians.

PMID- 8343737
TI  - Recruitment methods for screening programmes: trial of an improved method within
      a regional osteoporosis study.

PMID- 8343738
TI  - Fetal blood sampling in retreat.

PMID- 8343739
TI  - Why do adults sexually abuse children?

PMID- 8343740
TI  - Psychological consequences of screening for Down's syndrome.

PMID- 8343741
TI  - No escape: HIV transmission in jail.

PMID- 8343742
TI  - HIV outbreak investigated in Scottish jail.

PMID- 8343744
TI  - Case-control study of congenital anomalies in children of cancer patients.
AB  - OBJECTIVES: To determine whether the offspring of cancer survivors are at an
      increased risk of congenital anomalies and whether cancer therapy before
      conception is associated with such an increase. DESIGN: Case-control study using
      computerised record linkage. SETTING: Ontario, Canada. SUBJECTS: Parents of
      children born during April 1979 to December 1986 who had a congenital anomaly
      diagnosed within the first year of life (45,200 mothers and 41,158 fathers) and a
      matched sample of parents whose children did not have a congenital anomaly
      (45,200 mothers and 41,158 fathers). MAIN OUTCOME MEASURES: Cancer diagnosed in
      either parent before conception and radiotherapy to the pelvis or abdomen or
      chemotherapy with an alkylating agent. RESULTS: Among the mothers, 54 cases and
      52 controls were identified as having had cancer diagnosed in Ontario (relative
      risk = 1.04, 95% confidence interval 0.7 to 1.5) and among the fathers, 61 cases
      and 65 controls were identified (0.9, 0.7 to 1.4). No significant associations
      were found between congenital anomalies in the offspring and any type of cancer
      treatment in either the mothers or the fathers. CONCLUSIONS: The risk of
      congenital anomalies among liveborn offspring whose parents have had cancer or
      been treated for cancer is not higher than that in the general population.

PMID- 8343743
TI  - Genetic susceptibility to non-insulin dependent diabetes mellitus and glucose
      intolerance are located in HLA region.
AB  - OBJECTIVES: To test the hypothesis that the genetic susceptibility to non-insulin
      dependent diabetes mellitus is the same as that to insulin dependent disease and
      to see whether glucose intolerance is associated with specific HLA haplotypes.
      DESIGN: Population based study of men in 1989 first tested for glucose tolerance
      in 1984. HLA haplotypes, including HLA-A, C, B, DR, and DQ, were defined
      serologically. HLA haplotype data from a population based Finnish study of
      childhood diabetes were used for predicting non-insulin dependent diabetes and
      impaired glucose tolerance. SETTING: Two communities in Finland. SUBJECTS:
      Representative cohort of Finnish men aged 70-89, comprising 98 men with non
      insulin dependent diabetes mellitus and a randomly selected group of 74 men, who
      served as controls, who were tested for glucose tolerance twice within five
      years. MAIN OUTCOME MEASURES: Non-insulin dependent diabetes, impaired glucose
      tolerance, blood glucose concentration. RESULTS: Diabetes associated HLA
      haplotypes were present in 94% (85/90) of diabetic subjects, 79% (27/34) of
      subjects with impaired glucose tolerance, and only 13% (3/23) of non-diabetic
      subjects. In this group of elderly men sensitivity of the diabetes associated HLA
      haplotypes for non-insulin dependent diabetes and impaired glucose tolerance was
      90%, specificity 87%, and predictive power 97%. Mean fasting blood glucose
      concentration was only just significantly higher in men with diabetes associated
      haplotypes than in men with no such haplotypes, but there was a substantial
      difference in blood glucose values two hours after glucose loading (10.4 and 6.4
      mmol/l in men with diabetes associated HLA haplotypes and men with no such
      haplotypes, respectively (p < 0.0001)). CONCLUSIONS: These findings support the
      hypothesis that specific HLA haplotypes exhibit a common genetic determinant for
      insulin dependent and non-insulin dependent diabetes. Furthermore, HLA is a major
      genetic determinant of glucose intolerance in elderly Finnish men. The belief
      that the HLA predisposition to diabetes is specific for insulin dependent
      diabetes mellitus is largely incorrect.

PMID- 8343746
TI  - Effect of spinal osteophytosis on bone mineral density measurements in vertebral
      osteoporosis.

PMID- 8343745
TI  - Factors affecting uptake of measles, mumps, and rubella immunisation.
AB  - OBJECTIVE: To study factors affecting uptake of measles, mumps, and rubella
      immunisation. DESIGN: Cohort study using data from computerised child health
      systems. SETTING: 10 health districts in North East Thames and North West Thames
      regions. SUBJECTS: 7841 children born in January to March 1990 and resident in
      the districts up till the end of October 1991. MAIN OUTCOME MEASURES: Overall
      uptake of measles, mumps, and rubella immunisation, variation of uptake among
      groups of children, and odds ratio of being vaccinated against measles, mumps,
      and rubella. RESULTS: The overall uptake rate of measles, mumps, and rubella
      immunisation for the study cohort in the 10 districts was 82%. Wide variation was
      identified among children with different demographic characteristics. Lower
      uptake was associated with absent or incomplete primary immunisation, including
      omission of pertussis vaccine. Other factors affecting uptake included the type
      of resident district, birth order, where registered for immunisation (general
      practitioner or clinic), and one parent family status. CONCLUSIONS: Many
      districts have difficulties in meeting the 90% target for measles, mumps, and
      rubella immunisation, mainly because of the characteristics of their local
      population. To increase overall coverage, the health service should target
      families with adverse factors, especially those whose children have missed
      previous immunisations.

PMID- 8343747
TI  - Late cardiac manifestation of infection with Borrelia burgdorferi (Lyme disease).

PMID- 8343748
TI  - Serum screening for Down's syndrome: some women's experiences.
AB  - OBJECTIVES: To describe the experiences of a small group of women who had
      positive results after serum screening for Down's syndrome. DESIGN:
      Semistructured telephone interviews and correspondence with women after a
      positive screening result (four women) negative amniocentesis results (eight), or
      termination of a pregnancy with a confirmed abnormality (eight). SUBJECTS: 20
      women who contacted Support After Termination For Abnormality about their
      experiences of serum screening for Down's syndrome. MAIN OUTCOME MEASURES:
      Women's knowledge and understanding of the test; staff misconceptions;
      communication of results; how women coped with the diagnostic process; attitudes
      to the test and to termination of abnormal fetuses. RESULTS: All women were made
      anxious by their positive screening test, no matter how they were told. The
      women's experiences suggested that medical staff were unclear about the
      implications of screening tests and how to interpret risk. Even after receipt of
      negative amniocentesis results some women remained anxious. Staff did not always
      recognise women's concerns while awaiting amniocentesis results. CONCLUSIONS: The
      way in which serum screening is being implemented does not always meet the needs
      of women with positive results. Some of the problems were not specific to
      screening for Down's syndrome. When screening tests are introduced policies
      should be adopted to ensure appropriate support for participants.

PMID- 8343749
TI  - Personal computer software for handling references from CD-ROM and mainframe
      sources for scientific and medical reports.

PMID- 8343750
TI  - Methods of helping patients with behaviour change.

PMID- 8343751
TI  - ABC of one to seven. Health services for children: the community.

PMID- 8343753
TI  - Analgesia for children in intensive care. Consider the whole child.

PMID- 8343752
TI  - Analgesia for children in intensive care. Assessing pain is fraught with
      difficulties.

PMID- 8343754
TI  - Analgesia for children in intensive care. Paediatricians must take control of
      pain relief.

PMID- 8343755
TI  - Analgesia for children in intensive care. Study conclusions distorted by poor
      design.

PMID- 8343756
TI  - Analgesia for children in intensive care. Most units have acceptable written
      protocols.

PMID- 8343757
TI  - AIDS in Africa.

PMID- 8343759
TI  - Home treatment for acute psychiatric disorder. Innovative services merit
      investigation.

PMID- 8343758
TI  - Clozapine in the management of schizophrenia. All schizophrenic patients would
      benefit.

PMID- 8343760
TI  - Home treatment of acute psychiatric disorder. Inpatient treatment must remain an
      option.

PMID- 8343761
TI  - Management of patients in persistent vegetative state. Given proper
      rehabilitation a chance.

PMID- 8343763
TI  - Management of patients in persistent vegetative state. No one can define
      acceptable quality of life.

PMID- 8343762
TI  - Management of patients in persistent vegetative state. Economic arguments
      threaten all disabled people.

PMID- 8343764
TI  - Management of patients in persistent vegetative state. Moral arguments for ending
      life are flawed.

PMID- 8343765
TI  - Evidence for "clusters of anophthalmia" is thin.

PMID- 8343766
TI  - Management of patients in persistent vegetative state. Doctors should not be
      forced to practise euthanasia.

PMID- 8343767
TI  - Management of patients in persistent vegetative state. Reasons for withdrawing
      treatment should be explicit.

PMID- 8343768
TI  - Management of heparin induced thrombocytopenia.

PMID- 8343769
TI  - HIV and infection. Just say no.

PMID- 8343770
TI  - HIV and insurance. Catch 22.

PMID- 8343771
TI  - HIV and insurance. Insurers don't penalise if test result is negative.

PMID- 8343772
TI  - Doctors' HIV risk difficult to quantify.

PMID- 8343773
TI  - Assuring best practices in communication for children and youth with severe
      disabilities.

PMID- 8343774
TI  - Communication intervention for individuals with dual sensory and intellectual
      impairments.
AB  - For individuals with dual sensory and intellectual impairments, the lack of
      effective communication skills places severe limitations on their learning
      potential and sense of belonging. Educational intervention for this population
      has recognized the critical need to develop communication skills, yet the
      complexity of the individual's needs continues to plague progress. Unique needs
      and situations of individuals in this category, coupled with extremely limited
      numbers of trained and experienced professionals, challenge the field to develop
      creative means of addressing this vital issue. Documented case studies provide
      the field with examples of potential options to employ when addressing the
      communicative needs of individuals with dual sensory and intellectual
      impairments. However, these case studies provide partial communication systems
      that address partial communicative needs. Providing individuals having severe
      sensory, intellectual, and other disabilities with a true language that can meet
      all communication needs, both receptive and expressive, is still beyond our
      grasp. Future efforts with this focus will need to combine early intervention,
      creative technology, and principles of normalization in order to be successful.

PMID- 8343775
TI  - Enhancing curricula design.

PMID- 8343776
TI  - Functional communication training for challenging behaviors.

PMID- 8343777
TI  - Communication intervention for persons with severe and profound disabilities.
AB  - Traditionally, communication interventionists focused on teaching a beginning
      repertoire of communicative behavior, once learners with severe to profound
      disabilities had emitted intentional behavior. Increasingly, interventionists are
      recognizing that valuable opportunities may be lost if intervention does not
      begin at an earlier point. In part, intervention strategies at increasingly
      earlier points have resulted from a prevailing change from semantically-focused
      intervention logic to pragmatic, interaction-focused intervention logic. At the
      same time that intervention content has increasingly focused on pragmatics, there
      has been a wealth of information addressing the social functions served by
      repertoires of simple idiosyncratic (as well as socially unacceptable) behavior.
      The increasing availability of augmentative and alternative communicative options
      has provided an extensive array of motorically simple strategies to exert
      significant control and influence over one's environment. We have long since
      passed the need to demonstrate that persons with severe disabilities can be
      taught a repertoire of communicative functions. However, we have not been as
      successful in demonstrating that the communicative behavior taught is well
      maintained solely in the presence of natural maintaining contingencies. Nor have
      we adequately demonstrated that established repertoires are sufficiently
      generalized. Most recently, interventionists have begun to focus on more
      efficient strategies to use in the selection of the most critical teaching
      instances to teach a new communicative response. Additionally, interventionists
      are considering response efficiency as an important variable in determining the
      likelihood that a learner will choose to emit members of his or her communicative
      repertoire. There appears to be a consensus among those who currently serve
      individuals with severe disabilities that inclusion represents an attainable
      objective for students with even the most severe disabilities. Unfortunately, it
      is not clear that either special or regular educators are being adequately
      prepared to accomplish included placements. There remains a significant need to
      recognize those aspects of best practice which must be further explored in
      regular education settings. What once were considered best practice methods may
      not meet the test of social validity and be considered best practices in regular
      classrooms. The vast majority of intervention research has selected a fairly
      narrow communicative form or function to teach. Increasingly, information on
      maintenance and generalization is considered. However, often the periods sampled
      postacquisition are very modest. Among the plethora of available communication
      intervention curricula, there are virtually none that have taken a learner from a
      point of engaging in no intentional communicative behavior to the establishment
      of an effusive repertoire of communicative functions and corresponding
      vocabulary.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8343778
TI  - Facilitating and measuring the team process within inclusive educational
      settings.

PMID- 8343779
TI  - Nonoperative management of secondary shoulder impingement syndrome.
AB  - Shoulder pain secondary to impingement of the rotator cuff tendons underneath the
      coracoacromial arch is a common problem seen in athletes who perform repetitive
      overhead activities. Shoulder impingement has been classified into primary and
      secondary types. Several factors contribute to impingement, including rotator
      cuff weakness, posterior capsule tightness, and subacromial crowding. Recently,
      it has been proposed that scapulothoracic muscle weakness could be a factor that
      contributes to impingement. Traditional rehabilitation protocols for shoulder
      impingement syndrome stress individualized rotator cuff strengthening. The
      authors propose that individualized scapulothoracic muscle strengthening should
      be a part of any protocol for nonoperative treatment of secondary shoulder
      impingement syndrome.

PMID- 8343780
TI  - Stretch-shortening drills for the upper extremities: theory and clinical
      application.
AB  - Enhanced athletic performance emphasizes the muscle's ability to exert maximal
      force output in a minimal amount of time. Exaggerated maximal muscular force
      develops due to athletic movements producing a repeated series of stretch
      shortening cycles. The stretch-shortening cycle occurs when elastic loading,
      through an eccentric muscular contraction, is followed by a burst of concentric
      muscular contraction. A form of exercise called plyometrics employs a quick,
      powerful movement involving a prestretch of the muscle, followed by a shortening,
      concentric muscular contraction, thus utilizing the stretch-shortening muscular
      cycle. The literature contains numerous references to plyometric training for the
      lower extremity, but there is a lack of information on the upper extremity
      plyometric program. Overhead activities, such as throwing, necessitate elastic
      loading to produce maximal, explosive, concentric muscular contractions.
      Plyometric exercise employs the concept of the stretch-shortening muscular cycle.
      The rehabilitation concept of specificity of training suggests plyometric
      exercise drills should be performed by the throwing athlete. This paper discusses
      the basic neurophysiological science and theoretical basis for plyometric
      exercise, and it describes an upper extremity stretch-shortening exercise program
      for the throwing athlete.

PMID- 8343781
TI  - Treatment of the inversion ankle sprain: comparison of different modes of
      compression and cryotherapy.
AB  - Relatively few studies have been performed to examine the effectiveness of
      different methods of treatment for the inversion ankle sprain. In this study,
      restoration of function following a grade II inversion sprain was compared among
      34 subjects who received one of three methods of treatment, each of which
      incorporated an Air-Stirrup brace. The methods included uniform compression
      provided by elastic tape, focal compression provided by a U-shaped device, and
      focal compression with simultaneous cryotherapy. Although the results failed to
      demonstrate statistical significance at the .05 level (p = .055), the two groups
      that received focal compression attained each of nine levels of function in fewer
      days than the group that received uniform compression. The results of this study
      indicate that focal compression appears beneficial, but increased frequency and
      duration of cryotherapy does not appear to enhance the rate of recovery following
      an inversion ankle sprain.

PMID- 8343782
TI  - A comparison of temperature rise in human calf muscles following applications of
      underwater and topical gel ultrasound.
AB  - For ultrasound to be effective, a conducting medium must be placed between the
      soundhead and the skin. Little research has been performed to test whether or not
      these mediums actually work. The purpose of this study was to compare the effect
      of tap water immersion and ultrasound gel conducting mediums on tissue
      temperature rise in the human leg. A 23-gauge hypodermic needle microprobe was
      inserted 3 cm deep into the medial portion of the gastrocnemius muscle of 20
      subjects. Each subject participated in two random order treatments using tap
      water immersion and topical gel conducting mediums. Each treatment consisted of
      continuous ultrasound delivered topically at 1.5 W/cm2 for 10 minutes. During
      both treatments, the soundhead was moved at a speed of 4 cm per second, and the
      temperature was recorded every 30 seconds. A significant difference was found
      between the two treatment methods [t(19) = 9.18, p < .001]. The topical gel
      increased tissue temperature 4.8 degrees C, whereas the underwater treatment
      increased tissue temperature only 2.1 degrees C. Therefore, at a tissue depth of
      3 cm, ultrasound gel is a better conducting medium than water. Also, the authors
      discovered that it took nearly 8 minutes for the temperature to reach therapeutic
      levels during the gel technique. These findings should be of clinical
      significance to clinicians who regularly use ultrasound.

PMID- 8343783
TI  - The effects of unilateral velocity-specific concentric strength training.
AB  - There is conflicting evidence regarding the efficacy of various resistance
      training programs for increasing strength in trained and contralateral limbs. The
      purposes of this investigation were to examine the effects of unilateral velocity
      specific concentric isokinetic training of the extensor and flexor muscles of the
      elbow and knee on: 1) the carry-over effect in strength increases to velocities
      other than the training velocity in the trained limbs and 2) the cross-training
      effect at various velocities in the contralateral limbs. Twelve adult men (mean
      age +/- SD = 24 +/- 6 years) volunteered to train their nondominant extremities
      three times per week (six sets of 10 maximal repetitions) for 8 weeks at 120
      degrees/sec using a Cybex II isokinetic dynamometer. The subjects were tested for
      increases in peak torque at 60, 120, 180, 240, and 300 degrees/sec. The training
      resulted in significant (p < 0.05) increases in peak torque on the trained side
      of the body for elbow extension and flexion as well as knee extension and flexion
      at all velocities tested. These findings indicated that the velocity-specific
      training resulted in increases in peak torque at velocities that were both
      greater and less than the training velocity. In addition, there was a cross
      training effect, with significant (p < 0.05) increases in peak torque on the
      contralateral side of the body for elbow extension (all velocities except 300
      degrees/sec) as well as knee extension and flexion (all velocities). These
      results indicate that unilateral velocity-specific concentric isokinetic training
      is adequate stimulus for eliciting strength gains at a wide range of velocities
      in both the trained and contralateral limbs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343785
TI  - Generalizability in focus.

PMID- 8343784
TI  - Relationship between active knee extension and active straight leg raise test
      measurements.
AB  - This study was conducted to determine the relationship between two alternative
      tests for indicating hamstring musculotendinous length, active knee extension
      (AKE) and active straight leg raise (ASLR). Before alternatives to a commonly
      practiced clinical test such as AKE can be recommended for application, their
      convergent validity should be established. Twenty-three healthy subjects (mean
      age = 29.4 years) were tested. A 35-mm camera was used to record the position of
      the right side of the pelvis and lower limb during the performance of the ASLR
      test on the right. The camera set-up was also used to record the position of the
      right knee and pelvis during the performance of AKE with the right hip flexed to
      90 degrees. For ASLR, the angle of the straight leg to the horizontal was
      measured. For AKE, the angle of knee extension was measured. The intraclass
      correlation coefficients for the AKE (.861) and ASLR (.953) tests were good and
      high, respectively. There was a significant relationship (r = -.718; r2 = .515; p
      < .001) between AKE and ASLR. The significant correlation between the
      measurements obtained using these two tests suggests that both are providing an
      indication of the same basic phenomenon, presumably hamstring musculotendinous
      length. For this reason, the AKE test may be a useful alternative to the straight
      leg raise test for providing an indication of hamstring muscle length.

PMID- 8343786
TI  - Biomechanics of the elbow during baseball pitching.
AB  - By understanding pitching biomechanics, therapists can develop better preventive
      and rehabilitative programs for pitchers. The purpose of this study was to
      quantify and explain the joint motions, loads, and muscle activity that occur at
      the elbow during baseball pitching. Seven healthy, adult pitchers were examined
      with synchronized high-speed video digitization and surface electromyography.
      Elbow extension before ball release corresponded with a decrease in biceps
      activity and an increase in triceps activity. A varus torque of 120 Nm, acting to
      resist valgus stress, occurred near the time of maximum shoulder external
      rotation. Previous cadaveric research showed that the ulnar collateral ligament
      by itself cannot withstand a valgus load of this magnitude. Triceps, wrist
      flexorpronator, and anconeus activity during peak valgus stress suggests that
      these muscles may act as dynamic stabilizers to assist the ulnar collateral
      ligament in preventing valgus extension overload.

PMID- 8343787
TI  - The functional anatomy of the elbow complex.
AB  - The functional anatomy of the elbow joint complex is unique in orientation and
      configuration. Three bones, the ulna, radius, and humerus, articulate to form
      four articulations: the humeroulnar, humeroradial, superior radioulnar, and
      inferior radioulnar joints. This unique osseous structure provides the elbow
      excellent static stabilization, which is enhanced by the ulnar collateral
      ligament, the lateral collateral ligament, and the elbow joint capsule. Twenty
      three muscles are directly associated with the elbow joint and can be classified
      into four main groups: the elbow flexors and extensors and the flexor-pronator
      and extensor-supinator groups. These muscles provide dynamic stabilization to the
      elbow and enable the hand to perform skilled, precise motions. The purpose of
      this review article is to provide the clinician with an understanding of the
      unique anatomy at the elbow joint and to enhance the clinician's knowledge of the
      biomechanics, clinical examination, and rehabilitation of the elbow complex.

PMID- 8343788
TI  - Common elbow problems in the athlete.
AB  - Because of the popularity of sports participation, sports physical therapists
      must recognize in the athlete the many clinical conditions that occur about the
      elbow. The purpose of this paper is to present the most common elbow problems
      that an athlete may encounter and to provide information to facilitate
      recognition of elbow pathology. This information is essential before initiating
      treatment. An attempt is made to include sprains, strains, neuropathies,
      dislocations, fractures, contusions, vascular insults, and skin problems in the
      distal humerus, elbow, and proximal forearm of both the immature and mature
      athlete. Comprehension of the mechanism of injury aids clinical evaluation and
      rehabilitation and enhances early return to activity.

PMID- 8343789
TI  - Physical examination of the thrower's elbow.
AB  - The physical examination of the thrower's elbow presents the clinician with the
      clinical challenge of differentially diagnosing specific pathologies. The
      examination should include a thorough history and a well-organized physical
      examination, which relies on an extensive knowledge of the functional anatomy of
      the elbow. The components of an elbow examination include inspection/observation,
      palpation of bony and soft tissues, range of motion assessment, resisted muscle
      testing (both manual and mechanical), neurologic testing, and special tests. The
      special tests commonly performed on the thrower's elbow are the Tinel test,
      tennis elbow sign, ulnar collateral ligament stability testing, valgus extension
      overload test, and radiocapitella chondromalacia test. Other tests include
      radiographic examination, such as computerized tomograph arthrogram and magnetic
      resonance imaging testing. Information presented in this paper will provide the
      clinician with a systematic and thorough evaluation process for the thrower's
      elbow.

PMID- 8343790
TI  - Rehabilitation of the elbow in the throwing athlete.
AB  - Rehabilitation following an injury to the elbow joint complex is common in
      physical therapy practice. The unique anatomical considerations of the elbow
      joint provide a significant challenge to the therapist in rehabilitating elbow
      injuries. The purpose of this paper is to describe the rehabilitation process for
      various elbow pathologies and provide a rationale for their treatment. The
      rehabilitation process for the injured elbow presented in this paper will
      emphasize phases that are progressive, sequential, and based on clinical and
      scientific research.

PMID- 8343792
TI  - Sphygmomanometer vs. dynamometer.

PMID- 8343791
TI  - Ron Peyton Award Lecture. Quality, service, and innovation--the signature of a
      practice.

PMID- 8343793
TI  - Sympathetic effect of stretching: only neurogenic?

PMID- 8343794
TI  - Use of ultrasonography in the evaluation of the infertile man.
AB  - Transrectal ultrasonography (TRUS) is a modality that most urologists are
      familiar with in the interpretation of prostate anatomy and pathology.
      Understanding the anatomy and pathology of the genital ductal system will help in
      the diagnosis of disease entities related to male infertility. Familiarity with
      both scrotal and transrectal ultrasound is vital to the understanding and
      diagnosis of treatable causes of male infertility.

PMID- 8343796
TI  - Artificial intelligence in medicine and male infertility.
AB  - MAIN PROBLEM: fertility data is inadequately assessed by traditional statistical
      methods for a variety of reasons. First, the principal test of male fertility
      potential, the Semen Analysis (SA) is a composite of several dissimilar
      parameters, and the SA and other laboratory tests of fertility potential reflect
      physiological mechanisms that interact in complex ways. Second, patient data is
      often fragmented, obtained from multiple sources. Importantly, 2 patients are
      required for the final result. METHODS: Novel and powerful computational method,
      the neural network, was explored to analyze fertility data. An integrated series
      of programs was written in the C computer language to implement a back
      propagation algorithm. A model data analysis system was chosen, predicting the
      penetration of zona-free hamster ova by sperm (Sperm Penetration Assay (SPA)) and
      the distance travelled by the farthest swimming sperm (Penetrak Assay) from the
      SA, for these 2 assays are generally believed by the reproductive medical
      community to be independent of the SA. The classification accuracy of the neural
      network was compared to 2 standard statistical methods, linear discriminant
      function analysis (LDFA) and quadratic discriminant function analysis (QDFA).
      RESULTS: A neural network could be trained to correctly predict the Penetrak
      result in over 80% of assays it had not previously encountered, and another
      network could predict the SPA outcome in nearly 70%. The neural network was
      superior to LDFA and QDFA in predicting both assay outcomes (for Penetrak: LDFA =
      64%, QDFA = 69%; for SPA: LDFA = 65%, QDFA = 45%).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8343795
TI  - Preventable causes of male infertility.
AB  - The initial evaluation of the infertile man includes a diligent search for
      testicular factors, gonadotoxins, and coital factors so as to identify existing
      causes of impaired fertility and to prevent further dimunition in fertility.
      There are also prophylactic measures in the treatment of all men that can prevent
      future infertility, such as prompt correction of cryptorchidism, testicular
      torsion, genital infection, and adolescent varicocele and proper precautions to
      limit occupational, medical, and recreational gonadotoxins.

PMID- 8343797
TI  - The effect of age on male reproductive function.
AB  - When couples elect to defer child bearing, the effects of age on reproductive
      potential must be considered. The impact of advancing age on female reproductive
      potential has been well documented. Relatively less attention, however, has been
      directed toward the effect of age on male reproductive function. Although less
      pronounced than its effect on female fertility, advancing age does have an impact
      on male reproduction. Among men, increasing age is associated with a decrease in
      sexual function as well as changes in testicular histology and a decline in basic
      fertility parameters. Additionally, there is an identifiable association between
      advanced paternal age and subsequent birth defects. These issues should be borne
      in mind when men are counseled regarding the age at which they elect to establish
      families.

PMID- 8343798
TI  - Infection and pyospermia in male infertility.
AB  - Infections of the male genitourinary tract may contribute to infertility by
      adversely affecting sperm function, causing anatomical obstruction or initiating
      a leukocyte response. The majority of infertile males are asymptomatic, and the
      significance and the criteria for the diagnosis of a genital tract infection are
      controversial. The evaluation for a genital tract infection focuses on urine and
      semen cultures as well as on the accurate quantitation of seminal leukocytes. An
      elevated seminal leukocyte count, pyospermia, can be associated with male
      infertility and may reflect an infectious or inflammatory disorder. In addition,
      the role of specific genital tract infections such as chlamydiosis, gonorrhea,
      ureaplasma and trichomoniasis and their possible association with male
      infertility is addressed.

PMID- 8343799
TI  - Congenital bilateral absence of the vas deferens and cystic fibrosis. A genetic
      commonality.
AB  - CF and CBAVD are really just ends of a clinical spectrum. The type and nature of
      the mutations in the CF gene probably determine the phenotypic expression of the
      patient. Perhaps all patients homozygous for delta F508, for example, will have
      severe pulmonary and pancreatic disease as well as absent vasa, whereas those
      with other combinations, such as delta F508/D1270N, will be unaffected in terms
      of pulmonary and pancreatic function but will have absent vasa. Besides
      contributing to a better understanding of the nature of CBAVD, this linkage of CF
      and CBAVD most importantly mandates genetic screening and counseling for
      appropriate family members and even the patient's spouse. In addition, a broader
      understanding of CF is now at hand, as this brings a whole new cohort of patients
      under the CF umbrella. Many of these will have at least one, if not two, rare or
      novel CF gene mutations. Once all of these mutations have been detected and
      defined, our knowledge of the CF gene, its mutations, and their implications will
      be dramatically expanded.

PMID- 8343801
TI  - Laboratory testing in the evaluation of male infertility. A rational approach.
AB  - Laboratory testing is an integral component of the evaluation of the infertile
      man. This testing must be appropriate and specific for the individual couple. As
      there are many tests that evaluate various aspects of infertility, the urologist
      must understand what information the tests can offer as well as the limitations
      of each assay. The semen analysis remains the cornerstone of the evaluation but
      is not a functional assay. Other assays such as sperm-cervical mucus tests,
      hemizona assays, and the sperm-penetration assay are functional tests. Through
      the appropriate use of these and other tests, the urologist will be capable of
      better and more accurately counseling the infertile couple.

PMID- 8343802
TI  - Lelystad virus and the porcine epidemic abortion and respiratory syndrome.
AB  - Lelystad virus is the causal agent of a relatively new pig disease, variously
      known as mystery swine disease, porcine epidemic abortion and respiratory
      syndrome and porcine reproductive and respiratory syndrome. The virus is a small,
      enveloped RNA virus, that tentatively can be included in a new virus family, the
      Arteriviridae. The virus has infected pigs throughout the world and seems to
      persist in many pig populations and in individual pigs. Clinical signs of an
      infection with Lelystad virus are characterized by late term abortions and still
      birth in sows, and respiratory disease in piglets.

PMID- 8343800
TI  - Ejaculatory failure.
AB  - Although anejaculation is a relatively uncommon occurrence in the general
      population, over 12,000 new cases are reported annually. Anejaculation may result
      from spinal cord injury (SCI), retroperitoneal lymph node dissection (RPLND),
      diabetes mellitis, transverse myelitis, multiple sclerosis, or psychogenic
      disorders. At least 30% of men with this problem are or will be married and many
      will seek help to remedy their infertile state. The evolution of technique and
      instrumentation over the least 30 years has made electroejaculation an accessible
      and acceptable form of therapy. Recent successes in inducing ejaculation by means
      of rectal probe electrostimulation or vibratory stimulation combined with
      assisted reproductive techniques, such as zygote intrafallopian transfer (ZIFT),
      gamete intrafallopian transfer (GIFT), and in vitro fertilization (IVF), have
      provided these men a means of producing their own biologic offspring.

PMID- 8343803
TI  - [Viral epizootic in the marine seal calf (Phoca vitulina) in 1988.
      Epidemiological aspects].
AB  - During the year 1988, an epizootic spread through European populations of harbour
      seals (Phoca vitulina). The first studies shed light on the importance of a new
      morbillivirus, close to canine distemper virus but different. However, other
      factors, like pollution by polychlorinated biphenyl (PCB) compounds may have
      played a part in the epizootic by increasing mortality. Up to then virology and
      pathology of wild populations of seals were not well known. This epizootic was an
      opportunity to learn about seal virus and their specificity, and to discover some
      biological and evolutionary implications of such a phenomenon.

PMID- 8343804
TI  - Morbillivirus infections in aquatic mammals.
AB  - Infections with morbilliviruses have caused heavy losses among different
      populations of aquatic mammals during the last 5 years. Two different
      morbilliviruses were isolated from disease outbreaks among seals in Europe and
      Siberia: phocid distemper virus-1 (PDV-1) and phocid distemper virus-2 (PDV-2)
      respectively. PDV-1 was characterized as a newly identified morbillivirus, most
      related to canine distemper virus (CDV), whereas PDV-2 most probably is a strain
      of CDV. Morbilliviruses were also isolated from porpoises--porpoise morbillivirus
      (PMV)--and dolphins--dolphin morbillivirus (DMV)--which had stranded on the
      coasts of Europe. PMV and DMV proved to be closely related to, but distinct from
      2 ruminant morbilliviruses, rinderpest virus (RPV) and peste-des-petits-ruminants
      virus (PPRV). Serological surveys carried out among pinniped and cetacean species
      in the seas of Europe and North America indicated that infections with these
      newly discovered morbilliviruses or closely related viruses commonly occur among
      aquatic mammal species.

PMID- 8343805
TI  - Current status of the diagnosis and control of African horse sickness.
AB  - African horse sickness (AHS) is an infectious, non-contagious, highly fatal viral
      disease of Equidae, transmitted by arthropod vectors of the genus Culicoides, and
      endemic in Africa south and east of the Sahara. The disease is caused by a virus
      of the Reoviridae family, genus Orbivirus, and 9 serotypes have been recognized.
      Recent outbreaks of AHS in the Iberian peninsula and Northern Africa emphasize
      the need for accurate diagnosis and rapid implementation of control measures. In
      this paper, the epizootiological factors, clinical signs and necropsy findings of
      AHS are discussed, and an updated review of diagnostic laboratory methods
      together with a description of the main control measures is given.

PMID- 8343807
TI  - Special issue: New viral diseases of animals.

PMID- 8343806
TI  - [Bovine spongiform encephalopathy in Europe. Present and future].
AB  - Occurrence since 1986 and extension as an extended common source epidemic in
      United Kingdom of a new neurological bovine condition: bovine spongiform
      encephalopathy (BSE) initiated numerous epidemiological research actions in this
      country in order to discover the origin of this new disease, predict its
      evolution and implement control measures. In the same time epidemiological
      surveillance systems have been set up in several European countries leading to
      the identification of sporadic BSE cases in Ireland, Switzerland and France. In
      spite of the numerous informations published, a number of topics are not
      precisely known: identity and origin of BSE agent, influence of contaminated
      bovine genetics over disease development in contaminated bovine, infection
      incidence in herds where disease has been identified. As BSE is a member of the
      group of transmissible spongiform encephalopathies, concerns about foodborne
      transmission from cattle to human and inoculation of medicinal products
      containing bovine material and used for therapy or prevention in human beings or
      animals, has been expressed. The demonstration of iatrogenic transmission between
      human beings of Creutzfeld-Jakob disease has considerably influenced the
      implementation of measures to prevent the hypothetical risk for man to be
      infected by medicinal products or medical devises containing material of bovine
      origin.

PMID- 8343808
TI  - [Anticoccidial vaccines. Review and perspectives].
AB  - Coccidioses are a major problem for the poultry industry. Currently, the diseases
      are controlled by drug chemoprevention, but the development of chemoresistant
      strains has for several years incited investigators to search for a vaccine.
      Several methods were investigated: oocyst administration at low and controlled
      doses, administration of strains which had been attenuated by physical or
      biochemical means, immunization with extracted or recombinant antigens. For some
      years to come genetically selected precocious live strains of Eimeria which are
      now commercially available will be useful as vaccines; but in the future,
      genetically engineered antigens will provide new opportunities for a successful
      vaccination.

PMID- 8343809
TI  - Actinomyces pyogenes: susceptibility of 103 clinical animal isolates to 22
      antimicrobial agents.
AB  - Actinomyces pyogenes induces suppurative diseases in ruminants and many other
      animal species. Most of the earlier antimicrobial susceptibility data has been
      obtained by disk diffusion techniques. Minimal inhibitory concentrations (MIC) of
      22 antibiotics for 103 strains of A pyogenes of animal origin were determined by
      agar dilution test (Mueller-Hinton agar supplemented with 5% sheep blood). All
      the strains were susceptible to penicillin G, amoxicillin, methicillin,
      cephalothin, cefoperazone, pristinamycin, kanamycin, gentamicin, spectinomycin,
      chloramphenicol, vancomycin, novobiocin and rifampin. Fifty-nine percent were
      resistant to streptomycin, 67% to tetracycline, doxycycline and minocycline, 12%
      to erythromycin, spiramycin and lincomycin. Most of the strains resistant to
      macrolides and lincosamides exhibited a constitutive MLS(B)-like phenotype. In
      the cultural conditions used, it was not possible to determine accurate MIC of
      fucidic acid and pefloxacin.

PMID- 8343810
TI  - Liver biopsy in sheep.
AB  - Liver biopsies were performed in the same group of 16 sheep on 8 consecutive wk
      using an apparatus with a fibre optic continuous light source and a telescope.
      The sheep were placed in a sternal position on a special table constructed of
      metal pipes (3.8 cm diameter) and 4.5 cm spacing. Approximately 300 mg of fresh
      liver sample was removed from each sheep to be analyzed for copper or vitamin E.

PMID- 8343811
TI  - Comparative survival of first-stage larvae of small lungworms Muellerius
      capillaris and Neostrongylus linearis of goats in alfalfa and ryegrass plots.
AB  - Faeces from a goat infected with M capillaris and from another infected with N
      linearis were used to assess survival of first-stage larvae under natural
      conditions in northwest France in mid-autumn, at the high-risk period. The faeces
      were deposited on 3 plots covered respectively with ryegrass, short cut alfalfa
      and high alfalfa. The desiccation of faeces and survival of larvae were tested at
      1, 7, 14 and 21-d intervals. Survival of M capillaris was much higher than that
      of N linearis in all plots. The lower desiccations were observed in the high
      alfalfa plot whereas the best survivals were found in the 2 other plots.
      Vegetation where faeces are deposited may thus play a part in the accumulation of
      parasitic risk on a pasture.

PMID- 8343812
TI  - Intra- vs intermuscular injections in swine.
AB  - In order to determine the exact localization (intra- vs intermuscular) in which a
      drug is injected when administered by a so-called intramuscular injection
      technique, a radiopaque test article (2 ml) was injected into the cervical
      musculature (2 sites), the loins and the gluteal mass in anaesthesized pigs.
      Immediately after this, the pigs were euthanized and deep-frozen. Then they were
      cut into slices, which were X-rayed to determine the exact localization of the
      test material. Semi-quantitative scores were given to each injection site
      according to the amount of test article found in or out of muscle mass and also
      to the absence or the presence of test article subcutaneously. The loins area
      obtained the highest score for intramuscular location, but in this site,
      injections were almost always followed by a flowing back of the test article to
      the subcutaneous' area. It was shown that an injection in the neck perpendicular
      to the skin surface just behind the base of the ear was the most appropriate site
      for intramuscular injection in pigs.

PMID- 8343813
TI  - Serum coloration as a criterion of the severity of experimental coccidiosis in
      the chicken.
AB  - Serum decoloration may be used as a criterion for the severity of coccidiosis.
      Direct measurement of serum coloration at 480 nm is easy to carry out and, with
      micromethods, it is not necessary to slaughter animals. With intestinal coccidia
      the sensitivity is high, and there is good correlation with the severity of
      infection and variability is small. With Eimeria tenella infection the criterion
      is less sensitive, but may be of value for some purposes.

PMID- 8343814
TI  - Suppressive effect of serum from pigs and dogs fed a diet deficient in vitamin E
      and selenium on lymphocyte proliferation.
AB  - The effect of sera collected from either pigs or dogs previously fed a vitamin E
      (vit E)- and selenium (Se)-deficient diet on in vitro lymphocyte blastogenesis
      response to mitogens was studied. Porcine sera were obtained from pigs used in 2
      different trials. In I trial, 4-wk-old pigs received either a basal diet
      deficient in vit E and Se or the basal diet supplemented with Vit E, Se or Vit E
      and Se. Pigs were maintained on their respective diet for 25 d. Canine sera were
      collected from pups maintained on a deficient diet for 8 wk. Four dogs and 4 pigs
      maintained on a commercial diet were used as donors of peripheral blood
      lymphocytes (PBL). The addition of sera from pigs or dogs maintained on a vit E-
      and Se-deficient diet markedly suppressed both porcine and canine PBL response to
      mitogens. Porcine PBL blastogenesis was also suppressed when porcine or canine
      sera were added 8, 24 or 48 h after the beginning of the incubation period to
      culture containing 1% of fetal bovine serum (FBS). However, the suppressive
      effect caused by porcine sera was less severe than the one due to canine sera.
      Addition of 1% FBS in the cultures was sufficient to eliminate the suppression
      caused by the presence of sera from pigs fed a vit E- and Se-deficient diet.
      Other attempts to restore the lymphocyte response to mitogens by the addition of
      indomethacin, diethylcarbamazine or eicosatetraynoic acid, inhibitors of
      prostaglandin and/or leukotriene synthesis, were not successful. Because of the
      severe suppression caused by sera from animals maintained on a vit E- and Se
      deficient diet on the in vitro response of lymphocytes to mitogenic stimulations,
      it is very important to take precautions to avoid such deficiency. In vivo
      suppression of immunocompetent cells to antigenic stimulations may impair the
      capacity of the host to control infections.

PMID- 8343815
TI  - Using the social policy statement.

PMID- 8343816
TI  - The answer is in your hands.

PMID- 8343817
TI  - Casualisation crisis.

PMID- 8343818
TI  - Act condemned.

PMID- 8343820
TI  - Courageous nurses.

PMID- 8343819
TI  - Clients' rights: nurses' role.

PMID- 8343821
TI  - New Zealand Nurses' Organisation. Patients' code of rights and responsibilities.

PMID- 8343822
TI  - A bicultural journey.

PMID- 8343823
TI  - Nurses--get an attitude for the '90s.

PMID- 8343824
TI  - To know, you must pay.

PMID- 8343825
TI  - Promoting standards.

PMID- 8343826
TI  - [Intervertebral disc calcification in childhood].
AB  - Author describes a case of calcification of the intervertebral disk in a child,
      observed simultaneously in two segments on the dorsal spine. During a long
      observation the signs of remission were observed. The case was thought worthy to
      be published because of the rare occurrence and the problematic differential
      diagnosis.

PMID- 8343827
TI  - [The effect of breach presentation on the development of the hips].
AB  - Authors examined, using sonographic methods in 100 children with breech
      presentation, which of the intrauterine postures means a major danger in the
      development of hip dysplasia. It was found that acetabular alterations, requiring
      therapy or not, develop more frequently in groups in which the hips were in total
      flexion, the knees in semiflexion and the lower extremities in major external
      rotation. Based on their results they state that not the simple breech position
      is the greatest danger in the development of dysplasia and dislocation in babies
      born with breech presentation.

PMID- 8343828
TI  - [Injuries to the knee extensors. Rupture of the patellar tendon and the
      quadriceps].
AB  - Authors discuss, based on the experiences of their 18 cases, the injuries of the
      knee extensors. 5 ruptures of the quadriceps and 9 of the lig. patellae propr.
      were observed in the 14 cases controlled. Based on their own experiences and the
      standpoints of the literature they suggest the operative therapy within 6 hours
      in the open injury and within 1-5 days following the accident in closed cases.
      The experiences, the operative technique, the viewponts of the aftercare and the
      end results are described.

PMID- 8343829
TI  - [A Cloward-type bone-harvesting technic in the management of pseudarthrosis of
      the navicular bone].
AB  - Authors present an apparatus resembling the Cloward instrument, that can be
      however used more simply and safely for gaining a good quality cortico-spongious
      cylinder from the iliac wing. The functioning of the bone gaining instrument and
      the process of bone gaining is described. The apparatus was used in more than 100
      cases for filling up with spongious bone chips the cavity arising after the
      cleaning of the pseudarthrosis of the navicular bone. Three different cases are
      presented to demonstrate the alternative applications of the apparatus. It is
      supported by literary data that the autologous bone gained from the iliac wing is
      the most suitable for transplantation.

PMID- 8343830
TI  - [Traumatic hip dislocation in childhood].
AB  - Authors describe the diagnostic and therapeutic problems of the traumatic
      dislocation of the hip in children and report on the experiences of their 8
      cases. It is stressed that the condition of the good result in the early
      diagnosis and reduction. For the recognition and treatment of the late
      complications a 1.5-2 years follow-up of the patients is thought to be important.

PMID- 8343831
TI  - [Use of a distally pedicled radial artery as an island flap for covering
      traumatic skin losses].
AB  - Authors performed plastic operation using lower arm insulated flap with distal
      pedicle in 2 cases for covering traumatic skin defects on the dorsal side of the
      hand. Attention is called to the advantages of this method. Beside the shorter
      time of treatment in many cases a series of operations can be avoided by the
      primary covering with an insulated flap.

PMID- 8343832
TI  - [Use of preserved homograft for covering burn injuries].
AB  - Authors describe the considerations supporting the use of cadaveric skin
      homografts. The surgical relations of the burns, the site and advantages of the
      application of the homografts in the treatment of the burned patients are
      summarized.

PMID- 8343833
TI  - [Corrective possibilities by subcapital metatarsal osteotomy in the management of
      hallux valgus and metatarsus primus valgus].
AB  - The extent of correction achievable by inclined subcapital osteotomy of the
      metatarsus I. was studied in 100 cases of the deformation. The different angular
      values and dimensions were compared in the X-ray plates taken pre- and
      postoperatively and the clinical changes of the patients were evaluated on the
      basis of subjective complaints and objective symptoms. The angular limit values
      of the performability of osteotomy were determined. In deformations larger than
      the limit values wedge and half-wedge osteotomy, basisosteotomy, respectively,
      are the expedient methods.

PMID- 8343835
TI  - [DHS (Dynamic Hip Screw)-osteosynthesis in the management of femoral fractures in
      the hip region and the place of this method in the treatment of such injuries].
AB  - In the last four years we performed 182 osteosynthesizes with Dynamic Hip Screw,
      besides other methods on the fractures of the hip region. Here we are presenting
      the evaluation of our results, which, regarding the international scene, fall
      into the medium category. The operations were performed within three days after
      the injuries in 61 per cent of our patients. Our results are good in 80 per cent
      of our patients. The incidence of method-specific complications is 15 per cent in
      our statistics/such as wound haematomas, local infections, cut out of the device
      of the femoral head, metal failures, the fracture of the femur at the site of the
      introduction of the device). The rate of complications is 30 per cent in case of
      Ender nailing. More than a 1 cm shortening in the fracture after weight bearing
      was observed in the 47 per cent of our DHS cases. Patients who are complaining of
      pain during weight bearing belong to this group. In accordance with other
      authors, we consider the DHS osteosynthesis, due to its high stability, the best
      technique in case of unstable pertochanteric fractures of elderly patients. We
      recommend the angular plate fixation to the pertrochanteric fractures in young
      patients, in whose case it requires a more accurate reposition and who are able
      to walk without weight bearing. We can achieve good results with Ender nails in
      case of stable pertrochanteric fractures of elderly patients.

PMID- 8343834
TI  - [Results of osteotomies in the management of valgus gonarthrosis].
AB  - Authors report on the result of correction osteotomies in 31 cases of
      gonarthrosis, developed in consequence of valgus deformity. In 12 cases high
      tibial osteotomy, in 19 supracondylar femoral osteotomy were performed. The
      result was excellent in 15, good in 10 and poor in 6 patients. Decisive factors
      of the favourable result were partly the correction of the femorotibial valgus to
      around the physiological values, partly the horizontalization of the articular
      surface. In overcorrection the results deteriorate. The medial tilt of the tibial
      articular surface leads to the progression of the arthrosis. Supracondylar
      femoral osteotomy was found especially successful in the treatment of valgus
      gonarthrosis. High tibial osteotomy is suggested only in selective cases.

PMID- 8343836
TI  - [Surgical-technical problems of triple pelvic osteotomy. Early results of the
      polygonal method].
AB  - Since the first description of the triple pelvic osteotomies papers reporting on
      the improvement of the operative technique were continuously published. This is
      explained by the more problematic details of the operation. Authors worked out to
      the technique of the polygonal triple pelvic osteotomy, published by Kotz, David
      and Uyka, a new exposure that makes more simple, quick and safe the performance
      of the operation. The essential feature is that the os ischii is reached after
      the osteotomy of the trochanter major from a lateral exposure and so the field of
      operation can be widely surveyed. At the same time transposition can also be
      performed. The experiences gained in 12 operations are reported, 8 of which were
      made according to their own method (follow-up: 8-22 months, in average 15
      months). The patients were 14-33 years old and their complaints disappeared in
      every case. Authors suggest the operation for the correction of the dysplastic
      acetabulum in young adults and also in puberty after the fusion of the Y
      cartilage if no subluxation exists. Minor articular deformity and mild arthrosis
      are not considered as a contraindication.

PMID- 8343837
TI  - [A point system for the comparative evaluation of the treatment of
      acromioclavicular dislocations].
AB  - Authors treated 165 patients for fresh acromioclavicular dislocation. In the
      period examined four different operative procedures were used for the transitory
      fixation of the joint. The results of treatment are assessed with a point system
      worked out by them. Their method makes the establishment of collective
      statistics, based on uniform points of view and extended to more institutions
      possible. By this an objective comparison on the effectiveness of the single
      conservative and operative methods of treatment will be practicable.

PMID- 8343838
TI  - [Transposition of the trapezius muscle in the management of deltoid muscle
      paralysis caused by injury to the axillary nerve].
AB  - Authors report in connection with two cases, operated on with an operative
      procedure rather rare in the practice in this country. The deltoid paralysis,
      developed following the injury of the axillary nerve, was successfully treated
      with the transposition of the bony insertion of the trapezius muscle to the
      proximal part of the humerus.

PMID- 8343839
TI  - [Surgical treatment of inveterate Monteggia injury in childhood].
AB  - Authors, based on the experience gained from the operative therapy of a 9 year
      old child with inveterated Monteggia injury, discuss the types, the diagnosis and
      the principles of treatment of this injury. They take the part of urgent
      treatment following early diagnosis as the results of the treatment of the non
      fresh cases are generally less favourable.

PMID- 8343840
TI  - [Aseptic femur head necrosis and therapeutic possibilities by using a bone graft
      with a vascular pedicle].
AB  - The review of the occurrence, etiopathology, classification and diagnosis of the
      aseptic necrosis of the femoral head is followed by the description of the method
      of transplantation of the vascular pedicled bone graft. During 5 years
      implantation of 12 vascular pedicled bone grafts in 10 young patients with severe
      and of major extension necrosis of the femoral head was carried out. The early
      result was in every case the quick and significant decrease of pains and that the
      necrosis did not progress. In the early stage the severe consequence of the
      necrosis the collapse can be prevented with core decompression. In a later stage
      the vascular pedicled revascularization of the femoral head may retain in young
      patients, beside adequate hip movements, the gait and the working capacity. This,
      though it is not a final solution, will give chance by gaining time to perform
      prosthesis operations later.

PMID- 8343841
TI  - [Epidemiology of hand injuries based on surveys in Vas County].
AB  - Authors have found in a 1 year survey in the county Vas 7580 hand injuries. The
      major proportion of young men and adolescents in the material was conspicuous.
      The types of accidents were investigated together with the place of the accident
      and types of the injury. The material shows that in contrary to the accidents of
      the work in the recent past the number of the accidents at home has increased-
      and so their prophylaxis became the main point.

PMID- 8343842
TI  - [Surgical management of acetabulum fractures].
AB  - Author reports on the experiences with the operative treatment of 48 acetabular
      fractures in his Department during 19 years. He thinks that the operative
      treatment of the acetabular fractures may be successful only after the exact
      preoperative diagnosis and classification of the type of the fracture. After this
      the exposure may be chosen. During the operation one has to strive to the exact
      reconstruction of the articular surfaces and the performance of such stable
      osteosynthesis that will enable the early movements of the joint without weight
      bearing. If, because of the severity of the injury, the exact reconstruction of
      the acetabulum is not possible an effort must be made to create an anatomical
      situation that will give favourable conditions to late reconstruction operations
      (arthrodesis or endoprosthesis). Author describes after discussing the
      classification, diagnosis and treatment of the acetabular fractures his own
      results: in more than 3/4 of his cases excellent or good late results could be
      achieved. For this, with correct indication, the performance of the
      reconstruction operation is suggested.

PMID- 8343843
TI  - [Educational activities of the Hungarian National Institute of Traumatology].
AB  - Author recalls the nearly four decades education activity of the National
      Institute of Traumatology and the Chair of Traumatology of the Postgraduate
      University of Medicine. The importance of the high standard therapeutical
      activity is stressed. Similarly the education based on scientific activity is
      also thought indispensable. He describes the technical conditions and the data of
      the more important courses.

PMID- 8343844
TI  - [Immediate full-range active movement after suturing of the flexor tendon. A new
      dynamic guiding splint].
AB  - Immediate full range active movement after suture of the flexor tendon. New
      dynamic guiding splintAuthors emphasize based on literary data, the advantages of
      the active postoperative movements. A technique for suture and mobilization
      protocol are offered. They constructed a new dynamic guiding splint assisting the
      active movement and describe its preparation in details. Their own material,
      treated with the method suggested, is analysed.

PMID- 8343845
TI  - [Surgery of infected hand injuries in Bacs-Kiskun County].
AB  - The therapy of the diseases of the infected hand belongs to the most difficult
      tasks of the hand surgery. In the county Bacs-Kiskun we have reached important
      results during the last two decades, described in this paper, together with the
      Hand Surgery Work Groups of the Accident Departments of Kecskemet (County
      Hospital), Baja and Kiskunhalas.

PMID- 8343846
TI  - [Use of a new fixation device--the intraosseal compression loop --in the
      management of articular (osteochondral) fractures of the hand].
AB  - Author describes a new method, the intraosseal compression loop, unknown until
      now in this country for the treatment of intraarticular, osteochondral fractures.
      The advantages of the new method are analysed, attention is called however to the
      fact, that it can be used only in the therapy of certain types of fractures and
      it can be only one from the great variety of procedures for the treatment of
      osteochondrial fractures. It is demonstrated with a few examples that the method
      can be used to treat unstable diaphyseal fractures too.

PMID- 8343847
TI  - [Dorsal metacarpal vascular pedicled reverse flap].
AB  - Author describes the anatomical basis and the possibilities of application of the
      dorsal metacarpal vascular pedicled reverse flap used first in this country. The
      vascular pedicled flap ins suitable to cover the skin and soft part defects over
      the dorsal surface of the ground phalanx of the long fingers and over the PIP
      joint.

PMID- 8343848
TI  - [Talus substitution using a vascular pedicled bone flap].
AB  - Authors report on the substitution of in consequence of complete talus luxation,
      missing talus. It succeeded with the transplantation of a free vascular pedicled
      bone block, gained from the crista ilei to retain the length of the extremity and
      to secure the gait of the patient without aid, finally to make the return to the
      former active life possible. The use of the method in similar cases was found to
      be unknown after a review of the literature. This case is an example
      demonstrating the growing significance of microsurgery in the traumatology.

PMID- 8343849
TI  - [Examination of the reperfusion damage to a striated muscle: possible
      pathomechanism and prevention].
AB  - We have examined in a series of experiments the pathomechanisms of the damage
      caused by the reperfusion following ischaemia of the striated muscle. The lipid
      peroxidation products (thiobarbitur acid-reactive materials [TBARS]) and the
      glutathion state were observed comparing the behaviour of the white and red fiber
      types. We have found significantly higher reduced and oxydated glutathion (GSH
      and GSSG) and TBARS values also in physiological circumstances in the red muscle
      fibers. At the end of a 4 hours ischaemia period no significant alteration was
      found in the above parameters though both the levels of GSH and GSSG were raised
      their ratio however did not change. We have measured expressed change with the
      elevation of the GSSG/GSH rate following a 1 hour reperfusion (108% +/- 22 in the
      white and 490% +/- 103 in the red muscle fibers) whereas the TBARS values still
      did not show significant elevation. In the second hour of the reperfusion the
      GSSG/GSH further elevated and beside this the expressed elevation of the TBARS
      could also be demonstrated (164% +/- 48 in the white and 152% +/- 28 in the red
      fibers. During the further reperfusion lasting altogether 12 hours we did not
      observe a significant decrease. The time sequence of these processes suggest that
      the lipiduperoxidation occurs only after the total exhaustion of the antioxidant
      reserves of the cell. The treatment with Methylprednisolon (MP), deferoxamine
      (DFO) and superoxid-dismutase+catalase (SOD+CAT) diminished in both types of
      fibers the raise of TBARS values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343850
TI  - [The KT 1000 arhtrometer in the comparative study of stability of knee joints
      operated on for instability].
AB  - In 1981 through 1989 authors performed 160 complex reconstruction operations for
      instability of the knee joint according to the basic principles of W. Muller,
      striving to restore all structures injured. 92 patients with 378 operations were
      controlled. The assessment of the results was based on the physical examination,
      the measurement of ligament laxity with the K 1000 arthrometer, the opinion of
      the patients, the level of their activity and Lysholm's functional point system
      was used. The stability of the knee could be restored in 73 per cent of the
      cases. The patients have thought the knees, found more stable with the
      arthrometer, really more stable. There was however no unambiguous relation
      between the knee stability and the level of activity of the patients. The most
      frequent complaint was pain, increased synovial fluid and the hindrance of
      squatting. The results were better if the patient had no previous operation in an
      other department and in those who did not need menisectomy, who had less
      operations, less body weight and better muscular force.

PMID- 8343851
TI  - Three monoclonal antibodies differentiate human from murine epidermis.
AB  - In order to establish a set of epidermal species markers, normal human skin,
      murine skin and human skin transplanted to nude mice were stained with monoclonal
      antibodies directed to cell membrane-bound carbohydrates, a basement membrane
      component and a structure in the cell nucleus. Three epidermal species markers
      were identified. Two markers stained exclusively human epidermis: LH7.2 detects
      type VII collagen and stained the basement membrane of human epidermis in unfixed
      frozen sections, while LP4N stained cell nuclei in human epidermis in methanol
      acetone-fixed frozen sections. The third marker, HH14, stained exclusively murine
      epidermis. HH14 defines the histo-blood group H carbohydrate antigen and stained
      spinous cell membranes of murine epidermis in both frozen and formalin-fixed
      sections.

PMID- 8343852
TI  - Vectorial delivery of newly-synthesized secretory proteins by human tracheal
      gland cells in culture.
AB  - The polarized secretion of newly-synthesized proteins of human tracheal
      submucosal gland cells was studied. Human tracheal gland cells were cultured on
      permeable filter supports allowing a separate biochemical analysis of apical and
      basal secretion. By transmission electron microscopy, confluent filter-grown
      cells were seen to form a continuous sheet of both multilayer and monolayer
      epithelial cells. Junctional complexes between adjacent cells were observed. On
      immunofluorescence microscopy, human tracheal gland cells in cultured exhibited
      characteristics of epithelial and secretory cells, including cytoplasmic staining
      for cytokeratin and for two secretory protein markers specific to the glandular
      serous type cell: lysozyme and antileucoprotease. [35S]methionine metabolic
      labelling experiments demonstrated that at least 90% of newly-synthesized
      secretory proteins were recovered in the apical medium. Moreover, lysozyme
      secretion was strongly polarized since 85% was released into the apical medium.
      Conversely, antileucoprotease secretion was more bidirectional since nearly 40%
      of released antileucoprotease was present in the basal medium. The fact that
      these two secretory proteins are released with differing relative polarity
      emphasizes that human tracheal gland cells exhibit at least two different
      exocytotic routing operations.

PMID- 8343855
TI  - Effect of the pericardium on systolic ventricular interdependence in the dog.
AB  - Systolic ventricular interdependence, whereby changes in left ventricular (LV)
      ejection alter right ventricular (RV) ejection, has been described. It is
      unclear, however, whether this interaction is influenced by pericardial volume
      constraint or by myocardial mechanical coupling. We hypothesized that if
      mechanical coupling were the primary factor determining systolic ventricular
      interdependence then it should be unaltered by the presence or absence of an
      intact pericardium, but affected by changes in LV end-systolic volume. We tested
      this hypothesis by observing the changes in RV stroke volume (SVrv) and peak
      systolic pressure (PSPrv) during a single LV isovolumic contraction under
      conditions of normal or increased (1.3 x normal) RV end-diastolic volume with and
      without an intact pericardium. In 10 anesthetized, open-chested dogs SVrv was
      derived from the integrated pulmonary arterial flow probe signal and RV ejection
      fraction (EFrv) was derived from the thermodilution plateau method and a rapidly
      responsive thermistor in the pulmonary artery. Right ventricular end-diastolic
      volume was considered to be the ratio of SVrv to EFrv. Left ventricular
      isovolumic contraction increased SVrv and PSPrv during all conditions (P < .01).
      However, PSPrv increased more when the pericardium was intact (P < .05). These
      data suggest that LV ejection can enhance SVrv and that this interaction is not
      appreciably altered by volume loading or the presence of an intact pericardium.
      Pericardial interactions may alter PSPrv but do not affect SVrv.

PMID- 8343853
TI  - Sodium bicarbonate versus Carbicarb in canine myocardial hypercarbic acidosis.
AB  - The objective of this study was to compare the in vivo effects of sodium
      bicarbonate (NaHCO3) and Carbicarb infusion on regional contractile performance
      and acid-base status in the setting of hypercarbic acidosis. Animals (N = 9) were
      anesthetized and paralyzed using sodium pentothal, halothane, and pancuronium
      bromide, and mechanically ventilated with an air-O2 mixture so that arterial PO2
      was > or = 300 mm Hg. Following beta-adrenergic blockade, alveolar ventilation
      was gradually reduced over a 50-minute period to increase arterial PCO2 to 60 to
      80 mm Hg. Each of the following solutions was then infused in consecutive order
      directly into the left anterior descending artery coronary artery for 15 minutes:
      (1) 8.4% NaHCO3 at 2 mL/min; (2) 5% sodium chloride at 2 mL/min, equivalent to
      NaHCO3 in osmolality; (3) 6.3% Carbicarb at 0.5 mL/min, equivalent to NaHCO3 in
      buffer capacity; and (4) 6.3% Carbicarb at 2 mL/min, equivalent to NaHCO3 in
      volume. Regional stroke work analog (ultrasonic dimension transducers),
      interstitial myocardial pH (Khuri electrode), coronary blood flow (doppler flow
      probe), and hemodynamic/metabolic variables (heart rate, blood pressure, arterial
      and coronary venous blood gases) were measured at 1, 5, 10, and 15 minutes during
      each infusion and 10 minutes after the infusion was discontinued, ie, at 25
      minutes. Animals were allowed to recover for 45 minutes between interventions.
      Values at each time point were compared with baseline for statistical
      significance. Small reductions in interstitial myocardial pH (P < .05) and stroke
      work (P > .05) were observed within 1 minute of NaHCO3 administration. Both
      parameters increased significantly from baseline levels thereafter, ie,
      interstitial myocardial pH at 5 minutes and stroke work at 15 minutes. Infusion
      of Carbicarb invariably was associated with an increase (P < .05) in interstitial
      myocardial pH. Stroke work increased (P < .05) during low-dose Carbicarb
      administration, but infusion of the higher dose was accompanied by a biphasic
      response, ie, an increase (P < .05) from 0 to 5 minutes, followed by a gradual
      decrease that achieved statistical significance 10 minutes after termination of
      the infusion. End-diastolic length was inversely proportional to changes in
      stroke work, and coronary blood flow varied directly with changes in coronary
      venous Pco2. Myocardial O2 consumption decreased (P < .05) during Carbicarb
      infusion, but changes during NaHCO3 did not reach statistical significance. Our
      findings lend support to the hypothesis that intramyocardial pH determines
      myocardial function independent of CO2 production by buffer therapy.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8343854
TI  - Oxygen kinetics during liver transplantation: the relationship between delivery
      and consumption.
AB  - In anesthetized humans, oxygen consumption is independent of oxygen delivery
      above a critical threshold. Below this critical level, lactic acid is a marker of
      anaerobic metabolism and tissue oxygen debt, and heralds a supply dependency of
      oxygen consumption. The goal of this study was to determine whether a threshold
      value for oxygen delivery below which oxygen consumption becomes supply dependent
      can be identified in patients with normal, impaired, or absent liver function.
      Measurements were made in 34 surviving patients (group 1) and in 16 nonsurvivors
      with sepsis and postoperative liver graft failure (group 2). Hemodynamic
      measurements and blood samples were taken 10 minutes after introduction of
      anesthesia, 10 minutes after cross-clamping, and 10 minutes after reperfusion of
      the new liver. At these time points, we measured blood lactate, cardiac output,
      and arterial and mixed venous oxygen contents in order to calculate oxygen
      consumption and oxygen delivery. In both groups, cardiac output, oxygen delivery,
      and oxygen consumption decreased during the anhepatic phase and increased after
      unclamping of the inferior vena cava. Lactate increased in both groups during
      surgery, but was significantly higher in nonsurvivors (6.6 +/- 0.4 mmol/L) than
      in survivors (4.6 +/- 0.1 mmol/L) (P < .05). With similar changes for oxygen
      delivery and oxygen consumption during increased lactate levels we could not
      identify a clear supply dependency of oxygen consumption in survivors and
      nonsurvivors during liver transplantation. We conclude that the interpretation of
      blood lactate levels during circulatory shock can be biased due to a reduced
      lactate clearance in patients with impaired liver function, unrelated to the
      status of the relationship between oxygen delivery and consumption.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8343856
TI  - Oxygen uptake-oxygen delivery alterations in the isolated liver after hydrogen
      peroxide challenge.
AB  - Acute, diffuse lung injury is frequently complicated by systemic organ injury and
      alterations in the relationship between oxygen uptake (VO2) and oxygen delivery
      (QO2). In this regard, systemic organ neutrophil accumulation and morphologic
      alterations consistent with systemic organ injury often occur in nonpulmonary
      organs in these settings. However, whether VO2-QO2 matching is also altered in
      these injured systemic organs remains unproven. Thus, the present study was
      designed to test the hypothesis that hydrogen peroxide (H2O2), a product of
      neutrophil oxidative metabolism, will cause systemic organ structural
      abnormalities and alter VO2-QO2 matching. To test this hypothesis, VO2-QO2
      relationships, morphologic changes, and organ water content were evaluated in
      both uninjured, isolated perfused rabbit livers and in isolated perfused rabbit
      livers after injury with 5 mmol/L H2O2. Following H2O2 injury, peak VO2 fell from
      1.36 +/- 0.35 mL/min/100 g to 0.79 +/- 0.16 mL/min/100 g (P < .05) and peak O2
      extraction fell from 0.83 +/- 0.09 to 0.66 +/- 0.04 (P < .05). In addition, VO2
      was lower for any given level of QO2 in the H2O2-injured livers compared with the
      control livers (P < .01). Finally, liver extravascular water content was
      increased in H2O2-injured livers compared with the control livers (0.79 +/- 0.02
      v 0.71 +/- 0.05; P < .05). These observations indicate that H2O2, a product of
      neutrophil oxidative metabolism, is capable of producing both morphologic changes
      as well as gas exchange alterations in the isolated, perfused liver.

PMID- 8343857
TI  - Does alveolar recruitment occur with positive end-expiratory pressure in adult
      respiratory distress syndrome patients?
AB  - We studied the effects of positive end-expiratory pressure (PEEP) (2 to 14 cm
      H2O) on alveolar recruitment (Vrec), static respiratory compliance, and end
      expiratory lung volume (EELV) in nine sedated, paralyzed, mechanically ventilated
      adult respiratory distress syndrome patients. Positive end-expiratory pressure
      was applied in increasing and decreasing steps of 2 cm H2O. Flow, tidal volume,
      and airway pressure were measured. We used the rapid airway occlusion technique
      to determine static end-inspiratory elastic recoil pressure of the respiratory
      system (Pst, rs) and intrinsic PEEP (PEEPi). The changes in EELV were measured
      with respiratory inductive plethysmography. Alveolar recruitment was estimated as
      the difference in lung volume between PEEP and zero end-expiratory pressure
      (ZEEP) for the same end-inspiratory Pst, rs (20 cm H2O). We found that (1) Vrec
      with PEEP up to 14 cm H2O was in general rather small and was absent in two
      patients; (2) all patients exhibited PEEPi at ZEEP (5.6 +/- 1.0 cm H2O) and
      little change in EELV and Vrec was achieved until the external PEEP exceeded
      PEEPi; (3) if end-inspiratory Pst, rs is high at ZEEP, there is little or no
      alveolar recruitment with PEEP; and (4) Vrec and EELV were slightly higher during
      stepwise deflation than stepwise inflation with PEEP, except at ZEEP where EELV
      did not change after inflation-deflation runs with PEEP.

PMID- 8343858
TI  - Oxygen delivery-consumption relationship in adult respiratory distress syndrome
      patients: the effects of sepsis.
AB  - The oxygen consumption-delivery relationship (VO2/DO2) was studied in 15 sedated
      paralyzed patients with the adult respiratory distress syndrome (ARDS) due to
      multiple trauma and in whom sepsis was absent. Different levels (0 to 15 cm H2O)
      of positive end-expiratory pressure (PEEP) were applied. Oxygen delivery was
      calculated from cardiac index (thermodilution technique) and arterial oxygen
      content measurements. Oxygen consumption was calculated using Fick's equation.
      Regression lines were obtained for each patient. Oxygen supply dependency was
      defined as a significant (P < .05) relationship between changes in VO2 and DO2
      with PEEP. Results were compared with those obtained in 18 ARDS patients in whom
      ARDS was due to sepsis. In nonseptic ARDS patients no significant relationship
      between changes in VO2 and DO2 with PEEP was found within the experimental range
      of DO2 on zero end-expiratory pressure (ZEEP) (347 to 845 mL/min/m2). None of
      these patients had multiple organ system failure (MOSF), and 73% survived. In
      ARDS patients in whom sepsis was present, supply dependency was present only when
      DO2 on ZEEP ranged between 330 and 640 mL/min/m2. All these patients developed
      MOSF and died. When DO2 on ZEEP ranged between 686 and 951 mL/min/m2 in septic
      ARDS patients, the supply dependency phenomenon was absent and only three
      patients developed MOSF and died (70% survivors). In almost all patients PEEP
      reduced DO2 and therefore worsened O2 balance by either increasing O2 extraction
      ratio and approaching the critical threshold for supply dependency or dismissing
      DO2 from the range of non-supply dependency.

PMID- 8343860
TI  - On the allocation of critical care resources.

PMID- 8343859
TI  - How gram-positive organisms cause sepsis.

PMID- 8343861
TI  - The influence of gender on conflicts of interest in the allocation of limited
      critical care resources: justice versus care.
AB  - After noting that the principle of autonomy has been inadequate for the
      resolution of many of the complex and difficult moral dilemmas involving
      conflicts of interest in the allocation of limited critical care resources, this
      paper analyzes the concepts of justice and care as alternative solutions to moral
      problems and applies them to the issue of repeat organ transplants to a single
      recipient. These concepts are found to be the basis of the notions of moral
      reasoning and moral orientation, respectively, which serve in moral development
      theory as two fundamentally different ways to approach moral problem solving.
      Following an elaboration of moral reasoning as found in Kohlberg's cognitive
      moral development theory, the influence of gender on moral reasoning is
      investigated. The empirical data show that women (mean Defining Issues Test
      score, 47.18) score significantly higher (P < or = .0001) than men (mean Defining
      Issues Test score, 41.77) in the use of moral reasoning based on the concept of
      justice for resolving moral dilemmas. Following an elaboration of moral
      orientation as found in Gilligan's moral theory of the ethics of care, the
      influence of gender on moral orientation is investigated. The empirical data show
      that women use the concept of care significantly more often (P < or = .0139) than
      their male colleagues in resolving moral dilemmas. From these data it is
      concluded that men are more likely than women to use justice in the resolution of
      moral dilemmas, such as the conflicts of interest in the allocation of limited
      critical care resources, but that if women do use, or are required by the social
      system to use, justice in the resolution of moral dilemmas, they do a better job
      of it than men.

PMID- 8343862
TI  - Stressing the critically ill patient: the cardiopulmonary and metabolic responses
      to an acute increase in oxygen consumption.
AB  - Critically ill patients frequently have compromised respiratory and hemodynamic
      function. Chest physical therapy has been previously shown to increase oxygen
      demand and therefore was used to examine how postoperative mechanically
      ventilated patients responded to an increased oxygen demand. We found that during
      chest physical therapy, oxygen consumption increased 52% +/- 37% (SD) over
      baseline values. There was a 35% +/- 32% increase in oxygen extraction and a 17%
      +/- 33% increase in oxygen delivery. Arterial and pulmonary artery pressures also
      increased. The cardiac output increase was due to increased heart rate with no
      change in stroke volume. The increases in minute ventilation and alveolar
      ventilation were not sufficient to eliminate the greater quantity of carbon
      dioxide produced, resulting in a small increase in PaCO2. There was no
      significant change in systemic vascular resistance. The increase in oxygen demand
      caused by chest physical therapy triggered an integrated physiological response
      that resulted in increased respiratory and cardiac performance. This in some
      ways, such as the lack of increase in systemic vascular resistance, resembles the
      response to exercise.

PMID- 8343863
TI  - Effect of anesthesia and surgery on plasma cytokine levels.
AB  - Cytokines released in response to stress may have a profound impact on
      circulatory stability. There is no information on the effect of general
      anesthesia alone on plasma cytokine levels and little information on cytokine
      release following surgery. Plasma cytokine levels and hemodynamic parameters were
      measured during anesthesia and abdominal surgery under sterile and nonpyrogenic
      conditions in seven pigs anesthetized with ketamine and pentobarbital. Tumor
      necrosis factor (TNF) was measured by bioassay. Bioassays of low and high
      sensitivity were used to measure interleukin 6 (IL-6). Measurements were made
      sequentially during: (1) 4 hours observation with anesthesia alone; (2) 2 hours
      following laparotomy and traumatic intestinal manipulation (IM) sufficient to
      produce shock; and (3) after an intravenous bolus of 1 microgram/kg endotoxin as
      a positive control. Arterial blood pressure decreased following IM from 91.5 +/-
      5.8 to 48.6 +/- 3.2 mm Hg, (mean +/- SE, P < .05), with no further change
      following endotoxin. Heart rate was unchanged during the experiment, and central
      venous pressure decreased after endotoxin (P < .05). There were no increases in
      TNF or IL-6 (using a low sensitivity assay) with anesthesia alone or following IM
      with shock, but both increased after endotoxin administration (P < .05); using a
      high sensitivity assay, IL-6 did not change during anesthesia alone but did
      increase fivefold following IM with shock (P < .05) and 50-fold following
      endotoxin administration (P < .05). We conclude that in a porcine model under
      sterile and nonpyrogenic conditions, prolonged anesthesia does not increase
      plasma cytokine levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343864
TI  - Allocation of critical care resources: entitlements, responsibilities, and
      benefits.
AB  - Determination of allocation of limited critical care resources appears to be an
      inevitable development. Criteria proposed to assign such limited resources among
      patients are not defined. It has been argued that allocation of critical care
      resources could be based on the principals of patient entitlements to health
      care, responsibilities of the physician to the critically ill patient, and
      beneficence. However, based on an analysis of the philosophical tenants of the
      Hippocratic Oath, there is little to support the concept of "sin" taxes or
      patient triage on the basis of judgment on the moral merit of the patient.

PMID- 8343865
TI  - Oxygen kinetics and the art of physiological monitoring.

PMID- 8343866
TI  - Positive end-expiratory pressure increases capillary pressure relative to wedge
      pressure in the closed and open chest.
AB  - The pulmonary arterial wedge pressure is used as a measure of left atrial
      pressure and frequently as an estimate of pulmonary capillary pressure. The
      arterial occlusion concept has recently been used to derive a pressure that is
      thought to be more representative of capillary pressure (Pcap) than wedge
      pressure (Pw). The object of this study was to measure the arterial occlusion
      Pcap at different positive end-expiratory pressure (PEEP) levels and to compare
      it with Pw. Anesthetized, paralyzed, supine, and mechanically ventilated dogs
      were instrumented with a Swan-Ganz balloon tip catheter (7F) for monitoring
      pulmonary arterial pressure (Pa), for measuring cardiac output (CO;
      thermodilution technique), and for performing the arterial occlusions. The
      postocclusion tracings were analyzed for Pcap in a conventional manner:
      exponential fitting of the data during the 2 seconds immediately postocclusion
      and back extrapolating to the instant of occlusion. Instant of occlusion was
      defined as the time when the Pa tracing began to deviate from the normal tracing.
      Pw was averaged from the data between 8 to 10 seconds after the occlusion.
      Increasing PEEP between 0 to 15 mm Hg caused a gradual decline in cardiac output
      in the closed and open chest conditions. Despite this decline, all three
      pressures (Pa, Pcap, and Pw) rose gradually in the closed chest. However, in the
      open chest, increasing PEEP from 0 to 4.7 mm Hg had no effect on the pressures,
      but between 4.7 and 13.4 mm Hg of PEEP, Pa and Pcap increased markedly with
      minimal change in Pw.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343867
TI  - Cardiopulmonary responses to continuous positive airway pressure in acute asthma.
AB  - The effects of nasal continuous positive airway pressure (CPAP) on expiratory
      flow, arterial blood gas tensions, cardiovascular status, and dyspnea were
      studied in 21 patients with acute asthma. Therapy consisted of the following CPAP
      sequence: 30 minutes at 5 cm H2O, 20 minutes at 0 cm H2O, 30 minutes at 7.5 cm
      H2O, and 20 minutes at 0 cm H2O. Six control patients were fitted with a CPAP
      mask but given no positive-pressure therapy. Significant reductions in
      respiratory rate occurred from a baseline of 22.0 +/- 1.0 to 19.8 +/- 3.8
      breaths/min at CPAP 5 cm H2O and to 19.4 +/- 4.3 breaths/min at CPAP 7.5 cm H2O
      (P < .05). No significant change occurred in forced expiratory volume in 1 second
      (FEV1), heart rate, mean arterial blood pressure, or arterial blood gas tension
      with either level of CPAP. Dyspnea, as assessed by a breathlessness score,
      improved during CPAP therapy (P < .05). These levels of CPAP were tolerated
      without deleterious side effects. In comparison, the control group showed no
      change in heart rate, respiratory rate, or breathlessness score during the study
      period. These data show that application of CPAP in acute asthma reduces
      respiratory rate and dyspnea with no untoward effects on gas exchange, expiratory
      airflow, or hemodynamics.

PMID- 8343868
TI  - Systemic oxygen extraction can be improved during repeated episodes of cardiac
      tamponade.
AB  - We used a tamponade model to study the relationship between oxygen uptake (VO2)
      and oxygen delivery (DO2) during successive, reversible decreases in blood flow.
      In 7 pentobarbital-anesthetized and mechanically ventilated dogs, a catheter was
      introduced via a left thoracotomy into the pericardium to inject and to withdraw
      saline. Each experiment consisted of three steps. First, cardiac output was
      reduced by successive pericardial fluid injections until 4 to 6 data points were
      obtained in the dependent region of the VO2/DO2 plot (step 1). Second, cardiac
      output was restored by progressive withdrawal of pericardial fluid (step 2).
      Third, cardiac output was lowered again by reinjection of fluid into the
      pericardium until death (step 3). Expired gases were collected for determination
      of VO2. In each animal, critical DO2 (DO2crit), below which VO2 became DO2
      dependent, was determined from a plot of VO2 versus DO2. When releasing
      tamponade, VO2 was restored to baseline. For the 3 steps, DO2crit were 10.5 +/-
      2.2 mL/kg/min in step 1, 9.8 +/- 1.8 mL/kg/min in step 2, and 8.3 +/- 1.9
      mL/kg/min in step 3 (P < .01 v step 1; P < .05 v step 2, respectively). There was
      no significant difference in VO2 at DO2crit for the three steps. Hence, critical
      oxygen extraction ratio (ERO2crit) increased from 60% +/- 12% in step 1 to 64% +/
      11% in step 2 (not significant) and to 73% +/- 12% in step 3 (P < .01). The
      VO2/DO2 dependency slope was also steeper in step 3 than in step 1 (0.77 +/- 0.31
      v 0.54 +/- 0.20, P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343869
TI  - State of the art in upper-limb prosthetics.

PMID- 8343870
TI  - Fifty years of somatosensory research: from the Semmes-Weinstein monofilaments to
      the Weinstein Enhanced Sensory Test.
AB  - In this paper, the author's long history with somatosensation is overviewed with
      special emphasis on the creation of objective tests of sensibility. Objective
      testing is discussed using numerous examples from the author's experiences. The
      creation of the Semmes-Weinstein monofilaments is discussed. Tests employing the
      Semmes-Weinstein monofilaments, two-point discrimination, and point localization
      are discussed with reference to the fact that these tests reflect specific
      differences between the central and peripheral nervous systems. Towards that end,
      contrasts are made between the Semmes-Weinstein esthesiometer and both the two
      point discrimination and the point-localization tests. A new enhancement of the
      original Semmes-Weinstein monofilament test, the Weinstein Enhanced Sensory Test
      (WEST), is introduced. Advantages of the WEST are discussed.

PMID- 8343871
TI  - Localization of a constant-touch and moving-touch stimulus in the hand: a
      preliminary study.
AB  - There are limited normative data available defining a subject's ability to
      localize a constant-touch or moving-touch stimulus. The results that are
      obtainable to date have not been objectively measured so that they are
      reproducible. This study of a normal population suggests a standard to measure
      the error in a patient's capacity to localize both a constant-touch and a moving
      touch stimulus. The normative data demonstrate that in considering the ability to
      localize a constant-touch stimulus, there was less error of localization in the
      fingers than in the palm. The most sensitive finger was the index. In testing for
      localization of a moving-touch stimulus, seven types of responses were identified
      and classified. The procedure outlined in this study offers a means both to
      document the degree of sensory impairment in a more consistent manner and to
      objectively measure results of early-phase sensory re-education.

PMID- 8343872
TI  - Reliability of torque range of motion: a preliminary study.
AB  - The clinical reliability of torque range of motion (TROM) has not been tested.
      This preliminary review was performed to determine the intra- and interrater
      reliability of TROM. The proximal interphalangeal joints of the index and middle
      fingers of 14 normal subjects, 56 digits, were tested by applying extension
      forces of 200 g, 400 g, 600 g, and 800 g. Data were collected using both the hand
      held Haldex orthotic gauge with the dial goniometer (manual) and the cantilever
      beam force transducer and electrogoniometer (digital) as testing instruments. The
      testing order of digits, sides, and devices was randomized and tested separately
      by three different test teams. Results of the analysis of variance showed a
      significant difference of the means between raters at all force levels (p <
      0.0001) and between instruments at 600-g and 800-g forces (p < 0.01). The Pearson
      product-moment correlation coefficient test, used to test the consistency,
      resulted in moderate consistency of measures of intrarater reliability between
      trials, and between instruments used (digital and manual). Intraclass correlation
      coefficients (ICCs) were calculated with results that were nearly identical to
      those of the Pearson. Intrarater reliability was in more consistent agreement at
      the 600-g and 800-g levels. There was significantly high agreement between the
      tests of tester B, compared with moderate correlations of the tests of testers A
      and C.

PMID- 8343873
TI  - Circumferential finger measurements utilizing a torque meter to increase
      reliability.
AB  - The purpose of this study was to compare the reliabilities of two methods of
      measuring finger circumference. Traditionally, finger circumference is determined
      clinically by the use of a tape measure. In this study, a tape-measure device for
      recording finger circumference utilizing a torque meter was compared with the
      traditional method to determine reliability differences. Ninety-two occupational
      therapists and occupational therapy students obtained circumferential
      measurements of the author's left index finger at the middle of the proximal
      phalanx utilizing the two methods. The readings obtained for each method were
      analyzed to determine the coefficient of variation and to compare their
      variances. The coefficient of variation for the traditional method was 2.92 and
      for the device utilizing the torque meter was 0.75. The F ratio was 15.63, which
      is significant at the 0.01 level. The results of this study indicate greater
      interrater reliability using a device that can accurately measure torque and
      allow the therapist to control the amount of tension applied when obtaining
      circumferential measurements using a tape measure.

PMID- 8343874
TI  - A protective orthoplast splint in the treatment of a patient with Colles'
      fracture by external fixation.
AB  - Discussion is provided of an Orthoplast splint that was used to aid in the
      successful treatment of a mentally deficient patient who had sustained a fracture
      in the distal forearm, which was managed by external fixation. This splint is
      advocated for the treatment of various types of uncooperative patients. Although
      this splint has not been tried in the treatment of children, it appears likewise
      applicable for a noncompliant youngster.

PMID- 8343875
TI  - Splinting the arthritic hand.

PMID- 8343876
TI  - Stress testing of the wrist using the dystrophile.

PMID- 8343877
TI  - Skeletal muscle architecture: implications for muscle function and surgical
      tendon transfer.
AB  - Skeletal muscles have mechanical properties that are well-described by the length
      tension relationship (for isometric contractions) and the force-velocity
      relationship (for isotonic contractions). These two intrinsic properties are
      scaled for a given muscle based on its architectural properties. Muscle active
      force-generating range is determined by muscle fiber length, while maximum muscle
      force is determined by physiologic cross-sectional area. These and other
      architectural properties should be matched between muscles when planning surgical
      tendon transfers in order to closely match donor and recipient muscles. Finally,
      the fiber length/moment arm ratio of a muscle-joint combination must be
      considered when describing strength because strength is a manifestation of both
      muscle and joint properties and not either alone. Unfortunately, detailed
      description of normal musculoskeletal design or optimal transfer strategy cannot
      be made until more basic science studies of the musculoskeletal system are
      conducted.

PMID- 8343878
TI  - A study of sensory recovery following carpal tunnel release.
AB  - The purpose of this study was to define the testing parameters that are most
      sensitive to sensory loss in carpal tunnel syndrome and then to track recovery of
      these sensations postoperatively. Two dozen patients underwent standard nerve
      decompression and were subsequently re-evaluated at six weeks, three months, and
      six months. The test battery included provocative maneuvers, light-touch
      threshold determined by manually applied monofilaments and skin indentation with
      the Automated Tactile Tester (ATT), manual two-point discrimination, manual high
      frequency vibration and ATT low-frequency vibration, and ATT warmth detection.
      The most sensitive indicators of sensory abnormality were the ATT low-frequency
      vibration and skin indentation tests. Responses to all but these two tests
      returned to normal within two months postoperatively. The ATT indentation and
      vibration tests showed continual improvement over the study period, returning to
      nearly normal values by six months. Recommendations concerning the use of
      automated methods for testing sensory function are made in light of these
      findings.

PMID- 8343879
TI  - The assessment and treatment of patients who have sensory loss following cortical
      lesions.
AB  - The assessment of tactile and proprioceptive sensory function in patients with
      severe sensory deficits resulting from cortical lesions is reviewed. The
      importance of using age-appropriate normative data to interpret the scores on
      these tests is discussed in the context of the frequency of ipsilateral
      disturbances in somesthetic sensation following unilateral cerebral lesions.
      Tactile and proprioceptive sensory deficits not only affect the processing of
      sensory information but also result in impairments in manual control. Fine-motor
      skills, such as those required for grasping and manipulating small objects, must
      therefore be evaluated in these patients. The treatment of patients with severe
      sensory deficits focuses on improving the perception of sensory information
      arising from receptors in the hand and on retraining motor function. The
      procedures used for sensory re-education and retraining are described.

PMID- 8343880
TI  - Endoscopic carpal tunnel release--current status.
AB  - Endoscopic carpal tunnel release is one of the most controversial topics in hand
      surgery today. Many surgeons have reservations in doing carpal tunnel release
      endoscopically because its merits and demerits have not been clearly defined.
      This article describes the various techniques now available to perform endoscopic
      carpal tunnel release. The anatomic basis for a single-portal technique using the
      Concept Carpal Tunnel Release Kit is described in detail. The results of 100
      postoperative cases indicate that endoscopic carpal tunnel release was superior
      to the open technique in regard to postoperative morbidity and patient
      satisfaction in 92% of this patient group.

PMID- 8343881
TI  - Carpal tunnel neuropathy caused by injury: reconstruction of the transverse
      carpal ligament for the complex carpal tunnel syndromes.
AB  - A comprehensive surgical and therapy program for the management of carpal tunnel
      neuropathy caused by injury has been proposed. The program is based on the
      restoration of the gliding interface between the median nerve trunk, the flexor
      tendons of the fingers, and the inner gliding surface of the transverse carpal
      ligament. The development of these new gliding surfaces is achieved by a surgery
      program of circumferential mesoepineurolysis of the median nerve in the hand and
      wrist followed by an anatomic reconstruction of the transverse carpal ligament.
      This biologic process is completed by a postoperative program of immediate hand
      function and median nerve gliding. Three hundred consecutive surgical patients
      were studied to confirm that the elastic mobilization of the median nerve
      actually doubled after a comprehensive nerve mobilization, thus supporting the
      ligament closure and early nerve gliding. Patients who have been available for
      repeat electromyographic (EMG) study at four to six months show EMG improvement
      that supports the clinical improvement. Finally, mobilization of the median nerve
      as described in the study has shown nerve revascularization within 30 seconds
      after tourniquet release and biologic recovery signals in the postoperative nerve
      gliding period and has proven to be, from the nerve nutrition standpoint, a safe
      procedure. The reliability that has been achieved in median nerve recovery is due
      to the anatomic reconstruction of the entire transverse carpal ligament. This
      surgical technique has proven to be the step necessary to produce a symbiotic
      alignment of the median nerve and the flexor tendon gliding anatomy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8343883
TI  - Evaluation and treatment of pain: aspects for nerve injury and rehabilitation.
AB  - Pain, or at least discomfort in the form of hypersensitivity, is always a sequela
      to nerve injury and nerve repair. A carefully planned pain evaluation and
      treatment program has been shown to result in a decrease in pain and improved
      function. For a hand therapist, the commitment to evaluation and management of
      pain is a personal as well as a professional dedication. Patients may greatly
      vary in their responses to injury, symptomatology, and treatment interventions.
      Although the hand therapist can successfully intercede with many patients, it is
      often advantageous to involve a clinical psychologist. Psychosocial and
      psychophysiologic data can be imperative in evaluating the possibilities of
      patient outcome with regard to pain, evaluation, and treatment. Psychophysiologic
      information is likely to increase the hand therapist's evaluation and treatment
      potency. A psychological assessment and/or intervention is appropriate at several
      points of treatment--for example, after an appropriate interval of healing time
      in which an injury should resolve itself, after a major invasive procedure such
      as surgery, or when a condition is chronic and all other avenues of treatment
      have been unsuccessful.

PMID- 8343882
TI  - A numerical grading scale for peripheral nerve function.
AB  - A numerical grading scale for median and ulnar function is outlined. This system,
      based upon the known pathophysiology of chronic nerve compression, creates a
      hierarchical scale of mutually exclusive categories for motor and sensory
      function. The scale is responsive to incorporating new technologies for
      sensorimotor evaluation if these should offer advantages in computer-assisted
      evaluation, validity, or reliability. The scale is assumed to be nonuniform, and
      nonparametric statistical analysis, such as use of the Wilcoxon rank-sum test, is
      appropriate. Where motor function may predominate the peripheral nerve function,
      such as the ulnar nerve, in contrast to the median nerve, the scale may be
      uniquely defined to reflect this attribute. Pilot study examples of application
      of the numerical scoring system are given, and specific areas to better define
      the scale through research are suggested.

PMID- 8343884
TI  - A dentist's experience with change of hand dominance.
AB  - Ten years ago as a young dentist, the author found himself completely unable to
      engage in his practice as a result of a serious nerve injury permanently
      affecting his dominant right hand and forearm. Some unique opportunities and
      chance encounters have enabled him to overcome the permanence of the injury and
      to advance into a dental specialty field considered very demanding bimanually.
      Chronicled below are the process by which this occurred and, in particular, the
      author's assessment of what led to the necessary change of hand dominance. Also
      described is an interesting process that was required by the admissions committee
      of the postgraduate specialty training program as part of their assessment of the
      author's ability to adequately perform clinical procedures prior to his admission
      into the program. Descriptions of certain office design changes as well as
      changes in instrumentarium and techniques and the inventions to support those
      changes are described.

PMID- 8343885
TI  - Cutaneous mechanoreceptors of the hand: experimental studies and their
      implications for clinical testing of tactile sensation.
AB  - This paper reviews selected research on the neurophysiology of cutaneous
      mechanoreceptors and their relationship to tactile sensations. Particular
      emphasis is placed on studies in which neurophysiological results are directly
      comparable to psychophysical results. These studies provide the strongest
      evidence for correlating mechanoreceptor function with specific tactile
      sensations. Furthermore, these studies have implications for how one should
      administer tactile stimuli in order to selectively stimulate particular groups of
      mechanoreceptors.

PMID- 8343887
TI  - Endocrine therapy for prostate cancer: recent developments and current status.

PMID- 8343886
TI  - The quest for better recovery from peripheral nerve injury: current status of
      nerve regeneration research.
AB  - The author reviews relevant nerve regeneration research in the past half-century
      to give the reader familiarity with the background of current research efforts.
      Recent research has been aided by newer knowledge of the biology of nerve
      regeneration. Early efforts to improve nerve regeneration centered on
      improvements in technical or surgical repairs, with only modest gains. Although
      current technical improvements with lasers or fibrin glue to repair nerves may
      show promise, the approach of deMedinaceli et al. combines several new ideas with
      some improvement experimentally. With the discovery of nerve growth factors and a
      host of newer nerve growth promoting factors, the biochemical arena has explored.
      Special tubes to repair nerves enable easy manipulation of the environment to
      study the effects of various factors on nerve regeneration. Silastic and
      bioresorbable tubes show the most promise to enhance nerve regeneration by
      tubulization. Because of the explosion of knowledge and high levels of activity
      of research, it is apparent that further improvements of nerve regeneration are
      on the horizon.

PMID- 8343888
TI  - Extracorporeal shock wave lithotripsy induces the release of prostaglandins which
      increase ureteric peristalsis.
AB  - The aim of this study was to identify the changes in secretion of prostaglandins
      into the urinary tract as a result of treatment by extracorporeal shock wave
      lithotripsy (ESWL) and to determine their effects on ureteric motility. Sixteen
      patients with renal or upper ureteric calculi were studied. A peripheral blood
      and urine sample was collected immediately before and after ESWL, with further
      samples taken 24 h later. The following variables were assessed by
      radioimmunoassay:prostaglandin E2 (PGE2), prostaglandin F1 alpha (PGF1 alpha),
      and thromboxane B2 (TXB2). An in vitro canine study was then designed to study
      the activity of TXB2, PGF1 alpha and PGE2 on an isolated intact canine ureter
      model. Significant elevations of TXB2 were found immediately after ESWL in both
      serum and urine, which fell almost to pre-treatment levels by 24 h. PGF1 alpha
      levels showed significant elevations at 24 h but no immediate increase as seen
      with TXB2. In contrast, PGE2 levels were unchanged in the urine but significantly
      decreased in the serum. In vitro studies showed that both TXB2 and PGF1 alpha
      repeatedly produced an increased frequency of ureteric contraction. ESWL results
      in the release of prostaglandins from the urinary tract which are shown to cause
      increased ureteric peristalsis.

PMID- 8343889
TI  - Choosing a powerful lithotriptor.
AB  - Clinicians have no yardstick to help them choose the most efficient lithotriptor.
      Their leading priority is a system allowing complete disintegration of the stone
      with the minimum number of shocks and a low re-treatment rate. One of the
      prerequisites of this system is a powerful shock wave generator. "Power" is as
      yet ill defined in lithotripsy. Therefore clinicians' choice depends upon other
      factors. Acoustic output measurements were recorded on 3 commercial lithotriptors
      representing the 3 main shock wave generating systems. These were the Dornier MPL
      9000 (standard and X-155 electrodes), the Siemens (Lithostar, Lithostar Plus and
      System C) and the Wolf Piezolith 2300. The shock wave measurements were
      correlated to the capability of the lithotriptors to disintegrate standard stone
      models in vitro. Two factors were identified. The pulse intensity integral in the
      focus and the size of the focal zone proved to be the most important factors to
      assess and compare the efficacy or "power" of different lithotriptors. Together
      they can help clinicians to identify and choose the most efficient shock wave
      generating systems.

PMID- 8343890
TI  - Percutaneous nephrostomies.
AB  - A review was made of 127 percutaneous nephrostomies (PCN) in 106 patients with
      benign (74 patients) and malignant (32 patients) urinary tract obstruction. Data
      on underlying aetiology, complications, subsequent management and long-term
      management are presented. The study confirms that PCN is an effective and safe
      method of providing temporary or prolonged urinary diversion in obstruction. Its
      use in pelvic malignancy should be determined by the likelihood of obtaining
      worthwhile prolonged palliation in individual patients.

PMID- 8343891
TI  - Bladder Z-plasty for the repair of ureteric injuries. Experimental study in
      sheep.
AB  - There is general acceptance that the best substitute for a damaged distal ureter
      is an elongated bladder and that the bladder psoas hitch is the most reliable
      procedure. Nevertheless, it is not always sufficient to bridge a long ureteric
      gap. In order to obtain an equally safe but wider bladder elongation than the
      psoas hitch can provide, we have previously studied the effect of several Z
      shaped incisions on isolated pig bladders. The aim of the present study was to
      verify, in vivo, the efficacy and safety of the new technique. Five sheep
      underwent the psoas hitch procedure and 6 the Z-plasty procedure. The results
      showed that Z-plasty provides an equally safe but longer bladder elongation than
      the psoas hitch procedure.

PMID- 8343893
TI  - The bladder cooling reflex in man--characteristics and sensitivity to
      temperature.
AB  - The ice-water test is a simple supplementary urodynamic test that increases the
      precision of the diagnosis of overactive bladder subtypes. A similar bladder
      cooling reflex has recently been characterised in the cat and was found to
      originate from specific cold receptors in the bladder wall. In the present study,
      the threshold temperature of the human bladder cooling reflex was determined in
      patients with positive ice-water tests. Estimated threshold values were somewhat
      lower than those of the cat but still well above the temperatures required for
      cold stimulation of nociceptors. As in the cat, the strength of the cooling
      reflex varied inversely with the bladder temperature. These findings indicate
      that the human bladder cooling reflex is in principle organised in the same way
      as that of laboratory animals. The human bladder thus seems to be endowed with
      cold receptors with excitatory reflex connections to the detrusor.

PMID- 8343892
TI  - Retroperitoneal malignancy masquerading as ureteric colic.
AB  - This study reviews 6 patients who were referred with severe loin pain radiating
      to the groin and in whom a presumptive diagnosis of ureteric colic was made. Of
      these, 3 patients were found to have carcinoma of the pancreas and the remaining
      3 had retroperitoneal lymph node metastases. Retroperitoneal malignancies rarely
      present with loin pain, but this diagnosis should be considered in patients with
      long-standing loin pain in whom an obvious diagnosis is not apparent.

PMID- 8343894
TI  - The ice-water test--a simple and valuable supplement to routine cystometry.
AB  - The results of cystometrograms and ice-water tests (IWTs) were retrospectively
      evaluated in 557 patients with overactive bladders, lower motor neuron lesions or
      pure stress incontinence. The IWT was considered positive when, following ice
      water instillation, the fluid was expelled from the bladder within 1 min. The
      test was considered false negative when no fluid escaped despite a sustained
      detrusor contraction of the same magnitude as the micturition contraction. Ninety
      seven percent of patients with complete and 91% of those with incomplete upper
      motor neuron lesions had a positive or a false negative IWT. About 75% of the
      patients with multiple sclerosis, Parkinson's disease or previous cerebrovascular
      accident had a positive IWT. All patients with lower motor neuron lesions or pure
      stress incontinence had a negative IWT. There was a significant correlation
      between a positive IWT and an abnormal sensation of bladder filling and inability
      to inhibit micturition voluntarily, as well as between a negative IWT and the
      occurrence of phasic detrusor contractions during cystometry. The study shows
      that the IWT is a sensitive test for differentiating upper from lower motor
      neuron lesions. It is also a useful parameter for functional subdivision of
      overactive bladders. In patients with voiding dysfunction in the absence of lower
      urinary tract inflammation, a positive test is an indicator of a silent or overt
      neurological disorder.

PMID- 8343895
TI  - Relief of pain following intravesical capsaicin in patients with hypersensitive
      disorders of the lower urinary tract.
AB  - We have extended our earlier observations on pain relief produced by intravesical
      instillation of capsaicin (10 microM in saline) in patients with hypersensitive
      disorders of the lower urinary tract. Patients in group A (n = 15) received
      intravesical capsaicin on days 0, 14 and 28: on each occasion the drug produced a
      warm or burning sensation, reduction in bladder capacity and a delayed, transient
      improvement or disappearance of symptoms. Patients in group B (n = 5) received
      intravesical capsaicin (10 microM at cystometry) 3 times on day 0. The initial
      sensation of warmth was experienced on each occasion, indicating that no
      significant desensitisation has been produced by the first instillation. Clinical
      improvement similar to that found in group A was observed. Three patients (group
      C) received warm saline (42 degrees C) at cystometry. This produced a pricking
      sensation, no change at cystometry and no subjective clinical improvement. Apart
      from the initial sensation of warmth, no patient in group A or B experienced side
      effects, either local or systemic. These findings confirm that intravesical
      instillation of capsaicin has a beneficial effect on patients with hypersensitive
      bladder disorders. Counter-irritation rather than desensitisation of primary
      afferents could be a possible mechanism of action. Further studies are needed to
      establish whether the intravesical administration of capsaicin or capsaicin-like
      agents represents a new form of treatment for relief of bladder pain.

PMID- 8343897
TI  - Extracorporeal shock wave lithotripsy for vesical lithiasis: initial experience.
AB  - The classical treatment for vesical lithiasis consists of surgery or endoscopic
      transurethral disintegration. These procedures require anaesthesia and
      hospitalisation. We report our experience with the Siemens Lithostar in 18 male
      patients with bladder stones. Complete fragmentation was achieved after a single
      session in 14 patients and 4 required 2 sessions. A 3-way Foley catheter with
      saline irrigation was used during treatment. Patients were treated in the prone
      position followed by immediate evacuation of stone fragments in 9 cases.
      Morbidity was minimal. Two patients developed impacted fragments and required
      stone retrieval. Extracorporeal shock wave lithotripsy (ESWL) for vesical
      lithiasis appears to be a simple, well tolerated and effective form of treatment.

PMID- 8343896
TI  - Extracorporeal shock wave lithotripsy for bladder stones.
AB  - Between December 1989 and July 1991, 29 patients with bladder stones were treated
      on the MPL 9000 extracorporeal shock wave lithotriptor using ultrasound for
      localisation. The mean stone dimensions were 22.65 x 15.17 mm (< 400 mm2 in 20
      patients); 75% of patients required only 1 ESWL session but the largest stone
      (2025 mm2) required 3. Whilst larger stones tended to require more shock waves,
      linear regression analysis showed a poor fit and factors other than size
      (operator experience and stone hardness) may determine the number of shock waves
      required. Satisfactory fragmentation was obtained in all patients. All were
      treated under intravenous analgesia without anaesthesia. Three patients also had
      outflow obstruction and were treated by transurethral resection of the prostate
      (TURP) on the day after completing ESWL. ESWL prior to TURP reduces the morbidity
      and operating time associated with endoscopic therapy of bladder stones.
      Macroscopic fragments remaining after ESWL can be washed out at TURP.

PMID- 8343899
TI  - Is planned continuous irrigation indicated for haemorrhage following
      transurethral resection of the prostate?
AB  - A prospective audit was carried out of this unit's policy of non-irrigation
      following transurethral prostatectomy (TURP). Over an 11-month period 121 TURPs
      were performed. Only 29 patients required intervention to maintain bladder
      drainage post-operatively, 23 of these requiring bladder washout alone. In the
      remaining 6 patients catheter change and continuous irrigation were required. The
      weight of tissue resected was the only factor investigated which bore a
      significant relationship to the necessity for further intervention in bladder
      drainage post-operatively. Despite this, patients requiring continuous irrigation
      post-operatively could not be easily identified prior to or during surgery.

PMID- 8343898
TI  - Neobladder after cystectomy: an Indian experience.
AB  - A continent urinary reservoir was constructed from an ileocolonic segment and
      anastomosed to the urethra in 30 males after radical cystectomy for infiltrating
      bladder cancer. A small cuff of the prostate was retained for anastomosis with
      the reservoir and ureteric anastomosis was done from within the reservoir by the
      "pull through" method. Complete continence was achieved in 29 patients, all of
      whom had an adequate reservoir capacity exceeding 400 ml; they were able to empty
      the reservoirs satisfactorily as judged by the residual urine (< 50 ml).
      Urodynamic study revealed an intra-abdominal pressure < 30 cm of water at rest
      and at reservoir capacity of 500 ml. Early post-operative complications included
      urinary leaks in 3 patients, intestinal obstruction in 3 and a faecal fistula in
      1. Deterioration of the upper tracts was noted in 5 cases. Twenty-seven patients
      are alive after a mean follow-up of 36 months.

PMID- 8343900
TI  - Continuous flow resectoscopes. Are the theory and design wrong?
AB  - The optical design of rod-lens telescopes has now reached a zenith. The only way
      of improving the resectoscope is to investigate the ergonomics and flow dynamics.
      We present a comparative analysis of the flow mechanics of continuous flow
      resectoscopes. The morphology, flow characteristics and irrigating potential
      (washout gradient) of several instruments were examined. It was found that when
      used with balanced continuous flow (inflow and outflow balanced), all of the
      endoscopes had poor visibility compared with unbalanced continuous flow (inflow >
      outflow). Possible changes in the design of the instruments are discussed.

PMID- 8343901
TI  - Audit and its impact in the management of early prostatic cancer.
AB  - An analysis was made of a prospective database of 614 men with newly diagnosed
      carcinoma of the prostate who presented between January 1978 and December 1990; 3
      monthly updates were available on their clinical, haematological and biochemical
      parameters and 6-monthly updates on chest X-rays, bone scans and skeletal X-rays.
      It was found that 107 men (mean age 73.5 years) had early disease at
      presentation. Their management was based on regular surveillance and the
      treatment deferred until disease progression or development of symptoms. The
      audit of outcome measured various clinical events. Four patients (3.7%) developed
      local failure, 11 (10.3%) developed bone metastases, 3 (2.8%) died of cancer with
      a median survival of 6.3 years, and 34 (31.8%) died of intercurrent disease with
      a median survival of 2.6 years. The observed survival for 12 years of the whole
      group was similar to the expected survival for an age-matched population in
      Scotland. The standardised mortality ratio was 81 (95% confidence limits 57-112).

PMID- 8343902
TI  - Lipoprotein levels following treatment with cyproterone acetate or LHRH
      analogues.
AB  - Fasting serum lipoproteins were measured in patients with carcinoma of the
      prostate. Twelve patients were on no hormonal treatment (Group 1). Fifteen were
      on cyproterone acetate (Group 3), 17 were on the long-acting LHRH analogue
      Zoladex (Group 4) and 11 on a combination of cyproterone acetate and Zoladex
      (group 5). In addition, 27 patients with benign urological disease were taken as
      controls (Group 2). In both groups in which cyproterone acetate was part of the
      treatment the total high density lipoprotein cholesterol levels were
      significantly lower than in the other groups. Patients on cyproterone acetate
      alone had significantly higher levels of very low density lipoprotein (VLDL)
      triglyceride levels than those not on cyproterone acetate. These results confirm
      changes in serum lipoprotein levels in patients taking cyproterone acetate and
      these changes may have potential adverse effects if the treatment is prolonged.

PMID- 8343903
TI  - Effects of neurogenic bladder dysfunction in utero seen in neonates with
      myelodysplasia.
AB  - Twenty neonates with myelodysplasia were prospectively evaluated during the first
      month of life with urodynamic studies, contrast voiding cystourethrograms (VCUG)
      and renal ultrasound scans. Ten of 20 infants had abnormal VCUGs--6 with
      vesicoureteric reflux (VUR) and 4 with bladder trabeculation alone. Only 2/20
      neonates had abnormal ultrasounds--both with hydroureteronephrosis secondary to
      VUR. Elevated leak point pressure (LPP) and/or detrusor sphincter dyssynergia
      (DSD) were present in 10/20 infants--6 with elevated LPP and DSD, 3 with elevated
      LPP alone and 1 with DSD alone. Eight of 10 neonates with DSD or elevated LPP had
      abnormal VCUGs--4 with VUR and 4 with bladder trabeculation alone. Conversely,
      8/10 neonates without DSD or elevated LPP had normal VCUGs. Contrast VCUG
      performed shortly after birth, therefore, is essential for the discovery of
      bladder trabeculation and reflux. There is a strong correlation between an
      abnormal VCUG and the presence of DSD and elevated LPP, suggesting that
      neurogenic bladder dysfunction in utero can lead to these structural
      abnormalities.

PMID- 8343904
TI  - Evaluation and treatment of incontinence after bladder neck reconstruction in
      exstrophy and epispadias.
AB  - Twenty-five children with exstrophy/epispadias who had had at least one bladder
      neck operation (but no augmentation) for incontinence underwent cystometrography
      (CMG) and urethral pressure profile (UPP) studies. The purpose of this study was
      to examine all components of lower urinary tract function and to determine how
      the properties of the bladder and the properties of the bladder neck/urethra
      interacted to achieve continence or to result in incontinence in the individual
      child. Examination of detrusor function during filling revealed involuntary
      contractions in 12 children and an end-fill pressure > 10 cm H2O in 8. Of the 21
      children in whom voiding could be evaluated only 6 could initiate a detrusor
      contraction. In the 18 incontinent children leak pressure could be measured and
      was > or = 15 cm H2O in 12. Five of the 7 continent children also demonstrated at
      least one abnormality in lower tract function. The maximum pressure of the UPP
      did not agree with the leak pressure and may not be a valid measure of the
      closing pressure of the bladder neck/urethra in this patient population. Detailed
      urodynamic investigation is necessary in these children to guide the next step of
      management and to evaluate objectively each form of treatment.

PMID- 8343905
TI  - Sequential self-castration and amputation of penis.

PMID- 8343906
TI  - Pseudoregression of pulmonary metastasis after nephrectomy for renal carcinoma.

PMID- 8343907
TI  - Vesico-acetabular fistula after total hip replacement.

PMID- 8343908
TI  - Apparent Buschke-Loewenstein tumour of the penis.

PMID- 8343909
TI  - Primary seminal vesicle choriocarcinoma.

PMID- 8343910
TI  - Re: J-wire facilitates retrograde manipulation of ureteric calculi prior to
      extracorporeal shock wave lithotripsy.

PMID- 8343911
TI  - Bladder cancer in patients undergoing haemodialysis.

PMID- 8343912
TI  - Re: Surgery for hypospadias fistula.

PMID- 8343913
TI  - "The ICO cometh".

PMID- 8343914
TI  - Management of dislocated lens fragments following phacoemulsification surgery.
AB  - Twelve patients with retained nuclear lens fragments following
      phacoemulsification surgery were referred for management. Ocular findings
      included corneal edema in 4 (33%), elevated intraocular pressure in 6 (50%),
      vitreous inflammation in 10 (83%) and retinal detachment in 1 (8%). At initial
      examination 10 of the patients had a visual acuity of 20/200 or less. Two
      patients were managed conservatively with medical treatment and regained 20/20
      and 20/25 vision. Ten patients required pars plana vitrectomy; in six a posterior
      chamber lens was sutured into the ciliary sulcus after vitrectomy was completed.
      Postoperatively, 5 of the 10 surgically treated patients regained 20/40 or better
      vision. Preexisting age-related macular degeneration and chronic cystoid macular
      edema were the causes of a poor visual result.

PMID- 8343915
TI  - Effect of a topical anesthetic cream (EMLA) in reducing pain caused by
      infiltration of local anesthetic in eyelid surgery.
AB  - EMLA (eutectic mixture of local anesthetics) cream is a topical formulation of a
      mixture of lidocaine and prilocaine. It has been used to achieve local analgesia
      after application under an occlusive dressing. We carried out a double-blind
      randomized controlled clinical trial to assess the effect of 5% EMLA (25 mg/mL of
      lidocaine and of prilocaine) in reducing the pain caused by infiltration of local
      anesthetic in eyelid surgery. Pain was assessed by means of a modified visual
      analogue scale ranging from 0 (no pain) to 10 (excruciating pain) in 25
      consecutive patients (average age 65 years) undergoing bilateral eyelid surgery.
      Clinical significance was defined as a difference in pain scores of 3 or more
      between EMLA and placebo. The mean pain scores for EMLA and placebo were 3.1 and
      4.0 respectively, a nonsignificant difference. The EMLA preparation was found not
      to be clinically effective in reducing pain caused by infiltration of local
      anesthetic in eyelid surgery.

PMID- 8343916
TI  - The role of colour flow Doppler ultrasonography in the investigation of disease
      in the eye and orbit.
AB  - Colour flow Doppler ultrasonography is a relatively new technique in which colour
      encoded representations of flowing blood are imposed over a conventional grey
      scale ultrasound image. This allows interrogation of a relatively large volume of
      tissue to determine the presence and direction of blood flow. The waveform
      tracings are then evaluated by means of conventional Doppler imaging. We
      demonstrate examples of normal vascular structures in the orbit and describe the
      application of this technique in the investigation of vascular disease, such as
      carotid-cavernous fistula and ischemic disease. The technique can also be used to
      evaluate ocular membranes and masses. Colour flow Doppler imaging promises to be
      an important advance in ophthalmic ultrasonography.

PMID- 8343917
TI  - Posterior scleritis: ultrasound and clinical findings.

PMID- 8343918
TI  - Orbital abscess due to acute dacryocystitis.

PMID- 8343919
TI  - Monosporium apiospermum endophthalmitis in a patient without risk factors for
      infection.

PMID- 8343920
TI  - Congenital trichomegaly, pigmentary degeneration of the retina and growth
      retardation (Oliver-McFarlane syndrome): 28-year follow-up of the first reported
      case.

PMID- 8343922
TI  - The CNS influence on patient autonomy.

PMID- 8343921
TI  - Legislative and regulatory update: health care reform and managed competition:
      implications for CNSs.

PMID- 8343923
TI  - A model for the development of the CNS role in adolescent health promotion self
      care.
AB  - A meaningful definition of the CNS has been difficult to express because of the
      versatility of the role, yet a clear understanding of the role responsibilities
      is essential to ensure successful implementation of the CNS position within a
      select client population. Adolescence is a period in the life-span that
      represents such a population. Adolescents undergo certain cognitive changes that
      render them vulnerable to health-damaging behaviors often initiated during this
      stage of development. Health promotion self-care strategies by the CNS are
      important in helping the young person incorporate positive health practices in
      daily activities. A conceptual model, based on Orem's general theory of nursing,
      has been developed through literature review and refined through practical
      application. It is presented as a framework by which health promotion needs of
      the adolescent may be predicted, recognized, and satisfied through components of
      the CNS role, the basic concepts of Orem's model, and characteristics of
      adolescent cognitive development.

PMID- 8343924
TI  - Facilitating acceptance of a patient's decision to stop treatment.
AB  - Quality of life is a very personal issue. When illness reaches a point where life
      is believed to be intolerable, people may choose to stop treatment. This paper
      presents an intervention model for psychiatric liaison nurses to utilize in order
      to facilitate acceptance of such a decision. The model contains two parts:
      assessment and intervention. The assessment process can be broken down into five
      parts to include the assessment of self, patient, family, nursing, and medical
      staff. Intervention strategies to expedite acceptance include opening
      communication, resolving conflict, being a go-between, and advocating for the
      patient.

PMID- 8343925
TI  - Survey research.

PMID- 8343926
TI  - A survey of 636 staff nurses: perceptions and factors influencing the CNS role.
AB  - The specific aim of this investigation was to document the perceptions of the CNS
      role and the factors influencing the role. The Clifford Clinical Specialist
      Functions Inventory was used to survey staff nurses at two affiliated medical
      centers. A 38% response rate was obtained. A total of 636 surveys were returned.
      Analysis of the data indicated: the CNS was perceived as valuable; physical
      presence of the CNS on the nursing unit enhanced role enactment; and a list of
      CNS role expectations could be developed based on perceptions of staff nurses.
      The results indicated that perceptions of the CNS role did not vary among staff
      nurses at the two medical centers.

PMID- 8343927
TI  - Management does not equal leadership.

PMID- 8343928
TI  - Families need help too: group treatment for families of nursing home residents.
AB  - Despite long-standing interest in the family as the focal point of nursing care,
      there are few published reports of clinical interventions with families after
      they institutionalize an elderly relative. Family members experience loss, guilt,
      and grief, and report that these emotions continue throughout the time that their
      older member is in the nursing home. This paper presents the rationale for using
      a supportive, educational group approach with families of nursing home residents
      and describes a family group intervention, detailing the role of the geriatric
      mental health nurse specialist, group goals, and the focus of each session.
      Evaluations by families and staff are presented, and recommendations for practice
      are made.

PMID- 8343930
TI  - The role of the CNS in developing systems of health care delivery.

PMID- 8343929
TI  - Incorporating midmanagement skills in an oncology CNS program.
AB  - Today's health care system requires that CNSs be prepared to manage care within
      complex organizations as well as deliver expert care to individuals and their
      families. The integration of midmanagement preparation with clinical knowledge
      and skills is critical. In this paper, we (1) review the literature pertaining to
      the role of oncology CNS and management preparation, (2) describe the program at
      the University of Pennsylvania School of Nursing, and (3) identify the management
      content that was added to strengthen the theoretical and clinical components of
      the program and to prepare our graduates in assuming leadership positions.

PMID- 8343931
TI  - Enhancing case management through computerized patient files.
AB  - The need for developing an organizational system for managing a large patient
      specialty population prompted the use of a computerized data entry and retrieval
      system. The use of a computerized system has facilitated patient case management,
      chart organization, and development of accessible data for research. Patient data
      fields (topic headings) are used for: (1) storing specific categories of patient
      data, (2) compiling lists for management and research, and (3) referring
      physician and patient/family contact information. Various lists can be compiled
      from the field data base in order to develop research and patient management
      lists. Patient management lists are used to track a patient's progress, provide
      quality assurance of care, and contribute researchable data. Also, patient
      information can be transferred automatically from the computerized daily
      management system into a computerized form letter. Individualized patient letters
      may be generated. Laboratory and test information from the last clinic or
      hospital visit can be mailed to families along with a handwritten personalized
      interpretation of their results by the CNS or physician.

PMID- 8343933
TI  - The business of consultation.

PMID- 8343932
TI  - Novice CNS and role acquisition.
AB  - A master's-prepared nurse in an introductory role as a CNS will find the
      experience both challenging and rewarding. The CNS's first year is a time of self
      exploration, stimulation, ambivalence, and growth, both professionally and
      personally. These nurses are often experienced clinicians who strive to be in
      positions in which they can affect a large group of patients and colleagues with
      both their knowledge and expertise. Stress occurs because the experienced nurse
      who has felt competent, confident, and comfortable in his or her previous role as
      a direct caregiver is now in the role of novice CNS who must learn the
      expectations and responsibilities of a new role, and develop a broad set of new
      skills. Utilizing the Dreyfus model, as applied to the nursing profession by
      Benner, this article will explore the transition of the nurse from experienced
      staff nurse to novice CNS. Enhancing and restraining factors that influence role
      realization, as well as effectiveness in supporting staff, to achieve optimal
      outcomes for patients will be identified.

PMID- 8343934
TI  - The business of being an expert witness and legal consultant.
AB  - Nurses serve as expert witnesses and provide legal and other consultation for
      which they receive compensation. Although numerous articles describe the process
      of serving as an expert witness and providing consultation, the business aspects
      of such consultation is seldom addressed. Most nurses have little experience in
      managing the business and financial aspects of such consultation. To be a
      successful consultant, clinical expertise and business acumen are necessary.
      Suggestions are given for creating a system of record keeping, keeping track of
      expenses, billing for services, reporting expenses and income for tax purposes,
      and marketing services.

PMID- 8343935
TI  - A strategy for staff development: self-care and self-esteem as necessary
      partners.

PMID- 8343936
TI  - In theory and practice.

PMID- 8343937
TI  - [The improvement of the Doppler echocardiographic method for the estimation of
      pulmonary systolic pressure].
AB  - The formulas currently utilized for noninvasive evaluation of right ventricular
      systolic pressure (RVSP) include right ventricular-right atrial pressure gradient
      (RV-RAG) and right atrial pressure (RAP). The former is expressed by trans
      tricuspid systolic flow velocity, the latter is generally assumed. We recently
      observed that ultrasound estimation of RAP through inferior vena cava
      collapsibility index (CI) may help in the choice of the more appropriate formula
      for the evaluation of RVSP. However, these traditional methods (method A:RV-RAG +
      10; method B:RV-RAG x 1.1 + 14) have limitations, particularly when RAP is low.
      The present study was undertaken to improve noninvasive estimation of RVSP
      through new formulas based on CI prediction of RAP. One hundred and four
      patients, in whom tricuspid regurgitation was adequately documented with CW
      Doppler, were included in this study. They were classified into 3 groups: Group 1
      with CI > 45%, Group 2 with CI < or = 35%, Group 3 with CI 35-45%. RVSP was
      evaluated by 3 different methods: A, B, and C. Method C was based on CI,
      assigning 6, 16, or 9 mmHg to RAP (respectively, the mean values in the 3 groups
      of our previous study). Results indicate that method C improves noninvasive
      estimation of RVSP in Group 1 and Group 2, with respect to other methods, with
      reduction of the SEE and of the mean difference of the t-test between hemodynamic
      and echographic values. In Group 3, Doppler estimation by method A and C, and
      catheter measurements are comparable, whereas method B significantly
      overestimates the actual value.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343938
TI  - [Coronary angiography in a defined population: a pilot study of the residents of
      Padua].
AB  - In recent years there has been a steady increase in number of coronary
      angiography procedures and coronary angioplasty. Since these interventions are
      relatively expensive, we tried to evaluate the appropriateness of coronary
      angiography indications. A retrospective pilot study was undertaken on all
      residents in Padua who had had a coronary angiography performed in 1988. In order
      to take into account patients who, although resident in Padua, had a coronary
      angiography performed outside Padua or even abroad, all Italian Hemodynamic
      Centers and the Office for Foreign Cures Authorization of ULSS 21 were contacted.
      Follow-up was stopped on April, 1991. Patients were first checked if living by
      consulting the Register's Office of the Community of Padua; they were then
      interviewed by letter on state of health. One hundred twenty-four patients
      underwent 138 coronary angiography. Utilization rate is 5.6 per 10,000 people (CI
      4.6-6.6). This figure is lower than the present USA utilization rate, and is
      similar to the rate of late 70's. From patient records, 3 out 8 groups emerged as
      predominant indication for coronary angiography: unstable angina (37%), valvular
      heart disease (20%) and recent myocardial infarction (20%). According the ACC/AHA
      guidelines, indication was considered "appropriate" in 69%, "inappropriate" in
      7%, "doubtful" in 20% and impossible to evaluate in 5% of cases. Although this
      classification may have been built up with incomplete information, it is note
      worthy that the percentage of inappropriate indication is comparable to that of
      other reports. A further observation is that not in every case the treatment
      assigned at the time of diagnostic angiography was really carried out on the
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343939
TI  - [Myocardial revascularization in patients with compromised left ventricular
      function].
AB  - From March 1988 to March 1992, 69 patients with coronary artery disease (CAD) and
      left ventricular dysfunction (LVD) were referred to our Institute for surgical
      decision making. Sixty-nine (8.2%) had LVD. In 39/69 patients we performed the
      identification of viable myocardium with the use of [18F] FDG/PET in fasting
      conditions. We divided patients with LVD into 3 groups: Group A (30 patients)
      operated on without preoperative [18F] FDG/PET, Group B (32 patients) with FDG
      uptake in akinetic segments, and Group C (7 patients) with no FDG uptake; there
      was no significant difference among the 3 groups in age, sex, CAD, risk factors
      and ejection fraction EF (Group A: 29.1 +/- 6.6%, range 16-40; Group B: 32.9 +/-
      6.5%, range 20-40; Group C: 26.5 +/- 6.8%, range 18-37). All patients underwent
      [99mTc] MIBI/SPET to assess perfusion at rest and [99mTc] MIBI first pass
      radionuclide angiography to assess the EF. The study of perfusion and EF was
      repeated 6 months postoperatively in Group A and B. Myocardial protection was
      achieved according to the Buckberg protocol. Operative results in Group A and B
      were respectively: in-hospital deaths 2 (6.6%) versus 0 (NS), perioperative
      myocardial infarction 1 (3.3%) versus 1 (3.1%) (NS), IABP 10 (33.3%) versus 4
      (12.5%) (p = 0.048). Postoperative EF improved both in Group A (35.1 +/- 7.1%,
      range 20-50; p = 0.01) and in Group B (44.2 +/- 7.7%, range 26-62; p < 0.001). In
      Group C 6/7 patients were scheduled for heart transplantation according to
      standard criteria.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8343940
TI  - [The lipid profile after heart transplantation in relation to the preoperative
      cholesterolemia and to the main pathology].
AB  - Serum cholesterol plays a role only in the etiology of ischemic cardiomyopathy
      and increases in patients after heart transplantation. Aim of the present
      investigation was to verify whether lipid profile change is related to pre
      intervention type of cardiomyopathy and serum cholesterol level. Lipid profile
      was monthly monitored for at least 6 months in 21 consecutive patients after
      heart transplantation (19 males and 2 females, mean age 47 +/- 10 years). Serum
      cholesterol and triglycerides increased in all patients 2 months after surgery
      and thereafter it persisted significantly elevated. The increase was
      statistically significant only in patients with dilated cardiomyopathy and with
      normal cholesterolemia before surgery. In conclusion, lipid profile after heart
      transplantation should be especially monitored in patients with dilated
      cardiomyopathy and in those with normal serum cholesterol before heart
      transplantation.

PMID- 8343941
TI  - [Mechano-electric feedback and ventricular arrhythmias in heart failure. The
      possible role of permanent cardiac stimulation in preventing ventricular
      tachycardia].
AB  - Left ventricular dysfunction has been identified as the strongest independent
      predictor of sudden death in patients with ventricular tachyarrhythmias. It has
      been suggested that some of these arrhythmias might be due to myocardial stretch
      which may alter cellular electrophysiological properties. In heart failure (HF)
      the abnormal mechanics of contraction may directly initiate an arrhythmia by
      mechano-electric feedback (MEF), defined as changes in mechanical state that
      precede and alter transmembrane potential. So far, the significance of MEF and
      its role in clinical arrhythmogenesis have received minimal attention. We report
      data of 3 patients, aged from 60 to 64 years (mean age 62 +/- 2), affected by HF
      from 28.3 +/- 3.5 months and ventricular arrhythmias recorded by Holter:
      premature contractions, couplets, nonsustained ventricular tachycardia (VT).
      Sinus rhythm was present in 2 patients, atrial fibrillation in the last one. Many
      VT episodes started after an abrupt spontaneous increase in ventricular cycle
      length or following an ectopic beat. A permanent VVI pacemaker (MEDTRONIC Legend)
      was implanted in each patient and programmed at different rate from 50 to 80
      b/min. During the upper rates, 70 and 80 b/min, VT episodes decreased from 292 +/
      181 to 161 +/- 95 and 97 +/- 63 (p < 0.05), respectively. In fact, the permanent
      pacemaker could prevent the lengthening of ventricular cycle and the myocardial
      fibers stretch due to the increase in ventricular volume. In conclusion, in
      patients with HF and ventricular arrhythmias a pacemaker may be useful in
      preventing VT episodes and, probably, sudden death.

PMID- 8343942
TI  - [What is cytochrome P-450? Enzyme forms of cytochrome P-450--extent of
      knowledge].
AB  - The submitted review summarizes contemporary knowledge of the enzyme P 450, the
      importance of which in human metabolic processes has been beyond doubt for a long
      time. The existence of various forms of the enzyme (there is a number of
      enzymatic forms of this haemoprotein which does not differ only as regards the
      structure of the alipoprotein but also as regards some physical and chemical
      properties) was proved in many prokaryotic and eukaryotic organisms. It played a
      special role in herbivores. New forms were detected which can be induced e. g. by
      polycyclic hydrocarbons, barbiturates, steroids, ethanol (1), hypolipidaemic
      substances and some antibiotics. Also other regulating factors are known. The
      clinical use of P 450 is complicated so far by the great genetically conditioned
      multiplicity of its forms in man. However, a number of very promising and
      important applications are foreseen.

PMID- 8343943
TI  - [Changes in blood pressure, proteinuria and renal hemodynamics in type I diabetes
      with manifestations of diabetic nephropathy after 2 months of captopril therapy].
AB  - In 15 type I diabetics with manifest diabetic nephropathy the authors
      investigated the antihypertensive and antiproteinuric effect of captopril and in
      seven patients of this group also its effect on renal haemodynamics. Captopril
      treatment or its combination with hitherto used antihypertensive treatment was
      associated after two months with a significant drop of the systolic and diastolic
      blood pressure from 150/95 (120/70-195/110) to 130/90 (110/65-180/115) mmHg, (p <
      0.005 < 0.05). The median aortic pressure declined from 118.5 (92-140.8) to 106.5
      (84-1334.8) mm Hg (p < 0.005). Nine of 11 patients (82%) could be changed to
      reduced antihypertensive therapy. The antiproteinuric effect was manifested in 11
      patients (73%). Quantitative proteinuria dropped from 2.7 (0.83-8.65) to 1.85
      (0.38-8.84) g/24 h., (p < 0.05) without a significant change of serum creatinine:
      109 (70-342) vs. 135 (90-288) mumol/l, p = n.s.). The change of proteinuria, as
      compared with the baseline value, was -41 (-77 - +88)%, (p < 0.05) and did not
      correlate with the change of the median aortic pressure (correlation coefficient
      = -0.165, p = n.s.). In the group of seven patients the change of the median
      aortic pressure was -15% (-26.1 - +6.6), (p < 0.05). No statistically significant
      change of glomerular filtration was observed: 0.96 (0.32-1.38) vs. 0.96 (0.19
      1.71) ml/s, p = n.s.); effective renal plasma flow: 6.32 (2.24-7.74) vs. 7.22
      (1.68-10.55) ml/s, (p = n.s.); filtration fraction: 0.136 (0.123-0.220) vs. 0.130
      (0.110-0.236), change 0.0 (-43.0 - +31.0)% (p = n.s.) and renal vascular
      resistance: 15429 (12907-54148) vs. 13243 (7099-77832)%, (p. = n.s.).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8343944
TI  - [T-lymphocyte subpopulations in bronchoalveolar lavage in pulmonary sarcoidosis
      and other interstitial pulmonary diseases].
AB  - In the bronchoalveolar lavage of 17 patients with pulmonary sarcoidosis and in
      the lavage of 18 patients with other diseases of the pulmonary interstitium the
      authors assessed by means of monoclonal antibodies, T-lymphocyte subpopulations.
      In the lavage from sarcoidosis helper-inducer lymphocytes (CD4+) dominated
      markedly, while in other interstitial pulmonary diseases a predominance of
      suppressor-cytotoxic lymphocytes (CD8+) was found. The different ratio of CD4+
      and CD8+ lymphocytes was manifested particularly markedly when for evaluation the
      CD4/CD8 ratio was used: in sarcoidosis it was 7.2 +/- 3.5, while in other
      interstitial lung diseases only 0.9 +/- 0.6. The presented results indicate
      possible practical use of assessment of lymphocyte subpopulations in
      bronchoalveolar lavage for the differential diagnosis of interstitial lung
      diseases.

PMID- 8343945
TI  - [Immunologic study in HIV-positive patients. Hypergammaglobulinemia in HIV
      infection].
AB  - In all groups of patients--HIV, ARC, AIDS carriers--elevated serum concentration
      of IgG, IgA, IgM were found. In the group of HIV carriers a significant increase
      of the serum concentration of IgG at the 5% level was observed and of IgM at the
      1% level. In patients with ARC a significant increase of IgG and IgA was found at
      the 5% level and of IgM at the 1% level. In patients with AIDS significantly
      raised IgG values at the 5% level were recorded, and of IgA and IgM at the 1%
      level. In IgA a permanent increase of values occurs in AIDS carriers. In the AIDS
      stage 86% of the patients have values higher than mean +/- SD of controls. In all
      three stages of HIV infection a rise of concentrations of circulating
      immunocomplexes was observed (p < 0.01). The highest levels were recorded in
      patients with AIDS. In none of the patients the presence of antinuclear
      antibodies was detected. The authors discuss also possible causes of
      hypergammaglobulinaemia in HIV infection.

PMID- 8343946
TI  - [Therapy of ulcer disease using gastrinal-sucralfate produced in Czechoslovakia].
AB  - The authors present their experience with the use of the Czechoslovak preparation
      Gastrinal-Sucralphate in the treatment of 40 subjects with gastroduodenal
      ulceration. Moreover, they compared two forms of the drug--tablets and granulate.
      The healing effect of the drug is very high, in tablets 77.0%, in granulate as
      much as 89.5%. As far as tolerance is concerned, it was obviously better after
      the granulate, subjective side-effects were very rare. The drug does not affect
      any basic biochemical parameters which were monitored during administration of
      the drug.

PMID- 8343947
TI  - [Ethics committees in the Czech Republic].
AB  - The authors submit a report on the establishment and activities of new advisory
      organs which developed in hospitals and at medical faculties and bear the name of
      ethical commissions. Their task is to approve grants, advisory activities as well
      as organizing public discussions of ethical problems. The basis of the report are
      data obtained by means of questionnaires completed by 62 respondents. At present
      there are 20 ethical commissions in the Czech Republic, 19 local ones and one
      central one.

PMID- 8343948
TI  - Extracellular signals and reversible protein phosphorylation: what to Mek of it
      all.

PMID- 8343949
TI  - The torso receptor protein-tyrosine kinase signaling pathway: an endless story.

PMID- 8343950
TI  - Exercising self-restraint: discouraging illicit acts of S and M in eukaryotes.

PMID- 8343951
TI  - JAK2 associates with the erythropoietin receptor and is tyrosine phosphorylated
      and activated following stimulation with erythropoietin.
AB  - Erythropoietin (EPO) regulates the proliferation and differentiation of erythroid
      cells through interaction with its receptor (EPOR). Although EPOR is a member of
      the cytokine receptor superfamily and lacks a kinase domain, EPO induces tyrosine
      phosphorylation, which is correlated with gene transcription and mitogenesis.
      Here we demonstrate that EPO induces tyrosine phosphorylation of JAK2 kinase and
      activates its in vitro autophosphorylation. Using EPOR mutants, phosphorylation
      and activation of kinase activity correlate with the induction of mitogenesis.
      Furthermore, JAK2 physically associates with a membrane-proximal region of the
      EPOR cytoplasmic domain that is required for biological activity. The results
      support the hypothesis that JAK2 is the kinase that couples EPO binding to
      tyrosine phosphorylation and mitogenesis.

PMID- 8343952
TI  - Identification of JAK2 as a growth hormone receptor-associated tyrosine kinase.
AB  - Growth hormone receptor (GHR) forms a complex with a tyrosine kinase, suggesting
      involvement of a ligand-activated tyrosine kinase in intracellular signaling by
      growth hormone (GH). Here we identify JAK2, a nonreceptor tyrosine kinase, as a
      GHR-associated tyrosine kinase. Immunological approaches were used to establish
      GH-dependent complex formation between JAK2 and GHR, activation of JAK2 tyrosine
      kinase activity, and tyrosyl phosphorylation of both JAK2 and GHR. The JAK2-GHR
      and JAK2-erythropoietin receptor interactions described here and in the
      accompanying paper provide a molecular basis for involvement of tyrosyl
      phosphorylation in physiological responses to these ligands and suggest a shared
      signaling mechanism among members of the cytokine/hematopoietin receptor family.

PMID- 8343953
TI  - Transcytosis of the polymeric Ig receptor requires phosphorylation of serine 664
      in the absence but not the presence of dimeric IgA.
AB  - MDCK cells expressing the polymeric immunoglobulin (poly-Ig) receptor, cocultured
      with IgA-producing hybridoma cells, transported dimeric IgA (dIgA) from the
      basolateral into the lumenal compartment, where it was recovered as secretory
      component-dIgA complexes. The tail of the receptor was phosphorylated on serines
      664 and 726. Each serine was mutated to alanine. Appearance of A726 receptor at
      the basolateral surface was reduced approximately 5-fold. This was accompanied by
      a approximately 5-fold reduction in dIgA transcytosis. Basolateral delivery of
      receptor was not affected by mutation A664, and in the absence of dIgA, the
      receptor accumulated in recycling basolateral endosomes. In coculture, however,
      dIgA transcytosis by A664 receptor was normal. Thus, entry of receptor into the
      transcytotic pathway requires Ser-664 phosphorylation only in the absence of
      dIgA.

PMID- 8343954
TI  - The chondroitin sulfate form of invariant chain can enhance stimulation of T cell
      responses through interaction with CD44.
AB  - Invariant chain (Ii) is a nonpolymorphic glycoprotein that associates with major
      histocompatibility complex class II molecules and has been shown to mediate
      several functions in class II-restricted antigen presentation. A small proportion
      of Ii is modified by the addition of chondroitin sulfate (Ii-CS), and this form
      of Ii is associated with class II on the surface of antigen-presenting cells. In
      this report we show that expression of Ii-CS dramatically enhanced the ability of
      class II-positive EL4 transfectants to stimulate class II-dependent allogeneic
      and mitogenic T cell responses. Antibody blocking studies and the ability of CD44
      to bind directly to Ii-CS suggest that Ii-CS can function as an accessory
      molecule during T cell responses through interactions with CD44.

PMID- 8343955
TI  - Biosynthesis of succinoglycan, a symbiotically important exopolysaccharide of
      Rhizobium meliloti.
AB  - The exo genes of Rhizobium meliloti are needed for the synthesis of an acidic
      exopolysaccharide, succinoglycan. We have assigned biosynthetic roles to the
      products of the exo genes by characterizing succinoglycan biosynthetic
      intermediates from exo mutant strains. We propose a model of succinoglycan
      biosynthesis in which the products of the exoY and exoF genes function in the
      addition of the first sugar, galactose, to the lipid carrier; the products of the
      exoA, exoL, exoM, exoO, exoU, and exoW genes function in subsequent sugar
      additions; and the product of the exoV gene functions in the addition of
      pyruvate. The products of the exoP, exoQ, and exoT genes are required for
      polymerization of the octasaccharide subunits or transport of the completed
      polymer.

PMID- 8343956
TI  - The inactive X chromosome in female mammals is distinguished by a lack of histone
      H4 acetylation, a cytogenetic marker for gene expression.
AB  - We have immunolabeled human and mouse metaphase chromosomes with antibodies
      specific for the acetylated isoforms of histone H4. All chromosomes were labeled
      in regions corresponding to conventional R bands (regions enriched in coding
      DNA), except for a single chromosome in female cells, which was largely unlabeled
      and which we have identified as the inactive X (Xi). Three sharply defined
      immunofluorescent bands, enhanced by butyrate pretreatment, were observed in
      homologous positions on the human and mouse Xi, showing limited, regional
      persistence of H4 acetylation. Two of these bands are in cytogenetic regions
      known to contain genes expressed on Xi. We propose that H4 hyperacetylation
      defines regions of the genome containing potentially transcriptionally active
      chromatin, while virtual absence of H4 acetylation defines both constitutive and
      facultative heterochromatin.

PMID- 8343957
TI  - Crystal structure of the HhaI DNA methyltransferase complexed with S-adenosyl-L
      methionine.
AB  - The first three-dimensional structure of a DNA methyltransferase is presented.
      The crystal structure of the DNA (cytosine-5)-methyltransferase, M.HhaI
      (recognition sequence: GCGC), complexed with S-adenosyl-L-methionine has been
      determined and refined at 2.5 A resolution. The core of the structure is
      dominated by sequence motifs conserved among all DNA (cytosine-5)
      methyltransferases, and these are responsible for cofactor binding and
      methyltransferase function.

PMID- 8343958
TI  - Spatial segregation of odorant receptor expression in the mammalian olfactory
      epithelium.
AB  - The signal elicited by the interaction of odorous ligands with receptors on
      olfactory sensory neurons must be decoded by the brain to determine which of the
      numerous receptors have been activated. We have examined the patterns of odorant
      receptor expression in the rat olfactory epithelium to determine whether the
      mammalian olfactory system employs spatial segregation of sensory input to encode
      the identity of an odorant stimulus. In situ hybridization experiments with
      probes for 11 different odorant receptors demonstrate that sensory neurons
      expressing distinct receptors are topologically segregated into a small number of
      broad, yet circumscribed, zones within the olfactory epithelium. Within a given
      zone, however, olfactory neurons expressing a specific receptor appear to be
      randomly distributed, rather than spatially localized. The complex mammalian
      olfactory system may therefore compartmentalize the epithelium into anatomically
      and functionally discrete units, such that each zone expresses only a subset of
      the entire receptor repertoire.

PMID- 8343959
TI  - Specific truncations of Drosophila Notch define dominant activated and dominant
      negative forms of the receptor.
AB  - The Notch gene of Drosophila plays an important role in cell fate specification
      throughout development. To investigate the functions of specific structural
      domains of the Notch protein in vivo, a series of deletion mutants have been
      ectopically expressed under the hsp70 heat shock promoter. Two classes of
      dominant phenotypes are observed, one suggestive of Notch loss-of-function
      mutations and the other of Notch gain-of-function mutations. Dominant activated
      phenotypes result from overexpression of a protein lacking most extracellular
      sequences, while dominant negative phenotypes result from overexpression of a
      protein lacking most intracellular sequences. These results support the notion
      that Notch functions as a receptor whose extracellular domain mediates ligand
      binding, resulting in the transmission of developmental signals by the
      cytoplasmic domain. Finally, the phenotypes observed suggest that the cdc
      10/ankyrin repeat region within the intracellular domain plays an essential role
      in the postulated signal transduction events.

PMID- 8343960
TI  - Intrinsic activity of the Lin-12 and Notch intracellular domains in vivo.
AB  - The lin-12 gene of C. elegans and the Notch gene of D. melanogaster encode
      structurally related transmembrane proteins that mediate intercellular signaling.
      We show that truncated forms of these proteins consisting of only the
      intracellular domains cause cell fate transformations associated with
      constitutive activity in their respective organisms. This activity does not
      depend on endogenous gene function. Our results indicate that the intracellular
      domains of Lin-12 and Notch have intrinsic activity and that the principal role
      of the extracellular domains in the intact proteins is to regulate this activity.
      Our results also suggest that equivalent truncated forms of lin-12/Notch family
      members in vertebrates, including known oncogenes, are similarly active.

PMID- 8343961
TI  - Down-regulation of the Drosophila morphogen bicoid by the torso receptor-mediated
      signal transduction cascade.
AB  - Anterior body pattern in Drosophila is specified by the graded distribution of
      the bicoid protein (bcd), which activates subordinate genes in distinct anterior
      domains. Subsequently, transcription of these target genes is repressed at the
      anterior pole owing to the activity of the receptor tyrosine kinase torso (tor).
      We show that both activation by bcd and repression by tor can be reproduced by a
      minimal promoter containing only bcd-binding sites upstream of a naive
      transcriptional start site. Repression requires the D-raf kinase and is
      associated with phosphorylation of bcd protein. Repression does not require
      either tailless or huckebein, which were previously thought to constitute the
      sole zygotic output of the tor signaling system. Finally, addition of a
      heterologous transcriptional activation domain to bcd renders the protein
      insensitive to tor-mediated repression. We propose that phosphorylation resulting
      from the activity of the tor signal transduction cascade down-regulates
      transcriptional activation by the bcd morphogen.

PMID- 8343962
TI  - Fission yeast cut5+, required for S phase onset and M phase restraint, is
      identical to the radiation-damage repair gene rad4+.
AB  - Fission yeast cut5 mutants cause cytokinesis in the absence of normal nuclear
      division. We show here that cut5+ is required for both the onset of S phase and
      the restraint of M phase before the completion of S phase. The primary defects in
      cut5 mutants occur prior to S phase, but cells suffer lethal damage during M
      phase. Mitosis and cytokinesis occur in the presence of hydroxyurea or in the
      double mutant cdc10-cut5 (the cdc10 mutation alone blocks progression from G1 to
      S). Gene cloning shows that cut5+ is identical to the fission yeast rad4+ gene,
      which is similar to human XRCC1. The rad4+/cut5+ gene is unique in its positive
      role for replication/repair and in its negative role for mitosis/cytokinesis. We
      propose a single/twin chromatid marking model for rad4+/cut5+ function in cell
      cycle control.

PMID- 8343963
TI  - Mutations at the mouse microphthalmia locus are associated with defects in a gene
      encoding a novel basic-helix-loop-helix-zipper protein.
AB  - Mice with mutations at the microphthalmia (mi) locus have some or all of the
      following defects: loss of pigmentation, reduced eye size, failure of secondary
      bone resorption, reduced numbers of mast cells, and early onset of deafness.
      Using a transgenic insertional mutation at this locus, we have identified a gene
      whose expression is disrupted in transgenic animals. This gene encodes a novel
      member of the basic-helix-loop-helix-leucine zipper (bHLH-ZIP) protein family of
      transcription factors, is altered in mice carrying two independent mi alleles (mi
      and miws), and is expressed in the developing eye, ear, and skin, all anatomical
      sites affected by mi. The multiple spontaneous and induced mutations available at
      mi provide a unique biological resource for studying the role of a bHLH-ZIP
      protein in mammalian development.

PMID- 8343964
TI  - Proenzyme from of cathepsin L produced by thymic epithelial cells promotes
      proliferation of immature thymocytes in the presence of IL-1, IL-7, and anti-CD3
      antibody.
AB  - A thymic epithelial cell line (TEC1-4) established from newborn mouse thymus
      produced a cofactor to promote proliferation of double-negative (CD4-8-)
      thymocytes in the presence of IL-1, IL-7, and anti-CD3 antibody. Based upon the
      sequence of 8 amino acid residues near the N terminal portion, the factor was
      identified as the mouse proenzyme form of cathepsin L which is almost identical
      to the rat proenzyme form of cathepsin L (95% in homology). Production of the
      proenzyme form of cathepsin L was confirmed in the TEC1-4 and mouse embryonic
      thymus by Western blotting analysis and Northern blotting analysis. Furthermore,
      immunohistologically, the presence of cathepsin L was observed in the epithelial
      cells of the subcapsular layer and around the small vessels in the thymic cortex.
      It has been concluded that a subpopulation of thymic cortical epithelial cells
      produces the proenzyme form of cathepsin L which can act as a cofactor to promote
      proliferation of DN immature thymocytes.

PMID- 8343965
TI  - Antigen-specific suppressor factors of noncytotoxic CD8+ suppressor T cells
      downregulate antibody responses also to unrelated antigens when the latter are
      presented as covalently linked adducts with the specific antigen.
AB  - We had previously shown (i) that conjugates of a given antigen A (AgA) and
      monomethoxypolyethylene glycol (mPEG) induced AgA-specific tolerance in mice
      which was mediated by polyclonal CD8+ suppressor T (Ts) cells, as well as by
      soluble factor(s) of these cells (TsF), and (ii) that clones of nonhybridized
      CD8+ Ts cells could be derived from the above single cells, and monoclonal AgA
      specific TsF could be released from these cloned cells. In the present study, we
      demonstrate that mice pretolerized by injection of AgA(mPEG)n are also
      unresponsive to an unrelated antigen B (AgB), or to its haptenated derivative AgB
      Hpn, when AgB or AgB-Hpn is injected in the form of a covalent adduct with AgA,
      i.e., AgA-AgB or AgA-AgB-Hpn, but not when it is injected as a mixture with AgA;
      in this study human (myeloma) IgG (HIgG) served as AgA, and ovalbumin (OVA) or
      OVA-DNP3 served as AgB or AgB-Hpn. Moreover, this phenomenon was reproduced in
      vitro; i.e., Ts cells of mice tolerized with HIgG(mPEG)30, or the soluble
      monoclonal TsF of cloned Ts cells, exerted their associative suppressive effector
      function--in the obligatory presence of CD8+ T cells of syngeneic naive mice (Tn
      cells)--on antibody (Ab) formation to an Hp (DNP), when the Hp was present as a
      covalent adduct linked either directly to HIgG (e.g., HIgG-DNP7) or indirectly
      via OVA (as in HIgG-OVA-DNP3); however, no suppression of the anti-DNP Ab
      response was observed when OVA-DNP3 was present as a mixture with HIgG.
      Furthermore, it was established that the accessory cells involved in processing
      the specific Ag in the presence of the Ts cells were also downregulated, as
      reflected by their reduced capacity for presentation of the Ag to HIgG-specific
      helper T (Th) cells in proliferation assays. All these results demonstrate that
      (i) the phenomenon of linked immunological suppression may involve the
      downregulation of Th cells which recognize, concomitantly with the Ts cell, the
      appropriate epitopes of AgA and AgB on the same Ac cell, (ii) the downregulation
      of these Th cells may be a consequence of the downregulation of Ac cells by Ts
      cells interacting with the appropriate epitope(s) present on the Ac cells, and
      (iii) most remarkably the CD8+ Ts cells could be substituted by Tn cells "armed"
      with the specific monoclonal TsF.

PMID- 8343967
TI  - Low-dose streptozotocin-induced diabetes in mice. I. Course of Candida albicans
      infection.
AB  - Diabetic patients are highly susceptible to microbial and fungal infections. To
      better understand the immune mechanisms underlying the diabetic host-parasite
      relationship, we studied the course of systemic infection with Candida albicans
      in mice with low-dose streptozotocin-induced diabetes. For this purpose, we used
      a low-pathogenic strain of C. albicans, PCA-2, which causes a chronic infection
      in the intact host. Injection of PCA-2 cells into diabetic mice caused a lethal
      acute infection. The levels of interferon-gamma (IFN-gamma) determined in sera
      and splenocyte culture supernatants from diabetic mice were significantly higher
      than those in control mice. Moreover, splenic macrophages from diabetic mice were
      functionally activated relative to normal macrophages, as evaluated by
      significantly augmented C. albicans killing in vitro. However, when diabetic mice
      were infected with PCA-2, IFN-gamma levels dropped dramatically to undetectable
      levels during the first week of infection and there was a marked decrease in
      macrophage activation. These data suggest that the levels of IFN-gamma production
      early in infection might have a crucial role in generating the susceptibility of
      diabetic mice to infection.

PMID- 8343968
TI  - Reproducible procedures for establishing mouse thymic stromal cell lines.
AB  - Mouse thymic epithelial cell lines (MTEC) were established from Day 14-18 fetal
      thymus by two novel protocols. The first protocol involved the selection of TEC
      by the formation of complexes with adult thymocytes after transformation with the
      helper-free Ad5.SVR4 recombinant virus. The second protocol involved the
      stimulation and selection of TEC in Ca(2+)-free medium by the formation of
      complexes with Day 14 fetal thymocytes. The resulting TECs formed several types
      of thymic epithelial clusters to which Day 14 fetal thymocytes could bind. Many
      of these fetal thymocytes could deeply infiltrate, colonize, and proliferate
      within the clusters of NCAM(high) LFA-1(low) TEC (MTSC-0420-1.4, MTSC-0420-1.5,
      and MTSC-0613-1.2 clusters), whereas very few could infiltrate the clusters of
      NCAM(low) LFA-1(high) TEC (MTSC-0531-5.1 and MTSC-0531-5.2) and none bound to or
      infiltrated an NCAM(neg) fibroblast cluster (MTSC-fibro.). Hence, it is possible
      that the NCAM-positive epithelial cell lines are derived from the thymus cortex,
      where they may play an important role in intrathymic migration and the clonal
      growth of pro-T cells in fetal thymus.

PMID- 8343966
TI  - Differential effects of interleukin-2 and CD3 triggering on cytokine gene
      transcription and secretion in cultured tumor infiltrating lymphocytes.
AB  - The therapeutic potential of tumor-infiltrating lymphocytes (TIL) is currently
      under investigation. TIL have been reported to display characteristic functional
      defects, including impairments of activation mechanisms. In animal models,
      therapeutic efficacy of adoptive TIL transfer has been correlated with their
      capacity to produce cytokines rather than with their in vitro cytotoxic
      potential. In this work we assayed cytokine gene transcription and protein
      production in eight cultured TIL populations stimulated with recombinant human IL
      2 (rhIL-2), solid-phase-bound anti-CD3 monoclonal antibodies (mAb), or a
      combination of the two. By using a sensitive reverse polymerase chain reaction
      technique, we observed that transcription of IL-5, GM-CSF, and TNF-alpha could be
      detected in unstimulated, IL-2-starved TIL from all cultures, while IL-4 and IFN
      gamma genes were found to be transcribed in two cultures out of eight. A 50 U/ml
      dose of rhIL-2 was sufficient to induce IL-4 and IFN-gamma gene transcription in
      the remaining six cultures and in four more TIL populations, respectively. In
      contrast, rhIL-2 could not induce IL-2 gene transcription in five of eight TIL
      cultures. Furthermore, it could not induce IL-10 gene transcription in any TIL
      population. Anti-CD3 mAb triggering, however, induced transcription of all these
      cytokine genes. On the other hand, IL-6, IL-7, or TGF-beta 2 gene transcription
      could not be induced by any of the stimuli used, including the combination of
      anti-CD3 and rhIL-2. Despite detection of their gene transcripts, GM-CSF, IFN
      gamma, or TNF-alpha was never detectable, at the protein level, in unstimulated
      TIL. Stimulation by rhIL-2 induced GM-CSF secretion, albeit to different extents,
      in all TIL populations. In contrast, rhIL-2 induced IFN-gamma and TNF-alpha
      production in three and one TIL population, respectively. CD3 triggering however,
      induced cytokine production in all TIL populations. Addition of rhIL-2
      significantly increased production of GM-CSF, but not of IFN-gamma and TNF-alpha.
      These data underline that stimulation with a moderate dose of rhIL-2 reveals
      considerable heterogeneity of TIL populations regarding cytokine gene
      transcription and secretion. On the other hand, triggering of the CD3-T-cell
      receptor complex induces transcription of an extended panel of cytokine genes in
      all TIL populations and secretion of GM-CSF, IFN-gamma and TNF-alpha in virtually
      all cultures. Thus, if stimulated by properly presented antigenic peptides, TIL
      are capable of mounting an efficient response in terms of cytokine gene
      expression and protein production.

PMID- 8343969
TI  - Enzymes Interacting with Organophosphorus Compounds. Proceedings of 2nd
      International Meeting. Salsomaggiore, Italy, April 21-24, 1992.

PMID- 8343970
TI  - Biopolymer metal catalysts for the hydrolysis of nerve gases.
AB  - Glucosamine oligomers--monomer through tetramer--form complexes with Cu2+ that
      catalyse the hydrolysis of the 'nerve gas' 1,2,2-trimethylpropyl-
      methylphosphonofluroidate (soman) by cleaving the P-F bond. A 1/1
      glucosamine/Cu2+ ratio whether as glucosamine or glucosamine units, gives the
      highest hydrolytic rate over the 11.5/1 to 1/1 range. This trend also appears to
      hold for a glucosamine polymer, chitosan, which, when complexed with Cu2+ also
      hydrolyzes soman. The relatively low rate of hydrolysis by this polymer-Cu2+
      complex, while not yet explainable, is consistent with an extrapolation of the
      monomer-through-tetramer series. The question may be raised as to whether these
      biopolymer metal complexes provide any clues to the involvement of Mn2+ in the
      functioning of one class of P-F cleaving enzymes.

PMID- 8343971
TI  - The kinetics of O-hexyl O-2,5-dichlorophenyl phosphoramidate hydrolysing activity
      in hen plasma.
AB  - The organophosphorus (OP) compound O-hexyl-O-2,5-dichlorophenyl phosphoramidate
      (H-DCP) is hydrolysed in the plasma, liver and brain of hens and rats. We study
      in hen plasma the effect of tissue and substrate concentrations and of pH on the
      hydrolysing activity of H-DCP. The data on each tissue concentration were fitted
      to a double exponential mathematical model. The kinetics of this activity was not
      linear; in a first exponential component or fast initial phase (k1 = (1.603 +/-
      0.248) x 10(-3) min-1/microliter plasma (n = 4, S.E.)) about 15% of the total
      compound was hydrolysed, followed by a slow second phase (k2 = (0.144 +/- 0.026)
      x 10(-3) min-1/microliter plasma (n = 4, S.E.)) in which the remaining 85% was
      hydrolysed. Both constants increased in value with pH. The hydrolytic activity
      and rate constants increased with the amount of plasma, but no change in kinetics
      was observed. The kinetic data are discussed in terms to lend support to the
      hypothesis of a stereospecific degradation of H-DCP.

PMID- 8343972
TI  - Stereo-specific degradation of the R-(+) isomer of O-n-hexyl-S
      methylphosphorothioamidate catalysed by rabbit serum.
AB  - Resolved isomers of O-n-hexyl-S-methylphosphorothioamidate (HXM) which had been
      synthesised by separate stereospecific routes were analysed by chiral glc: about
      2-3% of R-(+) isomer was found in the S-(-) sample and accounted for nearly all
      the inhibitory power against neuropathy target esterase. Incubation of racemic
      HXM with rabbit serum led to slow but very specific disposal of R-(+) isomer to
      undetectable levels with very slight loss of S-(-): the rate of disposal was
      roughly estimated to be about 1% of the published rate of hydrolysis of paraoxon.
      Incubation with crystalline chymotrypsin caused a preferential but not totally
      selective disposal of S-(-) isomer.

PMID- 8343973
TI  - Recommendations of the IUBMB Nomenclature Committee: comments concerning
      classification and nomenclature of esterases hydrolysing organophosphorus
      compounds.

PMID- 8343974
TI  - Peripheral esterases in the rat: effects of classical inducers.
AB  - Liver microsomal paraoxonase, aryl esterase and fluazifop butyl esterase
      (carboxylesterase) were induced by pretreatment of rat with phenobarbitone but
      not by beta-naphthoflavone or clofibric acid. In the extrahepatic tissues lung
      cytosolicfluazifop butyl and phenylacetate esterase were induced.

PMID- 8343975
TI  - Three-dimensional structure of acetylcholinesterase and of its complexes with
      anticholinesterase drugs.
AB  - Based on our recent X-ray crystallographic determination of the structure of
      acetylcholinesterase (AChE) from Torpedo californica, we can see for the first
      time, at atomic resolution, a protein binding pocket for the neurotransmitter,
      acetylcholine. It was found that the active site consists of a catalytic triad
      (S200-H440-E327) which lies close to the bottom of a deep and narrow gorge, which
      is lined with the rings of 14 aromatic amino acid residues. Despite the
      complexity of this array of aromatic rings, we suggested, on the basis of
      modelling which involved docking of the acetylcholine (ACh) molecule in an all
      trans configuration, that the quaternary group of the choline moiety makes close
      contact with the indole ring of W84. In order to study the interaction of AChE
      with anticholinesterase drugs at the structural level, we have incorporated into
      the acetylcholinesterase crystals several different inhibitors, and have recently
      determined the 3-D structure of AChE:edrophonium and AChE:tacrine complexes. The
      crystal structures of both of these complexes are in good agreement with our
      model building of the ACh bound in the active site of AChE and indicate the
      interactions of these two drugs with the enzyme.

PMID- 8343976
TI  - Structure and regulation of expression of the acetylcholinesterase gene.
AB  - Acetylcholinesterase, an enzyme essential for the termination of the action of
      acetylcholine, is encoded by a single gene. Alternative mRNA processing gives
      rise to the expression of enzyme forms with three distinct carboxyl-termini.
      These structural differences govern the cellular disposition of the expressed
      enzyme but do not influence catalytic activity. Alternative polyadenylation
      signals give rise to distinct 3' non-coding regions which are likely to affect
      mRNA stability. Alternative splicing also occurs at the 5' end of the gene where
      two promoter regions can be identified. Hence, regulation of expression of the
      gene occurs at 3 levels, transcriptional through alternative promoters,
      translational by affecting mRNA stability and processing of distinct mRNAs and
      post-translationally by giving rise to distinct peptide chains which are
      processed differently. Recombinant DNA studies have also been extended to
      modifying protein structure through site-specific mutagenesis and studying the
      function of the mutant enzymes.

PMID- 8343977
TI  - Molecular dissection of cholinesterase domains responsible for carbamate
      toxicity.
AB  - Carbamate compounds marked for their cholinesterase (ChE) inhibition are widely
      used as therapeutics and as insecticides. Groups of closely related carbamate
      molecules provide an important tool in the understanding of the domains
      responsible for binding these ligands to ChEs. Comparative inhibition profiles
      were derived for five N-methyl carbamates, mostly carbofuran derivatives,
      differing in length and branching of their hydrocarbonic chain towards human
      erythrocyte acetylcholinesterase (H.AChE), human serum butyrylcholinesterase
      (H.BChE) in its normal form or in a mutant form containing the point mutation
      Asp70-->Gly, and Drosophila nervous system ChE. Carbofuran was more toxic to all
      three ChEs than any of the other derivatives, with IC50 values which differed by
      more than 1000-fold. Drosophila ChE appeared to be most sensitive to all of the
      examined carbamates, and H.AChE was consistently more sensitive than H.BChE.
      Moreover, inhibition efficiency for H.BChE decreased more effectively than it did
      for H.AChE with increased length and complexity of the side chain, indicating
      less flexible carbamate binding site in BChE as compared with AChE. The Asp70-
      >Gly mutation had no apparent effect on H.BChE inhibition by N-methyl carbamates,
      suggesting that the Asp70 domain localized near the rim of the active site groove
      is not important in carbamate binding. Comparison of the carbamate IC50 values
      with published LD50 values demonstrated correlation between the in vivo toxicity
      and inhibition of BChE by carbamates, suggesting a biological in addition to
      scavenging importance for BChE in mammals. Pinpointing different domains
      characteristic of carbamate binding in each member of the ChE family can thus
      shed light on the variable toxicity of these inhibitors to insects and mammals,
      predict the toxicity of yet untested inhibitor molecules and help in designing
      novel and improved ChE inhibitors.

PMID- 8343978
TI  - Organophosphate sensitive and insensitive carboxylesterases in human skin.
AB  - The influence of paraoxon and bis(4-nitrophenyl)phosphate (BNPP) on
      carboxylesterases of human skin is assayed. Both organophosphates have frequently
      been used as inhibitors of carboxylesterases of the B-esterase type. Homogenates
      from carefully washed skin have no paraoxon-cleaving activity and very little
      phosphodiesterase activity with BNPP. However, a number of skin enzymes are
      irreversibly inhibited by these compounds. Three zones of carboxylesterase bands
      can be detected in the soluble fraction of skin homogenate by isoelectric
      focusing. One zone containing 5 esterase bands in the pI-range of 6.7-7.0 and
      another zone at pI 4.9 are insensitive to organophosphate inhibition. The zone
      with the main esterase activities contains at least 6 bands in the range of pI
      5.7-6.2. All of these are quickly and completely inhibited by paraoxon. The
      complex inhibition kinetics with BNPP and observations with differing substrates
      point to a functional heterogeneity. The esterases with pI-values in the range of
      5.7 to 6.2 and the esterase with pI 4.9 can be enriched using anion exchange
      chromatography and FPLC. From the data presented here it is concluded that human
      skin contains at least four different carboxylesterases which act on simple
      aromatic esters.

PMID- 8343979
TI  - Drosophila acetylcholinesterase: mechanisms of resistance to organophosphates.
AB  - Quantitative and qualitative changes of acetylcholinesterase can affect the
      sensitivity of insects to insecticides. First, the amount of acetylcholinesterase
      in the central nervous system is important in Drosophila melanogaster, flies
      which overexpress the enzyme are more resistant than wild-type flies. On the
      contrary, flies which express low levels of acetylcholinesterase are more
      susceptible. An overproduction of acetylcholinesterase outside the central
      nervous system also protects against organophosphate poisoning, that is, flies
      producing a soluble acetylcholinesterase, secreted in the haemolymph, are
      resistant to organophosphates. Second, resistance can also result from a
      qualitative modification of acetylcholinesterase. Four mutations have been
      identified in resistant strains: Phe115 to Ser, Ileu199 to Val, Gly303 to Ala and
      Phe368 to Tyr. Each of these mutations led to a different pattern of resistance
      and combinations between these mutations led to highly resistant enzymes.

PMID- 8343981
TI  - Synthesis of the DNA probe for the determination of rat AChE mRNA.
AB  - This is a preliminary report on our attempts of synthesis by polymerase chain
      reaction (PCR), the cDNA probe for the determination of mRNA of the AChE
      catalytic subunit. As our strategy we took the advantage of the fact that
      sequence identity of AChE gene increases with phylogenetic proximity. Single
      codon usage could therefore be applied. Two non-degenerate PCR primers were
      synthesised corresponding to AChE regions which were highly conservative among
      species analyzed until now. The sequence amplified by these two primers should be
      339 base pairs long as concluded from mouse AChE sequence. By determining the
      nucleotide sequence of the PCR product and by comparison of this sequence with
      the corresponding mouse AChE region, we would be able to verify the
      correspondence of our PCR product to the rat AChE gene fragment. Only the first
      four amino acids of our PCR product flanking Phe 200, which is the first amino
      acid from the A2 primer, are 100% homologous with the mouse AChE. However, from
      the next 18 amino acids towards the N-terminal, only 4 are homologous with the
      mouse AChE. Since we expected more than 90% homology between the phylogenetically
      closely related species of mouse and rat, we doubt that the DNA sequence obtained
      belongs to the rat AChE gene.

PMID- 8343980
TI  - Computerized analysis of covalent inhibition kinetics for identification of heart
      muscle cholinesterase and brain carboxylesterase isoenzymes. Design of
      differential inhibition assays.
AB  - The kinetics of time- and concentration-dependent covalent organophosphorus
      inhibition of carboxylesterase isoenzymes (EC 3.1.1.1) and cholinesterase
      isoenzymes (EC 3.1.1.7 and EC 3.1.1.8) were investigated using a wide range of
      organophosphate inhibitor concentrations (10(-10)-10(-3) mol/l) and different
      inhibition times. Computerized analysis of inhibition curves by weighted non
      linear least-squares curve fitting was compared to graphic analysis by iterative
      elimination of exponential functions. Possible experimental errors due to
      inhibitor saturation kinetics and enzymatic organophosphate hydrolysis were
      thoroughly investigated. In mammalian heart muscle, three different
      cholinesterase isoenzymes were identified. High sensitivity and specificity of
      the classic differential inhibition test for carboxylesterase activity of hen
      brain neuropathy target esterase (NTE) could be confirmed independently with both
      methods of inhibition curve analysis.

PMID- 8343982
TI  - The influence of chronic treatment with dexamethasone on the acetylcholinesterase
      activity in rat skeletal muscle.
AB  - In the conditions of chronically elevated glucocorticoid agents in plasma, a drop
      in AChE activity of about 45% was reported. This data suggests the possibility
      that among other factors glucocorticoids also control AChE activity in the
      skeletal muscles. The question addressed in the present investigation was if AChE
      activity was reduced uniformly or selectively in the rat skeletal muscles after
      chronic application of dexamethasone? Selective effects of glucocorticoids on the
      AChE activity in different muscles and/or different types or regions of muscles
      would suggest the potential of these agents to regulate AChE metabolism in the
      skeletal muscle according to the environmental demands. Specific activity of
      skeletal muscle AChE was reduced in sternomastoideus (SM), extensor digitorum
      longus (EDL) and diaphragm (D) but not in soleus (SOL) after chronic
      dexamethasone treatment. Axial SM (white part) was more affected than distal
      white muscle EDL. AChE was better preserved in red rather than in white parts of
      muscles. The endplate-free region lost twice as much of specific AChE activity
      than the endplate-rich region. Our results suggest, but do not prove that
      glucocorticoid agents act in a selective way on the AChE metabolism of the
      skeletal muscles.

PMID- 8343983
TI  - The effects of pretreatment with soman simulator in the skeletal muscle: direct
      interactions with acetylcholinesterase.
AB  - Soman simulator PDP is a compound that has a chemical structure identical to
      soman, except that the fluorine atom is replaced by a methyl group which makes
      PDP unable to bind covalently to the AChE active center. In rats, late mortality
      observed after treatment with high doses of soman could be prevented by PDP
      pretreatment. Such pretreatment has been much less efficient in primates. The
      effect of PDP in rats has been explained by blocking the deposition of soman in
      so-called soman depots in which soman is stored intact and subsequently released.
      In this paper we demonstrate that in the presence of PDP, inhibition of rat
      muscle AChE by soman is reduced in rat but not in human muscle homogenates. This
      result suggests that at least part of the beneficial effects of PDP pretreatment
      in rat might be due to the direct interaction of PDP with AChE resulting in
      reduced AChE phosphorylation by soman.

PMID- 8343984
TI  - Sheep brain pseudocholinesterase: inhibition kinetics of the partially purified
      enzyme by some substrate analogues.
AB  - Pseudocholinesterase (ChE) (acylcholineacylhydrolase, EC 3.1.1.8) has been
      partially purified (about 270-fold) from sheep brain. The procedure included
      ammonium sulfate fractionation (20-80%), DEAE-Trisacryl M chromatography and
      procainamide-Sepharose 4B affinity chromatography. The molecular weight of
      purified ChE was found to be 290,000 by gel filtration. Kinetic properties of the
      enzyme have been studied using the substrate analogues choline, succinylcholine
      and benzoylcholine. It was shown that the inhibition was partially competitive.

PMID- 8343985
TI  - Rapid potentiometric determination of cholinesterases in plasma and red cells:
      application to eptastigmine monitoring.
AB  - Eptastigmine (MF 201) is a new physostigmine derivative with potent inhibitory
      activity on cholinesterases. Here we present a new potentiometric cholinesterase
      activity assay suitable for MF 201 monitoring. The analysis is performed on a
      differential pH system and has the following characteristics: (a) within-run
      precision: C.V. 2.0% (plasma cholinesterase), 1.8% (red cell cholinesterase); (b)
      between-run precision: C.V. 4.0% (plasma cholinesterase); (c) linearity: 1-10
      kU/l (plasma cholinesterase), 6-70 U/g Hb (red cell cholinesterase); (d)
      comparison with a reference method (x, HITACHI 737 Boerhinger Mannheim, Italy): y
      = 0.785x - 0.07; n = 37; r = 0.998. The assay has been applied to the
      determination of plasma and red cell cholinesterase activity in volunteers over
      60 years of age treated with a single oral dose of 30 mg eptastigmine. We found
      that red cell cholinesterase is selectively inhibited after MF 201 administration
      with the following kinetics (time, % of inhibition, mean +/- S.E., n = 6): 0 h,
      0; 1 h, 17 +/- 4.6; 2 h, 24 +/- 4; 4 h, 23 +/- 4.4; 12 h, 14 +/- 3. Eptastigmine
      plasma levels were also determined by a HPLC method: maximum concentration was
      found one hour after drug administration.

PMID- 8343986
TI  - Cholinesterases as scavengers for organophosphorus compounds: protection of
      primate performance against soman toxicity.
AB  - The present treatment for poisoning by organophosphates consists of multiple
      drugs such as carbamates, antimuscarinics, and reactivators in pre- and post
      exposure modalities. Recently an anticonvulsant, diazapam, has been included as a
      post-exposure drug to reduce convulsions and increase survival. Most regimens are
      effective in preventing lethality from organophosphate exposure but do not
      prevent toxic effects and incapacitation observed in animals and likely to occur
      in humans. Use of enzymes such as cholinesterases as pretreatment drugs for
      sequestration of highly toxic organophosphate anticholinesterases and alleviation
      of side effects and performance decrements was successful in animals, including
      non-human primates. Pretreatment of rhesus monkeys with fetal bovine serum
      acetylcholinesterase protected them against lethal effects of soman (up to 5
      LD50) and prevented signs of OP toxicity. Monkeys pretreated with fetal bovine
      serum acetylcholinesterase were devoid of behavioral incapacitation after soman
      exposure, as measured by serial probe recognition or primate equilibrium platform
      performance tasks. Use of acetylcholinesterase as a single pretreatment drug
      provided greater protection against both lethal and behavioral effects of potent
      organophosphates than current multicomponent drug treatments that prevent neither
      signs of toxicity nor behavioral deficits. Although use of cholinesterases as
      single pretreatment drugs provided complete protection, its use for humans may be
      limited, since large quantities will be required, due to the approximately 1:1
      stoichiometry between organophosphate and enzyme. Bisquaternary oximes,
      particularly HI-6, have been shown to reactivate organophosphate-inhibited
      acetylcholinesterase at a rapid rate. We explored the possibility that enzyme
      could be continually reactivated in animals pretreated with fetal bovine serum
      acetylcholinesterase, followed by an appropriate dose of reactivator, and
      challenged with repeated doses of sarin. In in vitro experiments, stoichiometry
      greater than 1:400 for enzyme:sarin was achieved; in vivo stoichiometry in mice
      was 1:65. Pretreatment of mice with fetal bovine serum acetylcholinesterase and
      HI-6 amplified the effectiveness of exogenous enzyme as a scavenger for
      organophosphate.

PMID- 8343987
TI  - Role of carboxylesterases in the prevention and potentiation of N-methylcarbamate
      toxicity.
AB  - Pretreatment of rats with iso-OMPA one hour prior to each of the N
      methylcarbamate insecticides, carbofuran, propoxur, or aldicarb, potentiated the
      toxicity of these carbamates threefold. None of these compounds alone in the
      dosage used produced toxic signs; however, carboxylesterase (CarbE) activity in a
      variety of organs including brain, muscle, liver, and plasma was significantly
      reduced, while acetylcholinesterase (AChE) activity was unchanged. Significant
      inhibition of AChE was observed after the combination of
      tetraisopropylpyrophosphoramide (iso-OMPA) with each one of these N
      methylcarbamates. It is suggested that CarbEs are more sensitive than AChE to
      these N-methylcarbamates and inhibition of CarbE by iso-OMPA raises the
      concentration of N-methylcarbamates available to inhibit AChE resulting in
      increased toxicity. Other N-methylcarbamates such as physostigmine do not inhibit
      CarbE, nor are their toxicities potentiated by iso-OMPA.

PMID- 8343988
TI  - Diethylphosphorus metabolites in serum and urine of persons poisoned by
      phosalone.
AB  - The presence and elimination rate of phosalone and its diethylphosphorus
      metabolites in blood serum and urine were studied in persons who had ingested a
      concentrated phosalone solution. Phosalone was detected only in serum samples. As
      it was rapidly hydrolysed and eliminated from the body, its diethylphosphorus
      metabolites were a more sensitive indicator of exposure. The concentration
      decrease of phosalone in serum and of total diethylphosphorus metabolites in
      serum and urine followed the kinetics of a biphasic reaction. The faster
      elimination half-times in serum, calculated for two persons, were 2.3 and 3.4 h
      for phosalone and 3.4 and 38.6 h for total diethylphosphorus metabolites. In the
      faster phase the average elimination half-time of total urinary metabolites in
      five persons was 25 +/- 17 h. The kinetic data for total urinary metabolites in a
      person occupationally exposed to phosalone indicated an early and very fast
      elimination phase (elimination half-time 1.3 h), which was overlooked in poisoned
      persons. The proportions of single metabolites in total urinary metabolites in
      poisoned persons depended on whether the total amount of diethylphosphorus
      metabolites was above 1000 or below 1000 nmol/mg creatinine.
      Diethylphosphorodithioate predominated at high and diethylphosphate at low
      concentrations of total metabolites. The correlation between the maximum
      concentrations of total metabolites, measured in urine of poisoned persons on the
      day of admission to hospital or a day later, and the initial depression of serum
      cholinesterase (EC 3.1.1.8) and erythrocyte acetylcholinesterase (EC 3.1.1.7)
      activities was poor (r = 0.6).

PMID- 8343989
TI  - Interaction of imidazolium and pyridinium dioximes with human erythrocyte
      acetylcholinesterase.
AB  - Two pyridinium and two imidazolium dioximes were tested as reversible inhibitors
      of human erythrocyte acetylcholinesterase (AChE), as protectors of the enzyme
      against phosphorylation and as reactivators of the phosphorylated AChE. All four
      dioximes reversibly inhibited AChE, protected the enzyme against phosphorylation
      by soman and tabun and reactivated AChE after phosphorylation by sarin, VX and
      tabun. From the experimental results the enzyme/dioxime dissociation constants
      were evaluated for the catalytically active enzyme and for phosphorylated enzyme.
      The evaluation constants have shown that all four dioximes have about the same
      affinity for the catalytically active as for the phosphylated AChE. Obtained
      results also indicate that imidazolium dioximes probably bind only to the
      allosteric, while pyridinium dioximes bind to both, the catalytic and the
      allosteric site of the enzyme.

PMID- 8343990
TI  - Avian serum esterases: species and temporal variations and their possible
      consequences.
AB  - Avian serum esterases are predominantly of the 'B' type (cholinesterases and
      carboxylesterases) and are inhibited by carbamates and the 'active' oxon forms of
      organophosphorus pesticides. Selective inhibition of mammalian serum
      carboxylesterase, a 'B' esterase, has shown that this enzyme may play an
      important role in detoxication by irreversibly binding, and thus inactivating,
      anticholinesterase compounds. Studies have shown differences between carnivorous
      and omnivorous/herbivorous avian species in the level of activity and range of
      forms of carboxylesterases and cholinesterases in sera. In addition, these
      enzymes show seasonal, diurnal and developmental variations in activity. This
      paper will discuss species and temporal variations in avian serum 'B' esterases
      in relation to their possible influence on pesticide toxicity.

PMID- 8343991
TI  - Symposium introduction: retrospect and prospects for neuropathy target esterase
      (NTE) and the delayed polyneuropathy (OPIDP) induced by some organophosphorus
      esters.
AB  - This article introduces a Symposium devoted to Neuropathy Target Esterase (NTE).
      The characteristics of the disorder known as OPIDP are described and the steps by
      which NTE was identified as the target are summarised. Studies with many
      organophosphates, phosphinates and chiral phosphonates are entirely consistent
      with a 2-step process of initiation referred to as 'NTE (70-80%) aging': about 70
      80% of available nervous system NTE is first covalently phosphylated causing
      inhibition of esterase activity, and then the molecules of inhibited NTE undergo
      a covalent bond-cleavage leaving a negative charge in the region of the still
      bound phosphorus. This understanding has clarified structure/activity studies of
      neuropathic potential of OP esters and is now routinely applied in toxicological
      evaluations for regulatory purposes. However, the biological function of NTE has
      remained a mystery. Prospective views of the role of NTE are presented by
      different authors. Attempts to isolate catalytically active or radiolabelled
      inhibited NTE are near to success. Since the Symposium, complete isolation of NTE
      affinity-purified from hen brain has been reported (see M.K. Johnson & P. Glynn,
      Toxicologist, 13 (1993) 211, Abstr. 773). Some minor, but possibly significant,
      differences in properties of a soluble and a membrane-bound form of NTE in
      sciatic nerve has been identified. The nature of the disturbance brought about by
      covalent binding of organophosphoramidates at the active site of NTE and the
      discovery that 'non-aging' inhibitors of NTE can promote neuropathy in hens given
      a sub-neuropathic dose of neuropathic OPs has led to a concept of NTE inhibitors
      having a range of 'partial agonist' effects at the covalent binding site.
      Evidence is emerging that the promotion target may be 'cousin-of NTE' with very
      similar inhibition characteristics and a function in the processes of response to
      or repair of axonal damage.

PMID- 8343993
TI  - Molecular characterisation of neuropathy target esterase: proteolysis of the
      [3H]DFP-labelled polypeptide.
AB  - Neuropathy target esterase (NTE) in hen brain membranes can be labelled with
      tritiated di-isopropylfluorophosphate ([3H]DFP) and appears to be associated with
      a 155-kDa polypeptide. Using preparative SDS-PAGE, we have obtained preparations
      in which [3H]DFP-labelled NTE comprises 2% of the total protein. Further
      purification of the 155-kDa polypeptide has proved difficult. We therefore
      attempted to use proteases to excise smaller [3H]DFP-labelled fragments which
      might be more amenable to fractionation. V8 protease treatment generated a
      labelled fragment of about 16 kDa which could be fractionated on SDS-PAGE and
      contained tritium attached to both site X (putatively the active site serine) and
      site Z (the residue to which an isopropyl moiety is transferred during aging of
      [3H]DFP-inhibited NTE). Papain and thermolysin treatments generated a small
      labelled peptide (< 10 kDa) which could be fractionated on reverse-phase HPLC and
      in which tritium was attached to site X but not site Z. N-terminal sequencing of
      the thermolysin-generated peptide fraction indicated sample heterogeneity but
      also suggested that the active site of NTE may contain the serine esterase
      consensus sequence: Gly-Glu-Ser-Xxx-Gly.

PMID- 8343992
TI  - Affinity chromatography of neuropathy target esterase.
AB  - Neuropathy target esterase (NTE) is a membrane-bound protein which has been
      proposed as the target site in nerve tissue for initiation of organophosphate
      induced delayed neuropathy (OPIDN). Efforts to characterize NTE and to determine
      the mechanism of its involvement in OPIDN have been hampered by the lack of a
      suitable method for its purification. We describe here the development of a
      trifluoromethyl ketone liganded affinity gel which selectively binds NTE. Triton
      X-100/NaCl extracts of NTE from chick embryo brain microsomal membranes were
      adsorbed to an affinity gel prepared by attachment of 3(9'-mercaptononylthio)
      1,1,1-trifluoropropan-2-one to epoxy-activated Sepharose CL4B (MNTFP-Sepharose).
      Typically 70-80% of NTE activity is bound under conditions in which undetectable
      quantities of total protein bound (< 4%). It proved difficult to elute active NTE
      under non-denaturing conditions, but SDS-PAGE analysis of MNTFP-Sepharose bound
      proteins eluted with 2% SDS identified a 155 kDa NTE-like protein that bound in a
      trifluoromethylketone- or mipafox-sensitive but paraoxon-insensitive manner. The
      levels of inhibition of binding correlated with the inhibition of activity and
      suggested that the 155-kDa band was composed of a single protein. MNTFP-Sepharose
      affinity chromatography in combination with preparative SDS-PAGE therefore holds
      promise as a method for obtaining microgram quantities of NTE for chemical
      analysis and sequencing.

PMID- 8343994
TI  - Biochemical properties and possible toxicological significance of various forms
      of NTE.
AB  - NTE (neuropathy target esterase) is considered to be the target for
      organophosphorus-induced delayed polyneuropathy and is operationally measured by
      radiolabelling or by determining its esteratic activity as the paraoxon-resistant
      mipafox-sensitive phosphorylable site(s). From electrophoresis and density
      gradient centrifugation using radiolabelling techniques, several phosphorylable
      sites have been described in hen brain that are paraoxon-resistant mipafox
      sensitive; however, only the majority electrophoresis band (155 kDa) shows
      properties related with the aging reaction. Kinetic criteria have also suggested
      two components of brain NTE (NTEA and NTEB). Most brain NTE is recovered in the
      particulate microsomal fraction and only about 1% in soluble fraction. In sciatic
      nerve about 50%/50% activity is recovered as soluble (S-NTE) or particulate (P
      NTE) forms. A similar distribution were observed in hen, cat, rat and young
      chick. The fixed time inhibition curves show that P-NTE is more sensitive to
      mipafox, DFP and hexyl-DCP than S-NTE, while the reverse is true for
      methamidophos. P-NTE fits properly to one sensitive component while S-NTE fits
      better to two sensitive component models, except in the case of methamidophos. In
      vivo, significant differences in the inhibition of P- and S-NTE by mipafox were
      found only when using low non-neuropathic dosing. The possible significance of
      different NTE forms are discussed.

PMID- 8343995
TI  - The cytoskeleton as a target for organophosphorus ester-induced delayed
      neurotoxicity (OPIDN).
AB  - Although the immediate action of organophosphorus esters is the inhibition of
      acetylcholinesterase, some of these compounds also produce a neurodegenerative
      disorder known as organophosphorus ester-induced delayed neurotoxicity (OPIDN).
      Tri-o-cresyl phosphate (TOCP) first produced this condition in humans and later
      in sensitive animal species. OPIDN is characterized by a delay period prior to
      onset of ataxia and paralysis. The neuropathologic lesions are Wallerian-type
      degeneration of the axon and myelin in the distal parts of the large tracts in
      both the central and peripheral nervous systems. In the past decade we have
      demonstrated that the pathognomonic features of OPIDN are an aberrant increase in
      autophosphorylation of calcium/calmodulin kinase II (CaM kinase II) and an
      increase in phosphorylation of cytoskeletal proteins, i.e., MAPs, tubulin,
      neurofilament triplet proteins, and myelin basic protein. Protein kinase-mediated
      phosphorylation of cytoskeletal proteins plays a critical role in regulating the
      growth and maintenance of the axon. We hypothesize that, in OPIDN,
      hyperphosphorylation of cytoskeletal proteins and axonal swelling are causally
      linked. Hyperphosphorylation of cytoskeletal proteins decreases their transport
      rate down the axon relative to their rate of entry into the axon, thus leading to
      their accumulation. Consistent with this hypothesis is our finding of the
      anomalous accumulation of phosphorylated neurofilament aggregates in the central
      and peripheral axons of hens treated with TOCP.

PMID- 8343996
TI  - The role of neurotoxic esterase (NTE) in the prevention and potentiation of
      organophosphorus-induced delayed neurotoxicity (OPIDN).
AB  - The first step in the initiation of organophosphorus-induced delayed neuropathy
      (OPIDN) is proposed to be the phosphorylation of an enzyme found in the nervous
      system called neurotoxic esterase (neuropathy target esterase, NTE). It has been
      known for over twenty years that non-neuropathic inhibitors of NTE exist and can
      actually prevent OPIDN when given before a neuropathic organophosphate (OP).
      Within the last three years it has become evident that another outcome is
      possible following in vivo interaction between neuropathic and nonneuropathic NTE
      inhibitors. When administered after OP exposure, nonneuropathic inhibitors can
      intensify or potentiate signs of OPIDN in adult chickens. Additionally, whereas
      developing chickens are typically resistant to the effects of neuropathic OPs,
      resistant age groups will develop OPIDN when exposure to a neuropathic OP is
      followed by the non-neuropathic NTE inhibitor phenylmethylsulfonyl fluoride. As
      in the case of prevention, studies of the potentiation of OPIDN may yield insight
      into mechanisms involved in the pathogenesis of delayed neurotoxicity. A brief
      review of current knowledge regarding the role of NTE in both the prevention and
      potentiation of OPIDN is presented.

PMID- 8343997
TI  - Properties of partly preinhibited hen brain neuropathy target esterase.
AB  - NTE inhibitors cause different toxicological consequences (protection, induction
      or potentiation/promotion of neuropathy) depending on the order of dosing. These
      effects might be explained in terms of several phosphorylable sites with
      'allosteric irreversible' behaviour. Brain neuropathy target esterase (NTE) has
      been preinhibited with phenylmethylsulphonyl fluoride (PMSF) (0, 5, 10, 15, 30
      and 60 microM) or with diisopropylphoshoro fluoridate (DFP) (0, 0.2, 0.5, and 1
      microM) at 37 degrees C for 30 min. After washing by centrifugation, tissues were
      then reinhibited with a range of PMSF (0 to 80 microM) or DFP (0 to 1 microM)
      concentrations. The slopes of the inhibition curves (log % activity vs.
      concentration) of pretreated tissues were identical to those of the non
      pretreated tissues, with non-distinguishable I50 values. It is concluded that
      allosteric effects are not likely to be involved in membrane-bound NTE of hen
      brain.

PMID- 8343998
TI  - Reactivation of phosphorodiamidated acetylcholinesterase and neuropathy target
      esterase by treatment of inhibited enzyme with potassium fluoride.
AB  - It has been thought that the phosphorus-enzyme bond in inhibited esterases
      inhibited by such agents as mipafox (N,N'-di-iso-propylphosphorodiamidate) was
      refractory to reactivating agents either because an 'aging' reaction occurs soon
      after inhibition or because the bond was intrinsically very strong. We have found
      that both acetylcholinesterase (AChE) and neuropathy target esterase (NTE) which
      had been inhibited with either mipafox or with a di-n-butylphosphorodiamidate
      could be reactivated by prolonged treatment with aqueous potassium fluoride (KF):
      the reaction proceeded with first-order kinetics. Furthermore there was no time
      dependent loss of reactivatability (aging). Di-isopropylphosphoro
      butyrylcholinesterase could be fully reactivated by this treatment but after 18 h
      to allow aging the monoisopropyl phosphoro-enzyme was totally refractory to KF.
      We conclude that it is likely that the mipafox-enzyme bond in inhibited NTE and
      AChE is relatively strong but that aging has not occurred. The local disturbance
      around the active site of NTE caused by attachment of the phosphorodiamidate
      molecule appears to be sufficient to initiate delayed neuropathy without
      necessity for an 'aging' reaction.

PMID- 8343999
TI  - Relationship of neuropathy target esterase inhibition to neuropathology and
      ataxia in hens given organophosphorus esters.
AB  - Adult White Leghorn hens were acutely exposed to 3 dosages of the following
      organophosphorus compounds: mipafox, tri-ortho-tolyl phosphate (TOTP), phenyl
      saligenin phosphate, and diisopropylphosphorofluoridate (DFP). Neuropathy target
      esterase (NTE) activity was measured in brain and spinal cord 4 or 48 h after
      exposure. Ataxia was assessed using an 8-point rating scale on days 9 through 21
      after administration, and neuropathological examination was conducted on samples
      collected from perfusion-fixed animals on day 21. Morphological alterations were
      indicated by lesion scores between 0 (no lesions) and 4 (diffuse involvement of
      spinal cord tracts and > 25% degeneration of peripheral nerve fibers). Dosages of
      mipafox (30 mg/kg i.p.), TOTP (500 mg/kg p.o.), phenyl saligenin phosphate (2.5
      mg/kg i.m.) and DFP (1 mg/kg s.c.) that were capable of inhibiting NTE > 80% in
      both brain and spinal cord preceded ataxia which reached maximal levels (scores
      of 7-8), and development of lesions scored as 4. Hens were notably impaired
      (ataxia scores of 3-4) 21 days after administration of dosages of mipafox (3 and
      6 mg/kg), TOTP (90 mg/kg), phenyl saligenin phosphate (0.1 and 0.2 mg/kg), and
      DFP (0.4 mg/kg) when spinal cord NTE was inhibited 40-75%. Lesions were, however,
      only noted in spinal cord and peripheral nerves of hens given TOTP or DFP (scores
      1-3). These data indicate that inhibition of spinal cord NTE > 80% was predictive
      of severe ataxia and extensive pathology in the hen and that less NTE inhibition
      was indicative of less severe ataxia and a lower score for neuropathological
      damage.

PMID- 8344000
TI  - Screening of O-ethyl O-4-nitrophenyl phosphoramidate (ENPP) for delayed
      neuropathic potential.
AB  - O-Ethyl-O-4-nitrophenylphosphoramidate is a short-acting anticholinesterase and a
      possible candidate for a prophylactic agent against nerve agents since human
      acetylcholinesterase inhibited by this agent undergoes rapid spontaneous
      reactivation which can be accelerated further, if necessary, by treatment with
      oximes. Doses of the agent > 1 mg/kg (s.c.) given to unprotected rats were fatal
      in a short time but 2 rats and one hen given 0.5 mg/kg survived. Hens given 2.5
      or 4 mg/kg s.c. 20 min after prophylactic physostigmine + atropine survived acute
      effects and were killed 4.5 or 24 h later. Brain and spinal cord neuropathy
      target esterase levels of these hens were depressed only 4-10% compared with
      levels in brains from hens given only oxime + atropine or of undosed animals.
      Clinical signs of neuropathy were not seen in surviving birds observed for 3
      weeks. It appears there would be negligible delayed neuropathic hazard associated
      with administration of O-ethyl-O-4-nitrophenylphosphoramidate at subacute doses.

PMID- 8344001
TI  - The R-(+)isomer of O-n-hexyl S-methyl phosphorothioamidate causes delayed
      neuropathy in hens after generation of a form of inhibited neuropathy target
      esterase (NTE) which can be reactivated ex vivo.
AB  - To initiate delayed neuropathy (DN) in adult hens organophosphates and
      phosphonates must inhibit most neural NTE and the inhibited NTE must undergo an
      'aging' reaction. Phosphinates and those chiral isomers of phosphonates which
      produce non-aging NTE do not cause DN but act as prophylactic agents. Some
      racemic phosphoramidates cause DN although the inhibited NTE in autopsy samples
      can be reactivated in vitro (Johnson, Read and Vilanova, 1991, Arch. Toxicol.,
      65, 618-624). We now report that pure R(+)isomer of O-n-hexyl S-methyl
      phosphorothioamidate (5-20 mg/kg per os) caused slight acute effects but typical
      DN associated with high inhibition of NTE in brain, spinal cord and sciatic nerve
      (maximum by 6-24 h): the inhibited NTE was easily reactivated by KF (presumed not
      aged). For each dose the average residual NTE activity in the three tissues 24 h
      after dosing and the clinical ataxia severity on peak days 15-17 (score out of 4)
      was: 5 mg/kg: 13, 14, 27% (2,2,2,1); 10 mg/kg: 10, 14, 12%, (4,3,2); 15 mg/kg:
      10,11,17%, (3,3,4); 20 mg/kg: 6, 10, 8% (3,3,3,2). The ability of this isomer and
      of other racemic phosphoramidates to initiate DN by covalent reaction at the
      active site of NTE (inhibition) without subsequent aging suggests that the
      chemistry (? charge distribution) in the region of the phosphorus atom determines
      that disturbance in the molecular environment of NTE which initiates DN.

PMID- 8344002
TI  - Prophylaxis against and promotion of organophosphate-induced delayed neuropathy
      by phenyl di-n-pentylphosphinate.
AB  - Phenyl di-n-pentylphosphinate (PPP) is a potent inhibitor of neuropathy target
      esterase (NTE) with negligible effect on acetylcholinesterase: I50S at 37 degrees
      C for 20 min and pH 8, respectively are 0.2 microM and > 2mM. PPP is not
      neuropathic. This is compatible with the fact that inhibited NTE is autopsy
      material from hens dosed with PPP can always be reactivated in vitro, presumably
      because no 'aging' reaction has occurred. PPP (10 mg/kg s.c.) given to hens up to
      4 days before severely neuropathic doses (1.7 mg/kg) of
      diisopropylphosphorofluoridate (DFP) prevented neuropathic but not cholinergic
      effects of DFP. Hens given PPP 3 days after a sub-neuropathic dose of DFP (0.4
      mg/kg) developed severe clinical neuropathy (clinical scores of 7 and 5 compared
      with DFP-plus-solvent scores 0,1,3). These prophylactic and promoting effects are
      similar to those exerted by phenylmethanesulphonyl fluoride (PMSF) at doses which
      inhibit NTE. In 3 out of 4 birds a pre-dose with PMSF (15 mg/kg) prevented the
      promoting effect of 120 mg/kg PMSF given after DFP.

PMID- 8344003
TI  - Phenylmethanesulfonyl fluoride delays the recovery from crush of peripheral
      nerves in hens.
AB  - Several esterase inhibitors (carbamates, phosphinates and sulfonyl halides) have
      been shown to promote organophosphate-induced delayed polyneuropathy (OPIDP). The
      mechanism of promotion is not understood, but indirect evidence suggests
      impairments of peripheral nerve repair. Also, other toxic neuropathies, such as
      those caused by 2,5-hexanedione in hens and bromophenylacetylurea in rats, have
      been reported to be promoted by phenylmethanesulfonyl fluoride (PMSF). Hen
      sciatic nerve was crushed at the bifurcation. Either mild or heavy pressure was
      applied by forceps obtaining a mild and rapidly recovering lesion (possibly
      myelinic) or a more severe, long-lasting lesion (possibly axonal), respectively.
      Hens were then treated with PMSF (120 mg/kg s.c. or 200 mg/kg s.c. x 2, 24 h
      apart) either before (5-48 h) crush or afterwards (5-48 h). Controls received
      vehicle only. Animals were observed for reappearance of digit movements, and
      standing and walking ability. PMSF treatment did not change the clinical outcome
      when animals received a mild crush. In hens receiving the more severe crush the
      reappearance of digit movements and the complete clinical recovery were observed
      after 43 +/- 14 and 63 +/- 9 days, respectively. In animals treated with PMSF
      there was a significant delay in both reappearance of digit movements (56 +/- 11
      days when PMSF was given 24 and 48 h before crush, and 55 +/- 10 days, when given
      24 and 48 h after crush) and in clinical recovery (75 +/- 15 and 80 +/- 18 days,
      respectively). It is concluded that traumatic axonopathy as well as toxic
      neuropathies can be promoted by PMSF. Moreover, it appears that PMSF promotion
      involves a target and a mechanism which are present in healthy axons and do not
      need to be activated by the insult to the axon.

PMID- 8344004
TI  - Postscript to the symposium on organophosphorus compound induced delayed
      neuropathy.
AB  - A short review is presented on the key points in the development of the
      hypothesis for the initiation of delayed neuropathy by reaction of
      organophosphorus compounds with neuropathy target esterase (NTE). It is now clear
      from information derived from experiments showing protection and promotion and
      from the action of some phosphorothioamidates (which cause delayed neuropathy
      without aging) that the original NTE hypothesis is not generally applicable and
      requires modification. A suggestion is made that aging of phosphorylated and
      phosphonylated NTE is facilitated perhaps by two linked esterases, one being NTE.

PMID- 8344005
TI  - The esterases: perspectives and problems.
AB  - Many proteins capable of hydrolysing esters are present in biological material of
      all kinds (microorganisms, plants, invertebrates and vertebrates). Some serve, as
      indicated by their substrate specificity and distribution within organisms, a
      defined biological function. However for most esterases a rather general
      substrate specificity is found indicating that they may have a broad biological
      function. Their properties will be briefly reviewed with particular emphasis on
      inhibitors. The mechanism of hydrolysis of esters by many carboxylesterases (B
      esterases) is well established largely due to the reaction of OP compounds with
      their catalytic centre. For others, such as enzymes hydrolysing (i) OP compounds
      and/or (ii) carboxyl esters which are not inhibited by a time and temperature
      dependent reaction by OP compounds, reaction mechanisms are still conjecture. The
      purpose of this presentation is to explore similarities and differences between
      the esterases and to discuss possible routes for progress in the A-esterase
      group.

PMID- 8344006
TI  - Catalytic antibodies hydrolysing organophosphorus esters.
AB  - Transition state stabilization is considered one means by which enzymes reduce
      free energy of activation. The transition state of phosphonic acid anhydrides
      acted on by OPA hydrolase is postulated to be pentacoordinate, which ordains
      either a square pyramid or a trigonal bipyramid structure. The advent of
      catalytic monoclonal antibodies has provided a system in which these assumptions
      can be tested. By immunizing mice with the protein conjugate of a trigonal
      bipyramid transition state analog, we have produced hybridomas secreting
      monoclonal antibodies which hydrolyze phosphonates. To date, activity has been
      shown toward pinacolyl methylphosphonofluoridic acid (soman). Preliminary results
      suggest that the antibody is an IgG2a with kappa light chain character. Our
      results support the trigonal bipyramidal transition state for this group of
      enzymes.

PMID- 8344007
TI  - Paraganglioma of the cauda equina: a case report and review of the literature.
AB  - This case report describes a paraganglioma of the cauda equina in a 57-year-old
      man. The clinical and pathological features of the 70 cases reported to date are
      reviewed. The importance of total surgical removal is stressed.

PMID- 8344008
TI  - Delay in diagnosis of X-linked adrenoleukodystrophy.
AB  - In 16 consecutive patients with clinically suspected and biochemically proven X
      linked adrenoleukodystrophy (X-ALD), total delay (interval between onset of
      symptoms and diagnosis) and specialist delay (interval between referral to a
      specialist and diagnosis) were determined. All patients previously were unaware
      of the existence of X-ALD in their families. From the time of onset of symptoms
      attributable to this disease until diagnosis, mean total delay was 9.9 (range 1
      33) years and mean specialist delay was 8.4 (range 0-33) years. Three patients
      who presented with adrenocortical insufficiency had mean total and specialist
      delays of 17.3 (range 9-33) years. Five patients with an initial diagnosis of
      multiple sclerosis had mean total and specialist delays of 12.8 (range 5-25) and
      11.2 (range 1-23) years, respectively. In 12 patients with adrenomyeloneuropathy-
      the second most frequent phenotype of X-ALD--mean total delay was 11.0 (range 2
      33) years and mean specialist delay 9.1 (range 0-33) years. Since 1981 X-ALD can
      be reliably diagnosed on the basis of elevated levels of very long chain fatty
      acids in plasma and/or cultured fibroblasts. The delays therefore must have been
      due to the unfamiliarity with the clinical manifestations and diagnostic
      possibilities of this disease. Once X-ALD is diagnosed, dietary treatment and/or
      bone marrow transplantation may be considered. Genetic counseling should be
      performed, and screening of other family members is essential for the early
      identification of affected relatives.

PMID- 8344009
TI  - Somatosensory evoked potentials after iohexol myelography.
AB  - Tibial nerve and S1 dermatome somatosensory evoked potentials (SSEPs) were
      recorded before and after iohexol lumbar myelography in order to evaluate
      possible neurotoxic effects of this contrast medium. No significant change in
      SSEP latencies nor amplitudes was noted after iohexol myelography, supporting the
      low neurotoxic profile of this contrast agent. Results were compared to those of
      a control group of patients before and after lumbar puncture (LP), without
      injection of contrast agent. In this group also no significant change in SSEP
      components was found, indicating that a preceding LP does not affect this
      electrophysiological examination.

PMID- 8344010
TI  - Hereditary spastic paraparesis. Clinical and genetic data from a large Dutch
      family.
AB  - A large Dutch family is presented with pure hereditary spastic paraparesis.
      Pedigree analysis indicates autosomal dominant inheritance with complete
      penetrance and possibly anticipation in successive generations. These
      observations may have implications for genetic studies. Linkage studies in this
      family have excluded more than 40% of the autosomal genome.

PMID- 8344011
TI  - Amnesic syndrome caused by neurosarcoidosis.
AB  - A 20-year-old woman presented with subacute amnesia, which turned out to have
      been caused by neurosarcoidosis. The patient showed several remarkable features:
      isolated bilateral temporal hydrocephalus, caused by ventriculitis/arachnoiditis;
      spinal arachnoiditis as demonstrated by myelography, which was not noticed on MR
      scan. Diagnostic difficulties that are sometimes encountered when
      neurosarcoidosis is suspected (particularly the differentiation from
      neurotuberculosis if insufficient evidence of systemic sarcoidosis is found) are
      discussed.

PMID- 8344012
TI  - Coexistence of Parkinson's disease and myasthenia gravis: a case report.
AB  - This is a report on a 62-year-old Chinese woman with Parkinson's disease (PD) for
      8 years who developed myasthenia gravis (MG) in the last year. In this case,
      there was no adverse effect of trihexyphenidyl on MG, whereas pyridostigmine
      worsened the PD.

PMID- 8344013
TI  - Hemiparkinsonism in a patient with primary Sjogren's syndrome. A case report and
      a review of the literature.
AB  - A 55-year-old woman presented with hemiparkinsonism on the left side. Clinical
      features suggested primary Sjogren's syndrome. Eye tests and a salivary gland
      biopsy confirmed this diagnosis. Magnetic resonance imaging of the brain showed
      distinct linear lesions of increased intensity on the T2-weighted images in the
      right striatum and globus pallidum. Treatment with prednisone and azathioprine
      did not give any improvement of the neurological symptoms. To date,
      hemiparkinsonism in association with primary Sjogren's syndrome has not been
      reported.

PMID- 8344014
TI  - Central nervous system lymphoma presenting with ataxic hemiparesis: a case
      report.
AB  - An 81-year-old man with central nervous system (CNS) lymphoma presenting with
      acute, progressive ataxic hemiparesis. Computed tomography and magnetic resonance
      imaging localized the lesion extending from the right internal capsule to the
      ventrolateral aspect of rostral midbrain tegmentum. A stereotactical biopsy
      yielded a microscopic diagnosis of medium-sized diffuse B-cell lymphoma. Although
      the most frequent cause of the syndrome of ataxic hemiparesis is a lacunar type
      of cerebral infarction, this article emphasizes that CNS lymphoma can produce the
      syndrome.

PMID- 8344015
TI  - Hydrocephalus due to bilateral obstruction of the foramen of Monro: a 'possible'
      late complication of mumps encephalitis.

PMID- 8344016
TI  - Calcification of basal ganglia associated with pontine calcification in four
      cases: a radiologic and genetic study.
AB  - We describe 4 brothers with calcification of basal ganglia, pons and dentate
      nuclei. An abnormal iron metabolism was found in one case. The radiological,
      pathogenetic and genetic aspects of this disease are discussed.

PMID- 8344017
TI  - A case of pontine lacunar infarction with ulcerative colitis.
AB  - We present the case of a young man who experienced a sudden onset of pure motor
      hemiplegia in association with ulcerative colitis. Based on a review of earlier
      reports, ulcerative colitis was suspected to be the background disease leading to
      cerebral infarction. A cerebral infarction of the lacunar type in the right
      ventromedial aspect of the upper pons was seen on magnetic resonance images.
      These images detected small lesions in the brain stem, and were used to follow-up
      their transitions.

PMID- 8344018
TI  - Reliability of the diagnosis of a first seizure.

PMID- 8344019
TI  - Neuro-imaging in the diagnosis of Alzheimer's disease. II. Positron and single
      photon emission tomography.

PMID- 8344020
TI  - Hereditary motor and sensory neuropathies. Present status of types I, II and III.

PMID- 8344021
TI  - The role of thallium scintigraphy in excluding malignancy in bone.
AB  - Scintigraphy with thallium-201 was performed on 22 patients in whom a solitary
      abnormality in bone was suspected of being malignant. In three patients, an
      additional lesion was subsequently identified. Preferential TI-201 uptake was
      found in 7 of 8 malignant lesions, but was absent in 16 of 17 abnormalities that
      proved to be benign. The use of TI-201 scanning is considered to offer high
      negative predictive value in the assessment of possible malignant change in bone.

PMID- 8344022
TI  - Infarctions of the ilia in young patients with sickle hemoglobinopathies.
AB  - Infarctions of the long bones in sickle cell anemia and some of its variant
      hemoglobinopathies are well known. Photopenia representing areas of acute
      infarctions of the ilia in two young children are presented as unusual
      presentations of bone ischemia.

PMID- 8344023
TI  - Parathyroid adenoma demonstrated with TI-201 SPECT.
AB  - A case of parathyroid adenoma with suppressed Tc-99m pertechnetate uptake of the
      thyroid due to L-thyroxine replacement therapy for hypothyroidism is reported.
      This case demonstrates successful localization of a parathyroid adenoma in the
      retrothyroid space using TI-201 SPECT. When the thyroid uptake of Tc-99m
      pertechnetate is reduced for whatever reason, a planar TI-201 followed by SPECT
      may be more helpful than TI-201/Tc-99m subtraction scintigraphy.

PMID- 8344024
TI  - DEXA bone densitometry measurements in adults with X-linked hypophosphatemia.
AB  - Bone mineral densities in adults with X-linked hypophosphatemia are variable, and
      while most are reportedly normal some can be very high. Eighteen patients with
      adult X-linked hypophosphatemia underwent bone mineral determinations of the
      lumbar spine and femoral neck with dual energy x-ray absorptiometry (DEXA). Most
      of them were on various treatment regimens. Ten of 18 patients (55%) had spinal
      bone mineral densities that were greater than two standard deviations above the
      age-matched mean, and 3 of 11 patients (27%) had bone mineral densities of the
      femoral neck in excess of two standard deviations. Eight patients (median age
      41.5 years) were followed serially for 24 to 42 months, and they exhibited a
      spinal bone loss of 0.019 gm/cm2/year.

PMID- 8344025
TI  - Bone scan appearances of a metastasizing aggressive osteoblastoma. A case report.

PMID- 8344026
TI  - Detection of focal inflammation with Tc-99m HMPAO labeled leukocytes in children.
AB  - To evaluate the applicability of Tc-99m HMPAO leukocyte scintigraphy in the
      assessment of focal infections in children, we retrospectively analyzed 26
      studies performed between 1988 and 1992. All patients (n = 25, age range 1 month
      15 years) were severely ill and suspected to have invasive bacterial infection.
      In each case, whole body scintigraphy was performed 2-4 hours after injection of
      autologous labeled leukocytes. There were 8 true positive and 14 true negative
      cases; specificity was 88% and sensitivity 80%. The two false negative findings
      were observed in patients on immunosuppressive therapy; both had fungal
      infections. In one case, atypical non-specific bowel accumulation of the tracer
      was falsely interpreted as an abscess. The other false positive finding was hip
      accumulation in a patient who later turned out to have Mucha-Haberman disease;
      transient synovitis may explain the finding. Of the eight true positive cases,
      six had an invasive infection focus and two had an aseptic inflammatory process.
      Tc-99m HMPAO leukocyte scintigraphy is a valuable method in the assessment of
      focal inflammation in children, including infants.

PMID- 8344027
TI  - Normal brain F-18 FDG-PET and MRI anatomy.
AB  - Image registration techniques will become increasingly important in correlative
      multimodality imaging. In the case of PET, a structural imaging study can be
      invaluable in correlating structure metabolism relationships. A registered brain
      atlas of PET and MRI has been developed by the authors that allows clinicians,
      residents, fellows, and others to refer to a structural abnormality on MRI or
      metabolic abnormality on PET and correlate it neuro-anatomically.

PMID- 8344028
TI  - The attenuation effect in brain SPECT.
AB  - False perfusion defects simulating Alzheimer's disease can be attributed to skull
      thickness and head holders of a SPECT scan table. Brain phantom SPECT was
      performed using a different type of head holder in order to evaluate the effect
      of attenuation due to head holders and skull thickness on brain SPECT. Skull
      thickness was measured in 10 normal or non-Alzheimer's patients and 10 patients
      with suspected Alzheimer's disease. Visual and quantitative analysis of regional
      perfusion showed a 19% count loss due to attenuation by commercially available
      head holders and average skull thickness, less than 18% count difference between
      frontal-temporal and parietal-occipital skull in non-Alzheimer's disease
      patients, and more than 22% count difference observed in suspected Alzheimer's
      patients.

PMID- 8344029
TI  - Planar and SPECT imaging with technetium-99m labeled antigranulocyte antibodies
      in bone and soft tissue infection.
AB  - Scintigraphy with technetium-99m labeled antigranulocyte antibodies including
      planar and SPECT imaging demonstrated areas of inflammation in bone and soft
      tissue of the thigh of a 38-year-old man who had a fracture of the femur 20 years
      earlier. The clinical potential of this imaging modality in the diagnostic
      assessment of inflammatory diseases is discussed.

PMID- 8344030
TI  - Grossly abnormal liver-spleen scan in a patient with veno-occlusive disease of
      the liver that normalized completely on follow-up.
AB  - A case of veno-occlusive disease of the liver of unknown etiology is reported. In
      the case, the gross abnormality of liver parenchyma, ascites, and colloid shift
      to spleen, bones, and lungs found on a Tc-99m SC liver-spleen scan, and confirmed
      on liver biopsy, resolved completely on follow-up. Histologic correlation and a
      brief review of the literature are presented.

PMID- 8344031
TI  - Fibrosing mediastinitis causing nonvisualization of one lung on pulmonary
      scintigraphy.
AB  - An interesting case of fibrosing mediastinitis, which is a rare cause of total
      nonvisualization of one lung on pulmonary scintigraphy, is presented.
      Scintigraphy with Tc-99m MAA showed a severe deficit of perfusion in the right
      lung, with normal perfusion of the left lung. Ventilation images were normal. CT
      and MRI each demonstrated the mediastinal nodal enlargement and MRI demonstrated
      the "flow void" signal phenomenon in the right pulmonary artery indicating its
      patency. Confirmation of actual patency without pulmonary artery emboli and with
      poor venous opacification was documented with angiography. Multiple complementary
      imaging modalities were helpful in correctly diagnosing fibrosing mediastinitis
      from an extensive list of differential possibilities for unilateral non
      visualization of the lung on perfusion scanning.

PMID- 8344032
TI  - Thyroid scintigraphy during antithyroid treatment for autonomous nodules as a
      means of imaging extranodular tissue.
AB  - The scintigraphic appearance of the thyroid gland after a course of methimazole
      treatment was studied in 22 patients with autonomous hot nodules. After 2-3
      months of treatment the extranodular tissue was reactivated in almost every
      patient. This treatment constitutes an endogenous TSH stimulation test and may be
      used clinically in selected cases.

PMID- 8344034
TI  - Stage II reflex sympathetic dystrophy syndrome with unexpected bone changes due
      to the use of walking crutches.

PMID- 8344033
TI  - Antibiotic associated colitis. A cause of absent marrow activity on In-111
      leukocyte imaging.

PMID- 8344035
TI  - Differential excretion of a transplanted kidney with dual vascular supply.

PMID- 8344036
TI  - Bilateral photon deficient area along lateral abdominal wall in a Tc-99m DTPA
      renogram. A sign of massive ascites.
AB  - A patient with congestive heart failure and hepatic and renal dysfunction
      underwent Tc-99m DTPA renal scintigraphic studies in which persistent cardiac
      blood pool activity, hepatic arterialization, and a longitudinal photon deficient
      area in each side of the abdominal wall were observed. The increase in hepatic
      artery inflow was believed to be due to a decrease in portal inflow of the liver.
      The elevation of portal pressure secondary to heart failure is attributable to
      the decrease in portal inflow of the liver; this phenomenon could account for the
      hepatic arterialization. Progressive renal dysfunction with high body background
      resulted in demonstrable ascites as photon deficient areas. Scintigraphic
      findings of hepatic arterialization plus an abdominal photon deficient area
      reflect severe heart failure and renal dysfunction.

PMID- 8344038
TI  - Psoas abscess demonstrated with SPECT and CT.

PMID- 8344037
TI  - Acute lobar nephronia secondary to infection with nocardia asteroides.

PMID- 8344039
TI  - Tc-99m HMDP accumulation in an alveolar soft part sarcoma.

PMID- 8344040
TI  - Three-dimensional surface display with I-123 IMP in amyotrophic lateral
      sclerosis.

PMID- 8344041
TI  - Incidental visualization of pituitary tumors during brain SPECT imaging with Tc
      99m HMPAO.

PMID- 8344042
TI  - Thoracic organ transplantation in children. The state of heart, heart-lung, and
      lung transplantation.
AB  - Heart, heart-lung, and lung transplantation have become accepted modalities for
      treatment in children with serious cardiopulmonary disease. Although early deaths
      secondary to infection and/or acute rejection have been reduced dramatically,
      there is still an early mortality related to cardiac complications and a late
      mortality related to rejection and infection. The management of hypoplastic left
      heart syndrome remains a special problem and is outlined in the review. There is
      much less experience in the newer modalities of heart-lung and lung
      transplantation in children and the results of these operative procedures are
      similar to what was seen in heart transplantation some 10 years ago. Ongoing and
      significant improvement continues, however, in all forms of transplantation
      dealing with the lung.

PMID- 8344043
TI  - Overall function in rural childhood cancer survivors. The role of social
      competence and emotional health.
AB  - This study compared the functioning of 20 rural cancer survivors, aged 6 to 16
      years, with that of 40 age- and gender-matched school peers. Social competence
      and emotional health were evaluated, along with academic performance and physical
      limitations. Eight measures were used: the teacher and parent Child Behavior
      Check Lists, the Health Resources Inventory, the Vineland Revised Scale of Social
      Maturity, the Piers-Harris Child's Self-Concept Scale, the Parcel and Meyers'
      Health Locus of Control, the Moos' Family Environment Scale, and the Functional
      Status II(r). Cancer survivors and controls had similar attitudes about self
      esteem, family conflicts, physical functioning, social skills, independence, and
      sense of control over health. Both parents and teachers noted poorer social
      competence among the cancer survivors than among controls, but parents of
      survivors reported more behavior problems, whereas teachers stressed poorer
      school performance. Routine screening for emotional health, social competence,
      and academic performance should be part of the follow-up care of pediatric cancer
      survivors.

PMID- 8344044
TI  - Correlating changes in body temperature with infectious outcome in febrile
      children who receive acetaminophen.
AB  - We reviewed the body-temperature patterns of 140 children ages 2 to 24 months who
      had fever > or = 39.0 degrees C, received acetaminophen 10 to 15 mg/kg, and had
      their temperatures remeasured 60 to 90 min later. The children comprised three
      groups: 22 had bacterial meningitis; 59, isolated bacteremia; and 59,
      nonbacterial febrile illness. Percentages of patients who became afebrile
      (temperature < 38.0 degrees C) after receiving acetaminophen were not
      significantly different among the three groups. Differences in mean temperature
      decrease after antipyretic was given were significant within each group but not
      between groups. An inverse relation (P < .004) between patient age and magnitude
      of temperature was revealed by the following formula: degrees C of defervescence
      = 1.66 - (0.028 x patient age in months). Thus, highly febrile young children
      with and without invasive bacterial infections who receive a therapeutic dose of
      acetaminophen experience a significant temperature drop after 60 to 90 min but do
      not commonly defervesce to an afebrile state. The degree of defervescence is age
      dependent and does not distinguish between infectious outcomes.

PMID- 8344045
TI  - The accuracy of infrared auditory canal thermometry in infants and children.

PMID- 8344046
TI  - Respiratory syncytial virus as a cause of fever and petechiae in infants.

PMID- 8344048
TI  - Development of pneumococcal meningitis during ceftriaxone therapy.

PMID- 8344047
TI  - Thyroid involvement in children with familial Mediterranean fever.

PMID- 8344049
TI  - Unilateral pulmonary edema in children.

PMID- 8344050
TI  - Causes of recurrent abdominal pain.

PMID- 8344051
TI  - Cerebrospinal fluid pleocytosis in children with pneumonia but lacking evidence
      of meningitis.
AB  - Headache, nuchal rigidity, positive Kernig's sign, and even convulsions may be
      observed during severe bacterial infections such as pneumonia, pyelonephritis,
      typhoid fever, and bacillary dysentery. In such cases, meningitis can be excluded
      only by documentation of normal cerebrospinal fluid (CSF). The authors describe
      four children with lobar pneumonia in whom the clinical signs of meningeal
      irritation were associated with a mild increase in the white blood cell count in
      the CSF (pleocytosis) although there was no other evidence of meningeal
      infection.

PMID- 8344052
TI  - Pediatric Miller Fisher syndrome requiring intubation: a case report.
AB  - In 1956, C. Miller Fisher described a clinical syndrome of ophthalmoplegia,
      ataxia, and areflexia. This syndrome, which now bears his name, shares certain
      features with the Guillain-Barre syndrome (GBS) and generally follows a benign,
      restricted clinical course, especially in the pediatric population. The authors
      report a pediatric case of Miller Fisher syndrome (MFS) who subsequently required
      intubation and mechanical ventilation.

PMID- 8344053
TI  - Extreme hyperlipidemia in type I diabetes mellitus.

PMID- 8344054
TI  - The patient care evaluation system: patients' perception of anesthetic care.
AB  - Our department's Patient Care Evaluation Survey was developed to measure the
      patients' perception of the care they received by our anesthesia caregivers
      (attending physicians, residents, and certified registered nurse anesthetists
      [CRNAs]), and identify those areas of patient contact which might require
      improvement in the delivery of anesthesia. The survey instrument (a personal
      letter sent by the chairman), is mailed to randomly selected patients two weeks
      following discharge from the hospital or ambulatory surgery center. Patients
      rated the anesthesia care they received from one (poor) to 10 (excellent) in
      three areas: the preoperative visit, the postoperative visit, and overall
      satisfaction. From October 1986 to October 1991, a total of 2,374 (n = 2,374)
      questionnaires representing a random sample of 99,964 anesthetics, were sent to
      patients. Fifty-four percent or 1,291/2,374 patients returned the survey. A high
      degree of patient satisfaction is seen for all categories: the preoperative
      visit, (mean score of 9.17 +/- 1.6); the postoperative visit (8.33 +/- 2.7); and
      overall satisfaction (9.15 +/- 1.7). Of the responses returned, 0.9% of the
      patients surveyed rated their interaction with the department as unsatisfactory
      in all three areas; 2.6% in two areas; 10.8% in at least one area. The Patient
      Care Evaluation system has served as an important means of feedback for medical,
      educational, and administrative goals of the department.

PMID- 8344055
TI  - Introducing physicians to case management in psychiatry.
AB  - All physicians sooner or later find themselves in contact with a case manager
      whose job is to help the noninstitutionalized psychiatric patient who is
      chronically ill. This paper is an attempt to orient the physician about this
      phase of treatment which started not many years ago. The article gives a short
      history of the development of case management and demonstrates the various steps
      the case manager takes in working with a patient. These are, assessment of the
      problems, plans to meet the problems, linkage with agencies, monitoring the
      progress, advocacy, and evaluation. These activities may bring about improvement
      in the kind of patient frequently considered hopeless.

PMID- 8344056
TI  - Social correlates of malnutrition among Filipino street children.
AB  - This study has sought to identify subgroups of street children at high risk for
      nutritional deficiency in metropolitan Manila in the Philippines. A sample of 150
      street children ages six through 18 were weighed, measured, and interviewed to
      establish nutritional parameters and to explore the interrelationships of
      nutritional status with social conditions. Two variables showed the highest
      association with low weight for age: children using drugs and children not in
      school. These variables should be seen as indicative of a range of variation
      among Filipino street children, in whom those on drugs and not in school
      represent the sector at greatest risk and one to which nutritional programs
      should be targeted.

PMID- 8344057
TI  - The Connecticut State Medical Society and the Connecticut Medical Insurance
      Company.

PMID- 8344058
TI  - A doctor's child is born.

PMID- 8344059
TI  - The international control of disease after the war. 1943.

PMID- 8344060
TI  - Reexamining liability for acts that lead to death.

PMID- 8344061
TI  - I swear by Apollo physician.

PMID- 8344062
TI  - Medical hydrology.

PMID- 8344063
TI  - Ethacrynic acid: outflow effects and toxicity in human trabecular meshwork in
      perfusion organ culture.
AB  - The effect of ethacrynic acid, a potential outflow agent for the treatment of
      glaucoma, was studied in a series of 25 pairs of human eyes in perfusion organ
      culture. Concentrations varied from 0.01 mM to 2.4 mM and were used in single or
      repetitive doses. Intraocular pressure was continuously recorded for up to two
      weeks after exposure. Eyes were then fixed and the meshwork examined
      histologically. Ethacrynic acid in single doses of 0.05 mM, 0.3 mM, and 0.6 mM
      increased facility of outflow at least 40% when compared with fellow control
      eyes. The duration of effect was approximately 18 hours, during which time the
      intraocular pressure gradually returned to baseline. Histologic examination
      revealed dose related effects on the trabecular cells, ranging from clumping of
      nuclear chromatin in some eyes to cellular swelling, disruption of cytoplasmic
      membranes, and cell necrosis in other eyes at concentrations of 0.1 mM and
      higher. No recovery or reversal of these changes was noted with time, even two
      weeks after a single exposure to the drug. Although ethacrynic acid is effective
      in temporarily lowering intraocular pressure in the human eye, a low therapeutic
      index may limit its clinical usefulness.

PMID- 8344064
TI  - A comparison of 5-fluorouridine and 5-fluorouracil in an experimental model for
      the treatment of vitreoretinal scarring.
AB  - 5-Fluorouridine (5-FUR), a ribonucleotide metabolite of 5-Fluorouracil (5-FU), is
      a more potent inhibitor of cellular proliferation and cell-mediated contraction
      in vitro than 5-FU. We compared the efficacy of these two drugs in a cell
      injection model of proliferative vitreoretinopathy using New Zealand albino
      rabbits. Forty-five eyes were divided into three groups and injected
      intravitreally with homologous fibroblasts. Eyes were examined at the time of
      injection and 7, 14, 21 and 28 days thereafter. By day 28, 70.5% (12 of 17) of 5
      FUR treated eyes demonstrated no appreciable proliferative or tractional activity
      compared with 41.7% (5 of 12) of 5-FU treated eyes and 10% (1 of 10) of control
      eyes (p < 0.006). Medullary ray puckers developed in 29.4% (5 of 17) and 25% (3
      of 12) of 5-FUR and 5-FU treated eyes respectively. No 5-FUR treated eye
      developed extensive tractional or combined tractional and rhegmatogenous retinal
      detachment compared with 33.3% (4 of 12) of 5-FU treated eyes and 80% (8 of 10)
      of control eyes (p < 0.001). These results suggest that 5-Fluorouridine may be
      more effective than 5-FU for the treatment of vitreoretinal scarring.

PMID- 8344065
TI  - Protein kinase C activity and its relationship to myo-inositol uptake during
      hyperglycemic conditions in cultured bovine lens epithelial cells.
AB  - Incubation of cultured bovine lens epithelial cells (BLECs) in minimal essential
      medium (MEM) containing 40 mM galactose for 20 hr results in an attenuation of 3H
      myo-inositol (3H-MI) concentrating ability. Decreased MI uptake could negatively
      impact on normal phosphoinositide turnover and diacylglycerol production, and
      presumably, protein kinase C (PKC) activation. The present report examines the
      relationship between PKC activity, myo-inositol transport and hyperglycemic
      conditions. PKC activities in the cytosol and particulate fractions of bovine
      lens epithelial cells in culture were quantitated using a mixed micelle assay
      following DEAE-cellulose (DE52) and Sephadex G-25 chromatography. Protein kinase
      C activity was assessed as Ca2+ and phospholipid-dependent Ac-myelin basic
      protein substrate peptide phosphorylation and confirmed using a PKC
      pseudosubstrate inhibitor peptide (PKC 19-36). Total PKC activity was similar in
      galactose-incubated cells (871 +/- 64 pmol/mg total protein/min) and control
      cells (881 +/- 8 pmol/mg total protein/min) after 20 hr. In unstimulated cells,
      approximately 90% of the total cellular PKC activity was recovered in the
      cytosolic fraction. Enzyme translocation was induced with the tumor promoting
      phorbol ester, phorbol 12-myristate 13-acetate (PMA), resulting in a 6-fold
      increase in membrane-associated PKC activity. A similar PMA-induced translocation
      was observed in BLECs incubated with 40 mM galactose MEM-maintained cells briefly
      treated with PMA or the non-phorbol PKC activators, SC-10 and mezerein, displayed
      a rate of 3H-MI uptake similar to the untreated control cells.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8344066
TI  - DNA single strand breaks in human lens epithelial cells from patients with
      cataract.
AB  - In recent years, there has been renewed interest in the association between DNA
      damage to the lens epithelium and the development of lens opacities. Although a
      number of in vitro studies have indicated that lens epithelial cells are
      susceptible to a variety of DNA damaging insults and that these cells possess the
      capacity to repair such damage, no previous studies have directly addressed
      whether DNA damage is associated with human cataract in vivo. Utilizing samples
      of lens epithelial cells obtained from patients undergoing cataract surgery, the
      percentage of cells containing DNA single strand breaks was directly determined
      by the single-cell gel assay (SGA) method. Non-cataractous human Eye Bank lenses
      of similar ages to the cataractous samples and calf lenses were used as controls.
      In approximately 50% of the cataractous samples analyzed, the proportion of cells
      containing DNA single strand breaks was significantly higher than in control
      lenses. No relationship between age and DNA damage was noted. These findings are
      consistent with the hypothesis that in some human patients with cataract, DNA
      damage in the lens epithelial cell population may be related to the development
      of lens fiber cell opacity.

PMID- 8344067
TI  - Distribution and activity of glutathione-S-transferase in normal human lenses and
      in cataractous human epithelia.
AB  - The distribution of glutathione-S-transferase (GST) activity was determined in
      frozen normal human lenses. The highest activity of GST was found in the
      peripheral and equatorial regions, whereas the lowest activity was found in the
      nucleus. Western blot showed that both mu and pi isoenzymes of GST were present
      in human lenses. This result is similar to that found in rat lenses. In addition,
      GST activity was analyzed in 50 lens epithelia which were obtained during
      cataract surgery. Twenty-seven lens epithelia showed no activity. Statistically
      significant association was found between cortical and mixed cortical--nuclear
      cataract and loss of GST activity. No association was found between pure nuclear
      cataract and loss of epithelial GST activity.

PMID- 8344068
TI  - Developmental changes in carbachol-stimulated inositolphosphate release in
      pigmented rat retina.
AB  - Carbachol-stimulated release of inositolphosphates (IP) was studied in the whole
      retina from Long-Evans rats of different ages (day 5, 10, 15, 20, adult)
      following in vitro incorporation of [3H]myo-inositol. Unlike the albino rat
      retina, the pigmented retina was highly light-sensitive, making it necessary to
      dark adapt the animals and perform retinal dissections under low illumination to
      prevent light-induced IP release. Retinae from postnatal day 10 rats showed the
      highest amount of carbachol-stimulated IP released. This response to carbachol
      decreased with age until postnatal day 20 when it reached adult levels. The
      pigmented rat retina showed a sharp fall in the degree of carbachol (1 mM)
      stimulated IP released at the time of eye-opening (450% above basal in retinae
      from 10 day old animals, as compared to 230% above basal in 15 day old retinae).
      Basal release of IP was not altered in the retina during development. Muscarinic
      cholinergic receptor density was, however, found to increase 5 fold with age,
      reaching adult levels by PND 20. Retinal weight and protein per retina also
      increased (four fold) from day 5 to adult; however, the in vitro incorporation of
      [3H]myo-inositol into phosphoinositides (calculated as per mg protein) did not
      change during development. Thus, in animals prior to eye opening, a much higher
      proportion of phosphoinositides appears to be hydrolyzed upon muscarinic receptor
      stimulation. During retinal development a change in sensitivity to the agonist
      sensitive pool(s) of phosphoinositides may occur and/or there may be alterations
      in the efficacy of receptor coupling to the second messenger system resulting in
      the disassociation observed between the drastic increase in receptor number and
      the apparent decrease in receptor-stimulated release of IP.

PMID- 8344070
TI  - Prednisolone acetate or prednisolone phosphate concurrently administered with
      ciprofloxacin for the therapy of experimental Pseudomonas aeruginosa keratitis.
AB  - This study was conducted to determine the therapeutic efficacy of 3.0 mg/ml
      ciprofloxacin administered concurrently with one of two salts of prednisolone for
      the treatment of experimental pseudomonal keratitis. Rabbit corneas were injected
      intrastromally with Pseudomonas aeruginosa ATCC strain 27853. Sixteen hr after
      injection, rabbits were randomly divided into four treatment groups (3 rabbits, 6
      eyes per group): 1) ciprofloxacin plus prednisolone acetate; 2) ciprofloxacin
      plus prednisolone phosphate; 3) ciprofloxacin only; 4) untreated. Signs of
      inflammation were graded in a masked fashion by slit lamp examination (SLE) and
      by estimating polymorphonuclear leukocyte (PMN) numbers in corneas 27 hr after
      injection. SLE scores and PMN numbers were significantly lower (P < 0.02) in eyes
      receiving either salt of prednisolone plus ciprofloxacin compared to the
      untreated controls. In contrast, SLE scores and PMN numbers were not
      significantly different in eyes treated with ciprofloxacin alone, compared to
      untreated controls (P > 0.13). No viable bacteria were recovered from any eye
      treated with ciprofloxacin (groups 1, 2, and 3). Ciprofloxacin concentrations in
      the aqueous humor of eyes in groups 1, 2, and 3 were greater than 15-fold higher
      than the MIC for P. aeruginosa 27853. These results suggest that either salt of
      prednisolone, when combined with ciprofloxacin, reduces ocular inflammation
      without affecting the antimicrobial efficacy of the antibiotic.

PMID- 8344069
TI  - Pseudomonas aeruginosa keratitis in leukopenic rabbits.
AB  - To study the role of the host inflammatory response in Pseudomonas aeruginosa
      keratitis, rabbits were made leukopenic with intravenous injections of
      cyclophosphamide and dexamethasone. Twenty-four hr later, keratitis was initiated
      in all rabbits with an intrastromal injection of 1,000 log phase P. aeruginosa
      strain 27853. Slit lamp examination of eyes showed that leukopenic rabbits had
      significantly less (P < 0.0001) ocular pathology at 16, 22, and 27 hr
      postinfection. The number of viable bacteria recovered from corneas of leukopenic
      rabbits was the same as the number recovered from nonleukopenic rabbits (P =
      0.95). These results suggest that the host inflammatory response significantly
      contributes to the overall ocular pathology associated with P. aeruginosa
      keratitis, but does not influence the survival of the infecting organism in the
      cornea at the height of the infection.

PMID- 8344071
TI  - External humeral condylar fracture in children. A long-term review of 30 cases
      operated.
AB  - Follow-up ranging from 2 to 14 years (mean 6 years) was obtained for 30 fractures
      of the external humeral condyle in children aged from 2 to 11 years; the patients
      had been submitted to reduction-osteosynthesis. Twelve patients were at the end
      of the growth period when followed-up. All of the patients were classified as
      Lagrange and Rigault grades II and III. Synthesis always involved two or three
      Kirschner wires bent under the skin. There were 24 perfect results and 6 good
      ones. Valgus equal to less than 10 degrees was present in 2 cases. Deficit in
      flexion-extension, present in 4 cases, did not exceed 20 degrees overall. Another
      case showed "fish-tail" radiographic deformity (due to epiphysiodesis) which did
      not interfere with function. Despite the potential danger of the lesion, the
      authors believe that careful surgical treatment provides very satisfactory
      results.

PMID- 8344072
TI  - Anesthesia and perioperative treatment in large resections of the pelvic girdle.
AB  - The authors examine 24 patients submitted to resection of the pelvic girdle in
      neoplastic pathology, illustrating the perioperative anesthesiologic procedures
      used. Sudden variations in blood and plasma volume and increasing hypothermia
      constitute the main problems. The prevention of hypothermia and continuous
      invasive monitoring of hemodynamic parameters and of oxygen saturation in mixed
      venous blood (SvO2) are of primary importance.

PMID- 8344073
TI  - Osteoid osteoma of the carpal scaphoid in the adult: a clinical case.
AB  - The authors present one case of osteoid osteoma of the carpal scaphoid,
      emphasizing the clinical rareness of the disease. Methods of diagnosis used and
      surgical treatment performed are described.

PMID- 8344074
TI  - Isolated dislocation of the pisiform. A case report.
AB  - The clinical case of an 81-year-old woman with an isolated pisiform dislocation
      is reported. This is an extremely rare lesion due to the sturdiness of the
      ligamentous complex which stabilizes the pisiform to the carpus; when it does
      occur closed reduction is impossible because of the action of the FCU tendon. In
      symptomatic cases the best therapeutic procedure consists in the surgical removal
      of the bone, resulting in complete recovery without consequence.

PMID- 8344075
TI  - Two cases of solitary subcutaneous angioleiomyoma.

PMID- 8344076
TI  - Quiz. McLaughlin fracture of the right humeral head with posterior dislocation of
      the shoulder.

PMID- 8344077
TI  - Anterior surgery of the upper part of the cervical spine by prevascular extraoral
      approach.
AB  - Anterior surgery of the upper part of the cervical spine, that is, proximal to
      C3, may be performed by transoral approach, possibly enlarged by
      glossomandibulotomy, by a retrovascular extraoral approach, or by a prevascular
      extraoral approach. The authors describe the surgical method of prevascular
      extraoral approach that allowed them to effectively treat osteoma localized at C2
      and C3, post-laminectomy instability at C3 and C4, solitary metastasis at C3. As
      compared to transoral surgery the prevascular extraoral approach has the
      advantage of avoiding the risk of infection from germs in the oral cavity and of
      allowing for easier postoperative management, avoiding tracheotomy and/or
      prolonged dysphagia. As compared to a retrovascular approach the prevascular
      approach obtains a truly anterior exposure instead of an anterolateral one.
      Prevascular extraoral approach should thus be used whenever possible. Transoral
      surgery is indicated for decompression, of the brainstem and a bilateral
      retrovascular approach may be used to perform anterolateral fusion at C1-C2.

PMID- 8344078
TI  - Microsurgery in the treatment of crural and sciatic pain due to disc and bone
      compression: considerations on the first 100 cases.
AB  - The authors present the results they obtained in the first 100 operations
      performed between January 1989 and November 1990 for the treatment of lumbar
      sciatic pain related to disc and/or bone compression: microsurgery according to
      the Caspar method was used. A total of 113 spaces were submitted to surgery;
      discectomy at two levels was performed in 13 patients. Nerve root compression
      observed was based on three causes: 1) pure disc hernia (57.5%), 2) pure lateral
      stenosis (15.9%), 3) combined pathology (hernia+stenosis) (25.6%). In one of the
      cases the pathology remained unknown. At an average two-year follow-up there were
      94 excellent or good results, 2 fair results, and 4 poor results. Complications
      included dural lacerations in 3 cases, with no sequelae. Eight patients were
      submitted to further surgery for recurrence of symptoms; the final results after
      reintervention were excellent in 7 cases, and fair in 1. The authors emphasize
      the advantages to using microsurgery as compared to macrosurgery, and stress a
      frequent finding of pure lateral stenosis or associated with disc pathology (47
      out of 113 levels operated, equal to 41%), as well as the reliability of CT scan
      when dealing with disc pathology (97% positive diagnosis) but its unreliability
      when diagnosis is lateral stenosis (19 out of 47, equal to 40%).

PMID- 8344079
TI  - The use of massive bone allografts for intercalary reconstruction and arthrodeses
      after tumor resection. A multicentric European study.
AB  - A multicentric study was conducted by the European Musculoskeletal Oncology
      Society on 113 cases of resection for tumors of the major long bones and
      reconstruction with massive allografts, as intercalary diaphyseal or for
      arthrodesis. The follow-up was at least 12 months. There was a 14% incidence of
      infection, with a higher frequency (18.5%) in intercalary grafts as compared to
      arthrodeses (7%). Fracture of the graft occurred in 15.5% of the cases with a
      prevalence in the humerus (28.5%) as compared to the tibia (21.4%) and femur
      (14.7%). Fracture constantly occurred after osteosynthesis with screws, in 16% of
      the cases after osteosynthesis with a plate, and in 12.5% of the cases after
      osteosynthesis with an intramedullary nail. It was observed in 32% of the grafts
      preserved at -30 degrees, in 17% of those irradiated, and in 7% and 7.6% of those
      preserved at -180 degrees and -80 degrees, respectively. Delayed union and non
      union was observed in 57% of the cases: 63% in intercalary grafts, 48% in
      arthrodeses. Final results after treatment of complications were excellent and
      good in 63% of the entire series. The results should, however, be evaluated after
      3 years, as during this period of time important transformation phenomena of the
      graft occur. Complications are observed in 75% of the cases, but they may be
      reduced if planning is correct and surgery is accurate. Each complication may be
      dealt with and resolved without high risks for preservation of the limb.

PMID- 8344081
TI  - [Pregnancy-induced hypertension and serum endothelin].

PMID- 8344080
TI  - Gastrocnemius flaps in the surgical treatment of sarcomas of the knee.
AB  - The authors discuss their experience with the pediculated gastrocnemius flap used
      in the oncological surgery of the knee, in 27 patients. Three groups of patients
      are evaluated: in one group the method was used in patients affected with bone
      sarcoma and associated with reconstruction of the resected bone segment; in
      another group the method was used after infection had occurred as a result of
      reconstructive surgery; in the third group the method was used at the same time
      as excision of sarcomas of the soft tissues. The gastrocnemius flap may be used
      to cover sufficiently wide areas of loss of skin and muscular substance around
      the knee, and may be effectively used to cover metallic prostheses or composite
      reconstructive implants (bone-cement-metal). We recommend using the covering
      technique at the same time as resection and reconstruction are performed in order
      to avoid the risk of infection, and thus reduce any changes in chemotherapy
      protocols that postoperative infection would require in these patients. The use
      of the gastrocnemius flap associated with excision of sarcomas of the soft
      tissues must be reserved for selected cases. The high incidence of local
      recurrence after such excisions indicates that either wider excisions using
      distant free flaps or the association of radiotherapy should be considered.

PMID- 8344082
TI  - [Neonatal effects of uterine incision-to-delivery interval during elective
      cesarean section under epidural anesthesia].
AB  - The relationships between uterine incision to delivery interval (U-DI) and
      neonatal umbilical blood acid-base status and Apgar scores at 1-minute were
      studied in 130 healthy parturients undergoing elective cesarean section under
      epidural anesthesia. U-DI was correlated with umbilical venous (UV) and umbilical
      arterial (UA) pH, PCO2 and PO2, and was also correlated with 1-minute Apgar
      scores. U-DI of more than 150 sec was associated with significantly higher
      UVPCO2, UAPCO2, lower UVpH, UApH, UVPO2, and UAPO2. The only two newborns with
      low 1-minute Apgar scores (6 and 3) in the present study both had prolonged U-DI
      (> 150 sec) and inhaled amniotic fluid just before the delivery. It is concluded
      that U-DI of more than 150 sec has considerable influence on the neonatal status.

PMID- 8344083
TI  - [Follow-up study on physical and mental development in small-for-gestational age
      infants].
AB  - A follow-up study on physical and mental development was carried out in 35 small
      for-gestational-age (SGA) and 35 appropriated-for-gestational age (AGA) infants.
      Excluded for congenital abnormality, intrauterine infection, and neonatal
      asphyxia SGA and AGA infants were similar in maternal education level, infant
      sex, illness, and feeding history. The results revealed that the body weight
      (8.09 +/- 0.73kg), height (69.55 +/- 2.49 cm), head circumference (43.27 +/-
      1.67cm), Kaup index (16.17 +/- 1.05), and development quotient (96.37 +/- 5.76,
      Gesell diagnostic method) level at 40 weeks of age in SGA infants was lower than
      that in AGA infants (P < 0.001), and the development quotient (DQ) in SGA infants
      was especially low in language and receptive regions. Cord serum insulin level
      was significantly correlated with follow-up body weight, height, and DQ level (P
      < 0.01). This article proposed that infants with intrauterine growth retardation
      have a physical development delay at 40 weeks of age, and which could be
      predicted by measuring cord insulin level.

PMID- 8344084
TI  - [Teratogenic effect of potato glycoalkaloids].
AB  - Potato glycoalkaloids were extracted from potato sprout and then analyzed to
      determine their purity by using TLC and HPLC methods and compare with pure alpha
      Solanine and alpha-Chaconine of Sigma. The result indicated that the purity of
      potato glycoalkaloids is 78. 31%, which contains 73.64% alpha-Solanine and 4.67%
      alpha-Chaconine. The LD50 of mice was 44.721 +/- 5.860 4 mg/kg. In order to
      determine the toxicity and teratogenicity of potato glycoalkaloids, the effect of
      potato glycoalkaloids on Kunming pregnant mice were studied. The results showed
      that: (1) potato glycoalkaloids have teratogenic effects on embryos of mice. It
      could induce neural tube defects (NTDs), and may be an important teratogen of
      NTDs. (2) potato glycoalkaloids have embryo toxicity. It could cause the death of
      embryos and result in absorbed and dead fetuses. (3) potato glycoalkaloids could
      evidently affect the development of embryos and lead to intrauterine growth
      retardation (IUGR). An interesting phenomena which just like the clinical
      manifestation of miscarriage in human being was noticed. If potato glycoalkaloids
      were given to the pregnant mice on the 5th or 6th day of gestation
      intraabdominally, vaginal bleeding and abortion would occur, and this has not
      been reported yet. The animal model of NTDs in this experiments supported our
      hypothesis that sprouted potato could be a teratogen of NTDs.

PMID- 8344086
TI  - [Bone metabolism in postmenopausal women and after estrogen treatment].
AB  - Changes of bone metabolism in 11 premenopausal women and 109 postmenopausal women
      were studied. 50 postmenopausal women were randomly divided into 4 groups: 20, 10
      and 6 cases were given nylestriol, diethyl stilbestrol and chlorotrianisen
      respectively, and 14 cases served as control. It was shown that bone mineral
      content (BMC), and, blood estrogen level in postmenopausal women were
      significantly lower than those of premenopausal women. Close correlation existed
      between E1, E2, and BMC. Serum alkaline phosphatase (ALP), bone GLA protein
      (BGP), urine Ca/Cr and Hpr/Cr were markedly increased in postmenopausal women and
      declined after 3 months of treatment with nylestriol, diethylstilbestrol or
      chlorotrianisen. The radial BMC increased by 0.8% with (P > 0.05) nylestriol
      treatment for one year and decreased by 1.1% (P < 0.05) in the control cases. The
      present study indicated that postmenopausal estrogen deficiency accelerated bone
      loss, which was prevented by small substitution doses of estrogen such as
      nylestriol.

PMID- 8344085
TI  - [Effect of nylestriol on postmenopausal uterine endometrium].
AB  - Curettage was performed in 139 postmenopausal women before as well as 6 months,
      12 months and 36 months after Nylestiol (CEE3) therapy, for totally 205 times. It
      was found that CEE3 could induce endometrial proliferation and uterine
      breakthrough bleeding, much greater in women using 2 mg of CEE3 than in those
      using 1 mg. Ciliated cell were present in the proliferative endometrium after
      CEE3. The endometrial tissues obtained in curettage in women after 12 months'
      therapy was similar to that of 6 months' therapy. No more endometrium was
      obtained after 36 months' therapy. Provera were given for women who had
      proliferative endometrium after 6-12 months' therapy with CEE3 1-2 mg/2w. There
      were no changes of endometrium. This suggested that further study the interval
      and dosage of provera should be given with CEE3.

PMID- 8344087
TI  - [Diagnosis of basal body temperature, serum progesterone and endometrial biopsy
      for luteal phase defect].
AB  - Fourteen infertile women and two women with recurrent abortions were suspected of
      having luteal phase defect (LPD) by BBT charts. In these patients, the midluteal
      phase serum progesterone (P) levels were determined together with histological
      examination by the late luteal endometrial biopsies during the same cycle. The
      diagnostic criteria for LPD was BBT of luteal phase < or = eleven days, mean P
      level of 3 blood samples taken on three days during midluteal phase was less than
      48 nmol/L (15 ng/ml) and the histological dating of endometrium was two or more
      days behind. The results showed that histological abnormality and low P level
      were 6.3% and 31.3%, respectively. When histological abnormality combined with
      lowered P level at the same cycle, the diagnosis of LPD increased to 87.5%. The
      author suggests that both midluteal phase P level and late luteal endometrial
      histological examination should be assessed at the same cycle in the diagnosis of
      LPD. BBT should also be assessed.

PMID- 8344088
TI  - [Determination of tumor necrosis factor from peripheral blood cells in patients
      with ovarian cancer].
AB  - The production of tumor necrosis factor (TNF) induced by LPS in the peripheral
      blood mononuclear cells from the patients with malignant and benign ovarian
      tumors were determined. Decreased production of TNF were observed in the patients
      with malignant ovarian tumor. In the advanced cases, TNF were lower than that in
      the early ones, which may indicate the progression of the tumors. These findings
      suggested that the TNF may be a useful indicator to diagnose the malignant tumors
      and prognosticate the tumors' developing.

PMID- 8344089
TI  - [Preliminary trials of immune function of erythrocytes in women with benign or
      malignant gynecologic tumors].
AB  - The immune function of erythrocytes in 74 women with benign or malignant
      gynecologic tumors were studied by red-cell immune adherence (RCIA), regulating
      factor of erythrocytes (RFER), inhibiting factor of erythrocytes (RFIR), and
      factor of promoting neutrocyte of erythrocytes (ERPN). Our results indicated that
      RCIA, RFER, and ERPN in women with malignant tumors were lower than those of
      normal and with benign tumors (P < 0.001). The RFIR of women with malignant
      tumors was higher than others (P < 0.001). Meanwhile, the changes of immune
      function of erythrocytes during treatment were compared and discussed. Our data
      suggested that women with malignant gynecologic tumors had lower immune function
      of erythrocytes.

PMID- 8344090
TI  - [A preliminary cytogenetic study of uterine leiomyoma].
AB  - Thirty fresh samples of uterine leiomyoma were disaggregated in collagenase
      (200kU/L) and cultured for 3-10 days with incubator. Of 30 cases, 27 cases of
      uterine leiomyoma obtained karyotypes and the rate of successful cultured was
      90%, 9 cases showed abnormal karyotypes. Structural changes were frequently seen.
      Breakpoint of chromosome were 12q13-15 (7 cases), 14q24 (6 cases), 7q31-32 (3
      cases). Specific chromosomal rearrangements were t(12;14) (q13-15; q24) and del
      (7) (q31-32). Our data suggested that chromosome 12q13-15, 14q24, 7q31-32 may be
      related to the proliferation of uterine leiomyoma.

PMID- 8344091
TI  - [Relation between the incidence of ectopic pregnancy and the use of intrauterine
      devices].
AB  - The relationship between the incidence of ectopic pregnancy (EP) and the use of
      IUD was examined by the method of analytical epidemiological study. 10,843 women
      of child-bearing age from the west district of Beijing were investigated. The
      conclusions were: (1) The incidence of EP in IUD users was 0.91/1,000 women year;
      and the EP incidence in women not using any contraceptives was 2.23/1,000 women
      year. (2) The incidence of EP in women with IUD inserted within 2 years was
      significantly higher than that in women using IUD longer than 2 years, that is
      5.64/1,000 women year and 0.47/1,000 women year respectively. (3) The probability
      of suffering from EP for accidental pregnancy in IUD users was 4.84%, which was
      much higher than that of women not using any contraceptives (0.20%). (4) The risk
      of EP for IUD users with pelvic inflammatory disease was 6.64 times compared to
      those without pelvic inflammatory disease. (5) EP was not related to previous
      cesarean section or induced abortion.

PMID- 8344092
TI  - Intestinal epithelial function: the case for immunophysiological regulation.
      Cells and mediators (1).
AB  - During the last decade the traditional view of epithelial function being
      controlled solely by the endocrine and nervous systems has been expanded by the
      realization that immune cells also have an important part to play in the control
      of intestinal physiology. Here, we review the current immunophysiological data
      pertaining to the control of the function of the intestinal epithelium, with
      particular reference to ion secretion. The role of immunocompetent cells
      (lymphocytes, mast cells, and granulated phagocytes) and their chemical messenger
      molecules (ie, biogenic amines, eicosanoids, cytokines) is discussed and the
      general theme of cell cooperation and integration is emphasized.

PMID- 8344093
TI  - Effects of PEG-electrolyte (Colyte) lavage on serum acetaminophen concentrations.
      A model for treatment of acetaminophen overdose.
AB  - The purpose of this study was to evaluate whole gut lavage with polyethylene
      glycol electrolyte solution (Colyte), as a potentially adjunctive measure in
      lowering serum acetaminophen levels. The effect of bowel lavage was evaluated on
      serial serum acetaminophen concentrations after 2-g and 4-g doses in 7 and 12
      male patients, respectively. Mean peak level of serum acetaminophen after 2 g (60
      min after intake) was not significantly lowered by bowel lavage. After 4 g, peak
      acetaminophen serum levels were significantly lower after bowel lavage (65.4% of
      controls, P < 0.001). Urinary concentrations of the mercapturic acid conjugate of
      the toxic metabolite were also significantly reduced by lavage (55% after 2 g and
      45% after 4 g, P < 0.01). Activated charcoal given orally after administration of
      4 g of acetaminophen had no significant effect on peak serum levels and had no
      additive effect on lavage. These studies suggest that rapid, complete bowel
      lavage with a polyethylene glycol electrolyte solution may be beneficial as an
      adjunct to the treatment of the acetaminophen intoxication.

PMID- 8344094
TI  - The symptom index. Differential usefulness in suspected acid-related complaints
      of heartburn and chest pain.
AB  - The symptom index is a quantitative measure developed for assessing the
      relationship between gastroesophageal reflux and symptoms. Controversy exists,
      however, over its accuracy and the appropriate threshold for defining acid
      related symptoms of heartburn and chest pain. Therefore, a retrospective review
      was done of 153 consecutive patients referred to our esophageal laboratory. Three
      groups were identified: patients with normal 24-hr pH tests and no esophagitis,
      patients with abnormal 24-hr pH tests and no esophagitis, and patients with
      abnormal 24 hr pH values and endoscopic esophagitis. If symptoms occurred during
      the pH study, a symptom index (number of acid related symptoms/total number of
      symptoms x 100%) was calculated separately for heartburn and chest pain.
      Heartburn and chest pain episodes were similar among the three groups. However,
      the mean symptom index for heartburn was significantly (P < 0.001) higher in the
      patient groups with abnormal pH values [abnormal pH/no esophagitis: 70 +/- 7.1%
      (+/- SE); abnormal pH/esophagitis: 85 +/- 4.6%] as compared to those with normal
      studies, ie, functional heartburn (26 +/- 10.7%). The mean symptom index for
      chest pain was similar for all three groups. Using receiver operating
      characteristic curves, a heartburn symptom index > or = 50% had excellent
      sensitivity (93%) and good specificity (71%) for acid reflux disease, especially
      if patients complain of multiple episodes of heartburn. In contrast, an optimal
      symptom index threshold for defining acid-related chest pain episodes could not
      be defined.

PMID- 8344095
TI  - Outcome after perforation sustained during pneumatic dilatation for achalasia.
AB  - Although esophageal perforation complicates about 5% of pneumatic dilatations
      performed for achalasia, little is known about associated hospital and long-term
      courses. In order to assess the outcome of such patients undergoing emergency
      surgery for repair, records of seven patients sustaining perforation during
      pneumatic dilatation were compared to those of five patients undergoing elective
      myotomy during the same period. In perforation patients, mean intervals following
      the procedure were 3.6 hr to administration of antibiotics and 9.6 hr to surgery.
      The perforation and elective myotomy groups had similar mean durations of
      operation (3.8 vs 3.3 hr), intensive care stays (2 vs 1 days) and hospitalization
      (12 vs 11 days); perforation patients had a significantly longer mean interval
      from surgery to oral intake (7 vs 5 days). Postdischarge long-term outcomes were
      alike in the groups. It is concluded that patients with perforation from
      pneumatic dilatation that is recognized and treated promptly have outcomes that
      are comparable to those of patients who undergo elective myotomy.

PMID- 8344097
TI  - Gastric emptying and bezoars in Japanese. Report of five cases.
AB  - Bezoars are conglomerates of undigested material in the stomach. Previous reports
      have shown that a decrease in secretion of pepsin and gastric acid and a delay in
      gastric emptying might contribute to their formation. To clarify the pathogenesis
      of the formation of gastric bezoars, we studied gastric emptying in five patients
      who presented with a bezoar. In addition, gastric acid secretion was studied in
      three of the cases. Gastric emptying was not delayed in any case, and there was
      no trend toward a decrease in gastric acid secretion. The five patients were
      successfully treated by the endoscopic fragmentation and enzymatic dissolution of
      the bezoars. We conclude that, in Japanese, factors other than a delay in gastric
      emptying are the main contributors to bezoar formation.

PMID- 8344096
TI  - Markers of slow-healing peptic ulcer in the elderly. A study on 1,052 ranitidine
      treated patients.
AB  - Little is known about ulcer outcome in the elderly. The aims of the present paper
      were to establish whether risk factors of slow-healing peptic ulcer can be
      demonstrated in the elderly and whether clinical differences exist between ulcer
      patients whose age of onset of the disease was before or after 65 years old. The
      short-term, open study, involving 1052 elderly patients (over 65 years) in 37
      gastroenterology centers throughout Italy aimed to compare two schedules of
      ranitidine treatment: 150 mg twice daily versus 300 mg at bedtime. As
      nonsignificant differences were found between these two schedules, the sample was
      considered as a whole. It included 319 gastric ulcer (GU) patients, 699 duodenal
      ulcer (DU) patients, and 34 concomitant GU and DU cases. Ninety-three patients
      dropped out of the trial; 79/294 GU, 138/635 DU, and 10/30 GU+DU were found still
      unhealed after four weeks and 20 GU, 15 DU, and 1 GU+DU remained so after eight
      weeks. Statistical analysis was performed using likelihood-ratio and Pearson's
      chi-squared tests and Cox's models. Univariate analysis showed that the
      indicators of slow-healing GU were ulcer size (P = 0.002) and persisting ulcer
      symptoms (P = 0.0001); indicators of slow-healing DU were ulcer size (P =
      0.0001), persisting ulcer symptoms (P = 0.0001), alcohol (P = 0.0003), and NSAID
      (P = 0.0088) consumption. DU patients taking antiplatelet drugs have
      significantly better results after four weeks and worse results after eight weeks
      (P = 0.0352).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8344098
TI  - Circadian rhythm in aspirin (ASA)-induced injury to the stomach of the fasted
      rat.
AB  - Circadian rhythms exist in several gastric parameters affecting ulcerogenesis.
      This study investigated possible circadian rhythmicity in observed aspirin (ASA)
      induced gastric lesions in the rat. In five experiments 183 rats were studied at
      14 time points over a 24-hr period. Rats were adapted for three weeks on a 12-hr
      light schedule, fasted 18 hr, then given oral acidified ASA. One hour later, the
      rats were sacrificed, the stomachs were removed, stretched flat, photographed,
      scanned, and measured for percent area of gross lesions in the gastric corpus by
      computer planimetry. Cosinor rhythmometric analysis showed a significant (P <
      0.001) rhythm. Mean of rhythm (MESOR) was 5.60 +/- 0.25% of total corpus.
      Amplitude was 25.89 +/- 6.07% of MESOR. Peak time (acrophase) was 1909 +/- 0101
      hr after lights on. Thus, gastric vulnerability to ASA injury exhibited circadian
      rhythmicity with peak injury during the dark period in this species.

PMID- 8344099
TI  - Nicotine has no effect on rat gastric mucosal prostaglandin generation in vitro.
AB  - Previous studies have shown that cigarette smoking depresses prostaglandin
      generation by human gastric mucosa, but the component of smoke that is
      responsible for that action is not known. To investigate whether nicotine has a
      direct effect on gastric mucosal prostaglandin generation, we performed the
      following study. Eight rats were sacrificed and the stomachs removed. Using a
      biopsy forceps, small pieces of gastric mucosa were resected and placed in
      incubation vials containing either buffered Krebs solution alone (control), Krebs
      solution plus indomethacin (5 micrograms/ml), or Krebs solution plus one of
      several concentrations of nicotine ditartrate (10, 100, 500, 1000 ng/ml). The
      nicotine concentrations we used ranged below and above the plasma nicotine
      concentrations of smokers shortly after smoking cigarettes. Three separate
      incubations of gastric mucosa were performed per experimental group from each
      animal. After 30 min of incubation, prostaglandin E2 and 6-keto-prostaglandin F1
      alpha concentrations in the incubation medium were measured by radioimmunoassay.
      We found that nicotine at any concentration tested had no effect on the
      generation of prostaglandin E2 and 6-keto-prostaglandin F1 alpha by rat gastric
      mucosa. Thus, this study indicates that, if nicotine is involved in the
      depression of prostaglandin generation in the gastric mucosa of smokers, its role
      is an indirect one and not by direct action on the gastric mucosa.

PMID- 8344100
TI  - Association between gastrointestinal tract carriage of Candida, blood group O,
      and nonsecretion of blood group antigens in patients with peptic ulcer.
AB  - Of 112 patients with peptic ulcer disease examined for oral carriage of Candida,
      66 (59%) were carriers. Candida carriage was associated with blood group O (P <
      0.05) and, independently, with nonsecretion of blood group antigens (P < 0.01).
      For each subject, the presence or absence of yeasts was found to be a constant
      characteristic, and only among patients positive for Candida was blood group O or
      nonsecretion more frequent than expected in the general population. The quantity
      of yeasts isolated was significantly greater in patients than in normal subjects
      (P < 0.002), as was the frequency of carriage in the patient population (59% vs
      32%). This increase was not associated with treatment with H2-receptor
      antagonists. The results of paired oral and gastroduodenal aspirate cultures
      suggested that identifying Candida in the oral cavity was a good indicator of the
      presence of yeasts elsewhere in the gastrointestinal tract. Mechanisms whereby
      overgrowth of Candida in the upper gastrointestinal tract might contribute to the
      inflammatory background of peptic ulcer disease are discussed.

PMID- 8344101
TI  - Early evening dosing of ranitidine. Comparison with nighttime dosing of
      ranitidine or cimetidine in duodenal ulceration.
AB  - A double-blind multinational comparison of ranitidine 300 mg post evening meal
      (pem), ranitidine 300 mg nocte and cimetidine 800 mg nocte has been carried out
      in 1677 patients with endoscopically verified duodenal ulcer disease. Fifty-three
      percent of ulers healed by two weeks during treatment with ranitidine 300 mg pem
      and 88% by four weeks, while the results for ranitidine 300 mg nocte were 50% and
      86%, respectively, and 44% and 84% for cimetidine. The difference between
      ranitidine 300 mg pem and cimetidine was significant at two weeks (P = 0.002,
      Mantel-Haenszel chi-squared test). The relative efficacy of the treatments was
      not dependent upon gender, smoking habit, alcohol intake, or ulcer frequency.
      However, the overall differences in healing between patients with small and large
      ulcers and patients with single and multiple ulcers were significantly different
      at weeks 2 and 4 (P < 0.001). Significantly more patients treated with ranitidine
      (60%) had complete relief of epigastric pain than those treated with cimetidine
      (54%) (P < 0.05). A meta-analysis of the four double-blind comparisons of
      ranitidine 300 mg pem (N = 841) and 300 mg nocte (N = 849), including the present
      study, failed to show the benefits of pem dosing, predicted from pharmacological
      studies.

PMID- 8344102
TI  - Relationship between tissue calcium content and duodenal ulcer in the rat.
AB  - Since the effect of cellular calcium on cell injury has been in question, this
      study focused on the relationship between tissue calcium content and cysteamine
      induced duodenal ulcer. Rats treated with cysteamine showed a high frequency and
      severity of duodenal ulcer, and the calcium content in the duodenal mucosa was
      elevated. Furthermore, the level of calcium content in duodenal mucosa was
      positively associated with the severity of the duodenal lesion. Whereas
      administration of calcium increased duodenal ulcerative response to cysteamine,
      verapamil afforded protection against ulceration. We conclude that calcium
      accumulation in duodenal mucosa is related to duodenal ulceration induced by
      cysteamine.

PMID- 8344103
TI  - Alpha-smooth-muscle actin expression in normal and fibrotic human livers.
AB  - To determine the significance of the expression of alpha-smooth-muscle actin in
      the fibrotic human liver, normal and diseased livers were stained with anti-alpha
      smooth-muscle-actin antibody by an immunoperoxidase method. Vitamin A-containing
      lipocytes were also identified by the modified Kupffer's gold chloride method. In
      the normal human liver, lipocytes as well as vascular smooth muscle cells
      expressed alpha-smooth-muscle actin. In alcoholic liver disease, there was an
      increase in the cells positive for alpha-smooth-muscle actin adjacent to the
      fibrotic areas, but the response of lipocytes to the gold chloride reaction
      diminished. In chronic hepatitis, the cells positive for alpha-smooth-muscle
      actin increased around the enlarged portal areas, and the response to the gold
      chloride reaction did not change appreciably. An increase in the cells positive
      for alpha-smooth-muscle actin was associated with the progression of hepatic
      fibrosis in the liver of patients with alcoholic liver disease and chronic
      hepatitis.

PMID- 8344104
TI  - Practice and complications of liver biopsy. Results of a nationwide survey in
      Switzerland.
AB  - Studies on the complication rate of liver biopsy have hitherto been conducted in
      referral hospital centers. They are therefore not representative for general
      practice where liver biopsy is performed by specialists and nonspecialists. In a
      postal nationwide survey, we approached all gastroenterologists and hospital
      internists to assess the complication rate and practice (setting, needle type,
      use of ultrasonography) of percutaneous liver biopsy performed in 1989 in
      Switzerland for diffuse liver disease. Two hundred eighty questionnaires were
      mailed and 252 were returned (response rate 90.0%) 165 respondents (65.5%)
      performed 3501 biopsies while 87 respondents (34.5%) did not practice liver
      biopsy; 67.7% of biopsies were executed blindly and 32.3% were guided. Eight
      nonfatal and three fatal complications occurred. Hemorrhage was the most frequent
      complication (five cases) and was responsible for all three fatal outcomes. The
      overall complication rate was 0.31%, being distinctly lower in the group of
      gastroenterologists (0.11%) as compared to the group of internists (0.55%; P =
      0.031). The complication rate was 1.68% in the group of internists performing
      fewer than 12 biopsies per year, while there was no complication in the group of
      internists performing more than 50 biopsies per year (P = 0.036). Complications
      were not related to the needle diameter or to the absence of ultrasonography
      before biopsy. In conclusion, this representative survey in Switzerland shows
      that the complication rate of liver biopsy is mainly related to the experience
      and training of the operator.

PMID- 8344105
TI  - Gender of donor influences outcome after orthotopic liver transplantation in
      adults.
AB  - Because male and female livers not only differ with respect to estrogen and
      androgen receptor content, but also demonstrate sexual dimorphism of certain
      functions, we examined the effect of donor gender on graft survival following
      liver transplantation (OLTx) in adults. Between February 1981 and February 1988,
      982 OLTx procedures were performed in 789 adult patients at the University of
      Pittsburgh. In this study, OLTx was categorized as a failure if the patient died
      or required retransplantation within 60 days of the surgery. When the donor
      recipient gender combinations were male-male, male-female, and female-female, the
      failure rates were 28%, 28%, and 36%, respectively. In contrast, 60% of female
      donor livers failed in male recipients. Compared to the pooled donor-recipient
      gender combinations, the odds of failure for female-male liver grafts were
      increased 3.7-fold (95% confidence interval: 6.5, 2.1; P < 0.001). These findings
      may result, at least in part, from alterations in the sex hormone milieu or
      changes in the graft estrogen or androgen receptor content.

PMID- 8344106
TI  - Effect of cyclosporine on liver regeneration after orthotopic reduced-size
      hepatic transplantation in the rat.
AB  - These experiments were undertaken to study the effects of cyclosporine A (CsA) on
      liver regeneration after an isogeneic orthotopic reduced-size hepatic
      transplantation (RSHT) in rats. Male Wistar rats were treated with or without a
      daily injection of CsA beginning 24 hr before surgery and were subjected to a 68%
      partial hepatectomy. A isogeneic orthotopic reduced-size hepatic transplantation
      was performed in recipient rats pretreated with or without CsA. A daily injection
      of CsA was continued until the recipient rats were sacrificed. Animals were
      sacrificed at various time points (12, 24, 36, 48, and 72 hr) postoperatively.
      The incorporation of bromodeoxyuridine (BrdU) into the DNA of the remnant
      hepatocytes was evaluated by immunohistochemical staining with a monoclonal
      antibody against BrdU. CsA (10 mg/kg/day) significantly augmented BrdU
      incorporation into hepatocytes after hepatectomy. The maximum labeling index (LI)
      was observed at 24 hr after hepatectomy. In contrast, the maximum LI in the
      recipient rats not receiving CsA was seen at 36 hr after RSHT, and 10 mg/kg/day
      of CsA decreased the LI at 36 hr after RSHT. A lower dose of CsA (3 mg/kg/day),
      however, significantly increased the LI in the recipient rats (P < 0.01), and it
      reached a peak at 24 hr after RSHT when compared to the transplant recipients not
      receiving CsA. The time course of the increase in the LI in the transplant
      recipient rats receiving 3 mg/kg/day of CsA was similar to that observed in the
      rats after hepatectomy. This dosage improved the delay in the reduced-size
      hepatic transplant LI reaching its peak.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8344107
TI  - Maternal malnutrition does not affect fetal hepatic glycogen synthase ontogeny.
AB  - Maternal malnutrition late in pregnancy results in the reduced storage of fetal
      hepatic glycogen in the final days of gestation and an accentuation of normal
      birth-related hypoglycemia. It was of interest to determine whether or not low
      glycogen levels resulted when maternal malnutrition disrupted the normal ontogeny
      of fetal hepatic glycogen synthase, an important glycogenic enzyme. A defect in
      this enzyme would be expected to seriously affect prenatal and postnatal glycogen
      synthesis. For this study, livers were removed from fetuses from malnourished
      (50% of normal dietary intake) mice, as well as from ad libitum-fed mice, and
      used for the determination of hepatic glycogen, glycogen synthase activity, and
      glycogen synthase protein levels. In this paper we report that maternal dietary
      restriction late in pregnancy produces growth-retarded fetuses with severely
      reduced hepatic glycogen levels, but the normal ontogenic changes in the quantity
      and activity of hepatic glycogen synthase were not affected. It is especially
      significant that the accumulation of glycogen synthase occurred despite the
      minimal level of natural substrate available for the enzyme. These results
      suggest that the accumulation and activity of hepatic glycogen synthase during
      late gestation is related to developmental events rather than levels of substrate
      or glycogen.

PMID- 8344108
TI  - Prophylactic versus emergency sclerotherapy of large esophageal varices prior to
      liver transplantation.
AB  - From January 1985 through July 1987, adult patients accepted for liver
      transplantation with large esophageal varices were enrolled in a study evaluating
      the use of prophylactic vs emergency sclerotherapy. Six hundred forty-eight
      subjects received prophylactic sclerotherapy, and 172 received emergent
      sclerotherapy. Esophageal stricture formation was increased 12.9-fold (P <
      0.001), esophageal perforation 6.4-fold (P < 0.005), and postsclerotherapy
      bleeding esophageal ulcers 3.7-fold (P < 0.001) in those receiving emergency
      sclerotherapy as opposed to prophylactic sclerotherapy. These differences were
      even greater if the number of sclerotherapy sessions rather than the number of
      patients was used as the denominator for the comparisons. In total, 19.6% of
      emergency sclerotherapy cases were associated with an untoward outcome of
      sclerotherapy; only 1.9% of cases receiving prophylactic sclerotherapy
      experienced an untoward outcome (P < 0.001). These data demonstrate that
      emergency sclerotherapy is associated with a greater prevalence of complications
      and support earlier studies that show that sclerotherapy prevents variceal
      bleeding over the short term. The data also suggest that when applied to patients
      with large varices awaiting orthotopic liver transplantation, it enhances the
      chance of a patient surviving to be transplanted by preventing a variceal bleed
      and the spiral of liver failure and death that frequently follows an episode of
      acute variceal bleeding.

PMID- 8344109
TI  - Abnormal progression of a liquid meal through the stomach and small intestine in
      patients with Chagas' disease.
AB  - This study describes the abnormal pattern of gastrointestinal progression of a
      liquid meal in patients with the digestive form of chronic Chagas' disease. This
      condition is known as a natural model of intramural denervation of the gut.
      Sixteen patients with clinical and radiographic evidence of esophageal and/or
      colonic involvement and 18 healthy volunteers were studied. Orocecal transit time
      after the ingestion of a 10% lactulose solution (180 ml) tagged with
      99mtechnetium was measured by a conventional H2 breath technique. Gastric
      emptying and the arrival of the front of the meal to regions of interest
      corresponding to proximal and distal areas of the small intestine were assessed
      by abdominal scintigraphy. Orocecal transit time was significantly greater (P <
      0.05) in Chagas' disease patients (N = 13) than in control subjects (N = 18)
      (mean +/- SD: 100.7 +/- 48.7 min vs 62.9 +/- 18.2 min). Half-time for gastric
      emptying of liquids in chagasic patients (N = 9) was significantly lower (P <
      0.01) than in controls (N = 7) (9.7 +/- 2.7 min vs 26.4 +/- 3.4 min). The time of
      arrival of the liquid meal to the proximal small intestine was also significantly
      shorter (P < 0.02) in patients than in controls (5.6 +/- 3.7 vs 11.4 +/- 5.5
      min), but there was no difference between the two groups concerning the time the
      meal first arrived to the distal small intestine (15.0 +/- 11.0 min vs 23.5 +/-
      11.4 min, P > 0.05). These results indicate that patients with Chagas' disease
      have a combination of exceedingly rapid gastric emptying and abnormally delayed
      transit of liquids through the more distal segments of the small bowel.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8344111
TI  - Anorectal dysfunction and delayed colonic transit in patients with progressive
      systemic sclerosis.
AB  - We studied 14 unselected patients with progressive systemic sclerosis (PSS), six
      with constipation, and eight with normal bowel habits. A control group, matched
      for age and sex, comprised six patients with idiopathic constipation and seven
      healthy subjects. Anorectal manometry was performed with perfused catheters and
      segmental colonic transit was measured by a radiopaque marker technique. The
      resting pressure of the anal canal was significantly reduced in PSS with
      constipation (P < 0.05). The rectoanal inhibitory reflex was detected in only one
      PSS patient with constipation, but was present in seven of eight PSS patients
      with normal bowel habits and in all controls (P < 0.01). Total and right colonic
      transit times were significantly delayed in PSS with constipation and in patients
      with idiopathic constipation (P < 0.05). In patients with PSS, colonic transit
      was delayed and anal sphincter function was impaired in constipated patients,
      suggesting involvement of both the colon and the anorectum by the disease.

PMID- 8344110
TI  - Electrogastrography in patients with gastroparesis and effect of long-term
      cisapride.
AB  - Abnormalities in the gastric pacemaker potentials occur in patients with impaired
      gastric emptying. It is unclear if treatment effects the underlying rhythm or if
      normalization of dysrhythmias is important. We examined the effect of cisapride
      using surface electrogastrograms and radionuclide gastric emptying studies of
      patients with idiopathic and diabetic gastroparesis. Twelve of 14 patients had
      abnormal baseline electrogastrograms. After six months of cisapride, four
      patients had normalization of their electrical activity and six had improvement.
      Patients with idiopathic gastroparesis had an increase in gastric emptying at 120
      min from 48.9 +/- 3.8% (baseline) to 70.9 +/- 6.0% (six months), P = 0.009.
      Patients with diabetes mellitus had a similar improvement. Patients who had
      normalization of the electrogastrogram had a greater gastric emptying rate than
      patients with continued dysrhythmias. Thus, dysrhythmias are important in the
      etiology for gastroparesis, but other factors need to be examined.

PMID- 8344112
TI  - Alterations in rat intestinal transit by morphine promote bacterial
      translocation.
AB  - Translocation of enteric microorganisms from the intestinal tract to
      extraintestinal sites has been proposed as an early step in the development of
      gram-negative sepsis. This study examined the role of altered bowel transit in
      influencing intestinal bacteriostasis and bacterial translocation using morphine
      as a pharmacologic inhibitor of such transit. In the first experiment, either
      normal saline (N = 8) or morphine sulfate (20 mg/kg; N = 8) was injected
      subcutaneously. Two hours later, morphine (7.5 mg/kg) was infused subcutaneously
      for an additional 22 hr; control animals received saline alone. After completion
      of this regimen, a volume of 0.2 ml of 2.5 mM FITC dextrans (10,000 daltons) were
      injected intraduodenally in each group. The bowel was removed 25 min later,
      divided into 5-cm segments, and the content of dextrans measured. Small bowel
      propulsion was expressed as the geometric center of the distribution of dextrans
      throughout the intestine (in percentage length of small bowel). Gut propulsion
      was significantly reduced after morphine treatment as compared to controls (32.8
      +/- 8.2% vs. 55.8 +/- 4.0%; P < 0.01). In 16 additional rats, saline or morphine
      was again administered as described. After 24 hr, samples were obtained from the
      mesenteric lymph node (MLN) complex, blood, spleen, liver, duodenum, jejunum,
      ileum, and cecum for standard bacteriology. The bacterial counts increased
      significantly in each intestinal segment following morphine treatment.
      Microorganisms translocated to the MLN complex in 5, and to distant sites in four
      of eight morphine-treated animals, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8344113
TI  - Lithocholate-3-O-glucuronide-induced cholestasis. A study with congenital
      hyperbilirubinemic rats and effects of ursodeoxycholate conjugates.
AB  - The mechanism of lithocholate-3-O-glucuronide-induced cholestasis is unknown. In
      this study, we investigated the cholestatic effects of this agent in a congenital
      hyperbilirubinemic rat, EHBR. We also studied the effects of ursodeoxycholate-3-O
      glucuronide and tauroursodeoxycholate on lithocholate-3-O-glucuronide-induced
      cholestasis in rats. Lithocholate-3-O-glucuronide, administered at the rate of
      0.1 mumol/min/100 g for 40 min, a cholestatic dose in control rats, failed to
      cause cholestasis in EHBR, and biliary lithocholate-3-O-glucuronide excretion was
      delayed. Biliary concentrations of this agent did not correlate with the severity
      of cholestasis. Both tauroursodeoxycholate and ursodeoxycholate-3-O-glucuronide,
      infused at the rate of 0.2 mumol/min/100 g for 120 min, completely inhibited
      cholestasis induced by lithocholate-3-O-glucuronide administered at the rate of
      0.1 mumol/min/100 g for 40 min. Only tauroursodeoxycholate enhanced biliary
      lithocholate-3-O-glucuronide excretion. These findings indicate that lithocholate
      3-O-glucuronide-induced cholestasis is induced by damage at the level of the bile
      canalicular membrane. Ursodeoxycholate-3-O-glucuronide inhibits this cholestasis,
      possibly by inhibiting the access of lithocholate-3-O-glucuronide to the bile
      canalicular membrane.

PMID- 8344114
TI  - Protein-losing enteropathy caused by mesenteric vascular involvement of
      neurofibromatosis.
AB  - A 44-year-old man with neurofibromatosis suffered from severe diarrhea and
      progressive hypoproteinemia. Enteric protein loss was confirmed by an alpha 1
      antitrypsin clearance test. An x-ray study showed irregular mucosa in the distal
      segment of the ileum. Protein loss has subsided after ileocecal resection.
      Laparotomy and radiological examinations failed to demonstrate neurofibroma or
      other tumors in the abdomen. The resected ileum revealed marked edema of the wall
      and a pseudomembranous enteritis-like appearance in the luminal surface.
      Microscopically, lymphatic vessels in the intestinal wall were dilated. Marked
      thickening of the intima with spindle cell proliferation was observed in the
      mesenteric arteries and veins. This finding is consistent with vascular changes
      in neurofibromatosis. These vascular changes in the mesentery due to
      neurofibromatosis may cause protein-losing enteropathy by altering the
      hemodynamic state and microvascular permeability in the intestine.

PMID- 8344115
TI  - Ganglioneuroma of the duodenum. Report of a case and literature review.
AB  - A 43-year-old male presented with upper gastro-intestinal bleeding. A polypoid
      tumor mass in the second part of the duodenum was found by endoscopic
      examination. Pathology revealed an extremely rare case of ganglioneuroma. The
      surgical local resection of the tumor was a sufficient procedure because of a
      lack of malignant potential. This is the fourth case since the first case was
      reported by Dahl et al in 1957 (1). We review the literature concerning duodenal
      paragangliomas, and discuss the histogenesis.

PMID- 8344117
TI  - Achalasia due to eosinophil infiltration: fact or fiction?

PMID- 8344116
TI  - Treatment of Crohn's disease recurrence after ileoanal anastomosis by
      azathioprine.
AB  - Ileoanal anastomosis is a surgical procedure performed in patients with
      ulcerative colitis. In a small number of patients operated on for ulcerative
      colitis, Crohn's disease occurs in the reservoir, mimicking pouchitis, and may
      lead to pouch excision and to a permanent terminal ileostomy. Two patients with
      recurrent Crohn's disease in the reservoir after ileoanal anastomosis were
      treated with azathioprine for 18 and 24 months, respectively. Azathioprine
      induced a complete clinical and endoscopic remission. These two observations
      suggested that immunosuppressive drugs were a good option for permanent ileostomy
      in cases of recurrence of Crohn's disease in the reservoir after ileoanal
      anastomosis.

PMID- 8344118
TI  - Gallbladder and cisapride.

PMID- 8344119
TI  - "Passive" gastric mucosal congestion in patients with gastropathy.

PMID- 8344120
TI  - Genetic factors of importance for beta-cell proliferation.

PMID- 8344122
TI  - The kidney disease of diabetes mellitus (KDDM): a cell and molecular biology
      approach.

PMID- 8344121
TI  - Intensified insulin therapy.

PMID- 8344123
TI  - Methodologies used in the study of the microcirculation in diabetes mellitus.

PMID- 8344124
TI  - Inhibitory effect of amiloride on glucose transport in isolated rat adipocytes.
AB  - The effect of amiloride on 3-O-methylglucose (3-O-MG) uptake was studied in
      isolated rat adipocytes to define to what extent amiloride inhibited the process
      of insulin action or glucose transport. Amiloride (1 mM), which did not change
      the intracellular water space of adipocytes, inhibited by 43.3% the insulin
      stimulated uptake of 3-O-MG, while it did not appear to inhibit the basal uptake.
      To distinguish the inhibitory effect on glucose transport activity from that on
      the process of insulin action, the effect of amiloride was evaluated in the
      transport system using adipocytes deprived of ATP, in which glucose transporters
      were considered immobile. Amiloride (1 mM) inhibited this transport by 32.8% in
      an insulin-stimulated state, which was obtained using adipocytes that had been
      treated with 20 nM insulin and exposed to 2 mM KCN, whereas it did not inhibit
      the transport system at the basal state. In the inhibitory effect, 76% was thus
      attributable to the inhibition of glucose transport activity recruited by insulin
      and 24% to the inhibition of the action of 20 nM insulin itself. These results
      indicate that amiloride can not be used as a specific inhibitor of the insulin
      action itself.

PMID- 8344125
TI  - Apolipoprotein E polymorphism affects the response to pravastatin on plasma
      apolipoproteins in diabetic patients.
AB  - In the present study, we examined the levels of plasma lipids and apolipoproteins
      in patients with non-insulin dependent diabetes mellitus (NIDDM) with
      hypercholesterolemia in different apolipoprotein E (apo E) phenotypes. We also
      examined the influences of apo E polymorphism on the response to pravastatin. The
      patients were divided into three groups, E4/E3, E3/E3, and E3/E2. There were no
      differences in the baseline levels of plasma lipids and apolipoproteins, except
      that the level of triglycerides in E3/E2 heterozygotes was significantly higher
      than E3/E3 homozygotes. Three months of pravastatin administration significantly
      reduced plasma levels of total cholesterol and low-density lipoprotein
      cholesterol in each group to the same degree. We observed a significant reduction
      of apo B both in the E4/E3 and E3/E3 groups and apo E in the E3/E3 group. Such
      reduction was not observed in the E3/E2 group. We conclude that pravastatin is a
      potent drug to correct lipid abnormalities, particularly in NIDDM patients with
      apo E4/E3 and E3/E3. In the E3/E2 group, its effectiveness may be diminished.

PMID- 8344126
TI  - Production of anti-cardiolipin antibody in AKR/J mice with streptozocin-induced
      insulitis and diabetes.
AB  - We herein report that anti-cardiolipin antibodies (ACA) were detected in AKR/J
      mice treated with multiple low doses of streptozocin (STZ)-induced insulitis and
      diabetes. Daily intraperitoneal (i.p.) injections of 40 mg/kg body wt. of STZ for
      five consecutive days in the AKR/J mice resulted in hyperglycemia and mononuclear
      cell infiltrations of islets (insulitis). ACA appeared on day 14, when
      hyperglycemia began to occur, at a rate of 13.3% (4/30). The rate increased to
      83.3% (25/30) on day 21, when diabetes developed, and then fell to 10% (3/30) on
      day 28. Neither the diabetic AKR/J mice treated with a single high dose of STZ
      (200 mg/kg body wt.) nor the non-diabetic insulitis free Balb/c mice and
      B10.S(9R) mice treated with multiple low doses of STZ (40 mg/kg body wt.)
      produced ACA. The IgG subclass of the ACA belonged mainly to IgG2a. These
      findings suggest that ACA are produced in association with the development of
      insulitis, but not induced by either hyperglycemia or STZ.

PMID- 8344127
TI  - Effects of a short prednisone regime at clinical onset of type 1 diabetes.
AB  - The effect of corticosteroids on beta cell function and humoral immune response
      in type 1 diabetes was tested in a 2-month trial conducted on 32 newly diagnosed
      patients (age 22.8 +/- 1.4 years, mean +/- S.E.M.). Prednisone was administered
      at immunosuppressive dosage (1 mg.kg-1.day-1) during the initial 10 days and at a
      maintenance dosage (0.3 mg.kg-1.day-1) for 50 days. Patients (n = 32) were
      enrolled within 6 weeks after diagnosis and matched in pairs for age, sex,
      presence of islet cell antibodies (ICA) and glucagon stimulated C-peptide levels.
      Insulin discontinuation was not contemplated. All the patients who received
      prednisone became ICA during treatment but in some (4 out of 10) this effect was
      only transient. Insulin antibodies (IA) were significantly lower in the
      prednisone group at second and third month (P < 0.05). No patient experienced
      complete remission but in 10 prednisone and 4 control patients the insulin
      requirements were below 0.3 IU/kg (P < 0.05). With similar glycemia the fasting C
      peptide levels were higher in the treated patients. The profile of the insulin
      requirements during the follow-up was different in the two groups and at 9 months
      the prednisone group needed less insulin than the control (P < 0.05).
      Interestingly, within the prednisone-treated group and after 6 months, the levels
      of stimulated C-peptide improved significantly among the ICA+ patients while they
      were steady or declined in ICA- (P < 0.01). The analysis of variance covariance
      confirmed a positive interaction between ICA and the administration of prednisone
      on the outcome of beta cell function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8344128
TI  - Clinical usefulness of a non-wiping type glucose meter in diabetic patients.
AB  - A non-wiping type glucose meter using electrochemistry was developed. The glucose
      sensor strip has a sophisticated micro-structure for aspirating blood
      automatically. The meter compensates for drift of sensor output due to
      temperature change of the atmosphere. Mounting blood on the sensing site and
      wiping blood and precise time are no longer required. Range of measurement is 40
      500 mg/dl. Reading of the meter for standard solutions of 90 or 360 mg/dl glucose
      showed negligible drift of measurement from 10.5 degrees C to 38.5 degrees C. The
      correlation between plasma glucose concentrations as determined by the meter and
      that by a Glucose Analyzer 2 was 0.995 with a slope of 1.00 and intercept of 
      0.65 (n = 48). In the case of blood glucose concentration (Y), the values were Y
      = 1.06X-0.91, r = 0.987, n = 62. This meter is quite easy to use and is highly
      accurate for glucose monitoring in patients regardless of operation skill. It
      should thus be readily applicable to diabetic patients.

PMID- 8344129
TI  - Erythrocyte sorbitol dehydrogenase activity in diabetic patients.
AB  - An increased polyol-pathway activity is implicated in the pathogenesis of some
      diabetic complications. Little is known about the sorbitol-dehydrogenase (SDH)
      activity in diabetic patients, although cataract is described in diabetes as well
      as in SDH deficiency. Therefore, we studied SDH activity and the relation with
      complications and with sorbitol accumulation in erythrocytes from 96 type 1
      diabetics and 29 age- and sex-matched healthy subjects. When comparing these
      groups erythrocyte sorbitol (ERY-SOR) was significantly (P < 0.001) increased in
      the diabetic patients, but no difference in SDH could be demonstrated. In the
      diabetic patients ERY-SOR was predominantly related to the glycaemia (r = 0.37; P
      < 0.001). The SDH activity correlated with HbA1 (r = 0.20; P < 0.03). In diabetic
      patients with severe nephropathy the ERY-SOR value is no longer different from
      the control value. It was concluded that, in poor metabolic control the SDH
      activity is increased, which counteracts but does not prevent the sorbitol
      accumulation nor the genesis of complications. In patients with macroalbuminuria
      the ERY-SOR decreases to the normal range. Since SDH activity is similar in type
      1 diabetics and controls the decreased ERY-SOR in this complication might be due
      to other metabolic pathways.

PMID- 8344130
TI  - Insulin resistance in the regulation of lipolysis and ketone body metabolism in
      non-insulin dependent diabetes is apparent at very low insulin concentrations.
AB  - The insulin sensitivity of intermediary metabolism was studied in 8 non-obese men
      with well-controlled diet-treated non-insulin dependent diabetes (NIDDM) using a
      low dose incremental insulin infusion (basal, 0.005 and 0.01 U/kg h-1). Results
      were compared to 8 healthy male control subjects matched (NIDDM vs. controls,
      mean +/- S.E.M.) for age (56 +/- 3 vs. 54 +/- 3 years, NS) and body mass index
      (24.6 +/- 0.7 vs. 25.3 +/- 0.5 kg/m2, NS). Basal fasting concentrations of
      insulin (4.7 +/- 0.8 vs. 3.2 +/- 0.8 mU/l, NS), glucose, total ketone bodies
      (TKB), and non-esterified fatty acids (NEFA) were not significantly different
      between the groups but glycerol concentrations were significantly elevated in
      NIDDM patients (0.072 +/- 0.007 vs. 0.049 +/- 0.003 mmol/l, P < 0.05). During
      incremental insulin infusion, plasma insulin concentrations rose to 12.8 +/- 1.5
      vs. 10.0 +/- 1.0 mU/l in NIDDM patients vs. control and metabolite concentrations
      fell significantly (P < 0.001). Significant linear dose-response relationships
      were found between plasma insulin (log) and glucose, TKB (log), NEFA, and
      glycerol concentrations by analysis of variance applied to regression (all P <
      0.001). For glucose and TKB (log), the group regression lines were parallel but
      were significantly right-shifted in the NIDDM group (P < 0.001). In contrast, the
      relationships of insulin (log) and both glycerol and NEFA concentrations
      converged over the observed range of insulin concentrations. Significant
      displacement of glycerol and NEFA dose-response relationships were found in NIDDM
      patients at an insulin concentration of 5 mU/l (P < 0.001) but not at 12.5
      mU/l.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8344131
TI  - Higher serum insulin level due to greater total body fat mass in offspring of
      patients with essential hypertension.
AB  - To determine whether the offspring of hypertensive patients (OHP) might have a
      higher serum insulin level than offspring of normotensive parents, we studied 152
      girls in junior high school, 21 of whom had at least one hypertensive parent. The
      remaining 131 girls had normotensive parents and served as the controls. After an
      overnight fast, we measured the subjects' height, body weight, blood pressure and
      body fat mass, and collected blood for assay of serum immunoreactive insulin
      (IRI), lipids and apolipoproteins. Despite a similar body mass index, the OHP had
      a significantly greater body fat mass (P < 0.05) and % fat mass (P < 0.05) than
      the controls. The OHP exhibited a significantly higher serum IRI level than the
      controls (P < 0.05), but no differences in blood pressure or serum lipids. In the
      OHP, % body fat mass was significantly correlated with systolic blood pressure (P
      < 0.05), triglyceride (P < 0.01) and apolipoprotein B (P < 0.01), not observed in
      controls. The serum IRI of the OHP, but not that of controls, was significantly
      correlated with systolic blood pressure (P < 0.05), serum triglyceride (P < 0.02)
      and apolipoprotein B (P < 0.05). Thus, a higher serum IRI level due to an
      increase in total body fat mass appears to be an inherited trait that contributes
      to the development of hypertension and dyslipidemia.

PMID- 8344132
TI  - Multiple insulin injection therapy using an insulin pen--who benefits? A clinical
      3-year follow-up study of 100 type 1 and 51 type 2 diabetic patients.
AB  - The present study was undertaken with the aim of evaluating the effect of
      multiple insulin injection therapy with an insulin pen in a large population of
      type 1 and type 2 diabetes patients and to investigate which factors predict a
      favorable response to the therapy change. We included 100 type 1 and 51 type 2
      patients with a minimum diabetes duration of 1 year who were followed for at
      least 3 years after changing from conventional insulin regimens to multiple
      insulin injection therapy with the pen. Both type 1 and type 2 patients were
      significantly improved with respect to metabolic control at 3 months. After 1
      year type 1 patients were no longer significantly improved compared to baseline.
      In type 2 patients a significant improvement was sustained for a longer period
      but at 3 years HbA1c had reverted towards the baseline level. Both type 1 and
      type 2 patients experienced a significant increase in body weight. Baseline
      metabolic control was strongly and inversely related to subsequent decline in
      HbA1c in both type 1 and type 2 patients. Those with initial poor control had a
      sustained improvement throughout follow-up, whereas those with initial very good
      control deteriorated significantly. No sustained change was noted in those in
      intermediate control. In addition, in type 1 patients a high body mass index at
      baseline was a weak negative predictor for improvement. In type 2 patients a
      longer duration of diabetes was a favorable factor. Both type 1 and 2 patients in
      poor control may be expected to benefit from multiple injection therapy.

PMID- 8344133
TI  - A microsatellite polymorphism in the human insulin receptor gene: a highly
      informative marker for linkage analysis.
AB  - To study genetic susceptibility to non-insulin dependent diabetes mellitus
      (NIDDM), association of insulin receptor gene, a candidate gene for NIDDM, with
      NIDDM was studied. A microsatellite polymorphism located in intron 2 of the human
      insulin receptor gene was detected by the polymerase chain reaction and used as a
      genetic marker. Eight different alleles were observed, indicating highly
      polymorphic nature of this marker. Although no association of this marker with
      NIDDM was observed in Japanese subjects, this marker will be useful for linkage
      studies of insulin receptor gene and genes located close to this gene on
      chromosome 19.

PMID- 8344134
TI  - Diabetes mellitus and hypertension based on the family history and 2-h
      postprandial blood sugar in the Ann-Lo district (northern Taiwan).
AB  - From July 1988 to June 1990, we performed an epidemiological study on the
      prevalence of hypertension and diabetes mellitus (DM) in the Ann-Lo district, a
      suburban area of Northern Taiwan. One third of the population in the district was
      randomly sampled. A total of 9087 persons were screened with 67.4% participating.
      Following completion of the questionnaire blood pressure, 2 h postprandial blood
      sugar were determined. DM was defined when the blood sugar was over 200 mg/dl or
      the subject had a diabetic history. Hypertension was defined if the systolic
      blood pressure was over 160 mmHg or the diastolic blood pressure over 95 mmHg.
      Statistical comparisons were performed with a chi-square test, analysis of
      covariance, stepwise multiple regression and Pearson correlation matrix. In this
      study, the prevalence rate of DM was 2.6% and of hypertension was 6.4%. For those
      patients 40 years or older, the prevalence rate for DM was 8.0% and for
      hypertension was 19.7%. The prevalence of hypertension was 24.8% in overt
      diabetes and 5.2% in the normal subjects. Analysis of the data between risk
      factors of DM revealed that DM correlated with age, body mass index,
      hypertension, smoking, family history of DM and correlated negatively with
      education. Hypertension correlated with gender, alcohol intake and smoking, sugar
      level, age and body mass index. The prevalence rate of diabetes and hypertension
      were quite high in the district and this study pointed out the important risk
      factors for hypertension and DM in Taiwan.

PMID- 8344136
TI  - Drug costs and treatment choices: a DTB symposium.

PMID- 8344135
TI  - Radioiodine for the treatment of thyroid disease.

PMID- 8344137
TI  - DTB position on drug costs.

PMID- 8344138
TI  - Angioplasty in the management of coronary artery disease.

PMID- 8344139
TI  - Flosequinan for chronic heart failure?

PMID- 8344140
TI  - Adenosine for acute cardiac arrhythmias.

PMID- 8344142
TI  - Benzodiazepine dependence--a helpful new report.

PMID- 8344141
TI  - Azelaic acid--a new topical treatment for acne.

PMID- 8344143
TI  - Managing high blood pressure in pregnancy.

PMID- 8344144
TI  - Mifepristone/gemeprost to abort early pregnancy.

PMID- 8344146
TI  - Typhoid vaccines--which one to choose?

PMID- 8344145
TI  - Hypoglycaemia and human insulin.

PMID- 8344147
TI  - Drugs affecting 5-hydroxytryptamine function.

PMID- 8344148
TI  - Hormonal emergency contraception.

PMID- 8344149
TI  - Getting to see your GP.

PMID- 8344150
TI  - [Environmental protection in the hospital as a task for nursing administration].

PMID- 8344152
TI  - [Possibilities and limitations of the organization of environmental protection in
      the hospital].

PMID- 8344151
TI  - [The treat to the female gender by environmental poisons].

PMID- 8344153
TI  - [Analysis of ecological weaknesses as a starting point for environmentally
      oriented hospital management].

PMID- 8344154
TI  - [Economic value of nursing equipment].

PMID- 8344155
TI  - [Tasks and methods of disposable equipment commissions].

PMID- 8344156
TI  - [Effective and environment-friendly methods of disinfection in surgery].

PMID- 8344157
TI  - [The reduction of hospital waste from the producer's viewpoint].

PMID- 8344158
TI  - [The Bavarian work group "Environmental Protection in the Hospital"].

PMID- 8344160
TI  - [The packaging legislation. For the application of packaging legislation in
      health related institutions].

PMID- 8344161
TI  - [Violation of confidentiality by the use of telefax devices].

PMID- 8344159
TI  - [Cotton diapers versus disposable diapers].

PMID- 8344162
TI  - [Producing a testament in the hospital].

PMID- 8344163
TI  - [Nursing personnel regulation--not just a request for personnel?].

PMID- 8344165
TI  - [Hygienic hand disinfection].

PMID- 8344164
TI  - [Pathways of infection in instrumental urinary diversion. The permeation by
      microorganisms of the balloon of Foley catheters].

PMID- 8344166
TI  - [Report of experiences of members of the work group "Nursing Research" at the
      Bamberg hospital].

PMID- 8344167
TI  - [Primary hyperreninemia. An unusual cause of secondary arterial hypertension].
AB  - In 1975, scintigraphy revealed a 6.5 x 5 cm tumour in the region of the left
      adrenal in a 36-year-old man with known hypertension for 5 years (systolic
      pressure up to 250 mm Hg, diastolic up to 130 mm Hg). A laparotomy was performed
      for a suspected phaeochromocytoma. A tumour was located in the upper pole of the
      kidney and removed together with the kidney. The blood pressure quickly returned
      to normal after the operation: it remained stable for the following 17 years
      (between 130/80 to 150/90 mm Hg). Originally the tumour could not be clearly
      classified either clinically or histologically. But recently the paraffin
      imbedded tumour specimen was re-examined by immunohistochemistry and in-situ
      hybridization. This identified a renin-producing tumour so that primary reninism
      was the cause of the arterial hypertension.

PMID- 8344168
TI  - [Granulocytic functional disorders: forms and diagnosis].

PMID- 8344169
TI  - [Opinion of the Federal Constitutional Court on abortion].

PMID- 8344170
TI  - [Coagulation parameters in high-dosage intravenous heparin therapy].

PMID- 8344171
TI  - [Hyposensitization treatment].

PMID- 8344172
TI  - [Prevention of early-summer meningoencephalitis].

PMID- 8344173
TI  - [Halofantrine in the treatment of imported malaria in non-immune travelers].

PMID- 8344174
TI  - [Contrast medium colonoscopy].

PMID- 8344175
TI  - [Juxtapapillary duodenal diverticulum].

PMID- 8344176
TI  - [Penicillin-resistant pneumococci].

PMID- 8344177
TI  - Acute suppurative otitis media.

PMID- 8344178
TI  - Severe laryngitis and Reinke's edema.

PMID- 8344179
TI  - Endoscopic view of sphenoid sinus cavity.

PMID- 8344180
TI  - The objective assessment of nasal patency.

PMID- 8344181
TI  - Antrochoanal polyposis: a review of 33 cases.
AB  - We report on a series of 33 consecutive cases of antrochoanal polyp (ACP) treated
      by endoscopic sinus surgery over a five-year period. All but one patient was
      treated by endoscopic sinus surgery alone. This method of treatment was quite
      effective for ACPs. These 33 patients represent 22.3% of all nasal polyp patients
      on whom we operated during the same period. This incidence of ACP is greater than
      that generally reported in the literature. Some authors have attempted to
      distinguish ACPs from common nasal polyps primarily on the basis of morphology,
      histology, and the clinical behavior of the ACPs. In our series, a multivariate
      analysis, including histopathologic correlation, did not support the notion that
      ACPs are clearly distinct from common nasal polyps. Some interesting differences
      between the polyp groups did, however, become evident in our data analysis.
      Generally, ACPs are not thought to be associated with allergic disease; however,
      in our series we found the association of allergic disease with ACPs to be
      statistically significant (Chi-square = 4.575, p < .05).

PMID- 8344182
TI  - Symptom relief after endoscopic sinus surgery: an outcomes-based study.
AB  - Previous studies of patients outcomes after sinus surgery have generally
      described only a summary measure of overall change in symptoms or health status.
      This paper describes an outcomes-based longitudinal study of sinus symptom
      prevalence among thirty-one patients treated with endoscopic surgery for chronic
      sinusitis. Patients completed structured data collection forms to quantify the
      prevalence of commonly experienced sinus-related symptoms during an eight-week
      period both before surgery and six months after undergoing sinus surgery.
      Significant decreases in nasal symptom prevalence (post-surgery versus pre
      surgery) were noted for headaches, nasal drainage, nasal congestion, sinus
      infection, and breathing difficulties. In addition, the proportion of subjects
      who rated their current health as "better" compared to one year previously
      increased from 27% pre-surgery to 58% six months after sinus surgery. These
      findings aid in quantifying the magnitude of improvement experienced by sinus
      surgery patients and provide further evidence that endoscopic sinus surgery
      represents an effective treatment for chronic sinusitis.

PMID- 8344183
TI  - Physician office laboratories and federal regulation with special attention to
      allergy testing.

PMID- 8344184
TI  - Allergic rhinosinusitis: the total rhinologic disease.

PMID- 8344185
TI  - Atopic keratoconjunctivitis (AKC).

PMID- 8344186
TI  - Are we facing the end of the antibiotic era?

PMID- 8344187
TI  - Estradiol acts via the estrogen receptor in the sexual differentiation of the rat
      brain, but what does this complex do?

PMID- 8344188
TI  - Enduring consequences of neonatal treatment with antisense oligodeoxynucleotides
      to estrogen receptor messenger ribonucleic acid on sexual differentiation of rat
      brain.
AB  - Sexual differentiation of the mammalian brain is regulated by steroids during a
      critical developmental period, particularly by estradiol, which is believed to be
      aromatized in brain from gonadally derived testosterone. To ascertain the
      importance of neuronal estrogen receptor expression during sexual
      differentiation, we infused a 15-mer oligodeoxynucleotide antisense to the region
      of the translation start codon of estrogen receptor messenger RNA (mRNA), into
      the hypothalamus of 3-day-old rat pups. Two separate control treatments consisted
      of either a scrambled nucleotide sequence oligodeoxynucleotide, which had little
      homology to known mRNAs, or vehicle. Female pups either received a lightly
      androgenizing dose of testosterone 6 h after oligo infusion or were not hormone
      treated. Infusion of antisense oligo to estrogen receptor mRNA protected against
      many of the androgenizing effects of testosterone. Androgenized females infused
      with antisense oligo were significantly more likely to exhibit female sexual
      behavior in adulthood after treatment with estrogen plus progesterone and
      remained sensitive to the induction of wheel-running behavior by estrogen
      treatment seen in normal females, whereas the control androgenized females did
      not. Normal females did not exhibit any effects of antisense oligo treatment on
      sexual or locomotor behavior, but antisense oligo-treated normal females showed a
      trend (P = 0.09) toward disrupted estrous cyclicity and behaved differently in
      tests of open field behavior compared to controls. After killing, brains were
      processed for histology. Morphometric analysis of the sexually dimorphic nucleus
      of the preoptic area demonstrated a significantly smaller volume in antisense
      oligo-infused androgenized females compared with vehicle and scrambled oligo
      infused controls. The sexually dimorphic nucleus volume was smaller still in
      normal females infused with antisense oligo, consistent with estrogen receptor
      activation playing an active role in sexual differentiation of the female brain.
      These results demonstrate the effectiveness of antisense oligodeoxynucleotides in
      permanently altering a developmental process if administered during a critical
      period.

PMID- 8344189
TI  - Characterization of mannose 6-phosphate receptors (MPRs) from opossum liver:
      opossum cation-independent MPR binds insulin-like growth factor-II.
AB  - Bovine, human, and rat cation-independent mannose 6-phosphate receptors (CI-MPRs)
      are capable of binding both mannose 6-phosphate and insulin-like growth factor-II
      (IGF-II). However, the receptor isolated from either chicken or frog lacks the
      high affinity IGF-II-binding site. To determine whether CI-MPRs isolated from a
      species that is closely related to placental mammals can bind IGF-II, the MPRs
      were purified from a marsupial, the American opossum (Didelphis virginiana), by
      phosphomannan-Sepharose affinity chromatography and then tested for their ability
      to bind IGF-II. Opossum liver expressed both the CI-MPR and the cation-dependent
      MPR (CD-MPR). Both receptors contained Asn-linked oligosaccharides. In contrast
      to CD-MPRs isolated from other species, the opossum CD-MPR displayed
      heterogeneity with respect to the number of Asn-linked oligosaccharide chains it
      contains. The CI-MPR isolated from opossum liver, like the CI-MPR from bovine
      liver, bound iodinated human recombinant IGF-II. However, Scatchard analysis
      revealed that the opossum CI-MPR bound IGF-II with a lower affinity (Kd = 14.5
      nM) than the bovine receptor (Kd = 0.2 nM). The addition of excess IGF-II, but
      not IGF-I or insulin, inhibited binding to [125I]IGF-II, indicating that the
      opossum CI-MPR exhibits specificity for IGF-II. These results suggest that the
      emergence of a high affinity IGF-II-binding site in the CI-MPR occurred in
      evolution before the divergence of marsupials and placental mammals from their
      last common ancestor.

PMID- 8344190
TI  - Androgen induction of steroid 5 alpha-reductase may be mediated via insulin-like
      growth factor-I.
AB  - The action of added insulin-like growth factor-I (IGF-I) and dihydrotestosterone
      (DHT) on steroid 5 alpha-reductase (5 alpha R) activity was studied using primary
      cultures of rat or human scrotal skin fibroblasts. Agents were added to cultured
      cells (2 x 10(5) cells) for 2 days, and enzyme activity was measured by the
      percent conversion of [3H] testosterone to DHT over a 4-h period in the absence
      of fetal calf serum or other growth factors. DHT, but not testosterone, at 10(-7)
      M significantly increased 5 alpha R activity (rat, 1.5 +/- 0.3% to 3.0 +/- 0.4%;
      human, 7.6 +/- 1.7% to 11.4 +/- 2.9%; P < 0.01). IGF-I (10(-9)-6.4 x 10(-9) M),
      but not IGF-II (10(-9)-10(-8) M) or insulin (10(-9)-10(-7) M), increased enzyme
      activity in a dose-related fashion [i.e. 1.5 +/- 0.5 to 10 +/- 2 in rat and 6.0
      +/- 1.1 to 9.8 +/- 1.6% (P < 0.01) in human cells]. No change in cell numbers was
      observed in any experiment. Since the effect of IGF-I was about 100 times that of
      androgen, we studied the possibility that androgen induction of the enzyme
      activity could be via IGF-I production. Addition of a monoclonal antibody against
      IGF-I significantly reduced the effect of DHT, and simultaneous addition of a
      specific IGF-I receptor antibody blocked the expected induction of 5 alpha R
      activity (control, 4.9 +/- 0.5; DHT, 8.0 +/- 1.9; DHT plus IGF-I receptor
      antibody, 3.7 +/- 0.4%). No effect on 3 alpha-reduction of [3H]DHT to 3 alpha
      androstanediol was detected in separate experiments. These studies indicate that
      IGF-I may be an important regulator of skin 5 alpha R activity and, thus, may
      influence DHT formation. The previously known androgen induction of this
      peripheral steroidogenic enzyme may be via paracrine/autocrine production of an
      IGF-I-type growth factor.

PMID- 8344191
TI  - Maternal adrenalectomy alters the immune and endocrine functions of fetal alcohol
      exposed male offspring.
AB  - Exposure to ethanol in utero compromises the offspring's developing immune and
      endocrine systems. Persistent functional changes, particularly in T-cell
      dependent aspects of immunity and in hypothalamic-pituitary-adrenal activity, are
      commonly seen. The present study examined the degree to which fetal alcohol
      exposure (FAE) during development suppressed the lymphocyte proliferative
      response to Concanavalin-A (Con A). We also examined the effect of maternal
      adrenalectomy on the expression of glucocorticoid-regulated genes and the
      response to Con A in FAE offspring. Con A-stimulated lymphocyte proliferation was
      stably suppressed (between 28-46%) in FAE males compared to isocalorically pair
      fed offspring at 7, 21, 40, and 60 days of age. In contrast, lymphocyte
      proliferation in the immature or peripubertal FAE female was totally unaffected.
      In 60-day- old male rats, maternal adrenalectomy reversed the FAE-induced
      suppression of Con A-stimulated proliferation, but had no effect on lymphocyte
      proliferation. FAE increased anterior pituitary POMC (the precursor of ACTH) mRNA
      levels dramatically in males, and this increase was also reversed by maternal
      adrenalectomy. In both sexes, anterior pituitary glucocorticoid receptor mRNA
      levels were unaffected by prenatal alcohol exposure alone, but were significantly
      decreased in male and increased in female offspring of adrenalectomized dams
      ingesting alcohol. Furthermore, in male, but not female, offspring, hypothalamic
      levels of glucocorticoid receptor and CRF mRNA were increased significantly by
      FAE alone or in combination with maternal adrenalectomy. In female, but not male,
      offspring, maternal adrenalectomy with concomitant alcohol exposure increased
      anterior pituitary POMC mRNA levels compared to that in sham/pair-fed offspring.
      In summary, FAE induced a gender-specific impairment of Con A-stimulated
      lymphocyte proliferation. This deficit is present both before and after puberty,
      demonstrating its stability into adulthood. Furthermore, in males, maternal
      adrenalectomy reversed these FAE-induced deficits in T-cell function as well as
      the effect of FAE on anterior pituitary POMC expression. This supports the
      hypothesis that maternal adrenal hormones participate in the immunosuppressive
      "imprinting" of the FAE fetus and are, therefore, causally implicated in the
      sexually dimorphic T-cell dysfunction found in FAE offspring.

PMID- 8344192
TI  - Parastatin (porcine chromogranin A347-419), a novel chromogranin A-derived
      peptide, inhibits parathyroid cell secretion.
AB  - Chromogranin A (CgA), previously referred to as secretory protein-I, is a 50
      kilodalton protein present in secretory granules of many endocrine and
      neuroendocrine cells. In the parathyroid it is present and cosecreted with PTH in
      response to hypocalcemia. CgA appears to be a precursor of bioactive peptides
      including pancreastatin, beta-granin, vasostatin, and chromostatin. The presence
      of several highly conserved pairs of basic amino acids, putative cleavage sites,
      in the CgA molecule suggests that other yet unidentified bioactive peptides might
      exist within the molecule. We tested this speculation by subjecting porcine
      parathyroid CgA to digestion by endoproteinase Lys-C. Resulting CgA-derived
      peptides were isolated by reverse-phase C18 HPLC and tested for their ability to
      affect low-Ca2+ stimulated secretion by porcine parathyroid cells. We
      characterized one peptide, which we named parastatin, that inhibited secretion of
      both PTH and CgA in a dose-dependent fashion over the range of 0.2-0.6 microM.
      Parastatin migrated as a single band on sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis with an apparent mol wt of 11,000. Edman degradation yielded the
      sequence L-S-F-R-A-P-A-Y-G-F-R-G-P-G-L corresponding to residues 347-361 of
      porcine CgA. Amino acid analysis of endoproteinase Lys-C and endoproteinase Asp-N
      generated fragments indicated that parastatin corresponds to residues 347-419 of
      CgA. A synthetic NH2-terminal fragment of rat parastatin corresponding to
      residues 1-19 was an inhibitory as intact porcine parastatin on parathyroid gland
      secretion. These results extend the concept that CgA is a precursor of
      biologically active peptides.

PMID- 8344193
TI  - Thyroid hormone regulation of RC3, a brain-specific gene encoding a protein
      kinase-C substrate.
AB  - RC3 is a brain-specific mRNA expressed in discrete neuronal groups of the
      forebrain that encodes a 78-amino acid protein, also called neurogranin, a
      calmodulin-binding, protein kinase-C substrate. Expression of RC3 mRNA was
      studied in normal and hypothyroid animals during the first month of life.
      Hypothyroid rats were produced by administration of methyl-mercapto-imidazol to
      the pregnant dams and subsequent surgical thyroidectomy on postnatal day 5 of the
      neonates. As studied by slot-blotting of total cerebrum poly(A)+ RNA, RC3 mRNA
      accumulates in normal brain from the fifth to seventh postnatal day, reaching
      maximal levels around days 10-12. RC3 mRNA accumulation in hypothyroid animals
      was blunted, and the maximal levels attained were about 30-50% of normal values.
      The effect of hypothyroidism on steady state mRNA levels was also observed by
      Northern blotting of RNA from cerebral cortex and striatum. As studied by
      immunoblotting using a polyclonal antibody, hypothyroidism also led to clear
      decreases in the amount of the RC3 protein in extracts from cerebral cortex,
      striatum, and hippocampus. A single administration of 10 micrograms T4 to
      hypothyroid rats on postnatal day 12 led to a steady increase in striatal RC3
      mRNA from levels that were about 40% of normal to about 70% of normal at 16 h and
      115% of normal at 48 h. In contrast to the effect on RC3, hypothyroidism did not
      affect developmental expression of the mRNA encoding GAP-43, another brain
      protein kinase-C substrate of axonal localization. RC3 is, thus, one of the few
      known neuronal genes whose expression is influenced by thyroid hormone in the
      brain. Thyroid hormone is required for an appropriate level of expression, not
      for the developmentally programmed timing of expression of the RC3 gene.

PMID- 8344194
TI  - Plasma membrane changes in the rat corpus luteum induced by oxygen radical
      generation.
AB  - The luteolytic mechanism was investigated in rat corpora lutea (CL). This study
      focused on the changes that occur in the plasma membrane. Previous experiments
      with rat luteal cells indicated that in vitro generation of superoxide radicals
      by xanthine oxidase disrupted LH-stimulated cAMP production and progesterone
      secretion similar to the effect of prostaglandin F2 alpha, the luteolytic
      hormone. In the present study, we observed that xanthine oxidase treatment of
      plasma membrane samples from CL caused a large decrease in fluidity, which also
      occurs during prostaglandin F2 alpha-induced luteolysis. This fluidity change was
      blocked by catalase, bromophenacyl bromide, an inhibitor of phospholipase-A
      activity, indomethacin, and free radical scavengers, and it was reversed by
      removal of FFA from the membrane. In addition, xanthine oxidase treatment caused
      phospholipid breakdown, formation of neutral lipids, a burst of inorganic
      peroxides, and a sustained rise in the level of lipid peroxides. These results
      indicate that free radical generation causes several changes that disrupt the
      plasma membrane of CL cells, and they raise the possibility that phospholipid
      breakdown could be involved in the mechanism that inhibits LH stimulation of
      steroidogenesis during luteolysis.

PMID- 8344195
TI  - Modulation of activin A action and specificity in the rat gonadotrope by protein
      kinase C.
AB  - This study was undertaken to assess the role of protein kinase C (PKC) in activin
      action in the rat pituitary. Pretreatment with 500 nM phorbol 12-myristate 13
      acetate (PMA) for 22-24 h reduced subsequent FSH and LH release (percentage of
      total cellular FSH and LH released) in response to 100 nM PMA. This action
      persisted for 2 days after the pretreatment. Pretreatment with 500 nM 4 alpha
      phorbol 12,13-didecanoate (4 alpha PDD, a phorbol ester which does not activate
      PKC) did not affect cell responsiveness to 100 nM PMA. Both PKC-down-regulated
      cells and cells with a full complement of PKC responded similarly to 100 nM GnRH
      and 100 microM A23187 during this period. Incubation with 50 ng/ml activin A for
      48 h significantly increased both FSH release and total FSH (extracellular plus
      intracellular) compared to corresponding basal values in PMA-pretreated cells, as
      well as in vehicle-or 4 alpha PDD-pretreated cells. Activin stimulation of basal
      FSH release and total FSH was significantly more potent in PMA-pretreated cells
      than in cells not pretreated with PMA. Activin did not alter basal LH release or
      total LH in vehicle- or 4 alpha PDD-pretreated cells but significantly increased
      both in PMA-pretreated cells. When PMA was present only during the initial 2 h of
      the 22- to 24-h pretreatment period at 50 nM, PKC was not down-regulated. In
      these cells, the potency of activin stimulation of basal FSH release was not
      affected, but stimulation of basal LH release by activin was still observed.
      These results suggest that PKC is not required for activin to stimulate FSH
      release but is involved as a modulator of potency and specificity of the activin
      action.

PMID- 8344196
TI  - Endothelin inhibits basal and stimulated release of prolactin by human decidual
      cells.
AB  - Recent studies have shown that the basal release of PRL from anterior pituitary
      cells is inhibited by endothelin-1 (ET-1) and ET-3. To determine whether ET also
      regulates the synthesis and release of PRL by decidual cells, we examined the
      effects of ET on the synthesis and release of PRL from an enriched fraction of
      human decidual cells prepared by isopycnic centrifugation of enzymatically
      dispersed term decidual tissue. Exposure of decidual cells to ET-1 (10(-7) M) for
      96 h caused a progressive decrease in basal PRL synthesis and release beginning
      24 h after exposure with half-maximal inhibition occurring at an ET-1
      concentration of 5 x 10(-9) M. Between 72-96 h of culture, ET-1-exposed cells
      synthesized 37.2 +/- 2.7% (SEM) and released 32.3 +/- 1.3% less PRL than control
      cells (P < 0.01). ET-1-exposed cells incubated with [35S]methionine between 72-96
      h also released less [35S] PRL than control cells. Sarafotoxin S6C, an ETB
      receptor agonist, also inhibited basal PRL release, whereas BQ-123, an ETA
      receptor antagonist, had no effect on basal or on ET-1-mediated inhibition of PRL
      release. ET-1 also markedly inhibited the stimulation of PRL synthesis and
      release in response to insulin and insulin-like growth factor-1 (IGF-1). Cells
      exposed to insulin (100 ng/ml) and IGF-1 (50 ng/ml) alone released 61.2 +/- 3.6%
      and 40.0 +/- 3.8% more PRL, respectively, than control cells between 72-96 h of
      exposure. However, cells exposed simultaneously to insulin and ET-1 (10(-7) M)
      released only 17.1 +/- 3.5% more PRL than control cells during the same time
      period, and cells exposed simultaneously to IGF-1 and ET-1 released only 4.1 +/-
      1.8% more PRL than controls during the same time interval (P vs. insulin or IGF-1
      alone < 0.001 in each instance). Both basal and insulin- and IGF-1-stimulated PRL
      release were also inhibited by the ET isotypes ET-2 and ET-3, and by the ET-1
      precursor, big ET. Since macrophages and decidual cells synthesize ET, and
      decidual tissue contains specific receptors for ET, the inhibitory action of ET
      on basal and stimulated PRL release may result from an autocrine and/or paracrine
      effect and appears to be mediated through the ETB receptor.

PMID- 8344197
TI  - Prolactin induces maturation of glucose sensing mechanisms in cultured neonatal
      rat islets.
AB  - The effects of PRL treatment on insulin content and secretion, and 86Rb and 45Ca
      fluxes from neonatal rat islets maintained in culture for 7-9 days were studied.
      PRL treatment enhanced islet insulin content by 40% and enhanced early insulin
      secretion evoked by 16.7 mM glucose. Insulin release stimulated by oxotremorine
      M, a muscarinic agonist, in the presence of glucose (8.3 or 16.7 mM) was
      unchanged by PRL treatment. However, PRL treatment potentiated phorbol 12,13
      dibutyrate-stimulated insulin secretion in the presence of the above glucose
      concentrations. PRL treatment potentiated the reduction in 86Rb efflux induced by
      glucose or tolbutamide and enhanced the increase in 86Rb efflux evoked by
      diazoxide. PRL treatment slightly potentiated the increment in 45Ca uptake
      induced by high concentrations of K+, but failed to affect the increment evoked
      by 16.7 mM glucose. Since glucose-induced 45Ca uptake was not affected by PRL, we
      suggest that the enhancement in first phase insulin secretion evoked by glucose
      in the PRL-treated islets occurs at a step in the secretory process that may
      involve protein kinase-C. These data further support observations that PRL
      treatment increases islet sensitivity to glucose.

PMID- 8344198
TI  - Expression and cellular localization of uterine side-chain cleavage cytochrome
      P450 messenger ribonucleic acid during early pregnancy in mice.
AB  - Very little is known about steroidogenic capacities in the uterus during the
      early stages of pregnancy in rodents. Cholesterol side-chain cleavage cytochrome
      P450 (P450scc) is the enzyme catalizing the first and key regulatory reaction
      controlling the production of steroid hormones. Using a cRNA probe, we made use
      of in situ hybridization analysis to evaluate the spatial and temporal patterns
      of P450scc mRNA expression in the mouse uterus until midgestation. Unexpectedly,
      we found that upon implantation on day 4.5, maternal cells of both decidua
      capsularis and decidua basalis expressed P450scc mRNA. Only later, and no earlier
      than day 6.5 of gestation, were high levels of P450scc mRNA also detected in the
      trophoblast giant cells surrounding the embryonal cavity. Analysis of
      pseudopregnant mice revealed that the induction of P450scc mRNA can be coupled to
      the decidual reaction evoked by intrauterine injection of mineral oil. These
      results, therefore, unambiguously confirmed the capacity of the decidualized
      cells of maternal origin to express P450scc mRNA and, thus, ruled out any direct
      role of the blastocyst involvement in P450scc induction. The dual localization of
      P450scc mRNA in maternal and trophoblast cells, expressing this cytochrome
      earlier than the previously suspected onset of uterine steroidogenesis, suggests
      an unexpected role for steroid hormones locally produced at the site of
      implantation and the surrounding milieu of the embryo during the first half of
      pregnancy.

PMID- 8344199
TI  - Synthetic antiestrogens modulate induction of pS2 and cathepsin-D messenger
      ribonucleic acid by growth factors and adenosine 3',5'-monophosphate in MCF7
      cells.
AB  - In MCF7 human breast cancer cells, the antiestrogens 4-hydroxy-tamoxifen and ICI
      164,384 inhibit the mitogenic activity of epidermal growth factor (EGF) and
      insulin-like growth factor-I (IGF-I). These growth factors also stimulate the
      expression of cathepsin-D and pS2 genes. Therefore, we studied the effects of
      antiestrogens on growth factor induction of pS2 and cathepsin-D mRNA. The two
      antiestrogens strongly inhibited the transcriptional induction of pS2 by growth
      factors. On the contrary, estradiol and IGF-I or EGF had an additive effect on
      pS2 mRNA accumulation. Growth factor induction of cathepsin-D was also inhibited
      by ICI 164,384. By contrast, 4-hydroxytamoxifen had an agonist effect on
      cathepsin-D and an additive effect on IGF-I-induced mRNA. When 12-O
      tetradecanoylphorbol-13-acetate or 8-bromo-cAMP (8-Br-cAMP) was used instead of
      growth factors, similar effects of 4-hydroxytamoxifen and ICI 164,384 were
      obtained on pS2 (12-O-tetradecanoylphorbol-13-acetate and 8-Br-cAMP) and
      cathepsin-D (8-Br-cAMP) induction. A mechanism based on the classical competitive
      inhibition by antiestrogens of estrogen binding and action on the estrogen
      receptor was very unlikely, as 1) no antigrowth factor activity was obtained with
      R5020, which was a potent inhibitor of estrogen induction of pS2 and cathepsin-D
      mRNA; 2) in the Ishikawa endometrial cancer cell line, the cathepsin-D gene is
      unresponsive to estrogen, but was inhibited by antiestrogen after its induction
      by EGF or 8-Br-cAMP; and 3) the residual estrogen concentration in cells was too
      low to induce the expression of estrogen-specific genes. However, antiestrogens
      did not inhibit the expression of all genes induced by growth factors, as they
      were without effect on IGF-I induction of glyceraldehyde-3-phosphate
      dehydrogenase mRNA. These results demonstrate that antiestrogens can modulate the
      transcription of some growth factor-induced genes and strongly suggest that this
      effect is not due to interference with residual estrogens.

PMID- 8344200
TI  - The diurnal rhythm in vasopressin V1a receptor expression in the suprachiasmatic
      nucleus is not dependent on vasopressin.
AB  - The mammalian suprachiasmatic nucleus is the site of the circadian rhythm
      generator. The degrees of expression there of several neuropeptides, including
      vasopressin and vasoactive intestinal polypeptide, follow a diurnal rhythm. The
      vasopressin V1a receptor, whose activation results in phosphoinositol hydrolysis
      and mobilization of intracellular calcium, is expressed in this nucleus. This
      study used double simultaneous hybridization histochemistry to show that V1a
      receptor transcripts are present in both vasopressin and vasoactive intestinal
      polypeptide neurons and that their levels follow a diurnal rhythm. Furthermore,
      the expression of the V1a receptor is 12 h out of phase from that of vasopressin.
      However, the receptor's diurnal rhythm is still maintained in the vasopressin
      deficient Brattleboro rat, indicating that the V1a receptor's rhythm is
      independent of any vasopressin feedback.

PMID- 8344201
TI  - Characterization of glucose transporter isoforms in the adult and developing
      human eye.
AB  - The expression of glucose transporter isoforms (Glut 1, Glut 3, Glut 4, and Glut
      5) in the human eye was investigated at various ages ranging between 8 weeks
      gestation (first trimester) and adult using Western blot and immunohistochemical
      analyses. Glut 1 and Glut 3 expression and cellular localization patterns were
      similar to those of human brain. Glut 1 (50-kilodalton protein) was expressed by
      epithelial cells (retinal pigmented epithelium, choroidal, iridial, and pars
      planus), which form the blood-eye barrier, retinal Mueller cells, the lens fiber
      cells, iridial microvascular endothelial cells, and to a lesser extent by the
      outer segments of the photoreceptor cells in the adult eye. This pattern was
      conserved throughout development and was evident as early as 8 weeks gestation.
      In addition, the endothelial cells of vitreous hyaloid vessels expressed Glut 1
      at 8 weeks gestation. Glut 3 (50 to 55-kilodalton protein) immunoreactivity was
      observed only in the adult inner synaptic layer of the retina. Neither Glut 4 nor
      Glut 5 was expressed in any occular tissue at any age examined. These results
      suggest that Glut 1 is the main glucose transporter of the human eye and that it
      is ontogenically conserved. In contrast, Glut 3 is associated with selective
      neuronal processes, and its expression is developmentally altered.

PMID- 8344202
TI  - Existence of activin-A in A- and D-cells of rat pancreatic islet.
AB  - Activin-A, a member of the transforming growth factor-beta supergene family,
      stimulates insulin secretion in rat pancreatic islets and causes glycogenolysis
      in isolated rat hepatocytes. These observations prompted us to determine whether
      activin-A existed in rat pancreas by using an immunocytochemical method. Cells in
      pancreatic islets were stained by antibody against activin-A, whereas no
      immunoreactivity was observed in exocrine pancreas. Cells localized in the mantle
      of the islets were densely stained by the antibody. Immunoelectron microscopic
      study showed that activin-A existed in secretory granules in both A- and D-cells.
      Furthermore, studies using a double labeling method revealed that activin-A
      coexisted with glucagon in secretory granules in A-cells and with somatostatin in
      D-cells. Antibody against inhibin-A weakly stained cells in both the core and
      mantle of the islets only when the rat was pretreated with colchicine. Subtypes
      of activin subunit in islets were identified to be beta A by a reverse
      transcription-polymerase chain reaction method. In addition, mRNA for inhibin
      alpha-subunit was expressed in islets. However, mRNA for these inhibin subunits
      was not detected in exocrine pancreas. To further examine the action of activin-A
      on insulin secretion, we examined the effect of activin-A in a flow-through
      perifusion system. Activin-A induced a biphasic insulin secretory response in the
      presence of 2.8 mM glucose, and a low concentration of activin-A, which does not
      stimulate insulin secretion by itself, markedly enhanced glucose-mediated insulin
      secretion at concentrations above 2.8 mM glucose. Inhibin-A did not affect
      insulin secretion. These results suggest the existence of activin-A in A- and D
      cells of rat pancreatic islets and raise the possibility that activin-A acts as a
      physiological regulator of carbohydrate metabolism.

PMID- 8344203
TI  - Processing of mutated proinsulin with tetrabasic cleavage sites to mature insulin
      reflects the expression of furin in nonendocrine cell lines.
AB  - Furin is a mammalian propeptide-processing endoprotease in nonendocrine cells and
      has been demonstrated to be present in virtually all nonendocrine cells,
      including fibroblasts, epithelial cells, and hepatocytes. Furin cleaves the
      concensus processing site -Arg-4-X-3-Lys/Arg-2-Arg-1 decreases X+1-. Some subunit
      containing precursor proteins, including an insulin receptor precursor, possess
      an additional basic residue at position -3, thus forming a tetrabasic processing
      site. This implies that a tetrabasic processing site must be easily cleavable in
      nonendocrine cells. We created a mutant proinsulin DNA with a peptide structure
      comprised of B- and A-chains linked to the C-peptide by a pair of tetrabasic
      residues, in the following order: B-chain-Arg-Arg-Lys-Arg-C peptide-Arg-Arg-Lys
      Arg-A-chain. The native proinsulin structure was B-chain-Arg-Arg-C-peptide-Lys
      Arg-A-chain. Both the native and mutant proinsulins were expressed in the
      following four cell lines: a monkey kidney-derived cell line (COS-7), a Chinese
      hamster ovary-derived cell line (CHO), a human liver cancer-derived cell line
      (HepG2), and a mouse fibroblast-like cell line (NIH3T3). We used these cell lines
      because they contain different quantities of furin mRNA, ranking as follows:
      NIH3T3 > HepG2 > COS > CHO. When mutant insulin was expressed in these cells, the
      conversion of proinsulin to mature insulin was approximately 85% in NIH3T3, 70%
      in HepG2, 60% in COS, and 50% in CHO. The conversion correlated well with the
      furin expression in each cell line as measured by the density of its Northern
      blot band. Moreover, in CHO, the cell line with the lowest furin expression,
      coexpression of mutant proinsulin with furin resulted in complete conversion of
      proinsulin to mature insulin.

PMID- 8344204
TI  - A developmentally regulated form of insulin-like growth factor receptor beta
      subunit in C2 myoblasts exhibiting altered requirements for differentiation.
AB  - Ligand-dependent autophosphorylation and immunoprecipitation have been used to
      distinguish insulin and insulin-like growth factor-I (IGF-I) receptor beta
      subunits in the permissive and inducible subclones of the C2 myoblast cell line.
      Permissive myoblasts differentiate spontaneously, whereas myoblasts of the
      inducible subclone require exogenous IGFs to undergo terminal differentiation.
      Permissive myoblasts contain beta-subunits of 95 and 101 kilodalton (kDa) mol wt.
      The 95-kDa subunits are immunoprecipitated with antipeptide antibodies directed
      against tyrosine kinase (AbP2), juxtamembrane (AbP4), and carboxy-terminal (AbP5)
      domains of the insulin receptor and insulin receptor monoclonal antibody 29B4.
      The tryptic phosphopeptide map of the 95-kDa band suggests that it contains both
      insulin and IGF-I receptor beta-subunits. The 101-kDa subunit is
      immunoprecipitated by AbP2, AbP4, and AbP5, because it forms a hybrid complex
      with the 95-kDa protein, but it does not react directly with AbP4, AbP5, or
      antibody 29B4. Phosphorylation of the 101-kDa subunit is more responsive to IGF-I
      than to IGF-II or insulin, indicating that it is a second IGF-I receptor beta
      subunit. Inducible myoblasts exhibit a single major beta-subunit of 106 kDa mol
      wt. Its immunoreactivity and phosphopeptide map are virtually identical to those
      of the 101-kDa IGF-I receptor beta-subunit from permissive cells. However, unlike
      the 101-kDa beta-subunit, phosphorylation of the 106-kDa protein appears to be
      more responsive to IGF-II than to either IGF-I or insulin. It is lost upon
      differentiation of myoblasts into myotubes concomittant with the appearance of 95
      and 101-kDa beta-subunits. These data demonstrate 1) an alpha 2 beta 2 IGF
      receptor that has high sensitivity for IGF-II in inducible, but not in
      permissive, myoblasts; 2) the beta-subunit of this receptor exhibits different
      migration in sodium dodecyl sulfate-polyacrylamide gels from either of those
      found in permissive cells; and 3) expression of this beta-subunit is
      developmentally regulated. This suggests that the inducible cell beta-subunit is
      a component of a stage-specific alpha 2 beta 2 IGF receptor subtype that
      functions as an IGF-II receptor.

PMID- 8344205
TI  - Neurons in the hypothalamic paraventricular nucleus mediate the serotonergic
      stimulation of prolactin secretion via 5-HT1c/2 receptors.
AB  - These studies examined the hypothalamic site and receptor subtype mediating the
      serotonergic (5-HT) control of PRL secretion in conscious male rats. Initially,
      we characterized the pharmacology of the 5-HT releaser and 5-HT agonists that
      increase PRL release. Subsequently, we performed lesion experiments to locate the
      5-HT receptors involved in PRL secretion. p-Chloroamphetamine, a 5-HT releaser,
      is postulated to enter serotonergic nerve terminals through the 5-HT uptake
      mechanism, which can be inhibited by fluoxetine. p-Chloroamphetamine (8 mg/kg,
      ip) increased the plasma PRL concentration approximately 6-fold. The 5-HT uptake
      inhibitor fluoxetine almost completely prevented this increase, demonstrating
      that p-chloroamphetamine increases PRL release via a serotonergic mechanism. The
      5-HT1C/5-HT2 agonist +(-)-1-(2,5-dimethoxy-4-iodophenyl)2-aminopropane HCl (ip)
      produced a strong (30-fold) dose-dependent elevation of plasma PRL, which was
      virtually eliminated by 0.1 mg/kg (sc) ritanserin, a 5-HT1C/5-HT2 antagonist. +(
      )-1-(2,5-Dimethoxy-4-iodophenyl)2-aminopropane HCl injected
      intracerebroventricularly (icv) in doses below those that were peripherally
      effective also produced a significant (8-fold) increase in PRL secretion that was
      again attenuated by icv pretreatment with ritanserin (2 micrograms/kg). RU 24969
      (5-methoxy-3-[1,2,3,4-tetrahydro-4-pyridinyl]1H-indole) was reported to act as
      both a 5-HT releaser and a direct postsynaptic 5-HT agonist. To test whether RU
      24969 releases 5-HT to increase PRL secretion, we depleted 5-HT stores with the 5
      HT synthesis inhibitor p-chlorophenylalanine. The ability of RU 24969 (0.5, 1, 5,
      and 10 mg/kg, ip) to elevate PRL secretion was not inhibited by pretreatment with
      p-chlorophenylalanine, suggesting that RU 24969 stimulates PRL secretion only
      through activation of postsynaptic 5-HT receptors. To test whether RU 24969 acts
      centrally, it was injected either icv, through chronic icv cannulae, or
      peripherally (ip). RU 24969 injected icv significantly stimulated PRL secretion
      (11-fold) at doses 500-fold lower than the peripherally effective doses (10
      micrograms/kg vs. 5 mg/kg), suggesting a role for central 5-HT receptors in the
      regulation of PRL secretion. In addition, rats pretreated with the 5-HT1C/5-HT2
      antagonist LY53857 (icv) significantly inhibited the PRL response if RU 24969 was
      injected ip, but not icv. The results of these experiments suggest that 5-HT1C or
      5-HT2 receptors in the brain participate in the serotonergic stimulation of PRL
      secretion.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8344206
TI  - ZR-75-1 breast cancer cells generate nonconjugated steroids from low density
      lipoprotein-incorporated lipoidal dehydroepiandrosterone.
AB  - Fatty acid esters of dehydroepiandrosterone (DHEA-FA) are present in the
      circulation, although no physiological function has yet been attributed to these
      metabolites. They are formed directly in serum and are predominantly localized in
      association with lipoproteins. The objective of this study was to determine the
      capacity of these lipoprotein-incorporated DHEA metabolites to generate
      nonconjugated steroids after incubation with cells in culture. A method for
      studying DHEA-FA using a radiolabeling technique that marks human low density
      lipoproteins (LDL) with tritiated DHEA-FA was elaborated. Analysis of the fatty
      acid composition of tritiated DHEA-FA-labeled LDL ([3H] DHEA-FA-LDL) indicated
      the prevalence of DHEA-linoleate/palmitoleate and DHEA-oleate. Incubation of
      [3H]DHEA-FA-LDL with ZR-75-1 breast cancer cells produced a time-dependent
      increase in labeled nonconjugated steroids in the cell culture medium, whereas
      the levels of tritiated DHEA-FA decreased. Lipoidal radioactivity in cells
      increased with time, but nonconjugated radioactivity associated with the cells
      showed no such increase. HPLC analysis of the culture medium indicated the
      presence of DHEA and androst-5-ene-3 beta,17 beta-diol. The endogenous levels of
      lipoidal DHEA were also determined in human plasma and its lipoprotein components
      to reveal that these metabolites circulate naturally in the range of 6.5 +/- 0.4
      nM. Approximately 90% of this concentration was associated with the lipoprotein
      components, namely among the LDL and high density lipoprotein fractions. These
      results suggest that lipoidal DHEA may indeed act as a substrate for potent
      steroid formation after their entry into steroid target cells.

PMID- 8344207
TI  - Coordinate induction and activation of metalloproteinase and ascorbate depletion
      in structural luteolysis.
AB  - Structural luteolysis was found decades ago to be induced by PRL in the
      hypophysectomized rat, but the mechanisms of this process are unknown. To gain
      information on mechanisms of luteal involution, we developed an animal model that
      circumvented complex surgery and provided ample tissue for analyses. Gonadotropin
      synchronized ovulation and luteinization were induced in immature rats, followed
      by treatment with ergot alkaloid and PRL. PRL-induced structural luteolysis, as
      shown by loss of luteal weight, protein, and DNA after pretreatment with ergot
      alkaloid, was evident after 36 h. Ascorbic acid depletion was rapid, severe, and
      lasting in luteal tissue during structural luteolysis, but lipid peroxidation or
      depletion of vitamin E was not evident. PRL treatment of animals with functional
      corpora lutea did not induce luteal involution. Significantly, after natural
      functional luteolysis occurred, PRL was highly effective in inducing structural
      luteolysis. Thus, either natural or ergot-induced functional luteolysis permitted
      the luteolytic expression of PRL. A greater depletion of protein than DNA was
      seen during PRL-induced structural luteolysis and was associated with a
      significant increase in neutral caseinase activity in luteal extracts. Caseinase
      activity was markedly reduced by calcium chelators and profoundly inhibited by
      the chelator orthophenanthroline; only slightly reduced activity was seen with
      serine, aspartate, or cysteine proteinase inhibitors. These findings implicate
      metalloproteinase (MMP) as the relevant caseinase that was increased during
      structural luteolysis. The major proteinase identified by zymography had apparent
      sizes of 72 and 66 kilodaltons (kDa), and slight but detectable activity was also
      seen at 92 and 84 kDa. Organomercurial treatment caused a major shift of the 72
      kDa band to 66 kDa and the 92-kDa band to 84 kDa, confirming MMP-2 and MMP-9 by
      activation of latent activity of each MMP, respectively. Structural luteolysis
      caused a significant increase in the activated 66-kDa form and the latent 72-kDa
      form of MMP-2, which occurred before a loss of luteal weight or protein. As MMP-2
      degrades collagen (type IV) in basement membranes, we conclude that an early
      event in PRL-induced structural luteolysis is the degradation of extracellular
      matrix. This conclusion is further emphasized by the marked and lasting depletion
      of ascorbic acid, a vitamin long known to serve an essential role in collagen
      synthesis.

PMID- 8344208
TI  - Noncoordinated expression of luteal cell messenger ribonucleic acids during human
      chorionic gonadotropin stimulation of the primate corpus luteum.
AB  - In nonfertile cycles, the absolute steroidogenic capacity of the primate corpus
      luteum, as reflected in the expression of messenger RNA (mRNA) for the
      progesterone biosynthetic enzymes cytochrome P450 cholesterol side-chain cleavage
      (P450SCC) and 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD), progressively
      declines until luteal regression. Despite this progressive loss in luteal cell
      function, the elaboration of CG by the implanted blastocyst is able to prolong
      the functional lifespan of the corpus luteum. It was the purpose of this study to
      investigate the relationship between aging of the primate corpus luteum and the
      cellular mechanisms by which the decline in luteal cell function is arrested by
      CG. Corpora lutea were obtained from cynomolgus monkeys on days 11 or 16 of the
      luteal phase after a 7-day treatment period with increasing doses of human CG
      (hCG) given intramuscularly beginning on days 5 or 10. Corpora lutea were also
      obtained from control animals on days 5, 10, 11, and 16 of the luteal phase.
      Human CG treatment significantly (P < 0.05) elevated both serum progesterone and
      estradiol levels throughout the treatment period; however, progesterone
      production in animals treated with hCG late in the luteal phase (days 10-16)
      steadily declined after the third treatment day. Expression of mRNA for P450SCC
      and 3 beta-HSD was markedly stimulated (P < 0.05) by hCG treatment early in the
      luteal phase. However, 3 beta-HSD message levels in corpora lutea from animals
      treated with hCG on days 10-16 were not different from those of day-16 control
      corpora lutea, whereas P450SCC mRNA was only minimally stimulated. There was a
      dramatic (P < 0.05) increase in mRNA levels for the aromatase enzyme and low
      density lipoprotein receptor in animals given hCG in both the early and the late
      luteal phase. In conclusion, there appears to be a differential responsiveness of
      the primate corpus luteum to hCG stimulation dependent upon luteal age. The loss
      in responsiveness to hCG in terms of maintenance of mRNA levels is reflective of
      the inability of the late luteal phase corpus luteum for continued progesterone
      biosynthesis in the face of heightened luteotropic stimulation.

PMID- 8344209
TI  - Modification of insulin resistance by diazoxide in obese Zucker rats.
AB  - Hyperinsulinism, insulin resistance, and decreased number of insulin receptors
      are characteristic of obesity in both humans and experimental animals. To assess
      the role of insulin in developing obesity, diazoxide (DZ), an inhibitor of
      glucose-stimulated insulin secretion, was administered for 8 weeks to 7-week-old
      female Zucker rats in two concentrations, 50 mg/kg.day (LD-DZ), and 100 mg/kg.day
      (HD-DZ). The obese and lean rats were divided into three subgroups: diazoxide
      (DZ), pair-fed (PF), and control (C) groups (n = 6 rats/subgroup-genotype).
      Diazoxide-treated obese and lean animals showed significantly lower
      postabsorptive plasma insulin concentrations (P < 0.005) than their respective
      obese and lean PF and C subgroups. HD-DZ obese rats consumed more calories (P <
      0.001), yet gained less weight (P < 0.05) than PF and C rats. The plasma glucose
      concentrations in the postabsorptive state and during glucose tolerance tests in
      HD-DZ obese rats were significantly lower than those in PF and C rats (P < 0.01)
      despite a decrease in their plasma insulin concentrations (P < 0.01), whereas HD
      DZ lean rats displayed a diabetic response (P < 0.01). The adipocyte-specific
      insulin receptor binding was dose-dependently increased in both lean and obese DZ
      animals (P < 0.01). DZ had a dual effect on insulin metabolism; it decreased
      insulin secretion and increased insulin receptor binding. This dual effect was
      associated with improved glucose tolerance and a decrease in weight gain in obese
      rats.

PMID- 8344210
TI  - Structure-function requirements of parathyroid hormone for stimulation of 1,25
      dihydroxyvitamin D3 production by rat renal proximal tubules.
AB  - PTH stimulates synthesis and secretion of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]
      in renal proximal tubule cells through activation of the protein kinase-A (PKA)
      or the protein kinase-C (PKC) signaling pathway. The relative contribution of the
      two transducing systems was explored using PTH fragments with selective
      activation of either PKA or PKC. Rat renal proximal tubules were isolated by
      Percoll centrifugation, and PKA and PKC activities were measured after treatment
      with synthetic fragments and analogs of PTH. Rat PTH-(1-34),
      [Nle8,Nle15,Tyr34]bovine PTH-(3-34), and human PTH-(13-34) increased PKC activity
      in a dose-dependent manner. All fragments tested stimulated PKC at physiological
      concentrations (10(-11)-10(-10) M). Rat PTH-(1-34) (10(-7) M) increased PKA
      activity 4.5-fold, but other fragments failed to stimulate PKA between 10(-12)
      10(-6) M. Human PTH-(28-34) stimulation of PKC was variable from experiment to
      experiment. All four PTH fragments tested increased 1,25-(OH)2D3 secretion by
      perifused renal proximal tubules at the lowest concentrations that stimulated PKC
      activity. The adenylate cyclase inhibitor 2',5'-dideoxyadenosine (10(-4) M)
      reduced PTH-(1-34)-stimulated PKA activity by 60%, but failed to block the rise
      in 1,25-(OH)2D3 secretion. The results of these studies demonstrate that PTH
      fragments that contain the PKC translocating domain stimulate 1,25-(OH)2D3
      secretion, whereas elimination of the PKA activation domain does not alter the
      potency of the analogs' 1,25-(OH)2D3-stimulating activity. These results support
      the concept that PKC translocation may be required for PTH stimulation of 1,25
      (OH)2D3 secretion.

PMID- 8344211
TI  - Interactions of transforming growth factor-alpha and -beta and luteinizing
      hormone in the regulation of plasminogen activator activity in avian granulosa
      cells during follicular development.
AB  - This study examined the influence of transforming growth factor-alpha (TGF
      alpha), TGF beta, and LH on progesterone (P4) secretion and plasminogen activator
      (PA) activity in cultured avian granulosa cells from the first (F1), third (F3),
      and fifth and sixth (F5-6) preovulatory follicles during a 21-h incubation
      period. PA activity in the cell (PAc) and the medium (PAm) fractions was measured
      by fibrinolysis and fibrin overlay methods. P4 was determined by RIA. Basal PAc
      and PAm activities were highest in cell cultures from the less mature (F5-6)
      follicles and decreased as follicles matured to the F1 stage of development. PAc
      activity was greater than PAm activity regardless of the stage of follicular
      maturation. TGF alpha (0.1-10 ng/ml) increased PA activity in cultures of
      granulosa cells from F1, F3, and F5-6 follicles in a concentration-dependent
      manner. TGF alpha-induced PAc and PAm activities were observed by 6 and 15 h of
      incubation, respectively, and increased rapidly between 15-21 h. LH (100 ng/ml)
      attenuated TGF alpha-induced PA activity by 15 h in cultures of granulosa cells
      from F1 and F3, but not F5-6, follicles. Basal PA activities were unaffected by
      the gonadotropin. TGF beta (2-100 ng/ml) stimulated PAc activity in a dose
      dependent manner only in cultures of granulosa cells from F5-6 follicles and
      significantly enhanced TGF alpha-induced PAc and PAm activities in cell cultures
      from F3 and F5-6, but not F1, follicles. Basal and growth factor-induced PAc and
      PAm activities corresponded to a mol wt of about 35 kDa, a value consistent with
      that of the low mol wt uPA species. TGF alpha and TGF beta, alone or in
      combination, had no effect on basal P4 secretion at all stages of follicular
      development. TGF alpha, however, decreased LH-induced P4 secretion in F1 and F3
      cultures. These results demonstrate a tightly controlled interaction of TGF
      alpha, TGF beta, and LH in regulating PA activity and P4 secretion during
      follicular development in the domestic hen.

PMID- 8344212
TI  - The steroid antagonist RU486 exerts different effects on the glucocorticoid and
      progesterone receptors.
AB  - To determine whether the steroid antagonist RU486 mediates its antiglucocorticoid
      and antiprogestin activities by the same or different receptor mechanisms, a
      direct comparison of RU486 interaction with glucocorticoid (GR) and progesterone
      (PR) receptors was made. The effects of RU486 on transformation of GR and PR 8
      10S complexes in the intact cell and in vitro were analyzed by sucrose density
      gradient centrifugation, and the in vitro stability of receptor-heat shock
      protein-90 interactions was analyzed by coimmunoprecipitation. Compared to
      agonist, RU486 binding produced a reduction in the amount of GR converted from 8S
      to 4S and stabilized the GR-heat shock protein-90 complex. By contrast, PR-RU486
      complexes were transformed both in vitro and in the intact cell to the same
      extent as receptor-agonist complexes. PR-RU486 complexes sedimented at 5-6S,
      whereas PR-R5020, GR-RU486, and GR-agonist complexes sedimented at 4S. The
      portion of GR that undergoes nuclear transformation when bound to RU486 was
      examined for binding to the glucocorticoid-progesterone response element of the
      mouse mammary tumor virus by an immunoprecipitation assay. The nuclear
      transformed GR-RU486 complex bound the glucocorticoid-progesterone response
      element with the same affinity as the nuclear-transformed GR-triamcinolone
      acetonide complex. The electrophoretic mobilities of GR-RU486 complexes and GR
      agonist complexes were the same, as determined by gel retardation assay. These
      results suggest that RU486 exerts its antiglucocorticoid activity at two levels
      of receptor action: prevention of complete GR transformation and alteration of a
      step subsequent to GR-DNA binding. As an antiprogestin, RU486 action is exerted
      predominantly at a post-DNA-binding step.

PMID- 8344213
TI  - Role of neuropeptide-Y in episodic luteinizing hormone release in ovariectomized
      rats: an excitatory component and opioid involvement.
AB  - We tested the hypothesis that hypothalamic neuropeptide-Y (NPY) is an excitatory
      signal in the episodic secretion of LH in ovariectomized (ovx) rats and that the
      suppression of LH secretion that consistently follows intracerebroventricular
      administration of NPY is due to concurrent release of opioids or CRH, both
      previously shown to readily inhibit LH release. In the first experiment, ovx rats
      received continuous intraventricular infusion of either serum containing NPY
      antibodies (NPY-Ab) or normal rabbit serum (control) at dilutions of 1:5 or 1:1.
      NPY-Ab infusion at a 1:5 dilution significantly decreased mean plasma LH levels
      and LH pulse amplitude without affecting LH pulse frequency over a 3-h period of
      observation. However, infusion of relatively more concentrated NPY-Ab (1:1)
      markedly decreased not only mean plasma LH levels and LH pulse amplitude, but
      also the frequency of LH episodes. In the next experiment, we observed that
      intraventricular administration of NPY (0.2 nmol) suppressed LH release for 60
      min. However, blockade of opiate receptors with iv infusion of naloxone (2 mg/h)
      before and after NPY injection completely counteracted the NPY-induced inhibition
      of LH release. On the other hand, prior blockade of the CRH receptors with alpha
      helical CRH-(9-41) (25 or 100 micrograms/rat) was ineffective in reversing the
      inhibitory LH response of NPY (0.125 nmol). These results together with our
      previous demonstration of morphological communication between NPY and beta
      endorphin neurons, show that suppression of LH by exogenous NPY in ovx rats may
      result from concurrent stimulation of opioids, primarily beta-endorphin. However,
      diminution of all parameters of episodic LH secretion by NPY-Ab affirms the
      notion that the NPY network is a physiologically important excitatory component
      of the hypothalamic pulse generator circuitry that regulates episodic LH
      secretion in rats.

PMID- 8344214
TI  - High neonatal triiodothyronine levels reduce the period of Sertoli cell
      proliferation and accelerate tubular lumen formation in the rat testis, and
      increase serum inhibin levels.
AB  - T3 was injected daily in newborn rats from birth to 16 days of age. Control rats
      received daily injections of vehicle during the same period. The proliferative
      activity of the Sertoli cells was studied by means of bromodeoxyuridine
      incorporation, and tubular lumen formation and nuclear size were taken as markers
      of Sertoli cell differentiation. T3 treatment strongly reduced the proliferative
      activity of Sertoli cells from day 7 on, and on day 12, proliferation of Sertoli
      cells had ceased, while in control rats proliferating Sertoli cells were observed
      up to day 16. As a result of the reduced Sertoli cell proliferation, the final
      Sertoli cell number per testis at 23 days of age was reduced by 50% from 38 +/- 1
      x 10(6) in control rats to 19 +/- 1 x 10(6) in T3-treated rats. Lumen formation
      in seminiferous tubules of T3-treated rats began at 12 days of age, while in
      controls lumen formation was first observed at 16 days. The area of the Sertoli
      cell nuclei was somewhat larger in T3-treated rats on day 16, but not at any
      other age examined. Body and testis weights in adult rats at 100 days of age were
      reduced by 46% and 48% of control values, respectively. The high neonatal T3
      levels reduced serum levels of TSH on days 7 and 9, but not at any other age
      examined. FSH levels were reduced in T3-injected rats on days 5 and 7 and
      increased on day 23, after cessation of treatment. Immunoreactive inhibin-alpha
      levels were increased on days 5-9 and reduced on days 16 and 23. These findings
      indicate that T3 stimulates the production of immunoreactive inhibin by Sertoli
      cells, but also of bioactive inhibin, as indicated by the reduced FSH levels. It
      is concluded that the levels of thyroid hormones early in life are important for
      the terminal differentiation of Sertoli cells and, therefore, for determining
      adult testis size. The data indicate that this might be a direct effect of T3 on
      Sertoli cells.

PMID- 8344215
TI  - Hormonal regulation, localization, and functional activity of the progesterone
      receptor in granulosa cells of rat preovulatory follicles.
AB  - Progesterone has been implicated to play a critical role in mediating LH
      induction of ovulation and possibly luteinization. The present study was
      undertaken to determine the effects of various agonists (LH, FSH, forskolin, and
      GnRH) known to stimulate ovulation on their abilities to induce progesterone
      receptor (PR) mRNA and protein in rat preovulatory follicles and in cultured rat
      granulosa cells exhibiting a preovulatory phenotype. In cultured granulosa cells,
      PR mRNA was induced by LH in a dose- and time-dependent manner. Transcripts of
      approximately 11.0, 7.2, 6.8, 6.2, 3.4, and 3.1 kilobases in size were induced by
      ovulatory (500 ng/ml), but not low (50 ng/ml), concentrations of LH and FSH as
      well as by forskolin (10 microM), GnRH (1 microM), and phorbol 12-myristate 13
      acetate (200 nM). Two forms (A and B) of PR protein were also induced in an
      agonist- and time-dependent manner, with the shorter form A (mol wt, 83,000
      85,000) appearing in greater abundance than the longer form B (mol wt, 115,000).
      Indirect immunofluorescent analyses verified nuclear localization of the induced
      receptor. Forskolin and progesterone, but not progesterone alone, were able to
      activate a glucocorticoid (progesterone) response element-E1b-chloramphenicol
      acetyltransferase reporter construct (12-fold) after transfection into cultured
      granulosa cells. The antiprogestins RU486 and ZK98299 did not inhibit induction
      of PR mRNA and protein, but effectively blocked agonist activation of
      glucocorticoid response element2-E1b-chloramphenicol acetyltransferase, as well
      as LH stimulation of luteinization in vitro. These results provide direct
      evidence that agonists stimulating diverse intracellular pathways can induce PR
      in granulosa cells, that progesterone plays a functional role in the
      luteinization process triggered by the LH surge, and that the effects are
      mediated at least in part by induction of PR.

PMID- 8344216
TI  - Mechanisms of regulation of ovarian sterol metabolism by insulin-like growth
      factor type II: in vitro studies with swine granulosa cells.
AB  - The present studies were designed to investigate the nature of the actions of
      insulin-like growth factor-II (IGF-II) on granulosa cell steroidogenesis and
      assess the potential facilitative interactions between IGF-II and other major
      regulators of ovarian sterol metabolism, viz. estrogen, FSH, and low density
      lipoprotein (LDL). In serum-free first passage monolayer cultures of swine
      granulosa cells, human recombinant IGF-II stimulated progesterone production with
      a half-maximally effective concentration of 4.6 +/- 1.2 ng/ml (0.61 +/- 0.16 nM)
      between 0-48 h of culture and 27 +/- 5.7 ng/ml (3.6 +/- 0.76 nM) between 48-96 h.
      Maximal progesterone accumulation increased 12-fold over that in untreated
      cultures (48-96 h). Over the latter interval, IGF-I stimulated progesterone
      production approximately 10-fold, with a significantly lower ED50 of 6.1 +/- 0.70
      ng/ml (0.78 +/- 0.09 nM; P < 0.01 vs. IGF-II effect). IGF-II (100 ng/ml) enhanced
      progesterone biosynthesis approximately 2-fold in the presence of 25
      hydroxycholesterol, suggesting that IGF-II increases the effective activity of
      the mitochondrial cholesterol side-chain cleavage enzyme. IGF-II (100 ng/ml)
      augmented human LDL-promoted progesterone production approximately 18-fold
      between 0-48 h of culture and approximately 6-fold between 48-96 h. In addition,
      IGF-II showed time-dependent stimulatory effects on the rates of [125I]iodo-LDL
      internalization, and the amounts of cell-associated and degraded lipoprotein. IGF
      II increased by approximately 10-fold the number of specific high affinity LDL
      receptors on granulosa cells, with no apparent change in their binding affinity,
      as assessed in equilibrium competition studies. Coadministration of IGF-II and
      FSH (100 ng/ml) or estradiol (E2; 1 microgram/ml) for 2 days increased
      progesterone production synergistically. Cotreatment with FSH or E2 for 4 days
      decreased the ED50 of IGF-II's stimulation of progesterone accumulation by 61%
      and 50%, respectively (P < 0.01). Synergistic interactions also existed between
      IGF-II and 8-bromo-cAMP, which indicates that IGF-II can act in part at cellular
      loci distal to cAMP generation. Northern blot analysis of total RNA isolated from
      granulosa cells treated with IGF-II (100 ng/ml), FSH (100 ng/ml), or IGF-II plus
      FSH for 2 days revealed 5-, 7-, or 8-fold increases, respectively, in the amount
      of cytochrome P450 cholesterol side-chain cleavage enzyme mRNA. The same
      treatments produced 6-fold increases in the level of LDL receptor mRNA, as
      determined by solution hybridization/RNase protection assays.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8344217
TI  - A cryptic peptide from the preprothyrotropin-releasing hormone precursor
      stimulates thyrotropin gene expression.
AB  - The precursor peptide of TRH (prepro-TRH) contains five copes of pro-TRH linked
      by other peptide sequences. These peptides are coprocessed with TRH in the median
      eminence of the hypothalamus and released into the portal circulation, rendering
      this family of peptides available to act at the level of the anterior pituitary.
      Therefore, we tested the potential bioactivity of one cryptic peptide, prepro-TRH
      amino acids 160-169 [prepro-TRH-(160-169)], in a TRH-responsive pituitary cell
      line (GH3). In a heterologous TSH expression assay, we found that prepro-TRH-(160
      169) stimulated TSH beta gene promoter activity in a time- and dose-dependent
      manner; moreover, the effect of prepro-TRH-(160-169) was more rapid and of
      greater magnitude than that of TRH on TSH beta-directed chloramphenicol
      acetyltransferase synthesis. In the same cells, we found that prepro-TRH-(160
      169) stimulated PRL synthesis and secretion, but the effect was similar in
      magnitude and duration to that of TRH. The effect of prepro-TRH-(160-169) appears
      to be additive to that of TRH, suggesting that prepro-TRH-(160-169) may act
      through a mechanism separate from that of TRH. Thus, prepro-TRH-(160-169) has
      potent endocrinological effects at the level of the genome.

PMID- 8344218
TI  - Endotoxin-induced corticotropin-releasing hormone gene expression in the
      hypothalamic paraventricular nucleus is mediated centrally by interleukin-1.
AB  - In the acute phase of bacterial infection, a variety of cytokines, including
      interleukin-1 (IL-1), are elicited by bacterial endotoxin in both the periphery
      and the central nervous system. Bacterial endotoxin has been previously reported
      to profoundly activate the hypothalamic-pituitary-adrenal axis, resulting in
      elevated glucocorticoid secretion that may serve an important role as part of the
      inhibitory feedback mechanisms on the activated immune system. To determine
      whether IL-1 acts within the brain to mediate endotoxin-induced CRH gene
      expression in the hypothalamic paraventricular nucleus (PVN), we studied the
      effect of administering the human IL-1 receptor antagonist (IL-1ra) into the
      brain, a competitive inhibitor of IL-1, on CRH gene expression in the PVN after
      systemic lipopolysaccharide (LPS) treatment. Eight hours after the ip
      administration of LPS, the paraventricular CRH mRNA content was elevated 3-to 4
      fold (P < 0.01) compared to the control value, and this elevation could be
      completely abolished by central IL-1ra pretreatment (P < 0.05 compared to LPS
      treated group; P > 0.05 compared to controls). In contrast, systemic IL-1ra
      administration did not inhibit endotoxin-induced CRH gene expression in the PVN.
      These studies demonstrate that LPS stimulates hypothalamic CRH by a mechanism
      that involves the action of IL-1 within the central nervous system and may
      proceed independently of peripheral actions of IL-1 circulating in the
      bloodstream.

PMID- 8344220
TI  - Oxytocin enhances myoepithelial cell differentiation and proliferation in the
      mouse mammary gland.
AB  - Using immunocytochemistry and electron microscopy, we demonstrate that oxytocin
      (OT) exerts a trophic effect on its target myoepithelial cells in the mammary
      gland. In vitro, in organotypic cultures of mouse mammary gland, we examined
      proliferation and differentiation of the different cell types induced by OT added
      to the medium. In vivo, we studied the effect of OT on the structure and cell
      composition of developing glands. Uptake of 5-bromo-2'-deoxyuridine was used as
      proliferation marker, while antibodies to smooth muscle alpha-actin (specific for
      myoepithelial cells) and keratin (MoAb AE1; selective for epithelial cells) were
      used to identify differentiated cell types. By electron microscopy, we studied
      structural modifications induced by OT on the extreme projections of the
      developing gland (sc end buds). The results indicate that OT induces
      myoepithelial cell differentiation and proliferation, enhancing the effect of
      mammotrophic hormones in nonlactating mouse mammary gland. A less marked effect
      was observed in luminal epithelial cells. No significant effect of OT alone was
      detected in cultured glands from unprimed animals.

PMID- 8344219
TI  - Vascular endothelial growth factor/vascular permeability factor expression in the
      rat uterus: rapid stimulation by estrogen correlates with estrogen-induced
      increases in uterine capillary permeability and growth.
AB  - In the uterus, estrogen causes a rapid increase in microvascular permeability,
      followed later by growth of the endometrium, including the richly vascular
      stroma. Vascular endothelial growth factor/vascular permeability factor (VEGF/VPF
      or VEG/PF) is an angiogenic protein that is not only a specific mitogen for
      endothelial cells, but also a potent stimulator of microvascular permeability.
      Because of these properties, it seems likely that VEG/PF might mediate estrogen
      induced increases in uterine vascular permeability and blood vessel growth.
      Therefore, we determined whether the gene for VEG/PF is expressed in the rat
      uterus and if mRNA abundance is regulated by steroid hormones, using reverse
      transcription-polymerase chain reaction. The VEG/PF gene is alternatively spliced
      and gives rise to three transcripts coding for proteins of 188, 164, and 120
      amino acids, which, in turn, form the active dimeric factors. Transcripts for
      VEG/PF mRNAs were detected in the uterus of the rat by reverse transcription
      polymerase chain reaction. The mRNAs for the VEG/PF164 and VEG/PF120 subunits
      were the dominant forms expressed. Treatment with both estradiol (E2) and estriol
      (E3) rapidly induced an increase in the level of the two smaller transcripts. The
      increase was detectable as early as 0.5-1 h and peaked at 2 h. Levels of the two
      smaller transcripts then declined, but remained above control levels for 24 h.
      The degree of stimulation of VEG/PF mRNA levels was 8-fold at 2 h. VEG/PF188 mRNA
      levels were higher by 6 h compared to control values. The increase in VEG/PF mRNA
      levels in response to E2 was not contingent upon de novo protein synthesis, as it
      was not blocked by cycloheximide. The increase occurred as rapidly as that of the
      mRNA for Zif268, an estrogen-induced transcription factor. Progesterone also
      stimulated the expression (at 6 h) of VEG/PF164 and VEG/PF120, but not that of
      VEG/PF188. We conclude that the VEG/PF gene is expressed in the rat uterus, and
      that mRNA levels are rapidly enhanced by estrogen. This response suggests that
      VEG/PF may be involved in the estrogen-induced increase in permeability and
      proliferation of uterine blood vessels. The identification of VEG/PF as a primary
      response gene also suggests that VEG/PF expression may be a prerequisite for the
      subsequent expression or action of other growth factors in the uterus.

PMID- 8344221
TI  - Potential role of 12 hydroxyeicosatetraenoic acid in angiotensin II-induced
      calcium signal in rat glomerulosa cells.
AB  - Recent evidence suggests that 12 hydroxyeicosatetraenoic acid (12HETE), a product
      of the 12 lipoxygenase (LO) pathway of arachidonic acid metabolism, may have a
      role in mediating angiotensin II (AII)-induced aldosterone secretion. The present
      study examined the possible role of the 12 LO product 12HETE in AII-induced
      calcium ([Ca++]i) signals in rat glomerulosa cells. The addition of 12HETE to
      glomerulosa cells induced a dose-dependent (10(-6)-10(-8) M) rise in [Ca++]i
      levels that was sustained over 15 min. The effects of 12HETE on [Ca++]i were
      attenuated but not blocked by nifedipine (5 x 10(-6) M) and were preserved in a
      calcium-free medium, suggesting mobilization of intracellular calcium stores.
      Furthermore, the 12HETE-mediated rise in [Ca++]i was almost entirely abolished by
      dantrolene. In parallel, 12HETE reversed the inhibitory effect of nifedipine on
      AII-induced aldosterone secretion [AII (10(-9) M) - 36 +/- 7, AII + nifedipine (5
      x 10(-6) M) - 13 +/- 2, AII + nifedipine + 12HETE (5 x 10(-8) M) - 27 +/- 4
      ng/10(6) cells]. Dantrolene also inhibited AII-dependent aldosterone secretion
      (AII 10(-9) M - 75.8 +/- 5.6, AII + dantrolene 10(-6) M 45.5 +/- 8.8 ng/10(-6)
      cells), but this inhibition could not be reversed by 12HETE 10(-8) M (45.4 +/-
      10.6 ng/10(6) cells). The LO blockers baicalein and BW755C inhibited the effect
      of AII on aldosterone production and on [Ca++]i in a parallel fashion. During LO
      blockade, the addition of 12HETE (10(-7) M) restored the AII-induced rise in
      [Ca++]i. Collectively, these observations suggest that activation of the LO
      pathway in the rat adrenal glomerulosa contributes to change in cytosolic
      calcium, which may be important for the steroidogenic effect of AII.

PMID- 8344222
TI  - Pleiotropic influence of triiodothyronine on thymus physiology.
AB  - It is well demonstrated that the thymus gland is under neuroendocrine control.
      Thymic endocrine function can be modulated by a variety of hormones including
      those secreted by the thyroid gland. This prompted us to investigate putative
      influences of T3 in further aspects of thymus physiology. We showed that T3
      treated animals exhibited an increase in thymus weight, cellularity and cycling
      cells. Moreover, Thy1+ thymocytes as well as CD4-CD8 defined subsets were
      augmented in absolute numbers, whereas PgP.1+ cells increased in both absolute
      and percentage values. In parallel, the total numbers of thymic nurse cells were
      also increased. Regarding the expression of extracellular matrix components (ECM)
      by microenvironmental cells, we observed an enhancement in the intrathymic ECM
      upon T3 in vivo treatment. Similar effects were found in vitro by treating a
      thymic epithelial cell line or thymic nurse cell-derived epithelial cultures with
      T3. This treatment also increased the expression of ECM receptors by thymic
      epithelial cultures. Interestingly, an enhancement in thymocyte/thymic epithelial
      cell adhesion ratio was observed after T3 treatment of epithelial cells. Our data
      suggest that T3 exerts a pleiotropic effect upon thymus physiology, stimulating
      thymocyte differentiation, not only by modulating epithelial cell hormonal
      secretion but also their production of ECM proteins and respective receptors.

PMID- 8344223
TI  - Distribution of estrogen receptor-immunoreactive cells in the sheep brain.
AB  - The distribution of immunoreactive (IR) estrogen receptor (ER)-containing cells
      was studied in the brains of adult Suffolk ewes using a rat monoclonal antibody
      (H222) which recognizes the human estrogen receptor. IR cells were characterized
      by dense nuclear reaction product, and in some instances, cytoplasmic
      immunostaining which filled dendrite-like processes. The greatest densities of ER
      IR cells were found in the medial preoptic area, the mediobasal hypothalamus, and
      in a number of limbic system structures (amygdala, bed nucleus of the stria
      terminalis, lateral septum). ER-IR cells were found at lower densities in several
      other subregions of the hypothalamus and limbic system, and in the periaqueductal
      gray of the caudal midbrain. Cytoplasmic ER immunoreactivity was most prominent
      among ER-IR cells in the ventrolateral-ventromedial nucleus, the bed nucleus of
      the stria terminalis, the midbrain periaqueductal gray, and some ER-IR cells in
      the substantia innominata. The distribution of ER-containing cells in the sheep
      brain closely parallels that seen in other mammals. ER-IR cells are found in
      sites such as the medial preoptic area and ventrolateral-ventromedial
      hypothalamus which have been implicated as targets in this species and others for
      the influence of estradiol on sexual behavior and reproductive neuroendocrine
      function.

PMID- 8344224
TI  - Fos expression during the estradiol-induced gonadotropin-releasing hormone (GnRH)
      surge of the ewe: induction in GnRH and other neurons.
AB  - The protein product of the protooncogene c-fos was used as a marker of cellular
      activation in an attempt to identify those neurons in the preoptic area and
      hypothalamus that participate in generation of the estradiol-induced surge of
      GnRH in the ewe. GnRH- and Fos-expressing cells were identified
      immunocytochemically, and the percent of coexpression was determined in three
      states: mid-luteal phase (low GnRH release, n = 6); short-term ovariectomy (high
      episodic GnRH release, n = 6); and induced GnRH surge (high sustained release, n
      = 8). To induce the GnRH surge, a follicular phase rise in circulating estradiol
      was simulated in a physiological model for the estrous cycle. Serum LH was
      measured as an indicator of GnRH release. In the luteal phase, LH was basal,
      indicating low GnRH secretion. Few cells expressed Fos; these were not GnRH
      cells. Despite high intermittent GnRH release in short-term ovariectomized ewes,
      GnRH cells did not express Fos. During the surge (sustained high GnRH release),
      41 +/- 8% of GnRH cells expressed Fos; these cells were dispersed throughout the
      field of distribution of GnRH neurons. In addition to Fos in GnRH-positive cells,
      many more non-GnRH cells in the preoptic area, anterior hypothalamus, and
      ventrolateral hypothalamus expressed Fos during the surge than in the luteal
      phase or after ovariectomy. We suggest that Fos expression in GnRH cells is
      markedly increased by the positive feedback action of estradiol (surge), whereas
      short-term removal of negative feedback (ovariectomy) has little, if any, effect,
      despite increased GnRH release in both states. Since estradiol induces Fos
      expression in far more than GnRH neurons, our results also suggest that estradiol
      activates other cells, some of which may be part of a neuronal chain leading to
      GnRH surge generation, and some of which may be related to other neural actions
      of estradiol, such as estrous behavior.

PMID- 8344225
TI  - Plural cells organize thyroid follicles through aggregation and linkage in
      collagen gel culture of porcine follicle cells.
AB  - Some follicle cells organize thyroid follicles through proliferation of single
      cells in collagen gel culture. The aim of this study was to clarify whether two
      or more (plural) cells can form follicles through aggregation and linkage in this
      culture system. To address this question, we performed collagen gel culture of
      porcine follicle cells, using cell labeling with PKH 2 dye. A mixture of dye
      labeled and nonlabeled cells was cultured in collagen gel. Organized follicles
      consisted of both dyed and nondyed cells. This suggested that plural cells
      reconstructed follicles through aggregation and linkage. To further confirm this
      finding, cells embedded in collagen gel were cultured in inhibition of cell
      proliferation with 2 micrograms/ml aphidicolin. Forty to 60 percent of the cells
      formed follicles, which did not grow larger. Electron microscopy showed that
      intracytoplasmic cavities appeared in the cells. In contrast, 20-30% of the
      embedded cells developed into cavity-embracing single cells, which remained
      signet rings. These results indicate that follicle cells organize follicles in
      collagen gel culture by two means: through cell division of cavity-embracing
      single cells and through aggregation and linkage of plural cells.

PMID- 8344226
TI  - Mass spectrometric analysis of the fragments produced by cleavage and reduction
      of rat prolactin: evidence that the cleaving enzyme is cathepsin D.
AB  - The site(s) at which mammary tissue enzymatically cleaves rat (r) PRL, and the
      possibility that the cleaving activity is cathepsin D, were investigated using
      mass spectrometry and enzyme inhibitors. Cleavage of intact rPRL [22,566 atomic
      mass units (amu)] by either mammary gland-conditioned medium or cathepsin D (both
      at pH 3) reduced the mass of the molecule by 397 amu. Subsequent reduction of the
      large rPRL fragment cleaved by either method generated two fragments of 16,364
      and 5808 amu. The mass of the smaller fragment is consistent with the report of
      Vick et al. (Biochim Biophys Acta 931: 196-204, 1987) that its amino-terminal
      residue is Ser149. These results indicate that both enzyme preparations cleave
      rPRL by excision of the tripeptide Leu-Val-Trp (mass = 397 amu) between residues
      145 and 149. The ability of both enzyme preparations to cleave rPRL at pH3 was
      inhibited by pepstatin A but not by phenylmethane sulfonyl fluoride, and both
      preparations were essentially inactive at pH7. Accordingly, the PRL-cleaving
      activity of rat mammary tissue is probably cathepsin D.

PMID- 8344228
TI  - The effects of ambient NO2 on lung function in primary schoolchildren.
AB  - The effect of ambient NO2 on lung function was investigated in a sample of 423
      schoolchildren. At each of four locations NO2 was monitored continuously. Over a
      6-month period from January to June 1990 two surveys were performed and
      spirometry recorded each time for each child. Linear regression was used to
      estimate the effect of NO2 for different time intervals preceding lung function
      testing. A decrease of NO2 between surveys was significantly associated with a
      higher forced vital capacity (FVC) at the second survey. For each microgram/m3
      NO2 decrease the model predicted an increase in FVC of 1.5 ml [for the 2-hr mean
      (P < 0.05)] and 3.1 ml [for the 12-hr mean (P < 0.01)]. We conclude that even at
      NO2 levels below current air-quality standards children demonstrate significant
      changes in lung function.

PMID- 8344227
TI  - Reproductive hormones modulate angiotensin II AT1 receptors in the dorsomedial
      arcuate nucleus of the female rat.
AB  - Angiotensin II AT1 receptors are highly localized in the dorsomedial arcuate
      nucleus. AT1 receptor number is very low during proestrus and in ovariectomized
      and male rats, and is high only during the estrus phase of the estrous cycle and
      after ovariectomized rats receive a sequential estrogen-progesterone treatment.
      Our results suggest that the mechanism of the estrogen-progesterone inhibition of
      the prolactin surge may involve the selective stimulation of dorsomedial arcuate
      AT1 receptors.

PMID- 8344229
TI  - Immediate-type allergy related to okra (Hibiscus esculentus Linn) picking and
      packing.
AB  - Two workers (cases A and B) engaged in picking and packing okra who had
      complaints of work-related allergic symptoms showed distinct positive intradermal
      reactions to two brands of okra extracts only with thresholds of 1 x 10(-8) w/v
      for Case A and 1 x 10(-6) w/v for Case B. Both also showed positive reactions to
      okra extracts in the Prausnitz-Kustner test and in the provocative nasal test.
      The radioallergosorbent test scores to the okra extract were determined to be 2
      (defined as clear positive) for Case A and 1 (border line) for Case B. These
      findings indicated that the allergic conditions of these cases were from an IgE
      mediated immediate-type allergy induced by handling okra. To confirm the etiology
      of the two cases 14 farmers engaged in picking and packing okra were examined.
      Among them, 8 subjects (57%) showed positive intradermal reactions to okra
      extracts. A close association between intradermal reactions to okra extracts and
      complaints of work-related allergic symptoms was seen in these subjects. These
      results confirm that the okra may be capable of inducing IgE-mediated immediate
      type allergy to workers handling okra.

PMID- 8344230
TI  - Assessment of the health impact of environmental exposure to cadmium:
      contribution of the epidemiologic studies carried out in Belgium.

PMID- 8344231
TI  - Arsenic and cadmium exposure in children living near a smelter complex in San
      Luis Potosi, Mexico.
AB  - The main purpose of this study was to assess environmental contamination by
      arsenic and cadmium in a smelter community (San Luis Potosi City, Mexico) and its
      possible contribution to an increased body burden of these elements in children.
      Arsenic and cadmium were found in the environment (air, soil, and household dust,
      and tap water) as well as in the urine and hair from children. The study was
      undertaken in three zones: Morales, an urban area close to the smelter complex;
      Graciano, an urban area 7 km away from the complex; and Mexquitic, a small rural
      town 25 km away. The environmental study showed that Morales is the most
      contaminated of the zones studied. The range of arsenic levels in soil (117-1396
      ppm), dust (515-2625 ppm), and air (0.13-1.45 micrograms/m3) in the exposed area
      (Morales) was higher than those in the control areas. Cadmium concentrations were
      also higher in Morales. Estimates of the arsenic ingestion rate in Morales (1.0
      19.8 micrograms/kg/day) were equal to or higher than the reference dose of 1
      microgram/kg/day calculated by the Environmental Protection Agency. The range of
      arsenic levels in urine (69-594 micrograms/g creatinine) and hair (1.4-57.3
      micrograms/g) and that of cadmium in hair (0.25-3.5 micrograms/g) indicated that
      environmental exposure has resulted in an increased body burden of these elements
      in children, suggesting that children living in Morales are at high risk of
      suffering adverse health effects if exposure continues.

PMID- 8344232
TI  - Assessment of sympathetic nerve activity controlling blood pressure in the
      elderly using head-up tilt.
AB  - In order to assess age-related changes in sympathetic nerve activity controlling
      blood pressure, we recorded muscle sympathetic nerve activity, blood pressure,
      and heart rate during head-up tilt in 10 healthy elderly (69-75 years) and 16
      healthy young (19-23 years) subjects. The elderly had significantly lower
      responsiveness of muscle sympathetic nerve activity to postural change than did
      the young subjects. In the elderly, marked rise in blood pressure without
      increase in muscle sympathetic nerve activity was observed in nearly upright
      position during head-up tilt, whereas this phenomenon was not observed in the
      young. We conclude that neural control function of blood pressure during head-up
      tilt in the elderly differs from that in the young, which may be due to age
      related change in baroreflex function.

PMID- 8344233
TI  - A prospective cohort study of the chronic effects of solvent exposure.
AB  - The issue of the health effects of long-term exposure to solvents still attracts
      considerable debate, particularly among regulators and policymakers. This is
      especially true for studies of neurobehavioral effects. A major reason for this
      debate is that cross-sectional research designs are almost universally used in
      this area. Cross-sectional studies suffer from problems of possible confounding
      by a range of unknown factors and also usually from poor estimates of exposure.
      This study is an attempt to solve this problem by using an inception cohort
      design in which the subjects are measured at the beginning of their exposure and
      then at intervals while their exposure continues. Two hundred first-year
      apprentice vehicle spray painters were entered into the study within 6 months of
      beginning their apprenticeship together with a comparison group of 76 first-year
      apprentice electricians and 49 first-year apprentice metal fabricators. Measures
      of neurobehavioral function using a test battery based on an information
      processing model were made at study entry and will be made annually. In addition
      apprentice's assessments of their own exposure are being made annually and
      compared with workplace-exposure assessments. So far measures have been made at
      the beginning of the second year for the entire cohort and at the beginning of
      the third year for one-third of the cohort. This paper is a description of the
      results for this one-third. The results suggest that there were no significant
      changes in neurobehavioral function in the first 2 years of exposure to solvents.
      However, the results of workplace monitoring suggest that exposure is
      considerably below current exposure standards for solvents during this time.

PMID- 8344234
TI  - Assessment of central, peripheral, and autonomic nervous system functions in
      vibrating tool operators: neuroelectrophysiological studies.
AB  - To evaluate the effects of vibrating tool operation (i.e., combined stressors of
      local vibration, noise, cold climate, and heavy work) on the central, peripheral,
      and autonomic nervous systems, the short-latency somatosensory and brain stem
      auditory evoked potentials (SSEP and BAEP), the distribution of sensory median
      nerve conduction velocities (DCV), conventional median nerve conduction
      velocities (NCV), and the electrocardiographic R-R interval variability (CVRR)
      were measured in three groups of male vibrating tool operators and age-matched
      male healthy adults. Two components of the CVRR reflecting parasympathetic
      activity (C-CVRSA) and sympathetic activity (C-CVMWSA) were also examined. In the
      first group of vibrating tool operators (15 chain saw operators), all parameters
      of DCV (V10-V90 velocities) and sensory and motor nerve conduction velocities of
      NCV were significantly slowed. All peak latencies of SSEP were significantly
      prolonged, while no significant differences were found in the interpeak latencies
      of SSEP. The N9 peak latency of SSEP was significantly related to total working
      days. In the second group of the operators (12 chain saw and 8 brush saw
      operators), the I-V interpeak and V peak latencies of BAEP were significantly
      prolonged in the 12 chain saw operators; the I-V interpeak latency of BAEP was
      significantly correlated with the working years in the 8 brush saw operators. In
      the third group of vibrating tool operators, i.e., 13 operators with a history of
      vibration-induced white finger (VWF group) and 11 operators without VWF (non-VWF
      group), both the CVRR and C-CVRSA were significantly reduced in the VWF group;
      only the CVRR was significantly reduced in the non-VWF group. Similarly, the
      faster velocities of DCV (V70, V80, and V90 velocities) were significantly slowed
      in both the VWF and non-VWF groups. In conclusion, it is suggested that vibrating
      tool operation affects the faster sensory and motor nerve fibers, the
      parasympathetic activity, and the auditory pathway from the acoustic nerve to the
      brain stem.

PMID- 8344235
TI  - Nd and P300 in healthy volunteers.
AB  - We attempted to standardize values of the attention-related negative potential
      (Nd) and the P300 in 100 healthy volunteers (50 females, 50 males) who were given
      the task of making dichotic syllable discriminations requiring key-press
      responses. Ages ranged between 18 and 59 years. Nd was found to be maximum in the
      Fz region, P300 being maximum in the Pz region. The means and standard deviations
      of the Nd and P300 areas in their maximum regions were 554.1 +/- 307.8
      microV.msec and 2148.5 +/- 1261.5 microV.msec, respectively. After being
      transformed into logarithmic values, the distribution patterns of the Nd and P300
      areas followed a Gaussian distribution. When the lower limit of normal values was
      tentatively assigned to mean--2 SD using logarithmically transformed data for
      both Nd and P300, 94% of the subjects were found to display values above the
      lower normal limit for Nd, and 95% for P300. Neither Nd nor P300 areas correlated
      with age, while P300 latencies displayed a weak positive correlation with age.
      Females displayed relatively larger values than males for Nd and P300 areas and
      P300-peak amplitudes. Females and males showed nearly equal P300-peak latencies.

PMID- 8344236
TI  - Subjective symptoms and neurobehavioral performances of ex-mercury miners at an
      average of 18 years after the cessation of chronic exposure to mercury vapor.
      Mercury Workers Study Group.
AB  - In order to determine if there are any residual effects of long-term exposure to
      mercury vapor, neurobehavioral tests were given to ex-mercury miners about 18
      years after the cessation of mercury exposure. Seventy-six male ex-mercury miners
      who had been exposed to relatively high concentrations of mercury vapor (over 1.0
      mg/m3) and with a past history of mercury intoxication were compared to age (+/-
      3 years)-, sex-, and years of education-matched controls. Although the extent of
      the workers' symptoms caused by mercury poisoning, termed erethismus merculialis,
      markedly decreased after the cessation of exposure, the prevalence of
      neurological symptoms (such as hand tremors, headaches, and slurred speech) and
      symptoms of senility (such as low-back pain, loss of sexual desire) in the ex
      miners was significantly higher than those in the controls. Matched-pair analysis
      showed that performances of motor coordination, Simple reaction time, and Short
      term memory in the ex-miners were significantly deteriorated compared to those of
      controls. There are slight but persistent effects on neurobehavioral function,
      especially on motor coordination function, among mercury miners more than 10
      years after the cessation of exposure.

PMID- 8344237
TI  - Neurobehavioral effects of chronic occupational exposure to organic solvents
      among Japanese industrial painters.
AB  - To investigate the relationship between chronic exposure to organic solvents and
      changes in central nervous system function, industrial painters were compared
      with an age- and education-matched referent group of nonexposed workers. Eighty
      one male painters completed a symptom questionnaire. Twenty painters underwent
      both questionnaire and neuropsychological examinations. From the results of
      pairwise comparisons of the symptoms, dry and scaly skin, being easily depressed
      without reason, coldness of hands and legs, being easily irritated without
      reason, loss of appetite, dizziness, and unsteadiness occurred statistically
      significantly more often among the exposed subjects than among the referents.
      Performances on the Digit symbol test and vocabulary test scores (synonyms) in
      exposed subjects were significantly lower than those of controls. In multiple
      regression models, controlling for age, education, and alcohol intake, a
      significant relation was found between the duration of the solvent exposure and
      poor performance in both the Block design and Digit span tests. The relation
      between toluene exposure and poor performance in both the Santa Ana coordination
      test and the Benton visual retention test was also significant. The results
      suggest that a symptom inquiry and some behavioral tests are helpful for
      detecting the possible effects of exposure to low levels of organic solvents.
      However, no consistent pattern was observed in regard to the effects of organic
      solvent exposure on neurobehavioral function, which is coincident with the type I
      toxic central nervous system disorder as classified by the World Health
      Organization.

PMID- 8344238
TI  - Relations of work stress to alcohol use and drinking problems in male and female
      employees of a computer factory in Japan.
AB  - To examine the effects of work stressors on alcohol use and drinking problems as
      well as a model of stress-induced drinking in Japanese male and female workers, a
      total of 2581 employees of a computer factory were surveyed using mailed
      questionnaires. Five psychosocial work stressors, overtime, rotating shift,
      frequency of drinking, amount of alcohol consumed per drinking occasion, and
      drinking problems, and depressive symptoms were assessed. The hierarchical linear
      and logistic regression analyses were conducted in 1043 male and 255 female
      current drinkers aged 20 years or older. The results suggested that overtime and
      lack of intrinsic work rewards are main factors for heavy and problem drinking in
      Japanese male workers and that ambiguity about job future is a factor for heavy
      drinking in Japanese female workers. However, the model of stress-induced
      drinking was supported neither in males nor in females, suggesting that the
      effects of these work stressors on heavy and problem drinking are not mediated by
      depressive symptoms.

PMID- 8344239
TI  - Assessment of the effects of occupational and environmental factors on all faster
      and slower large myelinated nerve fibers: a study of the distribution of nerve
      conduction velocities.
AB  - To assess the effects of occupational and environmental factors on all faster and
      slower large myelinated peripheral nerve fibers, we measured the distribution of
      nerve conduction velocities (DCV) in men exposed to local vibration, lead,
      thallium, styrene, mixed solvents, and alcohol as well as in diabetic patients.
      The results indicated that conduction velocities of faster large myelinated nerve
      fibers are more sensitive to most toxic chemicals and physical factors than those
      of the slower fibers. Further studies are needed to investigate which of the DCV
      and the conventional peripheral nerve conduction velocity is a more sensitive
      indicator of the subclinical effects of these factors and whether zinc and copper
      antagonize the effects of lead on the DCV.

PMID- 8344240
TI  - Are faster or slower large myelinated nerve fibers more sensitive to chronic lead
      exposure? A study of the distribution of conduction velocities.
AB  - To determine which of the faster and slower large myelinated nerve fibers (alpha
      fiber group) are more sensitive to chronic lead exposure, the distribution of
      nerve conduction velocities (DCV) as well as conventional sensory nerve
      conduction velocity (SCV) were measured once a month for 20 and 11 months in two
      male lead workers with blood lead concentrations of 70 to 121 and of 63 to 85
      micrograms/dl, respectively. Differences in the frequency beyond the "normal"
      ranges between conduction velocities of faster nerve fibers (V80, V90, or SCV)
      and those of slower fibers (V10 or V20) were analyzed by the McNemar test. In the
      two lead workers, the values below the lower normal limits for the V80 and V90
      velocities were more frequent than those for the V10 and V20 velocities;
      similarly, lower values for the SCV were more frequent than those for the V10 and
      V20 velocities (P < 0.05). It was suggested that faster nerve fibers are more
      sensitive to chronic lead exposure than slower nerve fibers. These findings agree
      with our published data on the effects of local vibration, thallium, n-hexane,
      styrene, mixed organic solvents, alcohol dependency, and diabetes mellitus.

PMID- 8344241
TI  - Mitotic stability and nuclear inheritance of integrated viral cDNA in engineered
      hypovirulent strains of the chestnut blight fungus.
AB  - Transmissible hypovirulence is a novel form of biological control in which
      virulence of a fungal pathogen is attenuated by an endogenous RNA virus. The
      feasibility of engineering hypovirulence was recently demonstrated by
      transformation of the chestnut blight fungus, Cryphonectria parasitica, with a
      full-length cDNA copy of a hypovirulence-associated viral RNA. Engineered
      hypovirulent transformants were found to contain both a chromsomally integrated
      cDNA copy of the viral genome and a resurrected cytoplasmically replicating
      double-stranded RNA form. We now report stable maintenance of integrated viral
      cDNA through repeated rounds of asexual sporulation and passages on host plant
      tissue. We also demonstrate stable nuclear inheritance of the integrated viral
      cDNA and resurrection of the cytoplasmic viral double-stranded RNA form in
      progeny resulting from the mating of an engineered hypovirulent C. parasitica
      strain and a vegetatively incompatible virulent strain. Mitotic stability of the
      viral cDNA ensures highly efficient transmission of the hypovirulence phenotype
      through conidia. Meiotic transmission, a mode not observed for natural
      hypovirulent strains, introduces virus into ascospore progeny representing a
      spectrum of vegetative compatibility groups, thereby circumventing barriers to
      anastomosis-mediated transmission imposed by the fungal vegetative
      incompatibility system. These transmission properties significantly enhance the
      potential of engineered hypovirulent C. parasitica strains as effective
      biocontrol agents.

PMID- 8344242
TI  - The methyl-accepting transducer protein HtrI is functionally associated with the
      photoreceptor sensory rhodopsin I in the archaeon Halobacterium salinarium.
AB  - We have investigated the functional relationship between two proteins involved in
      the photosensory system of the archaeon Halobacterium salinarium: the
      photoreceptor sensory rhodopsin I (SRI) and the halobacterial transducer
      rhodopsin I (HtrI), which has been proposed to be the putative signal transducer
      of SRI, by genomic DNA analysis of two independent SRI negative mutants, Pho81
      and D1. Southern and PCR analyses revealed that both strains bear alterations in
      the 5' flanking region of the gene encoding SRI, sopI. DNA sequence analysis
      confirmed the occurrence in this region of htrI, the gene encoding the putative
      transducer protein. PCR and Northern analyses have shown further that sopI and
      htrI are expressed as a single transcriptional unit, thus explaining the lack of
      SRI in mutants with a defective htrI. Expression of the cloned sopI under the
      control of a heterologous promoter did not restore the SRI-dependent
      photoresponse in the strain Pho81. Moreover, the photocycling rate of the
      expressed pigment was clearly lower than in wild type. HtrI is therefore
      essential for SRI function and most likely modulates the photochemical properties
      of the photoreceptor via direct physical interaction. Finally, reintroduction of
      both sopI and htrI into Pho81 and D1 restored the SRI photochemistry and its
      physiological function. Our results provide the first experimental evidence for
      the functional coupling between SRI and HtrI and corroborate the proposed model
      in which HtrI acts as the signal transducer of this archaeal seven-helix
      photoreceptor in a way analogous to the bacterial chemotaxis transducers.

PMID- 8344243
TI  - Agonist-induced localized Ca2+ spikes directly triggering exocytotic secretion in
      exocrine pancreas.
AB  - We investigated how agonist-induced patterned rises in cytosolic Ca2+
      concentration ([Ca2+]i) regulate exocytotic secretion in the rat pancreatic
      acinar cell. The distribution of [Ca2+]i was visualized with a confocal
      microscope, which revealed that a Ca2+ ionophore, A23187, induced slow and
      homogeneous [Ca2+]i rises, while acetylcholine (ACh) always triggered primary
      Ca2+ spikes at the granular area which bears secretory granules. Secretion was
      monitored by measuring capacitance with the patch clamp method. Errors in the
      estimates of membrane capacitance (C) due to changes in conductance (G) were
      experimentally as well as theoretically evaluated to be one-tenth of the actual
      signals. We found that A23187 raised G without changing C at a low concentration,
      while it triggered asynchronous rises in G and C with lags in C, at a high
      concentration. By contrast, ACh triggered simultaneous rapid rises in G and C.
      Our results support the hypothesis that exocytotic secretion is less sensitive to
      Ca2+ than to ion channels and is directly caused by agonist-induced primary Ca2+
      spikes at the granular area. It is therefore suggested that spatio-temporal
      patterns of Ca2+ oscillations could play a key role in exocytotic secretion from
      the exocrine acinar cell.

PMID- 8344244
TI  - Genetic and biochemical characterization of ISP6, a small mitochondrial outer
      membrane protein associated with the protein translocation complex.
AB  - To search genetically for additional components of the protein translocation
      apparatus of mitochondria, we have used low fidelity PCR mutagenesis to generate
      temperature-sensitive mutants in the outer membrane translocation pore component
      ISP42. A high copy number suppressor of temperature-sensitive isp42 has been
      isolated and sequenced. This novel gene, denoted ISP6, encodes a 61 amino acid
      integral membrane protein of the mitochondrial outer membrane, which is oriented
      with its amino-terminus facing the cytosol. Disruption of the ISP6 gene is
      without apparent effect in wild type yeast cells, but is lethal in temperature
      sensitive isp42 mutants. Immunoprecipitation of the gene product, ISP42p, from
      mitochondria solubilized under mild conditions reveals a multi-protein complex
      containing ISP6p and ISP42p.

PMID- 8344245
TI  - Protein import into yeast mitochondria: the inner membrane import site protein
      ISP45 is the MPI1 gene product.
AB  - Protein import across both mitochondrial membranes is mediated by the cooperation
      of two distinct protein transport systems, one in the outer and the other in the
      inner membrane. Previously we described a 45 kDa yeast mitochondrial inner
      membrane protein (ISP45) that can be cross-linked to a partially translocated
      precursor protein (Scherer et al., 1992). We have now purified ISP45 to
      homogeneity and identified it as the product of the nuclear MPI1 gene. Identity
      of ISP45 with the MPI1 gene product was shown by microsequencing of three tryptic
      ISP45 peptides and by demonstrating that an antibody against an Mpi1p-beta
      galactosidase fusion protein specifically recognizes ISP45. Antibodies
      monospecific for ISP45 inhibited protein import into right-side-out mitochondrial
      inner membrane vesicles, but not into intact mitochondria. On solubilizing
      mitochondria, ISP45 was rapidly converted to a 40 kDa proteolytic fragment unless
      mitochondria were first denatured with trichloroacetic acid. The combined genetic
      and biochemical evidence identifies ISP45/Mpi1p as a component of the protein
      import system of the yeast mitochondrial inner membrane.

PMID- 8344246
TI  - Lack of assembly of mitochondrial DNA-encoded subunits of respiratory NADH
      dehydrogenase and loss of enzyme activity in a human cell mutant lacking the
      mitochondrial ND4 gene product.
AB  - In most eukaryotic cells, the respiratory chain NADH dehydrogenase (Complex I) is
      a multimeric enzyme under dual (nuclear and mitochondrial) genetic control.
      Several genes encoding subunits of this enzyme have been identified in the
      mitochondrial genome from various organisms, but the functions of these subunits
      are in most part unknown. We describe here a human cell line in which the enzyme
      lacks the mtDNA-encoded subunit ND4 due to a frameshift mutation in the gene. In
      this cell line, the other mtDNA-encoded subunits fail to assemble, while at least
      some of the nuclear-encoded subunits involved in the redox reactions appear to be
      assembled normally. In fact, while there is a complete loss of NADH:Q1
      oxidoreductase activity, the NADH:Fe(CN)6 oxidoreductase activity is normal.
      These observations provide the first clear evidence that the ND4 gene product is
      essential for Complex I activity and give some insights into the function and the
      structural relationship of this polypeptide to the rest of the enzyme. They are
      also significant for understanding the pathogenetic mechanism of the ND4 gene
      mutation associated with Leber's hereditary optic neuropathy.

PMID- 8344247
TI  - Vps1p, a member of the dynamin GTPase family, is necessary for Golgi membrane
      protein retention in Saccharomyces cerevisiae.
AB  - The KEX2-encoded endoprotease of Saccharomyces cerevisiae resides in the Golgi
      complex where it participates in the maturation of alpha-factor mating pheromone
      precursor. Clathrin heavy chain gene disruptions cause mislocalization of Kex2p
      to the cell surface and reduce maturation of the alpha-factor precursor. Based on
      these findings, a genetic screen has been devised to isolate mutations that
      affect retention of Kex2p in the Golgi complex. Two alleles of a single genetic
      locus, lam1 (lowered alpha-factor maturation), have been isolated, which result
      in inefficient maturation of alpha-factor precursor. In lam1 cells, Kex2p is not
      mislocalized to the cell surface but is abnormally unstable. Normal stability is
      restored by the pep4 mutation which reduces the activity of vacuolar proteases.
      In contrast, the pheromone maturation defect is not corrected by pep4. Organelle
      fractionation by sucrose density gradient centrifugation shows that Kex2p is not
      retained in the Golgi complex of lam1 cells. Vacuolar protein precursors are
      secreted by lam1 mutants, revealing another sorting defect in the Golgi complex.
      Genetic complementation reveals that lam1 is allelic to the VPS1 gene, which
      encodes a dynamin-related GTPase. These results indicate that Vps1p is necessary
      for membrane protein retention in a late Golgi compartment.

PMID- 8344248
TI  - The N-terminal region of GAP regulates cytoskeletal structure and cell adhesion.
AB  - Ras GTPase activating protein (GAP) possesses a C-terminal domain that interacts
      with GTP-bound Ras, and an N-terminal region containing two SH2 domains and an
      SH3 domain. In addition to its association with Ras, GAP binds stably to
      autophosphorylated beta PDGF receptors, and to two cytoplasmic phosphoproteins:
      p62, an RNA binding protein, and p190, which possesses GAP activity towards small
      guanine nucleotide binding proteins in the Rho/Rac family. To define the region
      of GAP that mediates these interactions with cellular phosphoproteins, and to
      investigate the biological significance of these complexes, a truncated GAP
      polypeptide (GAP-N) containing residues 1-445 was stably expressed in Rat-2
      fibroblasts. GAP-N contains the SH2 and SH3 domains, but lacks the Ras GTPase
      activating domain. Stimulation of cells expressing GAP-N with PDGF induced
      association of GAP-N with the beta PDGF receptor, and phosphorylation of GAP-N on
      tyrosine, consistent with the notion that GAP SH2 domains direct binding to the
      autophosphorylated beta PDGF receptor in vivo. GAP-N bound constitutively to p190
      in both serum-deprived and growth factor-stimulated cells. This GAP-N-p190
      complex had Rho GAP activity in vitro. The expression of GAP-N in Rat-2 cells
      correlated with changes in the cytoskeleton and in cell adhesion, typified by the
      disruption of action stress fibres, a reduction in focal contacts, and an
      impaired ability to adhere to fibronectin. These results suggest that the N
      terminal domain of GAP can direct interactions with cellular phosphoproteins in
      vivo, and thereby exert an effector function which modulates the cytoskeleton and
      cell adhesion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8344249
TI  - trkC encodes multiple neurotrophin-3 receptors with distinct biological
      properties and substrate specificities.
AB  - The trkC gene product gp145trkC is a high affinity signaling receptor for
      neurotrophin-3 (NT-3), a member of the NGF family of neurotrophic factors. We now
      report that trkC encodes at least two additional tyrosine protein kinase
      receptors. These receptors, designated TrkC K2 and TrkC K3, have the same amino
      acid sequences as gp145trkC (now designated TrkC K1) except for the presence of
      14 and 25 additional amino acid residues between kinase subdomains VII and VIII,
      just downstream from the TDYYR motif which encompasses the putative
      autophosphorylation site of the Trk receptor family. Upon interaction with their
      cognate ligand, NT-3, all three TrkC receptor isoforms become rapidly
      phosphorylated on tyrosine residues and induce DNA synthesis in quiescent cells.
      However, only TrkC K1 has mitogenic activity in NIH3T3 cells and induces neuronal
      differentiation of PC12 cells. The different biological properties of these TrkC
      receptor isoforms probably result from their engagement with different signaling
      pathways. Whereas TrkC K1 phosphorylates phospholipase C gamma 1 and
      phosphatidylinositol-3 kinase, TrkC K2 and TrkC K3 do not. TrkC K2 and
      transcripts encoding TrkC K3 have been identified in various structures of the
      adult murine brain. These observations suggest that the trophic activities of NT
      3 in the mammalian nervous system might be mediated by different TrkC receptor
      isoforms.

PMID- 8344250
TI  - Depletion of the mitochondrial electron transport abrogates the cytotoxic and
      gene-inductive effects of TNF.
AB  - Tumor necrosis factor (TNF) has cytotoxic and gene-inductive activities on
      several cell types. Previous studies on L929 fibrosarcoma cells have revealed
      that the mitochondrial electron transport system plays a key role in inducing TNF
      cytotoxicity, presumably by the formation of reactive oxygen intermediates (ROI).
      Here we report that mitochondria-derived intermediates are not only cytotoxic
      but, in addition, function as signal transducers of TNF-induced gene expression.
      The activation of NF kappa B, which fulfills an important role in TNF-induced
      gene transcription, could be blocked by interference with the mitochondrial
      electron transport system. Furthermore, antimycin A, a mitochondrial inhibitor
      that increases the generation of ROI, potentiated TNF-triggered NF kappa B
      activation. The dual role of mitochondria-derived intermediates in cytotoxicity
      and immediate-early gene induction of TNF was further substantiated by isolating
      L929 subclones which lacked a functional respiratory chain. This depletion of the
      mitochondrial oxidative metabolism resulted in resistance towards TNF
      cytotoxicity, as well as in inhibition of NF kappa B activation and interleukin-6
      gene induction by TNF. These findings suggest that mitochondria are the source of
      second messenger molecules and serve as common mediators of the TNF-cytotoxic and
      gene-regulatory signaling pathways.

PMID- 8344252
TI  - CAK, the p34cdc2 activating kinase, contains a protein identical or closely
      related to p40MO15.
AB  - The mitotic inducer p34cdc2 requires association with a cyclin and
      phosphorylation on Thr161 for its activity as a protein kinase. CAK, the p34cdc2
      activating kinase, was previously identified as an enzyme necessary for this
      activating phosphorylation. We confirm here that CAK is a protein kinase and
      describe its purification over 13,000-fold from Xenopus egg extracts. We further
      show that CAK contains a protein identical or closely related to the previously
      identified Xenopus MO15 gene: p40MO15 copurifies with CAK, and an antiserum to
      p40MO15 specifically depletes cAK activity. CAK appears to be the only protein in
      Xenopus egg extracts that can activate complexes of either p34cdc2 or the closely
      related protein kinase, p33cdk2, with either cyclin A or cyclin B. The sequence
      similarity between p40MO15 and p34cdc2, and the approximately 200 kDa size of
      CAK, suggest that p40MO15 may itself be regulated by subunit association and by
      protein phosphorylations.

PMID- 8344251
TI  - The MO15 gene encodes the catalytic subunit of a protein kinase that activates
      cdc2 and other cyclin-dependent kinases (CDKs) through phosphorylation of Thr161
      and its homologues.
AB  - Phosphorylation of Thr161, a residue conserved in all members of the cdc2 family,
      has been reported to be absolutely required for the catalytic activity of cdc2,
      the major regulator of eukaryotic cell cycle. In the present work, we have
      purified from starfish oocytes a kinase that specifically activates cdc2 in a
      cyclin-dependent manner through phosphorylation of its Thr161 residue. Our most
      highly purified preparation contained only two major proteins of apparent M(r) 37
      and 40 kDa (p37 and p40), which could not be separated from each other without
      loss of activity. The purified kinase was found to phosphorylate not only cdc2,
      but also cdk2 and a divergent cdc2-like protein from Caenorhabditis, in chimeric
      complexes including both mitotic and G1/S cyclins. Extensive microsequencing of
      p40 did not reveal any convincing homology with any known protein. In contrast,
      p37 is the starfish homologue of the M015 gene product, a kinase previously
      cloned by homology probing from a Xenopus cDNA library. As expected,
      immunodepletion of the MO15 protein depleted Xenopus egg extracts of CAK (cdk
      activating kinase) activity, which was recovered in immunoprecipitates. Taken
      together, the above results demonstrate that MO15 is a gene conserved throughout
      evolution (at least from echinoderms to vertebrates) that encodes the catalytic
      subunit of a protein kinase that activates cdc2-cdks complexes through
      phosphorylation of Thr161 (or its homologues).

PMID- 8344253
TI  - Tumor rejection antigen gp96/grp94 is an ATPase: implications for protein folding
      and antigen presentation.
AB  - Immunization of mice with gp96/grp94 heat shock proteins (HSPs) elicits tumor
      specific cellular immunity to the tumors from which gp96 is isolated. However,
      the cDNA sequence of gp96 is identical among tumors and normal tissues. This
      raises the question regarding the structural basis of the specific immunogenicity
      of gp96. As HSPs bind a wide array of molecules including peptides, we have
      proposed that gp96 may not be immunogenic per se, but may chaperone antigenic
      peptides. Furthermore, gp96 is localized predominantly in the lumen of the
      endoplasmic reticulum (ER) suggesting that it may act as a peptide acceptor and
      as accessory to peptide loading of MHC class I molecules. We demonstrate here
      that gp96 molecules contain ATP-binding cassettes, bind ATP and possess an Mg(2+)
      dependent ATPase activity. Gp96 preparations are also observed to contain tightly
      bound peptides, which can be eluted by acid extraction. These properties of gp96
      are consistent with its proposed roles in chaperoning antigenic peptides and in
      facilitating MHC class I--peptide assembly in the ER lumen. We present a model to
      explain how interaction of gp96 with MHC class I may result in transfer of
      peptides to the latter.

PMID- 8344254
TI  - Novel proteins associated with MHC class I antigens in cells expressing the
      adenovirus protein E3/19K.
AB  - Assembly of histocompatibility class I antigens (MHC) with beta 2-microglobulin
      (beta 2m) and peptide takes place in the rough endoplasmic reticulum (ER). At
      present, it is unclear why peptides generated in the cytosol or ER by proteolysis
      are not further degraded. Also, it is an open question whether assembly and/or
      peptide binding is self-instructive or is promoted by additional molecules, for
      example, chaperones. We previously demonstrated that the adenovirus glycoprotein
      E3/19K binds to human and some mouse MHC molecules in the ER, interfering with
      their transport to the cell surface. Here we show that immunoprecipitates from
      human cells that express transfected E3/19K and murine MHC Kd molecules not only
      contain MHC heavy chain, beta 2m and E3/19K but also two additional proteins with
      apparent molecular weights of 100 kDa and 110 kDa. Biochemical characterization
      of these proteins, designated p100 and p110, demonstrates that they are
      transmembrane glycoproteins with a similar if not identical protein backbone.
      Consistent with a role as chaperones, we find that glucose starvation induces
      complex formation between p100/110 and MHC-E3/19K. Most interestingly, p100 and
      p110 are displaced from the complex by addition of Kd-specific peptides.
      Therefore, p100 and p110 might be chaperones that promote correct folding of MHC
      antigens and/or peptide binding to MHC.

PMID- 8344255
TI  - MHC class I gene expression is negatively regulated by the proto-oncogene, c-jun.
AB  - The trans-acting factor AP-1 is a heterodimeric complex composed of c-Jun and c
      Fos family proteins which bind and regulate genes containing a TPA responsive
      enhancer element. Although AP-1 binding sites have been identified within the
      regulatory region of major histocompatibility complex (MHC) class I genes in
      vitro, the role of AP-1 in regulating MHC class I transcription in vivo has not
      been investigated previously. The present study demonstrates that expression of c
      Jun results in decreased MHC class I promoter activity as determined in
      cotransfection assays of an MHC class I reporter construct with a c-Jun
      expression construct. The c-Jun responsive element is located between bp -440 and
      -431 upstream of initiation of transcription as determined both functionally and
      by direct binding of purified c-Jun. Furthermore, over-expression of c-Jun
      reduced the steady state levels of endogenous MHC class I RNA in murine L cells
      by approximately 10-fold. These data indicate that c-Jun/AP-1 acts as a negative
      trans-acting factor that down-regulates MHC class I gene expression.

PMID- 8344256
TI  - Conversion of a silencer into an enhancer: evidence for a co-repressor in dorsal
      mediated repression in Drosophila.
AB  - The dorsal (dl) protein gradient determines patterns of gene expression along the
      dorsal-ventral axis of the Drosophila embryo. dl protein is at peak levels in
      ventral nuclei of the embryo where it activates some genes (twist and snail) and
      represses others [zerknullt (zen), decapentaplegic and tolloid]. It is a member
      of the rel family of transcription factors and interacts with specific DNA
      sequences in the regulatory regions of its target genes. These sequences (dl
      binding sites), when taken from the context of either an activated or repressed
      promoter, mediate transcriptional activation of a heterologous promoter, but not
      repression. We found that T-rich sequences close to the dl binding sites in the
      silencer region of the zen promoter are conserved between three Drosophila
      species. Using this sequence information we defined a minimal element that can
      mediate repression of a heterologous promoter. This element interacts with at
      least two factors present in embryonic extracts, one of which is dl protein. The
      other factor binds to the T-rich site. Point mutations in either site abolish
      ventral repression in vivo. In addition, mutations in the T-rich site cause
      ectopic expression in ventral regions indicating that the minimal silencer was
      converted into an enhancer.

PMID- 8344257
TI  - Conversion of a dorsal-dependent silencer into an enhancer: evidence for dorsal
      corepressors.
AB  - In Drosophila, the dorsal (dl) morphogen gradient initiates the differentiation
      of the embryonic mesoderm and neuroectoderm by activating the expression of
      regulatory genes (e.g. twist and snail) in a concentration-dependent manner. dl
      also functions as a repressor that establishes the dorsal epidermis and
      amnioserosa by restricting regulatory genes such as dpp and zen to dorsal regions
      of the embryo. The ability of dl to function as both an activator and repressor
      distinguishes it from the bicoid morphogen, which appears to function solely as
      an activator. In an effort to determine how dl functions as a repressor we have
      performed a detailed characterization of a zen silencer element, called the VRE,
      which mediates ventral repression in response to the dl gradient. A minimal 110
      bp VRE sequence is identified, which is able to silence the ventral expression of
      a heterologous promoter. This sequence contains two dl binding sites as well as
      binding sites for additional nuclear factors present in early embryos. Mutations
      in the latter binding sites convert the minimal VRE into an enhancer, which
      mediates transcriptional activation in ventral regions in response to dl. These
      results suggest that dl is intrinsically an activator, but is converted into a
      potent silencer when it interacts with neighboring corepressors.

PMID- 8344259
TI  - Common features in DNA recognition helices of eukaryotic transcription factors.
AB  - Eukaryotic transcription factors which use an alpha-helix for DNA recognition,
      including the leucine zipper and homoeo domain proteins, have common features in
      the amino acid sequence of the DNA recognition helix, and also in the way this
      helix interacts with DNA. These factors all share a similar 12 residue segment in
      the DNA recognition helix, which is named the probe helix, since it covers all
      the pertinent interactions. Moreover, in all cases the interactions can be
      divided into two parts: the Arg/Lys residues at positions 7, 9, 11 and 12 in the
      C-terminal half of the segment contact phosphate groups, whereas the N-terminal
      half interacts with the DNA bases by using residues at positions 1, 4, 5 and 8.
      The residue occupying position 1 is the most important for sequence specific DNA
      recognition. Similar 12 residue sequences are found in the DNA binding domain of
      many transcription factors including those of the TEA family, the Myc type of
      bHLH family, the MADS family, the Ets family and the OmpR family. These
      generalities show that it might be possible to find a stereochemical code which
      explains three-dimensional interactions between DNA and an alpha-helix of this
      type.

PMID- 8344258
TI  - The Brachyury gene encodes a novel DNA binding protein.
AB  - Brachyury (T) mutant embryos are deficient in mesoderm formation and do not
      complete axial development. The notochord is most strongly affected. The T gene
      is expressed transiently in primitive streak-derived nascent and migrating
      mesoderm cells and continuously in the notochord. Ectopic expression of T protein
      in the animal cap of Xenopus embryos results in ectopic mesoderm formation. The T
      protein is located in the nucleus. These and other data suggested that the T gene
      might be involved in the control of transcriptional regulation. In an attempt to
      demonstrate specific DNA binding of the T protein we have identified a consensus
      sequence among DNA fragments selected from a mixture of random oligomers. Under
      our experimental conditions T protein binds as a monomer to DNA. This property
      resides in the N-terminal domain of 229 amino acid residues which is strongly
      conserved between the mouse protein, and its Xenopus and zebrafish homologues.
      The latter proteins also recognize the consensus DNA binding site. We suggest
      that the T protein is involved in the control of genes required for mesoderm
      formation, and for the differentiation and function of chorda mesoderm.

PMID- 8344260
TI  - Genetic analysis of the leucine heptad repeats of Lac repressor: evidence for a 4
      helical bundle.
AB  - Gel-filtration experiments indicate that a peptide (P2) composed of the basic
      region of GCN4 fused to the leucine heptad repeats of Lac repressor forms
      tetrameric aggregates. Gel-shift experiments were performed to determine the
      orientation of the helices in the tetrameric P2 aggregate. Sandwich-complex
      formation of peptide P2 with two DNA fragments containing two symmetrical CRE
      binding sites (5'-ATGACGTCAT-3') at a distance of 21 bp suggests antiparallel
      aggregation of the Lac leucine heptad repeats. Thus, we conclude that the leucine
      heptad repeats of Lac repressor have the ability to form homomeric 4-helical
      bundles with an antiparallel arrangement of the helices. This topology enables
      the two DNA fragments in the sandwich complexes to be held together by two
      tetramers of peptide P2. Replacement of the uncharged amino acids of the helical
      g and e positions of peptide P2 by the corresponding charged residues of GCN4
      (peptide P4) results in a dimeric and parallel aggregation of the leucine heptad
      repeats, and consequently abolishes the potential to form sandwich structures.
      Similarly, a hybrid Lac repressor in which the GCN4 leucine zipper replaces the
      natural Lac leucine heptad repeats forms dimers only. It regains the ability to
      form tetramers when the charged amino acids in helical positions g and e are
      replaced by uncharged alanines.

PMID- 8344261
TI  - SAR-dependent mobilization of histone H1 by HMG-I/Y in vitro: HMG-I/Y is enriched
      in H1-depleted chromatin.
AB  - An experimental assay was developed to search for proteins capable of
      antagonizing histone H1-mediated general repression of transcription. T7 RNA
      polymerase templates containing an upstream scaffold-associated region (SAR) were
      highly selectively repressed by H1 relative to non-SAR control templates. This is
      due to the nucleation of H1 assembly into flanking DNA brought about by the
      numerous A-tracts (AT-rich sequences containing short homopolymeric runs of dA.dT
      base pairs) of the SAR. Partial, selective titration of these A-tracts by the
      high mobility group (HMG) protein HMG-I/Y led to the complete derepression of
      transcription from the SAR template by inducing the redistribution of H1 on to
      non-SAR templates. SARs are associated with many highly transcribed regulated
      genes where they may serve to facilitate the HMG-I/Y-mediated displacement of
      histone H1 in chromatin. Indeed, HMG-I/Y was found to be strongly enriched in the
      H1-depleted subfraction which can be isolated from chromatin.

PMID- 8344263
TI  - Complementation between HIV integrase proteins mutated in different domains.
AB  - HIV integrase (IN) cleaves two nucleotides off the 3' end of viral DNA and
      integrates viral DNA into target DNA. Previously, three functional domains in the
      HIV IN protein have been identified: (i) the central catalytic domain, (ii) the C
      terminal DNA binding domain, and (iii) the N-terminal region, which is also
      necessary for activity. We have now investigated whether IN proteins mutated in
      different domains can complement each other. Mutant D116I does not contain an
      intact active site, but does bind DNA, whereas the C-terminal deletion mutant C
      delta 73 does not bind DNA, but does have an intact active site. Neither mutant
      protein mediates site-specific cleavage or integration. However, a mixture of
      both proteins is active, suggesting that IN functions as an oligomer, and that
      two subunits can have different functions; one subunit binds the (viral) DNA and
      another subunit provides the active site. We found three classes of mutants,
      corresponding to the three domains mentioned above. Mutants from different
      classes, but not from the same class, can complement each other. However,
      complementation is most efficient when the N- and C-termini are present on the
      same molecule.

PMID- 8344262
TI  - Chromatin disruption in the promoter of human immunodeficiency virus type 1
      during transcriptional activation.
AB  - Chromatin organization of eukaryotic promoters is increasingly recognized as an
      important factor in the regulation of transcription in vivo. To determine the
      role of chromatin in HIV-1 expression, we have examined the nucleosome
      organization of the promoter of HIV-1 under low and high transcription rates.
      Independently of the cell line examined, nucleosomes are precisely positioned in
      the viral 5' long terminal repeat (5' LTR) and define two large nucleosome-free
      regions encompassing nt 200-450 and 610-720. A nucleosome positioned between
      these two regions, immediately after the transcription initiation site (nuc-1),
      is disrupted following TPA or TNF-alpha treatment. The disruption of nuc-1 from
      DNA is independent of DNA replication since it is completed in 20 min and
      independent of transcription as it is alpha-amanitin insensitive. A model is
      proposed in which nuc-1 plays an organizing role in the HIV-1 promoter to bring
      in close proximity factors bound to DNA in the two nucleosome-free regions,
      upstream and downstream of the site of transcription initiation. These results
      define chromatin as an integral component of the HIV-1 transcriptional regulatory
      machinery and identify a chromatin transition associated with activation of viral
      gene expression.

PMID- 8344264
TI  - Identification of discrete functional domains of HIV-1 integrase and their
      organization within an active multimeric complex.
AB  - HIV-1 integrase protein possesses the 3' processing and DNA strand transfer
      activities that are required to integrate HIV DNA into a host chromosome. The N-,
      C-terminal and core domains of integrase are necessary for both activities in
      vitro. We find that certain pairs of mutant integrase proteins, which are
      inactive when each protein is assayed alone, can support near wild type levels of
      activity when both proteins are present together in the reaction mixture. This
      complementation implies that HIV-1 integrase functions as a multimer and has
      enabled us to probe the organization of the functional domains within active
      mixed multimers. We have identified a minimal set of functional integrase domains
      that are sufficient for 3' processing and DNA strand transfer and find that some
      domains are contributed in trans by separate monomers within the functional
      complex.

PMID- 8344265
TI  - Homologous recombination-dependent initiation of DNA replication from DNA damage
      inducible origins in Escherichia coli.
AB  - Escherichia coli cells induced for the SOS response express inducible stable DNA
      replication (iSDR) as an SOS function. Initiation of iSDR is independent of
      transcription, translation and DnaA protein, which are essential for initiation
      of DNA replication from oriC. We found that a recA mutant that is defective in
      recombination but proficient in SOS induction could not elicit iSDR. In contrast,
      iSDR was enhanced by recD and recJ mutations that inactivate the exonuclease V
      activity of the RecBCD enzyme and the RecJ exonuclease activity, respectively. A
      mutation in the ruvC gene that blocks the resolution of recombination
      intermediates (i.e. Holliday structures) also enhanced iSDR. Furthermore,
      inhibition of branch migration by recG or ruvAB mutations dramatically increased
      the iSDR activity. recBC mutants are defective in iSDR induction but the defect
      was suppressed by a mutation in the sbcA gene. The major product of
      minichromosomes replicated by iSDR was covalently closed circular monomers. We
      propose that recombination intermediates (i.e. D-loop structures) created by the
      action of RecA recombinase and RecBC(D) helicase play a central role in
      initiation of iSDR.

PMID- 8344266
TI  - Molecular dissection of the cauliflower mosaic virus translation transactivator.
AB  - The cauliflower mosaic virus (CaMV) transactivator (TAV) is a complex protein
      that appears to be involved in many aspects of the virus life cycle. One of its
      roles is to control translation from the polycistronic CaMV 35S RNA. Here we
      report a molecular dissection of TAV in relation to its ability to enhance
      dicistronic translation in transient expression experiments. We have identified a
      protein domain that is responsible and sufficient for that activity. This
      'MiniTAV domain' consists of only 140 of the 520 amino acids in the full-length
      sequence. A further domain located outside the MiniTAV, and therefore dispensable
      for transactivation, is probably involved in interactions with other molecules.
      This was identified by its ability to compete with wild-type TAV and some of its
      deletion mutants. We found, furthermore, that the TAV protein binds RNA. Two
      regions needed for RNA-binding properties were defined outside the MiniTAV domain
      and RNA binding seems not to be directly involved in the transactivation
      mechanism.

PMID- 8344267
TI  - Functional characterization of the eukaryotic SECIS elements which direct
      selenocysteine insertion at UGA codons.
AB  - We investigated the requirements for selenocysteine insertion at single or
      multiple UGA codons in eukaryotic selenoproteins. Two functional SECIS elements
      were identified in the 3' untranslated region of the rat selenoprotein P mRNA,
      with predicted stem-loops and critical nucleotides similar to those in the SECIS
      elements in the type I iodothyronine 5' deiodinase (5'DI) and glutathione
      peroxidase selenoprotein mRNAs. Site-directed mutational analyses of three SECIS
      elements confirmed that conserved nucleotides in the loop and in unpaired regions
      of the stem are critical for activity. This indicates that multiple contact sites
      are required for SECIS function. Stop codon function at any of five out-of
      context UGA codons in the 5'DI mRNA was suppressed by SECIS elements from the
      5'DI or selenoprotein P genes linked downstream. Thus, the presence of SECIS
      elements in eukaryotic selenoprotein mRNAs permits complete flexibility in UGA
      codon position.

PMID- 8344268
TI  - Yeast prt1 mutations alter heat-shock gene expression through transcript
      fragmentation.
AB  - The inhibition of translation initiation by modification or mutation of
      initiation factors can lead to disproportionate effects on gene expression. Here
      we report disproportionate decreases in gene expression in cells with mutated
      Prt1 activity. The PRT1 gene product of the budding yeast Saccharomyces
      cerevisiae is necessary for translation initiation and is thought to be a
      component of initiation factor 3. At a restrictive temperature the prt1-1
      mutation, in addition to decreasing global protein synthesis, caused
      disproportionate decreases of the synthesis of the Ssa1 and Ssa2 members of the
      hsp70 heat-shock gene family, and of the Hsp82 and Hsc82 heat-shock proteins.
      Quantification of pulse-labelled, immunoprecipitated lacZ fusion proteins showed
      that synthesis of each of these proteins was disproportionately decreased in prt1
      1 mutant cells. Although the mRNAs of affected genes were shown to be polysomal
      in mutant cells, they were fragmented and of decreased abundance, as indicated by
      transcript analysis and in vitro translation. Thus the mRNAs of these hsp genes
      become degraded under the conditions of limited translation initiation that are
      imposed by the prt1-1 mutation. This untimely mRNA degradation accounts for the
      disproportionate decreases in polypeptide synthesis in prt1 mutant cells. We
      propose that sequences at the translation initiation site of SSA2 mRNA bring
      about the observed mRNA fragmentation.

PMID- 8344269
TI  - Identity determinants of human tRNA(Ser): sequence elements necessary for
      serylation and maturation of a tRNA with a long extra arm.
AB  - Recently, there has been much progress in understanding tRNA identity, i.e. in
      elucidating the sets of nucleotides that are responsible for the specific
      aminoacylation of a tRNA with its cognate amino acid. Interest focused, however,
      on tRNAs from Escherichia coli and yeast. Here we have identified the major and
      minor determinants of human tRNA(Ser) which were revealed by an identity switch
      from human tRNA(Val) to tRNA(Ser). We used in vitro transcripts and subsequent
      aminoacylation by HeLa S100 extract to determine the kinetic parameter Vmax/Km.
      The two major identity elements which are absolutely required for aminoacylation
      by human seryl-tRNA synthetase are the discriminator base and the long extra arm.
      This is in contrast to E. coli tRNA(Ser) where the discriminator base is
      unimportant, whereas identity determinants in the acceptor stem are required.
      Other sequence elements have an influence not only on serylation, but also on
      tRNA maturation in vitro, i.e. on pre-tRNA processing and base modification.
      These nucleotides are located in the DHU and the T phi C arm and are probably
      necessary for the proper folding of tRNAs containing a long extra arm. A34 to
      inosine modification depends highly on the correct three-dimensional structure of
      the tRNA, whereas A58 to m1A methylation does not rely on the three-dimensional
      folding of the substrate. This is the first tRNA identity switch involving the
      exchange of a short versus a long extra arm.

PMID- 8344271
TI  - 5-lipoxygenase-activating protein stimulates the utilization of arachidonic acid
      by 5-lipoxygenase.
AB  - 5-Lipoxygenase (5-LO) and its activating protein (FLAP) are both required for
      cellular leukotriene (LT) synthesis, with 5-LO catalyzing both the synthesis of
      (5S)-5-hydroperoxy-6,8,11,14-eicosatetraenoic acid (5-HPETE) from arachidonic
      acid and the subsequent synthesis of LTA4 from 5-HPETE. We have previously
      expressed both human 5-LO and human FLAP to high levels in Spodoptera frugiperda
      (Sf9) insect cells, using recombinant baculoviruses. To study the mechanism by
      which FLAP activates 5-LO, we compared cellular 5-LO activity in Sf9 cells
      expressing this enzyme to that in Sf9 cells coexpressing FLAP and 5-LO. In this
      system, FLAP stimulates the utilization of arachidonic acid by 5-LO as a
      substrate, and increases the efficiency with which 5-LO converts 5-HPETE to LTA4.
      LT synthesis in cells coexpressing FLAP and 5-LO is inhibited by 3-[1-(p
      chlorophenyl)-5-isopropyl-3-tert-butylthio-1H-indol-2-yl]-2,2- dimethyl-propanoic
      acid (MK-886), an LT biosynthesis inhibitor which specifically binds to FLAP.
      These studies in Sf9 cells, together with our recent demonstration that FLAP
      specifically binds arachidonic acid, suggests that FLAP activates 5-LO by acting
      as an arachidonic acid transfer protein.

PMID- 8344270
TI  - In vivo reactivation of catechol 2,3-dioxygenase mediated by a chloroplast-type
      ferredoxin: a bacterial strategy to expand the substrate specificity of aromatic
      degradative pathways.
AB  - The meta-cleavage operon of the TOL plasmid pWW0 of Pseudomonas putida contains
      13 genes responsible for the oxidation of benzoate and toluates to Krebs cycle
      intermediates via estradiol (meta) cleavage of (methyl)catechol. The functions of
      all the genes are known with the exception of xylT. We constructed pWW0 mutants
      defective in the xylT gene, and found that these mutants were not able to grow on
      p-toluate while they were still capable of growing on benzoate and m-toluate. In
      the xylT mutants, all the meta-cleavage enzymes were induced by p-toluate with
      the exception of catechol 2,3-dioxygenase whose activity was 1% of the p-toluate
      induced activity in wild-type cells. Addition of 4-methylcatechol to m-toluate
      grown wild-type and xylT cells resulted in the inactivation of catechol 2,3
      dioxygenase in these cells. In the wild-type strain but not in the xylT mutant,
      the catechol 2,3-dioxygenase activity was regenerated in a short time. The
      regeneration of the catechol 2,3-dioxygenase activity was also observed in H2O2
      treated wild-type cells, but not in H2O2-treated xylT cells. We concluded that
      the xylT product is required for the regeneration of catechol 2,3-dioxygenase.

PMID- 8344272
TI  - A high-order structure of plant storage proprotein allows its second conversion
      by an asparagine-specific cysteine protease, a novel proteolytic enzyme.
AB  - During seed embryogenesis, glycinin, the 11-S seed storage protein found in
      soybeans, undergoes post-translational proteolytic processing, in which a
      proprotein molecule is cleaved into an acidic and a basic subunit by a one-point
      cleavage that occurs at the carboxyl side of the asparaginyl residue located at
      the junction of the subunits. To elucidate the mechanism of this very limited
      proteolysis, we purified the cysteine endoprotease and used purified proglycinin
      produced by Escherichia coli as a substrate. This enzyme was separated by
      isoelectric focusing into three isomeric forms: two had a molecular mass of 33
      kDa and the third, 33.8 kDa. The cysteine protease was found both in the
      proteinaceous vacuoles of cotyledonary tissue of immature seeds and in mature
      seeds, and is the first proteolytic enzyme to be classified as an asparagine
      specific endoprotease. The results also indicate that the above proteolysis is
      largely attributable to the conformational accessibility of the enzyme to the
      asparaginyl residue in the cleavage site of proglycinin. The conformation of this
      single enzyme-accessible region on the proglycinin molecule is relatively
      flexible and becomes unstable under low salt conditions, or when heat is applied,
      causing the enzyme to lose its specificity.

PMID- 8344274
TI  - Interaction of type IV collagen with the isolated integrins alpha 1 beta 1 and
      alpha 2 beta 1.
AB  - The triple-helical cyanogen-bromide-derived fragment CB3[IV] of collagen IV,
      located 100 nm from the N-terminus of the molecule, contains the binding sites
      for the integrins alpha 1 beta 1 and alpha 2 beta 1. To investigate the
      interaction of these integrins and collagen IV, we performed solid-phase and
      inhibition assays using as receptor isolated alpha 1 beta 1 and alpha 2 beta 1.
      The ligands used were the binding-site-bearing trimeric peptide CB3[IV] and its
      shorter tryptic fragments F1-F4. Using titration curves, in which the binding of
      soluble receptors to coated ligands and the binding of soluble ligands to coated
      receptors were analyzed, the binding sites for alpha 1 beta 1 and alpha 2 beta 1
      were in different but adjacent areas of CB3[IV]. Triple-helical conformation and
      distinct primary structures were required for the interaction. Dissociation
      constants (Kd), for the affinity of integrins for collagen IV, were determined in
      the 1-nM range in the presence of Mn2+ and Mg2+. In the absence of Mn2+, the Kd
      values indicated a 30-60-fold decrease in the affinities, which for alpha 2 beta
      1 was further reduced by adding Ca2+. In the presence of Ca2+ and Mg2+ the
      affinity of collagen IV for alpha 1 beta 1 was four-times higher than for alpha 2
      beta 1.

PMID- 8344273
TI  - Cell-cell adhesion by homophilic interaction of the neuronal recognition molecule
      axonin-1.
AB  - The axonal surface glycoprotein axonin-1, which occurs both as a glycosyl
      phosphatidylinositol-anchored membrane-bound form and a secreted form, promotes
      neurite outgrowth and is thought to be involved in axon-guidance mechanisms in
      the developing nervous system. Recently, we have demonstrated that the neurite
      outgrowth-promoting activity of axonin-1, presented as a substratum for cultured
      neurons, is mediated by a heterophilic interaction with the axonal glycoprotein
      neuronglia cell-adhesion molecule (Ng-CAM). Here we present evidence for
      homophilic (like-like) binding among axonin-1 molecules. Axonin-1 was
      heterologously expressed in myeloma cells. Clonal cell lines, with exposed
      membrane-bound axonin-1 at their surface, formed large multicellular aggregates.
      Incubations of transfected and parental myeloma cells, under a series of
      different conditions, revealed homophilic axonin-1/axonin-1 interactions across
      the intermembrane space as the molecular mechanism promoting stable cell-cell
      contacts. Using structural and functional characterisation, recombinant axonin-1
      was very similar to native axonin-1, suggesting that homophilic axonin-1
      interactions are also established in neurons. The capability of axonin-1 to
      interact with both Ng-CAM and other axonin-1 molecules might contribute to the
      formation of macromolecular networks at contact sites of growth cones and axons,
      comprising molecules of both membranes, and thus represent a mechanism for
      regulating neurite outgrowth and pathfinding.

PMID- 8344275
TI  - Synthesis of 3-arsonoalanine and its action on aspartate aminotransferase and
      aspartate ammonia-lyase. Comparison with arsenical analogues of malate and
      fumarate.
AB  - DL-3-Arsonoalanine has been synthesized by the Strecker synthesis from the
      unstable compound arsonoacetaldehyde. It inactivates pig heart cytosolic
      aspartate aminotransferase and inhibits aspartate ammonia-lyase by competing with
      aspartate (Ki/Km 0.23). The fumarate analogue (E)-3-arsonoacrylic acid and the
      malate analogue (RS)-3-arsonolactate also inhibit fumarate hydratase, competing
      with fumarate (Ki/Km 1.8) and malate (Ki/Km 1.6) respectively. Attempted non
      enzymic transamination of 3-arsonoalanine gave elimination of arsenite, in
      contrast with the transamination of 3-phosphonoalanine, which is either
      successful or leads to loss of phosphate.

PMID- 8344276
TI  - Increase of specificity of RNase from Bacillus amyloliquefaciens (barnase) by
      substitution of Glu for Ser57 using site-directed mutagenesis.
AB  - Bacterial ribonucleases from Bacillus amyloliquefaciens and Bacillus intermedius
      show the specificity towards the nature of a nucleoside at the O3' end of the
      phosphodiester bond to be split in the preference order G > A >> U > C in the
      cleavage reactions of polynucleotides. It follows from the X-ray data that the
      substrate guanosine base is bound at the active site of these RNases in the same
      manner as for high-specificity guanylic RNases. We supposed that the difference
      in specificity for the two types of RNases is due to the additional hydrogen bond
      between the protein and a purine base in the case of bacterial guanyl-preferring
      RNases in contrast to the high-specificity guanylic RNases. To examine this
      hypothesis we prepared the Ser57 --> Glu mutant of B. amyloliquefaciens, in which
      this hydrogen bond is eliminated. Kinetic studies demonstrate that the
      specificity of this mutant towards guanylic substrates is 35-times greater than
      that of the wild-type RNases from B. amyloliquefaciens and close to that of
      RNases T1.

PMID- 8344277
TI  - Localization of two myosin-subfragment-1 binding contacts in the 96-132 region of
      actin subdomain-1.
AB  - Many direct observations and indirect experimental approaches have pin-pointed
      two segments (sequences 1-28 and 360-372) in actin subdomain-1 which bind to
      myosin subfragment-1. In a previous investigation [Labbe, J. P., Mejean, C.,
      Benyamin, Y. & Roustan, C. (1990) Biochem. J. 271, 407-413], we have observed
      competition between myosin subfragment-1 and anti-actin antibodies specific to
      epitopes including Thr103. A multisite interface model has also been proposed to
      take into account myosin-head binding to the N-terminal and C-terminal regions
      and to more central 40-113 sequence of actin. In the present study, two limited
      actin segments encompassing residues 96-103 and 112-125 were identified as myosin
      head-binding sites. Myosin subfragment-1 competed for monomeric actin with the
      antibodies directed against sequences 96-105 and 114-120 and its binding to the
      tryptic 96-113 and synthetic 112-125 actin peptides was prevented by magnesium
      pyrophosphate but not by calcium pyrophosphate. In the presence of ATP-Mg2+,
      myosin subfragment-1 was dissociated by filamin from its complex with monomeric
      actin or with peptide 105-120. Contact points of filamin on actin were previously
      located in the 105-120 and 360-372 actin sequences [Mejean, C., Lebart, M. C.,
      Boyer, M., Roustan, C. & Benyamin, Y. (1992) Eur. J. Biochem. 209, 555-562]. The
      in vitro inhibitory effect of filamin on actin-activated Mg2+-ATPase would thus
      be explained by this competition. Furthermore, the (27-kDa-50-kDa-20-kDa) trypsin
      split myosin subfragment-1 which could no longer be activated by actin, did not
      bind at all to the two sites located in the 96-125 region, but it still
      interacted with the 360-372 segment. Our results regarding the position of the
      myosin head on actin monomers in rigor conditions provide evidence on the
      presence of two topologically independent contact points in the myosin-head/actin
      interface. One group exposed residues in the 1-7, 21-29, 77-95 and 96-103 actin
      segment, another, on the opposite side of subdomain-1, included residues from 112
      125 and 360-372 sequences.

PMID- 8344278
TI  - Structural study of the oligosaccharide moieties of sphingolipid activator
      proteins, saposins A, C and D obtained from the spleen of a Gaucher patient.
AB  - We have determined and compared the structures of the oligosaccharide moieties of
      saposin A, C and D purified from the spleen of a patient with Gaucher disease.
      These saposins, together with saposin B, are small glycoproteins, derived from
      separate domains of a single precursor, prosaposin, and are required for the
      lysosomal hydrolysis of various sphingolipids. The characteristic features of the
      oligosaccharide moieties of saposin A are (a) the predominance of a fucosylated
      trimannosyl core structure and (b) the occurrence of several different
      oligomannose-type and N-acetyllactosamine-type oligosaccharides. Saposin C
      contains (a) a predominance of oligomannose-type oligosaccharides and
      monoantennary oligosaccharides and (b) the presence of four different
      oligosaccharides having bisecting N-acetylglucosamine residues (found only in
      this saposin). Saposin D is distinguished by the occurrence of oligomannose-type
      oligosaccharides, which comprise nearly 90% of its total oligosaccharides. The
      possible reasons for the unique glycosylation of each saposin is discussed.

PMID- 8344279
TI  - Rapid dephosphorylation of microtubule-associated protein 2 in the rat brain
      hippocampus after pentylenetetrazole-induced seizures.
AB  - We have studied the effect of Pentylenetetrazole (PTZ)-induced seizures on the
      state of phosphorylation of microtubule-associated protein 2 (MAP-2) from rat
      hippocampus. A method for the in vivo 32P-labeling of hippocampal proteins has
      been established, consisting of intracerebro-ventricular injection of 32PO4 of
      high specific activity. The results obtained indicate that PTZ induces a rapid
      and transient dephosphorylation of high-molecular-mass MAP-2, which is prevented
      when the N-methyl-D-aspartate receptor antagonist MK-801 is previously
      administered. Phosphopeptide mapping of 32P-labeled MAP-2 obtained from
      hippocampi of PTZ-treated rats reveals a pattern of phosphorylation distinct from
      that obtained from control saline-treated rats or MK-801 plus PTZ treated rats.
      We discuss the possible implications of N-methyl-D-aspartate-receptor activation
      and MAP-2 dephosphorylation on the plastic changes induced in rat brain
      hippocampus after induced epileptiform activity.

PMID- 8344280
TI  - Biosynthesis and secretion of human interleukin 2 glycoprotein variants from
      baculovirus-infected Sf21 cells. Characterization of polypeptides and
      posttranslational modifications.
AB  - Human interleukin 2 (IL-2) and human IL-2 mutant proteins, with artificially
      introduced N-glycosylation or O-glycosylation sites, have been expressed in a
      lepidopteran cell line (Sf21, Spodoptera frugiperda) using recombinant
      baculovirus vectors. Only approximately 25% of the total recombinant IL-2 protein
      synthesized by Sf21 cells was secreted into the culture medium. Significant N
      terminal truncations were detected in the secreted polypeptides (up to 85% of the
      molecules). Alanine and proline were absent in the major truncated forms; the
      first 3-5 amino acids were also absent in a small proportion of the purified
      proteins. The introduction of potential artificial O-glycosylation peptide
      sequences (..GGKAPTPPPK..), to the C-terminus or between positions 80 and 81 of
      the IL-2 polypeptide chain, resulted in the secretion of unglycosylated and O
      glycosylated variant forms. Fast atom bombardment mass spectrometry,
      compositional analysis and methylation analysis, of the tryptic glycopeptide
      APTPPPK, revealed the presence of either GalNAc or the disaccharide Gal(beta 1
      3)GalNAc as the only carbohydrate constituents attached exclusively to Thr in
      this peptide, in a specific ratio for each individual IL-2 mutant protein. The
      Gal(beta 1-3)GalNAc protein forms could be partially altered in vitro to
      mammalian-type glycoforms by porcine liver beta-galactoside alpha-2,3
      sialyltransferase in the presence of CMP-N-acetylneuraminic acid. An IL-2 mutant
      form, with an 11-amino-acid peptide of human interferon-beta at position 4, which
      includes its only N-glycosylation site, had exclusively truncated proximally
      fucosylated oligomannosidic glycans; Man3GlcNAc[Fuc(alpha 1-6)]GlcNAc or
      Man2GlcNAc[Fuc(alpha 1-6)]GlcNAc structures, in a ratio of 3:1, were detected in
      the secreted proteins. No evidence was obtained for the presence of secreted
      proteins with complex oligosaccharide chains, irrespective of the cell-culture
      conditions used or the harvesting time, for infected cells with recombinant
      baculovirus constructs.

PMID- 8344281
TI  - The existence of two mitochondrial isoforms of 2,4-dienoyl-CoA reductase in the
      rat.
AB  - Isoforms of 2,4-dienoyl-CoA reductase (EC 1.3.1.34), which is the key enzyme in
      the beta-oxidation of fatty acids with double bonds, have been studied in rat
      heart and liver. Electrofocusing and adsorption chromatography on hydroxyapatite
      were used to separate the reductase activity in tissue homogenates into two
      peaks, one peak in each experiment being identified as the previously purified
      mitochondrial reductase. The novel activity was partially purified from rat liver
      by means of ammonium sulphate precipitation, anion-exchange chromatography on
      DEAE-cellulose (DE-52), hydrophobic chromatography on Phenyl-Sepharose and dye
      ligand binding chromatography (Blue Sepharose). Taking into account the
      contribution of the different reductases to the total activity in rat liver, the
      overall purification for the novel isoform was 1900-fold. Ultracentrifugation on
      a sucrose gradient gave an M(r) of 50,000 and size-exclusion chromatography on
      Superdex 200 an M(r) of 60,000. The antibody against the previously characterised
      reductase did not cross-react with this novel isoform, but the distribution of
      the activity peaks in heart and liver tissue, and an electrofocusing experiment
      with isolated mitochondria, both pointed to a mitochondrial origin. The novel
      reductase was estimated to account for 80% (50%) of the total reductase activity
      in rat heart (liver) homogenate measured with 2,4-hexadienoyl-CoA. The present
      results, together with those previously published, suggest that mammals have at
      least three reductase isoforms: two in mitochondria and a third one in
      peroxisomes, but the peroxisomal activity has not been characterised so far.

PMID- 8344282
TI  - X-ray and primary structure of horse serum albumin (Equus caballus) at 0.27-nm
      resolution.
AB  - The amino-acid sequence and three-dimensional structure of equine serum albumin
      have been determined. The amino-acid sequence was deduced from cDNA isolated from
      equine liver. Comparisons of the primary structure of equine serum albumin with
      human serum albumin and bovine serum albumin reveal 76.1% and 73.9% sequence
      identity, respectively. The three-dimensional structure was determined
      crystallographically by the molecular-replacement method using molecular
      coordinates from the previously determined structure of human serum albumin, to a
      resolution of 0.27 nm. In accordance with the primary structure, the three
      dimensional structures are highly conserved. There is a root-mean-square
      difference between alpha-carbons of the two structures of 0.201 nm. The
      association constants (Ka) for the binding of 2,3,5-triiodobenzoic acid were
      determined by ultrafiltration methods for equine and human serum albumins to be
      approximately 10(4) M-1 and 10(5) M-1, respectively. Crystallographic studies of
      equine serum albumin reveal two binding sites for 2,3,5-triiodobenzoic acid
      identical with those previously reported for human serum albumin which are
      located within subdomains in IIA and IIIA. Details and comparisons of the binding
      chemistry are discussed.

PMID- 8344284
TI  - Equilibrium and transient kinetic studies of the binding of cytochalasin B to the
      L-arabinose-H+ symport protein of Escherichia coli. Determination of the sugar
      binding specificity of the L-arabinose-H+ symporter.
AB  - The kinetics of the binding of cytochalasin B to the L-arabinose-H+ symport
      protein of Escherichia coli have been investigated, using a strain that over
      produces the symport protein in the cytoplasmic membrane. Equilibrium binding
      studies revealed a single set of binding sites (2.9-8.9 nmol/mg protein) with a
      Kd of 0.7-1.0 microM at 22 degrees C. It proved possible to follow the transient
      kinetics of cytochalasin B binding by measuring the changes in the fluorescence
      of the L-arabinose-H+ symporter upon binding the ligand, by stopped-flow
      fluorescence spectroscopy. The association and dissociation rate constants thus
      determined were confirmed by rapid filtration measurements, using
      [3H]cytochalasin B, yielding values of 4.5-6.5 microM-1.s-1 and 4-5 s-1,
      respectively, consistent with Kd values obtained by measuring equilibrium binding
      of [3H]cytochalasin B by dialysis at 22 degrees C. Titration of the protein
      fluorescence with cytochalasin B yielded a similar binding site concentration and
      Kd value to those obtained in equilibrium binding studies. All the measurements
      of binding site concentration are consistent with a stoichiometry of 1 mol
      cytochalasin B binding sites/mol L-arabinose-H+ symport protein. Inhibition of
      both the rate and equilibrium binding of cytochalasin B by sugars indicated the
      following order of substrate binding 5-thio-D-glucose > D-fucose > L-arabinose >
      6-deoxy-6-fluoro-D-galactose > D-xylose approximately 6-deoxy-D-glucose > D
      galactose > D-glucose > D-ribose. Neither D-arabinose nor L-fucose had any
      significant inhibitory effect upon cytochalasin B binding.

PMID- 8344283
TI  - Effect of bromoconduritol on glucosidase II from rat liver. A new kinetic model
      for the binding and hydrolysis of the substrate.
AB  - Bromoconduritol inhibits the p-nitrophenyl-glucosidase and maltase activities of
      glucosidase II purified from rat liver, an enzyme that removes the two alpha-1,3
      linked glucose residues of the protein-bound oligosaccharide Glc2Man9GlcNAc2 in
      the processing of N-glycoproteins. The inactivation process exhibits pseudo-first
      order kinetics. Previously, we have demonstrated the occurrence of two binding
      (active) sites in the glucosidase II for the substrates p-nitrophenyl alpha-D
      glucopyranoside (pNphGlc) and maltose (high- and low-affinity sites). The
      inhibition kinetic studies with bromoconduritol indicate that the high- and low
      affinity sites for pNphGlc correspond to high- and low-affinity sites for
      maltose, respectively. Bromoconduritol has no effect on the binding of the
      substrates (pNphGlc and maltose) to the high-affinity site, although it does
      modify the low-affinity site and hinders the binding of the two indicated
      substrates to this site. These results, together with previous reports, have
      prompted us to propose a new kinetic model of binding and hydrolysis of the
      physiological substrate of the enzyme, in which the outermost glucose residue
      would bind and be released at the high-affinity site, whereas the innermost
      glucose residue would do so at the low-affinity site.

PMID- 8344285
TI  - Structural change of jack bean urease induced by addition of surfactants studied
      with synchrotron-radiation small-angle X-ray scattering.
AB  - Both the quaternary and subunit structures of jack bean urease in solutions with
      ionic and nonionic surfactants have been studied by small-angle X-ray scattering
      using a synchrotron-radiation source. The effects of those surfactants on the
      enzyme activity of urease have also been investigated in the same kind of solvent
      systems as those used for the scattering experiments. The present results show
      that the quaternary structure of urease in solution is fairly elongate and that
      by the relatively minor binding of SDS (SDS/protein = 0.23/1) the native urease
      molecule is dissociated into six identical subunits with nearly spherical
      structures. In addition the enzyme activity of urease was mostly retained under
      every solvent condition investigated, indicating that the subunit found in the
      present scattering experiments is the fundamental monomeric unit for both the
      quaternary-structure formation and enzyme function of urease.

PMID- 8344286
TI  - Characterization of a marsupial sperm protamine gene and its transcripts from the
      North American opossum (Didelphis marsupialis).
AB  - A synthetic oligonucleotide primer, designed from marsupial protamine protein
      sequence data [Balhorn, R., Corzett, M., Matrimas, J. A., Cummins, J. & Faden, B.
      (1989) Analysis of protamines isolated from two marsupials, the ring-tailed
      wallaby and gray short-tailed opossum, J. Cell. Biol. 107] was used to amplify,
      via the polymerase chain reaction, protamine sequences from a North American
      opossum (Didelphis marsupialis) cDNA. Using the amplified sequences as probes,
      several protamine cDNA clones were isolated. The protein sequence, predicted from
      the cDNA sequences, consisted of 57 amino acids, contained a large number of
      arginine residues and exhibited the sequence ARYR at its amino terminus, which is
      conserved in avian and most eutherian mammal protamines. Like the true protamines
      of trout and chicken, the opossum protamine lacked cysteine residues,
      distinguishing it from placental mammalian protamine 1 (P1 or stable) protamines.
      Examination of the protamine gene, isolated by polymerase-chain-reaction
      amplification of genomic DNA, revealed the presence of an intron dividing the
      protamine-coding region, a common characteristic of all mammalian P1 genes. In
      addition, extensive sequence identity in the 5' and 3' flanking regions between
      mouse and opossum sequences classify the marsupial protamine as being closely
      related to placental mammal P1. Protamine transcripts, in both birds and mammals,
      are present in two size classes, differing by the length of their poly(A) tails
      (either short or long). Examination of opossum protamine transcripts by Northern
      hybridization revealed four distinct mRNA species in the total RNA fraction, two
      of which were enriched in the poly(A)-rich fraction. Northern-blot analysis,
      using an intron-specific probe, revealed the presence of intron sequences in two
      of the four protamine transcripts. If expressed, the corresponding protein from
      intron-containing transcripts would differ from spliced transcripts by length (49
      versus 57 amino acids) and would contain a cysteine residue.

PMID- 8344288
TI  - Purification and characterization of guinea pig gastric phospholipase A2 of the
      pancreatic type.
AB  - Guinea pig gastric mucosa and juice contained exceptionally high phospholipase-A2
      activity, whereas the activity in the pancreas was only minimal. Phospholipases
      A2 were purified to homogeneity from these three tissues. Structural evidence,
      including the sequence of the NH2-terminal 41 residues, the amino-acid
      composition and the molecular mass (13902 +/- 3 Da) determined accurately by mass
      spectrometry, showed that the gastric mucosa enzyme belongs to the pancreatic
      type. An unique feature of the sequence is the substitution of Phe for the
      hitherto invariant Tyr28 in the calcium-binding loop of pancreatic phospholipases
      A2. The affinity of the guinea pig enzyme for Ca2+ in the presence of substrate
      was, however, identical to that of the rat enzyme with Tyr28, suggesting the
      interaction of a phenolic hydroxyl group of the Tyr with its neighboring residues
      is not significantly linked to the binding of Ca2+. The NH2-terminal sequences
      and immunochemical properties of the enzymes purified from the gastric juice and
      pancreas were identical to those of the gastric mucosa enzyme. The distribution
      of cells immunoreactive with anti-(gastric PLA2) immunoglobulin in the stomach
      was quite similar to that of the chief cells. Unlike in pancreas of other
      animals, the prophospholipase A2 was not detectable in gastric mucosa or juice
      homogenates treated with diisopropyl fluorophosphate or in column effluents
      during purification under acidic conditions. An appreciable prophospholipase-A2
      activating activity was not detectable in gastric mucosa extracts at low pH
      relevant to gastric juice, using rat prophospholipase A2 as substrate. This
      opposes the activation of secreted proenzyme in the gastric juice.

PMID- 8344287
TI  - The US-1 element from the gene encoding rat poly(ADP-ribose) polymerase binds the
      transcription factor Sp1.
AB  - By comparing the upstream DNA sequence of the rat and human genes encoding
      poly(ADP-ribose) polymerase (PARP), we have defined a 16-bp conserved region and
      designated it as US-1 for 'upstream sequence 1'. This element is homologous to
      the recently described binding site for the transcription factor Sp1 in the
      promoter sequence of the mouse p12 gene which encodes a protease inhibitor.
      Analyses in gel mobility shift assays revealed that a nuclear protein, produced
      by all tissue-culture cells tested, specifically binds the US-1 element. The
      pattern of shifted DNA protein complexes obtained was strikingly similar to that
      for Sp1, which is supported by the positive displacement of these complexes by an
      oligomer containing the Sp1 binding site in gel shift competition experiments.
      Replacement of the Sp1 binding site from the basal promoter of the mouse p12 gene
      by the rPARP US-1 element did not result in any significant variations in the
      level of expression of the chloramphenicol acetyltransferase (CAT) reporter gene
      upon transient transfection of tissue-culture cells. However, when point
      mutations are introduced in the US-1 element in a similar substitution
      experiment, a significant reduction in CAT gene expression could be observed.
      These data are consistent with Sp1 interacting with the US1 element. Results from
      DNase I footprinting experiments clearly indicated that purified Sp1 not only
      binds to the US-1 element but also to four other closely located cis-acting sites
      scattered in the promoter of the rat PARP gene, therefore suggesting that Sp1 is
      likely to modulate strongly the expression of that gene in different tissues.

PMID- 8344289
TI  - A study of the binding of NADP coenzymes to dihydrofolate reductase by raman
      difference spectroscopy.
AB  - We report here the Raman spectra of NADPH, NADP+, 3-acetylpyridine adenine
      dinucleotide (AcPdADP+), NADH and a fragment of these molecules, 2'-phospho
      adenosine-5'-diphosphoribose (Ado2'p5'ppRib), bound to Escherichia coli
      dihydrofolate reductase (DHFR). The positions that are observed for the bound
      adenosine 'triplet' bands are consistent with a protein binding pocket for this
      group which is quite hydrophobic in nature. No binding effect is observed on
      Raman bands associated with the nicotinamide group of NADP+ as a binary complex
      with DHFR, suggesting very loose, if any, binding of this group. In contrast,
      changes in the Raman spectrum of the nicotinamide group of NADP+ bound to an
      inhibitor (trimethoprim) ternary complex of DHFR are clearly observed which
      indicate substantial binding interaction. The carboxamide group of bound NADPH
      (and NADH) adopts the trans conformation. A 35-cm-1 upshift is observed in the
      rocking motion of the carboxamide -NH2 group of NADPH, and a 5-cm-1 upward shift
      is seen in the C=O stretch mode of AcPdADP+ upon binding to the enzyme
      trimethoprim complex. These results suggest that the -NH2 group of the
      carboxamide moiety is more tightly hydrogen bonded in the protein binding pocket
      than in solution while that of the C=O group is less tightly hydrogen bonded;
      these hydrogen bonds would appear to be responsible for holding the nicotinamide
      headgroup in place properly for catalysis. We have compared this with the results
      obtained previously in other protein complexes, and interpret the observed shifts
      in these bands as a measure of the hydrogen bonding enthalpy of the -NH2 and C=O
      groups with their protein environments. Perhaps surprisingly, the magnitude of
      the hydrogen bonding enthalpy takes on a limited number of discrete values over
      five protein complexes rather than over a continuous range. The effect that this
      has on the catalytic properties of DHFR and the other NAD dehydrogenases that we
      have studied to date, particularly their stereochemistry, is discussed. A small
      downward shift is observed for the P = O stretch of the 2'-phosphate moiety of
      NADP. This indicates that the 2'-phosphate moiety binds to DHFR in the dianionic
      form. Furthermore, the local enthalpic interaction that the 2'-phosphate group
      has with protein is stronger than its interaction with water.

PMID- 8344290
TI  - Cloning and expression of phospholipase A2 from guinea pig gastric mucosa, its
      induction by carbachol and secretion in vivo.
AB  - A cDNA encoding phospholipase A2 (PLA2) was cloned from guinea pig gastric mucosa
      using a rat pancreatic-PLA2-cDNA fragment as a probe. The cDNA contains an open
      reading frame sufficient to encode the entire amino-acid sequence of a PLA2
      precursor protein consisting of 146 amino acids, including a putative 16-residue
      signal peptide and a 6-residue activation peptide at the NH2-terminus. Its
      nucleotide sequence exhibits 70% similarity to that of rat pancreatic PLA2 cDNA.
      The deduced amino-acid sequence has all the typical pancreatic PLA2
      characteristics, with the exception of the substitution of Phe for Tyr at
      position 28 in the calcium-binding loop of the mature enzyme. When an expression
      vector containing the PLA2 cDNA was transfected into COS-7 cells, a major portion
      of the proenzyme was secreted into the culture medium. Northern-blot analysis
      showed the mRNA was present in guinea pig lung and pancreas at much lower levels
      than in the stomach. The effect of carbachol, a muscarinic acetylcholine agonist,
      on the secretion of gastric PLA2 and on its mRNA level in the gastric mucosa were
      examined. PLA2 secretion into the gastric juice was maximal 30 min after the
      subcutaneous administration of carbachol (0.4 mg/kg). It also increased the PLA2
      mRNA level in the tissue, the maximal mRNA level being delayed about 15 min
      compared with that in PLA2 secretion. These results suggest that vagal stimuli
      may contribute to PLA2 secretion and its compensatory synthesis, and that the
      secreted PLA2 may participate in the digestion of dietary and biliary
      phospholipids in the small intestine of guinea pig.

PMID- 8344291
TI  - Isolation, characterization and expression of the eclosion hormone gene of
      Drosophila melanogaster.
AB  - Eclosion hormone (EH) is a neuropeptide that triggers the performance of ecdysis
      behaviors at the end of a molt. We have isolated the EH gene from Drosophila
      melanogaster, and localized the gene to the right arm of chromosome 3 at band
      position 90B1-2. The 97-amino-acid translation product contains a signal peptide
      followed by a 73-amino-acid prohormone. The N-terminus of the prohormone has
      diverged from lepidopteran EH both in its length and amino acid composition, and
      contains a potential endoproteolytic cleavage site. The deduced sequence of
      Drosophila EH is 58% identical (36 of 62 amino acids) to that of Manduca EH. The
      EH gene is expressed as a 0.8-kb transcript in a single pair of brain neurons
      which extend their processes the entire length of the central nervous system and
      also to the corpora cardiaca portion of the ring gland. These cells show massive
      depletion of immunoreactive EH at ecdysis.

PMID- 8344292
TI  - Lipase from Pseudomonas aeruginosa. Production in Escherichia coli and activation
      in vitro with a protein from the downstream gene.
AB  - The lipase gene from Pseudomonas aeruginosa TE3285 is followed by another gene,
      lipB. The lipase gene was expressed in Escherichia coli BL21(DE3)pLysS using the
      T7 RNA polymerase expression system. The mature lipase was accumulated as
      inclusion bodies at 42% of the total cell proteins. The inclusion bodies were
      solubilized with 8 M urea, but lipase activity was not detected in the
      solubilized preparation containing 85% lipase protein even after removing urea by
      dialysis. The lipB gene, positioned downstream of the lipase gene and thought to
      be necessary for the expression of the lipase gene, was expressed in Escherichia
      coli JM109 as a fusion with the glutathione transferase gene from Schistosoma
      japonicum. The fusion protein was partially purified on glutathione-agarose beads
      to 36% purity. Incubated with the fusion protein at a molar ratio of 1:1 at 4
      degrees C for 24 h, the solubilized lipase showed lipase activity of about a
      tenth that of the purified lipase prepared from Pseudomonas aeruginosa TE3285.
      Magnesium ions and ATP were not essential but increased the activation. When the
      fusion protein was treated with thrombin to release the glutathione transferase
      part, it retained its activity. The lipase activation with lipB protein probably
      proceeds to form a 1:1 complex with the inactive, solubilized lipase protein but
      by a different mode from known chaperones.

PMID- 8344293
TI  - Overproduction of S-adenosylmethionine decarboxylase in ethylglyoxal
      bis(guanylhydrazone)-resistant mouse FM3A cells.
AB  - A variant cell line, termed SAM-1, which overproduced S-adenosylmethionine
      decarboxylase (AdoMetDC), was isolated by treatment of mouse FM3A cells with N
      methyl-N'-nitro-N-nitrosoguanidine and subsequent incubation with ethylglyoxal
      bis(guanylhydrazone), an inhibitor of the enzyme. The cells were resistant to
      ethylglyoxal bis(guanylhydrazone), and showed AdoMetDC activity approximately
      five-times higher than control cells. The rate of AdoMetDC synthesis and the
      amount of AdoMetDC existing in SAM-1 cells were about five-times those in control
      cells. The amount of AdoMetDC mRNA existing in SAM-1 cells was five-times more
      than that in control cells. The amount of 5'-([(Z)-4-amino-2-butenyl]methylamino)
      5'-deoxyadenosine, an irreversible inhibitor of AdoMetDC, necessary to inhibit
      cell growth was also five-times more in SAM-1 cells than in control cells.
      However, the following were the same in both SAM-1 and control cells; the amount
      of genomic DNA for AdoMetDC, the size and nucleotide sequence of 5' untranslated
      region of AdoMetDC mRNA, the deduced amino acid sequence (334 residues) from the
      nucleotide sequence of AdoMetDC cDNA and the degradation rate (t1/2 = about 4 h)
      of AdoMetDC. In addition, AdoMetDC mRNA in control cells was slightly more stable
      than that in SAM-1 cells. The results indicate that the overproduction of
      AdoMetDC in SAM-1 cells was caused by the increase of AdoMetDC mRNA. The variant
      cell line is convenient for studying the regulation of AdoMetDC and the
      physiological function of polyamines.

PMID- 8344294
TI  - 1H-NMR analysis of turkey egg-white lysozyme and comparison with hen egg-white
      lysozyme.
AB  - The complete main chain and approximately 75% of the side chain 1H-NMR
      assignments of the 129-residue protein, turkey egg-white lysozyme, are presented.
      NOE data, hydrogen-exchange rates, chemical shifts and coupling constants are
      reported and are indicative of a structure in solution that is essentially
      identical to that of the homologous hen egg-white lysozyme. The NH-alpha CH
      coupling constants of turkey lysozyme are compared to torsion-angle data from
      three crystal structures of the protein and the results are interpreted in terms
      of crystal-structure resolution and refinement.

PMID- 8344295
TI  - Dimeric forms of cholinesterase in Sipunculus nudus.
AB  - In developing a research on the cholinesterase (ChE) evolution in Invertebrata,
      this enzyme was studied in the unsegmented marine worm Sipunculus nudus. ChE
      activity was solubilized through three successive steps of extraction. These
      fractions are noted as low-salt (LSS), detergent (DS) and high-salt soluble (HSS)
      and represent 27%, 68% and 5% of total activity, respectively. LSS and DS ChE
      were purified to homogeneity by affinity chromatography on edrophonium-Sepharose
      gel. Purification factors of 1700 (LSS) and 1090 (DS) were obtained. The small
      amount of HSS ChE prevented a similar purification and an extensive
      characterization. Based on SDS/PAGE and density-gradient centrifugation, both LSS
      and DS enzymes show a M(r) value of about 130,000 and are likely G2 globular
      dimers of a 67,000 subunit. Moreover, LSS ChE seems to be an amphiphilic form
      including a hydrophobic domain, while DS ChE is probably linked to the cell
      membrane by a phosphatidylinositol anchor. Both LSS and DS enzymes hydrolyze at
      the highest rate propionylthiocholine. However, they also show a fairly high
      catalytic efficiency with other thiocholine esters as substrates, thus suggesting
      a wide and little-specialized conformation of the active site. Based on
      immunological cross-reactivity trials, LSS and DS ChE from S. nudus show a
      reduced structural affinity with a molluscan (Murex brandaris) enzyme. HSS ChE,
      an acetylcholinesterase, is also solubilized by heparin, like typical vertebrate
      HSS asymmetric enzymes. However, it lacks fast-sedimenting forms and an enzyme
      anchoring collagenous structure.

PMID- 8344296
TI  - Analysis of the resistance to heat and hydrogen peroxide stresses in COS cells
      transiently expressing wild type or deletion mutants of the Drosophila 27-kDa
      heat-shock protein.
AB  - The Drosophila melanogaster small heat-shock protein, hsp27 (Dhsp27) belongs to a
      family of polypeptides which shares a sequence related to alpha-crystallin and
      which protect cell against heat shock. Dhsp27 accumulates following heat shock
      and, in absence of stress, in the central nervous system, imaginal discs and the
      gonads of the developing fly. Two internal and adjacent deletion mutants in the
      conserved alpha-crystallin domain of Dhsp27 were constructed. Expression vectors
      containing either the coding sequence of Dhsp27 or that of the two deletion
      mutants linked to the Simian-Virus-40 late promoter were used to transfect monkey
      COS cells. The transient expression of Dhsp27 was found to decrease the
      sensitivity of COS cells to heat and hydrogen-peroxide stresses as judged by
      Trypan-blue staining and indirect immunofluorescence analysis. Using this rapid
      test, we observed that a deletion of 62 amino acids, which lies at the 5' end of
      the conserved alpha-crystallin domain and covers the first 41 amino acids of this
      region had only a weak effect on the protective activity of Dhsp27. This suggests
      that the N-terminal half of the conserved alpha-crystallin domain may not be
      essential for the protective activity of the small hsp. In contrast, Dhsp27 was
      no more active when the last 42 amino acids of the alpha-crystallin domain were
      deleted. Biochemical fractionation and indirect immunofluorescence analysis
      indicated that the protective function of Dhsp27 was localized at the level of
      the nucleus.

PMID- 8344297
TI  - Ribosomes terminated in vitro are in a tight association with non-phosphorylated
      elongation factor 2 (eEF-2) and GDP.
AB  - A proportion of the ribosome population in the eukaryotic cell is present in the
      form of single 80-S ribosomes. These are not involved in translation and are
      tightly associated with eukaryotic elongation factor 2 (eEF-2). The factor
      dissociates from ribosomes when it is ADP-ribosylated. Attempts at reconstitution
      of such complexes from ribosomal subunits and eEF-2 were not successful. We have
      shown that monomeric ribosomes in a tight complex with eEF-2 can be obtained in
      vitro as terminated ribosomes in a reconstituted translation system containing
      isolated polyribosomes, elongation factors and pH5 enzymes (all from rabbit
      reticulocytes). Incubation of the system with radioactive GTP demonstrated that
      terminated ribosomes contain GDP. ADP-ribosylation of eEF-2 bound to terminated
      ribosomes by diphtheria toxin leads to dissociation of both eEF-2 and GDP to the
      same extent. Thus the presence of GDP in terminated ribosomes is eEF-2 dependent.
      Ribosomes terminated in vitro as well as native single ribosomes contain the non
      phosphorylated form of eEF-2. We assume that tight association of terminated
      ribosomes with the non-phosphorylated form of eEF-2 excludes both the ribosome
      and active eEF-2 from the translational cycle and thus, maintains the optimal
      proportion of translating ribosomes and free eEF-2 in the cell.

PMID- 8344298
TI  - Studies on the induction and phosphorylation of xanthine dehydrogenase in
      cultured chick embryo hepatocytes.
AB  - Chick embryo hepatocytes, cultured in a chemically defined medium, were used to
      investigate hormonal requirements for xanthine-dehydrogenase induction and to
      determine whether the enzyme is phosphorylated. Triiodothyronine is found to be
      required to induce the synthesis of active enzyme. Inclusion of sodium tungstate
      in the medium resulted in the complete loss of enzyme activity but no decrease of
      immunochemically detectable levels of enzyme. Immunoprecipitated xanthine
      dehydrogenase from cell extracts migrates with enzyme purified from adult chicken
      liver on SDS/PAGE. Both the native 150-kDa subunit and the 130-kDa form of the
      enzyme is observed. N-terminal sequence analysis of the 150-kDa subunit shows the
      following; Ala-Pro-Pro-Glu-Thr-Gly-Asp-Glu-Leu-Val-Phe-Phe-Val-Asn-Gly-Lys-Lys
      Val- Val which is similar to the published N-terminal sequences of rat, mouse and
      insect xanthine dehydrogenases. Autoradiography of denaturing gels of xanthine
      dehydrogenase isolated from 32P(i)-labeled hepatocytes demonstrates that the 150
      kDa and the 130-kDa forms of the enzyme are phosphorylated. Chemical phosphate
      analysis of acid-precipitated, electrophoretically pure chicken liver xanthine
      dehydrogenase also shows the presence of covalently bound phosphate. Phosphoamino
      acid analysis of both 32P-labeled forms of the enzyme demonstrates the presence
      of phosphoserine. Thus, chicken liver xanthine dehydrogenase contains a
      phosphoserine residue as found previously in bovine milk xanthine oxidase [Davis,
      M. D., Edmondson, D. E. & Muller, F. (1984) Eur. J. Biochem. 145, 237-250].

PMID- 8344299
TI  - Stabilized NMR structure of human parathyroid hormone(1-34).
AB  - The structure of the biologically-active N-terminal region of human parathyroid
      hormone, PTH(1-34), was investigated in the presence of 10% trifluoroethanol
      using two-dimensional proton NMR spectroscopy, distance geometry and dynamic
      simulated annealing. Complete assignments of all backbone and side chain
      hydrogens were made with the aid of totally correlated spectroscopy (TOCSY)
      experiments, providing through-bond 1H-1H connectivities, and NOESY providing
      through-space and sequential backbone connectivities. Distance and angle
      constraints were used in the distance geometry algorithm DIANA II to generate a
      family of structures satisfying all inputs. The lowest energy structures were
      further refined using the dynamic-simulated-annealing protocol XPLOR 3. The major
      structural features evident in 10% trifluoroethanol are two segments of alpha
      helix extending from residues Glu4 to Lys14/His14 and Ser17 to Asp30. A short
      length of unordered structure joined the two spans of helix. The structures of
      the N-terminal regions (4-13/14) agreed closely with the structure found in human
      parathyroid-hormone-related protein (PTHrP)(1-34) obtained earlier by Ray, Barden
      and Kemp [19]. However, PTHrP(16-19) exhibited a reverse turn which is
      incorporated in an extended helix in PTH. The consequent interactions between
      several hydrophobic residues in the C-terminal region in PTHrP are absent in PTH.
      Moreover, the turn in PTHrP(22-25) at the start of the C-terminal helix is
      present as a more standard loop of helix in PTH. Comparisons between the
      structures of the two hormones has enabled the probable location and structure of
      the PTH receptor-binding site to be placed in the segment of amphiphilic alpha
      helix (24-31).

PMID- 8344300
TI  - The isopenicillin-N acyltransferase of Penicillium chrysogenum has isopenicillin
      N amidohydrolase, 6-aminopenicillanic acid acyltransferase and penicillin amidase
      activities, all of which are encoded by the single penDE gene.
AB  - The isopenicillin-N acyltransferase of Penicillium chrysogenum catalyzes the
      conversion of the biosynthetic intermediate isopenicillin N to the hydrophobic
      penicillins. The isopenicillin-N acyltransferase copurified with the acyl-CoA:6
      aminopenicillanic acid (6-APA) acyltransferase activity which transfers an acyl
      residue from acyl-CoA derivatives (e.g. phenylacetyl-CoA, phenoxyacetyl-CoA) to 6
      APA. Other thioesters of phenylacetic acid were also used as substrates. An amino
      acid sequence similar to that of the active site of thioesterases was found in
      the isopenicillin-N acyltransferase, suggesting that this site is involved in the
      transfer of phenylacetyl residues from phenylacetyl thioesters. Purified
      isopenicillin-N acyltransferase also showed isopenicillin-N amidohydrolase,
      penicillin transacylase and penicillin amidase activities. The isopenicillin-N
      amidohydrolase (releasing 6-APA) showed a much lower specific activity than the
      isopenicillin-N acyltransferase of the same enzyme preparation, suggesting that
      in the isopenicillin-N acyltransferase reaction the 6-APA is not released and is
      directly converted into benzylpenicillin. Penicillin transacylase exchanged side
      chains between two hydrophobic penicillin molecules; or between one penicillin
      molecule and 6-APA. The penicillin amidase activity is probably the reverse of
      the biosynthetic acyl-CoA:6-APA acyltransferase. Four P. chrysogenum mutants
      deficient in acyl-CoA:6-APA acyltransferase lacked the other four related
      activities. Transformation of these mutants with the penDE gene restored all five
      enzyme activities.

PMID- 8344302
TI  - Extensive accumulation of an extracellular L-amino-acid oxidase during
      gametogenesis of Chlamydomonas reinhardtii.
AB  - In a previous study [Bulte, L. & Wollman, F.-A. (1992) Eur. J. Biochem. 204, 327
      336], we identified a novel gamete-specific polypeptide of Chlamydomonas
      reinhardtii, M alpha. This 66-kDa polypeptide reacts with antibodies to
      cytochrome f and accumulates in gametes only in conditions that promote
      destabilisation of the cytochrome b6/f complex. Here, we show that M alpha is not
      a modification product of cytochrome f, but is part of protein M, a high
      molecular-mass L-amino-acid oxidase located in the periplasm. It catalyzes
      oxidation of all L-amino acids tested, except cysteine. Using phenylalanine as a
      substrate, saturation of the enzymatic rate is reached at 2 microM. These
      characteristics suggest that protein M may operate in vivo as an efficient
      scavanger of ammonium from extracellular amino acids. The enzyme contains non
      covalently bound FAD. It exists in two forms with essentially similar enzymatic
      properties, of 1.2-1.3 MDa and 0.9-1.0 MDa, respectively. The lighter form is an
      oligomer of M alpha, while the heavier form contains, in addition to M alpha, a
      second polypeptide of 135 kDa, M beta, in a molar ratio of 3-4 M alpha/M beta.
      Both polypeptides are glycosylated.

PMID- 8344301
TI  - L-serine and L-threonine dehydratase from Clostridium propionicum. Two enzymes
      with different prosthetic groups.
AB  - L-Serine dehydratase from the Gram-positive bacterium Peptostreptococcus
      asaccharolyticus is novel in the group of enzymes deaminating 2-hydroxyamino
      acids in that it is an iron-sulfur protein and lacks pyridoxal phosphate
      [Grabowski, R. and Buckel, W. (1991) Eur. J. Biochem. 199, 89-94]. It was
      proposed that this type of L-serine dehydratase is widespread among bacteria but
      has escaped intensive characterization due to its oxygen lability. Here, we
      present evidence that another Gram-positive bacterium, Clostridium propionicum,
      contains both an iron-sulfur-dependent L-serine dehydratase and a pyridoxal
      phosphate-dependent L-threonine dehydratase. These findings support the notion
      that two independent mechanisms exist for the deamination of 2-hydroxyamino
      acids. L-Threonine dehydratase was purified 400-fold to apparent homogeneity and
      revealed as being a tetramer of identical subunits (m = 39 kDa). The purified
      enzyme exhibited a specific activity of 5 mu kat/mg protein and a Km for L
      threonine of 7.7 mM. L-Serine (Km = 380 mM) was also deaminated, the V/Km ratio,
      however, being 118-fold lower than the one for L-threonine. L-Threonine
      dehydratase was inactivated by borohydride, hydroxylamine and phenylhydrazine,
      all known inactivators of pyridoxal-phosphate-containing enzymes. Incubation with
      NaB3H4 specifically labelled the enzyme. Activity of the phenylhydrazine
      inactivated enzyme could be restored by pyridoxal phosphate. L-Serine dehydratase
      was also purified 400-fold, but its extreme instability did not permit
      purification to homogeneity. The enzyme was specific for L-serine (Km = 5 mM) and
      was inhibited by L-cysteine (Ki = 0.5 mM) and D-serine (Ki = 8 mM). Activity was
      insensitive towards borohydride, hydroxylamine and phenylhydrazine but was
      rapidly lost upon exposure to air. Fe2+ specifically reactivated the enzyme. L
      Serine dehydratase was composed of two different subunits (alpha, m = 30 kDa;
      beta, m = 26 kDa), their apparent molecular masses being similar to the ones of
      the two subunits of the iron-sulfur-dependent enzyme from P. asaccharolyticus.
      Moreover, the N-terminal sequences of the small subunits from these two organisms
      were found to be 47% identical. In addition, 38% identity with the N-terminus of
      one of the two L-serine dehydratases of Escherichia coli was detected.

PMID- 8344303
TI  - Primary structure of human milk octa-, dodeca- and tridecasaccharides determined
      by a combination of 1H-NMR spectroscopy and fast-atom-bombardment mass
      spectrometry. Evidence for a new core structure, the para-lacto-N-octaose.
AB  - Two octasaccharides, two dodecasaccharides and a tridecasaccharide have been
      isolated from human milk by a combination of paper chromatography, high
      performance liquid chromatography and high-performance anion-exchange
      chromatography. Their structural analysis investigated by 400-MHz 1H- and 13C-NMR
      spectroscopy and by mass spectrometry led to the following structures. [formula:
      see text] The two octasaccharides have been previously characterized in human
      milk; the complete assignment of the 1H and 13C spectra is reported here. One of
      the dodecasaccharides is a tetrafucosyl derivative with a new core: typeI-(beta 1
      3)-typeII-(beta 1-3)-typeII-(beta 1-3)-Gal((beta 1-4)Glc, where typeI = Gal(beta
      1-3)GlcNAc and typeII = Gal(beta 1-4)GlcNAc. These oligosaccharides display
      simultaneously Lewis(b) and Lewis(x) determinants or Lewis(a), Lewis(b) and
      Lewis(x) determinants.

PMID- 8344304
TI  - Kinetics of cytochromes P-450 IA1 and IIB1 in reconstituted systems with
      dilauroyl- and distearoyl-glycerophosphocholine.
AB  - In the present study the effect of changing the fatty acyl moiety of
      phosphatidylcholine from dilauroyl to distearoyl on the kinetic parameters of O
      dealkylation of alkoxyresorufins and ethoxycoumarin dependent on reconstituted
      cytochromes P-450 IA1 and IIB1 has been investigated. The results demonstrate
      that (a) the maximum rate of O-dealkylation (V) for both P-450 enzymes was about
      two times higher in the L-alpha-dilauroyl-sn-glycero-3-phosphocholine
      (Lau2GroPCho) system and (b) changes in the fatty acyl moiety of
      phosphatidylcholine (acyl2GroPCho) from dilauroyl to distearoyl affected the
      apparent Km for the substrate (Kms) of P-450 IA1 and IIB1 in a different way. In
      addition, (c) the kinetic parameters appeared to be dependent on the
      acyl2GroPCho/P-450 ratio and a change in this ratio affected the kinetic
      parameters of P-450 IA1 and IIB1 in a different manner. From these last two
      observations it was concluded that the mechanism by which phospholipids influence
      P-450-IIB1-dependent O-dealkylation of ethoxycoumarin is different from that by
      which they influence P-450-IIB1-dependent O-dealkylation of this substrate.
      Furthermore, the results of the present study demonstrate that the increase in
      the rate of O-dealkylation of ethoxycoumarin, reported in the literature for
      reconstituted systems in the presence of Lau2GroPCho, results from an effect of
      Lau2GroPCho on both the Kms and the V. In a number of additional experiments
      possible mechanisms underlying the observed differential effect of Lau2GroPCho
      and Ste2GroPCho on the Kms and V of P-450 IA1 and IIB1 were investigated. This
      was done by studying the effect of the two acyl2GroPCho species on the kinetic
      parameters of some of the different steps of the P-450 cycle, namely substrate
      binding, oxygen binding and the rate of electron transfer. The results
      demonstrate an influence of Lau2GroPCho and Ste2GroPCho on (a) substrate binding
      to cytochrome P-450, (b) the affinity of cytochromes P-450 for NADPH-cytochrome
      reductase and thus on (c) the electron flow through the reconstituted system.
      Based on the results from these experiments it was concluded that the increased V
      of P-450 IA1 and IIB1 in the presence of Lau2GroPCho compared to the systems with
      Ste2GroPCho was at least in part due to an increased affinity of both P-450
      enzymes for NADPH-cytochrome reductase in the presence of Lau2GroPCho compared to
      Ste2GroPCho.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8344305
TI  - Rat brain cytosol contains a factor which reconstitutes guanine-nucleotide
      binding-protein-regulated phospholipase-D activation in HL60 cells previously
      permeabilized with streptolysin O.
AB  - We report that guanosine 5'-[gamma-thio]triphosphate (GTP[S]) can stimulate
      phospholipase D (PLD) in HL60 cells acutely permeabilized with streptolysin O.
      The ability of GTP[S] to stimulate PLD is impaired if the cells are previously
      permeabilized such that the majority of the cytosol has leaked out. Rat brain and
      HL60 cytosols were both found to restore GTP[S]-stimulated PLD activity in a
      reconstitution assay consisting of previously permeabilized HL60 cells. Rat brain
      cytosol was fractionated on heparin agarose and assayed for reconstitution of
      GTP[S]-stimulated PLD activity. The active fractions were pooled, concentrated
      and chromatographed on gel filtration to assess its molecular mass. The molecular
      mass of the reconstituting factor was found to be 16 kDa. Reconstitution by the
      cytosolic factor was dependent on GTP[S]. Ca2+ (pCa 5), MgATP and MgCl2 enhanced
      GTP[S]-dependent reconstitution of PLD activity in the previously permeabilized
      HL60 cells. These results demonstrate the presence in rat brain cytosol of a
      factor which is an activator of GTP[S]-stimulated PLD.

PMID- 8344306
TI  - cDNA cloning of the sodium-influx-stimulating peptide in the mollusc, Lymnaea
      stagnalis.
AB  - We isolated and characterized a cDNA clone, encoding the prohormone of the sodium
      influx-stimulating (SIS) peptide of the freshwater snail Lymnaea stagnalis. The
      prohormone is cleaved to generate a signal peptide of 23 amino acids and a SIS
      peptide of 77 amino acids. The SIS peptide as encoded by the cDNA represents a
      novel and complex neuropeptide, which controls the activity of sodium pumps in
      the integument, pericardium, ureter and nephridial gland. In situ hybridization
      showed that the SIS-peptide gene is expressed by the neuroendocrine, so-called
      Yellow Cells of the central nervous system.

PMID- 8344307
TI  - Calcium binding by chick calretinin and rat calbindin D28k synthesised in
      bacteria.
AB  - Calretinin is a member of the EF-hand calcium-binding protein family, with a high
      similarity with calbindin D28k. The chick calretinin cDNA sequence was
      reconstructed in a M13 vector and transferred into an expression plasmid derived
      from the pET series. The calretinin gene was expressed in Escherichia coli and
      produced immunoreactive calretinin of the expected size. Bacterially expressed
      calretinin was purified with successive ammonium-sulfate precipitation, DEAE
      chromatography, hydroxyapatite chromatography, Sephadex G-75 chromatography and
      Mono-Q chromatography. Normally, 1.0-1.5 mg calretinin was obtained from 1 l
      bacterial culture with a protein recovery of 0.5-1.5%. Calbindin D28k was
      purified similarly from bacteria using an expression plasmid provided by W.
      Hunziker. Calcium-binding activity of purified proteins was measured by
      equilibrium dialysis in calcium/EGTA mixtures with 45Ca as tracer. Both
      calretinin and calbindin D28k bound 3-4 Ca2+/molecule (calretinin, 4.0 +/- 0.5;
      calbindin D28k, 3.5 +/- 0.4), implying that at least one of the canonical EF-hand
      domains does not bind calcium. The Kd was 0.3-0.5 microM with little difference
      between the values for the two proteins.

PMID- 8344308
TI  - The variants of the protein toxins abrin and ricin. A useful guide to
      understanding the processing events in the toxin transport.
AB  - Kinetic data on inhibition of protein synthesis in thymocyte by three abrins and
      ricin have been obtained. The intrinsic efficiencies of A chains of four toxins
      to inactivate ribosomes, as analyzed by ki-versus-concentration plots were abrin
      II, III > ricin > abrin I. The lag times were 90, 66, 75 and 105 min at a 0.0744
      nM concentration of each of abrin I, II, III and ricin, respectively. To account
      for the observed differences in the dose-dependent lag time, functional and
      structural variables of toxins such as binding efficiency of B chains to
      receptors and low-pH-induced structural alterations have been analyzed. The
      association constants obtained by stopped flow studies showed that abrin-I (4.13
      x 10(5) M-1 s-1) association with putative receptor (4-methylumbelliferyl-alpha-D
      galactoside) is nearly two times more often than abrin III (2.6 x 10(5) M-1 s-1)
      at 20 degrees C. Equilibrium binding constants of abrin I and II to thymocyte at
      37 degrees C were 2.26 x 10(7) M-1 and 2.8 x 107 M-1 respectively. pH-induced
      structural alterations as studied by a parallel enhancement in 8-anilino-L
      naphthalene sulfonate fluorescence revealed a high degree of qualitative
      similarity. These results taken with a nearly identical concentration-independent
      lag time (minimum lag of 41-42 min) indicated that the binding efficiencies and
      internalization efficiencies of these toxins are the same and that the observed
      difference in the dose-dependent lag time is causally related to the proposed
      processing event. The rates of reduction of inter-subunit disulfide bond, an
      obligatory step in the intoxication process, have been measured and compared
      under a variety of conditions. Intersubunit disulfide reduction of abrin I is
      fourfold faster than that of abrin II at pH 7.2. The rate of disulfide reduction
      in abrin I could be decreased 11-fold by adding lactose, compared to that without
      lactose. The observed differences in the efficiencies of A chains, the dose
      dependent lag period, the modulating effect of lactose on the rates of disulfide
      reduction and similarity in binding properties make the variants a valuable tool
      to probe the processing events in toxin transport in detail.

PMID- 8344309
TI  - Purification and properties of an iron-sulfur and FAD-containing 4-hydroxybutyryl
      CoA dehydratase/vinylacetyl-CoA delta 3-delta 2-isomerase from Clostridium
      aminobutyricum.
AB  - 4-Hydroxybutyryl-CoA dehydratase, the key enzyme in the metabolism of gamma
      aminobutyrate in Clostridium aminobutyricum, represents approximately 15-25% of
      the soluble protein. The enzyme was purified to homogeneity under anaerobic
      conditions to a specific activity of 209 nkat mg-1. The dehydratase catalyses the
      reversible conversion of 4-hydroxybutyryl-CoA (Km = 50 microM) to crotonyl-CoA
      and possesses a probably intrinsic vinylacetyl-CoA delta 3-delta 2-isomerase with
      a specific activity of 223 nkat mg-1. The equilibrium of the reversible
      dehydration was determined from both sides as K = [crotonyl-CoA]/[4
      hydroxybutyryl-CoA] = 4.2 +/- 0.3. Cyclopropylcarboxyl-CoA was not converted to
      crotonyl-CoA. The native enzyme has an apparent molecular mass of 232 kDa and is
      composed of four apparently identical subunits (molecular mass = 56 kDa),
      indicating a homotetrameric structure. Under anaerobic conditions the active
      enzyme revealed a brown colour and contained 2 +/- 0.2 mol FAD (64 +/- 5%
      oxidized), 16 +/- 0.8 mol Fe and 14.4 +/- 1.2 mol inorganic sulfur, which
      probably form iron-sulfur clusters. Exposure to air resulted initially in a
      slight activation followed by irreversible inactivation. Concomitantly the
      vinylacetyl-CoA delta-isomerase activity was lost and the colour of the enzyme
      changed to yellow. Reduction by sodium dithionite yielded inactive enzyme which
      could be completely reactivated by oxidation with potassium
      hexacyanoferrate(III). The data indicate that the active enzyme contains oxidized
      FAD despite its sensitivity towards oxygen. During the dehydration a non
      activated C-H bond at C-3 of 4-hydroxybutyryl-CoA has to be cleaved. A putative
      mechanism for 4-hydroxybutyryl-CoA dehydratase is proposed in which this cleavage
      is achieved by a FAD-dependent oxidation of 4-hydroxybutyryl-CoA to 4
      hydroxycrotonyl-CoA. In a second step the hydroxyl group is substituted by a
      hydride derived from the now reduced FAD in an SN2' reaction leading to
      vinylacetyl-CoA. Finally isomerisation yields crotonyl-CoA. 4-Hydroxybutyryl-CoA
      dehydratase is quite distinct from 3-hydroxyacyl-CoA dehydratase (crotonase) and
      2-hydroxyacyl-CoA dehydratases. Contrary to the latter enzyme [e.g. (R)-lactyl
      CoA dehydratase and (R)-2-hydroxyglutaryl-CoA dehydratase] which are composed of
      three different subunits and similarly catalyse the cleavage of a non activated C
      H bond at C-3, 4-hydroxybutyryl-CoA dehydratase does not require ATP, MgCl2 and
      Ti(III)citrate for activity. Furthermore 4-hydroxybutyryl-CoA dehydratase is not
      inactivated by oxidants such as 5 mM 4-nitrophenol, 5 mM chloramphenicol and 5 mM
      hydroxylamine.

PMID- 8344310
TI  - 1H-NMR study of reduced heme proteins myoglobin and cytochrome P450.
AB  - The 1H-NMR spectra of deoxymyoglobin and reduced cytochrome P450 are analyzed by
      NOE spectroscopy. Progress has been made in the assignment of the hyperfine
      shifted signals of deoxymyoglobin. The nuclear longitudinal-relaxation-time
      values indicate short electron-relaxation times whereas Curie relaxation
      contributes significantly to the signals linewidths. For reduced cytochrome P450
      the linewidths are larger due to the Curie-relaxation contribution in a large
      protein. Therefore, the spectral information is poor. The electron-relaxation
      rates are discussed in terms of possible electronic structure.

PMID- 8344311
TI  - Two salmon neuropeptides encoded by one brain cDNA are structurally related to
      members of the glucagon superfamily.
AB  - A cDNA that codes for two peptides in the glucagon superfamily has been isolated
      from sockeye salmon brain. The first peptide is related to growth hormone
      releasing hormone (GHRH), which has high sequence similarity with PACAP-related
      peptide. The second peptide is structurally related to vasoactive intestinal
      peptide, which is also related to a newly identified peptide in mannals,
      pituitary adenylate-cyclase-activating polypeptide (PACAP). The salmon precursor
      contains 173 amino acids and has dibasic and monobasic enzyme-processing sites
      for cleavage of a 45-amino-acid GHRH-like peptide with a free C-terminus and a 38
      amino-acid PACAP with an amidated C-terminus. The salmon GHRH-like peptide has
      40% amino acid sequence identity with a human GHRH and 56% identity with human
      PACAP-related peptide. The 38-amino-acid salmon PACAP is highly conserved (89-92%
      identity) with only three or four amino acid substitutions compared with the
      human, ovine and rat 38-amino-acid PACAP. Not previously reported for mammalian
      species, a short precursor coding for only one peptide exists in salmon in
      addition to the long precursor coding for two peptides. In the short precursor,
      the coding region for GHRH is deleted leaving the PACAP-coding region in a
      correct reading frame. This provides one possible control mechanism for an
      increased expression of one peptide (PACAP) without the concomitant increase in
      the other peptide (GHRH) as occurs in a double-peptide precursor. The importance
      of the 3' non-translated region of the salmon GHRH/PACAP precursor in the
      regulation of translation is suggested by its 70% nucleotide sequence identity to
      the 3' non-translated regions of the mammalian PACAP precursors. The structural
      organization of the salmon GHRH/PACAP precursor provides a possible evolutionary
      scheme for precursors that contain tandem peptides in the glucagon superfamily.

PMID- 8344312
TI  - Cell swelling and the sensitivity of autophagic proteolysis to inhibition by
      amino acids in isolated rat hepatocytes.
AB  - In the isolated perfused rat liver, autophagic proteolysis is inhibited by hypo
      osmotic perfusion media [Haussinger, D., Hallbrucker, C., vom Dahl, S., Lang, F.
      & Gerok, W. (1990) Biochem. J. 272, 239-242]. Here we report that in isolated
      hepatocytes, incubated in the absence of amino acids to ensure maximal
      proteolytic flux, proteolysis was not inhibited by hypo-osmolarity while the
      synthesis of glycogen from glucose, a process known to be very sensitive to
      changes in cell volume [Baquet, A., Hue, L., Meijer, A. J., van Woerkom, G. M. &
      Plomp, P. J. A. M. (1990) J. Biol. Chem. 265, 955-959], was stimulated under
      identical conditions. However, in isolated hepatocytes, hypo-osmolarity increased
      the sensitivity of autophagic proteolysis to inhibition by low concentrations of
      amino acids. The anti-proteolytic effect of hypo-osmolarity in our experiments
      was not due to stimulation of amino-acid transport into the hepatocytes: neither
      the consumption of most amino acids, nor the rate of urea synthesis was
      appreciably affected by hypo-osmotic incubation conditions. In the course of
      these studies we also found that hypo-osmolarity increased the affinity of
      protein synthesis for amino acids. In the presence of amino acids the
      intracellular level of ATP was not much affected. However, because of cell
      swelling under these conditions the intracellular concentration of ATP decreased.
      It is proposed that a small part of the inhibition of proteolysis by amino acids
      may be due to this fall in ATP concentration.

PMID- 8344313
TI  - Distinct mechanisms of phospholipase D activation and attenuation utilized by
      different mitogens in NIH-3T3 fibroblasts.
AB  - The activation of phospholipase D (PLD) by platelet-derived growth factor (PDGF),
      prostaglandin F2 alpha and 12-O-tetradecanoylphorbol 13-acetate (TPA) was studied
      in NIH-3T3 fibroblasts. PLD activation was determined by measuring the production
      of both [3H]phosphatidic acid and [3H]phosphatidylpropanol (products of the PLD
      catalyzed hydrolysis and transphosphatidylation reactions, respectively), in
      cells that were metabolically pre-labeled with [3H]oleic acid. All mitogens
      caused a rapid (within 2 min) activation of PLD. Activation of PLD by
      prostaglandin F2 alpha and PDGF was transient and declined to near basal levels
      by 15 min and 55 min, respectively. In contrast, TPA-induced activation of PLD
      was sustained for at least 60 min of incubation. A combination of maximally
      effective concentrations of PDGF and TPA stimulated PLD activity in a non
      additive manner, while the effect of prostaglandin F2 alpha was additional to
      that of either PDGF or TPA. The protein kinase inhibitor staurosporine inhibited
      PLD activation by PDGF or TPA with almost identical dose/response curves. In
      contrast, staurosporine potentiated prostaglandin-F2 alpha-induced PLD
      activation. The specific protein kinase C inhibitor GF109203X (a
      bisindolylmaleimide) inhibited PLD activation by prostaglandin F2 alpha and PDGF
      at concentrations higher than those required for inhibition of PLD activation
      induced by TPA. Depletion of cellular protein kinase C abolished PLD activation
      by all three mitogens without affecting in vitro activity of membrane-bound PLD.
      The distinct kinetics of PLD activation and its differential susceptibility to
      protein kinase inhibitors suggest the existence of agonist-specific activation
      and/or inactivation mechanisms. The results indicate also that protein kinase C
      participates in the mechanism of PLD activation via PDGF, while the effect of
      prostaglandin F2 alpha involves a pathway independent of protein kinase C.

PMID- 8344314
TI  - The bis(adenosin-N6-yl) alkanes, a family of potential dinucleoside polyphosphate
      analogue precursors. Mechanism of growth inhibition and suppression of adenosine
      toxicity in lymphoid cells.
AB  - The potential diadenosine polyphosphate analogue precursor, bis(adenosin-N6
      yl)dodecane (A[CH2]12A) (Chen, H. & McLennan, A. G. (1993) Eur. J. Biochem. 213,
      935-944.) is equally toxic to both wild-type and adenosine-kinase-deficient BHK
      cells at concentrations up to 100 microM; at higher concentrations, wild-type
      cells are more sensitive, as are cells over-expressing adenosine kinase. Thus
      both the nucleoside and its nucleotide products are toxic. In contrast to
      adenosine toxicity, the toxicity of A[CH2]12A to S-49 T-lymphoma cells could not
      be reversed by uridine or by L-homocysteine thiolactone. A[CH2]12A and all its
      shorter chain bis(adenosin-N6-yl)alkane homologues could relieve the toxicity of
      low adenosine concentrations (< 20 microM) to S-49 cells, mainly through
      inhibition of adenosine kinase, while relief of the toxicity of high adenosine
      concentrations (> 20 microM) required the longer chain homologues. A[CH2]12A at
      10 microM completely eliminated adenosine toxicity. Deoxyadenosine toxicity could
      also be relieved, but only that due to low concentrations (< 4 microM). A[CH2]12A
      had only a slight stimulatory effect on S-adenosylhomocysteine-hydrolase
      activity.

PMID- 8344315
TI  - Refolding and single-step purification of porcine interferon-gamma from
      Escherichia coli inclusion bodies. Conditions for reconstitution of dimeric IFN
      gamma.
AB  - Recombinant porcine interferon-gamma, overexpressed in Escherichia coli, was
      found to accumulate in cytoplasmic inclusion bodies. The influence of various
      physicochemical parameters on refolding was investigated using 6 M guanidine/HCl
      solubilised inclusion bodies which had been purified by ultracentrifugation on a
      sucrose step gradient. It appeared that the yield of reconstitution of denatured
      protein reached 60-70% under optimum conditions, i.e. at an intermediary
      guanidine/HCl concentration of 0.5 M and at a protein concentration of 10-20
      microM (0 degrees C). Since intermediary guanidine/HCl concentrations at 0.5-1.65
      M increasingly promoted off-pathway formation of soluble aggregates and at 0.5
      0.2 M progressively promoted precipitation, maximal recovery of biologically
      active protein required a twofold transition in the surrounding guanidine/HCl
      concentration (6 M-->0.5 M-->0 M). A single additional size-exclusion
      chromatographic step yielded a final product that was > 99.5% pure, had specific
      antiviral activity > 10(7) U/mg protein and contained < or = 25 pg/ml endotoxin.
      Cross-linking by means of disulfosuccinimidyl tartarate revealed that the
      refolded protein possessed a dimeric structure. Furthermore, we have
      characterized three different molecular species of recombinant porcine interferon
      gamma that are formed under non-optimal refolding conditions (1 M guanidine/HCl)
      and that differ from each other in specific activity, size and stability. One of
      these converts irreversibly into dimeric interferon-gamma in a temperature
      dependent manner and is therefore considered as a productive folding
      intermediate.

PMID- 8344316
TI  - Docking the mitochondrial inhibitor protein IF1 to a membrane receptor different
      from the F1-ATPase beta subunit.
AB  - Monoclonal antibodies reacting with the inhibitor protein (IF1) of the
      mitochondrial ATPase/ATP synthase complex did not modify the IF1-induced
      inhibition of soluble F1 ATPase activity. On the contrary, they increased the
      ATPase activity of inverted electron-transport particles without inducing a
      significant release of IF1 from these particles. This suggested that IF1 could be
      linked to a membrane protein when it was not inhibiting the ATPase activity. IF1
      antibodies have been used to show that IF1 can bind not only to the beta subunit
      of F1-ATPase [Klein, G., Satre, M., Dianoux, A. C. & Vignais, P. V. (1981)
      Biochemistry 20, 1339-1344] but also to a protein present in the inner
      mitochondrial membrane. The cross-linking of IF1 to this membrane protein gave a
      product of M(r) 15000-16000 that migrated differently from IF1 and from the dimer
      of IF1 using SDS/PAGE. When the cross-linked product was obtained by using a
      cleavable cross-linking reagent, the complex between IF1 and the docking protein
      was partly dissociated and free IF1 was recovered. Considering the molecular mass
      of IF1, this docking protein for IF1 has apparent M(r) 5000-6000. The complex
      between IF1 and this receptor protein can be detected in low amounts by
      antibodies against IF1 in the absence of cross-linking reagent. Since this
      complex remained in the pellet after treatment of the membrane with Triton X-100,
      it should be a membrane protein. Therefore, IF1 can bind not only to its
      inhibitory-binding site at the beta subunit of F1, but also to a non inhibitory
      site which is a membrane protein of approximate M(r) 5000-6000.

PMID- 8344317
TI  - Distribution of alcohol and sorbitol dehydrogenases. Assessment of mRNA species
      in mammalian tissues.
AB  - The tissue distribution of mRNA of alcohol dehydrogenases of classes I, II and
      III, and sorbitol dehydrogenase, was studied. mRNA from 19 different rat tissues
      was purified and analyzed by Northern blots, utilizing cDNA probes specific for
      the four dehydrogenases. Class-I alcohol-dehydrogenase mRNA was shown to be of
      widespread occurrence, detectable in all tissues including brain, but with
      pronounced differences in amounts. Hybridization revealed the pattern of
      occurrence of class-II alcohol-dehydrogenase mRNA to be unique, with transcripts
      only in the liver, duodenum, kidney, stomach, spleen and testis. Abundant levels
      of class-III alcohol-dehydrogenase (glutathione-dependent formaldehyde
      dehydrogenase) mRNA were present in all tissues analyzed, reflecting the general
      need for scavenging of formaldehyde in physiological cytoprotection. Sorbitol
      dehydrogenase mRNA was detected in all tissues except small intestine, in
      agreement with sorbitol resorbtion by passive diffusion in this tissue. In
      addition, evidence for a sex-specific expression, in the liver, of class-II
      alcohol dehydrogenase was obtained.

PMID- 8344318
TI  - Therapy for urologic complications secondary to irradiation of gynecologic
      malignancies.
AB  - Hemorrhagic cystitis, ureteral stenosis or obstruction, and bladder fistulas are
      the most serious urologic complications secondary to pelvic irradiation for
      gynecologic malignancies. Hemorrhagic cystitis is usually controlled by formalin
      instillation. In instances of ureteral stenosis or obstruction or bladder
      fistulas, the possibility of tumor recurrence must be eliminated. Most patients
      with ureteral stenosis or obstruction will require surgical correction. Most
      patients with bladder fistulas will be best served by creation of an ileal
      conduit. In selected patients, closure of the fistula with pedicle flaps will be
      possible.

PMID- 8344319
TI  - Cervical metastases in advanced ovarian malignancies.
AB  - Cervical metastases from ovarian malignancies are a rare event. In order to
      better define the incidence and pathogenesis of this phenomenon we
      retrospectively reviewed the charts and pathologic material from 171 Stage III
      ovarian malignancies. Nine patients (5.3%) were identified with cervical
      metastases and three patterns of spread to the cervix were recognized: 1)
      lymphatic permeation only; 2) para-cervical soft tissue extension and 3) direct
      stromal myometrial invasion. All of the patients with cervical metastases had
      high grade (Broder's grade III or IV) tumors and extensive abdominal disease at
      presentation. Although four patients had a positive or suspicious pap smear, none
      of these had cervical involvement. We conclude that ovarian metastases to the
      cervix are a rare event, occurring late in the course of the disease and arise
      from a variety of modes of spread.

PMID- 8344320
TI  - CA 125 in preoperative evaluation of pelvic masses.
AB  - Serum CA 125 levels were measured preoperatively in 126 women subjected to
      laparotomy due to palpable pelvic mass. Forty out of 42 patients with true
      malignant serous ovarian carcinoma had serum CA 125 levels higher than 35 U/ml.
      Among 62 patients with some types of gynecologic malignancy, 48 also met the
      cutoff value of 35 U/ml. Sensitivity, specificity, positive and negative
      predictive value of CA 125 as a tumor marker, proved to be satisfactory. These
      results suggest that CA 125 assay can be used as a diagnostic adjunct in the
      preoperative evaluation of patients with a pelvic mass.

PMID- 8344321
TI  - Age is prognostic variable in cervical squamous cell carcinoma.
AB  - A clinico-pathologic review was performed on all younger (under 35 years) and
      older (55 years or over) women with a diagnosis of cervical squamous cell
      carcinoma assessed at the Tom Baker Cancer Centre from 1980 to 1985 to determine
      the effect of age at diagnosis on survival. 45 younger women were identified: 32
      were Stage IB; 10, Stage II; and 3, Stage III. 64 older women were identified: 16
      were Stage IB; 30, Stage II; 14, Stage III; and 4, Stage IV. For Stage IB women,
      40.6% of younger patients developed persistent or recurrent disease and all
      except one are dead; only one (6.2%) older woman's tumour recurred and she is
      alive with disease. Younger women had a poorer disease-free survival not only for
      Stage IB disease (p = 0.014) but also in Stages II and III (p = 0.020). In this
      study age at diagnosis was an independent prognostic variable with younger women
      having a poorer disease-free and overall survival.

PMID- 8344322
TI  - Comprehensive breast diagnosis.
AB  - Applying a comprehensive diagnostic approach to breast pathology (clinical
      information, physical exam, state of the art mammography complemented by
      ultrasonography) 36,396 patients were evaluated. 462 malignancies (40%) were
      found. 81.2% of carcinomas were clinically occult. 45.2% of the non-palpable
      lesions were 1 cm or smaller. The yield of carcinomas was 1 every 2.7 biopsies.
      The preoperative diagnosis of presumptive extensive intraductal component was 85%
      correct. This information helps to define the excisional limits and upon
      pathological confirmation select the appropriate surgical therapy: lympectomy vs.
      mastectomy.

PMID- 8344323
TI  - Application of short-wave therapy in complex treatment for endometrial cancer.
AB  - The dynamics of the cellular immunity indices have been studied in 81 patients
      with endometrial cancer, during the period of combined surgery and post-operative
      gamma-therapy and also during short-wave therapy. The results obtained testify to
      the immunostimulating and immunomodulating effect of electromagnetic irradiation
      of short-wave frequency, thus providing rehabilitation of the immune system in
      endometrial cancer patients and serving as the basis for short-wave therapy,
      including it in the complex of therapies given to this group of patients.

PMID- 8344324
TI  - Simplified ondansetron regimens for antiemetic prophylaxis in cisplatin-based
      chemotherapy of ovarian cancer.
AB  - In past years prevention of emesis and nausea induced by antiblastics has been
      based on extremely heterogeneous protocols with little efficacy. However, by the
      use of selective antagonists of serotonin S3 receptors there has been a
      remarkable improvement in the control of side effects. Among these antagonists
      ondansetron has been till now the most studied. The dosage protocols with which
      it has usually been employed establish an i.v. administration of the drug of 1
      mg/h for 24 hours or the repetition of ondansetron 0.15 mg/kg x 2 every 2-4 hours
      after the end of chemotherapy. In our study, carried out from September 1991 till
      September 1992, 21 patients affected by ovarian carcinoma and treated by
      cisplatin chemotherapy protocols were evaluated (for a total of 63 cycles). Ten
      patients were under first line adjuvant chemotherapy treatment, whereas 11
      patients were in relapse and had already undergone previous antiblastic
      treatments with serious side effects. In 18 out of 21 patients cyclophosphamide
      which has a strong emetic factor was associated with cisplatin. According to the
      total quantity of cisplatin contained in each cycle (in all < or =/> 100 mg) we
      used ondansetron in two different dosages simplified and shortened in time. They
      have been illustrated with particular details in the text. The control of nausea
      and vomiting during the first 24 hours was similar to the controls obtained in
      other studies in which ondansetron was administered according to the "traditional
      schemes".(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8344325
TI  - Primary squamous cell carcinoma of the endometrium. Case report.

PMID- 8344326
TI  - Recurrent endometrial cancer arising in the round ligament.
AB  - An unusual case of recurrent endometrial carcinoma presenting as a round ligament
      metastasis is discussed. The primary lesion detected six years earlier was a well
      differentiated lesion with less than 50% myometrial invasion located in the
      fundus. A persistent inguinal swelling represented a metastasis to the round
      ligament. Histologic examination revealed a poorly differentiated adenocarcinoma.
      Patients with early stage well-differentiated endometrial carcinoma are not
      immune from late recurrence.

PMID- 8344327
TI  - Cisplatin-based chemotherapy in recurrent or high risk ovarian granulosa-cell
      tumor patients.
AB  - Nine chemotherapy-naive women with recurrent (2 patients) or high risk factors
      (bilateral or extraovarian spread, poorly-differentiated tumor, age > or = 40
      years at diagnosis, residual disease after surgery) granulosa-cell tumors were
      treated with cisplatin, cyclophosphamide with or without doxorubicin (PAC, PC) or
      cisplatin, etoposide and bleamycin (PVP-16B). Toxicity was acceptable and the
      most frequently encountered adverse reactions were WHO grade 3 gastrointestinal
      toxicity in 77% of patients, and grade 3 myelosuppression in 22% of cases.
      Clinical complete response was achieved in the 2 patients with recurrent disease.
      Five patients underwent second look surgery which documented: complete response
      in 3 patients, partial response in 1 patient and progressive disease in 1 case.
      Median survival was 85 months (range 14-103). Cisplatin-based cytotoxic regimens
      may be of benefit in the treatment of recurrent or high risk granulosa-cell
      tumors.

PMID- 8344328
TI  - The surgical management of recurrent carcinoma of the vulva.
AB  - One hundred and two patients with recurrent vulvar cancer were treated with
      surgical re-excision. At follow-up 57 patients (56%) were free of disease and 45
      were dead of disease. The cumulative 2-year and 5-year survivals were 74% and
      61%, respectively. Fifty-seven patients had a recurrence within 2 years and 27
      were free of disease, 30 patients relapsed between 2-10 years of whom 21 were
      free of disease, 15 patients relapsed after 10 years and 9 were free of disease.
      At the time of recurrence progression of metastatic disease to the groin lymph
      nodes was found in 30 cases, and all of these patients died of disease. Fifty
      seven of 72 patients remained free of disease when the lymph nodes were not
      involved (P < .00001). Radical excision of localized recurrent vulvar cancer
      provides acceptable survival results when the regional lymph nodes are not
      involved.

PMID- 8344329
TI  - Prevention of complications of subcutaneous peritoneal access devices in
      intraperitoneal chemotherapy of ovarian carcinoma.
AB  - The experience from 133 patients with ovarian cancer treated with intraperitoneal
      chemotherapy are reported. Type of PAC, the patient suitable for IP chemotherapy,
      the surgeon and the implantation technique and the timing are discussed with
      special attention to avoid complications in these patients.

PMID- 8344330
TI  - Cervical cancer in Khon Khaen University Hospital, Thailand 1985-1990.
AB  - From 1985 to 1990, 3040 patients with carcinoma of the uterine cervix were
      diagnosed and treated at Srinagarind Hospital, Faculty of Medicine, Khon Kaen
      University, Thailand. The epidemiological aspects including ages and geographical
      distributions, histology, stages, treatment and outcome were presented and
      compared with those of the previous report.

PMID- 8344331
TI  - Pathogenesis of genetic haemochromatosis.
AB  - Genetic haemochromatosis is an autosomal recessive inherited iron overload
      disease. The genetic defect and the underlying metabolic error are not known.
      Several observations indicate that the 2-4-fold increase of iron absorption is
      due to a regulatory defect of a membrane iron transport system in duodenal
      mucosal cells. The key pathophysiologic factor may be the increase of gut-derived
      non-transferrin bound iron liganded to low-molecular mass organic molecules. A
      putative membrane carrier protein for non-transferrin bound iron was identified
      and preliminary data suggest its enrichment in plasma membranes of human mucosal
      cells as well as in liver and other organs which are affected in genetic
      haemochromatosis. Cellular accumulation of ionic iron leads to peroxidative
      decomposition of organelle membrane phospholipids with the consequence of cell
      degeneration and cell death. Impairment of organ function and structural
      alterations such as cirrhosis of the liver are clinical manifestations.

PMID- 8344332
TI  - The aetiology of clubbing and hypertrophic osteoarthropathy.
AB  - The evidence is reviewed for the hypothesis that clubbing and hypertrophic
      osteoarthropathy are due to the peripheral impaction of megakaryocytes and
      platelet clumps in the fingers and toes, to which this particulate matter has
      passed in an axial stream. The normal pulmonary vascular bed retains these large
      particles, which fragment before entering the systemic circulation. A right-to
      left shunt allows them to bypass the pulmonary vascular bed. A preliminary
      histological report of platelet clumps seen at necropsy in nail bed capillaries
      of clubbed fingers supports the hypothesis. Platelets contain and release
      platelet-derived growth factor, whose known effects could explain all the
      pathological changes in clubbing. In addition to explaining why clubbing should
      occur in cyanotic congenital heart disease, clubbing in sub-acute bacterial
      endocarditis and distal to infected arterial grafts and aneurysms can be
      understood in terms of platelet clumps breaking off valves or arterial walls, and
      passing distally. Clubbing in liver disease is associated with multiple small
      pulmonary arteriovenous anastomoses which allow large particles through.
      Hypertrophic osteoarthropathy probably shares the same mechanism, and is mainly
      attributable to PDGF release; but there may also be altered platelet function and
      an additional growth factor derived from the lungs.

PMID- 8344333
TI  - Measuring collagen degradation.

PMID- 8344334
TI  - Factors affecting the assay of urinary 3-hydroxy pyridinium crosslinks of
      collagen as markers of bone resorption.
AB  - The measurement of the 3-OH pyridinium compounds, pyridinoline (Pyr) and
      deoxypyridinoline (Dpyr), in urine by high performance liquid chromatography is
      potentially useful in clinical studies, since they are specific biochemical
      markers of bone resorption. The aims of the present study were to improve assay
      performance and optimize sample collection. An isocratic high performance liquid
      chromatogram (HPLC) separation with baseline resolution was accomplished within 4
      min using heptafluorobutyric acid as an ion-pair. The sample preparation for
      HPLC, using CF1 cellulose, produced uncontaminated samples with a recovery higher
      than 90% for both crosslinks. An elastin-derived material, tentatively identified
      as isodesmosine (Ides), was also tested and proved to be a suitable internal
      standard. Use of this standard improved assay precision. The effect of an oral
      gelatin load on the excretion of Pyr and Dyr was investigated. The creatinine
      corrected excretion of Pyr and Dpyr was unchanged over a 6 h period, in contrast
      to the 10-fold increase in the excretion of urinary hydroxyproline with a peak 2
      4 h after ingestion. In 20 postmenopausal women, 2 h fasting morning urine
      results correlated with results from 24-h urine collections Dpyr/Cr (r = 0.70, n
      = 20). There was a day-to-day variation of 26% in adults studied for 10 days.

PMID- 8344335
TI  - Tritium and 14C isotope effects using tracers of leucine and alpha
      ketoisocaproate.
AB  - To test if different leucine tracers behave in an indistinguishable manner and,
      by implication, that their metabolism is identical to that of natural leucine, we
      measured whole body leucine turnover in dogs and humans and fibrinogen synthesis
      in dogs by simultaneously infusing either [1-14C]leucine or [4,5-3H]leucine or [1
      14C]alpha-ketoisocaproate (KIC) and [4,5-3H]KIC. Whole body leucine fluxes
      calculated from the plasma specific activity of the transaminated product of the
      infused tracer (reciprocal pool model) were lower (dogs by 5.7%; humans by 6.4%,
      both P < 0.02) when the plasma 3H specific activity compared to 14C specific
      activity were used with leucine tracers and were also lower (dogs by 4.4%, P <
      0.02; humans by 8.6%, P < 0.06) using the KIC tracers. Using leucine or KIC
      tracers in dogs, the fractional rate of fibrinogen synthesis was 6.7% or 9.4%
      lower, respectively, (P < 0.02) using the 3H versus the 14C tracer. The
      apparently lower incorporation of 3H into protein was only in part accounted for
      by detritiation (2.1%, P = 0.05) of [3H]leucine during acid hydrolysis of
      proteins. These results suggest that in vivo and/or in vitro differential isotope
      effects are small (approximately 5%), but should be considered when dual isotopes
      infusions are employed to partition amino acid metabolism.

PMID- 8344336
TI  - Influence of platelet size before coronary angioplasty on subsequent restenosis.
AB  - Platelet size has been shown to reflect platelet activity. We prospectively
      measured the mean platelet volume (MPV) in 47 patients undergoing single vessel
      angioplasty for symptomatic angina. The patients underwent repeat angiography 4-8
      months later irrespective of symptomatic status. Restenosis was assessed
      quantitatively by hand held calliper measurements of the lesion and qualitatively
      by a return of angina, ST segment changes on an exercise test and visual analysis
      of the lesion severity by two experienced angiographers. Twenty-four patients
      developed recurrent angina during the follow-up period, the MPV in the group with
      chest pain was 8.54 +/- 0.60 fl compared to 8.1 +/- 0.69 fl in the asymptomatic
      group (P = 0.04). Twenty two patients had significant ST segment changes at
      exercise. In this group the MPV was 8.6 +/- 0.56 fl compared to 8.0 +/- 0.70 fl
      for the group with a negative test (P = 0.002). Similarly visually assessed
      angiographic stenosis showed a significant increase in the restenotic group (8.6
      +/- 0.56 vs. 8.0 +/- 0.61 fl, P = 0.001). The relative odds for developing
      clinically defined restenosis were 10.2 times greater if the pre-procedural MPV
      lay in the upper compared to the lowest quartile. There was a positive
      correlation between MPV and change in minimal luminal diameter between post
      angioplasty and follow-up angiography, assessed quantitatively, r = +0.56, P =
      0.016. There was no association between clinical or angiographic definitions of
      restenosis and haemoglobin, red cell count, mean corpuscular volume, white cell
      count or platelet count. Platelet size may influence the development of
      restenosis after successful coronary angioplasty.

PMID- 8344337
TI  - Changes in biological activity and immunoreactive mass of lipoprotein lipase in
      congenital nephrosis: relationship to hypertriglyceridaemia.
AB  - The major lipid disturbance in children with congenital nephrosis of the Finnish
      type (CNF) is hypertriglyceridaemia. To determine whether or not
      hypertriglyceridaemia is caused by defective triglyceride catabolism, we measured
      lipoprotein lipase (LPL) activities and masses at various stages of the disease.
      At age 3 months in CNF both LPL activity and mass were decreased, but a close
      positive correlation between these parameters similar to that in controls was
      observed. At age 9 months both LPL activity and mass were even lower. At that
      time a significant positive correlation (r = 0.72, P < 0.05) between LPL
      activities and albumin concentrations and significant negative correlations
      between plasma free fatty acid (FFA) concentrations and LPL activities (r = 
      0.72, P < 0.05) and between plasma FFA concentrations and serum albumin
      concentrations (r = -0.73, P < 0.05) were observed, suggesting that low albumin
      concentrations result in increase of FFA levels, which could interfere with a
      normal LPL function at the endothelial surface. On dialysis after nephrectomy,
      LPL activities and masses increased. At age 3 and 9 months apoprotein C-II (apo C
      II) and apoprotein C-III (apo C-III) levels were not decreased although
      apoproteins were being lost into the urine. On dialysis the mean ratio of apo C
      II/C-III was significantly lower than the mean in controls (P < 0.001). We
      conclude that impaired function of LPL seems to be the major cause of
      hypertriglyceridaemia and disintegrity of the VLDL-IDL-LDL delipidation cascade
      in children with CNF.

PMID- 8344338
TI  - CD23 and CD21 function as adhesion molecules in homotypic aggregation of human B
      lymphocytes.
AB  - We have previously found that interleukin-4 and CD40 monoclonal antibodies (mAb)
      are strong potentiators of homotypic B cell aggregation which is dependent on LFA
      1. We show here that CD23 mAb were also able to inhibit aggregation to a similar
      extent as LFA-1 antibodies. This inhibition was restricted to the MHM6 epitope of
      CD23 and antibodies to other epitopes [Epstein-Barr virus (EBV) CS-1, EBV CS-2,
      EBV CS-5 and mAb 25] or occupation of the Fc-binding site by IgE had no or a
      slightly enhancing effect on aggregation. When testing two antibodies to CD21,
      the recently defined ligand for CD23, one of these (BU32) was found to be
      inhibitory whereas the other (THB5) had no effect. By combining antibodies to LFA
      1 and CD23, aggregation was often completely inhibited. These data suggest that
      LFA-1/ICAM-1 and CD23/CD21 are the major molecules involved in homotypic
      aggregation of human B cells.

PMID- 8344339
TI  - A soluble, single-chain Kd molecule produced by yeast selects a peptide
      repertoire indistinguishable from that of cell-surface-associated Kd.
AB  - Peptide binding to a soluble, single-chain Kd protein produced by the yeast
      strain Kluyveromyces lactis, and to Kd molecules on Kd-expressing cells (P815)
      was studied using radiolabeled Kd-restricted peptides. The stability of the
      peptide-Kd complexes formed was monitored in the absence and presence of
      unlabeled competitor peptides. Radioiodination of the Tyr anchor residue in
      position 2 of the peptide interferes with binding. A Kd-biased peptide library
      and a modified antigenic peptide in which a second Tyr was added in positions 6
      and 8, respectively, were therefore used to assay binding. Recombinant and cell
      associated Kd molecules are very similar in the following respects: the ease with
      which the proteins can be loaded with labeled peptide; the spectrum of peptides
      selected from a peptide library; the stability of the labeled peptide-Kd complex
      formed; and the ability to partially dissociate the class I-peptide complex with
      exogenous, unlabeled peptides. These results imply that measurements of peptide
      binding to soluble Kd molecules are a reliable indicator of the peptide-binding
      properties of Kd proteins on living cells. The large quantities of soluble
      recombinant Kd protein currently available represent an invaluable tool not only
      for dissecting the molecular mechanisms of antigen presentation but also for
      vaccinations and the design of T cell-specific toxins.

PMID- 8344340
TI  - Protection from insulin-dependent diabetes mellitus is linked to a peptide
      transporter gene.
AB  - HLA class II association with insulin-dependent diabetes mellitus (IDDM) is well
      established but is still difficult to map to a particular locus. Polymorphism of
      the genes coding for transporter associated with antigen processing (TAP1 and
      TAP2), and located in the HLA class II region, was studied in 167 IDDM patients
      (116 adult-onset and 51 childhood-onset patients) and 98 normal controls using
      oligotyping after genomic amplification. A dominant protective effect was
      observed for the TAP2*0201 allele [relative risk (RR) = 0.3, corrected
      probability (pc) < 0.001]. Conversely, susceptibility to IDDM was associated with
      apparent homozygosity for the TAP2*0101 allele (RR = 3.4, pc < 0.001). Protection
      was independent from but additive to the protection conferred by the DRB1*02
      DQB1*0602 haplotype (RR = 0.06, pc < 0.05), and antagonistic to the DRB1*03
      DQB1*0201 and DRB1*04 DQB1*0302 haplotypes predisposing effect (RR = 1.1, not
      significant), arguing in favor of an absence of linkage disequilibrium between
      TAP2 and HLA class II genes. This was assessed by chi 2 analysis. TAP1 allelic
      distribution was not different among diabetics and controls. A significant
      association was observed between the presence of TAP2*0101 and that of islet cell
      antibodies (p < 0.05). These data suggest that the TAP2 gene, which encodes
      protein required for delivery of antigen peptides to class I molecules in the
      endoplasmic reticulum, could modulate the autoimmune response leading to beta
      cell destruction. From a practical point of view, they make the combined
      screening of HLA class II and TAP2 loci a highly valuable tool in IDDM
      prediction.

PMID- 8344341
TI  - Methylation status of immunoglobulin kappa gene segments correlates with their
      recombination potential.
AB  - We have previously shown that unlike endogenous chi genes, unrearranged chi
      transgenes undergo V chi-J chi recombination in Tas well as B cells of transgenic
      mice. To determine whether the difference in recombination specificity of the
      transgenic and endogenous chi genes is associated with differences in DNA
      structure, the methylation status of the endogenous genes and three unrearranged
      chi transgenes was compared. The J chi-C chi locus of the transgenes was found to
      be hypomethylated in all tissues of the transgenic mice. In contrast, methylation
      of the endogenous chi genes was tissue and developmentally regulated.
      Hypomethylation of the endogenous J chi-C chi region occurs only in cells of the
      B lineage undergoing, or having completed chi gene recombination. Transfection of
      fibroblasts from transgenic and control mice with the recombination activating
      genes, Rag1 and Rag2, led to a high level of rearrangement of the hypomethylated
      transgenic, but not the endogenous chi genes. These results suggest that
      hypomethylation defines an accessible state of the chi locus and that
      methylation/demethylation could be involved in the control of chi gene
      rearrangement during lymphocyte differentiation.

PMID- 8344342
TI  - Cytokine production and heterogeneity of primary stromal cells that support B
      lymphopoiesis.
AB  - Many reports document that bone marrow stromal cells or their cytokine products
      can influence the formation of B cells in vitro. Most of this data comes from
      studies using lines or clones of stromal cells after multiple passage in culture,
      which could alter gene expression. Our aim in the present study was to determine
      which cytokines are produced by normal stromal cells under conditions that
      promote B lymphopoiesis. Primary cultured stromal cells were isolated on FACS
      from active Whitlock cultures. These cells proved to be relatively homogeneous in
      expression of cell surface antigens (CD44, VCAM-1, MECA10, and a molecule marked
      by hamster anti-mouse 8.28 monoclonal antibody). RNA from unselected Whitlock
      cultured adherent cells and sorted stromal cells from the same cultures were
      subjected to reverse transcriptase polymerase chain reaction to assess
      constitutive expression of several cytokine genes. Transcripts for interleukin-1
      beta (IL-1 beta), IL-7, macrophage (M)-colony-stimulating factor (CSF), stem cell
      growth factor (SCGF), insulin-like growth factor 1 (IGF-1) and occasionally
      leukemia inhibitory factor were detected in RNA from intact cultures. Messages
      for IL-7, M-CSF, and SCGF were selectively contained within the isolated stromal
      cell fraction; whereas, IL-1 beta was found solely within the non-stromal cell
      fraction. IGF-1 was transcribed by both stromal cells and macrophages in Whitlock
      cultures. No evidence was found for constitutive expression of IL-1 alpha, IL-4,
      IL-6, or granulocyte-macrophage-CSF. This is in contrast to some reported stromal
      cell lines and clones. To determine if all primary stromal cells from active
      lymphopoietic cultures produced IL-7, the isolated cells were stained to reveal
      cytoplasmic IL-7 protein. A majority of the cells produced IL-7, but about 20%
      had no detectable IL-7 protein. Taken together, our results suggest that the
      primary stromal cells are a distinguishable cell type but functional subsets may
      exist. In regard to the differences in IL-7 production, the primary cell
      phenotype appears to mirror at least one division noted among the stromal cell
      lines.

PMID- 8344343
TI  - Thymus-derived cytokine(s) including interleukin-7 induce increase of T cell
      receptor alpha/beta+ CD4-CD8- T cells which are extrathymically differentiated in
      athymic nude mice.
AB  - Extrathymic T cell differentiation pathways have been reported, although the
      thymus is the main site of T cell differentiation. The thymus is also known to
      produce several cytokines that induce proliferation of thymocytes. In the present
      study, we investigated the influence of thymus-derived cytokines on extrathymic T
      cell differentiation by intraperitoneal implantation with a diffusion chamber
      which encloses fetal thymus (we named it fetal thymus-enclosed diffusion chamber,
      FTEDC) in athymic BALB/c nu/nu mice. Increase in number of T cells bearing T cell
      receptor (TcR) alpha/beta was detected in lymph nodes and spleens of FTEDC
      implanted nude mice 1 week after implantation, whereas no such increase was
      detected in control nude mice implanted with a diffusion chamber without thymus.
      The FTEDC-induced increase of T cells was suppressed by intraperitoneal injection
      of anti-interleukin-7 monoclonal antibody (mAb). The TcR alpha/beta T cells in
      FTEDC-implanted BALB/c nu/nu mice preferentially expressed V beta 11, although V
      beta 11-positive T cells are deleted in the thymus of euthymic BALB/c mice by
      clonal elimination of self-super-antigen Dvb11-specific T cells. TcR alpha/beta T
      cells in FTEDC-implanted nude mice were of CD4-CD8- phenotype and showed no
      proliferative response against anti-TcR monoclonal antibody stimulation. These
      results suggest that the thymus can induce extrathymic T cell differentiation
      through the influence of thymus-derived cytokine(s) including interleukin-7, and
      that such extrathymically differentiated T cells have acquired only a little or
      no ability for proliferation when they recognize antigen by their TcR.

PMID- 8344344
TI  - Bacterial expression of a single-chain Fv fragment which efficiently protects the
      acetylcholine receptor against antigenic modulation caused by myasthenic
      antibodies.
AB  - Monoclonal antibodies (mAb) against the main immunogenic region (MIR) of the
      acetylcholine receptor (AChR) are very potent in inducing antigenic modulation of
      the AChR in animals and in muscle cell cultures. A recombinant antibody fragment
      of the rat anti-MIR mAb198 was cloned by polymerase chain reaction and expressed
      as soluble single-chain Fv fragment (scFv198) in E. coli and affinity purified.
      DNA sequencing was used to define the VH (IB) and VL (K2) chain gene usage.
      scFv198 was found immunologically and biologically active. Its binding affinity
      for the Torpedo AChR (KD = 2 +/- 0.6 nM) was very similar with that of the intact
      mAb198 (KD = 1.8 +/- 0.6 nM) while for the human AChR (KD = 80.7 +/- 16.6 nM) it
      was about four times lower than that of the intact mAb198 (KD = 21.6 +/- 6.6 nM).
      This fragment was capable of efficiently protecting the AChR in human cell
      cultures, against antigenic modulation caused by the intact mAb198 or by the
      antibodies from a myasthenic patient. The produced scFv198 fragment is,
      therefore, potentially useful in therapeutic applications for myasthenia gravis
      after appropriate genetic manipulations.

PMID- 8344345
TI  - Expansion of the CD4-, CD8- gamma delta T cell subset in the spleens of mice
      during non-lethal blood-stage malaria.
AB  - Splenic gamma delta T cells (CD4-, CD8-) increased more than 10-fold upon
      resolution of either Plasmodium chabaudi adami or P.c. chabaudi infections in
      C57BL/6 mice compared to controls. Similarly, a 10- to 20-fold expansion of the
      gamma delta T cell population was observed in beta 2-microglobulin deficient
      (beta 2-m0/0) mice that had resolved P.c. adami, P.c. chabaudi or P. yoelii
      yoelii infections. In contrast, increases in the number of splenic alpha beta T
      cells in these infected mice were only two to three-fold indicating a
      differential expansion of the gamma delta T cell subset during malaria. Because
      nucleated cells of beta 2-m0/0 mice lack surface expression of major
      histocompatibility complex class I and class Ib glycoproteins, our findings
      suggest that antigen presentation by these glycoproteins is not necessary for the
      increasing number of gamma delta T cells. Our observation that after resolution
      of P.c. adami malaria, C57BL/6 mice depleted of CD8+ cells by monoclonal antibody
      treatment had lower numbers of gamma delta T cells than untreated controls
      suggests that the demonstrated lack of CD8+ cells in beta 2-m0/0 mice does not
      contribute to the expansion of the gamma delta T cell population during non
      lethal malaria.

PMID- 8344346
TI  - Evaluation of functional heterogeneity in the CD8 subset with T cells from T cell
      receptor-transgenic mice.
AB  - The question of functional differentiation within the CD8 subset has been
      addressed in a model of TcR-transgenic (TcR-tg) mice expressing a TcR specific
      for H-2Kb (Ti). CD8+ Ti+ T cells present in the periphery of these mice have no
      cytotoxic T lymphocyte (CTL) activity unless they are stimulated with H-2Kb
      expressing cells. In contrast to T cells from normal H-2k littermates,
      alloantigen induction of CTL from TcR-tg mice is independent of CD4+ T helper
      (Th) cells and is accompanied by high level secretion of interleukin-(IL)-2 by
      Ti+ CD8+ T cells. Precursor frequency analysis performed on CD8+ cells from TcR
      tg mice revealed a high frequency of Th as compared to CTL precursors. This
      raised the possibility of the existence of distinct subpopulations within CD8+
      precursors with different requirements for differentiation to functional CTL.
      FACS analyses (performed on resting and on in vitro stimulated T cells from
      normal and TcR-tg mice) demonstrated a heterogeneous expression of Ly-6C on CD8+
      cells with a large enrichment of Ly-6C- cells among the Ti+ cells which persisted
      after stimulation with H-2b cells in conditions that led to a homogeneous
      expression of the activation markers pgp-1 and CD69. The possibility that Ly-6C
      expression could mark functionally different subpopulations in CD8+ T cells was
      investigated. Stimulation of sorted populations of Ly-6C- and Ly-6C+ cells
      allowed detection of CTL precursors in both these subsets and the majority of
      limiting dilution wells containing one pCTL also scored positive for IL-2
      secretion. Thus, for CD8+ T cells expressing the same TcR, differentiation led to
      acquisition of both IL-2 secretion and CTL function and there was no evidence for
      the existence of a distinct population of helper-dependent CTL precursors.

PMID- 8344347
TI  - Signaling through the LFA-1 leucocyte integrin actively regulates intercellular
      adhesion and tumor necrosis factor-alpha production in natural killer cells.
AB  - The LFA-1 leucocyte integrin is known to participate in natural killer (NK)
      cytolytic activity, mediating effector target interactions. The possibility that
      LFA-1 may also play an active regulatory role in NK cells has been explored. To
      this end, we have employed a monoclonal antibody (HP1N) raised against
      recombinant interleukin-2 (rIL-2)-activated NK cells, which recognizes the alpha
      chain of the LFA-1 heterodimer (CD11a). In contrast to other anti-CD11a mAb the
      HP1N and its F(ab')2 fragment did not affect NK cell-mediated cytotoxicity and
      triggered a strong homotypic adhesion of NK cells and other LFA-1+ cells.
      Cellular aggregation was inhibited by anti-CD18 mAb, anti-ICAM-1 mAb, and other
      anti-CD11a mAb. Remarkably, the HP1N mAb was also shown to induce tumor necrosis
      factor-alpha (TNF-alpha) production from NK cells upon costimulation with anti
      CD16 mAb. Such an effect appeared to be independent from homotypic adhesion since
      it took place in Mg(2+)-free medium, where NK cell aggregation was inhibited.
      Moreover, incubation with the HP1N mAb triggered a Ca2+ influx into the cytosol;
      this effect was clearly observed upon cross-linking of cell bound HP1N and was
      also substantiated with other anti LFA-1 (CD11a and CD18) mAb. Taken together
      these results indicate that the LFA-1 molecule is capable of transducing signals
      in NK cells, which regulate the intercellular interaction with its ligand, and
      enhance the activation via Fc gamma receptor type III.

PMID- 8344349
TI  - Regulation of perforin gene expression in a T cell hybrid with inducible
      cytolytic activity.
AB  - A mouse x rat T cell hybrid (PC60) that does not require interleukin (IL)-2 for
      proliferation, was used as a model to study regulation of perforin gene
      expression. Perforin mRNA is barely detectable in non-induced PC60 cells;
      however, a 30-fold induction is observed after stimulation with IL-1 alone. Peak
      perforin mRNA levels were reached after 10 h of induction with IL-1, and these
      levels were maintained for as long as the stimulus was present. IL-2 by itself
      has no detectable effect. However, in combination with IL-1 it shows the same
      induction kinetics as IL-1 alone for the first 10 h, subsequently there is
      synergism (100-fold induction) between IL-1 and IL-2. The induction response was
      mainly due to increased transcriptional rates of the perforin gene, and require
      newly synthesized proteins. The half-life of perforin mRNA in this system is
      about 5 h. In addition, we confirm the existence of two types of mouse perforin
      mRNA that differ in their 5' untranslated regions, and show evidence that both
      mRNA are translated in vivo with similar efficiencies.

PMID- 8344348
TI  - Association of a 70-kDa tyrosine phosphoprotein with the CD16: zeta: gamma
      complex expressed in human natural killer cells.
AB  - The CD16: zeta: gamma receptor complex allows natural killer (NK) cells to
      recognize and eliminate antibody-coated target cells. Whereas the ectodomain of
      CD16 is the receptor for Fc gamma domains of immunoglobulins, disulfide-linked
      homo- and heterodimers composed of zeta and gamma are required for the cell
      surface expression, and signal transduction properties of the complex. Engagement
      of CD16 activates the tyrosine kinase pathway, which induces the tyrosine
      phosphorylation of several substrates, including the zeta subunit and the
      phospholipase C gamma-1 and gamma-2 isoforms. Here we show that CD16 stimulation
      of either peripheral blood NK cells, leukemic NK cells, or Jurkat transformants
      expressing a CD16: zeta: gamma receptor complex, results in the tyrosine
      phosphorylation of a 70 kDa zeta-associated protein (pp70). Similarly, a 70-kDa
      zeta-associated phosphoprotein in T cells has been shown to be a tyrosine kinase
      (ZAP-70). Peptide mapping analysis indicates that the 70-kDa zeta-associated
      phosphoproteins from T cells and NK cells are structurally indistinguishable. We
      conclude that the CD16: zeta: gamma complex may use a ZAP-70-related non-receptor
      tyrosine kinase, in the CD16 signaling cascade leading to NK cell activation.

PMID- 8344350
TI  - Allogeneic recognition of class I molecules: anti-H-2Ld repertoire of H-2b mice
      includes T cells recognizing mutant class II H-2b (Abm12) molecules.
AB  - Two major histocompatibility complex (MHC) class I-reactive T cell clones derived
      from H-2b mice, generated against the allogeneic Ld molecule, were found to
      recognize the H-2b class II mutant Abm12 molecule as well. In addition, these
      clones also recognize the class II A(s) molecule, and display a class II
      dependent reactivity to staphylococcal enterotoxin B. Neither the class I nor the
      class II alloreactivities of the clones were found to be dependent on other MHC
      molecules. Both clones express CD4+CD8- phenotypes. The CD4 molecule appears to
      be involved in their class II reactivity, while little or no role for CD4 could
      be detected in the class I reactivity. This is the first report of a class
      I/class II cross-reactivity being mediated by CD4+ T cells. The structural basis
      for this cross-reactivity is discussed.

PMID- 8344351
TI  - Cachexia and the acute-phase protein response in inflammation are regulated by
      interleukin-6.
AB  - Cachexia and the acute-phase response are common manifestations of inflammation
      and are presumed to be the product of increased synthesis and release of
      cytokines, including tumor necrosis factor (TNF), interleukin-1 (IL-1) and
      interleukin-6 (IL-6). IL-1 receptor blockade has been previously shown to
      attenuate the weight loss, anorexia and acute-phase protein responses associated
      with a turpentine abscess. However, IL-1 receptor blockade was also associated
      with a reduced plasma IL-6 response, suggesting that the benefit achieved by IL-1
      receptor blockade may be mediated by reduced systemic IL-6 production. To gain a
      better understanding of the role of IL-6 in this model of inflammation, C57BL/6
      mice were passively immunized with either a monoclonal anti-IL-6 antibody (20F3),
      an anti-IL-1 type I receptor monoclonal antibody (35F5), a non-immune rat IgG, or
      a combined therapy of 35F5 and 20F3, before receiving a sterile turpentine
      abscess. IL-6 or IL-1 receptor blockade equally spared body weight and food
      intake. Compared to IL-1 receptor blockade, passive immunization against IL-6
      further reduced the hepatic acute-phase protein response, as represented by serum
      amyloid P and complement 3. Combined blockade of IL-6 and IL-1 receptor did not
      result in a further sparing of body weights or improvement of food intake. These
      results confirm that IL-1 contributes to host cachexia and the acute-phase
      response following a turpentine abscess, but also show that these actions are
      dependent upon an IL-6 response. We conclude that the influence of IL-1 on
      cachexia and the acute-phase response is mediated, at least in part, through IL-6
      and, thus, IL-6 may play a pivotal role in the cachexia and acute-phase response
      to inflammation.

PMID- 8344352
TI  - The expressed T cell receptor V gene repertoire of rheumatoid arthritis
      monozygotic twins: rapid analysis by anchored polymerase chain reaction and
      enzyme-linked immunosorbent assay.
AB  - Because of heterogeneity in the outbred human population, it has been difficult
      to determine the genetic factors that influence the expressed T cell receptor
      (TcR) repertoire in autoimmune diseases. To overcome this problem, we have
      developed a combination of anchored polymerase chain reaction (APCR) and enzyme
      linked immunosorbent assay (ELISA) that can accurately assess TcR V gene
      frequencies in numerous clinical samples. The results are independent of
      amplification efficiency, and V gene usage can be readily analyzed with an ELISA
      plate reader and associated software. Using this method, the TcR V beta gene
      repertoires in peripheral lymphocytes from nine sets of identical twins, normal,
      concordant or discordant for rheumatoid arthritis (RA), were studied. The TcR V
      beta results were compared with TcR V gamma frequencies in the same specimens as
      determined by APCR-ELISA and cDNA sequence analysis. The results showed a marked
      similarity in the TcR V beta gene repertoires between identical twins, compared
      to unrelated subjects (p < 0.05) whether or not they were concordant or
      discordant for RA. In contrast, the TcR V gamma gene repertoires in the
      monozygotic twins differed as much as in controls. The data imply that (a) the
      human TcR V beta gene repertoire in peripheral blood is genetically controlled,
      whereas (b) the TcR V gamma gene repertoire is primarily influenced by
      environmental stimuli, and (c) RA causes no consistent change in TcR V beta
      repertoire of peripheral blood. The APCR-ELISA method, in the context of large
      scale family and population studies, should facilitate a more precise delineation
      of the genetic factors that regulate human TcR V beta expression.

PMID- 8344353
TI  - Fc epsilon receptor-positive cells are a major source of antigen-induced
      interleukin-4 in spleens of mice infected with Schistosoma mansoni.
AB  - When cultured in vitro with either mitogen or parasite antigens, spleen cells
      from mice infected with Schistosoma mansoni produce significantly higher levels
      of IL-4 than splenocytes from control animals. Previous studies suggested that
      this increase in IL-4 production occurs because of a selective expansion of T
      helper type 2 (Th2) cells in infected mice. However, these experiments employed
      unfractionated spleen populations rather than purified T lymphocytes. Here we
      demonstrate that T-depleted spleen cells from infected animals synthesize high
      levels of interleukin-4 (IL-4), but no IL-5 when stimulated with parasite antigen
      in vitro. Nevertheless, when purified by sorting, T cells and non-B, non-T (NBNT)
      populations produced similar amounts of IL-4 in response to parasite antigen. The
      IL-4 producing NBNT cells were found to belong to an Fc epsilon receptor (Fc
      epsilon R)-positive population which after sort purification produced high levels
      of IL-4 (between 1000 and 2000 U of per 5 x 10(3) cells). FACS analysis revealed
      that these Fc epsilon R+ cells make up 0.53% of splenic NBNT cells in control
      animals while in 8-9-week-infected animals they increase to 3.8% of that
      population. In contrast, in mice with 8-week unisexual worm infections these
      cells comprise only 1.71% of NBNT cells, indicating that eggs are a major
      stimulus of the response. The expansion of Fc epsilon R+ cells and their
      production of IL-4 could be an important factor regulating the selection and
      induction of different CD4+ subsets in schistosome-infected hosts.

PMID- 8344354
TI  - The intronic immunoglobulin kappa gene enhancer acts independently on
      rearrangement and on transcription.
AB  - It is not known which cis-acting elements regulate kappa gene rearrangement.
      However, the onset of rearrangement coincides with the onset of transcription
      suggesting that common regulatory elements are used. We have investigated the
      role of the intronic enhancer on rearrangement using mice transgenic for kappa
      minigenes. The rabbit kappa enhancer, which is defective in activation of
      transcription in mouse cells, allows a high level of rearrangement. However,
      transgenes which possess no enhancer region at all are rearranged a hundred times
      less compared to transgenes which possess the rabbit enhancer. Our results
      suggest that while the enhancer region can activate rearrangement as well as
      transcription, its action on both phenomena can be uncoupled.

PMID- 8344355
TI  - Regulation of T cell production in T cell receptor transgenic mice.
AB  - The thymus produces many more cells than it releases into the periphery.
      According to generally accepted models of T cell development most of this loss
      occurs in the thymic cortex, among CD4+8+ thymocytes. An interesting situation
      arises in the case of T cell receptor (TcR) transgenic mice in which all cells
      can potentially be positively selected, leading to a theoretical increase of
      about 30-fold in the survival rate of CD4+8+ cells and in their transition to
      mature CD4+8- or CD4-8+ thymocytes. This in turn should lead to a 30-fold
      increase in the size of the thymic medulla, in the emigration rate and in the
      size of the peripheral T cell pool. Increases in medullary or peripheral pool
      sizes of this magnitude are not seen in TcR transgenic mice. The question was
      therefore asked whether some form of homeostatic process regulated the size of
      the mature T cell pool and at what level it might operate. In this report we
      demonstrate that the increased rate of double-positive to single-positive
      transition in the TcR transgenic mice is directly reflected in an increased
      emigration rate, and that the medulla seems to be relatively efficient regardless
      of the number of cells passing through it. However, the potential increases in
      emigrant numbers in TcR transgenic mice are offset by the reduced size of the
      CD4+8+ thymocyte pool. It would appear then that regulation of T cell production,
      if it occurs, probably does so through regulation of the size of the CD4+8+
      thymocyte pool. Mechanisms for regulation of this kind are not yet known.

PMID- 8344356
TI  - Expression of immunoglobulin kappa and lambda chains in mink.
AB  - The ratio of kappa and lambda chains of immunoglobulins varies significantly from
      one species to another. It has previously been thought that lambda was only type
      expressed in mink. We tested mink immunoglobulin light chains using two
      monoclonal antibodies G80 and G88. It has been shown that G80 and G88
      specifically recognize two antigenically different subpopulations of the light
      chains. Immunochemical analysis of these subpopulations separated by affinity
      chromatography suggested that they represent lambda and kappa types of light
      chains, respectively. Screening of a mink cDNA library with monoclonal antibody
      G88 resulted in the isolation of clone pIGK-1 containing kappa chain-encoding
      sequence. The cDNA insert of pIGK-1 included most of the V segment, as well as
      the J, C and 3' untranslated sequences. Mink V kappa sequence shown the highest
      homology with the human V kappa II subgroup genes (76-79%). Mink C kappa sequence
      was 53-63% homologous to C kappa of other species. The striking feature of mink C
      kappa chain is the presence of glutamine in the C-terminal position. Southern
      blot analysis suggested that mink haploid genome has one C kappa gene and
      multiple V kappa genes. The kappa:lambda chain ratio in the 12 minks studied was,
      on the average, 46:54. The same ratio was observed for the kappa- and lambda
      producing cells in the mesenteric lymph nodes. The five previously identified
      mink light chain allotypes were assigned to the lambda chains, thereby confirming
      that lambda chains in this species are additionally subdivided into several
      subtypes.

PMID- 8344357
TI  - Role of liver endothelial and Kupffer cells in clearance of human C1q in rats.
AB  - In the present study the contribution of rat liver endothelial cells (EC) and
      Kupffer cells (KC) in the clearance of human (hu) C1q in rats was investigated.
      In untreated rats and rats depleted from KC the clearance kinetics and the tissue
      distribution of hu C1q were measured. In untreated rats, the clearance of hu C1q
      occurred in a monophasic manner with a half-life of 66 +/- 26.7 min. The
      clearance of hu C1q in KC-depleted rats was delayed significantly (p < 0.001) and
      occurred with a half-life of 217 +/- 78.8 min. Fifteen min after injection, 11 +/
      3.5% of hu C1q was found in the liver of untreated rats and 8 +/- 1.4% was found
      in the liver of KC-depleted rats. The percentage non-trichloroacetic acid
      precipitable activity in the circulation, as a measure for degradation of C1q,
      reached a level of 11.6 +/- 5.6% at 240 min in untreated rats compared with 4.6
      +/- 5.8% in KC-depleted rats. Double immunofluorescence staining 5 min after
      administration of C1q in untreated rats, revealed that C1q was associated with KC
      and EC in the liver. Fifteen minutes after i.v. injection of hu C1q, there was an
      uptake of C1q in the hepatocytes. In KC-depleted rats, 5 min after administration
      of hu C1q, C1q was bound to the EC. Fifteen minutes after injection, C1q was also
      found in the hepatocytes. Electron microscopical studies revealed that C1q binds
      to EC, and that it is internalized in the hepatocytes and KC. The clearance of hu
      C1q in untreated rats was inhibited by preadministration of high concentrations
      of bovine C1q. These data show that rats depleted from KC are able to bind,
      internalize and degrade C1q, and that EC may play a role in the handling of C1q
      and C1q bound to immune complexes.

PMID- 8344358
TI  - Characterization and purification of T lymphocyte aminopeptidase B: a putative
      marker of T cell activation.
AB  - We have previously described that human T lymphocytes express membrane-associated
      peptidase activities (Mari et al., EMBO J., 1992, 11:3875). We show in this
      report that intact Jurkat T cells readily cleaved H-Arg-paranitroanilide, an
      aminopeptidase B (AP-B) substrate. The identification of the hydrolyzing activity
      as AP-B was confirmed by its sensitivity to both arphamenine B and bestatin in
      the nanomolar range. Significant AP-B activity was released in the supernatant
      upon incubation of intact T lymphocytes at 37 degrees C. However, AP-B activity
      was found mainly in the cytosolic fraction of Jurkat T cells. Cytosolic T cell AP
      B was purified to homogeneity and exhibited a molecular mass of 72 kDa. Purified
      AP-B cleaved N-terminal basic amino acid-containing peptides such as thymopentin
      (H-Arg-Lys-Asp-Val-Tyr-OH), indicating that it might play a role in the
      regulation of the concentration of important soluble mediators of T cell
      activation. A rabbit polyclonal antibody was shown to recognize AP-B as assessed
      by both immunoprecipitation and Western blot experiments. Finally, we found that
      AP-B was up-regulated during activation of normal and leukemic T lymphocytes.

PMID- 8344359
TI  - T cell immunity after a viral infection versus T cell tolerance induced by
      soluble viral peptides.
AB  - The fate of in vivo activated CD8+ cytotoxic T cells was studied in transgenic
      mice expressing a T cell receptor (TCR) specific for the lymphocytic
      choriomeningitis virus (LCMV) glycoprotein peptide 33-41 presented by major
      histocompatibility complex (MHC) class I molecules. LCMV infection of TCR
      transgenic mice induced LCMV-specific effector and memory T cells whereas
      injection of soluble LCMV glycoprotein peptide 33-41 resulted in tolerance by
      peripheral deletion and anergy of LCMV-specific T cells after an initial
      expansion phase. Similarly, LCMV peptide 33-41-specific tolerance could be
      achieved in normal C57BL/6 mice and was not abrogated by an LCMV infection. These
      results obtained with a classically MHC-restricted peptide antigen parallel
      previous findings with retroviral or bacterial superantigens and indicate a
      possibility to modulate specifically mature peripheral cytotoxic T lymphocytes in
      vivo.

PMID- 8344360
TI  - CD4+8- help prevents rapid deletion of CD8+ cells after a transient response to
      antigen.
AB  - We have followed the fate of mature CD8+ T cells with a male-specific transgenic
      T cell receptor after antigenic stimulation with hemopoietic cells in the absence
      or presence of help. Our data show that mature CD8+ T cells can be deleted after
      a 3-week period of transient activation and that help, e.g. in the form of
      interleukin-2, can considerably delay the deletion. These experiments have
      implications for the design of protocols aiming at the establishment of specific
      immunological tolerance in T cells.

PMID- 8344361
TI  - Thymus influences the development of extrathymically derived intestinal
      intraepithelial lymphocytes.
AB  - Overwhelming evidence suggests that the majority of murine small intestinal
      intraepithelial lymphocytes (IEL) are extrathymically derived. These IEL include
      those with T cell receptor (TCR) gamma delta and some TCR alpha beta (CD8 alpha
      alpha and Thy-1-). In contrast, congenitally athymic nude mice have low numbers
      of gamma delta TCR IEL as well as very few alpha beta TCR IEL, far less than that
      would be expected if one assumes that gamma delta TCR IEL and alpha beta TCR (CD8
      alpha alpha and Thy-1-) IEL in euthymic mice are extrathymically derived. To
      examine this discrepancy, we followed extrathymic IEL differentiation in IEL of
      day 3-thymectomized (NTX) mice as another athymic mouse model and found that
      gamma delta TCR IEL and extrathymically derived alpha beta TCR IEL in NTX mice
      are markedly reduced, almost to the level of nude mice. We further show that it
      is probably the absence of a thymic stroma that is responsible for the lower
      amounts of extrathymically derived IEL in nude mice, as the low amounts can be
      corrected to euthymic levels by syngeneic fetal thymus grafting but not by direct
      injection of F1 thymocytes. Lastly, unlike TCR/CD3+ extrathymically derived IEL,
      we noted a large proportion of extrathymic CD3-CD8- and CD3-CD8+ IEL; they were
      threefold more frequent in nude and NTX than in euthymic mice. This suggests that
      the thymus influences extrathymically derived IEL in its development from CD3- to
      CD3+ at the small intestinal epithelium.

PMID- 8344362
TI  - Pairing of VH gene families with the lambda 1 light chain: evidence for a non
      stochastic association.
AB  - The frequencies at which four VH gene families pair with the lambda 1 light (L)
      chain were determined by sequential hybridization of VH- and lambda 1-specific
      DNA probes to mitogen-induced colonies of B cells. Analysis of pair frequencies
      indicates that the repertoire of lambda L chain antibodies is generated by the
      stochastic pairing of smaller 3'-to-mid-locus VH gene families (X-24, S107, Q52).
      However, the large 5' VH J558 family appeared to associate with the lambda 1 L
      chain non-stochastically; the frequency of VHJ558/lambda 1+ colonies among all
      lambda 1+ colonies was significantly lower than the frequency of J558 expression
      among all (C mu+) B cell colonies. This difference suggests that selection,
      either intrinsic at the level of rearrangement or heavy and L chain pairing, or
      extrinsic following surface immunoglobulin expression, may operate to shape the
      lambda antibody repertoire prior to the introduction of exogenous antigen.

PMID- 8344363
TI  - Diversity of expressed V and J regions of immunoglobulin light chains in Xenopus
      laevis.
AB  - In Xenopus laevis, two immunoglobulin light chain isotypes, designated L1 or rho
      and L2 or sigma, have been identified. The genomic organization of the L1 locus
      has been described previously: a constant (C) gene segment is preceded by a
      joining (J) gene segment; in addition, there are many cross-hybridizing variable
      (V) gene segments. To evaluate the extent of sequence diversity of L1 V regions,
      we screened three cDNA libraries, constructed from mitogen-stimulated Xenopus
      splenocytes, with probes for the C or the J gene segment. Eighteen cDNA clones
      that contain complete or truncated V regions were chosen for sequence analysis.
      The C regions of all clones are identical or nearly identical to the genomic C
      gene segment; the V regions are greater than 80% identical in nucleotide sequence
      and are presumably derived from a single family of V gene segments. Although
      framework regions are nearly identical, complementarity-determining regions are
      quite diverse. The expressed J segments fall into distinct groups, suggesting the
      presence of more than one germ-line J segment. Therefore, a genomic library was
      screened with a J region probe. A clone overlapping with the previously
      identified J-C clone, and containing four additional J gene segments, was
      isolated. All five J gene segments are very similar and three are identical in
      nucleotide sequence. Each of the three distinct germ-line J sequences is
      represented in the set of cDNA clones, suggesting that combinatorial
      diversification occurs; imprecision of V-J joining also appears to contribute to
      variability. Overall, these results suggest that the immunoglobulin repertoire in
      this species is not significantly restricted by a limitation in the diversity of
      light chain V regions.

PMID- 8344364
TI  - An antigen processing polymorphism revealed by HLA-B8-restricted cytotoxic T
      lymphocytes which does not correlate with TAP gene polymorphism.
AB  - In previous studies of antigen presentation through HLA-B27, we identified a
      healthy person whose lymphoblastoid cells do not present three B27-restricted
      viral epitopes to specific cytotoxic T lymphocytes (CTL), despite adequate cell
      surface expression of HLA-B2702 of normal sequence. Similar findings were
      observed in all members of his family sharing the HLA-A3-B2702 haplotype. The
      original donor, NW, carries HLA-B8 on his other class I haplotype, which his
      daughter, HW, has inherited. We now report a failure to present an HLA-B8
      restricted epitope from influenza nucleoprotein following viral infection of NW
      cells, although exogenous added peptide is still presented normally. However,
      cells from HW, which do not carry the A3-B2702 haplotype, present the expected
      epitope after viral infection. Another B8-restricted epitope, from human
      immunodeficiency virus-gag, is presented equally well by both cell lines when
      infected with gag-vaccinia. This antigen processing phenotype does not correlate
      with any of the known human TAP-1 and TAP-2 polymorphisms.

PMID- 8344365
TI  - Variable binding affinities of listeriolysin O peptides for the H-2Kd class I
      molecule.
AB  - Previously we used the peptide-binding motif for the murine class I major
      histocompatibility complex molecule H-2Kd to identify a nonamer peptide of the
      Listeria monocytogenes listeriolysin (LLO) protein that was recognized by
      cytotoxic T lymphocytes (CTL) in association with H-2Kd. Eleven nonamer peptides
      contained in the LLO sequence were synthesized and one, LLO 91-99, proved to be a
      CTL target. Using peptide binding competition assays with H-2Kd-restricted CTL,
      we show that 3 out of the 11 LLO peptides, including the CTL epitope, have a high
      binding affinity for H-2Kd; 2 of 11 peptides have approximately 10-fold lower
      affinity, while the remaining 6 peptides have no or very low affinity for H-2Kd.
      Single residue changes were made in the LLO 91-99 peptide and two other LLO
      peptides to identify non-anchor amino acids that might interfere with peptide
      binding. In addition, we used the LLO peptides which bound well to H-2Kd to
      attempt to restimulate a secondary CTL response from L. monocytogenes-primed
      spleen cells. Only LLO 91-99 was able to induce such a response. Thus only a
      fraction of nonamer peptides which fit the original binding motif have a high
      affinity for the H-2Kd class I molecule, and only a fraction of these serve as
      CTL epitopes.

PMID- 8344366
TI  - Differential induction of Egr-1 expression in WEHI-231 sublines does not
      correlate with apoptosis.
AB  - To determine whether the absence of inducible Egr-1 expression correlates with
      apoptosis and growth arrest, we compared the inducible expression of two Egr
      family members (Egr-1 and Egr-2) in three sublines of WEHI-231. Expression of Egr
      2 is induced in all sublines of WEHI-231 following surface immunoglobulin (sIg)
      cross-linking, but Egr-1 expression is induced in only two. We find that the lack
      of inducible Egr-1 expression corresponded to an increase in the methylation
      pattern of the Egr-1 gene. In spite of these differences in Egr-1 expression, all
      the sublines demonstrate similar inhibition of [3H] thymidine incorporation
      following anti-Ig treatment. Growth arrest leads to apoptosis in only two of the
      sublines, but apoptosis does not correlate with the absence of inducible Egr-1
      expression. Demethylation, by treatment with 5-azacytidine, in the Egr-1 non
      expressing subline allows for induction of Egr-1 expression by anti-Ig, but fails
      to prevent growth arrest and apoptosis. Therefore, we conclude that the lack of
      Egr-1 expression is not responsible for either the apoptotic response or growth
      arrest induced by anti-Ig in WEHI-231.

PMID- 8344367
TI  - Human immunodeficiency virus type 1 gp120 C5 region mimics the HLA class I alpha
      1 peptide-binding domain.
AB  - Molecular mimicry of major histocompatibility (MHC) antigens by viral
      glycoproteins has been suggested as one of the possible mechanisms of induction
      of an autoimmune response by human immunodeficiency viruses. A monoclonal
      antibody (M38) was previously shown to bind to both human immunodeficiency virus
      type 1 (HIV-1) gp120 and beta-2 microglobulin-free HLA class I heavy chains
      encoded by an HLA C allele. Using HLA C recombinant proteins and synthetic
      peptides, the M38 class I binding site was mapped to a stretch of 44 amino acids
      of the alpha 1 domain. The amino acid residues recognized are clustered in two
      non-contiguous regions at positions 66-69 (KYKR) and 79-82 (RKLR) shared by
      almost all HLA C alleles. On HIV-1 gp120, M38 binds to two non-contiguous
      sequences (KYK and KAKR) at positions 490-492 and 505-508 located at the edges of
      a large hydrophobic region that is apparently involved in binding the
      transmembrane glycoprotein gp41. The C-terminal gp120 M38-reactive region (KAKR)
      lies within the immunodominant sequence APTKAKRRVVQREKR, against which the
      majority of HIV-infected individuals produce antibodies. The results indicate
      that a functionally important region of HIV-1 gp120 shares similar amino acid
      sequence motifs with the antigen recognition site of most HLA class I C alleles.
      The molecular mimicry may be the basis for autoimmune responses in HIV infection.

PMID- 8344368
TI  - Alloactivated cytotoxic T cells recognize the carboxy-terminal domain of human
      immunodeficiency virus-1 gp120 envelope glycoprotein.
AB  - Infection with the human immunodeficiency virus (HIV) virus leads to clinical
      disease in humans but not in chimpanzees. Progression to disease is associated
      with activation of the immune system followed by loss of T helper cell function
      and a slow decline in CD4-positive lymphocytes. The presence of autoreactive and
      cytotoxic cells in humans but not chimpanzees suggests that mechanisms other
      than, or in addition to, direct virus-induced cell killing, are required for
      disease to develop. The observed changes are similar to those seen in chronic
      allogeneic disease. Here we show that a peptide from the carboxy terminus of
      gp120, predicted to have a structure similar to the major alpha-helices of major
      histocompatibility complex (MHC) class I and class II, acts as a cytolytic target
      when presented on syngeneic cells for alloactivated cytotoxic T effector cells.
      These data add further evidence to the hypothesis that HIV can act as an
      allostimulant due to its dual properties of CD4 binding and MHC mimicry. The
      ability to signal nonspecifically through the T cell receptor could explain the
      initially paradoxical responses of proliferation, anergy and apoptosis.

PMID- 8344370
TI  - Thermostability analysis of major histocompatibility complex class I molecules by
      temperature gradient gel electrophoresis.
AB  - Empty major histocompatibility complex (MHC) class I molecules present on the
      surface of RMA-S (26 degrees C) cells were loaded with the iodinated peptides
      APGNYPAL, FAPGNYPAL (SEV-9) and RGYVYQGL (VSV-8), respectively. The
      thermostability of these peptide-loaded MHC class I molecules was assessed using
      temperature gradient native polyacrylamide gel electrophoresis. A linear
      temperature gradient perpendicular to the direction of electrophoresis yielded a
      graphical representation of the melting of MHC class I molecules. The class I
      signal disappeared when the peptide melted out of the groove, and gave rise to a
      second signal due to released peptide. APGNYPAL-loaded class I molecules melted
      at 11 degrees C with considerable release even at 0 degrees C. VSV-8-loaded class
      I molecules melted first at 36 degrees C, whereas SEV-9-loaded molecules melted
      at about 22 degrees C. A discrimination between the binding of SEV-9 to Kb and Db
      molecules was seen in the melting patterns. Results are discussed in correlation
      with known crystallographic structures of class I molecules containing peptides
      in the binding groove.

PMID- 8344369
TI  - Increased circulating interleukin-6 (IL-6) activity in endotoxin-challenged mice
      pretreated with anti-IL-6 antibody is due to IL-6 accumulated in antigen-antibody
      complexes.
AB  - Mice pretreated with monoclonal anti-interleukin-6 (IL-6) antibody and then
      challenged with lipopolysaccharide (LPS), paradoxically develop higher levels of
      circulating biological IL-6 activity, as measured by the hybridoma growth
      promotion assay, than mice similarly challenged but not pretreated with antibody.
      Here we provide evidence that this increased biological activity was entirely
      accounted for by the presence of increased amounts of IL-6 protein, which could
      be isolated by immunoaffinity chromatography and subsequently visualized after
      gel electrophoresis. Chromatography on a protein G matrix and a sandwich ELISA
      allowed to demonstrate that all IL-6 present in the serum was in the form of
      antigen-antibody complexes. Serum samples of antibody-treated animals which
      contained the highest biological activity typically contained near equimolar
      concentrations of IL-6 and antibody. In vitro neutralization tests with pure
      antibody and IL-6 demonstrated that, with both antibodies tested, more than 1000
      fold molar excess of antibody is needed for neutralization in the hybridoma
      growth assay. It is concluded that increased biological activity in serum of the
      anti-IL-6 antibody-treated mice is due to sequestration of the endogenous IL-6 in
      the form of antigen-antibody complexes which, due to the lack of sufficient
      antibody excess, produce nearly full activity in the hybridoma growth assay.

PMID- 8344371
TI  - Helper activity of CD4+ alpha beta T cells is required for the avian gamma delta
      T cell response.
AB  - We have studied the in vitro activation of chicken gamma delta T cells. Both
      splenic alpha beta and gamma delta T cells obtained from complete Freund's
      adjuvant-primed chickens proliferated in vitro when stimulated with mycobacterial
      sonicate or purified protein derivative of Mycobacterium tuberculosis. When CD4+
      cells or alpha beta T cell receptor (TcR)-positive cells were removed, both the
      proliferation and the blast formation of gamma delta T cells in response to
      mycobacterial antigens were abrogated. The response was restored if supernatant
      from concanavalin A (Con A)-activated lymphocyte cultures (CAS) as a source of
      helper factors was added together with the specific antigen purified protein
      derivative. The CD4- or alpha beta TcR-depleted cells still proliferated in
      response to Con A, although a decrease of the response was observed. To analyze
      the gamma delta T cell response more specifically we stimulated peripheral blood
      cells with immobilized monoclonal antibodies against T cell receptor. Anti-gamma
      delta TcR antibody alone did not induce significant proliferation. When CAS was
      added together with the anti-gamma delta TcR monoclonal antibody, a strong
      proliferation of gamma delta T cells was observed. In contrast, both V beta 1-
      and V beta 2-expressing alpha beta T cells proliferated in vitro in response to
      stimulation with the relevant anti-TcR monoclonal antibody alone. Depletion of
      either V beta 1+ or V beta 2+ T cell subset alone had no negative effect on the
      proliferation or blast formation of gamma delta T cells stimulated with
      mycobacterial antigens. Taken together our results suggest that CD4+ alpha beta T
      cells (both V beta 1- and V beta 2-expressing) play a role in the activation and
      response of chicken gamma delta T cells.

PMID- 8344372
TI  - High IgE secretion capacity of human plasma cells.
AB  - In accordance with results obtained in another culture system, it has previously
      been shown that human B cells frequently switch to immunoglobulin E (IgE) when
      they are co-cultured with irradiated mutant EL4 thymoma cells (which provide a
      CD40 ligand-mediated B cell activation signal), T cell supernatant and
      recombinant interleukin (IL)-4. However, because of the potentially severe side
      effects of IgE, such as anaphylaxis, B cells could have a limited capacity to
      produce this isotype. The IgE secretion rate of plasma cells is not known. In the
      present study, we compared the secretion rates for different Ig classes by means
      of limiting dilution analysis of plasmocytic cells that were harvested after 8 to
      9 days from primary EL4/B cell cultures and titrated into secondary cultures in
      the presence of a cell proliferation-blocking concentration of hydroxyurea. These
      cells secreted Ig at constant rates for periods of up to 2 weeks; IgE secretion
      was IL-4 independent. The mean cellular secretion rates were similarly high for
      IgE (150 pg/cell/24 h) and other isotypes (IgM 273 pg, IgG 112 pg, IgA 136
      pg/cell/24 h). In terms of molecules per min this represents 3.3 x 10(5) for IgE
      versus 1.2 x 10(5) for IgM, 3.1 x 10(5) for IgG and 3.6 x 10(5) for IgA. The
      relative frequency of IgE-secreting cells was only 0.3% of the total number of Ig
      secreting cells, suggesting a small size of IgE-producing clones in this in vitro
      system. Whether this is relevant regarding an in vivo response is not known.
      Clearly, the Ig secretion capacity of plasma cells would not limit an IgE
      response in the absence of extrinsic control.

PMID- 8344373
TI  - The Mycobacterium tuberculosis 71-kDa heat-shock protein induces proliferation
      and cytokine secretion by murine gut intraepithelial lymphocytes.
AB  - Murine intraepithelial lymphocytes (IEL) respond poorly to T cell mitogens and to
      monoclonal antibody stimulation of T cell receptor (TCR)- and CD3- associated
      molecules. In contrast, we found that a soluble extract of Mycobacterium
      tuberculosis (Mtb), but not purified protein derivative of tuberculin, induced
      significant proliferative responses in IEL cultures. The active component was
      apparently a heat shock protein (HSP), since recombinant 71-kDa HSP from Mtb
      induced IEL to proliferate, while 65-kDa HSP from M. bovis and M. leprae did not.
      Both alpha/beta and gamma/delta TCR-enriched IEL gave proliferative responses to
      71-kDa HSP. Further, culture supernatants from IEL stimulated with 71-kDa HSP
      contained elevated levels of interleukin-(IL)-3/granulocyte-macrophage colony
      stimulating factor, interferon-gamma and IL-6, but not IL-2, IL-4, IL-5 or
      transforming growth factor-beta. Finally, several IEL T cell clones have been
      maintained for up to 6 weeks, when stimulated with 71-kDa HSP, IL-2 and feeder
      cells. Our results show that the 71-kDa HSP of Mtb induces IEL T cells to divide
      and to secrete cytokines and this may offer a model for cloning and study of IEL
      T cells in vitro.

PMID- 8344374
TI  - Electron microscopic localization of ribosomal DNA in rat liver nucleoli by
      nonisotopic in situ hybridization.
AB  - We have used postembedding nonisotopic in situ hybridization, with biotinylated
      rat ribosomal DNA (rDNA) as a probe and streptavidin coupled to 10-nm colloidal
      gold particles as the detection system, to localize rDNA sequences in rat liver
      nucleoli at the electron microscopic level. For comparison purposes,
      immunoelectron microscopy was performed for the detection of DNA. Our results
      indicate that ribosomal DNA sequences are enriched in the dense fibrillar
      component of the rat liver nucleolus. These data are discussed in relation to the
      putative site(s) for transcription of ribosomal genes.

PMID- 8344376
TI  - Induction of thermotolerance by prostaglandin A in human cells.
AB  - Cyclopentenone prostaglandins (PGs) induce the synthesis of heat shock proteins
      (HSPs) in mammalian cells. Since arachidonic acid metabolites are implicated in
      the control of fever, we investigated the effect of PG treatment on thermal
      injury in human K562 erythro-leukemia cells. Prostaglandin A1 (PGA1) was found to
      protect cells after severe heat shock and to induce a thermotolerant state, which
      persisted for 24-48 h. Prostaglandins of the B, E, and F type were not effective.
      Kinetics of thermotolerance induction was comparable to heat-induced heat
      resistance. Establishment of a thermotolerant state was not a direct effect of
      PGA1, since it was dependent on de novo protein synthesis and was associated with
      HSP70 induction. This activity of PGA1 could be part of a protective control
      mechanism during fever.

PMID- 8344375
TI  - Conservation of the dimeric unit of H2A and H2B histones during the replication
      cycle.
AB  - The behavior of H2A and H2B histones during the replication cycle has been
      investigated. H2A-H2B dimer fractions obtained from MH-134SC cells labeled with
      suitable precursors were fractionated by rate zonal centrifugation in sucrose
      gradients containing 2 M NaCl. Labeling for one round of replication cycle with
      an amino acid mixture enriched with dense isotopes and [3H]lysine as a
      radioactive marker yielded a distinct peak of dense dimer that sedimented faster
      than the normal dimer. Similar density labeling of cells did not cause measurable
      alteration in the sedimentation profile of the preexisting normal dimer marked
      with [14C]lysine. The data suggest conservation of the bulk of the dimeric unit
      during the replication cycle. Biological significance of the dimeric behavior of
      H2A and H2B is discussed in favor of the partially conservative model of histone
      octamer assembly.

PMID- 8344377
TI  - Prompt protein glycosylation during acute heat stress.
AB  - Constitutive patterns of protein synthesis and protein glycosylation are severely
      disrupted by acute heat stress. Stressed cells respond by preferential synthesis
      of specific proteins, e.g., the well-known family of heat shock proteins. We
      observed another response that rapidly occurs during heating periods as short as
      10 min at 45 degrees C. During that period, CHO cells began to glycosylate
      specific proteins, designated as "prompt" stress glycoproteins (P-SG), while
      constitutive protein glycosylation ceased. Labeling of P-SGs showed a dose
      response with time and with temperature and appeared regardless of the label used
      (D-[3H]mannose or D-[3H]glucose). On SDS-PAGE, the major P-SG was characterized
      by M(r) approximately 67 kDa (P-SG67) and pI = 5.1. Other less prominent P-SGs
      appeared at M(r) 160, 100, 64, 60, and 47 kDa; incorporated label showed little
      turnover during 24 h at 37 degrees C. Prompt glycosylation was inhibited by
      tunicamycin, and label incorporated into P-SGs was sensitive to N-glycosidase F,
      but not to O-glycosidase. Analysis of enzymatically digested P-SG67 indicated
      that label had been incorporated into both high-mannose (Man9GlcNAc) and complex
      type oligosaccharides. Brefeldin A did not eliminate P-SG67 labeling, but caused
      the further appearance of novel, Brefeldin-associated P-SGs. Labeling of P-SG67
      oligosaccharides occurred without significant concomitant protein synthesis,
      suggesting that addition of labeled oligosaccharides largely occurred on mature,
      rather than nascent proteins. The functional significance of prompt glycosylation
      remains to be defined, but we propose that this novel phenomenon is an integral
      part of the cellular heat stress response.

PMID- 8344378
TI  - P- and E-cadherin are in separate complexes in cells expressing both cadherins.
AB  - E- and P-cadherin are members of a family of calcium-dependent, cell surface
      glycoproteins involved in cell-cell adhesion. Extracellularly, the transmembrane
      cadherins self-associate, while intracellularly, they interact with the actin
      based cytoskeleton. Several intracellular proteins, collectively termed catenins,
      are tightly associated with E- and P-cadherin. These proteins appear to link the
      cadherin to the cytoskeleton and have been proposed to be involved in
      concentrating cadherins at cell-cell adherens junctions. In this paper we report
      the production of monoclonal antibodies against both alpha- and beta-catenin and
      use these antibodies to show that in cells simultaneously expressing two
      different cadherins, E-cadherin and P-cadherin, each cadherin appears to be
      present in a separate cadherin/catenin complex.

PMID- 8344379
TI  - Disposition and orientation of ductin (DCCD-reactive vacuolar H(+)-ATPase
      subunit) in mammalian membrane complexes.
AB  - The disposition and orientation of mouse ductin (the subunit c of the vacuolar
      H(+)-ATPase) in gap junctions has been examined. Like the Nephrops norvegicus
      (arthropod) form, mouse ductin in the intact junctional structure is resistant to
      high levels of nonspecific proteinase, suggesting that it is for the most part
      buried in the bilayer. Antisera to an octapeptide near the N-terminus cross-react
      with ductins in gap junction preparations from four different mouse tissues, from
      chicken and Xenopus laevis liver, and from N. norvegicus hepatopancreas. The
      antisera and antibodies, affinity purified against the octapeptide, agglutinate
      isolated gap junctions, suggesting that the N-terminus is located on the exposed
      surface, equivalent to the cytoplasmic face of an intercellular gap junction. The
      antibodies also block dye coupling when injected into cells in culture,
      confirming the cytoplasmic location of the epitope. The lipophylic reagent
      dicylohexyl carbodiimide (DCCD), which targets carboxyl groups within the
      membrane and selectively reacts with ductin in N. norvegicus gap junction
      preparations, rapidly inhibits junctional communication. Bafilomycin A1, which
      inhibits V-ATPase and stops vacuolar acidification, does not affect dye coupling,
      showing that the inhibition seen with antibodies and DCCD is not an indirect
      consequence of their action on the ductin of V-ATPase. Consistent with this
      interpretation the anti-peptide antibodies do not bind to intact chromaffin
      granules or inhibit their V-ATPase activity, but do bind to osmotically disrupted
      granule membrane. This suggests that ductin has an orientation (N-terminus
      pointing away from the cytoplasm) in the vacuolar membrane opposite to that in
      the gap junction membrane.

PMID- 8344380
TI  - Control of apoptosis and growth of malignant T lymphoma cells by lymph node
      stromal cells.
AB  - We have previously established the malignant T lymphoma CS-21 cell line from a
      spontaneous lymphoma in a BALB/c mouse. CS-21 lymphoma cells grew continuously
      when they were cocultured with stromal CA-12 cells prepared from lymph nodes. CS
      21 lymphoma cells, however, could not proliferate by themselves, and they
      underwent apoptosis when separated from the stromal CA-12 cells. Apoptosis of CS
      21 lymphoma cells was determined by observation of morphological changes using a
      transmission electron microscope and also by detection of nuclear DNA degradative
      fragments of oligonucleosomal size. Stromal CA-12 cells secreted soluble factors
      that enhanced DNA synthesis in CS-21 lymphoma cells. The soluble factors,
      however, were not sufficient to prevent apoptosis of CS-21 cells. Apoptosis of CS
      21 lymphoma cells was suppressed only when the CS-21 lymphoma cells were
      cocultured with substantial numbers of CA-12 cells. The results suggest that the
      lymph node stromal CA-12 cells played an important role in the growth of CS-21
      lymphoma cells by providing at least two different signals. One signal prevented
      CS-21 cells from apoptotic cell death by direct cell-to-cell contact, and the
      other signal enhanced the CS-21 cell proliferation by secreted soluble factors.

PMID- 8344381
TI  - Negative trans-acting mechanisms controlling expression of platelet-derived
      growth factor A and B MRNA in somatic cell hybrids.
AB  - We have studied a human malignant melanoma cell line (WM115) which expresses high
      levels of PDGFA and PDGFB mRNAs, a hamster fibroblast cell line (Wq3H) which
      lacks PDGFB and has a very low expression of PDGFA mRNA, and hybrids between
      these cell lines. The PDGFA and PDGFB mRNA expression in the hybrid cells was
      markedly suppressed, indicating that the melanoma PDGF genes are controlled in
      the hybrid cells by negative factors/mechanisms contributed by the fibroblast
      genome. The melanoma but not the fibroblast PDGFB mRNA was induced by
      cycloheximide in the hybrid cells, indicating that the fibroblast and the
      melanoma PDGFB genes are regulated differently despite their presence in the same
      intracellular environment.

PMID- 8344382
TI  - Intramitochondrial localization of the main 70-kDa heat-shock cognate protein in
      Drosophila cells.
AB  - The main heat shock cognate protein (hsc) of 70 kDa in Drosophila, hsc 4, was
      localized in cultured cells using a specific affinity-purified antibody and
      colloidal gold immunoelectron microscopy. This constitutively expressed member of
      the heat shock protein (hsp) 70 family is found in the cytosol, in mitochondria,
      and in the nucleus of unstressed cells. The identity of hsc 4 in these three
      cellular compartments was confirmed by two-dimensional gel immunoblots and
      partial proteolytic digestion patterns. In mitochondria, the colloidal gold
      particles are observed in close proximity to or on the inner membranes. The
      intramitochondrial localization of this hsc was confirmed by density gradient
      purification and by resistance of hsc 4 to externally added trypsin. In the
      nucleus, the labeling is found on nucleo-plasmic perichromatin RNP fibrils and is
      not detected in the nucleolus. Heat shock induces an intracellular redistribution
      of hsc 4 with an enrichment in the nucleus. The localization of this hsc in
      different cellular compartments is consistent with the previously suggested
      functions of some members of this family of proteins in basic cellular processes
      such as protein folding. Moreover, the present data suggests that the main
      constitutively expressed member of the hsp 70 family, hsc 4, functions both
      within the mitochondrial compartment and in the nucleus.

PMID- 8344383
TI  - Cytoskeletal and cytocontractile protein composition of smooth muscle cells in
      developing and obstructed rabbit bladder.
AB  - The differentiation patterns of smooth muscle cells (SMC) in rabbit bladder
      during development and in the hypertrophic response to partial outflow
      obstruction induced in adult animals were evaluated by biochemical and
      immunochemical techniques and by using a panel of monoclonal antibodies specific
      for desmin, vimentin, alpha-actin of smooth muscle (SM) type, SM myosin, and
      nonmuscle (NM) myosin isoforms. Desmin and SM alpha-actin were homogeneously
      distributed in SMC of developing, adult, and obstructed bladders. Conversely,
      marked changes in the ratio and antigenicity of SM myosin isoforms were observed
      by SDS electrophoresis and Western blotting, respectively. In particular, the 205
      K (SM1) isoform was down-regulated with development whereas the 200 K (SM2)
      isoform was up-regulated around 7 days after birth and down-regulated in the
      obstructed bladder. Vimentin was expressed in SMC of the fetal bladder and
      declined markedly during postnatal, physiological hypertrophy of SMC, which
      occurs concomitantly with diminution of DNA synthesis. This polypeptide became
      detectable, however, in SMC of obstructed bladders. The 196 K (NM) myosin isoform
      recognized by NM-A9 antibody, present only in endothelium of blood vessels and in
      mucosa of normal fetal and adult bladders, became expressed in detrusor muscle,
      when SMC underwent a process of pathological hypertrophy. The reexpression of
      vimentin and the de novo appearance of NM myosin isoform in hypertrophic bladders
      can be reversed when the tissue mass is reduced, such as in bladders after 1
      month recovery from partial obstruction. Thus, a specific NM myosin isoform can
      be used as a marker of SMC hypertrophy in obstructed bladder. In addition, the
      combined use of anti-vimentin and NM-A9 antibodies can distinguish between SMC
      which are in the physiological or in the pathological condition of adaptive
      bladder hypertrophy.

PMID- 8344384
TI  - The role of macrophages in skeletal muscle regeneration with particular reference
      to chemotaxis.
AB  - The results from this investigation suggest that chemotactic factor(s) from
      damaged myofibers attract polymorphonuclear leukocytes (PML) and macrophages to
      the site of injury, while exudate macrophages but not PML induce a strong
      positive chemotactic response in myogenic cells. The AB and BB isoforms of
      platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF
      beta), basic fibroblast growth factor (bFGF), and leukemia inhibitory factor
      (LIF) (all of these are secreted by macrophages) were also shown to be
      chemoattractants for muscle precursor cells (MPC). The AA isoform of PDGF did not
      appear to have any such chemotactic effect on MPC. Macrophages were also shown,
      under tissue culture conditions, to stimulate the proliferation of MPC. This
      mitogenic effect was similarly demonstrated for the BB isoform of PDGF, bFGF, and
      TGF-beta but not for the AA or AB isoforms of PDGF nor for LIF. The results
      indicate that macrophages play a pivotal role in the orchestration of muscle
      fiber reconstitution.

PMID- 8344385
TI  - Constitutive production of macrophage colony-stimulating factor and interleukin-6
      by human ovarian surface epithelial cells.
AB  - Normal and neoplastic epithelial cells produce growth factors that can affect
      cells from different lineages. Epithelial ovarian cancers produce M-CSF and IL-6.
      In the present study, production of these cytokines has been measured in the
      apparently normal epithelial cells from which epithelial ovarian neoplasms are
      thought to arise. Epithelial cells from the surface of premenopausal human
      ovaries were established in short-term cultures. The cells bound anti-cytokeratin
      antibodies and exhibited characteristic epithelial morphology by light and
      transmission electron microscopy. M-CSF and IL-6 were detected in supernatants
      from cultures of these cells, using assays specific for each factor. Cytokine
      levels were comparable to those in supernatants from ovarian and breast cancer
      cell lines. M-CSF expression could also be demonstrated by immunohistochemical
      analysis with specific rabbit heteroantiserum. Thus, M-CSF and IL-6 are produced
      constitutively by normal as well as by neoplastic ovarian epithelium.

PMID- 8344386
TI  - PKC activity and PKC-alpha mRNA content are reduced in serum-derived human
      neuroblastoma cells without concomitant induction of differentiation.
AB  - Protein kinase C (PKC) is a serine/threonine kinase which is thought to play an
      important role in cellular proliferation and differentiation. PKC activity is
      stimulated physiologically by diacylglycerol and experimentally by phorbol
      esters. Long-term exposure of human neuroblastoma cells to phorbol esters results
      in down-regulation of PKC activity and induction of neuronal differentiation. In
      this study, we explored the hypothesis that reduced PKC expression is necessary
      for differentiation of the human neuroblastoma cell line SK-N-SH. PKC activity
      and PKC-alpha mRNA levels were assayed in cultured SK-N-SH cells over a period of
      several days in the presence or absence of serum. These determinants of PKC
      expression were compared with several known markers of neuroblastoma
      differentiation, including neurite outgrowth and steady-state levels of c-myc and
      GAP43 mRNA. We observed steady losses of PKC activity and PKC-alpha mRNA content
      after transfer of cells to serum-free or chemically defined media. However,
      morphological and biochemical differentiation of SK-N-SH cells occurred only in
      chemically defined medium, perhaps due to the presence of insulin. We conclude
      that while loss of PKC may be associated with neuroblastoma differentiation,
      diminished PKC alone is not sufficient to induce or support the differentiation
      process.

PMID- 8344387
TI  - Experimentally provoked neural induction results in an incomplete expression of
      neuronal traits.
AB  - In the amphibian embryo, the ectoderm becomes a neural structure during
      gastrulation as a result of an interaction with the dorsal mesoderm. From that
      time onward, neurectodermal cells have the ability to express in vitro a large
      variety of mature phenotypes without further interaction with the inducing
      tissue. The neuralization of the ectoderm can be reproduced in a variety of
      experimental situations that do not involve the dorsal mesoderm. In this study we
      have analyzed biochemically the extent to which artificial inductions mimic the
      natural inducing process. Making use of antibodies specific to different
      neurotransmitter pathways, we have shown that the repertoire of the phenotypes
      expressed by experimentally induced neurons is always restricted compared to
      those obtained after induction in vivo. Only a limited number of generic neuronal
      characteristics are expressed. These results suggest that the expression of a
      complete neuronal phenotype normally involves a sequence of inductive events that
      can be experimentally uncoupled.

PMID- 8344388
TI  - Modulation of activin expression by type beta transforming growth factors.
AB  - Activins are potentially important regulators of early developmental processes in
      vertebrates. Although the different forms of activin appear to be differentially
      expressed during early amphibian, avian, and murine development, little is known
      about the factors that regulate their expression. In this study we report the
      qualitative effects of several growth and differentiation factors on the
      expression of inhibin subunits in three differentiated cell lines derived from
      P19 embryonal carcinoma cells. These cell lines include mesodermal (MES-1),
      neuroepithelial (EPI-7), and visceral endoderm-like (END-2) cell types,
      expressing both inhibin beta A and beta B subunit mRNAs. We have shown for the
      first time that this expression is modulated by transforming growth factor
      (TGF)beta 1 and TGF beta 2 but not significantly by other growth factors such as
      leukemia inhibitory factor or members of the fibroblast growth factor family
      (aFGF, bFGF, or kFGF). beta A mRNA expression is increased while beta B
      expression is simultaneously decreased by TGF beta. Furthermore, TGF beta
      increased the amount of bioactive activin secreted by MES-1 and END-2 cells.
      Inhibin alpha subunit mRNA expression is not affected by TGF beta. These results
      point to a possible role of type beta transforming growth factors as regulators
      of activin expression in embryonal cells.

PMID- 8344389
TI  - Retinoic acid induces rapid mineralization and expression of mineralization
      related genes in chondrocytes.
AB  - Numerous studies of experimental hypo- and hypervitaminosis A have long suggested
      that retinoic acid (RA) is involved in chondrocyte maturation during endochondral
      ossification and skeletogenesis. However, the specific and direct roles of RA in
      these complex processes remain unclear. Based on recent studies from our
      laboratories, we tested the hypothesis that RA induces the expression of genes
      associated with the terminal mineralization phase of chondrocyte maturation and
      promotes apatite deposition in the extracellular matrix. Cell populations
      containing chondrocytes at advanced stages of maturation were isolated from the
      upper portion of Day 18 chick embryo sterna and grown for 2 weeks in monolayer
      until confluent. The cells were then treated with low doses (10-100 nM) of RA for
      up to 6 days in the presence of a phosphate donor (beta-glycerophosphate) but in
      the absence of ascorbic acid. Within 4 days of treatment, RA dramatically induced
      expression of the alkaline phosphatase (APase), osteonectin, and osteopontin
      genes, caused a several-fold increase in APase activity, and provoked massive
      mineral formation while it left type X collagen gene expression largely
      unchanged. The mineral had a mean Ca/Pi molar ratio of 1.5; Fourier transform
      infrared spectra confirmed that it represented hydroxyapatite. Mineralization was
      completely abolished by treatment with parathyroid hormone; this profound effect
      confirmed that RA induced cell-mediated mineralization and not nonspecific
      precipitation. When cultures were treated with both RA and ascorbic acid, there
      was a slight further increase in APase activity and increased calcium
      accumulation. The effects of RA were also studied in cultures of immature
      chondrocytes isolated from the caudal portion of sternum; however, RA only had
      minimal effects on mineralization and gene expression in these cells. Thus, RA
      appears to be a rapid, potent, maturation-dependent, ascorbate-independent
      promoter of terminal maturation and matrix calcification in chondrocytes.

PMID- 8344390
TI  - Activation of the gene for atrial natriuretic factor during in vitro cardiac
      myogenesis by P19 embryonal carcinoma cells.
AB  - We examined the transcriptional activity profile of the gene for atrial
      natriuretic factor (ANF) in mouse embryonal carcinoma P19 cells which had been
      induced for in vitro cardiac myogenesis. Differentiation was assessed visually,
      by the degree of spontaneous beating activity, and by the appearance of striated
      muscle structures detected by immunofluorescence with a myosin heavy chain
      antibody. Northern blot analysis of RNA isolated at regular intervals throughout
      the differentiation program revealed abundant cardiac alpha-actin transcripts
      beginning at Day 6, reaching maximum levels during Days 7 to 8 and declining to
      low levels by Days 12 to 15. Throughout this period, the transcriptional profile
      of the ANF gene was similar to that of alpha-actin but at lower levels; thus, in
      vivo stages of abundant ANF and structural muscle gene transcription were not
      reached and these gene expression states appear to be uncoupled. Using the more
      sensitive assay of reverse transcriptase-mediated polymerase chain reactions, we
      observed the presence of ANF transcripts even in small samples of muscle-induced
      P19 cells and not in neuron-induced or undifferentiated P19 cells. Induced ANF
      transcript levels reached about 5-10% that found in adult atrium muscle tissue.
      ANF gene activity was further corroborated by nuclear transcriptional run-on
      assays. The P19 stem cell model system will be of value in the study of early
      events during cardiac muscle commitment and differentiation.

PMID- 8344392
TI  - Differential subcellular distribution of mortalin in mortal and immortal mouse
      and human fibroblasts.
AB  - Mortalin, p66mot-1, from the cytosolic fractions of mouse embryonic fibroblasts
      (MEF) has been identified. We have cloned and characterized it as a novel member
      of mouse hsp70 family [R. Wadhwa, S. C. Kaul, Y. Ikawa, and Y. Sugimoto (1993) J.
      Biol. Chem. 268, 6615-6621]. We report that immortal clones from MEF such as NIH
      3T3, RS4, and Balb/c 3T3 harbor the same or a very similar protein but in the
      perinuclear locale. Biochemical analysis revealed that the proteins from mortal
      (MEF) and immortal (NIH 3T3) fibroblasts do not show gross differences. However,
      the phenomenon of differential distribution of p66 protein in mortal and immortal
      fibroblasts is conserved in three different strains of mouse and, interestingly,
      in human fibroblasts, too. The data suggest that at least one common step is
      involved in immortalization of mouse and human fibroblasts and also point to the
      practical implication(s) of such easily detectable differences.

PMID- 8344391
TI  - Retinoic acid-induced heparin-binding factor (RIHB) mRNA and protein are strongly
      induced in chick embryo chondrocytes treated with retinoic acid.
AB  - Retinoic acid-induced heparin-binding factor (RIHB) is a highly basic polypeptide
      expressed during early chick embryogenesis. We have examined the induction of
      RIHB by retinoic acid in chondrocytes isolated from the sterna of Day 15 chick
      embryos and the effects of exogenous RIHB on these cells. There is an induction
      of RIHB mRNA in chondrocytes which is dose dependent, with maximal levels of
      expression observed with concentrations of retinoic acid in the 10(-6) M range.
      RIHB mRNA is first observed 16 h after commencement of treatment, is maximal
      after 24-48 h, and is completely attenuated after 5 days. This transient pattern
      of expression is very similar to that of type X collagen; however, RIHB induction
      precedes that of type X collagen by about 24 h. The expression of both RIHB and
      type X collagen precedes the drop in keratan sulfate:chondroitin sulfate
      proteoglycan and type II collagen expression and the surge of fibronectin
      expression. The induction of RIHB mRNA is accompanied by an increased synthesis
      of the protein. No RIHB can be detected in untreated chondrocytes; however, large
      amounts are produced by cells treated with 5 x 10(-7) M retinoic acid. The
      protein is recovered mainly in the culture medium and bound to the extracellular
      matrix. Only a small amount can be detected in cell extracts. RIHB can be
      detected in the culture medium after 16-24 h and, unlike the mRNA, persists over
      the 5-day period examined. The effect of exogenous RIHB (purified from chick
      embryos) on chondrocyte proliferation and morphology was examined. When added to
      the culture medium in concentrations of up to 500 ng/ml RIHB had no effect on
      [3H]thymidine incorporation or cell morphology. Thus, RIHB is not the direct
      mediator of retinoic acid for these cells, but is strongly induced during the
      treatment.

PMID- 8344393
TI  - Influence of matricial molecules on growth and differentiation of entrapped
      chondrocytes.
AB  - Primary cultures of rabbit articular chondrocytes have been cultivated normally
      and within three-dimensional systems using different alginate matrices. The in
      vitro proliferation capacity of the cells immobilized in the calcium alginate
      beads was investigated. The growth curve showed that chondrocytes are able to
      grow and to divide for several days inside the beads; in parallel an increase in
      protein contents was also measured. The differentiated phenotype of rabbit
      articular chondrocytes consists of cartilage-specific proteoglycans. During
      serial monolayer cultures this phenotype was lost and replaced by a low level of
      proteoglycan synthesis. On the contrary when cultivated in beads, entrapped cells
      maintained their differentiated phenotype over time; the rates of proteoglycan
      were similar to those of primary chondrocytes. All these parameters were tested
      comparatively using different substrata in monolayer cultures and in alginate
      gels. Assays were carried out to assess the influence of type I collagen, type IV
      collagen, and of fibronectine on the growth as well as on the differentiation
      phenotype. The encapsulation methodology is readily applicable to the culture of
      chondrocytes in single beads, in multiwell dishes, or to mass culture for a
      bioproduction of extracellular matrix components.

PMID- 8344394
TI  - Reproductive life of French-Canadians in the 17-18th centuries: a search for a
      trade-off between early fecundity and longevity.
AB  - One of the predictions derived from Williams' (1957) evolutionary theory of
      senescence is the existence of a trade-off between early fecundity and longevity.
      The population register of the French immigrants to Quebec in the 17th century
      and of the first Canadians in the 17th and 18th centuries was used to detect such
      a trade-off in a noncontraceptive human population living at a time when
      longevity had not been prolonged by medical care and was not artificially
      shortened by wars, epidemics, or other external causes. No evidence for such a
      trade-off could be detected in these populations which had not yet reached the
      demographic transition phase (i.e., the historical period when longevity began to
      be extended and the progeny began to be reduced). Results are discussed in
      connection with the various studies aiming to test the Williams' theory.

PMID- 8344395
TI  - Fatty acid composition of adipose tissue in aged rats: effects of dietary
      restriction and exercise.
AB  - Little is known about the long-term effects of diet restriction, exercise, and
      aging on the fatty acid composition of adipose tissue. To investigate these
      effects, male Wistar rats were placed in one of four experimental groups: 1) ad
      libitum fed, nonexercised; 2) ad libitum fed, exercised; 3) diet restriction,
      nonexercised; and 4) diet restriction, exercised. Exercise consisted of swimming
      on alternate days, and diet-restricted animals were fed every other day. Animals
      were assigned to one of the four treatment groups at weaning, and the fatty acid
      composition in the epididymal, perirenal, and inguinal fat depots were determined
      every 4 months from 12 to 28 months of age. All animals were fed the same diet so
      the relative percentage of fatty acids in the diet did not contribute to the
      changes observed in adipose tissue fatty acid composition. Regardless of
      treatment groups and fat depot, the concentration of saturated fatty acids in
      adipose tissue tended to decrease as body weight increased. Saturated fatty acid
      composition was greater in the diet-restricted than the ad libitum-fed groups.
      The saturated fatty acid concentration was different between the three fat depots
      (perirenal 27.8%, inguinal 24.7%, and epididymal 21.6%; P < 0.001). The linoleic
      acid content did not change with age in the epididymal or perirenal fat depot;
      however, the change was significant for the inguinal fat depot. Following a large
      decrease in inguinal linoleic concentration through 20 months, linoleic acid
      concentration increased in all treatments between 20 and 28 months. The results
      indicate that diet restriction, exercise, and aging have significant effects on
      adipose tissue fatty acid composition and these effects are different depending
      on the anatomical location of the adipose tissue depot.

PMID- 8344396
TI  - Expression of protease genes in the gastric mucosa during aging.
AB  - The current investigation examines the changes in the expression of pepsinogen C
      and cathepsin D and E genes in the gastric mucosa during aging and following
      physiological stimuli of fasting and refeeding. Northern blot analysis of gastric
      mucosal RNA, isolated from overnight fasted 6-, 12-, and 24-month-old male
      Fischer 344 rats, revealed that although steady-state mRNA levels of each of
      these protease remained essentially unchanged between 6 and 12 months of age, in
      24-month-old rats the levels were decreased by about 60%, when compared with
      their younger counterparts. Interestingly, the relative concentration of beta
      actin mRNA--but not 18s rRNA--in 12- and 24-month-old rats was also decreased by
      23% and 37%, respectively, when compared with 6-month-old animals. In the next
      set of experiments, groups of young (3 month) and aged (24 month) rats were
      either fed throughout (controls) or fasted for 48 h and then fed for 6 h and 24
      h. Gastric mucosal RNA from each group was assayed for steady-state mRNA levels
      of pepsinogen C and cathepsin D. Results showed that whereas in young rats
      fasting decreased pepsinogen C and cathepsin D mRNAs by 80-85%, in aged rats only
      pepsinogen mRNA was significantly decreased (45%), when compared with the
      corresponding initial fed controls. In both age groups, refeeding increased
      pepsinogen C mRNA concentration essentially to the respective initial fed levels.
      In contrast, cathepsin D mRNA levels in the gastric mucosa of aged rats was
      affected neither by fasting nor by refeeding. Our current data show that aging
      not only diminishes the expression of protease genes in the gastric mucosa, but
      also the expression of one of its structural genes, beta-actin. In addition,
      responsiveness of these protease genes to the physiological stimuli of fasting
      and refeeding is also attenuated by aging. We postulate that these age-related
      changes may in part be due to diminished differentiation of gastric mucosal
      cells.

PMID- 8344397
TI  - Age-associated damage in mitochondrial function in rat hearts.
AB  - The aim of this study is to elucidate effects of aging on mitochondrial function
      and mitochondrial DNA (mtDNA) in rat heart and liver. The activities of complex I
      and complex IV of heart mitochondria of rats aged 100 weeks decreased
      significantly by 31% and 22%, respectively, compared with those of rats aged 7
      weeks. No significant changes were observed in these two parameters in rats aged
      7 weeks and aged 55 weeks. There were no significant differences in the specific
      activities of complex II and complex III among the age groups of 7, 55, and 100
      weeks. The mtDNA content decreased by 58% in rats aged 100 weeks compared with
      that in rats aged 7 weeks. Content of 8-hydroxydeoxyguanosine (8-OH-dG), an
      oxidative product of deoxyguanosine (dG), increased by 130% in rats aged 100
      weeks compared with that in rats aged 7 weeks. No significant changes were
      observed in these parameters between rats aged 7 weeks and 55 weeks. In contrast
      to heart mtDNA, these age-dependent changes were not observed in liver
      mitochondria at rats aged up to 100 weeks. From our results, age-associated
      decline in mitochondrial function might play an important role in cell aging,
      particularly in postmitotic cells such as heart muscle, and accumulation of
      oxidative damage to mtDNA might be involved in this mechanism.

PMID- 8344398
TI  - Porfiromycin as an adjunct to radiotherapy in young and old mice.
AB  - Radiobiological data and measurements with O2 microelectrodes show that EMT6
      tumors implanted into aged mice have a higher proportion of radioresistant,
      hypoxic cells than do tumors implanted into young adult animals; radiation is
      less effective in killing cells in tumors in old mice than in tumors in young
      adult mice. The studies reported here examine the effects of porfiromycin (POR),
      a bioreductive alkylating agent shown previously to be preferentially toxic to
      hypoxic EMT6 cells in vitro and in solid tumors in young adult mice. POR was
      effective in attacking the hypoxic cells of tumors in aged mice; regimens
      combining POR with x-rays overcame the radioresistance of tumors in the old
      animals. Comparisons of the distribution of 3H-labeled POR in young and old mice
      showed that tumors in aged mice had a slightly larger proportion of areas with
      necrotic features, which bound higher levels of tritiated POR than did healthy
      tumor regions without necrotic features. Studies of histology, lissamine green
      distributions, binding of tritiated POR, and radiation and POR cytotoxicity
      suggested that tumors in old mice contained a larger proportion of poorly
      perfused tumor cells, and that cells in these regions were resistant to radiation
      and sensitive to POR. Studies of the distribution of POR in normal tissues and of
      the toxicity of POR to bone marrow progenitor cells (CFU-GM) revealed no
      differences between young and old animals, showing that the differences observed
      in tumors reflected differences in the microenvironments within the tumors,
      rather than differences in the processing of drug in young and old animals.

PMID- 8344399
TI  - Leishmania pifanoi: kinetics of messenger RNA expression during amastigote to
      promastigote transformation in vitro.
AB  - Conditions have been developed which induce axenically grown Leishmania pifanoi
      amastigotes to transform into the promastigote stage in a highly reproducible
      fashion. Transformation was induced by a temperature shift from 31 to 22 degrees
      C, was inhibited by high cell concentration (> or = 40 x 10(6) cells/ml), and was
      unaffected by pH from 5.5-7.2. Morphologic transformation was first evident at 8
      hr after induction, had occurred in > 50% of cells by 24 hr, and was > 90%
      complete by 48 hr. This system enabled study of the kinetics of mRNA expression
      during the transformation of Leishmania. The differentially expressed mRNAs for
      ATPase 1a and 1b, alpha- and beta-tubulin, P100/11E, Pro-1, and pLm 2, 7, 14, and
      16 exhibited complex patterns of temporal expression, suggesting a highly
      regulated process. Differentiation on the biochemical level was evident within an
      hour and continued throughout the course of morphologic transformation. In
      addition, transformed L. pifanoi promastigotes in the plateau growth phase
      expressed genes characteristic of metacyclic promastigotes. Axenically cultured
      L. pifanoi should provide an excellent model for the study of differentiation in
      Leishmania.

PMID- 8344400
TI  - Plasmodium berghei: is nitric oxide involved in the pathogenesis of mouse
      cerebral malaria?
AB  - To analyze whether nitric oxide may be involved in the pathogenesis of the mouse
      cerebral malaria (CM), nitrate and nitrite were first measured in urines of
      Plasmodium species infected mice. The CM-susceptible CBA/J mice were infected
      with either Plasmodium berghei or Plasmodium chabaudi, and the CM-resistant
      BALB/c mice were infected with P. berghei. No increased levels of nitrate and
      nitrite were detected in urine of mice infected with Plasmodium whatever the time
      of monitoring. In contrast, the nitrite level was found to be increased in the
      urine of C3H/HeJ mice infected with Trypanosoma cruzi, used as a positive control
      for nitrate excretion in urine. Two analogs of L-arginine, the L-NG-monomethyl
      arginine acetate hydrate (L-NMMA) and N omega-nitro-L-arginine, which inhibit the
      nitric oxide synthase were used. CBA/J mice infected with P. berghei and treated
      ip with the analogs developed full neurological symptoms. Even administered
      intracranially, L-NMMA did not reverse CM. The role of nitric oxide in the CM
      pathogenesis of the mouse model is discussed.

PMID- 8344401
TI  - Entamoeba histolytica: the EHZc3 cDNA clone encodes a zinc-binding protein.

PMID- 8344402
TI  - Plasmodium: control of gene expression in malaria parasites.

PMID- 8344403
TI  - Toxoplasma gondii: differential location of antigens secreted from encysted
      bradyzoites.
AB  - Since we have previously demonstrated the protective role against infection
      played by Toxoplasma excreted-secreted antigens (Darcy et al. Parasite
      Immunology, 10, 553-567, 1988), the aim of the present work was an attempt to
      precisely define the location of GRA1, GRA2, and GRA5 in both the tachyzoite and
      the bradyzoite stages from distinct strains, in order to explore the mechanisms
      of secretion by Toxoplasma gondii. Three monoclonal antibodies (Charif et al.
      1990) and colloidal immunogold labeling were used to localize the 27-, 28.5-, and
      21-kDa target antigens to the matrix of the dense granules of tachyzoites and
      bradyzoites. They were, moreover, detected in the parasitophorous vacuole and in
      the cyst ground substance after host cell invasion. Our data suggest that a
      selective sorting mechanism for dense-granule contents exists at least in
      encysted bradyzoites. GRA2 was found preferentially associated with the ground
      substance of the cyst wall and the tubular elements of the network of the
      modified host cell phagosome, whereas GRA5 was located on the delimiting membrane
      of both the cyst wall and the parasitophorous vacuole. These observations reveal
      the selective targeting of dense-granule molecules, which could have different
      functions and fates when exocytosed into the parasite-containing vacuole.

PMID- 8344405
TI  - Ductular proliferation and hepatic secretory function in experimental
      fascioliasis.
AB  - Proliferation of bile duct-like epithelial cells is a common feature of
      extrahepatic biliary obstruction and it is also present in other forms of liver
      disease. Experimental infestation with Fasciola hepatica induces hyperplasia of
      ductular cells together with different functional alterations, such as
      hypercholeresis, in the rat. We have investigated the contribution of ductular
      biliary secretion to the hypercholeretic phenomenon in rats with experimental
      fascioliasis. Infestation was induced by oral administration of 20 metacercariae
      of F. hepatica. Twelve weeks later, histological study of the liver showed a
      hyperplastic reaction with proliferation of bile duct-like structures. Basal bile
      flow in infested animals was significantly higher than that of control animals
      (+17%), while biliary secretion of bile acids did not significantly differ
      between both groups. Bile flow increase was associated in parasitized animals
      with a significantly lower [14C]mannitol bile:plasma ratio (-23%). Intravenous
      secretin administration (0.3 CU/100 g body wt min) induced a significant increase
      in the biliary concentration of bicarbonate (+21%) and an enhancement of bile
      flow (+21%) only in the animals with ductular proliferation. Taurocholate
      infusion (0.5 nmol/100 g body wt min) produced a similar bile flow increase both
      in control rats and in rats with proliferated biliary ductules. These results
      indicate that proliferated bile ductules and ducts spontaneously secrete bile in
      response to infestation by F. hepatica and that secretin-stimulated bile flow
      originates at the proliferated biliary structures.

PMID- 8344404
TI  - Trichinella spiralis: genetic basis and kinetics of the anti-encysted muscle
      larval response in miniature swine.
AB  - Primary-infected swine lymphocyte antigen (SLA) inbred miniature swine, NIH
      minipigs, of the SLAa/a haplotype (aa) display markedly reduced Trichinella
      spiralis-encysted muscle larval (ML) burdens 6 weeks after homologous challenge
      and are therefore referred to as responders against encysted T. spiralis ML. To
      investigate the kinetics and genetics of the anti-encysted ML response, and in an
      attempt to ascertain the mechanisms underlying this phenomenon, NIH minipigs of
      multiple SLA haplotypes, designated either as ax (aa, ac, ad, af, ag, dh and hh)
      or non-ax (cc, cd, and dd), received a primary inoculation of 300 T. spiralis ML
      followed by a challenge inoculation of 10,000 ML 6 or 17 weeks later. Pigs were
      examined at necropsy and at Weeks 1, 2, 3.5, and 6 after challenge. Statistical
      cluster analyses, based on final ML burdens, performed on 129 pigs in 13 trials,
      revealed that 47% of primary-plus-challenged ax pigs exhibited responder
      phenotype as early as 1-2 weeks after T. spiralis challenge whereas this response
      was manifested in only 8% of non-ax pigs. No correlation was observed between
      responder phenotype and T. spiralis-specific blastogenesis, cell expression of
      class I or class II SLA molecules, lymphoid cell subsets, adult worm numbers, or
      fecundity. Although some ax responder pigs exhibited a localized inflammatory
      response with a prominent eosinophilic infiltrate surrounding degenerating
      encysted ML, no correlation was observed between responder phenotype and either
      peripheral blood eosinophilia or the ability of eosinophil-enriched cell
      populations from responder pigs to adhere to or destroy encysted ML in vitro.

PMID- 8344406
TI  - Theileria parva: detection of genomic polymorphisms by polymerase chain reaction
      amplification of DNA using arbitrary primers.
AB  - Genomic DNA fingerprints were generated from Theileria parva piroplasm DNA by
      polymerase chain reaction amplification using arbitrary decamers as primers. Four
      of 12 primers tested generated amplified fragments which were polymorphic between
      different T. parva stocks or clones. Hybridization of radiolabeled total
      amplification products to Southern blots of T. parva piroplasm and uninfected
      bovine DNA confirmed that none of the amplified fragments were derived from any
      contaminating bovine DNA which may have been present in small quantities.
      Polymorphic DNA fragments were reproducibly amplified from independent DNA
      preparations made from cloned parasites. Individual amplified DNA fragments were
      gel purified and shown to hybridize to size-polymorphic EcoRI fragments in T.
      parva genomic DNA. Hybridization of individual amplified fragments to total
      fingerprints, generated using the same arbitrary primer, demonstrated that a
      single primer detected at least three independent genomic polymorphisms in T.
      parva DNA.

PMID- 8344407
TI  - Leishmania mexicana: proteinase activities and megasomes in axenically cultivated
      amastigote-like forms.
AB  - Proteinase activities and megasomes were examined in axenically cultivated
      amastigote-like forms, freshly isolated lesion amastigotes, and promastigotes.
      Megasomes were absent in promastigotes and present in both amastigote stages, but
      they seemed to be less numerous and more homogeneous in cultured amastigote-like
      forms. Contrasting with the poor detection of proteinase activities in
      promastigote lysates, both types of amastigotes shared multiple proteinases,
      which were classified in two groups: (a) 60 to > 100 kDa, o-phenanthroline
      sensitive activities; and (b) 23- to 40-kDa cysteine proteinases, of which those
      resolving as 35- to 40-kDa bands in gelatin gels were more clearly visualized in
      lysates of cultured amastigote-like forms. Incubation of both kinds of
      amastigotes with 0.25 to 1.0 microM of either Z-Phe-AlaCHN2 or Z-Tyr-AlaCHN2
      selectively inactivated cysteine proteinases, but not the 35- to 40-kDa
      activities, which, again, were detected with higher intensity in cultured
      amastigote-like forms. The expression of the 35- to 40-kDa proteinases
      progressively increased when promastigotes were allowed to transform into
      amastigote-like forms or when lesion amastigotes were incubated at 34 degrees C
      for different time periods prior to exposure to Z-Phe-AlaCHN2; activities
      comparable to those of amastigote-like forms were attained within 24 to 48 hr.
      The activities resistant to Z-Phe-AlaCHN2 in vivo were fully inhibited by E-64 or
      Z-Phe-AlaCHN2 during gelatin digestion, suggesting that the 35- to 40-kDa
      proteinases were mainly inactive before cell lysis. The presence of cycloheximide
      (at 10, 50, and 100 micrograms/ml) during the pulse with Z-Phe-AlaCHN2 abolished
      the 35- to 40-kDa activities of lesion amastigotes and significantly reduced
      gelatin digestion by the similar enzymes of cultured amastigote-like forms. In
      the latter, the 35- to 40-kDa proteinases were no more detected when
      cycloheximide was given 60 min prior to Z-Phe-AlaCHN2. The results indicate
      higher rates of synthesis of the 35- to 40-kDa enzymes, and the existence of a
      more representative pool of inactive enzyme precursors, in cultured amastigote
      like forms.

PMID- 8344408
TI  - Gametocytogenesis induction by Berenil in cultured Plasmodium falciparum.
AB  - Berenil, which is known to inhibit synthesis of nucleic acid, DNA and RNA, and
      polyamine, induced gametocytogenesis in cultured Plasmodium falciparum, although
      the mechanism by which Berenil induces gametocytogenesis is unknown. Asexual
      parasites of a strain of P. falciparum that seldom produce gametocytes in in
      vitro culture began gametocytogenesis after 2-24 hr treatment with RPMI 1640
      medium containing Berenil (final concentration, 0.1-10.0 micrograms/ml) with
      horse serum. Gametocytogenesis was consistently observed from 3 days after the
      addition of Berenil to culture. After parasites were cultivated in RPMI 1640
      medium containing Berenil (final concentration, 3.0-10.0 micrograms/ml) and
      concanavalin A with horse serum for 2 hr, Berenil and concanavalin A were removed
      from culture medium by centrifugation. Nevertheless, induction of
      gametocytogenesis was observed. The addition of concanavalin A (final
      concentration, 10 micrograms/ml) to RPMI 1640 medium containing Berenil enhanced
      the induction of gametocytogenesis by Berenil. However, when RPMI 1640 medium
      with concanavalin A was used without the addition of Berenil, no
      gametocytogenesis was observed as in RPMI 1640 medium alone.

PMID- 8344409
TI  - Plasmodium falciparum: analysis of the cytoadherence inhibition of the human
      monoclonal antibody 33G2 and of antibodies reactive with antigen Pf332.
AB  - The capacity of a human monoclonal antibody (MAb 33G2) to interfere in vitro both
      with Plasmodium falciparum merozoite invasion and cytoadherence of infected
      erythrocytes to melanoma cells has been reported. MAb 33G2 cross-reacts with
      several P. falciparum antigens but shows highest reactivity with repeated
      sequences in the asexual blood stage antigen Pf332. This study was conducted in
      order to further analyze the cytoadherence inhibition mediated by MAb 33G2 and to
      evaluate the relative contribution of antibodies to Pf332 in the inhibitory
      activity of immunoglobulins from P. falciparum immune donors. We show here that
      MAb 33G2 inhibits cytoadherence of infected erythrocytes (PRBCs) with similar
      efficiency independently of the strain of parasite, while the inhibitory capacity
      of immunoglobulin fractions from Liberian immune donors was restricted to some
      strains only. There appears to be no correlation between the reactivity with
      Pf332 of immunoglobulin preparations from different donors and their capacity to
      inhibit cytoadherence of PRBCs to melanoma cells. In contrast to MAb 33G2,
      polyclonal antibodies affinity purified on the Pf332 peptide containing the
      epitope seen by the MAb showed little or no inhibition of cytoadherence of
      infected erythrocytes.

PMID- 8344410
TI  - Haemonchus contortus: ivermectin-induced paralysis of the pharynx.
AB  - How the avermectins cause the elimination of gastrointestinal nematodes from host
      animals has not yet been clearly identified. Using visual and radiometric
      parameters to measure oral ingestion in Haemonchus contortus, we showed that
      ivermectin (IVM) rapidly inhibited ingestion at concentrations > or = 10(-10) M.
      Motility, monitored quantitatively with an automated motility meter, was
      unaffected by IVM at concentrations < or = 10(-8) M, while ATP levels were
      unaffected at concentrations < or = 10(-6) M. Since motility and ATP levels,
      independent measures of short-term viability, are unaffected by concentrations of
      IVM that effectively block oral ingestion, the drug can be used as a chemical
      ligature. Although H. contortus was shown to be dependent upon an exogenous
      supply of glucose for survival in culture, IVM (10(-9) and 10(-7) M) altered
      neither the uptake of 3-O-[3H]methylglucose nor the metabolism of [13C]glucose by
      the parasite. These data suggest that H. contortus depends upon the
      transcuticular uptake of glucose in culture. If oral ingestion of other nutrients
      is essential for long-term survival in vivo, disruption of this process may
      represent the primary mechanism of IVM action.

PMID- 8344411
TI  - Babesia bovis: characterization of the T helper cell response against the 42-kDa
      merozoite surface antigen (MSA-1) in cattle.
AB  - The Babesia bovis major merozoite surface antigen (MSA-1) is a 42-kDa integral
      membrane glycoprotein previously shown to induce immunodominant antibody
      responses in cattle protectively immune to B. bovis and to induce neutralizing
      antibody. Recent studies have also shown that MSA-1 B cell epitopes common to New
      World strains of B. bovis are not present in either Israel or Australia strains.
      To understand the potential role of this protein in protective immunity, T helper
      cell responses specific for MSA-1 were characterized in Babesia-immune cattle.
      Peripheral blood mononuclear cells from immune cattle proliferated against
      affinity-purified recombinant MSA-1 protein expressed in Escherichia coli. MSA-1
      preferentially stimulated the growth of CD4+ T cells in cell lines cultured with
      antigen for 4 weeks. MSA-1-reactive cell lines responded to a membrane fraction
      of B. bovis merozoites, suggesting recognition of the native protein. However, B.
      bovis-reactive T cell lines and T helper clones established by stimulation with
      crude parasite membrane antigen failed to respond to recombinant MSA-1,
      indicating that this antigen is not immunodominant for T cells. The majority of
      MSA-1-specific T helper clones reacted to unfractionated merozoite membrane
      antigen from New World B. bovis strains, but none of the clones responded to
      Australia B. bovis or to a Mexico strain of Babesia bigemina. Several T helper
      clones produced low levels of cytokines when stimulated with concanavalin A and
      interleukin-2. Northern blot analysis revealed the expression of interleukin-2,
      interleukin-4, interferon-gamma, and tumor necrosis factor-alpha messenger RNA in
      mitogen-stimulated T helper clones, showing that the clones examined expressed an
      unrestricted T helper phenotype. We conclude that the MSA-1 protein, although
      serologically immunodominant and capable of inducing neutralizing antibodies as
      well as a T helper cell response, is not an immunodominant T cell antigen.
      Furthermore, the parasite strain specificity of the Th clones supports previous
      findings of extensive polymorphism in the MSA-1 glycoprotein and suggests that
      like B cell epitopes, T cell epitopes reside in a nonconserved portion of the
      protein.

PMID- 8344412
TI  - Biochemical events in naturally occurring forms of cell death.
AB  - Several molecular elements of programmed cell death and apoptosis have recently
      been revealed. The function of gene products which deliver the lethal 'hit' is
      still not known. Well-characterized and newly discovered cell surface structures
      (e.g. antigen receptors, FAS/APO-1), as well as transcriptional factors (steroid
      receptor, c-myc, P53, retinoblastoma protein and others), have been implicated in
      the initiation of the death pathway. Negative regulators of the process (ced-9
      gene product in programmed death of cells in Caenorhabditis elegans and bcl-2
      protein in apoptosis) have been described. Biochemical mechanisms responsible for
      the silent nature of natural deaths of cells include their rapid engulfment
      (mainly through integrin receptors), transglutaminase-catalyzed cross-linking of
      cellular proteins, and fragmentation of DNA. Several lines of evidence suggest
      that distinct molecular mechanisms may operate in various forms of natural cell
      death.

PMID- 8344413
TI  - The specificity of the S1' subsite of cysteine proteases.
AB  - The specificity of the S1' subsite of the cysteine proteases cathepsin B, L, S
      and papain has been investigated using a series of intramolecularly quenched
      fluorogenic substrates (Dansyl-Phe-Arg-AA-Trp-Ala) where the P1' amino acid (AA)
      has been varied. Taken individually, each enzyme displays a relatively broad S1'
      subsite specificity and this subsite cannot be considered as a primary site of
      specificity. Notable differences do exist however between the various proteases.
      Cathepsin B prefers large hydrophobic residues in the P1' position of a substrate
      while cathepsin L has an opposite trend, favoring amino acids with small (Ala,
      Ser) or long but non-branched (Asn, Gln, Lys) side chains. Cathepsin S and papain
      display a somewhat broader S1' subsite specificity.

PMID- 8344414
TI  - Determination of a functional lysine residue of a plant cysteine synthase by site
      directed mutagenesis, and the molecular evolutionary implications.
AB  - Comparison of seven deduced amino acid sequences of cysteine synthase (O-acetyl-L
      serine (thiol)-lyase, EC 4.2.99.8) from plants and bacteria disclosed the
      presence of 12 conserved Lys residues, which can be candidates for a functional
      binding site for pyridoxal phosphate cofactor. These 12 conserved Lys residues in
      a cDNA clone encoding spinach cysteine synthase A were replaced with Gly by
      oligonucleotide-directed in vitro mutagenesis. These Lys-->Gly mutated cDNAs were
      transferred into Escherichia coli NK3, a cysteine auxotroph lacking both cysteine
      synthase loci, cysK and cysM. One mutant replaced at Lys-49 could not complement
      the cysteine requirement of NK3, whereas other mutants and wild-type clone could.
      No enzymatic activity of cysteine synthase A was detected either in the cell-free
      extracts of E. coli NK3 transformed with the Lys-49 mutant. These results
      indicated that Lys-49 is a functional residue for the catalytic activity of
      cysteine synthase. This Lys residue is conserved in other evolutionarily related
      amino acid-metabolizing enzymes catalyzing reactions involving the beta-carbon of
      amino acids.

PMID- 8344415
TI  - Site-directed mutagenesis of the tick-borne encephalitis virus NS3 gene reveals
      the putative serine protease domain of the NS3 protein.
AB  - Several mutations were introduced into the putative serine protease domain of the
      tick-borne encephalitis virus NS3 protein and into a possible internal cleavage
      site within the protein. The influence of these mutations on proteolytic activity
      of NS3 protein and NS3' protein formation was tested in vitro. It was found that
      NS3' formation was not dependent on the activity of the NS3 N-terminal serine
      protease. Mutations affecting the Ser-138 residue of the NS3 protein prohibited
      cleavage between NS2B and NS3 proteins when the NS2B-NS3 part of the viral genome
      was expressed in vitro, suggesting the key role of Ser-138 in viral serine
      protease functioning.

PMID- 8344416
TI  - Zonation of glucokinase in rat liver changes during postnatal development.
AB  - In the liver many metabolic pathways are preferentially localized in different
      zones of the acinus. It is assumed that this zonation allows an efficient
      adaptation to different states of nutrition, because alternative pathways can be
      regulated independently. It is reported that the rate limiting enzyme for the
      glycolytic pathway, glucokinase (EC 2.7.1.2), is predominantly located in the
      pericentral zone. The gene expression of glucokinase is induced to a maximum
      level after a carbohydrate-rich diet. In starved or diabetic rats glucokinase
      gene expression is barely detectable. In postnatal development glucokinase is
      induced to significant levels only from day 14 onwards. The distribution of the
      glucokinase protein in the rat liver lobule in the first 4 weeks of postnatal
      life was investigated by immunohistochemistry and compared to the distribution
      observed in adult rats. In adult rats considerably high levels of glucokinase are
      measureable as shown by immunoblotting utilizing a monospecific antibody and a
      photometric assay of glucokinase enzyme activity, respectively.
      Immunohistochemically the hepatic glucokinase protein is detected in the
      perivenous area. During postnatal development, the quantities of hepatic
      glucokinase protein and glucokinase enzyme activity start to increase
      significantly from day 15 onwards. Subsequently, glucokinase levels rise further
      until day 29. In contrast to the results obtained by immunoblotting, glucokinase
      is already detectable in some liver cells in sections from 6-day-old rats by
      immunohistochemistry. The liver lobule structure at this age is not completely
      developed, therefore it is not possible to definitely assign these cells to
      periportal or pericentral areas. At day 10 post partum the number of glucokinase
      expressing cells, which appear to be localized preferentially in the periportal
      zone, increases. In agreement with the immunoblotting, an immense increase in
      glucokinase activity was observed at day 14. The periportal zonation, clearly
      detectable at this time, remains stable until day 24. In sections from 29-day-old
      rats the periportal zonation begins to change into a more homogeneous pattern
      with a slight preference for periportal areas. The observed appearance of the
      periportal zonation of glucokinase during neonatal development is obviously in
      contrast to the perivenous expression of glucokinase in adult rats.

PMID- 8344417
TI  - Mutation-spectrum of a true abasic site in codon 12 of a c-Ha-ras gene in
      mammalian cells.
AB  - An abasic site is postulated to be a premutagenic lesion. We previously reported
      that a c-Ha-ras gene with an abasic site analogue at either the first or the
      second position of codon 12 induced the formation of foci by point-mutational
      activation of the gene [Kamiya et al. (1992) Nucleic Acids Res. 20, 4409-4415].
      In this study we constructed c-Ha-ras genes with a true abasic site in codon 12.
      The ras genes were found to be activated in NIH3T3 cells by a mutation to A at
      the modified and flanking positions, and the flanking mutations were detected
      more frequently.

PMID- 8344419
TI  - Cloning and functional expression in Escherichia coli of a cyanobacterial gene
      for lycopene cyclase, the enzyme that catalyzes the biosynthesis of beta
      carotene.
AB  - Carotenoids with cyclic end groups are essential components of the photosynthetic
      membrane in all known oxygenic photosynthetic organisms. These yellow pigments
      serve the vital role of protecting against potentially lethal photo-oxidative
      damage. Many of the enzymes and genes of the carotenoid biosynthetic pathway in
      cyanobacteria, algae and plants remain to be isolated or identified. We have
      cloned a cyanobacterial gene encoding lycopene cyclase, an enzyme that converts
      the acyclic carotenoid lycopene to the bicyclic molecule beta-carotene. The gene
      was identified through the use of an experimental herbicide, 2-(4
      methylphenoxy)triethylamine hydrochloride (MPTA), that prevents the cyclization
      of lycopene in plants and cyanobacteria. Chemically-induced mutants of the
      cyanobacterium Synechococcus sp. PCC7942 were selected for resistance to MPTA,
      and a mutation responsible for this resistance was mapped to a genomic DNA region
      of 200 bp by genetic complementation of the resistance in wild-type cells. A 1.5
      kb genomic DNA fragment containing this MPTA-resistance mutation was expressed in
      a lycopene-accumulating strain of Escherichia coli. The conversion of lycopene to
      beta-carotene in these cells demonstrated that this fragment encodes the enzyme
      lycopene cyclase. The results indicate that a single gene product, designated
      lcy, catalyzes both of the cyclization reactions that are required to produce
      beta-carotene from lycopene, and prove that this enzyme is a target site of the
      herbicide MPTA. The cloned cyanobacterial lcy gene hybridized well with genomic
      DNA from eukaryotic algae, thus it will enable the identification and cloning of
      homologous genes for lycopene cyclase in algae and plants.

PMID- 8344418
TI  - Detection of complex gangliosides in human amniotic fluid.
AB  - Gangliosides are possibly very potent immunosuppressive molecules. Here we show
      that human amniotic fluid contains high concentrations of a number of previously
      unnoted, structurally complex and highly polar gangliosides. These unusual
      molecules are present early in pregnancy (first trimester), increase in
      concentration with gestational age, and reach maximum levels (0.8 microM) at
      term. Since similar gangliosides have been detected in human placenta,
      trophoblast, and amnion, we suggest that these molecules are shed into the
      amniotic fluid bathing these tissues.

PMID- 8344421
TI  - The structure of the complex between avidin and the dye, 2-(4'-hydroxyazobenzene)
      benzoic acid (HABA).
AB  - The crystal structure of the complex formed between the egg-white biotin-binding
      protein, avidin, and the dye, 2-(4'-hydroxyazobenzene) benzoic acid (HABA), was
      determined to a resolution of 2.5 A. The interaction of avidin with the benzoate
      ring of HABA is essentially identical to that of the complex formed between HABA
      and streptavidin (the bacterial analogue of the egg-white protein). This
      interaction emulates the definitive high-affinity interaction of both proteins
      with the ureido moiety of biotin. The major difference between the avidin- and
      streptavidin-HABA complexes lies in their interaction with the hydroxyphenyl ring
      of the dye molecule; in avidin, two adjacent amino acid residues (Phe72 and
      Ser73), which are not present in streptavidin, form additional interactions with
      this ring. These are suggested to account for the higher affinity of avidin for
      HABA. The characteristic red shift, which accompanies the interaction of both
      proteins with the dye, was traced to a proposed charge-transfer complex formed
      between the hydroxyphenyl ring of HABA and the indole ring of Trp70 in avidin
      (Trp79 in streptavidin). Comparison of binding site residues of two such similar
      proteins versus their markedly different affinities for two such different
      substrates should eventually contribute to a better design of biomimetic reagents
      and drugs.

PMID- 8344420
TI  - Molecular cloning and developmental expression of human cardiac troponin T.
AB  - We have isolated a full-size cDNA coding for cardiac troponin T (cTnT) from a
      human adult heart library, using a slow skeletal TnT probe. This cDNA detected a
      1.2 kb mRNA in fetal and post-natal human heart, the amount of which increased
      during ontogenic development. Interestingly, a similar transcript was coexpressed
      in fetal skeletal muscle, together with the 0.9 kb slow skeletal muscle mRNA, and
      its expression was down-regulated during further development.

PMID- 8344422
TI  - Purification of the beta product encoded by the Streptococcus pyogenes plasmid
      pSM19035. A putative DNA recombinase required to resolve plasmid oligomers.
AB  - Genetic evidence suggests that the gene beta product of Streptococcus pyogenes
      plasmid pSM19035 is required for converting plasmid multimers into monomers. The
      beta protein was purified from cells overexpressing the cloned gene. N-terminal
      protein sequence analysis demonstrated that the purified protein had the
      predicted sequence, except that the N-terminal initiator methionine was not
      present. Native beta protein consists of a dimer of two identical subunits with a
      molecular mass of 23.8 kDa (25 kDa in SDS-PAGE). The beta protein (isoelectric
      point of 9.7) binds specifically to a DNA fragment (312 bp in length) which
      contains the promoter region of the orf alpha-gene beta operon and two regions
      (sites I and II) that show dyad axes of symmetry. It is proposed that protein
      beta binds to sites I and II to mediate resolution of plasmid oligomers.

PMID- 8344423
TI  - Spleen-derived growth factor, SDGF-3, is identified as keratinocyte growth factor
      (KGF).
AB  - A heparin-binding mitogen rat for rat hepatocytes was partially purified from
      bovine spleen by a combination of heparin-affinity, cation-exchange and gel
      filtration chromatography. Besides stimulating rat hepatocytes, this factor,
      which was designated spleen-derived growth factor-3 (SDGF-3), exhibited mitogenic
      activity for mouse epidermal keratinocytes but not mouse fibroblasts. Its
      apparent epithelial specificity and heparin-binding properties corresponded to
      those of keratinocyte growth factor (KGF). These findings, together with the fact
      that the mitogenic activity of SDGF-3 was abolished by a neutralizing monoclonal
      antibody specific for KGF, identify this bovine spleen-derived hepatocyte mitogen
      as KGF.

PMID- 8344424
TI  - Metal as a novel type of the enzyme substrate. Metallic cadmium photogenerated in
      the system CdS-formate as a substrate of the NAD-dependent hydrogenase.
AB  - The process of NAD+ photoreduction under the coupled action of CdS semiconductor
      and NAD-dependent hydrogenase from hydrogen-oxidizing bacterium Alcaligenes
      eutrophus may be divided into light and dark stages. At the first stage,
      illumination of the system leads to the photooxidation of the sacrificial
      electron donor and results in the reduction of the semiconductor surface. At the
      second dark stage NAD+ is reduced to NADH in the presence of hydrogenase. Atoms
      of metallic Cd(0) are shown to be the true substrate of the enzymatic reaction.
      The prerequisite for the electron transfer from Cd(0) to hydrogenase is enzyme
      adsorption on the semiconductor surface. The redox center of the hydrogenase
      reacting with Cd(0) atoms resides on the flavin-containing heterodimer of the
      protein. The activity of the hydrogenase immobilized on CdS in the reaction of
      NAD+ reduction by metallic Cd is close to the enzyme activity with the
      physiological substrates in solution. Thus, the first example of a metal being
      the substrate of the enzymatic process is presented.

PMID- 8344425
TI  - Nucleotide/H(+)-dependent change in Mg2+ affinity at the ATPase inhibitory site
      of the mitochondrial F1-F0 ATP synthase.
AB  - The interactions between ADP and Mg2+ that result in the slowly reversible
      inhibition of the mitochondrial F1-F0 ATPase were studied. The Ki for the
      inhibitory Mg2+ is shown to be strongly dependent on the occupation of the
      nucleotide-binding sites. The inhibitory binding site for Mg2+ is not seen unless
      a stoichiometric amount of ADP is added [Biochem. J. 276 (1991) 149-156]; it
      appears (Ki = 2.10(-6) M) in the presence of stoichiometric ADP and the affinity
      for inhibitory Mg2+ decreases to a Ki value of 7.10(-5) M when the second
      nucleotide binding site with Kd = 5.10(-6) M is loaded with ADP. The binding of
      the inhibitory Mg2+ is competitively inhibited by H+ ions within the pH interval
      6.8-8.2. The nucleotide-dependent affinity transition of the Mg(2+)-specific site
      suggests that H+/Mg2+ exchange may play an important role in the catalytic
      mechanism of ATP synthesis/hydrolysis at the active site(s) of F1-F0 ATP
      synthase.

PMID- 8344426
TI  - Dp71, the nonmuscle product of the Duchenne muscular dystrophy gene is associated
      with the cell membrane.
AB  - The 70.8 kDa protein, Dp71, is the major Duchenne muscular dystrophy (DMD) gene
      product in many nonmuscle tissues including the brain. Dp71 shares most of the C
      terminal and cysteine-rich domains with the dystrophins but lacks the entire
      large rod shaped domain of spectrin-like repeats, and the N-terminal actin
      binding domain. The function of Dp71 is unknown. Using subcellular fractionation
      and immunostaining we show that Dp71 is associated with the plasma membrane. Dp71
      is also associated with the plasma membrane in mdx myogenic cells transfected
      with a vector expressing Dp71.

PMID- 8344427
TI  - PDI and glutathione-mediated reduction of the glutathionylated variant of human
      lysozyme.
AB  - A mutant human lysozyme, designated as C77A-a, in which glutathione is bound to
      Cys95, has been shown to mimic an intermediate in the formation of a disulfide
      bond during folding of human (h)-lysozyme. Protein disulfide isomerase (PDI),
      which is believed to catalyze disulfide bond formation and associated protein
      folding in the endoplasmic reticulum, attacked the glutathionylated h-lysozyme
      C77A-a to dissociate the glutathione molecule. Structural analyses showed that
      the protein is folded and that the structure around the disulfide bond, buried in
      a hydrophobic core, between the protein and the bound glutathione is fairly
      rigid. Thioredoxin, which has higher reducing activity of protein disulfides than
      PDI, catalyzed the reduction with lower efficiency. These results strongly
      suggest that PDI can catalyze the disulfide formation in intermediates with
      compact structure like the native states in the later step of in vivo protein
      folding.

PMID- 8344428
TI  - Osteoblast-like cells have a variable mixed population of purino/nucleotide
      receptors.
AB  - Osteoblast-like UMR 106.06 cells respond to extracellular application of
      nucleotides with a fast intracellular calcium pulse (latency of about 20 s, half
      width of about 10 s), as measured with fluo-3 on a confocal laser scanning
      system. Cross-inhibition experiments at 50 microM show that, on a cell population
      basis, adenosine triphosphate (ATP) strongly inhibits the effect of uridine
      triphosphate (UTP) or 2-methylthio-ATP (2-MeSATP) applied within 2 min after the
      end of the ATP-induced pulse, while prior application of UTP or 2-MeSATP only
      weakly inhibits the ATP effect, and UTP and 2-MeSATP weakly inhibit each other.
      Furthermore, there are clear differences in cross-inhibition between individual
      cells. Our measurements provide strong evidence that these cells have at least
      two types of purino/nucleotide receptors, probably P2y and P2u, with a proportion
      that varies between individual cells.

PMID- 8344429
TI  - In vitro phosphorylation of purified tobacco-leaf phosphoenolpyruvate
      carboxylase.
AB  - C3-leaf phosphoenolpyruvate (PEP) carboxylase (PEPC) was purified about 1,000
      fold from tobacco and displayed a final specific activity of 35 mumol/min/mg
      protein, an apparent Km (total PEP) of 95 muM [corrected] (both at pH 8.0, 30
      degrees C), and an I50(L-malate) value of 0.14 mM at pH 7.3, 0.2 mM PEP. The
      rapid, 5-step protocol involved polyethylene glycol fractionation and sequential
      FPLC on hydroxylapatite, phenyl-Sepharose, Mono Q and Superose 12. The
      electrophoretically pure protein and purified C4-leaf PEPC were phosphorylated in
      vitro in a reconstituted system with PEPC-kinase isolated from illuminated
      tobacco and maize leaves. These reciprocal phosphorylation experiments (i)
      indicate that Ser11 of tobacco PEPC is the likely target residue, situated in the
      plant-invariant Glu/Asp-Lys/Arg-X-X-Ser phosphorylation motif near the N
      terminus, and (ii) lend support to the recent hypothesis that C3-leaf PEPC is
      subject to regulatory phosphorylation in vivo.

PMID- 8344430
TI  - Proteolytic processing of the hepatocyte growth factor/scatter factor receptor by
      furin.
AB  - The hepatocyte growth factor/scatter factor (HGF/SF) receptor consists of an
      alpha- and a beta-subunit, which are derived from a single-chain precursor by
      endoproteolytic processing. The precursor is not proteolytically processed in
      LoVo colon carcinoma cells. The uncleaved receptor immunopurified from the cells
      was cleaved in vitro by furin. Furthermore, the HGF/SF receptor was
      proteolytically processed in LoVo cells transfected with furin cDNA. These
      results indicate that furin is a processing endoprotease for the HGF/SF receptor.
      Tyrosine autophosphorylation of the uncleaved receptor was induced by HGF/SF, and
      the growth of the cells expressing the uncleaved receptor was stimulated by
      HGF/SF, indicating that the proteolytic processing of the receptor is not
      essential for the signal transduction of HGF/SF.

PMID- 8344431
TI  - Expression of heterologous phosphofructokinase genes in yeast.
AB  - Genes encoding phosphofructokinases (PFK) from Escherichia coli and from the
      human muscle were expressed in PFK-deficient strains of Saccharomyces cerevisiae
      under the control of an inducible GAL1 promoter. They restored PFK activity under
      inducing conditions and complemented the galactose-negative growth phenotype of
      the recipient strains. The PFK enzymes expressed appear to be stable in yeast.
      The human muscle enzyme crossreacts with specific antibodies and shows the
      expected subunit size. As expected, its activity can be activated by fructose-2,6
      bisphosphate, in contrast to the bacterial enzyme.

PMID- 8344432
TI  - A putative transcription factor binding to the upstream region of the puf operon
      in Rhodobacter sphaeroides.
AB  - Gel shift assays of the upstream region of the puf operon in Rhodobacter
      sphaeroides were performed using cell-free extracts from cells grown under
      various culture conditions. The results suggested that a protein binding to the
      upstream region functioned as a repressor-like substance of the expression of the
      operon by oxygen tension or light. The density of the shifted band of cell-free
      extracts from cells irradiated with blue light under semi-aerobic conditions was
      higher than that with red light. Phosphatase treatment of the cell-free extracts
      strongly increased the DNA-binding affinity of the protein.

PMID- 8344433
TI  - Evidence for stacking interactions between 5-mercurated polyuridylic acid and HIV
      1 p7 nucleocapsid protein obtained by phosphorescence and optically detected
      magnetic resonance (ODMR).
AB  - The photoexcited triplet state of Trp-37 in the C-terminal zinc finger of the HIV
      1 p7 nucleocapsid protein was used as a probe of p7 interactions with the heavy
      atom-derivatized RNA homopolymer, poly-5-mercuriuridylic acid (5-HgU). Binding of
      p7 to 5-HgU (Hg blocked with 2-mercaptoethanol) produces an external heavy atom
      effect (HAE) on Trp-37 characterized by fluorescence quenching, reduction of the
      phosphorescence lifetime by three orders of magnitude, and the appearance of the
      D+E phosphorescence-detected ODMR signal, absent in unperturbed Trp, but induced
      by a HAE. The details of the HAE are consistent with out-of-plane van der Waals
      contact of Hg with the indole chromophore of Trp-37. Steric requirements suggest
      further that the Trp-RNA contact occurs via an aromatic stacking interaction.

PMID- 8344435
TI  - The 100 kDa F-actin capping protein of Dictyostelium amoebae is a villin
      prototype ('protovillin').
AB  - The 100 kDa actin-binding protein from Dictyostelium amoebae is an F-actin
      capping protein that displays neither severing nor crosslinking nor nucleating
      activities [Hofmann et al. (1992) Cell Motil. Cytoskel. 23,133-144]. Cloning and
      sequencing of the gene revealed that the protein is highly homologous to
      vertebrate villin, a unique component of brush border microvilli and contains six
      domains fused to a villin-like headpiece domain via a threonine/proline rich neck
      region. The functional differences and similarities between the 100 kDa protein
      and villin are reflected in the amino acid sequences. We draw from the data the
      following conclusions. (i) The presence of a six domain protein in Dictyostelium
      suggests that in contrast to the current view gene duplications must have
      happened before Dictyostelium branched off during evolution. (ii) The villin-like
      molecule in Dictyostelium appears to be a premature villin ('protovillin') which
      is able to cap actin filaments but still lacks the other villin-type actin
      binding activities. This renders capping of actin filaments as the evolutionarily
      oldest function of an F-actin binding protein.

PMID- 8344434
TI  - 13C NMR study of the mode of interaction in solution of the B fragment of
      staphylococcal protein A and the Fc fragments of mouse immunoglobulin G.
AB  - The mode of interaction of the B domain (FB) of staphylococcal protein A and the
      Fc fragments of mouse immunoglobulin G (IgG) has been investigated by 13C NMR
      spectroscopy. Mouse IgG1, IgG2a, and IgG2b proteins have been selectively labeled
      with 13C at the carbonyl carbon of His, Met, Trp or Tyr residue and used to
      prepare the corresponding Fc fragments by limited proteolysis. Site-specific
      resonance assignments have been made for each of these Fc analogues. FB was
      reported to form two contacts (contact 1 and contact 2) with human Fc in the
      crystal [Biochemistry 20 (1981) 2361-2370]. Comparisons of the chemical shift
      data of the Fc fragments observed in the absence and presence of FB have led us
      to conclude that in solution contact 1 is responsible for the formation of the Fc
      FB complexes.

PMID- 8344436
TI  - Endothelin-receptor interactions. Role of a putative sulfhydryl on the endothelin
      receptor.
AB  - The mechanism of action of endothelin-receptor interactions was studied, using
      radioligand binding assays and SDS-PAGE, to investigate the possibility of
      disulfide interchange. Electrophoretic analysis suggested involvement of
      disulfide bond(s) in the receptor-ligand complex. Treatment of Et receptors with
      sulfhydryl-specific alkylating reagents (NEM or others) resulted in decreased
      ability to bind [125I]Et-1. [Dpr1-Asp15]Et-1, an antagonist homologous to Et but
      with an amide link replacing one of the disulfides, bound to Et receptors
      reversibly, but binding of Et-1 was less reversible. Preincubation of receptors
      with Et-1, but not with [Dpr1-Asp15]Et-1, protected receptors from alkylation
      with [14C]NEM. The data suggest that the Et receptor has a sulfhydryl group at or
      near the Et binding site. A model is proposed in which the role of the putative
      sulfhydryl group is discussed.

PMID- 8344437
TI  - Proper processing of a G protein gamma subunit depends on complex formation with
      a beta subunit.
AB  - G protein beta and gamma subunits function as a tightly associated complex. We
      show that complex formation with the beta subunit is a critical step for post
      translational processing of a gamma subunit. When expressed alone in a cell line,
      the gamma 3 subunit type is isoprenylated but degraded; co-expression with the
      beta 1 subunit type stabilizes the gamma 3 protein. Furthermore, our experiments
      with partial cell fractionation indicate that the gamma 3 protein is localized
      differently in the cell depending on whether or not it is bound to the beta
      subunit. Binding of the gamma subunit to the beta subunit is thus one of the
      prerequisites for the appropriate intracellular localization of the beta gamma
      complex and potentially, for normal G-protein function.

PMID- 8344438
TI  - Regulation by growth factors (IGF-I, b-FGF and TGF-beta) of proto-oncogene mRNA,
      growth and differentiation of bovine adrenocortical fasciculata cells.
AB  - Nuclear proto-oncoproteins have been implicated in the regulation of gene
      expression by peptidic hormones and growth factors during cell proliferation and
      differentiation. In the present study we have investigated in bovine adrenal
      cells (BAC) the effects of basic fibroblast growth factor (b-FGF), insulin-like
      growth factor 1 (IGF-I) and transforming growth factor beta (TGF-beta) on c-jun,
      jun-B and c-fos mRNA levels and on cell growth and differentiation. Factors able
      to enhance the three proto-oncogenes (IGF-I, b-FGF and angiotensin II (A-II))
      stimulate cell growth, whereas those inhibiting cell growth (TGF-beta and ACTH)
      decrease c-jun mRNA level. These results suggest that expression of c-jun may be
      required to induce cell proliferation. The relation between proto-oncogenes and
      the expression of differentiated functions appears to be more complex. Whereas
      IGF-I, b-FGF and A-II increase the three nuclear proto-oncogenes, the effects of
      IGF-I and b-FGF on cytochrome P450 17 alpha-hydroxylase mRNA levels are opposite
      to those of A-II. On the other hand, while TGF-beta and A-II have inhibitory
      effects on P450 17 alpha mRNA level, they have opposite effects on c-jun mRNA.

PMID- 8344439
TI  - The relationships between transketolase, yeast pyruvate decarboxylase and
      pyruvate dehydrogenase of the pyruvate dehydrogenase complex.
AB  - The amino acid sequences of four thiamine pyrophosphate-requiring enzymes were
      aligned with the published amino acid sequence of the transketolase of Hansenula
      polymorpha. Sequences of the combined alpha and beta subunits of the E1 enzyme of
      the pyruvate dehydrogenase complexes of Homo sapiens and Bacillus
      stearothermophilus aligned well with the transketolase while the E1 of the
      pyruvate dehydrogenase complex of Escherichia coli aligned easily provided a non
      aligning segment of 77 amino acids was omitted. The non-acetylating pyruvate
      decarboxylase of Saccharomyces cerevisiae could only be aligned if the sequence
      was cut in two with the C-terminus corresponding to the N-terminus of the other
      TPP-dependent enzymes. Using the published 2.5 A resolution of the X-ray crystal
      structure of Saccharomyces cerevisiae transketolase as a template we show that a
      hydrophobic region of the beta-subunit of the PDH E1 alpha beta enzymes likely
      contains a binding site for the thiazolium ring of TPP and key motifs are
      retained in common by all the TPP-dependent enzymes considered, which are
      essential for catalysis.

PMID- 8344440
TI  - A compendium of reviews in biochemistry and molecular biology published in the
      second half of 1992.
AB  - 1. A compendium of reviews and mini-reviews in Biochemistry and Molecular Biology
      published in the second half of 1992 is presented. In all 776 titles are listed
      from 108 different publications. 2. This compendium presents the references by
      Journal Name. Keywords have been included with each reference to increase the
      value of the collection. Keyword and author cross-reference indexes are not
      included but are available in the electronic database from which this version was
      constructed. Should anyone wish to have this information in electronic form it
      can be distributed on MS-DOS formatted floppy disks in either Reference Manager
      or Medline format. The author should be contacted for details of the number of
      preformatted floppy disks required.

PMID- 8344441
TI  - Lectins and superantigens: membrane interactions of these compounds with T
      lymphocytes affect immune responses.
AB  - 1. Lectins and superantigens belong to two different families of macromolecules
      which are able to interact with cells of the immune system. 2. The principal
      mechanisms by which they modulate immune responses are presented in this review.
      3. Possible similarities shared by these proteins and their common mechanisms of
      action upon immunocytes will be presented along with a brief discussion regarding
      the role of these molecules in physiological immune responses and human diseases.

PMID- 8344442
TI  - Microfilaments and protein synthesis; effects of insulin.

PMID- 8344443
TI  - Effect of Berenil on polyamine metabolism in primary cultured rat hepatocytes.
AB  - 1. Putrescine and spermidine content increased in hepatocytes during culture. In
      the presence of 10 microM Berenil, putrescine content was further increased,
      while the increase of spermidine was prevented. 2. Ornithine decarboxylase
      activity was markedly reduced, and to a lesser extent also S-adenosylmethionine
      decarboxylase activity. 3. Berenil appears to promote an increase in the
      transformation of spermidine into putrescine, and to inhibit the polyamine
      efflux.

PMID- 8344444
TI  - Cloning and characterization of rabbit pancreatic colipase.
AB  - 1. Among the digestive enzymes synthesized by pancreas, lipase is the principle
      lipolytic enzyme which hydrolyses dietary glycerides. 2. For its action it
      requires a coenzyme, colipase. 3. The molecular mechanisms of the interaction of
      these two are not fully understood. 4. Further, molecular events that regulate
      and influence lipid absorption are ill defined. 5. The rabbit is the conventional
      animal model for the study of lipid absorption. We have undertaken the molecular
      cloning, and characterization of rabbit pancreatic colipase, the coenzyme for
      pancreatic lipase. 6. Colipase has been cloned from a gt 11 library of an adult
      rabbit pancreatic cDNA by probing with an oligonucleotide derived from human
      colipase sequence. 7. The total reading frame consists of 321 nucleotides coding
      for 90 amino acids of the functional protein and 17 nucleotides of the leader
      peptide. 8. Northern blot analysis revealed a distinct band around 0.5 kb.
      Comparison with other species revealed an over all homology of 75% at the
      nucleotide level. 9. At the amino acid level highest conservation is observed at
      the lipase-binding region (AA 53-73). 10. Rabbit enzyme also retained the N
      terminal pentapeptide of its preform. 11. The regions of homology and
      conservation may aid to define the sites of interaction of colipase with lipase.

PMID- 8344445
TI  - Algal phospholipids by 31P NMR: comparing isopropanol pretreatment with simple
      chloroform/methanol extraction.
AB  - 1. A modified Folch procedure [potassium (ethylenedinitrilo)-tetraacetic acid at
      pH 6 substituted for KCl] is suitable for the extraction of marine algae. 2. The
      quantitative 31P nuclear magnetic resonance phospholipid profiles of four marine
      algae, Gracilaria verrucosa, Bryothamnion triquetrum, Padina gymnospora, and
      Caulerpa sertularioides, were obtained from Folch and Nichols extractions of both
      fresh and dried algae, and essentially identical results were obtained using
      either extraction procedure. 3. Extracts of air-dried algae are statistically
      different when compared to extracts of living algae, suggesting that tissue
      handling is a critical factor in phospholipid extractions.

PMID- 8344446
TI  - Inhibitory effects of alpha- and beta-carotene on croton oil-induced or enzymatic
      lipid peroxidation and hydroperoxide production in mouse skin epidermis.
AB  - 1. The effects of carotenes (alpha- and beta-) on edema, MDA contents and
      peroxidizability of croton oil-treated mouse skin epidermis, hydroperoxide
      production and enzymatic lipid peroxidation of epidermal homogenates were
      studied. Edema was determined as ear punch weight and the intensity of lipid
      peroxidation was measured using malondialdehyde formation. 2. Carotenes (alpha-
      and beta-) significantly suppressed edema formation, hydroperoxide production,
      lipid peroxidation caused by croton oil, Fe + 3-ADP/NADPH or paraquat/NADPH in
      vivo as well as in vitro. 3. These results indicate that both alpha- and beta
      carotene have chemopreventive effects on croton oil-induced tumor promotion in
      skin tumorigenesis by scavenging oxygen free radicals, indirectly determined as
      carotene inhibition of lipid peroxidation and hydroperoxide formation.

PMID- 8344447
TI  - Demonstration of highly specific and sensitive antibodies to a naturally
      occurring tetrahydroisoquinoline alkaloid, salsolidine.
AB  - 1. We report for the first time on the production and characterization of
      antibodies against a naturally occurring tetrahydroisoquinoline, namely
      salsolidine (6,7-dimethoxy-1-methyl-1,2,3,4-tetrahydroisoquinoline). 2. Immunogen
      synthesis was carried out by coupling the hapten salsolidine to bovine serum
      albumin (BSA) as carrier protein on the basis of reductive amination. 3. By
      immunization of rabbits with salsolidine-BSA conjugate antisalsolidine antibodies
      were produced. 4. At a final dilution of 1:1700 the highest-titre antiserum bound
      35% of 0.21 pmol [3H]salsolidine. This antiserum was used to develop a
      radioimmunoassay for salsolidine. 5. Cross-reactivity studies revealed a high
      specificity of the antiserum to the hapten. 6. The antibodies had a high affinity
      to salsolidine (Ka = 1.5 x 10(9) M-1). 7. Standard curves covered a measuring
      range of 0.5-70 pmol/tube and the detection limit was found to be 0.27 pmol/tube.

PMID- 8344448
TI  - Molecular geometry of antigen binding by a monoclonal antibody against 5
      methylcytidine.
AB  - 1. The specificity of a monoclonal IgG1 raised against a 5-methylcytidine-keyhole
      limpet hemocyanin conjugate was investigated by inhibition experiments with
      soluble competing antigens. 2. A competitive enzyme immunoassay has been set up,
      with the antigen immobilized on polystyrene microtitration wells. 3. The analysis
      of the cross-reaction profile allowed the topography of the antigen-antibody
      interaction to be described. 4. The binding properties of the monoclonal antibody
      are discussed in terms of both analytical applications and working limitations in
      the immunochemical study of gene methylation.

PMID- 8344449
TI  - Differential expression of salivary mucin bacterial aggregating activity with
      caries status.
AB  - 1. The low and high mol. wt mucin forms were isolated from saliva of caries
      resistant (CR) and caries-susceptible (CS) individuals, and assessed for their
      bacterial aggregating potential towards S. mutans and S. sanguis, the common
      cariogenic microorganisms encountered in the oral cavity. 2. The high mol. wt
      mucin from both groups of subjects exhibited similar protein and carbohydrate
      content, but the level of covalently bound fatty acids was significantly lower in
      the CR group. The mucin from CR group showed only a weak inhibitory potential,
      and no inhibitory activity was observed with the mucin of CS group. 3. The low
      mol. wt mucins from both groups, while displaying compositional similarities,
      showed a marked variation in the bacterial aggregating activity. With both
      bacteria, the activity of the mucin from CR group was at least 128-fold greater
      than that of CS group. 4. The conversion of the high mol. wt mucin to a low mol.
      wt form through the action of salivary protease produced in both groups
      enhancement in mucin's bacterial aggregating capacity. This enhancement was,
      however, considerably less pronounced in the case of mucin from CS group. 5. The
      results for the first time demonstrate that the bacterial aggregating epitope of
      salivary mucins is expressed to a greater extent in CR individuals, and that this
      epitope is apparently more accessible to bacteria in the low mol. wt mucin form.

PMID- 8344450
TI  - In vitro non-enzymatic glycosylation of myofibrillar proteins.
AB  - 1. Glycation is non-enzymatic modification of proteins by sugars in which not
      only structural but also biological properties of proteins are altered. 2. Our in
      vitro experiments show that incubation of myofibrillar proteins with ribose
      results in sugar attachment to proteins and at the same time myofibrillar ATPase
      activity is lowered. 3. DETAPAC, aminoguanidine and 2-mercaptoethanol all
      partially block myofibrillar protein glycation and ATPase activity is less
      inactivated. 4. The dependence of ATPase activity of myofibrils incubated with
      ribose on the amount of 2-mercaptoethanol present suggests that also modification
      of SH groups is involved in enzyme inactivation. 5. Electrophoretic studies
      revealed that heavy chains of myosin, actin, and tropomyosins are proteins which
      are mainly glycated in vitro.

PMID- 8344452
TI  - Restoration of motor unit properties and fiber type distribution in reinnervated
      axolotl skeletal muscle.
AB  - The contractile properties of functionally isolated motor units and the muscle
      fiber type distribution of reinnervated iliotibialis posterior muscles were
      examined in axolotls (Ambystoma mexicanum) 7 to 12 months after complete
      transection of the hind limb nerve trunks. Motor units were continuously
      distributed with respect to size and contractile speeds and there was a positive
      correlation between motor unit size and twitch:tetanus ratio. The degree of
      overlap between motor units was positively correlated with motor unit size and
      inversely correlated with similarity of contractile speeds. In addition, the
      muscle fiber type distribution within the reinnervated muscles, as revealed by
      immunocytochemical localization of tonic, slow, and fast myosin isoforms, was
      indistinguishable from that in the contralateral unoperated muscles, with no
      evidence of fiber type grouping. Thus, the motor organization after reinnervation
      was very similar to that of normal muscles examined previously. The only
      difference found was that a small number of motor units contracted unusually
      rapidly in reinnervated muscles. The absence of muscle fiber type redistribution
      and the essentially normal motor unit characteristics suggest that the original
      pattern of synaptic connections was reestablished following reinnervation. These
      observations are consistent with the returning motor neurons selectively
      reinnervating their original muscle fiber types.

PMID- 8344451
TI  - Ecdysteroid induction of embryonic morphogenesis in a parasitic wasp.
AB  - Development of the parasitic wasp Copidosoma floridanum (Hymenoptera: Encyrtidae)
      is unusual in two ways. As many as 3000 embryos are formed from a single egg and
      embryonic morphogenesis is closely synchronized with the onset of the
      metamorphosis of its host. Given this extreme synchrony between parasite and host
      development, we undertook a series of experiments to determine whether host
      endocrine factors regulate C. floridanum embryonic morphogenesis. Here we report
      that C. floridanum embryos must develop for 9 days before acquiring the
      competence to undergo morphogenesis. Furthermore, several pieces of evidence
      suggest that ecdysteroids of host origin regulate induction of C. floridanum
      morphogenesis. First, competent embryos initiated morphogenesis when transplanted
      into host larvae and pupae, host stages possessing elevated ecdysteroid titers,
      but not when transplanted into adult moths. Second, morphogenesis was arrested by
      ablation of the host's source of ecdysone, but could be rescued by injection of
      20-hydroxyecdysone in a dose-dependent manner. Finally, a segment of DNA encoding
      a zinc finger nearly identical in sequence to a portion of the ecdysone receptor
      of Drosophila melanogaster was isolated and characterized from C. floridanum.
      This putative ecdysone receptor probe indicated that expression of this gene was
      correlated with the initiation of C. floridanum embryonic morphogenesis. The
      temporal pattern of putative receptor RNA accumulation increased in association
      with the onset of morphogenesis, while the spatial pattern of expression was
      associated with the invagination of cells forming the gastrula. Together, these
      data suggest that ecdysone of host origin is directly involved in the induction
      of C. floridanum embryonic morphogenesis.

PMID- 8344453
TI  - The proliferation of mature oligodendrocytes in vitro is stimulated by basic
      fibroblast growth factor and inhibited by oligodendrocyte-type 2 astrocyte
      precursors.
AB  - Basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF)
      are mitogens for bipotential oligodendrocyte-type 2 astrocyte (O-2A) progenitor
      cells. We investigated the mitogenic effect of these growth factors on quiescent
      mature oligodendrocytes (OL) expressing myelin basic protein (MBP) in OL cultures
      that were treated for 3 days with cytosine arabinoside (ARA-C) in order to kill O
      2A precursors which divide in chemically defined medium. After treatment with ARA
      C proliferation decreased and O-2A precursors identified with A2B5 monoclonal
      antibody were nearly undetectable. After exposure of mature OL to bFGF, cell
      proliferation increased markedly within 24 hr. PDGF had a much weaker effect.
      Cultures treated with ARA-C for 3 days and then with bFGF for the next 24 hr and
      incubated with BrdU for the last 2 hr before the end of the experiment were
      immunolabeled with anti-MBP or A2B5 and anti-bromodeoxyuridine (BrdU) antibodies.
      Eighty-seven percent of the cells were MBP+, 10% were both MBP+ and BrdU+, and
      none was A2B5+ BrdU+, showing that at least a part of the population of mature
      MBP+ OL retains the ability to reenter the cell cycle in vitro. Since mature OL
      did not proliferate in response to bFGF in the cultures not treated with ARA-C,
      i.e., in the presence of O-2A progenitors, we assumed that these precursors were
      responsible for the lack of mitogenic effect of bFGF on MBP+ OL in such
      conditions. Conditioned medium from O-2A precursors almost halved the bFGF
      induced OL proliferation after treatment with ARA-C, suggesting that O-2A
      progenitors control the proliferation of a subpopulation of mature OL (possibly
      young mature OL) via the secretion of active molecule(s).

PMID- 8344454
TI  - MAP kinase becomes stably activated at metaphase and is associated with
      microtubule-organizing centers during meiotic maturation of mouse oocytes.
AB  - Using antisera generated against sequences conserved between the ERK1- and the
      ERK2-encoded species of mitogen-activated protein (MAP) kinases of the rat,
      species of approximate M(r) 42 and 44 kDa were identified in mouse oocytes. When
      oocytes underwent meiotic maturation, both species displayed a retarded
      electrophoretic mobility, consistent with modification by phosphorylation. The
      slow-migrating forms first appeared after the oocytes had entered metaphase, and
      their appearance was sensitive to inhibitors of protein synthesis or
      phosphorylation. These forms remained throughout maturation and in oocytes
      arrested at metaphase II. Following oocyte activation, which induces a transition
      to interphase, the slow-migrating forms were replaced by the fast-migrating forms
      observed in prophase oocytes. MAP kinase activity also increased after oocytes
      entered metaphase, and this increase required protein synthesis and
      phosphorylation. To investigate the intracellular distribution of the
      immunoreactive species, spindles were purified from metaphase II eggs. Both the
      42- and the 44-kDa species were detected in immunoblots, and bright staining of
      the spindle poles was observed by immunofluorescence. When intact oocytes
      undergoing maturation were examined by immunofluorescence, foci of staining were
      initially detected on opposing sides of the condensing chromosomes and then
      became congregated at each pole of the first meiotic spindle. No localized
      staining was observed during the first meiotic division, but stained foci were
      present at the poles of the second meiotic spindle. In addition, several
      cytoplasmic foci of staining often could be seen. When oocytes were exposed to
      taxol, which permits nonspindle microtubule-organizing centers (MTOCs) present in
      the cytoplasm to nucleate microtubule assembly, the cytoplasmic foci labeled by
      the MAP kinase antibodies were found to contain tubulin. We conclude that mouse
      oocytes contain 42- and 44-kDa species of MAP kinase and that, after maturing
      oocytes enter metaphase, MAP kinase activity is stimulated by means of a process
      requiring protein synthesis and phosphorylation. MAP kinase is present in the
      spindle and is specifically associated with the MTOCs present at the spindle
      poles and in the cytoplasm. Evidence from cell-free systems suggests that the
      alterations in MTOC activity that normally occur at metaphase in oocytes may be
      regulated by MAP kinase. The association of MAP kinase with MTOCs provides a
      potential structural basis for this cell cycle-dependent change in MTOC activity.

PMID- 8344455
TI  - Induction of polarizing activity by retinoic acid occurs independently of
      duplicate formation in developing chick limb buds.
AB  - Retinoic acid (RA) is known to mimic the action of the zone of polarizing
      activity (ZPA) in inducing the formation of anteroposterior duplicates in the
      chick limb bud. Although RA had been thought to be a morphogen produced by the
      ZPA, recently we (Noji et al., 1991) and Wanek et al. (1991) independently
      concluded that RA induces polarizing activity in cells at the anterior margin of
      the chick limb bud. In this study, we examined the distribution of RA-induced
      polarizing activity in the limb bud. At first, RA-containing beads were implanted
      into various regions of stages 20-23 limb buds. After 24 hr, we grafted tissue
      fragments from sites adjacent to the RA beads into the anterior margin of host
      limb buds. High polarizing activity was induced in anterior-distal and apical
      mesoderm regions immediately under the apical ectodermal ridge (AER) when beads
      presoaked in 1 mg/ml RA were grafted to anterior sites at stages 19-20. However,
      in mesoderms distant from the AER, even if adjacent to the implanted RA bead,
      only low activity was induced. Although implantation of beads soaked in a high
      concentration (10 mg/ml) of RA did not result in duplications but rather in
      truncations of the limbs, the apical mesodermal cells in these limbs were
      converted to ZPA cells, indicating that induction of polarizing activity by RA
      can occur independently of duplicate formation. The ability to respond to RA
      treatment was rapidly lost in the cells along the anterior margin of stage 22
      limb buds. When the anterior AER was removed, the induction of polarizing
      activity in the anterior margin of limb buds was markedly reduced. Thus, the AER
      seems to be necessary for the RA-directed induction of polarizing activity.

PMID- 8344456
TI  - SpOct, a gene encoding the major octamer-binding protein in sea urchin embryos:
      expression profile, evolutionary relationships, and DNA binding of expressed
      protein.
AB  - We have characterized a sea urchin gene, SpOct, that encodes a 78-kDa POU-domain
      protein related to mammalian Oct-1 and Oct-2. The SpOct protein binds octamer
      elements in the promoters of the alpha H2B (Bell et al., 1992, Dev. Biol. 150,
      363-371) and CyIIIa actin genes, and it closely resembles the major octamer
      binding activity obtained from sea urchin blastula nuclear lysates in the size of
      its DNase I footprint on a canonical octamer element and in its relative binding
      affinity (Kr) for the octamer element versus poly(dAT) (1.4 x 10(4)). Moreover,
      partial protein sequences obtained from affinity-purified octamer-binding protein
      match sequences present in SpOct. These data suggest that SpOct is closely
      related to, if not identical with, the major octamer-binding activity in blastula
      nuclear extracts. RNA gel blots reveal four forms of SpOct mRNA, ranging in size
      from 4 to 12 kb. They are regulated coordinately in the embryo: all are present
      in the unfertilized egg, increase 28-fold in amount by the 8-hr blastula stage,
      and decline 6-fold by the 12-hr blastula stage. The same four size classes of
      SpOct mRNAs are present in several adult tissues, although their relative amounts
      vary. The temporal profile of SpOct mRNA expression in embryos closely resembles
      that of the alpha histone H2B gene. Our previous work (Bell et al., 1992) showed
      that expression of the alpha H2B gene in blastula-stage embryos was entirely
      dependent on an octamer element. Together, these data strongly suggest that SpOct
      may be the key regulator of the alpha H2B gene.

PMID- 8344457
TI  - Selective pathway choice of a single central axonal fascicle by a subset of
      peripheral neurons during leech development.
AB  - In the CNS of leech, the central projections of peripheral sensory neurons
      segregate into three distinct axonal tracts during early development. We have
      previously shown that a subset of these neurons, recognized by the monoclonal
      antibody lan 4-2, projects axons into only one of these fascicles (Johansen et
      al., 1992, Neuron 8, 599). Here we report on a developmental and biochemical
      characterization of another fascicle-specific antigen labeled by the monoclonal
      antibody lan 3-6. By immunocytochemistry and double labelings we demonstrate that
      the lan 3-6 epitope is expressed only by a small subgroup of the peripheral
      neurons in Macrobdella embryos. The axons of these neurons selectively
      fasciculate in the CNS, but to only one of the three lan 3-2-positive tracts,
      which is different from the previously described lan 4-2-positive tract. These
      observations support the existence of a hierarchy of guidance cues mediating
      specific tract formation in this system. A biochemical analysis of the antigen
      suggests that it is likely to be a glycosylated protein with a molecular weight
      of approximately 200 kDa. Thus, the restricted expression of the lan 3-6 antigen
      and its biochemical properties are consistent with the hypothesis that this
      antigen may be playing a role in axonal guidance.

PMID- 8344458
TI  - Secretion of cumulus expansion enabling factor by mouse oocytes: relationship to
      oocyte growth and competence to resume meiosis.
AB  - Fully grown mouse oocytes secrete a factor that enables the surrounding cumulus
      cells to undergo cumulus expansion upon stimulation of the cumulus cells with
      follicle-stimulating hormone in vitro. The secretion of the enabling factor by
      the oocytes is developmentally regulated; it is normally secreted in significant
      amounts only by oocytes that are competent of undergoing spontaneous germinal
      vesicle breakdown (GVB) and resuming the first meiotic division. The objective of
      this study was to determine the relationship, if any, among secretion of this
      factor, oocyte growth, and the competence to undergo GVB. Three experimental
      systems were used to assess these relationships. First, 20 to 25% of the oocytes
      isolated from the small antral follicles of mutant hypogonadal mice were GVB
      incompetent even though they had achieved a size typical of GVB-competent
      oocytes. These large GVB-incompetent oocytes secreted almost as much cumulus
      expansion enabling factor as the GVB-competent oocytes. Second, GVB-incompetent
      oocytes cultured under conditions that promote the acquisition of GVB competence
      but not oocyte growth acquired the ability to secrete the cumulus expansion
      enabling factor. Third, the precocious activation of maturation promoting factor
      (MPF) in GVB-incompetent oocytes by okadaic acid did not stimulate the secretion
      of cumulus expansion enabling factor. It is concluded that the secretion of
      cumulus expansion enabling factor by oocytes is (1) independent of oocyte growth,
      (2) independent of competence to undergo GVB, and (3) not induced by the
      precocious activation of MPF. Thus, although the secretion of the enabling factor
      normally coincides with the time of acquisition of competence to undergo GVB, the
      ability to secrete the enabling factor is independent of oocyte maturation.
      Nevertheless, factors that promote the oocyte's program that leads to competence
      to undergo GVB probably also promote the ability to secrete the enabling factor.

PMID- 8344459
TI  - ZAP-1 DNA binding activity is first detected at the onset of zona pellucida gene
      expression in embryonic mouse oocytes.
AB  - ZAP-1 (zona pellucida gene activating protein-1) is a putative transcription
      factor controlling the oocyte-specific expression of mouse and human zona
      pellucida genes. The DNA binding activity of ZAP-1 first appears in oocytes from
      19-day-old mouse embryos and reaches a maximum level at 10 days after birth. This
      developmental profile closely parallels that of mouse zona pellucida gene
      transcription, which is detected in oocytes at 19 days of fetal life using a
      sensitive RT-PCR method and is maximal in 10-day-old animals. DNA binding
      activity similar to that of ZAP-1 is present in ovarian extracts from rat, human,
      and opossum, suggesting that the ZAP-1 protein may be conserved among mammals.

PMID- 8344460
TI  - TGF-beta 1 prevents hypertrophy of epiphyseal chondrocytes: regulation of gene
      expression for cartilage matrix proteins and metalloproteases.
AB  - Using an in vitro model of rat epiphyseal chondrocyte differentiation in which
      cells are maintained in a three-dimensional cell pellet, we show that exogenous
      TGF-beta 1 reversibly prevents terminal differentiation of epiphyseal
      chondrocytes into hypertrophic cells. Through maintenance of gene expression for
      the cartilage matrix proteins type II collagen and aggrecan core protein, and
      with coordinate inhibition of expression of genes encoding the metalloproteases
      collagenase and stromelysin, TGF-beta 1 stabilizes the phenotype of the
      prehypertrophic epiphyseal chondrocyte. This ability of TGF-beta 1 to stabilize
      the cartilage phenotype is critically dependent on culture conditions. Epiphyseal
      chondrocytes cultured as a subconfluent monolayer of cells dedifferentiate
      (reduce type II collagen and aggrecan core protein expression, increase
      metalloprotease expression, and acquire a spindled morphology) in response to
      short-term TGF-beta 1 treatment. Increasing the initial seeding density and
      allowing the cells to become multilayered prior to the addition of growth factor
      reverse the effects of TGF-beta 1 on type II collagen and transin/stromelysin
      gene expression and maintain a rounded cellular morphology. This finding
      emphasizes the importance of considering cell density and environmental context
      in the analysis of the regulatory action of peptide growth factors in general and
      of the TGF-beta s in particular. We propose that one function of TGF-beta 1
      during endochondral ossification is regulation of chondrocyte growth and
      differentiation through modulation of the relative expression of cartilage matrix
      proteins and metalloproteases. This function of TGF-beta 1 helps illustrate how
      the regulation of diverse cellular processes such as matrix synthesis, matrix
      degradation, and cell growth and differentiation may be coordinated at the
      molecular level by a single peptide growth factor.

PMID- 8344461
TI  - The role of the tracheae and musculature during pathfinding of Drosophila
      embryonic sensory axons.
AB  - Developing sensory axons were studied in Drosophila embryos which carried a
      mutation in the trachealess and/or the twist gene. In these embryos, the tracheae
      and/or somatic muscles, which represent part of the substrate on which sensory
      axons normally grow, are absent. The results demonstrate that in each of these
      three mutant backgrounds, the majority of sensory nerves form normally. This
      indicates that neither the tracheae nor the somatic musculature is absolutely
      required for pathfinding of the embryonic sensory axons. On the other hand, the
      incidence of misrouted axons is significantly increased, most strongly in the
      trh, twi double mutant. Furthermore, axonal elongation is considerably slowed
      down, and sensory neurons which fail to send out an axon are frequent. We take
      our results to indicate that peripheral axons in the Drosophila embryo may be
      guided by multiple cues which, acting together, ensure the high fidelity of
      axonal pathways observed in normal development. The removal of one of these cues
      by itself does not necessarily lead to the total disability of axons to reach
      their target, although it enhances the frequency of error in pathfinding.

PMID- 8344462
TI  - Selective repression of actin and myosin heavy chain expression during the
      programmed death of insect skeletal muscle.
AB  - The intersegmental muscles (ISMs) of the tobacco hawkmoth Manduca sexta undergo
      two sequential changes in mass at the end of metamorphosis. Atrophy results in a
      40% loss of muscle mass beginning 3 days before adult eclosion (emergence).
      Coincident with eclosion, the ISMs undergo programmed cell death that results in
      the complete destruction of the muscles during the subsequent 30 hr. These
      developmental changes are initiated by sequential decreases in the circulating
      titer of the ecdysteroids. While the molecular basis of ISM atrophy is largely
      unknown, the commitment of the muscles to die has been shown to require the
      repression of specific genes and the activation of others. Data presented here
      suggest that two of the repressed genes encode the proteins actin and myosin
      heavy chain. Expression of both actin and myosin heavy chain mRNA was greatly
      decreased when the ISMs became committed to die. When animals were treated with
      20-hydroxyecdysone, cell death was delayed and the loss of these transcripts was
      reduced. At the protein level, actin expression was reduced by 84% at the time
      the muscles were committed to die. The reduction in actin and myosin heavy chain
      synthesis presumably plays a role in the rapid dissolution of the muscles.

PMID- 8344463
TI  - Induction of T alpha 1 alpha-tubulin mRNA during neuronal regeneration is a
      function of the amount of axon lost.
AB  - Axotomy of mature peripheral neurons leads to upregulation of T alpha 1 alpha
      tubulin mRNA. To distinguish whether this increase is due to interruption of
      target contact or to loss of the axon itself, we developed a model system that
      allowed us to axotomize mature sympathetic neurons proximal or distal to their
      cell bodies, severing contact with target tissue in all cases. Sympathetic
      neurons within the same superior cervical ganglion that project via the internal
      and external carotid nerves to the eye and to the ear, respectively, were
      differentially labeled with the retrograde tracers fast blue and fluorogold, and
      the labeled neurons were then transected close to or far from their cell bodies.
      In situ hybridization analysis 5 days postaxotomy (the time of peak T alpha 1
      mRNA expression) indicated that when eye and ear neurons were both axotomized
      close to their cell bodies. T alpha 1 mRNA increased to a similar degree in both
      populations. In contrast, when ear neurons were again cut close, but eye neurons
      of the same ganglion were transected far from their cell bodies by eye removal,
      peak T alpha 1 mRNA levels were two- to threefold lower in the eye neurons. Thus,
      the increase in T alpha 1 mRNA was much lower when only a small amount of axon
      was lost, even though contact with target tissue was completely interrupted in
      all groups. These results therefore suggest that neurons normally monitor the
      status of their axon via a mechanism that allows for graded responses and that
      the axotomy-induced increase in T alpha 1 mRNA is, to a great extent, due to loss
      of the nonterminal axon.

PMID- 8344465
TI  - A female sterile mutant, unfertilizable (uf), in Xenopus laevis.
AB  - We describe a female sterile mutant, unfertilizable (uf), in Xenopus laevis whose
      eggs cannot be fertilized by either natural mating or artificial insemination.
      The uf eggs were able to be activated by pricking with a fine glass needle.
      Ultraviolet-solubilized jelly from the uf eggs could permit the fertilization of
      the dejellied wild-type eggs by artificial insemination, while uv-solubilized
      jelly from the wild-type eggs did not permit the fertilization of the dejellied
      uf eggs. The uf eggs, whose jelly coats and vitelline envelopes were removed,
      could be fertilized by insemination in the uv-solubilized jelly from either wild
      type or uf eggs. These results show that the eggs and the jelly coats are intact
      but the vitelline envelopes are abnormal in uf mutant eggs. One- and two
      dimensional gel electrophoretic comparisons of vitelline envelopes from wild-type
      and uf eggs demonstrated that five protein components, having estimated molecular
      masses of about 26, 64, 69, 78, and 250 kDa, were present in the vitelline
      envelopes of uf eggs but were absent in those of wild-type eggs. All of these
      components were polymorphic in terms of isoelectric points. Thus the cause of
      unfertilizability of uf eggs resides in the vitelline envelopes whose protein
      components exceed those of the wild-type eggs.

PMID- 8344464
TI  - Alternative splicing of a neural-specific Src mRNA (Src+) is a rapid and protein
      synthesis-independent response to neural induction in Xenopus laevis.
AB  - Alternative splicing is used by the src protooncogene to derive two gene
      products, pp60c-src and pp60+. pp60+ is expressed exclusively in neurons, whereas
      pp60c-src is expressed in many tissues. The specific role of the src+ gene
      product in neurons is not yet understood. Expression of src+ mRNA begins early in
      neural development and is restricted to the neural plate in Xenopus embryos.
      Using a reverse transcription/polymerase chain reaction assay, we demonstrate
      that expression of src+ mRNA is dependent on neural induction. Src+ mRNA is
      expressed in animal cap ectoderm which is cocultured with mesoderm tissue, but
      not in ectoderm cultured alone. The protein kinase C (PKC) activator 12-O
      tetradecanoylphorbol-13-acetate (TPA) induces src+ mRNA expression in cultured
      stage 10+ animal cap ectoderm. This induction is rapid, with src+ mRNA being
      detected within 1 hr of TPA addition. Only dorsal ectoderm tissue is competent to
      express src+ mRNA upon TPA treatment, and stage 10+ ectoderm tissue becomes
      unresponsive to TPA after 4 hr in culture. TPA-dependent induction of src+ mRNA
      in ectoderm tissue is not blocked by cycloheximide and therefore is not dependent
      on protein synthesis.

PMID- 8344466
TI  - Origin of fetal troponin T: developmentally regulated splicing of a new exon in
      the fast troponin T gene.
AB  - We have identified a new exon in the fast troponin T (TnT) gene whose alternative
      splicing is developmentally regulated. In previous studies three novel isoforms
      of TnT were identified in fetal and neonatal rabbit skeletal muscles (Briggs et
      al., 1990, Dev. Biol. 140, 253-260). These proteins are recognized by an antibody
      against fast TnT, but no combination of the previously identified exons could
      explain their protein chemical properties. To determine whether an additional
      exon is present in the fast TnT gene, we have cloned and sequenced cDNAs from
      fetal rabbit muscle RNA. Reverse transcription coupled to PCR was used with
      primers from conserved regions of the fast TnT sequence that span the 5'
      alternatively spliced exons. Sequences were obtained for each of the fetal TnTs.
      All included known fast TnT coding sequences plus an additional 36 nucleotides
      between exons 8 and 9. The peptide predicted from this sequence is highly acidic
      and accounts for the chemical properties of the fetal proteins. Similar
      experiments analyzing neonatal rat TnT cDNAs identified an homologous sequence,
      and comparison with the genomic sequence revealed that it is encoded by a single
      exon. Thus, fetal TnTs are generated from the fast TnT gene by the inclusion of a
      new, alternatively spliced exon, which we have designated f (for fetal), whose
      developmentally regulated splicing appears to be a common feature of mammalian
      skeletal muscle development.

PMID- 8344467
TI  - Absence of somatic histone H1 in oocytes and preblastula embryos of Xenopus
      laevis.
AB  - Available data on the occurrence and expression of somatic histone H1 during
      oogenesis and early embryogenesis of Xenopus laevis are contradictory. In
      particular the reported presence of a large storage pool of histone H1A in
      oocytes is difficult to reconcile with the high transcriptional activity of all
      gene classes in this specific cell type. In the present study we have used
      polyclonal antibodies raised against somatic Xenopus histone H1 (H1A and H1A/B)
      for combined immunoblotting experiments to quantitate H1 pools and
      immunolocalization studies to visualize chromosome-bound H1. Both approaches
      failed to detect soluble or chromosomal histone H1 in vitellogenic oocytes, eggs,
      and cleavage-stage embryos up to early blastula. In addition, chromatin assembled
      in Xenopus egg extract was also negative for histone H1 as revealed by
      immunofluorescence microscopy. Lampbrush chromosomes not only lacked histone H1
      but also the previously identified histone H1-like B4 protein (Smith et al.,
      1988, Genes Dev. 2, 1284-1295). In contrast, chromosomes of eggs and early
      embryos fluoresced brightly with anti-B4 antibodies. Our results lend further
      support to the view that histone H1 expression is developmentally regulated
      during Xenopus oogenesis and embryogenesis similar to what is known from other
      species.

PMID- 8344468
TI  - Tracing the incorporation of the sperm tail in the mouse zygote and early embryo
      using an anti-testicular alpha-tubulin antibody.
AB  - The mechanism of sperm tail incorporation and the fate of the tail during mouse
      fertilization and early embryogenesis were examined. Time-lapse video microscopy
      and anti-tubulin immunofluorescence show that the incorporation of the sperm
      tail, but not the sperm head, is sensitive to cytochalasin B (a microfilament
      inhibitor). Colcemid, a microtubule inhibitor, does not affect tail
      incorporation. High-resolution, low-voltage scanning electron microscopy
      demonstrates that the plasma membrane covering the sperm tail does not appear to
      fuse with the oocyte membrane during in vitro fertilization in the presence of
      cytochalasin. In control and colcemid-treated oocytes, the plasma membrane along
      the sperm tail, which is oriented tangential to the egg surfaces, appears to fuse
      with the oocyte membrane at multiple sites. An antibody to testicular alpha
      tubulin detects sperm-derived, but not egg, microtubules and this has permitted
      us to trace the behavior and disappearance of the sperm tail during
      embryogenesis. Conventional and confocal microscopy show that following sperm
      incorporation, the tail often splays into multiple fibers. At the two-cell stage,
      the axoneme may be localized in either blastomere or it may be found to run
      through the midbody between both blastomeres. The tail appears to shorten by the
      8-cell stage and is undetectable after the 16-32 cell stage. In morulae, tail
      fragments have been found in outer cells but not in inner ones, and fragments
      have not be found in blastocysts. These data suggest that microtubules of sperm
      and oocytes contain different isotypes of alpha-tubulin, nongenomic sperm-derived
      components survive at least to the morula stage of mouse development, and egg
      microfilaments are involved in the incorporation of the sperm tail but not the
      sperm head, which demonstrates that motility during sperm incorporation is
      different in mammals when compared to lower vertebrates and invertebrates.

PMID- 8344469
TI  - Embryonic expression of Fgf-6 is restricted to the skeletal muscle lineage.
AB  - As part of an ongoing examination of the functions of the fibroblast growth
      factor (FGF) gene family in mammalian development, we have carried out an RNA in
      situ hybridization analysis of the Fgf-6 gene in the mouse embryo. In contrast to
      what has been found for three other members of the FGF gene family, no Fgf-6 RNA
      was detected in mouse embryos at E6.5 through E8.5. Fgf-6 RNA was first detected
      in embryos at E9.5 and was localized exclusively in the myotomal compartment of
      the somite. Similar results were obtained with embryos at E10.5 and E11.5. At
      E12.5, expression was still detected in the myotome, and also in the region
      containing the developing muscles of the body wall. By E14.5, Fgf-6 RNA was found
      in the majority of skeletal muscles in the fetus. These results are discussed in
      comparison with what is known about the expression patterns of the genes encoding
      other FGF family members, as well as their high-affinity receptors.

PMID- 8344471
TI  - Correlation of forelimb malformation asymmetries with visceral organ situs in the
      transgenic mouse insertional mutation, legless.
AB  - We studied the relationship between the sidedness of visceral organs and the
      expression of limb abnormalities in the legless mutant. The control of asymmetry
      in visceral development appears to be random in the legless mutant; that is, 50%
      develop normally (situs solitus) and 50% develop with inverted viscera (situs
      inversus). We find that the sidedness of forelimb abnormalities expressed in the
      mutants is highly correlated with visceral sidedness. Abnormalities are more
      severe in the right forelimbs in situs solitus mutants, while the left forelimb
      is more severely affected in situs inversus mutants.

PMID- 8344470
TI  - Role of epidermal growth factor expression in early mouse embryo lung branching
      morphogenesis in culture: antisense oligodeoxynucleotide inhibitory strategy.
AB  - Epidermal growth factor (EGF) expression and branching morphogenesis were
      inhibited using a 5' 15-mer antisense oligodeoxynucleotide (ODN) directed against
      EGF precursor mRNA in embryonic mouse lung in culture under chemically defined,
      serumless conditions. Antisense EGF ODN resulted in > 90% inhibition of EGF
      immunoreactive peptide synthesis, 75% reduction in branching morphogenesis, 73%
      decrease in DNA content, 64% decrease in RNA content, 73% decrease in protein
      synthesis, and 65% decrease in [3H]thymidine incorporation into DNA compared to
      Embryonic Day 11 controls in culture for 4 days. Sense ODN results were similar
      to control. Supplementing antisense ODN with EGF partially reversed antisense
      effects. The results further support a role for EGF in pulmonary organogenesis.

PMID- 8344472
TI  - Individual susceptibility to noise-induced hearing loss: an old topic revisited.
AB  - The wide range in susceptibility to noise-induced hearing loss has intrigued
      researchers and hearing conservationists alike. Some of these differences in
      variability have been attributed to various intrinsic factors such as eye color,
      gender, age, etc. However, a review of controlled research shows that the
      influence of these intrinsic variables is relatively small and cannot explain the
      wide range of hearing loss observed in demographic studies. Furthermore,
      uncontrolled variables or unrecognized drug and noise interaction may obscure the
      relation between noise exposure and hearing loss. With the growing understanding
      of the physiology of the auditory system, new possibilities are emerging that may
      explain the range of susceptibility. A review of the role of acoustic reflex
      effectiveness, cochlear efferent function, and history of noise exposure provide
      a perspective for future strategies in predicting susceptibility to noise-induced
      hearing loss.

PMID- 8344473
TI  - Concurrent right and left ear auditory brain stem response recording.
AB  - In auditory brain stem response testing, it is often advantageous to record the
      responses to right and left ear stimulation quickly. A method is described in
      which both ears are tested concurrently, each ear at a slightly different
      stimulus rate. With appropriate temporal parameters, the response of each ear can
      be recorded without contamination by the contralateral ear's response. When both
      ears were tested at the same intensity, either 40 or 70 dB nHL, there was little
      attenuation of wave V. When one ear was stimulated at 80 dB nHL, the response of
      the other ear at intensities down to 40 dB was not seriously affected; the
      response at 20 dB nHL was, however, so diminished by contralateral stimulation at
      80 dB that binaural testing would save no time. This method has promise for
      intraoperative monitoring and infant screening, and could be used in threshold
      determination if the stimulus intensities for the two ears are not too
      dissimilar.

PMID- 8344474
TI  - Auditory brain stem responses to air- and bone-conducted clicks in the
      audiological assessment of at-risk infants.
AB  - Auditory brain stem responses (ABRs) to air- and bone-conducted clicks were used
      to assess the auditory status of 170 at-risk neonates. During the perinatal
      period, 20.6% (35/170 cases) of the at-risk infants failed ABRs to air-conducted
      clicks at 30 dB nHL in at least one ear. Ear-specific results indicated an
      initial failure rate of 15.0% (51/340 ears). Approximately two-thirds (32/51
      ears) of these initial failures showed purely conductive deficits, whereas the
      remaining one-third (19/51 ears) involved suspected sensorineural components.
      Follow-up audiological evaluations were performed for 87.1% (148 cases) of these
      at-risk infants at 4 mo and/or 1 yr corrected age. Based on the initial tests and
      follow-up assessments, the tentative operating characteristics of ABRs to both
      air- and bone-conducted clicks for identification of sensorineural deficits in at
      risk neonates were calculated. It was found that the ABR to bone-conducted clicks
      yielded better specificity, predictive value of positive results, and overall
      efficiency. It is suggested that the ABR to bone-conducted stimuli should be
      viewed as a valuable addition in the assessment of cochlear reserve in infants
      who fail a newborn auditory screening to air-conducted stimuli.

PMID- 8344475
TI  - Temporal masking of human auditory evoked brain stem responses using two
      simultaneously presented maximum length sequences.
AB  - Two simultaneously presented maximum length sequences (MLSs) were used to
      investigate temporal nonlinearities. Not only did the recorded auditory evoked
      brain stem responses to these stimuli predictably increase in latency and
      decrease in amplitude as a function of the temporal interactions between MLSs,
      but thresholds were elevated by more than 20 dB. Simultaneous MLS paradigms make
      it possible to investigate a number of nonlinearities in the auditory system
      efficiently. This study also demonstrated that binaural MLS techniques can be
      used to assess auditory function even in individuals with asymmetric hearing
      losses without fear of crossover effects.

PMID- 8344476
TI  - Frequency discrimination in listeners with sensorineural hearing loss.
AB  - The difference limen for frequency (DLF) was measured in both ears of 34 hearing
      impaired subjects at the octave and interoctave frequencies between 500 and 4000
      Hz. In agreement with previous studies of DLF in the hearing impaired, there was
      only a moderate correlation (0.49) between DLF/F and hearing threshold level
      (HTL). Correlation and regression analyses at the individual frequencies,
      however, indicated that DLF/F is much more closely related to HTL at 1000 Hz and
      above than it is below 1000 Hz. Comparison of the right-left ear differences in
      DLF and HTL revealed some large DLF differences where there was no HTL difference
      and some large HTL differences where no DLF difference was found. The lack of a
      strong relationship between DLF and HTL asymmetries indicates that the structures
      that limit the DLF and the HTL may, at the same frequency, be damaged differently
      in each ear of the same subject.

PMID- 8344477
TI  - A videotape analysis procedure for assessing conversational fluency in hearing
      impaired adults.
AB  - This article describes a method for analyzing conversational difficulties and
      communication breakdown management in hearing-impaired adults and their
      communicative partners. The focus of the analysis is placed on the examination of
      conversational floor control, the proportion of repaired and nonrepaired
      communication breakdowns, and the strategies used by each member of the dyad to
      repair breakdowns. A case study illustrating the application of the procedure for
      aural rehabilitation is presented.

PMID- 8344478
TI  - Speech recognition in noise by children with minimal degrees of sensorineural
      hearing loss.
AB  - It is well recognized that the acoustical environment in a classroom is an
      important variable in the psychoeducational achievement of hearing-impaired
      children. To date, however, there remains a paucity of information concerning the
      importance of classroom acoustics for children with minimal degrees of
      sensorineural hearing loss (SNHL). The present investigation examined the effects
      of commonly reported classroom signal to noise ratios (+6, +3, 0, -3, and -6 dB)
      on the sentence recognition of 20 normal-hearing children and 20 children with
      minimal degrees of SNHL (i.e., pure-tone averages of 15-30 dB HL through the
      speech frequency range). Results indicated that children with minimal degrees of
      SNHL obtained poorer recognition scores than normal-hearing children across most
      listening conditions. Moreover, the performance decrement between the two groups
      increased as the listening environment became more adverse. Educational
      implications of these data, such as acoustical modification of the classroom
      and/or the utilization of frequency modulation sound field amplification systems,
      are discussed.

PMID- 8344479
TI  - Is disordered speech production a consequence of adventitious deafness? A comment
      to Leder and Spitzer.

PMID- 8344480
TI  - Tumor suppressor genes--the hope.

PMID- 8344481
TI  - Genes that can antagonize tumor development.

PMID- 8344482
TI  - Tumor suppressor genes studied by cell hybridization and chromosome transfer.
AB  - Although the cloning of tumor suppressor genes has proved to be an arduous task,
      often involving several years of labor intensive cloning strategies, a greater
      understanding of neoplastic progression will be made once the function and role
      of these genes have been sorted out. To fully appreciate the state at which this
      field of research currently is, however, one must understand that the road to
      tumor suppression was paved by both somatic cell hybridization and chromosome
      transfer studies. Although regarded by many as laboratory artifact, somatic cell
      hybridization has provided strong circumstantial evidence, if not formal proof,
      for the existence of tumor suppressor genes. In further reducing the complexity
      associated with whole genome transfer, single chromosome transfer was
      subsequently developed as a refinement to this technique so that one could
      unequivocally correlate suppression with a particular chromosome. We have learned
      from these studies that single chromosomes harbor the genetic information
      necessary to reverse the malignant phenotype associated with cancer cells.
      Furthermore, multiple tumor suppressor loci are now known to exist, with one to
      several different loci associated with a given tumor type. In this review, we
      present evidence for tumor suppressor genes and discuss the early studies that
      led to their discovery.

PMID- 8344483
TI  - Mechanisms of reversion.
AB  - Reversion of transformed cells provides biological system useful in multiple
      areas of cancer research. First, reversion can be induced by inhibiting the
      activities of specific oncogenes or replacing intact tumor suppressor genes, and
      such experiments yield important insights into the roles of these genes in
      carcinogenesis and normal growth regulation as well as the functional
      relationships between these genes and other known genes. Second, novel genes
      involved in growth regulation can be discovered by isolating revertants from
      transformed cells after mutagenesis or DNA transfection and then characterizing
      the genes responsible for the non-transformed phenotype. Third, potential anti
      cancer drugs can be screened by reversion assay using cells transformed by
      specific oncogenes. The novel genes and chemicals discovered through these
      studies serve as valuable tools that help our understanding of how cells regulate
      their growth and differentiation.

PMID- 8344484
TI  - Speculations on the roles of RB1 in tissue-specific differentiation, tumor
      initiation, and tumor progression.
AB  - Studies of retinoblastoma clearly identify mutation of the RB1 gene on chromosome
      13 as the primary cause of this cancer. However, all retinoblastoma tumors have
      an abnormal karyotype (1, 2) indicating the presence of additional mutations and
      suggesting that mutation of both RB1 alleles is insufficient for development of
      retinoblastoma. In addition, analysis of RB1 expression and of RB1 mutations in
      different tumors leads to the following dilemma: while the RB1 gene product,
      p110RB1, is expressed in most dividing cells, germline mutations inactivating the
      function of p110RB1 predispose primarily to retinoblastoma and to a lesser extent
      to osteosarcoma, but do not predispose to cancer in general. However, many tumors
      contain somatic mutations that disrupt RB1 function. Thus, we are faced with the
      unusual situation in which germline mutations in the RB1 gene predispose to a
      very limited set of cancers, but somatic mutations in RB1 appear to contribute to
      malignancy in many tissues. We propose that the role of the RB1 gene is to
      maintain the cells in a stable, quiescent state required for terminal
      differentiation and that the effect of RB1 mutations in different tissues depends
      on the pattern of differentiation in that tissue. In tissues where
      differentiation follows a linear process from undifferentiated precursors to
      fully differentiated cells, loss of RB1 function during early stages of
      differentiation may lead to uncontrolled growth and the development of cancer. On
      the other hand, in cell renewal systems where cell number is usually maintained
      by a process of programmed cell death (PCD) or apoptosis, loss of RB1 function
      may lead to cell death.

PMID- 8344485
TI  - A comparison of the biological activities of wild-type and mutant p53.
AB  - Tumorigenesis is characterized by a series of genetic alterations in both
      dominant oncogenes and tumor suppressor genes. A hallmark of tumor suppressor
      genes is that both alleles are generally altered during transformation, which
      usually represents a loss of function phenotype. The p53 tumor suppressor gene is
      the most frequently affected gene detected in human cancer. There is now growing
      evidence suggesting that mutation of p53 may involve not only a loss of function
      of wild-type p53 activity but also a gain of function phenotype contributed by
      the mutant p53 protein. The study of the biological properties and functions of
      both wild-type and mutant p53 is central to our understanding of human cancer.
      These properties and functions of wild-type and mutant p53 will be compared and
      contrasted here and elsewhere within this thematic issue. In addition, the
      mechanisms of inactivation of p53 function, which include: 1) mutation, 2)
      inhibition by viral oncogene products, 3) inhibition by cellular regulators, and
      4) alteration in subcellular localization, will be discussed.

PMID- 8344486
TI  - Interactions between SV40 large-tumor antigen and the growth suppressor proteins
      pRB and p53.
AB  - The oncogenic property of simian virus 40 depends in large part on the function
      of the virus-coded T-antigen. Although the precise mechanism of how T functions
      during neoplastic transformation is not clear, some answers to this question may
      lie in our understanding the nature of the proteins found to complex with T. The
      cellular protein p53 is perhaps the most extensively studied protein in this
      regard. Recently, p53 was defined as a growth suppressor protein. At about this
      same time, T was found to complex with another cell growth suppressor protein,
      the product of the retinoblastoma susceptibility gene. It has since become
      apparent that complex formation between these proteins affects their individual
      growth-modulating activities. Quite often this alteration of activity correlates
      with an uncontrolled proliferative state of the cell. Thus, transformation by
      SV40 is thought to involve complex formation between the viral T oncoprotein and
      cellular growth suppressor proteins. This complex formation is believed to result
      in nullification of the growth suppressor protein properties, thus increasing the
      propensity of the cell toward uncontrolled growth, the hallmark of neoplastic
      transformation.

PMID- 8344487
TI  - Interaction of adenoviral proteins with pRB and p53.
AB  - The transforming gene products of the small DNA tumor viruses subvert host cell
      growth control mechanisms by binding to specific cell regulatory proteins. These
      include the retinoblastoma gene product (pRB) and p53. One indication of the
      pivotal roles played by these regulatory products is the observation that they
      are each targeted consistently by viruses of several groups, by adenoviruses, the
      human papillomaviruses, and the papovaviruses. In adenovirus, pRB and p53 are
      targeted by the E1A and E1B genes, respectively. The genetic probes made possible
      by manipulation of the virus genes in vitro have helped to illuminate the
      pathways in which pRB and p53 function. E1A studies have contributed to our
      current understanding that the retinoblastoma product is one of a family of
      related proteins, which with associated cyclins and kinases can modulate the
      activity of the cellular E2F transcription factor. E1B studies have helped
      explore models of p53 function, including the suggestion that p53, probably
      through aspects of its transcription regulating activity, can initiate a pathway
      in which programmed cell death can be invoked to stop unrestricted cell
      proliferation.

PMID- 8344488
TI  - Multiple steps in carcinogenesis involving alterations of multiple tumor
      suppressor genes.
AB  - Recent advances in molecular genetics have made it possible to understand the
      molecular mechanisms of human cancer progression. The results indicate that
      clinically evident tumor cells already carry multiple genetic alterations and
      further accumulation of genetic alteration occurs during tumor progression. It is
      widely accepted that tumor suppressor genes play a central role in the genesis
      and progression of human cancers, as frequent alterations of tumor suppressor
      genes have been found in a variety of human cancers. Molecular analyses of
      various stages of human cancers, from precancerous lesions to advanced or
      metastatic tumors, indicate that sequential accumulation of genetic alterations
      correlates with more malignant phenotypes of tumor cells. Furthermore, biological
      studies of tumor suppressor genes have revealed that a single gene defect is not
      sufficient for the cells to gain growth advantage and start clonal expansion in
      vivo. These results are consistent with the concept of human multistage
      carcinogenesis, indicated by experimental animal models and epidemiological
      studies. Although it is supposed that there are more than 20 tumor suppressor
      genes in the human genome, only a few tumor suppressor genes have been identified
      to date. Thus, further studies should focus on the identification and
      characterization of novel tumor suppressor genes, and molecular analysis of those
      genes in human cancer would be of great help in clarifying the multiple steps in
      the process of human carcinogenesis.

PMID- 8344489
TI  - Gene and chromosomal alterations associated with the development of human
      gliomas.
AB  - The development of a malignant tumor generally entails a series of events that
      damage the genome of a somatic cell and result in the malignant phenotype. These
      events chronicle the malignant progression of a tumor; a dynamic process in which
      more aggressive and growth-deregulated cell populations are constantly evolving.
      Gliomas, the most common primary tumors of brain, are known to become
      increasingly malignant with time. Within recent years, several details of the
      molecular genetic events associated in their progression have been determined.
      The earliest events of glioma progression include loss of genetic information
      from the long arms of chromosomes 13 or 22, or the short arm of chromosome 17 for
      which targeting of the TP53 (p53) gene has been indicated. Loss of a single
      complement of type I interferon (IFN) genes from 9p and loss of genetic
      information from 19q are seen in the tumors of intermediate malignancy grade.
      Events associated with the most malignant of glial tumors include loss of the
      second, type I IFN gene complement, loss of genetic information from chromosome
      10, and gene amplification (most commonly the epidermal growth factor receptor,
      in 40% of cases). These findings have helped elucidate the events associated with
      glial tumorigenesis, and through the identification of specific genes, have
      provided a starting point for investigating the molecular biology of central
      nervous system neoplasia.

PMID- 8344490
TI  - RB1 protein in normal and malignant human colorectal tissue and colon cancer cell
      lines.
AB  - The pattern of human retinoblastoma (RB1) gene protein expression was directly
      examined in normal and malignant human colorectal tissues and in seven colorectal
      carcinoma cell lines by immunohistochemistry using the mouse monoclonal antibody
      (RB-MAb-1) directed against the retinoblastoma protein (RB). This is the first
      demonstration of RB immunostaining in adult human colonic epithelium and
      colorectal carcinomas. Specificity using RB-MAb-1 was confirmed by western blot
      analysis, which showed bands of 110-116 kDa corresponding to the sizes of
      unphosphorylated and phosphorylated RB. RB staining of normal adult colonic
      epithelium was confined to the nucleus and was most intense in the transitional
      zone of the crypt, whereas lumenal cells (fully differentiated) were RB negative.
      Primary colorectal carcinomas and all the colon cancer cell lines stained
      positively for nuclear RB, but the expression was heterogeneous with varying
      fractions of RB negative cells present. Because we and others have previously
      shown that loss or inactivation of the RB1 gene is infrequent in colorectal
      carcinomas, reduced RB expression in such cells is probably due to a cellular
      regulatory mechanism. For example, RB negative cells may be those in early-G1
      phase (known to have reduced RB levels) or growth-arrested cells that have
      differentiated. The ability to directly detect RB in primary colorectal
      carcinomas will permit assessment of whether heterogeneous expression of the RB1
      gene product has prognostic significance for survival of patients with this
      cancer.

PMID- 8344491
TI  - Genetic background alters the spectrum of tumors that develop in p53-deficient
      mice.
AB  - Using gene targeting in embryonic stem cells, we have generated mice with one or
      two null p53 germ line alleles. Mice with both p53 alleles inactivated are
      developmentally normal but highly susceptible to the early development of
      spontaneous tumors. Initial studies were performed in mice with a mixed inbred
      genetic background (75% C57BL/6 and 25% 129/Sv) (Donehower et al., Nature
      (London) 356, 215-221, 1992). To study the effect of genetic background on
      tumorigenesis in p53-deficient mice, we have put the p53 null allele into a pure
      129/Sv background and monitored tumor development. 129/Sv mice with two p53 null
      alleles developed tumors sooner than the mixed genetic background p53-deficient
      animals. The most frequently observed tumor in p53 null mice of both genetic
      backgrounds was a malignant lymphoma. Because the 129/Sv strain has a low
      incidence of lymphoma, the frequent occurrence of lymphomas in all p53 null mice
      suggests that this particular tumor type may be a direct result of p53 loss and
      not a result of a particular genetic background. In addition to malignant
      lymphomas, the 129/Sv p53-deficient mice showed an increased incidence of
      aggressive teratocarcinomas (8 of 18 tumor-bearing males), a tumor type rare in
      virtually all inbred mice except for 129 strains. Thus, it appears that loss of
      p53 may accelerate a prior tumor predisposition and that genetic background can
      play a role in mediating both the rate and spectrum of tumor development in these
      mice.

PMID- 8344492
TI  - Dosage-dependent dominance over wild-type p53 of a mutant p53 isolated from
      nasopharyngeal carcinoma.
AB  - Mutational inactivation of p53, a tumor suppressor gene, is the most common
      genetic alteration found in human cancer. Most mutated p53s either lose tumor
      suppressor function or gain oncogenic activity. We recently reported the
      detection of a heterozygous point mutation of p53 at codon 280 in nasopharyngeal
      carcinoma (NPC) (1), a high-incidence malignancy in southern China and southeast
      Asia. Given its heterozygous state, in which both wild-type and mutated p53 gene
      were expressed, p53-thr280 should function dominantly in the presence of the wild
      type form if it is to play a role in nasopharynx carcinogenesis. We tested this
      dominance hypothesis in the cells of two model systems: 1) human Saos-2 cells
      lacking endogenous p53, and 2) mouse JB6 tumor promotion-resistant cells (P-)
      expressing endogenous wild-type p53. The results showed dosage-dependent
      dominance of p53-thr280 in controlling WT p53-driven transcriptional activity; in
      governing cell growth; and in progressing P- phenotype to tumor promotion
      sensitive (P+) phenotype. This dominant negative effect was seen at a 1:1 (WT:MU)
      ratio and was more striking at a ratio of 1:3. A model is proposed to explain the
      dominant negative effect of mutant p53. We conclude from this study that p53
      thr280 is likely to be dominant in the heterozygous state found in NPC and that
      this dominant-negative mutated p53 may contribute to the genesis of NPC or of
      other carcinomas in which both mutant and wild-type p53 are expressed.

PMID- 8344493
TI  - Hemi- or homozygosity: a requirement for some but not other p53 mutant proteins
      to accumulate and exert a pathogenetic effect.
AB  - Activating mutations within the p53 gene cause stabilization and therefore
      increased steady-state levels of the p53 protein; some, but not all, also result
      in the generation of an epitope recognized by the antibody pAB240. We have shown
      here that in 70% of Burkitt lymphoma cell lines, but not in normal EBV
      transformed B cell lines, p53 protein is readily detectable by Western blot
      analysis using either an antibody directed against the 240 epitope or an antibody
      against wild-type p53. Genomic analysis of these BL cell lines demonstrated the
      presence of mutations within the p53 gene in all cell lines with detectable p53
      protein. We have also shown that in the cell lines ST486, Raji, and TE 110, which
      are heterozygous for a neutral sequence codon polymorphism (Arg/Pro) that causes
      altered migration of an otherwise normal protein and also contain a heterozygous
      mutation, only the protein derived from the mutated allele is stabilized. Thus
      the dominant effect of the mutations present in these cell lines apparently does
      not result from sequestering of the normal protein by the abnormal protein, and
      therefore presumably is a consequence of a gain-of-function resulting from the
      mutation. Although all cell lines with stabilized p53 also contained p53
      mutations, three lymphoid tumors (two cell lines and one fresh B-CLL) with a
      heterozygous mutation at codon 248 did not express elevated levels of p53. In
      contrast, p53 was readily detectable in Western blot analysis from cell lines
      KK124, Namalwa, and CA46, which had homo- or hemizygous mutations at codon 248,
      and from PP1084, a cell line with a codon 273 mutation and a carboxyl-terminal
      truncation in the other allele. These results suggest that mutations at codon
      248, unlike those in cell lines ST486 and TE110, are stabilizing only in the
      absence of the wild-type p53. Heterozygous mutations at codons 248 have been
      described in the germline of individuals belonging to cancer-prone families
      described by Li and Fraumeni (see ref 18), but tumors detected in such
      individuals are homozygous, i.e., contain only mutated p53. This is consistent
      with the possibility that such mutations exert a pathogenetic effect only in the
      absence of the wild-type protein, and are coupled to our findings that
      stabilization of p53 is a necessary component of the oncogenic pathways relevant
      to p53. However, whereas some mutations are stabilizing in the presence of the
      normal p53 protein, others are stabilizing only in the homozygous state.

PMID- 8344494
TI  - Identification of mutations in p53 that affect its binding to SV40 large T
      antigen by using the yeast two-hybrid system.
AB  - The tumor suppressor p53 protein binds to the products of several viral
      oncogenes, including SV40 large T antigen. We reconstructed the p53-T antigen
      interaction in the yeast two-hybrid system, a genetic assay that uses the
      reconstitution of the activity of a transcriptional activator to detect protein
      protein interactions. Using mutants of T antigen known to be defective in binding
      to p53, we demonstrate that the two-hybrid system is more sensitive than
      immunoprecipitation in the detection of weak interactions. We mutagenized the
      murine p53 gene and screened in the yeast assay for decreased reporter gene
      expression indicative of the failure of p53 to bind T antigen. This screen
      identified 34 p53 mutants, almost all of which contain at least one mutation in
      the conserved domains frequently found mutated in human cancers. These results
      support the idea that the function of the wild-type p53 protein requires residues
      involved in binding to T antigen, and indicate that this approach may be
      generally applicable in the analysis of protein-protein interactions.

PMID- 8344495
TI  - Identification by differential display of alpha 6 integrin as a candidate tumor
      suppressor gene.
AB  - A new method of differential expression cloning called differential display (DD)
      has been used to screen for novel tumor suppressor genes involved in breast
      cancer. The screen is based on positive selection at the mRNA level for genes
      expressed in normal mammary epithelial cells but decreased or lost in
      corresponding tumor cells. A candidate tumor suppressor gene recovered by DD is
      integrin alpha-6 (alpha 6), a component of the heterodimeric integrin receptors
      alpha 6 beta 1 and alpha 6 beta 4. Loss of alpha 6 expression was confirmed in
      total RNAs by Northern blot analysis and by immunostaining with alpha 6
      antibodies. Consistent with these cell culture findings, previous immunostaining
      of mammary tissue sections has identified decreased alpha 6 protein expression
      during breast tumor progression. Southern blot analysis demonstrated that alpha 6
      gene is present in tumor cell lines, suggesting that reexpression may be
      inducible by pharmacological intervention. The likelihood that alpha 6 may have
      tumor suppressing activity is supported by growing evidence of a central role for
      integrins in transducing growth control and differentiation signals from growth
      factors and the extracellular matrix (ECM).

PMID- 8344496
TI  - How tumour suppressor genes were discovered.

PMID- 8344497
TI  - Serum and gastric mucosal pepsinogens in atrophic gastritis, particularly in type
      A gastritis associated with pernicious anemia in Japanese.
AB  - The levels of serum pepsinogen I (PG I) and pepsinogen II (PG II) were determined
      by IRMA (immunoradiometric assay) and the ratio of PG I/II calculated in 37
      patients with type A gastritis and concomitant pernicious anemia (PA) and in 97
      with chronic gastritis (type B gastritis) among Japanese. In several patients
      from each group, PG I and PG II in the gastric mucosa were stained by an enzyme
      antibody assay to compare the percentage of positively stained cells with levels
      of serum PG I and PG II. The levels of serum PG I and PG II in chronic gastritis
      decreased as the degree of atrophy increased. Serum PG I and PG II levels in PA
      were lower than those of patients with severe atrophy. Most of serum PG I levels
      in PA were less than 10 ng/ml. The PG I/II ratio also decreased as the severity
      of atrophy increased, distinctly showing that in PA, the ratio were quite low and
      most of them are less than 1.0. Gastric mucosal pepsinogen showed a tendency
      similar to that of serum levels and also refrected the degree of atrophy.
      Therefore, by measuring these parameters it should be easier to determine the
      extent of atrophy, and to establish a serological diagnosis of type A gastritis
      associated with PA.

PMID- 8344498
TI  - Gastric motility and ischemic changes in occurrence of linear ulcer formation
      induced by restraint-water immersion stress in rat.
AB  - The pathogenesis of linear ulceration induced by restraint water-immersion (RWI)
      was investigated in view of gastric motility and early ischemic changes. After
      three hours of restraint-water immersion stress, the cross-sectioned gastric body
      was prepared for light microscopy. Most lesions (90.8%) were present in the
      mucosal folds projecting toward the cavity. Wedge-shaped degeneration in the
      crest of the folds was recognized as an ischemic lesion followed by hemorrhagic
      ulceration. Compressed arterioles were frequently encountered in the muscularis
      mucosae and circular muscle. Generally, mucosal folds appear merely with the
      reduction of gastric content, and run along with the elevation of the circular
      muscle as an anatomical structure, becoming tall and steep after RWI. Marked
      enhancement of contraction, observed with a strain gauge force transducer, was
      induced by RWI. This enhancement was suppressed by papaverine HCl pretreatment in
      accordance with suppression of the fold-related mucosal lesion even after 150 mM
      HCl perfusion into the stomach. In conclusion, gastric motility appears to play
      an important role in the pathogenesis of linear ulceration by causing ischemic
      change along the folds.

PMID- 8344499
TI  - Surgical experience with 5 n3(+) early gastric carcinoma cases.
AB  - Of 370 patients who underwent a resection for early gastric carcinoma, 317
      (85.6%) were N(-), 28 n1(+), 20 n2(+) and five (1.4%) n3 respectively. In this
      study, n3(+) early gastric cancers were clinicopathologically evaluated and sites
      of the metastatic nodes were also defined. In addition, a comparative study in
      DNA ploidy patterns between primary and metastatic node cell was performed
      according to Hedley's method using a FACS-IV scan of paraffin-embedded tissues.
      All n3(+) early gastric cancers showed an aneuploidy pattern. R2 or R3 operations
      are recommended for early gastric carcinomas with aneuploidy pattern and most of
      the metastatic nodes arise from the identical stem cell line of cancer cells.

PMID- 8344500
TI  - Relationship between amino acid transport and protein synthesis in rat isolated
      pancreatic acini under stimulation with cholecystokinin.
AB  - The effects of cholecystokinin octapeptide (CCK8) on amino acid transport and
      protein synthesis in the pancreatic acini were determined. The question of
      whether those effects differed between amino acid transport systems A and L was
      also investigated. The influx of alpha-[3H]aminoisobutyric acid (AIB, system A)
      and [14C]cycloleucine (system L) into isolated rat pancreatic acini and the
      incorporation of [14C]alanine (system A) and [3H]leucine (system L) into
      trichloroacetic acid (TCA)-precipitable protein in pancreatic acini were studied
      in the presence of various concentrations of CCK8. CCK inhibited the amino acid
      transport across the basolateral membrane of pancreatic acini. This effect was
      mediated by Ca2+, and was more responsive to amino acid transport system L than
      to A. CCK also inhibited protein synthesis in pancreatic acini in a dose
      dependent manner. The inhibition of protein synthesis by CCK was thought to be
      mainly due to the inhibition of amino acid transport by CCK. Therefore, the
      predominant utilization of extracellular amino acids in protein synthesis was
      suggested.

PMID- 8344501
TI  - Plasma lipase, C-peptide reactivity and human pancreatic polypeptide responses
      after ingestion of elemental diet in patients with chronic pancreatitis.
AB  - Plasma lipase, C-peptide reactivity (CPR) and human pancreatic polypeptide (HPP)
      responses after ingestion of elemental diet were studied in 27 patients with
      chronic pancreatitis. These subjects were classified into 3 groups according to
      ERP findings; minimum or mild (MIP, n = 17), moderate (MOP, n = 6) and advanced
      (ADP, n = 4). Basal plasma lipase levels in the MIP and MOP patients were
      significantly higher than that in the controls (P < 0.05). Plasma CPR response
      (sigma delta CPR) in MIP cases were significantly higher than that in controls (P
      < 0.05). Also, plasma HPP (response (sigma delta HPP) in MIP cases were
      significantly higher than that in controls (P < 0.05). Plasma CPR and HPP
      responses correlated with the severity of chronic pancreatitis. Fourteen of the
      17 MIP patients (82%) showed higher levels of basal lipase or sigma delta HPP in
      comparison to the respective normal ranges. This study suggested that the ED test
      may be more sensitive for detection of mild chronic pancreatitis and that it may
      be useful for evaluating exocrine and endocrine pancreatic functions in various
      stages of chronic pancreatitis.

PMID- 8344503
TI  - Solitary pedunculated polypoid gastric gland heterotopia.
AB  - A solitary pedunculated gastric polyp in the gastric fundus was removed from an
      asymptomatic 36-year-old woman with normal gastric acid secretion and a normal
      serum gastrin level. This lesion exhibited distinctive histological features
      including prominent proliferation of pseudopyloric glands, fundic glands,
      foveolar epithelium and a fibromuscular stroma. Moreover, its surface was
      entirely covered by a layer of normal gastric epithelium. Biopsies of the
      background mucosa taken from the gastric fundus revealed only mild superficial
      gastritis. A gastric gland heterotopia was diagnosed because of its unique
      morphology.

PMID- 8344502
TI  - Hepatic cholesterol and bile acid synthesis in Japanese patients with cholesterol
      gallstones.
AB  - In Japan the composition of gallstones is changing rapidly from the once
      predominant brown-pigment stones to cholesterol ones. The present work was
      undertaken to clarify the mechanism of cholesterol supersaturated bile production
      in Japanese patients with cholesterol gallstones. In 26 non-obese and
      normolipidemic patients (11 with cholesterol gallstones, 8 with black- or brown
      pigment gallstones, 7 without gallstones) a liver biopsy and hepatic bile were
      surgically obtained under standardized conditions. The cholesterol saturation of
      hepatic bile was significantly higher in cholesterol gallstone patients than in
      gallstone-free controls (195 +/- 10 vs. 146 +/- 8%, respectively; P < 0.01). The
      microsomal activities of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA)
      reductase, the rate-limiting enzyme for cholesterol synthesis, cholesterol 7
      alpha-hydroxylase, the rate-limiting enzyme for bile acid synthesis, and 7 alpha
      hydroxy-4-cholesten-3-one 12 alpha-hydroxylase (12 alpha-hydroxylase), the rate
      limiting enzyme for cholic acid synthesis, were assayed simultaneously in the
      same subjects. There were positive correlations between HMG-CoA reductase and
      cholesterol 7 alpha-hydroxylase activities (Rs = 0.62, P < 0.005), and between
      cholesterol 7 alpha-hydroxylase and 12 alpha-hydroxylase activities (Rs = 0.44, P
      < 0.05) in all subjects, irrespective of the existence of gallstones. The
      activities of the three rate-limiting enzymes did not differ significantly among
      the three groups (cholesterol stone, pigment stone and stone-free). In
      conclusion, the cholesterol supersaturation of hepatic bile in nonobese and
      normolipidemic Japanese patients with cholesterol gallstones does not result from
      an increased hepatic cholesterol synthesis or a decreased bile acid synthesis.

PMID- 8344505
TI  - A case report of celiac axis compression and implications in regional
      chemotherapy for liver metastasis.
AB  - Regional chemotherapy through a catheter placed in the hepatic artery is
      routinely used for treatment of unresectable liver metastasis from colon
      carcinoma. With some frequency, anatomical variations of the hepatic artery,
      including compression of the celiac axis, are found, and must be recognized
      preoperatively for appropriate management and placement of the catheter. We
      report a case of a colon cancer patient with multiple liver metastases and
      compression of the celiac axis, who received decompression of the celiac axis and
      catheterization of the hepatic artery.

PMID- 8344504
TI  - Detection of focal nodular hyperplasia of the liver with color Doppler
      ultrasonography.
AB  - A 3-cm lesion indicative of focal nodular hyperplasia (FNH) of the liver was
      coincidentally detected in a 21-year-old female. Ultrasonography (US), computed
      tomography (CT), magnetic resonance (MR) imaging and liver scintigraphy all
      proved nonspecific. However, color Doppler US demonstrated characteristic
      vascular patterns of FNH of the liver, including (a) hypervascularity of the
      mass, (b) an enlarged afferent blood vessel in the tumor with blood flow toward
      the center of the tumor, and (c) arterial pulse waves in all the vessels in the
      lesion, detected by means of the fast Fourier transformation (FFT). With
      selective hepatic angiography, a "spoke-wheel" pattern was revealed. The
      angiographic pattern corresponded well to that shown by color Doppler US. On the
      basis of the findings from these two modalities, the diagnosis of FNH was made.
      This report examines the effectiveness of color Doppler US in the differential
      diagnosis of FNH, compared with other imaging modalities.

PMID- 8344507
TI  - Novel sterol 7 alpha-hydroxylase(s) active towards not cholesterol but side-chain
      oxygenated steroids in liver microsomes.

PMID- 8344506
TI  - Hepatic triglyceride lipase mRNA expression in various liver diseases.

PMID- 8344508
TI  - Depressed mood and care preferences in patients with AIDS.
AB  - Eight hundred ninety-seven patients with AIDS seen in ambulatory settings were
      questioned about whether they would accept a nursing home or a respirator if
      necessary to prolong their lives. Two hundred ninety-one (32.9%) said they would
      accept a nursing home; 102 (11.5%) said they would accept a respirator.
      Acceptability of these life-sustaining interventions was significantly lower in
      those patients who showed evidence of clinical depression on a structural
      screening instrument (nursing home: 29.4% vs 39.5%, p = 0.002; respirator: 9.4%
      vs 14.3%, p = 0.032). Depression remained significant in multivariate models of
      care preferences that controlled for demographics and symptom severity. Based
      upon follow-up interviews conducted an average of 11 months later, subjects who
      were initially depressed and found nursing home care unacceptable were
      significantly more likely to have changed their minds at follow-up if their
      depression was no longer present (45.7% vs 28.4%; p = 0.0005). Findings for
      respirator preferences were similar, but did not attain significance. We conclude
      that assessment for depression is essential when advance directives for care are
      elicited from patients with AIDS.

PMID- 8344509
TI  - Somatization. Why can't we see the forest for the trees?

PMID- 8344510
TI  - Admission patterns of persistent somatization patients.
AB  - Persistent somatization patients put a serious burden on the health care system
      with multiple admissions, tests, surgeries, and medications. This study reports
      on factors relevant to the health-seeking behavior of somatizing patients and
      aspects of the health care system that facilitate their overutilization of health
      resources. Individuals (age 17-49 years) from the general population of two
      Danish municipalities with at least 10 general admissions during an 8-year period
      were studied comparing persistent somatizers with other high utilizers of medical
      admissions. Results are reported on geographical mobility, change in family
      doctors, route and distribution of admissions by time of day or week, discharges
      against medical advice, physical disease overlooked, and distribution of
      admissions to specialties. Although the health-seeking behavior of persistent
      somatizers may in part explain their overutilization of health care resources,
      such overutilization could be reduced and much suffering avoided if physicians
      displayed the same enthusiasm in diagnosing somatization as in ruling out organic
      pathology.

PMID- 8344511
TI  - Culture and psychiatric epidemiology in Japanese primary care.

PMID- 8344512
TI  - Lifetime prevalence of specific psychiatric disorders in a general medicine
      clinic.
AB  - Using a two-stage case identification method, the Japanese version of the General
      Health Questionnaire (GHQ) and the Japanese modified Diagnostic Interview
      Schedule (DIS-JM), patients in a general medicine clinic in Japan were assessed
      for psychiatric disorders (DSM-III categories) during a 12-month period. The
      lifetime prevalence of all psychiatric disorders was 30.6%, excluding tobacco
      dependence. The most prevalent diagnoses were alcohol abuse and dependence 9.4%,
      psychosexual dysfunction 5.9%, and major depressive episode 4.7%. The predominant
      disorders in males were alcohol abuse and dependence and tobacco dependence, and
      in females (aged 55-80 years), the most striking disorder was organic brain
      syndrome. The validity of the GHQ was examined against the DIS-JM based on DSM
      III as external criteria. A cutoff point between 7 and 8 is suggested.

PMID- 8344513
TI  - A survey of psychiatric consultations at a suburban emergency room.
AB  - The utilization of psychiatric crisis teams in urban hospitals is well
      documented. However, little is reported describing patients who use crisis teams
      in suburban general hospital emergency rooms. This is a descriptive survey of
      1707 suburban patient visits. This study relates patient demographics with the
      length of time required to provide crisis intervention and disposition. A
      regression model is used to analyze the duration of service time and utilization
      patterns in relation to eight variables: season, month, day, shift, diagnosis,
      method of payment, age, and disposition. Five predictors are identified as
      significantly relating to the duration of the psychiatric consultation process.
      These predictors may enable hospital administrators and medical staff to plan and
      implement psychiatric emergency room care.

PMID- 8344514
TI  - Establishing a consultation-liaison psychiatry clinical database in an Australian
      general hospital.
AB  - This paper describes the institution of a clinical database in the consultation
      liaison psychiatry service of an Australian general hospital psychiatry unit. One
      of the problems faced was that many researchers and clinicians in Australia use
      the ICD-9 rather than the DSM-III-R classification system. Nevertheless, it was
      possible to use the DSM-III-R-based MICRO-CARES clinical database management
      system in this project. The data obtained during the first 12 months of its use
      are presented. Despite differences in the patient demographic characteristics,
      the data obtained are within the ranges described for North American and European
      sites. The local benefits of such a clinical database are described, and it is
      argued that such a database is also necessary for interhospital and international
      collaborative studies and comparisons.

PMID- 8344515
TI  - Clinical interpretation of the mini-mental state.
AB  - The Mini-Mental Status Examination (MMSE) is a brief, structured test of
      cognitive function. The test is often used as a screening or case-finding
      instrument for the detection of organic mental disorders or cognitive impairment.
      However, many clinicians incorporate the MMSE into their clinical mental status
      examination. In both contexts, cutoff scores are often utilized to interpret the
      results, with scores below the cutoff being interpreted as evidence of cognitive
      dysfunction, and scores above the cutoff being interpreted as evidence against
      such dysfunction. However, when the test is done as part of a mental status
      examination, the application of a cutoff score fails to take account of prior
      clinical information, which is critical to the interpretation of all diagnostic
      tests. In this paper, an alternative approach to interpretation is proposed. In
      the proposed method, guidelines for interpretation are based on the probability
      of being free of organic disease at each potential score. Scores are interpreted
      in terms of their consistency or inconsistency with a prior diagnostic
      impression. This takes prior clinical information and clinical judgment into
      account. Although different from the traditional way of interpreting the MMSE,
      the proposed method can be implemented on an intuitive level and does not require
      mathematical calculations, which are inconvenient at the bedside.

PMID- 8344516
TI  - The use of midazolam for hypnosedative interviews.
AB  - The authors describe three cases in which midazolam was successfully used in
      diagnostic hypnosedative interviews. A discussion comparing and contrasting
      midazolam to other intravenous hypnosedatives is presented. The authors suggest
      that midazolam is an effective agent for diagnostic hypnosedative interviews and
      may be preferable to other agents when posthypnotic recollection of interview
      content is undesirable.

PMID- 8344517
TI  - Hybridization and DNA sequence analyses suggest an early evolutionary divergence
      of related biosynthetic gene sets encoding polyketide antibiotics and spore
      pigments in Streptomyces spp.
AB  - The whiE gene cluster of Streptomyces coelicolor, which is related to gene sets
      encoding the biosynthesis of polycyclic aromatic polyketide antibiotics,
      determines a spore pigment. Southern blotting using probes from three different
      parts of the whiE cluster revealed related gene sets in about half of a
      collection of diverse Streptomyces strains. A 5.2-kb segment of one such cluster,
      sch, previously shown to determine spore pigmentation in Streptomyces halstedii,
      was sequenced. Seven open reading frames (ORFs), two of them incomplete, were
      found. Six of the ORFs resemble the known part of the whiE cluster closely. The
      derived gene products include a ketosynthase (= condensing enzyme) pair, acyl
      carrier protein and cyclase, as well as two of unidentified function. The seventh
      ORF diverges from the main cluster and encodes a protein that resembles a
      dichlorophenol hydroxylase. Comparison with sequences of related gene sets for
      the biosynthesis of antibiotics suggests that gene clusters destined to specify
      pigment production diverged from those destined to specify antibiotics early in
      the evolution of the Streptomyces genus.

PMID- 8344518
TI  - A plasmid system for high-level expression and in vitro processing of recombinant
      proteins.
AB  - A novel plasmid expression system has been constructed that combines two useful
      functions: it facilitates single-step affinity purification of cytoplasmically
      overproduced fusion proteins and the in vitro processing of fusions with IgA
      protease (Igase). The significant features directing the high expression rate of
      pEV41-based gene fusions in Escherichia coli are the lambda pL promoter for
      temperature-regulated transcription and the translation initiation region of the
      bacteriophage MS2 polymerase gene including a downstream box (db) within the
      first few codons of the open reading frame. Fusion proteins generated with this
      system contain a short N-terminal carrier peptide allowing convenient affinity
      purification by means of the His6 peptide. As exemplified by the production of
      the variable heavy (VH) and light (VL)-chain domains of a monoclonal antibody,
      the fusion proteins can be specifically processed with Igase either in purified
      form or simply by incubation with the culture medium of recombinant E. coli
      [pJP10] cells. Chemical cross-linking of processed VH and VL domains resulted in
      a recombinant antibody Fv fragment that can specifically bind to its antigen.

PMID- 8344519
TI  - Construction of new Campylobacter cloning vectors and a new mutational cat
      cassette.
AB  - We have developed new Campylobacter shuttle vectors which are 6.5-6.8-kb plasmids
      carrying Campylobacter and Escherichia coli replicons, a multiple cloning site
      (MCS), the lacZ alpha gene, oriT and either a kanamycin or chloramphenicol
      resistance-encoding gene (KmR or CmR) from Campylobacter which functions in both
      hosts. These vectors can be mobilized efficiently from E. coli into C. jejuni or
      C. coli, and stably maintained in these hosts. Plasmids pRY107 and pRY108 carry a
      KmR marker and 17 unique cloning sites in two different orientations in lacZ
      alpha, allowing easy blue/white color selection. Plasmids pRY111 and pRY112
      contain a CmR gene and 17 unique sites in both orientations. In addition, MCS are
      flanked by T7 and T3 late promoters and M13 forward and reverse primer sites,
      facilitating expression in T7 or T3 expression systems and sequence analysis. A
      Campylobacter CmR gene cartridge, bracketed by six restriction sites, has been
      developed for use in site-specific mutagenesis of Campylobacter genes.

PMID- 8344520
TI  - Chloroperoxidase-encoding gene from Pseudomonas pyrrocinia: sequence, expression
      in heterologous hosts, and purification of the enzyme.
AB  - The nucleotide sequence of a 1.5-kb fragment of Pseudomonas pyrrocinia DNA
      containing the chloroperoxidase(CPO)-encoding gene (cpo) and its flanking regions
      was determined. The cpo codes for a protein of 278 amino acids (aa). The mature
      enzyme contains no N-terminal methionine, so that the CPO monomer consists of 277
      aa with a calculated M(r) of 30,304. Expression studies showed that the cpo from
      P. pyrrocinia is functionally expressed in Escherichia coli and Streptomyces
      lividans. Based on the overproduction of the CPO in E. coli, a novel and simple
      purification procedure was developed allowing the isolation of about 800-fold
      more CPO per gram of cells than was originally isolated from P. pyrrocinia.
      Comparison with the aa sequence of the bromoperoxidase BPO-A2 from S.
      aureofaciens ATCC10762 revealed an identity of 38%.

PMID- 8344521
TI  - Cloning and expression of a Pseudomonas 3 alpha-hydroxysteroid dehydrogenase
      encoding gene in Escherichia coli.
AB  - A bacterial strain, B-0831, which produced 3 alpha-hydroxysteroid dehydrogenase
      (3 alpha HSD) was isolated and identified as belonging to the genus, Pseudomonas.
      Molecular weights of the purified 3 alpha HSD, determined by SDS-PAGE and by
      chromatography on Sephacryl S-200, were about 25 and 50 kDa, respectively. A
      genomic library of Pseudomonas sp. B-0831, prepared in the plasmid vector
      pACYC184, was screened with probes based on the amino acid (aa) sequence of the
      protein to obtain the plasmid, p3 alpha HSD1, identified by hybridization with
      the probes, that contained a 2.4-kb insert from Pseudomonas DNA. When the 1.4-kb
      SphI fragment of p3 alpha HSD1 was inserted into the vector, pUC118, and
      introduced into Escherichia coli DH1 under the control of lacZ promoter in the
      vector, the transformants produced 200-fold more 3 alpha HSD intracellularly than
      Pseudomonas sp. B-0831. Sequence analysis of the 3 alpha HSD gene revealed that
      an ORF encoding 3 alpha HSD consists of 254 aa, with a calculated M(r) of 25,761,
      suggesting that the enzyme consists of homodimer subunits.

PMID- 8344522
TI  - Cloning and sequencing of the dnaK region of Streptomyces coelicolor A3(2).
AB  - The dnaK homologue of Streptomyces coelicolor A3(2) strain M145 has been cloned
      and sequenced. Nucleotide sequence analysis of a 2.5-kb region revealed an open
      reading frame (ORF) encoding a predicted DnaK protein of 618 amino acids (M(r) =
      66,274). The dnaK coding sequence displays extreme codon bias and shows a strong
      preference for CGY and GGY, for Arg and Gly codons, respectively. The predicted
      DnaK sequence has a high Lys:Arg ratio which is not typical of streptomycete
      proteins. The region immediately downstream from dnaK contains an ORF for a GrpE
      like protein; the predicted start codon of grpE overlaps the last two codons of
      dnaK, indicating that the two genes are translationally coupled. This
      organisation differs from that reported for other prokaryotes.

PMID- 8344524
TI  - Construction of new T vectors for direct cloning of PCR products.
AB  - More than half of the products of PCR contain an extra A residue at the 3' end,
      which is the result of the template-independent activity of Taq polymerase. To
      facilitate cloning of the products of PCR without modification, T vectors, which
      have a single overhanging T residue at the 3' end, have been developed. In the
      present study, we constructed new T vectors which can be prepared in the
      laboratory by simple digestion with the restriction enzymes AspEI or Eam1 105I.

PMID- 8344523
TI  - Construction and characterization of a novel cross-regulation system for
      regulating cloned gene expression in Escherichia coli.
AB  - A novel cross-regulation system employing two pairs of interacting promoter
      repressor systems was constructed using the tac-lacI and lambda pL-cI promoter
      operator-repressor systems. In particular, transcription of the cat gene and the
      fused cI gene is regulated by the tac promoter, while transcription of the lacI
      gene is controlled by the lambda pL promoter. In order to compare CAT production
      from this new system with a currently employed transcription control
      configuration, a control expression vector utilizing the constitutive repressor
      synthesis configuration was also constructed. In this construct, cat is under the
      control of the tac promoter, and lac repressor is provided from a single copy of
      the lacIq allele included in the plasmid. Induction results using different copy
      number vectors indicate that induced cat expression levels are at least twofold
      higher using the cross-regulation system which has very low basal expression.
      These results match well with previous mathematical modeling predictions
      indicating excellent control of basal expression and also higher cloned-gene
      expression post-induction over a broad range of copy numbers for a cross
      regulation control configuration. Induction of the cross-regulation system both
      up-regulated the activation pathway and down-regulated the inhibition pathway,
      shifting the system steady-state from lac repressor expression to cat and cI
      expression. The control strategy presented here should be equally applicable to
      regulate transcription in diverse hosts.

PMID- 8344525
TI  - Sequence of the Escherichia coli K-12 edd and eda genes of the Entner-Doudoroff
      pathway.
AB  - A 3.5-kb DNA fragment from the Clarke and Carbon Escherichia coli genomic clone,
      pLC37-44, was sequenced on both strands. Part of the zwf gene, encoding glucose-6
      phosphate dehydrogenase, and all of the edd and eda genes, encoding 6
      phosphogluconate dehydratase and 2-keto-3-deoxy-6-phosphogluconate aldolase,
      respectively, of the Entner-Doudoroff pathway, were identified. These data are
      compared with those of Egan et al. [J. Bacteriol. 174 (1992) 4638-4646] and
      important differences were noted.

PMID- 8344526
TI  - The Pseudomonas putida ML2 plasmid-encoded genes for benzene dioxygenase are
      unusual in codon usage and low in G+C content.
AB  - Benzene dioxygenase, catalyzing the oxidation of benzene to cis-1,2-dihydroxy
      cyclohexa-3,5-diene, comprises four polypeptides that are encoded by plasmid
      pHMT112 of Pseudomonas putida ML2. In this study, the nucleotide (nt) sequences
      of four genes encoding this enzyme (bedC1C2BA) were determined, and the amino
      acid (aa) sequences were deduced. The sequence showed significant homology with
      the chromosomally encoded benzene dioxygenase and toluene dioxygenase genes (73
      77% for nt and 83-99% for aa), but not the plasmid-encoded naphthalene
      dioxygenase genes (20-26% for nt and 32-36% for aa). A conserved motif (Cys-Xaa
      His-15-to-17 aa-Cys-Xaa2-His, where Xaa is any aa), proposed to bind the Rieske
      type [2Fe-2S] cluster, was identified in the deduced aa sequence of the iron
      sulfur proteins. Three regions were also identified in the flavoprotein which are
      likely to be involved in FAD and NAD+ binding. The gene order of bedC1C2BA is
      consistent with most ring-hydroxylating dioxygenases isolated from Pseudomonas.
      However, the G+C content of 47% is in contrast to the high G+C content of the
      Pseudomonas chromosome (63%) and other Pseudomonas plasmids (57%), and with its
      unique codon usage preference this suggests that bedC1C2BA originated from a host
      derived from a different genus.

PMID- 8344527
TI  - Genetic analysis of a Pseudomonas locus encoding a pathway for
      biphenyl/polychlorinated biphenyl degradation.
AB  - The cistronic organization of the bph locus, encoding a biphenyl/polychlorinated
      biphenyl (PCB) degradation pathway in Pseudomonas sp. LB400, has been elucidated.
      Seven structural genes, encoding biphenyl dioxygenase (bphA1A2A3A4), biphenyl-2,3
      dihydrodiol-2,3-dehydrogenase (bphB), biphenyl-2,3-diol-1,2-dioxygenase (bphC)
      and 2-hydroxy-6-oxo-6-phenylhexa-2,4-dienoate hydrolase (bphD), have been
      located. The complete sequences of bphB, bphC and bphD are reported. Taken
      together with the data of Erickson and Mondello [J. Bacteriol. 174 (1992) 2903
      2912], Pseudomonas sp. LB400 is now the first strain for which the sequences of
      all genes encoding the catabolism from biphenyls to benzoates have been
      determined. Comparisons of the deduced amino acid (aa) sequences of BphB, BphC
      and BphD with those of related proteins led to predictions about catalytically
      important aa residues. Six Bph have been detected and identified. Five of them
      could be obtained as the most abundant proteins when their genes were expressed
      in Escherichia coli.

PMID- 8344528
TI  - Cloning and sequence analysis of a hemolysin-encoding gene from Pseudomonas
      paucimobilis.
AB  - We report the cloning, expression and nucleotide (nt) sequence of a beta
      hemolysin-encoding gene, termed hlyA, from Pseudomonas paucimobilis. A genomic
      DNA library of the pseudomonad was constructed in Escherichia coli using the
      plasmid vector, pUC19. The hlyA gene was cloned by screening for a beta-hemolytic
      phenotype in E. coli transformants and was mapped to a 1100-bp PstI-SmaI
      fragment. The nt sequence analysis of the 1100-bp insert revealed a 789-bp open
      reading frame which is preceded by a 10-nt purine-rich sequence with a possible
      ribosome-binding site of GGA. The ORF terminates with a single UGA stop codon and
      is immediately followed by a large inverted repeat with 27-bp arms which may
      serve as a Rho-factor-independent transcriptional terminator. The hlyA gene codes
      for a protein of 263 amino acids (aa) residues with a deduced relative molecular
      mass (M(r)) of 29,695 and a predicted pI value of 11.5. Expression of hlyA from
      recombinant DNA in E. coli occurred regardless of insert orientation in the
      vector and produced a 29-kDa protein. Confirmation of P. paucimobilis as the
      source of the cloned hlyA gene was determined by DNA hybridization. A search of
      various nt and aa sequence databases revealed no homologues to hlyA or its
      encoded protein.

PMID- 8344529
TI  - A Bacillus subtilis large ORF coding for a polypeptide highly similar to
      polyketide synthases.
AB  - The nucleotide (nt) sequence of 13.6 kb of the outG locus of Bacillus subtilis,
      which maps at approximately 155 degrees between the genetic markers nrdA and
      polC, was determined. One putative coding sequence was identified corresponding
      to a large polypeptide of 4427 amino acids (aa). Structural organization at the
      nt and aa sequence level and extensive similarities of the deduced product,
      especially to EryA, suggest that the locus is potentially responsible for the
      synthesis of a polyketide molecule. The locus has been renamed pksX. Comparison
      of the deduced product with known fatty acid and polyketide synthases (PKS)
      suggested the presence of beta-ketosynthase, dehydratase, beta-ketoreductase and
      acyl-carrier protein domains. Preliminary data obtained with deletion mutants
      indicate that pksX is not an essential gene.

PMID- 8344530
TI  - Cloning and characterization of Neisseria meningitidis genes encoding the
      transferrin-binding proteins Tbp1 and Tbp2.
AB  - Genes tbp1 and tbp2, encoding the transferrin-binding proteins Tbp1 and Tbp2,
      have been isolated from two strains of Neisseria meningitidis. The tbp2 and tbp1
      open reading frames are tandemly arranged in the genome with an 87-bp intergenic
      region, and the DNA region upstream from the tbp2-coding sequence contains
      domains homologous to Escherichia coli promoter consensus motives. Nucleotide
      sequence analysis suggests the existence of a Tbp1 precursor carrying an N
      terminal signal peptide with a peptidase I cleavage site and of a Tbp2 precursor
      with N-terminal homology to lipoproteins, including a peptidase II cleavage site.
      Comparison of the Tbp1 deduced amino acid (aa) sequences from both strains showed
      about 76% aa homology, while those of Tbp2 revealed only about 47% aa homology.
      These comparisons should be extended to other Neisseria strains in order to
      evaluate further this genetic divergence further.

PMID- 8344531
TI  - Characterization of allelic replacement in Streptococcus parasanguis:
      transformation and homologous recombination in a 'nontransformable'
      streptococcus.
AB  - We have obtained transformants of Streptococcus parasanguis FW213 containing
      allelic replacements in several chromosomal loci. Transformation occurred
      following electroporation with nonreplicating plasmids carrying two antibiotic
      resistance-encoding genes, one of which is inserted into DNA homologous to the
      chromosomal target. In contrast with other streptococci, S. parasanguis FW213 is
      not transformed by linear DNA. Mutations in nonreplicating plasmid DNA
      preferentially replaced their homologues in the S. parasanguis FW213 chromosome
      by a double-crossover homologous recombination event, as shown by the fact that
      over 90% of transformants were sensitive to the vector-coded antibiotic marker.
      Southern blot analysis of these transformants showed that three of the five
      target loci had been mutated, and that the wild-type sequence had been replaced
      by the mutated sequence carried on the transforming plasmid. This bias toward
      homologous replacement rather than integration of the entire transforming plasmid
      DNA simplifies site-specific mutagenesis and genetic analysis of the
      streptococcal chromosome.

PMID- 8344532
TI  - Histidine-tagged RNA polymerase: dissection of the transcription cycle using
      immobilized enzyme.
AB  - A stretch of six histidine residues (His6) has been genetically fused to the C
      terminus of the beta' polypeptide of Escherichia coli RNA polymerase. The His6
      tagged beta' subunit assembles into RNA polymerase molecules which perform all
      vital in vivo functions and behave qualitatively normally in vitro. The His6 tag
      permits rapid purification of the enzyme directly from crude cell extracts or
      from an in vitro reconstitution reaction by adsorption to Ni(2+)-chelating
      agarose resin, followed by elution with imidazole. The enzyme bound to the matrix
      remains transcriptionally active. The immobilized enzyme can withstand repeated
      buffer changes without substantial activity loss and permits controlled stepwise
      'walking' of the transcriptional complex along the DNA template, and isolation of
      defined intermediates in the transcription cycle. The immobilized RNA polymerase
      provides a powerful experimental system for structural and functional analysis of
      RNA polymerase and its interaction with regulatory factors.

PMID- 8344534
TI  - [Atmospheric air pollution of Moscow].

PMID- 8344535
TI  - [ Hygienic prognosis of air pollution caused by Kansko-Achinsk thermoelectric
      power plant emission].

PMID- 8344533
TI  - Sequence of a staphylococcal gene, vat, encoding an acetyltransferase
      inactivating the A-type compounds of virginiamycin-like antibiotics.
AB  - The Staphylococcus aureus plasmids, pIP680 and pIP1156, which confer resistance
      to A-type compounds of virginiamycin-like antibiotics (Vml: streptogramin A,
      pristinamycin IIA, virginiamycin M) and to synergistic mixtures of the A and B
      compounds of Vml antibiotics, were shown to direct the modification of A-type
      compounds by acetylation. The vat gene, encoding the acetyltransferase modifying
      A-type compounds, was isolated from plasmid pIP680 and sequenced. This gene
      potentially encodes a 219-amino-acid (aa) protein, VAT, of 24 330 Da showing at
      least 38% aa identity with two chloramphenicol acetyltransferases encoded by cat
      genes isolated from Escherichia coli and Agrobacterium tumefaciens. Resistance to
      A-type compounds of Vml antibiotics conferred to S. aureus by vat was not
      expressed in E. coli, although a protein having a M(r) similar to that encoded by
      this gene was detected in E. coli minicells. The vat gene was detected by the
      polymerase chain reaction in two chromosomally located staphylococcal conjugative
      elements and in the conjugative plasmid, pIP1156, conferring resistance to A-type
      compounds.

PMID- 8344536
TI  - [Evaluation of maximum permissible concentration of melamine in the atmospheric
      air].

PMID- 8344537
TI  - [Hygienic assessment of the waste water disposal in electroplating production].

PMID- 8344538
TI  - [Effectiveness of an electrolysis unit for decontamination of biologically
      purified sewage waters].

PMID- 8344539
TI  - [Hygienic characteristics of the fibrous basalt soil substitutes].

PMID- 8344540
TI  - [Prognosis of development of cardiovascular diseases in managers].

PMID- 8344541
TI  - [Chemiluminescent study of the oxidative metabolism of leukocytes in dust induced
      respiratory diseases ].

PMID- 8344542
TI  - [Hygienic evaluation of workplace conditions at the thermoelectric power station
      in hot climate].

PMID- 8344543
TI  - [Experimental study on maximum allowable concentration of calcium
      carboxymethylcellulose in the air of the working area].

PMID- 8344545
TI  - [Results of experimental introduction of interregional standards for the
      assessment of physical development in children].

PMID- 8344544
TI  - [Physical work capacity of school children of different age, sex, and somatic
      development].

PMID- 8344546
TI  - [Physical development and health status of pre-school children in Orel].

PMID- 8344547
TI  - [Adaptation of the hypothalamo-hypophyseal-adrenal cortex system in children in
      various air pollution conditions].

PMID- 8344548
TI  - [Rationale for the comprehensive sanitary and ecologic index of the quality of
      urban residential section].

PMID- 8344549
TI  - [Ecologic and hygienic problems of environmental pollution by polychlorinated
      bicyclic aromatic hydrocarbons].

PMID- 8344550
TI  - [Physiologic standards of the parameters of peripheral blood and thermoregulation
      in laboratory animals].

PMID- 8344551
TI  - [Ozone in the atmospheric air of Havana].

PMID- 8344552
TI  - [History of the development of national hygiene of children and adolescents].

PMID- 8344553
TI  - [Methods of improvement of postgraduate training of public health physicians in
      the field of Soviet legislation].

PMID- 8344554
TI  - [Educational measurement of hygienic instruction and education of designated
      population groups].

PMID- 8344555
TI  - [History of development of the community hygiene department of the Leningrad
      medical institute of sanitation and hygiene].

PMID- 8344556
TI  - [Present problems of water supply and sanitary protection of reservoirs].

PMID- 8344557
TI  - [History of teaching hygiene at the medical school of Moscow university].

PMID- 8344558
TI  - [History of community hygiene in the USSR].

PMID- 8344559
TI  - [Experience in constructing quizes on environmental protection].

PMID- 8344560
TI  - [Gas-chromatographic determination of triadimenol in the environment and
      biological materials].

PMID- 8344561
TI  - [Analysis of formaldehyde in the water and in model systems].

PMID- 8344562
TI  - [Some problems of toxicology in the assessment of low intensity factors].

PMID- 8344563
TI  - [Stereometry in the evaluation of pesticide action on the gastric mucosa].

PMID- 8344564
TI  - [Mathematical and statistical aspects of the pupillometric information in the
      screening diagnosis systems].

PMID- 8344565
TI  - [Evaluation of epichlorohydrin in biologic media by vapor-phase gas
      chromatography].

PMID- 8344566
TI  - [Prognosis of risk from new pesticides for man].

PMID- 8344567
TI  - [The adaptive principle in radiation hygiene].

PMID- 8344568
TI  - [Research development of problem "Scientific principles of hygiene and physiology
      of human adaptation to conditions of the World's ocean"].
AB  - Work of problem-solving commission on "Scientific background of hygiene and
      physiology of human adaptation to World ocean conditions" is described. Medical
      problems of the water transport as key problems are noted.

PMID- 8344569
TI  - Painful rib syndrome--a review of 76 cases.
AB  - The painful rib syndrome consists of three features: pain in the lower chest or
      upper abdomen, a tender spot on the costal margin, and reproduction of the pain
      on pressing the tender spot. This is a common cause for referral to a general
      medical/gastroenterology clinic, accounting for 3% of new referrals in Lincoln.
      Seventy six consecutive patients were studied. The mean age was 48 years and 70%
      were women. Forty three per cent had been investigated, often extensively, before
      referral, and eight had had a non-curative cholecystectomy. The case notes from
      all patients were reviewed and a follow up questionnaire was sent after a mean
      period of four years to those 72 still alive, of which 56 replied. Thirty nine
      (70%) still had the pain although all except three had learnt to live with it.
      Despite a firm diagnosis being given, 25 (33%) patients were referred again to
      hospital by their general practitioner. All further investigations were negative
      apart from the finding of gall stones in three patients. The four patients who
      died had died from unrelated causes. The painful rib syndrome is common but
      underdiagnosed. It is a safe, clinical diagnosis requiring no investigation.
      Systematic firm palpation of the costal margin in recommended in all patients
      presenting with pain in the lower chest or upper abdomen.

PMID- 8344570
TI  - Inflammatory bowel disease--a radical view.

PMID- 8344571
TI  - Crohn's disease: the genetic contribution.

PMID- 8344572
TI  - Measurement of bicarbonate output from the intact human oesophagus.
AB  - Injury of the oesophageal mucosa can result from exposure to refluxed gastric
      acid and pepsin. Competence of the lower oesophageal sphincter and peristaltic
      activity serve to reduce contract time between luminal acid and oesophageal
      mucosa, but intraluminal neutralisation of residual acid by bicarbonate may also
      be important in preventing oesophageal mucosal injury. Whereas swallowed saliva
      contains bicarbonate, recent experiments have also demonstrated alkali secretion
      from the mammalian oesophagus. Bicarbonate secretion from the human oesophagus
      was therefore examined with an intubation technique and perfusion of the
      oesophagus with a non-absorbable marker. Saliva, gastric, and oesophageal
      aspirates were collected and bicarbonate concentrations determined by
      measurements of pH and pCO2 or by back titration. In 32 normal subjects (17
      women, 15 men) median basal oesophageal bicarbonate secretion determined by a
      pH/pCO2 method was 416 (range 139-1050) mumol/hour/10 cm. In a subgroup of 15
      experiments median oesophageal bicarbonate output was 489 (range 157-1033)
      mumol/hour/10 cm (pH/pCO2 method) compared with a median alkali output of 563
      (range 135-799) mumol/hour/10 cm as determined by back titration. The difference
      was not significant. Salivary contamination of the oesophagus accounted for 25%
      of all bicarbonate measured within the oesophagus and refluxed gastric
      bicarbonate accounted for 2.5%. Bicarbonate secretion from the normal human
      oesophagus may, in combination with swallowed salivary bicarbonate, play a part
      in preventing oesophageal mucosal damage due to refluxed gastric acid and pepsin.

PMID- 8344573
TI  - Fibroblast growth factor in gastroprotection and ulcer healing: interaction with
      sucralfate.
AB  - The study was designed to determine the gastroprotective and ulcer healing
      efficacy of basic transforming growth factor (bFGF) and to assess whether this
      peptide contributes to the action of sucralfate on the rat stomach. Application
      of human recombinant bFGF (1-100 micrograms/kg/hour subcutaneously) failed to
      affect the formation of acute gastric lesions induced by 100% ethanol and
      acidified aspirin but reduced the stress induced by gastric lesions. Sucralfate
      (100-200 mg/kg given orally) protected gastric mucosa against the ethanol,
      aspirin, and stress induced acute gastric lesions but the addition of bFGF (100
      micrograms/kg subcutaneously or intragastrically) failed to affect sucralfate
      induced protection against ethanol or aspirin but increased that against stress.
      Administration of bFGF (3-300 micrograms/kg/day) by an intragastric or an
      intraperitoneal route or sucralfate (400 mg/kg/day) orally to rats with acetic
      acid induced gastric ulcers, enhanced the healing rate of these ulcers during
      seven day treatment in a dose dependent manner. This was accompanied by a
      pronounced increase in the number of capillaries and myofibroblasts and in DNA
      synthesis and DNA and RNA concentrations in the granulation tissue in the ulcer
      area. [125I]bFGF (1 microCi) applied subcutaneously or intragastrically
      accumulated in two to threefold higher amounts in the ulcer area than in the
      intact mucosa, particularly in rats treated with sucralfate. Concurrent treatment
      with indomethacin (2 mg/kg intraperitoneally) delayed ulcer healing and reduced
      the binding of labelled bFGF to the ulcer area, angiogenesis, and DNA synthesis
      by sucralfate. Addition of [125I]bFGF to sucralfate at various pHs resulted in
      the coprecipitation of bFGF by sucralfate in a pH dependent manner from about 10%
      at pH 7.0 to 90% at pH 1.5. Thus bFGF shows little protective activity and is not
      essential for gastroprotection afforded by sucralfate but plays an important part
      in healing of gastric ulcers possibly due to its growth promoting and angiogenic
      actions.

PMID- 8344574
TI  - Acid secretion and sensitivity to gastrin in patients with duodenal ulcer: effect
      of eradication of Helicobacter pylori.
AB  - The effect of ulcer healing with eradication of Helicobacter pylori (H pylori) on
      gastric function was investigated in nine patients with duodenal ulcer disease.
      One month after eradication there were significant reductions in both basal
      plasma gastrin concentration, from a median (range) of 19 (1-22) to 6 (2-15)
      pmol/l (p < 0.05), and of basal acid secretion from 8.3 (2.4-24) to 2.6 (1.4-8.1)
      mM H+/h, (p < 0.01). The peak acid secretion rate was unchanged from 37 (16-59)
      to 37 (21-59) mM H+/h. After treatment there was no change in the parietal cell
      sensitivity to stepped infusions of gastrin heptadecapeptide: the median
      concentration of gastrin required for 50% of maximal acid secretion (EC50) was 41
      (14.8-126) before and 33 (23-125) pmol/l after eradication of H pylori. The
      metabolic clearance rate of gastrin was also unaffected by the eradication of H
      pylori. Thus eradication of H pylori infection from patients with active duodenal
      ulcers is accompanied by falls in both basal gastrin release and basal acid
      secretion without a change in the parietal cell sensitivity to gastrin. Cyclical
      changes in H pylori infection may cause the variations in basal acid secretion
      that are seen in duodenal ulcer disease.

PMID- 8344575
TI  - Study of the proliferation in human gastric mucosa after in vivo
      bromodeoxyuridine labelling.
AB  - Studies to measure human gastric crypt or gland cell proliferation may have a
      number of practical clinical applications in relation to both benign and
      malignant gastric conditions. Bromodeoxyuridine (BrdUrd) labels human gastric
      mucosal cells in the S phase. Computer aided data analysis of labelled mucosa
      allows static proliferative indices to be estimated, including the crypt
      labelling index (LI), the peak labelling position, the distribution of labelled
      cells and indirectly the crypt growth fraction. Multiparameter flow cytometric
      analysis of labelled nuclei allows the S phase duration (Ts) of mucosal cells to
      be estimated. Specimens of histologically normal gastric body (GB, n = 16) and
      antral mucosa (GA, n = 10) were obtained from 25 patients with gastric carcinomas
      who received a bolus dose of 250 mg BrdUrd between 3.0 and 15.7 hours before
      surgery. Tissue sections were stained by an immunohistochemical method and
      subjected to detailed counting of up to 50 longitudinal crypts per specimen. The
      total crypt labelling index was calculated by a grid counting method. A
      significant difference existed between the proliferative compartments of gastric
      antral and body mucosa measured by a number of criteria. The median lengths of
      the crypts were 137 cells (GB) and 188 cells (GA). The median peak labelling
      positions were cell 26 (GB) and cell 61 (GA) from the crypt orifice. The mean
      crypt labelling indices were 2.8% (GB) and 4.8% (GA). The mean Ts of GA cells was
      7.7 hours and of GB cells was 10.8 hours.

PMID- 8344576
TI  - Ablation of capsaicin sensitive afferent nerves impairs defence but not rapid
      repair of rat gastric mucosa.
AB  - Capsaicin sensitive afferent neurones have previously been reported to play a
      part in gastric mucosal protection. The aim of this study was to investigate
      whether these nociceptive neurones strengthen mucosal defence against injury or
      promote rapid repair of the damaged mucosa, or both. This hypothesis was examined
      in anaesthetised rats whose stomachs were perfused with ethanol (25 or 50% in
      saline, wt/wt) for 30 minutes. The gastric mucosa was inspected 0 and 180 minutes
      after ethanol had been given at the macroscopic, light, and scanning electron
      microscopic level. Rapid repair of the ethanol injured gastric mucosa (reduction
      of deep injury, partial re-epithelialisation of the denuded surface) took place
      in rats anaesthetised with phenobarbital, but not in those anaesthetised with
      urethane. Afferent nerve ablation as a result of treating rats with a neurotoxic
      dose of capsaicin before the experiment significantly aggravated ethanol induced
      damage as shown by an increase in the area and depth of mucosal erosions. Rapid
      repair of the injured mucosa, however, as seen in rats anesthetised with
      phenobarbital 180 minutes after ethanol was given, was similar in capsaicin and
      vehicle pretreated animals. Ablation of capsaicin sensitive afferent neurones was
      verified by a depletion of calcitonin gene related peptide from the gastric
      corpus wall. These findings indicate that nociceptive neurones control mechanisms
      of defence against acute injury but are not required for rapid repair of injured
      mucosa.

PMID- 8344577
TI  - Effect of gastro-oesophageal reflux on upper oesophageal sphincter motility in
      children.
AB  - Motor events of the upper oesophageal sphincter associated with gastro
      oesophageal reflux were evaluated in 53 symptomatic children (median age 13
      months) who were studied recumbent and unsedated. Children were divided into four
      groups according to symptoms, and then into two groups according to the presence
      or absence of neurological deficit. No grouping had basal upper oesophageal
      sphincter pressure that differed significantly from any other. Oesophageal
      distention due to gastro-oesophageal reflux, which was recognisable as
      oesophageal common cavity episodes, was associated with augmentation of mean
      basal upper oesophageal sphincter pressure from 36.5 (SD 18) mm Hg to 48.5 (18)
      mm Hg (p < 0.0001), irrespective of whether gastro-oesophageal reflux caused
      oesophageal acidification. Abrupt relaxations of the upper oesophageal sphincter
      independent of swallowing and lasting up to three seconds occurred during 54% of
      common cavity episodes. Forty nine per cent of these relaxations occurred within
      four seconds after the onset of distention. The oesophageal distention caused by
      gastro-oesophageal reflux is a potent stimulus of transient upper oesophageal
      sphincter relaxations in children. These relaxations are a more likely
      explanation for oesophagopharyngeal reflux than defective basal upper oesophageal
      sphincter tone.

PMID- 8344578
TI  - Isotope gastric emptying tests in clinical practice: expectation, outcome, and
      utility.
AB  - Tests of gastric emptying with modern scintigraphic methods are recommended in
      the clinical management of gastric disorders. An audit of 472 gastric emptying
      tests carried out over a 10 year period was performed to discover the reasons for
      requests from consultant clinicians, their anticipation of the results of tests,
      and the influence of the results upon the subsequent management of their
      patients. Excluding control (n = 47) and research (n = 50) studies, there were
      375 clinical referrals that could be grouped under the headings: non-ulcer
      dyspepsia (n = 72), suspected diabetic gastroparesis (n = 18), peptic ulcer (n =
      15), suspected delayed gastric emptying after surgery (n = 154), dumping and
      diarrhoea (= 107), and other indications (n = 9). Although the results were
      abnormal for 55 (48%) of the 'medical' patients, they did not seem to influence
      clinical management. Delayed gastric emptying after surgery was confirmed in only
      20% of patients referred with this clinical diagnosis. Conversely, most (79%) o
      the patients referred with dumping and diarrhoea exhibited abnormally rapid
      emptying. Isotope gastric emptying studies may be useful in clinical practice.
      The results are often at variance with the clinical diagnosis. Clinicians must
      take into account the nature of the test meal used when results are correlated
      with clinical features.

PMID- 8344579
TI  - Evidence of a dominant role for low osmolality in the efficacy of cereal based
      oral rehydration solutions: studies in a model of secretory diarrhoea.
AB  - Clinical trials suggest that including naturally occurring complex carbohydrate
      in oral rehydration solutions (ORS) in place of glucose increases water
      absorption and reduces stool volume during acute diarrhoea. The mechanisms for
      this greater clinical efficacy has not been established. This study examined the
      ability of two hypotonic rice based ORS, RS-ORS (137 mOsm/kg) and RP-ORS (143
      mOsm/kg), and HYPO-ORS (240 mOsm/kg) a glucose equivalent ORS, to effect water
      absorption by in vivo perfusion of normal and secreting rat small intestine. The
      results were compared with those for two widely used conventional hypertonic ORS,
      WHO-ORS (331 mOsm/kg) and UK-ORS (310 mOsm/kg). In the normal intestine, water
      absorption was similar from WHO-ORS (87.4 (45.1-124.6) microliters/min/g; median
      and interquartile range) and UK-ORS (57.6 (41.5-87)) but less than from the
      hypotonic solutions (p < 0.02); water absorption from RS-ORS (181.8 (168.5
      193.8)) and RP-ORS (195.7 (179.3-207.9)) was similar but less than from HYPO-ORS
      (241.3 (230.6-279.7); p < 0.005). In the secreting intestine, all ORS reversed
      net secretion of fluid to net absorption; the hypotonic solutions, HYPO-ORS
      (105.2 (95.2-111)), RS-ORS (127.7 (118.3-169.4)) and RP-ORS (133.7 (122.1
      174.5)), produced more water absorption (p < 0.005) than the hypertonic solutions
      WHO-ORS (47.1 (29-75.9)) and UK-ORS (24.9 (18.4-29.4)). The rice based ions
      promoted most water absorption in secreting intestine (p < 0.007). These data
      indicate that low osmolality is of primary importance in mediating the increased
      water absorption from cereal based ORS.

PMID- 8344580
TI  - Glycosylation and sulphation of colonic mucus glycoproteins in patients with
      ulcerative colitis and in healthy subjects.
AB  - Studies have been made of mucus glycoprotein biosynthesis in different regions of
      the lower gastrointestinal tract in normal patients and those with ulcerative
      colitis (UC), active or inactive, by means of 3H-glucosamine (3H-GlcNH2)--35S
      sulphate double labelling of epithelial biopsy specimens under culture
      conditions. The time based rate of 3H-GlcNH2 labelling of mucus in rectal tissue
      was similar to that in active or inactive UC whereas the rate of 35SO4(2)
      labelling was significantly increased in active disease. The 3H specific
      activities measuring the amount of isotopic incorporation into surface and tissue
      mucus glycoproteins were increased in patients with active UC compared with
      normal or inactive subjects. The 35S specific activities did not differ
      significantly between patients with active UC and those in remission. In the
      rectum, glycosylation of mucus glycoproteins decreases with the increasing age of
      the patient. Regional differences in 3H-labelling of mucus components are
      reported for ascending colon, transverse colon, sigmoid colon, and rectum.
      Sulphation (35S-labelling) was higher in all parts of the colon in left sided UC.
      Results point to accelerated glycosylation of core proteins in the active phase
      of UC.

PMID- 8344581
TI  - Serum carnitine concentrations in coeliac disease.
AB  - Carnitine is essential for muscle energy production and is required for the
      transport of long chain fatty acids and acyl co-enzyme A derivatives across the
      inner mitochondrial membrane. Recently, an absorptive transport mechanism was
      discovered at the small bowel level suggesting the possibility of a carnitine
      deficient state in patients with mucosal damage. Therefore, this study
      investigated carnitine concentrations in serum of patients with coeliac disease.
      Serum samples were obtained from 12 patients with active coeliac disease and
      seven with non-active disease, and compared with serum samples of 17 children
      with gastrointestinal symptoms but with a small bowel normal on biopsy
      examination and 33 normal controls. Total serum carnitine concentration was
      significantly lower in the patients with coeliac disease compared with the other
      two groups and to reference values. When the degree of atrophy of coeliac
      intestinal mucosa was numerically graded, serum carnitine concentrations did not
      correlate to the degree of the intestinal lesion but were significantly lower in
      the damaged intestine compared with the group with normal mucosa. It is suggested
      that coeliac disease should be considered as a potential cause of secondary
      carnitine deficiency.

PMID- 8344583
TI  - Restorative proctocolectomy with end to end pouch-anal anastomosis in patients
      over the age of fifty.
AB  - This study was to examine whether 'fit' patients over the age of 50 who require
      elective surgery for ulcerative colitis are suitable candidates for restorative
      proctocolectomy, providing that they are continent before operation and that the
      anal sphincter is preserved in its entirety without stripping of the mucosa or
      endoanal anastomosis. Between 1986 and 1991, 18 patients 50 to 66 years old
      (median 55 years: nine men) underwent restorative proctocolectomy with end to end
      ileoanal anastomosis without mucosal stripping (12 quadruplicated (W), four
      duplicated (J), two no reservoir). The results were compared 12 (range three to
      24) months later with those of 18 matched patients who were less than 50 years of
      age (median 34 years). In patients over 50, median resting anal pressure was 88
      (range 44-131) cm water before and 80 (47-138) cm water after the operation (NS).
      In patients under 50, median resting anal pressure was 76 (51-128) cm water
      before and 77 (36-137) cm water after operation (NS). Resting anal pressure in
      older patients did not differ significantly from that in younger patients either
      before or after the operation. Both sensory and reflex anal functions were
      preserved as well after operation in the older patients as in the younger ones.
      The clinical results in patients over 50 were slightly inferior to the results
      for the younger patients, but the difference was small and not significant. Hence
      age alone is not a contraindication to restorative surgery provided that the anal
      sphincter is preserved in its entirety.

PMID- 8344582
TI  - Growth and clinical course of children with Crohn's disease.
AB  - Growth impairment is a common complication of childhood Crohn's disease, but
      longitudinal data and follow up studies into adulthood are sparse. This study
      reviewed the records of 100 Tanner stages 1 and 2 children (66 males, 34 females)
      consecutively diagnosed with Crohn's disease at this hospital between January
      1980 and June 1988. The influence of sex, anatomical location of disease,
      severity of symptoms, corticosteroids, and surgical intervention on growth were
      analysed by univariate and multivariate regression analysis. At diagnosis mean
      standard deviation score (SDS) for height was -1.11 (1.28) (males -1.14 (1.26),
      females -1.05 (1.33)). Twenty one children were below the third centile for
      height. During years one and two height velocity (cm/y) was 4.4 (2.3) and 5.1
      (2.7), but 40% of children in year one and 33% of children in year two grew less
      than expected (< 4 cm). Forty nine children grew < 4 cm/y during two or more of
      the 4.9 (1.8) years of follow up. Severity of gastrointestinal symptoms was the
      major factor influencing linear growth velocity (p < 0.01 for years one and two).
      Despite the high prevalence of growth impairment, the subset of children who had
      reached maturity by the time of the study (n = 67) nevertheless maintained their
      height centile. The SDS for height at ultimate follow up was -0.82 (1.1).
      Compared with diagnosis, change in SDS was +0.35 (1.08). Growth increments were
      comparable for surgically treated patients v patients only treated medically and
      among patients stratified by location of disease. Females (n = 25) achieved
      greater catch up growth than males (n = 42). Ultimate SDS for height for females
      was -0.48 (0.91) v -1.02 (1.19) for males. Change in SDS for height was +0.66
      (1.27) for females v +0.16 (0.90) for males (p=0.02). These data confirm the
      frequency of growth impairment in childhood Crohn's disease. After diagnosis,
      however, the prognosis for ultimate linear growth is good.

PMID- 8344584
TI  - Effects of vitamin antioxidant supplementation on cell kinetics of patients with
      adenomatous polyps.
AB  - Colonic crypt cell proliferation is used as an indicator of risk of colorectal
      carcinoma. Subjects with adenomatous polyps and cancer have an increased cell
      proliferation and a shift of the proliferative zone towards the apex of the
      crypt. Epidemiological and in vitro studies have confirmed a link between
      vitamins A, E, C, beta-carotene, and colorectal cancer. In vitro
      bromodeoxyuridine immunohistochemical technique was used to assess the effect of
      daily oral supplementation with vitamin E (160 mg), vitamin C (750 mg), or beta
      carotene (9 mg) on the colonic crypt cell proliferation in patients with
      adenomatous polyps (n = 40) compared with normal subjects with no colonic disease
      (n = 20). The patients were given supplementation for one month and colonic
      biopsy specimens were taken before and at the end of the trial. Patients with
      adenomatous polyps had a significantly higher mean labelling index per cent than
      controls (p < 0.001). Vitamin C or beta-carotene supplementation, however,
      significantly reduced the total proliferation (p < 0.005) whereas vitamin E
      supplementation had no effect on the colonic crypt cell proliferation. beta
      carotene reduced cell proliferation at the base of the crypt only. Vitamin C
      reduced cell proliferation in all the crypt compartments from the apex to the
      base to those values seen in age and sex matched controls. These findings
      indicate that prolonged supplementation with vitamin C may reduce the recurrence
      of adenomatous polyps.

PMID- 8344585
TI  - Transjugular intrahepatic portasystemic stent shunting for control of acute and
      recurrent upper gastrointestinal haemorrhage related to portal hypertension.
AB  - The insertion of a transjugular intrahepatic portasystemic stent shunt (TIPSS)
      was evaluated in 22 patients with recurrent upper gastrointestinal haemorrhage
      related to portal hypertension (bleeding from oesophageal varices 10, gastric
      varices six, portal hypertensive gastropathy six). TIPSS was successfully
      performed electively in 15 patients and as an emergency in three patients. Twelve
      patients have had no further admissions with bleeding after TIPSS. Single
      episodes of bleeding were noted in six patients after TIPSS associated with shunt
      thrombosis (two), intimal hyperplasia within the shunt (two), and shunt migration
      (one). Another patient presented with reaccumulated ascites suggesting poor shunt
      function but died from massive variceal haemorrhage before further assessment
      could be performed. There was one death related to the procedure. Two patients
      developed encephalopathy after TIPSS, in one patient this was controlled by the
      insertion of a smaller diameter stent within the existing TIPSS. Several
      complications arose in earlier patients that have not recurred after modification
      of the initial technique. TIPSS can be life saving and is effective in
      controlling variceal haemorrhage and rebleeding from oesophageal or gastric
      varices and portal hypertensive gastropathy. Larger and longer term studies are
      required, however, to define the role of TIPSS in the overall management of such
      patients.

PMID- 8344586
TI  - Serum concentrations of laminin in cirrhosis of the liver.
AB  - Laminin, a glycoprotein synthesised by Ito cells, has been considered a marker of
      fibrogenesis. The behaviour of laminin and clinical and laboratory data in 83
      patients with cirrhosis were studied to find the factors associated with
      increases in this glycoprotein. There were increased concentrations of laminin in
      62.7% of the patients (40% of the Child's A, 64.5% of the Child's B, and 75% of
      the Child's C categories). Significant differences in laminin concentrations were
      found between the Child's grades (p = 0.009) and between patients and controls (p
      < 0.0001). Correlations were found between laminin concentrations and mean
      corpuscular volume, aspartate aminotransferase, aspartate aminotransferase:
      alanine aminotransferase ratio, alkaline phosphatase activity, bilirubin and
      glycocholic acid concentrations, and hypoalbuminaemia--that is, variables related
      to liver insufficiency and alcohol intake. Moreover, patients with an alcohol
      intake higher than 100 g/day had higher laminin concentrations than those with a
      lower intake (p = 0.03). Conversely, there was no significant association with
      portal hypertension. Multivariate analysis showed that mean corpuscular volume,
      bilirubin concentrations, and hypoalbuminaemia were independently associated with
      laminin concentrations. Poor degradation associated with liver insufficiency
      seems to play an important part in the increase in serum laminin concentrations
      in these patients.

PMID- 8344587
TI  - Inappropriate expression of blood group antigens on biliary and colonic epithelia
      in primary sclerosing cholangitis.
AB  - The distribution of carbohydrate antigens of the ABO, Lewis, and Kell systems was
      examined in biliary and colonic epithelial of 11 patients with primary sclerosing
      cholangitis (PSC) using a panel of 11 monoclonal antibodies. Controls consisted
      of 27 liver biopsy specimens (11 normal, six alcoholic liver disease, five
      extrahepatic obstruction, and five primary biliary cirrhosis) and 24 colonic
      biopsy specimens (six normal, four Crohn's disease, and 14 ulcerative colitis).
      There was inappropriate staining with anti-A (four of six, 66%) and anti-B (nine
      of 11, 81%) in biliary epithelium of PSC patients compared with normal and
      disease controls. Expression of Lewis antigens was increased in patients with
      cholestatic liver disease. Ninety one per cent of PSC patients showed a similar
      pattern of inappropriate staining by anti-A and anti-B antibodies in colonic
      epithelium compared with 33% of normal and 42% of inflammatory bowel disease
      controls. There is inappropriate expression of A and B carbohydrate antigens in
      biliary and colonic epithelium in PSC. Whether these oncofetal antigens are
      implicated in the pathogenesis of this condition is discussed.

PMID- 8344590
TI  - Isolated primary oesophageal involvement by lymphoma: a rare cause of dysphagia:
      two case histories and a review of other published data.
AB  - Primary oesophageal involvement by lymphoma in two patients, one with Hodgkin's
      disease and one with non-Hodgkin's lymphoma is reported. In both, there were no
      manifestations of the disease outside the oesophagus, which is exceptionally
      rare. In the patient with non-Hodgkin's lymphoma, the oesophageal tumour was the
      first manifestation of lymphoma. Shortly after admission he developed a tracheo
      oesophageal fistula from which he died before treatment could be started. In the
      patient with Hodgkin's disease, isolated oesophageal lymphoma was the first
      relapse after a 13 year interval free of disease. As he had previously received
      mediastinal irradiation he was treated with combination chemotherapy that
      resulted in long term survival (> five years). Several other long term survivors
      have been described but only after radiotherapy or surgery. These findings
      suggest that systemic chemotherapy may be equally successful in treating isolated
      primary oesophageal lymphoma, thus offering an alternative for those patients in
      whom local treatment is contraindicated.

PMID- 8344589
TI  - Pancreatic hypertrophy with acinar cell nodules after longterm fundectomy in the
      rat.
AB  - The effect of gastric fundectomy with hypergastrinaemia on the pancreas in rats
      was studied for 14 months. Rats with hypercholecystokininaemia that had had a
      pancreaticobiliary diversion (PBD) operation and sham operated rats served as
      controls. Fundectomised rats showed a significant increase in pancreatic weight
      and total DNA and protein content compared with sham operated rats. DNA flow
      cytometry showed a significantly higher ratio of tetraploid to diploid nuclei in
      pancreatic tissue after fundectomy than after sham operation. Mean values of all
      these variables were significantly lower after fundectomy than after PBD.
      Acidophilic atypical acinar cell foci of the pancreas were diagnosed in both
      fundectomised and PBD operated rats, but not in sham operated controls. The
      volume density and 3H-thymidine labelling index of the acidophilic atypical
      acinar cell foci were significantly lower after fundectomy than after PBD.
      Changes consistent with pancreatic adenoma were diagnosed in the PBD group only.
      In conclusion, fundectomy lasting about half of the life span in rats causes
      pancreatic hyperplasia and hypertrophy, as well as development of acidophilic
      atypical acinar cell foci. Although hypergastrinaemia is a prominent feature, it
      may not be the only factor responsible for this pancreaticotrophical effect of
      fundectomy.

PMID- 8344588
TI  - Complex carbohydrate malabsorption in exocrine pancreatic insufficiency.
AB  - The magnitude of complex carbohydrate malabsorption in exocrine pancreatic
      insufficiency has not been well quantified in the past. The quantity of
      carbohydrate malabsorbed after a rice starch (100 g) meal in 20 patients with
      chronic pancreatitis (n = 10) or pancreatic cancer (n = 10) was therefore
      estimated. Patients had a three day stool fat collection (80 g/24 hour fat
      intake), a lactulose (20 g), and a rice flour (100 g) breath hydrogen test.
      Normal controls (n = 29) had a postprandial H2 increase < or = 14 ppm and
      malabsorbed (mean (SEM)) 1.12 (0.44) (range 0-11.10) g of the 100 g of
      carbohydrate ingested. Patients malabsorbed significantly more carbohydrate
      (11.36 (2.23) (range 8.90-32.60) g, F1.47 = 29.92, p < 0.001). The number of
      patients with fat (> 7 g, n = 8) or carbohydrate (increase in H2 > or = 20 ppm, n
      = 10) malabsorption was not different (chi 2 = 0.10, p = 0.75). There was a
      significant correlation between faecal fat and amount of malabsorbed carbohydrate
      (r = 0.60, F1.17 = 9.70, p = 0.006) and faecal fat and stool wet weight (r =
      0.57, F1.18 = 8.67, p < 0.009), but not between stool wet weight and amount of
      malabsorbed carbohydrate (r = 0.28, F1.17 = 1.45, p = 0.25). Although patients
      with exocrine pancreatic insufficiency malabsorb 10%-30% of the ingested complex
      carbohydrate, the main determinant of stool wet weight could be faecal fat.

PMID- 8344591
TI  - Myofibroblasts in hollow visceral myopathy: the origin of gastrointestinal
      fibrosis?
AB  - A patient with hollow visceral myopathy is reported in whom light microscopical
      studies of the small and large intestine showed typical features of degeneration,
      thinning, and fibrous replacement of smooth muscle of the gastrointestinal tract.
      Electron microscopy showed a striking increase in collagen with minimal
      fibroblast proliferation. Smooth muscle fibres had a range of ultrastructural
      abnormalities including myofilament disarray, electron lucency of the cytoplasm,
      and proliferation of the endoplasmic reticulum. Some fibres seemed to have
      typical ultrastructural characteristics of myofibroblasts, and others to be
      transition forms between typical smooth muscle cells and typical myofibroblasts.
      It seems likely that the fibrosis typical of this disorder has its origin in the
      transformation of smooth muscle fibres from a purely contractile to a
      myofibroblast collagen synthetic phenotype.

PMID- 8344592
TI  - Following the spirit.

PMID- 8344593
TI  - Applying Orem's self-care Framework. Orem's framework encourages nurses to always
      keep the client's independence in mind.

PMID- 8344594
TI  - An investigation of rocking as relaxation for the elderly. Does rocking elicit in
      the elderly the physiologic changes of the relaxation response?

PMID- 8344595
TI  - Over-the-counter drug use by the rural elderly.

PMID- 8344596
TI  - What to negotiate before accepting a DON position.

PMID- 8344597
TI  - Caring for caregivers: a nursing role in a corporate setting.

PMID- 8344598
TI  - Preventing falls in the elderly: interviewing patients who have fallen.
      Researchers attempt to identify fall-risk factors from the patients' point of
      view.

PMID- 8344599
TI  - Foot care protocol for the older client. A guide for working with clients to
      improve care of the feet.

PMID- 8344600
TI  - A gerontologic nurse practitioner in every nursing home: a necessary expenditure.

PMID- 8344601
TI  - Playing it safe with food.

PMID- 8344602
TI  - Congestive heart failure: old and new drugs.

PMID- 8344603
TI  - [Prognosis of acute myocardial infarction in the elderly. SPRINT Study Group].
AB  - In countries with aging populations acute myocardial infarction (MI) in the
      elderly is increasing rapidly and hospital and long-term mortality remain high.
      During 1981-83, 5839 consecutive patients with acute MI were hospitalized in 13
      coronary care units in Israel. Of these, 653 (11%) were older than 75 years, 41%
      were women, and 70% had a first MI. The hospital mortality in these very elderly
      patients was 35%. The mortality rates 1 and 5 years postdischarge were 24% and
      55%, respectively. In view of this high risk and the promising results obtained
      elsewhere with thrombolysis, particularly in the elderly, this treatment should
      be routinely considered in elderly patients with acute MI when there are no
      specific contraindications.

PMID- 8344604
TI  - [Hemizona assay for evaluating fertilizing capacity of human spermatozoa].
AB  - The hemizona assay (HZA), which tests the binding capacity of human spermatozoa
      to the zona pellucida, is described. This assay has very high sensitivity (86
      100%) in predicting fertilizing capacity in the in vitro fertilization (IVF)
      system. It is recommended that it be carried out on semen samples before entering
      the IVF program. In addition, it can also help evaluate unexplained infertility
      and assess the quality of ova. The necessity for a control fertilized sample in
      each HZA might complicate the assay. To simplify the test, the use of sperm from
      the sperm bank was investigated. It was shown that fresh and frozen-thawed sperm
      have the same capacity to bind to the hemizonae. Thus, frozen donor semen
      preserved in the sperm bank can be used for controlling the HZA.

PMID- 8344605
TI  - [Actinobacillus actinomycetemcomitans endocarditis].
AB  - Bacterial endocarditis caused by Actinobacillus actinomycetemcomitans (AA) is an
      extremely rare disease. AA, a gram negative cocco-bacillus, normally resides in
      the oral cavity. It is involved mostly in local oral cavity infections, but
      severe systemic infections caused by it have been reported. We describe a 63-year
      old man with endocarditis caused by AA which probably originated from a dental
      abscess. The course of the disease was complicated by acute myocardial ischemia,
      apparently caused by coronary artery embolism. To enable growth of this
      bacterium, blood cultures should be maintained for 2-3 weeks in a CO2-rich
      atmosphere.

PMID- 8344607
TI  - [Treatment of eyelid burns and results].
AB  - Eyelid burns may cause irreversible damage to the eyelids and eye globe. We
      review 45 patients with eyelid burns, in 8 of whom skin grafting was required due
      to the deepness of the burn. The results were satisfactory in all except 1, in
      whom 9 surgical procedures were required to give complete coverage of the cornea.
      During 1 procedure skin was grafted directly onto the conjunctiva. The other 36
      patients were treated conservatively.

PMID- 8344606
TI  - [Fanconi anemia syndrome as a predisposing factor for acquired bone marrow
      aplasia].
AB  - A 4-year old girl who received prophylactic therapy with oral cephalexin for 1
      year because of a history of urinary tract infections, was referred for
      evaluation of short stature. On physical examination mildly dysmorphic features
      were observed. Blood counts disclosed pancytopenia, and bone marrow examination
      showed hypoplasia of all 3 cell lines. Chromosome analysis after exposure to a
      DNA cross-linking agent (diepoxybutane) showed a chromosomal breakage pattern
      consistent with Fanconi anemia. Discontinuation of cephalexin was followed by
      improvement in hematological values. This course of events supports the
      hypothesis that acquired bone marrow depression may be a manifestation of Fanconi
      anemia, warranting the appropriate diagnostic work up in every case of acquired
      bone marrow aplasia.

PMID- 8344608
TI  - [Malignant peritoneal mesothelioma].
AB  - Public attention has recently been devoted worldwide to malignant mesotheliomas
      and their relation to exposure to industrial materials, especially asbestos and
      its products. The more common form of the disease is the pleural type, while the
      peritoneal variant is rare, with an estimated incidence of less than 1:1,000,000
      new cases per year. In contrast to the pleural type, the relationship of
      malignant peritoneal mesothelioma to exposure to asbestos is unclear. The
      differential diagnosis, based on clinical appearance and imaging techniques, is
      broad and the diagnosis is inconclusive, so that the diagnosis must be confirmed
      by histologic examination. Treatment is a combination of surgery, chemotherapy
      and irradiation. Contrary to occasional reports, the malignancy is fatal, death
      occurring within a few months of diagnosis. We present a 65-year-old man in whom
      malignant peritoneal mesothelioma was diagnosed. The presenting symptoms were a
      large abdominal mass involving the colon, and ascites. He died 5 months after the
      diagnosis was made.

PMID- 8344609
TI  - [Pyridoxine for severe metabolic acidosis and seizures due to isoniazid
      overdose].
AB  - A 15-year-old girl took 3 g of isoniazid (15 tablets) in a suicide attempt and
      was brought unconscious to the emergency room. She was in respiratory failure,
      with seizures that could not be stopped with diazepam. Severe metabolic acidosis
      with normal serum lactate developed (pH 6.85), but did not improve after infusion
      of bicarbonate. Intravenous administration of pyridoxine led to prompt cessation
      of the seizures and to gradual improvement of acid-base status. She recovered
      consciousness after several hours and was discharged a week later.

PMID- 8344610
TI  - [Saline solution amnioinfusion--its role in modern obstetric care].

PMID- 8344612
TI  - [First-aid 1993].

PMID- 8344613
TI  - [Clinical guidelines. Background, methodology and significance].

PMID- 8344611
TI  - [Rationing health care: ethical, medical and economic aspects].

PMID- 8344614
TI  - [Results of medical licensing examinations: 1988-1991].
AB  - The State of Israel Physicians' Law of 1987 requires all immigrant physicians to
      pass a state licensing examination in order to practice medicine. The examination
      is prepared by the Board of Examination for the Medical License, appointed
      according to the Ministry of Health regulations of 1987. It consists of 220
      written multiple choice questions in internal medicine, surgery, pediatrics,
      psychiatry and obstetrics and gynecology. As decided by the Board of Examination,
      the examinations are given in Hebrew, English, Russian, Spanish, Rumanian,
      Bulgarian, French, Polish, Portuguese and Arabic. Physicians required to take the
      examination can participate in special preparatory courses given in university
      affiliated hospitals. The mark received at the end of the course is taken into
      consideration in the final grading of the candidate. Since 1988, 1,985 physicians
      have been examined, 89.3% of whom were immigrants from Russia and only 3% from
      Western countries. Of these, 1,968 (65.9%) were licensed. Factors affecting
      success rate were: age (mean 34 years), with the highest success rate at ages 31
      35; length of medical experience, with the best results in those with 11-15 years
      of experience (mean 12); and country of origin, which is crucial. The success
      rate in immigrants from Western countries was 79.2%, from South America 72.3% and
      from Russia and Eastern European countries about 60%.

PMID- 8344615
TI  - [p53--the genome policeman].

PMID- 8344617
TI  - ["Very important" patients].

PMID- 8344616
TI  - [Alcohol and AIDS].

PMID- 8344618
TI  - [Arrhythmias following cardiac surgery].

PMID- 8344619
TI  - [Acute myocardial infarction in the elderly: prognosis and treatment].

PMID- 8344620
TI  - [Fever and lymphadenopathy in a 33 year old patient with discoid lupus
      erythematosus].

PMID- 8344621
TI  - [Involuntary outpatient commitment: ethical and legal aspects].
AB  - In 1991 the Israeli Knesset (parliament) drafted new legislation for the
      treatment of the mentally ill. One of the innovations was involuntary outpatient
      commitment (IOC), which allows the district psychiatrist to order a patient to
      attend a clinic and receive ambulatory care. IOC is an attempt to address the
      problem of the "revolving door" patients, chronic mental patients who after
      discharge do not continue medication and therefore relapse and have to be
      readmitted.

PMID- 8344622
TI  - [Koro syndrome--clinical and cultural aspects].
AB  - Koro syndrome is a triad which includes a deep-seated fear that the penis will
      shrink, disappear into the abdomen, and that death will follow. The patient
      experiences profound anxiety and performs preventive manoeuvres, such as pulling
      his penis outward. The disorder is considered culture-related, and is endemic in
      South-East Asia and China, where it occurs in epidemic and sporadic forms.
      Sporadic cases appear in the western hemisphere, often in association with an
      underlying psychiatric or organic disorder, usually of the central nervous
      system. 6 cases of koro have been published from Israel.

PMID- 8344623
TI  - [Experience with laparoscopic appendectomy].
AB  - During April to August 1992, laparoscopies were performed in this department in
      35 of 100 cases of appendicitis. The average patient age was 29 years; 18 of the
      35 (51%) were women; 3 patients were operated on electively, and the rest as
      emergencies. Appendectomy was performed in 33 (94%), but not in 2 women with
      sepsis due to tubo-ovarian abscess; In 1 of these 2 we had to convert to
      laparotomy. Acute appendicitis was found in 20 (57%). In 7 women (20%)
      gynecologic disease was diagnosed. In 1 case (3%) a carcinoid tumor of the tip of
      the appendix was found and in another primary peritonitis. In the remaining 6
      (17%) no lesions were found. In 33 (94%) a regular diet was resumed 25 hours
      postoperatively and 25 (71%) were discharged the day after operation. The only
      complication was an abdominal wall hematoma in a single case, which resolved
      spontaneously. It is our impression that laparoscopy is a useful diagnostic tool
      in acute appendicitis, that it is a safe route for appendectomy, and that
      recovery is quick with minimal complications.

PMID- 8344624
TI  - [Treatment of the diabetic foot by hyperbaric oxygen].
AB  - Diabetic foot wounds are consequences of the neuropathy and the small and large
      vessel disease that complicate diabetes. At the cellular level, the result is
      hypoxia which impairs wound healing. Hyperbaric oxygenation (HBO) may be a useful
      adjuvant to wound care. It leads to enhanced oxygenation of the affected tissues,
      has an antiseptic effect, reduces edema, and accelerates collagen production and
      angiogenesis, thus enhancing tissue repair. 14 diabetics with chronic nonhealing
      wounds which did not respond to treatment for at least 3 months were treated by
      HBO. All had palpable pedal pulses. Transcutaneous measurements of tissue pO2
      showed elevation from 20 +/- 10 mm Hg during air breathing to 643 +/- 242 mm Hg
      while breathing pure oxygen at 2.5 ATA. They were treated with HBO in 56 +/- 10
      consecutive HBO sessions. In 11 there was complete wound healing, while in 1
      there was partial response, in 1 minimal response, and in 1 a transient response.
      HBO is useful in chronic nonhealing wounds of the diabetic foot and of the
      diabetic foot with impending amputation. It is a safe mode of therapy, but
      further studies are required to establish its efficacy and to ascertain which
      diabetic patients and wounds will benefit the most from it.

PMID- 8344625
TI  - [Diazepam-induced disinhibition].
AB  - Benzodiazepines are among the most often prescribed drugs worldwide, and are
      mostly prescribed by general practitioners and family physicians. Their side
      effects include tolerance, dependence, intoxication, withdrawal syndrome,
      retrograde amnesia, paradoxical agitation (frequent in the elderly) and
      disinhibition. A 32-year-old woman is presented. She was brought to the emergency
      room because of psychotic-like behavior. It was caused by severe disinhibition
      due to a single 5 mg dose of diazepam prescribed during uncomplicated
      bereavement. 14 hours later all symptoms had subsided and she was discharged.

PMID- 8344626
TI  - [Delayed pressure urticaria: therapeutic response to cetirizine].
AB  - We describe a 39-year-old man who suffered from delayed pressure urticaria for 2
      years. His severe symptoms did not respond to antihistamine (H1 and H2) treatment
      and corticosteroid therapy was given despite severe side-effects. A new,
      nonsedating antihistamine drug, cetirizine, relieved most of his symptoms,
      enabled him to be weaned from corticosteroid therapy, and restored his former
      quality of life.

PMID- 8344628
TI  - [Warm heart surgery].

PMID- 8344627
TI  - [First trimester sonographic diagnosis of acrania].
AB  - Anencephaly, a well-known lethal fetal malformation, was long considered to
      result from primary nonclosure of the neural tube. In the past few years other
      pathogenic mechanisms, such as reopening or degeneration of a closed neural tube
      have been suggested. High-resolution transvaginal ultrasonography, which provides
      fine visualization of the different stages in embryogenesis, allowed us to detect
      fetal acrania as early as the 12th week of gestation. Very high levels of alpha
      fetoprotein, almost undetectable levels of unconjugated estriol (E3), and
      postabortion histology were consistent with anencephaly, suggesting that
      anencephaly is the end result of fetal acrania.

PMID- 8344629
TI  - [Negative symptoms in schizophrenia].

PMID- 8344630
TI  - [Hypertension in pregnancy--diagnostic approach and pathogenesis (Part I)].

PMID- 8344631
TI  - [Pruritus in cholestatic liver diseases--still more questions than answers].

PMID- 8344632
TI  - [Current management of pancreatic necrosis and infections].

PMID- 8344633
TI  - [Aspects of epilepsy and psychiatry].

PMID- 8344634
TI  - [Compliance with recommended periodic examinations of workers in Israel].
AB  - Initial design and subsequent improvement of health education and health
      promotion programs should be based on reliable, current data on the health
      related habits of the target population. Various organizations in the Israeli
      health system conduct campaigns encouraging the general population to undergo
      periodic blood pressure and blood cholesterol measurements. In addition, regular
      examination of the breast and uterine cervix are recommended for women. However,
      there is no systematic on-going monitoring of compliance with these
      recommendations. Health promotion programs in the work-place are regularly
      conducted by the national Occupational Health Institute (affiliated with the
      General Labor Federation Health Insurance Institute). To obtain basic information
      on such health-related behavior, a survey was conducted in April 1992 in a sample
      of 1,042 employees at 6 places of work. The results indicate relatively low
      compliance with recommended periodic health examinations and demonstrate the need
      for regular studies of this kind in representative population samples. In this
      way decision-makers in public health service would be provided the data essential
      for determining optimal allocation of resources to health promotion programs.

PMID- 8344635
TI  - [Misinformation among physicians about dangers of fetal x-ray exposure].
AB  - A survey among 20 gynecologists and 86 family physicians and general
      practitioners revealed that only 46% (70% of the gynecologists and 41% of the
      others) knew that exposure of a pregnant woman to common diagnostic x-ray is not
      an indication for therapeutic abortion (the opinion of a consensus of experts).
      This lack of basic information by those who advise pregnant women points to a
      serious public health problem. Pregnant women are frightened, and in a sense
      abortions are "coerced" by increasing the unwarranted anxiety. It is incumbent
      upon individuals and institutions to ensure that physicians, nurses and others in
      the health professions be well-informed and not supply misinformation.

PMID- 8344636
TI  - [Molecular genetics in hematology--from the laboratory bench to beside
      application].

PMID- 8344638
TI  - [AIDS and public health law].

PMID- 8344637
TI  - [The Israeli health care crisis: leadership, a cure].

PMID- 8344639
TI  - [Breast milk banks--are they really necessary?].

PMID- 8344640
TI  - Effects of arterial-portal glucose difference on gluconeogenesis from lactate in
      the isolated bivascular-perfused rat liver.
AB  - The effects of arterial-portal glucose difference on the gluconeogenesis from
      lactate were studied using the bivascular perfused liver isolated from the fasted
      rat. The liver was cyclically perfused at flow rates of 14 ml/min from the portal
      vein and of 7 ml/min from the hepatic artery with the total volume of 35 ml of
      perfusion medium containing 2 mM glucose, 3 mM lactate and (U-14C)-lactate for 20
      min. Glucose was infused at a rate of 27.75 mumol/min into the arterial cannula
      (A-experiment) or the portal cannula (P-experiment), making each arterial-portal
      glucose gradient of +3.96 mM (arterial glucose > portal glucose) and -1.98 mM
      (arterial glucose < portal glucose) throughout the experiment. Perfusate lactate
      concentration was lower in A-experiment than in P-experiment (1.40 +/- 0.25 vs
      1.93 +/- 0.23 mM at 20 min, mean +/- SD, p < 0.05). Incorporation of
      radioactivity from (U-14C)-lactate into glucose carbon 1 in perfusate was 5.7 +/-
      0.8% of total radioactivity per 20 min in A-experiment vs 2.8 +/- 0.6%/20 min in
      P-experiment (p < 0.01). These results suggest that the arterial-portal glucose
      difference is an important factor to regulate the hepatic gluconeogenesis.

PMID- 8344641
TI  - Islet amyloid polypeptide/amylin contents in pancreata increase in genetically
      obese and diabetic mice.
AB  - To search for a possible relationship between islet amyloid polypeptide
      (IAPP)/amylin and the pathophysiology of type 2 diabetes mellitus, we examined
      IAPP contents in the pancreata of genetically obese and diabetic mice (C57BL/6J
      ob/ob and KK mice), at 24 weeks of age, using a specific radioimmunoassay. IAPP
      and insulin contents were noticeably increased in the ob/ob mice with marked
      obesity and moderate hyperglycemia. These contents slightly, but significantly
      increased in the KK mice with mild obesity and hyperglycemia. Thus, IAPP
      production is possibly influenced by factors coded by mutant genes and a possible
      relationship between IAPP and hyperglycemia in the strains of mice deserves
      further attention.

PMID- 8344642
TI  - The effects of growth hormone administration in vivo on skeletal muscle glutamine
      metabolism of the rat.
AB  - Human growth hormone administration to the rat for 3 or 10 days increased the
      concentrations of glutamine in both skeletal muscle and plasma and the rate of
      glutamine release was increased from muscle isolated from rats treated with
      growth hormone for 3 days. Growth hormone may therefore play an important role in
      the control of glutamine metabolism in muscle.

PMID- 8344643
TI  - Inhibition of progesterone action by a factor in human follicular fluid.
AB  - A factor was found in human follicular fluid that blocked progesterone-stimulated
      net uptake of 45Ca2+ in human sperm and progesterone-induced maturation of
      Xenopus oocyte. The factor was partially purified by ultrafiltration through PM
      10 membrane and gel filtration on Sephadex G-25 column. The active fraction is
      effective at a concentration of 200 micrograms/ml. The present findings suggest
      that hFF factor may regulate the metabolism of progesterone sensitive cells.

PMID- 8344644
TI  - The influence of growth factors on the prostaglandin synthesis in cultured rabbit
      luteal cells.
AB  - Isolated rabbit luteal cells from day 12 of pseudopregnancy were cultured with a
      variety of growth factors, hCG and arachidonic acid (AA) in serum-free culture
      medium for 96 hours. The time course of prostaglandin (PG) E2, PGF2 alpha, and
      progesterone was determined. TNF-alpha, IL-2, IGF-I, IGF-II, and EGF alone were
      not able to change significantly the production of either progesterone or PGE2
      and PGF2 alpha when compared with the controls. AA as the precursor of PG
      biosynthesis increased the production of PGE2 and PGF2 alpha significantly (1.2
      fold and 2.6-fold, respectively; p < 0.05; p < 0.01). AA together with EGF
      increased the level of PG more pronounced when compared with AA alone (1.5-fold
      for PGE2, 5-fold for PGF2 alpha; p < 0.05 and p < 0.005). The progesterone
      production of the cells remained unchanged during growth factor exposure. We
      conclude that EGF together with high amounts of AA is able to stimulate the PG
      biosynthesis in cultured rabbit luteal cells. Since the level of PGF2 alpha
      increases more pronounced than PGE2, an activation of the PGE2 9-ketoreductase
      may be possible. Therefore, EGF could be relevant as an additional regression
      factor controlling the PGE2/PGF2 alpha-ratio in the corpus luteum of rabbits.
      This mechanism seems to be independent from the progesterone synthesis.

PMID- 8344645
TI  - Repetitive GHRH administration fails to increase the response to GHRH in obese
      subjects. Evidence for a somatotrope defect in obesity?
AB  - Spontaneous GH secretion as well as GH response to several stimuli including GHRH
      have been shown to be reduced in obesity. To clarify the pathogenesis underlying
      these alterations, in six obese patients (3 males and 3 females, age 20-44 yrs,
      BMI = 42.1 +/- 2.2) on unrestricted diet we studied the effect of 8 day GHRH
      pretreatment (1 micrograms/kg iv each day) on the acute somatotropic response to
      the neurohormone administered both alone and combined with arginine (ARG, 0.5
      g/kg iv infused from 0 to 30 min) which likely inhibits the release of
      hypothalamic somatostatin. Before treatment the GH response to GHRH (AUC: 231.9
      +/- 106.4 micrograms/l/h) was potentiated (p < 0.001) by ARG (932.6 +/- 166.2
      micrograms/l/h). However, the GH responses to the neurohormone both alone and
      combined with ARG were lower (p < 0.02 and 0.002, respectively) than in normals
      (712.4 +/- 111.6 and 2608.3 +/- 453.2 micrograms/l/h, respectively). After
      repetitive GHRH administration, in obese subjects baseline GH and IGF-I levels
      were unchanged. Also the GH responses to GHRH both alone (217.3 +/- 68.1
      micrograms/l/h) and combined with ARG (756.3 +/- 202.9 micrograms/l/h) were not
      modified. In conclusion, our data demonstrate the failure of GHRH pretreatment to
      improve the somatotrope hyporesponsiveness to GHRH both alone and combined with
      ARG suggesting the existence of a somatotropic defect in obesity.

PMID- 8344646
TI  - Pyridostigmine effects on TSH response to TRH in adult and children obese
      subjects.
AB  - Thyrotropin releasing hormone (TRH) administration is known to induce a greater
      TSH response in normal subjects than in obese subjects. In obesity even GH and
      PRL response to various stimuli are blunted, presumably because of an augmented
      somatostatinergic tone in obese subjects. Further studies have shown that
      pyridostigmine (Pyr), an acetylcholinesterase inhibitor, is capable of augmenting
      GH in obesity by means of somatostatin inhibition. In order to evaluate the
      possible interference of an increased somatostatinergic tone on TSH secretion, we
      studied the TSH response to a TRH bolus in 5 obese children with or without a pyr
      pretreatment. Similarly, we tested a group of 10 obese adult subjects, with TRH
      alone or TRH plus pyr administration, 30 min or 60 min before TRH. All subjects
      had a body weight of 30-50% greater than I.B.W. Our data show that a pretreatment
      with pyr, 60 min before TRH administration, significantly augments the TSH
      response in adult obese subjects but not in children; the modality of pyr
      administration seems to be crucial to evidenciate such an alteration since the
      pyr pretreatment is not effective when administered 30 min before TRH. The
      absence of this pyr effect in obese children induces to hypothesize that
      somatostatinergic tone is differentially modulated in children vs adult obese
      subjects.

PMID- 8344647
TI  - The magnitude, the kinetics and the metabolic efficiency of first-phase insulin
      response to intravenous glucose are related.
AB  - We investigated the relationship between the kinetics, the magnitude and the
      metabolic efficiency of first-phase insulin response (FPIR) to intravenous
      glucose. Twenty healthy control subjects and fifty first degree relatives of Type
      1 diabetic patients were studied using a standardized protocol for the
      intravenous glucose tolerance test (IVGTT). The first significant increase in
      plasma insulin concentrations above baseline appeared as early as the 2nd min (1
      min before the end of glucose injection, fast response) in 80% of controls and
      70% of relatives, and at the 3rd min or later (delayed response) in the remaining
      subjects. The greatest delay in insulin release (5th min) was observed in 4 of 6
      relatives of Type 1 diabetic patients with impaired FPIR. In the controls and the
      relatives, the subjects with a fast insulin response had a significantly higher
      FPIR (controls 215.4 +/- 93.5 vs 59.7 +/- 5.6 microU/ml, p < 0.001 and relatives
      143.5 +/- 61.8 vs 55.9 +/- 27.7 microU/ml, p < 0.001) and showed better glucose
      assimilation (controls 3.05 +/- 1.05 vs 1.64 +/- 0.16%/min, p < 0.05 and
      relatives 2.6 +/- 0.96 vs 1.6 +/- 0.85%/min, p < 0.01) during IVGTT than the
      subjects with a delayed response. Moreover, for normal FPIR values in the group
      of relatives of Type 1 diabetic patients, a fast response was associated with a
      significantly better glucose assimilation as assessed by the incremental area
      under the glucose curve (358.6 +/- 64.7 vs 539.2 +/- 67.7 mmol/l per 90 min, p <
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8344649
TI  - Insulin stimulates the polymorphonuclear leukocyte chemokinesis.

PMID- 8344648
TI  - Octreotide treatment does not improve impaired glucose uptake in cirrhosis.
AB  - Forearm glucose uptake during a hyperglycaemic (10 mmol/l) glucose clamp was
      diminished to 33% of the normal value (p = 0.012) in six cirrhotic patients
      compared with matched control subjects. Fasting insulin concentrations were
      significantly elevated in the cirrhotic patients confirming insulin resistance
      which may have been induced by chronic hyperinsulinaemia. The cirrhotic patients
      received one week of treatment with 50 micrograms octreotide subcutaneously three
      times daily which reduced pre-dose fasting insulin levels from 26.2 +/- 7.9 to
      18.1 +/- 6.2 mU/l p < 0.005, and post dose levels to 7.0 +/- 3.5 mU/l p < 0.005.
      However when the glucose clamp was repeated 20 hours after the last dose of
      octreotide no change was detected in clamp glucose requirements, forearm glucose
      uptake, or stimulated insulin secretion. It was concluded that one week of
      lowering insulin levels does not reverse the insulin resistance of cirrhosis.

PMID- 8344651
TI  - Normalization of decreased plasma concentrations of growth hormone-binding
      protein by insulin treatment in spontaneously diabetic BB rats.

PMID- 8344650
TI  - Effect of macrophage colony-stimulating factor on the development of diabetes
      mellitus in BB rats.

PMID- 8344652
TI  - Effects of oestradiol-17 beta in hematological parameters and iron absorption in
      ovariectomized rats.

PMID- 8344653
TI  - The bone marrow trephine biopsy: a review of normal histology.
AB  - Bone marrow trephine biopsies are becoming increasingly common in routine
      surgical pathology. Familiarity with normal marrow histology plays an important
      part in understanding and interpreting marrow pathology. The aim of this article
      is to describe the histological features of normal human bone marrow, in
      particular those features which are relevant to the diagnostic pathologist. The
      advantages and disadvantages of different technical aspects, such as choice of
      embedding material and type of stain, are discussed. The use of immunochemistry
      in identifying different cell types within the marrow is illustrated.

PMID- 8344654
TI  - Lymphangiomyomatosis and angiomyolipoma: closely related entities characterized
      by hamartomatous proliferation of HMB-45-positive smooth muscle.
AB  - Angiomyolipoma is a hamartomatous condition which can occur as a component of the
      tuberous sclerosis complex. Lymphangiomyomatosis, another hamartomatous lesion
      occurring predominantly in the lungs, has long been suspected to be related to
      angiomyolipoma and tuberous sclerosis because of occasional clinical
      associations. We undertook this study to provide further support for the close
      relationship between these two entities. Five cases of lymphangiomyomatosis and
      20 case of angiomyolipoma were retrieved for histological review and
      immunohistochemical studies. The antibodies used were anti-muscle specific actin
      (HHF-35), anti-desmin (D33) and anti-melanoma (HMB-45). Lesions featuring smooth
      muscle proliferation were used as controls. The proliferated smooth muscle cells
      in both lymphangiomyomatosis and angiomyolipoma were much plumper and paler or
      even clear, when compared with the deeply eosinophilic cytoplasm of the normal
      spindly smooth muscle cells and those of leiomyomas. Their nuclei were round to
      oval and pale rather than elongated and dark. Cells with bizarre nuclei were
      commoner in angiomyolipoma (18/20 cases) than lymphangiomyomatosis (1/5). In 12
      cases of angiomyolipoma there were foci indistinguishable from
      lymphangiomyomatosis, i.e. plump spindle cells arranged in short fascicles around
      ramifying endothelium-lined spaces. All five cases of lymphangiomyomatosis
      stained for muscle-specific actin, desmin and HMB-45. For angiomyolipomas, the
      positivity rates for these markers were: 20/20, 17/20 and 18/20, respectively,
      including one case that was negative for both desmin and HMB-45. The various
      smooth muscle proliferations and tumours selected as controls were uniformly HMB
      45 negative. The distinctive cytological features, morphological overlap and
      immunophenotypic profile all support a close relationship between
      lymphangiomyomatosis and angiomyolipoma, which probably represent different
      morphological manifestations of hamartomatous proliferation of a peculiar form of
      HMB-45-positive smooth muscle.

PMID- 8344655
TI  - Metal deposition in post-surgical granulomas of the urinary tract.
AB  - Fourteen cases of post-surgical granulomatous inflammation of the urinary tract
      were studied to investigate the possible deposition in the tissues of metals
      derived from the diathermy instruments used. The granulomas showed central
      necrosis, palisaded histiocytes and giant cells. On electronmicroscopy both
      amorphous material and electrondense particles were seen in the granulomas. The
      former appeared to be necrotic tissue. The particles were metallic in nature.
      Energy dispersive analysis of X-rays showed the presence of tungsten, iron,
      copper, nickel, chromium, zinc and vanadium. Tungsten particles were always pure.
      Other single particles contained two or more of the remaining elements,
      indicating the presence of alloy metals. Analysis of the diathermy instruments
      showed the cutting loops to be pure tungsten and the 'rollerballs' to be nickel
      silver containing copper, zinc, nickel, manganese and iron. Both the loops and
      balls are supported on stainless steel wires containing iron, chromium, nickel,
      manganese, molybdenum, copper and vanadium. It is proposed that metallic
      fragments from the instruments were deposited in the tissues during the surgical
      procedures and elicited an immunological reaction with granuloma formation.
      Tungsten is probably inert but nickel, chromium, copper and zinc are immunogenic.
      Under certain circumstances both nickel and chromium may also be carcinogenic.

PMID- 8344656
TI  - Expression of alpha-amylase isoenzymes and trypsin by the proliferating
      epithelium of large intrahepatic bile ducts and intrahepatic peribiliary glands
      in hepatolithiasis.
AB  - The expression of alpha-amylase isoenzymes (pancreatic and salivary) and trypsin
      by the epithelium of large intrahepatic bile ducts and peribiliary glands was
      examined immunohistochemically in hepatolithiasis (n = 22), extrahepatic biliary
      obstruction (n = 20) and normal liver (n = 22). Hepatolithiasis was associated
      with marked proliferation of bile duct cells and peribiliary glands. Expression
      of pancreatic and salivary amylase was observed in the proliferating bile duct
      cells and peribiliary glands of all livers, and trypsin was found in 68% of the
      livers. In extrahepatic biliary obstruction, proliferation of the biliary
      epithelium was less marked, but expression of amylase isoenzymes was observed in
      all livers and trypsin was found in 50%. All normal livers showed expression of
      amylase isoenzymes in large intrahepatic bile ducts, septal bile ducts and
      peribiliary glands, and trypsin was found in 73%. The density of enzyme
      containing acini was highest in hepatolithiasis, intermediate in extrahepatic
      biliary obstruction and lowest in normal liver. These results show that the
      proliferating biliary epithelium in hepatolithiasis contains amylase isoenzymes
      and trypsin and that biliary epithelium retains the ability to produce these
      enzymes after proliferation, suggesting that a large amount of amylase isoenzyme
      and trypsin may be secreted into the bile ducts in hepatolithiasis. These enzymes
      may play an important role in the pathophysiology of hepatolithiasis.

PMID- 8344657
TI  - Granulation tissue polyposis associated with carcinoid tumours of the small
      intestine.
AB  - We report two patients with ileal carcinoid tumours which were associated with
      polyps due to mucosal granulation tissue proliferation. In both cases the tumours
      had extensively infiltrated the small bowel wall and mesentery, and one had
      hepatic metastases. The mucosal surface of each specimen showed numerous, pale
      brown, sessile polyps which were restricted to the intestinal segment involved by
      carcinoid tumour, although not always closely related to neoplastic cells. The
      polyps were formed by the proliferation of capillaries, smooth muscle cells and
      myofibroblasts as demonstrated by immunohistochemistry and electronmicroscopy.

PMID- 8344658
TI  - Nodular breast lesions during pregnancy and lactation.
AB  - A review of the clinical and pathological features of 30 lactating nodules which
      were retrieved over the period 1975-1991 was undertaken. Clinically, the nodules
      occurred during any pregnancy and in subsequent pregnancies no further nodules
      developed. There were no favoured sites or lateralization of nodules, nor was
      there any correlation between nodule occurrence and ethnic background.
      Morphologically, a pre-existing underlying lesion was readily recognized in 18
      cases. Seven fibroadenomas, five tubular adenomas, two of which were infarcted,
      and six breast hamartomas were identified. The other 12 cases were well
      circumscribed nodules with a variable degree of inflammation and lobular
      hyperplasia. It is best to recognize these lesions as a heterogeneous group and
      designate them as lactating nodules, noting any underlying pathological process
      rather than using the older term lactating adenoma which implies a single
      neoplastic entity.

PMID- 8344659
TI  - Mechanism of pain in osteoid osteomas: an immunohistochemical study.
AB  - Osteoid osteoma is a benign bone tumour characterized by pain which is relieved
      by non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin. To clarify
      the mechanism of the pain, five osteoid osteomas were studied
      immunohistochemically using polyclonal antibodies against prostaglandin E2
      (PGE2), S-100 protein and protein gene product 9.5 (PGP 9.5). In all five cases,
      the pain had been relieved by NSAIDs. Nerve fibres positive for S-100 protein and
      PGP 9.5 were observed in the fibrous zone, especially close to the blood vessels,
      around the nidus in all the lesions and also within the nidus in three lesions.
      PGE2 immunoreactivity was variably positive in the nidus of three lesions. In one
      case a large number of actively proliferating osteoblasts reacted with this
      antibody. The other cases showed unevenly distributed PGE2 positivity which
      tended to be prominent in the plump osteoblasts. As control material we examined
      fibrous dysplasia (3 cases), osteosarcomas (3) and giant-cell tumours of bone
      (3). The plump osteoblastic tumour cells of three osteosarcomas and the bone
      forming cells in two cases of fibrous dysplasia gave a positive reaction for
      PGE2. No S-100 or PGP 9.5 immunoreactive nerve fibres were seen in these lesions.
      It is concluded that the presence of nerve fibres alone might play a more
      important role in mediation of pain in osteoid osteomas than some effects of
      osteoblast-produced PGE2 on the nerves and proliferated blood vessels.

PMID- 8344661
TI  - The significance of prostatic urothelial dysplasia.

PMID- 8344660
TI  - Carcinosarcoma of the oesophagus with rhabdomyoblastic differentiation.
AB  - We report a case of oesophageal carcinosarcoma with prominent rhabdomyoblastic
      differentiation. Immunohistochemically, the rhabdomyblasts were mainly reactive
      to vimentin, cytokeratin, desmin, muscle-specific actin, myosin, and myoglobin,
      and were surrounded by laminin and type IV collagen-positive basement membranes.
      The tumour had dual differentiation, carcinomatous and sarcomatous, but also
      showed evident features of transition between the two components; suggesting a
      common origin. An epithelial-mesenchymal conversion could be the pathogenetic
      mechanism involved in the histogenesis of this lesion. The word carcinosarcoma,
      from a descriptive point of view, seems the most suitable to describe a tumour
      composed of both carcinomatous and true sarcomatous elements.

PMID- 8344662
TI  - In situ expression of cytokines and serine esterase B in small-bowel allograft
      rejection.

PMID- 8344663
TI  - Serous papillary adenocarcinoma of the uterine cervix.

PMID- 8344664
TI  - Malignant lymphoma and autoimmune disease.

PMID- 8344666
TI  - New contribution to the genetics of the Basques: heterogeneity in the esterase D
      subtype distribution.
AB  - A random sample of 1,491 individuals from three Basque provinces was studied for
      the red-cell esterase D (ESD) polymorphism by means of isoelectric focusing. The
      following allele frequencies were observed: Vizcaya, ESD*1 = 0.933, ESD*2 =
      0.058, ESD*5 = 0.009; Guipuzcoa, ESD*1 = 0.938, ESD*2 = 0.053, ESD*5 = 0.009; and
      Alava, ESD*1 = 0.894, ESD*2 = 0.088, ESD*5 = 0.018. The Basques from Vizcaya and
      Guipuzcoa display the lowest values for allele ESD*5 of any European population
      studied to date. The value obtained for this allele in the Basque population of
      Alava is significantly higher than those found in the other two Basque samples.
      This, together with the fact that Basques from Alava display the lowest ESD*1
      frequency of any Basque series, suggests that there are genetic differences
      between Basque provinces.

PMID- 8344665
TI  - Survey of the association of deoxyribonuclease I polymorphism with disease.
AB  - The deoxyribonuclease I (DNase I) system was studied in 120 unrelated Japanese
      patients with liver disease, malignant neoplasms, alimentary-canal disease and
      inflammatory conditions with respect to the distribution of phenotypes and gene
      frequencies in serum samples. In patients with alimentary-canal disease a
      significant deficit of the DNase I phenotype 1-2 was demonstrated, which suggests
      that heterozygosity may confer protection against such disease. Furthermore, a
      significant association between the DNase I phenotype 2 and liver disease was
      found. The possible involvement of these phenotypes in the response to these
      diseases would appear to merit further study.

PMID- 8344668
TI  - Serum protein markers in the Piaroa Indians of Amazonia (Venezuela).
AB  - A sample of 121 Piaroa Indians from the Federal Amazonia Territory (Venezuela)
      was studied for the following serum protein polymorphisms: haptoglobin (HP),
      group-specific component subtypes (GC), orosomucoid (ORM), third component of
      complement (C3), transferrin C subtypes (TF) and alpha 1-antitrypsin subtypes
      (PI). The gene frequencies in the whole sample were: HP1 = 0.821; GC1S = 0.698;
      GC1F = 0.058; GC2 = 0.244; ORMS = 0.434; C3S = 0.699; C3F = 0.289; C3var = 0.012;
      TFC1 = 0.955; PIM1 = 0.467; PIM2 = 0.004; PIM3 = 0.529. The studied Piaroa sample
      came from three different communities: Gavilan, Paria and Alto Carinagua. The
      distribution of GC, C3 and HP polymorphisms was heterogeneous within the three
      groups. All the examined serum protein markers were polymorphic, in contrast to
      some enzymatic markers (ADA, DIA, 6PGD, AK) previously studied, which were shown
      to be monomorphic in the Piaroa. The results were compared with data from other
      populations living in the same territory.

PMID- 8344667
TI  - Mendelian phenotypes in The Netherlands.
AB  - We report here a database listing Mendelian phenotypes described in the
      Netherlands and/or in populations originating from this country, and describe the
      results of a quantitative analysis of the database. The database is specifically
      directed at the presence, frequency and origin of the phenotypes. These are
      arranged according to their mode of inheritance: autosomal dominant (AD),
      autosomal recessive (AR) and X-linked. Only those phenotypes which have been
      reported in accessible sources were included. We entered 1,482 references up to
      January 1, 1991. At least 672 different loci were described in the Netherlands at
      this date: 321 (47.8%) AD, 283 (42.1%) AR and 68 (10.1%) X-linked. Almost 2.5% of
      all loci in our database have no comparable entry in McKusick [mendelian
      Inheritance in Man, ed 9. Baltimore, The Johns Hopkins University Press, 1990]
      (MIM). There is a significant difference (p < 0.01) according to the division
      into AD, AR, and X-linked phenotypes between our database and MIM, in which 61.7%
      of the phenotypes are AD, 31.5% AR and 6.8% X-linked. Dutch prevalence data for
      38 monogenic disorders and 24 polymorphic systems are listed.

PMID- 8344669
TI  - Distribution of some point mutations in the phenylalanine hydroxylase gene of
      phenylketonuria patients from the Moscow region.
AB  - Thirty-one unrelated phenylketonuria patients from the Moscow region were
      screened for mutations in the phenylalanine hydroxylase gene at the following
      codons: 408, 158, 261 and IVS-12. For detection of point mutations, polymerase
      chain reaction amplification was applied with allele-specific oligonucleotide
      hybridization. The following mutation frequencies were determined: codon 408
      56.4%; codon 158-8.1%; codon 261-3.2%, and IVS-12-16%.

PMID- 8344670
TI  - Linkage studies of cholestasis familiaris groenlandica/Byler-like disease with
      polymorphic protein and blood group markers.
AB  - In Greenland, and especially East Greenland (Tasiilaq), a common recessive
      disease, cholestasis familiaris groenlandica (CFG)/Byler-like disease, occurs in
      Eskimo children [1]. In a period from 1964-1991, at least 22 children out of
      about 2,121 newborns were born with this disease (gene frequency q = 0.102).
      Samples from 126 persons, from a large pedigree in East Greenland including 7
      affected and from two families in West Greenland with a total of 3 affected
      children, have been collected for studying 45 polymorphic markers and for mapping
      the CFG disease. Polymorphisms and exclusion data were found for the following
      markers: A1BG, ABO, ACP1, AHSG, C1R, C6, FY, GC, GLO1, GPT, HP, ITIH1, JK, GYPA,
      GYPB, ORM, P1, PGM1, PI, PON, RH and TCN2. Small positive lod scores (Z < 1.5)
      were found to the following markers: ITIH1, JK and TCN2. The following markers
      were nonpolymorphic in this material: ADA, AK1, ALAD, APOA4, APOH, BF, C3, BCHE,
      CHE2, CO, ESD, FUCA2, F13A1, F13B, KEL, LE, FUT1, LU, PEPD, PGD, PGP, PLG, FUT2,
      SOD1 and TF.

PMID- 8344672
TI  - Reassignment of human renin gene to chromosome 1q32 in studies of a
      (1;4)(q42;p16) translocation.
AB  - The human renin gene (REN) has been assigned to chromosome 1q42. Linkage studies
      are, however, inconsistent with this localization. We therefore reexamined the
      question of the location of REN using a patient whose distal chromosome 1q arm
      was translocated to chromosome 4 [(1;4)(q42;p16)]. In situ hybridization using a
      3H-labelled REN probe demonstrated hybridization signals confined to the q32 band
      of chromosome 1, with radioactivity in the translocated 1q42 region being similar
      to the low levels along all other chromosomes.

PMID- 8344671
TI  - An alternative modality for the immunodetection of the molecular phenotypes of
      coagulation factor XIIIB.
AB  - A new technical modality for the typing of coagulation factor XIIIB (F13B) is
      described. The determination of F13B phenotypes was carried out from desyalized
      plasma samples by means of polyacrylamide gel isoelectric focusing (pH range 6-8)
      followed by immunofixation-silver stain. This method combines high sensitivity,
      low expenditure, and a single methodology. A genetic analysis on F13B phenotypes
      in the Galician population is also discussed.

PMID- 8344673
TI  - [Adhesion molecules and homing in inflamed synovia].
AB  - The role of adhesion molecules for lymphocyte-endothelial interactions in the
      synovia of rheumatoid arthritis patients was studied using the frozen section
      assay. Partial inhibition of lymphocyte binding to endothelium of synovial
      sections could be observed with antibodies against CD44, L-selectin, beta 1 and
      beta 2 integrins, pointing to the participation of several adhesion molecules in
      the regulation of lymphocyte immigration into inflamed synovia.

PMID- 8344674
TI  - [Syndrome of T gamma lymphoproliferation of Fc gamma RIII- positive lymphocytes
      in rheumatoid arthritis].
AB  - A T gamma-lymphoproliferative syndrome is described in a 69-year-old woman with
      seropositive rheumatoid arthritis. The phenotype of this non-clonally increased
      large granular lymphocyte (LGL) population is unusual: LGL are CD56- Fc gamma
      RIII+(CD16+) and 30% coexpress gamma/delta-T-cell receptor.

PMID- 8344675
TI  - [Impaired function of polymorphonuclear neutrophilic granulocytes in rheumatoid
      arthritis].
AB  - The aim of this study was to investigate the PMN functions ingestion (I),
      bacterial killing (BK) as well as the chemiluminescence response to phorbol
      esters (PMACL) as a measure of PMN respiratory burst activity in RA compared to
      osteoarthritis and controls. Our findings demonstrated a significant reduction of
      I and BK in RA compared to OA and controls (p < 0.01 resp.) but an enhanced PMACL
      (p < 0.01). There was no significant difference of I, BK and PMACL in OA and
      control subjects. These data clearly demonstrated impaired PMN ingestion and
      bacterial killing yet enhanced PMACL in RA, thus contributing at least in part to
      altered host defense in these patients.

PMID- 8344676
TI  - [IgE rheumatoid factors: occurrence and diagnostic significance].
AB  - Sera from 80 patients suffering from rheumatoid arthritis--30 of them with
      extraarticular manifestations (EAM)--were analyzed for the presence of IgE
      rheumatoid factors (IgE RF), IgM RF, and immune complexes. Despite of a close
      correlation between IgM RF and IgE RF, IgE RF allow a better discrimination
      between patients with and without EAM (73.3 and 38.0%) compared to IgM RF (86.7
      and 78.0%). IgE RF could be found in 5% of patients suffering from bronchial
      asthma, but up to now not in nonrheumatic joint diseases.

PMID- 8344677
TI  - [Anti-neutrophil-cytoplasmic antibodies in rheumatoid arthritis: specificity and
      clinical relevance?].
AB  - Sera of 90 patients fulfilling the criteria of the American Rheumatism
      Association for the rheumatoid arthritis (RA) were screened for antibodies
      against neutrophil cytoplasmic antigens (ANCA) by an indirect immunofluorescence
      test. All sera were also tested for rheumatoid factor (Waaler-Rose-Test, WRT), C
      reactive protein (CRP), antinuclear autoantibodies (ANA) on HEp-2 cells. 40% of
      the 90 sera showed ANCA-positive reactions. c-ANCA and p-ANCA types were both
      observed but the latter was by far more common (91%). The peculiarity of the p
      ANCA pattern was a fine granular perinuclear staining. Antibodies against
      myeloperoxidase (MPO) were negative in all RA sera tested. So far we found a
      significant relationship between positive ANCA staining, functional Steinbrocker
      grades, and rheumatoid factor. No significant correlation was observed with
      extraarticular manifestation, CRP, therapeutic modalities (gold) or MHC antigens.
      Currently the nature of the neutrophil antigen involved is under investigation.

PMID- 8344678
TI  - [The matrix metalloproteinase gene family: structure, function, expression, and
      role in destructive joint disease].
AB  - The matrix metalloproteinases, i.e. collagenases, gelatinases and stromelysins,
      are members of a gene family. They are capable of degrading every component of
      the extracellular matrix. Tissue destruction observed in inflammatory joint
      disease is largely accounted for by the action of these enzymes. Among the most
      potent inducers of metalloproteinase expression are the inflammatory cytokines IL
      1 and TNF-alpha. Studies of mechanisms of induction by these mediators at the
      transcriptional level have improved our understanding of the biological controls
      of metalloproteinase synthesis. Cytokine inhibitors might serve to inhibit or
      postpone the crippling consequences of metalloproteinase action.

PMID- 8344679
TI  - [Anti-centriole antibodies and high neuron-specific enolase activity in a patient
      with Raynaud phenomenon, cerebrovascular lesions, and ischemic finger necrosis--a
      functional relationship?].
AB  - In a 49-year-old patient with acute thrombangitis obliterans, several vascular
      risk factors and associated features of collagen vascular disease, we observed
      anti-centriole autoantibodies and a strongly elevated neuron-specific enolase
      (NSE). The latter could not be attributed to an underlying malignant or
      neuroendocrine disease. The recent identification of NSE as a centrosomal protein
      suggests a causal relationship between anti-centriole autoantibodies and elevated
      serum NSE levels.

PMID- 8344680
TI  - [Cyclophosphamide bolus therapy in lupus nephritis--status of the clinical
      study].
AB  - In order to establish a low-dose cumulative cyclophosphamide therapy for lupus
      nephritis, 21 patients were either randomized for at least 3 i.v.
      cyclophosphamide pulses until remission occurred or for 12 pulses. 18/21 patients
      developed a remission after an average of 7.3 pulses and a cumulative
      cyclophosphamide dose of 9.3 g. Side effects were only mild.

PMID- 8344681
TI  - [Immunoglobulin therapy for systemic lupus erythematosus].
AB  - A 25-year-old patient with lupus erythematosus was admitted with myositis and
      erythema of the skin under chloroquine therapy. After improvement of clinical
      symptoms with cyclophosphamide and prednisolone he was again progredient with
      myositis. The changing of therapy to methotrexate showed a hepatotoxic side
      effect with elevated liver enzymes. Under subsequent therapy with azathioprine
      and prednisolone he developed leukopenia and sepsis. Because of persistent
      erythema of the skin under therapy with different immunosuppressives we performed
      a therapy with high-dose intravenous immunoglobulins. After application of
      immunoglobulins we observed an improvement of the erythema after 10 days, which
      was persistent after dose reduction for about 4 months.

PMID- 8344682
TI  - [Pulmonary thromboembolism in antiphospholipid syndrome].
AB  - The case of a young woman is presented who suffered from thromboembolic pulmonary
      hypertension. Thrombocytopenia developed late in the course of the disease and
      led to the diagnosis of secondary antiphospholipid syndrome.

PMID- 8344683
TI  - [Reduced "oxidative burst" in a granulocyte subpopulation in a case of Sweet
      syndrome].
AB  - Oxidative burst was defective in 50% of peripheral blood neutrophils in a case of
      Sweet syndrome with leukemoid granulocytosis. Phagocytosis was normal. We suggest
      that the decreased ability to produce oxygen radicals observed in this patient
      might lead to a compensatory recruitment of hematopoietic growth factors.
      Consecutive activation, increased chemotaxis and adhesion of polymorphonuclear
      granulocytes might be the cause of the neutrophilic dermal infiltrate of Sweet
      syndrome.

PMID- 8344684
TI  - [The mucosa-associated immune system--immune defense in the gastrointestinal
      tract].
AB  - The intestinal immune system has to protect the mucosa against microbial and
      toxic agents. This is achieved by elimination of potential antigens, which are
      inhibited to adhere and to invade the mucosa. Thus, induction of inflammatory
      processes is prevented. Elimination of antigens is mediated by the secretion and
      transport of IgA (and especially IgA2) to the lumen of the gut. There, IgA is the
      most efficient part of the so-called "mucosa block". The composition of
      mononuclear cells in the lamina propria exhibits the preference of a memory T
      cell type that is able to provide help for B cells. If IgA-mediated immune
      response proves not to be sufficient, IgG-mediated inflammatory processes are
      induced within the mucosa. The role of cytotoxic T cells and, moreover, the
      biological function of intraepithelial lymphocytes are still controversial.

PMID- 8344685
TI  - [Follow-up study of the development of autoantibodies in patients with chronic
      inflammatory bowel disease under anti-CD4 therapy].
AB  - 7 of 22 patients with chronic inflammatory bowel diseases (Crohn's disease,
      ulcerative colitis) were treated with an anti-CD4-mAb. In the immunological
      monitoring the amounts of autoantibodies to pancreatic acini cells, to intestinal
      goblet cells, to granulocytes with perinuclear fluorescence pattern were examined
      and human anti-mouse-antibodies were measured. After anti-CD4 therapy the
      production of autoantibodies was widely unchanged. Therefore its use as parameter
      in the follow-up is restricted.

PMID- 8344686
TI  - [Therapy of Crohn disease by immunomodulation with 7S immunoglobulins].
AB  - Immunoregulatory disturbances play an important role in pathophysiology of
      Crohn's disease. Because of this fact we tried to improve the situation in
      therapy-resistant cases by additional intravenous application of 10 g 7S
      immunoglobulin (Venimmun) for 10 days. The first patient with active Crohn's
      disease (CDAI 209) showed a steroid-related psychosis. Therapy had to be changed.
      During therapy with immunoglobulin Crohn's disease activity index decreased by 97
      points. Activity index fell in another patient during therapy from 363 to 150
      points. Both patients came into remission by additional therapy with 7S
      immunoglobulin. The number of leucocytes decreased and the number of lymphocytes
      increased. CD4/CD8 ratio in the peripheral blood changed in favour of suppressor
      cells and soluble interleukin-2 receptors were reduced. Immunoregulatory effects
      seem to be responsible for successful immunoglobulin therapy in Crohn's disease.

PMID- 8344687
TI  - [Characterization of allergens of timothy grass (Phleum pratense)].
AB  - By means of 2-D electrophoresis and subsequent immunoblotting allergens of
      timothy grass pollen are separated as single components. Via N-terminal
      sequencing, it is possible to classify these components as isoallergens of
      defined groups according to the allergen nomenclature. We are able to identify
      the allergens as Phl p I, Phl p IV, Phl p V and Phl p VI.

PMID- 8344688
TI  - [Circadian rhythm in cytokines].
AB  - The well-known human circadian rhythm (CR) in body temperature may be due to CR
      in endogenous pyrogens such as interleukin-1 (IL-1), interleukin-6 (IL-6), and
      tumor necrosis factor-alpha (TNF). We, therefore, investigated the daily
      variation in spontaneous and LPS-induced monokine release by peripheral blood
      cells (whole blood assay) in 10 healthy volunteers. Spontaneous release of
      monokines (IL-1, IL-6, TNF) showed a simultaneous significant peak at noon,
      whereas LPS-induced release of IL-1 and IL-6 was strictly correlated with the CR
      in body temperature with its significant maximum at 8.00 p.m. Since LPS-induced
      release of TNF showed a significant peak at 4.00 a.m., interleukins and TNF seem
      to be independently regulated. CR in IL-1 and IL-6 release are suggested to be
      responsible for the CR in body temperature.

PMID- 8344689
TI  - [20th conference of the clinical immunology group--a retrospective].

PMID- 8344690
TI  - [Preliminary results in a placebo-controlled, double-blind crossover clinical
      trial with human interleukin-2 (n-IL-2) in patients with variable
      immunodeficiency syndrome (CVID)].
AB  - Ten CVID patients with an in vitro defect for IL-2-synthesis were treated for 12
      months in a placebo-controlled double-blind crossover therapy study with human
      natural IL-2 s.c. There were no severe side effects of n-IL-2 recorded. Serum
      levels of soluble IL-2 receptors were unaffected by the therapy. Serum IL-2
      levels were only measurable in single patients during the therapy phase. Since
      verum and placebo groups did not differ with respect to requirement for
      intravenous gammaglobulin substitutions, n-IL-2 therapy was uneffective in
      switching on IgG synthesis in vivo. Nevertheless, there was an elevation in vitro
      of IgM synthesis in 5 patients and of IgG synthesis in 4 patients during n-IL-2
      therapy after stimulation of patients' lymphocytes with staphylococcus aureus
      Cowan I (SAC) plus n-IL-2 or with Pokeweed Mitogen (PWM) without n-IL-2.
      Additionally, an elevated IL-2-synthesis in vitro was recorded after OKT3
      stimulation for 3 CVID patients. There was a significant reduction of severe
      infections from 25 during the first 6 months of the study to 7 infections during
      the following 6 months, in the group of patients which received n-IL-2 first. In
      the second group, which received placebo first, there were no significant
      differences between placebo and n-IL-2 therapy phase detectable (25 infections
      during the first 6 months of the study and 24 severe infections in the second
      phase).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8344691
TI  - [In vitro IL-6- and immunoglobulin-production in patients with variable
      immunodeficiency syndrome (CVID)].
AB  - In vitro immunoglobulin and IL-6 synthesis were investigated in patients with
      CVID and healthy controls. The IL-6 production was increased in CVID patients.
      However, after calibration to equal monocyte counts in the mononuclear cell
      population the difference between patients and controls was no longer
      significant. The immunoglobulin production in CVID was decreased but no
      correlation between immunoglobulin and IL-6 production was found. From these
      results we suggest that monocyte activation might be of importance in terms of
      secondary organ lesions frequently occurring in CVID patients.

PMID- 8344692
TI  - [Wegener's granulomatosis and ANCA-associated vasculitis: pathogenic role of
      autoantigens, autoantibodies, and cytokines].
AB  - A real explosion of data is seen concerning the detection of autoantibodies
      collectively known as antineutrophil cytoplasmic antibodies (ANCA) recognizing
      granule proteins of granulocytes and monocytes. Distinct fluorescence staining
      patterns result from their diverse substrate specificities, and can even identify
      several disease entities mainly in the etiopathogenetically unclear group of
      primary systemic vasculitides (PSV). The well-documented disease specificity of
      ANCA recognizing proteinase 3 (PR3), and recent in vitro findings concerning the
      effect of cytokines on immunocompetent cells including the endothelium are the
      rationale for the presentation of a new model explaining the development of
      systemic vasculitis.

PMID- 8344694
TI  - [Silicosis and systemic diseases].
AB  - We present case histories of 5 patients with silicosis who developed systemic
      lupus erythematosus and microscopic polyarteritis in two cases each, and rapidly
      progressive glomerulonephritis (limited Wegener's granulomatosis) in one case. An
      association between silica exposure and autoimmune disease is emphasized.

PMID- 8344693
TI  - [Post infection antiidiotype vaccination against HIV: results of a phase Ia pilot
      study].
AB  - The mAb IOT4A against the HIV-gp 120 binding site on CD4 was shown to elicit the
      production of specific anti-idiotypes in rabbits neutralising HIV-1 in vitro.
      This study was designed in order to determine the safety and efficacy of the mAb
      IOT4A for the immunization of HIV+ volunteers. 10 patients in stages WR2-WR4B of
      HIV-disease were given six s.c. injections of the mAb IOT4A as an alum
      precipitate (each 3 patients receiving 0.6 or 1.2 mg, 4 patients receiving 2.4
      mg). 6 patients subsequently received a booster immunization with the same dose
      of the mAb IOT4A. The immunization schedule was accompanied by monitoring
      clinical, immunologic and virologic parameters. No systemic toxic or allergic
      effects of the idiotype vaccine were observed. 8/10 vaccinees displayed a delayed
      type hypersensitivity at the location of antibody administration beyond the third
      injection. The relative and absolute CD4 count showed a sustained increase in
      8/10 patients at the end of the booster immunization and an additional raise
      after booster immunization in 6/6 patients. 624 antigen levels became negative in
      2/2 patients during vaccination. In 4/10 patients in increase in HIV/gp 120
      antigen binding titres was observed. HIV neutralisation titer remained stable
      throughout the observation period, and no progression in HIV disease was observed
      in all patients included in this study. The administration of the mAb IOT4A as a
      vaccine in HIV-infected volunteers was well tolerated. The mAb ITO4A induced the
      production of specific anti-idiotypes, that might have been of clinical
      benefit.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8344695
TI  - [Interferon alpha antibodies show no cross reactions with typical
      autoantibodies].
AB  - Patients treated with natural human interferon alpha develop anti-interferon
      antibodies (IFN-AB) only in very rare cases. By contrast, patients with
      autoimmune disorders are able to generate high-titered IFN-AB against endogenous
      interferon alpha. One explanation for the development of auto-IFN-AB could be
      cross-reactivity with typical autoimmune antigens. We investigated the cross
      reactivity of 3 high-titered IgG IFN-AB of female autoimmune patients (aged 32,
      36, 74 years; two severe cases of SLE, one case of autoimmune thyroiditis) as
      well as 25 low-titered natural IgM IFN-AB of healthy blood donors (aged 19-48
      years). Typical autoimmune antigens including dsDNA, ENA, as well as natural
      interferon beta and recombinant interferon gamma are not able to inhibit binding
      of IFN-AB to interferon alpha in an ELISA test system. Preincubation of sera
      containing either dsDNA antibodies (dsDNA-AB) (24 patients), thyroid peroxidase
      (TPO-AB) (9 patients) or thyroglobulin (TG-AB) (12 patients) with interferon
      alpha resulted in no change in the respective autoantibody titer. These data
      suggest that there is no cross-reactivity between IFN-alpha-AB and dsDNA-AB, TPO
      AB or TG-AB. Thus, an explanation for the occurrence of IFN-AB in autoimmune
      disorders cannot be found in a cross-reaction between interferon alpha with
      typical autoimmune antigens.

PMID- 8344696
TI  - [Autoimmune diseases].
AB  - The etiology and pathogenesis of so-called autoimmune diseases are only known in
      rare examples. This speculative review argues that autoimmune diseases,
      particularly those mediated by, or dependent upon T cells may represent
      immunopathologies triggered by unrecognized infectious agents. Accordingly, when
      the etiologic agent is recognized, we call the ensuing disease
      immunopathological, where it is not known the disease is called autoimmune.

PMID- 8344697
TI  - [Virus and autoimmunity with emphasis on liver diseases].
AB  - The dualism virus pathogenesis and autoimmune pathogenesis in liver disease is
      given up increasingly. A survey is given about the development of autoimmunity
      and virus induction of the autoimmune hepatitis. The hypothesis of virus
      induction of autoimmune hepatitis put forward by Storch 1975 (19) is unproven up
      to now, but the concept of virus-associated autoimmune hepatitis put forward by
      Storch 1980 (23) is acknowledged today. First of all, antibodies against
      endoplasmic reticulum (liver and kidney microsomes) type 1, liver ribosomes, and
      liver cell cytoplasm are regarded as markers of a hepatitis C virus-associated
      autoimmune hepatitis. At present it is unknown, if antibodies against the surface
      of tongue epithelium, basal cells of squamous epithelium, Golgi apparatus, and
      nerve cells are further suitable markers.

PMID- 8344698
TI  - Schistosoma japonicum soluble egg antigens activate naive B cells to produce
      antibodies: definition of parasite mechanisms of immune deviation.
AB  - This study analysed the effect of Schistosoma japonicum egg antigens (SEA) on the
      activation of lymphocytes from naive mice. T cells were found to be unaffected by
      SEA. B cells, however, were activated by SEA without participation of adherent
      cells such as macrophages. B-cell activating factor(s) in SEA were distributed
      into a fraction of M(r) 120,000 and a fraction of M(r) 650,000 by gel filtration.
      However, a fraction of M(r) 120,000 demonstrated the presence of a limited number
      of components by polyacrylamide gel electrophoresis (PAGE) under non-denaturing
      conditions. These activating factor(s) were destroyed by peroxidase oxidation,
      heat treatment, chymotrypsin and trypsin digestion. These results indicate that
      the B-cell activating factor(s) in SEA contain both carbohydrate and protein. IgM
      antibodies were detected in the culture supernatant of SEA-activated B cells
      after 48 hr in culture, but IgG antibodies were undetected in culture. These
      antibodies did not react with SEA but reacted with sheep, horse, mouse red blood
      cells, carbonic anhydrase and autoantigens in myelinated nerve fibres of cerebrum
      as well as luminal surface and parietal cells of the stomach of naive mice. Thus
      our data demonstrated that SEA directly stimulates naive B cells to produce
      antibodies against heterophile and autologous antigens.

PMID- 8344699
TI  - The interaction of Tamm-Horsfall protein with the extracellular matrix.
AB  - Tamm-Horsfall protein (THP) is the major glycoprotein component of urine, yet its
      biological role remains obscure. Recent reports have suggested that a
      concanavalin A (Con A)-binding fraction of THP from pregnancy urine can bind the
      cytokines tumour necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1). In
      order to investigate this claim in relation to THP from normal adult urine we
      raised monoclonal antibodies to THP and sought THP/TNF-alpha interactions in
      three separate assay systems. We found no evidence that THP binds to TNF-alpha
      under physiological conditions, but we observed that it exerts a weak, probably
      not physiologically relevant, but reproducible inhibitory effect on the toxicity
      of TNF-alpha for monolayers of L929 cells, even when the cells are pretreated
      with the THP, and washed before addition of the cytokine. Since our preparations
      of THP do not interact directly with TNF-alpha we postulated an interaction with
      the cells themselves, or with their extracellular matrix. The THP was found by
      ELISA, immunoblotting and immunohistology, to bind to as yet unidentified
      components of the extracellular matrix in a manner dependent on cations, pH and
      carbohydrates. These data, considered in the light of the published amino acid
      sequence and biochemical properties, suggest that THP is a member of a structural
      glycoprotein family known to modulate cell adhesion.

PMID- 8344700
TI  - Down-regulation of cytokine production and interleukin-2 receptor expression by
      pooled human IgG.
AB  - The influence of pooled human IgG preparations for intravenous use (i.v.Ig) on in
      vitro-induced cytokine production was studied at the single-cell level using
      cytokine-specific monoclonal antibodies (mAb) and indirect immunofluorescent
      technique. Cultured mononuclear cells from peripheral blood from healthy adult
      donors were polyclonally stimulated for 96 hr by either direct ligation of T-cell
      receptors using immobilized anti-CD3 mAb or by a combination of a protein kinase
      C activator [phorbol 12-myristate 13-acetate (PMA)] and a calcium ionophore
      (ionomycin) in the absence or presence of i.v.Ig. A marked inhibition of
      proliferation and blast transformation was noted in all i.v.Ig exposed cultures,
      despite good cell survival. The production of the T-cell lymphokines interleukin
      2 (IL-2), IL-10,interferon-gamma (IFN-gamma) and tumour necrosis factor-beta (TNF
      beta) was significantly down-regulated during the whole studied period in the
      i.v.Ig containing anti-CD3 stimulated cultures. The synthesis of the monokine IL
      8 was not suppressed and that of TNF-alpha, which was made by both lymphocytes
      and monocytes, was only moderately inhibited. Somewhat different and more
      transient effects were observed in the i.v.Ig-exposed PMA/ionomycin-activated
      cultures. The production of IL-2, IL-3, IL-4, IL-5, IL-10, TNF-beta and
      granulocyte-macrophage colony-stimulating factor (GM-CSF) was down-regulated
      during the initial phase of the cultures up to 48 hr, but not at 48-96 hr. The
      synthesis of IFN-gamma and TNF-alpha was unaffected of the influence of i.v.Ig
      during the entire culture period. The expression of IL-2 receptors (IL-2R) was
      significantly suppressed in the i.v.Ig-treated anti-CD3-activated cells, but not
      in the PMA/ionomycin-stimulated cultures. Taken together our results indicate
      that pooled IgG may mediate immunomodulation by direct effects on cytokine
      production and on T-cell proliferation.

PMID- 8344701
TI  - Characterization of unique lymphoid cells derived from murine spleen which
      constitutively produce interleukin-6.
AB  - Attempts have been made to isolate continuous lines of rare subsets of lymphoid
      cells present in murine spleen in order to analyse their function and lineage
      relationship with respect to other lymphoid cells. Mitogenic stimulation was used
      to expand the lymphoid cells remaining in spleen following depletion of CD4+ and
      CD8+ T cells by antibody and complement treatment. Cells were cultured in the
      presence of concanavalin A (Con A), interleukin-2 (IL-2) and syngeneic irradiated
      spleen feeder cells. This procedure expanded a population of non-T-, non-B
      lymphoid cells bearing a common, unique phenotype resembling lymphoid precursors.
      Eight cloned lines from B10.A(2R) and B10.A(5R) strains of mice have been
      analysed here. Analysis of cell surface marker expression has revealed positive
      expression of class I and class II major histocompatibility complex (MHC)
      antigens, CD44, CD45 (T200 and B220) but expressing no markers unique to T, B or
      myeloid cells. All cell lines represent agranular lymphoblasts and show no
      evidence of early T-cell receptor (TcR) or Ig heavy chain gene rearrangements,
      suggesting no commitment to T-or B-lymphoid lineage. Despite expression of the
      NK1.1 marker for natural killer (NK) cells, none of the cell lines has been shown
      to have cytotoxic function for NK targets, nor could cytotoxic function be
      induced following various activation procedures. Analysis of lymphokine
      production has revealed no detectable IL-1, IL-2, IL-3, IL-4, IL-5, tumour
      necrosis factor-alpha (TNF-alpha) or granulocyte-macrophage colony-stimulating
      factor (GM-CSF) in cell supernatants. However, all but one of these cell lines
      constitutively produce IL-6. Each cell line has been shown to induce T-cell
      proliferation independently in mixed lymphocyte reactions, implicating the
      capacity of these cells to act as antigen-presenting cells. Consistent with this
      hypothesis is the observation that these cells also demonstrate endocytic
      activity for foreign proteins. This was visualized by their uptake of
      fluoresceinated albumin into cytoplasmic granules. Since they express many cell
      surface markers common to described isolates of spleen dendritic cells, including
      both class I and class II major histocompatibility molecules, they would appear
      to represent the first example of continuous lines of this rare cell subset.

PMID- 8344702
TI  - Effect of retinoic acid and vitamin D on the expression of interleukin-1 beta,
      tumour necrosis factor-alpha and interleukin-6 in the human monocytic cell line
      U937.
AB  - We have previously described a synergism between the two physiological hormones,
      retinoic acid (RA) and 1 alpha,25-dihydroxyvitamin D3 (VD) in the induction of
      U937 cell differentiation towards a more mature state. Herein, we investigated
      the regulation of cytokine production during RA and/or VD treatment of U937
      cells. Cell differentiation was followed by measurement of their capacity to give
      oxidative responses, and interleukin-1 beta (IL-1 beta), tumour necrosis factor
      alpha (TNF-alpha) and IL-6 gene and protein expression were determined in RA/VD
      treated cells, activated or not with lipopolysaccharide (LPS). The
      undifferentiated and RA-treated U937 cells were unable to produce monokines even
      when they were stimulated by LPS. VD induced the monokine mRNA expression in U937
      cells but failed to induce protein release. However, unlike RA, it primed the
      cells to secrete monokines upon endotoxin stimulation. A large enhancement of the
      production of the monokines both at mRNA and protein levels was observed in the
      U937 cells exposed to the combination of RA + VD. Nevertheless, protein release
      required a further step of activation of the RA + VD-primed cells. The co-inducer
      effect of RA and VD was not observed in HL-60 or THP-1 cells and seems to be
      restricted to U937 cells. These results on cytokine expression support our
      previous finding that a combination of RA and VD brings the U937 cells to a high
      stage of myeloid differentiation with major characteristics of
      monocytes/macrophages.

PMID- 8344703
TI  - C3 synthesis by A549 alveolar epithelial cells is increased by interferon-gamma
      and dexamethasone.
AB  - The third component of complement, C3, is produced in the lung by several cell
      types including alveolar epithelial cells. Since interferon-gamma (IFN-gamma) and
      dexamethasone regulate C3 gene expression in non-pulmonary cells, and because IFN
      gamma and dexamethasone interact to regulate the functional activity of alveolar
      epithelial cells, we investigated the effects of IFN-gamma and dexamethasone on
      C3 production by A549 human alveolar epithelial cells. Treatment of A549 cells
      with IFN-gamma alone increased C3 production in a time-and dose-dependent manner.
      Maximal increase in C3 production occurred after stimulation of A549 cells with
      500 IU/ml IFN-gamma for 3 days and was 3.4-fold greater than control.
      Dexamethasone (0.1 microM) stimulation of A549 cells increased C3 production 6.7
      fold over controls on day 3. Treatment of A549 cells with IFN-gamma plus
      dexamethasone resulted in an 11-to 13-fold increase in C3 synthesis. C3 mRNA
      levels were increased in A549 cells treated with IFN-gamma and dexamethasone
      individually and in combination suggesting that IFN-gamma and dexamethasone
      increase C3 synthesis by a pre-translational mechanism. IFN-gamma and
      dexamethasone did not alter the two-chain structure of the C3 molecule produced
      by A549 cells, as assessed by Western blotting. We speculate that IFN-gamma and
      glucocorticoids may be important in the local regulation of C3 synthesis in the
      lung.

PMID- 8344705
TI  - UVB irradiation renders corneal allografts tolerogenic for allospecific delayed
      hypersensitivity responses.
AB  - Heterotopic corneal allografts treated with ultraviolet (UV) radiation not only
      failed to elicit allospecific delayed-type hypersensitivity (DTH) responses in
      mice but rendered the hosts tolerant to subsequent immunization with normally
      immunogenic corneal allografts. The immunological tolerance induced by UV-treated
      grafts was cyclophosphamide sensitive and antigen specific. Adoptive transfer
      studies revealed that the tolerance to donor alloantigens could be transferred
      with CD4+, CD8- T cells which suppressed alloimmune DTH responses at the afferent
      but not the efferent limb. The capacity of UV-treated corneal allografts to
      induce allospecific tolerance was related to UV irradiation and not simply a
      result of loss of corneal viability. Formalin-fixed corneal allografts could not
      produce similar tolerization for DTH responses. Selective debridement of either
      the corneal epithelium or endothelium revealed that the corneal endothelium was
      the critical layer necessary for UV-dependent tolerance induction. Furthermore,
      the initial exposure to UV irradiation must occur through the endothelium and not
      the epithelium. Thus, the single-cell layered corneal endothelium is the target
      for the immunomodulatory effects of UV irradiation on corneal allografts.

PMID- 8344704
TI  - T-cell activation. VI. Inhibitory and stimulatory effects of anti-major
      histocompatibility complex class I antibodies in allogeneic mixed lymphocyte
      culture.
AB  - Murine T splenocytes stimulated in primary allogeneic mixed lymphocyte culture
      (MLC) were incubated with soluble anti-major histocompatibility complex (MHC)
      class I monoclonal antibodies. These antibodies induced inhibition in the
      cytotoxicity of the responding population and this inhibition was not dependent
      on the domain on class I molecules recognized by the antibodies. Cross-reactivity
      of the antibodies between the responder and stimulating cell population caused a
      marked reduction in the inhibitory effect compared to systems where no such cross
      reactivity was present. Saturating levels of the antibodies caused a reduction in
      generation of T-cell cytotoxicity, whereas low concentrations stimulated the same
      response. These results demonstrate that the MHC class I molecules of T cells are
      of significant importance in antigen-induced signal transduction.

PMID- 8344706
TI  - Variations in serum sCD23 in conditions with either enhanced humoral or cell
      mediated immunity.
AB  - Soluble CD23 (sCD23) is increased by interleukin-4 (IL-4) and decreased by
      interferon-gamma (IFN-gamma). On the basis of cytokine profiles T-helper (Th)
      cells may be functionally divided into IL-2- and IFN-gamma-secreting Th1 cells,
      which are involved in cell-mediated immunity (CMI), and IL-4- and IL-5-producing
      Th2 cells, which are involved in humoral immunity. Compared with sex-matched
      controls (median 8.5) we found significantly elevated levels of serum sCD23 in
      patients with rheumatoid arthritis (median 22.7, P < 0.0002), with the highest
      levels detected in patients fulfilling an increasing number of the American
      Association revised criteria for rheumatoid arthritis. Soluble CD23 levels were
      also significantly raised in autoimmune thyroiditis (median 11.7, P < 0.02) and
      myasthenia gravis (median 10.4, P < 0.05). In contrast patients with either
      coeliac (median 6.5) or Crohn's disease (median 5.8) had reduced levels of sCD23
      compared to appropriate controls (median 11.8), in both cases significant at P <
      0.01. Variations in sCD23 may, therefore, reflect enhanced Th1 activity in the
      two later conditions in contrast to heightened Th2 activity within the three
      classical autoimmune conditions.

PMID- 8344707
TI  - Renal allograft rejection: protection of renal epithelium from natural killer
      cells by cytokine-induced up-regulation of class I major histocompatibility
      antigens.
AB  - The potential of natural killer (NK) cells to contribute to renal allograft
      rejection was modelled by mixing NK cells with cultured renal epithelial cells.
      It was found that the renal cells were readily lysed by cytokine-activated NK
      cells. Renal cells which were previously stimulated by culture with either
      interferon-gamma (IFN-gamma) or supernatant from mixed leucocyte cultures (MLC)
      were relatively resistant to such lysis; stimulation with tumour necrosis factor
      alpha (TNF-alpha) had no effect. None of these cytokine preparations had any
      effect on the lysis of renal cells by either specific cytotoxic T lymphocytes or
      the antibody-dependent cell-mediated cytotoxic mechanism. The expression of class
      I major histocompatibility complex (MHC) antigens was up-regulated by stimulation
      of renal cells with either IFN-gamma or MLC supernatant; treatment with TNF-alpha
      had no effect on the expression of these antigens. Protection from NK cell
      mediated lysis appeared to correlate with the expression of class I MHC antigens
      by the renal cells. Artificial removal of these MHC antigens by treatment with
      citric acid significantly increased the susceptibility of cytokine-stimulated
      renal cells to lysis by activated NK cells. This increase was not caused by
      enhanced binding of NK cells to acid-treated renal cell targets. These results
      suggest that high levels of class I MHC antigen expression block NK cell
      triggering after engagement with renal epithelial cells. It is concluded that
      cytokines present within the renal microenvironment during rejection protect
      graft cells from lysis by NK cells by causing local upregulation of the
      expression of class I MHC molecules.

PMID- 8344708
TI  - The mechanisms of IgE uptake by human alveolar macrophages and a human B
      lymphoblastoid cell line (Wil-2wt).
AB  - Human alveolar macrophages (HAM) internalized more IgE (81%) than human Wil-2wt B
      lymphoblastoid cells (28%) suggesting a difference in the metabolic processing of
      the specific IgE receptor (CD23) or, alternatively, the presence of another
      functionally distinct receptor. The mannose receptor (MR), demonstrated to be
      present on the AM, may fulfil this role as IgE is heavily mannosylated and binds
      to a greater extent to concanavalin A (Con A) (which has specificity for
      oligomannose oligosaccharide chains) than other antibody isotypes. The hypothesis
      of a second IgE receptor was tested using mannan which is a competitive inhibitor
      of ligand binding to the MR and mannosylated bovine serum albumin (MBSA) which
      binds with avidity to the MR. Mannan (0.1 mg/ml) decreased internalized MBSA
      uptake in the HAM at 37 degrees suggesting the presence of the specific MR. In
      contrast, Wil-2wt cells did not bind MBSA. Mannan also reduced IgE uptake in the
      HAM at 37 degrees but had no effect on IgE uptake by Wil-2wt cells. Anti-CD23
      monoclonal antibody (mAb) 135 also partially reduced membrane IgE uptake in HAM
      while completely inhibiting it by Wil-2wt cells. However, there did not appear to
      be competition for binding sites between IgE and MBSA in HAM. If only CD23 is
      involved in IgE uptake by HAM its function appears to be different to that in Wil
      2wt cells. Definite involvement of the MR in IgE uptake will require further
      investigation as it may have an important role in allergic states.

PMID- 8344710
TI  - Cell-surface expression of human histocompatibility leucocyte antigen (HLA) class
      II-associated invariant chain (CD74) does not always correlate with cell-surface
      expression of HLA class II molecules.
AB  - The human histocompatibility leucocyte antigen (HLA) class II-associated
      invariant chain comprises at least four polypeptides. One of these is expressed
      as a membrane-bound subunit and has been designated as CD74. We investigated the
      expression of CD74 on B- and T-cell types utilizing monoclonal antibodies (mAb)
      specific for the c-terminus of CD74. All B cells tested expressed CD74 regardless
      of their HLA phenotypes. High and low CD74 expressors were provisionally assigned
      based on quantitative variations found in some haplotypes. A mutant cell with
      selective deletions of class II loci DR and DQ but with retention of DP and
      additional class II heterodimers synthesize normal amounts of CD74. In contrast,
      however, a mutant with a total class II deletion had diminished expression of
      CD74, suggesting that at least one of the class II isotypes is essential for full
      constitutive expression of CD74. Major histocompatibility complex (MHC) class II
      negative T-cell lines and CD3+ T cell isolated from peripheral blood did not
      express CD74. However, allostimulated T cells which express de novo induced class
      II determinants also did not express CD74. Taken together, these results show
      that CD74 is expressed on B cells and unexpectedly is not synthesized on de novo
      induced class II positive T-cell clones.

PMID- 8344711
TI  - Co-operation of interleukin-1 beta and tumour necrosis factor-alpha in the
      activation of human umbilical vein endothelial cells to inhibit Toxoplasma gondii
      replication.
AB  - The tachyzoites of the RH strain of Toxoplasma gondii invaded and replicated in
      cultured human umbilical vein endothelial cells (HUVEC). Co-treatment of the
      HUVEC with human recombinant interleukin-1 beta (IL-1 beta) and tumour necrosis
      factor-alpha (TNF-alpha) inhibited the replication of T. gondii. Growth of the
      parasite was measured in vitro by [3H]uracil incorporation assay 18 hr after
      infection. This assay showed that when cells were pretreated with IL-1 beta and
      TNF-alpha concentrations ranging from 1 to 100 U/ml, a high degree of inhibition
      was observed with a phenomenon of co-operation causing a dose-dependent
      inhibition of the replication of intracellular T. gondii. The mechanism(s) by
      which the inhibition of multiplication was effected remains to be elucidated.

PMID- 8344709
TI  - Eosinophil accumulation induced by human interleukin-8 in the guinea-pig in vivo.
AB  - Interleukin-8 (IL-8) is a neutrophil chemoattractant cytokine. Initially IL-8
      appeared to exhibit specificity for neutrophils over other cells of the immune
      system. However, several recent studies have shown that this mediator can also
      activate other leucocyte types in vitro. In this study we have used an in vivo
      model of local [111In]leucocyte accumulation in the guinea-pig and an in vitro
      assay of leucocyte activation (changes in cytosolic-free Ca2+) to investigate the
      eosinophil chemoattractant activity of IL-8. The intradermal injection of
      recombinant human (rh)IL-8 induced a dose-dependent accumulation of intravenously
      administered [111In]eosinophils into the skin sites over 4 hr. Time-course
      experiments revealed that this cell infiltration was delayed in onset, occurring
      between 1 and 2 hr after injection of IL-8. The delay may indicate that IL-8
      operates via an indirect mechanism. In contrast, eosinophil accumulation induced
      by the complement fragment C5a occurred within the first hour following
      injection. Other human cytokines, IL-1, IL-3, IL-5, tumour necrosis factor (TNF)
      and granulocyte-macrophage colony-stimulating factor (GM-CSF), were not
      eosinophil chemoattractants in this in vivo test system. Direct activation of
      eosinophils by IL-8 was demonstrated in vitro by a transient elevation in
      cytoplasmic-free Ca2+ levels where it was less potent than either rhC5a or
      leukotriene B4 (LTB4). Experiments using [111In]neutrophils in vivo indicated
      that rhIL-8 and rhC5a were similar in potency in inducing local neutrophil
      infiltration into guinea-pig skin. The demonstration of the eosinophil
      chemoattractant activity of IL-8 in vivo raises the possibility that this
      cytokine, or a structurally related molecule, contributes towards eosinophil
      infiltration in a number of inflammatory conditions such as asthma, helminthic
      infections and adult respiratory distress syndrome.

PMID- 8344712
TI  - Peripheral blood neutrophils from HIV-1-infected individuals are armed with
      factors that cause inhibition of their migration in response to specific
      antigens.
AB  - In this study, synthetic peptides that copy conserved regions of the HIV-1
      envelope proteins gp120 and gp41 were tested for their impact on the chemotaxis
      of leukocytes and neutrophils from HIV-1-infected individuals, while neutrophils
      from HIV-1-infected patients were tested for their effect on the chemotaxis of
      neutrophils from healthy donors. The synthetic peptides (corresponding to the 251
      272-amino acid sequence of gp120 and the 584-618-amino acid sequence of gp41)
      were capable of specifically inhibiting the formyl peptide-induced chemotaxis of
      cells from HIV-1-infected patients, and such inhibition was observed both with a
      total leukocyte population and with pure neutrophils. The migration of
      neutrophils from healthy donors was specifically inhibited in the presence of
      either of the synthetic peptides of HIV-1 envelope proteins after their
      incubation with neutrophil supernatants obtained from HIV-1-infected individuals.
      As shown by ELISA tests, the neutrophil supernatants from HIV-1-infected
      individuals contain antibodies to a recombinant env-1 protein that might be one
      of the reasons for the specific arming of neutrophils from HIV-1-infected
      persons.

PMID- 8344714
TI  - Enhancing effect of 17 beta-estradiol on human NK cell activity.
AB  - The in vitro effect of 17 beta-estradiol on NK activity was studied. The
      proliferation and NK activity of YT-N17 (a human NK-like cell line) were enhanced
      by 17 beta-estradiol (E2), and the enhancement was blocked by tamoxifen (Tx), an
      antagonist of E2. On the contrary, other steroid hormones such as Tx,
      progesterone, and testosterone had no effect. YT-N17 contained 11.8 fmol/mg
      protein of estrogen receptor (mean of two independent assays), a value which was
      5-10-fold higher than that of other hematopoietic cell lines. An enhancement of
      NK activity by E2 was also seen in large granular lymphocytes obtained from
      normal subjects, and it was again suppressed by Tx. These data suggest that E2 is
      one of the activating factors for NK/LGL cells.

PMID- 8344713
TI  - Analysis of the hairless mouse as a model for the effects of aging on the immune
      system.
AB  - Studies into the effects of aging on the immune system are hampered by the lack
      of a suitable animal model that is readily available and cost efficient. The
      mutant mouse, hairless (hr/hr genotype), has been shown to undergo an accelerated
      thymic involution with accompanying immunodeficiency. Thus, this strain of mouse
      has been proposed as a model for studying the interactions of aging and immune
      function. We have investigated the effects of homozygous hr gene expression over
      time on the immune function of these mice. It was observed that homozygous hr
      gene expression had minimal effects on peripheral lymphocyte subset compositions
      but did appear to result in changes in thymic differentiation. Further, hr/hr
      mice displayed decreased proliferative responses to IL2 and mitogen stimulation,
      although cytotoxic responses (both NK and T cell mediated) appeared normal. These
      defects appear to be attributable to T helper cell dysfunction. Each of the
      changes found in hr/hr mice were distinct from those seen with age-matched
      control mice. Thus, the hr/hr inbred strain of mouse does not appear to be a
      suitable model for use in analyzing the effects of aging on the immune system.

PMID- 8344715
TI  - The effect of IL-4 on the phenotype of a human B-cell lymphoma line (Farage)
      lacking immunoglobulin expression.
AB  - Farage cells do not express surface immunoglobulins (sIg) but display a high
      level of CD19, CD21, CD22, CD23, CD39, CD40 B-cell antigens, and various adhesion
      proteins, such as CD11a (LFA-1), CD29 (VLA-4), CD44, CD54 (ICAM-1), and CD58 (LFA
      3). The phenotype of Farage resembled that of EBV-LCL but differed from the
      phenotype of Burkitt's lymphoma lines, which were CD39- CD44-, expressed a high
      level of CD38, and either lacked CD21 or were weakly positive. Exposure to IL-4
      augmented the concentrations of CD23 and of adhesion proteins on the surface of
      Farage cells but diminished the expression of CD21, CD22, and CD38. IL-4 did not
      induce the expression of sIg on Farage cells and failed to affect the level of
      HLA-DR. IL-2 and TPA did not alter the level of CD21 and adhesion proteins on
      Farage cells. Although IL-4 induced unique changes of the antigenic pattern in
      Farage, no significant effect on the phenotype of Burkitt's lymphoma lines was
      detected after IL-4 treatment. The present study indicates that the
      responsiveness of B cells to IL-4 is not determined by the expression of sIg but
      rather is associated with the antigenic profile characteristic for non-germinal
      center B lymphocytes.

PMID- 8344716
TI  - Enhancement of systemic and mucosal immune responses following oral
      administration of liposomes.
AB  - The effects of liposomes on the systemic and mucosal immune response were
      investigated using bovine serum albumin (BSA) in BALB/c mice. Following three
      oral administrations of varied formulations at 1-week intervals, serum BSA
      specific IgG levels were increased significantly by BSA encapsulated in liposomes
      and moderately by a mixture of liposomes and BSA. Serum and salivary BSA-specific
      IgA levels were elevated by BSA-encapsulating liposomes only. Liposomes thus
      activate not only the systemic immune response but also the mucosal immune
      response following their oral administration. However, no increase in salivary
      IgA levels was observed by intraperitoneal or subcutaneous injection of BSA
      encapsulating liposomes. The production of IgA is closely related to the oral
      administration of liposomes encapsulating antigens. Liposomes thus function as
      carriers of oral vaccines against various infections of the mucosal surface.

PMID- 8344717
TI  - Isolation and amino acid sequence of a chemotactic protein, LECT/interleukin 8,
      from a human myeloid leukemia cell line, ML-1.
AB  - We looked for chemotaxin/interleukin 8 (CT/IL-8) activity in the culture fluids
      of 97 human leukemia cell lines and found it in two of the T cell lines, six of
      the myeloid cell lines, and one of the normal B-cell lines. It was particularly
      strong in the culture fluids of two cell lines. These cell lines secreted a
      chemotactic protein into the culture fluids under certain conditions of
      stimulation with phorbol-12-myristate 13-acetate (PMA), lipopolysaccharide, or
      hemagglutinin-P. A myeloid leukemia cell line, ML-1, secreted an inducible
      chemotaxin when stimulated with PMA (1 ng/ml) for 24 h. We purified the
      chemotaxin from ML-1 cell culture fluid using an improved procedure:
      concentration with DEAE-Sepharose CL-6B and CM-Sepharose CL-6B, CM-Sepharose
      column chromatography, and reverse-phase 5TMS-300 column on HPLC with the
      retention time coinciding with that of LUCT/IL-8 [Suzuki et al., 1989, J. Exp.
      Med. 169, 1895]. The yield was 200 micrograms protein from 6 liters of the
      culture fluid. The N terminus of CT/IL-8 was AVLPR-SAKELRXQXIKTYSK- - -, the same
      as that of LUCT/IL-8, which is constitutively secreted from lung giant cell
      carcinoma LU65C cells. The optimal concentration in the chemotactic activity of
      CT/IL-8, equivalent to that of bacterial chemotactic peptide fMet-Leu-Phe (10
      nM), was found to be 5 nM. The results show that this chemotaxin is identical to
      LUCT/IL-8.

PMID- 8344719
TI  - A physical map of the human complement component C6, C7, and C9 genes.
AB  - The genes for human complement components C6, C7, and C9 are linked on chromosome
      5. In this report we describe the physical linkage between C6 and C7 genes. DNA
      fragments obtained by digestion with several rare-cutting restriction enzymes
      were separated through pulsed field gel electrophoresis. Hybridization with
      probes corresponding to the 5' and 3' ends of the three cDNAs showed common bands
      for the C6 and C7 genes. Both genes are contained in a NotI fragment of 500
      kilobases (kb). Moreover, the presence of common 3' C6 and 3' C7 fragments
      indicates that both genes are oriented in a tail-to-tail, reverse way relative to
      transcription. No evidence of physical linkage between C9 and C6 or C7 was found
      in the range 50 kb-2.5 megabases (Mb).

PMID- 8344718
TI  - Phylogeny of immunoglobulin heavy chain isotypes: structure of the constant
      region of Ambystoma mexicanum upsilon chain deduced from cDNA sequence.
AB  - An RNA polymerase chain reaction strategy was used to amplify and clone a cDNA
      segment encoding for the complete constant part of the axolotl IgY heavy (C
      upsilon) chain. C upsilon is 433 amino acids long and organized into four domains
      (C upsilon 1-C upsilon 4); each has the typical internal disulfide bond and
      invariant tryptophane residues. Axolotl C upsilon is most closely related to
      Xenopus C upsilon (40% identical amino acid residues) and C upsilon 1 shares
      46.4% amino acid residues among these species. The presence of additional
      cysteines in C upsilon 1 and C upsilon 2 domains is consistent with an additional
      intradomain S-S bond similar to that suggested for Xenopus C upsilon and C chi,
      and for the avian C upsilon and the human C epsilon. C upsilon 4 ends with the
      Gly-Lys dipeptide characteristic of secreted mammalian C gamma 3, human C epsilon
      4, and avian and anuran C upsilon 4, and contains the consensus [G/GT(AA)]
      nucleotide splice signal sequence for joining C upsilon 4 to the transmembrane
      region. These results are consistent with the hypothesis of an ancestral
      structural relationship between amphibian, avian upsilon chains, and mammalian
      epsilon chains. However, these molecules have different biological properties:
      axolotl IgY is secretory Ig, anuran and avian IgY behave like mammalian IgG, and
      mammalian IgE is implicated in anaphylactic reactions.

PMID- 8344720
TI  - TAP1 and TAP2 polymorphism in coeliac disease.
AB  - Coeliac disease is strongly associated with HLA-DQ2, but it is possible that
      additional major histocompatibility complex genes also confer disease
      susceptibility. Encoded close to HLA-DQ are two genes, TAP1 and TAP2, whose
      products are believed to transport antigenic peptides from the cytoplasm into the
      endoplasmic reticulum. Comparison of 81 coeliac disease patients with caucasoid
      controls revealed an increased frequency of the alleles TAP1A and TAP2A in the
      patient population. However, no significant difference was found when patients
      were compared with HLA-DR and -DQ matched controls, indicating linkage
      disequilibrium between TAP1A, TAP2A, and HLA-DQ2. The TAP gene products do not
      have a major influence on susceptibility or resistance to coeliac disease in a
      Northern European Caucasoid population.

PMID- 8344722
TI  - Linkage studies between the Tcp-1, Tcp-10, and Mhc-Eqca-A loci in the horse.

PMID- 8344721
TI  - Sharing of an HLA-B27-restricted H-Y antigen between rat and mouse.
AB  - The purpose of this work was twofold: 1) to learn whether rats transgenic for HLA
      B27 and the human beta 2-microglobulin gene HB2M can mount B27-restricted
      cytolytic T lymphocyte (CTL) responses to the male H-Y antigen, and 2) to learn
      whether such CTLs would recognize both rat and mouse H-Y in the context of HLA
      B27. Female rats of the B27/HB2M transgenic line 21-4L were primed in vivo with
      cells from males of the same line. CTL effectors were generated from lymph node
      cells of these females following culture with irradiated antigen-presenting cells
      from either male 21-4L rats or male mice of the B27/HB2M transgenic 56-3 line.
      The CTLs showed male-specific, B27-specific lysis of both rat and mouse targets.
      Lysis of B27 targets was inhibitable by monoclonal antibodies specific for B27 or
      rat CD8. Specific lysis of male B27 rat and mouse targets was inhibitable equally
      by either rat or mouse male B27 cold targets, but not significantly by female or
      nontransgenic cold targets. The B27-restricted CTLs neither recognized nor were
      inhibited by B27+ or B27- male or female human targets. These results demonstrate
      that CD8+, B27-restricted, anti-H-Y CTLs recognize an evolutionarily conserved H
      Y peptide antigen in both rats and mice. In addition, they establish the
      transgenic rat as a model system for examining the T-cell response to antigen
      presented by class I HLA molecules.

PMID- 8344723
TI  - A large linkage group on pig chromosome 7 including the MHC class I, class II
      (DQB), and class III (TNFB) genes.

PMID- 8344724
TI  - Expression of the Q2 gene of the MHC in thymus and intestinal epithelial cells.

PMID- 8344725
TI  - Different genomic structure of mouse and human Lmp7 genes: characterization of
      MHC-encoded proteasome genes.

PMID- 8344726
TI  - Novel class II HLA-DRB4 and DPB1 alleles found in the Belgian population.

PMID- 8344727
TI  - Structural polymorphism of six rat RT1Ba genes.

PMID- 8344728
TI  - Polymorphisms involving the transmembrane domains of human TAP2.

PMID- 8344729
TI  - Nucleotide sequence of horse beta 2-microglobulin cDNA.

PMID- 8344731
TI  - Postoperative pulmonary complications in patients with preoperative lung disease.
AB  - A prospective study was carried out on the incidence of pulmonary complications
      in 728 patients who underwent major surgical procedures at a reputed hospital in
      New Delhi. These patients were preoperatively assessed on the basis of history,
      clinical examination and bedside pulmonary function tests including PEFR, VC, FVC
      and FEV1. On the basis of these criteria, 212 patients had significant
      preoperative pulmonary disease, while 516 had normal lung functions.
      Postoperative pulmonary complications developed in 7.69 per cent of the patients.
      They were more frequent in smokers (P < 0.001) and in those with preoperative
      pulmonary dysfunction (P < 0.001). Their incidence was greater following thoraco
      abdominal and musculoskeletal and miscellaneous operations compared to lower
      abdominal surgery (P < 0.001). The incidence was also higher following exposure
      to general anaesthesia compared to regional anaesthesia (P < 0.05). Pneumonia and
      atelectasis were the most common postoperative pulmonary complications. It was
      observed that the recovery of pulmonary functions was delayed in patients who
      developed postoperative pulmonary complications.

PMID- 8344730
TI  - DNA sequence analysis and polymorphism of the mouse CD4 gene.

PMID- 8344732
TI  - Immunocytochemical detection of prolactin binding sites in fine needle aspiration
      smears of breast lesions.
AB  - Specific prolactin (PRL) binding sites were demonstrated in the fine needle
      aspiration cytology (FNAC) specimens from 68 patients with benign and malignant
      diseases of the breast using highly sensitive technique of DNP hapten sandwich
      staining procedure and antibody against human PRL. In 16 patients,
      immunocytochemical staining was also carried out on paraffin embedded sections of
      corresponding lesions. FNAC specimens included 52 neoplasms and 16 non
      proliferative and proliferative benign breast disease. The reaction varied in
      different lesions, being maximum (72%) in malignant tumours and 60 per cent in
      benign tumours. However, benign breast disease showed a reaction that varied with
      the lesion. The technique was found to be simple, sensitive and economical for
      demonstrating specific PRL binding sites in cytology specimens of breast lesions.

PMID- 8344733
TI  - A hospital-based study on the use of paramedical personnel for clinical
      downstaging of cancer cervix.
AB  - Two auxiliary nurse midwives (ANMs) were recruited and trained to recognize
      normal and different types of abnormal cervices. A total of 2102 women were
      examined by a gynaecologist and ANM independently and their findings were noted.
      Comparison of their findings showed an overall agreement of 89.6 per cent (Kappa
      0.84 with standard error of 0.015 and a significantly large Z value of 55.6).
      Gross examination of 4679 women attending the Gynaecology OPD revealed normal
      cervix in 49.6 per cent and suspected lesions or malignant cervix in 3.4 per cent
      of women. Cytology smears were taken in 3608 women. Adequacy of smears was 97 per
      cent. Comparing the group clinically diagnosed as highly suspected or malignant
      to the cytologically diagnosed suspected group (atypical and malignant), clinical
      examination had a sensitivity of 81.7 per cent and specificity of 97.3 per cent;
      while comparison of the group clinically diagnosed as abnormal cervix to abnormal
      cytology (all grades of dysplasia, atypical and malignant cells), the clinical
      examination had a sensitivity of 92.5 per cent and specificity of 37.4 per cent.
      It was concluded that paramedical staff (ANMs) can be relied upon to do speculum
      examination in women in the community and take cytology smears in selected cases.

PMID- 8344734
TI  - A preliminary open trial on interferon stimulator (SNMC) derived from Glycyrrhiza
      glabra in the treatment of subacute hepatic failure.
AB  - The efficacy of the interferon stimulator named Stronger Neo Minophagen-C (SNMC)
      derived form the plant G. glabra was studied at a dose of 40 or 100 ml daily for
      30 days followed by thrice weekly intravenously for 8 wk in 18 patients of
      subacute hepatic failure due to viral hepatitis. The survival rate amongst these
      patients was 72.2 per cent, as compared to the earlier reported rate of 31.1 per
      cent in 98 patients who received supportive therapy (P < 0.01). Death in four of
      the five patients was due to associated infections leading to hepatorenal failure
      and terminal coma. Further studies are necessary to standardize the dose and
      duration of therapy with SNMC in subacute hepatic failure.

PMID- 8344735
TI  - Preclinical & pharmaceutical testing of liposomal amphotericin B.
AB  - Various liposomal amphotericin-B formulations prepared from soya
      phosphatidylcholine and cholesterol were tested for toxicity, therapeutic
      efficacy and stability in mice infected with Aspergillus fumigatus. No advantage
      was noted by removing the unencapsulated drug from that bound to liposomes, as
      evident by the LD50 and efficacy being similar with both dialyzed and undialyzed
      formulations. Small unilamellar liposomes were more effective and less toxic, but
      also less stable, as compared to multilamellar vesicles. In view of these
      results, multilamellar liposomes were prepared without removing the
      unencapsulated drug and converted to unilamellar vesicles just prior to
      administration. The LD50 and efficacy of this formulation was similar to freshly
      prepared small unilamellar liposomes. These liposomes were prepared under aseptic
      conditions and were found to be sterile and pyrogen-free. The batch-to-batch
      variation was also found to be quite low, and therefore liposomal amphotericin B
      formulation suitable for administration in patients suffering with systemic
      fungal infection has been developed.

PMID- 8344736
TI  - Lactose intolerance in idiopathic ulcerative colitis in north Indians.
AB  - The incidence of lactose intolerance in 60 patients with idiopathic ulcerative
      colitis (IUC) from northern India and the effect of disease activity and extent
      of colonic involvement on the occurrence of lactose intolerance, was studied.
      Twenty controls matched for age and sex were also studied using 50 g lactose
      hydrogen breath test. The incidence of lactose intolerance in patients with IUC
      (41.7%) was no different from that in the control group (40%). There was however,
      a significant difference (P < 0.05) in the incidence of lactose intolerance in
      patients with active colitis (59.1%) as compared to those with quiescent disease
      (31.5%).

PMID- 8344737
TI  - Effect of phenobarbitone on pituitary gland of male albino mice.
AB  - The effects of phenobarbitone on gonadotrophs and lactotrophs of pituitary gland
      were studied in male albino mice which were administered phenobarbitone 50 mg/kg
      body weight intraperitoneally (ip) daily for 14 days. A group of control mice
      were administered saline ip. In the experimental group, there was significant
      reduction in the average cell population of FSH cells in the cephalomedian area
      (P < 0.001) and in the lateral lobe (P < 0.01). The average volume of both FSH
      and LH cells was also significantly reduced (P < 0.001). The changes in the
      gonadotrophs of the experimental group could be attributed to the negative
      feedback action of testosterone which is being secreted from hypertrophied Leydig
      cells of testis.

PMID- 8344738
TI  - Evaluation of a modified IRMA for anti-D quantitation, using 3H protein A.
AB  - A modified immunoradiometry assay (IRMA) using tritiated (3H) protein A was
      developed to estimate anti-D concentration. The main advantages of the assay were
      longer shelf life of the labelled reagent (more than two years); minimum
      radiation hazard and; low non specific binding. Levels of anti-D were estimated
      in 23 Rh (D) immunised women. A good correlation of anti-D concentration
      (micrograms/ml) with Rh antibody titre was observed (r = +0.89, P < 0.01). Anti-D
      concentration estimated by 3H protein A IRMA correlated well with the severity of
      Rh-HDN. This assay could quantitate anti-D in sera having exclusively IgG3
      subtype.

PMID- 8344739
TI  - Changing profile of haematogenous osteomyelitis in a teaching hospital.
AB  - A total of 155 consecutive patients of osteomyelitis were studied clinically,
      radiologically and bacteriologically. The follow up ranged from 2 1/2 to 4 1/2 yr
      (average 3.5 yr). Age varied from 8 months to 50 yr. Onset of the disease was
      acute in 106 and insidious in 49 patients. Of these 116 cases were treated
      conservatively which include 12 treated by incision and drainage. The rest
      underwent surgery (saucerization, curettage, sequestrectomy etc.). There was a
      trend for osteomyelitis to shift from the known incidence in early age to
      adulthood, acute to insidious onset and infection by Gram positive to Gram
      negative organisms.

PMID- 8344740
TI  - Effect of tri-ortho-cresyl phosphate on hen nervous system.
AB  - Correlation of tri-ortho-cresyl phosphate (TOCP) toxicity with clinical symptoms
      and inhibition patterns of neurotoxic esterase (NTE) in different regions of the
      central nervous system was studied in hens. The total content of NTE in spinal
      cord and peripheral nerves was relatively much lower than that of the brain,
      about 29 and 4.8 per cent respectively. Brain and spinal cord NTE was inhibited
      to 75 and 67 per cent respectively on day 1 post-TOCP treatment, and 91 and 84
      per cent respectively on day 2, while the activity of the enzyme in peripheral
      nerve was inhibited to 92 per cent on day 1. However, the clinical manifestations
      of paralysis appeared after 7-8 days of TOCP treatment. It can be concluded that
      the presence of NTE in very low quantities in the peripheral nerves and its
      almost complete inhibition as compared to that of brain and spinal cord, could be
      of great significance in the development of neurotoxicity.

PMID- 8344741
TI  - From adjuvant to neo-adjuvant chemotherapy in high-risk breast cancer: the
      experience of the Milan Cancer Institute. Steiner Award Lecture 1992.

PMID- 8344742
TI  - Altered expression of basement-membrane components and collagenases in ascitic
      xenografts of OVCAR-3 ovarian cancer cells.
AB  - Ascitic ovarian cancer cells, which derive from solid tumors, complicate the
      treatment of ovarian cancer by spreading throughout the peritoneal cavity.
      Because basement-membrane components may influence tumor-cell proliferation and
      dissemination, the present studies examined the production of (a) basement
      membrane attachment and migration factors (laminin, fibronectin and type IV
      collagen); (b) a laminin receptor, the 32/67-kDa laminin-binding protein, the
      presence of which correlates with malignancy; and (c) metalloproteinases (types I
      and IV collagenase and stromelysin), by ascitic and cultured OVCAR-3 cells and
      solid OVCAR-3 tumors. The cultured cells and solid tumors produced high levels of
      mRNA encoding attachment factors and metalloproteinases, and low levels of mRNA
      for the 32/67-kDa laminin receptor. In contrast, the ascitic ovarian cells had
      low or undetectable levels of mRNA encoding laminin, type IV collagen and
      metalloproteinases, but higher levels of transcripts for the laminin receptor.
      Our results suggest that the apparent inability of ascitic OVCAR-3 cells to
      attach to host-tissue surfaces may be a consequence, in part, of low levels of
      expression of laminin, type IV collagen and/or type IV collagenase.

PMID- 8344743
TI  - Modification of TNF-alpha pharmacokinetics in SA-1 tumor-bearing mice.
AB  - Fibrosarcoma-SA-I-tumor-bearing mice were treated s.c. in the vicinity of tumors
      (peri-tumorally) or intravenously, with recombinant human TNF-alpha lacking 1 to
      3 amino acids from N-terminal part (TNF-alpha Nv3). Tumor growth delay, observed
      after both routes of TNF-alpha Nv3 application, was statistically significant,
      though a better anti-tumor effect was achieved after peri-tumoral application.
      TNF-alpha Nv3 serum levels were determined in these animals and compared with TNF
      alpha Nv3 serum levels in healthy animals, which were treated with TNF-alpha Nv3
      either s.c. or i.v. The peak serum levels of TNF-alpha Nv3 applied peri
      tumorally/s.c. were significantly higher in tumor-bearing than in healthy mice,
      whereas smaller differences in peak serum levels were found after i.v.
      application, which might correlate with anti-tumor activity. Whatever the route
      of application, TNF-alpha Nv3 elimination from the serum of tumor-bearing mice
      was slower than that in healthy animals. Also, comparison of TNF-alpha Nv3
      pharmacokinetic parameters for tumor-free and sarcoma- or melanoma-bearing mice
      has demonstrated that the pharmacokinetics of TNF-alpha Nv3 are modified in tumor
      bearing animals.

PMID- 8344744
TI  - Analysis of production, purification, and cytolytic potential of bi-specific
      antibodies reactive with ovarian-carcinoma-associated antigens and the T-cell
      antigen CD3.
AB  - OV-TL3 and MOv 18 MAbs, due to their restricted specificity, have been
      successfully used to visualize ovarian cancer in patients and might therefore be
      used to develop therapies for ovarian cancer. The bi-specific MAbs alpha T3/OC2
      and alpha OC/TR (both being combinations of MOv18 and alpha CD3) have been shown
      to lyse ovarian tumor cells in vitro. To evaluate the relative merits of
      MOv18/CD3 and OV-TL 3/CD3, the present study was undertaken in which the bi
      specific MAbs alpha T3/OC2 and alpha OC/TR, and a newly developed bi-specific
      MAb, OV-TL 3/CD3, were highly purified and compared for specificity, stability,
      purification and cytolytic potential. The dual specificity of the hybrid
      hybridoma supernatants was analyzed by immunohistochemistry, and by testing bi
      specific MAb-mediated cytotoxicity against relevant target cells in the presence
      of effector cells. Stability testing of bi-specific MAb-producing hybridomas
      showed that, after sub-cloning, clones stably produced up to 40% bi-specific MAb
      even after prolonged in vitro culture. The purification of the bi-specific
      fractions was performed with protein A and by ion-exchange high-pressure liquid
      chromatography, depending on the sub-class combination of the bi-specific MAb.
      The purified bi-specific MAbs were tested for their ability to mediate target
      cell lysis with the use of cytotoxic T-cell clones and activated peripheral-blood
      lymphocytes. The purified alpha T3/OC2, alpha OC/TR, and OV-TL3/CD3 were all able
      to mediate highly specific lysis of various ovarian-carcinoma cell lines. No
      correlation was found between the level of antigen expression and bi-specific MAb
      mediated cytolysis.

PMID- 8344745
TI  - Cytokines as adjuvants: effect on the immunogenicity of NeuAc alpha 2-6GalNAc
      alpha-O-Ser/Thr (sialyl-Tn).
AB  - Sialyl-Tn, defined by monoclonal antibody (MAb) B72.3, shows restricted normal
      tissue distribution but is expressed in a wide variety of carcinomas. To analyze
      the immunogenicity of sialyl-Tn, mice were immunized with ovine submaxillary
      mucin (OSM) in combination with monophosphoryl lipid A (MPLA), liposomes, or
      adjuvants that activate macrophages (rIL-1, rIFN-gamma, rM-CSF, IL-1-derived
      peptides) or T cells (rIL-2). The level and specificity of the immune response
      were analyzed by ELISA. rIL-1 and rIFN-gamma induced a very high and specific
      antibody response, whereas the effect of rM-CSF was dose-dependent: at a low dose
      it induced a high-level specific antibody response and at the high dose level it
      induced a polyclonal non-specific response. These results indicate that cytokines
      are powerful adjuvants which modulate both the magnitude and specificity of the
      immune response. More studies are necessary to determine the optimal doses in
      animal models and in active specific immunotherapy of patients with cancer.

PMID- 8344746
TI  - Complete local tumor remission after therapy with extra-corporeally applied high
      energy shock waves (HESW).
AB  - High-energy shock waves (HESW) have recently been proposed as a means of non
      invasive tumor therapy. Here we report the first successful local treatment of
      experimental tumors by means of multifocal and reported application of HESW. The
      experiments were performed on 29 Syrian golden hamsters bearing amelanotic
      hamster melanomas in the dorsal skin. HESW, generated electrohydraulically, were
      applied multifocally to the center and to 5 sites on the margin of the tumors. A
      group of animals undergoing surgical resection and an untreated group served as
      controls. Complete remission of local tumor was achieved in more than 90% of the
      HESW-treated hamsters and in the same number of surgically treated animals, while
      untreated tumors continued to grow. Frequency of metastasis was the same in both
      groups after HESW treatment or surgery. Tumor therapy with multifocally and
      repeatedly applied HESW was thus as successful as surgery.

PMID- 8344747
TI  - Human melanoma cells express a functional interleukin-2 receptor.
AB  - Flow cytometric analysis reveals that 5 human melanoma cell lines (M14, IGR3,
      ME1477, JUSO, GLL19) express both alpha and beta chain of the interleukin 2
      receptor (IL-2R alpha and IL-2R beta). These chains are able to specifically bind
      IL-2 and to form high-affinity heterodimers (IL-2R alpha beta). Analysis of poly
      A+ RNAs by Northern blot reveals the presence of typical transcripts for both the
      IL-2R alpha gene (3.6 kb) and the IL-2R beta gene (4 kb). Reverse
      transcription/polymerase chain reaction analysis allowed transcripts for the IL2R
      gamma (p64) gene to be detected in 3 of these melanoma cell lines (M14, IGR3, ME
      1477). Incubation with human recombinant IL-2 modifies in IL-2R alpha+beta+gamma+
      (M14) the expression of several surface molecules: down-regulation of ICAM-1, HLA
      class I and HLA-DR and up-regulation of CD44. IL-2 is also active on IL-2
      alpha+beta+gamma- cell lines since it decreases ICAM-1 and HLA class-II
      expression at the surface of JUSO cells. Down-regulation of ICAM-1, whose
      expression in melanoma cells is a marker of tumor progression, is detectable
      within 3 hr in M14 cells and is maximal after 48 hr incubation, at IL-2
      concentrations corresponding to the high-affinity heterodimers. This feature is
      specific since it is partially inhibited by MAbs directed against the IL-2
      binding site of the IL-2R alpha (MAR93, 10T14) and IL-2R beta (MiK beta 1, TU27)
      chains. Our data support the notion of a direct effect of IL-2 on human melanoma
      cells. Modulation of the expression of surface molecules which is important for
      the interaction with immunocompetent cells or for tumor progression, could have a
      role to play during in vivo IL-2 treatment of human melanomas.

PMID- 8344748
TI  - Enhanced expression of a tumor-cell-derived collagenase-stimulatory factor in
      urothelial carcinoma: its usefulness as a tumor marker for bladder cancers.
AB  - A mouse monoclonal antibody (MAb) E11F4, previously raised against the tumor-cell
      derived collagenase-stimulatory factor (TCSF) from LX-1 human lung-carcinoma
      cells, has been used to define the expression and distribution of TCSF in human
      non-neoplastic urothelium and tumors of the urinary bladder.
      Immunohistochemically, TCSF was detected in 27/28 transitional-cell carcinomas
      (TCC) of the bladder, of which 23 were judged to be positive for TCSF according
      to objective criteria. Twenty-four of 28 non-neoplastic urothelium from 22
      individuals were judged to be negative for TCSF by this criteria. However, TCSF
      immunostaining that was confined to the superficial umbrella cells was frequently
      observed in non-neoplastic urothelium. In bladder carcinomas, TCSF was in most
      cases demonstrated in the majority of cells, including at the invasion front. Its
      localization to the cell membrane was demonstrated by immunoelectron microscopy.
      The high level of expression of TCSF in bladder tumors, but not in non-neoplastic
      urothelium, was also demonstrated by immunoblotting of tissue extracts.
      Furthermore, E11F4 immunostaining identified tumor cells obtained from bladder
      washings or voided urine and detected more TCC cases than conventional cytology.
      Since TCSF immunostaining was positive even in low-grade TCC
      (immunohistochemically and immunocytochemically in 4/5 TCC grade I), the
      application of TCSF immunostaining to urine cytology appears promising as a
      valuable adjunct to conventional methods in the clinical evaluation of patients
      with TCC.

PMID- 8344749
TI  - The plasminogen-activation system in ovarian tumors.
AB  - We studied the plasminogen activation system in tumor tissue by measuring the
      antigen level of the 2 plasminogen activators, tissue-type (t-PA) and urokinase
      type (U-PA) and their inhibitors, plasminogen-activator inhibitors type-I (PAI-I)
      and type-2 (PAI-2) in the tissue extracts of 43 human benign and malignant
      ovarian tumors. U-PA levels were significantly higher in malignant than in benign
      tumors. In addition, U-PA antigen levels were higher in the metastatic tissue of
      advanced disease (FIGO stage III) than in the primary localized tumor (FIGO stage
      I/II). Also PAI-I concentrations tended to be higher in malignant than in benign
      tumors, but this difference was not statistically significant. In contrast, t-PA
      levels were lower in metastatic than in non-metastatic tumors, whereas PAI-2
      levels were unrelated to the stage of ovarian malignancy. These results were
      integrated in a plasminogen-activation-dependent malignancy index (U-PA x PAI-I/t
      PA). This index distinguished the different groups of benign ovarian tumors,
      localized and metastatic ovarian carcinomas better than U-PA levels. It could be
      useful as a prognostic indicator in ovarian cancer.

PMID- 8344750
TI  - Risk factors for renal-cell carcinoma in a French case-control study.
AB  - A hospital-based case-control study of renal-cell carcinoma was conducted in
      France from 1987 to 1991. A total of 196 histologically confirmed cases (138
      males and 58 females) and 347 controls (235 males and 112 females), matched for
      sex, age at interview, hospital and interviewer, were included. The risk of renal
      cell carcinoma was not apparently increased with number of cigarettes per day,
      duration of smoking or early age at first cigarette smoking in males. No
      significant trend was found in the risks with increasing Quetelet index (QI) at
      the age of 20 in males. On the contrary, the risks increased significantly with
      an increasing QI prior to diagnosis. In females, the trends in risks were
      significant both for the relative weight at the age of 20 and prior to diagnosis.
      The consumption of regular or decaffeinated coffee, tea or alcoholic beverages
      was not associated with renal-cell carcinoma, in males or in females.

PMID- 8344751
TI  - Cytogenetic findings in 33 osteosarcomas.
AB  - Thirty-three osteosarcomas (OS) were analyzed cytogenetically. Clonal chromosome
      changes were detected in 17 cases. Six tumors had chromosome numbers in the
      diploid range, 6 in the triploid range, 1 in the tetraploid range and 1 in the
      pentaploid range, while 3 tumors had multiple clones with different ploidy
      levels. Including the present 17 tumors, a total of 27 OS with clonal aberrations
      have been reported. The recognizable structural rearrangements in these 27 tumors
      clustered to chromosome arms 1p, 1q, 3p, 3q, 7q, 11p, 17p and 22q. Chromosome
      bands 1q11, 1q21, 1q42 and 7q11 were the most frequently rearranged, and the most
      common numerical rearrangements were -3, -10, -13 and -15. Supernumerary ring
      chromosomes, in 2 tumors as the sole change, were found in all 3 parosteal OS,
      which is in agreement with the findings in 1 previously reported parosteal OS.
      The association between ring formation and parosteal morphology represents the
      first cytogenetic-morphologic entity among OS.

PMID- 8344752
TI  - Risk of kidney cancer among patients using analgesics and diuretics: a population
      based cohort study.
AB  - The aim of this study was to determine the risk of kidney cancer in 2 cohorts
      defined on the basis of hospital discharge diagnoses associated with analgesic or
      diuretic use during the period 1965 to 1983. Patients were followed up through
      1984 for cancer incidence. After excluding cancers in the first year of
      observation, 161 kidney cancers were observed vs. 138 expected among 54,662
      patients in the analgesics cohort. The relative risk was higher for women than
      for men. When examined by sub-site within the kidney, risk for cancer of the
      renal pelvis was similar in magnitude to that for the renal parenchyma. Among
      115,616 patients in the diuretics cohort, 278 kidney cancers occurred vs. 209
      expected. The risk for women was higher than for men. This elevation in risk was
      confined to cancer of the renal parenchyma, with no significantly increased risk
      seen for cancer of the renal pelvis. Although we observed little excess risk
      among members of the analgesics cohort, the significantly elevated risk among
      patients using diuretics supports a number of recent studies, but inability to
      adjust for confounding factors such as obesity preclude drawing any conclusion
      regarding diuretics. Further research is warranted to assess in detail the
      relationship between diuretic use and cancer of the renal parenchyma.

PMID- 8344753
TI  - p53 protein expression in breast cancer as related to histopathological
      characteristics and prognosis.
AB  - Formalin-fixed, paraffin-embedded biopsies of 193 women with primary breast
      cancer followed-up for over 10 years were analysed immunohistochemically for the
      expression of p53 protein. Altogether, 58% (113/193) of the tumors were positive
      for p53 protein. Over-expression of p53 was associated with the ductal type, high
      grade tumors, dense stromal inflammatory cell infiltrate, high S-phase fraction,
      high mitotic frequency and high values of the nuclear factors. In univariate
      analysis, intense p53 over-expression predicted a poor outcome, whereas a short
      recurrence-free survival (RFS) was related to p53 negativity. In axillary lymph
      node-negative (ANN) tumors, p53 negativity was related to short RFS, and in
      axillary lymph-node-positive (ANP) tumors this inverse relationship was
      statistically significant. In Cox's analysis, p53 protein over-expression had no
      independent prognostic value comparable with the well-established prognostic
      factors. However, p53 protein accumulation was an independent indicator of long
      RFS in the entire cohort, in ANP tumors and in rapidly proliferating tumors. The
      results indicate a dual role for p53 protein over-expression in breast cancer
      prognosis. The low survival probability associated with intensively p53-positive
      tumors is probably related to rapid cancer-cell proliferation, whereas the long
      RFS of p53-positive tumors might be explained by the development of circulating
      antibodies to p53 protein. The role of p53 protein in breast cancer is
      incompletely understood, and the p53 gene should be subjected to detailed
      analysis of specific mutations.

PMID- 8344754
TI  - Cancer among teenagers in Denmark, 1943-1987.
AB  - A population-based study was carried out on 3,988 tumours in teenagers (aged 10
      19 years) diagnosed during the period 1943-87 in Denmark and abstracted from the
      files of the National Cancer Registry. In that Registry, codes for tumours were
      based solely on topography until the end of 1977. In order to obtain a uniform
      data set, coded by the system of the International Classification of Diseases for
      Oncology (ICD-O) now used at the Cancer Registry, all cases of teenage cancer
      diagnosed prior to 1978 were re-evaluated, and an ICD-O code was applied. Tumours
      were further aggregated into diagnostic groups using an internationally agreed
      scheme. The average incidence rates for all histological types combined were 136
      per million for boys and 108 per million for girls, which are close to those
      reported in Connecticut, USA. Central nervous system tumours, leukaemia and
      malignant lymphomas accounted for 60% of all cancers among teenagers. An overall
      excess of cancers among boys was mainly due to more frequent occurrence of
      leukaemias, malignant lymphomas, sarcomas and germ-cell tumours. Increasing
      trends with time were seen for malignant lymphomas in both boys and girls and for
      subtypes of non-seminoma germ-cell tumour among boys aged 15-19. For other
      diagnostic groups, including the main group of leukaemias, the rates have
      remained largely unchanged, suggesting that environmental factors associated with
      modern society play a minor role in the aetiology of cancer among teenagers.

PMID- 8344755
TI  - Aberrant expression of c-met mRNA in human gastric carcinomas.
AB  - We examined mRNA expression for c-met encoding hepatocyte growth factor receptor
      in 8 gastric carcinoma cell lines and 31 surgically resected gastric carcinoma
      tissues by Northern-blot analysis. Two forms of the transcript, sized 7.0 kb and
      6.0 kb, were found in gastric carcinomas. Transcripts of both sizes were detected
      at various levels in all the gastric carcinoma cell lines except the MKN-74 line,
      which expressed only the 7.0-kb form. Of the 31 gastric carcinomas, 15 (48%) over
      expressed the 7.0-kb transcript when compared with non-neoplastic mucosa. The 6.0
      kb transcript of the c-met gene was expressed at considerable levels in 52% of
      the gastric carcinoma tissues, whereas it was only slightly expressed in non
      neoplastic mucosa of a small number of cases. An important finding was that
      expression of the 6.0-kb transcript was closely correlated with tumor staging,
      lymph-node metastasis and depth of tumor invasion. These results, overall,
      suggest that the 6.0-kb transcript of the c-met gene might participate in the
      development and progression of gastric carcinomas.

PMID- 8344756
TI  - Cytotoxicity, differentiating activity and metabolism of tiazofurin in human
      neuroblastoma cells.
AB  - The IMP dehydrogenase inhibitor, tiazofurin (TR)-2-beta-D-ribofuranosylthiazole-4
      carboxamide, which exhibited oncolytic activity in patients with chronic
      myelogenous leukaemia (CML) in blast crisis was found to inhibit the growth of
      human neuroblastoma SK-N-SH cells with an IC50 of 4.2 microM. TR treatment of
      cells perturbed nucleic acid and catecholamine pathways. As biochemical markers
      of TR action decreased cellular GTP pools, increased inosine and hypoxanthine
      concentrations and depleted dopamine content were found. Incubation of tumour
      specimens obtained from paediatric patients with grade-IV neuroblastoma with TR
      resulted in the formation of the active metabolite, thiazole-4-carboxamide
      adenine dinucleotide, in concentrations sufficient to inhibit tumour growth.
      Cytotoxic and biochemical effects of TR were enhanced by combining it with
      allopurinol (an inhibitor of xanthine dehydrogenase), and hypoxanthine (an
      alternate substrate for hypoxanthine-guanine phosphoribosyltransferase).
      Induction of transdifferentiation of SK-N-SH cells from a neuroblast to an
      epitheloid, substrate-adherent phenotype was more pronounced with TR than with
      all-trans-retinoic acid. Transdifferentiating treatment with TR resulted in a 2
      fold-enhanced sensitivity towards adriamycin. However, differentiation with all
      trans-retinoic acid rendered the cells more resistant to adriamycin. Our results
      suggest that TR might be a promising agent for the treatment of children
      suffering from neuroblastoma.

PMID- 8344757
TI  - Interleukin-10 production by human carcinoma cell lines and its relationship to
      interleukin-6 expression.
AB  - Recent data indicate a major role for IL-10 in suppressing immune and
      inflammatory reactions. To date, expression of human IL-10 has been attributed
      primarily to helper T lymphocytes, activated monocytes, and neoplastic B cells,
      and was often found to be associated with IL-6 expression. In this study we
      sought to determine whether non-hematopoietic human tumor cell lines produce IL
      10 and, if so, what is the relationship between IL-10 and IL-6. Using ELISA, we
      determined IL-10 and IL-6 levels in culture supernatants of 48 cell lines
      established from carcinomas of the kidney, colon, breast and pancreas, malignant
      melanomas and neuroblastomas. IL-6 protein was secreted by 28 of the tumor cell
      lines; IL-10 was measurable in 15 cell lines. IL-6 secretion was maximal and most
      frequent in renal-cancer cell lines, while IL-10 production was found to be
      highest and most common among cell lines derived from colon carcinomas. IL-10 in
      conditioned medium of one of the colon carcinoma cell lines (CCL222) was bio
      active, as demonstrated in the mouse MC/9 mast-cell-line assay and in human mixed
      lymphocyte reactions. In both assays, IL-10 bio-activity was neutralized by an
      anti-IL-10 monoclonal antibody. Expression of IL-6 and IL-10 was confirmed by RNA
      analysis using message amplification by PCR and sequencing of amplified cDNA.
      LPS, IL-1 alpha, and TNF-alpha strongly enhanced the release of IL-6 by RCC
      cells, but only marginally affected IL-10 production in colon-carcinoma cells. IL
      10 secretion by colon-carcinoma cells was moderately stimulated by IFN-gamma and
      IL-4. Dexamethasone suppressed the release of IL-6, but had no inhibitory effect
      on IL-10 secretion. Our results demonstrate that tumor cell lines established
      from certain types of human carcinomas are capable of expressing and releasing IL
      6 and/or IL-10, suggesting a role of these cytokines in solid-tumor development
      and anti-tumor immunity.

PMID- 8344758
TI  - Endocervical glandular atypia and adenocarcinoma: a correlation of cytology and
      histology.
AB  - Of the 34,384 cervical smears sampled by cervical scraping and Cytobrush,
      reactive glandular atypia was found in 1.7%, low-grade glandular atypia in 0.08%,
      and high-grade glandular atypia/adenocarcinoma in 0.05%. Cells of reactive
      glandular atypia and low-grade atypia could be distinguished from those of high
      grade atypia/adenocarcinoma by the architecture of the cellular aggregates,
      nuclear morphology, and nuclear-cytoplasmic ratios. Further histologic studies
      found that most reactive and low-grade atypias were associated with condyloma,
      squamous dysplasia, carcinoma in situ, and cervicitis. Eighty-two percent of
      women with cellular evidence of high-grade atypia/adenocarcinoma were confirmed
      to have in situ or invasive adenocarcinoma of the cervix. Although Cytobrush
      samples seem to improve the detection of early-stage glandular neoplasms, many
      minor atypias unrelated to cervical carcinogenesis are also detected.

PMID- 8344759
TI  - Multinucleated stromal giant cells of the uterine cervix.
AB  - A prospective clinicopathological study including 100 consecutive hysterectomies
      and 100 consecutive cone specimens to investigate the frequency and pathogenesis
      of multinucleated stromal giant cells (SGCs) in the uterine cervix is presented.
      Sections containing SGCs were analyzed by immunohistochemical methods for the
      presence of cytokeratin, S-100 protein, factor VIII, desmin, muramidase, alpha 1
      antichymotrypsin, and vimentin. Tissue for electron microscopy was punched out of
      four paraffin blocks from four different cases. SGCs were not found in patients <
      30 years old, but their incidence increased with age until the sixth decade, at
      which time they were found in 42% of patients. We found at the same time that the
      incidence of SGCs declines in the seventh decade. SGCs were not related to any
      inflammatory or granulomatous lesion, and their presence was independent of other
      clinical parameters, such as hormonal therapy, history of trauma on the uterine
      cervix, pregnancy, or parity in general. Immunohistochemical and ultrastructural
      analyses support the concept of a fibroblastic-histiocytic origin of SGCs. SGCs
      in the uterine cervix may reflect a physiological tissue reaction during the
      transition from the fertile to the postmenopausal state.

PMID- 8344760
TI  - Flow cytometric DNA ploidy and quantitative histopathology in partial moles.
AB  - This study quantitates morphologic changes seen in partial moles and hydropic
      abortuses in an attempt to find a correlation with DNA content. Thirty-two
      products of conception were studied. Fifteen were diagnosed as definitive partial
      moles (DPM), and 17 had changes suggestive of a partial mole (SPM). We determined
      DNA ploidy by flow cytometry and quantitatively analyzed the following
      microscopic features: villous edema and sclerosis, central cistern formation,
      villous blood vessels, trophoblastic proliferation, and trophoblastic inclusions.
      No single pathologic feature significantly correlated with DNA content, even
      though triploid cases showed more inclusions than diploid cases (8.3 versus 7.2
      on the average per ten x 100 fields). An overall diagnosis of DPM did correlate
      with ploidy; 12 of 18 triploid cases (67%) compared with only three of 13 diploid
      cases (23%) had been previously diagnosed as DPM (p < 0.05). Flow cytometric DNA
      ploidy estimates DNA content and cannot determine chromosomal origin. It is
      possible that detailed cytogenetic studies of moles compared with abortuses may
      show a significant correlation of the proportion of paternal chromosomes,
      morphologic changes, and the risk of persistent gestational trophoblastic
      disease.

PMID- 8344761
TI  - Expression of epidermal growth factor receptors in human endometrial carcinoma.
AB  - Little data exist on the expression of epidermal growth factor receptors (EGF-Rs)
      in human endometrial cancer. EGF-R status was studied in 65 patients with
      endometrial carcinomas and in 26 women with nonmalignant postmenopausal
      endometria, either inactive/atrophic endometrium or adenomatous hyperplasia. EGF
      R was identified on frozen tissue sections by means of an indirect
      immunoperoxidase technique with a monoclonal antibody against the external domain
      of the EGF-R. Seventy-one percent of the carcinomas expressed positive EGF-R
      immunoreactivity. In general, staining was most prominent at the cell membranes,
      with a varying pattern in individual carcinomas. EGF-R expression was not
      correlated with histologic grade, surgical stage, or estrogen/progesterone
      receptor status evaluated immunohistochemically or biochemically in adjacent
      tissue sections of the tumor. Ten of 13 (77%) atrophic/inactive endometria and
      seven of 13 (54%) endometria with adenomatous hyperplasia were EGF-R positive,
      with an immunostaining pattern rather similar to that of the carcinomas.

PMID- 8344762
TI  - Use of monoclonal antibodies MSN-1 and B72.3 in the prediction of the natural
      history of endometrial hyperplasia.
AB  - Forty patients, originally diagnosed as endometrial hyperplasia, were reviewed
      histopathologically and evaluated for immunohistochemical staining with
      antibodies directed against TAG-72 and MSN-1 antigens. All patients had follow-up
      endometrial biospies or hysterectomies from 1 to 13 years later. The extent of
      regression to normal of nonhyperplastic endometrium, persistence as any type of
      endometrial hyperplasia, or progression to endometrial adenocarcinoma was
      correlated with the histologic hyperplastic subtype and immunohistochemical
      staining. As expected, cases of complex or atypical hyperplasia more often
      progressed to carcinoma than cases of simple or no hyperplasia. Interestingly,
      MSN-1 positivity was more prevalent in cases of higher grades than lower grades
      of hyperplasia and was associated with the tendency to show persistent
      hyperplasia or progression to carcinoma. B72.3 positivity was uncommon in the
      hyperplastic endometrium and was not correlated with clinical regression or
      progression. Although the tendency for progression of endometrial hyperplasia to
      endometrial carcinoma is best judged histologically, MSN-1 may add prognostic
      information in subgroups of hyperplasia.

PMID- 8344763
TI  - Prognostic significance of nucleolar organizer regions in ovarian epithelial
      tumors.
AB  - Recent studies have shown that the silver-stained nucleolar organizer region
      (AgNOR) score is related to the cell growth rate in several neoplasms. In the
      work presented here, we tested the AgNOR technique in 79 ovarian epithelial
      tumors (13 benign, 10 borderline, 56 malignant) to evaluate the diagnostic
      potential of AgNOR count in distinguishing between ovarian borderline tumors and
      carcinomas and to assess its prognostic value in carcinomas. Ovarian carcinomas
      exhibited higher mean AgNOR values than borderline and benign tumors, but
      statistically significant differences were found only in the serous type.
      Statistical analysis showed a positive correlation of higher AgNOR score,
      advanced tumor stage, and adverse prognosis. On the contrary, low AgNOR counts
      identified stages I and II carcinomas with disease-free follow-up. These results
      suggest that the AgNOR count may improve the prognostic evaluation of ovarian
      epithelial tumors by representing a reliable indicator of survival.

PMID- 8344764
TI  - Primitive neuroectodermal tumor arising in an ovarian mature cystic teratoma:
      immunohistochemical and electron microscopic studies.
AB  - The occurrence of a malignant neuroectodermal tumor in a mature cystic teratoma
      is extremely rare. Five cases of ovarian primitive neuroectodermal tumors (PNET)
      or neuroepitheliomas have been reported. In two, the tumor was adjacent to foci
      of a mature teratomatous element. We present the immunohistochemical profile and
      electron microscopic study of an ovarian mature cystic teratoma with PNET or
      malignant neuroepithelioma. The transition between the mature neural elements and
      the malignant PNET presents a model for monodermic neuroepithelial
      differentiation and explains the histogenesis of this unusual tumor.

PMID- 8344765
TI  - Cytogenetic analysis of an immature teratoma of the ovary and its metastasis
      after chemotherapy-induced maturation.
AB  - We report a case of an immature teratoma of the ovary, grade 3, in which
      cytogenetic studies were performed on the primary tumor at diagnosis and on a
      metastasis resected 1 year after removal of the primary tumor. The patient was
      treated with cisplatin, bleomycin, and etoposide (VP-16) combination
      chemotherapy. The metastatic tumor was composed of mature teratoma with only
      small foci of immature tissue. Despite the different histologic appearance of the
      primary tumor and the metastasis, there was no detectable difference in karyotype
      between the primary and metastatic tumors. Both showed a pseudodicentric
      chromosome derived from chromosome 1 and monosomy for chromosome 4. Flow
      cytometry analysis of the metastatic tumor showed a diploid DNA content, in
      agreement with the cytogenetic findings. From this case it would appear that
      chemotherapy-induced maturation of metastatic immature ovarian teratoma is not
      associated with regression of the malignant karyotype or selection of a
      karyotypically distinct population of tumor cells.

PMID- 8344766
TI  - On the drive-rootedness of psychoanalytic ego psychology.
AB  - This paper attempts, hypothetico-deductively, to conceptualise psychoanalysis on
      the level of fundamental theory. I begin by exploring the relevance for
      psychoanalytic theory of recent developments in the brain and cognitive sciences.
      Their site of articulation is identified as the concept of consciousness. I
      proceed to develop a conceptual integration of consciousness into psychoanalytic
      drive theory. This reveals the wish as the original psychical entity, with a self
      process imbricated in its structure. Narcissism in shown to be sexually grounded,
      vitally constitutive, and intrinsically aggressive. It becomes possible, using
      the neighbouring sciences as well, to work out a theory of the origin of the
      secondary process and early ego formation. My approach provides a view of mental
      development in which identification and repression represent two aspects of a
      unitary activity that structures the mind. This allows the unconscious and
      consciousness to be brought into dialectical relation. Implications follow for
      the 'activity of the repressed' and the theory of paranoia.

PMID- 8344767
TI  - The complementarity of object-relations and instinct theory.
AB  - Object-relations theory implicitly assumes primary drives to cope with the fact
      that some kinds of transaction with objects are not gratifying but are feared and
      avoided. Fairbairn's conception of motivation assumes that there is an
      independent primary drive which may be called 'need for love', independent of
      other gratifications. Such an instinctual-drive concept is defined solely by its
      direction towards a goal, and rests on an arbitrary intuition as to the 'real'
      goal of observed behaviour. As Freud pointed out, what is required for the
      objective identification of a drive is the discovery of its physiological source.
      Freud recognised that a drive can be gratified only by a 'specific action'
      performed upon a suitable object, and that object relations set up in very early
      life are especially long-lasting. The concept of fixation can bridge the gap
      between infantile instinctual reactions and adult object relations.

PMID- 8344768
TI  - Aggression and the psychological self.
AB  - In this paper we explore the idea of aggression as a defence against threats to
      the psychological self. This aspect of the self allows reflection about people in
      psychological terms and develops, in the first three years of life, through
      appreciation of mental states in the other. When the object is unpredictable or
      hostile, recognition of this is painful to the child, and his reflective function
      will not be adequately established. The defences of aggression or avoidance will
      be invoked very frequently. In time, aggression may become an organising
      influence in the construction of the self; pathological destructiveness then
      takes the place of emotional relatedness and concern for the other.
      Psychoanalytic treatment no longer works primarily by addressing conflict.
      Instead, particularly through interpretations of transference and
      countertransference, the analyst recreates an intersubjective process which
      enhances the patient's reflective self, this time in the safety of a benign
      relationship.

PMID- 8344769
TI  - A fundamental dilemma of psychoanalytic technique: reflections on the analysis of
      a perverse paranoid patient.
AB  - The work refers to the general topic of the traumatic effects of transference in
      the analytic situation. The author defines the fundamental dilemma of
      interpretive technique as the technical difficulty, sometimes insurmountable,
      faced by the therapist in the treatment of severely ill patients, particularly in
      the case of narcissistic, self-centred disorders, where the interpretive action
      itself often produces negative side effects that are not countered by the
      curative effect of the insight achieved through interpretation. In a brief
      theoretical introduction, this dilemma is described as a longstanding problem in
      psychoanalysis that has been systematically concealed by the protracted
      discussion on the subject of 'analysability' and which has still not been
      resolved by the theory of technique. Clinical case material on a perverse patient
      is then presented to illustrate the dilemma described and to demonstrate some
      general strategies by which it may be overcome.

PMID- 8344770
TI  - A self-psychological approach to the analysis of resistance: a case report.
AB  - This paper attempts to explore the understanding of resistance from a self
      psychological perspective through presenting a case report. This view is
      contrasted to the traditional psychoanalytic model which assumes that whatever
      impedes the analysis is a resistance, and construes such resistance in terms of
      the drive-defence model. The motivation for this blockade of the analysis is the
      protection of the ego from anxiety. By contrast, a self-psychological model
      suggests that 'so called defence-resistances' (Kohut, 1984, p. 141) are required
      for the protection of the weakened self. There is no blockade of the analytic
      process; rather, the 'resistance' safeguards the self so that the analysis may
      continue. The motivation for 'resistance' is to protect the self so that it will
      be ready to resume development when a safe, attuned selfobject environment is
      available. In the case presented the patient beseeched the analyst to refrain
      from speaking. The analyst's dilemma is discussed and the resolution of the
      resistance is described.

PMID- 8344772
TI  - First person personal pronouns and their psychic referents.
AB  - This paper presents a psychoanalytic description of the psychic referents for the
      personal pronouns I, me, myself. The referents are related to memorial processes
      of experiences of satisfaction is early bodily dialogues. Later interpersonal
      dialogues, bodily and verbal, factual or fantazised, add to the memories
      available as potential referents for the pronouns. The linguistically spoken
      pronoun has a narrower referential field because a speech act can only tap a
      limited number of memories. The 'I'/'me' of each spoken sentence is a selected
      libidinal and narcissistically organised self-perception at the service of an
      exchange with the interlocutor at hand, the specific 'you' of that linguistic
      act. The linguistic 'I' is a transient pronominal function linked to memories
      about oneself and others. It reveals in the selection of referential sources,
      libidinal and narcissistic regulatory functions in the service of satisfaction of
      wishes, defence, and modulation of self-esteem.

PMID- 8344771
TI  - Phallic patheticness.
AB  - The characteristic of patheticness in the case of a young female victim of child
      abuse has been presented, underscoring the phallic quality of this trait and its
      root distinctiveness from the tragic character. Many patients, historical
      figures, and other individuals are prematurely judged as tragic when, in fact, we
      are reacting uncritically to the impact of their profound patheticness, at a
      point when, more often than not, such patheticness has not yet reached its lowest
      ebb, when it is still not too late to transform mute resignation to the neurosis
      of tragic fatalism into a more heroic deployment of destiny (Bollas, 1991, pp. 31
      4). Phallic patheticness, in fact, represents a higher psychical achievement by
      virtue of its transient quality and its propensity to enable basic, if
      conflictual object-relationships and the recovery from psychic trauma. To be
      sure, many individuals with advanced personality structures have introjected into
      their personal value system a sense of the tragic, an identification with the
      tragic, or a special proclivity toward the tragic aspects of life, but this in
      and of itself does not render such individuals tragic, nor do they typically
      evoke in others the inner experience of maximum catastrophe or calamity. It is
      argued that the distinction between pathetic and tragic psychic structure can be
      clarified through carefully interpreted counter-transference.

PMID- 8344773
TI  - Adequate distance in the relationship between supervisor and supervisee. The
      position of the supervisor between 'teacher' and 'analyst'.
AB  - Supervision, being at the centre of our tripartite psychoanalytical training,
      imposes on the supervisor an extremely important, complex and difficult task.
      Supervision is central in the training of the future psychoanalyst because the
      outcome of the supervisory process will eventually be an internalisation of the
      supervisor's functioning, and this inner functioning of the internalised
      supervisor will be crucial for the competent functioning of the candidate as
      future psychoanalyst. This complex and difficult learning process will be best
      fostered if the supervisor permanently strives to maintain his supervisory
      balance between the two supervisory positions he is to take in the supervisory
      process, that between 'teacher' and 'analyst'. This paper tries to demonstrate
      both positions in this process and to discuss problems of how to maintain them;
      and how to re-establish the supervisor's balance, and with it, the adequate
      psychoanalytic distance in supervision in situations where they tend to get lost.

PMID- 8344774
TI  - The illusion of a future: a friendly disagreement with Prof. Sigmund Freud.
AB  - Freud's The Future of an Illusion was not just an abstract statement of his
      position on religion, but part of an ongoing exchange of views with Oskar
      Pfister, a Zurich pastor. Freud was continuing to try to settle differences
      between himself and Jung. Pfister, while practising as an analyst in 1928, wrote
      a respectful reply to Freud, and his 'The Illusion of a Future' has never before
      appeared in English. Pfister was expressing what he saw as the central weaknesses
      in Freud's attitude toward ethics, art, philosophy, and the practice of
      psychotherapy.

PMID- 8344775
TI  - Clinical application of a dysregulation model of illness and disease: a case of
      spasmodic torticollis.
AB  - A case of spasmodic torticollis is described to demonstrate the clinical
      usefulness of a new theoretical model of somatic illness and disease. Based on a
      conception of the living organism as a self-regulating system, the model
      attributes somatic disorders to a variety of regulatory disturbances including
      deficits in affect regulation and in the ability to maintain a stable and
      cohesive self. Throughout the analytical treatment, attention was given to
      repairing deficits in the patient's self-organisation, and to elevating chaotic
      impulses and inchoate emotions from a primitive sensorimotor level of experience
      to a mature representational level where they could be valued for their signal
      function and modulated through imaginal activity and communication with others.
      Analysis of the patient's pathologic internal object relations modified his self
      organisation, and enabled him to establish regulatory interpersonal relationships
      that complemented his enhanced self-regulatory capacities. These changes were
      accompanied by a gradual resolution of the patient's torticollis.

PMID- 8344776
TI  - Tiresias and the breast: thinking of Lacan, interpretation, and caring.
AB  - Lacan's intellectual complexity and fascination with language are too often taken
      as an indication that in his conception of analysis there is no room for caring
      and love. In this paper we argue that this impression represents a
      misunderstanding of Lacan. We explore the role of the analyst according to Lacan,
      both as the 'subject of absolute knowledge', 'supporting the function Tiresias'
      and the 'man of care' with breasts. To Lacan, the process of analysis is an
      adventure into the realm of the exotic where there is a complexity of excitement
      and deep anxiety, an interplay of words and illusive exploding breasts, the birth
      and death of desire, and the confrontation with the illusion of 'self'. The
      analyst recognises the patience and courage necessary to face this and to
      understand that 'life is a foreign language; all men mispronounce it' (Morley,
      1925, p. 188).

PMID- 8344777
TI  - What sort of a thing is a religion? A view from object-relations theory.
AB  - This paper suggests that a religion is not, as Freud proposed, a science-like
      thing, refutable by evidence. It is a socially constructed and maintained system
      of internal objects, analogous to those spoken of in psychoanalysis. Like
      analytic internal objects, religious objects have a heuristic function but no
      material existence. Unlike analytic objects, they are derived from a definite
      cultural tradition and are elaborated over time to meet the experience of
      practitioners. They may be understood to have a function of 'containing' the
      feelings, thoughts and fantasies arising in individual practitioners, and of
      making these experiences comprehensible. These objects then enable the believer
      to speak more truthfully of, and relate more fully to, the larger matrix within
      which the human world is situated. Finally, the suggestion is made that, as with
      analytic internal objects, religious objects may best be judged by their long
      term effects on the lives of believers.

PMID- 8344779
TI  - [The evolution of mortality in the first year of life in Spain (1975-1988)].
AB  - In recent years, the rate of decline in infant mortality and the proportional
      mortality by some causes of death in the first year of life have had important
      changes. The objectives of this study are to describe such changes, and to
      suggest hypotheses about their meaning. Infant, early neonatal, late neonatal and
      postneonatal mortality rates from 1975 to 1988 were calculated with information
      from the death register. Also, several indicators of the trends of those rates
      and proportional mortality by "certain conditions originating in the perinatal
      period" have been calculated. The reduction in infant mortality was due, mainly,
      to early neonatal mortality, which had an annual average decline of 4.6% during
      the study period. The proportional mortality and the mortality rate by perinatal
      conditions in the postneonatal period increased between 1975 and 1988. The first
      increased from 1.3% to 5.2%, and the second from 0.07 to 0.15 per 1000 live
      births. Hypotheses about the meaning of these results are suggested, and some
      actions are proposed in order to monitor and conduct research on mortality during
      the first year of life.

PMID- 8344778
TI  - [The prediction of the minimum incidence of AIDS in Spain for the period 1992
      1995].
AB  - In order to estimate minimum AIDS incidence in Spain between 1992 and 1995,
      annual AIDS incidence up to 1991 has been obtained from the June 1992 update of
      the National Register. Correction was made for reporting delays in cases
      diagnosed since July 1989, in order to run a subsequent back calculation on all
      cases and for each separate mode of transmission. It was assumed that no new HIV
      infections would appear after 1991. Since 1981 to 1995, more than 38,000 AIDS
      cases will have been diagnosed. Minimum AIDS incidence as forecast exhibits a
      rise between 1992 and 1995 for the total number of cases and for all categories
      of transmission, except for recipients of blood and blood products, and children
      of mothers at risk. Real incidence will probably prove higher than estimated
      owing to the effect of new infections which may arise, and to the underreporting
      of cases.

PMID- 8344780
TI  - [The follow-up and monitoring of forecasts: the case of asthma epidemics in
      Barcelona].
AB  - In this work we discuss several procedures of evaluation of time series models
      and analyze practical aspects of the management of a data base relative to a
      health information system devoted to the epidemiological surveillance and the
      detection of unusual values that could correspond to epidemic events. The
      analyzed statistical information corresponds to the time series of the number of
      emergency room admissions for asthma in several hospitals of Barcelona city,
      between the first of January of 1985 and the seventh of september of 1987. Among
      the three analyzed methods, the one based on the correlations of the one-step
      ahead residuals (the second one) is the most specific and, furthermore, it
      doesn't require the previous definition of an epidemic day. In addition, this
      second procedure has less analytical and computational difficulty.

PMID- 8344781
TI  - [Lateness in the treatment of diabetic retinopathy: the efficacy of an effective
      treatment].
AB  - Despite the efficacy of laser photocoagulation as the treatment for diabetic
      retinopathy, this condition is the leading cause of blindness in developed
      countries. In this survey we have tried to find out whether this lack of
      effectiveness is due to a lack of adequate control and screening. As a proxy
      measure for this we have developed an indicator called "lateness" and we have
      followed a sample of diabetics drawn from the two public hospitals in Vizcaya
      (Spain). Seventy five percent of them were not at regular intervals and half of
      the sample was late for treatment. Among these, Insulin-dependent diabetics of
      older age and with more years of the disease are at a higher of entering late for
      treatment. We could not find any risk factor lateness among non insulin dependent
      diabetics. We concluded that most of diabetics are not adequately followed up for
      the prevention of diabetic retinopathy, and when they are referred to treatment
      it is too take the most advantage of it.

PMID- 8344782
TI  - [Hospital financing systems: an analysis of trends and a study of the consistency
      of reform proposals for introduction into public health systems].
AB  - The author comments in this paper on the recent literature on reforms in hospital
      reimbursement systems. Instead of taking a theoretical approach to this topic,
      the article adopts a "middle of the road" view, by looking at the consistency of
      applying some of these reforms (mainly on contract management and DRGs) in Public
      Health Systems. After recognising some of the existing problems in the management
      of public hospitals in Spain, the author advocates for a common sense strategy to
      health reforms in terms of the following: (i) at the time of implementing changes
      in the hospital sector keep targets defined as simple as possible, (ii) go to
      reforms through a step-by-step procedure, and (iii) whenever things look complex,
      use basic "house-keeping" economics, instead of just importing additional
      economic literature from abroad.

PMID- 8344783
TI  - [The 1991 population census: the principal new changes].

PMID- 8344784
TI  - Fluorometric assessment of equivalent healthy lens age for people with diabetes.

PMID- 8344785
TI  - Detection of melanocytes from uveal melanoma in peripheral blood using the
      polymerase chain reaction.
AB  - PURPOSE: Uveal melanoma is the most common intraocular malignancy in adults and
      can cause loss of vision in the affected eye and death from metastasis, usually
      to the liver. The techniques currently used to detect cellular dissemination from
      the tumor are inadequate, and lack the sensitivity required for the detection of
      low levels of melanocytes in the peripheral blood of patients. The detection of
      circulating melanocytes is important as an early indication of the possibility of
      metastasis. METHODS: The viability of reverse transcription/polymerase chain
      reaction amplification of the tyrosinase gene to detect circulating melanocytes
      was examined as a first sign of dissemination from uveal melanoma. RESULTS: It
      was shown that it is possible to detect as few as ten circulating melanocytes in
      5 ml of blood. Blood-borne dissemination was also detected in three of six
      patients with uveal melanoma examined. Two of these patients had clinically
      confirmed widespread metastases. A positive result was also recorded in one
      patient in whom there was no other evidence for tumor dissemination. Overt
      metastatic disease developed in this patient 9 months after blood collection.
      CONCLUSIONS: The success of this technique has important implications for the
      detection of circulating tumor cells from uveal melanoma, as an early indication
      of dissemination. This may be important when considering the administration of
      adjuvant therapy.

PMID- 8344786
TI  - Visual pigment gene changes in adrenoleukodystrophy.
AB  - PURPOSE: The gene for X-linked adrenoleukodystrophy, a neurodegenerative
      disorder, is closely linked to the red/green color pigment genes on the distal X
      chromosome Xq28 and one kindred is known to have a genetic change affecting both
      loci. The purpose of this article is to perform a systematic assessment of the
      frequency of this situation in many affected kindreds. METHODS: Recombinant DNA
      probes were used in blot hybridization studies to determine the structure of the
      color pigment genes in affected males from 59 different adrenoleukodystrophy
      kindreds. Whenever possible, color vision was measured using the Farnsworth 100
      Hue test. RESULTS: Eleven of the 59 kindreds had abnormal color pigment gene
      clusters; these included fusion genes and changes in gene number. Only one
      kindred had a deletion of sequences immediately 5' to the color pigment genes.
      CONCLUSIONS: The incidence of color pigment gene changes in our 59
      adrenoleukodystrophy kindreds is approximately twice the frequency of defective
      color vision reported in historic studies but is about the same as that found in
      studies of the actual genes in large populations. However, the range of changes
      in the color pigment genes in adrenoleukodystrophy is broader than encountered in
      most populations. Changes in the highly conserved color pigment genes reflect
      reorganizations in the Xq28 chromosomal region, some of which involve the
      contiguous gene for adrenoleukodystrophy.

PMID- 8344787
TI  - Sites of cone system sensitivity loss in retinitis pigmentosa.
AB  - PURPOSE: To examine the sites of cone sensitivity loss in patients with retinitis
      pigmentosa by comparing focal electroretinographic and psychophysical modulation
      thresholds. METHODS: Both psychophysical and electrophysiologic increment
      threshold curves were obtained in retinitis pigmentosa patients and a group of
      age-matched, normally-sighted adults. RESULTS: The majority of the retinitis
      pigmentosa data could be accounted for by a vertical displacement of the normal
      curve. The retinitis pigmentosa patients showed similar patterns of cone
      sensitivity losses using both techniques. CONCLUSIONS: The combined
      electrophysiologic and psychophysical results provide support for an outer retina
      locus for these cone sensitivity losses. The data suggest that these deficits may
      be caused by a spatially independent loss of cone photoreceptors with normal
      adaptation properties in the remaining photoreceptors.

PMID- 8344788
TI  - Effect of vitamin A deficiency on the adhesion of rat corneal epithelium and the
      basement membrane complex.
AB  - PURPOSE: To understand the underlying mechanisms responsible for the easy removal
      and sloughing of corneal epithelium in vitamin A deficiency. METHODS: An animal
      model of vitamin A deficiency, the vitamin A-deficient rat (A-rat), transmission
      electron microscopy, computer-assisted morphometric analysis and indirect
      immunofluorescence were used to study the adhesion of rat corneal epithelium to
      its basement membrane with emphasis on structure and molecular composition of the
      anchoring structures such as the hemidesmosome and bullous pemphigoid antigen.
      RESULTS: Transmission electron microscopy resolved numerous microseparations of
      the basal epithelial cell membrane from the basement membrane with intervening
      segmental basement membrane duplications and electron dense deposits.
      Morphometric analysis disclosed a statistically significant reduction in the
      frequency and size of hemidesmosomes. Four weeks after supplementing the diet
      with retinyl acetate (700 micrograms/week), significant reversal of these same
      structural abnormalities could be detected. Immunofluorescence staining for
      bullous pemphigoid antigen, a component of the adhesion complex, showed intense
      staining of the basal epithelial cytoplasm but weak and discontinuous staining of
      the basement membrane. Weak staining for laminin was also evident in A- corneas.
      In contrast, normal corneas displayed no cytoplasmic staining for bullous
      pemphigoid antigen and intense staining of the basement membrane for bullous
      pemphigoid antigen and laminin. CONCLUSIONS: The authors propose that structural
      abnormalities of the epithelial basement membrane complex are responsible for the
      observed loose epithelial adhesion and sloughing, as well as other known
      abnormalities of healing in the vitamin A-deficient rat cornea.

PMID- 8344789
TI  - Ontogeny of corneal epithelial tight junctions: stratal locale of biosynthetic
      activities.
AB  - PURPOSE: On reaching the surface position, corneal epithelial cells assemble a
      tight paracellular barrier rapidly. The purpose of this study was to identify at
      what maturation stage the cells acquire biochemical elements underpinning this
      ability. METHODS: Rabbit corneas were subjected to a digitonin-exposure protocol
      that results in the devitalization and desquamation of the three outermost cell
      layers of the 5-6-layer thick epithelium and thus, exposes winglike cells to the
      tear surface. Corneas were then mounted in Ussing-type chambers to measure
      transepithelial resistance and solute fluxes. RESULTS: After the devitalization
      treatment transepithelial resistance remained near baseline for 2 hours and then
      rose to 8.24 +/- 3.12 K omega.cm2 (+/- SD, n = 15) during the next 8 hours. This
      increase was matched by increases in the resistance to the paracellular flow of
      mannitol. Transmission electron microscopy confirmed de novo formation of tight
      junctions over this time span in the new surface. The addition of transcription
      (actinomycin D; alpha-amanitin), translation (cycloheximide), core glycosylation
      (tunicamycin), and endoplasmic reticulum-to-Golgi traffic (brefeldin A)
      inhibitors immediately after the devitalization protocol prevented the
      transepithelial resistance raise. Introducing time delays between the cell
      devitalization and the addition of these biosynthesis inhibitors reduced their
      effect; a time delay of 90 minutes abolished the inhibition by alpha-amanitin.
      CONCLUSION: Devitalization of overlying cells induces the assembly of a tight
      paracellular barrier in the wing cells. The process requires and includes the
      synthesis of essential transcripts and proteins that were initially absent in
      these cells. In vivo, the synthesis of these elements must occur as cells reach
      the squamous stage of maturation.

PMID- 8344790
TI  - In vitro propagation of human ocular surface epithelial cells for
      transplantation.
AB  - PURPOSE: To examine the possibility that ocular surface epithelial cells might be
      grown in culture for use as grafts. METHODS: The proliferative capacity of
      epithelial cells cultured from the conjunctiva, limbus, and central cornea of
      normal human eyes was compared. Single cells disaggregated from approximately 1
      mm2 biopsy specimens were serially cocultured with lethally irradiated mouse 3T3
      fibroblasts. To study the cells' ability to reform a stratified epithelium,
      confluent limbal cultures were released as an intact cell sheet with the enzyme
      Dispase and transplanted to a dermal connective tissue bed in nude mice.
      Attachment and differentiation properties of the reconstituted epithelium were
      examined immunohistochemically. RESULTS: Central corneal epithelial cells could
      not be propagated; they senesced in first or second passage. In contrast, limbal
      epithelial cells exhibited a substantial (i.e., mean of 23 population doublings)
      and conjunctival cells a moderate (i.e., mean of 11 population doublings)
      proliferative capacity. Within 4 days of transplantation to the nude mouse
      dermis, cultured limbal epithelial cells formed an epithelium 5-6 cell layers
      thick. The epithelium adhered firmly to the graft bed, and deposition of the
      basement membrane and anchoring fibril protein collagens IV and VII and laminin
      was detectable immunohistochemically. The transplanted epithelium displayed
      limbuslike compartmental expression of keratins K3, K13, and K19, and of the
      enzyme enolase. CONCLUSIONS: These results support the concept that corneal
      epithelial stem cells are located in the limbus and indicate that cultured
      autologous limbal cells may function as grafts to permanently restore the corneal
      epithelium after severe ocular surface injury.

PMID- 8344792
TI  - Effect of Pseudomonas aeruginosa elastase, alkaline protease, and exotoxin A on
      corneal proteinases and proteins.
AB  - PURPOSE: To determine the effects of exoproducts from the corneal pathogen
      Pseudomonas aeruginosa on corneal proteinases and proteins. METHODS: Whole rabbit
      corneas were cultured in the presence or absence of broths conditioned with
      Pseudomonas aeruginosa, elastase, alkaline protease, and exotoxin A. Protein
      synthesis was assayed by adding 35S-methionine during the last 6 hours of
      culture. Caseinolytic assays and zymography on sodium dodecyl sulfate
      polyacrylamide gels containing casein and gelatin were used in the presence and
      absence of inhibitors to quantify and identify corneal proteinases. RESULTS: The
      major proteinases released by the corneas were 92/89 kD (MMP9) and 65 kD (72 kD
      gelatinase, MMP2) gelatinases and a 97 kD caseinase. Minor proteinases observed
      included 184, 166, 156, 153, 126, 111, 102, 60, 57, and 43 kD gelatinases and
      170, 136, 85, and 54 kD caseinases. P. aeruginosa elastase at 1 microgram/ml
      cleaved the 92 kD gelatinase to yield a 77 kD active form and cleaved the 65 kD
      gelatinase to yield a 57 kD active form. At 25 micrograms/ml elastase, the
      gelatinases were degraded. P. aeruginosa alkaline protease had no effect on the
      92 or 65 kD gelatinases. Both elastase and alkaline protease degraded the 97 kD
      caseinase. Proteinases other than elastase and alkaline protease in P.
      aeruginosa103- and P. aeruginosa01-conditioned broths also activated and/or
      degraded corneal proteinases. Exotoxin A inhibited the synthesis of the 92 kD
      gelatinase and most other proteins. The 72 kD gelatinase and the 97 kD caseinase
      were released in the presence of exotoxin A. CONCLUSIONS: Pseudomonas aeruginosa
      exoproducts can contribute directly to keratitis caused by Pseudomonas organisms
      through toxic effects on corneal cells and degradation of corneal proteins and
      indirectly through the activation of corneal proteinases.

PMID- 8344791
TI  - Identification of integrins in cultured corneal fibroblasts and in isolated
      keratocytes.
AB  - PURPOSE: The integrins are a family of transmembrane glycoproteins that function
      in attachment of cells to one another and to the extracellular matrix. When cell-
      cell and cell--matrix interactions are altered, the population of integrins may
      change. In particular, removing cells from their normal environment may be used
      as a model of wounding. The current study reports the identification of the
      integrins expressed at the cell surface of noncultured keratocytes and of
      cultured corneal fibroblasts, which are derived from keratocytes grown in primary
      culture. METHODS: For integrin identification, the surface proteins of
      keratocytes and cultured corneal fibroblasts were labeled with biotin, and the
      integrins were immunoprecipitated using anti-integrin antibodies. Attachment
      assays determined (1) the extracellular matrix preference of the cultured corneal
      fibroblasts and (2) the effects of function-perturbing antibodies against the
      fibronectin receptor (alpha 5 beta 1) or against other beta 1-containing
      integrins. RESULTS: The integrins of noncultured keratocytes were present as
      heterodimeric alpha, beta surface proteins that were immunoprecipitated by anti
      beta 1, anti-alpha v, anti-alpha 6, anti-alpha 3, anti-alpha 1, and anti-beta 3.
      Furthermore, when the keratocytes were placed in culture, the integrin pattern
      changed. The classic fibronectin receptor, alpha 5 beta 1, is then expressed
      along with additional integrins that bind to fibronectin. Using attachment
      assays, we determined that the cultured corneal fibroblasts prefer fibronectin to
      collagen, vitronectin, or laminin as extracellular matrix substrate. In addition,
      function-perturbing antibodies against the fibronectin receptor (alpha 5 beta 1)
      or against beta 1 inhibit attachment of cultured corneal fibroblasts to
      fibronectin. CONCLUSIONS: Receptors for fibronectin and other extracellular
      matrix molecules are expressed at the cell surface in cultured corneal
      fibroblasts, and are in position to play a significant functional role as seen in
      attachment to extracellular matrix.

PMID- 8344794
TI  - Extraction of choriocapillaris hemodynamic data from ICG fluorescence angiograms.
AB  - PURPOSE: There are conflicting views about the organization of the posterior pole
      choriocapillaris, particularly concerning blood flow through it, and there are
      difficulties associated with attempting to obtain such information using
      histologic techniques, sodium fluorescein angiography, or both. The present study
      uses a method of analysis based on high-speed angiograms to investigate posterior
      pole choroidal blood flow. METHOD: The analysis method employed is based on the
      premises that dye filling of the choriocapillaris is more rapid (because it is
      pulsatile) than dye filling of the underlying larger diameter vessels, and that
      fluorescence from these two overlapping layers is additive. The described
      analysis algorithm was applied to high-speed ICG fluorescence angiograms to
      emphasize information about choriocapillaris hemodynamics. RESULTS: The analysis
      method was demonstrated in rhesus monkeys, and results indicate that the
      posterior pole choriocapillaris does not behave as a homogeneous structure,
      consisting of discrete lobular segments. In general, the cycle of dye filling of
      the choriocapillaris begins in the macular area and progresses radially toward
      the periphery in a wavelike manner, the filling cycle beginning with and being
      completed during one cycle of the intraocular pressure pulse. CONCLUSIONS: It is
      possible to extract information related to choriocapillaris blood flow from high
      speed ICG angiograms when a fairly well-defined dye bolus wavefront is present.
      Interpretation of the results suggests that the choriocapillaris lobules fill in
      a pulsatile manner, out of phase with each other, and may act thereby to
      dissipate the blood volume entering the choroid during each cardiac cycle in such
      a way that the retinal macular is not significantly displaced by expansion of the
      choroidal vascular volume. Depending upon the distribution of pressure gradients
      across a group of lobules, blood may flow from one lobule into or even through an
      adjacent one.

PMID- 8344793
TI  - Adenosine-mediated autoregulation of retinal arteriolar tone in the piglet.
AB  - PURPOSE: To determine if the purine vasodilator adenosine participates in
      mediating autoregulatory dilations of the retinal microcirculation in vivo.
      METHODS: The retinal microcirculation of isoflurane-anesthetized newborn pigs was
      observed by videomicroscopy (x310). Systemic hypoxia (PaO2 = 24 +/- 1 mm Hg; n =
      8) or hemorrhagic hypotension (MABP = 41 +/- 1 mm Hg; n = 5) was induced, and the
      effect of intravitreal microsuffusion of 0.4 nmol of the adenosine receptor
      antagonist 8-sulfophenyltheophylline (8SPT) on retinal arteriolar dilations
      resulting from these stimuli were measured. The effect of potentiation of
      endogenous interstitial adenosine concentrations with 0.2 nmol 4-nitrobenzyl-6
      thioinosine (NBTI) on the response to hypotension (MABP = 43 +/- 2 mm Hg; n = 4)
      was also determined. RESULTS: The significant vasodilatative response of the
      retinal arterioles to systemic hypoxia (36 +/- 8% increase in diameter above
      baseline; P = 0.0012) was attenuated 55% (P < 0.0001) by the adenosine antagonist
      8SPT. Similarly, the significant arteriolar vasodilation induced by systemic
      hypotension (29 +/- 3% increase in diameter; P < 0.0001) was inhibited 76% by
      8SPT (P = 0.0002). When adenosine reuptake was inhibited with NBTI, the
      arteriolar dilation induced by hypotension (32 +/- 5% increase in diameter; P =
      0.0234) was potentiated 100% (P = 0.0117). CONCLUSIONS: Our finding that
      inhibition or potentiation of endogenous adenosine action uniquely affected
      retinal arteriolar dilatative responses to hypoxia and hypotension suggests that
      adenosine is a key participant in mediating autoregulatory adjustments in retinal
      blood flow in the eye of the newborn.

PMID- 8344795
TI  - Local anesthetic drugs reduce endothelium-dependent relaxations of porcine
      ciliary arteries.
AB  - PURPOSE: During retrobulbar anesthesia ocular hemodynamics are altered. The
      purpose of this study is to investigate the effects of local anesthetics in
      isolated porcine ciliary arteries (diameter between 200 and 400 microns).
      METHODS: Isolated porcine ciliary arteries were suspended in myograph systems
      filled with modified Krebs-Ringer solution for isometric tension recording.
      RESULTS: In quiescent or serotonin-precontracted arteries, lidocaine,
      bupivacaine, or mepivacaine (10(-9)-10(-5)M) evoked no change in vascular tone.
      However, all local anesthetics (10(-5)M) and bupivacaine (10(-5)-10(-6)M) reduced
      endothelium-dependent relaxations to bradykinin (10(-9)-10(-6)M), whereas the
      endothelium-independent relaxations to the nitric oxide-donor 3-morpholino
      sydnonimine (SIN-1; 10(-9)-10(-5)M) were unaffected by local anesthetics. The
      addition of L-arginine (10(-4)M) markedly reduced the inhibitory effects of
      bupivacaine on endothelial vasodilatation function. CONCLUSION: These findings
      demonstrate that in porcine ciliary arteries, local anesthetics impair
      endothelial formation of nitric oxide from L-arginine after stimulation with
      bradykinin, which may contribute importantly to the reduction in blood flow to
      the eye during retrobulbar anesthesia.

PMID- 8344797
TI  - Does topical hydrogen peroxide penetrate the cornea?
AB  - PURPOSE: To determine under what conditions hydrogen peroxide (H2O2) can
      penetrate the cornea and cause increased concentrations of H2O2 in the aqueous
      humor. METHODS: Rabbit corneas were exposed in vitro and in vivo to H2O2
      concentrations up to 60 mmol/l either in a 600 microliter volume or as
      consecutive drops. H2O2 was measured over time either in the endothelial
      superfusate or in tapped samples of aqueous humor, and in the fluid applied to
      the ocular surface. The stability of exogenous H2O2 added directly to aqueous
      humor was also determined. RESULTS: Exogenous H2O2 in aqueous humor decays with a
      half-life of 20 minutes, chiefly as a result of catalase activity. When applied
      to the entire ocular surface, 600 microliters of 60 mmol/l H2O2 caused no change
      in the concentration in aqueous humor, but when applied to the corneal surface
      alone, penetration occurred at 18 mmol/l and above. When applied as eight 40
      microliters drops to the ocular surface the threshold for H2O2 penetration was
      above 36 mmol/l. CONCLUSIONS: H2O2 is rapidly eliminated on the ocular surface,
      chiefly by enzyme activity of the conjunctiva and cornea. Threshold for
      penetration of H2O2 into the aqueous humor depends on volume, concentration,
      duration, and ocular surface exposed. In a healthy eye, exogenously derived H2O2
      is eliminated by enzyme activity of the aqueous humor and tissues surrounding the
      anterior chamber.

PMID- 8344796
TI  - Sustained delivery of retinoic acid from microspheres of biodegradable polymer in
      PVR.
AB  - PURPOSE: The aims were to obtain a controlled intravitreous release of retinoic
      acid (RA) by injecting drug loaded microspheres of biodegradable polymers and to
      study the potential use of this RA delivery system in a rabbit model of
      proliferative vitreoretinopathy (PVR). METHODS: The release of RA in vitro from
      15 mg of 50-50 poly(DL-lactide-co-glycolide) (PLGA) in 1 ml of water at room
      temperature was measured with a spectrophotometer. In a rabbit model of PVR, 11
      eyes were injected with 5 mg of microspheres containing 22 micrograms of RA/mg of
      PLGA, and seven control eyes were injected with microspheres of the same polymer
      that did not contain RA. In a third group, six rabbits were injected with 5 mg (n
      = 3) and 10 mg (n = 3) of microspheres containing RA. RESULTS: The initial
      concentration of RA was 20.8 micrograms/mg of PLGA. The release curve showed a
      fairly constant daily release of 7 micrograms/d for about 30 days. At 40 days,
      the release rate decreased to about 6 micrograms/d. After 40 days, 82.8% of the
      RA was released. Four of 11 treated rabbits (36%) and 7/7 (100%) controls showed
      tractional retinal detachment (TRD) (P < 0.01) after 2 months.
      Histopathologically, a mild, localized, foreign body reaction was observed.
      CONCLUSIONS: The authors obtained a sustained release of RA from PLGA
      microspheres in vitro for 40 days. A single injection of RA-loaded microspheres
      in suspension in BSS was effective in reducing the incidence of TRD after 2
      months in a rabbit model of PVR.

PMID- 8344798
TI  - Expression of three forms of melanoma growth stimulating activity (MGSA)/gro in
      human retinal pigment epithelial cells.
AB  - PURPOSE: To characterize mRNA expression and protein production of the cytokine
      MGSA/gro in human retinal pigment epithelial (RPE) cells and to determine whether
      expression of MGSA/gro is modulated by serum and the cytokines interleukin 1 beta
      (IL-1 beta), tumor necrosis factor alpha (TNF alpha), or transforming growth
      factor beta (TGF beta) mediators implicated in proliferative vitreoretinopathy
      (PVR). METHODS: Reverse-transcription polymerase chain reaction was used to
      determine the steady-state mRNA expression of three forms of MGSA/gro, alpha,
      beta, and gamma, by cultured human RPE cells in the presence or absence of
      recombinant IL-1 beta, TNF alpha, or TGF beta, or when serum-starved cells were
      re-fed with medium containing serum. Immunocytochemistry was used to characterize
      RPE cell-associated MGSA/gro protein, and immunoprecipitation of MGSA/gro from
      cell-conditioned medium was used to demonstrate MGSA/gro secretion. RESULTS:
      MGSA/gro mRNA was expressed minimally under basal conditions. Expression for all
      three forms of MGSA/gro mRNA was induced in a dose- and time-dependent manner
      after exposure to IL-1 beta, to a lesser extent after exposure to TNF alpha, but
      not after exposure to TGF beta. Serum induced MGSA/gro alpha and gamma
      transcripts, but not beta transcripts. Cell-associated MGSA/gro was identified on
      RPE cells grown in the absence of cytokines, but MGSA/gro was not secreted under
      these conditions. Exposure to IL-1 beta did not consistently cause increased cell
      associated MGSA/gro; however, IL-1 beta induced secretion of MGSA/gro in a time
      dependent manner. CONCLUSION: MGSA/gro is produced by human RPE in response to
      mediators implicated in PVR. Because MGSA/gro is a pleiotropic modulator of cell
      proliferation and inflammation, it may contribute to the intraocular wound
      healing response that characterizes PVR.

PMID- 8344799
TI  - Combination drug testing of Mycobacterium chelonae.
AB  - PURPOSE: Medical therapy of Mycobacterium chelonae keratitis is difficult because
      there are so few effective antimicrobial agents and single agent therapy
      frequently fails clinically. To identify more effective medical treatment
      regimens, the in vitro antimicrobial efficacy of amikacin, the most frequently
      used single agent, was investigated in combination with four antibiotics
      previously reported to have activity against M. chelonae: erythromycin, imipenem,
      ciprofloxacin, and vancomycin. METHODS: The drug combinations were tested by the
      checkerboard method against seven corneal isolates of M. chelonae. RESULTS: The
      combination of amikacin with erythromycin or vancomycin consistently led to
      synergistic or additive effect, however the minimum inhibitory concentrations for
      vancomycin were very high. The combination of amikacin with imipenem or
      ciprofloxacin led to results ranging from antagonism to additive effects.
      CONCLUSIONS: Of the antibiotics tested, erythromycin showed the most activity
      against M. chelonae in combination with amikacin. In vitro combination drug
      testing of M. chelonae by the checkerboard method should be further evaluated for
      clinical relevance in microbial keratitis.

PMID- 8344800
TI  - Prejunctional modulation of norepinephrine release in the human iris-ciliary
      body.
AB  - PURPOSE: To characterize the prejunctional mechanisms that control the impulse
      evoked release of norepinephrine in the isolated, superfused human iris-ciliary
      body. METHODS: Human iris-ciliary body tissue segments were preincubated with 3H
      norepinephrine, superfused and electrically-stimulated in vitro to evoke the
      discharge of 3H-norepinephrine. The effects of prejunctional modulators on evoked
      3H-norepinephrine overflow were evaluated. RESULTS: Stimulation-evoked (but not
      spontaneous) 3H-norepinephrine release was inhibited by alpha 2-adrenergic,
      muscarinic, dopaminergic, neuropeptide Y, and prostaglandin agonists and was
      enhanced by angiotensin II. Agonist-induced effects on 3H-norepinephrine overflow
      were blocked by selective antagonists, where available. Yohimbine and atropine
      alone enhanced 3H-norepinephrine output, suggesting that prejunctional alpha 2
      adrenergic and muscarinic receptors undergo tonic activation by endogenously
      released neurotransmitters. CONCLUSIONS: Human ocular sympathetic nerves express
      inhibitory alpha 2-adrenergic, muscarinic, dopaminergic, prostaglandin, and
      neuropeptide Y receptors and facilitatory angiotensin II receptors that control
      the impulse-evoked release of 3H-norepinephrine. These receptors may be useful
      targets for pharmacologic manipulation of the adrenergic system in vivo.

PMID- 8344801
TI  - Myopia and myopic progression among schoolchildren: a three-year follow-up study.
AB  - PURPOSE: To discuss the factors that might explain the rate of myopic progression
      and the degree of myopia after a 3-year follow-up among schoolchildren with
      myopia. METHODS: Myopic progression among 238 schoolchildren was followed up in a
      randomized clinical trial of myopia treatment. The associations between the
      explanatory factors and myopic progression and the final value of the spherical
      equivalent after the follow-up were studied by analysis of variance and
      regression analysis. RESULTS: Myopia progressed faster among girls than boys.
      According to the regression models for the boys, 25% of the variation of myopic
      progression and 57% of the final spherical equivalent could be explained by
      initial spherical equivalent, age at receiving first spectacles, time spent on
      sports and outdoor activities, and on reading and close work. Among the girls,
      30% of myopic progression could be explained by age at receiving first
      spectacles, time spent on reading and close work, and reading distance.
      Similarly, 49% of the final spherical equivalent could be explained by age at
      receiving first spectacles, initial spherical equivalent, time spent on reading
      and close work, and reading distance. The rest of the variations could not be
      explained by the variables measured in this study. CONCLUSIONS: The factors with
      the most significant relationships to myopic progression were sex, age of onset,
      and degree of myopia at the beginning of the follow-up. Myopic progression and
      final myopia were related to time spent on reading and close work and to reading
      distance but not, however, to accommodation stimulus.

PMID- 8344802
TI  - Actin filament organization during endothelial wound healing in the rabbit
      cornea: comparison between transcorneal freeze and mechanical scrape injuries.
AB  - PURPOSE: To compare and contrast the in vivo mechanism of wound healing after
      mechanical scrape and transcorneal freeze (TCF) injury in a rabbit eye model by
      examining changes in the cytoskeletal organization of contractile, filamentous
      actin (f-actin) microfilaments as relates to differences in cell migration or
      translocation during endothelial repair. METHODS: Endothelial wound healing after
      mechanical scrape and transcorneal freeze injury was studied in rabbit eyes using
      laser scanning confocal microscopy (LSCM). Central corneal mechanical scrape
      injury was made using an olive tip cannula, and TCF injury was made using a 3-mm
      diameter stainless steel probe cooled with liquid nitrogen. Cytoskeletal changes
      in f-actin stained with phalloidin-FITC were observed during wound healing using
      LSCM. RESULTS: At 6 hours after mechanical scrape, the leading edge of the
      migrating sheet showed a decrease in the intensity of phalloidin-FITC staining,
      suggesting a decrease in cortical f-actin. Migrating endothelial cells in vivo
      did not appear to develop stress fibers after mechanical scrape, which is
      consistent with an in vitro cell spreading mechanism of endothelial wound
      healing. By 24 hours, the denuded area was almost fully resurfaced by migrating
      endothelial cells. On the other hand, TCF injury produced fibroblastic changes in
      the endothelial cells with extension and elongation of spindle-shaped endothelial
      cells at the leading edge by 24 hours after injury. Fibroblastic endothelial
      cells developed prominent actin stress-fibers, which is consistent with an in
      vitro cell migration mechanism of endothelial wound healing. Three days after
      TCF, the wounded area was resurfaced with two cell types: rough, fibroblast-like
      cells forming a retrocorneal fibrous membrane having prominent f-actin bundles or
      stress fibers with few cell-cell junctions, and smooth, polygonal-shaped
      endothelial cells having tight cell junctions with a cortical distribution of f
      actin. After 28 days the retrocorneal fibrous membrane was posteriorly covered
      with normal endothelium. CONCLUSIONS: These data support the hypothesis that
      endothelial wound healing involves two separate, injury-dependent, mechanisms-
      cell spreading and cell migration.

PMID- 8344804
TI  - Hyperlucent thorax from rotation. Anatomic basis.
AB  - RATIONALE AND OBJECTIVES: The authors studied a large group of patients with a
      computed tomography (CT)-based model to evaluate the presence, significance, and
      anatomic basis of unilateral hyperlucency from patient rotation. METHODS: Chest
      CT sections at three levels in 65 consecutive patients undergoing routine
      diagnostic studies were read into a microcomputer. Radiographic transmittance
      data were calculated across each CT section at different degrees of rotation as
      well as for lateral decentering. Data were analyzed for the pattern of density
      variation both individually as well as in stratified subgroups. RESULTS: The data
      showed a trend of increasing radiographic transmission on the side opposite that
      of the anterior obliquity. The resulting optical density difference was small and
      was not clinically significant. Lateral decentering produced smaller changes than
      rotation. The anterior breast/pectoral structures are the etiology for the
      phenomenon. Optical density differences of 0.1 result from a difference in tissue
      thickness of 4 mm. CONCLUSIONS: The changes in radiographic transmission with
      rotation are small and are overshadowed by soft tissue compression. Rotation
      alone will result in decreased radiographic transmission on the side of anterior
      obliquity; thus, the left side will be more lucent in an right anterior oblique
      projection.

PMID- 8344803
TI  - Developmental expression of bFGF in the bovine retina.
AB  - PURPOSE: To examine the expression of bFGF in the developing bovine retina.
      METHODS: Fetal bovine eyes at 90, 120, 150, and 180 days gestational age, as well
      as adult bovine eyes, were immunohistochemically stained for the presence of
      bFGF. Detailed characterization of the anti-bFGF antibodies by immunoblot and
      Western blot analysis against pure FGF gene family standards and crude extracts
      of bovine retina were also performed. RESULTS: Expression of bFGF occurs
      beginning at 150 days of gestation, a period when photoreceptor development and
      secondary capillary network development is in process. No bFGF expression was
      found at 90 days, but primary capillaries were already apparent at this stage of
      development. CONCLUSIONS: Expression of bFGF in the developing bovine retina may
      play a functional role in outer retinal development.

PMID- 8344805
TI  - The relationship of trabecular and cortical bone mineral density to spinal
      fractures.
AB  - RATIONALE AND OBJECTIVES: The relationships between trabecular, cortical, or
      integral bone mineral densities (BMD) to spontaneous vertebral fractures was
      investigated. METHODS: In 360 Japanese women, ranging from 20 to 83 years of age,
      vertebral trabecular and cortical BMD were measured using quantitative computed
      tomography (QCT). Among 46 oophorectomized women, BMD was measured using QCT and
      dual-energy x-ray absorptiometry (DXA). RESULTS: For patients in their sixth and
      seventh decades, those with fractures could be differentiated from those without
      fractures by measuring their trabecular BMD using QCT. Cortical BMD of women with
      fractures and trabecular BMD more than 80 mg/mL was significantly lower than that
      of women without fractures and trabecular BMD less than 70 mg/mL. CONCLUSIONS:
      Trabecular BMD can be a good predictor of spinal fracture. Cortical BMD may be
      important in cases with decreased trabecular BMD.

PMID- 8344806
TI  - Double contrast small bowel follow-through with an acid-resistant effervescent
      agent.
AB  - RATIONALE AND OBJECTIVES: A new technique was developed to achieve double
      contrast examinations in the small bowel without intubation. METHODS:
      Effervescent granules and tablets were coated with an acid-resistant acrylic
      lacquer to provide selective enteric gas release. The coating thickness was 15%
      of dry weight for the granules and 1 to 4.5 mg/cm2 for the tablets. Fifty
      patients were examined using the method in a controlled study. All examinations
      were reviewed by two radiologists using a three-step quality score. The results
      were compared to 20 enteroclysis examinations. RESULTS: Image quality was better
      for the coated tablets compared with the granules (P < .01). The double-contrast
      small bowel follow-through (DC-SBFT) provided a better quality examination in the
      terminal small bowel than in the jejunum. Enteroclysis yielded better results for
      the jejunum, but was not superior in the terminal ileum. Average time of
      fluoroscopy was 477 seconds for the DC-SBFT (n = 50) compared with 952 seconds
      for patients receiving enteroclysis (n = 528). No side effects or adverse
      reactions occurred due to contrast media application. CONCLUSIONS: The results of
      this new method are preliminary, yet promising. For young patients and certain
      indications it may provide a less invasive alternative to enteroclysis.

PMID- 8344807
TI  - Clot-blood contrast in fast gradient-echo magnetic resonance imaging.
AB  - RATIONALE AND OBJECTIVES: Contrast between clot and blood in magnetic resonance
      imaging (MRI) at 1.5T using fast gradient-echo pulse sequences (fast GRE), with 8
      ms < TR < 20 mseconds was studied both in vitro and in clinical human deep venous
      thrombosis (DVT) to assess whether good contrast could be obtained at such short
      repetition times and at clinically relevant flow rates. METHODS: In vitro studies
      used an apparatus that contained flowing MnCl2[aq] (water adjusted with manganese
      chloride to have T1, T2 similar to blood) and an immobilized clot (T1, T2 similar
      to those in DVT) for flow velocities between 0 and 16.5 cm/sec. Seven patients
      with DVT were imaged with the fast GRE sequences to observe the clot-blood
      contrast in vivo. RESULTS: Peak contrast-to-noise ratio (CNR) was achieved using
      flip angles between 20 degrees and 40 degrees (increasing with flow velocity)
      with or without radiofrequency "spoiling," consistent with a natural spoiling
      effect of flow. The CNR between MnCI2[aq] and clot decreased less than 10% as TR
      was reduced 56% from 18 mseconds to 8 mseconds (30 degrees flip angle). In four
      patients with nonocclusive DVT, fast GRE imaging provided good contrast while in
      occlusive cases (three patients) the contrast was not as good as conventional GRE
      sequences with longer TR values (TR = 33 mseconds). CONCLUSION: A fast GRE
      sequence with TR = 8 mseconds, TE = 3 mseconds, and a flip angle = 40 degrees is
      a promising approach to speeding up the detection of nonocclusive clinical DVT.

PMID- 8344808
TI  - Absence of an angiogenic factor in large systemic arteriovenous malformations.
AB  - RATIONALE AND OBJECTIVES: Large symptomatic arteriovenous malformations (AVMs)
      are currently managed by a combination of surgery, embolization, and supportive
      measures. If patients with such lesions should have a circulating factor
      responsible for their growth and development, the evolution of a more rational
      therapy might be possible. METHODS: To explore this possibility, sera from 14
      patients with high-flow systemic AVMs, widely distributed anatomically, were
      tested for the presence of a circulating growth factor using an assay already
      successfully used to isolate such a factor in diabetics with proliferative
      retinopathy. RESULTS: None of the patients tested positive for such a factor.
      CONCLUSIONS: This result, although negative, contributes to our knowledge of the
      biology of these uncommon but important lesions and leads us to conclude that,
      for the foreseeable future, embolization is likely to remain the most effective
      form of treatment for high-flow AVMs.

PMID- 8344810
TI  - In-vitro assessment of the behavior of magnetic resonance angiography in the
      presence of constrictions.
AB  - RATIONALE AND OBJECTIVES: Time-of-flight magnetic resonance angiography (TOF/MRA)
      is increasingly used to assess the nature and severity of stenotic blood vessels.
      Flow artifacts associated with high flows and/or narrow constrictions may confuse
      the interpretation of these studies. Accurate TOF/MRA evaluations demand an
      understanding of the nature of these flow effects. METHODS: A two-dimensional TOF
      pulse sequence was used to acquire images of five smoothly constricted phantoms
      at various flows. Analysis included assessment of phantom appearance and
      quantification of apparent constriction diameter and signal variations. RESULTS:
      Most notable flow phenomena were a cone-shaped region of high signal, a region of
      signal void, and signal preservation along the wall. When visible, constriction
      diameter was accurately measured. CONCLUSIONS: The behavior observed in TOF/MRA
      images can be understood by considering the contributing mechanisms of phase
      dispersion, turbulence, poststenotic flow eddies, flow reversal, and flow
      separation.

PMID- 8344809
TI  - Calculation of tissue attenuation with a clinical ultrasound unit.
AB  - RATIONALE AND OBJECTIVES: Five alternative methods for estimating tissue
      attenuation with a clinical ultrasound unit were evaluated. METHODS: Two
      homogeneous tissue mimicking phantoms (with known attenuations of 0.25 and 0.54
      db/cm/MHz) and 22 human placentas were scanned. Attenuation coefficients were
      computed by linear regression of 1) L(f), the log spectral difference; 2) Fav
      (d), the average spectral frequency; 3) log[P(d)], the logarithm of the spectral
      power; 4) Fav (d) x log[P(d)]; and 5) (Fav(d) + log[P(d)])/2. RESULTS: Each of
      these five heuristics provided accurate estimates for the relative attenuations
      of the two phantoms. For placental tissue, method 3 provided better regression
      fits than methods 1 and 2. Methods 4 and 5 provide the best regression fits (P <
      .01). CONCLUSIONS: The combination of both frequency and power information in
      methods 4 and 5 compensates, in part, for nonlinearities introduced by tissue
      heterogeneity. A parameter that combines both frequency and time domain
      information is likely to provide more reliable estimates of attenuation than
      power or frequency measurements alone.

PMID- 8344811
TI  - Acute effects of shock waves on tumors assessed by magnetic resonance imaging.
      Possible role of blood flow reduction.
AB  - RATIONALE AND OBJECTIVES: The effects of shock waves on experimental tumors in
      vivo by gadolinium(+)-DTPA-enhanced magnetic resonance imaging (MRI) are
      assessed. METHODS: Two amelanotic hamster melanomas were implanted in the dorsal
      skin of 19 hamsters. In experiment 1 (n = 7), MRI of untreated tumors was
      performed before, and 5 and 15 minutes after intravenous injection of Gd(+)-DTPA.
      In experiment 2 (n = 12), 200 shock waves were applied on one of the implanted
      tumors. Magnetic resonance imaging was performed 15 minutes after treatment
      before, and 5 and 15 minutes after injection of Gd(+)-DTPA. RESULTS: In
      experiment 1, signal intensities (SI) of untreated tumors increased after
      injection of Gd(+)-DTPA. In experiment 2, enhancement was significantly delayed
      in shock-wave-treated tumors as compared with controls. Histology of the treated
      tumors revealed vascular damage. CONCLUSION: Differences in enhancement between
      shock-wave-treated and control tumors after injection of Gd(+)-DTPA are
      interpreted as the consequence of reduced and delayed accumulation of Gd(+)-DTPA
      in treated tumors due to shock wave induced vascular damage and reduced tumor
      perfusion.

PMID- 8344812
TI  - Effect of lidocaine on acute regional myocardial ischemia and reperfusion in the
      cat. An in-vivo 31P magnetic resonance spectroscopy study.
AB  - RATIONALE AND OBJECTIVES: The authors examined the relationship between
      myocardial infarction, high-energy phosphate compounds, and regional
      contractility after myocardial ischemia and reperfusion in cats. METHODS:
      Hemodynamic measurements, high-energy phosphate levels, and segmental shortening
      were measured every 30 minutes in two groups of cats subjected to 2 hours of
      occlusion of the left anterior descending coronary artery and 4 hours
      reperfusion. Group 1 (n = 10) animals were infused with a low level of lidocaine,
      0.05 mg/kg/hr, while group 2 (n = 10) received a higher dose, 7.5 mg/kg/hr. The
      infarcted region was measured postmortem. RESULTS: Group 1 animals had larger
      infarcts (39 +/- 6 vs. 12 +/- 5% of jeopardy, P < .05) and less phosphocreatine
      recovery during reflow (52 +/- 7% vs. 73 +/- 2% of control, P < .01) than did
      group 2. Group 2 showed recovery of percentage systolic shortening during reflow
      (1.4 +/- 2% at 30 minutes vs. 7.1 +/- 2.3% at 4 hours, P < .05), whereas group 1
      exhibited no improvement. A significant correlation was found between infarct
      size under the surface coil and phosphocreatine content during reflow, but not
      between contractile function and infarction size or metabolite levels during
      reflow. CONCLUSIONS: Lidocaine infusion enhanced recovery of myocardial
      contractility during reperfusion and decreased infarct size. Greater recovery of
      phosphocreatine during reperfusion was predictive of greater myocardial salvage
      during reperfusion.

PMID- 8344813
TI  - Hemodialysis and iopamidol clearance after subclavian venography.
AB  - RATIONALE AND OBJECTIVES: The dialyzability of iopamidol is unknown and was
      investigated in patients undergoing long-term hemodialysis for chronic renal
      failure. METHODS: Ten patients received 30 ml Niopam 300 (Bracco SpA, Milan,
      Italy) (identical to 18372 mg iopamidol) intravenously into a forearm vein to
      investigate for occult subclavian stenosis. RESULTS: The elimination half-life of
      iopamidol before hemodialysis was 69.6 hours and during 4 hours of hemodialysis
      was 3.5 hours. A single 4-hour hemodialysis cleared 55.7% (95% Ci 51-5-59.8) of
      the administered dose, while second and third dialyses cleared 25.3% (95% Ci 21.4
      29.1) and 10.1% (95% Ci 7.7-12.6) of the administered dose, respectively. Two
      patients with significant residual urine excretion excreted more than 10% of the
      administered dose in the urine. For anuric patients, extrarenal clearance
      provided total body clearance of up to 0.266 L/hr. CONCLUSIONS: Hemodialysis is a
      rapid and efficient means of clearing iopamidol provided it is performed soon
      after the contrast study.

PMID- 8344814
TI  - Mechanism of gravity-dependent atelectasis. Analysis by nonradioactive xenon
      enhanced dynamic computed tomography.
AB  - RATIONALE AND OBJECTIVES: The physiologic mechanism of gravity-dependent
      atelectasis (GDA), a common finding identified during anesthesia, is not well
      understood. The purpose of this study was to determine whether an inherent
      reduction in alveolar volume or a reduction in alveolar ventilation is the more
      important causative factor for the development of GDA in an experimental animal
      model. METHODS: After uniform reduction of lung volume in ten rabbits by
      artificially induced pneumoperitoneum, dynamic inhalation computed tomography
      (CT) was performed using 50% nonradioactive xenon in oxygen. Time-CT attenuation
      value curves were fitted to an exponential function, CT value = a - b x e(-kt),
      and K value, which is proportional to the alveolar ventilation/alveolar volume
      ratio, was calculated by regression analysis. RESULTS: Gravity-dependent
      atelectasis occurred only in 5 of 10 rabbits. In this group, K values in the
      dorsal regions increased before the appearance of GDA. No significant change in K
      values in the ventral regions was observed. CONCLUSION: One mechanism of GDA may
      be a preferential reduction in alveolar volume without small airway collapse
      rather than alveolar volume loss secondary to decreased ventilation.

PMID- 8344815
TI  - How to implement a radiology quality improvement program. Pearls and pitfalls.
AB  - To get started and to help overcome some of the problems with implementation
      mentioned above, five essential things need attention: 1. Top level commitment;
      2. Physician participation; 3. On-going education; 4. Performance measurement
      (both of the department and individual); 5. Up-front investment of time and
      resources. The fundamental changes in technology, financing, and accountability
      present formidable challenges to departments of radiology today. Fortunately,
      quality management techniques offer a way to meet the challenges and
      simultaneously improve efficiency of care and quality. Learning and practicing
      these techniques is not an easy task, but overcoming the obstacles to
      implementation and getting on with the job will prove very rewarding.

PMID- 8344816
TI  - The instructional effectiveness of a radiology multimedia textbook (HyperLung)
      versus a standard lecture.
AB  - RATIONALE AND OBJECTIVES: Information overload is a significant problem for the
      modern radiologist. This prospective study compares the instructional
      effectiveness of a multimedia textbook (HyperLung) with a lecture. HyperLung is a
      radiologic multimedia textbook about imaging diffuse lung disease created using a
      multimedia authoring tool, the Annotator (the University of Iowa Second Look
      Computing, Iowa City, IA), on the Apple Macintosh computer (Apple Computer,
      Cupertino, CA). METHODS: Forty-nine staff physicians and residents in the
      Department of Radiology were randomized to receive instruction either by
      HyperLung or by a lecture. The instructional content was the same in both groups,
      and both groups were tested before and after instruction. The actual time spent
      in each instructional situation was recorded. RESULTS: The instructional
      effectiveness of the multimedia textbook and lecture was equal. The instructional
      efficiency of HyperLung was only 60% of the lecture. Users of the multimedia
      textbook found it enjoyable and straightforward to use. CONCLUSIONS: Multimedia
      textbooks have a promising future in radiology education.

PMID- 8344817
TI  - The role of research in a radiotherapy training program.

PMID- 8344818
TI  - Uroradiology in Europe.

PMID- 8344819
TI  - Magnetic resonance imaging of angiographically occult run off vessels in
      peripheral arterial occlusive disease.

PMID- 8344820
TI  - Use of Medicare services before and after introduction of the prospective payment
      system.
AB  - OBJECTIVE: The case mix-adjusted pattern of use of health care services,
      especially posthospital care, is compared before and after the introduction of
      Medicare's Prospective Payment System (PPS). DATA SOURCES: The 1982 and 1984
      National Long Term Care Surveys (NLTCS) linked to Medicare administrative records
      1982-1986 provide health and health service use data for 12-month periods before
      and after the introduction of PPS. STUDY DESIGN: Case-mix differences between pre
      and post-periods are controlled by using the Grade of Membership model to
      identify health groups from the NLTCS data. Differences in timing (e.g., hospital
      length of stay) were controlled using life table models estimated for each health
      group, that is, service use patterns pre- and post-PPS are compared within
      groups. PRINCIPAL FINDINGS: Hospital LOS and admission rates declined post-PPS.
      Changes in the timing and location of death occurred but, overall, mortality did
      not increase. Changes in post-acute care service use by elderly, chronically
      disabled Medicare beneficiaries were observed: home health service use increased
      overall and among the unmarried disabled population. CONCLUSIONS: PPS did not
      adversely affect quality of care as reflected in mortality or in hospital
      readmissions. Moreover, the differential use of post-acute care, and changes in
      hospital LOS by health group, indicate that the system responded, specific to
      marital status and age, to the severity of needs of chronically disabled persons.

PMID- 8344821
TI  - Measuring differences and similarities in hospital caseloads: a conceptual and
      empirical analysis.
AB  - OBJECTIVE: This article conceptually and empirically evaluates alternative index
      measures that have been used to distinguish among hospital caseloads. It
      introduces two new measures. DATA SOURCES/STUDY SETTING: The study relies on 1987
      Medpar data, which provide a 100 percent sample of Medicare Part A claims for the
      calendar year. STUDY DESIGN: Descriptive statistics indicate the sensitivity of
      alternative caseload measures to hospital bed size, region, and urban/rural
      location. Multiple regression analysis then examines the ability of the caseload
      measures to distinguish among hospitals based on hospital- and area-specific
      characteristics. DATA COLLECTION/EXTRACTION METHODS: A provider level file
      containing the number of cases treated by each provider in each DRG was
      constructed from the Medpar data and merged with data from the American Hospital
      Association and the Area Resource File. PRINCIPAL FINDINGS: Different indexes
      purporting to measure hospital specialization are often evaluating very different
      aspects of the hospitals' caseloads. Prior work has indicated a specialization
      among hospitals during the period from 1980 to 1985. Replication of this work
      using other indexes could verify the increase in specialization and might provide
      a clearer picture of market or hospital characteristics associated with changing
      caseloads.

PMID- 8344822
TI  - A variable-radius measure of local hospital market structure.
AB  - OBJECTIVE: To provide a radius measure of the structure of local hospital markets
      that varies with hospital characteristics and is available for all hospitals in
      the United States. DATA SOURCES: 1982 American Hospital Association (AHA) Survey
      of Hospitals, 1982 Area Resource File (ARF), and 1983 California Office of
      Statewide Health Planning and Development (OSHPD) discharge abstracts. STUDY
      DESIGN: The OSHPD data were used to measure the radii necessary to capture 75
      percent and 90 percent of each hospital's admissions. These radii were used as
      the dependent variables in regression models in which the independent variables
      were from the AHA and ARF. To estimate predicted market radii, the estimated
      parameters from the California models were applied to all nonfederal, short-term,
      general hospitals in the continental United States. These radii were used to
      define each hospital's service area, and all other hospitals within the
      calculated radii were considered potential competitors. Using this definition, we
      calculated two measures of local market structure: the number of other hospitals
      within the radius and a Herfindahl-Hirschman Index based on the distribution of
      hospital bed shares in the market. DATA EXTRACTION METHODS: These measures were
      calculated for all nonfederal, short-term, acute care hospitals in the
      continental United States for whom complete data were available (N = 4,884).
      CONCLUSIONS: These measures are available from the authors on computer-readable
      diskette, matched to hospital identifiers.

PMID- 8344824
TI  - Hospital board effectiveness: relationships between governing board composition
      and hospital financial viability.
AB  - OBJECTIVE: Two theories--agency and managerialism--are compared with respect to
      their usefulness in explaining the role of insiders on the hospital board:
      whether their participation enhances or impairs board financial decision making.
      DATA SOURCES/STUDY SETTING: The study used 1985 hospital financial and governing
      board data for a representative sample of acute care California hospitals. STUDY
      DESIGN: Relationships were examined cross-sectionally between the presence or
      absence of insiders on the board and measures of hospital financial viability
      while controlling for the organizational factors of system affiliation,
      ownership, size, region, and corporate restructuring. PRINCIPAL FINDINGS:
      Multiple regression analysis found significant relationships between insider
      (CEO, medical staff) participation and hospital viability. CONCLUSIONS: These
      results support the managerial theory of governance by suggesting that the CEO
      and medical staff provide informational advantages to the hospital governing
      board. However, the cross-sectional design points to the need for future
      longitudinal studies in order to sequence these relationships between insider
      participation and improved hospital viability.

PMID- 8344825
TI  - Evaluation of HCFA's Medicare hospital mortality report.

PMID- 8344826
TI  - Back to bondage.

PMID- 8344823
TI  - Corporate and philanthropic models of hospital governance: a taxonomic
      evaluation.
AB  - OBJECTIVE: We assess the theoretical integrity and practical utility of the
      corporate-philanthropic governance typology frequently invoked in debates about
      the appropriate form of governance for nonprofit hospitals operating in
      increasingly competitive health care environments. DATA SOURCES: Data were
      obtained from a 1985 national mailed survey of nonprofit hospitals conducted by
      the American Hospital Association (AHA) and the Hospital Research and Educational
      Trust (HRET). STUDY DESIGN: A sample 1,577 nonprofit community hospitals were
      selected for study. Representativeness was assessed by comparing the sample with
      the population of non-profit community hospitals on the dimensions of bed size,
      ownership type, urban-rural location, multihospital system membership, and census
      region. DATA COLLECTION: Measurement of governance types was based on hospital
      governance attributes conforming to those cited in the literature as
      distinguishing corporate from philanthropic models and classified into six
      central dimensions of governance: (1) size, (2) committee structure and activity,
      (3) board member selection, (4) board composition, (5) CEO power and influence,
      and (6) bylaws and activities. PRINCIPAL FINDINGS: Cluster analysis and ANCOVA
      indicated that hospital board forms adhered only partially to corporate and
      philanthropic governance models. Further, board forms varied systematically by
      specific organizational and environmental conditions. Boards exhibiting more
      corporate governance forms were more likely to be large, privately owned, urban,
      and operating in competitive markets than were hospitals showing more
      philanthropic governance forms. CONCLUSIONS: Findings suggest that the corporate
      philanthropic governance distinction must be seen as an ideal rather than an
      actual depiction of hospital governance forms. Implications for health care
      governance are discussed.

PMID- 8344827
TI  - Health visitors torn between clients and employer.

PMID- 8344828
TI  - Staff to apply for 'own jobs' as GPs shift contract to save grades.

PMID- 8344829
TI  - Vistas of common sense in 233 words.

PMID- 8344830
TI  - Children behind bars.
AB  - Over half the women serving prison sentences are mothers--many with dependent
      children under 16. Three women's prisons have special mother and baby units but
      there is little provision for the majority of women prisoners to maintain contact
      with their children. Campaigners say too little thought is given to the rights of
      the children.

PMID- 8344831
TI  - Nicaragua. Deaths by a thousand cuts. Interview by Cath Jackson.

PMID- 8344832
TI  - Patch and practice: specialist roles for health visitors.
AB  - Health visiting is facing its biggest ever challenge from the government's
      decision to give GP fundholders the powers to purchase health visiting and other
      community nursing services, writes WALTER BARKER. Here he proposes that health
      visitors should specialise and work either as practice health visitors employed
      by GP fundholders or as community health visitors employed by FHSAs or public
      health directorates. This approach would retain a strong home support service for
      families in need while maintaining the health visitor's public health role, he
      argues.

PMID- 8344833
TI  - Health visiting and the new public health.

PMID- 8344834
TI  - How important are early mother/infant relationships?
AB  - Developmental psychologists tend to believe the early relationship between mother
      and baby has a major impact on the child's later cognitive, emotional and social
      development. Ruth Paradice argues that an infant's early relationship with its
      primary caretaker, though important, is but one in a rich social network and that
      babies may be more resilient than is generally believed.

PMID- 8344836
TI  - Some current issues for health visiting.
AB  - Michael Traynor argues that recent legislation with its emphasis not only on
      targeted, measurable and effective service but also on the importance of health
      promotion offers exciting opportunities for health visiting. But to take
      advantage of these, health visitors will need to become familiar with the growing
      body of research into the evaluation of health visitors' preventive, supportive
      and health promotion roles.

PMID- 8344835
TI  - Older patients are people first.
AB  - Older people, and their health, are widely seen as 'different', writes Paula
      Jones. Services for older people have failed to keep pace with the medical
      advances which have resulted in increased longevity; they are largely ignored in
      the 'Health of the nation' strategy. Here she questions society's attitudes to
      older people and examines the consequences for the delivery of health services
      and for older people themselves.

PMID- 8344837
TI  - Belfast. Working with girls.
AB  - Belfast has many of the social problems common in major British cities: soaring
      unemployment, teenage crime, joy-riding, high levels of teenage pregnancy, drug
      and alcohol abuse. In Belfast, these problems are further complicated by the
      political and religious divide which affects virtually every area of society.
      Maura Thompson reports on a unique health visitor-led initiative working with
      teenage girls.

PMID- 8344838
TI  - Measuring down: PRP pitfalls.
AB  - Within the next three years many NHS staff will be on a performance related pay
      (PRP) scheme, writes ROGER KLINE. PRP, together with job evaluation (see May
      Health visitor) is likely to become the main means of determining NHS staff pay.
      Already many senior NHS managers are on PRP and many trusts see it as one of
      their goals.

PMID- 8344840
TI  - Close contact theory and SIDS.

PMID- 8344839
TI  - Networking against harassment at work.

PMID- 8344841
TI  - Lessons from our children.
AB  - While the incidence of cancer is increasing among both children and adults,
      mortality rates have decreased for children, while they have increased for
      adults. Of children diagnosed with cancer today, 80% are predicted to be long
      term survivors. Although there are differences between children and adults with
      respect to the tumor types, biology, and outcome, there are common lessons which
      we can learn from our children regarding the genetics of cancer, its management
      and treatment, and the importance of longitudinal studies of the survivors.
      Specific pediatric cancers, such as retinoblastoma, have led to the recognition
      of tumor suppressor genes, now also observed among adult tumors including
      sarcomas, breast, lung, and bladder cancer. The presence of the tumor suppressor
      gene provides an understanding for the incidence of second malignant tumors among
      patients with heritable diseases. Furthermore, cancer prone families, such as
      those with the Li-Fraumeni syndrome, also carry the p 53 tumor suppressor gene;
      the presence of which greatly increases the risk of developing invasive cancer.
      Childhood cancer is rare; it represents only 1% of the total US cancer problem.
      However, 53% of all children with cancer, but only 2% of all adults, are studied
      via the NCI cooperative group mechanism. For some specific childhood tumors such
      as rhabdomyosarcoma and Wilms' tumor, as many as 70-85% of all cases are managed
      via NCI sponsored trials. Essentially all pediatric cancer is treated by
      interdigitating radiation with surgical resection and systemic chemotherapy. This
      approach has contributed to high cure rates. Finally, our understanding of the
      late effects of being a cancer survivor have come from longitudinal studies of
      children. The most severe long-term effects related to radiation in childhood
      pertain to growth and development, infertility, and second malignant tumor
      induction. Here the children treated for Hodgkin's disease have taught us the
      dose and volume effects on axial skeletal and soft tissue growth. Infertility
      issues are also treatment-related and may often be obviated by using gonadal
      shielding. The risk of secondary leukemia is related to dose and class of
      specific chemotherapeutic agents administered; it is 5.5% among children
      receiving 6 cycles of MOPP. There is a 22-fold risk at 30 years of age of solid
      tumor induction following radiotherapy for children with Hodgkin's disease. These
      serious concerns have been offset by current therapeutic approaches of using
      lower doses and smaller volumes of radiation with fewer cycles of less toxic
      chemotherapeutic agents. Childhood cancer ranks high among number of person-years
      of potential life saved annually.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8344842
TI  - Pharyngeal wall carcinoma treated with radiotherapy: impact of treatment
      technique and fractionation.
AB  - PURPOSE: To determine whether a modification in treatment technique and the
      routine use of twice-daily fractionation have influenced the likelihood of local
      control in carcinomas of the hypopharyngeal and/or oropharyngeal wall. METHODS
      AND MATERIALS: Between October 1964 and July 1990, 99 patients with invasive,
      previously untreated T1-T4 squamous cell carcinoma of the pharyngeal wall were
      treated with continuous-course, external-beam radio-therapy with curative intent
      at the University of Florida. All patients had a minimum 2-year follow-up.
      RESULTS: The 2-year local control rates for patients treated with once-daily vs.
      twice-daily fractionation were T1, 100% each; T2, 67% vs. 92%; T3, 43% vs. 80%;
      and T4, 17% vs. 50%. The 2-year local control rates for patients treated with our
      former technique (posterior border placed at middle of the vertebral body when
      the portals were reduced off the spinal cord) vs. our current, modified technique
      (posterior border placed at posterior edge of the vertebral body) were T1, 100%
      each; T2, 57% vs. 100%; T3, 46% vs. 73%; and T4, 29% vs. 75%. The parameters of T
      stage, fractionation schedule, primary site, (oropharynx vs. hypopharynx)
      treatment technique, and lateral vs. posterior pharyngeal wall location were
      evaluated in a multivariate analysis for the end point of local control. T stage
      (p = .003), fractionation schedule (p = .001), and primary site (p = .028) were
      of independent prognostic significance. CONCLUSION: Twice-daily fractionation was
      the most important treatment-related variable in this patient population.

PMID- 8344843
TI  - The management of the clinically positive neck as part of a larynx preservation
      approach.
AB  - PURPOSE: For patients with squamous cell carcinoma of the head and neck with
      palpable neck node metastases, the standard management of the neck usually
      involves neck dissection and postoperative neck irradiation. A strategy of larynx
      preservation with induction chemotherapy and radiation therapy has been utilized
      for patients with locally advanced resectable cancer of the larynx, hypopharynx,
      and oropharynx. For patients treated in this non-surgical manner for the primary
      site, the optimal management of the clinically positive neck has not been
      clarified. To determine whether response to induction chemotherapy could help to
      select patients in whom neck dissection could be omitted in favor of definitive
      radiation therapy alone, we have analyzed our prospective larynx preservation
      experience. METHOD AND MATERIALS: Between 1983-1989, 80 patients were entered
      onto larynx preservation protocols involving 1-3 cycles of cisplatin based
      chemotherapy followed by radiation therapy with or without neck dissection. There
      were 54 patients with clinically positive necks to treatment, of whom 44% (24/54)
      had a complete response, and of whom 20% (11/54) had a partial response to
      chemotherapy in the neck. In 22 of these 35 patients with clinically positive
      necks who achieved a major neck response to chemotherapy, radiation therapy
      (median 66 Gy) was used as the only subsequent treatment of the neck. RESULTS: At
      a median follow-up of 25 months (range 7-83 months), neck control for this subset
      is 91% (20/22). Neck failure occurred in 20% (1/5) of patients with a partial
      response to chemotherapy treated without neck dissection and 6% (1/17) of node
      positive with a complete response. CONCLUSION: These results suggest that
      patients with clinically palpable cervical nodal metastases who have a complete
      response to chemotherapy and receive high dose radiation therapy have excellent
      neck control and may not need neck dissection. Further experience will be
      required to confirm these preliminary data and to determine if patients who
      achieve a partial response in the neck after induction chemotherapy can be
      treated with radiation therapy without neck dissection.

PMID- 8344844
TI  - Prognostic factors for local control and survival in T1 squamous cell carcinoma
      of the glottis.
AB  - PURPOSE: To evaluate the effect of host, tumor, and treatment-related variables
      on local control and survival in patients with T1N0M0 squamous cell carcinoma of
      the glottis. MATERIALS AND METHODS: Ninety-one patients with T1N0M0 squamous cell
      carcinoma of the glottic larynx were analyzed. Median follow-up was 9 years
      (range 2-25). Patients were treated with daily fractions of 180 cGy to 220 cGy to
      doses of 5925-7000 cGy (median 6400). The following factors were analyzed: age,
      sex, histologic grade, disease extent, beam energy, field size, total dose, dose
      per fraction, and elapsed treatment days. RESULTS: The 5-year actuarial local
      control was 80%. On univariate analysis, only elapsed treatment days and dose per
      fraction were significant factors for local control. Local control was 100% if
      treatment was completed within 42 days, 91% for 43-46 days, 74% for 47-50 days,
      65% for 51-54 days, and 50% for 55-66 days (p = 0.0001). In patients treated at <
      200 cGy per fraction, local control was 62% as compared to 87% for > or = 200 cGy
      per fraction (p = 0.006). On multivariate analysis, only elapsed treatment days
      was a significant factor for local control (p = 0.0001). The 5-year actuarial
      survival for the whole group was 92%. Elapsed treatment days was the only
      variable affecting survival. Survival was 100% if treatment was delivered within
      42 days, 96% for 43-46 days, 94% for 47-50 days, 91% for 51-54 days, and 67% for
      55-66 days (p = 0.02). The 5-year actuarial disease-specific survival was 95%,
      with treatment duration again being the only significant prognostic factor.
      Disease-specific survival was 97% for treatment completed within 39-54 days
      versus 80% for 55-66 days (p = 0.02). Only three (3.3%) patients experienced
      moderate or severe complications. None of the evaluated parameters impacted
      significantly on complications. CONCLUSION: We conclude that elapsed days is the
      most prognostically significant factor for local control and survival in patients
      treated with radiotherapy for T1 squamous cell carcinoma of the glottis. We
      recommend that these patients be treated with 210 cGy daily fractions to 6300
      cGy.

PMID- 8344845
TI  - Retrospective analysis of patients with nasopharyngeal carcinoma treated during
      1976-1985: survival after local recurrence.
AB  - PURPOSE: To study the value of re-irradiation, the overall survival and pattern
      of failures for patients with nasopharyngeal recurrence. METHODS AND MATERIALS:
      All the 891 patients with local recurrence following radiotherapy for
      nasopharyngeal carcinoma during 1976-1981 were retrospectively analyzed. Only 70%
      of them had local failure alone at the time of detection, and the T-stage
      distribution (by Ho's system) was 31% rT1, 16% rT2, 51% rT3, and 1% rT?. Seven
      hundred and six (79%) patients had been re-irradiated with various techniques and
      doses. Among those who failed, 50 had further irradiation. RESULTS: The overall 5
      and 10-year actuarial cancer-specific survival rates were 14% and 9%,
      respectively. Patients with rT3 disease had the worst prognosis. Successful local
      salvage was achieved in 32% of those re-irradiated (26% of the whole series). The
      highest control rate was achieved by those treated with external radiotherapy to
      60 Gy (equivalent) or above. Only 8/50 patients responded to the third course of
      radiotherapy. The cumulative incidence of late post-re-irradiation sequelae was
      24%, and the treatment mortality rate 1.8%. Besides local failure, 54% had
      regional relapse and/or distant metastasis. Thus, only 16% of recurrent patients
      were totally disease-free at final assessment. CONCLUSION: The overall prognosis
      for patients with nasopharyngeal recurrence was grave. High dose re-irradiation
      could achieve successful local salvage in a substantial number of patients with
      early recurrence, but late complications did occur. Furthermore, high incidence
      of failure at other sites was observed.

PMID- 8344846
TI  - Re-irradiation of laryngeal carcinoma--techniques and results.
AB  - PURPOSE: Occasionally in the long-term survivors of early carcinoma of the
      larynx, following radiation therapy a second carcinoma may arise from the
      previously irradiated larynx. Traditionally, management of such lesions is by non
      radiation means in the belief that a further full course of radiation therapy is
      not possible and may exceed the tolerance of the normal laryngeal structures.
      Unfortunately, surgical treatment of the second carcinoma is often either total
      or partial laryngectomy which may not be acceptable to the patients and therefore
      radiation therapy is used as an alternative. METHODS AND MATERIALS: This paper
      presents our experience in re-irradiation of laryngeal carcinomas arising from
      the previously irradiated larynx. As of October 1992 a total of 20 patients were
      available for evaluation. Most patients had Stage I and II laryngeal carcinoma
      and received high doses of re-irradiation ranging from 60 to 70 Gy either by
      conventional or accelerated hyperfractionation schemes. RESULTS: The 5-year
      actuarial local control and survival rates were 60 to 93%, respectively. The
      majority of the survivors had relatively normal and functional larynges. Those
      who failed locally had total laryngectomy without significant postoperative
      complications. CONCLUSION: With this information the radiation tolerance of
      laryngeal structures is found to be much higher than commonly believed and re
      irradiation for early carcinoma of the larynx is possible and proved to be a
      useful alternative to surgery and laryngectomy is therefore reserved for failure.
      The techniques of re-irradiation will be discussed.

PMID- 8344847
TI  - Computed tomography evaluation of neck node metastases from nasopharyngeal
      carcinoma.
AB  - PURPOSE: To study the role of computed tomography in the pre-therapy evaluation
      of nasopharyngeal carcinoma. METHODS AND MATERIALS: The computed tomography of
      119 new patients of nasopharyngeal carcinoma were evaluated independent of
      clinical findings for neck node metastases, and then compared with clinical
      findings. Contrast enhanced axial scans were obtained at 5 mm intervals with the
      infraorbitomeatal line parallel to the gantry. Scans were obtained from the supra
      sellar cistern to the C5 or C6 vertebra for the evaluation of the base of skull,
      nasopharynx, paranasopharyngeal space and the upper and mid neck. RESULT: The
      present study confirmed the disparity of nodal extent documented by clinical
      palpation and computed tomography. Of the 37 patients who have no clinically
      palpable node (N0), computed tomography showed nodal involvement in 11 (29.7%) of
      them, and they were up-staged from N0 to N1. Computed tomography showed multiple
      or bilateral nodes in seven (58.3%) of the 12 patients with AJC N1 disease and
      they were hence up-staged to N2. All together, there were 28 (23.5%) patients who
      have no computed tomography evidence of nodal involvement by tumor. In agreement
      with clinical experience, the most commonly involved nodal groups were the upper
      internal jugular and upper spinoaccessary, followed by the lateral
      retropharyngeal. The percentage of nodes which were not clinically palpable was
      roughly the same for different regions (15-30%), except, as expected, that all
      the retropharyngeal nodes were not palpable. The risk of harboring
      retropharyngeal node was proportional to the size of the largest node in the
      ipsilateral neck. CONCLUSION: A significant proportion of patients with
      clinically negative neck (N0) or AJC N1 disease will be upstaged by computed
      tomography, thus supporting its routine use in pre-therapy evaluation of
      nasopharyngeal carcinoma.

PMID- 8344848
TI  - In vivo measurement of the potential doubling time by flowcytometry in
      oropharyngeal cancer treated by conventional radiotherapy.
AB  - PURPOSE: Experimental and clinical studies suggest that the pre-treatment
      potential doubling time could be predictive of tumor control in patients treated
      by conventional radiotherapy and could help to identify the rapidly growing
      tumors for which accelerated radiotherapy is required. METHODS AND MATERIALS: To
      test this hypothesis, we studied prospectively 48 patients with a squamous cell
      carcinoma of the oropharynx and treated by conventional radiotherapy (70 Gy/7
      weeks). The duration of S phase, the labeling index and the potential doubling
      time were obtained by flowcytometry measurements of a tumor biopsy obtained after
      injection of 200 mg bromodeoxyuridine to the patient. RESULTS: Three parameters
      were significantly associated with an increased risk of relapse namely the tumors
      size (T4; p < 0.01), the nodal status (> or = N2; p < 0.05) and the site of the
      primary within the oropharynx (p = 0.08). The S phase, labeling index, DNA index
      and potential doubling time were not significantly associated with an increased
      risk of relapse. However when considering only the T2 subgroup of patients, high
      labeling indexes and short potential doubling time were associated with an
      increased risk of relapse: the mean pre-treatment potential doubling time of the
      tumors which relapsed was 3.21 versus 5.5 days when there was no evidence of
      local relapse (p < 0.05). The mean labeling index for the group of tumors
      associated with a tumor recurrence was 11.7% compared to 7.3% when there was no
      evidence of relapse (p = 0.02). CONCLUSION: Factors other than proliferation play
      a role in determining the outcome of oropharyngeal cancers treated by
      conventional radiotherapy. However there was a significant correlation between
      short potential doubling time, high labeling index and tumor recurrence in the T2
      subgroup of patients. The finding of significance for potential doubling time and
      labeling index in the T2 subset of tumors may be a reflexion of the more
      homogeneous nature of these tumors with regard to prognostic variables.

PMID- 8344849
TI  - Cisplatin, hyperthermia, and radiation (trimodal therapy) in patients with
      locally advanced head and neck tumors: a phase I-II study.
AB  - PURPOSE: Hyperthermia is now being widely used to treat clinical malignancies
      especially combined with radiotherapy and more rarely with chemotherapy. The
      combination of heat, radiation, and chemotherapy (trimodality) can lead to potent
      interaction. The present Phase I-II study was conducted to evaluate the
      feasibility and acute toxicity of a combination of cisplatin, hyperthermia, and
      irradiation in the treatment of superficial cervical nodal metastases from head
      and neck cancer. METHODS AND MATERIALS: Eighteen patients with measurable neck
      metastases from previously untreated squamous cell head and neck tumors were
      entered into the trial. Therapy consisted of a conventional irradiation (total
      dose 70 Gy, 2 Gy five times a week) combined with a weekly administration of 20
      mg/m2 iv of cisplatin and a total of two sessions of local external microwave
      hyperthermia (desired temperature of 42.5 degrees C for 30 min). RESULTS:
      Feasibility of the treatment was demonstrated. Acute local toxicity was mild; no
      thermal blisters or ulcerations were reported and only two patients experienced
      local pain during hyperthermia. Cutaneous toxicity appeared greater than in our
      previous studies with irradiation plus hyperthermia and irradiation plus
      cisplatin. Systemic toxicity was moderate with major toxic effects observed in
      three patients (World Health Organization (WHO) grade 3 anaemia). Even though it
      was not an aim of the study to evaluate the nodal response, we observed a
      complete response rate of 72.2% (95% confidence interval 51-93.4%), 16.6% of
      partial response and 11.1% of no change. CONCLUSION: The study confirms the
      feasibility of the combination of cisplatin, heat, and radiation with an
      acceptable toxicity profile. The trimodal therapy deserves further evaluation as
      a way to enhance the efficacy of irradiation in the treatment of nodal metastases
      from head and neck tumors.

PMID- 8344851
TI  - Mathematical models of marrow cell kinetics: differential effects of protracted
      irradiations on stromal and stem cells in mice.
AB  - It is known that hematopoiesis is supported by bone-marrow stem cells, but those
      cells must seed and grow on a stromal microenvironment. Typically, studies have
      shown that a surviving fraction of about 30 hematopoietic stem cells (HSCs)
      (i.e., about 0.04%) correspond to the LD50, although other studies have shown
      that marrow can repopulate from a single viable cell under strong regiments of
      antibiotics and infusions of irradiated blood elements. PURPOSE: This paper
      describes comparisons between our results (from maximum-likelihood estimation
      techniques for cellular damage, repair, and compensatory repopulation) and
      published experimental data on marrow stromal cells. METHODS AND MATERIALS: After
      biophysical consideration of the rate constants that were derived by maximizing
      the likelihood function (a consideration necessary to extend the model to cell
      populations not indicated by the model as "critical" for recovery), the rate
      constants for cellular damage to stem cells are fitted to experimental data. Rate
      constants for repair and proliferation of stem cells are assigned based on
      published data on repair/proliferation half-times, and these assignments affect
      the evaluation of the rate constants for cellular damage. From the two models,
      that is one for "critical" cells (having radiosensitive and repopulation
      characteristics similar to stromal cells) and another for stem cells, effects on
      two cell populations of different radiosensitivities and repopulation rates can
      be demonstrated for complex schedules of protracted irradiations which could
      reduce either cell population below a critical need for marrow repopulation.
      RESULTS: Our analysis of animal mortality data has indicated that recovery of an
      animal from potentially lethal irradiation is dominantly regulated by cells with
      survival and repopulation characteristics similar to those of stroma cells.
      CONCLUSION: In contrast to the surviving fraction of hematopoietic stem cells, it
      appears that the probability of an animal's recovery is high if the "critical"
      population of cells is above 1% (our "best" maximum likelihood estimate, from
      mouse data, with the corresponding lower confidence bound at about 0.2%). Of
      course, a few stem cells--perhaps only one--must maintain a potential for
      repopulation of blood and marrow.

PMID- 8344850
TI  - Combined radiotherapy and chemotherapy in the management of local-regionally
      advanced vulvar cancer.
AB  - PURPOSE: To determine, in a retrospective single institutional study, the role of
      concurrent radiotherapy and chemotherapy in the treatment of local-regionally
      advanced vulvar cancer. METHODS AND MATERIALS: From 1984 to 1991, 20 patients
      with locally extensive primary or recurrent carcinoma of the vulva were treated
      with initial combined radiotherapy and chemotherapy. Seven patients had
      Federation Internationale de Gynecologie et d'Obstretrique Stage III disease, 10
      had Stage IV disease, and three were treated for recurrent disease. None of these
      patients were considered candidates for primary radical vulvectomy and groin node
      dissection. Median radiation doses to regions of microscopic disease and gross
      tumor were 40 Gy (range 30-54 Gy) and 54 Gy (34-70.4 Gy), respectively. All
      patients received 2 or 3 cycles of 5-Fluorouracil concurrently with radiotherapy.
      In addition, five patients received Cis-platinum, and one Mitomycin-C. Median at
      risk follow-up interval was 37 months. RESULTS: Ten patients had complete
      resolution of tumor to initial chemoradiotherapy, and eight of these have
      remained free of tumor relapse. Eight other patients had partial responses, with
      tumor bulk reduced by > 50%, while the remaining two patients had local
      regionally progressive disease. Six of the patients with partial responses had
      residual tumor successfully resected, although four subsequently recurred. For
      the entire group of 20 patients, the actuarial 3- and 5-year local control rates
      were 48% each, and the corresponding disease-specific survival rates were 59% and
      49%. There was a suggestion that better local control was obtained in patients
      who received gross tumor radiation doses > or = 50 Gy. Skin reaction was the
      major acute toxicity and responded well to conservative management. Long-term
      sequalae were limited to skin and subcutaneous atrophy. CONCLUSION: These results
      indicate that initial combined radiotherapy and chemotherapy is effective in the
      management of advanced vulvar cancer.

PMID- 8344852
TI  - Expression of p210 bcr/abl increases hematopoietic progenitor cell
      radiosensitivity.
AB  - PURPOSE: The cytogenetic finding of the Ph1+ chromosome and its molecular
      biologic marker bcr/abl gene rearrangement in cells from patients with chronic
      myeloid leukemia are associated with a proliferative advantage of the Ph1+ clone
      in vivo. Although the transition to the acute terminal phase or blastic crisis is
      often associated with additional cytogenetic abnormalities, the molecular events
      which correlate the initial cytogenetic lesion with the terminal phase are poorly
      understood. Defective cellular DNA repair capacity is often associated with
      chromosomal instability, increased mutation frequency, and biologic alterations.
      METHODS AND MATERIALS: We, therefore, tested whether the protein product of the
      bcr/abl translocation (p210) could alter DNA repair after gamma-irradiation of
      murine cell lines expressing the bcr/abl cDNA. RESULTS: The 32D cl 3 parent, 32D
      cl 3 pYN (containing the control vector plasmid) and each of two sources of 32D
      cl 3 cells expressing p210 bcr/abl cDNA (32D-PC1 cell line and 32D-LG7 subclone)
      showed a D0 of 1.62, 1.57, 1.16, and 1.27 Gy, respectively. Thus, expression of
      the p210 bcr/abl product induced a significant (p < 0.05) increase in
      radiosensitivity at the clinically relevant radiation therapy dose-rate (1.16
      Gy/min). The increased radiosensitivity of p210 bcr/abl expressing cells
      persisted if cells were held before plating in a density-inhibited state for 8 hr
      after gamma-irradiation, indicating little effect on the repair of potentially
      lethal gamma-irradiation damage. The IL-3 dependent parent 32D cl 3 cells
      demonstrated programmed cell death in the absence of growth factor or following
      gamma-irradiation to 200 cGy. Expression of bcr/abl cDNA in the 32D-PC1 and 32D
      LG7 sub clones abrogated IL-3 requirement of these cell lines and inhibited gamma
      irradiation induced programmed cell death. CONCLUSION: These data suggest a role
      for bcr/abl p210 in amplifying gamma-irradiation DNA damage or broadly inhibiting
      DNA repair, conditions that may stimulate further cytogenetic alterations in
      hematopoietic cells.

PMID- 8344853
TI  - The differential induction of collateral resistance to 62.5 MeV (p-->Be+)
      neutrons and 4 MeV photons by exposure to cis-platinum.
AB  - PURPOSE: To determine the relative sensitivity to cis-platinum, 4 MeV photons and
      62.5 MeV (p-->Be+) neutrons in five human tumor cell lines, and their cis
      platinum resistant variants. METHODS AND MATERIALS: The degree of cross
      resistance of five human in-vitro cell lines to photons or fast neutrons was
      analysed for both cisplatinum-sensitive and resistant variants. RESULTS: The
      development of acquired cis-platinum resistance conferred collateral resistance
      to 62.5 MeV (p--Be+) neutrons in all five cell lines, but did not consistently
      decrease the photon sensitivity of these same cells. CONCLUSION: The reduction in
      photon and neutron sensitivity following the development of acquired cis-platinum
      resistance may possibly be regulated by different mechanisms. The reduction in
      neutron sensitivity was primarily due to a 1.3-1.7 fold reduction in the
      magnitude of the initial slope (alpha), which was independent of the degree of
      platinum resistance induced, suggesting a non-stochiometric relationship between
      the mechanisms responsible for acquired cis-platinum, and 62.5 MeV (p-->Be+)
      neutron resistance.

PMID- 8344854
TI  - The management of desmoid tumors.
AB  - PURPOSE: To determine the efficacy of different treatment modalities for desmoid
      tumors. MATERIALS AND METHODS: We reviewed the treatment of 40 patients with
      histologically confirmed desmoid tumors seen at Duke University Medical Center
      between 1974 and 1990. RESULTS: Radiotherapy was administered to 16 patients
      (Group I)--14 with recurrent disease s/p surgery and in two as initial treatment.
      The average size of the irradiated lesions was 9.3 +/- 3.9 X 8.4 +/- 3.5 cm. With
      a median follow-up of 57.5 months and a median administered dose of 5400 cGy
      (mean 5286 cGy, range 4960-5620 cGy), local control has been obtained in 15/16
      patients (94%). Complete regression (5/16), partial regression (5/16), or stable
      disease (5/16) was produced in 15 patients while one patient failed and was
      salvaged via gross total resection. Continued regression has been seen up to 60
      months after treatment. Fourteen patients underwent primary gross total resection
      and two underwent subtotal resection (Group II). None received post-operative
      radiotherapy. Three of 14 patients (21%) recurred after gross total resection.
      All three were salvaged with subsequent gross total resection. After subtotal
      resection, 2/2 patients recurred. With a mean follow-up of 52 months, 14 patients
      are without evidence of disease, one is dead with disease (unrelated cause of
      death), and one was lost to follow-up after recurrence. Eight patients have been
      treated with combinations of chemotherapy, NSAIDS, anti-estrogens, and
      immunotherapy with mixed results (Group III). A subset of seven patients with
      retroperitoneal disease taken from all three groups had large tumor burden (mean
      size 17 X 15 cm), an infiltrative nature, as well as a difficult location. The
      disease was surgically resectable in three patients. One is without evidence of
      disease 9 years after gross total resection alone. Disease has been stabilized
      with radiotherapy in the other two patients after multiple unsuccessful surgical
      resections. Of four patients with unresectable disease, two are dead of disease,
      one died of unrelated causes with disease, and regression of disease was obtained
      in the other with Gamma-interferon after unsuccessful treatment with tamoxifen
      and vincristine, doxorubicin, and cyclophosphamide chemotherapy. CONCLUSION:
      Gross total resection is the indicated initial therapy, if it can be performed
      without significant disfigurement. Radiotherapy is also excellent for obtaining
      local control, even in patients with a large burden of recurrent disease. Doses
      in the range of 50 to 55 Gy give a chance of local control equal to that obtained
      with higher doses previously reported.

PMID- 8344855
TI  - Intraoperative radiotherapy in locally advanced recurrent colorectal cancer.
AB  - PURPOSE: In an effort to promote local control and improve quality of life in
      patients with recurrent colorectal cancer, a multimodality approach has been
      used. METHODS AND MATERIALS: Twenty-seven patients were treated with moderate
      doses of pre/postoperative radiotherapy with/without simultaneous systemic
      chemotherapy, surgical re-resection and IORT electron boost over areas at high
      risk for local recurrence. RESULTS: The 2-year actuarial disease-free and local
      relapse-free survival for the entire group were 14% and 26%, respectively. The
      most important factor predicting a favorable outcome was the radicality of
      surgical procedure. The determinate local control rate and the actuarial 2-year
      local relapse-free, and disease-free survival for patients undergoing complete
      resections were 50%, 56%, and 34%, respectively, whereas for patients undergoing
      partial resections these figures were 16%, 13%, and 6%. The radicality of
      surgical procedure was influenced by both tumoral size and previous treatment
      with irradiation. Complete resection rate was higher in patients with tumors less
      than 5 cm vs. more than 5 cm (40% vs. 22%), and in patients without previous
      radiotherapy versus those with previous radiotherapy (40% vs. 28%). Distant
      metastasis rate was high (41%). The most significant toxicities attributable to
      the whole treatment protocol were enteritis (37%), hydronephrosis (30%), and
      pelvic neuropathy (52%). CONCLUSION: Currently, our policy is to recommend IORT
      in patients with "favorable factors" such as: absence of previous pelvic
      radiotherapy, single previous surgical procedure, and complete resections.

PMID- 8344856
TI  - Objective decision-making following a portal film: the results of a pilot study.
AB  - PURPOSE: To discriminate between random and systematic treatment setup errors
      using portal films. METHODS AND MATERIALS: A bi-dimensional analytic techniques
      using multiple analyses of variance based on Hotelling's T2 statistics to derive
      numerical and graphical measures of daily portal film accuracy and precision has
      been trialed using 88 daily portal films from seven patients' treatment. RESULTS:
      A demonstration is provided of how a reasonable approximation of random variation
      from the intended (Simulator) field center, and systematic displacement of the
      mean position of the portal film centers may be derived from a minimum number of
      portal films. If a random error as great as 10 mm exists, at least six or seven
      portal films are considered necessary to reliably detect and quantify the size of
      a systematic error. CONCLUSION: Our results suggest that a modest systematic
      error could go undetected until the end of a 5 or 6 week course of treatment if
      only one portal film is obtained each week. A greater number of portal films
      should be performed during the first week of treatment to reduce the frequency of
      such errors. Efforts to separate and quantify both random and systematic errors
      in setup are worthwhile and will lead to improvements in outcome at the
      individual patient level and at a departmental level in the development of
      quality assurance programs.

PMID- 8344857
TI  - A new technique for positioning tangential fields.
AB  - PURPOSE: A technique that eliminates the use of a mechanical "breast-bridge" for
      positioning tangential fields for treatment of the intact breast or chest wall
      has been developed. METHODS AND MATERIALS: Treatment set-up parameters are
      determined using measuring capabilities (gantry angles and source-skin distances)
      available on a standard simulator unit. A programmable scientific calculator is
      used to determine field geometry from polar coordinates for various points on the
      patient's skin. The calculator program determines the field size, a depth and
      lateral shift from a skin reference point to the isocenter for the tangential
      fields, and the gantry angles. The program provides additional information which
      facilitates the simulation process: First, the coordinates of the isocenter for
      the tangential fields are expressed relative to couch coordinates for an initial
      arbitrary isocenter so that the "auto go to" capability available on some
      simulators can be used. Second, the coordinates of the medial and lateral entry
      points can be edited when the first set of tangents are not accepted. This part
      of the program allows quick and efficient adjustment of the fields to obtain
      adequate treatment volume coverage and a minimum of irradiated lung or heart.
      RESULTS: Simulation of more than 300 patients has shown the technique to be a
      practical and efficient method for positioning tangential fields for breast or
      chest wall irradiation. CONCLUSION: The technique described here takes full
      advantage of the capabilities of the new generation of computer controlled
      simulators, and offers an alternative to previous methods employing a mechanical
      "breast-bridge."

PMID- 8344858
TI  - Tolerances in setup and dosimetric errors in the radiation treatment of breast
      cancer.
AB  - PURPOSE: Treatment failure in radiation therapy, as well as unexpected
      complications, can be associated with set up changes or variations that can cause
      deviations from the prescribed radiation dose distribution both inside and
      outside the target volume. The effect of various deviations from the planned
      setup on the delivery of the prescribed radiation dose to the desired treatment
      volume was studied. METHODS AND MATERIALS: Adding a second simulation was
      investigated as means of minimizing setup changes on treatment. The first
      simulation was used for planning the treatment and the second simulation was
      essentially a mock treatment. Dosimetric evaluations based on dose volume
      histograms were analyzed for each deviation in the setup. RESULTS: In 95% of the
      patients, the frequency of the changes in the setup parameters between the second
      simulation and the treatment setup were reduced significantly from the changes
      that occurred between the first simulation and the second simulation. The changes
      in isocenter coordinates up to +/- 1.0 cm have minimal effects (+/- 2%) on the
      dose distributions. Gantry angle variations up to +/- 4 degrees produce a change
      of less than +/- 5% in the dose distribution within the target volume. However,
      this angular variation resulted in additional tissue irradiation outside of the
      desired treatment field (about 10 cm3 for a large patient). A gantry angle
      variation of +/- 6 degrees can change the volume of tissue that receives the
      prescribed dose by at least +/- 10%. In addition, such a change can increase the
      volume of tissue outside the desired treatment field that is irradiated.
      CONCLUSION: It is concluded that individually, deviations in one of the
      parameters from the planned setup of +/- 1.0 cm in isocenter position and +/- 4
      degrees in gantry angle do not produce significant deviations from the planned
      dose distribution. However, a significant change in dose distribution is observed
      if the setup parameters are concurrently changed. A second simulation may
      minimize the deviations of the treatment setup from the planned setup and
      maximize the precision in dose delivery to the target volume.

PMID- 8344859
TI  - Analysis of temperature distributions of interstitial hyperthermia using a hot
      water system.
AB  - PURPOSE: Interstitial hyperthermia is being increasingly used as an adjunct to
      brachytherapy in the treatment of implantable tumors. Of the several interstitial
      hyperthermia systems available, perhaps the simplest to use are the circulating
      hot water systems. An analysis of the thermal distributions obtained during our
      initial experience with interstitial hyperthermia using steel needles and the KHS
      9 hot water system was therefore undertaken. METHODS AND MATERIALS: Between
      September 1988 and June 1991, 23 patients were treated with interstitial Iridium
      192 high dose-rate brachytherapy immediately followed by interstitial hot water
      hyperthermia. A total of 32 implants were performed in these patients, of whom 14
      presented with primary anal carcinomas, six with recurrent gynecological tumors,
      and three with subcutaneous metastases from malignant melanoma. All but the
      patients with anal cancers had failed in previously irradiated sites. One or two
      heat treatments were delivered to each tumor with the goal to reach and maintain
      an intratumoral temperature 42.5 degrees C over a period of 40 min. Temperature
      measurements were carried out by mapping three-point thermocouple probes along
      the track of one or two needles parallel to the implanted needles. RESULTS:
      Minimum intratumoral temperatures exceeded 42.0 degrees C in 41%, 42.5 degrees C
      in 19%, 43.0 degrees C in 13%, and 44.0 degrees C in 3% of treatments. The
      average minimum, maximum, and mean intratumoral temperatures for all treatments
      were 41.7 degrees C, 43.5 degrees C, and 42.6 degrees C, respectively.
      CONCLUSION: The temperature profiles obtained in this series compare favorable to
      those reported in literature for radiofrequency local current field systems and
      suggest the hot water device may be an alternative heating method. It is
      relatively simple to use, does not require shielding of the treatment room, and
      can easily be adapted to currently used brachytherapy systems. Further patient
      accrual and longer follow-up will be needed to assess the clinical results in
      terms of tumor response and duration of response.

PMID- 8344860
TI  - Solid phantom material for the dosimetry of iodine-125 seed ophthalmic plaques.
AB  - PURPOSE: A tissue-equivalent solid phantom material, RE-1, closely simulating the
      radiological attenuation and scattering properties of the human eye for the
      iodine-125 photon spectrum and their Compton-scattered secondary photons, was
      fabricated on a polyethylene base with CaCO3 and MgO as inorganic additives.
      METHODS AND MATERIALS: A 24 mm diameter spherical phantom was made from 1.1 mm
      thick sheets of RE-1, and holes were drilled in which 1 mm3 TLD cubes were
      placed. RESULTS: The radial dose function g(r), which determines the dose profile
      on the transverse axis, was measured in a quasi-infinite phantom of RE-1.
      CONCLUSION: The values obtained deviate only slightly from those for a quasi
      infinite phantom made from water-equivalent material.

PMID- 8344861
TI  - Decision making for re-irradiation of nasopharyngeal carcinoma.

PMID- 8344862
TI  - Xanthofusin, an antifungal tetronic acid from Fusicoccum sp.: production,
      isolation and structure.

PMID- 8344863
TI  - Microbial conversion of avermectins by Saccharopolyspora erythrea: hydroxylation
      at C28.

PMID- 8344864
TI  - Studies on free radical scavenging substances from microorganisms. III. Isolation
      and structural elucidation of a novel free radical scavenger, resorstatin.

PMID- 8344865
TI  - On the structure of alisamycin, a new member of the manumycin class of
      antibiotics.

PMID- 8344866
TI  - Synthesis and antiviral activity of adenosine deaminase-resistant oxetanocin A
      derivatives: 2-halogeno-oxetanocin A.

PMID- 8344867
TI  - A new neuritogenetic compound BU-4514N produced by Microtetraspora sp.
AB  - A novel neuritogenetic compound BU-4514N was isolated from the fermentation broth
      of Microtetraspora sp. T689-92. It showed significant NGF-mimic activity and
      antibacterial activity against Gram-positive bacteria. Structural studies
      revealed that BU-4514N was a new chemotype antibiotic related to lydicamycin.

PMID- 8344868
TI  - Rumbrin, a new cytoprotective substance produced by Auxarthron umbrinum. I.
      Taxonomy, production, isolation and biological activities.
AB  - Rumbrin has been isolated from a fungus, Auxarthron umbrinum, by a screening
      program designed to find microorganism-produced cytoprotective substances. It was
      purified by use of column chromatography on silica gel, reversed phase HPLC and
      then isolated as fine red needles. Rumbrin prevented cell death caused by calcium
      overload and exhibited a potent inhibitory activity against lipid peroxidation.

PMID- 8344869
TI  - Rumbrin, a new cytoprotective substance produced by Auxarthron umbrinum. II.
      Physico-chemical properties and structure determination.
AB  - The structure of rumbrin (Fig. 1), a new cytoprotective substance, was elucidated
      by NMR spectral analysis. Rumbrin was found to possess a novel skeleton
      containing alpha-pyrone, tetraene and pyrrole moieties.

PMID- 8344870
TI  - Pyrrolostatin, a novel lipid peroxidation inhibitor from Streptomyces
      chrestomyceticus. Taxonomy, fermentation, isolation, structure elucidation and
      biological properties.
AB  - Pyrrolostatin, a new lipid peroxidation inhibitor, was isolated from the culture
      of Streptomyces chrestomyceticus EC40. The structure was determined to be 4
      geranylpyrrole-2-carboxylic acid on the basis of its spectroscopic and physico
      chemical properties. Pyrrolostatin inhibited lipid peroxidation in rat brain
      homogenate.

PMID- 8344871
TI  - FR901277, a novel inhibitor of human leukocyte elastase from Streptomyces
      resistomycificus. Producing organism, fermentation, isolation, physico-chemical
      and biological properties.
AB  - A novel human leukocyte elastase inhibitor, FR901277 was discovered in the
      fermentation broth of Streptomyces resistomycificus No. 7622. FR901277 has a
      molecular weight of 961 and a molecular formula of C47H63N9O13. The mode of
      inhibition is competitive, with a Ki of 1.2 x 10(-8) M. Oral administration of
      FR901277 at doses from 32 to 320 mg/kg significantly prevented human leukocyte
      elastase-induced foot edema in mice.

PMID- 8344872
TI  - Bequinostatins A and B new inhibitors of glutathione S-transferase, produced by
      Streptomyces sp. MI384-DF12. Production, isolation, structure determination and
      biological activities.
AB  - New benzo[a]naphthacenequinone metabolites, designated bequinostatins A and B,
      have been isolated from the culture broth of the benastatin-producing strain
      Streptomyces sp. MI384-DF12. The structures of bequinostatins A and B were
      determined by spectral analyses to be 5,6,8,13-tetrahydro-1,6,7,9,11-pentahydroxy
      8,13-dioxo-3- pentylbenzo[a]naphthacene-2-carboxylic acid and 2
      decarboxybequinostatin A, respectively. Bequinostatin A showed considerable
      inhibitory activity against human pi class glutathione S-transferase (GST pi).

PMID- 8344873
TI  - Verucopeptin, a new antitumor antibiotic active against B16 melanoma. I.
      Taxonomy, production, isolation, physico-chemical properties and biological
      activity.
AB  - A new antitumor antibiotic verucopeptin was isolated from the culture broth of
      Actinomadura verrucosospora Q886-2. It should potent cytotoxicity and specific in
      vivo activity against B16 melanoma. Maximum T/C value (162%) was obtained by Q1D
      x 1 treatment schedule.

PMID- 8344874
TI  - Verucopeptin, a new antitumor antibiotic active against B16 melanoma. II.
      Structure determination.
AB  - The structure of a new antibiotic verucopeptin has been determined by the
      spectroscopic analyses and chemical degradation studies. It is a 19-membered
      cyclodepsipeptide which is structurally related to azinothricin and A83586C.

PMID- 8344875
TI  - Respinomycins A1, A2 B, C and D, a novel group of anthracycline antibiotics. I.
      Taxonomy, fermentation, isolation and biological activities.
AB  - Respinomycins are a novel group of anthracycline antibiotics produced by
      Streptomyces xanthocidicus. Respinomycins A1, A2, B, C and D were isolated by
      EtOAc extraction, silica gel column chromatography, centrifugal partition
      chromatography and preparative silica gel thin layer chromatography.
      Respinomycins A1 and A2 induced the terminal differentiation of human leukemia K
      562 cells.

PMID- 8344876
TI  - Respinomycins A1, A2, B, C and D, a novel group of anthracycline antibiotics. II.
      Physico-chemical properties and structure elucidation.
AB  - Respinomycins A1, A2, B, C and D were revealed to be novel anthracycline
      antibiotics with molecular formulae of C51H72N2O20, C43H58N2O15, C35H43NO14,
      C36H45NO14 and C51H70N2O22, respectively. Their structures were determined by
      means of 1H-1H COSY, 13C-1H COSY and HMBC spectra. The structure of the aglycone
      of respinomycins was unambiguously determined by LSPD experiments and NOESY. The
      common skeleton of respinomycins is a new type and is distinguished from that of
      the nogalamycin group.

PMID- 8344877
TI  - BU-4794F, a new beta-1,3-glucan synthase inhibitor.
AB  - New beta-1,3-glucan synthase inhibitor (BU-4794F) was isolated from the culture
      broth of Gilmaniella sp. FA4459. Structural studies indicated that it was a novel
      member of the papulacandin group of antibiotics.

PMID- 8344878
TI  - Lachnumon and lachnumol a, new metabolites with nematicidal and antimicrobial
      activities from the ascomycete Lachnum papyraceum (Karst.) Karst. I. Producing
      organism, fermentation, isolation and biological activities.
AB  - Several chlorinated metabolites with nematicidal, antimicrobial, and cytotoxic
      activities were isolated from submerged cultures of the ascomycete Lachnum
      papyraceum. Three compounds were identified as (+)-mycorrhizin A (3), (+)
      chloromycorrhizin A (4) and (+)-dechloromycorrhizin A (5). The occurrence of 5 as
      a natural product is new. Two compounds, lachnumon (1) and lachnumol A (2), were
      found to be new fungal metabolites with cytotoxic, nematicidal and antimicrobial
      activities.

PMID- 8344879
TI  - Lachnumon and lachnumol a, new metabolites with nematicidal and antimicrobial
      activities from the ascomycete Lachnum papyraceum (Karst.) Karst. II. Structural
      elucidation.
AB  - The structures of two new biologically active chlorinated metabolites isolated
      from submerged cultures of the ascomycete Lachnum papyraceum have been elucidated
      by NMR and mass spectroscopy. The compounds, lachnumon (1) and lachnumol A (2),
      which structurally are related with mycorrhizin A that also is produced by the
      fungus, contain an unusual chlorinated epoxide group.

PMID- 8344880
TI  - Chemical transformation of gilvocarcin V. Modification of the side-chain.
AB  - Gilvocarcin V was chemically transformed to alter its biological activities as
      well as its solubility by mainly focusing on the vinyl side chain. The oxirane
      and oxime derivatives showed slightly decreased in vivo antitumor activity, while
      the aminoethylmorpholine derivative turned out to be soluble in some organic
      solvents.

PMID- 8344881
TI  - Synthesis and structure-activity relationships of new cephalosporins with
      aminoimidazoles at C-7. Effect of the pKa of the C-7 aminoimidazole on
      antibacterial spectrum and beta-lactamase stability.
AB  - Cephalosporins with new aminoimidazole heterocycles at C-7 have been synthesized
      by reaction of anti-alpha-aminooximes with C-7 dihaloisocyanocephalosporins
      esters or by direct condensation of 2-fluoroimidazoles with C-7
      aminocephalosporins esters. These compounds combine a broad spectrum of
      antibacterial activity, including Gram-negative and Gram-positive organisms with
      a good beta-lactamase stability. Activity is discussed in terms of its
      relationship to the pKa of the C-7 aminoimidazole heterocycle, basic C-7
      aminoimidazole residues gave cephalosporins with the best beta-lactamase
      stability but the poorest activity against Gram-positive organisms. An additional
      interesting property of the C-7 imidazolylaminocephalosporins is the oral
      activity present in some compounds of this series.

PMID- 8344882
TI  - Role of autologous bone marrow transplantation for patients with acute and
      chronic leukemias.
AB  - Autologous bone marrow transplantation has been increasingly used as effective
      curative therapy for patients with acute myelocytic leukemia or acute
      lymphoblastic leukemia who are not candidates for allografting. Its potential
      role for patients with chronic myelocytic leukemia is considered investigational;
      however, recent advancements in stem cell separation may make autologous
      transplantation an attractive alternative for this disease as well. The timing of
      the autologous transplant and the role of marrow purging are discussed in depth.
      In addition, post-transplant immune modulation and the use of growth factors and
      other cytokines following autologous reinfusion are currently being investigated.

PMID- 8344884
TI  - Role of autotransplantation in neuroblastoma.
AB  - Neuroblastoma is the most enigmatic disease treated by pediatric oncologists. The
      same pattern of apparent metastatic spread is associated with a high rate of
      spontaneous regression in children under 1 year of age (stage IVS) but an
      invariably fatal course in older children. For these children with truly advanced
      neuroblastoma, recent studies have demonstrated that the possibility of complete
      remission and disease-free survival is increased with more intensive conventional
      combination chemotherapy. Supportive care with autologous marrow has enabled
      further significant dose escalation of cytotoxic therapy active against
      neuroblastoma, resulting in disease-free survival in between 25% and 50% of
      patients at 2 years, an improvement over historical experience with conventional
      chemotherapy. The development of more effective cytotoxic combinations active
      against neuroblastoma, improvements in ex vivo techniques to purge marrow of
      neuroblastoma cells, and the application of cytokines to hasten marrow recovery
      should further enhance the effectiveness of autotransplantation in the treatment
      of advanced neuroblastoma and further improve the chances for complete remission
      and longer remission duration. Whether this improved remission induction and
      duration will translate into an increased cure rate remains to be determined.
      Parallel advances in therapies not involving autologous marrow support will
      undoubtedly modify the role of autotransplantation in neuroblastoma. Currently,
      however, autotransplantation offers one potential solution to a major challenge
      in the treatment of advanced neuroblastoma--obtaining and maintaining complete
      remissions--and a promising basis for future therapeutic studies.

PMID- 8344883
TI  - Role of autotransplantation in Hodgkin's disease.
AB  - Autologous bone marrow transplantation offers the opportunity for long-term
      disease-free survival in patients with Hodgkin's disease who might be considered
      incurable with other treatments. The appearance of late relapses in some reports
      is worrisome, but it is hoped that the majority of long-term survivors are indeed
      cured. Fundamental questions remain concerning the best conditioning regimen, the
      best rescue source, the optimal timing of transplantation, and ultimately whether
      transplantation is better than conventional salvage techniques. Some of these
      answers may be provided if long-term follow-up studies are reported and results
      are analyzed with reference to known prognostic factors. Ultimately, prospective
      trials will be needed to more clearly define the role of transplantation in
      Hodgkin's disease. It is hoped that ongoing trials will lead to higher remission
      rates, lower relapse rates, and diminished transplant-related mortality.

PMID- 8344885
TI  - Role of autotransplantation in treatment of other solid tumors.
AB  - This article reviews the use of high-dose chemotherapy with autologous bone
      marrow support for a variety of solid tumors. A major feature of the vast
      majority of studies examined is the high response rates achieved with intensive
      therapy when compared with those reported with standard chemotherapy. If these
      rates can be obtained in patients with diseases refractory to standard therapy,
      then applying the same treatment earlier in the disease course may produce more
      durable antitumor effects.

PMID- 8344887
TI  - Infectious complications during autotransplantation.
AB  - Bacterial and fungal infections are the most common cause of morbidity and
      mortality following autologous marrow transplant. An understanding of defects in
      host defense and the sources of bacterial and fungal infections allows a rational
      approach to controlling infections through prophylactic and empiric treatment.
      Recent availability of growth factors, broad-spectrum antibiotics, monoclonal
      antibodies to endotoxin, new antiviral agents, and new antifungal agents have
      enhanced our ability to successfully support patients through high-dose therapy
      and autologous stem cell reinfusion.

PMID- 8344886
TI  - Developments in purging in autotransplantation.
AB  - High-dose therapy and bone marrow transplantation has been shown to be a
      potentially curative modality for patients with hematologic malignancies. Several
      obstacles to the use of this approach include the availability of histocompatible
      siblings and the increased toxicity even in HLA-matched patients owing to graft
      versus-host disease and interstitial pneumonitis. The use of autologous marrow in
      support of high-dose therapy has lower toxicity; however, there is the issue that
      residual tumor cells may be reinfused into the patient. There are several
      laboratory studies demonstrating that residual tumor cells persist in the marrow
      despite histologic remission. In addition, case reports suggest that contaminated
      marrow has led to widespread early relapse owing to reinfusion of tumor cells. A
      variety of techniques have been developed that can deplete up to 5 logs of tumor
      cells from the marrow. These techniques include very specific immunologic as well
      as less specific pharmacologic purging. Both approaches have been refined so that
      normal hematopoietic stem cell reconstitution is relatively preserved. Although a
      large number of studies have been reported that have utilized ex vivo marrow
      purging, few have examined whether there has been an impact on disease-free
      survival. Although randomized studies have not been performed to date, several
      recent studies in ANLL and B-cell NHL strongly suggest that there is a
      relationship between the quality of elimination of the disease ex vivo in the
      marrow and disease-free survival. With further improvements in marrow treatment,
      whereby all detectable cells are depleted, as determined by highly sensitive
      molecular biologic techniques, and randomized trials involving purged and
      unpurged BM, the question of the impact of ex vivo marrow treatment can be better
      answered.

PMID- 8344888
TI  - Role of cytokines in autologous bone marrow transplantation.
AB  - High-dose chemotherapy with autologous bone marrow support has been increasingly
      used in the treatment of malignant disease. The use of hematopoietic colony
      stimulating factors (CSF), particularly when coupled with the use of CSF-primed
      peripheral blood progenitor cells, has enabled a substantial reduction in the
      duration of severe leukopenia and in the morbidity associated with bone marrow
      transplantation. Furthermore, their use has reduced resource utilization and
      hospital charges and has also permitted the performance of autologous bone marrow
      transplantation support largely on an outpatient basis.

PMID- 8344889
TI  - Mitochondrial transcription initiation. Variation and conservation.

PMID- 8344890
TI  - In vivo gene delivery. Efficient transfection of T lymphocytes in adult mice.
AB  - We have demonstrated that a single intraperitoneal injection of cationic
      liposomes complexed to a chloramphenicol acetyltransferase (CAT) gene expression
      plasmid can transfect the majority of splenic Thy 1.2+ T lymphocytes, as well as
      significant numbers of bone marrow-derived hematopoietic cells, in adult mice.
      CAT activity was detected in the spleen for at least 2 weeks, and there was no
      evidence of treatment-related toxicity. Some degree of tissue-specific transgene
      expression was achieved by varying the cationic lipid used.

PMID- 8344891
TI  - The immunosuppressant rapamycin induces inactivation of p70s6k through
      dephosphorylation of a novel set of sites.
AB  - The immunosuppressant rapamycin selectively abolishes phosphorylation and
      activation of p70s6k/p85s6k at concentrations that either block or suppress cell
      growth. The four sites of phosphorylation associated with p70s6k/p85s6k
      activation all display Ser/Thr-Pro motifs and are closely clustered within a
      putative autoinhibitory domain of the enzyme. To produce a constitutively active,
      rapamycin-resistant form of the kinase, these four sites were converted to either
      Asp or Glu. When overexpressed in human 293 cells, the activity of the mutant is
      similar to that of the parent enzyme, under conditions where the parent is
      phosphorylated and active. Unexpectedly, however, the mutant remains sensitive to
      rapamycin and is inactivated in vitro by protein phosphatase 2A. Peptide maps
      reveal that rapamycin abolishes the activity of the overexpressed p70s6k through
      the dephosphorylation of a novel set of sites distinct from those associated with
      mitogenic activation.

PMID- 8344892
TI  - The photochemical reactions of sensory rhodopsin I are altered by its transducer.
AB  - The sopI gene, which encodes the phototaxis receptor sensory rhodopsin I (SR-I),
      was expressed in Halobacterium salinarium strains with chromosomal deletions of
      (i) sopI only or of (ii) the region containing sopI and htrI. The htrI gene
      encodes a transducer protein for SR-I signals. Transformation of the sopI
      deletion mutant containing the htrI gene by a multicopy expression plasmid for
      sopI results in normal physiological and photochemical properties of SR-I.
      Transformation by the same plasmid of the mutant lacking the htrI gene as well as
      sopI results in production of pigment with a normal absorption spectrum but
      altered photochemical properties, and no phototaxis by the transformants.
      Analysis of flash-induced absorbance changes shows that the transducer protein
      increases light-induced production of the photocycle intermediate S373, the SR-I
      signaling conformation, and modulates the rate of S373 return to the prestimulus
      state, rendering this return pH-independent. These effects are interpreted in
      terms of receptor/transducer interactions that influence proton transfer
      reactions occurring in the photoactive site.

PMID- 8344893
TI  - The DNA-binding subunit of human transcription factor IID can interact with the
      TATA box as a multimer.
AB  - Transcription initiation from eukaryotic protein-coding genes is a complex
      process that minimally requires RNA polymerase (pol) II (B) and at least seven
      general transcription factors. The 38-kDa subunit (TBP) of the human general
      transcription factor TFIID recognizes the TATA sequence element and initiates the
      assembly of the other general transcription factors and RNA pol II. It is
      believed, based on experiments with yeast recombinant protein, that TBP binds as
      a monomer to DNA. Using purified recombinant human TBP protein we find that TBP
      interacts with the TATA element as both a monomer and a dimer. The multimeric
      binding of TBP to DNA revealed by this study has important implications for the
      role of TBP in transcription initiation and suggests novel mechanisms whereby
      other transcription factors may interact with a RNA pol II preinitiation complex.

PMID- 8344894
TI  - A novel zinc(II) binding site modulates the function of the beta A4 amyloid
      protein precursor of Alzheimer's disease.
AB  - Abnormalities of zinc metabolism occur in Alzheimer's disease (AD), a condition
      where pathological catabolism of the amyloid protein precursor (APP) causes
      cerebral beta A4 amyloidosis. An association between zinc and APP metabolism was
      sought by studying the binding of 65Zn2+ to APP. 65Zn2+ bound in a rapid,
      saturable, and specific manner (KD = 764 nM). A novel zinc binding motif,
      strongly conserved between members of the APP family, was located between the
      cysteine-rich and negatively charged domains of the protein. Zinc increased
      binding of APP to heparin and has been shown to potentiate the inhibition of
      coagulation factor XIa by an APP isoform containing a Kunitz-type inhibitory
      domain (Komiyama, Y., Murakami, T., Egawa, H., Okubo, S., Yasunaga, K., and
      Murata, K. (1992) Thromb. Res. 66, 397-408) situated near the zinc binding
      region. Zinc is a factor that modulates the functional properties of the
      substrate for beta A4 amyloidogenesis.

PMID- 8344895
TI  - Evidence from transgenic mice that glucose transport is rate-limiting for
      glycogen deposition and glycolysis in skeletal muscle.
AB  - A line of transgenic mice was constructed in which the human Glut1 glucose
      transporter is overexpressed in skeletal muscle. Overexpression of Glut1 protein
      was evident in epitrochlearis, extensor digitorum longus (EDL), and quadriceps
      muscles, and resulted in 6.6-7.4-fold elevations in basal glucose transport
      activity as measured in isolated muscles in vitro. The elevated glucose
      transporter activity in the skeletal muscles of transgenic mice was associated
      with a 10-fold increase in glycogen concentration in EDL and quadriceps muscles
      that was not due to an increase in muscle glycogen synthase activity or a
      decrease in glycogen phosphorylase activity. The increased glucose transport
      activity also resulted in a 2-fold increase in muscle lactate concentration, with
      no increase in muscle glucose 6-phosphate. Despite a slight (10%) increase in
      muscle hexokinase activity, there was a 4-fold increase in total muscle free
      glucose in transgenic mice, indicating that hexokinase becomes rate-limiting for
      glucose uptake when the rate of glucose transport is very high. These results
      demonstrate that the muscle glycogen content can be dramatically elevated by
      increasing the muscle Glut1 protein level and that glucose transport is a rate
      limiting step for muscle glucose disposal in normal, resting mice.

PMID- 8344896
TI  - Dephosphorylation and inactivation of the mitogen-activated protein kinase by a
      mitogen-induced Thr/Tyr protein phosphatase.
AB  - The activation of extracellular signal-regulated kinase (ERK) or mitogen
      activated protein kinase (MAPK) by a dual specific kinase, MEK (MAPK or ERK
      kinase), is a critical event in the mitogenic signal transduction pathway.
      However, little is known about the mechanism of ERK inactivation, which occurs
      after stimulation. In this report, we demonstrated that a dual specific protein
      phosphatase, HVH1 (human VH1 phosphatase homolog) whose expression is induced by
      mitogenic growth factors, specifically inactivates ERK. When several
      phosphoproteins were tested for recombinant HVH1, only MEK-activated ERK1 was
      dephosphorylated. HVH1 selectively dephosphorylated threonine and tyrosine
      residues but not serine residues of the activated ERK1. Inactivation of ERK1 by
      HVH1 could be reversed by MEK, suggesting that HVH1 dephosphorylates the same
      residues that are recognized and phosphorylated by MEK. Our results suggest that
      mitogenic growth factors transiently activate ERK (peak at 5 min followed by a
      rapid decline) by temporally activating MEK (the on signal) and inducing the
      expression of HVH phosphatase (the off signal).

PMID- 8344897
TI  - Effects of phorbol ester on mitogen-activated protein kinase kinase activity in
      wild-type and phorbol ester-resistant EL4 thymoma cells.
AB  - Phorbol ester-sensitive and -resistant EL4 thymoma cell lines differ in their
      ability to activate mitogen-activated protein kinase (MAPK) in response to
      phorbol ester. Treatment of wild-type EL4 cells with phorbol ester results in the
      rapid activations of MAPK and pp90rsk kinase, a substrate for MAPK, while neither
      kinase is activated in response to phorbol ester in variant EL4 cells. This study
      examines the activation of MAPK kinase (MAPKK), an activator of MAPK, in wild
      type and variant EL4 cells. Phosphorylation of a 40-kDa substrate, identified as
      MAPK, was observed following in vitro phosphorylation reactions using cytosolic
      extracts or Mono Q column fractions prepared from phorbol ester-treated wild-type
      EL4 cells. MAPKK activity coeluted with a portion of the inactive MAPK upon Mono
      Q anion-exchange chromatography, permitting detection of the MAPKK activity in
      fractions containing both kinases. This MAPKK activity was present in phorbol
      ester-treated wild-type cells, but not in phorbol ester-treated variant cells or
      in untreated wild-type or variant cells. The MAPKK from wild-type cells was able
      to activate MAPK prepared from either wild-type or variant cells. MAPKK activity
      could be stimulated in both wildtype and variant EL4 cells in response to
      treatment of cells with okadaic acid. These results indicate that the failure of
      variant EL4 cells to activate MAP kinase in response to phorbol ester is due to a
      failure to activate MAPKK. Therefore, the step that confers phorbol ester
      resistance to variant EL4 cells lies between the activation of protein kinase C
      and the activation of MAPKK.

PMID- 8344898
TI  - Growth-dependent changes in arachidonic acid release from endothelial cells are
      mediated by protein kinase C and changes in diacylglycerol.
AB  - When stimulated, endothelial cells release arachidonic acid from phospholipids
      and oxidize it to eicosanoids. The rate-limiting step in this pathway is the
      initial release step, catalyzed by phospholipase(s), a process that exhibits
      growth-dependent changes. We examined the role of protein kinase C (PKC) as a
      regulator of this process. Activators and inhibitors of protein kinase C, used at
      different growth states, demonstrated distinct differences in their effects on
      arachidonic acid release, consistent with a growth-dependent change in PKC
      activity (with greater activity in proliferating cells compared with quiescent
      cells). Although immunoreactive PKC was slightly greater in the proliferating
      cells, there was a more striking redistribution of PKC activity between cytosol
      and membrane. To identify the cause, we measured the diacylglycerol (DG) content
      and found that DG concentrations decreased as cells progressed from preconfluence
      to confluence. Further studies demonstrated increases in DG kinase and DG lipase
      in confluent compared with preconfluent cells, consistent with the alterations in
      DG content. These findings suggest that growth-dependent changes in DG lipase and
      DG kinase activities regulate basal DG levels and PKC activity. The consequent
      alteration in PKC activity regulates the growth-dependent changes in arachidonic
      acid release.

PMID- 8344899
TI  - Biosynthesis of oligosaccharides in intact Golgi preparations from rat liver.
      Analysis of N-linked glycans labeled by UDP-[6-3H]N-acetylglucosamine.
AB  - During short incubations of a Golgi apparatus-enriched subcellular fraction from
      rat liver with UDP-[3H]GlcNAc, label is efficiently transferred to endogenous
      acceptors. Most of the macromolecular radioactivity is specifically released by
      peptide-N4-(N-acetyl-beta-glucosaminyl)asparagine amidase, indicating that it is
      mainly associated with N-linked oligosaccharides. The glycoprotein acceptors are
      resistant to proteases unless detergent is added in amounts greater than the
      critical micellar concentration. This shows that the acceptors are within the
      lumen of intact compartments, which have the correct topological orientation
      expected for the Golgi apparatus in intact cells. Structural characterization of
      the radiolabeled N-linked oligosaccharides shows a variety of distinct neutral
      and anionic species. The neutral chains include bi-, tri-, and tetra-antennary
      molecules with terminal beta-[3H] GlcNAc residues. In vitro sialylation shows
      that some of the tetra-antennary chains have beta 1,3-linked Gal residues on
      their unlabeled antennae. An unknown modification appears to block the action of
      beta-galactosidase on these galactosylated oligosaccharides. Chasing the labeling
      reaction with a mixtures of UDP-Gal, CMP-Neu5Ac, and adenosine 3'-phosphate,5'
      phosphosulfate causes an increase in the percent of radiolabeled anionic
      oligosaccharides. Most of the negative charge is due to sialic acid (Sia), and
      some appears to be in phosphodiester-linked [3H]GlcNAc. The sialylated
      oligosaccharides are a mixture of bi-, tri-, and tetra-antennary species with 1-3
      Sia residues, and some of the [3H]GlcNAc residues are directly covered with
      unlabeled Gal and Sia residues. This in vitro approach should recapitulate
      reactions that occur in the biosynthesis of N-linked oligosaccharides in the
      Golgi apparatus of the intact cell. Since the conditions during labeling do not
      permit inter-compartmental transport, the oligosaccharides produced should
      represent the biosynthetic capabilities of individual Golgi compartments.
      Evidence is presented for a functional association of GlcNAc transferases I, II,
      and alpha-mannosidase II, with separation from GlcNAc transferase IV and/or V.
      The structures also indicate co-compartmentalization of several GlcNAc
      transferase(s) with beta-galactosyltransferase(s) and sialyltransferase(s). The
      compartmental organization of the Golgi apparatus is discussed in light of these
      findings.

PMID- 8344900
TI  - Biosynthesis of oligosaccharides in intact Golgi preparations from rat liver.
      Analysis of N-linked glycans labeled by UDP-[6-3H]galactose, CMP-[9-3H]N
      acetylneuraminic acid, and [acetyl-3H]acetyl-coenzyme A.
AB  - When a rat liver Golgi apparatus-enriched subcellular fraction is incubated with
      UDP-[3H]Gal, CMP-[3H] Neu5Ac, or [acetyl-3H]acetyl (Ac)-CoA, label is efficiently
      transferred to endogenous acceptors, which are resistant to added proteases,
      unless detergent is added at a sufficiently high concentration. Thus, the
      acceptors are within the lumen of intact compartments of correct topological
      orientation, which are likely to be similar to those of the Golgi apparatus in
      the intact cell. In each case, approximately 90% of the macromolecular
      radioactivity is specifically released by peptide-N4-(N-acetyl-beta
      glucosaminyl)asparagine amidase digestion, as labeled N-linked oligosaccharides.
      Label from UDP-[3H]Gal is transferred to several distinct N-linked
      oligosaccharides, and many of these carry sialic acid (Sia) residues. This amount
      increases if the transfer reaction is chased with CMP-Neu5Ac. A major fraction of
      the [3H]Gal is directly "covered" with Sia residues, indicating that at least a
      portion of the beta-galactosyltransferase(s) are co-localized with one or more
      sialyltransferases. The majority of the [3H]Gal is found in a beta 1,3-linkage,
      rather than the more common beta 1,4-linkage. The N-linked oligosaccharides
      labeled by CMP-[3H] Neu5Ac carry labeled Sia residues in either alpha 2,3 or
      alpha 2,6 linkage, and showed a range of charge distribution. The transferred
      [3H]Neu5Ac is not O-acetylated even when Ac-CoA is added at saturating
      concentrations, implying that the sialyltransferases and the O
      acetyltransferase(s) are not functionally co-localized. However, approximately
      20% of label released from N-linked oligosaccharides by sialidase does not co
      migrate with authentic Neu5Ac in high performance liquid chromatography analysis,
      indicating that transferred [3H] Neu5Ac is modified by unknown enzymes in the
      Golgi. Most of the [3H]acetate transferred from [acetyl-3H] Ac-CoA to N-linked
      oligosaccharides is on Sia residues that are exclusively alpha 2,6-linked, and is
      enriched on tri- and tetra-antennary chains that do not appear to carry any 2,3
      linked Sia residues. These data indicate a restricted substrate preference of the
      O-acetyltransferase(s). About one-quarter of the [3H]acetate transferred is
      sialidase-resistant, indicating either transfer to monosaccharides other than
      sialic acid, or to sialidase-resistant sialic acids. While most of these
      sialidase-resistant oligosaccharides remain negatively charged, about 10% are
      neutralized by sialidase, confirming transfer of [3H]acetate to monosaccharides
      other than sialic acid.

PMID- 8344902
TI  - High levels of photosystem I subunit II (PsaD) mRNA result in the accumulation of
      the PsaD polypeptide only in the presence of light.
AB  - The light-regulated mRNA and polypeptide accumulation of the nuclear encoded
      subunit II (PsaD) of the photosystem I reaction center was studied during the
      greening of etiolated spinach seedlings. Upon exposure to continuous white light,
      the mRNA, detected at low levels in etiolated seedlings, accumulated in a
      specific pattern. In contrast, the PsaD subunit could not be detected in the
      etiolated seedlings; the polypeptide could first be detected in thylakoid
      membranes approximately 4 h after exposure to continuous light. A pulse of red
      light induced the expression of the PsaD mRNA, but the polypeptide could not be
      detected unless the seedlings were exposed to light. In the light (but not in the
      dark), the PsaD mRNA was found associated with the polysomal fraction. Taken
      together, the data suggest a dual regulatory mechanism in which both the level of
      mRNA and the presence of light control the accumulation of the PsaD polypeptide.

PMID- 8344901
TI  - The biosynthesis of oligosaccharides in intact Golgi preparations from rat liver.
      Analysis of N-linked and O-linked glycans labeled by UDP-[6-3H]N
      acetylgalactosamine.
AB  - Endogenous acceptors in a Golgi apparatus-enriched subcellular fraction from rat
      liver were labeled with UDP-[3H]GalNAc. The great majority of these acceptors
      were protected from protease degradation in the absence of detergent. These
      molecules are therefore present in intact vesicles of the correct topological
      orientation, which are likely to be similar to the Golgi compartments of the
      intact cell. Several distinct glycoproteins are labeled, but most are different
      from those labeled with UDP-[3H]GlcNAc. The enzyme peptide-N4(N-acetyl-beta
      glucosiminyl)asparagine amidase releases label from a few specific proteins,
      indicating that [3H]GalNAc is transferred to N-linked oligosaccharides. Both
      neutral and anionic N-linked oligosaccharides are found, the great majority of
      which do not bind to ConA-Sepharose. Most of the [3H]GalNAc found in neutral
      oligosaccharides is terminal and beta-linked. The negative charge on the anionic
      molecules is due to sialic acid, and phosphate. A major portion of the [3H]
      GalNAc in this fraction is acid labile, and is released with kinetics consistent
      with it being in a phosphodiester linkage. These results show the existence of a
      whole new class of GalNAc-containing N-linked oligosaccharides, and demonstrates
      that this in vitro approach can detect previously undescribed structures. O
      linked oligosaccharide biosynthesis was also studied in the same labeled rat
      liver Golgi apparatus preparations. beta-Elimination releases approximately 95%
      of the peptide-N4-(N-acetyl-beta-glucosaminyl)asparagine amidase (PNGase F)
      resistant label which, in the absence of other added nucleotides, is almost
      exclusively [3H] GalNAcitol. If other unlabeled sugar nucleotides and adenosine
      3'-phosphate,5'-phosphosulfate are added during the chase period two anionic O
      linked oligosaccharides are synthesized, indicating that the UDP-GalNAc:peptide-N
      acetylgalactosaminyltransferase is at least in part functionally co-localized
      with enzymes that extend and modify O-linked oligosaccharides.

PMID- 8344903
TI  - Fluorescent pyrrole products from carbonyl-amine reactions.
AB  - The reaction of (E)-4,5-epoxy-(E)-2-heptenal with butylamine and glycine methyl
      ester produced brown macromolecular pigments, which showed fluorescent
      characteristics similar to lipofuscins. This polymerization reaction implies in
      the first step the formation of 1-alkyl-2-(1'-hydroxyalkyl)pyrroles (IV, VI).
      Compounds IV and VI have been isolated and characterized from the above
      reactions, and their structures confirmed with the synthesis of 2-(1'
      hydroxyethyl)-1-methylpyrrole (V). Compounds IV-VI resulted very unstable and
      even diluted solutions of them polymerized with time. The first step was the
      production of a dipyrrymethane VIII, which evolved more stable dipyrrylmethenes
      IX and X by intramolecular dehydration. These dimers continued polymerizing to
      produce 16H-tripyrrin derivatives XI and XII, and, in the next step,
      hexahydroglobins XIII and XIV. All these compounds have been characterized by 1H
      NMR and/or gas chromatography coupled with mass spectrometry or mass
      spectrometry. Additional polymerization produced higher molecular weight polymers
      that were the responsible for the brown color and the fluorescence. The above
      results suggest that the fluorescence produced by reaction between some oxidized
      lipids and amino acids may be related to polymerization more than to the
      formation of single structures.

PMID- 8344904
TI  - Membrane lipid regulation in Acholeplasma laidlawii grown with saturated fatty
      acids. Biosynthesis of a triacylglucolipid forming reversed micelles.
AB  - The membrane lipid composition in several strains of Acholeplasma laidlawii is
      regulated upon a change in the growth conditions. Monoglucosyldiacylglycerol
      (MGlcDAG) and diglucosyldiacylglycerol (DGlcDAG) are the most abundant lipids in
      the A. laidlawii membrane. A third glucolipid, 3-O-acyl
      monoglucosyldiacylglycerol (MAMGlcDAG) is synthesized by strain A-EF22 when the
      membrane lipids contain large amounts of saturated acyl chains. The lipid
      regulation can be understood from a simple theoretical model, in which the cells
      strive to maintain a balance between the lipids constituting a bilayer and those
      forming reversed non-lamellar liquid crystalline phases. Thus, the physical
      chemistry of membrane lipids, in particular their ability to form different
      aggregate structures, constitutes the basis for the lipid regulation, and
      therefore an understanding of the phase equilibria of membrane lipids is crucial.
      MGlcDAG and MAMGlcDAG isolated from A. laidlawii strain A-EF22 membranes were
      studied mainly by 2H NMR, 1H NMR, and 1H NMR diffusion measurements. MAMGlcDAG,
      containing 96 mol % saturated acyl chains formed a gel/crystalline phase up to
      about 80 degrees C, where a transition occurred to a reversed micellar (L2)
      phase. This is an unexpected finding for a membrane lipid. However, this lipid
      homogeneously mixes with the other membrane lipids at physiological temperatures.
      Previous and new data on MGlcDAG show that the lamellar phase is stabilized when
      the length and the degree of unsaturation of the acyl chains are decreased. The
      physicochemical properties of MAMGlcDAG and MGlcDAG were compared and found to be
      of great significance for the physiological regulation of the lipids in the
      membrane. MAMGlcDAG is synthesized under conditions when the phase equilibria of
      MGlcDAG are shifted from a non-lamellar toward a lamellar phase. Apart from
      MAMGlcDAG, MGlcDAG is the major lipid in A. laidlawii strain A-EF22 which is able
      to form reversed aggregate structures. MAMGlcDAG probably assists MGlcDAG in
      maintaining an optimal molecular packing, or negative curvature, of the lipids in
      the membrane.

PMID- 8344905
TI  - The gamma subunit of R-phycoerythrin and its possible mode of transport into the
      plastid of red algae.
AB  - R-phycoerythrin is the major light-harvesting pigment protein of most red algal
      phycobilisomes. It is composed of three pigmented polypeptide subunits, the
      alpha, beta, and gamma. While alpha and beta phycoerythrin subunits are each
      unique in the red alga Aglaothamnion neglectum, there are two different gamma
      subunits with distinct molecular masses. Both gamma subunits are pigmented by
      virtue of covalently attached linear tetrapyrroles. The amino acid sequence of
      one of the gamma subunits, as deduced from the nucleotide sequence of a cDNA
      clone, has no significant similarity to any known sequence in the data bases.
      This result is surprising, since the gamma subunit of phycoerythrin is thought to
      have a function that is similar to cyanobacterial linker polypeptides. The A.
      neglectum gamma subunit is synthesized as a 36-kDa precursor protein that is
      processed at the amino terminus to yield a 33-kDa mature protein. The amino
      terminal extension was able to direct the pea small subunit of Rubisco into
      isolated pea chloroplasts. This result suggests that red algae transport proteins
      into the plastid by a mechanism similar to that of higher plants. There are
      significant changes in levels of mRNA encoding the gamma 33 subunit when A.
      neglectum is grown under different conditions of illumination and in nitrogen
      deficient medium. These changes parallel those previously observed for
      transcripts encoding the alpha and beta phycoerythrin subunits. Hence, there may
      be coordinated expression of nuclear and plastid-encoded phycoerythrin subunit
      genes.

PMID- 8344906
TI  - A Kazal-type inhibitor with thrombin specificity from Rhodnius prolixus.
AB  - A thrombin-specific inhibitor with an apparent molecular mass of 11 kDa has been
      purified from the insect Rhodnius prolixus. Amino-terminal protein sequence
      analysis allowed the molecular cloning of the corresponding cDNA. The open
      reading frame codes for a protein of about 103 amino acid residues and displays
      an internal sequence homology of residues 6-48 with residues 57-101 indicating a
      two-domain structure. Based on the amino acid sequence the two domains exhibit
      high homology to protease inhibitors belonging to the Kazal-type family. Model
      building suggests that the first domain binds to the active site with residue
      His10 pointing into the specificity pocket. From gel filtration and tight-binding
      inhibition experiments the inhibitor appears to form 1:1 complexes with thrombin.
      Periplasma-directed heterologous expression of the rhodniin cDNA in Escherichia
      coli yields the intact thrombin inhibitor. Natural and recombinant rhodniin both
      display inhibition constants of about 2 x 10(-13) M.

PMID- 8344907
TI  - Toward an understanding of the biogenesis of the starch granule. Evidence that
      Chlamydomonas soluble starch synthase II controls the synthesis of intermediate
      size glucans of amylopectin.
AB  - Low starch mutants of Chlamydomonas reinhardtii were isolated after x-ray
      mutagenesis of wild-type strain 137C. The mutants accumulated 20-40% of the
      normal amount and displayed a 2-fold decrease of the total glycogen-primed
      soluble starch synthase activity. Three different mutant alleles of the st-3 gene
      were isolated that were characterized by similar defects and displayed a net
      increase in amylose content. Amylose-primed synthesis of glucan in native gels
      revealed a complete wipe out of one of the soluble starch synthases. Zymograms
      and kinetic analyses performed both in the mutant and in partially purified wild
      type extracts reveal at least two distinct activities that are partly analogous
      to higher plant soluble starch synthases I and II (SSI and II). The st-3 mutants
      were defective for SSII. Methylation and debranching of the purified amylopectin
      fraction clearly show a decrease in the number of intermediate size glucans (dp8
      to 50) and an absolute and relative increase of very short glucans (dp2 to 7).
      These results suggest that a soluble starch synthase may be necessary for the
      synthesis or maintenance of intermediate size glucans that are the main component
      of the branched clusters of amylopectin.

PMID- 8344908
TI  - Isolation and characterization of proteolytic fragments of human factor VIIa
      which inhibit the tissue factor-enhanced amidolytic activity of factor VIIa.
AB  - The interaction of circulating factor VII/VIIa with tissue factor presented by
      cells in extravascular tissues represents the initial event in the extrinsic
      pathway of blood coagulation. To determine the tissue factor binding domains in
      human factor VIIa, we have subjected recombinant human factor VIIa to tryptic
      digestion and isolated two proteolytic fragments (molecular mass = 32 and 20 kDa)
      by a combination of immunoaffinity chromatography and reversed phase high
      performance liquid chromatography (HPLC) which strongly inhibits the tissue
      factor-enhanced amidolytic activity of factor VIIa and inhibits the activation of
      factor X by factor VIIa in the presence of tissue factor. The 32-kDa factor VIIa
      fragment consisted of residues 1-137/143 from the light chain of factor VIIa
      connected by a disulfide bond to residues 153-277 from the heavy chain. The 20
      kDa factor VIIa fragment consisted of residues 1-137 of the light chain of factor
      VIIa in disulfide linkage with residues 248-266 of the heavy chain. The 32- and
      20-kDa factor VIIa fragments inhibited the tissue factor apoprotein-enhanced
      factor VIIa amidolytic activity with Ki values of 35 and 65 nM, respectively. The
      Ki values for the inhibition of relipidated tissue factor apoprotein-enhanced
      factor VIIa amidolytic activity by the 32- and 20-kDa factor VIIa fragments were
      70 and 610 nM, respectively. Factor X activation by factor VIIa-relipidated
      tissue factor was inhibited half-maximally by the 32- and 20-kDa factor VIIa
      fragments at 65 and 680 nM concentrations, respectively. Equilibrium binding
      studies indicated that the 32- and 20-kDa factor VIIa fragments interacted with
      cell surface tissue factor expressed on J82 cells in a specific and saturable
      manner with Kd values of 30 and 64 nM, respectively. In addition, a peptide
      consisting of residues 1-109 from the light chain of factor VIIa obtained by
      reduction and HPLC of the 20-kDa factor VIIa fragment retained inhibitory
      activity, but the selective removal of the gamma-carboxyglutamic acid domain from
      the 20-kDa factor VIIa fragment by cathepsin G cleavage resulted in the complete
      loss of inhibitory activity in this fragment. Our data strongly suggest that the
      epidermal growth factor-like domains covalently linked to the gamma
      carboxyglutamic acid domain in factor VIIa constitute the high affinity tissue
      factor binding domain in this molecule.

PMID- 8344909
TI  - Leucine/isoleucine/valine-binding protein contracts upon binding of ligand.
AB  - Small-angle x-ray scattering and computer modeling have been used to study the
      effects of ligand binding to the leucine/isoleucine/valine-binding protein, an
      initial component of the high-affinity active transport system for branched-chain
      aliphatic amino acids in Escherichia coli. Measurements were made with no ligand
      present and with either L-leucine or L-valine present. Upon binding of either
      leucine or valine, there is a decrease in the radius of gyration, from 23.2 +/-
      0.2 to 22.2 +/- 0.2 A, and in the maximum particle dimension, from 82 +/- 3 to 73
      +/- 3 A. The x-ray structure of the unbound form has been determined and gives a
      radius of gyration and a maximum dimension consistent with the values found for
      the solution structure in this study (Sack, J. S., Saper, M. A., and Quiocho, F.
      A. (1989) J. Mol. Biol. 206, 171-191). The reduction in the radius of gyration
      and maximum dimension upon ligand binding can be accounted for by a substrate
      induced cleft closure in a combined "hinge-twist" motion. Modeling of the
      substrate-bound state was done by comparison of this protein with another
      periplasmic binding protein (L-arabinose-binding protein), which possesses a
      similar two-lobe structure and for which the x-ray structure is known in its
      ligand-bound form.

PMID- 8344910
TI  - Novel, non-crinophagic, degradation of connecting peptide in transformed
      pancreatic beta cells.
AB  - Proinsulin is converted to equimolar amounts of insulin and connecting peptide (C
      peptide) in pancreatic beta cell secretory granules. The fate of C-peptide, which
      remains soluble in granules while insulin is crystallized, was studied in a rat
      insulinoma cell line (INS cells). A pulse-chase approach demonstrated that
      insulin to C-peptide ratios (I/CP) began to rise in INS cells as soon as
      conversion took place, reaching 2.2:1 at 6 h of chase, and 5.3:1 by 24 h. During
      the first 4 h of chase, this ratio was inverted in the medium under basal
      conditions, possibly reflecting preferential secretion of C-peptide via the post
      granular constitutive-like pathway. However, the amount of C-peptide secreted to
      the medium (1.4%/h) was trivial compared with the net loss of C-peptide from the
      INS cells, estimated to be approximately 33% during the 1st h. As no
      extracellular degradation of insulin or C-peptide was observed, the data show
      progressive, extensive intracellular degradation of C-peptide. Stimulation of INS
      granule exocytosis revealed that the I/CP ratio in secretory granules is
      representative of that of cell extracts, indicating that C-peptide, but not
      insulin, is lost from functionally competent granules with time. This particular
      degradative route for C-peptide is thus distinct from crinophagy (fusion of
      granules and lysosomes) and was found to be much more active in INS cells than in
      primary islet beta cells.

PMID- 8344911
TI  - A cardiac clathrin assembly protein forms a potassium channel in planar lipid
      bilayers.
AB  - A novel clathrin assembly protein (designated cardiac AP-3) has been isolated
      from dog heart which forms a K+ channel in planar lipid bilayers. AP-3
      facilitated the in vitro formation of clathrin cages, which is diagnostic for
      clathrin assembly proteins. AP-3 consists mainly of 100-, 97-, and 55-kDa bands.
      A GTP-binding protein of approximately 25 kDa also co-purifies. The 100-kDa band
      was recognized by a monoclonal antibody to the gamma-adaptin of bovine brain
      clathrin assembly protein AP-1. A polyclonal antibody to the approximately 100
      kDa doublet (alpha- and beta-adaptins) of bovine brain AP-2 did not cross-react
      with the purified protein. Western blot analysis of cardiac subcellular fractions
      showed that anti-AP-1 immunoreactivity was strongest in a sarcolemma-enriched
      fraction. Little immunoreactivity was detected in other cardiac subfractions,
      including sarcoplasmic reticulum, intercalated discs, and mitochondria. When
      reconstituted into planar lipid bilayers, AP-3 displays ion channel activity.
      Permeability ratios were PK/PCl approximately 16 and PK/PNa approximately 3,
      indicating a cation-selective channel somewhat selective for K+ versus Na+. The
      K+ channel displays several subconductance states (9 and 12 picosiemens in the
      main) and was blocked by CaCl2 (mM), inositol 1,3,4,5-tetrakisphosphate (20
      microM), inositol 1,4,5-trisphosphate) (40 microM), and guanosine 5'-O-(3
      thiotrisphosphate) (mM). Thus, the cardiac AP-3 appears to act as a K+ channel
      modulated by inositol polyphosphates and a small GTP-binding protein.

PMID- 8344912
TI  - Identification of the metal ligands and characterization of a putative zinc
      finger in methionyl-tRNA synthetase.
AB  - A truncated form of the methionyl-tRNA synthetase (delta MTS), which has been
      cloned, overproduced, and characterized, was used in an attempt to better
      understand the role of the enzyme-bound zinc in the amino-acylation process. Apo
      , Zn(2+)-, Co(2+)-, and 113Cd(2+)-substituted delta MTS proteins were prepared in
      vivo and purified to homogeneity. Apo-delta MTS was devoid of enzymatic activity
      in the aminoacylation of tRNA(fMet) and in the methionine-dependent ATP
      pyrophosphate exchange reactions. Kinetic constants in both the aminoacylation
      and ATP-pyrophosphate exchange reactions for the Co(2+)- and 113Cd(2+)
      substituted delta MTS proteins were found to be identical with those of the
      native Zn2+ protein. The low energy absorption spectrum of Co(2+)-substituted
      delta MTS resembles the d-d transition bands characteristic of tetrahedrally
      coordinated Co(2+)-substituted proteins. A strong S-->Co2+ charge transfer
      absorption at 350 nm was clearly evident having a molar absorptivity consistent
      with four thiolate ligands. The environment of the metal center was further
      probed by measuring the 113Cd chemical shift of 113Cd(2+)-substituted delta MTS.
      A single resonance at 759.6 ppm was observed. This chemical shift is consistent
      with Cd2+ coordinated to four thiolate ligands. The Escherichia coli methionyl
      tRNA synthetase contains a potential metal binding sequence Cys-X2-Cys-X9-Cys-X2
      Cys in a connecting polypeptide within the nucleotide fold. Titration of a 21
      amino acid peptide corresponding to this putative metal binding site, Cys145
      Cys161, was shown to bind Co2+ with a Kd of 120 +/- 11 microM. These results
      demonstrate that the isolated zinc finger binding domain is capable of
      specifically forming a stoichiometric complex with the divalent cation. Taken
      together, our studies identify the 4 cysteine residues in the zinc finger-like
      domain as the metal binding ligands in the E. coli methionyl-tRNA synthetase. The
      role of the enzyme-bound metal appears to be structural and not directly involved
      in catalysis.

PMID- 8344913
TI  - Induction of Rev-ErbA alpha, an orphan receptor encoded on the opposite strand of
      the alpha-thyroid hormone receptor gene, during adipocyte differentiation.
AB  - Rev-ErbA alpha (Rev-Erb) is a nuclear hormone receptor-related transcriptional
      activator that is encoded on the noncoding strand of the alpha-thyroid hormone
      receptor (TR) gene. The similarities between Rev-Erb and receptors for
      differentiating agents, as well as the abundance of Rev-Erb mRNA in fat, led us
      to study Rev-Erb gene expression during adipogenesis. Remarkably, Rev-Erb mRNA
      levels increased dramatically during the differentiation of 3T3-L1 cells into
      adipocytes. Rev-Erb was similarly induced in the related 3T3-F442A cell line but
      not in nondifferentiating 3T3-C2 cells. The time course of Rev-Erb induction was
      similar to that of C/EBP alpha, an important transcriptional regulator in
      adipocytes, and Rev-Erb mRNA was superinduced by cycloheximide. Nuclear run-on
      assays indicated that an increased rate of Rev-Erb mRNA synthesis accounted for
      the increased steady state mRNA levels; the half-life of Rev-Erb mRNA was
      indistinguishable in preadipocytes and adipocytes. Treatment of preadipocytes
      with retinoic acid inhibited adipocyte differentiation and also prevented Rev-Erb
      induction. Thus, there is a correlation between Rev-Erb gene expression and
      differentiation, and transcriptional regulation by Rev-Erb could play an
      important role in the generation and/or maintenance of the adipocyte phenotype.
      Interestingly, and possibly related to the overlap between the Rev-Erb gene and
      the exon specific for TR alpha 2, the induction of Rev-Erb was also associated
      with a 3-fold increase in the ratio of TR alpha 1 to TR alpha 2 mRNA levels,
      indicating that Rev-Erb expression has the potential to modulate adipocyte gene
      expression by multiple mechanisms.

PMID- 8344914
TI  - Thyroid hormone-induced gene expression program for amphibian tail resorption.
AB  - The changes in gene expression leading to tail resorption that are initiated by
      thyroid hormone (TH) were studied in Xenopus laevis. Four of the less than 10
      genes that are down-regulated during this period have been isolated; their mRNAs
      decay with identical kinetics. Twenty of the approximately 35 genes that are up
      regulated in the first 48 h have been isolated. The up-regulated genes fall into
      two kinetic patterns. After a lag of several hours, the direct response genes
      (including thyroid hormone receptor beta) increase their mRNA level steadily for
      24-48 h. The delayed genes respond mainly in the second 24 h after TH addition.
      The importance of these genes for tail resorption is supported by the fact that
      they are all regulated developmentally during normal metamorphosis in tail and
      respond to hormone induction when the tail becomes competent to respond to TH.
      The relatively simple gene expression program leading to tail resorption is
      contrasted with the complex and multiple periods of gene expression during limb
      development. The gene expression screen defines the tail resorption program and
      has isolated the majority of TH-regulated genes.

PMID- 8344915
TI  - Role of the alpha subunit cytoplasmic domain in regulation of adhesive activity
      mediated by the integrin VLA-2.
AB  - To investigate the role of the alpha subunit cytoplasmic domain in the regulation
      of VLA-2 functional activity, we expressed several chimeric and deleted forms of
      the alpha 2 subunit in two different human cell lines, K562 and RD. Each mutant
      construct formed surface VLA-2 heterodimers as efficiently as wild type alpha 2
      subunit, except for a construct (X2CO1127) truncated just before the consensus
      GFFKR cytoplasmic domain motif, that was not expressed at the cell surface.
      Truncation of the alpha 2 cytoplasmic domain just after the GFFKR motif resulted
      in a complete loss of constitutive activity of VLA-2 in RD cells. If the integrin
      was already constitutively inactive, as in K562 cells, the cytoplasmic domain
      deletion had no effect. In both K562 and RD cells, cytoplasmic tail deletion
      eliminated up-regulation of adhesion in response to the phorbol ester, phorbol 12
      myristate 13-acetate (PMA). In comparison, exchange of the alpha 2 cytoplasmic
      domain with the alpha 4 or alpha 5 cytoplasmic domains had no effect on
      constitutive activity (in RD cells), or on constitutive inactivity (in K562
      cells) and did not eliminate PMA-stimulated activity (in K562 or RD cells). These
      results clearly demonstrate that the cytoplasmic domain of an alpha chain (not
      necessarily from alpha 2 itself) is required to maintain VLA-2 constitutive
      activity and to allow a responsiveness to PMA stimulation. In cases where VLA-2
      was either constitutively inactive (as in K562 cells) or inactive due to
      cytoplasmic domain deletion (e.g. in RD cells), agents such as Mn2+ or the anti
      beta 1 monoclonal antibody TS2/16 caused a marked increase in adhesive function,
      thus proving that the integrins were not irreversibly inactive, and that cellular
      regulatory constraints could be bypassed by extracellular stimuli.

PMID- 8344916
TI  - Amino acid exchange and covalent modification by cysteine and glutathione explain
      isoforms of fatty acid-binding protein occurring in bovine liver.
AB  - A unique property of the liver-type member of the family of fatty acid-binding
      proteins is the heterogeneic pattern observed upon isolation, which can only
      partly be ascribed to the state of lipidation. Here we unraveled the structural
      basis of the heterogeneity of delipidated liver-type fatty acid-binding protein
      (L-FABP). Charge fractions of L-FABP focusing at pH 6.0 and at pH 7.0/7.1 were
      first isolated from bovine liver. Upon reduction, however, two distinct isoforms,
      namely pI 6.0 L-FABP and pI 7.0 L-FABP, were observed. From these isoforms
      peptides were generated enzymically and chemically by four independent methods.
      Peptides were separated by reverse phase high performance liquid chromatography
      and analyzed by Edman degradation and plasma desorption mass spectrometry. The
      complete amino acid sequences of the isoforms were established; they consist of
      127 amino acids and each is N-terminally blocked with an acetyl group. The
      difference between pI 6.0 L-FABP and pI 7.0 L-FABP was attributed to an
      asparagine-aspartate exchange at position 105. When tryptic peptides of the pH
      7.0/7.1 fraction were analyzed, discrepancies between sequence and mass data of
      the peptides containing at position 69 the sole cysteine of L-FABP led to the
      disclosure of a cysteinylation occurring at this position and giving rise to the
      slightly more basic pH 7.1 species. Moreover, chemical modification studies
      revealed that a part of the pH 6.0 fraction was pI 7.0 L-FABP that was
      glutathionylated at Cys69. Neither modification, however, prevented the binding
      of fatty acids. Together amino acid exchange and covalent modification of
      cysteine entirely explain the heterogeneity of L-FABP from bovine liver.

PMID- 8344917
TI  - Reciprocal effects of proline and glutamine on glycogenesis from glucose and
      ureagenesis in isolated, perfused rat livers.
AB  - L-Proline and L-glutamine were used to probe the inverse relationship between
      glycogenesis and ureagenesis in isolated, perfused livers from 48-h fasted rats.
      Both amino acids may provide nitrogen in the form of NH+4 for carbamyl-P
      synthesis. However, one molecule of glutamine may provide additionally for the
      synthesis of one molecule of the urea cycle substrate L-aspartate, but proline
      can provide for the synthesis of a molecule of NH+4 or one molecule of aspartate
      on an either/or basis only. In all perfusates, glucose was initially 30 mM (to
      favor phosphotransferase activity of glucose-6-phosphatase) and 0.5 mM 3
      mercaptopicolinate was present (to inhibit glyconeogenesis from endogenous
      substrates, from the added amino acids, and via the indirect pathway).
      Glycogenesis from glucose, perfusate and hepatic urea formation, and levels of
      hepatic glucose-6-P, citrulline, PPi, and carbamyl-P were measured. The addition
      of glutamine to the perfusate markedly stimulated the urea cycle, but not
      glycogenesis. Hepatic urea level, perfusate urea concentration, and hepatic
      citrulline and PPi increased while carbamyl-P content decreased. In contrast,
      proline stimulated glycogenesis from glucose, but not ureagenesis. In the proline
      supplemented compared with glutamine group, hepatic glycogenesis and carbamyl-P
      content increased; hepatic glucose-6-P levels showed a tendency toward increase;
      and hepatic urea formation, hepatic citrulline, and PPi levels were decreased.
      These observations are interpreted to support an hepatic mechanism whereby the
      relative availability of carbamyl-P to the urea cycle and as a substrate for
      glucose phosphorylation via phosphotransferase activity of the glucose-6
      phosphatase system preliminary to glycogenesis from glucose is a major metabolic
      determinant.

PMID- 8344918
TI  - Energy transduction between membranes. TonB, a cytoplasmic membrane protein, can
      be chemically cross-linked in vivo to the outer membrane receptor FepA.
AB  - TonB, a cytoplasmic membrane protein, couples cytoplasmic membrane protonmotive
      force to active transport across the outer membrane of Escherichia coli. In vivo
      cross-linking studies were initiated to analyze TonB interactions with other cell
      envelope proteins. Four TonB-specific cross-linked complexes were detected with
      apparent molecular masses of 195, 77, 59, and 43.5 kDa. The 195-kDa complex was
      shown to contain both TonB and FepA, the outer membrane receptor for the
      siderophore enterochelin. The 195-kDa complex is absent in strains missing either
      TonB or FepA and can be detected by either TonB-specific or FepA-specific
      monoclonal antibodies. This is the first direct in vivo evidence that TonB can
      span the periplasmic space to interact physically with outer membrane receptors.
      Consistent with that observation, the outer membrane protease OmpT was shown to
      play a role in TonB turnover, both in the presence and absence of ExbB results in
      the rapid degradation of TonB. The absence of OmpT could be used to stabilize
      TonB in an exbB::Tn10 strain such that steady state levels of TonB protein are
      identical to a wild-type strain. Under those conditions, the absence of ExbB
      results in greatly reduced TonB activity, indicating that ExbB plays a direct
      role in energy transduction and probably secondarily protects TonB protein from
      proteolysis. The 59-kDa complex was absent in an exbB::Tn10 strain, suggesting
      either that ExbB is in the complex with TonB or that ExbB is required to form the
      59-kDa complex. A tolQ nonsense mutation had no effect on the cross-linking
      profile observed, confirming that its participation in TonB-dependent phenomena
      is minor and most likely the result of evolutionary cross-talk.

PMID- 8344919
TI  - Structural organization of the human gene encoding nuclear lamin A and nuclear
      lamin C.
AB  - We have determined the structural organization of the human gene that encodes
      nuclear lamins A and C, intermediate filament proteins of the nuclear lamina.
      Sequencing and restriction mapping show that the coding region spans
      approximately 24 kilobases. The 5'-proximal promoter region contains several GC
      rich stretches, a CCAAT box, and a TATA-like element of sequence TATTA. The lamin
      A/C gene contains 12 exons. Alternative splicing within exon 10 gives rise to two
      different mRNAs that code for pre-lamin A and lamin C. Consequently, two proteins
      are generated, only one of which, pre-lamin A, can be modified by isoprenylation.
      The intron positions in the human lamin A/C gene are generally conserved in the
      previously characterized genes for Xenopus lamin LIII and mouse lamin B2, but
      different from those in a Drosophila lamin gene. In the regions coding for the
      central rod domains, the intron positions are also conserved when compared with
      the intron positions in the genes for most cytoplasmic intermediate filament
      proteins except those for nestin and neurofilaments. Analysis of the intron
      positions in these genes supports the hypothesis that the nuclear lamins and
      other intermediate filament proteins arose from a common ancestor.

PMID- 8344920
TI  - Sequencing of the amylopullulanase (apu) gene of Thermoanaerobacter ethanolicus
      39E, and identification of the active site by site-directed mutagenesis.
AB  - The complete nucleotide sequence of the gene encoding the dual active
      amylopullulanase of Thermoanaerobacter ethanolicus 39E (formerly Clostridium
      thermohydrosulfuricum) was determined. The structural gene (apu) contained a
      single open reading frame 4443 base pairs in length, corresponding to 1481 amino
      acids, with an estimated molecular weight of 162,780. Analysis of the deduced
      sequence of apu with sequences of alpha-amylases and alpha-1,6 debranching
      enzymes enabled the identification of four conserved regions putatively involved
      in substrate binding and in catalysis. The conserved regions were localized
      within a 2.9-kilobase pair gene fragment, which encoded a M(r) 100,000 protein
      that maintained the dual activities and thermostability of the native enzyme. The
      catalytic residues of amylopullulanase were tentatively identified by using
      hydrophobic cluster analysis for comparison of amino acid sequences of
      amylopullulanase and other amylolytic enzymes. Asp597, Glu626, and Asp703 were
      individually modified to their respective amide form, or the alternate acid form,
      and in all cases both alpha-amylase and pullulanase activities were lost,
      suggesting the possible involvement of 3 residues in a catalytic triad, and the
      presence of a putative single catalytic site within the enzyme. These findings
      substantiate amylopullulanase as a new type of amylosaccharidase.

PMID- 8344921
TI  - Cholesterol ester transfer mediated by lipid transfer protein as influenced by
      changes in the charge characteristics of plasma lipoproteins.
AB  - The relationship between the cholesterol ester (CE) transfer activity of lipid
      transfer protein (LTP) and its affinity with lipid and lipoprotein particles was
      investigated. The study of the effects of chemical modification of low density
      lipoprotein (LDL) amino groups and carboxyl groups on the CE transfer activity
      showed that the maximal activity is obtained upon succinylation or acetylation of
      approximately 7% of LDL amino groups. Further increases in the extent of
      modification progressively reduced the transfer activity. The treatment of LDL
      with fatty acids gave results comparable to the chemical modification of LDL
      amino groups. The addition of low concentrations of fatty acids was stimulatory,
      while that of high concentrations was inhibitory. Although increases in the
      positive charges of LDL by the carboxyl group modification did not appreciably
      influence the CE transfer, the addition of cationic detergents gave a profound
      effect on the CE transfer. A maximal CE transfer activity was obtained upon
      addition of very small amounts of the detergents, with the higher concentrations
      sharply reducing the transfer activity. We also studied the effects of the
      concentrations of phosphate buffer and various salts on the CE transfer as well
      as the affinity of LTP for very low density lipoproteins, low density
      lipoproteins, high density lipoproteins 3, and high density lipoproteins 2. It
      appeared that the affinity of LTP for various lipoproteins is governed by a
      delicate balance of electrostatic and hydrophobic interactions. Optimal degrees
      of the interaction of LTP with both donor and acceptor particles seem to be
      required for the maximal degree of CE transfer.

PMID- 8344922
TI  - Structure, organization, and expression of the lct gene for lacticin 481, a novel
      lantibiotic produced by Lactococcus lactis.
AB  - The structural gene for the lactococcal lantibiotic lacticin 481 (lct) has been
      identified and cloned using a degenerated 20-mer DNA oligonucleotide based on the
      amino-terminal 7 amino acid residues of the purified protein. The transcription
      of the lct gene was analyzed, and its promoter was mapped. DNA sequence analysis
      of the lct gene revealed an open reading frame encoding a peptide of 51 amino
      acids. Comparison of its deduced amino acid sequence with the amino-terminal
      sequence and the amino acid composition of lacticin 481 indicates that the 51
      residue peptide is prelacticin 481, containing a 27-residue carboxyl-terminal
      propeptide and a 24-residue amino-terminal leader peptide which lacks the
      properties of a typical signal sequence and which is significantly different from
      the leaders of other lantibiotics. The predicted amino acid sequence of
      prolacticin 481 contains 3 cysteines, 2 serines, and 2 threonines which were not
      detectable in amino acid analyses of mature lacticin 481. Based on these results
      and on characterization by two-dimensional NMR techniques, a structural model is
      proposed in which 2 cysteine residues are involved in lanthionine and one in beta
      methyllanthionine formation, and a 4th threonine residue is dehydrated. This
      model predicts a molecular mass for lacticin 481 of 2,901, which is in excellent
      agreement with that obtained from mass spectrometry.

PMID- 8344923
TI  - Thermodynamic and kinetic studies on the mechanism of binding of
      methylumbelliferyl galactosides to the basic agglutinin from winged bean
      (Psophocarpus tetragonolobus).
AB  - The binding of winged bean basic agglutinin (WBA I) to 4-methylumbelliferyl
      (MeUmb) galactosides was examined by extrinsic fluorescence titration and stopped
      flow spectrofluorimetry. Upon binding to WBA I, MeUmb alpha-galactosides show
      quenching in fluorescence intensity, decrease in UV absorbance with a concomitant
      blue shift, and decrease in fluorescence excited-state lifetimes. However, their
      beta-analogues show enhancement in fluorescence intensity, increase in UV
      absorbance with a red shift, and an increase in fluorescence excited-state
      lifetimes. This implies that the umbelliferyl groups of alpha- and beta
      galactosides experience non-polar and polar microenvironments, respectively, upon
      binding to WBA I. Replacement of the anomeric hydroxyl group of galactose by 4
      methylumbelliferyl moiety increases the affinity of resulting saccharides.
      Substitution of C-2 hydroxyl of galactose by an acetamido group leads to
      increased affinity due to a favorable entropy change. This suggests that
      acetamido group of MeUmb-alpha/beta-GalNAc binds to a relatively non-polar
      subsite of WBA I. Most interestingly, this substitution also reduces the
      association rate constants dramatically. Inspection of the activation parameters
      reveals that the enthalpy of activation is the limiting factor for the
      differences in the forward rate constants for these saccharides and the entropic
      contribution to the activation energy is small.

PMID- 8344924
TI  - Structure-function relationships in an antifreeze polypeptide. The role of
      charged amino acids.
AB  - Several analogs of an alanine-rich alpha-helical antifreeze polypeptide were
      synthesized and studied to evaluate the role of charged amino acids on structure
      and activity. alpha-Helix content and thermal stability were assessed by circular
      dichroism spectrometry and antifreeze activity by freezing point depression
      (thermal hysteresis) and ice crystal growth rate measurements. Rearrangement,
      deletion and replacement of charged amino acids resulted in reduced helicity and
      antifreeze activity in some cases, but the effects were not dramatic. We conclude
      that the i+4 ion pair Lys18/Glu22 helps to stabilize the alpha-helix but is not
      absolutely essential for activity. NH2-terminal Asp does not contribute
      significantly to helix stability or activity, but the COOH terminus is sensitive
      to modification, since replacement of Arg37 can lead to reduced helix content and
      activity. In general, factors which reduce alpha-helix content also reduce
      antifreeze activity.

PMID- 8344925
TI  - Structure-function relationships in an antifreeze polypeptide. The effect of
      added bulky groups on activity.
AB  - We have proposed that the antifreeze activity of an alanine-rich alpha-helical
      antifreeze polypeptide (AFP) is due in part to side-by-side hydrophobic
      interactions of AFP molecules bound on the ice surface (Wen, D., and Laursen, R.
      A. (1992b) Biophys. J. 63, 1659-1662). To test this hypothesis and to assess the
      importance of a hydrophobic surface on the outward facing (non-ice-binding)
      portions of the helix, we synthesized several AFP analogs with up to four Ala-
      >Gln or Ala-->Leu replacements and determined the effect of these changes on
      antifreeze activity and helix stability. Although Gln replacements caused some
      helix destabilization and resultant reduction of antifreeze activity, they were
      in general well tolerated, suggesting that the bulk hydrophobicity of the non-ice
      binding faces of the AFP, per se, is probably not a major factor determining AFP
      activity. However, placement of either Gln or Leu in position 17 on one side of
      the helix completely abolished activity, demonstrating that the specific location
      of bulky groups can dramatically alter activity. We conclude from molecular
      modeling studies that the effect seen by placing bulky groups in position 17 is
      due to steric hindrance that prevents effective association or packing of AFP
      molecules on the ice surface, in support of our hypothesis.

PMID- 8344926
TI  - Molecular basis of the inhibition of beta s-chain-dependent polymerization by
      mouse alpha-chain. Semisynthesis of chimeras of human and mouse alpha-chains.
AB  - The transgenic mouse models expressing beta s-globin genes do not fully exhibit
      the sickling phenotype, primarily as a result of the inhibition of beta s-chain
      dependent polymerization by the mouse alpha-chains. The mouse alpha-chain differs
      from the human alpha-chain at 19 sequence locations. Of these, only alpha 78 and
      alpha 116 are the known hemoglobin (Hb) S polymer contact sites. To define
      whether the inhibition of polymerization by the mouse alpha-chain is solely a
      consequence of the differences at these two sites or additional sites of sequence
      differences are also involved, we have constructed chimeric alpha-chains by
      employing the alpha-globin semisynthetic reaction (Sahni, G., Cho, Y. J., Iyer,
      K. S., Khan, S. A., Seetharam, R., and Acharya, A. S. (1989) Biochemistry 28,
      5456-5461). Mouse alpha 1-30 was spliced with human alpha 31-141 using
      endoproteinase Glu-C to generate a chimeric alpha-globin (alpha MH) containing
      eight of the 19 sequence differences of mouse alpha-globin. Similarly, human
      alpha 1-30 was spliced with mouse alpha 31-141 to generate another chimeric alpha
      globin (alpha HM) containing 11 sequence differences. The respective chimeric
      globins were purified, reconstituted with heme and beta s-chain into tetrameric
      hemoglobin, and the tetramers were purified by ion-exchange chromatography. The
      inhibitory potential of the chimeric alpha MH-chain on the polymerization is 10
      fold lower than that of the mouse alpha-chain. The absence of the alpha 31-141
      region of the mouse alpha-chain relieves only a portion of the inhibition. The
      inhibitory potential of alpha MH contributed by the mouse alpha 1-30 segment is
      significant although none of the sequence differences in this segment are located
      at any of the implicated polymer contact sites. The chimeric alpha HM-chain also
      inhibits the polymerization, but the extent of inhibition is again lower (4-fold)
      than that of the full-length mouse alpha-chain. The results demonstrate that the
      inhibitory potential of mouse alpha-chains involves the sequence differences from
      both the alpha 1-30 and alpha 31-141 regions. Besides, since the sum of the
      inhibitory potential of either of these chimeric alpha-chains is lower than that
      of the intact mouse alpha-chains, we speculate that conformational changes that
      require the copresence of sequence differences in both portions of the mouse
      alpha-chain also contribute to the inhibitory propensity of the mouse alpha
      chain.

PMID- 8344927
TI  - Effect of deletion from the carboxyl terminus of the 12 S subunit on activity of
      transcarboxylase.
AB  - Transcarboxylase from Propionibacterium shermanii is a biotin-containing enzyme
      which catalyzes the reversible transfer of a carboxyl group from methylmalonyl
      CoA to pyruvate. The central hexameric 12 S subunit of the enzyme associates with
      six 6 S subunits in the complete enzyme complex. We have constructed a series of
      cloned genes which encode COOH-terminal truncations of the 12 S subunit. Five of
      these subunits, which remained soluble following expression in Escherichia coli
      and were missing from 39 to 97 COOH-terminal amino acids, were purified and
      compared to the full-length subunit after enzyme complexes were assembled in
      vitro. All of the truncated subunits were 90% as active in the transcarboxylase
      reaction as wild type except the reaction containing the shortest complex, TC-12
      S (1-507), which had 54% of the wild type activity (TC-12 S-WT). The reduced
      activity was not due to a lack of CoA ester binding sites or the Km for
      substrate. However, TC-12 S (1-507) was slower to form than TC-12 S-WT and had
      more incomplete complexes as judged by high performance liquid chromatography gel
      filtration profiles and electron microscopy. Isolated TC-12 S (1-507) was 70-80%
      as active as TC-12 S-WT. We also noted that the truncated form was heat-labile
      compared to wild type. We conclude that the COOH-terminal region of the 12 S
      subunit plays a role in assembly and stability of the hexamer and also affects
      the binding of 6 S subunits to form enzyme complexes. Once complexes do form, the
      catalytic capacity of TC-12 S (1-507) is almost the same as TC-12 S-WT.

PMID- 8344928
TI  - Stathmin gene family: phylogenetic conservation and developmental regulation in
      Xenopus.
AB  - The ubiquitous cytoplasmic phosphoprotein stathmin was proposed to play a general
      role as an intracellular relay integrating diverse signals regulating the
      proliferation, differentiation, and functions of cells (Sobel, A. (1991) Trends
      Biol. Sci. 16, 301-305). It was originally identified in mammalian cells and
      tissues, but antibodies directed against the mammalian protein also recognized a
      stathmin-like 19-kDa protein in all vertebrate classes. The immunoreactive
      protein in Xenopus laevis displayed, like mammalian stathmin, several
      nonphosphorylated and phosphorylated heat-soluble forms with distinct migration
      on two-dimensional polyacrylamide gel electrophoresis. Screening of Xenopus
      oocyte and brain cDNA libraries with a rat stathmin cDNA probe allowed us to
      isolate several stathmin-related cDNA clones, among which clone XO35 encodes the
      Xenopus homologue of stathmin whose deduced amino acid sequence is 79% identical
      to and displays most of the characteristic structural features of the mammalian
      protein. In particular, one of the cAMP-dependent protein kinase and the two
      "proline-directed" kinase-specific sites known to be phosphorylated in rat
      stathmin are also present in the Xenopus protein. Furthermore, two other sets of
      clones coding for related proteins belonging to the stathmin gene family were
      also isolated; clone SC15 encodes the Xenopus homologue of SCG10, a rat protein
      specifically related to neuronal differentiation; clone XB3 encodes a protein
      which, as SCG10 or SC15, possesses a stathmin-like domain and an additional N
      terminal extension but is more distant from SCG10 than SC15. Interestingly, the
      mRNA transcripts of Xenopus stathmin (XO35) appear ubiquitous, like stathmin in
      mammals, whereas the SC15 and XB3 mRNAs appeared as markers of the nervous tissue
      in Xenopus. During Xenopus oogenesis, stathmin accumulates and remains stable as
      a maternal product throughout early development. Concurrently, its
      phosphorylation is regulated from essentially unphosphorylated forms to highly
      phosphorylated ones in the mature egg, which are then progressively
      dephosphorylated again from the midblastula to the tailbud stage. Altogether, our
      results demonstrate the high evolutionary conservation of stathmin together with
      the members of its related gene family, not only at the level of their molecular
      structures, but also of their biochemical and biological regulation. These
      observations are thus further in favor of a very general and likely essential
      role of stathmin in the normal control of cells throughout development and in the
      adult.

PMID- 8344929
TI  - Photoaffinity labeling of human placental NAD(+)-linked 15-hydroxyprostaglandin
      dehydrogenase with [alpha-32P]2N3NAD+. Identification of a peptide in the adenine
      ring binding domain.
AB  - Oxidation of many prostaglandins at C-15 results in the formation of 15-keto
      metabolites, which have reduced biological activity. This reaction is catalyzed
      by NAD(+)-dependent 15-hydroxyprostaglandin dehydrogenase. Using the
      photoaffinity analog of NAD+, [alpha-32P]nicotinamide-2-azidoadenine
      dinucleotide, we have identified a peptide in the adenine ring binding domain of
      the NAD+ binding site of 15-hydroxyprostaglandin dehydrogenase. The specificity
      of photolabeling was demonstrated by saturation and protection experiments.
      Saturation of photolabeling was observed at approximately 45-50 microM with an
      apparent Kd of 8-10 microM. Approximately 90% of photolabeling could be protected
      by 200 microM NAD+ when the protein was photolyzed in the presence of 10 microM
      probe. The photolabeled protein was digested with Staphylococcus aureus V8 or
      chymotrypsin, and the photolabeled peptides were purified by either boronate
      affinity chromatography or Fe+3 chelate chromatography followed by reverse phase
      HPLC. The photolabeled peptide region was identified to be Val32-Glu40.

PMID- 8344930
TI  - Arachidonate 12-lipoxygenase of platelet-type in human epidermal cells.
AB  - A homogenate of epidermal cells isolated from human skin converted arachidonic
      acid to 12S-hydroxy-5, 8,10,14-eicosatetraenoic acid and 15-hydroxy-5, 8,11,13
      eicosatetraenoic acid as the main lipoxygenase products. The production of these
      hydroxy acids was not stimulated by the addition of 1 mM NADPH required for
      cytochrome P-450 reaction, but inhibited by 65-75% with 40 microM
      nordihydroguaiaretic acid, a nonspecific lipoxygenase inhibitor. In addition to
      these lipoxygenase products, the epidermal cell homogenate converted arachidonic
      acid to prostaglandin E2 together with minor amounts of prostaglandins D2 and F2a
      and 12-hydroxy-5,8,10-heptadecatrienoic acid. Thromboxane B2 was not detected.
      This finding rules out the possible contamination of platelet 12-lipoxygenase in
      the epidermal cells. After subcellular fractionation of the epidermal cell
      homogenate, the 12-lipoxygenase activity was found in the 164,000 x g
      supernatant, the 164,000 x g pellet, and the 10,000 x g pellet. The cytosolic
      enzyme and the enzymes solubilized from the two pellets produced 12S-hydroperoxy
      5,8,10,14-eicosatetraenoic acid as the primary product in contrast to cytochrome
      P-450 which produces primarily hydroxy acids. The 12-lipoxygenase in the 164,000
      x g supernatant and the solubilized enzymes from the 164,000 x g pellet and
      10,000 x g pellet were precipitable by antibodies raised against human platelet
      12-lipoxygenase, but not by antibodies against porcine leukocyte 12-lipoxygenase.
      The immunoprecipitated 12-lipoxygenase from each fraction was almost inactive
      with linoleic acid as substrate, characteristic of 12-lipoxygenase of platelet
      type. Furthermore, 12-lipoxygenase mRNA in the epidermal cells could be reverse
      transcribed and amplified by polymerase chain reaction with the primers specific
      for human platelet 12-lipoxygenase cDNA, but not with those for porcine leukocyte
      12-lipoxygenase cDNA. Thus, the 12-lipoxygenase of human epidermal cells is
      similar to human platelet 12-lipoxygenase in terms of immunogenicity, catalytic
      property, and primary structure, and distinct from leukocyte 12-lipoxygenase.

PMID- 8344931
TI  - Protein folding and assembly in vitro parallel intracellular folding and
      assembly. Catalysis of folding and assembly of the human chorionic gonadotropin
      alpha beta dimer by protein disulfide isomerase.
AB  - Although purified proteins will refold and assemble in vitro, it is not known if
      cellular factors change the mechanisms of these processes. Based on the gel
      migration of folding intermediates, the kinetic relationships between these
      intermediates, and on the order of formation of six disulfide bonds, we have
      found that the in vitro folding pathway of the human chorionic gonadotropin beta
      subunit (hCG-beta) is indistinguishable from the intracellular folding pathway.
      The same rate-limiting event was found in both folding environments; however, the
      t1/2 for this step in a cell is 4 min, whereas in vitro the t1/2 was > or = 80
      min. Protein disulfide isomerase (PDI) increased the in vitro rate of this event
      (t1/2 = 25 min) without changing the order of disulfide bond formation. PDI also
      catalyzed the in vitro rate of assembly of hCG subunits. In intact cells,
      assembly of the alpha beta heterodimer occurs before all of the intramolecular
      disulfide bonds of beta are formed. In vitro, assembly was increased after
      reduction of two of the carboxyl-terminal disulfide bonds of hCG-beta by PDI.
      These results strongly suggest that both in intact cells and in vitro, partially
      unfolded hCG-beta is more assembly-competent than is fully folded hCG-beta. The
      comparison of in vitro and intracellular hCG-beta folding and hCG subunit
      assembly which is shown in this report indicates that the assisted folding and
      assembly pathway that occurs in cells, where proteins such as PDI play a role,
      differs only in rate but not in the order of disulfide bond formation or in the
      precursor-product relationships among the folding intermediates.

PMID- 8344932
TI  - Regulation of neutrophil elastase activity by elastin-derived peptide.
AB  - To understand the interaction between elastin and elastase, elastin from human
      aorta was incubated with human leukocyte elastase under conditions favoring
      proteolysis. Low molecular weight species were separated from the protein
      fraction by a small centrifuged gel filtration column. The only product of the
      elastin digest detected on acid polyacrylamide gel electrophoresis was a single
      band of slower cathodal mobility than human leukocyte elastase alone. This band
      cross-reacts with antibody to human elastase, indicating that the slow migrating
      band contains elastase. The putative human leukocyte elastase-elastin-derived
      peptide complex was treated with hydroxylamine to cleave any possible acyl-enzyme
      complexes and was then measured for amidolytic activity. Analysis of the amino
      acid composition of elastin-derived peptide indicates the presence of alanine,
      glycine, and richness in hydrophobic residues, suggesting that these residues are
      involved in elastase interaction(s). Incubation of the elastase-elastin-derived
      peptide with alpha 1-protease inhibitor causes dissociation of the complex and
      formation of an elastase-alpha 1-protease inhibitor complex. Our results suggest
      that, locally at the site of proteolysis, elastase activity may be regulated by
      elastin-derived peptide(s) during elastinolysis.

PMID- 8344933
TI  - HIV nucleocapsid protein. Expression in Escherichia coli, purification, and
      characterization.
AB  - The single-stranded nucleocapsid protein that coats the RNA genome of human
      immunodeficiency virus within the virion core has been produced in Escherichia
      coli and purified to homogeneity. The mature 55-amino acid protein, normally
      generated from the gag polyprotein precursor by HIV protease-catalyzed processing
      of both its amino and carboxyl termini, was produced in E. coli with authentic
      termini directly, without the need for processing. The protein was purified 30
      fold to apparent homogeneity, as determined by both amino acid analysis and SDS
      polyacrylamide gel electrophoresis. Sequencing of each terminus of the purified
      protein indicated that no proteolytic degradation occurred. A molar extinction
      coefficient (epsilon 280 = 8350 cm-1 M-1) was determined. The purified
      nucleocapsid protein binds tightly to single-stranded RNA as judged by a
      nitrocellulose filter binding assay. A binding constant (Kw) of 1 x 10(8) M-1 was
      calculated. Using fluorescence quenching of nucleocapsid protein upon RNA binding
      as an assay, a binding site size of seven nucleotides was determined. These
      results contrast to a larger 15-nucleotide site measured by others for a larger
      form of nucleocapsid protein-containing sequences from its immature precursor.
      The possible relevance of these findings are discussed.

PMID- 8344934
TI  - A 72-kilodalton fyn-related polypeptide (p72fyn-R) binds to the antigen
      receptor/CD3 (TcR/CD3) complex.
AB  - Protein-tyrosine kinases play crucial roles in the activation and transformation
      of T lymphocytes. In this study, we have identified a variant of the fyn kinase
      at 70-72 kDa (termed p72fyn-R) that can preferentially associate with the TcR/CD3
      complex in certain T cells. Phosphoamine acid analysis revealed that the CD3
      associated p72fyn-R is labeled on both tyrosine and serine/threonine residues.
      TcR/CD3-associated p72fyn-R could be specifically reprecipitated using anti-fyn
      antisera to both the N and C terminus of p59fyn. In addition, two-dimensional
      phosphotryptic peptide map patterns of TcR/CD3-associated p72fyn and anti-fyn
      precipitable p72 were identical. By contrast, a comparison of p72fyn-R and p62fyn
      showed similarities and differences. p72fyn-R possesses a peptide corresponding
      to the autophosphorylation site that migrates in the same position as found for
      p59/62fyn. However, p72fyn-R possessed at least four novel phosphorylated sites
      labeled on serine and threonine residues that are absent in the p62fyn pattern.
      Phosphatase digestion experiments indicated that p72fyn-R is more resistant to
      dephosphorylation than p59/62fyn. Two-dimensional phosphotryptic analysis
      indicated that the novel serine/threonine phosphorylation sites were responsible
      for the resistance to phosphatase digestion. Although the exact nature of the
      relationship between p72fyn-R and p59/62fyn remains undetermined, these data
      indicate that TcR/CD3 may utilize novel variants of src-related kinases in the
      generation of signals which regulate T-cell growth.

PMID- 8344935
TI  - Isolation and characterization of a temperature-sensitive mutant of Salmonella
      typhimurium defective in prolipoprotein modification.
AB  - A temperature-sensitive (ts) mutant of Salmonella typhimurium that accumulated
      unmodified murein prolipoprotein at 42 degrees C but not at 30 degrees C was
      identified. In vivo and in vitro studies of the biosynthesis of Braun's
      lipoprotein revealed that this mutant (SE5221) was defective in the glyceryl
      modification of prolipoprotein. The ts mutation was mapped to 60.6 min of the S.
      typhimurium chromosome and was linked to argA and cysH. A clone with a 1.4
      kilobase S. typhimurium DNA insert that complemented the ts mutation and restored
      the prolipoprotein modification activity both in vivo and in vitro was isolated.
      DNA sequencing of the complementing region revealed an open reading frame
      encoding a protein with 291 amino acids lacking NH2-terminal signal sequence.
      This open reading frame is immediately 5' to the thyA gene and is allelic to umpA
      of Escherichia coli. Wild-type strains harboring the cloned gene exhibited
      elevated levels of prolipoprotein modification activity. At the non-permissive
      temperature, the mutation affected both growth and viability, and the mutant
      cells exhibited anomalous cell morphology. The ts phenotype was suppressed by the
      introduction of a lpp::Tn10 mutation. These results suggest that the cloned gene
      encodes prolipoprotein glyceryl transferase (lgt), and in the wild-type
      background, this prolipoprotein modification enzyme is essential for the growth
      and viability of S. typhimurium.

PMID- 8344936
TI  - Characterization of a temperature-sensitive mutant of Salmonella typhimurium
      defective in apolipoprotein N-acyltransferase.
AB  - On screening 440 temperature-sensitive (ts) mutants of Salmonella typhimurium, a
      mutant strain SE5312 which accumulated apolipoprotein (ALP) at 42 degrees C was
      identified. In vitro assay of apolipoprotein N-acyltransferase activity indicated
      that the mutant cell envelope contained reduced activity as compared to the wild
      type strain. Transduction with a Mud-P22 mapping set placed the ts mutation to 14
      17 min region of the S. typhimurium chromosome. P22 transduction using transposon
      insertions in this region revealed a linkage of the ts mutation to cobD (6%), nag
      (8%), and corC68 (99%). The ts phenotype was complemented by a 2.3-kilobase EcoRI
      subclone derived from lambda-phage 170 of Kohara's bank of Escherichia coli.
      Restriction enzyme analysis of the cloned DNA revealed that this 2.3-kilobase
      EcoRI fragment included the copper transport (cutE) gene in E. coli. The mutant
      strain SE5312 was copper-sensitive at 30 degrees C, and the complementing clone
      conferred copper resistance and restored the ALP N-acyltransferase activity in
      the mutant cell. Wild-type strain of S. typhimurium harboring this clone
      exhibited elevated levels of ALP N-acyltransferase activity. These results
      suggest that the cloned gene encodes the ALP N-acyltransferase. Upon shift to the
      non-permissive temperature, the viability of the mutant cells decreased, and the
      mutant cells assumed anomalous morphology. Temperature-resistant revertants could
      be readily isolated, and a subset of tr revertants contained no detectable
      lipoprotein. A lpp::Tn10 derivative of the mutant SE5312 was also temperature
      resistant. These observations suggest that ALP N-acyltransferase is essential for
      the growth and viability of S. typhimurium, and this requirement is decreased in
      the absence of major outer membrane lipoprotein.

PMID- 8344937
TI  - Epithelial glycoprotein-330 mediates endocytosis of plasminogen activator
      plasminogen activator inhibitor type-1 complexes.
AB  - Epithelial glycoprotein 330 (gp330) is structurally similar to the
      multifunctional alpha 2-macroglobulin receptor/low density lipoprotein receptor
      related protein (alpha 2MR/LRP), gp330 and alpha 2MR/LRP bind Ca2+ with high
      affinity, and both receptors bind and mediate endocytosis of alpha 2MR-associated
      protein (RAP). In the present report, we describe that affinity-purified gp330
      from rabbit renal cortex binds plasminogen activator inhibitor type-1 (PAI-1)
      complexed with urokinase-type plasminogen activator (uPA). alpha 2M-methylamine,
      which binds with high affinity to alpha 2MR/LRP, did not bind to gp330. The
      apparent Kd for binding of uPA.PAI-1 complexes was about 0.8 nM at 4 degrees C.
      The binding was calcium-dependent and inhibited by recombinant RAP (rRAP) and
      tissue type plasminogen activator-PAI-1 complexes. Thin sections of rabbit renal
      proximal tubules bound 125I-labeled uPA.PAI-1 and rRAP in the apical part of
      proximal tubules corresponding to the localization of gp330. The binding of 125I
      uPA.PAI-1 complexes in tubules was abolished by excess unlabeled rRAP, and a rRAP
      inhibitable endocytosis and degradation of labeled uPA.PAI-1 complexes was
      demonstrated by perfusion of isolated rabbit proximal tubules. The results
      establish an endocytotic function of gp330 and suggest that gp330 is an important
      component of the fibrinolytic system in gp330-containing epithelial as found in,
      for example, kidney and lung.

PMID- 8344938
TI  - A kinase-related protein stabilizes unphosphorylated smooth muscle myosin
      minifilaments in the presence of ATP.
AB  - An apparent paradox in smooth muscle biology is the ability of unphosphorylated
      myosin to maintain a filamentous structure in the presence of ATP in vivo,
      whereas unphosphorylated myosin filaments are depolymerized in vitro in the
      presence of ATP. This suggests that additional uncharacterized factors are
      required for the stabilization of myosin filaments in the presence of ATP. We
      report here that an abundant smooth muscle protein forms sedimentable complexes
      with unphosphorylated smooth muscle myosin, partially reverses the depolymerizing
      effect of ATP on unphosphorylated myosin, and promotes the assembly of
      minifilaments as revealed by electron microscopy. This protein is called kinase
      related protein (KRP) because it is derived from a gene within the gene for
      myosin light chain kinase (MLCK) and has an amino acid sequence identical to the
      carboxyl-terminal domain of MLCK. Consistent with the results with purified KRP,
      deletion of the KRP domain within MLCK results in a diminished ability of MLCK to
      interact with unphosphorylated myosin. KRP binds to the heavy meromyosin fragment
      of myosin but not to myosin rod or fragments lacking the hinge region and light
      chains. Altogether, these results suggest that KRP may play a critical role in
      stabilizing unphosphorylated myosin filaments and that the KRP domain of MLCK may
      be important for subcellular targeting to filaments.

PMID- 8344940
TI  - The gene encoding IFP 53/tryptophanyl-tRNA synthetase is regulated by the gamma
      interferon activation factor.
AB  - We have obtained genomic DNA encoding the interferon-gamma (IFN-gamma)-inducible
      IFP 53/tryptophanyl-tRNA synthetase. Comparison with several different IFP 53
      cDNA clones revealed a complex pattern of alternatively spliced 5'-untranslated
      regions. The interferon-responsive region within the IFP 53 promoter was found to
      contain a gamma-interferon activation site (GAS) but not the interferon
      stimulated response element and to bind the gamma-interferon activation factor
      (GAF). GAF.GAS complexes contained the IFN-regulated 91-kDa protein. Competition
      experiments defined the GAS boundaries and showed that GAF binding to the IFP 53
      GAS could be prevented by an excess of the IFN-gamma response regions of several
      other IFN-gamma-inducible genes. We thus provide evidence for a central role of
      GAS.GAF in gene transcription mediated by IFN-gamma and suggest a consensus
      sequence defining more precisely the requirements for GAF binding to DNA.

PMID- 8344939
TI  - Mouse ethanol-inducible cytochrome P-450 (P450IIE1). Characterization of cDNA
      clones and testosterone induction in kidney tissue.
AB  - A mouse cDNA clone for the ethanol-inducible cytochrome P-450 (P450IIE1) was
      obtained by screening a liver cDNA library with an oligonucleotide representing a
      consensus sequence found in the orthologous rat, human, and rabbit sequences. The
      protein sequence deduced from the cDNA sequence had an identity of 93% to rat,
      81% to rabbit, and 76% to human orthologous sequences. The highest levels of
      P450IIE1 mRNA were found in liver of both sexes, and male kidney.
      Developmentally, C57BL/6 female liver P450IIE1 mRNA was detectable 1 day
      postpartum and reached steady-state levels in animals approximately 16-20 days of
      age. Kidney and adrenal gland P450IIE1 mRNA was found to be induced 25-50-fold
      and 4-fold by testosterone treatment, respectively, and the level in both tissues
      reached maximum levels between 12 h and 2 days after treatment. Nuclear run-on
      experiments demonstrated that testosterone treatment for 24-48 h resulted in a
      slight transcriptional activation of the P450IIE1 gene in the kidney. However,
      the increase in transcription rate was far below the increase in mRNA level,
      suggesting that much of the induction occurs by posttranscriptional mechanisms.
      This process requires the androgen receptor since mutant Tfm mice lacking
      receptor are not inducible.

PMID- 8344941
TI  - Intracellular Ca2+ and the regulation of early response gene expression in HL-60
      myeloid leukemia cells.
AB  - To gain direct insight into the action of the second messenger Ca2+ on
      transcriptional regulation, we have developed an intact cell model in which the
      intracellular free Ca2+ concentration ([Ca2+]i) can be measured, set, and varied
      at any level within the physiological range and in which the expression of early
      response genes is assayed in parallel. Using promyelocytic HL-60 cells, we have
      observed an exquisite sensitivity to Ca2+ of c-fos, c-jun, and zif268 mRNA
      accumulation, since early and maximal inductions were observed at 200-300 nM
      [Ca2+]i. At early times (10-20 min), the [Ca2+]i dose dependence of c-fos
      transcription and mRNA accumulation displayed a bell shape since c-fos expression
      was barely modified at high (700-1,250 nM) [Ca2+]i. The threshold [Ca2+]i
      concentration for prolonged (60 min) c-fos mRNA accumulation was greater than 200
      nM. This indicates that the quantitative effects of Ca2+ on a given gene can vary
      markedly as a function of both the [Ca2+]i concentration and the duration of
      stimulation. Strikingly, a [Ca2+]i perturbation of only 1 min was sufficient for
      full induction of c-fos and zif268 transcripts. This demonstrates that a
      transient perturbation of [Ca2+]i has long term effects on gene expression. The
      half-life of c-fos mRNA (16 min) was unaltered by Ca2+. Nuclear run-on analysis
      of the distribution of RNA polymerase II along the c-fos locus indicated that
      Ca2+ promotes a small increase in transcriptional initiation and a pronounced
      relief of a block to transcriptional elongation beyond intron 1. The extreme
      sensitivity to [Ca2+]i, in terms of both the length of time and the dose of
      [Ca2+]i required for maximal gene induction, demonstrates that Ca2+ is a major
      physiological regulator of early response gene expression. In addition, the
      results indicate that a c-fos intragenic element is the main target of Ca(2+)
      regulated transcriptional activation.

PMID- 8344942
TI  - Processing of the beta-amyloid precursor. Multiple proteases generate and degrade
      potentially amyloidogenic fragments.
AB  - Proteolytic processing of the beta-amyloid precursor proteins (APP) is required
      for release of the beta/A4 protein and its deposition into the amyloid plaques
      characteristic of aging and Alzheimer's disease. We have examined the involvement
      of acidic intracellular compartments in APP processing in cultured human cells.
      The use of acidotropic agents and inhibitors to a specific class of lysosomal
      protease, coupled with metabolic labeling and immunoprecipitation, revealed that
      APP is degraded within an acidic compartment to produce at least 12 COOH-terminal
      fragments. Nine likely contain the entire beta/A4 domain and, therefore, are
      potentially amyloidogenic. Treatment with E64 or Z-Phe-Ala-CHN2 irreversibly
      blocked activities of the lysosomal cysteine proteases cathepsins B and L but did
      not inhibit the lysosomal aspartic protease cathepsin D and did not alter the
      production of potentially amyloidogenic fragments. Instead, the inhibitors
      prevented further degradation of the fragments. Thus, large numbers of
      potentially amyloidogenic fragments of APP are routinely generated in an acidic
      compartment by noncysteine proteases and then are eliminated within lysosomes by
      cysteine proteases. Immunoblot and immunohistochemical analyses confirmed that
      chronic cysteine protease inhibition leads to accumulation of potentially
      amyloidogenic APP fragments in lysosomes. The results provide further support for
      the hypothesis that an acidic compartment may be involved in amyloid formation
      and begin to define the proteolytic events that may be important for
      amyloidogenesis.

PMID- 8344943
TI  - Sequencing and cloning of human prolylcarboxypeptidase (angiotensinase C).
      Similarity to both serine carboxypeptidase and prolylendopeptidase families.
AB  - Prolylcarboxypeptidase, a lysosomal serine carboxypeptidase, cleaves COOH
      terminal amino acids linked to proline, as in angiotensin II and III and [des
      Arg9] bradykinin. About 25% of the enzyme protein was sequenced, and the complete
      sequence was deduced from its human kidney cDNA. The cDNA insert contained an
      open reading frame of 1488 base pairs coding for a protein of 496 residues. The
      authentic NH2-terminal sequence matched the deduced protein sequence starting
      with residue 46, suggesting the presence of both a signal and propeptide. The
      mature enzyme (451 residues) has a calculated M(r) = 51,043, whereas the M(r) of
      the purified glycoprotein is 58,000, indicating 12% carbohydrate. The overall
      sequence identity with serine peptidases is low (10-18%), but sequences around
      residues of the putative catalytic triad (Ser134, Asp333, His411) are similar (30
      67%) to both the serine carboxypeptidases (e.g. deamidase or lysosomal protective
      protein, yeast carboxypeptidase Y, and KEX1 gene product) and the
      prolylendopeptidase family. Thus, prolylcarboxypeptidase links these two
      families, suggesting an evolutionary relationship. It is inhibited (Ki = 2.6 x
      10(-7) M) by benzyloxycarbonyl-Pro-prolinal, a specific inhibitor of
      prolylendopeptidase, another angiotensin metabolizing enzyme.
      Prolylcarboxypeptidase contains serine or threonine residues repeated as the 26th
      residue 7 out of 9 times, with identical or similar amino acids in other
      positions in the repeats. The KEX1 gene product contains a similar motif, with
      serine or threonine as every 27th residue. The importance of
      prolylcarboxypeptidase is strongly suggested by its presence in various organs
      and cells and by the substrates it cleaves.

PMID- 8344944
TI  - Effects of substitutions of closely related amino acids at the contact surface in
      an antigen-antibody complex on thermodynamic parameters.
AB  - We constructed a library of 512 kinds of Fv fragment, derivatives of a monoclonal
      antibody, D1.3, specific for hen egg-white lysozyme, in which a total of nine of
      the original amino acids were replaced by closely related amino acids at
      positions in the complementarity-determining regions of the H chain. More than
      80% of the clones in the library produced Fv fragments in Escherichia coli. Two
      wild-type and 13 mutant Fv fragments were prepared in large quantities and
      subjected to analysis by differential titration calorimetry. The association
      constants of the 15 Fv fragments with hen egg-white lysozyme were distributed
      between 0.12 x 10(7) and 1.59 x 10(8) M-1. The changes in delta H0 and -T delta
      S0 caused by one-point mutation at each position did not have intrinsic values
      for each change. The same changes at one position had different effects on KA,
      delta H0, and -T delta S0 when differences had been introduced in other regions.
      The delta(delta G0) caused by a single-point mutation ranged from -0.56 to 1.56
      kcal/mol. By contrast, the delta(delta H0) and delta(-T delta S0) caused by a
      single-point mutation ranged from -3.5 to 3.4 and from -3.8 to 3.4 kcal/mol,
      respectively. When antibodies gain the binding energy contributed by the effects
      of enthalpy, they lose the binding energy contributed by the effects of entropy
      and vice versa. In general, changes in entropy compensate for changes in
      enthalpy.

PMID- 8344945
TI  - Cloning and expression of a novel phosphatidylethanolamine N-methyltransferase. A
      specific biochemical and cytological marker for a unique membrane fraction in rat
      liver.
AB  - Phosphatidylethanolamine N-methyltransferase catalyzes the synthesis of
      phosphatidylcholine from phosphatidylethanolamine and is most active in liver. A
      cDNA for this enzyme from a rat liver cDNA library has been cloned, sequenced,
      and expressed in COS-1 cells, McArdle-RH7777 rat hepatoma cells, and Sf9 insect
      cells. The expressed protein was capable of converting phosphatidylethanolamine
      into phosphatidylcholine in intact COS-1 cells, which normally have very low
      methyltransferase activity. The calculated molecular mass of the
      methyltransferase protein is 22.3 kDa, which is equivalent to that of the pure
      protein isolated from rat liver. Comparison of the sequence of the cloned rat
      liver methyltransferase with the yeast phosphatidylethanolamine methyltransferase
      PEM2 gene product revealed 44% identical amino acids and 68% similarity in the
      two predicted protein sequences. A polyclonal antibody was raised against a
      synthetic peptide corresponding to the carboxyl-terminal region of the enzyme and
      was affinity purified. The antibody recognized a single protein with a molecular
      mass of approximately 20 kDa when either rat liver proteins or proteins derived
      from the transfected COS-1 cells were electrophoresed on polyacrylamide gels
      containing sodium dodecyl sulfate. Surprisingly, the antibody exhibited no
      reactivity with endoplasmic reticulum proteins, even though the major
      phosphatidylethanolamine methyltransferase activity resides on this subcellular
      organelle. Instead, the antibody specifically recognized a protein in a unique
      subcellular membrane fraction purified from a crude mitochondrial preparation on
      a Percoll gradient. Immunocytochemical examination by electron microscopy showed
      positive labeling only in unique regions of the hepatocytes. The data suggest
      that this phosphatidylethanolamine methyltransferase is a specific marker for
      this unique membrane fraction.

PMID- 8344946
TI  - Glycosylation of mammalian neurofilaments. Localization of multiple O-linked N
      acetylglucosamine moieties on neurofilament polypeptides L and M.
AB  - Neurofilaments are neuronal intermediate filaments that play an important role in
      the growth and maintenance of large myelinated axons. Mammalian neurofilaments
      are composed of three polypeptide subunits, designed as NF-L, NF-M, and NF-H, all
      of which are phosphorylated. Here, we demonstrate by several criteria that
      neurofilament polypeptides are also modified by an abundant type of intracellular
      protein glycosylation in which single N-acetylglucosamine monosaccharides are O
      glycosidically (O-GlcNAc) linked to serine or threonine residues. In purified
      neurofilament proteins, the O-GlcNAc modifications occur at a stoichiometry of
      approximately 0.1 and 0.15 mol of GlcNAc/mol of NF-L and NF-M, respectively. The
      predominant sites of O-GlcNAc attachment on NF-L and NF-M are identified using
      proteolysis, purification of the glycopeptides, and subsequent analysis by
      automated gas-phase sequencing, manual Edman degradation, and laser desorption
      mass spectrometry. For NF-L, both major sites of glycosylation (Thr21 and Ser27)
      are located at the NH2-terminal head domain. For NF-M, one major site (Thr48)
      lies within the NH2-terminal head domain, whereas the other (Thr431) is located
      at the tail domain. Deletions encompassing these sites have been shown previously
      to have a dominant detrimental effect upon neurofilament assembly, raising
      questions about the specific function(s) of the saccharide moieties at these
      sites. Specific identification of these O-GlcNAc attachment sites has set the
      stage for more detailed mutagenic analysis of O-GlcNAc functions on
      neurofilaments.

PMID- 8344947
TI  - p72syk tyrosine kinase is activated by oxidizing conditions that induce
      lymphocyte tyrosine phosphorylation and Ca2+ signals.
AB  - We have used H2O2 as a pharmacologic agent to examine the effects of oxidizing
      conditions on lymphocyte signal pathways. Treatment of Ramos cells with 5-10 mM
      H2O2 gave rapid and strong tyrosine phosphorylation of multiple cellular proteins
      and activation of p72syk to levels equal to or greater than that observed upon
      surface Ig cross-linking. Strong Ca2+ signals that could be blocked by the
      tyrosine kinase inhibitor herbimycin A were also observed under these conditions.
      However, there was no increase in activity for the Src family kinases p56lck,
      p59fyn, or p56/p53lyn. Our findings that the p72syk tyrosine kinase responds to
      H2O2 treatment of cells suggest that this kinase is likely to contribute to
      cellular tyrosine phosphorylation and calcium signaling induced by oxidizing
      conditions. Furthermore, H2O2 may be useful as a pharmacologic agent to
      distinguish the effects of p72syk-related kinases from those of Src family
      kinases.

PMID- 8344948
TI  - Cyclosporine A inhibits the activity of a TATA box-binding protein that is
      required for transcription from the adenovirus major late promoter.
AB  - Nuclear extracts from P1798 lymphoma cells support transcription from the
      adenovirus major late promotor (AdMLP) and the human histone H4 promoter. Nuclear
      extracts prepared from P1798 cells treated with 1 microgram/ml cyclosporine A for
      24 h fail to support transcription from AdMLP, whereas transcription from the
      histone H4 promoter is unimpaired. Both control and cyclosporine-treated extracts
      contain proteins that interact with synthetic deoxyoligonucleotides that
      correspond to the CAAT box, TATA box, and upstream stimulatory element of AdMLP.
      Cyclosporine had no discernible qualitative or quantitative effect upon such DNA
      protein interactions, as observed by gel mobility shift assays. Analysis of 5'
      deletion mutants of AdMLP indicates that deletion of sequences upstream of the
      TATA box reduces AdMLP transcription by only 50%. This observation suggests that
      cyclosporine A, which inhibits AdMLP transcription by > 90%, is unlikely to act
      through changes in the amount or activity of upstream activators such as upstream
      stimulatory factor- or CAAT box-binding proteins. On the other hand, deletion of
      TATA box sequences between -50 and -11 base pairs virtually eliminates
      transcription from AdMLP in vitro. A partially purified TFIID fraction was
      obtained from control P1798 nuclear extracts. The TFIID fraction reconstitutes
      transcription from AdMLP when added to extracts from cyclosporine A-treated
      cells. Recombinant TATA box-binding protein also reconstitutes transcription from
      AdMLP in cyclosporine A-treated extracts. These results are consistent with the
      hypothesis that cyclosporine A regulates the activity of a subset of general
      transcription factors which are required for initiation from some promoters (such
      as AdMLP) but not from others (such as histone H4).

PMID- 8344949
TI  - Enzymatic generation of the amino terminus of the beta-amyloid peptide.
AB  - The major pathological change in Alzheimer's disease is the deposition of 39-42
      amino acid beta-amyloid peptide (BAP) in the brain. Since BAP begins at the
      aspartate residue (Asp1, or codon 672 of the amyloid precursor protein (APP)770
      transcript), the ability of several proteases to cleave the peptide bond
      methionine-Asp1 (M/D) was evaluated by using peptides and recombinant APP
      molecules as substrates. Cathepsin G and chymotrypsin cleave the synthetic
      peptide HSEVKMDAEF at M/D under acidic conditions, whereas cleavage at lysine
      methionine (K/M) predominates when the pH is alkaline. Trypsin and cathepsins B,
      D, and L are unable to cleave the synthetic peptide at M/D. Peptide SEVNLDAEF,
      representing the mutation found in early onset Alzheimer's disease families from
      Sweden, is cleaved by cathepsin G and chymotrypsin at leucine-aspartate (L/D).
      Incubation of cathepsin G with soluble protease nexin-2 obtained from recombinant
      APP (APP-REP) derivatives resulted in proteolytic cleavage at or near the amino
      terminus of BAP. Cathepsin G-mediated cleavage was also observed in the domain
      representing the amino terminus of BAP when mature plasma membrane-associated APP
      REP molecules were used as substrates. Our results strongly suggest the
      involvement of a chymotrypsin-like serine protease in the generation of the amino
      terminus of BAP beginning at Asp1.

PMID- 8344950
TI  - Purification and characterization of a poly(dA-dT) lux-specific DNA-binding
      protein from Vibrio harveyi and identification as LuxR.
AB  - A lux-specific DNA-binding protein was purified to homogeneity from Vibrio
      harveyi by chromatography on DEAE-Sepharose, DNA-cellulose, Superose 12, and Mono
      Q. A single polypeptide of M(r) = 23,000 was found on SDS-polyacrylamide gel
      electrophoresis with an amino-terminal sequence corresponding to that predicted
      for luxR, a gene that causes a shift in the transcriptional start site from
      position -123 to -26 base pairs upstream of the initiation codon of luxC in the
      V. harveyi lux operon and is required for high expression of lux mRNA in
      recombinant Escherichia coli. Identification of the DNA-binding protein as LuxR
      was confirmed by showing its absence in V. harveyi luxR-mutants and its synthesis
      in recombinant E. coli containing V. harveyi luxR. The LuxR protein was shown to
      bind to two specific (A + T)-rich regions of DNA upstream of the V. harveyi luxC
      gene: region A, -290 to -253 base pairs, and region B, -170 to -116 base pairs.
      Synthetic poly(dA-dT) but not poly(dA)-poly(dT) competed with the lux DNA for
      binding to LuxR suggesting that this protein may be a novel poly(dA-dT)-binding
      protein in prokaryotes. The LuxR protein inhibited transcription from the -123
      promoter in vitro; however, transcription from the -26 promoter was not
      reconstituted suggesting the possible requirement for other factors in lux gene
      regulation. LuxR shared sequence identity with two proteins linked to the
      regulation of enzymes involved in electron transport indicating that it may be a
      member of a family of regulators of metabolic functions responsible for diverting
      electrons from the respiratory chain.

PMID- 8344951
TI  - The role of conserved amino acids in substrate binding and discrimination by
      photolyase.
AB  - DNA photolyases catalyze the light-dependent repair of pyrimidine dimers in DNA.
      We have utilized chemical modification and site-directed mutagenesis to probe the
      interactions involved in substrate recognition by the yeast photolyase Phr1.
      Lys517 was protected from reductive methylation in the presence of substrate, but
      not in its absence, and the specific and nonspecific association constants for
      substrate binding by Phr1 (Lys517-->Ala) were decreased 10-fold. These results
      establish a role for Lys517 in substrate binding. Mutations at Arg507, Lys463,
      and Trp387 reduced both the overall affinity for substrate and substrate
      discrimination. Sites of altered interactions in ES complexes were identified by
      methylation and ethylation interference techniques. Interaction with the base
      immediately 3' to the dimer was altered in the Phr1(Lys517-->Ala). DNA complex,
      whereas interactions with the phosphate and base immediately 5' to the dimer were
      reduced when Phr1(Arg507-->Ala) bound substrate. Multiple interactions 5' and 3'
      to the dimer were perturbed in complexes containing Phr1(Trp387-->Ala) or
      Phr1(Lys463-->Ala). In addition the quantum yield for dimer photolysis by
      Phr1(Trp387-->Ala) was reduced 3-fold. The locations of these mutations establish
      that a portion of the DNA binding domain is comprised of residues in the highly
      conserved carboxyl-terminal half of the enzyme.

PMID- 8344952
TI  - Stereochemistry specifies the regiochemistry of phosphorylation in two cAMP
      dependent protein kinase substrates.
AB  - The substrate specificity of the cAMP-dependent protein kinase has been assessed
      with peptides bearing threoninol diastereomers. The threoninol residue contains
      both a primary alcohol and a secondary alcohol, either of which may serve as a
      site of phosphorylation. The enzyme-catalyzed phosphorylation of Gly-Arg-Thr-Gly
      Arg-Arg-Asn-(2R,3R)-threoninol furnishes a Km of 498 +/- 39 microM and a Vmax of
      7.8 +/- 0.2 mumol/min-mg, whereas the phosphorylation of Gly-Arg-Thr-Gly-Arg-Arg
      Asn-(2S,3S)-threoninol provides a Km of 16.3 +/- 0.8 microM and a Vmax of 16.0 +/
      0.4 mumol/min-mg. Mass spectral analysis of the phosphopeptide reaction products
      revealed that each species is phosphorylated only once. 1H-coupled 31P NMR
      experiments unequivocally demonstrated that the (2R,3R)-isomer is specifically
      phosphorylated at the secondary alcohol, whereas the (2S,3S)-isomer is
      exclusively phosphorylated at the primary alcohol. This regiospecificity appears
      to be a consequence of the stereochemistry at C-2 in the threoninol residues. The
      structural attributes of the protein kinase that appear to be responsible for the
      observed differentiation between the C-2 stereoisomers is discussed.

PMID- 8344953
TI  - Biochemical characterization of human osteoclast integrins. Osteoclasts express
      alpha v beta 3, alpha 2 beta 1, and alpha v beta 1 integrins.
AB  - The study of osteoclast integrins has been previously hampered by the lack of a
      source of large numbers of purified osteoclasts. Osteoclastoma, a human giant
      cell tumor of bone, supplied a rich source of osteoclasts within a tissue
      containing many diverse cell types. Osteoclastoma integrin immunostaining
      confirmed the presence of the integrin alpha v beta 3 complex and the alpha 2 and
      beta 1 integrin subunits on osteoclasts. However, weak integrin expression, for
      example with alpha v beta 5, was difficult to interpret. Purification with
      magnetic beads coated with vitronectin receptor monoclonal antibody (13C2)
      enabled osteoclast membranes to be isolated with high purity and yield (57%) from
      osteoclastoma tissue. Positively (osteoclast-enriched) selected membranes were
      biochemically assessed for integrin expression by immunoprecipitation and
      visualization by non-radioactive enhanced chemiluminescence. alpha 1, alpha 4,
      alpha 6, alpha 8, alpha M, alpha X, gpIIb, beta 4, beta 6, and beta 8 integrin
      chains were undetectable at a sensitivity of 1 ng. alpha 3, alpha 5, alpha L,
      beta 2, and alpha v beta 5 were found in the negatively selected osteoclastoma
      tissue but not in the positively purified osteoclast membranes. The presence of
      alpha v beta 1 and alpha 2 beta 1 dimers was demonstrated biochemically on the
      immunoisolated osteoclast membranes. Osteoclast alpha v beta 3 isolation by Arg
      Gly-Asp (RGD) affinity chromatography for NH2-terminal amino acid sequencing
      confirmed that the osteoclast vitronectin receptor was identical to that
      previously characterized on other cell types. In situ hybridization using human
      alpha v riboprobes in osteoclasts from human and rodent bone further demonstrated
      the high level and specificity of expression of alpha v vitronectin receptor in
      osteoclasts.

PMID- 8344954
TI  - The hydrophobic domain of dolichyl-phosphate-mannose synthase is not essential
      for enzyme activity or growth in Saccharomyces cerevisiae.
AB  - Dolichyl-phosphate-mannose synthase is a membrane-bound enzyme of the endoplasmic
      reticulum that catalyzes the formation of dolichyl phosphate mannose from
      dolichyl phosphate and GDP-mannose. It is an essential enzyme for growth of
      Saccharomyces cerevisiae, and, like other enzymes that utilize some form of the
      lipid dolichol as substrate, dolichyl-phosphate-mannose synthase contains a
      putative "dolichol recognition sequence" in the predicted membrane-spanning
      domain. To investigate the importance of this sequence in particular and the
      hydrophobic region in general, a series of mutants of dolichyl-phosphate-mannose
      synthase were constructed that contained successive deletions or mutations of the
      hydrophobic region, and their in vivo functions and in vitro activities were
      examined. While all of the mutant proteins exhibited decreased transferase
      activities in vitro compared to the wild-type enzyme, the sequence was not
      essential for growth or for protein glycosylation in S. cerevisiae.
      Interestingly, although deletion of the entire hydrophobic region resulted in a
      soluble protein, mutant proteins containing 3 or 8 hydrophobic residues at the
      carboxyl terminus were still membrane-associated. These mutant proteins could be
      released from membranes by treatment with sodium carbonate, indicating peripheral
      associations.

PMID- 8344955
TI  - Influence of different signal peptides and prosequences on expression and
      secretion of human tissue plasminogen activator in the baculovirus system.
AB  - Foreign secretory pathway proteins are often produced in surprisingly low amounts
      in the baculovirus/insect cell expression system. One possible reason for this is
      that heterologous signal peptides might be inefficiently recognized by the insect
      cell protein translocation machinery. This idea was supported by a recent study
      showing that secretion of a plant protein in the baculovirus system was enhanced
      when its signal peptide was replaced with an insect-derived signal peptide
      (Tessier, D. C., Thomas, D. Y., Khouri, H. E., Laliberte, F., and Vernet, T.
      (1991) Gene (Amst.) 98, 177-183). We have extended these observations by
      measuring the effects of different signal peptide and signal peptide-prosequence
      combinations on baculovirus-mediated expression and secretion of human tissue
      plasminogen activator (t-PA). Replacement of the native prepropeptide with signal
      peptides from a lepidopteran insect secretory protein (cecropin B), a major
      baculovirus structural glycoprotein (64K), or an abundant, highly conserved
      lumenal protein of the rough endoplasmic reticulum (GRP78/BiP, a 78-kDa glucose
      regulated protein/immunoglobulin heavy chain-binding protein), had no significant
      effect on t-PA expression or secretion. The same results were obtained with the
      signal peptide from honeybee prepromellitin, which was able to enhance secretion
      of plant propapain (Tessier et al., 1991 (above)). Similar results were obtained
      when heterologous signal peptides were combined with the native prosequence or
      when the intact cecropin B preprosequence was used. Translational initiation at
      an upstream, in-frame ATT, which could functionally inactivate any signal
      peptide, did not explain the low efficiency of t-PA secretion. Finally, deletion
      of the native signal peptide, prosequence, or both, failed to increase t-PA
      production. These results showed that insect-derived signal peptides and/or
      prosequences cannot always enhance the expression and/or secretion of foreign
      secretory pathway proteins in the baculovirus system. They also suggested that
      the inability of insect cells to recognize the processing signals in human t-PA
      efficiently is probably not the major factor preventing its high level production
      in this system.

PMID- 8344956
TI  - Phi 29 DNA polymerase active site. The conserved amino acid motif "Kx3NSxYG" is
      involved in template-primer binding and dNTP selection.
AB  - phi 29 DNA polymerase shares with other alpha-like DNA polymerases several
      regions of amino acid similarity. Among them, the conserved region characterized
      by the amino acid motif "Kx3NSxYG" has been proposed to form part of the
      polymerization active site of alpha-like DNA polymerases. Mutants in phi 29 DNA
      polymerase residue Tyr390 of this conserved motif had been previously described
      to be affected in DNA-dependent dNTP binding. In this paper, the functional
      significance of this conserved motif is further studied by the analysis of
      mutants in conserved residues Asn387, Ser388, and Gly391. Residue Phe393 of phi
      29 DNA polymerase has also been selected as target for site-directed mutagenesis
      because of its conservation within the group of alpha-like DNA polymerases from
      genomes that replicate by a protein-priming mechanism. Mutant N387Y was shown to
      be affected both in initiation and polymerization reactions, showing 3-fold
      higher Km value for dATP and more than 11-fold lower Vmax value than the wild
      type enzyme in the initiation reaction; moreover, it was affected in enzyme-DNA
      translocation. Mutant S388G retained initiation and polymerization activities;
      interestingly, this mutation significantly increased the efficiency of dNTP
      incorporation in non-templated reactions. Mutation Gly391 to Asp abolished
      template-primer binding as shown by gel retardation assays; this mutant was
      drastically affected in template-dependent dNTP incorporation both in initiation
      and polymerization reactions, but the efficiency of the non-templated phi 29
      terminal protein-deoxynucleotidylation was higher than with the wild-type
      protein. Mutation Phe393 to Tyr severely decreased initial binding to template
      primer DNA molecules, resulting in a reduced activity in DNA primer-dependent
      polymerization reactions but not in phi 29 terminal protein-dependent ones.

PMID- 8344957
TI  - Activation of cytosolic phospholipase A2 by transforming growth factor-alpha in
      HEL-30 keratinocytes.
AB  - In the mouse keratinocyte line HEL-30 the epidermal mitogen transforming growth
      factor-alpha (TGF-alpha) stimulated the rapid release of arachidonic acid in a
      dose- and time-dependent manner. The liberation of arachidonic acid was due to
      the activation of a Ca(2+)-dependent cytosolic phospholipase A2 (cPLA2). The
      activation mechanism critically depended on a functionally active epidermal
      growth factor receptor tyrosine kinase and occurred independently of
      phospholipase C-mediated increases in cellular diacylglycerol and inositol 1,4,5
      trisphosphate concentrations and protein kinase C activation. The activation
      included an increase in cytosolic PLA2 (cPLA2) activity and an association of the
      enzyme with the membrane fraction. Both activation steps apparently occurred in
      the presence of basal cytoplasmic Ca2+ concentrations. Moreover, cPLA2 or a
      closely associated protein was found to be phosphorylated on tyrosine upon TGF
      alpha challenge of the cells. The data suggest that tyrosine phosphorylation is
      involved in the TGF-alpha-induced activation of cPLA2.

PMID- 8344958
TI  - Characterization of DNA synthesis at a restrictive temperature in the temperature
      sensitive mutants, tsFT5 cells, that belong to the complementation group of ts85
      cells containing a thermolabile ubiquitin-activating enzyme E1. Involvement of
      the ubiquitin-conjugating system in DNA replication.
AB  - A temperature-sensitive mutant defective in DNA replication, tsFT5, has been
      isolated from the mouse mammary carcinoma cell line FM3A. DNA synthesis in tsFT5
      cells at a restrictive temperature (39 degrees C) has been characterized in
      detail. Incorporation of [3H]thymidine decreased rapidly after an increase in
      temperature to 39 degrees C and the incorporation was less than 20% and 10% of
      the initial level after 4 and 8 h, respectively. Analysis by DNA fiber
      autoradiography revealed that the initiation of DNA replication at the origin of
      the replicons was impaired in tsFT5 cells but that the DNA chain elongation rate
      of the mutant cells did not decrease at the nonpermissive temperature. tsFT5
      cells were confirmed to belong to the complementation group which includes ts85
      cells arrested mainly in the G2 phase at the nonpermissive temperature. It has
      been observed that the amount of ubiquintin-conjugated histone H2A (uH2A) in ts85
      cells decreases at the nonpermissive temperature (Marunouchi, T., Yasuda, H.,
      Matsumoto, Y., and Yamada, M. (1980) Biochem. Biophys. Res. Commun. 95, 126-131).
      The amount of uH2A in tsFT5 cells also decreased rapidly at 39 degrees C. This
      decrease occurred at the same time as or slightly preceding to reduction in DNA
      synthesis, and the reappearance of uH2A was followed by the restoration of DNA
      synthesis after the temperature was reduced. A similar temporal relationship
      between decrease in the amount of uH2A and reduction in DNA synthesis was
      observed in ts85 cells cultured at 39 degrees C. However, the rates of the
      decrease of uH2A and of the reduction in DNA synthesis in ts85 cells were slower
      than those observed in tsFT5 cells. A comparison of the thermolability of
      purified ubiquitin-activating enzyme E1s revealed that the E1 from ts85 cells had
      a thermolability intermediate between those of the E1 from tsFT5 cells and of the
      wild-type cells. A reduction in the phosphorylation of histone H1 was observed in
      tsFT5 cells cultured at 39 degrees C, but the reduction occurred several hours
      after the decrease in uH2A and the reduction in DNA synthesis.

PMID- 8344959
TI  - N-syndecan (syndecan 3) from neonatal rat brain binds basic fibroblast growth
      factor.
AB  - The cell surface proteoglycan N-syndecan (syndecan 3) was isolated from neonatal
      rat brain. Purified brain N-syndecan had biochemical properties very similar to N
      syndecan previously identified in Schwann cells: it contained mainly, if not
      exclusively, heparan sulfate glycosaminoglycan chains and had a core protein with
      an apparent molecular mass of 120 kDa by sodium dodecyl sulfate-gel
      electrophoresis. We examined the interactions between purified N-syndecan and
      extracellular ligands using a solid phase binding assay. It was found that among
      all proteins tested, including a variety growth factors and extracellular matrix
      molecules, only basic fibroblast growth factor (bFGF) exhibited significant N
      syndecan binding. N-syndecan binding to bFGF was saturable and exhibited a KD =
      0.5 nM. Soluble bFGF effectively competed with immobilized bFGF for binding to N
      syndecan, indicating that these two proteins also interact in solution. Heparin
      and heparan sulfate, but not chondroitin sulfate, inhibited N-syndecan-bFGF
      binding. Isolated N-syndecan core protein did not exhibit significant binding to
      bFGF. Thus, the heparan sulfate chains of N-syndecan, rather than its core
      protein, appear to be responsible for binding to bFGF. Interestingly, acidic
      fibroblast growth factor, which is structurally similar to bFGF, did not exhibit
      significant N-syndecan binding. N-syndecan also did not bind to several other
      heparin-binding proteins used in this study, indicating a high degree of
      specificity for the N-syndecan-bFGF interaction. Both N-syndecan and bFGF are
      abundant in neonatal brain, suggesting that N-syndecan may function as a co
      receptor for bFGF during nerve tissue development.

PMID- 8344960
TI  - Cloning, sequencing, and mutation of thiol-specific antioxidant gene of
      Saccharomyces cerevisiae.
AB  - We have previously shown that the yeast Saccharomyces cerevisiae contains an
      antioxidant enzyme that can provide protection against a thiol-containing
      oxidation system but not against an oxidation system without thiol. This 25-kDa
      enzyme was thus named thiol-specific antioxidant (TSA). We have now isolated and
      sequenced a yeast genomic DNA fragment that encodes TSA. Comparison of the
      predicted amino acid sequence of TSA with those of conventional antioxidant
      enzymes, including catalases, peroxidases, and superoxide dismutases, revealed no
      sequence homology. The 195-amino acid TSA sequence contains 2 cysteine residues.
      Southern blot analysis of petite yeast DNA, studies with protein synthesis
      inhibitors, and protein immunoblot analyses of cytosolic and mitochondrial
      proteins suggest that TSA is a cytosolic protein encoded by nuclear DNA
      (chromosome XIII). The yeast TSA gene was selectively disrupted by homologous
      recombination. The haploid tsa mutant was viable under air, suggesting that TSA
      is not essential for cell viability. The growth rates of the tsa mutant and wild
      type strains were identical under anaerobic conditions. However, under aerobic
      conditions, especially in the presence of methyl viologen or a peroxide (t-butyl
      hydroperoxide or H2O2), the growth rate of the mutant was significantly less than
      that of wild-type cells. This result suggests that TSA is a physiologically
      important antioxidant.

PMID- 8344962
TI  - Orphan receptor HNF-4 and bZip protein C/EBP alpha bind to overlapping regions of
      the apolipoprotein B gene promoter and synergistically activate transcription.
AB  - As the sole protein component of low density lipoproteins, apolipoprotein B
      (apoB) plays an important role in cholesterol metabolism. Previously, we found
      that the proximal promoter region of apoB (-81 to -52 relative to the start site)
      played a critical role in hepatocyte-specific gene expression and that that
      region contained overlapping binding sites for nuclear factors AF-1 (-81 to -62)
      and C/EBP (-69 to -52) (Metzger, S., Leff, T., and Breslow, J. L. (1990) J. Biol.
      Chem. 265, 9978-9983). In this study, we show that HNF-4, a member of the steroid
      hormone receptor superfamily, binds the AF-1 site on the apoB promoter and
      through it activates transcription in transient transfection assays in both liver
      and non-liver cell lines, HepG2 and HeLa, respectively. Mutational analysis of
      the AF-1/HNF-4 binding site indicated a correlation of HNF-4 binding and
      transcriptional activity. In addition, transient co-transfection experiments with
      HNF-4 and C/EBP alpha expression vectors showed that the two factors can
      synergistically activate transcription to levels more than 3-fold above the sum
      of either factor alone. Finally, using gel retardation analysis we show that
      purified HNF-4 and C/EBP proteins can concurrently occupy their overlapping
      binding sites on the apoB promoter in vitro. However, since the same system
      showed a lack of cooperative binding, we argue that an alternative mechanism is
      responsible for the synergistic effect of HNF-4 and C/EBP alpha on apoB gene
      transcription.

PMID- 8344961
TI  - Human RNA helicase A is homologous to the maleless protein of Drosophila.
AB  - RNA helicase A is an abundant nuclear enzyme of HeLa cells that unwinds double
      stranded RNA in a 3' to 5'direction (Lee, C. G., and Hurwitz, J. (1992) J. Biol.
      Chem. 267, 4398-4407). A complementary DNA (cDNA) clone expressing RNA helicase A
      was isolated by screening a human cDNA library with polyclonal antibodies
      produced against the purified protein. The deduced amino acid sequence from this
      clone showed that RNA helicase A is a member of the DEAH family of proteins
      thought to be helicases. Sequence comparison among all known proteins of the DEAH
      family revealed that the highest homology was between RNA helicase A and the
      maleless protein (MLE) of Drosophila. There was 49% identity and 85% similarity
      throughout the overall primary sequences of both proteins, suggesting that RNA
      helicase A is the human counterpart of Drosophila MLE. Polyclonal antibodies
      against Drosophila MLE recognized RNA helicase A in crude nuclear extracts of
      HeLa cells as well as the purified protein. A recombinant RNA helicase A
      containing 6 histidine residues at the NH2 terminus was expressed in Sf9 cells
      using a baculovirus vector. The protein isolated from insect cells and the enzyme
      purified from HeLa cells exhibited identical RNA helicase and RNA-dependent
      ATPase activities.

PMID- 8344963
TI  - Partial assembly of the yeast vacuolar H(+)-ATPase in mutants lacking one subunit
      of the enzyme.
AB  - Partial assembly of the peripheral and integral membrane sectors of the yeast
      vacuolar H(+)-ATPase has been detected in mutants lacking one subunit of the
      enzyme. Assembled complexes of the vacuolar H(+)-ATPase could be
      immunoprecipitated from biosynthetically labeled wild-type cells using monoclonal
      antibodies specific for the 69- and 60-kDa subunits of the enzyme, and assembled
      membrane (V0) sectors could be immunoprecipitated using a monoclonal antibody
      against the 100-kDa subunits. Parallel immunoprecipitations from mutant cells
      lacking one subunit of the vacuolar H(+)-ATPase revealed different degrees of
      assembly depending on the subunit that was missing. Partially assembled complexes
      of the peripheral subunits could also be detected in a soluble, cytoplasmic
      fraction from wild-type and mutant cells following glycerol gradient
      fractionation. The results indicate that the peripheral (V1) sector and integral
      membrane (V0) sectors of the yeast vacuolar H(+)-ATPase can assemble
      independently. The 69-, 60-, and 27-kDa subunits all appear to be necessary for
      any assembly of the V1 sector to occur, but these subunits and the 32-kDa subunit
      can assemble into a complex in the absence of the 42-kDa peripheral subunit. The
      implications of the results for the structure and assembly of the yeast vacuolar
      H(+)-ATPase are discussed.

PMID- 8344964
TI  - Induction and nuclear accumulation of fos and jun proto-oncogenes in hypoxic
      cardiac myocytes.
AB  - Hypoxic and ischemic stresses cause a series of well documented changes in
      myocardial cells and tissues, including increased anaerobic glycolysis, loss of
      contractility, changes in lipid and fatty acid metabolism, and eventual
      irreversible membrane damage and cell death. In this article we describe changes
      in the expression and regulation of the proto-oncogenes fos and jun in cardiac
      myocytes exposed to severe hypoxia. The mRNAs encoding c-Fos, c-Jun, Jun-D, and
      Jun-B were induced within 1 h of exposure to hypoxia, increased 5-10-fold between
      1 and 4 h and then declined. These inductions coincided with loss in myocyte
      contractility but occurred before there was irreversible cell damage or
      significant ATP loss. Immunostaining with anti-Fos and anti-Jun antibodies
      revealed the accumulation of these proteins in hypoxic cell nuclei. Pre-treatment
      of cells with protein kinase inhibitors significantly repressed the response at
      the mRNA level. We propose that hypoxic stress in these cells activates signal
      transduction pathways, possibly involving protein kinases, that result in the
      inductions of fos and jun gene families. Therefore AP1 may regulate myocardial
      adaptive responses to hypoxia in advance of energy depletion, cell damage, or
      reoxygenation.

PMID- 8344965
TI  - Normal insulin receptor substrate-1 phosphorylation in autophosphorylation
      defective truncated insulin receptor. Evidence that phosphorylation of substrates
      might be sufficient for certain biological effects evoked by insulin.
AB  - A mutant human insulin receptor that lacked the 82 amino acids of the COOH
      terminus of the beta-subunit (del82) was studied. Both the wild type insulin
      receptor (HIR) and the mutant receptor were expressed in Chinese hamster ovary
      (CHO) cells by stable transfection. Autophosphorylation and tyrosine kinase
      activities toward exogenous substrates of solubilized and partially purified
      del82 were severely impaired. When CHO cells transfected with del82 (CHO-del82)
      were stimulated with insulin, autophosphorylation was decreased to a great extent
      compared with cells expressing HIR (CHO-HIR). Nevertheless, tyrosine
      phosphorylation of an endogenous substrate, pp185, and insulin receptor substrate
      1 (IRS-1) in CHO-del82 was comparable with that in CHO-HIR. Insulin-stimulated
      activation of phosphatidylinositol 3-kinase activity in CHO-del82 was also
      equivalent to that in CHO-HIR. Moreover, CHO-del82 exhibited the same insulin
      sensitivity as CHO-HIR with respect to 2-deoxyglucose uptake and thymidine
      incorporation into DNA. Insulin-induced internalization in CHO-del82 was
      decreased by 46% as compared with that in CHO-HIR. These data suggest that: 1)
      the COOH-terminal domain of the insulin receptor may play an inhibitory role in
      the phosphorylation of pp185 and IRS-1; and 2) phosphorylation of substrates such
      as pp185 and IRS-1, rather than autophosphorylation of the receptor per se,
      correlates better with certain biological effects that were mediated by insulin,
      suggesting that phosphorylation of the substrates might be sufficient for
      transducing signals downstream.

PMID- 8344966
TI  - Angiotensin II regulates insulin-like growth factor I gene expression in vascular
      smooth muscle cells.
AB  - The potent vasoconstrictor peptide angiotensin II (ang II) has been shown to
      promote growth of vascular smooth muscle cells (VSMC) in vitro and in vivo. We
      have previously demonstrated that VSMC synthesize insulin-like growth factor I
      (IGF I), an important autocrine/paracrine growth factor. Exposure of quiescent
      VSMC to ang II caused a marked increase in IGF I mRNA levels, peaking at 6 h (199
      +/- 26% above control) and sustained for at least 24 h. This increase was
      completely inhibited by actinomycin D. Nuclear run-on assays indicated that ang
      II stimulated IGF I gene transcription 3.6-fold. Protein synthesis inhibition
      with cycloheximide increased basal IGF I mRNA levels but blocked ang II-induced
      IGF I expression. Immunoreactive IGF I levels in VSMC-conditioned medium were
      increased by 2.7-fold 24 h following ang II exposure. Measurements of
      [3H]thymidine incorporation showed that ang II caused a 117% increase in DNA
      synthesis at 24 h that was almost completely inhibited in the presence of an anti
      IGF I antibody. Thus, ang II regulates transcription of the IGF I gene in VSMC
      and IGF I is required for ang II-induced DNA synthesis. These findings suggest a
      potentially important role for IGF I as a mediator of the vascular growth
      responses induced by activation of the renin-angiotensin system in vivo.

PMID- 8344967
TI  - Long term follow-up of Mitroflow pericardial valve prostheses in the small aortic
      annulus.
AB  - Between January 1985 and April 1992 we implanted 477 Mitroflow pericardial
      bioprostheses in 476 patients in our clinic. All except one valve prostheses were
      implanted in the aortic position. There were 160 male and 316 female patients,
      with a mean age of 74.1 years (range 30-89 years). Combined cardiac procedures
      were performed concomitantly with aortic valve replacement in 45 patients (9.5%):
      coronary artery revascularisation (n = 38), endarterectomy of the internal
      carotid artery (n = 4) and multiple valve replacement (n = 3). The sizes of the
      implanted Mitroflow prostheses were 100% in 19 mm, 70% in 21 mm, 60% in 23 mm and
      8% in more than 25 mm. The hospital mortality was 1.3% (n = 5). During the mean
      follow-up period of 47.6 months valve failure requiring reoperation occurred in 7
      patients (1.2%). The actuarial freedom from tissue failure is 89.9 +/- 2.5% and
      the actuarial survival rate is 90.3 +/- 1.7% (27 deaths) at 7 years. These
      findings corroborate our policy to continue to implant a pericardial prosthesis
      in the aortic position, especially in elderly patients with a smaller aortic
      annulus.

PMID- 8344968
TI  - Doppler echocardiographic evaluation of the Omnicarbon cardiac valve prostheses.
AB  - Comprehensive 2 D/Doppler examination of 98 patients (mean age 56), implanted
      between September 1984 and February 1991, with normally functioning aortic (n =
      49) and mitral (n = 49) Omnicarbon valves (OC) were analyzed in order to
      characterize the normal hemodynamic profiles of the OC valves. The mean time from
      implantation was 36.4 months (range 6 to 78). The following parameters were
      assessed (average of 5 measurements): peak transvalvular velocity (peak V), peak
      instantaneous gradient (peak G), mean transvalvular gradient (mean G), effective
      aortic valve area (ef Va), modified aortic valve area (m Va), aortic permeability
      index (PI), mitral valve area (Mit Va). Doppler data were correlated to
      prosthetic sizes (ranging from 21-29 mm for aortic OC and from 23-31 mm for
      mitral OC). The study establishes normal Doppler hemodynamics for each size
      (especially in aortic position) of OC valves and shows excellent performance.
      Significant correlations between peak G, mean G, Pl, and prosthetic aortic valve
      size (AS) were moderate. By contrast there were strong relationships between AS
      and ef Va (r = 0.56, p < 0.001) or mVa (r = 0.55, p < 0.001). These data should
      be helpful to identify OC prosthetic dysfunction.

PMID- 8344969
TI  - Criteria to select proper valve prosthesis for aortic valve replacement.
      Comparative assessment of various valve prostheses via continuous wave Doppler
      echocardiography.
AB  - Continuous wave Doppler echocardiography was used to measure pressure gradients
      (PG) across various aortic valve prostheses [St. Jude Medical (SJM) valve: 55
      cases; Bjork-Shiley (B-S) valve: 18 cases; Lillehei-Kaster (L-K) valve: 25 cases;
      and Omniscience (O-S) valve: 49 cases]. Disc-opening angles of the L-K and O-S
      valves were measured via cineradiography. Pressure gradient across the SJM valve
      tended to be low. Increase in pressure gradients during exercise tended to be
      greater in the small valves. There was a significant correlation between the
      valve area index (VAI) and pressure gradients in the SJM valve (PG = 85.3-40.2 x
      VAI, r = -0.71, p < 0.005) and in the B-S valve (PG = 64.6-23.3 x VAI, r = -0.89,
      p < 0.025). To keep pressure gradients below 20 mmHg, SJM valve #23 and B-S valve
      #25 should be selected for patients with a body surface area of 1.3-1.7 m2. In
      the L-K and O-S valves, there was no significant correlation between VAI and PG,
      likely because the disc-opening angles of these valves were suboptimal--averaging
      57 degrees in the L-K valve and 47 degrees in the O-S valve. None of the patients
      with SJM or B-S valves had pressure gradients of 50 mmHg or above. However,
      pressure gradients exceeded 50 mmHg in 7 cases with the L-K valve (28%) and 10
      with the O-S valve (20%), suggesting the necessity of careful follow-up in
      patients with these prostheses.

PMID- 8344970
TI  - Detection of internal carotid artery stenosis. Comparison of 2D-MR angiography,
      duplex scanning, and arteriography.
AB  - The purpose of this study was to compare digital subtraction angiography (DSA)
      and duplex scanning with 2D-Magnetic Resonance Angiography (MRA) to evaluate the
      accuracy of MRA in determining carotid stenosis. All three methods were applied
      to 101 carotid arteries in 51 patients. Diameter stenosis of the internal carotid
      artery was categorized as follows: 0 to 39%, 40% to 59%, 60% to 94%, 95% to 99%,
      and occlusion (100%). All images were read in blind fashion by different
      physicians. DSA is still considered the "gold standard" investigation. In 78
      arteries the degree of stenosis according to MRA correlated exactly with that of
      conventional angiography. In the remaining 23, carotid arteries MRA upgraded the
      stenosis in 13 and downgraded it in 8. The principal problem is the
      overestimation of the lesion, which was particularly revealing in lesions of more
      than 60%. Furthermore to date MRA is not able to evaluate the presence of
      ulceration. For this reason 2D-MRA alone is not a reliable method for evaluating
      the presence of carotid artery stenosis.

PMID- 8344972
TI  - Splanchnic artery aneurysms.
AB  - From 1970 to October 1991, 26 patients affected by splanchnic artery aneurysms
      were observed and treated at the Department of General and Cardiovascular
      Surgery, University of Milan, Italy. Three splanchnic artery aneurysms were
      operated on in emergency. Visceral artery aneurysms are often completely silent
      and are generally detected during diagnostic procedures performed in order to
      clarify some diagnostic questions. When symptomatic they present a characteristic
      clinical picture of the involved vascular district. Two patients affected by
      aneurysmal disease of the proper hepatic artery died after operation. All the
      other splanchnic aneurysms underwent a successful surgical procedure. This study
      is aimed at analyzing some characteristic clinical pictures, diagnostic methods,
      therapeutic procedures and postoperative results.

PMID- 8344971
TI  - Emergency myocardial revascularization for myocardial infarction evolving outside
      the hospital. A feasible option when thrombolysis and coronary angioplasty have
      failed.
AB  - Most reports on emergency coronary revascularization deal with failed
      percutaneous transluminal coronary angioplasty (PTCA) or refractory ischemia
      which developed after hospital admission. The objective of this study was to
      evaluate the feasibility and prognosis of emergency revascularization for acute
      myocardial infarction evolving outside the hospital. Between 1974 and 1992 54
      cases were included in this study. The patients had both electrocardiographic and
      clinical evidence of ongoing ischemia. One or more infarct-related obstructed
      coronary arteries were documented by emergency angiography. Since 1981, the
      patients have been given urokinase, and, since 1986, they have undergone PTCA
      initially and, when reperfusion failed, revascularization was started. Overall in
      hospital mortality has been 11.1% (6/54). All other patients were discharged in
      satisfactory condition. Follow-up for periods of up to nearly twenty years has
      been uneventful with the exception of two late sudden deaths. The above results
      confirm that emergency coronary revascularization is a therapeutical option worth
      considering.

PMID- 8344973
TI  - Lower extremity revascularization.
AB  - Atherosclerotic occlusive disease of the lower extremity in patients exhibiting
      severe rest pain, ulceration, or tissue necrosis represents a serious threat to
      extremities. In the past two decades the surgical approach in the treatment of
      lower extremity ischemia has changed significantly due to better understanding of
      segmental disease and infrapopliteal disease. Also, better visualization of leg
      and foot arteries due to improved angiographic and surgical techniques aided by
      magnification have all significantly contributed to increased limb salvage. Vein,
      when available, is the ideal graft material both for supra and infrapopliteal
      reconstruction. Availability of vein as a conduit can be increased when ectopic
      veins such as cephalic etc., are used and also when short segments of veins are
      used with unconventional distal inflow sites such as SFA, distal deep femoral
      artery, and popliteal artery. However, when vein is unavailable, PTFE graft is a
      good option particularly in patients with life expectancy of less than three
      years. Better understanding of graft failure has lead to better graft
      surveillance with PVR, ABI and Duplex scanning. Timely intervention with either
      PTA or surgery has lead to better secondary patency of grafts. Veith et al.
      looked at amputation rates during the period of changing therapeutic approach and
      found both a decrease in primary and secondary amputation rate implying the
      effectiveness of an aggressive therapeutic approach. Not all aspects of lower
      extremity disease are understood. However, infrapopliteal disease has now been
      addressed and new, innovative therapeutic approaches have made significant
      advances in limb salvage.

PMID- 8344974
TI  - Changing trends in the outcome of urgent aneurysms surgery. A retrospective study
      on 170 patients treated in the years 1966-1990.
AB  - During the last 25 years 170 patients with ruptured aortic aneurysms were treated
      in our centre for vascular surgery with an overall mortality of 54%. We have
      subdivided these patients into three groups according to temporal factors: the
      1st group includes 16 patients treated in the years 1966-1978; the 2nd group
      includes 93 patients treated from 1979 to 1987; the 3rd group includes patients
      from 1988 to 1990. In these years no selection of patients was made and everybody
      still alive was operated on. Starting from the second period, haemodynamical
      monitoring of the patients was performed with the adoption of the Swan-Ganz
      catheter in almost all cases. Mortality in the first period was 69%, in the
      second period 60% and in the third period 40%. There was no difference in the
      haemodynamical state in the three groups. The difference lies in the number of
      surgical interventions per year: 1.33 intervention per year in the first period;
      11.625 interventions per year in the second period and 20 in the third. We
      conclude that an improvement in the survival rate of patients undergoing urgent
      aortic aneurysm repair is due to precise haemodynamical intraoperative monitoring
      and a well trained surgical team.

PMID- 8344975
TI  - Preoperative evaluation of inferior vena cava involvement secondary to malignant
      abdominal neoplasms.
AB  - The authors report their experience of different imaging techniques (US, CT, MRI,
      and cavography) used to evaluate inferior vena cava involvement due to abdominal
      malignant neoplasms. The study is a retrospective analysis of preoperative data
      on 15 patients of both sexes in comparison with intraoperative and/or
      pathological findings. All patients underwent ultrasonography, with good results
      in all the venous segments studied, as for the CT scan; the limitation of both
      techniques is the unsafe evaluation of venous wall involvement when the
      neoplastic tissue is confined inside the vessel. The results obtained using MRI
      seem to be very encouraging, but we only studied three cases with this technique,
      and so cannot assess the real value of the method. In nine patients we performed
      inferior cava phlebography: we believe this to be a very reliable exam to
      demonstrate vessel wall invasion, even if it is a very invasive procedure, its
      limits being the inability to observe proximal thrombotic extension when the vein
      is completely obstructed by the tumor. On the basis of their experience the
      authors suggest a multi-technique imaging diagnostic procedure for preoperative
      staging with a view to obtaining as much information as possible to correctly
      program surgical procedure.

PMID- 8344976
TI  - New-style Univent with a light source on the blocker.
AB  - The author has introduced a new-style "endotracheal tube with a movable blocker"
      which has a transillumination light source on the front-most portion of the
      blocker. This device may obviate the need for bronchoscopic guidance of the
      blocker.

PMID- 8344977
TI  - Unilateral upper extremity edema. A case report.
AB  - A case report of a 28-year-old Hispanic male with a 5-month history of left arm,
      face and supraclavicular edema is presented. Chest radiography revealed bilateral
      pleural effusions. Thoracentesis was negative for malignant cells. Left arm
      venogram demonstrated compression of the left subclavian vein and lymphangiogram
      was consistent with perilymphatic stasis. Computerized tomography and magnetic
      resonance imaging demonstrated a questionable mass in the left side of the neck.
      On exploration of the left supraclavicular fossa, a severely fibrotic thoracic
      duct was encountered as well as a prominent scalene lymph node. Pathological
      section revealed an adenocarcinoma in both specimens which was positive for
      keratin and carcinoembryonic antigen. Chemotherapy was begun, however, the
      patient died 3 months later secondary to a respiratory arrest. This presentation
      of an adenocarcinoma arising from an unknown gastrointestinal source is unusual.
      A search should be made to locate the primary site. Prognosis is unclear but
      presumed poor due to the rarity of this presentation.

PMID- 8344978
TI  - Percutaneous aspiration embolectomy.
AB  - Percutaneous aspiration thromboembolectomy (PAT) for management of a spontaneous
      arterial embolus, or following a complication of balloon angioplasty, was
      initially described in 1984. Instrument developments using a new clot aspiration
      system have facilitated this procedure. We report a case where PAT was successful
      in retrieving a spontaneous arterial embolus, and describe this new technique. We
      feel that PAT broadens the armamentarium of the vascular surgeon in the
      management of emboli to the distal circulation, where the results for operative
      embolectomy are frequently less than ideal.

PMID- 8344979
TI  - Tissue-type plasminogen activator (t-PA) lysis of aortic and mitral valve
      thrombosis.
AB  - Valve thrombosis is one of the most serious complications after prosthetic valve
      replacement. We report the use of tissue-type plasminogen activator (t-PA) in the
      treatment of a patient with thrombosed aortic and mitral valves. Thrombolysis
      resulted in immediate hemodynamic improvement and resolution of congestive heart
      failure, thereby avoiding surgical intervention. Based on our experience,
      thrombolysis with t-PA is an effective alternative in the treatment of thrombosed
      prosthetic valves.

PMID- 8344980
TI  - Creatine-kinase isoenzyme pattern in colonic infarction consequent to acute
      aortic dissection. A case report.
AB  - Bowel infarction can complicate acute aortic dissection (AAD); in that case early
      diagnosis, which decreases the high mortality, is often difficult. We report the
      case of one patient who underwent surgery for AAD and developed a colonic
      infarction, which was clinically manifest on the 4th postoperative day. However,
      bowel ischemia was suspected already 48 hours after surgery, on the basis of the
      suggestive CK pattern and the absence of myoglobin in plasma. Total CK activity
      reached the highest level only 48 hours after surgery (92,800 U/l); the peak was
      coincident with LDH, which increased proportionally less; CK-MM constituted 100%
      of total CK activity. The absence of myoglobin in plasma excluded the presence of
      rhabdomyolysis. We conclude that such laboratory findings suggest the occurrence
      of severe bowel ischemia.

PMID- 8344981
TI  - The reconstruction of major femoral vessels in a four-year-old girl wounded with
      shrapnel.
AB  - A four-year-old girl who sustained an explosive injury to the femoral artery and
      vein underwent vascular reconstruction. An allograft was used as a substitute
      conduit for both the artery and the vein. Eight months after reconstruction there
      was no pulse deficit and decrease in systolic blood pressure, nor were there any
      signs of venous obstruction.

PMID- 8344982
TI  - Type IV collagenase(s) and TIMPs modulate endothelial cell morphogenesis in
      vitro.
AB  - It has been proposed that proteases are important in endothelial cell behavior.
      We examined the contribution of the gelatinase/type IV collagenase system in an
      in vitro model of endothelial differentiation. Human umbilical vein endothelial
      cells rapidly align and form networks of tubes when cultured on a basement
      membrane preparation, Matrigel. Zymograms of culture supernates demonstrate a 72
      kD and a 92-kD gelatinase activity; the cells produce most of the 72-kD
      gelatinase, whereas the 92-kD activity is derived entirely from the Matrigel.
      Addition of antibodies against type IV gelatinase/collagenase decreases the area
      of the tube network. Both tissue inhibitors of metalloproteinases, TIMP-1 and
      TIMP-2, similarly decrease tube formation when added to cultures. Conversely,
      exogenous recombinant 72-kD gelatinase increases tube-forming activity. The
      effects of the anti-gelatinase antibodies and the TIMPs are not additive.
      Inhibition by either antibodies or TIMPs is greatest when they are added at
      culture initiation, suggesting that the protease activity is important in the
      early steps of morphogenesis. However, culture of the cells on Matrigel does not
      increase early expression of mRNA for the 72-kD gelatinase. Expression of message
      for the enzyme actually decreases during the course of the assay, while
      transcription of mRNAs for TIMPs increases, further supporting the concept that
      collagenases facilitate an early event in tube formation. These data demonstrate
      that gelatinase/type IV collagenase activity is important in endothelial cell
      morphogenesis on Matrigel, and suggest a role for collagenases in formation of
      new capillaries in vivo.

PMID- 8344983
TI  - Secretion of transforming growth factor-beta isoforms by embryonic stem cells:
      isoform and latency are dependent on direction of differentiation.
AB  - Murine embryonic stem (ES) cells are maintained in an undifferentiated state when
      cultured in medium conditioned by Buffalo rat liver (BRL) cells. BRL conditioned
      medium (CM) contains a differentiation inhibitory activity (DIA) that is
      synonymous with leukemia inhibitory factor (LIF). ES cells in monolayer culture
      can be induced to differentiate by addition of all-trans retinoic acid (RA) to
      the BRL CM, when they mainly form cells resembling parietal endoderm, or by
      culture in medium not conditioned by BRL cells. ES cells thus deprived of LIF/DIA
      differentiate spontaneously to a cell type that expresses Brachyury (T), a marker
      of early mesoderm. Northern blot analyses have shown previously that transcripts
      for transforming growth factor beta 1 (TGF-beta 1) are detected in
      undifferentiated cells while transcripts for TGF-beta 2 and TGF-beta 3 only
      become detectable after differentiation. We have now determined levels of TGF
      beta protein in CM and in the extracellular matrix (ECM) and have used
      neutralizing antibodies specific for TGF-beta 1 and TGF-beta 2 that do not react
      with recombinant human TGF-beta 3 to determine the isoform secreted. Using the
      growth inhibition of mink lung CCL64 cells as a bioassay for TGF-beta activity,
      we demonstrate that undifferentiated ES cells secrete latent TGF-beta 1 into the
      medium but no activity is found in their ECM. Cells induced to differentiate with
      RA contain TGF-beta 2 in both active and latent forms in their CM. Likewise their
      ECM contains TGF-beta 2 as the sole isoform. ES cells deprived of LIF/DIA secrete
      both TGF-beta 1 and TGF-beta 2 isoforms in their CM but TGF-beta-like activity
      remains after addition of neutralizing antibodies for TGF-beta 1 and TGF-beta 2.
      This active TGF beta is the major component of the TGF-beta activity in this CM.
      By contrast, ECM from LIF/DIA deprived cells contains only the TGF-beta 1 and
      beta 2 isoforms. The remaining activity in CM correlates with high expression of
      TGF-beta 3 by Northern blot analysis in these cells. We speculate that TGF-beta 3
      is secreted by these cells and may be activated more efficiently and/or in a
      different manner to TGF-beta 1 and TGF-beta 2, since it is present in CM only in
      its active form.

PMID- 8344985
TI  - Transforming growth factor beta 1 selectively regulates ornithine decarboxylase
      gene expression in malignant H-ras transformed fibrosarcoma cell lines.
AB  - Negative growth regulators such as the transforming growth factor beta (TGF-beta)
      family appear to be important inhibitors in most tissue types. However,
      inhibition of DNA synthesis and cell proliferation is frequently lost during
      malignant transformation, and in some cases, tumor cell proliferation is actually
      stimulated by TGF-beta. The present study demonstrates a novel link between
      alterations in TGF-beta regulation during malignant conversion, and the
      expression of ornithine decarboxylase, a key rate-limiting activity in the
      biosynthesis of polyamines, and an enzyme that plays an important role in cell
      growth and differentiation. A panel of radiation and H-ras transformed mouse
      10T1/2 cell lines exhibiting increasing malignant potential was investigated for
      possible TGF-beta 1 mediated changes in ornithine decarboxylase gene expression.
      Selective induction of gene expression was observed since only H-ras transformed
      cell lines with malignant potential exhibited marked elevations in ornithine
      decarboxylase message levels. Ornithine decarboxylase gene expression in
      nontransformed 10T1/2 cells and cell lines capable of only benign tumor formation
      was unaffected by TGF-beta 1 treatment. H-ras transformed cells were transfected
      with a plasmid placing the TGF-beta 1 coding region under the control of a zinc
      sensitive metallothionein promoter. When these cells were cultured in the
      presence of zinc an elevation of TGF-beta 1 mRNA was observed within 30 min. This
      increase in TGF-beta 1 message closely coincided with an elevation in ornithine
      decarboxylase message, and preceded an induction of jun-B, an early response gene
      in cells sensitive to TGF-beta 1 stimulation. Evidence for regulation of
      ornithine decarboxylase gene expression by TGF-beta 1 at both transcription and
      posttranscription was found. Actinomycin D pretreatment of malignant cells prior
      to TGF-beta 1 exposure prevented the increase in ornithine decarboxylase message.
      Marked differences in the rates of ornithine decarboxylase message decay were
      observed when cells treated with TGF-beta 1 were compared to untreated controls,
      with the half-life of ornithine decarboxylase mRNA increasing from 2.5 h in
      untreated cells to 17.5 h in cells exposed to TGF-beta 1. In addition, evidence
      was obtained for a cycloheximide sensitive regulator of ornithine decarboxylase
      gene expression, since the presence of this protein synthesis inhibitor increased
      the levels of ornithine decarboxylase message, and this effect was
      synergistically augmented by exposure of cells to cycloheximide and induction of
      TGF-beta 1 gene expression together.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8344984
TI  - Modulation of myogenic determination factor 1 expression by cell-cell contact.
AB  - Myogenic determination factor 1 (MyoD1) expression is modulated by a variety of
      agents including growth factors and activated cellular proto-oncogenes. However,
      little is known about the effect of cell-cell contact, which increases as
      myoblasts terminally differentiate, on the control of MyoD1 expression. Steady
      state levels of MyoD1 transcripts decline over a 6-12 hour time period when
      myoblasts plated at a single cell density are incubated in media supplemented
      with 0.2% serum; by 48 hours MyoD1 mRNA levels have returned to the initial basal
      level. The decline in MyoD1 transcripts is diminished, but not prevented in
      myoblasts which maintain cell-cell contacts (at least 50% of cells with two or
      more sites of contact). MyoD1 transcript levels do not change if single cell
      cultures are maintained in 10% serum or are cocultured with fibroblasts. Analysis
      of conditioned media revealed that myoblasts plated at the single cell density or
      at a density which allowed multiple sites of cell-cell contact are not producing
      an activity(s) responsible for modulating MyoD1 mRNA levels. The changes in MyoD1
      expression are mediated at the transcriptional level. Thus changes in the degree
      of cell-cell contact in cultures of myogenically determined cell lines effect
      changes in MyoD1 gene expression. Consequently when the influence of cytokines or
      other pharmacological agents on commitment to terminal myogenic differentiation
      is examined, the degree of cell-cell contact within the culture system may affect
      the response elicited.

PMID- 8344986
TI  - Transferrin is made and bound by photoreceptor cells.
AB  - Retinal pigment epithelial cells, which form one aspect of the blood-retinal
      barrier, control the access of blood-borne components such as diferric
      transferrin to the neural retina. It has recently been shown that RPE cells
      remove iron from diferric transferrin in a low pH compartment and subsequently
      release it in a low molecular weight form that can be chelated by apo-transferrin
      (Hunt and Davis: J. Cell Physiol. 152:102-110, 1992). It is now shown that
      photoreceptor cells can bind diferric transferrin to receptors on their inner
      segments. Moreover, polymerase chain reaction and in situ hybridization show that
      cells of the neural retina, particularly photoreceptors, make apo-transferrin.

PMID- 8344988
TI  - Microtubules are involved in transport of macromolecules by vesicles in cultured
      bovine aortic endothelial cells.
AB  - The macromolecular transport in bovine aortic endothelial monolayers, cultured in
      vitro, was studied by fluorescence microscopy, confocal laser scanning
      microscopy, and transmission electron microscopy. A fluid-phase endocytic tracer,
      fluorescein isothiocyanate dextran 70 kD (FITC-dextran 70), was found to be
      transported into and out of endothelial cells via vesicles arranged as chains
      stretching between the luminal surface and the cell interior and also from cell
      interior to the abluminal surface. The endocytic activity was reduced by
      colchicine, which disrupts microtubules, and increased during treatment with
      cytochalasin B, which blocks microfilament polymerization. These findings
      indicate that microtubules are required for fluid-phase endocytosis and that
      microfilaments hinder this process.

PMID- 8344987
TI  - Effect of pH and ATP on the equilibrium density of lysosomes.
AB  - Lysosomes are membrane bound structures that accumulate and hydrolyze material
      internalized by the endocytic pathway. A very conspicuous property of this
      subcellular compartment is its relatively high equilibrium density. The actual
      mechanism that regulates lysosomal density is poorly understood. In an attempt to
      gain knowledge on the factors that regulate lysosomal density we have assessed
      the equilibrium density of lysosomal markers after in vitro incubation of a
      lysosome-enriched subcellular fraction. Incubation at pH 6 for 10 min at 37
      degrees C causes a density shift of several lysosomal markers to light density
      regions of Percoll gradients. Addition of ATP was able to prevent the acid
      induced density shift. Pretreatment of the vesicles with N-ethylmaleimide (NEM)
      or trypsin inhibited the effect of ATP. Working in intact cells, ATP depletion, a
      condition that causes cytoplasmic acidification, also decreases lysosomal
      density. The results indicate that at low pH lysosomal density is preserved by an
      active process that requires ATP and membrane associated proteins.

PMID- 8344989
TI  - Interaction of facilitative glucose transporter with glucokinase and its
      modulation by ADP and glucose-6-phosphate.
AB  - Bacterial glucokinase (GK) binds to purified, human erythrocyte glucose
      transporter (GT) reconstituted in vesicles. The binding is largely abolished if
      GT is predigested with trypsin, indicating that GK binds to the cytoplasmic
      domain of GT. The binding is a saturable function of GK concentration showing two
      distinct affinities with apparent KD of 0.33 and 5.1 microM. The binding is
      stimulated by an increasing concentration of ADP with the 50% maximal effect at 5
      mM. Glucose-6-phosphate (G6P) also stimulates the binding with a distinct optimum
      at 25 mM. The binding is stimulated only slightly by ATP. D-glucose has no affect
      on the binding. KCl enhances the binding with the maximal effect at physiological
      intracellular concentrations. The binding is sensitive to changes in pH with an
      optimum at pH 4. The binding causes no detectable functional change in GT.
      However, the enzymatic activity of GK measured at nanomolar concentrations of GK
      is significantly greater in the presence of GT vesicles than in its absence or in
      the presence of protein-free vesicles, indicating that GK interacts with GT at
      this low concentration range with an apparent KD of 10 mM. Although its
      physiological significance is not known, the GK-GT interaction in vitro described
      here suggests that these two proteins may also interact in the cell and regulate
      carbohydrate metabolism.

PMID- 8344990
TI  - Activation of potassium channels by hypoxia and reoxygenation in the human lung
      adenocarcinoma cell line A549.
AB  - Active oxygen species are generated in cells during pathophysiologic conditions
      such as inflammation and postischemic reperfusion. If oxygen radical scavengers
      are added before reperfusion, then the magnitude of injury is reduced. We
      investigated whether free radicals generated following exposure to hypoxia and
      reoxygenation activate voltage-dependent K+ ion channels in tumor cells in vitro.
      Using the technique of whole cell voltage clamping, we recorded currents from two
      families of potassium (K+) channels that were activated following reoxygenation.
      One of these groups possessed the electrophysical characteristics of a
      tetraethylammonium (TEA)-sensitive delayed rectifier channel and the other
      possessed characteristics of a Tea-insensitive slow inactivating channel. We
      present evidence which suggests that K+ channels are activated following
      reoxygenation but not during the hypoxia phase. The K+ currents decayed with time
      following reoxygenation. The decay characteristics of the K+ currents depended on
      the duration and level of hypoxia to which the cells were exposed. To determine
      whether activation of K+ channels by reoxygenation was initiated by free
      radicals, we pretreated cells with N-Acetyl L-Cysteine (NAC), a free radical
      scavenger, and found that this pretreatment abolished the currents induced by
      reoxygenation. We also present evidence that free radicals do not directly act on
      the channel itself, but activate a protein kinase which, in turn, activates the
      K+ channels. Taken together, these results indicate that one of the early
      responses to oxidative stress is the activation of K+ currents.

PMID- 8344991
TI  - Modulation of the immunophenotype of ovarian cancer cells by N,N
      dimethylformamide and transforming growth factor-beta 1.
AB  - Exposure of HOC-7 ovarian adenocarcinoma cells to regulators of cell
      differentiation caused inducer-dependent alterations of the antigenic pattern of
      the cells. Immunocytochemistry revealed that N,N-dimethylformamide (DMF) elevated
      the membrane staining for epidermal growth factor (EGF)-receptor and for
      desmoplakins I and II. DMF also stimulated cytoplasmic and surface labeling for
      CA 125 and the deposition of fibronectin into the extracellular matrix.
      Stimulation of fibronectin was also seen after addition of transforming growth
      factor (TGF)-beta 1. These responses were quantified using a fixed-cell, enzyme
      linked immunosorbent assay (ELISA) and revealed that DMF dose-dependently induced
      expression of EGF-receptor, CA 125, fibronectin, and desmoplakins I and II. TGF
      beta 1 stimulated fibronectin and desmoplakins I and II only. Production of EGF
      and TGF-alpha was not affected by these inducers. Immunocytochemistry, ELISA and
      Western blotting showed that both inducers caused down-regulation of myc
      oncoproteins. DMF was more effective in changing the immunophenotype of HOC-7
      cells than TGF-beta 1. Desmoplakins I and II demonstrated elevated epithelial
      differentiation, whereas fibronectin indicated stimulation of extracellular
      matrix formation. Elevated EGF-receptor could not compensate for the growth
      inhibition induced by DMF. The expression of myc oncoproteins was inversely
      related to cell proliferation. CA 125, however, seems to be unrelated to cell
      growth.

PMID- 8344992
TI  - Estrogen enhances epidermal growth factor-induced DNA synthesis in mammary
      epithelial cells.
AB  - Estradiol (E2) priming (1 nM for 48 h) of normal murine mammary gland epithelial
      cells significantly increased the response of those cells to epidermal growth
      factor (EGF)-induced DNA synthesis. The synergism between E2 and EGF was evident
      in two aspects: After serum-free synchronization for 24 h, more cells entered the
      S-phase of the cell cycle after E2 priming and when treated with 0.17 nM EGF
      (13%) than did control cells (1.3%) or cells treated with EGF (4%) or E2 (3.5%)
      alone; further, the dose of EGF required to elicit maximal response was reduced
      an order of magnitude in estrogen-primed cells (0.17 nM) compared to controls
      (1.7 mM). Estrogen alone, however, did not increase DNA synthesis in these cells.
      Ligand binding studies indicate that these effects of estrogen on proliferating
      mammary epithelial cells may be explained, at least in part, by a 3.7-fold
      increase in the number of high affinity EGF-receptors observed in estrogen primed
      cells (7,300 receptors per cell) compared to estrogen deprived cells (1,960
      receptors/cell).

PMID- 8344993
TI  - Intracellular calcium oscillations induced in a T-cell line by a weak 50 Hz
      magnetic field.
AB  - Applied weak magnetic fields have been shown to affect cellular activity on
      several levels, but the mechanisms involved remain elusive. We have decided to
      study an early signal transduction event in the human T cell line Jurkat;
      oscillations of free [Ca2+]i, of the type seen by crosslinking the CD3 complex.
      Cells were exposed to a 50 Hz, 0.1 mT, sinusoidal magnetic field while
      intracellular free calcium was measured in individual cells, using fura-2 as a
      probe. An acute response was observed with oscillatory increases in [Ca2+]i,
      which subsided when the field was turned off. The effect of the magnetic field on
      [Ca2+]i was comparable to that achieved by an anti-CD3 monoclonal antibody.

PMID- 8344994
TI  - Adhesion molecules in skeletogenesis: II. Neural cell adhesion molecules mediate
      precartilaginous mesenchymal condensations and enhance chondrogenesis.
AB  - Neural cell adhesion molecules (NCAM) was expressed transiently by mesenchymal
      cells in precartilaginous condensations of the embryonic chicken limb but was
      lost upon differentiation into cartilage. Consequently, NCAM was present in the
      periphery of the limb anlagen but was absent in the cartilaginous center of the
      growing limb. To determine NCAM function in limb bud chondrogenesis we incubated
      dissociated stage 22/23 distal mesenchymal limb bud cells with Fab' fragments of
      antibodies to NCAM. Cell aggregation was inhibited by incubating the cells with
      anti-NCAM Fab'. These results suggest that NCAM may mediate the formation of
      precartilaginous condensations. This hypothesis was further tested using
      micromass cultures. NCAM expression in micromass cultures in vitro recapitulated
      that in vivo. NCAM was enriched in condensations of 2 day cultures, but was
      diminished and concentrically distributed around cartilage nodules in 4 day
      cultures. Anti-NCAM Fab' fragments reduced the area occupied by precartilaginous
      condensations and the degree of chondrogenic differentiation. Control antibody
      against chicken embryo fibroblasts had no effect. The effect of overexpressing
      NCAM was analyzed by electroporating expression vectors directing the synthesis
      of chicken NCAM. Limb bud cells cultured after electroporation with an NCAM
      expression vector displayed larger cartilage nodules and greater chondrogenic
      differentiation than cells electroporated with vector alone. The expression of
      NCAM in electroporated cells also increased. Control experiments using plasmids
      encoding beta-galactosidase indicated that approximately 10% of the limb bud
      cells were transfected under these conditions. The results suggest that NCAM is
      involved in the chondrogenesis pathway by mediating the formation of
      precartilaginous condensations.

PMID- 8344995
TI  - Investigation of possible autocrine functions for rat GRO/CINC (cytokine-induced
      neutrophil chemoattractant).
AB  - Rat cytokine-induced neutrophil chemoattractant (CINC) is an eight kilodalton
      polypeptide originally purified from media conditioned by interleukin-1 beta
      stimulated 52E, an epithelioid clone derived from normal rat kidney (NRK) cells.
      Using a fibroblastic clone of the NRK cells, 49F, we found expression of the CINC
      gene to be induced by either serum or cytokines in growth-arrested cultures
      within 1 hour of stimulation. There was no observable CINC expression in
      exponentially growing cells in the absence of cytokine stimulation. CINC protein
      had no significant effect on 3H-thymidine incorporation or growth rate of NRK49F.
      We have observed that CINC is constitutively produced by some transformed NRK
      cells, clone RC20, suggesting an association with the expression of a transformed
      phenotype. Unlike the parent 49F, RC20 cells are capable of growth in soft agar
      and serum-free media and form highly metastatic tumors in nude mice. We have
      examined the possible autocrine functions of CINC and its possible links to the
      expression of the transformed phenotype by these cells. The use of a blocking
      CINC polyclonal antibody demonstrated that CINC did not function as an autocrine
      growth factor for RC20. Though CINC is a potent chemoattractant for neutrophils,
      it did not induce migration of either RC20 or 49F cells. CINC only moderately
      promoted adhesion of RC20 cells when used as a matrix protein. These data do not
      support the hypothesis that production of CINC by the RC20 cells provides an
      obvious advantage for the transformed cells constitutively producing it.

PMID- 8344996
TI  - High-level expression of cytokine-induced neutrophil chemoattractant (CINC) by a
      metastatic rat cell line: purification and production of blocking antibodies.
AB  - Significant levels of cytokine-induced neutrophil chemoattractant (CINC) were
      found in serum-free medium conditioned by a highly metastatic rat cell line,
      RC20. To study CINC's role in inflammation and metastasis, CINC was purified from
      this source for use in in vitro assays and for antibody production in goats and
      rabbits. CINC was a potent chemoattractant for rat neutrophils (EC-50 0.5 nM). A
      fusion protein of glutathione-S-transferase and CINC (GST-CINC) was produced in
      E. coli. Anti-CINC polyclonal IgG was purified from immune goat and rabbit sera
      by protein A and GST-CINC affinity chromatography. Both goat and rabbit anti-CINC
      antibody preparations at 4 micrograms/mL (an 11-fold molar excess) were found to
      completely block the activity of 2.5 nM CINC in a rat neutrophil chemotaxis
      assay. These antibodies have been used to develop a sensitive immunoassay for
      CINC. The availability of large amounts of affinity-purified blocking anti-CINC
      antibody will allow investigations into the role played by CINC in rodent
      inflammation models and in the metastasis of RC20 cells.

PMID- 8344998
TI  - Pharmaceutical care: desiderata.

PMID- 8344997
TI  - Deposition of reactive oxygen metabolites onto and within living tumor cells
      during neutrophil-mediated antibody-dependent cellular cytotoxicity.
AB  - In this study we test the hypothesis that reactive oxygen metabolites are
      delivered from neutrophils to simultaneously both the cell surface and cytosol of
      opsonized YAC erythroleukemic target cells. Using 5' (or 6') carboxyl-2',7'
      dichlorodihydrofluorescein (H2-CDCF) diacetate as starting material, we
      synthesized its succinimidyl ester derivative. H2-CDCF-conjugated IgG prepared
      from the succinimidyl ester derivative was used to opsonize targets. In vitro
      studies have shown that H2-CDCF becomes fluorescent upon exposure to reactive
      oxygen metabolites, including hydrogen peroxide. Using video intensified
      epifluorescence microscopy, we observed that reactive oxygen metabolites are
      deposited on tumor cell membranes during neutrophil-mediated antibody-dependent
      cellular cytotoxicity (ADCC). This deposition process is catalase sensitive. The
      role of reactive oxygen metabolites produced by neutrophils in triggering the
      oxidation of H2-CDCF is further supported by the observation that neutrophils
      from chronic granulomatous disease (CGD) patients did not affect target
      fluorescence. YAC tumor cells were also labeled with dihydrorhodamine 123 or
      dihydrotetramethylrosamine. The oxidized forms of these reagents were found
      within the cytoplasm of YAC cells. During ADCC normal neutrophils, but not
      neutrophils obtained from CGD patients, triggered the oxidation of
      dihydrorhodamine 123 and dihydrotetramethylrosamine within tumor cells. Using two
      color automated epifluorescence microscopy, we could not detect temporal
      intermediates with fluorescence in only one compartment, i.e., either solely on
      the plasma membrane or in the cytoplasm. These observations suggest that reactive
      oxygen metabolites cross target membranes (< 12 sec. These studies show that
      reactive oxygen metabolites are deposited both onto and into tumor cells during
      ADCC, wherein both compartments could become vulnerable to oxidant-mediated
      damage.

PMID- 8344999
TI  - Amphotericin B and its delivery by liposomal and lipid formulations.
AB  - In recent years, new formulations of the original amphotericin B preparation
      (Fungizone) have been devised in order to overcome toxicity problems that
      frequently occur. These preparations represent an improved method of drug
      delivery, with an increased therapeutic index and a decrease in toxicity to
      mammalian cell membranes. The new formulations have different physico-chemical
      characteristics and differ in pharmacokinetic parameters. Their effects must be
      compared with conventional amphotericin B to ascertain potential roles in future
      antifungal therapy.

PMID- 8345000
TI  - Serum creatinine levels during cardiac surgery: absence of effect by
      aminoglycosides.
AB  - The literature indicates that the relative nephrotoxicities of the three drugs
      used in this investigation are gentamicin > tobramycin > or = netilmicin. Serum
      creatinine levels over time were used in an attempt to elucidate the situation.
      They varied widely in all three groups and in controls in theatre. No definite
      trend was shown. Measurements performed for the ICU period showed continued
      variation. Fluctuations were so great during the perioperative period that the
      levels were analysed in terms of 44 mumol/litre difference between admission and
      discharge, ignoring changes between these times. It is now clear that the
      operative procedure itself is associated with fluctuating serum creatinine
      levels. The use of these aminoglycosides does not measureably affect the
      situation adversely over the short period of treatment. The use of nomograms,
      based on creatinine levels, to set aminoglycoside doses during the perioperative
      period may therefore be misleading, because of the wide fluctuations shown.

PMID- 8345001
TI  - Pharmacokinetics of fusidic acid after a single dose of a new paediatric
      suspension.
AB  - The pharmacokinetics of fusidic acid (Fucidine, Leo Laboratories) were studied in
      10 children after single oral dosing with 20 mg/kg of a new banana-flavoured
      paediatric suspension (titrating at 50 mg/ml). Nine blood samples were drawn from
      each child at 0, 1, 2, 3, 6, 8, 12, 24 and 48 h following dosing with the
      antibiotic. Serum fusidic acid levels were measured by high-performance liquid
      chromatography (HPLC). A model-independent method was used for the
      pharmacokinetic analysis. Results were compared with those obtained after dosing
      eight healthy adult volunteers with 500 mg of sodium fusidate by parenteral
      administration (infusion) then per os. The acceptability of the single dose was
      good. The terminal elimination half-life t1/2 (h) and the mean residence time
      (MRT, h) of fusidate were similar to those determined in healthy adults after
      oral dosing, i.e. 16.0 +/- 14.5 versus 16.0 +/- 3.5 and 17.7 +/- 12.1 versus 17.7
      +/- 2.5, respectively. In contrast, the oral bioavailability of the suspension
      (Fapprox., %) was relatively low: of the order of 22.5 versus 91.0% for tablets
      in the healthy adult, which justifies the use of a relatively higher dose in the
      child. This led to the calculation of an estimated total clearance (Clest.,
      ml/min) significantly less than that in the healthy adults, while the estimated
      apparent volume of distribution (Vd, litre/kg) was significantly increased (10.4
      +/- 9.1 versus 21.8 +/- 2.1 and 0.73 +/- 0.53 versus 0.30 +/- 0.04,
      respectively). Fusidic acid is normally excreted in metabolized form (98%). The
      decrease in clearance could be attributed to the almost immediate saturation of
      liver enzymes in immature infants.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345002
TI  - Is there a need for improved pharmacy services to the operating theatre?
AB  - A study to assess the control and handling of drugs within an operating theatre
      complex (10 theatres) of an 850-bed hospital, has revealed the presence of
      unusable medication and thus highlighted the need for improved pharmacy services.
      The aims and objectives of the pharmacy department to enhance such services
      included improvement of drug control of stock medication and the introduction of
      clinical pharmacy services within the operating theatre. To undertake this, three
      systems were evaluated with reference to systems already in use in the U.S.A.
      Operating theatre visits by a clinical pharmacist, coupled with the expansion of
      the existing drug distribution service, were identified as the most cost
      effective methods that would allow the objectives to be met. Consequently, this
      has now been implemented within the operating theatre complex.

PMID- 8345003
TI  - The use of evaporative cooling to extend the shelf life of reconstituted oral
      penicillin solutions.
AB  - The relationship between temperature and the degradation of reconstituted
      penicillin solutions was evaluated. In all cases storage at temperatures of 25
      degrees C or less was sufficient to maintain penicillin stability within
      acceptable pharmacopoeial limits for 5 days. In addition, the relationship
      between humidity and dry bulb temperature was examined in order to assess the use
      of evaporative cooling in lowering the temperature of penicillin solutions in
      those areas of the country where temperatures commonly exceed 25 degrees C. The
      results of this study suggest that, with the use of evaporative cooling,
      penicillin solutions can be maintained in a stable state for a 5-day period
      without the need for refrigeration.

PMID- 8345004
TI  - Plasma protein binding kinetics of valproic acid over a broad dosage range:
      therapeutic implications.
AB  - The aim of the study was to characterize, from the relationship between total and
      free serum levels of valproic acid obtained over a broad dosage range (10-50
      mg/kg), the parameters defining the in-vivo kinetic behaviour of the binding of
      valproic acid to plasma proteins, their pharmacokinetic and clinical
      repercussions, and their application to therapeutic drug monitoring (TDM). The
      study was performed in nine healthy adults (20-35 years) who were given doses of
      1000 (group A), 2000 (group B) and 3000 mg (group C) of sodium valproate
      according to a compensated cross-over design, simultaneously determining the
      total and free serum levels of valproic acid over a 24-h period. The mean free
      fraction increases with dose, although this increase is only significant (P <
      0.05) for the highest dose (3000 mg). The variation in the free fraction of
      valproic acid begins to become significant (P < 0.05) at a total drug
      concentration above 100 mg/l. The mean values of the dissociation constant (K)
      and binding sites (n) were 460 mumol/l and 1.79, respectively, showing a
      variability of 86.6 and 38.7%, respectively, and a residual variability of 13.0%.
      Significant differences (P < 0.05) were found for the total plasma clearance (Cl)
      but not for the intrinsic plasma clearance (Clu) values, despite their tendency
      to decrease with the dose. If TDM is to be used for valproic acid, it is the free
      serum levels that should be determined, especially if high doses are
      administered, because the total serum levels are not a true reflection of the
      free ones, as is the case of other anti-epileptic drugs.

PMID- 8345005
TI  - Knowledge and compliance with medications in South East Asian refugees.
AB  - We evaluated knowledge about prescribed medications and compliance with taking
      those medications in 96 South East Asian refugees of different ethnic backgrounds
      seen in a primary care clinic. Two hundred and thirty (88%) of 262 prescribed
      medications were currently being taken by the patients. Although 97% of the
      medications were either named or described correctly, the correct rationale for
      taking the medication was known for only 79% and the correct dosage regimen for
      only 63%. Thirty-two (33%) of the 96 patients were not taking one or more of
      their prescribed medications, 17 (18%) were taking one or more medications not
      prescribed, 5 (5%) were taking duplicate forms of the same medication, and 4 (4%)
      were taking a medication that had been discontinued by the clinic provider.
      Seventy-two (75%) patients were taking one or more medications at an incorrect
      dose. Only 12 (12%) patients were fully compliant with all prescribed
      medications. We conclude that knowledge about and compliance with medications is
      a major problem among South East Asian patients attending a primary care refugee
      clinic.

PMID- 8345006
TI  - High-performance liquid chromatographic determination of perphenazine in plasma.
AB  - A reversed-phase high-performance liquid chromatographic (HPLC) method for the
      analysis of perphenazine in rabbit plasma was developed. Amitriptyline HCl was
      used as the internal standard. The chromatography was performed using a Microsorb
      CN column; the mobile phase consisted of 85:15 methanol/0.005 M ammonium acetate
      buffer; flow rate of 1.6 ml/min; and ultraviolet detection at 254 nm. Retention
      times were 10.8 and 18.1 min for perphenazine and amitriptyline HCl,
      respectively. The recovery of perphenazine added to plasma in the concentration
      range of 0.05-5 micrograms/ml was found to be greater than 80%. This procedure
      was used for the analysis of plasma samples collected over time following the
      oral administration of perphenazine tablets in rabbits.

PMID- 8345007
TI  - Comparison of the effectiveness of two oral phenytoin products and
      chronopharmacokinetics of phenytoin.
AB  - A cross-over study was carried out in 14 epileptic patients to compare the steady
      state serum phenytoin concentrations produced by two phenytoin formulations
      (Phenytoin Sodium and Epanutin). Differences in steady-state phenytoin
      concentrations following a change from one product to the other were not
      significant, indicating that the two brands manifest equivalent therapeutic
      efficacy. The results suggest that no overall dosage adjustments are required
      when switching from one brand to the other. Chronopharmacokinetic parameters of a
      single 300-mg dose of phenytoin, given at 08.00 and 20.00 hours, were studied in
      10 healthy, male volunteers under controlled conditions. No evidence was found
      that circadian rhythms influenced absorption and disposition.

PMID- 8345008
TI  - [Wounding of an iliac artery during celioscopy].
AB  - Vascular accidents during celioscopy are rare but potentially serious. Arterial
      injuries usually involve the aortic bifurcation and are generally recognized and
      treated as emergencies. In the present case, a transfixing wound of the right
      common iliac artery provoked by a trocar during gynecological celioscopy in a 36
      year old woman was diagnosed secondarily, the posterior orifice being
      unrecognized during laparotomy to control hemorrhage. A false iliac artery
      aneurysm was detected 2 months later when she presented signs of a compressive
      retroperitoneal hematoma confirmed by arteriography and scan images. The common
      iliac artery was ligatured through a right retroperitoneal approach with extra
      anatomical revascularization by a crossed iliofemoral venous shunt. The
      postoperative course was uncomplicated apart from a right cruralgia sequela.
      Immediate circumferential dissection for treatment of aortic bifurcation injuries
      is recommended, to avoid missing a transfixing wound, and to allow direct
      restoration usually by simple suture. In contrast, secondary treatment is
      complex, raises problems of arterial reconstruction, and cannot always prevent
      functional sequelae.

PMID- 8345009
TI  - [Place of pelvic exenteration in the treatment of recurrence of cancer of the
      uterine cervix].

PMID- 8345010
TI  - [A rare form of internal hernia: hernia of the sigmoid mesocolon].
AB  - An internal hernia of sigmoid mesocolon provoking an occlusive syndrome is
      described, and the different types of hernia of sigmoid mesocolon analyzed and
      discussed. The diagnosis of these rare (5% of cases) internal hernias is
      established frequently at operation only, their treatment, always surgical, being
      simple when instituted in their early stages.

PMID- 8345011
TI  - [Place of super-selective vagotomy in the treatment of perforated duodenal
      ulcer].
AB  - Thirty-two duodenal ulcer perforations were treated by suture and supraselective
      vagotomy. Perioperative mortality was nil. The recurrence rate was 6.2% against
      17% after elective supraselective vagotomy performed by the same surgeons during
      the same period. Results of this technique for treatment of perforated duodenal
      ulcer are compared with those of 28 simple sutures and 32 truncal vagotomies.

PMID- 8345012
TI  - [A method of intraoperative colonic irrigation during appendectomy].

PMID- 8345013
TI  - [Internal hernia of the abdomen. Apropos of 14 cases].
AB  - Internal abdominal hernias develop when one or more viscera extrude through an
      intraperitoneal orifice but remain within the peritoneal cavity. The orific may
      be normal (Winslow's foramen) or paranormal (peritoneal fossae: paraduodenal,
      ileocecal, inter- and mesosigmoidal, paracolic, supravesical, of the large
      ligament of uterus). All these hernias possess a sac and are true hernias. The
      orifice may also be abnormal: pathologic origin if formed in a mesentery or an
      omentum (trans-mesenteric, trans-mesocoloic, trans-omental, by colo-omental
      disinsertion) or in the form of an anomalous orific if it occurs in a congenital
      anomaly of a ligament (falciform ligament of liver) or a mesentery (mesentery of
      Meckel's diverticulum): all these hernias lack a sac and are "internal prolapses
      or procidentia". Of the 14 cases presently reported, 6 were hernias through a
      paranormal orifice: 2 left and 2 right paraduodenal, 1 intra-mesosigmoidal and 1
      retrocecal; 6 were hernias through a pathologic orifice: 2 trans-mesenteric, 1 in
      the posterior cavity through a colo-omental dissinsertion hole and 3 trans
      omental, and 2 were hernias through an anomalous orifice from absence of the
      falciform ligament of liver. Incidence of these hernias reported in the
      literature is between 0.2 and 0.9% of autopsies and 0.2 and 2% of parietal
      hernias, findings in our series being 0.098% (14 of 14,199 cases) of laparotomies
      and 0.32% (14 of 4,374 cases) of parietal hernias. Of 1,871 cases described in
      the occidental or near occidental literature (in French, English, Italian or
      German), 160 (8.55%) were hernias through Winslow's foramen, 1035 (55.31%)
      through a para-normal orifice and 676 (36.1) through an abnormal orifice
      (pathologic and anomalous). The sex ratio showed a male prevalence (3:2), age
      distribution demonstrating the onset of internal hernias at all ages with a
      preference for the 5th decade and a mean age of 46 years. Symptomatology was
      totally non specific, subacute to acute occlusive symptoms or even signs of
      already installed necrotizing-peritonitis being detected in 80 to 90% of cases.
      In 10 to 15% of patients the hernia was an unexpected finding during laparotomy
      for another affection, an almost typical feature of the largest para-normal
      hernias, the paraduodenal hernias. Preoperative diagnosis is practically
      impossible, and in many cases cannot be made because of time restriction, but it
      is sometimes possible with the largest hernias after a longer sub-occlusive
      period by radiologic, arteriographic and scan imaging. However, the primary task
      of the surgeon is not so much to establish the diagnosis as to assess the need
      for urgent operation. Hernias provoking large displacements of viscera can even
      make intraoperative diagnosis difficult with subsequent errors, and surgeons must
      recognize all possible types of these hernias, especially those passing through a
      para-normal orifice, and must be able to pinpoint the fixed guiding points. They
      must also work in as large an operative field as possible and should therefore
      always start by a median infra-supra-umbilical laparotomy to allow its maximum
      extension. Reduction of herniated viscera can be simple, by gentle traction, or
      difficult requiring dilatation of the hernial orifice and/or opening of the
      sac.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8345014
TI  - [Contribution of imipenem/cilastatin in the treatment of peritonitis: a
      comparative economic analysis in the case of France].
AB  - Imipeneme, a molecule chemically related to the carbapenems (beta-lactam), is a
      potent wide spectrum antibiotic reserved for hospital use. Effective as therapy
      for major infections, and for use in severely debilitated patients
      (immunodepressed, etc ...) its efficacy in the treatment of peritonitis has been
      demonstrated in numerous studies abroad, confirmed by results of a French
      multicenter trial in 1989. Its cost-effectiveness ratio was assessed as excellent
      in a comparative case-controlled study of totally matched patients treated with
      other antibiotics. As expected, the cost of the treatment itself
      (imipeneme/cilastatine plus associated products and costs of their
      administration) was higher by about 1000 F per patient when compared with other
      antibiotic regimens, but its markedly superior efficacy allowed overall economies
      of about four and a half times this sum (4300 F). This cost reduction was related
      to different factors, some of which could not be individualized because of
      missing data (personnel) or protocol bias (laboratory examinations).
      Nevertheless, the global result was a shortening of hospital stay by more than
      two days due to a very pronounced decrease in failure rate of the first
      treatment. This result is even more remarkable in that the peritonitis treated by
      Tienam was significantly more severe than that treated by the other antibiotics.

PMID- 8345015
TI  - [Escherichia coli septicemia revealing acute appendicitis. Apropos of a case].

PMID- 8345016
TI  - [Echinococcosis of the iliac bone. Apropos of a case].

PMID- 8345017
TI  - [Severe complications after cholecystectomy by celioscopy: lessons from yesterday
      and today].
AB  - The case of a series of grave complications after a laparoscopic cholecystectomy
      is reported: a common bile duct section diagnosed rather late, hemoperitoneum,
      inappropriate common bile duct reconstruction and late anastomic leakage,
      stenosis of an hepatico-jejunal anastomosis, haemorrhage through the external
      biliary drainage and iterating sepsis. The final outcome was good. The stenotic
      hepatico-jejunal anastomosis was dilated by a Gianturco self-expanding prosthesis
      percutaneously placed. As an evidence, this alternative treatment is only
      exceptional, the treatment of choice for postsurgical benign strictures being
      surgical repair.

PMID- 8345018
TI  - [Radiotherapy in cancer of the rectum].
AB  - The response of adenocarcinoma of rectum to radiotherapy is dependent on the use
      of irradiation techniques that ensure a sufficient dose be applied to the tumor
      without exceeding tolerance limits of pelvic tissues. This has been clearly
      demonstrated by results of contact radiotherapy over the last 30 years or so.
      Doses of about 100 Gy provide local control in 90% of cases and a 5 year survival
      rate of 80% in patients with highly selected tumors. For several years now,
      contact radiotherapy has been associated with external irradiation and iridium
      therapy with resulting sterilization of T2 and even T3 or N1 tumors in inoperable
      cases. Endorectal ultrasound imaging is essential for selecting those patients
      requiring radiotherapy alone and for evaluating the results, but in more than 90%
      of patients, surgery remains basic treatment for cancer of rectum. The incidence
      of local recurrence, very difficult to treat, is non negligible, however, but
      combining radiotherapy with surgery has been shown to reduce the rate of by 50%.
      Opinions differ on the relative efficacy of pre- or post-operative radiotherapy,
      but tolerance to this treatment is good in both cases if the technique used
      limits radiation to the posterior pelvis. Results of a Swedish randomized trial
      demonstrated greater efficacy for pre-operative radiotherapy for controlling
      local spread. Meta analysis showed that irradiation produces a definite gain in
      local control with a resulting gain in survival of about 5 to 10%. In the USA,
      chemotherapy based on 5 FU combined with post-operative radiotherapy was equally
      favorable in terms of survival. Pre-operative radiotherapy may also increase the
      chance of conservation of the sphincter. Although numerous points concerning
      chronology and mode of treatment remain open to discussion, a combination of
      radiotherapy and surgery now appears as standard treatment for rectal cancer.

PMID- 8345019
TI  - [Choledochoduodenal anastomosis by laparoscopy].
AB  - Eleven patients underwent choledochoduodenostomy under laparoscopic control: 5
      for adenocarcinoma of head of pancreas, including 2 with extension into duodenum,
      3 for chronic pancreatitis. 1 for gastric carcinoma with pancreatic infiltration
      1 for carcinoma of ampulla and 1 for stenosing papillitis. Mean duration of
      operation was 97.9 minutes and mean hospital stay 7.8 days. No immediate or
      delayed postoperative complications were reported. The advantages of this method
      are the marked reduction in recovery time, especially in severely debilitated
      elderly patients, and the absence of postoperative pain.

PMID- 8345020
TI  - [Boerhaave syndrome or spontaneous rupture of the esophagus].
AB  - Spontaneous rupture of esophagus is a rare affection resulting from barotrauma to
      lower esophagus during the effort of vomiting. The diagnosis is suggested by the
      presence of violent retrosternal pain after a bout of vomiting following the
      partaking of a copious meal by an alcoholic patient. Prognosis is dependent on
      the rapidity of treatment, always surgical and completed by long-term antibiotic
      therapy. Complementary examinations should be limited to a standard chest x ray
      and esophageal imaging with water-soluble contrast. Recovery is now the rule for
      patients treated within 24 hours. Mortality is high in patients diagnosed at a
      late stage, but this could be reduced by improved recognition of the syndrome.

PMID- 8345021
TI  - [An unusual complication of perforated sigmoid diverticulitis: gas in the portal
      vein with miliary liver abscesses].
AB  - A patient presented with gas in the portal vein and miliary liver abscesses due
      to perforation of a sigmoid diverticulitis abscess. The outcome was favorable
      after surgical treatment. Gas in the portal vein, a sign of extreme seriousness,
      is generally the result of intestinal necrosis from ileo-mesenteric artery
      infarction, responsible for more than 75% of deaths. Diagnosis of this
      exceptional complication, suggested from a straight abdominal film, was confirmed
      by hepatic ultrasound and scan imaging. Urgent surgical intervention can
      hopefully, as in the present case, result in the patient's survival.

PMID- 8345022
TI  - [Peritonitis caused by rupture of a retroperitoneal abscess].
AB  - A 30 year old man presented with an initial clinical picture limited to low back
      pain. Increasing severity of the pain after one month led to his admission to a
      surgical department and the diagnosis of a large right retroperitoneal abscess.
      Several hours before the proposed operation for extraperitoneal surgical drainage
      of the abscess through a lumbar approach, his condition was complicated by the
      intraperitoneal rupture of the abscess. The resulting peritonitis and the
      retroperitoneal abscess were treated through a laparotomy and the postoperative
      course was uncomplicated. A literature review showed this to be only the second
      case of this rare generalized peritonitis complication to be reported, for which
      a parallel can be drawn with the intraperitoneal rupture of a pyonephrosis. A
      general overview of retroperitoneal abscesses is presented.

PMID- 8345023
TI  - [Therapeutic problems of cancers of the gallbladder].
AB  - Data of 32 patients who were operated for gallbladder carcinoma were evaluated in
      a retrospective meta-analysis. Results were compared with endoscopic retrograde
      cholangio-drainage (ERCP) using large size 12/14-French gauge endo-prostheses
      with side flaps to prevent migration. According to the TNM classification 84% of
      patients were classified as stage IV, 12.5% were in a stage III and 3% were in a
      stage II. Only 22% of cases were operated for cure (cholecystectomies,
      lymphadenectomy, wedge resection of the liver). All patients died in between one
      year on cancer, average survival was 158 days in TNM stage II, 183 days in stage
      III and 75 days in stage IV. Early complication rate was in stage III and 75 days
      in stage IV. Early complication rate was at 28% due to cardiac and pulmonary
      complications. No one died as a result of the operation. Endoscopic bile duct
      drainage (ERCP) for gallbladder carcinoma (n = 21) was shown to be superior to
      surgical results with an average survival of 160 days. Early complication rate
      (30 day interval) was at 5.6% (n = 1014), mostly due to tube occlusion with
      cholangitis; clinical mortality was 2.6% only (n = 393). Occlusion of the
      endoscopic 12/14-French gauge tube was seen after 213 days in average. Endoscopic
      therapy was shown to represent an independent way in gallbladder cancer treatment
      not only for patients defined as not suitable for operation. All own results were
      compared to the literature, therapeutic regimen in gallbladder carcinoma is
      summarized as an organigramm.

PMID- 8345024
TI  - [Internal hernias of the abdomen. Apropos of 14 cases].

PMID- 8345025
TI  - [Agenesis of the gallbladder diagnosed by celioscopy].

PMID- 8345026
TI  - Analysis of multiple sugar probes in urine and plasma by high-performance anion
      exchange chromatography with pulsed electrochemical detection. Application in the
      assessment of intestinal permeability in human immunodeficiency virus infection.
AB  - Mannitol, 3-O-methylglucose and lactulose administered orally are used to
      investigate small intestinal absorption pathways and mucosal integrity. Current
      methods of analysis include thin-layer chromatography, gas chromatography (GC)
      and enzymatic analysis, which require separate estimation of mono- and
      disaccharides and for GC, prior derivatization. We describe a high-pressure anion
      exchange chromatographic method coupled with pulsed electrochemical detection
      allowing simultaneous measurement of all three sugars and its clinical
      application in monitoring intestinal damage in human immunodeficiency virus (HIV)
      infection. Sample preparation is simple and fast. All sugars are resolved within
      10 min. Mean recovery is 93.3% for all sugars and the overall relative standard
      deviation is 4.2%. Intestinal permeability (lactulose/mannitol ratio) rises with
      disease progression to AIDS, indicating mucosal damage. The greatest increase in
      permeability is associated with chronic diarrhoea. The method is an ideal non
      invasive test to assess gut mucosal damage in HIV infection.

PMID- 8345027
TI  - Analysis of cationic nutrients from foods by ion chromatography.
AB  - This paper describes the feasibility of combining two relatively new technologies
      to generate data on the cationic nutrient content of foods. Single-column ion
      chromatography was used to monitor several analytes following the use of a
      microwave digestion scheme aimed at rapid, multiple sample digestion. The result
      is a more streamline and productive approach to multi-sample preparation and
      multi-analyte determination when investigating the cation content of foods.
      Linearity and limits of detection for the chromatographic procedure were
      established. Sample size as well as digestion acid type and amount were
      investigated during the microwave process. The method was applied to a variety of
      food matrices to evaluate its scope. Results generated with this method compare
      favorably to those from atomic absorption. Finally, capillary ion electrophoresis
      (Waters' trade name: Capillary Ion Analysis), a subset of capillary
      electrophoresis which has been optimized for ion analysis, was applied to the
      sample digests to investigate the usefulness of this technology to the analysis
      of mono-/divalent cations from foods.

PMID- 8345028
TI  - Effect of temperature on the salt balance of milk studied by capillary ion
      electrophoresis.
AB  - Many inorganic species, such as calcium, phosphate and magnesium, are in
      equilibrium between the liquid and colloidal phases of milk and hence are of
      importance with respect to the coagulation properties of milk. Capillary ion
      electrophoresis makes possible the determination of anions and cations in less
      than 6 min. The soluble phase of milk was obtained by ultrafiltration and samples
      had to be diluted 250-fold before analysis. Cold storage increased soluble
      calcium and phosphate concentrations, and warm-up of the milk restored the
      initial ionic equilibria. More drastic heat treatments (80-90 degrees C) caused
      precipitation of tricalcium phosphate and calcium citrate.

PMID- 8345029
TI  - Clinical review 48: The current status of diagnosis and therapeutic intervention
      in Turner's syndrome.

PMID- 8345030
TI  - Of scid mice and men.

PMID- 8345031
TI  - Preservation of functioning human thyroid organoids in the scid mouse: 1. System
      characterization.
AB  - We have characterized a system for preserving reconstituted human thyroid
      follicles in vivo by transplanting human thyrocytes into mice with severe
      combined immunodeficiency (scid mice). Human thyroid organoids were constructed
      from thyroid monolayer cells derived from both normal and abnormal thyroid
      tissue, and embedded within a basement membrane preparation which was then
      transferred sc to scid mice. As early as 4 weeks, and as late as 3 months post
      transplantation, histological examination of human thyroid organoids demonstrated
      widespread neofollicle formation and colloid accumulation which stained positive
      for human thyroglobulin (hTg). Although there were no changes in murine serum T4
      levels; the transplanted thyroid epithelial cells secreted hTg into the scid
      mouse circulation (with an average level of 29 micrograms/L). In addition, hTg
      release was stimulated in vivo by ip administration of recombinant human TSH (0.1
      1.0 IU/mouse) achieving greater than 20-fold increases in scid mouse serum hTg
      levels. In situ immunohistochemistry showed that thyroid organoids derived from
      patients with Graves' disease retained scattered lymphocytes in peripolesis with
      the thyroid epithelial cells; those lymphocytes were identified as human T cells
      of the memory (CD45RO +), rather than naive, type. These data demonstrate that
      functioning human thyroid organoids establish in scid mice and remain responsive
      to TSH stimulation. The system offers a unique opportunity to examine human
      thyroid-lymphocyte interaction within the confines of a predictable animal model.

PMID- 8345032
TI  - Preservation of functioning human thyroid organoids in the scid mouse: II. Biased
      use of intrathyroidal T cell receptor V genes.
AB  - The severe combined immunodeficiency (scid) mouse, which lacks functional B cells
      and T cells, has proven a useful model for exploring the survival of transplanted
      human lymphocytes and thyrocytes. In order to further characterize T cell
      infiltrates in reconstituted sc human thyroid organoids, we examined for the
      presence of 18 human T cell receptor (hTcR) V alpha and 21 hTcR V beta gene
      families using polymerase chain reaction (PCR) analysis. Human TcR V gene
      activity was confirmed by Southern blot analysis of the PCR fragments from all
      but one of the thyroid organoids, confirming the continued survival of human T
      cells within the thyroid organoids. However, only 3.5 out of 18 V alpha and 5.9
      out of 21 V beta gene families were detected in these human thyroid organoids
      indicating a marked bias in T cell survival. Sequencing of the V-D-J regions of
      the amplified TcR fragments showed that approximately 60% of the sequences were
      representative of clonally expanded T cells. Hence, these passenger T cells
      exhibited highly biased use of particular TcR V gene families similar to that
      observed previously in thyroid tissue and intrathyroidal T cell cultures.
      Furthermore, variations in the V-D-J regions of sequences from similar V gene
      families indicated that the V gene region was important in T cell selection
      rather than the CD3 region.

PMID- 8345033
TI  - Estrogen synthesis inhibitors: from "off the rack" to haute couture.

PMID- 8345034
TI  - Open dose-finding study of a new potent and selective nonsteroidal aromatase
      inhibitor, CGS 20 267, in healthy male subjects.
AB  - The aim of this open, dose-finding study was to evaluate the effects of single
      dose CGS 20 267, a new oral nonsteroidal aromatase inhibitor, on the inhibition
      of estrogen production and also on the production of adrenal and testicular
      steroids in healthy male subjects. Nine dose levels ranging from 0.02-30 mg and
      placebo were tested, each dose being given to 3 subjects only. A total of 18
      subjects were included; 12 of them received 2 single administration, the
      remaining 6 were exposed only once to one of the 2 highest dose levels. A
      reduction in serum estrogen levels when compared to baseline was already observed
      after 2 h, reaching maximum suppression between 10 and 48 h after administration.
      After 24 h, a suppression of estrone levels by 60-85% from baseline was achieved
      with all tested doses. A reduction in estradiol levels by about 30% from baseline
      was observed at the lowest dose (0.02 mg). This reduction was further enhanced
      dose dependently to a maximum of about 90% from baseline at 24 h after
      administration of the highest dose (30 mg). With the higher doses (10 and 30 mg),
      estrogen suppression was maintained up to 3 days. A dose-dependent increase of
      testosterone, LH, and FSH was observed and was most pronounced in the 10- and 30
      mg dose groups, which can be considered as a consequence of the long-lasting
      aromatase inhibition achieved with these high doses. No effect on serum cortisol
      and aldosterone levels was observed up to the highest dose. No clinically
      relevant changes were observed in blood chemistry and hematology tests. The
      systemic and subjective tolerability of CGS 20 267 was good at all doses. This
      study has shown that CGS 20 267 is a well tolerated, potent, selective, and long
      acting inhibitor of the aromatase enzyme after single administration.

PMID- 8345035
TI  - Phase I study of the oral nonsteroidal aromatase inhibitor CGS 20267 in healthy
      postmenopausal women.
AB  - We have performed a phase I study of the effect of a single dose of CGS 20267, an
      oral nonsteroidal aromatase inhibitor, in 12 healthy volunteer postmenopausal
      women. Each subject received 2 single doses of CGS 20267 (0.1, 0.5, or 2.5 mg) or
      placebo separated by a washout period of at least 6 weeks. There was
      statistically significant suppression of serum estrone and estradiol at all three
      doses of CGS 20267 tested. Serum estrone and estradiol concentrations were
      maximally suppressed by 76% and 79% from baseline levels, respectively. Urinary
      excretion of estrone and estradiol was also suppressed, although this did not
      reach statistical significance. Serum concentrations of aldosterone, cortisol, 17
      alpha-hydroxyprogesterone, androstenedione, testosterone, FSH, LH, and TSH were
      unaffected by CGS 20267. The drug was well tolerated, with no significant side
      effects. This study has shown CGS 20267 to be a potent and specific aromatase
      inhibitor, and further studies are now needed to assess its clinical efficacy.

PMID- 8345036
TI  - Thyrotoxicosis and the heart: something old and something new.

PMID- 8345038
TI  - Is hypothalamic-pituitary-adrenal hyperactivity important in the pathogenesis of
      excessive abdominal fat distribution?

PMID- 8345037
TI  - Cardiac effects of long term thyrotropin-suppressive therapy with levothyroxine.
AB  - To investigate the effects of long term thyroid hormone suppressive therapy on
      the heart, 20 patients were evaluated by noninvasive techniques. Of them, 10 were
      athyreotic after surgery for differentiated thyroid cancer, and 10 had diffuse or
      nodular goiter. The mean age of the group was 39 +/- 11 yr. Twenty age- and sex
      matched subjects served as controls. The mean dose of levothyroxine was 163 +/-
      34 micrograms daily. Plasma TSH was undetectable in all patients. Mean serum T4,
      free T4, and sex hormone-binding globulin were significantly higher (P < 0.001),
      whereas mean serum T3, free T3, and osteocalcin did not differ from control
      levels. Cardiac evaluation consisted of a standard 12-lead electrocardiogram, an
      ambulatory electrocardiographic monitoring (Holter), and an echocardiographic
      study. Two patients showed abnormal electrocardiograms for left ventricular
      hypertrophy. Holter demonstrated an increase in average heart rate (84 +/- 7 vs.
      70 +/- 6 beats/min; P < 0.01). Prevalence of atrial premature beats was higher in
      the patient group than in the control group (100% vs. 60%; P < 0.006). The
      echocardiogram showed an increased left ventricular mass index in the patient
      group (97 +/- 24 vs. 80 +/- 18 g/m2; P < 0.02). Furthermore, left ventricular
      systolic function was enhanced, with higher values of fractional shortening (38
      +/- 7% vs. 34 +/- 4%; P < 0.05) and rate-adjusted velocity of shortening (1.2 +/-
      0.13 vs. 1.05 +/- 0.14 circumferences/sec; P < 0.01). These findings indicate
      that long term levothyroxine therapy at suppressive doses markedly affects
      cardiac function.

PMID- 8345039
TI  - Analysis of 24-hour plasma profiles of growth hormone (GH)-binding protein, GH/GH
      binding protein-complex, and GH in healthy children.
AB  - Human blood contains a high affinity GH binding protein (GHBP) which corresponds
      to the extracellular domain of he GH-receptor. It has been suggested that GHBP
      can modify the biological actions of GH, and alter the distribution of GH in the
      body. To study the hormonal regulation of growth, it is therefore necessary to
      measure GHBP as well as GH. We recently developed a ligand-mediated
      immunofunctional assay (LIFA) which allows separate quantitation of total GHBP
      (free and GH-bound) and the complex formed by GH and GHBP (GH/GHBP-complex) in
      human blood. We have now used the ligand-mediated immunofunctional assay to
      measure GHBP levels in plasma profiles from healthy children. GH was measured by
      immunoradiometric assay. Fifteen 24-h plasma profiles from 12 healthy children (3
      girls and 9 boys) of different ages (6-15 yr), heights (-2.5 to +3.0 SD scores)
      and pubertal stages (1-4) were examined. Blood was withdrawn continuously for 24
      h and collected in 20-min fractions. Time series for GH, GHBP, and GH/GHBP
      complex were analyzed by cross-correlation and Fourier analysis. GH was secreted
      in a pulsatile fashion in all subjects. The concentration of the GH/GHBP-complex
      varied during the sampling period, and the changes correlated significantly with
      the GH pulses with correlation coefficients reaching maximum at zero time lag. In
      contrast, the changes in the total GHBP concentration were minor (coefficients of
      variation approximately 10%), and not correlated to GH pulses. Fourier analysis
      showed similar spectral power patterns for GH and GH/GHBP-complex, suggesting a
      diurnal rhythm (12- to 24-h periods) as well as components of higher frequencies
      (around 4-h periods). Although there were only subtle fluctuations in the total
      GHBP concentration, Fourier transformation revealed a diurnal rhythm with nadir
      during the night, while components of higher frequencies were much less abundant.
      We conclude that variations in total GHBP as measured by LIFA during a 24-h
      sampling period are small and that the concentration can be estimated from a
      single random blood sample.

PMID- 8345040
TI  - Dose-response relationships for radiation-induced thyroid cancer and thyroid
      nodules: evidence for the prolonged effects of radiation on the thyroid.
AB  - The risk of developing thyroid cancer and other thyroid neoplasms after radiation
      exposure is well known, but specific modifiers of the dose-response relationship
      are not. We have identified 4296 subjects who received treatment before their
      sixteenth birthday with orthovoltage radiation for benign conditions in the head
      and neck area. Individual thyroid dose estimates were calculated for 3843
      subjects. Of the 2634 subjects who have been found, 1043 have developed thyroid
      nodules of all types, and 309 have developed thyroid cancer. The radiation dose
      response relationship was consistent with a linear excess relative risk model for
      thyroid cancer and thyroid nodules within the range of observed doses. Women
      developed thyroid cancer and thyroid nodules at a higher rate, but the slopes of
      the dose-response curves were the same for men and women. Age at radiation
      exposure was a significant factor of the risk, with a lower age at exposure
      associated with a higher risk. To determine the effect of the wide publicity and
      our screening program, which began in 1974, we compared the dose-response
      relationship for cases diagnosed before and after 1974. The overall rates
      increased dramatically after 1974, but the estimates of the slopes of the dose
      response curves were not statistically different. The slope of the dose-response
      curve for thyroid neoplasms appears to have reached a maximum 25-29 yr after
      radiation exposure, but the dose response continued to be elevated at the end of
      follow-up. These data are consistent with the tumorigenic effects of radiation
      lasting at least 40 yr.

PMID- 8345041
TI  - Thyroxine interactions with transthyretin: a comparison of 10 different naturally
      occurring human transthyretin variants.
AB  - Transthyretin (TTR) is a tetrameric protein that transports 15-20% of circulating
      T4. Alterations in TTR structure can manifest clinically as familial amyloidotic
      polyneuropathy or euthyroid hyperthyroxinemia. We have measured the relative
      affinity for T4 of several variant TTR molecules in human plasma. We have
      compared control plasma to plasma from a patient heterozygous for a [Thr109]TTR
      mutation associated with a 3-fold increased affinity for T4 and to plasma from
      patients with familial amyloidotic polyneuropathy with different point mutations
      in TTR. Relative affinity was measured in an assay in which [125I]T4 bound by TTR
      was isolated by immunoprecipitation with an antibody specific for TTR.
      [Thr109]TTR displayed the highest affinity for T4, whereas homozygous [Met30]TTR
      did not bind appreciable amounts of [125I]T4. The rank order of affinity of the
      various TTR mutations for T4 was: Thr109 heterozygous > wild type = Ala60
      heterozygous = Ile122 heterozygous > His58 heterozygous approximately Tyr77
      heterozygous approximately Ser84 heterozygous approximately Ile122 homozygous
      approximately Met30 heterozygous >> Met30 homozygous TTR. Thus, different point
      mutations in TTR increase, decrease, or do not affect TTR's affinity for T4. The
      ability of TTR to form amyloid fibrils does not appear to be related to its
      affinity for T4. Further study is required to define the molecular basis of
      alterations in T4 binding induced by point mutations located along the TTR
      tetramer.

PMID- 8345042
TI  - Carbohydrate metabolism and urinary excretion of calcium and oxalate after
      ingestion of polyol sweeteners.
AB  - Polyols are widely used instead of glucose and sucrose in sweets and dietary
      products because they are barely cariogenic, and their energy value is lower. In
      addition, it has been shown that calciuria and oxaluria increase after an oral
      glucose (Glu) load. We, therefore, investigated the effects of a single polyol
      ingestion on carbohydrate, calcium, phosphate, and oxalate metabolism in 10
      healthy subjects. On 5 experimental days, subjects ingested 20 g Glu, Lycasin
      (Lyc), Maltisorb (Mal), sorbitol (Sor), or xylitol (Xyl). Glu, Lyc, and Mal
      intake caused an increase in glycemia [respectively, +34% (P < 0.001), +15% (P <
      0.001), and +15% (P < 0.001)], insulinemia [respectively, +358% (P < 0.001), +88%
      (P < 0.05), and +94% (P < 0.01)], and C-peptide level [respectively, +170% (P <
      0.001), +15% (P < 0.01), and +15% (P < 0.001)]. Conversely, no change occurred in
      glycemia, insulinemia, or C-peptide levels after ingestion of Sor or Xyl. Urinary
      calcium increased after Glu (+64%; P < 0.01) and Xyl (+74%; P < 0.01) intake, and
      urinary phosphate increased after Xyl (+27%; P < 0.05), but decreased after a Glu
      load (-68%; P < 0.01). Only Xyl increased urinary excretion of oxalate (+53%; P <
      0.05). Our results suggest that ingestion of polyols causes a much lesser
      pancreatic stimulation than Glu intake. Also, Lyc, Mal, and Sor sweeteners have
      no effect on urinary excretion of calcium and oxalate, whereas calciuria and
      oxaluria increase after Xyl ingestion.

PMID- 8345043
TI  - Variable carbohydrate structures of circulating thyrotropin as studied by lectin
      affinity chromatography in different clinical conditions.
AB  - Carbohydrate structures of intrapituitary and circulating TSH were studied by
      Concanavalin-A (Con A) and ricin lectin chromatography under different clinical
      conditions. Con A permits the separation of molecules differing in the extent of
      their carbohydrate branching, whereas ricin gives an estimation of the degree of
      their sialylation. Intrapituitary TSH was more retained on Con A and less
      sialylated than circulating hormone, suggesting that carbohydrate chains of
      intrapituitary molecules are less mature than those present in the circulation. A
      greater proportion of TSH firmly bound to Con A, compared to control values, was
      found in sera from fetuses and patients with uremia, TSH-secreting adenomas, and
      central hypothyroidism. In primary hypothyroid patients, TSH binding to Con A was
      similar to that found in controls, but a greater percentage of sialylated forms
      was seen. In central hypothyroidism patients, TSH released in response to TRH was
      less sialylated. Interestingly, no sialylated TSH was found in normal fetuses. In
      conclusion, the present data show that both TSH carbohydrate branching and
      sialylation may vary in different clinical conditions. As some of the above
      clinical conditions are known to be accompanied by variations in the bioactivity
      of circulating TSH, the finding of changes in TSH carbohydrate structures further
      supports the view that glycosylation modulates the expression of TSH biological
      activity.

PMID- 8345044
TI  - Pulsatile secretion of parathyroid hormone in normal young subjects: assessment
      by deconvolution analysis.
AB  - Preliminary reports suggest that PTH is secreted in a pulsatile fashion. However,
      available studies have not attempted to calculate actual PTH secretion rates in
      healthy individuals. To accurately characterize PTH secretory dynamics in healthy
      subjects, we studied seven young women and six young men, all of whom had hip and
      spine bone densities by dual photon densitometry in the upper tertile for age
      matched control subjects. PTH concentrations were measured by immunoradiometric
      assay in blood sampled every 2 min over 6 h. Ionized calcium levels were obtained
      during the second and third hours of the study. Plasma PTH profiles were
      subjected to deconvolution analysis, which resolves measured hormone levels into
      secretion and clearance components. Cross-correlation analysis was performed to
      assess direct or inverse correlations between serum PTH and ionized calcium
      concentrations at various time lags. In these subjects, PTH was secreted in a
      dual fashion, with significant basal (tonic) secretion and PTH pulses
      approximately every 20 min. Pulsatile PTH secretion accounted for approximately
      25% of the total secreted PTH. There were no differences in PTH secretory
      parameters between men and women, nor were there any significant correlations
      between PTH and ionized calcium concentrations. We conclude that in normal
      subjects, the predominant mode of PTH secretion is tonic, with superimposed PTH
      pulses of small amplitude but high frequency. The clinical significance of this
      complex physiological pattern of secretion awaits further study.

PMID- 8345045
TI  - Carboxyl-terminal fragments of parathyroid hormone are not secreted
      preferentially in primary hyperparathyroidism as they are in other hypercalcemic
      conditions.
AB  - Calcium infusion in normal men decreases immunoreactive PTH (iPTH). Intact iPTH
      (I) shows the greatest decline, and there is a greater decrease in carboxyl
      terminal iPTH (C) than in midcarboxyl-terminal iPTH (M); thus, C/I, M/I, and M/C
      ratios are increased. To verify whether this adaptive mechanism to hypercalcemia
      was present in patients with primary hyperparathyroidism (PHP), we measured total
      serum calcium (Ca), I, C, and M as well as C/I, M/I, and M/C ratios in 32
      normocalcemic normal subjects (NN), in the same normal subjects made
      hypercalcemic (HN), in 31 patients with PHP, and in 12 patients with
      nonparathyroid hypercalcemia (NPHN). Eight patients with PHP and the 32 NN were
      submitted to CaCl2 and Na2 EDTA infusions to evaluate their parathyroid function.
      Ca was lower (P < 0.005) in NN (2.21 +/- 0.06 mmol/L) than in PHP (2.80 +/- 0.25
      mmol/L) or NPHN (2.83 +/- 0.20 mmol/L). The HN Ca value (2.80 +/- 0.18 mmol/L)
      was similar to those in PHP and NPHN subjects. C, M, and I were increased in PHP
      compared to the other groups (P < 0.005). PHP had C/I and M/I ratios of 2.03 +/-
      0.72 and 9.04 +/- 7.69, values similar to NN (2.29 +/- 0.55 and 8.70 +/- 3.0),
      but lower than HN (5.36 +/- 2.48 and 25.93 +/- 13.86; P < 0.005) and NPHN (11.91
      +/- 13.06 and 18.69 +/- 10.81; P < 0.005). NPHN also had a lower M/C ratio than
      HN (2.76 +/- 2.02 vs. 4.99 +/- 1.81; P < 0.05). PHP and NN could increase their
      C/I ratio to the same maximum (4.71 +/- 1.26 vs. 5.70 +/- 2.94), but PHP did so
      at a much higher set-point (2.67 +/- 0.19 vs. 2.24 +/- 0.10 mmol/L; P < 0.005).
      PHP also had higher set-points for M/I, and M/C ratios even if they failed to
      increase the ratios to the high values in NN [M/I 11.6 +/- 6.4 vs. 29.3 +/- 18.3
      (P < 0.005); M/C, 2.16 +/- 1.20 vs. 5.0 +/- 1.93 (P < 0.005)]. Thus, carboxyl
      terminal fragments are not secreted preferentially in PHP as they are in other
      hypercalcemic conditions. This relates to a higher set-point for the regulation
      of C/I and M/I ratios, permitting the secretion of more intact hormone relative
      to C or M fragments. The lower M/C ratio in NPHN and in PHP made more
      hypercalcemic compared to HN suggests a lower production or a higher clearance of
      midcarboxyl-terminal fragments in chronic hypercalcemia.

PMID- 8345046
TI  - Pulsatile luteinizing hormone patterns in long term oral contraceptive users.
AB  - Oral contraceptives (OC) inhibit folliculogenesis by a central suppressive action
      on the release of gonadotropins. To characterize the nature of these central
      effects, we studied 40 long term OC users on 3 different OCs: two monophasic
      preparations with 30 micrograms ethinyl estradiol and 150 micrograms l-norgestrel
      (group 1; n = 15), 150 micrograms desogestrel (group 2; n = 10), and a triphasic
      formulation containing 30-40 micrograms ethinyl estradiol and 50, 75, and 125
      micrograms l-norgestrel (group 3; n = 15). Blood sampling at 10-min intervals
      during 6-h periods was performed at different moments in the pill cycle. Thirteen
      healthy volunteers with regular ovulatory cycles served as normal controls. FSH
      and LH were measured by a sensitive immunoradiometric assay. Pulsatile LH release
      was observed in all OC users. Mean serum LH and FSH levels, number of LH pulses
      per 6 h, and the amplitude of LH pulses on day 1 of the pill cycle did not differ
      from early follicular phase control values. FSH levels were rapidly suppressed
      from day 2 onward in all three groups, whereas LH levels progressively declined
      in groups 1 and 2 from day 8 onward. In group 3, however, LH levels were only
      significantly suppressed after day 13. The number of LH pulses per 6 h decreased
      in all groups starting on day 2, whereas the amplitude of LH pulses increased. A
      substantial percentage of LH pulses observed in OC users after day 1 were of low
      amplitude (< 0.75 IU/L). From these results, we conclude that 1) pulsatile
      release of LH is maintained during OC use; 2) FSH levels are suppressed equally
      early and equally effective by all OCs studied; 3) during OC use, the number of
      LH pulses per 6 h is reduced; 4) modulation of LH pulse amplitudes, and
      subsequently of serum LH levels, is mainly mediated by a dose- and time-dependent
      effect of the gestagenic component of the OC; and 5) after the 7-day pill-free
      interval, a normal early follicular phase pulse pattern is found, even in long
      term OC users, suggesting that in this period, most of the steroidogenic feedback
      effects wear off.

PMID- 8345049
TI  - Role of estradiol in the rise in follicle-stimulating hormone levels during the
      luteal-follicular transition.
AB  - Follicular recruitment takes place under FSH stimulation at the end of the luteal
      phase and the beginning of the subsequent follicular phase, the so-called luteal
      follicular transition (LFT). Inhibin, a known suppressor of FSH, has been
      implicated in the onset of the rise in FSH levels, as the fall in its
      immunoreactive plasma levels after the demise of the corpus luteum has been shown
      to correlate negatively with the increase in FSH. To analyze the role of
      estradiol (E2), another inhibitor of FSH secretion in the LFT, we designed an
      experimental paradigm to dissociate the physiological falls in inhibin and E2.
      This was achieved by extending the duration of luteal plasma E2 levels with
      transdermal E2 treatment. Untreated ovulatory cycles in seven healthy female
      volunteers, aged 28-38 yr, were compared with E2-treated cycles in the same
      subjects, with treatment starting on the 10th day after the LH surge and
      continuing through the 4th day of the following menses [either 0.2 mg (n = 6; G1)
      or 0.1 mg (n = 6; G2) E2 daily]. Blood samples were obtained daily from the LH
      surge until the 11th day of the next cycle. Immunoreactive plasma inhibin levels
      reached a nadir on day 2 of menses regardless of whether women received E2.
      Plasma E2 (mean +/- SEM) levels remained within the normal luteal range (220 +/-
      51 to 635 +/- 279 pmol/L) until the end of the treatment period in G2 (range, 253
      +/- 40 to 382 +/- 62 pmol/L), but not in G1 (range, 598 +/- 195 to 1835 +/- 1259
      pmol/L). However, the onset of the FSH rise was clearly delayed, from a mean of 2
      days before menstruation in the controls to day 4 of the cycle in G1 and G2. Peak
      plasma FSH levels were attained within 6 days in the controls and within 2 or 3
      days in both treatment periods. Our data suggest that it is the decrease in
      plasma E2 rather than inhibin that is the triggering signal for the LFT rise in
      plasma FSH. The exact roles of inhibin and other gonadal proteins (e.g. activins)
      in follicular recruitment remain to be determined.

PMID- 8345047
TI  - Comparison of a gonadotropin releasing-hormone antagonist plus testosterone (T)
      versus T alone as potential male contraceptive regimens.
AB  - Efforts to develop a hormonal contraceptive regimen for men have focused on
      administration of testosterone (T), alone or together with other agents. Previous
      regimens have successfully induced azoospermia in only 50-70% of subjects,
      however. GnRH antagonists, alone or in combination with T, have been shown to
      induce azoospermia in a very high percentage of nonhuman primates. We tested the
      hypothesis that the addition of a GnRH antagonist to a high-dose T regimen would
      lead to a higher percentage of men developing azoospermia than would T alone. We
      administered the GnRH antagonist, Nal-Glu (100 micrograms/kg.day sc), plus T
      enanthate, 200 mg im weekly or placebo sc injections daily plus T enanthate, 200
      mg im weekly, to separate groups of healthy men for 16-20 weeks. Seven of 10 men
      who received Nal-Glu plus T and 6 of 9 men who received T alone became
      azoospermic; gonadotropin levels were suppressed and T levels were increased
      similarly in both groups. There was a trend toward higher pretreatment
      gonadotropin levels and lower sperm counts in men who became azoospermic. Weight
      gain, development of acne, and increases in hematocrit and hemoglobin were
      similar in the two groups. In the majority of the men, sperm counts returned to
      the baseline levels within 4-5 months after treatment ended. We conclude that
      with the dosages of Nal-Glu and T we used in this study, the addition of GnRH
      antagonist to a high-dose T regimen does not increase the ability of T to
      suppress spermatogenesis in healthy men. Use of a higher dose of Nal-Glu, a lower
      dose of T, delaying the start of T replacement until several weeks after Nal-Glu
      injections are initiated, or prolonged hormonal administration might lead to a
      combination regimen that will suppress spermatogenesis more fully than does T
      alone.

PMID- 8345048
TI  - Tissue specificity and serologic reactivity of an autoantigen associated with
      autoimmune thyroid disease.
AB  - A recent report has identified a new autoantigen called D1 that appears to be
      associated with Graves' ophthalmopathy and is expressed in the thyroid and eye
      muscle. To better characterize the tissue specificity and disease relevance of
      this antigen, we evaluated the expression of D1 RNA in various human tissues
      using a reverse transcriptase polymerase chain reaction assay. These studies
      indicate a wide tissue distribution of the messenger RNA for this antigen,
      including the thyroid, eye muscle, parathyroid, spleen, skeletal muscle, and
      uterus. There were variations in the relative amounts of specific message for D1
      in the different tissues, with the uterus, thyroid, and eye muscle having the
      greatest amount of product per microgram of total RNA. A maltose binding protein
      D1 fusion protein was expressed in Escherichia coli, purified, and used to assess
      serologic reactivity to D1 by Western blot. Autoantibodies to this antigen were
      noted in 19 of 24 (78%) of Hashimoto's disease patients, 26 of 41 (63%) of
      Graves' disease patients, and in 9 of 17 (53%) of normal controls. Sixty percent
      of Graves' disease patients with clinical ophthalmopathy had antibodies to D1, as
      did 63% of Graves' patients without signs or symptoms of clinical ophthalmopathy.
      There was no correlation between reactivity to D1 and either clinical measures of
      hyperthyroidism or antibody titers to thyroid peroxidase or thyroglobulin. The
      presence of autoantibodies to this antigen in patients with Hashimoto's disease,
      in Graves' disease patients without ophthalmopathy and in normal controls
      indicate that serologic recognition of this antigen is not restricted to patients
      with ophthalmopathy. In addition, the expression of messenger RNA for this
      antigen in multiple types of cells questions the tissue specificity of this
      autoantigen.

PMID- 8345050
TI  - Insulin surrogates in insulinoma.
AB  - Universally accepted criteria for relative hyperinsulinemia have not been
      established for the diagnosis of insulinoma. Therefore, we sought measures of
      insulin action which might act as surrogates for insulin measurements and thereby
      contribute to the assessment of hyperinsulinemia. Since insulin is antilipolytic,
      antiketogenic, and glycogenic we measured plasma beta-hydroxybutyrate, FFA, and
      the response of plasma glucose to iv glucagon at the end of the prolonged fast in
      40 patients, later confirmed histologically to have insulinoma and 25 normal
      persons. Plasma beta-hydroxybutyrate and FFA concentrations were significantly
      lower in the patients with insulinoma (median, range), (0.3, 0.1-2.7 vs. 4.5, 1.2
      7.0 mmol, P < 0.0001, and 1.03, 0.17-1.75 vs. 1.79, 1.17-3.12 mmol, P < 0.001,
      respectively), whereas the responses of plasma glucose to glucagon were
      significantly greater (3.0, 1.4-5.4 vs. 0.7, 0.0-1.3 mmol, P < 0.001) than in the
      normals. For patients with insulinoma (20/40) and normal subjects (13/25) with
      plasma glucose less than or equal to 3.3 mmol and plasma insulin and C-peptide
      concentrations in the normal overnight fasting range, conditions in which
      hyperinsulinemia is most difficult to assess, a clear distinction was provided by
      plasma glucose response to glucagon and plasma beta-hydroxybutyrate but not by
      plasma FFA, plasma insulin, nor plasma C-peptide. We conclude that plasma glucose
      response to iv glucagon greater than or equal to 1.4 mmol and plasma beta
      hydroxybutyrate less than or equal to 2.7 mmol, at the end of the prolonged fast
      are indicative of hyperinsulinemia of insulinoma when the plasma glucose is less
      than or equal to 3.3 mmol. In this plasma glucose range these insulin surrogates
      provide better diagnostic accuracy than plasma insulin and C-peptide.

PMID- 8345051
TI  - A longitudinal assessment of hormonal and physical alterations during normal
      puberty in boys. I. Serum growth hormone-binding protein.
AB  - Previous studies have provided compelling evidence that GH secretion increases
      transiently during midpuberty in normally growing children. Although it is likely
      that the increase in GH production serves a primary role in generating the
      pubertal growth spurt, such a conclusion necessarily assumes that other essential
      "down-stream" components of the GH axis responsible for mediating the effects of
      GH remain unchanged. To investigate this concept, we assessed longitudinally
      another important component of the endogenous GH axis, the serum GH-binding
      protein (GHBP)/receptor system, in a cohort of 11 normal boys as they matured
      through normal puberty. At 4-month intervals over 4.0-5.1 yr, 24-h serum GH
      concentration profiles and serum GHBP activity were evaluated. Serum GHBP levels
      varied over a more than 12-fold range (40-504 pmol/L) among all subjects.
      However, the values for individual subjects consistently varied within more
      narrow limits. The coefficient of variation for values from all subjects was 51%
      compared to the mean intrasubject coefficient of variation of only 30% (P <
      0.05). Although the highest GHBP level (all subjects) was 12.6-fold greater than
      the lowest, the mean intrasubject range was only 3.1 +/- 0.5-fold (P < 0.05). The
      overall mean serum GHBP level correlated directly with the overall mean body mass
      index (r = 0.69; P = 0.018), but correlated inversely with the mean 24-h GH
      concentration (r = -0.61; P < 0.05). There was no significant increase in the
      GHBP level during puberty. However, because mean 24-h GH concentrations did
      increase during midpuberty, the data suggest that an increase in the relative
      amounts of free vs. bound GH develops during the period of the pubertal growth
      spurt. These data indicate that serum GHBP levels are regulated in individual
      children within much more narrow limits than those present in the larger
      population and do not undergo the dramatic changes during puberty typical of GH
      secretion and linear growth velocity. As a consequence, alterations may develop
      in the relative amounts of free vs. bound GH present in serum during the
      midpubertal years compared to those present during either the prepubertal or
      postpubertal periods. The majority of the known age-related increase in serum
      GHBP levels probably occurs before the period of active pubertal development.
      These findings strengthen further the concept that the midpubertal changes in GH
      secretion serve a primary role in generating the growth spurt.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8345052
TI  - Characterization of pulsatile secretion and clearance of plasma cortisol in
      premature and term neonates using deconvolution analysis.
AB  - Pulsatile secretion of cortisol (F) has not been documented in the newborn
      infant. Using repeated blood sampling and deconvolution analysis, we investigated
      F secretion and elimination dynamics in a group of five premature (gestational
      age, 24-34 weeks) and five term neonates. These infants had required placement of
      an umbilical arterial cannula for monitoring respiratory status, but were
      otherwise clinically stable. Blood samples were obtained at 15-min intervals for
      a 6-h period. All plasma F determinations were 58 nmol/L (2.1 micrograms/dL) or
      more, and pulsatile F secretion was observed in all infants. No significant
      differences were noted between the two groups with regard to 6-h mean plasma F
      concentration [350 +/- 129 (premature) vs. 277 +/- 54 nmol/L (term)], plasma
      corticosteroid-binding globulin (14 +/- 0 vs. 13 +/- 1 mg/L), F secretory burst
      frequency (4 +/- 0 vs. 5 +/- 1 bursts/6 h), mass of F secreted per burst [760 +/-
      480 vs. 310 +/- 100 nmol/Lv [Lv, liter of F distribution volume)], F production
      rate (FPR; 2.7 +/- 1.4 vs. 1.1 +/- 0.2 mumol/Lv.6 h), or plasma F half-life (45
      +/- 6 vs. 56 +/- 4 min). However, the premature infants had a significantly
      longer F secretory burst half-duration (63 +/- 18 vs. 6.7 +/- 4.0 min; P < 0.01)
      and a significantly lower maximal F secretory rate (9.4 +/- 3.4 vs. 100 +/- 26
      nmol/Lv.min; P < 0.02) than the term infants. Body surface area and body weight
      were inversely correlated with F secretory burst half-duration (r = -0.74 and 
      0.75, respectively); both were also positively correlated with the maximal F
      secretory rate (r = 0.66 and 0.72). The two most premature infants had
      significantly greater mean plasma F and FPR than the other three premature and
      all of the term infants. Extrapolating to 24 h and correcting for the
      distribution volume of F and body surface area, we estimate FPR to be
      approximately 17-24 mumol/m2.24 h (6.6-8.8 mg/m2.24 h) for newborn infants of 34
      weeks or more gestational age. These values are consistent with newer estimates
      of FPR in older children and adults determined using either deconvolution
      analysis or stable isotope dilution methods.

PMID- 8345054
TI  - Magnetic resonance imaging of overall and regional body fat, estrogen metabolism,
      and ovulation of athletes compared to controls.
AB  - The association of menstrual dysfunction of athletes with changes in body
      composition has been controversial, because most estimations of body fatness have
      been indirect. Using magnetic resonance imaging, we quantified the sc and
      internal fat over a specific volume from the fifth thoracic vertebra to femoral
      fat in the upper thigh and at 4 other anatomical landmarks of 17 athletes (13
      oarswomen and 4 runners) compared to that in 11 nonathletic controls. The
      magnetic resonance imaging data were also analyzed for the athletes and controls
      in relation to ovulatory status, which was determined by assay of urinary
      pregnanediol glucuronide, and in relation to the extent of 2-hydroxylation of
      estradiol to a nonpotent metabolite, 2-hydroxyestrone, which was evaluated by
      radiometric analysis. We found that 1) the relative and absolute body fat values
      of the athletes were significantly less (P < 0.05) than those of the controls
      overall and at each of the six regional sites, although the body weights of the
      rowers were significantly heavier than those of the controls, and the runners did
      not differ from the controls; 2) the ratio of sc fat to internal fat was 80%:20%
      among both athletes and controls, even though the athletes had significantly less
      fat; 3) the extent of estradiol 2-hydroxylation was significantly (P = 0.005)
      inversely related to total fat as a percentage of the total volume and to sc fat
      as a percentage of the total volume (P = 0.004) overall and at each of the
      regional fat depots; 4) athletes with menstrual disorders had significantly
      decreased sc and internal fat overall and at all regional sites compared to
      controls; and 5) a subgroup of ovulatory rowers had an apparent increase or lack
      of decrease in internal fat at the level of vertebrae lumbar 4, sacral 1, and
      sacral 4, compared to controls, whereas their sc fat was decreased at these sites
      compared to that in controls. Changes in regional fat deposits of both sc and
      internal fat may be involved in the menstrual dysfunction of the athletes in
      addition to their decreased overall fatness. The body weight and body mass index
      of well trained athletes can be a misleading index of body composition.

PMID- 8345053
TI  - Intracellular glucose metabolism after long term metabolic control with
      glyburide: improved glucose oxidation with unchanged glycogen synthase activity.
AB  - To determine whether improved metabolic control with long term glyburide
      treatment alters intracellular glucose metabolism independent of effects on
      glucose uptake (GU), we studied eight obese patients with noninsulin-dependent
      diabetes mellitus before and 7 months after glyburide therapy. Indirect
      calorimetry and skeletal muscle biopsies were performed in the basal state and
      during 300 pmol/m2.min insulin infusions, with glucose turnover rates determined
      by [3-3H]glucose turnover. During the glucose clamps, rates of GU were matched
      before and after treatment using equivalent hyperinsulinemia and variable levels
      of hyperglycemia. After glyburide treatment, rates of GU were decreased in the
      basal state [4.16 +/- 0.57 vs. 3.29 +/- 0.37 mg/kg fat free mass (FFM)/min; P <
      0.05], but similar during glucose clamps (11.53 +/- 1.42 vs. 11.93 +/- 1.32 mg/kg
      FFM.min; P = NS) according to study design. In both the basal state and during
      glucose clamps after glyburide therapy, rates of glucose oxidative metabolism
      (Gox) increased by 68-78% [1.21 +/- 0.16 vs. 2.03 +/- 0.31 mg/kg FFM.min (P <
      0.05) and 3.13 +/- 0.51 vs. 5.58 +/- 0.55 mg/kg FFM.min (P < 0.05),
      respectively], and rates of nonoxidative glucose metabolism decreased [2.96 +/-
      0.68 vs. 1.25 +/- 0.21 mg/kg FFM.min (P < 0.05) and 8.40 +/- 1.50 to 6.30 +/-
      1.40 mg/kg FFM.min (P < 0.01), respectively]. Circulating plasma FFA levels and
      rates of fat oxidation (Fox) remained unchanged in both the basal state and
      during clamp studies. Skeletal muscle glycogen synthase (GS) activity, expressed
      as fractional velocity, was unchanged by glyburide therapy (2.2 +/- 0.8 vs. 2.7
      +/- 0.3% in the basal state and 7.3 +/- 1.8 vs. 6.1 +/- 0.9% during clamps; both
      P = NS). In summary, at both matched (during clamp studies) and unmatched (during
      basal studies) rates of GU, improved metabolic control with glyburide therapy
      resulted in marked improvement of Gox independent of the effects on GU. The
      improvement in Gox was not associated with changes in Fox, circulating FFA, or
      muscle GS activity. These data indicate that long term metabolic control achieved
      by glyburide therapy markedly improves Gox, but not skeletal muscle GS activity,
      in noninsulin-dependent diabetes mellitus independent of GU and Fox.

PMID- 8345055
TI  - Factors determining glucose tolerance in patients with thalassemia major.
AB  - To better understand the pathophysiology of glucose intolerance secondary to iron
      overload in patients with thalassemia major, we performed tolbutamide-modified
      frequently sampled iv glucose tolerance tests (FSIGTs) in 10 thalassemic patients
      (6 males and 4 females; 21.7 +/- 1.2 yr old; body mass index, 19.7 +/- 0.6 kg/m2)
      and 10 healthy controls (5 males and 5 females; 22.4 +/- 1.3 yr; body mass index,
      20.6 +/- 0.5 kg/m2). Insulin secretion and action were quantified by application
      of the minimal model of glucose kinetics and the combined model of insulin and C
      peptide kinetics to the FSIGT data. The insulin sensitivity index was
      significantly lower in thalassemia patients [72 +/- 12 min-1(nmol/mL)] compared
      to controls [158 +/- 21 min-1(nmol/mL); P = 0.0026]. The integrated insulin
      response during the FSIGT was significantly greater in thalassemia patients than
      in controls after tolbutamide injection (P = 0.042). The difference in insulin
      levels was apparently due to reduced hepatic insulin extraction in thalassemia
      (78 +/- 2% vs. 68 +/- 3%; P = 0.0251). Seven of the 10 thalassemia patients were
      studied prospectively at 6-month intervals for 6-12 months. Repeated measures
      analysis of variance indicated that across a 6-month interval, there was a
      decrease in the total integrated insulin response (P = 0.002), with no change in
      insulin sensitivity (P = 0.86). In conclusion, patients with thalassemia major
      have significant insulin resistance, which may be compensated for by an elevated
      circulating insulin level. The elevated insulin level in response to tolbutamide
      appears to be due to reduced hepatic extraction of insulin and not to an enhanced
      insulin secretory response. Over time, patients with thalassemia experience a
      reduction in their circulating insulin levels. Persistent insulin resistance
      along with a progressive reduction in circulating insulin levels may lead to
      glucose intolerance and diabetes mellitus, which have a high prevalence in
      patients with thalassemia major.

PMID- 8345056
TI  - Deletion of amino acids Asp487-Ser488-Phe489 in human cytochrome P450c17 causes
      severe 17 alpha-hydroxylase deficiency.
AB  - 17 alpha-Hydroxylase deficiency blocks the biosynthesis of cortisol and sex
      steroids, resulting in mineralocorticoid excess, hypertension, sexual
      infantilism, and female phenotype in both genetic sexes. The disease is caused by
      mutations in the gene encoding cytochrome P450c17, which is the single enzyme
      that mediates both 17 alpha-hydroxylase and 17,20-lyase activities. We report a
      14-yr-old patient from Thailand with a classical clinical presentation of this
      rare disorder. Analysis of her P450c17 gene by polymerase chain reaction
      amplification and sequencing showed a nine-base deletion, eliminating codons 487
      489 (Asp-Ser-Phe) near the carboxy-terminus of P450c17. This deletion creates a
      BclI site in the mutant DNA, permitting accurate demonstration that the patient
      was homozygous for this lesion, whereas one parent and two siblings were
      heterozygous. By use of site-directed mutagenesis, we created a vector that could
      express this mutated form of P450c17 when transfected into non-steroidogenic COS
      1 cells. Such transfected cells produced immunodetectable P450c17 protein, but
      had no 17 alpha-hydroxylase or 17,20-lyase activity, whereas cells similarly
      transfected with a vector expressing normal human P450c17 could 17 alpha
      hydroxylate either pregnenolone or progesterone and convert 17 alpha
      hydroxypregnenolone to dehydroepiandrosterone, showing the presence of both
      activities. This is the first report of the molecular genetic basis of 17 alpha
      hydroxylase deficiency in a Southeast Asian patient.

PMID- 8345057
TI  - Estradiol stimulates cortisol production by adrenal cells in estrogen-dependent
      primary adrenocortical nodular dysplasia.
AB  - Adrenal glands from a patient with ACTH-independent Cushing's syndrome, whose
      symptoms worsened during pregnancy and oral contraceptive use, were cultured in
      different concentrations of estradiol. Estradiol stimulated cortisol secretion in
      a dose-response manner in the absence of ACTH. Since immunoglobulins G from this
      patient did not stimulate corticosterone production in a mouse adrenal bioassay,
      an adrenal-stimulating immunoglobulin is unlikely to be the cause of adrenal
      hyperfunction in this case. This is the first description of estradiol
      stimulation of cortisol production by cultured adrenal cells in ACTH-independent
      Cushing's syndrome.

PMID- 8345058
TI  - Glomerular hyperfiltration in insulin-dependent diabetes mellitus is correlated
      with enhanced growth hormone secretion.
AB  - Enhanced GH secretion and hyperglycemia are suggested to play a role in the
      pathogenesis of glomerular hyperfiltration in insulin dependent diabetes
      mellitus. In this study we measured the GH response to GHRH (1 microgram/kg body
      weight), metabolic control, and renal function in 44 patients in order to explore
      a possible association between these parameters. Hyperfiltration [glomerular
      filtration rate (GFR) > 130 ml/min/1.73 m2] was present in 21 patients and
      normofiltration in 23. The duration of diabetes, plasma concentrations of renin,
      catecholamines, insulin-like growth factor-1 and blood glucose during renal
      function measurements were not different. GH response was significantly higher in
      patients with hyperfiltration. There was a positive relation between GH response
      and GFR (r = 0.51, P < 0.001) and effective renal plasma flow (r = 0.39, P <
      0.01). GFR was correlated with insulin dose (r = 0.48, P < 0.001). There was no
      difference in glycosylated hemoglobin between the two groups. Patients with
      hyperfiltration used more insulin, had more frequent blood glucose values below
      the threshold level for activation of GH secretion, and had greater glycemic
      excursions than patients with normofiltration. The results suggest that GH
      hypersecretion and glomerular hyperfiltration are related and they support the
      possibility of a linkage between GH hypersecretion and glucose variability.

PMID- 8345059
TI  - Do heat shock proteins play a role in Graves' disease? Heat shock protein
      specific T-cells from Graves' disease thyroids do not recognize thyroid
      epithelial cells.
AB  - Thyroid-derived T-cells from patients with Graves' disease were analyzed for
      their reactivity to recombinant heat shock proteins (hsp) and autologous thyroid
      epithelial cells (TEC). Five of six uncloned T-cell lines responded to
      stimulation with recombinant mycobacterial 71-kilodalton (kDa) hsp and cross
      reacted with the corresponding amoebial and human proteins. Only one line reacted
      with recombinant 65-kDa hsp. Thyroid-derived T-cell lines also showed a
      proliferative response to TEC, which could be increased in four of the lines,
      when hsp expression was induced in thyroid cells by heat stress before the
      initiation of coculture. Clonal specificity analysis of thyroid-derived T-cell
      clones, however, demonstrated that distinct T-cells were responsible for the
      recognition of recombinant hsp and TEC. None of the clones responsive to
      recombinant hsp recognized TEC, whereas TEC-responsive clones did not react with
      recombinant hsp. Interestingly, the response of the majority of TEC-reactive
      clones could be dramatically increased when heat-shocked TEC were used as
      stimulator cells. These results suggest that T-cells specific for hsp of the 70-
      or 60-kDa families do not recognize TEC in the autoimmune thyroid gland. Heat
      shock-inducible proteins may, however, still play a role in the autoimmune
      process by facilitating the presentation of thyroid-specific autoantigen(s) to
      autoreactive T-cells.

PMID- 8345060
TI  - Inhibin and activin in human fetal membranes: evidence for a local effect on
      prostaglandin release.
AB  - Trophoblast and fetal membranes (amnion and chorion) are the tissues forming the
      anatomical/functional interface between the mother and the fetus. The aim of the
      present study was to evaluate the presence and a possible effect of inhibin and
      activin in human amnion and chorion. The expression of inhibin/activin alpha,
      beta A, and beta B subunit messenger RNA (mRNA) and the localization of
      immunoreactive material were evaluated in amnion and chorion collected at term
      pregnancy by a Northern blot analysis and by immunohistochemistry. Amnion cells
      expressed the mRNA of the three inhibin/activin subunits, with the beta B message
      the most abundantly expressed. The epithelial layer of the amnion showed an
      intense fluorescent staining of beta B inhibin/activin subunit, and positive
      signals were also observed for the alpha and beta A subunits. Inhibin/activin
      alpha and beta A subunit mRNAs were found highly expressed in chorion. The
      cytotrophoblast of the chorion showed a positive staining for the three
      inhibin/activin subunit antisera. The addition of activin A increased the release
      of prostaglandin E2 from human amnion-derived cultured cells. The effect was dose
      and time dependent. Inhibin A did not induce significant changes of prostaglandin
      E2 release from amnion cells. The present results show that amnion and chorion
      produce inhibin and activin subunits and that activin stimulates the release of
      prostaglandin E2 from cultured amnion cells, suggesting a possible role of
      inhibin and activin in fetal membranes.

PMID- 8345061
TI  - Localization of interleukin-1 type I receptor and interleukin-1 beta in human
      endometrium throughout the menstrual cycle.
AB  - Previous studies in the human suggest that the interleukin-1 (IL-1) system, may
      be an important paracrine/autocrine mediator in local intercellular interaction
      in endometrial tissue. In this study we have determined that IL-1 receptor type I
      (IL-1R tI) is expressed at the messenger RNA (mRNA) and protein levels in
      glandular cells and its ligand, IL-1 beta has been localized by
      immunohistochemical methods in endothelial cells and isolated stromal cells in
      the human endometrium throughout the menstrual cycle. IL-1R tI mRNA was detected
      in glandular epithelium using both specific complementary DNA and complementary
      RNA 32P-labeled probes. Human glandular epithelium contains a 5.1-kilobase mRNA
      transcript throughout the complete menstrual cycle. Quantitative densitometric
      analysis of slot blot hybridization signals shows an increase of IL-1R tI mRNA in
      both early and mid-late secretory phases in comparison with the proliferative
      phase (P < 0.05). IL-1R tI protein was localized in endometrial glandular
      epithelial cells using both indirect immunofluorescence and avidin-biotin
      peroxidase methods. However, more intense staining for IL-1R tI was observed in
      lumenal epithelial cells compared with the staining present deep in the
      endometrial glands. Using the same methods, IL-1 beta was detected in endothelial
      cells of spiral vessels and isolated stromal cells throughout the menstrual
      cycle, and an increased staining from proliferative to secretory phase was
      observed. The detection of IL-1R tI in the human endometrial epithelium and its
      ligand, IL-1 beta, in isolated stromal cells and endothelial cells, is another
      example of possible communication between the immune and reproductive systems
      with special relevance to human implantation.

PMID- 8345062
TI  - Prostaglandins stimulate the secretion of inhibin from human placental cells.
AB  - In this study, the effects of prostaglandins (PGs) on inhibin secretion were
      investigated in primary culture of human placental cells. Isolated trophoblast
      cells were cultured for 2-5 days with PGE1, PGE2, 6-keto-PGF1 alpha, PGF2 alpha,
      and thromboxane B2. Inhibin levels in the culture medium were measured by
      immunoenzymatic assay. PGs significantly stimulated inhibin secretion in the cell
      culture. The addition of PGs (1 nM to 10 microM) to the culture resulted in dose
      dependent increases in inhibin levels in the medium. At a dose of 10 microM,
      inhibin levels in the medium were increased by 35.2-172.5% compared to the
      control value. Compared with the efficacies of these PGs, PGE2 and PGF2 alpha
      enhanced inhibin secretion more potently than other tested PGs. A close
      correlation between the effects of PGs and the number of trophoblasts seeded in
      the culture was observed, with an optimal response of the cells to PGs at 1.0-2.0
      x 10(6) cells/well. Time-course studies showed that a significant increment in
      inhibin levels in the PG-treated culture occurred after 48-120 h, but not during
      the first 24 h, of the culture, indicating a possible involvement of PGs in
      inhibin biosynthesis in the cells. Epidermal growth factor (EGF) could enhance PG
      stimulated inhibin releases in the cell culture. Treatment with EGF (100 ng/mL)
      increased inhibin in the medium by 83.3% (ED50) in the presence of PGE2 or by
      70.3% (ED50) in the presence of PGF2 alpha compared to the control values. The
      addition of 8-bromo-cAMP (100 microM) and cholera toxin (1000 ng/mL) to the
      culture also enhanced basal and PG-induced inhibin secretion, but the addition of
      the 4-bromo-calcium ionophore A23187 (1 microM) did not alter inhibin releases,
      suggesting that the stimulatory effects of PGs on inhibin secretion in placental
      cells may be mediated through the cAMP pathway. In the cell cultures treated with
      PGE and PGF2 alpha, there was no change in cell growth or intracellular DNA
      content, as measured by 3-(4,5-dimethylthiazol-2-yl)2,5-diphenyltetrazolium
      bromide assay and DNA determination with fluorescence spectrophotometry.
      Morphological studies showed that PGE2 alpha (1 microM), alone or combined with
      EGF (100 ng/mL), significantly accelerated the process of differentiation from
      cytotrophoblasts to syncytiotrophoblasts, indicating that the actions of PGs may
      be related to their effects on syncytial transformation, rather than cellular
      proliferation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8345063
TI  - Circulating calcitonin levels in healthy children and subjects with congenital
      hypothyroidism from birth to adolescence.
AB  - Using an extraction-concentration technique of circulating calcitonin (exCT) that
      permits a sensitive and specific assessment of circulating CT monomer levels, we
      measured exCT levels in 115 healthy children (59 girls and 56 boys), aged 0-16
      yr, and 25 patients (15 girls and 10 boys), aged 2 months to 22 yr, with
      congenital hypothyroidism (CH), a condition characterized by a marked CT
      deficiency in adults. We found a significant negative correlation between CT
      levels and age in healthy children (girls, r = -0.83; boys, r = -0.63; P <
      0.001). There was a 5-fold decrease in CT levels from the neonatal period to
      adolescence. The fall in CT levels was particularly marked in early infancy (e.g.
      for the age category 1 day to 1 yr, 19.0 +/- 1.9 vs. 7.3 +/- 1.2 ng/L for the
      group 1-5 yr, P < 0.01), but less pronounced thereafter (for the group 5-10 yr,
      4.7 +/- 0.8 ng/L; P < 0.001 vs. the group 1 day to 1 yr). The well established
      sex difference in CT levels in adults was significant only for the age category
      above 10 yr (2.7 +/- 0.4 ng/L for girls vs. 4.5 +/- 0.7 ng/L for boys, P < 0.05).
      In patients with CH, the mean exCT level was 2.0 +/- 0.3 ng/L under 3 yr of age
      (n = 9), whereas all CT values were undetectable after the age of 3 yr, which
      could contribute to the lower bone mass of adult CH patients. CT values were
      normal in 3 children with metabolic goiter. In healthy children, our results
      demonstrate the existence of an age-related decrease in circulating CT levels,
      which was particularly marked in infancy. The sex difference in CT levels
      progressively appeared in childhood, but was significant only after 10 yr of age.
      Such changes in CT levels could be important for neonatal calcium metabolism and
      contribute to the lower bone mass in females.

PMID- 8345064
TI  - Search for a biological clock in the ontogeny of puberty.

PMID- 8345065
TI  - The production of placental protein 14 and interleukin 6 by human endometrial
      cells in culture.
AB  - Epithelial and stromal cells prepared from endometrium taken at different times
      in the menstrual cycle were grown in primary culture and the production of
      placental protein 14 (PP14) and interleukin-6 (IL6) measured. Only the epithelial
      cells produced PP14. Epithelial cells from endometrium in the late secretory
      phase produced significantly greater amounts of PP14 (42 +/- 5.8 ng/24 h)
      compared with that produced by cells from early secretory and proliferative
      endometrium (16 +/- 1.7 and 11 +/- 1.9 ng/24 h respectively). PP14 production by
      cells from endometrium at all stages in the cycle was increased by progesterone,
      or progesterone and oestradiol together, while oestradiol alone had no effect on
      PP14 production. The greatest stimulation was seen during the early secretory
      phase when stimulated levels of PP14 reached those obtained during the late
      secretory phase. IL6 production by epithelial cells also varied depending on the
      phase of the menstrual cycle. More IL6 was produced by the cells prepared from
      the endometrium in the proliferative phase (10.9 +/- 0.56 ng/24 h) compared with
      that produced by cells from early and late secretory endometrium (2.5 +/- 0.19
      and 1.45 +/- 0.09 ng/24 h respectively). Addition of steroids to the media
      stimulated the production of IL6 by cells from proliferative and early secretory
      endometrium but decreased IL6 production from cells in the late secretory phase.
      IL6 was also produced by stromal cells but could only be detected in supernatants
      of cells prepared from late secretory endometrium, and the amounts produced (0.8
      +/- 0.09 ng/24 h) were less than that produced by epithelial cells.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8345066
TI  - Transvaginal sonographic evaluation of endometrial growth and texture in
      spontaneous ovulatory cycles--a descriptive study.
AB  - Repeated transvaginal ultrasonographic examinations were performed during
      spontaneous ovulatory cycles to follow the texture and growth pattern of the
      endometrium in 23 healthy volunteers. The serum concentrations of oestradiol,
      progesterone and luteinizing hormone (LH) were measured regularly. The day of the
      LH peak was designated as day 0. On ultrasound only one thin echogenic line was
      seen from menstruation to day -7. From days -6 to -1 a change from one to three
      thin lines was observed together with an increasing hypoechogenic texture between
      the lines. These changes corresponded to the increasing serum concentration of
      oestradiol and increasing thickness of the endometrium. At ovulation there was
      maximum hypoechogenic texture between the lines which had become thicker. At
      ovulation the endometrium had a mean thickness (both layers) of 12 mm. From days
      +1 to +6 an increasing blurring of the three lines became apparent and the
      previously hypoechogenic layers gradually displayed a more echogenic texture.
      From day +7 to menstruation the lines were indistinguishable due to the
      appearance of a general hyperechogenic texture of the endometrium. In the luteal
      phase the growth of the endometrium plateaued. The results indicate that
      ultrasound assessment of endometrial growth and texture may be an important tool
      to evaluate normal ovulatory endometrial development. It can also be useful in
      monitoring stimulated cycles in different treatment modalities of assisted
      reproduction.

PMID- 8345067
TI  - Ovarian stimulation with buserelin/HMG/HCG: prospective randomized study of short
      versus long protocol.
AB  - The combined administration of the gonadotrophin-releasing hormone (GnRH) agonist
      buserelin and human menopausal gonadotrophin (HMG) was evaluated in 527 cycles
      (428 patients) of an assisted reproduction programme. All women were randomly
      allocated according to the ovulation induction protocol into two groups: group I
      (short protocol; 318 cycles) was given buserelin (1 mg/day) intranasally from
      cycle day 1 and HMG (2 ampoules/day) from day 3 until human chorionic
      gonadotrophin (HCG) administration: group II (long protocol; 209 cycles) was
      given buserelin (1 mg/day) intranasally from cycle day 1 for at least 14 days and
      then 2 ampoules HMG/day were added, increasing progressively according to the
      ovarian response. The number (mean +/- SEM) of follicles developed was higher in
      group II than in group I (9.1 +/- 0.4 versus 7.7 +/- 0.3, respectively; P <
      0.05). More oocytes were retrieved in group II (8.4 +/- 0.5) than in group I (6.5
      +/- 0.3) (P < 0.001), as well as more embryos (6.3 +/- 0.5 and 4.0 +/- 0.3,
      respectively; P < 0.001). Moreover, in group II there was a better correlation
      between oestradiol and the total follicular volume (r = 0.5391) on cycle day 0
      compared with group I (r = 0.458), while oestradiol values were similar between
      the two groups. No differences were observed in the cancellation rate,
      fertilization rate and maturity of the oocytes between the two groups. The
      pregnancy rate per transfer was slightly better in group II (25.8%) than in group
      I (19.4%), but this difference was not significant.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8345068
TI  - Pharmaco-dynamics of human menopausal gonadotrophin (HMG) and follicle
      stimulating hormone (FSH). The importance of the FSH concentration in initiating
      follicular growth in polycystic ovary-like disease.
AB  - Using a randomized double-blind cross-over design, the pharmaco-dynamic and
      pharmaco-kinetic properties of 'pure' follicle-stimulating hormone (FSH)
      (Metrodin) and human menopausal gonadotrophin (HMG) (Pergonal) were studied in 24
      women with polycystic ovary-like disease (PCOD) during induction of ovulation.
      Fifty-six cycles were stimulated with FSH and 60 cycles with HMG, according to a
      standard protocol. Gonadotrophins were administered i.v. in a pulsatile fashion
      using pulse frequencies of either 30 or 120 min. The cycles stimulated with
      either 30 or 120 min pulse intervals showed no differences among themselves.
      During the stimulation phase, the FSH and HMG stimulated cycles showed equal and
      dose dependent FSH concentrations (mean +/- SD). The luteinizing hormone (LH)
      concentrations (mean +/- SD) were also equal but unchanged compared to the mean
      basal concentration. The LH, FSH, total urinary oestrogen excretion, and
      testosterone profiles (mean +/- SD) obtained from cycle days -10 to 0 as well as
      the pregnanediol profiles obtained from cycle days 0 to +14 showed no differences
      either. The occurrence of an endogenous preovulatory LH surge was significantly
      more frequent in the cycles stimulated with a pulse interval of 30 min compared
      to the cycles stimulated with a pulse interval of 120 min. The addition of LH as
      provided in HMG did not influence the FSH threshold concentration above which
      initiation of follicular growth occurred, since no differences were found in the
      FSH 'stable' concentrations between FSH and HMG stimulated cycles. However, intra
      and inter-individual variation in the FSH 'stable' concentration at which
      follicular growth was initiated became obvious.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345069
TI  - Effects of gonadotrophin surge-attenuating factor on the two pools of
      gonadotrophin-releasing hormone-induced luteinizing hormone secretion in vitro.
AB  - In order to study the in-vitro mechanism of action of gonadotrophin surge
      attenuating factor (GnSAF), ovine pituitary monolayers were incubated for 48 h
      either with steroid-free follicular fluid from women in whom ovulation had been
      induced or oestradiol or progesterone. Monolayers were also incubated with 10-30
      and > 30 kDa follicular fluid fractions. The effect of these preparations on
      gonadotrophin-releasing hormone (GnRH)-induced luteinizing hormone (LH) secretion
      was then determined by incubation with GnRH for between 15 and 240 min.
      Incubation with steroid-free follicular fluid resulted in the significant
      attenuation of both the acutely releasable LH pool (LH 54.3 +/- 3.0% of control
      secretion at 15 min of GnRH incubation) and the reserve LH pool (LH 36.8 +/- 1.6%
      of control secretion at 240 min GnRH incubation). The 10-30 kDa follicular fluid
      fraction had similar effects while the > 30 kDa follicular fluid fraction
      significantly stimulated GnRH-induced LH secretion, with concentrations up to
      134.0 +/- 8.6% of controls. Oestradiol or progesterone at doses of 1000
      nmol/l/well did not significantly reduce any aspect of GnRH-induced LH secretion
      (never < 95.1 +/- 15.1% of controls). These results demonstrate that GnSAF
      markedly attenuates both the acutely releasable and reserve pools of GnRH-induced
      LH secretion. Inhibin, oestradiol and progesterone are not responsible for the
      marked attenuation of either the initial or reserve pools of GnRH-induced LH
      secretion.

PMID- 8345070
TI  - Hypersecretion of luteinizing hormone and ovarian steroids in women with
      recurrent early miscarriage.
AB  - Polycystic ovary syndrome is associated with hypersecretion of luteinizing
      hormone (LH) which has been implicated in the aetiology of early pregnancy loss.
      Although 82% of women with recurrent early loss have polycystic ovaries on
      ultrasound imaging, random serum LH concentrations are normal. In the present
      study, we have obtained further information from serial samples concerning the
      cyclical patterns of gonadotrophin and sex steroid secretion in these women.
      Twenty-one women with recurrent early pregnancy loss and 10 multiparous controls
      were investigated; 81% of them and one of ten control subjects had polycystic
      ovaries. Mean mid-follicular and mid-luteal serum LH and follicle stimulating
      hormone (FSH) levels were similar in both groups. Seventeen women with pregnancy
      loss had either raised urinary LH excretion or a premature LH surge; one control
      subject had a premature LH surge. Total LH excretion during the cycle and mean
      follicular phase serum testosterone was significantly greater with early
      pregnancy loss than in the control group, the difference in LH being greatest in
      the early luteal phase. Urinary oestrone-3-glucuronide excretion was raised in
      the early luteal phase of the cycle in the group with early pregnancy loss; there
      was no difference between the groups in pregnanediol-3 alpha-glucuronide
      excretion. These data demonstrate abnormalities in LH secretion in 81% of women
      with recurrent fetal loss. Inappropriately raised LH levels may have adverse
      effects on the developing oocyte or endometrium either directly, or indirectly by
      causing an elevation in testosterone and oestrogen levels.

PMID- 8345071
TI  - Another look at co-treatment with growth hormone and human menopausal
      gonadotrophins in poor ovarian responders.
AB  - The objective of this study was to evaluate whether a combined human growth
      hormone (HGH) and human menopausal gonadotrophin (HMG) treatment can improve
      ovulation induction in poor ovarian responders. Ten patients aged 28-43 years and
      requiring > 25 ampoules of HMG for ovulation were admitted to the study.
      Pituitary growth hormone reserve was evaluated by clonidine stimulation and
      insulin tolerance tests before commencement of treatment. The patients underwent
      one treatment cycle with D-tryptophan-6-luteinizing hormone-releasing hormone (D
      Trp6-LHRH) and HMG and another cycle with D-Trp6-LHRH, HMG and HGH. Serum HGH,
      insulin-like growth factor (IGF)-I and oestradiol were measured throughout the
      two treatment cycles and follicular maturation was assessed by ultrasonographic
      studies. All patients tested showed no elevation of their serum HGH concentration
      during a clonidine test, but showed an adequate response during insulin tolerance
      tests. No significant difference was found in the number of HMG ampoules,
      duration of treatment, number of leading follicles, and serum oestradiol
      concentration between the two treatment cycles. Co-treatment with HGH and HMG did
      not improve ovarian performance in poor ovarian responders. No correlation was
      found between the results of HGH pituitary function tests and the ovarian
      response to gonadotrophins.

PMID- 8345072
TI  - Endocrine composition of follicular fluid comparing human chorionic gonadotrophin
      to a gonadotrophin-releasing hormone agonist for ovulation induction.
AB  - Concentrations of inhibin, oestradiol and progesterone were determined in pre
      ovulatory follicular fluid from 16 women undergoing in-vitro fertilization and
      embryo transfer treatment. A prospective randomized design was used such that
      ovulation was induced in eight women with human chorionic gonadotrophin (HCG)
      (9000 IU), and in eight women with an endogenous surge of luteinizing hormone
      (LH) and follicle stimulating hormone (FSH) caused by a single injection of
      gonadotrophin-releasing hormone agonist (GnRHa). Inhibin was measured by an
      enzyme-linked immunosorbent assay, and oestradiol and progesterone were measured
      by radio-immunoassay. Concentrations of inhibin and progesterone are
      significantly higher in follicular fluids collected after ovulation induction
      with HCG compared with ovulation induction with GnRHa (P < 0.001, P < 0.02,
      respectively). Concentrations of oestradiol were similar in the two groups. This
      study shows that the method by which ovulation is triggered significantly affects
      the micro-environment of the oocyte just prior to ovulation. The results indicate
      that HCG causes a prolonged luteotrophic effect well before ovulation, compared
      to an endogenous surge of gonadotrophins caused by GnRHa, and suggest that
      follicular maturation with an endogenous surge of gonadotrophins may be closer to
      the natural cycle than those cycles in which HCG is administered for ovulation
      induction. In addition, this study shows that the concentrations of inhibin and
      progesterone in follicular fluid may be valuable parameters in assessing the
      midcycle LH surge requirements for induction of ovulation.

PMID- 8345073
TI  - Morphological assessment of polycystic ovary using transvaginal ultrasound.
AB  - A total of 104 patients with bilateral polycystic ovaries (PCO) diagnosed by
      transvaginal ultrasound were classified into four groups (A < 5 cysts, B 5-10
      cysts, C > 10 cysts located under ovarian capsule, D numerous cysts distributed
      all over the ovary) according to the number of microcysts. Ovarian volume,
      clinical features (menstrual disturbance, obesity and hirsutism), endocrine
      levels [luteinizing hormone (LH), LH/follicle stimulating hormone ratio,
      testosterone, androstenedione and dehydroepiandrosterone-sulphate] and response
      to clomiphene were compared for each group and 17 control subjects with normal
      ovulatory cycles. Ovarian volume in PCO subjects was significantly larger than
      that in control subjects. As the number of microcysts increased, the ovarian
      volume enlarged and the endocrine abnormality worsened. All endocrine parameters
      in PCO subjects with menstrual disturbances were significantly higher than those
      in PCO subjects without menstrual disturbances and controls. In PCO subjects
      without menstrual disturbances only androstenedione was significantly higher than
      in controls. Among PCO subjects, the frequency of menstrual disturbances, the
      percentage of response to clomiphene and the pregnancy rate in groups C and D
      were significantly higher than in groups A and B. Therefore, screening the
      ovaries in infertile patients by means of transvaginal ultrasound and subsequent
      assessment of morphology in PCO may suggest endocrine abnormality and help in
      selecting the proper treatment.

PMID- 8345074
TI  - Effect of insulin on human chorionic gonadotrophin secretion by placental
      explants.
AB  - The effect of physiological concentrations of insulin (5-50 microU/ml) was tested
      on human chorionic gonadotrophin (HCG) secretion by first trimester (7-9 weeks)
      and term placental explants using both static and dynamic culture models. In
      static cultures, insulin exerted a significant biphasic inhibitory effect (80% at
      5 microU/ml and 40% at 50 microU/ml) on HCG secretion by placental explants. At
      approximate fasting plasma levels, 25 microU/ml insulin added to superfused
      explants for > or = 8 min also had a rapid inhibitory effect. A delayed
      inhibitory effect on HCG pulsatility was also observed using 25 microU/ml
      insulin, with a 2-fold decrease in HCG pulse amplitude and a 4-fold decrease in
      the area under the curve following overnight pre-incubation (P < 0.01). Insulin
      had no effect in static cultures at term. The effect of insulin-like growth
      factor (IGF-I) and fibroblast growth factor (bFGF) on HCG secretion in static
      cultures was not statistically significant. In conclusion, physiological
      concentrations of insulin inhibit HCG secretion in first trimester placenta in
      vitro. This effect is gestational age dependent and specific since it is not
      mimicked by IGF-I or bFGF. Thus, insulin may be an important modulator of
      trophoblastic HCG secretion during early pregnancy.

PMID- 8345075
TI  - First established pregnancy and birth after ovarian stimulation with recombinant
      human follicle stimulating hormone (Org 32489).
AB  - This case report describes the first established pregnancy and birth after
      ovarian stimulation with Org 32489, pure recombinant human follicle stimulating
      hormone (recFSH, Organon International). A patient with tubal infertility
      participated in an open efficacy study of recFSH evaluating the efficacy of
      combined gonadotrophin-releasing hormone (GnRH)-agonist/recFSH treatment in women
      undergoing in-vitro fertilization (IVF) and embryo transfer. Ovarian stimulation
      was induced by recFSH in association with buserelin (Suprecur, 4 x 150
      micrograms/day) using a short protocol. After 9 days of recFSH treatment (75
      IU/day), six pre-ovulatory follicles (> or = 15 mm) were observed and 10,000 IU
      human chorionic gonadotrophin were administered. Nine mature oocytes were
      retrieved by oocyte puncture and after IVF, three embryos were replaced in the
      uterus. A viable singleton intra-uterine pregnancy was revealed at a gestational
      age of 7 weeks. The pregnancy progressed normally and ended with a vaginal
      delivery at a gestational age of 39.5 weeks. A healthy girl was born and
      paediatric examination did not demonstrate any abnormality.

PMID- 8345076
TI  - Early luteal phase treatment with mifepristone (RU 486) for fertility regulation.
AB  - Mifepristone (RU 486) is an antiprogestin which interacts with progesterone at
      the receptor level. Administration of mifepristone immediately after ovulation
      does not upset the menstrual cycle. However, the maturation and function of the
      endometrium is inhibited and uterine contractility is changed. To test if these
      effects are sufficient to prevent implantation, 21 women agreed to use one single
      treatment with 200 mg mifepristone on day luteinizing hormone (LH) + 2 monthly as
      their only contraceptive method. The women were treated for 1-12 months. The time
      of the LH peak was determined in the urine by the women themselves using a rapid
      LH test (Ovu-quick, Organon). The overall number of cycles studied was 169. In 12
      cycles the women were unable to detect the LH peak. In these cycles no treatment
      was given and the women advised to use barrier methods during the time to
      menstruation. The remaining 157 cycles with a detectable LH peak were all
      ovulatory based on plasma progesterone measurement. One pregnancy occurred. On
      the basis of the time of the LH peak, it was retrospectively calculated that in
      124 cycles at least one act of intercourse occurred during the period 3 days
      before to 1 day after ovulation. The probability of pregnancy in this period of
      the menstrual cycle is thus 0.008. The women did not complain of any treatment
      related side-effects apart from slight bleeding for 2-3 days starting a few days
      after the day of treatment in 35% of the cycles.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345077
TI  - Psychological considerations of anonymous oocyte donation.
AB  - This study involved 50 patients interviewed in conversations with a psychologist.
      It was found that it was possible to characterize the kind of couples using
      assisted reproductive techniques in terms of diagnostic and psychological
      profile. Other observations included the repercussions of this action on the
      couples' stability in case of failure or success, the desire for children and the
      plans concerning them, the secrecy theme and questions arising from the practice
      of anonymous or non-anonymous oocyte donation. The relationship between
      recipients and donors, as well as the specific relationship between couples and
      their consultants, were also examined. It is concluded that the problems
      encountered differ according to the infertility diagnosis. Donor anonymity allows
      oocyte recipients to impose their own identity patterns onto the future child and
      to introduce him/her in an unbiased way to their own lives. Artificial techniques
      to assist in the conception of a child do not appear to interfere with the
      couple's relationship and their desire for a child, which remains constant for
      each member of the couple.

PMID- 8345078
TI  - Male infertility and donor insemination: couples' decisions, reactions and
      counselling needs.
AB  - This paper reports findings of a postal survey of 205 couples belonging to the
      National Association for the Childless, whose infertility had been attributed to
      the male partner. Spontaneous resolution was seldom reported, but 36 couples had
      become parents by donor insemination (DI) and 28 through adoption. Almost a third
      of respondents had managed to resolve their childlessness. Although reasons for
      rejecting DI or preferring other options were offered by 60 couples, 125 had
      taken active steps towards it. Most of the 80 couples who had been counselled had
      found this helpful. Regardless of counselling, of the 76 couples who had
      considered whether or not to tell their children of their mode of conception, 56
      (74%) stated that they had no intention of doing so. Quantitative indices from
      two self-report scales confirm that male infertility is commonly a source of
      distress, especially for the female partner. However, the data also suggest that
      this is not necessarily associated with chronic marital discord. Couples who had
      already decided for or against DI reported less distress than others. The need
      for mutual support may well be enhanced until the couple's quest for a child has
      been either achieved or abandoned.

PMID- 8345079
TI  - Drop-out behaviour and fertility table analysis of pregnancy rates.
AB  - The life table analysis of infertility study data uses information from patients
      who drop out and are lost to follow-up. The fact that drop-out patients were not
      pregnant when last seen has been taken to be useful information that has been
      entered into the calculation of cumulative pregnancy rates for the population as
      a whole. However, drop-out patients who subsequently achieve pregnancy have
      motivations to return to their physician for follow-up, while those who do not
      become pregnant usually remain lost to follow-up. This can result in a systematic
      error toward reporting an excess of pregnancies, raising the apparent fecundity
      rates and plateau values. This study was undertaken to investigate the potential
      magnitude of these errors. Computer simulations of hypothetical infertility
      treatments using large cohorts (n = 32 000) were undertaken. Varying assumptions
      were made regarding post-treatment monthly fecundity rates, 'cure rates', drop
      out rates and the percentage of pregnant drop-outs who would return to their
      physician after achieving pregnancy. Using a range of clinically reasonable
      assumptions, very large deviations from ideal behaviour were noted in the
      direction of elevated cumulative pregnancy rates. The non-ideal behaviour was
      most apparent with lower fecundity rates, lower 'cure rates', higher drop-out
      rates and higher pregnant drop-out return rates. A change in the method of data
      collection to minimize the impact of this bias in infertility studies is
      proposed. This method of active data collection is a departure from that used in
      classical life table studies and therefore the method is titled the 'fertility
      table method' in order to avoid confusion.

PMID- 8345080
TI  - Fallopian tube sperm perfusion (FSP) versus intra-uterine insemination (IUI) in
      the treatment of unexplained infertility: a prospective randomized study.
AB  - Prospective randomization of 60 couples with unexplained infertility was
      performed for treatment either with intrauterine insemination (IUI), using a
      volume of 0.5 ml of the inseminate, or Fallopian tube sperm perfusion (FSP),
      using a volume of 4 ml of inseminate. The protocols for ovarian stimulation and
      induction of ovulation were the same in the two groups. The two groups were
      similar concerning age of the female at the start of treatment and the number of
      follicles > 15 mm diameter, the serum oestradiol concentrations and the
      endometrial thickness on the day of human chorionic gonadotrophin (HCG)
      administration. The mean (+/- SD) number of motile spermatozoa inseminated was
      significantly higher in the FSP group than in the IUI group (52 +/- 5 x 10(6) and
      28 +/- 3 x 10(6) respectively). In the FSP group, 30 women were given a total of
      52 treatment cycles; 14 clinical pregnancies occurred in this group, giving a
      pregnancy rate of 26.9% per cycle and 46.7% per woman. In the IUI group, 28 women
      were given a total of 51 treatment cycles; five clinical pregnancies occurred,
      giving a pregnancy rate of 9.8% per cycle and 17.9% per woman. The pregnancy
      rates per cycle and per woman in the FSP group were significantly higher than in
      the IUI group (P < 0.05, chi-square test). This study indicates that in the
      treatment of couples with unexplained infertility, Fallopian tube sperm perfusion
      (FSP) is more successful than intra-uterine insemination (IUI).

PMID- 8345081
TI  - Assessment of polyploidy in human morulae and blastocysts using co-culture and
      fluorescent in-situ hybridization.
AB  - Fluorescence in-situ hybridization with DNA probes for X, Y and no. 18
      chromosomes was used to analyse human morulae (n = 13) and blastocysts (n = 41),
      obtained after co-culture on Vero cells. On the basis of the number of
      hybridization signals, the proportion of embryos with more than five polyploid
      cells was 30.8% for morulae and 29.3% for blastocysts. These values are similar
      to those for mixoploidy (mosaicism of diploid and polyploid cells) observed in
      blastocysts of animal species. The results were confirmed by scanning electron
      microscopy, which showed a wide variation in the size of blastocyst nuclei, and
      by classical cytogenetic analysis. Mixoploidy seems to be a normal feature in
      preimplantation embryos and to occur very early in human embryo development. This
      lays open to doubt the preimplantation diagnosis of genetic errors at these
      stages, since results obtained from single cell analysis may not be
      representative of the whole embryo.

PMID- 8345082
TI  - Immediate rearrangements of human sperm chromosomes following in-vivo
      irradiation.
AB  - The short-term effects of radiotherapy on sperm chromosomes was evaluated in two
      Hodgkin patients. Sperm cytogenetics were analysed by using human-hamster cross
      fertilization. Immediately after irradiation, most sperm metaphases from the
      first patient exhibited multiple rearrangements, whereas in the second one, the
      incidence of such abnormalities was only slightly increased. Multi-fragmented
      chromosomes and structural aberrations of the chromatid-type were observed,
      suggesting a specific immediate response.

PMID- 8345083
TI  - Sub-zonal insemination for extreme male factor infertility.
AB  - When in-vitro fertilization (IVF) is used for severe male infertility, the zona
      pellucida constitutes a major barrier to sperm-oocyte interaction, a barrier that
      may, in principle, be overcome by micro-injecting one or more spermatozoa into
      the sub-zonal perivitelline space ('sub-zonal insemination' or SZI). We have
      defined suitable patients for SZI as having 'extreme' male factor in that they
      have either shown a failure of fertilization in previous IVF cycles or had < 50
      000 motile spermatozoa recoverable after semen preparation. (This is distinct
      from those with only 'severe' male factor in whom sufficient (> 50 000) motile
      spermatozoa could be recovered from a semen preparation.) A total of 213 SZI
      cycles were performed at Sydney IVF in the 4 year period September 1988 to
      September 1992, for extreme male factor patients with previous IVF failures or
      extremely low sperm numbers for whom SZI was the first option (about two-thirds
      and one-third of cases respectively). A total of 138 embryo transfers are
      reported, producing 20 clinical pregnancies after performing SZI on 1899 oocytes.
      One patient miscarried at 12 weeks gestation and there have been nine normal
      deliveries (so far) of 10 healthy infants. The first delivery was in February
      1990. One pregnancy was achieved in the only patient in whom spermatozoa were
      obtained by epididymal aspiration, and transfer of three cryopreserved embryos in
      another patient resulted in a singleton pregnancy. Of the 492 oocytes fertilized,
      282 had two pronuclei (57.3%) and normal embryos were transferred in 138/213
      (64.8%) treatment cycles, giving an overall pregnancy rate of 14.5% per embryo
      transfer or 9.4% per cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345085
TI  - Growth hormone status in patients with maturation arrest of spermatogenesis.
AB  - The growth hormone levels of 11 azoospermic patients with histological evidence
      of maturation arrest of unknown aetiology were studied using the clonidine test.
      The results were compared with the results from clonidine tests on 10 healthy
      fertile men and on a group of patients with severe oligozoospermia of various
      aetiologies. The results demonstrated that 10 patients (91%) in the azoospermic
      group had non-reactive, pathological responses while none of the control group
      had a pathological response. Of the severe oligozoospermic group, 82% had normal
      reactive clonidine tests (P < 0.005). We suggest that growth hormone deficiency
      may be associated with maturation arrest, and the possibility of treatment with
      growth hormone should be considered.

PMID- 8345084
TI  - Efficacy of the sperm survival test for the prediction of oocyte fertilization in
      culture.
AB  - The present study was carried out to investigate the predictive value of the
      sperm survival test (SST) with respect to the fertilization of oocytes in
      culture. In general, our laboratory uses a total of 50,000-150,000 motile
      spermatozoa to inseminate each oocyte. The remaining material is evaluated for
      motility before and after 24 h of incubation at 37 degrees C in a 5% CO2
      atmosphere. A total of 250 oocytes from 50 cases (mean +/- SD, 5.0 +/- 2.4
      oocytes per retrieval) were inseminated and the final rate of cleaved embryos
      obtained was 52.5%. The SST (%) was considered normal when the ratio (final
      density of progressing spermatozoa after 24 h x 100/initial density of
      progressing spermatozoa) was 50% or more. Any other result was considered
      abnormal. Cases presenting one or more cleaved embryos (n = 40) were separated
      from those in which no embryo formation occurred (n = 10) and the results were
      compared in terms of the respective sperm survival rates over a period of 24 h:
      normal SST (one or more cleaved embryos, 37; none, five), abnormal SST (one or
      more cleaved embryos, three; none, five). The specificity of the SST was 0.92 and
      sensitivity 0.50, the predictive value of the abnormal test was 0.62 and the
      predictive value of the normal test 0.88. The efficacy of the test was estimated
      at 0.71, which was better than the conventional parameters of sperm analysis. A
      receiver-operating characteristics curve for SST confirmed that the test can be
      useful for the prediction of fertilizability of oocytes in the laboratory.

PMID- 8345086
TI  - Effect of clomiphene citrate on sperm cell function.
AB  - Experiments were performed to determine time and dose-dependent effects of
      clomiphene citrate on the function of fertile donor spermatozoa. The percentages
      of acrosome-reacted, motile and live spermatozoa were assessed. Incubation with
      clomiphene citrate (1-1000 mumol/l; 1-4 h) induced a dose- and time-dependent
      increase in the percentage of acrosome-reacted spermatozoa (up to 100%). Acrosome
      reaction was associated with an impairment of both motility and viability. The
      maximal value for percentage of live reacted spermatozoa (37 +/- 1%) was obtained
      when cells were incubated for 1 h with 100 mumol/l of clomiphene citrate.
      Oestradiol neither affected sperm function when used alone nor inhibited
      clomiphene action. These results show that clomiphene strongly triggers the
      acrosome reaction, but that this action is not related to its anti-oestrogenic
      properties.

PMID- 8345087
TI  - Uterine flushing: a method to recover spermatozoa and leukocytes.
AB  - The process of sperm transport from the cervix, where a leukocytic reaction is
      initiated, through the uterus to gain access to the site of fertilization is very
      poorly understood. This preliminary study was designed to utilize a uterine
      flushing technique to determine firstly, the number of spermatozoa that can be
      recovered from the uterine cavity at 4 h post-insemination, around the time of
      ovulation, and secondly, to establish whether the spermatozoa initiate a
      leukocytic response while present. Uterine flushing was carried out in 10
      potentially fertile women at 4 h post-insemination with donor semen, 24-36 h
      after the onset of the luteinizing hormone (LH) surge. The flush fluid was
      analysed for the numbers of spermatozoa and leukocytes present. In 8/10 women
      spermatozoa were retrieved from the uterus, in consistently low numbers (median
      46, range 3-415). In 5/5 women leukocytes were recovered (median, 2.75 x 10(8)/l,
      range 2.0 x 10(8)-12.7 x 10(8)/l) from an origin other than peripheral blood
      contamination. These results suggest firstly that the flushing technique was a
      consistent method for retrieving spermatozoa and leukocytes from the uterine
      cavity, secondly that only low numbers of spermatozoa can be retrieved on
      flushing and thirdly that the leukocytic reaction to spermatozoa extends to the
      uterine cavity.

PMID- 8345089
TI  - Opening of the mouse zona pellucida by laser without a micromanipulator.
AB  - A contact-free laser system is described for ablation of the embryonic mouse zona
      pellucida using a pulsed excimer 308 nm laser. Effects on further embryonic
      development were evaluated. Zonae of 8- to 16-cell mouse embryos were either
      lased (n = 189), zona-drilled with acidified Tyrode's solution (n = 183) or left
      zona-intact (n = 188). Blastocyst formation (99-100%) was similar in the three
      groups. Hatching occurred earlier in lased embryos compared to those of the
      control group. These blastocysts hatched through the laser ablated area.
      Significantly more embryos were hatching on day 4 in the conventionally drilled
      group when compared to the laser treated group (50% versus 24% respectively). On
      day 7 of development, significantly (P < 0.05) more embryos conventionally zona
      drilled (37%) were intact than those which were previously laser treated (10%).
      Abnormal development was also noted in a small group of embryos which were lased
      just on the outside of the zona in comparison to 1/3 of an embryonic width away
      from the zona. The current results suggest that apparently precise zona laser
      ablation with an excimer laser at 308 nm may have potential adverse effects which
      may only be manifested after a prolonged period of culture past the cavitation
      stage. However, implantation rates of morphologically normal laser abalated
      embryos were not impaired when compared to control embryos.

PMID- 8345088
TI  - Ovarian function, tubal viability and pregnancy after tubo-ovarian
      transplantation in the rabbit.
AB  - A rabbit model was developed for microsurgical en-bloc vascularized tubo-ovarian
      allograft. Transplantation of tube and ovary from donors to tubo-oophorectomized
      recipients was technically successful in 50 rabbits. After surgery, animals were
      randomly allocated into two groups: animals in group A received cyclosporine for
      immunosuppression; animals in group B did not receive immunosuppressive therapy.
      In group A, 16 animals survived the transplant procedure and six animals became
      pregnant (38%). No pregnancies were obtained among animals in group B. In group
      A, plasma concentrations of ovarian and pituitary hormones were similar to those
      found in non-transplanted animals. Our results show firstly that tubo-ovarian
      transplantation is technically feasible, and secondly that cyclosporine improves
      not only tubal viability but also ovarian function after transplantation.

PMID- 8345090
TI  - The effects of the sperm motility activators 2-deoxyadenosine and pentoxifylline
      used for sperm micro-injection on mouse and human embryo development.
AB  - The sperm motility stimulants 2-deoxyadenosine (DOA) and pentoxifylline (PTF),
      used to improve the success of insemination and sperm micro-injection for low
      motility sperm samples, were studied for their effects on the developmental
      capacity of mouse and human oocytes. When human oocytes were micro-injected with
      spermatozoa in 3 mM DOA 80% of them became blocked at the 1-cell pronuclear
      stage. However, when spermatozoa in 3 mM PTF were used for micro-injection or
      when spermatozoa were washed to remove DOA before micro-injection only a few
      oocytes (9-10%) were blocked. Pregnancies occurred in five of 14 patients into
      whom cleaving embryos from all three treatments had been transferred, indicating
      that once cleavage was initiated, development of embryos occurred at expected
      rates. Exposure of mouse oocytes to DOA for a short period during insemination (4
      6 h) or a longer period during the pronuclear cell cycle (18-20 h) significantly
      reduced cleavage beyond the 2-cell stage, resulting in a dramatic reduction in
      blastocyst formation. PTF did not significantly reduce mouse embryo development.
      Similar results were obtained for oocytes inseminated in vitro or micro-injected
      with a spermatozoon into the perivitelline space. Neither DOA nor PTF increased
      fertilization of mouse oocytes. PTF reduced fertilization, particularly in
      cumulus-enclosed oocytes and oocytes micro-injected with spermatozoa in PTF. We
      conclude that DOA is a potent inhibitor of embryo development and oocytes should
      not be exposed to DOA. Exposure of oocytes to PTF had little effect on their
      subsequent development but treatment of cauda epididymal mouse spermatozoa can
      reduce their fertilizing capacity.

PMID- 8345091
TI  - Miscarriage rates following in-vitro fertilization are increased in women with
      polycystic ovaries and reduced by pituitary desensitization with buserelin.
AB  - To assess the risk of miscarriage after in-vitro fertilization (IVF) with respect
      to age, cause of infertility, ovarian morphology and treatment regimen, a
      retrospective analysis was performed of the first 1060 pregnancies conceived
      between June 1984 and July 1990 as a result of 7623 IVF cycles. Superovulation
      induction was achieved with human menopausal gonadotrophin (HMG) and/or purified
      follicle stimulating hormone (FSH) together with either clomiphene citrate or the
      gonadotrophin hormone-releasing hormone (GnRH) agonist buserelin, the latter
      either as a short 'flare' regimen or as a 'long' regimen to induce pituitary
      desensitization. There were 282 spontaneous abortions (26.6%) and 54 ectopic
      pregnancies (5.1%). The mean age of women with ongoing pregnancies was 32.2 (SD
      3.9) years compared with 33.2 (SD 4.1) years in those who miscarried, which were
      significantly different (P = 0.008). There was no relation between the
      miscarriage rate and the indication for IVF. The miscarriage rate was 23.6% in
      women with normal ovaries compared with 35.8% in those with polycystic ovaries [P
      = 0.0038, 95% confidence interval (CI) 4.68-23.10%]. There was no difference in
      the miscarriage rate between treatment with HMG or FSH. Women whose ovaries were
      normal on ultrasound were just as likely to miscarry if they were treated with
      clomiphene or with the long buserelin protocol. Those with polycystic ovaries,
      however, had a significant reduction in the rate of miscarriage when treated with
      the long buserelin protocol, 20.3% (15/74), compared with clomiphene citrate,
      47.2% (51/108) (P = 0.0003, 95% CI 13.82-40.09%).

PMID- 8345092
TI  - Evidence for decidua-trophoblast interactions in early human pregnancy.
AB  - Medium conditioned by decidual cells decreased the growth of cultured BeWo
      choriocarcinoma cells. The degree of inhibition was dependent on the
      concentration of the conditioned medium used, and suggested that maternal decidua
      might regulate the growth of the fetal placenta. Medium from BeWo cells and
      primary trophoblast had the opposing effect and increased the growth of cultured
      decidual cells for up to 120 h of culture. These results suggest that a
      regulatory loop to control placental and decidual growth exists at the materno
      fetal interface, and this may be an important factor in the development of
      adequate placentation and the subsequent growth of the placenta during pregnancy.

PMID- 8345093
TI  - Family planning: cultural and religious perspectives.
AB  - The world population explosion has caused political leaders to look upon national
      and regional birth control projects as vital. Support for regulation of
      individual fertility has been evident in all cultures, and at all times, even in
      those societies in which social and religious rules have favoured the abundant
      production of children. As the secularization of Western society and scientific
      enquiry gained momentum during the modern period, knowledge of reproduction
      increased and was applied to control human population growth. The various methods
      of contraception and their development through the years from the ancient ideas
      to the modern era are presented. Each approach to fertility control has its
      advantages and disadvantages. No one method is perfect for everyone, for every
      clinical setting, and in every culture. Higher levels of fertility have been
      associated with 'traditional', religious prohibitions on some forms of birth
      control, 'traditional' values about the importance of children and the priority
      of family, and 'traditional' family and gender roles reinforced by religion. The
      attitude of the main religious groups to contraceptive practice is discussed.

PMID- 8345094
TI  - Recommendations of the ESHRE workshop on 'Unexplained Infertility'. Anacapri,
      August 28-9, 1992.

PMID- 8345095
TI  - Clomiphene citrate and pregnancy loss.

PMID- 8345097
TI  - Mutagenic sensitivity of human post-spermatogonial cells.

PMID- 8345096
TI  - Population growth.

PMID- 8345098
TI  - Treatment of Wernicke's aphasia with jargon: a case study.
AB  - This case study concerns an adult with Wernicke's aphasia characterized by
      neologistic jargon and a severe auditory comprehension deficit. No communicative
      or linguistic improvements had been observed after eight months poststroke. Up
      until this time, therapeutic intervention was aimed at managing the patient's
      rambling communicative style and improving auditory comprehension skills. A
      therapeutic regimen was introduced that focused on visual/written information and
      included a hierarchy of visual word and sentence comprehension tasks. All
      auditory/verbal stimulus presentation was eliminated. After two months on the
      program, improvement was noted in naming abilities and general ability to
      communicate in conversation, including a reduction of neologistic jargon and an
      increase in semantic jargon. No improvement was noted in auditory comprehension.
      The visual program may have facilitated the patient's general attentional set,
      thereby possibly contributing to her improvement in communicative style and
      sensitivity to conversational interactions with others.

PMID- 8345099
TI  - Word retrieval in fluent and nonfluent dysphasia: utilization of pictogram.
AB  - Connected speech samples were elicited from 10 nonfluent and 10 fluent dysphasic
      subjects utilizing two contexts, picture and pictogram descriptions. Incidences
      of word retrieval problems were identified and assigned to nine word retrieval
      categories. Results revealed pictogram elicited a greater incidence of word
      retrieval problems, and therefore, proved as a more informative context for
      identifying word retrieval problems in mild dysphasia. Also, certain word
      retrieval categories were selectively used by specific dysphasic classification
      categories and severity levels.

PMID- 8345101
TI  - Istvan Tork 1939-1992.

PMID- 8345100
TI  - Common hemisphericity of language and music in a musician. A case report.
AB  - Aphasia coupled with amusia is reported in a 73-year-old male musician who was a
      lawyer by profession. This condition followed an ischemic stroke in the lateral
      aspect of the parieto-occipital region of the left hemisphere. The patient's
      music production exhibits jargon amusia, similar to that in his verbal
      production. This case supports the thesis that language and music may share a
      common hemisphere.

PMID- 8345102
TI  - Retinal degeneration in the nervous mutant mouse. II. Electron microscopic
      analysis.
AB  - Nervous mutant mice (nr/nr) show a rapid loss of most of cerebellar Purkinje
      cells between the ages of 3 and 7 weeks, as well as a progressive photoreceptor
      cell degeneration that occurs most rapidly between postnatal days (P) 13 and 19,
      but with a much slower attrition during the subsequent months. We have carried
      out an electron microscopic analysis of nr/nr and littermate control mice at
      representative ages to characterize the subcellular cytopathological changes in
      this form of retinal degeneration, to gain insight into photoreceptor cell
      degeneration mechanisms by comparing these changes to those in other rodent forms
      of retinal degeneration, and to compare the photoreceptor changes with those of
      cerebellar Purkinje cells. Ultrastructural observations were limited to rod
      photoreceptors, since the number of cones was limited in our micrographs. The
      retinas of nr/nr mutant mice can be distinguished from those of normal
      littermates as early as postnatal day (P) 6. At this time, some of the
      mitochondria in rod inner segments are larger and more rounded than normal. This
      represents the earliest cytopathological change thus far observed in this mutant.
      As early as P9 and thereafter, the volume and integrity of rod outer segment
      membranes are reduced from normal. In the inner segments of some rod
      photoreceptor cells, there is a reduction in the volume or number of
      polyribosomes as early as P11, a reduction in rough endoplasmic reticulum as
      early as P13, and reduced incidence and less organized Golgi membranes as early
      as P16. Qualitative evaluation and quantitative stereological analysis show that
      the enlarged mitochondria in rod inner segments never become normal in shape or
      size. No changes are seen in the inner retinal layers at any age. Despite
      similarities with inherited retinal dystrophy in the Royal College of Surgeons
      rat, as noted in the original description of retinal degeneration in nr/nr mice,
      ultrastructural features clearly distinguish these mutants. Moreover, nr/nr mice
      can be distinguished from all other murine forms of retinal degeneration by
      electron microscopy.

PMID- 8345104
TI  - Developmental study of GnRH neuronal projections to the medial basal hypothalamus
      of the male Djungarian hamster.
AB  - The present study in the male Djungarian hamster determined the neuroanatomical
      distribution and morphology of gonadotropin-releasing hormone (GnRH) neurons
      which innervate the medial basal hypothalamus during sexual maturation.
      Prepubertal, peripubertal, and postpubertal males were perfused, brains were
      removed, and crystals of the fluorescent tract tracer, DiI, were implanted
      directly into the median eminence of the brain. Eight weeks later, brains were
      sectioned and processed for GnRH immunofluorescence. At all ages, GnRH cell
      bodies were bipolar or unipolar; both subtypes were labeled with DiI in
      proportion to their respective numbers in each brain region. GnRH perikarya were
      distributed in a diffuse ventromedial continuum from the septum through the
      anterior hypothalamus. In prepubertal males, DiI was present in the majority of
      GnRH neurons (54% of total) that were located in brain regions rostral to and
      including the medial preoptic area. In lateral and caudal brain areas, fewer GnRH
      perikarya contained DiI (28% of total or less). With sexual maturation, fewer
      GnRH somata were labeled with DiI in areas rostral to the hypothalamus. The data
      suggest that bipolar and unipolar GnRH neurons in the forebrain, rostral to the
      preoptic area, are major contributors to the GnRH innervation of the median
      eminence in the male Djungarian hamster. With the onset of puberty, the finding
      that decreasing numbers of GnRH perikarya directly project to the medial basal
      hypothalamus suggests that fewer GnRH neurons constitute the final common pathway
      that controls gonadotropin secretion.

PMID- 8345103
TI  - Differential time course and spatial expression of Fos, Jun, and Krox-24 proteins
      in spinal cord of rats undergoing subacute or chronic somatic inflammation.
AB  - We have used the evoked expression of both immediate early gene (IEG)-encoded
      proteins (Krox-24, c-Fos, Fos B, Jun D, Jun B, c-Jun), and dynorphin to monitor
      sensory processing in the spinal cords of rats undergoing subacute or chronic
      somatic inflammation (i.e., subcutaneous inflammation of the plantar foot and
      monoarthritis, respectively). Behavioral and immunocytochemical approaches were
      conducted in parallel up to 15 weeks postinjection in order to detect possible
      relationships between clinical evolution and spatiotemporal pattern of IEG
      encoded protein expression. Each disease had specific characteristics both in
      terms of their clinical evolution and pattern of evoked protein expression. All
      IEG proteins were expressed in both cases. Most of the staining was observed in
      both the superficial layers of the dorsal horn and deep dorsal horn (laminae V
      VII and X). Monoarthritis was distinguished by a high level of total protein
      expression. Staining was especially dense in the deep dorsal horn. More labelled
      cells were observed at 1-2 days and at 2 weeks postinjection, corresponding to
      the initiation and progressive phases of the disease, respectively. Subcutaneous
      inflammation was characterized by a moderate level of total IEG expression. More
      labelled cells were observed in the first day following injection. It is the
      relative degree of expression of each IEG-encoded protein with regard to the
      others that characterized the progression of the diseases. Early stages of the
      diseases coincided with the expression of all Fos and Jun proteins, while late
      stages showed an increase in Jun D and Fos B involvement; Krox-24 was induced
      mostly during the early phases and/or periods of paroxysm of the diseases.
      Persistent stimulation was characterized by a predominant expression in deep
      versus superficial layers of the dorsal horn. Evoked expression of c-Jun in
      motoneurons was only observed in monoarthritis. The peak of dynorphin expression
      was late in regard to both the induction of inflammation and period of maximal
      IEG-encoded protein expression. The present work indicates that the neural
      processing that takes place during progression of these diseases can be monitored
      well at the spinal cord level by using the expression of an array of IEG-encoded
      proteins. Study of long term evolutive diseases and especially those that evolve
      into chronicity can largely benefit from such an approach.

PMID- 8345105
TI  - Collateral sprouting in the electrosensory lateral line lobe of weakly electric
      teleosts (gymnotiformes) following ricin ablation.
AB  - Sprouted collateral axons were observed in the electrosensory lateral line lobe
      (ELL) of gymnotiform teleosts (Apteronotus leptorhynchus) following the ablation
      of the supraorbital branch of the anterior lateral line nerve. Ablation was
      accomplished by using microinjections of the toxic lectin ricin. Sprouted axons
      were followed for up to 26 weeks postablation. Ricin exposure severely reduced
      axonal numbers and the peripheral electroreceptors in the region innervated by
      these fibers. To visualize sprouted fibers, intact lateral line afferent nerve
      branches were anterogradely labelled with the neuronal tract tracers horseradish
      peroxidase or cobalt chloride, or the monoclonal antibody Q26A3. Within the four
      somatotopically organized ELL segments, sprouted collaterals were first observed
      two weeks after ricin injection in the medial and centromedial segments, and four
      weeks postinjection in the centrolateral and lateral segments. Sprouting involved
      intrasegmental, horizontally directed axons from adjacent nerve branch terminal
      fields, and mixed intra- and extrasegmental, dorsally directed axons from the ELL
      deep fiber layer. The sprouting response was robust but variable in its timing,
      peaking between 6 and 12 weeks. Subsequently, the intrasegmental, horizontally
      directed fibers were retained but the mixed dorsally directed fibers, including
      all extrasegmental axons, were retracted. Therefore, this sprouting response
      appears to consist of a collateral overproduction followed by a selective axonal
      retraction. In our view, the most likely explanation for this axonal retraction
      is that the descending inputs from the isthmus and the cerebellum, as well as
      commissural fibers from the contralateral ELL, maintain established somatotopic
      relationships by eliminating somatotopically mismatched sprouted collaterals.

PMID- 8345106
TI  - Spatial organization of inner hair cell synapses and cochlear spiral ganglion
      neurons.
AB  - The morphological organization of the central projections of the cat cochlear
      spiral ganglion into the cochlear nucleus was previously investigated by creating
      restricted lesions in the anteroventral cochlear nucleus (AVCN) to ablate
      selectively either the lateral or the medial aspect of isofrequency projection
      laminae. Such lesions resulted in highly selective retrograde degeneration of
      spiral ganglion cells. Ablation of the lateral part of the AVCN caused
      degeneration of cells within the scala tympani part of the ganglion, whereas
      medial ablations within the AVCN induced degeneration of the scala vestibuli
      aspect of the ganglion. The peripheral axons also degenerated and this fiber loss
      exhibited selective topographies that paralleled the cell loss within the spiral
      ganglion, although this phenomenon was more prominent in the proximal part of the
      osseous spiral lamina near the ganglion and less obvious more distally near the
      habenula perforata. In this investigation, inner hair cells (IHCs) from these
      selective lesion cases were evaluated by electron microscopy of serial sections
      through the basal synaptic regions. Results demonstrated differential
      degeneration of afferent synapses, with greater (but not completely selective)
      loss of pillar synapses after lateral AVCN lesions and greater loss of modiolar
      synapses after medial lesions. Because auditory nerve fibers of different
      spontaneous discharge rates (SRs) have different spatial distributions on the IHC
      (Liberman, Science 216:1239, 1982), our results suggest that this SR-based
      organization is maintained in a topographic organization across the vertical
      (scala tympani-to-scala vestibuli) dimension of the spiral ganglion cell cluster
      and carried into the ventral cochlear nuclei (VCN). Thus, in addition to the
      spiral frequency organization represented by the dorsal-to-ventral frequency map
      in the VCN, there is also an orderly organization of inputs from high- and low-SR
      fibers across the lateral-to-medial dimension of the VCN such that the lateral
      isofrequency laminae receive a proportionately greater input from high-SR fibers,
      whereas medial isofrequency laminae receive preferential input from low- and
      medium-SR fibers.

PMID- 8345107
TI  - JUN, FOS, KROX, and CREB transcription factor proteins in the rat cortex: basal
      expression and induction by spreading depression and epileptic seizures.
AB  - The expression of the nuclear c-JUN, JUN B, JUN D, c-FOS, FOS B, KROX-24, and
      CREB transcription factors was investigated in the cortex of adult rats by
      immunocytochemistry. The expression patterns were studied in untreated rats and
      up to 24 hours following topical application of 1 M KCl to the cortical surface
      (KCl) or i.v. injection of bicuculline (BIC). Topical KCl induced cortical
      spreading depression and systemic injection of bicuculline evoked generalized
      tonic-clonic seizures. In untreated rats, JUN B, c-FOS, and FOS B were expressed
      in a small number of neurons in the piriform, perirhinal, entorhinal, and insular
      cortex and in layers II, III, and VI of all neocortical areas. In contrast, c
      JUN, JUN D, and KROX-24 were expressed in all cortical layers but with different
      intensities of immunoreactivity (IR): c-JUN-IR was generally weak and
      predominantly present in layers II, III, and VI. JUN D-IR was equally strong in
      all layers. KROX-24 showed a prominent expression in layers II, IV, and VI. The
      CREB protein exhibited a slight preponderance in layer II and piriform cortex.
      Following KCl or BIC, a strong induction was seen for c-FOS, JUN B, and KROX-24,
      whereas c-JUN, JUN D, and FOS B showed only a moderate increase compared to basal
      levels. Changes of CREB-IR could not be detected. The localization of induced
      JUN, FOS, and KROX proteins reflected the pattern of labelling in untreated
      animals but demonstrated a higher intensity of labelling and an increased number
      of immunoreactive nuclei. The intensity and persistence of IR as well as the
      number of labelled cells following BIC exceeded those following KCl. Following
      BIC, increased levels of FOS B and JUN D were still present after 24 hours.
      Counterstaining with cresyl-violet and GFAP, a marker for astrocytes, revealed
      that JUN, FOS, and KROX proteins were expressed in neurons but not in glial cell
      populations. The present data demonstrate that CREB, JUN, FOS, and KROX
      transcription factors exhibit a layer-specific expression in the cerebral cortex
      with only slight area-specific differences both in untreated rats and following
      stimulation with KCl and BIC. The expression of transcription factor proteins
      indicate complex molecular genetic changes in cortical neurons due to
      pathophysiological events such as seizure activity and spreading depression.

PMID- 8345108
TI  - Development of the olfactory organ in the zebrafish, Brachydanio rerio.
AB  - The development of the olfactory organ of the zebrafish, from the forming of
      early placode to the adult organ, was investigated by electron microscopy and DiI
      labeling. The olfactory placode is formed by a subepidermal layer of cells. These
      cells differ from those of the epidermis as well as from brain cells, and they do
      not mingle either with epidermal or with brain cells. No migration of cells from
      the brain or the epidermis towards the subepidermal cell layer has been observed.
      The cells of the subepidermal layer seem to form all cell types of the olfactory
      mucosa, i.e., basal cells, ciliated and microvillous receptor cells, supporting
      cells, and ciliated nonsensory cells. Axons grow into the forebrain at a very
      early stage when the epidermis still covers the placode completely. Dendrites
      grow out when the epidermis separates, building the olfactory pit. This process
      implicates neither cell lysis nor cell degeneration. The olfactory pit forms a
      rosette with a midline raphe and olfactory lamellae. The incurrent nostril is
      separated from the excurrent nostril by a funnel-shaped structure.
      Differentiation of the olfactory placode in the embryo is accomplished very
      quickly, whereas the development into the adult organ during larval stages is a
      slow process.

PMID- 8345109
TI  - The differentiation between neuroglia and connective tissue sheath in insect
      ganglia revisited: the neural lamella and perineurial sheath cells are absent in
      a mesodermless mutant of Drosophila.
AB  - Two morphogenetic mutations, twist and Delta, that affect the embryonic
      development of Drosophila in known ways were used to examine the derivation and
      function of the outer layers of the central nervous system (CNS). Both the
      extracellular neural lamella, which ensheaths the CNS, and its source, the
      underlying perineurial sheath cell layer, fail to develop in Drosophila embryos
      that are homozygous for a loss of function mutation in the twist gene, and which
      thus lack mesodermal derivatives. The cell layer immediately below the
      perineurial sheath cells, here termed barrier glial cells, constitute the ion
      permeability barrier in wild-type embryos. They are present in twist mutant
      embryos, appear to be normal at the ultrastructural level, and function as a
      blood-brain ion barrier. The apparent derivation of perineurial sheath cells from
      mesodermal precursors distinguishes them from neurons, glia and other nonneural
      components of the CNS, such as tracheae, all of which are of ectodermal origin.
      We confirm Scharrer's interpretation of the relationship between the perineurium
      and underlying neuroglia. In embryos homozygous for the neurogenic mutant Delta,
      an embryonic lethal in which excess ventral blastoderm gives rise to neuroblasts,
      the CNS forms as an amorphous cell mass, with discontinuous perineurial sheath
      and barrier glial cell layers. We propose that the cell mass is permeable to
      lanthanum ions and fails to form a blood-brain barrier because volume growth
      prevents the formation of continuous surface cell layers.

PMID- 8345110
TI  - Continuing education and health care reform.

PMID- 8345111
TI  - Preparing for mandatory continuing education--assessing interests.
AB  - Assessment of needs is the foundation of nursing practice as well as nursing
      education. To increase responsivity to the continuing education (CE) needs of
      registered nurses (RNs) within a small, yet diverse, mid-Atlantic state in which
      CE was recently mandated for relicensure, a telephone survey was used to gather
      information on a large nonrandomized sample of RNs. Preferences for types of
      programming, methods and locations for acquiring CE, scheduling, academic credit
      in addition to CE credit, and an automated service for maintaining CE attendance
      records were identified. This study presents an overview of survey results
      helpful in planning offerings most likely to attract and satisfy nurses.

PMID- 8345112
TI  - Collaborative preceptor training: a creative approach in tough times.
AB  - Rapid changes in the health care environment have challenged educators to find
      more efficient methods of developing nurses. These demands are leading to the use
      of collaborative approaches to education. Nurse educators have also found that
      they have to rely on preceptors for orientation of new employees. The Texas
      Medical Center Collaborative Preceptor Program was developed in 1989 to prepare
      nursing preceptors for all nine participating institutions. The goals of the
      program were to increase efficient use of instructor time, standardize preceptor
      preparation in the Texas Medical Center, and offer more programs and prepare more
      nurses per year than each individual institution could do alone. There were many
      unexpected benefits as well, and future plans for collaboration are already being
      formulated.

PMID- 8345113
TI  - Predictors of clinical performance of new graduate nurses participating in
      preceptor orientation programs.
AB  - Orientation programs providing designated preceptors for graduate nurses are used
      widely, but few studies support their success in assisting graduates to assume
      staff nurse positions. This study addressed the research question: What variables
      are related to clinical performance among new nursing graduates? Self-evaluations
      of clinical performance, preceptor evaluations, and demographic information were
      collected from a sample of 65 new graduates. The most useful predictors of
      clinical performance scores were support provided by other nurse friends,
      preceptor skills, and emotional support provided by preceptors. Participation in
      formal support groups, however, was not found to be a predictor.

PMID- 8345114
TI  - Clinical ladder development: implementing contract learning.
AB  - Expanding the clinical ladder concept in nursing at the Presbyterian Hospital in
      New York prompted the Department of Education, Research, and Development to
      further implement contract learning as an innovative adult education technique.
      The process was applied in orienting new Clinical Nurse IIs (experienced nurse
      preceptors) and Clinical Nurse IIIs (assistants to the Nursing Care Clinicians)
      to their advanced clinical roles. The process of implementation, the development
      of learning contracts, and the week-long workshop designed for each of the new
      clinical leaders is discussed.

PMID- 8345115
TI  - Comparison of classroom instruction and independent study in body mechanics.
AB  - This study was designed to determine which method of instruction in body
      mechanics results in the higher subsequent use of the techniques taught. Two
      groups were formed from nursing personnel at a rural general medical-surgical
      hospital in the southwestern United States. Subjects from the direct care nursing
      staff were randomly assigned to one of the two groups. One group attended two
      hours of classroom instruction in body mechanics, while the other completed an
      independent study module. Subjects were pre- and posttested using the Work
      Related Body Mechanics Evaluation (Carlton, 1987) while performing a standardized
      lifting task in the clinical setting. Using analysis of covariance, no
      significant differences were found in the posttest scores of the two groups.

PMID- 8345116
TI  - Revisiting CPR knowledge and skills among registered nurses.
AB  - The purpose of this investigation was to explore facets involved in the retention
      of the cognitive knowledge and psychomotor skills of cardiopulmonary
      resuscitation (CPR) by 73 RNs from three general hospitals. Data analysis
      indicated that cognitive knowledge was adequately retained but that skills were
      not. Product-moment correlation coefficients showed that the number of CPR
      courses taken, certification as a CPR instructor, the number of years certified,
      and time since last certification were significantly related to skill scores.
      Findings prompt questions of appropriateness of the usual certification
      procedures for hospital-based RNs.

PMID- 8345117
TI  - Codependency in nursing: using a simulation/gaming teaching method.
AB  - Practicing nurses can benefit by learning to differentiate their caretaking
      (potentially destructive) from their caregiving (constructive) behaviors, and by
      learning strategies to facilitate caregiving. A new simulation/game was developed
      to assist nurses to recognize codependent behaviors in themselves and others and
      to practice some alternative patterns of behavior. This team-based
      simulation/game, "The Climb," uses the metaphor of a mountain-climbing
      expedition. The experiences of the journey promote dynamic insights into the
      consequences of codependency in the professional and personal lives of the nurse.

PMID- 8345118
TI  - The mock isolation room: a fun way to review infection control.
AB  - The Infection Control Unit of the Montreal General Hospital implemented a Mock
      Isolation Room that tested nurses' knowledge with a review of common medical
      device and isolation infractions and recommendations. Consultants reinforced
      correct practices and clarified misconceptions. The Mock Isolation Room is
      recommended as an effective review strategy that encompasses the principles of
      adult learning. The material was identified by the nurses as clinically relevant
      and the learning method was considered to be fun and effective. The exercise can
      also be used as a needs assessment tool.

PMID- 8345119
TI  - Don't go 'way, it's time to play ... the safety game!
AB  - In an attempt to decrease the amount of time and dollars spent while increasing
      positive staff response, Emanual Hospital in Portland, Oregon, developed a game
      format to review required safety information. The game was piloted, then
      presented to the hospital's safety committee where it was approved as part of the
      hospital's education program. The game has significantly increased the percentage
      of staff participation in required classes. At the same time, cost of presenting
      the classes has decreased significantly.

PMID- 8345120
TI  - Summary of conclusions from a consensus panel of experts on health attributes of
      lactic cultures: significance to fluid milk products containing cultures.
AB  - A panel of experts sponsored by the California Dairy Research Foundation was
      convened on January 31, 1992 to discuss the effect of the consumption of lactic
      cultures on human health. The panel was composed of 10 scientists with diverse
      applicable specialties. Topics discussed included lactose digestion, diarrheal
      diseases, chronic kidney disease, cancer, adherence, immune system stimulation,
      cholesterol reduction, constipation, and safety. Legitimacy of health claims and
      research needs for these areas were determined. The panel noted the promising
      results in the areas of positive effects of ingestion of lactic cultures on
      lactose digestion, some diarrheal illnesses, small bowel overgrowth associated
      with chronic kidney disease, and reduction of fecal enzymes that may play a role
      in colon cancer. However, additional research is necessary to confirm the effects
      in all of these areas. A coordinated research effort between microbiologists and
      clinicians is essential for the most effective research to ensure the choice of
      best available strains, the best conditions of analysis, and the best clinical
      models.

PMID- 8345121
TI  - Shelf-life of pasteurized process cheese spreads made from cheddar cheese
      manufactured with a nisin-producing starter culture.
AB  - Cheddar cheese made with a nisin-producing starter culture and Cheddar cheese
      made with a commercially available starter culture were used to manufacture
      pasteurized process cheese spreads at low and high moisture percentages (53 and
      60%, respectively). Composition did not differ between spreads of similar
      moisture content with and without nisin. The nisin contents of cheese spreads
      were 301 and 387 IU/g at the high and low moisture percentages, respectively.
      Nisin was not inactivated by the thermal process used during cheese spread
      manufacture. Shelf-life of pasteurized process cheese spreads was determined
      during storage at 22 and 37 degrees C. Low moisture cheese spreads with nisin had
      a longer shelf-life than corresponding cheese spreads without nisin when cheeses
      were incubated at either temperature. High moisture cheese spreads with nisin had
      a longer shelf-life than control spreads when cheeses were incubated at 22
      degrees C. However, shelf-life did not differ between high moisture spread with
      nisin and cheese spreads without nisin when cheeses were incubated at 37 degrees
      C.

PMID- 8345123
TI  - Composition of molecular species of triacylglycerols in bovine milk fat.
AB  - Triacylglycerols from bovine milk fat were fractionated by reversed-phase liquid
      chromatography. The fatty acid and triacylglycerol compositions of each fraction
      were determined by capillary gas chromatography. These data were used to
      determine the accurate proportions of 223 individual molecular species of even
      numbered triacylglycerols, accounting for 80% of total triacylglycerols (all
      percentages are expressed as moles per 100 mol). The three major triacylglycerols
      were butyroylpalmitoylacylglycerols, namely butyroylpalmitoyloleoylglycerol
      (4.2%), butyroyldipalmitoylglycerol (3.2%), and
      butyroylmyristoylpalmitoylglycerol (3.1%). Twenty-two triacylglycerols (> 1%)
      contained at least two of the four major long-chain fatty acids (C14:0, C16:0,
      C18:0, and C18:1). Among them were eight butyroyldiacylglycerols, the proportions
      of which reached 19% in total but only 12% when calculated on the basis of a
      random distribution of the fatty acids in the triacylglycerol molecules. More
      generally, most of the triacylglycerols that are composed of a short-chain fatty
      acid (C4:0 or C6:0) and two fatty acids in the range of C12 to C18 are
      preferentially synthesized by the mammary gland; their proportions (36% in total)
      were higher than the corresponding random values (24% in total). Conversely, the
      total amounts of simple (.4%) and mixed (2.9%) saturated long-chain (C14:0 to
      C18:0) triacylglycerols were much lower than those expected from random
      calculation (1.9 and 6.1%, respectively).

PMID- 8345124
TI  - Iron-binding properties of bovine lactoferrin in iron-rich solution.
AB  - The iron-binding properties of bovine lactoferrin in iron-rich solution were
      investigated. Ferrous iron was not stable in solution and was easily changed to
      the insoluble ferric state, but solubility of ferrous iron was stabilized by the
      presence of lactoferrin. However, casein hydrolysate or BSA was not effective in
      stabilizing iron in solution. As indicated by use of cibacron blue affinity gel,
      iron bound to lactoferrin, and the charge of supersaturated lactoferrin was
      higher than that of normal iron-saturated lactoferrin according to native PAGE
      electrophoresis. The evidence suggests that lactoferrin can bind iron at sites
      other than its chelate-binding sites, thereby stabilizing iron in solution.

PMID- 8345122
TI  - Application of a diphasic dialysis technique to the extraction of aflatoxins in
      dairy products.
AB  - A new method is described for the extraction of aflatoxins from milk and milk
      products based on a diphasic dialysis technique, followed by detection and
      quantification of aflatoxins by TLC. Recovery was 65 to 99% for aflatoxins B1,
      G1, and M1, and the detection limit in milk and yogurt was .01 to .02 ppb for all
      aflatoxins studied. In cheese, the detection limit was .03 to .04 ppb for
      aflatoxins B1 and G1 and .1 ppb for aflatoxin M1. The main advantages of this
      technique are its simplicity; sensitivity; very economical use of reagents,
      thereby minimizing environmental pollution; efficiency, allowing the quick
      processing of a high number of samples; use by laboratories with little
      equipment; and a sensitivity comparable with that of much more sophisticated
      techniques.

PMID- 8345125
TI  - Role of protein and lactose interactions in the age gelation of ultra-high
      temperature processed concentrated skim milk.
AB  - Skim milk was pasteurized, diafiltered, and concentrated three times by UF.
      Lactose or sucrose was then added at 3 or 6%. The five samples containing < .05%
      lactose, 3 and 6% lactose, and 3 and 6% sucrose were UHT processed at 140 degrees
      C for 4 s using indirect heating, collected aseptically in presterilized
      containers, and stored at 4, 20, and 35 degrees C. All samples stored at 4 and 20
      degrees C gelled after 21 wk of storage. Samples stored at 35 degrees C did not
      gel. Browning occurred only in samples containing lactose stored at 35 degrees C.
      Proteolysis in gelled samples was shown by SDS-PAGE. Bands were due to
      proteolysis, protein crosslinking, and a streaking pattern in ungelled samples.
      Electron micrographs of gelled samples showed that various casein particles were
      connected by hairlike protrusions, but the micelles in ungelled samples were not
      connected and had few protrusions. The Maillard reaction neither promoted nor
      deferred age gelation. Protein modifications prevented gelation in samples stored
      at 35 degrees C. Age gelation was probably a two-step process in which
      dissociated proteins from the casein micelles reformed on micelles as hairlike
      protrusions. This process was followed by aggregation of the protein particles.

PMID- 8345126
TI  - Characteristics of beta-lactoglobulin binding to the all-trans-retinal moiety
      covalently immobilized on Celite.
AB  - All-trans-retinal was covalently immobilized on Celite and investigated as a
      bioselective adsorption matrix for beta-lactoglobulin. Two types of Celite
      supports were compared, indicating the best performance with 100/120 mesh, type
      R648. The R648 matrix yielded a high concentration (9.2 mumol/ml) of the ligand
      when the derivative was produced, and the derivatized matrix exhibited the best
      retention of beta-lactoglobulin. Binding of beta-lactoglobulin to the immobilized
      trans-retinal matrix is biospecific, but the affinity is dependent on pH and
      ionic strength. alpha-Lactalbumin is not bound to this bioselective adsorbant, so
      its elution was not retarded or affected by pH or buffer concentration. Affinity
      for beta-lactoglobulin was optimal at pH 5.14; a dissociation constant of 2.7
      microM was obtained in .1 M buffer solutions. At pH 7.0, the affinity decreased
      44-fold, and, below pH 3.5, no binding occurred. The estimated loading capacity
      based on chromatographic data was approximately 14 g/L (.75 mumol/ml) of support.

PMID- 8345127
TI  - Improving survival of culture bacteria in frozen desserts by microentrapment.
AB  - Lactobacillus bulgaricus cells were entrapped in beads of calcium alginate and
      evaluated for their ability to survive freezing processes. Cells survived
      freezing (without agitation) in ice milk mix much better than in distilled water,
      and more entrapped cells survived than did cells that were not entrapped.
      Glycerol and mannitol were cryoprotective, but glucose was not, when each was
      added (6%) separately to the beads. Entrapment protected the lactobacilli in
      batch frozen and continuously frozen ice milk mixes. The percentage of survival
      for entrapped and unentrapped cells in continuously frozen ice milk approximated
      90 and 40%, respectively. Lactobacilli survived better in beads with mean
      diameters > 30 microns than in those averaging 15 microns. Addition of entrapped
      lactobacilli had no measurable effect on the sensory characteristics of the ice
      milk.

PMID- 8345128
TI  - Fertility of bull spermatozoa frozen in whole milk extender with trehalose,
      taurine, or blood serum.
AB  - Fertility of bull semen processed in heated whole milk-glycerol control semen
      extender with various additives was compared in six field trials. The additive in
      field trials 1 and 2 was 25.6 g of trehalose/L of the glycerol fraction of whole
      milk. Whole milk was heated to 95 degrees C for 10 min, cooled, and filtered 1 d
      before use (trial 1) or 3 d before use (trial 2). In field trial 3, 3.0 g/L of
      taurine were added to the glycerol fraction of whole milk. In field trial 4,
      specially prepared bovine serum (15% vol/vol) was included in the glycerol
      fraction of whole milk. Field trials 5 and 6 were larger fertility studies with
      trehalose in extenders prepared the day before use (trial 5) and 1 and 3 d before
      use (trial 6). Control and treated semen were coded and distributed randomly over
      a large group of professional inseminators. The 59-d nonreturn rates for control
      and treated semen, respectively, were as follows: trial 1, 74.1 and 73.7%; trial
      2, 71.3 and 73.1%; trial 3, 74.9 and 70.9%; and trial 4, 75.1 and 71.6%. No
      significant differences resulted in trials 1 to 3, but bovine serum decreased the
      non-return rate in trial 4. Trials 5 and 6 resulted in nonsignificant improvement
      in fertility with added trehalose. Thus, these additives, useful as
      cryopreservatives or membrane protectors in other systems, did not enhance the
      fertility of sperm frozen in whole milk.

PMID- 8345129
TI  - Milk as a source of deoxyribonucleic acid and as a substrate for the polymerase
      chain reaction.
AB  - Somatic cells in milk were used as a source of DNA and as a substrate for the
      polymerase chain reaction. Successful DNA extraction required a minimum total of
      17 x 10(6) cells in the milk sample. The DNA yield per cell was highly variable
      but comparable, on average, with the yield from peripheral blood leukocytes. In
      all cases, direct polymerase chain reaction on milk samples, using a variety of
      primer pairs, yielded amplified products of correct size that were identical to
      those obtained by polymerase chain reaction of purified DNA extracted from milk
      or blood. Milk and DNA extracted from milk served as substrates for direct
      sequencing of part of the bovine growth hormone gene. Milk samples with added
      preservative were stored over 200 d without effect on the polymerase chain
      reaction. Thus, milk can often substitute for blood as a source of DNA for
      Southern blot analysis and is a preferred substrate for the polymerase chain
      reaction. The technical convenience of milk as a source of DNA can be expected to
      increase the field of application of marker-based methods for genetic analysis
      and genetic improvement of economic traits in dairy cattle.

PMID- 8345130
TI  - Evaluation of 57 teat sanitizers using excised cow teats.
AB  - Fifty-seven teat dip formulations were tested for germicidal activity with an
      excised teat assay. Streptococcus agalactiae (ATCC 27956), Staphylococcus aureus
      (ATCC 29740), and Escherichia coli+ (a wild strain isolated from an Ohio cow
      2956RR during the dry period) were used. Log reductions ranged from 5.6480 to
      1.8330 for Strep. agalactiae compared with undipped controls. Staphylococcus
      aureus were reduced from 4.8972 to 1.0102. Escherichia coli were reduced from
      5.8677 to 1.1450. The percentages of the products tested that had log reductions
      < 3 against Strep. agalactiae, Staph. aureus, and E. coli were 24, 30, and 61.
      Four teat dip formulations contained 4% sodium hypochlorite; all were effective
      against Strep. agalactiae, Staph. aureus, and E. coli. The three formulations
      containing glutaraldehyde were effective against the three mastitis pathogens.
      Formulations containing 1 and .5% iodine were not consistently effective against
      Strep. agalactiae, Staph. aureus, or E. coli. Teat sanitizers containing .5%
      chlorhexidine also showed inconsistency. Variations in formulation for products
      containing iodine or chlorhexidine affected germicidal activity.

PMID- 8345131
TI  - Regulation of growth and development of the gastrointestinal tract.

PMID- 8345132
TI  - Role of peptide YY in the endocrine control of digestion.
AB  - Peptide YY is released into the circulation after ingestion of a meal, a response
      that is markedly enhanced in patients with malabsorption. The enhanced release of
      peptide YY slows gastric emptying and transit of meals through the small
      intestine. The net effect is increased efficiency of digestion and absorption of
      nutrients. Once the efficiency of nutrient utilization is optimized and the
      delivery of unabsorbed nutrients to the distal gut decreased, peptide YY release
      is inhibited. As peptide YY slows colonic transit, it could also improve salvage
      of unabsorbed nutrients by enhancing bacterial production of volatile fatty acids
      and their subsequent absorption by the colonic mucosa.

PMID- 8345133
TI  - Nutritional regulation of postruminal digestive enzymes in ruminants.
AB  - Nutritional regulation of digestive enzymes has received limited study in
      ruminants. Comparable studies with nonruminants report adaptations occurring in
      pancreatic and mucosal enzyme concentrations and synthesis in response to
      increased consumption of carbohydrate, lipid, or protein. Adaptations in
      carbohydrases apparently are mediated through changes in blood glucose and
      insulin, and changes in lipase are mediated through changes in circulating beta
      hydroxybutyrate. Increased synthesis and secretion of pancreatic proteases
      apparently are mediated directly through luminal effects of protein, possibly
      through a messenger peptide. Available information for ruminants suggests that
      pancreatic alpha-amylase concentration increases with increased energy intake,
      but not with increased carbohydrate intake, independent of energy. This result
      may indicate an adaptation mechanism similar to that of nonruminants, one that is
      mediated through increased glucose turnover, not intestinal carbohydrate supply
      alone. Increased intake of energy or increased intestinal supply of carbohydrates
      results in little or no increase in mucosal carbohydrases in the ruminant.
      Comparable data for effects of changing intestinal supply of protein are limited
      to the developing ruminant. Experiments involving lipid feeding are not
      available, but duodenal lipid infusion decreases pancreatic lipase secretion.
      Ruminant data are inadequate to predict accurately an adaptive response to
      feeding any diet.

PMID- 8345134
TI  - Manipulation of gastrointestinal nutrient delivery in livestock.
AB  - Discussed herein are the constraints of nutrient delivery from the
      gastrointestinal tract that are placed on postabsorptive synthetic processes in
      highly selected strains of domestic livestock or livestock treated with growth
      promotants exogenously or via transgenic manipulation. Emphasis is placed on the
      discussion of recent advances in the knowledge of the regulation and manipulation
      of digestion and the absorption by the intestinal epithelium. Slaframine, a
      muscarinic exocrine secretagogue with a high affinity for the gastrointestinal
      tract, and epidermal growth factor may have practical potential for the
      manipulation of digestion and absorption, respectively. Special consideration is
      given to energetic considerations that must accompany any manipulation of
      gastrointestinal function. Down-regulation and up-regulation of mechanisms must
      be equally considered as this area is explored further.

PMID- 8345135
TI  - Nutrient metabolism by gut tissues.
AB  - The gut uses a disproportionate amount of energy (about 25% of total oxygen
      consumption) for the size of the tissue (about 6% of body weight). Therefore,
      knowledge of metabolites used in gut tissues is important to assess nutrient
      needs. The VFA produced intraruminally are used to varying degrees by rumen
      epithelial tissue. A review of net portal absorption data essentially confirms
      earlier studies that show acetate, propionate, and butyrate metabolism by stomach
      tissue to be 30, 50, and 90%, respectively, of ruminant production. Glucose also
      is used by rumen epithelial tissue; however, glutamine appears to be a poor
      substrate for energy production. Tissue of the small intestine uses glutamine,
      glucose, and ketones but does not use VFA very well for energy. Cecal and colonic
      tissues can use glucose and glutamine for energy, but butyrate is the preferred
      substrate in both tissues.

PMID- 8345136
TI  - American Association of Dental Schools 1992-93 annual proceedings. March 8, 1992
      March 10, 1993. Including the proceedings of the 1993 annual session.

PMID- 8345137
TI  - Independently living seniors and vitamin therapy. What nurses should know.
AB  - 1. Over-the-counter vitamin/mineral supplement consumption has become customary
      among many older adults in the United States. Inappropriately used, these dietary
      supplements possess the capacity for producing toxic reactions. 2.
      Vitamins/minerals can be harmful when taken incorrectly or in lavish proportions.
      Even though the Food and Drug Administration does not classify dietary
      supplements as drugs, a vitamin must be viewed as a medication when consumed in
      excess. Excessive intakes of vitamins A, C, and D are known to have adverse
      effects. 3. It is imperative that nurses incorporate vitamin therapy assessment
      into their practice, whether it be administration, education, or research. Unless
      ordered by a physician for a medically based pathology, nutrient supplementation
      should not exceed the RDA levels for older adults, if supplementation is used at
      all.

PMID- 8345138
TI  - Nursing implications. Functional status of older persons with schizophrenia.
AB  - 1. Older persons with schizophrenia underreport medical symptoms and overrate
      physical well-being. 2. Changes in mental functioning and ability to perform
      activities of daily living are often the first signs of physical illness. 3.
      Completing a drug inventory for tardive dyskinesia and extrapyramidal side
      effects should be ongoing. 4. Social assessment and intervention should focus on
      the well part of the person.

PMID- 8345139
TI  - Clinical manifestations. Failure to thrive in the elderly.
AB  - 1. Failure to thrive (FTT) is a diagnosis used with increasing frequency in the
      acute care setting. The purpose of this study was to determine how the diagnosis
      of FTT was being applied to the geriatric population. 2. FTT was used in the
      study population to describe the general deterioration seen in patients with
      chronic or incurable illnesses. Many patients were near the terminal stage. The
      diagnosis was not used specifically for the geriatric population; there was a
      lack of specificity in the diagnosis and treatment of FTT. 3. Common complaints
      of patients diagnosed as FTT included ADL changes, weight loss, and anorexia.
      Nursing care can significantly contribute to the management of symptoms and the
      prevention of complications.

PMID- 8345140
TI  - The case for an integrated health care reform plan.

PMID- 8345141
TI  - Geriatric nursing. Health care reform in Scotland.
AB  - 1. The United Kingdom's private practitioners are awarded a yearly budget by the
      National Health Service. Within that budget, the practitioners design a practice
      that fits into this financial constraint. Certain practice guidelines are also
      dictated by the government. A reform measure, "Working With People," has been
      introduced to correct flaws in the system. 2. "Working With People" has created a
      considerable amount of rhetoric and debate. The paper has been enthusiastically
      supported by independent sector interests and encourages privatization and
      development of self-governing hospitals. 3. Gerontological nursing education and
      practice in the United States has much to gain from its colleagues in the UK--and
      vice versa. There is room for collaboration and consultation from nursing
      professionals in the United States to avoid the many negatives that have faced
      the industry there.

PMID- 8345142
TI  - Focus on breast cancer screening.

PMID- 8345143
TI  - Elder hearing aids. Infrared listening device in a geriatric day center.
AB  - 1. An infrared listening device (IRLD) is a device that changes an auditory
      signal into infrared light. This signal is delivered to an infrared receiver via
      light-emitting diodes. The signal is then converted back into auditory energy. 2.
      Nineteen percent of elders at the Day Care Center for the Elderly who
      participated in the survey expressed an interest in using an IRLD if it were made
      available to them. More than half of the clients in this group were successful in
      using the listening device. 3. The application of an IRLD can add a dimension of
      independence to the lives of older adults. For those individuals who are unable
      to operate a conventional hearing aid, an IRLD can offer the benefits of
      amplification in a form that may be easier to comprehend and operate.

PMID- 8345144
TI  - [An experimental animal model for inducing fetal distress during pregnancy].
AB  - In order to try to understand and treat efficiently pathology in the human
      pregnant woman the authors have carried out experimental work on animals. Twenty
      four pregnant ewes with a single fetus were operated on in the last trimester of
      pregnancy. Fetal distress was provoked by injecting microspheres into the aorta
      beneath the renal arteries via the femoral route. The first results in terms of
      survival, by chemical and Doppler measurements were very encouraging. The
      operation itself was not a significantly disturbing factor, but the injection of
      microspheres did cause fetal distress. This experiment should be continued.

PMID- 8345145
TI  - [A new approach to the axilla: functional axillary lymphadenectomy and padding].
AB  - Axillary lymph node dissection, which is now mandatory in the conservative breast
      cancer surgery and classically involves Berg's two lower levels, is burdened with
      numerous complications. In 1988 and 1989, two technical modifications were
      introduced and are described here: padding of the axilla as preventive treatment
      of postoperative lymphocele and, more recently, functional axillary
      lymphadenectomy (FAL) in which the medial cutaneous nerve of the arm, the two
      perforating intercostal nerves and above all the lateral thoracic pedicle
      (external mammary artery and vein) are spared. These two technical innovations,
      more respectful of anatomy, are aimed at reducing the morbidity of conservative
      breast cancer at a time when detection enables breast cancers to be treated at an
      increasingly early stage, which results in a increase of negative axillary
      dissections. The postoperative period is simplified (no drainage, immediate
      mobilization), and the hospital stay is reduced to 2 days. Complementary
      treatments can thus be started early on, without any functional or cosmetic
      damage while the number of lymph nodes removes remains the same as in the
      conventional axillary dissection technique. The authors describe the operative
      procedures and analyse the 100 cases of conservative breast cancer they have
      treated with padding and FAL. These two technical modifications are now
      systematically used by them in the management of breast cancers.

PMID- 8345146
TI  - [Metastasis of breast cancer to a uterine leiomyoma].
AB  - The authors report a case of metastasis of cancer from the breast in a uterine
      leiomyoma. The metastases into the body of the uterus from extragenital cancers
      are rare. If they occur they are usually in the myometrium where they are
      asymptomatic and where the diagnosis is difficult, or in the endometrium where
      the diagnosis can be made by biopsy after curettage. A few rare cases of
      metastases in uterine leiomyoma have been reported in the literature. They can be
      the cause of very sudden increase in size of fibroids with compression of the
      pelvic organs.

PMID- 8345147
TI  - [Cancer of the ovary and the hormonal context].
AB  - Screening for ovarian cancer can only be worthwhile if it is applied to a
      population at risk. Recent studies show that there is a significant lowering of
      the risk for cancer of the ovary after all contraceptive preparations containing
      oestrogens and progestogens have been used. The longer these preparations are
      used the greater the protection for the user and this protection continues for a
      long time after treatment has stopped. One finds, in truth, that if the ovary is
      put functionally at rest whether it is because ovulation has been stopped by
      pregnancy or by oral contraception or by a premature menopause, or late puberty,
      the ovaries are somewhat protected from cancer. On the other hand, women whose
      reproductive life is long without being interrupted as far as ovarian function is
      concerned, have a higher risk of developing cancer and, therefore, would be
      worthwhile screening. Furthermore, on the other hand the problems of stimulating
      the ovaries when treating for sterility must be considered in the relationship to
      the possibility of provoking cancer of the ovary. A better knowledge of the
      hormone status would make it easier to decide what cases should be screened for
      epithelial cancer of the ovary so that the prognosis can be less disastrous than
      it is.

PMID- 8345148
TI  - [Endometrioid adenofibroma of the ovary. An anatomo-clinical case report].
AB  - Endometrioid adenofibromas are rare tumours of the ovary characterised by
      proliferation of endometrial type glands without any particular atypical cell
      structure, within a dense and thick stroma. We report a case of such a tumour
      which showed an outline of stromal luteinisation.

PMID- 8345149
TI  - [Benign teratoma of the ovary with fistula to the uterus].

PMID- 8345151
TI  - [Management of a short femur discovered via ultrasound in utero. Prenatal
      diagnosis of Stuve-Wiedemann syndrome].
AB  - The authors report a case of familial Stuve-Wiedemann syndrome where the
      diagnosis was made in utero. Following this case the authors discuss the
      management of short femur discovered by ultrasound. The analysis of the
      morphology, the ultrasound appearance and the radiographic appearance (X-ray of
      the uterine contents) may make it possible sometimes to diagnose the syndrome. An
      important element is a study of the genealogy to discover the way in which a
      large number of these bone diseases are transmitted. The prognosis for life is
      very variable according to the severity of the syndrome.

PMID- 8345150
TI  - [Antenatal diagnosis of toxoplasmosis. 176 case reports].
AB  - OBJECTIVE: To determine the value of antenatal diagnosis of congenital
      toxoplasmosis by ultrasound guided aspiration of cord blood for testing.
      MATERIAL: This is a prospective study of 176 cases. As well as obtaining fetal
      blood and amniotic fluid the searched for specific IgM and A as well as culturing
      for the parasites on human fibroblasts and inoculation of mice, as well as
      researching them for non-specific signs of fetal infection. 149 children were
      able to be followed up one year after birth. RESULTS: 15% of the children
      (22/149) were infected with toxoplasmosis. 11 out of these were diagnosed
      positive antenatally. For the 11 others the diagnosis of fetal infection could
      only be made after birth, but the non-specific signs made it possible to expect
      early that they had been contaminated. 59% (13/22) had latent toxoplasmosis which
      only showed up after a mean interval of 34 months after birth. 41% (9/22) had
      clinical and/or paraclinical signs of toxoplasmosis (mainly unilateral non
      macular chorioretinitis and intracranial calcifications) but they are well after
      a follow-up period averaging 30 months. COMMENTARY: Ultrasound alone, when it
      shows up fetal abnormalities, can make the diagnosis of the severity of the
      condition. The role of taking fetal specimens is to make clear those infants that
      are infected because of specific signs, and to find those fetuses which are at
      high risk because of non-specific signs in order to improve the management of the
      cases. This development has made it possible to avoid carrying out a large number
      of unnecessary terminations of pregnancy and has resulted in the birth of
      affected infants that had no functional sequelae from the infection.

PMID- 8345152
TI  - [Toxoplasmosis and pregnancy: is it possible to simplify the diagnostic
      procedures?].
AB  - About 1% of all pregnancies in France are complicated by a primary infection with
      toxoplasmosis. The risk for the fetus being affected increases during the
      pregnancy but the seriousness of the effect on the fetus becomes less with more
      advanced pregnancies. Treatment of the mother using Spiramycin have been proven
      to be efficient, lessening the risk for the fetus being affected. The diagnosis
      of the fetus being affected rests on a whole bundle of presumptive evidence
      culled from non-invasive methods and invasive methods which are not without risk.
      (Direct or over-enthusiastic diagnostic techniques or none at all). We have
      studied a series of 101 primary infections with toxoplasmosis for which we have
      not carried out any invasive diagnostic techniques. The long term results in 77
      infants show no difference in fetal morbidity and better results as far as
      mortality are concerned. We therefore propose simplifying the diagnostic approach
      in cases of primary infection with toxoplasmosis during pregnancy.

PMID- 8345153
TI  - [Antiphospholipid syndrome. Proposition for management].
AB  - Antiphospholipid antibodies (antiprothrombinase and anticardiolipin) carry with
      them for mothers the risks of repeated fetal loss and of disorders of the blood
      clotting mechanism both before and after delivery. All the same screening does
      not have to be carried out routinely but should be reserved for patients who have
      already lost one fetus (intrauterine death after 12 weeks of amenorrhoea) and/or
      venous or arterial thrombosis. The diagnosis depends on a strict methodology and
      strict criteria for making a positive diagnosis. The treatment of these
      antibodies (with corticosteroids and intravenous immunoglobulin) or the
      prevention of possible thrombotic complications (using platelet
      antiaggregation/heparin) has to be decided taking into account the level of
      antibodies, previous obstetric and thrombotic history and the lupus
      symptomatology as shown by the patients. The overall success rate of treatment is
      between 53 and 81%.

PMID- 8345154
TI  - [Pathological Doppler uterine readings when the placenta is laterally situated].
AB  - We carried out a retrospective study on 96 patients whose uterine waveforms were
      abnormal, in order to determine if a laterally located placenta further increased
      this risk. Our population was separated into 2 groups (75 women with a laterally
      located placenta, 21 with a centrally located placenta). We have found a
      significant difference between ipsi placental uterine blood flow velocity and
      contralateral placental blood flow velocity when the placenta is located
      laterally, where as the 2 arteries are similar when the placenta has a central
      location. The following factors were used to compare the two groups: the
      patient's previous obstetric record and the incidence of hypertensive disorders
      and fetal distress. In the group with laterally located placentas, the incidence
      of complications in previous pregnancies was higher, hypertension was more
      frequently serious or presented complications, fetal distress and cesarean
      sections were more frequent as was IUGR. All cases of intrauterine death were
      found in the group with laterally located placentas. In determining the
      predictive value of the "laterally located placenta" test, we found in the
      centrally located placenta group that hypertensive disorders were often less
      serious and less frequently complicated by albuminuria, that the outcome of
      pregnancy disorders was less serious for the fetus, and that the neonate was less
      hypotrophic. No incidence of intrauterine death was recorded for the centrally
      located group. Placental laterality significantly increases both the frequency
      and the seriousness of fetomaternal hypertensive disorders.

PMID- 8345155
TI  - [Congenital arteriovenous malformation of the internal iliac artery discovered
      during pregnancy].
AB  - We report a case found at the start of labour because of the presence of a
      "tumour praevia". Ultrasound, Doppler and tomodensitometric examination carried
      out after caesarean section confirmed the vascular origin of this lesion.
      Arteriography made it possible to decide the pattern of this arteriovenous
      malformation which was occurring in several branches of the left internal iliac
      artery. It was not possible to obliterate it completely by selective arterial
      embolisation, so it was removed surgically a few months later. Little is known
      about the complications that occur because of these arteriovenous malformations
      in pregnancy and during delivery. There is the theoretical risk that spontaneous
      rupture will occur in pregnancy but this does not justify terminating the
      pregnancy. It is better to carry out caesarean section because the tumour can
      obstruct delivery and may rupture as well as causing delay in labour. The
      treatment for these lesions is sometimes difficult and complex and one has to
      decide whether to preserve the uterus or not. Selective embolisation and pre
      operative embolisation followed by surgical removal of dysplasic tissue are the
      therapies of choice.

PMID- 8345156
TI  - [Endoscopic surgery during pregnancy. A case report of cholecystectomy].
AB  - Pregnancy used to be considered a contraindication for endoscopic surgery of the
      digestive tract. We report a case of cholecystectomy carried out laparoscopically
      for complicated gall stones in a woman who was 14 weeks pregnant. There was no
      post-operative maternal or fetal morbidity. The mother carried on the pregnancy
      to term normally and gave birth to a normal infant. The same results have been
      reported in the literature for three other cases of cholecystectomy and six of
      appendicectomy. The sole technical precautions that had to be undertaken were in
      introducing and placing the trocars, taking into account the size of the uterus.
      There has been no scientific proof that CO2 is toxic for the fetus. Clinical
      practice shows that endoscopic surgery is possible without any obstetrical risk
      including thrombo-emboli, nor specific sepsis occurring in any of the three
      trimesters of pregnancy. The advantages of the endoscopic approach are that there
      is less post-operative pain and therefore less need to take analgesics. There are
      no complications because of an abdominal wound and the patient can both feed and
      walk about immediately after the operation with a reduction of the time spent in
      hospital. There is probably less risk of aborting when compared with classical
      laparotomy. The endoscopic route can be chosen when surgery is needed in the
      digestive tract during pregnancy.

PMID- 8345157
TI  - [Prohibition concerning gifts to the medical corps].

PMID- 8345158
TI  - Aggression in the demented patient: a double-blind study of loxapine versus
      haloperidol.
AB  - Aggression is common in dementia, with devastating social consequences. While
      high or low potency neuroleptics are the usual treatment of choice, they have
      been shown to yield inconsistent behavioral improvement and significant
      iatrogenic disability. This double-blind study was undertaken with aggressive
      demented patients to assess the efficacy and safety of a mid-potency neuroleptic,
      loxapine, in comparison to the more commonly prescribed high potency drug,
      haloperidol. Using an optimizing dosage regime, the outcome variables studied
      were aggression frequency and the number and nature of emergent side effects.
      Results demonstrated no significant difference regarding efficacy, but
      significantly fewer side effects with loxapine administration. The clinical and
      theoretical implications of these findings are discussed.

PMID- 8345159
TI  - Responders and non-responders to bifemelane hydrochloride in Alzheimer-type and
      multi-infarct dementia.
AB  - Although metabolically active compounds sometime attenuate cognitive deficits of
      dementia patients, this mechanism has not been discussed or investigated. We
      hypothesized that these compounds improve cognitive disorders not by directly
      acting on this cognitive function, but by increasing the arousal level. Based on
      this hypothesis, we investigated the change of arousal levels and the improvement
      of intellectual functions in 10 patients with Alzheimer-type dementia (ATD) and
      10 patients with multi-infarct dementia (MID) before and 3 months after
      pharmacotherapy using bifemelane hydrochloride. For each patient, a psychological
      test battery was carried out and the arousal level was evaluated using the
      frequency of rapid eye movements in the electro-oculogram (EOG) and the frequency
      analysis of electroencephalogram (EEG) before and after the treatment. Evaluation
      of the cognitive improvement was made and eight out of the 20 patients were
      regarded as responders to the treatment. The frequency of small rapid eye
      movements (SREM) in the EOG increased significantly only in responders and the
      rate of change in SREM appearance in responders was significantly different from
      that in non-responders. This finding suggests that a part of the intellectual
      improvement in ATD and MID results from the increased level of arousal.

PMID- 8345160
TI  - Three-year follow-up of patients with panic disorder after short-term treatment
      with alprazolam and imipramine.
AB  - Fifty-five patients with moderate to sever panic disorder were treated for 9
      weeks with alprazolam or imipramine and were then, except for one patient who had
      committed suicide, re-examined after on average 3 years of treatment. At follow
      up most patients (74%) did not suffer from panic attacks at all. In the beginning
      of the study 87% exhibited phobic avoidance behaviour but after 3 years 68% no
      longer revealed phobic behaviour. At follow-up 28% of the patients were no longer
      having psychotropic drug treatment and 20% were completely free of overt
      psychopathology. No tolerance phenomena were associated with the long-term
      medication applied in the study.

PMID- 8345161
TI  - Tryptophanemia and tyrosinemia in adolescents with impulsive behavior.
AB  - Tryptophan (TRP) and tyrosine (TYR), respectively the circulating precursors of
      the central serotonergic (5-HT) and catecholamine systems, were measured in eight
      adolescents with impulsive behavior regardless of the exact type of disorder. The
      6 week study period included weekly blood sampling and clinical evaluation. The
      ratios of TRP and TYR to large neutral amino acids (LNAA), which indicate the
      availability for the synthesis of neurotransmitters, were calculated. Comparison
      of results with eight hospitalized controls of the same age (12.5 to 18 years)
      revealed lower total TRP levels in four adolescent patients, a lower TRP/LNAA
      ratio in three adolescents, and a lower free TRP concentration in six adolescents
      with discretely enhanced albuminemia. A slight increase in TYR and the TYR/LNAA
      ratio was noted in nearly all of the adolescent patients. Despite the
      heterogeneity of individual biological results, the impulsive behavior subjects
      in this study seemed to present abnormalities in neurotransmitter precursors.

PMID- 8345162
TI  - Evidence for a defective platelet L-tryptophan transport in depressed patients.
AB  - The kinetic characteristics of platelet L-tryptophan uptake were investigated in
      23 untreated depressed patients and 18 healthy volunteers. A significant increase
      of 50% in the apparent Michaelis constant (Km) was observed in depressed patients
      compared with controls, without significant change in the maximal velocity
      (Vmax). After 1 month of successful antidepressant treatment the mean Km value
      decreased significantly and reached the control value. This result raises the
      possibility that the decrease in platelet tryptophan uptake affinity is a state
      dependent marker for depression. It is likely that the transport alteration
      results in a decrease in platelet tryptophan accumulation. The effect of this
      peripheral membrane defect on brain serotonin function is discussed.

PMID- 8345163
TI  - Fluoxetine's spectrum of action in premenstrual syndrome.
AB  - This study extends our previous report of the efficacy and tolerability of
      fluoxetine in severe premenstrual syndrome (PMS), describes which aspects of the
      disorder are responsive to such treatment, and assesses the relationship between
      steady-state drug level and clinical outcome. Twenty-one women with documented
      PMS satisfied criteria for late luteal phase dysphoric disorder (DSM-III-R) and
      accepted the offer of a double-blind, randomized crossover trial of fluoxetine
      hydrochloride 20 mg/day vs placebo. Symptom severity was measured with daily self
      rating, monthly premenstrual assessment forms and psychiatric interviews after 3
      months each of baseline, placebo and fluoxetine treatment. Compared with an
      inconsistent placebo response, fluoxetine produced marked improvement in 15 of 16
      women completing the trial, eight showing virtually complete remission of PMS
      symptoms. Fluoxetine's efficacy extended over a range of affective, physical and
      behavioural symptoms; its superiority obtained whether it preceded or followed
      placebo. Three women withdrew due to adverse effects of fluoxetine, and 10 of 16
      completing the trial reported at least one adverse effect of this agent. Compared
      with placebo, fluoxetine produced more (but usually transient) insomnia,
      sweating, gastrointestinal and menstrual disturbance. Plasma levels of fluoxetine
      and its active metabolite were not reliably associated with efficacy nor with
      side effects. Serotonergic agents appear to have considerable promise in treating
      a range of symptoms in women with severe PMS.

PMID- 8345164
TI  - DNA hybridization techniques and their application to the diagnosis of infectious
      diseases.
AB  - Several commercial DNA probe assays are widely used in clinical microbiology
      laboratories. These include culture-confirmation assays for Mycobacterium
      species, which are recommended by CDC because they are both rapid and accurate,
      and culture-confirmation assays for N. gonorrhoeae. Probe assays for direct
      detection of N. gonorrhoeae and C. trachomatis are also widely used in public
      health and large reference laboratories. In many cases, the probe assays have
      decreased the time to identification of positive cultures and improved detection
      of these pathogens because they do not depend on the presence of viable organisms
      to achieve a positive result. Nucleic acid amplification assays hold promise for
      the rapid detection and identification of many infectious agents. PCR using
      universal primers enables researchers to identify new agents of disease that
      cannot be cultured in vitro; more importantly, PCR provides a method for
      detecting the presence of any bacterial species, including common organisms, in
      normally sterile body fluids, such as blood and cerebrospinal fluids. The use of
      such primers may well give PCR the broad-based approach needed to identify
      organisms in the clinical microbiology laboratory of the future.

PMID- 8345165
TI  - New developments in the diagnosis of viral diseases.
AB  - Major technical advances have occurred, especially in the last 5 years, in the
      laboratory diagnosis of viral infections. Immunologic detection of immediate
      early antigens in specimens such as bronchoalveolar lavage fluid and blood
      inoculated into shell vial cell cultures, particularly for herpesvirus
      (cytomegalovirus, herpes simplex virus, varicella-zoster virus), has provided
      results 16 to 48 hours after inoculation rather than the several days required
      for recognition of cytopathic effects in conventional tube cell cultures.
      Similarly, cytomegalovirus viremia can be detected directly by immunostaining of
      peripheral blood leukocytes with commercially available reagents the same day the
      specimen is submitted to the laboratory. Single-test membrane immunoassays have
      provided rapid (15 minutes) detection of viral antigens (respiratory syncytial
      virus, rotavirus, influenza virus type A). In the near future, diagnostic
      virology laboratories will be expected to monitor viral strains for
      susceptibility to the growing list of antiviral drugs. Amplification of nucleic
      acid sequences of viruses from cerebrospinal fluid or tissue, which generally
      does not yield isolates by conventional diagnostic techniques, has added a new
      dimension to the laboratory diagnosis of viral infection.

PMID- 8345166
TI  - Laboratory diagnosis of human immunodeficiency virus infection.
AB  - HIV infection and AIDS will continue to grow as a major medical and social
      problem. The incidence of heterosexual transmission is rising, and it will become
      increasingly difficult for physicians and counselors to assess an individual's
      risk of infection. In coming years, physicians can expect to see patients who are
      infected, but whose risk may not be apparent, and who may not present with
      conditions immediately suggestive of their infection. The majority of these
      patients may not even suspect they are infected. Many of the tests currently
      available for diagnosing HIV infection are very good. They are both highly
      sensitive and highly specific and their predictive values are good when their
      limits are understood. But, as HIV infection expands to an ever larger number of
      women and children and as the ability to sharply define risk groups fades, demand
      for a broader range of tests that can reliably confirm infection and are easy to
      perform can only increase. We have attempted to describe some of the common
      serologic tests currently used to diagnose HIV infection and some of the
      limitations of these tests. We also have pointed out that criteria used by
      laboratories for interpreting tests such as the Western blot may not always be
      uniform, and physicians should know the criteria used by their reference
      laboratory and the quality control measures taken. We also have attempted to
      describe some of the tests available to detect the virus, its genes, or its gene
      products. PCR and other rapidly evolving gene amplification techniques hold great
      promise as highly sensitive and specific tests for the diagnosis/confirmation of
      HIV infection. As with the serologic tests, it is important for those who may use
      these tests to understand their value as well as their limitations.

PMID- 8345167
TI  - Blood cultures.
AB  - Bacteremia and fungemia are encountered commonly and are associated with
      significant morbidity and mortality. Laboratory detection is therefore of
      paramount importance. Principles of successful blood culturing, clinically
      important technical issues, manual and automated detection systems, and
      interpretation of culture results are reviewed in this article.

PMID- 8345168
TI  - The microbiologic aspects, including diagnosis, of beta-hemolytic streptococcal
      and enterococcal infections.
AB  - Basic principles concerning the collection, transport, and processing of clinical
      specimens for the detection of Streptococcaceae are given. Identification of beta
      hemolytic streptococci (S. pyogenes, S. agalactiae, Lancefield group C and G
      streptococci, S. anginosus) and enterococci is based on the careful observation
      of colony morphology and hemolytic pattern on sheep blood agar plates; subsequent
      genus or species confirmation is achieved by rather simple biochemical or
      enzymatic tests and by detection of streptococcal cell wall carbohydrate antigens
      (Lancefield grouping). Rapid antigen tests for the detection of group A and B
      streptococci directly from pharyngeal and vaginal swabs, respectively, are highly
      specific, thus allowing an immediate antibiotic therapy in patients with a
      positive test result. The reported sensitivities of these nonculture tests are
      too low to exclude streptococcal colonization or infection, however. The
      elucidation of the genetics of some major virulence factors of group A and B
      streptococci has contributed to knowledge of their association with disease, and
      molecular techniques have supplemented the traditional (mostly culture and
      serologic) methods for an improved understanding of the epidemiology and
      pathogenesis of streptococcal infections. Recently employed examples include the
      M protein gene typing of group A streptococci by oligonucleotide probes and the
      use of PCR assays for the detection of the genes encoding for the pyrogenic
      exotoxins. Restriction enzyme endonuclease digestions of bacterial DNA in
      association with DNA fragment separation by conventional or PFGE have been
      applied successfully to several species of Streptococcaceae (e.g., S. pyogenes,
      S. agalactiae). Enterococci are important pathogens in the hospital setting,
      exhibiting high morbidity and mortality rates in bacteremic patients with severe
      underlying disease. Molecular typing methods have clearly confirmed their
      potential to be nosocomially transmitted. E. faecalis and E. faecium still
      account for the majority of human infections, but some of the newer enterococcal
      species (at present 19 species are recognized) have been encountered as well. The
      definitive species identification of enterococci requires the performance of an
      array of biochemical tests. The increasing antimicrobial resistance of
      enterococci, including high-level resistance to penicillins and aminoglycosides
      and occasionally also to glycopeptides, has hampered standard therapeutic
      regimens. All enterococci isolated from serious infections should be tested for
      high-level gentamicin and streptomycin resistance by one of several methods
      evaluated; beta-lactamase production (primarily found in E. faecalis) is reliably
      detected by the nitrocefin test.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8345169
TI  - Current perspectives on anaerobic infections: diagnostic approaches.
AB  - This article discusses when to look for anaerobes, anaerobic infections as clues
      to other problems in patients, and underlying clinical conditions as clues to the
      nature of anaerobic infections. Diagnostic approaches, identification methods,
      and susceptibility testing are reviewed.

PMID- 8345170
TI  - The role of the clinical microbiology laboratory in the management of Clostridium
      difficile-associated diarrhea.
AB  - Nosocomial diarrhea due to infection with C. difficile is a major health care
      problem, causing 20% to 30% of institutionally acquired diarrhea and affecting up
      to 8% of hospitalized patients. The clinical microbiology laboratory should be
      able to provide both diagnostic and epidemiologic services for institutions where
      this disease occurs. Diagnostic testing includes culture for isolation of
      toxigenic C. difficile and detection of either toxin A or B from stool specimens.
      Epidemiologic services include providing appropriate media and specimen
      preparation for surveillance activities and performance of accurate typing of C.
      difficile strains when necessary to determine organism relatedness for
      development of effective infection control practices.

PMID- 8345171
TI  - Diagnosis of ventilator-associated pneumonia.
AB  - Ventilator-associated pneumonia is a frequent complication of mechanical
      ventilation, and it carries a significant added mortality. Proper recognition and
      treatment of pneumonia are associated with improved outcome. Clinical
      manifestations of pneumonia, chest radiograph findings, and routine analysis of
      the tracheal aspirate are inadequate, alone or in combination, in diagnosing
      pneumonia. This article discusses the methodologies that are presently available
      for diagnosing pneumonia in ventilated patients. Correct use of these techniques
      helps the clinician to establish a diagnosis with a high degree of reliability
      and facilitates the rational use of antibiotic treatment.

PMID- 8345172
TI  - Microbiologic diagnosis of ventilator-associated pneumonia.
AB  - Specific etiologic diagnosis in ventilator-associated pneumonia is critical to
      optimal patient care, and a wide array of microbiologic procedures are available
      to aid in diagnosis. In bacterial infection, direct stains, particularly the Gram
      stain, provide rapid presumptive information, and cultures provide definitive
      identification. Specimen selection is critical; endotracheal or ordinary
      bronchoscopic aspirates provide nonspecific information, and quantitative
      analysis of protected specimen brushes or bronchoalveolar lavage provides more
      accuracy. Specialized procedures for other groups of organisms, such as
      Chlamydia, Legionella, mycobacteria, fungi, and viruses, also may be indicated in
      some cases.

PMID- 8345173
TI  - The laboratory diagnosis of mycobacterial diseases.
AB  - Recent developments in diagnostic mycobacteriology are surveyed with emphasis on
      laboratory capabilities relevant to the more rapid and accurate detection and
      identification of mycobacterial pathogens. Some terminologic problems are
      reviewed, and some newly recognized mycobacterial pathogens are discussed. Newer
      methodologies presented in some detail include the radiometric technique for
      detection, identification, and susceptibility testing of mycobacteria, and the
      use of DNA probes for identification of mycobacterial species and species
      complexes. The utility of other developing methodologies, such as polymerase
      chain reaction technology, analysis of body fluids for tuberculostearic acid, and
      the use of ELISA are also assessed.

PMID- 8345175
TI  - Antimicrobial susceptibility testing of bacteria that grow aerobically.
AB  - This article focuses on susceptibility testing methods for aerobic and fastidious
      bacteria that may be tested using standard dilution or agar diffusion methods.
      Also discussed are those bacteria that may be tested by use of an automated or
      nontraditional methodology.

PMID- 8345174
TI  - Legionella and the clinical microbiologist.
AB  - Legionella species are important etiologic agents of sporadic and epidemic
      community-acquired and nosocomial respiratory disease. The list of species
      continues to expand, and tools for classification and characterization of
      isolates have become increasingly sophisticated. These organisms are associated
      with aquatic habitats and are transmitted by aerosol or direct contact. Bacterial
      culture is the cornerstone of laboratory diagnosis. Careful surveillance of
      infections is important, because infections potentially can be prevented.

PMID- 8345176
TI  - Problems with detection of beta-lactam resistance among nonfastidious gram
      negative bacilli.
AB  - The single most important aspect of any susceptibility test is the accurate
      detection of resistance, because resistance carries a strong prediction of
      therapeutic failure. However, the accurate detection of resistance has been
      difficult in tests performed with gram-negative organisms producing certain beta
      lactamases and in tests with the new beta-lactam drug/beta-lactamase inhibitor
      combinations. These problems are due to limitations in the design of studies
      performed to establish test parameters, and these problems can be avoided if a
      new predictor panel approach is used. This, coupled with the use of special tests
      to detect resistance mechanisms, could optimize the accurate identification of
      beta-lactam resistance in gram-negative bacteria.

PMID- 8345177
TI  - Detection of methicillin-resistant staphylococci.
AB  - Susceptibility tests commonly used in the clinical laboratory for detection of
      methicillin-resistant strains of staphylococci are discussed. The biochemical and
      genetic basis of methicillin resistance, including heterogeneous expression of
      resistance, is summarized. The conditions that can affect results of disk
      diffusion, broth dilution, and agar screen tests and sensitivity and specificity
      of these tests are reviewed. DNA detection methodologies, which, with their
      greater accuracy, may replace susceptibility testing, also are discussed.

PMID- 8345178
TI  - Antifungal susceptibility testing. Current state of technology, limitations, and
      standardization.
AB  - In parallel with the escalating incidence of serious, invasive fungal infections
      in the immune-compromised host has been the development and use of new,
      potentially efficacious antifungal agents as well as recognition of both primary
      and secondary resistance to such drugs by the etiologic mycotic agents. These
      findings have generated considerable enthusiasm for a reproducible and
      standardized means for the laboratory evaluation of antifungal drugs. For over a
      decade, global investigations have ensued in the hope of generating laboratory
      methods analogous to those used for antibacterial drugs that may predict the
      optimal therapeutic choice for clinicians treating mycoses. This article reviews
      the background, history, and development of in vitro antifungal susceptibility
      efforts, details the problems inherent in this area of laboratory
      medicine/infectious diseases, and assesses the contemporary aspects of
      standardization.

PMID- 8345179
TI  - Bactericidal testing.
AB  - Recognition of the importance of bactericidal activity in certain clinical
      settings has generated a great deal of interest in bactericidal testing. Indeed,
      bactericidal testing can be of great use in a number of settings, but it also has
      the potential for being overutilized. Moreover, there are biologic and technical
      pitfalls inherent in bactericidal testing. This article addresses these issues
      and summarizes the progress toward standardization of these methods. Thoughtful
      and deliberate application of standardized bactericidal testing should make this
      controversial test much more useful in the future.

PMID- 8345180
TI  - The good old days--past, present, and future.

PMID- 8345181
TI  - Increasing the immunogenicity of protein antigens through the genetic insertion
      of VQGEESNDK sequence of human IL-1 beta into their sequence.
AB  - The immunogenicity of two recombinant protein Ag containing the immunostimulatory
      sequence of human IL-1 beta 163-171 (VQGEESNDK) genetically engineered into their
      structure has been evaluated. The IL-1 beta sequence was inserted into the loop
      between alpha helices D and E of recombinant human ferritin H chain and into the
      hypervariable region of recombinant flagellin from Salmonella muenchen. The
      chimeric proteins were injected into mice and the level of humoral immune
      response developed against the native proteins was assessed by measuring the
      number of Ag-specific plaque forming cells/spleen or as the level of serum IgG
      response. The response was compared to that of mice receiving injections with
      wild-type protein Ag not containing the VQGEESNDK sequence or with hybrid
      constructs containing unrelated foreign peptide sequences of the same length. A
      significantly higher immune response was observed in mice immunized with chimeric
      constructs containing the human IL-1 beta 163-171 sequence. These data suggest
      that the insertion of the VQGEESNDK sequence may prove useful to increase the
      immune response against poorly immunogenic recombinant proteins.

PMID- 8345182
TI  - Regional specialization of the mucosal immune system. Intraepithelial lymphocytes
      of the large intestine have a different phenotype and function than those of the
      small intestine.
AB  - Intraepithelial lymphocytes (IEL) are found in both the small and the large
      intestine. We demonstrate that there are a number of striking phenotypic and
      functional differences between the two populations of IEL isolated from mice. In
      the large intestine, the majority of IEL express the alpha beta TCR, and among
      these TCR-alpha beta+ lymphocytes, CD4+ cells are as prevalent as CD8+ cells. In
      contrast, in the small intestine, most of the TCR-alpha beta+ IEL express CD8,
      and an increased percentage of cells express TCR-gamma delta. In addition, most
      TCR-gamma delta+ IEL isolated from the large intestine (LI-IEL) are CD4- CD8-
      cells, as compared to TCR-gamma delta+ IEL isolated from the small intestine (SI
      IEL), which are predominantly CD8+. Furthermore, CD2 and the lymph node homing
      receptor, L-selectin, are expressed by most LI-IEL but not by SI-IEL.
      Furthermore, LI-IEL have much less cytolytic activity than SI-IEL. These data
      suggest that LI-IEL are a distinct population of lymphocytes that may have a
      different immunologic role than that of SI-IEL.

PMID- 8345183
TI  - Expression of merosin in the thymus and its interaction with thymocytes.
AB  - Merosin is a 700 kDa multichain protein that has several properties in common
      with laminin, one of the major extracellular matrix proteins present in basement
      membranes. Both contain B1 and B2 light chains, but merosin has a distinct M
      chain compared with the laminin A-chain. Merosin is present in the basement
      membrane of placenta, striated muscle, and peripheral nerve. Using the RT-PCR
      assay, we demonstrate that merosin, but not laminin, is also expressed in the
      thymus. A partial cDNA sequence of the mouse merosin M-chain was 88% identical to
      the human M-chain, and the deduced amino acid sequences were 95% identical. 18
      24% of adult mouse thymocytes bound to human merosin in vitro. Mg2+, but not
      Ca2+, was essential for binding. Binding was inhibited by antibodies recognizing
      VLA alpha 6 or beta 1, suggesting that the VLA-6 integrin is a merosin receptor.
      An anti-beta 4 integrin subunit mAb failed to inhibit binding, suggesting that
      the alpha 6 beta 4 integrin was not involved. Thymocytes were fractionated into
      immature and mature populations based on their expression of the heat stable
      antigen, recognized by the J11d mAb. Virtually all thymocytes expressed VLA-6,
      but only immature thymocytes (J11d+) bound to meroson. PMA treatment did not
      significantly increase the binding of J11d+ thymocytes nor did induce binding in
      the mature J11d- population. In constrast, both splenic T cells and unseparated
      lymph node cells showed enhanced binding to merosin after PMA stimulation. The
      expression of merosin in the thymus and its selective interaction with immature
      thymocytes suggest that thymocyte-merosin interactions may play a role in T cell
      development.

PMID- 8345184
TI  - Urtica dioica agglutinin. A superantigenic lectin from stinging nettle rhizome.
AB  - Urtica dioica agglutinin (UDA) is an unusual plant lectin that differs from all
      other known plant lectins with respect to its molecular structure and its
      extremely low specific agglutination activity. We recently reported that this
      small lectin (8.5 kDa) is a T cell mitogen distinguishable from classical T cell
      lectin mitogens by its ability to discriminate a particular population of CD4+
      and CD8+ T cells as well as its capacity to induce an original pattern of T cell
      activation and cytokine production. The mechanism by which UDA activates T cells
      was investigated and compared with the conventional T cell mitogen Con A and the
      known superantigen staphylococcal enterotoxin B. Our data show that T cell
      proliferation induced by UDA is strictly dependent on AC expressing MHC class II
      molecules but is not MHC restricted. This proliferation can be partially
      inhibited by anti-I-A or anti-I-E mAb and completely blocked by a mAb recognizing
      monomorphic determinants on the Ia molecule. UDA indeed binds to specific
      carbohydrate structures present on class II molecules. UDA-induced T cell
      stimulation is dependent on TCR recognition of the unprocessed intact molecule in
      association with various Ia molecules. T cell response to UDA is clonally
      expressed and correlates with particular TCR V beta gene families usage. This
      stimulation leads to a sixfold enrichment of V beta 8.3+ T cells within 3 days.
      Therefore, UDA appears to use the same molecular mechanism as structurally
      unrelated bacterial or retroviral superantigens and we propose that this lectin
      is a superantigen. UDA, which is not a pathogenicity factor, could provide a
      useful probe for the analysis of T cell activation by superantigens.

PMID- 8345185
TI  - Early signals in alloantigen induced B-cell proliferation. Comparison between B
      cell triggering by intact allogeneic cells and solubilized alloantigen.
AB  - Stimulation of B cells from BALB/c with allogeneic lymphocytes from C57BL/6 mice
      resulted in a slight increase in cytosolic Ca2+ but in the absence of
      proliferative response. Immunization of BALB/c mice with C57BL/6 total
      lymphocytes resulted in an enhancement of cytosolic Ca2+ and of B cell
      proliferation. Phosphatidylinositol specific phospholipase C was activated
      immediately after allogeneic stimulation as deduced by the concomitant rise in
      inositol 1,4,5-trisphosphate and 1,2-diacylglycerol. Translocation of protein
      kinase C from the cytosol toward the membranes paralleled the elevation in
      cytosolic free Ca2+. Activation of BALB/c B cells with solubilized alloantigen
      from the plasma membrane of C57BL/6 lymphocytes produced qualitatively the same
      early responses as the treatment with allogeneic cells, although quantitatively
      more intense. Concerning protein kinase C, an important degradation was observed
      in these conditions. Soluble alloantigen failed to promote B cell proliferation,
      being observed when cells were costimulated with a low concentrations (2 ng/ml)
      of phorbol 12,13-dibutyrate before alloantigen addition. Analysis of the
      molecular weight of the active fraction of the solubilized alloantigen revealed
      the presence of a 51 kDa protein that mimicked all properties of the alloantigen
      preparation. This molecule was also recognized in Western blot by an anticlass I
      mAb and by the sera of immunized animals. A putative MHC class I antigen is
      proposed as the nature of the active molecule, and its interaction with specific
      membrane Ig on the B cell is analyzed. Although the results fit with a cellular
      response mediated through membrane Ig, the involvement of other B cell surface
      molecules interacting with the alloantigens cannot be disregarded.

PMID- 8345186
TI  - Superantigen-driven peripheral deletion of T cells. Apoptosis occurs in cells
      that have lost the alpha/beta T cell receptor.
AB  - Injection of lymphoid cells expressing minor lymphocyte-stimulating antigen-1
      (Mls-1a) induces tolerance to the superantigen, and partial deletion of Mls-1a
      reactive T cells. We have identified a transient population of T cells that have
      lost the alpha/beta T cell receptor at the time when Mls-1a-reactive T cells
      start to disappear during the process of tolerance induction. Apoptosis was
      directly demonstrated in this TCR-alpha/beta negative T-cell population. This
      indicates a peripheral T-cell deletion pathway, characterized by TCR down
      regulation, apoptosis, and clonal deletion. The consequence of Mls-1a-induced TCR
      down-regulation appears to be different in CD4+ cells and in CD8+ cells. Although
      most of the CD4+ cells that have lost TCR expressing alpha- and beta-chains
      appear to be undergoing apoptosis, many of their CD8+ counterparts may be able to
      re-express the Ag receptor. This argues for the involvement of coreceptors in the
      induction of apoptosis during peripheral deletion.

PMID- 8345187
TI  - Wasting, ischemia, and lymphoid abnormalities in mice expressing T cell-targeted
      human tumor necrosis factor transgenes.
AB  - To evaluate the biologic potential of T cell-specific TNF production in vivo, we
      have generated transgenic mice constitutively expressing TNF in their T cell
      compartment. This was achieved by placing a wild-type or a 3'-UTR modified
      fragment of the human TNF gene under the influence of the T cell-specific, locus
      control region of the human CD2 gene. Transgenic mice that express human TNF mRNA
      in T cells develop marked histologic and cellular changes locally in their
      lymphoid organs and a lethal wasting syndrome associated with widespread vascular
      thrombosis and tissue necrosis. The extent of pathologic changes and their time
      of onset appear to reflect levels of transgene expression. Thus, transgenic lines
      that express the transgene at high levels show both lymphoid organ and systemic
      abnormalities with wasting. In one transgenic line, mice express lower levels of
      the transgene and develop normally despite pronounced local lymphoid organ
      defects, confirming in vivo, the differential potential of localized and systemic
      TNF action. All pathologic changes could be neutralized by the administration of
      mAb specific for human TNF. These results demonstrate the important role of T
      cell-specific TNF production in the development of specific pathology and provide
      a means by which to evaluate the role of TNF in thymocyte development. Transgenic
      mice that express TNF constitutively in the T cell compartment offer a unique in
      vivo system by which to analyze the molecular character of systemic vs contact
      dependent and paracrine modes of TNF action. Furthermore, given the species
      specific nature of the mouse p75 TNF receptor, it is assumed that the pathology
      induced by human TNF in these transgenic mice is associated exclusively with p55
      TNF receptor signaling. Conceivably, the differential contribution of each of the
      two TNF receptors in thymus development and TNF-mediated disease can be assessed
      by comparison of the biologic potential of human vs mouse TNF in the transgenic
      system developed.

PMID- 8345188
TI  - Specific V beta T cell subsets mediate the immediate hypersensitivity response to
      ragweed allergen.
AB  - T and B cell responses after sensitization to ragweed (RW) were examined in a
      mouse model in which BALB/c mice were exposed to the allergen by ultrasonic
      nebulization. Sensitization resulted in the stimulation of an IgE anti-RW
      response and was paralleled by a rise in IgG1 anti-RW titers. Skin testing for
      immediate cutaneous hypersensitivity revealed the presence of allergic type I
      reactions to RW. Sensitization to RW in this way was also associated with the
      development of increased airways responsiveness as determined by electrical field
      stimulation of preparations of tracheal smooth muscle. Histologic examination of
      the airways and the lung indicated the presence of a mononuclear cell infiltrate
      in the mucosa and submucosa of the airways that was accompanied by an enlargement
      of local draining lymph nodes of the airways and the lung. T cell populations
      were analyzed for the frequency of V beta-expressing T cells. Such analysis
      indicated that RW sensitization stimulated the expression of V beta 8.1+, V beta
      8.2+, and V beta 13+ T cells in the local lymphoid tissue and of V beta 8.1+, V
      beta 8.2+, V beta 8.3+, V beta 9+ and V beta 14+ T cells in the spleen. Co
      culture of these T cell populations with RW-primed B cells indicated that in the
      presence of RW, V beta 8.2 T cells stimulated IgE and IgG1 production, whereas
      the other T cell populations showed a different stimulation profile for Ig
      isotypes and IgG subclasses. The transfer of V beta 8.2 T cells from sensitized
      but not from nonsensitized control mice stimulated an allergen-specific IgE and
      IgG1 response and increased airways responsiveness in naive recipients. These
      data provide additional support for the pivotal role of specific V beta
      expressing T cell subpopulations in the stimulation of IgE/IgG1 production and
      increased airways responsiveness.

PMID- 8345190
TI  - A hit-and-run system for introducing mutations into the Ig H chain locus of
      hybridoma cells by homologous recombination.
AB  - The traditional method of site-specific mutagenesis is to introduce predetermined
      mutations into an expression vector, which is then transferred to cells so that
      the relevant gene product and the effects of the mutations can be measured. A
      problem with this approach is that the expression of the transferred genes varies
      from transformant to transformant, presumably because the number of vector copies
      and the site of chromosomal integration vary among transformants. While it should
      be possible to avoid this variability by mutagenizing the chromosomal gene
      itself, the labor involved in introducing predetermined mutations by homologous
      recombination with a mutagenized vector is usually so intense that this has not
      been the favored method. We describe here a system for introducing mutations into
      the IgH locus of hybridoma cells. This system greatly reduces the labor that
      would usually be required to identify and recover the rare recombinants. This is
      a two-step, so-called "hit-and-run," method, whereby mutations are first
      introduced into the chromosomal locus by targeted vector integration, after which
      the vector is excised so as to leave the mutation in the chromosomal target. The
      first step employs an enhancer trap vector bearing an enhancerless gpt gene;
      using this vector the frequency of randomly inserted transformants which grow in
      mycophenolic acid containing selective medium is so low that approximately 25% of
      the selected transformants have integrated the vector into the IgH locus by
      homologous recombination. Properly targeted transformants can then be used to
      derive secondary recombinants that have excised the vector and thus become gpt-.
      This second step which involves selection of gpt- cells by their resistance to 6
      thioxanthine is also efficient, in that approximately 75% of the treated cells
      have excised the gpt gene by homologous recombination. Overall the labor involved
      in mutagenizing the chromosomal locus is not much more than is needed to produce
      the traditional transformants expressing a mutagenized transferred gene.

PMID- 8345189
TI  - Rapid Il-2-induced adherence of human natural killer cells. Expression of mRNA
      for cytokines and IL-2 receptors in adherent NK cells.
AB  - Natural killer (NK) cells selected by IL-2-induced rapid adherence to plastic and
      called A-NK cells represent a phenotypically and functionally distinct subset of
      mature peripheral blood NK cells. To further characterize this subset of NK cells
      functionally, their potential to express mRNA for the IL-2R and various cytokines
      after IL-2 activation was examined. Highly purified normal human peripheral blood
      resting NK (R-NK) cells were obtained by negative immunoselection using OKT3 mAb
      and magnetic beads coated with goat anti-mouse Ig. By two-color flow cytometry, >
      90% of these R-NK cells were either CD3-CD56+CD16+ or - or CD3-CD56-CD16+. R-NK
      cells were activated in the presence of 6000 IU/ml (22 nM) of IL-2 for different
      periods of time. After 1, 3, 5, or 24 h, plastic-adherent (A) and nonadherent
      (NA) NK cells were separated and compared for the expression of the IL-2R or
      cytokine mRNA by in situ hybridization, using 35[S]-cDNA probes. Only low
      proportions of R-NK cells expressed genes for IL-2Rp55 (16%) or cytokines IL-2
      (20%), IFN-gamma (18%), TNF-alpha (16%), and TGF-beta (7%). Thus, the genes for
      the IL-2Rp55 and these cytokines were not constitutively expressed by most human
      R-NK cells, and there was no indication that the NK cells used in these
      experiments were activated in vivo or during the purification procedure. However,
      larger proportions of R-NK cells showed expression of mRNA for IL-1-beta (35%)
      and IL-6 (40%), which indicates that genes for these cytokines may be
      constitutively expressed in a substantial proportion of normal human circulating
      NK cells. When R-NK cells were incubated in the presence of 22 nM of IL-2 for 1
      to 24 h and separated into A-NK cells and NA-NK cells, a large proportion of A-NK
      cells became positive for IL-2R and cytokine gene expression. In contrast, the
      proportion of mRNA-positive NA-NK cells was similar or lower than that observed
      for R-NK cells, with the exception of an increase in TGF-beta.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8345192
TI  - Role of the Q10 class I regulatory element region 1 in controlling tissue
      specific expression in vivo.
AB  - The MHC class I regulatory element (CRE) region 1 has been previously described
      as a positive cis-acting regulatory element essential for class I gene
      expression. We have generated transgenic mice (CBA x C57BL/6) with the MHC class
      I gene H-2Dd driven by two different 400-bp promoter regions of Q10, a
      nonpolymorphic MHC class I gene expressed in the liver, kidney, and fetal yolk
      sac. One transgene contained the wild-type Q10 promoter (Q10WT/Dd). The second
      construct (Q10M3/Dd) had 2 bp substitutions introduced in region 1 of the CRE
      that reconstituted the CRE inverted repeat present in classical class I genes.
      Mice containing the wild-type Q10/Dd gene expressed membrane-bound H-2Dd
      molecules in a tissue-restricted expression pattern similar to that observed for
      endogenous Q10. In mice containing the mutant construct (Q10M3/Dd), H-2Dd was
      also expressed in the thymus, a tissue not normally associated with Q10
      expression but, surprisingly, the Dd was not expressed in other lymphoid tissues.
      Furthermore, thymic expression was greatest on double positive (CD4+ CD8+)
      thymocytes. Thymic Dd expression was correlated with the presence of what appears
      to be a previously unidentified transcription factor in thymocytes that is
      capable of interacting with the CRE-inverted repeat. These results show that the
      mutations in region 1 altered the tissue-specific regulation of the Q10 promoter
      in vivo, although an intact inverted repeat did not restore the ubiquitous
      pattern of expression characteristic of classical class I genes. Thus, these
      results indicate that elements in addition to CRE region 1 in the Q10 promoter
      region serve to limit ubiquitous tissue expression.

PMID- 8345191
TI  - Characterization of A1, a novel hemopoietic-specific early-response gene with
      sequence similarity to bcl-2.
AB  - Granulocyte-macrophage colony-stimulating factor (GM-CSF) stimulates hemopoietic
      cell proliferation, differentiation, and functional activation by inducing the
      expression of specific genes. As part of an investigation of the regulation of
      gene expression by GM-CSF, we have previously identified a novel murine GM-CSF
      inducible gene, A1. In this report, we present the complete nucleotide sequence
      of the A1 mRNA as well as a portion of the 5' flanking region, and describe the
      expression pattern of the gene. The results demonstrate that A1 is a hemopoietic
      tissue-specific gene that is expressed in several hemopoietic cell lineages,
      including T-helper lymphocytes, macrophages, and neutrophils. In murine bone
      marrow-derived macrophages, A1 gene expression is rapidly and transiently induced
      by GM-CSF, and the induction was independent of de novo protein synthesis. In
      addition to GM-CSF, a transient induction of A1 mRNA accumulation was observed in
      response to LPS in macrophages. This induction is not mediated by IL-1 alpha or
      IL-6, neither of which stimulate A1. In the myeloid precursor cell line, 32D cl3,
      A1 gene expression is stably induced during granulocyte colony-stimulating factor
      stimulated myeloid cell differentiation. The A1 message encodes a predicted
      polypeptide with an M(r) of 20,024 and no signal peptide. The peptide sequence
      contains a region of 80 amino acids that shows similarity to bcl-2 and to the
      recently described bcl-2-related gene, MCL1. These data demonstrate that A1 is a
      novel early-response gene whose expression is associated with a variety of
      stimuli and occurs in several hemopoietic cell types.

PMID- 8345193
TI  - Expression cloning of complementary DNA encoding three distinct isoforms of
      guinea pig Fc receptor for IgG1 and IgG2.
AB  - Three cDNA clones encoding the guinea pig Fc receptor for IgG1 and IgG2 (Fc gamma
      1/gamma 2 R) have been isolated by an expression cloning strategy using mAb
      directed against the receptor. When transfected into COS-7 cells, these cDNA
      induced cell surface expression of the receptor that bound IgG1 and IgG2
      antibodies complexed with the Ag. The ligand-binding affinities of these
      receptors were indistinguishable. Nucleotide sequencing has indicated that one of
      these clones, Fc gamma 1/gamma 2R-B1, is identical to the previously isolated
      cDNA clone homologous to the b2 isoform of human Fc gamma RIIB and that of murine
      Fc gamma RII, encoding a transmembrane glycoprotein containing two Ig-like
      extracellular domains. Two other clones, Fc gamma 1/gamma 2R-B2 and -B3, are
      identical to Fc gamma 1/gamma 2R-B1 except for an inframe insertion in the
      cytoplasmic region. The 48-nucleotide insertion found in Fc gamma 1/gamma 2R-B2
      is identical to the first 48 nucleotides of the B3 insert that comprises 132 bp.
      Based on the size and homology of the inserted sequence, Fc gamma 1/gamma 2R-B2
      and -B3 are identified as the homologues of the b1 isoform of human Fc gamma RIIB
      and that of murine Fc gamma RII, respectively. Reverse transcription and
      polymerase chain reaction of RNA revealed that macrophages and polymorphonuclear
      leukocytes expressed preferentially Fc gamma 1/gamma 2R-B1. On the other hand, B
      lymphocytes expressed all three forms, among which Fc gamma 1/gamma 2R-B2 and -B3
      were selectively expressed in LPS-activated B lymphocytes that showed a dramatic
      increase in the levels of cell surface expression of Fc gamma 1/gamma 2R. These
      results suggest that the inserted sequences of Fc gamma 1/gamma 2R-B2 and -B3 are
      important to generate responses specific for B lymphocytes, which may include
      regulation of cell activation.

PMID- 8345194
TI  - Priming immunization determines T helper cytokine mRNA expression patterns in
      lungs of mice challenged with respiratory syncytial virus.
AB  - Defining the mechanism for the vaccine-enhanced illness associated with
      respiratory syncytial virus (RSV) is critical for advancing RSV vaccine
      development. Previous studies in which infants were vaccinated with formalin
      inactivated alum-precipitated whole virus did not protect from RSV infection, and
      those infected had a high incidence of severe illness. In contrast, previous
      clinical trials evaluating live attenuated RSV showed no associated vaccine
      enhanced illness. We have used a mouse model to explore the immunopathogenesis of
      RSV infection. In this study cytokine mRNA expression was examined using 32P
      labeled oligonucleotide probes in Northern blot analyses of polyA RNA extracted
      from lungs of mice primed with various vaccine preparations then challenged
      nasally with live RSV. We have shown that upon challenge, priming of mice with
      inactivated virus or subunit F glycoprotein induced a pattern of cytokine mRNA
      expression suggesting a dominant Th2-like lymphocyte response (relative increase
      in IL-4 mRNA expression). In contrast, challenge of mice primed with live RSV by
      parenteral or mucosal routes induced a Th1-like pattern of cytokine mRNA
      expression (relative decrease in IL-4 mRNA expression compared to IFN-gamma mRNA
      expression). Thus, the formulation and route of delivery of vaccine products can
      influence the pattern of cytokine expression in lung upon RSV challenge.

PMID- 8345195
TI  - Selective tolerance to the E1 protein of rubella virus in congenital rubella
      syndrome.
AB  - Rubella virus (RV) infection of the fetus in the first trimester of pregnancy
      usually results in severe birth defects collectively termed Congenital Rubella
      Syndrome (CRS) and is frequently associated with prolonged RV persistence in the
      infant. Immunological tolerance to RV is believed to contribute to viral
      persistence, but the mechanism for this is unknown. In this study, RV-specific
      antibody responses in CRS patients and healthy controls who had experienced
      Rubella infection postnatally were compared to determine if there were
      differences that might account for RV persistence in the former group. Levels and
      functional affinities of IgG specific for individual RV proteins (E1, E2, and C)
      were measured by enzyme immunoassay (EIA). Relative amounts of RV protein
      specific IgG directed to linear and topographic epitopes were compared by
      immunoblots run under reducing or nonreducing conditions, respectively, and
      biological activity was determined by hemagglutination inhibition (HAI) assay.
      Results showed that both CRS patients and control subjects had comparably high
      levels of IgG directed to whole RV and to RV E2 and C proteins as measured by
      EIA. However, in contrast to the controls, CRS patients were found to have
      significantly reduced levels of antibodies directed to RV E1 protein and its
      linear (but not topographic) epitopes. Also, functional affinities of specific
      IgG directed to whole RV and E1 protein, as well as hemagglutination inhibition
      titers, were found to be significantly lower in CRS patients than in controls.
      The data suggest that intrauterine exposure to RV may result in selective
      immunological tolerance to the RV E1 protein. A model is presented that
      accommodates the serological findings of this investigation within a proposed
      mechanism of RV persistence resulting from selective immunological tolerance to
      RV E1 protein.

PMID- 8345196
TI  - Synergism between IFN-gamma and IL-1 alpha/beta in growth inhibition of an
      allografted tumor.
AB  - Soluble effector molecules involved in the rejection of allografted mouse Meth A
      (3-methylcholanthrene-induced ascites type tumor) cells were examined. A potent
      antiproliferative activity against the tumor cells was detected in the culture
      supernatant of leukocytes that had infiltrated into the peritoneal cavity of
      C57BL/6 mice on days 6-8 after transplantation, when the i.p. transplanted Meth A
      cells were undergoing rejection. Studies with neutralizing antibodies indicated
      that both IFN-gamma and IL-1 alpha/beta were required for the activity but that
      TNF-alpha was not. Actually, mouse rIFN-gamma and rIL-1 alpha/beta used, at the
      concentrations found in the culture supernatant determined by ELISA, were able to
      reconstitute the potent antiproliferative activity, although each cytokine alone
      had a weak growth inhibitory activity against Meth A cells. The half-maximal
      inhibition was observed with 0.02-0.03 U/ml of rIL-1 alpha/beta at 1-100 U/ml of
      rIFN-gamma. The synergistic growth inhibitory effect of these cytokines also was
      observed with four of 15 mouse transformed cell lines tested, indicating that the
      effect was not specific to Meth A cells. These findings suggest that IFN-gamma
      and IL-1 alpha/beta participate as soluble effector molecules in the rejection of
      some allografted tumor cells including Meth A cells.

PMID- 8345197
TI  - Quantitation and kinetics of blood monocyte migration to acute inflammatory
      reactions, and IL-1 alpha, tumor necrosis factor-alpha, and IFN-gamma.
AB  - Monocytes migrate from the blood into acute inflammatory reactions, where they
      differentiate into macrophages, and after 12 to 24 h become the predominant
      histologic feature of the inflammatory infiltrate. The quantitation of monocyte
      migration into these reactions has been difficult. This report employs a novel
      combination of techniques to isolate highly purified monocytes from the blood of
      rats, and shows that these cells have a normal t1/2 of 26 h and migrate
      efficiently after i.v. injection into cutaneous acute inflammatory sites.
      Monocytes labeled with 51Cr accumulated in delayed-type hypersensitivity
      reactions, and sites injected with killed Escherichia coli, LPS, poly-inosine:
      cytosine, zymosan-activated serum (ZAS), a source of C5adesArg, and the cytokines
      IL-1 alpha, TNF-alpha, and IFN-gamma. Both radiolabeled monocytes and neutrophils
      migrated rapidly to E. coli, LPS, ZAS, IL-1 alpha, and TNF-alpha with a large
      increase in cell accumulation by 2 h. Neutrophil migration declined rapidly to
      undetectable levels by 3 to 4 h to all five stimuli, and monocyte migration to
      ZAS and IL-1 alpha also declined by this time. In contrast, E. coli, LPS, and TNF
      alpha caused a sustained migration of monocytes for 5 to 6 h, long after
      neutrophils had stopped accumulating. Intradermal IFN-gamma did not recruit
      neutrophils but stimulated a prolonged monocyte migration from 1 to 6 h.
      Combinations of LPS, TNF-alpha, and IFN-gamma synergistically enhanced the late
      (> 5 h) but not the early phase of monocyte recruitment. In conclusion, purified
      monocytes isolated from rat blood can be used to quantify monocyte migration in
      vivo, and these cells migrate rapidly to cutaneous inflammation and in response
      to chemotactic factors, IL-1 alpha, TNF-alpha, and IFN-gamma, with initial
      kinetics similar to those of neutrophils. However, monocyte-selective mechanisms
      are induced by IFN-gamma and also appear to be involved in prolonged monocyte
      migration to TNF-alpha, LPS, and E. coli.

PMID- 8345198
TI  - Mechanism of increased tumor necrosis factor production after thermal injury.
      Altered sensitivity to PGE2 and immunomodulation with indomethacin.
AB  - Altered macrophage function after thermal injury is associated with increased
      production of PGE2 and TNF. However, it is not clear why synthesis of both
      cellular products remains elevated, as PGE2 is a potent inhibitor of TNF
      secretion. We studied the relationship between PGE2 and TNF synthesis in a murine
      model of thermal injury, and examined the effect of prostaglandin blockade on
      splenic macrophage secretion of these mediators of inflammation. LPS-stimulated
      production of PGE2 was significantly elevated in burn groups compared with sham
      burned controls (pg/ml mean(SEM); sham 151(32): burn 597(147), p < 0.01). TNF
      production was similarly increased after thermal injury (pg/ml mean(SEM); sham
      62(20): burn 928(316), p < 0.01). In vitro culture of macrophages with
      indomethacin augmented LPS stimulated TNF production in sham-burned controls but
      did not affect synthesis in burn groups, suggesting a loss of PGE2-dependent
      regulation of TNF synthesis after thermal injury. Direct measurement of TNF
      secretion as a function of exogenous PGE2 confirmed this dissociation between
      PGE2 and TNF synthesis, as burned animals displayed a 5-fold reduction in
      sensitivity to PGE2-induced inhibition of TNF, when compared with sham-burned
      controls (ID50 PGE2 molar; sham 1.26 x 10(-8): burn 6.43 x 10(-8), p < 0.05). In
      vivo pretreatment of burn groups with indomethacin for 5 days before assay
      partially restored sensitivity to the prostaglandin, and significantly down
      regulated synthesis of both TNF and PGE2. These data show that thermal injury is
      associated with a loss of PGE2-dependent down-regulation of TNF synthesis, which
      accounts at least in part for increased TNF in these animals. In vivo
      cyclooxygenase blockade partially restored sensitivity to the prostaglandin and
      consequently down-regulated synthesis of TNF. These data further support existing
      evidence that suggests a potential therapeutic role for cyclooxygenase blockade
      after major thermal injury and trauma.

PMID- 8345199
TI  - Transforming growth factor-beta suppresses activation and proliferation of
      microglia in vitro.
AB  - Transforming growth factor-beta (TGF-beta) has been shown to be produced in the
      central nervous system (CNS). The functions of TGF-beta, however, remain to be
      elucidated. We investigated the effects of TGF-beta on the proliferation,
      activation, and cytokine production of isolated microglia in vitro. TGF-beta dose
      dependently suppressed the acid phosphatase activity of and formation of
      superoxide anion by LPS activated microglia. It also suppressed the IFN-gamma
      induced expression of class II MHC Ag- and the production of cytokines, IL-1, IL
      6, and TNF-alpha, by these cells. TGF-beta also inhibited the proliferation of
      microglia that was induced by either GM-CSF or M-CSF. Because various
      immunoregulatory cytokines are produced in the CNS that serve as autocrine or
      paracrine mediators it is suggested that TGF-beta could be a negative regulator
      in the CNS cytokine network. It may play a role in the development of various
      disease processes in the CNS by inhibiting the function of microglia in
      inflammation or in immunoregulation.

PMID- 8345200
TI  - Clusterin, the human apolipoprotein and complement inhibitor, binds to complement
      C7, C8 beta, and the b domain of C9.
AB  - Clusterin is a heterodimeric multifunctional protein expressed in a variety of
      tissues and cells. It forms high density lipid complexes in plasma and
      participates in the control of the lytic activity of the late complement complex
      (TCC, C5b-9). Together with vitronectin, clusterin binds to the nascent
      amphiphilic C5b-9 complex, rendering it water soluble and lytically inactive. To
      define the interactions that underlie the complement-inhibitory function of
      clusterin, we have examined the binding interactions between [125I]clusterin and
      the isolated components of the complex, C5b-6, C7, C8, and C9 and vitronectin. By
      using ligand blotting in the presence of Tween, specific binding of the labeled
      clusterin with C7, the beta-subunit of C8 and C9 was detected. Binding to C9 was
      competed by polymerized C9, but not by C8, C7, C6, and CD59, suggesting that the
      conformational change occurring during the hydrophilic-amphiphilic transition of
      C9 exposes the interaction site for clusterin. When thrombin-treated C9 was
      analyzed, clusterin was found to recognize the C9b fragment containing the
      hydrophobic membrane interaction segment. Both subunits of clusterin interact
      with C9 and are similarly potent in inhibiting C5b-9-mediated hemolysis and
      Zn+(+)-induced C9 polymerization. These results show that clusterin exerts its
      inhibitory effect by interacting with a structural motif common to C7, C8 alpha,
      and C9b.

PMID- 8345201
TI  - Regulation of neutrophil-derived IL-8: the role of prostaglandin E2,
      dexamethasone, and IL-4.
AB  - Historically, the neutrophil has been perceived as a terminally differentiated
      leukocyte with limited ability to produce de novo proteins. Furthermore, in the
      context of acute inflammation the activated neutrophil has been appreciated only
      for its ability to release various proteases, reactive oxygen, and arachidonic
      acid metabolites. Recently, the neutrophil has been shown to have the capacity to
      produce a number of cytokines that may be instrumental in orchestrating the
      progression of acute inflammation to a more chronic and specific immune response.
      These cytokines include IFN-alpha, M-CSF, G-CSF, TNF, IL-1, and IL-6. Our
      laboratory and others have shown that neutrophils produce IL-8 in response to LPS
      or a phagocytic challenge. Although these studies have shown the induction of IL
      8 from polymorphonuclear neutrophils (PMN), relatively little is known regarding
      the regulation of PMN-derived IL-8. Because PMN and monocytes share the same stem
      cell, and monocyte-derived IL-8 is regulated by prostaglandin E2 (PGE2),
      glucocorticoids (dexamethasone; DEX) and the T-Lymphocyte-derived IL-4, we
      postulated that PMN-derived IL-8 production may be regulated in a similar manner.
      To test this hypothesis, PMN were isolated (> 99% pure) from peripheral blood and
      cultured in media with 5% FCS in the presence or absence of LPS (10 ng/ml; a
      concentration of LPS that induced the half-maximal production of PMN-derived IL
      8) and in the presence or absence of DEX (10(-6) M to 10(-10) M), PGE2 (10(-6) M
      to 10(-10) M), or IL-4 (100 ng/ml to 100 pg/ml). PMN-derived IL-8 was measured
      using a specific sandwich ELISA. DEX and IL-4 in the presence of LPS were found
      to inhibit PMN-derived IL-8 in both a dose- and time-dependent fashion. DEX and
      IL-4 in concentrations of 10(-6) M and 10 ng/ml resulted in maximal inhibition of
      LPS-induced PMN-derived IL-8, respectively. Moreover, both DEX and IL-4
      administration could be delayed 4 hr post-stimulation with LPS and result in
      significant suppression of PMN-derived IL-8. Interestingly, in contrast to the
      regulation of monocyte-derived IL-8 by PGE2, PGE2 treatment of PMN failed to
      inhibit the generation of LPS-induced IL-8. Northern blot analysis of steady
      state IL-8 mRNA demonstrated that both DEX and IL-4 treatment of PMN resulted in
      a 40 and 52% reduction in LPS-stimulated PMN-derived IL-8 mRNA,
      respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8345202
TI  - Recombinant tetravalent group A streptococcal M protein vaccine.
AB  - Previous studies have shown that the amino-terminal regions of group A
      streptococcal M proteins contain primarily protective (opsonic) epitopes and not
      tissue-cross-reactive epitopes. Limited primary structures from multiple
      serotypes of M protein containing only protective epitopes could potentially be
      linked together to form a broadly protective vaccine. The present studies were
      undertaken to determine the protective immunogenicity of a recombinant,
      multivalent hybrid molecule containing amino-terminal subunits of types 24, 5, 6,
      and 19 M proteins. Polymerase chain reaction primers were designed to amplify emm
      gene fragments ranging from 35 to 113 codons. The PCR products were ligated in
      tandem and inserted into pKK223-3. The tetravalent M protein that was purified
      from extracts of Escherichia coli migrated as a single band on SDS-PAGE with an
      apparent m.w. of 31 kDa. In immunoblot analyses, the hybrid protein reacted with
      serotype-specific antisera indicating that it contained all four M protein
      subunits. Rabbits immunized with the purified tetravalent M protein developed
      significant antibody levels against all four serotypes of native M proteins
      represented in the hybrid protein. None of the antisera cross-reacted with human
      tissues. The immune sera also opsonized all four serotypes of group A
      streptococci. Our data show that a hybrid protein containing subunits from
      multiple M proteins can evoke broadly protective immune responses without tissue
      cross-reactive antibodies.

PMID- 8345203
TI  - Molecular analysis of IgE H-chain transcripts expressed in vivo by peripheral
      blood lymphocytes from normal and atopic individuals.
AB  - The low levels of IgE produced by PBMC from normal individuals has so far
      prevented an analysis of their IgE H chain repertoire. Using a nested polymerase
      chain reaction approach, we were able to detect epsilon transcripts in all normal
      and allergic individuals we investigated. We further cloned epsilon CDR3/FW4
      regions from two normal and two atopic individuals with low serum IgE levels.
      Sequence analysis of 104 clones identified 26 different epsilon CDR3/FW4 regions
      and an additional number of clonally related transcripts in the two atopic
      individuals. Preferential usage of DH genes from the DXP family (33%) and of the
      JH4b gene (35%) were observed, similar to reported findings for the IgM-producing
      peripheral blood B cell subset. Using CDR3 specific oligonucleotides, we detected
      the CDR3/FW4 regions of a particular set of clonally related epsilon transcripts
      in mu and gamma 4 transcripts of the same individual. This finding demonstrates
      the in vivo production of IgE together with the two other Ig isotypes (IgM and
      IgG4) by the progeny of a common B cell precursor, and suggests a possible
      mechanism for regulating the allergic response. The clonally related epsilon
      transcripts were found to be only of the secreted form. We give also evidence
      that the IgE-producing B cells undergo somatic mutation because a number of
      identical mutations were observed in the FW4 regions of epsilon and mu clonally
      related transcripts. Some of these mutations were shared with other transcripts
      from the same and other individuals, supporting the existence of sequence
      specific hot spots for the somatic hyper-mutation machinery in the JH gene
      segments.

PMID- 8345204
TI  - Induction of IFN-alpha by HIV-1 in monocyte-enriched PBMC requires gp120-CD4
      interaction but not virus replication.
AB  - IFN-alpha is in plasma of HIV-1 infected patients during early and late-stage
      disease and may play a role in control of virus replication. The stimulus for IFN
      alpha production, the cells that produce this cytokine, and the effectiveness of
      this IFN-alpha response for control of virus infection are not yet defined.
      Culture fluids from freshly isolated PBMC of HIV-1 seronegative donors contained
      high levels of IFN-alpha after exposure to 100 to 1000 infectious HIV-1 particles
      per culture. Levels of IFN-alpha induced by HIV-1 were directly dependent on the
      number of monocytes in cell preparations: No IFN-alpha was detected from T cell
      enriched PBMC. In monocyte cultures, induction of IFN-alpha by HIV-1 was
      relatively specific: Levels of IL-1 beta, IL-6, IFN-gamma, and TNF-alpha remained
      at baseline. Capacity of HIV-1 virions to induce IFN-alpha was not dependent on
      virus replication. IFN-alpha was induced by (a) heat-inactivated HIV-1, (b)
      virions from 8E5 cells, a cell line that releases noninfectious HIV-1, (c) HIV-1
      infected cells fixed in paraformaldehyde, and (d) T cell-tropic HIV-1 that binds
      to but does not infect monocytes. Capacity of HIV-1 virions and HIV-1 infected
      cells to induce IFN-alpha was completely inhibited by soluble rCD4 or mAb against
      CD4 or gp120. Antibodies against CD4, however, did not induce monocytes to
      produce IFN-alpha. HIV-1-induced IFN-alpha production was inhibited by antibodies
      against both V3 loop determinants and the CD4 binding site of gp120. Further,
      sera and purified immunoglobulin from HIV-1 infected patients also inhibited HIV
      1-induced IFN-alpha production. These observations suggest that potentially
      protective antiviral responses associated with IFN-alpha production in HIV-1
      infected patients are inhibited by the development of antibodies against gp120.

PMID- 8345205
TI  - Cord blood contains high numbers of autoimmune T cells recognizing multiple
      myelin proteins and acetylcholine receptor.
AB  - To analyze Ag-specific T cell autoimmunity in the newborn, umbilical cord blood
      cells of newborns were investigated by an immunospot assay for occurrence and
      numbers of cells secreting IFN-gamma after short-term culture in presence of
      myelin basic protein (MBP), proteolipid protein, myelin associated glycoprotein,
      nicotinic acetylcholine receptor and the synthetic MBP amino acid sequences 1-20,
      63-88, and 110-128. These Ag were chosen because they represent putative targets
      for autoimmune attack in multiple sclerosis and myasthenia gravis. Surprisingly,
      numbers of T cells recognizing MBP, proteolipid protein, MBP peptides, and
      acetylcholine receptor were high in cord blood of newborns compared to peripheral
      blood of patients with neurologic diseases. No immunodominant T cell epitope
      could be discerned among the Ag included. The responses to purified protein
      derivate and PHA were lower among cord blood cells than peripheral blood cells of
      adults. Parallel enumeration of autoimmune T cells in cord blood and peripheral
      blood obtained from corresponding mothers at delivery, revealed that the high
      cell numbers in newborns were not a result of contamination from the mothers
      blood. The high numbers of T cells recognizing nervous system myelin proteins and
      acetylcholine receptor in cord blood could have importance for the mechanism and
      timing of tolerance induction, and also reflect excessive myelination and
      receptor maturation at birth.

PMID- 8345206
TI  - HIV-induced loss of CD44 expression in monocytic cell lines.
AB  - We have found that HIV-1 infection of monocytic cell lines results in a new
      adhesion phenotype. Whereas uninfected cells grow as single cell suspensions, HIV
      infected cells grow as large aggregates. When the expression of adhesion
      molecules was investigated, CD44 was almost completely depleted from the surface
      of HIV-infected cells. Immunoprecipitation with mAb confirmed the loss of CD44
      from the surface of infected cells. In addition, loss of surface CD44 was not due
      to formation of internal complexes or release into the culture supernatant.
      Soluble CD44 was not detected in culture supernatant from HIV-infected cells.
      Northern blot analysis showed an altered RNA pattern in HIV-infected cells. The
      high molecular mass CD44 RNA (7.0 kb) was lost from infected cells, and the low
      molecular mass CD44 RNA (1.2 kb) remained. We have previously shown that anti
      CD44 mAb induces homotypic adhesion in CD44+ cell lines. In this report, we show
      that homotypic adhesion of the HIV-infected cells occurs through a different
      mechanism than anti-CD44 mAb-induced aggregation. The homotypic adhesion in
      infected cells was CD18-mediated, but anti-CD44 mAb-induced homotypic adhesion in
      uninfected cells was CD18-independent. The change in adhesion phenotype and the
      loss of CD44 from the surface of HIV-1-infected monocytic cells are discussed in
      terms of their potential implications in cell-to-cell transmission of HIV.

PMID- 8345207
TI  - Responses of mesangial cells of autoimmune mice to cytokines.
AB  - Glomerulonephritis is one of the most important complications of SLE. The genesis
      of the renal lesions in this disorder is determined by a cascade of events that
      leads to mesangial cell proliferation as one of the hallmarks of the kidney
      disease. The current study examines the postulate that there may be intrinsic
      abnormalities in the mesangial cells of the autoimmune host which predisposes it
      to develop nephritis. It investigates the possibility that growth responses of
      mesangial cells of the autoimmune MRL/MpJ-lpr/lpr mice are different from those
      of their congenic normal MRL/MpJ-(+)/+ (MRL-(++)) counterparts when cultured with
      various cytokines. To test this possibility, growth responses of mesangial cells
      as assessed by [3H]TdR uptake were measured when these cells were cultured with
      epidermal growth factor, platelet-derived growth factor, transforming growth
      factor-beta, and 1,25-dihydroxy vitamin D3. Epidermal growth factor stimulated
      the growth of mesangial cells of both strains of mice equally, but platelet
      derived growth factor appeared to elicit a more pronounced proliferative response
      from mesangial cells of the autoimmune mice. In regard to inhibitory substances
      tested, mesangial cells of autoimmune MRL-lpr mice appeared to be relatively
      insensitive to the suppressive effects of transforming growth factor-beta and
      1,25-dihydroxy vitamin D3. Collectively, the response profile of mesangial cells
      of the MRL-lpr mice suggests that these cells have a tendency to proliferate when
      they are acted on by cytokines, so that they may be more susceptible to develop
      the proliferative lesions seen in the nephritis of SLE.

PMID- 8345208
TI  - Concurrent infection of human macrophages with HIV-1 and Mycobacterium avium
      results in decreased cell viability, increased M. avium multiplication and
      altered cytokine production.
AB  - The effects of a concurrent HIV-1 and Mycobacterium avium infection in vitro were
      assessed in human peripheral blood-derived macrophages (M phi). M phi were
      infected with HIV-1Ba-L strain for 14 days then infected with M. avium (HIV/M.
      avium) or treated with LPS (HIV/LPS). At various times after M. avium or LPS
      treatment, Mo phi cultures were harvested for quantitation of HIV and M. avium
      replication, as well as M phi cellular viability. In addition, mRNA and
      supernatants were collected for assessment of induction of the cytokines TNF
      alpha, IL-1 beta and IL-6. M. avium multiplication was greater in HIV-infected M
      phi, whereas no difference in virus production, based on p24 and RT values, was
      observed between HIV-infected cells and HIV/M. avium or HIV/LPS M phi. M. avium
      infection of HIV-1-infected M phi also caused a decrease in viability of the M
      phi. HIV-1/M. avium-infected M phi had a 24 h delay in induction of TNF-alpha
      steady state mRNA when compared with HIV/LPS or M. avium only or LPS-only treated
      M phi. HIV infection also increased the amount and the length of induction of IL
      1 beta and IL-6 steady state mRNA stimulated by either M. avium or LPS. In
      addition, prolonged and increased protein production of TNF-alpha, IL-6, and IL-1
      beta was observed in HIV/M. avium-infected cells when compared with the other
      treatments. In direct contrast to M. avium infection, no significant differences
      in LPS-induced protein production of the three cytokines was observed between HIV
      1-infected and -noninfected M phi. Treatment of HIV/M. avium-infected cells with
      human rGM-CSF did not increase either the time or quantity of induction of TNF
      alpha mRNA or protein production in HIV/M. avium-infected M phi. The increase in
      M. avium numbers, dysregulation of cytokine production, and subsequent cell death
      seen in vitro in HIV/M. avium-infected human M phi may reflect part of the
      underlying cause of the highly disseminated M. avium disease pattern observed in
      AIDS patients.

PMID- 8345209
TI  - Pentoxifylline attenuates neutrophil activation in experimental endotoxemia in
      chimpanzees.
AB  - Costimulation of neutrophils and cytokines may play an important role in organ
      injury in sepsis. Pentoxifylline inhibits various neutrophil functions in vitro,
      and attenuates endotoxin-induced production of TNF in both in vitro and in vivo
      models. To assess the effect of pentoxifylline on neutrophil activation in
      endotoxemia, nine adult chimpanzees (Pan troglodytes) were i.v. injected with
      saline (n = 2), Escherichia coli endotoxin (4 ng/kg; n = 4), or E. coli endotoxin
      (4 ng/kg) in combination with pentoxifylline (500 mg/3 h, starting 30 min before
      the endotoxin injection; n = 3). Serial blood samples were obtained for
      measurements of leukocyte counts and the granulocytic proteinases elastase
      complexed with alpha 1-antitrypsin and lactoferrin, and cytokines during the next
      5 h. No changes were observed in the saline-treated chimpanzees. Endotoxin
      induced a marked leukocytosis and neutrophilia, which were slightly reduced by
      pentoxifylline. In contrast, pentoxifylline almost completely prevented endotoxin
      induced neutrophil degranulation: peak elastase-alpha 1-antitrypsin was 164 +/-
      21 ng/ml (mean +/- SE) after endotoxin alone, vs 71 +/- 7 ng/ml after endotoxin
      with pentoxifylline (t = 3 h; p < 0.05); peak lactoferrin was 329 +/- 15 and 182
      +/- 5 ng/ml, respectively (t = 5 h; p < 0.05). Pentoxifylline also inhibited the
      endotoxin-induced release of TNF (271 +/- 26 vs 55 +/- 23 pg/ml at t = 1.5 h; p <
      0.05) and IL-6 (225 +/- 42 vs 73 +/- 25 pg/ml at t = 2 h; p < 0.05). IL-8 release
      was not significantly inhibited by pentoxifylline. In none of the animals
      activation of the C system could be detected. We conclude that pentoxifylline
      attenuates neutrophil activation in endotoxemia in chimpanzees, probably in part
      by inhibiting the release of TNF.

PMID- 8345210
TI  - Cell death by apoptosis in epidermal biology.
AB  - Homeostasis in continually renewing tissues is maintained by a tightly regulated
      balance between cell proliferation, cell differentiation, and cell death. Until
      recently, proliferation was thought to be the primary point of control in the
      regulation of normal tissue kinetic homeostasis and as such has been the major
      focus of both understanding the etiology of disease and developing therapeutic
      strategies. Now, physiologic cell death, known as apoptosis (a-pop-to' sis, a-po
      to' sis [Thomas CL (ed.): Taber's Cyclopedic Medical Dictionary. F.A. Davis, Co.,
      Philadelphia, 1989)] has gained scientific recognition as an active regulatory
      mechanism, complementary, but functionally opposite, to proliferation with
      important roles in shaping and maintaining tissue size and prevention of disease.
      In this review we will describe the concept of apoptosis and discuss possible
      molecular mechanisms of its regulation that may have implications for skin
      biology.

PMID- 8345211
TI  - Hemopoietic stem cell inhibitor (SCI/MIP-1 alpha) also inhibits clonogenic
      epidermal keratinocyte proliferation.
AB  - The maintenance and regulation of continuously renewing tissues is ultimately
      controlled at the level of stem-cell proliferation. We have recently identified a
      reversible inhibitor of hemopoietic stem-cell proliferation (stem-cell inhibitor
      [SCI]), which is identical to the macrophage inflammatory protein, MIP-1 alpha, a
      69-amino-acid heparin-binding cytokine. To test the cell/tissue specificity of
      the inhibition of proliferation by SCI/MIP-1 alpha, we have investigated its
      activity on epidermal keratinocytes, the principal cell type of another
      continuously renewing tissue. Here we show that SCI/MIP-1 alpha inhibits the
      proliferation of epidermal keratinocytes in vitro and that the MIP-1 alpha mRNA
      is present in epidermal Langerhans cells but not in keratinocytes. This suggests
      an important growth regulatory function for SCI/MIP-1 alpha in keratopoiesis, as
      well as hemopoiesis, and may also indicate a novel role for the epidermal
      Langerhans cell. As SCI/MIP-1 alpha can inhibit the proliferation of
      embryologically distinct precursor cells, this raises the possibility that it may
      also function in a number of other tissues.

PMID- 8345212
TI  - MCP-1 mRNA expression in basal keratinocytes of psoriatic lesions.
AB  - In addition to hyperproliferation of keratinocytes, psoriasis is characterized by
      pronounced leukocytic infiltration. In contrast to the epidermal localization of
      neutrophils and T lymphocytes, macrophages are almost exclusively restricted to
      the dermal compartment. By immunohistologic analysis, these dermal macrophages
      were mainly encountered in the papillary dermis and arranged along the rete
      ridges in close proximity to proliferating keratinocytes. Monocyte
      chemoattractant protein (MCP-1) anti-sense RNA probes yielded abundant signals
      over the proliferating basal keratinocytes of the tips of the rete ridges, and,
      to a lesser extent, in cells in the papillae. Thus, the strongest MCP-1 message
      in psoriatic lesions is found above the dermal-epidermal junction and this may
      explain the characteristic sub-basal distribution of dermal macrophages. These
      results suggest that MCP-1 is important in regulating the interaction between
      proliferating keratinocytes and dermal macrophages in psoriasis pathogenesis.

PMID- 8345213
TI  - Studies of contact hypersensitivity induction in mice with optimal sensitizing
      doses of hapten.
AB  - To avoid unsuspected and unwanted consequences of excess hapten during
      epicutaneous sensitization, optimal sensitizing doses of dinitrofluorobenzene
      (DNFB) were determined for several ultraviolet B radiation (UVB)-resistant and
      UVB-susceptible strains of mice. Using these doses of hapten applied
      epicutaneously or injected intracutaneously into normal or UVB-exposed body wall
      skin, it was determined that four consecutive daily exposures to UVB prevented
      contact hypersensitivity induction in all mice when optimal sensitizing doses of
      DNFB were applied epicutaneously. By contrast, UVB-resistant, but not UVB
      susceptible, mice developed contact hypersensitivity when an optimal sensitizing
      dose of DNFB was injected intracutaneously into UVB-irradiated skin. Moreover,
      whereas UVB-susceptible mice failed to develop contact hypersensitivity when an
      optimal sensitizing dose of DNFB was painted on skin exposed to a single dose of
      UVB, UVB-resistant mice did develop contact hypersensitivity under similar
      circumstances. Based on these results, it is concluded that 1) conventional doses
      of epicutaneously applied haptens induce contact hypersensitivity with the aid of
      antigen-presenting cells derived from both the epidermis and the dermis, 2) the
      phenomenon of UVB susceptibility is mediated by cells and molecules within the
      dermis when conventional doses of hapten and UVB radiation are employed, and 3)
      UVB susceptibility is mediated by cells and molecules within the epidermis when
      optimal sensitizing doses of hapten and a single exposure to UVB are employed.

PMID- 8345214
TI  - Identification of a mammalian melanosomal matrix glycoprotein.
AB  - Antiserum raised in rabbits against the Triton X-100 insoluble fraction of
      melanosomes from mouse melanoma cells specifically decorates the internal matrix
      of melanosomes in immunoelectron microscopy. In metabolic labeling studies, the
      antiserum recognizes a protein of 94 kDa, which is processed to a band of 53 kDa.
      Whereas the precursor is relatively soluble in buffers containing Triton X-100,
      the processed protein requires the addition of sodium dodecyl sulfate for
      effective solubilization, as would be expected for a melanosomal matrix
      constituent. Tunicamycin reduces the Mr of the nascent protein to 75 kDa, but
      deoxymannojirimycin and swainsonine have no effect, suggesting that following
      initial glycosylation in the endoplasmic reticulum, the protein is not subject to
      processing by glycosidases in the Golgi apparatus or may bypass it entirely.
      Subcellular fractionation followed by immunoblotting confirms that the protein is
      present in the melanosome-rich, large granule fraction. Expression of the protein
      is regulated differently from that of the tyrosinase-related protein family.
      Conditions that greatly stimulate expression of tyrosinase-related proteins do
      not affect matrix protein expression, nor is the protein immunologically related
      to the tyrosinase-related protein family. Our results suggest that we have
      identified an authentic component of the mammalian melanosomal matrix, and that
      its characteristics lend support to a bipartite pathway for melanosomal
      biogenesis.

PMID- 8345215
TI  - Combination of 4-hydroxyanisole and all-trans retinoic acid produces synergistic
      skin depigmentation in swine.
AB  - A combination of 4-hydroxyanisole (4HA) and all-trans retinoic acid (TRA) was
      found to synergistically cause moderate to complete depigmentation of Yucatan
      swine skin. Two hyperpigmentation models were used: Natural dark-skinned swine, a
      potential model for melasma-like disorders, and ultraviolet light-stimulated
      hyperpigmentation, a model of solar lentigines. Test materials were applied twice
      daily, 5 d/week, to dorsal flank skin. Application sites were graded at weekly
      intervals for skin color using a 0 to 4 grading scale. After 8 weeks of treatment
      of naturally dark swine skin, a combination of 2% 4HA and 0.01% TRA produced
      grade 2 hypopigmentation (definite but moderate hypopigmentation). In contrast,
      2% 4HA alone or 0.01% TRA alone did not produce significant hypopigmentation.
      After cessation of treatment, the 4HA/TRA-treated sites reverted to normal color
      within 7-12 weeks. The 4HA/TRA combination completely reversed the
      hyperpigmentation induced by ultraviolet light after 8 weeks of treatment. In
      vitro skin-penetration studies using hairless mouse and human skin show that skin
      penetration of 4HA was not significantly affected by adding 0.01% TRA. These data
      suggest that the observed synergy is not due to enhanced bioavailability of 4HA.
      We have demonstrated that combining low concentrations of 4HA and TRA results in
      effective skin lightening without causing irreversible depigmentation and with
      minimal local skin irritation.

PMID- 8345216
TI  - Mast cell degranulation upregulates alpha 6 integrins on epidermal Langerhans
      cells.
AB  - The expression of the alpha 6 beta 4 and alpha 6 beta 1 integrins on epidermal
      Langerhans cells (LC) before and after mast cell degranulation was studied in
      cultured human neonatal foreskin by immunohistochemistry. Twenty-four hours after
      addition of mast cell secretagogues, morphine sulfate, or substance P, solitary
      mid-epidermal cells showed staining for the integrin subunits alpha 6, beta 4,
      and beta 1. This expression was not observed in cultured control explants, and
      immunostained cells were confirmed to be non-epithelial, dendritic cells by
      immuno-electron microscopy. The identity of these cells as LC was further
      established by coincident staining for alpha 6 and CD1a using double
      immunofluorescence labeling. Addition of tumor necrosis factor-alpha (TNF alpha),
      the predominant cytokine in mast cell granules, also induced LC to express alpha
      6 integrins. Furthermore, preincubation of skin organ cultures with anti-TNF
      alpha antibodies or the mast cell inhibitor cromolyn sodium abrogated the ability
      to induce alpha 6 integrins on LC consequent to experimental mast cell
      degranulation by substance P. These data implicate a role for mast cell-derived
      TNF alpha in the regulation of the integrins alpha 6 beta 4 and alpha 6 beta 1 on
      LC. These findings may have important implications relevant to mechanisms for
      spatial localization of LC within the cutaneous compartments during immune
      responses.

PMID- 8345217
TI  - Effect of phototherapy and urocanic acid isomers on natural killer cell function.
AB  - Ultraviolet (UV) radiation suppresses a variety of immune responses but it is
      uncertain whether this action contributes to the effectiveness of phototherapy.
      Urocanic acid (UCA) has been proposed as a mediator of the immunologic effects of
      UV. On exposure the naturally occurring trans-isomer of UCA in the skin changes
      into the cis-isomer, which has been demonstrated to mimic many of the
      immunomodulatory effects of UV irradiation. Natural killer (NK) cells play an
      important role in several immunologic processes and published evidence indicates
      that their activity is altered by UV irradiation. To ascertain the effect on NK
      cells of phototherapy used in the treatment of psoriasis, modulation of NK
      activity in psoriatic patients undergoing broad-band UVB, narrow-band UVB, or
      psoralen plus (PUVA) regimens was examined. This was compared with NK cell
      activity in psoriatic patients treated with topical coal tar and in normal
      subjects receiving broad band UVB. The NK cell activity of psoriatic and normal
      subjects was the same over a wide range of effector to target cell ratios. Almost
      all patients undergoing phototherapy exhibited depressed NK cell activity during
      or after irradiation, although the timing of the depression varied between the
      lamps used and may be related to dose. However, patients treated with topical
      coal tar showed unchanged NK cell activity throughout the therapy. The effect of
      UCA isomers on NK cell activity in vitro was also determined. It was found that
      cis-UCA induced a dose-dependent suppression of NK cell activity in both patients
      and normal subjects, whereas trans-UCA had hardly any effect in either group.
      Thus it is possible that there may be a correlation between cis-UCA formation in
      the epidermis and the modulation of NK cell activity that occurs during
      phototherapy.

PMID- 8345218
TI  - Lipid supplemented medium induces lamellar bodies and precursors of barrier
      lipids in cultured analogues of human skin.
AB  - Barrier function of cultured skin substitutes (CSS) is required for their
      effective use in clinical treatment of skin wounds, and for percutaneous
      absorption in vitro. Arachidonic, palmitic, oleic, and linoleic free fatty acids,
      in conjunction with the antioxidant alpha-tocopherol acetate (lipid supplements,
      "LS"), were added to nutrient media of CSS to provide precursors of epidermal
      barrier lipids. CSS were composed of human keratinocytes (HK), fibroblasts (HF),
      and collagen-glycosaminoglycan substrates, and were incubated for 14 d submerged
      or lifted to the air-liquid interface in media based on MCDB 153 +/- LS.
      Duplicate samples (30 cm2) were harvested and the epidermal analogue was analyzed
      for total protein, total DNA, total lipid, lipid fractions including
      acylglucosylceramide (AGC), and presence of lamellar bodies. Significant
      increases (p < 0.05) were detected between CSS incubated in +LS medium for total
      lipid, total DNA, ceramide, glucosylceramide, triglycerides, and diglycerides.
      AGC and lamellar bodies were detected only in epithelia of CSS incubated in +LS
      medium. These data show that free fatty acids, vitamin E, and lifting of CSS
      promote increased epithelial morphogenesis compared to CSS cultured submerged
      without lipid supplements. Presence of lamellar bodies and AGC suggests enhanced
      production in vitro of barrier-associated epidermal lipids.

PMID- 8345219
TI  - Inhibition of cholesterol and sphingolipid synthesis causes paradoxical effects
      on permeability barrier homeostasis.
AB  - Cholesterol, fatty acid, and sphingolipid synthesis are required for barrier
      homeostasis, as demonstrated by studies where synthesis of these species is
      stimulated in parallel with barrier repair. Moreover, blockade of synthesis of
      these lipids with inhibitors of two of the rate-limiting enzymes, HMGCoA
      reductase (lovastatin, fluvastatin) and serine palmitoyl transferase (beta
      chloroalanine), alters the kinetics of barrier repair. Whereas these studies
      demonstrated a requirement for these lipids individually, we asked here whether
      these lipids are required in either an additive or cooperative fashion. We
      applied each class of inhibitor alone or the two classes of inhibitors together
      to acetone-treated skin, or each class separately to essential fatty acid
      deficient murine skin. When fluvastatin or beta-chloroalanine was applied
      individually to acetone-treated skin, each caused a delay in the early or late
      stages of barrier recovery, respectively (assessed as transepidermal water loss).
      However, when applied together they caused no further worsening at the early time
      point and a paradoxical improvement at the later time points. This improvement
      correlated with an accelerated return of sphingolipids, which was perhaps due to
      a global stimulation of lipid synthesis induced by HMGCoA reductase inhibitors.
      In essential fatty acid deficient animals, inhibition of HMGCoA reductase caused
      drastic worsening of both clinical appearance and barrier function, but beta
      chloroalanine caused a paradoxical improvement, which correlated with a
      significant reduction in epidermal sphingolipids. These results are consistent
      with a requirement for both cholesterol and sphingolipids for barrier
      homeostasis, and also with the suggestion that both of these lipids must be
      present (with free fatty acids) for optimal barrier function.

PMID- 8345221
TI  - Cold shock induces the synthesis of stress proteins in human keratinocytes.
AB  - Heat shock proteins or stress proteins are synthesized when cells are exposed to
      a wide variety of physiologic stresses. The stress response is evolutionarily
      highly conserved, suggestive of an essential function(s) for the survival of
      organisms, protecting them from harmful trauma. Exposure to cold induces a stress
      response in organisms such as Drosophila melanogaster and Sarcophaga crassipalpis
      and this led us to determine whether or not cold shock responses occur in human
      skin after exposure to cold such as might occur during cryopreservation of
      tissues or cryosurgery. Biopsies taken from fresh human skin at chest surgery
      were exposed to 4, 15, 20, and 37 degrees C (control) for 60 min and then allowed
      to incorporate 35S-methionine at 37 degrees C for up to 3 h. Proteins from the
      epidermis were extracted and analyzed by sodium dodecyl-sulfate-polyacrylamide
      gel electrophoresis. At 15 degrees C and below there was increased synthesis of
      90 and 72 kD proteins 2 h after shocking. The 72-kD protein was identified as a
      heat shock protein using a monoclonal antibody to HSP72 and it is proposed from
      electrophoretic evidence that the 90-kD protein is also a heat shock protein.
      Clearly, cold shock stimulates a stress response in human epidermis altering the
      spectrum of proteins expressed and inducing the synthesis of heat shock proteins.

PMID- 8345220
TI  - Relationship between heat shock protein induction and the binding of antibodies
      to the extractable nuclear antigens on cultured human keratinocytes.
AB  - The importance of environmental factors such as ultraviolet light and temperature
      in the pathogenesis of cutaneous lupus erythematosus is well recognized. Recent
      evidence suggests the presence of autoantibodies to heat shock proteins (HSP) in
      the sera and enhanced expression of the HSP70 gene in peripheral blood
      mononuclear cells of patients with systemic lupus erythematosus. We designed
      experiments to determine how HSP or stress protein inducers affect the cell
      surface binding of IgG antibodies from sera containing anti-SS-A/Ro and anti
      ribonuclear protein (RNP) antibodies to keratinocytes because these antibodies
      are considered to be one of the immunologic triggers of cutaneous lupus
      erythematosus. Immunofluorescence and immunoblot analysis using a monoclonal
      antibody to the 72 kDa of HSP revealed that an 18-h incubation with 10
      micrograms/ml of delta 12-PGJ2, one of cytotoxic prostaglandins, induced HSP72
      formation in cultured human keratinocytes. delta 12-PGJ2 augmented the binding of
      IgG antibodies from sera containing anti-U1RNP and anti-SS-A/Ro antibodies to
      cultured keratinocytes, but produced no enhancement of the binding of IgG
      antibodies from sera containing anti-Sm or anti-DNA antibodies. Similar results
      were also obtained by using flow cytometry analysis. HSP was also induced by
      ultraviolet B irradiation. These results suggest that exposure of keratinocytes
      to stressors such as delta 12-PGJ2 and ultraviolet light increases the binding
      sites for U1RNP,SS-A/Ro, and SS-B/La antibodies. The association between HSP
      induction and the appearance of extractable nuclear antigens may provide a better
      understanding of why environmental stimuli can promote the development of
      erythematous lesions in the skin.

PMID- 8345222
TI  - Demonstration of 72-kDa and 92-kDa forms of type IV collagenase in human skin:
      variable expression in various blistering diseases, induction during re
      epithelialization, and decrease by topical glucocorticoids.
AB  - Type IV collagenases have been shown to play an important role in tumor
      metastasis and wound healing. In the present study, we have demonstrated the
      presence of 72-kDa and 92-kDa forms of type IV collagenase in human skin by
      biochemical and in situ hybridization techniques. In situ hybridization allowed
      us to localize the 72-kDa form mostly to fibroblasts and the 92-kDa form to the
      epidermis and endothelial cells. The presence of type IV collagenase was
      confirmed by Western blotting. Enzyme activity was assayed in spontaneous
      blisters (18 subjects) and suction-induced blisters (29 subjects) by the
      zymography method, and by using type IV collagen as the substrate. Thus, it was
      possible to detect both the 92-kDa and 72-kDa forms in spontaneous and induced
      blisters. An especially high level of the 92-kDa enzyme was found in a bullous
      pemphigoid patient. Type IV collagenases were studied during re-epithelialization
      of the blister, using the suction-blister model. There was a marked induction of
      the 92-kDa type that was confirmed to be in the regenerating, migratory,
      epithelium by in situ hybridization studies. These results indicate that 92-kDa
      type IV collagenase may play an essential role in the normal physiology and
      integrity of the skin and may be an important regulator of re-epithelialization.
      It was also shown that potent topical glucocorticoid down-regulated the 92-kDa
      type collagenase, suggesting that glucocorticoids may have a beneficial role in
      some skin diseases by decreasing type IV collagenase activity and, thus, reducing
      tissue destruction.

PMID- 8345223
TI  - Microcirculatory functions in systemic sclerosis: additional parameters for
      therapeutic concepts?
AB  - To study the functional reactivity of the cutaneous microcirculation in
      progressive systemic sclerosis (PSS), hyperemic responses after arterial
      occlusion (3 min) and during local heating (42 degrees C) were investigated with
      simultaneous measurements of red blood cell flux and cutaneous oxygen tension
      (pcuO2) of the skin in female patients (n = 19) with PSS and in healthy female
      controls (n = 15). Additionally, serum levels of 6-keto-prostaglandin 1 alpha
      (PGF1 alpha), a stable metabolite of prostacyclin, were compared to the
      microcirculatory data, and both were used to evaluate further a standardized
      therapy with 10-d intravenous calcitonin (100 IU/d) infusion in six PSS patients.
      In PSS, the initial mean pcuO2 value was significantly reduced and was inversely
      proportional to flux and to PGF1 alpha levels, whereas the flux and pcuO2
      responses to the above hyperemic stimuli showed significant reductions, revealing
      a pattern of "hyperemic hypoxia" probably due to exhausted functional reserves of
      cutaneous perfusion. During calcitonin infusion significant rises in pcuO2 and
      temporarily in PGF1 alpha and flux were found. After 10 d of therapy, increased
      pcuO2 was associated significantly with decreased flux, indicating a shifting of
      blood from deeper regulatory vessels to the subepidermal capillaries. Both
      clinical improvement and the results of microcirculatory measurements demonstrate
      a beneficial effect of calcitonin on the cutaneous microcirculation in PSS
      patients, possibly due in part to a short-term increase in release of endogenous
      prostacyclin from the vascular endothelium during the infusion. The disturbed
      reactivity of the dermal vessels in PSS is important for the evaluation of
      therapeutic concepts and stresses, together with the elevated PGF1 alpha plasma
      levels, vascular factors in the pathogenesis of PSS.

PMID- 8345224
TI  - Impaired regulation of collagen pro-alpha 1(I) mRNA and change in pattern of
      collagen-binding integrins on scleroderma fibroblasts.
AB  - We explored the hypothesis that dermal fibroblasts isolated from patients
      suffering from systemic sclerosis are disturbed in their ability to interact
      functionally with native collagen fibers. Additionally, we investigated the
      expression of one collagen-binding integrin matrix receptor, alpha 1 beta 1 on
      those cells. Two populations of primary dermal fibroblasts were established, one
      from patients with systemic sclerosis and one from normal subjects. When cultured
      for 24 h in free-floating collagen gels, both types of fibroblasts down-regulated
      the cellular content of collagen pro-alpha 1(I) messenger ribonucleic acid, the
      systemic sclerosis fibroblasts less markedly than the normals. In normal, but not
      in systemic sclerosis fibroblasts, the kinetics of collagen gel contraction were
      directly proportional to the extent of the down-regulation. Fetal bovine serum
      stimulated collagen gel contraction in both populations. When grown in collagen
      gels in the presence of fetal bovine serum, no difference between systemic
      sclerosis and normal fibroblasts in capacity to down-regulate pro-alpha 1(I) was
      observed. Collagen-binding beta 1 integrins mediate the functional interactions
      between fibroblasts and the collagen fibers. To assess the cell surface
      expression of collagen-binding beta 1 integrins on fibroblasts, we labeled cells
      with 125I and subjected Triton X-100 extracts from them to immunoprecipitation
      with anti-beta 1 integrin immunoglobulin G. Among the systemic sclerosis
      fibroblasts, a larger number of isolates expressed low amount of alpha 1 beta 1
      than did the fibroblasts isolated from normal individuals. Our data are
      compatible with the hypothesis that systemic sclerosis fibroblasts have a
      disturbed interaction with collagen fibers; this disturbance may in part be the
      result of an aberrant expression of collagen-binding beta 1 integrins.

PMID- 8345226
TI  - Effects of all-trans retinoic acid on glycosaminoglycan synthesis in photodamaged
      hairless mouse skin.
AB  - All-trans retinoic acid (tRA) was previously shown to be active in wrinkle
      reduction in the hairless mouse photoaging model. To address the questions of
      whether tRA also alters glycosaminoglycan (GAG) synthesis and whether observed
      wrinkle effacement can be attributed to changes in total GAG production, the
      effects of tRA on de novo GAG synthesis were examined in this model. Sulfated
      glycosaminoglycans (S-GAG) and the non-sulfated hyaluronic acid (HA) labeled with
      [3H]-glucosamine or [35S]-sulfate were found to diffuse differentially into the
      medium during the labeling period in the control animals (9% and 35% of total
      incorporated label for HA and S-GAG, respectively). Furthermore, the diffusion of
      HA into media was significantly changed after tRA treatment (from 9% to 24%), but
      no alteration was observed in the diffusion of S-GAG. Separation of epidermis and
      dermis indicated that the additional HA in medium after retinoid treatment
      primarily originated from the dermis. When incorporated label from the medium and
      skin fractions was combined, both labeling protocols revealed that 10 weeks of
      tRA treatment did not increase the total (medium plus skin) de novo synthesis of
      either HA or S-GAG. Wrinkle effacement as induced by retinoids in the
      photodamaged mouse skin therefore can not be related to an increased total GAG
      synthesis.

PMID- 8345225
TI  - Intracytoplasmic retention of type VII collagen and dominant dystrophic
      epidermolysis bullosa: reversal of defect following cessation of or marked
      improvement in disease activity.
AB  - It has been recently shown that the presence of perinuclear "stellate bodies"
      within the epidermis in patients with a form of dominant dystrophic epidermolysis
      bullosa named "transient bullous dermolysis of the newborn" corresponds to
      collections of type VII collagen. To determine the temporal relationship of this
      unique immunohistochemical defect with course of clinical disease activity, we
      have longitudinally studied the expression of two epitopes of type VII collagen
      (LH 7:2; L3d) in nine patients in four such kindreds by immunofluorescence and
      immunoelectron microscopic technique. In every infant so studied at the time of
      active blistering, type VII collagen was detectable primarily within basilar and,
      to a lesser extent, suprabasilar keratinocytes. In contrast, type VII collagen
      was detectable solely in linear array along the dermoepidermal junction in skin
      from each patient following complete cessation or at least marked diminution of
      visible clinical disease activity. These findings support the hypothesis that the
      temporary mechanical fragility and blistering of the skin in infants with this
      rare subset of dominant dystrophic epidermolysis bullosa reflect the presence of
      reduced amounts of type VII collagen along the dermoepidermal junction, and that
      this diminution may be the result of either a delay in transport and integration
      of type VII collagen from basilar keratinocytes into the skin basement membrane
      or excessive phagocytosis of type VII collagen.

PMID- 8345227
TI  - Cloning of the 5' mRNA for the 230-kD bullous pemphigoid antigen by rapid
      amplification of cDNA ends.
AB  - The 230-kD bullous pemphigoid antigen (BPAG1), defined by autoantibodies in
      patient sera, is a hemidesmosomal plaque protein in the same gene family as the
      intracellular proteins desmoplakin I/II and plectin. We had previously isolated,
      from a lambda gt11 library, overlapping cDNA clones with 6921 bp of mRNA sequence
      for BPAG1. The coding sequence encoded by these clones included the 3' stop codon
      but not the 5' coding and non-coding region of the mRNA. To obtain these
      sequences we used the polymerase chain reaction (PCR) method called rapid
      amplification of cDNA ends (RACE). The PCR products were cloned into plasmids and
      sequenced. With five PCR primers we were able to obtain overlapping clones
      containing the 5' region of the mRNA. An upstream stop codon in frame with the
      rest of the coding sequence demonstrates that the full 5' coding sequence is
      obtained. Four different PCR products from two separate reactions had the same 5'
      end, suggesting that this 5' end is near, or at, the transcription start site. No
      alternatively spliced clones were found and no transmembrane site was predicted,
      confirming that BPAG1 is an intracellular hemidesmosomal plaque protein.

PMID- 8345228
TI  - Persistent misconceptions in leprosy research.

PMID- 8345229
TI  - Bioavailability of dapsone on oral administration of Dapsomine--a comparative
      evaluation.
AB  - This study describes a comparative evaluation of dapsone kinetics in humans on
      administration of Dapsomine, a capsule containing dapsone 100 mg dispersed in
      oily-base suspension of clofazimine 50 mg. Seven untreated lepromatous leprosy
      patients were given one capsule of Dapsomine a day for seven days and the
      pharmacokinetics parameters in this group were compared with those from another
      group of seven patients who received dapsone 100 mg and clofazimine 50 mg
      separately. There were no statistically significant differences in parameters
      such as peak dapsone plasma concentration (Cmax), basal plasma level (C24h), time
      to peak level (tmax), absorption half-life (t1/2 alpha), elimination half-life
      t1/2 beta) and areas under plasma concentration-time curves (AUC0-8h) and AUC0
      24h) between the two groups.

PMID- 8345230
TI  - Observations on attempted leprosy cultures in two media.
AB  - Suspensions of skin tissue material collected from lepromatous leprosy patients
      and material from mouse foot-pad harvests were inoculated into two media, viz., a
      biphasic medium and a minimal basal medium. The cultures were incubated at 37
      degrees C and 15 degrees C. Small oval (or round) cells appeared in these
      cultures around the tenth day along with a few cystic structures; and they
      increased in number later, reaching the maximum around six-seven weeks. The above
      cells appeared acid-fast in some cultures and some of them appeared to split into
      pairs of acid-fast bacilli. The cells were most often seen in the biphasic medium
      at 37 degrees C. The identity of these structures is not known at this stage.

PMID- 8345231
TI  - Comparative study of short term results in two multidrug regimens in
      multibacillary leprosy.
AB  - Thirty lepromatous and Borderline lepromatous leprosy patients were treated with
      multidrug therapy in an open trial. Fifteen of them received the standard WHO
      multidrug regimen ie., rifampicin 600 mg and clofazimine 300 mg monthly,
      supervised, and dapsone 100 mg daily and clofazimine 100 mg on alternate days as
      self administered; the other 15 received a modified multidrug therapy regimen
      comprising of rifampicin 600 mg, clofazimine 100 mg and dapsone 100 mg daily for
      21 days as suggested by the Indian Association of Leprologists, followed by the
      standard WHO regimen. The observation period was six months. Clinical,
      bacteriological, histological and immunological parameters were studied. The fall
      in morphological index was much faster in patients receiving modified multidrug
      therapy regimen compared to those receiving the standard WHO regimen. Otherwise,
      there was no difference between the two groups of patients. Five patients
      developed type I (upgrading) reaction with one developing ulnar nerve paralysis.
      No untoward effects of drugs were noted in the study subjects except for
      darkening of skin colour of all the patients.

PMID- 8345232
TI  - Electro neuro physiological studies in early tuberculoid leprosy.
AB  - Electro physiological studies were carried out in early tuberculoid type of
      leprosy in order to study their utility in detecting nerve damage before the
      onset of obvious functional deficit. Fifty-three cases showing one mixed nerve
      thickening in one limb were selected. Nerve conduction studies (both motor and
      sensory) were done using single blind technique. There was no statistically
      significant difference between the findings obtained from clinically thickened
      and non-thickened nerves. There was also no direct relationship between clinical
      sensory deficit and electro physiological abnormality. Clinical motor power loss
      was well correlated with electro physiological abnormalities.

PMID- 8345233
TI  - Adenosine deaminase activity in leprosy.
AB  - Serum adenosine deaminase (ADA) was studied in 60 patients of different types of
      leprosy and 50 healthy control subjects. ADA levels in patients with tuberculoid
      (50.50 +/- 5.22 U/L), borderline (41.14 +/- 3.89 U/L) and lepromatous leprosy
      (30.10 +/- .03 U/L) were higher than that in controls (17.84 +/- 2.78 U/L), thus
      correlating with the immunological status of patients. Patients with lepra
      reaction showed decreased ADA levels and higher grade of lepromin test positivity
      was associated with increased ADA activity.

PMID- 8345234
TI  - Application of filter paper method for collection of blood for MLPA test.
AB  - The results of MLPA test using serum and filter paper eluate have been compared
      in this paper. Testing 64 patient samples at 1:32 dilution, 31 were negative by
      both serum and eluate, 20 were positive by both, six were positive only by serum
      and one was positive only eluate. In six other cases eluate gave equivocal
      results while serum result was clearly positive. Some eluates negative at 1:32
      dilution gave weak positive agglutination at 1:16 dilution.

PMID- 8345235
TI  - Evolving consensus on the probable nocardioform morphology of the leprosy
      bacillus.

PMID- 8345236
TI  - "Flu" syndrome associated with other systemic manifestations with once a month
      rifampicin in the treatment of multibacillary leprosy.

PMID- 8345237
TI  - Shoreline nails following type II lepra reaction.

PMID- 8345238
TI  - Mycetomas in leprosy.

PMID- 8345239
TI  - Solitary neurofibroma mimicking nerve abscess of leprosy.

PMID- 8345240
TI  - Reaction in borderline tuberculoid leprosy presenting with multiple subcutaneous
      nodules.

PMID- 8345241
TI  - Prevalence rate of leprosy.

PMID- 8345242
TI  - Disability grading systems in leprosy.

PMID- 8345243
TI  - [Dentin bonding: personal view and it's materialization].

PMID- 8345244
TI  - [Review and outlook on sports dentistry].

PMID- 8345245
TI  - [Production of monoclonal antibody that recognizes glycogen and its application
      for immunohistochemistry].
AB  - In this study, I made a monoclonal antibody, using the mandibular condylar
      cartilage as antigen. By light microscopic immunocytochemical observations, this
      antibody reacted with the chondrocytes both in the mandibular condyle and the
      costal cartilage, hepatocytes and skeletal muscle cells. By electron microscopic
      immunocytochemical observations, reaction products (gold particles) were seen on
      the glycogen particles in the chondrocytes. Further, by dot blotting assay, this
      antibody was found to react directly with the purified glycogen. Meanwhile, all
      these reactions disappeared after alpha-amylase digestion. These results indicate
      that this antibody specifically recognizes glycogen or glycogen-related sugar
      chains. Therefore, I think that this antibody is very much useful for detecting
      the glycogen instead of the PAS reaction, since PAS reaction is not a specific
      method to detect the glycogen.

PMID- 8345246
TI  - [Study on the oral health status of schoolchildren in Korea].
AB  - In 1992, dental health examination was conducted in three areas in Korea; Seoul
      (large city), Cheonan (rural city) and Cheongju (water fluoridated rural city).
      We also examined the children of Tokyo in Japan. The subjects were the
      schoolchildren in the 6th grade of primary school and the 3rd grade of junior
      high school, and the number of the subjects was 202 in Seoul, 191 in Cheonan, 164
      in Cheongju and 152 in Tokyo. We compared the oral health status among these four
      areas using many indices such as the prevalence rate of dental caries and
      malocclusion, DMFT, DMFS, DI-S and P-M-A index. In Korea the children in Seoul
      showed the highest caries prevalence rate, DMFT and DMFS. The Cheonan children
      were average. The children in Cheongju had the lowest caries experience. The
      children in Tokyo had more dental caries than the Korean children in both school
      grades. The children in Tokyo had more gingivitis and malocclusion than the
      Korean children in the three areas. It was revealed that the oral health status
      of the Korean schoolchildren was much better than the Japanese children. And
      water fluoridation project in Cheongju was effective to prevent the dental caries
      especially in the 6th grade children.

PMID- 8345247
TI  - [Study on dental cement. Part 4. Protective effect of a newly designed light
      cured varnish on the vulnerability to water of glass polyalkenoate cement
      restorations].
AB  - The protective effect of a newly designed light-cured varnish on the
      vulnerability to water of two kinds of glass polyalkenoate cement restorations
      was examined by determining the penetration depth of Ag ion into the set cement
      on the SEM pictures in comparison with those of the conventional varnish and a
      light-cured resin bonding agent. The protective effect of the experimental light
      cured varnish was perfect, while those of the conventional varnish and the light
      cured resin bonding agent were inferior to that.

PMID- 8345248
TI  - [Clinical and microbiological study concerning effects of scaling and root
      planing. 2. The effects of mechanical debridement until one year and of
      minocycline application topically].
AB  - This study was performed to assess the effect of scaling and root planing
      clinically and microbiologically during one year. Nine patients with moderate to
      severe periodontitis were studied. After the process of plaque control, the
      selected single rooted teeth with 5mm probing depth were debrided mechanically
      under non-local anesthesia four times biweekly. Observing the results of the
      treated teeth until three months, the experimental teeth were divided into two
      groups. The standard of division was whether they showed good response to the
      mechanical debridement or not. Observation was continued until one year after the
      debridement according to the following criteria: 1. The sites which showed good
      responses at three months were continued to be observed biweekly. 2. The sites
      which showed no improvement at three months were applied the gel of minocycline
      (Periocline) four times biweekly. 3. The untreated sites used as control until
      three months received mechanical debridement four times biweekly. The following
      results were obtained: The sites that showed good responses to the mechanical
      debridement at three months were maintained in good condition continuously during
      one year. The topical application of Periocline was effective in reducing the
      inflammation and probing depth clinically and microbiologically until three
      months.

PMID- 8345249
TI  - Free tissue transfers to the upper limb.
AB  - 90 consecutive free tissue transfers to the upper limb have been performed in 75
      patients (33 children and 42 adults) by one surgeon over a 3-year period. The
      average age for children was 5 years, and 25 years in adults. 17 transfers were
      performed as emergency or urgent procedures. The main indications were congenital
      and traumatic defects. Included in this series were 44 toe transfers, 28 lateral
      arm flaps and six functional muscle transfers. The overall success rate was 99%.
      The re-exploration rate was 5.6% with only one failure. There were no failures in
      children.

PMID- 8345250
TI  - Congenital pseudarthrosis of the ulna treated by free vascularized fibular graft:
      a case report and review of methods of treatment.
AB  - Congenital pseudarthrosis of the ulna is an extremely rare condition for which
      current surgical techniques have been unsatisfactory in restoring a normal two
      bone forearm. We report a case which was treated by excision of the ulnar
      pseudarthrosis and interposition of a free vascularized fibular graft with a skin
      island to monitor anastomotic patency. Forearm rotation has been restored and the
      potential for normal forearm growth has been preserved.

PMID- 8345251
TI  - Changes in carpal alignment following radial osteotomy for Kienbock's disease.
AB  - Changes in carpal alignment following radial osteotomy were studied in 30
      patients with Kienbock's disease. The carpal height ratio and carpal-ulnar
      distance ratio were significantly less in wrists with Kienbock's disease than
      unaffected wrists. This observation implies proximal-ulnar translation of the
      capitate. In addition, the lunate-covering ratio increased significantly,
      reflecting radial translation of the lunate. Radial osteotomy corrected ulnar
      translation of the capitate and increased the radial translation of the lunate,
      thus increasing the lunate-covering ratio. The increased lunate-covering ratio is
      believed to increase the area of distribution of the axial load through the
      lunate by increasing the contact area with the radius. The satisfactory clinical
      outcome of radial osteotomy is believed to be due to this effect on carpal
      alignment.

PMID- 8345252
TI  - Aetiology of Kienbock's disease based on a study of the condition among patients
      with cerebral palsy.
AB  - Examination of 110 patients with cerebral palsy revealed a diagnosis of
      Kienbock's disease in six wrists in five cases. All had cerebral palsy of the
      mixed type with athetosis and high muscle tone. It is considered that the
      increased prevalence of Kienbock's disease in these cases was attributable to
      repeated minor trauma to the lunate from childhood due to high muscle tone across
      the wrist joint, together with negative ulnar variance. The high prevalence of
      Kienbock's disease observed in patients with cerebral palsy strongly suggests
      that repeated minor trauma together with negative ulnar variance is also the
      cause of Kienbock's disease in normal individuals.

PMID- 8345253
TI  - Functional outcome of upper limb tendon transfers performed in children with
      spastic hemiplegia.
AB  - Children with spastic hemiplegia often present with upper limb muscle imbalance.
      The purpose of this paper was to determine whether reconstructive surgery
      improved their functional ability. 17 children under the age of 16 years with
      spastic hemiplegia underwent reconstruction that included tendon transfers,
      tendon lengthenings and thumb metacarpophalangeal fusion. They were assessed pre
      operatively and at an average follow-up period of 2.6 years. Children's abilities
      were classified according to House's functional rating scale. Tendon transfers
      improved functional grading by two grades, from good passive assist to fair
      active assist. Improvement in the arc of wrist motion and forearm rotation was
      also seen. Parental satisfaction was high. Reconstructive surgery improved the
      functional abilities in this group of children with spastic hemiplegia.

PMID- 8345254
TI  - Early corrective surgery of the wrist and elbow in arthrogryposis multiplex
      congenita.
AB  - An early one-stage corrective surgical procedure for the elbow and wrist of
      patients suffering from arthrogryposis multiplex congenita is advocated. The
      procedure involves adequate proximal row carpectomy, tendon transfers to achieve
      a balanced wrist and a triceps to radius transfer for elbow flexion. Experience
      with 47 limbs showed that the best results were obtained in children operated on
      between 3 and 6 months of age.

PMID- 8345255
TI  - Macrodactyly in Proteus syndrome.
AB  - A case of Proteus syndrome in a 13-year-old boy with macrodactyly,
      hemihypertrophy, exostosis of the skull, epidermal naevi, palmar and plantar
      masses, and scoliosis is reported. Macrodactyly involving the left thumb was
      treated surgically. The usual findings in macrodactyly, hypertrophy of the
      digital nerves and proliferation of subcutaneous fat, were not observed in this
      case. Macrodactyly associated with Proteus syndrome should be distinguished from
      other forms of macrodactyly because of its poor prognosis and high rate of
      recurrence.

PMID- 8345257
TI  - Bilateral anomalous insertion of flexor pollicis longus.
AB  - A case of bilateral insertion of flexor pollicis longus to the proximal as well
      as the distal phalanges is reported. Initially, this case was diagnosed as
      congenital absence of the flexor pollicis longus, but surgery revealed an intact
      tendon, with the abnormality only present in the site of insertion. A survey of
      the literature on congenital abnormalities of flexor pollicis longus failed to
      reveal any reports of similar abnormalities.

PMID- 8345256
TI  - Camptodactyly caused by abnormal insertion and origin of lumbrical muscle.
AB  - A 12-year-old boy had camptodactyly of the little finger. Operative findings
      revealed an abnormal origin of the lumbrical muscle from the transverse carpal
      ligament, and abnormal insertion into the tendon sheath of the flexor digitorum
      superficialis tendon. No similar case has been reported in the literature.

PMID- 8345258
TI  - The anatomical course of the palmar cutaneous branch of the median nerve,
      including a description of its own unique tunnel.
AB  - In order to obtain a better understanding of the palmar cutaneous branch of the
      median nerve, dissections of 21 forearms from 12 fresh cadavers were done with
      loupe magnification. Discrete regions of potential surgical significance were
      identified, including an origin that can be as high as 11 cm proximal to the
      wrist crease, a radial position immediately after its origin so that it lies
      adjacent to flexor carpi radialis in the distal forearm, and the existence of an
      anatomical tunnel through the palmar aponeurosis.

PMID- 8345259
TI  - The results of secondary repair of 254 digital nerves.
AB  - 95 patients with 254 completely divided digital nerves were reviewed, on average,
      12.4 (5-20) years after repair. There were 47 sharp and 48 blunt injuries. 45
      injuries were at the level of the palm of the hand and 50 more distally.
      Secondary epineurial suture was used in 53, fascicular grafting in 37 and
      fascicular suture in five. Four sensory factors were assessed and evaluated
      quantitatively. Useful sensory function was recovered in 79.5% of the nerves
      operated on with epineurial or fascicular suture and in 56.3% with fascicular
      grafting.

PMID- 8345260
TI  - An open twin incision technique of carpal tunnel decompression with reduced
      incidence of scar tenderness.
AB  - We retrospectively compared a single curved incision for carpal tunnel
      decompression (group A, 29 wrists in 26 patients) with a twin incision technique
      (group B, 34 wrists in 30 patients), leaving an intact bridge of skin at the base
      of the palm. Patients in group B reported statistically significant subjective
      improvement in the early post-operative period, with fewer residual symptoms and
      earlier recovery of function compared to patients in group A. After a mean post
      operative period of 23 months, 5/29 wrists were symptomatic in group A compared
      to 1/34 wrists in group B at 13 months, but this was not statistically
      significant. The twin incision technique is easy to perform and allows rapid post
      operative recovery. The incidence of scar tenderness is reduced as palmar
      cutaneous branches of the median nerve are avoided. Because the distal portion of
      the transverse carpal ligament is divided under direct vision, this technique is
      not associated with any significant neurovascular complications.

PMID- 8345261
TI  - Acute calcification and carpal tunnel syndrome.
AB  - Carpal tunnel syndrome is a common diagnosis, and often there is no identifiable
      cause. We describe the case of a patient who developed acute symptoms secondary
      to calcification in the carpal tunnel. The patient was treated by decompression,
      and made a slow, but uneventful recovery.

PMID- 8345262
TI  - The association of peripheral nerve compression and reflex sympathetic dystrophy.
AB  - 35 patients who presented with reflex sympathetic dystrophy (RSD) are reported.
      Peripheral nerve compression was present in 86% of the patients (30). 50% of the
      patients (15) had a single nerve compression, and 50% had multiple nerve
      compressions. The high incidence of these entrapments should alert the clinician
      to check for this treatable problem early in the course of RSD.

PMID- 8345263
TI  - Objective improvements in algodystrophy following regional intravenous
      guanethidine.
AB  - 17 patients with established algodystrophy following trauma were treated with
      serial intravenous regional guanethidine blockade. Subjective improvement
      occurred in all cases. This improvement could be confirmed quantitatively using
      objective assessment criteria. The subjective and objective improvements
      demonstrated in each of the features of algodystrophy correlate closely (p <
      0.001). There appears to be no difference in the effectiveness of one block
      compared to another in the same patient.

PMID- 8345264
TI  - Provisional fixation of distal radial osteotomies using the AO small external
      fixator.

PMID- 8345265
TI  - Treatment of volar instability of the metacarpophalangeal joint of the thumb by
      volar capsulodesis.
AB  - The metacarpophalangeal joint bears most of the stresses to which the thumb ray
      is subjected. Instability of this joint results in considerable functional
      impairment of the hand. Volar instability may be secondary to trauma, rheumatoid
      arthritis, or adduction spasms in cerebral palsy. The resulting hyperextension
      causes pain and weakness of pinch (Fig. 1). Various techniques have been
      described to correct this deformity. We prefer a volar capsulodesis as first
      described by Filler (1976), in which the whole volar plate is reinserted.
      Detailed knowledge of the complicated volar anatomy is essential. We have treated
      eight patients (two bilaterally) with this technique, all with satisfactory
      results.

PMID- 8345266
TI  - Intraosseous ganglia of carpal bones.
AB  - 25 patients with 26 intraosseous ganglia in carpal bones are described, 14 in the
      scaphoid and 12 in the lunate. In most cases, attention was drawn to the lesion
      when X-rays were performed after a recent injury to the wrist. Typically, they
      occurred eccentrically and were surrounded by a radio-dense rim of bone. In a few
      cases the cortex was breached but never expanded by the lesion. Curettage and
      bone grafting were performed only if symptoms persisted and no other source for
      the pain could be found. Most contained the typical jelly-like material also
      found in soft tissue ganglia and the histology showed an identical structure. A
      suggested format for the management of these lesions is presented.

PMID- 8345267
TI  - Ewing's sarcoma of the thumb.

PMID- 8345268
TI  - Paronychia: a mixed infection. Microbiology and management.
AB  - Cultures of paronychia of the fingers have grown aerobic and anaerobic bacteria.
      Each was recovered individually in only about a quarter of the patients and a
      mixed aerobic/anaerobic flora was isolated in half of the patients. The
      predominant anaerobic organisms were Gram-positive anaerobic cocci, Bacteroides
      species and Fusobacterium species. The predominant aerobic organisms were
      Staphylococcus aureus, gamma-haemolytic streptococci, Eikenella corrodens, group
      A beta-hemolytic streptococci, alpha-hemolytic streptococci, and Klebsiella
      pneumoniae. Candida albicans was recovered in about 15% of the cases. The
      management of this infection is discussed.

PMID- 8345270
TI  - Dupuytren's disease: a legacy of the north?
AB  - This study identifies four miracle cures set in Orkney and Iceland in the 12th
      and 13th Centuries and recorded in the sagas of the earls of Orkney and the
      bishops of Iceland, in which the condition of the hand which was healed bears a
      resemblance to Dupuytren's disease. The possibility that one hand was cured by
      traumatic rupture of this condition and another treated by palmar fasciotomy is
      discussed.

PMID- 8345269
TI  - Cysticercosis of the flexor digitorum profundus muscle producing flexion
      deformity of the fingers.
AB  - Selective flexion deformity of the middle and ring fingers resembling a mild type
      of Volkmann's contracture resulted from Cysticercus cellulosa infection within
      the deep flexor muscle of the forearm in a middle-aged woman. Excision of the
      fibrotic segment of the muscle and tenodesis of all the flexor profundus tendons
      restored normal range of motion to these fingers. Vascular compromise in addition
      to the inflammatory response to the infection were considered causes for the
      deformity. There is no previous report of this kind in the literature.

PMID- 8345271
TI  - Dupuytren's disease in identical twins.
AB  - The aetiology of Dupuytren's disease remains unknown, although hereditary and
      environmental influences have been implicated. Previous reports have suggested
      that identical twins will develop identical contractures. This paper reports two
      pairs of identical twins, in each of which only one twin has evidence of
      Dupuytren's disease. This demonstrates that an appropriate genetic background is
      inadequate of itself for the development of Dupuytren's disease without a
      suitable, and as yet unknown, environmental trigger.

PMID- 8345272
TI  - Capsular tissues of the proximal interphalangeal joint: normal composition and
      effects of Dupuytren's disease and rheumatoid arthritis.
AB  - Three fibrocartilages associated with the proximal interphalangeal joint are
      described--at the attachment of the central slip to bone, within the slip where
      it passes over the joint, and the volar plate. Material was obtained at surgery
      following trauma, Dupuytren's disease and rheumatoid arthritis. The
      fibrocartilages were structurally distinct and immunolabelled differently with
      monoclonal antibodies to extracellular matrix components. All fibrocartilages
      from normal and Dupuytren's fingers contained chondroitin and keratan sulphate.
      Type II collagen was present in all attachment zones, although there was little
      in rheumatoid fingers. It was also present in the dorsal hood of some normal
      fingers, but not in pathological specimens or the volar plate. The results show
      that the fibrocartilages are dynamic tissues whose composition varies according
      to function and use, and changes in disease.

PMID- 8345273
TI  - Wrist arthrodesis in rheumatoid arthritis. A comparison of two methods of fusion.
AB  - 17 wrists were arthrodesed in 13 patients with severe wrist disease due to
      rheumatoid arthritis. Eight fusions in seven patients were carried out using a
      radial sliding bone graft technique whilst nine fusions in nine patients were
      undertaken using a third tubular AO plate. Subjective, objective and radiological
      assessments confirmed the efficacy of both methods but indicated a shorter period
      of post-operative immobilization for patients treated using the AO plate fixation
      technique. The importance of this is discussed.

PMID- 8345274
TI  - Long-term results of Swanson silastic arthroplasty in the rheumatoid wrist.
AB  - We report a long-term follow-up of 6 to 11.8 years (mean = 8 years) of our first
      50 Swanson wrist arthroplasties. All patients had long standing sero-positive
      rheumatoid arthritis with a mean age of 48 years. A detailed clinical and
      radiologic assessment was carried out on all the wrists. There was excellent
      sustained pain relief (mean score = 1.7) with improved activities of daily
      living. A mean range of wrist movement of 25 degrees of extension and 31 degrees
      of flexion was obtained. The prosthetic fracture rate was 22% of which 14% were
      symptomatic and needed re-operation. Carpal collapse was seen in all wrists, but
      was often symmetrical and accompanied by radial new bone formation on X-ray
      (86%). We feel that our long-term results justify the continued selective use of
      the Swanson wrist in the low-demand patient with quiescent disease who desires
      pain-free limited mobility and sophisticated grasp.

PMID- 8345275
TI  - The Guildford elbow.
AB  - The Guildford elbow is a new unconstrained elbow arthroplasty. From 1985 to 1991,
      this arthroplasty was used in 24 patients with rheumatoid arthritis. The patients
      were reviewed after an average of 28 months (4-59 months). Good to excellent
      results were obtained in 95% regarding pain relief and functional improvement.
      Complications were few, with only one case of clinical loosening and three of
      radiological loosening. Ulnar nerve hypo-aesthesia was common but did not
      jeopardize the final result in any patient.

PMID- 8345276
TI  - The relationship between handedness, mechanism of injury and which hand injured.

PMID- 8345277
TI  - The economic impact of hand injuries.
AB  - The socio-economic effect of 156 hand injuries was studied prospectively. The
      average cost per injury was IR 474.28 pounds of the more serious injuries
      utilized two-thirds of the resources and resulted in 83% of the days lost from
      work. In the working population approximately 50% of hand injuries occurred at
      work. In assessing the economic impact of hand injuries, labour costs account for
      55 to 65% of costs. Amputation and complicated laceration were the most costly
      and resulted in more days lost at work. Injuries at work result in greater costs
      because they involve more serious injuries, and because workers requiring manual
      skills need a higher level of hand rehabilitation to return to work. Unless the
      labour costs are taken into account, the true impact of hand injuries is greatly
      underestimated.

PMID- 8345278
TI  - V-Y advancement of the entire volar soft tissue of the thumb in distal
      reconstruction.
AB  - The commonly used variant of Moberg's advancement flap for thumb reconstruction
      requires a skin graft to reconstruct the proximal thumb defect after advancing
      the flap. A modification has been described previously which allows direct
      closure of this proximal defect by incorporation of the V to Y principle into the
      design of the proximal part of the flap. A variant of the V-Y Moberg flap is
      presented and its advantages discussed.

PMID- 8345279
TI  - The value of radiographs and bone scintigraphy in suspected scaphoid fracture. A
      statistical analysis.
AB  - The role of radiography and bone scintigraphy in the diagnostic management of
      suspected scaphoid fracture is controversial. Two strategies were compared for
      patients with initial negative radiographs: repeated radiography versus selective
      bone scintigraphy. Using the known positive predictive value of scintigraphy, the
      sensitivity and specificity of both diagnostic strategies were evaluated in a
      series of 78 consecutive patients. The kappa value for initial radiographs was
      0.76 but decreased to 0.5 for follow-up radiographs. Similarly, sensitivity
      decreased from 64% to 30% in follow-up radiographs. Specificity of the bone scan
      was 98%. The best diagnostic strategy in the management of clinically suspected
      scaphoid fractures consists of initial radiography followed by bone scintigraphy
      in patients with negative radiographs.

PMID- 8345280
TI  - Erik Moberg (1905-1993).

PMID- 8345281
TI  - Acute carpal tunnel syndrome due to pseudogout.

PMID- 8345282
TI  - Aspiration of ganglia.

PMID- 8345283
TI  - Claw-finger correction.

PMID- 8345284
TI  - Studies of topical carbonic anhydrase inhibitors: ocular hypotensive effect of
      thiadiazole derivatives.
AB  - A series of thiadiazole derivatives were topically applied in gels or suspensions
      to rabbits to determine their ocular hypotensive effect. As a result, the
      compounds with higher corneal permeabilities showed stronger effect in lowering
      IOP. In addition, gels also caused stronger effect than suspensions. Different
      concentrations of gel preparations produced diverse ocular hypotensive effects. A
      linear relationship between the integrated IOP response and logarithm
      concentration of inhibitor was found. It is proposed that the ocular hypotensive
      effect was attributed to the level of inhibitor in ciliary body.

PMID- 8345285
TI  - The presence of sigma-receptors in the lacrimal gland.
AB  - Applying the technic of S.A. Wolfe et al. [Endocrinology, 124, 1160-1172, 1989],
      we have established the presence of sigma receptors in isolated, but intact,
      lacrimocytes excised from main lacrimal gland tissue of the New Zealand white
      rabbit. 3H-Haloperidol was used as the ligand (0.5-2500 nM), in the presence of
      spiperone. From a Scatchard plot, a single binding site was statistically chosen
      over two sites for a majority of the data associated with the intact
      lacrimocytes. Kd (71.0 +/- 46.4 nM) and Bmax (588.2 +/- 166.7 fmol/mg of protein)
      values showed lower binding affinity but a similar density of sigma sites in
      rabbit lacrimocytes when compared to published results obtained for rat exocrine
      glands and brain tissue. Using the technic of McCann and Su [J. Pharm. Exp.
      Therap., 257, 547, 1991], membrane suspensions of the sigma receptor were also
      prepared and tested for binding to radioligands, 3H-DTG, as well as 3H
      haloperidol. A Scatchard plot revealed two binding sites for 3H-DTG and one
      binding site for 3H-haloperidol. The high affinity site for 3H-DTG yielded a Kd
      of 1.04 +/- 0.64 nM, whereas, Bmax was 135.9 +/- 11.62 fmol/mg of protein. The
      low affinity site gave a Kd = 75.3 +/- 26.8 nM and Bmax = 344.0 +/- 222.0 fmol/mg
      of protein. The weaker site is suspected to be intracellular. IC50 values were
      determined for N,N-disubstituted arylphenylalkylamines (Kd approximately low nM).

PMID- 8345286
TI  - Preliminary evaluation of a series of amphiphilic timolol prodrugs: possible
      evidence for transscleral absorption.
AB  - A series of amphiphilic esters of timolol malonate (octanoyl, decanoyl,
      dodecanoyl, myristoyl and palmitoyl timolol) were tested in rabbits for their
      capacity to antagonise the isoproterenol-induced ocular hypotension, using
      timolol maleate as reference standard. The most active prodrug, palmitoyl timolol
      malonate (PTM) was also evaluated for its capacity: (a) to decrease IOP in a
      model of bethamethasone-induced ocular hypertension, and (b) to permeate "in
      vitro" through rabbit corneal tissues. PTM, the prodrug with the longest
      aliphatic chain and therefore the greatest amphiphilic/lipophilic character,
      showed "in vivo" significant activity differences with respect to timolol
      maleate: the beta-antagonism was more important at earlier and later experimental
      times, and the IOP decrease was more marked at longer times. The prodrug,
      however, showed "in vitro" an inferior corneal permeability when compared with
      timolol maleate. The significant differences observed for the beta-antagonism of
      PTM at earlier times of the test might be attributed to transscleral absorption,
      due to the physicochemical characteristics of the prodrug, while the prolonged
      action (also observed in the IOP-depression test) might be due to sustained
      release, resulting from accumulation of the prodrug in the corneal epithelium.
      The present preliminary results are indicative of the potentiality of amphiphilic
      properties in a prodrug molecule.

PMID- 8345287
TI  - Inhibitory effects of tetrandrine on bovine serum albumin-induced uveitis in
      rabbits.
AB  - Experimental uveitis was successfully induced in rabbits by bovine serum albumin
      (BSA). Tetrandrine (Tet), 50 mg/kg/d i.p., and dexamethasone (Dex), 5 mg/kg/d
      i.p., for 8 d showed marked inhibition of uveitis in rabbits. Eight d after drug
      administration, ocular inflammation was markedly inhibited. The maximum
      inhibitory rate of Tet and Dex was 48.9% and 56.0%, respectively. The protein
      content of the aqueous humor (PAH) was reduced significantly; phytohemagglutinin
      (PHA)-induced peripheral T lymphocyte transformation of 3H-thymidine (3H TdR)
      incorporation was suppressed markedly; and serum circulating immune complexes
      (CIC) also were reduced. Four d after Dex withdrawal, ocular inflammation, PHA
      and CIC rose again, but these parameters were not changed after Tet withdrawal.
      These results suggest that Tet is an effective inhibitory agent on BSA-induced
      uveitis in rabbits. The inhibiting action may be related to the suppression of
      cellular and humoral immune function and, unlike Dex, Tet did not produce
      withdrawal rebound.

PMID- 8345288
TI  - Intraocular pressure response to loteprednol etabonate in known steroid
      responders.
AB  - The continuing development of ophthalmic steroids has resulted in compounds that
      have a low tendency to raise intraocular pressure (IOP). Preliminary clinical
      data have suggested that loteprednol etabonate (LE) 0.5% suspension may not
      elevate IOP while having promise as a potent topical ophthalmic steroid. This
      study was designed to evaluate the comparative potential of topical LE and
      prednisolone acetate (PA) to raise IOP in a population of individuals known to be
      steroid responders. The study used a double-masked, randomized, single eye,
      crossover design comparing LE 0.5% and PA 1.0%. Subjects instilled 1 drop of the
      assigned medication 4 times daily while awake, and follow-up examinations
      occurred on days 14, 28, and 42. Following a washout period of at least 14 days,
      subjects entered the second phase of the study, which was identical to the first
      phase, except that subjects received the alternate study medication. The mean IOP
      in the LE group increased from 17.4mm Hg at baseline to 21.5mm Hg at day 42 (p >
      0.05), while in the PA group the mean IOP increased from 18.1mm Hg at baseline to
      27.1mm Hg at day 42 (p < 0.05). There were no serious, severe, or clinically
      significant events in either group, and LE's effect on IOP was differentiable
      from that of PA. LE has less effect on IOP when compared to the IOP response
      induced by PA. LE may become a clinically useful ocular steroid with a favorable
      IOP-safety profile.

PMID- 8345289
TI  - Levels of vancomycin in aqueous humor after topical eye drops administration.
AB  - Vancomycin is an antibiotic which is especially active against Gram positive
      bacteria. At present, numerous infections of the anterior segment of the eye are
      caused by the Staphilococcus aureus and epidermis. Strains which are resistant to
      methicilin are more and more frequent and for this reason Vancomycin is becoming
      the antibiotic of choice to combat these infections since no resistance of the
      Staphilococcus to it has been demonstrated. The authors evaluated the levels of
      Vancomycin in aqueous humor after the administration of topical eye-drops. For
      the first two hours after the last administration, levels of 0.52 micrograms/ml
      were detected. These inhibit the growth of the majority of bacteria sensitive to
      Vancomycin. Between two and four hours, the levels decreased to 0.15
      micrograms/ml; these are therapeutic levels for a large number of Gram positive
      bacteria. From four hours after the last administration, these levels are
      undetectable. Due to the success of its penetration, topical administration of
      Vancomycin should be considered as a therapeutic modality against infections by
      gram positive bacteria of the anterior segment. The ideal guideline for
      administration would be one drop every two hours, especially if the infection is
      severe. In this way, subconjunctival injection could be avoided.

PMID- 8345290
TI  - The effects of photofrin on human Tenon's capsule fibroblasts in vitro.
AB  - Pharmacological agents that modulate the wound healing process by inhibiting
      fibroblast proliferation may improve the success of proliferative
      vitreoretinopathy and glaucoma filtration surgery and may have applications in
      other surgical fields. It is possible that light-absorbing chemicals can be used
      to cause photo reactions in proliferating fibroblasts as a means of controlling
      this wound healing process. We present the effects of photofrin porfimer sodium
      (serial tenfold dilutions 1000-0.00001 micrograms/ml) on human fibroblasts from
      Tenon's capsule in vitro, with and without photoactivation with Argon green laser
      (700 mW for 1 and 5 minutes) and with bright sunlight (for 1 and 5 min). The cell
      density was measured on day 2 by 3H-thymidine uptake and on day 9 by means of a
      coulter counter, and optical density was measured in terms of the activity of the
      enzyme hexosaminidase. Each experiment was performed three times in
      quadruplicate. The counts were averaged for each drug concentration and mean cell
      count with a standard error as well as the 50% inhibitory doses (ID50s) were
      calculated. Photofrin demonstrated an inhibitory dose response curve (dark
      toxicity) to human fibroblasts. Concentrations greater than 100 micrograms/ml of
      photofrin alone completely inhibited cell growth. Concentrations less than 0.01
      micrograms/ml did not have any effect on fibroblast proliferation. There was no
      significant log dose shift of the inhibitory effect of photofrin with the
      exposure to either sunlight or Argon laser. Photofrin may be used as a cytotoxic
      agent alone but does not appear to be activated by light to modulate
      subconjunctival fibroblast proliferation within the laser parameters used.

PMID- 8345291
TI  - Effects of dopamine antagonists on retinal B-wave recovery after retinal
      ischemia.
AB  - Retinal ischemia was developed by occlusion of the central retinal artery for 30
      minutes. The artery was reperfused thereafter, and the recovery of the b-wave
      amplitude was determined as an indication of the recovery of retinal function
      after ischemia. Following ischemia, it was found that dopamine antagonists,
      including chlofluperol, metoclopramide, trifluperol and droperidol, increased in
      b-wave amplitude recovery significantly over the control b-wave recovery. Similar
      effects were observed with haloperidol and loxapine, but to a lesser extent. The
      results correlated well with the improvement of retinal blood flow by these
      dopamine antagonists (4,5). Neither floropipamide, a dopamine antagonist, nor
      bromocriptine, a dopamine agonist, affected the b-wave recovery after ischemia.
      These results also correlate well with the inability of these agents to increase
      the retinal blood flow measured by the microsphere technique (4,5). These
      findings suggest that most of the dopamine antagonists, with the exception of
      floropipamide, could be used for the treatment and/or prevention of ischemic
      retinopathy.

PMID- 8345292
TI  - Studies of carbonic anhydrase inhibitors: physicochemical properties and
      bioactivities of new thiadiazole derivatives.
AB  - A series of thiadiazole derivatives of carbonic anhydrase inhibitors were
      prepared and their physicochemical properties and pharmacological activities such
      as corneal permeabilities, inhibition of carbonic anhydrase activities were
      evaluated. The solubilities and pKa values were determined in varied pH of
      phosphate buffers at 35 degrees C after equilibrium. Intrinsic solubility and pKa
      value were calculated from the plot of solubility versus the reciprocal of
      hydrogen ion concentration. The distribution coefficient was determined in the
      system of octanol/pH 7.65 phosphate buffer. As a result, the sigma (Hammett
      constant) and pi (hydrophobic substituent constant) values of substituents were
      found to be correlated to the logarithm of Ka and partition coefficient. Corneal
      permeabilities of the analogue were determined in a specially designed diffusion
      cell using excised rabbit cornea, which ranged from 1.32 x 10(-5) (compound II)
      to 3.48 x 10(-7) cm/sec (compound VI). Compound with high permeability might be
      expected to be absorbed well after topical administration into the eye. The
      methodology of pH-stat was used to determine the inhibition of the carbonic
      anhydrase activity of the analogue. The IC50 values of the analogue around 10(-8)
      M as determined were less than that of acetazolamide. The results suggest that
      the analogue had good pharmacological activity. Finally, an equation for
      quantitative structure-activity relationship was established for the analogue,
      which is as follows: [formula: see text]

PMID- 8345293
TI  - Vestibular testing: the current position.

PMID- 8345294
TI  - A review of the definition, terminology and pathology of aural cholesteatoma.
AB  - Despite a considerable amount of discussion and research in the course of many
      years, aural cholesteatoma has remained a matter of controversy. This review
      concerns only the definition, terminology and pathology of this common and severe
      disease.

PMID- 8345295
TI  - Clinical otosclerosis and auditory exostoses in ancient Europeans (investigation
      of Lithuanian paleoosteological samples).
AB  - The purpose of this investigation was to establish the incidence of clinical
      otosclerosis and auditory exostoses in Lithuanian paleopopulations. The total
      sample consists of 4080 skulls, dating from the Neolithic to the C17th-C18th
      A.D., investigated visually, under magnification and radiologically. Eight cases
      of clinical otosclerosis and 22 of auditory exostoses were identified. The
      general epidemiology of otosclerosis (0.19 +/- 0.08 per cent) was established to
      be similar to contemporary populations. This suggests that there are no new
      aetiological factors attributable to our modern society. Clear diminution of the
      incidence of auditory exostoses from the 1st to the 2nd millenium A.D. (3.46 +/-
      0.76 per cent, against 0.06 +/- 0.04 per cent, p < 0.001) and definite sexual
      differences (males: 1.21 +/- 0.28 per cent; females: 0.17 +/- 0.10 per cent, p <
      0.001) were also noted. In general, auditory exostoses were found much more
      frequently than in recent populations.

PMID- 8345296
TI  - Congenital cerebrospinal fluid fistula through the inner ear and meningitis.
AB  - Congenital deformities of the labyrinth of the inner ear can be associated with a
      fistulous communication between the intracranial subarachnoid space and the
      middle ear cavity. We describe seven such cases, six confirmed by high resolution
      CT and one by postmortem histological section. The seven patients all presented
      with meningitis although a cerebrospinal fluid fistula was demonstrated at
      subsequent surgery or postmortem. The lesions were bilateral in three patients,
      unilateral in three and probably bilateral in the postmortem case although only
      one temporal bone was obtained. In every case there was a dilated sac instead of
      the normal two and a half turn cochlea on the affected side and this was
      confirmed at surgery. The demonstration of the basal cochlear turn is of
      paramount importance in any deaf child presenting with meningitis. A true Mondini
      deformity with a normal basal turn and some hearing is not at risk of developing
      a fistula.

PMID- 8345297
TI  - Sensory interaction testing in platform posturography.
AB  - Mostly techniques measuring the vestibulo-ocular reflex (VOR) have been used for
      the evaluation of patients with dizziness problems. Some investigators, however,
      have also tried to take into account the vestibulospinal reflex (VSR). So
      recording techniques for the Romberg-test have been proposed and called
      posturography (PG). By interfering with the visual and proprioceptive sensory
      inputs during this PG-testing one tries to find out how 'sensory interaction' is
      organized in the balance performance of the patient examined. To interfere with
      vision, closure of the eyes has been commonly used and to interfere with
      proprioception, the patient can be put on foam-rubber, which makes the
      contribution of the foot-ankle proprioception less adequate. These interferences
      are applied once separately and once combined. The degree of 'abnormality' is
      assessed by a score-system for parameters surface (S) and velocity (V), which
      measure the postural sway. A comparison of tests with and without influence on
      the sensory inputs gives an idea of the sensory interaction. Patients with
      peripheral vestibular disorders were examined: patients with BPPV, with
      spontaneous vertigo attacks and with a sudden vestibular deficit. When applying
      this evaluation technique different formulae or patterns can be found. Firstly
      complete normal evaluation, which means that there is no influence of the
      vestibular disturbance upon the PG results. Secondly a normal balance when using
      all available sensory information, but disturbed balance as soon as one of the
      sensory inputs is influenced by the test conditions. Thirdly striking
      destabilization when closing the eyes. Fourthly striking destabilization when
      misleading the ankle and foot proprioceptor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345298
TI  - Osseointegrated implants in the management of childhood ear abnormalities: the
      initial Birmingham experience.
AB  - Over a four-year period 72 children with ear abnormalities have been referred for
      assessment by the extraoral osseointegrated implant team at The Queen Elizabeth
      Hospital, Birmingham. Thirty-two children have been judged suitable for
      rehabilitation. Twelve children have completed rehabilitation using bone-anchored
      hearing aids and/or auricular prostheses. Two fixtures (seven per cent of those
      loaded) have dislodged and required replacement. Audiological assessment of the
      bone-anchored hearing aid users shows only small improvements in their aided
      thresholds, compared to thresholds obtained with their previous aid. However all
      now have thresholds of 30 dB(A) or better and report a marked improvement in
      sound quality. When surveyed, hearing aid and prosthesis users report high levels
      of satisfaction with this form of rehabilitation. The technique adds a new
      dimension to the management of children with aural anomalies. The approach and
      results of a multidisciplinary programme are reported.

PMID- 8345299
TI  - A new technique using cultured epithelial sheets for the management of epistaxis
      associated with hereditary haemorrhagic telangiectasia.
AB  - A new technique for the treatment of severe epistaxis associated with hereditary
      haemorrhagic telangiectasia is described. The nasal septum and inferior
      turbinates, surgically denuded of respiratory epithelium, were grafted using
      autografts of cultured epithelial sheets derived from buccal epithelium. All
      patients upon whom this technique has been used have shown considerable lessening
      in the frequency and severity of their epistaxes although two patients received
      grafts on two occasions, in each case approximately three months apart. It is
      postulated that a nasal lining of stratified squamous epithelium is likely to be
      more resistant to trauma than the normal respiratory type, and this is supported
      by the observation that bleeds very seldom occur from the oral cavity in this
      syndrome.

PMID- 8345300
TI  - Risk factors involved in stomal recurrence following laryngectomy.
AB  - Stomal recurrence after surgery for laryngeal tumours is an extremely serious
      complication, with a dismal prognosis despite aggressive surgical therapy or high
      dose irradiation. Data from 209 patients who underwent total laryngectomy for
      cancers of the larynx and hypopharynx were retrieved from the registry of the
      Department of Otorhinolaryngology at the Hospital 'Virgen de las Nieves' of
      Granada. Stomal recurrence developed in 8.1 per cent of them (17 cases). We
      analysed several parameters from each case: first, those parameters significantly
      associated with stomal recurrence were detected, and secondly, a logistic
      regression analysis was done. Three factors were found independently related to
      stomal recurrence: T-staging, site of the primary tumour and prior tracheostomy.
      Together with a review of the literature, we discuss our findings and a proposal
      for management of the high risk patient.

PMID- 8345301
TI  - The relationship between SIgA and chronic granular pharyngitis.
AB  - A survey of the SIgA content in saliva, serum and pharyngeal mucosa with lymphoid
      tissue (PMLT) of chronic granular pharyngitis patients was conducted by a double
      antibody PEG radio-immune method. These data were compared with those from a
      healthy control group. Result shows that SIgA in patients with chronic granular
      pharyngitis had dissociation of saliva, serum and PMLY. There was low salivary
      SIgA level but higher levels in serum and PMLT. These data suggest that the
      saliva and serum immunoglobulin pools are under separate regulation.

PMID- 8345302
TI  - The globus syndrome: value of flexible endoscopy of the upper gastrointestinal
      tract.
AB  - Flexible endoscopy of the upper gastrointestinal tract usually does not form part
      of the primary diagnostic evaluation of the globus syndrome. In a prospective
      trial, a flexible endoscopy was performed in 51 globus patients with normal
      results of the laryngologic and radiographic examination. Pathologic findings
      requiring therapy were diagnosed in 70.6 per cent of cases. The most frequent
      findings were reflux oesophagitis (n = 24; 47 per cent) and hiatal hernia (n =
      25; 49 per cent). In 16 cases (31.4 per cent) these were accompanied by other
      pathologic lesions. A total of 32 patients (62.7 per cent) suffered from
      oesophageal diseases as sole aetiologic factors of the globus syndrome, which led
      us to postulate a causative relationship in these cases. Flexible endoscopy
      therefore can contribute significantly to the differential diagnosis of the
      globus syndrome. It must be kept in mind, however, that there is a 'blind zone'
      for endoscopic assessment in a region of the hypopharynx, thus some indications
      may require rigid endoscopy.

PMID- 8345304
TI  - Parathyroid adenomas: pre-operative localization with ultrasound combined with
      fine-needle biopsy.
AB  - Sixteen patients with biochemically proven primary hyperparathyroidism (PHPT)
      underwent ultrasonography (US), fine-needle aspiration (FNA) for cytologic
      sampling (n = 9), or intact parathormone assay (n = 3) before operation (n = 15)
      in order to determine the accuracy of the methods. Pre-operative US was found
      sensitive (100 per cent), but two thyroid lesions were initially diagnosed as
      parathyroid tumours by US (i.e. false positives). Parathyroid cells were detected
      in six cytologic specimens, one sample was insufficient and another inconclusive,
      while one was diagnosed as thyroid tissue. Parathormone assay revealed a high
      hormone content in all three patients who underwent the procedure. We conclude
      that US is sufficiently sensitive to detect enlarged parathyroid tumours.
      Specificity can be improved by US-guided FNA for cytology or parathormone assay
      prior to neck exploration.

PMID- 8345303
TI  - The management of multiple paraganglioma of the head and neck.
AB  - During the years 1984 to 1991, of 32 patients who had one large glomus or carotid
      body tumour, six were found to have other paragangliomas. Excluded from the above
      total of 32 are patients whose only lesion was a solitary glomus tympanicum. No
      two patients had identical problems and no pattern emerged on which patient
      management in any particular case could be based. The major problems associated
      with the tumours themselves and their treatment is the risk to hearing and the
      lower cranial nerves. Individual cases and their treatment are discussed.

PMID- 8345305
TI  - Tympanic membrane ossification.
AB  - Ossification of the tympanic membrane after myringoplasty is recorded for the
      first time. Myringoplasty was performed for closure of a perforation which
      followed the surgical treatment of otitis media with effusion and had included
      the insertion of a long-term T-tube.

PMID- 8345306
TI  - Cerebellopontine angle lipoma.
AB  - A case of a cerebellopontine angle lipoma is presented with a typical clinical,
      audiometric and radiological features of an acoustic neuroma. The correct pre
      operative diagnosis was elusive even with the aid of magnetic resonance imaging.

PMID- 8345307
TI  - Polypoid lipoma of the palatine tonsil.
AB  - A polypoid, pedunculated tumour of the left palatine tonsil was incidentally
      detected in a 42-year-old female. It was composed of mature fat and was covered
      by a nonkeratinizing squamous epithelium with an underlying rim of fibrous
      tissue. The literature on tonsillar lipoma is reviewed and the differential
      diagnosis of polypoid lesions of the tonsil is discussed.

PMID- 8345308
TI  - Mycobacterial infection of the parotid gland: an unusual cause of parotid
      swelling.
AB  - Six cases of mycobacterial infection of the parotid gland are reviewed. All six
      cases presented solely with a slowly enlarging parotid swelling clinically
      indistinguishable from a parotid tumour. All of the swellings required surgical
      removal, superficial parotidectomy in four cases, and enucleation in two cases to
      obtain a definitive diagnosis.

PMID- 8345309
TI  - Laryngeal imaging by computerized tomography and magnetic resonance following
      radiation therapy: a need for caution.
AB  - For patients with laryngeal tumours, the use of computerized tomography (CT) or
      magnetic resonance imaging (MR) may facilitate accurate staging by the
      demonstration of cartilage invasion or tumour extension to areas such as the pre
      epiglottic space. The role of imaging in the follow-up of patients after
      radiotherapy, however, has not been examined. A prospective study of 18 patients
      undergoing laryngectomy was performed. The results of pre-operative CT and MR
      imaging were correlated with the pathological findings from whole organ axial
      sections of the laryngeal specimens. In five patients (28 per cent) both CT and
      MR images were significantly impaired by movement artefact. In the eight patients
      without previous radiotherapy, seven had adequate quality imaging and both CT and
      MR accurately demonstrated the site, size and extent of laryngeal tumour. In
      eight of the ten patients following radiation therapy the presence of tumour was
      correctly identified, however there was a poor correlation between the imaging
      and pathological findings. Two patients had radionecrosis alone. Neither CT nor
      MR imaging could differentiate between radionecrosis and recurrent tumour.

PMID- 8345310
TI  - Temporal bone histopathology of open mastoidectomy cavities.
AB  - Open cavity mastoidectomy remains the principle surgical treatment of middle ear
      cholesteatoma in the United Kingdom. A significant proportion of mastoid cavities
      are prone to intermittent or continuous discharge. In this study the temporal
      bone histopathology of four patients who had undergone open cavity mastoidectomy
      is presented. Cavities were predominantly lined with stratified keratinizing
      squamous epithelium. Residual air cells were obliterated by fibrous tissue, with
      no evidence of persistent respiratory epithelium. Where inflammatory changes were
      found, these consisted of areas of granulation tissue in association with
      epithelial ulceration. Residual cholesteatoma pearls (epidermoids) were not
      associated with significant inflammatory changes.

PMID- 8345311
TI  - A comparison of health care costs for chiropractic and medical patients.
AB  - OBJECTIVE: To compare the health care costs of patients who have received
      chiropractic treatment for common neuromusculoskeletal disorders with those
      treated solely by medical and osteopathic physicians. DESIGN: Retrospective
      statistical analysis of 2 yr of claims data on various categories of utilization
      and insurance payments for a large national sample of patients. SETTING:
      Ambulatory and inpatient care. PATIENTS: A total of 395,641 patients with one or
      more of 493 neuromusculoskeletal ICD-9 codes. OUTCOME MEASURES: Hospital
      admission rates and 10 categories of insurance payments. RESULTS: Nearly one
      fourth of patients were treated by chiropractors. Patients receiving chiropractic
      care experienced significantly lower health care costs as represented by third
      party payments in the fee-for-service sector. Total cost differences on the order
      of $1,000 over the 2-yr period were found in the total sample of patients as well
      as in subsamples of patients with specific disorders. The lower costs are
      attributable mainly to lower inpatient utilization. The cost differences remain
      statistically significant after controlling for patient demographics and
      insurance plan characteristics. CONCLUSIONS: Although work is in progress to
      control for possible variations in case mix and to compare outcomes in addition
      to costs, these preliminary results suggest a significant cost-saving potential
      for users of chiropractic care. The results also suggest the need to reexamine
      insurance practices and programs that restrict chiropractic coverage relative to
      medical coverage.

PMID- 8345312
TI  - Abnormal joint mechanics and the proteoglycan composition of normal and healing
      rabbit medial collateral ligament.
AB  - OBJECTIVE: This study investigated the influence that abnormal joint mechanics
      may have upon the biochemical composition of the joint's own soft tissue holding
      elements. DESIGN: The investigation used an animal model of ligament injury, the
      rabbit medial collateral ligament (MCL). The proteoglycan component of the
      ligament extracellular matrix was extracted, purified and characterized.
      INTERVENTIONS: The experimental groups consisted of: a) a control group
      consisting of the MCL from both right and left knees of six animals that had not
      undergone surgery; b) a group (healing gap injury) of six MCL from right knees in
      which a segment of tissue had been excised from the anterior cruciate and the MCL
      of the right knee 3 wk prior to sacrifice; and c) a third group (contralateral
      gap injury) comprised of the MCL from the six left knees of the same gap injury
      animals. OUTCOME MEASURES: The MCL water content, total proteoglycan content,
      hexose and hexuronate-containing proteoglycan and proteoglycan electrophoretic
      mobility were determined for each group studied. RESULTS: The healing gap injury
      MCL was found to have a higher water content, a higher total proteoglycan content
      and a higher proportion of aggregating proteoglycan than MCL from control
      animals. The nonaggregating proteoglycan fraction from the contralateral MCL
      (group 3) had a greater electrophoretic mobility and probably, therefore, a
      smaller molecular weight than that found in the MCL from the same knee of control
      animals. CONCLUSIONS: Since MCL healing took place in an abnormal mechanical
      environment, these results suggest that joint biomechanics may be an important
      factor in mediating connective tissue proteoglycan composition.

PMID- 8345313
TI  - Responsiveness of leg alignment changes associated with articular pressure
      testing to spinal manipulation: the use of a randomized clinical trial design to
      evaluate a diagnostic test with a dichotomous outcome.
AB  - OBJECTIVE: A study was undertaken to assess the stability of leg alignment
      reaction to a pressure challenge and its responsiveness to an adjustive
      intervention. DESIGN: Prospective, double-blind clinical trial of a diagnostic
      test. SETTING: Laboratory: Center for Technique Research. PARTICIPANTS: Forty-two
      chiropractic college students, faculty and staff. INTERVENTIONS: A high-velocity,
      low-amplitude, short lever adjustment of a single vertebra from among C1 and T3
      T7; or a sham adjustment similar to a manual diagnostic pressure test at C1, T3
      T7 or T9-T10. MAIN OUTCOME MEASURES: Leg alignment reactivity: An increase in leg
      alignment discrepancy (yes or no) following a metered pressure challenge to a
      vertebra. RESULTS: On average, stability was poor at T3-T7 (Kappa = 0.04),
      moderate at C1 (K = 0.47), and fair for sham pressure tests (K = 0.30).
      Responsiveness: The proportion of positive baseline leg alignment reactions that
      responded (became negative) to sham adjustment was 95% at T3-T7 and 55% at C1.
      Further analysis was untenable since too few vertebrae were implicated for an
      adjustment. CONCLUSIONS: For the population investigated, the majority of the
      responsiveness of the leg alignment diagnostic test to a rotatory adjustment
      appears to be a diagnostic illusion (i.e., background noise unrelated to a
      treatment intervention). Further research with different subject populations,
      regions of investigation, leg alignment measurement techniques and vertebral
      challenge techniques are indicated.

PMID- 8345314
TI  - Determination of lactate threshold by respiratory gas exchange measures and blood
      lactate levels during incremental load work.
AB  - OBJECTIVE: The purpose of this investigation was the determination of the lactate
      threshold (LT) by selected respiratory gas exchange measures and venous blood
      lactate levels during incremental load work on a mechanically braked cycle
      ergometer. DESIGN: Repeated measures design. SETTING: Human Performance
      Laboratory. PARTICIPANTS: Eight healthy trained soccer players (mean age 21.9 +/-
      3.0 yr, mean VO2max = 59.2 +/- 3.6 ml.kg.min-1). OUTCOME MEASURE: Subjects
      conducted two incremental load work tests. Incremental load work was increased by
      1 kilopond (kp) every third minute at 60 rpm until voluntary exhaustion. Blood
      samples from a forearm vein were collected during the second trial (T2) only and
      analyzed for lactic acid [LA-]. RESULTS: One-way analysis of variance (ANOVA)
      with repeated measures indicated no statistically significant difference between
      the two tests for maximal oxygen uptake (VO2max), maximal carbon dioxide
      production (VCO2max), maximal heart rate (HRmax), maximal pulmonary ventilation
      (VEBTPSmax) and lowest ventilatory equivalent of oxygen (VE/VO2), respectively;
      however, there was a significant difference among the oxygen uptake (VO2) values
      at the LT for the four determination methods. In our subjects, the measured (mean
      +/- SD) VE/VO2 in relation to VO2 for the first trial (T1) of 22.9 +/- 1.9
      occurred at VO2 of 1.27 +/- 0.8 l.min-1. The lowest VE/VO2 and the onset of [LA-]
      accumulation calculated from individual exponential equations relating VE to VO2
      yielded VO2 values of 1.77 +/- 0.18 and 1.74 +/- 0.25 l.min-1 for the T2.
      Utilizing natural log for lactate ln [LA-] to natural log for ln (VO2) equations,
      the LT for T2 occurred at VO2 of 1.30 +/- 0.70 l.min-1. CONCLUSION: LT was best
      predicted by the measured lowest VE/VO2 and the plot of the ln [LA-] to ln VO2
      relationship. The methods used in this study provide a valid estimate of the LT
      and support the use of measured lowest VE/VO2 as an indirect measure of the LT.

PMID- 8345315
TI  - Metaphysics, rationality and science.
AB  - The debate over the metaphysical elements of Palmer's theories, and in
      chiropractic generally, has been a long and frequently bitter one. This article
      attempts to show the illogicality of both sides of the debate by reviewing the
      role of metaphysics in science and the discussions of metaphysics in philosophy.
      Within philosophy, metaphysics have been viewed, at least by those who do not
      object to them outright, as heuristic devices, which, although they cannot be
      subjected to either confirmation or refutation (that is, we cannot know if they
      are true or false), can be subjected to rational criticism. Furthermore, the
      article suggests that a critical confrontation with Palmer's metaphysical
      constructs should begin with a critique of vitalism, the philosophical source of
      these constructs (innate and universal intelligence).

PMID- 8345316
TI  - The effect of coffee consumption on serum cholesterol levels.
AB  - OBJECTIVE: Studies investigating the association of coffee consumption and serum
      cholesterol levels report conflicting results. In an attempt to resolve this
      controversy, we reviewed the literature to answer the question: Is there a true
      positive association between coffee consumption and serum cholesterol levels?
      DATA SOURCES: A Medline database search dating back to 1965 was utilized. Key
      words used in the search were coffee, caffeine and cholesterol. Cholesterol was
      expanded to include lipoproteins and LDL-, HDL- and VLDL-cholesterol. All
      articles that presented cholesterol data in association with coffee consumption
      were examined for references missed by Medline. Recently published articles were
      located by a hand search through Current Contents and the latest monthly editions
      of Index Medicus. STUDY SELECTION: Three reviewers made the decision to include
      all publications that met the following criteria: a) reported original
      experimental results; b) reported total serum cholesterol levels; and c) were
      published in peer-reviewed journals. DATA EXTRACTION: Two to four articles were
      read and analyzed each week in chronological order. Independent data extraction
      was performed by three reviewers, who then met as a group once a week to cross
      check the analyses. DATA SYNTHESIS: A trend, representing the association between
      coffee consumption and serum cholesterol, was calculated for each study. The
      trend was based on the percent difference in cholesterol values between subjects
      drinking four or more cups of coffee per day in comparison to those drinking zero
      or less than one cup of coffee each day. In order to compare studies that
      reported different cup sizes and different levels of intake, weighted mean
      cholesterol levels were calculated. In studies discussing the data in terms of
      correlations, trends were established according to the r values provided by the
      authors. CONCLUSIONS: The majority of studies demonstrated a positive trend in at
      least one subpopulation of their subjects, indicating that serum cholesterol
      levels increase with increasing coffee consumption. Stronger trends were seen
      among subjects drinking boiled coffee than in those drinking filtered,
      decaffeinated or instant coffee. However, most studies were not randomized
      clinical trials, and results can be countered by a number of biases prevalent in
      the studies, indicating the need for additional well-designed investigations to
      resolve remaining issues.

PMID- 8345317
TI  - Post-traumatic myelopathy following flopping high jump: a pilot case of spinal
      manipulation.
AB  - OBJECTIVE: To present the first case of spinal cord injury from high jump and the
      first pilot case of spinal manipulation for post-traumatic myelopathy. CLINICAL
      FEATURES: An 11-yr-old tetraplegic boy was admitted to the hospital, where he had
      a thorough neurological examination, including myelogram, EEG and skull and
      spinal X rays, with normal findings. The author revealed subtle subluxations on
      plain X-ray films. Triceps hyperreflexia was detected bilaterally. Bilateral
      patella and ankle clonus with hyperreflexia, basic and excess spasticity, and
      bilateral extensor plantar responses were noted in the lower limbs. A clinical
      diagnosis of early post-traumatic incomplete spastic tetraplegia below C7 was
      made. INTERVENTION AND OUTCOME: He did not respond to 3 months of orthodox
      conservative hospital management, including steroid therapy. Spinal manipulation
      of the lower cervical and upper thoracic spine was performed in a private
      chiropractic clinic for 2 wk. He apparently recovered after 3 months of spinal
      manipulation. On recent examination, he has virtually completely recovered. He
      still suffers from hand muscle atrophy, hyperreflexia of the triceps and ankle
      reflex and bilateral positive Babinski reflex; ankle and patellar clonus are
      almost absent. CONCLUSIONS: The early response and long-term (9-yr follow-up)
      benefits of spinal manipulation to the early delayed traumatic myelopathy of this
      patient suggest spinal cord ischemia as its pathophysiology. Mechanisms of post
      traumatic myelopathy are postulated. Biomechanical mechanisms of spinal
      manipulation for neurological recovery of post-traumatic myelopathy and/or
      radiculopathy are advanced. Further pilot spinal manipulation by experienced
      chiropractors after adequate anti-edematous (steroid) therapy is recommended for
      selected patients with post-traumatic myelopathy and/or radiculopathy, especially
      in a multidisciplinary spinal injury unit.

PMID- 8345318
TI  - Distraction manipulation reduction of an L5-S1 disk herniation.
AB  - OBJECTIVE: A computed tomography (CT)-confirmed L5-S1 disk protrusion is reported
      to be reduced following chiropractic adjustment, as seen on repeat CT scanning.
      Correlation of the CT reports with the patient's symptoms before and after
      manipulation is reported. CLINICAL FEATURES: A 38-yr-old female was treated for
      low back pain and right lower extremity first sacral dermatome sciatica. CT
      confirmed disk herniations at both the L4-L5 and L5-S1 levels were found. Motor
      weakness of the right gluteus maximus muscle was found and extremely tight
      hamstring muscles accompanying positive straight leg signs were elicited. A
      clinical and imaging diagnosis of an L5-S1 disk herniation was made. INTERVENTION
      AND OUTCOME: Distraction type chiropractic manipulation, electrical stimulation,
      exercises, nutrition advice and low back wellness class were administered with
      complete relief of sciatic pain and nearly complete relief of low back pain.
      CONCLUSIONS: Chiropractic distraction manipulation is an effective treatment of
      lumbar disk herniation, if the chiropractor is observant during its
      administration for patient tolerance to manipulation under distraction and any
      signs of neurological deficit demanding other types of care.

PMID- 8345319
TI  - Treatment of facial muscles affected by Bell's palsy with high-voltage electrical
      muscle stimulation.
AB  - OBJECTIVE: This report discusses high-voltage electrical muscle stimulation and
      chiropractic manipulation used to treat two patients who suffered from Bell's
      palsy. CLINICAL FEATURES: Case A: A 15-yr-old with left sided facial palsy was
      seen 2 days after the onset of symptoms. Upon observation, the left upper and
      lower eyelids were drooping and the left eye had excessive tearing. Motion
      palpation indicated multiple fixations in the cervical spine. Laboratory studies
      showed a microcytic anemia. A clinical diagnosis of Bell's palsy (House-Brackmann
      Grade V) and microcytic anemia was made. Case B: A 17-yr-old with left sided
      facial palsy was seen 8 days after onset of symptoms. Upon observation, the
      patient showed left sided facial paralysis and an inability to close the left eye
      completely. Motion palpation indicated multiple fixations in the cervical spine.
      A clinical diagnosis of Bell's palsy (House-Brackmann Grade V) was made.
      INTERVENTION AND OUTCOME: Both patients were treated with high-voltage pulsed
      galvanic current at 80 peaks/sec with a 7-inch hand-held held probe for 10 min
      each visit. In addition, the cervical spine fixations were mobilized using
      chiropractic manipulation. Case A was resolved after 6 wk of treatment and case B
      was resolved after 3 wk of treatment. CONCLUSION: Both patients benefited from
      these procedures with complete resolution of symptoms. The techniques outlined
      should be used at an early stage to accelerate progress toward normal facial
      muscle function.

PMID- 8345320
TI  - Intersegmental sagittal motion in the lower cervical spine and discogenic
      spondylosis: a preliminary study.

PMID- 8345321
TI  - Basilar artery migraine or cerebral vascular accident?

PMID- 8345322
TI  - Implicit memory: effects of network size and interconnectivity on cued recall.
AB  - Previous findings have indicated that the recall of a recently studied word is
      affected by how many associates it has in long-term memory (set size). The
      purpose of these experiments was to determine whether recall is also affected by
      the connectivity of these associates. Studied words were preselected to represent
      combinations of set size and connectivity and, in different experiments, recall
      was cued with extralist or intralist cues and with cues sharing few or many
      associates with the studied words. Effects of study time, encoding context, and
      levels of processing were also investigated. The results indicated that recall
      was more likely for words with smaller associative sets and for words with more
      interconnected sets of associates. These findings demonstrate that the recall of
      a recently presented word in the presence of a retrieval cue is affected by both
      the size and organization of its implicitly activated associative structure.

PMID- 8345323
TI  - Direct comparison of four implicit memory tests.
AB  - Four verbal implicit memory tests, word identification, word stem completion,
      word fragment completion, and anagram solution, were directly compared in one
      experiment and were contrasted with free recall. On all implicit tests, priming
      was greatest from prior visual presentation of words, less (but significant) from
      auditory presentation, and least from pictorial presentations. Typefont did not
      affect priming. In free recall, pictures were recalled better than words. The
      four implicit tests all largely index perceptual (lexical) operations in
      recognizing words, or visual word form representations.

PMID- 8345324
TI  - Implicit learning of color-word associations using a Stroop paradigm.
AB  - Our experiments asked whether implicit learning occurs for novel nonverbal
      associations. We presented subjects with color names printed in incongruent
      colors; subjects were asked to name the color in which the word was printed. In
      Experiment 1, each of 7 color words were associated with the same incongruent
      color across 6 blocks of trials, and then the color-word associations were
      abruptly changed. Both control subjects and patients with amnesia reduced their
      color-naming times across the first 6 trial blocks, and naming times increased
      when the color-word associations were changed. In Experiment 2, similar results
      were obtained when neutral words were associated with colors. In Experiment 3, we
      found that naming times were not disrupted when an irrelevant dimension
      (typecase) was changed. Finally, in Experiment 4, we found that the effect
      persisted across a 5-min delay. These studies provide evidence that implicit
      learning occurs for nonverbal associations and is independent of the brain
      structures damaged in amnesia.

PMID- 8345325
TI  - An evaluation of the total similarity principle: effects of similarity on
      frequency judgments.
AB  - Memory models that embody the total similarity principle (e.g., Gillund &
      Shiffrin, 1984; Hintzman, 1988; Murdock, 1982; Ratcliff, 1990) assume that
      frequency judgments reflect the total similarity of a test item to stimuli that
      have been studied. In 4 experiments, subjects estimated the frequencies of target
      words that had been presented in the context of varying numbers of semantically
      similar words. In a fifth experiment, subjects made forced-choice relative
      frequency judgments. The results of these experiments supported 1 prediction of
      total similarity models: Presenting similar words will increase rather than
      decrease frequency judgments of target words. However, a second prediction of
      these models was not supported. In particular, similar-word presentations had no
      effect on the judged frequencies of target words that had not been shown.

PMID- 8345326
TI  - Visual word recognition: a multistage activation model.
AB  - Although many models of word recognition have postulated loci for the simple
      effects of Context, Stimulus Quality, and Word Frequency, most of them are
      problematic in that they do not account for the pattern of joint effects among
      these factors. The experiments reported here show that, among other things, Word
      Frequency interacts with Context but is additive with Stimulus Quality in the
      context of a lexical decision experiment that also produces an interaction
      between Stimulus Quality and Context. The pattern of joint effects among these
      factors is accommodated by a multistage activation model that is based on the
      framework proposed by Besner and Smith (1992a).

PMID- 8345327
TI  - The cue-familiarity heuristic in metacognition.
AB  - Four experiments contrasted the cue-familiarity hypothesis of feeling-of-knowing
      judgments (FKJs) and tip-of-the-tongue feelings (TOTs) to the target
      retrievability hypothesis. Familiarity of the cues was contrasted to memorability
      of the targets in a paired-associate design (e.g., A-B A-B, A-B A-B', A-B A-D, A
      B C-D), in which the number of repetitions of the cue A terms was dissociated
      from the memorability of the target B terms. Little support was found for the
      target-retrievability hypothesis, because in none of the 4 experiments were FKJs
      related to target memorability. In one experiment, an omnibus retrieval
      hypothesis (which implicates total retrieval rather than just correct retrieval)
      and the cue-familiarity hypothesis produced isomorphic predictions that were
      borne out by the FKJ and TOT results. All 4 experiments supported the cue
      familiarity hypothesis, because FKJs and TOTs were directly related to the number
      of presentations (and thereby the familiarity) of the cues.

PMID- 8345328
TI  - Memory prerequisites of mismatch negativity in the auditory event-related
      potential (ERP).
AB  - The mismatch negativity (MMN) is a component of the auditory event-related brain
      potential that occurs in response to infrequent changes in the physical
      properties of homogeneous series of sounds, even when subjects are instructed to
      ignore the auditory channel of stimulation. It has been proposed (e.g., Naatanen,
      1990) that the MMN is generated by an automatic process in which a difference
      between the deviant sound and the previous, standard sound is detected by the
      brain. However, it is unclear how the form of memory involved is related to the
      rest of the memory system. The present study indicates that, for an MMN to be
      elicited in response to a change in tone frequency, the representation of the
      standard tone must be both (a) well-established as a standard in memory, and (b)
      in a currently active state. The relation between physiological and psychological
      aspects of memory representation is discussed.

PMID- 8345329
TI  - Do the same stimulus-response relations influence choice reactions initially and
      after practice?
AB  - A two-choice reaction task was used to evaluate changes in stimulus-response
      translation with practice. In Experiment 1, four groups of Ss practiced with
      either a direct or indirect mapping of left-right stimuli to left-right responses
      and either a crossed or uncrossed hand placement and transferred to one of the
      four Mapping x Placement conditions. Stimulus-response location and response
      location-effector relations affected performance initially and after practice. In
      Experiments 2 and 3, Ss switched every 42 trials between conditions for which
      only the stimulus location-effector (Experiment 2) or stimulus-response location
      relation (Experiment 3) remained constant. Switching produced interference in
      Experiment 2 but not in Experiment 3, corroborating the influence of the stimulus
      response location relation on performance. Mediation based on spatial codes
      continues to be a factor in the performance of practiced Ss.

PMID- 8345330
TI  - Use of analogy in learning scientific concepts.
AB  - Four experiments compared learning of scientific concepts as expressed in either
      traditional literal form or through an analogy. Comprehension of basic-level
      details and inferential implications was measured through multiple-choice
      testing. In Experiment 1, literal or analogical renditions were presented in
      textual form only. In Experiment 2, text was accompanied by a dynamic video. In
      Experiment 3, the video and text literal rendition was compared with a text-only
      analogical rendition. In Experiment 4, subjects read only about a familiar
      domain. Subjects consistently answered basic-level questions most accurately when
      concepts were expressed literally, but answered inferential questions most
      accurately when concepts were expressed analogically. Analysis of individual
      differences (Experiment 2) indicated that this interaction strongly characterized
      the conceptual learning of science novices. The results are discussed within the
      framework of schema induction.

PMID- 8345331
TI  - Psychiatry in 2001.

PMID- 8345333
TI  - Practice guidelines: promise or panacea?

PMID- 8345332
TI  - Myocardial infarction.

PMID- 8345334
TI  - Interspecialty wars over endoscopy.

PMID- 8345335
TI  - The effect of parental expectations on treatment of children with a cough: a
      report from ASPN.
AB  - BACKGROUND: A previous retrospective study of children with cough raised
      questions about how physicians diagnose acute bronchitis. We hypothesized that if
      the physician perceives a parental expectation that an antibiotic is needed, it
      is more likely that a child with a cough will be diagnosed as having bronchitis
      and treated with an antibiotic. METHODS: Data were collected prospectively in 44
      primary care practices in the Ambulatory Sentinel Practice Network. Variables
      examined included elements of the patient's history and physical examination,
      diagnoses made, and treatments prescribed. RESULTS: Data regarding 1398 patients
      were collected. A parental expectation that a prescription for an antibiotic
      would be given was associated with an increased likelihood of a diagnosis of
      bronchitis (relative risk 2.04, 95% confidence limits, 1.76 to 2.35, P < .001),
      and was second only to the physical finding of rales in the magnitude of its
      association with that diagnosis. The only other diagnosis associated with
      parental expectation of an antibiotic was viral upper respiratory tract
      infection, where parental expectation of treatment with an antibiotic was
      associated with a 49% reduction in the probability of that diagnosis.
      CONCLUSIONS: The expectations of parents of children with a cough appear to
      influence physician decision making.

PMID- 8345336
TI  - Extraordinary daytime urinary frequency in children.
AB  - BACKGROUND: Sudden onset of daytime urinary frequency of a small amount of urine
      in a previously toilet-trained child can be a disturbing problem. Psychosocial
      problems, problems at school, or problems within the family have to be taken into
      consideration. METHODS: Fifteen children with sudden onset of isolated daytime
      urinary frequency were evaluated and followed for a period of 12 to 18 months. A
      thorough medical and family history was obtained for each child, with special
      attention given to any psychosocial problems the child had experienced. All the
      children underwent a physical examination, complete urinalysis, and
      ultrasonography of the kidneys and bladder. RESULTS: In all of the patients, the
      urinalysis and ultrasonographic findings were within normal limits. A trigger
      factor was identified as the cause of urinary frequency in each case.
      CONCLUSIONS: Because urinary frequency is usually a benign self-limited
      condition, an extensive urological evaluation is not indicated. In most cases,
      providing reassurance to the parents and the child is the only intervention
      necessary.

PMID- 8345337
TI  - Physicians' usefulness ratings of family-oriented clinical tools.
AB  - BACKGROUND: Family-oriented patient care is a cornerstone of family practice.
      Family practice educators have proposed various methods to help the physician to
      better assess and treat families. Little is known, however, of the usefulness of
      family-oriented clinical tools to practicing physicians. METHODS: On a mailed
      survey questionnaire, 595 members of the Wisconsin Academy of Family Physicians
      were asked to rate the usefulness of 10 family-oriented tools and indicate the
      frequency of use and level of training received for each item. In addition,
      physicians rated their current and desired level of competency for involving
      families in patient care. RESULTS: Two hundred ninety-nine (50%) physicians
      responded. Most of the tools were rated as useful but used infrequently.
      Identifying the effects of chemical dependency on the health of families and
      conducting family conferences were rated as highly useful and frequently used
      skills. Clinical tools rated as least useful were record keeping by family charts
      and folders and family function assessment by the Family APGAR: Physicians who
      had received training in the use of a tool rated it as more useful, except for
      the Family APGAR and family charts or folders. Physicians with busier practices
      rated some of the tools as less useful than did other physicians. Respondents
      indicated a desire to develop their family counseling skills. CONCLUSIONS: Most
      family-oriented tools were reported to be useful but used infrequently by
      practicing physicians. Residency programs should continue to provide training for
      assessing and treating families, particularly in the areas of family systems
      theory, self-awareness of the physician's own family background, and the effect
      of chemical dependency on families. Future research should target larger and more
      varied groups of family physicians.

PMID- 8345338
TI  - Family practice and internal medicine office fees: an analysis of charge
      differences.
AB  - BACKGROUND: This study applies the concept of economic efficiency to primary
      health care physicians. Comparisons of charges made by family physicians and
      general internists would provide evidence of "optimal" health care delivery of
      primary care services. METHODS: A list of all active licensed primary care
      physicians was obtained from the office of the Oregon State Board of Medical
      Examiners. Two thousand eight hundred forty-three questionnaires were sent to
      Oregon primary care physicians. Of the 1365 responses, 484 were family physicians
      and 341 were general internists. RESULTS: The study found that family physicians
      had significantly lower mean office visit fees than general internists, while
      both groups had essentially similar patient mixes. This difference in fees could
      not be explained by patient case mix. CONCLUSIONS: The findings of this study and
      the body of literature available support the concept that family practice
      physicians provide economically efficient primary health care. If two similarly
      trained physicians provide a comparable level of medical care, with the same or
      similar outcome (or output), the physician who provides the care for the lowest
      cost should be used.

PMID- 8345339
TI  - Factors associated with research efforts of academic family physicians.
AB  - BACKGROUND: Family medicine has struggled to gain stature among academic medical
      disciplines. One factor has been the paucity of quality family medicine research.
      METHODS: Two hundred eight full-time physician faculty members at family practice
      residency programs completed a survey that focused on demographics, training,
      experience, professional activities, and factors that motivated them to select
      academic careers. Bivariate and multivariate analyses were performed to determine
      if any of these factors was associated with increased time spent on research.
      RESULTS: Faculty members who spent 10% or more of their professional time on
      research were more likely to be fellowship trained, employed in university
      training programs, have more academic experience, and to cite the opportunity to
      do research as a factor motivating them to enter academic medicine. However, when
      multivariate analysis was performed, the only significant factor that predicted
      that a faculty member would devote 10% or more time to research was having an
      interest in research when first seeking a position in academic medicine.
      CONCLUSIONS: The amount of time that family medicine faculty members dedicate to
      research is related to a strong interest in research when seeking their academic
      position. Fellowship training and an academic environment may have assisted
      faculty in performing research, but were not independent predictors of future
      involvement in research.

PMID- 8345340
TI  - Screening for diabetic retinopathy in a clinical setting: a comparison of direct
      ophthalmoscopy by primary care physicians with fundus photography.
AB  - BACKGROUND: Type II diabetes mellitus is a major health problem among Native
      Americans, and diabetic retinopathy is a frequent complication of this disease.
      Screening for retinopathy can identify early disease and prevent major vision
      loss, but the most cost-effective screening method has not yet been determined.
      METHODS: In a rural clinic that served more than 400 Native Americans with
      diabetes, we compared the accuracy of referrals made based on two screening
      methods: ophthalmoscopy by trained primary care physicians and seven-view
      nonstereoscopic, mydriatic fundal photography read by two general
      ophthalmologists and a retinal specialist. Patients in whom abnormal findings
      were detected by either screening method were then referred to a general
      ophthalmologist for further evaluation. RESULTS: Two hundred forty-three
      examinations were performed and 83 referrals made. Both screening methods had
      high sensitivity for referring patients with retinopathy that required treatment
      or follow-up sooner than 1 year (100% for direct ophthalmoscopy by primary care
      physicians, 94% for the general ophthalmologist photography readers, and 100% for
      the retinal specialist reader). The calculated costs of screening by direct
      ophthalmoscopy and by retinal photography were 64% less and 44% to 35% less,
      respectively, than the cost of yearly ophthalmological examinations by
      ophthalmologists. CONCLUSIONS: Careful screening for treatable diabetic eye
      disease by trained primary care physicians proved to be a clinically acceptable,
      cost-effective strategy. Screening methods for diabetic retinopathy should be
      evaluated based on the absolute sensitivity, specificity, and predictive values
      of their ability to correctly refer patients rather than their diagnostic
      accuracy.

PMID- 8345341
TI  - A critique of the practice-expense values of the resource-based relative value
      scale.
AB  - The resource-based relative value scale (RBRVS) was implemented by the Health
      Care Financing Administration on January 1, 1992. The practice-expense payments
      from the old Medicare fee scale were moved unchanged into RBRVS. This resulted in
      underpayment of office-based practice expenses and overpayment of hospital-based
      practice expenses. For example, office visits are underpaid by $10.28, whereas
      coronary angiograms are overpaid by $123.00. Unpaid practice expenses reduce the
      after-expense physician-work fee of the average office visit by about one half,
      yet overpayment of practice expenses for some hospital procedures almost doubles
      the after-expense physician-work fee for some subspecialties. Inflation will
      likely increase the actual practice expense of the average office visit to the
      point that the after-expense physician-work fee for the family physician will be
      reduced to zero by the year 2001.

PMID- 8345342
TI  - Pathophysiology and management of endometriosis.
AB  - Endometriosis is a common disease that affects up to 5 million women in the
      United States. Specifically the prevalence of endometriosis is 1 in 15 (7%) women
      of reproductive age, and there is an associated incidence of infertility in as
      many as 30% to 40% of cases. The precise physiologic mechanism for the
      development of endometriosis lesions in the pelvis and abdominal cavity has not
      been elucidated. Substantial evidence exists, however, that endometriosis is
      dependent on estrogen for continued growth and proliferation. Therefore,
      suppression of the hypothalamic-pituitary-ovarian axis with analogues of a
      gonadotropin-releasing hormone is being increasingly undertaken. Since the most
      effective resolution of endometriosis occurs after oophorectomy or onset of
      menopause, the hypoestrogenic state induced by GnRH analogues is of major
      significance for patients with active disease. Medical therapy for endometriosis
      is often used as primary therapy for symptomatic disease or as an adjunct to
      surgical management of pelvic pain or infertility.

PMID- 8345343
TI  - Failure of insulin treatment in obese patients with non-insulin-dependent
      diabetes mellitus.
AB  - A number of experts recommend the use of insulin for patients with non-insulin
      dependent diabetes mellitus (NIDDM) who fail to respond to diet, exercise, and
      oral hypoglycemics, even when the patient is morbidly obese. This article
      describes the use of insulin in two obese patients with NIDDM whose obesity
      worsened following the institution of insulin therapy. In some cases the risk for
      increased obesity and its complications following the institution of insulin may
      offset the potential benefits of insulin therapy itself. There are two main
      drawbacks associated with insulin therapy in these patients. First, from a
      medical point of view, insulin has a lipogenic effect and may actually contribute
      to weight gain, hyperinsulinemia, and increased insulin resistance in obese
      patients with NIDDM. Second, from a behavioral point of view, the institution of
      insulin therapy may shift the patient's and physician's focus from the preferred
      lifestyle adjustments to the numerous details associated with insulin use and
      monitoring. Since weight gain and sedentary activity are themselves risk factors
      for coronary artery disease, the benefits of decreased blood glucose levels
      should be balanced against the risk of increased weight gain in these patients.

PMID- 8345344
TI  - Appendectomies for Madeline and Madlon.

PMID- 8345345
TI  - The closteroviruses, capilloviruses and other similar viruses: a short review.

PMID- 8345346
TI  - Involvement of cellular adhesion sequences in the attachment of adenovirus to the
      HeLa cell surface.
AB  - Immunofluorescence analysis of HeLa cells incubated with human adenovirus
      serotype 2 (Ad2) inoculum suggested that Ad2 receptors co-localized with the
      receptors of fibronectin (FNR) and vitronectin (VNR) at the cell surface. Ad2
      adsorption also resulted in the occurrence of intracytoplasmic actin cables with
      submembranal anchorage. The cell binding of Ad2 virions, pentons and fibres was
      found to be efficiently inhibited by concanavalin A, laminin, anti-FNR and anti
      VNR antibodies. Arginine-glycine-aspartyl tripeptide (RGD) and other related
      peptides reproducing cellular attachment sequences of adhesion proteins also
      competed with Ad2 for cell adsorption, and drastically reduced the virus progeny
      yield at the end of the infectious cycle. Data from binding competition assays
      with Ad2 virions showed that the apparent affinity constants of RGD motif
      containing peptides for Ad2 receptor ranged from 0.75 x 10(8) M-1 to 2.2 x 10(8)
      M-1, with a number of peptide recognizing sites varying from 1.5 x 10(4) to 9 x
      10(4) per cell for the different peptides studied. Polypeptide analysis of
      labelled plasma membrane fractions isolated after cross-linking to unlabelled Ad2
      virions showed three major protein species with apparent M(r) of 130K, 60K and
      44K, respectively, reacting with anti-FNR and anti-VNR antibodies. These results
      suggested that Ad2 and extracellular matrix proteins recognize similar adhesion
      sequences at the surface of HeLa cells, or alternatively that integrins and Ad2
      receptors have overlapping ligand specificity.

PMID- 8345347
TI  - Restricted replication of respiratory syncytial virus in human alveolar
      macrophages.
AB  - The cellular factors that regulate infection and replication of respiratory
      syncytial virus (RSV) in human alveolar macrophages were examined. RSV-exposed
      alveolar macrophages demonstrated a time-dependent expression of viral
      glycoproteins, maximal by 24 h post-infection resulting in infection of approx.
      38% of the cells. Essentially all (33%) of these freshly isolated alveolar
      macrophages replicated RSV as shown by infectious centre assays. This RSV
      permissive subpopulation of alveolar macrophages consisted primarily of major
      histocompatibility class II-expressing cells as determined by fluorescence
      activated cell sorting. Re-infection of alveolar macrophages did not
      significantly alter the number of cells infected or capable of replicating RSV.
      However, in vitro differentiation of alveolar macrophages prior to infection
      resulted in a significant (P < 0.05), time-dependent decrease (approx. sevenfold)
      in the number of cells that replicated virus. The mechanism by which cellular
      differentiation restricted RSV replication is unknown. Production of defective
      interfering particles did not account for this decrease. Alveolar macrophages
      infected with RSV produce a variety of cytokines potentially contributing to this
      restricted viral replication. Pretreatment with several of these cytokines did
      not affect viral infection or replication. However, tumour necrosis factor (TNF
      alpha) significantly (P < 0.05) decreased viral replication but only by 30 to
      60%. Thus RSV replication is reduced by in vitro differentiation of alveolar
      macrophages and, to a lesser degree, by pretreatment with TNF.

PMID- 8345348
TI  - Morphological and genomic characterization of two reoviruses (P and W2)
      pathogenic for marine crustaceans; do they constitute a novel genus of the
      Reoviridae family?
AB  - P and W2 viruses are pathogenic in two crustaceans of the Mediterranean Sea,
      Macropipus depurator and Carcinus mediterraneus, respectively. Investigation of
      virus, virus density and genome structure leads us to propose their
      classification in a genus similar to aquareovirus of the Reoviridae family. They
      differ from aquareoviruses by the number of dsRNA segments forming the genome (12
      instead of 11), their electrophoretic pattern in PAGE (1/5/6 instead of 3/3/5),
      and the absence of virus replication in fish cell lines.

PMID- 8345349
TI  - Identification of cellular proteins that bind to the human immunodeficiency virus
      type 1 nef gene product in vitro: a role for myristylation.
AB  - The human immunodeficiency virus (HIV) type 1 nef gene product was expressed as
      an N-terminal fusion protein with glutathione-S-transferase (GST) in the
      baculovirus system. The resulting nefGST fusion protein was found to be
      authentically myristylated at the N terminus and could be purified to homogeneity
      by one-step affinity chromatography on immobilized glutathione. The high affinity
      of nefGST for glutathione was exploited to develop an assay to identify cellular
      proteins capable of interacting with nef. Several such proteins were identified
      in extracts from the Jurkat human T cell line. The interaction between nef
      binding proteins and immobilized nefGST could be specifically competed by the
      addition of soluble nef. Cell fractionation showed that nef-binding proteins were
      present in both cytosolic and membrane-associated fractions. A non-myristylated
      derivative failed to bind to the membrane-associated proteins but was able to
      bind to the cytosolic group, albeit with reduced affinity. In addition, a single
      protein present in both soluble and membrane-associated fractions exhibited
      myristylation-independent binding to nef. By analogy with other myristylated
      proteins such as MARCKS (myristylated alanine-rich C kinase substrate) and the
      Rous sarcoma virus transforming protein, src, the membrane-associated proteins
      that bind only to myristylated nef may represent a specific membrane target for
      nef. The cytosolic proteins that interact with nef may constitute soluble
      components of an as yet unidentified signal transduction pathway which is the
      target of nef action in the HIV-1-infected cell.

PMID- 8345350
TI  - Characterization of an early gene coding for a highly basic 8.9K protein from the
      Orgyia pseudotsugata multicapsid nuclear polyhedrosis virus.
AB  - A new gene of the baculovirus Orgyia pseudotsugata multicapsid nuclear
      polyhedrosis virus (OpMNPV) has been identified that encodes a highly basic 8.9K
      protein. The gene called p8.9 is expressed as a 0.5 kb transcript by 1 h post
      infection and initiates at an early gene motif. The promoter of the 0.5 kb
      transcript has two upstream elements, repeats I and II, which are similar to
      motifs previously characterized in the OpMNPV IE-2 gene and the Autographa
      californica nuclear polyhedrosis virus IE-N and PE38 genes. A second p8.9
      transcript expressed from 8 to 72 h post-infection was shown to initiate 634 bp
      upstream from the early gene motif in a region that has no similarity to any
      previously described baculovirus promoter or initiation site. Transient assays
      utilizing a reporter gene have shown that the p8.9 early promoter is active in a
      Lymantria dispar (LD652Y) and Spodoptera frugipeda (Sf9) cell lines in the
      absence of other viral factors. In addition, it was also demonstrated that the
      p8.9 promoter is trans-activated by the OpMNPV IE-2 and p34 genes, but not by IE
      1.

PMID- 8345351
TI  - Replication of Cydia pomonella granulosis virus in cell cultures.
AB  - Several primary cell lines that support the complete replication of Cydia
      pomonella granulosis virus have been established from one culture of C. pomonella
      embryonic cells. Virus passaged three times in cells and once in larvae showed no
      change in restriction enzyme fragment patterns. Stages in virus replication
      observed by electron microscopy resembled those from in vivo studies. Cell lines
      that were maintained at or below 21 degrees C retained susceptibility to virus
      over a period of 4 years whereas the same cell lines maintained at 27 degrees C
      gradually lost their susceptibility and eventually could not be infected at all.

PMID- 8345352
TI  - A strong-stop DNA in rice plants infected with rice tungro bacilliform virus.
AB  - A virus-specific small nucleic acid (strong-stop DNA) was identified in rice
      plants infected with rice tungro bacilliform virus, but not in the virus
      particles. This nucleic acid was shown to consist of about 595
      deoxyribonucleotides with about 70 ribonucleotides covalently linked at the 5'
      end. Hybridization with sequence-specific oligonucleotides showed that the
      ribonucleotides were from the plant cytoplasmic tRNA(iMet) sequence. PCR analysis
      detected hairpin structures at the 3' end of the DNA.

PMID- 8345354
TI  - Characterization of a single SA7-like VA RNA gene in subgroup F adenoviruses.
AB  - The virus-associated (VA) RNA gene regions of the human subgroup F adenoviruses
      (types 40 and 41) were amplified using primers corresponding to flanking open
      reading frames of human and simian (SA7) adenovirus sequences previously
      published. The subgroup F adeno-viruses, like human Ad12 (subgroup A) and SA7,
      were found to have only one VA RNA gene at this locus (map unit 30). The type 40
      and type 41 VA RNA genes have primary sequence characteristics in common with
      other known VA RNA genes, have high cross-identity (93%), and show appreciably
      higher identity to the single VA RNA gene present in SA7 (77% and 81%,
      respectively) than to any of the VA RNA genes of Ad2, Ad7 or Ad12 (< 61%). These
      findings may have implications for explaining the evolution and growth
      peculiarities of human subgroup F adenoviruses.

PMID- 8345353
TI  - Nucleotide sequence of the Buzura suppressaria single nucleocapsid nuclear
      polyhedrosis virus polyhedrin gene.
AB  - A portion of the genome of the Buzura suppressaria (Lepidoptera) single
      nucleocapsid nuclear polyhedrosis virus (BsSNPV) containing the polyhedrin gene
      was sequenced. An open reading frame of 738 nucleotides encoded a protein of 246
      amino acids and represented the polyhedrin gene. A conserved TAAG motif,
      associated with transcriptional start sites in other polyhedrin genes, was
      identified 51 nucleotides upstream of the BsSNPV polyhedrin gene. A putative
      polyadenylation signal, AATAAA, was found immediately downstream of the
      polypeptide termination codon. Comparison of the amino acid sequence of BsSNPV
      polyhedrin with other NPV polyhedrins and granulosis virus granulins showed that
      the BsSNPV polyhedrin was most closely related to the polyhedrin of Orgyia
      pseudotsugata (Lepidoptera) SNPV and most distantly related to the polyhedrin of
      Neodiprion sertifer (Hymenoptera) SNPV.

PMID- 8345355
TI  - Identification of a new hepatitis B virus (HBV) genotype from Brazil that
      expresses HBV surface antigen subtype adw4.
AB  - The complete genome of a hepatitis B virus (HBV) from Brazil that expressed the
      subtype adw4 of HBV surface antigen (HBsAg) was cloned and sequenced. The genome,
      termed w4B, consists of 3215 bp. The overall genetic organization of typical
      hepadnaviruses with four open reading frames including the preC region was found
      to be conserved. When comparing the w4B sequence with 19 complete HBV genomes it
      was, however, found to be more divergent (15%) than any other HBV sequence thus
      far reported. Until now, no more than 11% divergence has been reported. Distinct
      from the five known HBV genotypes A to E, w4B made up a new, sixth genotype. The
      importance of the conserved third start codon in the HBV X gene became apparent
      in isolate w4B. By mutation, this ATG was out of frame, and by what appears to
      have been a linked mutation, a new start site two codons downstream was re
      established. The significance of several other mutations is discussed.

PMID- 8345357
TI  - Location on the evolutionary trees of the non-structural protein (NS) and
      neuraminidase (NA) genes of late human influenza A (H2N2) viruses: parental
      viruses of the NS and NA genes of Hong Kong influenza A (H3N2) viruses.
AB  - The nucleotide sequences of the non-structural protein (NS) and neuraminidase
      (NA) genes of human influenza A (H2N2) viruses isolated in 1967 and 1968 in
      Europe, Asia and North and South America were located on evolutionary trees in
      order to identify the parental virus of Hong Kong influenza A (H3N2) viruses,
      which appeared in the human population in 1968. From the evolutionary trees, the
      H2N2 viruses isolated during the 1967 to 1968 period were divided into two
      groups. Group I includes that A/Tokyo/3/67, A/Hachioji/1/67, A/Perg/1/68,
      A/Cordoba/522/67, A/Texas/2/68 and A/Berkeley/1/68 viruses, whereas group II
      includes the A/Georgia/1/67, A/England/10/67 and A/Poland/6/67 viruses. The NS
      and NA genes of Hong Kong H3N2 viruses isolated in 1968 were genetically closer
      to those of group II viruses and closest to those of A/Poland/6/67.

PMID- 8345356
TI  - Lipopolysaccharide inhibits the production of lymphocytic choriomeningitis virus
      in a human monocytic cell line.
AB  - The human monocytic cell line THP-1 was used as a model to study the mechanism of
      infection in the monocyte/macrophage, a natural target of lymphocytic
      choriomeningitis virus (LCMV) infection in vivo. Both the virulent strain,
      LCMV.WE, and the avirulent strain, LCMV.ARM, infected THP-1 cells, but did not
      stimulate THP-1 cells to secrete interleukin 1 (IL-1) or tumour necrosis factor
      (TNF-alpha). When lipopolysaccharide (LPS) was added to THP-1 cells together with
      LCMV, an 80 to 90% reduction in the number of infected cells (measured by
      immunofluorescence) and a 90% reduction in viral plaques was observed 5 to 6 days
      post-infection. Neither interferon alpha (IFN-alpha) nor IFN-beta were detected
      in supernatants from THP-1 cells after the addition of LCMV, LPS, or LPS plus
      LCMV. In contrast, the same levels of IL-1 and TNF-alpha were observed in the
      presence of LPS and LCMV, or LPS alone. However, antibodies to IL-1, TNF-alpha,
      interleukin 6 and IFN-alpha did not block the antiviral effect of LPS. In kinetic
      studies, LPS added 1 day after adding LCMV to THP-1 cells was still effective in
      reducing the number of infected cells. Our findings suggest that LPS alters
      cellular metabolism, possibly through the induction of IFN-alpha, and that IFN
      alpha in the absence of LPS suppresses virus production.

PMID- 8345358
TI  - Production of the M2 protein of influenza A virus in insect cells is enhanced in
      the presence of amantadine.
AB  - Recombinant baculoviruses that express the M2 protein from the genes of either
      the amantadine-sensitive, influenza A/Ann Arbor/6/60 virus or a laboratory
      derived, amantadine-resistant mutant of this virus were constructed. Addition of
      amantadine or rimantadine at 2 micrograms/ml to cultures of Sf9 cells infected
      with the recombinant baculoviruses increased the yield of the M2 protein from the
      amantadine-sensitive virus approximately 10-fold, but did not increase the yield
      of the M2 protein from the amantadine-resistant virus. Flow cytometry
      demonstrated that the increased production of M2 in the presence of amantadine
      resulted in increased cell surface expression of the M2 protein. Pulse-chase
      experiments indicated that whereas the rate of synthesis of the M2 protein
      increased in the presence of amantadine, the M2 protein was stable in both the
      presence and absence of amantadine. Addition of amantadine to Sf9 cells as late
      as 72 h after infection with the recombinant virus increased the production of M2
      protein. These data suggest that the M2 protein exerts some biological activity
      in Sf9 cells.

PMID- 8345359
TI  - Characterization of the gene encoding the A-type inclusion protein of camelpox
      virus and sequence comparison with other orthopoxviruses.
AB  - A gene was identified in camelpox virus strain CP-1 that is similar to the 160K
      gene of cowpox virus strain Brighton (BR) that encodes the A-type inclusion body
      protein (ATIP). The CP-1 gene was mapped, sequenced, and the presence of the ATIP
      specific mRNA was demonstrated. The open reading frame [2178 nucleotides (nt)]
      was found at a similar position in the CP genome as the one reported for the
      cowpox virus 160K ATI gene. DNA sequence comparison revealed a deletion of two
      adjacent adenine residues relative to cowpox virus BR, generating a reading frame
      shift accompanied by the formation of a translational stop codon. An identical
      deletion has been described for vaccinia virus strain Western Reserve. The DNA
      sequence of the corresponding region of monkeypox virus strain Copenhagen
      revealed a deletion leading to a putative stop codon 75 nt upstream of the same
      stop codons in the camelpox and vaccinia virus genes. These findings are
      consistent with the expression of truncated ATIPs, of 94K in vaccinia and
      camelpox viruses and of 92K in monkeypox virus. In addition, a deletion of 789 bp
      could be localized downstream of the ATI open reading frame in camelpox virus
      isolates of different origin. This causes the transcription of a shortened ATI
      specific mRNA (3.7 kb) relative to vaccinia and cowpox viruses (both 4.5 kb). The
      similarity observed in ATIP-encoding and flanking sequences might suggest that
      vaccinia and camelpox viruses are descended from a common ancestor.

PMID- 8345360
TI  - Sindbis virus pathogenesis: phenotypic reversion of an attenuated strain to
      virulence by second-site intragenic suppressor mutations.
AB  - Monoclonal antibodies (MAbs) specific for the E2c neutralizing antigenic site on
      the Sindbis virus E2 glycoprotein define a pathogenesis domain that affects
      neonatal mouse virulence. Sequence analysis of E2c MAb escape mutants showed that
      the domain included E2 amino acids 62, 96 and 159. The pathogenesis domain is
      also influenced by changes at E2 position 114. Mutation of E2 residues Asn 62 to
      Asp or Lys 159 to Glu results in suppression of the attenuated phenotype
      conferred by a mutation from Ser to Arg at E2 position 114. Possible mechanisms
      of phenotypic suppression within the E2c pathogenesis domain were investigated by
      using site-directed mutagenesis to determine the effects of specific combinations
      of positively charged, negatively charged and uncharged amino acid substitutions
      at E2 positions 62, 114 and 159. Phenotypic reversion to virulence by second-site
      suppressor mutations at E2 amino acids 62 or 159 was not dependent on ionic
      interaction with the residue at E2 114. Rather, suppression appeared to be the
      result of independent virulence effects mediated by specific residues.

PMID- 8345361
TI  - Subgenomic RNAs of Lelystad virus contain a conserved leader-body junction
      sequence.
AB  - During the replication of Lelystad virus in alveolar lung macrophages, a 3'
      coterminal nested set of six subgenomic RNAs (RNA2 to RNA7) is formed. These
      contain a common leader sequence derived from the 5' non-coding region of the
      genomic RNA. In this study, the sequence of the junction sites, i.e. the sites
      where the leader sequence joins to the body of the subgenomic RNA, was determined
      for all six subgenomic RNAs. For each subgenomic RNA, six to nine cDNA clones
      were isolated by means of reverse transcription and PCR. The nucleotide sequence
      at the junction site was identical for all eight cDNA clones derived from
      subgenomic RNA4. However, heterogeneity was observed in the nucleotide sequence
      surrounding the junction sites of the cDNA clones derived from subgenomic RNAs 2,
      3, 5, 6 and 7. This heterogeneity suggests that the fusion of the leader to the
      body of the subgenomic RNA may be imprecise. The junction sites of the six
      subgenomic RNAs had a conserved sequence motif of six nucleotides (UCAACC or a
      highly similar sequence). The distance between the junction site and the
      translation initiation codon of the downstream open reading frame varied from
      nine to 83 nucleotides.

PMID- 8345362
TI  - St Louis encephalitis virus establishes a productive, cytopathic and persistent
      infection of Sf9 cells.
AB  - The Sf9 cell line, commonly used for gene expression by recombinant baculovirus,
      has been productively infected by St Louis encephalitis (SLE) virus, a
      flavivirus. SLE viral infection produced a c.p.e. in the Sf9 cells characterized
      by giant cells and the presence of 10-fold fewer cells in the infected cultures
      after the first week of infection compared with uninoculated control cultures.
      Infected Sf9 cells expressed SLE viral antigens, and intracellular virus
      particles were observed by electron microscopy. Titres of cell-associated SLE
      virus rose slightly over an 8 week period, whereas titres of cell-free virus
      remained stable, suggesting that SLE virus establishes a productive and
      persistent infection of Sf9 cells. The SLE virus produced by the Sf9 cells could
      be neutralized by SLE virus-immune mouse ascitic fluid, and no evidence of escape
      mutants was detected. Sf9 cells persistently infected with SLE virus could be
      superinfected with a recombinant baculovirus and expressed recombinant antigen.
      The successful infection of Sf9 cells by SLE virus represents the first report of
      production of c.p.e. by SLE virus in insect cells under routine cell culture
      conditions and of the infection of Sf9 cells by a human pathogen.

PMID- 8345363
TI  - Sequence and structure of defective interfering RNAs associated with cucumber
      necrosis virus infections.
AB  - The presence of symptom-attenuating defective interfering (DI) RNAs in a
      laboratory culture of cucumber necrosis tombusvirus (CNV) was confirmed.
      Sequencing of cDNA clones of these DI RNAs revealed that CNV DI RNAs retained
      sequences from the CNV 5'-untranslated and 3'-terminal regions as well as a
      portion of the coding region for the 92K protein. Similar sequence arrangements
      were also observed in symptom-attenuating DI RNAs generated de novo from
      synthetic wild-type CNV transcripts. A comparison of the sequences and biological
      activities of these CNV DI RNAs is presented. In co-infections of synthetic wild
      type CNV and CNV DI RNAs, prominent RNA species of a higher M(r) than the DI RNA
      used in the co-infection were found. The possible nature of these RNA species is
      discussed.

PMID- 8345364
TI  - The involvement of cowpea mosaic virus M RNA-encoded proteins in tubule
      formation.
AB  - On the surface of cowpea protoplasts inoculated with cowpea mosaic virus (CPMV),
      tubular structures containing virus particles have been found. Such tubular
      structures are thought to be involved in cell-to-cell movement of CPMV in cowpea
      plants. To study the involvement of the 58K/48K and capsid proteins of CPMV in
      the formation of the tubular structures, mutations were introduced into M cDNA
      clones from which infectious transcripts could be derived. No tubules were found
      on protoplasts inoculated with a mutant that fails to produce the 48K protein nor
      with a mutant that has a deletion in the 48K coding region, suggesting that the
      48K protein is essential for this process. However, a possible role of the 58K
      protein in tubule formation could not be excluded. A mutant that fails to produce
      the capsid proteins did produce tubules and therefore the capsid proteins are not
      involved in the formation of the tubular structures. Electron microscopic
      analysis revealed that the tubules produced by this mutant are, apart from the
      absence of virus particles, morphologically identical to the tubules formed by
      the wild-type virus.

PMID- 8345365
TI  - Immunocytochemistry of B-50 (GAP-43) in the spinal cord and in dorsal root
      ganglia of the adult cat.
AB  - The distribution of the neural-specific growth associated protein B-50 (GAP-43),
      which persists in the mature spinal cord and dorsal root ganglia, has been
      studied by light and electron microscopic immunohistochemistry in the cat.
      Throughout the spinal cord, B-50 immunoreactivity was seen confined to the
      neuropil, whereas neuronal cell bodies were unreactive. The most conspicuous
      immunostaining was observed in the dorsal horn, where it gradually decreased from
      superficial laminae (I-II) toward more ventral laminae (III-V), and in the
      central portion of the intermediate gray (mainly lamina X). In these regions, the
      labelling was localized within unmyelinated, small diameter nerve fibres and axon
      terminals. In the rest of the intermediate zone (laminae VI-VIII), B-50
      immunoreactivity was virtually absent. The intermediolateral nucleus in the
      thoracic and cranial lumbar cord showed a circumscribed intense B-50
      immunoreactivity brought about by the labelling of many axon terminals on
      preganglionic sympathetic neurons. In motor nuclei of the ventral horn (lamina
      IX), low levels of B-50 immunoreactivity were present in a few axon terminals on
      dendritic and somal profiles of motoneurons. In dorsal root ganglia, B-50
      immunoreactivity was mainly localized in the cell bodies of small and medium
      sized sensory neurons. The selective distribution of persisting B-50
      immunoreactivity in the mature cat throughout sensory, motor, and autonomic areas
      of the spinal cord and in dorsal root ganglia suggests that B-50-positive systems
      retain in adult life the capacity for structural and functional plasticity.

PMID- 8345366
TI  - Distribution of three retinal proteins in developing octopus photoreceptors.
AB  - The expression of proteins unique to plasma membrane domains of developing
      photoreceptors is used as a marker for retinal differentiation in vertebrates.
      Invertebrate photoreceptors are also compartmentalized, but little information is
      available on the development of these compartments or the expression of retinal
      proteins specific to these cellular regions. Using routine electron microscopy
      techniques, we have made observations on the formation of photoreceptor
      organelles, including myeloid bodies and rhabdomeres, in embryonic octopus eyes
      from an early stage in development through hatching. Immunocytochemical
      experiments on the embryos demonstrate a timed expression of three retinal
      proteins during development, and the early separation of the octopus
      photoreceptor plasma membrane into distinct domains. Using polyclonal antibodies
      for opsin, retinochrome and retinal binding protein we have shown that opsin
      appears first and is confined to the distal end of the photoreceptor that will
      eventually differentiate into rhabdomeres. This membrane domain is separated from
      the proximal/inner segment plasma membrane by a septate junction. Retinochrome is
      expressed later when the myeloid bodies appear in the inner segments, and retinal
      binding protein is apparently not synthesized until sometime after hatching.
      These results suggest that, in the cephalopod retina, protein components of the
      retinoid cycling apparatus appear in a specific developmental sequence during the
      differentiation of this tissue.

PMID- 8345367
TI  - Observations on the progress of Wallerian degeneration in transected peripheral
      nerves of C57BL/Wld mice in the presence of recruited macrophages.
AB  - The first part of this study is a description of the effect of the intraneural
      injection of lysophosphatidyl choline into the sciatic nerves of C57BL/Wld mice.
      This mouse is unusual because its peripheral nerve fibres degenerate very slowly
      after transection, and few myelomonocytic cells are recruited into the
      endoneurium after traumatic injury. However, intraneural injection of
      lysophosphatidyl choline produced a typical demyelinating lesion in which
      recruited macrophages were active in removal of myelin. In the second part of the
      study, nerves were transected either before, at the same time as, or some days
      after, the intraneural injection of lysophosphatidyl choline into the distal
      stump; the changes within the endoneurium were compared with those seen in distal
      stumps which had not been injected with lysophosphatidyl choline.
      Immunohistochemical and ultrastructural examination during the period 1-4 weeks
      after transection showed that degeneration occurred in the portion of each nerve
      which had been injected with LPC (and which therefore contained exogenous
      macrophages) but failed to occur in the portion of nerve which was not penetrated
      by the injected bolus of lysophosphatidyl choline. It is suggested that the
      unusual property of sealing off of the tips of the transected axons within the
      distal stumps may be a significant factor in maintaining 'normal' Schwann cell
      axon relationships along transected axons, even though the axons are separated
      from their cell bodies. Lysophosphatidyl choline destabilises the Schwann cell
      axon relationship by initiating myelin breakdown within the Schwann cell. It is
      suggested that while the Schwann cells remain closely associated with the axons
      in the distal stumps, they do not behave as denervated cells and consequently may
      be incapable of signalling their damaged status.

PMID- 8345368
TI  - Near-infrared monitoring of the cerebral circulation.
AB  - Near-infrared spectroscopy is a noninvasive bedside technique for monitoring
      hemoglobin saturation (HbO2%) in brain vasculature. The method linearly relates
      the optical signal detected from the surface of the head to HbO2%. To do so, the
      method relies on constant transcranial optical pathlength and light scattering as
      well as minimal interference by tissues overlying the brain. This study examined
      these premises. Optical signals from a dual-wavelength, near-infrared
      spectrometer were correlated with sagittal sinus HbO2% in 7 anesthetized piglets
      subjected to 7 different physiological conditions: normoxia, moderate and severe
      hypoxia, hyperoxia, hypocapnia, hypercapnic hyperoxia, and hypotension. These
      conditions were induced by varying the inspired O2 concentration (7-100%),
      ventilatory rate (5-35 breaths/min), and blood pressure (phlebotomy 20 ml/kg) to
      force HbO2% over a wide range (5-93%). To evaluate interference by tissues
      overlying the brain, correlations were repeated after the scalp and skull were
      rendered ischemic. Transcranial optical pathlength was measured by phase
      modulated spectroscopy. Linear relationships between optical signals and sagittal
      sinus HbO2% were found with correlation coefficients ranging from -0.89 to -0.99
      (p < 0.05) among animals; however, slope and intercept had coefficients of
      variability of approximately 15 and 333%, respectively. Almost identical linear
      expressions were observed whether scalp and skull were ischemic or perfused.
      Transcranial optical pathlength was constant in each animal, but ranged from 10
      to 18 cm among animals. The data indicate that the assumptions underlying near
      infrared spectroscopy are reasonably accurate in a given animal, but that the
      constants for transcranial optical pathlength and light scattering are not the
      same in all animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345369
TI  - Clinical experience with a fiberoptic intracranial pressure monitor.
AB  - Retrospective clinical experience with our first 46 patients monitored with a
      fiberoptic intracranial pressure device is described. In 43 of 46 patients, the
      transducer was introduced into brain parenchyma. A ventriculostomy system was
      used in 3 of 46 patients. The monitoring system was generally characterized by
      ease of placement and system maintenance and by technical simplicity. Several
      problems were encountered, including breakage of system components (12%),
      erroneous readings requiring transducer repositioning (8.6%), epidural hematoma
      (3.4%), and infection (1.7%). No infections or hematomas occurred in the 3 cases
      in which the ventriculostomy system was used. Overall, our experience with the
      Camino intracranial pressure fiberoptic monitoring system confirms previous
      reports of its favorable features.

PMID- 8345370
TI  - Electroencephalogram spectral edge frequency, lower esophageal contractility, and
      autonomic responsiveness during general anesthesia.
AB  - Both the electroencephalogram (EEG) spectral edge frequency (SEF) and lower
      esophageal contractility (LEC) indices have been reported to be useful indicators
      of anesthetic depth. We designed a prospective study to evaluate the relationship
      between changes in these two variables and objective measurements of physiologic
      responsiveness to surgical stress (i.e., changes in hemodynamic variables and
      plasma levels of norepinephrine, epinephrine, total catecholamines, and
      vasopressin). Eighty-nine consenting adult males undergoing radical prostatectomy
      procedures under a standardized general anesthetic technique were studied
      according to a randomized, single-blinded protocol. General anesthesia was
      induced with 30 micrograms/kg intravenous (i.v.) alfentanil, 2.5 mg/kg i.v.
      thiopental, and 0.1 mg/kg i.v. vecuronium, and subsequently maintained with 0.5
      microgram/kg/min alfentanil, nitrous oxide (N2O) 67% in oxygen, and 0.8
      microgram/kg/min vecuronium. Following retropubic dissection, 81 patients (92%)
      manifested acute hypertensive responses, with mean arterial pressure increasing
      from 90 +/- 14 to 122 +/- 14 mm Hg (mean +/- SD). This acute hypertensive
      response was treated with one of three different treatment modalities (20 to 60
      micrograms/kg i.v. alfentanil, 0.5 to 2.0% inspired isoflurane, or 0.05 to 0.15
      mg/kg i.v. trimethaphan) to return the mean arterial pressure to within 10% of
      the preincisional (baseline) value within 5 to 10 minutes. Although the mean
      arterial pressure, heart rate, and plasma levels of catecholamines and
      vasopressin significantly increased following the surgical stimulus, and
      decreased after adjunctive therapy, the EEG-SEF and LEC index (LECI) values did
      not significantly change during these study intervals. Furthermore, using a
      logistic regression analysis, we observed that preincision EEG-SEF and LECI
      values could not predict whether patients would manifest a hypertensive response.
      Therefore, the EEG-SEF and LECI were unreliable indicators of anesthetic depth.

PMID- 8345371
TI  - Spinal evoked potential in patients undergoing thoracoabdominal aortic
      reconstruction: a prognostic indicator of postoperative motor deficit.
AB  - We studied 76 patients who had thoracoabdominal aortic reconstruction between
      January 1981 and March 1991. Evoked potential monitoring of the spinal cord
      (peridural bipolar catheter stimulation at level L4-L5, recording via a second
      bipolar catheter at level Th4) was used to predict intraoperatively a possible
      motor deficit. There was a close linear correlation of r = 0.892 between
      postoperative motor deficit (normal, paraparesis, paraplegia) and the time from
      declamping to reappearance of the potential. Forty-three of 76 patients received
      prostaglandin E1 (5 ng/kg/min) for pharmacologic protection of the spinal cord 15
      minutes before onset of clamping and through the entire clamping period. Patients
      with protection had a loss of their potential significantly later (20.2 min; p <
      0.05) than those patients who had not received any pharmacologic treatment (15.2
      min). Pharmacologic protection also resulted in a reduced incidence of
      postoperative neurologic deficit and paraplegia when compared with patients
      receiving no treatment (25% vs 5%). These data suggest that spinal evoked
      potentials may be very useful for monitoring during these hazardous cases. They
      also suggest that pharmacologic protection before clamping may help preserve the
      function of the spinal cord during aortic clamping.

PMID- 8345372
TI  - Somatosensory evoked potential, a prognostic tool for the recovery of motor
      function following malperfusion of the spinal cord: studies in dogs.
AB  - The potential usefulness of somatosensory evoked potential monitoring during
      aortic cross-clamping is slowly being realized. In addition, the protection of
      endangered spinal nervous tissue during aortic cross-clamping has not been
      sufficiently evaluated. To test the pharmacologic protective efficacy of various
      agents, we recorded spinal evoked somatosensory potentials (bipolar epidural
      catheter) in dogs under controlled conditions (N2O/O2-enflurane anesthesia)
      following clamping of the aorta for 1 hour. There were 5 groups of animals: those
      treated with different medications, such as prostaglandin E1 (PGE1), prostacyclin
      (PGI2), superoxide dismutase (SOD), and PGE1 plus SOD for pharmacologic
      protection during ischemia, and the controls. The time to recovery of evoked
      potentials during the reperfusion period was 36 minutes in the controls, 15.9
      minutes in the SOD group (p < 0.01), 12.5 minutes in the PGE1 group (p < 0.001),
      10.8 minutes in the PGI2 group (p < 0.001), and 3.8 minutes in the combination
      group (p < 0.001). In addition, treatment resulted in a better neurologic outcome
      on the seventh postoperative day when compared with the control group. While in
      the control group only 1 animal could walk (9%), 7 of 12 in the PGE1 group (58%),
      4 of 12 in the SOD group (33.8%), 8 of 12 in the PGI2 group (66.7%), and all
      animals in the combination group (100%) could walk. We computed an exponential
      correlation that related the mean time of potential recovery during reperfusion
      with Tarlov scoring (grade 0 = paraplegia; grade 1 = paraplegia with little
      movements; grade 2 = paraparesis; grade 3 = paraparesis with some problems; grade
      4 = normal motor function) in the various groups.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8345373
TI  - Evaluation of five small turbine-type respirometers used in adult anesthesia.
AB  - OBJECTIVE: The purpose of this study was to determine the accuracy of five
      rotating vane or turbine-type respirometers--fdE Magtrak Respiratory Monitor, fdE
      Haloscale Standard Wright Respirometer, Micro-Medical Pocket Monitor II, and
      Ohmeda 5400 and 5410 Volume Monitors--which are marketed as suitable for
      measuring expired gas volume in anesthetized adult patients. METHODS: The devices
      were tested for accuracy at simulated minute ventilations ranging from 2.4 to 15
      L/min with three gas mixtures: air, air saturated with water vapor, and N2O/O2
      (70:30). RESULTS: In the usual range for adult minute ventilation during general
      anesthesia with intermittent positive-pressure ventilation (5-12 L/min), all
      devices were on average accurate to within 12%. At the lowest minute volume
      readings (2.4 L/min) all devices except the Pocket Monitor tended to have low
      readings. No significant differences in readings were introduced by either
      saturation with water vapor or introduction of 70% N2O, except with ventilation
      below 4 L/min with both Ohmeda respirometers. CONCLUSIONS: All monitors showed
      reasonable clinical accuracy in the usual adult minute ventilation range during
      general anesthesia with intermittent positive-pressure ventilation (> 5 L/min)
      when used to measure air, water vapor-saturated air, or N2O/O2 mixtures.

PMID- 8345374
TI  - A reference system in clinical anesthesia.
AB  - We have developed, as a pilot project, a hypertext-based reference system for
      anesthesia in a neurosurgical clinic. The intention is to give passive decision
      support prior to the operation. The information is presented according to the
      different needs and knowledge levels of the anesthesiologists. Therefore, with
      the aid of a simple and universal user interface (mouse and screen keys, no
      keyboard) the information is structured from basic to more detailed information.
      To complete the operation-related material the system also offers relevant data
      from the "anesthesia-related background knowledge" (pre-existing diseases, drugs,
      and medication, etc.). As an example, a short path through the system is shown to
      illustrate the presentation and linkage of information.

PMID- 8345375
TI  - Capnography does not reliably detect double-lumen endotracheal tube malplacement.

PMID- 8345376
TI  - Right heart, right principle, wrong catheter.

PMID- 8345377
TI  - A simple index for ventriculoarterial coupling.

PMID- 8345378
TI  - The new health culture: tradition in turmoil.

PMID- 8345379
TI  - Persistent pulmonary hypertension of the newborn infant. Comparison of
      conventional versus extracorporeal membrane oxygenation in neonates fulfilling
      Bartlett's criteria.
AB  - Persistent pulmonary hypertension of the newborn (PPHN) is a challenge for the
      neonatologist and a common indication for treatment with extracorporeal membrane
      oxygenation (ECMO) when medical management fails. We observed 132 neonates born
      between January 1985 and December 1988 with the diagnosis of persistent pulmonary
      hypertension of the newborn: 73 (55%) met the Bartlett criteria for treatment
      with ECMO with 80% predicted mortality; 21 (29%) deteriorated despite
      conventional medical treatment, were thought to be dying, and were sent for ECMO.
      Among the 52 patients who were medically treated 40 (77%) survived, a marked
      difference compared with a predicted 20% survival. All ECMO-treated neonates
      survived. Although conventionally treated infants showed a trend toward less
      dependence on supplemental oxygen at > 28 days of life, this study failed to
      detect a significant difference between those two groups. We conclude that
      mortality was lower for ECMO-treated infants than for those who were medically
      treated (0 of 21 vs 12 of 52, p < 0.05); mortality for infants with persistent
      pulmonary hypertension of the newborn who met Bartlett's criteria and were
      medically treated was lower than published data; and there was no significant
      difference in oxygen dependence at > 28 days between the survivors who received
      ECMO and those who received medical therapy.

PMID- 8345380
TI  - Intrapartum hydramnios at term and perinatal outcome.
AB  - The objective of this study was to compare the intrapartum outcome among laboring
      patients with hydramnios (amniotic fluid index > or = 24.0 cm) versus those with
      adequate fluid (amniotic fluid index > 5.0 and < 24.0 cm). Prospectively, during
      a 2-year period, 341 patients in early labor underwent four-quadrant measurement
      of amniotic fluid volume. Forty-two patients had intrapartum oligohydramnios
      (amniotic fluid index < or = 5.0 cm) and were excluded from further analysis. The
      study compares the outcome between 277 subjects with adequate fluid and 22 with
      hydramnios. The intrapartum amniotic fluid index, birth weight, incidence of
      macrosomia (birth weight > or = 4000 gm), shoulder dystocia, cesarean section for
      fetal distress or cephalopelvic disproportion, Apgar score, and neonatal
      malformations were noted in each of the 299 subjects. Umbilical arterial blood
      gas was analyzed in 189 patients. In this study, 22 women with hydramnios had a
      significantly higher risk of delivering a macrosomic fetus than the 277 patients
      with a normal index (36.3% vs 13.7%; p = 0.01). There was no significant
      difference in the incidence of shoulder dystocia, cesarean section for
      cephalopelvic disproportion, or fetal distress, Apgar scores < 7 at 1 and 5
      minutes, fetal acidosis, or neonatal anomalies. We conclude that hydramnios
      during the intrapartum period in patients at term is significantly associated
      with delivery of a macrosomic fetus, but not with delivery of a compromised
      neonate.

PMID- 8345381
TI  - User-friendly computerized quality assurance program for regionalized neonatal
      care.
AB  - In October 1983 a computerized data base system was implemented to perform
      quality assurance in the neonatal referral region of the University of Michigan.
      This system was customized to match and expand forms and reports already in use.
      It is menu driven, requires only rudimentary skills, and is compatible with
      existing computer equipment. To assess the effectiveness of the program in
      monitoring and improving neonatal care within the region, data from the first
      full year (1984) were compared with data from the last full year (1990).
      Statistically significant changes were found for referring physician presence at
      transfer, a greater assumption of initial stabilization procedures by community
      hospital personnel (continuous cardiorespiratory monitoring, orogastric tube
      placement, provision of respiratory support, blood glucose screening, blood gas
      evaluation, blood culturing, and antibiotic therapy), and an overall improvement
      in patient status before transfer. Review of reports generated by data analysis
      enables design of educational programs that are hospital specific and that focus
      on problems or deficiencies determined during quality assurance conferences. The
      chief benefit of this system is the provision of an objective basis for
      constructive criticism, which leads to both cognitive and behavioral changes in
      care providers and ultimately improves the delivery of care to neonates.

PMID- 8345382
TI  - Pump administration of exogenous surfactant: effects on oxygenation, heart rate,
      and chest wall movement of premature infants.
AB  - Adverse reactions of infants to surfactant administration include loss of chest
      wall movement and decrease in oxygen saturation and heart rate. We are aware of
      no previous studies addressing the administration of surfactant. We studied 22
      infants with respiratory distress syndrome to determine whether these adverse
      reactions could be reduced by giving surfactant slowly by microinfusion syringe
      pump. Loss of chest wall movement was significantly greater in infants receiving
      surfactant by the hand-dosing method as compared with administration of
      surfactant by pump. A significant increase in ventilator pressure interventions
      was observed when surfactant was given by standard hand bolus method compared
      with pump infusion. Heart rate and oxygen saturation did not differ significantly
      between the two techniques. These findings suggest that pump administration of
      surfactant minimized potential airway obstruction; thus it may be an alternative
      to standard bolus dosing techniques.

PMID- 8345383
TI  - Increased mortality in neonates with low thyroxine values.
AB  - Serum thyroxine values were determined prospectively over a 6-month interval in
      97 newborn infants with birth weight < 2200 gm or gestational age < 37 weeks.
      There were 89 survivors and 8 deaths. Infants with thyroxine values of < 2.5
      micrograms/dl (32.2 nmol/L) had a significantly higher mortality rate (p < 0.001)
      compared with infants with higher thyroxine levels. In neonates there may exist a
      critical thyroxine value below which there is an increased risk of mortality.

PMID- 8345384
TI  - Effect of position on pulmonary mechanics in healthy preterm newborn infants.
AB  - Preterm infants are often placed in the supine position to facilitate care and
      observation. Prone positioning may positively affect later neurodevelopmental
      outcome, but it may also affect pulmonary function. Using a computerized system,
      we examined the effect of positioning on pulmonary mechanics in spontaneously
      breathing healthy preterm infants. Eleven infants with a mean birth weight (+/-
      SD) of 1523 +/- 171 gm and a mean gestational age (+/- SD) of 31.7 +/- 1.5 weeks
      were studied during the first 2 weeks of life. Pulmonary mechanic measurements
      were obtained in both supine and prone positions by mask pneumotachography and
      esophageal balloon technique. Respiratory rate and oxygen saturation were
      unaffected by positioning. There was a statistically, but not clinically,
      significant increase in heart rate in the prone position. However, there were no
      significant differences in tidal volume, minute ventilation, pulmonary
      resistance, or dynamic compliance between positions. The contribution of
      intrasubject variability of serial measurements was assessed in a separate group
      of four infants studied three times in the same position. There was no
      significant difference in respiratory rate, tidal volume, dynamic compliance per
      kilogram, or total pulmonary resistance in the same infant when studied in the
      same position over time (p > or = 0.24). The maximum variability (95% confidence
      limit) was 25.5% for tidal volume, 21% for dynamic compliance, and 44.3% for
      resistance. Because prone positioning did not adversely affect pulmonary
      mechanics or oxygen saturation in these healthy preterm infants, we suggest that
      prone position be used to facilitate the developmental needs of these infants.

PMID- 8345385
TI  - Failure of intrapartum antibiotics to prevent culture-proved neonatal group B
      streptococcal sepsis.
AB  - Early-onset group B streptococci (GBS-EOS) sepsis may be prevented by intrapartum
      antibiotics administered for GBS maternal colonization, premature labor, or
      prolonged rupture of membranes. We sought to identify cases of neonatal GBS
      sepsis after apparent failure of intrapartum chemotherapy and to determine the
      factors associated with failure of intrapartum antibiotics in these cases. We
      identified 96 GBS blood culture-positive infants at five military medical centers
      from 1987 to 1990. Eighteen (18.7%) of these infants had mothers who had received
      intrapartum antibiotics; 16 of 18 cases were early-onset disease, 15 of which
      initially had symptoms at less than 1 hour of age. Two infants had late-onset
      disease develop at 3 weeks of age. At least one perinatal risk factor
      (prematurity, prolonged rupture of membranes > 12 hours, maternal fever) was
      present in each of the 16 cases. Indications for intrapartum antibiotics were
      suspected chorioamnionitis (13 cases), GBS colonization and prolonged rupture of
      membranes or prematurity (3), and GBS colonization alone (2). Maternal
      antibiotics included ampicillin (14 cases), cephadyl (1), vancomycin (1),
      clindamycin (1), and gentamicin alone (1). The median number of doses of
      ampicillin before delivery was 1 (range, 1 to 21), which was administered at a
      median of 4 hours (range, 1 to 84) before birth. The mean dose of ampicillin was
      1.8 gm/dose (range, 1 to 2 gm/dose). Two of 16 (12.5%) infants with GBS-EOS died
      as a result of GBS sepsis. In our population of neonates with GBS-EOS, 18.4% (16
      of 87) of the infants had positive blood cultures despite intrapartum
      antibiotics. Intrapartum antibiotics may fail to prevent GBS sepsis in a number
      of infants born to mothers colonized with GBS or to those with acute
      chorioamnionitis.

PMID- 8345386
TI  - Impact of a Resource-Based Relative Value Scale fee schedule on reimbursements to
      neonatologists.
AB  - We investigated the possible effect of the Resource-Based Relative Value Scale
      (RBRVS) fee schedule on reimbursements for neonatologists. This payment system
      may prove attractive to most third-party payers and is predicted to result in
      lower procedural reimbursement, which is a significant component of neonatal
      care. We studied the charges and reimbursements for the portion of our intensive
      care nursery patient population covered by Medicaid for a 1-year period. Total,
      procedural, and nonprocedural reimbursements under three current systems and the
      RBRVS were compared. The RBRVS system produced overall improved reimbursement
      compared with Medicaid, but decreased reimbursement compared with the other two
      systems. Nonprocedural services were relatively better reimbursed than procedural
      services. The impact of RBRVS will depend on the population mix of third-party
      payers, the proportion of nonprocedural charges in a particular neonatal
      intensive care unit, and the conversion factor used by the third-party payer.

PMID- 8345387
TI  - New approaches for the treatment of neonatal sepsis.

PMID- 8345388
TI  - Subgaleal hematoma causing hypovolemic shock during delivery after failed vacuum
      extraction: a case report.
AB  - Subgaleal hematomas are potentially lethal intracranial bleedings, occurring most
      commonly in the neonate after difficult vacuum extraction. We report a case of
      hypovolemic shock occurring at birth after failed extraction and subgaleal
      bleeding. Subgaleal hematomas may form because of preexisting risk factors (e.g.,
      coagulopathy), but vacuum extraction itself predisposes an infant toward
      subgaleal bleeding. Although the frequency of these bleedings has decreased with
      introduction of silicone extraction cups, the risk of subgaleal bleeding after
      vacuum extraction continues to be increased for primiparous women; severe
      dystocia, occiput lateral or posterior head presentations; and repeated,
      forceful, or prolonged use of vacuum suction. The presence of ballotable cranial
      fluid collections and signs of volume loss in a neonate raise the possibility of
      subgaleal bleeding. Treatment, if the subgaleal hematoma is symptomatic, requires
      restoration of blood volume and control of bleeding, inasmuch as these hematomas
      can be fatal if not treated. Prevention may require limitation of the frequency
      and duration of vacuum assistance in high-risk infants.

PMID- 8345389
TI  - Diabetic ketoacidosis after steroid administration for bronchopulmonary
      dysplasia: a case report.

PMID- 8345390
TI  - Neonatal radiology casebook. Neonatal lactobezoar.

PMID- 8345391
TI  - Fetal heart rate monitoring casebook. Precipitate labor and fetal heart rate
      monitoring.

PMID- 8345392
TI  - Special imaging casebook. Periventricular leukomalacia.

PMID- 8345393
TI  - Overestimation of neonatal PO2 by collection of arterial blood gas values with
      the butterfly infusion set.

PMID- 8345394
TI  - [Cases of lethal midline granuloma (polymorphic reticulosis) at our department in
      a recent 10-year period].
AB  - We had 18 patients (15 males and 3 females) with lethal midline granuloma
      (polymorphic reticulosis) in the period from 1981 to 1990. This number was about
      5.6% of the total number of patients with malignant head and neck tumors that we
      encountered during this period. An average of 9.1 months separated the first
      appearance of disease and the beginning of treatment. Most of the 18 patients
      underwent both radiation therapy and chemotherapy (COP, CHOP, MACOP-B), but,
      since their disease had reached an advanced stage, 3 underwent radiation therapy
      only, 3 underwent chemotherapy only, and 1 received no radical therapy at all. Of
      the 18 patients, 13 died of the disease. In of 6 of these, the disease was
      confined to the local lesion. The 5-year cumulative survival rate was 15.7%
      (Kaplan-Meier). Fourteen autopsy studies revealed that tumor cells had invaded
      the liver (92.8%), lung (92.8%) and spleen (71.4%) and in all cases it was in
      leukemic patterns. Fifteen cases were studied for tumor surface marker phenotype,
      but none was found to be positive for L26, CD43, Leu M1 (CD15), or MAC 387. Five
      cases were positive for UCHL-1 (CD45RO) and 10 cases were positive for lysozyme.
      All cases were positive for Ki-1 (CD30).

PMID- 8345395
TI  - [Three cases of aspiration caused by cerebrovascular disorder that were managed
      with total laryngectomy].
AB  - Total laryngectomy can be used to prevent aspiration pneumonia in patients with
      severe dysphagia, though caution is required with regard to the indications. In
      this paper, we describe 3 patients in whom severe dysphagia developed as a result
      of cerebrovascular disorders, and who repeatedly developed aspiration pneumonia.
      We managed them with total laryngectomy, and this has prevented aspiration
      pneumonia in all three. Oral feeding became possible in two of these patients,
      and home care became possible for one. This report includes a discussion based on
      the literature, and includes preoperative evaluation and indications for
      laryngectomy.

PMID- 8345396
TI  - [Laryngeal control mechanisms during respiration and phonation analyzed by
      excitability changes of laryngeal motoneurons in decerebrate cats].
AB  - Laryngeal motoneurons (LMNs) innervating the intrinsic laryngeal muscles also
      control glottal movements such as swallowing, respiration and phonation. The
      present study was performed on decerebrate cats to clarify the laryngeal control
      mechanisms during respiration and phonation using extracellular single unit
      recordings from the nucleus ambiguus. First, functional differences among LMNs
      during the respiratory phases were investigated by analysis of the activity of
      LMNs innervating laryngeal adductor (TA-LCA: thyroarytenoid-lateral
      cricoarytenoid) or abductor (PCA: posterior cricoarytenoid) muscles; Second,
      laryngeal control mechanisms during phonation were investigated by the analysis
      of neural activity of TA-LCA motoneurons during vocal fold vibration elicited by
      a constant air flow through the glottis. In both cases, motoneuronal excitability
      changes were expressed by measuring fluctuation of peak latencies of action
      potentials antidromically elicited by selective stimulation of the recurrent
      nerve or its peripheral branch. In 14 out of 24 TA-LCA motoneurons, neuronal
      excitability was increased during the expiratory phase, whereas in the remaining
      10, it was increased during the later half of the inspiratory and the early half
      of the expiratory phase. On the other hand, 9 out of 13 PCA motoneurons showed
      increased neuronal excitability during the end of the expiratory and the
      beginning of the inspiratory phase, while the remaining 4 showed increased
      excitability during the inspiratory phase. These results suggest that there are
      functional differences among the homogeneous laryngeal motoneurons. In seven TA
      LCA motoneurons, neuronal excitability was decreased by vocal fold vibration
      elicited by phonation throughout the whole respiratory cycle. On the other hand,
      when the bilateral superior laryngeal nerves were cut, neuronal excitability was
      increased during phonation throughout the whole respiratory cycle. These results
      indicate that TA-LCA motoneurons receive inhibitory inputs from the superior
      laryngeal nerve and excitatory inputs from the recurrent laryngeal nerve during
      the vocal fold vibration elicited by phonation.

PMID- 8345397
TI  - [Idiopathic bilateral sensorineural hearing loss: clinical study of cases with
      rapidly progressed deafness].
AB  - In a series of 127 patients with idiopathic bilateral sensorineural hearing loss
      (IBSH) at the Hearing Clinic in the Department of Otolaryngology, Kitasato
      University Hospital, 20 cases showed rapid progression of hearing impairment.
      These patients had been treated with the same therapeutic regimen used in sudden
      deafness (S.D.). Improvement of hearing loss after treatment was generally less
      effective in the cases with rapidly progressed IBSH than in the cases with S.D.
      However, hearing improvement was achieved in some cases with rapidly progressed
      IBSH when the treatment had started in the early stages after the onset of
      rapidly progressive hearing loss. The mode of fluctuating hearing loss in the
      cases with rapidly progressed deafness was assumed to be similar to that in the
      group of all cases with IBSH.

PMID- 8345398
TI  - [A statistical analysis of sudden deafness].
AB  - The present study was carried out in order to determine factors which influenced
      the prognosis of sudden deafness and to try to predict the prognosis of sudden
      deafness, analyzed statistically by multivariate analysis. A total of 143
      patients with sudden deafness diagnosed and treated at the department of
      otolaryngology, Ebetsu Municipal General Hospital and Obihiro Kohsei Hospital
      between 1986 and 1991, were selected for this study. Statistical analysis
      disclosed the following. 1. A good hearing level at the initial visit, a low
      frequency hearing loss, the absence of vestibular symptoms and an initial visit
      within seven days after onset, indicate a good prognosis for sudden deafness. 2.
      Multivariate analysis showed that the hearing level at the initial visit most
      strongly influences sudden deafness, followed by the number of days from onset to
      initial visit, vestibular symptoms and the difference between low- and high
      frequency hearing level, in that order. 3. Furthermore, multivariate analysis
      showed that the prognosis of sudden deafness can be predicted at a level of
      78.3%, considering the above four factors. This facilitates treatment of patients
      with sudden deafness.

PMID- 8345399
TI  - [Changes in human spontaneous otoacoustic emissions with contralateral acoustic
      stimulation].
AB  - According to current cochlear concepts, spontaneous otoacoustic emissions (SOAEs)
      are thought to be the product of outer hair cell (OHCs) movement. Furthermore,
      efferent neurofibers from the olivocochlear bundle primarily innervate OHCs.
      Thus, we designed this investigation to determine changes in SOAE under
      conditions of contralateral acoustic stimulation. Fouty-two normal ears of 34
      subjects with uni- or bilateral SOAEs were examined. The sound pressure level
      (SPL) of SOAE was measured 3 times in each subject and was initially averaged.
      The white noises of 30 or 40dBSPL, believed not to affect the other side, were
      then loaded contralaterally and the SPL of SOAEs were measured and compared with
      the non-loaded data. The SPL of single SOAEs were actually suppressed with
      40dBSPL stimulation while the SPL of multiple SOAEs showed typical changes.
      Interestingly, no significant suppression of SOAEs was noticed under conditions
      of contralateral acoustic stimulation of the impaired ear. These data suggest
      that contralateral acoustic stimulation could affect OHC function via the
      olivocochlear bundle.

PMID- 8345400
TI  - [Multichannel cochlear implantation in a deaf child].
AB  - A multichannel cochlear implantation was performed in an 8-year-old child and the
      following results were obtained. The surgical procedures were not particularly
      difficult as compared to cochlear implantation for adults. Postoperative
      rehabilitation requires a longer time than in adult patients. Cochlear implants
      are useful not only for the recognition of environmental sound but also for the
      recognition of speech. Cooperation with the medical facility, as well teachers
      and family members, is essential.

PMID- 8345401
TI  - [Mild hearing loss in children with communication disorders].
AB  - The prevalence of MHL in 202, 1 to 6 year-old children with communication
      disorders who visited our clinic in 1991 was investigated. 1) 31% of the subjects
      had MHL bilaterally. The prevalence of MHL was 44% at age 1 year, 20% at age 2
      years, 36% at age 3 years, 24% at age 4 years, 39% at age 5 years, 33% at age 6
      years. 2) 88% of children with MHL had OME, 10% had mild sensorineural hearing
      loss, and 2% had cerminous plug. 3) The prevalence of MHL in children with mental
      retardation and autistic disorders was 9%, that with stuttering was 9%, that of
      OME accompanied by moderate and severe hearing disorders was 6%. 4) The primary
      causes in 191, except for those with stuttering, were as follows; the prevalence
      of MHL was 30%, that of mental retardation and autistic disorders was 24%, and
      that of articulation disorders was 28%. 5) On the other hand, the prevalence of
      MHL in children with retarded language development and articulation disorders was
      30%, which was significantly higher than that of the other communication
      disorders. Accordingly, the results of this study suggest that MHL in early
      childhood greatly influences communication disorders.

PMID- 8345402
TI  - [Antibody titers to bacterial antigens in middle ear effusion of otitis media
      with effusion].
AB  - Antibody titers against H. influenzae, S. pneumoniae, S. pyogenes, S. mitis, S.
      sanguis, and S. salivarius in middle ear effusions (MEE) of 46 children (60 ears)
      with chronic otitis media with effusion (OME) are reported. H. influenzae, S.
      pneumoniae and S. pyogenes are predominant microorganisms in acute suppurative
      otitis media. S. mitis, S. sanguis, and S. salivarius are major species of normal
      adenoid flora. Specific antibodies against the above bacterial species were
      detected in all samples. In the chronic group, IgG titers against H. influenzae,
      IgG and IgM against S. pneumoniae, IgG and IgM against S. pyogenes, and IgG
      against S. salivarius were statistically higher than in the acute and subacute
      groups. IgG, IgM and IgA titers against S. mitis and S. pneumoniae in MEE with
      chronic sinusitis were higher than those from sinusitis free children. Anti-S.
      sanguis and S. pyogenes IgG and IgA of sinusitis free patients' MEE were higher
      than those with chronic sinusitis. The antibody titers against H. influenzae did
      not differ statistically between those with and without sinusitis. The presence
      of anti-bacterial antibodies inhibits acute infection in MEE, and the difference
      in titers with sinusitis may be caused by bacterial numbers in the adenoids and
      the host's response to the bacteria.

PMID- 8345403
TI  - [Bacterial quantification and anti-bacterial antibodies in otitis media with
      effusion in children].
AB  - Quantification of bacterial flora in middle ear effusions (MEE) and adenoids in
      children with otitis media with effusion (OME) was performed. IgG, IgA and IgM
      titers against H. influenzae, S. pneumoniae, S. mitis, S. sanguis, and S.
      salivarius were measured in MEE, sera and the supernatant of adenoid lymphocyte
      cultures. The adenoid lymphocytes were stimulated by each inactivated bacteria
      species for 7 days, before antibody titers were measured. Seven species were
      detected in 6 of 18 MEE samples (33.3%). Six of these species were also detected
      in the adenoids of the same cases. Bacterial identification of flora in adenoids
      was as follows. S. pneumoniae: 8, H. influenzae: 4, B catarrhalis: 4, S. mitis:
      9, S. sanguis: 8, S. salivarius: 12 of cases. The antibody titers against
      bacteria from adenoids in MEE and the supernatant were significantly higher than
      those of the group in which no species were detected. These specific antibodies
      in MEE inactivate bacteria from the adenoid, but the immune complex probably
      plays some part in chronic inflammation of the middle ear.

PMID- 8345404
TI  - [Changes in the utricular otoconia of the chick embryo developed under 2G
      gravity].
AB  - Whether or not vestibular adaptation occurs upon exposure to altered gravity is
      an important human problem. Studies have been performed to ascertain whether
      morphological changes in vestibular organs occur in animal models upon exposure
      to microgravity. On the other hand, the morphological changes which occur in
      vestibular organs under hypergravity have not yet been fully elucidated and
      morphological changes in the otoconia of the chick embryo exposed to hypergravity
      during the embryonic period remain to be thoroughly examined. The purpose of this
      paper is to clarify the effects of hypergravity on vestibular organs, especially
      its effects on otoconial formation in the developing chick embryo. Thus, we
      designed an apparatus which creates artificial gravity, creating approximately 2G
      gravity by means of centrifugation. The utricular macula was chosen for study
      because it can be prepared for examination with a minimum of dissection
      artifacts. The data presented show that morphological changes were confined to
      otoconial size alterations according to scanning electron microscopic
      observations. Giant otoconia were observed along the marginal zones of utricle .

PMID- 8345405
TI  - Academic departments of histopathology and the UFC research selectivity exercise.

PMID- 8345406
TI  - C. L. Oakley Lecture (1993). Cellular and molecular aspects of hepatic fibrosis.
AB  - Hepatic fibrosis, a consequence of most forms of chronic liver disease, is a
      dynamic process involving complex interactions between several cell types, the
      net result of which is accumulation of several distinct extracellular matrix
      (ECM) proteins. The resultant disruption of intrahepatic blood flow contributes
      to the development of portal hypertension. The effects, however, are not merely a
      space-occupying phenomenon; by changing the composition of the ECM, fibrosis may
      also alter hepatocyte function via cellular integrins. The principal source of
      ECM proteins in normal and fibrotic liver is the perisinusoidal cells which lie
      in the space of Disse. The response of this cell population to acute and chronic
      liver injury has been studied in detail. Perisinusoidal cells proliferate and
      become activated following hepatocyte necrosis. This phenomenon is transient in
      acute injuries, but in chronic liver disease, continued activation is associated
      with phenotypic modulation of perisinusoidal cells to myofibroblasts. This
      process is mediated by various cytokines including TGF-beta and PDGF. Some of the
      growth factors involved are derived from activated Kupffer cells and there is
      evidence of a complex interplay between mediators; injured sinusoidal endothelial
      cells and platelets are possible additional sources. Accumulation of ECM proteins
      in fibrosis can be explained not only by increased synthesis, but also by
      decreased degradation. There is growing evidence that in fibrotic liver there is
      decreased interstitial collagenase activity. This is, at least in part, due to
      expression of a tissue inhibitor of metalloproteinase, TIMP-1, by activated
      perisinusoidal cells.

PMID- 8345407
TI  - An immunohistological study of cutaneous lymphocytes in vitiligo.
AB  - In a study of 49 biopsies from the margins of depigmented cutaneous lesions in 18
      patients with vitiligo, highly significant overall increases were found in CD3+,
      CD4+, and CD8+ T cells, though cell numbers in individual cases were often within
      the normal range. Many of the T cells were activated (MHC class II+, interferon
      gamma+), of CD45RO (UCHL1+) memory subset, and many expressed the cutaneous
      lymphocyte-associated antigen (HECA-452+) typical of skin-homing T cells.
      Immunohistologically, the most intense epidermal T-cell infiltration was present
      within 0.6 mm of the edge of the lesion in 10 of 13 double-stained sections with
      a clearly defined zone of melanocyte depletion. In 40 lesions from 17 patients
      seen 11-64 weeks after biopsy, no apparent association was found between T-cell
      numbers and disease activity as assessed by Kobnerization of biopsy wounds or
      spread of depigmentation. These findings are consistent with the hypothesis that
      lesional T cells rather than circulating antimelanocytic antibody may be
      responsible for the supposedly autoimmune but characteristically patchy
      destruction of cutaneous melanocytes in vitiligo. Nevertheless, many of the
      infiltrating T cells are probably innocent bystanders attracted by upregulated
      cell adhesion molecules near sites of melanocyte damage.

PMID- 8345408
TI  - Participation of macrophages in segmental endocapillary proliferation preceding
      focal glomerular sclerosis.
AB  - We studied infiltrating cells in the glomeruli of eight cases with focal
      segmental endocapillary proliferation (FSEP) using monoclonal antibodies to
      leukocyte common antigen, T cells, B cells, and monocytes/macrophages (Mo/M psi).
      It was demonstrated by sequential biopsies performed in five cases that FSEP
      preceded focal glomerular sclerosis (FGS). Cell types in FSEP were compared with
      those in FGS from 17 patients with persistent nephrotic syndrome, ten non
      nephrotic patients, and eight patients with nephrotic syndrome which was
      initially responsive to steroid therapy but relapsed, as well as minimal change
      specimens from nine nephrotic patients. In the glomeruli, the mean total
      leukocyte counts increased significantly in the FSEP group (P < 0.01). The serial
      sections in FSEP revealed that Mo/M psi were the predominant cells and were
      localized in areas of endocapillary proliferation. T-cell or B-cell infiltration
      was less marked. The extensive intracapillary distribution of p150,95 antigen
      belonging to the integrin family and acting as a C3bi receptor suggested that
      FSEP may be mediated by adhesion molecules expressed on Mo/M psi. These findings
      indicate that Mo/M psi may play a key role in FGS which shows endocapillary
      proliferation in the initial stage.

PMID- 8345410
TI  - Scatterbrain fetus.

PMID- 8345409
TI  - Immune complex degradation by cultured rat mesangial cells.
AB  - The binding and degradation of radiolabelled immune complexes by cultured rat
      glomerular mesangial cells were measured and compared with the binding and
      degradation by thioglycollate-elicited rat peritoneal macrophages. Mesangial
      cells are generally considered to be a modified pericyte with smooth muscle-like
      properties, but they were able to bind and degrade soluble immune complexes at
      rates comparable to those of the macrophages. In a second study, the ability of
      cultured mesangial cells to bind and degrade immune complexes of varying
      molecular weight was assessed. Very large, insoluble complexes were found to bind
      to mesangial cells more avidly than small soluble complexes, but unlike the small
      complexes, the large complexes did not appear to undergo degradation. These
      findings support a role for the intrinsic mesangial cell in the elimination of
      small soluble immune complexes as they arrive in the glomerulus. They also
      provide a possible explanation for the paradox that large immune complexes--i.e.,
      electron-dense deposits--can persist in the mesangium next to the intrinsic
      mesangial cells without being rapidly destroyed.

PMID- 8345411
TI  - Familial combined hyperlipidemia in children: clinical expression, metabolic
      defects, and management.
AB  - Familial combined hyperlipidemia (FCHL) is a dominantly inherited hyperlipidemia
      that occurs in at least 1% of the adult population and is responsible for 10% of
      premature coronary artery disease. In families referred for evaluation because of
      primary hyperlipidemia in a child, FCHL is expressed three times more commonly
      than familial hypercholesterolemia and half of the siblings are affected. Several
      metabolic defects apparently are associated with the FCHL phenotype. Most
      commonly, excess production of very low density lipoprotein apolipoprotein B can
      be demonstrated. In other families, reduced lipoprotein lipase activity is
      associated. One allele at a locus influencing apolipoprotein B levels predicts
      FCHL in a large proportion of families ascertained through affected children.
      Whether this allele is responsible for the excess of very low density lipoprotein
      apolipoprotein B detected in metabolic studies has not been elucidated.
      Management of FCHL in children begins with dietary modification. A bile acid
      sequestrant may be considered as well if diet cannot reduce the plasma low
      density lipoprotein cholesterol level to less than 4.13 mmol/L (160 mg/dl) after
      the age of 10 years. Although the hydroxymethylglutaryl-coenzyme A reductase
      inhibitors are not currently recommended for children younger than 19 years of
      age, we speculate that they will be increasingly utilized for the management of
      FCHL in teenage boys who continue to have low density lipoprotein cholesterol
      levels greater than 4.13 mmol/L (160 mg/dl) after dietary modification.

PMID- 8345413
TI  - Energy expenditure during walking and running in obese and nonobese prepubertal
      children.
AB  - We measured body composition and energy expenditure during walking and running on
      a treadmill in 40 prepubertal children: 23 obese children (9.3 +/- 1.1 years of
      age; 46 +/- 10 kg (mean +/- SD)) and 17 nonobese matched control children (9.2 +/
      0.6 years of age; 30 +/- 5 kg). Energy expenditure was assessed by indirect
      calorimetry with a standard open-circuit method. At the same speed of exercise,
      the energy expenditure was significantly (p < 0.01) greater in obese than in
      control children, in both boys and girls. Expressed per kilogram of body weight
      or per kilogram of fat-free mass, the energy expenditure was comparable in the
      two groups. Obese children had a significantly (p < 0.01) larger pulmonary
      ventilatory response to exercise than did control children. Heart rate was
      comparable in boys and girls combined but significantly higher (p < 0.05) in
      obese subjects, if boys and girls were analyzed separately. These data indicate
      that walking and running are energetically more expensive for obese children than
      for children of normal body weight. The knowledge of these energy costs could be
      useful in devising a physical activity program to be used in the treatment of
      obese children.

PMID- 8345412
TI  - Association among serum lipid and lipoprotein concentrations and physical
      activity, physical fitness, and body composition in young children.
AB  - OBJECTIVE: To examine the relationships among indicators of physical activity,
      physical fitness, and body composition with serum lipid and lipoprotein levels in
      young children. DESIGN: Cross-sectional and 1-year prospective cohort. SETTING:
      Studies of Child Activity and Nutrition (SCAN) program, Galveston, Tex. SUBJECTS:
      One hundred twenty-three 4- or 5-year-old black, Hispanic (of Mexican origin),
      and white children. MEASUREMENTS: Body composition, resting heart rate, and
      cardiovascular fitness variables and serum lipid and lipoprotein levels were
      measured at age 3 or 4 years (study year 1) and at age 4 or 5 years (study year
      2), and day-long heart rate was measured and the Children's Activity Rating Scale
      was administered between study years 1 and 2. RESULTS: Year-1 waist/hip ratios
      were inversely correlated with total serum cholesterol (TSC) and low-density
      lipoprotein (LDL) levels. Mean activity level was inversely correlated with
      waist/hip ratios. On the basis of multiple regression analysis, the sum of seven
      skin-fold measurements, height, and gender explained 15.4% of the variation in
      triglyceride levels. The sum of seven skin-fold measurements was inversely
      correlated with the high-density lipoprotein (HDL) level. Resting heart rate,
      waist/hip ratio, and the slope of the exercise heart rate during fitness testing
      explained 19.5% of the variation in the concentration of an HDL subclass, HDL2.
      These children's levels of physical activity were associated with higher fitness
      levels. Year-1 waist/hip ratios and year-2 sum of seven skin-fold measurements
      were positively correlated with the LDL/HDL and TSC/HDL ratios. CONCLUSION:
      Higher levels of cardiovascular fitness and lower levels of fatness were
      associated with more favorable serum lipid and lipoprotein levels in these young
      children. Physical activity appeared to have an indirect association with serum
      lipid and lipoprotein values through its relationship with higher fitness levels
      and lower levels of fatness.

PMID- 8345414
TI  - Daily energy expenditure by five-year-old children, measured by doubly labeled
      water.
AB  - Current recommendations for daily energy requirements in 5-year-old children (90
      kcal/kg per day) are based on energy intake associated with normal growth. It is
      not known, however, how these recommendations compare with total free-living
      energy expenditure (TEE) and how much of TEE is related to physical activity. The
      TEE and the resting metabolic rate (RMR) were measured in 28 white children, aged
      5 years (15 boys, 13 girls; mean (+/- SD) weight 20.1 +/- 3.4 kg; height 113 +/-
      6 cm; fat 20% +/- 5%). The TEE was calculated during a 7-day period from urinary
      elimination rates of deuterium (2H) and heavy oxygen (18O) by using a
      modification of the two-point slope-intercept method; RMR was measured by a
      ventilated-hood indirect calorimeter. Physical activity indexes were also
      collected from questionnaires completed by the parents. Measured TEE was
      considerably lower than the recommended dietary allowances (1370 +/- 222 kcal/day
      vs 1807 +/- 310 kcal/day; p < 0.0001), whereas measured RMR was slightly higher
      than predicted RMR (1001 +/- 119 kcal/day vs 952 +/- 78 kcal/day; p < 0.001). The
      energy cost of physical activity accounted for only 16% +/- 7% of TEE. An index
      of activity, assessed as the difference between the measured TEE and the
      predicted TEE, correlated positively with past-year sport-leisure activity
      assessed by questionnaire (r = 0.40; p < 0.05). We conclude that measured TEE in
      5-year-old children yields lower values (approximately 400 kcal/day) than current
      estimates. A minute part of this difference (20 to 30 kcal/day) is related to the
      changes in energy stores during growth, but most seems due to lower-than-expected
      levels of physical activity. This might be related to increased television
      viewing, which replaces activities requiring energy.

PMID- 8345415
TI  - Oxygen consumption-oxygen delivery relationship in children.
AB  - We examined the relationship between oxygen consumption (VO2) and oxygen delivery
      (DO2) over a range of metabolic demand in two groups of children. We studied 15
      children after cardiac surgery (plasma lactate levels < 2.2 mmol/L, VO2 < 6
      ml/min per kilogram, oxygen extraction ratio < 25%); 8 were given transfusions
      with erythrocytes, 10 to 15 ml/kg, and 7 received adrenaline infusions (0.05 to
      0.3 micrograms/kg per minute). Blood transfusions significantly increased DO2
      (20.5 +/- 6.4 to 26.2 +/- 7.1 ml/min per kilogram; p < 0.05) but did not alter
      VO2. Adrenaline increased DO2 (19.9 +/- 5.0 to 25.9 +/- 6.1 ml/min per kilogram;
      p < 0.05) and VO2 (4.3 +/- 0.8 to 5.5 +/- 1.2 ml/min per kilogram; p < 0.05), but
      the oxygen excretion ratio and the mixed venous oxygen saturation were unchanged.
      We also measured VO2 and Doppler-derived DO2 in 25 normal children during
      exercise. The relationship during exercise is given by the following equation:
      VO2 index (in milliliters per minute per kilogram) = 0.88 x DO2 index - 6.95.
      Adrenaline infusions, but not blood transfusions, increased VO2 and DO2 together.
      This effect may be due to increased demand, analogous to exercise, and probably
      does not represent improved perfusion. We also found significant measurement
      error in DO2 and spontaneous variation in VO2. We believe that the concept of
      supply-dependent VO2 is based on a number of methodologic and measurement errors.
      It should not be used to justify potentially dangerous therapies in sick
      children.

PMID- 8345416
TI  - Growth response of children with non-growth-hormone deficiency and marked short
      stature during three years of growth hormone therapy.
AB  - Short-term administration of human growth hormone to children with idiopathic
      short stature can improve mean growth rate and predicted adult height. It is yet
      unknown whether therapy would alter pubertal development or affect final height.
      Three-year treatment results in a group of children with idiopathic short stature
      are reported. For year 1 of the study, 121 prepubertal children were randomly
      selected to receive somatotropin, 0.3 mg/kg per week, administered subcutaneously
      three times weekly (n = 63), or to be nontreatment control subjects (n = 58).
      After 1 year, all subjects were again randomly selected to receive either three
      times-weekly or daily dosing at the same total dose. For the 92 subjects who
      completed 36 months of treatment, mean growth rate increased from a mean of 4.6
      cm/yr before treatment to a mean of 8.0 cm/yr in the first year of treatment.
      Daily dosing resulted in a significantly faster mean growth rate (9.0 cm/yr) than
      three-times-weekly dosing (7.8 cm/yr) (p = 0.0005). Mean growth rates were 7.6
      and 7.2 cm/yr during years 2 and 3, respectively, and did not differ by dosing
      group. Mean standardized height for all subjects improved from -2.7 to -1.6 after
      3 years. When the growth rate was standardized for bone age, however, subjects
      who remained prepubertal had a significantly greater gain in mean height SD score
      than subjects who became pubertal during that 3-year period (p < 0.02). Mean
      standardized Bayley-Pinneau predicted adult height SD score increased from -2.7
      to -1.6 and was independent of the timing of pubertal onset, but for individuals
      this score was more variable. Year-1 growth response, expressed as growth rate or
      change in height SD score, was the best predictor of growth in subsequent years.
      Responses to therapy could not be reliably predicted from baseline anthropometric
      variables, plasma insulin-like growth factor I SD score, growth hormone levels.
      Final height assessment will be needed to determine the ultimate benefit of
      therapy.

PMID- 8345417
TI  - Prematurity as a risk factor for asthma in preadolescent children.
AB  - Information on long-term respiratory symptoms in prematurely born children is
      scanty. We studied an unselected population of 9- to 11-year-old schoolchildren.
      A self-administered questionnaire was distributed to the parents. Children
      underwent lung function testing, cold air challenge, and skin prick tests. A
      gestational age < 37 weeks in children with a birth weight < or = 2500 gm was
      reported by 5% of the parents. Premature girls had significantly more current
      asthma (odds ratio (OR) 2.6; 95% confidence interval (CI) 1.4, 4.7; p < 0.05),
      recurrent wheezing (OR 1.7; 95% CI 1.1, 2.7; p < 0.001), recurrent shortness of
      breath (OR 2.4; 95% CI 1.5, 3.9; p < 0.001), and frequent cough with exercise (OR
      1.8; 95% CI 1.1, 2.9; p < 0.05) than term girls, especially if they required
      mechanical ventilation after birth. No such differences could be shown in boys.
      More prematurely born children who required mechanical ventilation (OR 3.7; 95%
      CI 2.2, 6.4; p < 0.0001) had a family history of asthma than children born at
      term. Significant decrements could be demonstrated for different measurements of
      lung function in premature girls. These results remained significant after
      control for confounders in a multivariate regression analysis. No difference was
      found between groups for bronchial hyperresponsiveness to cold, dry air or for
      atopic sensitization. We conclude that a family history of asthma may predispose
      premature children to more severe respiratory disease. Respiratory symptoms and
      decrements in lung function seen in girls may reflect abnormalities of lung
      function in survivors of severe neonatal respiratory disease.

PMID- 8345418
TI  - Cerebral palsy in four northern California counties, births 1983 through 1985.
AB  - To examine the impact of demographic shifts and changes in perinatal medicine on
      the distribution of cerebral palsy (CP), we investigated characteristics of
      affected children in a large, recent population-based American cohort study.
      Children with moderate or severe congenital CP born in four northern California
      counties in 1983 through 1985 and surviving to age 3 years were identified
      through records of state service agencies and clinical examination or record
      review by a single physician. We compared information from birth certificates for
      192 children with CP and 155,636 survivors without CP born in those counties in
      the same period. Children with birth weights < 2500 gm contributed 47.4% of the
      CP in this population; those < 1000 gm, who were 0.20% of survivors, contributed
      7.8%. Children with birth weights of 4000 to 4500 gm were at lowest risk. Among
      singletons, prevalence of CP was lowest (0.92/1000) in infants born to women aged
      25 to 34 years, and was significantly higher in children whose mothers were 40
      years or older (3.3/1000), especially if they were high in parity (6.9/1000).
      Children of teenaged mothers or fathers were at somewhat increased risk of CP.
      Early gestational age at birth was also an important independent risk factor.
      Prevalence of CP was slightly higher in black children, apparently related to a
      greater tendency to be low in birth weight. The time during pregnancy when
      prenatal care began was similar for children with CP and for the general
      population. For the 95% of children born weighing > or = 2500 gm, birth in a
      hospital lacking a special care nursery was not associated with increased risk of
      CP. Almost 8% of CP occurred in children born weighing < 1000 gm, a group that
      produced few survivors in the past; 28.1% occurred in children born weighing <
      1500 gm. Neither early initiation of prenatal care nor, for that large majority
      of neonates weighing > 1500 gm, delivery at a hospital with specialized
      facilities was associated with a lower risk of CP.

PMID- 8345419
TI  - Iron overload in children receiving prolonged parenteral nutrition.
AB  - This study was carried out to evaluate the iron status of 30 children aged 1 to
      18 years who had been receiving total parenteral nutrition (TPN) for an average
      of 43 months with iron intakes of 100 micrograms/kg per day. Iron status was
      assessed by assaying the serum iron and ferritin levels and the transferrin
      saturation coefficient as a function of iron intake. Liver biopsy specimens were
      taken from 13 children. Twelve children had serum ferritin levels greater than
      300 ng/ml, and 8 had levels greater than 800 ng/ml. The serum ferritin level and
      the transferrin saturation coefficient were positively correlated (r = 0.81; p <
      0.01). The serum ferritin level was positively correlated with TPN duration and
      with the total iron intake (r = 0.68; p < 0.01). Of the 13 liver biopsy
      specimens, six showed signs of iron deposition. We conclude that there is a risk
      of iron overload in children receiving 100 micrograms iron per kilogram of body
      weight per day by TPN, indicating that intake should be reduced.

PMID- 8345420
TI  - Urinary oxalate and glycolate excretion patterns in the first year of life: a
      longitudinal study.
AB  - To determine the range of normal values, we studied urinary excretion of oxalate
      and glycolate prospectively and longitudinally in a cohort of 30 healthy term
      infants. Random urine samples were obtained at 2 days, 2 weeks, and 2, 4, 6, and
      9 months of age. The results had a log-normal distribution. The mean
      oxalate/creatinine ratio, as determined by the oxalate oxidase method, was 0.08
      (in milligrams of oxalate to milligrams of creatinine) with a normalized range of
      0.02 to 0.31. The mean ratio when oxalates were measured by using the Olthuis
      assay was 0.13 (range 0.03 to 0.53). The mean glycolate/creatinine ratio was 0.07
      (range 0.02 to 0.26). These values did not correlate with increasing age. The
      oxalate/creatinine ratios were higher in formula-fed infants than in those who
      were fed human milk (0.14 +/- 0.16 vs 0.08 +/- 0.04; p < 0.01).

PMID- 8345421
TI  - Identifying human immunodeficiency virus infection at birth: application of
      polymerase chain reaction to Guthrie cards.
AB  - Guthrie cards containing dried blood spots from 67 children now known to be
      infected with human immunodeficiency virus (HIV) and 63 children now classified
      as having had seroreversion were retrieved from the newborn infant archives from
      1986 through 1991 to determine whether the polymerase chain reaction (PCR) could
      predict the infection at birth. The PCR assays operating at a sensitivity capable
      of detecting 2 to 10 copies of HIV proviral DNA per microgram were able to detect
      HIV proviral DNA in 52% (35/67) of the infected neonatal blood specimens. Longer
      storage times did not decrease PCR positivity rates, an advantage over assays for
      HIV antibody. Children whose clinical progression has been aggressive had high
      rates of PCR positivity in neonatal specimens, 50% (7/14) in those with low CD4
      cell counts during the first year of life, 71% (10/14) in those with Pneumocystis
      pneumonia or disseminated cytomegalovirus infection by age 1 year, 62% (18/29) in
      those with onset of acquired immunodeficiency syndrome by 18 months, and 66%
      (14/21) in those who died of the disease by 36 months of age. No evidence of HIV
      proviral DNA was found in any of the 63 specimens from children with
      seroreversion. We conclude that PCR, using routinely available dried blood spots
      from neonates, has applications in early diagnosis and in epidemiologic
      projections going beyond current seroprevalence studies.

PMID- 8345422
TI  - A rapid test for the detection of human immunodeficiency virus antibodies in cord
      blood.
AB  - A commercially available rapid test (HIVCHEK) was compared with an enzyme-linked
      immunosorbent assay (ELISA) for identifying human immunodeficiency virus type 1
      in the serum of newborn infants. Of 1309 cord blood samples tested, the HIVCHEK
      test detected all the true-positive samples detected by ELISA. Of the 35 samples
      with positive ELISA results, six had negative results on Western blot; only 1 of
      the 30 samples with positive HIVCHEK results had negative results on Western
      blot. Thus the HIVCHEK test can be used to facilitate the rapid identification of
      HIV-1 in the serum of newborn infants.

PMID- 8345423
TI  - Incidence of celiac disease identified by the presence of serum endomysial
      antibodies in children with chronic diarrhea, short stature, or insulin-dependent
      diabetes mellitus.
AB  - We determined the incidence of celiac disease in the western New York area to be
      1.29 per 10,000 live births. Celiac disease occurred in 29 children with
      gastrointestinal symptoms. Two children (1.7%) of 117 with short stature and 10
      (4.0%) of 211 with diabetes mellitus had serum anti-endomysial antibodies. We
      conclude that the incidence of childhood celiac disease in our area is much less
      than that reported in Europe.

PMID- 8345424
TI  - Malignant osteopetrosis treated with high doses of 1 alpha-hydroxyvitamin D3 and
      interferon gamma.
AB  - A male infant with malignant osteopetrosis was treated with high doses of 1 alpha
      hydroxyvitamin D3 and interferon gamma. Therapy with 1 alpha-hydroxyvitamin D3
      increased the serum calcium level despite the markedly elevated serum level of 1
      alpha, 25-dihydroxyvitamin D before treatment. Recombinant human interferon gamma
      increased neither the bone mineral nor matrix turnover, and was not tolerated
      because of bone marrow suppression.

PMID- 8345425
TI  - Widespread hemangiomatosis of bone associated with rickets: recovery after
      irradiation.
AB  - We describe a 15-year-old boy with hemangiomatosis of bone and hypophosphatemic
      rickets. The rickets was ameliorated by irradiation of the skeletal lesions.

PMID- 8345426
TI  - Alveolar-arterial oxygen gradient in acute chest syndrome of sickle cell disease.
AB  - In 44 episodes of acute chest syndrome of sickle cell disease occurring in 37
      children, simple clinical severity score, duration of hospital stay, transfusion
      data, and alveolar-arterial oxygen gradient were analyzed as indicators of
      severity of disease. The alveolar-arterial oxygen gradient, measured during
      breathing of room air, proved, on multivariate analysis, to be the strongest
      predictor of both clinical severity and the need for blood transfusion.

PMID- 8345427
TI  - Lysinuric protein intolerance with chronic interstitial lung disease and
      pulmonary cholesterol granulomas at onset.
AB  - Hyperammonemia and encephalopathy developed in an 11-year-old girl with chronic
      interstitial lung disease and cholesterol casts in her lung biopsy specimen. She
      had decreased plasma levels of ornithine, lysine, and arginine and excessive
      urinary excretion of lysine and arginine, consistent with the diagnosis of
      lysinuric protein intolerance. Analysis of plasma and urinary amino acids should
      be considered in the diagnostic evaluation of patients with interstitial lung
      disease of uncertain origin.

PMID- 8345428
TI  - Suppression of erythropoiesis by intrauterine transfusions in hemolytic disease
      of the newborn: use of erythropoietin to treat the late anemia.
AB  - Hemolytic disease of the fetus and newborn has three phases of anemia: in utero,
      in the first week of life, and in the weeks and months after birth. Intrauterine
      transfusions can ameliorate the severity of both fetal and early anemia, but late
      anemia and the need for transfusion remain significant problems. Bone marrow
      hypoplasia--probably a result of suppression of erythropoiesis from the
      intrauterine transfusions--was documented in the three patients tested in our
      study. Because erythropoietin (EPO) levels have been found to be low (i.e.,
      normal) in these previously transfused patients despite the degree of anemia, we
      treated four affected infants with EPO, 200 microliters/kg subcutaneously three
      times a week, and noted reticulocytosis and increased hemoglobin values 2 to 4
      weeks later. One patient again had reticulocytopenic anemia when the EPO therapy
      was stopped but responded to retreatment. Our study indicates that EPO treatment
      may be effective in the management of late anemia and could help to decrease the
      need for postnatal transfusions.

PMID- 8345429
TI  - A randomized, controlled trial of platelet transfusions in thrombocytopenic
      premature infants.
AB  - A multicenter prospective, randomized controlled trial was conducted to determine
      whether early use of platelet concentrates would reduce the incidence or
      extension of intracranial hemorrhage or both in sick preterm infants with
      thrombocytopenia. The effects on bleeding as reflected by the amount of blood
      product support administered and a shortened bleeding time were assessed as
      secondary outcomes. Premature infants with a platelet count < 150 x 10(9)/L
      within the first 72 hours of life were randomly assigned to receive either
      conventional therapy or conventional therapy plus platelet concentrates (10
      ml/kg). The platelet count was maintained < 150 x 10(9)/L until day 7 of life by
      one to three platelet transfusions. In 22 (28%) of the 78 treated infants and 19
      (26%) of the 74 control infants, either a new intracranial hemorrhage developed
      or an already-present one became more extensive (p = 0.73). Similar numbers of
      infants had each grade of intracranial hemorrhage on both initial and follow-up
      ultrasonography. Similar numbers of infants received fresh frozen plasma and
      packed red blood cells, but treated infants received less of both. The bleeding
      time was prolonged in the treated group before the infusion of platelet
      concentrates but subsequently shortened (mean difference, 79.0; 95% confidence
      interval, 73.1 to 84.9). Subanalysis of the control group showed that infants
      with platelet counts < 60 x 10(9)/L (n = 21) on at least one occasion received
      more fresh frozen plasma and packed red blood cells than did those with platelet
      counts > 60 x 10(9)/L.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345430
TI  - Production of tumor necrosis factor by human cells in vitro and in vivo, induced
      by group B streptococci.
AB  - Tumor necrosis factor alpha (TNF alpha) has been implicated as one of the major
      mediators of the gram-negative septic shock syndrome. In our studies, group B
      streptococci (GBS) induced the production of TNF alpha by human mononuclear cells
      in a dose- and time-dependent manner. Human mixed mononuclear cell cultures
      exposed to an encapsulated (657.6 +/- 71.3 pg/ml; n = 30 preparations) or an
      unencapsulated transposon mutant of type III GBS (755.8 +/- 54.7 pg/ml; n = 9)
      produced similar amounts of TNF alpha. Isolated monocytes and culture-derived
      macrophages produced higher amounts of TNF alpha (1565 +/- 211 and 1790 +/- 928
      pg/ml respectively) in response to GBS than did mixed mononuclear cell cultures.
      In response to GBS, mixed mononuclear cells from neonates produced significantly
      more TNF alpha (729.1 +/- 45 vs 520.3 +/- 47.2 pg/ml; p = 0.004) than did cells
      from adults. Examination of specimens from patients with neonatal GBS disease
      revealed detectable levels of TNF alpha (7 to 424 pg/ml) in the serum of 5 of 10
      patients with sepsis, in 5 of 5 urine samples from infants with sepsis, and in
      the cerebrospinal fluid of 1 patient with meningitis. These results suggest both
      a major role for TNF alpha in the pathogenesis of human neonatal GBS sepsis and
      shock and a potential role for immunotherapy directed against this cytokine in
      this fulminant neonatal bacterial infection.

PMID- 8345431
TI  - Effect of intrauterine growth retardation on postnatal weight change in preterm
      infants.
AB  - To investigate the cause or causes of early postnatal weight change, we measured
      total body water and fluid and energy balances in 14 preterm infants who were
      appropriate in size for gestational age (AGA) and in 5 weight-matched, preterm,
      small-for-gestational-age (SGA) infants. On the first day of life, AGA and SGA
      infants had the same weight and total body water content. At 6 +/- 2 days (mean
      +/- SD), AGA infants had had significant weight loss (94 +/- 45 gm) and body
      water loss (67 +/- 80 ml), whereas weight and total body water content in the SGA
      infants at the same age (5 +/- 1 days) did not differ from the values at birth.
      Loss of weight and total body water in AGA infants was accompanied by a greater
      diuresis than in SGA infants at the same amount of fluid intake. At the end of
      week 1, AGA and SGA infants had the same total energy expenditure (184 +/- 33 vs
      171 +/- 17 kJ.kg-1 x day-1); energy intake, which had exceeded total energy
      expenditure from the third day of life and beyond, already provided 188 +/- 46
      (AGA) or 209 +/- 109 kJ.kg-1 x day-1 (SGA), respectively, for energy storage.
      Nitrogen balance was positive. Subsequent weight gain occurred at the same rate
      in AGA and SGA infants; both total body water and solids increased. Energy
      intake, total energy expenditure, and the amount of energy stored (measured
      during stable weight gain on a regimen of full enteral feedings) had
      significantly increased compared with week 1, but both groups maintained similar
      energy storage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345432
TI  - Expected duration of hospital stay of low birth weight infants: graphic depiction
      in relation to birth weight and gestational age.
AB  - Neonatal duration of hospital stay correlated with both birth weight and
      gestational age in positively skewed, nonlinear relationships. Within increments
      of birth weight, gestational age had a semi-independent influence on length of
      stay. Log length of stay correlated with both birth weight and gestational age in
      linear, normally distributed relationships. A nomogram is provided for predicting
      individual lengths of stay.

PMID- 8345433
TI  - Standardization of prothrombin times in newborn infants.
AB  - The prothrombin time (PT) for patients receiving warfarin varies widely,
      reflecting the heterogeneity of thromboplastin reagents. The International
      Committee on Thrombosis and Haemostasis recommends that PT values for these
      patients be expressed as international normalized ratios. This study showed that
      thromboplastin reagents also significantly influence PT values in neonatal plasma
      and that expressing PT values as international normalized ratios decreases this
      variability.

PMID- 8345434
TI  - Efficacy of albuterol administered by nebulizer versus spacer device in children
      with acute asthma.
AB  - The aim of this study was to compare the response to inhaled albuterol after
      administration by nebulizer with the response after administration by a metered
      dose inhaler and spacer device (MDI-spacer) to children with acute asthma. In a
      double-blind fashion, 33 children (6 to 14 years of age) with forced expiratory
      volume in 1 second (FEV1) between 20% and 70% of predicted values, and who were
      seen in the emergency department with acute asthma, were studied. They were
      treated with aerosolized albuterol or placebo by MDI-spacer, followed immediately
      by albuterol or placebo administered by nebulizer with oxygen. The dose ratio for
      albuterol by MDI-spacer versus nebulizer was 1:5. Outcome measures included a
      clinical score, respiratory rate, arterial oxygen saturation, and FEV1, measured
      before and 10, 20, and 40 minutes after treatment. With the exception of heart
      rate (which increased in the nebulizer group and decreased in the MDI-spacer
      group (p < 0.05), no difference in the rate of improvement of clinical score,
      respiratory rate, arterial oxygen saturation, or FEV1 was noted during the 40
      minute study period between children who received albuterol by nebulizer and
      those who received it by MDI-spacer. We conclude that spacers and nebulizers are
      equally effective means of delivering beta 2-agonists to children with acute
      asthma.

PMID- 8345436
TI  - Death from a morphine infusion during a sickle cell crisis.
AB  - A 15-year-old boy died during a vaso-occlusive sickle cell crisis after having
      received a prolonged infusion of morphine. Even in therapeutic doses, narcotics
      may cause significant respiratory acidosis and hypoxemia, enhancing
      polymerization of hemoglobin SS and thereby promoting sickling and vaso
      occlusion. When narcotics are used during a sickle cell crisis, the best method
      is pharmacokinetically based patient-controlled analgesia.

PMID- 8345435
TI  - Hepatotoxic effects in a child receiving valproate and carnitine.
AB  - L-Carnitine supplementation has been recommended to prevent the fatal hepatotoxic
      effects associated with valproic acid. We report on a child with fatal valproate
      related hepatotoxic effects despite this supplementation.

PMID- 8345437
TI  - Mineral balance and bone turnover in adolescents with anorexia nervosa.
AB  - We evaluated seven female adolescents with anorexia nervosa to determine whether
      calcium metabolism was affected by their disorder. We measured calcium
      absorption, urinary calcium excretion, and calcium kinetics, using a dual-tracer,
      stable-isotope technique during the first weeks of an inpatient nutritional
      rehabilitation program. Results were compared with those from a control group of
      seven healthy adolescent girls of similar ages. The percentage of absorption of
      calcium was lower in subjects with anorexia nervosa than in control subjects
      (16.2% +/- 6.3% vs 24.6% +/- 7.2%; p < 0.05). Urinary calcium excretion was
      greater in subjects with anorexia nervosa than in control subjects (6.4 +/- 2.5
      vs 1.6 +/- 0.7 mg.kg-1 x day-1; p < 0.01) and was associated with bone resorption
      rather than calcium hyper-absorption. Calcium kinetic studies demonstrated a
      decreased rate of bone formation and an increased rate of bone resorption. These
      results suggest marked abnormalities in mineral metabolism in patients with
      anorexia nervosa. From these results, we hypothesize that improvement in bone
      mineralization during recovery from anorexia nervosa will require resolution of
      hormonal abnormalities, including hypercortisolism, in addition to increased
      calcium intake.

PMID- 8345438
TI  - Hydramnios in pseudohypoaldosteronism versus hypoaldosteronism in neonates.

PMID- 8345439
TI  - Thyroxine-binding globulin deficiency misdiagnosed as hypothyroidism.

PMID- 8345440
TI  - Treatment of hyperprostaglandin E syndrome with indomethacin.

PMID- 8345441
TI  - Local reactions to depot leuprolide therapy for central precocious puberty.

PMID- 8345442
TI  - Errors in citations in foreign languages.

PMID- 8345443
TI  - Development of a scale measuring genetic variation related to expressive control.
AB  - It has been theorized that a substantial genetic component underlies the Self
      Monitoring Scale. The identity of this component, however, is not yet known. In
      order to identify and better understand it, a more precise measure of the
      component is required. The present research attempted to (a) identify an axis of
      the self-monitoring two-factor space with maximum genetic variance; and (b)
      bootstrap a scale more highly correlated with this genetic maximum than is the
      Self-Monitoring Scale using twins. Evaluation of the new scale against criteria
      of validity indicates that scale construction was reasonably successful. The new
      measure had a cross-validated monozygotic twin intraclass correlation of .76 and
      a dizygotic twin intraclass correlation of .16. This work yields a new research
      tool and suggests a new approach to personality assessment. Correlates of the new
      measure as well as theoretical and methodological issues relevant to the
      measurement of a latent genetic entity are discussed.

PMID- 8345445
TI  - Analyzing individual status and change with hierarchical linear models:
      illustration with depression in college students.
AB  - A recently developed class of multilevel or hierarchical linear models (HLM)
      provides an intuitive and efficient way to estimate individual growth or change
      curves. The approach also models the between-subjects variation of the individual
      change curves with treatment factors and individual attributes. Unlike other
      repeated measures analysis methods common in the behavioral sciences, HLM allows
      the fit of data with unequal numbers of repeated observations for each subject,
      variable timing of observations, and missing data, features which are often
      characteristic of data from field studies. The application of HLM for the
      analysis of repeated psychological measures is discussed and illustrated here
      with depression data for college students. Strengths and limitations of the
      approach are discussed.

PMID- 8345444
TI  - Genetic and environmental effects on openness to experience, agreeableness, and
      conscientiousness: an adoption/twin study.
AB  - Previous research has indicated that extraversion and neuroticism are
      substantially affected both by genotype and environment. This study assesses
      genetic and environmental influences on the other three components of the five
      factor model of personality: Openness to Experience, Agreeableness, and
      Conscientiousness. An abbreviated version of the NEO Personality Inventory (NEO
      PI) was administered to 82 pairs of identical twins and 171 pairs of fraternal
      twins reared apart and 132 pairs of identical twins and 167 pairs of fraternal
      twins reared together. Estimates of genetic and environmental effects for
      Openness and Conscientiousness were similar to those found in other studies of
      personality: Genetic influence was substantial and there was little evidence of
      shared rearing environment. Results for Agreeableness were different: Genetic
      influence accounted for only 12% of the variance and shared rearing environment
      accounted for 21% of the variance. Few significant gender or age differences for
      genetic and environmental parameters were found in model-fitting analyses.

PMID- 8345446
TI  - Inhibitory effect of melatonin on platelet activation induced by collagen and
      arachidonic acid.
AB  - Melatonin, an indolamine synthesized in the pineal gland, is known to have
      antiprostanoid activity. The inhibition of platelet aggregation induced by
      melatonin has been proposed to take place through the cyclooxygenase pathway. In
      the present study, we found that melatonin has a marked inhibitory effect on
      collagen, arachidonic acid (AA), adenosine diphosphate (ADP), epinephrine, and
      A23187-induced aggregation in platelet-rich plasma. On the other hand, using
      metrizamide-filtered platelets resuspended in Tyrode's buffer, melatonin fails to
      suppress AA-induced platelet aggregation and 14C-5-HT release. Under the same
      conditions, melatonin inhibits collagen-induced platelet activation; however, the
      addition of threshold doses of AA (0.3 mM) abrogates this effect. These studies
      suggest that melatonin also inhibits platelet function at a stage preceding the
      cyclooxygenase-dependent pathway.

PMID- 8345447
TI  - The circadian nature of melatonin secretion in Japanese quail (Coturnix coturnix
      japonica).
AB  - Plasma melatonin concentrations were measured in Japanese quail held under
      different photoperiods and constant darkness (< 1 lux). When subjected to LD6:18
      (6 hr light: 18 hr darkness), levels rose approximately 2 hr after lights-off,
      attained a peak level 8 hr after lights off, and subsequently declined to low
      daytime levels before the next lights-on signal. This generated a distinct daily
      rhythm in melatonin secretion with a duration of approximately 13 h. On exposing
      quail to a range of photoperiods, containing 6, 9, 11, 12, 13, 15, 18, or 20 hr
      of light per day, the onset of melatonin secretion remained essentially similar
      with the rise occurring soon after lights-off. However, the offset of melatonin
      secretion was suppressed by the light of the next day and thus a much truncated
      rhythm was produced under long (> 12 hr) photoperiods. Importantly, between night
      lengths of 4 to 18 hr (i.e., LD 20:4 to LD 6:18) a linear relationship existed
      between the duration of night-length and secretion of melatonin with the duration
      increasing by about 0.8 hr for each additional hour of darkness. If quail were
      released into darkness following a short (LD 6:18) or long (LD 20:4) day
      schedule, the rhythm persisted for at least two cycles with peaks occurring at
      about 24 hr intervals. In those quail coming into darkness from long days (LD
      20:4), the rhythm of melatonin secretion decompressed rapidly on both sides of
      the peak, indicating that both the onset and offset of melatonin secretion were
      suppressed under long days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345448
TI  - Junk science v. American competitiveness.

PMID- 8345449
TI  - Cardiovascular devices for the 1990s.

PMID- 8345450
TI  - Biological interactions: causes for risks and failures of biomaterials and
      devices.
AB  - Biomaterials and devices have been used in a variety of applications ranging from
      disposable extracorporeal devices and soft and hard tissue augmentation, to total
      artificial internal organs. However, there are risks and failures in each
      application which are a result of undesirable biological interactions. This
      article deals with various biological interactions in each category of implants
      and devices used in medical applications.

PMID- 8345451
TI  - Bacterial adhesion to protein-coated hydrogels.
AB  - Extended wear soft contact lenses have been implicated in the increased
      occurrence of corneal bacterial infections. This research investigated the
      effects of polymer chemistry, water content, and pre-sorbed proteins upon the
      adherence of Pseudomonas aeruginosa to model hydrogels with chemistries similar
      to those of extended wear soft contact lenses. The hydrogels were exposed to
      washed suspensions of P. aeruginosa in a laminar flow cell. Albumin, fibrinogen,
      desialylated fibrinogen, or mucin were deposited on the hydrogels before exposure
      to the bacteria. Results showed that with or without protein pre-exposure,
      bacterial adhesion decreased as water content increased. In the presence of the
      sorbed protein, the number of adherent bacteria increased by about 45%, and all
      four proteins caused similar increases in adhesion. Bacterial adhesion was not
      significantly influenced by the presence of sialic acid residues in the pre
      sorbed protein.

PMID- 8345452
TI  - Paracrine factors relevant to the regulation of spermatogenesis--a review.

PMID- 8345453
TI  - Effect of oestradiol on oxytocin-stimulated prostaglandin F2 alpha release in
      mares.
AB  - The objective of this study was to clarify the role of oestradiol in luteal
      function by examining its effect on the oxytocin stimulation of 15-keto-13,14
      dihydro-prostaglandin F2 alpha (PGFM) concentrations in cyclic mares. In the
      first experiment, three groups of mares (4 per group) were given a bolus
      injection of 17 alpha-oestradiol (1 mg), oestradiol (1 mg) or vehicle on days 7,
      9, 11, 13 and 15 of the cycle. Six hours later the mares were challenged with 10
      iu oxytocin intravenously and frequent blood samples were taken from 15 min
      before to 15 min after for measurement of PGFM. Results showed a significant
      stimulatory effect of oestradiol (five times greater than controls at day 11; P <
      0.05), but not of 17 alpha-oestradiol, on the oxytocin stimulation of PGFM. As a
      relatively large dose was given systemically in this experiment, a second
      experiment was performed to introduce a dose that was more physiological into the
      uterus. Small Silastic spheres (1 cm diameter) were impregnated with or without
      oestradiol at a concentration that gave a release rate similar to that of embryos
      at day 12 (10 ng h-1). These were inserted (one per mare) into the uterus of two
      groups of mares (five per group) on day 7. The mares were challenged with
      oxytocin on days 9, 11, 13 and 15 of the cycle and blood samples were taken as
      before for determination of PGFM. The results showed that oestradiol enhanced
      (four times greater than controls at day 13; P < 0.05) the oxytocin stimulation
      of PGFM concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345454
TI  - Effects of suppressing plasma FSH on ovarian follicular dominance in cattle.
AB  - The importance of FSH during development of the dominant follicle of the first
      wave of follicular growth in cattle was assessed by injecting heifers twice daily
      with 20 ml saline (n = 6) or 20 ml charcoal-extracted bovine follicular fluid
      (bFF; n = 10), containing inhibin, on days 6 and 7 of the oestrous cycle. All
      animals received a luteolytic dose of PGF2 alpha on day 8. The interval to
      oestrus after PGF2 alpha in controls was 2.6 +/- 0.2 days. Five of ten bFF
      treated heifers exhibited oestrus at the same time as controls (2.7 +/- 0.1
      days), whereas time to oestrus in the remaining five bFF-treated heifers was
      significantly longer (6.8 +/- 0.6 days; P < 0.05). Treatment with bFF suppressed
      plasma FSH during the 48 h injection period (P < 0.05). Concentrations of FSH
      were not different in bFF-treated animals that did not display delayed oestrus
      compared with those in animals that exhibited delayed oestrus. In controls, the
      dominant follicle of the first wave continued growing during treatment and
      ovulated after injection of PGF2 alpha. In all ten bFF-treated animals, growth of
      the dominant follicle of the first wave was arrested during the treatment period.
      In bFF-treated animals that did not exhibit delayed oestrus, the dominant
      follicle resumed growth after luteolysis and ovulated. In bFF-treated animals
      that displayed delayed oestrus, the dominant follicle regressed after luteolysis
      and the ovulatory follicle was selected from a newly recruited (second) wave of
      follicular growth.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345455
TI  - Effect of photoperiod on the annual cycle of testis growth in a tropical mammal,
      the little red flying fox, Pteropus scapulatus.
AB  - Little red flying foxes (Pteropus scapulatus) are seasonal breeders: they mate in
      late spring/early summer, and young are born the following autumn. In captivity,
      males housed outdoors in a normal breeding colony in natural daylight showed a
      single cycle of testis growth and regression each year. During reproductive
      quiescence, testicular volume was approximately 2 cm3; recrudescence began soon
      after the winter solstice; testicular volume was maximum at approximately 6.5 cm3
      at the spring equinox; and regression was complete by the end of summer. To test
      whether photoperiod entrains or synchronizes the cycle, groups of males were
      housed indoors, without females, at constant temperature, and artificial lighting
      was timed to either mimic naturally changing daylength or provide alternating 3
      month periods of short (11 h light:13 h dark) or long (16 h light:8 h dark) days
      (two groups, three months out of phase with each other). During 18 months, the
      applied photoperiod protocol had no effect on the frequency of testicular cycles
      (which remained at one per year), the time course of recrudescence and regression
      (as described above for normal outdoor control males), or the completeness of
      growth and regression stages. These results suggest that male P. scapulatus are
      not reproductively photoresponsive.

PMID- 8345456
TI  - Partial characterization of galactosyltransferase in human seminal plasma and its
      distribution in the human epididymis.
AB  - Galactosyltransferase activity has been partially characterized in human seminal
      plasma. Km values of 130 mumol l-1 for UDP-galactose and 2.25 mmol l-1 for N
      acetylglucosamine were calculated and the enzyme was found to be dependent on
      temperature and manganese and present as a highly active component of human
      seminal plasma. Galactosyltransferase was inhibited by nucleotides, glycosylated
      nucleotides, bovine and human alpha-lactalbumin but not by monosaccharides.
      Radiation inactivation studies revealed that the biologically active unit of
      seminal plasma galactosyltransferase has a molecular mass of 45 kDa. Although the
      majority of galactosyltransferase activity found in seminal plasma is probably of
      prostatic origin, we report for the first time that it is also present in human
      epididymal intraluminal fluid. Low activity was detected in the proximal caput
      region but activity increased to maximum values in the adjacent downstream
      segment, the intermediate caput region. Specific activity was relatively constant
      albeit at a lower value in the following epididymal segments and vas deferens.
      The significance of the epididymal and seminal plasma galactosyltransferase
      activities is unknown, but the enzyme could be implicated in glycosylation events
      that are known to be important in gamete interaction.

PMID- 8345457
TI  - Cryopreservation of expanded mouse blastocysts by vitrification in ethylene
      glycol-based solutions.
AB  - Experiments were conducted to find optimal conditions for obtaining high survival
      of expanded mouse blastocysts after vitrification. The vitrification solutions
      used were designated EFS20, EFS30 and EFS40, and contained 20%, 30% and 40%
      ethylene glycol, respectively, diluted in PB1 medium containing 30% Ficoll plus
      0.5 mol sucrose l-1. In the toxicity test of the solutions and each
      cryoprotectant, ethylene glycol was found to be toxic to embryos. For
      vitrification, expanded blastocysts were exposed to the vitrification solutions
      at 10, 20 or 25 degrees C for various periods; they were then cooled rapidly in
      liquid nitrogen, after which they were warmed rapidly. When the embryos were
      directly exposed to EFS40 at 20 degrees C for 2 min before vitrification, 66% of
      them re-expanded during 48 h of post-warming culture. The re-expansion rates
      decreased when exposure time was shortened (0.5 min), when exposure temperature
      was lowered (10 degrees C), or when embryos were vitrified in EFS20 and EFS30,
      although these conditions should be less toxic. When embryos had been pretreated
      in a dilute (10-20%) ethylene glycol solution for 5 min, followed by short
      exposure (0.5 min) to EFS40 at 20 degrees C, post-vitrification survival rate
      increased to 83-84%; furthermore, the rate reached 94% when the temperature was
      increased to 25 degrees C. Expanded blastocysts cryopreserved by this two-step
      method developed into live young as well as control embryos after
      transfer.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345458
TI  - Follicular fluid composition in the grey seal (Halichoerus grypus) during the
      oestrous cycle.
AB  - During the period of lactational oestrus, the corpus luteum of ovaries of grey
      seals decreased in size following the birth of the pup, while on the
      contralateral ovary one major large follicle rapidly expanded. These large
      follicles had the highest concentration of oestradiol (4282 +/- 609 ng ml-1) and
      progesterone (499 +/- 168 ng ml-1). Osmolality (322 +/- 3 mosmol kg-1) and the
      intrafollicular concentration of electrolytes (Na: 126 +/- 1; Cl: 96 +/- 1; Ca:
      1.3 +/- 0.1 mumol ml-1) and proteins (94 +/- 1 mg ml-1) were independent of stage
      of lactation and follicle size. Concentrations were lower in follicular fluid
      than in plasma. The concentrations of triglycerides and, to some extent, those of
      vitamin E, cholesterol and phospholipids were affected by the decrease in the
      plasma concentration of these components with the onset of lactation and the
      increase in follicle size. These two events resulted in a marked decrease of
      these components in the largest follicles at the end of lactational oestrus.
      Vitamin A (exclusively as retinol), although a blood-borne component in
      follicular fluid, was the only component with a higher concentration in small and
      medium follicles than in plasma and decreased with increasing follicle size
      despite an increase in plasma retinol. This decrease and the negative correlation
      with intrafollicular oestradiol might indicate a high demand of preovulatory
      follicle structures for vitamin A owing to its possible importance in steroid
      hormone or protein synthesis or in both processes.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8345459
TI  - Stimulation of collagen secretion by relaxin and effect of oestrogen on relaxin
      binding in uterine cervical cells of pigs.
AB  - The role of relaxin and oestrogen in the remodelling of connective tissue was
      investigated by testing collagenase-dispersed cells (3 x 10(5) cells per well)
      from the uterine cervix of gilts for relaxin binding and collagen secretion.
      Relaxin-binding sites on these cells were quantified by specific binding of a
      saturating dose of 125I-labelled monotyrosyl relaxin at optimal conditions.
      Oestrogen at doses from 0.4 to 50 ng ml-1 increased relaxin binding in a time-
      and dose-dependent manner. Scatchard plot analysis exhibited curvilinearity,
      which suggested two classes of relaxin-binding sites. The addition of relaxin (0,
      100, 500 ng ml-1) alone (P < 0.05) or in combination with oestrogen (oestradiol
      benzoate: 0, 50, 250 ng ml-1) increased protein secretion into the culture
      medium. Hydroxyproline concentration (as an index of collagen) in the medium was
      increased (P < 0.05) only in the presence of both relaxin and oestrogen.
      Actinomycin D (500 ng ml-1) and cycloheximide (500 ng ml-1) inhibited
      hydroxyproline secretion induced by combined relaxin and oestrogen treatment.
      Dibutyryl cyclic adenosine 3',5'-monophosphate (dibutyryl cAMP: 0, 0.1, 1.0, 5.0
      mmol l-1) was a potent stimulator of hydroxyproline secretion. These results
      indicate that relaxin, probably via a cAMP pathway, stimulates hydroxyproline
      secretion in the presence of oestrogen through a protein- and RNA-synthesis
      dependent process. Oestrogen plays a role in augmenting the sensitivity of
      uterine cervical cells to relaxin in the pig.

PMID- 8345460
TI  - GnRH in the male dog: dose-response relationships with LH and testosterone.
AB  - Dose-response relationships between GnRH and LH, and between GnRH and
      testosterone, were investigated in six male dogs by intravenous administration of
      a GnRH analogue at different doses. Each dose of GnRH analogue induced an
      immediate rise in the plasma concentration of LH and then a rise in plasma
      testosterone concentration. Irrespective of the dose used, the rise in
      testosterone began 10 min after the GnRH injection. Administration of GnRH at
      doses of 0.01, 0.1, 1, 10 and 100 micrograms kg-1 resulted in maximum LH
      concentrations in plasma (mean +/- SEM; n = 6) of 22 +/- 7, 27 +/- 6, 40 +/- 7,
      57 +/- 13 and 56 +/- 10 micrograms l-1, respectively. These doses induced maximum
      concentrations of testosterone in plasma (mean +/- SEM; n = 6) of 16 +/- 4, 20 +/
      4, 22 +/- 3, 22 +/- 4 and 24 +/- 7 nmol l-1, respectively. The lag time between
      peak concentrations of LH and testosterone varied from 35 to 55 min. The
      calculated maximum response of testosterone to LH, secreted by the anterior
      pituitary after GnRH injection, was 1.8 times higher than to GnRH. It was
      concluded that intravenous administration of GnRH induced marked and dose
      dependent increases in plasma concentrations of LH and testosterone, and that
      there does not appear to be a direct effect of GnRH on Leydig cells in male dogs.

PMID- 8345461
TI  - Culture of rabbit zygotes into blastocysts in protein-free medium with one to
      twenty per cent oxygen.
AB  - Embryos were collected from superovulated Dutch rabbits 19 h after injection of
      LH and insemination. The embryos were at the one-cell stage at that time and
      those judged to be normal by the absence of granular cytoplasm and regular shape
      were distributed randomly within donors into culture dishes containing 500
      microliters of a macromolecule-free medium consisting of RPMI-1640 and low
      glucose Dulbecco's modified Eagle's medium, 1:1, without a cover of oil. In Expt
      1, O2 concentrations of 5, 10 and 15%, with 5% CO2 plus 90, 85 and 80% N2,
      respectively, were tested. In Expt 2, O2 concentrations of 1, 5 and 20% were
      combined with 5% CO2 and the remaining gas was N2. After 84 h in culture at 39
      degrees C, embryos were examined for stage of development and stained with
      Hoechst 33342 so that the number of cells could be counted. In Expt 1, the
      proportion of embryos reaching the hatching blastocyst stage after 84 h in
      culture in 5, 10 and 15% O2 was 48, 38 and 21%, (P < 0.01) and the cell number
      per embryo averaged 258, 226 and 188, respectively (P < 0.01). In Expt 2, the
      proportion of hatching embryos after 84 h in culture in 1, 5 and 20% O2 was 67,
      72 and 29% (P < 0.01), respectively. Cell numbers in the 1 and 5% O2
      concentrations were higher than in the 20% O2 concentration (P < 0.01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8345462
TI  - Glucose and pyruvate metabolism in preimplantation blastocysts from normal and
      diabetic rats.
AB  - Glucose metabolism was analysed in day-5 rat blastocysts incubated in the
      presence of [5-3H]-, [6-14C]- or [U-14C]glucose. Glycolysis, quantified by 3H2O
      recovery rate, was the main pathway of glucose utilization by fresh (11.5 +/-
      0.36 pmol per embryo h-1) or cultured (24 h) blastocysts (20.4 +/- 0.6 pmol per
      embryo h-1). Glucose consumption rate was almost saturated at a medium glucose
      concentration of 0.28 mmol l-1 (Km: 0.17 mmol l-1; Vmax: 23 pmol per embryo h-1).
      A further 10% increase in glucose utilization was obtained with a tenfold higher
      glucose concentration (3 mmol l-1). Phloretin completely abolished the rapid
      component of glucose utilization kinetics, suggesting the existence of a Na(+)
      independent glucose transport system. Less than 1% of [6-14C]glucose consumed by
      cultured blastocysts was oxidized through the Krebs cycle. [1-14C]pyruvate,
      however, was oxidized at a rate of 2 pmol per embryo h-1 by fresh blastocysts.
      The pentose-phosphate pathway accounted for about 2% of glucose utilization. One
      to two per cent of the total glucose metabolized in 24 h was retained in
      macromolecules. Insulin had no effect on glucose uptake, utilization,
      incorporation and turnover, or on pyruvate oxidation. Blastocysts from diabetic
      mothers utilized glucose at a rate similar to that of normal blastocysts. These
      results show that glucose is actively taken up by rat blastocysts and utilized
      mainly through the Embden-Meyerhof pathway, which is rapidly saturated at low
      glucose concentrations. Retention of glucose-derived products in macromolecules,
      although relatively small, may modulate the effect of high glucose concentrations
      on embryo growth.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345463
TI  - Effects of the duration of exposure to hormone supplements on cytoplasmic
      maturation of pig oocytes in vitro.
AB  - The effect of hormone supplements on cytoplasmic maturation in vitro was examined
      by incubating oocyte-cumulus complexes, in a medium with PMSG (10 iu ml-1), hCG
      (10 iu ml-1) and oestradiol (1 microgram ml-1) for various periods and then
      transferring them to medium without added hormones for the remainder of the
      maturation period. Exposure of oocyte-cumulus complexes to hormone supplements
      for 2 h improved only germinal vesicle breakdown and maturation rates compared
      with complexes not exposed to added hormones. The removal of hormone supplements
      at 20 h after the start of culture enhanced the ability of oocytes to form male
      pronuclei 10 to 12 h after insemination. Further, the effects of transfer of
      intact and oocytectomized oocyte-cumulus complexes to hormone-free medium at 20 h
      on cumulus expansion were examined. The diameter and morphology of the intact
      oocyte-cumulus complexes were improved after the removal of oocyte-cumulus cell
      complexes from hormonal exposure. The responses of oocytectomized oocyte-cumulus
      complexes to hormone were similar to those of intact oocyte-cumulus complexes
      with the exception of corona radiata expansion. The results suggest that the
      removal of hormone supplements from maturation media at 20 h after culture
      enhanced cytoplasmic maturation and cumulus expansion. Further, cumulus expansion
      does not appear to depend on intercellular communication between cumulus cells
      and oocytes. Oocytectomy did influence expansion of the corona radiata during
      culture.

PMID- 8345464
TI  - Effects of alpha-amanitin on nuclear maturation of porcine oocytes in vitro.
AB  - The effects of alpha-amanitin on cumulus enclosed and denuded porcine oocytes
      exposed to this heterogeneous nuclear RNA (hnRNA) synthesis inhibitor at
      different times (0, 0.5, 1, 2, 4, 6, 8, 12 and 20 h) after the start of culture
      was investigated. A further objective was to determine the sequence of nuclear
      progression after removing the inhibitor. The addition of 10 micrograms alpha
      amanitin ml-1 to a gonadotrophin containing medium (10 iu PMSG ml-1 in TCM 199)
      at 0, 0.5 or 1 h after the onset of culture prevented cumulus expansion, and only
      4.4, 6.4 and 3.5% of oocytes underwent germinal vesicle breakdown. This
      inhibitory effect was considerably reduced by delaying the addition of the drug
      to the culture medium for 2-8 h (2 h: 34.9%, 4 h: 53.5%, 6 h: 46.9%, 8 h: 59.2%
      germinal vesicle breakdown), and no inhibition of nuclear maturation was observed
      when alpha-amanitin was added after 12 or 20 h following explantation of the
      oocytes. When cumulus-oocyte complexes were cultured for > or = 2 h in inhibitor
      free medium and then transferred to medium supplemented with alpha-amanitin, full
      cumulus expansion was observed in all cases, at the end of the 44 h culture.
      Denudation of the oocytes before culture in either medium supplemented with alpha
      amanitin or microinjection of alpha-amanitin into the ooplasm at concentrations
      of 1.0 and 10.0 mg ml-1 remained without any effect on nuclear
      progression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345465
TI  - Binding of lipid droplets and mitochondria to intermediate filaments in rat
      Leydig cells.
AB  - We have examined the distribution of lipid droplets and mitochondria in relation
      to the cytoskeletons of Leydig cells in primary culture by using light and
      electron microscopy on living, intact and detergent-extracted cells. After mild
      extraction with Triton X-100 lipid droplets and mitochondria retained their
      original distribution within the cell. Double immunofluorescent microscopy showed
      that both structures co-localise with intermediate filaments. Transmission
      electron microscopy of intact (unextracted) and mildly extracted Leydig cells
      showed that intermediate filaments are closely associated with mitochondria and
      lipid droplets. By examination of stereo pairs, intermediate filaments were shown
      to establish direct contact with mitochondria and lipid droplets. The association
      of droplets and mitochondria with intermediate filaments suggests possible
      mechanisms by which the transport of cholesterol takes place from droplets to
      mitochondria where this substrate enters the steroidogenic pathway.

PMID- 8345466
TI  - Characteristics of the oestrous cycle and duration of gestation in chital hinds
      (Axis axis).
AB  - Duration of oestrous cycle and gestation, and characteristics of postpartum
      oestrus of chital hinds are described. Mean duration of the oestrus cycle of
      chital hinds was 19.3 +/- 1.3 days, with a range of 17-21 days. Serum
      progesterone profiles are shown, with minimum progesterone concentrations near
      oestrus less than 2.7 nmol l-1, and maximum luteal values 16-26 nmol l-1. Mean
      duration of gestation was 234.5 +/- 3.0 days (n = 17).

PMID- 8345467
TI  - Localization and concentration of a new bioactive acetic seminal fluid protein
      (aSFP) in bulls (Bos taurus).
AB  - The concentration of the new bioactive acetic seminal fluid protein (aSFP) was
      determined in body fluids of bulls. An aSFP-specific radioimmunoassay was
      elaborated and established for routine measurement. No crossreaction of the aSFP
      antibody was found with other seminal plasma proteins and known growth factors.
      The 14 kDa aSFP was detected in secretions of ampulla and seminal vesicles by
      immunoblot analysis, but not in testis, epididymis or blood. Large quantities of
      aSFP were measured by radioimmunoassay in the fluid from the ampulla (2.6 +/- 0.3
      mg ml-1) and seminal vesicles (3.0 +/- 0.4 mg ml-1). Immunohistochemistry
      techniques demonstrated that aSFP was localized mainly in the secretory
      epithelium of ampulla and seminal vesicles. Large amounts of aSFP (4.0 +/- 0.4 mg
      ml-1) were present in seminal plasma of bulls within a range of 1-7 mg ml-1, but
      aSFP could not be found on membranes of spermatozoa. Concentrations vary
      considerably among individuals, suggesting that aSFP may have a role in bovine
      reproduction.

PMID- 8345468
TI  - Effect of exposure to a boar on circulating concentrations of LH, FSH, cortisol
      and oestradiol in prepubertal gilts.
AB  - Serum concentrations of LH, FSH, oestradiol and cortisol were measured in control
      gilts not exposed to a boar and in gilts with fence-line exposure to a boar that
      allowed full muzzle contact. All gilts were between 134 and 200 days of age.
      Control gilts showed first oestrus at 193 +/- 7 days of age (n = 5). Twelve of
      the gilts exposed to the boar showed first oestrus at 169 +/- 5 days of age and
      five had not shown oestrus by 200 days of age. Introduction of a boar produced a
      transient increase in LH pulse frequency lasting no longer than 20 days (P <
      0.001) in gilts responding to the boar with oestrus. Basal and mean serum LH
      concentrations were also increased (P < 0.05) in the gilts that responded to a
      boar with oestrus, but only in the 6 h after introducing the boar. Mean serum
      concentrations of FSH were lower in gilts exposed to a boar compared with the
      controls at 10 days after introduction of the boar, but by 20 days only gilts
      responding to the boar with oestrus had lower FSH concentrations (P < 0.05).
      Serum concentrations of cortisol decreased over the day the boar was introduced
      in all groups of gilts (P < 0.05) and were always highest in gilts exposed to a
      boar but not showing oestrus by 200 days of age (P < 0.05). There were no
      significant trends in serum concentrations of oestradiol but oestradiol
      concentrations varied over a wide range in gilts that did not respond to the boar
      with oestrus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345470
TI  - Relationship between iron-catalysed lipid peroxidation potential and human sperm
      function.
AB  - The relationship between lipid peroxidation and the functional competence of
      human spermatozoa has been investigated in a cohort of 31 infertility patients.
      Lipid peroxidation was assessed using a sensitive fluorometric assay for the
      generation of malondialdehyde in response to the presence of a ferrous ion
      promoter. Sperm function was evaluated by monitoring the movement characteristics
      of these cells and their capacity for sperm-oocyte fusion. Each sample was
      separated into high- and low-density sperm populations on discontinuous, two-step
      (40%:80%), Percoll gradients prior to analysis. The way in which individual
      ejaculates fractionated on these gradients was highly positively correlated (P <
      0.001) with the lipoperoxidation status of the spermatozoa; the greater the
      potential for malondialdehyde generation, the higher the proportion of cells
      entering the low density region of the gradients. The lipoperoxidation potential
      of the freshly prepared spermatozoa was also highly predictive (P = 0.0001) of
      their capacity for movement at 3 and 24 h and their ability to exhibit sperm
      oocyte fusion in response to the ionophore A23187. The potential for
      malondialdehyde generation in the 40% and 80% Percoll fractions was positively
      associated with midpiece abnormalities in the spermatozoa. These results
      emphasize the importance of lipid peroxidation in the pathophysiology of male
      infertility and suggest a mechanism by which such damage might arise.

PMID- 8345469
TI  - Identification of endothelin-1, endothelin-2 and endothelin-3 in human
      endometrium.
AB  - This study determined the presence of specific endothelin isoforms in human
      endometrium using high performance liquid chromatography (HPLC) combined with
      radioimmunoassay, and immunocytochemistry to detect the endothelin precursors
      (proendothelin-1, proendothelin-2 and proendothelin-3). Endothelin-like
      immunoreactivity was measured in HPLC eluates using antisera raised in rabbits
      against the carboxy-terminal heptapeptide of endothelin-1, which is common to the
      three endothelin isoforms. Of eight endometrial samples analysed by HPLC, three
      were in the proliferative phase of the cycle, and five in the secretory phase.
      Endothelin-1 was detected in seven samples, whereas endothelin-2 and endothelin-3
      were seen in four and five specimens, respectively. No relationship was seen
      between endothelin isoforms and the stage of the cycle. Immunocytochemistry was
      performed on five proliferative and three secretory phase tissues. When present,
      staining for the precursor proendothelins was localized to endometrial glandular
      and luminal epithelium (proendothelin-1, 5 of 8; proendothelin-2, 5 of 8;
      proendothelin-3, 6 of 8). In two sections, staining was also seen in vascular
      endothelium using antibody raised against proendothelin-1 (n = 1) and
      proendothelin-3 (n = 1). These data provide evidence that the three endothelin
      isoforms are present in human endometrium, and suggest that these potent
      vasoactive agents may play a role in the paracrine control of the uterine
      vascular bed.

PMID- 8345471
TI  - In vitro fertilization and embryo culture in the grey short-tailed opossum,
      Monodelphis domestica.
AB  - In vitro fertilization and early embryo culture was undertaken in the South
      American marsupial, the grey short-tailed opossum, Monodelphis domestica. Adult
      females were induced into oestrus by a system of pairing with an unfamiliar male
      and mature oocytes were recovered from the ovary 15-18 h after mating and placed
      in pre-warmed modified MEM medium at 33 degrees C (basal body temperature) or 37
      degrees C. Spermatozoa recovered from the cauda epididymides of adult males were
      preincubated in medium for 2 h during which time paired spermatozoa separated and
      initiated hyperactivated motility. Oocytes were transferred to 0.4 ml drops of
      spermatozoa containing 0.5-1.0 x 10(6) spermatozoa ml-1. Only single spermatozoa
      bound to the zona pellucida, and fertilization occurred within 1-2 h as indicated
      by a breach in the zona and confirmed by electron microscopy. At 37 degrees C, 95
      of 152 (62.5%) oocytes were fertilized and 64 (67%) developed to two-cell stage
      or beyond. At 33 degrees C, 5 of 28 (18%) oocytes were fertilized. This is the
      first report of complete in vitro fertilization in a marsupial.

PMID- 8345472
TI  - Possible roles for prostaglandins E2 and F2 alpha in seasonal changes in ovarian
      steroidogenesis in the frog (Rana esculenta).
AB  - Concentrations of PGE2, PGF2 alpha, androgens and oestradiol in plasma, and ovary
      weights were measured in the female frog, Rana esculenta, during the annual
      breeding cycle. Experiments were carried out in vivo to study the effects of PGE2
      and PGF2 alpha on plasma sex steroids during the following stages: pre
      reproduction (April), reproduction (May), post-reproduction (June) and recovery
      (October). Experiments were performed in vitro during these stages to evaluate
      the effects of these two prostaglandins on the secretion of ovarian steroids.
      Concentrations of PGE2 were low in plasma during winter hibernation, the
      reproduction and post-reproduction stages, whereas they were high during the pre
      reproduction and recovery stages. PGE2 treatment in vivo increased androgen
      secretion in April, whereas PGF2 alpha treatment increased oestradiol secretion
      in June and October. In experiments in vitro, PGE2 increased androgen secretion
      and decreased oestradiol secretion from ovaries collected in April, whereas PGF2
      alpha increased oestradiol secretion from ovaries collected in October. These
      results suggest that a seasonal increase in plasma PGE2 may inhibit breeding
      activity, probably by stimulating ovarian androgen secretion, whereas, as
      previously reported, a seasonal increase in plasma PGF2 alpha may inhibit
      breeding, by stimulating ovarian oestradiol secretion.

PMID- 8345473
TI  - Cellular dynamics of growth in sheep and goat synepitheliochorial placentomes: an
      autoradiographic study.
AB  - This paper demonstrates that in sheep and goats the two definitive fetomaternal
      interface layers are developmentally related. The fetal trophectoderm consists of
      binucleate and uninucleate cells. The apical microvilli of the trophectoderm
      interdigitate with a layer consisting of syncytial plaques of limited area
      bounding the maternal connective tissue. Our previous histological
      ultrastructural and immunocytochemical work has indicated that throughout
      pregnancy the fetal binucleate cells migrate to and fuse with the uterine
      epithelium or its derivatives to form these syncytial plaques which constitute a
      persistent fetomaternal tissue unique to ruminants. This quantitative
      autoradiographic study of thymidine incorporation into sheep and goat placentas
      confirms the central role of the binucleate cell in placental growth,
      demonstrates that throughout pregnancy all binucleate cells migrate and indicates
      that most of the nuclei of the syncytial plaques, which appear to have a limited
      lifespan, derive from binucleate cell fusion.

PMID- 8345474
TI  - Concentrations of faecal immunoreactive progestagen metabolites during the
      oestrous cycle and pregnancy in the black rhinoceros (Diceros bicornis michaeli).
AB  - The analysis of reproductive hormones in faecal samples is a possibility for non
      invasive monitoring of reproductive status in free-ranging or intractable
      species. In the present study, faecal samples from three black rhinoceroses
      (Diceros bicornis michaeli) were collected at about weekly intervals during
      oestrous cycles and pregnancy. Daily samples were taken during the week after
      parturition. Total immunoreactive progestagens in faecal extracts were analysed
      with three different enzymeimmunoassays (EIA) that had considerable specificity
      for progestagens containing either a 20 alpha-hydroxyl or a 20-keto group. With
      each EIA it was possible to distinguish between the follicular and luteal phases
      of the oestrous cycle. Mating corresponded with low concentrations of faecal
      progestagens. Samples from five and six consecutive cycles were available from
      two rhinoceroses and cycle lengths of 24 and 26.5 days were calculated. All three
      animals became pregnant and the duration of gestation ranged from 440 to 470
      days. After fertilization, the concentration of progestagens increased
      continuously, as in the luteal phase, reaching values 5-10 times higher between
      days 60 and 250. During the two weeks before parturition faecal progestagens
      declined and within 3-4 days post partum had reached follicular phase values. It
      was concluded that several immunoreactive progestagens are present in the faeces
      of black rhinoceroses and that their measurement with EIA enables non-invasive
      monitoring of the oestrous cycle and pregnancy.

PMID- 8345475
TI  - Maturational changes in gonadotrophin secretion: the LH response to
      realimentation and a nocturnal increment in LH secretion of feed-restricted
      prepubertal gilts.
AB  - Potential maturational changes in patterns of LH secretion during feed
      restriction and the LH response to realimentation were examined. Ten sets of four
      growth-matched littermate gilts were fed ad libitum, to reach either 55, 65, 75
      or 85 kg target body weights (one littermate per weight). Gilts were then
      maintenance fed for 8 days (days 1-8), and to appetite on day 9, and kept in a 9
      h light (07:00-16:00 h):15 h dark photoperiod. Blood samples were obtained every
      10 min from 07:00 to 16:00 h, and from 16:00 to 24:00 h on day 8 to evaluate any
      nocturnal rise in LH, and from 07:00 to 16:00 h on day 9 to evaluate the LH
      response to realimentation. Radioimmunoassays for LH, FSH, melatonin and
      oestradiol were performed on selected plasma samples. In all three sampling
      periods, LH and FSH secretion decreased as gilt weight increased, in a quadratic
      manner. During feed restriction, daytime LH, but not FSH, secretion was lower
      than at nighttime, irrespective of weight. Daytime LH secretion increased in
      response to realimentation, irrespective of weight. Plasma oestradiol
      concentrations were increased by feed restriction and decreased by realimentation
      but showed little relationship to gilt weight. No consistent relationship was
      established between plasma melatonin concentrations and ambient illumination. In
      conclusion, LH secretion exhibits a diurnal rhythm during feed restriction in the
      prepubertal gilt and, in a similar way to FSH, decreases as puberty is
      approached. The plane of nutrition influences circulating oestrogen
      concentrations. The increase of LH secretion following realimentation is not
      influenced by maturation over the prepubertal period.

PMID- 8345476
TI  - Effects of onapristone, tamoxifen and ICI 182780 on uterine prostaglandin
      production and luteal function in nonpregnant guinea-pigs.
AB  - Onapristone (a progesterone antagonist) or ICI 182780 (an oestrogen antagonist)
      administered to guinea-pigs on days 11-14 of the cycle significantly reduced
      uterine PGF2 alpha output on day 15. Concentrations of progesterone in plasma of
      onapristone-treated and ICI 182780-treated guinea-pigs were still high on day 15
      indicating that luteal regression had been prevented. These findings indicate
      that progesterone and oestradiol are necessary for increased PGF2 alpha
      production by the uterus towards the end of the cycle, and support the hypothesis
      that oestradiol acting on a progesterone-primed uterus is the physiological
      stimulus for increased uterine PGF2 alpha synthesis and release in guinea-pigs.
      The capacity of the endometrium to synthesize PGF2 alpha on day 15 was reduced by
      treatment with ICI 182780 and, unexpectedly, by treatment with onapristone,
      indicating that onapristone may also be antagonizing the release or action of
      oestradiol in some way. Tamoxifen was an agonist in guinea-pigs since it induced
      vaginal opening. It had no inhibitory effect on uterine PGF2 alpha output and did
      not delay luteal regression when administered between days 11 and 14 of the
      cycle. However, it redirected PG synthesis in homogenates of endometrium and
      myometrium from PGI2 (as indicated by 6-keto-PGF1 alpha) to PGF2 alpha. The
      output of 6-keto-PGF1 alpha from the uterus of day 15 guinea-pigs was reduced
      following tamoxifen treatment, but the high output of PGF2 alpha from the uterus
      was not affected.

PMID- 8345477
TI  - Changes in adenylyl cyclase activity in human endometrium during the menstrual
      cycle and in human decidua during pregnancy.
AB  - Adenylyl cyclase activity was studied in human endometrium during the menstrual
      cycle and in human decidua during pregnancy. Higher adenylyl cyclase activity was
      found in the endometrium than in the myometrium, corpus luteum or Fallopian
      tubes. In the endometrium, the basal and stimulated activities were highest in
      the fundus and decreased slightly from the fundus to the isthmus. Prostaglandin
      stimulated adenylyl cyclase activity increased gradually from the proliferative
      phase to the secretory phase, and then quickly reached its highest value in the
      late secretory phase. Catecholamine-stimulated adenylyl cyclase activity reached
      a peak in the late proliferative phase and decreased significantly thereafter.
      Forskolin-stimulated activity was significantly higher throughout the secretory
      phase than in the proliferative phase. In the decidua, prostaglandin-,
      catecholamine- and forskolin-stimulated adenylyl cyclase activities in late
      pregnancy were significantly lower than those in early pregnancy. Our results
      demonstrate dramatic alterations in adenylyl cyclase activity in human
      endometrium during the menstrual cycle and in human decidua during pregnancy.

PMID- 8345478
TI  - Effects of the Booroola gene (FecB) on body weight, ovarian development and
      hormone concentrations during fetal life.
AB  - The aim of this study was to determine whether the FecB gene influenced some
      aspects of fetal development in sheep. Carrier (BB/B+) and non-carrier (++)
      female fetuses were recovered at specific times of gestation, namely, days 40,
      55, 75, 90, 95 and 135. The results showed that the FecB gene influenced litter
      size, body weight and ovarian development during fetal life. The mean litter
      sizes were larger (P < 0.05) and body weights were lighter (P < 0.05) at most
      gestational ages in BB/B+ than in ++ fetuses. Morphometric studies of the ovary
      showed that the development of the BB/B+ ovaries was retarded: the ++ genotype
      had more oogonia at day 40 (P < 0.01), more germ cells entering meiosis at day
      55, more primordial follicles developing at days 75, 90 and 95 (P < 0.05), a
      greater loss of germ cells by atresia at day 90 (P < 0.01) and more growing
      follicles (P < 0.01) and more antral follicles (P < 0.05) at day 135. Differences
      between the BB/B+ and ++ genotypes in the plasma concentrations of immunoreactive
      (i) inhibin, i-FSH, bioactive (b)-FSH or (i)-LH were not apparent at any age
      except for i-LH at day 75 (BB/B+ > ++; P < 0.05). Likewise no differences were
      noted in the contents of ovarian or adrenal oestradiol or i-inhibin except for i
      inhibin in the adrenal at day 75 (++ > BB/B+, P < 0.01). No differences between
      the genotypes were noted in the i-inhibin contents of the mesonephros at day 40.
      In mid- to late but not early gestation (i.e. days 40 and 55) significant
      correlations (i.e. P < 0.05) were noted between litter size and body weight at
      days 75, 90 and 135, and between litter size and ovary weight, ovary volume,
      adrenal weight and pituitary weight at day 135. To eliminate the effect of litter
      size, equal numbers of BB/B+ and ++ embryos were transferred to respective
      recipient ewes, and fetuses were recovered at the equivalent of days 40 and 90 of
      gestation. The results showed that the genotypic difference in fetal body weight
      at day 40 (++ > BB, P < 0.001) and in number of oogonia at day 90 (++ > BB/B+, P
      < 0.05) were independent of litter size.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345479
TI  - Effects of fetal genotype and uterine environment on placental development in
      equids.
AB  - Measurement of the concentrations of equine chorionic gonadotrophin (eCG) in the
      serum of pregnant mares and Jenny donkeys carrying normal intraspecies and hybrid
      interspecies pregnancies suggested that the production of this hormone may be
      influenced by parental gene imprinting. Specifically, a differential expression
      of maternal and paternal genes may control the size and secretory activity of the
      structures that secrete eCG, the fetal endometrial cups. However, bisection of an
      interspecies mule embryo followed by transfer of the resulting demi-embryos and
      other intact mule embryos to horse and donkey recipients resulted in striking
      differences in the size, secretory activity and lifespan of the endometrial cups
      in two types of surrogate mother. This finding has therefore demonstrated the
      ability of uterine factors to alter profoundly the development and characteristic
      phenotype of the specialized invasive chorionic girdle portion of the equine
      trophoblast that gives rise to the endometrial cups.

PMID- 8345480
TI  - Role of platelet-derived growth factor in development of in vitro matured and in
      vitro fertilized bovine embryos.
AB  - This experiment was designed to determine whether the stimulatory effects of
      bovine oviductal epithelial cells (BOEC) on development of early bovine embryos
      are due to platelet-derived growth factor (PDGF). Four hundred and twenty five 8
      cell bovine embryos derived from in vitro maturation and in vitro fertilization
      procedures were equally and randomly allotted to one of the following culture
      treatment groups: control medium alone (Menezo's B2 medium; MB2), MB2 with 1 ng
      PDGF ml-1 (PDGF), 1 ng PDGF ml-1 and 10 micrograms anti-PDGF antibody ml-1 (PDGF
      + Ab), BOEC or BOEC and 10 micrograms anti-PDGF antibody ml-1 (BOEC + Ab). All
      embryos were cultured in 100 microliters of serum-free MB2 medium supplemented
      with 2 mg fatty-acid-free bovine serum albumin ml-1. Embryos for all treatment
      groups were incubated at 39 degrees C and 5% CO2 in humidified air in groups of
      five embryos per well in 96-well culture plates until 7 days after in vitro
      insemination. A higher proportion of embryos developed to > 8-cell and to the
      morula stage following culture with PDGF, BOEC or BOEC+Ab than with MB2 alone.
      Incubation of PDGF and BOEC-treated embryos with anti-PDGF reduced development to
      the morula and blastocyst stages. However, anti-PDGF did not completely inhibit
      blastocyst development when added to BOEC. In addition, embryos incubated with
      BOEC and anti-PDGF contained a reduced number of inner cell mass cells compared
      with embryos incubated with BOEC alone. These results indicate that PDGF provides
      a developmental stimulus similar to BOEC for bovine embryos at the fourth cell
      cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345481
TI  - Secretion of matrix metalloproteinases by human endometrial cells in vitro.
AB  - At each menstrual cycle, the uterine endometrium undergoes intense remodelling.
      Of the many factors implicated in tissue remodelling, the matrix
      metalloproteinases (MMPs) play a central role owing to their capacity to degrade
      the extracellular matrix. The aim of this study was to examine the nature and
      cellular origin of endometrial proteases as evaluated in culture systems with
      clearly characterized cell types. Endometrial cells from hysterectomy specimens
      were prepared using collagenase digestion. Bone-marrow-derived cells (a known
      source of proteases) were removed by immunopurification. Cells were cultured on
      different substrates (matrigel, agarose, glass or plastic). Purity of cell
      preparations was examined by immunocytochemistry, and proteases were
      characterized by zymography on SDS-PAGE containing gelatin. The cell phenotype in
      culture was largely influenced by the type of substrate. Gelatin-degrading
      enzymes detected in culture supernatants of stromal and epithelial cells had
      molecular masses ranging from 42 to 248 kDa, and were identified as
      metalloproteinases. We conclude that human endometrial stromal and epithelial
      cells express several matrix metalloproteinases, the expression of which clearly
      depended on the purity of cell preparation, on cell adhesion and on the nature of
      the substrate on which the cells grew. These enzymes might be involved in
      endometrium remodelling, blastocyst implantation and trophoblast invasion.

PMID- 8345482
TI  - Effects of induction of low plasma progesterone concentrations with a
      progesterone-releasing intravaginal device on follicular turnover and fertility
      in cattle.
AB  - The effects of concentration of progesterone in plasma on development and
      fertility of the first wave dominant follicle were studied in cattle. To identify
      a source of exogenous progesterone that would permit extension of the first wave
      dominant follicle, nonlactating Holstein cows (n = 6) received on day 8 of two
      successive oestrous cycles an injection of PGF2 alpha (25 mg) and a new (1.9 g of
      progesterone (Period 1)) or used (approximately 1.2 g of progesterone (Period 2))
      CIDR-B device that was removed on day 17. Control cows (n = 6) received a new
      CIDR-B device on day 8 that was removed on day 17 and a PGF2 alpha injection (25
      mg) on day 17. Ultrasonography and collection of blood samples were performed on
      alternate days throughout the experiment. Plasma concentrations of progesterone
      and oestradiol were different between treatments (P < 0.0001 and P < 0.05,
      respectively). The dominant follicle was maintained until day 17 and ovulated
      upon removal of the intravaginal device in 1 of 6, 6 of 6 and 0 of 6 in new CIDR
      B, used CIDR-B and control groups, respectively (P < 0.01). The preovulatory
      dominant follicles were 14.2 +/- 1.6 mm, 20 +/- 1.3 mm and 10 +/- 1.3 mm,
      respectively (P < 0.001) on day 17. There were fewer 5-9 mm follicles in cows
      having a persistent dominant follicle (P < 0.01). The interval to onset of
      oestrus was negatively correlated with size of the dominant follicle on day 17 (P
      < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345483
TI  - Influence of day of oestrus on egg viability and comparative efficiency of in
      vitro fertilization in domestic cats in natural or gonadotrophin-induced oestrus.
AB  - Thirty-six domestic cats received 100 iu hCG (i.m.) on day 1, 2 or 3 of a
      natural, behavioural oestrus. Twenty-two anoestrous cats were injected with 150
      iu pregnant mares' serum gonadotrophin (PMSG; i.m.) followed 84 h later by 100 iu
      hCG. Twenty-four to 26 h after hCG, all cats were examined laparoscopically to
      determine the number of ovarian follicles and to recover follicular eggs. Mature
      eggs were cultured with conspecific spermatozoa and examined 30 h later for
      cleavage. Within the natural oestrus group, cats on day 1 produced fewer (P <
      0.05) follicles and total eggs than females on day 2 or 3, and 88.9% of the day 1
      eggs were degenerate or immature and unsuitable for in vitro fertilization (IVF).
      Although only 54.5% of the cats in the PMSG/hCG group exhibited overt oestrus,
      mean (+/- SEM) numbers of follicles (9.7 +/- 0.8) and oocytes recovered (8.7 +/-
      0.8) were at least twofold greater (P < 0.001) than those measured in the natural
      oestrus group (3.7 +/- 0.6; 3.4 +/- 0.6, respectively) or subgroups on day 2 (3.7
      +/- 0.4; 3.3 +/- 0.4) and day 3 (5.7 +/- 0.8; 5.3 +/- 0.8). Overall, the
      proportion of eggs cleaving in vitro was similar (P > 0.05) between the natural
      oestrus group (48.3%) and the PMSG/hCG group (50.9%), but the latter group
      produced more than twice the number of embryos per donor. Embryo quality was
      unaffected (P > 0.05) by day of hormone treatment, and more than 80% of all two
      cell embryos were rated good-to-excellent quality.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8345484
TI  - Serum concentrations of oestradiol and progesterone and frequency of sexual
      behaviour during the normal oestrous cycle in the snow leopard (Panthera uncia).
AB  - Serum oestradiol and progesterone concentrations were measured at weekly
      intervals for six months, and correlated with daily behavioural observations in
      two adult female snow leopards (Panthera uncia). Three oestradiol peaks (> 21 pg
      ml-1; interval 3.6 weeks) were identified in a snow leopardess housed alone (two
      more were probably missed because of the weekly sampling schedule), and three
      oestradiol peaks were identified in a snow leopardess housed with a male as a
      breeding pair (interval 6 weeks). Daily frequencies of feline reproductive
      behaviour averaged 1.77 observations per observation period during weeks of high
      oestradiol and 0.62 during weeks of low oestradiol. Progesterone concentrations
      did not rise above baseline values (< 2 ng ml-1) in the isolated animal, but 6
      weeks of high progesterone concentrations (4.9-38.8 ng ml-1) was recorded in the
      paired snow leopardess following mating. No offspring were produced. Snow
      leopards were observed daily for an additional 4.5 years. Sexual behaviour peaks
      could be clearly identified from December through April, and average daily sexual
      behaviour scores were higher during these months than during the rest of the
      year. Intervals between sexual behaviour peaks for the isolated snow leopardess
      averaged 3.03 weeks. The sexual behaviour of the paired snow leopards decreased
      for 8-9 weeks following mating when no offspring were produced, and decreased for
      13 weeks in one year when a single cub was born.

PMID- 8345485
TI  - Gonadotrophin-releasing hormone and the control of ovulation rate by the FecB
      gene in Booroola ewes.
AB  - Booroola sheep carry a FecB gene that confers high fecundity. The aims of the
      present studies were to determine in homozygous carriers (BB) and non-carriers
      (++) of the Booroola FecB gene whether there are FecB differences in the
      secretory characteristics of GnRH in hypophyseal-portal blood of ovariectomized
      ewes (Expt 1) and whether differences in ovulation rate would occur following the
      administration of PMSG and pulsatile GnRH to ovary-intact Booroola ewes with
      hypothalamic-pituitary disconnection (HPD) (Expt 2). In Expt 1, no FecB gene
      specific differences were noted for GnRH with respect to pulse frequency, pulse
      amplitude or overall secretion rate. Irrespective of genotype there were 1.9 +/-
      0.2 GnRH pulses h-1 (n = 20 ewes; 10 BB and 10 ++ animals) and 1.9 +/- 0.1 pulses
      of immunoreactive (i) LH h-1. In Expt 2, ovulation was induced in the HPD ovary
      intact animals on three occasions (e.g. 56, 393 and 423 days after HPD surgery)
      using a PMSG (200 or 400 iu)-GnRH pulse (250 ng i.v. for 96 h)-GnRH bolus (10
      micrograms i.v.) regimen after pretreating the animals with GnRH pulses (250 ng
      i.v. for 14 days). On all occasions the ovulation rates were significantly higher
      (P < 0.05) in BB ewes (n = 6 or 7) than in ++ animals (n = 7). No differences
      between the genotypes were noted with respect to the mean concentrations of
      progesterone in plasma notwithstanding the differences in ovulation
      rates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345486
TI  - Calcium channel blockers: do they offer renal protection?
AB  - Calcium channel blockers are used in the treatment of hypertension because of
      their ability to decrease peripheral vascular resistance. Recent research has
      suggested that these drugs also preserve or improve renal function in patients
      with essential hypertensive renal disease, diabetic renal disease, and in renal
      transplant recipients with or without cyclosporine therapy. In general, studies
      in both animal models and humans have demonstrated maintenance or reduction in
      renal vascular resistance, and preservation or enhancement of renal blood flow
      and glomerular filtration rate. In addition, calcium channel blockers appear to
      have a positive effect on renal haemodynamic function in the setting of diabetes
      mellitus; prospective trials have demonstrated reductions in urinary protein
      excretion in these patients. Current evidence suggests that calcium channel
      blockers are well suited for the treatment of patients with hypertensive disease
      even in the presence of renal impairment.

PMID- 8345487
TI  - Developmental vascular biology and the early phases of essential hypertension in
      the young.

PMID- 8345488
TI  - Determinants of retinal vascular abnormalities in children and adolescents with
      essential hypertension.
AB  - The predictors of retinal vascular abnormalities in patients with elevated BP
      have not been studied extensively in children or adults. The purpose of this
      study was to investigate potential correlates of arteriolar narrowing, tortuosity
      and arteriovenous nicking in a population of children and adolescents with
      essential hypertension. A total of 97 subjects, aged 6-23 years, were studied.
      Retinal vascular abnormalities were determined by photographs of the optic fundus
      which were interpreted independently by two opthalmologists. In 50 subjects (51%)
      there were one or more abnormalities. Potential correlates of retinal
      abnormalities included: (1) demographic factors, (2) body size, (3) level of BP
      and duration of hypertension, (4) family history of cardiovascular disease, (5)
      treatment with antihypertensive medication, (6) dietary sodium intake, (7)
      laboratory analyses, (8) the reactivity of BP and heart rate to playing a video
      game, and (9) cardiovascular reactivity to exercise. Using stepwise multiple
      logistic regression, the variables that were independently associated with the
      presence of retinal vascular abnormalities were family income, dietary sodium
      intake, fasting blood glucose, pulse pressure during mental stress and the change
      in SBP from rest to maximum exercise. In addition, subjects with more than one
      retinal vascular abnormality had higher average DBP during follow-up in the
      Hypertension Clinic and a smaller rise in SBP from rest to maximum exercise.
      Identification of these independent predictors of retinal vascular abnormalities
      and factors associated with more than one abnormality may provide insight into
      the pathogenesis of hypertensive vascular disease.

PMID- 8345489
TI  - Lifestyle factors associated with geographic blood pressure variations among men
      and women in the UK.
AB  - The importance of various factors in explaining geographical BP variations in the
      UK has been examined among 2,596 men and women living in nine British towns.
      Associations between BP and potential explanatory variables have been examined
      first for individual subjects (within-population), and second for towns (between
      populations). The factors showing associations with BP that were consistent
      within-population and between-towns were BMI, urine sodium/potassium ratio
      (Na/K), alcohol and anxiety at examination for men, and BMI, Na/K and anxiety at
      examination for women. After adjustment for these factors and age, the male BP
      differences between the nine towns were reduced from 10.1 mmHg systolic in men (P
      = 0.001) to 7.1 mmHg (P = 0.04), and from 5.9 mmHg diastolic (P = < 0.0001) to
      5.5 mmHg (P < 0.0001). For women, adjustment only marginally reduced the between
      town systolic differences from 5.6 mmHg (P = 0.05) to 5.5 mmHg (P = 0.3) and
      increased the diastolic differences from 3.7 mmHg diastolic (P = 0.03) to 5.0
      mmHg (P < 0.0001). It is concluded that BMI, alcohol consumption and the Na/K
      ratio play an important part in the pattern of male SBP variations in the UK. The
      factors associated with female geographical differences in BP were less clear,
      but BMI and Na/K ratio appear to be important. This study has been unable to
      identify factors associated with geographical differences in DBP, with the
      possible exception of BMI in men. However, as systolic pressure is recognised to
      be more strongly associated with cardiovascular outcome than diastolic pressure,
      it can be recommended that primary prevention strategies aimed at reducing the
      population mean level of BP should involve efforts to reduce overweight, alcohol
      consumption and the Na/K ratio.

PMID- 8345490
TI  - Urine albumin excretion in healthy subjects.
AB  - The relationship between cardiovascular risk factors and urine albumin excretion
      were studied in 474 healthy office workers. Albumin concentration was measured
      fresh in first morning midstream urines. Lifestyle details, oscillometric BP and
      lipids were assessed. Subjects with urine albumin concentration above the median
      (5.30 mg/l) were compared with those with albumin concentration below the median.
      Subjects with above median urinary albumin concentration had higher systolic
      blood pressure (mean 115.2 vs. 113.1 mm Hg for above median, respectively, P =
      0.06), were more likely to be male (56.8 vs. 45.0%, respectively, P = 0.01) and
      to have lower levels of high density lipoprotein (HDL)-cholesterol (mean 1.34 vs.
      1.41 mmol/l, P = 0.006). Multivariate analysis following adjustment for urine
      creatinine concentration to allow for urine volume confirmed the relationship
      with systolic blood pressure (P = 0.01) and sex (P = 0.02), and in addition
      revealed a relationship with alcohol intake approaching significance (mean intake
      70.8 and 76.0 g/week, respectively, P = 0.06). The univariate finding of
      increased albuminuria with lower HDL-cholesterol appeared to be attributable to
      the associated relationships with male sex and lower alcohol intake. The
      relationships between albumin excretion and BP, male sex and alcohol intake may
      reflect the effects of asymptomatic developing arterial disease. The relationship
      with BP may also be a consequence of effects on glomerular hydrostatic or
      interstitial renal pressure on albumin filtration or resorption. Very low level
      urine albumin excretion in healthy subjects is associated with factors which
      predict arterial disease. Urine albumin excretion may prove to be a useful early
      marker of cardiovascular disease in population studies.

PMID- 8345491
TI  - Plasma concentrations and comparisons of brain and atrial natriuretic peptide in
      normal subjects and in patients with essential hypertension.
AB  - We have developed a radioimmunoassay for the measurement of immunoreactive BNP (1
      32) in human plasma. Simultaneous measurement of ANP have also been carried out
      to allow for direct comparison between circulating BNP and ANP. Plasma levels of
      immunoreactive BNP (means +/- SEM) were 1.1 +/- 0.1 pmol/l in 36 normal healthy
      subjects and were significantly elevated in 50 patients with essential
      hypertension (1.6 +/- 0.2 pmol/l, P < 0.02). Similarly, in patients with
      essential hypertension plasma levels of ANP were also significantly raised (5.5
      +/- 0.6 pmol/l, P < 0.001) when compared with the group of normal healthy
      subjects (2.8 +/- 0.2 pmol/l). ANP was significantly higher than BNP in normal
      subjects and in patients with essential hypertension, with ANP/BNP ratios of 2.8
      +/- 0.2 and 3.8 +/- 0.3, respectively, in these two groups. A major finding was a
      significant and positive association between plasma levels of both BNP and ANP
      within the healthy subjects (r = 0.49, P < 0.05, n = 36) and within the
      hypertensive subjects (r = 0.76, P < 0.001, n = 50). When all plasma values for
      BNP and ANP were taken together for both groups, there was an overall correlation
      coefficient of 0.65 (P < 0.001, n = 86). Both BNP and ANP had significant
      positive associations with age in hypertensive patients, with correlation
      coefficients of 0.53 (P < 0.001, n = 50) and of 0.53 (P < 0.001, n = 50) for BNP
      and ANP, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345492
TI  - Relationship between autonomic dysfunction and BP variability in subjects with
      diabetes mellitus.
AB  - Autonomic vagal heart rate (HR) control, office BP and ambulatory BP were
      examined in 54 diabetic subjects, aged 63 +/- 6 years. Sixteen subjects were
      insulin-dependent. The HR response to deep breathing (the bradypnoea test) was
      used to evaluate the vagal HR control, and ambulatory BP was determined by the
      Spacelabs 5200 system (one determination every 15 minutes, for 24 hours). Twenty
      seven subjects had normal office BP (SBP < or = 140 mmHg and DBP < or = 90 mmHg),
      seven had established hypertension (SBP > or = 160 mmHg and DBP > or = 95 mmHg)
      and 30 were borderline hypertensives. Over the total group, office
      systolic/diastolic BP (mean +/- SD) was 142 +/- 20/85 +/- 10 mmg.
      Systolic/diastolic ambulatory BP was 123 +/- 13/77 +/- 10 mmHg and ambulatory HR
      was 70 +/- 8 beats/min. Because of the small age range of our subjects, the HR
      score was not correlated with age (r = 0.19, NS). The HR score was not correlated
      with the levels of office and ambulatory pressures. In contrast, it was
      significantly correlated with the variability of ambulatory SBP, whether the
      variability was defined by the pressure standard deviation, or by the ratio
      SD/mean value (r = 0.40, P = 0.005 and r = 0.33, P < 0.017, respectively). We
      suggest that an impairment of the autonomic control in diabetics might induce an
      increase in variability of SBP. BP variability might play a role in the
      cardiovascular complications observed in diabetics.

PMID- 8345493
TI  - WHO-WHL Hypertension Management Audit Project.
AB  - The quality of the control of hypertension has been assessed in 18 European
      population groups, in a multicentre cooperative project. Five approaches were
      taken: epidemiological survey, clinical evaluation of samples of patient records,
      assessment of patient satisfaction, exploration of physicians' attitudes and
      knowledge, and drug utilisation studies. The participating centres could choose
      any or all of the above approaches; a total of 31 subprojects was carried out.
      Undiagnosed hypertension varied in different centres from 17% to 34% of all
      hypertension, and not more than 29% of all treated hypertensive patients had
      attained normal BP. Diuretics were the most commonly prescribed drugs, followed
      by beta-blockers. Although physicians expressed their concern about other
      cardiovascular risk factors and declared that they considered nonpharmacological
      treatment important, the findings in the patient survey did not confirm such
      attitudes. Finally, an analysis of patient satisfaction showed a mixed pattern.
      In conclusion, the control of hypertension in populations, through detection and
      treatment, as well as patient education and physician information, was studied.

PMID- 8345494
TI  - Nitrendipine in older patients with isolated systolic hypertension: second
      progress report on the SYST-EUR trial.
AB  - This report from the double-blind placebo-controlled SYST-EUR trial investigated
      whether modern antihypertensive drugs are suitable for maintaining long-term BP
      control in older (> or = 60 years of age) subjects with isolated systolic
      hypertension (SBP 160-219 mmHg and DBP < 95 mmHg). Active treatment consisted of
      nitredipine (10-40 mg/day) with the possible addition of enalapril (5-20 mg/day)
      and hydrochlorothiazide (12.5-25 mg/day), if necessary to reduce SBP to < 150
      mmHg and by > or = 20 mmHg. Matching placebos were used in the control group.
      This analysis was restricted to 18 months of follow-up. The placebo (n = 456) and
      active treatment (n = 485) groups had similar characteristics at randomisation
      (sitting pressure 176/85 mmHg; age 73 years). SBP fell (P < 0.001) on average 10
      mmHg more on active treatment than on placebo and DBP 4 mmHg more. Fewer patients
      remained on monotherapy in the placebo than in the active treatment group (P <
      0.001); on placebo the second and third line medications were started earlier (P
      < 0.001). Nitrendipine tablets were discontinued in nine patients on placebo and
      in 29 patients assigned to active treatment (P < 0.001). In conclusion, a
      significant BP reduction can be achieved and maintained in older patients with
      isolated systolic hypertension treated with a calcium antagonist (associated with
      a converting-enzyme inhibitor and a thiazide, where necessary). Whether this BP
      reduction results in a clinically meaningful decrease of cardiovascular
      complications is under investigation.

PMID- 8345495
TI  - Blood pressure, plasma catecholamine and renin responses to caffeine in elderly
      hypertensives.
AB  - In young hypertensive patients, after a short period of abstention, caffeine
      ingestion has a significant pressor effect, although the acute cardiovascular
      responses have not been reported in elderly hypertensives. This study assessed
      the acute changes in BP, pulse rate, plasma renin activity (PRA) and arterialised
      plasma catecholamines after 250 mg of caffeine and matching placebo following 12
      and 48 hours of caffeine abstention. After 48 hours caffeine abstention supine
      SBP was higher over the 120 minute study period following acute caffeine loading
      than following placebo (10 mmHg; 95% Cl 3-17 mmHg, P = 0.016) although the
      overall post-caffeine rise from baseline values was small (2 mmHg; -3 to 8 mmHg,
      P = 0.30). Similar differences were seen for supine DBP and standing SBP and DBP
      although pulse rate was unchanged throughout. After 12 hours abstention no acute
      pressor effect of caffeine was seen, in fact SBP fell over the study period (-5
      mmHg; -10 to 0 mmHg, P = 0.05), and there was no difference between the caffeine
      and placebo phases. No change in plasma catecholamines or PRA values was found
      during any of the phases. These results suggest that in elderly hypertensives the
      pressor effect of caffeine (the equivalent of two to three cups of coffee) is
      small even after prolonged abstention. After the shorter abstention period, of
      the duration likely to be seen in clinical practice, no pressor response to
      caffeine was demonstrated. It is unlikely that acute caffeine ingestion has a
      significant effect on clinic BP measurements in elderly hypertensives who are
      regular caffeine consumers.

PMID- 8345496
TI  - Psychomotor performance in elderly hypertensive patients.
AB  - The psychomotor performance of 25 elderly patients with mild to moderate
      hypertension (aged 62-78 years, SBP = 162-212 mmHg; DBP = 98-124 mmHg) was
      compared with 25 age-matched controls (SBP = 110-160 mmHg; DBP = 64-92 mmHg). The
      hypertensive subjects did not have evidence of target-organ damage and were on no
      antihypertensive treatment at the time of assessment. Performance on a range of
      tests: symbol/digit substitution test (SDST) (34.3 vs. 39.5, P < 0.01),
      continuous attention test (CAT) (33 vs. 36.2, P < 0.01), choice reaction time
      (CRT) (270 ms vs. 320 ms, P < 0.01), paired word association test (PWAT) (4.1 vs.
      7.0, P < 0.001) and inspection time threshold (INSP) (158 ms vs. 52 ms, P <
      0.001), showed significant impairment in the hypertensive group compared with
      controls. These differences did not correlate with the duration of hypertension
      or degree of BP elevation. The impairment in hypertensive subjects was stable
      over a four week period. These results suggest the occurrence of a functional and
      possibly reversible impairment of psychomotor performance in elderly hypertensive
      patients which may have implications for antihypertensive treatment.

PMID- 8345497
TI  - Effect of antihypertensive treatment on psychomotor performance in the elderly.
AB  - The psychomotor effects of control of hypertension were studied in a parallel
      group comparison of 25 elderly hypertensives (aged 61-79 years; SBP = 192 (range
      162-212) mmHg; DBP = 112 (range 98-124) mmHg) shown to have psychomotor
      impairment when not on antihypertensive treatment. Single blind treatment was
      commenced with placebo or a diuretic: atenolol, nifedipine or captopril (5 x n =
      5). A range of tests using an automated psychomotor test battery showed a
      significant improvement compared with placebo in tests of attention and
      psychomotor speed in subjects rendered normotensive (n = 18) after treatment for
      one week (SDST + 3.8, P < 0.001; CAT + 1.2, P < 0.03; PWAT + 1.9, P < 0.004; INSP
      -49.5 ms, P < 0.001). Subgroup analysis suggested greater improvement in
      psychomotor performance with captopril, but this was equivocal because of the
      small sample size in each group. Hence, the psychomotor effects of treatment with
      nifedipine and captopril were compared in a further 13 hypertensives (aged 62-76
      years; SBP = 178 (range 169-193) mmHg; DBP = 106 (range 97-117) mmHg) in a double
      blind crossover study. With both drugs, control of hypertension was associated
      with a significant and comparable improvement in several psychomotor performance
      measures. The results suggest that impaired psychomotor performance due to
      hypertension improves with antihypertensive treatment. The improvement appears to
      be related to control of hypertension rather than to the direct CNS effects of
      antihypertensive drugs.

PMID- 8345498
TI  - Nocturnal hypotension and ACE inhibitors.
AB  - Thirty essential hypertensive subjects had their BP measured by 24h ambulatory
      monitoring before (first placebo period) and after exposure to antihypertensive
      therapy with either enalapril (four weeks) or nitrendipine (six weeks). Similar
      measures of BP were obtained during a second placebo period intercalated between
      the two active drugs. The 24h averages of systolic and diastolic pressures were
      higher during placebo (148 +/- 3/91 +/- 1 mmHg, respectively) than during
      treatment periods. Four weeks of treatment with enalapril reduced arterial
      pressure to a 24h average of 137 +/- 1/86 +/- 1 mmHg while nitrendipine given for
      six weeks lowered BP to an average of 135 +/- 1/84 +/- 1 mmHg. The
      antihypertensive effect of the drugs was of a comparable magnitude (P > 0.05). In
      addition both drugs produced analogous reductions in BP during the day (07.00 to
      23.00 h). In contrast, the nocturnal fall in BP was significantly greater during
      treatment with nitrendipine. Average systolic and diastolic pressures between
      23.00 h and 07.00 h were 133 +/- 1 mmHg and 82 +/- 2 mmHg with enalapril compared
      with 129 +/- 3 mmHg (P < 0.01) and 77 +/- 3 mmHg (P < 0.01) with nitrendipine,
      respectively. These data suggest that antihypertensive agents show important
      differences in terms of their action on the mechanisms that regulate BP during
      sleep. Medications that amplify the otherwise physiological fall in BP during
      sleep may add risk to patients with impaired coronary vasodilator reserve owing
      to ventricular hypertrophy, coronary atherosclerosis, or both.

PMID- 8345499
TI  - Combination therapy with verapamil and nitrendipine in patients with
      hypertension.
AB  - Forty patients with mild to moderate hypertension were divided into two groups,
      20 patients (group A) received 240 mg verapamil and 20 patients (group B)
      received 20 mg nitrendipine daily during the first six weeks. During the second
      six weeks, all 40 patients were given 10 mg nitrendipine plus 120 mg verapamil.
      After the combination therapy, group B received verapamil, 240 mg and group A
      nitrendipine 20 mg for a further period of six weeks. When verapamil and
      nitrendipine were used alone, BP decreased significantly in each group. However,
      BP decreased more when the combination therapy was used and increased when the
      treatment was changed to single drug therapy from the two-drug combination. In
      addition, side-effects were three to four times fewer during the combination
      therapy. It is concluded that the combination of two different calcium
      antagonists in the treatment of hypertension provides a new dimension to therapy.

PMID- 8345501
TI  - Attenuation of nocturnal BP fall in essential hypertensives with cerebral
      infarction.

PMID- 8345500
TI  - Cuff sizes.

PMID- 8345502
TI  - Multiple phaeochromocytoma with renal artery stenosis or occlusion: report of two
      cases.

PMID- 8345503
TI  - Serum lipids, lipoproteins and apolipoproteins in untreated essential
      hypertension.

PMID- 8345504
TI  - Influence of subinhibitory levels of antibiotics on expression of Escherichia
      coli lipopolysaccharide and binding of anti-lipopolysaccharide monoclonal
      antibodies.
AB  - The expression of Escherichia coli lipopolysaccharide (LPS) and the binding
      capacity of anti-LPS monoclonal antibodies (MAbs) to E. coli grown in the
      presence or absence of subinhibitory concentrations of various antibiotics was
      studied. Four E. coli strains (three clinical blood-culture isolates and an
      isogenic, non-capsulate mutant of the O18:K1 parent) were grown in the presence
      of the beta-lactam antibiotic, ampicillin, the aminoglycoside gentamicin, the
      fluoroquinolone ciprofloxacin and chloramphenicol. The techniques of silver
      staining, immunoblotting, whole-cell ELISA and flow cytometry were all used to
      monitor the expression of LPS on the bacteria and the binding of the anti-LPS
      MAbs. Treatment with ampicillin, chloramphenicol and ciprofloxacin resulted in
      enhanced binding of anti-core reactive MAbs to most E. coli strains. Overall,
      treatment with gentamicin produced the least effect on MAb binding. The presence
      of chloramphenicol decreased the expression of high molecular mass O-antigen or
      increased the expression of low molecular mass substituted E. coli LPS or both.
      These results further illustrate that LPS core, especially the inner-core region,
      becomes more accessible to antibodies when bacteria are grown in the presence of
      certain antibiotics. Possible synergy between antibodies and antibiotics for
      treatment of septicaemia and septic shock remains an intriguing possibility.

PMID- 8345505
TI  - Characterisation of strains of Aeromonas spp. by phenotype and whole-cell protein
      fingerprint.
AB  - Sixty-eight isolates of Aeromonas spp. were examined biochemically and their cell
      proteins were analysed by silver-stained SDS-PAGE. Protein fingerprints did not
      correlate with phenotype. However, consideration of both phenotype and
      fingerprint showed clustering of epidemiologically related isolates. There was
      also evidence that similar strains could be found in infected people and water or
      other environmental samples.

PMID- 8345506
TI  - Enterotoxigenic bacteria in the sudden infant death syndrome.
AB  - Faecal samples from 123 infants who died with sudden infant death syndrome (SIDS)
      and from a comparative group of 52 age-matched babies were analysed for toxigenic
      bacteria and their toxins. Serum samples from the SIDS infants were also analysed
      for these toxins. A significantly higher proportion of toxigenic bacteria and
      their toxins were found in faecal samples of SIDS babies than in samples from the
      comparative group. These toxins were also found in serum from the SIDS babies.
      Clostridium perfringens was found in 54 (45.4%) of 119 SIDS cases compared with
      10 (19.6%) of 51 healthy babies (chi 2 = 10.1, p < 0.01); C. difficile in 33
      (27.7%) of 119 SIDS cases compared with 8 (14.8%) of 54 healthy babies (chi 2 =
      3.43ns, p < 0.1); Staphylococcus aureus in 12 (27.3%; 66.7% enterotoxigenic) of
      44 SIDS cases compared with 12 (85.7%; non-enterotoxigenic) of 14 healthy babies
      (chi 2 = 14.9, p < 0.001); C. botulinum in 6 (5.0%) of 120 SIDS cases compared
      with 0 of 53 healthy babies (chi 2 = 2.74, p < 0.1). Campylobacter jejuni,
      Yersinia enterocolitica, Vibrio parahaemolyticus, salmonellae and Bacillus cereus
      were not detected. Heat-labile toxin, lethal to mice (HLML) was found in 32
      (27.1%) of 118 SIDS faecal samples compared with 5 (10.6%) of 47 healthy babies
      (chi 2 = 5.24, p < 0.05); cytotoxins in 38 (30.9%) of 123 SIDS faecal samples
      compared with 0 of 21 of healthy babies (chi 2 = 8.8, p < 0.01) and 24 (27.6%) of
      87 SIDS serum samples. C. perfringens enterotoxin was detected in 33 (34.4%) of
      96 SIDS faecal extracts compared with 0 of 23 of healthy babies (chi 2 = 10.94, p
      < 0.001), and in 27 (24.5%) of 110 SIDS serum samples. C. perfringens alpha-toxin
      (presumptive) was detected in 14 (17.5%) of 80 SIDS faecal extracts compared with
      0 of 17 from healthy babies (chi 2 = 3.5ns, p congruent to 0.05) and in 2 (2.3%)
      of 87 SIDS serum samples. C. difficile toxin was detected in four SIDS faecal
      samples and two serum samples. C. botulinum toxin was detected in only one of 120
      SIDS faecal samples compared with none of 49 from healthy babies. Staphylococcal
      enterotoxins were detected in 8 (19.5%) of 41 SIDS faecal samples compared with 0
      of 19 from healthy babies (chi 2 = 4.278, p < 0.05), and in 4 (10.8%) of 37 SIDS
      serum samples.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8345507
TI  - Detection of Staphylococcus aureus with biotinylated monoclonal antibodies
      directed against staphylococcal TNase complexed to avidin-peroxidase in a rapid
      sandwich enzyme-linked immunofiltration assay (sELIFA).
AB  - For rapid identification of Staphylococcus aureus, a monoclonal antibody (MAb)
      biotin-avidin-peroxidase complex, directed against the S. aureus thermostable
      nuclease (TNase), was formed and used in a rapid three-step sandwich enzyme
      linked immunofiltration assay (sELIFA) and a three-step sandwich enzyme-linked
      immunosorbent assay (sELISA). The MAb-peroxidase complex was formed by incubating
      the biotinylated MAbs with a streptavidin-peroxidase conjugate and the complex
      was purified by gel permeation chromatography. When compared with a four-step MAb
      based sELISA described previously, this complex permitted one reagent step to be
      omitted in a three-step sELISA, and the test time was significantly reduced. The
      test sensitivity was slightly reduced in the three-step ELISA (detection limit
      1.0-2.0 ng of TNase/ml) when compared to the four-step sELISA (detection limit
      0.5-1.0 ng of TNase/ml). The sELIFA method was based on the filtration of
      bacterial culture supernates through nitrocellulose membrane disks pre-spotted
      with a MAb directed against the S. aureus TNase, followed by detection with the
      MAb-peroxidase complex (three-step sELIFA). A detection limit of 0.5-2.0 ng of
      TNase/ml was achieved with the three-step sELIFA, depending on the filtrate
      volume of culture supernates. The total test time was 10-15 min when pre-spotted
      and blocked membranes were used. A total of 85 bacterial strains was tested in
      the sELIFA. All the 28 S. aureus strains showed positive results, but none of the
      57 non-S. aureus strains did so, although some of these produced thermostable
      nuclease activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345508
TI  - Human immune response to the 18-kDa outer-membrane antigen of Vibrio cholerae.
AB  - The serum IgG response of human volunteers challenged with Vibrio cholerae O1 was
      analysed for reactivity to V. cholerae O1 outer-membrane antigens by enzyme
      linked immunosorbent assay (ELISA) and the immunoblot technique. Purified outer
      membrane antigen preparations from vibrios grown in low-iron conditions were
      separated by SDS-PAGE. Specific immunoblot reactions of human sera showed that an
      18-kDa antigen, cholera protective antigen, was the major antigen with which sera
      reacted. ELISA revealed an increase in antibody to the 18-kDa antigen in nine of
      10 challenged volunteers. This response was independent of the biotype and
      serotype of the V. cholerae O1 challenge strain. Cholera protective antigen
      appears to be one of the major outer-membrane antigens involved in the human
      immune response to infection with V. cholerae.

PMID- 8345509
TI  - Mortality rates amongst mice with endogenous septicaemia caused by Pseudomonas
      aeruginosa isolates from various clinical sources.
AB  - Mice that had been treated with cyclophosphamide and ampicillin were fed with
      Pseudomonas aeruginosa. These procedures induced an endogenous septicaemia under
      conditions mimicking the pathophysiology of the disease in man. This model was
      used to compare the mortality rates in mice infected with P. aeruginosa isolates
      from various clinical sources. Mortality rates in mice given isolates from blood
      cultures had a broad range (0-100%), but the mean rate was significantly higher
      than with isolates from other infection sites. Moreover, blood isolates persisted
      in the intestines of mice after oral inoculation, whereas most isolates from
      other sources were gradually eliminated. Most P. aeruginosa isolates from blood
      culture produced significantly higher levels of exotoxin A and total proteases
      than isolates from other infection sites. Amongst the blood isolates, all but one
      of the lethal strains produced large quantities of exotoxin A or total proteases
      or both. Taken together, the results suggest that the ability of P. aeruginosa to
      adhere to the intestinal tract and to produce high levels of exo-enzymes may
      contribute to the development of fatal septicaemia.

PMID- 8345510
TI  - The application of flow cytometry to the study of bacterial responses to
      antibiotics.
AB  - Experiments were performed to determine whether a modern flow cytometer could be
      used to study bacterial populations in suspension, with particular reference to
      their morphological characteristics and their responses to antibiotics. The
      FACScan, a commercial benchtop flow cytometer fitted with an air-cooled laser,
      designed primarily for the study of eukaryotic peripheral blood mononuclear
      cells, yielded reproducible data relating to bacterial shape and internal
      architecture. It was sensitive enough to detect changes in bacterial morphology
      on entry into the growth cycle and after exposure to antibiotics. Antibiotic
      induced morphological changes affecting subpopulations of bacteria were
      sufficiently specific to allow differentiation between antibiotics with different
      cell-wall enzyme targets. Simultaneously, the effect of such antibiotics on the
      integrity of the outer cell membrane of Escherichia coli was assessed by
      measurement of the association of the nucleic acid-binding dye propidium iodide
      with the bacteria. These experiments demonstrated complex patterns of probable
      cell-wall leakage, related to the modes of action of the antibiotics. The FACScan
      is a useful and sensitive tool for the study of the morphology and physiology of
      bacterial populations in suspension, and is especially applicable to the study of
      antibiotic action.

PMID- 8345511
TI  - Use of tellurite for the selection of verocytotoxigenic Escherichia coli O157.
AB  - Potassium tellurite was assessed for the selection of verocytotoxigenic (VT+)
      Escherichia coli O157. MICs were higher for VT+ E. coli O157 than for other
      strains of E. coli and for Aeromonas spp. MacConkey medium containing sorbitol,
      tellurite and cefixime (TC-SMAC) permitted the growth of VT+ E. coli O157 and
      Shigella sonnei but partially or completely inhibited the growth of 67% of other
      strains of E. coli and all or most strains of other sorbitol-non-fermenting
      species tested. Of 391 rectal swabs from cattle screened on TC-SMAC medium, 26
      yielded isolates of VT+ E. coli O157 whereas sorbitol-MacConkey medium with
      cefixime and rhamnose yielded only nine isolates. Inclusion of potassium
      tellurite in sorbitol-MacConkey agar markedly increased the rate of isolation of
      VT+ E. coli O157 from cattle rectal swabs and may do so for other types of
      specimen.

PMID- 8345512
TI  - A microbiologist's perspective.

PMID- 8345513
TI  - Metallo-beta-lactamases--a new therapeutic challenge.

PMID- 8345514
TI  - kappa B-like motifs regulate the induction of immune genes in Drosophila.
AB  - The mammalian transcription factor NF-kappa B regulates a number of genes
      involved in immune and acute phase responses, by interacting with a nucleotide
      sequence element, the kappa B-motif. In this work we demonstrate the
      participation of similar motifs in the immune response of insects as well: kappa
      B-like motifs have a regulatory role in the synthesis of cecropins, a set of anti
      bacterial peptides, triggered by the presence of bacterial cell wall components
      in the insect blood. We show that the upstream region of the Cecropin gene CecA1
      contains elements responsible for inducible and tissue-specific expression.
      Furthermore, a trimer of kappa B-like motif confers high levels of inducible
      expression from the reporter gene, after transfection in a Drosophila blood cell
      line. As in the moth Hyalophora cecropia, stimulation with bacterial
      lipopolysaccharide induces a nuclear factor that specifically binds to the kappa
      B-like motif. Our data suggest a functional and evolutionary relationship between
      these insect immune response factors and the mammalian NF-kappa B.

PMID- 8345515
TI  - A conformational change in the actin subunit can change the flexibility of the
      actin filament.
AB  - The mechanical properties of F-actin are very significant, given the central
      structural role played by actin filaments within muscle and the cytoskeleton. We
      have determined that actin can exist in a state that has a fourfold increase in
      flexibility over normal F-actin, and nucleotide. Three-dimensional
      reconstructions from electron micrographs suggest that this increased flexibility
      arises from a rotation of subdomain-2, the smallest subdomain, of the actin
      subunit. The modulation of actin's flexibility by Ca2+ and Mg2+ may have
      important physiological consequences within the cell. Further, since it has been
      shown that myosin-decorated actin filaments are more flexible than pure F-actin,
      it is possible that myosin induces this more flexible state in actin.

PMID- 8345516
TI  - Nucleotide sequence requirements for self-cleavage of Neurospora VS RNA.
AB  - We have used several complementary approaches to investigate the minimal
      contiguous sequence required for the in vitro self cleavage reaction performed by
      Neurospora VS RNA. Deletion analysis and site-directed mutagenesis revealed that
      only a single nucleotide is required upstream of the self-cleavage site, and that
      the identity of this nucleotide is not critical. This distinguishes VS RNA from
      all currently known ribozymes except hepatitis delta virus RNA. The shortest
      contiguous sequence capable of cleavage contains 153 nt downstream of the
      cleavage site. Linker insertion mutagenesis suggests that much of this downstream
      sequence is important for self-cleavage. Comparative sequence analysis of the VS
      plasmid from six natural isolates supports the importance in vivo of the minimal
      region determined by in vitro methods. Also, phylogenetic analysis raises the
      possibility of a recent horizontal transfer of the VS plasmid from Neurospora
      intermedia to Neurospora sitophila.

PMID- 8345517
TI  - Dynamics of in vitro assembly of 16 S rRNA into 30 S ribosomal subunits.
AB  - One of the important unsolved problems in the ribosome field is the molecular
      basis for the sequential and co-operative nature of ribosome assembly. As an
      approach to this problem, we have taken advantage of the temperature dependence
      of in vitro reconstitution and have used chemical probing methods to examine the
      conformation and reactivity of 16 S rRNA at successive stages during subunit
      assembly. One class of nucleotides displays reactivities similar to those
      observed in native 30 S particles when the RNA and protein are incubated in the
      absence of any heat step (0 degrees C effects). At 30 degrees C, where the
      assembly process takes 2 hours, other bases can be assigned to one of several
      additional kinetic classes, determined by the rate at which their chemical
      reactivities transit from levels observed in naked RNA to levels observed in
      fully assembled subunits: (1) fast (t1/2 = < 5 min at 30 degrees C); (2) slow
      (t1/2 = 15 to 30 min at 30 degrees C); (3) delayed slow (t1/2 = 30 to 60 min at
      30 degrees C). Finally, several nucleotides display transient kinetics in their
      reactivities, showing increasing reactivity at early time points and becoming
      protected later in assembly; most of these effects correspond to residues that
      were previously shown to display reciprocal enhancement and protection patterns
      during step-wise in vitro assembly. These findings, together with our previous
      studies using purified individual proteins lead to the following conclusions: (1)
      there is a predominant 5' to 3' polarity to in vitro assembly, even though it is
      uncoupled from transcription; (2) portions of the central and 3' major domains
      fold into an active conformation only at a very late stage of assembly; (3) bases
      footprinted by late-assembling proteins, according to the 30 S subunit assembly
      map, show generally slower kinetics than residues footprinted by proteins that
      bind early in the assembly map, providing direct evidence for the sequential
      nature of the in vitro assembly process; (4) most proteins are associated with
      nucleotides that fall into more than one kinetic class, suggesting that assembly
      proceeds through multiple pathways, or that individual proteins interact
      sequentially with different regions of the RNA.

PMID- 8345518
TI  - Nutrient-responsive promoter elements of the V4 gene of Dictyostelium discoideum.
AB  - Expression of the V4 gene of Dictyostelium discoideum is required for the
      transition from growth to development in response to an altered nutrient
      environment. In addition, the expression itself is sensitive to the types and
      amounts of nutrients supporting growth. We describe the structure of the two
      copies of the V4 gene and the relationship between these genes and the two V4
      mRNA species produced during growth. In addition, three regions were identified
      within the upstream sequences of the V4b gene that are important for proper
      transcription. At least two of the regions can, independently of the others,
      confer deactivation of transcription upon initiation of development and thus
      serve as redundant regulatory sequences. However, the regions are differentially
      responsive to the types and amounts of nutrients present in the cell's
      environment and thus are distinct from one another.

PMID- 8345519
TI  - The minus 35-recognition region of Escherichia coli sigma 70 is inessential for
      initiation of transcription at an "extended minus 10" promoter.
AB  - It is known that Escherichia coli promoters having the major minus 10 consensus
      sequence TATAAT, but lacking significant resemblance to consensus in the minus 35
      region, allow transcriptional initiation in vivo and in vitro if they have an
      additional TGn motif immediately upstream of minus 10. To determine whether
      region 4.2 of sigma 70, whose normal role is sequence recognition at minus 35, is
      unnecessary for initiation of transcription at such "extended minus 10"
      promoters, we modified the sigma 70 gene so as to generate a carboxy-truncated
      polypeptide lacking the last 84 amino acids and therefore missing region 4.2. Our
      results show that both the intact and truncated sigma 70 allow purified RNA
      polymerase to initiate efficiently and specifically at an extended minus 10
      promoter, whereas only the intact sigma 70 permits efficient initiation at normal
      promoters (defined by minus 35 and minus 10 hexamer sequences).

PMID- 8345520
TI  - Cloning, DNA sequence, functional analysis and transcriptional regulation of the
      genes encoding dipicolinic acid synthetase required for sporulation in Bacillus
      subtilis.
AB  - Dipicolinic acid (DPA) is a small polar molecule that accumulates to high
      concentrations in bacterial endospores, and is thought to play a role in spore
      heat resistance, or the maintenance of heat resistance. Previous work has shown
      that mutations in the spoVF locus of Bacillus subtilis prevent the formation of
      DPA, and give rise to heat-sensitive spores. Addition of exogenous DPA during
      spore development led to the restoration of heat resistance. This suggested that
      the spoVF locus encoded dipicolinic acid synthetase, the enzyme thought to
      catalyse the single reaction needed to synthesise DPA from dihydroxydipicolinic
      acid, an intermediate in the lysine biosynthetic pathway. We have now cloned and
      sequenced the spoVF locus of Bacillus subtilis and show that it comprises two
      coordinately regulated genes, now designated dpaA and dpaB. Expression of
      fragments of the dpa operon in Escherichia coli has shown that the two gene
      products together specify DPA synthetase activity. The promoter of the dpa
      operon, which lies just upstream of the first gene, has been identified by primer
      extension analysis. Sequences in this region show strong sequence similarity to
      several promoters recognized by the sigma K form of RNA polymerase. Transcription
      from this promoter was detected four hours after the onset of sporulation, at
      about the same time that sigma K activity is known to appear. Furthermore,
      transcription was abolished by mutations in a series of genes that are known to
      be required for the synthesis of active sigma K. These results are in accordance
      with previous work indicating that DPA synthetase activity was present only
      during the late stages of sporulation and specifically in the mother cell
      compartment. Transcription was enhanced by a gerE mutation, indicating that, like
      the previously described cotA gene, spoVF is negatively regulated by GerE. The
      mother-cell-specific synthesis of an enzyme responsible for a compound that
      accumulates to high concentrations in the prespore raises interesting questions
      about intercellular transport mechanisms.

PMID- 8345521
TI  - Different mechanisms of recognition of bacteriophage Q beta plus and minus strand
      RNAs by Q beta replicase.
AB  - Our earlier work on the recognition of Q beta plus strand RNA by replicase had
      shown by RNase degradation and by electron microscopic techniques that specific
      binding interactions occurred at two internal sites, the S-site and the M-site,
      but not at the 3'-end, i.e. the site of initiation of synthesis. Using
      essentially similar methods, we have found now for binding complexes of replicase
      with the minus strand a completely different pattern, namely considerable
      terminal binding, whereas binding to internal sites was without detectable
      specificity. In the case of plus strand complexes, simultaneous binding at the
      two internal sites and at a terminal site could be demonstrated by electron
      microscopy after initiation of RNA synthesis in the presence of host factor, GTP
      and ATP. A variant plus strand RNA containing a 490 nucleotide duplication near
      the 5'-end resulted in similar double-looped complexes, however with an elongated
      free arm, showing that the protein-bound terminal site was the 3'-end of the RNA.
      Interestingly, the same two-looped structures were also found for complexes
      consisting of plus strand RNA and host factor without replicase. This suggests
      that the role of the host factor on the plus strand template is to bring the 3'
      end into the proximity of the S-site/M-site domain, where replicase can initiate
      on it. In contrast, the 3'-end of the minus strand appears to be directly
      available to the enzyme.

PMID- 8345522
TI  - Influence of fluctuations on DNA curvature. A comparison of flexible and static
      wedge models of intrinsically bent DNA.
AB  - Matrix-generator and Monte Carlo methods have been employed to study the
      influence of thermal fluctuations on the overall sizes and shapes of curved
      pieces of DNA. The DNA model involves the independent angular parameters relating
      successive base-pair steps: the sequence-dependent equilibrium values and
      fluctuations of the twist, tilt, and roll angles. The curved sequence under study
      is the (A5X5)n repeating polymer, the AA and XX steps having different
      equilibrium roll and twist values. Both planar circles and superhelices are
      analysed. Detailed comparison is made between the rigorous statistical mechanical
      representation of the DNA and simplified static models currently used in the
      literature. That is, a more realistic "flexible wedge" model is contrasted with
      the existing "static wedge" model of DNA curvature, which is demonstrated to be
      inadequate. The size of the coils is described by the unperturbed root-mean
      square end-to-end distance and the shape by a ratio of the principal moments of
      the radius of gyration. The moment ratios indicate that when DNA is relatively
      short (e.g. its length is shorter than half a turn of the static superhelix), the
      flexible chains are more "short and thick" than the static structure. The end-to
      end distances, however, are practically the same in the two models. For longer
      DNA fragments, the flexible chain is more extended in terms of the end-to-end
      distance and more globular in terms of the moment ratio. Thus, fluctuations
      "blur" the curvature of longer DNA fragments compared with static models.
      Furthermore, the overall average shape of slightly curved DNA subject to natural
      bending and twisting fluctuations is essentially indistinguishable from that of
      the corresponding "straight" DNA. Such configurational similarities are
      apparently responsible for the relative insensitivity of the polyacrylamide gel
      matrix to small degrees of DNA curvature. These findings raise serious questions
      regarding the quantitative estimation of wedge angles in DNA from electrophoretic
      experiments, based on static models. Comparison between planar circles and
      superhelices shows that when fluctuations are considered, the flexible circles
      are more spherical than the superhelices. The results imply that when DNA bending
      is exactly "in phase" with the helical repeat (i.e. when the DNA loop is exactly
      planar at 0 K), the DNA coil is packed more tightly than when bending and
      twisting are "out of phase" (and a superhelix is formed at 0 K). This finding is
      consistent with polyacrylamide gel electrophoresis data testifying to an increase
      in DNA retardation when twisting is more precisely "tuned".(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8345523
TI  - Refined structures of the ligand-binding domain of the aspartate receptor from
      Salmonella typhimurium.
AB  - The aspartate receptor is a transmembrane-signalling protein that mediates
      chemotaxis behaviour in bacteria. Aspartate receptors in Salmonella typhimurium
      and Escherichia coli exist as dimers of two subunits in the presence as well as
      in the absence of aspartate. We have previously reported the three-dimensional
      structures of the external ligand-binding domain of the S. typhimurium aspartate
      receptor with and without bound aspartate. The external or periplasmic region of
      the aspartate receptor is a dimer of four-alpha-helical bundle subunits; a single
      aspartate molecule binds to one of two sites residing at the subunit interface,
      increasing the affinity of the subunits for one another. Here we report the
      results of a detailed analysis of the aspartate receptor ligand-binding domain
      structure (residues 25 to 188). The dimer interface between the twofold related
      subunits consists primarily of contacts mediated by the side-chains of the N
      terminal helix of each four-alpha-helical bundle subunit. The N-terminal helices
      pack approximately 20 degrees from parallel as an approximate coiled-coil super
      secondary structure. We have refined aspartate receptor ligand-binding domain
      structures in the presence and in the absence of a bound aromatic compound, 1,10
      phenanthroline, to 2.2 A and 2.3 A resolution, respectively, as well as crystal
      structures in the presence of specifically bound Au(I), Hg(II) and Pt(IV) complex
      ions at 2.4 A, 3.0 A and 3.3 A resolution, respectively. The possible biological
      relevance of the aromatic ligand-binding site and the metal ion-binding sites is
      discussed. The dimer of four-alpha-helical bundle subunits composing the
      periplasmic region of the S. typhimurium aspartate receptor provides a basis for
      understanding the results of mutational analyses performed on related chemotaxis
      transmembrane receptors. The crystal structure analysis provides an explanation
      for the way in which mutations in the E. coli aspartate receptor affect its
      binding to the periplasmic maltose-binding protein and how mutations in the more
      distantly related E. coli Trg chemotaxis receptor affect its binding to the
      periplasmic ribose and glucose-galactose binding proteins.

PMID- 8345524
TI  - Long-range surface charge-charge interactions in proteins. Comparison of
      experimental results with calculations from a theoretical method.
AB  - Long-range coulombic interaction energies between surface-charges in barnase and
      subtilisin have been determined to provide data for calibrating theoretical
      methods. The pKa of His18 in barnase can be measured accurately by titrating the
      fluorescence of Trp94 that is significantly quenched on protonation of His18. The
      pKa of His64, the active site base of subtilisin, has previously been shown to be
      measured accurately from the pH dependence of kcat/Km for the hydrolysis of
      substrates. The titration curves of both histidine residues fit the theoretical
      equations for the ionization of single groups with great precision; the Hill
      constants for wild-type and mutant enzymes are all close to 1.0. The coulombic
      interaction energies of distant charged side-chains with the protonated form of
      His18 and His64 have been measured from changes in pKa of these residues on
      mutation of those charged side-chains. The interaction energies between single
      charges on the surfaces of the proteins at low ionic strength are small, some 0.3
      0.5 kcal mol-1 at a distance of 12 A, and fall gradually with distance to 0.05
      0.3 kcal mol-1 at 20 A. Multiple mutations are frequently additive. Effects are
      larger in subtilisin than in barnase, possibly related to the degree of solvent
      exposure of the charge. These data have been used to benchmark the finite
      difference method of calculating electrostatic interactions as implemented in the
      program DelPhi. There is reasonable agreement between the calculated and measured
      results as a function of both position and ionic strength.

PMID- 8345525
TI  - Prediction of protein secondary structure at better than 70% accuracy.
AB  - We have trained a two-layered feed-forward neural network on a non-redundant data
      base of 130 protein chains to predict the secondary structure of water-soluble
      proteins. A new key aspect is the use of evolutionary information in the form of
      multiple sequence alignments that are used as input in place of single sequences.
      The inclusion of protein family information in this form increases the prediction
      accuracy by six to eight percentage points. A combination of three levels of
      networks results in an overall three-state accuracy of 70.8% for globular
      proteins (sustained performance). If four membrane protein chains are included in
      the evaluation, the overall accuracy drops to 70.2%. The prediction is well
      balanced between alpha-helix, beta-strand and loop: 65% of the observed strand
      residues are predicted correctly. The accuracy in predicting the content of three
      secondary structure types is comparable to that of circular dichroism
      spectroscopy. The performance accuracy is verified by a sevenfold cross
      validation test, and an additional test on 26 recently solved proteins. Of
      particular practical importance is the definition of a position-specific
      reliability index. For half of the residues predicted with a high level of
      reliability the overall accuracy increases to better than 82%. A further strength
      of the method is the more realistic prediction of segment length. The protein
      family prediction method is available for testing by academic researchers via an
      electronic mail server.

PMID- 8345526
TI  - Crystallographic refinement and structure analysis of the complex of wheat germ
      agglutinin with a bivalent sialoglycopeptide from glycophorin A.
AB  - Wheat germ agglutinin (WGA) elicits a number of biological effects in
      erythrocytes as a result of specific binding to the transmembrane protein
      glycophorin A. The structure of co-crystals of WGA (isolectin 1: WGA1) with a
      bivalent sialoglycopeptide fragment of glycophorin A (T5), determined at 2.0 A
      resolution, has been further refined and analyzed with respect to ligand-induced
      changes in the tertiary structure, mobility, solvation, saccharide conformation
      and protein/saccharide interactions at three independent N-acetyl-D-neuraminic
      (NeuNAc) binding sites. The final model, which includes the two independent WGA1
      monomers (composed of domains A, B, C and D), two positions for bound T5 sialo
      tetrasaccharide (NeuNAc-alpha 2,3-Gal-beta 1,3-(alpha 2,6-NeuNAc)GalNAc) and 386
      water molecules, refined to a crystallographic R-factor of 17.1% (Fo > 1.0 sigma)
      and an average temperature factor of 31.99 A2. Comparisons between the tertiary
      structures of the liganded and unliganded WGA1 dimers indicate that the largest
      deviations from 2-fold symmetry are localized in domains engaged in sugar binding
      (B1 and C2) and at the C-terminal domain of monomer II (D2), forming a strong
      lattice contact. Interactions of the tetrasaccharide with amino acid ligands in
      the three binding sites and with water were carefully analyzed and compared.
      Bound conformations of terminal NeuNAc match to within a root-mean-square delta r
      of 0.3 A. The specificity-determining N-acetyl group superimposes best in
      comparison with other substituents of the sugar ring. Of the five domain binding
      sites that are not occupied in this dimeric crosslinked complex, only one is
      accessible to the NeuNAc monosaccharide as determined from a difference Fourier
      map at 3.0 A resolution.

PMID- 8345527
TI  - Localization of proteins HL29 and HL31 from Haloarcula marismortui within the 50
      S ribosomal subunit by chemical crosslinking.
AB  - Isolated 50 S ribosomal subunits from the halophilic archaebacterium Haloarcula
      marismortui were treated in situ with the homobifunctional and cleavable
      crosslinking reagent dithiobis(succinimidyl propionate) (12 A). Several
      crosslinked complexes were obtained. Among these were the protein pairs HmaL4
      HL29 and HmaL18-HL31; HL29 and HL31 are ribosomal proteins without any equivalent
      in eubacterial ribosomes. The crosslinked protein pairs were isolated on a
      preparative scale by combining conventional ion-exchange chromatography and
      reverse phase high-pressure liquid chromatography. The monomeric proteins
      involved in crosslink formation were unambiguously identified by two-dimensional
      gel electrophoresis and N-terminal or internal protein sequencing. Due to the
      homology between HmaL4 and HmaL18 and their Escherichia coli counterparts, and
      the roughly known location of these proteins within the 50 S subunit, our results
      demonstrate that HL29 is probably located in the centre of the large subunit in
      the vicinity of the peptidyltransferase domain, whereas HL31 must be situated
      within the central protuberance close to the region of the 5 S RNA.

PMID- 8345528
TI  - Crystallization and preliminary crystallographic characterization of aspartic
      proteinase-A from baker's yeast and its complexes with inhibitors.
AB  - The aspartic proteinase from yeast vacuoles, proteinase-A, has been crystallized
      with and without non-hydrolysable transition-state analogue inhibitors. The
      native enzyme crystals belong to the space group I2(1)2(1)2(1), with two
      molecules per asymmetric unit. The inhibitor complex crystals are trigonal with
      space group P3(2)21 and with one molecule in the asymmetric unit. Preliminary X
      ray analysis of both native enzyme and its complexes indicate that the complexes
      diffract to higher resolution than the native crystals. This is probably due to
      reduced flexibility in the enzyme-inhibitor complex.

PMID- 8345529
TI  - Purification and crystallization of Shiga toxin from Shigella dysenteriae.
AB  - The protein toxin produced by Shigella dysenteriae consists of one enzymatically
      active A subunit of 293 amino acid residues and five B subunits of 69 amino acid
      residues that are involved with cell attachment. The holotoxin has been purified
      by blue Sepharose and chromatofocusing column chromatography. Two crystal forms
      of purified holotoxin have been grown by vapor diffusion. One grows as fine
      needles, hexagonal in cross-section, which do not diffract well enough to
      characterize crystallographically. The second grows as thin plates that diffract
      to at least 3 A resolution. Their space group is P2(1)2(1)2(1) with unit cell
      dimensions of a = 132.0 A, b = 146.0 A and c = 82.5 A. The asymmetric unit of the
      crystals is likely to contain two AB5 units.

PMID- 8345530
TI  - Comparison of toxicities of acrylamide and 2,5-hexanedione in hens and rats on 3
      week dosing regimens.
AB  - Survival rates, changes in body weight, gait/ataxia scores, and neuropathological
      lesions were compared between adult Long-Evans rats and adult White Leghorn hens
      given equivalent dosages of the peripheral neurotoxicants acrylamide and 2,5
      hexanedione (12, 25, and 50 mg/kg acrylamide 3 times per week; or 75, 105, 150,
      225, or 350 mg 2,5-hexanedione/kg/d, with hens receiving the lowest 3 dosages of
      2,5-hexanedione and rats receiving the highest 3 dosages of this test compound).
      All rats survived the 3-wk acrylamide study period, although those given 50 mg/kg
      did not gain weight and showed alterations in gait. Hens given 50 mg/kg
      acrylamide were moribund by 2 wk and were sacrificed before the end of the 3-wk
      study period. By this time they had lost 29 +/- 3% of their body weight, but none
      showed significant renal or hepatic lesions on necropsy. Hens given all doses of
      acrylamide showed dose-related ataxia, weakness, and depression. Gait changes
      were seen in rats given the high dose of acrylamide for the 3-wk test period.
      Neuropathological studies revealed that both rats and hens given acrylamide had
      distal myelinated fibers with dose-related neurofilament-rich axonal swelling and
      Wallerian-like degeneration, better developed in the rodents. In addition, high
      dose acrylamide rats had recent necrosis of cerebellar Purkinje cells. Deaths
      occurred in all groups of hens given 2,5-hexanedione (75, 105, or 150 mg/kg)
      before sacrifice at 3 wk, but all rats given 2,5-hexanedione (150, 225, 350
      mg/kg) survived a 4-wk study period, even though gait changes were evident in the
      225 and 350 mg/kg dosage groups by 3 wk. Neither hens nor rats dosed with 2,5
      hexanedione for 3 wk had significant neuropathic lesions, although the hens
      showed dose-related ataxia, weakness, and depression. Early neurofilamentous
      intraaxonal masses in distal levels of selected myelinated tracts were seen in
      rats given the high dose of 2,5-hexanedione for an additional week. These studies
      suggest that hens are sensitive to acrylamide and 2,5-hexanedione toxicities, and
      that the rat is more likely than the hen to develop neuropathological lesions.

PMID- 8345531
TI  - Direct measurement of fast axonal organelle transport in the sciatic nerve of
      rats treated with acrylamide.
AB  - The effects of acrylamide on fast axonal transport have been measured primarily
      using the indirect methods of isotope or enzyme accumulation. We report the first
      direct evaluation of the effects of subchronic acrylamide dosing (150, 300, or
      500 mg/kg total dose, i.e., 50 mg/kg, 2x/wk, for 1.5, 3, 5 wk, respectively) on
      the fast axonal transport motility machinery itself using video-enhanced
      differential interference contrast optics with digital image processing and
      computer analysis. Four principle observations were made: (1) Rapid anterograde
      transport was not affected at any dosage level within 1 wk after cessation of
      dosing. (2) A high cumulative dosage (500 mg/kg total) of acrylamide or
      bisacrylamide produced approximately 7-18% decrease in the rate of retrograde
      transport in both myelinated and unmyelinated axons. (3) Lower dosages of
      acrylamide (150 or 300 mg/kg total) produced an increase in retrograde transport
      rates in myelinated axons only. (4) During the "recovery" phase for the 500 mg/kg
      acrylamide animals (i.e., 3 or 5 wk after the last dosage of acrylamide) the rate
      of anterograde transport in the myelinated axons was decreased at 3 wk but not at
      5 wk, and the rate of retrograde transport in the myelinated axons returned to
      control levels while the retrograde transport in the unmyelinated axons continued
      at abnormally slow speeds. The application of this new technique to evaluate the
      neurotoxic effects of acrylamide provides evidence of dynamic changes in the
      axonal transport motility machinery itself and differential effects on myelinated
      versus unmyelinated fibers.

PMID- 8345532
TI  - Neurotoxicity of glycidamide, an acrylamide metabolite, following intraperitoneal
      injections in rats.
AB  - Acrylamide (2-propenamide) monomer produces central-peripheral distal axonopathy
      in humans and some animal species. Its neurotoxicity is characterized by abnormal
      sensation, decreased motor strength, and ataxia. Acrylamide forms adducts with
      glutathione, proteins, and DNA. Recent studies demonstrated that acrylamide is
      metabolized to its epoxide, glycidamide (2,3-epoxy-1-propanamide). We studied the
      neurotoxicity potential of glycidamide in male Sprague-Dawley rats. Animals
      (groups of 6) were injected ip daily with either aqueous acrylamide or
      glycidamide at an acrylamide-equivalent dose of 50 mg/kg (0.70 mmol/kg). Both
      treatments resulted initially in the rats circling, which was followed by the
      onset of ataxia at 7-9 d and hindlimb paralysis at 12-14 d. Treated animals
      showed muscle wasting. At termination, acrylamide- and glycidamide-treated rats
      weighed 105% and 86% of initial weight, respectively, compared to 145% for
      controls. Animals were anesthetized and perfused with 10% neutral phosphate
      buffered formalin 12 or 14 d after beginning of treatment. Both treatment groups
      exhibited similar neuropathologic changes in the central and peripheral nervous
      systems. More severe lesions were produced by glycidamide. A marked increase in
      the number of affected Purkinje cells in the cerebellum, which exhibited changes
      ranging from pyknosis to cell death, were present. The brainstem exhibited axonal
      degeneration with chromatolytic necrosis in midbrain medial and lateral reticular
      nuclei. The spinal cord was characterized by spongy form changes with vacuoles of
      different sizes in various levels. These results suggest that glycidamide is an
      active neurotoxic metabolite of acrylamide.

PMID- 8345534
TI  - Whole-body exposures to a phosphoric acids aerosol: II. Food/water/weight effects
      in wild rodent and avian species.
AB  - Separate inhalation-chamber studies were conducted to assess acute/subacute food
      intake (g), water intake (ml), and body weight (g) effects of four whole-body
      phosphoric-acids-aerosol exposures in black-tailed prairie dogs (Cynomys
      ludovicianus); subacute effects of two exposures were studied in rock doves
      (Columba livia). A 95% red phosphorus/5% butyl rubber (RP/BR) mixture was burned
      to produce the aerosol. Each study involved (1) 3 RP/BR target concentration
      groups (0.0, 1.0, and 4.0 mg/L), (2) 24 prairie dogs or doves (8/group), with
      gender included as a factor in each study, and (3) a successive 3-phase paradigm
      (2 d preexposure; 4 and 2 d of approximately 80 min/d exposures to RP/BR for
      prairie dogs and rock doves, respectively; and 6 d postexposure). Results showed
      that in-chamber atmospheres were uniform and acceptable for all exposures. No
      prairie dogs died, but 1 male rock dove died on d 3 postexposure to 4.0 mg/L
      aerosol. Concentration and gender main effects were significant for the acute (2
      h out-of-chamber) food intake, water intake, and weight change of prairie dogs,
      with aerosol-exposed and male rodents showing decrements. Gender and day main
      effects were also significant for the subacute (23 h/d) variables in prairie
      dogs; females weighted less than males, and reduced food/water/weight was evident
      for all animals during the 4 exposure days and first 3 postexposure days. For
      rock doves, subacute gender and day main effects, plus concentration x day and
      concentration x gender x day interactions, characterized the data. A transitive
      relationship was evident among RP/BR aerosol conditions (0.0 < 1.0 < 4.0 mg/L)
      and mean decreased food intakes on the exposure days (d2 < d1). Enhanced
      postexposure water replenishment by female versus male doves exposed to 4.0 mg/L
      RP/BR aerosol was a main finding. Results are explained based upon a temporal
      model of phosphoric acid caused ulcers/edema. Effects are compared to prior
      evidence for albino rats, prairie dogs and rock doves; these are also discussed
      relative to certain human health and ecotoxicological literature.

PMID- 8345533
TI  - Neurobehavioral testing of subjects exposed residentially to groundwater
      contaminated from an aluminum die-casting plant and local referents.
AB  - Residents adjoining a die-casting plant had excessive headaches, numbness of
      hands and feet, dizziness, blurred vision, staggering, sweating, abnormal heart
      rhythm, and depression, which led to measurements of neurobehavioral performance,
      affective status, and the frequency of symptoms. They had all been exposed via
      well water and proximity to the plant to volatile organic chemicals (VOC) and to
      polychlorinated biphenyls (PCBs). The 117 exposed women and men and 46 unexposed
      referents were studied together for simple and choice visual reaction time, body
      sway speed, blink reflex latency, color discrimination, Culture Fair (a nonverbal
      nonarithmetic intelligence test), recall of stories, figures, and numbers,
      cognitive and psychomotor control (slotted pegboard and trail making A and B),
      long-term memory, profile of mood states (POMS), and scores and frequencies of 34
      symptoms. Choice reaction time, sway speed, and blink latency were impaired in
      both sexes of the exposed group and trail making B was impaired in exposed women.
      The POMS scores and frequencies of 30 of 34 symptoms were elevated in both sexes,
      compared to referents. Recall, long-term memory, psychomotor speed, and other
      cognitive function tests were reduced in exposed subjects and in the referents as
      compared to national referents. Neurophysiological impairment, and cognitive and
      psychomotor dysfunction and affective disorders, especially depression and
      excessive frequency of symptoms, were associated with the use of wells
      contaminated with VOCs, TCE and PCBs.

PMID- 8345535
TI  - Distribution of radioisotopic beryllium in mice after administration by various
      routes of injection.
AB  - A 7BeCl2 solution containing 0.5 micrograms Be per mouse was injected
      subcutaneously, intraperitoneally, intramuscularly, intrathoracically, and
      intravenously, and distribution was observed for periods up to 1 wk. 7Be was
      excreted more rapidly following intravenous injection than by the other routes of
      injection. The amount of Be found in the liver or the spleen was substantial at 1
      d after intraperitoneal injection. It increased more in the spleen at 7 d after
      either intraperitoneal or intrathoracic injection. On the other hand, the amounts
      of Be stayed almost constant in the kidneys, by the various routes of injection.
      When injected intrathoracically, the amounts of Be in the heart and the lung were
      greater than when administered by the other routes of injection. The amounts of
      Be in the femurs of mice administered by these routes of injection, except with
      intravenous injection, were greater than in the other organs. The percentage of
      7Be in the mineralized bone was 90% of that of 7Be in the femurs when injected
      intraperitoneally or intrathoracically. However, the ratio of Be in the
      mineralized bone to that in the bone marrow was 3 to 2. Beryllium had thus a
      closer affinity for the femurs than for the other organs investigated, with the
      different modes of administration used. The amount of Be in the entire skeleton
      was estimated to be substantial. Within the limitations of 1 wk of exposure, the
      skeleton would appear to be a critical organ. This would suggest that
      osteosarcomas may occur following administration of Be to laboratory animals for
      a long-term period.

PMID- 8345536
TI  - Lack of effect of carcinogen treatment on development of tumors arising
      spontaneously in Fischer 344 rats.
AB  - The incidence of a set of neoplasms arising "spontaneously" in Fischer 344 (F344)
      rats was determined in control and carcinogen-treated animals. Data were obtained
      from approximately 9000 rats (4000 males and 5000 females) used to study the
      carcinogenicity of a variety of alkylating compounds, including N-nitroso
      compounds, azoxyalkanes, and triazenes. In these experiments treated rats and
      controls were allowed to die naturally and were necropsied, and the tissues were
      examined histopathologically. The spontaneous neoplasms of interest were
      mononuclear cell leukemia and neoplasms of the anterior pituitary, adrenal
      medulla, pancreas, thyroid gland, mammary gland, and testis. These tumors were
      generally absent from control animals that (rarely) died before 70 wk of age.
      Although many carcinogen-treated rats died early with treatment-related tumors, a
      substantial number (1700 males and 2300 females) survived as long as controls.
      The incidence of spontaneous neoplasms was determined among controls and
      chemically treated rats at 10-wk intervals from 0 to 140 wk. The incidence of
      spontaneous tumors was not higher and was frequently statistically lower among
      treated rats than the corresponding incidence in controls, with the exception of
      leukemia in female rats. The same result was obtained with the subset of
      carcinogens not requiring metabolic activation (mostly alkylnitrosoureas). These
      data indicate that in this rat tumor model system, the alkylating carcinogens,
      while capable collectively of tumor induction at more than 20 sites, did not
      accelerate the development of any of the six spontaneously arising solid tumors.
      This suggests that these spontaneous tumors might arise by a mechanism that is
      unresponsive to the actions of the alkylating carcinogens.

PMID- 8345537
TI  - Differences between genetic stocks of chickens in response to acute and delayed
      effects of an organophosphorus compound.
AB  - The influence of genotypes of the major histocompatibility complex (MHC) on
      susceptibility to acute and delayed effects of an organophosphorus ester was
      measured in adult White Leghorn chickens from lines differing in response to
      sheep red blood cell (SRBC) antigen. Chickens from lines selected for high (HA)
      or low (LA) antibody response to SRBC and homozygous for B13B13 or B21B21
      genotypes at the MHC were administered a single subcutaneous injection of
      diisopropyl phosphorofluoridate (DFP) at dosages of 0, 0.25, 0.50, or 1.0 mg/kg
      body weight using corn oil as the carrier. Criteria for toxicological responses
      included clinical, biochemical, and pathological measures. Clinical signs of
      acute cholinergic poisoning and delayed neuropathy were dose related. Brain and
      blood cholinesterase and carboxylesterase activities were more sensitive to
      inhibition by DFP than were liver cholinesterase and carboxylesterase activities.
      Cholinergic signs 3 h after administration of DFP were more pronounced in line HA
      than in line LA chickens. Pathological evidence of delayed neuropathy 2 wk after
      DFP administration was also more evident in HA than LA chickens. Although less
      pronounced than that for lines, differences in neurotoxic manifestations
      following DFP administration were greater for chickens of B21B21 than B13B13
      genotypes. Activity of A-esterases, which hydrolyze organophosphorus esters
      without being inhibited by them, was lower in plasma of line HA than line LA
      chickens. Differences among the genotypes in activity of other esterases were not
      found in chickens not receiving DFP. These results indicated that responses of
      chickens to the neurotoxicant DFP were influenced by the background genome of the
      chickens.

PMID- 8345538
TI  - HIV, breast-feeding and under-5 mortality: modelling the impact of policy
      decisions for or against breast-feeding.
AB  - A computer model was developed to assess the impact on under-5 child mortality of
      breast-feeding practices in developing countries in the context of HIV infection.
      The model was used to estimate the effect on mortality of cessation of breast
      feeding among mothers HIV-positive and mothers HIV-negative at birth, for both
      urban and rural settings. Using parameter values for a hypothetical East African
      country, cessation of breast-feeding in urban areas was predicted to result in
      increases in under-5 mortality of 108% for children of mothers HIV-negative at
      birth, and 27% for those HIV-positive at birth, with slightly larger increases in
      rural areas, suggesting that breast-feeding should continue to be promoted. A
      sensitivity analysis was conducted to identify critical values of key variables
      for which a review of policies encouraging breast-feeding is indicated. This
      showed that, even under extreme assumptions, cessation of breast-feeding among
      mothers HIV-negative at birth (but at risk of acquiring HIV during the lactation
      period) would increase under-5 mortality. For mothers HIV-positive at birth, the
      key variables are the additional risk of vertical transmission attributable to
      breast-feeding, the under-5 mortality rate (U5MR) in breast-fed children, and the
      relative risk of mortality in non-breast-fed compared to breast-fed children.
      Depending on the values of these key variables, there may be some urban
      populations with low U5MR in which the positive and negative effects on under-5
      mortality of a policy change are finely balanced. However, no change in policy
      should be made in these areas until more precise information is available on the
      key variables, and the many adverse consequences of such a change have been fully
      explored.

PMID- 8345539
TI  - Clinical spectrum of pulmonary hydatidosis and raised serum IgE levels in the
      Indian southern peninsula.
AB  - Fifteen patients with surgically proven hydatid disease of the lung aged between
      4 and 51 years were studied. The disease spectrum varied from single to multiple
      cysts of different sizes, with associated pyogenic chest infections or parasitic
      infestations of the gut. The serum IgE level varied widely in these cases and
      very high levels were found in 60% of the patients. This high IgE response was
      related to the vitality of the cysts, associated bacterial infection of the
      chest, infection with helminths and smoking habit.

PMID- 8345540
TI  - Surgical services and training in the context of national health care policy: the
      Malawi experience.
AB  - Malawi has a pyramidal health care structure, featuring at its broad base health
      centres and outreach stations in villages and rural areas; at the middle the
      district hospitals which receive cases from the villages and outreach health
      stations, and at its narrow apex the few central hospitals one of which is
      located in each of the three regions as a referral centre. Primary health care is
      practised at the health centres mostly by paramedical workers. The district
      hospitals are manned by general duty doctors and the central hospitals by
      specialists. Medical auxiliaries (clinical officers and medical assistants) play
      a vital role in the surgical and anaesthetic services of Malawi. Surgical
      education is community based and aims at providing staff for the various tiers of
      the health care pyramid, the surgical training being now jointly supervised by
      both government and non-government organizations and the new College of Medicine
      of Malawi. The internship programme is designed to prepare doctors for service in
      the districts where the bulk of their clinical hospital duties is of a surgical
      nature.

PMID- 8345541
TI  - Prevalence of HIV-1 infection in a rural medical clinic in Haiti.
AB  - To estimate the prevalence of the human immunodeficiency virus type 1 (HIV-1)
      among the patients attending the out-patient Medicine Clinic of the Hopital
      Albert Schweitzer in Haiti, the serum samples of 535 consecutive patients were
      examined for HIV-1 antibodies by enzyme immunoassay. One hundred and twelve sera
      (20.9%) tested positive (19.3% of the in-district patients and 27.6% of the out
      district patients). We concluded that HIV-1 infection has already spread to rural
      areas in Haiti and that we should prepare ourselves for the impact that the
      increasing number of infected patients will have.

PMID- 8345542
TI  - Impact of Schistosoma haematobium infection and of praziquantel treatment on
      anaemia of primary school children in Bertoua, Cameroon.
AB  - There is some debate as to the extent to which Schistosoma haematobium haematuria
      may be the cause of anaemia. Our goal was to evaluate the impact of a single 40
      mg kg-1 dose of praziquantel on anaemia. Since praziquantel does not reduce the
      hookworm intensity of infection (a major cause of anaemia in children in the
      area) changes in the prevalence of anaemia in the study population should be due
      only to the elimination of S. haematobium. Seven hundred and seventy-one primary
      schoolboys from Bertoua (East Cameroon) were divided into four groups: high
      infection, moderate infection treated with praziquantel or placebo, and non
      infected. Haemoglobin concentrations of the children were determined at the onset
      of the study and 6 months after the praziquantel intervention. Mean haemoglobin
      concentrations were not significantly different for no infection or for mild or
      heavy infection by S. haematobium. A factorial analysis of variance using S.
      haematobium intensity of infection, malaria and intestinal parasite infections
      and age as independent variables and haemoglobin concentration as the dependent
      variable show that only age and malaria infection show a significant relationship
      with haemoglobin concentration. Despite treatment with praziquantel, all the
      children in the treatment groups had lower mean haemoglobins 6 months after
      intervention. A factorial analysis of variance using age, malaria infection and
      the treatment category as independent variables and the difference in haemoglobin
      concentration as the dependent variable shows that only malaria infection showed
      a significant relationship with haemoglobin concentration.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8345543
TI  - Childhood infections in Nigeria: an autopsy study.
AB  - Infections are the leading cause of childhood morbidity and mortality in
      developing countries. Bronchopneumonia, meningitis and gastroenteritis are the
      commonest fatal infections encountered in Ibadan. Tuberculous lymphadenitis,
      bronchopneumonia and meningitis are other frequent causes of death. The
      predominant sequela of measles is respiratory tract infection. Another important
      cause of childhood mortality is cerebral malaria. In half of the cases of tetanus
      no obvious portal of entry can be found. It is advocated that the implementation
      of immunization schedules should be vigorously pursued to curtail childhood
      mortality resulting from infection.

PMID- 8345544
TI  - Assessment of the response in vivo and in vitro of Plasmodium falciparum to
      sulphadoxine-pyrimethamine in the malarious areas of Iran.
AB  - Studies of drug resistance of Plasmodium falciparum cases from SE Iran were
      carried out in vivo and in vitro during 1990-91. In a study of 26 chloroquine
      resistant infections, using amodiaquine (25 mg kg-1 over 3 days), followed by two
      thirds of the standard dose of sulphadoxine-pyrimethamine, six cases were
      resistant at the RI(3) and RII(3) levels. An additional study testing the
      standard dose of sulphadoxine-pyrimethamine in 43 chloroquine-resistant cases
      revealed five (11.6%) resistant at the RI(2) and RII(3) levels. Six of the above
      resistant infections were contracted in Hormozgan, three in Sistan-Baluchestan,
      one in Kerman provinces of Iran and one in Pakistan. In five of 22 successful in
      vitro tests, carried out on different isolates, the parasites grew to schizonts
      (> or = 8 nuclei) in the wells containing 1000 pmol sulphadoxine and 12.5 pmol
      pyrimethamine, indicative of resistance.

PMID- 8345545
TI  - Ophthalmomyiasis in Kuwait: first report of infections due to the larvae of
      Oestrus ovis before and after the Gulf conflict.
AB  - We report for the first time four cases of ophthalmomyiasis due to the larvae of
      Oestrus ovis in Kuwait, before and after Operations Desert Shield and Desert
      Storm. The larvae were easily removed under local anaesthetic. The symptom
      complex of acute foreign body sensation, irritation, redness, lacrimation and
      photophobia resolved rapidly. Ophthalmic antibiotic and corticosteroid drops were
      also instilled and recovery was uneventful. The ophthalmomyiasis may not always
      be associated with contact with sheep-rearing per se. Medical personnel should
      therefore be aware that in cases of what might appear initially as acute, non
      specific catarrhal conjunctivitis, patients with the persistent symptom complex
      should be re-examined to exclude ophthalmomyiasis due to the larvae of O. ovis in
      endemic areas.

PMID- 8345546
TI  - Improved method for the concentration and purification of faecal cysts of
      Entamoeba histolytica for use as antigen.
AB  - Human stool samples are the most widely used source of E. histolytica cysts for
      diagnosis and research. Cysts concentrated from faecal samples are contaminated
      with faecal debris and bacteria and are unsuitable for use as antigens. Other
      gradient purification and sedimentation procedures result in considerable cyst
      losses. We present an effective and simple purification procedure using varying
      densities of Percoll that yields an adequate cyst concentration from a moderate
      cyst load in a single stool sample.

PMID- 8345548
TI  - Brain echinococcal disease in Pondicherry.
AB  - A 29-year-old man, a vegetarian, agriculturist and resident of a village near
      Pondicherry, presented with focal seizures with secondary generalization. EEG
      showed a right frontoparietal focus, the blood eosinophil count was 25%, the
      indirect haemagglutination titre was more than 1:2048 for Echinococcus protein
      and Casoni's skin test was strongly positive, the CT scan showed an isolated
      rounded lesion in the right frontoparietal area partially enhanced with contrast
      media. He was subjected to surgery with complete removal of the cyst which
      confirmed the diagnosis of echinococcal disease of the brain. Post operatively he
      took only anticonvulsant drugs and was free of seizures during the two-year post
      operative follow-up period. The CT scan is a superior neurodiagnostic tool to
      blood serological tests in the diagnosis of brain echinococcal disease.

PMID- 8345547
TI  - A study of placentas from Wuchereria bancrofti microfilaraemic and
      amicrofilaraemic mothers.
AB  - The prevalence of transplacental transfer of microfilariae and structural lesions
      in the placentas of amicrofilaraemic (n = 10) and Wuchereria bancrofti
      microfilaraemic (n = 10) pregnant women from the prenatal care unit of the
      Hospital das Clinicas, Recife, Brazil, was investigated. Study participants were
      selected by filtration (3 microns/13 mm) of nocturnal (2300-0100 h) venous blood.
      A detailed histopathological examination was performed to detect abnormalities in
      the placenta, the cord and the foetal membranes. Both study groups had similar
      obstetric profiles. Parasitaemia was present during labour in nine of ten
      microfilaraemic women, but no microfilariae were found by filtration of 5-10 ml
      cord blood. No macroscopic abnormalities were seen in placentas from
      microfilaraemic mothers; two placentas from the amicrofilaraemic cases contained,
      respectively, infarcted areas and cysts at the cut surface. Microscopy failed to
      detect microfilariae in the intervillous spaces, chorionic and decidual vessels,
      or the umbilical cord. Thus, transplacental transfer of Wuchereria bancrofti
      microfilariae seems to be a rare phenomenon, and microfilaraemia does not appear
      to be a risk factor for placental pathology.

PMID- 8345550
TI  - Sonography of fetal midgut herniation: normal size criteria and correlation with
      crown-rump length.
AB  - Forty-eight fetuses were prospectively evaluated to (1) determine the normal size
      range of herniated midgut and (2) correlate sonographically the timing of midgut
      herniation with CRL. All fetuses of CRL 38 mm or less, and two of six fetuses
      with a CRL of 40 to 42 mm, demonstrated midgut herniation. No fetuses with a CRL
      greater than 44 mm had this finding. The cord containing midgut increased roughly
      from 4 to 7 mm, in maximum dimensions, for CRL of 19 to 41 mm. An anterior
      abdominal wall mass greater than 7 mm at any CRL, or of any size in a fetus of
      CRL greater than 44 mm, is suggestive of a fetal anomaly. Alternatively, a cord
      base "mass" within the 4 to 7 mm range for a CRL of 19 to 44 mm can be considered
      normal and not to require any follow-up.

PMID- 8345549
TI  - Protocol for out-patient management of dengue illness in young adults.
AB  - A prospective study on the practicality of an out-patient management protocol for
      dengue infection in adults was carried out during a 2-month period. Doctors were
      requested to follow the protocol and assessment was done on the patients'
      outcome, the admission rate, and the compliance to the protocol by doctors and
      patients. One hundred and sixty-two patients (mean age 27.3 years) were
      clinically diagnosed to have dengue illness. Among them, 82.7% had dengue fever
      (DF); 13.0% had dengue haemorrhagic fever (DHF) and 4.3% had dengue shock
      syndrome (DSS). Dengue aetiology was confirmed in 69.4% of the DF group and 85.7%
      of the DHF and DSS groups. There were no deaths among the 162 patients. The
      admission rate was 43.8%. A high compliance rate of 86.4% by the doctors and a
      low patient default rate of 16.4% showed that the protocol was practical.

PMID- 8345551
TI  - Pretreatment sonographic evaluation of inguinal lymph nodes in patients with
      vulvar malignancy.
AB  - The state of the inguinal nodes is a major prognostic factor in vulvar carcinoma.
      Because of new surgical trends with selective inguinal lymphadenectomy, the
      preoperative evaluation of inguinal lymph nodes is essential for adequate
      treatment of vulvar carcinoma. To evaluate the adequacy of clinical examination
      and high-frequency transducer sonography in detecting metastatic inguinal lymph
      nodes, we studied 25 patients with vulvar malignancy who underwent operation.
      Histopathologically proved lymph node metastases were found in 11 (22%) of 50
      inguinal areas studied. All of the suspected metastases were in patients with
      stage III-IV disease. The inguinal lymph node metastases were found by sonography
      in nine (82%), by preoperative palpation in one (9%), and by operative palpation
      in six (55%) of 11 areas. The difference between sonography and palpation was
      statistically significant (P < 0.01). The sensitivity and specificity were 82%
      and 87% for sonography, 9% and 100% for preoperative palpation, and 55% and 90%
      for operative palpation.

PMID- 8345552
TI  - Duplex ultrasonography of superior mesenteric artery: interobserver variability.
AB  - The aim of this study was to evaluate the interobserver variability during duplex
      ultrasonographic investigation of the SMA. Eleven healthy volunteers were
      examined twice under the same conditions by two independent observers. Three
      basic Doppler wave parameters were assessed for the SMA: pV, edV, and rT. The tD
      was recorded for SMA and abdominal aorta (AotD) with B-mode imaging. The
      interobserver variability was very low for all parameters: pV = 13.5 cm/s; edV =
      3.4 cm/s; rT = 0.01 s; tD = 0.3 mm; AotD = 0.5 mm, with corresponding 95%
      confidence intervals as follows: pV = 19 cm/s; edV = 4.7 cm/s; rT = 0.015 s; tD =
      0.4 mm; and AotD = 0.75 mm. Coefficients of variation also showed very low
      dispersion for results obtained. Under the appropriate standard conditions for
      duplex sonographic examination of the mesenteric artery, assessments of basic
      Doppler wave parameters do not differ significantly between independent
      investigators. Reliable evaluation of B-mode distances can be obtained by
      replication of measurements.

PMID- 8345553
TI  - Nomograms of the fetal lateral ventricles using transvaginal sonography.
AB  - Nomograms of the fetal lateral ventricles were obtained by the transvaginal
      approach. Three hundred low-risk women with no sonographically apparent fetal
      anomalies were scanned prospectively in a cross-sectional study. Three
      measurements in the parasagittal plane, three in the midline coronal plane, and
      two in the posterior coronal plane were used to generate seven nomograms. Two
      additional nomograms reflecting two calculated ratios also were created. A mean
      regression line and the 5th and 95th confidence intervals were determined. We
      concluded that transvaginal sonography of the fetal brain generates images of
      both hemispheres of good enough resolution to allow several precise and
      reproducible measurements.

PMID- 8345554
TI  - Fetal growth: a comparison of growth curves with mathematical modeling.
AB  - This study compared the use of fetal growth curves with the Rossavik mathematical
      model in predicting third trimester fetal growth in 27 Hispanic patients. The
      parameters tested were BPD, HC, AC, and FL. The growth curve method of predicting
      third trimester fetal growth was significantly more accurate than the
      mathematical model for three of the four fetal parameters tested: BPD, HC, and
      FL. We conclude that the mathematical model method offered no advantage over the
      more commonly used growth curve method for predicting third trimester fetal
      growth. In addition, growth curves do not require complex calculations and are
      conceptually simpler and easier to use.

PMID- 8345555
TI  - Ultrasonographic evaluation of the endometrium and correlation with endometrial
      sampling in postmenopausal patients treated with tamoxifen.
AB  - Seventy-two asymptomatic, postmenopausal women treated with tamoxifen for breast
      cancer were studied prospectively with vaginal ultrasonography, followed by
      endometrial sampling. Seventy-one patients demonstrated an endometrial echo of
      more than 5 mm, and one displayed an endometrial echo of less than 5 mm. No
      patient with an endometrial echo of less than 5 mm displayed any endometrial
      pathology. Different endometrial pathologic conditions were found when the
      endometrial echo was over 5 mm. When classifying those patients whose ultrasonic
      endometrial widths were wider than 5 mm, on the basis of different endometrial
      histologic findings, no obvious correlation was found between the various
      pathologic endometrial findings and endometrial thickness. Thus, a "thicker"
      endometrial sonographic image did not necessarily correlate with pathologic
      endometrial findings. When ultrasonic endometrial thickness of 5 mm was
      considered the upper limit of normal, the sensitivity of ultrasonography in
      correlating to positive histologic findings was 91% and the specificity was 96%.
      These findings suggest that there is good correlation between endometrial width
      measured by ultrasonographic assessment and histologic findings.

PMID- 8345556
TI  - Fetal Doppler echocardiography in pulmonary atresia.
AB  - The prenatal diagnosis of pulmonary atresia is of particular importance because
      the affected neonate may be dependent on ductal blood flow to the lung, requiring
      urgent administration of prostaglandins. We review eight cases studied by
      ultrasonography in utero. Severe tricuspid regurgitation was present in six
      fetuses. Right ventricular size varied among cases. Right atrial enlargement was
      present in seven, usually with tricuspid regurgitation. Failure to identify the
      main pulmonary artery or valve on a single examination was not specific. Doppler
      flow studies were most reliable for the diagnosis by establishing the existence
      of retrograde flow in the ductus arteriosus from the aorta.

PMID- 8345557
TI  - Sonographic heat generation in vivo in the gravid long-tailed macaque (Macaca
      fascicularis).
AB  - Temperature elevations that occur during diagnostic ultrasonic exposure were
      assessed in vivo in gravid macaques after 10, 20, or 30 min (scan mode; N = 30)
      or 5, 10, or 15 min (pulsed Doppler; N = 32). Five time points were assessed
      during the second and third trimesters (gestational days 70 to 150 +/- 2; term,
      approximately 165 days) using a transient thermocouple technique. Measurements
      were obtained intracranially or at the muscle-bone interface using a commercial
      sector scanner (ATL MK 600, 7.5 MHz scanhead; scan mode, ISPTA) = 27 mW/cm2,
      ISPPA = 85 W/cm2, pulse repetition frequency (PRF) = 1 kHz; pulsed Doppler -
      ISPTA = 54 mW/cm2, ISPPA = 1.5 W/cm2, PRF = 18.5 kHz). Overall, the greatest
      temperature elevation achieved with either modality or location was 0.6 degrees
      C.

PMID- 8345558
TI  - Preoperative sonographic diagnosis of gallbladder torsion: report of two cases.

PMID- 8345559
TI  - Sonographic diagnosis of traumatic gallbladder avulsion.

PMID- 8345560
TI  - Prenatal diagnosis of cerebral neuroblastoma by fetal brain biopsy.

PMID- 8345561
TI  - Doppler sonographic detection of reverse twin-twin transfusion after intrauterine
      death of the donor.
AB  - We report a "stuck" twin, in which a reverse blood shunt from the recipient to
      the donor was detected by Doppler sonography after death of the donor. This acute
      reverse transfusion caused intrauterine fetal distress and severe neonatal anemia
      of the surviving recipient. We believe that acute hemodynamic change after death
      of one fetus, in addition to causing a derangement in coagulation, causes
      immediate danger or subsequent organ damage for the surviving co-twin.

PMID- 8345562
TI  - Pharmacokinetics of single intravenous and single and multiple dose oral
      administration of rifampin in mares.
AB  - The disposition of rifampin in six healthy mares after single intravenous (i.v.)
      and oral (p.o.) doses and after seven oral doses of 10 mg/kg administered twice a
      day was investigated using a high performance liquid chromatographic (HPLC)
      method. Pharmacokinetic variables for rifampin determined using the HPLC method
      were comparable to variables reported from earlier studies utilizing a
      microbiological assay. Desascetylrifampin, a major metabolite of the parent
      compound, could not be detected in the serum but was detected at low
      concentrations in urine. Mean trough concentrations of rifampin increased from
      the first to the second dose of the multiple dose oral study and then remained
      unchanged through 72 h. At 84 h after the first dose (i.e. 12 h after the final
      dose) the rifampin concentration was significantly decreased (P = 0.001). The
      harmonic mean of the half-life of rifampin decreased significantly from 13.3 h
      after a single oral dose of 7.99 h after the seventh oral dose. The mean serum
      protein binding of rifampin over the concentration range of 2-20 micrograms/ml
      was 78%. Mean trough serum concentrations of unbound rifampin after multiple oral
      doses ranged from 0.67 micrograms/ml at 24 h to 0.40 micrograms/ml at 72 h. The
      mean unbound serum rifampin concentration at 84 h (i.e., 12 h after the final
      dose) was 0.30 micrograms/ml. Trough concentrations and the 84-h sample
      concentration of unbound rifampin exceeded the minimum inhibitory concentration
      for most gram positive bacterial isolates from horses reported in this study. All
      organisms with minimum inhibitory concentrations less than 0.125 micrograms/ml
      were considered susceptible. Based on the pharmacokinetics of rifampin after p.o.
      administration, we concur with the current dosage recommendation of 10 mg/kg
      twice a day by mouth. At this dose, most streptococci, Rhodococcus equi, and
      coagulase-positive staphylococci would be considered susceptible to rifampin.

PMID- 8345563
TI  - Biliary secretion and enterohepatic recycling of fenbendazole metabolites in
      sheep.
AB  - Fenbendazole (FBZ) was administered intraruminally at 5.0 mg/kg, containing a
      trace of [14C]-FBZ, to sheep fitted with a permanent bile duct cannula and the
      behaviour of FBZ and its metabolites examined in bile and plasma. Of the
      administered radiolabelled dose, 47% was secreted in bile of which 34% was
      accounted for as conjugated and 4% as unconjugated (free) metabolites.
      Hydroxylated oxfendazole (OH.OFZ) was the major biliary metabolite contributing
      66%, and hydroxy-FBZ (OH.FBZ) 27%, of the total metabolites characterized. Small
      amounts of OFZ and hydroxy FBZ sulphone (OH.FBZ.SO2) were also present in bile.
      The rapid appearance of OH.OFZ in bile, even before maximum concentrations of OFZ
      occurred in plasma, indicated that sulphoxidation and hydroxylation was the major
      route of FBZ metabolism. Following intraduodenal infusion of free biliary
      metabolites, FBZ and its metabolites rapidly appeared in bile indicating
      absorption from the small intestine. When conjugated metabolites were infused
      they continued to appear in bile for a further 15-20 h after cessation of
      infusion indicating that absorption of hydroxylated metabolites occurred largely
      after bacterial deconjugation in the large intestine. Approximately 40% of
      biliary metabolites were estimated to undergo enterohepatic reabsorption but they
      contributed minimally to the metabolite content in plasma. It is suggested that
      during the process of recycling-biliary metabolites make substantial contact with
      parasites in the mucosa of the small and large intestine thereby contributing to
      the anti-helminthic activity of FBZ.

PMID- 8345564
TI  - The effect of age on phenylbutazone pharmacokinetics, metabolism and plasma
      protein binding in goats.
AB  - Phenylbutazone (PBZ) was administered intravenously as a single dose (10 mg/kg)
      to adult male and 1-day-, 10-day-, 4-week- and 6 week-old male goats. The plasma
      concentration of PBZ and its major metabolites oxyphenbutazone (OPBZ) and gamma
      hydroxyphenbutazone (gamma-OHPBZ) was measured over time. The elimination half
      life (t 1/2 beta) of PBZ decreased from 120 h in the 1-day-old to 16 h in the
      adult goats. Although the volume of distribution (Vd) did not change
      significantly during maturation, the total body clearance (Cl B) increased from 2
      ml.h-1.kg-1 in 1-day-old to 13 ml.h-1.kg-1 in the adult goats; the increase was 2
      fold in the first 10 days of life. Oxyphenbutazone was detectable in the plasma
      of adult and 6-week-old goats as early as 15 min after PBZ administration. Its
      peak concentration occurred at 1.5 h (1.6 micrograms/ml) in adults and at 6 h
      (0.95 micrograms/ml) and 12 h (0.36 micrograms/ml) in 6- and 4-week-old goats
      respectively. The highest plasma concentration of gamma-OHPBZ was achieved in 4
      week-old followed by 6-week-old and adult animals.

PMID- 8345565
TI  - The postnatal development of drug-metabolizing enzymes in hepatic, pulmonary and
      renal tissues of the goat.
AB  - It is important to study the development of drug biotransformation enzymes,
      because from a pharmacological and therapeutic point of view these enzymes are
      responsible for eliminating most drugs. Their concentration at each age is
      critical when deciding the dose regimen, particularly in the neonates who are
      deficient or have very low levels of these enzymes. From a toxicological
      perspective, the role of these enzymes varies, with some of them being directly
      responsible for activation of certain chemicals to reactive intermediates with
      deleterious consequences to the animal. The time course of appearance of these
      enzymes throughout the life of the animal could be depicted from the study of
      their ontogeny and therefore the prediction of when the animal would be at risk
      should be possible. Experiments were designed to measure in vitro, the activity
      of drug-metabolizing enzymes in liver, lung and kidney of newborn, 1-week-, 4
      week and 6-week-old and adult goats. The microsomal monoxygenase activities were
      measured utilizing substrates designed to characterize the development of the
      cytochrome P450 (P450). For phase II enzymes, the activity of UDP
      glucuronyltransferase towards 1-naphthol and p-nitrophenol was measured in
      addition to the cytosolic glutathione S-transferase activity towards, 1,2
      dichloro 3-nitrobenzene. The results indicated that the newborn goat tissues
      exhibited very low activity of drug-metabolizing capacity in all pathways
      studied. These activities increased to the adult values by 6 weeks of age. In
      general, the development of the mono-oxygenase activities followed the same
      pattern as the overall P450. The UDP-glucuronyltransferase activity towards both
      substrates was deficient at birth and surged to above adult values by the first
      week of age. The toxicologic and pharmacologic implication of the development of
      these enzyme activities are discussed.

PMID- 8345566
TI  - Effect of gonadal hormones on the plasma clearance and metabolite formation of
      antipyrine in the dwarf goat.
AB  - The effect of gonadal hormones on the plasma elimination and urinary metabolite
      profile of antipyrine was studied in dwarf goats. Female goats were treated with
      testosterone and male goats were treated with 17 beta-oestradiol. Castrated males
      were treated with either testosterone or 17 beta-oestradiol. Antipyrine (25
      mg/kg, i.v.) was given both before and after the hormonal treatments. The effects
      of the hormonal status on the plasma elimination of the parent compound were not
      consistent. This was possibly due to the fact that formation of the main
      metabolite of antipyrine in the goat, 4-hydroxy antipyrine (OHA), was not
      affected by sex or hormonal treatment. On the other hand, there were clear
      effects of hormonal status on urinary excretion of the three other metabolites.
      In females and castrated males testosterone suppressed the formation of
      norantipyrine (NORA), 3-hydroxymethylantipyrine (HMA) and 4,4'
      dihydroxyantipyrine (DOHA). Intact males produced smaller amounts of these
      metabolites than females. It is concluded that distinct xenobiotic metabolizing
      pathways exist in the dwarf goat, which are influenced in their activity by
      gonadal hormones. This confirms previous findings in rats and mice. The
      possibility that sex hormones influence drug metabolism in food-producing animals
      could have consequences for veterinary therapeutics and public health. This study
      also demonstrates that, when using the antipyrine test for the assessment of
      hepatic drug metabolism, it is very important to include the determination of
      metabolites.

PMID- 8345567
TI  - Percutaneous absorption of organophosphorus insecticides in pigs--the influence
      of different vehicles.
AB  - In 40 experiments on 20 pigs three different organophosphorus insecticides (OPs),
      parathion (n = 6), phoxim (n = 7) and phosmet (n = 7), were administered both
      intravenously (i.v.) and dermally (d.) as 'pour-ons' in a crossover design in
      order to determine the dermal bioavailability of the OPs. As percutaneous
      absorption of drugs may be affected by the vehicle used, three chemically
      different vehicles--DMSO, 1-octanol and macrogol 400-were used for the dermal
      administration of each of the OPs. The pharmacokinetic parameters measured showed
      that 15-30% of dermally applied parathion is absorbed when administered in DMSO
      or octanol, but only 4-5% when administered in macrogol. Absorption was fastest
      with DMSO and slowest with macrogol. For the two ectoparasiticides, phoxim and
      phosmet, only between 0.5 and 3% of the dermal dose was absorbed with little
      difference in the absorption rate between the three vehicles. On the basis of the
      very limited dermal bioavailability for these two OPs it seems doubtful whether
      sufficient concentrations can reach the ectoparasites through the systemic route.

PMID- 8345568
TI  - The pharmacokinetics of flunixin meglumine in the sheep.
AB  - Flunixin meglumine was administered intravenously and intramuscularly in sheep
      and the pharmacokinetics of the drug studied. Plasma concentrations of flunixin
      were measured by high performance liquid chromatography. The decline in plasma
      flunixin concentration with time was best fitted by a triexponential equation.
      The pharmacokinetics following intravenous administration of 1.0 mg/kg indicate
      that flunixin has a rapid distribution half-life (t1/2 pi = 2.3 min), a slow body
      clearance rate (Clb = 0.6 ml/kg/min) and an elimination half-life of 229 min.
      Similarly, at 2.0 mg/kg, flunixin is rapidly distributed from the plasma, t1/2 pi
      = 2.7 min, has a slow body clearance rate (Clb = 0.7 ml/kg/min) and an
      elimination half-life of 205 min. Following intramuscular injection flunixin is
      rapidly and well absorbed from the injection site. It had a mean maximum
      concentration (Cmax) of > or = 5.9 micrograms/ml when administered at a dose rate
      of 1.1 mg/kg, and a relative bioavailability of 70%. Plasma concentrations
      increase proportionally to dose over the range 1.1 mg/kg-2.2 mg/kg when
      administered by the intramuscular route.

PMID- 8345569
TI  - Oral absorption and bioavailability of fenbendazole in the dog and the effect of
      concurrent ingestion of food.
AB  - Fenbendazole was administered orally without food to six beagle dogs at 2.5, 5.0,
      10, 20, 40 and 80 mg/kg of body weight. Increasing the dose rate did not
      significantly increase the amount of fenbendazole absorbed. In a separate study
      fenbendazole was administered to the same six beagle dogs at a dose rate of 20
      mg/kg of bodyweight in food with high, medium and low fat content. The food
      provided 1.52, 0.70 or 0.34 g of fat per kg of body weight. Administration of
      fenbendazole in food with different fat contents did not affect its relative
      bioavailability. Administration of fenbendazole at a dose rate of 20 mg/kg in
      food, irrespective of fat content, did however significantly increase its
      bioavailability when compared to administration of the same dose as a bolus on an
      empty stomach.

PMID- 8345570
TI  - Effects of age and indomethacin on response and sensitivity of pulmonary artery
      to phenylephrine and to histamine in pigs.
AB  - The vasoconstrictor effects of phenylephrine and histamine were investigated in
      isolated strips of pulmonary arteries in pigs during ageing. Interactions between
      phenylephrine-induced responses and arachidonic acid derivatives were also
      studied by incubating the blood-vessels with indomethacin. Potency (pD2 values)
      and maximal effects (EmaxX) recorded in 5-week-old piglets (group I, n = 5) with
      phenylephrine [5.71 +/- 0.17 and 0.76 +/- 0.22 g/mg of dry tissue respectively
      (mean +/- SEM)] were similar to values found in 12-week-old animals (group 2, n =
      5) (5.49 +/- 0.30 and 1.06 +/- 0.27 g/mg of dry tissue respectively). The
      sensitivity and responsiveness of tissues to this agonist were significantly
      reduced in 26-week-old mature pigs (group 3, n = 6) as indicated by the decrease
      in pD2 (3.91 +/- 0.23; P < 0.01) and Emax (0.27 +/- 0.13 g/mg of dry tissue; P <
      0.05) values observed in this group. Histamine (10(-3) M)-induced maximal
      responses (Emax) were significantly higher in group 2 (2.23 +/- 0.49 g/mg) than
      in group 1 (0.85 +/- 0.11 g/mg; P < 0.05) and in group 3 (0.48 +/- 0.10 g/mg; P <
      0.01). In 5-week-old animals, indomethacin (3 x 10(-5) M) significantly (P <
      0.05) shifted the concentration-response curve to phenylephrine to the right
      (0.28 log. units) and depressed contractions to this drug as shown by the
      significant decrease of 39.5% (P < 0.05) in Emax. This cyclo-oxygenase inhibitor
      had no effect in other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345571
TI  - Three phase elimination of oxytetracycline in veal calves; the presence of an
      extended terminal elimination phase.
AB  - The pharmacokinetics of oxytetracycline were studied after both intravenous
      (i.v.) and intramuscular (i.m.) administration to a group of five veal calves.
      Blood samples were taken frequently during the terminal elimination phase in
      order to calculate a reliable elimination rate constant. Because of the low limit
      of quantification of the method of analysis used, oxytetracycline plasma
      concentrations could be monitored over a 12-day period of time. After the
      intravenous administration of oxytetracycline, data were fitted according a three
      compartment model. After i.m. administration, plasma-concentration-time curves
      could best be described by a two-compartment model. It was demonstrated that a
      very slow terminal elimination phase was present both after i.v. and i.m.
      administration with a half-life of approximately 95 h. The data show that this
      phase cannot be explained by slow absorption from the injection site and that
      release of oxytetracycline incorporated into bone is not a likely explanation.

PMID- 8345572
TI  - Pharmacokinetics and anthelmintic efficacy of febantel in the racing pigeon
      (Columba livia).
AB  - This paper reports on the pharmacokinetics and the efficacy of febantel against
      Capillaria obsignata and Ascaridia columbae in the racing pigeon. Febantel was
      rapidly cleared from the circulation and highly metabolized. The efficacy of
      febantel against Capillaria and Ascaridia was studied on lightly and heavily
      infected pigeons. The efficacy against Ascaridia was 100% for the faecal egg
      count reduction (FECR) as well as for the worm reduction in all treated pigeons.
      After two treatments with febantel against Capillaria in heavily infected pigeons
      the FECR amounted to 96.7% and worm reduction was 95%. In order to effectively
      remove both parasites from the host, repeated treatments with febantel at a short
      interval could be the treatment of choice.

PMID- 8345573
TI  - The pharmacokinetics of sulfachlorpyridazine in channel catfish, Ictalurus
      punctatus.

PMID- 8345574
TI  - Pharmacokinetics of albendazole, albendazole sulfoxide and netobimin in goats.

PMID- 8345575
TI  - Pharmacokinetic behaviour of phenylglyoxal bis(guanylhydrazone) (PGBG) after oral
      administration to rabbits.

PMID- 8345576
TI  - Comparison of detrusor contractility of guinea pig bladders in situ and strips
      from these in vitro.
AB  - To study the relative importance of neurogenic factors in detrusor contractility,
      active bladder wall stress values were compared in situ and in vitro. Eight male
      guinea pigs were used. The active stress in the bladder wall in spontaneous
      micturition contractions was calculated from the results of urodynamic
      examinations and compared with the active stress developed in response to optimum
      electrical stimulation in full-thickness bladder wall strips taken from the same
      bladders. The results indicated that, in normal micturition, the detrusor muscle
      is not fully stimulated, and the rate of pressure development is not determined
      by mechanical factors. To identify topological variations of detrusor
      contractility, the strips were taken from three different locations. It was found
      that strips from the posterior wall contracted more forcefully than those from
      the anterior wall.

PMID- 8345577
TI  - Hormonal regulation of human testicular inhibin alpha and beta B subunit
      messenger RNAS.
AB  - Changes in messenger ribonucleic acids (mRNAs) of human testicular inhibin alpha
      and beta B subunits induced by human menopausal gonadotropin (hMG) and human
      chorionic gonadotropin (hCG) were assessed in vivo and in vitro. After a single
      administration of hMG, inhibin alpha mRNA in the human testis significantly
      increased, whereas inhibin beta B mRNA remained unchanged. Administration of hCG
      induced a slight increase in inhibin alpha mRNA without affecting inhibin beta B
      mRNA. In experiments in vitro using the testicular organ culture technique, an
      exposure to hMG for 24 hours induced a dose-related significant increase in
      inhibin alpha mRNA. Inhibin beta B mRNA was not affected by either hCG or hMG
      exposure. These results indicate that luteinizing hormone (hCG) as well as
      follicle stimulating hormone (hMG) may play a role in the regulation of human
      testicular inhibin alpha mRNA, although the mechanism of the LH action is not
      clear.

PMID- 8345578
TI  - Effect of atrial natriuretic peptide on urine flow and glomerular filtration
      during acute renal allograft rejection.
AB  - The effect of exogenous atrial natriuretic peptide (ANP) on urine excretion and
      glomerular filtration rate (GFR) during acute renal allograft rejection was
      evaluated in a canine model. Eight animals underwent simultaneous
      allotransplantation and unilateral native nephrectomy. No preoperative or
      postoperative immunosuppressive therapy was given. Acute renal function studies
      were performed on the allografts and companion, native kidneys following surgical
      exposure and mobilization on the third postoperative day. At reexploration, the
      allografts were found to be grossly enlarged (138 +/- 10 gm.) and contained
      moderate-to-marked perivascular interstitial infiltration. Glomerular filtration
      rate, determined by measurement of urinary inulin clearance, was significantly
      reduced from prenephrectomy baseline values (19 +/- 4 ml. per minute versus 32 +/
      5 ml. per minute, p < .05). During a 30 minute, intravenous ANP infusion,
      allograft urine flow rates increased from 1.4 +/- 0.5 ml. per minute to 3.3 +/-
      0.4 ml. per minute (p < .01), and GFR increased from 19 +/- 4 ml. per minute to
      24 +/- 4 ml. per minute (p < .05). During ANP infusion, mean arterial pressure
      declined from 136 +/- 7 mm. Hg to 116 +/- 7 mm. Hg (p < .05), and the hematocrit
      remained unchanged. These observations are consistent with previously described,
      ameliorative effects of ANP in other models of acute ischemic renal injury and
      provide an experimental basis for more extended studies examining the potential
      usefulness of ANP as adjunctive therapy in the treatment of acute renal allograft
      rejection.

PMID- 8345579
TI  - Plasminogen activators: regulators of tumor cell adherence to sites of lower
      urinary tract surgical trauma.
AB  - Tumor cell adherence (TCA) to sites of surgical injury is a requisite step in
      implantation-mediated tumor recurrence. This study examined the relationship
      between tumor-associated plasminogen activator (PA) and the ability of tumor
      cells to remain adherent to surgical injury sites. High (1E8) and low (3A9) PA
      producing clones from the murine transitional carcinoma cell line 4909 were
      selected using an in vitro 125I fibrinolysis assay. Net cellular PA activity of
      each clone was determined from cell lysates using a chromogenic substrate assay.
      In vitro TCA and fibrin substrate lysis as a function of time were simultaneously
      measured using a tetrazolium dye assay in combination with an 125I fibrinolysis
      assay. In vivo TCA to in situ cautery-injured rat bladders was measured 30
      minutes (n = 12 animals/cell line) and 24 hours (n = 18 animals/cell line)
      following tumor exposure with a radiolabeled TCA assay. In vitro and in vivo
      competitive binding assays evaluated the relative adherence of mixtures of the
      1E8 and 3A9 clones. Cellular PA activity was 0.022, 0.014 and 0.007 units per mg.
      protein for the 1E8, 4909 and 3A9 cell lines. In vitro TCA to fibrin in the
      presence of plasminogen was significantly different for each cell line and
      demonstrated an inverse relationship with both plasminogen-dependent fibrin lysis
      and cellular PA activity (p < 0.0001). The in vivo assay showed that the
      percentage of 1E8 cells remaining adherent 24 hours after tumor exposure was
      significantly less than that of the 3A9 cells (p = 0.01). Both in vitro and in
      vivo competitive binding assays demonstrated preferential adherence of the 3A9
      cell line. Cellular PA production appears to be a tumor-intrinsic variable that
      modulates TCA to surgical injury sites.

PMID- 8345580
TI  - Events leading to septic death from experimental acute pyelonephritis in the
      monkey.
AB  - Experimental acute pyelonephritis in monkeys led to death in some of the animals
      following renal E. coli inoculation. It was found that both the inflammatory
      response and cytokine activation were much more severe in these monkeys as
      compared with others that survived. IL-1 was decreased just before death, and
      there were early increases in IL-2 and IL-6 serum concentrations, but no
      significant increase in TNF values. The data suggest that death in sepsis is due
      in part to excessive cytokine release because of a decrease in the protective
      activity of IL-1.

PMID- 8345581
TI  - Subcutaneous port for longterm access and administration of topical chemotherapy
      to the upper urinary tract.
AB  - Fourteen silicone pigtail catheters were inserted into the renal pelves of ten 25
      kg. pigs. These catheters were connected to injection ports implanted in the
      flank. Each animal received 15 mg. of thiotepa, into one port, weekly for 8
      weeks. These were well tolerated. Percutaneous radiography and histological
      examination showed effective distribution of thiotepa throughout the upper
      urinary tract. Microscopic changes included cytoplasmic vacuolation, cystic
      changes and denudation of the mucosa. There was edema and chronic inflammatory
      infiltrate in the submucosa. This method of access to the upper tracts should be
      considered for long-term recurrent treatment of upper tract superficial
      transitional cell carcinoma.

PMID- 8345582
TI  - Characterization of a new human bladder cancer cell line, UCRU-BL-28.
AB  - A new human bladder cancer cell line, UCRU-BL-28 has been established and
      characterized from a relapsed, cisplatin resistant, grade II, stage T4 tumor.
      This line is tumorigenic in nude mice and reflects the pathology of the original
      tumor. The morphology, the expression of tumor-associated antigens and EGF
      receptors, and the ability to grow both in an anchorage independent manner and in
      the absence of serum is explored. The BL-28 line has 71-74XXY chromosomes, with
      del 5q, der(9) and i(19q). Further studies on the molecular basis of bladder
      cancer, chemosensitivity to cisplatin, growth factor production and tissue
      invasion are under way.

PMID- 8345583
TI  - Chromophore enhanced laser welding of canine ureters in vitro using a human
      protein solder: a preliminary step for laparoscopic tissue welding.
AB  - Laser welding of the genitourinary tract has the potential advantage of forming
      an immediate watertight seal. It may obviate the need for sutures, eliminate the
      inherent lithogenic reaction to suture, and potentially improve healing. In the
      current study we employed a KTP-532 laser in vitro to weld canine ureters.
      Ureters were transected over a stent and immediately repaired using the KTP-532
      laser (power density 7.14 W/cm.2, spot size = 0.5 cm.) alone or in combination
      with different tissue solders. Solders consisted of 40% human albumin alone or
      with the addition of iron oxide or fluorescein as light absorbing dyes
      (chromophores). Following the repairs, intraluminal bursting strength and the
      total energy required to complete the repairs were measured. The KTP laser alone
      was not able to achieve a satisfactory repair. Successful ureteral repairs were
      achieved in all solder groups while maintaining ureteral continuity at
      supraphysiologic pressures.

PMID- 8345584
TI  - Angiotensin II receptors in the rat urinary bladder smooth muscle: type 1 subtype
      receptors mediate contractile responses.
AB  - Angiotensin II (Ang II) receptors in the rat urinary bladder smooth muscle were
      investigated by in vitro responses of smooth muscle strips to exogenous Ang II
      stimulation and in radioligand binding assays. Ang II (10(-10) M. to 10(-5) M.)
      caused a potent contractile response in a concentration-dependent manner. Using
      the recently developed nonpeptide subtype-selective antagonists, the Ang II
      induced contractile response was further characterized. The Ang II-induced
      contractile response was inhibited weakly by the type 2 subtype (AT2)-selective
      antagonist PD123319 but was potently inhibited by the type 1 subtype (AT1)
      selective antagonist DuP 753 with a pA2 value of 9.03, suggesting that the
      response is mediated predominantly by AT1 receptors. [125I]Ang II was used to
      specifically label a single class of binding sites with a dissociation constant
      of 0.31 nM. and a maximal binding capacity of 41.5 fmol./mg. of protein. DuP 753
      could completely antagonize the binding of Ang II in a particulate fraction of
      rat bladder (Ki = 14 nM), whereas PD123319 did not have any effect in the
      concentration range of 10(-9) to 10(-5) M. The results suggest that AT1 receptors
      rather than AT2 receptors predominantly mediate Ang II-induced contraction in the
      rat urinary bladder.

PMID- 8345585
TI  - Developmental alterations in the fetal lamb bladder subjected to partial urethral
      obstruction in utero.
AB  - To identify the structural changes seen in the developing bladder subjected to
      outflow obstruction, a fetal lamb model was developed. With this model, which
      attempts to reproduce conditions such as those found in posterior urethral
      valves, quantitative biochemical parameters were used to evaluate the effects of
      partial outflow obstruction on detrusor cellularity and innervation in the
      developing bladder. Partial urethral obstruction was created in 9 fetal sheep (90
      to 100 days gestation), 6 sham operated animals serving as controls. Fetuses were
      delivered at term and sacrificed. Bladders were removed and weighed. Mucosa free
      detrusor was assayed for DNA and choline acetyltransferase (ChAT) activity,
      indices of cell number and cholinergic innervation, respectively. In similar
      specimens of detrusor, cell ploidy and nuclear size were determined by flow
      cytometry and nuclear morphometry, respectively. The results showed that partial
      urethral obstruction in utero resulted in a significant increase in bladder
      weight (p < 0.05) and total detrusor DNA content (p < 0.01). With the increase in
      detrusor DNA content, there was a parallel increase in total detrusor ChAT
      activity. These results suggest that early development of the bladder is altered
      both on a cellular level (increase in cellularity) and a neural level (increase
      in cholinergic nerve density) under conditions of mechanical distension.

PMID- 8345586
TI  - Positron emission tomography: a new method for determination of renal function.
AB  - Positron emission tomography (PET) is a newly evolving diagnostic modality that
      has been widely used in many facets of clinical medicine, but whose use in the
      diagnosis and management of disorders of the kidney has not been previously
      described. Employing the radiotracer N-13 ammonia, flow-dependent extraction of
      this compound after intravenous injection was used to measure renal blood flow
      (RBF) in a swine model (N = 10). A mean baseline value of 3.16 ml./min./gm.
      kidney was obtained with this method, in close agreement with values previously
      reported using established invasive techniques. Four conditions known to affect
      RBF were also studied to determine the ability of PET to detect changes in RBF.
      Kidneys were subjected to varying durations of warm ischemia, demonstrating a
      progressive decrease in RBF with increasing ischemic insult, with return to
      normal significantly impaired in animals exposed to the greatest degree of
      ischemia (180 minutes versus 150 or 120 minutes ischemia). Cross-transplant
      between animals produced acute allograft rejection and a corresponding marked
      decrease in RBF that failed to normalize. After unilateral nephrectomy, RBF
      increased two-fold in the remaining kidney by 7 days (R = 0.79), as predicted for
      compensatory renal hypertrophy. Lastly, there was an inverse, linear relationship
      between toxic cyclosporine level and RBF (R = 0.68), indicative of vascular
      mediated cyclosporine nephrotoxicity. Positron emission tomography is safe and
      efficient, and yields an accurate measurement of RBF in several important
      physiologic states. The development of PET as a quantitative measure of renal
      function is promising.

PMID- 8345587
TI  - Hereditary prostate cancer: epidemiologic and clinical features.

PMID- 8345588
TI  - Alterations in renal stone risk factors after space flight.
AB  - Exposure to the microgravity environment of space produces a number of
      physiological changes of metabolic and environmental origin that could increase
      the potential for renal stone formation. Metabolic, environmental and
      physicochemical factors that influence renal stone risk potential were examined
      in 24-hour urine samples from astronauts 10 days before launch and on landing day
      to provide an immediate postflight assessment of these factors. In addition,
      comparisons were made between male and female crewmembers, and between
      crewmembers on missions of less than 6 days and those on 6 to 10-day missions.
      Results suggest that immediately after space flight the risk of calcium oxalate
      and uric acid stone formation is increased as a result of metabolic
      (hypercalciuria, hypocitraturia, pH) and environmental (lower urine volume)
      derangements, some of which could reflect residual effects of having been exposed
      to microgravity.

PMID- 8345589
TI  - Management of renal cell carcinoma with coexistent renal artery disease.
AB  - Coexistence of renal cell carcinoma and renal artery disease is an unusual and
      challenging problem. From 1969 to 1991, 34 patients presented with localized
      renal cell carcinoma and renal artery disease affecting all of the functioning
      renal parenchyma. These patients represented 4 categories: 1) a solitary kidney
      with renal cell carcinoma and renal artery disease (5), 2) bilateral renal cell
      carcinoma and coexistent renal artery disease (5), 3) unilateral renal cell
      carcinoma and contralateral renal artery disease (13), and 4) unilateral renal
      cell carcinoma and bilateral renal artery disease (11). Atherosclerosis was the
      most common cause of renal artery disease (30), followed by medial fibroplasia
      (2), renal artery aneurysm (1) and arteriovenous malformation (1). A total of 23
      patients (68%) presented with azotemia (serum creatinine 1.5 mg./dl. or more) and
      11 (32%) presented with hypertension. All patients underwent complete surgical
      excision of renal cell carcinoma. A nephron sparing operation was performed
      preferentially (30 patients) and bilateral renal cancer operations were staged.
      Eight patients underwent simultaneous partial (6) or radical (2) nephrectomy and
      surgical renal revascularization. There were no operative deaths.
      Postoperatively, preservation of renal function was achieved in 33 patients and 1
      required chronic dialysis. At mean followup of 47 months 23 patients (68%) were
      alive with no evidence of malignancy and 2 were alive with recurrent renal cell
      carcinoma. Three patients died of metastatic renal cell carcinoma, while 6 died
      of unrelated causes. All of the latter 6 patients were free of renal cell
      carcinoma at death. Nephron sparing surgery combined occasionally with renal
      arterial reconstruction can yield gratifying results in this complex patient
      population.

PMID- 8345591
TI  - Failed endopyelotomy: implications for future surgery on the ureteropelvic
      junction.
AB  - During the last 8 years we performed 212 endopyelotomies with an overall success
      rate of 86%. To determine if the failed endopyelotomies resulted in a more
      difficult subsequent open corrective procedure, we compared the procedures and
      outcomes of 15 failed endopyelotomies with 16 control patients undergoing
      pyeloplasty who had not undergone a previous endopyelotomy. The variables of
      duration of the surgical procedure, average estimated blood loss, average number
      of transfusions and average length of hospitalization were analyzed for both
      groups. No statistically significant differences were detected for any of these
      variables. We conclude that despite a previously failed endopyelotomy, a
      subsequent open operation on the ureteropelvic junction, although slightly more
      difficult, was not associated with an increased morbidity rate nor less
      successful than de novo pyeloplasty. Therefore, we continue to advocate
      endopyelotomy as the procedure of choice for obstruction of the ureteropelvic
      junction.

PMID- 8345590
TI  - Treatment of metastatic renal cell carcinoma with recombinant interleukin-2 in
      combination with vinblastine or lymphokine-activated killer cells.
AB  - Fifty patients with metastatic renal cell carcinoma were treated with recombinant
      interleukin-2 alone or in combination with the antitumor drug vinblastine or
      lymphokine-activated killer cells. Of 34 evaluable patients treated with
      intravenous bolus interleukin-2, 1 (3%) had a partial response. Vinblastine
      increased myelotoxicity but did not enhance response to interleukin-2 in 15 of
      these patients. Two partial responses were observed among 15 patients treated
      with lymphokine-activated killer cells in addition to interleukin-2. In 1 patient
      biopsy documented complete resolution of hepatic metastases lasting for 1 year
      was observed. All responders had undergone previous nephrectomy and none had
      multiple sites of metastatic disease. Toxicity was significant and caused
      termination of therapy in 40% of the patients. Biological therapy using
      interleukin-2 can result in prolonged responses in renal cell cancer but future
      trials should be directed at lessening toxicity.

PMID- 8345592
TI  - Extracorporeal shock wave lithotripsy in situ or after push-up for upper ureteral
      calculi: a prospective randomized trial.
AB  - A total of 110 patients with upper ureteral calculi was admitted to a prospective
      trial and randomly allocated to 2 groups: 1 group treated with in situ
      extracorporeal shock wave lithotripsy (ESWL) and 1 group treated with ureteral
      manipulation before ESWL. All patients had solitary upper ureteral calculi
      without urinary infection. The stones had to be smaller than 1 cm. and located
      more than 2 cm. lateral to the spine. ESWL was performed with the Dornier HM3
      lithotriptor. One patient in the in situ ESWL group had to be treated twice
      because disintegration of the stone was insufficient after the initial treatment
      session. All other patients underwent only 1 treatment session. Because 16
      patients were lost to followup, 94 were evaluable for the analysis of immediate
      and long-term results. For disintegration of the stones in situ ESWL needed
      significantly more shock waves (1,844 +/- 639 versus 1,297 +/- 473, p < 0.001)
      and a higher voltage (19.5 +/- 1.4 versus 18.7 +/- 0.9 kv., p < 0.001). There
      were no severe complications in either treatment group. At 3 months 44 of 46
      patients (96%) after in situ ESWL and 45 of 48 (94%) after ureteral manipulation
      before ESWL were free of stones. In view of these results it is suggested that
      uncomplicated upper ureteral calculi (as defined previously) should be treated
      first with in situ ESWL, thus, avoiding an invasive procedure.

PMID- 8345593
TI  - The fate of the iatrogenic retroperitoneal stone.
AB  - Ureteral perforation with resultant retroperitoneal stone expulsion is a
      recognized complication of ureteroscopy. In a 5-year retrospective review of 400
      cases we identified a 1.3% incidence of iatrogenic retroperitoneal stone
      dislodgment. Average followup was 21 months. Four cases were managed with
      observation and 1 required surgical correction of a ureteropelvic junction
      stricture. We discuss the management of this problem, which begins with thorough
      radiographic documentation in the perioperative period. Aggressive ureteroscopic
      manipulation and attempted stone retrieval are not warranted, and a ureteral
      stent should be placed. Radiographic followup and clinical observation confirm
      the low morbidity associated with retroperitoneal urinary stones. Patient
      understanding of the extra-ureteral stone location is essential to avoid
      misdiagnosis and mismanagement by uninformed physicians in the future.

PMID- 8345594
TI  - Yang needle tunneling technique in creating antireflux and continent mechanisms.
AB  - A total of 7 patients underwent cystectomy due to bladder malignancy and the
      ileum was used for lower urinary tract reconstruction (5 underwent bladder
      substitutions, 1 an internal ileal reservoir and 1 ileal conduit diversion).
      Antireflux mechanisms were created by submucosally tunneled ureters and in 1 case
      the continent mechanism was created by a submucosally tunneled ileal tube. In all
      cases the Yang needle was used, which consists of a needle portion and a forceps
      portion. The selected position of the ileum for ureteral and ileal tube
      implantation is injected with normal saline submucosally to form a wheal. The
      Yang needle is introduced submucosally, guided under the wheal for a certain
      distance and then directed through the ileal wall. Smooth dilation of the tunnel
      is achieved with the dilated portion of the needle without laceration of the
      mucosa. The needle portion is then removed. The ureter or ileal tube is grasped
      by the forceps portion of the needle and brought through the tunnel to the
      mucosal side of the ileal plate, followed by mucosa-to-mucosa anastomosis. For
      all 14 ureteral implantations only 1 ureter had reflux on postoperative
      radiographic studies and only 1 of 4 hydroureters remained. No additional
      obstructive lesions or pyelonephritis was noted postoperatively. The patient
      whose continent mechanism is formed by the submucosal tunneled ileal tube method
      is continent and free of an appliance. The Yang needle tunneling technique may be
      a choice in the creation of antireflux and continent mechanisms.

PMID- 8345595
TI  - Direct (nontunneled) ureterocolonic reimplantation in association with continent
      reservoirs.
AB  - A total of 190 patients underwent continent urinary diversion using the Florida
      pouch. Direct mucosa-to-mucosa ureterocolonic reimplantation was used in 165
      patients (326 ureters). Of the first 30 ureters in patients who underwent
      antireflux tunneled reimplantation obstruction occurred in 4 (13.3%). Obstruction
      developed directly in 16 of the ureters reimplanted (4.9%), and 3 of the 6
      plicated and reimplanted megaureters (50%). Among the obstructed units 3 (13%)
      were treated unexpectedly by autonephrectomy, while the other 20 units (87%) were
      treated with percutaneous balloon dilation and internal stenting for 6 to 8
      weeks. In the latter group 12 units (60%) recovered function, 3 (15%) had
      pyelonephritis requiring nephrectomy and 5 (25%) stabilized following a new
      reimplantation. Reflux was demonstrated in 23 units (7%). All units with reflux
      are being followed conservatively and renal deterioration has not been
      demonstrated. The incidence of ureteral obstruction with direct reimplantation is
      lower compared to a tunneled technique. This reimplantation procedure is
      technically simpler than others and is safe in adults when performed in
      association with a large volume, continent colonic reservoir.

PMID- 8345596
TI  - The valved S-shaped rectosigmoid pouch for continent urinary diversion.
AB  - Continent urinary diversion to the valved S-shaped rectosigmoid pouch was
      performed in 9 female and 6 male patients 12 to 65 years old (mean age 51 years).
      The pouch was constructed by detubularization and S-shaped reconfiguration of 30
      cm. of the intact rectum and sigmoid colon. The ureters were reimplanted into the
      pouch using antireflux techniques. Reflux of urine from the pouch to the proximal
      colon was prevented by fashioning an intussusception valve. The construction was
      protected by a transverse colostomy for 6 to 8 weeks. With a followup of 3 to 24
      months (mean 11 months), all patients are continent during the day and also at
      night with evacuation intervals of 3 to 6 hours. There have been no cases of
      symptomatic urinary tract infection. Only 1 patient had mild hyperchloremic
      acidosis. No patient complained of abdominal distention or constipation. Contrast
      study via the anus (radiography of the pouch) showed that the intussusception
      valve was competent in all but 1 patient in whom reflux to the proximal colon was
      noted due to sliding of the nipple valve, which was revised successfully.
      Urodynamic studies (cystometry of the pouch) showed a capacity of 400 to 900 ml.
      (mean 600) with an intraluminal pressure of 22 cm. water (range 10 to 34) at
      maximal filling. The valved S-shaped rectosigmoid pouch is a faster and simpler
      surgical procedure compared with the modified rectal bladder (valved rectum
      augmented with ileum). It also results in a smooth postoperative course, since an
      intestinal anastomosis proximal to the colostomy is avoided.

PMID- 8345597
TI  - Continent urinary reservoirs.

PMID- 8345599
TI  - Long-term consequences of urethral stents.
AB  - The results of the self-expandable urethral stent (Wallstent) in the treatment of
      urethral strictures were evaluated in 7 patients with a followup of 23 to 31
      months. The 4 failures were caused by exuberant fibrotic proliferation in the
      lumen of the stent, which required further endoscopic treatment in 2 patients and
      even surgical removal of the stent in 1. In the other 2 patients the fibrotic
      proliferation was progressive and will require further treatment. In 1 patient
      there is slowly progressive proliferation and a diminishing urine flow rate, and
      in 2 the fibrotic proliferation seems to be stable. Early reports on the stent
      suggest that its use will obviate the necessity for complex surgery of urethral
      stricture. Strictures involving layers deeper than the urothelium and traumatic
      strictures are not good indications for the self-expandable stent. As this
      technology continues to evolve, we must continue to follow these patients closely
      and be attentive to the possible long-term consequences.

PMID- 8345598
TI  - Neoadjuvant cisplatin, methotrexate and vinblastine for muscle-invasive bladder
      cancer: long-term followup.
AB  - A total of 26 patients with locally advanced bladder cancer received chemotherapy
      consisting of cisplatin, methotrexate and vinblastine. Radical cystectomy was
      performed in 24 of 26 patients (92%) receiving neoadjuvant therapy, with a
      pathological complete response in 6 (23%) and pathological partial response in 1
      (4%) for an overall response rate of 35% (95% confidence limits 17 to 56%). The
      overall median survival time is currently undefined. Of the patients 15 (58%) are
      alive with a median followup of 48.6 months. Response rates from this neoadjuvant
      chemotherapy appear to be similar to those reported with methotrexate,
      vinblastine, doxorubicin and cisplatin, and may represent a therapeutically
      equivalent regimen but neither may be curative in the majority of the patients.

PMID- 8345600
TI  - Transurethral polytetrafluoroethylene injection in female patients with urinary
      continence.
AB  - We present our results with the use of transurethral injection of
      polytetrafluoroethylene (Teflon) in 128 female patients with moderate to severe
      urinary incontinence from 1964 to 1991. Of the patients 60% had undergone
      previous surgical treatment for the incontinence. The etiologies included stress
      incontinence, neurogenic bladder, congenital anomalies, trauma and others. More
      than 73% of the patients improved (54.3% were totally dry). The failure rate was
      27%. Complications were minimal. Urinary tract infection and temporary urinary
      retention occurred in 7 and 6 patients, respectively. Mean followup was 31
      months. This study demonstrates that transurethral polytetrafluoroethylene
      injection is a useful treatment of moderate to severe urinary incontinence in
      female patients. Polytetrafluoroethylene is particularly useful for patients with
      failed previous incontinence procedures and poor surgical candidates. Failures
      are more likely in patients with periurethral fibrosis secondary to a previous
      urethral operation.

PMID- 8345601
TI  - Intracavernous sodium nitroprusside: inappropriate impotence treatment.
AB  - On the basis of reports describing nitric oxide as a form of endothelium-derived
      relaxing factor and on our own experience with intracavernous use of nitric oxide
      releasing substances in animal models, we undertook an approved human study of
      intracavernous sodium nitroprusside as a treatment for impotence. We report our
      early experience in which severe hypotension and only mild tumescence in our
      first 3 patients caused us to discontinue the trial.

PMID- 8345602
TI  - Carbon dioxide laser treatment of lichen sclerosus et atrophicus.
AB  - We followed 62 men treated with the carbon dioxide laser for lichen sclerosus et
      atrophicus for an average of 30 months (3 months to 7 years). Of the patients 47
      (76%) became asymptomatic and 10 (16%) had minor residual symptoms. In 26
      patients (40%) concomitant superficial meatal stenosis was simultaneously treated
      with laser meatotomy. The cosmetic and functional results of treatment were
      highly encouraging. Provided that radicality is achieved at the primary
      application, the carbon dioxide laser is an excellent therapeutic modality for
      lichen sclerosus et atrophicus.

PMID- 8345603
TI  - Varicocele-related infertility is not associated with increased sperm-bound
      antibody.
AB  - Immunological factors have been implicated as a cause of unexplained infertility.
      Previous studies have demonstrated increased levels of sperm-bound antibody in
      infertile men with varicoceles and have postulated their role in varicocele
      related infertility. However, these studies were performed using an enzyme-linked
      immunosorbent assay. We evaluated retrospectively 111 male patients referred for
      infertility using a direct immunobead assay. Of the patients 29 had grade II or
      III varicoceles (that is palpable or easily visualized) and 82 were without
      varicocele. Four patients who had undergone vasovasostomy were included as
      controls for the assay. A direct immunobead assay was performed for isotype IgG
      and IgA sperm-bound antibody using a standard protocol. A computerized semen
      analysis was also performed. Greater than 20% binding, excluding tail tip
      activity, was considered significant. Of 29 patients with and 82 without a
      varicocele significant binding was identified in 5 (17%) and 9 (11%),
      respectively. Chi-square statistical analysis did not reveal this difference to
      be significant (p < 0.05). All 4 vasovasostomy patients demonstrated significant
      binding. We conclude from this study that infertile men with varicoceles do not
      demonstrate significantly increased levels of sperm-bound antibody compared to
      infertile controls and, therefore, sperm-bound antibody does not appear to have a
      significant role in varicocele-related infertility.

PMID- 8345604
TI  - Chest staging in testis cancer patients: imaging modality selection based upon
      risk assessment as determined by abdominal computerized tomography scan results.
AB  - We compared chest computerized tomography (CT) to chest x-ray as chest staging
      modalities in testis cancer patients on the basis of abdominal CT findings. We
      identified 92 patients who presented with negative staging abdominal CT scans and
      52 with abnormal abdominal CT scans. Of these patients 42 and 32, respectively,
      underwent a chest x-ray and chest CT concurrently as part of the initial staging
      evaluation. Dictated x-ray reports were used to compare study findings. Findings
      on chest x-ray and chest CT were considered concordant if both studies identified
      similar chest abnormalities. Findings were considered discordant if either study
      failed to identify an abnormality noted on the other test. Patient outcome during
      followup, response to therapy or chest pathology was used to discriminate benign
      from malignant radiological abnormalities. Radiographic chest abnormalities
      (chest x-ray and/or chest CT) were identified in 12 of the 42 patients with
      negative abdominal CT scans. Three of these 12 studies represented metastasis
      with the remainder being benign. Imaging results were concordant in all 3
      patients with chest metastasis and 5 of 9 with benign chest disease. Chest x-ray
      identified abnormalities not observed on chest CT in 1 patient, with chest CT
      identifying abnormalities not observed on chest x-ray in 3. Radiographic chest
      abnormalities (chest x-ray and/or chest CT) were identified in 15 of 32 patients
      who had a positive abdominal CT. All chest lesions identified in these patients
      were believed to represent metastatic disease. Chest x-ray failed to identify
      abnormalities present on chest CT in 4 of the 15 patients. The use of chest CT as
      a staging modality in abdominal CT negative patients failed to increase
      diagnostic sensitivity relative to chest x-ray alone. However, in 32 patients
      with abnormal abdominal CT scans the use of chest x-ray alone would have missed
      intrathoracic metastatic disease in 4. These data suggest that chest x-ray may be
      the preferred initial chest staging study for testis cancer patients with
      negative abdominal CT, while chest CT is mandated in patients with abnormal
      abdominal CT.

PMID- 8345605
TI  - p53 gene mutations in Chinese human testicular seminoma.
AB  - Genomic deoxyribonucleic acid from 17 primary human testicular seminomas was
      screened for the presence of mutations in exons 5 to 8 of gene p53, using the
      single strand conformation polymorphism assay, followed by direct
      deoxyribonucleic acid sequencing. The p53 mutations in 1 allele leading to an
      amino acid change but a normal (wild-type) sequence in the remaining allele were
      identified in 4 of 17 seminomas (23.5%). Sites of mutations were in exon 5 (codon
      141), exon 7 (codon 238, codon 258) and exon 8 (codon 270). The present study
      suggested that mutation of the p53 gene is involved in the development of human
      testicular seminoma as in the case of several other types of human cancers.

PMID- 8345606
TI  - Laparoscopic standard pelvic node dissection for carcinoma of the prostate: is it
      accurate?
AB  - The acceptably low morbidity of laparoscopic pelvic lymphadenectomy has allowed
      us to perform the procedure systematically on all patients who presented with
      localized adenocarcinoma of the prostate. Data on 147 consecutive cases enable us
      to state that the overall accuracy and morbidity of this method are equal if not
      better than the rates available in the literature for open procedures. In
      addition, analysis shows that the standard dissection is more accurate than the
      obturator dissection because in 30% of the patients with positive nodes malignant
      infiltrates were found in the iliac specimen only. Finally, it appears that
      patients in whom the malignancy was detected by ultrasound only may not require
      lymphadenectomy because in our group of 28 patients no positive nodes were
      detected.

PMID- 8345607
TI  - Return of erections and urinary continence following nerve sparing radical
      retropubic prostatectomy.
AB  - We evaluated recovery of erections and urinary continence following anatomical
      radical retropubic prostatectomy in a series of 784 consecutive patients with
      clinical stage A or B prostate cancer. Nerve sparing radical prostatectomy was
      performed in men deemed appropriate candidates. Recovery of erections sufficient
      for intercourse and urinary continence were analyzed controlling for patient age,
      pathological tumor stage and the performance of unilateral or bilateral nerve
      sparing surgery in men followed for a minimum of 18 months. Erections were
      regained in 149 of 236 preoperatively potent men (63%) treated with bilateral and
      24 of 59 (41%) treated with unilateral nerve sparing surgery. Recovery of
      erections correlated with patient age and pathological tumor stage in patients
      treated with bilateral nerve sparing surgery. Continence was regained in 409 of
      435 patients (94%) and did not correlate with patient age, tumor stage or nerve
      sparing surgery. Anatomical radical retropubic prostatectomy can be performed
      with favorable results in preserving potency and urinary continence. Better
      results are achieved in younger men with organ confined cancer.

PMID- 8345608
TI  - Seminal vesicle parameters at 10-year intervals measured by transrectal
      ultrasonography.
AB  - The volume, maximum horizontal area, maximum length, maximum width and depth of
      the seminal vesicles were measured by transrectal ultrasonography in 76 subjects
      without seminal vesicle disorders, divided into 7 groups at 10-year intervals.
      The average of each parameter in each group was presented. The volume and maximum
      horizontal area began to decrease after the age of 60 years. No statistically
      significant difference among subject ages was observed for the other 3
      parameters. A correlation was observed between the volume and maximum horizontal
      area of the seminal vesicles. Our study confirmed that maximum horizontal area of
      the seminal vesicles may be substituted for the volume.

PMID- 8345609
TI  - Oral immunotherapy of recurrent urinary tract infections: a double-blind placebo
      controlled multicenter study.
AB  - We treated 166 patients suffering from recurrent urinary tract infections under
      double-blind conditions for 3 months with 1 capsule daily of either the
      immunostimulating bacterial extract (85) or a placebo (81), followed by a 3-month
      observation period without the test drugs. The bacterial extract exerted a
      significant beneficial curative action and long-term consolidative effect on the
      frequency of recurrent urinary tract infections with marked improvements in the
      characteristic signs and symptoms. It was significantly superior to placebo for
      the majority of the assessed parameters: number of recurrent urinary tract
      infections, bacteriuria, leukocyturia, erythrocyturia, nitrituria, albuminuria
      and casts in urine. Consumption of antibiotics, chemotherapeutics, urinary
      antiseptics or disinfectants was significantly less under active drug therapy
      compared to placebo. Tolerance was good with only 2 side effects reported in 2
      patients (2%) in the active group compared to 11 among 5 (6%) in the placebo
      group. Therefore, the bacterial extract can be considered an efficient and well
      tolerated drug for the treatment of urinary tract infections, and their
      accompanying signs and symptoms, as well as for decreasing the risk of
      recurrences and the need for antibiotics and other antibacterial drugs.

PMID- 8345611
TI  - Penile prosthesis corporotomy closure: a new technique.
AB  - A new technique for corporotomy closure during penile prosthesis implantation is
      described. Horizontal mattress sutures placed after the corpus cavernosum is
      opened serve first as stay sutures and then are used to close the corporotomy
      after device implantation. This technique eliminates placing stay sutures as a
      separate step, avoids damage to the prosthesis and provides an aesthetic
      horizontal mattress closure.

PMID- 8345610
TI  - A new use of ureteroscopy.
AB  - Failure to deflate a Foley balloon is a rare but annoying complication. We
      describe 2 simple techniques to solve this problem.

PMID- 8345612
TI  - Automatic integrated circuit card system for recording 24-hour uroflowmetry.
AB  - A new system for obtaining accurate and stable urine flow data was developed, in
      which patients have a key role in recording their own urinary flow data. Flow
      curves and urination data are recorded on an integrated circuit card, which the
      patient carries in a pocket. Before urinating, the patient inserts the card into
      the system. Urination data are recorded automatically. The card can record up to
      14 days worth of urination data. A personal computer then calculates and prints
      all of the flow curves including maximum flow rate, average flow rate, voided
      volume, duration time, hesitation time, and date and time of urination. This
      system is useful for detecting subtle changes in urination patterns. Typical
      circadian rhythms for urination can also be recorded. With this integrated
      circuit card system the clinical course under alpha-blocker administration could
      be precisely monitored.

PMID- 8345613
TI  - Urinary dysfunction in tropical spastic paraparesis: preliminary urodynamic
      survey.
AB  - Tropical spastic paraparesis is an infection caused by human T lymphotropic virus
      type 1 (HTLV-1). We present the urodynamic findings in 4 female and 1 male
      patient with tropical spastic paraparesis. All patients underwent synchronous
      video-pressure-flow urodynamics, while 3 also underwent electromyographic
      examination. Of the 5 patients 4 presented with detrusor external sphincter
      dyssynergia and 1 had detrusor hyperreflexia with a coordinated sphincter
      contraction. The preliminary results of this series suggest that patients with
      tropical spastic paraparesis and voiding symptoms should undergo urodynamic
      examination so that diagnosis and appropriate therapy may be instituted.

PMID- 8345614
TI  - Laparoendoscopic upper pole partial nephrectomy with ureterectomy.
AB  - A 14-year-old white girl presented with a history of recurrent urinary tract
      infections beginning at age 18 months. Anatomical evaluation revealed bilateral
      duplication of the collecting systems. On the right side of the upper pole moiety
      ended at an obstructing orthotopic ureterocele. On the left side the upper pole
      moiety was associated with an ectopic ureteral orifice. The patient underwent
      laparoendoscopic right upper pole partial nephrectomy with ureterectomy. To our
      knowledge this is the first report of a laparoendoscopic upper pole partial
      nephrectomy. Details of the procedure are discussed.

PMID- 8345615
TI  - The changing urodynamic pattern in infants with myelomeningocele.
AB  - A total of 43 infants with spina bifida was evaluated with a standard simplified
      urodynamic technique to determine whether bladder behavior altered with
      development and the optimal timing for urodynamic testing. Using urodynamic
      evaluation plus renal ultrasound and voiding cystourethrography the patients were
      divided into 2 groups: 1) those with a favorable prognosis and 2) those with an
      unfavorable prognosis. Only 55% of the initial urodynamic studies were predictive
      of future clinical course. The patients who worsened generally did so in the
      first 6 months of life. Of the patients initially believed to have an unfavorable
      prognosis 86% improved or stabilized with therapy. Urodynamic testing appears to
      be an important adjunct at 6-month intervals in infancy and early childhood as
      bladder behavior continues to evolve.

PMID- 8345616
TI  - Urological aspects of sacrococcygeal teratoma in children.
AB  - Sacrococcygeal teratoma is the most common extragonadal germ cell tumor of
      infancy. Associated urological complications, most of which are reported in
      children with malignancy, include vesicoureteral reflux, ureteral and urethral
      obstruction, and neurogenic bladder. To evaluate the influence of tumor grade and
      type on adverse urological outcome we reviewed the charts of 29 children with
      sacrococcygeal teratoma and correlated urological problems to lesion type and
      grade. No correlation was noted between tumor grade and the incidence of
      urological complications. The most common urological complications were
      neurogenic bladder in 12% of the patients, ureteral obstruction in 10% and
      vesicoureteral reflux in 7%. The highest incidence of urological complications
      (81%) was seen in patients with type IV (presacral) disease. We recommend early
      radiographic and neurourodynamic evaluation in all children with sacrococcygeal
      teratoma.

PMID- 8345617
TI  - Potassium thiophosphate laser treatment of genitourinary hemangioma in the
      pediatric population.
AB  - Multiple hemangiomas of the urogenital system are uncommon lesions that usually
      recur and can cause significant morbidity. Three pediatric patients with
      urethral, bladder, penile, scrotal and vaginal hemangiomas underwent treatment of
      these lesions with the potassium thiophosphate laser. All patients had multiple
      lesions and suffered from recurrent bleeding before treatment. Potassium
      thiophosphate photocoagulation was delivered to the surface, urethral and vaginal
      lesions. Treatment-associated bleeding did not occur in any case. Followup
      urogenital and cystoscopic examinations revealed complete obliteration or marked
      diminution in the size of the treated hemangiomas. All patients had a decrease in
      the frequency and intensity of bleeding episodes and 2 were subsequently without
      further episodes of bleeding. Potassium thiophosphate laser photoablation
      provides excellent results in the pediatric population and is preferred to more
      extensive surgical intervention.

PMID- 8345618
TI  - Hygroma renale: pararenal lymphatic cysts associated with renin-dependent
      hypertension (Page kidney). Case report on bilateral cysts and successful therapy
      by marsupialization.
AB  - A total of 42 cases of large symptomatic parapelvic or pararenal lymphatic cysts
      has been reported since 1890, of which 54% were associated with hypertension and
      14% were bilateral. We report on a patient in whom during a 3-month period
      abdominal pain and distention developed successively on both sides associated
      with hypertension. Initially, ultrasound and computerized tomography revealed a
      large multicystic pararenal lymphatic mass on the right side and small parapelvic
      hilus lesions on the left side. Two months after resection and marsupialization
      of the large cyst on the right side the small hilus lesions on the left side
      developed into large pararenal cysts requiring the same therapeutic measures.
      Hypertension was reversible after surgery in both instances; at the second
      operation high preoperative and lower postoperative renin activity, active renin,
      total renin, aldosterone and atrial natriuretic factor in plasma were noted.
      Immunoreactive active and total renin levels in the lymph fluid were elevated, a
      finding that may be explained by the renal origin of the lymph. Marsupialization
      is a kidney preserving measure that reverses all symptoms of large pararenal
      cysts, including Page kidney hypertension.

PMID- 8345619
TI  - Strategies for the successful transplantation of the horseshoe kidney.
AB  - Horseshoe kidney is probably the most common renal fusion anomaly. Horseshoe
      kidneys have been successfully transplanted en bloc into a single recipient or,
      alternatively, they have been divided and implanted into 2 patients. Despite
      these facts the use of horseshoe kidney allografts for transplantation is rare.
      We report a case of the successful transplantation of an en bloc horseshoe kidney
      into a single recipient. The evaluation of fused kidneys for transplantation,
      technical considerations and previously reported cases are discussed.

PMID- 8345620
TI  - Obliterative pyeloureteritis: a complication of stone disease in patients with
      urinary conduit diversion.
AB  - In 4 patients with cutaneous urinary diversion who underwent percutaneous
      ureteral stone removal, similar ureteral complications developed as a result of
      severe ureteritis at the site of the stone. Ureteral narrowing occurred within
      days of percutaneous ureteral stone removal, progressing to complete occlusion in
      2 cases. These complications led to prolonged hospitalization and additional
      procedures for each patient. One patient with an occluded ureter was lost to
      followup. Two patients responded satisfactorily to repeated ureteral dilations
      and prolonged stenting. One patient underwent excision of the affected ureteral
      segment. The average interval between tube placement and removal of tubes and
      stents was 15 weeks in 4 patients. The average inpatient period was 24 days.
      Patients with a cutaneous urinary conduit diversion may be at increased risk for
      complications following percutaneous treatment of ureteral stones. This risk may
      be secondary to an intense inflammatory response due to infection and other local
      factors.

PMID- 8345621
TI  - Percutaneous nephrostomy drainage in the treatment of severe hemorrhagic
      cystitis.
AB  - We report on 2 patients who underwent urinary diversion with bilateral
      percutaneous nephrostomy tube drainage for intractable hemorrhagic cystitis. Both
      patients received cyclophosphamide-based chemotherapy and 1 also underwent pelvic
      irradiation for locally advanced prostate adenocarcinoma. In each case the
      bleeding gradually ceased during a 1-week period. Both patients were alive at 6
      months and were voiding spontaneously. We propose that the mechanism of treatment
      involves diverting endogenous urokinase as well as avoiding overdistention of the
      bladder.

PMID- 8345622
TI  - High flow priapism: a spectrum of disease.
AB  - We describe 4 cases of high flow arterial priapism, ranging from 1 week to 3
      years in duration. The mode of presentation, evaluation using a duplex scanner,
      treatment and ultimate resolution are discussed. In 1 patient treated with ice
      compression the erection subsided spontaneously. One patient underwent
      percutaneous embolization and achieved detumescence. In 2 men a vascular
      pseudocapsule formed around the site of the ruptured cavernous artery that
      provided an important anatomical landmark for intraoperative localization. The
      ruptured branch of the cavernous artery was ligated in an open procedure. Based
      on these cases and a review of the literature, we outline a modified diagnostic
      and therapeutic approach for patients with high flow arterial priapism.

PMID- 8345624
TI  - Carcinoma of the rete testis: case report and review of the literature.
AB  - The literature suggests that carcinoma of the rete testis is a rare neoplasm of
      unknown etiology that arises in the mediastinum testis and may grow slowly for
      months before clinical detection. Diagnosis is often confounded by symptoms
      suggesting inflammation in middle aged and older men presenting with diffuse
      enlargement rather than discrete testicular nodules. Pathological features are
      those of an adenocarcinoma but are not sufficiently distinctive to identify the
      rete testis as the site of origin. Many patients die of the disease soon after
      diagnosis despite local resection with or without adjuvant therapy. Long-term
      survival has been observed in at least 2 cases and more than 40% of the patients
      were alive without disease when reported in the literature. Much of the available
      information is incomplete, however, and firm conclusions regarding the nature of
      this cancer must await more solid data.

PMID- 8345623
TI  - Color Doppler ultrasound for the diagnosis of segmental testicular infarction.
AB  - We report a case of segmental infarction of the testis associated with scrotal
      pain diagnosed by color Doppler ultrasound. Histological examination of the
      testis confirmed the diagnosis. Use of this imaging modality may obviate surgical
      exploration in select cases.

PMID- 8345625
TI  - The syndrome of inappropriate antidiuretic hormone secretion in a patient with
      adenocarcinoma of the prostate.
AB  - We report the syndrome of inappropriate antidiuretic hormone secretion in a 59
      year-old man with stage C adenocarcinoma of the prostate. Serum antidiuretic
      hormone levels returned to normal following treatment with a gonadotropin
      releasing hormone analogue. To our knowledge this case represents the first in
      which resolution of this syndrome occurred with treatment of the carcinoma.

PMID- 8345626
TI  - The resource-based relative value scale: methods, results and impacts on urology.
AB  - Increased concern for rising health care costs in the United States has led to
      the passage of legislation to reform physician payment for Medicare services
      based on resource inputs. In January 1992 the Health Care Financing
      Administration began implementing the new law, which replaces the existing
      Medicare system of physician payment with a fee schedule based on the resource
      based relative value scale (RBRVS). We summarize the methods and data used to
      derive the RBRVS for urology. A national random sample of 115 practicing
      urologists completed structured telephone surveys to provide ratings of physician
      time and work required before, during and after most frequently performed
      urological services. Subsequent survey cycles with urologists provided further
      refinement. Urologists then participated in a cross-specialty physician panel to
      link services from all specialties onto a common scale. This common scale was
      adjusted for geographic differences in practice overhead costs and malpractice
      insurance premiums. A monetary conversion factor, determined by the Health Care
      Financing Administration, was then applied to convert the RBRVS into a Medicare
      fee schedule. The merits and demerits of the scientific process used to develop
      and maintain the relative value scale are extensive. While statistically valid
      and reproducible, the study results have been altered in the political arena. The
      results and impacts of the new Medicare payment system on urology will be
      significant, although it is not yet clear how urological practice will be
      affected. Although faring better than most surgical specialties, urologists stand
      to lose approximately 8% of their Medicare income when the new fee schedule is
      fully implemented. There will be relative gains for evaluation and management
      services and losses for most invasive procedures.

PMID- 8345627
TI  - Re: Risk factors for male partner antisperm antibodies.

PMID- 8345628
TI  - Immunohistochemical localization of epidermal growth factor and transforming
      growth factor alpha in the male rat accessory sex organs.
AB  - We examined the presence of epidermal growth factor (EGF) and transforming growth
      factor alpha (TGF alpha) in the prostate (ventral, lateral, dorsal lobes),
      coagulating gland and seminal vesicle of Fisher 344 adult male rats by
      immunohistochemical and radioimmunoassay methods. Immunohistochemically
      demonstrable EGF was localized in the luminal secretion only of the dorsal lobe
      of the prostate. Reactive TGF alpha was localized in the lateral lobe (100% of
      epithelial cells), dorsal lobe (about 40% of the epithelial cells) and seminal
      vesicle (100% of epithelial cells), but not in the coagulating gland or ventral
      lobe of the prostate. Radioimmunoassay also demonstrated a measurable amount of
      TGF alpha in the lateral lobe (194 pg./gm. wet weight) and seminal vesicle (74
      pg./gm.). Assayable EGF was demonstrated at much higher levels in all prostate
      lobes (ranging from 1.2 micrograms./gm. wet weight in the ventral lobe to 26.4
      micrograms./gm. in the dorsal lobe) and wet weight in the ventral lobe to 26.4
      micrograms./gm. in the dorsal lobe) and the seminal vesicle (0.9
      micrograms./gm.). This is the first report describing the presence of
      immunoreactive TGF alpha and EGF in the male accessory sex organs.

PMID- 8345629
TI  - Conditioned media from a renal cell carcinoma cell line demonstrates the presence
      of basic fibroblast growth factor.
AB  - In a previous report, we demonstrated the isolation and purification of a heparin
      binding growth factor from human renal carcinoma, and suggested that this growth
      factor may play a role in the neovascularity and growth of the tumor. In this
      report, we demonstrate that the growth of the renal cell carcinoma cell line RC29
      is stimulated by the addition of exogenous fibroblast growth factor (FGF),
      epidermal growth factor (EGF) and transforming growth factor alpha (TGF alpha).
      Also, media conditioned by this cell line was able to stimulate growth of the
      A431 vulvar tumor cell line, known for its high concentration of EGF receptors,
      3T3 fibroblasts, human umbilical vein (HUV) cells and RC29 cells. Using heparin
      sepharose chromatography and then SDS polyacrylamide gel electrophoresis (PAGE),
      we were able to demonstrate several proteins in the conditioned media of the RC29
      cell line. Using Western blot analysis, we detected that at least one of the
      proteins expressed in this conditioned media was FGF and that it belongs to the
      basic, not acidic, family of fibroblast growth factors. These findings suggest
      that renal tumors may express growth factors that may play a direct role in
      maintaining their unrestricted proliferation.

PMID- 8345630
TI  - A piece of my mind. Dispatch from the front.

PMID- 8345631
TI  - 'Female athlete triad' risk for women.

PMID- 8345633
TI  - Iffy climate deters medical technology innovation.

PMID- 8345632
TI  - 'Global package' saves money but stirs criticism.

PMID- 8345634
TI  - From the Institute of Medicine.

PMID- 8345635
TI  - From the Centers for Disease Control and Prevention. Update: acquired
      immunodeficiency syndrome--United States, 1992.

PMID- 8345636
TI  - From the Centers for Disease Control and Prevention. Update: barrier protection
      against HIV infection and other sexually transmitted diseases.

PMID- 8345637
TI  - From the Centers for Disease Control and Prevention. Update: hantavirus disease-
      southwestern United States, 1993.

PMID- 8345638
TI  - Blood cholesterol measurement in young adults.

PMID- 8345639
TI  - Blood cholesterol measurement in young adults.

PMID- 8345640
TI  - Blood cholesterol measurement in young adults.

PMID- 8345641
TI  - Adolescent tobacco use and physical activity.

PMID- 8345642
TI  - Definitions for sepsis and organ failure.

PMID- 8345643
TI  - Primary care in the future.

PMID- 8345644
TI  - Risk of tuberculosis and time spent in jail.

PMID- 8345645
TI  - Children who witness violence.

PMID- 8345646
TI  - Children who witness violence.

PMID- 8345647
TI  - Risk factors for HIV infection among young adult men in northern Thailand.
AB  - OBJECTIVE: To determine the sociodemographic and behavioral risk factors
      associated with human immunodeficiency virus (HIV) infection in two cohorts of
      young men selected for military service in northern Thailand. DESIGN: Military
      conscripts were studied cross-sectionally after conscription in May 1991 and
      November 1991. Risk factors were assessed by interview with trained nonmilitary
      interviewers. SETTING: Two military training bases in Chiang Mai, Thailand.
      PARTICIPANTS: A total of 2417 young men aged 19 to 23 years (mean age, 21 years)
      conscripted by lottery into military service in the Royal Thai Army or Royal Thai
      Air Force from six provinces in northern Thailand. MAIN OUTCOME MEASURES: Human
      immunodeficiency virus seroprevalence by enzyme-linked immunosorbent assay
      confirmed by Western blot and univariate and multivariate analyses of
      sociodemographic and behavioral risk factors associated with HIV seroprevalence.
      RESULTS: Overall, 289 (12.0%) of 2417 men were HIV-seropositive at baseline. The
      strongest associations with being HIV positive were heterosexual activities.
      History of sex with a female commercial sex worker (CSW) was frequent (96.5% of
      men who were HIV-positive and 79.0% of men who were HIV-negative) and strongly
      associated with HIV infection on univariate and multivariate analyses (adjusted
      odds ratio, 1.60 to 2.07, depending on the frequency of CSW contact). Also,
      sexually transmitted diseases were common and associated with HIV infection in
      both univariate and multivariate analyses (adjusted odds ratio, 3.36). Sex with
      other males and injection drug use were uncommon and not associated with HIV
      infection. Condom use was reported in 61.5% of men at last sex with a CSW but was
      not shown to be protective of prevalent HIV infection. CONCLUSION: The epidemic
      of HIV infection has spread widely among young men in northern Thailand, despite
      reported frequent and recent use of condoms during sex with female CSWs. Control
      of HIV infection in this population will probably require more regular and
      effective use of condoms, prevention and treatment of sexually transmitted
      diseases, and reduction in the frequency of CSW contact.

PMID- 8345648
TI  - Very low-calorie diets. National Task Force on the Prevention and Treatment of
      Obesity, National Institutes of Health.
AB  - OBJECTIVE: To provide an overview of the published scientific information on the
      safety and efficacy of very low-calorie diets (VLCDs) and to provide rational
      recommendations for their use. DATA SOURCES AND EXTRACTION: Original reports
      obtained through a MEDLINE search for 1966 through 1992 on VLCDs or reducing
      diets plus obesity, supplemented by a manual search of bibliographies and the
      opinions of experts in the field of nutrition and weight loss therapy for
      obesity. Only studies of humans were cited. DATA SYNTHESIS: Current VLCDs are
      usually provided in the context of comprehensive treatment programs, during which
      usual food intake is completely replaced by specific foods or liquid formulas
      containing 3350 kJ/d (800 kcal/d) or less. Weight loss on VLCDs averages 1.5 to
      2.5 kg/wk; total loss after 12 to 16 weeks averages 20 kg. These results are
      superior to standard low-calorie diets of 5020 kJ/d (1200 kcal/d), which lead to
      weight losses of 0.4 to 0.5 kg/wk and an average total loss of only 6 to 8 kg.
      There is little evidence that intakes of less than 3350 kJ/d (800 kcal/d) result
      in better weight losses than 3350 kJ. Intake of at least 1 g/kg of ideal body
      weight per day of protein of high biologic value appears to be important in
      helping to preserve lean body mass. Serious complications of modern VLCDs are
      unusual, cholelithiasis being most common. CONCLUSIONS: Current VLCDs are
      generally safe when used under proper medical supervision in moderately and
      severely obese patients (body mass index [weight in kilograms divided by height
      in meters squared] > 30) and are usually effective in promoting significant short
      term weight loss, with concomitant improvement in obesity-related conditions.
      Long-term maintenance of weight lost with VLCDs is not very satisfactory and is
      no better than with other forms of obesity treatment. Incorporation of behavioral
      therapy and physical activity in VLCD treatment programs seems to improve
      maintenance.

PMID- 8345649
TI  - Pathogenesis of disseminated intravascular coagulation in sepsis.
AB  - OBJECTIVE: To review new insights in the pathogenetic mechanisms involved in the
      development of disseminated intravascular coagulation (DIC) in septic patients,
      in order to develop new directions for therapeutic intervention. DATA SOURCES:
      Articles and published peer-reviewed abstracts on the mechanism of the initiation
      of DIC in sepsis. STUDY SELECTION: Studies selected for detailed review were
      those reporting specifics about the mechanism of activation of coagulation and
      fibrinolysis in experimental human and animal models of sepsis. Data extraction
      guidelines for assessing data quality included validity of the model, quality of
      the laboratory assessment of activation of coagulation and fibrinolysis, and
      methodological considerations, such as the presence of control experiments and
      statistical analysis. DATA SYNTHESIS: After the presence of endotoxin in the
      circulation, significant coagulation activation can be detected. This activation
      is preceded by an increase in the serum levels of various cytokines, such as
      tumor necrosis factor and interleukins. Inhibition of the increase in tumor
      necrosis factor results in inhibition of coagulation activation. Measurement of
      molecular markers for the activation of coagulation proteins at various levels
      indicates that the activation of coagulation is mediated by the tissue factor
      dependent pathway, which is further confirmed by experiments in which the
      inhibition of the tissue factor-dependent pathway resulted in complete inhibition
      of coagulation activation. The activation of coagulation seems to be amplified by
      impaired function of the protein C-protein S inhibitory pathway. An imbalance
      between coagulation and fibrinolysis, ultimately leading to plasminogen activator
      inhibitor type 1-mediated inhibition of fibrinolysis, may further promote the
      procoagulant state. CONCLUSION: The increased knowledge of the various
      pathogenetic mechanisms of coagulation activation and fibrinolysis in sepsis may
      have therapeutic implications; however, their efficacy needs to be assessed in
      appropriate clinical trials.

PMID- 8345650
TI  - Maintaining hospital quality. The need for international cooperation.

PMID- 8345651
TI  - CEA monitoring after surgery for colorectal cancer. When is the evidence
      sufficient?

PMID- 8345652
TI  - Desocializing health care in a developing country.

PMID- 8345653
TI  - [Symposium "infections, recently worth noticing". Introductory address].
AB  - There was once an idea that the extensive development of antibiotics and vaccines
      would cause most bacterial and viral infections to fade away someday. However,
      the occurrence of antibiotic resistant bacteria and variant viruses proved this
      to be illusion. The spread of HIV infection, since there is no way to cure it so
      far, is of great concern. The occurrence of methicillin resistant Staphylococcus
      aureus (MRSA) presents another difficulty in preventing nosocomial infections due
      to the existence of healthy carriers. The out-break of MRSA in wards is one of
      the most serious problems in hospital management. HCV is capable of inducing
      chronic hepatitis, hepatic cirrhosis and hepatoma. HCV is thus a more serious
      concern today than HBV, since preventive measures against HBV by vaccination and
      anti-HBV immunoglobulin are fully established. We, doctors, nurses and clinical
      technologists are apt to be exposed to these hazardous microorganisms and thus
      should take appropriate precautions during routine work. The present symposium
      was planned to present recent research on these microorganisms, HIV, MRSA and
      HCV, so that we can improve our measures to prevent them.

PMID- 8345654
TI  - [Hepatitis C].
AB  - Hepatitis C virus (HCV) is a major cause of post transfusion non-A, non-B
      hepatitis. The virus contains a positive-strand RNA genome comprised of
      approximately 9,400 nucleotides. HCV E2/NS1 is probably an envelope glycoprotein
      (E2). The E2 hypervariable domain appears to contain isolate-specific antibody
      binding linear epitopes. Recently, comparative sequence analysis of all the
      complete and partial HCV sequences published to date indicates that known
      genotypes of HCV can be classified into six basic groups. We report here that the
      prevalence of HCV-I, HCV-II, and a mixed form are 77.2%, 11.4%, and 11.4%,
      respectively. Patients with anti-HCV and HCV-RNA positive chronic active
      hepatitis received 6MU of interferon-alpha or beta everyday for two weeks
      followed by 6MU thrice a week for 14 weeks. Complete response to interferon
      treatment was defined as an ALT level normalized within six months after the end
      of treatment and maintained within the normal limit for an additional six months.
      Complete response was found in 42.9% of patients treated for 16 weeks. In a six
      month follow-up of the complete responders, clearance of viremia was observed in
      90.3% at the end of interferon treatment and in 71.0% six months after the end of
      interferon treatment.

PMID- 8345655
TI  - [Assay of erythropoietin in serum with short term enzyme linked immunosorbent
      assay method--the clinical significance, Part 1: Relation to anemia in renal
      failure and hematological disorders].
AB  - With a newly developed enzyme linked immunosorbent assay kit TOYOBO Co. in which
      2 anti-EPO monoclonal antibodies were used, we assayed EPO concentration in sera
      from normal adults, 168 patients with renal failure and 333 patients with
      hematological disorders. In the patients with renal failure, serum EPO level was
      normal (52.9%) or reduced (42.9%), and there was no correlation to their
      hematocrits. However, there was an increment in EPO concentration correlated to
      their severity of anemia in the most patients with hematological disorders, such
      as iron deficiency anemia (correlation coefficient r = -0.74), aplastic anemia (r
      = -0.89), leukemia (r = -0.81), and MDS (r = -0.65). On the other hand, EPO
      concentration in sera from all the untreated patients with polycythemia vera were
      significantly low level. But the concentrations of EPO from the patients
      successfully treated, with normal hematocrit were recovered to normal level. In
      the patients with secondary polycythemia, there were much varieties in EPO level.
      Assay of EPO in blood is important not only for diagnosis of polycythemia but
      also for the analysis of anemia and clinical use of EPO in vivo. The method
      described here is accurate and technically not complicated, and could be widely
      induced in most laboratories.

PMID- 8345657
TI  - [Risk factors of cerebral embolism in patients with atrial fibrillation].
AB  - Cerebral embolism is one of the major complications of atrial fibrillation (Af).
      We studied patients with Af, retrospectively, as to the factors related to
      cerebral embolism. We examined 82 cases with transthoracic echocardiography (TTE)
      and trans-esophageal echocardiography (TEE) as well as ambulatory (Holter) ECG
      and 12 leads ECG. Thirty-three patients had cerebral ischemic attack (CIA),
      including 14 patients with mitral stenosis (MS) and 19 patients with other heart
      disease or lone Af (NonMS). The CIA group of NonMS were older than other groups.
      Both the CIA and NonCIA groups had the same frequency of paroxysmal and chronic
      Af. In the CIA group, there was a tendency of small amplitude of f wave and
      longer RR interval than the NonCIA group with ambulatory ECG. The CIA group also
      had larger left atrial cavity size and aortic diameter with TTE. TEE revealed
      thrombus formation in 29 cases, and the CIA group had a higher occurrence rate of
      thrombus than NonCIA group. TEE also detected a fuzzy echo in the left atrium in
      88% of the CIA group and 42% of the NonCIA group. The risk factors of cerebral
      embolism could not be made clear in this study, but a fuzzy echo and thrombus in
      the left atrium with TEE are specific findings of cerebral embolism. Therefore,
      older patients with paroxysmal Af, large LAD, AOD, small f wave or long RR
      interval need to be examined by TEE to detect LA thrombus or a fuzzy echo, which
      are probably major risk factors of cerebral embolism.

PMID- 8345656
TI  - [Within-day and day-to-day variations of serum M-CSF levels in healthy
      volunteers].
AB  - We have investigated on within-day and day-to-day variations of serum M-CSF
      levels in healthy volunteers (ranges of age: 20-21 years old). M-CSF levels in
      serum were measured using enzyme-linked immunosorbent assay (ELISA). Serum M-CSF
      levels in early morning were 1.31 +/- 0.30 ng/ml (mean +/- SD, n = 10) in male
      volunteers, 1.50 +/- 0.13 ng/ml (n = 10) in female volunteers. No significant
      difference was observed between male and female volunteers in serum M-CSF levels.
      No significant within-day variations in serum M-CSF levels were also observed.
      Serum M-CSF levels in period of thirteen days in each individual person were
      almost constant (n = 5). The inverse correlation was observed between M-CSF
      levels and number of neutrophils. The correlation, however, was not observed
      between M-CSF levels and number of monocytes. The present results suggest that
      there are mechanisms in vivo which maintain serum M-CSF in a constant level in
      each individual person.

PMID- 8345658
TI  - [Screening of sleep apnea syndrome using daytime polysomnography--its usefulness
      and the characteristics of daytime sleep in the patients with sleep apnea
      syndrome].
AB  - Some attempts have been made to screen sleep apnea syndrome (SAS). In this study,
      we performed daytime polysomnography (DPSG) as a means of screening SAS. 33
      patients (28 males and 5 females, a mean age of 50.7 years) who were seen with
      the complaints of sleep-wake disorders, snoring and breathing disturbance in
      their nocturnal sleep were subjects for the screening. EEG, EMG, and EOG
      according to standard polysomnographic technique were recorded from 3:30 (p.m.)
      for 60 minutes, as additional indicators, oro-nasal airflow and abdominal
      movement were monitored simultaneously to confirm cessation of breathing. After
      the screening, we performed conventional polysomnography (PSG) to make a
      diagnosis of SAS, and compared the diagnosis with the appearance of apnea in the
      screening. We studied on the characteristics of daytime sleep in SAS and NonSAS
      by the comparison of EEG variables obtained from DPSG. Sleep apnea was detected
      in 20 cases with DPSG, 18 cases of these 20 were diagnosed as SAS. However, there
      were 6 patients who were diagnosed as SAS without the appearance of apnea in the
      screening. Dominant type of apnea in the screening were corresponded to ones
      confirmed with PSG, 16 cases showed obstructive type and 4 cases indicated
      central type. Some statistical differences of EEG variables between SAS and
      NonSAS were recognized. Number of stage shifts and percentage of stage W to total
      sleep time were significantly increased in SAS, on the contrary, percentage of
      stage 2 to total sleep time tended to be lower in SAS.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8345659
TI  - [Age-associated morphological change in interventricular septum].
AB  - To investigate the morphological features of the interventricular septum (IVS) in
      the senile heart, we examined 123 normotensives (59 males and 64 females),
      ranging in age from 22 to 91 yrs using 2D echocardiography. End-diastolic IVS
      thickness was measured at the mid-portion (M) and at the thickest portion within
      15 mm distal to the aorto-septal junction (basal portion, B) on left parasternal
      long-axis tomogram. The sigmoid shape of the basal portion was evaluated in terms
      of aorto-septal (AS) angle. M showed no correlation with age, whereas B increased
      significantly with age in both sexes (males, r = 0.42, p < 0.01; females, r =
      0.51, p < 0.01). B/M ratio, therefore, also increased with age (males, r = 0.49,
      p < 0.01; females, r = 0.39, p < 0.01). The AS angle decreased with age in both
      sexes (males, r = -0.33, p < 0.01; females, r = -0.51, p < 0.01). There was a
      significant inverse correlation between B/M ratio and AS angle (males, r = -0.31,
      p < 0.05; females, r = -0.50, p < 0.01). We conclude that the B/M ratio is a
      novel index reflecting heterogenously distributed hypertrophy in the IVS
      associated with age.

PMID- 8345660
TI  - [Granule-accumulation in VERO cells used for determination of antitoxin titration
      by micro cell culture method: I. Influence of mouse serum].
AB  - When the titration of diphtheria antitoxin of mouse serum was carried out by
      micro cell culture method using VERO cells, a large number of granules were
      observed in the cells. In order to examine the influence of this phenomenon on
      the titration of antitoxin, kinetics of the granule-accumulation was
      investigated. The granule-accumulation occurred in the cells in the culture
      medium to which either immunized or normal mouse serum was added. The granule
      rich cells appeared at the dilution of the serum less than 1:32 and increased in
      number with the concentration of the serum. After 4 days of incubation 88% of the
      cells showed granule-accumulation when undiluted serum was added. Besides the
      mouse serum, those from guinea-pigs, horses, fetal calves and humans were
      examined. However, intensive accumulation of granules such as shown with mouse
      serum was not observed. From these results it was suggested that mouse serum
      might have some unknown mechanism which caused the remarkable accumulation of
      granules in VERO cells. The nature of granule and influence of this phenomenon on
      the titration of diphtheria antitoxin will be presented in an accompanying paper.

PMID- 8345661
TI  - [Effect of surface antigens on granulocytes in phagocytosis].
AB  - To analyze phagocytosis mechanism of granulocyte using fluorescent microspheres,
      changes of phagocytic index, complement receptors, Fc receptors and adhesion
      molecules on cell membrane, after exogenous stimulation were determined by flow
      cytometry. The changes of phagocytic index by blocking test was also determined
      using monoclonal antibodies for receptors. The phagocytic index was decreased by
      supernatant of S. aureus, and was increased by supernatant of E. coli and phorbol
      myristate acetate (PMA). By PMA stimulation, surface marker positive cells
      increased in CR1, IgGFcR2 and decreased in IgGFcR3, LFA-3, Homing receptor,
      whereas they increased in CR1, IgMFcR, LFA-1 beta and decreased in LFA-3 by the
      supernatants of S. aureus and E. coli. Blocking test using monoclonal antibodies
      to individual receptors showed decrease of phagocytic index in CR1, CR3, LFA-1
      beta. In this phagocytosis using fluorescent microspheres, the complement
      receptors were most dedicating in phagocytosis of granulocyte.

PMID- 8345662
TI  - [Causes of anomalous patterns of haptoglobin using polyacrylamide gel
      electrophoresis].
AB  - We could observe several anomalous electrophoretic patterns of haptoglobin during
      serotype analysis. We classified these anomalous patterns of haptoglobin into two
      major classes. The first is the change of number of haptoglobin bands, and the
      second is the shift from the normal serotype patterns. The change of number of
      haptoglobin bands was caused by unsaturation of haptoglobin in binding with
      hemoglobin, mixing of different serotypes by blood transfusion or injection of
      haptoglobin and serotype variants of haptoglobin. The shift of haptoglobin PAGE
      pattern was occurred from a large amount of M-protein or lipoproteins in serum.

PMID- 8345663
TI  - [Isospora belli infection in a patient with adult T cell leukemia].
AB  - A 53-year-old man was hospitalized for the development of watery diarrhea
      associated with decreased appetite and progressive weight loss and was found to
      have leukocytosis. The white blood cell count was 14,600/microliters with 66
      percent abnormal lymphocytes. Serum anti-HTLV-I was positive and monoclonal
      insertion of HTLV-I provirus into the atypical cell genome was confirmed with the
      southern blotting hybridization technique. A diagnosis of ATL was made.
      Examination of fresh stool specimens revealed Isospora belli (I. belli) oocysts.
      Initial treatment for I. belli consisted of oral trimethoprim 160mg and
      sulfamethoxazole 400mg given twice daily for nine days. Diarrhea ceased within 2
      days of the start of treatment, but I. belli oocysts were again detected after 20
      days. Trimethoprim 160mg and sulfamethoxazole 400mg were reinstituted four times
      daily for 10 days, and then twice daily for 21 days. The clinical response was
      again dramatic, with rapid clearance of oocysts from the stool. There has been no
      recurrence of diarrhea. The patient's leukemia was refractory to chemotherapy;
      the white blood cell count continued to rise, pneumonia developed, and the
      patient died. I. belli is a previously unrecognized opportunistic pathogen that
      must be considered in the clinical setting of chronic diarrhea in patients with
      ATL.

PMID- 8345664
TI  - [Elevation of serum apo E-rich HDL concentration in a patient with cholestatic
      liver disease].
AB  - A remarkable elevation of serum HDL cholesterol concentration (165mg/dl) was
      found in a 42-year-old Japanese male with chronic pancreatitis who had been
      cholestatic for several years. An abnormal slow alpha-migrating lipoprotein,
      larger in particle size and more enriched with cholesteryl ester and apo E than
      normal HDL, was found in the patient's plasma. Quantitative determination of apo
      E-rich HDL revealed a striking increase of this lipoprotein in plasma. After
      choledocho-jejunostomy, a prompt and remarkable decrease of plasma apo E-rich HDL
      was observed, indicating a direct contribution of cholestasis to the accumulation
      of apo E-rich HDL in plasma in this patient.

PMID- 8345666
TI  - [A study on medical examination items added to periodic health examination as a
      result of amendment of the Ordinance on Occupational Safety and Health].
AB  - In accordance with the recent amendment of the Ordinance on Occupational Safety
      and Health, anemia (Hb, RBC), liver function (GOT, GPT, gamma-GTP), serum lipid
      levels (T-Chol, TG) and ECG have become essential items of the general periodic
      health examination. Data on these items were examined on 86 employees on whom
      chest radiography, blood pressure, urinalysis and past history revealed no
      abnormalities in periodic health examination at their companies. The subjects
      were 58 males and 28 females, between 34 and 66 years old (47.6 years on
      average). Anemia was found in 3 (3.5%), liver dysfunction in 13 (15.1%), abnormal
      serum lipid levels in 24 (27.9%) and ECG abnormalities in 8 (9.3%). The new
      periodic health examination system is thus thought to be useful in the early
      detection and prevention of adult diseases. To enhance this utility, it appears
      important to instruct those found abnormal in any parameter to have extensive
      examination. In discussing liver function and serum lipid level abnormalities,
      obesity, drinking and food intake should be considered.

PMID- 8345665
TI  - [Studies on the gamma delta T lymphocytes in the peripheral blood in healthy
      adults].
AB  - Since gamma delta T lymphocytes has been found to be increased in patients with
      some immunological disorders, there exists clinical needs to determine the
      population of the cells in peripheral blood in normal subjects. We counted the
      number of gamma delta T lymphocytes in samples obtained from 151 healthy
      volunteers, aged from 20 to 69 years, by using a dual-color flow cytometry with
      fluorescence-conjugated CD3 and anti-TCR-gamma delta antibodies. Distribution
      ratio of gamma delta T lymphocytes among peripheral blood lymphocytes was 3.8 +/-
      2.5% (range, 0.6-16.1%). Difference in the ratio and the number of gamma delta T
      lymphocytes among sex was not significant, but those decreased slightly but
      significantly with age.

PMID- 8345667
TI  - [Surgery under peritoneoscopy--impact on gastroenterology].

PMID- 8345668
TI  - [Mutagenicity of the gastric juice in chronic gastritis].
AB  - Mutagenicity of the gastric juice in patients with chronic gastritis was
      determined by reverse mutation test using Salmonella typhimurium TA100 and
      investigated the relationship between intestinal metaplasia which has been
      regarded as a precancerous lesion (candidate) of gastric cancer, and atrophy of
      gastric mucosa. The degree of intestinal metaplasia was quantified in six biopsy
      specimen for one patient and represented as metaplasia index (MI). The Ames
      ratio, mutagenicity, of gastric juice showed no significant relationship with the
      age of patient. On the other hand, Ames ratio and MI, and the age of patient
      showed significant relationship, respectively (p < 0.01). Furthermore, patients
      with more intensive atrophy tended to show higher Ames ratio. As shown above,
      mutagenicity of the gastric juice suggested some relationships to the development
      of intestinal metaplasia and atrophy of gastric mucosa.

PMID- 8345669
TI  - [Type IV collagenase activities in human colorectal cancers and its role in
      cancer invasion and metastasis].
AB  - In 36 patients with colorectal cancers, type IV collagenase activities were
      measured in cancer and non-cancer tissues for evaluating its role in the process
      of cancer invasion and metastasis. The colorectal cancer tissues revealed
      remarkably higher activities than the distant normal and tumor-neighboring mucosa
      (p < 0.001). The activities in the colorectal cancer tissues with high-grade
      histological venous invasion were higher than those with low-grade histological
      venous invasion (p < 0.005). But no differences of the activities were found
      between patients with and without hepatic metastasis. These results suggest that
      the type IV collagenase plays an important role in the cancer invasion to the
      blood vessels around the primary site in colorectal cancers.

PMID- 8345670
TI  - [Evaluation of activated T cells among isolated colonic mucosal lymphocytes in
      ulcerative colitis--using three color flow cytometry].
AB  - In present study, the subsets of activated (HLA-DR+) lamina propria T cells were
      evaluated in ulcerative colitis (UC) mucosa using three-color flow cytometry.
      Activated suppressor-inducer T cells (T(si)), helper T cells (Th) and cytotoxic T
      cells (Tc) were increased in affected mucosa of UC patients not given steroid
      hormones (SH) compared with in the normal control mucosa. It was supposed that
      the increase of activated T(si) was the secondary change of inflammation, because
      this change was demonstrated in non-IBD colitis too. However, the increase of
      activated Th and Tc might indicate the immunological abnormalities related to the
      pathogenesis of UC, because these changes were demonstrated only in UC, not in
      non-IBD colitis. On the other hand, no increase of these activated T cells were
      demonstrated in affected mucosa of UC patients given SH, perhaps reflecting the
      immuno-suppressive effect of SH.

PMID- 8345671
TI  - [Examination of cholangiogram of obstructive jaundice using MRI--compared with
      PTC and ERCP].
AB  - PTC and ERCP are most often used in diagnosis of obstructive jaundice. We studied
      the possibility of clinical diagnosis using MRI in 33 cases of obstructive
      jaundice. A clinical diagnosis of malignant tumors could be given in 17 cases out
      of 20 (85%) using MRI if respiratory standstill was possible. An MRI
      cholangiogram was particularly effective in describing tearful parting bile ducts
      and was clearer than PTC in describing negative gallbladders. Choledochal stones
      could be diagnosed in 58% of cases, which was less than the rate for malignant
      tumors. MRI is not an invasive examination, can be used in diagnosis of
      obstructive jaundice, and helps in selecting treatment methods such as PTCD and
      ERBD.

PMID- 8345672
TI  - [A case of post transfusion graft versus host disease in hemorrhagic gastric
      ulcer].

PMID- 8345674
TI  - [A case of Crohn's disease manifesting collagen disease-like symptoms as an
      initial sign].

PMID- 8345673
TI  - [A case of extra-gastric, pedunculated leiomyoma of the stomach].

PMID- 8345675
TI  - [A case report of ileocecal malignant lymphoma presenting intussusception
      detected by ultrasonography].

PMID- 8345676
TI  - [A case of gas-containing liver abscess complicated with endotoxin shock and
      DIC].

PMID- 8345677
TI  - [Pancreatico-duodenal artery aneurysm associated with complete occlusion of the
      celiac axis and its rupture].

PMID- 8345678
TI  - [A case of pancreatic pseudocyst being complicated with fistulization into the
      transverse colon and presenting repeated melena].

PMID- 8345679
TI  - [Retroperitoneal fibrosis complicated with ascending colon obstruction, report of
      a case].

PMID- 8345680
TI  - [HLA-DR2 DNA typing in Japanese ulcerative colitis].

PMID- 8345681
TI  - Sex differences in respiratory and cardiovascular effects of beta-endorphin.
AB  - An attempt was made to determine sex differences in the effects of beta-endorphin
      (beta-EP) on respiratory and cardiovascular systems using Wistar rats. By the
      intracerebroventricular administration of beta-EP (0.18 mg/kg) to normal male and
      female rats, respiratory rate (RR), heart rate (HR) and mean arterial blood
      pressure (MABP) were depressed significantly (p < 0.01 or 0.001) and CO2 in
      expired gas increased significantly (p < 0.01). These suppressive effects of the
      peptide were transiently blocked by the intravenous injection of naloxone (0.2
      mg/kg). No differences in the effects of beta-EP between estrous and diestrous
      female rats could be detected. The effects of the peptide were significantly
      stronger in RR, HR and MABP for females than for males (0.001 < p < 0.05).
      Testectomized rats showed suppressive effects of the peptide to the same extent
      as intact females, but the effects in ovariectomized rats did not differ from
      those for intact females. In testectomized and ovariectomized rats treated with
      testosterone, the former showed the same results as intact males, but not the
      latter. The suppressive effects of beta-EP on the respiratory and cardiovascular
      systems are thus remarkably relieved by androgen in male rats.

PMID- 8345682
TI  - Immunohistochemical localization of paraquat in skin and eye of rat.
AB  - Immunohistochemical techniques were used to observe the localization of paraquat
      in the skin and eyes of rats. Paraquat poisoned rats were killed 3 h, 12 h, 24 h,
      3 days, 7 days and 10 days after intravenous administration of paraquat. In skin,
      paraquat was localized in the ducts of sweat glands and sebaceous glands between
      3 and 10 days after paraquat injection. In eyes, weak positive findings were
      observed in nerve fibers of retina between 3 and 10 days after the injection. In
      cornea, paraquat was localized in epithelial cells at the first 3 h and between 3
      and 10 days after paraquat administration. Since skin occupies a vast area of the
      body in animals, as an organ, it seems to be an important storage pool for the
      redistribution of paraquat.

PMID- 8345683
TI  - Hymenoptera sting anaphylaxis: detection and clinical significance of individual
      bee and wasp venoms specific IgE and IgG4 antibodies.
AB  - In Japan, an average of 37 fatalities per year related to bee or wasp stings were
      reported during the years 1979-1988. To confirm fatal anaphylaxis serologically,
      we measured bee or wasp venom specific IgE (sIgE) and IgG4 (sIgG4) antibodies in
      the sera of 22 patients who visited hospitals with either allergic or
      anaphylactic reactions after bee or wasp stings by using Enzyme-Linked
      Immunosorbent Assay. Specific IgE or IgG4 antibodies against Polistes apachus
      (Paper wasp) and/or a mixture of Polistes annularis, P. exceramans, P. fuscatus,
      and P. metricus venoms of Polistes genus were detected in 11 patients and the
      detection frequencies were the highest among positive antibodies against bee or
      wasp venoms. The severity of allergic reactions was graded from 0-4 according to
      Mueller. The detection frequencies of sIgE in Mueller grade 0-3 patients were in
      the range of 33% to 67%, and in grade 4 were 100%. Whereas, the detection
      frequency of sIgG4 was high (67-100%) in grade 2-4 patients. Especially high
      levels of sIgE and sIgG4 were detected in patients experiencing the most severe
      clinical reactions. The detection of venom specific IgE and IgG4 antibodies
      appears to be useful when determining bee or wasp stings as the cause of
      fatalities.

PMID- 8345684
TI  - Analysis of hemoglobin in bloodstains using high-performance liquid
      chromatography.
AB  - Hemoglobin (Hb) extracted from bloodstains was investigated using cation-exchange
      high-performance liquid chromatography (HPLC). Among the HbA1 fractions, the
      amount of HbA1d increased linearly as the ages of the bloodstains increased,
      although the amount of HbA1c remained virtually unchanged. As HbA1 fractions are
      Hb modified with glucose or glycolytic intermediates, the total Hb were separated
      into glycated and non-glycated Hb fractions using affinity chromatography to
      investigate the effects of glucose on the age-induced Hb changes. The amounts of
      glycated Hb increased in proportion to the blood glucose level, and the increased
      glycated Hbs were eluted at retention times that corresponded to those of HbA1d
      and HbA0, although HbA1c peak area was virtually unchanged. The amounts of both
      glycated and non-glycated HbA1d increased with bloodstain aging, and the
      proportion of non-glycated HbA1d relative to the total HbA1d was greater than
      that of glycated HbA1d. These findings show that glucose has little effects on
      the elevation of HbA1d in bloodstains that occurs as they age. Furthermore,
      measuring HbA1d levels in bloodstains using HPLC may prove useful for the
      determination of their ages.

PMID- 8345685
TI  - [Determination of benzodiazepines by thermospray liquid chromatograph-mass
      spectrometer. Part 1. Nitrazepam, estazolam, bromazepam, flunitrazepam].
AB  - Thermospray liquid chromatography mass spectrometric method is described for the
      determination of the benzodiazepines (Nitrazepam, Estazolam, Bromazepam,
      Flunitrazepam). Reversed-phase liquid chromatography was performed using a 15 cm
      Shim-pack CLC-ODS (Shimadzu) column, with acetonitrile-water (40:60) + 0.1 M
      ammonium acetate as mobile phase, at a flow rate of 1.0 ml/min. The temperature
      of the vaporizer, block and TH of the source block were 166, 270 and 275 degrees
      C, respectively. Positive ion thermospray mass spectra by thermospray ionization
      (TSP ionization) mode or thermospray on filament ionization (filament-on
      ionization) mode were obtained. Formation of the MH+ ion was observed as a base
      peak under TSP ionization and filament-on ionization conditions and fragment ions
      were very few. On both ionization mode, peaks representing nitrazepam as MH+ at
      m/z 282 at a retention time (R.T.) of 6.4 min, from estazolam as MH+ at m/z 295
      at an R.T. of 6.4 min, from bromazepam as MH+ at m/z 316 at an R.T. of 4.5 min
      and from flunitrazepam as MH+ at m/z 314 at an R.T. of 8.8 min. The detection
      limit for all the benzodiazepines under investigation was less than 0.5 ng (S/N =
      9.4 +/- 4.6) using selected ion monitoring.

PMID- 8345686
TI  - [Concentration of serum proteins and blood group substances in human saliva. 1.
      Quantitation method and variation of secreting quantities among daily life].
AB  - Immunoelectrophoretic analysis of 100 times concentrated human saliva specimens
      showed marked individual differences in the content of albumin (Alb), IgA, IgG
      and transferrin (Tf). We concluded that the planimetric measurement of the
      precipitated area produced by latex-agglutination or hemagglutination on
      microtiter plates was an appropriate method for quantitating these serum proteins
      or ABO and Lewis blood group substances in saliva. Nonspecific agglutinating
      activity caused by mucinous substances in saliva was prevented when the saliva
      was once stained on a filter paper then dried and extracted with a buffer
      solution. Quantities of the serum proteins and blood group substances in saliva
      decreased immediately after meals and gradually increased 2 to 3 hours
      thereafter. The ratios of IgA/Alb, IgA/IgG and IgG/Alb did not differ remarkably
      with the time of sample collection. Saliva from parotid and submaxillary
      sublingual glands contained similar quantities of the serum proteins, whereas
      more ABO and Lewis blood group substances were found in saliva from submaxillary
      sublingual glands than in that from parotid gland.

PMID- 8345687
TI  - [Application of fuzzy inference to personal identification--sex determination
      from teeth].
AB  - Fuzzy inference has received much attention recently as a new type of computer
      control technology for application in various fields. In this study I applied
      fuzzy inference to personal identification in medical jurisprudence. Sex
      determination program was constructed from teeth using the fuzzy inference
      technique and was compared with known discriminant analysis. The materials
      examined were mandibular and maxillary dental plaster models of 100 adult males
      and females, and 80 infant males and females. For the permanent teeth,
      measurements were made on crown width and thickness of the mandibular and
      maxillary central incisors, canines, first premolars, and first molars, and of
      the width and length of the maxillary dental arch. For the deciduous teeth,
      measurements were made on crown width and thickness of all teeth. Stepwise
      discriminant analysis was conducted using these values. The values from 5
      selected upper-ranked items were set as input objects of the fuzzy inference
      program and the probability of maleness obtained from the discriminant analysis
      was set as the output object. Finally, sex determination program for both
      permanent and deciduous teeth was constructed using a fuzzy inference software
      development tool. Each measured value was input into this program and the output
      results were compared with those of discriminant analysis. The percentages of
      correct determinations for permanent teeth were 83.0% for males and 86.0% for
      females using stepwise discriminant analysis, however it increased to 93.0% for
      males and 89.0% for females using the fuzzy inference program. The percentages of
      correct determinations for deciduous teeth models were 67.5% for males and 75.0%
      for females using stepwise discriminant analysis, and increased to 86.3% for
      males and 81.3% for females using the fuzzy inference program. Among samples with
      probabilities between 40% and 60%, 3 out of 14 males and 4 out of 13 females were
      misjudged using stepwise discriminant analysis in cases of permanent teeth.
      However using fuzzy inference program, it reduced to 0 for males and 3 for
      females. In case of deciduous teeth, 9 out of 20 males and 9 out of 23 females
      were misjudged using stepwise discriminant analysis. But it reduced to 5 for
      males and 4 for females using the fuzzy inference program.

PMID- 8345688
TI  - [AIDS epidemic and infection control in the United States].
AB  - AIDS is the second leading cause of death among persons 25-44 years of age. The
      risk to patients from physicians and other health care workers with HIV infection
      has also become a great public concern. There are no specific procedures for
      infection control in AIDS. Universal precautions are applied to AIDS as well as
      to any other infectious diseases. Recommended universal infection control in
      autopsy room is as follows: 1. Wear protective masks and eyewear (or face
      shields), laboratory coats, gloves, and waterproof aprons; 2. Develop and
      consistently practice the skills necessary to avoid penetrating injuries; 3.
      Decontaminate instruments and work areas contaminated during postmortem
      procedures with a 1:10 dilution of common household bleach, whose active
      ingredient is sodium hypochlorite; 4. Dispose of waste contaminated with body
      fluids into a red trash can indicated "BIOHAZARD". In case of accident such as
      needlestick or cut during autopsy of HIV infected corpe, the person should have
      the HIV antibody test and start taking azidothymidine (AZT) within 24 hours.

PMID- 8345689
TI  - [Evaluation of 99mTc-HM-PAO thigh accumulation in patients with cerebro-vascular
      disease].
AB  - 99mTc-HM-PAO cerebral SPECT and whole body scintigraphy (WBS) were performed in 5
      patients without cerebro-vascular disease (CVD) (Group 1), 31 patients with CVD
      but not hemiparesis (Group 2) and 18 patients with CVD and hemiparesis (Group 3).
      Four ROIs were drawn manually around the whole body (WB), brain (Br), right and
      left thigh (Th). We calculated some ratios: the total counts in the brain over
      the total counts in the whole body (Br/WB), the total counts in the thigh over
      the total counts in the whole body (Th/WB) and the mean counts in the thigh over
      the mean counts in the brain (Th/Br). The Br/WB was 6.9 +/- 1.8%, rt-Th/WB was
      4.9 +/- 2.1%, lt-Th/WB was 5.1 +/- 1.3% and Th/Br was 0.46 +/- 0.17 in group 1.
      Whole body scintigraphies in group 1 revealed clear and similar images between
      right and left thigh. The Br/WB was 6.7 +/- 1.4%, Th/WB of paretic side was 4.6
      +/- 1.0%, Th/WB of non-paretic side was 5.8 +/- 1.2% and Th/Br was 0.47 +/- 0.18
      in group 3. The Th/WB in non paretic side was significantly higher than that in
      paretic side (p < 0.01). The thigh images in group 3 revealed clearly different
      between paretic and non-paretic thigh. In conclusion we could acquire the clear
      thigh images with 99mTc-HM-PAO. It was possible that we evaluated not only
      cerebral perfusion but also muscle atrophy and/or perfusion in patients with CVD
      using 99mTC-HM-PAO.

PMID- 8345690
TI  - [Transient ischemic dilatation of the left ventricle observed on dipyridamole
      stressed thallium-201 scintigraphy].
AB  - To assess clinical significance of transient ischemic dilatation of the left
      ventricle (TID) on dipyridamole-stressed 201Tl myocardial scintigraphy, 110
      patients suspected with coronary artery disease, including 13 with normal
      coronary, 48 with single vessel disease, 30 with 2 vessel disease, and 19 with 3
      vessel disease were analyzed. TID was visually and quantitatively assessed
      calculating the ratio of the area within the left ventricular region on the
      initial and delayed image (TID ratio). TID was observed in 3 of 1 vessel disease
      (6%), 5 of 2 vessel disease (17%), and 8 of 3 vessel disease (42%). None of
      normal coronary artery showed TID. In patients with multivessel disease (MVD),
      TID was observed more frequently (27%) than in patients with 1 vessel disease
      (6%) (p < 0.025). Furthermore, the TID ratio tended to be higher (1.15 +/- 0.11)
      than those with single vessel disease (1.03 +/- 0.03). To identify patients with
      MVD, TID had a sensitivity of 27% and a specificity of 95%. ECG changes were
      observed more often in patients with TID than those without TID. Five patients
      showing TID underwent coronary artery bypass graft surgery, TID disappeared
      postoperatively in each patient. In conclusion, TID on dipyridamole 201Tl scan
      seems to be a specific although not sensitive marker for detecting MVD.

PMID- 8345691
TI  - [Brain SPECT by intraarterial infusion of 99mTc-HMPAO for assessing the cerebral
      distribution of carotid artery infusions in patients with brain tumor].
AB  - In order to assess the cerebral distribution of intracarotid chemotherapy, 17
      postoperative patients with brain tumor underwent brain SPECT obtained by
      intraarterial infusion of 18.5 MBq of 99mTc-HMPAO. Injection methods were
      continuous (5.0 ml/min) or pulsatile infusion with supraor infraophthalmic
      catheterization. The findings obtained by brain SPECT were frequently different
      from those of angiography and/or DSA. In supraophthalmic catheterization with
      continuous infusion, only 2 of 10 studies (20%) had homogeneous distribution and
      5 of them (50%) had maldistribution of 99mTc-HMPAO which appears in association
      with laminar flow effect. The remaining 3 studies showed localized distribution
      (two: tumor localization, one: healthy brain localization). On the other hand,
      all of 5 studies with pulsatile infusion had homogeneous distribution of 99mTc
      HMPAO. In infraophthalmic catheterization, all but one of 5 studies had
      homogeneous distribution with continuous infusion. These results suggest that
      pulsatile infusion may be effective in eliminating maldistribution of 99mTc-HMPAO
      in supraophthalmic catheterization. In conclusion, we are convinced that 99mTc
      HMPAO is a useful intraarterial agent for assessing cerebral distribution of
      intracarotid chemotherapy.

PMID- 8345692
TI  - [Increased lung uptake and transient left ventricular dilatation at stress
      myocardial scintigraphy with 99mTc-MIBI].
AB  - On exercise 201Tl scintigraphy in coronary artery disease, left ventricular
      transient dilatation (LVTD) and increased lung uptake were noted as a marker of
      multivessel critical stenosis. To compare the two markers of 99mTc
      methoxyisobutyl isonitrile (MIBI) and 201Tl, planar and SPECT myocardial
      scintigraphy were performed with both radiopharmaceuticals in 27 patients with
      ischemic heart disease. Lung uptake (lung/max myocardial ratio) of MIBI was
      significantly lower than that of 201Tl, but the relationship of the lung uptake
      was linearly correlated (r = 0.77). The LVTD ratio (mean radial ratio = m-RR) was
      determined by the mean radius of the immediate postexercise short axial image by
      that of rest (redistribution) image. There was no significant correlation between
      the m-RR of 201Tl and that of MIBI (r = 0.27). We suggest that the mechanism of
      LVTD is due to not only subendmyocardial ischemia but also another factors.

PMID- 8345693
TI  - [Clinical application of 11C-NMSP to the patients with pituitary adenoma other
      than prolactinoma].
AB  - The existence of dopamine D2 receptors in the pituitary adenoma is an important
      factor for bromocriptine therapy. In order to evaluate the D2 receptors in the
      pituitary adenoma, 11C-N-methylspiperone (NMSP) and positron emission tomography
      was performed in a variety of pituitary adenomas other than prolactinoma. Eight
      patients with pituitary adenoma including four non-functioning adenomas, two
      growth hormone (GH) secreting adenomas, one ACTH secreting adenoma and one TSH
      secreting adenoma and ten normal healthy volunteers were examined. 740 MBq of 11C
      NMSP was injected and dynamic scan was performed from the time of injection to 80
      min postinjection. The time dependent regional radioactivity in the striatum (st)
      and in the tumor tissue (tm) was measured and the binding rate, alpha, was
      calculated according to the following equation: Cst, tm/Ccbl = alpha x integral
      of t0 Ccbl dt/Ccbl + 1. The ratio of total radioactivity in the striatum or tumor
      over total activity in the cerebellum was plotted versus "normalized time", which
      was obtained by dividing integrated cerebellar radioactivity by actual cerebellar
      radioactivity for each timepoint. In three patients with pituitary adenoma, two
      scans were performed before and three hours after oral intake of 2.5 mg of
      bromocriptine. The alpha values for pituitary adenoma and normal striatum were
      0.031 +/- 0.023 (0.017-0.088) and 0.042 +/- 0.006 (0.034-0.049), respectively.
      Bromocriptine reduced alpha value to various degree in pituitary adenoma (13-56%)
      but not in striatum (-3.7-3.3%). Our data suggests that in some of pituitary
      adenoma other than prolactinoma, dopamine D2 receptors existed but that
      nonspecific binding also contributed to the radioactivity in the tumor
      tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345694
TI  - [Relation between uptake of 67Ga-citrate in salivary glands and irradiation
      doses].
AB  - A retrospective study is performed 67Ga-citrate uptake by scintigraphy to
      evaluate the relation between gallium uptake of salivary glands and radiotherapy
      with special reference to radiation dose and period after initial irradiation.
      Sixteen patients with radiotherapy to their head and neck regions were studied,
      undergone 67Ga scintigraphy for four times or more were investigated. The
      following results were obtained: 1. About half of the total number of salivary
      glands increased the uptake of 67Ga-citrate during radiotherapy. 2. The number of
      salivary glands which increased uptake in a group which received more than 30 Gy
      was greater than that in a group less than 30 Gy, and many of them remained with
      increased activity for one year after radiotherapy. 3. Uptake in glands that
      received dose less than 30 Gy showed rapid increasement initially, and showed
      decrease of uptake in six months after the irradiation. We concluded that there
      was different tendency of gallium uptake between a group of patient with
      irradiation of less than 30 Gy and that with irradiation of more than 30 Gy. It
      is suggested that we must always consider gallium uptake of salivary glands for
      long term after the radiotherapy, when we discuss the recurrence or metastases of
      neck lymph nodes of patients, who have performed radiotherapy to their head and
      neck regions, especially high dose irradiation.

PMID- 8345695
TI  - [Usefulness and safety of dobutamine stress thallium myocardial scintigraphy].
AB  - Pharmaceutical stress test is performed for diagnosis of coronary artery disease
      in patients who can not perform exercise test. We studied whether high dose
      dobutamine stress test is useful and safe. Subjects consisted of 133 patients
      (pts) in doubutamine stress test and 45 pts in exercise test. Dobutamine stress
      test was initiated by 10 micrograms/kg/min, followed by 10 micrograms/kg/min
      increment every 3 minutes. Maximal doubutamine dose was 40 micrograms/kg/min for
      3 minutes. Endpoints of dobutamine stress were as follows: ST depression equal to
      or more than (> or =) 0.2 mV: 30 pts, > or = 75% predictive maximum heart rate:
      20 pts, > or = 20 mmHg systolic blood pressure fallen: 10 pts, 40
      micrograms/kg/min for 3 minutes: 10 pts, chest pain: 7 pts, pressure rate product
      (PRP) > or = 25,000: 1 patient. Side effects of dobutamine stress test were as
      follows: palpitation: 52%, arrhythmia: 13%, angina and dyspnea: 7%, headache: 6%.
      These symptoms were disappeared within 2 minutes. One patient, who performed
      dobutamine test 2 day after PTCA, had myocardial infarction. At peak of
      dobutamine stress test, systolic blood pressure, heart rate and PRP were
      increased similar to exercise test. However, diastolic blood pressure was not
      changed. The concentration at peak of dobutamine was 25.5 +/- 7.8
      micrograms/kg/min. The duration of dobutamine stress test was 7.3 +/- 2.3
      minutes. The 65 patients (49%) need more than 20 micrograms/kg/min of dobutamine
      which was maximal loading dose in previous reports. For diagnosis of coronary
      artery disease, sensitivity was 91% (31/34) and specificity was 70% (7/10). From
      these data, high dose dobutamine stress test is useful and relatively safe stress
      method for diagnosis of coronary disease. This stress test would be performed in
      patients who can not perform exercise test.

PMID- 8345696
TI  - [99mTc-HMPAO SPECT in the brain death--a case report].
AB  - Brain single photon emission computed tomography (SPECT) with 99mTc-d,l
      hexamethyl-propyleneamine oxime (HMPAO) was performed twice in a 78-year-old man
      clinically diagnosed as brain death according to the standard criteria of the
      Japanese Ministry of Welfare. The first brain SPECT demonstrated the tracer
      accumulation in the brain, indicating preserved cerebral blood flow. The second
      brain SPECT performed 3 days later revealed cessation of the blood flow. In
      patients with preserved cerebral blood flow, the diagnosis of brain death cannot
      be made, even if they meet the existing criteria, because previous report noted
      the recovery in some of those patients. Brain perfusion SPECT plays an important
      role as a confirmatory test for the diagnosis of the brain death.

PMID- 8345697
TI  - [Detection of myocardial ischemia by 99mTc-Teboroxime myocardial SPECT: a
      comparison with 201Tl myocardial SPECT].
AB  - Exercise myocardial SPECT using 99mTc-Teboroxime was performed and the regions of
      ischemic area were compared with 201Tl myocardial SPECT in 8 patients with
      coronary artery disease. All patients had no evidence of previous myocardial
      infarction, and underwent bicycle ergometer exercise according to a standardized
      multistage exercise protocol. At peak exercise, 555 MBq 99mTc-Teboroxime or 75
      MBq 201Tl was injected intravenously. After termination of exercise, images were
      obtained with a gamma camera rotating through a 180 degrees arc from 45 degrees
      right anterior oblique to 45 degrees left posterior oblique. The concordance of
      99mTc-Teboroxime SPECT and 201Tl SPECT was 63% in ischemic region and 83% in
      normal region. Furthermore, one patient underwent dipyridamole infusion and 99mTc
      Teboroxime SPECT was carried out. The images obtained by dipyridamole 99mTc
      Teboroxime SPECT were equivalent to the images of exercise 201Tl SPECT. 99mTc
      Teboroxime SPECT seems useful for the detection of the coronary artery disease.
      It was suggested that evaluation of the myocardial viability in acute phase of
      myocardial infarction can be possible by using 99mTc-Teboroxime SPECT.

PMID- 8345698
TI  - [Assessment of reverse redistribution on exercise 201Tl myocardial SPECT in
      patients with hypertrophic cardiomyopathy].
AB  - Reverse redistribution is revealed on exercise 201Tl myocardial SPECT in some
      cases with hypertrophic cardiomyopathy. Ten patients with hypertrophic
      cardiomyopathy without coronary artery disease who showed reverse redistribution
      visually were studied. Reverse redistribution was evaluated by the early and
      delayed images of exercise 201Tl myocardial SPECT. Relation between reverse
      redistribution and distribution of left ventricular hypertrophy estimated by
      echocardiography and magnetic resonance imaging was investigated, and the
      mechanism of reverse redistribution was analyzed by referring to Bull's eye
      display of washout rate. Reverse redistribution was displayed in non-hypertrophic
      region and washout rate was normal in that region and low in hypertrophic region.
      In conclusion, in order to interpret reverse redistribution it is necessary to
      recognize hypertrophic region and to refer to washout rate.

PMID- 8345699
TI  - [Assessment of the background count to measure the left ventricular ejection
      fraction with a nuclear stethoscope].
AB  - The nuclear stethoscope is a newly developed device for monitoring left
      ventricular ejection fraction (EF) with a pair of cadmium telluride detector for
      both left ventricular count (first channel) and background count (second
      channel). Although it is useful for evaluating the cardiac function during
      exercise, the methodology of the calculation for distinguishing the net
      ventricular blood count from the background count has not been established yet.
      In order to establish a reasonable method to calculate EF, we measured EF using a
      nuclear stethoscope and conventional gated blood pool scintigraphy in 20 healthy
      volunteers. All subjects underwent two supine ergometer exercise tests consisting
      of the 3 stages for the nuclear stethoscope and blood pool scintigraphy. The EF
      was determined with the following three method for the nuclear stethoscope; 1)
      Cut-off level was fixed at 70% of first channel, 2) Cut-off level at 75%, 3) Cut
      off level was determined by the background count obtained from second channel.
      There was a poor relationship between the EFs obtained from gated blood
      scintigraphy and the EFs from the nuclear stethoscope calculated by any of these
      method. Regarding the EF calculated using the background count, however, the
      delta values of EF between rest and any of the 3 stages during exercise
      correlated closely to those EF from blood scintigraphy. When we apply the EF-at
      rest value obtained from blood pool scintigraphy to analysis with the nuclear
      stethoscope, the EFs of 3 stages indicated good correlation (Stage I r = 0.91,
      Stage II r = 0.82, Stage III r = 0.69).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345700
TI  - [Analysis of cells in bronchoalveolar lavage and ultrastructure of lung tissues
      in experimental silicosis].
AB  - Sprague-Dawley rats received intratracheal instillation of 50 mg silica dissolved
      in 1 ml saline. Animals were killed by intraperitoneal injection of nembutal at
      periods between 0.5 hour and 4 months. Analysis of bronchoalveolar lavage (BAL)
      cells and histological and ultrastructural studies were performed on the right
      and left lungs, respectively. A large number of neutrophils was recovered in BAL
      fluid from 3 hours after silica infusion, and was maintained until 4 months as
      the silica stimulus remained in the lung tissues. The absolute number of
      lymphocytes gradually increased in BAL fluid from day 2. The recovery of
      macrophages was quite low 24 hours after silica instillation. In contrast,
      massive aggregates of macrophages were forming silica granulomata in the lung
      tissues. This discrepancy of results between cells obtained from BAL and those in
      the lung tissues was caused by an impaired capacity of migration of alveolar
      macrophages by the development of a junctional apparatus, the "subplasmalemmal
      linear densities (SPLD)". These structures consisting of hemidesmosome-like
      unpaired and desmosome-like paired ones infrequently appeared in the acute stages
      of granuloma formation and were quite common in macrophages and epithelioid-like
      cells in granulomata 2 weeks after instillation and thereafter. Silicotic
      granulomata grew in the alveolar ducts from the aggregates of macrophages
      superimposed on a various number of alveolar sacs. Regeneration of type II
      alveolar epithelial cells and bronchiolar cuboidal cells usually covered the
      outer border of the granuloma. Endothelial cells of alveolar capillaries
      regenerated following recurrent injuries, and only occasionally formed a
      fenestration structure in their cytoplasm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345701
TI  - [Epidemiological study of snoring--a questionnaire survey in factory workers].
AB  - There has been no epidemiological study of snoring in Japan, and we therefore
      performed a questionnaire survey (in about 7,000 adult men working at a steel
      making factory at the time of the yearly health examination, and investigated the
      relationship between the severity of snoring and 17 items including age, obesity,
      family history of snoring, daytime hypersomnolence, hypertension, smoking,
      alcohol intake and traffic accidents. We classified all the subjects into three
      groups, no snoring, mild snoring, and severe snoring group. We defined severe
      snorers as persons who snored loudly in both inspiratory and expiratory phases
      and those who snored loudly with apnea. We found that aging, obesity, smoking and
      alcohol intake are risk factors for snoring. Compared with non-snorers, severe
      snorers were found to have a high incidence of family history of snoring, daytime
      hypersomnolence, and history of treatment of hypertension. No relationship was
      found between the severity of snoring and the occurrence of automobile accidents.
      The proportion of severe snorers over 40 years old with obesity, daytime
      hypersomnolence and morning headache was 0.25%, representing the group that may
      have obstructive sleep apnea syndrome. The probable incidence of sleep apnea
      syndrome in men may be considerably lower in Japan compared with that in either
      U.S.A. or Europe.

PMID- 8345702
TI  - [Effects of antioxidant enzymes in erythrocytes on pulmonary arterial pressure
      during hypoxic gas breathing].
AB  - Using isolated rabbit lungs (n = 72) perfused at a constant flow of 70 ml/min, we
      analyzed whether the antioxidant system in erythrocytes significantly contributes
      to maintaining pulmonary vascular responsiveness to alveolar hypoxia (HPV) in
      normal lungs. As a measure of HPV, we observed the difference (delta P) between
      mean pulmonary arterial pressure during ventilation with normoxic gas mixture
      (21% O2, 5% CO2 in N2) and that during hypoxic gas breathing (3% O2, 5% CO2 in
      N2). Autologous erythrocytes obtained from the animals treated with various
      substances inhibiting either superoxide dismutase (SOD), the anion channel of the
      membrane, catalase (CAT) or glutathione peroxidase (GSH-Px). Subsequently, delta
      P was systematically measured in the perfusate, whose hematocrit was adjusted to
      6-7% with normal or treated erythrocytes as described above. Further, the effects
      of adding SOD (75 U/ml) or CAT (1000 U/ml) to the perfusate on delta P were
      examined. The following results were obtained. (1) Inhibition of the superoxide
      scavenging mechanism in erythrocytes (SOD and anion channel) exerted no
      significant influence on delta P. (2) Inhibition of hydrogen peroxide scavengers
      in erythrocytes did not alter the scope of delta P. (3) Addition of either SOD or
      CAT to the perfusate did not show any significant effect on delta P. The findings
      are highly consistent with the idea that HPV in normal lungs is essentially
      independent of antioxidant enzymes in erythrocytes, which are expected to be one
      of the important factors determining the total capacity to deal with oxidant
      stress in the lung.

PMID- 8345703
TI  - [Effect of thromboxane A2 synthetase inhibitor (OKY-046) on leukotriene C4
      induced airway hyperresponsiveness in guinea pigs].
AB  - In this study, we investigated the effects of peroral (p.o.) administration of a
      thromboxane A2 (TXA2) synthetase inhibitor, OKY-046, on the airway
      hyperresponsiveness (AHR) in guinea pigs induced by intravenous administration of
      leukotriene C4 (LTC4). A 3 micrograms/kg/hr LTC4 infusion induced airway wall
      thickening (AWT) and AHR to 1.8 and 3.6 micrograms/kg histamine bolus shot. OKY
      046 100 mg/kg p.o. partially inhibited the AHR induced by LTC4 without inhibition
      of AWT. Previously, we have reported that LTC4-induced AHR was partially
      inhibited, to the same exert as by OKY-046, by TXA2 receptor antagonists, ONO-NT
      126 and ONO-8809. These data suggest that intravenous administration of LTC4
      generates TXA2, and TXA2 augments LTC4-induced AHR partially in guinea pigs.

PMID- 8345704
TI  - [Determination of pulmonary blood flow by acetylene rebreathing method in
      patients with chronic respiratory disease].
AB  - Non-invasive measurement of pulmonary blood flow by acetylene rebreathing was
      performed in patients with pulmonary diseases. Cardiac output measurement by
      thermodilution method was also used simultaneously. A fast computation system was
      coupled with the measurement. Fourteen emphysema patients and 7 pulmonary
      fibrosis patients were the subjects. Ten patients with normal lung function were
      normal controls. After the measurement of cardiac output, the subjects rebreathed
      mixed gas containing acetylene and argon from the end tidal level. The
      inspiratory and expiratory gas was measured by mass-spectrometer. A lung model
      made of two compartments connected in series, a compartment of the rebreathing
      bag and a compartment of the lung were used for the analysis, while taking
      account of the volume reduction due to O2 and CO2 exchange and the fluctuation of
      end tidal gas concentration until equilibrium between the bag and the lung was
      reached. Values in 9 emphysema cases and 6 fibrosis cases were within or near the
      90% confidence limits of control. Five emphysema cases were obviously out of the
      range, and their pulmonary blood flow was less than the cardiac output and their
      mean arterial PCO2 was higher than that of the other emphysema cases. These cases
      were considered to have blood flow to the sites with low alveolar ventilation per
      unit volume.

PMID- 8345705
TI  - [Changes in bronchoalveolar cell profiles of asthma patients induced by long-term
      glucocorticoid therapy].
AB  - Effects of long-term glucocorticoid therapy on airway inflammatory cells were
      examined in 40 patients with bronchial asthma. 1. The dose of glucocorticoids
      required by asthmatic patients tended to increase and the level of serum cortisol
      tended to decrease with prolongation of the period of glucocorticoid therapy. 2.
      The proportion and number of lymphocytes in bronchoalveolar lavage (BAL) fluid
      decreased with prolongation of the period of glucocorticoid therapy. The
      proportion of BAL lymphocytes in asthmatic patients treated with glucocorticoids
      for more than 5 years was significantly lower than that in those treated for less
      than 4.9 years. 3. The proportion and number of BAL neutrophils increased with
      prolongation of the period of glucocorticoid therapy and the proportion of BAL
      neutrophils in patients treated with glucocorticoids for more than 10 years was
      significantly higher compared with those treated for less than 9.9 years. These
      findings indicate that long-term glucocorticoid therapy induces changes in airway
      inflammatory cell profiles, with a decrease in the number of lymphocytes and
      increase in the number of neutrophils.

PMID- 8345706
TI  - [Contact time of red blood cells with alveolar air].
AB  - The contact time between red blood cells and alveolar air is one of the most
      important factors affecting red blood cell oxygenation in the lungs. Many methods
      have been presented for contact time measurement, however, no work, evaluating it
      by tracing red blood cell movement through the pulmonary capillary network has
      been reported. In this study, the contact time was measured by tracing red blood
      cells, stained with fluorescein isothiocyanate (FITC-RBC), with a fluorescent
      microscope in living rat lung. It was assumed that the transit time of red blood
      cells through the pulmonary capillary network was equivalent to the contact time.
      The flow patterns of red blood cells were complicated, namely, FITC-RBC
      discharged from one arteriole flowed into several venules through many routes in
      the pulmonary capillary network, and those ejected from several arterioles pored
      into one venule. Furthermore, the FITC-RBC flow rate changed many times in the
      pulmonary capillary network. The contact time varied from 0 to 1.2 seconds. The
      measurement was performed in each classified route by the straight distance
      between arteriole and venule, in order to simplify the various capillary
      networks. The results revealed that the contact time was 0.3, 0.4, 0.5, 0.7, 0.7
      and 0.7 seconds on the average respectively in the routes of 101--150, 151--200,
      201--250, 251--300 and 301--350 microns straight distance. The frequencies of the
      above distance routes were 5, 8, 15, 23, 26 and 21%, respectively. As a result,
      the total lung contact time calculated using these frequencies was 0.7 +/- 0.2
      seconds (mean +/- standard deviation) on average.

PMID- 8345707
TI  - [Case report of miliary TB, with mediastinal TB involving the aorta, trachea and
      esophagus with death due to hemorrhage from perforation of aorta into the
      esophagus during treatment].
AB  - A 32-year-old male was diagnosed as having miliary tuberculosis in May 1990. In
      spite of antituberculosis chemotherapy, he developed tuberculous meningitis and
      intracranial tuberculoma in September 1990. Miliary shadows on chest X-ray
      disappeared in December 1990. However, he developed left atelectasis, and
      bronchofiberscopy revealed soft tumor in the left main bronchus in January 1991.
      He suddenly vomited large amounts of blood and expired in February 1991. At
      autopsy, tuberculous lymphadenitis and cavitation were noted in the mediastinum,
      through which the left main bronchus, esophagus and descending aorta
      communicated. The patient died of massive bleeding which resulted from the
      rupture of tuberculous aortitis into the esophagus. This is a very rare case of
      tuberculous aortic aneurysm rupturing into both the bronchus and esophagus.

PMID- 8345708
TI  - [A case of T-cell lymphoma showing marked bronchial invasion].
AB  - We report a case of malignant lymphoma with bronchial involvement in a 35-year
      old male patient. On admission, chest X-ray revealed enlargement of bilateral
      hilar lymph nodes and expansion of the superior mediastinal space. CT and MR
      images showed that the tumor shadow appeared to wrap around the left and right
      main bronchi. Bronchoscopy revealed that the entire periphery of the left main
      bronchus was constricted. Transbronchial biopsy specimens, which revealed
      findings consistent with non-Hodgkin's lymphoma, were positive for surface
      markers of CD2, CD4, and CD8 and negative for those of CD19 and CD20. After MACOP
      B treatment, the patient entered complete remission. He received 41.4 Gy
      radiotherapy thereafter, and has shown no signs of recurrence during continuing
      follow-up.

PMID- 8345709
TI  - [Two cases of mediastinitis as a complication of odontogenic infection and
      tonsillitis].
AB  - We experienced two cases of descending necrotizing mediastinitis with different
      etiology. Case 1: A 59-year-old woman presented with chief complaints of dyspnea
      and swallowing disturbance. She had been diagnosed as having tonsillitis one week
      before. She was very pyrexic, and laboratory examination indicated acute
      inflammation. Chest X-ray and CT-scan showed enlargement of the mediastinum and
      pleural effusion. We diagnosed the mediastinitis to be a complication of
      tonsillitis. Case 2: A 54-year-old man had a tooth extracted 3 weeks prior to
      admission. His chief complaints were craniomandibular disturbance and neck
      swelling. Laboratory examination disclosed multiple organ failure and DIC. Chest
      X-ray and CT-scan showed enlargement of the mediastinum and pleural effusion. We
      diagnosed the mediastinitis in this case to be a consequence of an odontogenic
      infection following tooth extraction. Both patients received continuous drainage
      and irrigation of the abscesses and recovered in about 2 months. Case 1 showed an
      impaired glucose tolerance after recovery from mediastinitis. Although the main
      causes of mediastinitis are cardiac surgery and esophageal perforation, our cases
      demonstrate that mediastinitis may occur as a complication of deep neck
      infection.

PMID- 8345710
TI  - [Home intermittent negative pressure ventilation in a case of chronic respiratory
      failure due to old tuberculous pleuritis].
AB  - A 64-year-old male with a history of tuberculous pleuritis at age 29 had received
      home oxygen therapy since age 58 because of chronic respiratory failure. He was
      admitted with symptoms of dyspnea at rest and myoclonus at age 62. Because CO2
      narcosis occurred twice, we performed intermittent negative pressure ventilation
      (INPV) after short-term positive pressure ventilation with transnasal intubation.
      He has received INPV for 7 hours every day at his home for 20 months without
      acute exacerbation of respiratory failure, and his activity of daily life
      subsequently improved. In conclusion, INPV seems to be useful for patients with
      chronic hypercapnic respiratory failure due to lung disease.

PMID- 8345711
TI  - [A case of limited form of Wegener's granulomatosis without detection of anti
      neutrophil cytoplasmic antibody].
AB  - A 52-year-old woman was admitted to our hospital because of high fever and
      productive cough. Her chest X-ray showed multiple cavitary nodules in both lungs.
      Although we suspected Wegner's granulomatosis (WG), anti-neutrophil cytoplasmic
      antibody (ANCA) was not detected in her serum. Finally, an open lung biopsy was
      performed, and the limited form of Wegener's granulomatosis was diagnosed. With
      cyclophosphamide and steroid treatment, she markedly improved. We conclude that
      in patients suspected of having WG, it is necessary to perform open lung biopsy
      regardless of the detection of ANCA.

PMID- 8345712
TI  - [A case of status asthmaticus complicated by with pneumoperitoneum during
      mechanical ventilation therapy].
AB  - A 46-year-old woman was admitted to our hospital for a severe asthma attack. On
      admission, systemic cyanosis was observed, and her consciousness state was
      drowsy. Arterial blood gas showed severe respiratory acidosis, hypoxia, and
      hypercapnea, with pH, PaO2, and PaCO2 of 7.163, 29.9 torr and 81.3 torr,
      respectively. Immediately, mechanical ventilation was commerced but on the third
      hospital day pneumomediastinum and subcutaneous emphysema appeared, and on the
      sixth day pneumoperitoneum also appeared. The chest CT scan on the sixth day
      showed free air around bilateral internal mammary vessels. This indicated that
      air moved from the mediastinum into the peritoneal cavity through an anterior
      route, via the sternocostal triangle formed by the xiphoid origins of the
      diaphragm medially and the costal origins laterally.

PMID- 8345713
TI  - [Analysis of bronchoalveolar lavage fluid in a case of high altitude pulmonary
      edema].
AB  - A 29-year-old male climber developed high altitude pulmonary edema (HAPE),
      progressing from headache and dyspnea to disturbance of consciousness in the
      Japan Alps. He was admitted to Shinshu University Hospital. Physical examination
      on admission revealed a cyanotic patient with coarse crackles and wheezes in
      bilateral lungs. Chest X-ray film showed bilateral patchy infiltrates. Arterial
      blood gases indicated severe hypoxemia, and respiratory alkalosis; pH 7.452, PO2
      35.5 Torr, PCO2 31.6 Torr. Right heart catheterization showed noncardiogenic
      pulmonary edema, analysis of bronchoalveolar lavage (BAL) fluid was as follows;
      cells 2.05 x 10(5)/ml (alveolar macrophages 61.5%, neutrophils 25.5%, lymphocytes
      13.0%), protein concentration 91 mg/dl. Cellular and protein analysis of BAL has
      been shown to be of value to clarify the pathogenesis of the permeability edema
      in patients with HAPE.

PMID- 8345714
TI  - [A case of adenocarcinoma presenting as a cavitary lesion with niveau formation].
AB  - Primary pulmonary adenocarcinoma rarely shows cavitation with a fluid level on
      chest roentgenograms. Herein we describe such a case misdiagnosed as pulmonary
      tuberculosis. The patient was a 63-year-old, female who had never smoked. Chest
      roentgenograms revealed a cavitary lesion in the left lower lobe, possessing a
      prominent fluid level. Fiberoptic bronchoscopic aspirate was positive for acid
      fast bacilli on stains. Since there was no improvement with antituberculous
      chemotherapy, a left lower lobectomy was performed. The present case is of
      interest in the light of cavity formation in pulmonary carcinoma. The diagnosis
      and roentgenographic features are discussed.

PMID- 8345715
TI  - [A case of primary pulmonary artery sarcoma].
AB  - A 39-year-old male was admitted with persistent cough, palpitations and dyspnea
      on exertion. Chest X-ray showed cardiomegaly, left pleural effusion and left
      hilar mass shadow. Echocardiogram revealed dilatation and hypertrophy of the
      right atrium and ventricle. Perfusion lung scintigram disclosed a complete defect
      of the left lung and a partial defect of the right upper lobe. CT scan showed an
      intravascular tumor mass in the bilateral main pulmonary arteries. Digital
      subtraction angiography of the pulmonary artery revealed complete obstruction of
      the left pulmonary artery and stenosis of the right pulmonary artery. MR image
      showed intravascular tumor infiltrating the mediastinum and surrounding tissue.
      Sarcoma was highly suspected, but a histopathological diagnosis could not be
      made. The patient died of heart failure two months after admission to our
      hospital. Postmortem examination showed that the pulmonary trunk and left main
      pulmonary artery were markedly dilated and completely occluded by the tumor.
      Tumor infiltrated into the left upper lobe and mediastinal lymph nodes. The tumor
      was histologically diagnosed as undifferentiated sarcoma.

PMID- 8345716
TI  - [A case of small-sized lung adenocarcinoma, 4 mm in diameter, detected by CT].
AB  - A 67-year-old woman presented to our hospital because of an abnormal shadow on
      her chest X-ray film. The film showed a well-circumscribed nodule, 15 mm in
      diameter, in her left lower lung field. Compared with her prior film of 1.5 years
      ago, the size of the nodule had not changed, suggesting the possibility of a
      benign lung tumor. Chest CT with 10 mm-thick collimation demonstrated another
      small round opacity near the nodule in the left lower lobe; this small opacity
      was not detectable on plain chest films. For further analysis of the small
      opacity, high resolution CT was carried out. High resolution CT with 1.5 mm
      collimation showed a 4 mm nodule with an ill-defined margin and relatively low
      internal density, and probable involvement of a peripheral branch of the
      pulmonary vein. These features suggested the possibility of malignant
      characteristics of this small opacity. The patient underwent thoracotomy and
      pathologic examination revealed that the large well-circumscribed nodule was a
      hamartoma and the small nodule was a papillary adenocarcinoma lesion. High
      resolution CT is prerequisite to diagnosing the characteristics of small
      pulmonary nodules.

PMID- 8345717
TI  - [Shock wave therapy of the rabbit VX2 bladder cancer--THP-ADM concentration in
      the tissue after combination therapy of THP-ADM and shock wave].
AB  - Tissue concentration of THP-ADM was analysed after the administration of THP-ADM
      with or without exposure of high energy underwater shock waves (SW) to rabbit
      bladder VX2 cancer. THP-ADM was administered intravenously (2 mg/kg) or into the
      urinary bladder (10 mg/body). After the administration of THP-ADM, SW was exposed
      (6,000-10,000 shots) to VX2 bladder cancer or normal bladder tissue. One hour
      later, THP-ADM tissue concentration was measured by high performance liquid
      chromatography method. In intra-venous group, THP-ADM concentration of cancer
      tissue was significantly lower (p < 0.02) in SW group than that of non-SW group.
      In bladder instillation group, THP-ADM concentration of normal bladder tissue was
      significantly higher (p < 0.02) in SW group than that of non-SW group and the
      average concentration of cancer tissue was higher about three times in SW group
      than that of non-SW group.

PMID- 8345718
TI  - [Tumor recurrence and grade and/or stage progression in low grade tumor. Analysis
      of 154 patients with superficial transitional cell carcinoma of the bladder].
AB  - The clinicopathological findings of 154 patients with initially superficial
      (stage pTa or pT1) transitional cell carcinoma in the bladder were analyzed to
      study risk factors for tumor recurrence or progression in grade and/or stage of
      the low grade tumor. The number, size, grade and stage of tumor at the first
      presentation were the significant predictors for the first tumor recurrence.
      However, only the tumor grade and size at the first recurrence were the
      predictors for the second recurrence. In 19 (33%) of 57 patients with recurrence,
      low grade superficial tumor progressed in tumor grade and/or muscle invasion. The
      progression of low grade tumor correlated with short tumor free intervals and
      tumor size. Grade and/or stage progression was observed in 14% of the tumor of 1
      cm or less in diameter, whereas in 42% of the tumor more than 1 cm in diameter
      (Chi-square test: p < 0.25). These results indicate that tumor grade and size are
      important predictors for recurrences. Short tumor free intervals and sizes of
      tumors in the second recurrence are significant predictors for grade and/or stage
      progression in low grade superficial cancer.

PMID- 8345719
TI  - [Establishment and characterization of a new human renal cell carcinoma cell line
      (KG-2) and metastatic model in nude mice].
AB  - A new cultured cell line (KG-2) derived from human renal cell carcinoma and a
      metastatic model in nude mice were studied. KG-2 was cultured from renal cell
      carcinoma (clear cell carcinoma) of the left kidney. In vitro doubling time of KG
      2 was approximately 50 hours. KG-2 cells produced tumors in both the subcutaneous
      and renal sub-capsular space in nude mice, with tumorigenicity of 75%, showing no
      difference between the two sites. Histologically, tumors formed in the
      subcutaneous sites were hypovascular granular cell carcinoma. Moreover, each
      tumor was encapsulated by a thick fibrous capsule and never produced distant
      metastasis or invasion into the surrounding tissue. However, tumors formed in the
      subrenal capsular space were clear cell carcinoma. These tumors were
      hypervascular, and produced distant metastases. The most common metastatic site
      was the lung. Immunohistochemical analysis using anti-human collagenase type IV
      antibody on tumors formed in subcutaneous and subrenal capsular sites
      demonstrated that the expression of this enzyme in tumors formed in the subrenal
      capsular space was much higher than that in tumors formed in the subcutaneous
      site. Additionally, immunohistochemical study using anti-mouse collagen type IV
      antibody, a major components of the vascular wall, demonstrated many small
      densely growing vessels in tumors formed in the subrenal capsular space. In
      contrast, few vessels were produced in tumors formed in subcutaneous sites. These
      findings suggest that factors relating to the different injection sites may
      regulate the production of collagenase type IV secreted by KG-2 cells and
      neovascularity in nude mice. This metastatic model may be useful in the study of
      the mechanism of cancer metastases.

PMID- 8345720
TI  - [Expression of HLA class II antigen-associated invariant chain on renal cell
      cancer].
AB  - Major histocompatibility complex (MHC) antigens play important roles in immune
      responses. MHC class II molecules serve as restriction elements for cells
      presenting antigens to CD4-positive helper T-cells. They also function as
      histocompatibility antigens responsible for graft rejections by stimulating
      allogenic reaction. Furthermore, it was reported that the expression of class II
      antigen on tumor cells increases immunogenicity in mice by a mechanism involving
      class II molecule positive tumor cells which present tumor associated antigens to
      host immune cells or induce allogenic reactions against tumor cells. Class II
      molecules associate with the HLA class II antigen-associated invariant chain (Ii)
      as soon as class II molecules are produced in the rough endoplasmic reticulum. Ii
      is considered to block the binding of endogenous peptides to class II molecules,
      and to be a signal for transporting class II molecules to endosomes. Both
      functions of Ii are essential for the function of class II molecules. To
      investigate the association between renal cell cancer (RCC) and the host's immune
      system, we immunohistochemically examined 60 RCCs for the expression of Ii, class
      II and class I antigens on RCC and the degree of lymphocytic infiltration. We
      detected Ii to varying degrees on 53 out of 60 RCC tissues but none on normal
      renal tubular cells. Compared with class II antigens, they were detected in the
      order DR > or = Ii > or = DP not equal to DQ. A significant correlation was found
      between the expression of Ii and the degree of lymphocytic infiltration.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8345721
TI  - [Evaluation of vasculogenic erectile impotence using DICC (dynamic infusion
      cavernosometry & cevernosography) with intracavernous injection of papaverine].
AB  - Dynamic infusion cavernosometry and cavernosography (DICC) with intracevernous
      injection of papaverine was performed in 28 men. The change of the corporal body
      pressure after injection of papaverine and the intracavernous pressure decrease
      within the first 30 seconds after discontinuation of saline infusion were
      observed. Four different patterns of cavernometric findings can be identified on
      the basis of the intracavernous pressure behavior in response to injection of
      papaverine, infusion of saline and discontinuation of infusion: pattern A
      represents no vasculogenic insufficiency, pattern B represents pure arterial
      insufficiency, pattern C clearly represents venous leak and pattern D represents
      venous leak and arterial insufficiency. Cavernosography has found out effectively
      the sites of venous leakage in most our cases.

PMID- 8345722
TI  - [Detection of numerical chromosome aberrations in urologic malignancies using in
      situ hybridization from formarin-fixed paraffin sections].
AB  - It has been shown that molecular cytogenetics in interphase nuclei is applicable
      to paraffin embedded sections from formarin-fixed materials utilizing in situ
      hybridization (ISH). This allows precise identification of numerical
      abnormalities of chromosome in tumor cells without disruption of tumor
      morphology. Thirteen cases of bladder cancer and twenty six cases of prostate
      adenocarcinoma were evaluated for numerical aberrations of chromosome 1, 7, 10,
      11, 17, 18, X and Y utilizing biotinylated probes specific for the alpha
      satellite region. In two cases from total prostatectomy, one case from total
      cystectomy and two cases from TUR-P specimen, hybridized chromosomes could not be
      detected in individual tumor cells. With respect to the appearance of the ISH
      signal, optical concentration and time for the digestion enzyme has to be
      established essentially. This technique can now be applied on the detection of
      biological activity in various types of urological cancer.

PMID- 8345723
TI  - [Anticholinergic therapy of urinary incontinence and urinary frequency associated
      with the elderly--with special reference to dementia].
AB  - Pharmacotherapy with anticholinergic agents was studied in a total of 80 patients
      aged 65 years or older with chief complaints of urinary frequency (4 patients)
      and/or ugency incontinence (76 patients). The subjects were 45 men and 35 women
      at the age ranging between 65 and 92 (mean 73.7). The patients received
      anticholinergic agents (terodiline hydrochloride 24 mg/day, oxybutynin
      hydrochloride 6 mg/day, propantheline bromide 60 mg/day separately or in
      combination) for more than two weeks. Subjective symptoms and objective findings
      were assessed before and after the administration. In addition, according to the
      result of Hasegawa's dementia rating scale the patients were divided into
      dementia group and non-dementia group for further evaluation of the study drugs.
      As a result, cystometrogram revealed significant increase of maximum bladder
      capacity in either dementia group or non-dementia group. There was no significant
      difference in rate of objective improvement between both groups. On the other
      hand, rate of subjective improvement was significantly higher in non-dementia
      group (40%) than in dementia group (15%). As mentioned above, improvement of
      cystometrogram findings was not associated with improvement of subjective
      symptoms in the demented patients. This suggests that the major cause of
      incontinence in demented patients is not the bladder dysfunction but the specific
      conditions of demented patients such as agnosia and apraxia.

PMID- 8345724
TI  - [The clinical significance of carbohydrate antigen 19-9 (CA19-9) in transitional
      cell cancer of urinary tract].
AB  - For the purpose of evaluating the utility of CA19-9 determination in transitional
      cell cancer (TCC) of the urinary tract, its serum value, tissue level and,
      immunohistochemical study, and follow up study, with high serum value were
      examined in 43 cases with TCC and 13 cases of control. 1. Serum values were 19.1
      U/ml in the control group and 198 U/ml in the tumor group. Though those of tumor
      were higher than those of the control group, there is no statistical difference
      between both groups. The cases with abnormally high value were observed in 13.7%
      of the control group, 13.8% of the bladder cancer, and 57.1% of the upper urinary
      tract cancer. 2. Tissue levels were 816 U/g wet tissue in the control group and
      13,000 U/g wet tissue in the tumor group, showing a significantly higher value (p
      < 0.01) in the tumor group, statistically. 3. Immunohistochemical study were
      positive in 4.0% of the control group and 88.4% of the tumor group. 4. There is a
      significant correlation between serum values and tissue levels (p < 0.05, r =
      0.483). 5. The serum values did not correlated with the staining property, tumor
      size, grade, and stage. 6. The tissue levels correlated with the tumor size, but
      did not correlate with the staining property, grade, and stage. 7. In the follow
      up study of cases with high value, those, who had not attained postoperative
      normalization, died of recurrent carcinoma. In cases showing an elevation despite
      postoperative normalization, too, all showed recurrence. Only those, whose value
      were normalized and remained at the normal range, are living without
      metastasis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345726
TI  - [Transrectal hyperthermia for chronic prostatitis].
AB  - Transrectal hyperthermia was performed on 13 patients with chronic non-bacterial
      prostatitis which failed to respond to the conventional treatments. We used
      "Prostathermer" (Biodan-Medical system, Israel) for heating the prostate gland.
      The prostate was heated at 42 degrees C-43 degrees C, for 60 minutes in 1
      session. Treatment consisted of 6 sessions, and was performed during a period of
      three weeks on an outpatient basis. Of 11 patients re-evaluated after 3 months, 6
      (55%) achieved improvement of subjective symptoms. Of 9 patients, 4 (44%) showed
      reduction of the number of white blood cells (> or = 10 leukocytes count per high
      power field) in their expressed prostatic secretion (EPS), which however was not
      always correlate with improvement of subjective symptoms. No complications were
      encountered in our series. Our result indicates that local hyperthermia is safe,
      and would become new modality in the treatment for chronic prostatitis.

PMID- 8345725
TI  - [Active uptake of oxalate in a renal tubular cell line (LLC-PK1)].
AB  - The oxalate uptake was studied in LLC-PK1 cells, an epithelial cell line
      originated in proximal tubular cells of porcine kidney. It was clear that the
      cells contain an oxalate exchanger highly sensitive to 4,4-diisothio
      cyanostilbene-2-' disulfonic acid (DIDS). The uptake was inhibited by the
      addition of inorganic anions (chloride, sulphate and bicarbonate) to the reaction
      system, but was unaffected by sodium ion. The data suggest the possibility that
      it should be consistent with at least two transport systems for oxalate in LLC
      PK1 cells, a SO4-/oxalate/HCO3- exchanger and a Cl-/oxalate exchanger.

PMID- 8345727
TI  - [Clinical experience of simultaneous fiber-urethrocystoscopy and cystometry
      recording].
AB  - We performed fiber-urethroscopy and cystometry recording simultaneously in 15
      male patients. Fifteen patients were consisted of 12 complaining of micturition
      difficulty (such as BPH, NB, BNS) and 3 normal control. Fiberscope, Olympus CYF-1
      and BF3C10, and cystometry were connected the DISA system. Firstly, we insert
      fiberscope from the urethra to bladder careful, and then cystometry recording
      using carbon dioxide gas started under direct vision of fiberscope. We compared
      cystometrical parameters based on our original method to these on conventional
      one. There were slight statistical significances in the pressure at the first
      desire to void and the maximum desire to void. But these differences as well as
      the frequently and the size of uninhibited contraction were not induced by the
      caliber of the urethroscopy. In conclusion, cystometric recording and
      urethroscopic observation using fiberscope are simultaneously carried out safely
      without reducing their diagnostic accuracy.

PMID- 8345728
TI  - [Investigation on recurrent and evolutionary factors in superficial bladder
      cancer].
AB  - To evaluate clinical and pathological factors responsible for tumor recurrence,
      disease progression and upper urinary tract reoccurrence, we reviewed data from
      244 patient with superficial bladder cancer (pTa and pT1) who were initially
      treated by bladder sparing operation between 1961 and 1990. The factors assessed
      in the present analysis included sex, age, interval between initial symptoms and
      first consultation, presence of hematuria, bladder irritability, tumor shape,
      tumor base configulation size, number, grade, stage, initial treatment, bladder
      instillation and medication. Accumulated recurrence rates were 13% for the first
      year, 20% for the second year, 23% for the third year and 28% for the fifth year.
      Tumor base configulation, number and grade demonstrated significant difference
      among each category. Multivariate analysis by the Cox's proportional hazards
      model confirmed that tumor number was the most important factor, followed by
      grade in this order. Disease progression developed in 7 patients (3%) and number
      and grade of tumor demonstrated significant difference. Progression was noted in
      60% of multiple, G3 and pT1 tumor. Upper urinary tract recurrence developed in 5
      patients (2%), however, we can find no risk factor for upper urinary tract
      recurrence.

PMID- 8345729
TI  - [Histopathological comparison of prostatic adenocarcinoma in Japan and the United
      States].
AB  - Histopathological comparison of clinical prostatic adenocarcinoma between Japan
      and the United States (US) has been made with retrospective analyses on 1,037 and
      987 cases, respectively. All cases were histologically evaluated by the same
      pathologist (M.H.) without previous knowledge of clinical information according
      to application of the Japanese General Rules for Prostatic Cancer (JGRPC) based
      on the predominant degree of histological differentiation, the nuclear grading by
      WHO classification and the Gleason grading systems. The age distribution of the
      patients was slightly different among both groups. However, this difference
      appeared not to be essential, because there existed difference of the date on
      diagnosis between two groups. Even though considering this time difference on
      registration, much more cases from Japan had stage D disease. The observed
      incidence of the histological differentiation classified by JGRPC among over-all
      cases did not show significant difference, however, the incidence among the cases
      with same stage between two groups differed with some statistical significance.
      Much more cases from the US fell in well differentiated adenocarcinoma and
      frequency of moderately differentiated adenocarcinoma was higher in the Japanese
      even in the cases diagnosed at advanced stages. The observed incidence of nuclear
      grade 3 was also higher in the Japanese. Gleason primary and secondary grade 5
      and score 9-10 appeared more frequently in the cases from Japan.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8345730
TI  - [Histopathological comparison of stage A prostatic adenocarcinoma in Japan and
      the United States].
AB  - Histopathological characteristics of stage A prostatic adenocarcinoma from Japan
      (137 cases) and the United States (51 cases) were comparatively evaluated by
      retrospective analysis. All cases were examined by one referee pathologist (MH)
      using classification based on Japanese General Rules for Prostatic Cancer
      (JGRPC), nuclear grading by Mostofi-WHO system and Gleason grading. The
      incidences of the cases with well differentiated, low nuclear anaplasia and
      Gleason grade 1 or 2 on primary and secondary grades as well as histologic score
      2-4 were much more higher in the cases from Japan as compared with those from the
      US. In the cases from the US proportion of the cases with moderately
      differentiated adenocarcinoma and grade 2 nuclear anaplasia exceeded those with
      well differentiated and grade 1 anaplasia. Adenocarcinomas with Gleason grade 3
      in primary and secondary grade and 6-8 of histologic score were also more
      frequently observed in the cases from the US. No different distribution of each
      histologic grade could be obtained among the Japanese cases classified stage A2
      and entire cases from the US. These results suggest that much more stage A
      adenocarcinoma in the US might fall into A2 if strict criteria was applied for
      subcalssification of stage A, which may reflected in the remarkable difference in
      the incidence of clinical prostatic carcinoma.

PMID- 8345731
TI  - [A case of cutaneous squamous cell carcinoma after renal allotransplantation].
AB  - We describe herein a renal transplant recipient who developed cutaneous squamous
      cell carcinoma 15 years after the first transplantation. A 41-year-old Japanese
      man received a renal transplant from his mother for end-stage glomerulonephritis
      in December 1975 when he was 25 years old. Unfortunately, he suffered
      irreversible chronic rejection and returned to hemodialysis in March 1986. In
      December 1986 he received the second renal transplant from his father. In
      November 1990, the patient developed a nodule just lateral to his right lateral
      eye angle. He was treated with cryosurgery by a nearby dermatologist four times.
      However, the lesion did not improve, and he came to our hospital. Cutaneous
      biopsy specimen showed squamous cell carcinoma. The nodule was resected without
      decreasing the dose of cyclosporine and azathioprine. He has remained
      asymptomatic with out evidence of recurrent cutaneous lesions for two years of
      followup. This patient seems to represent the 3rd case of cutaneous cancer after
      renal transplantation in Japan.

PMID- 8345732
TI  - [Renin-secreting renal tumor. A case report].
AB  - We reported a case of juxtaglomerular cell tumor, which excessively produced
      renin, resulting in secondary hypertension. A 25-year-old woman complained of
      headache and nausea. Hypertension and elevation of plasma renin activity were
      found by physical and laboratory examination. US and CT showed a space occupying
      lesion at upper pole of the right kidney. Angiography showed a hypovascular area
      at the corresponding area of the right kidney. Renin-secreting renal tumor of the
      right kidney was diagnosed and right nephrectomy was performed. Postoperatively,
      blood pressure and plasma renin activity became normalized and symptoms
      ameliorated. The juxtaglomerular cell tumor was pathologically confirmed and
      localization renin in the tumor cells was shown by immunohistochemical study.
      Forty one cases of juxtaglomerular cell tumor have been reported, since Robertson
      reported the first case. We discussed the clinical and pathological
      characteristics of the disease in this report.

PMID- 8345733
TI  - [AIDS].

PMID- 8345734
TI  - [Renal functions of the patients with long-term catheterization in upper urinary
      tract].
AB  - In order to investigate long-term effects of indwelling urinary catheters on
      renal functions, in 46 patients (27 male and 19 female) with ureterostomy or
      nephrostomy serum creatinine values were measured periodically. Average age of
      the patients was 60.6 years old. Duration of catheterization was more than 3
      years (average 8.1 years). Renal dysfunction was defined as an elevation of serum
      creatinine more than 2 mg/dl. It was found that catheterization used more than 15
      years evoked renal insufficiency over 50% of such patients. This period, however,
      was shorten to 11 years in patients with nephrolithiasis or frequent fever. It
      was concluded that urolithiasis and symptomatic urinary tract infections were two
      remarkable risk factors for the deterioration of renal functions, and that these
      risk factors must be avoided in patients on long-term catheterization in the
      upper urinary tract.

PMID- 8345735
TI  - Quality of life.

PMID- 8345736
TI  - Wellness and aging: are nurses ready for the year 2000?

PMID- 8345737
TI  - Perspectives on gerontologic nursing.

PMID- 8345738
TI  - Cognitive control: a concept worth considering for older adult clients.

PMID- 8345739
TI  - Our future in history.

PMID- 8345740
TI  - LPN's and i.v.'s. Questions & answers.

PMID- 8345741
TI  - [How does reflexology enrich nursing care? 2. A reflexologic follow-up in
      intensive care service].

PMID- 8345742
TI  - [Continuing education and the future of the profession. What do we expect of
      specialists?].

PMID- 8345743
TI  - [The role of the nurse anesthetist. "Let us use nursing procedures"].

PMID- 8345745
TI  - [The onerous heritage of serving and caring...].

PMID- 8345744
TI  - ["Education new--career free", a congress report. Start towards new horizons].

PMID- 8345746
TI  - [Education, so everybody becomes a winner].

PMID- 8345748
TI  - [When practice and school cooperate: education, responsive to new nursing
      requirements].

PMID- 8345747
TI  - [The profession at the threshold of the university. The door has been unlocked].

PMID- 8345750
TI  - [Petition launched].

PMID- 8345751
TI  - [Specialization--mode or necessity?].

PMID- 8345749
TI  - [All that is different in the health professions].

PMID- 8345752
TI  - [Nuclear weapons and the law. The medical society must take its responsibility].

PMID- 8345753
TI  - [Clarifications concerning hospices].

PMID- 8345754
TI  - [Misunderstanding psychodynamics].

PMID- 8345755
TI  - [Cooperating clinics--pathology departments are important].

PMID- 8345756
TI  - [Guidelines in the book on proctology are well-founded].

PMID- 8345757
TI  - [Do we physicians want to be graded?].

PMID- 8345758
TI  - [It is incorrect to measure only the number of patient admissions].

PMID- 8345759
TI  - [Protect the vaccines].

PMID- 8345760
TI  - [To compare the quality between different clinics is difficult].

PMID- 8345761
TI  - [Eye examination in diabetes. Every year or every other year?].

PMID- 8345762
TI  - [Nitric oxide. A new drug in lung disease?].

PMID- 8345763
TI  - [Magnetic resonance tomography. A new method in the diagnosis of breast cancer].

PMID- 8345764
TI  - [Primary breast reconstruction. An alternative to breast-conserving surgery].

PMID- 8345765
TI  - [Acupuncture therapy in stroke. Patients experience significant improvement].

PMID- 8345766
TI  - [Rehabilitation after stroke. The plasticity of the brain is an unexplored
      resource].

PMID- 8345767
TI  - [Epidemiology of infections in primary health care. It is needed but who is going
      to pay for it?].

PMID- 8345768
TI  - [Cutaneous malignant melanoma. Perform excisions of pigmented changes on wide
      indications].

PMID- 8345769
TI  - [Do not normalize drug addiction. Resignation is not a solution of the drug
      problem].

PMID- 8345770
TI  - [The economical incentives change health care. First year of the Stockholm
      model].

PMID- 8345771
TI  - Effects of alterations in auditory feedback and speech rate on stuttering
      frequency.
AB  - This study investigated the effects of altered auditory feedback on stuttering
      frequency during speech production at two different speech rates, Nine
      stutterers, who exhibited at least 5% dysfluency during a reading task, served as
      subjects. They read eight different passages (each 300 syllables in length) while
      receiving four conditions of auditory feedback: nonaltered, masking, delayed, and
      frequency altered. For each auditory feedback condition, subjects read at both a
      normal and a fast rate. Results indicated that stuttering frequency was
      significantly decreased during conditions of delayed and frequency altered
      auditory feedback at both speech rates (p < 0.05). These findings refute the
      notion that a slowed speech rate is necessary for fluency enhancement under
      conditions of altered auditory feedback. Considering previous research and the
      results of this study, it is proposed that there may be two interdependent
      factors that are responsible for fluency enhancement: alteration of auditory
      feedback and modification of speech production.

PMID- 8345772
TI  - Productions of English vowels by native speakers of Arabic: acoustic measurements
      and accentedness ratings.
AB  - Productions of ten English vowels in /bVt/ and /bVd/ contexts were elicited from
      a group of native American English speakers and a group of native Arabic speakers
      who had learned English in adulthood. When a variety of acoustic measurements,
      including vowel durations, F1 and F2 frequencies, and movement in F1 and F2 were
      examined, the two groups were found to differ on at least one of these parameters
      for nearly every vowel considered. A subset of the Arabic speakers' productions,
      and the productions of two native English speakers, were rated for accentedness
      by five native English judges. The rating data indicated that only a minority of
      the Arabic group's productions were regarded by the judges as "native-like". When
      the acoustic measurement data were regressed on the mean ratings, it was found
      that the accentedness scores were correlated primarily with F1 frequency and
      movement in F2, although the significant predictors varied from vowel to vowel.

PMID- 8345773
TI  - Progressive utterance-final lengthening in syllables with final fricatives.
AB  - The generality of the pattern of progressively greater lengthening within the
      utterance-final syllable, previously found with respect to final stops, is shown
      to extend to syllables in Hebrew with final fricatives. Seven native speakers of
      Hebrew read matched sentence pairs in which bisyllabic key words appeared in non
      final and sentence-final position. Final fricatives showed almost four times as
      much utterance-final lengthening as the preceding stressed vowel. Final
      lengthening affected the duration of each segment of the final syllable, and also
      extended to the initial unstressed syllable of the final word. Though final
      fricatives showed more lengthening in sentence-final position than final-stop
      closures, no difference was found in the lengthening of the vowels preceding
      these consonants. The greater lengthening of the final fricative relative to the
      preceding vowel resulted in C/V ratios which failed to distinguish between the
      voiceless fricative in non-final position and the voiced fricative in utterance
      final position. These results suggest that sentence position is taken into
      account in the perception of voicing, such that the C/V ratio applicable in non
      final position is increased by a factor of two in final position.

PMID- 8345774
TI  - PREVIEW: a new ultrafast imaging sequence requiring minimal gradient switching.
AB  - A new ultrafast imaging technique is presented that can be performed on standard,
      unmodified magnetic resonance imaging spectrometers. The method uses very few
      gradient switching steps and does not require that the switches are very rapid.
      It is based on the generation of a multiplicity of signals by a few
      radiofrequency (RF) pulses and their separate frequency- and phase-encoding
      before acquisition of all signals in a single period.

PMID- 8345775
TI  - Differentiation of benign from malignant breast masses by time-intensity
      evaluation of contrast enhanced MRI.
AB  - Using gadolinium-DTPA enhanced MRI we analyzed the enhancement characteristics of
      palpable breast masses in 23 patients--10 cancers and 13 benign lesions. The most
      specific finding for separating benign from malignant lesions was a ratio of
      maximum intensity change divided by the time interval during which this first
      occurred. Designated ranges of this ratio were specific for benign disease and
      sensitive for malignancy in this small patient group. Three of eight
      fibroadenomas exhibited enhancement patterns indistinguishable from cancer.

PMID- 8345776
TI  - High resolution spin-echo imaging of the temporomandibular joint.
AB  - High resolution thin section (1.5 mm thick) spin echo images (HRSE) with narrow
      bandwidth of TMJ were compared to the conventional (3 mm thick) spin echo images
      (CSE) in 20 symptomatic patients. Our results revealed that the disk delineation
      was superior with HRSE and the degree of confidence in making the diagnosis was
      significantly higher with HRSE than with CSE. Narrow bandwidth, high resolution
      spin echo technique offers better anatomic detail in the TMJ, resulting in
      improved degree of confidence, without penalty in additional imaging time.

PMID- 8345777
TI  - Echo-planar chemical shift imaging of silicone gel prostheses.
AB  - We have developed an echo-planar (EP) proton chemical shift imaging (CSI) MR
      technique that allow us to discriminate the polydimethylsiloxane (PDMS, silicone)
      proton MR signal from that of the fat and water protons found in tissues, in
      order to map the distribution of PDMA in humans who have silicone gel prostheses.
      Silicone gel-filled prosthetic implants induce histologic changes in the
      surrounding tissue which are attributed to the leakage of free PDMS from the
      prosthesis. The T2 relaxation measurements of three silicone gels show that there
      are two components in them, each with a different degree of molecular mobility.
      The presence of free silicone is confirmed by chloroform extraction, which
      removed 14-28% of the material. This free polymer present in the gel can pass
      through the intact or ruptured membrane of the implant into the surrounding
      tissue. Our preliminary imaging results indicate that EP-CSI MR might be useful
      as a diagnostic technique for implant malfunction.

PMID- 8345778
TI  - Mechanisms that contribute to the in vitro relaxation and signal intensity of
      water in barium sulfate suspensions used as MRI contrast agents.
AB  - The individual components of two commercially available barium sulfate (BaSO4)
      suspensions, Liquid HD and E-Z-paque (E-Z-EM Inc., Westbury, NY), were
      investigated to determine their contribution to relaxation. Longitudinal and
      transverse relaxation times of suspensions and solutions of the different BaSO4
      particles and the vehicle used to keep them in suspension were measured
      separately at 2.0 T. A multiple echo Carr-Purcell-Meiboom-Gill (CPMG) pulse
      sequence was used for T2 determinations with different values of the echo spacing
      2 tau. Longer values of 2 tau resulted in significant shortening of the
      calculated T2 relaxation times, indicating that the major mechanism leading to
      signal loss in BaSO4 suspensions is the diffusion of water molecules through
      susceptibility gradients in the vicinity of suspended particles. At higher BaSO4
      concentrations, decreased water proton density also produces significant signal
      loss. Viscosity has little effect on the relaxation. A combination of larger and
      smaller BaSO4 particle sizes was found to be more effective than smaller sizes
      only in enhancing signal decay.

PMID- 8345779
TI  - Dual contrast enhancement of both T1- and T2-weighted sequences using ultrasmall
      superparamagnetic iron oxide.
AB  - BMS 180549 (previously AMI-227), an ultrasmall superparamagnetic iron particulate
      agent, was investigated to determine its utility as a contrast agent on T1
      weighted, as well as T2-weighted sequences, as a function of route of
      administration, (intravenous versus selective arterial) and concentration. Twelve
      farm pigs were divided into three groups of four each by route of administration
      (intravenous, selective superior mesenteric, or selective hepatic arterial
      injection). 10 mumol/kg and 20 mumol/kg dosages were given and evaluated both
      immediately after and 20-24 hr after contrast infusion, using both spin-echo and
      gradient-echo T1 and T2-weighted sequences. Significant postcontrast liver and
      spleen enhancement was noted at both concentrations, regardless of route of
      administration on both T1- and T2-weighted sequences. The earliest postcontrast
      T1-weighted sequence obtained during the 1-3 min interval following IV
      administration of high dose (20 mumol/kg) contrast demonstrated an average of
      +42.8% liver and +249.0% spleen enhancement; 24 hr later this decreased to 0 and
      7.2%, respectively. The earliest postcontrast T2-weighted sequence obtained
      during the 8-17 min interval post high-dose IV contrast showed an average of 
      75.8% decrease in liver and -28.7% decrease in spleen signal intensity; 24 hr
      later the magnitude of these changes diminished to -33.1% and +2.5%,
      respectively. No significant difference was noted in liver or spleen enhancement,
      regardless of route of contrast administration (intravenous versus
      intraarterial).

PMID- 8345780
TI  - NMR-contrast enhancement of experimental brain tumors with MnTPPS: qualitative
      evaluation by in vivo relaxometry.
AB  - The applicability of the synthetic manganese porphyrin MnTPPS as tumor-selective
      MRI-contrast agent for brain tumors was investigated quantitatively by in vivo
      relaxometry. To exclude toxic effects of side products, the purification method
      for MnTPPS was improved. As a result, MnTPPS+Cl- (free acid) with a purity of
      more than 99.8% was obtained. For the in vivo quantification of the contrast
      effect the magnetization M(0) and the transversal relaxation time T2 were
      evaluated in different regions of rat brains with or without implanted gliomas
      and in temporal muscle. Measurements were performed before and after the
      application of MnTPPS. The ratio of the magnetization M(0) (TR = 3.5 sec) of the
      tissue under investigation and the contralateral striatum was defined as contrast
      ratio Rc(0). Without MnTPPS Rc(0) of edema (0.93 +/- 0.08) and tumor (0.91 +/-
      0.07) did not differ from normal brain tissue (corpus callosum: 0.96 +/- 0.07;
      cortex: 0.98 +/- 0.05). T2 of edema (110 +/- 12 msec) and intracranial tumor (93
      +/- 7 msec) were significantly longer than in normal tissue (corpus callosum: 73
      +/- 8 msec; parietal cortex: 75 +/- 6 msec; striate nucleus: 78 +/- 7 msec, p <
      .01). Two hours after the injection of MnTPPS, magnetization of neoplastic tissue
      was selectively enhanced (TR = 3.5 sec), and T2 was reduced. The smallest dose of
      0.06 mmol/kg body weight (bw) increased Rc(0) to 1.12 +/- 0.04, and 0.38 mmol/kg
      to 1.30 +/- 0.13 (p < .01). T2 of tumor decreased to 85 +/- 6 msec after 0.06
      mmol/kg and to 65 +/- 6 msec after 0.38 mmol/kg bw.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8345781
TI  - Comparison between Gd-DTPA, Gd-EOB-DTPA, and Mn-DPDP in induced HCC in rats: a
      correlation study of MR imaging, microangiography, and histology.
AB  - The behaviour of two liver-specific contrast MR agents, Gd-EOB-DTPA and Mn-DPDP
      and one nonspecific contrast agent, Gd-DTPA, was compared in a rat model of
      chemically induced hepatocellular carcinoma (HCC). The study included contrast
      enhanced MR imaging and the corresponding microangiography and histology.
      Analysis of the MR images showed similar degrees of maximum relative liver
      enhancement: 47.5 +/- 8.2% for Gd-EOB-DTPA (0.03 mmol/kg) at 5 min postinjection
      and 52.5 +/- 14.4% for Mn-DPDP (0.025 mmol/kg) at 15 min; both exceeded the value
      obtained with Gd-DTPA (34.8 +/- 13.6%, at 5 min), even at 0.3 mmol/kg. Gd-EOB
      DTPA caused a similar "negative" enhancement of all types of HCC, independent of
      their differentiation and vascularization, i.e., lesion-to-liver contrast-to
      noise ratio (CNR) of differentiated and undifferentiated HCC increased negatively
      from, respectively, 1.9 +/- 1.1 and -5.1 +/- 3.1 before contrast to -5.2 +/- 2.4
      and -11.8 +/- 4.8 at 5 min after contrast. On Mn-DPDP enhanced images, the
      undifferentiated HCCs showed up negatively (CNR -5.5 +/- 4.7 before contrast to 
      13.7 +/- 10 at 15 min after contrast), whereas the more differentiated tumors
      showed up positively (CNR from 2.3 +/- 2.0 before contrast to 12.5 +/- 3.5 at 24
      hr postcontrast) due to active uptake and delayed elimination of Mn-DPDP.

PMID- 8345782
TI  - Complementary use of T2- and postcontrast T1-weighted NMR images for the
      sequential monitoring of focal ischemic lesions in the rat brain.
AB  - The noninvasive nature of NMR imaging enables serial studies on a single animal.
      In 12 male Wistar rats, the dynamic progression of a photochemically induced
      (Rose Bengal) infarct was studied starting immediately after induction and up to
      10 days. The results demonstrated that both T2- and postcontrast T1-weighted NMR
      images are required to discern the time dependent dynamics of the ischemic
      process. The ischemic lesion was already visible on T2-weighted images within 30
      min after the induction. Twenty-four hours after the insult, both area and
      intensity reached maximum values. Hereafter and up to day 10, both parameters
      decreased. Postcontrast T1- weighted images revealed a blood-brain barrier (BBB)
      rupture immediately after the induction which persisted until 10 days after the
      insult. The application of contrast agents such as Gd-DOTA or Gd-HP-DO3A also
      allowed the detection of 10-day-old lesions which were not always discernable on
      T2-weighted images. The penetration of both contrast agents in the affected area
      proceeded slower the first 5 days after the insult while at day 10, maximum
      contrast enhancement was reached almost immediately after administration of the
      contrast agent. At 24 hr after the insult, the discrepancy between the lesion
      area as determined on T2-weighted images and on postcontrast T1-weighted images
      was maximal. At this stage, the lesion was characterized by central core with a
      leaky BBB surrounded by a reversible zone which appeared enhanced on T2-weighted
      images.

PMID- 8345783
TI  - Baseline consideration of liposomal contrast agent. CNS transport by macrophages
      in experimental allergic encephalomyelitis.
AB  - The purpose of this study was to investigate a specialized liposomal contrast
      agent for magnetic resonance imaging (MRI), as part of a program to examine
      infiltrating immune cells in lesions of experimental allergic encephalomyelitis
      (EAE). A potent investigational liposomal contrast agent,
      phosphatidylethanolamine-DTPA-gadolinium, was chosen which has been shown to
      remain tightly liposomal-associated, with long persistence in vivo. Europium
      (Eu3+), a fluorescent paramagnetic metal, was also utilized in these experiments
      in place of gadolinium. This material is avidly taken up by monocytes in vivo.
      Thirty-four animals received some form of liposomal material either before or
      during the opening of the blood-brain barrier (BBB). Twenty-seven Hartley guinea
      pigs were inoculated for EAE with homogenized brain and Complete Freunds Adjuvant
      (CFA) and seven control animals received CFA alone. Eighty-two percent of the
      experimental animals exhibited degeneration of the BBB with inflammation and
      edema in the brain, while all control animals had normal brain scans. T1-weighted
      MRI, performed to detect the presence of liposomal contrast material in
      experimental animals, was not different from untreated animals. Fluorescent
      microscopy revealed no characteristic changes associated with Eu3+ presence in
      the brains of treated or control animals. Therefore, it would seem that
      insufficient material crosses the disrupted BBB, either in free form or
      subsequent to macrophage ingestion, to be detected by MRI or fluorescent
      microscopic examination.

PMID- 8345784
TI  - Uptake and life time of fluoride ion in rats by 19F-NMR.
AB  - 19F nuclear magnetic resonance (NMR) was utilized to obtain information on the
      uptake and half-life time of fluoride ion in rats. Changes in tissue fluoride
      level after acute loading were monitored over time in blood and tissue
      homogenates obtained from liver and brain. The rate of fluoride elimination from
      various tissues was roughly similar, following in all cases a first-order kinetic
      rate law. The F- concentration in brain was about 20% of that found in liver,
      indicating a reduced fluoride diffusion across the blood-brain barrier. In vivo F
      spectra were obtained in rat brain in few minutes with a good signal-to-noise
      ratio; this confirms the possibility of extending the use of F- as a probe of
      biomolecules to in vivo applications.

PMID- 8345786
TI  - The use of agarose gels for quantitative determination of fluid saturations in
      porous media.
AB  - The use of agarose gel reference standards for quantifying petrophysical
      properties in porous media is described. The specific interest is to determine
      the values of fluid saturations and porosity in oil bearing rocks; the MRI
      methodology for estimating these properties is discussed. It is shown that the
      relaxation times of the gel reference standard and the relaxation times of the
      fluid contained in the porous media affect the estimation process. The
      determination of porosity and fluid saturations can be greatly simplified if the
      relaxation times of the reference standard and the relaxation times of the fluid
      are closely matched. Gel concentration of paramagnetic impurities in the form of
      copper ions is used to control the longitudinal relaxation properties. The
      relaxation properties of agarose gels, as a function of agarose and paramagnetic
      impurity concentrations, have been measured at 2.0 T. The data are well fitted by
      a simple polynomial in agarose concentration and paramagnetic impurity
      concentration. Finally, a one-dimensional imaging example of use of agarose gels
      as reference phantoms is discussed.

PMID- 8345785
TI  - Use of transmission line analysis for multi-tuning of birdcage resonators.
AB  - A general analysis for double- and higher order tuning of birdcage resonators is
      presented based on a lumped element transmission line model. Expressions were
      developed for the determination of the resonant frequencies of bandstop and
      bandpass birdcage coils and, with specific restrictions, for capacitor values
      required to obtain any two desired mode one resonant frequencies. Experimental
      measurements on three variants each of an eight-column bandstop and an eight
      column bandpass were in excellent agreement with theory; the average absolute
      frequency difference and percent deviation were 1.51 +/- 1.57 MHz and 2.61 +/-
      2.36%, respectively. In addition, 31P and 1H phantom images were obtained at 2.0
      T using a representative bandstop coil.

PMID- 8345787
TI  - MR image compression using iterated function systems.
AB  - This paper presents a method for MR image compression using iterated function
      systems based on fractal models. The method makes use of self-similarities of an
      image and achieves compression by matching similar image blocks. A fast matching
      procedure is proposed in this paper for efficient image encoding. The method is
      tested with real MR images.

PMID- 8345788
TI  - MRI and determination of T1 and T2 of solid polymers using a 1.5 T whole-body
      imager.
AB  - Spin-echo sequences with echo times as short as 3.5 msec were implemented on a
      standard 1.5 T NMR whole-body imager for 1H imaging of polymers in the solid
      state. No modification of the NMR hardware designed for clinical usage was made.
      Beside images of different polymers a "self-portrait" of the polymeric materials
      of the receiver coil is given as a neat application. Based on imaging experiments
      the longitudinal and transverse relaxation time of polymers were investigated.
      The results indicate that using a standard whole-body imager, it is possible to
      provide additional information to other examination techniques in polymer and
      materials science.

PMID- 8345789
TI  - A theoretical study of amplitude modulation and time shifting in quantitative MR
      measurements of motion in brain tissue.
AB  - MR imaging pulse sequences can be made sensitive to motion by adding gradients
      with different strengths at different time intervals. In the well-known phase
      mapping method, such velocity encoding gradients are used to obtain phase
      information linear to the velocity of the studied object in the direction of the
      gradient. When very low velocities are studied, a long duration velocity-encoded
      gradient is required to obtain sufficient velocity sensitivity. In such cases,
      variation in the object velocity during the execution of the sequence may hamper
      the accuracy of the method. In this study, we have made a computer simulation of
      the performance of a phase mapping method sequence (TE = 46 msec) designed for
      quantitative studies of motion in brain tissue. Using a Gaussian-shaped velocity
      input function, the time shifting and the amplitude modulation properties of the
      sequence was studied for various values of the duration, defined as the full
      width of tenth of maximum (FWTM), of the input function. The time shift
      corresponded well to the center of the 180 degrees RF pulse, and the amplitude
      modulation was seen to decrease with increasing time duration of the velocity
      input function. Applied on in vivo data, where an approximately gaussian-shaped
      brain motion velocity pattern was assumed to have a duration of 150 msec, the
      amplitude modulation of the sequence was estimated to 2%.

PMID- 8345790
TI  - Apolipoproteins A-I and B and cholesterol in synovial fluid of patients with
      rheumatoid arthritis.
AB  - Synovial fluid (SF) of patients with rheumatoid arthritis (RA) has been noted to
      contain cholesterol crystals and increased amounts of cholesterol compared with
      normal SF. SF, plasma apolipoproteins (apos) A-I and B, and cholesterol in 12
      untreated classic RA patients (inflammatory arthritis) and eight untreated
      degenerative joint disease ([DJD] noninflammatory arthritis) patients were
      analyzed. Results showed that mean apo A-I, apo B, and cholesterol levels of RA
      SF were significantly higher than those of DJD SF (apo A-I, P = .004; apo B, P =
      .0008; cholesterol, P = .0004). Regression analyses of plasma and SF apo A-I and
      apo B (r = .72, P = .008 and r = .63, P = .02, respectively) suggested an
      increased permeability for these lipoprotein constituents across RA synovial
      membrane that was not observed in DJD synovial membrane. These data suggest that
      RA synovium but not DJD synovium is more permeable to major apoproteins of low-
      and high-density lipoproteins (LDL and HDL). These apolipoproteins have been
      shown to influence the immune response and may therefore be involved in the
      pathogenesis of RA.

PMID- 8345791
TI  - Lipoprotein-X fails to inhibit hydroxymethylglutaryl coenzyme A reductase in
      HepG2 cells.
AB  - Abnormalities of lipid composition and metabolism are frequently observed in
      patients with cholestatic liver disease. Both elevated low-density lipoprotein
      (LDL) levels and the appearance of lipoprotein-X (LP-X) in plasma underlie the
      high incidence of hypercholesterolemia in this population. We tested the
      hypothesis that the hypercholesterolemia of cholestasis may reflect a failure of
      normal feedback regulation of hepatic cholesterogenesis by determining the
      influence of LP-X on the rate-limiting enzyme of cholesterol synthesis,
      hydroxymethylglutaryl coenzyme A (HMG CoA) reductase. Cultured human hepatoma
      (HepG2) cells were incubated in purified lipoprotein for 24 hours, harvested, and
      then assayed for HMG CoA reductase activity and mass. LDL isolated from either
      normal controls or patients with cholestasis decreased reductase activity in a
      dose-dependent fashion (2 to 30 micrograms cholesterol/mL media) to a level
      approximately 50% of that measured in cells incubated in lipid-deficient serum.
      LP-X failed to downregulate enzyme activity compared with LDL, with little change
      in reductase activity at cholesterol concentrations (30 micrograms/mL media) that
      produced maximal reductase inhibition by LDL. Three distinct LP-X subspecies were
      purified from the plasma of a patient with primary biliary cirrhosis (PBC) and
      tested in an analogous manner. All LP-X subspecies were similar in their
      inability to decrease reductase activity as compared with LDL. HMG CoA reductase
      mass was increased approximately twofold in cells incubated with LP-X, as
      estimated by Western blot analysis. These results suggest that LP-X may
      contribute to hypercholesterolemia in the cholestatic patient by not effectively
      downregulating hepatic cholesterol synthesis.

PMID- 8345792
TI  - Factors influencing excess postexercise oxygen consumption in trained and
      untrained women.
AB  - This study investigated the effects of blood lactate and norepinephrine levels
      and rectal temperature on excess postexercise oxygen consumption (EPOC) following
      two different exercise intensities. Six trained and seven untrained women each
      performed two exercise tests, short-term high-intensity exercise ([HI]
      approximately 80% maximum oxygen consumption [VO2max]) and long-term low
      intensity exercise ([LOW] approximately 65% VO2max) until 300 kcal were expended.
      Rectal temperature, oxygen consumption (VO2), and lactate and norepinephrine
      levels were monitored at rest, during exercise, and for 60 minutes into recovery.
      Exercise times averaged 30.0 +/- 4.5 and 23.7 +/- 0.9 minutes in trained women
      and 45 +/- 3.6 and 30.0 +/- 0.4 minutes in untrained women for LOW and HI,
      respectively. Rectal temperature, VO2, and lactate and norepinephrine levels were
      significantly elevated (P < .05) during HI compared with LOW in both groups. VO2
      was elevated throughout recovery following LOW and HI in untrained women only.
      Additionally, VO2 was elevated until minutes 50 and 40 following LOW and HI,
      respectively, in trained subjects. Rectal temperature returned to resting levels
      after 30 minutes of recovery following LOW, but remained significantly elevated
      throughout minute 50 of recovery following HI in trained women. However, values
      remained significantly elevated throughout recovery following both exercise bouts
      in untrained subjects. Norepinephrine levels remained elevated above resting
      levels throughout recovery following HI and until minute 50 following LOW in
      trained subjects, whereas levels remained elevated for 5 minutes following LOW
      and 50 minutes following HI in untrained subjects. Lactate levels remained
      elevated above baseline values throughout recovery following HI and LOW in both
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345793
TI  - Quantitative evaluation of the effect of low-intensity exercise on insulin
      secretion in man.
AB  - We studied insulin secretion rates (ISR) during low-intensity exercise (40% peak
      aerobic capacity [VO2]) in 12 normal subjects to assess the contribution of
      altered insulin secretion to the reduction in peripheral insulin concentrations
      associated with exercise. ISR were calculated by a previously validated method of
      two-compartment analysis of peripheral C-peptide concentrations using individual
      parameters derived following a bolus injection of biosynthetic human C-peptide.
      In addition, the effect of low-intensity exercise on kinetic parameters of C
      peptide was evaluated. The results showed that low-intensity exercise did not
      significantly affect C-peptide kinetics. Peripheral insulin concentrations and
      ISR decreased to a similar degree throughout exercise. There was a mean maximum
      decrease in serum insulin concentrations from 42 +/- 5.4 pmol/L basally to 24 +/-
      2.6 pmol/L, constituting a 51% +/- 5.9% decrease (P < .001), and ISR decreased
      from 85.7 +/- 11.9 pmol/min to a nadir of 45.6 +/- 10.6 pmol/min (P < .001), a
      48% +/- 8.4% decline. Plasma glucose and glucagon concentrations did not change
      significantly either during or after exercise, although there was a matched
      twofold increase in glucose utilization and disposal rates. We suggest that the
      reduction in peripheral insulin concentrations during exercise is due to reduced
      insulin secretion.

PMID- 8345794
TI  - Insulin resistance, secretion, and elimination in postmenopausal women receiving
      oral or transdermal hormone replacement therapy.
AB  - Estrogen/progestin steroid combinations adversely affect glucose tolerance and
      insulin resistance, but their effects in combined hormone replacement therapy
      (HRT) have rarely been evaluated. We studied 61 untreated symptomatic
      postmenopausal women randomized to receive oral (conjugated equine estrogens,
      0.625 mg/d continuous + levonorgestrel, 0.075 mg/d for 12 days of each 28-day
      cycle) or transdermal therapy (estradiol 17 beta, 0.05 mg/d continuous +
      norethindrone acetate, 0.25 mg/d for 14 days of each 28-day cycle). An untreated
      control group of 30 postmenopausal women not seeking HRT was also studied.
      Intravenous glucose tolerance tests (IVGTT) were performed at baseline and 3, 6,
      and 18 months later. Mathematical modeling analysis of plasma glucose, insulin,
      and C-peptide concentration profiles provided measures of insulin resistance,
      secretion, and elimination. There were no changes in glucose or insulin
      concentrations with transdermal therapy. Oral therapy caused a deterioration of
      glucose tolerance and an increased overall plasma insulin response, apparently
      due to a reduction in the immediate plasma insulin response to glucose. This may
      have resulted from increased hepatic insulin uptake, uncompensated for by an
      increase in first-phase pancreatic insulin secretion. Neither treatment caused
      significant insulin resistance compared with baseline, but with the oral
      treatment insulin resistance was greater during the combined phase compared with
      the estrogen-only phase. Thus the oral regimen affected both insulin delivery and
      insulin resistance. The transdermal regimen had relatively few effects on insulin
      metabolism.

PMID- 8345795
TI  - Pancreatic beta-cell destruction in non-obese diabetic mice.
AB  - We determined the natural history of the widespread pancreatic islet beta-cell
      destruction that precedes the onset of spontaneous putative autoimmune diabetes
      mellitus in NOD mice. For this purpose, we performed both histological and
      immunocytochemical examinations of pancreata retrieved from mice at 2 through 30
      weeks of age. An overexpression of la antigens was identified on islet beta cells
      at 4 weeks of age, without evidence of mononuclear cell infiltration. The
      abnormal expression of la antigens was age-related and was associated with
      hyperexpression of class I antigens and progressive islet cell histologic damage
      after 17 weeks of age. Immunocytochemical examination of islet cell infiltrate
      showed that the number of macrophages did not increase during the early phase of
      islet cell damage in these mice. The L3T4/Lyt-2 ratio increased after 7 weeks of
      age, but was 1:1 in the late stage of insulitis. These findings suggest that
      widespread islet beta-cell destruction is a process that begins primarily with
      derangements of the pancreatic beta-cell immune pattern, which may trigger a
      mononuclear cell reaction.

PMID- 8345796
TI  - An evaluation of fetal glucogenesis in intrauterine growth-retarded pregnancies.
AB  - The presence of fetal glucogenesis was evaluated in nine patients with
      pregnancies complicated by intrauterine growth retardation (IUGR) at the time of
      fetal blood sampling (FBS) between 29 and 35 weeks of pregnancy. Eight were
      singleton pregnancies and one was a twin pregnancy in which blood samples were
      obtained from both twins. A maternal primed-constant infusion of D(U-13C]glucose
      was performed, and the presence of fetal glucogenesis was assessed by a
      comparison of steady-state maternal and fetal glucose enrichments. No significant
      difference was present between maternal and fetal molar percent excess ([MPE] P =
      .97), and the mean fetal to maternal (F/M) MPE ratio (0.99 +/- 0.01) was not
      significantly different from 1 (P = .76). F/M MPE ratio was independent of the
      time of FBS and umbilical venous glucose and lactate concentrations. Thus fetal
      glucogenesis is not demonstrable in a group of fairly severe growth-retarded
      fetuses after an overnight fast with this relatively noninvasive approach.

PMID- 8345797
TI  - Cyclophosphamide-induced diabetes in Long-Evans Tokushima Lean rats: influence of
      ovariectomy on the development of diabetes.
AB  - We studied the effect of treatment with cyclophosphamide (CY) on the incidence of
      diabetes in Long-Evans Tokushima Lean (LETL) rats, a newly established strain of
      spontaneously type I diabetic rats. The overall incidence of diabetes among 356
      LETL rats treated with CY was 25.6%, which was significantly higher than the
      10.5% among 857 untreated LETL rats at 27 weeks of age, and there was no
      significant sex difference. The incidence of CY-induced diabetes in adult (> 16
      weeks of age) female LETL rats was 7.7% (10/130), which was significantly lower
      than that in other CY-treated groups of LETL rats. No diabetes mellitus was
      induced by administration of CY to 23 diabetes-resistant LETO rats. There were no
      significant differences in the degrees of hyperglycemia or hyperketonemia in
      spontaneously and CY-induced diabetic LETL rats, but the plasma glycated albumin
      level of CY-induced diabetic rats (10.3% +/- 2.1%) was significantly higher than
      that of spontaneously diabetic rats (8.2% +/- 1.3%), suggesting that plasma
      glucose levels increased more rapidly in the latter. More than half of the
      diabetic rats showed type C or D morphological changes of the islets, ie,
      atrophic change with little mononuclear cell infiltration or almost complete loss
      of the islets. However, distributions of various types of morphological changes
      in the islets were not significantly different in the two groups. Ovariectomy
      (OVX) significantly increased the incidence of CY-induced diabetes in adult
      female rats from 7.7% to 20.8%. The number of CD8+ cells was significantly
      increased in noncastrated adult female LETL rats and decreased to the level of
      other groups after OVX.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345798
TI  - Is alcohol an osteoporosis-inducing agent for young and middle-aged women?
AB  - The effects of alcohol abuse on the bone of women have scarcely been
      investigated, although women are more prone than men to osteoporosis. We studied
      19 noncirrhotic female alcoholics (aged 24 to 48 years) hospitalized for 2 weeks
      for withdrawal and three groups of control women (n = 182). Sixteen patients and
      all control subjects had regular menstrual cycles. Forearm bone mineral content
      (BMC) and axial bone mineral density (BMD) were measured by single-photon
      absorptiometry and dual-energy x-ray absorptiometry, respectively. Parameters of
      bone metabolism were analyzed at the beginning and end of the withdrawal period.
      BMC and BMD did not differ between patients and controls at any of the five
      measurement sites. On admission, bone formation of the alcoholics was depressed
      as reflected by osteocalcin levels (-48%, P < .01); it normalized during
      abstention (P < .01). Urinary hydroxyproline, a parameter of bone resorption, and
      serum intact parathyroid hormone were at the control level throughout the
      observation period. Serum ionized calcium level increased by 4% (P < .0001), and
      serum free fatty acid (FFA) levels decreased by 30% (P < .05) during withdrawal;
      there was an inverse correlation between changes in these two parameters (r = 
      .49, P < .05). On admission, serum concentrations of 25-hydroxyvitamin D3 [25-OH
      D3] and 1,25-dihydroxyvitamin D3 [1,25-(OH)2-D3] were reduced by 46% (P < .001)
      and 16% (P = .16); these did not normalize during abstention. In conclusion,
      provided that liver cirrhosis and gonadal dysfunction are not contributing, even
      heavy drinking does not seem to decrease bone mass in young and middle-aged
      women.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345799
TI  - Three-year treatment of familial heterozygous hypercholesterolemia by
      extracorporeal low-density lipoprotein immunoadsorption with polyclonal
      apolipoprotein B antibodies.
AB  - Familial hypercholesterolemia is a disorder of lipid metabolism associated with a
      highly increased risk for cardiovascular disease. Since in such patients even
      combined drug therapy often fails to decrease low-density lipoprotein (LDL)
      cholesterol levels sufficiently, extracorporeal LDL elimination has been
      developed. We treated eight adult patients with LDL immunoadsorption using
      antibodies against apolipoprotein B without additional lipid-lowering drug
      therapy for 3 years; this procedure was performed at weekly intervals. By one
      treatment session, LDL cholesterol and lipoprotein(a) levels were decreased by
      55%. Under regular treatment, mean LDL cholesterol levels of 165 mg/dL between
      two consecutive treatment sessions could be reached, compared with 522 +/- 24
      mg/dL before any treatment. As high-density lipoprotein (HDL) cholesterol levels
      increased under regular treatment, the LDL/HDL cholesterol ratio decreased from
      13.4 to 3.4. Positive influences on plasma and whole-blood viscosity as well as
      on erythrocyte aggregation also seem to be beneficial with regard to retarding
      atherosclerosis. Very-low-density lipoprotein (VLDL) levels were reduced by
      approximately 50% after treatment, accompanied by a marked increase of
      lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL) activity. The
      effects of LDL apheresis on hemostasis, complement activation transport proteins,
      and hematological parameters were found to be small. In addition, no side effects
      amounting to any major clinical relevance occurred in any of the patients. After
      3 years of LDL apheresis, a decrease in the frequency of anginal chest pain and
      ST segment depression on exercise testing and a marked reduction of tendon
      xanthoma size were observed.

PMID- 8345800
TI  - The response to lovastatin treatment in patients with heterozygous familial
      hypercholesterolemia is modulated by apolipoprotein E polymorphism.
AB  - In a retrospective study, we examined the influence of apolipoprotein (apo) E
      polymorphism and gender on the response to treatment with 80 mg/d lovastatin in a
      homogeneous population of patients with familial hypercholesterolemia (FH), most
      of whom were carriers of the 10-kb deletion of the low-density lipoprotein (LDL)
      receptor gene. Apo E phenotype distribution among the 189 FH patients was not
      different from that of a normal population sample. The total and LDL cholesterol
      (LDL-C) response to lovastatin in the overall group (men and women) was
      significantly lower in the E4 subset compared with E2 and E3 subsets. This
      finding is in agreement with trends observed in previous reports. On the other
      hand, the response of LDL-C to lovastatin was significantly lower in E4 men than
      in E4 women, whereas the high-density lipoprotein cholesterol (HDL-C)
      concentration in the E4 group increased significantly more in men than in women,
      suggesting a role of gender in modulating the response to lovastatin. Hence, apo
      E polymorphism influenced LDL-C (and HDL-C) response to lovastatin in men, but
      not in women, revealing the existence of a gene-by-gender interaction. These
      findings were independent of the nature of the LDL receptor defect. We conclude
      that male FH patients carrying the epsilon 4 allele respond less efficiently to
      lovastatin than men carrying the epsilon 3 or epsilon 2 allele or women of any
      apo E phenotype with respect to decreasing total cholesterol and LDL-C levels,
      but respond more efficiently with respect to increasing HDL-C levels. The full
      practical implication of these findings remains to be explored.

PMID- 8345801
TI  - Anticonvulsant-induced changes in tissue manganese, zinc, copper, and iron
      concentrations in Wistar rats.
AB  - Human epileptics have been reported to have low blood manganese (Mn)
      concentrations in comparison to nonepileptics, an observation that is important
      because Mn deficiency can increase seizure susceptibility in experimental
      animals. Factors that have been suggested to contribute to the low blood Mn
      levels in epileptics include anticonvulsant use, seizure-induced tissue
      redistribution of Mn, and genetics; in the present study, the first of these
      possibilities was tested. Wistar rats were fed semipurified diets containing
      diphenylhydantoin ([DPH] 3 g/kg diet), phenobarbital ([PB] 2 g/kg diet), or
      primidone ([PRIM] 3 g/kg diet) for 7 weeks, at which time they were killed and
      tissues collected and analyzed for Mn, zinc (Zn), copper (Cu), and iron (Fe)
      concentrations. In comparison to pair-fed rats, DPH- and PRIM-fed rats had
      significantly elevated liver Mn concentrations, while Mn concentrations in blood,
      brain, heart, and kidney were unaffected by anticonvulsant exposure. Changes in
      the concentrations of Zn, Cu, and Fe in specific tissues were also found.
      Overall, these findings suggest that the anticonvulsants tested do not lead to
      significant derangements in the metabolism of Mn.

PMID- 8345802
TI  - Comment on the recent studies of dietary fatty acid.

PMID- 8345803
TI  - Time course of the response of myofibrillar and sarcoplasmic protein metabolism
      to unweighting of the soleus muscle.
AB  - Contributions of altered in vivo protein synthesis and degradation to unweighting
      atrophy of the soleus muscle in tail-suspended young female rats were analyzed
      daily for up to 6 days. Specific changes in myofibrillar and sarcoplasmic
      proteins were also evaluated to assess their contributions to the loss of total
      protein. Synthesis of myofibrillar and sarcoplasmic proteins was estimated by
      intramuscular (IM) injection and total protein by intraperitoneal (IP) injection
      of flooding doses of 3H-phenylalanine. Total protein loss was greatest during the
      first 3 days following suspension and was a consequence of the loss of
      myofibrillar rather than sarcoplasmic proteins. However, synthesis of total
      myofibrillar and sarcoplasmic proteins diminished in parallel beginning in the
      first 24 hours. Therefore sarcoplasmic proteins must be spared due to a decrease
      in their degradation. In contrast, myofibrillar protein degradation increased,
      thus explaining the elevated degradation of the total pool. Following 72 hours of
      suspension, protein synthesis remained low, but the rate of myofibrillar protein
      loss diminished, suggesting a slowing of degradation. These various results show
      (1) acute loss of protein during unweighting atrophy is a consequence of
      decreased synthesis and increased degradation of myofibrillar proteins, and (2)
      sarcoplasmic proteins are spared due to slower degradation, likely explaining the
      sparing of plasma membrane receptors. Based on other published data, we propose
      that the slowing of atrophy after the initial response may be attributed to an
      increased effect of insulin.

PMID- 8345804
TI  - Influence of meal ingestion on insulin profiles following intraperitoneal
      delivery.
AB  - This study evaluated the effect of meal ingestion on intraperitoneal insulin
      absorption in type I diabetic patients with an implanted pump for long-term
      intraperitoneal insulin delivery. On four separate occasions, patients (n = 7)
      were administered 15 IU insulin as a 20-minute square-wave infusion using their
      implanted device; hypoglycemia was prevented by intravenous infusion of 10%
      dextrose at a variable rate. Two studies were performed during fasting conditions
      (n = 2 fasting tests) and two studies after the administration of an 800-kcal
      standard meal (n = 2 postprandial tests). An insulin peak of 630 +/- 545.4 pmol/L
      (mean +/- SD) in fasting tests and 696 +/- 420.5 pmol/L in postprandial tests was
      reached in the peripheral circulation after 45 +/- 11.7 and 45 +/- 14.7 minutes,
      respectively, with no significant difference between the two experimental
      conditions. Areas under the insulin curves were not significantly different in
      fasting and postprandial tests (51,500 +/- 34,278 v 50,916 +/- 20,558 pmol/L.min
      1, respectively; NS). In type I diabetic patients receiving long-term
      intraperitoneal insulin therapy, the increase in splanchnic blood flow following
      ingestion of a standard meal does not accelerate the appearance of insulin in the
      peripheral circulation.

PMID- 8345805
TI  - Effect of pioglitazone on insulin receptors of skeletal muscles from high-fat-fed
      rats.
AB  - A new oral agent, 5-[4-[2-(5-ethyl-12-pyridyl)ethoxy]-benzyl]-2,4
      thiazolidinedione, or pioglitazone, has been developed for the treatment of non
      insulin-dependent diabetes mellitus (NIDDM). We examined its effectiveness in
      high-fat-fed rats resistant to insulin. Administration of the agent (10 mg.kg-1 x
      d-1) for 2 weeks resulted in decreases in hyperlipidemia and hyperinsulinemia,
      indicating that insulin sensitivity had increased in vivo in high-fat-fed rats.
      To clarify the mechanism of the drug, we examined insulin binding and kinase
      activity of insulin receptors from muscles of both untreated and treated high-fat
      fed rats. Pioglitazone treatment did not change insulin binding in high-fat-fed
      rats, but increased insulin-stimulated autophosphorylation of insulin receptors
      to the level of control animals. Kinase activity toward an exogenous substrate,
      poly Glu4-Tyr1, in pioglitazone-treated high-fat-fed rats was also increased to
      the level of control animals. These results suggest that pioglitazone increases
      insulin sensitivity by activating tyrosine kinase activity of receptors in high
      fat-fed rats, and this drug appears to be a useful one with a new mode of action
      for the treatment of NIDDM with insulin resistance.

PMID- 8345806
TI  - Thermogenesis secondary to transdermal water loss causes growth retardation in
      essential fatty acid-deficient rats.
AB  - Manifestations of essential fatty acid (EFA) deficiency in rats include growth
      retardation and increased transdermal water loss. The extra metabolic energy
      requirement could be caused by greater evaporative water loss from the skin
      surface. To test this hypothesis, 38 weanling rats were randomly assigned to one
      of two environments, control (CE) at 20 degrees C and 40% humidity or warm/humid
      (WHE) at 30 degrees C and 90% humidity. Half of the 20 CE rats were fed an EFA
      adequate diet and the other 10 an EFA-deficient diet; the 18 WHE rats were also
      equally partitioned to the two diets. CE and WHE animals were independently group
      fed to maintain equal energy intakes within each environment. Weight gain at 90
      days was lower for CE EFA-deficient rats than for CE EFA-adequate rats (P <
      .0001). Growth rates in the WHE to 140 days did not differ. Mean weights at 90
      days were as follows: CE EFA-adequate, 196 g; CE EFA-deficient, 148 g; WHE EFA
      adequate, 148 g; WHE EFA-deficient, 135 g. In both CE and WHE animals, the
      triene/tetraene ratio of both serum and liver phospholipids (PL) was 100-fold
      greater for EFA-deficient versus EFA-adequate diets. PL fatty acids of liver in
      CE and WHE EFA-deficient rats contained 2.09 and 1.92 micrograms of 20:3 omega 9
      per micrograms phosphorus (Pi), respectively, compared with 0.03 and 0.02
      microgram 20:3 omega 9/micrograms Pi in CE and WHE EFA-adequate rats. These
      results indicate equivalent degrees of EFA deficiency in the two
      environments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345807
TI  - Insulin modulates circulating endothelin-1 levels in humans.
AB  - Recent data indicate that insulin stimulates synthesis of the vasoconstrictor
      peptide endothelin-1 (ET-1) by cultured vascular endothelial cells in vitro. To
      determine whether insulin modulates ET levels in vivo and whether this effect is
      important in the pathogenesis of obesity-associated hypertension, we measured
      circulating immunoreactive ET-1 levels during euglycemic hyperinsulinemic clamps
      (20 mU/m2.min-1 for 120 minutes) in eight obese women (body mass index, 36 +/- 1
      kg/m2) before and after 10 weeks on an 800-kcal/d protein-sparing liquid diet.
      During the clamp that preceded weight loss, insulin levels were increased from 17
      +/- 2 to 51 +/- 3 mU/L and this was associated with an increment in ET-1 level
      from 28 +/- 3 to 33 +/- 3 pg/mL (P < .05). After weight loss, insulin levels were
      increased from 10 +/- 2 to 47 +/- 3 mU/L during the clamp, and there was a
      corresponding increase in ET-1 levels from 24 +/- 3 to 30 +/- 3 pg/mL (P < .025).
      The reduction in basal ET-1 level (from 28 +/- 3 to 24 +/- 3 pg/mL) with weight
      loss correlated strongly with the reduction in fasting immunoreactive insulin
      level (from 17 +/- 2 to 10 +/- 2 mU/L; r = .92, P < .01). The decrease in blood
      pressure with weight loss (from 130 +/- 6/73 +/- 3 to 118 +/- 4/72 +/- 3 mm Hg)
      did not correlate with the corresponding reduction in circulating ET-1 levels.
      These results indicate that insulin modulates ET-1 levels in vivo.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8345808
TI  - The serum insulin-like growth factor-II/mannose-6-phosphate receptor in normal
      and diabetic pregnancy.
AB  - The extracellular domain of the insulin-like growth factor-II/mannose-6-phosphate
      (IGF-II/Man-6-P) receptor is present in the circulation of several species
      including man. The purpose of the present study was to establish whether this
      truncated receptor is present in higher concentrations in fetal sera compared
      with adult sera and whether the metabolic status of the individual alters serum
      concentrations of this protein. Nondiabetic and diabetic pregnant women were
      studied throughout gestation, and at term fetal cord sera were obtained. Levels
      of IGF-I increased throughout pregnancy in normal and diabetic women. IGF-II
      levels significantly increased during the third trimester in both groups and
      levels of IGF-I and IGF-II were significantly elevated in fetal cord samples from
      diabetic women only. Serum samples were gel-filtered on Sephadex G-200, and
      column fractions were assayed for binding of radiolabeled IGF-II and IGF-I. There
      was specific binding (SB) of IGF-II in the void volume fractions in all samples
      examined. Normal women had 3% +/- 0.5% SB, whereas in cord sera SB was 5% +/-
      0.7% and in pregnant sera 10% +/- 2%. There was no difference in SB in fetal cord
      or pregnant samples from normal and diabetic women. In addition, there was a peak
      of binding activity of both IGF-I and -II in gamma-globulin and postalbumin
      fractions of the columns in pregnant and nonpregnant women, but only in
      postalbumin fractions in fetal cord samples.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345809
TI  - Inhibition of melatonin secretion by ethanol in man.
AB  - To determine whether ethanol inhibits nocturnal melatonin (MT) secretion, three
      experiments (A, B, and C) were performed in seven normal subjects. In A, ethanol
      at a dose of 0.34 g/kg was administered orally at 6:00, 8:00, and 10:00 PM. Each
      dose was increased to 0.52 g/kg in B. In C, water was substituted for ethanol.
      Blood samples for determination of serum MT levels were drawn every second hour
      between 6:00 PM and 8:00 AM. Urinary excretion of MT during the night was also
      determined. In A, serum ethanol reached a maximal level of 13 +/- 1 mmol/L at 12
      midnight. In B, the corresponding maximum was 25 +/- 1 mmol/L. The higher alcohol
      dose inhibited nocturnal MT secretion by 20% +/- 5% (P < .01), whereas the lower
      dose lacked such effect. Urinary excretion of MT was left unaffected by alcohol
      at both doses. Five additional normal subjects were given alcohol as described
      above at a dose of 0.52 g/kg (experiment D). This induced mild nocturnal
      hypoglycemia as evidenced by a glucose decremental area (5.9 +/- 1.8 mmol/L.h)
      that differed significantly from zero (P < .05). To determine whether a reduced
      glucose delivery to pinealocytes might contribute to the decreased MT secretion
      in alcohol-intoxicated subjects, two experiments (E and F) were performed in
      eight healthy individuals. In E, ethanol was given orally as in B; three small
      oral doses of glucose were also given at 8:00 PM, 10:00 PM, and 12 midnight. In
      F, water was substituted for ethanol and glucose.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8345810
TI  - Sodium-lithium countertransport activity is decreased after weight loss in
      healthy obese men.
AB  - Maximal red blood cell (RBC) sodium-lithium countertransport activity has been
      consistently related to essential hypertension and may be a marker for risk of
      developing hypertension. Although there is strong evidence for genetic control of
      sodium-lithium countertransport, increasing evidence suggests that obesity and
      insulin-glucose metabolism are related to countertransport activity. This study
      was performed to determine whether countertransport activity decreases with
      weight loss in healthy obese adults. Forty-five healthy, white, obese adults were
      studied at baseline and after 6 months of behavioral dietary intervention. Weight
      loss was 11.5 kg (25.4 lb) in 24 men and 8.1 kg (17.8 lb) in 21 women. Sodium
      lithium countertransport activity decreased 55.0 mumol Li/L RBC/h in men (P <
      .001, paired t test) and 14.6 mumol Li/L RBC/h in women (NS). Change in
      countertransport activity was correlated with change in body mass index (BMI) in
      men (r = .52, P < .01) and women (r = .27, NS) and was also strongly correlated
      with change in fasting glucose levels in both men and women (r = .50 and r = .56,
      respectively; P < .01) and with change in fasting insulin levels in men (r = .42,
      P = .04). Change in countertransport activity was not significantly related to
      change in physical exercise or serum lipid levels. There was a large decrease in
      systolic blood pressure in men (10.0 mm Hg, P < .001) and a smaller decrease in
      women (4.1 mm Hg, P < .05). These changes were significantly correlated with
      change in weight, but not with change in countertransport or baseline
      countertransport activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345811
TI  - Stimulation of brain natriuretic peptide release from the heart by thyroid
      hormone.
AB  - This study was designed to examine the involvement of thyroid hormone in the
      release of brain natriuretic peptide (BNP) from the heart. We measured plasma
      immunoreactive BNP (ir-BNP) concentrations in patients with untreated
      hyperthyroidism. We also measured BNP values in experimental rats with
      hyperthyroidism induced by thyroxine (T4) and in rats with hypothyroidism induced
      by propylthiouracil (PTU). The in vitro effects of triiodothyronine (T3) and T4
      on the release of BNP were examined in newborn rat atrial and ventricular
      myocytes in primary culture. Plasma BNP levels were increased in hyperthyroid
      patients compared with normal control subjects. Plasma BNP levels were increased
      in hyperthyroid rats and decreased in hypothyroid rats compared with euthyroid
      rats. Plasma BNP level was correlated with serum T4 level in hyperthyroid
      patients and hyperthyroid rats. A major component of ir-BNP in plasma from
      hyperthyroid patients was human BNP-32 and that in plasma from hyperthyroid rats
      was rat BNP-45. T4 and T3 stimulated release of ir-BNP from both cultured atrial
      and ventricular myocytes in a dose-dependent manner. Plasma BNP concentration is
      frequently increased in hyperthyroidism, and thyroid hormone may regulate BNP
      release from both atrial and ventricular myocytes.

PMID- 8345813
TI  - Hepatic extraction of insulin after stimulation of secretion with oral glucose or
      parenteral nutrients.
AB  - To determine whether hepatic extraction of insulin differs when glucose is
      administered by parenteral and physiological routes, we studied responses to oral
      glucose and to intravenous (IV) infusion of glucose or glucose plus arginine in
      normal volunteers. As in earlier studies, when IV glucose infusions were
      empirically programmed to to produce isoglycemic responses with 50 or 75 g oral
      glucose, ratios of integrated areas under concentration curves for immunoreactive
      C-peptide (CP) to insulin in the plasma were higher with IV than with oral
      glucose. Mean values +/- standard errors for these ratios in paired experiments
      with 50 g oral glucose were 5.6 +/- 0.66 compared with 8.3 +/- 1.4 with IV
      glucose (P < .03). With 75 g oral glucose, the corresponding values were 4.3 +/-
      0.38 and 7.8 +/- 0.50 (P < .001). These results suggest that hepatic extraction
      of insulin is diminished when insulin secretion is potentiated by enteroinsular
      mechanisms after oral glucose administration. To determine whether this
      phenomenon is related to the route of administration of glucose or to the
      enhancement of insulin secretion with oral glucose, programmed IV infusions of
      glucose were used to elicit excursions of plasma CP similar to those obtained
      after 50 g oral glucose, and programmed infusions of glucose plus arginine were
      used to elicit excursions of plasma CP similar to those obtained after 75 g oral
      glucose. Plasma levels of immunoreactive gastric inhibitory polypeptide (GIP)
      increased substantially after ingestion of 75 g glucose, but did not change
      during isoglycemic IV glucose infusions or during IV infusions of glucose plus
      arginine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345812
TI  - Response of cholesterol synthesis to cholesterol feeding in men with different
      apolipoprotein E genotypes.
AB  - To investigate the influence of dietary cholesterol level and apolipoprotein
      (apo) E polymorphism on cholesterol synthesis, seven apo E2/- and six apo E4/-
      normolipidemic subjects consumed self-selected diets containing low cholesterol
      ([LC] 250 mg/d) and high cholesterol ([HC] 800 mg/d) levels for approximately 20
      days. On day 20, subjects were given 0.7 g deuterium oxide (D2O)/kg body water
      followed by maintenance doses. Cholesterol synthesis was measured as the uptake
      rate of D into plasma free cholesterol over 24 hours. Serum total cholesterol
      levels were higher (P < .05) in the apo E4/- versus apo E2/- group over both
      dietary periods. No influence of dietary cholesterol content on serum levels was
      observed, nor was there an effect of apo E genotype or dietary cholesterol level
      on cholesterogenesis. However, a genotype-independent association was observed
      between both cholesterogenesis (P < .001) and the increase in cholesterogenesis
      (P = .05) with the change in serum total cholesterol level subsequent to high
      cholesterol feeding. These findings suggest that (1) apo E genotype is not
      associated with cholesterol synthesis rate in subjects on self-selected diets,
      and (2) hyporesponders to a dietary cholesterol challenge display higher
      synthetic rates than hyperresponders. The observation of lower cholesterol
      synthesis in individuals with the largest increases in serum cholesterol level
      after a dietary cholesterol challenge suggests a passive rather than dominant
      role of cholesterol synthesis in regulating serum levels.

PMID- 8345814
TI  - Carbohydrate oxidation rates in patients with anorexia nervosa.
AB  - Twenty-one hospitalized anorexia nervosa (AN) patients underwent a 50-g glucose
      challenge. All patients were then fed for 10 days and divided into two groups
      based on weight gain. Group AN-a (n = 10) gained little or no body weight over
      the 10-day period, whereas the second group, AN-b (n = 11), did gain weight
      during the same period. A third group of normal women (n = 10) served as control
      subjects (NC). Following ingestion of 50 g of glucose, group AN-a showed
      virtually the same nonprotein respiratory quotient (NPRQ) response as group NC.
      Group AN-b showed significant increases in basal and glucose-stimulated NPRQ and
      carbohydrate oxidation rate responses compared with group NC. Serum insulin
      responses in both AN groups were lower than those of group NC. These results
      indicate that insulin sensitivity in both liver and muscle may be increased in AN
      patients, and that refeeding tends to increase body weight rapidly in some
      patients due to this mechanism.

PMID- 8345816
TI  - Insulin therapy normalizes GLUT1 glucose transporter mRNA but not immunoreactive
      transporter protein in streptozocin-diabetic rats.
AB  - Previous studies have shown that the principal glucose transporter isoform within
      the blood-brain barrier (BBB) is GLUT1, and that GLUT1 mRNA is upregulated and
      immunoreactive GLUT1 protein is downregulated in rats with streptozocin (STZ)
      induced experimental diabetes. The present studies investigate effects of insulin
      therapy on both GLUT1 mRNA and immunoreactive GLUT1 protein in brain capillaries
      isolated from control (CO), diabetic (DM), and insulin-treated diabetic (IRx)
      rats. The following variables were measured: serum glucose levels, rat brain
      capillary immunoreactive GLUT1 level by quantitative Western blotting, and rat
      brain capillary GLUT1 and actin mRNA levels by quantitative Northern blotting.
      Serum glucose levels were 6.4 +/- 1.2, 30.3 +/- 3.2, and 3.7 +/- 1.7 mmol/L in
      CO, DM, and IRx rats, respectively. Brain capillary immunoreactive GLUT1
      transporter protein level was 53% +/- 13% of CO values in DM rats, and this value
      was unchanged with insulin treatment. GLUT1 mRNA level in rat brain was increased
      to 131% +/- 8% of CO values in DM rats and was 80% +/- 5% of CO values in IRx
      rats. In conclusion, short-term insulin therapy in rats with STZ-induced diabetes
      normalizes BBB GLUT1 mRNA level, but does not normalize depressed immunoreactive
      GLUT1 protein level.

PMID- 8345815
TI  - Prevalence and pathophysiology of impaired glucose tolerance in three different
      high-risk white groups.
AB  - Insulin resistance and beta-cell function were assessed by a continuous infusion
      of glucose in the following three groups of white subjects at risk of developing
      impaired glucose tolerance and diabetes: 41 subjects who were the offspring of
      patients with type II diabetes, 26 general-population subjects with an increased
      fasting plasma glucose level of at least 5.6 mmol/L on screening, and 22 subjects
      who had had gestational diabetes but were now nondiabetic. Subjects had a mean
      (+/- 1 SD) age of 43 +/- 9 years and a body mass index (BMI) of 27 +/- 5 kg/m2.
      Subjects with previously increased fasting glucose levels were significantly more
      insulin resistant than a control group, taking into account BMI, age, and gender
      (% normal insulin sensitivity [%], 59 [50 to 79] v 87 [73 to 96]; P < .005), and
      previously gestationally diabetic subjects showed greater impairment of beta-cell
      function (% normal beta-cell function [% beta], 69 [60 to 87] v 97 [89 to 105]; P
      < .005). Diabetes (defined by World Health Organization criteria) or impaired
      glucose tolerance (defined as an achieved plasma glucose concentration [APG] >
      95th percentile of an age- and weight-matched population) was identified in 22%
      of family members, 31% of fasting hyperglycemic subjects, and 41% of previously
      gestationally diabetic subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345817
TI  - The cardiovascular risk factor plasminogen activator inhibitor type 1 is related
      to insulin resistance.
AB  - The cardiovascular risk factor plasminogen activator inhibitor type 1 (PAI-1) has
      been associated with abdominal obesity, hypertension, hypertriglyceridemia,
      hyperinsulinemia, glucose intolerance, and type II diabetes, conditions known to
      be linked with insulin resistance. To determine whether PAI-1 is related to
      insulin resistance, we studied nine obese nondiabetics and 10 obese type II
      diabetics by means of a sequential hyperinsulinemic euglycemic clamp study.
      Plasma PAI-1 antigen (Ag) correlated significantly with peripheral insulin
      resistance, represented by the insulin level at which peripheral glucose uptake
      (PGU) is half-maximal ([ED50PGU] r = .87, P < .001). Multiple regression analysis
      including indices of hepatic and peripheral insulin action, fasting plasma
      insulin levels, triglyceride levels, blood pressure (BP), waist to hip ratio
      (WHR), and body mass index (BMI) disclosed ED50PGU to account for 76% of the
      variance of PAI-1 Ag. We suggest that PAI-1 contributes to the increased
      cardiovascular risk encountered with insulin resistance.

PMID- 8345818
TI  - A practical equation to predict resting metabolic rate in older men.
AB  - The accuracy of previous equations for predicting resting metabolic rate (RMR) in
      healthy older men is questionable because they are based on limited sample sizes
      and the absence of cross-validation procedures. The purposes of this study were
      to (1) examine biological predictors of RMR in healthy older men; (2) develop a
      practical equation to predict RMR from easily measured variables and examine its
      accuracy using cross-validation procedures; and (3) test the validity of existing
      equations in the literature to predict RMR in older men by comparison with
      measured RMR values. RMR, body composition, anthropometric measurements, leisure
      time activity (LTA), maximal aerobic power (VO2max), energy intake, and plasma
      thyroid hormone levels were determined in 89 healthy older men aged 50 to 78
      years. Stepwise regression analysis showed that RMR was best predicted by fat
      free weight ([FFW] R2 = 85%), free 3,5,3'-triiodothyronine (T3) level (R2 = 1%),
      and VO2max (R2 = 1%); these variables predicted RMR with a residual error of +/-
      30 kcal/d. A practical equation was developed in a randomly selected subsample (N
      = 61) using easily measured variables as potential predictors, and was
      successfully cross-validated in a random subsample of older men (N = 28). The
      pooled equation to predict RMR is as follows: RMR (in kilocalories per day) = 9.7
      (weight in kilograms) - 6.1 (chest skinfold thickness in millimeters) - 1.8 (age
      in years) + 0.1 (leisure time activity [LTA] in kilocalories per day) + 1,060.
      These variables accounted for 76% (R2) of the variation, and predicted RMR with a
      residual error of +/- 42 kcal/d.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345819
TI  - Organ clearance of tyrosyl-arginine and its effect on amino acid metabolism in
      young sheep.
AB  - In a long-term multiple-catheter sheep model (n = 5), organ clearance of the
      dipeptide tyrosyl-arginine (TyrArg) and its effects on interorgan amino acid
      metabolism were investigated. Clearance by hindlimb and splanchnic tissues was
      measured during infusion into the external iliac artery and superior mesenteric
      artery, respectively. The hindlimb, intestine, and total splanchnic region
      removed 32% +/- 9.2% (mean +/- SE), 23% +/- 15%, and 33% +/- 24%, respectively,
      of the amount of TyrArg infused. There was a large release of tyrosine and
      arginine when TyrArg was infused into either the hindlimb or intestine, which was
      quantitatively similar to the TyrArg taken up by these organs. However, across
      the total splanchnic region, the baseline influx of tyrosine and arginine was not
      altered by infusion of TyrArg. During either clearance study, only trace amounts
      of TyrArg or its constituent amino acids were excreted in urine. Infusion of
      TyrArg produced the following effects on interorgan amino acid metabolism: (1) a
      reduction in the initial efflux of phenylalanine, leucine, isoleucine, and valine
      from the hindlimb; (2) a reduction in net efflux of citrulline by the intestine
      and total splanchnic tissues; and (3) a reduction in efflux of arginine and
      uptake of citrulline from the kidney. In conclusion, we have shown that TyrArg is
      cleared from the bloodstream by hindlimb (predominantly muscle) and splanchnic
      tissues. These results indicate that TyrArg taken up by the hindlimb and
      intestine was hydrolyzed to its constituent amino acids, which were released
      quantitatively into the circulation. Of the tissues studied, only the liver
      appeared to use the amino acids liberated from hydrolysis of TyrArg.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8345820
TI  - Body composition in children and Tanner's stages: a study with dual-energy x-ray
      absorptiometry.
AB  - Total body bone mineral content (TBBM), body fat content (BF), and fat-free mass
      (FFM) were measured in 154 children using dual-energy x-ray absorptiometry
      (DEXA). Total body calcium level (TBCa) was calculated from TBBM. Children were
      divided into groups according to Tanner's stages 1, 2, 4, and 5. Children in
      stage 3 were not included in the study in order to better differentiate between
      prepubertal and postpubertal individuals. We did not find differences in TBBM,
      TBCa, BF, and FFM between Tanner's stages 1 and 2 or between sexes. TBBM and TBCa
      in stages 4 and 5 were lower in girls than in boys (P < .001 and P < .01,
      respectively); no differences were observed between girls of both groups,
      although boys showed significant differences (P < .05). FFM for both sexes was
      lower in stages 1 and 2 than in stages 4 and 5. Girls showed lower FFM (P < .001)
      than boys in stages 4 and 5; FFM was higher in boys in stage 5 than in those in
      stage 4 (P < .005), and the same was true for girls (P < .002). Boys in stage 4
      had less BF than girls (P < .005), and the same was true for stage 5 (P < .001).
      Girls in stages 4 and 5 had greater BF than those in stages 1 and 2 (P < .001).
      These differences suggest that as boys go through puberty, both TBBM and FFM
      continue to increase, while in girls only BF and FFM increase. These data
      indicate clear sex differences in somatic postpubertal development.

PMID- 8345821
TI  - Is exercise training effective in preventing diabetes mellitus in the Otsuka-Long
      Evans-Tokushima fatty rat, a model of spontaneous non-insulin-dependent diabetes
      mellitus?
AB  - We determined whether exercise training is effective in preventing the
      development of diabetes mellitus in a model rat (Otsuka-Long-Evans-Tokushima
      Fatty [OLETF]) with non-insulin-dependent diabetes mellitus (NIDDM). Thirty male
      OLETF rats aged 5 weeks were assigned to one of the following three groups:
      trained rats placed individually in an exercise wheel (EW) cage, EW-control rats
      housed in the same cages equipped with a fixed rotatory wheel, and sedentary rats
      maintained two or three to a conventional cage. Eight male diabetes-resistant
      Long-Evans rats were used as nondiabetic controls. At 24 weeks of age, the
      trained, EW-control, sedentary, and nondiabetic control rats weighed an average
      of 445, 559, 621 and 513 g and had abdominal fat deposits of 16, 55, 67, and 23
      g, respectively. The mean amount of exercise of trained rats was 5,243 m/d. At 24
      weeks of age, the cumulative incidences of diabetes mellitus in sedentary and EW
      control rats were 78% and 50%, respectively, while neither trained nor
      nondiabetic control rats became diabetic. Fasting and 120-minute plasma
      immunoreactive insulin (IRI) levels after oral glucose administration were
      significantly lower in the trained group than in the other groups. In vivo
      insulin-stimulated glucose uptake as measured with a euglycemic clamp was reduced
      37% in sedentary rats and increased 35% in trained rats compared with that in
      nondiabetic control rats. Morphological studies on the pancreas of sedentary and
      EW-control rats showed enlarged multilobulated fibrotic islets, whereas sections
      of islets from trained rats appeared normal but slightly enlarged.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8345823
TI  - Glycosylated serum proteins and glycosylated hemoglobin in the assessment of
      glycemic control in insulin-dependent and non-insulin-dependent diabetes
      mellitus.
AB  - To evaluate the relative value of glycosylated serum proteins (GSPs) versus
      glycosylated hemoglobin (HbA1c) in assessing glycemic control in diabetes
      mellitus, we performed regular monitoring of GSPs and HbA1c in 30 subjects with
      insulin-dependent diabetes mellitus (IDDM) or non-insulin-dependent diabetes
      mellitus (NIDDM) who performed frequent self-glucose monitoring. Analysis of the
      relationship between patterns of glycemic control and GSPs and HbA1c demonstrated
      that subjects with IDDM and NIDDM appeared similar when the more traditional
      indicators of glycemic control such as mean blood glucose level (166.9 +/- 20.9 v
      177.4 +/- 39.6 mg/dL) or HbA1c (83.57 +/- 12.8 v 80.24 +/- 15.7 mmol
      hydroxymethyl furfuraldehyde [HMF]/mol hemoglobin [Hgb]) were used. However, when
      GSP levels or the standard deviation of mean glucose levels (SDMG) were used to
      assess glycemic control, higher levels were found in subjects with IDDM (52 +/-
      10.3 mg/g protein and 28.59 +/- 7.60 mg/dL) versus NIDDM (44.6 +/- 15.2 mg/g
      protein and 21.6 +/- 15.9 mg/dL). Using multivariate analysis, GSPs were
      predictive of SDMG (P = .046), whereas HbA1c added no significant further
      information (P = .27). Our results suggest that GSPs may be more sensitive than
      HbA1c assay to the greater fluctuations in blood glucose levels generally
      associated with IDDM.

PMID- 8345822
TI  - Elevation of 2-methylcitric acid I and II levels in serum, urine, and
      cerebrospinal fluid of patients with cobalamin deficiency.
AB  - Citrate synthase catalyzes the condensation of acetyl-coenzyme A (CoA) and
      oxaloacetic acid to form citric acid. The enzyme also catalyzes the condensation
      of propionyl-CoA and oxaloacetic acid with a maximal reaction velocity (Vmax)
      approximately 10(-4) times that of acetyl-CoA to form 2-methylcitric acid, which
      contains two asymmetric carbon atoms and exists as two pairs of related
      enantiomers designated as 2-methylcitric acid I and II. Cobalamin (Cbl)
      deficiency can lead to increases in intracellular levels of propionyl-CoA. To
      assess the magnitude of increased synthesis of 2-methylcitric acid in Cbl
      deficiency, we developed a new capillary gas chromatographic-mass spectrometric
      assay and measured 2-methylcitric acid levels in serum and cerebrospinal fluid
      (CSF) of normal subjects and patients with clinically confirmed Cbl deficiency.
      The normal range for 2-methylcitric acid level was 60 to 228 nmol/L for serum in
      50 normal blood donors and 323 to 1,070 nmol/L for CSF in 19 normal subjects. In
      50 patients with clinically confirmed Cbl deficiency, values for 2-methylcitric
      acid in serum ranged from 93 to 13,500 nmol/L; 44 (88%) had values above the
      normal range. In five patients with clinically confirmed Cbl deficiency, levels
      of the sum of 2-methylcitric acid I and II ranged from 1,370 to 16,300 nmol/L in
      CSF, and all five (100%) patients had levels above the normal range. We conclude
      that levels of 2-methylcitric acid are elevated in serum and CSF of most patients
      with Cbl deficiency.

PMID- 8345825
TI  - Dental clues.

PMID- 8345824
TI  - Abdominal obesity is associated with insulin resistance and reduced glycogen
      synthetase activity in skeletal muscle.
AB  - Insulin resistance is commonly associated with obesity. The present study was
      performed to investigate the relative importance of total fat mass versus
      localization of adipose tissue in insulin-stimulated glucose disposal (Rd) and
      skeletal muscle glycogen synthase (GS) activity in obese individuals. Twenty
      obese women with an average body mass index (BMI) of 37.8 +/- 1.3 kg/m2 and a
      waist to hip ratio (WHR) ranging from 0.78 to 1.02 were examined during basal
      conditions and following hyperinsulinemia (hyperinsulinemic euglycemic clamp). To
      accurately determine body composition, the following three methods were used:
      anthropometric measurements, dual-energy x-ray absorptiometry scanning (DEXA
      scan), and bioelectric impedance measurements. In addition, indirect calorimetry
      and muscle biopsy were performed. Insulin-stimulated glucose Rd was negatively
      correlated with WHR (R = -.52, P < .025) whereas there were no correlations with
      BMI or percent fat (R = .16, NS and R = .16, NS, respectively). Furthermore, a
      negative correlation between WHR and insulin stimulation of GS activity in
      skeletal muscle was found (R = -.62, P < .005). In contrast, BMI and percent fat
      were not correlated with the insulin effect on GS activity in skeletal muscle (R
      = .34, NS and R = -.35, NS, respectively). The concentration of nonesterified
      fatty acids (NEFA) during hyperinsulinemia was strongly correlated with WHR and
      abdominal localization of adipose tissue (determined by DEXA-scan; R = .60, P <
      .005 and R = .60, P < .007, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345826
TI  - Slander and exhumation.

PMID- 8345827
TI  - The Children Act 1989: the lawyer and the doctor--conflict or co-operation.

PMID- 8345828
TI  - The M'Naghten Rules--the story so far.

PMID- 8345829
TI  - Hypercalcemia in association with acute renal failure and rhabdomyolysis. Case
      report and literature review.
AB  - The syndrome of hypercalcemia during the course of acute renal failure (usually
      associated with rhabdomyolysis) occurs most commonly in young men with very
      severe renal failure. Although fewer than 90 such patients have been reported,
      the prevalence of hypercalcemia in patients with rhabdomyolysis-associated renal
      failure averages 30%. Hypercalcemia occurs most commonly in the diuretic phase
      and resolves spontaneously. The mean duration of hypercalcemia is 14 days. The
      pathogenesis of this syndrome has not been clearly defined. In the rare instances
      where it has been measured, intact PTH is suppressed. In contrast, both elevated
      and suppressed values of plasma 1,25-dihydroxyvitamin D have been reported. The
      release of calcium from ectopic calcification in damaged muscle tissue provides a
      potential explanation for this syndrome. Therapy for the hypercalcemia should
      generally be conservative given its self-limited nature.

PMID- 8345830
TI  - Myocardial texture and cardiac calcification in uremia.
AB  - Seventy patients with advanced chronic renal failure were examined by 2D
      echocardiography in an effort to determine the prevalence of changes in
      myocardial texture and of valvular calcification. Changes in myocardial texture
      may be due to calcium deposition in the myocardium, the relationship between
      changes in myocardial texture and factors that may enhance myocardial
      calcification (blood levels of parathyroid hormone, PTH, and calcium-phosphorus
      product) were also evaluated. Myocardial texture was abnormal in 36 patients. In
      68 patients, structural calcification could be assessed; a high degree of
      calcification was found. No correlation was found between either the
      echocardiographic parameter and blood levels of PTH or calcium-phosphorus
      product. We conclude that myocardial textural changes and intracardiac
      calcification are common in chronic renal failure and that these abnormalities do
      not correlate with blood PTH levels or calcium-phosphorus product.

PMID- 8345831
TI  - Peripheral metabolism of branched-chain keto acids in patients with chronic renal
      failure.
AB  - Peripheral tissue metabolism of branched-chain amino acids (BCAA) and branched
      chain keto acids (BCKA) in the postabsorptive state was evaluated in 8 patients
      with chronic renal failure (CRF) and 7 controls by measuring the arterial-deep
      forearm venous differences for BCAA and BCKA. Arterial whole blood levels of BCAA
      and BCKA were also measured in an additional 7 patients and 11 controls. In CRF,
      total BCKA levels are reduced owing to a decrease in ketoisocaproic acid (KICA)
      and ketoisovaleric acid (KIVA) levels, parallel to changes in BCAA levels,
      whereas levels of ketomethylvaleric acid (KMVA) are not different from controls.
      Both in normal conditions and in patients, arterial levels of individual BCAA are
      directly correlated with arterial levels of the corresponding BCKA. However, in
      CRF, the ratios of leucine to KICA and of isoleucine to KMVA are increased. A
      direct correlation between KICA and HCO3- levels is observed. In CRF, the release
      of leucine and valine as well as of KICA and KMVA from peripheral tissues is
      reduced, whereas KIVA is neither released nor taken up by the forearm. The lack
      of KICA release from peripheral tissues likely accounts for its low circulating
      levels. The depressed peripheral release of leucine associated with the lack of
      KICA release suggests an increased degradation of leucine which proceeds beyond
      the transamination step.

PMID- 8345832
TI  - Hypernatremia in the acutely ill elderly patients: role of impaired arginine
      vasopressin secretion.
AB  - Hypernatremia, a common finding among the elderly, is believed to be due to water
      deficit. In the present study, in 12 consecutive hospitalized elderly patients
      (mean age 82.2 years) with moderate to severe hypernatremia (mean serum sodium
      166.9 mEq/l), inappropriately low plasma levels of vasopressin were found in
      relation to serum osmolality (mean 1.8 pg/ml and 343 mosmol/l, respectively). All
      patients but 1 were hospitalized with acute febrile disease and all but 2 had
      underlying neurological disease. Hypernatremia persisted for at least 3 days
      despite the patients' rehydration. It seems, therefore, that temporary
      hypernatremia in elderly patients with acute febrile disease, especially in the
      presence of underlying neurological disorder, reflects an inadequate vasopressin
      response to the hyperosmolar state.

PMID- 8345833
TI  - Potassium intake and urinary calcium excretion in healthy subjects.
AB  - Potassium depletion increases and potassium supplementation decreases urinary
      calcium excretion. To determine whether these experimental observations have any
      significance in healthy free living subjects, we measured 24 h urinary calcium,
      sodium, potassium and serum parathyroid hormone (PTH) in 142 healthy young (aged
      18-40 years) female Chinese subjects. Sodium excretion and potassium excretion
      were positively correlated with calcium excretion (r = 0.494, p < 0.0001 and r =
      0.181, p = 0.031, respectively). However stepwise multiple regression analysis
      showed that only urinary sodium excretion contributed to the excretion of
      calcium. We conclude that in free living subjects potassium intake has little
      effect on calcium excretion.

PMID- 8345834
TI  - Early detection of breast cancer: implications for nurses.

PMID- 8345835
TI  - Voluntary vs. mandatory continuing education.

PMID- 8345836
TI  - Clinical speaking--certification, licensure and continuing education in advanced
      practice.

PMID- 8345837
TI  - Surveillance for primary and secondary syphilis--United States, 1991.
AB  - PROBLEM/CONDITION: From 1986 through 1990, an epidemic of syphilis occurred
      throughout the United States. In 1991, the number of reported cases of primary
      and secondary (P&S) syphilis in the United States declined for the first time
      since 1985. REPORTING PERIOD COVERED: To examine how this decline reflected sex
      specific, race/ethnicity-specific, and regional patterns of syphilis morbidity,
      we analyzed data for syphilis cases reported to CDC from 1984 through 1991.
      DESCRIPTION OF SYSTEM: Summary data for cases of syphilis reported to state
      health departments were sent quarterly and annually to CDC. The quarterly data
      from each state included total number of syphilis cases by sex, stage of disease
      (primary, secondary, early latent, and late latent), and source of report (public
      or private). The annual data from each state included total number of P&S
      syphilis cases by sex, racial/ethnic group (white, not of Hispanic origin; black,
      not of Hispanic origin; Hispanic; Asian/Pacific Islander; or American
      Indian/Alaskan Native), 5-year age group, and source of report. RESULTS: The
      decline in both the number and rate of reported syphilis cases in 1991 occurred
      in every racial group in the United States and in both sexes. This decline also
      occurred in every region of the United States except the Midwest, where the total
      P&S syphilis rate increased 37.3% from 1990 through 1991. Despite the increase in
      syphilis rates in the Midwest, the highest rates of P&S syphilis in 1991 were
      reported from the South. INTERPRETATION: The reasons for the decline in syphilis
      are unclear. No data exist to conclusively identify which STD control program
      activities affected the level of syphilis morbidity or to what extent those
      activities may have contributed to the decline. Changes in drug use and limited
      immunity to Treponema pallidum may have accounted for some of the decrease in
      syphilis incidence. Higher levels of poverty in the South and poor access to
      health-care services associated with poverty probably contributed to continued
      high levels of disease transmission in the South. ACTIONS TAKEN: Better
      evaluation of STD control program activities will be necessary to help determine
      the most effective strategies for preventing and controlling syphilis in
      different high-risk populations.

PMID- 8345838
TI  - An evaluation of surveillance for Chlamydia trachomatis infections in the United
      States, 1987-1991.
AB  - PROBLEM/CONDITION: Chlamydia is the most common sexually transmitted bacterial
      pathogen in the United States; however, no precise data on the prevalence and
      incidence of chlamydia infection are available because currently no comprehensive
      national surveillance system exists for chlamydia. Despite the absence of such a
      system, states do report numbers of male and female chlamydia cases to CDC on a
      quarterly basis. REPORTING PERIOD COVERED: This report summarizes and reviews the
      chlamydia surveillance data received by CDC from 1987 through 1991. DESCRIPTION
      OF SYSTEM: Summary data on cases of chlamydia reported to state health
      departments were sent quarterly to CDC in Atlanta, Georgia. The quarterly data
      from each state included total number of chlamydia cases by sex and by source of
      report (public, private). RESULTS: From 1987 through 1991, the number of states
      with legislation mandating reporting of chlamydia increased twofold. The reported
      chlamydia rate from those states also doubled during the same time period, from
      91.4 cases per 100,000 population in 1987 to 197.5 cases per 100,000 population
      in 1991. INTERPRETATION: This twofold increase in the rate of chlamydia reported
      to CDC did not represent a doubling in chlamydia prevalence or incidence during
      this time period. Instead, the increase resulted from the increase in the number
      of states with reporting laws and from the initial attempts of those states to
      identify and report diagnosed chlamydia infections. ACTIONS TAKEN: More accurate
      measures of the number of chlamydia infections and of trends in the chlamydia
      infection rate are needed to justify, develop, and evaluate public health
      programs to control chlamydia infections. An outline of possible surveillance
      activities for local communities is presented.

PMID- 8345839
TI  - Sentinel surveillance for antimicrobial resistance in Neisseria gonorrhoeae-
      United States, 1988-1991. The Gonococcal Isolate Surveillance Project Study
      Group.
AB  - PROBLEM/CONDITION: The prevalence of antimicrobial resistance in Neisseria
      gonorrhoeae in the United States has been increasing since the mid-1970s.
      DESCRIPTION OF SYSTEM: The Gonococcal Isolate Surveillance Project (GISP) was
      established in 1986 to monitor trends of antimicrobial resistance in N.
      gonorrhoeae. GISP is a sentinel surveillance system consisting of 26 publicly
      funded sexually transmitted disease clinics and five regional laboratories. At
      each clinic, urethral isolates are obtained from the first 20 men diagnosed with
      gonorrhea each month; these isolates are shipped to one of the regional
      laboratories, where the susceptibilities of the organisms to a panel of
      antibiotics are determined. REPORTING PERIOD COVERED: This report describes the
      results of surveillance for antimicrobial resistance in N. gonorrhoeae from
      January 1991 through December 1991. These results are compared with data obtained
      from January 1988 through December 1990. RESULTS AND INTERPRETATION: In the 1991
      GISP sample, 32.4% of isolates were resistant to penicillin or tetracycline. The
      proportions of isolates with high-level, plasmid-mediated resistance to
      penicillin, tetracycline, or both drugs have increased significantly (p < 0.001)
      in the GISP sample during 1988-1991. No documented clinical treatment failures
      have been related to decreased susceptibility of N. gonorrhoeae to either
      ceftriaxone or ciprofloxacin, which belong to the classes of antibiotics
      currently recommended for gonococcal therapy. ACTION TAKEN: Because of the
      demonstrated ability of N. gonorrhoeae to develop resistance to antimicrobial
      agents, surveillance to guide therapy recommendations will be continued.

PMID- 8345840
TI  - Frontiers in gastroenterology. In honor of dedication of the Dr. Henry D.
      Janowitz Division of Gastroenterology, The Mount Sinai Hospital.

PMID- 8345841
TI  - Henry D. Janowitz and American gastroenterology.

PMID- 8345842
TI  - Modern concepts in pancreatitis.
AB  - A great deal remains to be learned about the pathophysiology, natural history,
      and treatment of acute and chronic pancreatitis. As we consider problems in
      treatment, we would be well advised to consider these words of Dr. Henry
      Janowitz: "Gastroenterologists are physicians who know how to think about and
      manage patients who have gastrointestinal problems." (44). To the extent that we
      heed these words and always give serious thought to what we are trying to
      achieve, we will provide greater help for our patients.

PMID- 8345843
TI  - New frontiers in gastrointestinal hormones.

PMID- 8345844
TI  - Current advances in gastrointestinal immunology.

PMID- 8345845
TI  - Evolution of the controlled clinical trial.

PMID- 8345846
TI  - Advances in knowledge of inflammatory bowel disease at Mount Sinai Medical
      Center.

PMID- 8345847
TI  - Obscure gastrointestinal bleeding.
AB  - I want to convey the notion that enteroscopy has opened many doors, and continues
      to open up more doors, in understanding and diagnosing diseases of the small
      intestine. The true nature of small-bowel angiodysplasia is still unanswered. It
      seems unlikely that the lesions in the small bowel are similar to the lesions
      that Scott Boley talks about in the right colon. I doubt that the intermittent
      obstruction to venous outflow, theorized in the colon, is the pathophysiologic
      change in the small intestine. Those studies, trying to look for the changes that
      Boley described, need to be done. We are trying to better characterize
      angiodysplasia of the small intestine, understanding where they occur, with how
      many lesions, and whether they are associated with any other illnesses. We are
      looking at the association of small-bowel vascular lesions with lesions in the
      stomach and colon. Enteroscopy will in the future, we hope, answer these
      questions. Enteroscopy, especially push enteroscopy, can help us with the
      treatment of angiodysplasias. We are now evaluating new instruments that reach
      not just two feet beyond the ligament of Treitz, but the entire jejunum, reaching
      6 feet beyond the ligament of Treitz (16). Enteroscopy facilitates clinical
      research, can be used in patient care, and guides treatment.

PMID- 8345848
TI  - The pharmacology of antiinflammatory agents: a new paradigm.

PMID- 8345849
TI  - Asthma: an inflammatory disease.

PMID- 8345850
TI  - Prevalence of atopy in an inner-city asthmatic population.
AB  - Seventy-three patients at The Mount Sinai Hospital Emergency Room were
      investigated to determine the prevalence of atopy in asthma in a predominantly
      black and Hispanic inner-city population. Serum IgE levels and
      radioallergosorbent tests (RASTs) to eight common inhalant allergens were
      measured in both the asthmatic group and a nonasthmatic emergency-room control
      group. The mean total IgE level for the asthma group was 263.8 IU/mL compared to
      63.8 IU/mL in the control group (p = 0.032), and 60% of the asthmatics had IgE
      levels in the atopic range (> 100 IU/mL). Increases in IgE were associated with
      age under 50 years but did not reach statistical significance. Cockroach, dust
      mite, cat, and dog were the most common RASTs in the asthmatic group; there were
      no positive RASTs in the control group. There was a correlation (p = 0.04)
      between age (less than 50 years) and increased numbers of positive RASTs. These
      results are similar to those of other studies that have associated atopy with
      asthma in rural and suburban populations. These data demonstrate that atopy is
      common in the asthmatic patients seen in The Mount Sinai Hospital Emergency Room
      and strongly suggest that management of atopic factors should become routine in
      the care of adult asthmatic patients.

PMID- 8345851
TI  - Oligoclonal banding in AIDS and hemophilia.
AB  - Hypergammaglobulinemia is a consistent finding in patients within the AIDS
      spectrum and with hemophilia A. Serum samples from patients with these conditions
      were analyzed for the presence of oligoclonal banding, using a high-resolution
      serum protein electrophoresis system. The incidence of banding is significantly
      greater in well homosexuals who are HIV-antibody positive and in patients with
      pre-AIDS-related complex, AIDS-related complex, AIDS with opportunistic
      infections, and AIDS with Kaposi's sarcoma than in normal blood donors. The
      incidence of banding is similar to controls in patients with hemophilia who have
      received either no blood products, cryoprecipitate only, or limited infusions of
      factor VIII concentrate. In patients who have received frequent infusions of
      factor VIII concentrate, the incidence of banding significantly increases.
      Thirteen of sixty-seven hemophiliac patients developed AIDS or symptoms related
      to HIV infection independent of their banding pattern. We hypothesize that the
      bands are not diagnostic of AIDS, but seem to correspond with disease
      progression, and that they are absent early in the disease, appear later in the
      course, and may disappear with advanced disease.

PMID- 8345852
TI  - Gold-induced colitis: a case report and review of the literature.
AB  - A case of severe colitis requiring subtotal colectomy following administration of
      35 mg Solganal b for intractable arthritis is described. Abdominal pain and
      watery diarrhea developed six weeks after the last dose of gold. Colonoscopy
      revealed mucosal edema and ulceration of the entire colon. Supportive measures
      failed and the patient required subtotal colectomy. Review of the literature
      revealed 29 cases, ranging in severity from limited ileal involvement to
      fulminant panenteritis. Most of the patients responded to intravenous fluids,
      steroids, and antibiotics, but four required surgery. The case described is
      notable for the delay in appearance of abdominal symptoms following the cessation
      of gold therapy. The mechanism of injury is unknown. Abdominal complaints in a
      patient who has received gold therapy, especially parenteral, merit strict
      attention, even if occurring several weeks after the final dose, and the
      diagnosis of gold colitis should be entertained.

PMID- 8345853
TI  - Progressive nemaline rod myopathy in a woman coinfected with HIV-1 and HTLV-2.
AB  - Nemaline-rod myopathy was recently reported in eight young males infected with
      human immune deficiency virus type 1 (HIV-1). A 41-year-old woman had a 2-year
      history of progressive proximal-muscle weakness. Muscle biopsy demonstrated the
      presence of nemaline rods, predominantly in type 1 fibers. She was coinfected
      with HIV-1 and HTLV-2, as evidenced by positive polymerase chain reaction and
      serology. There was no lymphopenia or CD4 lymphopenia, despite an abnormal T-cell
      subset ratio, high CD8 count, skin anergy, and depressed in vitro response to
      mitogens. This case raises the possibility that dual infection may play a role in
      the pathogenesis of the rare nemaline-rod myopathies of HIV-infected patients.

PMID- 8345854
TI  - Lymphocytic infundibuloneurohypophysitis as a cause of central diabetes
      insipidus.
AB  - BACKGROUND: Central diabetes insipidus may be familial, secondary to hypothalamic
      or pituitary disorders, or idiopathic. Idiopathic central diabetes insipidus is
      characterized by selective hypofunction of the hypothalamic-neurohypophysial
      system, but its cause is unknown. METHODS: We studied 17 patients with idiopathic
      diabetes insipidus, in whom the duration of the disorder ranged from 2 months to
      20 years. Only four patients had been treated with vasopressin before the study
      began. All the patients underwent endocrinologic studies and magnetic resonance
      imaging (MRI) with a 1.5-T superconducting unit, and two patients had biopsies of
      the neurohypophysis or the pituitary stalk. RESULTS: Nine of the 17 patients had
      thickening of the pituitary stalk, enlargement of the neurohypophysis, or both
      and lacked the hyperintense signal of the normal neurohypophysis. In the
      remaining eight patients, the pituitary stalk and the neurohypophysis were
      normal, although the hyperintense signal was absent. The abnormalities of
      thickening and enlargement were seen on MRI only in the patients who had had
      diabetes insipidus for less than two years, and the abnormalities disappeared
      during follow-up, suggesting a self-limited process. In addition to vasopressin
      deficiency, two patients had mild hyperprolactinemia and nine had impaired
      secretory responses of growth hormone to insulin-induced hypoglycemia. The two
      biopsies revealed chronic inflammation, with infiltration of lymphocytes (mainly
      T lymphocytes) and plasma cells. CONCLUSIONS: Diabetes insipidus can be caused by
      lymphocytic infundibuloneurohypophysitis, which can be detected by MRI. The
      natural course of the disorder is self-limited.

PMID- 8345855
TI  - Images in clinical medicine. Metastatic calcification of the shoulder in chronic
      renal failure.

PMID- 8345856
TI  - Thrombolysis in acute myocardial infarction.

PMID- 8345857
TI  - Clinical problem-solving. The sooner the better.

PMID- 8345858
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 35-1993. A two-year-old boy with recurrent infections, cervical
      lymphadenopathy, and fever.

PMID- 8345859
TI  - Coronary thrombolysis--a perspective for the practicing physician.

PMID- 8345860
TI  - Problems in primary care.

PMID- 8345861
TI  - Problems in primary care.

PMID- 8345862
TI  - Problems in primary care.

PMID- 8345863
TI  - Problems in primary care.

PMID- 8345864
TI  - Problems in primary care.

PMID- 8345865
TI  - Problems in primary care.

PMID- 8345866
TI  - Problems in primary care.

PMID- 8345867
TI  - Problems in primary care.

PMID- 8345868
TI  - Problems in primary care.

PMID- 8345869
TI  - Problems in primary care.

PMID- 8345870
TI  - Shattuck Lecture--misconduct in medical research.

PMID- 8345871
TI  - Shattuck Lecture--misconduct in medical research.

PMID- 8345872
TI  - Shattuck Lecture--misconduct in medical research.

PMID- 8345873
TI  - Shattuck Lecture--misconduct in medical research.

PMID- 8345874
TI  - The medical treatment of open-angle glaucoma.

PMID- 8345875
TI  - If not nurses, who? If not now, when?

PMID- 8345876
TI  - An interview with Ellen Canepa Brzytwa and Scott Sutorius. Interview by Connie R
      Curran.
AB  - The Greater Cleveland Hospital Association Center for Health Careers Development
      analyzes health care manpower issues and implements action plans to assist its
      members with image, retention, recruitment, and other staff development
      initiatives. In this interview, Ellen Canepa Brzytwa and Scott Sutorius discuss
      their work with the Center for Health Careers Development, the nurse's presence
      at the decision table, and nursing leadership development.

PMID- 8345877
TI  - Effects of RN wages and non-wage income on the performance of the hospital RN
      labor market.
AB  - The complex hospital RN labor market is influenced by a number of intertwined and
      dynamic forces. Understanding how these pieces can be pulled together may improve
      the ability to anticipate changes in the RN labor market before they occur.

PMID- 8345878
TI  - Monitoring unit-based innovations: a process evaluation approach.
AB  - A comprehensive program evaluation helps assure that the program envisioned is
      implemented; or helps determine why it failed. It strengthens assumption about
      causality by clarifying the relationships between intervention and outcome. A
      program evaluation planning map can be helpful in measuring the extent of
      professional practice model implementation.

PMID- 8345879
TI  - Outcomes analysis: methods and issues.
AB  - Patient outcomes research provides an opportunity to improve the quality of
      patient care by modifying the structures and processes of care delivery. Optimal
      application of outcomes analysis involves collaboration between the health care
      disciplines. The result of such an endeavor would be the identification of health
      care practices that lead to desired patient outcomes in the most cost-effective
      manner.

PMID- 8345880
TI  - Discovering work excitement among navy nurses.
AB  - An interest in what makes work exciting among Navy Nurse Corps officers led to
      the use of Simms' work excitement data collection protocol in Navy Medical
      Centers. Significant levels of work excitement were found among Navy nurses when
      compared to civilian nurses in non-military settings. Overall, results indicated
      that Navy nurses are excited about the variety, the leadership/management
      experiences, and the opportunities for teaching and learning--elements that are
      the very essence of Navy nursing practice.

PMID- 8345881
TI  - Models of nursing care delivery and case management: clarification of terms.
AB  - Case management is a popular term used to describe a wide variety of nursing care
      programs in acute hospital and community settings. However, confusion exists
      about what programs and services compose case management, and how case management
      differs from nursing care delivery models. Defining nursing care delivery models
      and case management programs in acute-care and community settings, and
      identifying criteria for defining case management facilitates comprehension of
      program purposes and services.

PMID- 8345882
TI  - Addressing variations in nursing practice/technology through clinical practice
      guidelines methods.

PMID- 8345883
TI  - Risk management and the nurse manager: the role of patient-focused care.

PMID- 8345885
TI  - Options and opinions offered for financing health care reform.

PMID- 8345884
TI  - Diversified nursing practice in ambulatory care.
AB  - Expanding RN utilization in the ambulatory care setting provides numerous cost
      and patient care benefits during a time when health care costs are rising.
      Ambulatory care management personnel and physicians should analyze their present
      staffing and patient mix to determine if using a diversified nursing practice
      could benefit their practice. Nurses have been an integral part of the health
      care team since the 1800s. As the 21st Century quickly approaches, the role of
      the RN will be critical as ambulatory medicine attempts to improve patient
      satisfaction and patient access while continuing to provide quality care in a
      cost-effective manner.

PMID- 8345886
TI  - [Dilemmas in pediatric surgery].

PMID- 8345887
TI  - [Folic acid for all fertile women?].

PMID- 8345888
TI  - [Psychiatric disorders with use of simvastatin].
AB  - Three patients are described with serious psychiatric complications related to
      use of simvastatin. The psychiatric symptoms concerned were mainly depression,
      anxiety and suicidal tendencies but also psychotic symptoms. The hypothesis is
      developed that in a particular population psychiatric (mood) disorders may be
      triggered by use of simvastatin or other cholesterol lowering compounds. A low or
      lowered cholesterol level may be related to disturbances in the cerebral
      serotonin metabolism. It may be necessary to be more alert for psychiatric (mood)
      disorders when a cholesterol lowering treatment (with simvastatin) is started and
      to stop it when psychiatric symptoms develop, or grow worse.

PMID- 8345889
TI  - [The return of serious infections caused by Streptococcus pyogenes].

PMID- 8345890
TI  - [Measurement of body temperature].

PMID- 8345891
TI  - [Degree of protection against poliomyelitis of Dutch subjects born before 1945
      and of allochthonous subjects in Utrecht, and the relationship to socioeconomic
      status].
AB  - In 1992 a seroepidemiological survey regarding the immune status for
      poliomyelitis was carried out amongst the population of the city of Utrecht:
      Dutch people born before 1945 and migrant workers and their families of all ages.
      Migrant workers and their families were well protected against poliomyelitis,
      using the WHO criteria (titre > or = I:8). The Dutch people born before 1945 were
      also well protected. Protection of Dutch people born before 1945 was better as
      their socioeconomic status was lower.

PMID- 8345893
TI  - [HIV-related non-Hodgkin lymphoma in 45 patients; a retrospective analysis].
AB  - Non-Hodgkin lymphoma is seen in approximately 5% of patients with AIDS. In recent
      years, the incidence has increased due to an extension of the average lifespan of
      HIV-infected individuals. In this article we describe the histological and
      clinical features of 45 patients with HIV-related non-Hodgkin lymphoma seen at
      the Academic Medical Centre between 1984 and 1991. There were 43 men and 2 women
      with a median age of 40 years. Most patients had high-grade B-cell lymphoma; 85%
      had extranodal sites. Prognosis was poor: overall median survival was only 3.8
      months. Twelve patients were treated with 3 or more courses of chemotherapy:
      their median survival was 8 months. In 7 of 12 patients a complete remission was
      obtained; their median survival was 18 months. A history of AIDS was a poor
      prognostic factor.

PMID- 8345892
TI  - [Surgical complications in treatment with continent ambulatory peritoneal
      dialysis; 9-year experience].
AB  - OBJECTIVE: To determine the number of surgical complications in patients treated
      with continuous ambulatory peritoneal dialysis (CAPD). DESIGN: Retrospective
      (1980-1989), partially prospective (1987-1989). SETTING: Rijnstate Hospital,
      Arnhem, the Netherlands. METHOD: In 1978 CAPD was introduced in the Netherlands.
      Since 1980 we have used this technique in our clinic. Over the period 1980-1989
      we studied the number of surgical complications of CAPD and the loss of catheter
      caused by these complications. With these numbers the probability of having a
      functioning Tenckhoff double cuff catheter was calculated with the Kaplan-Meier
      method. RESULTS: 101 patients (54 men (mean age 52.5 years), 47 women (mean age
      49.6 years)) with terminal renal insufficiency were treated during the study
      period. 123 catheters were implanted of which 33 had to be removed afterwards.
      The probability of having a functioning catheter after one year was 85%, after
      two years 64% and after three years 53%. Peritonitis was the main cause of
      temporary or final loss of the catheter. The number of observed cases of
      peritonitis was 187. CONCLUSION: Methods to improve the survival of the catheter
      are prevention of peritonitis by using an appropriate system for the fluid
      exchanges, screening patients for the existence of diverticulosis before starting
      CAPD, and prevention of exit site and tunnel infections.

PMID- 8345894
TI  - [Leiomyosarcoma of the small intestine: a rare cause of gastrointestinal blood
      loss].
AB  - A 61-year old man is described with recurrent gastrointestinal bleeding, due to a
      metastatic jejunal leiomyosarcoma. Because of the low incidence and the aspecific
      symptoms, a long delay occurred until the bleeding tumour and its metastases were
      demonstrated at radionuclide scanning and mesenteric angiography. The tumour
      bearing segment could be removed by simple surgical excision.

PMID- 8345895
TI  - [National study of the treatment of obstructive sleep apnea syndrome using
      uvulopalatopharyngoplasty or continuous positive pressure].

PMID- 8345896
TI  - [Misconduct in biomedical research].

PMID- 8345897
TI  - [Medical-ethical testing of family medicine research].

PMID- 8345898
TI  - [Myth about the disadvantage of lowering of serum cholesterol level refuted].

PMID- 8345899
TI  - [Myth about the disadvantage of lowering of serum cholesterol level refuted].

PMID- 8345900
TI  - [AIDS and HIV-infection as occupational disease].

PMID- 8345901
TI  - [AIDS and HIV-infection as occupational diseases].

PMID- 8345902
TI  - Chronic spondylogenic cervical myelopathy. A critical evaluation of surgical
      treatment after early and long-term follow-up.
AB  - In the past, chronic spondylogenic cervical myelopathy has been thought of being
      a disease often resistant to neurosurgical therapy. 56 out of 70 patient treated
      by laminectomy or different ventral fusion procedures improved immediately
      following operation. Only 36, however, continued to be improved at follow-up 5 to
      8 years later, whereas additional 8 had worsened again, and another 5 mean-while
      had died due to myelopathy. Laminectomy turned out to be the least successful
      procedure of treatment. Nevertheless, early diagnosis, early operation,
      appropriate and individual surgical procedures, careful re-evaluation at follow
      up, and -- if needed -- an early decision for a second-step operation can
      impressively improve the prognosis.

PMID- 8345903
TI  - Meningiomas of the tuberculum sella.
AB  - A series of 88 consecutive patients operated on for tuberculum sellae meningioma
      at the Neurosurgery Department of the University of Ankara Medical School was
      reviewed. Visual impairment was the most common initial complaint. All but 9
      patients had visual symptoms. All patients underwent craniotomy, with an
      operating microscope being used in 62 cases. Use of the operating microscope
      appeared to increase the total removal rate while lowering the mortality. In our
      series visual function improved in 53.5%, was unchanged in 27.5%, and worsened in
      19% of the patients.

PMID- 8345904
TI  - Percutaneous endoscopic lumbar discectomy (PELD).
AB  - Percutaneous endoscopic lumbar discectomy (PELD) is a new technique for the
      decompression of the lumbar disc space and removal of nucleus pulposus via a
      posterolateral approach. The technique was introduced in Germany by the authors
      in April 1987. The method is indicated in patients with nonsequestrated lumbar
      disc herniation with an intact dorsal longitudinal ligament. In local anesthesia,
      a working cannula (OD 5 mm) is placed at the dorsal lateral border of the disc.
      The disc space is opened with anulus trephines and the nucleus pulposus is
      removed with rigid and flexible forceps as well as with automated shaver systems
      under intermittent endoscopic control (discoscopy). The procedure is performed in
      local anesthesia. The results of the first thirty patients with a follow-up time
      between 6 months and 17 months could be graded as excellent in 13 cases, as good
      in 9 cases, as fair in 6 cases, and as bad in 2 cases. The relief of symptoms as
      judged by the patients was between 70-100 percent in the majority of the cases.
      Three patients had to be reoperated at the same level and site, because of either
      persistent or recurrent sciatica. The performance in local anesthesia, the
      atraumatic extraspinal approach, the reduced time of hospitalization and
      postoperative morbidity as well as the reduced time of work incapability are the
      main advantages of this new method.

PMID- 8345905
TI  - Aspiration or extirpation in cerebral abscess surgery?
AB  - The author carried out CT investigation of 11 patients who recovered after
      cerebral abscess operation. The finding established in all cases was a hypodensic
      area of various extensions, which, in 4 patients, made the impression of
      pseudocysts. Large pathologic lesions were found mainly in the patients in whom
      healing was complicated by relapse. Surprisingly, rather extensive pathologic
      changes in the patients were found which were cured by so-called "minimalized
      surgical intervention". The author imputes these changes to the remaining
      granulation tissue of the abscess capsula, which worsens conditions for healing.
      Aspiration is suitable mainly in cases in which the abscess is not -- or only
      slightly encapsulated. Preoperation CT scans cannot establish exactly the
      presence and eventual thickness of the capsula. The establishment relationship of
      the kind and extent of operation to the extent of later cerebral tissue changes
      in CT findings requires further observation and verification in a larger group of
      patients.

PMID- 8345906
TI  - The value of nuclear medicine for the diagnosis of spine diseases.
AB  - Nuclear medicine examinations hold an important position in the diagnosis of
      diseases of the spine. During the last decade, decisive progress has been made in
      the field of instrumentation and radiopharmaceutical techniques: the use of high
      resolution collimators and the introduction of emission computer tomography as
      examples of improved instrumentation as well as 99m-Technetium red blood cell
      labelling as a new radiopharmaceutical technique. These present some of the
      developments responsible for the growing importance of scintigraphical diagnosis.
      Inflammatory processes of the vertebrae and the surrounding soft tissues can be
      detected or excluded with high reliability by the use of radionuclide-labelled
      granulocytes. The important role of bone scintigraphy in the differential
      diagnosis of neoplastic bone disease relies on its high sensitivity combined with
      the quantitative analysis of increased bone metabolism. Furthermore, it provides
      exact information about the extent and a possible metastatic spread of bone
      tumours. In the field of orthopaedy and surgery, skeletal scintigraphy is of
      growing importance as a highly sensitive procedure in the detection of special
      traumatic lesions such as acute vertebral compression fractures and in the follow
      up of patients after bone surgical interventions. Despite the progress of other
      imaging modalities such as computer tomography and magnetic resonance imaging,
      nuclear medicine today is well-established in the assessment of diseases of the
      vertebral column. Among all scintigraphical diagnostic procedures, bone
      scintigraphy and the different techniques of inflammation imaging are of special
      importance.

PMID- 8345907
TI  - Surgical treatment of posterior fossa tumors in infancy and childhood: techniques
      and results.
AB  - In a collective of 72 children with tumors of the posterior fossa, the
      preoperative diagnosis, operation planning and performance, and use of additional
      procedures, like the preliminary ventricular drainage and interventriculostomy
      are described. The extent of intra- and postoperative complications is given.
      Postoperative lethality was 0% in the group operated on between 1979 and 1991.
      The responsible factors are discussed. The findings support the opinion of
      ALBRIGHT (1989) that the prognosis for such patients is most promising in the
      hands of a specialist in pediatric neurosurgery.

PMID- 8345908
TI  - The growth potential of ependymomas with varying grades of malignancy measured by
      the Ki-67 labelling index and mitotic index.
AB  - The prognostic significance of histopathological grade for postoperative outcome
      is not yet known for ependymomas. Data on proliferation kinetics of these tumors
      are few. In our study, the growth fraction was immunohistochemically determined
      by labelling cell nuclei with the monoclonal antibody Ki-67 in 24 tumors of the
      ependymoma group (2 malignant ependymomas grade III, 11 ependymomas grade II, 8
      spinal ependymomas, and 3 subependymomas). The results were compared with the
      mitotic index in the same tumor areas. Both growth parameters are related to the
      grade of malignancy. The differences between the results of spinal ependymomas
      (grade I) and of intracranial tumors (grade II) were statistically significant.
      Malignant ependymomas had the highest values. Variable growth potentials could be
      demonstrated in a few tumors. A non-linear relationship between growth fraction
      and mitotic index was found, indicating a variable generation time in ependymomas
      (as in astrocytomas). Thus, with rising grade of malignancy the growth fraction
      increases and the generation time decreases.

PMID- 8345909
TI  - Physical exercise increases middle cerebral artery blood flow velocity.
AB  - The effect on the middle cerebral artery blood flow velocity (VMCA) of moderate
      and hard physical exercise on an ergometer cycle was examined in 10 healthy
      volunteers using transcranial Doppler sonography (TCD). During exercise, the
      heart rate increased by 136% and the systolic blood pressure by 37% (mean
      values). During initial moderate exercise, VMCA increased by 51%; in a following
      period of maximal physical work, VMCA decreased again by 20% in 9 of 10
      volunteers although the heart rate continued to increase by 10% and the systolic
      blood pressure by 5% (mean values). Constriction of the MCA may explain the
      initial increase of VMCA, suggesting a role for large cerebral arteries in
      autoregulation. Our data indicate that the subsequent decrease of VMCA is caused
      by arteriolar constriction, a likely cause of which was hyperventilation during
      the excessive work period.

PMID- 8345910
TI  - Hypothalamic hamartoma: the role of surgery.
AB  - A hypothalamic hamartoma associated with true precocious puberty in a 7-month-old
      girl is hereby reported. Hormonal studies disclosed elevated serum levels of
      luteinizing hormone (LH) and follicle stimulating hormone, both of which
      responded well to LH-releasing hormone stimulation. Following a subtotal removal
      of the tumor, the clinical manifestations of precocious puberty as well as
      associated endocrinological abnormalities returned to normal. The role of surgery
      for this lesion, which appears to be safe when a planned microsurgical course is
      employed, is discussed.

PMID- 8345911
TI  - Encephalo-myo synangiosis (EMS) in the vertebrobasilar occlusive disease. Case
      reports.
AB  - Two cases of vertebro-basilar insufficiency treated with infratentorial (IT)
      Encephalo-Myo-Synangiosis (EMS) using the pedicled occipitalis muscle flap, are
      presented. IT EMS was carried out for revascularization of the vertebro-basilar
      system. None of these cases has suffered from either carotid or vertebro-basilar
      insufficiency during seven years follow-up period. As far as we know this is the
      first report of successful IT EMS for vertebro-basilar insufficiency.

PMID- 8345913
TI  - Implementation of an elective wellness course.
AB  - In an effort to increase knowledge and attitudes toward promoting health rather
      than treating disease, faculty in one school developed an elective wellness
      course open to all university students. The authors discuss how students learned
      concepts of wellness and developed individualized plans to improve their own
      health status.

PMID- 8345912
TI  - New aspects of neurotransplantation.
AB  - We have examined the possibility of promoting axonal regeneration within lesioned
      neural tissue using grafted artificial gel matrices. Polymeric matrices which
      feature a three-dimensional crosslinked macromolecular network were implanted
      into preformed lesions of the central nervous system (CNS). The host response
      consisted of matrix invasion by glial elements and the deposition of newly
      synthesized extracellular molecules. This rearrangement of the brain scarring
      process into an organized cellular coating promoted axonal regeneration into the
      gels. Entrapment of embryonic neurons and embryonal carcinoma (EC)-derived
      neurons, within the gels, was performed to explore the possibility of using
      polymer brain implants as neural graft microcarriers. Our results suggest that
      this approach will be useful for the delivery of cells and the promotion of
      axonal elongation required for successful neurotransplantation.

PMID- 8345914
TI  - The curriculum revolution: transforming barriers to education for registered
      nurses.
AB  - While designing an RN/BSN program, a small group of faculty accepted the
      challenge of the National League for Nursing (NLN) to initiate flexible,
      innovative learning experiences. Heeding the pleas of nursing leaders to engage
      in a curriculum revolution while incorporating the caution to maintain a balance
      within the curriculum, the group developed a nursing program that meets the
      current standards for NLN accreditation.

PMID- 8345915
TI  - A teaching strategy for identifying values: a clinical experience with the
      homeless.
AB  - Beginning baccalaureate students recorded their thoughts, feelings, and
      observations after participating in a clinical experience with the homeless. A
      content analysis protocol was used to uncover the meaning of the encounter. The
      findings suggest that assigning students to a homeless clinic is one way to help
      students identify professional values, such as altruism, equality, and human
      dignity.

PMID- 8345916
TI  - Managing adversity in the tenure and promotion process.
AB  - Faculty who meet tenure and promotion criteria may still be evaluated negatively
      at some point in the review process, perhaps by individuals who are unfamiliar
      with aspects of scholarship and teaching in the discipline of nursing. The author
      presents practical strategies that may succeed in turning over a negative
      decision. A prompt and aggressive course of action may prevent the need for an
      emotionally and financially draining lawsuit or grievance.

PMID- 8345917
TI  - Clinical memos: more than a communication tool.

PMID- 8345918
TI  - Faculty evaluation for professional growth.
AB  - This article tells the story of an attempt by one school of nursing to develop a
      system of faculty evaluation that nurtured professional growth. Recommendations
      for change in faculty evaluation practices were based on recognition of the need
      to develop a system of evaluation that was seen as less threatening and punitive
      and that encouraged self direction and participation in the evaluation process.
      Tools developed to evaluate teaching effectiveness were based on National League
      for Nursing outcome criteria, and were dependent on concept rather than context
      (i.e., classroom, clinical).

PMID- 8345919
TI  - Video taping return demonstrations.

PMID- 8345920
TI  - The public library as a clinical setting.

PMID- 8345921
TI  - An academic nursing center integrating education, role modeling, and research.

PMID- 8345922
TI  - Information literacy: educating for life-long learning.
AB  - Creating information-literate nurses is a challenging and complex task for nurse
      educators. It requires expertise on the part of the instructor, and a solid
      commitment to the importance of acquiring information skills and a willingness to
      demand quality work from the students. A librarian shares her views on
      information literacy.

PMID- 8345923
TI  - Student attitude toward computer-assisted instruction.

PMID- 8345924
TI  - A restructured nursing process model.
AB  - Nursing process has guided clinical nursing practice for more than 25 years.
      During this time, many changes have occurred in healthcare practices, delivery
      systems, and nursing. The cumulative effects of such changes show a need to
      restructure the basic nursing process model. The author presents a three-level
      differentiated nursing process model.

PMID- 8345925
TI  - Building on experiential learning in a leadership/management internship.

PMID- 8345926
TI  - Recommend changing answers on multiple choice examinations.

PMID- 8345927
TI  - The curriculum revolution within the constraints of academia.

PMID- 8345928
TI  - Mind the gap.

PMID- 8345929
TI  - Saudi women.

PMID- 8345930
TI  - What will PPS look like for FY 1994?

PMID- 8345931
TI  - Legal aspects--standards of care: Part II.

PMID- 8345932
TI  - Primary care: in legislation and in practice.

PMID- 8345934
TI  - Hospital redesign demands "open" information systems.

PMID- 8345933
TI  - Conscience and clinical care.

PMID- 8345935
TI  - Building a managed care approach.
AB  - Managed care enhances nursing autonomy and accountability and increases awareness
      of patients' interactions within a complex multidisciplinary healthcare delivery
      system. By using this approach, both physicians and nurses are able to assist
      patients to achieve outcomes quickly, decrease length of hospital stay, and
      facilitate continuity of care in a cost-effective manner.

PMID- 8345936
TI  - Making the commitment to managed care.
AB  - To develop and to implement managed care requires support from key participants
      including administrators, physicians, nurse managers and all healthcare
      providers. This multidisciplinary approach assures success and increases support
      when making the move toward managed care.

PMID- 8345937
TI  - Starting a hospital-based home health agency: Part I. The service and its
      environment.
AB  - Alternative care services and delivery options can improve quality, access and
      institutional viability. When properly implemented, home healthcare--an important
      link in the continuum of the healthcare delivery system--provides this service.
      Part I of this three-part series describes the research, review and beginning
      implementation, defines populations, and evaluates environmental assessments
      which set the foundation to establish a hospital-based agency.

PMID- 8345938
TI  - Depression among female registered nurses.
AB  - Depression, the most frequently diagnosed psychiatric illness, is characterized
      by feelings of sadness, pessimism, self-dislike and loss of energy, motivation
      and concentration. The relationship of self-esteem, assertiveness and anxiety to
      depression is studied in a group of female nurses. Recognizing predisposing
      factors in this high-risk group can begin a process to treat this illness.

PMID- 8345939
TI  - Costing the nursing service of patient education.
AB  - Patient Classification Systems (PCS) are one method of determining nursing
      service cost of patient education. A teaching classification study compares the
      value that different PCSs place on this aspect of nursing care. Through this
      comparison, information obtained helps nurses objectively update existing patient
      classification systems and provides guidelines for developing a system to include
      patient education.

PMID- 8345940
TI  - Decentralizing an overtime budget.
AB  - Decentralizing overtime costs moves this area of authority and accountability
      from central management to the unit level. Efficiency, quality and cost
      containment are addressed in the transition process. Together, nurse managers,
      staff and fiscal services discuss and plan alternatives to assure cost-effective
      resource allocation.

PMID- 8345941
TI  - Using market research for product line development.
AB  - A marketing research study determined patient needs and wants in order to tailor
      services within a family maternity care unit. In addition, an educational
      program, implemented in an effort to change the behavior of the caregivers in the
      clinical area, is described.

PMID- 8345942
TI  - From court to certification: establishing credibility.

PMID- 8345943
TI  - Staffing solutions: an in-house agency.
AB  - Cost-efficient, flexible labor and scheduling can be met within one's own
      organization through a professional staffing program. Conceptualization,
      implementation and evaluation of this in-house agency are detailed. In addition
      to meeting unit schedules, this program improved staff morale due to better
      coverage and compensation.

PMID- 8345944
TI  - Leadership: effects of birth order and education.
AB  - This study examines the dichotomy between female leadership qualities and those
      that traditionally link firstborn males and females to leadership positions.
      Research has repeatedly supported the belief that oldest children should rate
      higher than later born children on the California Psychological Inventory scales,
      but as this theoretical framework implies, these characteristics are inconsistent
      with the evolving leadership paradigm.

PMID- 8345945
TI  - On life and labels.

PMID- 8345946
TI  - My job as a staff nurse will change.

PMID- 8345949
TI  - Practice points. Issue: what qualifies me to administer intravenous chemotherapy?

PMID- 8345947
TI  - Nursing roles in advanced practice. The pilot project at Wright State University.

PMID- 8345950
TI  - In-utero diagnosis of Norrie disease by ultrasonography.
AB  - Obstetric ultrasonography of an obligate Norrie disease carrier revealed
      bilateral retinal detachments in a third trimester male fetus. Postnatal
      examination confirmed the diagnosis of Norrie disease. DNA linkage analysis with
      the markers L1.28 and MAO had been uninformative for this family. This report
      suggests that retinal detachment occurs late in the gestation of the affected
      fetus.

PMID- 8345951
TI  - Broad-spectrum Mobius syndrome associated with a 1;11 chromosome translocation.
AB  - The authors report a case of Mobius syndrome with Poland syndrome, cleft palate,
      dextrocardia, mandibular hypoplasia, and multiple areas of diffuse brain volume
      loss. Karyotype demonstrated a t(1;11)(p22;p13) translocation in the patient and
      his phenotypically normal father and brother. This case extends the spectrum of
      congenital disorders that are associated with Mobius syndrome and raises the
      possibility of genetic heterogeneity for the Mobius disorder.

PMID- 8345953
TI  - High symmetric anisometropia in monozygotic twins.
AB  - The first case in the literature of anisometropia of more than 20 dioptres in
      both left eyes of a pair of monozygotic 64-year-old twins is presented. The
      refractive parameters are given together with a short overview of the literature
      on anisometropia.

PMID- 8345952
TI  - Pigmented paravenous retinochoroidal atrophy (PPRCA) with optic disc drusen.
AB  - Pigmented paravenous retinochoroidal atrophy (PPRCA) is a rare retinal disorder
      which is diagnosed primarily on its typical funduscopic appearance of retinal
      pigment epithelial atrophy and clumping in a paravenous distribution. Pigmented
      paravenous retinochoroidal atrophy is usually asymptomatic and seldom causes
      marked decrease in visual acuity or significant impairment of electrophysiologic
      functions. Optic nerve head drusen, which are thought to be inherited as an
      autosomal dominant trait, rare in blacks, and known to be associated with
      retinitis pigmentosa, have not been previously reported with PPRCA. The authors
      present a case of PPRCA which is classic except for an additional finding of
      optic nerve head drusen. The heritability of PPRCA remains controversial but the
      authors' reported association of PPRCA and disc drusen seems to suggest some
      genetic influence.

PMID- 8345954
TI  - Retinoblastoma. Unusual warning and clinical signs.
AB  - Three clinical cases have been chosen to illustrate the pitfalls that can be
      encountered when warning signs other than leukokoria or strabismus indicate
      possible retinoblastoma. The first case, a four-year-old boy, was admitted to
      hospital after an accident, presenting uveitis, glaucoma and a subluxated lens.
      He was suffering from unilateral retinoblastoma, already exteriorized and the
      cause of death some months later. The second case, and 11-month-old female child
      was seen on fundus examination to present a yellowish elevated calcified mass
      which turned out to be tuberous sclerosis. The third patient, a 43-year-old male,
      father of two children suffering from retinoblastoma, was found on routine
      examination to be carrying a partially-calcified retinal tumour. Subsequent
      haemorrhaging rendered enucleation necessary and microscopic examination
      confirmed the diagnosis of retinoma. The diagnosis of retinoblastoma should
      always be kept in mind whenever an intraocular mass is revealed or where there
      are unexplained atypical ocular signs.

PMID- 8345955
TI  - An experience of the use of radioactive plaques after failure of external beam
      radiation in the treatment of retinoblastoma.
AB  - The authors have reviewed the results of radioactive plaques in recurrent
      retinoblastoma after external beam radiation in 34 eyes. They give their results
      on ocular conservation and on the visual outcome and compare these results with
      other series previously published. They think radioactive plaques are an
      alternative to enucleation in recurrent retinoblastoma after external beam.

PMID- 8345956
TI  - Cosmetic possibilities and problems in eyelid neurofibromas.
AB  - Neurofibromatosis type 1 (NF1) is an inherited systemic disease with frequent
      ocular involvement. A typical alteration observed in NF1 is the eyelid plexiform
      neurofibroma, often associated with facial homolateral hypertrophy. In such
      cases, surgical cosmetic results are rather unsatisfactory, since plexiform
      neurofibromas classically show a non-capsulated mass, with a marked tendency to
      local recurrence. The techniques for a cosmetic attempt are discussed on the
      basis of a personal series of eyelid reconstructions in NF1. The results can be
      considered satisfactory in some cases, when the orbital shape is preserved and
      the eyelid structure has not been excessively altered by the neurofibroma; in all
      other cases, the cosmetic outcome is inferior to the patient's and parents'
      expectations. The serious problem of recurrence is however a limitation to
      cosmetic surgery in eyelid neurofibromas.

PMID- 8345957
TI  - Optic atrophy in Marinesco-Sjogren syndrome: an additional ocular feature. Report
      of three cases in two families.
AB  - Marinesco-Sjogren syndrome (MSS) is a rare inherited disease with neurological
      and ocular manifestations. The latter include bilateral cataracts and, less
      frequently, nystagmus and strabismus. The authors report here three cases of MSS
      syndrome, all with optic atrophy, an additional ocular feature not hitherto
      described in this syndrome.

PMID- 8345958
TI  - Transthyretin-related TTR hereditary amyloidosis of the vitreous body. Clinical
      and molecular characterization in two Italian families.
AB  - Two unrelated Italian families affected by hereditary amyloidosis are described.
      Molecular genetic characterization demonstrated different mutations of the
      transthyretin gene. In all patients belonging to the TTR Ala 49 family the
      vitreous body, the heart and the peripheral nervous system were massively
      infiltrated by amyloid matter. In the TTR Pro 36 family vitreous opacities were
      the long-standing isolated manifestations of the disease. Two different patterns
      of vitreous deposits can be observed in these two families. The authors' data
      support the hypothesis that different pathological transthyretin proteins may
      have different affinity for the connective tissue in the vitreous.

PMID- 8345959
TI  - Development of vision in infants and young children.
AB  - Behavioral improvement in the quality of infant vision parallels neuroanatomic
      and neurophysiologic brain development. Progressive refinement of acuity can be
      tracked by means of tests that employ fixation and following, optokinetic
      nystagmus, preferential viewing, and pattern-evoked visual responses. These
      methods of evaluating vision in the preverbal child differ from each other in
      several respects; their relative advantages and disadvantages are discussed.

PMID- 8345960
TI  - Retinopathy of prematurity.
AB  - Retinopathy of prematurity (ROP) remains a nonpreventable disorder associated
      with extreme prematurity. Recent advances in establishing the International
      Classification of ROP have facilitated both clinical care and research,
      highlighted by the demonstration of the effectiveness of cryoablative therapy for
      vision-threatening ROP. For those individuals who have ROP, early and life-long
      ophthalmic follow-up is critical. This is true for those with any residual
      retinal scars that we now know can lead to later vision loss as well as those who
      require services for the visually impaired.

PMID- 8345961
TI  - Ophthalmia neonatorum.
AB  - Ophthalmia neonatorum is the most common infection in the first month of life and
      can have serious systemic as well as ophthalmic morbidity. This article discusses
      the differential diagnosis and treatment of conjunctivitis in the neonate.
      Controversies in method of prophylaxis are reviewed.

PMID- 8345962
TI  - Amblyopia. Diagnosis and management.
AB  - Amblyopia is a difficult challenge for physicians caring for these children. If
      detected early with screening programs, the prognosis for successful treatment is
      greatly increased. If missed, the child may suffer from a lifetime of poor vision
      in one eye. Children who fail a visual screening test should be promptly referred
      to an ophthalmologist. Prompt detection and treatment of amblyopia secure a child
      the best chance for a good visual outcome.

PMID- 8345963
TI  - Diagnosis and treatment of strabismus disorders.
AB  - Strabismus is a common ocular abnormality in children and can have significant
      effects on visual, physical, and psychological development. The causes of ocular
      misalignment are numerous. Primary care physicians should be skilled in the
      evaluation of ocular motility in children. They also should understand the basic
      pathophysiology of common strabismus disorders and be able to identify those
      children at risk. This knowledge will aid in making a proper referral to an
      ophthalmologist when a strabismic disorder is suspected or detected.

PMID- 8345964
TI  - Common ocular signs and symptoms in childhood.
AB  - Children have many ocular complaints that generate a referral to the eye doctor.
      The complaints originate either from the child, the parents, the primary care
      physician, or teachers. This article describes the common complaints for which
      patients are referred and then how these problems should be addressed.

PMID- 8345965
TI  - Disorders of the lacrimal system apparatus.
AB  - Epiphora, or excess tearing, is a common problem in infants. The most frequent
      etiology of this disorder is a nasolacrimal duct obstruction. There are other
      conditions, however, some of which can be serious, which can cause tearing.
      Infections of the eyelids and conjunctiva, an undiscovered foreign body, and
      congenital glaucoma are among the conditions that must be ruled out when any
      child presents with excessive tearing.

PMID- 8345966
TI  - Common pediatric neuro-ophthalmologic conditions.
AB  - Neuro-ophthalmologic problems are some of the most distressing ocular conditions
      to affect children. In this article the author discusses the differential
      diagnosis and management of blindness during the first year of life. Nystagmus or
      'jiggling eyes' tumors of the visual pathways and acquired ocular motor
      neuropathies comprise the balance of the article.

PMID- 8345967
TI  - The swollen and droopy eyelid. Signs of systemic disease.
AB  - Swollen and droopy eyelids are obvious ocular findings, unlike many ocular
      conditions that require the use of special equipment to observe. Neither of these
      findings is a specific diagnosis but rather each is evidence of localized disease
      and often is a sign of underlying systemic disorder. Therefore, it is important
      for the clinician evaluating the child with a swollen or droopy lid to have a
      working knowledge of these diagnostic possibilities. In this article the author
      presents the various causes of the swollen and droopy eyelid, focus on the most
      relevant clinical characteristics, and emphasize systemic associations.

PMID- 8345968
TI  - Ocular tumors of childhood.
AB  - It is important for the pediatrician to be aware of the benign and malignant
      ophthalmic tumors that can occur in children. This article covers some general
      concepts related to ocular tumors in children and briefly describes the clinical
      features and management of some of the more important tumors of the eyelids,
      conjunctiva, intraocular structures, and orbit. Although most ocular tumors in
      children are benign, certain malignant neoplasms can threaten the child's life as
      well as the child's sight. Hence, prompt recognition and patient referral to an
      ocular oncologist are crucial for proper clinical management.

PMID- 8345969
TI  - Eye injuries and prevention.
AB  - A disproportionate share of ocular and orbital injuries occur in children. This
      article reviews the evaluation and initial management of ocular trauma and
      chemical burns to the eye. Traumatic conditions are classified according to the
      particular area of the eye or orbit involved; chemical burns constitute a
      separate section. Sports-related injuries and their prevention are emphasized.

PMID- 8345970
TI  - Pediatric cataracts.
AB  - The presentation, etiology, diagnostic examination, and management of pediatric
      cataracts are discussed in this article. If untreated, cataracts result in
      significant visual deprivation. Evaluation of the pupillary light reflex should
      become an integral part of every pediatrician's physical examination. Patients
      should be referred for a complete eye examination whenever a cataract is
      suspected because early intervention may be the most important factor in
      determining a good visual outcome.

PMID- 8345971
TI  - Glaucoma in children.
AB  - Glaucoma in children is a relatively rare but frequently debilitating disorder.
      Pediatricians must be aware of the association of glaucoma with certain systemic
      diseases and congenital ocular abnormalities. Recognition of the signs of
      infantile glaucoma allows the physician to refer patients for definitive care.
      Timely therapy is critical to the successful management of children affected with
      glaucoma.

PMID- 8345972
TI  - The pediatrician's role in reading disorders.
AB  - This article summarizes clinically pertinent information on dyslexia and various
      disorders that contribute to school failure. Clinical, school, and research
      findings related to dyslexia are discussed. The role of the eyes, visual system,
      and controversial therapies are explored. The author emphasizes the role of the
      pediatrician as a team leader on the multidisciplinary approach to the diagnosis,
      therapy, and counseling of children with learning disabilities.

PMID- 8345973
TI  - Working with visually impaired children and their families.
AB  - This article contains basic information such as definitions and educational
      options for blind and partially sighted children. Specific suggestions for the
      pediatrician when working with these youngsters are included. Guidelines for
      parents to use when making educational decisions and when selecting adaptive
      technology are presented as well as a list of national organizations serving the
      visually impaired.

PMID- 8345974
TI  - Scientific literature on Ribavirin should be "objectively reviewed".

PMID- 8345975
TI  - Helping Down Syndrome children to reach new heights: the role of the pediatric
      nurse.

PMID- 8345976
TI  - Consensus: diagnosis and management of neurocysticercosis in children.

PMID- 8345977
TI  - Increased mortality after high titer measles vaccines: too much of a good thing.

PMID- 8345978
TI  - Antimicrobial treatment of occult bacteremia: a multicenter cooperative study.
AB  - This prospective multicenter study was conducted to define more clearly clinical
      and laboratory criteria that predict a strong probability of occult bacteremia
      and to evaluate the effect of empiric broad spectrum antimicrobial treatment of
      these children. Children 3 to 36 months old with fever > or = 40 degrees C (104
      degrees F) or, > or = 39.5 degrees C (103 degrees F) with white blood cells (WBC)
      > or = 15 x 10(9)/liter, and no focus of infection had blood cultures obtained
      and were randomized to treatment with oral amoxicillin/potassium clavulanate or
      intramuscular ceftriaxone. Sixty of 519 (11.6%) study patients had positive blood
      cultures: Streptococcus pneumoniae, 51; Haemophilus influenzae b, 6; Neisseria
      meningitidis, 2; and Group B Streptococcus, 1. Subgroups of high risk were
      identified as fever > or = 39.5 degrees C and WBC > or = 15 x 10(9)/liter, 55 of
      331 or 16.6% positive with increasing incidence of positive culture with
      increasing increments of degrees of leukocytosis to WBC > or = 30 x 10(9)/liter
      where 9 of 21 or 42.9% were positive. Subgroups of significantly lower risk were
      identified as fever > or = 39.5 degrees C and WBC < 15 x 10(9)/liter, 5 of 182 or
      2.7% positive and those with WBC < 10 x 10(9)/liter, 0 of 99 or 0.0% positive.
      Children with positive cultures who received ceftriaxone were nearly all afebrile
      after 24 hours whereas a significant number who received amoxicillin/potassium
      clavulanate remained febrile. In the 459 culture-negative children more
      amoxicillin/potassium clavulanate-treated children developed diarrhea and had
      less improvement in clinical scores after 24 hours than ceftriaxone-treated
      children.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8345979
TI  - Occult blood and fecal leukocytes as screening tests in childhood infectious
      diarrhea: an old problem revisited.
AB  - During a 24-month period 446 children with diarrhea and 16 controls had
      examination of their stools for leukocytes and for occult blood. Fecal leukocytes
      were found in 36, 16 and 18% of children with Salmonella-Shigella-Campylobacter,
      rotavirus or enterotoxigenic Escherichia coli, or cryptosporidial diarrhea,
      respectively. Similarly 43, 39 and 38% of these groups, respectively, as well as
      13% of controls had occult blood. Notably 70% of 10 Shigella cases had fecal
      leukocytes. In 166 children with mixed pathogens leukocytes were seen in 27 and
      8% of children with Salmonella-Shigella-Campylobacter or noninvasive pathogen,
      respectively. Likewise 44 and 18% of these groups had occult blood. Agreement
      between both tests being positive was poor, the highest result being 50% for
      Shigella. Dysentery combined with both tests positive was associated with 15
      (88%) cases of invasive agents present in stool cultures, and combination of
      dysentery with fecal leukocytes was associated with 21 (72%) cases of invasive
      agents recovered. The results of these tests should be interpreted in the context
      of the clinical situation. A combined clinical-epidemiologic and screening tests
      based approach to infectious diarrhea of childhood is suggested.

PMID- 8345980
TI  - Haemophilus influenzae type b carriage and immunity four years after receiving
      the Haemophilus influenzae oligosaccharide-CRM197 (HbOC) conjugate vaccine.
AB  - Late in 1991, before the implementation of a national immunization program
      against Haemophilus influenzae type b (Hib) in the United Kingdom, we performed a
      4-year follow-up of 120 children who in 1987 had been enrolled in an
      immunogenicity trial in which 60 of them (vaccinees) received an Hib conjugate
      vaccine (HbOC) at the same time as diphtheria-tetanus toxoid-pertussis vaccine at
      the ages of 3, 5 and 9 months. Sixty others (controls) received only diphtheria
      tetanus toxoid-pertussis vaccine at the same ages and were not subsequently
      immunized against Hib. We investigated Hib pharyngeal colonization using the
      antiserum agar method and the concentrations of serum IgG antibody to the type b
      capsule by enzyme-linked immunosorbent assay. At 4 years of age the Hib
      colonization rates in vaccinees and controls were 8% (5 of 60) and 5% (3 of 60),
      respectively. The children colonized with Hib had greater serum anti-capsular IgG
      concentrations than did noncolonized children (P < 0.001), and colonized
      vaccinees tended to have higher concentrations than colonized controls (P =
      0.053). Regardless of Hib colonization status vaccinees had greater antibody
      concentrations than controls (P < 0.001). Forty-nine percent of vaccinees had an
      antibody concentration > 1 microgram/ml. There was an inverse relationship
      between the Hib colony count on culture and the serum IgG concentration. These
      data indicate that the increase in serum antibody concentration after
      immunization with an Hib conjugate vaccine is sustained and that immunization
      primes for a booster response on exposure to Hib. There may be a relationship
      between previous Hib conjugate immunization and the density of Hib colonization
      in children.

PMID- 8345982
TI  - Clinical and laboratory diagnosis of pertussis in the regions of a large vaccine
      efficacy trial in Germany.
AB  - As a support service for a pertussis vaccine efficacy trial, a central diagnostic
      laboratory was established. Physicians in the geographic areas of the planned
      study were encouraged to send nasopharyngeal specimens from children and
      household contacts with cough illnesses whether or not the illnesses were typical
      of pertussis. From April, 1991, to February, 1992, 3629 specimens were received
      and in 601 instances (16.6%) Bordetella pertussis was isolated. Only 3.3% of
      patients with positive cultures had received pertussis vaccine whereas 16.1% of
      culture-negative patients had received vaccine (P < 0.0001). Fever was more
      common (12.2%) in patients with negative cultures compared with those with
      positive cultures (5.4%) (P < 0.0001). B. pertussis isolation rates fell markedly
      after 21 days of cough. Significantly more patients with negative cultures
      compared with those with positive cultures had been treated with erythromycin
      (8.5 vs. 2.9%; P < 0.0001). Patients with cough for greater than 4 weeks and
      specimen collection within 2 weeks of cough onset had a B. pertussis isolation
      rate of 59%. Similarly if whoop occurred under the same circumstances the
      isolation rate was 80%. In this study 25.5% of patients with culture confirmed
      pertussis had illnesses with cough of less than 21 days duration. This finding
      suggests to us that a pertussis case definition in efficacy trials that requires
      cough of 21 days is excessively restrictive.

PMID- 8345981
TI  - Comparative immunogenicity of four Haemophilus influenzae type b conjugate
      vaccines in Alaska Native infants.
AB  - We compared the immunogenicity of the four available Haemophilus influenzae type
      b (Hib) conjugate vaccines in Alaska Native infants. Three of the vaccines, Hib
      oligosaccharide-CRM197 (HbOC), polyribosylribitol phosphate-diphtheria toxoid
      (PRP-D) and polyribosylribitol phosphate-tetanus toxoid (PRP-T), were given at 2,
      4 and 6 months of age, and the PRP Neisseria meningitidis outer membrane protein
      (PRP-OMP) conjugate vaccine was given at 2 and 4 months of age. Enrollment was
      largely sequential by vaccine availability beginning with HbOC and ending with
      PRP-T. A total of 225 infants completed the full vaccination series. Groups of
      infants receiving the different vaccines did not differ significantly by sex,
      ethnicity, degree Alaska Native or age at vaccination. The only vaccine that
      induced a response with the first 2-month dose was PRP-OMP; 91% of infants had >
      or = 0.15 micrograms/ml and 57% had > or = 1.0 microgram/ml of anti-PRP antibody
      by 4 months of age. After two doses it also remained the most immunogenic. After
      the full three vaccine series, trials that requires cough of 21 days is
      excessively restrictive.

PMID- 8345983
TI  - Efficacy of plasmin-treated intravenous gamma-globulin for therapy of Kawasaki
      syndrome.
AB  - In order to delineate the efficacy of plasmin-treated intravenous gamma-globulin
      (IVGG) in the treatment of Kawasaki syndrome, we compared the frequency of
      coronary artery abnormalities in children treated or not with IVGG for Kawasaki
      syndrome. Among 291 cases of Kawasaki syndrome diagnosed during the period of
      1987 to 1991 without coronary abnormalities within 10 days of the onset of
      illness, 128 were treated with IVGG and aspirin and were compared with 163
      treated with aspirin alone. IVGG was given in a dosage of 400 mg/kg/day for 4
      consecutive days. The detection of coronary abnormalities was monitored by two
      dimensional echocardiography. Two weeks after enrollment coronary artery
      abnormalities were present in 37 (22.7%) of 163 children in the aspirin group and
      in 9 (9%) of 128 in the gamma-globulin group (P < 0.05). Seven weeks after
      enrollment, abnormalities were present in 20 (12.3%) of 163 children in the
      aspirin group and in 6 (4.6%) of 128 in the IVGG group (P < 0.05). We conclude
      that plasmin-treated IVGG is effective in reducing the prevalence of coronary
      artery abnormalities in Kawasaki syndrome and suggest a predominant role of the
      Fc gamma fragment of IgG in the therapeutic effect.

PMID- 8345984
TI  - International childhood vaccine initiative.

PMID- 8345985
TI  - Hydrocephalus complicating lymphocytic choriomeningitis virus infection.

PMID- 8345986
TI  - Infections caused by beta-lactamase-producing Fusobacterium spp. in children.

PMID- 8345987
TI  - Recurrent hydatid disease after therapy with albendazole.

PMID- 8345988
TI  - Corynebacterium xerosis ventriculoperitoneal shunt infection in an infant: report
      of a case and review of the literature.

PMID- 8345989
TI  - Diphtheria presenting as abdominal pain and arthralgia.

PMID- 8345990
TI  - Pyosalpinx caused by Streptococcus pneumoniae in a young girl.

PMID- 8345991
TI  - Kingella kingae osteomyelitis of the calcaneus in young children.

PMID- 8345992
TI  - Persistent coccobacillary sepsis in a preterm newborn.

PMID- 8345993
TI  - Cefixime therapy for otitis media.

PMID- 8345994
TI  - Significance of abnormal liver function tests associated with administration of
      amoxicillin and other penicillins.

PMID- 8345995
TI  - Intravenous immunoglobulin use in the neonate: role in prophylaxis and therapy of
      infection.

PMID- 8345996
TI  - Failure of tracheal aspirate cultures to define the cause of respiratory
      deteriorations in neonates.
AB  - The spectrum of organisms responsible for lower respiratory tract infection in
      chronically ventilated neonates is poorly defined. During an 18-month period 63
      infants with a respiratory deterioration defined as an increase in fractional
      inspired O2 concentration > or = 20% and/or mean airway pressure > or = 3 cm H2O
      were evaluated for pulmonary infection. These infants were compared with 58
      stable control ventilated infants. Tracheal aspirates for culture and Gram stain
      were taken from both groups and were cultured for bacteria, viruses, Chlamydia
      trachomatis, Ureaplasma urealyticum and Mycoplasma hominis. In addition each
      infant had complete blood counts with differential and chest roentgenograms
      evaluated. Positive tracheal aspirates defined as a heavy growth of a single or
      two bacterial organisms, and/or any growth of virus, Chlamydia and U. urealyticum
      were found in 23 of 63 study patients and 20 of 58 controls (P > 0.05). The most
      frequent isolate in both groups was U. urealyticum. Chest radiographs were
      positive (new changes, particularly atelectasis and infiltrates) more frequently
      in the study group than in controls, but complete blood count and tracheal
      aspirate Gram-stained smears were not helpful in discerning colonization from
      infection. We conclude that positive tracheal aspirates occur with equal
      frequency among infants with a clinical suspicion of lower respiratory tract
      infection and in "well" controls. Chest roentgenogram may be a useful adjunctive
      test to discriminate between colonization and lower respiratory tract infection.

PMID- 8345997
TI  - Outbreak of early onset group B streptococcal sepsis.
AB  - During January and August, 1990, 23 cases of early onset Group B Streptococcus
      (GBS) disease occurred in a Kansas City, MO, hospital with an attack rate of
      14/1000 live births, compared with an annual rate of 1.2 cases/1000 live births
      for 1988 through 1989. Case infants were compared with controls matched by birth
      weight, race, maternal age and day of delivery and to a second group of infants
      of mothers colonized with GBS to identify risk factors and consider intervention
      strategies during the outbreak. The presence of multiple serotypes among the
      invasive strains suggested that the outbreak was not caused by a common source.
      Case mothers were more likely than control mothers to have chorioamnionitis,
      intrapartum fever or rupture of membranes > 12 hours, and premature case infants
      were more likely to have a history of rupture of membranes before onset of labor.
      Multiparous mothers of case infants were more likely to have a history of
      spontaneous abortion (odds ratio, 6.7; 95% confidence interval, 1.0 to 45.9). No
      single factor could explain the increase in GBS disease. If intrapartum
      antibiotic prophylaxis had been used for selected GBS carriers based on presence
      of either rupture of membranes > 12 hours, intrapartum maternal fever or preterm
      labor, 7.4% of all deliveries would have received antibiotics and 73% of cases
      could potentially have been prevented. We conclude that identification of
      colonized mothers with perinatal risk factors and use of intrapartum antibiotics
      could be expected to prevent substantial disease during an outbreak of early
      onset GBS disease.

PMID- 8345998
TI  - Mycoplasma hominis and Ureaplasma urealyticum in neonates with suspected
      infection.
AB  - The role of genital mycoplasmas in the pathogenesis of neonatal infection is
      incompletely understood. We performed nasopharyngeal, blood and cerebrospinal
      fluid (CSF) cultures for Mycoplasma hominis and Ureaplasma urealyticum in 69
      neonates who underwent a diagnostic workup for suspected sepsis. The mean
      gestational age was 35.9 weeks (range, 25 to 42 weeks) with a mean birth weight
      of 2386 g (range, 652 to 4420 g). Twenty-seven infants (39.1%) had positive
      nasopharyngeal cultures; 6 were positive for M. hominis, 10 for U. urealyticum
      and 11 for both organisms. Seven (26%) of these 27 patients developed chronic
      lung disease compared with 2 (4.7%) infants in the non-colonized group. Nine
      infants had positive CSF cultures for M. hominis and one infant had a positive
      CSF culture for U. urealyticum. All blood cultures were sterile. One of the
      infants with a positive CSF culture for M. hominis had clinical evidence of
      systemic infection. All of the infants were treated with antibiotic agents that
      were not active against mycoplasmas. These data indicate that genital mycoplasmas
      can be found commonly in the CSF and nasopharynx of infants with suspected
      sepsis. Their etiologic role in the causation of infection and chronic lung
      disease, however, remains unclear.

PMID- 8345999
TI  - Risk factors associated with fungal peritonitis in very low birth weight neonates
      with severe necrotizing enterocolitis: a case-control study.
AB  - Fungal peritonitis is uncommon in infants with severe necrotizing enterocolitis
      with intestinal perforation. In our institution we noted a significant (P < 0.01)
      increase in fungal peritonitis from 7% (3 of 45 cases of peritonitis) from
      January, 1980, to June, 1989, to 35% (8 of 23 cases of peritonitis) from July,
      1989, to December, 1991. The mean birth weight of 11 infants with fungal
      peritonitis (946 +/- 70 g) (mean +/- SE) was significantly less (P = 0.008) than
      that of 57 infants with bacterial peritonitis (1282 +/- 52 g). In a case-control
      study to identify risk factors associated with fungal peritonitis, 11 infants
      with bacterial peritonitis were matched to the 11 infants with fungal peritonitis
      by age at bowel perforation and birth weight. Infants with fungal compared with
      bacterial peritonitis had significantly longer (P < 0.05): median duration of
      umbilical vessel catheterization before bowel perforation, 10 vs. 3 days,
      respectively; median duration of antibiotic therapy before bowel perforation, 23
      vs. 14 days, respectively; and median duration of intubation, 13 vs. 5 days,
      respectively. Other potential risk factors that were not significant in this
      study included duration of central venous catheterization, total parenteral
      nutrition, intravenous lipid administration, aminoglycoside use, dexamethasone
      use or methyl xanthine therapy. In summary fungal peritonitis in neonates with
      necrotizing enteritis was significantly related to extremely low birth weight,
      prolonged umbilical vessel catheterization, prolonged exposure to antibiotics and
      prolonged intubation.

PMID- 8346001
TI  - Inactivation of respiratory syncytial virus by detergents and disinfectants.
AB  - The activity of a number of detergents and disinfectants against respiratory
      syncytial virus (RSV) was evaluated in an in vitro assay system. Equal volumes of
      RSV and serial 10-fold dilutions of the test agents were mixed at 4 degrees C for
      5 minutes. The RSV titer in each mixture was compared with that of untreated RSV
      alone. In 14 experiments with input RSV titers ranging from 2.6 x 10(3) to 2 x
      10(7) plaque-forming units/ml, a 10-fold dilution of 5.25% sodium hypochlorite
      (generic bleach) inactivated (> or = 3-log reduction in titer) the virus. With
      lower RSV titers inactivation was also observed at a 100-fold dilution of bleach.
      Fetal calf serum concentrations up to 50% as an organic load did not diminish the
      bleach effect. The degree of RSV inactivation was also defined for Lysol,
      povidone-iodine, Amphyl, Hibiclens, Osyl, ethanol and Listermint. The short
      contact time, the reproducible nature of the findings and the continued
      effectiveness with increasing organic loads all suggest that detergents and
      disinfectants can potentially play an important role in decreasing the spread of
      RSV infection.

PMID- 8346000
TI  - Cimetidine as an immunomodulator in subacute sclerosing panencephalitis: a double
      blind, placebo-controlled study.
AB  - Cimetidine, an H2 histamine receptor antagonist, was used in subacute sclerosing
      panencephalitis patients for its immunomodulatory effect. Patients were randomly
      assigned to cimetidine (n = 7) and placebo (n = 7) groups. Neurologic disability
      index, lymphocyte functions, cerebrospinal fluid measles antibodies and IgG index
      were evaluated before and after 2 months of treatment. The neurologic disability
      index of the cimetidine group remained stable during the study period whereas the
      placebo group worsened. There were no differences in the immunologic test
      results, cerebrospinal fluid measles antibody titers and IgG index of the two
      groups. This study suggests that cimetidine may have a favorable effect on the
      clinical progression of subacute sclerosing panencephalitis. Further studies are
      required to investigate its mechanism of action and the associated changes in
      immune status.

PMID- 8346002
TI  - Microalbuminuria: an index of severity in childhood meningitis.
AB  - Urinary albumin excretion (AE) was determined by a sensitive method (below
      dipstick positive values, 15 to 300 micrograms/minute) in 68 children with
      meningitis during 48 hours after hospital admission; 51 children had bacterial
      meningitis (BM) and 17 had aseptic meningitis. AE (results as mean +/- SD) during
      0 to 24 hours was higher (P < 0.001) in patients with BM (36 +/- 40
      micrograms/minute) than with aseptic meningitis (7 +/- 5 micrograms/minute),
      albeit no cutoff value distinguished the two conditions accurately. In BM the
      clinical course (uneventful, intermediate, complicated, fatal) correlated with AE
      of 0 to 24 hours (r = 0.34, P < 0.05) and AE of 25 to 48 hours (r = 0.63, P <
      0.001). Cerebrospinal fluid protein concentration 24 to 36 hours after initiation
      of treatment correlated with AE of 25 to 48 hours (r = 0.34, P < 0.05). An index
      obtained by dividing AE by the weight of the child predicted the severity of
      clinical course more precisely (77% sensitivity, 85% specificity) than AE alone.
      Hence renal AE is an easily and non-invasively determined acute phase reactant of
      potential value as an early estimate of severity of BM.

PMID- 8346003
TI  - Carriage of Haemophilus influenzae type b in children after widespread
      vaccination with conjugate Haemophilus influenzae type b vaccines.
AB  - Rates of invasive Haemophilus influenzae type b (Hib) disease in children
      decreased very rapidly after licensure of Hib conjugate vaccines. A role for a
      vaccine-related reduction in nasopharyngeal carriage of Hib has been suggested.
      We studied oropharyngeal carriage of Hib and vaccination rates in a population of
      2- to 5-year-old children in metropolitan Atlanta. Among 584 children 75% were
      vaccinated with an Hib conjugate vaccine, 17% had not been vaccinated and 8% had
      no vaccination records available. Forty-one percent of the children were
      colonized with H. influenzae. One child was colonized with Hib. Hib carriage
      (0.17%; upper 95% confidence interval boundary, 0.97%) was substantially lower
      than the estimates of Hib carriage from prior studies of children who had not
      received Hib conjugate vaccines. Our data are consistent with a decline in Hib
      carriage induced by widespread use of conjugate Hib vaccines, which may have
      contributed to the decline of Hib disease in United States children.

PMID- 8346004
TI  - Vaccination with Haemophilus influenzae type b meningococcal protein conjugate
      vaccine reduces oropharyngeal carriage of Haemophilus influenzae type b among
      American Indian children.
AB  - The effect of Haemophilus influenzae type b (Hib) meningococcal protein conjugate
      vaccine (Hib-OMPC; Merck, Sharp & Dohme) on oropharyngeal (OP) carriage of Hib
      was evaluated in Navajo and Apache Indian children, who are known to be at high
      risk for invasive Hib disease. We obtained 1423 OP swabs at well child visits
      from 1321 children 3 months to 4 years of age: 293 of the swabs were obtained
      from children before the administration of any Hib-OMPC; 1119 were taken after
      the primary vaccination series; and 11 after the booster dose. Swabs were tested
      for the presence of Hib capsular polysaccharide antigen by enzyme-linked
      immunosorbent assay. Forty of 1423 swabs were positive for Hib. Among the 40
      positive swabs 5 (13%) were obtained from children who had received Hib-OMPC
      vaccine appropriate for age at swabbing, compared with 500 of 1383 (36%) of
      negative swabs. Children who were OP carriers of Hib were older than noncarriers
      (mean age, 13 and 9 months, respectively) and a greater proportion of carriers
      (48%) had symptoms of respiratory infection at the time of swabbing than
      noncarriers (30%). These variables were significantly related to increased risk
      of OP carriage of Hib when incorporated jointly in a logistic regression model:
      not vaccinated according to age (odds ratio 2.7, 95% confidence interval 1.00 to
      7.05); increase of age in months (odds ratio 1.1, 95% confidence interval 1.02
      1.10); and respiratory infection symptoms present (odds ratio 2.0, 95% confidence
      interval 1.06-3.77). Thus besides preventing invasive Hib disease, appropriate
      vaccination with Hib-OMPC appears to reduce OP carriage of Hib.

PMID- 8346006
TI  - Antibacterial activity of garlic and onions: a historical perspective.

PMID- 8346005
TI  - Trivalent cold recombinant influenza live vaccine in institutionalized children
      with bronchial asthma and patients with psychomotor retardation.
AB  - Twenty asthmatic children and 48 patients with severe psychomotor retardation
      were inoculated intranasally with trivalent cold-adapted recombinant (CR)
      influenza vaccine containing CR-125 (H1N1), CR-159 (H3N2) and CRB-117 (B). The
      vaccinees were mostly seropositive. Severe adverse reactions or asthmatic attacks
      were not observed, but 7 (15%) of 48 vaccinees with severe psychomotor
      retardation developed mild to moderate fever. Significant antibody responses in
      hemagglutination-inhibition tests were demonstrated in 33 (49%) vaccinees to CR
      125, 20 (29%) to CR-159 and 8 (12%) to CRB-117. Two nosocomial outbreaks of
      influenza were observed in the subsequent winter. During an outbreak with H3N2 in
      one ward of severe psychomotor retardation patients, 2 (11%) of 18 vaccinees
      became infected compared with 10 (48%) of 21 placebo controls in the same ward (P
      < 0.05). In the other outbreak, with influenza B virus, 2 (14%) of 14 vaccinees
      and 13 (52%) of 25 controls in the ward for asthmatic children were infected (P <
      0.05). The results indicate that trivalent CR vaccine is safe and effective
      against nosocomial outbreaks of influenza.

PMID- 8346007
TI  - False positive latex agglutination test in cerebrospinal fluid after immunization
      for Haemophilus influenzae type b.

PMID- 8346008
TI  - Mycobacterium avium complex parotid lymphadenitis: successful therapy with
      clarithromycin and ethambutol.

PMID- 8346009
TI  - Mycobacterium chelonae causing recurrent neck abscess.

PMID- 8346010
TI  - Acute supraglottitis caused by varicella.

PMID- 8346011
TI  - Hepatitis B virus infection in children with cancer.

PMID- 8346013
TI  - Tuberculin skin tests: why the Mantoux?

PMID- 8346012
TI  - Cost of congenital syphilis.

PMID- 8346014
TI  - A role in DNA binding for the linker sequences of the first three zinc fingers of
      TFIIIA.
AB  - Zinc fingers of the TFIIIA type are connected by short linker sequences between
      the structural units. Structural investigations by 2D NMR in solution and by X
      ray crystallographic analyses of complexes with DNA point to a passive role for
      the linkers. We have therefore investigated the influence of the linker sequence
      on DNA binding using as a model the first three fingers of the protein TFIIIA.
      Insertion of certain heterologous linkers abolishes binding, and replacement of
      individual amino acids can reduce binding by factors of up to twenty-four.

PMID- 8346015
TI  - Cytoskeletal reorganization and TPA differently modify AP-1 to induce the
      urokinase-type plasminogen activator gene in LLC-PK1 cells.
AB  - Urokinase-type plasminogen activator (uPA) is an extracellular protease and
      expressed in various cells that exhibit dynamic changes in cell morphology,
      suggesting a link between cytoskeletal reorganization (CSR) and uPA expression.
      CSR can be induced by pharmacological agents, such as by colchicine for
      microtubule cytoskeleton and by cytochalasin for microfilament cytoskeleton.
      Using these agents, we previously showed that CSR induced the uPA gene in LLC-PK1
      cells independently of the protein kinase C and cAMP-dependent protein kinase.
      Here we show that the induction of the uPA gene by CSR is mediated by the
      activation of c-Jun which interacts with an AP-1-like site located 2 kb upstream
      of the uPA gene. 12-O-tetradecanoylphorbol 13-acetate (TPA) induces the uPA gene
      through the same elements, but additionally utilizes an adjacent PEA3 element and
      induces c-fos. Furthermore, CSR induces a greater accumulation and a more
      pronounced phosphorylation of c-Jun than TPA induction. AP-1 is a positive
      regulator of growth and oncogenesis, and CSR is an integral part of these
      processes. Our results provide a view how CSR and AP-1 could be coupled in these
      processes. We also show that TPA and CSR act synergistically, suggesting a model
      where an initial activation signal could be amplified by CSR.

PMID- 8346016
TI  - Identification of amino acids in HIV-2 integrase involved in site-specific
      hydrolysis and alcoholysis of viral DNA termini.
AB  - The human immunodeficiency virus integrase (HIV IN) protein cleaves two
      nucleotides off the 3' end of viral DNA and subsequently integrates the viral DNA
      into target DNA. IN exposes a specific phosphodiester bond near the viral DNA end
      to nucleophilic attack by water or other nucleophiles, such as glycerol or the 3'
      hydroxyl group of the viral DNA molecule itself. Wild-type IN has a preference
      for water as the nucleophile; we here describe a class of IN mutants that
      preferentially use the 3' hydroxyl group of viral DNA as nucleophile. The amino
      acids that are altered in this class of mutants map near the putative active-site
      residues Asp-116 and Glu-152. These results support a model in which multiple
      amino acid side-chains are involved in presentation of the (soluble) nucleophile.
      IN is probably active as an oligomeric complex, in which the subunits have non
      equivalent roles; we here report that nucleophile selection is determined by the
      subunit that supplies the active site.

PMID- 8346017
TI  - Genome sequencing on both strands: the Janus strategy.
AB  - The design of large scale DNA sequencing projects such as genome analysis demands
      a new approach to sequencing strategy, since neither a purely random nor a purely
      directed method is satisfactory. We have developed a strategy that combines these
      two methods in a way that preserves the advantages of both while avoiding their
      particular limitations. Computer simulations showed that a specific balance of
      random and directed sequencing was required for the most efficient strategy,
      termed the Janus strategy, which has been used in the Escherichia coli genome
      sequencing project. This approach depended on obtaining sequence easily from
      either strand of a cloned insert, and was facilitated by inversion of the insert
      in the engineered M13 vector Janus, by site-specific recombination. The inversion
      was accomplished simply by growth on the appropriate host strain, when the DNA
      strand incorporated into the new single stranded phage was complementary to that
      in the original phage, and was sequenced by the same simple protocol as the first
      strand.

PMID- 8346018
TI  - Analysis of the Escherichia coli genome. III. DNA sequence of the region from
      87.2 to 89.2 minutes.
AB  - The DNA sequence of 96.5 kilobases of the Escherichia coli K-12 genome has been
      determined, spanning the region between rrnA at 87.2 minutes and katG at 89.2
      minutes on the genetic map. The sequence includes 84 open reading frames, of
      which 46 code for unidentified proteins. Six previously mapped but unsequenced
      genes have been identified in this span: mob, fdhD, rhaD, rhaA, rhaB, and kdgT.
      In addition, five new genes have been assigned: the heat shock genes hsIU and
      hsIV, and the genes fdoG, fdoH, and fdoI, which encode the three subunits of
      formate dehydrogenase-O. The arrangement of the genes relative to possible
      promoters and terminators suggests 57 potential transcription units. Other
      features include the precise location of the bacteriophage P2 attachment site
      attP2II, and eleven REP elements, including one containing 9 REP sequences--one
      of the largest such elements known. This segment brings the total length of
      contiguous finished sequence to 325 kilobases.

PMID- 8346019
TI  - Purification of a HeLa cell nuclear protein that binds selectively to DNA
      irradiated with ultra-violet light.
AB  - Ultraviolet (UV) light induces a variety of lesions in DNA of which the
      pyrimidine dimer represents the major species. Pyrimidine dimers exist as both a
      cyclobutane type and a 6-4' (pyrimidine-2'-one) photoproduct. We have purified a
      protein of M(r) approximately 125,000 from HeLa cell nuclei which binds
      efficiently to double-stranded DNA irradiated with UV light but not to undamaged
      DNA. This protein was designated UVBP1 (UV damage binding protein 1). UVBP1 did
      not recognise DNA damaged by cisplatin. Using oligonucleotides with a single
      dipyrimidine site for induction of UV photoproducts, binding of UVBP1 to a TC
      containing substrate was shown to be more efficient than to substrates containing
      a TT, a CT or a CC pair. This binding specificity implies selective recognition
      of the 6-4' photoproduct. Further evidence for this was provided by the finding
      that hot alkali treatment of the substrate (which selectively hydrolyses 6-4'
      photoproducts) abrogated binding of UVBP1, whereas incubation with DNA photolyase
      to remove cyclobutane dimers did not. No detectable DNA helicase, ATPase or
      exonuclease activity was associated with the purified protein. We suggest that
      UVBP1 may be involved in the lesion recognition step of DNA excision repair and
      could contribute to the preferential repair of 6-4' photoproducts from the DNA of
      UV-irradiated mammalian cells.

PMID- 8346021
TI  - Direct selection of DNA sequences conserved between species.
AB  - An essential requirement in the analysis of genomes is the identification of
      functionally important sequence elements, which are often evolutionarily
      conserved. We describe here the development of a novel procedure for the
      selective isolation of conserved sequences which is based on hybridization of PCR
      amplifiable DNA fragments from the whole genome of one species to biotinylated
      DNA from a genomic region of another species. The interspecies DNA hybrids are
      immobilized and the PCR-amplifiable DNA fragments are eluted, amplified and after
      further hybridization-amplification rounds cloned. This method was used for the
      generation of sublibraries of conserved sequences from mouse and pig DNA from
      regions corresponding to cosmids from the human Xq28 region. Mouse and pig
      homologs of sequences containing exons of known human genes, as well as exons
      from novel genes have been identified.

PMID- 8346020
TI  - The Kluyveromyces gene encoding the general transcription factor IIB: structural
      analysis and expression in Saccharomyces cerevisiae.
AB  - The Kluyveromyces lactis gene encoding the general transcription factor IIB
      (TFIIB) was isolated from a genomic library by complementation of the cold
      sensitive phenotype conferred by a mutation in the SUA7 gene, which encodes TFIIB
      in Saccharomyces cerevisiae. DNA sequence analysis of the KI-SUA7 gene revealed a
      357 amino acid open reading frame that is 67% identical (81% overall similarity)
      to S. cerevisiae TFIIB. Comparison with other eukaryotic TFIIBs indicated that
      the most highly conserved sequence is located adjacent to the Zn-finger motif
      near the N-terminus. A plasmid shuffle system was used to replace the essential
      Sc-SUA7 gene with KI-SUA7 in S.cerevisiae. The resulting strain was viable and
      phenotypically indistinguishable from the normal strain. However, transcription
      start site selection at the ADH1 locus, shown previously to be affected by
      mutations in Sc-SUA7, was affected by K.lactis TFIIB. This result provides
      further evidence that TFIIB is a principal determinant of start site selection in
      yeast.

PMID- 8346022
TI  - Solution structure of a DNA-binding domain from HMG1.
AB  - We have determined the tertiary structure of box 2 from hamster HMG1 using
      bacterial expression and 3D NMR. The all alpha-helical fold is in the form of a V
      shaped arrowhead with helices along two edges and one rather flat face. This
      architecture is not related to any of the known DNA binding motifs. Inspection of
      the fold shows that the majority of conserved residue positions in the HMG box
      family are those involved in maintaining the tertiary structure and thus all
      homologous HMG boxes probably have essentially the same fold. Knowledge of the
      tertiary structure permits an interpretation of the mutations in HMG boxes known
      to abrogate DNA binding and suggests a mode of interaction with bent and 4-way
      junction DNA.

PMID- 8346023
TI  - Uracil-DNA glycosylase as a probe for protein--DNA interactions.
AB  - The DNA repair enzyme Uracil-DNA Glycosylase (UDG) can be used to investigate
      three different features of protein-DNA interactions. Complexes can be probed by
      simple protection experiments ('footprinting') or by two kinds of interference
      assays: a missing thymine site (MT-site) experiment and a missing thymine methyl
      site (MTM-site) experiment. The three probing methods are assessed using the well
      characterized in vitro systems of lambda repressor and lac repressor binding to
      their respective operator sites. The results obtained with UDG probing agree well
      with previous probing experiments on the same systems and, in certain cases,
      extend previous interpretations: for example, comparison of the results obtained
      with the two interference assays shows that formation of the lac repressor
      operator complex requires interactions with the methyl group of one particular
      thymine residue (T-13) in the operator but also requires interactions with other
      parts of the thymine base at operator positions 7, 8, 9, 21, 23 and 24. Overall,
      the properties of UDG recommend it as a versatile and convenient method to
      investigate DNA-protein interactions both in vitro and possibly in vivo.

PMID- 8346024
TI  - Microtiter format gene quantification by covalent capture of competitive PCR
      products: application to HIV-1 detection.
AB  - We have developed a simple gene quantification system using the competitive
      polymerase chain reaction (CPCR) followed by microtiter format analysis. CPCR is
      carried out using a mutant competitor with the same size as the target DNA
      product, and a minimal base exchange to insure the same amplification kinetics.
      One primer is aminated at the 5' end to produce PCR products that are captured
      onto carboxylated wells of microtiter plates through peptide bond formation. The
      non-aminated DNA strands are stripped off from the wells by alkali washing, and
      the remaining aminated strands are hybridized with either a digoxigenin-labeled
      wild type-specific oligonucleotide probe or a competitor-specific probe. To
      standardize the hybridization conditions of the probes, a DNA construct
      containing wild type and mutant competitor sequences in tandem is captured at
      different concentrations, hybridized with the probes, and used to generate a
      standard curve. Bound probes are detected by anti-digoxigenin antibody conjugated
      with peroxidase and chromogen. Optical densities are recorded with a conventional
      microtiter plate reader and converted to concentrations according to the standard
      curves. The ratios of wild type DNA to mutant competitor are used to determine
      the initial amounts of wild type DNA in the samples. This method was used
      successfully to quantify human immunodeficiency virus type 1 (HIV-1) env gene in
      human lymphocytes. It only requires a thermal cycler and a conventional
      microtiter plate reader, and can be readily done on a large scale. Potential
      applications include detection of other pathogens, diagnosis of genetic disorders
      and studies of gene expression.

PMID- 8346025
TI  - MGM101, a nuclear gene involved in maintenance of the mitochondrial genome in
      Saccharomyces cerevisiae.
AB  - A nuclear mutation, mgm101, results in temperature sensitive loss of
      mitochondrial DNA (mtDNA) in the yeast Saccharomyces cerevisiae. The
      corresponding gene, MGM101, was isolated from a genomic DNA library by
      complementation. Sequence analysis shows that MGM101 encodes a positively charged
      protein of 269 amino acids with a calculated molecular weight of 30 kDa. This
      analysis also reveals that MGM101 is adjacent to the ribosomal protein gene RPS7A
      on chromosome X and hybridization indicates it occurs in single copy. Creation of
      a null mutant by targeted disruption showed that the gene has no essential
      cellular function, aside from its participation in mitochondrial genome
      maintenance. As no counterpart has been identified in databases it is a novel
      protein whose role has yet to be determined. Expression of MGM101 is low on
      glucose medium but on galactose there is a two-fold increase in the level of the
      transcript.

PMID- 8346026
TI  - The ets multigene family is conserved throughout the Metazoa.
AB  - This study provides the first empirical evidence for the conservation of the ets
      proto-oncogene transcription factor family throughout the Metazoa. Using the
      polymerase chain reaction with degenerate primers corresponding to conserved
      sequences within the ETS DNA-binding domain, we have detected ets genes in a
      range of lower metazoans, including sponges, ctenophores, anemones, flatworms and
      nematodes, and in several higher invertebrate metazoans. Many of these sequences
      are significantly divergent from the original v-ets-1 oncogene, although most can
      be aligned with recently defined groups within the ets gene family. Multiple ETS
      domain sequences were detected in a number of the lower metazoan species,
      providing evidence for the existence of an ets multigene family at the earliest
      stages of metazoan evolution. In contrast, we were unable to detect any ETS
      sequences in fungal, plant or several protozoan DNAs. Our findings suggest that
      the duplication and divergence of ets proto-oncogenes responsible for generating
      the multigene family occurred concomitantly with the development of metazoan
      animals. In addition, these data corroborate other recent molecular evidence in
      providing strong support for the monophyletic origin of all multicellular
      animals, including sponges.

PMID- 8346027
TI  - Synthesis and properties of oligodeoxynucleotides containing the analogue 2'
      deoxy-4'-thiothymidine.
AB  - The 2'-deoxythymidine analogue 2'-deoxy-4'-thiothymidine has been incorporated,
      using standard methodology, into a series of dodecadeoxynucleotides containing
      the EcoRV restriction endonuclease recognition site (GATATC). The stability of
      these oligodeoxynucleotides and their ability to act as substrates for the
      restriction endonuclease and associated methylase have been compared with a
      normal unmodified oligodeoxynucleotide. No problems were encountered in the
      synthesis despite the presence of a potentially oxidisable sulfur atom in the
      sugar ring. The analogue had very little effect on the melting temperature of the
      self-complementary oligoeoxynucleotides so synthesised and all had a CD spectrum
      compatible with a B-DNA structure. The oligodeoxynucleotide containing one
      analogue in each strand within the recognition site, adjacent to the bond to be
      cleaved (i.e. GAXATC, where X is 2'-deoxy-4'-thiothymidine), was neither a
      substrate for the endonuclease nor was recognized by the associated methylase.
      When still within the recognition hexanucleotide but two further residues removed
      from the site of cleavage (i.e. GATAXC), the oligodeoxynucleotide was a poor
      substrate for both the endonuclease and methylase. Binding of the
      oligodeoxynucleotide to the endonuclease was unaffected but the kcat value was
      only 0.03% of the value obtained for the parent oligodeoxynucleotide. These
      results show that the incorporation of 2'-deoxy-4'-thionucleosides into synthetic
      oligodeoxynucleotides may shed light on subtle interactions between proteins and
      their normal substrates and may also show why 2'-deoxy-4'-thiothymidine itself is
      so toxic in cell culture.

PMID- 8346028
TI  - The application of the AMB protective group in the solid-phase synthesis of
      methylphosphonate DNA analogues.
AB  - Partially methylphosphonate-modified oligodeoxynucleotides were synthesized on
      solid-phase by employing the easily removable 2-(acetoxymethyl)benzoyl (AMB)
      group as base-protecting group. Although a rapid AMB deprotection can be
      accomplished in methanolic potassium carbonate, the lability of the
      methylphosphonate linkage towards potassium carbonate/methanol excludes the use
      of this deprotection reagent. Thus, saturated ammonia solution in methanol was
      investigated as an alternative reagent for AMB removal. It is demonstrated that
      the combination of the AMB protective group and ammonia/methanol as deprotection
      reagent significantly improves the synthesis of methylphosphonate-modified DNA
      fragments. A mild overnight treatment at room temperature is sufficient for
      complete removal of the AMB group, whereas deprotection of conventionally
      protected oligonucleotides requires much longer exposure to basic conditions at
      elevated temperatures.

PMID- 8346029
TI  - Human snRNP polypeptide D1 promotes pre-mRNA splicing in yeast and defines
      nonessential yeast Smd1p sequences.
AB  - Parallel investigations of yeast and metazoan pre-mRNA splicing have documented
      enormous complexity in the nucleic acid and protein components of the cellular
      splicing apparatus, the spliceosome. The degree to which yeast and metazoan
      spliceosomal proteins differ in composition and structure is currently unknown.
      In this report we demonstrate that the human small nuclear ribonucleoprotein
      (snRNP) polypeptide D1 complements the cell lethality, splicing deficiency, and
      snRNA instability phenotypes associated with a yeast smd1 null allele. Mutational
      analysis of yeast SMD1, guided by a comparison of the predicted yeast and human
      proteins, reveals that a large, nonconserved portion of Smd1p is dispensable for
      biological activity. These observations firmly establish D1 as an essential
      component of the cellular splicing apparatus and suggest that yeast and metazoa
      are remarkably similar in the polypeptides guiding early snRNP assembly.

PMID- 8346030
TI  - Characterization of a DNA binding domain in the C-terminus of HIV-1 integrase by
      deletion mutagenesis.
AB  - The integrase (IN) protein of human immunodeficiency virus type 1 (HIV-1)
      catalyzes site-specific cleavage of 2 bases from the viral long terminal repeat
      (LTR) sequence yet it binds DNA with little DNA sequence specificity. We have
      previously demonstrated that the C-terminal half of IN (amino acids 154-288)
      possesses a DNA binding domain. In order to further characterize this region, a
      series of clones expressing truncated forms of IN as N-terminal fusion proteins
      in E.coli were constructed and analyzed by Southwestern blotting. Proteins
      containing amino acids 1-263, 1-248 and 170-288 retained the ability to bind DNA,
      whereas a protein containing amino acids 1-180 showed no detectable DNA binding.
      This defines a DNA binding domain contained within amino acids 180-248. This
      region contains an arrangement of 9 lysine and arginine residues each separated
      by 2-4 amino acids (KxxxKxxxKxxxxRxxxRxxRxxxxKxxxKxxxK), spanning amino acids 211
      244, which is conserved in all HIV-1 isolates. A clone expressing full-length IN
      with a C-terminal fusion of 16 amino acids was able to bind DNA comparably to a
      cloned protein with a free C-terminus, and an IN-specific monoclonal antibody
      which recognizes an epitope contained within amino acids 264-279 was unable to
      block DNA binding, supporting the evidence that a region necessary for binding
      lies upstream of amino acid 264.

PMID- 8346031
TI  - Complete sequence of Euglena gracilis chloroplast DNA.
AB  - We report the complete DNA sequence of the Euglena gracilis, Pringsheim strain Z
      chloroplast genome. This circular DNA is 143,170 bp, counting only one copy of a
      54 bp tandem repeat sequence that is present in variable copy number within a
      single culture. The overall organization of the genome involves a tandem array of
      three complete and one partial ribosomal RNA operons, and a large single copy
      region. There are genes for the 16S, 5S, and 23S rRNAs of the 70S chloroplast
      ribosomes, 27 different tRNA species, 21 ribosomal proteins plus the gene for
      elongation factor EF-Tu, three RNA polymerase subunits, and 27 known
      photosynthesis-related polypeptides. Several putative genes of unknown function
      have also been identified, including five within large introns, and five with
      amino acid sequence similarity to genes in other organisms. This genome contains
      at least 149 introns. There are 72 individual group II introns, 46 individual
      group III introns, 10 group II introns and 18 group III introns that are
      components of twintrons (introns-within-introns), and three additional introns
      suspected to be twintrons composed of multiple group II and/or group III introns,
      but not yet characterized. At least 54,804 bp, or 38.3% of the total DNA content
      is represented by introns.

PMID- 8346032
TI  - Regulation of tissue-specific expression of the esterase S gene in Drosophila
      virilis.
AB  - The esterase S gene (estS) of Drosophila virilis is specifically expressed in the
      ejaculatory bulbs of males. Its sequencing shows similarities between estS
      product and other esterases of different origin. The transcription of estS in
      ejaculatory bulbs is at least 2 orders of magnitude higher than in other tissues
      of males. Two promoters, P1 (distal) and P2 (proximal), and two different
      transcripts were identified. The promoter P2 is used much more efficiently, and
      in a stringent, tissue-specific manner. The transcription from P1 takes place in
      different tissues and stages of development of D. virilis. However, the mRNA
      transcribed from P1 seems to be inactive in translation as there are three open
      reading frames (ORF) between P1 and P2, which may block the translation in P1
      initiated mRNA. Insertion of sequence containing the three ORFs into the 5'
      untranslated region of the CAT gene strongly inhibited expression of CAT. Point
      mutations destroying the three ORFs completely eliminate the inhibitory effect.
      Hence tissue-specific expression of the estS gene may depend on control at the
      level of transcription, promoter selection and translation.

PMID- 8346033
TI  - Electroporation enhances c-myc antisense oligodeoxynucleotide efficacy.
AB  - Obtaining high transfection efficiencies and achieving appropriate intracellular
      concentrations and localization are two of the most important barriers to the
      implementation of gene targeted therapy. The efficiency of endogenous uptake of
      oligodeoxynucleotides (ODNs) varies from cell type to cell type and may be a
      limiting factor of antisense efficacy. The use of electroporation to obtain high
      intracellular concentrations of a synthetic ODN in essentially 100% of viable
      cells is described. It is also shown that the transfected ODNs initially localize
      to the nucleus and remain there for at least 48 hours. The cellular trafficking
      of electroporated ODNs is shown to be an energy dependent process. Targeting of
      the c-myc proto-oncogene of U937 cells by electroporation of phosphorothioate
      modified ODNs results in rapid and specific suppression of this gene at ODN
      concentrations much lower than would otherwise be required. This technique
      appears to be applicable to a variety of cell types and may represent a powerful
      new investigate tool as well as a promising approach to the ex vivo treatment of
      hematologic disorders.

PMID- 8346034
TI  - Pw Sox-1: the first member of the Sox gene family in Urodeles.

PMID- 8346035
TI  - Identification of a Candida utilis gene encoding ribosomal protein L7: evidence
      for two divergent subclasses of the eukaryotic ribosomal protein L7 family.

PMID- 8346036
TI  - Cloning and sequencing of the gene encoding the ribosomal L7/L12-like protein of
      Mycobacterium bovis BCG.

PMID- 8346037
TI  - Coding sequence of ERF-1, the human homologue of Tis11b/cMG1, members of the
      Tis11 family of early response genes.

PMID- 8346038
TI  - Nucleotide sequence of the mini-plasmid pSLG33 from Streptomyces lavendulae
      grasserius RIA746.

PMID- 8346039
TI  - The 18S ribosomal RNA gene of a crustacean branchiopod Bosmina longirostris:
      comparison with another branchiopod Artemia salina.

PMID- 8346040
TI  - Cloning of a human GHF-1/Pit-1 cDNA variant.

PMID- 8346041
TI  - BseRI a novel restriction endonuclease from a Bacillus species which recognizes
      the sequence 5'...GAGGAG...3'.

PMID- 8346042
TI  - Cloning and analysis of the macronuclear gene for histone H1 from Euplotes
      eurystomus.

PMID- 8346043
TI  - Nucleotide sequences and secondary structures of four tRNA genes in mitochondrial
      DNA of Hansenula wingei yeast.

PMID- 8346044
TI  - Chemical Cleveland mapping: a rapid technique for characterization of crosslinked
      nucleic acid-protein complexes.

PMID- 8346045
TI  - Polymerase-chain reaction: analysis of DNA/DNA hybridization by capillary
      electrophoresis.

PMID- 8346046
TI  - Determination of messenger RNA 5'-ends by reverse transcription of the cap
      structure.

PMID- 8346047
TI  - Rapid cloning by homologous recombination in vivo.

PMID- 8346048
TI  - DISEC-TRISEC: di- and trinucleotide-sticky-end cloning of PCR-amplified DNA.

PMID- 8346049
TI  - Collaborative interdisciplinary bioethical decision making in intensive care
      units.
AB  - There is strong support in the literature for involvement of nurses with patients
      and physicians in bioethical decision making about patient care. There are
      indications that nurses and physicians have different beliefs about decisions
      made and about the decision-making processes, such as who should be involved and
      what factors should influence such decisions. The literature also demonstrates
      that nurses often disagree with physicians or are not involved in ethical
      decision making or both. Interdisciplinary collaboration has been proposed to
      improve decision making and recommended for health care giving generally. There
      is research support for the benefit of collaboration in care giving. Ethical
      principles also support collaborative decision making, involving nurses, as well
      as physicians, patients, and family. With collaboration there is sharing of
      information and perspectives, respect for patient and family autonomy, and
      disclosure. More studies of interdisciplinary bioethical decision making are
      needed, measuring both professions' perceptions of their roles in ethical
      decision making, as well as examining the effects of collaboration on care
      outcomes.

PMID- 8346050
TI  - The 'doctor-nurse game': a comparison of 100 years--1888-1990.

PMID- 8346051
TI  - The passionate connection: feminism invigorates the teaching of nursing.

PMID- 8346052
TI  - 'Unknowing': toward another pattern of knowing in nursing.
AB  - Knowing is wonderful, but it is just a guiding means. Unknowing is a condition of
      openness. This unknowing in the intersubjective space of two people or people of
      two cultures allows others to be. This art of unknowing may enable a nurse to
      understand, with empathy, the actual essence of the meaning an experience has for
      a patient. This pattern of unknowing focused herein on the intersubjective whole
      between patient and nurse is applicable as well to learning in a more formal
      sense. To be open to learning one needs to posture oneself in a position of
      unknowing to hear a colleague, a teacher, a student. To provide and find openness
      is to be able to say, "I never thought about it that way," and at once experience
      the wonderment of coming upon an "unknown."

PMID- 8346053
TI  - Problems and progress as Australia adopts the bachelor's degree as the only entry
      to nursing practice.

PMID- 8346054
TI  - Castles in the air. Interview by Andrew Cole.

PMID- 8346055
TI  - Alternative approach. Interview by Tricia Reid.

PMID- 8346056
TI  - Off target.

PMID- 8346057
TI  - School for scandal?

PMID- 8346058
TI  - Generic nurse. A dream ticket?

PMID- 8346060
TI  - Targets go up in smoke.

PMID- 8346059
TI  - Generic nurse. Breaking the mould.

PMID- 8346061
TI  - Generic nurse. A dilution of skills.

PMID- 8346062
TI  - Health promotion. Education on the rocks.

PMID- 8346063
TI  - Transplants. Given the choice.

PMID- 8346064
TI  - Professional development. A guiding light.

PMID- 8346065
TI  - Bedside manners.

PMID- 8346066
TI  - Stress. Taking control.

PMID- 8346067
TI  - Helpline will urge HIV nurses to keep quiet.

PMID- 8346068
TI  - Here comes the sun.

PMID- 8346069
TI  - Starting from scratch.

PMID- 8346070
TI  - Creche course in hygiene.

PMID- 8346071
TI  - Help from EPI info.

PMID- 8346072
TI  - RRR-alpha-tocopheryl succinate inhibits proliferation and enhances secretion of
      transforming growth factor-beta (TGF-beta) by human breast cancer cells.
AB  - The RRR-alpha-tocopheryl succinate form of vitamin E inhibits the proliferation
      of estrogen receptor-positive and estrogen receptor-negative human breast cancer
      cell lines in a dose-dependent manner in vitro. Analyses of cell-conditioned
      medium from RRR-alpha-tocopheryl succinate growth-inhibited cells revealed the
      presence of a potent antiproliferative activity. Characterization of the
      antiproliferative activity as transforming growth factor-beta (TGF-beta) was
      established by 1) growth inhibition of the TGF-beta-responsive Mv1Lu-CCL-64 mink
      lung and murine CTLL-2 cell lines, 2) combination of physical characteristics
      including heat stability, acid stability, and Bio-Gel P-60 column chromatography
      elution profile, and 3) neutralization of the antiproliferative activity in the
      conditioned media by antibodies specific for TGF-beta.

PMID- 8346073
TI  - RRR-alpha-tocopheryl succinate inhibition of lectin-induced T cell proliferation.
AB  - The effect of RRR-alpha-tocopheryl succinate (VES) on lectin-induced chicken T
      cell proliferation was investigated. The T cell mitogens concanavalin A and
      phytohemagglutinin induce chicken thymic and splenic T cell proliferation.
      Addition of VES to the in vitro cultures inhibited T cell proliferation in a dose
      dependent manner. Addition of VES to spleen cell cultures at different times
      after mitogen stimulation also suppressed T cell mitogenesis, suggesting that VES
      is not mediating its antiproliferative effects by interfering with ligand
      (mitogen)-receptor binding or early ligand-bound receptor-signaling events. Three
      lines of evidence suggest that the growth-inhibitory properties of VES are unique
      and may not involve antioxidant properties. 1) Three other forms of vitamin E, dl
      alpha-tocopherol, d-alpha-tocopherol, and d-alpha-tocopherol acetate, do not
      inhibit the proliferation of mitogen-stimulated chicken spleen cells. 2) Spleen
      cells were treated with an inhibitor of nonspecific esterases to prevent the
      conversion of VES, which does not exhibit antioxidant properties to d-alpha
      tocopherol, a lipid-soluble antioxidant. Treatment of spleen cells with the
      inhibitor did not affect VES's growth-inhibitory properties. 3) Trolox, a water
      soluble vitamin E analogue with potent antioxidant properties and two lipid
      soluble antioxidants, butylated hydroxyanisole and butylated hydroxytoluene, did
      not inhibit mitogen-induced T cell proliferation. Attempts to reverse VES's
      antiproliferative effects by addition of exogenous interleukin-2 or addition of
      sodium selenite, an enhancer of interleukin-2 receptors, failed. Acetylsalicylic
      acid had no effect on VES's inhibition of mitogen-activated T cell proliferation.
      These studies support the role of VES as a growth inhibitor of lectin-activated
      normal T cells in chickens.

PMID- 8346074
TI  - Lack of significant changes in nutrition-related parameters with tumor necrosis
      factor treatment of cancer.
AB  - Cancer and its therapies frequently produce anorexia and cachexia. In this study,
      the acute (3 days) and chronic (4 wks) nutrition-related effects of cancer
      therapy with recombinant human tumor necrosis factor (rHuTNF) were investigated
      and described. Nutritional status, as measured by body weight and body
      composition (body fat and lean-to-fat ratio) with use of bioelectrical impedance,
      did not appear to deteriorate. None of the serum lipids changed significantly,
      but triglycerides did rise modestly over four weeks of therapy. Glucose and the
      peptide hormones (insulin, C-peptide, glucagon, and pancreatic polypeptide)
      thought to affect appetite did not change with rHuTNF therapy. Therefore,
      although TNF is thought to contribute to wasting in animal models, it had no
      negative effect on nutritional status in our small sample. The lack of adverse
      effect noted in this study is possibly due to the low dose level of rHuTNF or to
      adaptation.

PMID- 8346075
TI  - Mitotic activity in colorectal mucosa of healthy subjects in two Italian areas
      with different dietary habits.
AB  - The proliferative activity was evaluated in colorectal biopsies of 39 healthy
      subjects living in two distinct geographical areas, Trieste in northern and
      Florence in central Italy. Subjects living in Trieste had a significantly higher
      mitotic activity compared with subjects living in Florence (mitoses/cells counted
      x 100 were 0.17 +/- 0.04 in Trieste and 0.089 +/- 0.02 in Florence). The results
      of a dietary questionnaire also showed that subjects in Trieste consumed
      significantly fewer starches, fibers, nitrites, and proteins. However, no
      correlation was evident between the consumption of these nutrients and intestinal
      proliferation.

PMID- 8346076
TI  - Studies of immunomodulating actions of carotenoids. II. Astaxanthin enhances in
      vitro antibody production to T-dependent antigens without facilitating polyclonal
      B-cell activation.
AB  - Previously we have shown that astaxanthin, a carotenoid without provitamin A
      activity, enhances in vitro antibody (Ab) production to sheep red blood cells in
      normal B6 mice. In this study, we further attempted to examine the mechanisms of
      this enhancing action of carotenoids on specific Ab production in vitro in
      relation to different antigen (Ag) stimuli, cytokine production, and T- and B
      cell interactions in both normal and autoimmune strains of mice. When the actions
      of carotenoids were tested in normal strains of mice, we found that astaxanthin
      enhanced in vitro Ab production to T cell-dependent Ag, but not to T-independent
      Ag, and did not augment total immunoglobulin production. Astaxanthin exerted
      maximum enhancing actions when it was present at the initial period of Ag
      priming. This action of astaxanthin was abolished when T cells were depleted from
      spleen cell suspensions and appeared to require direct interactions between T and
      B cells. The results also indicated that carotenoids may modulate the production
      of interferon-tau in this assay system. When the actions of carotenoids were
      tested in autoimmune-prone MRL and NZB mice, the enhancing action of astaxanthin
      on in vitro Ab production was less significant. Furthermore, carotenoids did not
      potentiate or augment spontaneous Ab and immunoglobulin production by spleen
      cells in these strains. Taken together, carotenoids without provitamin A activity
      may be able to augment in vitro specific Ab production to T cell-dependent Ag
      partly through affecting the initial stage of Ag presentation without
      facilitating polyclonal B-cell activation or autoantibody production.

PMID- 8346077
TI  - Preparation and production of a cancer chemopreventive agent, Bowman-Birk
      inhibitor concentrate.
AB  - We describe our studies to produce an extract of soybeans with anticarcinogenic
      activity that we believe will be useful as a human cancer chemopreventive agent
      for several different organs. The anticarcinogenic activity of the extract is
      thought to be due to chymotrypsin inhibitor activity, which is due to the Bowman
      Birk protease inhibitor (BBI) present in the extract, termed BBI concentrate
      (BBIC). We describe the contents of BBIC, the ability of BBIC to inhibit
      malignant transformation in vitro in terms of its chymotrypsin inhibitor
      activity, and the results of long-term toxicity studies in which mice and rats
      were exposed to high levels of BBIC for long periods of time.

PMID- 8346078
TI  - Moderate beer consumption and the risk of colorectal cancer.
AB  - The relationship between beer consumption and the risk of colon and rectal cancer
      was considered in a case-control study conducted in northern Italy. The study was
      based on 828 histologically confirmed incident cases of colon cancer, 498 of
      rectal cancer, and 2,024 controls in hospital for a wide spectrum of acute,
      nonneoplastic, nonalcohol-related diseases. Beer drinking was reported by 6% of
      colon cancer cases, 7% of rectal cancer cases, and 10% of controls; regular beer
      drinkers (> or = 1 drinks/day) made up 2.6% of colon cancer cases, 3.2% of rectal
      cancer cases, and 4.1% of controls. Thus the multivariate relative risks (RR) for
      irregular drinkers were 0.6 [95% confidence interval (CI) 0.4-1.0] for colon and
      0.7 (95% CI 0.4-1.2) for rectum. Corresponding values for regular drinkers were
      0.7 (95% CI 0.4-1.2) for colon and 0.9 (95% CI 0.5-1.5) for rectal cancer.
      Despite the low frequency of beer drinking in this study, and hence its limited
      statistical power, the originality of the population in terms of colorectal
      cancer incidence, patterns of risk factor exposure, and the large dataset provide
      interesting and useful confirmation that moderate beer drinking is not associated
      with elevated colon or rectal cancer risk.

PMID- 8346080
TI  - Caraway oil inhibits skin tumors in female BALB/c mice.
AB  - Caraway oil, supplemented in diet or painted on the skin, inhibited 7,12
      dimethylbenz[a]anthracene- (DMBA) and croton oil-induced skin tumors in female
      BALB/c mice. The inhibition was manifested by disappearance of carcinomas,
      reduced incidence and number of papillomas, delay of their appearance,
      retardation of their development, and regression of already established
      papillomas. Caraway oil is more effective when topically applied than when
      supplemented in the diet.

PMID- 8346079
TI  - Dietary fatty acid modulation of events associated with mouse skin tumor
      promotion.
AB  - Increasing levels of dietary corn oil have been correlated with inhibition of 12
      O-tetradecanoylphorbol-13-acetate-(TPA) promoted skin tumorigenesis in mice
      (Leyton et al. Cancer Res. 51, 907-915, 1991). This study was undertaken to
      assess the effects of dietary corn oil on several events associated with tumor
      promotion. Three semipurified diets containing 15% (wt/wt) total fat with
      increasing levels of linoleate (0.8%, 4.5%, and 8.4%) supplied by corn oil were
      fed to mice for at least four weeks. Although incorporation of linoleate into
      epidermal phosphatidylcholine increased with increasing amounts of dietary corn
      oil, the elongated desaturated product of linoleate, arachidonate, was similar or
      decreased slightly in mice fed the three diets. Minimal activity of delta 6
      desaturase, the rate-limiting enzyme in the conversion of linoleate to
      arachidonic acid, was found in the epidermis compared with the liver, suggesting
      that linoleate is not converted to arachidonic acid in the skin. Subcellular
      distribution of protein kinase C was altered in mice fed 0.8% linoleate, where
      69% of protein kinase C activity was in the cytosol compared with 78% and 74% for
      groups fed 4.5% and 8.4% linoleate, respectively. Activation of partially
      purified protein kinase C isolated from mouse epidermis by linoleate was
      significantly lower (p < 0.01) than that isolated by arachidonic acid. TPA
      induced vascular permeability was significantly greater (p < 0.05), whereas
      hyperplasia 48 hours after TPA treatment was significantly lower, in mice fed the
      8.4% linoleate diet. However, TPA induction of ornithine decarboxylase activity
      did not appear to be significantly modified by dietary linoleate. These data
      suggest that cellular processes associated with carcinogenesis are affected by
      the level of dietary linoleate.

PMID- 8346081
TI  - Dietary factors and breast cancer risk in Vaud, Switzerland.
AB  - The relationship between dietary factors and the risk of breast cancer was
      investigated in a case-control study conducted in the Canton of Vaud, Switzerland
      as a pilot phase for a larger cooperative study within the SEARCH Programme of
      the International Agency for Research on Cancer (Lyon, France). A total of 107
      incident, histologically confirmed cases of breast cancer and 318 controls
      admitted to hospital for acute, nonhormone-related, gynecological, metabolic, or
      neoplastic disorders were interviewed. Significant direct trends in risk were
      observed with total energy intake [relative risk (RR) for highest vs. lowest
      intake tertile = 1.9] and, after allowance for energy intake, with frequency of
      consumption of various types of meat (RR = 2.1 for the highest tertile), cheese
      (RR = 2.7), and alcohol (RR = 2.1). Significant protections, on the order of 40
      60% reductions for the highest vs. lowest consumption tertile, were conferred by
      total green vegetable consumption, selected types of vegetables and fruits
      (cucumbers, onions, pears), and a summary index of beta-carotene intake (RR = 0.4
      for highest consumption tertile). Thus the present study confirmed the existence
      of an unfavorable dietary pattern for breast cancer risk (characterized by high
      calorie, selected sources of animal fat and alcohol intake). Moreover, a
      significant protection could be gained by consuming a diet rich in vegetables and
      perhaps fruits.

PMID- 8346082
TI  - Theophylline toxicity in children: a retrospective review.
AB  - Theophylline has been a mainstay of asthma therapy despite its narrow therapeutic
      index, which makes toxicity a common problem. To study toxicity in children, we
      reviewed hospital laboratory records (1980 to 1988) and identified cases (n =
      163) with theophylline concentrations of > 133 mumol/L (24 micrograms/ml). We
      reviewed these cases for symptoms of theophylline intoxication; we were
      interested in associating symptoms with serum drug concentrations and in
      understanding how intoxication occurred. The median patient age was 3.0 years;
      40/163 were younger than one year. Males were 90/163 patients (55%). Patients
      were classified by pattern of ingestion: 20 patients had acute ingestions; 17
      patients had an acute ingestion while on chronic medication; and 126 patients
      became toxic on chronic therapy. Symptoms were absent in 44/150 patients (29%)
      with theophylline concentrations of 139 to 278 mumol/L (25-50 micrograms/ml);
      concentrations of > 278 mumol/L (50 micrograms/ml) were always associated with
      symptoms. The most common clinical symptoms were tachycardia (47%) and vomiting
      (52%); both occurred more frequently with higher theophylline concentrations (P <
      0.002 and P < 0.01). Nine patients had seizures, including five who were
      previously neurologically normal. Seizures developed with a theophylline
      concentration of < 278 mumol/L (50 micrograms/ml) in four of these five patients.
      There was no association between seizures and patient age or between seizures and
      a particular pattern of theophylline use. In 105/126 cases of intoxication
      associated with chronic use, the cause of the intoxication could not be
      determined. Appropriate management of theophylline toxicity can occur only if
      toxicity is recognized.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346083
TI  - General trauma in a pediatric emergency department: spectrum and consultation
      patterns.
AB  - To assess the consultation patterns of pediatric emergency physicians in the
      management of injured children and to describe the spectrum of pediatric trauma,
      we retrospectively reviewed 601 patients treated in the emergency department for
      injuries during four one-week periods at a designated level I regional pediatric
      trauma center (50,000 patients/year) with a pediatric emergency medicine
      fellowship. The majority (94%) of pediatric trauma was minor; only 2% of children
      had injuries severe enough to require direct transfer to the operating room. The
      highest volume of patients, the greatest number of consultations, and the
      majority of admissions to the operating room occurred between 4 PM and midnight.
      No patients went to the operating room on the night shift. Musculoskeletal
      injuries constituted the predominant category of pediatric trauma, and
      lacerations were the most common specific injury. One half of all procedures
      involved laceration repair, and one third involved splinting or casting. Four
      hundred ten patients (68%) were managed by physicians in the emergency department
      without consultation. The orthopedic service performed one half of all
      consultations and admitted the largest number of patients; the majority of
      patients taken directly to the operating room had musculoskeletal
      injuries.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346084
TI  - Clinical presentation and radiographic identification of small bowel rupture
      following blunt trauma in children.
AB  - The incidence of significant intraabdominal injuries from blunt trauma in
      children is low (1-8%); however, a missed intestinal laceration may result in a
      devastating, if not morbid, consequence. We present retrospective case studies of
      eight children with intestinal lacerations following blunt trauma. Each patient
      has a unique anatomic defect with misleading initial laboratory and radiographic
      studies. We did not find a single laboratory or roentgenographic study to be
      consistently reliable for diagnosis of hollow viscus laceration. The combination
      of a high index of suspicion and serial abdominal examinations, coupled with
      subsequent comparative laboratory and radiographic evaluations, proved most
      reliable in identifying patients with intestinal injury.

PMID- 8346085
TI  - Pediatric education in emergency medicine residency programs--10 years later.
AB  - The purpose of this study is to examine the changes in the pediatric emergency
      medicine education of emergency medicine (EM) residents over the last decade.
      Questionnaires were mailed to the training directors of all EM residency
      programs. Sixty-five programs (79%) responded. While children represent 29 +/- 2%
      of all patients seen in the institutions surveyed, only 17 programs (26%) provide
      more than six months of pediatric education, ie, no increase in the last decade.
      EM residents frequently rotate through pediatric emergency departments (72%),
      inpatient pediatric wards (51%), and pediatric intensive care units (88%). Most
      physicians in charge of pediatric emergency medicine education are emergency
      medicine trained (75% vs 29% in 1981), and only 12% are pediatric emergency
      medicine fellowship trained. Despite several improvements and the increased
      satisfaction of program directors, the pediatric component of EM residents'
      training continues to be disproportionate to the number of children in the
      emergency medicine patient population. Specialists in pediatric emergency
      medicine should strive to play a more significant role in the pediatric education
      of EM residents.

PMID- 8346086
TI  - Two-week-old infant with isopropanol intoxication.
AB  - Isopropyl alcohol continues to be a frequent toxicologic exposure. However, no
      cases involving the newborn period have been described. A 14-day-old male infant
      presented to the emergency department (ED) with the mother's chief complaint that
      "He is not himself." Physical examination observed the infant to be lethargic and
      hypotonic. Laboratory evaluation revealed a positive urine drug screen for
      isopropanol and acetone. Elevated serum levels (in mg/dl) of isopropanol/acetone
      at 2:45, 4:15, 11:10, and 29:53 hours postpresentation were 101/136, 81/149,
      20/155, and 5/72, respectively. Overall, this patient did remarkably well with
      minimal supportive care and was noted to have a normal neurologic examination
      within 10 hours of presentation despite rising serum acetone levels. This case
      brings into question the hypothesis that acetone, a metabolite of isopropanol,
      prolongs central nervous system depression in acute isopropyl alcohol
      intoxication. The importance of urine drug screens in children who present to the
      ED with unusual neurologic examinations is appreciated.

PMID- 8346087
TI  - Fungal osteomyelitis and sepsis from intraosseous infusion.

PMID- 8346088
TI  - Haemophilus influenzae meningitis in twins.

PMID- 8346089
TI  - Aerosolized atropine as an unusual cause of anisocoria in a child with asthma.

PMID- 8346090
TI  - Childhood sledding injuries in 1990-91.
AB  - Sledding injuries are a common wintertime problem. To better characterize these
      injuries, three analyses were done: a retrospective chart review of all injured
      sledders at St. Louis Children's Hospital (SLCH) in the winter of 1990-91, a
      review of Consumer Product Safety Commission (CPSC) injury data for 1990, and
      measurements of sledding speeds. Analyses of the SLCH data and the CPSC data
      yielded similar results. Younger children incur more head injuries, while older
      children incur more extremity injuries. The SLCH data indicate that most injuries
      occur close to home when a sledder strikes a fixed object in his path. Velocities
      of 10 to 20 mph may be easily achieved. Injury prevention includes appropriate
      selection of sledding site, use of protective clothing, and refraining from
      sledding at times of highest risk.

PMID- 8346092
TI  - Blood warmers: dry heat, water bath, circulating fluid.

PMID- 8346091
TI  - Childhood injury: a current perspective.
AB  - The majority of childhood injuries requiring admission are due to traffic-related
      injury, falls, and burns. Many of these injuries are preventable. In the case of
      the unpreventable, unintentional injury, the natural history of the injury and
      outcome can be altered by adherence to established safety standards. New
      standards also need to be set. There is definitely room for improvement in
      vehicular restraint systems for the smaller and younger passengers. It is known
      that wearing bicycle helmets, using safety belts, securing firearms in the home,
      and controlling hot water heater temperature levels will prevent or lessen injury
      in children. This information is being promulgated to communities by activities
      such as the National SAFE KIDS Campaign, a program of Children's National Medical
      Center sponsored by Johnson & Johnson Family of Companies and the National Safety
      Council. This campaign emphasizes important aspects of childhood injury: scope,
      causes, and prevention. Questions about the most devastating of childhood
      injuries, child abuse and assault related to violent crime, are more complex and
      the answers elusive. The study of patterns of injury in children highlights the
      need to implement new strategies aimed at prevention. At the same time, valuable
      information is obtained about specific injuries and responses seen in children
      that set them apart from adults.

PMID- 8346093
TI  - Jerky movements in a child.

PMID- 8346094
TI  - A 19-year-old thalassemic with an irregular pulse.

PMID- 8346095
TI  - Controversies in Pediatric Emergency Medicine. To do or not to do.

PMID- 8346096
TI  - Case 02-1993: a three-year-old boy with acute-onset abdominal pain.

PMID- 8346097
TI  - The utility of skull radiographs in the evaluation of asymptomatic infants
      following minor head injury.

PMID- 8346098
TI  - Urticaria in children.
AB  - The etiologic factors responsible for urticaria were analyzed in 44 children seen
      in the Urticaria Clinic, a referral center of the Dermatology Department. Of
      these, 23 were girls and 21 boys. Nine (20.5%) had acute urticaria and 25 (79.5%)
      were diagnosed as having chronic urticaria. A definitive etiology factor was
      identified in 18 (40%) patients. Of these, 15 had physical urticarias; in 2 foods
      and in 1 drug was incriminated. Probable etiologic factors were identified in 19
      (43%) patients, in 5 (11.3%) of whom more than one factor was identified. In 11
      (25%) children, it was not possible to establish the cause. Our study suggests
      that etiologic factors of urticaria are more readily identifiable in children
      than in adults.

PMID- 8346099
TI  - Trichothiodystrophy: ultrastructural studies of two patients.
AB  - An 18-month-old and an 8-year-old girl had trichothiodystrophy (TTD). Microscopic
      observation of the hair under polarized light showed typical alternation of
      bright and dark bands; amino acid analysis of the hair demonstrated a marked
      reduction of cystine levels. Both patients had skin lesions consisting in the
      older child of diffuse follicular keratosis since birth, and in the younger of an
      ichthyosiform dermatitis on the lower legs that appeared at age 4 months.
      Ultrastructural studies of the skin showed striking similarities in both cases:
      perinuclear vacuoles with a unit membrane in the keratinocytes, and dispersed,
      irregularly arranged bundles of tonofilaments particularly at the desmosome
      junction. The origin of the vacuoles is unknown; the abnormalities of the
      tonofilaments could be explained on the basis of a generalized abnormality in
      sulfur-containing proteins, reflecting a disturbance in the synthesis of
      keratins. These electron microscopy findings could be considered as a peculiar
      feature of ichthyotic skin in patients with TTD.

PMID- 8346101
TI  - Benign pigmented apocrine vulvar hamartomas.
AB  - Pigmented vulvar lesions were observed in a child during a sexual abuse
      evaluation. Gross examination of the lesions appeared most consistent with
      bowenoid papulosis; however, biopsy confirmed the lesions to be pigmented
      apocrine hamartomas. To our knowledge, these rare and benign tumors have never
      been described as pigmented, but should be added to the differential diagnosis of
      pigmented vulvar lesions.

PMID- 8346100
TI  - Trichothiodystrophy and associated anomalies: a variant of SIBIDS or new symptom
      complex?
AB  - Trichothiodystrophy is characterized by sparse, short, sulfur-deficient hair.
      Numerous symptom complexes have been described in which the hair abnormality
      represents a constant feature. We report a boy with trichothiodystrophy,
      ichthyotic skin changes, onychodystrophy, chronic neutropenia, osteosclerosis,
      hypothyroidism, nystagmus, growth and mental retardation, and microcephaly, who
      developed a progressive encephalopathy with ataxia and optic atrophy at 2.5 years
      of age. In addition to a deficient cystine level identified on a hair sample, a
      disturbance in the composition of other amino acids was present. Although
      features were reminiscent of osteosclerosis, ichthyosis, brittle hair due to
      trichothiodystrophy, impaired intelligence, decreased fertility, and short
      stature (SIBIDS) and could represent a variant of this disorder, findings in our
      patient may reflect a new trichothiodystrophy symptom complex that carries a poor
      prognosis for survival beyond childhood.

PMID- 8346102
TI  - Erythema elevatum diutinum associated with celiac disease: response to a gluten
      free diet.
AB  - An 11-year-old girl with a history of insulin-dependent diabetes mellitus had
      erythema elevatum diutinum (EED) associated with a celiac disease related to a
      possible kidney disease. Dapsone did not improve the skin manifestations.
      However, the lesions disappeared after a gluten-free diet was begun. To our
      knowledge, this report describes the first case of EED in a patient with celiac
      disease.

PMID- 8346103
TI  - Penile purpura as a manifestation of lichen sclerosus et atrophicus.
AB  - Heightened public and professional awareness of the sexual abuse of children
      demands that physicians be able to distinguish lesions associated with sexual
      abuse from those caused by primary skin disorders. Purpura is an occasional
      manifestation of pediatric lichen sclerosus et atrophicus (LSA), especially when
      the vulva is affected. We report a 12-year-old boy with penile purpura that
      occasioned a consideration of sexual abuse but proved to be due to LSA.

PMID- 8346104
TI  - Lichen planus in children: a case report.
AB  - Lichen planus (LP) is rare in children. A review of the literature reveals that
      it has some peculiarities with respect to sex, localization, clinical aspect,
      race, and family history. We present an Indian child with the documented
      peculiarities of infantile LP. A comparison of LP and graft-versus-host disease
      points to the importance of thymic involution in the pathogenesis of the former,
      which could explain the rarity of this disorder in infants.

PMID- 8346105
TI  - Scabies of the scalp mimicking seborrheic dermatitis in immunocompromised
      patients.
AB  - Two children with acute lymphoblastic leukemia undergoing chemotherapy had a
      special form of scabies characterized by fine scaling of the scalp simulating
      seborrheic dermatitis. Pruritus was mild or absent. Immunocompromised children
      and adults should receive whole-body and scalp antiscabietic treatment.

PMID- 8346106
TI  - Papular xanthoma in children: report and immunohistochemical study.
AB  - Papular xanthoma was diagnosed in a 14-month-old boy. The eruption cleared
      spontaneously within four years. Immunohistopathologic study revealed that the
      predominant foamy histiocytic cells had the phenotypic features of the dermal
      dendrocyte. Giant multinucleated cells, which showed characteristics of monocyte
      derived macrophages, were also present. We suggest classifying diseases derived
      from dermal dendrocytes into a separate group of histiocytoses.

PMID- 8346107
TI  - Congenital smooth muscle hamartoma of the skin.
AB  - A 2-month-old white girl had a congenital, tan-colored, slightly elevated, 3 x 2
      cm plaque on the left midback. Clinically, the lesion was suspected to be a
      solitary mastocytoma. Rubbing the lesion produced a transient erythema and edema
      that was similar to Darier sign seen in mastocytoma. Analysis of a skin biopsy
      specimen revealed a smooth muscle hamartoma; special stains did not show evidence
      of increased numbers of mast cells. This relatively uncommon condition can be
      confused with a variety of other cutaneous diseases. Light microscopic
      examination of a skin biopsy specimen establishes the diagnosis. A review of the
      approximately 50 cases reported in the literature showed that there is no known
      associated systemic involvement or malignant transformation. The clinical lesions
      usually become less prominent with time.

PMID- 8346108
TI  - Case report of Darier disease localized to the vulva in a 5-year-old girl.
AB  - A 5-year-old girl with Darier disease had numerous verrucous papules coalescing
      into plaques on both labia majora of approximately one year's duration. She was
      diagnosed as having genital warts, raising the suspicion of sexual abuse.
      Subsequently, a biopsy specimen from one of the vulvar lesions revealed
      histologic characteristics consistent with a diagnosis of Darier disease. The
      case is unusual for the age of onset and the site of initial involvement, and
      stresses the importance of including acantholytic disorders such as Darier
      disease in the differential diagnosis of a child with clinically verrucous
      lesions.

PMID- 8346109
TI  - Occult spinal dysraphism: a neurosurgical problem with a dermatologic hallmark.
AB  - Lumbosacral congenital cutaneous lesions have been recognized for a long time by
      neurologists and neurosurgeons as markers of occult spinal defects, but only a
      few cases have been published and discussed in the dermatologic literature. Based
      on a case report, we emphasize the importance of early diagnosis of these
      lesions, the use of new diagnostic techniques, and the correct management.

PMID- 8346110
TI  - Granular cell tumor of the vulva.
AB  - Granular cell tumors are uncommon in the vulva. We cared for a child who had a
      solitary vulvar tumor since infancy.

PMID- 8346111
TI  - Linear and whorled nevoid hypermelanosis.
AB  - A case of hyperpigmentation distributed in streaks and whorls was recently
      delineated and separated from a confusing number of pigmentary disorders. A 13
      year-old boy had hyperpigmented, reticulate spots on his trunk and neck in a
      linear and whorled distribution following the lines of Blaschko. Onset was at age
      1 year. Histologically, the spots showed increased melanin in the basal layer of
      the epidermis, but no increase in melanocytes, incontinence of pigment, or
      melanophages were seen in the dermis. The karyotype was 46,XY and there was no
      evidence of chromosomal mosaicism or chimerism. This entity represents a disorder
      separated recently from other pigmentary alterations that follow Blaschko lines,
      such as Bloch-Sulzberger incontinentia pigmenti, hypomelanosis of Ito, early
      systematized epidermal nevus, and chimerism.

PMID- 8346113
TI  - Encephalocraniocutaneous lipomatosis: case report and review of the literature.
AB  - Encephalocraniocutaneous lipomatosis is a congenital disorder characterized by
      unilateral cerebral malformations and ipsilateral scalp, face, and eye lesions.
      Distinguishing histopathologic features are dysgenesis and neoplasia of the
      adipose tissue. A Caucasian boy had soft tumors and elastic papules on his head
      since birth, associated with atrophic areas, and a bilobed lesion on the upper
      right eyelid. On the bulbar conjunctiva of the right eye, an oval 6-mm lesion was
      present. Ultrasonogram, computerized tomographic scan, and magnetic resonance
      imaging revealed a dilation of the right lateral ventriculus, a mass on the
      pontocerebellar angle, agenesia of the corpus callosum, an arachnoidal cyst on
      the right hemisphere, microcalcifications, and pachygyria. The histology of a
      soft cutaneous tumor was consistent with a fibrolipoma, and dispersed
      extracellular lipid globules in the upper dermis were found on electron
      microscopy. The diagnosis suggested by these findings was
      encephalocraniocutaneous lipomatosis. Even in view of the rarity of the syndrome
      (11 cases described in the literature), this patient seems unusual because of the
      bilateral distribution of the cutaneous lesions and because of the agenesia of
      the corpus callosum. The peculiar ultrastructural findings require further
      confirmation.

PMID- 8346112
TI  - Rothmund-Thomson syndrome associated with annular pancreas and duodenal stenosis:
      a case report.
AB  - The Rothmund-Thomson syndrome is a rare autosomal recessive condition. It is
      primarily a clinical diagnosis with manifestations that include poikiloderma,
      short stature, sparse hair, juvenile cataracts, small hands and feet, bone
      defects, photosensitivity, hypogonadism, defective dentition, onychodystrophy,
      and hyperkeratosis. There is only one published case of associated
      gastrointestinal abnormalities. We report a patient with Rothmund-Thomson
      syndrome with annular pancreas and duodenal stenosis.

PMID- 8346114
TI  - Pemphigus neonatorum.
AB  - The diagnosis of pemphigus neonatorum in an infant girl was based on clinical,
      histologic, and immunofluorescence evidence. The outcome was benign, and the skin
      lesions resolved within two weeks.

PMID- 8346116
TI  - Neonatal lupus erythematosus and maternal lupus erythematosus mimicking HELLP
      syndrome.
AB  - A 4-month-old boy had a faint, confluent, macular erythema involving the
      forehead, nose, and philtrum, and matlike telangiectases over the forehead and
      eyelids. The clinical features, course, and laboratory studies were
      characteristic of neonatal lupus erythematosus. He was otherwise healthy and the
      product of a preterm twin pregnancy complicated by the development of maternal
      HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. The patient
      had elevated Ro(SSA) and La(SSB) antibody titers, and studies performed on
      maternal blood disclosed positive antinuclear antibodies and elevated Ro and La
      antibody titers.

PMID- 8346115
TI  - Linear IgA bullous dermatosis in a neonate.
AB  - A newborn black boy had two facial blisters at birth that progressed to bullous
      lesions over the trunk, genitals, extremities, and oral and tracheal mucosa. A
      biopsy specimen demonstrated a subepidermal bulla with mixed eosinophilic and
      neutrophilic, inflammatory infiltrate. Direct immunofluorescence showed linear
      IgA, IgG, and C3 depositions along the basement membrane zone, consistent with a
      diagnosis of childhood linear IgA bullous dermatosis (chronic bullous dermatosis
      of childhood). The skin disease was controlled with combined prednisone and
      dapsone. This is the youngest reported patient with the disease. Linear IgA
      bullous dermatosis should be considered in the differential diagnosis of
      blistering diseases of the newborn, and immunofluorescence should be performed on
      a skin biopsy specimen.

PMID- 8346117
TI  - Congenital platelike osteoma cutis: case report and review of the literature.
AB  - An 18-year-old girl had a progressive enlarging plate of subcutaneous bone in the
      scalp since birth. Histologic examination of the lesion showed typical osteoma
      cutis. There was no history of any skin disease prior to development of the
      osteoma. Frequently congenital and usually located on the scalp, platelike
      osteoma is a rare variant of osteoma cutis.

PMID- 8346118
TI  - Down syndrome, alopecia universalis, and trachyonychia.
AB  - A 16-year-old boy with Down syndrome and alopecia universalis had dystrophy of
      all nails. A presumptive diagnosis of tinea unguium, common in persons with Down
      syndrome, had been made nine years earlier. Despite antifungal therapy, the
      condition of the nails worsened. We were unable to detect fungi, and believe that
      his nail changes are most consistent with alopecia-associated trachyonychia
      (formerly 20-nail dystrophy), a condition not previously reported in persons with
      Down syndrome.

PMID- 8346119
TI  - Linear nevus sebaceus of Jadassohn treated with the carbon dioxide laser.
AB  - A 10-year-old boy from Guiana was born with a linear nevus sebaceus covering his
      entire nose from the glabella area to the tip. Cosmetic appearance, which was the
      major concern of the patient and his family, was greatly improved by the use of
      the carbon dioxide (CO2) laser. The CO2 laser has not been reported previously as
      a treatment modality for nevus sebaceus.

PMID- 8346120
TI  - What syndrome is this? Monilethrix syndrome.

PMID- 8346121
TI  - An 18-month-old boy with a persistent papular eruption.

PMID- 8346122
TI  - Early-onset nevi.

PMID- 8346123
TI  - Leucotrichia in nevus depigmentosus.

PMID- 8346124
TI  - Acute lymphoblastic leukemia associated with dermatomyositis in a child.

PMID- 8346125
TI  - Nodular prurigo in a child.

PMID- 8346126
TI  - Topical progesterone as treatment of choice in genital lichen sclerosis et
      atrophicus in children.

PMID- 8346127
TI  - Treatment of childhood linear morphea with D-penicillamine.

PMID- 8346128
TI  - Diagnosis and treatment of digoxin toxicity.

PMID- 8346130
TI  - Management of hyperlipidaemia: guidelines of the British Hyperlipidaemia
      Association.
AB  - There is considerable evidence to suggest that the identification and treatment
      of dyslipidaemia will reduce the risk of premature CHD, i.e. before the age of
      65. Diagnosis of the cause of raised plasma lipid levels will enable appropriate
      decisions to be taken with regard to management. The cornerstone of treatment is
      nutritional counselling and attention to other major risk factors for CHD,
      particularly smoking and hypertension. For a small percentage of patients with
      severe hyperlipidaemia drug therapy is indicated. Appropriate drug choices need
      to be made based on the particular lipid abnormality to be treated. In general
      those patients with clinical vascular disease are treated more aggressively than
      those where the aim is primary prevention. More research is needed to determine
      individual risk more precisely and to allow proper targeting of therapy. Genetic
      factors, qualitative changes in lipoproteins, lipoprotein (a), fibrinogen, and
      other coagulation and thrombotic factors are likely to be important in individual
      risk assessment. There is no doubt that more information is needed from
      prospective studies of lipid-lowering therapy in terms of risk benefit for
      affected individuals. Hopefully the major studies currently underway will fill
      some of the gaps in our knowledge. Until then aggressive therapy with drugs
      should be reserved for those at highest risk where the benefit is likely to be
      greatest.

PMID- 8346131
TI  - Clinic blood pressure measurements and blood pressure load in the diagnosis of
      hypertension.
AB  - We have retrospectively compared the blood pressure load derived from 24 hour
      ambulatory blood pressure monitoring in patients with all clinic blood pressure
      readings elevated with those with only some elevated pressures to establish
      whether clinic readings alone are good predictors of blood pressure status. Fifty
      seven patients attending a district general hospital hypertension clinic who were
      not on anti-hypertensive treatment were selected. Between two and six clinic
      readings were taken over a period of 1-6 months. Forty out of 57 patients had at
      least one clinic diastolic blood pressure reading of < 90 mmHg and, of these, 14
      (35%) had a high blood pressure load and 26 (65%) had a normal blood pressure
      load. Patients with all diastolic blood pressure readings > 90 mmHg totalled 17
      and of these 11 (65%) had high load and six (35%) had normal load. Patients with
      clinic diastolic blood pressure > 90 mmHg were significantly more likely to be
      truly hypertensive on the basis of blood pressure load than if one or more clinic
      readings was below 90 mmHg (P < 0.05). Diastolic pressures have some predictive
      power as to the blood pressure status defined by blood pressure load, but even
      consistently raised diastolic pressures do not necessarily indicate hypertension.
      Likewise one or more clinic diastolic blood pressure < 90 mmHg does not assuredly
      indicate normotension. Twenty-four hour ambulatory blood pressure monitoring may
      have an increasingly important role in the assessment of hypertension.

PMID- 8346132
TI  - Osteoporosis and the Marfan syndrome.
AB  - Fourteen patients with Marfan syndrome, defined according to present criteria,
      had bone mineral content of the distal forearm measured by single photon
      absorptiometry. Patients were matched for age and sex with a large local group of
      healthy volunteers. While further work is needed with other methods of
      densitometry with measurements at other sites, our results provide no evidence
      that there is an increased incidence of osteoporosis in Marfan syndrome. Previous
      reports of an association were probably due to incorrect clinical diagnosis or
      confusion with clinically similar syndromes known to cause osteoporosis.

PMID- 8346129
TI  - Intensive care.

PMID- 8346133
TI  - A comparison of 10 MHz ultrasound and 201-thallium/99m-technetium subtraction
      scanning in primary hyperparathyroidism.
AB  - Both high resolution (10 MHz) ultrasound and 201-thallium/99m-technetium
      subtraction scanning (Tl/Tc) were carried out preoperatively in 25 patients with
      primary hyperparathyroidism. Operative findings were the standard against which
      these two imaging methodologies were compared. Tl/Tc scanning showed a
      sensitivity of 42% and a specificity of 97%. By comparison, sensitivity of
      ultrasound was 38% and specificity 89%. Both techniques were positive together in
      nine instances and correctly localized the parathyroid adenoma in eight of these.
      In 44% of cases, however, both methods together failed to localize any abnormal
      parathyroid tissue. The ability of these modalities to localize abnormal
      parathyroid tissue correctly tended to vary with gland size. Where both
      ultrasound and Tl/Tc scans were negative, median gland size was smaller at 170 mg
      (range 50-2,500 mg), compared with where Tl/Tc scanning was correct (750 mg, 150
      6,820 mg; P < 0.03), ultrasound was correct (960 mg, 100-6,820 mg; P < 0.03) and
      both techniques together were correct (980 mg, 600-6,820 mg; P = 0.002). These
      results suggest that neither Tl/Tc scanning or ultrasound has sufficient
      sensitivity or specificity to be used routinely in the preoperative evaluation of
      patients with primary hyperparathyroidism.

PMID- 8346134
TI  - Ultrasound-guided needle aspiration of amoebic liver abscess.
AB  - This prospective study was carried out on 200 patients with clinically,
      ultrasonographically and serologically confirmed amoebic liver abscess. The role
      of ultrasound-guided needle aspiration in addition to medications was evaluated
      compared to drug treatment alone. Both the groups were monitored clinically and
      sonographically for up to 6 months after diagnosis. The initial response (after
      15 days) was better in the aspirated group (P < 0.05) but resolution of abscess
      after 6 months were similar. There was a more rapid clinical response in the
      aspirated group, particularly in those with larger (> 6 cm) abscesses and there
      were no complications. Percutaneous ultrasound-guided needle aspiration is a safe
      diagnostic and therapeutic approach which enhances clinical recovery, accelerates
      resolution, especially in large abscesses, and prevents complications.

PMID- 8346135
TI  - Combined transhepatic and endoscopic procedures in the biliary system.
AB  - Endoscopic biliary procedures are 89-97% successful in skilled hands. The
      commonest causes of failure are inability to cannulate the papilla of Vater due
      to difficult anatomy or tortuosity of the distal common bile duct and failure to
      cross a rigid biliary stricture. In nearly all of these cases, successful
      endoscopic procedures can be completed after percutaneous antegrade placement of
      a small catheter or guidewire to the duodenum. In 44 such combined procedures on
      42 patients, the success rate was 43 (98%). There were two severe and eight mild
      complications. Combined procedures overcome the difficulties caused by tortuous
      biliary ducts and rigid strictures while obviating the need for more extensive
      percutaneous procedures and transhepatic tract dilatation.

PMID- 8346136
TI  - Use of intravenous cannulae by junior hospital doctors.
AB  - One hundred junior hospital doctors were surveyed to investigate their use of
      intravenous cannulae. Anaesthetists inserted more cannulae per day than non
      anaesthetists and were more likely to use local anaesthetic and wear gloves,
      although most doctors never or rarely did so. Anaesthetists were also more
      knowledgeable than non-anaesthetists about the sizes of cannulae they used and
      the sizes available, although there was considerable ignorance overall in this
      regard. Many doctors regularly place themselves at risk and expose their patients
      to unnecessary pain during intravenous cannula insertion, and have little
      knowledge about the cannulae they use.

PMID- 8346137
TI  - Recurrent confusion and hypopituitarism.
AB  - Three women in late middle age had recurrent episodes of confusion which could
      not be explained solely on the basis of an associated infection. All three
      patients had latent hypopituitarism diagnosed on final presentation. Each patient
      had a previous history of a severe postpartum haemorrhage followed by two further
      pregnancies. Experienced clinicians had not made a diagnosis of confusional
      episodes due to hypopituitary encephalopathy because the history was not
      immediately available in the confused patient, and the significance of deficient
      axillary and pubic hair was not given due emphasis.

PMID- 8346138
TI  - Adrenocorticosteroid deficiency: an unusual cause of fever of unknown origin.
AB  - We report the case of a lady with multiple presentations and admissions with
      fever. The eventual diagnosis was made of adrenocorticosteroid deficiency.

PMID- 8346139
TI  - Significance of a low serum ferritin level in elderly in-patients.
AB  - Iron deficiency, defined as a serum ferritin level less than or equal to 50
      micrograms/l was found in 28 (11%) of 252 consecutive elderly in-patients (mean
      age 81 years). Sixteen among them were anaemic and only five had a microcytic
      anaemia. In a separate study, 15 anaemic and 13 non-anaemic iron-deficient
      elderly in-patients were investigated in order to evaluate the prevalence of
      gastrointestinal symptoms and lesions in both groups. In nine of the anaemic and
      seven of the non-anaemic patients a potential cause for the iron deficiency was
      established. Most anaemic and non-anaemic patients lacked the symptoms described
      as suggestive of underlying gastrointestinal pathology. Thus, a ferritin level
      less than or equal to 50 micrograms/l justifies a gastrointestinal investigation
      if the general condition allows for it as well in anaemic as in non-anaemic
      elderly hospitalized patients. Therefore, serum ferritin should be part of the
      routine biochemical investigation of elderly in-patients.

PMID- 8346140
TI  - Multiple lymphomatous polyposis and the role of fine needle aspiration cytology.
AB  - Multiple lymphomatous polyposis is an uncommon but distinctive form of
      gastrointestinal lymphoma. Clinical symptoms may closely resemble those of
      colorectal carcinoma and diagnostic confusion may result. The condition has a
      characteristic pathological appearance and immunophenotype which is important in
      allowing distinction from other less aggressive forms of gastrointestinal
      lymphoma. We report a case of this unusual condition in which the diagnosis was
      aided by fine needle aspiration cytology.

PMID- 8346141
TI  - Pyrexia of unknown origin in association with bladder diverticulum tumour.
AB  - A case of pyrexia due to a rapidly growing undifferentiated transitional cell
      carcinoma in a bladder diverticulum is described. The literature is reviewed and
      the causes of pyrexia associated with neoplasia briefly discussed.

PMID- 8346143
TI  - Parathyroid crisis and acute viral hepatitis B infection.
AB  - The simultaneous development of acute hyperparathyroidism and viral hepatitis B
      infection in a 72 year old male is described. Resolution of the hepatitis was
      accompanied by improvement in the parathyroid hormone mediated hypercalcaemia. It
      is postulated that antibodies to the hepatitis B virus may have altered the
      calcium 'set point' allowing uncontrolled synthesis and release of parathyroid
      hormone during the acute illness.

PMID- 8346144
TI  - Bot-fly bite.

PMID- 8346142
TI  - Invasive aspergillosis in two patients with acute lymphoblastic leukaemia in
      complete remission.
AB  - Invasive aspergillosis is a disease of the immunosuppressed patient. We describe
      two patients with acute lymphoblastic leukaemia who attained complete remission,
      with partial or complete bone marrow recovery, but who went on to develop fatal
      invasive aspergillosis contemporaneous with recovery of neutrophil counts.
      Quantitative recovery of peripheral blood neutrophil counts does not guarantee
      control of Aspergillus infection, perhaps due to functional neutrophil
      deficiencies post-chemotherapy, and specific defensive strategies adopted by the
      organism itself.

PMID- 8346145
TI  - Primary tuberculous appendicitis.

PMID- 8346146
TI  - An unusual cause of biliary peritonitis.

PMID- 8346147
TI  - Atypical manifestations of ruptured abdominal aortic aneurysms.

PMID- 8346148
TI  - Effects of different floor types and levels of washing of waterers on broiler
      performance and bacteria count of drinking water.
AB  - The objective of the present experiment was to determine the effect of different
      flooring materials and washing of waterers on broiler performance. The floor
      treatments were 1) black, plastic-coated expanded metal, relatively rigid (B); 2)
      white plastic, semi-rigid, with rectangular openings (WR); 3) white plastic, semi
      rigid, with square openings (WS); and 4) 3 cm of rice hull litter (C). One
      hanging waterer was placed in each pen. Wash treatments were 1) trough and bell
      washed every Monday, Wednesday, and Friday (AW); 2) wash trough only on Monday,
      Wednesday, and Friday (TW); and 3) the waterers were never washed after the 2nd
      wk (NW). Broilers reared on C has significantly lower BW than those broilers on B
      floors. Broilers reared on the B and WS floors had significantly higher breast
      blister scores and percentage of birds with blisters than broilers reared on C
      floors. Broilers reared on C had lower enlarged feather follicle scores than
      those reared on all raised floors and a lower percentage of enlarged feather
      follicles than those broilers reared on WS or WR floors. Broilers reared on WS+TW
      had significantly better feed conversion than WS+AW, B+TW, and B+AW treatments.
      Broilers reared on WR+TW treatment were significantly higher in breast blister
      score than broilers reared on WR+AW, C+TW, and C+AW treatments. Broilers reared
      on C+TW and C+AW treatments were significantly lower in breast blister score
      except for broilers reared on C+NW, WR+AW, and WS+AW treatments. Broilers reared
      on C+NW treatment were significantly lower in enlarged feather follicle score
      than those broilers reared on B+TW, WR+AW, and WS+NW treatments.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8346149
TI  - Behavioral responses of broiler chickens to handling: effects of dietary
      tryptophan and two lighting regimens.
AB  - In three 2 x 2 factorial experiments, effects of added dietary Trp (0 or .2%,
      Experiments 1 and 2; 0 or .4%, Experiment 3) and two lighting regimens [1)
      constant 23-h photoperiod (23H); or 2) increasing photoperiod (INC)] on
      behavioral responses of broilers to handling were assessed. In Week 6 of
      Experiment 1, and Weeks 3 and 6 of Experiments 2 and 3, 32 chickens from each
      treatment were picked up and held by both legs for 30 s, carried for 60 s, and
      induced into tonic immobility (TI). In all experiments, chickens reared under INC
      were more likely to flap when carried, and flapped longer, than chickens reared
      under 23H (P < .01). In Experiments 2 and 3, INC chickens were more likely to
      curl the body ventrally when handled and were more susceptible to TI induction
      than 23H chickens (P < .05). The duration of TI was shorter on INC than 23H in
      Experiment 2 (P < .05), and longer in Experiment 3 (P < .001). Dietary Trp
      supplementation resulted in a lower flapping duration and higher incidence of
      body curling in Experiment 2 (P < .05), and a shorter TI duration in Experiment 3
      (P < .05). Flapping, body curling, and TI responses of chickens varied between
      handlers (P < .05). Vocalization and flapping rates were lower, and flapping
      incidence and duration of flapping and TI higher, in Week 6 than in Week 3 (P <
      .05). Chickens reared under INC may be at greater risk of injury during
      preslaughter handling than chickens reared under 23H.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8346150
TI  - Liquid methionine hydroxy analog (free acid) and DL-methionine attenuate calcium
      induced kidney damage in domestic fowl.
AB  - To evaluate the possibility that kidney damage may be induced by the commercial
      practice of feeding high-Ca (HCa) prelayer rations, and to evaluate the
      protective efficacy of supplementing HCa diets with liquid methionine hydroxy
      analog free acid or DL-methionine, 12-wk-old female Single Comb White Leghorn
      pullets were fed one of the following corn-soybean meal-based diets until they
      reached 22 wk of age: normal-Ca (NC, 1% Ca); HCa (HC, 3.5% Ca); HCa supplemented
      with .34 or .68% liquid methionine hydroxy analog free acid (HC3A or HC6A); or
      HCa supplemented with .3 or .6% DL-methionine (HC3DL or HC6DL). The
      unsupplemented HC diet caused a significant reduction in kidney mass and a
      significant increase in the incidence of gross kidney damage and urolithiasis in
      pullets necropsied at 22 wk of age. Calcium-induced kidney damage was attenuated
      in a dose-response fashion by supplementing the HC diet with liquid methionine
      hydroxy analog and DL-methionine. None of the diets caused a significant
      metabolic acidosis. Plasma uric acid concentrations were not predictive of the
      extent of Ca-induced kidney damage. Analyses of glomerular size distributions
      indicated that subclinical or "hidden" kidney damage may not progressively
      develop into urolithiasis as hens mature. When compared with hens reared on the
      NC diet, rearing hens on the HC, HC3A, HC3DL, HC6A, or HC6DL diets did not
      consistently affect hen-day egg production, egg mass, eggshell mass, percentage
      eggshell, or bone mineralization.

PMID- 8346151
TI  - Bursal secretory dendritic-like cell: a microenvironment issue.
AB  - In 1978, Olah and Glick identified in the medulla of the bursa of Fabricius a
      dendritic cell, the bursal secretory dendritic-like cell (BSDC). The morphology
      of BSDC, the functional relationship of BSDC to bursal follicle development and
      the spleen, and the identification in the embryo of the BSDC precursor was
      reported. The precursor BSDC appeared in the bursa before B cells. A monoclonal
      antibody to vimentin, an intermediate filament, will identify BSDC and not B
      cells in posthatch chickens. The vimentin-positive cells, but not B cells, in
      hatched chicks express complete IgG chain. Taken together, the present data may
      contribute to the events occurring during the bursal-dependent stages of B cell
      development. Immunoglobulin gene rearrangement, within the bursa or at extra
      bursal sites, and clonal expansion at extra-bursal sites are antigen-independent
      and dependent, respectively. The bursal-dependent stage includes the expansion of
      the Ig rearranged cells and gene conversion, which contributes to antibody
      diversity. The IgG and granular products produced by BSDC may act as ligand and
      signals for B cell expansion and gene conversion.

PMID- 8346152
TI  - Plasma cells of the chicken Harderian gland.
AB  - The chicken Harderian gland (HG) is densely populated in its subepithelial spaces
      with plasma cells (PC). These immune cells produce and secrete Ig of the IgA,
      IgG, and IgM classes. Such Ig secretion into the tears affords the upper
      respiratory tract with protective antibodies. The immunological role of the HG is
      quite interesting; yet this gland is a site of unusual PC proliferation. Studies
      of the gland utilizing bromodeoxyuridine (BrdUrd) incorporation into DNA and
      propidium iodide (PI) staining of PC DNA have verified previous suggestions in
      the literature that PC of the chicken HG proliferate. Both isolated PC
      suspensions and frozen sections of the HG from chicks aged 6 to 9 wk reveal that
      BrdUrd is incorporated into PC DNA. Furthermore, flow cytometric analysis of PI
      stained PC indicates a relatively high percentage of PC in S phase of the cell
      cycle. Continued studies are examining possible mechanisms controlling
      proliferation and differentiation of PC in the HG. It is believed that the
      stromal elements of the HG produce and secrete a factor(s) that influences PC
      proliferation and differentiation. Isolation and characterization of this
      influencing factor(s) will allow for the possible systemic application of the
      factor(s) for enhancement of immune responses.

PMID- 8346153
TI  - Avian macrophages: contribution to cellular microenvironment and changes in
      effector functions following activation.
AB  - The capacity of macrophages to generate metabolites and monokines having effector
      and regulatory functions can result in a major impact on their cellular
      microenvironment. Macrophage products synthesized in response to bacterial
      lipopolysaccharide stimulation include reactive oxygen and nitrogen intermediates
      as well as tumor necrosis factor (TNF). These secreted products of macrophages
      exhibit bioactivity either locally or systemically. Although the mechanism of
      action of avian monokines such as TNF-like factor may be similar to their
      mammalian counterparts, chicken TNF seems to lyse cells of chicken origin and not
      of mammalian origin. Furthermore, the generation and activity of products such as
      TNF is directly influenced by environmental stressors such as heat and toxins.

PMID- 8346154
TI  - Biogenic amines regulate avian immunity.
AB  - Alzet mini-osmotic pumps were implanted subcutaneously to administer
      norepinephrine (NE) and epinephrine (E) to 6-wk-old line UNH 105 chickens. Dose
      time studies showed the most effective NE and E dose and exposure time on two
      chicken cellular immune responses: the phytohemagglutinin (PHA) wattle response
      and leukocyte migration. Administration of 1 microgram/h NE for 72 h suppressed
      significantly the wattle stimulation index [2.48 +/- .3 (SE)] compared to that of
      saline controls (4.1 +/- .3) but enhanced mean leukocyte migration (7.7 +/- .3
      versus 4.9 +/- .3). Epinephrine at 1 microgram/h for 72 h significantly
      suppressed the wattle index (1.8 +/- .2) compared to that of controls (2.8 +/-
      .3) but E at 1 microgram/h for 48 h enhanced leukocyte migration (9.5 +/- .2
      versus 6.4 +/- .2). Continuous administration of NE and E at physiological levels
      alters cell-mediated immunity and appears to have an immune regulatory role in
      the chicken.

PMID- 8346155
TI  - The humoral activity of the avian thymic microenvironment.
AB  - The thymic microenvironment (composed of the lymphoepithelial stroma and the
      secretory products of the thymic epithelium) provides the required milieu for the
      development of the thymus-derived lymphocytes (T cells). There is limited
      information characterizing or identifying the active secretory components of the
      avian thymus. The work discussed here has focused on examination of the presence,
      regulation, and activity of one of the thymic hormones (thymulin) in the chicken.
      A thymulin-like product has been shown to exist in chicken serum as assessed by
      the mammalian bioassay and an ELISA immunoassay; thymectomy removes this product
      from the serum. Serum thymulin activity has been shown to be directly related to
      the thyroid status of the chick with the functionally hypothyroid Cornell sex
      linked dwarf strain having lower levels than the euthyroid K strain. Alterations
      in circulating thymulin concentrations produced by daily thymulin injections
      resulted in an altered profile of the major peripheral blood T cell
      subpopulations and produced significant changes in the autoimmune pathology
      present within the Obese strain chicken. These approaches represent preliminary
      attempts to study the role of thymulin in avian immune development and in immune
      neuroendocrine interactions.

PMID- 8346156
TI  - Immune modulation by altered nutrient metabolism: nutritional control of immune
      induced growth depression.
AB  - The ability of conjugated isomers of linoleic acid (CLA) to prevent reduced
      growth rate following endotoxin (lipopolysaccharide, LPS) injection was studied
      in two chick trials and one rat trial. Chicks (10 per treatment) were fed a corn
      and soybean meal-based diet with or without .5% CLA. At 21 days of age, chicks
      were weighed and injected i.p. with 1 mg/kg BW Escherichia coli LPS and sterile
      PBS. Body weights were again determined 24 h later. Antibody responses to SRBC
      were also determined. Rats fed .5% stearic acid or CLA for 4 wk (seven per
      treatment) were also injected with LPS, and BW change over a 24-h postinjection
      period was determined. Antibody responses to BSA, phytohemagglutinin foot pad
      swelling, and phagocytosis of elicited peritoneal macrophages were also
      determined. The CLA had no adverse effects on any immune variables measured in
      the chicks and rats. The CLA enhanced the phytohemagglutinin response and
      macrophage phagocytosis in rats. Chicks fed CLA and injected with LPS continued
      to grow, whereas those not fed CLA either failed to grow or lost weight following
      LPS injection. Both control and CLA-fed rats lost weight over the 24-h period
      after LPS injection; however, the loss of weight in rats fed CLA was only half of
      the weight loss of the control rats. Thus, CLA is effective in preventing the
      catabolic effects of immune stimulation.

PMID- 8346157
TI  - Avian gut-associated immune system: implication in coccidial vaccine development.
AB  - Host responses to coccidia are complex and involve both humoral and cellular
      immune mechanisms. Convincing evidence exists for a major role of cell-mediated
      immunity in anticoccidial resistance. With an increasing need for the development
      of coccidial vaccine, understanding of the intestinal immune system is crucial.
      To provide increased insight into the immune mechanisms involving mucosal immune
      response to coccidia, cellular events involved in the maturation of intestinal
      immune system were studied. Postnatal development of various T lymphocyte
      subpopulations expressing CD3, CD8, CD4, and antigen-specific T cell receptor
      (TCR) heterodimers expressing gamma delta (TCR1) or alpha beta (TCR2) was
      investigated in chickens. Intraepithelial lymphocytes (IEL) expressing the CD8
      antigen increased gradually following hatching and subsequently declined with
      age. The CD4+ cells represented a minor subpopulation among the IEL. The ratios
      of IEL T cells expressing gamma delta (TCR1) or alpha beta (TCR2) in the
      intraepithelium of chickens gradually increased after hatching. These results
      indicate maturational changes of intestinal immune system that should be
      considered in the development of vaccine against coccidia.

PMID- 8346158
TI  - Relative bioavailability of L-ascorbyl-2-polyphosphate in broiler chickens.
AB  - Broiler chick diets and drinking water were supplemented with two sources of
      vitamin C: crystalline L-ascorbic acid (AsA) or L-ascorbyl-2-polyphosphate (APP)
      to provide 0, 25, 50, 100, 200, 400, 800, 1,600, and 3,200 ppm (mg/kg) AsA. The
      bioavailability of APP relative to AsA, as estimated by the change in plasma AsA
      concentration, was evaluated during 24-h periods of supplementation. When
      provided in the feed, no differences in dietary AsA content were attributed to
      vitamin source. In contrast, APP administration at 25 and 50 ppm, resulted in
      higher (P < .001) AsA values in drinking water when compared with AsA
      supplementation. Plasma AsA values were elevated (P < .05) above baseline when
      either AsA or APP were supplemented in the feed or water at a level of 400 ppm or
      greater. Plasma AsA concentrations, following supplementation of the diets, were
      higher (P < .05) in AsA-treated (800 ppm) chicks when compared with APP
      supplemented chicks. During water supplementation, AsA (800 ppm) and APP (3,200
      ppm) administration resulted in higher plasma AsA values when compared with their
      alternate vitamin source. At all other levels of water supplementation, no
      differences in plasma AsA were associated with vitamin source. The absence of a
      consistent difference in plasma AsA, relative to vitamin source, suggests that
      the isolated differences observed may be due to chance. It was concluded that APP
      was of similar bioavailability to that of AsA, as estimated by the ability to
      elevate plasma AsA concentrations in broiler chicks.

PMID- 8346160
TI  - Treatment of osteoporosis.

PMID- 8346159
TI  - Carotid endarterectomy for TIAs.

PMID- 8346161
TI  - Long-term management.

PMID- 8346162
TI  - The final hurdle.

PMID- 8346163
TI  - Management of gout.

PMID- 8346164
TI  - Disorders of calcium metabolism.

PMID- 8346165
TI  - The menarche.

PMID- 8346166
TI  - Growth problems.

PMID- 8346167
TI  - Screening for metabolic disorders.

PMID- 8346168
TI  - Management of hypercholesterolaemia.

PMID- 8346169
TI  - Prescribing in the elderly.

PMID- 8346170
TI  - The "cause of death" is dying.

PMID- 8346171
TI  - Diffuse alveolar damage and acute interstitial pneumonitis: histochemical
      evaluation with lectins and monoclonal antibodies against surfactant apoprotein
      and collagen type IV.
AB  - Diffuse alveolar damage (DAD) and acute interstitial pneumonitis (AIP) often
      present clinically as the adult respiratory distress syndrome. To evaluate the
      usefulness of histochemical techniques and to better understand the
      histopathologic changes of these diffuse lung injuries, postmortem lung sections
      of 14 and 33 patients who had been diagnosed as having DAD in organizing stage
      and AIP, respectively, were studied with the use of lectins and monoclonal
      antibodies against surfactant apoprotein (PE-10) and collagen type IV. On
      hematoxylin-eosin stained sections, type II pneumocyte hyperplasia and hyaline
      membrane formation were the major histopathologic findings in both DAD and AIP.
      The binding rates of type II pneumocytes to Ulex europaeus agglutinin I (UEA-I)
      in both DAD (64%) and AIP (45%) cases were significantly higher than those of
      type I pneumocytes or alveolar macrophages (both P < 0.001). Reactions of type II
      pneumocytes to PE-10 varied from 40 to 44% in DAD and 0 to 100% in AIP cases
      depending on the use of respirator and steroid medication. Therefore, it may be
      said that UEA-I and PE-10 are useful methods for outlining hyperplastic type II
      pneumocytes in both DAD and AIP. Hyaline membrane coating alveolar septal
      surfaces and exudate in alveolar air spaces were also stainable with PE-10.
      Surfactant apoprotein remained demonstrable histochemically within type II
      pneumocytes and hyaline membrane despite severe inflammatory injuries of the
      lungs. The immunohistochemical stain using anti-collagen type IV antibody
      revealed discontinuous alveolar basement membrane in 50% of DAD patients with
      respirator use and 80% of AIP patients with steroid medication.

PMID- 8346172
TI  - Membranous glomerulonephritis (MGN) in transplanted kidneys: morphologic
      investigation on 256 renal allografts.
AB  - Twenty-two cases of membraneous glomerulonephritis (MGN) were identified among
      256 bioptically investigated transplanted patients. MGN was defined as de novo in
      15 patients and recurrent in three. The type of MGN could not be ascertained with
      certainty in the other four. Several morphologic features unusual for the
      idiopathic form of MGN were found. Most cases disclosed focal segmental
      distribution of subepithelial deposits and showed the contemporaneous presence of
      different stages of the disease according to Ehrenreich and Churg classification.
      In addition mild-to-moderate mesangial cell proliferation was found in about one
      third of de novo MGN biopsies. Endocapillary hypercellularity was observed in 14
      specimens and held to be due to an excess of mononuclear blood cells, related to
      a concomitant episode of rejection. Chronic transplant glomerulopathy was found
      in 47% of patients with de novo MGN and in 66% of those with recurrent MGN, being
      more frequently observed in specimens with diffuse distribution of deposits.
      Repeated biopsies showed progression of the stage and extension of deposits to a
      large number of capillary loops in four out of six patients. De novo MGN was
      documented 1 to 54 mo (mean value 20.2 mo) after transplantation, and the
      recurrence was observed after 12, 15, and 42 mo. All but two patients (who were
      anuric) complained of proteinuria, which was in the nephrotic range in 12. Apart
      from the significantly higher frequency in de novo MGN patients of DR4 antigen,
      whose significance must in any case be re-evaluated in a larger series, none of
      the factors so far suggested to be linked to the onset of de novo MGN has found
      further support in our study. On the contrary, relevance in favoring the
      appearance and the evolution of MGN has to be attributed to transplant
      glomerulopathy, which, moreover, seems to be more important than MGN itself in
      causing the unfavorable outcome of the graft.

PMID- 8346173
TI  - Expert systems as an aid for the pathologist's role of clinical consultant:
      CANCER-STAGE.
AB  - The traditional role of the pathologist as a clinical consultant for various
      clinical specialists has become more difficult with the explosion of information
      that has taken place in the past decades. Rule-based expert systems offer the
      ability to store and quickly and efficiently retrieve information that is
      relevant to specific clinical situations. They are ideally suited for simple
      repetitive tasks such as the staging of patients with cancer and the retrieval of
      therapeutic and prognostic information. A microcomputer-based expert system,
      CANCER-STAGE, is described that allows a pathologist to perform these tasks with
      minimal computer training. The system was constructed by utilizing an inexpensive
      expert system development package (EXSYS). The knowledge base from the literature
      is stored in 370 IF-THEN rules that have notes with therapeutic information and
      references. The computer user interacting with the system answers questions and
      is quickly provided with the TNM stage of a particular patient and a short
      summary with therapeutic options. The conditions can be changed and the results
      of various WHAT-IF simulations compared for educational purposes.

PMID- 8346174
TI  - Image analysis versus flow cytometry for DNA ploidy quantitation of solid tumors:
      a comparison of six methods of sample preparation.
AB  - With the availability of user-friendly interactive image analysis instruments for
      DNA analysis, there is a growing need for comparison with the established
      methodology of flow cytometry. We have compared the results of DNA ploidy
      quantitation in 12 solid tumors prepared by six different techniques of sample
      preparation: flow cytometry of fresh cell suspensions and of nuclei isolated from
      formalin-fixed, paraffin-embedded tissue; and image analysis of touch
      preparations, of disaggregated cells from paraffin-embedded tissue as well as of
      3- and 7-microns-thick tissue sections. Complete agreement in DNA ploidy results
      obtained by the six methods was found in six out of 12 solid tumors. Image
      analysis of touch preparations detected most tetraploid and multiple aneuploid
      peaks. Sections of 7-microns-thick tissue gave better histogram quality than 3
      microns-thick sections, however tetraploid peaks were not resolved in one case.
      Image analysis of disaggregated paraffin-embedded tumor showed comparable ploidy
      to fresh touch preparations in seven out of 12 cases, the discrepancies being due
      to loss of tetraploid or multiple aneuploid peaks. Flow cytometry gave good
      histograms, but tetraploid and multiple aneuploid peaks were occasionally not
      detected. Each method presents advantages and disadvantages. Flow cytometry and
      image analysis are complementary methods for DNA quantitation, and more than one
      method may be necessary to confirm the DNA content of solid tumors.

PMID- 8346175
TI  - Adhesion onto and invasion into mammalian cells by mycoplasma penetrans: a newly
      isolated mycoplasma from patients with AIDS.
AB  - The newly identified mycoplasma, Mycoplasma pentrans shows remarkable
      pathobiologic properties: it adheres to cell surfaces, deeply penetrates into the
      cell, strongly hemadsorbs human red blood cells, and cytadsorbs human CD4+
      lymphocytes and monocytes. These in vitro biologic activities of mycoplasmas have
      been previously shown to be associated with pathogenic virulence in vivo. Both
      adhesion and invasion clearly involve the organism's unique tip-like structure.
      Invading mycoplasmas often have their tip-like structure deeply buried in the
      cytoplasm of infected mammalian cells. Extensive invasion of the mycoplasma into
      the cytoplasm may kill the cells. The same pathobiologic processes of adhesion
      and invasion using the specialized tip-like structure are found on the epithelium
      in the patient's urogenital tract infected by M. penetrans. Both in vitro and in
      vivo findings suggest a possible pathogenic role of this newly discovered human
      mycoplasma and call for careful evaluation of its role in human diseases.

PMID- 8346176
TI  - Changes in the gastric mucosa following eradication of Helicobacter pylori.
AB  - Although most studies reporting on the examination of Helicobacter pylori
      infection have focused on the clearance of the bacteria and the rapid
      disappearance of the neutrophil infiltrates, the evolution of inflammatory and
      architectural changes in the antral and corporal mucosa following the eradication
      of H. pylori has not been addressed systematically. This study examines in detail
      the histopathologic appearance of the antral and corporal mucosa in a group of
      patients infected with H. pylori and follows the spectrum of morphologic changes
      in each of them after the eradication of the infection. At least 11 biopsies
      ("gastric mapping") were obtained from the antrum and body of each of 15 patients
      with H. pylori. Complete mapping was then repeated 1, 4, and 10 to 12 mo after
      the eradication of H. pylori by a course of "triple therapy." Each biopsy was
      assessed in a semi-quantitative fashion for presence of H. pylori, neutrophils,
      eosinophils, lymphocytes, lymphoid follicles, and intestinal metaplasia. Other
      features (integrity of surface epithelium, architecture, fibrosis) were evaluated
      descriptively. Results were compared with those obtained from a control group of
      16 uninfected, healthy adult volunteers. H. pylori infection was eradicated in 11
      subjects. The disappearance of neutrophils and the normalization of the surface
      epithelium closely paralleled that of H. pylori. Persistence of even small
      numbers of neutrophils was a predictor of relapse. Eosinophils and lymphocytes
      decreased slowly and did not return to normal levels within 1 yr. Lymphoid
      follicles decreased very slowly in all patients but were still present in all
      gastric locations at one year after treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346177
TI  - An immunophenotypic study of the inflammatory cell populations in colon adenomas
      and carcinomas.
AB  - There is increasing interest in the host immunologic response to colon carcinoma
      as immunotherapeutic techniques are being developed. We studied the inflammatory
      cells in 27 specimens of normal mucosa, 16 hyperplastic polyps, 21 tubular
      adenomas, 19 tubulovillous adenomas, 12 villous adenomas, and 17 invasive
      carcinomas using immunohistochemical techniques in paraffin-embedded tissue. UCHL
      1-positive T-cells predominated in the lamina propria of all specimens. In polyps
      and carcinomas, reactive lymphoid follicles composed of L26-positive B-cells, and
      UCHL-1-positive T-cells were a prominent feature and UCHL-1-positive cells were
      increased in the epithelial compartment. Cells bearing surface immunoglobulins
      were widely distributed in all specimens, with IgA predominating. There was a
      relative increase in IgG-positive cells in the carcinomas. KP1-positive
      macrophages, S-100-positive dendritic cells, and HLA-DR-positive cells were
      oriented toward the lumenal surface in normal mucosa and hyperplastic polyps,
      suggesting a diffuse antigen presenting system. Macrophages and dendritic cells
      were increased and dispersed in the neoplasms. HLA-DR expression was increased in
      the neoplasms, mainly in the stromal cells. We conclude that there is an
      activated immune response in adenomas and carcinomas of the colon compared to
      normal mucosa. This is represented by expansion and reorganization of both the T-
      and B-cell compartments and the macrophage-cell systems.

PMID- 8346178
TI  - Immunohistologic evaluation of invasion-associated proteases in breast carcinoma.
AB  - Immunostaining of two invasion-associated proteolytic enzymes, cathepsin D (CD)
      and urokinase-type plasminogen activator (uPA), was assessed in cryostat sections
      of 86 stage-heterogeneous breast carcinomas using monoclonal antibodies. Most
      tumors displayed a focal and/or heterogeneous staining pattern. Overall, staining
      was more frequent in host-derived stromal and inflammatory cells (uPA 54%, CD
      89%) than neoplastic epithelium per se (uPA 24%, CD 70%). Intense (i.e., 2+)
      stromal, but not neoplastic, CD was significantly correlated with nodal or
      systematic metastases (node negative--10% versus node positive/systemic--33%, p =
      0.04). Further, cumulative staining of more than one enzyme (CD + uPA) or more
      than one tumor component (stroma + epithelium) correlated with metastatic disease
      (no metastases--35% versus metastatic--72%, p = 0.005). Neither stromal nor
      epithelial CD alone was significantly correlated with short-term recurrence free
      survival, however additive CD staining (i.e., stromal + epithelial) was strongly
      predictive, overall (both + -75% recurred versus both weak/negative--16%
      recurred, p = 0.0004) and in node positive patients (p = 0.02). We conclude that
      (a) enzymes putatively mediating extracellular matrix dissolution may be derived
      from multiple sources and (b) the metastatic capacity and/or clinical
      aggressiveness of breast carcinomas may reflect overall proteolytic enzyme
      expression, suggesting that cooperative enzyme interaction may be required for
      invasive growth and/or metastasis.

PMID- 8346179
TI  - The immunopathology and clinical relevance of lymphocyte cultures in liver
      transplantation.
AB  - Lymphocytes infiltrating human liver allograft biopsies were expanded in vitro
      for 3 to 5 days in recombinant IL-2 and then uniformly quantified and
      phenotypically characterized. The extent of proliferation was correlated with the
      degree and pattern of lymphocyte infiltration of the source biopsy as well as
      with the subsequent clinical outcome. Each of the 117 cases was assigned to one
      of three primary clinical outcome groups based on a retrospective evaluation of
      the clinical course before and after biopsy. The groups consisted of cases
      involving viral infection (n = 21), rejection (n = 40), or nonrejection-related
      allograft dysfunction (n = 56). The rejection group showed significantly greater
      in vitro expansion of lymphocytes (4201 +/- 685) compared to the nonrejection
      group (2720 +/- 408, P < 0.05). However, cases from the viral infection group
      showed the highest overall average lymphocyte growth (6655 +/- 2595, P < 0.05).
      Immunohistologic evaluation of the source liver transplant biopsy demonstrated
      increased T-cell infiltration of portal triads primarily by CD8+ T-cells in
      rejection compared to nonrejection cases (semiquantitative grade 1.3 +/- 0.1
      versus 1.0 +/- 0.1, P < 0.05). The viral infection group demonstrated more
      significant T-cell infiltration (again predominantly CD8+) of the lobules
      compared to cases without viral infection (1.9 +/- 0.3 versus 1.3 +/- 0.1, P <
      0.05). Immunohistologic evaluation of the cultured lymphocytes from the biopsies
      demonstrated a marked predominance (75% of cultures) of CD8+ T-cells compared to
      CD4+ T-cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346180
TI  - Immunohistochemical profile and differential diagnosis of microglandular
      adenosis.
AB  - Twelve examples of microglandular adenosis (MA) were evaluated
      immunohistochemically using a panel of antibodies directed against actin, S-100
      protein, collagen type IV, the c-erb-B2 gene product, and the progesterone
      receptor, as well as antibodies BER-EP4 and B72.3. The results were compared with
      the reactions observed in 15 cases of tubular carcinoma and 11 examples of
      sclerosing adenosis. Three examples of secretory adenosis were also evaluated,
      but only for S-100 protein and actin. The results confirmed the absence of a
      myoepithelial cell layer and the presence of basal laminar investiture in MA.
      Tubular carcinoma lacked a myoepithelial cell layer and basal laminar
      investiture. Sclerosing adenosis, in contrast, had both a myoepithelial cell
      layer and displayed basement membrane around the tubules. Secretory adenosis also
      had a myoepithelial cell layer; the presence of basement membrane could be
      confirmed easily using periodic acid-Schiff reaction in the three cases of
      secretory adenosis. An interesting and unexpected finding was the presence of an
      intensely positive reaction in the epithelial lining cells of the tubules in
      microglandular adenosis for S-100 protein. A far less intense positivity for S
      100 protein was observed sporadically in many normal myoepithelial and some
      epithelial cells in the adjacent breast lobules. The intensely positive reaction
      suggests that the proliferating cells in MA correspond to an S-100-positive
      epithelial cell type that is often present in a small number and in a sporadic
      manner in the normal breast. The epithelial cells in tubular carcinoma,
      sclerosing and secretory adenosis were negative for S-100 protein.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8346181
TI  - HLA-DR expression in bile duct damage in hepatitis C.
AB  - Several investigations have demonstrated aberrant expression of HLA-DR on damaged
      bile duct epithelium of patients with primary biliary cirrhosis, liver allograft
      rejection, graft versus host disease, and AIDS. Since bile duct damage is a
      prominent feature of chronic hepatitis C, it may also be associated with HLA-DR
      induction. Therefore, we examined the expression of HLA-DR antigen in formalin
      fixed, paraffin-embedded liver biopsy sections of 30 patients with chronic
      hepatitis C by the avidin-biotin peroxidase complex method using a monoclonal
      antibody to HLA-DR. HLA-DR was not detected on bile duct epithelium in any of the
      cases, although bile duct damage of varying degree was observed in 90% of the
      cases. HLA-DR was expressed by Kupffer cells; inflammatory infiltrates in portal
      tracts, and in areas of piecemeal necrosis and lobular necrosis; dendritic cells
      in portal and periportal areas; and occasionally hepatocytes. These observations
      suggest that the mechanism of bile duct injury in chronic hepatitis C may be
      different from that of other conditions such as primary biliary cirrhosis, liver
      allograft rejection, and graft versus host disease.

PMID- 8346182
TI  - Mucoid vasculopathy: vascular lesions in an autopsy study.
AB  - Mucoid vasculopathy is a unique, idiopathic, vascular entity observed in autopsy
      material at the Sree Chitra Tirunal Institute for Medical Sciences and
      Technology, Trivandrum, India. The vascular lesions are the most prominent
      manifestation of a pathologic condition characterized by a generalized
      mucopolysaccharidosis of connective tissues found, for example, within nerve
      bundles in the adventitia of blood vessels and in the interstitium of such organs
      as the heart, lung, and kidney. Tissue deposits are accompanied by a
      mastocytosis. The pathology of vascular lesions observed in 44% of 131 autopsies
      is described. In this group, mucoid vasculopathy occurred more commonly in young
      males of lower socioeconomic status. Both arteries and veins are affected,
      particularly muscular arteries. They present a uniform concentric thickening of
      the intima and media, causing an apparent reduction in luminal diameter.
      Significant histological features include (a) large quantities of
      glycosaminoglycans accompanied by smooth muscle hyperplasia in the intima and
      media and (b) degenerative changes with mineralization of the internal elastic
      lamina of arteries and of mucoid material in the media. Except for the mucoid
      arteriopathy described in popliteal vessels in cases of idiopathic peripheral
      gangrene from Central Africa, which mucoid vasculopathy resembles somewhat, the
      latter condition is not exactly comparable to any other known vascular or
      connective tissue disorder.

PMID- 8346183
TI  - Cytogenetic and ploidy analysis of prostatic adenocarcinoma.
AB  - The cytogenetic evaluation of prostatic adenocarcinoma has shown no consistent
      cytogenetic abnormalities. Despite manipulation of culture conditions, the
      majority of low-stage, untreated prostatic adenocarcinomas show a normal
      karyotype. We have performed cytogenetic analysis on eight primary prostate
      adenocarcinomas, using several control measures to increase the probability that
      any normal karyotype was derived from neoplastic cells rather than accompanying
      normal cells. Tumors were grown in media that encourages epithelial growth; DNA
      ploidy studies were performed before and after tissue culture; and
      immunohistochemical confirmation of the prostatic and epithelial nature of the
      cells was done following culture. Percentage of tumor on tissue sections adjacent
      to those submitted for culture was > 75% in all cases. Seven of eight cases were
      evaluable, and six cases showed no clonal abnormalities and were diploid. One
      tumor showed a population of tetraploid cells, without structural abnormalities.
      Three additional tumors showed evidence of tetraploidy by DNA analysis. One case
      showed nonclonal marker chromosomes and was aneuploid. This patient was
      pathologic Stage D. We conclude that the majority of prostatic adenocarcinomas at
      their inception may not show routinely detectable cytogenetic abnormalities.
      However, tetraploidy may play a role in the evolution of prostatic
      adenocarcinoma.

PMID- 8346184
TI  - Application of flow cytometry in diagnosis of hydatidiform moles.
AB  - We analyzed the nuclear DNA content of 219 hydropic placentas and 68 control
      (nonhydropic) placentas by flow cytometry (FCM) using formalin-fixed paraffin
      embedded tissues. Of 129 cases originally diagnosed as complete hydatidiform mole
      (CM), 91 were diploid, 25 tetraploid, one triploid, and 12 aneuploid. Of five
      invasive CM, two were diploid, and three (including one metastasizing mole) were
      tetraploid. Of 49 partial hydatidiform moles (PM), 36 were triploid and 13 were
      diploid. Of 41 hydropic abortuses (HA), 34 were diploid, one tetraploid, four
      triploid, and two aneuploid. Three control placentas were triploid, and the
      remaining 65 placentas were diploid. Based on FCM and review of the histology, 10
      PM were reclassified as HA, and one PM was revised as CM. Four HA were
      reclassified as PM. One CM was revised as PM. These results show that the
      difficulty of histologic diagnosis of gestational trophoblastic diseases may lie
      in PM. Clinical follow-up information was available in 51 CM and 20 PM, and
      persistent trophoblastic disease followed 18% of CM and 0% of PM. Among diploid
      complete moles, DNA ploidy did not associate with persistent disease. A
      significant increase S-phase fraction (SPF) was detected in diploid CM when
      compared with HA and control placentas. However, among diploid CM, there was no
      significant difference of SPF between those with and without persistent disease.
      These findings suggest that DNA measurements by FCM may be an important aid in
      the diagnosis of hydropic placentas, but not a useful tool for predicting
      persistent disease.

PMID- 8346185
TI  - Proliferation of dendritic cells in the bronchioles of sudden infant death
      syndrome victims.
AB  - Sudden Infant Death Syndrome (SIDS) victims have significantly thickened
      bronchiolar walls with increased mononuclear cells in the adventitia. An
      immunohistochemical study was performed on 25 SIDS and 18 aged-matched control
      infants to characterize these cells. The panel of antibodies included alpha-1
      antitrypsin, lysozyme, actin, vimentin, Leu M1, NSE, S-100, Leu 6, bombesin,
      serotonin, anti-substance P, vasoactive intestinal peptide, MAC 387, and Factor
      XIIIa. The bronchiolar cells stained with S-100 antibody and demonstrated slender
      processes similar to dendritic cells, such as Langerhans' cells, and
      interdigitating reticulum cells, present in normal tissues as well as in certain
      tumors and inflammatory diseases. Manual counting of the S-100 positive cells and
      fibers revealed both of these to be significantly increased in SIDS infants as
      compared to age-matched control infants. Morphologically, the bronchiolar
      dendritic cells closely resembled Langerhans' cells and therefore may have
      similar immunologic functions, such as antigen presentation and viral and
      neoantigen immunosurveillance. We hypothesize that the proliferation of these
      dendritic cells in SIDS victims is a result of exposure to environmental
      antigens, resulting in a thickening of the bronchiolar walls, narrowing of the
      lumen, and reduction in airflow, thus causing a chronic or persistent hypoxia.

PMID- 8346186
TI  - Evaluation of prognostic indicators in squamous carcinoma of the vulva including
      nuclear DNA content.
AB  - The prognostic value of clinical and pathologic features including tumor ploidy
      status was evaluated in 43 randomly selected primary invasive squamous carcinomas
      of the vulva in which the lesion was totally excised and a lymph node dissection
      performed. By both univariate and multivariate analysis, survival most closely
      correlated with the number of involved lymph nodes. In the subgroup of patients
      with negative lymph node dissections, outcome was also found to correlate with
      tumor diameter but not with any other feature studied including nuclear DNA
      content. Both the FIGO surgical staging system and stratification of patients by
      Gynecologic Oncology Group (GOG) risk groups provided valuable methods of
      estimating prognosis with survival rates of 100%, 80%, 59%, and 25% for FIGO
      stages I, II, III, and IV, respectively, and rates of 100%, 75%, 56%, and 42% for
      GOG groups of minimal, low, intermediate, and high risk. Subdivision of patients
      with FIGO Stage III disease based on tumor diameter and the number of involved
      lymph nodes appeared to be of prognostic value with a survival rate of 67% when
      tumor diameter was below 8 cm and less than three lymph nodes were involved but
      only 50% when either value was above the cut-off point. This study suggests that
      DNA ploidy status is not a prognostic value in vulvar squamous carcinoma, but the
      results support the value of utilizing the number of involved lymph nodes for
      prognosis assessment. The latter feature in combination with tumor size may be
      useful in the subdivision of FIGO Stage III patients into prognostic subgroups.

PMID- 8346187
TI  - Reactive states in lymph nodes resembling lymphomas or progressing to lymphomas:
      a selective review.

PMID- 8346188
TI  - Correspondence re: W. Lawrence Selby, Keith V. Nance, and H. Kim Park, CEA
      immunoreactivity in metastatic malignant melanoma. Mod. Pathol 5:415, 1992.

PMID- 8346189
TI  - Fluoride inhibition of yeast enolase: crystal structure of the enolase-Mg(2+)-F(
      )-Pi complex at 2.6 A resolution.
AB  - Enolase in the presence of its physiological cofactor Mg2+ is inhibited by
      fluoride and phosphate ions in a strongly cooperative manner (Nowak, T, Maurer,
      P. Biochemistry 20:6901, 1981). The structure of the quaternary complex yeast
      enolase-Mg(2+)-F(-)-Pi has been determined by X-ray diffraction and refined to an
      R = 16.9% for those data with F/sigma (F) > or = 3 to 2.6 A resolution with a
      good geometry of the model. The movable loops of Pro-35-Ala-45, Val-153-Phe-169,
      and Asp-255-Asn-266 are in the closed conformation found previously in the
      precatalytic substrate-enzyme complex. Calculations of molecular electrostatic
      potential show that this conformation stabilizes binding of negatively charged
      ligands at the Mg2+ ion more strongly than the open conformation observed in the
      native enolase. This closed conformation is complementary to the transition
      state, which also has a negatively charged ion, hydroxide, at Mg2+. The synergism
      of inhibition by F- and Pi most probably is due to the requirement of Pi for the
      closed conformation. It is possible that other Mg(2+)-dependent enzymes that have
      OH- ions bound to the metal ion in the transition state also will be inhibited by
      fluoride ions.

PMID- 8346190
TI  - Absolute and relative binding free energy calculations of the interaction of
      biotin and its analogs with streptavidin using molecular dynamics/free energy
      perturbation approaches.
AB  - We present calculations of the absolute and relative binding free energies of
      complexation of streptavidin with biotin and its analogs by means of a
      thermodynamic free energy perturbation method implemented with molecular
      dynamics. Using the recently solved crystal structure of the streptavidin-biotin
      complex, biotin was mutated into a dummy molecule as well as thiobiotin and
      iminobiotin both in the protein and in solution. The calculated absolute binding
      free energy was dependent on the simulation model used. Encouragingly, the "best
      models" provided a reasonable semiquantitative reproduction (-20 to -22 kcal/mol)
      of the experimental free energy (-18.3 kcal/mol). Furthermore, the calculated
      results give clear insights into the binding nature of the protein-ligand
      complex, showing that the van der Waals energy dominates the electrostatic and
      hydrogen bonding energies in the binding of biotin by streptavidin. Specifically,
      the mutation of biotin into a dummy molecule in solution has a delta G (van der
      Waals) approximately -4 kcal/mol, due to the cancellation of dispersion and
      repulsion "cavity" effects. On the other hand, in the protein, a very small free
      energy price must be paid to create a cavity since one already exists and the
      mutation of biotin into a dummy molecule has a delta G (van der Waals)
      approximately 15 kcal/mol. These results are also consistent with the
      interpretation that the entropy increase to be expected from hydrophobic
      interactions from desolvation of biotin is counterbalanced by a decrease in
      entropy accompanying the formation of buried hydrogen bonds, which have been
      derived from the apparently conflicting experimental data. They provide an
      alternative interpretation of the reason for the extremely high affinity of the
      biotin-streptavidin interaction than that recently proposed by Weber et al. (J.
      Am. Chem. Soc. 114:3197, 1992). In the case of the relative binding free
      energies, the calculated values of 3.8 +/- 0.6 and 7.2 +/- 0.6 kcal/mol compare
      well with the experimental values of 3.6 and 6.2 kcal/mol for the perturbation of
      biotin to thiobiotin and iminobiotin, respectively in the related protein avidin.
      The calculations indicate that desolvation of the ligand is important in
      understanding the relative affinity of the ligands with the protein. The above
      successful simulations suggest that the molecular dynamics/free energy
      perturbation method is useful for understanding the energetic features affecting
      the binding between proteins and ligands, since it is generally difficult to
      determine these factors unambiguously by experiment.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8346191
TI  - Principles and pitfalls in designing site-directed peptide ligands.
AB  - An immunoglobulin light chain dimer with a large generic binding cavity was used
      as a host molecule for designing a series of peptide guest ligands. In a
      screening procedure peptides coupled to solid supports were systematically tested
      for binding activity by enzyme linked immunosorbent assays (ELISA). Key members
      of the binding series were synthesized in milligram quantities and diffused into
      crystals of the host molecule for X-ray analyses. These peptides were
      incrementally increased in size and affinity until they nearly filled the cavity.
      Progressive changes in binding patterns were mapped by comparisons of
      crystallographically refined structures of 14 peptide-protein complexes at 2.7 A
      resolution. These comparisons led to guidelines for ligand design and also
      suggested ways to modify previously established binding patterns. By manipulating
      equilibria involving histidine, for example, it was possible to abolish one
      important intramolecular interaction of the bound ligand and substitute another.
      These events triggered a change in conformation of the ligand from a compact to
      an extended form and a comprehensive change in the mode of binding to the
      protein. In dipeptides of histidine and proline, protonation of both imidazolium
      nitrogen atoms was used to program an end-to-end reversal of the direction in
      which the ligand was inserted into the binding cavity. Peptides cocrystallized
      with proteins produced complexes somewhat different in structure from those in
      which ligands were diffused into preexisting crystals. In such a large and
      malleable cavity, space utilization was thus different when a ligand was
      introduced before the imposition of crystal packing restraints.

PMID- 8346192
TI  - A molecular dynamics study of solvent behavior around a protein.
AB  - The solvent structure and behavior around a protein were examined by analyzing a
      trajectory of molecular dynamics simulation of the trp-holorepressor in a
      periodic box of water. The calculated self diffusion coefficient indicated that
      the solvent within 10 A of the protein had lower mobility. Examination of the
      solvent diffusion around different atoms of different kinds of residues showed no
      general tendency. This fact suggested that the solvent mobility is not influenced
      significantly by the kind of the atom or residue they solvated. Distribution
      analysis around the protein revealed two peaks of water oxygen: a sharp one at
      2.8 A around polar and charged atoms and a broad one at approximately 3.4 A
      around apolar atoms. The former was stabilized by water-protein hydrogen bonds,
      and the latter was stabilized by water-water hydrogen bonds, suggesting the
      existence of a hydrophobic shell. An analysis of protein atom-water radial
      distribution functions confirmed these shell structures around polar or charged
      atoms and apolar ones.

PMID- 8346193
TI  - The structure of a centrosymmetric protein crystal.
AB  - Crystals of racemic rubredoxin, prepared by independent chemical synthesis of the
      two enantiomers, have been grown and characterized. The unit cell contains two
      molecules, one of each enantiomer. Examination of the intensity distribution in
      the diffraction pattern revealed that the crystals are centrosymmetric. This was
      confirmed by solution of the structure to 2 A resolution via molecular
      replacement methods. The electron density maps are of very high quality due to
      the fact that the phase of each reflection must be exactly 0 degrees or exactly
      180 degrees. These results demonstrate the feasibility of using synthetic racemic
      proteins to yield centrosymmetric protein crystals with electron density maps
      that have very low phase error and model bias.

PMID- 8346194
TI  - A comparison of the immunogenicity of a pair of enantiomeric proteins.
AB  - The immunogenicity of a folded, all D-amino acid protein, rubredoxin, has been
      compared with that for the corresponding L-protein enantiomer. Following multiple
      administrations with alum adjuvant, the L-protein induced a strong, specific IgG
      antibody response, whereas the D-protein did not. This relative lack of
      responsiveness to the D-protein cannot be attributed to rapid excretion, since it
      is retained at least 4 times longer than the natural L-protein. These
      observations provide the first direct evidence that a folded D-amino acid protein
      has low immunogenicity and is long lived in vivo. Proteins with such properties
      may be useful as molecular platforms in a variety of chemical and pharmacological
      applications.

PMID- 8346195
TI  - Are there ecological limits to population?
AB  - Policy on population and environment in the United States and abroad has been
      vacillating, unsure of its course; it would be more decisive if the several
      disciplines could agree on the nature of the problems and their urgency. The two
      disciplines principally concerned are biology and economics, and the contribution
      of this paper is to identify eight of the many axes or directions on which the
      methods and traditions of the two are different. For example, the first of the
      axes runs between contingency and orderly progress, with biology tending to seek
      out the former and economics the latter; thus biologists can more easily
      comprehend catastrophes, such as the demise of the dinosaurs or widespread
      desertification. The third axis concerns indefinite market-driven
      substitutability, seen by economists as resulting from scientific discovery;
      natural scientists, including biologists, whose discoveries make possible the
      substitutions, are skeptical. Axis 7 results from the fact that economics
      concentrates on goods that are on the market, and so deals with a truncated part
      of the commodity cycle, while ecology aims at the whole; because goods disappear
      from economic statistics once they pass into the hands of consumers many of their
      ecological effects are invisible. I believe that from similar further study of
      the two disciplines a common set of policy recommendations will ultimately
      emerge.

PMID- 8346196
TI  - E2F-1-mediated transactivation is inhibited by complex formation with the
      retinoblastoma susceptibility gene product.
AB  - Previous studies have shown that the carboxyl-terminal region of E2F-1 (residues
      368-437) can support transcriptional activation when linked to the DNA-binding
      domain of the yeast transcription factor GAL4. This region also contains an 18
      residue retinoblastoma (RB)-binding sequence, raising the possibility that RB
      binding might inhibit the ability of E2F-1 to form protein-protein contacts
      required for activation. Here we report a further analysis of the E2F-1
      activation domain. In addition, we show that overexpression of RB, but not the RB
      mutant, RBd22, can inhibit GAL4/E2F-1 activity in vivo. Moreover, expression of
      the simian virus 40 large tumor antigen (T antigen), but not the RB-binding
      defective T antigen point mutant, K1, can overcome this repression. Three
      different GAL4/E2F-1 mutants that activate transcription, but fail to bind to RB,
      are not significantly affected by overexpression of RB. These findings support a
      model wherein RB suppresses E2F-1-mediated transcriptional activation through
      direct physical association.

PMID- 8346197
TI  - Dominant lethality by expression of a catalytically inactive class I tRNA
      synthetase.
AB  - Alignment-guided mutagenesis was used to create an inactive, but toxic, aminoacyl
      tRNA synthetase. An Asp-96-->Ala (D96A) replacement in the nucleotide binding
      fold of the class I Escherichia coli isoleucyl-tRNA synthetase inactivates the
      enzyme without disrupting its competence for binding isoleucine tRNA. Expression
      of plasmid-encoded mutant enzyme in a cell with a wild-type ileS chromosomal
      allele resulted in cell death. Introduction of a second K732T substitution
      previously shown to weaken tRNA binding gives an inactive D96A/K732T double
      mutant. Expression of the double mutant is not lethal to E. coli. D96A but not
      the double mutant significantly inhibited in vitro charging of isoleucine tRNA by
      the wild-type enzyme. The results suggest a dominant tRNA binding-dependent
      arrest of cell growth caused by a reduction in the pool of a specific tRNA.
      Specific tRNA binding drugs may have therapeutic applications for treatment of
      microbial pathogens.

PMID- 8346198
TI  - Folding pathway mediated by an intramolecular chaperone.
AB  - The N-terminal propeptide of subtilisin, a serine protease, functions as an
      intramolecular chaperone which is crucial for proper folding of the active
      enzyme. This nascent N-terminal propeptide is removed after completion of the
      folding process. Here we present a possible pathway by which intramolecular
      chaperones mediate protein folding. Using circular dichroism to analyze acid
      denatured subtilisin we have identified a folding-competent state which can
      refold to an active conformation in the absence of the propeptide. Earlier work
      had shown that guanidine hydrochloride-denatured subtilisin was in a state
      incapable of folding in absence of its propeptide. Comparison of the folding
      incompetent and folding-competent states indicates that refolding is facilitated
      by the presence of residual structure present only in the folding-competent
      state. The analysis further indicates that the propeptide is essential for
      inducing this state. Therefore the folding-competent state may lie on--or be in
      rapid equilibrium with an intermediate on--the folding pathway of subtilisin. In
      the absence of the propeptide, formation of such a state--and hence refolding--is
      extremely slow.

PMID- 8346199
TI  - Properties and purification of an active biotinylated lactose permease from
      Escherichia coli.
AB  - A simplified approach for purification of functional lactose permease from
      Escherichia coli is described that is based on the construction of chimeras
      between the permease and a 100-amino acid residue polypeptide containing the
      biotin acceptor domain from the oxaloacetate decarboxylase of Klebsiella
      pneumoniae [Cronan, J. E., Jr. (1990) J. Biol. Chem. 265, 10327-10333]. Chimeras
      were constructed with a factor Xa protease site and the biotin acceptor domain in
      the middle cytoplasmic loop (loop 6) or at the C terminus of the permease. Each
      construct catalyzes active lactose transport in cells and right-side-out membrane
      vesicles. Moreover, the constructs are biotinylated in vivo, and in both
      chimeras, the factor Xa protease site is accessible from the cytoplasmic surface
      of the membrane. Both biotinylated permeases bind selectively to immobilized
      monomeric avidin and are eluted with free biotin in a high state of purity, and
      the loop 6 chimera catalyzes active transport after reconstitution into
      proteoliposomes. The methodology described should be applicable to other membrane
      proteins.

PMID- 8346200
TI  - Interferon alpha induces protein kinase C-epsilon (PKC-epsilon) gene expression
      and a 4.7-kb PKC-epsilon-related transcript.
AB  - Protein kinases play key roles in the induction by human interferon alpha (IFN
      alpha) of specific gene expression and biological activity in various human cell
      lines. We now report that IFN-alpha increased the 7-kb transcript for the epsilon
      isotype of protein kinase C (PKC-epsilon) and the cellular content of PKC-epsilon
      24 and 48 hr after IFN-alpha addition (a 2-fold and 6-fold increase,
      respectively). Furthermore, IFN-alpha markedly induced a 4.7-kb transcript that
      hybridized to a PKC-epsilon-specific, but not to a PKC-eta-specific, cDNA probe.
      The induction of the 4.7-kb PKC-epsilon-related mRNA by IFN-alpha had the
      following properties reported for the classical IFN-alpha-stimulated genes: rapid
      kinetics of induction, high maintained levels in IFN-alpha-sensitive but not in
      IFN-alpha-resistant cell lines, protein synthesis-independent induction, and high
      sensitivity to inhibitors of protein tyrosine kinase activity. These results show
      that the regulation of gene expression by IFN-alpha include not only the
      classical IFN-alpha-stimulated genes but also the coordinated regulation of two
      PKC-epsilon-related transcripts that appeared to be highly relevant to the
      biological actions of IFN-alpha.

PMID- 8346201
TI  - Alloantibodies can discriminate class I major histocompatibility complex
      molecules associated with various endogenous peptides.
AB  - Molecules encoded by a single major histocompatibility complex class I gene can
      associate with any one of a large number of peptide ligands. T-cell receptors
      have the capacity to discriminate among these peptide-class I complexes and in
      many cases bind only a single peptide-class I complex with sufficient affinity to
      trigger effector function. In contrast, it is generally assumed that class I
      specific alloantibodies are indifferent to peptide heterogeneity, being directed
      toward allele-specific determinants on the molecule. In this report, three
      monoclonal antibodies were used to precipitate Kb molecules from cell lysates.
      Surprisingly, in each case a different set of peptides was found to be associated
      with Kb as detected by peptide-dependent Kb-specific alloreactive cytolytic T
      lymphocytes or by biochemical resolution. These results demonstrate that the
      affinity of binding by alloantibodies can be affected by the endogenous peptide
      ligand.

PMID- 8346202
TI  - Ethanol selectively blocks a noninactivating K+ current expressed in Xenopus
      oocytes.
AB  - There is presently a debate regarding the relative merits of lipid-based and
      protein-based theories of anesthesia and the action of ethanol in the central
      nervous system. Voltage-sensitive K+ channels play a key role as regulators of
      neuronal electrical activity and are potential targets of ethanol and other
      anesthetic agents. We investigated the action of low concentrations of ethanol on
      four structurally homologous cloned K+ channels expressed in Xenopus oocytes. We
      report that only the Drosophila Shaw2 channel, which does not inactivate upon
      prolonged depolarization, is rapidly and reversibly blocked by ethanol in a
      concentration-dependent manner (17-170 mM). The concentration dependence of the
      blockade can be explained by assuming a bimolecular interaction between ethanol
      and the channel. We also found that Shaw2 K+ channels were selectively blocked by
      halothane (1 mM). Our results support the "protein hypothesis" of ethanol and
      anesthetic action. These findings open ways to elucidate directly the molecular
      mechanism of interaction between general anesthetics and a voltage-sensitive K+
      channel.

PMID- 8346204
TI  - Composite, large spirochetes from microbial mats: spirochete structure review.
AB  - Phenomena previously unknown in free-living spirochetes are reported: large-sized
      cells with variable diameter (length to 100 microns, width between 0.4 and 3.0
      microns), composite structure (smaller spirochetes inside larger ones), and
      positive phototropic behavior. These bacteria, Spirosymplokos, are compared with
      all other spirochete genera. The large spirochete, grown in mixed culture, was
      studied live and by transmission EM. The protoplasmic cylinder was replete with
      spherical granules 20-32 nm in diameter, and three to six periplasmic 26-nm
      flagella were inserted subterminally. Comparably granulated and flagellated small
      spirochetes were located inside the protoplasmic cylinder and in the periplasm of
      the large ones. When exposed to air, movement became erratic, protoplasmic
      cylinders retracted to lie folded inside the outer membrane, and refractile
      membranous structures formed. From one to four structures per still-moving
      spirochete were seen. Spirosymplokos was enriched from laboratory samples exposed
      to oxygen-rich and desiccating, but not dry, conditions for at least 4 mo after
      removal of microbial mat from the field.

PMID- 8346203
TI  - hP1.B, a human P-domain peptide homologous with rat intestinal trefoil factor, is
      expressed also in the ulcer-associated cell lineage and the uterus.
AB  - The six-cysteine P-domain motif forms the basic repeat unit of a growing family
      of mucin-associated peptides. A precursor for a human secretory polypeptide has
      been discovered by molecular cloning and deduced to have a single P-domain,
      termed hP1.B. The pre-pro-peptide has 67% amino acid identity with rat intestinal
      trefoil factor. We find, using the techniques of RNA analysis and in situ
      hybridization, that this P-domain peptide is expressed in the human
      gastrointestinal tract, where a number of pathological conditions affect its
      expression, and surprisingly find it is expressed in the uterus also. In the
      intestine, hP1.B is expressed by goblet cells, but in Crohn disease this peptide
      is synthesized and secreted additionally by the ulcer-associated cell lineage
      that is known to secrete two other trefoil peptides, pS2 and spasmolytic
      polypeptide (hSP). In the stomach, hP1.B mRNA is relatively scarce but is more
      abundant in foci of intestinal metaplasia and near to ulceration. Mucin-rich
      epithelial cells in hyperplastic polyps of the colon also express this peptide.
      The discovery of this P-domain peptide and its expression in association with
      mucins support the hypothesis that P-domains with mucins may subserve related
      functions in the maintenance and repair of mucosal function.

PMID- 8346206
TI  - Calsequestrinlike calcium-binding protein is expressed in calcium-accumulating
      cells of Pistia stratiotes.
AB  - To contend with high calcium (Ca) levels in the environment, many plant species
      contain crystal idioblasts, specialized cells which accumulate large amounts of
      Ca as oxalate crystals. The biochemical processes involved in the accumulation of
      Ca in crystal idioblasts are unknown, as these cells constitute only a minor
      proportion of the total plant tissue. To address how crystal idioblasts buffer
      cytosolic Ca during crystal formation, we purified these cells from water lettuce
      and assessed their biochemistry. We show here that crystal idioblast cells
      contain three Ca-binding proteins not detectable in mesophyll cells. One of the
      Ca-binding proteins shares antigenicity with rabbit calsequestrin, a high
      capacity low-affinity Ca-binding protein, and is encoded by related nucleotide
      sequences. Immunocytochemical localization studies further demonstrate that a
      calsequestrinlike protein is present primarily in crystal idioblasts and is
      preferentially localized in the endoplasmic reticulum, an organelle enriched in
      Ca as evidenced by vital staining. We thus conclude that crystal idioblasts
      possess a buffering system involving calsequestrinlike proteins, a process that
      likely plays an essential role in the bulk control of Ca in plant cells.

PMID- 8346205
TI  - Chlamydomonas mutants affected in the light-dependent step of sexual
      differentiation.
AB  - Sexual differentiation of Chlamydomonas reinhardtii is induced by the consecutive
      action of two extrinsic cues--nitrogen deprivation and blue light. The definition
      of a blue light-dependent step in gamete formation provided a basis for the
      isolation of mutants altered in the signal transduction pathway by which light
      controls sexual differentiation. In one mutant (lrg1), gamete formation has
      become light independent. In the other mutant (lrg2), perception or transduction
      of the light signal appears to be partially impaired. In both mutants, the
      expression of genes activated by light in the late phase of gamete formation is
      affected. Genetic analyses showed that genes LRG1 and LRG2 are linked. The
      recessive nature of the lrg1-1 mutation implies that the gene encodes a negative
      factor or a protein that controls the activity of a negative factor. In the case
      of lrg2-1, neither wild-type nor mutant allele was dominant. Rather, two copies
      of the lrg2-1 gene simulate a wild-type phenotype. The identification of genetic
      loci in the pathway for blue light-mediated differentiation provides a basis for
      the isolation of signal transduction genes in Chlamydomonas.

PMID- 8346207
TI  - Hammerhead ribozymes: importance of stem-loop II for activity.
AB  - The activity of several hammerhead ribozyme constructs with constant lengths of
      stems I and III of 5 nt each but with variously shortened stems II is reported.
      Stems with 2 bp rather than the conventional 4 bp show essentially unaltered
      catalytic activity, independent of the composition of the tetraloop. Further
      reduction in size to 1 bp or 0 bp decreases activity drastically. Inversion of
      the G10.1.C11.1 bp next to the invariant core leads to a loss in activity, even
      when the stem consists of 4 bp. Thus, the minimal structural requirement for stem
      loop II is a 2-bp stem with a conserved G.C bp. The reduction in catalytic
      activity is predominantly a result of a decrease of catalytic constant kcat,
      whereas Km is only slightly affected. Thus, the structural requirement for
      optimal activity in these constructs where the chemical-cleavage step is rate
      limiting is determined by the stabilization of the transition state.

PMID- 8346208
TI  - Determination of the phylogenetic relationships among Pacific salmonids by using
      short interspersed elements (SINEs) as temporal landmarks of evolution.
AB  - Several subfamilies of the salmonid Hpa I short interspersed element (SINE)
      family were isolated from salmonid genomes and were sequenced. For each genomic
      locus that represented the subfamily, amplification by PCR of the orthologous
      loci in the 12 fish allowed us to determine the order of branching of the Pacific
      salmonid species. The deduced phylogeny suggests three evolutionary lines,
      namely, a line of chum salmon, pink salmon, and kokanee; a line of coho salmon
      and chinook salmon; and a line of steelhead trout. Our data also support a change
      in the phylogenetic assignment of steelhead trout from Salmo to Oncorhynchus. We
      present here an extensive phylogenetic tree constructed from an analysis of
      differential insertion of SINEs, and we propose that SINE insertion analysis is
      one of the best available methods for clarifying the order of divergence of
      closely related species.

PMID- 8346209
TI  - The cAMP-response-element-binding protein interacts, but Fos protein does not
      interact, with the proenkephalin enhancer in rat striatum.
AB  - The proenkephalin gene is a well-studied model of transcription factor-target
      gene interaction in the nervous system and has been proposed as a regulatory
      target of the protein product of the immediate-early gene c-fos. This regulatory
      mechanism has been proposed, in part, because the cAMP response element 2 (CRE-2)
      site, the key DNA regulatory element within the proenkephalin second-messenger
      inducible enhancer, avidly binds AP-1 proteins, including Fos, in vitro. However,
      we observe a dissociation in the time course of activation of c-fos and
      proenkephalin mRNA in rat striatum after administration of the dopamine D2
      receptor antagonist haloperidol. This result prompted us to investigate the
      composition of protein complexes in striatal nuclear extracts that bind to the
      CRE-2 site. Even though our striatal nuclear extracts had substantial basal and
      haloperidol-inducible AP-1-binding activities that contained Fos, we could not
      detect Fos in complexes bound to the CRE-2 element. Instead, as determined by
      antibody supershift analysis, we detect CRE-binding protein (CREB)-like proteins
      binding to CRE-2 in both basal and haloperidol-stimulated conditions. Finally, we
      show that haloperidol induces CREB protein phosphorylation in striatum.

PMID- 8346210
TI  - Genetic fusion of subunits of a dimeric protein substantially enhances its
      stability and rate of folding.
AB  - The gene V protein of bacteriophage f1 is a single-stranded DNA and RNA-binding
      protein composed of two identical subunits. We have constructed single-chain
      variants of the protein using short peptide linkers of five or six amino acids to
      connect the carboxyl terminus of one monomer to the amino terminus of the second
      monomer. The resulting subunit-fusion gene V proteins were found to bind single
      stranded DNA nearly as tightly as the wild-type protein. Denaturation
      measurements show that the subunit-fusion gene V proteins are 5 kcal/mol (1 kcal
      = 4.18 kJ) more stable than the wild-type protein at a protein concentration of
      10 microM. The rate of unfolding of the protein is essentially unaffected by the
      fusion of monomeric subunits, whereas the rate of folding is greatly enhanced.
      Our results suggest a simple way of obtaining a substantial thermodynamic
      stabilization for some oligomeric proteins.

PMID- 8346212
TI  - Regression of established macroscopic liver metastases after in situ transduction
      of a suicide gene.
AB  - The herpes simplex virus type 1 thymidine kinase (HSV1-TK) converts nontoxic
      nucleoside analogs such as ganciclovir into phosphorylated compounds that act as
      chain terminators and specifically kill dividing cells. This property could be
      exploited for the treatment of tumors that are made up of rapidly dividing cells
      invading a nonproliferating tissue. For this purpose, specific expression of the
      suicide gene into dividing tumor cells can be further targeted by using
      retroviral-mediated gene transfer. We investigated whether the direct
      intratumoral transduction of a suicide gene might induce the elimination of
      malignant solid tumors. Rats with established macroscopic liver metastases were
      given an intratumoral injection of packaging cells producing either HSV1-TK- or
      lacZ-expressing recombinant retroviral particles. All rats were next treated with
      ganciclovir. A dramatic regression of the tumor volume was observed in the HSV1
      TK-treated animals. The residual tumors were mostly made up of a massive fibrotic
      reaction, with the mean cancer cell mass being reduced approximately 60-fold
      compared to controls. In some animals, the residual tumors were devoid of cancer
      cells. This treatment efficacy appears in part due to a "bystander effect" in
      which phosphorylated ganciclovir could be transferred from cell to cell and to an
      active local immune reaction evidenced by massive infiltration of the tumors by
      macrophages and both CD4+ and CD8+ lymphocytes. This efficient therapeutic
      approach might be an ultimate treatment for disseminated liver metastases in
      humans and could also be applied to treatment of a large variety of solid tumors.

PMID- 8346211
TI  - Regional cerebral glucose metabolism in late-life depression and Alzheimer
      disease: a preliminary positron emission tomography study.
AB  - Eight subjects with late-life depression, eight subjects with probable Alzheimer
      disease, and eight healthy age-matched controls were studied using 2-[18F]fluoro
      2-deoxy-D-glucose positron emission tomography in the resting state with their
      eyes open and ears unoccluded. The depressed subjects showed widespread
      reductions in the regional cerebral metabolic rate for glucose in most major
      neocortical, subcortical, and paralimbic regions that were significantly
      different from control values (P < 0.01). The metabolic decrements in the
      depressed group were comparable in magnitude to those seen in the Alzheimer
      disease group. These data demonstrate widespread nonfocal decline in glucose
      metabolism in late-life depression that is comparable to the hypometabolism seen
      in Alzheimer disease. These findings have pathophysiological implications in
      major depressive disorder in the elderly.

PMID- 8346213
TI  - Stabilization and ribosome association of unspliced pre-mRNAs in a yeast upf1-
      mutant.
AB  - Nonsense-mediated mRNA decay, the accelerated turnover of mRNAs transcribed from
      genes containing early nonsense mutations, is dependent on the product of the
      UPF1 gene in yeast. Mutations that inactivate UPF1 lead to the selective
      stabilization of mRNAs containing early nonsense mutations but have no effect on
      the half-lives of almost all other mRNAs. Since the transcripts of nonsense
      alleles are not typical cellular constituents, we sought to identify those RNAs
      that comprise normal substrates of the nonsense-mediated mRNA decay pathway. Many
      yeast pre-mRNAs contain early in-frame nonsense codons and we consider it
      possible that a role of this pathway is to accelerate the degradation of pre
      mRNAs present in the cytoplasm. Consistent with this hypothesis, we find that, in
      a strain lacking UPF1 function, the CYH2, RP51B, and MER2 pre-mRNAs are
      stabilized 2- to 5-fold and are associated with ribosomes. We conclude that a
      major source of early nonsense codon-containing cytoplasmic transcripts in yeast
      is pre-mRNAs and that the UPF1 protein may be part of a cellular system that
      ensures that potentially deleterious nonsense fragments of polypeptides do not
      accumulate.

PMID- 8346214
TI  - Expression of transduced tropomyosin 1 cDNA suppresses neoplastic growth of cells
      transformed by the ras oncogene.
AB  - Synthesis of certain members of the tropomyosin family of microfilament
      associated proteins is suppressed in fibroblasts neoplastically transformed by a
      number of retroviral oncogenes, by transforming growth factor alpha, and by
      chemical mutagens. To test whether tropomyosin suppression is a required event in
      neoplastic transformation, expression of one of two suppressed tropomyosins in
      NIH 3T3 mouse cells transformed by the ras oncogene was restored by retrovirally
      mediated cDNA transfer. Cells expressing the inserted cDNA showed partial
      restoration of microfilament bundle formation (which is typically deranged in
      transformed cells) together with increased cytoplasmic spreading. More
      importantly, they lost anchorage-independent growth capability, and the onset of
      tumor growth in athymic mice was delayed. When tumors arose they no longer
      expressed the inserted cDNA. These observations support the conclusion that
      tropomyosin suppression is a necessary event for the expression of components of
      the transformed phenotype, particularly with respect to anchorage-independent
      growth and tumorigenesis, which correlate closely with neoplastic potential. This
      potentially reversible requirement may link different initial events produced by
      a variety of oncogenic modalities to a common pathway leading to neoplastic
      growth.

PMID- 8346215
TI  - Identification of four murine cDNAs encoding putative protein kinases from
      primitive embryonic stem cells differentiated in vitro.
AB  - Protein kinases transduce signals from extracellular ligands in the hematopoietic
      and other systems through direct phosphorylation of tyrosine, serine, or
      threonine residues. Little is known about the ligands and receptors that are
      important in the earliest stages of development--i.e., stem cell self-renewal and
      lineage commitment. We have made use of the lineage differentiation potential of
      the murine embryonic stem cell system to clone partial cDNAs encoding four
      putative protein kinases. Three of the four genes contain the highly conserved
      residues Asp-Phe-Gly in domain VII of the protein kinase family. These genes are
      candidates for receptors or downstream effectors of cytokines that regulate self
      renewal and lineage commitment in embryogenesis.

PMID- 8346216
TI  - Duplication of the CD8 beta-chain gene as a marker of the man-gorilla-chimpanzee
      clade.
AB  - In earlier studies we have found that the gene encoding the CD8 beta chain is
      duplicated in man. We demonstrate here that the duplicated genes are both located
      on chromosome 2. We have also studied the moment of the duplication event
      relative to the evolution of higher primates by using genomic DNA of a panel of
      primates. Our data strongly suggest that duplication occurred after the orangutan
      lineage had split and before the chimpanzee, gorilla, and man clade diverged,
      some 8-9.5 million years ago. This result makes the CD8 beta-chain gene
      duplication a convenient marker for the study of the evolution of higher
      primates.

PMID- 8346217
TI  - Interleukin 1 induction of the c-jun promoter.
AB  - Interleukin 1 (IL-1) induces pleiotropic effects in many cell types during
      inflammation and immunity. We have recently shown how the IL-1 signal is
      transmitted to the nucleus: In T cells and in pituitary cells, IL-1 induced genes
      via activation of the nuclear factor AP-1. We now demonstrate how IL-1 activates
      the AP-1 factor in liver cells, which are a major target for IL-1 during the
      acute phase response in vivo. IL-1 induced gene transcription of both AP-1
      components, c-jun and c-fos. IL-1 also increased the stability of c-jun mRNA. We
      define two enhancer sites in the jun promoter that are required for induction by
      IL-1. Although the binding sites share some similarity with the AP-1 binding
      site, the nuclear factors binding the jun motifs are not composed of Jun or Fos
      proteins. Thus these data identify two binding proteins that serve as one of the
      first nuclear targets for IL-1 signal transduction.

PMID- 8346218
TI  - Reproductive failure of dominant males in the poeciliid fish Limia perugiae
      determined by DNA fingerprinting.
AB  - Hierarchical structures among male individuals in a population are frequently
      reflected in differences in aggressive and reproductive behavior and access to
      the females. In general, social dominance requires large investments, which in
      turn then may have to be compensated for by high reproductive success. However,
      this hypothesis has so far only been sufficiently tested in small mating groups
      (one or two males with one or two females) due to the difficulties of determining
      paternity by conventional methods. DNA fingerprinting overcomes these problems by
      offering the possibility to determine genetic relationships and mating patterns
      within larger groups [Burke, T. (1989) Trends Ecol. Evol. 4, 139-144]. We show
      here that in the poeciliid fish Limia perugiae, in small mating groups the
      dominant male has a mating success of 100%, whereas in larger groups its
      contribution to the offspring unexpectedly drops to zero.

PMID- 8346220
TI  - Habitat-dependent hybrid parentage and differential introgression between
      neighboringly sympatric Daphnia species.
AB  - Allozyme, morphological, and PCR-generated mtDNA markers were used to analyze
      hybrid parentage and introgression between the neighboringly sympatric
      crustaceans Daphnia galeata mendotae and Daphnia rosea. mtDNA analysis of D.
      galeata mendotae from 15 lakes and of D. rosea from 8 lakes revealed species
      specific fragment patterns resulting from TaqI and RsaI digestion. No individuals
      of one parent species possessed the typical mtDNA of the other parent species,
      suggesting that mtDNA introgression is rare or nonexistent. Hybrids from 18 lakes
      possessed either the mtDNA patterns of D. rosea or of D. galeata mendotae,
      indicating that reciprocal hybridization occurs. The mtDNA genome of the dominant
      parent species in a lake was overrepresented in the hybrids, suggesting that
      hybridization most often involves females of the common species and males of the
      rare species. Such a pattern is consistent with the differing importance of
      density to the environmental induction of males and sexual eggs in Daphnia. For
      the assessment of nuclear gene flow, eight sympatric populations of each parental
      taxon and seven allopatric populations of D. galeata were analyzed for allozyme
      variation at nine polymorphic loci. Our results provided evidence for asymmetric
      interspecific gene flow involving alleles at six loci that are unlikely to be
      convergent or symplesiomorphic. This reticulate evolution accounted for much of
      the genetic divergence between European and North American populations of D.
      galeata.

PMID- 8346219
TI  - Molecular cloning of the human kidney differentiation antigen gp160: human
      aminopeptidase A.
AB  - gp160 is a cell surface differentiation-related glycoprotein of 160 kDa expressed
      by epithelial cells of the glomerulus and proximal tubule cells of the human
      nephron but only by a subset of renal cell carcinomas (RCCs). We have reported
      that gp160 expression correlates with the resistance of cultured RCCs to the
      antiproliferative effects of alpha interferon, while lack of expression
      correlates with sensitivity to alpha interferon. In this study, we have purified
      gp160 protein, obtained partial sequences of random peptides, and isolated a full
      length cDNA. The gp160 cDNA possesses 78% homology to the murine BP-1/6C3
      antigen, a B-lymphocyte differentiation protein that exhibits aminopeptidase A
      (APA; EC 3.4.11.7) activity. Enzymatic assays on human RCC cell lines indicated a
      100% concordance between APA activity and gp160 expression. APA activity of gp160
      expressing RCC cells was increased or decreased by a panel of APA activators or
      inhibitors, respectively. Furthermore, anti-gp160 monoclonal antibodies
      immunoprecipitate APA activity from RCC cell lysates and selectively deplete APA
      activity from RCC cell extracts. These data indicate that the gp160 human
      kidney/RCC glycoprotein is human APA.

PMID- 8346221
TI  - Broad-spectrum virus resistance in transgenic plants expressing pokeweed
      antiviral protein.
AB  - Exogenous application of pokeweed antiviral protein (PAP), a ribosome-inhibiting
      protein found in the cell walls of Phytolacca americana (pokeweed), protects
      heterologous plants from viral infection. A cDNA clone for PAP was isolated and
      introduced into tobacco and potato plants by transformation with Agrobacterium
      tumefaciens. Transgenic plants that expressed either PAP or a double mutant
      derivative of PAP showed resistance to infection by different viruses. Resistance
      was effective against both mechanical and aphid transmission. Analysis of the
      vacuum infiltrate of leaves expressing PAP showed that it is enriched in the
      intercellular fluid. Analysis of resistance in transgenic plants suggests that
      PAP confers viral resistance by inhibiting an early event in infection. Previous
      methods for creating virus-resistant plants have been specific for a particular
      virus or closely related viruses. To protect plants against more than one virus,
      multiple genes must be introduced and expressed in a single transgenic line.
      Expression of PAP in transgenic plants offers the possibility of developing
      resistance to a broad spectrum of plant viruses by expression of a single gene.

PMID- 8346222
TI  - Corticotropin-releasing factor mRNA in rat thymus and spleen.
AB  - Corticotropin-releasing factor (CRF) initiates stress-induced immunosuppression
      via the hypothalamic-pituitary-adrenal axis. CRF has also been shown to have
      direct stimulatory and suppressive effects on immune cells. We have previously
      detected immunoreactive and bioactive CRF in the rat spleen and thymus. To
      determine if CRF is synthesized in these tissues, we analyzed rat spleen and
      thymus for the presence of CRF mRNA. RNA was reverse transcribed, and the
      resulting cDNA was amplified by the polymerase chain reaction with CRF gene
      specific oligonucleotide primers. After Southern blotting and hybridization with
      an internal CRF gene probe, a product of the expected size was detected in the
      spleen, thymus, and hypothalamus (positive control) but not in liver or kidney
      (negative controls), indicating that CRF is synthesized in the spleen and thymus.
      Furthermore, CRF could be secreted from splenic and thymic adherent cells in
      culture. Secretion increased severalfold in response to nordihydroguaiaretic acid
      (NDGA), a lipoxygenase pathway inhibitor, whereas interleukin 1 had no effect,
      suggesting that regulation of CRF secretion may differ from that in the
      hypothalamus. CRF mRNA was detected in NDGA-stimulated thymic adherent cells and
      in both control and NDGA-stimulated splenic nonadherent cells. The finding that
      CRF is synthesized in the spleen and thymus suggests that locally synthesized
      "immune" CRF, acting as an autocrine or paracrine cytokine, may have direct
      regulatory effects on immune function.

PMID- 8346223
TI  - An erythromycin analog produced by reprogramming of polyketide synthesis.
AB  - The polyketide-derived macrolactone of the antibiotic erythromycin is made
      through successive condensation and processing of seven three-carbon units. The
      fourth cycle involves complete processing of the newly formed beta-keto group
      (beta-keto reduction, dehydration, and enoyl reduction) to yield the methylene
      that will appear at C-7 of the lactone ring. Synthesis of this molecule in
      Saccharopolyspora erythraea is determined by the three large eryA genes,
      organized in six modules, each governing one condensation cycle. Two amino acid
      substitutions were introduced in the putative NAD(P)H binding motif in the
      proposed enoyl reductase domain encoded by eryAII. The metabolite produced by the
      resulting strain was identified as delta 6,7-anhydroerythromycin C resulting from
      failure of enoyl reduction during the fourth cycle of synthesis of the
      macrolactone. This result demonstrates the involvement of at least the enoyl
      reductase from the fourth module in the fourth cycle and indicates that a
      virtually complete macrolide can be produced through reprogramming of polyketide
      synthesis.

PMID- 8346224
TI  - Single core polypeptide in the reaction center of the photosynthetic bacterium
      Heliobacillus mobilis: structural implications and relations to other
      photosystems.
AB  - The gene for a reaction center core polypeptide from the anoxygenic
      photosynthetic bacterium Heliobacillus mobilis was cloned and sequenced. The
      deduced amino acid sequence consists of 609 residues with a molecular mass of 68
      kDa. An adjacent open reading frame is not transcribed under our experimental
      conditions. No evidence for a second related reaction center core gene was found.
      The primary sequence of the reaction center protein (P800 protein) shows a high
      percentage of sequence identity to photosystem I in a cysteine-containing loop,
      which is the putative binding site of the iron-sulfur center FX and in the
      preceding hydrophobic region. Our data imply a homodimeric organization of the
      reaction center. This is fundamentally different from photosystem I and most
      other photosynthetic reaction centers, where the reaction center core is composed
      of two similar but nonidentical subunits.

PMID- 8346225
TI  - Identification, cloning, and nucleotide sequencing of the ornithine decarboxylase
      antizyme gene of Escherichia coli.
AB  - The ornithine decarboxylase antizyme gene of Escherichia coli was identified by
      immunological screening of an E. coli genomic library. A 6.4-kilobase fragment
      containing the antizyme gene was subcloned and sequenced. The open reading frame
      encoding the antizyme was identified on the basis of its ability to direct the
      synthesis of immunoreactive antizyme. Antizyme shares significant homology with
      bacterial transcriptional activators of the two-component regulatory system
      family; these systems consist of a "sensor" kinase and a transcriptional
      regulator. The open reading frame next to antizyme is homologous to sensor
      kinases. Antizyme overproduction inhibits the activities of both ornithine and
      arginine decarboxylases without affecting their protein levels. Extracts from E.
      coli bearing an antizyme gene-containing plasmid exhibit increased antizyme
      activity. These data strongly suggest that (i) the cloned gene encodes the
      ornithine decarboxylase antizyme and (ii) antizyme is a bifunctional protein
      serving as both an inhibitor of polyamine biosynthesis as well as a
      transcriptional regulator of an as yet unknown set of genes.

PMID- 8346226
TI  - Early evolution of photosynthesis: clues from nitrogenase and chlorophyll iron
      proteins.
AB  - Chlorophyll (Chl) is often viewed as having preceded bacteriochlorophyll (BChl)
      as the primary photoreceptor pigment in early photosynthetic systems because
      synthesis of Chl requires one fewer enzymatic reduction than does synthesis of
      BChl. We have conducted statistical DNA sequence analyses of the two reductases
      involved in Chl and BChl synthesis, protochlorophyllide reductase and chlorin
      reductase. Both are three-subunit enzymes in which each subunit from one
      reductase shares significant amino acid identity with a subunit of the other,
      indicating that the two enzymes are derived from a common three-subunit ancestral
      reductase. The "chlorophyll iron protein" subunits, encoded by the bchL and bchX
      genes in the purple bacterium Rhodobacter capsulatus, also share amino acid
      sequence identity with the nitrogenase iron protein, encoded by nifH. When
      nitrogenase iron proteins are used as outgroups, the chlorophyll iron protein
      tree is rooted on the chlorine reductase lineage. This rooting suggests that the
      last common ancestor of all extant photosynthetic eubacteria contained BChl, not
      Chl, in its reaction center, and implies that Chl-containing reaction centers
      were a late invention unique to the cyanobacteria/chloroplast lineage.

PMID- 8346227
TI  - A base-pairing interaction between U2 and U6 small nuclear RNAs occurs in > 150S
      complexes in HeLa cell extracts: implications for the spliceosome assembly
      pathway.
AB  - In mammalian cells, base pairing between the U2 and U6 small nuclear RNAs is
      required during pre-RNA splicing. We show by psoralen crosslinking of HeLa
      nuclear extract that U2.U6 base pairing occurs within abundant ribonucleoprotein
      complexes that sediment at > 150 S in glycerol gradients. All of the spliceosomal
      RNAs (U1, U2, U4, U5, and U6) cosediment with these large complexes, suggesting
      that they may be related to small nuclear RNA-containing structures called
      speckles/coiled bodies or snurposomes, which have been visualized in mammalian or
      amphibian nuclei, respectively. In contrast to nuclear extract, S100 extract,
      which is splicing-defective and lacks the > 150S complexes, does not contain base
      paired U2.U6. However, U2.U6 base pairs form in S100 extract that has been made
      splicing-competent by supplementation with Ser/Arg-rich (SR) proteins, ATP, and
      an adenovirus splicing substrate. During splicing in supplemented S100 extract,
      U2.U6 base pairing precedes the appearance of splicing intermediates and occurs
      initially in an approximately 60S spliceosome complex but also in progressively
      larger (100-300 S) complexes. Possible functional relationships between the 60S
      spliceosome and the > 150S complexes are discussed.

PMID- 8346228
TI  - Molecular cloning and sequencing of a canine tracheobronchial mucin cDNA
      containing a cysteine-rich domain.
AB  - To date the complete sequence of only one mammalian mucin cDNA, MUC1, has been
      reported, although several mucin proteins have been partially characterized. Here
      we report the nucleotide sequence of a canine tracheal mucin cDNA containing two
      potential translation initiation codons, one translation termination codon and a
      poly(A) tail. A lambda gt11 cDNA library prepared from canine tracheal epithelial
      cells was screened with polyclonal anti-apo-canine tracheal mucin antibodies with
      the aim of obtaining the deduced amino acid sequence of the mucin core protein.
      Antibody-positive clones containing overlapping inserts of various lengths were
      purified and used for nucleotide sequencing. Based on the sequencing data,
      synthetic oligonucleotide primers were constructed and both ends (5' and 3') of
      the cDNA were determined. The complete sequence was 3.7 kb and included an open
      reading frame with coding capacity for 1118 aa, two translation initiation ATG
      codons in context with Kozak consensus sequences, one polyadenylylation site, and
      a poly(A) stretch. The protein was rich in Thr, Pro, Ser, Gly, and Ala and poor
      in Tyr, Phe, and Trp. Although tandem repeats of amino acids were absent in the
      deduced canine tracheal mucin sequence, motifs TPTPTP and TTTTPV appeared 13 and
      19 times, respectively. The C-terminal region contained a Cys-rich domain
      (although a few Cys residues were also present in the middle of the protein) as
      has been reported for bovine submaxillary mucin, porcine submaxillary mucin, rat
      intestinal mucin, human intestinal mucin, and frog skin mucin. This suggested
      that a broad group of mucins contain such a Cys-rich domain whose functional
      significance is yet to be understood. Three potential N-glycosylation sites were
      present in canine tracheal mucin and the amino acid sequence showed homology with
      both human tracheal and intestinal mucins. The N-terminal domain showed more
      flexibility (probably due to a high number of Pro residues in this region) when
      analyzed by the University of Wisconsin Genetics Computer Group program package
      to determine the predicted secondary structure. Evaluation of the transcripts
      using the canine mucin cDNA as a probe indicated a polydisperse message with
      total RNA.

PMID- 8346229
TI  - The discriminator base influences tRNA structure at the end of the acceptor stem
      and possibly its interaction with proteins.
AB  - For many tRNAs, the discriminator base preceding the CCA sequence at the 3' end
      is important for aminoacylation. We show that the discriminator base influences
      the stability of the 1.72 base pair onto which it is stacked. Mutations of the
      discriminator base from adenosine to cytidine or uridine make the cytidine
      residue in the C1-G72 base pair of mutant Escherichia coli initiator tRNAs more
      reactive toward sodium bisulfite, the single-strand-specific reagent. The
      activity of the enzyme Met-tRNA transformylase toward these and other mutant
      initiator tRNAs is also consistent with destabilization of the 1.72 base pair in
      vitro and in vivo. By influencing the strength of the 1.72 base pair, the
      discriminator base could affect the energetic cost of opening the base pair and
      modulate the structure of the tRNA near the site of aminoacylation. For some
      aminoacyl-tRNA synthetases and other proteins that interact with tRNA, these
      factors could be important for specific recognition and/or formation of the
      transition state during catalysis.

PMID- 8346230
TI  - Binding to heparan sulfate or heparin enhances neutrophil responses to
      interleukin 8.
AB  - The interaction of interleukin 8 (IL-8) with heparin was studied by using
      synthetic IL-8 analogs with C- and N-terminal truncations. Elimination of the N
      terminal region preceding the first cysteine, which constitutes the IL-8 receptor
      binding site, did not affect the affinity to heparin-Sepharose. Affinity,
      however, decreased with progressive truncation at the C terminus, and no binding
      was observed when the C-terminal alpha-helix was eliminated. The effect of
      heparin and other glycosaminoglycans on IL-8 activity was also tested. When IL-8
      was applied together with heparan sulfate, neutrophil chemotaxis in vitro was
      enhanced up to 4-fold, and the stimulus-dependent increase in cytosolic free Ca2+
      increased markedly in both rate and peak value. Heparin had a similar effect on
      the Ca2+ response but did not enhance chemotaxis. The glycosaminoglycans by
      themselves did not elicit neutrophil responses. Their enhancing effect was
      restricted to stimulation with IL-8 and was not observed when the unrelated
      chemoattractant fMet-Ile-Phe-Leu was used as the stimulus. Elastase released from
      stimulated neutrophils was inhibited by heparin, heparan sulfate, and, to a
      lesser extent, chondroitin sulfate B, confirming previous observations. Taken
      together, these results suggest that heparan sulfate, which is present on the
      endothelial cell surface and in the basement membrane, may have a dual function
      in diapedesis, promotion of IL-8-dependent transmigration of neutrophils, and
      protection of the tissue microenvironment from damage by lytic enzymes released
      from the migrating cells.

PMID- 8346231
TI  - Identification of an isoform of the estrogen receptor messenger RNA lacking exon
      four and present in the brain.
AB  - An isoform of the estrogen receptor messenger RNA (ER-mRNA) was identified in RNA
      from the brain of lizards and rats. Poly(A)+ RNA from brain and uteri was reverse
      transcribed using gene-specific primer for the ER. The resulting complementary
      DNA was amplified in a polymerase chain reaction followed by cloning and
      sequencing of the amplified products. This isoform lacks exon four and is
      designated delta 4 ER-mRNA. Although several isoforms of the ER have been
      described from cancerous cells, to our knowledge, none has been identified
      previously in the brain. Furthermore, the delta 4 isoform is the only isoform
      detected in normal tissue. The delta 4 isoform appeared most abundant in RNA from
      brain tissue, whereas uterine RNA contained only trace amounts of the isoform.
      Apparently, tissue-specific alternative splicing accounts for these differences
      in abundance. Because exon four encodes a part of the steroid-binding domain, we
      predict that the corresponding protein encoded by the isoform will not bind
      estradiol and may therefore belong to a growing subclass of the
      steroid/thyroid/vitamin superfamily known as orphan receptors. We predict that
      the putative delta 4 protein may function as a ligand-independent transcription
      factor that acts on the same DNA response elements as the conventional ER. The
      abundance of this isoform in the brain relative to the uterus raises fundamental
      questions regarding the regulation of estrogen-responsive genes in different
      tissues.

PMID- 8346232
TI  - Covariation of mutations in the V3 loop of human immunodeficiency virus type 1
      envelope protein: an information theoretic analysis.
AB  - The V3 loop of the human immunodeficiency virus type 1 (HIV-1) envelope protein
      is a highly variable region that is both functionally and immunologically
      important. Using available amino acid sequences from the V3 region, we have used
      an information theoretic quantity called mutual information, a measure of
      covariation, to quantify dependence between mutations in the loop. Certain pairs
      of sites, including non-contiguous sites along the sequence, do not have
      independent mutations but display considerable, statistically significant,
      covarying mutations as measured by mutual information. For the pairs of sites
      with the highest mutual information, specific amino acids were identified that
      were highly predictive of amino acids in the linked site. The observed
      interdependence between variable sites may have implications for structural or
      functional relationships; separate experimental evidence indicates functional
      linkage between some of the pairs of sites with high mutual information. Further
      specific mutational studies of the V3 loop's role in determining viral phenotype
      are suggested by our analyses. Also, the implications of our results may be
      important to consider for V3 peptide vaccine design. The methods used here are
      generally applicable to the study of variable proteins.

PMID- 8346233
TI  - Hepsin, a putative cell-surface serine protease, is required for mammalian cell
      growth.
AB  - Hepsin was previously identified as a putative cell-surface serine protease. When
      hepatoma cells were treated with anti-hepsin antibodies, their growth was
      substantially arrested, suggesting the requirement of hepsin molecules present at
      the cell surface for normal cell growth. This was further supported by a gross
      inhibition of cell growth with hepsin-specific antisense oligonucleotides. Upon
      treatment of cells with antisense oligonucleotides, rapid reduction in cellular
      hepsin was observed. This reduction in cellular hepsin levels was accompanied by
      drastic morphological changes. Various tissues in the developing mouse embryo
      showed greatly elevated hepsin levels in regions of active proliferation. These
      results indicate that hepsin plays an essential role in cell growth and
      maintenance of cell morphology.

PMID- 8346234
TI  - Inhibition of RNA polymerase II transcription by oligonucleotide-RecA protein
      filaments targeted to promoter sequences.
AB  - In the presence of RecA protein, which plays a major role in genetic
      recombination in Escherichia coli, an oligodeoxyribonucleotide can find its
      homologous counterpart in double-stranded DNA and form triple-stranded
      structures. A triple-stranded structure formed by an oligonucleotide with a
      sequence overlapping essential regulatory elements of a viral promoter, such as
      TATA or GC boxes, inhibited in vitro transcription driven by RNA polymerase II.
      An oligonucleotide with eight nucleotides homologous to its target suppressed RNA
      polymerase II activity in HeLa cell extracts. This procedure offers a potential
      alternative to the usual mutational analysis of transcriptional promoters.

PMID- 8346235
TI  - Engineering of stable and fast-folding sequences of model proteins.
AB  - The statistical mechanics of protein folding implies that the best-folding
      proteins are those that have the native conformation as a pronounced energy
      minimum. We show that this can be obtained by proper selection of protein
      sequences and suggest a simple practical way to find these sequences. The
      statistical mechanics of these proteins with optimized native structure is
      discussed. These concepts are tested with a simple lattice model of a protein
      with full enumeration of compact conformations. Selected sequences are shown to
      have a native state that is very stable and kinetically accessible.

PMID- 8346236
TI  - Isolation of x-ray-inducible transcripts from radioresistant human melanoma
      cells.
AB  - Twelve x-ray-induced transcripts (xips), differentially expressed 8- to 230-fold
      in x-irradiated versus unirradiated radioresistant human melanoma (U1-Mel) cells,
      were isolated as cDNA clones (xip1 through xip12) after four rounds of
      differential hybridization. Northern analyses revealed rare, medium, and abundant
      xips, ranging in size from 1.2 to 10 kb. All transcripts were transiently
      expressed and induced by low, but not by high (> 600 cGy), doses of radiation.
      Three transcripts (xip4, -7, and -12) were induced only by ionizing radiation,
      and many (i.e., xip1, -2, -3, -5, -6, -8, -9, -10, and -11) were also induced by
      UV irradiation or phorbol 12-myristate 13-acetate. Heat shock did not induce any
      of the xips, but it decreased basal levels of xip4, -7, -11, and -12. Three xip
      cDNA clones were identified as encoding thymidine kinase, DT diaphorase, and
      tissue-type plasminogen activator. The remaining nine cDNA clones showed little
      homology to known genes. Three clones contained regions homologous to c-fes/fps
      protooncogene, recombination activating gene 1, or the human angiogenesis factor
      gene. X-ray-inducible genes may function in damaged cells to regulate DNA repair,
      apoptosis, mutagenesis, and carcinogenesis.

PMID- 8346237
TI  - Integration of gene maps: chromosome 21.
AB  - Physical, cytogenetic, and genetic data including microsatellite markers and a
      covering sequence-tagged site (STS) map have been entered into a location
      database and integrated into a summary map that subsumes a composite physical
      location, sex-specific genetic locations, cytogenetic and regional assignments,
      mouse homology, rank, and references. With the omission of 52 loci whose location
      is known only from cytogenetic assignment to an interval greater than 10
      megabases, there are 198 loci in the covering STS map and an additional 145 loci.
      The physical length is consistent with 11 megabases for 21p and 39 megabases for
      21q. With error filtration and allowance for high interference, the genetic
      length in males corresponds to the chiasma map (54.7 centimorgans), and the
      genetic length in females is 76.5 centimorgans. The relation between map
      integration and the STS paradigm is illustrated and discussed.

PMID- 8346239
TI  - Reversal of muscle differentiation during urodele limb regeneration.
AB  - Recent studies suggest that maintenance of the differentiated state requires
      continuous regulation. Limb regeneration in urodele amphibians provides a context
      in which to address this issue, as limb regeneration may involve the
      dedifferentiation of multinucleate myotubes to yield mononucleate blastemal
      cells, which then proliferate and contribute to regenerate tissues. To evaluate
      this possibility, cultured newt limb myotubes were selectively microinjected with
      the lineage tracer rhodamine-dextran and introduced into regenerating limbs. In
      culture, such labeled myotubes were stable after 6-8 weeks, and transfer of the
      tracer to mononucleate cells was not observed. In contrast, after implantation of
      labeled myotubes under the wound epidermis of limb blastemas, strongly labeled
      mononucleate cells were observed after 1 week. These cells could be double
      labeled with the cytoplasmic lineage tracer and [3H]thymidine that had been
      incorporated into the nuclei of implanted myotubes. The number of labeled
      mononucleate cells increased significantly by 2-3 weeks after implantation,
      indicating that these cells proliferated. Although the fate of these cells at
      later times was uncertain, we provide evidence consistent with their subsequent
      differentiation. These results demonstrate reversal in the mononucleate-to
      multinucleate transition of vertebrate myogenesis.

PMID- 8346238
TI  - Identification of a precursor genomic segment that provided a sequence unique to
      glycophorin B and E genes.
AB  - Human glycophorin A, B, and E (GPA, GPB, and GPE) genes belong to a gene family
      located at the long arm of chromosome 4. These three genes are homologous from
      the 5'-flanking sequence to the Alu sequence, which is 1 kb downstream from the
      exon encoding the transmembrane domain. Analysis of the Alu sequence and flanking
      direct repeat sequences suggested that the GPA gene most closely resembles the
      ancestral gene, whereas the GPB and GPE genes arose by homologous recombination
      within the Alu sequence, acquiring 3' sequences from an unrelated precursor
      genomic segment. Here we describe the identification of this putative precursor
      genomic segment. A human genomic library was screened by using the sequence of
      the 3' region of the GPB gene as a probe. The genomic clones isolated were found
      to contain an Alu sequence that appeared to be involved in the recombination.
      Downstream from the Alu sequence, the nucleotide sequence of the precursor
      genomic segment is almost identical to that of the GPB or GPE gene. In contrast,
      the upstream sequence of the genomic segment differs entirely from that of the
      GPA, GPB, and GPE genes. Conservation of the direct repeats flanking the Alu
      sequence of the genomic segment strongly suggests that the sequence of this
      genomic segment has been maintained during evolution. This identified genomic
      segment was found to reside downstream from the GPA gene by both gene mapping and
      in situ chromosomal localization. The precursor genomic segment was also
      identified in the orangutan genome, which is known to lack GPB and GPE genes.
      These results indicate that one of the duplicated ancestral glycophorin genes
      acquired a unique 3' sequence by unequal crossing-over through its Alu sequence
      and the further downstream Alu sequence present in the duplicated gene. Further
      duplication and divergence of this gene yielded the GPB and GPE genes.

PMID- 8346240
TI  - Target-derived influences on axon growth modes in cultures of trigeminal neurons.
AB  - Cellular and molecular signals involved in axon elongation versus collateral and
      arbor formation may be intrinsic to developing neurons, or they may derive from
      targets. To identify signals regulating axon growth modes, we have developed a
      culture system in which trigeminal ganglion cells are challenged by various
      target tissues. Embryonic day 15 (E15) rat trigeminal ganglion explants were
      placed between peripheral (vibrissa pad) and central nervous system targets.
      Normally, bipolar trigeminal ganglion cells extend one process to the vibrissa
      pad and another to the brainstem trigeminal complex. Under coculture conditions,
      the peripheral processes invade the vibrissa pad explants and form a
      characteristic circumfollicular pattern. Central processes of E15 ganglion cells
      invade many, but not all, central nervous system tissues. In isochronic (E15)
      central nervous system explants such as brainstem, olfactory bulb, or neocortex,
      these central processes elongate and form a "tract" but have virtually no arbors.
      However, in more mature targets (e.g., a section from postnatal brainstem or
      neocortex), they form arbors instead of a tract. We conclude from these
      observations that whether trigeminal axons elongate to form a tract, or whether
      they begin to arborize, is dictated by the target tissue and not by an intrinsic
      developmental program of the ganglion cell body. The explant coculture system is
      an excellent model for analysis of the molecular basis of neuron-target
      interactions.

PMID- 8346241
TI  - The 31-kDa precursor of interleukin 1 alpha is myristoylated on specific lysines
      within the 16-kDa N-terminal propiece.
AB  - The cytokine interleukin 1 alpha (IL-1 alpha) is a critical mediator of the
      immune and inflammatory responses. A unique determinant of its activity as
      compared with IL-1 beta may be its association with the plasma membrane. While
      the biologic activity of "membrane IL-1" has been extensively reported, the
      mechanism of membrane binding remains unclear. We report that the N terminus of
      the 31-kDa IL-1 alpha precursor is myristoylated on specific internal lysine
      residues. Immunoprecipitation of [3H]myristic acid-radiolabeled human monocyte
      lysates with IgG antibodies to the 31-kDa IL-1 alpha precursor recovered a
      protein with the physicochemical properties of the IL-1 alpha N-terminal propiece
      (16 kDa, pI 4.45). Glycyl N-myristoylation of this protein is precluded by the
      absence of a glycine residue at position 2, suggesting that the propiece is
      myristoylated on epsilon-amino groups of lysine. To determine which lysine(s) are
      acylated, a series of synthetic peptides containing all lysines found in the IL-1
      alpha N-terminal propiece were used in an in vitro myristoylation assay
      containing peptide, myristoyl-CoA, and monocyte lysate as enzyme source. Analysis
      of the reaction products by reverse-phase HPLC and gas-phase sequencing
      demonstrated the specific myristoylation of Lys-82 and Lys-83, yielding
      predominantly monoacylated product. A conserved sequence in the IL-1 beta
      propiece was myristoylated with at least 8-fold less efficiency. Acylation of the
      IL-1 alpha precursor by a previously unrecognized lysyl epsilon-amino N-myristoyl
      transferase activity may facilitate its specific membrane targeting.

PMID- 8346242
TI  - Protein oxidative damage is associated with life expectancy of houseflies.
AB  - The objective of this study was to test some of the predictions of the oxidative
      stress hypothesis of aging, which postulates that aging is causally associated
      with the molecular damage inflicted by reactive oxygen species. Protein carbonyl
      content was used as an index of molecular oxidative modifications. The carbonyl
      content was found to be associated with the physiological age or life expectancy
      of flies rather than with their chronological age. Exposure of flies to sublethal
      hyperoxia (100% oxygen) irreversibly enhanced the carbonyl content of the flies
      and decreased their rate of oxygen consumption. Results of this study indicate
      that protein carbonyl content may be a biomarker of aging and support the general
      concept that oxidative stress may be a causal factor in the aging process.

PMID- 8346243
TI  - Ultraviolet-induced mutations in Cockayne syndrome cells are primarily caused by
      cyclobutane dimer photoproducts while repair of other photoproducts is normal.
AB  - We compared the contribution to mutagenesis in Cockayne syndrome (CS) cells of
      the major class of UV photoproducts, the cyclobutane pyrimidine dimer, to that of
      other DNA photoproducts by using the mutagenesis shuttle vector pZ189.
      Lymphoblastoid cell lines from the DNA repair-deficient disorders CS and
      xeroderma pigmentosum (XP) and a normal line were transfected with UV-treated
      pZ189. Cyclobutane dimers were selectively removed before transfection by
      photoreactivation (PR), leaving nondimer photoproducts intact. After UV exposure
      and replication in CS and XP cells, plasmid survival was abnormally reduced and
      mutation frequency was abnormally elevated. After PR, plasmid survival increased
      and mutation frequency in CS cells decreased to normal levels but remained
      abnormal in XP cells. Sequence analysis of > 200 mutant plasmids showed that with
      CS cells a major mutational hot spot was caused by unrepaired cyclobutane dimers.
      These data indicate that with both CS and XP cyclobutane dimers are major
      photoproducts generating reduced plasmid survival and increased mutation
      frequency. However, unlike XP, CS cells are proficient in repair of nondimer
      photoproducts. Since XP but not CS patients have a high frequency of UV-induced
      skin cancers, our data suggest that prevention of UV-induce skin cancers is
      associated with proficient repair of nondimer photoproducts.

PMID- 8346245
TI  - Distribution of the aquaporin CHIP in secretory and resorptive epithelia and
      capillary endothelia.
AB  - The existence of water-selective channels has been postulated to explain the high
      water permeability of erythrocytes and certain epithelial cells. The aquaporin
      CHIP (channel-forming integral membrane protein of 28 kDa), a molecular water
      channel, is abundant in erythrocytes and water-permeable segments of the nephron.
      To determine whether CHIP may mediate transmembrane water movement in other water
      permeable epithelia, membranes of multiple organs were studied by immunoblotting,
      immunohistochemistry, and immunoelectron microscopy using affinity-purified anti
      CHIP IgG. The apical membrane of the choroid plexus epithelium was densely
      stained, implying a role for CHIP in the secretion of cerebrospinal fluid. In the
      eye, CHIP was abundant in apical and basolateral domains of ciliary epithelium,
      the site of aqueous humor secretion, and also in lens epithelium and corneal
      endothelium. CHIP was detected in membranes of hepatic bile ducts and water
      resorptive epithelium of gall bladder, suggesting a role in bile secretion and
      concentration. CHIP was not detected in glandular epithelium of mammary,
      salivary, or lacrimal glands, suggesting the existence of other water-channel
      isoforms. CHIP was also not detected within the epithelium of the
      gastrointestinal mucosa. CHIP was abundant in membranes of intestinal lacteals
      and continuous capillaries in diverse tissues, including cardiac and skeletal
      muscle, thus providing a molecular explanation for the known water permeability
      of certain lymphatics and capillary beds. These studies underscore the hypothesis
      that CHIP plays a major role in transcellular water movement throughout the body.

PMID- 8346244
TI  - Rearrangement of sapA homologs with conserved and variable regions in
      Campylobacter fetus.
AB  - The Campylobacter fetus surface-layer (S-layer) proteins mediate both complement
      resistance and antigenic variation in mammalian hosts. Wild-type strain 23D
      possesses the sapA gene, which encodes a 97-kDa S-layer protein, and several sapA
      homologs are present in both wild-type and mutant strains. Here we report that a
      cloned silent gene (sapA1) in C. fetus can express a functional full-length S
      layer protein in Escherichia coli. Analysis of sapA and sapA1 and partial
      analysis of sapA2 indicate that a block of approximately 600 bp beginning
      upstream and continuing into the open reading frames is completely conserved, and
      then the sequences diverge completely, but immediately downstream of each gene is
      another conserved 50-bp sequence. Conservation of sapA1 among strains, the
      presence of a putative Chi (RecBCD recognition) site upstream of sapA, sapA1, and
      sapA2, and the sequence identities of the sapA genes suggest a system for
      homologous recombination. Comparison of the wild-type strain (23D) with a
      phenotypic variant (23D-11) indicates that variation is associated with removal
      of the divergent region of sapA from the expression locus and exchange with a
      corresponding region from a sapA homolog. We propose that site-specific
      reciprocal recombination between sapA homologs leads to expression of divergent S
      layer proteins as one of the mechanisms that C. fetus uses for antigenic
      variation.

PMID- 8346246
TI  - Characterization of an intronless collagen gene family in the marine sponge
      Microciona prolifera.
AB  - Two independent clones from the genomic DNA of a marine sponge Microciona
      prolifera were isolated by hybridization to the Caenorhabditis elegans Col-1 gene
      and one clone was obtained from genomic DNA by PCR. They contain open reading
      frames (MpCol1, MpCol2, MpCol3, MpCol4) capable of coding for a family of
      collagens different from those previously found in sponges. Southern blotting of
      genomic DNA suggested the presence of several other homologous genes. cDNA clones
      covering most of the triple-helical coding domain and the 3' untranslated region
      of MpCol1 were isolated by specific primers and reverse PCR. Two cDNA clones end
      in the middle of an AATAAA sequence 170 bp downstream from the translation stop
      codon of MpCol1. The putative NH2-terminal noncollagenous peptide is composed of
      only seven amino acid residues. The 1074-bp triple-helical coding region is not
      interrupted by intervening sequences. It codes for a polypeptide of 120 Gly-Xaa
      Yaa triplets with only one short interruption near the COOH terminus. A putative
      N-glycosylation sequence (Asn-Gly-Ser), three Arg-Gly-Asp triplets known as cell
      recognition peptides, frequent Lys residues in the Yaa position (which are
      templates for hydroxylation), several Lys-Gly-Asn/Xaa-Arg peptides known as the
      lysyl oxidase recognition site, and long stretches without imino acids could be
      found within the triple-helical domain. The short COOH-terminal noncollagenous
      domain closely resembles that of nematode cuticular collagens and vertebrate
      nonfibrillar collagens. Our results strongly support the idea that the diversity
      of collagen genes and gene families found in higher organisms already existed in
      sponge.

PMID- 8346247
TI  - NF-IL6-mediated transcriptional activation of the long terminal repeat of the
      human immunodeficiency virus type 1.
AB  - An upstream control region in the long terminal repeat (LTR) of human
      immunodeficiency virus type 1 (HIV-1) includes a potential negative regulatory
      element (NRE1). Cotransfecting multimers of a sequence spanning this element with
      an LTR-CAT construct produced an increase in chloramphenicol acetyltransferase
      (CAT) activity in Jurkat and HepG2 cells, providing further evidence and support
      for the existence of an NRE. In screening experiments aimed at identifying those
      factors that regulate HIV-1 transcription through interactions with the NRE1
      region, we isolated a cDNA for NF-IL6. Previous studies have shown that NF-IL6 is
      a key nuclear factor that activates gene expression in response to interleukin 6.
      By methylation interference analysis, we have localized the NF-IL6 binding site
      within the NRE1 region and found that it overlaps an E box that has previously
      been implicated as the binding element for a negative regulator of HIV-1
      expression. Through a database search, we identified an additional consensus
      binding sequence for NF-IL6 in the LTR of many HIV-1 variants and found that over
      this sequence, purified NF-IL6 can produce an extended footprint that overlaps
      one of the binding sites for NF-kappa B. A product of the nf-il6 gene activated
      transcription from several LTR-CAT constructs in transient transfection assays.
      Thus, NF-IL6 could play a central role in the control of HIV-1 gene expression
      and this protein might be a key mediator in signaling pathways where HIV-1 is
      activated by interleukin 6.

PMID- 8346249
TI  - Photoaffinity labeling of Torpedo acetylcholine receptor at multiple sites.
AB  - The acetylcholine receptor from Torpedo californica electroplax was labeled with
      the photoaffinity reagent bis(3-azidopyridinium)decane perchlorate. All four
      receptor subunits (alpha, beta, gamma, and delta) were specifically labeled. In
      the presence of cholinergic agonists the gamma-, beta-, and delta-subunit
      labeling was decreased significantly, whereas labeling of the alpha subunit was
      minimally affected. Full occupancy of the two high-affinity sites involving the
      alpha subunits in the vicinity of alpha-Cys-192-Cys-193 by covalent reaction with
      bromoacetylcholine also caused a large decrease of gamma-subunit labeling by the
      photoaffinity reagent and lesser but significant decreases in beta- and delta
      subunit labeling. No decrease in labeling of the alpha subunit was seen. Labeling
      of the alpha subunit could, however, be inhibited by high concentrations of the
      agonist carbamoylcholine. We conclude that the binding sites of high-affinity
      reside at interfaces of the alpha subunit and other subunits and that the alpha
      subunit also contributes to formation of a low-affinity site(s) for cholinergic
      compounds.

PMID- 8346248
TI  - Pleiotropic effect of the human T-cell leukemia virus Tax protein on the DNA
      binding activity of eukaryotic transcription factors.
AB  - The Tax protein, encoded by the human T-cell leukemia virus type I, is a potent
      activator of viral and cellular gene transcription. Tax does not bind DNA
      directly but appears to trans-activate through an interaction with host-cell
      transcription factors that recognize sequences within the promoters of Tax
      responsive genes. Cellular transcriptional activators implicated in mediating Tax
      trans-activation include members of the activating transcription factor/cAMP
      response element binding protein (ATF/CREB) family of proteins, serum response
      factor, Fos-Jun, and NF-kappa B. Recent evidence suggests that Tax may stimulate
      human T-cell leukemia virus type I transcription, at least in part, through
      enhanced binding of ATF/CREB proteins to their recognition elements within the
      Tax-responsive 21-bp repeats of the viral promoter. In this report, we
      demonstrate that Tax also enhances the site-specific DNA binding activity of
      serum response factor and Fos-Jun and modestly enhances the binding of the NF
      kappa B subunits, p50 and p65. We also show that Tax increases the DNA binding
      activity of the eukaryotic transcription factors ATF-1, Sp1, and GAL4. These
      results are consistent with the finding that Tax is highly pleiotropic and
      suggest that Tax trans-activation may involve enhancement in the DNA binding
      activity of target transcriptional regulatory proteins. In addition, we show that
      the mechanism of Tax-enhanced DNA binding activity does not involve an alteration
      in the redox state of the target protein.

PMID- 8346250
TI  - CCAAT/enhancer binding protein alpha (C/EBP alpha) undifferentiated protein: a
      developmentally regulated nuclear protein that binds to the C/EBP alpha gene
      promoter.
AB  - During differentiation of 3T3-L1 preadipocytes into adipocytes, transcription of
      the C/EBP alpha (CCA-AT/enhancer binding protein alpha) gene is activated. The
      promoter of the C/EBP alpha gene contains a bipartite cis element with binding
      sites for C/EBP alpha undifferentiated protein (CUP) and an Sp1-like GT box
      binding protein. Binding of CUP to this element is markedly enhanced by its
      interaction with the Sp1-like protein. CUP, purified approximately 100,000-fold
      from HeLa cell nuclear extracts, appears to be composed of at least two types of
      subunit. Evidence is presented that a CUP-containing protein complex bridges
      between the CUP/Sp1-like GT box element and a downstream cis element, which
      contains a C/EBP binding site. During differentiation of 3T3-L1 preadipocytes
      into adipocytes, CUP activity or expression decreases as expression of C/EBP
      alpha increases. It is suggested that bridging by the CUP-containing protein
      complex may play a role in transcriptional regulation of the C/EBP alpha gene.

PMID- 8346251
TI  - Thyroid hormone-dependent transcriptional regulation of exogenous genes
      transferred into Xenopus tadpole muscle in vivo.
AB  - Metamorphosis in amphibians is marked by dramatic thyroid hormone-induced changes
      that include tail regression. To examine thyroid hormone effects on gene
      transcription during the early stages of tail resorption, we injected exogenous
      genes directly into the caudal skeletal muscle of Xenopus tadpoles and followed
      their expression in vivo. Gene expression was both strong and reproducible, and
      it correlated with the amount of DNA injected. Moreover, expression continued as
      long as the animals were blocked in prometamorphosis by antithyroid drugs (for up
      to 4 months). Thyroid hormone-dependent effects on transcription were examined by
      using a palindromic thyroid hormone response element linked to a chloramphenicol
      acetyltransferase reporter gene. Reporter gene expressions were normalized for
      transfection efficiency by using a constitutively expressed luciferase construct.
      Physiological concentrations of 3,5,3' triiodo-L-thyronine (1 nM), applied for
      120 hr, produced a 5-fold increase in transcription (P < 0.05) from the thyroid
      hormone response element but did not modify transcription from constitutive viral
      promoters. This study thus demonstrates that by directly expressing genes in
      Xenopus tadpole muscle in vivo, one can exploit the powerful experimental
      advantages of gene transfer systems in an intact, physiologically normal animal.

PMID- 8346253
TI  - Can a protein influence the fate of its own coding sequence?: the amino- and
      carboxyl-terminal regions of H1 histone.
AB  - The amino- and carboxyl-terminal regions of H1 histone are afforded an
      opportunity to bind to their own coding segments. While such binding is of no
      consequence to the type of H1 histone that is expressed only in terminally
      differentiated cells (here referred to as H5), the same binding occurring in H1
      of proliferating cells might affect the course of evolution of its amino- and
      carboxyl-terminal regions. With the above in mind, amino acid sequences of H5
      from three species were compared with those of H1 from five species. The
      spherical core was more conserved in H1 than in H5, whereas the amino- and
      carboxyl-terminal regions of both were hypervariable. A distinct evolutionary
      pattern, however, was observed only in these regions of H1 but not of H5. Tandem
      repeats of short palindromes often generated nearly identical long palindromes in
      distantly related species. Thus, as far as the 37-residue-long amino-terminal
      region was concerned, the greatest homology was between the rat and human rather
      than between the rat and the mouse. With regard to the last 25 residues in the
      carboxyl-terminal region, the greatest homology was between the chicken and the
      rainbow trout; the next was between the mouse and the trout. Successions of long
      palindromes populating the amino- and carboxyl-terminal regions of H1 might be
      the direct consequence of the autologous binding between peptides and their
      coding sequence.

PMID- 8346252
TI  - Increased tolerance to two oomycete pathogens in transgenic tobacco expressing
      pathogenesis-related protein 1a.
AB  - Expression of pathogenesis-related protein 1a (PR-1a), a protein of unknown
      biochemical function, is induced to high levels in tobacco in response to
      pathogen infection. The induction of PR-1a expression is tightly correlated with
      the onset of systemic acquired resistance (SAR), a defense response effective
      against a variety of fungal, viral, and bacterial pathogens. While PR-1a has been
      postulated to be involved in SAR, and is the most highly expressed of the PR
      proteins, evidence for its role is lacking. In this report, we demonstrate that
      constitutive high-level expression of PR-1a in transgenic tobacco results in
      tolerance to infection by two oomycete pathogens, Peronospora tabacina and
      Phytophthora parasitica var. nicotianae.

PMID- 8346254
TI  - Nonreciprocal homologous recombination between Agrobacterium transferred DNA and
      a plant chromosomal locus.
AB  - Previously, we demonstrated the occurrence of gene targeting in tobacco cells
      after Agrobacterium-mediated transformation. In these experiments a defective
      kanamycin resistance (Kmr) gene residing at a chromosomal location was restored
      via homologous recombination with an incoming transferred DNA (T-DNA) repair
      construct (pSDM101) containing a different defective Kmr gene. In this article we
      describe gene targeting experiments with the same target line, but using an
      improved repair construct, pSDM321. In one of the Kmr calli obtained after
      transformation with pSDM321 (line A) the product of homologous recombination was
      detected using PCR. Further molecular analysis revealed that the defective Kmr
      gene present on the incoming T-DNA had been restored via homologous recombination
      with the target locus. The target locus was left unchanged and the corrected T
      DNA was found to be inserted on the same chromosome but not close to the target
      locus. This paper presents molecular evidence in plants for the conversion of an
      introduced DNA molecule (in this case, T-DNA) by a homologous chromosomal locus.

PMID- 8346255
TI  - Molecular mechanisms of oncogenic mutations in tumors from patients with
      bilateral and unilateral retinoblastoma.
AB  - The RB1 gene from 12 human retinoblastoma tumors has been analyzed exon-by-exon
      with the single-strand conformation polymorphism technique. Mutations were found
      in all tumors, and one-third of the tumors had independent mutations in both
      alleles neither of which were found in the germ line, confirming their true
      sporadic nature. In the remaining two-thirds of the tumors only one mutation was
      found, consistent with the loss-of-heterozygosity theory of tumorigenesis. Point
      mutations, the majority of which were C-->T transitions, were the most common
      abnormality and usually resulted in the conversion of an arginine codon to a stop
      codon. Small deletions were the second most common abnormality and most often
      created a downstream stop codon as the result of a reading frameshift. Deletions
      and point mutations also affected splice junctions. Direct repeats were present
      at the breakpoint junctions in the majority of deletions, supporting a slipped
      mispairing mechanism. Point mutations generally produced DNA sequences which
      resulted in perfect homology with endogenous sequences which lay within 14 bp.

PMID- 8346256
TI  - Fractionated nuclear extracts from hamster cells catalyze cell-free recombination
      at selective sequences between adenovirus DNA and a hamster preinsertion site.
AB  - We have explored the mechanism of adenovirus type 12 (Ad12) DNA integration
      because of its importance for viral oncogenesis and as an example of insertional
      recombination. We have used a fractionated cell-free system from nuclear extracts
      of hamster cells and have partly purified nuclear proteins that could catalyze in
      vitro recombination. As recombination partners, the 20,880- to 24,049-nucleotide
      Pst I D fragment of Ad12 DNA and the hamster preinsertion sequence p7 from the
      Ad12-induced tumor CLAC1 have proven to recombine at higher frequencies than
      randomly selected adenoviral or cellular DNA sequences. A preinsertion sequence
      might carry elements essential in eliciting recombination. Patch homologies
      between the recombination partners seem to play a role in the selection of sites
      for recombination in vivo and in the cell-free system. Nuclear extracts from
      BHK21 cells were prepared by incubating the nuclei in 0.42 M (NH4)2SO4 and
      fractionated by Sephacryl S-300 gel filtration, followed by chromatography on
      Mono S and Mono Q columns. The purified products active in recombination
      contained a limited number of different protein bands, as determined by
      polyacrylamide gel electrophoresis and silver staining. The most highly purified
      fraction IV had helicase and topoisomerase I activities. We used two different
      methods to assess the in vitro generation of hamster DNA-Ad12 DNA recombinants
      upon incubation with the purified protein fractions: (i) transfection of the
      recombination products into recA- strains of Escherichia coli and (ii) the
      polymerase chain reaction by using amplification primers unique for each of the
      two recombination partners. In p7 hamster DNA, the nucleotide sequence 5'
      CCTCTCCG-3' or similar sequences served repeatedly as a preferred recombination
      target for Ad12 DNA in the tumor CLAC1 and in five independent cell-free
      recombination experiments.

PMID- 8346257
TI  - Detection of recombinations between c-myc and immunoglobulin switch alpha in
      murine plasma cell tumors and preneoplastic lesions by polymerase chain reaction.
AB  - Virtually all murine plasmacytomas carry chromosomal translocations that activate
      c-myc. The predominant (approximately 90%) c-myc-activating chromosomal
      translocation in pristane (2,6,10,14-tetramethylpentadecane)-induced
      plasmacytomas in BALB/c mice is a reciprocal translocation t(12;15) in which an
      immunoglobulin heavy-chain switch sequence is joined to the 5' region of c-myc.
      The most common switch region involved is S alpha. We developed a direct PCR
      method to screen for recombinations between c-myc and S alpha. The critical step
      in establishing the method was the cloning and sequencing of the 5' flank of C
      alpha, a region with a reduced number of switch repeats that is much more
      favorable for designing specific PCR primers than the highly repetitive S alpha
      region. In applying this PCR method, we detected translocation-specific junction
      fragments in transplanted (10/16, 63%) and primary (5/15, 33%) plasmacytomas.
      Moreover, the sensitivity of a nested version of that technique allowed us to
      discern rare t(12;15)s in BALB/c mice in the preneoplastic stage of plasmacytoma
      genesis (8/20 mice, 40%) as early as 30 days after administration of pristane. We
      conclude that t(12;15) is the probable primary, if not initiating, oncogenic step
      in plasmacytomagenesis.

PMID- 8346258
TI  - Isolation and transmission of the Lyme disease spirochete from the southeastern
      United States.
AB  - The isolation of the Lyme disease spirochete (Borrelia burgdorferi) from the
      southeastern United States is reported. Three isolates, two from cotton mice
      (Peromyscus gossypinus) and one from the black-legged tick (Ixodes scapularis),
      were recovered from Sapelo Island, Georgia, in July and September 1991. The
      spirochetes were characterized by indirect fluorescent antibody assay using a
      battery of five monoclonal antibodies, by sodium dodecyl sulfate/polyacrylamide
      gel electrophoresis (SDS/PAGE) of whole cell lysates, and by the polymerase chain
      reaction (PCR) assay using primers for three DNA target sequences found in B.
      burgdorferi reference strain B-31. Transmission experiments indicate that the
      three Georgia isolates can infect experimentally inoculated hamsters and mice.
      Tick transmission of one of the isolates has been attempted so far; I. scapularis
      transmitted isolate SI-1 from hamsters to mice, but the lone-star tick, Amblyomma
      americanum, did not.

PMID- 8346259
TI  - Vpu protein of human immunodeficiency virus type 1 enhances the release of
      capsids produced by gag gene constructs of widely divergent retroviruses.
AB  - The Vpu protein of human immunodeficiency virus type 1 facilitates the release of
      virus particles from the surface of infected cells. The ability of the Vpu
      protein to facilitate release of Gag proteins from retroviruses that lack a Vpu
      like protein was examined. The results of these experiments show that Vpu
      significantly increases the release of the Gag proteins of human immunodeficiency
      virus type 2, visna virus, and Moloney murine leukemia virus from HeLa cells. The
      results indicate that Vpu-mediated enhancement of particle release requires
      neither amino-terminal myristoylation of the Gag precursor nor cleavage of the
      Gag precursor by the viral protease. The results raise the possibility that Vpu
      modifies a cellular pathway common to the release of all retroviruses from the
      cell surface.

PMID- 8346260
TI  - Long-term depression of glutamate-induced gamma-aminobutyric acid release in
      cerebellum by insulin-like growth factor I.
AB  - We tested the possibility that insulin-like growth factor I (IGF-I) acts as a
      neuromodulator in the adult cerebellar cortex since previous observations
      indicated that IGF-I is located in the olivo-cerebellar system encompassing the
      inferior olive and Purkinje cells. We found that conjoint administration of IGF-I
      and glutamate through a microdialysis probe stereotaxically implanted into the
      cerebellar cortex and deep cerebellar nuclei greatly depressed the release of
      gamma-aminobutyric acid (GABA), which normally follows a glutamate pulse. This
      inhibition was dose-dependent and long-lasting. Moreover, the effect was specific
      for glutamate since KCl-induced GABA release was not modified by IGF-I. Basic
      fibroblast growth factor, another growth-related peptide present in the
      cerebellum, did not alter the response of GABA to glutamate stimulation. In
      addition, electrical stimulation of the inferior olivary complex significantly
      raised IGF-I levels in the cerebellar cortex. Interestingly, when the inferior
      olive was stimulated in conjunction with glutamate administration, GABA release
      by cerebellar cells in response to subsequent glutamate pulses was depressed in a
      manner reminiscent of that seen after IGF-I. These findings indicate that IGF-I
      produces a long-lasting depression of GABA release by Purkinje cells in response
      to glutamate. IGF-I might be present in climbing fiber terminals and/or cells
      within the cerebellar cortex and thereby might affect Purkinje cell function.
      Whether this IGF-I-induced impairment of glutamate stimulation of Purkinje cells
      underlies functionally plastic processes such as long-term depression is open to
      question.

PMID- 8346261
TI  - Segregation of keratinocyte colony-forming cells in the bulge of the rat
      vibrissa.
AB  - The epidermis and its related appendages such as the hair follicle constitute the
      epithelial compartment of the skin. The exact location and distribution of the
      keratinocyte colony-forming cells within the epidermis or its appendages are
      unknown. We report that in the rat vibrissa, keratinocyte colony-forming cells
      are highly clustered in the bulge-containing region. Approximately 95% of the
      total colonies formed in culture from fractionated vibrissae were in this
      location and fewer than 4% were located in the matrix area of the follicle. Finer
      dissection of the bulge-containing region located the colony-forming cells in the
      small part containing the bulge itself. The segregation of keratinocyte colony
      forming cells in the bulge confirms the hypothesis that the bulge is the
      reservoir of the stem cells responsible for the long-term growth of the hair
      follicle and perhaps of the epidermis as well.

PMID- 8346262
TI  - Individual variation in contractile cost and recovery in a human skeletal muscle.
AB  - This study determined the variation among individuals in ATP use during
      contraction and ATP synthesis after stimulation in a human limb muscle. Muscle
      energetics were evaluated using a metabolic stress test that separates ATP
      utilization from synthesis by 31P NMR spectroscopy. Epicutaneous supramaximal
      twitch stimulation (1 Hz) of the median and ulnar nerves was applied in
      combination with ischemia of the finger and wrist flexors in eight normal
      subjects. The linear creatine phosphate (PCr) breakdown during ischemic
      stimulation defined ATP use (delta PCr per twitch or approximately P/twitch) and
      was highly reproducible as shown by the relative standard deviation [(standard
      deviation/mean) x 100] of 11% in three repeated measures. The time constant of
      the monoexponential PCr change during aerobic recovery represented ATP synthesis
      rate and also showed a low relative standard deviation (9%). Individuals were
      found to differ significantly in both mean approximately P/twitch (PCr breakdown
      rates, 0.29-0.45% PCr per sec or % PCr per twitch; ANOVA, p < 0.001) and in mean
      recovery time constants (41-74 sec; ANOVA, P < 0.001). This range of
      approximately P/twitch corresponded with the range of fiber types reported for a
      flexor muscle. In addition, approximately P/twitch was negatively correlated with
      a metabolite marker of slow-twitch fiber composition (Pi/ATP). The nearly 2-fold
      range of recovery time constants agreed with the range of mitochondrial volume
      densities found in human muscle biopsies. These results indicate that both
      components involved in the muscle energy balance--oxidative capacity and
      contractile costs--vary among individuals in human muscle and can be measured
      noninvasively by 31 P NMR.

PMID- 8346263
TI  - Change of apparent stoichiometry of proximal-tubule Na(+)-HCO3- cotransport upon
      experimental reversal of its orientation.
AB  - Electrogenic cotransport of Na+ with HCO3- has been reported in numerous tissues.
      It has always been shown with a net transfer of negative charge, but in some
      situations achieves net outward transport of both species with a stoichiometry of
      at least three HCO3- ions per Na+ ion (3:1), and in other situations achieves net
      inward transport of both species and has a stoichiometry of at most two HCO3-
      ions per Na+ ion (2:1). This suggests either that there may be more than one
      protein responsible for Na(+)-HCO3- cotransport in different tissues or that if
      there is a single protein, its stoichiometry may differ depending on the
      orientation of net transport. The present study, using conventional or double
      barreled ion-selective microelectrodes to follow basolateral membrane potential
      and intracellular pH or Na+ activity in Necturus proximal convoluted tubule in
      vivo, shows that the orientation of the basolateral Na(+)-HCO3- cotransporter can
      be reversed upon switching from a perfusate simulating normal acid-base
      conditions to one that imposes peritubular isohydric hypercapnia. Moreover,
      accompanying the reversal of orientation is a change of apparent stoichiometry
      from 3:1 to 2:1. Given that the observed change of orientation and accompanying
      change of apparent stoichiometry occur within seconds and in the same
      preparation, these results suggest that a single transport protein is responsible
      for both types of behavior.

PMID- 8346264
TI  - Cloning and characterization of cDNA encoding glyoxal oxidase, a H2O2-producing
      enzyme from the lignin-degrading basidiomycete Phanerochaete chrysosporium.
AB  - Glyoxal oxidase is produced by ligninolytic cultures of the white-rot fungus
      Phanerochaete chrysosporium and is a source of the extracellular H2O2 that is
      required by ligninolytic peroxidases. We report here the cloning and
      characterization of glx-1c cDNA, which encodes glyoxal oxidase. The deduced
      mature protein has 537 amino acids, a molecular size of 57 kDa, and a pI of 5.1.
      Five potential N-glycosylation sites are present. The predicted N-terminal
      sequence is identical to the experimentally determined sequence of purified
      enzyme and is preceded by a leader peptide of 22 amino acids. The sequence of glx
      1c lacks significant homology with known sequences. Specific comparisons were
      made between the glx-1c translated sequence and that of galactose oxidase from
      Dactylium dendroides because of previously observed catalytic similarities of the
      enzyme. Although no significant homology is observed, in both cases extensive
      beta-sheet regions are predicted from the primary sequences. Glyoxal oxidase
      activity correlates with transcript levels and is also coordinate with the lignin
      peroxidases in nutrient nitrogen-starved cultures.

PMID- 8346266
TI  - A common language for a shared purpose.

PMID- 8346265
TI  - Molecular cloning of the cDNA for an MDCK cell Na(+)- and Cl(-)-dependent taurine
      transporter that is regulated by hypertonicity.

PMID- 8346267
TI  - How do you put the client's needs first? Aspects of AIDS counselling in nursing.
AB  - While it is generally accepted that counselling should be client centred, that
      offered to people with Aids or who are HIV positive tends to be more prescriptive
      in approach. A study was therefore devised to determine Aids counsellors'
      concepts of their role and its requirements.

PMID- 8346268
TI  - Expectations they cannot meet: Understanding postnatal depression.
AB  - While many medical explanations have been presented to explain the cause of
      postnatal depression, there is a strong argument that it may be due to
      psychological distress. Offering mothers a less idealised image of motherhood and
      greater child care support may help to undermine feelings of dependence,
      isolation and low self-support, which are known to lead to depression.

PMID- 8346269
TI  - Improved coordination makes for faster work. Ergonomic analysis of a trauma
      resuscitation room.
AB  - It is essential that health professionals feel comfortable in a working
      environment which enables them to work effectively and efficiently. This study
      used an ergonomic approach to analyse whether the layout of equipment and
      materials in a trauma resuscitation unit met its users' needs.

PMID- 8346270
TI  - Reflexology--its place in modern healthcare.
AB  - 1. Reflexology is a safe treatment promoting homeostasis. 2. It is an ancient
      method of healing which is regaining popularity. 3. Reflexology has no side
      effects, only so-called healing crises--stepping stones to better health. 4.
      Reflexology is now an established branch of paramedical medicine, and should be
      available to NHS patients.

PMID- 8346272
TI  - Radiotherapy skin reactions and treatments.
AB  - 1. Radiotherapy can often lead to skin reactions of varying severity, yet there
      has been little research into how these should be treated. 2. A survey was
      undertaken to find the prevalence of skin reactions and the treatments used. 3.
      The centres participating in the study use a wide range of treatments for each
      level of skin reaction. 4. More controlled studies are required to ascertain
      which treatments are most suitable for each level of reaction.

PMID- 8346271
TI  - A basis for future action: applying clinical findings of trials on pressure
      relieving supports to practice.
AB  - Various research trials have been undertaken to assess the efficacy of pressure
      relieving aids. The last in a four-part series outlining such trials, this
      article suggests improvements that can be made to practice in the light of
      research findings.

PMID- 8346273
TI  - An issue of sensitivity. Use of analgesic gel in catheterizing women.
AB  - Catheterisation is an invasive, and often painful procedure for women, yet the
      use of analgesic gel does not appear to be the norm. It does, however, have a
      number of benefits for patient and nurse.

PMID- 8346274
TI  - Working at play. The role of recreation in healthcare.
AB  - The therapeutic effects of recreation for people with mental health problems in
      institutions are often ignored by carers and managers. However, with adequate
      planning, recreation can provide pleasure to both patients and carers, and for
      the former the benefits extend to their rehabilitation in the community.

PMID- 8346275
TI  - Bringing purpose to life. The relationship between unemployment and health.
AB  - It is a common assumption that a person's mental and physical health will suffer
      during or even under the threat of a period of unemployment. It is important that
      community healthcare professionals can diagnose to what extent the trauma of
      unemployment has affected their patients. Only then can appropriate treatment be
      designed and implemented.

PMID- 8346276
TI  - Informed choice leads to a satisfactory outcome. Guidelines for choosing a
      nursing home and residential care.
AB  - Choosing a nursing home or residential care can be stressful for all concerned.
      This article outlines the types of homes available, and the financial
      implications and levels of service to be taken into account. The right choice can
      only be made if the elderly person and his or her family are aware of all the
      available options.

PMID- 8346277
TI  - A right to be heard.

PMID- 8346278
TI  - A model for calculating tumour control probability in radiotherapy including the
      effects of inhomogeneous distributions of dose and clonogenic cell density.
AB  - Most calculations of the biological effect of radiation on tumours assume that
      the clonogenic cell density is uniform even if account is taken of non-uniform
      dose distribution. In practice tumours will almost certainly have a non-uniform
      clonogenic cell density. This paper extends one particular model of tumour
      control probability (TCP) to incorporate a variable clonogenic cell density while
      at the same time assuming a constant 2 Gy fraction size and a uniform
      radiosensitivity throughout the treatment. Since there are virtually no in vivo
      data on the variation of density we consider some model situations. One clear
      conclusion is that a large reduction in clonogenic cell density at the edges of a
      tumour would permit only a very modest decrease in dose if the TCP is not to be
      reduced. In general the effect on TCP is a complicated function of the variation
      in both dose and clonogenic cell density. We give the equations which enable both
      to be included.

PMID- 8346280
TI  - The measurement of silicon in a lung phantom--a comparison of two nuclear
      reactions for in vivo activation analysis.
AB  - The amount of silica in the human lung may be estimated by measurement of silicon
      using in vivo neutron activation analysis. A pulsed, fast neutron beam, produced
      with a 2 MV Van de Graaff generator using the 2H + 2H reaction, was used to
      irradiate a Si-doped chest phantom in order to determine minimum detection limits
      (MDL). Two 'in-beam' nuclear reactions on Si were studied; prompt fast neutron
      inelastic scatter 28Si (n,n' gamma)28Si reaction was measured during the beam
      burst and the slow neutron prompt capture reaction was measured between the fast
      neutron bursts. Although the latter reaction appeared less favourable due to
      neutron cross section and measurement efficiency considerations, it yielded an
      MDL of 1.8 g compared with 2.3 g for the 28Si(n,n' gamma)28Si reaction. A
      comparison was made with a 252Cf neutron irradiation system where a Si MDL of 6.3
      g was obtained using the slow neutron capture reaction. The Van de Graaff system
      permits 'exposed' Si lung burdens to be measured but not normal levels. Improved
      measurement sensitivity may be achieved by reduction of high counting-rate losses
      and high background radiation.

PMID- 8346279
TI  - The application of correlated sampling to the computation of electron beam dose
      distributions in heterogeneous phantoms using the Monte Carlo method.
AB  - Although the Monte Carlo method is capable of computing the dose distribution in
      heterogeneous phantoms directly, there are some advantages to computing a
      heterogeneity correction factor. If this approach is adopted there are savings in
      time using correlated sampling. This technique forces histories to have the same
      energy, position, direction and random number seed as incident on both the
      heterogeneous and homogeneous water phantom. This ensures that a history that
      has, by chance, travelled through only water in the heterogeneous phantom will
      have the same path as it would have through the homogeneous phantom, resulting in
      a reduced variance when a ratio of heterogeneous dose to homogeneous dose is
      formed. Metrics to describe the distributions of uncertainty, efficiency, and
      degree of correlation are defined. EGS4 Monte Carlo calculation of the dose
      distribution from a 20 MeV electron beam on water phantoms containing aluminum or
      air slab heterogeneities illustrate that this technique is the most efficient
      when the heterogeneity is deep within the phantom, but that improved efficiency
      can be realized even when the heterogeneity is at or near the surface. This is
      because some correlation between the two histories is retained despite passage
      through the heterogeneity.

PMID- 8346282
TI  - A generalized Gibbs prior for maximum a posteriori reconstruction in SPECT.
AB  - In this paper, we introduce a Gibbs prior for use in MAP (maximum a posteriori)
      reconstruction in SPECT. This new prior, with three parameters, is able to
      approximate the results of previously-proposed priors with two parameters, as
      well as a continuum of others. Also, it allows the user increased flexibility in
      selecting the properties to be emphasized in the final reconstructed image
      estimate. The additional flexibility offered by the new prior is important in
      addressing the problem of selecting a prior and its associated parameters in a
      clinical situation. The paper demonstrates the importance of the derivative
      potential function (DPF) of the Gibbs distribution in determining which
      properties will be emphasized in the iterated image estimates. The effects of
      each of the three parameters are demonstrated on reconstructions from acquired
      SPECT data. We conclude that the parameters must be chosen carefully with
      consideration for the object distribution and the relative requirements for low
      contrast detail, smoothing and edge sharpness in the reconstructed image.

PMID- 8346281
TI  - Dielectric properties of lung tissue as a function of air content.
AB  - Dielectric measurements were made on lung samples with different electrode
      systems in the frequency range 5 kHz-100 kHz. In the case of plate electrodes and
      spot electrodes, the effects of electrode polarization were partly corrected. An
      air filling factor F is defined, which is determined from the mass and volume of
      the sample. The results indicate that the electrical properties of lung tissue
      are highly dependent on the condition of the tissue. Furthermore they show that
      the conductivity sigma as well as the relative permittivity epsilon r decreases
      with increasing F. This is discussed using histological material. Using a simple
      theoretical model, the decrease of sigma and epsilon r is explained by the
      thinning of the alveolar walls as well as by the deformation of the epithelial
      cells and blood vessels through the expansion of the alveoli.

PMID- 8346283
TI  - Determination of both mechanical and electronic shifts in cone beam SPECT.
AB  - The difference between the displacement of the centre of rotation (mechanical
      shift, MS) and the electronic centring misalignment (electronic shift, ES) in
      cone beam SPECT is evaluated. A method is proposed to determine both MS and ES
      using the centroid of a projected point source sampled over 360 degrees and the
      Marquardt non-linear fitting algorithm. Both shifts are characterized by two
      orthogonal components. This method is verified using Monte Carlo simulated point
      source data with different combinations of mechanical and electronic shifts. Both
      shifts can be determined correctly. We have also applied the proposed method to
      our cone beam SPECT system to determine both shifts as well as the focal length.
      The determined ES parameters are then used to correct the projections and the MS
      parameters are incorporated into a reconstruction algorithm. The point source
      images are reconstructed and the image resolutions with and without the shift
      corrections are measured. The experimental results demonstrate that the image
      resolution is improved after shift corrections. The experimental results also
      indicate that the shift parameters determined in the same experiment with the
      point source located at different places are consistent but change from time to
      time, suggesting that calibration of the system is needed on a periodic basis.

PMID- 8346284
TI  - Excision of a trabecular ROI from resin-embedded vertebrae: report on a computer
      assisted method.
AB  - A major problem when evaluating the accuracy of quantitative computed tomography
      (QCT) against chemical analysis of bone mineral is to ensure that the same region
      of interest (ROI) is measured with two techniques. The method described here
      attempts to reach this objective. Forty-nine lumbar vertebrae were scanned. The
      mid-vertebral portion was sawed and embedded in a polyester resin. The ROI
      defined with an automated contour detection was transmitted, using a Hewlett
      Packard scanjet, to a computer-assisted milling machine which excised a
      trabecular ROI sample. The volume of each trabecular sample was determined using
      an Archimedian method. ROI volumes assessed on QCT were highly correlated with
      those obtained with the Archimedian method (r = 0.98). The standard error of the
      estimate was 170 mm3 (4.5%). These results suggest that trabecular samples
      obtained with this method optimally agree with the ROIs selected on QCT
      examination.

PMID- 8346285
TI  - Circadian drinking rhythms in SHR and WKY rats: effects of increasing light
      intensity.
AB  - This study sought to define the generality of a previous finding that the
      spontaneously hypertensive (SHR) and normotensive Wistar-Kyoto (WKY) rat strains
      differ in free-running circadian period when maintained in running-wheel cages
      under constant light. Circadian drinking rhythms were monitored in SHRs and WKYs
      housed without access to running wheels under an increasing series of light
      intensities beginning with constant darkness. Strain differences in circadian
      period were seen only at relatively high light intensities, indicating that SHRs
      and WKYs differ in circadian light sensitivity. Since SHRs and WKYs differ in
      circadian period with or without access to running wheels, this strain difference
      is not likely to depend on differential locomotor activity levels. SHRs and WKYs
      also differed in spectral profile and circadian waveform, but only under low
      light intensities. At higher intensities, dissociation of rhythmicity was seen in
      both strains.

PMID- 8346286
TI  - Effects of amygdaloid lesions on gastric erosion formation during exposure to
      activity-stress.
AB  - To examine the role of the amygdala in the production of gastric ulcers induced
      by activity-stress, electrolytic lesions were placed in the centromedial (CENT)
      and medial (MED) amygdaloid nuclei, as well as in the intra-amygdaloid division
      of the bed nucleus of the stria terminalis (BNST). As compared to sham-operated
      controls (CONT), gastric ulceration was attenuated in rats with CENT lesions and
      exacerbated in rats with lesions located in the BNST or MED. Wheel running did
      not differ significantly between control animals and lesioned rats, but did
      differ within lesioned groups. Rats with MED lesions ran more than rats with CENT
      or BNST lesions. Results support the view that the integrity of the centromedial
      amygdala is critical for the maintenance of the viscera and demonstrate that
      neurogenic factors contribute to the development of gastric erosions during
      exposure to activity-stress.

PMID- 8346287
TI  - Wheel running raises body temperature and changes the daily cycle in golden
      hamsters.
AB  - The purpose of this study was to characterize the influence of wheel-running
      activity on temperature circadian rhythm in golden hamsters. Amplitude of body
      temperature rhythm was significantly higher in animals that had access to the
      running wheel. Qualitatively, wheel running resulted in squaring of temperature
      rhythm waveform, a phenomenon that was independent of ambient illumination. When
      the hamsters had access to an immobilized wheel, the effect on temperature was no
      longer observed. Fast Fourier Transformation after subtracting 24-h sine
      waveforms (to rule out harmonics of the principal frequency), indicated distinct
      secondary components of the rhythms, i.e., a 12-h component in animals that had
      access to the wheels and an 8-h component in animals that did not. The rise in
      body temperature could be dissociated from the start of the activity period, body
      temperature augmenting before the time of light-dark transition, while activity
      increased about 12 min later. On the first night after presentation of an estrous
      female, the temperature cycle in male hamsters that did not access to the wheels
      was similar to that found in animals running on the wheels; the effect was no
      longer observed in subsequent nights. The results contribute to the view that the
      spontaneous locomotor activity in hamsters has a significant effect on
      temperature cycle.

PMID- 8346288
TI  - Antiaggressive and motor effects of haloperidol show different temporal patterns
      in the development of tolerance.
AB  - The study of the temporal course of tolerance development was used as a means to
      separate different aspects of the action of haloperidol on social behavior.
      Agonistic behavior was studied in isolated male mice that confronted standard
      opponents (anosmic and grouped conspecifics) in a neutral area. The aggressive
      and motor behaviors of the experimental animals were evaluated 30 min or 24 h
      either after a single injection of haloperidol (0.4 mg/kg) or following the last
      of a series of 15 or 30 injections. When animals were evaluated 30 min after the
      haloperidol injection, no tolerance to the antiaggressive effects was evident.
      The action on immobility, on the contrary, showed a clear tolerance development
      with repeated drug administration, both with 15 and 30 injections. When evaluated
      24 h after the last injection, tolerance to the antiaggressive effects developed
      with repeated injections. Increased immobility was never found in the tests
      carried out after 24 h, not even in the single injection group. The clear
      divergence found in the temporal courses of tolerance to haloperidol in its
      antiaggressive and motor effects suggests that these actions are mediated through
      different neurophysiological mechanisms. A parallel with extrapyramidal and
      therapeutic effects is discussed.

PMID- 8346289
TI  - Sound levels in rooms housing laboratory animals: an uncontrolled daily variable.
AB  - High sound levels are known to have adverse effects on the behaviour and
      physiology of laboratory animals, yet their acoustic environment is rarely
      monitored. In particular, high-frequency sounds that are above the limit of human
      hearing, but are well within the limits of many laboratory species (i.e.,
      ultrasounds), are usually ignored. In this study, the acoustic environment of
      laboratory animals was investigated in a variety of different animal facilities.
      Sound pressure levels (dB SPL) were monitored for periods up to 24 h over two
      frequency ranges: a relatively low range (0.01-12.5 kHz), and a high range (12.5
      70 kHz). While background sound levels in undisturbed situations were generally
      low (i.e., below 50 dB SPL), marked increases in sound levels often occurred
      during the working day, producing characteristic daily variations in the sound
      profile. Peak SPLs commonly reached values of 80-95 dB in the low-frequency range
      and 50-75 dB in the higher range. In most cases, sound levels were low over
      weekends. The results suggested that human activities were a very important
      source of sound in most animal facilities. In a few situations (e.g., rabbits,
      marmosets, dogs), the animals themselves provided a significant contribution to
      the acoustic environment. It is clear that the acoustic environment of laboratory
      animals is a daily variable that is usually uncontrolled and that may have
      important implications for behavioural and physiological experiments and for
      animal welfare.

PMID- 8346290
TI  - The role of the lateral septum in anxiolysis.
AB  - Behavior of rats in the water-lick conflict test was examined during stimulation,
      and after lesions of the lateral septal nucleus. Continuous low-current
      stimulation resulted in an anxiolytic effect, an increase in the number of licks,
      and hence in the number of shocks, during a signaled, punished period. This
      effect is similar to the one seen with peripheral administration of
      benzodiazepine and other anxiolytic agents. Rewarding medial forebrain
      stimulation did not have this effect. Conversely, septal lesions resulted in an
      anxiogenic effect, a significant decrease in the number of licks during the
      punished period. Lesions had this effect when the conflict behavior was already
      well established. Septal lesions performed before acquisition of the conflict
      behavior resulted in initial retardation of acquisition. The results suggest an
      important role for the lateral septum in the inhibition of anxiety and in the
      acquisition of behaviors reinforced by alleviation of anxiety.

PMID- 8346291
TI  - Sex differences and gonadal hormones influence susceptibility to the activity
      stress paradigm.
AB  - The present study investigated the effect of gonadal hormones on activity, food
      consumption, severity of ulceration, weight loss, and survival duration in male
      and female rats exposed to the activity-stress (A-S) paradigm. Animals received
      either sham surgery or gonadectomy and were housed in activity wheels or standard
      suspended cages. Results indicated that gonadectomized animals were more likely
      to engage in high running levels in the A-S paradigm; in addition, castrated
      males developed significantly more ulceration than the other groups. Neither sex
      nor gonadectomy affected the survival duration of A-S animals.

PMID- 8346292
TI  - Deprivation alters rats' flavor preferences for carbohydrates and fats.
AB  - The effects of food deprivation on rats' preferences for the flavors of different
      macronutrients were investigated. To minimize postingestive influences on flavor
      preferences, brief test sessions (30 min) and calorically dilute (0.08 kcal/g)
      solutions or suspensions were used. The findings revealed that whereas
      nondeprived rats preferred sucrose (2%) to hyrolyzed starch (2% Polycose), food
      deprived rats strongly preferred Polycose to sucrose. Deprived rats also acquired
      a preference for a cue flavor paired with Polycose, while nondeprived rats
      preferred a sucrose-paired cue flavor. Food deprivation also caused rats to
      switch their preferences from sucrose to corn starch, and from sucrose to corn
      oil. Food deprivation did not, however, alter the rats' preference for Polycose
      over corn starch, and it blocked, but did not reverse, their preference for
      Polycose over corn oil. Taken together, the findings indicate that food
      deprivation enhances the preference for palatable nonsweet nutrients (Polycose,
      corn starch, corn oil) over a sweet nutrient (sucrose). This effect was specific
      to food deprivation; water deprivation did not reverse the rats' preference for
      sucrose to Polycose.

PMID- 8346293
TI  - Persistent plasma cholesterol elevations are produced by one or three stressor
      exposures in rats fed a normal laboratory diet.
AB  - Typically, stress-related elevations in rat plasma cholesterol (CHOL) require
      preexposure to diets high in fats or cholesterol and lengthy stressor protocols.
      We report on two studies in which we measured plasma CHOL 22-h poststressor in
      rats fed Purina Laboratory Rodent Chow and exposed to 3 (3-day) or 1 (1-day)
      daily stressor sessions [40, 2 mA tailshocks]. In the first study, both the 3-day
      and 1-day groups exhibited moderately elevated morning plasma CHOL 22-h
      poststressor compared to nonshocked controls. Along with the groups in the first
      study, a second study included a restricted food control, rats transferred to the
      stressor environment, and rats simply transferred to an adjacent room. Neither
      restricted feeding nor the room transfers had an effect on morning plasma CHOL.
      However, the 3-day and 1-day groups again exhibited moderately elevated CHOL.
      Previous reports did not find elevated plasma CHOL in rats given a single
      stressor exposure when sampled at the end of the stressor session. Thus, the
      persistently elevated morning CHOL exhibited by the 1-day group may develop over
      time. The relatively slow development of plasma CHOL elevations may be related to
      the time course of stressor-induced thyroid suppression.

PMID- 8346294
TI  - Evidence for a separate food-entrainable circadian oscillator in the pigeon.
AB  - In Experiment 1, four pigeons lived in a metabolic chamber on a 12h:12h LD cycle
      where they maintained a reduced body weight by consuming a daily ration of food
      presented at the eighth hour of the photophase. Body temperature (Tb) and oxygen
      consumption (Vo2) increased prior to the daily feeding. The possibility that a
      food-entrainable oscillator timed these anticipatory responses was tested by four
      manipulations, conducted in successive phases, each of which involved eliminating
      the regularly scheduled food presentation, which is the putative entraining
      stimulus for such an oscillator, while the 12h:12h LD cycle remained in effect.
      The manipulations, and their outcomes, were: when fasting was imposed for 3 days,
      the anticipatory responses continued to occur; when ad lib feeding was allowed
      for 11 days, the anticipatory responses were mostly eliminated; when fasting was
      reimposed for 5 days, there was evidence that the anticipatory responses
      reoccurred; and, when the time of the daily feeding was phase-shifted earlier in
      the photophase for 8 days, anticipatory responses persisted at the original
      feeding time and simultaneously developed at the new feeding time. In the first
      phase of Experiment 2, key pecking by two pigeons produced food only during hours
      9-11 of the daily photophase (12h:12h LD). In this condition, Tb increased and
      key pecking occurred in anticipation of the daily period of food availability.
      Evidence for a food-entrained oscillator was sought in a second phase when
      constant dim light (LL) was imposed without changing the hours of food
      availability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346295
TI  - Biotelemetry: adjustment of a telemetry system for simultaneous measurements of
      acute heart rate changes and behavioral events in unrestrained rats.
AB  - The radiotelemetry system described in this paper consists of an implantable
      transmitter and a receiver, connected to a microcomputer. The hardware and
      software belonging to Mini-Mitters, for the collection and analysis of heart rate
      (HR), core temperature (CT), and gross activity data, do not possess the
      flexibility to detect acute changes in HR nor to discriminate among
      simultaneously occurring different types of behavior. In order to study short
      term changes in HR in response to stress or drugs, in relation to behavioral
      responses, an inexpensive computer interface and a software program (CARDIAQ)
      were developed to collect data from Mini-Mitters. The interface conveys the QRS
      signal, which is converted to a TTL pulse train, to the parallel printer adapter
      (LPT1) of an IBM-compatible computer. Heart rate is determined by measuring
      single interbeat intervals (IBI). The software controls the sampling schedule and
      stores the collected data in a format compatible with a commercial spreadsheet
      package. The program calculates the median IBI per s, mean +/- SD IBI, variance,
      skewness, and kurtosis of the IBI distribution. In addition, it enables
      simultaneous recording of behavior by entering data through the keyboard at the
      occurrence of each event. In this paper, we describe the CARDIAQ program and
      provide examples of its application together with the implantable transmitters in
      freely moving rats.

PMID- 8346296
TI  - The effects of the spontaneous ingestion of particular foods or beverages on the
      meal pattern and overall nutrient intake of humans.
AB  - The influence of the ingestion of particular beverages and foods on the overall
      nutrient intakes and meal patterns of humans was investigated by paying 323
      adults to maintain 7-day diaries of everything they ingested, time of ingestion,
      and subjective and social conditions. Ingestion of noncaloric beverages, diet
      sodas, and coffee or tea, were associated with low overall intakes but were not
      found to influence the amount eaten over the course of the day or in individual
      meals. Fifteen different caloric containing drink or food types were found, in
      general, to add to the total calories ingested in meals or over the day without
      displacing calories ingested in other forms. The results indicate that individual
      foods or beverages are ingested independent of other constituents and that intake
      within meals or over the entire day is elastic and readily influenced by
      nonregulatory factors.

PMID- 8346297
TI  - Effect of photoperiod on the development of wheel-running activity rhythms in
      LEW/Ztm rats.
AB  - Wheel-running activity of LEW/Ztm rats is characterized by a multimodal pattern
      consisting of two activity bouts about 3-5 h apart. In this study we investigated
      the development of activity rhythms in LEW rats born and raised under three
      different photoperiods (LD 18:6, LD 12:12, and LD 6:18). Wheel-running activity
      was measured for 6 weeks in LD and for another 6 weeks in constant darkness (DD).
      The length of the photoperiod influenced the phase relationship between the two
      activity bouts only during the first week after weaning. Then, the characteristic
      activity pattern was established independently of the length of the photoperiod.
      However, development under long photoperiods (LD 18:6) resulted in a temporary
      increase in the level of activity and a significant shortening of the free
      running period under DD. These results indicate that the multimodal activity
      pattern displayed by LEW rats is controlled by separate activity oscillators that
      establish their unique phase relationship early during development.

PMID- 8346298
TI  - Restoration of staggerer mouse maternal behavior following long-term breeding
      selection.
AB  - Two lines of staggerers from the C57BL/6 strain were tested for disturbances in
      maternal behavior and locomotion. One line, called Pasteur, included staggerers
      available at L'Institut Pasteur. The second line, called Selected, included
      staggerers that had been bred in our laboratory for several generations for their
      ability to reproduce. While none of the Pasteur animals showed any evidence of
      maternal behavior, most of the Selected mutant mice became maternal, carrying
      about 90% of the pups until weaning. No group differences were seen in locomotory
      behavior. It was concluded that a) as a result of long-term breeding selection,
      homozygous (sg/sg) animals of the C57BL/6 strain may be able to exhibit maternal
      behavior from birth on, even under standard laboratory conditions; b) the
      restoration of the maternal behavior does not equally affect all components of
      this behavior pattern; and c) the impairment of the maternal behavior showed by
      the staggerer females is not a necessary consequence of impaired locomotory
      capacity characteristic of the staggerer.

PMID- 8346299
TI  - Aggressive behaviour in immature captive Nile crocodiles, Crocodylus niloticus,
      in relation to feeding.
AB  - This study presents five aspects of aggressive behaviour in juvenile Nile
      crocodiles, Crocodylus niloticus, as observed in five cohorts of 6-18 month-old
      animals. During this period, the animals grew from a range of 35-55 cm, to a
      range of 65-115 cm. 1) Stock density related to aggression: decrease in density
      resulted in significant decrease in the frequency of agonistic events, with 0.64
      events/100 crocodiles/min observed in a density of 6.7 crocodiles/m2, compared to
      0.26 events/100 crocodiles/min observed in a density of 4.7 crocodiles/m2. 2)
      Aggression during feeding: in all five groups, there was a significantly higher
      level of aggression during feeding times. 3) Aggression related to body size: the
      largest crocodiles were the most aggressive group in agonistic events, mainly
      against the smallest ones. The largest group, the medium sized, was the least
      involved in agonistic events. 4) Aggression related to food preference: crocodile
      food preference was live fish > live chicks > dead fish > ground meat. Except for
      one food type (live chicks), a significant (p < 0.05) correlation was found
      between food preference and feeding related aggression in the prey diet groups.
      5) Aggression related to an artificial selection for size: removal of the largest
      crocodiles (which formed 30% of the stock) from the population caused a dramatic
      decrease in all forms of aggressive behaviour.

PMID- 8346300
TI  - A noninvasive strategy for identifying and quantifying innocuous and nociceptive
      peripheral afferent activity evoked by nerve stimulation.
AB  - This study evaluated the utility of the compound nerve action potential (CAP) and
      spinal nociceptive withdrawal (R3) reflex in identifying and quantifying
      peripheral afferent activity evoked by sural nerve stimulation in humans. The
      results of this work demonstrate that currents less than or equal to that which
      elicits a just-maximal CAP can be considered purely innocuous; provide further
      evidence that the R3 is an objective means of identifying noxious stimulus
      levels; and suggest that current provides the best noninvasive quantitative
      estimate of afferent activity throughout the innocuous and noxious range. This
      work also demonstrates that some of the individual variability in the
      psychophysical function can be attributed to peripheral factors that affect the
      amount of current reaching the nerve. It is important, therefore, that these
      peripheral factors be considered when studying individual differences in the
      psychophysical function generated by electrical stimulation.

PMID- 8346302
TI  - Hypergastric acid secretion in rats with ventromedial hypothalamic lesions.
AB  - This study was designed to investigate abnormal gastric acid secretion in
      ventromedial hypothalamic (VMH)-lesioned rats. Basal secretion and secretion
      stimulated by pentagastrin (25 micrograms/kg, IP) or histamine (2 mg/kg/h, IV)
      were significantly higher in VMH-lesioned rats than in sham VMH-lesioned rats.
      Subdiaphragmatic vagotomy and methyl atropine treatment (5 mg/kg, IV) remarkably
      decreased both basal (about 36-44%) and stimulated secretion (about 36-67%) in
      VMH-lesioned rats, but did not completely reverse it to normal. Serum insulin and
      glucose levels were significantly higher in VMH-lesioned rats, but serum gastrin
      levels were not. VMH-lesioned rats showed significantly heavier gastric dry
      weight; however, no difference in the mucosal layer/total layer ratio of the
      gastric wall and the density of the parietal cells was observed between the two
      groups, indicating that the total number of parietal cells might have increased
      in VMH-lesioned rats because the increase of gastric dry weight can be presumed
      to be due to increase of the gastric mucosal layer as well as total layer. These
      results suggest that vagal activation is one of the main contributors to
      hypergastric acid secretion in VMH-lesioned rats, but that other factors such as
      increase of parietal oxyntic cell number may also contribute.

PMID- 8346301
TI  - Exercise endurance in rats: roles of type I and II corticosteroid receptors.
AB  - Intact and adrenalectomized (ADX) rats were mildly food deprived and administered
      dexamethasone (type II agonist), aldosterone (type I agonist), corticosterone
      (mixed agonist), or vehicle 24 and 2 h prior to forced exercise in a treadmill.
      The endurance of intact animals was unaffected by hormone treatments.
      Adrenalectomy greatly advanced the onset of fatigue, and aldosterone exacerbated
      the effect of adrenalectomy. Corticosterone improved endurance in ADX rats, and
      dexamethasone was even more potent in this respect. Aldosterone slowed
      deprivation-induced weight loss in ADXs, while corticosterone and especially
      dexamethasone accelerated loss. Thus, endurance was directly related to body
      weight loss, and presumably to the fuels released by such loss. The results
      extend the type I-type II functional dichotomy to the delivery of utilizable
      energy for metabolically active tissues.

PMID- 8346303
TI  - Responsiveness to testosterone of male gerbils from known intrauterine positions.
AB  - Following either a) castration or b) both castration and implantation with
      capsules releasing a constant, physiological dose of testosterone, adult male
      Mongolian gerbils that had matured in intrauterine positions between two male
      fetuses still scent marked with greater frequency than did male gerbils that had
      matured in intrauterine positions between two female fetuses. We also found
      significant positive correlations between the relative frequency of scent marking
      exhibited by individual male gerbils when intact, after castration and after both
      castration and implantation with capsules releasing testosterone. Each of these
      findings is consistent with the view that differential exposure to testosterone,
      as a consequence of fetal intrauterine position, has lasting effects on the
      organization of scent-marking by male gerbils.

PMID- 8346304
TI  - Validation study of a total body electrical conductive (TOBEC) instrument that
      measures fat-free body mass.
AB  - Validation of the model SA-2's (EM-SCAN, Inc.) ability to measure fat-free body
      mass (FFM) and indirectly predict body fat mass using total body electrical
      conductivity (TOBEC) methodology was investigated. To simulate changes in FFM
      (6.8 to 27.2 g) and fat mass (5 to 20 g), saline and oil, respectively, were
      injected into multiple sites of male Sprague-Dawley rats in separate trials. Two
      identical experiments were conducted; only the body weights differed. In
      Experiment 1 the rats' starting body weight averaged 171.8 +/- 3.4 g, while it
      averaged 214.0 +/- 2.8 g in Experiment 2. In Experiments 1 and 2, model SA-2 was
      used, and theoretical changes in FFM had correlations of r = 0.88 and r = 0.82,
      respectively. There was a tendency of the machine to consistently overpredict FFM
      as greater amounts of saline were injected. In Experiment 1, when oil was
      injected, FFM remained extremely stable, whereas in Experiment 2, it consistently
      overpredicted the amount of fat added in these heavier rats. Because the
      overpredictions in both the cases were consistent, an adjustment to the
      prediction equation can possibly correct these problems. Until this is done,
      caution must be used in interpreting data gather from the model SA-2.

PMID- 8346305
TI  - Measurement of body composition of live rats by electromagnetic conductance.
AB  - Measurement of body composition in vivo is important in many nutritional studies.
      One method for estimating body composition is total body electrical conductance
      (TOBEC). The TOBEC methodology is based on measuring changes of an
      electromagnetic field that are proportional to lean body mass (LBM). Sprague
      Dawley rats (n = 117) ranging in age from 49 to 105 days were measured by TOBEC,
      and the TOBEC results were compared with direct carcass chemical analyses. The
      rats ranged in weight from 155 to 500 g. Mean LBM was 92.4% of total body weight
      (b.wt.), and mean body fat was 7.4% of total b.wt. Mean hydration of LBM was
      71.7% and decreased (r = -0.59, p < 0.0001) with age. Using the manufacturer's
      supplied equation, TOBEC measurement underestimated actual LBM by 12% (p <
      0.0001). As a consequence of this error, a new prediction equation was generated
      using half of the data set, and this equation was cross-validated with the other
      half of the data set. The mean LBM calculated from the new prediction equation
      was not different from chemically determined LBM, but the estimated percent body
      fat of some rats was negative. Thus, TOBEC may be useful in predicting mean LBM
      of a population, but this indirect method may lack the sensitivity to provide
      accurate estimates of body composition of an individual.

PMID- 8346306
TI  - Electrophysiological and behavioral correlates of sleep in the blackbird (Turdus
      merula).
AB  - Sleep in five blackbirds was investigated by continuous 24-h recordings of EEG,
      EOG, EMG, HR, and behavior. Because these recordings were similar in many
      respects to those obtained previously in other species, it was possible to define
      the electrophysiological correlates of active wakefulness (AW), quiet wakefulness
      (QW), slow wave sleep (SWS), and paradoxical sleep (PS). The time spent in SWS
      and PS was 32.2% and 5.7% of the 24-h period, respectively. The amount of SWS
      decreased during the course of the dark period, whereas PS exhibited an
      increasing trend. In addition, SWS always preceded PS, as in mammals. Thus,
      homeotherms may share common mechanisms of sleep regulation. Blackbirds turned
      their heads so that their beaks pointed backwards only during darkness. This back
      posture was usually associated with sleep. Head nodding, which occurred only when
      the beak pointed forward, was observed during 13% of PS episodes. Eye closure was
      a reliable behavioral index of sleep. Detailed behavioral observations alone do
      not provide sufficient information for the accurate assessment of sleep stages in
      blackbirds.

PMID- 8346307
TI  - Lack of potassium-anion interaction in diet selection by captive meadow voles.
AB  - An experiment was conducted to test whether selective avoidance of high-potassium
      diets by captive meadow voles (Rodentia: Microtus pennsylvanicus) depends on the
      anions with which potassium is associated. Voles were presented simultaneously
      with a) low- and high-potassium diets formulated with either potassium sulfate,
      potassium chloride, or a mixture of potassium chloride and potassium citrate; or
      b) paired combinations of high-potassium diets containing different anions. In
      the first part of the experiment, voles preferentially selected the low-potassium
      diets, with the degree of selectivity virtually completely independent of the
      associated anion. These results confirm previous suggestions that potassium
      avoidance may be a component in diet selection by herbivores, especially during
      spring and summer. There is only weak indication that anion content affects
      selection of diets with fixed potassium content.

PMID- 8346308
TI  - A rat model for attention deficit-hyperactivity disorder.
AB  - A number of animal models for attention deficient-hyperactivity disorder (ADHD),
      a common childhood disorder, have been developed. However, none of these models
      are truly representative of naturally occurring developmental ADHD. In such
      models, hyperactivity is induced by electrical or chemical brain lesions, by
      pharmacological manipulation, or by genetic breeding that is coupled with
      hypertension. Based on the observation that some hyposexual rats also are
      hyperactive, we have studied these rats in order to determine whether they
      portray characteristics representative of ADHD. Results of open field testing,
      response to stimulant medication challenge, and measurement of the rat's ability
      to block irrelevant information in a conditioned avoidance response demonstrate
      three properties characteristic of ADHD: a) a high level of spontaneous motor
      activity; b) an attenuation of motor activity in response to amphetamine; and c)
      a deficit in selective attention. These data indicate that these rats may be a
      model for the study of ADHD.

PMID- 8346310
TI  - Effects of bombesin on temporal patterns of ingestion in the rat.
AB  - Bombesin, an analog to gastrin releasing peptide, has previously been shown to
      inhibit food intake in the rat. In order to further characterize the effects of
      bombesin on ingestive behavior, the present study examined licking patterns of
      rats drinking sweetened condensed milk following bombesin (4 micrograms/kg, IP)
      or vehicle injection under two levels of food deprivation (0 and 24 h). Both
      bombesin treatment and satiety (reducing food deprivation from 24 to 0 h)
      significantly decreased total milk consumption during a 1-h test. Analysis of
      licking patterns suggested that bombesin and satiety operate by similar but not
      identical mechanisms. Deprivation reduction tended to decrease ingestion by
      reducing the rate of drinking and size of the first meal. Bombesin, by contrast,
      reduced the total duration of drinking and the number of meals taken, but had no
      effect on lick rate. Cumulative intake records suggested that bombesin reduces
      the volume threshold for termination of drinking such that intake continues at a
      normal rate below this threshold but ceases above it. This bombesin-imposed
      threshold for cessation of drinking was between about 5 and 7 ml for individual
      animals under both food-deprived and nondeprived testing conditions.

PMID- 8346309
TI  - Effect of life in a constant light environment on the course of hypertension in
      Dahl rats.
AB  - An important goal for biobehavioral scientists is to evaluate treatments that
      might extend life in the presence and absence of disease. The prototypic example
      of such a treatment is food restriction. Importantly, we have shown that exposure
      to a life-long environment of constant light extends life in hamsters with
      severe, life-threatening heart disease. The purpose of this experiment was to
      determine whether constant light would also extend the life of rats with an
      inherited form of hypertension. Constant light neither delayed the progression of
      hypertension nor extended life in this model. These data suggest that constant
      light may have a more limited use as an experimental therapeutic modality to
      extend life as compared to food restriction.

PMID- 8346311
TI  - Context conditioning: positive reinforcing effects of various food-related
      stimuli.
AB  - Rats were subjected to context preference tests to investigate the degree to
      which various manipulations involving food stimuli can be used to appetitively
      condition contextual cues. One manipulation consisted of placing hungry rats in a
      context that contained food that they could consume. A second one involved
      exposure to a context containing food that could only be seen and smelled,
      without consumption being possible. A third type of manipulation consisted of
      exposing animals to a context after the consumption of a small meal in the home
      cage. Finally, hungry, control subjects were merely exposed to a context
      containing an empty food tray. Preference for the context was only enhanced after
      the first type of manipulation, indicating that the actual consummatory act
      constitutes the major source of reinforcement in the present procedure. Olfactory
      and visual food cues, as well as postingestional aftereffects in isolation, did
      not function as reinforces.

PMID- 8346312
TI  - Short-term oral sensory deprivation: possible cause of binge eating in sham
      feeding dogs.
AB  - Six mongrel dogs (18-20 kg) were prepared with gastric and esophageal fistulas.
      All dogs were studied under four experimental conditions. In conditions 1 and 3
      the dogs were allowed to sham feed either a high-palatable or low-palatable meal
      on days 1-5 followed by a sham feed of a high-palatable or low-palatable meal on
      day 6. In conditions 2 and 4 the dogs were not sham fed (oral sensory deprived)
      on days 1-5 but were allowed to sham feed either a high-palatable or low
      palatable meal on day 6. Total caloric requirement during each 6-day study was
      given by infusion of a liquid diet (Isocal) through the gastric fistula following
      the experiment. In condition 4, dogs deprived of oral sensation on days 1-5,
      significantly overconsumed their low-palatable meal on day 6. In condition 2,
      dogs deprived of oral sensation on days 1-5 also overconsumed their high
      palatable meal on day 6, although this did not reach statistical significance.
      Dogs that received oral stimulation days 1-5 (conditions 1 and 3) did not
      overconsume their high- and low-palatable meals on day 6, suggesting that binge
      eating following short-term oral deprivation may be avoided if the diet provides
      adequate oral sensory stimulation. Body weights were well maintained throughout
      each study period and no changes were observed.

PMID- 8346314
TI  - Preoperative skin preparation of patients.

PMID- 8346313
TI  - Modulation of the satiety effect of cholecystokinin by estradiol.
AB  - Data obtained from a wide variety of mammalian species indicate that feeding
      behavior can be influenced by changes in endogenous estrogens and by exogenous
      estrogenic treatments. The present experiment represents an initial investigation
      of the hypothesis that the suppression of food intake by estradiol is mediated by
      an enhancement of the satiety effect of cholecystokinin (CCK). Twenty-four female
      rats were ovariectomized and implanted either with a 5% estradiol silastic
      capsule or an empty capsule on the day of surgery. Three weeks later, animals
      received IP injections of CCK-octapeptide (5.0 or 10.0 micrograms/kg) or saline
      after 24-h food deprivation. Food and water intake were measured 60 min after
      treatment. Although CCK suppressed feeding in all subjects, the effects on food
      intake were greater in estradiol-treated females. CCK injections also reduced
      water intake, but there was no interaction between estradiol and CCK on drinking.
      These findings indicate that the inhibitory effect of CCK on food intake is
      enhanced in females treated with a physiological dose of estradiol, and suggest
      that the effects of estradiol on feeding behavior may be mediated by a
      potentiation of the satiety effect of CCK.

PMID- 8346315
TI  - Making a video about facial disfigurement: a challenging process.

PMID- 8346316
TI  - Laser surgery.

PMID- 8346317
TI  - The American Disabilities Act: a guide to implementing in the plastic surgical
      setting.

PMID- 8346318
TI  - The role of the literature review in research.

PMID- 8346319
TI  - Psychological factors in cosmetic plastic surgery: recent developments in patient
      care.
AB  - The goal of cosmetic surgery is to facilitate improvement in the patient's
      psychological functioning primarily by modifying the patient's body image. This
      article updates the professional literature on recent developments in the study
      of the psychology of cosmetic plastic surgery.

PMID- 8346320
TI  - Psychological adjustment to hand injuries: nursing management.
AB  - Traumatic hand injuries can be devastating experiences both physically and
      psychologically. The plastic surgery nurse who can identify the various responses
      that routinely occur with hand injured patients is better prepared to normalize
      their experiences and implement the necessary interventions toward overall
      rehabilitation. This article will provide an overview of specific characteristics
      and emotional reactions following hand injuries, factors that influence
      adjustment, and nursing management that promotes optimal recovery.

PMID- 8346321
TI  - A woman's psychological response and adjustment to the breast cancer diagnosis.
AB  - The permanent loss of a breast from cancer brings forth a range of emotional and
      behavioral reactions. As more and more women opt for immediate breast
      reconstruction, plastic surgical nurses need to recognize the acute stress
      reactions these patients are experiencing. Not only should the disease itself be
      treated, but the individual suffering from the disease. This article provides an
      overview of women's psychological responses and adjustments to the breast cancer
      diagnosis that plastic surgical nurses need to consider.

PMID- 8346322
TI  - A less-than-perfect experience.
AB  - Plastic surgical nurses frequently work with pediatric patients who have physical
      or cognitive differences. In a society that puts such high value on physical
      appearance and perfection, these children are vulnerable to discrimination.
      Parents and children look to the plastic surgical nurse for support and
      acceptance.

PMID- 8346323
TI  - Social service collaboration: meeting the patient's psychosocial needs.
AB  - Plastic surgical nurses and social workers can collaborate to meet their
      patient's psychosocial needs. Patients and their families benefit from access to
      social services intervention and resources.

PMID- 8346324
TI  - The effects of dieting on eating behavior: a three-factor model.
AB  - I review and critique restraint theory and develop a 3-factor model of dieting
      behavior. The factors--frequency of dieting and overeating, current dieting, and
      weight suppression--are embedded within a 3-dimensional grid that also considers
      mechanisms mediating the effects of dieting and the influence of weight status. I
      argue that the eating behavior exhibited by restrained eaters stems from their
      frequent dieting and overeating in the past rather than from their current state
      of dietary or cognitive restraint. Evidence is reviewed, indicating that current
      dieting and weight suppression have different effects on eating than does
      restraint. The 3-factor model is used to reinterpret findings consistent with
      restraint theory and to explain findings inconsistent with restraint theory.
      Finally, clinical and research implications of the 3-factor model are discussed.

PMID- 8346325
TI  - Do people know how others view them? An empirical and theoretical account.
AB  - Meta-accuracy is the extent to which people know how others see them. Following
      D.A. Kenny and L. Albright (1987), we show how the social relations model (SRM)
      can be used to investigate meta-accuracy. The results from 8 SRM studies
      involving 569 subjects are reviewed. We argue that people determine how others
      view them not from the feedback that they receive from others but from their own
      self-perceptions. Consistent with this argument are the findings that (a) people
      overestimate the degree of consistency in the ways that different targets view
      them and (b) people are better at understanding how others generally view them
      than how they are uniquely viewed by specific individuals.

PMID- 8346326
TI  - The problem of equivalent models in applications of covariance structure
      analysis.
AB  - For any given covariance structure model, there will often be alternative models
      that are indistinguishable from the original model in terms of goodness of fit to
      data. The existence of such equivalent models is almost universally ignored in
      empirical studies. A study of 53 published applications showed that equivalent
      models exist routinely, often in large numbers. Detailed study of three
      applications showed that equivalent models may often offer substantively
      meaningful alternative explanations of data. The importance of the equivalent
      model phenomenon and recommendations for managing and confronting the problem in
      practice are discussed.

PMID- 8346327
TI  - Gender differences in sexuality: a meta-analysis.
AB  - This meta-analysis surveyed 177 usable sources that reported data on gender
      differences on 21 different measures of sexual attitudes and behaviors. The
      largest gender difference was in incidence of masturbation: Men had the greater
      incidence (d = .96). There was also a large gender difference in attitudes toward
      casual sex: Males had considerably more permissive attitudes (d = .81). There
      were no gender differences in attitudes toward homosexuality or in sexual
      satisfaction. Most other gender differences were in the small-to-moderate range.
      Gender differences narrowed from the 1960s to the 1980s for many variables.
      Chodorow's neoanalytic theory, sociobiology, social learning theory, social role
      theory, and script theory are discussed in relation to these findings.

PMID- 8346328
TI  - Source monitoring.
AB  - A framework for understanding source monitoring and relevant empirical evidence
      is described, and several related phenomena are discussed: old-new recognition,
      indirect tests, eyewitness testimony, misattributed familiarity, cryptomnesia,
      and incorporation of fiction into fact. Disruptions in source monitoring (e.g.,
      from confabulation, amnesia, and aging) and the brain regions that are involved
      are also considered, and source monitoring within a general memory architecture
      is discussed. It is argued that source monitoring is based on qualities of
      experience resulting from combinations of perceptual and reflective processes,
      usually requires relatively differentiated phenomenal experience, and involves
      attributions varying in deliberateness. These judgments evaluate information
      according to flexible criteria and are subject to error and disruption.
      Furthermore, diencephalic and temporal regions may play different roles in source
      monitoring than do frontal regions of the brain.

PMID- 8346329
TI  - Long-term consequences of childhood physical abuse.
AB  - This article reviews the literature on the long-term consequences of childhood
      physical abuse. Empirical research is discussed within 7 topic areas: aggressive
      and violent behavior, nonviolent criminal behavior, substance abuse, self
      injurious and suicidal behavior, emotional problems, interpersonal problems, and
      academic and vocational difficulties. The studies reviewed involve primarily
      adult populations, although pertinent findings from literature on children and
      adolescents are briefly summarized. Some variables that affect the relation
      between physical abuse and long-term consequences are examined. These moderator
      variables include maltreatment characteristics, individual factors, family
      factors, and environmental factors. The article ends with suggestions for future
      research on long-term consequences and variables that may affect these outcomes.

PMID- 8346330
TI  - Context, time, and memory retrieval in the interference paradigms of Pavlovian
      learning.
AB  - In this article I review research and theory on the "interference paradigms" in
      Pavlovian learning. In these situations (e.g., extinction, counterconditioning,
      and latent inhibition), a conditioned stimulus (CS) is associated with different
      unconditioned stimuli (USs) or outcomes in different phases of the experiment;
      retroactive interference, proactive interference, or both are often observed. In
      all of the paradigms, contextual stimuli influence performance, and when
      information is available, so does the passage of time. Memories of both phases
      are retained, and performance may depend on which is retrieved. Despite the
      similarity of the paradigms, conditioning theories tend to explain them with
      separate mechanisms. They also do not provide an adequate account of the
      context's role, fail to predict the effects of time, and overemphasize the role
      of learning or storage deficits. By accepting 4 propositions about animal memory
      (i.e., contextual stimuli guide retrieval, time is a context, different memories
      are differentially dependent on context, and interference occurs at performance
      output), a memory retrieval framework can provide an integrated account of
      context, time, and performance in the various paradigms.

PMID- 8346331
TI  - Festschrift issue honoring Donald Oken, M.D.

PMID- 8346332
TI  - Coping theory and research: past, present, and future.

PMID- 8346333
TI  - Life events and affective disorder: replications and limitations.
AB  - Previously unpublished analyses from two longitudinal inquiries are presented
      that use a contextual approach to rating the meaning of life events based on
      intensive semistructured interviews. The studies concern the longstanding
      question of specific versus general susceptibility in disease causation. The
      first study is based on a general population sample of 400 women and deals with
      the specificity of meaning of events provoking clinical depression and anxiety
      disorders. The second is based on a study of 127 depressed women contacting
      psychiatric services in North London and deals with the role of positive events
      in recovery. Each of the studies replicate a prior one and confirm the importance
      of considering specific meaning. The first study demonstrates that loss is
      important in provoking depression, danger for anxiety, and danger and loss for
      the onset of mixed depressive and anxiety disorders. The second study suggests
      that positive events involving hope are particularly important for recovery in
      depression.

PMID- 8346334
TI  - Pathological grief: diagnosis and explanation.
AB  - Pathological grief deserves a place in the diagnostic nomenclature. Because
      posttraumatic stress disorder requires an event beyond the range of usual
      experience and bereavement is virtually a universal experience, a new diagnosis
      of signs and symptoms precipitated by a loss event is needed. Many varieties of
      pathological grief have been noted in clinical research studies, and multiple
      diagnoses of pathological grief would make research difficult. The authors
      advance a solution in a personality-based explanation of abnormal responses to
      loss events; this allows for a single diagnosis of pathological grief. The
      authors also present a predictive model to partially explain pathological grief
      by antecedent trait combinations. The hypothesis is that persons with a preloss
      combination of both contradictions in relational schemas about the deceased and
      tendencies toward excessive control to stifle unwanted affect will tend to have
      unsuccessful processes of mourning. Types of contradictions and overcontrol may
      vary, yielding personality-based varieties of response within a single diagnostic
      category.

PMID- 8346335
TI  - Control and intrusive memories as possible determinants of chronic stress.
AB  - Amidst confusion about the nature and usefulness of the stress construct and
      distinctions between acute and chronic stress, research has begun to identify
      mechanisms by which stress affects health and by which stress can persist beyond
      the physical presence of the stressor. In addition, research has begun to
      identify reasons for selective vulnerability to chronic stress. One of the
      possible reasons for chronic stress following traumatic events is the
      disorganizing effect of loss of control and violation of expectations for
      regulating aspects of one's life normally under control. Data from a longitudinal
      study of chronic stress at Three Mile Island in the wake of the nuclear accident
      there suggest that loss of control and frequent experience of intrusive memories
      about the accident and its aftermath were related to persistent stress responding
      several years after the accident. The relationships between stress responding and
      conditioning and consolidation of stressful memories are considered as a basis
      for persistent intrusive memories and chronic stress.

PMID- 8346336
TI  - Long-lasting hormonal alterations to extreme stress in humans: normative or
      maladaptive?
AB  - The biological consequences of stress have been studied for over half a decade,
      however, little is known about persistent biological alterations after extreme
      stress in humans. Posttraumatic stress disorder (PTSD) is a syndrome that occurs
      in some individuals after exposure to extreme stress. In this review, we
      summarize some of our studies of hypothalamic-pituitary-adrenal axis alterations
      in PTSD and compare and contrast these findings with knowledge concerning
      biological changes following stress.

PMID- 8346337
TI  - Psychosocial factors and immunity in nonhuman primates: a review.
AB  - This review summarizes research from several laboratories that has assessed the
      influence of psychosocial factors on immune responses in nonhuman primates. These
      studies have demonstrated that the formation and disruption of social
      relationships should be viewed as significant psychobiological events with many
      immunologic sequelae, especially for the young monkey. Prolonged changes in
      leukocyte numbers, in vitro measures of lymphocyte function, and antibody
      responses to antigenic challenge have been reliably observed. There is also
      evidence in infant monkeys suggesting that normal maternal care may be important
      for the development and maintenance of the physiological set points for certain
      immune responses. Similarly, immune responses in adult monkeys can be affected by
      the level of aggression occurring within the group. Collectively, this research
      reiterates the important influence that psychosocial variables can have on basic
      physiological responses, particularly when social relationships are in the
      process of change.

PMID- 8346338
TI  - Ambulatory stress psychophysiology: the study of "compensatory and defensive
      counterforces" and conflict in a natural setting.
AB  - Thirty years ago, Donald Oken raised basic questions about psychophysiological
      research strategies for the study of the "psychological stress response" in the
      laboratory. Is it possible to simulate in the laboratory the situations one
      normally encounters? Do laboratory stimuli provoke affective arousal? Are
      different classes of stress stimuli associated with specific physiological
      response patterns? How do one's characteristic "defenses" and coping styles
      modulate one's responses? This paper describes a novel ambulatory research
      strategy in which the laboratory is moved into the natural setting. The
      advantages of this strategy are exemplified in studies of paramedics in whom 24
      hour recordings were made of ambulatory blood pressure and heart rate. The
      ambulatory physiological data were then related to information about specific
      work location and subjective ratings of stress made in a diary at the time of
      each reading, objective assessments of the different stressful situations
      encountered, and the role of individual differences in anger expression and
      defensiveness in modulating these relationships. The findings illustrate the
      ability of real-life stressors to bring out relationships not typically obtained
      in the laboratory. Moreover, the natural setting permits individuals to respond
      to behavioral challenges using their preferred mode of coping with stress, as
      opposed to the constraints imposed on them in the laboratory. This research
      strategy has also helped uncover the significance of conflict about the
      expression of hostility, rather than hostility per se, as a key factor in the
      "stress response."

PMID- 8346339
TI  - [Prolegomena to nonionizing radiative energies. Their biological effects and the
      protection elements. I].

PMID- 8346340
TI  - [The mammographic images of the irradiated breast after conservative therapy for
      carcinoma].
AB  - The mammographic patterns of the patients treated with conservative surgery
      (quadrantectomy) plus radiotherapy for early breast carcinoma were evaluated to
      assess treatment-induced changes over time and to improve the differential
      diagnosis between postirradiation effects and possible tumor recurrences. The
      mammographic examinations of 79 patients who had undergone quadrantectomy and
      radiotherapy for breast carcinoma (stage T1-T2) were examined. Skin thickening,
      edema, fibrosis, distortion and calcifications were considered and classified by
      comparing the radiographic patterns of the treated breast with those of the
      contralateral and untreated one. Pattern changes over time were also evaluated
      and quantified by comparing serial follow-up examinations of the same breast. The
      percentage of patients with irradiation-induced skin thickening steadily reduced
      from 100% at 6 months to just above 50% at 4 years. The number of patients
      showing diffuse irradiation-induced edema decreased from 56% at 6 months to 15%
      at 1 year and to 0% at 2 years, while the number of cases with localized edema
      decreased more slowly. The incidence of localized postirradiation breast fibrosis
      increased to 74% at 4 years, while diffuse fibrosis stabilized around 14%. The
      patients with no postoperative breast distortion accounted for nearly 33% of the
      examined cases, while those with minimal distortion approximated 58% and those
      with gross distortion 9%. In conclusion, the overall results confirmed the value
      of mammography in the follow-up of the patients treated with QUART.

PMID- 8346341
TI  - [CT in the diagnosis and treatment of lymphoceles following gynecologic cancer
      surgery].
AB  - The staging of gynecologic cancers requires the knowledge of lymph node status
      and thus pelvic and/or lumbo-aortic lymphadenectomy remains, to date, a widely
      used procedure. Lymphoceles are a frequent complication of surgical lymph node
      dissection. They are lymph collections in the retroperitoneum following the
      continuous drainage of afferent lymph vessels. To assess the incidence of this
      complication, its CT features and the role of diagnostic imaging to treat
      lymphoceles, 140 patients were retrospectively evaluated. Forty of them had
      undergone pelvic and/or lumbo-aortic lymphadenectomy for proved endometrial
      carcinoma, 51/140 for proved carcinoma of the cervix uteri, and 49/140 for proved
      malignant epithelial cancer in the ovary. CT exams were performed during the
      follow-up, not on a systematic basis but only when a recurrence was clinically
      suspected (117 cases), or in the presence of surgery and/or irradiation
      complications (11 cases), or to assess the extent of residual lesion during
      chemo/radiotherapy (12 cases). Fifty-three lymphoceles were observed in 36
      patients: they were monolateral in 18 cases and bilateral in 16; in 34 cases the
      lymphoceles were found in the iliac space and in 3 cases only in the median
      perivascular lumbo-aortic space. In the patients with clinically suspected
      recurrence (117 patients, 27 lymphoceles), lymphoceles were associated with the
      recurrence in 25 cases, while they were the only CT evidence of a mass in 2
      patients. In the cases with clinically suspected complications of former
      irradiation and surgery (11 patients, 3 lymphoceles), lymphoceles were correctly
      differentiated from abscesses (2 cases), seroceles (1 case), and hematomas (2
      cases). In the group of asymptomatic patients monitored for residual disease (12
      patients, 5 lymphoceles), lymphoceles were an occasional finding and, since they
      caused no complications to the urinary and GI tracts, they were never treated.
      Four asymptomatic patients only, with no evidence of disease, were submitted to
      transcutaneous aspiration and drainage under CT-US guidance (1.7 procedures per
      patient), and lymphoceles resolved in 3/4 cases. The only lymphocele recurring
      more than once required another laparotomy. In our experience, lymphoceles appear
      as a common sequela of pelvic lymphadenectomy for gynecologic cancer. CT has
      proved to be a useful diagnostic tool to assess and characterize the lesions,
      which must be differentiated from other postoperative complications and from
      recurring tumors. Lymphoceles needed to treatment in most cases and thus only
      symptomatic patients, with no cancer, were submitted to aspiration and drainage
      under CT-US guidance; the maneuver was successful on 75% of cases.

PMID- 8346342
TI  - [Xeroradiography and digital luminescence radiography in the study of the
      technics of manufacturing ancient ceramics. The advantages and limits].
AB  - This paper reports on the cooperative work of the Department of Radiology of the
      Catholic University, Rome, and of the Italian Institute for Middle and Far East.
      The study was aimed at using xeroradiography and digital luminescence radiography
      for the archeometric evaluation of ancient ceramics and at assessing the imaging
      potentials of the two techniques. Some manufacturing techniques are reported
      which were used in the ancient world and societies for pottery making--i.e., coil
      building (the superimposition of clay rings), paddle and anvil beating and
      throwing of the wheel. Such techniques leave, on the vessel's wall, clear traces
      which can be detected by X-ray imaging. After discussing the main semiologic
      features, we present 4 case studies from the project archive. Each vase underwent
      xeroradiography and digital luminescence radiography. The former technique was
      useful in detailing minor phase transitions--e.g., pores and inclusions--while
      the latter, thanks to both its wide dynamic range and its image processing
      potentials, was optimal in defining very gradual thickness transitions due to the
      different techniques used to join the clay parts. By combining the two
      techniques, the manufacturing technology of the artifacts could be defined. The
      interactive processing of radiographic images at the system console was seen to
      be of major importance: it allowed the best results to be obtained thanks to the
      integration of the radiologists' and archeologists' know-how during the actual
      analytical stages.

PMID- 8346343
TI  - [A new biological irradiator for the laboratory].
AB  - The use of high doses (15-20 Gy) of X- or gamma-rays to irradiate blood-derived
      materials is a common practice by now. It is usual especially when materials must
      be transfused into non-immunocompetent patients. This is done to avoid the so
      called GVH disease. Nowadays, for this purpose, units containing radioactive
      gamma-emitting sources with high activity and long half-life (usually 137Cs) are
      on the market. The characteristics of these "irradiators" allow their
      implementation in any laboratory with no need of structural shieldings. In spite
      of it, serious accidents (e.g., fire, fallings, etc.) which could imply hazards
      for the operating staff and even the general population, cannot be excluded. At
      the same time, the problem of long-term disposal of exhausted sources cannot be
      neglected. For these reasons, a new type of self-shielded irradiator was
      designed. It is equipped with an X-ray tube, operating at nearly 200-kV voltage,
      with 12-mA anodic current. The system is water- and oil-cooled and can work for a
      long time without thermal overloads. In this paper, the environmental and
      dosimetric measurements for beam characterization are reported. The system can
      produce beams with satisfactory characteristics for this specific problem.
      Moreover, its use may greatly reduce administrative radioprotection problems.

PMID- 8346344
TI  - [The prognostic role of the parameters of cellular kinetics in head and neck
      tumors treated solely by radiotherapy].
AB  - Cell cycle and cell population characteristics, as obtained for head and neck
      cancers by flow-cytometry analysis of a single tumor sample, after in vivo
      bromodeoxyuridine (Burd) infusion, were proposed for their prognostic value and
      for their potentials for radiotherapy planning (conventional vs accelerated) and
      monitoring. DNA ploidy, the S phase fraction labeling index (LI), and duration
      (Ts) as well as cell population potential doubling time (Tpot) were measured in
      42 head and neck squamous cell carcinoma patients and analyzed along with
      histopathological and clinical data. Twenty-seven patients received standard
      radiotherapy (70 Gy/35 fractions/7 weeks) whereas 15 patients were treated with
      the concomitant boost technique (75 Gy/40 fr/6 weeks). The univariate analysis of
      31 patients, for whom all the cell kinetic parameters were available, indicated
      that local control probability was strongly affected by lymph node status (p =
      0.05) and by potential doubling time (p = 0.04). Patients having tumor Tpot < 5
      days had markedly lower two-year local control rate (13%) than patients with Tpot
      > 5 days (68%). Furthermore, tumors with Tpot < or = 5 days exhibited a trend
      toward better local control after concomitant boost regimen compared with the
      patients treated with standard regimen (p = 0.06). These preliminary results
      point out that Tpot could play a role as additional prognostic factor influencing
      disease outcome in head and neck carcinomas treated by radiotherapy. In patients
      with fast growth-rate tumors (Tpot < or = 5 days) a more aggressive radiotherapy
      combination or chemo-radiotherapy should be suggested.

PMID- 8346346
TI  - [An intracranial arachnoid cyst with a repeated intracystic hemorrhagic
      complication].

PMID- 8346345
TI  - [Anatomico-functional assessment by neuroimaging technics in a female patient
      with partial posttraumatic epilepsy].

PMID- 8346347
TI  - [Altered ventilation of the right lung due to tubercular adenopathy treated by
      endoscopic laser surgery].

PMID- 8346348
TI  - [The traumatic opening of a mediastinal bronchogenic cyst in the left primary
      bronchus].

PMID- 8346349
TI  - [A case of leiomyoma of the breast].

PMID- 8346350
TI  - [Bilateral galactoceles in an 18-month-old male infant].

PMID- 8346351
TI  - [CT in tumors of the horseshoe kidney. A report of 2 cases of adenocarcinoma].

PMID- 8346352
TI  - [Integrated imaging of the vessels of the neck].

PMID- 8346353
TI  - [Ovarian carcinoma and intrasplenic metastases. A report of 4 cases].

PMID- 8346354
TI  - [The echographic diagnosis of a sigmoid-bladder fistula. A case report].

PMID- 8346355
TI  - [The quantitative assessment of pulmonary emphysema by computed tomography. The
      evolution of the methods and their possible applications].

PMID- 8346356
TI  - [The radiological diagnosis of bronchiectasis today].

PMID- 8346357
TI  - [The assessment of the severity of pulmonary edema by computed tomography. A
      comparison between high-resolution computed tomography, objective evaluation with
      density masks and functional tests].
AB  - The results of high-resolution computed tomography (HRCT) were correlated with
      those of pulmonary function tests, chest films and CT expiratory density mask
      values in the evaluation of pulmonary emphysema in 33 symptomatic subjects.
      Emphysema was quantitated with both subjective and objective measurements.
      Conventional chest films were useful to diagnose severe emphysema but its actual
      extent was more reliably evaluated with CT scoring systems. HRCT and density mask
      correlated well with function tests, but the former method exhibited stronger
      correlation with carbon monoxide diffusion capacity. The opposite was true for
      hyperinflation and expiratory obstruction variables. Subjective CT estimates,
      which are quick and easy to perform, were seen to correspond more specifically to
      the pathophysiologic derangement and should therefore be used to evaluate the
      anatomic extent of disease. The functional severity of emphysema correlated only
      with the overall extent of disease and not with its regional distribution in the
      upper or lower lungs. Finally, in 4 cases (12.1%) with low CT scores, FEV1 was
      reduced but diffusion capacity values were normal. In one of these patients HRCT
      showed signs of bronchiolitis. In fact, small airway disease might be a more
      critical factor in determining functional impairment than the actual anatomical
      emphysema.

PMID- 8346358
TI  - [The diagnosis of lung inflammation in AIDS patients. The use of 99mTc-labelled
      human polyclonal immunoglobulins and a comparison with 67Ga citrate and high
      resolution computed tomography].
AB  - Technetium-99m (99mTc) labelled polyclonal human immunoglobulin (HIG) is a new
      agent for the localization of active inflammatory diseases. The results obtained
      with HIG in 29 AIDS patients referred for suspected lung infections are reported
      (Table I). The patients also underwent Gallium-67 citrate scanning (GS), chest
      radiography (Rx), high-resolution thin-layer computed tomography (HRCT) and
      broncho-alveolar lavage (BAL). The study population was classified as follows: 12
      patients (Table II) were studied before treatment for suspected Pneumocystis
      carinii pneumonia (PCP), 7 patients (Table III) had known PCP and were studied
      during medical therapy, and 10 patients (Table IV) had lung infections other than
      PCP. In all PCP patients studied before treatment, positive agreement was
      observed between HIG, Rx and HRCT findings. In 4 patients with final clinical
      diagnosis of no lung conditions, both nuclear and radiologic imaging were
      negative. 99mTc-HIG results in the PCP patients studied during therapy were
      consistent with clinical and radiologic improvement; there was disagreement with
      67Ga findings in one case (no. 9). In lung infections other than PCP, HIG studies
      were often negative (always negative in mycobacteriosis), while they were
      positive in 3 pyogenic abscesses. In conclusion, as for PCP and abscesses, the
      results obtained with 99mTc-HIG are usually in agreement with GS findings, while
      HIG scans seem to be negative in mycobacterial infections. Moreover, HIG
      scintigraphy seems to be suitable for the evaluation of treatment results in PCP
      (this subject deserves further research). To assess respiratory impairment a
      semiquantitative index (ISQ) of 99mTc-HIG lung uptake is suggested, which showed
      a significant linear correlation with arterial pO2.

PMID- 8346359
TI  - [Echography, magnetic resonance and double-contrast arthrography of the rotator
      cuff. A prospective study in 30 patients].
AB  - Shoulder pain is a common clinical problem with different etiologies. Without a
      specific diagnosis, treatment could be ineffective, causing functional
      limitation, chronic pain and atrophy. US and MRI allow in many cases to correctly
      define the different etiologies causing shoulder pain, often due to rotator cuff
      conditions. From June to September 1992, thirty patients with clinically
      suspected acute or chronic rotator cuff lesion were studied with US, MRI and
      double contrast arthrography. US and MRI findings were evaluated and compared
      using arthrography and surgery as the gold standard. The overall accuracy of MRI
      was 93%: the method yielded accurate information about size and number of rotator
      cuff tears, and about bursal, bone and muscle involvement. US accuracy was 83% in
      the diagnosis of large tears, 63% in the diagnosis of small and partial tears and
      only 11% in the diagnosis of tendinitis. Both MRI and arthrography exhibited high
      accuracy (respectively 91 and 100%) in the detection of rotator cuff tears when
      their results were compared with surgical findings. A flow chart to be used in
      the patients with acute or chronic shoulder pain was drawn from the critical
      analysis of the above results.

PMID- 8346360
TI  - [Reconstruction of the anterior cruciate ligament using the patellar tendon: its
      magnetic resonance evaluation].
AB  - MRI of the knee was performed in 30 patients who had been submitted to
      arthroscopically-guided reconstruction of the anterior cruciate ligament from
      patellar tendon. The autograft structure was investigated and MR results were
      correlated with clinical findings. Partial/total meniscectomy had been carried
      out in 21/30 cases. The patients were imaged at various postoperative intervals
      (3-24 months) by means of an 0.5-T magnet (GE MR Max Plus) in full knee extension
      and internal rotation. Sagittal and axial T1-weighted images (slice thickness: 3
      mm) were combined with real-time reconstruction which better demonstrated the
      whole graft. T2-weighted coronal images (slice thickness: 5 mm) were also
      acquired. In each patient the following clinical variables were considered:
      anterior drawer sign, Lachman test, pivot shift, degree of leg extension, and
      finally functional recovery. The following MR variables were then considered:
      structure and alignment of bone tunnels, structure and signal intensity of the
      graft, degree of synovial inflammation, structure and signal intensity of the
      posterior cruciate ligament and finally structure of the menisci and/or meniscal
      residues. Symptoms-MR correlation suggests that the different outcome of surgical
      reconstruction may depend on the correct alignment of the tibial and femoral bone
      tunnels and on good meniscal condition. Bone tunnels must be located on the same
      plane, posterior and parallel to the slope of the intercondylar roof, since
      angulation causes the latter to impact the graft during knee extension, with
      inflammation and risk for rupture. As for menisci, tiny residues or total
      ablation overload tha graft, whose signal increases and whose synovia becomes
      inflamed. The latter pattern is always distinguished from that of the autograft,
      whose signal intensity seems not to change in time. In conclusion, MR proved an
      accurate and non-invasive technique to image this kind of postoperative knee,
      since metallic artifacts do not reach the joint space.

PMID- 8346362
TI  - Hazards from pathogenic microorganisms in land-disposed sewage sludge.
AB  - Sewage sludge is a complex mixture of organic and inorganic compounds of
      biological and mineral origin that are precipitated from wastewater and sewage
      during primary, secondary, and tertiary sewage treatment. Present in these
      sludges are significant numbers of microorganisms that include viral, bacterial,
      protozoan, fungal, and helminth pathogens. The treatment of sludge to reduce
      biochemical oxygen demand, solids content, and odor is not always effective in
      reducing numbers of pathogens. This becomes a public health concern because the
      infectious dose for some of these pathogens may be as low as 1 particle (virus)
      to 50 organisms (Giardia). When sludge is applied to land for agricultural use
      and landfill compost, these pathogens can survive from days (bacteria) to months
      (viruses) to years (helminth eggs), depending on environmental conditions.
      Shallow aquifers can become contaminated with pathogens from sludge and,
      depending on groundwater flow, these organisms may travel significant distances
      from the disposal site. Communities that rely on groundwater for domestic use can
      become exposed to these pathogens, leading to a potential disease outbreak.
      Currently, methods to determine the risk of disease from pathogens in land
      disposed sludge are inadequate because the sensitivity of pathogen detection is
      poor. The application of recombinant DNA technology (gene probes and polymerase
      chain reaction) to environmental samples may provide increased sensitivity for
      detecting specific pathogens in land-disposed sludge and greatly improved risk
      assessment models for our exposure to these sources of pathogens.

PMID- 8346361
TI  - [Definition of the T parameter in nasosinusal neoplasms: a CT-MR comparison].
AB  - This study was aimed at investigating the value of CT and MRI in the staging of
      sinonasal tumors. The authors report 22 cases of sinonasal tumors: 7 squamous
      cell carcinomas, 4 adenoid-cystic carcinomas, 1 mucoepidermoid carcinoma, 6
      adenocarcinomas, 1 esthesioneuroblastoma, 1 osteosarcoma, 1 small-cell sarcoma
      and finally 1 non-Hodgkin lymphoma. No significant differences were observed
      between CT and MR staging: 2 T2 and 15 T4 lesions were diagnosed in the maxillary
      sinuses and 3 stage-II and 1 stage-III lesions in the naso-ethmoidal region.
      Tumor spread was similar in 20/22 cases: MRI excluded the involvement of
      maxillary and sphenoid sinuses in 2 cases. CT was superior in the assessment of
      bone destruction particularly at the base of the skull, but MRI better
      demonstrated intracranial spread. MRI detailed the intraorbital muscles and, in
      the infratemporal fossa, the pterygoid muscles better than CT. High agreement was
      observed between CT and histology in 5/7 cases and between MRI and histology in
      6/7 cases undergoing craniofacial resection. Seventeen of 22 cases had low to
      intermediate signal intensity on T1-weighted, PD and T2-weighted MR images.
      Signal was hyperintense in 5 cases: 1 adenocarcinoma with mucinous features, 3
      adenoid-cystic carcinomas and 1 esthesioneuroblastoma. In agreement with
      literature data, this study confirms CT as the examination of choice in staging
      sinonasal tumors: nonetheless, MRI yields valuable information in the cases with
      tumor spread to the muscles and soft tissues.

PMID- 8346363
TI  - [Pollution in the home interior and asthma].

PMID- 8346364
TI  - [The pertinence of bronchial provocation tests to allergens].
AB  - The contribution and the relevance of bronchial provocation tests to allergens
      have been evaluated in the realm of clinical research and in the diagnosis of the
      aetiology of asthma. These tests enable the recognition or to confirm the role of
      certain allergens in asthma, as well as to study the delayed reaction which
      occurs in some cases after the inhalation of an allergen as well as the relations
      existing between HRBNS and bronchial provocation tests to allergens. They also
      can show the preventative action of certain drugs on the immediate and/or delayed
      reaction induced by allergens. The methodology of bronchial provocation tests to
      allergens, notably their variability and their reproductibility, as well as the
      initial and maximal inhaled doses that can be realistically used, are discussed.
      The final point touched upon concerns the justification of bronchial provocation
      tests to allergens in the aetiological diagnosis of asthma. The indications of
      these tests have been restricted, they seen nonetheless always to be of interest
      in cases of discordance with the clinical history, cutaneous tests and/or
      measures of specific serum IgE.

PMID- 8346365
TI  - [Healing of bronchial anastomoses in single and double pulmonary
      transplantations].
AB  - Bilateral single lung transplantation (BSLT) (the procedure of choice for double
      lung replacement) and single lung transplantation (SLT) have at present a low
      incidence of anastomotic problems. In our experience, we have recorded no death
      related to anastomotic problems and 4 complications occurred for 33 anastomoses
      with a follow up of at least 2 months. A stent was temporarily inserted for two
      patients. The decrease of anastomotic complications is confirmed in the
      literature. It is one of the reasons why the number of SLT and BSLT performed all
      over the world increases rapidily to the detriment of heart lung transplantation.

PMID- 8346366
TI  - [Severe late stage lesions of pulmonary histiocytosis X. Report of 3
      transplantations].
AB  - The anatomical lesions of three subjects suffering from pulmonary histiocytosis X
      and treated with lung transplantation were studied in order to detail the changes
      occurring in late stages of the disease; the early stages are known on account of
      lung biopsies done with a diagnostic aim. All the subjects were, at the time of
      transplantation, in a precarious clinical state and were practically bed-bound as
      a result of their dyspnoea with a history of histiocytosis X which had been known
      for 9, 7 and 3 years respectively; one patient had a cardiopulmonary bypass and
      two unilateral lung transplant. The results of the histological study produced
      data which was slightly discordant from the communly held ideas; the de
      Langerhans cells persist in large numbers and after many years of the evolution
      of the disease, even though other elements of the granuloma have practically
      disappeared. Fibrosis is absent playing no role in the genesis of the respiratory
      failure. The lesions are destructive, leading to a disappearance of the alveolar
      capillary bed which is the source of the dyspnea. The honeycomb cavities to the
      destroyed lung are varied in nature: most correspond to the disappearance of the
      dividing walls of the alveoli or the pulmonary acinus, some others related to
      dilated terminal bronchioles and finally others to hollowed out granulomas which
      have become cavities. The peculiar characteristic of the lung allows for
      destructive cavities to be produced by the airflow, submitted to a process of
      auto-aggravation by the elastic forces and the tension of the pulmonary
      parenchyma.

PMID- 8346367
TI  - [Asthma, urban atmospheric pollution and the weather].
AB  - The aim of this study, which was carried out in an urban environment, was to
      research in to a possible relationship between temporal variations in the level
      of atmospheric pollution in the centre of Paris, compared to the frequency of
      acute dyspnoeic crises in which asthmatic patients had requested the emergency
      service (SOS Medecins). This study began in the first half of 1989; during this
      period there were 701 cases of acute asthma recorded within the Paris city
      boundary by "SOS Medecins". The pollutants recorded were sulphur dioxide (SO2),
      an index of black smoke (FN), oxides of nitrogen (NOx), ozone (O3) and soluble
      sulphate particles (SO4). In addition, the weather patterns were examined and
      pollen counts were recorded. In spite of a sub-acute episode of pollution in
      January and February, there was no definite increase noted in the number of
      emergency calls made for acute asthma. In the first three months, the number of
      crises were, on average, higher in association with high levels of the principal
      pollutants (SO2 FN, NOx, SO4) as well as with the periods of high atmospheric
      pressure; however, only the sulphate content and atmospheric pressure remained
      correlated with the daily number of asthmatic crises. In the second three months,
      there were some co-variations uniquely associated with sulphate particles, the
      atmospheric pressure, and above all the ozone level (allowing for a gap of one
      day). The influence of the daily variations in total pollen content or of grass
      pollens did not show up in this study.

PMID- 8346368
TI  - [Urban asthma and habitat].
AB  - This study examines in urban area the housing conditions in asthma patients who
      called a first-aid association of doctors (SOS Medecins) and their relationships
      to symptoms. The patient population is compared with the non asthmatic population
      who called SOS Medecins during the same period. During the first six months of
      1989, among 102,791 calls, 701 were related to acute asthma symptoms, and 100 non
      asthma patients were sorted at random as a control group. A telephonic
      questionnary has been carried out to asthmatic patients and to control group. A
      particular aspect of asthma in Paris is given in this study: the homogeneous
      distribution of asthma attacks in the different districts of Paris, (with a light
      prevalence in three districts of the city). Sex, age, occupation were non
      discriminant and no significant difference was established in housing conditions
      and indoor air pollution sources, between the two groups of asthma and non-asthma
      patients.

PMID- 8346369
TI  - [Surgery for bronchiectasis. Operative indications and results. 48 observations].
AB  - Forty-eight patients: 27 women and 21 men, with mean age of 36 +/- 14 years were
      operated on for bronchiectasis from 1976 to 1989. In 20 cases bronchiectasis was
      the sequelae of acute bronchopathy of childhood, 6 cases of tuberculosis and 5
      cases of inhalated foreign bodies. The bronchiectasis was apparently primitive in
      12 occasions. Five varied etiologies were found of which 2 congenital
      hypogammaglobulinemias. The anatomic extension of the lesions was precised in 47
      cases by bronchography and CT scan in 6 cases, in 1 case with CT scan only. The
      lesions were bilateral in 5 cases. One pneumonectomy, 42 lobectomies (of which 10
      bilobectomies) and 5 segmentectomies were performed. The operative mortality was
      nil. The morbidity (14 cases among 48, i.e. 29%) was not negligible and was
      comparable with the literature data. The evalued results for 36 patients (mean
      post-operative follow-up: 54 +/- 58 months) showed that 24 patients (67%) were
      asymptomatic, 34 have taken their normal professional activities.

PMID- 8346370
TI  - [Chronic atrophic polychondritis. Clinical polymorphism and severity of
      respiratory lesions].
AB  - The authors report the case of chronic destructive polychondritis (PCA) with
      extensive and predominant laryngo-tracheal involvement. The respiratory
      localisation of PCA is apparent in around 50% of cases. In a quarter of patients
      presenting with this type of localisation, the outcome is fatal. Tracheal
      disorders as the presenting feature is a rarity, as in the majority of cases it
      occurs either concomitantly or after the appearance of classic cartilagenous
      disease in the nose or ear. The diagnosis of the airways disease rests on the
      interpretation of the flow volume curve and the CT scan of the inspiration and
      expiration. Taking account of the absence of any correlation between the
      disturbed respiratory function and the laryngotracheal bronchial lesions, the
      authors stress the value of an endoscopic assessment with a fibroscope of reduced
      calibre. The narrowing of the laryngo-tracheal region is due to a thickening of
      the walls with oedema and inflammatory granulomas, and to collapse of the lumen
      caused by the destruction of cartilage and by fibrous scarring of the tracheal
      walls. Either general or local treatment is virtually non-existent and the
      prognosis of these extensive respiratory forms of the disease is very poor.

PMID- 8346371
TI  - [An uncommon thoracic tumor: an hour-glass shaped parietal lipoma. Contribution
      of MRI and CT].
AB  - One case of transmural thoracic lipoma is reported. Thoracic lipomas are rare
      tumors. This report illustrates the usefulness of CT and MRI in the preoperative
      diagnosis and subsequent evaluation of transmural thoracic lipoma.

PMID- 8346372
TI  - [Multiple complications of a mycoplasma pneumoniae infection].
AB  - We report the case of a patient who was admitted to hospital for a pneumonia in
      association with a Stevens-Johnson syndrome. The association of these conditions
      suggested a Mycoplasma pneumoniae infection, which was confirmed on serology.
      There were three other extra-respiratory complications discovered: cold
      agglutinins, a disturbance of liver function tests, and circulating
      anticoagulant; both the two latter and the Stevens-Johnson syndrome are rare
      complications.

PMID- 8346373
TI  - [Pulmonary and cerebral nocardiosis in a patient infected with HIV].
AB  - We report a case of pulmonary and cerebral nocardiosis in a patient infected with
      HIV. On the basis of this observation, the authors review the frequency of
      nocardiosis during the course of an HIV infection and the diagnostic problems
      proposed, and finally the therapeutic difficulties encountered.

PMID- 8346374
TI  - [Atypical pulmonary hydatid cyst].
AB  - An atypical form of a pulmonary hydatid cyst is described. This was a solitary
      super-infected pseudo-tumoral cyst and the membrane was incarcerated which has
      enabled us to propose as a description for this new morphological aspect of a
      cyst, with a filled margin of the proliferative membrane. We propose the term
      "Rosebud".

PMID- 8346375
TI  - [Acute bronchospasm due to periwinkle alkaloid and mitomycin association].
AB  - We report six cases in which patients presented with acute dyspnoea following
      injections of either vindesine or vinorelbin. These patients were receiving
      chemotherapy in association with cisplatin, mitomycin, and vindesine or
      vinorelbin, for inoperable bronchial cancer. Three of the patients had evidence
      of airflow obstruction before these incidents. The clinical picture suggested
      bronchospasm and appeared in the two hours following an injection of the vinca
      alkaloid and a significant time away from the administration of the mitomycin.
      Additional respiratory support was necessary in one patient, the bronchial spasm
      stopped spontaneously in three cases, and following bronchodilator in two. The
      respiratory toxicity of vinca alkaloids (vindesine, vinblastin) was observed in
      4% of the cases, uniquely when they were associated with mitomycin. Vinorelbin
      seems to possess the same respiratory toxicity. The bronchospasm, sometimes very
      severe, seems to occur in the two hours following the injection in the case of
      the cytotoxics and some time after the administration of mitomycin. The
      recurrence of the bronchospasm is a constant feature when the vinca alkaloid is
      readministered. This side effect is different to the pulmonary fibrosis due to
      mitomycin. Clinical follow up and spirometry is thus necessary in those patients
      receiving chemotherapy in which vinca alkaloids and mitomycin are associated and
      the regime should be followed after each administration of a vinca derivative.
      After the first episode of dyspnoea, it is probably wise to stop the
      administration of these anti-mitotics to prevent any further respiratory side
      effects which could be more severe.

PMID- 8346376
TI  - [Subpleural adenopathy].

PMID- 8346377
TI  - [Mediastinal pseudo-tumor: 2 case reports].

PMID- 8346378
TI  - [2000 asthma deaths in France each year: who are they?].

PMID- 8346379
TI  - [Anti-tuberculous program in the Long-An province (South Vietnam). 5 year
      prospective study].

PMID- 8346380
TI  - [What is your diagnosis? Reactive salmonella oligo-arthritis with bilateral
      involvement of the proximal ankle joint].

PMID- 8346381
TI  - [Magnesium therapy of acute heart infarct--has its time come?].

PMID- 8346382
TI  - [Is there a clinical indication for the determination of atrial natriuretic
      peptide?].
AB  - Atrial natriuretic peptide (ANP) is a hormone produced, stored and secreted by
      atrial muscle cells. By its natriuretic, diuretic and blood pressure lowering
      activities ANP is possibly an endogenic antagonist for the sodium-retaining,
      vasopressor renin-angiotensin-aldosterone system (RAAS). In diseases associated
      with increased intravascular volume ANP plasma concentrations have been found
      elevated, in those associated with decreased volume ANP has been found decreased.
      In essential hypertension and chronic heart or renal failure diagnostic
      conclusions may be drawn from the ANP plasma concentration. This review
      summarizes the present knowledge about physiology and pathophysiology of ANP and
      values in addition the diagnostic power of ANP measurements for clinical routine
      in hypertension, heart and renal failure.

PMID- 8346383
TI  - [Tremors].
AB  - Tremor can present a diagnostic problem in family practise. Systematic analysis
      of this symptom allows rapid classification of the problem without use of rigid
      definitions. Unilateral or very asymmetric tremor that disappears at the onset of
      a movement is for example a typical sign for parkinsonism without analysis and
      differentiation between tremor at rest or position-dependent tremor. Also one may
      assume, that a symmetric tremor that aggravates during standing or movement in
      most cases is essential and not of cerebellar origin. Different forms of tremor
      and their therapies and main tremor types are presented graphically.

PMID- 8346384
TI  - [Febrile status and micronodular changes of the lung parenchyma in HIV
      infection].
AB  - This 49-year-old man with the acquired immunodeficiency syndrome (AIDS) was
      admitted to the hospital because of fever, weight loss and respiratory symptoms.
      The radiograph of the chest showed diffuse fine nodular opacities. Histology of
      lung and lymph node revealed a necrotising granulomatosis and yeasts suggesting
      histoplasmosis. It's identity was confirmed by positive cultures for Histoplasma
      capsulatum in blood, urine, lung specimen and lymph node. There was a successful
      induction treatment and a maintenance therapy with amphotericin B. We discuss
      disseminated histoplasmosis in the immunodeficiency syndrome.

PMID- 8346385
TI  - [A case from practice (271). Therapy-resistant leg ulcer of venous origin due to
      calcifications in the subcutaneous ulcer area].

PMID- 8346386
TI  - [Vaccine against AIDS is being tested].

PMID- 8346387
TI  - [Eating behavior. Contributions from anthropology].

PMID- 8346388
TI  - [Anthropology and drug dependence].

PMID- 8346389
TI  - [The medicalization of sex].

PMID- 8346391
TI  - [Professional nursing].

PMID- 8346390
TI  - [The anthropology of death].

PMID- 8346392
TI  - [Anthropology and education for health].

PMID- 8346393
TI  - [The use of anthropology for tackling care situations].

PMID- 8346394
TI  - [The reorientation of the nursing activities in health centers].

PMID- 8346395
TI  - [Continuing education. 81. Medical-surgical. Acute kidney failure].

PMID- 8346396
TI  - [An anthropological "look" at health and disease].

PMID- 8346397
TI  - [Epidemiological trends of primary lung cancers].
AB  - Due to a dramatic increase in the present century, lung cancer is now undoubtedly
      the most frequent cancer in the world. Their principal risk factor for lung
      cancer is active smoking, but passive smoking is also responsible. Eighty to 90%
      of lung cancer cases in men and 50 to 75% in women are caused by tobacco smoke.
      The most effective prevention is cessation of smoking.

PMID- 8346398
TI  - [Mechanisms of lung oncogenesis].
AB  - Precancerous lesions of the bronchial epithelium are dysplasias and in situ
      carcinomas. Squamous metaplasia has not yet been considered as a true malignant
      state. Epithelial cells, which are able to proliferate (non terminally
      differentiated) in bronchial tree and alveoli, are the candidates for malignant
      proliferation (basal cells, mucus cells, Clara cells and type II pneumonocytes).
      Their initial growth is probably promoted by deregulated autocrine growth factors
      (EGF, GRP, IGF1), or their receptors (EGF-R). Under continuous carcinogens
      exposition these proliferating cells accumulate multiple genetic abnormalities
      affecting dominant oncogenes such as myc and ras, and recessive tumor suppressor
      genes such as Rb and p53. Neither the order of intervention of these genetic
      factors nor their correlation with premalignant states have been demonstrated.

PMID- 8346399
TI  - [Anatomopathology of lung carcinoma: classic data and new concepts].
AB  - The classification of lung cancers is based on that defined by the WHO in 1982.
      Electron microscopy and immunohistochemistry have put some tumours (carcinoids
      and small cell carcinomas) in the same neuroendocrine differentiation family.
      Between the two ends of the differentiation spectrum are tumours of intermediate
      malignancy, such as well-differentiated neuroendocrine carcinomas or atypical
      carcinoids. Numerous proposals of classification have been published, and in
      particular some large cell lung cancers have been included in the neuroendocrine
      carcinoma group. The type of lung cancer is sometimes difficult to diagnose on
      biopsy material; it is easier to determine with precision on surgical specimens.
      TNM evaluation is based on detailed macroscopic evaluation of local and regional
      lymph node invasion by the tumour.

PMID- 8346400
TI  - [Diagnosis of primary lung cancers].
AB  - Symptoms of bronchial cancers are varied and misleading, source of late diagnosis
      which had to be avoided by systematic suspicion in front of all symptoms from a
      "high-smoker". Fiberoptic bronchoscopy is the best exam for anatomic diagnosis of
      central forms. It is normal in peripheral forms but may yet be useful by directed
      samplings. If negative, it may be necessary to perform thoracotomy or
      transthoracic needle punction if surgery is contra-indicated. Pretherapeutic
      assessment of loco-regional and metastatic extension has recently profited by new
      imaging and endoscopic techniques, useful to the best realisation of TNM
      classification.

PMID- 8346401
TI  - [Tomodensitometry imaging and MRI of primary lung cancers].
AB  - Accurate determination of the extent of lung cancer is essential to decide on its
      surgical treatment and to evaluate its prognosis. Modern medical imaging is there
      to spare the patients an unnecessary thoracotomy, knowing that the only
      satisfactory treatment is surgical resection. Computed tomography (CT) and
      magnetic resonance imaging (MRI) are part of the preoperative evaluation, side by
      side with the patient's general condition, his cardiovascular and respiratory
      status and the histological type of his tumor. It seems rational to ask for these
      imaging methods for all tumors seemed to be operable after radiology and
      fibroscopy, except perhaps, for some authors, in cases of peripheral T1 NO tumors
      not in contact with the chest wall. CT remains the reference examination for
      preoperative evaluation of lung cancer extension, provided it is performed with
      technical rigor and is interpreted on the basis of strict criteria. The
      opposition of MRI in this field has not yet been definitely established, largely
      because of possible improvements of this new method in the years to come. In
      certain cases, it seems to be a useful complement to CT or even a possible
      alternative to this examination.

PMID- 8346402
TI  - [Effects of antibiotics of subinhibitory concentrations. New mechanisms of action
      for new indications].

PMID- 8346403
TI  - [Mitochondrial diseases].
AB  - Mitochondrial diseases are very complex. Their description, recent but still in
      progress, makes all classifications risky. In the first part of this article we
      present the original character of mitochondria, which is due to their functional
      structure aimed to produce energy, the respiratory chain being fundamental for
      the phosphorylation/oxidation and ATP production processes. Beside Mendelian
      transmission, mitochondria have their own DNA which codes for proteins that are
      few but play an essential role; the nuclear DNA probably has a regulatory effect.
      For these reasons, explorations of mitochondrial functioning, mainly by
      morphological, biochemical and genetic techniques, are specific. In the second,
      clinical part, we analyse the whole range of symptoms and syndromes which
      includes purely muscular lesions, predominantly nervous lesions and multisystemic
      lesions. Some syndromes can be individualized on a biochemical basis, whereas
      other are individualized on a genetic basis involving mainly mutations of
      mitochondrial DNA. Finally, we merely list lesions the origin of which might be
      mitochondrial but remains unknown.

PMID- 8346404
TI  - [Bacterial cutaneous infections: erysipelas. Etiology, diagnosis, clinical course
      amd treatment].

PMID- 8346405
TI  - [Polyuria-polydipsia syndrome. Diagnostic orientation].

PMID- 8346406
TI  - [Manic-depressive disease. Diagnosis, course, treatment].

PMID- 8346407
TI  - [Renal colic. Diagnostic orientation and emergency treatment].

PMID- 8346408
TI  - [Painful knee. Diagnostic orientation].

PMID- 8346409
TI  - [Menopause. Diagnosis, treatment].

PMID- 8346410
TI  - The specificity of alternative complement pathway-mediated lysis of erythrocytes:
      a survey of complement and target cells from 25 species.
AB  - Sera from 20 species of mammals were tested for their ability to lyse
      erythrocytes from 18 species of mammals and birds by the alternative complement
      pathway. Erythrocytes were not lysed by homologous complement, with one minor
      exception, but all erythrocytes tested were lysed by at least one complement
      source, and all sera tested except that of the horse lysed at least one type of
      erythrocyte. Control experiments indicated that lysis was via the alternative
      complement pathway and that antibodies were not involved. Complement from the
      various species could be ranked from most active to least active, and
      erythrocytes could be ranked from most susceptible to least susceptible. There
      was an inverse correlation between complement activity and erythrocyte
      susceptibility. The ranking of the orders of placental mammals, from strongest to
      weakest complement, was carnivore > artiodactyl (ruminants and swine) > primate =
      armadillo > rodent > rabbit > horse. Opossum serum had activity that placed it in
      the centre of this range. Ferret complement, the most potent tested, lysed all
      erythrocytes tested except for homologous erythrocytes, with APCH50 titres as
      high as 4000. Although the overall reactivity pattern was clear, there were
      several striking exceptions. For example, the only complement source which lysed
      ferret erythrocytes was sera of the mouse. The amount of sialic acid present on
      erythrocytes of 14 mammals was determined, and was, in general, directly
      correlated with resistance to alternative complement pathway lysis, although
      there were prominent exceptions to this correlation, involving erythrocytes of
      the horse, burro and human. All 20 types of complement were also tested for their
      ability to lyse antibody-coated human tumour cells, under conditions in which
      both the classical and alternative complement pathways were functional. The data
      obtained suggest that alternative pathway activation is, in some cases, a major
      factor determining the effectiveness of a particular complement source in the
      lysis of xenogeneic tumour cells.

PMID- 8346411
TI  - In vivo depletion of chicken T-cell subsets.
AB  - In the chicken three types of T-cell receptors can be defined by monoclonal
      antibodies TCR1, TCR2 and TCR3, which recognize gamma delta T cells, and V beta 1
      and V beta 2-expressing alpha beta T cells, respectively. In the present report
      we have analysed means of selectively depleting the gamma delta T cells and the V
      beta 1+ alpha beta T cells. gamma delta T cells, which represent up to 66% of all
      T cells in blood of a 6-month-old chicken, can be effectively depleted by
      neonatal thymectomy (Tx) to levels as low as 1%. Immunohistology demonstrates a
      similar depletion in lymphoid organs while intestinal epithelium-associated gamma
      delta T cells are affected by Tx to a lesser extent. V beta 1-bearing alpha beta
      T cells, which comprise about 80% of the alpha beta T cells, were depleted by
      embryonic and neonatal injection of the TCR2 antibody. In the thymus such
      treatment depleted only the V beta 1+ alpha beta T cells with high density
      expression of T-cell receptor. Therefore, we thymectomized TCR2-treated animals
      in order to prevent development of mature V beta 1+ alpha beta T cells from the
      low density immature thymocytes. Treatment of chickens with a total of 22 mg of
      TCR2 antibody plus Tx reduced V beta 1+ alpha beta T cells from an average of 65%
      to 10% of all T cells. In these TCR2 antibody-treated animals the V beta 2
      expressing alpha beta T cells become the predominant type of T cell (average
      85%).

PMID- 8346412
TI  - Murine APC activation in the xenogeneic MLC.
AB  - Purified human T cells proliferate in response to direct and indirect
      presentation of human alloantigens. However, until recently it was believed that
      human T cells could respond only indirectly to murine xenoantigens. We recently
      used the mixed leucocyte culture (MLC) to demonstrate that purified human T cells
      proliferate in response to direct presentation of murine xenoantigens by murine
      antigen-presenting cells (APC) in the presence of human cytokines. We suggested
      that cytokines might function poorly across species barriers. In this study, we
      demonstrate that although proliferation occurs in the presence of exogenously
      added cytokines, the precursor frequency of responding human T cells is much
      lower in a xenogeneic than in an allogeneic MLC. We demonstrate that human T
      cells also proliferate in response to murine APC in the presence of murine
      cytokines, and murine cytokines augment the proliferative response seen in a
      human anti-human MLC, ruling out the possibility that an absolute cytokine
      incompatibility exists between these species. We show that exogenously added
      human IL-1 causes maximal proliferation of human T cells in response to murine
      xenoantigens only when added early in the culture. We further demonstrate that
      murine APC preincubated in human rIL-1, and washed extensively, prior to use as
      stimulating cells, cause human T-cell proliferation without the need for
      exogenously added cytokines. Finally, we noted that during interactions of human
      T cells and murine APC, little to no IL-1 is produced, whereas after the addition
      of exogenous IL-1, a marked increase in the production of IL-1 is seen. These
      data suggest that during interactions between human T cells and murine APC, the
      murine cells do not receive adequate stimulation to produce sufficient
      costimulatory signals to allow proliferation of the human T cells.

PMID- 8346413
TI  - Interleukin-6 is a mediator of TNF-alpha regulation of LAK cell function.
AB  - TNF-alpha at 50-100 U/ml synergizes with IL-2 in enhancing LAK activity and IL-6
      production in low-dose IL-2 (1-10 U/ml) culture of human PBL. High-dose TNF-alpha
      (> or = 200 U/ml) has less effect and even sometimes resulted in lowering of both
      LAK activity and IL-6 production below control levels. TNF-alpha-mediated
      regulation of low-dose IL-2 activation occurs even at late stages (effector
      phase) of LAK development. IL-6, as previously reported, acts at late stages of
      low-dose IL-2 culture to enhance LAK, but does not stimulate TNF-alpha
      production. The combined addition of TNF-alpha and IL-6 to late stages of IL-2
      culture does not produce any additive or synergistic effect on LAK. We tested for
      the relative roles of TNF-alpha and IL-6 in late stage regulation of LAK
      development with antibodies (Abs) to these cytokines. Anti-IL-6 Ab abrogates late
      phase LAK enhancement by TNF-alpha, while anti-TNF-alpha Ab has no effect on IL-6
      augmentation of LAK cytotoxicity. IL-2 added to PBL culture at doses greater than
      10 U/ml induces production of both TNF-alpha and IL-6. Addition of anti-TNF-alpha
      Ab at late stages of high-dose IL-2 (> or = 20 U/ml) culture decreases both LAK
      cytotoxicity and IL-6 production, and the inhibition of LAK is reversed by the
      addition of IL-6. By contrast, anti-IL-6 Ab decreases LAK cytotoxicity, but does
      not alter TNF-alpha production, and the inhibition of LAK is not reversed by
      addition of TNF-alpha. These data indicate that TNF-alpha is important for both
      LAK development and IL-6 secretion in PBL, and that IL-6 is the proximate
      mediator in TNF-alpha regulation of these cytotoxic cell functions.

PMID- 8346414
TI  - Development of B cells secreting endogenous or transgene-encoded immunoglobulins
      in H-chain transgenic mice.
AB  - The development of splenic B cells secreting transgene-encoded or endogenous
      immunoglobulin (Ig) was analysed in the mu heavy (H-)chain transgenic mouse line
      M54. The results show that cells secreting endogenous Ig are not detectable
      during the perinatal period, even after lipopolysaccharide stimulation in vitro.
      At this time, transgene-secreting cells are readily detectable and keep
      increasing with age of the animals. After a few weeks of age cells secreting
      endogenous Ig appear in the spleen and keep increasing with age, reaching numbers
      comparable to non-transgenic littermates by 5 weeks of age. Thereafter, the
      proportion of transgene-secreting B cells decreases. We conclude that the
      preferential expression of endogenous Igs by secreting B cells in the adult does
      not result from peculiar genetic features of those cells, but from age-dependent
      cellular selection operating on all B cells.

PMID- 8346415
TI  - Lactoferrin triggers in vitro proliferation of T cells of Lewis rats submitted to
      mycobacteria-induced adjuvant arthritis.
AB  - We have recently reported antigenic (B-cell) cross-reactivity between the
      mycobacterial 65 kDa heat shock protein (hsp65) and human lactoferrin (LF) and we
      suggested that this cross-reactivity might have a role in mycobacteria-associated
      autoimmune disease. Here, we have searched for anti-LF T-cell reactivity in Lewis
      rats submitted to a mycobacteria-triggered autoaggressive disorder (adjuvant
      arthritis, AA), an autoimmune disorder characterized by high anti-hsp65
      reactivity. We have quantified the in vitro proliferative response to LF of lymph
      node and spleen cells of Lewis rats killed 9, 14 and 21 days after the
      immunization with the AA-triggering, mycobacteria-containing adjuvant (complete
      Freund's adjuvant, CFA). We found that LF induced significant proliferation of
      lymph node T cells of rats undergoing AA. This T-cell proliferation was not as
      marked as the one provoked by hsp65; it was, nevertheless, significantly higher
      (P < 0.05) than that produced by a non-arthritogenic antigen (i.e. albumin). T
      cells from naive or mineral oil (incomplete Freund's adjuvant, IFA) injected rats
      did not respond to LF or hsp65. These data indicate that LF may work as an
      accessory stimulatory factor of the T-cell autoreactivity associated with
      mycobacteria-induced arthritis.

PMID- 8346416
TI  - T-cell stimulation with purified mycobacterial antigens in patients and healthy
      subjects infected with Mycobacterium leprae: secreted antigen 85 is another
      immunodominant antigen.
AB  - Peripheral blood leucocytes from 9 paucibacillary and 12 multibacillary leprosy
      patients, from 18 healthy controls and from 34 healthy leprosy contacts were
      stimulated with three mycobacterial heat shock proteins with respective molecular
      weights of 70, 65 and 18 kDa and with the secreted 30-32 kDa protein, also called
      antigen 85. Antigen 85 was found to be the most powerful T-cell antigen (as
      measured by lymphoproliferation and IFN-gamma secretion), eliciting a positive
      response in all (100%) paucibacillary patients and in all lepromin-positive
      controls and contacts. The three heat shock proteins (hsp) were less active T
      cell stimuli. Reactivity to the 70 kDa hsp was found in only 44% of the
      paucibacillary patients, in 80% of the lepromin-positive controls and in 60% of
      the lepromin-positive leprosy contacts. The 65 kDa hsp stimulated T cells in 89%
      of the paucibacillary patients and in 80% of the lepromin-positive controls and
      contacts. Responsiveness to the 18 kDa hsp, finally, was clearly more frequent in
      tuberculoid leprosy patients (78%) than in lepromin-positive controls (40%) or
      lepromin-positive leprosy contacts (4%). T-cell reactivity of 8 lepromin-negative
      controls, of 9 lepromin-negative contacts and of 12 multibacillary leprosy
      patients was low to all the antigens tested. Although proliferative and IFN-gamma
      responses were generally closely related, some subjects demonstrated a
      dissociation of these two immune parameters. Our data confirm previous findings
      on the powerful T-cell stimulatory properties of antigen 85 during M. leprae
      infection and suggest that this antigen is indeed a potentially protective T-cell
      immunogen.

PMID- 8346417
TI  - Evidence for the role of CR1 (CD35), in addition to CR2 (CD21), in facilitating
      infection of human T cells with opsonized HIV.
AB  - Complement activation by HIV results in the binding of C3 fragments to the gp160
      complex and enhanced infection of C3 receptor-bearing target cells. We have
      studied complement-mediated enhancement of infection of the human CD4-positive T
      cell line HPB-ALL which expresses the CR1 (CD35) and CR2 (CD21) receptors for C3.
      CR1 and CR2 are present on 15% and 40% of normal peripheral blood CD4-positive T
      lymphocytes respectively. Opsonization of the virus with complement resulted in a
      3- to 10-fold enhancement of infection of HPB-ALL cells, as assessed by measuring
      the release of p24 antigen in culture supernatants throughout the culture period.
      Blockade of CR2 with cross-linked anti-CR2 monoclonal antibodies decreased
      infection to the level observed with unopsonized virus. Blocking CR1 reduced
      complement-mediated infection by 50-80%. Experiments using serum deficient in
      complement factor I demonstrated that CR1 mediates the interaction between
      opsonized virus and T cells in addition to its ability to serve as a cofactor for
      the cleavage of C3b into smaller fragments that interact with CR2. A requirement
      for CD4 in complement-mediated enhancement of infection was observed with HIV-1
      Bru but not with HIV-1 RF. Thus, CR1 and CR2 contribute in an independent and
      complementary fashion to penetration of opsonized virus into complement receptor
      expressing T cells. Involvement of CD4 in infection with opsonized virus depends
      on the viral strain.

PMID- 8346418
TI  - Polyreactivity is a property of natural and disease-associated human
      autoantibodies.
AB  - Polyreactivity was earlier recognized as a feature of naturally expressed
      autoantibodies in serum. In the present study, we have compared the reactivity on
      a panel of self antigens of affinity-purified anti-DNA and anti-thyroglobulin
      (TG) IgG autoantibodies from the serum of patients with systemic lupus
      erythematosus (SLE) and autoimmune thyroiditis with their affinity-purified
      counterparts isolated from the serum of healthy individuals. Anti-DNA
      autoantibodies exhibited a similar degree of polyreactivity whether originating
      from patients or from healthy adults. Natural anti-TG autoantibodies were also
      found to be polyreactive. Anti-TG autoantibodies from patients with Hashimoto's
      thyroiditis showed little or no polyreactivity. Natural anti-TG autoantibodies
      were equally polyreactive whether or not they belonged to a fraction of normal
      IgG that is connected through V regions with other IgG molecules from the same
      source. These results indicate that polyreactivity of autoantibodies is a feature
      that does not allow one to distinguish between natural and disease-associated
      autoantibodies as well as between V-region-connected and unconnected
      autoantibodies.

PMID- 8346419
TI  - Interferon-gamma induces a phospholipase D-dependent release of arachidonic acid
      from endothelial cell membranes: a mechanism for protein kinase C activation.
AB  - Interferon-gamma (IFN-gamma) induces MHC class II expression on endothelial cells
      in a protein kinase C (PKC)-dependent manner. Here we show that IFN-gamma induces
      a sixfold arachidonic acid (AA) release from cultured rat microvascular
      endothelial cell membranes compared with non-treated cells. Since this result
      suggests that AA could act as a second messenger for IFN-gamma, we analysed its
      capacity to directly activate PKC. We have previously shown that IFN-gamma
      induces a transient, multiphasic activation of PKC via the action of the
      phospholipase D (PLD) pathway. Here we show that AA is able to activate PKC. In
      an attempt to characterize the source of the liberated AA after IFN-gamma
      induction in endothelial cells we used a panel of enzyme inhibitors. The IFN
      gamma-induced release of AA could not be modified by interfering either with the
      phospholipase A2 (PLA2) pathway using bromophenacyl bromide (BPB), or with the
      phospholipase C (PLC) pathway using neomycin. The phosphatidic acid phosphatase
      (PAPase) inhibitor propranolol, inhibiting the generation of diacylglycerol (DAG)
      and further AA from phosphatidic acid (PA), could totally down-regulate the IFN
      gamma-induced release of AA. Since PA is produced solely by the action of PLD
      from phosphatidylcholine (PC) we conclude that the AA originated from the cell
      membrane-associated PC. In summary, we show here that IFN-gamma causes the
      liberation of cell membrane-associated, PC-linked AA. This AA could directly
      activate PKC in a similar multiphasic manner to IFN-gamma, suggesting that it is
      a true second messenger for IFN-gamma in cultured endothelial cells.

PMID- 8346420
TI  - B-cell activation in duodenal mucosa after oral cholera vaccination in IgA
      deficient subjects with or without IgG subclass deficiency.
AB  - Alterations in duodenal Ig-producing cells induced by two oral cholera
      vaccinations were studied by two-colour immunofluorescence in mucosal tissue
      sections from adults with selective IgA deficiency (IgAD), either with (n = 7) or
      without (n = 9) frequent infections, infection-prone patients with combined IgAD
      and IgG subclass deficiency (IgGSD) (n = 7), and normal control subjects (n =
      11). The proportion of IgG-producing cells prior to immunization tended to be
      lower in the symptomatic IgAD subjects than in the clinically healthy ones. In
      the first subgroup the absolute number of IgG cells per intestinal length unit
      was significantly increased after immunization (P < 0.04), and this tendency was
      also observed in the healthy IgAD subjects (6/9) and in those with combined
      deficiency (5/7). Very few IgAD subjects responded with an increase of IgM
      producing cells. The normal controls responded variably in all major immunocyte
      classes, in the order IgA > IgG > IgM. Compared with these controls, the patients
      with combined IgAD and IgGSD showed significantly increased IgG1 (P < 0.01) and
      reduced IgG2 (P < 0.006) proportions, which was in accordance with their serum
      subclass levels. Our study showed that oral cholera vaccination preferentially
      activates intestinal IgG-producing cells in IgAD subjects. This result agreed
      with data recently obtained by ELISPOT in the same patients with regard to
      antibody-forming cells specific for cholera toxin. Both methods suggested that
      IgG rather than IgM antibodies are elicited as compensation for a lacking IgA
      response. However, our overall results showed that intestinal B-cell activation
      is quite variable after oral cholera vaccination. Although such vaccination might
      be of importance for enhancing mucosal immunity also in IgAD patients, a
      concurrent gut disease could possibly be aggravated by IgG-mediated mucosal
      immunopathology in the absence of anti-inflammatory IgA antibodies.

PMID- 8346421
TI  - [Who should practice psychosomatic medicine?].

PMID- 8346422
TI  - [Delay in management and treatment of patients with suspected acute myocardial
      infarction: role of the public, of extra- and intra-hospital structures and
      transportation methods].
AB  - The potential impact of thrombolytic agents on mortality and morbidity from
      coronary artery disease is weakened by in- and out-of-hospital delays occurring
      in the management of acute myocardial infarction. The goals of this study were to
      review the situation 5 years after the publication of the GISSI study. From
      October 1, 1991 to March 31, 1992, all the events occurring between symptom onset
      and in-hospital treatment were analyzed for 620 consecutive patients with
      suspected myocardial infarction seen in the emergency ward of the University
      Hospital, Geneva. Among them, 189 (30.5%) had myocardial infarction and 144 (23%)
      unstable angina. Mean and median delay between symptom onset and hospital arrival
      for the 620 patients were 10 h 02 min and 2 h 55 min respectively; 117 (19%)
      patients came straight to the hospital alone, with the risk of arrhythmic
      complications en route to the emergency ward but with shorter time delays (mean
      delay: 6 h 13 min; median delay: 2 h 30 min) than the 503 (81%) patients who
      called out-of-hospital services (mean delay: 10 h 55 min; median delay: 3 h; p <
      0.04). The latter patients accounted for 47% of mean out-of-hospital delay and
      the out-of-hospital services for 53%. Minimization or ignorance of symptoms,
      waiting for relief from medication and attempts to reach relatives were
      responsible for long patients' decision times.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346424
TI  - [Vertebral artery dissection following manipulation of the cervical vertebrae].
AB  - We report on two patients who developed symptoms and signs of infarction of
      dorsolateral medulla oblongata (Wallenberg's syndrome) and the cerebellum
      respectively, following cervical manipulation for slight neck pain. Subsequent
      vertebral artery angiography and MRI showed the typical signs of vertebral artery
      dissection of the atlantoaxial and intracranial segment in one patient, and of
      the intertransverse segment in the second. The pathogenesis of vertebral artery
      injury following cervical manipulation is discussed and the literature is
      reviewed. The practical implications of this rare complication are discussed.

PMID- 8346423
TI  - [Alpha-interferon therapy in Crohn's disease: initial clinical results].
AB  - 4 therapies in 3 patients (1 female, 2 male) suffering from steroid dependent
      Crohn's disease are described. Interferon alpha-2b was administered for 24 weeks
      (3 million I.U. per day for 4 weeks, and 3 x 3 million U.I. per week for 20
      weeks). Prednisolone dosage at start of therapy depended on initial inflammatory
      activity (CDAI). The daily dose was reduced stepwise and omitted after 12 weeks.
      In two courses patients did not respond and therapy had to be halted after 12 and
      14 weeks' duration because of increasing disease activity. During the other two
      treatments a decrease in disease activity of 118 and 70 CDAI units (in both cases
      after 8 weeks) could be achieved. In particular, the course in one patient with
      abundant intestinal and extraintestinal inflammatory activity was quite
      impressive: extraintestinal activity disappeared completely within 10 days, CDAI
      ameliorated substantially for 30 weeks and the patient could be treated without
      steroids for a total period of 18 weeks. As a preliminary conclusion from the
      cases described up to now, it can be speculated that females probably respond
      more favorably to a combined therapy with interferon alpha and corticosteroids.
      Moreover, we suggest that the potential of interferon in Crohn's disease might be
      to overcome a steroid refractory disease state rather than to allow omission of
      steroid medication which could not be further reduced without exacerbation.
      Clearly, present experience of interferon therapy in Crohn's disease is still too
      scarce and more work needs to be done to define the role of interferon in IBD.

PMID- 8346425
TI  - [Professional management of death--sociocultural aspects].
AB  - During recent decades, treatment of death has been removed from the family and
      placed in the hands of experts and specialized institutions. More and more people
      die outside their homes. Our statistical analysis shows that in Switzerland
      between 1969 and 1986 the old people's home has replaced the private home.
      However the proportion of people dying in the hospital (55%) has not changed.
      Proceeding from these facts, we conducted a sociological research project with
      participant observation that explored attitudes, strategies and practices of
      professionals who deal closely with death and dying. Our case studies involved
      people working on the wards of a hospital, in a hospital mortuary, in an old
      people's home, in an autopsy department, in a funeral home and in a cemetery. The
      analysis showed that in the context of preservation of life (hospital), the
      consciously maintained attitude is ambivalence and an openness to various
      outcomes. In the context of applied science (autopsy department), the attitude is
      search for unequivocal exactness. In the context of loss (funeral home,
      cemetery), we find two different orientations among two different groups of
      actors. Those who deal with the practical side of death, such as the crematorium
      attendant, show a technical orientation, while those who deal with death's non
      practical side, such as the minister, show a social and a symbolic orientation.
      At the points of intersection between these contexts, the actors develop complex
      strategies: maintenance of the past, negation of the present and anticipation of
      the future. CONCLUSIONS: (1.) The fight against death in the university hospital
      is being more and more replaced by the development of a strategy of
      openness.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346427
TI  - Computing in science.

PMID- 8346426
TI  - [Concerning: Herzog Ch: quantification of mRNA using the polymerase chan
      reaction, cytokines in rheumatoid arthritis (Schweiz Med Wochenschr 1992;
      122:229)].

PMID- 8346429
TI  - Army to test only MicroGeneSys vaccine.

PMID- 8346428
TI  - Choose your poison.

PMID- 8346430
TI  - Varmus tapped to head NIH.

PMID- 8346431
TI  - How Varmus got the job.

PMID- 8346433
TI  - A Manhattan Project by any other name...

PMID- 8346432
TI  - Army clears Redfield--but fails to resolve controversy.

PMID- 8346434
TI  - New piece in Alzheimer's puzzle.

PMID- 8346435
TI  - Protein signals frog embryo to start getting a head.

PMID- 8346436
TI  - Beyond databases and E-mail.

PMID- 8346437
TI  - AI helps researchers find meaning in molecules.

PMID- 8346438
TI  - The collaboratory opportunity.

PMID- 8346439
TI  - Genetic algorithms: principles of natural selection applied to computation.
AB  - A genetic algorithm is a form of evolution that occurs on a computer. Genetic
      algorithms are a search method that can be used for both solving problems and
      modeling evolutionary systems. With various mapping techniques and an appropriate
      measure of fitness, a genetic algorithm can be tailored to evolve a solution for
      many types of problems, including optimization of a function of determination of
      the proper order of a sequence. Mathematical analysis has begun to explain how
      genetic algorithms work and how best to use them. Recently, genetic algorithms
      have been used to model several natural evolutionary systems, including immune
      systems.

PMID- 8346440
TI  - Metal ion-dependent modulation of the dynamics of a designed protein.
AB  - The peptide alpha 4 is a designed four-helix bundle that contains a highly
      simplified hydrophobic core composed exclusively of leucine residues; its
      tertiary structure is therefore largely dictated by hydrophobic forces. This
      small protein adopts a structure with properties intermediate between those of
      the native and molten globule states of proteins: it is compact, globular, and
      has very stable helices, but its apolar side chains are mobile and not as well
      packed as in many natural proteins. To induce a more native-like state, two
      Zn(2+)-binding sites were introduced into the protein, thereby replacing some of
      the non-specific hydrophobic interactions with more geometrically restrictive
      metal-ligand interactions. In the metal-bound state, this protein has properties
      that approach those of native proteins. Thus, hydrophobic interactions alone are
      sufficient to drive polypeptide chain folding nearly to completion, but specific
      interactions are required for a unique structure.

PMID- 8346441
TI  - Determinants of binding-site specificity among yeast C6 zinc cluster proteins.
AB  - Related DNA binding proteins often recognize similar DNA sites but can
      distinguish among them with the use of different protein-DNA contacts. Here, it
      is shown that members of the C6 zinc cluster family of yeast transcriptional
      activators distinguish related DNA sites by a different mechanism. The DNA
      binding site for each of these proteins contains identical nucleotide triplets
      (CGG ... CCG) but differs in the spacings between the triplets. It is shown that
      zinc clusters of these proteins work interchangeably to recognize the conserved
      triplets and that the region 19 amino acids to the carboxyl-terminal side of the
      zinc cluster, comprising the linker and the beginning of a dimerization element
      as inferred from the GAL4 crystal structure, directs the protein to its preferred
      site.

PMID- 8346442
TI  - Reconstitution of T cell receptor zeta-mediated calcium mobilization in
      nonlymphoid cells.
AB  - T cell antigen receptor (TCR) activation involves interactions between receptor
      subunits and nonreceptor protein tyrosine kinases (PTKs). Early steps in
      signaling through the zeta chain of the TCR were examined in transfected COS-1
      cells. Coexpression of the PTK p59fynT, but not p56lck, with zeta or with a
      homodimeric TCR beta-zeta fusion protein produced tyrosine phosphorylation of
      both zeta and phospholipase C (PLC)-gamma 1, as well as calcium ion mobilization
      in response to receptor cross-linking. CD45 coexpression enhanced these effects.
      No requirement for the PTKZAP-70 was observed. Thus, p59fynT may link zeta
      directly to the PLC-gamma 1 activation pathway.

PMID- 8346444
TI  - Delegation.

PMID- 8346445
TI  - ANA concerned at growing RN layoffs.

PMID- 8346443
TI  - Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer's disease
      in late onset families.
AB  - The apolipoprotein E type 4 allele (APOE-epsilon 4) is genetically associated
      with the common late onset familial and sporadic forms of Alzheimer's disease
      (AD). Risk for AD increased from 20% to 90% and mean age at onset decreased from
      84 to 68 years with increasing number of APOE-epsilon 4 alleles in 42 families
      with late onset AD. Thus APOE-epsilon 4 gene dose is a major risk factor for late
      onset AD and, in these families, homozygosity for APOE-epsilon 4 was virtually
      sufficient to cause AD by age 80.

PMID- 8346446
TI  - Black dog and nursing diagnosis.

PMID- 8346447
TI  - Primary health care: the nurse solution.

PMID- 8346448
TI  - Professional practice: standards, code, and accountability.

PMID- 8346449
TI  - Code for nurses.

PMID- 8346450
TI  - [Correction of double-outlet right ventricle using the Kawashima intraventricular
      tunnel procedure].
AB  - Anatomical correction with an intraventricular tunnel, as suggested by Kawashima,
      was performed in 14 children with a double-outlet right ventricle and a
      subpulmonary (4) or non-committed (10) defect of the ventricular septum with one
      early and one late death. Nine children had previous palliative operations.
      Complications after radical surgery were residual ventricular defects (4),
      infectious endocarditis (2) and impaired rhythm (one sudden death). Twelve
      patients are after medium- term or long-term follow-up free from subjective
      complaints, ten children report good performance, in two the performance is
      slightly reduced. Anatomical intraventricular correction of double-outlet right
      ventricle restores the mitral valve and left ventricle to the systemic
      circulation. The prognosis of children with double-outlet right ventricle and
      subpulmonary or remote ventricular defect improves substantially.

PMID- 8346451
TI  - [Peroperative transluminal angioplasty as a supplementary procedure to arterial
      reconstruction surgery].
AB  - Patients with affections of the vascular system of the lower extremities at
      several levels present a complicated problem for vascular surgery. The authors
      submit their experience with a combination of vascular reconstruction and
      peroperative transluminal angioplasty. In 25 patients, mean age 64 years, they
      performed 29 of these combined operations, 10 times on account of claudications,
      11 times on account of pain at rest, 8 times on account of trophic defects. The
      pelvic vessels were dilated 6 times; the dilated vessels as well as the
      reconstruction remained patent. Peroperative angioplasty of the superficial
      femoral artery was performed 6 times, occlusion occurred once. Twelve times they
      dilated the distal portion of the popliteal artery or the vessels of the leg, 3
      times the dilated portion became occluded. None of the patients lost the limb,
      one patient died from acute myocardial infarction shortly after operation. The
      authors describe the technique of peroperative transluminal angioplasty, evaluate
      the results and discuss the advantages and disadvantages of this method.

PMID- 8346452
TI  - [Injuries of the bile ducts and fundamentals of therapy].
AB  - In the submitted paper the authors present an account on 88 patients with
      reconstructions of the biliary pathways, most frequently after iatrogenic damage.
      Check-up examinations revealed that the results in patients who survive for
      prolonged periods and were reoperated in time, unless they developed irreversible
      liver damage, are very satisfactory. 81.8% of the patients have no subjective
      complaints and the objective finding (laboratory examination, HIDA) is consistent
      with the subjective report. In the author's opinion a certain part in these
      satisfactory long-term results is played by short-term, or if necessary, long
      term drainage of the anastomosis. This problem is discussed in detail.

PMID- 8346453
TI  - [Changes in hemocoagulation in children with cranio-cerebral trauma].
AB  - The authors monitored in children with craniocerebral injuries hospitalized in
      their department in the course of the more than one-year existence of the child
      ARO ward in addition to other vital parameters also changes of the
      haemocoagulation system. They describe the majority of commonly observed
      abnormalities as "latent consumption coagulopathy", where laboratory findings are
      not associated with clinical signs of coagulopathy. On the other end of the
      spectrum of coagulopathies after head injuries is the unit of disseminated
      consumption coagulopathy which is generally evaluated as a secondary phenomenon
      or as an intermediary mechanism of the disease which complicates various
      pathological conditions incl. craniocerebral injuries. The authors discuss the
      pathophysiology, diagnostic possibilities and their experience with the treatment
      of the mentioned disorders.

PMID- 8346454
TI  - [Treatment of peripheral nerves in a district hospital].
AB  - The authors submit the results of 23 operations performed on peripheral nerves of
      the upper extremity in a district hospital. They emphasize the good cooperation
      of the surgeon with the neurologist, the importance of clinical and EMG
      examinations for diagnosis as well as during evaluation of the accomplished
      operation. In cooperation with the Physical Institute of the Czech Academy of
      Sciences it proved possible to reconstruct for surgical purposes a common
      colposcope so that it can be used for microsurgical operations. A brief
      description of the apparatus is given in the paper. From a total of 23 performed
      operations a satisfactory result was recorded in 87% of the operated patients.

PMID- 8346455
TI  - [Urologic complications in colorectal carcinoma].
AB  - Urological complications of colorectal cancer during surgery of the large bowel
      are relatively frequent. Fortunately these complications are as a rule transient
      and recede either spontaneously or after a suitably selected therapeutic
      procedure. Permanent complications account in our group comprising 311 patients
      only for a fraction of a per cent. The problem of carcinoma of the colon and
      rectum and treatment, along with possible complications, is becoming increasingly
      important in particular in conjunction with an objectively assessed shift of the
      prevalence of the disease to younger age groups. The group of patients treated in
      the authors' department on account of colorectal carcinoma during the last five
      years was evaluated in detail and thus it was possible to detect why different
      complications developed. This evaluation of all recorded cases was made from the
      diagnostic aspect as well as with regard to therapeutic possibilities, taking
      into account the technique of surgical approaches.

PMID- 8346456
TI  - [Short-term hospitalization and ambulatory care of patients with advanced
      hemorrhoidal disease].
AB  - The authors describe possible non-surgical treatment of extensive haemorrhoids
      grade 3 and 4, using Barron's rubber band ligation. To make comparison of
      therapeutic results possible Dennison's Sheffield classification is used. In the
      mentioned new approach indications for ambulatory treatment or short-term
      hospitalization in patients with an advanced grade of internal or external
      haemorrhoids are extended. From a group of 145 patients treated by this method
      126 were free of subjective complains during a check-up 12 months after
      termination of treatment.

PMID- 8346457
TI  - [Excellent therapeutic results in an "apparently hopeless case"--an example of
      good interprofessional cooperation].
AB  - The authors demonstrate on the example of a patient the correct procedure as
      regards collaboration between different departments with excellent results-
      survival and cure of the patient. It was a serious case where the patient with
      the basic diagnosis (acute phlegmon of the neck with an abscedent mediastinitis)
      and several serious associated complications theoretically did not have a chance
      of survival. The authors emphasize the importance of collaboration of different
      departments where each played in a certain stage of the disease a leading role in
      therapy.

PMID- 8346459
TI  - [2 comments on terminology relating to the large intestine].

PMID- 8346458
TI  - [Fatal surgical complications in obstetrics].

PMID- 8346460
TI  - [A years' experience in working with the General Health Insurance Company].

PMID- 8346461
TI  - [Thinking about rheumatic diseases in childhood].

PMID- 8346462
TI  - [Cause of death in autopsied RA patients].
AB  - A mortality study was performed based on the data of Annual of the Pathological
      Autopsy Cases in Japan in 1985-1989. The average life span of the RA patients,
      revealing 66.5 years in male and 64.6 years in female, was shorter than that of
      general population in Japan. Of 1,246 autopsied RA cases, the most common causes
      of death were infections (26.6%), respiratory diseases including interstitial
      lung disease (17.5%) and amyloidosis (12.5%). Amyloidosis was common among RA
      cases (25.2%), and it was suggested that RA was the most important underlying
      disorder of the secondary amyloidosis: in 1985 to 1989, 316 cases of 515
      secondary amyloidosis (61.4%) were associated with RA.

PMID- 8346463
TI  - [Clinicopathological evaluation and treatment of bucillamine induced membranous
      nephropathy].
AB  - We discussed clinicopathological evaluation and treatment of bucillamine induced
      renal destruction. Thirteen cases of rheumatoid arthritis were investigated in
      whom proteinuria had developed while being treated with bucillamine. The dose of
      bucillamine ranged from 100 to 300 mg/day, and many of them were treated with a
      dose of 200-300 mg/day. The total dose was in the range of 9-57 g. Proteinuria
      had developed within 3 months after perceiving the efficacy of bucillamine in
      many of the cases. The details of renal histology revealed that membranous
      nephropathy was noted in all of the 13 cases and that mesangial proliferative
      gromerulonephritis was noted in eight cases (61.5%), thin basement membrane was
      noted in four cases (30.8%) and in one case (7.7%) amyloidosis were identified in
      parallel. After suspending further administration of bucillamine, the proteinuria
      was gradually reduced without any specific treatment or without increase in the
      dose of corticosteroid, and was eliminated in all cases within 10 months. There
      were some cases in whom proteinuria was eliminated within a short period of time
      by the administration of corticosteroid in a moderate dose (prednisolone 30
      mg/day). It is necessary to initiate the administration of bucillamine from a
      small dose such as 100 mg/day and pay attention to onset of any side effect. It
      was also seemed necessary to confirm the renal histology by renal biopsy as far
      as feasible because a large variety of pathological findings are developed in the
      kidney of these cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346464
TI  - [Terminal phalangeal osteosclerosis in rheumatoid arthritis].
AB  - OBJECTIVE: Osteosclerosis of the terminal phalanges of the hand has been reported
      in the collagen diseases including rheumatoid arthritis (RA). The current study
      was made to clarify the significance of terminal phalangeal osteosclerosis in RA.
      METHODS: Hand x-ray films of 108 patients (male 13, female 95) with RA for more
      than 10 years were assessed by Halim's grading. Grade 2, (Distance between both
      cortices is < 1 mm but there is still an intermediate space discernible), and
      grade 3, (Complete fusion of both cortices, but the base of the terminal phalanx
      is open), were classified as the positive group. Grades 0 and 1 were classified
      as the negative group. Both groups were compared and sigma GS/D values was
      measured at terminal phalanges, middle phalanges and metacarpuses of right middle
      fingers using digital image processing method. sigma GS/D index was calculated as
      being equal to the ratio of sigma GS/D value of the terminal or middle phalanx to
      sigma GS/D value of the metacarpus. RESULTS: Thirty cases (28%) were positive
      (male 1, female 29). Osteosclerosis of terminal phalanges usually appeared in
      more than two digits bilaterally. It was located as follows; thumb-1 case, index
      13 cases, middle-24 cases, ring-51 cases, little-58 cases. Obliteration of the
      medullary space of middle phalanges was seen in 5 cases. No difference was
      observed between the positive and negative groups about sex, age, the mean value
      of C-reactive protein, the incidence of Steinblocker's class classification and
      the rate of seropositive patients. Osteosclerosis of terminal phalanges was
      observed at first consultation in 93% of positive cases. Osteosclerosis is
      expected to appear in the early phase of RA and to last for more than 10 years.
      sigma GS/D index of the positive group (1.03 +/- 0.24, mean +/- SD) was greater
      than that of the negative group (0.63 +/- 0.25) (p < 0.05).

PMID- 8346465
TI  - [Soluble IL-2 receptor levels in rheumatic diseases].
AB  - We measured soluble interleukin-2 receptors (sIL-2R) in plasma and/or joint fluid
      (JF) from patients with rheumatoid arthritis (RA: 16 patients), Sjogren's
      syndrome (SS: 24 patients) and Behcet's disease (BD: 23 patients). Plasma sIL-2R
      levels were significantly higher in RA patients (956 +/- 994 U/ml, p < 0.01) and
      SS patients (1025 +/- 1112 U/ml, p < 0.01) than 20 healthy subjects (338 +/- 159
      U/ml), but not significantly increased in BD patients (408 +/- 329 U/ml). sIL-2R
      levels higher than the mean of healthy subjects +2 standard deviations were
      observed in 3 BD patients (13.0%), 7 RA patients (43.8%) and 10 SS patients
      (41.7%). sIL-2R levels positively correlated with erythrocyte sedimentation rates
      and C-reactive protein levels in RA patients, or IgM levels in SS. There was no
      significant correlation between plasma sIL-2R levels and disease activity,
      clinical symptoms, or other laboratory parameters in BD patients. However, sIL-2R
      concentrations in the JF from 4 BD patients (1644 +/- 198 U/ml: p < 0.05) or 16
      RA patients (3946 +/- 5424 U/ml: p < 0.01) were significantly higher than
      corresponding plasma sIL-2R concentrations. Above results indicate that
      lymphocytes are being activated in patients with RA or SS and in the inflammatory
      lesions of BD patients, while the whole immunologic activation are relatively
      lower in BD than RA and SS.

PMID- 8346466
TI  - [Vasculitis-related acute abdomen in systemic lupus erythematosus--ultrasound
      appearances in lupus patients with intra-abdominal vasculitis].
AB  - Although an acute abdomen often occurs in lupus patients, definitive treatment is
      commonly delayed due to the difficulty in diagnosis. We performed an abdominal
      ultrasound (US) in two patients with severe abdominal pain and recognized mural
      thickenings of intestinal walls. In the first case high dose prednisone was given
      for severe abdominal pain, with subsequent perforation of sigmoid colon.
      Pathological specimens showed a thrombotic vasculitis in the mesenteric artery
      and arteriole of intestinal walls. In the second case physical examination
      elicited a rebound tenderness. An abdominal X-ray demonstrated a gasless ileus
      and US also showed marked thickening of intestinal walls, 16 mm in thickness. A
      CT scan revealed the same findings in the entire bowel. After high dose
      methylprednisolone was administered, her symptoms markedly improved. The mural
      thickenings disappeared within 10 days as seen by abdominal ultrasound
      examination. The US is very useful in order to make an early diagnosis of
      intestinal vasculitis, showing as edema (but non-specific) of intestinal wall and
      we can use it safely and repetitively without exposure to radiation, compared
      with other examinations, such as CT scan and gastrointestinal contrast study etc.
      The US is not only useful in diagnosis, but also helpful for follow up of
      patients after the initiation of treatment.

PMID- 8346467
TI  - [Success of cyclosporine therapy in two patients with PSS].
AB  - Two PSS patients, unresponsive to D-penicillamine, steroid, cyclophosphamide and
      plasma exchange therapy, were treated with cyclosporine. One patient complained
      scleroderma, dysphagia and dyspnea during movement after treatment with steroid,
      plasma exchange and cyclophosphamide. He showed a increased Leu3a/2a ratio
      (6.72). About 3 months after treatment with cyclosporine, these complain
      decreased with normalization of elevated Leu 3 a/2 a ratio. 1 year after
      treatment, %DLco increased 86% from 50% and pneumonitis findings of chest X-ray
      and chest CT were also improved. Another patient who complained Raynaud's
      phenomenon and scleroderma which had extended over his abdomen despite treatment
      with steroid and cyclophosphamide. 1 month after treatment with cyclosporine,
      improvement of these phenomenon were recognized. It is concluded that
      cyclosporine can be an effective agent in the treatment of PSS.

PMID- 8346469
TI  - [Allergic granulomatosis and angiitis associated with intestinal perforation and
      eye movement disorder].
AB  - A perforation in the small intestine and one and a half syndrome were observed in
      45-year-old male with allergic granulomatosis and angiitis (AGA). The patient was
      first admitted to our hospital in 1988 with complaints of bronchial asthma and an
      abnormal density on his chest X ray. The diagnosis of PIE syndrome was made based
      on marked peripheral blood eosinophilia. He was successfully treated with
      prednisolone and had been well on the maintenance therapy of small doses of it.
      In May 1990, peripheral neuropathy occurred in his bilateral lower legs and it
      was followed by nausea and vomiting. The laboratory findings on admission showed
      leukocytosis (19,300/mm3) with 43% eosinophilia and elevated blood level of IgE
      (3000 IU/ml). On the tenth day of admission, ileus symptom and subsequently a
      perforation of the small intestine were observed. The mesenterial specimens
      obtained during the emergency operation showed the findings compatible with AGA.
      Remission of AGA was induced by the treatment with 60 mg prednisolone and 100 mg
      cyclophosphamide per day following methylprednisolone pulse therapy. He was well
      on maintenance prednisolone until June 1991, when he suddenly developed one and a
      half syndrome. Although cranial CT scan and MRI showed no abnormal findings,
      cyclophosphamide therapy was resumed and prednisolone was increased because
      microangiopathy due to AGA was thought to be the cause of this central nervous
      system symptom. The one and a half syndrome improved with this therapy. This case
      suggests that the long term treatment with prednisolone and cyclophosphamide
      would be indicated in the severe AGA with close monitoring of the symptoms and
      peripheral blood eosinophilia.

PMID- 8346468
TI  - [A case of Sjogren's syndrome accompanied by lymphadenopathy and IgG4
      hypergammaglobulinemia].
AB  - A 78-year-old male patient suffered from slight dryness of his mouth and eyes,
      which was followed by swelling of the parotid and submandibular glands on both
      sides. Subsequently, he developed generalized lymphadenopathy accompanied by
      hypergammaglobulinemia IgG 7740 mg/dl, main subclass: IgG4, 5800 mg/dl.
      Histopathological examination of lymph nodes from his left neck showed follicular
      proliferation of plasma cells containing cytoplasmic kappa and lambda chains of
      IgG4, without destruction of the lymph node structure. His serum showed very low
      levels of complement: 0 U/ml of CH 50, 14 mg/ml of C3 and less than 11 mg/ml of
      C4. During treatment with prednisolone at 30 mg/day, the swelling of the salivary
      glands and lymph nodes reduced the IgG and IgG4 decreased and the complement
      increased. Finally, all lymph nodes, IgG and complement abnormalities were
      normalized. Anticomplementariness of IgG4 was demonstrated in this patient.

PMID- 8346470
TI  - [Anticardiolipin antibodies do not recognize cardiolipin antigen].

PMID- 8346471
TI  - Some thoughts concerning the position of neurosurgery in the last decade of the
      20th century.

PMID- 8346472
TI  - Distribution of intrathecally administered ACNU in mongrel dogs: pharmacokinetics
      and quantitative autoradiographic study.
AB  - The pharmacokinetics of 1-(4-amino-2-methyl-5-pyrimidinyl) methyl-3-(2
      chloroethyl)-3-nitrosourea (ACNU) in the cerebrospinal fluid (CSF), were
      determined in dogs after ventriculolumbar perfusion (VLP, n = 6), and bolus
      injection into the ventricle (VB, n = 2), cisterna magna (MB, n = 5), and lumbar
      cistern (LB, n = 3), by high-performance liquid chromatography. The VLP method
      introduced effective amounts of ACNU into the lumbar cistern for cell kill in
      vitro. That is, the areas under the time concentration curve (AUC) of ACNU in the
      lumbar CSF for those receiving a 1.5 mg perfusion of ACNU were 481, 791, and 520
      micrograms.min/ml and those receiving a 5 mg perfusion were 1,081, 2,048, and
      1,215 micrograms.min/ml, respectively. These values were superior to 3-log cell
      kill condition of 9L gliosarcoma and 1.5-log cell kill of HU-126 human glioma
      cell line. Among the groups to which 5 mg of ACNU was administered, the VLP
      method attained significantly higher AUC values in the lumbar CSF than MB method.
      Quantitative autoradiography using an imaging plate system was performed in the
      VLP group (n = 2), VB group (n = 1), MB group (n = 2), and LB group (n = 2) using
      a 10 microCi/kg [ethylene-14C] ACNU dose which is thought to be related to the
      alkylating activity of ACNU. The VLP method attained a stable and abundant
      distribution of ACNU in the neural axis from the ventricular cavity to the lumbar
      cistern, but the cerebral convexity surface was devoid of a significant level of
      ACNU. When the MB method was used, the pharmacokinetic data varied in the
      cisterna magna and lumbar region, and again no significant level of ACNU was
      detected in the ventricular cavity. With the LB method, although a rich
      distribution was detected in the spinal cord, the concentration decreased
      abruptly at the upper cervical level. The VB method was unsatisfactory for
      obtaining an effective amount of ACNU in the lumbar region. The research and
      testing to date indicate that the VLP method is the procedure of choice in the
      treatment of meningeal dissemination.

PMID- 8346473
TI  - Role of hypervolemic hemodilution in focal cerebral ischemia of rats.
AB  - This study was designed to better define a protocol for hypervolemic hemodilution
      in acute cerebral ischemia and investigate the mechanism of action of this
      therapy. Anesthetized rats (n = 40) were subjected to 6 h of middle cerebral
      artery (MCA) occlusion. At 45 min after MCA occlusion, each rat received one of
      the following treatment modalities: (1) control, (2) isovolemic hemodilution, (3)
      hypervolemic nonhemodilution (whole blood), (4) hypervolemic hemodilution (normal
      saline), and (5) hypervolemic hemodilution (hetastarch). Local cerebral blood
      flow (CBF) was determined with hydrogen clearance technique, and cardiac output
      was assessed by measuring the descending aorta blood flow (DAF). Infarction
      volume was estimated by 2,3,5-triphenyltetrazolium chloride staining method.
      Hetastarch infusion increased both DAF and local CBF more than the other
      treatments, by 98% and by 89%, respectively. Hetastarch also reduced infarction
      volume the most to 71 +/- 19 mm3 (p < 0.01 versus control 117 +/- 32 mm3). A
      significant correlation between percent (%) changes in local CBF and % changes in
      DAF existed in ischemic brain regions, and the hetastarch infusion improved local
      CBF more prominently in profoundly ischemic regions in contrast to isovolemic
      hemodilution. These data demonstrated the superiority of hypervolemic
      hemodilution with hetastarch as compared to other similar treatment modalities
      for acute cerebral ischemia, and indicate that cardiac output augmentation may be
      more responsible than decreased blood viscosity for the beneficial effect of
      hypervolemic hemodilution on local CBF in profoundly ischemic regions, as such
      ischemic brain tissue can severely lose its regulatory control of CBF to
      alterations in cardiac output.

PMID- 8346474
TI  - Changes in epidemiology of acute spinal cord injury from 1947 to 1981.
AB  - The aim of this study was to determine whether there have been epidemiologic
      changes in acute spinal cord injury. Two groups of patients injured in the same
      geographic area were compared: the first group of 351 patients was injured
      between 1947 and 1973; and the second group of 201 patients between 1974 and
      1981. The results showed that there were indeed major epidemiologic changes in
      spinal cord injury between the two study periods. Most importantly, the more
      recently injured group were younger, arrived sooner, had less severe cord
      injuries, and higher frequencies of motor vehicle, and sports and recreational
      accidents, but fewer work-related injuries.

PMID- 8346475
TI  - Correlation between somatosensory-evoked potentials and magnetic resonance
      imaging of focal cerebral ischemia in cats.
AB  - Serial measurements of somatosensory-evoked potentials (SEPs) and magnetic
      resonance imaging (MRI) were performed in 17 cats for 24 h after unilateral
      middle cerebral artery occlusion. Intravoxel incoherent motion (IVIM) imaging
      demonstrated ischemic cerebral injury 2 h post-occlusion in all cats, while T2
      weighted imaging failed to show clear evidence of injury until 2-6 h. In the
      severely affected group of eight cats as determined by SEP criteria, ischemic
      injury evaluated by MR imaging was detected extensively in not only the basal
      ganglia but also the frontoparietal cortex including part of the somatosensory
      center. In contrast, in the mildly affected group of nine other cats, ischemic
      injury was limited to the basal ganglia with or without some involvement of the
      lower temporal cortex. The quantitative signal intensity ratios in the
      frontoparietal cortex were significantly greater in the severely affected group
      than in the mildly affected group, but showed no difference between them in the
      basal ganglia.

PMID- 8346476
TI  - Cytogenetic findings in pituitary adenoma: results of a pilot study.
AB  - Pituitary adenomas are the most common tumors of the sellar region and are, with
      rare exception, benign neoplasms. The natural history of these lesions is only
      poorly understood and, although histologic, immunocytologic, and ultrastructural
      characteristics have been well established, predicting the natural history of
      individual tumors is, at best, unreliable. In an effort to better characterize
      pituitary adenomas, we have analyzed the karyotypes of 18 surgical specimens and
      attempted to correlate with the morphologic appearance and the clinical data, for
      example, endocrinologic subtypes, histology, and tumor invasiveness. Most
      hormonal subtypes were studied including seven growth hormone-prolactin (GH-PRL),
      two Prolactin (PRL), two Adrenocorticotrophin (ACTH), seven nonsecretory (NULL).
      No correlations with morphology or invasiveness could be made. Of 7 null cell
      adenomas, five (71%) had normal karyotypes, whereas of 11 hormone-secreting
      adenomas three (28%) were normal. Of seven tumors with mixed GH-PRL activity, six
      had abnormal karyotypes. At least three chromosomes harbored abnormalities shared
      by more than two tumors. The results demonstrate that chromosome abnormalities
      are also found in benign tumors. These findings, however, suggest that hormone
      secreting adenomas may be more likely to be associated with karyotypic
      abnormalities especially those of the GH-PRL variety. Genetic abnormalities
      associated with chromosomes 1, 4, 7, and 19 were common and warrant further
      investigation.

PMID- 8346477
TI  - Aqueductal stenosis due to mesencephalic venous malformation: case report.
AB  - The authors report the case of a 43-year-old woman with a venous malformation of
      the mesencephalon occluding the sylvian aqueduct. Neuroradiological
      investigations suggested aqueductal stenosis, while the presence of a venous
      malformation was diagnosed by both magnetic resonance imaging and an angiogram,
      and was visualized using a neuroendoscope. This is the first reported instance of
      a venous malformation being observed in situ and the subependymal course taken.

PMID- 8346478
TI  - Syrinx-fourth ventricle and lateral ventricle-peritoneal shunts for congenital
      hydrocephalus with syringobulbia and syringomyelia: case report.
AB  - A case of congenital hydrocephalus with syringobulbia and syringomyelia was
      reported. Although his neurological condition had deteriorated because of shunt
      malfunction, progressing syringobulbia, and syringomyelia, he recovered because
      of the direct communication from the syrinx in the medulla to the fourth
      ventricle, the shunt from the syrinx in the cervical spinal cord to the fourth
      ventricle, and the lateral ventriculoperitoneal shunt.

PMID- 8346479
TI  - A case of vessel perforation during interventional neuroradiological procedure.
      Operative findings of the perforated vessel.
AB  - A case of vessel perforation by a guide wire during an interventional
      neuroradiological procedure is reported. The patient was a 59-year-old woman with
      a left frontal basal arteriovenous malformation (AVM) fed by the left anterior
      cerebral artery. Transarterial embolization of the AVM was attempted. During the
      procedure, vessel perforation by the guide wire occurred at the left A1-A2
      junction and resulted in subarachnoid hemorrhage, which stopped spontaneously.
      The patient developed progressive obstructive hydrocephalus, and surgical
      treatment was performed. The AVM was totally removed after ventricular drainage,
      and the arterial perforation site was explored. When clot around the left A1-A2
      junction was removed, hemorrhage recurred. This hemorrhage was similar to what
      has been observed when a small perforating artery was avulsed. The hemorrhage
      site was coagulated under temporary occlusion of both A1 segments. Surgical
      intervention was probably not necessary for this type of bleeding if it had
      stopped spontaneously, because the rebleeding from the small pinhole would be
      unlikely, and the operation was more hazardous than the usual aneurysmal surgery.

PMID- 8346480
TI  - Complex occipital arteriovenous fistula associated with neurofibromatosis treated
      by embolization and surgery. Case report.
AB  - It is well known that neurofibromatosis is associated with various types of
      arteriovenous fistulas (AVF), but association with an occipital AVF has not been
      reported. We are reporting this case which was successfully treated with a
      combination of embolization and surgery. Superselective angiography defines the
      anatomic details of the fistula and intraoperative digital subtraction
      angiography (DSA) facilitates the surgery to cure the fistula. It is important to
      identify the best therapeutic options using angiographic information to treat a
      complex arteriovenous fistula.

PMID- 8346481
TI  - Emergent aneurysmal surgery without preoperative angiography: usefulness of the
      intraoperative portable digital subtraction angiography.
AB  - A 42-year-old male with subarachnoid and large intracerebral hemorrhage in coma
      was operated without preoperative angiography because of impending cerebral
      herniation. After emergent decompressive craniotomy, intraoperative digital
      subtraction angiography (DSA) was performed and a middle cerebral artery aneurysm
      was demonstrated clearly. Aneurysmal neck clipping was successfully performed,
      and the patient made a good recovery and returned to almost independent activity
      with minimal hemiparesis. The prognosis of patients with ruptured aneurysm with
      large intracerebral hematoma is affected by early hematoma evacuation. Since the
      time spent for preoperative angiography may cause irreversible damage to the
      brain stem, in such case, early decompressive procedure and subsequent aneurysm
      diagnosis by intraoperative DSA may be used as alternative method to achieve a
      good outcome.

PMID- 8346482
TI  - Occipitocervical fixation in nontraumatic upper cervical spine instability.
AB  - Ten patients requiring occipitocervical fixation were reviewed: five were
      unstable secondary to rheumatoid arthritis, one had Klippel-Feil, and four had
      neoplastic disease. Patients with nonneoplastic disease improved, having
      decreased pain, decreased paresthesias, and increased ambulation. Patients with
      neoplastic disease improved significantly after the surgery, but eventually died
      from different tumors. The technique found to be most efficient was the placement
      of an intraoperatively contoured Luque rectangle wired from the occiput to
      appropriate cervical spine levels.

PMID- 8346483
TI  - Following the course of chronic subdurals in adults.

PMID- 8346484
TI  - Osteoporosis and cystic fibrosis.

PMID- 8346485
TI  - Bone mineral density and body composition in adult patients with cystic fibrosis.
AB  - BACKGROUND: Cystic fibrosis is a multisystem disease characterised by chronic
      pulmonary sepsis and malnutrition. To ascertain whether osteoporosis is a feature
      of cystic fibrosis in adult patients, total body and regional bone mineral
      density (BMD) was measured in a group of eight men and eight women aged 17-42
      years. METHODS: Total body and regional BMD (lumbar spine L2-L4, femoral neck,
      trochanteric, and Ward's triangle), as well as total body fat and lean mass, were
      measured by dual energy x ray absorptiometry. A range of biochemical, lifestyle,
      and anthropometric variables was also assessed. RESULTS: Patients with cystic
      fibrosis had significantly reduced bone density at all sites compared with normal
      young adults. The mean reductions ranged from 7% at Ward's triangle to 13% at the
      trochanter. Body mass index (BMI) was positively correlated with BMD at four
      sites and disease severity negatively correlated with BMD at two sites. Other
      biochemical and anthropometric variables were not predictive of bone density.
      Total body fat mass was reduced by 30% compared with normal young adults.
      CONCLUSIONS: Bone density is decreased in adult patients with cystic fibrosis and
      BMI and disease severity are independent predictors of bone density.

PMID- 8346486
TI  - Effect of a platelet activating factor antagonist, WEB 2086, on allergen induced
      asthmatic responses.
AB  - BACKGROUND: Platelet activating factor (PAF) has been implicated in the
      pathogenesis of airway hyperresponsiveness in asthma. The purpose of this study
      was to evaluate the effects of a selective PAF antagonist (WEB 2086), given in
      doses known to antagonise the effects of inhaled PAF in human subjects, on
      allergen induced early and late asthmatic responses and on airway
      hyperresponsiveness. METHODS: Eight atopic, mildly asthmatic subjects were
      studied during a screening period and two treatment periods. During the screening
      period subjects inhaled an allergen to which they were known to be sensitised and
      the response was measured as the fall in the forced expired volume in one second
      (FEV1) to show the presence of early (0-1 h) and late (3-7 h) asthmatic
      responses. On another day the subjects inhaled allergen diluent. During the
      treatment periods subjects inhaled allergen after one week's pretreatment with
      WEB 2086 (100 mg three times a day) or placebo administered in a randomised,
      double blind, crossover fashion. Histamine airway responsiveness was measured 24
      hours before and 24 hours after allergen and the results were expressed as the
      provocative concentration causing a 20% fall in FEV1 (PC20). RESULTS: The maximal
      early asthmatic response after allergen with placebo treatment was 18.4% (SE
      4.4%) and with WEB 2086 18.9% (4.4%). The maximal late response with placebo
      treatment was 21.7% (5.3%) and with WEB 2086 21.2% (3.0%). The log difference
      (before and after allergen) in histamine PC20 was 0.35 (0.06) after placebo
      treatment and 0.30 (0.1) after WEB 2086. CONCLUSIONS: These results indicate that
      one week of treatment with an orally administered PAF antagonist (WEB 2086) does
      not attenuate allergen induced early or late responses or airway
      hyperresponsiveness.

PMID- 8346487
TI  - Effects of high doses of inhaled corticosteroids on adrenal function in children
      with severe persistent asthma.
AB  - BACKGROUND: Childhood asthma generally responds well to inhaled corticosteroids
      within the dosage range recommended by the manufacturers, but it is sometimes
      necessary to use higher doses--that is, above 400 micrograms/day--a practice
      which has become more widespread recently. Whereas the lack of adrenal
      suppression in children given inhaled corticosteroids in normal doses is well
      documented, little is known about the effects of higher doses. METHODS: The
      effects on adrenal function of high dose (above 400 micrograms/day) inhaled
      corticosteroids were evaluated by measuring cortisol concentration in the morning
      and performing a short tetracosactrin test in 49 children taking budesonide (mean
      age 9.2 years (range 4 to 16 years) and 28 children taking beclomethasone
      dipropionate (10.2 years (5 to 13 years)). Twenty three non-asthmatic children
      (8.9 years (4.9 to 13 years)) who were under investigation for short stature
      served as controls for the study. RESULTS: Compared with controls mean basal
      cortisol concentration was lower in children taking budesonide and beclomethasone
      dipropionate (control 401 (26.8) nmol/l, budesonide 284 (22) nmol/l,
      beclomethasone dipropionate 279 (23.2) nmol/l). Sixteen of the 49 children taking
      budesonide had subnormal basal cortisol concentrations compared with seven of the
      28 taking beclomethasone dipropionate. Mean stimulated cortisol concentrations
      were lower in children taking inhaled corticosteroids than in controls, with no
      difference between those taking budesonide or beclomethasone dipropionate.
      CONCLUSIONS: Adrenal suppression occurs in some children who are given inhaled
      corticosteroids in doses greater than 400 micrograms/day. It may therefore be
      advisable to try alternative treatments before such doses are used.

PMID- 8346488
TI  - Improvement in sodium cromoglycate delivery from a spacer device by use of an
      antistatic lining, immediate inhalation, and avoiding multiple actuations of
      drug.
AB  - BACKGROUND: Aerosols generated from metered dose inhalers may be highly charged.
      The aim of this study was to determine whether lining the walls of a
      polycarbonate spacer device with an antistatic agent would result in an increase
      in drug output. The effects of multiple actuations of drug into the spacer device
      and increasing residence time of drug within the spacer were also determined.
      METHODS: The amount of sodium cromoglycate contained in particles of various size
      available for inhalation (per 5 mg actuation) from a 750 ml polycarbonate spacer
      was determined by impinger measurement and spectrophotometric assay. RESULTS:
      Lining the spacer with an antistatic agent increased the mean (SD) amount of
      sodium cromoglycate in particles < 5 microns available for inhalation (per 5 mg
      actuation) by 244% from (0.59 (0.03) to 1.44 (0.2) mg). When there was a 20
      second interval between actuation into the spacer device and inhalation, sodium
      cromoglycate available for inhalation in particles < 5 micrograms decreased by
      67% (from 0.59 (0.03) mg to 0.2 (0.01) mg). Use of the spacer device increased
      sodium cromoglycate available for inhalation in respirable particles (< 5
      microns) by 18% compared with direct delivery by metered dose inhaler. Multiple
      actuations into the spacer decreased the amount of sodium cromoglycate available
      for inhalation in particles < 5 microns by 31% after two actuations and 56% after
      three acutations. CONCLUSIONS: Multiple actuations of sodium cromoglycate into a
      spacer device before inhalation should be avoided, and inhalation from spacer
      devices should take place immediately after actuation to ensure maximum dose.
      Lining of a standard spacer device with an antistatic agent significantly
      increased output of sodium cromoglycate. This may have implications for improved
      therapeutic response and drug cost.

PMID- 8346489
TI  - Investigations of an optimal inhaler technique with the use of urinary salbutamol
      excretion as a measure of relative bioavailability to the lung.
AB  - BACKGROUND: A simple non-invasive method, in which a urine sample is taken 30
      minutes after drug administration, has previously been shown to be a measure of
      the relative bioavailability of salbutamol to the lungs. This technique has been
      used to determine an optimal inhaler technique with commercially available
      metered dose inhalers (MDI). METHODS: Ten healthy subjects were trained in the
      use of MDIs. Each inhaled 4 x 100 micrograms salbutamol in a series of
      experiments to examine the relative bioavailability to the lung after different
      respiratory manoeuvres. Urine collection intervals were 0-0.5 hours and 0.5-24
      hours after administration. RESULTS: There was significantly greater elimination
      of unchanged salbutamol 30 minutes after administration, indicating a greater
      relative bioavailability of salbutamol to the lungs after (1) exhaling gently to
      residual volume rather than to functional residual capacity before inhalation;
      (2) slow inhalation (10 l/min) compared with fast inhalation (50 l/min); (3)
      breath holding for 10 seconds after inhalation compared with no breath holding.
      CONCLUSIONS: All patient information leaflets and healthcare personnel should
      standardise the instructions given to patients and should adopt the inhalation
      method proposed.

PMID- 8346490
TI  - Time course and duration of bronchodilatation with formoterol dry powder in
      patients with stable asthma.
AB  - BACKGROUND: Formoterol, a new beta 2 agonist, is long and fast acting when given
      as an aerosol. The aim was to determine the onset and duration of
      bronchodilatation with formoterol as a dry powder compared with salbutamol dry
      powder and with placebo. METHODS: Fifteen patients with stable asthma with a
      reversibility of 15% or more participated in a double blind, within patient
      study. On five different days the patients received formoterol 6 micrograms, 12
      micrograms, or 24 micrograms, salbutamol 400 micrograms, or placebo in random
      order. Forced expiratory volume in one second (FEV1) was measured 10 minutes
      before, 30 minutes after, and then every hour for up to 12 hours after treatment.
      Specific airway resistance (sRaw) and specific airway conductance (sGaw) were
      measured immediately before and one, three, five, 10, 15, and 30 minutes after
      treatment. RESULTS: Formoterol 12 micrograms and 24 micrograms caused
      bronchodilatation as rapidly as salbutamol 400 micrograms. Peak values were not
      significantly different in the active treatments. The duration of action,
      calculated as median time with 20% or more of the maximum achieved increase in
      FEV1, was sustained for 9 hours and 16 minutes with salbutamol 400 micrograms,
      for 9 hours and 45 minutes with formoterol 6 micrograms, for 11 hours and 22
      minutes with formoterol 12 micrograms, and for 11 hours and 42 minutes with
      formoterol 24 micrograms. CONCLUSIONS: Formoterol as a dry powder at doses of 12
      micrograms and 24 micrograms produces a rapid onset of action and has a
      bronchodilator effect comparable with salbutamol 400 micrograms as a dry powder.
      The bronchodilatation was sustained for 11-12 hours. Formoterol 6 micrograms
      caused similar bronchodilatation but more slowly and for a shorter time.

PMID- 8346491
TI  - Effect of inhaled procaterol on cough receptor sensitivity to capsaicin in
      patients with asthma or chronic bronchitis and in normal subjects.
AB  - BACKGROUND: To evaluate the effect of inhaled beta 2 adrenergic agonists on the
      sensitivity of airway cough receptors, the effect of inhaled procaterol on cough
      induced by aerosolised capsaicin, a stimulant of C fibres, was studied in
      patients with asthma or chronic bronchitis and in normal subjects. METHOD: Eleven
      patients with asthma and 10 with chronic bronchitis and 14 normal subjects
      participated. Increasing concentrations of capsaicin solution were inhaled for 15
      seconds by tidal breathing through the mouth at one minute intervals until five
      or more coughs were elicited, before and 30 minutes after inhalation of 20
      micrograms procaterol or placebo (freon gas alone) through a metered dose
      inhaler. Cough threshold was defined as the lowest concentration of capsaicin
      that elicited five or more coughs. To evaluate the bronchodilator effect of
      procaterol and the bronchoconstrictor effect of inhaled capsaicin, forced
      expiratory volume in one second (FEV1) was measured before and one minute after a
      capsaicin provocation test. This test was carried out both before and 30 minutes
      after treatment with procaterol or placebo. RESULTS: The geometric mean value of
      cough threshold to capsaicin was significantly increased by procaterol and
      placebo in both groups of patients but not in the control subjects. The increment
      in the cough threshold was not significantly different between the treatments
      with procaterol and placebo in each group. FEV1 was significantly increased by
      procaterol but not by placebo in all three groups. CONCLUSIONS: Inhaled
      procaterol has no effect on airway cough receptor sensitivity to capsaicin. The
      attenuation of the cough sensitivity seen after inhalation of procaterol in
      patients with asthma and bronchitis may result from tachyphylaxis to capsaicin.

PMID- 8346492
TI  - Serum titres of Pneumocystis carinii antibody in health care workers caring for
      patients with AIDS.
AB  - BACKGROUND: Pneumocystis carinii pneumonia was thought to occur from reactivation
      of latent infection, but recent studies with the polymerase chain reaction have
      failed to detect P carinii in normal subjects. If pneumocystis pneumonia is
      therefore caused by new infection the source and mode of transmission of P
      carinii remains unknown. METHODS: Natural exposure to P carinii was detected by
      measuring antibodies by indirect immunofluorescence in 24 health care workers
      working continuously with patients with AIDS and 24 control health care workers
      exclusively treating elderly patients. RESULTS: P carinii antibody titres were
      significantly higher in the health care workers exposed to AIDS than in the
      control group (median titre 1:32 v 1:16 respectively). Three control subjects had
      no antibodies compared with none of the subjects exposed to AIDS, and 10 of the
      12 highest titres came from the exposed group. CONCLUSIONS: Raised P carinii
      antibody titres in health care workers caring for patients with AIDS suggest that
      patients infected with HIV may be a potentially infectious source of P carinii
      for susceptible subjects.

PMID- 8346493
TI  - Ciliary beat frequency in transplanted lungs.
AB  - BACKGROUND: Patients with lung transplantation are prone to respiratory
      infections. Generally this is attributable to the effects of immunosuppressive
      drugs but mucociliary clearance has been found to be impaired in these subjects.
      A study was performed to determine whether this finding is accompanied by a
      reduction in ciliary beat frequency (CBF). METHODS: Six patients who had
      undergone single lung transplantation for fibrosing lung disease were
      investigated. CBF was measured in mucosal samples from native and transplanted
      bronchi by a videophotometry method. RESULTS: The CBF was reduced in the
      transplanted bronchi in all cases when both fastest and slowest beating cilia
      were examined. The fastest beating cilia on the native side had a mean (SD) CBF
      of 12.1 (1.3) Hz compared with 9.6 (2.0) Hz on the transplanted side. The slowest
      beating cilia also had reduced CBF on the transplanted side. CONCLUSION: In
      patients with fibrotic lung disease, CBF is reduced in transplanted bronchi in
      comparison with native bronchi.

PMID- 8346494
TI  - Percutaneous needle biopsy of the mediastinum: review of 94 procedures.
AB  - BACKGROUND: A number of reports of radiologically guided percutaneous biopsy of
      mediastinal masses have been described but techniques have varied, particularly
      the type of needle used. In this study mediastinal biopsies with fine aspiration
      needles and cutting needles have been compared, sometimes in the same patient.
      The results are reviewed with particular emphasis on the choice of biopsy needle
      and its influence on pathological diagnosis. METHODS: A retrospective review was
      undertaken of radiologically guided mediastinal biopsies performed between 1981
      and 1991. RESULTS: Sixty fine needle aspiration biopsies (FNA) and 34 Tru-Cut
      biopsies of mediastinal masses were performed in 75 patients with fluoroscopic or
      computed tomographic guidance. Overall sensitivity and specificity in terms of
      diagnosis of malignant disease were 90% and 100% respectively for FNA biopsies,
      and 96% and 100% for Tru-Cut biopsies. Diagnostic accuracy in terms of precise
      diagnosis of the malignant or benign nature of a mass and its origin was 77% for
      FNA biopsies and 94% for Tru-Cut biopsies. For FNA biopsies sensitivity and
      accuracy were higher for carcinomatous lesions (96% and 88%) than for
      noncarcinomatous lesions (81% and 69%). The only significant complication
      encountered was a pneumothorax following a biopsy which required intercostal
      drainage. CONCLUSIONS: Radiologically guided percutaneous needle biopsy is a safe
      procedure which provides useful diagnostic information in the majority of cases.
      Fine needle aspiration techniques usually suffice for carcinomatous lesions but a
      cutting needle biopsy should be performed whenever possible when lymphoma,
      thymoma, or neural masses are suspected to obtain larger specimens for more
      accurate histological diagnosis.

PMID- 8346495
TI  - Effects of recombinant GM-CSF and IgA opsonisation on neutrophil phagocytosis of
      latex beads coated with P6 outer membrane protein from Haemophilus influenzae.
AB  - BACKGROUND: IgA is the major antibody class in mucosal secretions, yet its
      biological functions remain poorly understood and its role as an opsonin for
      neutrophils has been the subject of controversy. It has been reported that
      treatment of neutrophils with granulocyte-macrophage colony stimulating factor
      (GM-CSF) induces the cells to phagocytose particles opsonised with IgA. A study
      was performed to investigate the effects of GM-CSF and IgA opsonisation on the
      ability of human neutrophils to recognise and phagocytose latex beads coated with
      the P6 outer membrane protein of Haemophilus influenzae. METHODS: Human
      neutrophils with and without preincubation with 100 pmol/l GM-CSF, were incubated
      with non-opsonised P6-coated latex beads or beads opsonised with IgA purified
      from the blood of a bronchiectatic patient with high titres of IgA anti-P6.
      Phagocytosis was measured by counting internalised beads during microscopic
      examination. RESULTS: The phagocytosis of IgA opsonised beads by untreated
      neutrophils (mean (SE) 2.1 (0.43) beads/cell) was significantly greater than that
      of non-opsonised beads (mean (SE) 1.3 (0.30) beads/cell). Treatment of
      neutrophils with GM-CSF resulted in increased phagocytosis of non-opsonised beads
      (mean (SE) 2.1 (0.39) beads/cell) but opsonisation with IgA increased this
      further (mean (SE) 3.4 (0.53) beads/cell). CONCLUSIONS: Human neutrophils
      recognise and phagocytose non-opsonised particles coated with bacterial antigen.
      Antibodies of the IgA isotype opsonise for neutrophil phagocytosis of particles
      coated with bacterial antigen but this behaviour is enhanced, in an additive
      fashion, by treatment of the cells with GM-CSF. The results suggest that IgA and
      GM-CSF are important cofactors for neutrophil recognition and elimination of
      bacterial pathogens.

PMID- 8346496
TI  - Use of a combined oxygen and carbon dioxide transcutaneous electrode in the
      estimation of gas exchange during exercise.
AB  - BACKGROUND: Accurate and reliable measurement of gas exchange during exercise has
      traditionally involved arterial cannulation. Non-invasive devices to estimate
      arterial oxygen (O2) and carbon dioxide (CO2) tensions are now available. A
      method has been devised and evaluated for measuring gas exchange during exercise
      with a combined transcutaneous O2 and CO2 electrode. METHODS: Symptom limited
      exercise tests were carried out in 24 patients reporting effort intolerance and
      breathlessness. Exercise testing was performed by bicycle ergometry with a
      specifically designed protocol involving gradual two minute workload increments.
      Arterial O2 and CO2 tensions were measured at rest and during exercise by direct
      blood sampling from an indwelling arterial cannula and a combined transcutaneous
      electrode heated to 45 degrees C. The transcutaneous system was calibrated
      against values obtained by direct arterial sampling before each test. RESULTS: In
      all tests the trend of gas exchange measured by the transcutaneous system was
      true to the trend measured from direct arterial sampling. In the 140 measurements
      the mean difference between the O2 tensions estimated by direct sampling and the
      transcutaneous method was 0.08 kPa (0.62 mm Hg, limits of agreement 4.42 and 
      3.38 mm Hg). The mean difference between the methods for CO2 was 0.02 kPa (0.22
      mm Hg, limits of agreement 2.20 and -1.70 mm Hg). There was no morbidity
      associated with the use of the transcutaneous electrode heated to 45 degrees C.
      CONCLUSIONS: A combined transcutaneous O2 and CO2 electrode heated to 45 degrees
      C can be used to provide a reliable estimate of gas exchange during gradual
      incremental exercise in adults.

PMID- 8346497
TI  - Effect of seasonal allergic rhinitis on airway mucosal absorption of chromium-51
      labelled EDTA.
AB  - BACKGROUND: Hyperpermeability of the airway mucosa is thought to be
      characteristic of allergic rhinitis and asthma. Nine subjects with seasonal
      rhinitis caused by birch pollen were studied and the nasal mucosal absorption of
      chromium-51 labelled EDTA was examined both in an asymptomatic period before the
      season and late into the season when significant allergic rhinitis symptoms were
      present. METHODS: A nasal pool device was used to keep a concentration of the
      absorption tracer in contact with a larger part of the mucosa of the ipsilateral
      nasal cavity. Absorption was allowed for 15 minutes and measured as the
      radioactivity appearing in the 24 hour urine sample. RESULTS: The nasal
      absorption of 51Cr-EDTA in subjects with seasonal allergic rhinitis was less
      during active disease than before the season. CONCLUSIONS: An airway epithelial
      barrier that is subject to prolonged eosinophilic inflammation may not be
      disrupted but may rather increase its functional tightness.

PMID- 8346498
TI  - Effects of nicotine on the human nasal mucosa.
AB  - BACKGROUND: Topical application of nicotine and stimulation of tachykinin
      containing sensory nerves have been shown to produce mucosal exudation of plasma
      and derangement of the epithelial lining in guinea pig and rat airways. If this
      occurred in man these effects might contribute to the pathogenesis of airway
      disease. This study, performed in healthy volunteers without atopy, examined
      whether nicotine affects the plasma exudation response and the mucosal absorption
      permeability of the human nasal airway. METHODS: The acute effects of increasing
      topical doses of nicotine (0.08-2.0 mg) were examined (n = 8) on nasal symptoms
      (pain), mucosal exudation of plasma (albumin), mucosal secretion of mucin
      (fucose), and mucosal exudative responsiveness (histamine induced mucosal
      exudation of albumin). A separate placebo controlled study was carried out to
      determine whether frequent applications of the high dose of nicotine (2.0 mg
      given eight times daily for nine days) had any deleterious effects on the airway
      mucosa detectable as altered responses to histamine challenge. Both mucosal
      exudation of plasma (n = 12) and mucosal absorption of chromium-51 labelled EDTA
      (n = 8) were thus examined in nasal airways exposed to both nicotine and
      histamine. RESULTS: Nicotine caused nasal pain and produced dose dependent
      mucosal secretion of fucose but failed to produce any mucosal exudation of
      albumin. The exudative responsiveness to histamine was, indeed, decreased when
      the challenge was performed immediately after administration of acute doses of
      nicotine, whereas the responsiveness was unaffected when histamine challenges
      were carried out during prolonged treatment with nicotine. The nasal mucosal
      absorption of 51Cr-EDTA in the presence of histamine did not differ between
      subjects receiving either placebo or nicotine treatment for nine days.
      CONCLUSIONS: The results indicate that nicotine applied to the human airway
      mucosa produces pain and secretion of mucin, but inflammatory changes such as
      mucosal exudation of plasma and epithelial disruption may not be produced.
      Neurogenic inflammatory responses, which are so readily produced in guinea pig
      and rat airways, may not occur in human airways.

PMID- 8346500
TI  - Age related increase in the intra-alveolar macrophage population of non-smokers.
AB  - The alveolar macrophage population is higher in smokers than in non-smokers. An
      age related increase in the alveolar macrophage number in the lungs of non
      smokers has been found, whether expressed per unit lung volume or per unit lung
      surface area.

PMID- 8346499
TI  - Cytokines. 1. Overview.

PMID- 8346501
TI  - Mucosa associated lymphoma of the lung.
AB  - Two cases of mucosa associated lymphoma (pseudolymphoma) of the lung are
      described which highlight the varied clinical and radiological features of this
      rare pulmonary condition. Following chemotherapy with prednisolone and
      chlorambucil, both patients are disease free three years later.

PMID- 8346502
TI  - Culture of Mycobacterium kansasii in the blood of an HIV negative patient.
AB  - A 23 year old man with a congenital myelodysplastic disorder and fibrosing lung
      disease received treatment with prednisolone. After nine months his condition
      deteriorated and Mycobacterium kansasii was isolated from blood cultures and
      lymph node biopsy specimens. He responded to antituberculous treatment. M
      kansasii has not previously been isolated from the blood stream of HIV negative
      patients.

PMID- 8346503
TI  - Lung abscess: a neglected cause of life threatening haemoptysis.
AB  - Three cases who presented with life threatening haemoptysis are reported, all of
      whom required surgery to control the bleeding. In all three patients chronic lung
      abscess was responsible for the haemoptysis. Even in the absence of typical
      clinical or radiographic features of an abscess this diagnosis should be
      considered in any patient presenting with life threatening haemoptysis.

PMID- 8346504
TI  - Mitral valve replacement for an annular submitral aneurysm of the left ventricle.
AB  - Successful surgical repair of an annular submitral aneurysm of the left ventricle
      in two patients is described. In both cases the diagnosis was made at surgery and
      they were treated successfully by transatrial closure of the aneurysm with Teflon
      felted sutures and mitral valve replacement. This is the first report of the use
      of mitral valve replacement for this condition.

PMID- 8346505
TI  - Cohabiting with domestic mites.

PMID- 8346506
TI  - Tuberculin positive children.

PMID- 8346507
TI  - Estimating age, sex and period specific constant tar cigarette consumption in the
      UK.

PMID- 8346508
TI  - Alveolar atypical hyperplasia in association with primary pulmonary
      adenocarcinoma: a clinicopathological study of 10 cases.

PMID- 8346509
TI  - [Serological study of the occurrence of L. hardjo in sheep in The Netherlands].
AB  - Sheep (3918) from 137 farms in the regions of North-, West- and Mid-Netherlands
      and Gelderland were serologically investigated for the presence of antibodies
      against Leptospira hardjo. Antibodies were detected in 3.3% of the sheep. There
      were large regional differences with respect to both the percentage of positive
      sheep and the percentage of positive flocks. All sera from sheep in Gelderland
      were negative. In West- en Mid-Netherlands there were 0.9 and 6.5% positive sera,
      respectively, and 19.4 and 32.7% positive flocks. The percentage of positive
      sheep per positive flocks varied from 1 tot 51.6. Serological positive sheep were
      from farms with and without cattle. On farms with cattle, there was no clear
      relationship between serologically sheep and the presence of hardjo antibodies in
      cattle. It thus seems plausible that sheep can be infected with hardjo
      independently of cattle.

PMID- 8346512
TI  - [Keeping pigs after the turn of the century; a healthy look forward and only when
      'pigs will fly'].

PMID- 8346510
TI  - [A case of oleander poisoning in a cat].
AB  - This case history describes clinical symptoms and pathological changes in a cat
      that are consistent with those of oleander intoxication. The clinical symptoms
      were characterized by vomiting, diarrhoea, and ventricular extrasystoles. On post
      mortem examination focal degeneration and necrosis of the myocardium was seen, as
      well as haemorrhage of myocardium and wall of the gastrointestinal tract. An
      overview is given of the literature on the diagnosis, pathogenesis, and treatment
      of oleander intoxication in different animals and in humans.

PMID- 8346511
TI  - [Analgesics; the use of aspirin in dogs; effects of tablet type and food intake
      on plasma salicylate level].
AB  - Administration of acetylsalicylic acid (aspirin) in the dog may cause gastric
      mucosal damage. Enteric-coated tablets protect the canine stomach during oral
      aspirin medication. A therapeutic plasma salicylate concentration can be attained
      using enteric-coated aspirin tablets at a dosage of 25 mg/kg TID. In a series 4
      of experiments using adult beagle and large mixed breed dogs and two types
      enteric-coated tablets, the influence of food intake on the plasma salicylate
      concentration was studied. Tablets were administered with 8h intervals and food
      intake was either once daily or three time daily with 8h intervals. Plasma
      salicylate concentrations were also studied during fasting. It is concluded that,
      when using enteric-coated tablets, the plasma salicylate concentration in the dog
      after oral medication is strongly influenced by the aspirin dosage, the tablet
      type and the feeding pattern. Large enteric-coated tablets may accumulate in the
      stomach over several days and are not suitable for use in the dog. The gastric
      accumulation is caused by the enteric-coating of the large tablets and not by the
      aspirin medication.

PMID- 8346514
TI  - [Specific gravity of urine].

PMID- 8346513
TI  - [What is a rodent ulcer?].

PMID- 8346515
TI  - [Low selenium status].

PMID- 8346516
TI  - [United Europe and veterinary professional level. Lecture on the occasion of the
      celebration of the promotion of the veterinary faculty at Munich on February 26,
      1993].

PMID- 8346517
TI  - [The use of zinc oxide in piglets].

PMID- 8346518
TI  - [The clinical case. Mixed breed bitch, 8 years old].

PMID- 8346519
TI  - [An unusual combination of different organ and skeletal abnormalities in a black
      and white calf].
AB  - This is a case report of a rare malformation in a calf: duplicitas posterior
      incompleta in combination with multiple malformations (diphallia, polymelia,
      polydactylism, lack of the bony floor of the pelvis, asymmetrical pelvis,
      asymmetrical sacral and coccygeal vertebrae, unilateral hypoplasia of the
      kidneys). A detailed description of the clinical and pathological findings is
      presented.

PMID- 8346520
TI  - [Oral aspergillosis in a goat--a stomatologic problem. Case report].
AB  - This report describes a case of chronic and granulomatous proliferation in the
      lower jaw of a six-year-old female Saanen goat due to Aspergillae spp. Within the
      granulomatous lesion, foreign body and Langhans type giant cells were present in
      addition to the common granuloma components, such as lymphocytes, epithelioid
      cells and fibroblasts. Hyphae with a configuration typical of Aspergillae spp.
      could be demonstrated within the lesions by the use of special stains. The
      prognosis of this disease in the advanced stage is poor.

PMID- 8346521
TI  - [The forecasting of the time of calving using a rapid progesterone test].
AB  - The rectal temperature and any alterations in eight different external signs of
      parturition were investigated twice daily in 22 "Deutsche Schwarzbunte" cows
      during the last 10 days of gestation. There was great variation in the externally
      detectable signs of parturition during the preparatory stages and short before
      labour. During the same time period, plasma progesterone and total oestrogens
      were determined using radioimmunology. From 60 hours to 12 hours prior to calving
      the progesterone levels fell rapidly to 0.77 +/- 0.22 ng/ml. Additionally, the
      plasma progesterone was determined semi-quantitatively in 31 cows using a rapid
      progesterone assay in order to predict the commencement of parturition within 36
      hours. This allowed a more objective and reliable assessment of calving time than
      the evaluation of external signs of labour.

PMID- 8346522
TI  - [Observations on the maturity of stillborn calves].
AB  - Organ weight and trace element analyses were performed on 75 stillborn calves
      from the same dairy cow herd. The elements Fe, Mn, Zn and Cu were measured in the
      livers of 66 of the calves. The calves ranged in age from 259 to 299 days of
      gestation, and in weight from 18 to 58 kg. Based on the quotients of organ and
      other body parts, stage of growth of the humerus and age, the animals were
      grouped as either preterm (P), term but light (TL), and term with appropriate
      weight (TA) calves. In P group calves the heart, lungs, liver, kidneys, thymus,
      spleen and thyroid glands were relatively heavy. In the TL group calves the
      brain, heart, lungs and thyroid glands were relatively heavy whereas the spleen
      and thymus were comparatively light. The liver Fe and Zn values were lower in
      this group than in the other 2 groups.

PMID- 8346523
TI  - [Analysis of the obstetrical situation in swine from the clinical point of view].
AB  - In a study including 477 parturitions in sows the obstetrical situation of this
      species is analyzed from the clinical point of view. Obstetrical interventions
      before consulting the veterinary clinics led to partly severe lesions of soft
      tissues of the genital tract in 35.5% of all primiparous and in 12.6% of all
      pluriparous sows. So 3.1% of all obstetrical patients had to be slaughtered due
      to the enormous perforating lesions in vestibular-vaginal-cervical parts of the
      genital tract. In 71 cases parturition could not be completed because of stress,
      insufficiency of the cardiovascular system or economic reasons. In general, 76%
      of parturitions came to an end conservatively and 24% by caesarean section. In
      older sows the relation was 88% vs. 13%. During the recent years the loosing-rate
      by completed parturition could be reduced to 3.4% after conservative obstetrical
      intervention and to 20.6% after caesarean section in preinjured sows by
      compensation of the respiratory and metabolic acidosis, stabilizing of the
      cardiovascular system and the supply of warmth. Possibilities to diminish total
      losses are discusses, concerning the large number of animals with injuries due to
      inappropriate conservative obstetrics as well as the intensification of intra-
      and postoperative supportive therapy.

PMID- 8346524
TI  - [The occurrence of Chlamydia psittaci infections in raptors from wildlife
      preserves].
AB  - 152 free-living raptors found in the area around Munich, Germany, were
      investigated for possible Chlamydia psittaci infections. Chlamydia psittaci was
      detected in 13.2% of these birds of prey (Strigiformes, Falconiformes and
      Accipitriformes) by examination of cloacal swabs with an antigen ELISA (IDEIA
      Chlamydia test kit). Chlamydia psittaci antibodies could be demonstrated in 85.1%
      of 121 birds by a Chlamydia antibody ELISA (Chlamydia-psittaci-AK-EIA). 29.7% of
      the samples investigated were positive, 55.4% showed strong positive reactions.
      The birds showed neither clinical nor pathological signs of chlamydial
      infections. The specificity and sensitivity of the Chlamydia antibody ELISA, as
      determined using positive sera and epidemiological criteria are discussed.
      Antigen ELISA and the cell culture method showed a consistency of 94%. The
      results and their consequences for diagnostic procedures and state regulations
      are discussed.

PMID- 8346525
TI  - [Bilateral blindness after injury in a riding horse].
AB  - Bilateral blindness was diagnosed in a 5-year-old Hanoverian gelding presented
      for evaluation of a corneal opacity in one eye. About 12 months prior to the
      examination, the gelding had fallen head over, hitting his head and the cornea.
      Clinical and electroretinographic findings as well as pathohistologic and
      ultrastructural lesions of both eyes including the optic nerves are presented.
      Ophthalmoscopically visible pigment disruption of the non-tapetal fundus adjacent
      to the optic discs correlated morphologically with foci of degeneration and
      atrophy of the retina, whereas ophthalmoscopically visible accumulation of
      pigment was morphologically characterized by hypertrophy of the pigment
      epithelium, increased intracellular pigment accumulation and by migration of
      pigment cells into the inner lamina of the retina. Severe atrophy of the retinal
      neuronal layer was linked to traumatic optic nerve degeneration.

PMID- 8346526
TI  - [Foal diseases and foal loss].
AB  - An investigation was carried out upon occurrence and course of infectious and non
      infectious diseases as well as the mortality in foals born and raised at the
      State Stud Marbach/Lauter between 1982 and 1991. The foals have been investigated
      from birth to weaning, they consisted of 177 Thoroughbred Arabians and 285 German
      Warmblood foals (total 462 foals). The diseases were divided into pre-, peri- and
      postnatal according to their known or assumed cause and onset. There was a
      preponderance of prenatal diseases (11.25%) whereas the perinatal rate was 1.30%
      and the postnatal rate of diseases was 8.66%. The rate of infectious diseases
      increased from the pre- to the postnatal period of life. A comparison between the
      two breeds showed that 9% of the Arabian foals suffered from infectious diseases
      whereas only 4.9% of the Warmblood foals were similarly affected. This is
      probably linked to the lower level of colostral immunoglobulins in the Arab herd,
      as previously shown by us. The measurement of mare colostral and foal serum IgG
      as well as the paramunisation of neonatal and weaned foals are important factors
      in the prevention of infectious diseases.

PMID- 8346527
TI  - [Symptoms: anorexia and emaciation].
AB  - Anorexia and emaciation are symptoms which can be found in many diseases either
      singly or in combination with other unspecific clinical signs such as diarrhea
      and vomiting. Therefore accurately assessing the medical history, performing a
      thorough clinical examination and carrying out laboratory tests are all necessary
      steps in establishing a diagnosis. Further specific examinations such as
      radiography, ultrasonography or endoscopy may also have to be performed. Since
      anorexia and emaciation can result in severe consequences for the organism,
      establishing a definitive diagnosis is important to enable the appropriate
      therapy to be applied without delay.

PMID- 8346528
TI  - [Significance of bone marrow cytology in the diagnosis of leukosis in dogs].
AB  - In the differential diagnosis of neoplastic diseases of blood cells or their
      precursors, cytological examination of bone marrow is a valuable diagnostic tool.
      Depending on the expected cell type, an aspiration followed by clinical
      cytological examination, or a biopsy followed by histopathological examination is
      indicated. In all unclear cases of cytopenia, if blood parasites or a lymphatic
      leukemia without tumors are suspected or in myeloproliferative diseases, bone
      marrow cytology can provide the diagnosis. If the aspiration of bone marrow is
      not possible in spite of correct technique (punctiosicca), myelofibrosis must be
      suspected. The diagnosis is confirmed by bone marrow biopsy. In the most common
      form of leukemia in dogs, the lymphosarcomatosis, a bone marrow biopsy can be
      helpful in assessment of the prognosis.

PMID- 8346529
TI  - [Stabilization of tracheal collapse in dogs].
AB  - A surgical technique to stabilize collapsing trachea in dogs by implanting strips
      of porous polyethylene around the trachea is reported.

PMID- 8346530
TI  - [Feline ocular melanoma. Clinical and pathologico-anatomic findings in 37 cases].
AB  - The clinical and pathological findings of 37 feline ocular melanomas are
      described. The majority of the tumors examined were diffuse iris-ciliary body
      melanomas of epithelioid and pleomorphic (anaplastic) cell type with numerous
      mitotic figures. The majority of the tumors showed invasion of the anterior
      sclera. Metastases were found in three cases predominantly in the abdominal
      viscera (liver). The clinical diagnostics as well as the differential diagnosis,
      therapy and prognosis of feline uveal melanoma are presented. The causal
      pathogenesis is discussed comparatively.

PMID- 8346531
TI  - [Functional and applied anatomy of the shoulder joint of the domestic cat].
AB  - The freedom of movement of the feline shoulder joint corresponds to that of a
      ball-and-socket joint, although the humeral head is not ball-shaped. The profiles
      of the humeral head and glenoid fossa were analysed with respect to their lines
      of movement in three planes of motion. The incongruity of the joint surfaces
      allows the variety of movements. Of clinical relevance are the description of a
      shoulder joint injection site and of the extent of joint movement in degrees.

PMID- 8346532
TI  - [Monkey AIDS, a new zoonosis?].
AB  - Monkeys may carry dangerous infectious diseases. Several studies have
      demonstrated frequent lentivirus infections in different monkey species. This
      report describes virological and epizootiological aspects of and the diagnostic
      procedure for the evaluation of SIV infections in African green monkeys.
      Recommendations for the prevention of transmission of SIV to humans are
      discussed.

PMID- 8346533
TI  - The toxicologic interactions resulting from inhalation of carbon black and
      acrolein on pulmonary antibacterial and antiviral defenses.
AB  - The goal of this study was to investigate whether coexposures to carbon black and
      acrolein result in a toxicologic interaction having effects on lung defenses
      against infectious agents. This aim was accomplished through in vivo studies with
      inhalation challenges of infectious agents that probe the functional integrity of
      the multicomponent system that comprises the integrated defenses of the lungs.
      Staphylococcus aureus was used for the alveolar macrophage (AM) surveillance
      phagocytic system, Proteus mirabilis for the dual phagocytic system composed of
      AMs and inflammatory polymorphonuclear leukocytes (PMNs), Listeria monocytogenes
      for the lymphokine-mediated arm of the acquired cellular immune response, and
      influenza A virus for the cytotoxic T-cell-mediated effector mechanism of
      cellular immunity. Exposures of Swiss mice to target concentrations of 10 mg/m3
      of carbon black and 2.5 ppm acrolein for 4 hr/day for 4 days suppressed the
      intrapulmonary killing of S. aureus a day after exposure with a return to control
      levels by Day 7. In contrast, the coexposure enhanced the intrapulmonary killing
      of P. mirabilis which correlated with a significant increase in accessory
      phagocytic PMNs recovered from the lungs. Combined exposure to carbon black and
      acrolein also resulted in impaired elimination of L. monocytogenes and influenza
      A virus from the lungs. Neither exposure to carbon black alone nor exposure to
      acrolein alone had any effect on the functional integrity of lung defenses
      against the four infectious agents. These data demonstrate the effects of the
      toxicologic interaction of coexposures to an inert particle and acrolein on
      innate and acquired defenses of the lungs. The mechanism for the enhanced
      biologic effect may be that the carbon black particle acts as a carrier mechanism
      for acrolein to the deep lung.

PMID- 8346534
TI  - Transport and toxicity of methylmercury along the proximal tubule of the rabbit.
AB  - Toxicity and transport of methylmercury were studied in isolated perfused S1, S2,
      and S3 segments of the renal proximal tubule of the rabbit. Methylmercury (II)
      chloride, ranging from 1 nM-1 mM, was perfused through the lumen of the three
      segments for up to 60 min. Lumen-to-bath transport of methylmercury was studied
      when the concentration of methylmercury in the perfusing solution was 18.4
      microM. S1 segments of the proximal tubule were most vulnerable to the toxic
      effects of methylmercury. Cellular swelling and blebbing occurred when the
      concentration of methylmercury in the perfusate was as low as 1 nM. In the S2 and
      S3 segments, morphologically discernable cellular injury did not occur until the
      concentration of methylmercury in the perfusate was greater than 100 nM. Due to
      severe cellular injury and luminal occlusion, transport data could not be
      obtained from S1 segments. However, transport could be measured in both S2 and S3
      segments. Methylmercury (18.4 microM) disappeared from the luminal fluid across
      the luminal membrane (JD) very rapidly in both segments. The rate was so rapid
      that about 80% of the methylmercury that entered the luminal fluid was
      abstracted. Interestingly, the rate at which mercury appeared in the bathing
      solution (JA) was statistically equivalent to the JD. Since the predicted leak of
      methylmercury was very low, most of the JA represented actual transepithelial
      flux of methylmercury. When 80 microM glutathione (GSH) was added to the
      perfusate along with 18.4 microM methylmercury, the JD was decreased
      significantly in both S2 and S3 segments. Moreover, the addition of 80 microM GSH
      caused cellular injury to be exacerbated in the S3 segments. In conclusion, there
      are differences in the toxicity of methylmercury along the three segments of the
      proximal tubule when the methylmercury is delivered to the lumen of the segments
      in a simple electrolyte solution. Methylmercury is very avidly transported across
      the tubular epithelium in S2 and S3 segments of the proximal tubule. In addition,
      when 80 microM GSH is added to the perfusate, the toxicity and transport of
      methylmercury are modified.

PMID- 8346535
TI  - Alveolar and airway cell kinetics in the lungs of rats exposed to nitrogen
      dioxide, ozone, and a combination of the two gases.
AB  - Rats carrying minipumps filled with 5-bromo-2'deoxyuridine were exposed to ozone,
      NO2, or a mixture of the two gases using four different protocols: (A) ozone 0.2
      ppm, NO2 3.6 ppm, or their mixture for 24 hr a day; (B) ozone 0.2 ppm, NO2 7.2
      ppm, or their mixture for 12 hr per night; (C) ozone 0.6 ppm, NO2 10.8 ppm, or
      their mixture for 8 hr per night; and (D) ozone 0.8 ppm, NO2 14.4 ppm, or their
      mixture for 6 hr per night. After three consecutive daily exposures, the animals
      were returned to filtered air and killed 7 days after implantation of the
      minipump. Alveolar labeling indices were comparable to control values except in
      the group of animals exposed for 6 hr nightly to a combination of 0.8 ppm of
      ozone and 14.4 ppm of NO2. Labeling indices in the peripheral airways were the
      most sensitive exposure index since they were significantly increased over
      control values in all animals exposed to ozone, NO2, or a mixture of the two
      gases, regardless of concentration or exposure duration. Labeling indices
      increased with elevated dose rate, i.e., concentration of the gases in the
      inspired air. The response to the combined gases was greater than the calculated
      sum of the responses to the two individual gases for the three higher dose rates
      in the large airways and for the highest dose rate in the peripheral airways. The
      results led to the following conclusions: (1) By the criterion of analysis of
      cell kinetics in rat large and peripheral airways, neither ozone, NO2, nor their
      mixture follows Haber's law (c x t = k) over the concentration ranges studied;
      and (2) at the higher dose rates studied, there is a more than additive
      (synergistic) airway response to the combination of ozone and NO2.

PMID- 8346536
TI  - The genotoxic effects of arachidonic acid in V79 cells are mediated by
      peroxidation products.
AB  - Chinese hamster lung fibroblasts (V79 cells) were exposed to 2, 20, 160, and 200
      microM arachidonic acid (AA). At 20 microM, a stimulatory effect on cell growth
      was observed, while at 200 microM, an inhibitory effect was found. AA at 160 and
      200 microM induced a 10- to 12-fold increase of 6-thioguanine-resistant mutants
      in V79 cells, whereas increased alkaline labile sites on DNA were consistently
      produced only with 200 microM treatment doses. The induction of alkaline labile
      lesions was partially inhibited in the presence of an antioxidant NDGA. [3H]AA
      metabolism in cells was examined by HPLC analysis following reductive
      transmethylation of the cell lipid extracts. Two fractions corresponding to
      [3H]AA-derived peroxidation products were identified by HPLC-radiochromatography
      and analyzed by mass spectrometry. Quantitative evaluation of the radioactivity
      associated with these peaks revealed an increase in [3H]AA peroxidation products
      when cells were exposed to increasing amounts of AA. The AA-dependent stimulation
      of lipid peroxidation product formation was partially inhibited when cells were
      treated in the presence of NDGA. The results provide evidence that substantially
      enlarged AA pools in cells may induce genotoxic effects mediated through
      increased endogenous lipid peroxidation products.

PMID- 8346537
TI  - Cadmium uptake by primary cultures of rat renal cortical epithelial cells:
      influence of cell density and other metal ions.
AB  - The uptake and accumulation of 1-5 microM cadmium (Cd) was studied in primary
      cultures of rat renal cortical epithelial cells under protein-free conditions at
      4 or 37 degrees C for up to 30 min. The cells were isolated from female rats by
      collagenase digestion and cultured for 3-7 days. Confluency of the culture,
      monitored morphologically as well as by total protein content, was achieved on
      Day 5. Cd accumulation at 1 microM concentration demonstrated an inverse
      relationship to the cell density; the Cd level in Day 5 culture was only 45% of
      that in Day 3 culture. In subconfluent cultures (Days 3 and 4) the Cd
      accumulation was temperature sensitive; on Day 3 the cells accumulated one-third
      less Cd at 4 degrees C than at 37 degrees C. In comparison, the confluent cells
      (Day 5) had the same Cd accumulation regardless of the incubation temperature. In
      these cells, preincubation with cyanide also had no significant effect on Cd
      accumulation, implying a lack of energy requirement for Cd uptake. As the
      transport of Cd may involve processes that exist for the essential metal ions,
      the effect of 30 microM zinc (Zn) and copper (Cu) on the accumulation of 1 microM
      Cd was studied in Day 5 cultures. Coincubation with Zn caused a 16% reduction in
      Cd levels at 37 degrees C and even greater reduction (44% of control) at 4
      degrees C. Similarly, Cu inhibited Cd accumulation by 26 and 45% at 37 and 4
      degrees C, respectively, as compared to the temperature-matched controls. The
      Vmax for the initial Cd uptake (1 min) was 125 pmol/mg protein/min and the Km was
      7 microM. Both Zn and Cu exhibited competitive inhibition kinetics and doubled
      the Km for Cd uptake. The Ki for Zn and Cu was 23 and 30 microM, respectively.
      Mercury (Hg) and lead (Pb) were also tested for their ability to affect Cd
      accumulation. As compared to the controls, 1 microM Hg caused an 11% reduction in
      Cd level at 37 degrees C. In contrast, 1 microM Pb enhanced Cd accumulation by
      20%. However, neither Hg nor Pb had any significant effect on Cd accumulation at
      4 degrees C. All four metals had no significant effect on the efflux of Cd from
      the cells. Thus, these metals affected Cd accumulation by changing its uptake
      rather than its efflux.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8346538
TI  - Effects of the bisphosphonate, alendronate, on parturition in the rat.
AB  - Alendronate is a bisphosphonate which inhibits bone resorption. In female
      fertility studies in rats, dosages of 10 and 15 mg/kg/day produced physical signs
      of toxicity at parturition, including tremors, dystocia, and death in the dams
      and these were associated with neonatal deaths. These effects were associated
      with hypocalcemia in the dams but the fetuses were normocalcemic. There was no
      one critical period of treatment during gestation for these effects; they were
      instead proportional to length of treatment. Neonatal deaths were due to
      protracted deliveries rather than a direct effect of alendronate on the pups.
      Intravenous calcium supplementation (9.3 mg/dam) prevented the above-described
      adverse effects on dams and pups. In rats, fetal skeletal ossification is at its
      greatest rate in late gestation, and during this period free calcium is
      preferentially transported to the fetal compartment. The females meet this
      increased demand by calcium mobilization via increased bone resorption. We
      conclude that the maternotoxicity of alendronate in rats is due to the designed
      pharmacologic activity of this bisphosphonate; the drug prevents bone resorption
      and thereby denies the dam an important source of calcium at a time when fetal
      demand for this mineral is at its peak. The alendronate-induced hypocalcemia
      adversely affects parturition because uterine muscle contraction is a calcium
      dependent process.

PMID- 8346539
TI  - Metabolism and toxicity of intravenously injected yttrium chloride in rats.
AB  - Although radioactive yttrium (Y) has been used for medical treatment, little
      attention has been directed toward the toxicity of Y. We report time-course and
      dose-related changes in tissue distribution, subcellular localization, clearance,
      and acute toxicity of iv-injected yttrium chloride (YCl3) in rats. Intravenously
      injected Y was predominantly distributed to plasma in the blood. At doses more
      than 0.2 mg Y/rat, most plasma Y appears to be in colloidal material which was
      composed of proteins and some minerals. Electron microscopic analyses revealed
      that the colloidal material was taken up by phagocytic cells in the liver and
      spleen. The liver Y was slowly cleared with a half-time of 144 days at a dose of
      1 mg Y/rat. Glutamic-oxaloacetic and glutamic-pyruvate transaminase activities in
      blood plasma were increased with a peak at 20 hr postinjection at a dose of 1 mg
      Y/rat and returned to their control values at 170 hr postinjection, indicating
      that iv-injected YCl3 caused acute hepatic injury. Some of the plasma Ca was
      translocated to the colloidal material and plasma Ca concentration was increased
      transiently following injection of YCl3, probably because of resorption of bone.
      At a dose of 1 mg Y/rat, a significant and tremendous amount of Ca was deposited
      in the liver (over 10-fold) and spleen (over 100-fold), while Ca concentration
      was only slightly increased in the lung and kidney (less than 1.5-fold). These
      results indicate that the liver and spleen are primary target organs of iv
      injected YCl3.

PMID- 8346540
TI  - Comparative developmental toxicity and metabolism of nitrazepam in rats and mice.
AB  - This study was designed to evaluate the developmental toxicity of nitrazepam (NZ)
      in Sprague-Dawley rats and ICR mice and to determine the metabolic factors which
      modulate susceptibility to the developmental effects of NZ. Rats were treated
      orally with a single dose of NZ at 300 mg/kg on Day 12 of gestation. Mice
      received one dose of 300 mg/kg NZ via gavage between Days 9 and 14 of gestation.
      NZ administration resulted in a significant incidence of malformations in rats,
      while no evidence of teratogenic action was observed in mice. Pronounced species
      differences in the metabolism of NZ were observed. In rats, 7
      acetylaminonitrazepam (AANZ) was detected as the major metabolite in plasma and
      embryos, whereas in mice, only small amounts of this product were found. The rate
      of N-acetylation of 7-aminonitrazepam (ANZ) to AANZ was 8.5-fold greater in rat
      liver cytosol than that in mouse liver cytosol. In contrast, the rate of
      deacetylation of AANZ to ANZ was 9-fold greater in mouse liver microsomes than
      that in rat liver microsomes. The developmental effects of authentic metabolites
      of NZ were studied in the two species. A single oral administration of 300 mg/kg
      ANZ to pregnant animals produced a significant incidence of malformations in
      rats, but not in mice. On the other hand, AANZ was teratogenic in both species.
      These results suggest that the difference in the susceptibility to NZ-induced
      teratogenicity between rats and mice may be related to differences in the levels
      of N-acetyltransferase and deacetylase, and that AANZ may be involved in the
      teratogenic mechanism.

PMID- 8346541
TI  - Pharmacokinetics of 2-methoxyethanol and 2-methoxyacetic acid in the pregnant
      mouse: a physiologically based mathematical model.
AB  - A physiologically based pharmacokinetic (PBPK) model was created to describe the
      disposition of 2-methoxyethanol (2-ME) and its teratogenic metabolite, 2
      methoxyacetic acid (2-MAA), in the pregnant CD-1 mouse. The model's foundation is
      a mathematical description of the physiological changes that occur during
      gestation (O'Flaherty et al., Toxicol. Appl. Pharmacol. 112, 245-256, 1992). The
      PBPK model was developed and validated with data collected on Gestation Day (GD)
      11. Absorption, distribution, and oxidation of 2-ME to 2-MAA and ethylene glycol
      (EG) were simulated. Flow-limited disposition of 2-ME in maternal tissues was
      described using in vitro-determined tissue partition coefficients (PCs). The
      maximum velocity (Vmax) of 2-ME oxidation to 2-MAA was calculated from literature
      based in vitro data. Vmax for EG formation, and Michaelis constants for 2-MAA and
      EG pathways, were estimated from optimized simulations of plasma 2-ME and
      metabolite levels obtained after intravenous injection of 5-600 mg 2-ME.kg-1.2
      MAA disposition and elimination in the dam were described by a nonphysiological
      one-compartment model, which was linked to the 2-ME model, based on the volume of
      distribution (0.510 liters.kg-1) and overall elimination rate constant (0.124 hr
      1) calculated from iv 2-MAA plasma concentration-time courses. Transfer of 2-MAA
      between the placenta and conceptus was described as a diffusion-limited process
      to more accurately simulate the higher concentrations of 2-MAA determined in
      embryonic compartments compared with maternal plasma levels. Subsequent 2-MAA
      disposition within the embryo proper and surrounding fluid of the GD 11 conceptus
      was adequately described using embryo/blood (0.94) and extraembryonic fluid/blood
      (1.33) PCs. Extension of the PBPK model to oral and subcutaneous 2-ME
      administrations required optimization of first-order absorption rates; model
      simulations agreed closely with measured 2-ME/2-MAA levels. With refinements and
      further validation, the PBPK model of 2-ME/2-MAA disposition should prove helpful
      for extrapolation throughout gestation and between species.

PMID- 8346542
TI  - Application of computational fluid dynamics to regional dosimetry of inhaled
      chemicals in the upper respiratory tract of the rat.
AB  - For certain inhaled air pollutants, such as reactive, water soluble gases, the
      distribution of nasal lesions observed in F344 rats may be closely related to
      regional gas uptake patterns in the nose. These uptake patterns can be influenced
      by the currents of air flowing through the upper respiratory tract during the
      breathing cycle. Since data on respiratory tract lesions in F344 rats are
      extrapolated to humans to make predictions of risk to human health, a better
      understanding of the factors affecting these responses is needed. To assess
      potential effects of nasal airflow on lesion location and severity, a methodology
      was developed for creation of computer simulations of steady-state airflow and
      gas transport using a three-dimensional finite element grid reconstructed from
      serial step-sections of the nasal passages of a male F344 rat. Simulations on a
      supercomputer used the computational fluid dynamics package FIDAP (FDI, Evanston,
      IL). Distinct streams of bulk flow evident in the simulations matched inspiratory
      streams reported for the F344 rat. Moreover, simulated regional flow velocities
      matched measured velocities in concurrent laboratory experiments with a hollow
      nasal mold. Computer-predicted flows were used in simulations of gas transport to
      nasal passage walls, with formaldehyde as a test case. Results from the uptake
      simulations were compared with the reported distribution of formaldehyde-induced
      nasal lesions observed in the F344 rat, and indicated that airflow-driven uptake
      patterns probably play an important role in determining the location of certain
      nasal lesions induced by formaldehyde. This work demonstrated the feasibility of
      applying computational fluid dynamics to airflow-driven dosimetry of inhaled
      chemicals in the upper respiratory tract.

PMID- 8346543
TI  - Automated counting of nuclei in series of conventional liver sections to
      differentiate hypertrophy and hyperplasia.
AB  - A method based on image analysis and applicable in pharmacology and toxicology is
      described that has been designed to meet the statistical requirements for the
      determination of liver hypertrophy or hyperplasia. An algorithm has been
      developed to detect and count fluorescent nuclei in Feulgen-stained liver
      sections (12,500 to 25,000 nuclei or 170 to 350 fields of observation per section
      within 2-4 hr) by means of fully automatic image analysis with the Leitz Texture
      Analysis System (TAS) (up to 23 sections in series on the microscope stage). The
      applicability of this method to conventionally derived, formaldehyde-fixed,
      tissue sections has been tested on 3-microns sections cut from archived paraplast
      blocks of already diagnosed materials. Alterations in the liver induced by eight
      different compounds administered perorally for 28 days to rats have been studied.
      The morphometric results were found to be specific for a given compound and
      revealed reproducible and statistically significant dose dependencies of
      hypertrophy or hyperplasia, or both. Increased frequencies of mitotic figures
      observed by eye correlated reasonably well with the morphometrically determined
      hyperplasia, but many hyperplastic livers revealed no mitotic figures. By
      contrast, the histological diagnoses of an increased degree of hypertrophy were
      only poorly correlated with the morphometric determinations and, in many
      instances, were made in livers showing no decrease in the frequency of nuclei. On
      the other hand, the results from electron microscopy agreed well with the
      corresponding morphometric analyses: in cases with predominant hypertrophy the
      proliferation of the smooth endoplasmic reticulum was distinct or striking, or
      the peroxisomes were altered and increased in number, whereas no obvious
      ultrastructural changes were seen in cases of morphometrically exclusive
      hyperplasia.

PMID- 8346544
TI  - Influence of the formamidine pesticide chlordimeform on ovulation in the female
      hamster: dissociable shifts in the luteinizing hormone surge and oocyte release.
AB  - The formamidine pesticide chlordimeform (CDF) has been found to interfere with
      the hormonal control of ovulation in the rat by a presumptive disruption in the
      catecholaminergic regulation of the midcycle surge of luteinizing hormone (LH).
      While the brain hypothalamic mechanisms underlying generation of the hamster
      surge have not been as well-defined, there is evidence for an adrenergic
      component. The present experiments were designed to investigate the effects of
      CDF on ovulation in the golden hamster and whether any observed alterations are
      associated with differences in the appearance of the surge. Intraperitoneal CDF
      injections (0, 75, 150, or 200 mg/kg) at 1400 hr on proestrus caused a dose
      related reduction in oocytes retrieved at 0700 hr on the day of estrus.
      Additional experiments demonstrated that this effect was due to a delay in
      ovulation and not a decrease in the complement of oocytes released. Doses of 150
      or 200 mg/kg at 1100 hr or 200 mg/kg at 1600 hr were without a comparable
      ovulatory effect. Characterization of the LH surge indicated that there was a
      dose-related delay, but that this effect was not sufficient to account for the
      delay in ovulation. Animals dosed at 1100 hr (150 or 200 mg/kg) exhibited shifts
      in the surge identical to those animals injected at 1400 hr, but did not show any
      such detectable effects on the time of oocyte release. CDF administered at 1100
      or 1400 hr also caused alterations in serum estradiol and progesterone, even at a
      relatively low dose of 37.5 mg/kg. The results indicate that CDF given at a time
      just prior to the preovulatory rise in LH is able to impede ovulation in the
      hamster by possibly influencing some ovulatory event(s) triggered by the surge.
      Also, the ability of CDF to alter the timing of LH release is consistent with
      catecholaminergic participation in the generation of the gonadotropin signal
      stimulating the final events leading to ovulation. Under the present conditions,
      this perturbation can be characterized as a delay in the LH trigger, rather than
      a blockade.

PMID- 8346545
TI  - Mechanism of trichloroethylene-induced elevation of individual serum bile acids.
      I. Correlation of trichloroethylene concentrations to bile acids in rat serum.
AB  - The temporal relationship between trichloroethylene (TRI) and individual serum
      bile acids (SBA) has been investigated to gain insight into the mechanism of
      solvent-induced increases in SBA. Male Sprague-Dawley rats were treated with 1
      mmol/kg TRI in corn oil, while control rats received only corn oil. Blood samples
      were collected from the abdominal aorta at 2, 4, 8, and 16 hr after dosing.
      Individual SBA were determined by high-performance liquid chromatography (HPLC).
      Liver and blood concentrations of TRI and one of its metabolites,
      trichloroethanol (TCEOH), were determined by gas chromatography. SBA levels
      reached their peak at 4 hr and returned to control levels by 16 hr. There was a
      relationship between SBA levels and TRI concentrations, which were also at their
      peak 4 hr after dosing. By 16 hr the levels were undetectable. However, peak
      blood concentrations of TCEOH were reached 8 hr after dosing, and remained high
      at 16 hr. Cholic acid and taurocholic acid showed the highest levels of bile
      acids. Some other bile acids were also elevated, including deoxycholic acid,
      taurodeoxycholic acid, ursodeoxycholic acid, chenodeoxycholic acid, and
      taurochenodeoxycholic acid. Determination of total bile acids in serum using an
      enzymatic/colorimetric method showed a similar pattern of response to that
      obtained with the HPLC analysis. The data are consistent with TRI having a rapid
      and specific effect on SBA levels by a mechanism other than liver cell damage.

PMID- 8346546
TI  - Mechanism of trichloroethylene-induced elevation of individual serum bile acids.
      II. In vitro and in vivo interference by trichloroethylene with bile acid
      transport in isolated rat hepatocytes.
AB  - The effects of trichloroethylene (TRI) on bile acid transport in isolated rat
      hepatocytes have been studied using doses ranging from 0.5 to 4.0
      microliters/flask and a 20-min equilibration period. It was found that TRI caused
      a dose-related suppression of initial rates of uptake of cholic acid (CA) and
      taurocholic acid (TC) with no significant effect on enzyme leakage and
      intracellular potassium ion contents. Accumulation over 30 min for each of those
      two bile acids was also inhibited. A noncompetitive inhibition of bile acid
      uptake was shown as indicated by a decrease in maximum velocity (Vmax) and
      unchanged Michaelis constant (Km). Thirty minutes after cessation of TRI exposure
      in vitro the uptake of bile acids had gradually returned to normal levels. No
      significant interference of efflux was found in cells preloaded with either CA or
      TC. After dosing rats with 1 mmol/kg TRI in vivo the inhibition of uptake of CA
      and TC by subsequently isolated hepatocytes was not detected until 4 hr. By 16 hr
      uptake had returned to normal. The accumulation of bile acids was also suppressed
      at 4 and 8 hr. The inhibition of uptake after in vivo treatment was also
      noncompetitive. The data are consistent with the reversible increase of serum
      bile acids (SBA) in experimental animals after exposure to TRI. Furthermore, they
      support the contention that it is an interference with bile acid uptake, rather
      than actual cell damage, that is responsible for TRI-induced increases in SBA.
      Thus, the changes in SBA seem to be the result of interference with a
      physiological process rather than an event associated with significant
      pathological consequences.

PMID- 8346547
TI  - Epithelia hyperplasia in the renal papilla and pelvis but not the urinary bladder
      of male F344 rats associated with dietary sodium phosphates after uracil
      exposure.
AB  - Effects of the bladder tumor promoter Na3PO4 and the non-bladder-tumor promoter
      NaH2PO4 on development of hyperplastic lesions of urinary bladder and renal
      papilla/pelvis were investigated after exposure of male F344 rats to the
      nongenotoxic carcinogen uracil. Animals were administered with 3.0% uracil in the
      diet for 4 weeks and thereafter fed 3.0% Na3PO4 or 3.0% NaH2PO4 for 32 weeks. No
      enhancing effect of either phosphate salt on uracil-induced proliferative lesions
      of urinary bladder was observed. However, the sequential treatments gave rise to
      enhanced development of hyperplastic lesions in the renal papilla/pelvis compared
      to the case with uracil alone. In addition, a small number of renal pelvic
      papillomas were observed in the group given Na3PO4 after uracil. These phosphate
      salts also induced nephrocalcinosis in the papilla/pelvis concomitant with
      development of renal hyperplastic lesions in this location. A sequential study
      revealed calculus formation and proliferative lesions in both the urinary bladder
      and renal papilla/pelvis after 4 weeks dietary application of uracil. After
      cessation, calculi disappeared and the majority of hyperplastic lesions
      regressed, consistent with a decrease in DNA synthesis levels. Persistence of
      uracil-induced epithelial hyperplasia in renal papilla/pelvis under the influence
      of phosphate salts might have been directly due to chronic stimulation by
      nephrocalcinosis in these sites.

PMID- 8346548
TI  - Disposition of polycyclic aromatic hydrocarbons in the respiratory tract of the
      beagle dog. I. The alveolar region.
AB  - Clearance of polycyclic aromatic hydrocarbons (PAHs) from the respiratory tract
      follows a biphasic pattern, with a rapid clearance of most of the PAH followed by
      a slow clearance of a small fraction. In previously published models, it was
      predicted that the rapid phase represents clearance through the thin epithelial
      barriers in the alveoli, the slow clearance is through the thicker epithelium of
      the airways, and the rate of clearance from either region will be slowed if the
      PAH has a high degree of lipophilicity. The objective of this first study in a
      series of three was to validate model predictions for rates of alveolar clearance
      of PAHs of different lipophilicities. A new method was developed to expose dogs
      to a bolus of aerosolized crystals of either benzo[a]pyrene (BaP) or phenanthrene
      (Phe) in a single breath. A bolus of PAH crystals was formed by condensation from
      a heated vapor and was injected into the pulmonary region. The bloodborne
      clearance of the PAHs was monitored by repeatedly sampling blood through
      catheters in the ascending aorta and the right atrium of the dog. Half of the Phe
      and the BaP cleared within 1 min and 2.4 min, respectively. The data indicated
      that the clearance of the highly lipophilic BaP was limited by diffusion of the
      PAH through the alveolar septa, while clearance of the moderately lipophilic Phe
      was limited mostly by the rate of perfusion of the blood. The results indicate
      that inhaled PAHs of sufficient lipophilicity to limit diffusion through cells
      have a greater potential for toxicity to the lung than less lipophilic PAHs.
      Because of thicker epithelia, bronchi should be at greater risk than the alveoli
      for PAH-induced toxicity exerted at the portal of entry.

PMID- 8346549
TI  - Disposition of polycyclic aromatic hydrocarbons in the respiratory tract of the
      beagle dog. II. The conducting airways.
AB  - Physiological models have predicted that the lipophilicity of solutes such as
      polycyclic aromatic hydrocarbons (PAHs) will delay clearance from the respiratory
      tract. This clearance consists of a delayed penetration of the mucous lining
      layer (MLL), allowing mucociliary clearance, followed by a slow penetration of
      PAHs through walls of the conducting airways. To test this prediction,
      mucociliary clearance and retention in the mucosa of PAHs deposited in the
      conducting airways of the Beagle dog were measured. Mucociliary clearance of
      particles and dissolved PAHs was measured by instilling onto the MLL in a main
      stem bronchus or the distal trachea small volume of saline containing either
      dissolved benzo(a)pyrene (BaP) or phenanthrene (Phe), or a suspension of
      particulate solvent green (SG) or macroaggregated albumin (MAA). Sequential
      lavage of the mucous-retained materials followed the instillations. Retention of
      BaP in the airway walls of the bronchial tree was studied by instilling the
      hydrocarbon in an ethanol/saline solution at precise locations of the upper
      bronchial tree, and measuring the concentration of BaP and its major metabolites
      in the tissues. Results indicated that mucociliary clearance of SG and MAA
      particles in the trachea of the Beagle dog occurred at average rates of 27-30
      mm/min. Of the two solutes, only the highly lipophilic BaP was sufficiently
      retained within the MLL to be transported with the mucociliary escalator. In
      addition, a fraction of the lipophilic materials cleared at a very rapid rate, in
      excess of 90 mm/min. This may indicate that one monolayer of pulmonary surfactant
      at the air interface is spreading out of the lungs on top of the MLL ata faster
      rate than mucociliary clearance. However, despite the protective properties of
      the MLL, fractions of BaP penetrating to the bronchial epithelium had a clearance
      half-time in the range of 1.4 hr, a period during which considerable metabolism
      of the PAH occurred. This long retention indicates a diffusion-limited uptake of
      BaP by the airways, and underscores the potential for local toxicity of highly
      lipophilic toxicants in the bronchial epithelium.

PMID- 8346550
TI  - Disposition of polycyclic aromatic hydrocarbons in the respiratory tract of the
      beagle dog. III. Mechanisms of the dosimetry.
AB  - The disposition of polycyclic aromatic hydrocarbons (PAHs) in the respiratory
      tract of the Beagle dog was measured and presented in two previous papers. In
      this paper, the data were used to demonstrate that highly lipophilic toxicants,
      such as PAHs, were diffusion-limited during clearance from the respiratory tract.
      Organic toxicants are usually regarded as perfusion-limited during clearance from
      the lungs. Within minutes after inhalation, the perfusion-limited substance is
      though to be cleared from all regions of the respiratory tract to the circulating
      blood. However, the length of time required for appearance of highly lipophilic
      PAHs in blood exiting the lungs following transient exposures of the alveolar
      region suggested that alveolar clearance of highly lipophilic PAHs was diffusion
      limited. But even though this transport was diffusion-limited, clearance of the
      highly lipophilic PAH benzo(a)pyrene (BaP) from the thin alveolar epithelium of
      the dog took only minutes, whereas clearance through the thicker epithelium of
      the conducting airways took hours. This phenomenon of slow airway clearance
      results from slower diffusion of highly lipophilic substances through the thicker
      air/blood barrier of the conducting airways compared to the thinner alveolar
      epithelium. A direct result of slowed clearance is a high concentration of BaP in
      the bronchial walls and an increased opportunity for metabolism to reactive
      forms. For this reason, the bronchial epithelium may become a preferential target
      of inhaled highly lipophilic toxicants. While the elevated dose during diffusion
      limited clearance involves only a few cell layers, the importance of this
      microdosimetry in contributing to local toxicity should not be overlooked. The
      findings suggest that bronchial cancer following inhalation exposures is more
      likely to be induced by highly lipophilic carcinogens such as PAHs than by less
      lipophilic carcinogens.

PMID- 8346551
TI  - Cyclins and cyclin-dependent kinases: take your partners.

PMID- 8346552
TI  - Reaction-induced infrared difference spectroscopy for the study of protein
      function and reaction mechanisms.
AB  - Infrared spectroscopic methods have been developed in the past decade to a
      sensitivity and selectivity which renders them useful for the study of enzyme
      function and enzyme reaction mechanisms. Originally developed as difference
      techniques for the investigation of light-induced reactions of photoreactive
      proteins, and matured in the field of bacteriorhodopsin and rhodopsin, they can
      now be used for the study of redox proteins by the use of electrochemical cells,
      or for the study of many different enzymes by the use of photolabile effector
      molecules. This brief review summarizes the currently available methods of
      infrared difference spectroscopy, the technical prerequisites, achievements and
      limitations.

PMID- 8346553
TI  - Multimeric complexes formed by DNA-binding proteins of low sequence specificity.
AB  - Some proteins bind to double-stranded DNA with low sequence specificity, forming
      regular multimeric complexes that extend over large regions of DNA, strongly
      distorting its conformation. Formation of these complexes at particular DNA sites
      usually depends on the structural ability of the DNA to follow the path imposed
      by the protein array. These complexes are found in both prokaryotic and
      eukaryotic organisms and participate in processes such as DNA replication,
      transcription and packaging.

PMID- 8346554
TI  - Lipocalins: do we taste with our tears?

PMID- 8346555
TI  - Ca(2+)-independent protein kinase Cs contain an amino-terminal domain similar to
      the C2 consensus sequence.

PMID- 8346556
TI  - The plant Golgi apparatus: a factory for complex polysaccharides and
      glycoproteins.
AB  - The Golgi apparatus of plant cells serves two major functions: it assembles and
      processes the oligosaccharide side chains of glycoproteins, and it synthesizes
      the complex polysaccharides of the cell wall matrix, the hemicelluloses and
      pectins. The first function is common to plant and animal cells while the second
      is unique to plants. The recent introduction of novel biochemical and electron
      microscopical techniques, as well as the production and the application of highly
      specific anti-glycan antibody probes have led to major advances in understanding
      the structural and functional organization of plant Golgi stacks.

PMID- 8346557
TI  - Lectin-carbohydrate complexes of plants and animals: an atomic view.
AB  - Lectins are a structurally diverse class of proteins, their only common features
      being the ability to bind carbohydrates specifically and reversibly, and to
      agglutinate cells. Some, however, can be grouped together into distinct families,
      such as those of the legumes or the cereals that are structurally similar, or the
      C-type (Ca(2+)-dependent) animal lectins that contain homologous carbohydrate
      recognition domains. Recent high-resolution X-ray crystallographic studies have
      revealed the structures of the sugar complexes of over half a dozen lectins.
      These studies demonstrate that the combining sites of lectins are also
      structurally diverse, although they may be similar in the same family.

PMID- 8346558
TI  - Screening for breast cancer: report of a population-based experience in the city
      of Milan, Italy.
AB  - AIMS AND BACKGROUND: Mammographic screening is recommended as a current health
      practice. The aim of the present study is to report the results of a new program
      which started in the city of Milan in 1989. METHODS: A total of 4882 women aged
      50 to 61 years and resident in quarter no. 16 of Milan were invited by mail to
      attend the screening at the San Paolo Hospital based on two-view mammography and
      physical examination. RESULTS: A total of 2953 (60.5%) women attended the first
      screening round, and 18 cancers were detected (1 Tis, 8 T1, 9 T2). The detection
      rate was 6.9 x 1000, and the prevalence/incidence ratio was around 3.5.
      CONCLUSIONS: The study confirms the feasibility of breast cancer screening in an
      urban setting by using the existing general hospital facilities and should be
      considered as a possible model for other urban experiences.

PMID- 8346560
TI  - Is early gastric cancer, diffuse type, a forerunner of advanced gastric cancer.
AB  - AIMS AND BACKGROUND: Gastric cancer (GC) represents one of the most important
      causes of death by malignancy world wide. Our retrospective study was carried out
      on surgical stomach specimens obtained from a series of 552 consecutive cases of
      GC observed in the Departments of Surgical Pathology of the Public Hospitals of
      L'Aquila and Atri which cover the 17% of the entire population of the Italian
      Region Abruzzo. The aim of the study was to compare the anatomo-clinical
      characteristics of early GC (EGC) and advanced GC (AGC). METHODS: The diagnosis
      was achieved by the criteria of the Lauren's histopathological classification
      (intestinal and diffuse types). Our study also stratified the cases by sex, age,
      lymph node metastases and associated lesions such as chronic atrophic gastritis,
      intestinal metaplasia and dysplasia. RESULTS: On an average, patients affected by
      EGC were 8.1 years younger than those with AGC. This age gap could support the
      hypothesis that early lesions represent the first stage of AGC. However, when
      patients were subdivided according to Lauren's classification, the mean age of
      patients with EGC, diffuse type, was 12.2 years less than that of AGC patients of
      the corresponding histological type. Furthermore, the subset of patients with
      EGC, diffuse type, and lymph node metastases was 17.8 years younger than patients
      affected by AGC diffuse type, with lymph node metastases. CONCLUSIONS: The
      present study offers an original survey on GC in a defined Italian population. As
      far as the intestinal histotype is concerned, the slight age difference between
      EGC and AGC suggests that these tumors are different steps of the same process.
      On the contrary, the age distribution suggests that EGC, diffuse type, has a
      different biological behaviour.

PMID- 8346559
TI  - Secondary leukemia following treatment for Hodgkin's disease.
AB  - AIMS AND BACKGROUND: Patients treated for Hodgkin's disease with chemotherapy or
      with the association of chemotherapy and radiotherapy have an increased risk of
      secondary leukemia. The aim of this study was to evaluate the leukemogenic risk
      due to these treatment modalities. METHODS: We performed a case-control study on
      a population of 1410 patients treated for Hodgkin's disease from 1970 to 1990 in
      our Institute. Among these patients, we identified 25 cases of secondary leukemia
      and 3 cases of myelodysplasia, all occurring more than one year after the
      diagnosis of Hodgkin's disease. Three cases occurred among the patients treated
      with radiotherapy alone. When we analyzed the risk in relation to the type of
      treatment (radiotherapy, chemotherapy, or both), the comparisons were relative to
      patients treated with radiotherapy alone. RESULTS: We found that chemotherapy
      alone is associated with a fivefold increased risk (odds ratio = 5.4) compared
      with radiotherapy alone. When both treatments are used, the risk is not further
      increased (odds ratio = 4.4). Patients receiving more than 6 courses of
      chemotherapy have an excess risk (relative risk = 2.5) compared with those
      treated with 6 courses or less. No increased risk was observed after splenectomy.
      CONCLUSIONS: This study confirms an increased incidence of secondary leukemia
      occurring in patients treated for Hodgkin's disease. The increased risk seems to
      be correlated with the number of courses of alkylating agent therapy, whereas it
      is unaffected by the addition of radiotherapy.

PMID- 8346561
TI  - Infections in patients with acute non-lymphocytic leukemia nursed with central or
      peripheral venous access.
AB  - AIMS AND BACKGROUND: Infections are a major problem in patients undergoing
      induction chemotherapy for acute leukemia. Granulocytopenia is the single most
      important risk factor, but the pattern of infecting organisms can change
      according to nursing facilities or bacterial and fungal prophylaxis. METHODS: We
      reviewed the patterns and types of infections in 30 patients with acute non
      lymphocytic leukemia. Eighty-nine periods of neutropenia following chemotherapy
      were evaluated: in 60 courses patients had central and in 29 had peripheral
      venous access. RESULTS: Almost all patients (97%) became febrile after the 1st
      course of therapy, but one-third remained apyretic after the fourth course (P =
      0.002). In this series, the incidence of gram-positive, gram-negative and mycotic
      isolations were respectively 76%, 18% and 6%. The need for antimicrobic treatment
      varied in relation to the course of chemotherapy. CONCLUSIONS: We conclude that
      in acute non-lymphocytic leukemia the first neutropenic period following the
      onset of disease is the most critical regarding infectious problems. Both
      quinolonic prophylaxis and central venous access could be responsible for the
      microbiologic findings.

PMID- 8346562
TI  - Fluorouracil plus folinic acid in metastatic adenocarcinoma of unknown primary
      site suggestive of a gastrointestinal primary.
AB  - AIMS AND BACKGROUND: The results of treatment strategies for carcinoma of an
      unknown primary location have been discouraging. Currently, no chemotherapeutic
      approach can be considered standard. METHODS: We therefore initiated a Phase II
      study in which fluorouracil (370 mg/m2, day 1 through 5) plus folinic acid (200
      mg/m2 day 1 through 5) was administered in a subset of 17 patients (median age,
      57 years) affected by histologically diagnosed adenocarcinoma of unknown primary
      location characterized by liver metastases and elevated CEA of CA 19.9. All of
      the patients had a performance status of 0-2 (ECOG Scale), and liver involvement
      was > 30% in 7 cases. RESULTS: No objective response was observed (4 cases of
      stabilization and 13 of disease progression). Median survival was 5 months.
      Toxicity was mild or moderate, and severe diarrhea was observed in only one case.
      CONCLUSIONS: The proposed regimen is inactive among this subset of patients and
      confirms that subdiaphragmatic metastases are related to a poor prognosis. Our
      results, in agreement with data published in the literature, suggest that
      patients affected by adenocarcinoma of an unknown primary origin metastatic to
      the liver and with a good performance status should be treated in an
      investigative setting.

PMID- 8346563
TI  - Antiemetic activity of oral lorazepam in addition to methylprednisolone and
      metoclopramide in the prophylactic treatment of vomiting induced by cisplatin. A
      double-blind, placebo-controlled study with crossover design.
AB  - AIMS AND BACKGROUND: It has been suggested that lorazepam has a definite role as
      an antiemetic drug in antiemetic cocktails. In this study we examined the
      antiemetic efficacy of metoclopramide (200 mg) and methylprednisolone (1000 mg)
      with or without lorazepam. METHODS: Sixty patients treated with cisplatin
      containing regimens were entered into a randomized, double-blind study with cross
      over. Lorazepam 2.5 mg or placebo were administered orally the evening before
      therapy and just after the beginning of fluid infusion for chemotherapy. Degree
      of nausea and number of vomiting episodes, together with somnolence, were
      recorded on a data flow sheet and visual-analogue scales. RESULTS: 100 cycles (50
      patients) are evaluable. In 39 cycles there was no nausea and vomiting, in 74
      cycles acceptable control of emesis was reached (0-2 episodes of vomiting),
      without significant differences among the two arms. However, nausea was shorter
      in lorazepam arm (p < 0.01), and 80% of the patients preferred treatment with
      lorazepam (p < 0.003). Anxiety was reduced in the patients treated with lorazepam
      (p < 0.4). CONCLUSIONS: Lorazepam improves tolerability to cisplatin-containing
      chemotherapy, mainly by influencing the psychological status of the patient and
      favoring the amnestic process.

PMID- 8346564
TI  - Nasopharyngeal carcinoma in children and adolescents successful role of retrieval
      therapy.
AB  - BACKGROUND: The nasopharyngeal carcinoma in children and adolescents usually
      presents in advanced locoregional stages. METHODS: Seventeen patients, below the
      age of 18 years, with the diagnosis of nasopharyngeal carcinoma were diagnosed
      and treated at the National Cancer Institute (NCI), Cairo, Egypt, during the
      period 1982-1987. These 17 patients were selected from 28 patients of the same
      age group to whom the diagnosis of nasopharyngeal malignancies were established.
      This diagnosis was confirmed morphologically and with immunostaining using
      antibodies against leucocyte common antigen (LCA), epithelial membrane antigen
      (EMA), cytokeratin and vimentin. RESULTS: Eighty two percent of our patients were
      in T3 + T4 and 94% had N 1-3 nodal status. The locoregional control was 94% with
      adequate conventional radiotherapy, while the distant metastasis rate was also
      high (81%). The 5-year actuarial survival rate was 47 +/- 11% and the survival
      worsened with the advancement in T stage. However, the present study did not show
      any influence of N stage on survival. The relatively high survival rate depended
      mainly upon successful retrieval therapy with radiochemotherapy. CONCLUSIONS:
      This emphasizes the role of combination chemotherapy in the treatment of
      relapsing nasopharyngeal carcinoma in young patients.

PMID- 8346565
TI  - The basement membranes in sarcomatoid carcinomas. An immunohistochemical study.
AB  - AIMS: Eight sarcomatoid carcinomas from various anatomical locations were
      investigated by immunohistochemical staining to laminin, type IV collagen and
      heparan sulfate proteoglycan, to study the characteristics of basement membranes
      at the interface between carcinomatous and sarcomatous tissues. METHODS: Paraffin
      wax embedded tissue sections from representative tumor samples have been stained
      with specific antibodies, using the peroxidase-antiperoxidase technique. RESULTS:
      In all cases several interruptions or discontinuities of the basement membrane
      staining pattern were seen. In 4 cases, larger defects or complete loss of
      staining was also noted. At these places, the boundaries between carcinomatous
      and sarcomatous tissue were often blurred. CONCLUSIONS: Disruption and loss of
      basement membranes at interface between carcinomatous and sarcomatous tissues is
      a frequent finding in sarcomatoid carcinomas. These changes could be consistent
      with an epithelial origin of the sarcomatous component in these tumors by means
      of an epithelial-mesenchymal conversion mechanism.

PMID- 8346567
TI  - Kasabach-Merritt syndrome associated to angiosarcoma of the breast. A case report
      and review of the literature.
AB  - INTRODUCTION: Kasabach-Merritt syndrome is characterized by the association of a
      consumptive thrombohemorrhagic disorder and angioma occurring usually in
      children. In the present study, a case of Kasabach-Merritt syndrome associated to
      an angiosarcoma of the breast is reported. CLINICAL HISTORY: The tumor together
      with the thrombohemorrhagic disorder manifested in a 28-year-old woman. The
      patient underwent mastectomy. The tumor recurred in the same site 2 years later.
      The patient died of severe anemia 8 years after the first appearance of the
      angiosarcoma. MATERIAL AND METHODS: Tissues were formalin fixed and paraffin
      embedded; in addition, selected sections were immunohistochemically stained.
      RESULTS AND CONCLUSIONS: A well-differentiated angiosarcoma was visible
      throughout the removed organ. A review of the literature showed that only 6 cases
      of Kasabach-Merritt syndrome associated to malignant vascular tumors have been
      previously reported. All these 6 cases occurred in adult patients. On the
      contrary, Kasabach-Merritt syndrome associated to benign vascular tumors affects
      children. This is the first case occurring in the breast.

PMID- 8346566
TI  - Study of the HLA-DP beta 1 locus by the polymerase chain reaction technique in
      patients with Hodgkin's disease.
AB  - BACKGROUND: A number of reports have studied associations between Hodgkin's
      disease and HLA. Some of them established correlation between several antigens
      and Hodgkin's disease, and others found no correlations. METHODS: The HLA DP
      locus was determined by the polymerase chain reaction method in 31 Hodgkin's
      disease patients and 58 healthy controls. RESULTS: No significant difference
      between patients and controls was noted. CONCLUSIONS: Further investigations are
      needed to confirm the hypothesis of a possible role of the HLA complex as one of
      the factors involved in Hodgkin's disease.

PMID- 8346568
TI  - Cavitation of lung metastases from bladder cancer. Report of two cases.
AB  - We describe 2 cases of cavitary lung metastasis from bladder cancer and
      retrospectively analyze the frequency of such an event in our environment.
      Although rare, this finding is not exceptional and should be taken into account
      when clinicians and oncologists face the differential diagnosis of pulmonary
      cavitation. Moreover, a cavitary pulmonary nodule may also be the presenting sign
      of bladder cancer.

PMID- 8346569
TI  - Epididymal lymphoma. A case report.
AB  - Primary epididymal lymphoma is an unusual observation. Only 2 cases of non
      Hodgkin's lymphoma of the epididymis have been previously reported. We describe
      the clinical and pathologic features and management of a primary high-grade
      malignant lymphoma of the epididymis in which a tentative diagnosis of lymphoma
      was made on the basis of cytologic examination and immunochemical staining of the
      material obtained from an aspiration needle biopsy.

PMID- 8346571
TI  - [Treatment of rheumatoid arthritis--are we good enough?].

PMID- 8346570
TI  - Sarcomas involving the abdominal and pelvic cavity.
AB  - The principles of management of all sarcomas that involve the abdominal and
      pelvic cavity are presented. The anatomic sites for the primary malignancy
      include retroperitoneal sarcomas, pelvic side-wall sarcomas, sarcomas arising
      from the abdominal viscera, and sarcomas arising from the pelvic organs. All
      histologic types of sarcomas may be considered together when therapeutic options
      are being discussed. This presentation stresses surgical removal with an adequate
      margin of resection as the principal goal of management. The curative treatment
      of these cancers places great emphasis on the surgeon's knowledge of anatomy,
      technical skills, innovation, and surgical courage. Systemic chemotherapy and
      radiotherapy have not shown reproducible efficacy. Complete resection in the
      absence of tumor spillage remains the only reliable treatment option. Possible
      benefits of induction chemotherapy and intraperitoneal chemotherapy using
      cisplatin and doxorubicin in the early postoperative period are presented.

PMID- 8346572
TI  - [Methotrexate therapy of rheumatoid arthritis. An open observation study of 110
      patients with median length of treatment of 17.8 month].
AB  - Effects and side-effects of treating patients with rheumatoid arthritis with
      methotrexate given as weekly pulse-treatment are examined in an open observation
      study. One hundred and ten consecutive patients with active rheumatoid arthritis
      entered the study. Six criteria of remission were registered as effect variables.
      Median length of treatment at the time of investigation was 17.8 months. At this
      point, 34 patients were in complete remission, with a median effect score of five
      point five out of six possible points. Twenty-nine were in partial remission and
      47 (42.7%) had not improved. The median effect score for all patients was three
      point 6 (95% confidence limits (2-4). Methotrexate treatment was stopped in 24
      patients, in 15 of these because of a combination of side-effects and lack of
      therapeutic response. Prednisone treatment could be discontinued in 20 out of 57
      patients during the course of methotrexate treatment. Side-effects were
      registered in 67 cases (62.7%), and led to treatment being discontinued in 21
      cases. Nearly half the side-effects consisted of dyspepsia and rises in amino
      transferase levels (48 of 67 patients). Consistently raised amino-transferase
      levels were found in five cases, all returned to normal after methotrexate was
      stopped. Serious side-effect were registered in four cases, consisting of two
      cases of short-term pancytopenia following overdosage and two cases of severe
      hypoxia following methotrexate-induced alveolitis.

PMID- 8346573
TI  - [Experimental gastrointestinal motility].
AB  - Gastrointestinal motility is a major field of research today; however, despite
      there being a huge amount of available data in the literature, its exact role as
      a diagnostic tool has yet to be defined. The purpose of this paper is to describe
      some of the existing experimental models and methods for conducting motility
      studies.

PMID- 8346574
TI  - [The Thule case. Mortality and hospitalization after the crash of an American B
      52 bomber in 1968].
AB  - In 1968, a B-52 bomber carrying nuclear bombs crashed near the Thule US Air-Base
      in Greenland. By 1986, many cases of disease had been reported among Danish
      workers employed at the base. A database has been constructed from staff files of
      workers employed from 1963 to 1971. Of 4,322 workers, 98.7% were identified in
      1987. The study group consisted of 1,202 workers employed during the clean up
      period (from the time of the crash until the last of the contaminated material
      had been removed). The reference group consisted of 3,120 workers employed
      outside the clean up period. No differences were found in total mortality, or
      mortality from cancer, heart disease or accidents between the groups after
      adjusting for age, marital status and length of employment. Mortality from
      suicide was lower in the study group. The hospitalization rates for the period
      1977-1985 also showed no differences between the two groups. The conclusion of
      the register surveys is that no harmful effect on health due to the crash can be
      established by measuring mortality or hospital admissions.

PMID- 8346575
TI  - [Tobacco, lung cancer and chronic obstructive lung disease. Results from the
      Osterbro study].
AB  - Data from The Copenhagen City Heart Study, a prospective population study, were
      analysed to investigate the influence of the type of tobacco and inhalation on
      mortality from lung cancer and chronic obstructive pulmonary disease (COPD). The
      study sample comprised 2986 plain cigarette smokers, 3222 filter cigarette
      smokers, 1578 smokers of cheroots/cigars, 433 male pipe smokers and 773 smokers
      smoking more than one type of tobacco. From 1976 to the end of 1989 we observed
      268 deaths from lung cancer and 195 deaths, where COPD was considered as either
      the main or the contributory cause of death. Current smokers of all types of
      tobacco had a significantly higher risk of mortality from the investigated
      diseases than never-smokers. In both sexes the risks of death from both lung
      cancer and COPD were lower in cheroot/cigar smokers and in pipe smokers than in
      cigarette smokers, but these differences were markedly diminished after an
      adjustment for the inhalation habit. The present study substantiates that tobacco
      smoking increases pulmonary mortality. The small differences between the various
      types of tobacco are probably caused by different inhalation patterns.

PMID- 8346576
TI  - [How much is lung function affected by smoking and occupation? Dichotomy of
      continuous variables can change the results].
AB  - Data from a cross-sectional study of 1045 men comprising a random population
      sample (768 men) and a sample of cement workers (277 men) were analyzed in order
      to examine the effects of smoking and occupation on forced expiratory volume in
      one second (FEV1). The continuous FEV1 variable and five dichotomous FEV1
      variables based on % of predicted were analyzed. Differences between the
      "relative importance" of smoking and occupation were found to depend on the
      choice of the FEV1 variable. The effects of occupation compared with the effects
      of smoking varied considerably with different FEV1 variables, continuous or
      dichotomized at different cut-off levels. We conclude that comparison of surveys
      utilizing different FEV1 variables must be made with caution.

PMID- 8346577
TI  - [Displaced proximal humeral fracture--conservative treatment].
AB  - The results of 42 patients with displaced proximal humeral fractures treated by
      conservative methods were reviewed. Follow-up evaluation included clinical and
      radiographic examination median two years after the trauma. The results were
      assessed using Neer's protocol. The patients were asked to assess the results.
      The patients assessed the results better than the Neer score (p < 0.001). The
      patients' response to non-operative treatment was satisfactory. It is concluded
      that the Neer classification of the results underestimates the degree of
      satisfaction achieved by the patients. It is concluded that displaced proximal
      humeral fractures can be treated satisfactorily by non-operative methods.

PMID- 8346578
TI  - [Corticosteroid treatment of patients with AIDS and severe Pneumocystis carinii
      pneumonia. A European multicenter study. Danish-Dutch AIDS Study Group].
AB  - Fifty-nine HIV-1 infected patients with a microscopically proven first episode of
      moderate to severe Pneumocystis carinii pneumonia (PCP) were enrolled into a
      randomized European multicenter study. The effect of adjunctive corticosteroid
      (CS) therapy was assessed on: 1) survival to discharge, 2) need for mechanical
      ventilation (MV) and 3) survival at day 90. CS was given within 24 hours of
      standard therapy as intravenous methylprednisolone 2 mg/kg bodyweight daily for
      ten days. All patients received cotrimoxazole as standard treatment. Inclusion
      criteria were a PaO2 < 9.0 kPa (67.5 mmHg) and/or a PaCO2 < 4.0 kPa (30.0 mmHg).
      During the acute episode of PCP nine (31%) of the 29 control patients died versus
      three (10%) of the 30 CS patients; p = 0.01. Mechanical ventilation was necessary
      in 15 patients; 12 (41%) in the control group and three (10%) in the KS group; p
      = 0.01. The 90-day survival was 69% in patients receiving cotrimoxazole alone
      versus 87% in patients receiving adjunctive KS; p = 0.07. Based on these data we
      conclude that adjunctive CS therapy for moderate to severe PCP in AIDS-patients
      reduces the acute mortality and the need for mechanical ventilation.

PMID- 8346579
TI  - [Use of bladder thermistor catheters in an intensive care unit. Comparative study
      of core temperature measurements with bladder thermometers and rectal
      thermometers in an intensive care unit].
AB  - Bladder temperature measured by a thermistor tipped urinary catheter was compared
      to rectal temperature in 14 ICU patients. During a period of five days 2 x 232
      measurements were recorded, and good correlation was found between rectal and
      bladder temperatures (R = 0.97). There did not seem to be any drift in the
      bladder thermistor. Measurement was accurate during periods of oliguria. We find
      that bladder temperature measurement is reliable, safe, convenient and accurate
      for routine use in the ICU.

PMID- 8346580
TI  - [Infections after insertion of epidural catheters].
AB  - Three cases of iatrogenic infection following the insertion and subsequent use of
      an epidural catheter are described. The development, symptoms, diagnostic
      possibilities and treatment of epidural abscess are described. It is stressed
      that patients with decreased immunological defences are more prone to infection.
      Two patients with epidural abscesses are described. In both cases there was a
      "doctors-delay" before diagnosis was reached. Despite neurosurgical intervention
      both patients developed paralysis of the lower extremities, bladder and
      intestinal function, in one of them irreversibly. We also describe one patient
      who developed meningitis following eight attempts to insert an epidural catheter.
      The importance of quick diagnosis and intervention is stressed as well as the
      importance of strict sterility while inserting and using epidural catheters.

PMID- 8346581
TI  - [Spontaneous bladder perforation--a rare complication of neurogenic bladder
      dysfunction].
AB  - Spontaneous rupture of the urinary bladder which is not associated with trauma is
      uncommon. A case of spontaneous bladder perforation (triggered by an episode of
      urinary retention) and peritonitis in a 69-year old male patient with neurogenic
      bladder dysfunction is reported. The latter was due to disseminated sclerosis and
      was complicated by recurrent urinary tract infection and two bladder calculi. The
      etiology, diagnosis and treatment of spontaneous bladder perforation is briefly
      discussed. The diagnosis spontaneous bladder perforation should be considered in
      patients with non-characteristic acute abdominal conditions and voiding symptoms,
      especially if they have neurogenic bladder dysfunction and a history of recurrent
      lower urinary tract infections and/or bladder calculi. We recommend that bladder
      stones should be removed--also in asymptomatic cases.

PMID- 8346582
TI  - [2 cases of lymphangioleiomyomatosis treated by hormonal manipulation].
AB  - The course of disease in two women with bioptically verified
      lymphangioleiomyomatosis (LAM) is demonstrated. One was oestrogen- and
      progesterone-receptor negative, but responded promptly to hysterosalpingo
      oophorectomy and has had no symptoms later. The other was receptor positive, but
      in spite of hysterosalpingo-oophorectomy and hormonal manipulation with tamoxifen
      and medroxyprogesterone, has had a complicated course of the disease with
      symptoms for ten years. LAM is a hormone dependent disease, but our knowledge is
      still incomplete. Hormonal manipulation should be tried in receptor positive as
      well as negative patients. Tamoxifen seems to have deleterious effects on the
      course of disease.

PMID- 8346583
TI  - [Children in families with alcohol and drug problems].

PMID- 8346584
TI  - [Complications of MMR vaccinations].

PMID- 8346585
TI  - [Toxic epidermal necrolysis].

PMID- 8346586
TI  - [Travelers' diarrhea].

PMID- 8346587
TI  - [Ingestion of caustic agents. Epidemiology, pathogenesis, course, complications
      and prognosis].
AB  - The incidence of caustic ingestion varies with the availability of caustic
      products and preventive measures. A transient increase was seen in the US round
      1970, in Denmark in the late seventies. Diagnosis and treatment of caustic
      ingestion injuries remains controversial, and must to a high degree be based on
      retrospective studies and animal studies, especially concerning the pathology and
      clinical course of the disease. These subjects are reviewed together with
      complications and prognosis. It is stressed, that ingestion of alkalies and acids
      result in a variety of lesions, depending on a number of factors listed.
      Ingestion of alkalies occurs in approximately 85% of all cases, with oesophageal
      stricture as the most frequent complication, and tracheal necrosis as the most
      frequent cause of death. Ingestion of acid in large amounts may lead to early
      gastric perforation, massive metabolic acidosis, and eventual death. Pyloric
      stenosis is the most common complication of acid ingestion. Approximately 33% of
      all patients admitted with (suspected) caustic injury reveal oesophageal damage.
      This leads to subsequent oesophageal stricture in 10-15%. Mortality is less than
      10% in unselected groups.

PMID- 8346588
TI  - [Salmon calcitonin in osteoporosis. The effect of intranasal application on bone
      mineral content and fracture frequency in postmenopausal women with manifest
      osteoporotic changes].
AB  - The objective was to study the dose-related response of intranasal salmon
      calcitonin (Salcatonin) on bone mass and bone turnover and the effect of
      salcatonin on rates of fracture in elderly women with moderate osteoporosis. A
      total of 208 healthy women aged 68-72 years, who had a bone mineral content (BMC)
      of the distal forearm 30% below the mean value for healthy premenopausal women,
      were examined in a double-blind, placebo-controlled, randomized group comparison
      study. They were randomized to a two-year daily treatment of either 50 IU, 100
      IU, 200 IU Salcatonin or placebo. All received 500 mg calcium daily. In the
      calcium-(placebo)-treated group the BMC of the spine increased 1%, whereas an
      increase of 3% was seen in the 200 IU Salcatonin treated group. There was a dose
      related response to Salcatonin manifested by an increase in BMC of 1.0%/100 IU.
      The incidence of new fractures was significantly lower in the women treated with
      Salcatonin (about one third of that in the non-Salcatonin treated women). In
      conclusion the results suggest that, compared with calcium alone, Salcatonin
      given intranasally reduces the rate of fracture by two thirds in elderly women
      with moderate osteoporosis. Furthermore, it increases spinal bone mass in a dose
      dependent manner.

PMID- 8346589
TI  - [No increase in the prevalence of vertebral fractures among postmenopausal women
      over a 10-year period].
AB  - We examined whether the prevalence of vertebral fracture in otherwise healthy, 70
      year-old Danish women had increased over a period of ten years. The population
      based, epidemiological study included two age-matched, representative samples of
      postmenopausal women. Group 1 (1979) consisted of 173 healthy women without
      secondary causes of osteoporosis, Group 2 (1989) of 387 women. X-rays of the
      thoraco-lumbar spine were assessed for vertebral fracture by five radiological
      methods. There was no significant difference between the two groups in the
      prevalence of vertebral fracture and the 95% confidence intervals overlapped
      completely in all methods. The prevalence rates varied by method from 35% to 80%
      but the distribution of fracture types was similar in the two groups. We conclude
      that the prevalence of vertebral fractures due to postmenopausal osteoporosis has
      not increased since 1979 in suburban Copenhagen, and that comparison of
      prevalences requires the same method of radiological assessment.

PMID- 8346590
TI  - [Significant prognostic factors for recurrence-free survival after surgical
      treatment of head-neck melanoma].
AB  - The clinico-pathological and therapeutic data of 512 patients with clinical stage
      I invasive head and neck melanoma of the skin were re-evaluated. There were 287
      females and 225 males. The median age at primary surgery was 65 years, range 18
      to 96 years. The median observation period was 5 years, range 1 month to 25
      years. Sex, age, ulcerated tumor and tumor thickness were found by Cox
      multivariate regression analysis to act as independent prognostic factors for
      recurrence-free survival. In addition, size of the excision margin was found of
      no significance for survival without relapse when adjusting for the independent
      risk factors.

PMID- 8346591
TI  - [Early complications of enterostomy. Importance of the type of suture].
AB  - The frequency and character of early complications following creation of
      enterostomies, and their relation to the type of suture material used were
      studied in 50 consecutive patients. The stomas were matured by muco-cutaneous
      eversion, and were fixated with Maxon 4-0 and Vicryl 3-0 sutures. Half the stoma
      circumference was sutured with the one suture type, and the other half with the
      other. No statistically significant correlation was found between enterostomy
      type or surgical procedure and complications. The incidence of muco-cutaneous
      complications was significantly higher following fixation with Vicryl as compared
      to Maxon sutures. The cause of this difference is uncertain, however, the
      physical configuration of the sutures seems important, Maxin being monofile
      versus Vicryl being braided. Whether the chemical structure is significant as
      well remains undetermined at present.

PMID- 8346593
TI  - [Angiotensin I converting enzyme inhibitor enalapril in treatment of progressive
      chronic nephropathy. An open randomized controlled trial].
AB  - In order to study the influence of angiotensin converting enzyme (ACE) inhibition
      on the progression of chronic nephropathy, 70 patients with a median glomerular
      filtration rate (GFR) of 15 (range, 6 to 54) mL/min/1.73 m2 were randomised in an
      open study to basic treatment with enalapril or conventional antihypertensive
      treatment. The patients were followed for at least two years or until they needed
      dialysis. The therapeutic goal, was a blood pressure of 120 ti 140/80 to 90 mmHg.
      In the enalapril group, the median decline in GFR was -0.20 (range, +0.18 to 
      7.11) mL/min/1.73 m2/month, and in the control group, it was -0.31 (+0.01 to 
      1.97) mL/min/1.73 m2/month (p < 0.05). There was no significant difference in
      blood pressure between the groups. Thus, the progression of moderate to severe
      chronic nephropathy was slower on a basic treatment with enalapril as compared to
      conventional antihypertensive therapy.

PMID- 8346592
TI  - [Radioiodine therapy of recurrent hyperthyroidism in patients previously treated
      for diffuse toxic goiter with subtotal surgery].
AB  - Radioiodine therapy is often employed for treatment of patients with relapse of
      hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is
      known about the outcome of this treatment compared to patients with no previous
      surgery. A total of 20 patients, who had received surgical treatment for Graves'
      hyperthyroidism 1-46 years previously and with relapse of hyperthyroidism, and 25
      patients with hyperthyroidism due to Graves' disease and no previous thyroid
      surgery were treated with radioiodine, following the same protocol. Early after
      treatment the previously operated patients showed a higher sensitivity to
      radioiodine, with more cases of early hypothyroidism than non-operated patients.
      However, after 50 months of follow-up the outcome was identical. The results
      indicate that frequent assessment is necessary after radioiodine treatment of
      patients with previous thyroid surgery, since some patients develop early
      hypothyroidism.

PMID- 8346595
TI  - [Facial erysipelas].
AB  - Facial erysipelas is quite uncommon today in Denmark. However, as the disease may
      be fatal without the proper treatment, the necessity for definite diagnosis is
      stressed on the basis of a case.

PMID- 8346594
TI  - [Diaphragm-like strictures of the small intestine after treatment with non
      steroidal anti-inflammatory agents].
AB  - Although final proof of a causal relationship is missing, it is believed that
      NSAID-induced lesions in the distal gut are common. We present a case where nine
      years of NSAID treatment appears to have caused characteristic, membrane-like
      strictures of the small intestine, and give a brief discussion of the possible
      pathogenetic mechanisms.

PMID- 8346596
TI  - [Back pain in abdominal aortic aneurysm].
AB  - Back pain is a typical symptom of abdominal aortic aneurysm. Symptoms of root
      compression may also be present if the aneurysm has caused changes to the
      vertebral column. A typical case is presented. The condition is life-threatening
      and requires vascular reconstruction.

PMID- 8346598
TI  - [Antidepressive therapy].

PMID- 8346597
TI  - [Purulent arthritis after blockade treatment].
AB  - Injections of local anaesthetics with or without steroids are widespread in the
      treatment of muscular pain. Occasionally, however, they are followed by serious
      bacterial infections. Three cases of septic arthritis, one localised to the hip,
      one to the knee and one to the sacroiliac joint are presented. One should offer
      great consideration to the possible complications following injections into or
      near joints.

PMID- 8346599
TI  - [Perinatal autopsy of stillborn infants].

PMID- 8346600
TI  - Doppler color flow images of iliofemoral graft end-to-side distal anastomotic
      models.
AB  - Hemodynamics within the distal anastomoses of iliofemoral bypass grafts were
      simulated using Plexiglas models (2.5 cm ID) within a pulsatile flow loop system
      (Re(mean) = 92, Re(peak) = 459 and alpha = 3.56). End-to-side distal anastomoses
      were constructed with angles of 30 degrees, 45 degrees and 60 degrees to bypass
      proximal artery segments with stenoses of 60% and 100% diameter reduction.
      Velocities were obtained over a two-dimensional field within the artery using an
      ultrasonic Doppler color flow imager operating at 5 MHz at positions from 1.5
      diameters upstream to 3 diameters downstream of the anastomosis. Flow patterns
      downstream of an occlusion demonstrated definite skewing effects toward the outer
      wall with resultant flow separation along the inner wall. Presence of a partial
      (60% diameter reduction) arterial stenosis upstream of the anastomosis produced
      flow separation along both artery walls and a more symmetric profile downstream.
      Measurement of a separation area index (SAI) along each arterial wall
      demonstrated a minimum area exposed to low velocities for the 30 degrees
      anastomotic angle compared to the 45 degrees and 60 degrees anastomotic angles
      and for the occluded proximal artery cases compared to corresponding stenotic
      artery cases. The SAI values were minimal at peak systole compared to successive
      quarter cycle intervals. The findings of this study provide further information
      regarding the relationship between local fluid mechanics and predominant sites
      for intimal hyperplasia formation.

PMID- 8346601
TI  - Doppler quantification of echo-contrast injections in vivo.
AB  - It is difficult to quantify myocardial perfusion using contrast echocardiography
      because the echogenicity of injected contrast is unknown. We propose that a
      measurement of Doppler amplitude from blood in a systemic artery during the
      passage of contrast could define the needed input function. Time-amplitude curves
      from pulsed Doppler cuffs on coronary and carotid arteries of 7 dogs were
      analyzed during aortic root and left atrial injections of Albunex. We found in
      individual animals that the areas under the Doppler time-amplitude curves were
      correlated to the amount of Albunex injected (R = 0.87-0.99), inversely
      correlated to cardiac output (R = 0.83), and uncorrelated to coronary flow (R =
      0.18). Due to better mixing, the coronary and carotid response areas correlated
      better for left atrial injections (R = 0.96) than for aortic root injections (R =
      0.56). We conclude that Doppler amplitude detection can be used to quantify the
      passage of echo-contrast agents, that the measurements comply with indicator
      dilution principles, and that systemic measurements in the carotid artery could
      be used to predict the coronary input function for injection sites with good
      systemic mixing.

PMID- 8346602
TI  - Quantification of transpulmonary echocontrast effects.
AB  - Videodensity of left heart and right heart were studied after intravenous
      injection of increasing dosages of 0.01-0.02 and 0.04 mL/kg bodyweight of Albunex
      in 10 healthy volunteers. The increase in videodensity in the left ventricle was
      always lower than in the right ventricle. Possible explanations are diffusion of
      gases caused by ambient pressures changes and change in microspheres distribution
      due to the sieving effect of the lung capillary bed. These phenomena were studied
      in vitro and were consistent with clinical observations. These limitations
      restrict a quantitative assessment of left heart echocontrast after intravenous
      injection.

PMID- 8346603
TI  - Quantitative echo contrast concentration measurement by Doppler sonography.
AB  - The hypothesis investigated in this study is that Doppler ultrasound can be used
      to make quantitative echo contrast concentration measurements in flow systems.
      Our motivation was to demonstrate the utility and some of the pitfalls of using
      scattered ultrasound intensity to quantify echo contrast in chambers and vessels.
      Doppler ultrasound was used rather than conventional imaging techniques because
      of its natural association with the assessment of flow in chambers and vessels.
      We compared the intensity of audio Doppler to various steady-state concentrations
      echo contrast in a carefully controlled in vitro flow system. A total of 62
      paired audio Doppler intensity and echo contrast concentration measurements were
      made. A weak positive correlation was found between the absolute echo contrast
      concentration and audio Doppler intensity (r = 0.510, p = 0.001). The correlation
      was weak because of the many unknowns and effervescent nature of microbubble echo
      contrast agents. However, audio Doppler intensity was shown to correlate strongly
      with the relative concentration of echo contrast over short time periods (r =
      0.958, p = 0.0001). The results show that Doppler intensity can be used to
      quantitatively measure the relative, but not the absolute concentration of echo
      contrast in in vitro flow systems.

PMID- 8346604
TI  - Ultrasonic tissue characterization of experimental venous intimal hyperplasia.
AB  - Ultrasonic tissue characterization (UTC) employing slope and Y-intercept
      parameters from the normalized power spectrum of backscattered echoes was
      employed in vivo to study compositional changes in the walls of pig jugular veins
      in which thrombi were experimentally induced. Light microscopy revealed these
      changes to be intimal hyperplasia with an early predominance of smooth muscle
      cells and a later mixture of smooth muscle cells and collagen deposits. UTC
      distinguished intimal hyperplasia from previously reported data from luminal
      thrombosis UTC. Furthermore, UTC was able to discriminate between early
      (predominantly smooth muscle cells) and older (smooth muscle cells plus collagen
      deposits) intimal hyperplasia. The study suggests that intimal hyperplasia in the
      experimental model used may be organized thrombus and that UTC may be able to
      follow both the development of wall changes as well as luminal changes occurring
      in venous thrombosis.

PMID- 8346605
TI  - Experimentally induced changes in heart rate alter umbilicoplacental hemodynamics
      in fetal sheep.
AB  - In the anesthetized sheep fetus, we have accelerated heart rate by atrial pacing
      (n = 6) or caused decelerations by stimulating the vagus nerve (n = 7).
      Alterations in heart rate were linearly related to changes in the ratio of the
      diastolic minimum (D) to systolic maximum (S) of flow and velocity, and to
      changes in the flow pulsatility index in the umbilical artery. Decelerations
      slightly increased vascular resistance, and decreased blood flow and mean
      arterial pressure, but accelerations had no significant effect. The index of
      impedance was unaltered by either intervention. The major factor mediating the
      influence of heart rate on blood flow pulsatility in the umbilical artery was the
      aortic blood pressure pulsatility. An equation was derived to adjust flow D/S to
      a standardized heart rate. Results showed that heart rate correction can affect
      the interpretation of experimental data.

PMID- 8346606
TI  - Estimation of in situ ultrasound exposure during obstetric examinations.
AB  - Layered tissue models are developed to estimate in situ ultrasound intensity
      during common obstetric examinations by incorporation of measured overlying
      tissue thicknesses with data on the attenuation properties of tissues. Results
      are compared with attenuation models recommended by the United States Food and
      Drug Administration (FDA) and National Council on Radiation Protection and
      Measurements (NCRP). For abdominal and transvaginal scanning in the first
      trimester, fixed attenuation models based on attenuation values of 1.2 dB/MHz and
      0.6 dB/MHz, respectively, are representative of worst-case exposure conditions.
      For second and third trimesters, a fixed attenuation value of 0.8 dB/MHz is
      representative of worst-case exposure conditions. A fixed attenuation value of
      1.0 dB/MHz is suggested for common Doppler examinations. The study suggests that
      the FDA-derating factor of 0.3 dB/cm.MHz may not give a conservative estimate of
      in situ intensity for certain obstetric examinations.

PMID- 8346607
TI  - Transient acoustic cavitation in gallstone fragmentation: a study of gallstones
      fragmented in vivo.
AB  - The mechanism of gallstone fragmentation by shock waves in vivo is uncertain. We
      used scanning electron microscopy to study 9 partially fragmented stones obtained
      from 6 patients who underwent lithotripsy and subsequently had surgery because of
      incomplete fragmentation. Surface characteristics of the stone were studied using
      scanning electron microscopy and compared to gallstones fragmented in degassed
      water in vitro and to control stones obtained from patients with uncomplicated
      cholelithiasis. Characteristic damage caused by transient acoustic cavitation was
      visible in all stones fragmented in vivo and in vitro as pits 10-100 microns
      diameter. In these pits, cholesterol crystals were fractured, and the symmetry of
      crystal boundaries was damaged. In areas of more severe damage, individual pits
      coalesced to form craters on the stone surface. High magnification of the pit
      walls revealed cracks, which in some instances radiated out onto the unpitted
      surface of the stone. We conclude that transient acoustic cavitation plays a role
      in gallstone fragmentation in vivo through the mechanism of surface pitting and
      the formation of cracks that radiate outward from the surface pits. Measures to
      enhance cavitation may improve the results of gallstone lithotripsy.

PMID- 8346608
TI  - Ultrasonic gas body activation in Elodea leaves and the mechanical index.
AB  - Membrane damage resulting from ultrasonic gas body activation was investigated in
      leaves of the aquatic plant Elodea using pulse-mode exposures from 0.745-15 MHz.
      The frequency response was similar to that previously observed for continuous
      exposures. Cell death thresholds were higher for the pulse modes; for example, at
      6 MHz the threshold was 166 W/cm2 spatial-peak, pulse-average (SPPA) intensity
      for 1 microsecond pulses and 1 kHz pulse repetition frequency (PRF) for 60 s
      exposures, compared to 12 W/cm2 for 60 ms continuous exposure. Increasing the PRF
      for 2.5 MHz, 3 microseconds pulses from 10 Hz to 5 kHz resulted in a gradual
      decrease in the threshold. Increasing the pulse duration from 1 microsecond to 30
      microseconds and PRF from 33 Hz to 1 kHz only weakly influenced the threshold,
      for the constant 60 ms total on-time. Decreasing the pulse duration for single 6
      MHz pulses increased the threshold up to 1,540 W/cm2 at 30 microseconds. The gas
      body activity was modeled with linear theory for oscillation of the gas channel
      walls, and intracellular shear stress, which causes lethal damage to the plasma
      membranes, was modeled with theory for acoustic microstreaming. Theory and
      observation indicate that the minimum shear stress threshold as a function of
      resonance frequency has essentially the same form as the Mechanical Index (MI) in
      the 0.5 to 20 MHz range. Specifically, for 3 microseconds pulses with 0.2-2 kHz
      PRF and 60 ms total on-time, the pressure-amplitude threshold divided by the
      square root of the frequency was approximately constant at 0.95 MPa/MHz1/2.

PMID- 8346609
TI  - An efficient computer model of three-dimensional speckle patterns in dynamically
      focused annular array.
AB  - This paper describes an efficient computer method for generating three
      dimensional (3-D) ultrasonic speckle patterns for sector scans of an annular
      array with dynamic focusing in both transmit and receive. Assuming random
      scatterers in an attenuating medium, the system synthesizes the waveform for each
      scan line using echo data received at all annular elements of the transducer when
      short pulses are transmitted by one annulus after another. The amount of echo
      data needed to synthesize one waveform is tremendously reduced by reducing the 3
      D distributions of scatterers to line distributions and by representing
      scatterers on a small line segment by a single equivalent scatterer taking into
      account the two-way travel time differences. Furthermore, by a judicious 3-D
      arrangement of the scatterer lines and scan lines, it is possible to synthesize
      the waveform for a new scan line with negligible computation overhead. The
      waveforms of the scan lines are detected to obtain a B-mode image or speckle
      patterns. The patterns obtained on several differently-oriented image planes
      showed a good statistical agreement with experimentally obtained patterns.

PMID- 8346610
TI  - Deconvolution of in-vivo ultrasound B-mode images.
AB  - An algorithm for deconvolution of medical ultrasound images is presented. The
      procedure involves estimation of the basic one-dimensional ultrasound pulse,
      determining the ratio of the covariance of the noise to the covariance of the
      reflection signal, and finally deconvolution of the rf signal from the
      transducer. Using pulse and covariance estimators makes the approach self
      calibrating, as all parameters for the procedure are estimated from the patient
      under investigation. An example of use on a clinical, in-vivo image is given. A 2
      x 2 cm region of the portal vein in a liver is deconvolved. An increase in axial
      resolution by a factor of 2.4 is obtained. The procedure can also be applied to
      whole images, when it is ensured that the rf signal is properly measured. A
      method for doing that is outlined.

PMID- 8346611
TI  - Producing deep depth of field and depth-independent resolution in NDE with
      limited diffraction beams.
AB  - Limited diffraction beams, such as Durnin's J0 Bessel beam, are a class of
      nonspreading solutions to the isotropic/homogeneous scalar wave equation. These
      beams can be approximately produced with finite aperture and energy over a deep
      depth of field. In this paper, we report the application of a broadband J0 Bessel
      beam to nondestructive evaluation (NDE) of materials. Pulse-echo images of a
      stainless steel block phantom were obtained with both the J0 Bessel beam and a
      conventional focused Gaussian beam. Results show that uniformly high resolutions
      were obtained with the J0 Bessel beam over a large distance. In addition, the
      lateral resolution of the J0 Bessel beam is almost independent of the speed of
      sound of the materials inspected. In contrast, the lateral resolution of images
      obtained with the conventional focused Gaussian beam changes dramatically with
      the distance and the focal length of the beam in water is greatly reduced by the
      steel block. Therefore, limited diffraction beams could be useful for
      nondestructive evaluation of materials of different speeds of sound. Restoration
      of pulse-echo images obtained with these beams could be simplified.

PMID- 8346612
TI  - Elastography: elasticity imaging using ultrasound with application to muscle and
      breast in vivo.
AB  - Changes in tissue elasticity are generally correlated with its pathological
      state. In many cases, despite the difference in elasticity, the small size of a
      lesion or its location deep in the body preclude its detection by palpation. In
      general, such a lesion may or may not possess echogenic properties that would
      make it ultrasonically detectable. Elastography is an ultrasonic method for
      imaging the elasticity of compliant tissues. The method estimates the local
      longitudinal strain of tissue elements by ultrasonically assessing the one
      dimensional local displacements. This information can be combined with first
      order theoretical estimates of the local stress to yield a quantitative measure
      of the local elastic properties of tissue. The elasticity information is
      displayed in the form of a gray scale image called an elastogram. An experimental
      system for elastography in phantoms based on a single element transducer has been
      described previously [1]. Here we introduce a new elastography system based on a
      linear array transducer that is suitable for in vivo scanning. We describe tissue
      mimicking phantom experiments and preliminary in vivo breast and muscle
      elastograms confirming the feasibility of performing elastography in vivo. An
      elastogram of a breast containing an 8 mm palpable cancer nodule clearly shows
      the lesion. Elastograms and their corresponding sonograms show some similarities
      and differences in the depiction of tissue structures.

PMID- 8346613
TI  - Reduction of image noise in elastography.
AB  - Elastography is a method for imaging the elastic properties of compliant tissues
      which produces gray scale elasticity images called elastograms. The elastograms
      of phantoms with homogeneous elastic properties exhibit a noisy appearance. We
      demonstrate that this noisy appearance of the elastograms is due to the
      nonstationary relationship between the pre- and postcompression signals that
      results in an artifactual modulation of the strain estimates by the amplitude
      variations of the envelope of the rf signal. We have identified two methods to
      reduce the strain modulation artifact. The first method consists of reducing the
      signal amplitude swings within the observation windows by logarithmically or
      otherwise compressing the rf signal. The sensitivity of this method to amplitude
      compression strength and the ability to reduce the noise in the elastograms
      without affecting the spatial resolution are investigated through simulations.
      The second method to reduce the strain modulation artifact consists of temporal
      stretching of the signal obtained after physical compression to approximate the
      shape of the signal obtained before compression. In this paper, we discuss the
      first method. The results show that significant improvement in image noise can be
      obtained with logarithmic amplitude compression. This improvement is obtained in
      conjunction with improved spatial resolution.

PMID- 8346614
TI  - [Antagonistic activity of the rumen bacteria, Enterococcus faecium and
      Staphylococcus warneri].
AB  - The bacterial strains E. faecium and S. warneri were tested for their
      antagonistic activities, and/or for the antimicrobial spectrum of bacteriocin
      like substances produced by these bacteria. Isolates of rumen and non-rumen
      origin were used as indicator strains (Tab. I). All the isolates (except the
      strains SW48 and EF24c as indicators of rumen origin) produced bacteriocin-like
      substances inhibiting the growth of at least one of the series of the nine
      indicators used while clear inhibition zones 2-10 mm prevailed (Tabs. II, III).
      Among the enterococci, the inhibition of non-rumen indicators was more intensive
      in comparison with the indicators of rumen origin, but the inhibition zones were
      only 2-5 mm. In general, the staphylococci showed the antagonistic activity with
      the lower antimicrobial spectrum in comparison with the enterococci. None of the
      tested strains inhibited the growth of the indicator E. faecium A26. The summary
      results show that the growth of both gram-positive and gram-negative bacteria was
      inhibited. The prolonged cultivation time did not influence the antagonistic
      activity of the tested strains. In the strains EF35, SW34 and SW98, the
      antagonistic activity was maintained after trypsin treatment. But in the other
      strains, this treatment led to the loss of the antagonistic activity. The use of
      pronase P resulted in the loss of the activity in the strains SW24, EF35 and
      EF26/142. The use of pronase P did not lead to the loss of the activity in the
      other tested isolates (Tab. IV).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346615
TI  - [Long-term exposure to PCB in broiler chickens--metabolic and immunotoxic
      effects].
AB  - Even though it has been forbidden to produce and commerically use polychlorinated
      biphenyls (PCB) in this country, their stocks and contaminated refuses continue
      to be a source of danger at present. Hence prevention of environment and food
      chain contamination is being focused on, along with their monitoring in various
      commodities. In the poultry operations random contacts of poultry with PCB
      containing materials may be expected (paints, plasters, litter). In our
      experiment we investigated metabolic and immunotoxic effects of low PCB doses on
      broiler chickens. A hundred and twenty sexed straight-run chicks randomly divided
      themselves into three departments on deep litter. Cockerels had an ad libitum
      access to feeds and water, and they were reared under a continuous lighting
      regime. A feed mix BR-2 (ME 12.8 i.u., crude protein 19.9%) was used as an
      experimental diet. The experimental groups received a contaminated mix (equal
      portions of original commercial PCB preparations--Delor 103 and Delor 105
      manufactured by the firm Chemko Strazske) at doses of 5 and 50 mg/kg. Chick
      exposure to PCB lasted from the first to 42nd day of their life. Chick weight,
      relative organ weight and vitamin A and E levels in liver were determined at the
      end of the experiment (42 days). The concentrations of cholesterol,
      triglycerides, proteins, calcium and lysozyme were determined in the blood serum.
      The concentrations of antibodies to chick repeated immunization with a vaccine
      against Newcastle disease (AVIPEST) and the blood picture of chicks were also
      evaluated. Chronical PCB applications in broiler diet resulted in a significant
      decrease in the weight of broiler chicks at the age of 21 and 28 days (P < 0.01).
      The weight differences were compensated later on, and the chick weight of the
      different groups at the age of 42 days was not significantly affected by this
      treatment. Hepatitis and hydropericarditis were found in affected chicks at their
      dissection (age of 42 days). Liver weight significantly increased after
      administration of both PCB doses (P < 0.01), but the relative weight of
      lymphoreticular organs (thymus, spleen, bursa Fabricii) decreased (P < 0.05).
      There were serious metabolic disorders in the blood serum after 42-day PCB
      applications. Cholesterol and triglyceride concentrations (P < 0.01) were
      significantly increasing (P < 0.01), while the content of serum calcium
      significantly dropped (28 and 35 days of age). PCB exposed cockerels had the
      significantly lower titre of antibodies to repeated immunization against
      Newcastle disease.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8346616
TI  - [Forms of xanthine oxidoreductase in the tissues of Japanese quail].
AB  - The Japanese quail tissues--liver, kidney and pancreas were analysed for the
      presence of forms of xanthine oxidoreductase utilised cofactors NAD+, molecular
      oxygen or artificial acceptor--methylene blue, as well as for the validity of
      correlation between enzymatic activity and diet protein content. Four groups of
      animals with the experimental diets, the formulae of which are given in Tab. I,
      and control group with a commercial mash were fed for ten days. For enzyme
      preparation, the rough purification of cytoplasmic fraction with subsequent
      dialysis was used. The xanthine oxidoreductase utilised NAD+ (XOR-NAD) was
      detected in all examined tissues (Fig. 1), whereby the correlation of enzymatic
      activity with diet protein content was shown only in liver, according our
      previous findings (Jankela; 1978; Baranovska and Gazo, 1990). The values in liver
      and pancreas of animals fed a commercial mash were somewhat out of the range of
      linearity, probably because of the presence of nonprotein substances in mash,
      which affected the XOR activity in these organs (Jankela, 1992). The XOR utilised
      O2 (Fig. 2) was only detected in liver and kidney with certain activity in
      animals fed free protein diet. The percentage of this enzyme form was below 18%
      of the total activity (Fig. 5). The xanthine oxidoreductase utilised methylene
      blue (XOR-MM) was detected in liver, kidney and pancreas (Fig. 3). The
      correlation of enzymatic activity with diet protein content was linear in liver
      and kidney. The percentage of XOR-MM activity was very high, it amounted to 55%
      of the total activity (Fig. 4).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346617
TI  - [The occurrence of avian mycobacteriosis in wild birds during various epizootic
      conditions of tuberculosis in poultry].
AB  - The occurrence of tuberculosis in free-living birds was studied in relation to a
      certain epidemiological situation in a long-term study from 1966 to 1990. A total
      of 3210 birds were examined. Mycobacteria were isolated in five cases from free
      living birds in the environment of six poultry rearing farms where tuberculosis
      was found in domestic fowl. At individual localities, the occurrence of
      mycobacteria was 3.5-50.0%. Generalized tuberculosis was found in one case in
      house sparrow (Passer domesticus). On the investigated poultry rearing farms, the
      distribution of tuberculosis infection in free-living birds was directly related
      to the distribution and stage of tuberculosis in poultry or to the achieved
      extent of eradication. On a poultry rearing farm where no mycobacteria were
      isolated from free-living birds, a successful eradication of tuberculosis by
      flock exchange was in progress. During the examination of free-living birds on
      three farms, mycobacteria were found at two localities where poultry infected
      with tuberculosis was kept either on the farm or in its immediate vicinity. On
      the third farm, where no mycobacteria were found in free-living birds, only
      sporadic reactors to tuberculin were found during survey in spatially separated
      flocks. No mycobacteria were isolated from birds examined on two farms in whose
      vicinity poultry was not reared at all. Similarly, bacteriological cultures were
      negative in a group of 298 birds examined during five years in the environment of
      a poultry enterprise farm free from tuberculosis. No mycobacteria were found in a
      large group of 2303 free-living birds taken in the wild except four rooks (Corvus
      frugilegus). However, this is a migratory species which is noted for its
      considerable longevity. It is thus more probable that these birds were infected
      outside the locality which the specimens were taken from. Out of the isolated
      strains of mycobacteria that were further examined by a biological experiment,
      86.6% were pathogenic to domestic fowl, serotype M. avium 2. The results of these
      examinations suggest that the presence of tuberculosis-infected poultry as a
      major source of M. avium is necessary for the infection of free-living birds. The
      infectious agent apparently does not persist and spread within the flocks of free
      living birds.

PMID- 8346618
TI  - [Steroid dominance, enzyme activity and morphological appearance of granulosa
      cells in the largest follicles in cows].
AB  - The cyclic nature of the female reproduction process depends to a considerable
      degree on the unique capacity of ovarial follicles to change their structure and
      function. The differentiation process during folliculogenesis takes place in all
      parts of the follicle. Granulosa cells reflect a high degree of structural
      changes and play an important role in functional maturation of the inert
      follicle. Changes in the reaction to endocrine and paracrine effects from a
      unique environment that is inevitably necessary for oocyte growth and ovulation
      were reached by changes in the biochemical activity and the internal anatomic
      mutual relation of the follicle (Linder et al., 1976; Hsueh, 1976). This growth
      process and differentiation depend on gonadotropic stimulation of the follicles
      and the quantity of receptor sites able to bind them. The aim of this work was
      compare estradiol 17-beta and progesterone levels in the follicular fluid of the
      largest follicles with the morphological structure and enzymatic activity of
      membrana granulosa cells. Ovaries were obtained from 34 SS x LBS randomly chosen
      cows at the slaughter-house. Follicular fluid to estradiol 17-beta and
      progesterone level determination was obtained by aspiration of the largest
      follicles. Estradiol 17-beta and progesterone levels were determined by RIA sets
      from the URVJT (Institute of Radioecology and Use of Nuclear Techniques) in
      Kosice, type RIA-test-ESTRA (SI-125-129) and RIAA-test-Prog (SI-125-6),
      respectively. With the methods used the variation coefficient of intra- and
      interassay for the estradiol 17-beta of the RIA set were 10.1 and 13.3%, for
      progesterone of the RIA set these values were 11.4 and 13.7% respectively.
      Steroid dominance of follicles was determined by the method described by Callesen
      et al. (1986), based on the expression of the index of the mutual relation
      between progesterone levels and estradiol 17-beta was levels. Excisions from the
      follicular wall were examined under the scanning electron microscope JEOC 1200 Mx
      at an acceleration voltage of 20 kV. In granulosa cell smears acid phosphatase
      and non-specific esterase activity were determined by incubation in the
      incubation media according to Lojda et al. (1979). Steroid levels are given in
      nmol/l +/- SEM. Mean estradiol 17-beta levels in estrogen dominant follicles were
      proved to be 2170.0 +/- 1605.3 nmol/l, whereby individual concentrations ranged
      from 17.0 nmol/l to 10180.0 nmol/l.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8346619
TI  - [The effect of bentazone, an herbicide produced in Czechoslovakia, on the
      invasiveness of intestinal nematodes in sheep].
AB  - Possible anthelmintic effects of the Czechoslovak herbicide bentazone (Research
      Institute of Chemical Technology, Bratislava) on gastrointestinal tract
      strongylates of common occurrence were investigated in sheep of the Slovak Merino
      breed (housed on deep bedding and put out to grass daily) during the autumn and
      spring seasons. Our orientation to the investigation of anthelmintic effects of
      the mentioned herbicide resulted from the fact that its possible intervention in
      the energy metabolism of helminths could not be excluded, as it was indirectly
      indicated by our toxicological studies under the conditions of acute and subacute
      intoxication. Bentazone was administered at a dose of 250 mg/kg live weight in
      autumn and 500 mg/kg live weight in the spring season. It was administered per os
      as a single dose in sunflower oil. A control coprological examination on day 10
      following the administration of the herbicide in question indicates the lower
      invasiveness of sheep in comparison with findings prior to its application (Tab.
      I) in both experiments (autumn, spring). No marked dose-dependent differences of
      bentazone efficiency were recorded.

PMID- 8346620
TI  - [Levels of total lipids, cholesterol and progesterone during estrus
      synchronization and pregnancy in sheep].
AB  - Our investigations were concerned with dynamic changes in total lipids (CL),
      cholesterol (CHOL) and progesterone (P4) in blood serum of sheep in the period of
      oestrus synchronization treatment and during mating and gravidity. Our experiment
      was carried out using 10 animals housed under the conditions of productive
      rearing. Blood samples were taken from v. jugularis on day of swab application
      (day 0) and on days 3 and 7 of the action of Agelin vaginal swabs, on day of
      insemination, and on days 7, 14, 17 and in the 2nd, 3rd and 4th month of
      gravidity. Blood serum was used to determine total lipids and cholesterol by
      means of Bio-Lachema tests, and P4 concentrations employing RIA-test-Prog kits
      (URVJT, Kosice). A statistically significant decrease in concentrations of total
      lipids (Fig. 1, Tab. I) in sheep blood serum was recorded on day of insemination
      (P < 0.05) compared to day 0, with the value 1.59 +/- 0.31 g/l of serum, and in
      the 3rd month of gravidity (P < 0.01), at concentrations 1.36 +/- 0.38 g/l of
      serum. The determined decrease in their values in the mentioned period can be
      modulated by the mutually changing ratio of steroid hormones or by inhibition of
      synthesis of lipoproteins responsible for changes in total plasma lipids. Changes
      in cholesterol concentrations (Fig. 2, Tab. I) during the introduction of swabs
      were insignificant and ranged from 1.60 +/- 0.42 to 1.73 +/- 0.33 mmol/l of
      serum. An insignificant increase in cholesterol concentrations (P < 0.05), with
      its highest levels 1.98 +/- 0.43 mmol/l of serum, was recorded in the 3rd month
      of gravidity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346621
TI  - [Alkaline phosphatase during the puerperium in ewes and its relation to thyroid
      hormones and ovarian steroids].
AB  - Triacylglycerols as the sources of cholesterol, the primary precursor of steroid
      synthesis, are one of the factors that limit the speed of steroidogenesis.
      Synthesis and resynthesis of triacylglycerols depend, in addition to other
      factors, on phosphatid hydrolysis that is controlled during pregnancy by
      placentary ALP (Sumikawa et al., 1987) and the FFA pool in the systemic blood
      stream. Enzymes participating in FFA release from the fat tissue are affected by
      thyroid hormones and TSH (Mayes, 1977). In view of the above facts, this work was
      aimed at the observation of changes in alkaline phosphatase (ALP), thyroxine
      (T4), triiodothyronine (T3), 17 beta-oestradiol (E2) and progesterone (P4) levels
      and their mutual correlations in the systemic blood stream of sheep from the
      first day after parturition to day 51 p.p. Our attention was paid to the possible
      delayed effects of placentary ALP and thyroid hormones on the synthesis of
      ovarian steroids in puerperal ewes. Nine merino sheep were included in the
      experiment; they lambed in the first decade of February and were kept together
      with their lambs in a classical sheep-cot on deep litter. The animals were fed
      according to the Czechoslovak State Standard CSN 46 7070. Blood samples were
      taken from the v. jugularis from 8 to 9 o'clock a.m. 24 hs (day -1) prior to
      parturition (a.p.), 36 hs and on days 4, 7, 14, 17, 21, 25, 34, 42 and 51 after
      parturition (p.p.). As compared with day -1 (2.6 +/- 1.08 mu kat/l), ALP
      concentrations showed a decrease with minimum values occurring on day 17 (1.34 +/
      0.97 mu kat/l, P < 0.05). T4 concentrations also decreased from day -1 (59.4 +/-
      9.69 nmol/l) to day 21 (54.89 +/- 11.06 nmol/l, P < 0.05). A similar decrease
      (from 1.82 +/- 0.33 nmol/l on day 1 to 0.85 +/- 0.32 nmol/l on day 21) could also
      be observed in T3 levels. As early as 36 hs p.p., the concentrations of both
      steroid hormones, E2 and P4, significantly decreased [from 2.45 +/- 0.65 and 9.46
      +/- 0.34 nmol/l on day -1 to 0.30 +/- 0.24 and 0.05 +/- 0.08 nmol/l, respectively
      (P < 0.001)]. Throughout the period of investigation, apart from an unsubstantial
      increase in E2 values on days 17 and 42 and an episodic increase in P4 levels on
      day 34, the concentrations of both steroids had the values that were
      significantly lower than those observed on day -1.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8346622
TI  - [Anthelmintic control of multiresistant nematodes in the gastrointestinal tract
      of imported goats].
AB  - Multiple resistant strains of Ostertagia and Trichostrongylus were detected in a
      flock of cashmere and angora goats imported from New Zealand. The ED50 values
      detected by in vitro EHA test were from 0.27 to 0.36 micrograms/ml (while the
      reference value of sensitivity is 0.10 microgram/ml TBZ). Multiple resistance to
      all the types of currently used anthelmintics was confirmed by in vivo FECRT,
      when the efficacy of recommended doses was lower than 90% (albendazole 74%,
      levamisole 86%, ivermectin 83%). Two control schemes were investigated. In the
      simultaneous application of anthelmintics in the double or triple of recommended
      doses (0.4 mg/kg ivermectin s.c., 30 mg/kg levamisole and 20 mg/kg albendazole
      p.o.) was effective. Examination of goats 7 and 8 months after treatment revealed
      the repeated presence of multiple resistant gastrointestinal nematodes. It is the
      first published case of intercontinental transfer of resistant strains of
      nematodes when importing small ruminants.

PMID- 8346623
TI  - [Virologic detection of arboviruses in greater cormorants].
AB  - Cormorants (Phalacrocorax carbo, Pelecaniformes) caught in southern Moravia
      (Czech Republic) in 1989-1990 were examined for arbovirus infections. Isolation
      experiments were carried out using blood samples of 56 birds. The results were
      negative. Serological examinations of 31 birds were performed by
      haemagglutination-inhibition test (HIT) using 5 arboviral antigens of the genera
      Alphavirus (Sindbis--SIN) and Flavivirus (tick-borne encephalitis--TBE, West Nile
      -WN) and of the family Bunyaviridae (Tahyna--TAH, Calovo--CVO). Antibodies were
      detected only to viruses SIN, WN and TAH at different frequencies: 9.7%, 9.7% and
      22.6%. The titres ranged from 1:20 to 1:80.

PMID- 8346624
TI  - [The first finding of Giardia spp. in roebucks (Capreolus capreolus L.)].
AB  - Roe deer (Capreolus capreolus L.) is a representative of the new host of an
      intestinal flagellate of the genus Giardia. Giardia spp. was found during autopsy
      in three dead head of roe deer (roe deer calf 7-8 months, doe, buck) sent for
      examination to the State Veterinary Institute, Praha, from three different
      localities of the Czech Republik. Localization of the Giardia spp. was studied in
      the intestinal tract of the roe deer calf in native preparations in the
      intestinal contents and in the smears of intestinal mucosa stained after Giemsa
      (at a distance of 30-40 cm along the whole length of the small intestine).
      Giardia trophozoites were found in the small intestine in the section of 280-770
      cm from the caudal part of duodenum. The trophozoites occurred most intensively
      within the section of 350-420 cm. The trophozoites showed active, motility in
      this part of the small intestine as late as in more than 48 hours after the death
      of the row calf. Their size (obtained by measuring 30 trophozoites) was from 12.4
      16.2 to 8-11.5 microns with the mean of 14.5 to 9.4 microns. In the contents of
      the caeca and colons of all three animals after death numerous Giardia cysts were
      found, in the caecum of the roe calf trophozoites were detected rarely. Most of
      the cysts were of ovoid shape. Their size, by measuring 50 cysts from each of the
      animals, was from 11.2-14.4 to 8-10.4 microns with the mean of 13.3 x 9.1
      microns. Sporadically, nearly spherical cysts occurred (12.8-13.6 to 9.6-10.4
      microns).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346625
TI  - Special issue: Environmental impact of avermectin usage in livestock.

PMID- 8346626
TI  - Environmental effects of the usage of avermectins in livestock.
AB  - Abamectin (avermectin B1) and ivermectin (22,23-dihydroavermectin B1) are high
      molecular weight hydrophobic compounds, active against a variety of animal
      parasites and insects. Numerous environmental fate and effects studies have been
      carried out in the development of these two compounds as antiparasitic agents and
      for abamectin as a crop protection chemical. They were found to be immobile in
      soil (Koc > or = 4000), rapidly photodegraded in water (degradation half-life
      (t1/2) in the summer 0.5 days or less) and as thin films on surfaces (t1/2 < 1
      day), and aerobically degraded in soil (ivermectin in soil/feces mixtures (t1/2)
      = 7-14 days; avermectin B1a in soils, t1/2 = 2-8 weeks) to less bioactive
      compounds. Abamectin is not taken up from the soil by plants, nor is it
      bioconcentrated by fish (calculated steady-state bioconcentration factor of 52,
      with rapid depuration). Daphnia magna is the fresh water species found to be most
      sensitive to ivermectin and abamectin (LC50 values of 0.025 and 0.34 ppb
      respectively); fish (e.g. rainbow trout) are much less sensitive to these
      compounds (LC50 values of 3.0 ppb and 3.2 ppb, respectively). In the presence of
      sediment, toxicity toward Daphnia is significantly reduced. The metabolism and
      degradation of ivermectin and abamectin result in reduced toxicity to Daphnia.
      Abamectin and ivermectin possess no significant antibacterial and antifungal
      activity. They display little toxicity to earthworms (LC50 values of 315 ppm and
      28 ppm in soil for ivermectin and abamectin, respectively) or avians (abamectin
      dietary LC50 values for bobwhite quail and mallard duck of 3102 ppm and 383 ppm,
      respectively), and no phytotoxicity. Residues of the avermectins in feces of
      livestock affect some dung-associated insects, especially their larval forms.
      This does not delay degradation of naturally formed cattle pats under field
      conditions; however, in some cases, delays have been observed with artificially
      formed pats. Based on usage patterns, the availability of residue-free dung and
      insect mobility, overall effects on dung-associated insects will be limited. As
      abamectin and ivermectin undergo rapid degradation in light and soil, and bind
      tightly to soil and sediment, they will not accumulate and will not undergo
      translocation in the environment, minimizing any environmental impact on non
      target organisms resulting from their use.

PMID- 8346627
TI  - Effects of avermectin residues in cattle dung on dung beetle (Coleoptera:
      Scarabaeidae) reproduction and survival.
AB  - Scarabaeine dung beetles feeding on dung from cattle treated with an injection of
      avermectin at a therapeutic dose to control internal parasites, show larval
      mortality, mortality of immature adults, reduced egg production, and inhibited
      ovariole development for periods of 1-4 weeks following treatment. In winter
      rainfall regions of Australia, feeding by newly emerged adults of an introduced
      species, Onthophagus binodis, resulted in shredding of cattle dung between
      December and May. Production of brood masses and eggs resulted in dung being
      buried from September to November. Feeding by newly emerged adults of a native
      species, Onthophagus ferox, resulted in dung being buried in May and June, and
      production of brood masses for breeding resulted in dung burial between September
      and November. There are thus 2-6 months of the year when injection of cattle with
      avermectin would affect mortality of newly emerged beetles, and 3 months of the
      year when avermectin treatment of cattle would affect dung beetle oviposition or
      larval survival. Beetles were attracted to fresh dung for 2-4 days, and most had
      left the pad within a week. There are no data to indicate the effects of
      avermectin residues in dung on dung beetle populations and on beetle fitness.
      Tests should be done to determine if avermectins in slow release devices have a
      greater effect on dung beetles than injections, and to determine what effects
      both have on dung beetle populations.

PMID- 8346628
TI  - Effects of ivermectin residues in sheep dung on the development and survival of
      the bushfly, Musca vetustissima Walker and a scarabaeine dung beetle,
      Euoniticellus fulvus Goeze.
AB  - During produced by sheep for up to 1 week post-treatment (drenching) with
      ivermectin caused significant mortality to newly emerged larvae of the bushfly
      Musca vetustissima. Dung from sheep drenched with a mixture of levamisole and
      oxfendazole also resulted in larval mortality, but here the effect was limited to
      the first 48 h after treatment. Flies reared through to the adult stage on dung
      collected up to 32 days post-drenching were tested for evidence of fluctuating
      asymmetry, which is an indicator of developmental stress. None was found for
      either drench treatment, although there was evidence that ivermectin residues
      directly affected wing size. The introduced dung beetle, Euoniticellus fulvus was
      also found to be sensitive to ivermectin residues in sheep dung. Dung produced
      during the first day after drenching caused mortality among newly emerged beetles
      and delayed the reproductive development of survivors. However, beetles in which
      ovarian development was impaired regained their reproductive capacity following
      transfer to nontoxic dung. Day 1 dung caused no mortality among sexually mature
      beetles, although there was a significant reduction in their fecundity. Dung
      collected from 2 to 10 days post-drenching had no detectable effects on either
      the survival or reproductive development of adult beetles, regardless of age.
      Residues in dung collected 1-2 days post-drenching caused 100% mortality in
      beetle larvae, but by Day 5 there was no evidence of acute toxicity. These
      findings indicate that insects feeding on the dung of ivermectin-treated sheep
      display adverse effects similar in range to those reported for cattle dung.
      However, their duration is much more transient, owing probably to differences in
      drug formulation and route of administration.

PMID- 8346629
TI  - Attractiveness of dung from ivermectin-treated cattle to Danish and afrotropical
      scarabaeid dung beetles.
AB  - The effect of ivermectin treatment of cattle on the attractiveness of dung to
      scarabaeid dung beetles was assessed by pitfall trapping in Denmark, Tanzania and
      Zimbabwe. Traps were baited with dung collected at intervals after heifers were
      treated with ivermectin by subcutaneous injection (0.2 mg kg-1 body weight). In
      one Danish trial, beetles preferred control dung from untreated cattle, whereas
      no preference was found in two other experiments. In Tanzania, the overall
      tendency for beetles was also to prefer control dung. In Zimbabwe, two species
      (Euoniticellus intermedius and Liatongus militaris) were particularly attracted
      to dung from treated cattle, whereas three others did not discriminate between
      dung types. It is concluded that at least in some cases the attractiveness of
      cattle dung to scarabaeid beetles is affected by avermectin therapy. Beetle
      discrimination between dung types is probably attributable to some unknown side
      effect of the treatment rather than being a direct response to the drug itself.

PMID- 8346630
TI  - Effects of ivermectin on two afrotropical dung beetles, Onthophagus gazella and
      Diastellopalpus quinquedens (Coleoptera: Scarabaeidae).
AB  - Subcutaneous injection of 0.2 mg kg-1 ivermectin to heifers negatively affected
      larvae of the afrotropical dung beetles, Diastellopalpus quinquedens and
      Onthophagus gazella, developing in the dung. Although closely related, the two
      species seem to differ in susceptibility; 28% of brood masses made of dung voided
      2 days after treatment contained third instar D. quinquedens, whereas O. gazella
      died as first instars in dung voided up to 8 days after treatment. Folding of the
      head capsules and lack of mandibular wear in the dead O. gazella larvae suggest
      that ivermectin could be absorbed through the integument and prevent normal
      feeding and distension of the head capsule. In addition, the surviving third
      instar O. gazella in dung voided 16 days after treatment had significantly
      reduced clypeal and mandibular widths. The dung burial activity, mainly by D.
      quinquedens, estimated in a field experiment was not affected by ivermectin
      residues in the dung.

PMID- 8346631
TI  - Some effects of ivermectin on the yellow dung fly, Scatophaga stercoraria.
AB  - Ivermectin was added to fresh cattle dung at a range of concentrations based on
      those found in faeces of livestock treated by injection. Newly hatched larvae of
      Scatophaga stercoraria were then reared in the dung as a bioassay. The EC50
      values for 24 h and 48 h larval mortalities were 0.051 ppm and 0.036 ppm (wet
      wt.) respectively. When the dung concentration was 0.015 ppm, 50% of the insects
      failed to pupariate and a level of 0.001 ppm prevented adult emergence in 50% of
      the insects. When batches of larvae were reared in dung containing as little as
      0.0005 ppm, the emerging adults showed developmental abnormalities in wing
      morphology. In addition to the significantly higher level of fluctuating
      asymmetry, 23% of the treated insects developed new veins and new cells in the
      wings. The observations are discussed in relation to previous work and attention
      is drawn to the practice of failing to observe the full impact of sublethal
      effects, which can be as serious as those of acute toxicity.

PMID- 8346632
TI  - A review of regional and temporal use of avermectins in cattle and horses
      worldwide.
AB  - Ivermectin and abamectin are two members of the group of parasiticides known as
      the avermectins; ivermectin was first registered as an injectable treatment for
      cattle in 1981. Since then, abamectin has been registered for cattle and
      ivermectin for horses. The relative popularity of the avermectins amongst farmers
      and veterinarians can be attributed to their spectrum of activity, convenience,
      wide margin of safety and the improved health and performance of stock following
      their use. Patterns of use in grazing animals apply equally to the avermectins as
      to other antiparasitics, particularly anthelmintics; these are based on a
      knowledge of epidemiology integrated with practical management considerations.
      For cattle, programs are commonly aimed at control of abomasal nematodes of the
      genera Ostertagia and Haemonchus. Use of avermectins is largely strategic in
      cattle, treatments being favored at the end of the period of transmission of
      these parasites; this frequently coincides with housing, entry into a feedlot or
      movement to another pasture. Simultaneous control of important ectoparasites at
      this time is an added benefit. Prophylactic use of avermectins at pasture is
      primarily targeted at the young first season grazing animal. In horses, a
      bimonthly treatment schedule during the period of risk has proved effective in
      helping prevent adverse effects of the main target parasites, including large and
      small strongyles and stomach bots. These patterns of use can be applied to the
      evaluation of the potential for avermectin residues in feces to have impact on
      pasture ecology. The evidence presented suggests that any effects are temporally
      and spatially limited. After more than a decade of practical use, there is no
      indication that avermectins have had a significant impact on pasture ecology and
      the environment.

PMID- 8346633
TI  - Reproductive development and survival of Lucilia cuprina Wiedemann when fed sheep
      dung containing ivermectin.
AB  - When fed dung from sheep treated with ivermectin 24 h previously, Lucilia cuprina
      adults exhibited reduced survival, delayed ovarian development and reduced egg
      production. These effects were absent in dung produced 2 or more days after
      ivermectin treatment. Such transient toxicity is ideal to restrict the evolution
      of resistance to this drug. This situation may change if the current practice of
      oral treatment is replaced by a slow-release system of administering avermectins.
      The avoidance of coincidental evolution of resistance is critical to the long
      term welfare of the Australian sheep industry as the avermectins represent an
      important, and as yet unexploited, insecticide for the treatment of flystrike
      caused by Lucilia cuprina.

PMID- 8346634
TI  - Effect of avermectin residues in sheep dung on mating of the Australian sheep
      blowfly Lucilia cuprina.
AB  - Male and female Lucilia cuprina adults were separated after emergence and then
      fed either dung excreted from sheep after an oral treatment with ivermectin
      (Ivomec) or non-treated sheep dung. Fresh dung (non-treated or ivermectin
      treated) was collected daily and fed to adults for 6 days after drenching. After
      this feeding period, males and females from each feeding treatment were paired
      and all aspects of mating behaviour recorded. Feeding on avermectin residues by
      adults had a significant effect on two components of mating: (1) males fed on
      ivermectin-treated dung directed less mating attempts at females compared with
      males fed on non-treated dung; (2) mating duration by males fed on ivermectin
      treated dung was longer compared with males fed on non-treated dung. There was no
      significant difference in the level of sexual receptivity (percentage mating)
      between females fed on either ivermectin-treated dung or non-treated dung,
      although subsequent oviposition by females fed ivermectin-treated dung was
      significantly delayed. Both female and male mortality was significantly greater
      when feeding on ivermectin-treated dung compared with non-treated dung. The
      effects on mating, when coupled with the deleterious effects on ovarian
      development and adult mortality, demonstrate the potential for avermectin usage
      in a control strategy against L. cuprina.

PMID- 8346635
TI  - The degradation of dung produced by cattle treated with an ivermectin slow
      release bolus.
AB  - Eight female calves of the Deutsches Fleckvieh breed, weighing 161-207 kg, were
      each treated at turnout on 16 May 1989 with one ivermectin sustained-release
      intraruminal bolus designed to release ivermectin at 12 mg day-1 for
      approximately 120 days. Eight animals remained as untreated controls. A third
      group of eight unmedicated tracer calves was not considered as part of this
      evaluation. All 24 animals grazed together on a single pasture throughout the
      study. On Days 21/22, 70 and 119, 15 faecal pats were selected from each
      treatment group and ranked according to surface area; within each group of three
      consecutively ranked pairs of pats, two pairs were randomly allocated as
      observation pats and the third as a sampling pat. The surface area of observation
      pats was measured, photographs taken, and dry matter, crude ash and organic
      matter determined at various intervals following deposition. A 1/4 sample
      collected from sampling pats 3, 7, 14 and 28 days after deposition was weighed
      and examined for Coleoptera (adults and larvae), Diptera larvae and nematodes. No
      differences between groups were seen in respect of organic matter content,
      numbers or frequency of adult Coleoptera species and soil nematodes. A decrease
      in numbers of Coleoptera larvae, Diptera larvae and dung-specific nematodes was
      observed in pats from ivermectin-treated cattle. Based on the evaluation of the
      surface area, a delay in the degradation rate of pats from treated compared with
      those from untreated animals was seen; however, the difference was statistically
      not significant (P > 0.05).

PMID- 8346636
TI  - Dung dispersal and grazing area following treatment of horses with a single dose
      of ivermectin.
AB  - Environmental consequences of treating horses with recommended dosages of
      ivermectin paste were studied in two controlled experiments with 29 horses in
      Ohio. In 1988, dung dispersal rates were measured by changes in dry weight over
      time of 48 copromes (300 g) formed from feces taken from four treatment and four
      control horses 3 days post ivermectin treatment. There was delayed dispersal of
      copromes from horses treated with ivermectin in June, resulting in significantly
      heavier ivermectin copromes compared with those of control horses by September.
      There was no difference in ivermectin or control copromes after treatment in
      August. In 1989, the effects of treating horses with oral ivermectin or
      oxibendazole compared with untreated controls were quantified in a study with 21
      horses under natural grazing conditions after treatment on 7 June. Sequential
      measurements of dung pat circumferences from 20 June 1989 to 7 March 1990 showed
      highly significant differences between ivermectin and control pats and between
      ivermectin and oxibendazole pats. Reductions in mean dung pat diameters did not
      occur in ivermectin pats until 11 October, when there was a 4.1% reduction
      compared with 35.1% for control pats and 37.2% for oxibendazole pats. By the end
      of the study, there was a 24.7% reduction in ivermectin pats compared with 59.1%
      and 59.9% for control and oxibendazole pats respectively. In addition, there were
      significantly more pats showing complete dispersal in oxibendazole or control
      plots than in ivermectin plots. The calculated grazing area lost to feces was
      three times greater for ivermectin plots than for oxibendazole or control plots.
      It is suggested that environmental effects of the avermectins can be reduced by
      more rational use of anthelmintics.

PMID- 8346637
TI  - Ivermectin treatment of horses: effect on the distribution of lawns and roughs in
      horse pastures.
AB  - A study was carried out to assess the feasibility of determining the grazing
      patterns of horses bimonthly via aerial survey and standard cartographic
      techniques. The grazing patterns in pastures with equivalent stocking rates of
      horses treated bimonthly with 200 micrograms of ivermectin kg-1 or 10 mg of
      oxibendazole kg-1 was assessed using aerial survey mapping performed three times
      during a grazing season. The distribution patterns of lawns and roughs in
      pastures were similar at all times during the study. Aerial survey was determined
      to be a very efficient and objective method of determining the composition of
      pastures grazed by horses.

PMID- 8346638
TI  - Soil invertebrate/micro-invertebrate interactions: disproportionate effects of
      species on food web structure and function.
AB  - The preservation of biodiversity requires an appreciation of food web structure
      and an understanding of how disturbance alters their structure and function.
      Theoretical and empirical studies of food webs demonstrate that food webs possess
      a regular structure. Food chain length appears limited to three to four
      transfers, and, complexity and diversity are constrained. When ecosystem
      energetics are considered, species within food webs are seen to form interactive
      assemblages that process matter at different rates and respond to disturbance
      differently. Disturbance may affect the diversity of a system, or, may influence
      the relative importance of one species assemblage over another. Moreover,
      predicting the impact of disturbance on a system is difficult as species that
      comprise and process a small fraction of the system's biomass may control a
      disproportionate fraction of the system's biomass and diversity. Seven food webs
      at four sites were used in a modeling exercise to demonstrate this point. Field
      studies involving the role of mycorrhizal fungi yielded results consistent with
      the modeling studies as the types of plant species present, the level of
      production and the diversity of production were related to the levels of
      mycorrhizal fungi in the soils following disturbance. The results indicate that
      all species are important to ecosystem structure and function and that the
      monitoring of ecosystems and conservation efforts should expand their emphasis to
      the preservation of ecosystem integrity as well as that of individual species.

PMID- 8346639
TI  - The potential for avermectins to affect the nutrient economy of grazed pastures.
AB  - This examination of the potential ecotoxic effects of the avermectins in
      temperature pastures grazed by sheep is based on a community approach and is
      focussed on one important aspect of ecosystem function, the nutrient cycle. Data
      on the amount and distribution of sheep dung on pastures grazed at different
      stocking rates indicated that areas of high stocking and sheep camps would be
      affected by avermectin residues to the greatest extent. Mineral losses from sheep
      dung which does not contain ivermectin, have been examined to provide a
      background against which the potential effects of avermectins on nutrient cycling
      can be appraised. The source of the diet is important; for example, dung from
      sheep grazing on improved pasture loses sulphur faster, and has higher microbial
      activity, than that of native pasture, regardless of whether it is fresh or old.
      Dung-dwelling fauna such as dung beetles and microarthropods are most abundant in
      areas of high dung concentration and microbial activity is greatest in sheep
      camps where a large quantity of excreta is voided. However, while there is
      evidence that avermectin does affect certain of the larger dung-dwelling fauna,
      little is known of its effects on the smaller invertebrate biota such as free
      living nematodes and microarthropods. Calculations for phosphorus budgets on both
      native and improved pastures indicate that the amount of phosphorus recycled in
      these systems could be reduced by up to 5% the dosage levels currently
      recommended for the drug.

PMID- 8346640
TI  - The potential for avermectins to affect wildlife.
AB  - Avermectin residues in the dung from treated livestock are detrimental to dung
      insects. Rare insects could be put at risk by the use of avermectins, especially
      those which breed exclusively in the dung of the herbivores on which avermectins
      are used. Livestock dung is an important feeding habitat for a number of
      vertebrate species. The potential for direct poisoning of vertebrates through the
      accumulation of avermectins in the body, after consumption of invertebrates
      containing residues, would, on present knowledge, appear to be limited, but
      should not be disregarded. The use of avermectins may also indirectly affect some
      species of vertebrate by depleting the quality and quantity of important food
      resources. The effects of any reduction in invertebrate food in livestock dung
      would be expected to be especially severe if it occurred at critical times for
      the vertebrates, such as during the breeding season or when newly independent
      young animals were foraging and fending for themselves. Insects that develop in
      livestock dung therefore have important, additional roles in the ecology of
      pasture-lands, other than aiding dung degradation processes. It is essential that
      these other roles are taken into account when any assessment of the environmental
      consequences of using avermectins in livestock is being made.

PMID- 8346641
TI  - Environmental assessment of avermectins by the US Food and Drug Administration.
AB  - The Center of Veterinary Medicine (CVM) of the Food and Drug Administration (FDA)
      is required under the National Environmental Policy Act (NEPA) to include in its
      decision making, an objective consideration of the potential environmental
      impacts associated with each contemplated action. As part of the application
      process for new animal drugs, detailed data must be submitted in order to develop
      a prediction of the environmental fate and effects of the drug and/or its active
      metabolites. Ivermectin (22,23-dihydroavermectin B1) is a highly active
      antiparasitic animal drug utilized in a variety of injectable, oral and topical
      formulations. Residues of this drug may reach the environment through
      manufacturing and animal wastes and may potentially have effects on terrestrial
      and aquatic organisms. A comprehensive data base has been submitted to the FDA in
      support of the environmental assessments for ivermectin drug products. Detailed
      information has been submitted on the physical and chemical properties,
      introduction, fate and effects of the ivermectins in the environment. These data
      indicate that ivermectin binds tightly to soil and is subject to photodegradation
      and biotransformation to less active compounds. In contrast, ivermectin is highly
      toxic to certain aquatic organisms but would not be expected to partition into
      the aquatic environment. Much lower toxicity has been demonstrated toward
      bacteria, fungi, earthworms, plants and birds. CVM evaluated ivermectin products
      based on the use pattern of the product, the metabolism pattern in target
      animals, calculations of potential ivermectin residue concentrations in the
      environment and data on persistence, soil sorption and acute toxicity in aquatic
      and terrestrial environments.

PMID- 8346642
TI  - Regional and temporal use of avermectins for ruminants in Australia.
AB  - The avermectin class of anthelmintics has been available for approximately 4
      years (sheep) and 7 years (cattle) in Australia. They are highly efficacious
      against a very broad spectrum of nematode parasites and certain ectoparasites of
      livestock. To date there are no field reports of resistance to these compounds in
      either the cattle or sheep industry, despite the fact that nematode parasites of
      sheep show high levels of resistance to other broad spectrum anthelmintics. The
      avermectins have gained rapid acceptance, but their share of the anthelmintic
      market is less than expected, owing to several factors such as drought and
      recession of the rural economy. Nevertheless, it can be expected that this class
      of compounds will assume greater importance, particularly in the sheep industry,
      when greater awareness of the widespread failure of alternative broad spectrum
      anthelmintics, and the value of regional worm control programs become accepted by
      producers.

PMID- 8346643
TI  - Towards sustainable nematode parasite control of livestock.
AB  - Farmers worldwide have come to expect, and rely almost exclusively on, broad
      spectrum anthelmintics to effectively control nematode parasites amongst their
      livestock. However, the threats of resistance, residues and ecotoxicity are of
      increasing concern to the future of chemotherapy. It is imperative that
      sustainable parasite control schemes be developed and implemented which will
      integrate a range of techniques to minimise anthelmintic use and still maintain
      high levels of profitability of the farming enterprise. At present, these need to
      focus on the better use of existing drugs to maximise their effectiveness and
      minimise the selection for resistance and impact on the environment. New drugs
      should also be used according to these principles. In the future it is expected
      that other non-chemotherapeutic options will become available, e.g. helminth
      vaccines, resistant hosts, biological control, nematode growth regulators, which
      will revolutionize the current thinking on nematode parasite control of
      livestock.

PMID- 8346644
TI  - Overview: the impact of avermectins on pastureland ecology.
AB  - Avermectins, a relatively new class of broad spectrum pesticides, are used widely
      to control livestock parasites. Following treatment, avermectins are eliminated
      in the livestock faeces where they also have a wide range of harmful affects upon
      certain characteristic insects that breed in dung, few of which are pests, and
      many of which are beneficial. The effects range from acute toxicity in larvae and
      adults, through disruption of metamorphosis, to interference with reproduction.
      Different methods of drug administration lead to different concentrations of drug
      residues in the faeces, which in turn influence the responses of non-target
      organisms. Higher Diptera are particularly sensitive to drug residues and show a
      wide range of responses from death of larvae to developmental abnormalities in
      the adults. Larvae and immature adults of Coleoptera show some mortality in the
      dung of recently treated animals, while delayed effects upon reproduction and
      physiology have been observed in adults feeding on dung at longer post-treatment
      times. Although the impact of lethal doses has been described in some species,
      the effects of sub-lethal doses have hardly been recognised at the present time.
      Correlated with the deleterious effect upon dung-breeding insects, a retardation
      in the rate of loss of biomass of dung pats from avermectin-treated cattle has
      been observed following the various forms of drug administration. Differences in
      methodology, inappropriate statistics, and/or extremes of climatic conditions
      prevailing at the time of testing, explain the results of those studies where
      such delays have not been observed. It is short-sighted to consider only dung
      dispersal in relation to avermectin usage, a practice that overlooks the impact
      on the insects themselves and their diverse roles in pastureland ecology.

PMID- 8346645
TI  - Biological control of nematode parasites in cattle with nematode-trapping fungi:
      a survey of Danish studies.
AB  - In Denmark two series of experiments have been performed to study the
      interactions between larvae of bovine gastrointestinal nematode parasites and
      nematode-trapping fungi. For practical reasons we were interested in the
      possibility of depositing nematode-trapping fungi in cattle faeces after passage
      through the gastrointestinal tract. In the first series, laboratory tests with
      the fungus Arthrobotrys oligospora showed that motile free-living larvae of a
      wide range of animal-parasitic nematodes and some soil-living nematodes
      effectively induce the formation of traps. Larvae of all parasitic nematodes are
      rapidly captured in these traps. The induction of nets was influenced by
      temperature, number of larvae, atmosphere, light, and media composition. Captured
      first- and second-stage larvae were quickly penetrated and killed while third
      stage larvae were killed slowly, perhaps because they are partially protected by
      an outer dead sheath. Laboratory and field studies showed that when A. oligospora
      material was directly mixed into dung a significant reduction in the number of
      infective parasite larvae in the dung and surrounding herbage occurs. This
      reduction was also reflected in the acquired worm burden of calves grazing on
      fungal treated pasture. However, the A. oligospora strain studied in the above
      mentioned experiments did not survive passage through the alimentary tract of
      cattle. This prompted us to start a second series of experiments to isolate fungi
      that could survive gut passage of cattle. Different soil and compost samples were
      screened by an in vitro stress selection technique. This simulated certain
      important stress factors which occur during passage through the alimentary tract
      of ruminants. Rumen exposure was found to be a major limiting factor, but some
      Arthrobotrys and Duddingtonia strains survived submersion in rumen fluid. In a
      subsequent in vivo experiment, some of these survivors were fed to calves, and it
      was hereby demonstrated that isolates of both genera, i.e. Arthrobotrys and
      Duddingtonia, were able to survive passage through calves and significantly
      reduce the number of developing preparasitic larvae in dung of fungal treated
      calves. In a controlled field experiment, isolates of Duddingtonia reduced the
      level of infective third-stage larvae in herbage by 74-85%.

PMID- 8346646
TI  - Control strategies for ruminant and equine parasites to counter resistance,
      encystment, and ecotoxicity in the USA.
AB  - The need for improved parasite control strategies to conserve anthelmintic
      efficacy and to avoid drug-related problems are addressed. Recent surveys have
      revealed a trend for sole dependence on ivermectin by livestock owners in the
      USA, with little regard for epidemiologic-based strategies, or the annual
      rotation of unrelated anthelmintic groups. Innovative parasite control strategies
      for cattle, sheep, and horses in northern USA are presented. The importance of
      closer monitoring and more rational use of anthelmintics is stressed.

PMID- 8346647
TI  - Research recommendations.
AB  - Delegates met on the final morning to identify areas where information is lacking
      and to highlight priority areas for future research. Five principal topics were
      discussed: veterinary usage, methodology, invertebrate populations, agricultural
      impact and integrated pest management.

PMID- 8346648
TI  - Pharmacokinetics and metabolism of avermectins in livestock.
AB  - The kinetics of avermectin disposition and metabolism in ruminant livestock and
      horses are reviewed with particular emphasis on the influence of route of
      administration and formulation on persistence of residues in tissues and
      excretion in faeces. Because information is not publicly available on other
      compounds in this class currently under development (e.g. moxidectin,
      doramectin), ivermectin only is considered. The biological half-life of
      ivermectin in plasma is similar in cattle and sheep but because of a larger
      volume of distribution, plasma clearance is more rapid in sheep. However,
      injection of the subcutaneous formulation of ivermectin prolongs plasma residence
      time and persistence of drug residues particularly in liver and fat. Increasing
      the organic solvent content of subcutaneous formulations slows the release of
      drug from the injection site and thereby prolongs its presence in the
      bloodstream. Because ivermectin and its metabolites are mainly excreted in bile,
      residues continue to appear in faeces for substantially longer following
      subcutaneous injection than after oral dosing. Aqueous based injectable
      formulations in cattle may therefore reduce the impact of ivermectin treatment on
      dung fauna. Binding of avermectins to digesta particulates during gut transit may
      potentially lower drug bioavailability and also contribute to faecal residues.
      Further research on formulation and dosage strategies is advocated to increase
      bioavailability at the gastrointestinal site of action so that both dose rate and
      faecal residues can be reduced.

PMID- 8346650
TI  - Changes with time after treatment in the concentrations of ivermectin in fresh
      cow dung and in cow pats aged in the field.
AB  - An analytical procedure for detection of ivermectin in plasma samples was
      modified and used for measuring ivermectin concentrations in dung samples. The
      residues were quantified by high-performance liquid chromatography and
      fluorescence detection after extraction, purification, and derivatization into
      fluorescent reaction products. The concentrations of ivermectin in dung were
      measured after dosing heifers with 0.2 mg kg-1 by subcutaneous injection or 0.5
      mg kg-1 by pour-on. Despite the 2.5 times higher pour-on dose, this formulation
      did not result in excretion of detectable concentrations of ivermectin over a
      longer period of time than did the injection treatment. Dung pats with ivermectin
      residues were exposed on grazing pastures until they were no longer colonised by
      flies and beetles. In the experiments performed under temperate and tropical
      conditions, the aging of the pats did not lead to a significant lowering of the
      concentrations of ivermectin. Flies or beetles colonising the pats some time
      after deposition may therefore not be exposed to decreased levels of ivermectin.

PMID- 8346649
TI  - Chemical assay of avermectins by high performance liquid chromatography with
      fluorescence detection.
AB  - Chemical methods for determining the concentrations of the avermectins in feeds,
      dosage forms, and biological samples are reviewed. The earliest methods for
      measuring the avermectins made use of the intense ultraviolet absorption due to
      the conjugated diene (olefinic bonds between carbons 8 and 9 and carbons 9 and
      10) that has an ultraviolet absorption maximum at 245 nm and a molar absorptivity
      of over 30,000 l mol-cm-1. High performance liquid chromatographic (HPLC)
      separation of the avermectins and photometric measurement of their absorption at
      245 nm has permitted the determination of plasma or serum concentrations to
      approximately 10 ng ml-1. Increased sensitivity of detection has been achieved by
      dehydration of the dihydroxycyclohexene ring of the avermectins in the presence
      of various catalysts that produces an intensely fluorescent derivative with an
      absorption maximum at 365 nm and emission maximum at 475 nm. These derivatives
      have been separated by HPLC and detected by fluorescence detectors at
      concentrations less than 1.0 ng ml-1 of plasma or serum. Recent improvements in
      the use of more efficient catalysts to effect the dehydration have reduced
      analysis time and decreased the formation of by-products, thereby improving the
      performance of these methods. A method based on HPLC with fluorescence detection
      of the dehydrated derivative was developed to determine ivermectin in horse dung
      after oral ivermectin doses of 200 micrograms kg-1 of body weight. Ivermectin
      concentrations greater than 0.05 microgram g-1 of wet feces were detectable for 1
      2 days after dosing.

PMID- 8346651
TI  - Assessment of disturbance on soil ecosystems.
AB  - Given the complexity of ecosystems, the high degree of interactions among
      species, and the numerous responses of systems to disturbance, it is unlikely
      that simple assays developed for other systems would adequately serve to monitor
      soil systems. Apart from the questionable applicability of non-soil techniques,
      protocols to monitor soil biota in a standardized manner have not been developed.
      To monitor soils, a five-phase plan is proposed. The plan involves: (1) a
      thorough survey of the systems biota; (2) laboratory toxicity trials on indicator
      species (Folsomia candida); (3) field tests on indicator processes (litter
      decomposition); (4) field monitoring of indicator functional groups (nematodes);
      (5) the development of standardized statistical techniques and simulation models.
      Each phase of the plan was designed to capture a different aspect of food web
      structure and function.

PMID- 8346652
TI  - Methods for assessing the impact of avermectins on the decomposer community of
      sheep pastures.
AB  - This paper outlines methods which can be used in the field assessment of
      potentially toxic chemicals such as the avermectins. The procedures focus on
      measuring the effects of the drug on decomposer organisms and the nutrient
      cycling process in pastures grazed by sheep. Measurements of decomposer activity
      are described along with methods for determining dry and organic matter loss and
      mineral loss from dung to the underlying soil. Sampling methods for both micro-
      and macro-invertebrates are discussed along with determination of the percentage
      infection of plant roots with vesicular-arbuscular mycorrhizal fungi. An
      integrated sampling unit for assessing the ecotoxicity of ivermectin in pastures
      grazed by sheep is presented.

PMID- 8346653
TI  - Importance of methodology in the interpretation of factors affecting degradation
      of dung.
AB  - Many factors affect dung degradation and colonization, including the location,
      composition, moisture content, weight, surface area and organic matter content of
      dung pats. Because of the number and variability of these factors, methodology
      plays a major role in studies using the dung pat as an experimental unit. For
      results of such studies to be meaningful, conditions should be standardized as
      much as possible and the sampling technique should be systematic and consistent.
      This paper reports the results of experiments or trials which pay particular
      attention to aspects of methodology.

PMID- 8346654
TI  - The strategy for treatment of helminth infections in domestic ruminants.

PMID- 8346655
TI  - [In memory of Professor Bronislaw M. Honigberg].

PMID- 8346656
TI  - [Coccidiosis of rabbits and its control].
AB  - The investigations were performed on 6 farm rabbitries in Wroclaw district.
      Average extensiveness of coccidia infection was 95%, while intensity ranged from
      50 to 408,700 ocysts/g of faeces. Nine species of coccidia were identified.
      Eimeria perforans (84.5%) and E. stiedai (73.2%) dominated, E. coecicola was
      noticed most seldom (20.7%). In young rabbits up to 3 months of life the
      infections were caused by 5-9 species of coccidia. However, in animals from
      breeding herd there prevailed infections caused by 1-3 species. Congeneric
      infections were stated very rarely, i.e. in 5.7% of infected animals only.
      Dynamic changes in the intensity of coccidia infections in rabbits in the course
      of one year breeding cycle on one of the farms demonstrated the occurrence of two
      peaks in females used for reproduction: the first one in the perinatal period and
      the second one in the period preceding weaning. The letter one, higher than the
      first one, was caused by keeping young rabbits with mothers for 8-10 weeks. The
      studies on the effectiveness of anticoccidial drugs were carried out on
      California White rabbits (age 5-7 weeks), infected naturally with 9 species of
      coccidia. Rabbits were given for 5 weeks the following anticoccidials: lasalocid
      (Avatec), maduramycin (Cygro), robenidine (Cycostat), salinomycin (Sacox),
      monensin (Elancoban), clopidol + methylbenzoquate (Lerbek) and narasin
      (Monteban). The best results were obtained with salinomycin at the dosages of 35,
      50, 25 ppm and maduramycin at 2 and 3 ppm. Equally effective, but characterized
      by lower production indices, were: clopidol + methylbenzoquate (216.7 ppm),
      lasalocid (90, 125 ppm) and monensin (20 ppm). Robenidine was very effective
      against intestinal coccidia at the dose of 66 ppm, however it had weak effect on
      E. stiedai's infection. Narasin and maduramycin (4.5 ppm) had toxic effect on
      animals. A field trial (anticoccidials applied for 6 weeks in does and their
      progeny) confirmed high effectiveness of salinomycin (25 ppm), maduramycin (1.5
      ppm) and monensin (20 ppm).

PMID- 8346657
TI  - [Histochemical estimation of lipid amounts in cells of the hepato-pancreatic
      gland of Lymnaea stagnalis (L.) (Gastropoda, Pulmonata) naturally infected with
      digenetic larvae].
AB  - Acid and neutral lipids in epithelial cells building tubules of the digestive
      gland of snails naturally infected with digenetic larvae were stained with nil
      blue sulphate. Strong decrease in number of phospholipids granules in secretory
      cells, as well as in calcium cells in the infected glands was observed. The
      larvae caused also decrease of number of neutral lipids in both types of cells,
      but these changes were much smaller and did not refer to small granules laying in
      top parts of the epithelial cells. Changes in number of lipids granules were
      limited only to the cells of tubules damaged by parasites.

PMID- 8346659
TI  - [Bird trematodes of lower Silesia. IV. Specimens from the genus Mosesia
      (Pleurogenidae, Trematoda)--new element of parasitic-fauna passeriform birds from
      lower Silesia].
AB  - Illustrated descriptions of Mosesia pavlovskii, M. sittae and M. microsoma have
      been presented. These species have been described for the first time in Poland,
      and two of them--M. sittae and M. microsoma--have not been know in Europe until
      now. Motacilla flava, Turdus philomelos and T. merula are new hosts of these
      trematodes. M. sittae has been recognized as an autochthonous species--completing
      its life cycle in the climatic conditions of Lower Silesia. As for the other two
      species, the author supposes that their invasion has been connected with the
      birds' migrations or wintering.

PMID- 8346658
TI  - [Processes connected with hatching of larvae from eggs of parasitic nematodes].
AB  - Influence of such factors as temperature, pH, CO2 level and oxidation- reduction
      potential value in the alimentary tract of host on the stimulation of invasive
      eggs was studied. Changes of these factors lead to change in permeability of
      inner layer of egg-shell. Then the hatching fluid is released and its enzymes
      digest the egg-shell. In the nematodes, which have the free-living larvae, the
      initiation process can depend on parasite or environmental agents.

PMID- 8346660
TI  - [Fecunditiy and reproductive activity of Argas (A.) reflexus (Fabricius, 1794)
      (Acari: Ixodida: Argasidae) under laboratory conditions].
AB  - Fecundity and reproductive activity of 179 females of Argas (A.) reflexus in
      laboratory conditions, i.e. at temperature 23 +/- 1 degree C and 75% of relative
      humidity were observed. Under these conditions reproduction activity of females
      fed in spring lasted since March till August. However, most of females (63.0
      91.8%) laid eggs in June and July. Disturbances in egg-laying process of Argas
      (A.) reflexus females fed in abnormal time, i.e., in autumn and kept in
      laboratory conditions, were stated. These females were active since December till
      July (maximum activity was observed in February-34.3% and March-40.0%). Pre
      oviposition and oviposition periods were observed in this study, too.

PMID- 8346661
TI  - Canestriniid mites (Acari, Astigmata, Canestriniidae) occurring on chrysomelidae
      (Insecta, Coleoptera) in neotropical region. II. Genera Ovarrothiana n. gen.,
      Ennodithiana n. gen.
AB  - Two genera Ovarrothiana, Ennodithiana and 10 species are described as new:
      Ovarrothiana nikodemi from Peru, Brazil, O. erazmi from French Guiana, Brazil, O.
      ozannae from Peru, Brazil, Ecuador, O. ludomiri and O. leopoldi from Bolivia,
      Ennodithiana messalinae from Costa Rica, Cuba, E. maniusi from Brazil, Mexico, E.
      penelopae from Surinam, Brazil, E. medoni and E. megesi from Brazil.

PMID- 8346662
TI  - Responses of immune sheep to challenge and the periparturient egg rise.

PMID- 8346663
TI  - Haemonchus contortus: a challenging parasite from immunological point of view.

PMID- 8346664
TI  - Exchangeable body potassium as an in vivo indicator of changes in body
      composition of calves exposed to natural infection with gastrointestinal
      nematodes.

PMID- 8346666
TI  - Immunosuppression during infections with adult tapeworms.

PMID- 8346665
TI  - Effect of diet in immunity and local immune responses of rabbits to Obeliscoides
      cuniculi.

PMID- 8346667
TI  - The epidemiological situation of parasite infections in wild ruminants.

PMID- 8346668
TI  - The epidemiological situation of gastrointestinal nematode infections in domestic
      ruminants.

PMID- 8346669
TI  - The sequence of hepatitis E virus isolated directly from a single source during
      an outbreak in China.
AB  - In this study an IgM antibody-mediated antigen-capture procedure for direct
      extraction of hepatitis E virus (HEV) RNA from clinical specimens was developed
      and used with an efficient method for generating viral cDNA that was subsequently
      sequenced using the dideoxy chain termination method. This is the first time the
      complete HEV genome has been isolated directly from a single human clinical
      specimen obtained during an outbreak of enterically transmitted non-A, non-B
      hepatitis. When the Chinese-derived sequence was compared with the original
      isolate of Burmese HEV from an experimentally infected cynomolgus macaque, the
      homology between the two sequences was 94% and 98.5% at the nucleotide and amino
      acid levels, respectively. The methods we developed for generating and sequencing
      genomic HEV cDNA dramatically improved the efficiency of cloning the viral genome
      and should be helpful for continued analysis of this virus as well as other RNA
      viruses that have proven to be difficult to clone and sequence directly.

PMID- 8346670
TI  - The gene encoding the late nonstructural 36K protein of vaccinia virus is
      essential for virus reproduction.
AB  - Two genetic markers--the thymidine kinase gene of herpes simplex virus, and the
      beta-galactosidase gene of Escherichia coli--were incorporated into the 36K
      protein gene (IL1 gene according to the nomenclature of the Copenhagen strain of
      vaccinia virus; Goebel et al., 1990) from the HindIII-P DNA fragment of the LIVP
      strain (variant of Lister strain) of vaccinia virus (VV). After recombination of
      the obtained integration plasmid pVZ64-TK with the VV genome (tk-), it was found
      that the resultant TK+ viruses were unstable with respect to the Lac+ phenotype.
      On the basis of hybridization of DNA fragments of selected clones, a scheme for
      the formation of hybrid viruses is proposed, and an approach to a simple
      phenotypical discrimination between essential and non-essential genes for VV
      viability is described.

PMID- 8346671
TI  - The complete nucleotide sequence of African horsesickness virus serotype 4
      (vaccine strain) segment 4, which encodes the minor core protein VP4.
AB  - The complete sequence of RNA segment 4 of African horsesickness virus serotype 4
      (AHSV-4) vaccine strain was determined from the full-length cDNA clone inserted
      into pBR322. The RNA is 1978 bp long (M(r) 1.27 x 10(6)) and contains an open
      reading frame encoding a protein of 642 amino acids (M(r) 75826) with a net
      charge of +10 at neutral pH. The 5' and 3' termini of AHSV-4 segment
      4,5'GTTTAT... and ...CCTTAC3', were different from orbivirus characteristic
      terminal sequences, being 5'GTTAAA... and ...ACTTAC3'. A comparison of the
      sequence of AHSV-4 segment 4 with that of bluetongue virus (BTV) serotype 10
      revealed 55.4% nucleotide similarity and 48.5% amino acid similarity. In
      addition, Northern blot hybridization showed that the full-length AHSV-4 segment
      4 cDNA cross-hybridized well with the corresponding genes of serotype 1, 2, 3, 4
      and 7 but slightly with serotype 5, 6 and 8 of attenuated AHSV.

PMID- 8346672
TI  - Expression of HIV-1 nef in yeast: the 27 kDa Nef protein is myristylated and
      fractionates with the nucleus.
AB  - The nef gene of human immunodeficiency virus type 1 (HIV-1) has been expressed in
      the yeast Saccharomyces cerevisiae to produce native Nef proteins. The proteins
      of M(r) 27 kDa and 25 kDa, produced by translation from the first and second
      start codons of the nef gene react with human HIV-1 antisera. Under low-level
      steady-state expression conditions, Nef27 undergoes myristylation and is targeted
      to the nuclear fraction while Nef25 is not myristylated and not nuclear
      localized. When produced rapidly and to high levels, Nef27 is initially present
      in the cytoplasm as a soluble myristylated protein that later fractionates with
      the nucleus.

PMID- 8346673
TI  - Alteration of cell population structure due to cell lysis in Saccharomyces
      cerevisiae cells overexpressing the GAL4 gene.
AB  - Transformed Saccharomyces cerevisiae cells overexpressing the Escherichia coli
      LacZ gene and the transcriptional activator GAL4, release in the external medium
      a fraction (from 2 to 10%) of the total beta-galactosidase activity (Porro et
      al., 1992b). It is known that this abnormal release of a cytoplasmic protein is
      related to a partial cell lysis of the yeast population, which is likely to be
      caused by the overexpression of the transcriptional activator GAL4. In the
      present paper we have characterized the GAL4-induced cell lysis phenomenon. The
      expression of the GAL4 gene causes morphological modifications and alteration of
      the cell size distribution. The cell lysis is independent of the expression of
      the heterologous LacZ gene and occurs in a specific subpopulation of cells (the
      parent cells) independently of the genealogical age, growth phase conditions and
      cell cycle progression. Lysis is preceded by a loss of the plasma membrane
      integrity as indicated by the uptake of ethidium bromide in unfixed cells.
      Computer analysis of simulated protein distributions indicates that cell lysis
      takes place in a sizeable aliquot (about 50%) of the parent cells, therefore
      profoundly altering the age structure of the population.

PMID- 8346674
TI  - Known heat-shock proteins are not responsible for stress-induced rapid
      degradation of ribosomal protein mRNAs in yeast.
AB  - We have previously shown that the heat-induced enhanced decay of yeast mRNAs
      encoding ribosomal proteins (rp-mRNAs) requires ongoing transcription during the
      heat treatment [Herruer et al. (1988) Nucl. Acids Res. 16, 7917]. In order to
      determine whether this requirement reflects the need for heat-shock protein
      (hsp), we analysed the effect of heat shock on rp-mRNA levels in several yeast
      strains in which each of the heat-shock genes encoding hsp26, hsp35 or hsp83 had
      been individually disrupted. In all three strains we still observed increased
      degradation of rp-mRNAs immediately after the temperature shift, demonstrating
      that hsp26, hsp35 and hsp83 are not required for this effect. Accelerated
      turnover of rp-mRNA was also found to occur upon raising the growth temperature
      of a mutant strain that contains a disruption of the gene specifying the heat
      shock transcription factor and in wild-type yeast cells treated with canavanine,
      an arginine analogue that will be incorporated into all known hsps and that is
      known to cause misfolding of the polypeptide chain. Latter observation suggests
      that enhanced rp-mRNA decay is a more general stress-related phenomenon. Taken
      together, these data strongly indicate that the trans-acting factor required for
      the increase in the rate of degradation of rp-mRNAs upon stress is not one of the
      known yeast hsps.

PMID- 8346675
TI  - Absence of cell wall chitin in Saccharomyces cerevisiae leads to resistance to
      Kluyveromyces lactis killer toxin.
AB  - Kluyveromyces lactis killer toxin causes sensitive strains of a variety of yeasts
      to arrest at the G1 stage of the cell cycle, and to lose viability. We describe
      here the isolation and characterization of a class of recessive mutations in
      Saccharomyces cerevisiae that leads to toxin resistance and a temperature
      sensitive phenotype. These mutant cells arrest growth at 37 degrees C with a
      characteristic phenotype of elongated buds. Cloning of the gene complementing
      these defects revealed it to be CAL1, coding for chitin synthase 3 activity.
      Calcofluor staining of the mutant cells indicated that chitin is absent both at
      23 degrees C and 37 degrees C. Given that the CAL1 activity is responsible for
      the synthesis of most of chitin in yeast cells, and that in its absence the cells
      are viable but resistant to the killer toxin, our results strongly suggest that
      chitin might represent the receptor for this killer toxin.

PMID- 8346676
TI  - A new promoter-probe vector for Saccharomyces cerevisiae using fungal
      glucoamylase cDNA as the reporter gene.
AB  - A system is described for the selection of DNA sequences showing promoter
      activity in the yeast Saccharomyces cerevisiae using a heterologous reporter
      enzyme which is efficiently secreted by the yeast host. A multicopy shuttle
      plasmid of the YEp-type was constructed so as to carry multiple unique cloning
      sites at the 5' end of the Aspergillus awamori glucoamylase cDNA. Glucoamylase
      can only be expressed upon insertion at one of these unique cloning sites of a
      DNA fragment from any source, provided it is endowed with promoter function in S.
      cerevisiae. As the glucoamylase signal-peptide is functional in S. cerevisiae,
      the enzyme is efficiently secreted by the yeast transformants. This phenotype can
      be very easily detected on plate assays and accurately quantified by
      spectrophotometric analysis of the culture supernatant. Since S. cerevisiae
      naturally lacks amylolytic activity, any wild-type strain can be used as a host
      in this system. To evaluate the system, a DNA pool of random fusions was created
      by ligating sau 3A digested S. cerevisiae genomic DNA to the BglII-linearized
      vector. The resulting hybrid plasmids were transformed into S. cerevisiae and
      several transformants secreting glucoamylase to varying degrees were obtained.

PMID- 8346677
TI  - Assay of trehalose with acid trehalase purified from Saccharomyces cerevisiae.
AB  - An enzymatic end-point assay of trehalose using acid trehalase from yeast is
      described. After quantitative hydrolysis of trehalose by acid trehalase, the
      resulting glucose is assayed with the commercially available glucose
      oxidase/peroxidase dye system. Pre-existing glucose is determined in a control
      reaction from which acid trehalase is omitted. When intact cells are analysed for
      trehalose, pre-existing glucose can be washed out with ice-cold water without
      reducing the trehalose content of the cells. A convenient method for extraction
      of trehalose from intact yeast cells is heating for 20 min at 95 degrees C
      followed by centrifugation. The specificity of the assay is determined by the
      specificity of the acid trehalase preparation used. As described previously
      (Mittenbuhler, K. and Holzer, H., 1988, J. Biol. Chem. 263, 8537-8543;
      Mittenbuhler, K., 1988, Thesis, University of Freiburg), the following sugars and
      sugar derivatives do not form glucose when incubated with purified acid
      trehalase: sucrose, cellobiose, mellobiose, raffinose, maltose, lactose, glucose
      6-phosphate, glucose-1-phosphate, galactose. The application of the new trehalose
      assay to yeast cells grown to different growth stages and at various temperatures
      is presented.

PMID- 8346679
TI  - Expression of the glucose oxidase gene from Aspergillus niger in Hansenula
      polymorpha and its use as a reporter gene to isolate regulatory mutations.
AB  - The glucose oxidase gene (god) from Aspergillus niger was expressed in Hansenula
      polymorpha using the methanol oxidase promoter and transcription termination
      region and the MF-alpha leader sequence from Saccharomyces cerevisiae to direct
      secretion. The expression cassette was cloned into the S. cerevisiae vector YEp13
      and used to transform H. polymorpha strain A16. In the initial transformants
      plasmid replication was unstable, but was stabilized by a growth regime
      consisting of alternating cycles of selective and non-selective growth. The
      stabilized strain was grown to high cell density by fed-batch fermentation. Upon
      induction of the MOX promoter, glucose oxidase synthesis was initiated. At the
      end of the fermentation, the culture density was 76 g dry weight/1 and 108 IU/ml
      (0.5 g/1 or 0.65% dry weight) glucose oxidase was found in the culture medium; a
      further 86 IU/ml (0.43 g/1 or 0.56% dry weight) was recovered from the cell
      lysate. A plate assay was used to monitor glucose oxidase levels in individual
      colonies. This was then used to isolate mutants which showed abnormal regulation
      of god expression or which showed an altered pattern of secretion. One mutant,
      which showed increased production of glucose oxidase, was grown to high cell
      density by fed-batch fermentation (100.6 g/l) and produced 445 IU/ml(2.25 g/l or
      2.2% dry weight) extracellularly and 76 IU/ml (0.38 g/l or 0.4% dry weight)
      intracellularly. The mutant thus not only increased total production but exported
      83% of the total enzyme made compared to 55% in the parent strain.

PMID- 8346678
TI  - Molecular analysis of HEM6 (HEM12) in Saccharomyces cerevisiae, the gene for
      uroporphyrinogen decarboxylase.
AB  - HEM6 (HEM12) in Saccharomyces cerevisiae encodes uroporphyrinogen decarboxylase,
      the fifth enzyme in the heme biosynthetic pathway. The HEM6 (HEM12) gene was
      cloned by complementation of heme auxotrophy of a hem6 mutant. Sequence analysis
      revealed an open reading frame of 1086 nucleotides. The predicted amino acid
      sequence of HEM6 (HEM12) shows extensive homology to those reported for
      uroporphyrinogen decarboxylase from mammalian sources. Expression of HEM6 (HEM12)
      was investigated and was found to increase two-fold in a non-fermentable carbon
      source. However, HEM6 (HEM12) transcription was unaffected by heme or by
      intermediates in the heme biosynthetic pathway. In addition, HEM6 (HEM12)
      expression is not regulated by the transcriptional activator complex HAP2-3-4, as
      has been shown for some genes encoding heme biosynthetic enzymes.

PMID- 8346680
TI  - Purification and characterization of aminopeptidase yspI from Schizosaccharomyces
      pombe.
AB  - Aminopeptidase yspI was purified to apparent homogeneity from the fission yeast
      Schizosaccharomyces pombe. The molecular mass of the native enzyme was estimated
      to be 184 kDa by gel filtration chromatography. A value of 92 kDa was calculated
      after sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The enzyme is
      thus a dimer with two identical subunits. Optimum pH for cleavage of synthetic
      aminoacyl-4-nitroanilides is 7.0. Mercury ions, EDTA and chloroquine were found
      to be potent inhibitors of aminopeptidase yspI activity. Substrate specificity
      studies indicate that the purified enzyme cleaves L-lysine-4-nitroanilide with
      high efficiency.

PMID- 8346681
TI  - RIM2, MSI1 and PGI1 are located within an 8 kb segment of Saccharomyces
      cerevisiae chromosome II, which also contains the putative ribosomal gene L21 and
      a new putative essential gene with a leucine zipper motif.
AB  - We report the DNA sequence of an 8 kb segment localized on the right arm of
      chromosome II from Saccharomyces cerevisiae. The sequence reveals the presence of
      eight open reading frames (ORFs). Three of them, YBR1402, YBR1405 and YBR1406 are
      previously sequenced genes, respectively the RIM2 (replication in mitochondria),
      MSI1 (multicopy suppressor of IRA1 gene) and PGI1 (phosphoglucoisomerase) genes.
      The predicted product of the ORF YBR1401 could be the putative yeast ribosomal
      protein L21. A new essential gene, YBR1403, has been identified by disruption; it
      possesses a leucine zipper motif.

PMID- 8346683
TI  - Cloning and sequencing of the URA3 gene of Kluyveromyces marxianus CBS 6556.
AB  - The URA3 gene, coding for orotidine-5'-phosphate decarboxylase, from
      Kluyveromyces marxianus CBS 6556, was isolated from a genomic DNA library. The K.
      marxianus URA3 gene encodes a protein of 267 amino acids with a calculated
      molecular weight of 29.3 kDa. Comparison of the K. marxianus protein with the
      corresponding enzymes of Saccharomyces cerevisiae and Kluyveromyces lactis showed
      amino acid sequence identities of 81% and 88%, respectively. Using contour
      clamped homogenous electric field gel electrophoresis, the genomic copy was found
      to be located on chromosome VI. We have used the cloned gene for the construction
      of a K. marxianus leu2 mutant. This mutant contains no heterologous sequences,
      which is essential to make it acceptable for application in the food industry.

PMID- 8346682
TI  - Para-aminobenzoate synthase gene of Saccharomyces cerevisiae encodes a
      bifunctional enzyme.
AB  - The Saccharomyces cerevisiae gene for para-aminobenzoate (PABA) synthase has been
      identified based upon its ability to confer sulfonamide resistance when present
      on a multicopy episomal vector. The 3840 bp DNA sequence fragment reported here
      contains a 2199 bp open reading frame encoding a 733 amino acid protein with
      similarity to the two components of PABA synthase described for prokaryotes
      (Escherichia coli PabA and PabB), suggesting that PABA synthase is bifunctional
      in yeast. The cloned sequence was confirmed to be PABA synthase by gene
      disruption. Chromosome gel analysis places the gene for PABA synthase on
      chromosome XIV.

PMID- 8346684
TI  - [Leg lengthening using callotasis. 2. Evaluation of a group of patients with
      surgical treatment, discussion, literature].
AB  - In part 2 of the article the authors evaluate a group of 45 completed cases of
      lengthening of long bones, using the method of consecutive distraction according
      to Ilizarev. On average a lengthening of 5.4 cm was achieved. The authors
      evaluate the procedure of lengthening, the period taken by therapy in relation to
      the patients' age. The mean period of treatment was 5.7 weeks per 1 cm
      lengthening and it depends distinctly on the patient's age. In a total of 16
      patients at the same time also correction of the axis of the leg was made. A
      major part of the investigation is devoted to evaluation of complications which,
      consistent with the literature, are classified as major, requiring further
      surgery, and minor ones which can be resolved without surgery during the
      lengthening procedure. Major complications were recorded 9 times, minor ones 8
      times. Only in one instance the lengthening was terminated before the planed
      distraction was achieved. The authors evaluate these complications in relation to
      the length of distraction, the patient's age and the time when the lengthening
      was performed. At the same time they give instructions how to prevent
      complications and how to deal with them, if they arise. The conclusions and
      evaluation of the group of patients are dealt with in a detailed discussion where
      the authors compare their results with extensive references in the literature.

PMID- 8346685
TI  - [Locked nailing of fractures of the long bones. 1. Fractures of the leg].
AB  - The authors present an account of their initial experience with the use of a
      method of locked nailing of fractures of the leg, applying the technique
      described by Grosse and Kempf. They use original implants of Howmedica Co. They
      indicated for osteosynthesis closed fractures of the leg in the middle three
      fifths of the bone length, without major damage of soft tissues (grade 0 and 1 of
      Tscherne's classification). In injuries with imminent compartment syndrome they
      operated after a delay, in all others they operated early after injury. Using the
      described method, the authors operated 16 patients. In three instances they used
      static locking of the nail, in 13 instances dynamic locking. The authors did not
      observe any delayed healing of the fractures. The only complication was partial
      paresis of the deep branch of the peroneal nerve. In all instances the patients
      were allowed to weight-bearing of the operated extremity soon--on average 3.5
      weeks after operation. Recovery followed after 8-15 weeks. The authors consider
      this method with regard to the possible functional treatment, stability for
      weight-bearing, and rapid recovery of the fracture as the optimal therapeutic
      procedure for almost all types of closed fractures in the middle three fifths of
      the leg.

PMID- 8346686
TI  - [Complications after replacement of a knee joint endoprosthesis with a cementless
      "low contact stress" prosthesis].
AB  - Total endoprosthesis of the knee joint of the LCS type reduce due to the mobile
      placement of the menisci and rotatable components the mechanical demands on
      anchoring in bone and thus contribute to satisfactory biological integration.
      During the period between June 1, 1989 and December 31, 1991 in the orthopaedic
      department of the general hospital in Zwettel 41 patients had 42 total
      endoprostheses (LCS) of the knee joint implanted. The group comprised 34 women
      and 7 men. All patients were checked and evaluated according to Hungerdorf's
      schema. The age range was 62 to 79 years with an average of 65.8 years. The
      follow-up period was 8 to 38 months, mean 21 months. The results as regards pain,
      stability, mobility, axis of the extremity and ability to walk were evaluated as
      very good and good. The authors discuss also postoperative complications. They
      did not observe loosening of cement-free components.

PMID- 8346687
TI  - [Technical problems in reoperation of hip joint prostheses].
AB  - At the Orthopaedic Clinic of the Institute for Postgraduate Medical Training in
      the course of 10 years (1979-1989) 2340 primary implantations of total
      endoprostheses of the hip joint were performed. During the same period 168 total
      endoprostheses of the hip joint and 20 cervico-occipital prostheses were
      reoperated. The most frequent reason for reoperation was aseptic loosening of the
      acetabular component. The mean period between operation and reoperation in these
      patients was 98 months. In the group with loosening of the socket associated with
      mechanical destruction of the component the mean period which had elapsed since
      the primary operation was 43 months. In 87% small size sockets were involved. The
      most serious problem of reoperation of total endoprostheses of the hip joint is
      replacement of bone defects. During reoperation of acetabular components an
      isolated defect on the floor of the acetabulum was found in 26%, a defect of the
      margins in 38% and a combined defect of the margins in 26% of the patients. For
      treatment of the defects the authors used bone grafts in the majority allogenic
      grafts were involved which were used to reconstruct the margins and floor of the
      acetabulum. Metal implants should hold the bone grafts in the desired position
      and should not serve as a skeleton. Reoperation of the acetabular part of total
      endoprostheses of the hip joint is easier from the technical aspect; in defects
      of the upper portion of the femur it is essential to use a very careful procedure
      and to preserve the skeleton to a maximal extent.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8346688
TI  - [Autofixation of the transposed tibial tuberosity in habitual patellar
      dislocation].
AB  - Habitual luxation of the patella is as a rule considered an indication for a
      stabilizing operation. As regards approaches to the surgical solution of this
      problem we can differentiate between operations of the proximal part of the
      extension apparatus, i.e. operations of the soft tissues and operations on the
      distal part of the extension apparatus, above all plastic operations and
      transposition of the insertion of the lig. patellae on the tuberositas tibiae. In
      the present paper the authors submit their own modification of transposition of
      the tuberositas tibiae, suitable in severe affections after closure of the
      epiphyseal space. The described technique makes it possible to anchor the
      transposed tuberosity by an autofixation mechanism without using osteosynthetic
      material. The basis of the method is removal of a small block of bone with the
      insertion of the lig. patellae, size 2 x 4 cm, and its insertion beneath the
      corticalis at a site selected in advance into an opening 2 x 2 cm with subsequent
      covering and stitching of the periosteum. The extent of medialization depends on
      testing during flexion and extension. To prevent the development of the syndrome
      of patellar hyperpression it is important to avoid excessive distalization of the
      insertion of the ligament. During the preoperative period it is recommended to
      apply a plaster splint for two weeks, followed by functional rehabilitation and
      gradual burdening; complete burdening should be attained by the third month after
      operation. The surgical technique was tested in a group of 16 patients at the
      First Orthopaedic Clinic and with regard to its simplicity and reliability the
      method can be recommended.

PMID- 8346690
TI  - [Rehabilitation after total endoprosthesis replacement of the hip joint].
AB  - The authors present an account on the rehabilitation programme used in patients
      after total endoprostheses, as practiced in their department. They draw attention
      to the importance of mutual collaboration of doctors and rehabilitation
      instructors. Without it even the best surgical operation would not produce the
      desirable effect. They also draw attention to the advantages of remedial exercise
      before operation and the necessity to start with remedial exercise immediately
      after surgery and continue after discharge from the hospital. In the conclusion
      they outline some problems they encountered during their work with patients after
      total endoprostheses.

PMID- 8346689
TI  - [Revitalization of bone transplants using vascular implants].
AB  - For investigation of revascularization of free autogenous bone grafts by
      implantation of blood vessels the authors used rats as experimental material. The
      arteries or bundles of arteries were implanted into the spongiosa of the free
      bone transplant--a tall vertebra. It was revealed that capillary proliferation
      which promotes revascularization of the graft started in the adventitia of the
      implanted artery. Therefore it is not necessary to severe the artery, as
      recommended in methods used in previous studies. Revascularization occurs even
      when the implanted artery retains its original function. Implantation of blood
      vessels does not prevent extensive necrosis of the graft but indicates
      osteogenesis which results in substitution of the necrotic tissue.

PMID- 8346691
TI  - [Dual x-ray absorptiometry in the diagnosis of osteoporosis].
AB  - The author presents a review providing information on contemporary modern
      radiological possibilities as regards the diagnosis of osteoporosis at the First
      Orthopaedic Clinic in Bratislava. At present this department possesses a
      densitometer LUNAR DPX-L. This apparatus assesses the bone density on the basis
      of double X-ray absorption. The software available at present makes it possible
      to assess the bone density of the lumbar spine in the anterio-posterior and
      lateral projection, as well as the proximal femur and whole body. The mean time
      required for assessment is 4 mins. 24 secs. to 16 mins. 30 secs. The mean
      radiation load of the patient is 1.5 mrem, the maximal load 3.5 mrem. The
      apparatus compares the assessed density values with mean values of the healthy
      population, it evaluates automatically statistical values of the Z and T score.
      These results are presented either as a coloured graph or as values of bone
      mineral density and bone mineral content. The author explains in more detail the
      principle of modern densitometry and its development during the past three
      decades.

PMID- 8346692
TI  - [Arteriovenous aneurysm--an uncommon complication in open fractures of the leg].
AB  - The authors describe a less common complication of external osteosynthesis--a
      false arteriovenous aneurysm. On the case-history of a patient they demonstrate
      the risk associated with insertion of nails, the necessity of careful follow-up
      of patients after operation, and in case of suspicion, the necessity of accurate
      diagnosis and urgent surgical operation.

PMID- 8346693
TI  - Abuse in the workplace: a symptom that signs alone won't cure.

PMID- 8346694
TI  - Choosing nursing--an Edmonton perspective.

PMID- 8346695
TI  - The role of nursing research in the development of a knowledge base for practice.

PMID- 8346697
TI  - Holistic nursing. Reflexology.

PMID- 8346696
TI  - Boston: an education experience.

PMID- 8346698
TI  - Screen test Alberta. After the NBSS: has anything changed?

PMID- 8346699
TI  - Pain corner. The substance abuser with chronic malignant pain: nursing
      approaches.

PMID- 8346700
TI  - Health information: nursing components.

PMID- 8346701
TI  - Relationship between nursing practice and the practice of other health care
      professionals.

PMID- 8346702
TI  - [Reversible dementia and polyneuritis in an elderly woman: a case of late-onset
      disseminated lupus erythematosus].
AB  - Reversible dementia and polyneuropathy in an elderly woman: a case of late onset
      systemic lupus erythematosus. We report the case of a 76-year-old woman with
      undiagnosed systemic lupus erythematosus. She presented with severe dementia. She
      was given prednisolone 20 mg daily with dramatic improvement occurring within one
      month. Electrophysiological study showed evidence of axonal neuropathy.

PMID- 8346703
TI  - Intranasal caffeine and amphetamine causing stroke.
AB  - A 37 year-old man with an ischaemic stroke after the nasal use of amphetamine and
      caffeine is reported. Transient arterial hypertension due to these agents may
      have been the mediator of the stroke. Mitral annular calcification was the only
      other abnormality found, and was thought not to play an important role in this
      patient. There was no evidence of a primary or secondary hypercoagulable state.
      Stroke due to nasal use of these agents appears not to have been previously
      reported (Medline literature search 1983-1993).

PMID- 8346704
TI  - Function of proteoglycans in the extracellular matrix.
AB  - Proteoglycans are glycosylated proteins which have covalently attached highly
      anionic glycosaminoglycans. Many forms of proteoglycans are present in virtually
      all extracellular matrices of connective tissues. The major biological function
      of proteoglycans derives from the physicochemical characteristics of the
      glycosaminoglycan component of the molecule, which provides hydration and
      swelling pressure to the tissue enabling it to withstand compressional forces.
      This function is best illustrated by the most abundant proteoglycan in cartilage
      tissues, aggrecan. During the past decade, diverse species of proteoglycans have
      been identified in many connective tissues, on cell surfaces and in intracellular
      compartments. These proteoglycans have distinct biological functions apart from
      their hydrodynamic functions, and their involvement in many aspects of cell and
      tissue activities has been demonstrated. For example, decorin, which is widely
      distributed in many connective tissues, may have functions in regulating collagen
      fibril formation and in modifying the activity of transforming growth factor
      beta; perlecan, the major heparan sulfate proteoglycan in the glomerular basement
      membrane, may play an important role as the major anionic site responsible for
      the charge selectivity in glomerular filtration. Specific interactions between
      proteoglycans (through both their glycosaminoglycan and core protein components)
      and macromolecules in the extracellular matrix are the key factors in the
      functions of proteoglycans. Exciting biological functions of proteoglycans are
      now gradually emerging.

PMID- 8346705
TI  - Consultations in surgical pathology. Association of Directors of Anatomic and
      Surgical Pathology.

PMID- 8346706
TI  - Immunohistochemical and ultrastructural characterization of autoimmune
      sialoadenitis in aging BDF1 mice.
AB  - To further the understanding of the immunopathologic mechanisms involved in
      spontaneous autoimmune sialoadenitis of aging BDF1 mice, immunohistochemical and
      ultrastructural studies were undertaken. Eighteen of 19 aging BDF1 mice, 23-27
      months of age, developed sialoadenitis spontaneously. By light and electron
      microscopy, it was observed that the submandibular gland lesion was characterized
      by mononuclear cell infiltration in the periductal and perivascular areas often
      accompanied by parenchymal destruction. Immunohistochemically, T cells
      predominated. The ratio of CD4+ to CD8+ T cells ranged from 0.5:1 to 2.9:1, with
      an average of 1.4:1. It seems likely that not only CD4+ cells, but also CD8+
      cells, play a major role in submandibular gland inflammatory reactions of aging
      BDF1 mice.

PMID- 8346707
TI  - Pathological analysis of hypertrophic cardiomyopathy simulating dilated
      cardiomyopathy.
AB  - The pathomorphologic features of hypertrophic cardiomyopathy simulating dilated
      cardiomyopathy in the late stage (HCM-DCM) were compared with those of ordinary
      hypertrophic cardiomyopathy (HCM). Seven autopsied hearts with HCM-DCM and 11
      with HCM were assessed quantitatively using an image analyzer. Unlike HCM,
      significant left ventricular enlargement and wall thinning were observed in HCM
      DCM, and the percentage areas of massive fibrosis and disarray were significantly
      greater. In HCM-DCM, the disarray was distributed diffusely, whereas massive
      fibrosis was distributed more intensively in the ventricular septum and anterior
      wall than in the lateral and posterior wall. Narrowing of intramyocardial small
      arteries was observed more frequently in HCM-DCM, especially in the ventricular
      septum and anterior wall, than in HCM. These results suggest that the enlargement
      and wall thinning of the left ventricle in HCM-DCM are attributable to non
      uniform progression of massive fibrosis, which is closely related to small
      arterial lesions.

PMID- 8346708
TI  - Cell-cycle analysis detecting endogenous nuclear antigens: comparison with BrdU
      in vivo labeling and an application to lung tumors.
AB  - The versatility of non-radioactive cell-cycle analysis in detecting endogenous
      nuclear antigens of the proliferating cells was evaluated. Optimal conditions for
      immunostaining varied in fixation and pretreatment procedures among antigens,
      bromodeoxyuridine (BrdU), Ki-67 epitope, DNA polymerase alpha and PCNA. A
      significant correlation between BrdU labeling index (LI) was observed in each
      positive ratio (PR, positive/total neoplastic cells) for nuclear antigens in
      tumor-sections which had been labeled in vivo with BrdU. The best correlation was
      observed in Ki-67 PR (y = 1.26x + 2.5; y = Ki-67 PR; x = BrdU LI; r = 0.97). To
      determine its prognostic value, Ki-67 analysis was applied to the surgically
      resected lung tumors. Ki-67 PR were different according to the histologic types
      of the tumors: 47.8 +/- 3.4% in small cell carcinoma; 29.5 +/- 3.5% in squamous
      cell carcinoma; 28.3 +/- 4.7% in large cell carcinoma; 15.2 +/- 1.8% in
      adenocarcinoma and 0.1 +/- 0.1% in mature carcinoid tumor. When the mean value
      was used to divide each type to a higher or lower proliferative activity (15% Ki
      67 PR for adenocarcinoma and 30% for squamous cell carcinoma), the group with the
      lower Ki-67 PR showed a significantly more favorable prognosis than that of a
      higher ratio. Ki-67 PR was not correlated with other pathologic factors such as
      size, lymph node metastasis or pleural involvement. Non-radioactive cell-cycle
      analysis was feasible and useful for detecting endogenous nuclear antigens even
      in the lung tumors, particularly when the analysis was coupled with histologic
      typing.

PMID- 8346709
TI  - Early stage of development in testicular choriocarcinomas.
AB  - Choriocarcinoma is the most malignant among germ cell tumors in the testis.
      However little is known about the early stage of its development. To understand
      the development of testicular choriocarcinomas, twenty cases of testicular
      choriocarcinoma were studied histologically and immunohistochemically. It was
      found that in the early stage of development, choriocarcinomas imitate the
      morphologic or functional differentiation of normal trophoblasts. It was also
      found that some choriocarcinomas regress spontaneously in the early stage. The
      majority of choriocarcinomas seemed to develop by first going through the
      embryonal carcinoma phase. However, there were some choriocarcinomas that showed
      no relationship with embryonal carcinoma.

PMID- 8346710
TI  - Protein-losing enteropathy due to secondary amyloidosis of the gastrointestinal
      tract.
AB  - A case of a 71 year old woman who experienced weight loss, diarrhea and edema due
      to protein-losing enteropathy caused by amyloidosis secondary to rheumatoid
      arthritis is described. Amyloid deposits were found in the systemic organs,
      specifically in the bowel. The arterioles were massively involved within the
      laminae propriae and many were narrowed considerably due to amyloid deposits.
      Ulcerative lesions, which were accompanied with the ruptured arterioles, were
      also found. Lymphangiectasia was present in the submucosa, subserosa and
      mesenterium. The mesenteric lymphatic vessels were deposited markedly with
      amyloid. The principal cause of the protein loss might be related to the
      increased capillary permeability to plasma proteins and the exudation through an
      inflamed mucosa. Functional disruption of the lymphatic flow in the bowel and
      mesenterium might also participate in the mechanisms of the protein loss.
      Evidence in this study supports the theory that lymphatic disorders in some
      patients with gastrointestinal amyloidosis are one of the important factors in
      the pathogenesis of protein-losing enteropathy.

PMID- 8346711
TI  - Myxoma of the breast: report of a case with unique histological and
      immunohistochemical appearances.
AB  - A case of myxoma of the breast is reported. The patient, a 19 year old Japanese
      woman, showed a lump in the left breast which had enlarged gradually over 3
      years. A tumor measuring 5 x 5 x 4.5 cm was located mainly in the mammary
      parenchyma, but partially involved the overlying subcutaneous tissue.
      Histologically the tumor was multinodular and each nodule consisted of an
      abundant myxoid substance with a few spindle or stellate mesenchymal cells. The
      presence of hyaluronic acid was observed in the myxoid area, and a few
      constituent cells showed immunoreactivities for S-100 protein and alpha 1
      antichymotrypsin. Electron microscopic studies revealed that some constituent
      cells looked like undifferentiated mesenchymal cells, while others showed a
      differentiation similar to fibroblast or histiocyte. These findings suggest that
      the constituent cells might derive from totipotential primitive mesenchymal
      cells.

PMID- 8346712
TI  - Mistletoe (viscum album) lectins as cytokine inducers and immunoadjuvant in tumor
      therapy. A review.
AB  - Therapy of cancer with a Viscum extract has been carried out in Europe for over
      six decades in thousands of patients with uncertain advantages. This approach has
      been bedeviled by major problems such as variable composition of the extract,
      lack of knowledge of active component(s) and mechanism of action, to cite a few.
      However the recent standardization of Viscumin in terms of galactoside-binding
      lectin activity has allowed to clarify that it can act as powerful inflammatory
      mediator able to stimulate the immune system. Merits and demerits of this
      approach have been reviewed and although the active component has probably not
      unique immunoenhancing properties, it may be useful as an adjuvant in the
      biological therapy of cancer and it should not be ignored any longer. As usual,
      medical progress depends upon experimentation and not exclusively on intuition
      and emotion.

PMID- 8346713
TI  - Cytokine regulation of iron metabolism: effect of low-dose interleukin-2
      subcutaneous therapy on ferritin, transferrin and iron blood concentrations in
      cancer patients.
AB  - It is known that the anemias of chronic diseases, which often occur in neoplastic
      and in systemic inflammatory disorders, are characterized by high levels of
      ferritin associated with generally low iron concentrations, by suggesting an iron
      transfer defect due to unknown factors. Since both chronic inflammatory diseases
      and advanced neoplasms are characterized by alterations in the endogenous
      production of cytokines, a possible involvement of interleukins in chronic
      disease-related anomalies of iron metabolism cannot at present be excluded. The
      present study was carried out to investigate the effect of low-dose IL-2
      subcutaneous immunotherapy (3 million IU/day for 6 days/week for 4 weeks) on
      ferritin, transferring and iron serum levels in cancer patients. Six patients
      with metastatic gastrointestinal carcinomas were evaluated. Ferritin mean levels
      significantly decreased during IL-2 treatment, and this finding was associated
      with a significant increase in transferrin values. Iron mean levels increased in
      response to IL-2, without, however, significant differences in respect to the
      pretreatment concentrations. These preliminary data, by showing changes in
      ferritin, transferrin and iron in cancer patients during the immunotherapy with
      IL-2, would suggest the existence of a cytokine regulation of iron transfer from
      tissues to blood, perhaps by modulating the macrophage function.

PMID- 8346715
TI  - Generalized occurrence of the broadly antiviral substance UTI beta in mammalian
      sera.
AB  - This study compares the characteristics of naturally occurring antiviral
      activities in nonhuman mammalian sera to UTI beta (University of Texas virus
      inhibitor beta), an innate, non-specific viral inhibitor found in human serum.
      The antiviral agent in sera from four different species appears to possess
      properties similar to those of UTI beta, e.g. molecular weight of 60 +/- 10 kDa,
      broad spectrum antiviral activity, glycoprotein structure with antiviral
      oligosaccharide moiety(s) attached to a carrier protein, and inhibition of most
      viruses by preventing their attachment to target cells. These findings suggest
      that UTI beta or UTI beta-like virus inhibitors are a normal component of the non
      specific immune defenses of mammals.

PMID- 8346714
TI  - Amplification of eosinophilia by melatonin during the immunotherapy of cancer
      with interleukin-2.
AB  - Eosinophilia, which occurs during IL-2 immunotherapy, has appeared to be due to
      an enhanced secretion of IL-5 and to be associated with a clinical response.
      Since our previous experimental studies showed that the pineal hormone MLT
      potentiates IL-2 efficacy, a study was started to evaluate the influence of a
      concomitant MLT administration on IL-2-induced eosinophilia. The study included
      30 advanced solid tumor patients, 16 of whom received IL-2 alone (6 million
      IU/day) and the other 14 IL-2 plus MLT (10 mg/day orally at 8.00 P.M.).
      Eosinophil mean number was significantly enhanced during both treatments, but its
      increase in patients receiving IL-2 plus MLT was significantly higher than that
      seen in patients treated with IL-2 alone. These results show that MLT may enhance
      IL-2-induced eosinophilia, by suggesting that T helper lymphocyte- type 2, which
      is the source of IL-5, may be the target cell for MLT action.

PMID- 8346717
TI  - Unraveling the function of the retinoblastoma gene.

PMID- 8346716
TI  - Cancer prevention research trials.

PMID- 8346718
TI  - Oncogenic basis of radiation resistance.

PMID- 8346720
TI  - Molecular approaches to cancer therapy.

PMID- 8346719
TI  - Molecular genetic changes in human breast cancer.

PMID- 8346721
TI  - Regulation and mechanisms of mammalian gene amplification.

PMID- 8346722
TI  - Clinical pharmacokinetics of sotalol.
AB  - Sotalol is an antiarrhythmic agent with combined class II and III properties. It
      is nearly completely absorbed after oral administration and undergoes essentially
      no first-pass hepatic metabolism. As a result, its absolute bioavailability is 90
      100%. Peak plasma concentrations are reached 2-4 hours after an oral dose.
      Administering sotalol with food reduces its bioavailability by approximately 20%.
      A 2-compartment model adequately describes the decline of sotalol plasma
      concentrations after intravenous or oral administration. The drug has an apparent
      volume of distribution of 1.2-2.4 liters/kg. Results of animal studies indicate
      that sotalol distributes into a number of tissues, including those of the heart,
      liver, and kidney, but it is hydrophilic and thus penetrates the central nervous
      system poorly. Sotalol does not bind to plasma proteins. No significant
      biotransformation of sotalol takes place in humans. Sotalol is primarily
      eliminated by renal excretion, with approximately 80-90% of a dose being excreted
      unchanged in the urine; a small amount is excreted unchanged in the feces. In
      subjects with normal renal function, total body clearance of sotalol averages 150
      mL/min and the terminal elimination half-life is 10-20 hours. Long-term
      administration of sotalol does not alter its kinetics, and plasma concentrations
      following single or multiple doses are proportional to the dose. Sotalol is a
      racemic mixture of the d- and l-stereoisomers. d,l-Sotalol is excreted in the
      urine equally as d- and l-sotalol, and there is no evidence of racemization. The
      clearance of sotalol is reduced and its elimination half-life is prolonged in
      patients with renal insufficiency; as a result, dosage adjustment is
      necessary.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346723
TI  - Pharmacologic basis of the antiarrhythmic and hemodynamic effects of sotalol.
AB  - Sotalol is a competitive beta adrenoceptor antagonist devoid of membrane
      stabilizing activity and intrinsic sympathomimetic activity that has no
      preferential actions on beta 1 or beta 2 responses. No other tested receptor
      systems are affected by sotalol. In addition to having class II (beta blockade)
      effects, sotalol also has class III antiarrhythmic activity. It increases the
      action potential duration (APD) and prolongs atrial and ventricular
      repolarization. The effect on APD is independent of beta blockade; the same
      effect is seen with similar concentrations of the d stereoisomer of sotalol,
      which does not have beta-blocking activity. Sotalol prolongs the rate-corrected
      QT interval and ventricular and atrial refractoriness without affecting atrial,
      His-Purkinje, or ventricular conduction velocity. Atrioventricular nodal
      conduction is decreased, largely because of beta blockade. Sotalol increases the
      fibrillation threshold and decreases the defibrillation threshold. Sotalol is an
      effective antiarrhythmic in various animal models of arrhythmia (e.g.,
      chloroform, hydrocarbon-catecholamine, ouabain, and coronary ligation). In
      addition, it reduces the severity and frequency of arrhythmias induced by
      programmed electrical simulation. By comparison, metoprolol is ineffective and d
      sotalol is as effective as the racemate in this model, indicating that this
      effect is independent of beta blockade. Sotalol causes concentration-dependent
      increases in the contractility of isolated ventricular tissue that is not blocked
      by previous beta or alpha blockade or catecholamine depletion. The positive
      inotropic effect may be related to inhibition of time-dependent K+ current
      responsible for the increase in APD. Like propranolol, sotalol decreases
      contractile force, heart rate, arterial blood pressure, left ventricular dP/dt,
      and cardiac output in intact animals due to blockade of circulating
      catecholamines. Sotalol consistently reduces the heart rate to a greater degree
      than propranolol and causes significantly less cardiac suppression than
      propranolol at a given heart rate.

PMID- 8346724
TI  - Indications for antiarrhythmic suppression of ventricular arrhythmias: a
      definition of life-threatening ventricular arrhythmias.
AB  - A surprising finding of the Cardiac Arrhythmia Suppression Trial (CAST), reported
      in 1989, is that well-tolerated and effective antiarrhythmic drugs may also be
      associated with an increase in mortality due to arrhythmia. Consequently,
      attention has been focused on the importance of the benefit-versus-risk
      assessment of such therapy. The benefits of antiarrhythmic therapy are reduction
      or elimination of arrhythmia-caused symptoms (both hemodynamic and
      nonhemodynamic) and of the associated risk of death. The risks of such treatment
      include not only noncardiac adverse effects and organ toxicity, but also early
      cardiac effects (proarrhythmia, heart failure, and conduction defects), as well
      as the newly recognized potential for late proarrhythmia or late arrhythmic
      death. Unfortunately, as the potential benefits of antiarrhythmic therapy
      increase in patients with poorer left ventricular function (owing to their being
      at greater risk for sudden death), the effectiveness of suppression decreases and
      the incidence of life-threatening complications increases. The impact of this
      benefit-risk profile is that the indication for most currently approved
      antiarrhythmic drugs needs to be limited to those patients with definite life
      threatening ventricular arrhythmias that take the form of sustained ventricular
      tachyarrhythmias with associated hemodynamic symptoms. Broadening this indication
      to include patients with probable life-threatening or even possible life
      threatening arrhythmias must await the availability of drugs with better benefit
      risk profiles.

PMID- 8346725
TI  - Effect of oral sotalol on systemic hemodynamics and programmed electrical
      stimulation in patients with ventricular arrhythmias and structural heart
      disease.
AB  - We explored the central hemodynamic responses to oral sotalol during dose
      titration in patients with ventricular arrhythmias who underwent programmed
      ventricular stimulation. Twelve patients were included in the study, 9 with a
      history of sustained ventricular tachyarrhythmias (6 postmyocardial infarction
      and 3 with cardiomyopathy) and 3 with a history of nonsustained ventricular
      tachycardia postmyocardial infarction. Left ventricular ejection fractions were <
      45% in 10 patients, and < 35% in 5; the mean ejection fraction was 37% (range 20
      51%). Sotalol prevented the induction of ventricular tachycardia in each of 3
      patients with nonsustained ventricular tachycardia and in 6 of 9 with sustained
      ventricular tachycardia at baseline study. At peak action (2 hours) after sotalol
      loading (mean dose, 167 mg orally twice daily), the hemodynamic effects included
      bradycardia, decreased cardiac index, increased left ventricular filling pressure
      and systemic vascular resistance, and no change in stroke volume or stroke work
      index. One patient was not continued on sotalol, owing to an excessive increase
      in the pulmonary capillary wedge pressure, despite the lack of symptomatic heart
      failure. Congestive heart failure in association with marked bradycardia
      developed in another patient, who had suppression of inducible ventricular
      tachycardia after sotalol loading; this patient was managed with a reduction in
      the dose of sotalol and a regimen of digoxin and furosemide, and has been well
      compensated and without a recurrence of sustained ventricular tachycardia for
      more than 4 years. Ventricular tachycardia has been controlled with sotalol,
      without hemodynamic deterioration, in 6 of these patients.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8346726
TI  - Clinical safety profile of sotalol in the treatment of arrhythmias.
AB  - The safety of sotalol was evaluated in 3,257 patients treated for cardiac
      arrhythmias in double-blind and open-label clinical trials that support United
      States registration of the drug. In this composite population, 80% of patients
      had structural heart disease and 42% had life-threatening ventricular
      arrhythmias, i.e., ventricular tachycardia (VT) or fibrillation (VF).
      Proarrhythmia was reported in 141 patients (4.3%). Of these, 78 (2.4%) had
      torsades de pointes and 26 (0.8%) had sustained VT or VF. The overall incidence
      was higher in patients treated for sustained VT or VF (6.5%). In these patients,
      serious proarrhythmia was predominantly torsades de pointes (4.1%) and was more
      prevalent in patients with congestive heart failure and low ejection fraction.
      Torsades de pointes was observed early in the course of treatment, and its
      occurrence was related to dose. The overall mortality in patients treated with
      sotalol was 4.3% (139 patients); in patients with life-threatening arrhythmias,
      cardiac mortality was 4.8%. In only 27 patients (0.8%) was the death thought to
      be potentially drug-related. The deaths were not related to dose. Data from a
      previously reported placebo-controlled postmyocardial infarction trial indicated
      no significant difference in mortality between sotalol and placebo. Heart failure
      was reported in 3.3% of patients and was most prevalent in those with a previous
      history of congestive heart failure, cardiomyopathy, or structural heart disease.
      The occurrence of heart failure was unrelated to dose or time on drug; in more
      than half of the patients, sotalol treatment was continued. On average, there was
      no decrease in ejection fraction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346727
TI  - Usefulness of sotalol for life-threatening ventricular arrhythmias.
AB  - Two trial designs have been used in evaluating sotalol in patients with sustained
      tachyarrhythmias: open-label dose escalation and randomized comparison with
      reference agents. At least 7 open-label studies (n = 16-65) have been reported
      from single centers in patients in whom trials of numerous other antiarrhythmic
      agents were unsuccessful. At the doses used, usually 320-640 mg/day, plasma
      concentrations were in the range associated with both beta blockade and class III
      antiarrhythmic activity (2-3 micrograms/mL). These concentrations produced
      electrophysiologic changes that were consistent across studies: 10-16% increase
      in right ventricular effective refractory period (ERP), 4-8% increase in
      corrected QT interval (QTc), and 17-30% increase in sinus cycle length
      (corresponding to a 15-23% decrease in heart rate). In these open-label trials,
      sotalol suppressed inducible ventricular tachyarrhythmias in 20-72% of patients;
      the higher degrees of efficacy were reported when induction protocols were
      confined to double extrastimuli. Side effects leading to discontinuation of
      sotalol in patients with sustained ventricular tachycardia or fibrillation
      include fatigue (4.0%), marked bradycardia (3.0%), torsades de pointes (3.0%),
      and heart failure or pulmonary edema (1.0%). A multicenter randomized trial
      compared intravenous sotalol with intravenous procainamide in a double-blind
      prospective fashion. Sotalol suppressed ventricular tachyarrhythmias inducible
      with triple extrastimuli in 15 (30%) of 50 patients, whereas procainamide was
      effective in 10 (20%) of 50. In this and other series, responsiveness to sotalol
      was prospectively identified by a particularly fast tachycardia at baseline
      (e.g., cycle length of < 270 msec), but not by the extent of changes in global
      indices of repolarization (QTc, ERP).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346728
TI  - Safety and efficacy of oral sotalol for sustained ventricular tachyarrhythmias
      refractory to other antiarrhythmic agents.
AB  - The safety and efficacy of oral sotalol were evaluated in 481 patients with drug
      refractory sustained ventricular tachyarrhythmias (VT) in an open-label
      multicenter study. After drug-free baseline evaluations, therapy was initiated at
      80 mg every 12 hours, with upward dose titrations of 160 mg/day being allowed at
      intervals of 72 hours to a maximum dose of 480 mg every 12 hours. Efficacy
      determinations were made by either programmed electrical stimulation (PES) or
      Holter monitoring responses. Of the 481 patients enrolled, 473 underwent acute
      phase titration. Of the 269 patients assessable by PES, 94 (34.9%) exhibited
      complete response (suppression of inducible VT), with an additional 67 patients
      (24.9%) exhibiting partial response. Of the 109 patients assessable by Holter
      monitoring, 43 (39.4%) exhibited a complete response. There were no significant
      differences between responders and nonresponders with regard to left ventricular
      ejection fraction. Although response rates tended to improve as the sotalol dose
      was increased to 640 mg/day, efficacy was most commonly achieved at a sotalol
      dose of 320 mg/day. Sotalol was discontinued because of adverse effects in 42
      (8.9%) of the acute-phase patients. The most common adverse effect was
      proarrhythmia, which was observed in 23 patients (4.9%). Proarrhythmia took the
      form of torsades de pointes in 12 patients and an increase in VT episodes in 11.
      In 3 acute-phase patients (0.6%), sotalol was discontinued because of the
      emergence of congestive heart failure. A total of 286 patients entered the long
      term phase. Life-table estimates of the proportion of patients who remained free
      of recurrence of arrhythmia at 12, 18, and 27 months were 0.76, 0.72, and 0.66,
      respectively. There were no significant differences in time to recurrence of
      arrhythmia as related to PES response, Holter monitor response, baseline left
      ventricular ejection fraction, or history of congestive heart failure. Among the
      70 patients (24.5%) in whom there was recurrence of arrhythmia, sudden death
      occurred in 17 and sustained VT in 41. Sotalol was discontinued owing to presumed
      adverse effects in 21 (7.3%) of the long-term patients, including 8 with
      proarrhythmia; proarrhythmia consisted of torsades de pointes in 3 patients and
      increased episodes of VT in 5. These findings suggest that sotalol is an
      effective drug for the long-term treatment of patients with drug-refractory
      sustained VT. Proarrhythmia was observed in only 6.4% of the study population and
      tended to occur during the acute titration phase. The need to discontinue therapy
      because of congestive heart failure was uncommon.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8346729
TI  - Effect of sotalol on heart rate variability assessed by Holter monitoring in
      patients with ventricular arrhythmias.
AB  - Reduced vagal activity has been demonstrated to be associated with an increased
      risk of sudden death. Assessing the heart rate variability as a measure of the
      autonomic control of the heart has been established as a useful tool for the risk
      stratification of patients after myocardial infarction. In the current study,
      heart rate variability assessed by time- and frequency-domain measures was
      determined from Holter recordings before and during treatment with sotalol in 28
      patients with chronic ventricular arrhythmias. The heart rate variability at
      baseline was independent of the presence or absence of spontaneous arrhythmias
      and of left ventricular function. Therapy with sotalol produced a significant
      improvement over control values in indices of parasympathetic tone (root mean
      square of the difference in successive RR intervals, proportion of adjacent RR
      intervals different by > 50 msec, high-frequency power spectrum). This
      improvement was not related to drug-induced changes in the mean heart rate or the
      suppression of ventricular ectopic activity. These effects on heart rate
      variability may contribute significantly to the overall efficacy profile of
      sotalol.

PMID- 8346730
TI  - Effect of sotalol on ventricular fibrillation and defibrillation in humans.
AB  - Antiarrhythmic drugs are frequently administered to patients receiving implanted
      cardioverter defibrillators. Some of these drugs may decrease the efficacy of
      defibrillation shocks from the defibrillator. Sotalol, a drug with beta-blocking
      and class III antiarrhythmic properties, lowers defibrillation energy
      requirements in experimental animals and may do so in humans. Oral sotalol 171 +/
      58 mg was administered before and after device implantation in 25 patients
      receiving implanted defibrillators. During sotalol therapy, the lowest energy
      required for successful defibrillation was 5.9 +/- 3.4 J (range 2-15J). In a
      concurrent nonrandomized comparison group of 23 patients, including 18 treated
      with amiodarone, the lowest successful energy was 16 +/- 10 J (p < 0.01). In 5
      sotalol patients, ventricular fibrillation (VF) could not be induced at all (1
      patient) or more than 2 or 3 times (4 patients) despite repeated 60 Hz
      stimulation. The induced VF had a pronounced tendency to terminate spontaneously,
      with the termination occurring at up to 23 seconds after the offset of 60 Hz
      stimulation. The cycle length of the VF was 236 +/- 34 msec, significantly
      greater than in patients not given drug therapy (191 +/- 21 msec, p < 0.01). In
      10 patients, but none of the controls, intracardiac electrograms during surface
      electrocardiographic VF were regular, monoform, and without low-amplitude
      diastolic activity. In addition, monophasic action potentials during apparent VF
      showed maintenance of distinct and normal morphology. The ventricular effective
      refractory period increased after sotalol (249.4 +/- 19 to 278.4 +/- 24 msec; p <
      0.03) and the maximum heart rate response to exercise was limited to 120 +/- 28
      beats/min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346731
TI  - Electrophysiologic basis for the antiarrhythmic actions of sotalol and comparison
      with other agents.
AB  - Although synthesized as a nonselective beta-adrenergic blocking compound, sotalol
      has emerged as the prototype of the so-called class III antiarrhythmic compounds.
      It delays cardiac repolarization by inhibiting the delayed rectifier potassium
      current, having a lesser effect on the inward rectifying potassium current with
      little or no effect on the inward calcium or sodium currents. This property of
      prolonging repolarization with an accompanying increase in the effective
      refractory period is not due to blockade of the beta-adrenergic receptors. The
      major electrophysiologic profile of sotalol constitutes the summed effects of
      beta blockade and prolonged repolarization. Sotalol exerts a potent
      antifibrillatory action modulated by its antiadrenergic effects. It suppresses
      premature ventricular contractions and nonsustained ventricular tachycardia while
      preventing inducible ventricular tachycardia and fibrillation in patients with
      advanced structural heart disease. The compound is therefore likely to exert a
      broad spectrum of antiarrhythmic actions in ventricular arrhythmias.

PMID- 8346732
TI  - Practical considerations in the use of sotalol for ventricular tachycardia and
      ventricular fibrillation.
AB  - Sotalol is a unique antiarrhythmic drug that combines beta-blocking effects with
      actions to prolong action potential duration. The net effect is a drug that is
      efficacious in the management of ventricular tachyarrhythmias. Although sotalol
      has effects on both heart rate and QT interval, these effects do not help predict
      the antiarrhythmic efficacy of the agent. Changes in QT dispersion may, however,
      prove to be relevant to both the antiarrhythmic effects and the arrhythmogenic
      effects of sotalol. Thus, although sotalol may occasionally cause torsades de
      pointes, this complication may be predictable and clinically controllable.
      Sotalol is well tolerated, and it may be used, with caution, in some patients
      with impaired myocardial contractile performance, despite its beta-blocking
      action. Sotalol has an important indication for the management of ventricular
      tachyarrhythmias.

PMID- 8346733
TI  - The biology of the clinical pathologist.

PMID- 8346735
TI  - Something old? Something new? Second primary or pulmonary metastasis in the
      patient with known extrathoracic carcinoma.

PMID- 8346734
TI  - Adenocarcinoma in the lung in patients with breast cancer. A prospective analysis
      of the discriminatory value of immunohistology.
AB  - In some patients with a history of breast cancer who also have masses in the
      lung, making a clinical distinction between primary pulmonary neoplasia and
      pulmonary metastasis of mammary carcinoma may be impossible. To ascertain whether
      immunohistologic studies could contribute to resolving this problem, the authors
      undertook a prospective study of 30 cases showing synchronous or metachronous
      adenocarcinomas in these two sites. A predefined panel of antibodies--as derived
      from published antigenic catalogs for breast and lung cancer--was applied to each
      case. Tumors were interpreted as metastases if they were positive for gross
      cystic disease fluid protein-15, estrogen receptor protein, or S-100 protein.
      Conversely, primary adenocarcinomas of the lung were defined by their expression
      of carcinoembryonic antigen and a lack of the other three determinants. Using
      these criteria, 15 lesions were classified as metastatic; 11 were categorized as
      primary pulmonary adenocarcinomas; and 4 cases were indeterminate in origin.
      Responses to corresponding therapeutic protocols generally supported the validity
      of the immunohistologic diagnoses; 8 of 15 patients treated for metastatic breast
      cancer were well at least contact, as were 5 of 11 patients who received therapy
      for primary carcinoma of the lung. These data suggest that immunohistology plays
      a useful role in distinguishing mammary from pulmonary adenocarcinomas.

PMID- 8346736
TI  - Emergence of antimicrobial resistance in gram-negative bacilli causing bacteremia
      during therapy.
AB  - Treatment of serious infections caused by gram-negative bacilli with beta-lactam
      antimicrobial agents can induce Class I beta-lactamase production. This
      phenomenon can result in resistant microorganisms, and has been postulated to be
      a cause of therapeutic failure. The charts of patients bacteremic with
      Pseudomonas aeruginosa, Serratia marcescens, Enterobacter cloacae, Citrobacter
      freundii, Proteus vulgaris, and Providencia species (n = 120) during a 3-year
      period were reviewed to determine how common the emergence of resistance was, and
      to determine if in vitro susceptibility testing was a reliable therapeutic guide.
      Emergence of resistance was believed to occur when a subsequent bacteremic
      isolate showed at least a fourfold increase in minimum inhibitory concentration
      accompanied by a change of interpretive susceptibility category. In the group of
      patients who survived at least 48 hours that received beta-lactam therapy (n =
      76), one case of emergence of resistance was identified (1.3%). Emergence of
      resistance to beta-lactam antimicrobial agents did not commonly cause therapeutic
      failure at our institution, and susceptibility testing of gram-negative bacilli
      by usual methods was a reliable guide to antimicrobial therapy.

PMID- 8346737
TI  - Disseminated bacillus Calmette-Guerin infections in patients with primary
      immunodeficiencies.
AB  - The pathologic findings from biopsy or autopsy material in four patients, who
      were vaccinated with bacillus Calmette-Guerin (BCG) at birth in Chile, are
      presented. Two patients had severe combined immunodeficiency, and two had more
      restricted cellular (T-cell) immunodeficiency with no evidence of human
      immunodeficiency virus infection. The patients had distinct skin nodules and
      nodular lesions in systemic organs and bone marrow. Three patients had regional
      BCG lymphadenitis. One patient with severe combined immunodeficiency, however,
      had disseminated BCG without any local reaction. In all cases BCG strains of
      Mycobacterium were identified in a reference mycobacteriology laboratory. The
      histologic lesions in most patients usually consisted of diffuse histiocytic
      infiltrates with poorly formed granulomas and variable or no necrosis.
      Histiocytes were plump and engorged with numerous acid-fast bacilli (AFB). In
      some areas the massive histiocytosis resembled a spindle cell neoplasm. Other
      histologic findings supported the underlying immunodeficiency. The pattern of
      histiocytic response and degree of microbial killing depend on the host's
      immunocompetence. In the later stages of disease or in severe immunodeficiency,
      there is a lack of granuloma formation and unimpeded proliferation of AFB. These
      findings are reminiscent of nontuberculous mycobacterial infections in AIDS
      patients. Bacillus Calmette-Guerin dissemination has to be considered in
      immunocompromised individuals when the patient comes from other countries in
      which such vaccinations are practiced.

PMID- 8346738
TI  - Marrow B-cell precursors are increased in lymphomas or systemic diseases
      associated with B-cell dysfunction.
AB  - Marrow regeneration is known to be associated with an increase in immature B
      cells, including CD10+ cells. A similar phenotype has been seen in some children
      with unusual cytopenias. This article describes 21 adult patients not recovering
      from chemotherapy, who had increased CD10+ cells in their marrows. These cells
      had the relatively uniform scatter properties of small lymphocytes by flow
      cytometry, and by multiparameter analysis were found to have a distinct phenotype
      in that they were CD19+, lacked surface immunoglobulin, and heterogeneity
      expressed CD20. In two of three patients tested, some but not all of these early
      B cells were TdT+. CD10+ cells accounted for 10-76% of total mononuclear cells.
      All 21 patients had some systemic illness. Thirteen patients had a diagnosis of
      lymphoma (three Hodgkin's, ten non-Hodgkin's); all ten of the latter were
      extranodal and seven of seven phenotyped cases were B-cell lymphomas. Seven
      patients had autoimmune disease (one also had lymphoma) and one had the acquired
      immunodeficiency syndrome with mycobacterial infection of the marrow. One patient
      with a history of a "viral illness" had a lymph node showing atypical lymphoid
      hyperplasia with progressive transformation of germinal centers. Examination of
      marrow core biopsies in these patients showed a proliferation of small
      lymphocytes ranging from a barely perceptible diffuse increase to numerous
      lymphoid aggregates. The extensive lymphocytosis seen in two marrows suggested a
      diagnosis of lymphoma on morphologic grounds alone, but neither these patients
      nor any others had B-cell clonal excess. The presence of this phenotype suggests
      nonspecific stimulation of marrow B-cell precursors associated with systemic B
      cell activation in either an immunologic or neoplastic disorder. Presence of this
      unusual phenotype does not imply involvement of marrow by B-cell neoplasia.

PMID- 8346739
TI  - Informatics. A subspecialty in pathology.
AB  - The emerging discipline of pathology informatics is reviewed, and its placement
      as a subspecialty within the broader field of pathology and laboratory medicine
      is proposed. Informatics concepts should guide the development of the next
      generation of laboratory information systems. Advanced laboratory systems will
      incorporate decision support leading to improvements in quality and in
      interpretive reporting providing support for clinical diagnosis and decision
      making. Training programs in pathology should take into account the need for
      expertise in informatics and develop fellowships in this area to adequately
      prepare junior faculty members for their future professional role.

PMID- 8346740
TI  - Limitations of the osmolal gap with toxin ingestion.

PMID- 8346741
TI  - Undertransfusion.

PMID- 8346742
TI  - Correction.

PMID- 8346743
TI  - Anabolic steroids--round 4.

PMID- 8346744
TI  - Effect of surgical timing on recovery and associated injuries after anterior
      cruciate ligament reconstruction.
AB  - This study was undertaken to determine the optimal time after injury for
      arthroscopically assisted anterior cruciate ligament reconstruction using a
      double semitendinosus graft. We analyzed 87 patients. Time from injury to surgery
      was established as acute, subacute, or chronic; the three groups were matched.
      Meniscal damage and treatment were categorized. Chondral lesions were graded,
      postoperative parameters of motion, strength recovery, and stability were
      tabulated at 3, 6, 12, and 18 months. Complications were compared. Six percent of
      the patients with chronic knee injuries had two normal menisci at surgery,
      compared with 29% of the acute and subacute groups. Reparable tears were found in
      37.8% of the knees. Chondral lesions were found in the tibiofemoral joint in 17%
      of acute, 7% of subacute, and 44% of the chronic knees. Postoperative motion
      recovery was significantly less at all time intervals for the acute group.
      Quadriceps strength recovery was slower in the acute knees. Stability was similar
      in all groups. Arthrofibrosis was found in 22% of acute, 0 subacute, and 12.5% of
      the chronic knees. Patellofemoral pain was noted in 17% of the acute, 0 of the
      subacute, and 9.3% of the chronic knees. This study showed that surgery done
      within 6 months of injury does not jeopardize the knee. Recovery after acute
      anterior cruciate ligament reconstruction is significantly slower than after
      subacute or chronic reconstruction.

PMID- 8346745
TI  - Arthrography for the diagnosis of acute lateral ligament injuries of the ankle.
AB  - Arthrography was used for diagnosis of ruptures of lateral ligaments in 589
      acutely injured ankles that were treated operatively. The accuracy of the method
      was tested comparing the findings of arthrography with those at operation. We
      found arthrography to be almost 100% reliable for diagnosing a fresh anterior
      talofibular ligament rupture. The best criterion for detecting calcaneofibular
      ligament rupture was filling of the peroneal tendon sheath with contrast medium.
      Leakage below and behind the lateral malleolus, when present with peroneal tendon
      sheath filling, confirms the diagnosis of calcaneofibular ligament rupture, but
      these findings without peroneal tendon sheath filling are too rare to base the
      diagnosis on them alone.

PMID- 8346746
TI  - Arthroscopic Bankart suture repair.
AB  - The purpose of this paper was to report our experience with an arthroscopic
      technique of repair for the Bankart lesion following shoulder instability. Twenty
      seven patients (average age, 21.7 years) were followed for an average of 36
      months after arthroscopic suture stabilization of anterior shoulder instability.
      Patients were excluded if instability was multidirectional or voluntary and if
      there was radiographic evidence of a significant loss of glenoid bone stock.
      Clinical evaluation using a functional grading system showed that 10 patients
      were rated as excellent, 5 good, and 12 poor. Fourteen patients returned to their
      previous level of activity. There were 12 patients rated as failed; all had
      recurrent instability of the shoulder. Success was associated with a period of
      immobilization of 3 weeks or longer and a history of acute injury, especially
      subluxation. Failures were associated with shorter immobilization periods after
      surgery and in patients who had recurrent dislocations. The younger patient, who
      may not have complied with the immobilization protocol, also seemed to be
      associated with failure. Contact sports seems to leave a patient at high risk for
      recurrence. We recommend caution in the use of arthroscopic procedures for the
      competitive athlete in whom a second surgery and rehabilitation might mean loss
      of more sports participation.

PMID- 8346747
TI  - Longitudinal rupture of the peroneal tendons.
AB  - To determine more precisely the injury mechanism of the peroneal tendon
      longitudinal tear, we studied 15 cadaveric lower extremities. Our study was
      motivated by our observation from a retrospective study of athletes treated by
      one surgeon (FHB) over a 17-year period. Eight patients who sustained lateral
      ankle sprains by plantar flexion and inversion of the foot on the leg also had
      longitudinal tears (1 to 3 cm) of the peroneal tendon--five in the peroneus
      longus and three in the peroneus brevis. All of the lateral ankle sprains were
      successfully managed nonoperatively. However, even after a period of
      rehabilitation, when their ankles should have been asymptomatic, the patients
      continued to complain of persistent lateral ankle swelling, popping, and
      retrofibular pain. On physical examination, all ankles were clinically stable.
      Palpable retrofibular popping occurred with active foot rotation. There was no
      evidence of peroneal tendon instability. Radiographs were normal and tenograms
      were suggestive of peroneal tendon injury but did not have the specificity to
      reveal the rupture. Primary suture repair of this peroneal tendon split was
      performed and gave excellent long-term results. The cadaveric studies revealed
      that the tear of the tendon could occur in the 25 degrees to 15 degrees range of
      plantar flexion as the peroneus longus impinged against the tip of the fibula and
      as the peroneus brevis impinged against the lateral wall of the peroneal groove
      or against the longus tendon.

PMID- 8346748
TI  - Reconstruction of old anterior cruciate ligament tears with a Dacron prosthesis.
      A prospective study.
AB  - Seventy patients with chronic anterior instability underwent anterior cruciate
      ligament reconstruction with a Dacron prosthesis pretensioned to 60 N. Of these
      patients, 49% (34%) had combined medial instability, 32% (22) had failed previous
      anterior cruciate ligament surgery, and 37% (26) had previous meniscectomy. At
      reconstruction, 12 patients had their medial instability treated; 22 did not.
      Follow-up intervals were 3, 6, and 12 months and then each year to 5 years. The 5
      year followup included 69 patients; the other 1 had the ligament removed because
      of a synovial fistula at 8 months. Results were 23% prosthesis ruptures, 3% poor,
      17% fair, 16% good, and 39% excellent. The 2-year results showed the same
      distribution, but a lower rupture rate, which was affected by placement of the
      tibial tunnel within the anterior one-third of the tibia (9 times increase) and
      coexisting nonrepaired medial instability (5 times increase). Those patients with
      perfect placement of the ligament who also had good medial stability and no
      previous ligament surgery had no rupture at 5 years. The stability that was
      gained at surgery was gradually lost (-11.2% per year). At 5 years, the uninjured
      knee also had lost 41% of the preoperative stability; the mean laxity difference
      was within +/- 2 mm. The mean improvement in subjective knee function (Lysholm
      score 74.5 to 91.9) was maintained during the followup. The mean preoperative
      activity level improved significantly, but did not reach the preinjury level.
      These results show that the Dacron prosthesis will not give acceptable results in
      salvage cases where other instabilities are left untreated.

PMID- 8346749
TI  - The Dacron ligament prosthesis in anterior cruciate ligament reconstruction. A
      four-year review.
AB  - We studied 40 patients who underwent reconstruction for chronic anterior cruciate
      ligament deficiency with a Dacron ligament prosthesis using a modified MacIntosh
      over-the-top technique, augmented with iliotibial band. Thirty patients had
      undergone at least 1 prior surgical procedure on the affected knee, but only 7
      patients had previous anterior cruciate ligament reconstruction. All patients
      were followed for a mean of 47.5 months. The results at final followup
      demonstrated an average side-to-side arthrometer difference of 1.0 mm. The
      Lysholm score improved from 65 preoperatively to 89 at the end of the review; the
      Tegner activity level score improved from 3 to 5. Objectively, 75% of the
      patients had a negative Lachman test result and 95.1% of the subjects had
      negative or trace pivot shift results at review. Mild knee pain was still present
      with day-to-day activity in 87.7% of the patients. Complications occurred in
      27.5% of patients, including five who had implant ruptures and two who had their
      grafts removed. Synovitis was a significant problem. Based on our failure
      criteria, 47.5% (19) of the subjects had failed results. In this study,
      radiologic evidence of tracer separation greater than 1 cm was a criterion of
      failure. With inclusion of tracer separation, the failure rate increased to 60.0%
      (24). Multiple previous surgeries of any type had an adverse effect on results.
      Damage to secondary stabilizers in these cases increased failure rate. Based on
      the high complication and failure rates, and relatively poor end result in this
      retrospective review, we cannot recommend this procedure.

PMID- 8346750
TI  - Dacron ligament reconstruction for chronic anterior cruciate ligament
      insufficiency.
AB  - We report the 5-year follow-up results of a prospective, multicenter study
      evaluating the use of a Dacron prosthetic ligament in reconstruction of anterior
      cruciate-deficient knees. The study group consisted of 84 patients, followed for
      at least 5 years. The patients were divided into 2 groups: 50 patients with
      isolated anterior cruciate ligament laxity (Group 1) and 34 patients with a
      failed previous anterior cruciate ligament surgery or combined laxities (Group
      2). Two surgical techniques were employed: reconstruction through drill holes in
      the tibia and femur (30 patients) and reconstruction using the over-the-top
      position with the Dacron ligament wrapped in a strip of iliotibial band (54
      patients). The overall failure rate was 35.7% at 5 years. The failure rate at 2
      years was 20%, illustrating a significant deterioration of results between the
      two follow-up intervals. Evaluation of subjective criteria using the Lysholm
      score showed an improvement from preoperative status at the 2-year followup;
      however, there was a slight decline when 5-year results were evaluated. Tegner
      activity levels increased from a mean of 2.9 +/- 2.1 at the preoperative visit,
      to a mean of 4.9 +/- 2.0 at the 2-year followup and a mean of 5.0 +/- 2.0 at the
      5-year visit. These results show that the Dacron ligament prosthesis achieves the
      short-term goal of restoring stability and improving function and may be
      sufficient to provide long-term stability for the anterior cruciate-deficient
      knee.

PMID- 8346751
TI  - Surgical treatment of Freiberg's infraction in athletes.
AB  - Ten patients with 11 cases of Freiberg's infraction were studied retrospectively.
      The patients had varying amounts of sports participation. All cases were treated
      surgically, most after some form of nonoperative intervention. Surgery consisted
      of metatarsophalangeal joint debridement, except in 1 patient where the
      metatarsal head was resected. All patients had improvement of their symptoms and
      80% of normal joint range of motion was restored. No patient had joint space
      narrowing or major arthritic changes on follow-up roentgenographic studies.

PMID- 8346752
TI  - Electromyographic analysis of the trunk in golfers.
AB  - Golf is a popular sport for both men and women. The trunk is the most common area
      of injury during the golf swing. The purpose of this study was to describe and
      compare the muscle firing patterns in the trunk during the golf swing. Twenty
      three golfers with handicaps of five or below volunteered for this study. Surface
      electromyographic electrodes were placed on the abdominal oblique and erector
      spinae muscles bilaterally. High-speed cinematography was used in conjunction
      with the electromyographic electrodes. The results demonstrated relatively low
      activity in all muscles during takeaway (below 30% of maximal muscle test), and
      relatively high and constant activity throughout the rest of the swing (above 30%
      maximal muscle test, with the exception of the contralateral erector spinae
      during late follow-through, which was 28% maximal muscle test). This high and
      constant activity demonstrated the importance of the trunk muscles during a golf
      swing. These results indicate the need for an effective preventive and
      rehabilitative exercise program for the golfer.

PMID- 8346753
TI  - Comparison of symptomatic versus nonsymptomatic patients with chronic anterior
      cruciate ligament insufficiency. Radiographic sagittal displacement during
      weightbearing.
AB  - The sagittal anterior displacement of the tibia, induced by weightbearing, in
      chronic anterior cruciate ligament-insufficient knees was measured
      radiographically in 2 groups of patients. All patients in both groups had an
      increased laxity when assessed with the Lachman and flexion-rotation-drawer test.
      Sixteen patients were functionally improved and were relatively asymptomatic
      after a neuromuscular rehabilitation program, while the second group consisted of
      another 16 patients with persistent functional instability, despite the same
      rehabilitation program, who eventually had ligament reconstruction. The mean
      radiographic anterior displacement during weightbearing in the nonsymptomatic
      group was 4.3 mm, and 8 patients had a displacement < or = 2 mm. In the
      symptomatic group, the corresponding value was 8.1 mm (P < 0.05), and 3 patients
      had a displacement < or = 2 mm. No correlations to meniscal injuries, age, or
      time from injury were found between the patients having a displacement >2 mm and
      those with < or = 2 mm. The findings should be explained by differences in
      neuromuscular control of the increased laxity in the injured knee.

PMID- 8346754
TI  - Electromyographic and cinematographic analysis of elbow function in tennis
      players using single- and double-handed backhand strokes.
AB  - It is generally believed that tennis players using a double-handed backhand
      rarely develop lateral epicondylitis since the helping arm appears to absorb more
      energy and changes the mechanics of the swing. The purpose of this paper was to
      compare muscle activity about the elbow in single- and double-handed backhand
      strokes in competitive tennis players. Muscle activity in 3 elbow extensors, a
      wrist flexor, and a forearm pronator of the dominant arm was compared during the
      single-handed (N = 14) and double-handed (N = 13) backhand ground strokes using
      indwelling electromyography and high-speed cinematography. Significantly higher
      activity was seen in the double-handed technique in the flexor carpi radialis
      muscle in the preparation phase and in the pronator teres muscle in the
      acceleration phase. Higher flexor carpi radialis muscle activity in preparation
      of the double-handed stroke appeared to be a function of the double-handed grip
      used on the racquet, and the increased pronator teres muscle activity in
      acceleration indicated maintenance of greater pronation provided by the grip of
      the non-dominant hand. The decreased occurrence of lateral epicondylitis in
      players using a double-handed backhand may not be caused by decreased extensor
      activity, but rather by factors associated with flawed stroke mechanics more
      often seen in the single-handed technique.

PMID- 8346755
TI  - Biceps tendon tenodesis for posterolateral instability of the knee. An in vitro
      study.
AB  - The effects of biceps tendon tenodesis on internal-external and varus-valgus
      laxity were measured using fresh-frozen cadaveric specimens that had undergone
      sequential sectioning of the posterolateral structures and of the fibular
      collateral ligament. Tenodesis (using 89 N graft tension and a fixation point
      located 1 cm anterior to the fibular collateral ligament's insertion on the
      femur) was effective in restoring external rotation and varus laxity; the
      procedure actually overconstrained external tibial rotation at all flexion
      positions and varus angulation at 60 degrees and 90 degrees of flexion. Internal
      rotation and valgus laxity were unaffected by the tenodesis procedure. The
      anterior fixation point was more effective in reducing laxity than a fixation
      point located 1 cm proximal to the fibular collateral ligament insertion.
      Tenodesis using the proximal fixation point, which was nonisometric, did not
      restore external rotation and varus laxities to intact values at 60 degrees and
      90 degrees of knee flexion. Graft tension (45 or 89 N) had no measurable effect
      on the results of the tenodesis. This study has demonstrated that the biceps
      tenodesis procedure is effective for reducing static laxity in the knee with
      posterolateral instability.

PMID- 8346756
TI  - Posterior subluxations of the medial and lateral tibiofemoral compartments. An in
      vitro ligament sectioning study in cadaveric knees.
AB  - We report for the first time the abnormal increases in posterior subluxation of
      the medial and lateral tibial plateaus after sectioning the posterolateral
      structures and posterior cruciate ligament. We applied specific forces and
      moments to the knees of seven cadaveric whole lower limbs and measured the
      position of the tibia at which the ligaments and the geometry of the joint
      limited motion. Removal of only the posterolateral structures resulted in an
      average increase in posterior translation of the lateral tibial plateau of 8.0 mm
      (range, 5.7 to 10.6) at 30 degrees of flexion over the intact state (P < 0.01),
      but no significant increase at 90 degrees of flexion (mean, 2.7 mm). Knees with
      underlying physiologic cruciate ligament laxity (high anterior/posterior
      displacement in the intact knee) had the greatest lateral tibial plateau
      subluxation (P < 0.01). There was no abnormal posterior translation of the medial
      tibial plateau. After sectioning the posterior cruciate ligament and the
      posterolateral structures, statistically significant increases in posterior
      translation of both the medial and lateral tibial plateaus occurred at 30 degrees
      and 90 degrees of flexion (P < 0.01). The increase in posterior translation of
      the lateral tibial plateau over the intact state averaged 17.8 and 23.5 mm at 30
      degrees and 90 degrees of flexion, respectively; for the medial tibial plateau
      this increase averaged 7.6 and 12.3 mm at 30 degrees and 90 degrees of flexion,
      respectively. The diagnosis of abnormal tibiofemoral rotatory subluxations
      requires knowledge of the anteroposterior direction and magnitude of each tibial
      plateau under both low flexion and high flexion knee angle positions.

PMID- 8346757
TI  - Anterior cruciate ligament reconstruction. The effect of tibial tunnel placement
      on range of motion.
AB  - In 111 patients who had anterior cruciate ligament reconstructions, postoperative
      radiographic measurements of anterior to posterior and medial to lateral location
      of the tibial tunnels were correlated with the final range of motion achieved. In
      the 25 patients with extension deficits of 10 degrees or more, placement of the
      tibial tunnel was more anterior (average, anterior 23% of the tibia) than in the
      remaining 86 patients with extension deficits of < 10 degrees (average, anterior
      29% of tibia). This difference was statistically significant with P < 0.001.
      Logistic regression analysis revealed that the more anterior the placement of the
      tibial tunnel, the greater the loss of both flexion (P = 0.01) and extension (P =
      0.002). In the 21 patients with full extension but flexion < 130 degrees,
      placement of the tibial tunnel tended to be more medial (average, medial 40% of
      the tibia) than in the 65 patients without flexion deficit (average, medial 45%
      of the tibia). We conclude that placement of the tibial tunnel in the
      "eccentric," anteromedial position may contribute to the development of flexion
      and extension deficits after anterior cruciate ligament reconstruction.

PMID- 8346758
TI  - Arthroscopic treatment of glenoid labral tears.
AB  - We reviewed 52 consecutive patients who had undergone arthroscopic labral
      debridement. The average age was 29 and there were 35 men and 17 women. At
      operation, 27 patients had superior labrum anterior and posterior (SLAP) lesions,
      20 patients had anteroinferior labral lesions, and 5 patients had posterior
      labral lesions. Despite the fact that, preoperatively, none of these patients had
      a history of dislocations or clinically evident instability, 70% of the patients
      with superior labral lesions, and all of those with anteroinferior and posterior
      lesions had instability on examination under anesthesia. The average followup was
      36 months. At 1 year after arthroscopy, 78% of the patients with superior lesions
      had excellent relief compared with 30% of the patients in the anteroinferior
      group. At 2 years followup, these results decreased to 63% and 25%, respectively,
      and only 45% of the patients with superior labral lesions and 25% of those with
      anteroinferior lesions had returned to their previous athletic performance level.
      Four patients required a reoperation: 2 for instability and 2 for impingement. We
      conclude that occult instability is frequently present in patients with glenoid
      labral tears. The overall results are not encouraging, but this procedure may
      have an indication for short-term goals in competitive athletes or those who are
      willing to accept some compromise in function.

PMID- 8346760
TI  - Biomechanical considerations in patellofemoral joint rehabilitation.
AB  - Patellofemoral joint biomechanics during leg press and leg extension exercises
      were compared in 20 normal subjects (10 men, 10 women) aged 18 to 45 years. Knee
      moment, patellofemoral joint reaction force, and patellofemoral joint stress were
      calculated for each subject at four knee flexion angles (0 degree, 30 degrees, 60
      degrees, and 90 degrees) during leg press and leg extension exercises. All three
      parameters (knee moment, patellofemoral joint reaction force, and patellofemoral
      joint stress) were significantly greater in leg extension exercise than leg press
      exercise at 0 degree and 30 degrees of knee flexion (P < 0.001). At 60 degrees
      and 90 degrees of knee flexion, all three parameters were significantly greater
      in leg press exercise than leg extension exercise (P < 0.001). Patellofemoral
      joint stresses for leg press and leg extension exercises intersected at 48
      degrees of knee flexion. This study demonstrates that patients with
      patellofemoral joint arthritis may tolerate rehabilitation with leg press
      exercise better than with leg extension exercise in functional ranges of motion
      because of lower patellofemoral joint stresses.

PMID- 8346759
TI  - Isolated arthroscopic partial meniscectomy. Functional radiographic evaluation at
      five years.
AB  - Fifty patients who underwent isolated arthroscopic partial meniscectomy with a
      minimum followup of 5 years were analyzed retrospectively. To analyze the factors
      associated with a satisfactory or an unsatisfactory clinical result, we looked at
      the patient's age, duration of symptoms, type of meniscal lesion, and articular
      cartilage abnormalities. The patients were graded with a functional knee score
      (Lysholm-Gillquist), and activity level before surgery and at followup was
      determined. The data also included radiographic evaluation of 29 of the 50
      patients. Tibiofemoral alignment was measured, and osteoarthritic changes were
      graded and correlated with the type of meniscal abnormality and functional
      result. Eighty-two percent of our patients had satisfactory knee function, and
      the activity level was maintained. The factors associated with a satisfactory
      result after a partial meniscectomy included age less than 40 years, symptoms
      less than 12 months duration, type of tear, and chondromalacia less than grade
      II. Fairbank's changes were present in 50% of the patients, with significant
      grade III and IV changes identified in 30%. Although the radiographic changes did
      not necessarily correlate with the functional result, we felt that the changes
      were significant and indicative of abnormal stress transfer to articular
      cartilage and bone.

PMID- 8346762
TI  - Patellar tendon length change after anterior cruciate ligament reconstruction
      using the midthird patellar tendon.
AB  - The purpose of this study was to determine if use of the midthird patellar tendon
      autograft contributes to or causes patellar tendon shortening or patella baja in
      anterior cruciate ligament reconstruction. Thirty-six patients undergoing
      arthroscopically assisted midthird patellar tendon autograft anterior cruciate
      ligament reconstruction were studied prospectively. Intraoperative patellar
      tendon length changes were measured. Half of the patients had the tendon defect
      closed and half had it left open (closing peritenon only). Radiographic tendon
      length changes and patella baja were assessed using Insall-Salvati and Blackburne
      Peel ratios measured on 45 degrees lateral knee radiographs using an adjustable
      polypropylene jig. Bilateral films were obtained preoperatively and at 2 weeks, 3
      months, and 6 months postoperatively. No patients demonstrated evidence of
      patellar tendon shortening greater than the 5.5% measurement error. Tendon defect
      closure resulted in negligible tendon shortening intraoperatively, averaging
      2.28% (1.11 mm). Of the 18 patients whose defects were closed, 5 showed no
      shortening. The remaining 13 patients had measurable tendon shortening less than
      4% (2 mm). No patients developed patella baja.

PMID- 8346763
TI  - Partial meniscectomy and anterior cruciate ligament rupture in soccer players. A
      study with a minimum 20-year followup.
AB  - A retrospective review of 77 soccer players with 91 affected knees that had
      undergone the same operation, a rim-preserving meniscectomy, was made with a
      minimum followup of 20 years and an average followup of 27 years. The patients
      were divided into groups based on the presence of an intact (Group 1) or ruptured
      (Group 2) anterior cruciate ligament. At 5 years after meniscectomy, 75% of Group
      1 and 52% of Group 2 were still playing soccer, and 13% in Group 1 as opposed to
      28% in Group 2 had given up sports. The sporting class assessment was good in 80%
      of the Group 1 knees and 62% in the Group 2 knees. By followup, 5% of Group 1 and
      32% of Group 2 required further meniscectomies, and 2% of Group 1 and 16% of
      Group 2 required operations for osteoarthritis. Radiologically diagnosed
      osteoarthritis was present in 24% of Group 1 knees compared with 77% of Group 2.
      Functionally, 60% of the Group 1 knees were excellent at followup as opposed to
      9% in Group 2 knees. In Group 1, 49% were still involved in sports compared with
      22% in Group 2. However, 97% of Group 1 were satisfied with their knees compared
      with 74% of Group 2. All of these differences were statistically significant.

PMID- 8346761
TI  - Development of lower leg strength and flexibility with the strength shoe.
AB  - The Strength Shoe is a modified athletic shoe with a 4-cm thick rubber platform
      attached to the front half of the sole. It is promoted as an effective method of
      increasing "speed, quickness, and explosive power," as well as ankle flexibility
      and calf circumference, when used in a plyometrics-based training regimen. This
      study evaluates, in a prospective, randomized trial, the efficacy and safety of
      the Strength Shoe training regimen for increasing lower leg flexibility and
      strength in intercollegiate track and field participants. No enhancement of
      flexibility, strength, or performance was observed for participants wearing the
      Strength Shoe at the end of an 8-week training program, following the suggested
      regimen of the manufacturer. The use of the Strength Shoe cannot be recommended
      as a safe, effective training method for development of lower leg strength and
      flexibility. However, the use of plyometrics in a properly supervised setting may
      improve athletic performance and merits further investigation.

PMID- 8346764
TI  - Injuries in recreational adult fitness activities.
AB  - Volunteers (986) from fitness clubs and studios were recruited and followed for a
      3-month period to document the injury consequences of adult recreational fitness
      participation. Participants were telephoned each week and their activities as
      well as any injuries that occurred were recorded. Of the 525 injuries and
      complaints reported during 60,629 hours of activity, 475 occurred as a result of
      sports participation for an overall rate of 7.83 per 1000 hours of participation.
      Seventy-six percent of these episodes caused the patient to alter or miss 1 or
      more activities, while 9.5% involved a physician visit. The rate for time-loss
      injuries was less than 2 per person per year (1.76 per 298 hours) or 5.92 per
      1000 hours. Running had a higher risk of injury compared with most other
      individual sports. Cardiovascular fitness activities had low to medium rates, as
      did weight work; competitive sports were higher. For 6 of the most commonly
      injured areas, the reinjury rate was about twice that reported for those with no
      history of previous injury. The risks of injury from most recreational fitness
      activities were relatively modest, particularly if the activities were not
      competitive. Physicians might help patients reduce their risks of injury by
      encouraging suitable activities and by reducing the risks of reinjury by
      implementing appropriate rehabilitation programs.

PMID- 8346765
TI  - Anabolic steroids and growth hormone.
AB  - Athletes are generally well educated regarding substances that they may use as
      ergogenic aids. This includes anabolic steroids and growth hormone. Fortunately,
      the abuse of growth hormone is limited by its cost and the fact that anabolic
      steroids are simply more enticing to the athlete. There are, however, significant
      potential adverse effects regarding its use that can be best understood by
      studying known growth hormone excess, as demonstrated in the acromegalic
      syndrome. Many athletes are unfamiliar with this syndrome and education of the
      potential consequences of growth hormone excess is important in counseling
      athletes considering its use. While athletes contemplating the use of anabolic
      steroids may correctly perceive their risks for significant physiologic effects
      to be small if they use the steroids for brief periods of time, many of these
      same athletes are unaware of the potential for habituation to the use of anabolic
      steroids. The result may be incessant use of steroids by an athlete who
      previously considered only short-term use. As we see athletes taking anabolic
      steroids for more prolonged periods, we are likely to see more severe medical
      consequences. Those who eventually do discontinue the steroids are dismayed to
      find that the improvements made with the steroids generally disappear and they
      have little to show for hours or even years of intense training beyond the
      psychological scars inherent with steroid use. Counseling of these athletes
      should focus on the potential adverse psychological consequences of anabolic
      steroid use and the significant risk for habituation.

PMID- 8346766
TI  - Rupture of the pectoralis major muscle in a collegiate football player. Use of
      magnetic resonance imaging in early diagnosis.
AB  - We have reported an unusual case of pectoralis major muscle rupture and repair.
      There were three interesting aspects of this case. First, the injury occurred in
      a football player with an unusual mechanism of injury. Second, MRI using special
      techniques was valuable in confirming the diagnosis acutely and in planning
      treatment. Finally, we reported on the use of suture anchors to secure the
      avulsed tendon. We recommend the early use of MRI for diagnosis and in planning
      treatment of suspected pectoralis major muscle ruptures.

PMID- 8346767
TI  - Nonunion of a medial malleolus stress fracture. A case report.

PMID- 8346768
TI  - Rupture of the triceps tendon associated with steroid injections.
AB  - Rupture of the triceps mechanism is an uncommon injury that has been recognized
      with increasing frequency in recent years. It has been proposed that such
      injuries commonly accompany fractures of the radial head and must be actively
      evaluated in the presence of such a fracture. We present a unique case of
      isolated rupture of the triceps tendon in an athlete who was lifting weights.
      This case was complicated by a history of olecranon bursitis that had been
      treated with numerous local steroid injections, as well as a history of anabolic
      steroid abuse. Both systemic steroids and local injections may predispose tendons
      to rupture. Triceps tendon ruptures may result in uniformly good to excellent
      results if recognized and treated surgically. This case also serves as a reminder
      of the risks of treating inflamed tissues with local steroid injections,
      especially in strength athletes who place high demands on their musculoskeletal
      structures. Finally, this case documents a second case of triceps mechanism
      rupture in an athlete who has abused anabolic steroids. A study by Hunter et al.
      suggests that oral steroid abuse may be associated with detrimental effects on
      the mechanical properties of connective tissue, demonstrating another negative
      effect of anabolic steroid use in athletes.

PMID- 8346769
TI  - An evaluation of anaesthetic loss from a closed breathing system.
AB  - We present the results of a laboratory study of the loss of isoflurane from a to
      and-fro system, ventilated with oxygen, using a standard ventilator connected to
      the system via a long corrugated tube (the trunk) in place of the reservoir bag.
      No conventional fresh gas supply is used and isoflurane is injected as a liquid
      directly into the soda lime canister. The loss of isoflurane from the system due
      to mixing in the trunk was generally less than that lost by absorption into
      rubber and plastic system components. Glass syringes used for injection of liquid
      isoflurane were found to be a potential source of much greater leaks. The results
      showed that a to-and-fro system ventilated with oxygen via an open trunk
      functions as a virtually completely closed anaesthetic breathing system.

PMID- 8346770
TI  - The nasopharyngeal airway. Assessment of position by fibreoptic laryngoscopy.
AB  - Artificial nasopharyngeal airway position and performance were assessed in 120
      anaesthetised adult patients. Using a fibreoptic laryngoscope mean distances from
      nares to larynx were measured at 209 mm (SD 11) in males and 180 mm (SD 11) in
      females; those from nares to epiglottis were 159 mm (SD 12) in males and 140 mm
      (SD 11) in females. Nasopharyngeal airways were frequently misplaced, 60% lying
      beyond the tip of the epiglottis and 13% lodged in the vallecula. Forty-two
      percent of subjects had clinical evidence of respiratory obstruction.
      Nasopharyngeal airway compression in the nasopharynx and obstruction by the
      tongue and soft palate were common causes of respiratory obstruction. Regression
      analysis revealed that nares-epiglottis length correlated significantly with
      subject height (t = 3.9, p = 0.0002), but not with three external measurements
      made around the head and neck. Head flexion and extension resulted in
      comparatively little relative movement of the nasopharyngeal airway.
      Nasopharyngeal airway length and diameter should be standardised to optimise
      performance.

PMID- 8346771
TI  - Anxiety levels following anaesthesia for day-case surgery. A comparison of state
      anxiety levels following induction of anaesthesia with propofol or thiopentone.
AB  - The effect of different induction agents on postoperative state anxiety levels
      was investigated. Propofol produces statistically significant lower levels when
      compared with thiopentone. This finding suggests that propofol should remain the
      drug of choice for short duration anaesthesia.

PMID- 8346772
TI  - A comparison of diclofenac and ketorolac for postoperative analgesia following
      day-case arthroscopy of the knee joint.
AB  - Seventy-one patients presenting for day-case arthroscopy were randomly allocated
      to receive either intramuscular diclofenac 75 mg or ketorolac 30 mg immediately
      after induction of anaesthesia. One hour after operation visual analogue pain
      scores were significantly lower in the ketorolac group compared with those
      receiving diclofenac. Pain scores at 2 and 4 h postoperatively were not
      significantly different between the two groups although six of those receiving
      diclofenac required opioid analgesia compared with only one in the ketorolac
      group. Discomfort in the operated knee was similar for both groups on the day
      following surgery, but pain from the intramuscular injection site was
      significantly greater in the diclofenac group. Intramuscular ketorolac 30 mg
      provided better postoperative analgesia and less pain at the injection site than
      diclofenac 75 mg.

PMID- 8346773
TI  - The use of propofol in a child with hepatitis A.
AB  - Propofol was used for the induction and maintenance of anaesthesia in a 4-year
      old girl with hepatitis A and haematemesis. The anaesthetic was uneventful with
      no postoperative sequelae.

PMID- 8346774
TI  - The management of anaesthesia for caesarean section in a patient with paroxysmal
      ventricular tachycardia.
AB  - We describe the successful management of general anaesthesia for Caesarean
      section in a patient with poorly controlled paroxysmal ventricular tachycardia of
      pregnancy. The use of alfentanil before laryngoscopy and tracheal extubation
      ensured cardiostability without compromising maternal or fetal wellbeing. General
      anaesthesia allows prompt cardioversion. We believe that in the presence of a
      life-threatening unstable cardiac rhythm this consideration outweighs any
      theoretical advantage of regional blockade.

PMID- 8346776
TI  - The additional work of breathing imposed by Mapleson A systems.
AB  - The additional work attributable to breathing through five Mapleson A anaesthetic
      breathing systems (Magill, Lack, Parallel Lack, Humphrey ADE and Enclosed Magill)
      was studied using a lung model. With all five systems, the additional work was
      found to be a function of fresh gas flow, respiratory flow as well as system
      geometry. Within the range of fresh gas flow and respiratory flow studied, the
      additional work ranged between 80 mJ.l-1 and 182 mJ.l-1. Expiratory work was
      always greater than the inspiratory workload. Increasing fresh gas inflow into
      the system increases expiratory work, both resistive and elastic components. The
      Magill system posed the least work expenditure. The values for the additional
      work obtained with the lung model were of the same order of magnitude when
      measurements were taken in volunteers.

PMID- 8346775
TI  - Combined high frequency ventilation in the management of respiratory failure in
      late pregnancy.
AB  - We describe a pregnant patient with respiratory failure due to an atypical
      pneumonia and asthma that was successfully treated with the combination of high
      frequency oscillatory ventilation and intermittent positive pressure ventilation.
      This combined high frequency ventilatory technique is not commonly used in adults
      with respiratory failure and is largely contraindicated in patients with
      prolonged respiratory time constants such as occurs in asthma because of the risk
      of gas trapping. We suggest that this technique be considered in cases of
      respiratory failure refractory to conventional intermittent positive pressure
      ventilation and, that with appropriate monitoring of airways pressure, is worthy
      of a trial in patients with prolonged respiratory time constants.

PMID- 8346777
TI  - The genius infrared tympanic thermometer. An evaluation for clinical use.
AB  - A clinical tympanic thermometer was evaluated. In vitro it was found to be
      accurate over the temperature range 28 degrees C to 40 degrees C. Clinical
      assessment was made during the cooling and rewarming phases of patients
      undergoing surgery with the aid of cardiopulmonary bypass and compared with the
      results obtained with an Ellab thermocouple thermometer. It was also used in
      patients in the intensive care unit in whom core temperature was being measured
      using the thermistor incorporated in a pulmonary artery catheter. The infrared
      thermometer was found to be accurate, rapidly responding and easy to use.

PMID- 8346778
TI  - Noninvasive monitoring of respiratory volume. Experimental evaluation of a breath
      monitoring device.
AB  - The authors studied the accuracy of the noninvasive breath monitor (Voltek
      Enterprise, Willowdale, Ontario, Canada) in predicting the tidal volumes in five
      healthy human volunteers. The signals of the breath monitor were compared with
      the volumes estimated by a calibrated pneumotachograph. The results show that the
      breath monitor is considerably accurate and can be accepted as a reliable device
      for clinical applications.

PMID- 8346779
TI  - The Finapres 2300e finger cuff. The influence of cuff application on the accuracy
      of blood pressure measurement.
AB  - Blood pressure measurements associated with malapplication of a finger cuff were
      compared with contemporaneous intra-arterial pressure data in seven volunteers to
      determine the influence of cuff application on the accuracy of the Finapres
      2300e. Systolic readings in all cuff positions differed from arterial line data
      by more than the recommended standard and tight and loose cuff applications under
      and over-read respectively, in all subjects. The results show the Finapres to be
      sensitive to small degrees of finger cuff malapplication which contribute to the
      bias on direct arterial comparison and limit the reliability of the instrument in
      clinical practice.

PMID- 8346780
TI  - Breast feeding and anaesthesia.
AB  - Anaesthetists require a good knowledge of the excretion of drugs in breast milk
      and the potential hazards to suckling infants of drug ingestion via breast milk.
      A brief account of the physiology of lactation is given. The mechanisms of drug
      passage into breast milk are discussed followed by a review of the excretion in
      breast milk of drugs used in anaesthetic practice. Suggestions for the management
      of anaesthesia in breast feeding mothers are offered.

PMID- 8346781
TI  - Myalgia and biochemical changes following suxamethonium after induction of
      anaesthesia with thiopentone or propofol.
AB  - The incidence and severity of muscle pains and changes in creatine kinase were
      assessed following administration of 1 mg.kg-1 suxamethonium either immediately
      or 2 min after induction of anaesthesia with propofol or thiopentone in patients
      undergoing elective dental and ophthalmic surgery. The incidence of muscle pains
      was 35 and 60% respectively in the groups given suxamethonium immediately and 2
      min after propofol, and 35 and 55% when given immediately and 2 min after
      thiopentone, with no statistically significant differences among the groups.
      Creatine kinase levels increased in all the groups after operation with the least
      average increase in the group receiving suxamethonium immediately after propofol
      and the highest increase in the group receiving suxamethonium 2 min after
      thiopentone. There was no correlation between the incidence and severity of
      fasciculations, muscle pains and changes in creatine kinase within or between the
      groups. It is concluded that neither the induction agent nor the time between the
      induction agent and suxamethonium administration has any significant influence on
      the incidence of muscle pains or creatine kinase elevation following
      suxamethonium.

PMID- 8346783
TI  - More problems with the Selectatec system.

PMID- 8346782
TI  - Does a bloody tap prevent postdural puncture headache?
AB  - The regional anaesthesia records of 274 obstetric patients who had inadvertent
      dural puncture were reviewed to see whether a bloody dural tap resulted in a
      lower incidence of postdural puncture headache. No such influence was found.

PMID- 8346784
TI  - Stylet for reinforced laryngeal mask airway.

PMID- 8346785
TI  - Pattern of usage of the laryngeal mask airway.

PMID- 8346787
TI  - A method of fixing of laryngeal mask airways.

PMID- 8346786
TI  - The laryngeal mask airway and resuscitation.

PMID- 8346788
TI  - Alternative techniques for laryngeal mask airway insertion.

PMID- 8346789
TI  - The split laryngeal mask airway.

PMID- 8346791
TI  - General anaesthesia for caesarean section--noradrenaline response.

PMID- 8346790
TI  - Anesthetic drug allergies.

PMID- 8346792
TI  - Unexpectedly high spinal anaesthesia following failed extradural anaesthesia for
      caesarean section.

PMID- 8346793
TI  - Anaesthetic death of a child with a cold.

PMID- 8346794
TI  - Transverse myelitis following general anaesthesia.

PMID- 8346795
TI  - A source of artefact during general anaesthesia for magnetic resonance imaging.

PMID- 8346796
TI  - Infusion delays through multilumen catheters using standard syringe pumps.

PMID- 8346797
TI  - Reversal of atracurium after low dose tubocurarine.

PMID- 8346798
TI  - Increasing the likelihood of success of brachial plexus block.

PMID- 8346799
TI  - Prevention of bronchial intubation with RAE tube during adenotonsillectomy.

PMID- 8346800
TI  - Lignocaine sprays and cross infection.

PMID- 8346802
TI  - T-piece scavenging--the double-bag system.

PMID- 8346803
TI  - Confirmation of intravascular catheter placement by pulse oximetry following
      indocyanine green injection.

PMID- 8346801
TI  - The Whisperflow adjustable flow generator.

PMID- 8346804
TI  - The historic development of pain relief clinics.

PMID- 8346805
TI  - 1994 LabGuide.

PMID- 8346806
TI  - Histochemical identification of the striated muscle of the canine esophagus.
AB  - Histochemistry on the cervical, thoracic, and abdominal esophageal muscle of
      immature, young, and adult normal dogs revealed type IIA striated musculature in
      contrast to some other species. No other types or subtypes were observed. This
      suggests that esophageal muscle type is established at birth and does not vary or
      that any variation has been completed by 4 weeks-of-age unlike some canine limb
      musculature.

PMID- 8346807
TI  - An additional bone in the carpal region of raptorial birds.
AB  - In a series of 4 species of owls and 12 species of diurnal raptors, an additional
      bone was present bilaterally in the area of the carpus. Designating the bone as
      an "additional bone of the raptorial carpal region" is suggested pending
      appropriate embryological studies to determine the origin of the bone. Generally,
      the bone was present in owls and in diurnal raptors with relatively short,
      rounded wings, but was absent in species with longer, more tapered wings. The
      bone lies at the cranial edge of the carpal area near the radial carpal bone, and
      is fixed to the surrounding skeleton by ligaments. The tendon of the tensor
      patagium longus muscle has one slip that attaches to the additional bone and
      another that passes over its craniodorsal surface en route to insertion.
      Awareness of the occurrence of this bone in some raptors, but not others, is
      essential in clinical evaluation of wing injuries, as well as in forming a
      prognosis for the return to soundness, the potential for release, and, therefore,
      the life of an injured raptor.

PMID- 8346808
TI  - Ultrastructure of the rete testis in the cat (Felis domestica, L.).
AB  - The rete testis (RT) in the cat comprises three distinct and sequential parts:
      septal or adlobular; mediastinal and tunical parts. This last part is followed by
      the small extratesticular rete testis. The whole of the RT tubules and/or
      channels is lined by single low columnar and/or cuboidal epithelium with
      ultrastructural peculiarities of secretory and absorptive functions. The Golgi
      apparatus polarity (cis-trans surfaces), its relation with the long profiles of
      the ER, mainly with the rough ER, and presence of apical uncoated electrodense
      granules are suggestive of active release of macromolecules, probably
      glycoproteins. The absorptive function is proposed through the observation of a
      conspicuous microvacuolar-vesicular apical complex in epithelial cells. Moreover
      spermatozoa phagocytosis is also noticed, mainly in the septal part of the RT.

PMID- 8346809
TI  - [Anatomy of the development of the digestive tract and shape of the external body
      during the embryonic period of the goat (Capra hircus)].
AB  - The purpose of this work has been to establish the pattern of prenatal growth and
      normal development of the digestive tract and annex glands during goat embryonic
      stages. 21 embryos with ages ranging from 14 to 34 days (1.69 to 5.90 cm CR) as
      determined by registering the mating time, were obtained by cesarean section.
      This material was histologically processed to obtain complete serial sections of
      the stomatodaeum, foregut, midgut, hindgut and cloaca. In this work, it is
      chronologically described the morphogenesis and histogenesis of the mouth,
      hypophysis, pharynx and its derivatives, stomach, intestine, liver, pancreas and
      cloaca. The results obtained establish chronological comparisons with the
      development of the lamb and gives information on the unitary origin of the
      gastric compartments in ruminants.

PMID- 8346810
TI  - Globule leukocytes and bovine parasitic bronchitis.
AB  - Globule leucocytes (GL) occur in the respiratory tract of cattle from foetuses to
      adult animals. Large numbers of this cell have been found in the lungs of cows
      both in normal lung and in the lungs of cows from various outbreaks of
      respiratory diseases, but the significance was not known. In the rat and in
      cattle, the occurrence of GL in the gastrointestinal and urinary tracts has been
      associated with parasitic infections. The relationship between the respiratory
      tract GL and Dictyocaulus viviparus infections in cattle was studied in three
      groups of parasite free calves experimentally infected with D. viviparus. Group 1
      animals received single challenge infections. Group 2 had three subgroups (2a,
      2b, 2c) which were either vaccinated and challenged (2a), given a single
      challenge (2b) or used as vaccinated controls (2c). Group 3 with four subgroups
      (3a, 3b, 3c, 3d) were either used as environmental controls (3a), vaccinated and
      repeatedly challenged (3b), given normal larvae of D. viviparus and repeatedly
      challenged (3c) or as a trickled group 3d. Although GL were found in infected
      calves, it was not possible to demonstrate a clear cut correlation between their
      presence or density and the method of exposure.

PMID- 8346812
TI  - [Mathematical models applied to the growth of the ovine stomach during
      intrauterine life].
AB  - One hundred forty four ovine embryos and feti were used in an investigation to
      determine mathematical models describing the histomorphometric growth of tissues
      and compartments of the ruminant stomach. The results indicate that during
      prenatal life the diameter of the gastric chambers increase more slowly than the
      length. The tissue layers of the gastric walls, particularly the muscular tunic
      of all compartments demonstrated a uniform tendency toward more rapid development
      than the compartment walls proper.

PMID- 8346811
TI  - Actin filaments in the ruminal epithelium of cattle.
AB  - Phalloidin and immunogold labeling were used to localize actin filaments in the
      ruminal pilar epithelium of adult cattle on the light and electron microscopic
      level. Incubation with rhodaminyl-phalloidin permitted an overview of general
      actin distribution pattern. Distinct subcellular localization of actin was
      revealed with the biotin-streptavidin bridge technique in a postembedding
      procedure. Superior fixation of membranes and filaments was achieved with tannic
      acid-glutaraldehyde. Surface-etching prior to immunoincubation ensured
      restoration of actin immunoreactivity. Patterns of distribution in non
      keratinized and keratinized epithelial cells as well as in pericytes and
      endothelial cells point to cell-specific cytoskeletal and motile functions of
      actin filaments.

PMID- 8346813
TI  - [The topography of the skull and brain of the goat].
AB  - This study, based on three goats, provides a radiographic projection of a median
      section of the brain and the skull. The method allows a topographic correlation
      of brain structures with the skull and surrounding osseous structures. A standard
      skull position, with the basic horizontal plane passing through the external
      acoustic meatus, and parallel to the floor of the skull, results in a method of
      localizing brain structures in specific transverse planes. This stereotaxic
      method allows investigators to account for variability in topography between
      animals in the localization of brain structures through external morphology.

PMID- 8346814
TI  - The structure of the harderian gland of the guinea fowl at embryonic and post
      embryonic stages.
AB  - The Harderian gland of the guinea fowl is a bright, pink and relatively large
      orbital organ situated at the ventromedial aspect of the orbit. It possesses a
      single duct that has its exit on the convex medial surface. The outline is
      irregular with its caudal half narrower than the rostral half, and possessing a
      slight constriction about the mid point. Histologically, the gland had been
      outlined with the existence of a large contorted lumen by day 18 of incubation.
      The surface epithelial lining showed two layers of cells all through and
      lymphocytes were also present. By day 19 of incubation, certain zones of the
      surface epithelium had become pseudostratified and some of these cells contained
      vacuoles indicative of secretory materials within their cytoplasm. By day 21, few
      definitive acini with lumina had been observed and at day 23, the epithelium had
      assumed only a single layer of cells that were tall columnar cells, except at the
      junctions of the folds. By day 24, the tunica propria seemed to have completely
      disappeared with the acini occupying every available space. Plasma cells were
      seen three days after hatching.

PMID- 8346815
TI  - Gross anatomy of the canine portal vein.
AB  - The gross anatomy of the portal vein of 21 dogs was studied by venous
      portography, corrosion casting, and gross dissection. The portal vein in all
      specimens originated by confluence of the cranial and caudal mesenteric veins.
      Its large tributaries were the splenic and gastroduodenal veins, which entered
      the portal vein between its origin and the hepatic porta. At the hepatic porta,
      the portal vein divided into a short right branch and a larger left branch. The
      right branch ramified in the caudate process of the caudate lobe and in the right
      lateral lobe of the liver. The left branch was essentially the continuation of
      the portal vein from which successive branches passed to each of the remaining
      lobes of the liver and the papillary process of the caudate lobe.

PMID- 8346816
TI  - Use of ketorolac and fentanyl during outpatient gynecologic surgery.
AB  - In healthy outpatients undergoing minor gynecologic surgery, the analgesic
      efficacy of ketorolac was compared to fentanyl and to a combination of the two
      analgesics. One hundred and nine patients were randomly selected to receive
      fentanyl 50-100 micrograms, ketorolac 30-60 mg, or a combination of fentanyl 50
      100 micrograms and ketorolac 30-60 mg, intravenously (IV). Anesthesia was induced
      with midazolam 2 mg IV and propofol 1 mg/kg, IV, and maintained with propofol, 50
      160 micrograms.kg-1.min-1, IV, and nitrous oxide 67% in oxygen via a face mask.
      Intraoperative anesthetic conditions, recovery times, and postoperative pain and
      side effects were evaluated. In the ketorolac group, 75% of patients required
      supplemental fentanyl intraoperatively (mean dose +/- SD, 47 +/- 54 micrograms),
      compared to only 19% (13 +/- 30 micrograms) and 18% (6 +/- 15 micrograms) of
      patients in the fentanyl and combination groups, respectively. In the ketorolac
      group, 74% of patients moved in response to surgical stimulation compared to only
      16% and 19% of patients in the fentanyl and combination groups, respectively.
      Although there were no significant differences in intraoperative mean arterial
      pressure, heart rate, and oxygen saturation of hemoglobin values among the three
      treatment groups, the ketorolac group manifested significantly more rapid
      respiratory rates throughout the procedure compared with the fentanyl and
      combination groups. Recovery times, postoperative side effects, and pain scores,
      as well as postoperative analgesic and antiemetic requirements, were similar in
      all three treatment groups. However, the ketorolac group reported significantly
      higher pain scores in the early postoperative period.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8346817
TI  - Isoflurane, compared to halothane or enflurane, causes increased lactate
      production but no transmural coronary steal during myocardial ischemia in swine.
AB  - We compared the effects of isoflurane, enflurane, and halothane on myocardial
      blood flow, function, and metabolism in normally perfused and ischemic regions of
      the swine heart. A model of single vessel incomplete occlusion was used so that
      the capacity of these anesthetics to cause transmural coronary steal could be
      tested. After median sternotomy, the left anterior descending coronary artery
      (LAD) was cannulated and autoperfused from the carotid artery. Systolic segment
      shortening was measured in the regions of the heart perfused by the LAD and left
      circumflex arteries. Regional myocardial blood flow was measured with radioactive
      microspheres. Blood was obtained from the anterior cardiac vein for measurement
      of lactate. Measurements were made during imposition of a stenosis on the
      perfusion circuit sufficient to decrease resting flow by 25%. The same stenosis
      was imposed during three treatment periods in a randomized and balanced cross
      over design. In one group of 12 swine, treatments were two doses of intracoronary
      adenosine and a control period. A second group of 12 were given 1.5% isoflurane,
      2.18% enflurane, and 0.98% halothane. Heart rate, mean aortic pressure, and left
      atrial pressure were matched during the three treatments in each animal.
      Adenosine caused transmural steal resulting in diminished systolic segment
      shortening in the ischemic LAD region. During isoflurane, compared to halothane,
      the first derivative of left ventricular pressure with respect to time was
      greater by 28%, and systolic segment shortening in the normal left circumflex
      artery and ischemic LAD regions was greater by 27% and 31%, respectively.
      Subepicardial flow in the ischemic region was greater with isoflurane but
      subendocardial flow was unchanged. Lactate production during isoflurane was 52%
      and 76% greater than during halothane and enflurane, respectively. Our results
      indicate that isoflurane is not a sufficiently potent arteriolar vasodilator in
      swine to cause transmural steal. Although myocardial performance was superior
      with isoflurane in both ischemic and normally perfused regions, lactate
      production also increased, suggesting worsened ischemic metabolism. It is likely
      that the myocardial oxygen supply/demand ratio worsened with isoflurane because
      it caused less myocardial depression than the other anesthetics.

PMID- 8346818
TI  - Myocardial ischemia: a comparison between isoflurane and enflurane in coronary
      artery bypass patients.
AB  - Isoflurane may precipitate ischemia in patients with coronary artery disease,
      presumably via "coronary steal." We sought to examine whether myocardial ischemia
      is more common in patients with coronary artery disease receiving isoflurane
      (0.7%) than in a control group receiving enflurane (0.9%). Thirty-eight patients
      scheduled for coronary artery bypass surgery were randomly assigned one
      anesthetic and monitored for ischemia. All patients had ejection fractions of at
      least 45%. Extraneous causes of ischemia were controlled as much as possible:
      arterial blood pressure was maintained within 20% of baseline (primarily with
      phenylephrine), heart rate was maintained below 80 bpm, effects from endotracheal
      intubation were monitored, and measurements were made before incision.
      Electrocardiogram, transthoracic echocardiography, and coronary sinus lactate
      measurement were used to detect ischemia. Measurements were made after insertion
      of vascular catheters, after intubation, and after 20 min of breathing the
      inhaled anesthetic. During the awake period and after induction of anesthesia
      with fentanyl (25 micrograms/kg), there was no significant difference detected
      between the two groups in incidence of ischemia: 20% in the enflurane group and
      22% in the isoflurane group (P = 0.38). After 20 min of receiving the inhaled
      anesthetic, the incidence of ischemia in the isoflurane group increased to 50%,
      whereas the incidence in the enflurane group was unchanged at 20% (P = 0.02).
      These results show that, even with strict control of hemodynamics, isoflurane is
      associated with more myocardial ischemia than is enflurane.

PMID- 8346819
TI  - The effect of phenylephrine bolus administration on left ventricular function
      during isoflurane-induced hypotension.
AB  - By using transesophageal echocardiography, we examined the effect of
      phenylephrine (PHE) bolus administration on left ventricular function in 16
      patients with no known cardiovascular disease during isoflurane-induced
      hypotension. PHE was compared with norepinephrine (NE). The patients received an
      intravenous bolus of PHE (2 micrograms/kg) or NE (0.1 microgram/kg) in random
      order. The second substance was administered after levels of arterial blood
      pressure and heart rate returned to baseline levels. We determined fractional
      area change, end-systolic wall stress, and rate-corrected mean velocity of
      circumferential fiber shortening. Both substances effectively restored arterial
      blood pressure. However, after PHE, fractional area change decreased from 0.45 to
      0.31 (mean) and rate corrected mean velocity of circumferential fiber shortening
      from 0.88 to 0.57 circumference/s, whereas both variables remained unchanged in
      response to NE. End-systolic wall stress increased after PHE and NE from 47.4 to
      91.2 and from 54.0 to 65.2 10(3) dyne/cm2, respectively. We conclude that
      phenylephrine, given as intravenous bolus to patients under isoflurane
      hypotension, causes a transient impairment of left ventricular systolic
      performance.

PMID- 8346820
TI  - Nitrous oxide constricts epicardial coronary arteries in pigs: evidence
      suggesting inhibitory effects on the endothelium.
AB  - Nitrous oxide increases peripheral vascular tone in animals and humans and
      constricts epicardial coronary arteries in dogs. Current studies sought both to
      determine whether nitrous oxide caused epicardial coronary artery constriction in
      a second animal species, pigs, and to investigate mechanisms. Left anterior
      descending coronary artery diameters were measured by using computer-assisted
      angiography in intact pigs anesthetized with ketamine and fentanyl. In separate
      experiments, isolated porcine coronary arteries were used to assess nitrous oxide
      effects on both vascular tone and norepinephrine overflow. Agonist-induced
      increases in [Ca2+]i were estimated in cultured porcine coronary endothelial
      cells. Nitrous oxide caused epicardial coronary artery vasoconstriction in vivo
      by about 20%. Nitrous oxide did not affect endothelium-dependent relaxations and
      contractions in isolated vessels. Norepinephrine overflow was increased but only
      in vessels with endothelium. The anesthetic attenuated Ca2+ mobilization in
      endothelial cells. We conclude that nitrous oxide induces epicardial coronary
      artery constriction in pigs and suggest that the mechanism may involve the
      inhibition of endothelium-dependent norepinephrine turnover.

PMID- 8346821
TI  - Lower extremity hypothermia is beneficial during infra-renal aortic cross
      clamping in pigs.
AB  - The effects of lower extremity hypothermia during aortic cross-clamping are
      unknown. To compare the effects of lower extremity hypothermia with normothermia
      during aortic cross-clamping, two groups of six (25-40 kg) anesthetized pigs had
      their aortas cross-clamped below the renal arteries for 2 h. The cold group had
      their lower extremities cooled during cross-clamping to a quadriceps muscle
      temperature of 28 degrees C by using convective cooling. The warm group had the
      quadriceps muscle temperature maintained at 38 degrees C with convective warming.
      Saline, 0.9%, was used to maintain the pulmonary capillary wedge pressures at 5
      mm Hg in both groups. Reperfusion of the lower extremities resulted in a small
      but significant decrease in the blood temperature from 36.6 +/- 0.3 degrees C
      (mean +/- SE) to 35.6 +/- 0.3 degrees C 1 min after reperfusion in the cold
      group, but did not change the blood temperature in the warm group. Both the
      cardiac output and the lower extremity arterial flow were greater in the cold
      group at 1 and 5 min after cross-clamp release. Also one pig in the warm group
      required resuscitation with 1 mg of epinephrine intravenously to treat severe
      hypotension and myocardial depression after cross-clamp release. We conclude that
      hypothermia of the lower extremities may be beneficial for surgery involving
      aortic cross-clamping.

PMID- 8346822
TI  - Separation of myocardial versus peripheral effects of calcium administration in
      normocalcemic and hypocalcemic states using pressure-volume (conductance)
      relationships.
AB  - This study used left ventricular pressure-volume (conductance) relationships to
      separate the effects of calcium administration on myocardial performance and
      peripheral vasoconstriction in normocalcemic and hypocalcemic states.
      Hypocalcemia was produced in anesthetized dogs with intravenous citrate-phosphate
      dextrose until serum [Ca2+] was approximately 0.7 mmol/L. Calcium (CaCl2) bolus
      (5 mg/kg) was administered during normocalcemia (n = 6) and hypocalcemia (n = 6),
      and data were collected at 1, 5 and 10 min after CaCl2 administration. During
      normocalcemia, CaCl2 administration increased [Ca2+] 19% at 1 min and was
      accompanied by a 47% (P < 0.05) decrease in left ventricular contractility (i.e.,
      end-systolic elastance or E(lves)) and a 13% (P < 0.05) increase in systemic
      vascular resistance. At 5 and 10 min, serum [Ca2+] and the hemodynamic variables
      began to return to the baseline values. During hypocalcemia, E(lves) decreased
      25% (P < 0.05), but after CaCl2 bolus, it increased to baseline levels and
      remained there during the 10-min period. Hypocalcemia and the CaCl2 bolus did not
      significantly affect SVR. In conclusion, these studies suggest that the
      indications for the use of calcium should depend on the initial serum level of
      ionized calcium.

PMID- 8346823
TI  - Parental knowledge and attitudes toward discussing the risk of death from
      anesthesia.
AB  - There is considerable debate as to the extent of disclosure of risks when
      obtaining informed consent for anesthesia, especially when discussing with
      parents the rare risk of death of healthy children about to undergo elective,
      outpatient surgery. In Part I, we attempted to determine parents' knowledge about
      the risks of anesthesia as well as their thoughts toward either hearing, or not
      hearing, about the risk of death. In the first part of our study, 115 parents
      completed questionnaires before speaking with the anesthesiologist. Ninety-six
      (87%) wanted to know the chances of death as a result of anesthesia, whereas 14
      (13%) did not. Seventy-five (68%) parents knew that this risk was "extremely
      rare," 21 (19%) believed that it occurs "once in a while," and 14 (13%) thought
      there was "no chance." Eighty-two (74%) parents wanted to know "all possible
      risks," 26 (24%) wanted to know only "those that are likely to occur," and 3 (2%)
      wanted to know only about those that would "result in significant injury."
      Mothers were more likely to want to hear all possible risks, whereas fathers were
      more likely to want to know only about those that are likely to occur (P =
      0.001). Otherwise, responses were not influenced by the sex of the parents, the
      age of the child, or whether the child or any siblings had had surgery in the
      past. In Part II, a separate group of 121 parents were surveyed after
      participating in the preanesthetic discussion with the anesthesiologist.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8346824
TI  - Performance of pediatric resuscitation bags assessed with an infant lung
      simulator.
AB  - Many pediatric self-inflating bags are equipped with pressure relief (pop-off)
      valves to prevent barotrauma. We participated in a resuscitation in which a valve
      malfunction briefly caused inadequate ventilation. The pop-off valve was seated
      in an intermediate position between open and closed settings. To investigate this
      problem, we assessed the performance of several commonly used pediatric self
      inflating bags using an infant lung simulator (D, B & M, Redlands, CA). Bags were
      deflated using a range of inspiratory times (TI), delivered tidal volumes, peak
      proximal airway pressure (Pp), and peak distal pressure (lung pressure, Pd). When
      the pop-off valve was set in the open position, Pp ranged from 42 cm to 105 cm
      H2O, although P(d) never exceeded 45 cm H2O. The mean difference between Pp and
      P(d) decreased from 14.2 +/- 1.1 cm H2O at TI = 0.2 s to 6.1 +/- 0.5 cm H2O at TI
      = 1 s. Inflation of all DMR (disposable) and PMR (nondisposable) bags in the
      intermediate valve position produced marked air leakage through the valve, with
      delivered tidal volumes of only 92 +/- 13 mL (DMR) for TI < 0.5 s, and
      unrecordable tidal volumes (< 50 mL) for both DMR and PMR self-inflating bags for
      TI > 0.6 s. A wide range of delivered tidal volumes was observed among all bags
      examined. We conclude that both DMR and PMR bags can be placed inadvertently in
      an intermediate valve position that can produce disastrous hypoventilation during
      resuscitation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346825
TI  - Suppression of nociceptive responses by spinal mu opioid agonists: effects of
      stimulus intensity and agonist efficacy.
AB  - To determine the influence of stimulation intensity on dose-response curves of
      three analgesics in halothane-anesthetized rats, continued immersion of the tail
      in 52.5 degrees C or 60 degrees C water for 15 s results first in a nociceptive
      reflex tail movement (tail flick = 2.8 +/- 0.4 s and 1.4 +/- 0.2 s,
      respectively), and a progressive increase in arterial blood pressure (delta BP =
      21 +/- 1 and 24 +/- 1 mm Hg) and heart rate (delta HR = 27 +/- 2 and 32 +/- 2
      beats/min). Intrathecally administered mu opioids, morphine (MOR), sufentanil
      (SUF), and [D-Ala2-N-Phe4,Gly-ol]-enkephalin (DAG), produced a dose-dependent
      inhibition of the tail flick and BP response with the relative activity being SUF
      = DAG > MOR. Although the magnitude of the response evoked by increasing stimulus
      intensity from 52.5 degrees C to 60 degrees C was increased only mildly
      (suggesting that both represented essentially supramaximal stimuli), this
      increase in stimulus intensity resulted in a significant rightward shift in the
      dose-response curves (decrease in apparent potency) of the three agonists, with
      the magnitude of the shift being MOR > SUF = DAG. Thus, the dose ratio (ED50 at
      60 degrees C/ED50 at 52.5 degrees C) for these three analgesics given
      intrathecally on the tail flick and BP response was, respectively, 3.7 +/- 0.9
      and 6500 +/- 465 for MOR; 0.5 +/- 0.9 and 2.4 +/- 0.9 for SUF; and 0.5 +/- 1.2
      and 7.0 +/- 0.9 for DAG. Unlike SUF and DAG, with the 60 degrees C stimulus, the
      highest dose of MOR failed to abolish the BP and heart rate response. Previous
      work with an irreversible antagonist to define receptor occupancy requirements
      showed that the relative efficacy was SUF = DAG >> MOR. The present studies thus
      confirm the pharmacodynamically based prediction that for a given change in
      stimulus intensity, anesthetics with a high efficacy (DAG and SUF) show less
      shift in their dose response curves with a given increase in stimulus intensity
      than an agonist with low efficacy (MOR).

PMID- 8346826
TI  - Continuous spinal anesthesia with a microcatheter and low-dose bupivacaine
      decreases the hemodynamic effects of centroneuraxis blocks in elderly patients.
AB  - This prospective randomized study was designed to investigate the hemodynamic
      effects and quality of continuous spinal anesthesia (CSA) after rapid injection
      of a low dose of 0.5% bupivacaine through a 32-gauge microcatheter. The method
      was compared with continuous epidural (CEA) and single-dose spinal anesthesia
      (SSA). Seventy-seven elderly patients (ASA II-III) ranging from 57 to 94 yr old
      and undergoing lower limb surgery were assigned to CSA (n = 26), CEA (n = 26),
      and SSA groups (n = 25). In all three groups, mean arterial pressure (MAP) and
      heart rate (HR) were assessed continuously for 30 min after initial injection, as
      well as after every reinjection of local anesthetic in the CSA and CEA groups.
      Bupivacaine (0.5%) was used as a local anesthetic. The initial doses were 1 mL of
      CSA, 10 mL of CEA, and 3 mL of SSA. The reinjection doses were 1 mL of CSA and 5
      mL of CEA. In the CSA group, MAP did not decrease, whereas in the CEA group, the
      maximum decrease was 15% +/- 3% (mean +/- SEM) for the initial injection, 12% +/-
      2% for the first repetition, and 13% +/- 2% for the second repetition. In the SSA
      group, the largest decrease of MAP was 19% +/- 2%. All changes of MAP in the CEA
      and SSA groups were significantly larger compared with CSA group (P < 0.05). A
      total of seven patients in these two groups needed vasopressors due to a decrease
      of MAP of more than 30% from baseline values. Heart rate did not change.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8346828
TI  - Malignant hyperthermia: a review of published cases.
AB  - Malignant hyperthermia (MH) is triggered by many anesthetics. This study
      investigates the epidemiology of MH, its association with various drugs, and
      mortality rates. Five hundred three cases of MH were reported. MH patients were
      demographically similar worldwide. Pediatric (52.1%, age < 15 yr) and male
      (65.8%) MH patients exceed the general surgical population. Congenital defects
      and musculoskeletal surgical procedures were associated clearly with MH. Previous
      uneventful anesthesia (20.9%) and absence of positive family history (75.9%) were
      common. Case fatality rates have decreased with time to 10% since 1985. This
      decline is partly and independently due to dantrolene therapy, as well as to
      better vigilance and awareness on the part of the anesthetic community.

PMID- 8346827
TI  - Isoflurane-induced splanchnic sympathectomy.
AB  - To ascertain whether isoflurane produces a peripheral splanchnic sympathectomy as
      compared to fentanyl or pentobarbital anesthesia, 12 mongrel dogs (30-45 kg) were
      allocated randomly to one of three anesthetic test groups, tracheally intubated,
      surgically prepared, and subjected to unilateral electrical stimulation of the
      greater splanchnic nerve. Anesthetically, Group 1 animals (n = 4) received
      pentobarbital, Group 2 animals (n = 4) were administered fentanyl, and Group 3
      animals (n = 4) received isoflurane. Stimulation continued for 90 min. Each
      second of stimulation consisted of 20 stimuli of 0.5 minimum alveolar anesthetic
      concentration duration and 5 V intensity, delivered during a 0.2-s interval,
      followed by an 0.8-s pause. To assess splanchnic sympathetic responses, mean
      arterial blood pressure, heart rate, pulmonary artery diastolic, cardiac output,
      adrenal blood flow, adrenal and arterial norepinephrine (N) and epinephrine (E)
      were obtained before and at 5, 10, 15, 30, 45, 60, and 90 min during stimulation.
      In Group 1 animals (pentobarbital), electrical stimulation elicited marked
      increases in mean arterial blood pressure, pulmonary artery diastolic, and
      cardiac output (P < 0.001). Examination of the adrenal effluent, which was
      exteriorized from the animal during the protocol, revealed that adrenal blood
      flow, adrenal vein N and E concentrations dramatically increased (P < 0.0001).
      Arterial N and E concentrations remained unchanged. Results of Group 2 animals
      (fentanyl) were similar to those of Group 1; mean arterial blood pressure,
      pulmonary artery diastolic, and cardiac output increased (P < 0.005). Adrenal
      blood flow, adrenal vein N and E increased dramatically (P < 0.0001).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8346829
TI  - A clinical comparison of bronchial cuff pressures in three different designs of
      left double-lumen tubes.
AB  - This study compared the bronchial cuff pressures and volumes required by three
      different designs of disposable left double-lumen tubes during clinical one-lung
      ventilation in 48 patients having right thoracotomies. Mallinckrodt, Rusch, and
      Sheridan design tubes (n = 16 for each) were studied in a randomized fashion
      using Fr# 35, 37, 39, and 41 sizes (n = 12 for each size). There were no
      pressure/volume differences between brands during bronchial cuff inflation before
      endotracheal intubation. Intraoperatively, the Sheridan design required
      significantly higher mean bronchial cuff pressures: [27.9 cm H2O +/- 17 cm H2O
      (SD)] than either the Mallinckrodt [17.6 cm H2O +/- 8.5 cm H2O (P = 0.012)] or
      Rusch [14.1 cm H2O +/- 8.6 cm H2O (P = 0.010)] to achieve one-lung isolation.
      During prolonged one-lung ventilation, the potential for trauma to the bronchus
      may be reduced with a Mallinckrodt or Rusch design of left double-lumen tube.

PMID- 8346831
TI  - The selection of a residency program: prospective anesthesiologists compared to
      others.
AB  - A study was undertaken to investigate factors important to senior medical
      students, particularly prospective anesthesiology residents, in selecting a
      residency program. A previously published questionnaire was used to determine
      whether previous findings could be replicated. One hundred ninety-seven senior
      medical students rated the importance of 22 items in their selection of a
      residency program. Factors were ranked nearly identically as in the previous
      study. Factors rated as most important were "diversity of training experience" as
      well as "house officer satisfaction," whereas items about treating patients with
      the acquired immunodeficiency syndrome were rated as least important. There were
      gender differences that showed women assigned more importance to having a
      manageable case load, call schedules, and geographic location. Prospective
      anesthesiology residents perceived "prestige" of the program, and the department
      as significantly more important than did prospective nonanesthesiology residents.
      The replication of results with regard to the overall ranking of factors
      demonstrates the reliability of the results. Resident selection committees need
      to focus on the issue of quality of training, the impression made by the
      interviewers, and include satisfied residents as part of the interview process.

PMID- 8346830
TI  - Intravenous lidocaine as a suppressant of coughing during tracheal intubation in
      elderly patients.
AB  - The effects of intravenously administered lidocaine on cough suppression in
      elderly patients over the age of 60 yr during tracheal intubation under general
      anesthesia were evaluated in two studies. In the first study, 100 patients
      received a placebo of either 0.5, 1.0, 1.5, or 2.0 mg/kg lidocaine intravenously
      1 min before tracheal intubation. All visible coughs were classified as coughing.
      The incidence of coughing decreased as the dose of lidocaine increased. A dose of
      1.5 mg/kg or more of intravenous lidocaine suppressed the cough reflex
      significantly (P < 0.01). In the second study, 108 patients received 2 mg/kg
      lidocaine intravenously or a placebo 1, 3, 5, 7, 10, or 15 min before intubation.
      The same criteria for determining whether a patient did or did not cough during
      tracheal intubation were used as in Study 1. The incidence of coughing decreased
      significantly (P < 0.01) when 2 mg/kg lidocaine was injected intravenously
      between 1 min and 3 min before attempting intubation. The cough reflex was almost
      entirely suppressed by plasma concentrations of lidocaine in excess of 4
      micrograms/mL. The results suggest that intravenous administration of lidocaine
      is effective in suppressing the cough reflex during tracheal intubation in
      elderly patients under general anesthesia, but that relatively high plasma
      concentrations of lidocaine may be required for suppression of coughing.

PMID- 8346832
TI  - Diltiazem reduces the dose requirement for nitroprusside-induced hypotension.
AB  - The efficacy of diltiazem, a calcium channel blocker, for reducing the dose
      requirement for nitroprusside-induced hypotension was studied in 20 healthy
      patients during spine fusion for scoliosis. Anesthesia included methohexital (3
      mg/kg followed by 3 mg.kg-1.h-1 intravenously), nitrous oxide, and alfentanil (40
      micrograms/kg, followed by 0.7 microgram.kg-1.min-1 intravenously). Patients were
      assigned randomly to two groups, receiving either nitroprusside alone or
      nitroprusside and diltiazem (bolus of 80 micrograms/kg with two consecutive
      infusions of 4.5 micrograms.kg-1.min-1 during the first 30 min and then 1.3
      micrograms.kg-1.min-1). Nitroprusside was used to maintain mean arterial pressure
      at 55-60 mm Hg in both groups. Hypotension was obtained in similar times, 4 min
      in the group receiving nitroprusside alone (range, 1-8 min) and 2 min in the
      group receiving nitroprusside and diltiazem (range, 1-8 min). Nitroprusside
      administration lasted 186 +/- 17 min (mean +/- SEM) in the group receiving
      nitroprusside alone and 214 +/- 26 min (mean +/- SEM) in the other group (NS).
      After hypotension, arterial blood pressure returned to its initial value in a
      time of 7 min in the group receiving nitroprusside alone (range, 5-9 min) and 9
      min in the group receiving nitroprusside and diltiazem (range, 7-13 min) (NS).
      Cumulative doses of nitroprusside were larger in the group receiving
      nitroprusside alone (0.47 +/- 0.07 mg/kg; mean +/- SEM) than in the other group
      (0.24 +/- 0.05 mg/kg; mean +/- SEM) (P < 0.01). Significant increase in plasma
      thiocyanate concentration, cardiac index, and heart rate was observed only in the
      group receiving nitroprusside alone, but no intergroup differences were
      found.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346833
TI  - Comparative myocardial depressive effects of propofol and thiopental.
AB  - To compare the direct myocardial effects of thiopental and propofol,
      concentration-contractility curves were determined by using an isolated guinea
      pig left atrial preparation. Contractility was measured as peak twitch tension,
      maximum rate of contraction (dT/dt), and maximum rate of relaxation (-dT/dt).
      Drug concentrations ranged from 56 microM (10 micrograms/mL) to 2800 microM (500
      micrograms/mL) propofol and 3.8 microM (1 microgram/mL) to 190 microM (50
      micrograms/mL) thiopental. Data were fitted to a sigmoidal inhibitory
      pharmacodynamic model in which an increasing incremental drug concentration is
      needed to cause a consistent incremental effect. Comparisons were then made of
      the drug concentrations at which a 50% inhibition in contractility was noted
      (IC50). To compare drugs on an equi-anesthetic basis, comparisons also were made
      between IC50 values normalized to anesthetic concentrations needed to produce
      anesthesia (67.8 microM and 28.1 microM for thiopental and propofol,
      respectively). Data from seven atrial preparations for thiopental and seven
      atrial preparations for propofol were analyzed. The IC50 (microM) for peak twitch
      tension were 20.9 +/- 6.3 and 96.6 +/- 10.1 (P < 0.05), for dT/dt were 21.1 +/-
      5.9 and 86.9 +/- 8.3 (P < 0.05), and for -dT/dt were 21.0 +/- 6.1 and 84.3 +/-
      9.2 (P < 0.05) for thiopental and propofol, respectively. When the normalized
      IC50 were compared, the differences between anesthetics became greater. For
      guinea pig left atria in vitro, thiopental is a more potent myocardial depressant
      than propofol, especially when compared relative to anesthetic potencies; neither
      anesthetic preferentially affects peak twitch tension, maximum rate of
      contraction, or maximum rate of relaxation.

PMID- 8346834
TI  - Effect of anesthetics on neuropathologic sequelae of status epilepticus in rats.
AB  - We compared the efficacy of four different classes of anesthetics to arrest the
      progression of brain damage after chemoconvulsant-induced seizures in rats. In
      two series of experiments, ventilated, paralyzed Long-Evans rats were subjected
      to 30 or 45 min of continuous seizures induced by intravenous (IV)
      mercaptopropionic acid (MPA) or inhaled flurothyl, respectively. In the first
      series, seizures produced with MPA were treated with: 1) thiopental, 15 mg/kg IV
      bolus (controls); 2) thiopental, 27 mg/kg IV followed by 20.9 mg.kg-1.h-1 for 2
      h; 3) isoflurane 4% inhaled concentration for 1 min followed by 1%-2% for 2 h; 4)
      ketamine 30 mg/kg IV followed by 9.12 mg.kg-1.h-1 for 2 h; 5) midazolam 25 mg/kg
      IV followed by 9.7 mg.kg-1.h-1 for 2 h. In a second series, seizures were
      produced by flurothyl and, based on suggestive results in the MPA series, control
      rats were compared with rats receiving midazolam 25 mg/kg IV followed by 9.7
      mg.kg-1.h-1. In all instances, seizure activity, recorded by
      electroencephalograph, stopped with anesthetic treatment. In MPA-treated rats
      extranigral damage was mild, with no differences apparent between anesthetics.
      Control animals sustained severe lesions in the substantia nigra pars reticulata
      (SNPR). No statistically significant differences between anesthetic groups were
      present, although an effect was suggested for midazolam to decrease SNPR lesional
      area (P = 0.06). In flurothyl-treated rats, there were significant reductions in
      SNPR neuropathologic grade (P = 0.025) and lesional area (P = 0.025) with
      midazolam. We conclude that midazolam attenuates postseizure SNPR damage in rats.

PMID- 8346835
TI  - High levels of carbon monoxide are produced by electro-cautery of tissue during
      laparoscopic cholecystectomy.
AB  - Pyrolysis of tissue in a hypoxic environment can produce carbon monoxide. The
      atmosphere of the peritoneal cavity is rendered hypoxic during laparoscopic
      cholecystectomy by insufflation with 100% carbon dioxide. To determine whether
      carbon monoxide is produced by electrocautery of tissue during laparoscopic
      cholecystectomy, nine patients undergoing this procedure had the insufflation gas
      after use of electrocautery analyzed for carbon monoxide. Blood was analyzed for
      carboxyhemoglobin in these same patients to determine whether carbon monoxide was
      being absorbed in dangerous amounts. Carbon monoxide was present in the
      peritoneal cavity 5 min after use of electrocautery was initiated at a median
      concentration of 345 ppm (range 25-1600 ppm), and at the end of surgery at a
      concentration of 475 ppm (range 100-1900 ppm). This was well in excess of the 35
      ppm upper limit for a 1-h exposure set by the Environmental Protection Agency.
      The carboxyhemoglobin concentrations (mean +/- SD) were the same at the beginning
      (1.3% +/- 0.7%), end (1.2% +/- 0.7%), and the day after surgery (1.1% +/- 0.6%).
      Although there was no evidence of significant absorption of carbon monoxide in
      these patients, care should be taken to scavenge the gases produced by cautery of
      tissues to avoid operating room contamination during laparoscopic surgery.

PMID- 8346837
TI  - Influence of inhaled anesthetics on the pharmacokinetics and pharmacodynamics of
      morphine.
AB  - We determined the magnitude and duration of the effect of morphine (1.0 mg/kg
      intravenous bolus) on isoflurane and halothane minimum alveolar concentration
      (MAC) in six dogs anesthetized on two occasions in cross-over fashion. Plasma
      morphine concentration-time profiles and changes in PaCO2 were determined after
      morphine injection. After morphine injection, the end-tidal anesthetic dose was
      manipulated over the course of a 4-h observation period to account for the
      decline in plasma morphine concentration and to maintain an anesthetic level
      equivalent to 1.0 MAC isoflurane or halothane alone. Morphine decreased the MAC
      of halothane and isoflurane. The magnitude of MAC decrease was related to time
      after morphine injection and was similar for a given time with both halothane and
      isoflurane. For example, at 28.8 +/- 3.6 (mean +/- SE) and 34.8 +/- 6.3 min after
      morphine injection, the MAC for halothane and isoflurane were reduced by 35.7% +/
      4.5% and 39.3% +/- 3.4%, respectively. By 4 h after morphine injection, the MAC
      reduction for both anesthetics was less than 10% in most of the animals. Except
      for systemic clearance of morphine during halothane and isoflurane (40.1 +/- 6.1
      and 53.7 +/- 5.6 mL.min-1.kg-1, respectively), there were no differences in
      disposition kinetics of free morphine associated with the two inhaled
      anesthetics. Morphine increased PaCO2 to a similar degree with both halothane
      (from 42.2 +/- 2.1 mm Hg to 55.6 +/- 2.3 mm Hg) and isoflurane (46.2 +/- 2.4 mm
      Hg to 55.3 +/- 2.1 mm Hg). Respiratory depression was abolished by noxious
      stimulation (tail clamp) and naloxone in all animals with both
      anesthetics.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346836
TI  - The impact of streptozotocin-induced diabetes on the minimum alveolar anesthetic
      concentration (MAC) of inhaled anesthetics in the rat.
AB  - We designed experiments to examine the effects of insulin-dependent diabetes
      mellitus on the anesthetic requirements for volatile anesthetics. A standard tail
      clamp technique was used to determine minimum alveolar anesthetic concentrations
      for halothane, enflurane, and isoflurane in spontaneously breathing rats. Three
      groups of animals were used: 1) diabetic rats (12 wk after induction of diabetes
      with streptozotocin, 50 mg/kg, single dose, intravenously), 2) insulin-treated (7
      U extended insulin zinc suspension per day, subcutaneously, beginning 5 wk after
      streptozotocin treatment) diabetic rats, and 3) control rats. The minimum
      alveolar anesthetic concentration values of the control animals were 1.16 +/-
      0.02 vol% for halothane, 2.25 +/- 0.05 vol% for enflurane, and 1.42 +/- 0.04 vol%
      for isoflurane. Minimum alveolar anesthetic concentration was reduced by 23% for
      halothane (0.90 +/- 0.06 vol%), by 18% for enflurane (1.85 +/- 0.07 vol%), and by
      17% for isoflurane (1.18 +/- 0.04 vol%) in diabetic rats. Insulin treatment
      restored the anesthetic requirement to control levels for all three anesthetics.
      These data from the rat model indicate that uncontrolled diabetes lowers
      anesthetic requirements significantly.

PMID- 8346838
TI  - Folinic acid protection against hematopoietic depression induced by nitrous oxide
      in rats.
AB  - We studied the degree of hematopoietic depression and spontaneous recovery of
      depressed hematopoietic cells with 50% nitrous oxide-oxygen inhalation for 6 or
      12 h in 120 Sprague-Dawley rats. Bone marrow and blood were sampled serially
      immediately after, 1 day, 3 days, and 1 wk following nitrous oxide inhalation.
      After 1 wk of culturing of hematopoietic stem cells, the number of the colony
      forming units of granulocytes and monocytes and the colony-forming units of T
      lymphocytes grown from bone marrow and blood were counted. There was no change in
      the number of colonies immediately after inhalation compared with the control
      group, but there was a significant decrease in the number of colonies 1 and 3
      days after inhalation (P < 0.001), and 1 wk after inhalation, there was
      spontaneous recovery without any treatment. Nitrous oxide may depress the early
      phase of differentiation of hematopoietic stem cells such as granulocytes,
      monocytes, and lymphocytes as well as erythrocytes. Also, the degree of
      suppression was more intense after 12 h than after 6 h of inhalation. That is,
      the length of inhalation time corresponds to the intensity and rapidity of
      suppression. To evaluate the protective effect of folinic acid against
      hematopoietic depression, folinic acid (0.1 mg/0.3 mL) was injected
      intraperitoneally before or after nitrous oxide inhalation. The groups injected
      with folinic acid showed significant increase in the number of colonies,
      especially in the group receiving folinic acid 12 h and 1 h before nitrous oxide
      inhalation (P < 0.001). Pretreatment with folinic acid may prevent the
      hematopoietic depression caused by the prolonged and repeated use of nitrous
      oxide.

PMID- 8346839
TI  - Preemptive analgesia--treating postoperative pain by preventing the establishment
      of central sensitization.

PMID- 8346840
TI  - Plasma cholinesterase: gene and variations.
AB  - The traditional tests that have been used for the past 30 yr to determine plasma
      cholinesterase phenotype--measurement of esterase activity with a variety of
      substrates, dibucaine inhibition, fluoride inhibition, and Ro2-0683 inhibition-
      are inadequate for identifying some variants of this enzyme and leave many cases
      of prolonged response to succinylcholine unexplained. The application of the
      techniques of molecular genetics has permitted precise identification of plasma
      cholinesterase variants and has resulted in the discovery of previously
      unrecognized variants. It is now possible, in cases of prolonged response to
      succinylcholine resulting from genetically determined alterations in plasma
      cholinesterase, to ascertain the nature of the mutations in the alleles, and from
      them to deduce the structural changes in the enzymes responsible for the
      impairment in drug metabolism.

PMID- 8346841
TI  - Reduction of jugular venous oxygen saturation coincidental with
      electroencephalographic abnormality.

PMID- 8346842
TI  - Fentanyl transdermal system overdose secondary to cutaneous hyperthermia.

PMID- 8346843
TI  - Is mivacurium chloride effective in electroconvulsive therapy? A report of four
      cases, including a patient with myasthenia gravis.

PMID- 8346844
TI  - Respiratory obstruction in a patient with Melkersson-Rosenthal syndrome.

PMID- 8346845
TI  - Continuous caudal epidural bupivacaine infusions in children.

PMID- 8346846
TI  - An algorithm for use of the laryngeal mask airway during failed intubation in the
      patient with a full stomach.

PMID- 8346847
TI  - Glass ampules.

PMID- 8346848
TI  - The esophageal detector device in the morbidly obese.

PMID- 8346849
TI  - The increase in plethysmographic amplitude due to the clipping of the vein of
      Galen aneurysm.

PMID- 8346850
TI  - Severe deformation of a small-gauge spinal needle.

PMID- 8346851
TI  - Perioperative serum bupivacaine levels after topical bladder anesthesia for
      bladder biopsy.

PMID- 8346852
TI  - Risk of cerebellar tonsillar herniation after diagnostic lumbar puncture in
      pseudotumor cerebri.

PMID- 8346853
TI  - Fiberoptic tracheal intubation through the laryngeal mask in an awake patient
      with cervical spine injury.

PMID- 8346854
TI  - Postoperative ulnar nerve palsy--is it an unpreventable complication?

PMID- 8346855
TI  - Peroneal palsy after epidural analgesia.

PMID- 8346856
TI  - Limitations of somatosensory evoked potentials for quantitating isolated nerve
      block.

PMID- 8346857
TI  - What is general anesthetic action?

PMID- 8346858
TI  - Intraoperative aspiration pneumonitis and the laryngeal mask airway.

PMID- 8346859
TI  - Intermittent throat tightness in a 37-year-old woman.
AB  - Intermittent throat tightness with dysphagia can be a complaint with numerous
      potential underlying causes. It was useful to think of this patient's complaints
      as secondary to an allergic, neuromuscular, or mechanical/structural disorder.
      Dysphagia can usually be separated into two broad categories according to
      location: oropharyngeal or esophageal. The patient typically can help one
      localize the area of involvement by pointing to the area where the difficulty in
      swallowing is felt to be present. This patient pointed to the throat area.
      Helpful diagnostic studies in the evaluation of oropharyngeal dysphagia include
      barium swallow with cine-esophagogram, rhinopharyngoscopy, or upper
      gastrointestinal endoscopy. It was interesting that this patient was referred to
      the Allergy Service because a physician felt that intermittent laryngeal
      angioedema was also a possible consideration. It is known that dysphagia,
      hoarseness, and sensations of throat tightness or closing frequently accompany
      this entity. The finding of a palpable thyroid was the clue that further
      evaluation of this organ was also indicated. Alfonso et al have reported on
      tracheal or esophageal compression secondary to benign thyroid disease. In their
      series, goiter, though previously felt to be associated with a low incidence, was
      reported to have an overall high incidence. Of the several types of thyroid
      disease encountered, they noted thyroiditis was associated with the highest
      likelihood of compression and a 67% frequency of associated obstruction. Our
      patient's scan and uptake findings are consistent with thyroiditis although
      multinodular goiter may occasionally show similar results. This case reminds us
      that in the differential of laryngeal angioedema and complaints associated with
      the throat or referred in the throat area, local extrinsic compression secondary
      to masses should be included. In this patient, a goiter, of which the extent of
      gland enlargement may not be fully appreciable on physical examination, was
      determined to be the etiology of her complaints. She was placed on a thyroid
      hormone suppression treatment regimen. At a followup visit several months later,
      she noted marked improvement of her symptoms with resolution of her dysphagia and
      episodes of throat tightness.

PMID- 8346860
TI  - Administration errors with a conventional metered dose inhaler versus a novel
      breath actuated device.
AB  - Metered dose inhalers are difficult for patients to use. A device that eliminates
      coordination and timing of actuation may simplify the use of metered dose
      inhalers. This trial compared (1) number of errors made and (2) specific errors
      made between the conventional press and breathe metered dose inhaler (MDI) and
      the novel breath actuated Autohaler inhalation device in 24 subjects. We studied
      the use of each device in 12 patients trained and experienced in using an MDI and
      in 12 volunteers who had never been exposed to any inhalation device. We observed
      that even experienced patients continue to have difficulty with the coordination
      and timing of metered dose inhalers. The volunteer group had equal difficulty
      with both devices but it appeared that it was easier for them to learn how to use
      the breath actuated device than the MDI.

PMID- 8346861
TI  - Food specific IgE antibodies: a comparative study of AlaSTAT and Pharmacia RAST
      Phadebas CAP systems in 49 patients with food allergies.
AB  - Forty-nine sera from patients with food allergies confirmed by challenge and of
      14 with suspected allergy were assayed with the DPC AlaSTAT liquid phase EIA and
      the Phadebas RAST CAP radioimmunoassay (RIA). Twenty-two foods were tested (four
      animals, 18 vegetables). Controls were performed on nonatopic subjects (N = 8).
      Specificity was 100%. Concordance RAST CAP/AlaSTAT was 79.6%; prick
      tests/AlaSTAT: 76%; prick tests/RAST CAP: 73.9%. AlaSTAT detected specific IgE
      even in sera with low total IgE (< 60 KU/L), while RAST CAP was inconclusive.
      Dilution studies and reproducibility were excellent. AlaSTAT EIA compares
      favorably with the Phadebas RAST CAP RIA for measurement of food-specific IgE
      antibodies.

PMID- 8346862
TI  - Allergist influence on asthma care.
AB  - In 1989, the hospitalization rate for asthma at our institution had increased
      23%. To evaluate possible reasons for this we examined all new patients seen in
      our clinic between June, 1985 and June, 1986. A second assessment of the same
      patients between June, 1987 and June, 1988 was also performed. Two-hundred nine
      patients were seen for asthma in 1986. Analyzed by follow-up care provider, care
      by an allergist (CA), and nonallergist care (NAC), at baseline patients had
      similar hospitalization (CA = 37%, NAC = 40%) and emergency room (CA = 61%, NAC =
      45%) visit rates. At follow-up (1988), there was a significantly higher
      hospitalization rate in the NAC group (35%) than in the CA group (13%). Emergency
      room visits during the previous year were also significantly greater in the NAC
      group (47%) compared with the CA group (18%). Major differences in drug therapy
      between 1986 and 1988 included a marked increase in the utilization of inhaled
      corticosteroids and sodium cromolyn in the maintenance therapy of patients
      followed by an allergist. The use of spacer devices for inhalers and home peak
      flow meters also increased significantly in the CA group. Oral corticosteroid use
      increased similarly in both groups. Although there is an overall increase in
      admissions for asthma at our institution in 1989, these data suggest that
      continued follow-up care by an allergist is associated with a decreased hospital
      admission and emergency room visit rates when compared with care given by a
      generalist.

PMID- 8346863
TI  - Seasonal allergic rhinitis and antihistamine effects on children's learning.
AB  - Children suffering from seasonal allergic rhinitis and matched normals were
      instructed on the use of a didactic computer simulation in a realistic classroom
      situation. Groups of atopic children received different treatments before
      instruction; ie, sedating (diphenylhydramine HCl) or nonsedating (loratadine)
      antihistamines or placebo. All returned after 2 weeks for an examination
      measuring factual and conceptual knowledge and the application of a learned
      strategy. Examination results showed large and consistent impairing effects of
      the allergic reaction on prior learning. Both the placebo and diphenhydramine
      groups learned significantly less than normal controls. The loratadine group's
      learning performance was superior to either of the other atopic groups' but still
      inferior to the normals'. Our conclusions are that the allergic reaction reduces
      learning ability in children and that this effect is partially counteracted by
      treatment with loratadine and aggravated by diphenhydramine.

PMID- 8346864
TI  - Falafel burger anaphylaxis due to sesame seed allergy.
AB  - With the increasing demand for vegetarian food the consumption of vegetable
      burgers as an alternative to beef burgers has now become widespread. Since
      products of this kind are often not provided with a clear description of their
      components or ingredients, potential allergens generally cannot be identified by
      the consumer. Their ingestion, however, may lead to severe allergic reactions in
      sensitized individuals. Here we describe nine systemic allergic reactions to
      sesame seeds that were diagnosed at the Allergy Unit, Department of Dermatology,
      Zurich, Switzerland between 1978 and 1991. In 1991 alone, we registered three
      cases of anaphylactic reaction to falafel vegetable burgers in patients allergic
      to sesame seeds. A falafel is an oriental specialty consisting of a wheat flour
      bun filled with chickpea balls. It is served together with a white sauce
      containing freshly ground sesame seeds. Our cases highlight the potential danger
      of vegetarian food and underline the importance of a proper allergologic
      assessment to recognize food allergy promptly so that the patient can eliminate
      the causative allergen and use suitable medication in the event of a dietary
      indiscretion.

PMID- 8346865
TI  - Effect of economic status on the use of house dust mite avoidance measures in
      asthmatic children.
AB  - To assess the effect of socioeconomic status on compliance with house dust mite
      avoidance measures, we interviewed the parents of 60 mite-allergic, asthmatic
      children about mite avoidance. Thirty were of lower socioeconomic status and 30
      were of higher socioeconomic status, as determined by the type of insurance. All
      had previously learned mite avoidance measures at the time of diagnosis. Twenty
      of 30 lower socioeconomic status parents had removed stuffed toys from the
      child's bedroom compared with only 12 of 30 higher socioeconomic status parents
      (P = .07). Twelve of 30 parents in the lower socioeconomic status group had
      obtained plastic mattress covers compared with 22 of the 30 higher socioeconomic
      status parents (P = .018). Eighteen parents in the lower socioeconomic status
      group expressed reasons for not obtaining plastic covers. Nine cited lack of
      funds, four did not know where to buy them, and four did not think it would help.
      Of the eight parents in the higher socioeconomic status group that did not obtain
      covers, six cited inconvenience and two thought it would not help. We conclude
      that education alone will not ensure compliance with house dust mite controls.
      Economic factors influence utilization. Access to free or low cost mite-proof
      pillow and mattress covers may improve asthma care for poor children.

PMID- 8346866
TI  - Heterogeneity of human Fc epsilon RI-bearing cells.
AB  - Basophils and mast cells (Fc epsilon RI-bearing cells) play important but clearly
      distinct roles in human inflammatory and allergic reactions. While many
      similarities have been described, it is increasingly evident that many more
      differences exist between these two cell types. These include maturational and
      ultrastructural as well as functional differences. Basophils and mast cells can
      be activated by different stimuli, produce different profiles of inflammatory
      mediators, and their response can be modulated in a different fashion. The
      heterogeneity of Fc epsilon RI-bearing cells has recently been extended by
      studies on mast cells isolated from different human tissues. These studies may
      suggest the existence of different human mast cell phenotypes the development of
      which may be regulated by microenvironmental factors. A better understanding of
      the heterogeneity of basophils and mast cells is a necessary step to define their
      respective roles in the pathophysiology of human inflammatory responses.

PMID- 8346868
TI  - Influence of hypoallergenic milk formula on the incidence of early allergic
      manifestations in infants predisposed to atopic diseases.
AB  - One hundred twenty-two infants at risk of atopy on the basis of IgE screening at
      birth and family history of atopy were studied. The occurrence of atopic
      manifestations was analyzed in relation to their diets during the first 3 months
      of age. Only the infants receiving hypoallergenic milk were protected
      effectively; all other regimens (humanized cow milk, hypoallergenic milk or
      humanized cow milk + supplements) increased the frequency of allergic symptoms (P
      < .07). After a 1-year follow-up, the infants fed strictly on hypoallergenic milk
      during their 3 first months presented allergic symptoms less frequently than
      other infants (P < .007).

PMID- 8346867
TI  - Time course of plasma histamine and tryptase following food challenges in
      children with suspected food allergy.
AB  - This study was undertaken to investigate the kinetics of histamine and tryptase
      in the circulation of patients with food allergy and to determine whether the
      measurements of plasma histamine and tryptase concentrations after food
      challenges provided additional predictive markers for the diagnosis and
      evaluation of food allergy. Twenty-one open food challenges were performed on 13
      patients with suspected food allergy. Plasma histamine and tryptase
      concentrations were measured during 4 hours after challenge. In the group of
      patients with immediate reactions after challenges, the mean plasma histamine
      concentration rose significantly at 120 and 240 minutes after the challenge, and
      the mean plasma tryptase concentration was increased significantly at 240 minutes
      after challenge. Plasma histamine and tryptase concentrations were measured
      during 24 hours after 8 open food challenges in 7 other patients with suspected
      food allergy. In each patient with a nonimmediate reaction, plasma histamine
      concentrations were increased at the onset of symptoms after challenge, but no
      plasma tryptase concentrations increased. The elevation of plasma histamine and
      tryptase in patients with immediate reactions following food challenge indicates
      mast cell activation. On the other hand, the elevation of plasma histamine
      without elevated plasma tryptase in the patients with nonimmediate reactions
      following food challenge may indicate basophil activation rather than mast cell
      activation. Plasma histamine and tryptase measurements after food challenge may
      be useful in the detection and evaluation of food allergy.

PMID- 8346869
TI  - IgG and IgE antibody responses to dust mite allergens among children with asthma
      in Brazil.
AB  - We compared exposure and levels of IgE and IgG antibodies to inhalant allergens
      in 20 children with asthma and positive skin tests to Dermatophagoides
      pteronyssinus, living in Sao Paulo, to 20 control children without history of
      asthma or allergy and negative skin tests to D. pteronyssinus, D. farinae, and
      Blomia tropicalis. In 16/20 and 17/20 houses of asthmatic and control children,
      respectively, at least one sample was obtained which contained > 10 micrograms
      Der p I/g of dust. Serum IgE antibodies to D. pteronyssinus and Blomia tropicalis
      were > 200 RAST U/mL in 19/20 and in 16/20 asthmatic children, respectively. In
      the control group, IgE antibodies to either mite species were < 40 RAST U/mL in
      most cases. IgG anti-Der p I and anti-Der f I antibodies were detected in 17/20
      asthmatics, as opposed to 3/20 controls. Neither cat nor cockroach allergens
      caused significant sensitization among asthmatic or control children. Although
      exposure to high levels of mite allergens was common in Sao Paulo, significant
      IgE and IgG antibody responses were detected only in children with asthma.

PMID- 8346870
TI  - Fish allergy in children.
AB  - Fish allergy is a relevant clinical problem in fish eating and/or processing
      communities but, because of the technologic advances of the preserved food
      industry, it may now be said to be a worldwide problem. Among 558 consecutive
      children referred for atopic diseases, 25 (4.48%) subjects skin test- and RAST-
      positive to cod were recorded and we extrapolated that about 4-5/1000 children
      have allergy to cod in our areas. As a group, children with cod allergy seem to
      manifest a higher atopic condition and more severe clinical manifestations. IgE
      level z-score (mean +/- SD) was significantly (P < .001) higher in 68 cod
      positive children (14.27 +/- 3.87) than in 533 children positive to other
      inhalant and/or food allergens (8.12 +/- 4.06). In spite of a smaller median age
      (59 months), cod-positive children had a higher frequency of asthma (41/68 =
      60.2%) than children with other allergies, and age at the onset of asthma was
      significantly (P < .001) younger in the former (32 months) than in the latter (41
      months) subjects. In addition, urticaria-angioedema was more frequently recorded
      in cod-allergic children (23/68 = 33.8%) than in patients with allergy to
      inhalants (26/410 = 6.3%; P < .01), inhalants and foods different from cod (11/74
      = 14.8%; P < .01), or foods different from cod (6/49 = 12.2%; P < .01). The
      male:female ratio in cod-allergic children (3.53) was significantly higher than
      that observed in children with allergy to inhalants (1.78; P = .037) or foods
      (0.68; P < .0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346871
TI  - Methyldopa hypersensitivity syndrome.
AB  - A 74-year-old man developed an extensive erythematous skin eruption, fever,
      lymphadenopathy and eosinophilia probably due to methyldopa. The symptoms
      reappeared shortly after unintentional reexposure to the drug. The positive
      results of two in vitro tests for the detection of drug allergy not only give
      further support to the causal relationship between the drug and the symptoms, but
      also indicate the involvement of an immunologic, allergic mechanism. Although
      every individual symptom represented in our case has been reported in previous
      cases, the association of the symptoms together in one patient has never before
      been reported. An awareness that adverse reactions to methyldopa can mimic a
      variety of acute infectious diseases and lymphoproliferative disorders is the key
      to diagnosis and might prevent unnecessary hospitalizations, procedures, and use
      of potentially toxic antibiotics and chemotherapy.

PMID- 8346872
TI  - Practical issues in asthma management: correct use of inhalation devices.

PMID- 8346873
TI  - The need for early interventions in childhood asthma.

PMID- 8346874
TI  - A comprehensive evaluation of within- and between-worker components of
      occupational exposure to chemical agents.
AB  - A database of approximately 20,000 chemical exposures has been constructed in
      close co-operation between the School of Public Health of the University of North
      Carolina at Chapel Hill and the Department of Air Pollution of the Wageningen
      Agricultural University. A special feature of this database is that only multiple
      measurements of exposure from the same workers were included. This enabled
      estimation of within- and between-worker variance components of occupational
      exposure to chemical agents throughout industry. Most of the groups were not
      uniformly exposed as is generally assumed by occupational hygienists. In fact
      only 42 out of a total of 165 groups (25%), based on job title and factory, had
      95% of individual mean exposures within a two-fold range. On the contrary, about
      30% of the groups had 95% of individual mean exposures in a range which was
      greater than 10-fold. Environmental and production factors were shown to have
      distinct influences on the within-worker (day-to-day) variability, but not on the
      between-worker variability. Groups working outdoors and those working without
      local exhaust ventilation showed more day-to-day variability than groups working
      indoors and those working with local exhaust ventilation. Groups consisting of
      mobile workers, those working with an intermittent process and those where the
      source of contamination was either local or mobile also showed great day-to-day
      variability. In a multivariate regression model, environment (indoors-outdoors)
      and type of process (continuous-intermittent) explained 41% of the variability in
      the within-worker component of variance. Another model, in which only type of
      process (continuous-intermittent) had a significant effect, explained only 13% of
      the variability in the between-worker component of variance.

PMID- 8346875
TI  - Dust from cotton manufacture: changing from static to personal sampling.
AB  - Several designs of personal samplers were tested for use to collect cotton dust.
      The IOM personal inhalable-dust sampler was selected because: (1) collection of
      the whole inhalable fraction was preferred, since all inhaled sizes are under
      suspicion as contributing to respiratory symptoms in cotton exposure; (2) this
      sampler is well characterized; and (3) it was found to be practicable in the
      environments examined. Gauze shields to exclude 'fly' from the personal sampler
      were tried, but were rejected mainly because measurement of the whole inhalable
      fraction by a validated sampler was felt to be more appropriate. A range of
      processes at a representative selection of mills was assessed by a hygiene team,
      and classified as 'clean' or 'dirty' in terms of present standards of control.
      This classification agreed well with subsequent measurements using the present
      method, which uses a large static sampler. A personal sampling survey then showed
      that in about two-thirds of 'clean' processes personal exposure of at least 80%
      of those employed was less than about 2-2.5 mg m-3. Only one-tenth of 'dirty'
      processes met this standard. Personal exposure correlates poorly with the present
      static method, as expected, but comparison of the results suggested that a mean
      background level of 0.5 mg m-3 would correspond to a median personal exposure of
      about 2.2 mg m-3. Side-by-side measurements by the background method differed by
      less than 0.15 mg m-3 on about 95% of occasions. Niven et al. (to be published)
      have compared the IOM head used in this study with the Manchester University
      sampler previously used by Cinkotai et al. [Ann. occup. Hyg. 32, 103-113 (1988)]
      to derive a relationship between personal exposure and prevalence of byssinotic
      symptoms in spinners. According to Cinkotai et al.'s results the concentrations
      of 2-2.5 mg m-3 discussed would correspond to a prevalence of 3-5%. However, this
      prevalence probably reflects higher exposures in the past.

PMID- 8346876
TI  - Occupational health problems in processing of X-ray photographic films.
AB  - Hazards to health from exposure to chemicals in automatic processing of
      photographic film is well documented by ILO and others. In the early 1980s
      increasing reports of miscellaneous health problems including respiratory and
      skin effects in radiographers processing X-ray films were published. In some
      cases asthmatic type responses were reported to be so severe as to exclude the
      radiographer from further work. It has been suggested that the increased number
      of such cases coincided with process changes, in particular the increased
      addition of glutaraldehyde as a hardening agent in the developer to offset the
      softening of the film especially those of low silver content. Attention must also
      be focused however on other miscellaneous chemicals present and of the
      possibility of synergistic reactions. The major problems appear to be associated
      with heavy workloads, poorly designed and ill-ventilated darkrooms or processing
      rooms, and lack of appropriate safe handling techniques for the chemicals used.
      Several studies illustrate improvements by attention to good occupational hygiene
      practice. The necessity for a holistic approach to control of such a complex
      micro-environment is stressed. It is unlikely that a single causal agent can be
      identified.

PMID- 8346877
TI  - Asbestos induced oxidative injury to DNA.
AB  - DNA-damaging effects of asbestos in the presence of organic peroxides and
      hydroperoxides were investigated. The destabilization of the secondary structure
      of DNA, damage to deoxyribose sugar and DNA fidelity were measured, respectively,
      by S-1 nuclease hydrolysis, the formation of thiobarbituric acid (TBA)-reacting
      species and a melting temperature (Tm) profile using calf thymus DNA. S-1
      nuclease hydrolysis and Tm determinations have shown that the presence of
      benzoylperoxide (BOOB), cumene hydroperoxide (COOH) or tertiary-butyl
      hydroperoxide (t-BOOH) increased asbestos-mediated DNA damage by a large factor
      compared either to asbestos alone or to peroxide or hydroperoxide alone. However,
      no formation of TBA-reacting species could be observed in this system. The
      quenchers of reactive oxygen species (ROS) afforded protection against DNA
      damage. These results suggest that asbestos in the presence of organic peroxides
      and hydroperoxides damage the DNA which is mediated by the generation of oxygen
      free radicals. The significance of these results in relation to the development
      of cancer of the respiratory tract among the asbestos exposed population is
      discussed.

PMID- 8346878
TI  - Education and training in occupational hygiene in the United Kingdom.
AB  - Occupational hygiene education and training is undergoing rapid changes both in
      the United Kingdom and elsewhere, developing closer links with safety and
      environmental matters whilst retaining the essential and well developed links
      with occupational medicine. At the same time major developments in the role of
      professional accreditation bodies including BEBOH are being reviewed. This paper
      identifies recurring themes on the scope of professionalism, accreditation and
      the requisite education and training for occupational hygienists.

PMID- 8346879
TI  - [Striated osteopathy].
AB  - Striated osteopathy, a roentgenological entity characterized by longitudinal
      striations, can occur concomitantly with a number of disorders which should be
      routinely looked for. There are three types of striated osteopathy. The pure form
      without severe bone disorders is the form originally reported by Voorhoeve. In
      the second form, there is a concomitant fibrous dysplasia, such as Jaffe
      Lichtenstein-Uehlinger disease, Ollier enchondromatosis, sponastrism dysplasia,
      or osteopetrosis. This group also includes bone dysplasias with sclerosis such as
      melorheostosis, osteopecilia, and sclerosis of the base of the skull which is
      sometimes seen in patients with striated osteopathy. In the third form, striated
      osteopathy occurs concomitantly with a skin disease such as patchy dermal
      hypoplasia or hyperpigmented skin lesions.

PMID- 8346882
TI  - [Psychological approach to obesity in children and adolescents in a
      multidisciplinary consultation].
AB  - Obesity is a multifactorial syndrome involving both a genetic susceptibility and
      environmental factors such as early eating experiences in infancy. Interviews,
      drawings, and a personality test (Rorschach) were used to classify obese children
      according to their personality. Results suggest that the eating disorder is only
      one component of a more global alteration in psychological organization. These
      data support the need for psychological intervention.

PMID- 8346880
TI  - [Energy metabolism in obese children].
AB  - Childhood obesity results from excessive dietary intake as compared with energy
      expenditure. This imbalance can result from either overeating or a constitutional
      decrease in one or several of the components of energy expenditure: resting
      metabolic rate, diet-induced thermogenesis, or exercise-related thermogenesis.
      Decreased energy expenditure is probably at least partly genetic in origin,
      contributing to the significant clustering of obesity in families. Management
      aims at reducing the imbalance by decreasing the caloric intake. Once the desired
      weight is achieved, intake must be adjusted to expenditure to avoid weight
      regain.

PMID- 8346881
TI  - [Obesity in children: value of clinical evaluation criteria].
AB  - To clarify risk factors for obesity in children and look for factors affecting
      prognosis, simple clinical parameters were analyzed in 113 obese children at the
      first visit and during treatment. Height and weight charts were constructed. The
      main risk factors were parental obesity, excess weight at the age of one and
      above all young age at the time of the rebound in body mass index (W/H2).
      Severity of obesity was unrelated to spontaneous caloric intake but was
      negatively correlated with age at the time of rebound in body mass index (r = 
      0.34; p = 0.017) and above all with age at onset of obesity (r = -0.53; p <
      0.001). Closely spaced measurements of weight, stature, and body mass index in
      high risk children would allow appropriate preventive treatment before the phase
      of established obesity. Curative treatment is disappointing: only 28% of the
      study subjects achieved significant reductions in weight.

PMID- 8346883
TI  - [Deficiency in medium chain acyl coA dehydrogenase manifested as febrile coma].
AB  - A 21-month-old infant developed coma with hypotonia during a viral infection.
      Acyl CoA dehydrogenase deficiency was diagnosed on the basis of results of the
      chromatographic study of organic acids performed on a urine specimen collected
      during the acute episode. However, other disorders of mitochondrial and fatty
      acid oxygenation can generate similar symptoms. Emphasis is put on the need for
      collecting urine specimens in patients who develop alterations in consciousness
      and hypoglycemia without ketonuria during prolonged fasting or repeated vomiting
      due to a viral infection. Urine chromatography can suggest which enzyme is
      defective, although the diagnosis should always be confirmed by a study of fatty
      acid oxygenation in lymphocytes or fibroblasts.

PMID- 8346884
TI  - [Histiocytosis X and sclerosing cholangitis].
AB  - The case of a seven-year-old with multifocal (type II) Langheran's cell
      histiocytosis since the age of two years is reported. Despite therapy, biliary
      cirrhosis with portal hypertension developed gradually. Histologic studies of
      liver biopsy specimens, computed tomography, and transhepatic cholangiography
      disclosed dilatation of the bile ducts, suggesting sclerosing cholangitis, a
      specific complication of Langherans' cell histiocytosis which precipitates the
      development of biliary cirrhosis.

PMID- 8346885
TI  - [Neural sarcoidosis in children. A case report].
AB  - A case of cerebral sarcoidosis of fortuitous discovery is reported in an
      adolescent. Neurosarcoidosis is exceedingly rare in the pediatric age groups.
      Clinical manifestations are widely variable and nonspecific, making diagnosis
      difficult in patients without extraneurologic involvement. The mainstay of
      management is early, prolonged corticosteroid therapy. Outcome varies with
      location of the lesions.

PMID- 8346886
TI  - [Type II primordial microcephalic dwarfism. Report of a patient with completed
      growth].
AB  - Type II primordial microcephalic dwarfism is a rare form of bird-headed dwarfism
      individualized in 1982 by Majewski. A case in a female patent with completed
      growth illustrates the main features, which include severe growth retardation
      (greater than 4 SD reduction in height) of prenatal onset, short limbs, coxa vara
      with epiphysiolysis of the hips, metaphyseal flaring and, in some instances,
      shortness of the ulnas and curvature of the radiuses. A genetic cause (with
      autosomal recessive inheritance) is very likely. A number of features in the case
      reported herein may be of pathogenetic relevance: growth hormone levels were
      elevated before closure of the epiphyses and normal thereafter, no growth spurt
      occurred at puberty, polycystic ovaries with hirsutism developed after puberty,
      and surgical wound healing was unusually slow.

PMID- 8346887
TI  - [Pulmonary sequestration in an infant].
AB  - A case of intralobar pulmonary sequestration in an infant is reported. The lesion
      presented as recurrent bronchopulmonary infections. The chest film showed a
      density in the right lower lobe, in which air-filled images and air-fluid levels
      developed rapidly. Aortography demonstrated systemic blood supply to the lesion
      from three arteries stemming from the thoracic aorta. The pathological study of
      the operative specimen confirmed the diagnosis. Postoperative outcome was
      satisfactory.

PMID- 8346888
TI  - [Measuring fecal lipid output in infants receiving a neonatal milk-based
      formula].
AB  - Fecal fat output was measured over three days in ten infants aged 28 to 115 days
      fed an infant formula (SMA Comfort, Sodilac) containing 39.2% unsaturated fatty
      acids and 20.1% medium-chain triglycerides (C8, C10, and C12). Fat intake ranged
      from 59.32 to 136.80 g. Mean fat absorption coefficient was 96 +/- 2%. SMA
      Comfort offers a fat absorption coefficient comparable to that seen with breast
      milk.

PMID- 8346889
TI  - A practical approach to surgical training abroad.

PMID- 8346890
TI  - An audit of the surgical workload on a renal unit.
AB  - OBJECTIVE: To assess the surgical workload on a renal unit, with particular
      reference to non-transplant-related surgery and to assess the workload in
      relation to surgical staffing levels. DESIGN: Prospective audit of all surgical
      procedures carried out on patients in acute or chronic renal failure, and on
      transplanted patients, within a one year period. SETTING: A purpose-built renal
      unit serving a population of 1.7 million. MAIN OUTCOME MEASURES: The number of
      surgical procedures, both transplant and non-transplant-related, according to
      type and severity, with particular reference to the levels of surgical staffing.
      RESULTS: Transplant-related surgery accounted for only 6.5 per cent of the total
      surgical workload (general, vascular and renal) of the 'transplant surgeons'.
      Taking into account only the renal-related workload, transplant-related surgery
      accounted for just 16.5 per cent of the workload, the remainder being related to
      vascular access and peritoneal access for dialysis, and general surgical
      procedures on patients in renal failure and transplanted patients. The surgical
      workload undertaken by a relatively small number of staff was high, representing
      531 Intermediate Equivalents per Service Equivalent Value per annum. CONCLUSIONS:
      When assessing workload and adequacy of surgical staffing on a Renal Unit, care
      should be taken to account for all surgical activity on renal patients and not
      just that related to transplantation since only 16.5 per cent of the surgical
      workload is transplant-related.

PMID- 8346891
TI  - What value is the patient's experience of surgery to surgeons?: the merits and
      demerits of patient satisfaction surveys.

PMID- 8346892
TI  - Portraits of a paradox: council room reflections.

PMID- 8346894
TI  - A test of a path model of biocultural transmission of fertility.
AB  - A model adapted to a general linear model of phenotypic transmission (two
      components: (1) genetic additive, (2) cultural [age at marriage]) has been used
      to analyse the familial correlations of fertility (number of children) born
      before the demographic transition at Arthez d'Asson (Bearn, 1744-1889). The model
      is rejected: chi 2 = 55.7 with 6d.f. In the ancient demographical regime,
      reproduction and nuptiality of a couple were not influenced by their parents but
      by their generation.

PMID- 8346893
TI  - Individual and community characteristics influencing breastfeeding duration in
      Vietnam.
AB  - This analysis of selected community and maternal characteristics influencing
      duration of breastfeeding in Vietnam utilized data from the 1988 Demographic and
      Health Survey and 1990 Accessibility of Contraceptives Survey available for the
      4434 children born to 2769 women having their last birth between 1983-88.
      Explanatory variables included as covariates in the hazards model were mother's
      education, age of the mother at the time of the child's birth, birth order, and
      gender of the child, urban versus rural residence, infant mortality risk in the
      child's province, locality (mountains and highlands compared to delta and
      coastal), and region of the country (north, south). Indicators of development in
      the child's village included availability of electricity and public
      transportation. Breastfeeding duration was longer among the more highly educated
      women and among those women living in provinces with higher infant mortality.
      However, there were no significant differences in the duration of breastfeeding
      with variations among certain development characteristics of the village.
      Although there were regional differences in the duration of breastfeeding for the
      rural population, there were no regional differences for the overall population.
      There were no significant variations in the duration of breastfeeding by age of
      the mother, birth order or gender of the child. Although there were significant
      variations in duration of breastfeeding by some maternal and community
      characteristics, between 80-90 per cent of all women breastfeed for at least the
      first year of the child's life.

PMID- 8346896
TI  - Estimating inbreeding from the Faculty Office Registers, 1534-1540.
AB  - Estimates of inbreeding are rather scarce for British populations. A number of
      studies, especially of Scottish island populations, have focused on pedigree
      analysis, whilst others have used survey methods or inference from isonymy. By
      comparison with continental Europe, however, little is known of the historical
      development of inbreeding. This is undoubtedly due to the lack of evidence from
      dispensations to marry blood relatives, which are routinely available in the
      records of marriage of the Roman Catholic church. The paper uses as its data
      source the Faculty Office Registers, 1534-1540, which were the product of a new
      system of issuing dispensations following the Dispensations Act of 1533, and
      which are among the earliest administrative records of the Church of England,
      founded as a result of Henry VIII's breach with Rome. Dispensations are recorded
      in the Faculty Office until 1540, when all prohibitions on marriage beyond the
      proscribed relationships laid down in Leviticus were lifted. The data suggest
      surprisingly low levels of consanguineous marriage, including a lack of first
      cousin marriages. These findings are discussed in terms of the reliability of the
      archive, and of the social and religious views attending marriage between blood
      relatives in the medieval and early modern periods.

PMID- 8346895
TI  - Evidence for a secular trend in heights and weights of adults in Papua New
      Guinea.
AB  - Evidence for a secular change in heights and weights of adults of 13 populations
      in Papua New Guinea was sought by comparing data collected at two different
      times, using three types of source. These are: (1) values obtained from the
      literature; (2) previously unpublished measurements made by author; and (3) data
      found in the research notes of A.C. Haddon, and which were collected between 1897
      and 1914. An increase in heights and weights has taken place in some, but not
      all, populations examined, whilst a decrease in adult body size has taken place
      in a smaller number of groups.

PMID- 8346897
TI  - Respiratory conditions, including asthma, and height in primary school.
AB  - The National Study of Health and Growth (NSHG) of primary school children has
      examined the relationships between height and each of six separate respiratory
      conditions, one of which was asthma, in children aged 5-11 years, allowing for a
      number of genetic and environmental confounding factors, in particular for
      parental height. The relationships were investigated in a 'representative' sample
      of 4974 Caucasian English children in 1984 and in an 'ethnic/inner city' sample
      of 3419 Afro-Caribbean/Indian and Pakistani/Caucasian English children in 1985.
      None of the respiratory conditions was found to be related to height except for
      'wheeze most days', whether or not it was accompanied by an asthma attack in the
      last 12 months. The Caucasian children in the 'representative' sample who had
      'wheeze most days', were 0.17 height standard deviation score (95% confidence
      interval 0.03 to 0.31) less (approximately 1 cm) than those with no wheeze.
      Comparisons with previous results for NSHG 'representative' Caucasian English
      children in 1973 showed good agreement except for children with three or more
      asthma attacks who were found to be shorter in 1973, but not in 1984, which may
      reflect improved treatment, or milder asthma being reported in 1984. It was
      concluded that, in the 1980s, the respiratory conditions were not related to
      height. The exception was 'wheeze most days'. It is suggested that this is an
      indicator of sickness, most likely asthma, which is being experienced with
      sufficient severity to affect growth slightly.

PMID- 8346898
TI  - A path analysis of some determinants of infant growth in Khartoum.
AB  - The interrelationships between some socioeconomic and behavioural characteristics
      of mothers and the growth and illness experience of their infants in poor
      Khartoum townships have been examined by path analysis. For both infant body
      weight and supine length it is shown that weaning age and illness experience are
      important determinants of growth. It is also shown that greater maternal income
      has disadvantageous effects through encouraging early weaning. Most importantly
      the infants of housewives have later weaning, less illness and greater weight and
      length at 1 year of age than the infants of mothers with jobs, showing the value
      of time for caring in the prevailing environmental circumstances.

PMID- 8346899
TI  - Inbreeding and developmental stability in a small human population.
AB  - Inbreeding coefficients are reported for all members of the isolated Havasupai
      tribe of northern Arizona (USA), based upon pedigrees which are as deep as eight
      generations. Because inbreeding has been repeatedly shown to reduce developmental
      homeostasis in a large number of species, we ask if the degree of inbreeding in
      the Havasupai is associated with reduced developmental stability. Fluctuating
      asymmetry in two dermatoglyphic traits suggests that inbreeding significantly
      compromises developmental homeostasis in this population.

PMID- 8346900
TI  - Maximal aerobic power in high-altitude runners.
AB  - Maximal aerobic power (VO2max) was assessed in seven male and one female middle-
      and long-distance recreational runners residing in La Paz, Bolivia (3600 m). All
      runners were born and raised at high altitudes (> 2500). Mean VO2max in the male
      runners was 60.8 ml/kg/min while VO2max in the female runner was 55.5 ml/kg/min.
      These values are higher than in any previously reported sample of either trained
      or untrained high-altitude natives. In addition, mean VO2max in the La Paz male
      runners and VO2max in the La Paz female runner were very similar to those found
      in comparable low-altitude samples of recreational athletes, suggesting that the
      cardiorespiratory systems of both normally active and highly active native Andean
      highlanders are capable of successfully responding to the stress of hypobaric
      hypoxia. This ability may have both developmental and genetic components.

PMID- 8346902
TI  - High-throughput microtiter plate-based chromogenic assays for glycosidase
      inhibitors.
AB  - Rapid microtiter plate-based colorimetric assays have been developed that allow
      the screening of large numbers of samples for the presence of inhibitors of alpha
      glucosidase, alpha-amylase, and beta-galactosidase. The assays are particularly
      useful for screening large numbers of microbial culture filtrates.

PMID- 8346901
TI  - Cellular and metabolic engineering. An overview.
AB  - Metabolic engineering is defined as the purposeful modification of intermediary
      metabolism using recombinant DNA techniques. Cellular engineering, a more
      inclusive term, is defined as the purposeful modification of cell properties
      using the same techniques. Examples of cellular and metabolic engineering are
      divided into five categories: 1. Improved production of chemicals already
      produced by the host organism; 2. Extended substrate range for growth and product
      formation; 3. Addition of new catabolic activities for degradation of toxic
      chemicals; 4. Production of chemicals new to the host organism; and 5.
      Modification of cell properties. Over 100 examples of cellular and metabolic
      engineering are summarized. Several molecular biological, analytical chemistry,
      and mathematical and computational tools of relevance to cellular and metabolic
      engineering are reviewed. The importance of host selection and gene selection is
      emphasized. Finally, some future directions and emerging areas are presented.

PMID- 8346903
TI  - DNA sequencing. Recent innovations and future trends.
AB  - Determination of the sequence of DNA is one of the most important aspects of
      modern molecular biology. New sequencing methods currently being developed enable
      DNA sequence to be determined increasingly faster and more efficiently. One of
      the major advances in sequencing technology is the development of automated DNA
      sequencers. These utilize fluorescent rather than radioactive labels. A laser
      beam excites the fluorescent dyes, the emitted fluorescence is collected by
      detectors, and the information analyzed by computer. Robotic work stations are
      being developed to perform template preparation and purification, and the
      sequencing reactions themselves. Research is currently in progress to develop the
      technology of mass spectrometry for DNA sequencing. Success in this endeavor
      would mean that the gel electrophoresis step in DNA sequencing could be
      eliminated. A major innovation has been the application of polymerase chain
      reaction (PCR) technology to DNA sequence determination, which has led to the
      development of linear amplification sequencing (cycle sequencing). This very
      powerful yet technically simple method of sequencing has many advantages over
      conventional techniques, and may be used in manual or automated methods. Other
      recent innovations proposed recently to increase speed and efficiency include
      multiplex sequencing. This consists of pooling a number of samples and processing
      them as pools. After electrophoresis, the DNA is transferred to a membrane, and
      sequence images of the individual samples are obtained by sequential
      hybridizations with specific labeled oligonucleotides. Multiplex DNA sequencing
      has been used in conjunction with direct blotting electrophoresis to facilitate
      transfer of the DNA to a membrane. Chemiluminescent detection can also be used in
      conjunction with multiplex DNA sequencing to visualize the image on the membrane.

PMID- 8346904
TI  - Methods for pulsed-field gel electrophoresis.
AB  - The term pulsed-field gel electrophoresis (PFGE) is used as an acronym to
      indicate any technique that resolves (large) DNA molecules by continuous
      reorientation. It bridges the resolution gap between cytogenetic methods (> 5 Mb)
      and DNA analysis (< 50 kb). Initially, PFGE was used to study the chromosomal
      content of unicellular eukaryotic organisms of interest to genetic research and
      population health. Later, PFGE was used to construct megabase maps of segments of
      the human genome. Successfull utilization of PFGE requires the availability of
      very high-molecular weight DNA. This article describes the modification of
      standard DNA protocols necessary to handle large DNA molecules, based on its
      encapsidation in agarose.

PMID- 8346905
TI  - Immobilization as a tool for the stabilization of lignin peroxidase produced by
      Phanerochaete chrysosporium INA-12.
AB  - Lignin peroxidase immobilization was achieved by covalent coupling on CNBr
      Sepharose 4B. Protein immobilization yield was around 80%. For veratryl alcohol
      oxidation, in the presence of hydrogen peroxide, both soluble and bound enzymes
      exhibited the same pH profile with an optimum near 2.5. Catalytic parameters (kc
      and Km) were seriously affected by immobilization. On the other hand,
      immobilization provided a noticeable stabilization of the enzyme against acidic
      pH and high temperatures. A 15-20 increase in the half-inactivation times at pH
      2.2 and 2.7, respectively, could be observed. Bound enzyme was also much more
      thermostable than soluble.

PMID- 8346907
TI  - Salt-tolerant and thermostable alkaline protease from Bacillus subtilis NCIM no.
      64.
AB  - The proteolytic activity produced by a Bacillus subtilis isolated from a hot
      spring was investigated. Maximum protease production was obtained after 38 h of
      fermentation. Effects of various carbon and nitrogen sources indicate the
      requirement of starch and bacteriological peptone to be the best inducers for
      maximum protease production. Requirement for phosphorus was very evident, and the
      protease was secreted over a wide range of pH 5-11. The partially purified enzyme
      was stable at 60 degrees C for 30 min. Calcium ions were effective in stabilizing
      the enzyme, especially at higher temperature. The enzyme was extremely salt
      tolerant and retained 100% activity in 5M NaCl over 96 h. The molecular weight of
      the purified enzymes as determined by SDS-PAGE was 28,000. The enzyme was
      completely inactivated by PMSF, but little affected by urea, sodium dodecyl
      sulfate, and sodium tripoly phosphate.

PMID- 8346906
TI  - Immobilization of Aspergillus niger NRC 107 Xylanase and beta-Xylosidase, and
      Properties of the Immobilzed Enzymes.
AB  - Aspergillus niger NRC 107 xylanase and beta-xylosidase were immobilized on
      various carriers by different methods of immobilization, including physical
      absorption, covalent binding, ionic binding, and entrapment. The immobilized
      enzymes were prepared by physical adsorption on tannin-chitosan, ionic binding
      onto Dowex-50W, covalent binding on chitosan beads through glutaraldehyde, and
      entrapment in polyacrylamide had the highest activities. In most cases, the
      optimum pH of the immobilized enzymes were shifted to lower than those of free
      enzymes. The optimum reaction temperature of immobilized xylanase was shifted
      from 50C to 52.5-65C, whereas that of immobilized beta-xylosidase was shifted
      from 45C to 50-60C. The Km values of immobilized enzymes were higher than those
      of native enzymes. The operational stability of the immobilized enzymes was
      evaluated in continuous operation in packed-bead column-type reactors. The
      enzymes covalently bounded to chitosan showed the highest operational stability.
      However, the enzymes immobilized by physical absorption or by ionic binding
      showed a low operational stability. The enzymes entrapped in polyacrylamide
      exhibited lower activity, but better operational stability.

PMID- 8346908
TI  - Filamentous aggregates of native titin and binding of C-protein and AMP
      deaminase.
AB  - In solutions of high ionic strength, native titin-2, a large extractable fragment
      of the sarcomere matrix protein titin, appears as extremely long, flexible, and
      slender beaded strings. We report here that in solutions of lower ionic strength
      near neutral pH, titin-2 assembles into higher-order aggregates with surface
      projections. Solid phase binding assays show that two myosin-binding proteins, C
      protein and AMP-deaminase, are also titin-binding proteins. Both proteins
      decorate titin aggregates, producing filaments of more uniform appearance.
      Numerical Fourier transforms of these decorated aggregates show approximately 12
      nm periodicities. The interaction of titin with myosin-associated proteins such
      as C-protein may take part in the anchoring mechanism that prevents the
      stretching and extension of titin filaments in the A band.

PMID- 8346909
TI  - Adenine nucleotides and inhibition of protein synthesis in isolated hepatocytes
      incubated under different pO2 levels.
AB  - Hepatocytes incubated at a pO2 of 0 mm Hg (N2/CO2, 95%/5%) loose their
      intracellular ATP content and their ability to synthesize RNA and proteins.
      Protein synthesis is virtually inhibited from the beginning of the incubation,
      while ATP content is gradually lost, thus suggesting a primary response of the
      cell to the absence of O2 rather than to ATP depletion. Such an early decrease of
      protein synthesis (as estimated as the incorporation of [14C]Leu into cell
      proteins) is unlikely the result of inhibition of amino acids uptake, enhanced
      protein degradation, or decreased RNA synthesis. Reoxygenation of such previously
      hypoxic cells with O2/CO2 at 95%/5% (pO2 of 700 mm Hg), leads to the recovery of
      both ATP and protein synthesis, even better the hypoxic period is not longer than
      30 min. In hepatocytes incubated for 30 min under a pO2 of 700, 80, or 50 mm Hg,
      cell survival and ADP content are almost identical. Incorporation of
      radiolabelled leucine is linear in cells incubated under 700 mm Hg O2, but it
      rather stops at a pO2 of 80 or 50 mm Hg. The time course of both ATP and GTP
      content behaves in a similar way: it is fairly constant at a pO2 of 700 mm Hg,
      but a depletion is initiated after 20 min of incubation at a pO2 of 50 or 80 mm
      Hg. Finally, incubation of hepatocytes either at 700 or 0 mm Hg O2, in the
      presence of fructose (10 mM), shows that ATP content is maintained at the same
      level whatever the pO2 level. AMP content is increased only in cells incubated at
      0 mm Hg O2 in the absence of fructose. Incorporation of radiolabelled leucine is
      stopped in such hypoxic cells incubated or not in the presence of fructose. From
      these results it appears that the presence or the absence of O2 might represent a
      turn on/off signal to which hepatocytes respond immediately by important
      metabolic changes like the inhibition of protein synthesis.

PMID- 8346910
TI  - Application of quantitative structure-activity relationship modeling to the
      evaluation of the changes in enzymatic activity of carboxypeptidase Y upon
      chemical modifications.
AB  - A series of 18 phenacyl bromide and iodoacetamide analogues have been synthesized
      and used to alkylate Met-398 situated in the S'1 binding site of carboxypeptidase
      Y. The course of the reactions was monitored by measurements of the peptidase and
      esterase activities. All except four of the reagents reacted selectively, and
      from these preparations the modified enzymes were purified and kinetically
      characterized toward a methyl ester substrate and a peptide substrate with a
      large leaving group in the P'1 position. The Km, kcat, and kcat/Km for the
      hydrolysis of these substrates have been quantitatively correlated to parameters
      describing the properties of the modification reagents. The esterase activity
      depends only on the steric bulk of the para-substituents with the phenacyl
      modified enzymes, but on both steric and electronic factors of the N-alkyl
      substituents with the acetamide modified enzymes. The peptidase activity, on the
      other hand, is dependent on steric and electronic factors with both types of
      modified enzymes.

PMID- 8346911
TI  - Steady-state kinetic evaluation of the reverse reaction for Escherichia coli 5
      enolpyruvoylshikimate-3-phosphate synthase.
AB  - Recently it has been found that the kinetic mechanism for Escherichia coli 5
      enolpyruvoylshikimate-3-phosphate synthase (EPSPS) in the forward direction is
      random with synergistic binding of substrates and inhibitors (K. J. Gruys, M. C.
      Walker, and J. A. Sikorski, 1992, Biochemistry 31, 5534). This work, however, did
      not address the reverse reaction with 5-enolpyruvoylshikimate-3-phosphate (EPSP)
      and phosphate (Pi) as substrates where a similar question of random versus
      ordered addition of substrates remained. Previous transient-state kinetic results
      led to a proposal for an equilibrium-ordered mechanism, where binding of EPSP
      occurs first followed by Pi (K. S. Anderson, and K. A. Johnson, 1990, Chem. Rev.
      90, 1131). Steady-state kinetic results of the reverse reaction presented here
      suggest that, like the forward reaction, addition of substrates occurs randomly.
      Initial velocity studies with EPSP and Pi show a normal intersecting pattern in
      the reciprocal plots, consistent with a random or steady-state-ordered mechanism,
      but not with equilibrium-ordered addition of substrates. Inhibition of the EPSPS
      reverse reaction by 5-amino-S3P or the S3P-glyphosate hybrid molecule gave the
      expected competitive patterns versus EPSP, but mixed noncompetitive patterns
      versus Pi. These results also disfavor an equilibrium-ordered model, but again
      are consistent with a random or steady-state-ordered mechanism. A more
      quantitative mechanistic analysis of the inhibition data to determine the true
      rather than apparent Ki values provides evidence for a random over a steady-state
      ordered addition of substrates. These results in combination with previous
      findings lead to the conclusion that the mechanism is random addition of EPSP and
      Pi since it is the only possible model for substrate addition that is consistent
      with the cumulative data from all kinetic (transient- as well as steady-state)
      and direct binding studies.

PMID- 8346913
TI  - The conserved methionines of the 1.3 S biotinyl subunit of transcarboxylase:
      effect of mutations on conformation and activity.
AB  - Transcarboxylase from Propionibacterium shermanii is a biotin-containing enzyme
      which catalyzes the reversible transfer of a carboxyl group from methylmalonyl
      CoA to pyruvate. Transcarboxylase 26 S complexes consist of a central, hexameric
      12 S subunit with 6 outer, 5 S subunits attached by 12 1.3 S biotinyl subunits.
      Each of the subunits has been cloned and expressed in Escherichia coli in active
      form. We have used the cloned genes in mutagenic studies of the structure
      function interactions of these subunits. One particular target of our studies has
      been the evolutionarily conserved tetrapeptide Ala-Met-Bct-Met which surrounds
      the biotinyl lysine. We have investigated the properties of subunits containing
      leucine substitutions at each methionine (1.3 S M88L and 1.3 S M90L) by assaying
      their activity in the two partial reactions in which this subunit participates.
      Partial reaction assays demonstrate that leucine substitution at either position
      has a greater effect on the 12 S partial reaction than on the 5 S reaction and
      Met 88 is more significant catalytically than Met 90. To determine whether
      structural alterations in the 1.3 S mutants were responsible for the effects on
      activity, the conformations of these mutants were investigated. In vitro
      hydrolysis studies with trypsin and V8 protease demonstrated differences in the
      susceptibility of 1.3 S M88L relative to 1.3 S WT and 1.3 S M90L. Complexes of
      avidin with 1.3 S WT or mutant subunits, as monitored by fluorescence properties,
      indicated that the microenvironment of the biocytin of 1.3 S M88L was different
      from those of 1.3 S WT and 1.3 S M90L. By contrast, substrate binding
      (oxalacetate for 5 S and methylmalonyl-CoA for 12 S) was unaffected by any of the
      1.3 S mutants. Taken together, these results indicate that the conserved
      tetrapeptide of the 1.3 S biotinyl subunit, particularly Met 88, is required to
      provide an essential conformation and proper binding properties for catalysis of
      the partial reactions and the overall reaction.

PMID- 8346912
TI  - Isolation and biochemical characterization of procathepsin E from human
      erythrocyte membranes.
AB  - Cathepsin E (CE) is an intracellular, nonlysosomal aspartic proteinase which
      consists of two identical subunits with a molecular weight of about 42 kDa (K.
      Yamamoto, M. Takeda, H. Yamamoto, M. Tatsumi, and Y. Kato, 1985, J. Biochem. 97,
      821-830). In order to clarify its nature and proteolytic activation, the pro-CE
      and the mature enzyme were simultaneously purified from human erythrocyte
      membranes. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the
      reduced proenzyme showed a single protein band, exhibiting an apparent molecular
      weight of 46 kDa. The proenzyme was found to be catalytically inactive, but it
      was rapidly converted into the active enzyme after brief acid treatment at pH
      4.0, which was accompanied by a reduction in molecular size to 43 kDa. The
      activated form of pro-CE was essentially identical with the mature enzyme in
      enzymatic properties such as specific activities toward synthetic and protein
      substrates, and susceptibilities to various protease inhibitors. The N-terminal
      amino acid sequence analysis revealed that pro-CE started with the third amino
      acid residue, Ser3, of the sequence of human gastric CE predicted from its cDNA
      sequence and that the autocatalytic cleavage occurred at the Met36-Ile37 and
      Phe39-Thr40 bonds to produce two mature isozymic forms. The mature enzyme
      purified from human erythrocyte membranes also showed two different N-terminal
      sequences identical with those of the in vitro-activated form of pro-CE. The
      proenzyme, as well as the mature enzyme from human and rat erythrocyte membranes,
      was shown to be as an endo-beta-N-acetylglucosaminidase H-resistant form, whereas
      CE from rat spleen was N-glycosylated with a high-mannose-type oligosaccharide
      chain, suggesting that the carbohydrate modification of this protein varies with
      the cell type or the cellular localization. These data also suggest that the
      proenzyme in human erythrocytes is processed from the high-mannose type to the
      complex/hybrid type during its biosynthesis at early stages of erythroid
      differentiation, which precedes the proteolytic activation.

PMID- 8346915
TI  - Two purine biosynthetic enzymes that are required for cadmium tolerance in
      Schizosaccharomyces pombe utilize cysteine sulfinate in vitro.
AB  - In plants and in certain fungi, exposure to heavy metals induces the synthesis of
      metal-binding peptides commonly known as phytochelatins. With cadmium,
      phytochelatins can sequester the metal into a sulfide-containing complex. From
      genetic analysis of fission yeast mutants, we previously reported that two genes
      in purine biosynthesis, encoding adenylosuccinate synthetase and
      succinoaminoimidazole carboxamide ribonucleotide (SAICAR) synthetase, are
      required for the biogenesis of the phytochelatin-cadmium-sulfide complex in vivo.
      We suggested that a sulfur analog of aspartate, cysteine sulfinate, might be
      utilized by these enzymes and that the cysteine sulfinate-derived products would
      then become intermediates or carriers in a sulfur transfer pathway leading to the
      sulfide found within the metal chelate. In this paper, we report that partially
      purified adenylosuccinate synthetase and SAICAR synthetase are capable of
      utilizing cysteine sulfinate in vitro to form sulfur analog products.
      Adenylosuccinate lyase, however, fails to catalyze further conversion of these
      sulfur derivatives. These observations support the genetic data implicating a
      link among purine biosynthetic enzymes, sulfur metabolism, and cadmium tolerance.

PMID- 8346914
TI  - Alanine dehydrogenase from soybean nodule bacteroids: purification and
      properties.
AB  - Alanine dehydrogenase (ALADH) from soybean nodule bacteriods was purified 184
      fold with 14% yield, using ammonium sulfate precipitation, hydroxylapatite, gel
      filtration, ion exchange, and dye affinity chromatography. The subunit molecular
      weight was 43,000 and the native molecular weight was approximately 190,000,
      suggesting that ALADH is a tetramer. ALADH was confined to the bacteroid cytosol
      fraction only. ALADH is specific for NAD(H) and does not use NADP(H) as a
      substrate, but it does use glyoxylate and hydroxypyruvate as substrates in lieu
      of pyruvate. The pH optimum was 8.5 for the amination reaction and 10.0 for the
      deamination reaction. The apparent Michaelis constants for NADH, NH4+, pyruvate,
      L-alanine, and NAD were 86 microM, 8.9 mM, 0.49 mM, 1 mM and 200 microM,
      respectively. High concentrations of pyruvate, L-alanine, or NH4+ caused
      inhibition of activity with Ki's of 8.6 mM, 6.5-15 mM, and 188 mM, respectively.
      The amination reaction of ALADH was 95-100% of the control at levels of NADH/NAD
      corresponding to those measured in isolated bacteroids. The deamination reaction,
      on the other hand, was only 35-40% of control. Thus, an aminating role for ALADH
      is possible.

PMID- 8346916
TI  - The signal for retention of the egasyn-glucuronidase complex within the
      endoplasmic reticulum.
AB  - Egasyn is localized within the lumen of the endoplasmic reticulum (ER) where it
      complexes with and thus causes sequestration of a considerable portion of beta
      glucuronidase. Egasyn has an HTEL sequence at its carboxyl terminus rather than
      the KDEL sequence that serves as a retention signal for many ER lumenal proteins.
      To determine whether the HTEL sequence acts as an ER retention signal and/or
      functions in complex formation, HTEL-deleted egasyn was expressed in mammalian
      cell lines. The majority of HTEL-deleted egasyn was secreted, while wild type
      egasyn was retained in the ER. Furthermore, the egasyn HTEL sequence, when added
      to the carboxyl termini of two secretory proteins, mouse esterase, Es-N, and rat
      alpha 1-acid glycoprotein (AGP), caused retention of both proteins within the ER,
      demonstrating that the HTEL sequence is both necessary and sufficient for
      retention of egasyn and, by extension, the egasyn-glucuronidase complex within
      the ER. Other carboxyl terminal tetrapeptides including HIEL and HVEL, naturally
      occurring in other ER lumenal proteins, were also sufficient for ER retention of
      AGP, while HTEHT and HTEHK were inefficient in ER retention. The HTEL sequence,
      in contrast, is not required for egasyn-glucuronidase complex formation. Further,
      the complex is apparently unstable outside the ER since it was not visible in the
      medium of cells transfected with egasyn lacking the HTEL sequence despite
      abundant secretion of this egasyn. These results show that it is possible to
      localize proteins within the lumen of the ER if they form complexes with ER
      lumenal proteins containing an intrinsic ER retention sequence.

PMID- 8346917
TI  - Overexpression in Escherichia coli of soluble aristolochene synthase from
      Penicillium roqueforti.
AB  - Aristolochene synthase, a fungal cyclase which has been isolated from Aspergillus
      terreus and Penicillium roqueforti, catalyzes the cyclization of farnesyl
      diphosphate to the sesquiterpene hydrocarbon aristolochene. The aristolochene
      synthase gene (Ari1) of P. roqueforti has previously been cloned and expressed at
      low levels as a protein A-aristolochene synthase fusion protein in Escherichia
      coli. We have now used the polymerase chain reaction to amplify the aristolochene
      synthase coding sequence using engineered primers which produced dsDNA carrying
      an EcoRI restriction site and the T7 gene 10 ribosome binding site and
      translational spacer element immediately upstream of the ATG start codon and a
      BamHI site adjacent to the TAA stop codon. The PCR product was digested with
      EcoRI and BamHI and inserted into the multiple cloning site of the expression
      vector pLM1 which carried the promoter and translational leader sequence from T7
      gene 10 and the E. coli rrnBT1T2 tandem transcription terminator. Cloning of the
      resulting construct into E. coli XL1-Blue and subcloning into the expression host
      E. coli BL21 (DE3) gave transformants which expressed aristolochene synthase at
      levels up to 40% of soluble protein when induced with isopropyl beta-D
      thiogalactoside. Purification of the recombinant protein by ammonium sulfate
      precipitation, ion-exchange chromatography on Q Sepharose, and affinity dye
      chromatography on Reactive Blue 4-agarose gave homogenous aristolochene synthase
      which had the expected N-terminal sequence, ATSTE, mobility on sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis, and steady-state kinetic parameters
      when compared to native fungal protein.

PMID- 8346918
TI  - The effect of changes in iron redox state on the activity of enzymes sensitive to
      modification of SH groups.
AB  - Iron ions in micromolar concentrations induced a rapid and selective inhibition
      of the activity of skeletal muscle creatine kinase (CK), sarcoplasmic reticulum
      (SR) Ca(2+)-ATPase, and pyruvate kinase (PK). This effect of iron was dependent
      on the presence of adenine nucleotides and on the redox state of iron. Changing
      the redox state of the media created different Fe2+/Fe3+ ratios which selectively
      depressed different enzymes: depression of PK activity occurred when iron was
      predominantly in its reduced form and, consequently, when there was a high
      Fe2+/Fe3+ ratio; depression of SR Ca2+ uptake and SR Ca(2+)-ATPase activity
      occurred when the Fe2+/Fe3+ ratio was close to 1; depression of CK activity
      occurred when iron was predominantly in its oxidized form and the Fe2+/Fe3+ ratio
      was low. All iron-sensitive enzymes possessed sulfhydryl groups, accessible to N
      ethylmaleimide (NEM), which were essential for their activity. The rate of
      inhibition of enzyme activity with NEM increased in the order PK < Ca(2+)-ATPase
      < CK. Iron-induced depression of CK and PK activities was reversible by
      dithiotreithol. Results suggest that changes in the redox state of cellular
      microenvironments, which inevitably occur during reperfusion of ischemic tissue
      or rapid increase in tissue oxygen consumption, may selectively depress the
      activity of several enzymes bearing SH groups that are sensitive to modifications
      and that are essential for their activity. Iron-induced depression of enzyme
      activity depends on the availability of iron bound to adenine nucleotides and
      possibly to other low molecular weight chelators and on the Fe2+/Fe3+ ratio
      generated by the induced redox change.

PMID- 8346919
TI  - The kinetics of multiphosphorylation of rhodopsin.
AB  - Rhodopsin kinase catalyzes the incorporation of up to seven phosphates into the
      carboxyl terminal region of freshly bleached rhodopsin. In order to study the
      mechanism of this reaction, we have separated different phosphorylated species of
      rhodopsin using Mono P FPLC chromatofocusing chromatography. The purity of the
      isolated species of rhodopsin was determined by isoelectric focusing. Separation
      yielded two forms of monophosphorylated and two diphosphorylated species of
      rhodopsin. Other species, containing up to five phosphates, were not fully
      separated. The phosphorylated forms of rhodopsin were characterized by
      competition enzyme-linked immunosorbent assay and immunoblotting using anti
      rhodopsin site-specific monoclonal antibodies. A combination of the above methods
      allowed quantitative determination of the formation of different phosphorylated
      species of rhodopsin. A computer model for the consecutive time course of
      rhodopsin phosphorylation was developed and employed to characterize this
      reaction. Our data suggest that the rate of incorporation of the first phosphates
      into rhodopsin is slower than the rate of formation of more highly phosphorylated
      species. These data are supported by results showing that some monophosphorylated
      synthetic peptides are phosphorylated significantly faster than control
      unphosphorylated peptides.

PMID- 8346920
TI  - Cloning, sequencing, and functional studies of phenobarbital-inducible forms of
      cytochrome P450 2B and 4B expressed in rabbit kidney.
AB  - Expression of several forms of cytochrome P450 2B and of P450 4B1 in rabbit
      kidney was investigated by cloning from cDNA libraries constructed with renal
      mRNA from animals treated with phenobarbital. Isolation and sequencing of several
      cDNAs demonstrated that: (i) cytochrome P450 2B-B0 can be found in rabbit kidney
      along with a newly discovered form of P450 2B termed "P450 2B-Bx." P450 2B-Bx
      differs from P450 2B-B0 at 25 nucleotide positions and at four positions in the
      derived sequence of 491 amino acids. Two previously identified forms of
      cytochrome P450 2B, 2B-B1 and 2B-B2, are not detected in rabbit kidney. cDNA
      encoding cytochrome P450 4B1 was also cloned from the kidney library and found to
      be identical in sequence to cDNAs cloned from rabbit hepatic and pulmonary
      libraries. Analysis of renal mRNA indicates that forms of cytochrome P450 2B and
      P450 4B1 are expressed in a number of species but induced by phenobarbital in
      rabbit only (4B1) or rabbit and hamster (2B). Relatively high levels of mRNA
      related to P450 4B1 were detected in samples from untreated and phenobarbital
      treated mice. Analysis of protein by immunoblotting was less sensitive but
      produced results consistent with those obtained by analysis of mRNA; protein
      related to cytochrome P450 2B was detected in renal microsomal samples from
      rabbit and hamster (phenobarbital > untreated), and protein related to P450 4B1
      in samples from rabbits (phenobarbital > untreated) and mice (phenobarbital =
      untreated). The four forms of cytochrome P450 2B were expressed in COS-7 cells,
      and their activities were evaluated with androstenedione, testosterone, and 7
      ethoxycoumarin as substrates. Three of the P450 2B forms, B0, B1, and Bx,
      metabolize these substrates in a manner characterized by preference for 16 beta
      hydroxylation of androstenedione, low testosterone 16-hydroxylation, and high
      ethoxycoumarin O-deethylation. The fourth form, P450 2B-B2, is catalytically
      distinct from the others, with activities characterized by high androstenedione
      16 alpha- and 15 alpha-hydroxylation and high testosterone 16-hydroxylation.
      Since P450 2B-B2 is catalytically distinct from the other forms, the metabolic
      profiles of phenotypes that include P450 2B-B2 might differ significantly from
      those of phenotypes that lack P450 2B-B2.

PMID- 8346921
TI  - Ascorbic acid inhibition of cytochrome P450-catalyzed uroporphyrin accumulation.
AB  - Previous studies on the mechanism of the uroporphyria caused by polyhalogenated
      aromatic hydrocarbons have indicated a key role of cytochrome P450 of the 1A
      subfamily in catalyzing uroporphyrinogen (UROgen) oxidation. Here we report that
      ascorbic acid (ASC) inhibits UROgen oxidation in primary cultures of chick embryo
      hepatocytes and hepatic microsomes from chickens and mice. In hepatocyte
      cultures, 0.15 mM ASC totally prevented the accumulation of uroporphyrin (URO)
      induced by treatment of cells with the combination of 3,4,3',4'
      tetrachlorobiphenyl (TCB) and 2-propyl-2-isopropylacetamide (PIA), but had no
      effect on the induction of protoporphyrin accumulation by PIA and
      desferrioxamine. However, addition of 5-aminolevulinic acid (ALA) to cultures
      treated with PIA plus TCB decreased the ability of ASC to prevent URO
      accumulation, suggesting that the effectiveness of ASC was dependent on the
      intracellular concentration of ALA or its metabolites. Similarly, when chick
      hepatocyte cultures were treated with TCB plus exogenous ALA to produce URO
      accumulation, the effectiveness of ASC was also less than when ALA was produced
      endogenously. Under this condition, addition of piperonyl butoxide, a P450
      inhibitor, increased ASC inhibition of URO accumulation. ASC competitively
      inhibited the oxidation of UROgen by hepatic microsomes from chicks or mice
      treated with 3-methylcholanthrene (MC) with Ki for ASC being about 0.1 mM. ASC
      prevented formation of a 500-nm absorbing compound, probably
      tetrahydrouroporphyrin, the first intermediate in UROgen oxidation. These results
      are consistent with ASC preventing URO accumulation in hepatocytes by competitive
      inhibition of the first step of UROgen oxidation and suggest a new physiological
      role of ASC, that of maintaining UROgen in the reduced state.

PMID- 8346922
TI  - Post-translational processing and membrane association of the two early endosome
      associated rab GTP-binding proteins (rab4 and rab5).
AB  - The two early endosome-associated rab GTP-binding proteins, rab4 and rab5, are
      suggested to regulate endocytosis. In this report, we examined post-translational
      processing and membrane association of the two rab proteins. Human rab4 and rab5
      were expressed in chicken embryo fibroblasts using a Sindbis virus expression
      vector. Cells were labeled with either [35S]methionine or [3H]mevalonolactone.
      Cell lysates were immunoprecipitated with antisera specific for rab4 and rab5,
      respectively, and analyzed by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. It was found that both rab4 and rab5 contained at least three
      forms: the precursor form, the isoprenylated intermediate, and the isoprenylated
      mature form of faster mobility. The rab5 intermediate comigrated with the
      precursor form, whereas the rab4 intermediate migrated slightly faster than the
      precursor form. The intermediate form of rab4, but not rab5, accumulated in the
      presence of a chymotrypsin-like protease inhibitor (N-acetyl Tyr ethyl ester),
      suggesting that proteolysis was required for generation of the mature form.
      Furthermore, the intermediate and mature forms of rab4, but not rab5, were
      carboxyl-methylated as demonstrated by incorporation of alkali-labile counts from
      [methyl-3H]methionine. Membrane association of the distinct rab4 and rab5 forms
      was examined by subcellular fractionation and Triton X-114 partitioning. The
      precursor forms were found in the cytosol and partitioned into the aqueous phase.
      The mature forms were membrane-associated and partitioned into the detergent
      phase. Unexpectedly, the isoprenylated intermediate forms of both rab4 and rab5
      partitioned exclusively into the aqueous phase. Taken together, the data indicate
      that the entire post-translational processing, which includes isoprenylation,
      carboxyl methylation (rab4), and possibly proteolysis, confers the competency for
      membrane association of rab4 and rab5.

PMID- 8346923
TI  - Alkaline lipase in rat intestinal mucosa: physiological parameters.
AB  - The present studies describe an alkaline active lipase in the rat intestinal
      mucosa. Alkaline lipase activity was determined using a glyceryl tri[14C]oleate
      emulsion at pH 8.0. Subcellular fractions were prepared from mucosal homogenates
      by differential centrifugation. Cells from villus to crypt were sequentially
      released using citrate and EDTA buffer. The enzyme was found to be most active in
      the proximal quarter of the intestine and in villus tips. Most of the activity
      was found in the cytosolic fraction. Bile salts stimulated the enzyme activity
      threefold. The presence of both Ca2+ and taurocholate was essential for optimal
      activity. Mucosal activity was greatly reduced on intraduodenal glyceryl
      trioleate infusion. Activity was restored when phosphatidylcholine was added to
      the glyceryl trioleate infusion. The fact that mucosal lipase has its greatest
      activity in the villus tips of the proximal intestine and in cytosol suggests
      that it may play an important role in mucosal glyceryltrioleate metabolism.

PMID- 8346924
TI  - Partial purification and characterization of phosphoenolpyruvate carboxylase
      protein-serine kinase from illuminated maize leaves.
AB  - Following in situ renaturation and assay of protein kinase activity after
      denaturing electrophoresis of relatively impure samples of maize
      phosphoenolpyruvate carboxylase (PEPC) kinase, a approximately 30-kDa polypeptide
      was implicated as the best candidate for the PEPC kinase catalytic subunit. This
      kinase's apparent native molecular weight was estimated at 28,000 by gel
      filtration on a calibrated Superose 12 column (HR 10/30), suggesting that the
      isolated PEPC kinase is monomeric. This protein-serine kinase was partially
      purified about 4000-fold from illuminated maize leaves by ammonium sulfate
      precipitation and sequential chromatography on Ultrogel AcA 54, hydroxylapatite,
      blue dextran-agarose, and an analytical AcA 54 column. Analysis by denaturing
      electrophoresis revealed that a 30-kDa polypeptide copurified with PEPC kinase
      activity during the final step. This highly purified kinase had an apparent Km
      (PEPC subunit) of 2.5 microM and a Km (total ATP) of 40 microM at pH 8.0, its pH
      optimum. Upon in vitro phosphorylation of darkform (dephospho) C4 PEPC at Ser-15
      (maize PEPC) or Ser-8 (sorghum), the malate sensitivity of the target enzyme
      decreased significantly. The maize PEPC kinase activity was markedly inhibited by
      L-malate, a negative allosteric effector of its protein substrate, in a
      concentration- and pH-dependent manner. Comparative phosphorylation studies with
      the catalytic subunit of mammalian cAMP-dependent protein kinase and casein
      revealed that a significant part of the malate inhibition of PEPC kinase activity
      in vitro was due to this effector's interaction with PEPC. The activity of both
      the highly purified PEPC kinase and a less pure sample prepared rapidly in the
      presence of various protease inhibitors was insensitive to Ca2+ chelation or
      addition. It is concluded that the approximately 30-kDa maize PEPC kinase is a
      low abundance, Ca(2+)-independent protein-serine kinase that activates its target
      enzyme by the exclusive phosphorylation of the regulatory serine residue near the
      N terminus and the resulting decrease in feedback inhibition by L-malate.

PMID- 8346925
TI  - Hormonal regulation of platelet-activating factor-acetyltransferase activity in
      rat tissues.
AB  - Platelet-activating factor (PAF) plays a very important role in a number of
      physiological or pathological conditions. Recently, we and others have suggested
      that the PAF concentration in various tissues may be regulated by the enzyme that
      inactivates PAF, PAF acetylhydrolase (PAF-AH). Furthermore, it has been shown
      that the plasma isozyme of PAF-AH is regulated by various steroid hormone. Lyso
      PAF:acetyl-CoA acetyltransferase (PAF-AT) is a key enzyme in PAF biosynthesis by
      the remodeling pathway. In the present study, the hormonal effects on the tissue
      levels of PAF-AT activity were investigated in various organs of the rat. The
      microsomal fraction was prepared from the spleen, lung, uterus, and liver of
      female rats which had been pretreated with dexamethasone, 17 alpha
      ethynylestradiol, medroxyprogesterone-acetate, or vehicle and the PAF-AT activity
      was assayed. The rats treated with dexamethasone demonstrated significantly lower
      PAF-AT specific activity in the liver (P < 0.001) and spleen (P < 0.01), compared
      to the control group. A dose-dependent decrease of PAF-AT specific activity was
      demonstrated following dexamethasone treatment. Medroxyprogesterone injection
      also caused a significant decrease of PAF-AT activity in the liver (P < 0.01). No
      change of PAF-AT activity in any tissue was observed in the 17 alpha
      ethynylestradiol-injected animals. Plasma PAF-AH activity was increased
      significantly by the administration of dexamethasone (P < 0.001) or
      medroxyprogesterone (P < 0.001), and decreased by 17 alpha-ethynylestradiol (P <
      0.001), as previously described. The observation that dexamethasone or
      medroxyprogesterone treatment decreases the activity of PAF-AT and increases the
      plasma PAF-AH activity provides a mechanism for the tight control of PAF in
      tissues.

PMID- 8346926
TI  - Purification and properties of laminaribiose phosphorylase (EC 2.4 1.31) from
      Euglena gracilis Z.
AB  - Three isoforms of laminaribiose phosphorylase, F0, F1, and F2, were purified to
      an electrophoretically homogeneous state from a cell free extract of Euglena
      gracilis Z (IAM E-6). F1 and F2 were the major components. The three enzymes
      showed very similar properties except their isoelectric points. They could also
      use laminaribiose as the glucosyl acceptor instead of glucose. The isoforms the
      same molecular mass of 120 kDa by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (PAGE) or 200 kDa by the gel filtration method, suggesting that
      they have a dimer structure. They could not be distinguished on the Ouchterlony's
      double diffusion test with mouse antiserum against F1 or F2. The substrate
      specificities of F1 and F2 were determined to be essentially the same. Both of
      the reaction mechanisms of F1 and F2 were determined to be ordered bi-bi
      mechanisms, as in the case of cellobiose phosphorylase. A competitive substrate
      inhibition was observed in their synthetic reaction. Two other strains, E.
      gracilis var. bacillaris (IAM E-2) and E. gracilis (IAM E-3), had only one
      laminaribiose phosphorylase, which corresponded to F0 on native PAGE.

PMID- 8346928
TI  - [The functions of stress proteins in recent research].
AB  - Stress proteins are highly conserved among all living organisms and play
      important roles in protection of cells against environmental stresses. At the
      same time, stress proteins function also in cells under normal conditions as
      molecular chaperones in assisting cellular proteins in folding and assembly.

PMID- 8346927
TI  - Glucose utilization by tumor cells: the enzyme hexokinase autophosphorylates both
      its N- and C-terminal halves.

PMID- 8346929
TI  - [Chemotherapy for the treatment of angiosarcoma].
AB  - A common type of angiosarcoma in the dermatological field is Wilson-Jones type
      angiosarcoma arising on the head and neck of elderly. It is called malignant
      hemangioendothelioma (MHE) and its prognosis is extremely poor, even though
      treated with the present state of the art: surgical excision, radiation,
      chemotherapy, and immunotherapy. Recently, chemotherapy has been done with
      CYVADIC (CPM, VCR, ADM, DTIC), and in some cases intraarterial fusion of ADM and
      5-FU has been tried in combination therapy. But older patients are particularly
      intolerant of this chemotherapy, because of its severe toxic effects.
      Unfortunately, there is no evidence that these chemotherapeutic trials have
      helped to improve the prognosis.

PMID- 8346930
TI  - [Intraperitoneal chemotherapy of CDDP and etoposide in patients with advanced
      ovarian cancer].
AB  - Intraperitoneal disseminated ovarian cancer has a poor prognosis and its
      treatment is difficult. Recently, we undertook intraperitoneal chemotherapy (IP)
      of CDDP (Pt) and etoposide (Et) using an implantable reservoir. The subjects were
      14 patients with advanced ovarian cancer. One hundred mg of Pt and 200 mg of Et
      were administered intraperitoneally through the reservoir, and the therapeutic
      results were evaluated. In 6 patients, levels of total platinum (t-Pt), free
      platinum (f-Pt) and Et were determined in the blood and intraperitoneal fluid by
      flameless atomic absorption spectrophotometry. 1. The 14 patients received 82
      courses of IP. In 10 cases of IIIrd stage, no recurrence was detected in 5
      radical operable cases, and 4 of 5 inoperable cases were able to undergo radical
      operation after IP. One case was inoperable even after IP. Recurrences were
      detected in 2 of 4 cases which subsequently became operable. In a case of IVth
      stage, remission was achieved, but the tumor markers began rising again 18 months
      after operation. No further recurrence was detected in a treated recurrence case.
      In 2 cases of metastatic cancer, recurrences were detected 3 and 7 months after
      operation, respectively. As a side effect, the incidence of gastrointestinal
      toxicities, anemia, leukocytopenia and alopecia was high, but the grade was
      almost 1 or 2. Intraperitoneal mean maximum concentrations were t-Pt: 21.98 +/-
      5.78; f-Pt: 17.72 +/- 4.97; Et: 62.98 +/- 23.94 micrograms/ml. Blood mean maximum
      concentrations were t-Pt: 2.84 +/- 0.41; f-Pt: 0.84 +/- 0.22; Et: 11.38 +/- 2.12
      micrograms/ml. Mean AUC of the blood were t-Pt: 57.76 +/- 6.62; f-Pt: 2.96 +/-
      0.47; Et: 108.76 +/- 18.94 micrograms.h/ml. 2. IP is considered to be effective
      for advanced ovarian cancer not only as a local therapy but as a general therapy,
      and is feasible as maintenance therapy with the implantable reservoir and
      tolerable side effects.

PMID- 8346931
TI  - [Clinical results of repeated intraperitoneal administration of CDDP in patients
      with ovarian cancer].
AB  - CDDP was intraperitoneally administered to 45 ovarian cancer patients (9 cases in
      Stage Ic, 9 cases in Stage II, 19 cases in Stage III and 8 cases in Stage IV) as
      the first line chemotherapy to examine response rates and cumulative survival
      rates by Kaplan-Meier method. Among 18 cases with measurable tumor, there were 5
      CR cases, 6 PR cases, 4 NC cases and 3 PD cases. Eleven out of 18 responded, for
      a response rate of 61.1%. The 3- and 5-year survival rates were 88.9% and 88.9%
      in Stage I, 46.7% and 0% in Stage II, 48.6% and 41.7% in Stage III, and 0% and 0%
      in Stage IV, respectively. The 3- and 5-year survival rates in patients with
      residual tumor smaller than 2 cm in diameter after the first surgery in Stage III
      or IV were 76.9% and 61.4% respectively, in contrast to 11.5% and 11.5% in
      patients with residual tumor of 2 cm or larger in diameter. Thus, a significantly
      better prognosis was demonstrated in patients with residual tumor smaller than 2
      cm. These results indicate that intraperitoneal administration of CDDP
      demonstrated high response rates and proved to be useful as the first line
      chemotherapy, yet did not manage to improve the long-term prognosis of patients
      with progressive cancer.

PMID- 8346932
TI  - [Clinical efficacy of cis-diamminedichloroplatinum [II] and 5-fluorouracil (UFT)
      in advanced cancer of the alimentary tract].
AB  - A clinical study of the combination of cis-diamminedichloroplatinum [II] (CDDP)
      and 5-fluorouracil derivatives was conducted in advanced cancer of the alimentary
      tract. The regimen consisted of CDDP 50 mg/body/day (day 1-2, continuous
      infusion), 5-fluorouracil 500-750 mg/body/day (day 2-7, continuous infusion) and
      UFT 400 mg/day (day 8-28) on 1-3 courses. Thirty patients could be evaluated. The
      response rate was 25% (2/8) in cases of esophageal cancer, 31% (4/13) in gastric
      cancer and 33% (3/9) in colorectal cancer, with an overall response rate of 30%
      (9/30). A comparatively higher response rate was obtained in lymph node
      metastases (46%) and liver metastases (50%). Anorexia, nausea/vomiting and
      leukocytopenia were frequently observed, but almost all were well tolerated and
      recovered except two cases with severe leukocytopenia and nephrotoxicity. Based
      on these results, this combination chemotherapy seems to be useful for advanced
      cancer of the alimentary tract.

PMID- 8346934
TI  - [Prophylactic effect of methylprednisolone on cisplatin-induced nephrotoxicity in
      rats].
AB  - Cis-diamminedichloroplatinum (II) (cisplatin) is a very effective antitumor drug,
      but It has an adverse effect of nephrotoxicity. There are many reports concerning
      protective agents against cisplatin nephrotoxicity, but clinically useful
      modalities are very few. In the present study, prophylactic effects of
      methylprednisolone (MP) on cisplatin-induced nephrotoxicity were examined. Male
      Sprague-Dawley rats were injected iv with 6.5 mg/kg of cisplatin combined with a
      subcutaneous MP given sc in various doses at various timing. Rats were killed 5
      days after cisplatin injection to determine BUN and serum creatinine levels. BUN
      and serum creatinine levels in rats pretreated with MP 4 or 2 hr before cisplatin
      injection were significantly lower than those in rats received cisplatin alone.
      Our preliminary results suggest that pretreatment with MP is an effective means
      of protection against cisplatin-induced nephrotoxicity.

PMID- 8346933
TI  - [Tissue and serum levels of 5-FU in the patients with head and neck malignant
      tumors--influence of a streptococcal preparation OK-432].
AB  - Concentrations of Tegafur, 5-FU, and Uracil were measured in the tissues and
      serum of 32 patients with malignant head and neck tumors after administration of
      UFT or UFT and OK-432. Of the 32 patients, 15 patients were treated with UFT
      alone and 17 patients with a combination of UFT and a clinical dose of OK-432.
      The level of 5-FU was higher in the tissues and serum in the patients who
      received the combined administration of UFT and OK-432 than in those the received
      UFT alone. In particular, levels of 5-FU in tumor tissue and metastatic lymph
      node tissue were higher than 0.05 micrograms/g even 14.6 hours after the last
      administration of UFT. No significant undesirable interactions between UFT and OK
      432 were exhibited during combination therapy of these agents in clinically
      administered doses. From our satisfactory results, clinical cures would be
      expected by the combined immuno-chemotherapeutic action of these agents.

PMID- 8346935
TI  - [Photodynamic therapy (PDT) in roentgenographically occult lung cancer by
      photofrin II and excimer dye laser].
AB  - Patients (pts) with hilar type early lung cancer from 5 hospitals served as the
      subjects to assess the complete response rate and toxicity of PDT with Photofrin
      II (PHE) and excimer dye laser (PDT EDL-1). ENTRY CRITERIA: 1. Histologically
      proven lung cancer with endoscopically superficial thickening or small
      protrusion. 2. All lesions that were located proximally from the subsegmental
      bronchus, were visible to the distal margin of the lesions. 3. N0M0. METHOD: All
      pts received PHE (2 mg/kg) i.v., 48 hours before PDT. Tumor lesions superficially
      photoradiated by an excimer dye laser via flexible bronchoscope. RESULTS: From
      September 1990 to March 1992, 39 pts with 46 carcinomas (CA) were enrolled.
      Thirty-three pts with 40 CA were evaluable. 1. RESPONSE: Thirty-five in 40 CA
      showed a complete response (CR) (87.5%, 95% confidence limit: 73.2-95.8%). All 32
      cases of CA equal to or less than 1 cm of tumor length were CR, but 3 CA relapsed
      locally. Thirty-three of 35 CA visible to the distal margin were CR (91.7%, 95%
      confidence limit: 77.5-98.3%). 2. Toxicity (> WHO grade 2): Three pts (7.7%) had
      transient dermatitis and sunburn, while another pt (2.6%) had symptoms due to
      obstructive pneumonitis. CONCLUSIONS: Tumors equal to or less than 1 cm in length
      and visible to the distal margin are curable by PDT.

PMID- 8346936
TI  - [Six cases of therapy related leukemia; case reports and review of the
      literature].
AB  - The following presents 6 cases of therapy related leukemia (TRL) along with
      discussion of their clinical features in comparison with those previously
      reported in Japan. Common primary malignancies were mammalian cancer, lung cancer
      and malignant lymphoma in both groups. It was observed that, 1) average age was
      higher (68 years), 2) average latent period from primary malignancy to leukemia
      was longer (10 years), particularly in patients treated solely with radiation, 3)
      in 4 out of 6 patients (67%) karyotype analysis of leukemia cells showed normal
      results, but in one case previously administered etoposide, translocation
      involving 15q+, 17q- was noted, and 4) the CR ratio in our cases was 83%; half
      the cases are still alive at 10 months of follow-up, while in previously reported
      cases the CR ratio was 41%, and the median survival time was 12 months according
      to Kaplan-Meier analysis. Although poor response to conventional chemotherapy has
      been reported in TRL patients, the present data indicated TRL in some cases to
      achieve complete response and long-term survival. Aggressive chemotherapy should
      be considered for such patients.

PMID- 8346937
TI  - [Growth rate analysis of pulmonary metastases in giant cell tumor of bone].
AB  - We reviewed six cases with pulmonary metastases in giant cell tumor of bone. The
      growth rate and the doubling time of pulmonary metastases was measured and
      compared to the clinical course. The six cases were classified into two each of
      the following three types: 1) spontaneous remission, 2) continuously slow growing
      and 3) rapid growing. A favorable factor was a doubling time of more than 80 days
      in pulmonary metastases. A poor prognosis was indicated by a doubling time of
      around 30 days. Aggressive primary lesions should be excised widely.

PMID- 8346938
TI  - [Successful chronic daily administration of oral etoposide for a case of adult T
      cell leukemia].
AB  - A 54-year-old woman with leucocytosis and skin lesion was hospitalized and
      diagnosed as chronic type adult T cell leukemia (ATL) in August 1989. Since her
      ATL cell count and LDH level increased after hospitalization, oral administration
      of etoposide was started at a dose of 100 mg/day for seven days. The oral
      administration of etoposide induced another chronic state of ATL. After 10 months
      without medication, she was readmitted because of an acute ATL crisis. After
      daily administration of etoposide at a dose of 50 mg/day, the white blood cell
      count and serum LDH level decreased to the normal range, and abnormal lymphocytes
      of peripheral blood disappeared. The low-dose daily administration of etoposide
      at a dose of 25 approximately 50 mg/day could be maintained over six months. No
      severe side effects except for alopecia and mild myelosuppression were noted
      during the treatment. Chronic daily administration of oral etoposide is one
      candidate for the treatment of ATL in an outpatient clinic.

PMID- 8346940
TI  - [Role in mucosal ornithine decarboxylase activity during dimethylhydrazine
      induced colonic carcinogenesis in the rat].

PMID- 8346939
TI  - [Successful oral administration of etoposide therapy for refractory malignant
      lymphoma treated with frequent combination chemotherapy].
AB  - A 67-year-old man was diagnosed as non-Hodgkin lymphoma (diffuse, mixed cell
      type, B cell) with clinical stage IV in March 1989. He had been treated many
      times with salvage chemotherapy on admission including CHOP-etoposide and ProMACE
      Cyta BOM. Recurrence, however, occurred in two or three months after any therapy.
      He had a therapeutic history of chronic daily administration of etoposide. In
      November 1991, recurrence was found in the peripheral lymph node and the colon. A
      new regimen of oral administration of etoposide, 50 mg/day four times a week, was
      employed. Two months later, the peripheral lymph node swelling disappeared. Seven
      months later, the patient showed no signs of recurrence by Ga-scintigraphy. This
      therapy is being continued. It is suggested that anti-neoplastic activity of
      etoposide is dependent on the schedule of administration. This regimen is
      suggested to be effective in the treatment of patients with refractory malignant
      lymphoma.

PMID- 8346941
TI  - [A comparison of 5-fluorouracil concentration of 5-fluorouracil drip infusion
      versus orally UFT in plasma of same patients].

PMID- 8346942
TI  - [Endocrine therapy for breast cancer. Round table discussion].

PMID- 8346943
TI  - [Functions of antioncogene products].
AB  - Inactivation of antioncogenes result in the generation of tumor cells. Recent
      progress in molecular biology of antioncogenes enabled us to study the function
      of the products of RB, WT, p53, NF1, DCC, APC and MCC genes. Analyses of the
      function of these proteins will give us an insight into the mechanisms of cell
      transformation.

PMID- 8346944
TI  - Fetal activity, behaviour, and neurology: fact or fiction?

PMID- 8346945
TI  - Prospective surveillance of neonatal meningitis.
AB  - Neonatal meningitis is a serious problem with a high mortality and frequent
      neurological sequelae. The incidence of neonatal meningitis was calculated and
      the aetiology, clinical and laboratory features, and the treatment of cases
      recorded prospectively over a 7 year 8 month period was documented. It was
      further investigated whether secondary meningitis had occurred after lumbar
      puncture. The estimated incidence of bacterial, viral, and fungal meningitis was
      0.25, 0.11, and 0.02 per 1000 live births respectively. There were eight cases of
      early onset meningitis (seven definite, one probable) and group B streptococci
      accounted for six (75%) of these. Blood cultures were negative in only one of
      seven cases of definite early bacterial meningitis. Of the 15 late onset cases,
      Gram negative organisms accounted for six of the seven bacterial cases. The
      overall mortality was 26%. Of the 11 survivors of bacterial meningitis, three
      (27%) had significant neurological sequelae at follow up (between three months to
      three years later). As in the first 48 hours after birth an initial blood culture
      is unlikely to be negative if bacterial meningitis is present, lumbar puncture
      can be deferred if the procedure might exacerbate respiratory distress. Although
      approximately 1880 infants had a lumbar puncture during the review period, only
      one case of meningitis was found where it was possible that lumbar puncture in a
      bacteraemic infant may have caused meningeal infection. The incidence of this
      potential complication must therefore be low.

PMID- 8346946
TI  - Erythropoietin, protein, and iron supplementation and the prevention of anaemia
      of prematurity.
AB  - The effectiveness of recombinant human erythropoietin (r-HuEpo) in raising
      haemoglobin concentrations in very low birthweight infants was examined in a
      randomised multicentre study. Twenty nine 'healthy' appropriate for gestational
      age infants with birth weights 900-1400 g entered the study at 3 weeks of age.
      All infants received breast milk supplemented with 9 g/l human breast milk
      protein from 3 to 8 weeks of age. Eighteen mg iron was given daily from week 3
      and was doubled if serum iron concentration fell below 16.0 mumol/l. Fourteen
      infants were randomised to receive 100 U/kg r-HuEpo subcutaneously three times a
      week from week 3 to week 7; 15 infants served as controls. After one week
      reticulocyte and haemoglobin concentrations were significantly higher in the r
      HuEpo treated group and the haemoglobin values remained significantly higher
      throughout r-HuEpo treatment and at the concentrations observed in full term
      infants. No adverse effects were associated with the treatment. In stable very
      low birthweight infants with optimal iron and protein intakes, moderate dose r
      HuEpo can produce significant gains in red cell production that may be clinically
      useful.

PMID- 8346948
TI  - Dilution kinetics of H(2)18O for the measurement of total body water in preterm
      babies in the first week after birth.
AB  - The aim of this study was to determine the kinetics of H(2)18O equilibration and
      elimination in preterm babies for the estimation of total body water. Thirteen,
      clinically stable, preterm babies of less than 32 weeks' gestation were studied
      in the first week after birth. Blood and urine samples were obtained for baseline
      measurement of 18O:16O ratio and 1 ml/kg of 10% H(2)18O (0.1 g/kg isotope)
      administered orally. Eleven blood samples were obtained over the next six hours
      and between one and four over the next 18 hours. During the same 24 hour period
      between three and eight urine samples were also obtained. The dilution space at
      zero time (volume of distribution or total body water) was estimated using double
      exponential curve fitting using all available points, from single samples and
      from linear regression on the log data using two or three samples. Equilibration
      time was variable and showed a significant correlation with percentage change in
      body weight from birth. For blood samples, the median time to equilibrium was 81
      minutes (range 2 to 191). A plateau phase was not detected, with H(2)18O
      enrichment declining after the point of maximum enrichment. The median volume of
      distribution at time 0, based on double exponential curve fit analysis, was 859
      ml/kg (range 755 to 995). The volume of distribution, estimated from linear
      regression on the log data using two serum samples obtained at three and six
      hours, approximated most closely to that based on exponential curve fit analysis
      with a median difference of -4 ml/kg (range -41 to 73). It was concluded that in
      most situations blood sampling at three and six hours may be acceptable. However,
      as equilibration time is variable and influenced by the state of expansion or
      depletion of body water compartments, when studying overhydration states,
      multiple sampling is advised in order to be certain that the elimination phase
      has been reached.

PMID- 8346947
TI  - Urea kinetics in neonates receiving total parenteral nutrition.
AB  - Urea kinetics were measured on 10 occasions in eight neonates who had not
      received an oral intake from birth and were maintained on total parenteral
      nutrition. After a prime/intermittent oral dose of 15N15N-urea over 14 hours
      urine was collected every three to four hours, urea isolated, and kinetics
      determined from the plateau level of enrichment in urea, measured by isotope
      ratio mass spectrometry. The total parenteral nutrition provided 393 kJ (94
      kcal)/kg/day and 360 mg nitrogen/kg/day. Urea production was mean (SD) 84 (44) mg
      nitrogen/kg/day, or 50% of intake. Urinary excretion of urea, 39 (16) mg
      nitrogen/kg/day, was 40% of production. Therefore 54% of urea production was
      salvaged through the lower bowel, 45 (35) mg nitrogen/kg/day. It is concluded
      that even in infants who have never had a regular dietary intake the microflora
      of the lower bowel is sufficiently developed to salvage urea nitrogen for further
      metabolic interaction, however it is not clear whether the rate of salvage is
      adequate to satisfy the metabolic demand.

PMID- 8346949
TI  - Can brain impairment be detected by in utero behavioural patterns?
AB  - Fetal behavioural patterns were examined to test whether they could be used to
      localise sites of brain damage antenatally. Decreased fetal movement, persistent
      nonreactive fetal heart rate (FHR) pattern, and/or central nervous system
      malformation were used as indicators of possible neurological impairment. Ten
      fetuses tested in this way underwent further ultrasound examination observing
      movement of the extremities, chest wall (breathing), and eye and mouth, and
      active/quiet FHR patterns. Eight of these 10 fetuses were found on postnatal
      examination to have a brain impairment. The fetuses having potential in utero
      brain impairment were divided into four groups: those with (1) lesion sites at,
      or caudal to, the pons-medulla that were specifically identified by fetal
      behaviour, (2) diffuse lesions in the brain which, although resulting in abnormal
      behaviour, could not be localised by this behaviour, (3) lesions localised in the
      cerebral hemisphere(s) but with no abnormal behaviour and (4) temporally abnormal
      behaviour in utero, finally changing over to a normal pattern with no neonatal
      neurological abnormality. A screening system for the antenatal assessment of
      brain impairment is thus proposed.

PMID- 8346950
TI  - Ultrasonic assessment of gastric emptying in the preterm infant.
AB  - The study of gastric emptying in the preterm infant has been hampered by the
      absence of a suitable, valid technique. We have evaluated gastric antral
      clearance using serial ultrasonic measurement of the antral cross sectional area
      (ACSA). The study was easy to perform, providing successful results in 15 of 17
      low birth-weight infants, with feed volumes of 8-31 ml/kg. ACSA was closely
      related to intragastric volume (mean (range) r = 0.96 (0.89-0.99)). Measurements
      were reproducible: mean (SE) coefficient of variation was 7.7% (1.1). Gastric
      antral clearance was observed as a fall in ACSA that began shortly after
      completion of the feed and returned to prefeed values at a variable rate. The
      pattern of gastric antral transit was entirely consistent with recognised
      patterns of gastric emptying and half gastric antral clearance times ranged from
      20-63 minutes. Ultrasonic measurement of gastric antral clearance is a new
      technique allowing the study of gastric emptying in the preterm infant.

PMID- 8346951
TI  - The effect of intravenous ranitidine on the intragastric pH of preterm infants
      receiving dexamethasone.
AB  - Gastric perforation is a catastrophic, albeit uncommon, side effect of steroid
      treatment for premature infants with bronchopulmonary dysplasia (BPD). A
      reduction of intragastric acidity may protect against peptic ulceration. The
      effect of different doses of ranitidine, given as intravenous infusions, on
      intragastric acidity in premature neonates was therefore examined. Ten
      consecutive, enterally starved, infants receiving dexamethasone (0.6 mg/kg) for
      BPD were enrolled. Intragastric pH was continuously monitored on the day before
      steroid treatment and on the four following days, initially without H2 blockade
      and then using a continuous intravenous infusion of ranitidine at 0.031, 0.0625,
      and 0.125 mg/kg/hour. An infusion of 0.0625 mg/kg/hour of ranitidine was
      sufficient to increase and maintain gastric pH above 4; the authors therefore use
      this infusion during dexamethasone administration as possible prevention of
      gastric perforation.

PMID- 8346952
TI  - Inflammatory cells in the lungs of premature infants on the first day of life:
      perinatal risk factors and origin of cells.
AB  - Neither the origin of leucocytes in the premature newborn airway nor their
      relationship to perinatal factors has been adequately determined. In order to
      sample airway cells, modified bronchoalveolar lavage was performed on 74
      intubated infants of < 32 weeks' gestation and < 24 hours of age. Cells were
      counted, stained and, in a small separate group of six infants, four boys and two
      girls, probed for the Y chromosome with suitable control samples. Perinatal risk
      factors for increased airway cellularity were analysed by multiple regression.
      Premature rupture of membranes of more than 24 hours' duration was independently
      associated with increased numbers of airway leucocytes (n = 74). More than 90% of
      airway leucocytes from four boys with pulmonary inflammation were positive for
      the Y chromosome indicating that the cells were of fetal rather than maternal
      origin.

PMID- 8346953
TI  - Pulmonary inflammatory cells in ventilated preterm infants: effect of surfactant
      treatment.
AB  - The aim of this study was to determine the effect of surfactant treatment on the
      number and distribution of inflammatory cells in bronchoalveolar lavage fluid
      (BALF) from mechanically ventilated preterm infants over the first week of life
      in relation to the subsequent development of chronic lung disease (CLD). The
      study included 25 babies who received surfactant on clinical grounds and 29
      babies of similar severity who did not. BALF was collected on days 1, 3, 5, and 7
      after birth. Cell counts were performed and differentials were calculated on 300
      cells. CLD was equally common in both treatment groups. Of the 54 infants, 29
      (53%) who developed CLD had a higher incidence of patent ductus arteriosus and
      air leak and needed a higher concentration of inspired oxygen on the fifth and
      seventh days of life. Babies who developed CLD had more polymorphonuclear
      leucocytes and fewer macrophages on days 5 and 7 than those who recovered.
      Surfactant treatment was associated with a higher total white cell count on day
      3. Between days 3 and 7, macrophage numbers were higher in surfactant treated
      babies, whatever the pulmonary outcome. This data suggests that CLD was
      associated with persistence of high numbers of polymorphonuclear leucocytes in
      BALF at the end of the first week. Surfactant treatment caused a persistent
      increase in macrophage numbers. The association between persistent neutrophilia
      and CLD was unaffected by surfactant treatment.

PMID- 8346954
TI  - Bronchoalveolar lavage fluid glutathione in intubated premature infants.
AB  - Lower concentrations of uncorrected glutathione in the bronchoalveolar lavage
      fluid were found on the first day of life in seven infants who subsequently
      developed chronic lung disease when compared with 27 infants who did not require
      supplemental oxygen at 36 weeks' postconceptional age. The concentration of
      glutathione on the first day was independent of gestational age. These
      preliminary results suggest that glutathione accumulates in the lung epithelial
      lining fluid of preterm infants and that a relative deficiency may predispose to
      lung injury.

PMID- 8346955
TI  - Aminophylline and increased activity of peripheral chemoreceptors in newborn
      infants.
AB  - Peripheral chemoreceptor activity was studied in nine healthy, unsedated neonates
      (with a mean (SD) postconceptional age of 39 (2) weeks and birth weight of 3000
      (400) g) by measuring the inhibition of ventilation elicited by five breaths of
      100% oxygen (Dejours technique). Changes in tidal volume, frequency, and minute
      ventilation were measured before and after administration of aminophylline (10
      mg/kg by mouth). Before aminophylline hyperoxia induced a decrease in minute
      ventilation (from a mean (SE) of 825 (55) to 520 (30) ml/kg/min) as result of
      reduction of tidal volume (from 12 (0.3) to 8 (0.3) ml/kg). After aminophylline
      administration the hyperoxia induced decrease in tidal volume (from 14 (0.7) to 6
      (0.3) ml/kg) and minute ventilation (from 847 (57) to 386 (21) ml/kg/min) was
      significantly greater than before. It is concluded that in neonates peripheral
      chemoreceptors are more active in the presence of aminophylline. It is speculated
      that aminophylline increases the activity of peripheral chemoreceptors, reducing
      the breakdown of cAMP, which is a crucial mediator for peripheral chemoreceptor
      discharge.

PMID- 8346956
TI  - Pharmacokinetics of morphine infusion in premature neonates.
AB  - Morphine pharmacokinetics were studied in 17 premature neonates (26-34 weeks'
      gestation) after intravenous infusion during the first 24 hours of life. Infants
      received either standard dose morphine that comprised of a 100 micrograms/kg/hour
      loading infusion for 2 hours followed by a maintenance infusion of 12.5
      micrograms/kg/hour, or a high dose of 200 micrograms/kg/hour for 2 hours followed
      by 50 micrograms/kg/hour. Mean plasma concentrations of morphine (SD) after 2 and
      24 hours were 99 (12.9) and 96.4 (3.2) ng/ml, and 184.2 (37.7) and 319 (71.2)
      ng/ml for the standard and high dose regimens, respectively. Morphine-3
      glucuronide plasma concentrations achieved about 20% and 80% of morphine values
      at 2 and 24 hours respectively. Morphine-6-glucuronide could not be detected at 2
      hours, but attained 20-25% of morphine plasma concentrations by 24 hours. The
      population mean morphine clearance was 2.4 ml/min/kg, the elimination half life
      was 8.75 hours and the volume of distribution was 1.82 1/kg. High plasma
      concentrations of morphine appeared to be well tolerated. Although mean arterial
      blood pressure decreased during the first six hours of treatment, this was not
      statistically significant; two infants experienced transient muscle rigidity, but
      no evidence of seizures was noted. There appears to be no clinical advantage in
      using the high dose regimen.

PMID- 8346957
TI  - Response to dobutamine and dopamine in the hypotensive very preterm infant.
AB  - A randomised double blind study was designed to evaluate haemodynamic response to
      dobutamine and dopamine in 20 hypotensive preterm infants of less than 32 weeks'
      gestation. Neonates initially received dopamine or dobutamine 5
      micrograms/kg/min. If mean arterial pressure (MAP) remained below 31 mm Hg, the
      infusion rate was increased in increments of 5 micrograms/kg/min. If 20
      micrograms/kg/min of the initial drug failed to achieve a MAP above 30 mm Hg, it
      was discontinued and the other drug was administered at the same infusion rate.
      Left ventricular output (LVO) was measured by pulsed Doppler echocardiography.
      Mean (SE) MAP increased significantly from 24.4 (1.0) to 32.0 (1.4) mm Hg at a
      median dobutamine dosage of 20 micrograms/kg/min and from 25.6 (1.2) to 37.7
      (1.5) mm Hg at a median dopamine dosage of 12.5 micrograms/kg/min. The percentage
      LVO increase was +21 (7)% with dobutamine compared with -14 (8)% with dopamine.
      Dobutamine failed to increase MAP above 30 mm Hg in six infants out of 10,
      whereas dopamine succeeded in all 10 infants. Six switches from dobutamine to
      dopamine were thus performed, providing a rise in MAP (29.2 (0.5) to 41.2 (2.0)
      mm Hg) and drop in LVO (356 (40) to 263 (36) ml/kg/min). These data indicate that
      dopamine is more effective than dobutamine in raising and maintaining MAP above
      30 mm Hg; however dopamine does not increase LVO.

PMID- 8346958
TI  - Cyclical variation of blood pressure and heart rate in neonates.
AB  - Using a computerised physiological monitoring system a cyclical variation in
      blood pressure (waves), with associated changes in heart rate and transcutaneous
      oxygen, was observed. Twenty five episodes were seen in 10 neonates, with a
      median gestation of 33 weeks (range 28-42 weeks). Eight neonates had an asphyxial
      injury. Blood pressure waves had a mean (SD) amplitude of 11.6 (5.6) mm Hg with a
      mean wavelength of 9.0 (5.2) minutes. Both amplitude and frequency were
      independent of gestation. In neonates of less than 34 weeks an inverse phase
      relation existed between heart rate and blood pressure waves (blood pressure rose
      as heart rate fell); in infants with a gestation greater than 34 weeks a direct
      phase relationship occurred (blood pressure and heart rate rose together). It is
      postulated that hypertensive blood pressure waves may cause or exacerbate
      cerebral pathology in neonates with a pressure passive cerebral circulation.

PMID- 8346959
TI  - Is specialist centre delivery of gastroschisis beneficial?
AB  - This study aims to establish the usefulness of delivering neonates with
      gastroschisis in a regional obstetric and neonatal centre without the facility of
      on site surgery. A retrospective analysis was performed on the notes of 43
      consecutive neonates with gastroschisis referred to Birmingham Children's
      Hospital over a 10 year period. Two groups were compared: those delivered at the
      regional obstetric centre (n = 9) and those delivered peripherally (n = 34). Both
      groups underwent postnatal transfer. There were no significant differences with
      regard to gestational age, birth weight, caesarean section rate, time to
      operation, and mortality. Primary closure rates were 89% for the regional centre
      group and 94% for the peripheral hospital group. Mean time to full enteral
      feeding was 24 days for the regional centre group and 23 days for those delivered
      peripherally. These data show that good results can be achieved with postnatal
      transfer. If on site surgery is not available, neonatal services are adequate
      peripherally, and the transfer distance is not too great, then delivery in a
      regional obstetric centre with subsequent postnatal transfer offers no advantage.

PMID- 8346960
TI  - Changes in cerebral artery blood flow velocity after intermittent cerebrospinal
      fluid drainage.
AB  - Doppler ultrasound was used to measure blood flow velocity in the anterior
      cerebral artery of six premature infants with posthaemorrhagic hydrocephalus,
      before and after intermittent cerebrospinal fluid (CSF) drainage, on 23
      occasions. There was a significant increase in mean blood flow velocity after the
      drainage procedures (+5.6 cm/s, 95% confidence interval +2.9 to +8.3 cm/s), which
      was accompanied by a decrease in velocity waveform pulsatility. CSF pressure also
      fell significantly. In patients with posthaemorrhagic hydrocephalus, intermittent
      CSF drainage was associated with acute changes in cerebral haemodynamics.

PMID- 8346961
TI  - Measurement of ionised calcium concentration in neonates.
AB  - Whole blood ionised calcium concentration was measured simultaneously in
      capillary and arterial blood from neonates being nursed on an intensive care unit
      using an ion selective electrode. The mean arterio-capillary difference was 
      0.027 mmol/l (95% confidence intervals -0.041 to -0.012 mmol/l) and the limits of
      agreement between the two measurements were 0.034 and -0.088 mmol/l. Measurement
      of ionised calcium in capillary blood is acceptable for clinical purposes.

PMID- 8346962
TI  - Inadvertent brain penetration during neonatal nasotracheal intubation.
AB  - During routine nasal intubation of a premature infant, the endotracheal tube
      penetrated the brain. Bloodstained cerebrospinal fluid and neural tissue was
      apparent. Initial cranial sonography was normal, but the infant later developed
      extensive intracranial haemorrhage. Rotation of an endotracheal tube to
      facilitate insertion angles the bevel at the tip upwards, increasing risk of
      brain penetration. Great care is required during nasal intubation; use of a small
      feeding tube over which to slide an endotracheal tube may be helpful.

PMID- 8346963
TI  - Nasal endotracheal intubation in a premature infant with a nasal encephalocele.
AB  - After a difficult nasal intubation a premature infant leaked cerebrospinal fluid
      (CSF) from one nostril. After developing bacterial meningitis, the baby was
      referred for neurosurgical management of the CSF fistula. Transaxial computed
      tomograms demonstrated a nasal encephalocele, but coronal scans were needed to
      show the defect in the cribriform plate.

PMID- 8346965
TI  - A method for urine collection in infants.
AB  - A simple, inexpensive, non-invasive method for urine collection was used in 28
      consecutive infants for periods of 48 hours (n = 10) and 72 hours (n = 18). The
      incidence of urine collector detachment was low on the first and second days (<
      4%) and increased significantly on the third day (28%). Volume of urine leaked
      was < 4% of the total volume collected daily. This method is applicable to both
      sexes and is reliable for up to 48 hours.

PMID- 8346964
TI  - Urea salvage in a neonate with cloacal exstrophy.
AB  - Urea kinetics were measured in a child with congenital absence of the colon on
      days 15, 19, and 23 of age. Urea salvage was 5% of urea production in the first
      study, increasing to 79% by the third. This provides evidence that the colonic
      microflora play a more active part in urea salvage than the mucosa and that the
      establishment of an active lower ileal microflora takes over some of the
      metabolic functions of the intact colon.

PMID- 8346966
TI  - Sodium intake and preterm babies.

PMID- 8346967
TI  - Duration of periventricular densities in preterm infants and neurological outcome
      at 6 years of age.
AB  - Parenchymal echogenicities that break down into extensive cystic lesions are
      generally followed by severe motor deficit. However, the effect of echodensities
      in the periventricular white matter, so called 'flares', on later development is
      less well documented. The aim of the present study was to investigate the impact
      of neonatal flares in preterm infants on neurological status and motor competence
      at 6 years of age and to see to what extent outcome was related to duration of
      flares. Forty four children with flares, subdivided into three groups according
      to the duration of flares, and 62 children with normal scans were assessed on
      Touwen's neurological examination, the Movement ABC, and the British Ability
      Scales. No differences in cognitive abilities were found between the groups. The
      results of the motor assessments showed that performance decreased significantly
      with increasing duration of flares. In addition, there was a suggestion that this
      trend was stronger in measures assessing lower limb function than those of upper
      limb. Teachers were also able to identify differences between the groups of
      children on the basis of their motor performance in school.

PMID- 8346968
TI  - Spinal cord birth injury--diagnostic difficulties.

PMID- 8346969
TI  - Dr Alfred Hart (1888-1954) of Toronto and exsanguination transfusion of the
      newborn.

PMID- 8346970
TI  - Toxic potential of non-ortho and mono-ortho coplanar polychlorinated biphenyls in
      Aroclors, seals, and humans.
AB  - Mono-ortho and non-ortho coplanar polychlorinated biphenyls (PCBs) were analyzed
      in Aroclors, seals, and humans by graphitized carbon, a recently developed HPLC
      method (Hong et al. 1992b) and high-resolution gas chromatography with electron
      capture detection (HRGC/ECD). The concentration data were multiplied by potency
      factors derived from aryl hydrocarbon hydroxylase (AHH) induction to give 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD) equivalents. The ability to separate coplanar
      PCBs from the majority of PCBs has allowed the use of TCDD toxicity equivalence
      to compare the relative dioxin-like potency of PCB residues in the complex
      mixtures. The most active mixtures, Aroclors 1254, 1248, and 1242, contained 42
      54% by weight of chlorine. The results demonstrate that the apparent dioxin-like
      potency of PCB residues in Aroclors, seals, and humans is dominated by three
      congeners, 3,3',4,4'-tetra-, 2,3,3'-4,4'-, and 3,3',4,4',5-pentachlorobiphenyl
      (IUPAC nos. 77, 105, 126).

PMID- 8346971
TI  - Dentin as a possible bio-epidemiological measure of exposure to mercury.
AB  - The subtle human health effects from prolonged exposure to small amounts of
      mercury vapor are unknown. It has been difficult to study possible effects of low
      dose exposure for lack of a good measure of long-term exposure. Current methods
      which use blood, urine, hair, and nails reliably measure only recent exposures.
      Long-term exposure to lead has been measured using levels found in human dentin.
      The purpose of this study was to determine whether mercury also accumulates in
      dentin. In this study, dentin from 16 human teeth, all without dental amalgam
      restorations, was analyzed by thermal neutron activation analysis. The teeth were
      selected from people with and without dental mercury amalgam restorations
      elsewhere in their dentitions. Mercury was found in amounts up to 5.9 ppm. While
      the highest mercury level was from a sample from someone who had dental amalgam
      restorations elsewhere in their dentition, the second highest was from someone
      who had no amalgam restorations. Also, a sample which was not used for any
      statistical comparisons but which was analyzed because the tooth contained an
      amalgam restoration had one of the lowest levels of mercury. These results, while
      inconclusive due to a small sample size, suggest that inorganic mercury vapor is
      a relatively small contributor to the overall body burden of mercury.

PMID- 8346972
TI  - Exposure-excretion relationship of styrene and acetone in factory workers: a
      comparison of a lipophilic solvent and a hydrophilic solvent.
AB  - A factory survey was conducted in the second half of a working week on 41 exposed
      male workers, who were engaged in fiber-reinforced plastics work and exposed to
      the mixed vapors of styrene and acetone. Nonexposed workers, 20 men, were
      recruited from the same factory. Styrene and acetone in respiratory zone air were
      monitored for a 8-h shift with carbon cloth- and water-equipped personal
      diffusive samplers, respectively. Blood and urine samples were collected at the
      shift-end. Acetone and styrene concentrations in whole blood, serum and urine
      were measured by head-space gas chromatography, and phenylglyoxylic acid in urine
      by high-performance liquid chromatography. All biological exposure indicators
      analyzed correlated significantly with the intensity of exposure to the
      corresponding solvent during the shift. The slopes of the regression lines
      indicate that a very small fraction of styrene absorbed will be excreted into
      urine as styrene per se, and that styrene is quite effectively excreted into
      urine after metabolic conversion. In contrast, the slopes of regression lines for
      acetone suggest that acetone distributes both in the blood and urine quite
      evenly. When the distribution of the solvent in serum was compared with that in
      the whole blood, it was found that almost all of styrene in blood is present in
      the serum, whereas acetone distributed very evenly in the cellular and
      noncellular fractions of the blood.

PMID- 8346973
TI  - Contaminants in L-tryptophan associated with eosinophilia myalgia syndrome.
AB  - In late 1989, an epidemic of eosinophilia-myalgia syndrome (EMS) that resulted in
      several thousand cases of the syndrome and 36 deaths was recognized in the United
      States. Physicians in New Mexico linked the epidemic to the ingestion of L
      tryptophan (LT). Results of studies indicated that one or more trace contaminants
      in LT were likely causes of the EMS epidemic. Investigators traced the LT that
      was taken by most patients with EMS to a single manufacturer, Showa Denko K.K. of
      Japan. We now report results of high performance liquid chromatographic analysis
      of LT samples from this manufacturer. Three sets of blind-coded samples were
      analyzed: the priority case lot set, which included 54 case-associated LT lots
      and 50 noncase-associated LT lots that were taken by case and control subjects
      who used only one brand of LT; the single lot case set, which included 73 case
      associated LT lots and 25 noncase associated LT lots taken by case and control
      subjects who used only a single lot of LT; and the South Carolina tablet set,
      which included LT tablets taken by case subjects (n = 26) and by control subjects
      (n = 52). We statistically compared the concentration of each contaminant in case
      associated, noncase-associated, and control samples of each sample set. The
      analyses showed that there were more than 60 minor contaminants in the LT from
      Showa Denko K.K., and that six of these contaminants were associated with EMS.
      The structures of three contaminants are known, but the identities of the other
      three contaminants are currently unknown.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346974
TI  - The effect of salinity on the acute toxicity of cadmium to the tropical,
      estuarine, hermaphroditic fish, Rivulus marmoratus: a comparison of Cd, Cu, and
      Zn tolerance with Fundulus heteroclitus.
AB  - The mangrove-dwelling fish, Rivulus marmoratus, is the only vertebrate that is a
      synchronous, internally self-fertilizing hermaphrodite. This unique reproductive
      mode yields offspring with little genetic variation, which offers significant
      advantages for the use of this species in bioassays. We conducted acute (96 h)
      LC50 tests of Cd toxicity under four different water chemistry conditions,
      representing fresh water (low [Ca+Mg] and low [Na+K]), 14 ppt sea water simulated
      with Cl salts (high [Ca+Mg] and high [Na+K]) and two artificial conditions (high
      [Ca+Mg], low [Na+K] and low [Ca+Mg], high [Na+K]). Two replicates were conducted
      at different times for each of the four treatments and the results were very
      reproducible. The mean LC50's as mg total Cd/L were 2.96 (fresh water), 21.12
      (high [Ca+Mg], high [Na+K]), 17.86 (high [Ca+Mg], low [Na+K]) and 12.67 (low
      [Ca+Mg], high [Na+K]). An additional test in 14 ppt sea water (made up from
      Instant Ocean salts) yielded a 96h LC50 of 24.48 mg Cd/L, and was thus similar to
      the high [Ca+Mg]-high [Na+K] treatment, despite some differences in anion and
      cation concentrations. The degree to which [Ca+Mg], [Na+K] and [Cl] interact to
      determine Cd toxicity is still unclear, although the role of [Cl] is likely to be
      equal to or greater than that of [Ca+Mg]. When all solutes are high, it is likely
      that the formation of a Cd complex with Cl (248 mM) leads to the observed
      reduction in Cd toxicity in comparison with hard fresh water, not the increased
      divalent [Ca+Mg] levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346975
TI  - Recent developments in the understanding of paediatric musculoskeletal pain
      syndromes.

PMID- 8346976
TI  - Joint hypermobility and fibromyalgia in schoolchildren.
AB  - OBJECTIVES: To test the hypothesis that joint hypermobility may play a part in
      the pathogenesis of pain in fibromyalgia, schoolchildren were examined for the
      coexistence of joint hypermobility and fibromyalgia. METHODS: The study group
      consisted of 338 children (179 boys, 159 girls; mean age 11.5 years, range 9-15
      years) from one public school in Beer-Sheva, Israel. In the assessment of joint
      hypermobility, the criteria devised by Carter and Bird were used. Any child who
      met at least three of five criteria was considered to have joint hypermobility.
      Children were considered to have fibromyalgia if they fulfilled the 1990 American
      College of Rheumatology criteria for the diagnosis of fibromyalgia, namely,
      widespread pain in combination with tenderness of 11 or more of the 18 specific
      tender point sites. The blind assessments of joint hypermobility (by AG) and
      fibromyalgia (by DB) were carried out independently. RESULTS: Of the 338 children
      43 (13%) were found to have joint hypermobility and 21 (6%) fibromyalgia; 17
      (81%) of the 21 with fibromyalgia had joint hypermobility and 17 (40%) of the 43
      with joint hypermobility had fibromyalgia. Using chi 2 statistical analysis,
      joint hypermobility and fibromyalgia were found to be highly associated.
      CONCLUSIONS: This study suggests that there is a strong association between joint
      hypermobility and fibromyalgia in schoolchildren. It is possible that joint
      hypermobility may play a part in the pathogenesis of pain in fibromyalgia. More
      studies are needed to establish the clinical significance of this observation.

PMID- 8346977
TI  - Self report functional disability scores and the use of devices: two distinct
      aspects of physical function in rheumatoid arthritis.
AB  - OBJECTIVES: Self report scores of physical disability and the use of devices or
      assistance in performing activities are sometimes integrated in one index of
      physical function, although they are aimed at measuring different dimensions of
      physical disability. The properties of both parameters were evaluated in two
      groups of patients with rheumatoid arthritis (RA). METHODS: A group of patients
      with RA of recent onset was compared with a group with established disease on
      four parameters of disability: use of devices, use of personal assistance, and
      scores on a validated Dutch version of the Health Assessment Questionnaire
      Disability Index, with and without integrating the use of devices or assistance.
      Correlation coefficients among disability parameters were calculated. In multiple
      regression analysis the influence of disease duration on the disability
      parameters was determined after disease activity, psychological wellbeing, and
      demographical characteristics had been controlled. RESULTS: Functional disability
      scores were mainly related to inflammatory activity and psychological wellbeing,
      whereas the uses of devices had a strong relation with disease duration,
      independent of current disease activity. Integrating these parameters of
      disability yielded a parameter that was still mainly associated with disease
      activity. CONCLUSION: Self report scores of functional disability and the use of
      devices represent distinct dimensions of physical function in RA. Integrating
      both parameters into one measure of physical disability does not provide an index
      adequately reflecting both dimensions. The use of both parameters to measure
      outcome in long term clinical studies is recommended.

PMID- 8346978
TI  - Small intestinal bacterial overgrowth in patients with rheumatoid arthritis.
AB  - OBJECTIVES: To examine the microflora of the upper small intestine in patients
      with seropositive rheumatoid arthritis (RA) using a combination of microbial
      cultivation and tests for microbial metabolic activity. METHODS: Twenty five
      patients with seropositive RA, 12 achlorhydric control subjects, and 11 control
      subjects with normal gastric acid secretion were investigated. Disease activity
      was evaluated in the patients with RA by three different indices. Eight (32%) of
      the patients with RA had hypochlorhydria or achlorhydria. The acid secretory
      capacity was determined with pentagastrin stimulation. A modified Crosby capsule
      was used to obtain biopsy specimens and samples of intestinal fluid from the
      proximal jejunum; aerobic and anaerobic microbial cultivation of mucosal
      specimens/intestinal fluid was carried out, and gas production and microflora
      associated characteristics in jejunal fluid were determined. Additionally, a bile
      acid deconjugation breath test was performed. RESULTS: Subjects with at least one
      of the following findings were considered to have bacterial overgrowth: positive
      bile acid deconjugation test; growth of Enterobacteriaceae; positive gas
      production; or low tryptic activity. By these criteria half of the patients with
      RA with hypochlorhydria or achlorhydria and half of the achlorhydric controls had
      bacterial overgrowth. Thirty five per cent of the patients with RA with normal
      gastric acid secretion had bacterial overgrowth compared with none of the normal
      controls. Disease activity indices and rheumatoid factor titres were
      significantly higher in patients with RA with bacterial overgrowth than in those
      without. CONCLUSIONS: A high frequency of small intestinal bacterial overgrowth
      was found in patients with RA; it was associated with a high disease activity and
      observed in patients with hypochlorhydria or achlorhydria and in those with
      normal acid secretion.

PMID- 8346979
TI  - Radiographic patterns and associations of osteoarthritis of the knee in patients
      referred to hospital.
AB  - OBJECTIVES: To investigate differing patterns and associations of osteoarthritis
      of the knee in patients referred to hospital. METHODS: Two hundred and fifty two
      consecutive patients (161 women, 91 men; mean age 70 years, range 34-91 years)
      referred to hospital with osteoarthritis of the knee underwent clinical,
      radiographic, and synovial fluid screening. RESULTS: Radiographic changes of
      osteoarthritis of the knee (definite narrowing with or without osteoarthritic
      features) were bilateral in 85% of patients. Of 470 knees affected, 277 (59%)
      were affected in two compartments and 28 (6%) in three compartments. Unilateral
      and isolated medial tibiofemoral osteoarthritis were more common in men. Calcium
      pyrophosphate crystal deposition was common (synovial fluid identification in 132
      (28%) knees; knee chondrocalcinosis in 76 (30%) patients) and associated with
      disability, bilateral, multicompartmental and severe radiographic osteoarthritis,
      marked osteophytosis, attrition, and cysts. Multiple clinical nodes (58 (23%)
      patients) and radiographic polyarticular interphalangeal osteoarthritis (66 (26%)
      patients) were associated with a higher frequency of inactivity pain, disability,
      multicompartmental and severe radiographic change. Forestier's disease
      predominated in men but showed no other associations. CONCLUSIONS: In a group of
      patients referred to hospital osteoarthritis of the knee is usually bilateral and
      affects more than one compartment. Severe and multicompartmental radiographic
      changes are associated with calcium pyrophosphate crystal deposition, nodal
      change, and polyarticular interphalangeal osteoarthritis.

PMID- 8346981
TI  - Scleroderma and malignancy: an epidemiological study.
AB  - OBJECTIVES: Although case reports and some patient series suggest an increased
      risk of cancer among patients with scleroderma, there are no population based
      studies to support this association. A population based follow up study was
      therefore carried out of 233 patients with scleroderma from the six-county
      Uppsala health care region of Sweden for the time period 1955-84. METHODS: Using
      the inpatient registry for the Uppsala health care region, all patients with
      scleroderma were identified. Their unique identification codes were then used to
      perform a record linkage with the National Cancer Registry. Expected cancer rates
      were determined using the age and gender specific rates for the Uppsala health
      care region. RESULTS: The standardised incidence ratio (SIR) for all cancers
      among these patients was significantly increased (SIR = 2.4; 95% CI = 1.5 to
      3.6). The SIRs for lung cancer (SIR = 7.8; 95% CI = 2.5 to 18.2) and non
      Hodgkin's lymphoma (SIR = 9.6; 95% CI = 1.1 to 34.5) were also significantly
      increased. Excluding patients who were diagnosed with cancer within a year of
      their scleroderma diagnosis resulted in similar findings, though the SIR for non
      Hodgkin's lymphoma was no longer statistically significant. CONCLUSIONS: Larger
      population based investigations of cancer risk among patients with scleroderma
      are needed to confirm these initial findings and to evaluate in greater detail
      possible cancer risk among these patients.

PMID- 8346980
TI  - Various rheumatic syndromes in adult patients associated with high
      antistreptolysin O titres and their differential diagnosis with rheumatic fever.
AB  - OBJECTIVES: The purpose of this study was to analyse retrospectively adult
      patients with acute joint or muscle symptoms and a high antistreptolysin O (ASO)
      titre to find out which syndromes of clinical arthritis are associated with
      serological evidence of streptococcal infection. METHODS: Seventy six adult
      patients with an acute arthritis syndrome or an exacerbation in their chronic
      rheumatic disease and simultaneously a high ASO titre (> or = 500 Todd units)
      were examined in two time periods in the 1980s. RESULTS: Twenty six patients had
      arthritis associated with a known rheumatic disease, 25 had non-specific
      arthralgia/myalgia, 20 had reactive arthritis, and five had septic arthritis. No
      case of classic rheumatic fever classified by two major criteria was found. Six
      patients fulfilled one major and at least two minor criteria. The frequency of
      HLA-B27 was significantly higher in the whole patient group than in the healthy
      Finnish population (30 v 14%). CONCLUSIONS: It is concluded that classic
      rheumatic fever is now rare, even in patients with arthritis with a high ASO
      titre. These results support the suggestion that beta haemolytic streptococci may
      trigger reactive arthritis as well as rheumatic fever.

PMID- 8346982
TI  - Absence of an association between HLA-DRB1*04 and rheumatoid arthritis in newly
      diagnosed cases from the community.
AB  - OBJECTIVES: To determine HLA-DR4 and DR1 allele frequencies in a series of
      patients with newly diagnosed early inflammatory arthritis. METHODS: HLA-DR1 and
      DR4 frequencies were determined by oligonucleotide typing of 208 patients
      classified as having either rheumatoid arthritis (RA) or undifferentiated
      inflammatory polyarthritis. RESULTS: The frequency of occurrence of DR4 in these
      patients with RA did not differ significantly from that in controls in the United
      Kingdom (42 v 37%). HLA-DR1 was increased in the group with inflammatory
      polyarthritis (25 v 18%). CONCLUSIONS: The frequency of DR4 is not increased in
      newly diagnosed community based patients with RA. This supports the hypothesis
      that DR4 is less important as a marker for susceptibility to RA than it is for
      disease persistence or severity.

PMID- 8346984
TI  - Clinical evolution of sacral stress fractures: influence of additional pelvic
      fractures.
AB  - OBJECTIVES: To evaluate the clinical evolution of sacral stress fractures in
      relation to the scintigraphic pattern and the presence of additional pelvic
      fractures. METHODS: This was a retrospective study of 14 patients with sacral
      fractures. RESULTS: Six patients had additional pelvic fractures. Four bone
      scintigraphic patterns were found. The resolution of symptoms was longer in
      patients with associated pelvic fractures (30 weeks v three weeks). No relation
      was found between the bone scintigraphic pattern and the time of evolution.
      CONCLUSION: Associated pelvic fractures delay the resolution of symptoms in
      patients with sacral fractures, regardless of scintigraphic pattern.

PMID- 8346983
TI  - Lack of association of increased antibody levels to mycobacterial hsp65 with
      rheumatoid arthritis: results from a study of disease discordant twin pairs.
AB  - OBJECTIVES: To investigate the role of humoral immunity to mycobacterial hsp65 in
      the aetiology of rheumatoid arthritis. METHODS: Levels of IgG antibodies to
      recombinant mycobacterial hsp65 were measured by enzyme linked immunosorbent
      assay (ELISA) in serum samples of 152 twin pairs discordant for RA and in serum
      samples from 62 normal blood donors. RESULTS: No significant differences between
      antibody levels in the subjects with RA compared either with their unaffected
      twins or with a group of normal blood donors was observed. In the monozygotic
      twins there was a strong but negative association between levels of antibody to
      hsp65 and disease status. Zygosity, sex, and HLA status did not significantly
      affect levels of antibody to hsp65. CONCLUSION: Previous reports of an
      association between hsp65 and RA were not confirmed.

PMID- 8346985
TI  - Long term follow up of radiosynovectomy with yttrium-90 silicate in haemophilic
      haemarthrosis.
AB  - OBJECTIVES: The aim of this study was to evaluate the long term effect of
      radiation synovectomy with yttrium-90 silicate in haemophiliac patients with
      recurrent haemarthrosis. METHODS: The bleeding frequency and the mobility of the
      joint were recorded in 16 joints of 14 patients 1 year before radiosynovectomy
      and during follow up, which ranged from 3 to 6 years. Patients evaluated the
      effect of their own treatment by completing a questionnaire. Radiographs of the
      joints were scored by an independent radiologist before treatment. RESULTS: A
      satisfactory reduction of the frequency of haemorrhage was achieved in 94% of
      joints during the first year after treatment and was maintained in 63% until the
      end of the follow up period. In general there was no decrease in mobility
      attributable to radiosynovectomy, and the patients' own evaluations agreed with
      the evaluations based on the frequencies of haemarthrosis in 75%. Patients who
      had only minor, or no, radiological abnormalities of the joints before treatment
      showed the best results. One patient developed synovitis as a complication of the
      radiosynovectomy. CONCLUSION: Radiosynovectomy is an effective and safe treatment
      for recurrent haemarthrosis in haemophiliac patients, especially in those who
      have joints with no or minor radiological damage.

PMID- 8346986
TI  - Visceral leishmaniasis.

PMID- 8346987
TI  - The chemotherapy of rodent malaria. XLVIII. The activities of some synthetic
      1,2,4-trioxanes against chloroquine-sensitive and chloroquine-resistant
      parasites. Part 1: Studies leading to the development of novel cis-fused
      cyclopenteno derivatives.
AB  - The new Chinese antimalarial blood schizontocide, artemisinin, derived from the
      plant Artemisia annua, displays a high level of activity against polyresistant
      Plasmodium falciparum. Several synthetic 1,2,4-trioxanes were examined in a
      search for compounds that exhibit a similar type of action against drug-resistant
      parasites. This paper, the first of a series, describes the examination of these
      trioxanes against drug-sensitive and drug-resistant malaria parasites in a rodent
      model, using artemisinin and arteether as comparison standards. Cis-fused
      cyclohexeno-1,2,4-trioxanes (10-17) substituted with various side-chains revealed
      for the most part variable but weak antimalarial activity. On the other hand, cis
      fused cyclopenteno-1,2,4-trioxanes (18-19) showed greater activity, 19 showing
      about 1/30th of the activity of arteether against drug-sensitive Plasmodium
      berghei in vivo, thereby providing a clue to the structure-activity relationship.

PMID- 8346988
TI  - Increased circulating levels of transcobalamin II in malarial patients with renal
      involvement.
AB  - Vitamin B12 and its binding proteins were measured in the serum and urine of four
      patients with Plasmodium falciparum who had renal insufficiency. The results
      showed that these patients had elevated serum transcobalamin II (TCII) levels
      which decreased to the normal level after recovery from azotaemia. There were
      direct relationships between serum TCII levels and blood urea-nitrogen or
      creatinine concentrations. The clearance and urinary excretion of vitamin B12 and
      TCII were significantly lower in the patients' group than in normal subjects. All
      these findings indicated that elevated serum TCII could occur in P. falciparum
      patients with renal insufficiency. This is probably caused by a reduction in
      renal plasma flow and glomerular filtration rate (GFR), secondary to a low or
      ineffective blood volume. The reduced GFR, in turn, reduces the TCII-B12 that
      filters through the glomeruli, resulting in decreased TCII-B12 uptake by the
      renal tubules, and thus slows down the TCII degradation by lysosomal enzymes. The
      decreased TCII catabolism therefore prolongs the TCII survival in the circulation
      and probably stimulates TCII synthesis and secretion in a feedback mechanism.

PMID- 8346989
TI  - Thermotherapy v. antimonials: what happens after the healing of cutaneous
      leishmaniasis lesions?
AB  - The long-term effects of meglumine antimoniate (chemotherapy) or exposure to an
      environmental temperature of 37 degrees C (thermotherapy) on the evolution of
      Leishmania mexicana infections and on the response to challenge infections six
      months after treatment were compared in susceptible (BALB/c) and partially
      resistant (C57BL/6) mice. Thermotherapy was better than chemotherapy in that it
      healed lesions quicker and prevented relapses in the partially resistant mice
      during the observation period. However, both treatments appeared equally
      effective in terms of clinical cure. Neither treatment cleared all parasites from
      the hosts and both impaired the hosts' immune response to a challenge infection.
      The results indicate that specific immunity fades with time post-infection and
      that the persistence of the parasite in a clinically cured host does not maintain
      protective immunity against challenge infections.

PMID- 8346990
TI  - Entamoeba histolytica: antibody response to recent and past invasive events.
AB  - Sero-epidemiological data from endemic amoebiasis areas are difficult to evaluate
      because the serology of individuals affected by an active process of Entamoeba
      histolytica tissue invasion is, at present, almost impossible to distinguish from
      that of individuals who have had an invasive event in the past. The present study
      compares serum antigenic recognition frequencies among three groups of
      individuals with different infective conditions: amoebic liver abscess patients;
      asymptomatic cyst passers; and individuals who have had amoebic liver abscess
      from one to three years before the study. Control groups consisted of Mexican and
      Canadian healthy adults. Western blots of E. histolytica membrane extract antigen
      were reacted with sera from the studied individuals, recognition frequency values
      were calculated and immunoplots of frequency differences were constructed. The
      results obtained suggest that the identification and purification of antigenic
      fractions, which are frequently recognized by sera of amoebic liver abscess
      patients (136, 132, 93, 70 and 62 kDa), or preferentially associated with past
      invasive events (144, 140 and 49 kDa), or related to the E. histolytica cyst
      passer condition (62 and 136 kDa), are important improvements in the use of
      serology for diagnosis and epidemiological studies in endemic areas of
      amoebiasis.

PMID- 8346991
TI  - Description of a computer model of forest onchocerciasis transmission and its
      application to field scenarios of vector control and chemotherapy.
AB  - This paper describes a computer simulation model for onchocerciasis (SIMON).
      Using epidemiological and entomological data from a specific hyperendemic village
      in the forest area of Sierra Leone, the model is used to examine the effect of
      vector and chemotherapeutic control strategies, both separately and in
      combination, as well as the risk to an uninfected population caused by immigrant,
      infected Simulium damnosum and humans. The model suggests that, in this village,
      the human population of about 420 requires an average annual input of about 200
      mature fecund, female Onchocerca volvulus per year to maintain a skin-snip
      prevalence of just under 70%. SIMON also predicts that 99% effective vector
      control would lead to eradication of all adult worms in 18 years, and that
      abandoning control before 14 years could lead to recrudescence. Chemotherapy with
      ivermectin at six-month intervals reaching 90% of eligible persons (effective
      66%) might take 29 years to achieve eradication because of continuing
      transmission, particularly in the early years, but it would probably be possible
      to abandon treatments after 18 years because the residual worm population would
      no longer be self-sustaining. Combined ivermectin and vector control, both at
      reduced levels, could be as effective as 99% vector control. Immigrant infected
      flies are likely to pose a greater threat to an uninfected human population than
      small numbers of infected persons. The model suggests that, at levels of
      infection undetectable by skin-snip, the parasite could linger in the human
      population for 30 or more years sustained by sporadic transmission.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8346992
TI  - Multivariate morphotaxonomy in the identification of adult females of the
      Simulium damnosum Theobald complex (Diptera: Simuliidae) in the Onchocerciasis
      Control Programme area of West Africa.
AB  - Adult female Simulium damnosum s.l. flies obtained in nine countries of the
      Onchocerciasis Control Programme were examined for 14 morphological characters
      with the aim of selecting specific characters to identify the main species that
      form the complex. Two approaches were used, the first involved discriminant
      function analysis of the species groups using all the characters which were both
      qualitative (the colour of the fore coxa, the antennae, the wing tuft, the
      arculus, the ninth abdominal tergite setae and the scutellar setae) and
      quantitative (the lengths of thorax, antenna, and femur, tibia and first
      basitarsus of both the fore and hind legs) in nature. The second sought colour
      characters unique to the S. damnosum subcomplex and to S. yahense, to separate
      them from the rest, and progressively applied discriminant analyses in the
      dichotomous stepwise manner to within the subcomplex level. The combination of
      pale arculus and pale antennae with pale or dark fore coxae were unique to the S.
      damnosum subcomplex, whilst those of black arculus together with wholly dark or
      mixed ninth abdominal tergite setae and scutellar setae were unique to S.
      yahense. Further discrimination was achieved between subcomplexes and species by
      entering the qualitative and quantitative characters into discriminant function
      analysis. The two schemes were both successful at separating the main species
      subcomplexes of the S. damnosum complex, with 90-100% correct classification.
      Within the subcomplex level, correct identification of sibling species was 85
      100% successful.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8346993
TI  - Check list and geographical distribution of phlebotomine sandflies in China.
AB  - A total of 42 species of sandflies, included in five genera, have been recorded
      from 31 of 32 provinces, municipalities and autonomous regions of China
      (excluding Heilongjiang Province). Five species, namely Phlebotomus alexandri, P.
      chinensis, P. longiductus, P. sichuanensis and P. smirnovi (syn. P. wui), are
      known to be vectors of human leishmaniasis. A list of these 42 phlebotomines is
      given, and their geographical distributions in China are described.

PMID- 8346994
TI  - The chemotherapy of rodent malaria. XLIX. The activities of some synthetic 1,2,4
      trioxanes against chloroquine-sensitive and chloroquine-resistant parasites. Part
      2: Structure-activity studies on cis-fused cyclopenteno-1,2,4-trioxanes
      (fenozans) against drug-sensitive and drug-resistant lines of Plasmodium berghei
      and P. yoelii ssp. NS in vivo.
AB  - The activity of 51 synthetic cis-fused cyclopenteno-1,2,4-trioxanes has been
      examined against drug-sensitive and chloroquine-resistant malaria parasites in
      vivo. Some of them display high levels of blood schizontocidal activity when
      administered orally or subcutaneously. They retain their activity against lines
      of parasites that are resistant to widely differing antimalarials such as 4
      aminoquinolines, aminoalcohols, dihydrofolate reductase inhibitors and
      artemisinin. The most potent compound of the present series is cis-(+/-)-4a,7a
      dihydro-6,7a-di(p-fluorophenyl)spiro [cyclopentane-3,3'-7H-cyclopenta-1,2,4
      trioxin], otherwise known as Fenozan-50F.

PMID- 8346995
TI  - Development of Theileria sergenti in vector ticks, Haemaphysalis longicornis,
      during blood sucking.

PMID- 8346996
TI  - Comparative evaluation of five diagnostic methods for demonstrating microsporidia
      in stool and intestinal biopsy specimens.

PMID- 8346997
TI  - Halfway technology takes another step forward.

PMID- 8346998
TI  - Electrical therapy of ventricular arrhythmias: the surgeon's approach.

PMID- 8346999
TI  - Heart-lung transplantation: consensus, experience, or both?

PMID- 8347000
TI  - Isolated single-lung perfusion with doxorubicin is pharmacokinetically superior
      to intravenous injection.
AB  - To investigate new modalities in the treatment of pulmonary metastases we
      developed a model of isolated single-lung perfusion in the rat. In this study we
      compare the pharmacokinetics of isolated lung perfusion and intravenous
      doxorubicin. In the first experiment, designed to evaluate lung tissue levels of
      doxorubicin, 35 rats were randomized into seven groups (n = 5). The first five
      groups underwent isolated lung perfusion with 72.1 +/- 6.9, 118.4 +/- 12.1, 255.2
      +/- 12.8, 384.1 +/- 46.2, and 457.6 +/- 32.5 micrograms/mL of doxorubicin,
      respectively, for 10 minutes. Groups 6 and 7 received 5 mg/kg and 7 mg/kg of
      intravenous doxorubicin, respectively. A second study was designed to measure
      heart tissue level of doxorubicin in 3 groups of 5 rats each. Two groups received
      5 or 7 mg/kg of intravenous doxorubicin and a third group underwent isolated lung
      perfusion with 255.2 +/- 12.8 micrograms/mL of doxorubicin for 10 minutes. A
      third study, designed to evaluate toxicity in vivo, had a similar design, and the
      animals were followed up for 21 days after treatment. Lung doxorubicin
      concentration after isolated lung perfusion was significantly higher than after
      intravenous doxorubicin (p < 0.01). Tissue doxorubicin concentration was 25 and
      20 times higher after isolated lung perfusion with 255.2 +/- 12.8 micrograms/mL
      than after 5 or 7 mg/kg of intravenous doxorubicin, respectively. Heart
      concentration of doxorubicin was significantly lower after isolated lung
      perfusion with 255.2 +/- 12.8 micrograms/mL of doxorubicin as compared with 5 or
      7 mg/kg of intravenous doxorubicin (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347001
TI  - Effects of triiodothyronine supplementation after myocardial ischemia.
AB  - Cardiopulmonary bypass causes a "euthyroid-sick" state characterized by low
      levels of circulating triiodothyronine. Triiodothyronine supplementation in this
      setting has been postulated to improve postischemic left ventricular function by
      increasing the availability of myocardial high-energy phosphates. These
      postulates have not been substantiated, however, using load-independent
      parameters of left ventricular function and analysis of high-energy phosphate
      metabolism. To test these hypotheses, 14 healthy pigs (30 to 40 kg) were placed
      on cardiopulmonary bypass and instrumented with left ventricular minor-axis
      ultrasonic crystals and micromanometer-tipped pressure catheters. Hearts were
      subjected to 30 minutes of global, normothermic ischemia. Triiodothyronine (0.1
      mg/kg; n = 7) or placebo (n = 7) was administered in a random, investigator
      blinded fashion at the removal of the aortic cross-clamp and after 60 minutes of
      reperfusion. Hemodynamic, metabolic, and ultrastructural data were obtained
      before ischemia and after 30, 60, 90, and 120 minutes of reperfusion. By 90
      minutes of reperfusion left ventricular contractility had returned to preischemic
      levels in hearts supplemented with triiodothyronine, despite postischemic
      myocardial adenosine triphosphate levels of 50% to 60% of baseline in both
      groups. Ultrastructurally, the sarcoplasmic reticulum and mitochondria were
      significantly better preserved in the group treated with triiodothyronine. This
      study suggests that triiodothyronine supplementation significantly enhances
      postischemic left ventricular functional recovery and that this recovery is due
      to mechanisms other than enhanced availability of myocardial high-energy
      phosphates.

PMID- 8347002
TI  - Thromboembolism in patients undergoing thoracotomy.
AB  - To determine the incidence of thromboembolism in relation to thoracotomy, 77
      patients undergoing pulmonary resection were prospectively studied up to 30 days
      postoperatively for deep venous thrombosis and pulmonary embolism. Overall, 20 of
      77 patients (26%) had thromboembolic events during their hospitalization. Four
      deep venous thromboses and 1 pulmonary embolism were detected in 5 of 77 patients
      preoperatively for an incidence of 6%. Postoperative thromboembolism was detected
      in 15 of 77 (19%): deep venous thrombosis in 11 (14%) and pulmonary embolism in 4
      (5%). No postoperative thromboembolisms occurred in the 17 patients receiving
      preoperative aspirin or ibuprofen, whereas they did occur in 25% of the remainder
      (15/60). Thromboembolism after pulmonary resection was more frequent with
      bronchogenic carcinoma than with metastatic cancer or benign disease (15/59 [25%]
      versus 0/18 [0%]; p < 0.01), adenocarcinoma compared with other types of
      carcinoma (11/25 [44%] versus 4/34 [12%]; p < 0.0004), large primary lung cancer
      (> 3 cm in diameter) compared with smaller lesions (9/19 [47%] versus 6/40 [15%];
      p < 0.0001), stage II compared with stage I (7/14 [50%] versus 7/34 [21%]; p <
      0.04), and pneumonectomy or lobectomy compared with segmentectomy and wedge
      resection (14/49 [29%] versus 1/28 [4%]; p < 0.005). Three of 4 patients with
      thromboembolism detected preoperatively had operation within the previous year.
      Postoperative pulmonary embolism was fatal in 1 of 4 (25%) and accounted for the
      one death. These results suggest patients undergoing thoracotomy for lung cancer,
      especially adenocarcinoma, should be considered for thromboembolic prophylaxis.

PMID- 8347003
TI  - Replacement of the aortic valve with cryopreserved aortic allograft.
AB  - Replacement of the aortic valve with cryopreserved aortic allograft was performed
      in 88 patients during the period from July 1985 until January 1993. Age of
      patients ranged from 15 to 75 years (mean, 44 years). The cause of aortic valve
      disease was congenital in 39 (44%), rheumatic in 9 (10%), degenerative in 14
      (16%), endocarditis in 11 (13%), and failed prosthesis in 15 (17%). The operation
      was performed by freehand allograft technique in 71 patients (81%). There were no
      perioperative deaths. Two patients died later at 4 months and 5 years after
      operation (actuarial survival = 94% at 7.5 years). Follow-up extending to 7.5
      years shows 87% of patients are in New York Heart Association functional class I.
      No thromboembolism has been detected in any patient. Infection was cured in all
      patients with endocarditis. Mild aortic valve incompetence was detected by
      diastolic murmur in 45% of patients. Only three valves have been removed at
      reoperation: one was removed early for technical reasons, and two valves were
      removed for structural degeneration at 33 and 55 months; the latter was infected.
      Actuarial freedom from reoperation for any reason was 89%; for structural
      deterioration it was 93% at 7.5 years. Aortic valve replacement with
      cryopreserved aortic allograft can be safely performed in adult patients. Medium
      term results show excellent freedom from thromboembolism and cure of bacterial
      endocarditis. Mild aortic valve incompetence is often present, but reoperation
      for progressive incompetence is unusual.

PMID- 8347004
TI  - Endothelial cell replication in an in vivo model of aortic allografts.
AB  - Previous studies of aortic valve allograft viability have used in vitro
      assessments that may not reflect in vivo properties. This study evaluated in vivo
      endothelial cell replication in experimental valved aortic grafts and examined
      the consequences of histoincompatibility and cryopreservation. Valved aortic
      conduits were heterotopically transplanted into syngeneic or allogeneic rats.
      Tritiated thymidine was administered to graft recipients and control rats. After
      72 hours, monolayers from the native aortas and the aortic portion of the grafts
      were prepared for autoradiography, with six or more silver grains per nucleus
      considered evidence of replication. Percentages of replicating cells in native
      aortas ranged from 0.3% to 2.3% (p = not significant). Percentages of replicating
      cells in the fresh isografts (12.4%) and allografts (12.2%) were not
      significantly different from each other, although each was significantly greater
      than the percentage in its native aorta (p < 0.04). Cryopreserved allografts and
      isografts displayed a few endothelial cells, none of which was replicating.
      Immunologic differences do not affect endothelial cell replication in this early
      period after fresh graft transplantation. Cryopreservation, however, results in
      the absence of replicating endothelium.

PMID- 8347005
TI  - Linear left ventricular aneurysmectomy: modern imaging studies reveal improved
      morphology and function.
AB  - It remains uncertain whether left ventricular aneurysmectomy (LVA) improves
      ventricular function and whether LVA improves or distorts left ventricular
      contour. We applied the powerful imaging techniques of multiple-gated acquisition
      scanning, intraoperative transesophageal echocardiography, and magnetic resonance
      imaging to assess functional and morphologic changes after LVA in 75 consecutive
      patients undergoing LVA by conventional resection and linear closure. Fifty-two
      patients (69%) underwent concomitant coronary artery bypass grafting, 25 (33%)
      had directed endocardial resection, and 4 (5%) had valve replacement. The
      hospital mortality rate was 6.7% (5/75). Actuarial survival rates were 86%, 80%,
      and 64% at 1 year, 2 years, and 5 years, respectively. Mean anginal class
      improved from 3.49 to 1.24 (p < 0.0001). Mean congestive heart failure class
      improved from 3.04 to 1.70 (p < 0.0001). By multiple-gated acquisition scan (48
      patients), mean ejection fraction improved from 0.25 preoperatively to 0.33
      postoperatively (p < 0.0001). Intraoperative transesophageal echocardiography (28
      patients) revealed no cases of distortion and demonstrated normalization of left
      ventricular contour in 69% of patients. Mean wall motion score improved from 16.4
      to 18.8 (p < 0.001). Mean cross-sectional area of the left ventricle decreased
      from 18.7 cm2 to 12.8 cm2 (p < 0.006). Magnetic resonance imaging confirmed
      normalization of left ventricular contour without distortion. We conclude that
      linear LVA is clinically effective and objectively improves left ventricular
      morphology and function. On this basis, we have extended application of LVA to
      include patients with at least moderate-sized aneurysms undergoing coronary
      artery bypass grafting, despite the absence of traditional indications of
      arrhythmia, embolism, and frank congestive heart failure.

PMID- 8347006
TI  - Pulmonary arteriovenous malformations: therapeutic options.
AB  - We have treated 21 patients (13 female, 8 male) with pulmonary arteriovenous
      malformations (PAVMs). Mean age at diagnosis was 37.5 years (range, 15 to 72
      years). Presenting symptoms included dyspnea on exertion (67%), hereditary
      hemorrhagic telangiectasia (57%), and major neurologic events (33%). In our early
      experience, 8 patients had no specific treatment; their case histories illustrate
      the major neurologic complications of untreated PAVMs. Nine patients (8
      primarily, 1 after recurrence) underwent conservative surgical excision; 4 had
      lobectomy, and 5 had segmentectomy or subsegmental excision. One patient
      underwent staged bilateral thoracotomies for multiple bilateral lesions. The
      arterial oxygen tension was found to increase after excision of large or solitary
      PAVMs. All surgically treated patients were relieved of dyspnea, and none had
      postoperative recurrence of PAVMs or neurologic complications related to PAVMs.
      Five patients underwent balloon occlusion of PAVMs. Two patients chose to have
      solitary PAVMs occluded rather than undergo thoracotomy. One underwent surgical
      excision 5 years later, and the other required repeat balloon embolization 4
      years later when recanalization of the PAVMs was documented. Three patients with
      numerous PAVMs received palliation with multiple balloon embolizations. The high
      incidence of associated major neurologic complications mandates aggressive
      treatment of PAVMs whenever feasible. Conservative surgical resection remains the
      treatment of choice. Balloon embolization offers an alternative therapy for
      patients who are poor surgical risks or those whose lesions are too numerous to
      resect.

PMID- 8347007
TI  - Reoperations after operation on the thoracic aorta: etiology, surgical
      techniques, and prevention.
AB  - Recurrent aortic aneurysms, persistent or new dissection, new onset of valvular
      and coronary artery disease, graft infection, and prosthetic endocarditis are not
      rare after thoracic aortic operations; they can be difficult to diagnose and
      represent a formidable surgical challenge. Between 1977 and 1991, 876 operations
      were performed on the thoracic aorta in our institution: 340 in dissections, 299
      in true aneurysms, 150 for aortic remodeling and external wall support during
      aortic valve replacement, and 87 for miscellaneous causes. During the same
      period, there were 193 additional reoperations. Vascular reoperations on
      abdominal aorta and peripheral arteries accounted for 73 cases and are not
      further discussed in this study. The reasons for reoperation (n = 130) in 120
      patients were: failure of biologic valves (n = 23); aneurysm recurrence in a
      proximal or distal aortic segment (n = 21); pseudoaneurysm formation at suture
      lines (n = 13); new dissection or dilatation involving ascending aorta (n = 11),
      aortic arch (n = 13), and descending aorta (n = 10); aneurysm after aortic
      remodeling (n = 13); new onset of valvular disease (n = 5); and new onset of
      coronary disease (n = 5). Infected aortic graft and prosthetic endocarditis
      accounted for 10 reoperations, and a planned two-staged procedure was performed
      in 6 patients. Omitting the failed biologic valves, reoperations were performed
      on the aortic segment previously operated on in 69.3% of the cases and on other
      thoracic segments in 30.7%. Overall hospital mortality rate after reoperation was
      5.8%. A significant decrease in operative mortality was observed in the most
      recent period (3.0% between 1989 and 1991). Reoperations are technically
      demanding, and some of them are preventable; therefore (1) graft inclusion
      technique should be abandoned in ascending aortic operation due to formation of
      false aneurysms; (2) in patients with Marfan syndrome, complete repair of the
      diseased aorta should be attempted during the initial operation; (3) aortic arch
      dissection should be repaired definitively during the first operation in low-risk
      patients; (4) biological valves should be avoided in aneurysm operations; and (5)
      homograft replacement is the treatment of choice in prosthetic endocarditis or in
      infected composite graft after an aortic valve or ascending aortic operation.

PMID- 8347008
TI  - Brain protection via cerebral retrograde perfusion during aortic arch aneurysm
      repair.
AB  - Eleven patients underwent resection and graft replacement of ascending and aortic
      arch aneurysms. Retrograde cerebral perfusion was used during the procedures to
      minimize cerebral ischemia. Retrograde cerebral perfusion (15 degrees to 24
      degrees C) was administered through the superior vena cava. The mean cerebral
      ischemic time was .35 minutes (range, 11 to 71 minutes). Throughout retrograde
      cerebral perfusion, blood samples were drawn from the innominate and left carotid
      arteries at 1, 5, and every 10 minutes thereafter for analysis of arterial oxygen
      content, total creatine kinase level, and creatine kinase BB fraction. All
      patients survived. All except 1 awoke neurologically intact. In this patient,
      electroencephalogram and transcranial Doppler studies conducted before
      circulatory arrest were consistent with embolic phenomena. There was no
      significant difference between the current group's intraoperative
      electroencephalograms and those of a similar historical group. Postoperative
      complications included transient renal failure, myasthenia gravis, cholecystitis,
      premature atrial contractions, atrial fibrillation, and vocal cord paralysis. The
      creatine kinase BB fraction range was 1.8 to 13.4. The increase of total creatine
      kinase level was due to MM fraction. Retrograde cerebral perfusion during
      circulatory arrest is a valuable adjunct for protecting the brain. The creatine
      kinase BB band was not a good marker to detect brain injury. With continued use
      of this technique and accumulation of a larger series, we may better define the
      role of retrograde cerebral perfusion in brain protection.

PMID- 8347009
TI  - Failure of the Hemashield extension in right ventricle-to-pulmonary artery
      conduits.
AB  - Between 1989 and 1991, 17 children underwent 18 right ventricle-to-pulmonary
      artery conduit placement operations using a composite of an aortic or pulmonary
      valved homograft and a Hemashield extension to the ventricle. Hemashield is a
      collagen-coated knitted Dacron graft with excellent compliance and hemostatic
      properties. Diagnoses included tetralogy of Fallot with pulmonary atresia (7),
      truncus arteriosus (6), and complex transposition of the great arteries (4). Mean
      age at conduit placement was 4.9 +/- 4.2 years, and all patients survived. At a
      mean follow-up of 14 +/- 4 months, postoperative Doppler echocardiographic
      gradients between the ventricle and pulmonary artery ranged from less than 20 to
      60 mm Hg. At cardiac catheterization 13 +/- 3 months postoperatively (6
      patients), the systolic pressure gradient across the conduits ranged from 14 to
      90 mm Hg (mean gradient, 59 +/- 29 mm Hg). Conduit obstruction, when present, was
      demonstrated angiographically to be in the Hemashield portion and led to early
      conduit replacement six times in 5 patients (33% of operations) within 10 to 18
      months (mean time, 14 months) after insertion of the original conduit. Pathologic
      examination of the explanted conduits revealed the obstruction to be a thick
      neointimal peel that was impossible to separate from the Hemashield graft.
      Failure of the Hemashield as an extension for ventricle-to-pulmonary artery
      conduits secondary to accelerated neointimal formation has led us to abandon its
      use in clinical practice.

PMID- 8347010
TI  - Preliminary results with neoadjuvant therapy and resection for esophageal
      carcinoma.
AB  - Between December 1988 and August 1992, 68 patients with adenocarcinoma (n = 39)
      and squamous carcinoma (n = 29) of the esophagus were entered prospectively in a
      treatment protocol to receive two cycles of cisplatin, 5-fluorouracil, etoposide,
      leucovorin, and 3,000 cGy of radiation to the involved esophagus and adjacent
      mediastinum, followed by resection. There were four deaths during chemotherapy,
      and 7 patients had a decline in condition or were denied operation. Fifty-six
      patients have come to operation, and 1 awaits resection. Twenty-two patients had
      transhiatal esophagectomy and 29 patients had esophagogastrostomy with a combined
      abdominal and right thoracic approach. Five patients did not undergo resection at
      operation. There was one hospital death (2%). A complete response to preoperative
      therapy was seen in 12 patients (21%): 5 of 20 with squamous cancer (25%) and 7
      of 36 with adenocarcinoma (19%). Average follow-up is 19 months. Median survival
      in these patients after entrance in the protocol is 24 months. Actuarial survival
      at 12, 18, and 24 months is 72% (confidence limits, 66% and 78%), 53% (confidence
      limits, 46% and 60%), and 51% (confidence limits, 44% and 58%). Significantly
      better survival was associated with adenocarcinoma (p = 0.041). There is no
      survival advantage based on complete response to preoperative therapy. This
      neoadjuvant regimen is effective in patients with squamous carcinoma and
      adenocarcinoma. These preliminary results demonstrate an improved median and
      actuarial survival compared with historical controls in 137 patients operated on
      between 1966 and 1985 at our institution.

PMID- 8347011
TI  - Aortic coarctation with hypoplastic arch in neonates: a spectrum of anatomic
      lesions requiring different surgical options.
AB  - Hypoplasia of the transverse aortic arch is frequently associated with isthmic
      coarctation in many patients referred for operation in early infancy, and the
      surgical technique should be adjusted to suit each type of anatomic lesion.
      Referring to the anatomic description of hypoplastic aortic arch reported by
      Moulaert and associates, between January 1988 and July 1991 we operated on 32
      consecutive infants (< or = 3 months old) using a surgical approach based on the
      echocardiographic and angiographic findings; 20 patients (62%) were younger than
      2 weeks of age and 20 patients (62%) had associated intracardiac lesions.
      According to the location, extension, and size of the hypoplasia of the aortic
      arch, we had three groups of patients: in group 1 (21 patients) we performed
      resection and extended end-to-end anastomosis, as previously described in 1985;
      in group 2 (5 patients) we performed resection, posterior end-to-end anastomosis,
      and anterior subclavian flap enlargement; and in group 3 (6 patients) we
      performed direct side-to-end anastomosis between ascending and descending aorta
      through a median sternotomy. One patient died during the postoperative course in
      group 3. With a mean follow-up time of 26 months we had 4 cases (13%) of
      "residual" or "recurrent" coarctation in group 1, successfully repaired at 2
      months of age by an anterior approach in 2 patients and by percutaneous
      angioplasty in the others. In conclusion, hypoplastic aortic arch in neonates
      represents a common difficulty, and optimal reconstruction of the entire aortic
      arch is mandatory to reduce operative mortality and incidence of recoarctation,
      especially when there are complex associated intracardiac lesions or left
      ventricular dysfunction.

PMID- 8347012
TI  - Valve morphology in complete atrioventricular septal defect: variability relevant
      to operation.
AB  - The remodeling of the atrioventricular valves in patients with complete
      atrioventricular septal defects is the crucial part of surgical repair.
      Variability in valve morphology is an important factor. This study evaluates the
      variability in morphology of the anterior and posterior leaflets in 30 heart
      specimens. All hearts had an anterior bridging leaflet: Rastelli type A in 12,
      type B in 2, and type C in 16. The posterior leaflet revealed four morphologic
      patterns: a right- and left-sided posterior leaflet, both inserting directly onto
      the crest of the ventricular septum (5 hearts); a common posterior leaflet
      attached to the septal crest by a membrane (2 hearts); a common posterior leaflet
      attached to the septal crest by multiple chordae (13 hearts); and a virtually
      free-floating posterior leaflet (11 hearts). The categorization is surgically
      relevant in making a distinction between hearts with and without an
      interventricular communication underneath the posterior leaflet. Surgically
      relevant variations occurred also in arrangement and positioning of chordae
      originating from the right septal side. There was no relationship between the
      Rastelli classification of the anterior leaflet and that of the posterior
      leaflet. The variability in morphology of the posterior leaflet and its
      attachments to the ventricular septum appear equally crucial for successful
      repair as that of the anterior leaflet.

PMID- 8347013
TI  - Warm blood cardioplegia: ultrastructural and hemodynamic study.
AB  - Forty patients with coronary artery disease were included in this study. Half of
      them received cold crystalloid and cold blood cardioplegia (group 1), and half
      received normothermic blood cardioplegia (group 2). In group 1, left ventricular
      stroke work index was 24 +/- 3 g.m/m2 1 hour after the operation, 29 +/- 8 g.m/m2
      12 hours after the operation, and 33 +/- 6 g.m/m2 24 hours after the operation.
      In group 2, left ventricular stroke work index was 37 +/- 4 g.m/m2 1 hour after
      the operation, 37 +/- 4 g.m/m2 12 hours after the operation, and 44 +/- 7 g.m/m2
      24 hours after the operation. Myocardial oxygen extraction 20 minutes after the
      termination of cardiopulmonary bypass was 0.28 +/- 0.03 in group 1 and 0.44 +/-
      0.08 in group 2. Myocardial lactate extraction at the same time was -0.09 +/-
      0.02 in patients receiving cold blood cardioplegia and 0.17 +/- 0.07 in patients
      receiving normothermic blood cardioplegia. Electron microscopic study revealed no
      calcium accumulation in the mitochondria in group 2 patients, whereas calcium
      accumulation was present in the other group.

PMID- 8347014
TI  - Subxiphoid approach for insertion of ICDs after previous median sternotomy.
AB  - To avoid the risks both of repeat median sternotomy and of thoracotomy, the
      modified subxiphoid approach was adopted for insertion of implantable
      cardioverter-defibrillators in 10 patients who had previously undergone cardiac
      operations via median sternotomy. Effective implantable cardioverter
      defibrillator systems were implanted in all patients. There were no operative
      deaths and no hemorrhagic or respiratory complications. One patient underwent
      repositioning of a dislodged superior vena caval electrode, and an infected
      generator pocket developed in 1 patient. Early extubation was routine. Two
      patients were observed in the coronary care unit for the first postoperative
      night. Postoperative pain was controlled with oral analgesic agents. The
      subxiphoid approach is safe and effective, and it carries a substantially lower
      risk of complications than other techniques, even in this high-risk group of
      patients. By minimizing the need for admission to the intensive care unit,
      invasive monitoring, and prolonged ventilatory support, by reducing surgical
      complications, and by shortening the hospital stay, the subxiphoid approach saved
      an average of $3,295 per patient.

PMID- 8347015
TI  - Functional results of left ventricular reconstruction.
AB  - From 1988 to 1991, 48 patients with left ventricular aneurysm underwent
      endoventriculoplasty with a circular patch to preserve the left ventricular
      geometry. Of these patients, 98% underwent concomitant myocardial
      revascularization, and in 77% the left anterior descending coronary artery was
      bypassed. The overall operative mortality rate was 4.1%. The 3-year survival rate
      was 91%, and 67% of patients had no further cardiac complications. Cardiac
      performance was assessed postoperatively by ventriculography in 28 patients. The
      global ejection fraction rose from 0.39 +/- 0.11 to 0.57 +/- 0.14 (p < 0.001);
      the left ventricular end-diastolic pressure fell from 20 +/- 7.5 mm Hg to 15 +/-
      7.8 mm Hg (p < 0.05). Computerized analysis of regional contraction revealed a
      significant improvement in the anterolateral and apical segments and in the
      transitional zone. In 61% of the patients, a normal contraction pattern resumed,
      whereas in the remaining 39%, a residual deformity of the left ventricular
      chamber was present. The best results were obtained in patients with a preserved
      proximal septum at echocardiography.

PMID- 8347016
TI  - Expandable prosthesis in right postpneumonectomy syndrome in childhood and
      adolescence.
AB  - Right pneumonectomy can lead to severe respiratory impairment due to stenosis of
      the left main bronchus. This syndrome is usually treated by inserting a fixed
      volume prosthesis but, in children, expandable prostheses have the advantage of
      being adaptable to growth and permit progressive recentering of the mediastinum.
      We report 3 such cases, with the results of pulmonary function tests. The
      patients were aged 11, 17, and 22 years at the time of implantation and had
      undergone pneumonectomy during childhood for either bronchiectasis or complete
      pulmonary sequestration. All 3 patients are doing well, with a follow-up of 1 to
      3 1/2 years. Pulmonary function tests have shown a substantial improvement in the
      obstructive syndrome in 2 patients whereas, in the third patient, in whom the
      contralateral lung was not perfectly healthy, the functional improvement was only
      moderate.

PMID- 8347017
TI  - Phrenic nerve damage via a right thoracotomy in older children with secundum ASD.
AB  - Phrenic nerve damage (PND) in children after cardiac operations is now recognized
      as being more frequent than previously thought. In a prospective study on 400
      children, we previously demonstrated electrophysiologic evidence of postoperative
      PND in approximately 16% of patients, with one third of cases occurring in
      children under 18 months. In the past 18 months, 30 children have had atrial
      septal defect (ASD) repairs as their only operative procedure. Fourteen children
      had ASD repairs via a midline incision, and 16 ASD repairs were via a right
      thoracotomy. No PND (assessed by phrenic nerve latency) was found after a midline
      approach. In the right thoracotomy group, 5 children had evidence of PND (31%; p
      = 0.05). Four of these 5 patients were female and more than 14 years of age. The
      incidence of damage in this pubescent group was 80% (p < 0.05). In the older age
      group the duration of ventilation was not prolonged, but affected patients had
      symptoms of fatigue and breathlessness postoperatively. These data suggest a
      strong association between right thoracotomies for ASD repairs and PND,
      especially in the female pubescent group when a low submammary skin incision
      (seventh to eighth space) is used with a fifth to sixth space entry into the
      thoracic cavity. In conclusion, the right thoracotomy approach for ASD repair
      appears to be a significant risk factor for PND in older children.

PMID- 8347018
TI  - Use of intraoperative mapping to optimize surgical ablation of atrial flutter.
AB  - The purpose of this study was to develop a surgical treatment for atrial flutter
      using intraoperative activation sequence mapping to minimize the surgical
      procedure necessary to ablate the flutter. A canine model (n = 10) of left atrial
      enlargement was developed by creating a shunt from the left subclavian artery to
      the left superior pulmonary vein. Sustained atrial flutter was easily induced in
      this model. The flutter consisted of a single reentrant circuit that rotated
      around one or two anatomic obstacles linked by a region of functional block.
      Epicardial templates, consisting of 252 bipolar electrodes, were used to record
      activation time maps. After localization of the reentrant circuit, surgical
      incisions were placed to interrupt the pathways. In all 10 animals, flutter could
      be induced and intraoperative mapping localized the reentrant circuit. Seven
      circuits were in the right atrium and three were in the left atrium. The
      operation ablated all of the preoperative circuits. However, in 5 of the animals,
      flutter originating from a new circuit could be induced. Activation sequence
      mapping before and after operation demonstrates that there are multiple potential
      reentrant pathways in this canine model of atrial flutter. Therefore, all
      potential pathways must be surgically interrupted to prevent inducibility of
      atrial flutter.

PMID- 8347019
TI  - Determinants of heart-lung transplantation outcomes: results of a consensus
      survey.
AB  - Substantial progress has been made in clinical heart-lung transplantation.
      Although outcomes vary across centers, 1-year patient survival is now 59%. This
      study was an attempt to assess consensus among transplant program directors
      regarding the major determinants of patient outcome. In the National Cooperative
      Transplantation Study we evaluated consensus through a survey of all heart-lung
      transplant programs active in 1988. Of the eligible programs, 23 (85%) returned
      completed surveys. Data on the medical and surgical determinants of outcome were
      analyzed. There was considerable consensus among program directors as to the
      importance of several factors. The three most critical predictors of favorable
      outcomes were periodic pulmonary function tests to detect rejection (85.7%),
      avoidance of use of prednisone during the first 14 days after transplantation
      (76.2%), and annual left and right heart catheterization with coronary
      arteriography (76.2%). Several approaches were considered undesirable or
      unnecessary. These included electrocardiogram as standard rejection monitoring
      technique (71.4%), cytoimmunological monitoring as standard rejection monitoring
      technique (66.7%), and routine steroid discontinuation after transplantation
      (66.7%). On various other treatment approaches there was little evidence of
      consensus. These included prophylaxis with acyclovir and severe bronchiolitis as
      a criterion for retransplantation. Although controversial, consensus conferences
      are one means by which to evaluate technological innovations. Based on their
      results, practice guidelines can be developed to better inform third-party payers
      on issues related to transplantation.

PMID- 8347020
TI  - Postcardiotomy shock: clinical evaluation of the BVS 5000 Biventricular Support
      System.
AB  - This prospective trial evaluated the safety and efficacy of a new pulsatile,
      temporary ventricular assist device, the BVS 5000. Patients were eligible for
      treatment if they were hemodynamically unstable despite maximal pharmacologic and
      intraaortic balloon pump therapy, were free of concomitant complications, and
      were less than 6 hours from the first attempt to separate from cardiopulmonary
      bypass. Fifty-five postcardiotomy patients were enrolled; 31 met all selection
      criteria and the remainder failed to meet criteria (n = 15) or were not
      successfully supported (n = 9). The BVS 5000 effectively restored hemodynamics:
      Mean arterial pressure increased (77.1 +/- 8.0 mm Hg on-support versus 50.1 +/-
      15.3 mm Hg presupport; p = 0.0001). Cardiac index increased (2.3 +/- 0.3 L.min
      1.m-2 on-support versus 1.6 +/- 0.6 L.min-1.m-2 presupport; p = 0.0013). Left
      ventricular filling pressure decreased (11.9 +/- 4.5 mm Hg on-support versus 23.8
      +/- 8.7 mm Hg presupport; p = 0.0030). The most frequent complication was
      bleeding in 42 patients (76%). Of the patients meeting all criteria, 17 (55%)
      were weaned from support and 9 (29%) were discharged. Survival was significantly
      influenced by presupport cardiac arrest events. Survival among patients not
      experiencing arrest was 47%. Eight patients are long-term survivors and were
      asymptomatic in New York Heart Association class I or II at 1-year follow-up. The
      BVS 5000 restored hemodynamics, permitted myocardial recovery, and improved
      survival in a group of patients who would have otherwise died.

PMID- 8347021
TI  - Hemorrhage due to inflammatory erosion of the pulmonary artery stump in
      postpneumonectomy bronchopleural fistula.
AB  - Bleeding from the pulmonary artery in patients with a bronchopleural fistula
      after pneumonectomy is a rare but devastating complication. The incidence is
      unknown, but our data suggest an incidence of 4% in all postpneumonectomy
      bronchopleural fistulas. Two case histories are presented in which the anterior
      transpericardial approach was used to stop the pulmonary bleeding by direct
      suturing. Nevertheless, 1 patient died 5 days later because of irreversible brain
      damage; the other patient recovered well after a protracted convalescence.

PMID- 8347022
TI  - Transesophageal Doppler echocardiographic monitoring for malperfusion during
      aortic dissection repair.

PMID- 8347023
TI  - Mechanical assist device for right ventricular failure after acute aortic
      dissection.
AB  - Acute myocardial ischemia and infarction due to retrograde coronary artery
      dissection are uncommon complications after ascending aortic dissection. A case
      of acute aortic dissection with massive right ventricular failure successfully
      treated by replacement of the ascending aorta and postoperative right ventricular
      mechanical support is presented. Although mechanical assistance may be hazardous
      after ascending aortic replacement, because of the need of anticoagulation, it
      represents a valid therapeutic option when severe right ventricular failure due
      to acute myocardial infarction ensues.

PMID- 8347024
TI  - Combination gastric seromuscular patch and omental pedicle flap for bronchial
      fistula.
AB  - We report the successful closure of a recurrent bronchial fistula using a
      combination gastric seromuscular patch and omental pedicle flap. This new method
      provided an immediate airtight closure of the bronchial fistula. This technique
      appears superior to closure by omentum alone.

PMID- 8347025
TI  - Intraaortic balloon entrapment.
AB  - A review of intraaortic balloon pump use at the University of Miami/Jackson
      Memorial Medical Center over the past 21 years identified 2 cases where a balloon
      was found to be entrapped. The balloon catheters had been in place for
      approximately 10 days when this complication occurred. The retained balloons were
      torn, filled with clotted blood, and impacted in the vasculature. In our first
      case, forceful removal of the intraaortic balloon was complicated by
      unintentional extraction of the external iliac and common femoral arteries. In
      the second case, clot within the balloon was dissolved with tissue plasminogen
      activator injected into the drive lumen of the catheter before removal. The
      prevention and management of this rare but serious complication of intraaortic
      balloon pumping is reviewed.

PMID- 8347026
TI  - Bullet embolization to a coronary artery.
AB  - A rare case of coronary artery embolization is presented. A 48-year-old man
      arrived with multiple pellet wounds, severe chest pain, and an inferior
      myocardial infarction. Chest roentgenograms showed one of the pellets overlying
      the cardiac shadow, and coronary arteriography revealed complete occlusion of the
      posterior descending branch of the right coronary artery with a radiopaque
      foreign body, which corresponded exactly to the pellet first seen. Intravascular
      arterial embolization of small caliber bullets has been reported in the abdomen,
      lower extremities, and the carotid territory. Here we report such an event
      occurring in the coronary circulation.

PMID- 8347027
TI  - Management of giant coronary artery aneurysm with fistulization into the right
      atrium.
AB  - A giant right coronary artery aneurysm communicating with the right atrium is
      reported. Its diagnosis using echocardiography, computed tomography of the chest,
      and angiography is illustrated. The operative management of this rare cardiac
      pathology is described. The role of operation in such a large aneurysm is
      emphasized.

PMID- 8347028
TI  - Metastatic malignant schwannoma in the heart.
AB  - A rare case of metastatic malignant schwannoma is described. The secondary tumor
      in the right lung grew along the pulmonary vein and filled almost the whole of
      left atrium. Operation was later performed, and a large tumor extension from the
      left atrium was removed.

PMID- 8347029
TI  - Esophageal schwannoma.
AB  - A 56-year-old woman was seen with an abnormal shadow on chest radiogram.
      Evaluation revealed an esophageal tumor, which was resected. The tumor was found
      in the muscular layers of the esophagus; esophageal schwannoma was diagnosed by
      light microscopic and immunohistochemical studies. There was no relationship
      between the tumor and vagus nerve. The tumor demonstrated partially invasive
      growth, and mitotic figures were occasionally observed.

PMID- 8347031
TI  - Successful left ventricular assist after a first and second heart operation.
AB  - Progressive coronary artery disease and recurrent symptoms developed in a 57-year
      old man. Nine years earlier he had undergone coronary artery bypass grafting and
      was supported with a centrifugal left ventricular assist device. He underwent
      redo coronary artery bypass and again required left ventricular assistance. The
      patient recovered and was discharged on the 15th postoperative day. He is doing
      well 1 year after operation and has good left ventricular function.

PMID- 8347030
TI  - Management of an innominate artery aneurysm during an open heart operation.
AB  - A 76-year-old woman was found to have a 4 x 2.5-cm saccular aneurysm at the
      origin of the innominate artery at the time of a reoperative open heart
      operation. The operative procedure was modified to include repair of the aneurysm
      with a Dacron patch. During the period of innominate artery occlusion, the
      patient was cooled to 25 degrees C and the mean arterial pressure was maintained
      at 90 mm Hg to maximize cerebral protection.

PMID- 8347032
TI  - Use of cardioplegia delivery equipment for rapid warm volume replacement after
      cardiopulmonary bypass.
AB  - Often, after cardiopulmonary bypass involving aortic dissection, aortic root
      replacements, or valve conduits, rapid volume replacement with blood products is
      essential to obtain hemostasis and patient survival. We describe a method of
      using cardiopulmonary bypass equipment for rapid warm volume replacement and
      infusion of remaining residual volume in the cardiopulmonary bypass circuit after
      a cardiac operation.

PMID- 8347034
TI  - Saphenous vein preparation for coronary artery bypass grafting using a
      cardioplegia delivery set.
AB  - Many techniques of saphenous vein preparation for coronary artery bypass grafting
      and their relation to endothelial preservation and graft patency have been
      published. We describe a method for final preparation of saphenous vein segments
      that uses the patient's undiluted heparinized blood infused at physiologic
      arterial pressure with a standard cardioplegia delivery apparatus. This method
      provides excellent demonstration of vein caliber and allows for quick
      identification and control of any previously undetected side branches or leaks.
      No additional equipment or instruments are required, and preparation can be
      performed before or after the institution of cardiopulmonary bypass.

PMID- 8347033
TI  - Technical modification for anastomosis of low-lying coronary ostia in Bentall
      procedure.
AB  - Bentall procedure is not advisable when the origins of the coronary artery ostia
      cannot reach the composite valve graft at a satisfactory level for direct
      reimplantation. The other alternatives to coronary artery ostia reimplantation
      have some disadvantages. A technical modification of the Bentall procedure,
      successfully used in 3 patients and allowing direct coronary reimplantation
      without any tension on the suture line, is described.

PMID- 8347035
TI  - Intraoperative procurement of autologous fibrin glue.
AB  - A method of intraoperative procurement of autologous fibrin glue is described.
      The relative efficacy of our autologous preparation is compared with that of
      fibrin glue made with homologous cryoprecipitate. Experimentally, the fibrinogen
      content and the strength are less than those found in cryoprecipitate and appear
      related to the fibrinogen content of the autologous plasma used as substrate in
      the fibrin glue reaction. Clinically, no significant differences are noted in the
      performance of autologous fibrin glue. We believe the absence of the risk of
      blood-borne infection with the autologous product is a major advantage.

PMID- 8347036
TI  - Cardiac hemangiomas.
AB  - Cardiac hemangiomas are rare benign vascular tumors of the heart. To date, 23
      cases have been reported. Symptoms are usually due to compression of cardiac
      structures or obstruction of outflow tracts. Echocardiography usually directs the
      diagnosis toward a cardiac mass. Enhanced-contrast computed tomographic scan or
      magnetic resonance imaging establishes the diagnosis of hypervascularized cardiac
      tumor. Coronary arteriography establishes the diagnosis by showing the
      characteristic tumor blush. Surgical resection is done using cardiopulmonary
      bypass. Long-term outcome is favorable.

PMID- 8347037
TI  - Preoperative glucose-insulin-K+ therapy for cardiac protection: what can be
      recommended?

PMID- 8347038
TI  - How to prevent pleural opening in harvesting the internal mammary arteries.

PMID- 8347039
TI  - Hypothermic thoracoabdominal aneurysm operation.

PMID- 8347040
TI  - Sense, antisense, nonsense, and missense.

PMID- 8347041
TI  - Release of vasoactive substances during cardiopulmonary bypass.

PMID- 8347042
TI  - Device-supported myocardial revascularization.

PMID- 8347043
TI  - Bronchial polyp secondary to foreign body.

PMID- 8347044
TI  - Septal myocardial infarction: a complication of coronary artery stay sutures.

PMID- 8347045
TI  - Adverse hemodynamic effects of pericardial closure soon after an open heart
      operation.

PMID- 8347046
TI  - Simple way to improve right ventricular flow distribution during continuous
      retrograde cardioplegia.

PMID- 8347047
TI  - [The 50th anniversary of the Secretaria de Salubridad y Asistencia Pblica, today
      the Secretaria de Salud (1943-1993). The year 1943 and the transformation of
      Mexican medicine].

PMID- 8347048
TI  - [Coronary angioplasty in 40 patients with 518 stenoses: complications and
      surgical support].
AB  - We analyze the outcome of 400 patients (pts) with coronary angioplasty in 518
      stenosis (314 men, age 29 to 80). The clinical syndromes were unstable angina in
      252 pts, acute myocardial infarction (MI) in 26, angina or residual ischemia
      after thrombolysis for MI in 34 and 18 pts with post-MI angina. Success was
      achieved in 478 of 518 segments (92%). Mean stenosis was reduced from 88 to 15%.
      Revascularization was complete in 92% of pts. Primary success was 74% in total
      occlusions. We had 25 major complications (6%): 8 emergency bypass surgery (2%),
      MI in 12 pts (3%) and 5 deaths (1%). The procedures were performed without
      surgical standby in 220 pts: in 68 it was an emergency and in 152 it was
      considered a low risk procedure. Major complications in emergency cases were 3 MI
      (4%) and 2 deaths (3%). In the low risk procedures there were no deaths, 3 MI
      (2%) and 1 aortic dissection. We conclude that in well selected patients coronary
      angioplasty gives a high success rate with very few complications. Furthermore,
      it is possible to identify a very low risk subset of patients in whom the
      procedure can be performed without having a surgical standby.

PMID- 8347049
TI  - [The treatment of severe mitral stenosis by percutaneous transvenous
      commissurotomy].
AB  - In 110 adult selected patients, 87.1% female (average age 38.2 years, range 16
      72) with symptomatic, severe mitral stenosis eligible for surgery, we performed
      balloon catheter transvenous mitral commissurotomy (BCTMC) as alternative
      treatment. Inoue's catheter was utilized in 80 cases (72.7%), and the double
      balloon technique in 30 (27.3%). The procedure was successful in 102 patients
      (92.7%, 2nd attempt in 5 cases), with optimal results in 96 (87.3%); and it was
      unsuccessful in one patient for a technical difficulty. Complications occurred in
      3 cases due to perforation of a cardiac chamber (2.7%); and 4/106 patients
      developed severe mitral insufficiency (3.8%). The mitral valve area increased
      from 1.09 +/- 0.27 to 2.6 +/- 0.87 cm2 (p < 0.0001); the diastolic mitral
      gradient decreased from 18.9 +/- 5.9 to 3.6 +/- 2.8 mmHg (p < 0.0001); similar
      reduction was obtained in mean left atrial pressure from 26.2 +/- 6.5 to 12.5 +/-
      4.2 mmHg (p < 0.0001), and mean pulmonary artery pressure from 38 +/- 17 to 26.2
      +/- 10.4 mmHg (p < 0.005). New mitral insufficiency appeared or increased in more
      of one grade in 12/106 patients (11.3%), and it was not detectable in 86/106
      patients. During long-term follow-up (average 10.4 months, range 5 to 24), all
      patients (100 cases) improved their functional class (83.1% asymptomatic), and
      maintained their 2D echocardiographic mitral valve area. In conclusion BCMTC is
      the treatment of choice for selected cases of acquired symptomatic mitral
      stenosis, with immediate and long term results comparable to surgical
      commissurotomy.

PMID- 8347050
TI  - [The absence of characteristics lesions in the microcirculation of non-insulin
      dependent diabetic patients].
AB  - Diabetic cardiomyopathy apparently has an important role in the increased
      cardiovascular morbi-mortality of diabetic patients and its cause is likely to be
      secondary to small vessel disease. We undertook the present study to compare
      small and large vessel disease in hearts of patients who died with coronary
      disease, and determine how diabetes and/or hypertension correlates with these
      findings. The paraffin blocks of 52 hearts were used in this study. Cases were
      selected if they died from coronary artery disease and excluded if they had a
      previous angioplasty, revascularization surgery, congenital, rheumatic or other
      causes of heart disease. They were divided in two groups; diabetics and non
      diabetics and each group was subdivided in hypertensives an non hypertensives.
      They were matched by age and sex. DM duration was 11 +/- 6 years and known
      hypertension of 10 +/- 4 years with no significant differences between both
      groups. The results were recorded without knowledge of patients clinical
      findings. Atherosclerotic heart disease was more advanced in DM patients, with an
      increased prevalence of three vessels disease, and more extensive myocardial
      infarctions. Diabetic subjects had increased (non significant) basal membrane
      thickening of the capillaries. We could not find differences in parenchymal
      hypertrophy, interstitial edema, proliferative endothelial lesions and luminal
      width in middle and large size vessels. Hypertensive patients had increased
      perivascular fibrosis (NS). Our results suggest that advanced atherosclerotic
      heart disease is more common in diabetic patients and diabetic cardiomyopathy, if
      present, seems not to related to a particular structural microvascular disease.

PMID- 8347051
TI  - [Sudden death and the congenital long QT syndrome (Romano, Ward and Barlow)].
AB  - We present four cases, a mother and three sons with Romano, Ward and Barlow
      syndrome (long QT without deaf-muteness) controlled over the past 20 years. The
      mother died suddenly at the age of 42, as did two sons at 24 and 17 years. A
      retrospective study was conducted comprising the three generations prior to the
      mother, and a high rate of sudden death was found. Possible causes were analyzed
      with a view to implementing proper prophylaxis treatment for ventricular
      tachycardia or fibrillation as causes for syncopal patterns and sudden death.
      Therefore, digital, left stellectomy and betablocker effects were analyzed. The
      anatomical study of the patient who died at 17 years is presented, and finally
      the new perspectives of the syndrome in terms of possible recognition of the
      responsible gene, as well as the convenience of implanting new defibrillating
      cardioverters, were evaluated.

PMID- 8347052
TI  - [High doses and the rapid infusion of streptokinase for the treatment of massive
      pulmonary thromboembolism].
AB  - We report the case of a 65 year old woman with no prior cardiac or pulmonary
      disease, who suffered pulmonary embolism (PE); diagnosis was made on the basis of
      the existence of risk factors, clinical, radiographic and electrocardiographic
      features, and a lung scan with perfusion defects and normal ventilation. PE was
      considered massive because the patient developed acute respiratory failure that
      required tracheal intubation and mechanical ventilation as well as obstructive
      shock, electrocardiographic and echocardiographic data of right ventricle
      overload, and pulmonary hypertension, with pulmonary artery pressure of 38 mmHg.
      She received an initial treatment with high doses (1,500,000 UI) and rapid
      infusion (1 hr) of intravenous streptokinase (SK) followed by heparin
      anticoagulation. Thereafter the hemodynamic disturbances improved and pulmonary
      artery pressure post-thrombolysis was 23 mmHg. In this report SK at high doses
      and rapid infusion showed effectiveness and security. We emphasize the usefulness
      of echocardiography as a diagnostic aid in patients with a previously healthy
      cardiopulmonary system, as well as the possible role of electrocardiogram as an
      early indicator of pulmonary reperfusion. This could be the first report of
      successful thrombolysis with high doses and rapid infusion of SK in massive PE.

PMID- 8347053
TI  - [Variations in hemostasis and fibrinolysis during the treatment of acute
      myocardial infarct (AMI) with tissue-type plasminogen activator (TTPA). A study
      of 17 cases].
AB  - The aim of this trial was to estimate changes in the coagulation and fibrinolysis
      systems during the thrombolytic treatment with recombinant human tissue-type
      plasminogen activator (rt-PA) in patients with acute myocardial infarction and
      correlate with hemorrhagic complications. We studied 17 patients with a 3 hours
      continuous systemic infusion of 100 mg of rt-PA. Prothrombin time, activated
      partial thromboplastin time, thrombin time, fibrinogen splits products,
      plasminogen, alfa-2-antiplasmin (a-2AP) and antithrombin III (AT-III) were
      performed before, during and after infusion. Most patients showed lengthening
      coagulation times. Fibrinogen and plasminogen were decreased and PDF was
      increased. No variations in alpha-2AP or AT-III were observed. The recuperation
      of fibrinogen levels occurred in 3 hours and there was hyperfibrinogenemia after
      day 3. No hemorrhagic complication was observed in patients with abnormalities in
      these coagulation or fibrinolytic tests.

PMID- 8347054
TI  - [The anti-arrhythmia effect of carbamazepine in chagasic patients with advanced
      myocardial damage].
AB  - Oral administration of 600 mg/day of carbamazepine to 14 arrhythmic chagasic
      patients with advanced myocardial damage and no signs of congestive heart failure
      did not alter the frequency of ventricular extrasystoles, but reduced the total
      number of supraventricular ectopic beats in 7/14 patients and the episodes of
      complex ventricular arrhythmias in up to 43% of patients. This assessment was
      made from 24 hour continuous Holter recording during the course of this double
      blind, placebo controlled, randomized crossover study. Serum levels of
      carbamazepine were also determined and found within therapeutic limits. Six
      patients complained of minor side effects. One patient presented with iatrogenic
      complete AV block, another case had proarrhythmic effect and one patient had to
      be withdrawn from the study because of gastric irritation. No instance of
      contractile depression was observed. Accordingly, carbamazepine is a therapeutic
      alternative for treatment of symptomatic complex ventricular or supraventricular
      arrhythmias in chronic chagasic patients without evidence of conduction system
      involvement or with intolerance to other antiarrhythmic drugs.

PMID- 8347055
TI  - [Cerebral ischemia: a complication in heart catheterization. An assessment in
      2178 catheterizations].
AB  - Cardiac catheterization is highly recognized as the more definitive test in
      several cardiac diseases. However it has a small but definite risk. Cerebral
      ischemia is an unusual complication of this procedure; the main recognized
      physiopathological mechanism is thromboembolism. We present the analysis of 7
      cases observed in 2178 consecutive cardiac catheterizations. In all cases the
      neurological dysfunction developed during the procedure or in the few minutes
      after it. One patient had a complete cerebral infarct. All cases of cerebral
      infarct were confirmed with computed tomography scan or magnetic resonance
      imaging. The clinical profile supported an embolic mechanism. The early
      recognition and management of this complication can influence the prognosis of
      these patients and therefore emphasize the importance of the monitoring of the
      neurological function in the hemodynamic department.

PMID- 8347057
TI  - [The direction of Mexican electrovectorcardiography].

PMID- 8347056
TI  - [Transesophageal electrophysiological study. A report of 2 cases].
AB  - Intraesophageal electrocardiography and transesophageal atrial pacing are
      procedures used for the study of supraventricular arrhythmias. A systematic study
      and integration of these two techniques on the part of the author lead him to
      develop a methodology for noninvasive electrophysiological supraventricular
      studies. The methodology is based on low-energy transesophageal atrial pacing and
      on a simultaneous recording system with unipolar and bipolar intraesophageal
      leads, bipolar transthoracic leads and body surface leads. The frequency range,
      amplitude and velocity of the recording play an important role. A pharmacological
      protocol is studied for each patient. Aspects of the methodological contribution
      are briefly documented for two cases. This method is a good alternative for
      supraventricular electrophysiologic study but is limited when compared to
      invasive procedures.

PMID- 8347058
TI  - [The participation of the endothelium in physiopathological processes].

PMID- 8347059
TI  - [Cyclic ureas. 2. Racemates and enantiomers of imidazolidin-2-ones: synthesis,
      configuration and sedative-hypnotic action].
AB  - The racemates and the enantiomers of the imidazolidin-2-ones 2a and 2b, which can
      be considered as cyclic ureas, are obtained from the racemates and the
      enantiomers of the hydantoins 1a and 1b by reduction with LiAlH4/AlCl3. The
      enantiomers that are dextrorotating in ethanol possess S-configuration. In a
      study with Wistar-rats, 2a and 2b show sedative-hypnotic activity. The
      enantiomers exhibit marked enantioselective differences in their potency.

PMID- 8347060
TI  - [Synthesis and biological effects of new N,N-disubstituted 5-alkyliden- and 5
      aralkyliden-3-aminorhodanines].
AB  - Numerous novel N,N-disubstituted 5-alkyliden- or 5-aralkyliden-3-aminorhodanines
      2 have been prepared by condensation of carbonyl compounds with 1. The
      effectiveness of some derivatives in an "akanthose test" with hairless mice was
      shown.

PMID- 8347061
TI  - High-performance liquid chromatographic analysis of cyclosporine A in human skin.
AB  - A three-dimensional high-performance liquid chromatography (HPLC) method is
      described for the determination of cyclosporine A in human skin. The method
      allows to determine at least 3 ng cyclosporine A in 10 mg skin (total sample
      amount needed) and is suitable for cyclosporine A level monitoring in the skin of
      psoriatic patients.

PMID- 8347062
TI  - Applying quantitative methods to the prediction of full functional recovery in
      adult rehabilitation patients.
AB  - The purpose of this project was to construct a pilot prognostic index for use in
      research and clinical practice that would predict functional recovery in adult
      rehabilitation patients at discharge using clinical characteristics at admission
      to rehabilitation (independent performance of seven activities of daily living
      and three basic mobility tasks). We constructed the index from retrospectively
      collected data on 1,020 adult rehabilitation patients who underwent
      rehabilitation between 1980 and 1986. Adjusting for patient characteristics, the
      odds of recovering independent function doubled for each ten-point increase in
      the 100-point functional status score measured at admission to rehabilitation
      (odds ratio = 2.1, 95% confidence interval [CI] = 1.9 to 2.4). The odds increased
      by a factor of 1.9 (95% CI = 1.1 to 3.2) in patients with an impairment
      considered more functionally reversible and by a factor of 2.1 (95% CI = 1.3 to
      3.4) in patients transferred from an acute hospital. The odds of functional
      recovery decreased in those over 79 years of age, in those who were unemployed
      before hospitalization, and as the number of comorbid conditions increased. Our
      findings demonstrate the feasibility of developing quantitative estimates of
      functional prognosis. Prior to use, the index should be externally validated in
      different rehabilitation facilities.

PMID- 8347063
TI  - Does functional reach improve with rehabilitation?
AB  - Functional reach (FR, maximal safe standing forward reach) is a precise,
      reliable, clinically accessible, age-sensitive measure of balance that
      approximates center of pressure excursion and validly estimates physical frailty.
      We now test its ability to detect improvement in balance over time. Twenty-eight
      inpatient male veterans (age 40 to 105, mean, 67.3) undergoing physical
      rehabilitation and 13 nonrehabilitation controls were evaluated at baseline and
      every 4 weeks using FR (yardstick method), 10-foot walking time (WT), the Duke
      hierarchical mobility skills protocol (HMS) and a portion of the Functional
      Independence Measure (FIM). Their sensitivity to change was determined using the
      responsiveness index (RI). FR as well as the other physical performance
      instruments tested were found to be sensitive to change (RI for FR = 0.97, WT =
      11.26, HMS = 4.63, FIM = 4.93) and therefore, appropriate measures for use in
      prospective clinical trials.

PMID- 8347064
TI  - Assessment of hand function in Duchenne muscular dystrophy.
AB  - Eighteen boys with Duchenne muscular dystrophy (DMD) were assessed for their
      ability to perform tasks involving wrist and hand function. Each subject was
      assessed using the Jebsen Test of Hand Function, range of motion measurements,
      and muscle strength tests. Writing and simulated page turning were performed
      successfully by boys in all age groups. Boys over age 15 had difficulty
      completing simulated feeding and picking up large and small objects. The muscle
      strength of the wrist extensors and the radial deviation range of motion at the
      wrist were found to be strongly correlated with six of the seven tasks assessed.
      These two clinical assessments appear to be good indicators of overall wrist and
      hand function. Life expectancy with DMD is increasing with advances in
      respiratory care making preservation of wrist and hand function, the major
      activity remaining with advanced disease, increasingly important.

PMID- 8347065
TI  - Elbow joint restriction: effect on functional upper limb motion during
      performance of three feeding activities.
AB  - This study was conducted to quantify and compare changes in upper limb joint
      motion during different feeding tasks when the elbow joint was restricted. Ten
      male and nine female volunteer subjects age 18 to 50 years participated; all were
      healthy, right dominant, with no upper limb pathology. A splint was used to
      restrict elbow joint motion. Three feeding tasks under both unrestricted and
      restricted conditions were randomly assigned; motion was recorded by a video
      based three-dimensional motion analysis system. Elbow restriction resulted in
      significantly (p < .05) larger arcs of motion in shoulder flexion and internal
      rotation. Differences between feeding types were similar during both unrestricted
      and restricted conditions. Increased shoulder joint motion resulting from elbow
      joint restriction may require greater activity of shoulder girdle muscles
      increasing the risk of soft tissue problems and degenerative joint disease.
      Decisions regarding elbow immobilization should take into consideration potential
      effects upon total upper limb motion.

PMID- 8347066
TI  - Behavior analysis and intervention during hospitalization for brain trauma
      rehabilitation.
AB  - Continued problematic behavior in children and adolescents after brain trauma is
      a major barrier to medical care, rehabilitation, and eventual independent living.
      The present study demonstrates the application of already well-developed behavior
      analysis techniques to the early posttrauma expression of behavior problems
      during hospital recovery. To satisfy concerns regarding both cost and
      individualized treatment, interventions were carried out primarily by regular
      hospital staff (nurses and therapists), medical record data were used to document
      gains, and time series, within subject designs were used to show experimental
      control. Four patients (three male and one female) ranging in age from 10 to 16
      years, received intervention based on behavior analysis techniques, which reduced
      disruption and increased cooperation with therapy and medical care. Behavior
      analysis techniques will be relevant to future rehabilitation research to the
      extent that the posttrauma patient's behavior is effected by environmental
      consequences as demonstrated here.

PMID- 8347067
TI  - Attitudes of medical students and health-care professionals toward people with
      disabilities.
AB  - This study used the Attitude Towards Disabled Persons Scale (ATDP) to investigate
      differences in attitudes toward individuals with physical disabilities among
      first-year and fourth-year medical students and health-care professionals. Of 851
      questionnaires sent out, 310 were returned, and 297 were used in the final
      analyses. The fourth-year medical students had significantly more positive
      attitudes toward people with physical disabilities when compared to the first
      year medical students. Differences between health-care professionals and fourth
      year medical students were nonsignificant. Across the sample, females, compared
      to males, and whites, compared to Asians, were found to hold significantly more
      positive attitudes toward people with physical disabilities. Contact with people
      with physical disabilities did not have to be on an equal-status basis to have a
      positive effect on attitudes toward people with physical disabilities. The need
      for health and educational disciplines to further the movement towards
      integration of people with physical disabilities was emphasized, and suggestions
      for future research were offered.

PMID- 8347068
TI  - Balance, reaction time, and muscle strength in exercising and nonexercising older
      women: a pilot study.
AB  - Twenty-one women, aged 57 to 75 years, who had been taking part in exercise
      programs for periods of 12 months or more underwent tests of muscle strength,
      reaction time, proprioception, and body sway. The performance of these women in
      the tests was compared with 21 women of the same age who were not taking part in
      any organized physical activity and were not exercising more than 30 minutes a
      day. The women who had been taking part in the exercise program performed
      significantly better in the tests of quadriceps strength, reaction time, and sway
      on a compliant surface than the nonexercising women. The exercisers also had
      lower body mass index scores. These pilot results suggest that exercise may play
      a role in improving a number of sensori-motor systems that contribute to
      stability, and that exercise of this nature may help prevent falls in older
      women.

PMID- 8347069
TI  - Quantitative effects of physical therapy on muscular and functional performance
      in subjects with osteoarthritis of the knees.
AB  - Osteoarthritis (OA) of the knees is a functionally limiting disability. Physical
      therapy (PT) is considered a useful treatment for OA, although evidence is
      qualitative. The purpose of this study was to quantitatively measure the effects
      of a 3-month PT program (n = 40; 20 men and 20 women) with knee OA. Muscle
      function and functional assessment parameters were measured. All data were
      analyzed by repeated measures analysis of variance (p < 0.05). There were no
      significant changes in handgrip strength and endurance, limb volume, or angular
      velocity after PT. Maximal muscle length was significantly increased. Muscle
      strength significantly increased for the hamstrings (9% and 19%) and quadriceps
      (8% and 24%) for the men and women, respectively. Endurance improved for the
      quadriceps (26% and 39%) and hamstrings (18% and 28%) for men and women,
      respectively. Functionally, there were significant improvements in the ability to
      climb stairs, rise from a chair, and walk. Walking time (50 ft) and the
      difficulty and pain of performing various activities decreased. Most improvements
      had occurred after 1 month of PT. For the first time, the effects of a PT program
      have been quantitatively measured for patients with knee OA.

PMID- 8347070
TI  - Reliability of isokinetic and isometric measurement of leg strength on men with
      mental retardation.
AB  - The purpose of this study was to determine the reliability of isokinetic and
      isometric measurement of strength for tests of knee extension and hip abduction
      on men with mental retardation (MR). In addition, the relationships between
      isokinetic measures of peak torque (PT) and total work (TW) and isometric peak
      torque were examined. Twenty-two men with mild to moderate MR were tested for
      isokinetic knee extension and hip abduction strength on a Musculoskeletal,
      Evaluation, Rehabilitation and Conditioning (MAREC) systems dynamometer at
      velocities of 60 and 30 degrees/sec, respectively. Isometric peak torque was
      determined by an examiner using a Nicholas Manual Muscle Tester (NMMT).
      Intrarater correlation coefficients for the isokinetic PT and TW scores ranged
      from .97 to .99, whereas coefficients for isometric NMMT scores ranged from .97
      to .98. Pearson correlation coefficients between PT and TW scores ranged from .76
      to .93. Coefficients between isokinetic and isometric scores ranged from .43 to
      .73. These results indicate that highly reliable isokinetic and isometric
      measurements can be obtained on men with MR. Also, the relatively simple
      measurement of PT may be the isokinetic parameter of choice at the clinical
      setting. Moderate relationships between NMMT and isokinetic scores were found,
      indicating that the generalization of test scores from one test modality to
      another is not warranted.

PMID- 8347071
TI  - Comprehensive analysis of dynamic elastic response feet: Seattle Ankle/Lite Foot
      versus SACH foot.
AB  - This study evaluated biomechanical and metabolic performance differences between
      two prosthetic foot designs in light of their mechanical properties. Ten
      unilateral below-knee amputee subjects, at least 1 year after amputation, capable
      of walking and running, were studied. Differences in heel and forefoot compliance
      explained differences in gait events and alignment. Increased efficiency of
      pushoff in the Seattle Ankle/Lite Foot exists as evidenced by the decrease
      loading on the opposite limb during double support and a less shortened step
      length on the sound side compared to the SACH foot. The natural frequency of
      oscillation for the prosthetic feet was determined to be too high to provide
      energy storage and release synchronized with kinematic requirements because
      neither metabolic cost savings nor differences in metabolic efficiency were
      found. Comfortable walking speed and the nadir of metabolic rate and efficiency
      are not different. Via accelerometer measurement, it was found that the more
      compliant and lossy SACH foot heel was less likely to transmit high frequency
      vibration.

PMID- 8347072
TI  - Prosthetic profile of people with lower extremity amputation: conception and
      design of a follow-up questionnaire.
AB  - A questionnaire, the Prosthetic Profile of the Amputee (PPA), is described both
      in terms of its conceptualization and design. The objectives of the questionnaire
      (mail and telephone versions) were to evaluate and to determine the factors
      potentially related to prosthetic use by a person with a lower extremity
      amputation after discharge from rehabilitation. The PRECEDE theoretical model
      (Predisposing Reinforcing and Enabling Causes in Educational Diagnosis and
      Evaluation) was adapted to the present study and served as a guide for the
      conceptual basis of the instrument. A multidisciplinary group of 13 experts and
      another group of eight persons with lower limb amputation were involved in the
      identification, classification, and priority rating of the factors related to
      prosthetic use. The design of the questionnaire was structured according to
      Dillman's Total Design Method. To ensure the content validity of the instrument,
      the pertinence of each question with regard to the questionnaire's objectives was
      assessed by the group of experts. Pretesting of the questionnaire was then
      conducted with a random sample of 26 people with lower extremity amputations. The
      preliminary version of the instrument has already demonstrated the potential for
      clinical and research use.

PMID- 8347073
TI  - Autotraction versus passive traction: an open controlled study in lumbar disc
      herniation.
AB  - Autotraction (AT) is a treatment for low-back pain syndrome of benign etiology
      that uses a specially designed traction table divided into two movable sections.
      While lying on the table, the pelvis secured, the patient controls the traction
      forces by grasping and pulling the bars at the head of the table. There are
      controls for the therapist to apply, through movable sections of the table,
      rotation and bending forces to help restore mobility to the lumbar spine without
      inducing pain. The present study is based upon a randomized treatment trial
      comparing conventional passive traction (PT) to AT. The following outcome
      indicators were used: (1) subjective response concerning overall improvement, (2)
      pain intensity (visual analog scale, 0-100), (3) qualitative pain severity
      (McGill Pain Questionnaire, short-form, 0-45), and (4) pain related disability
      (Oswestry Low Back Pain Disability Score, 0-100). The favorable response to AT
      was 75% (30 of the 40 patients) versus the 22% (6 of 27 patients) to PT (p <
      0.001). After 3 months, 19 of the 30 responders to AT (63%) reported continued
      improvement. In these patients, pain ratings remained stable and the disability
      scores decreased to 0 to 23% of the pretreatment value (median and mean
      respectively, p < 0.001).

PMID- 8347074
TI  - Seating and wheeled mobility in the disabled elderly population.
AB  - Elderly persons constitute the largest among the populations regularly using
      wheelchairs. This is a review of the few studies specifically concerned with
      seating for the elderly; it identifies current problems, particularly in the
      seating for aged people who are in long-term care facilities. This review
      describes ways of matching currently available seating technology with the needs
      of disabled elderly persons. Two major barriers to greater use of newer seating
      technology are (1) the high cost of durable medical equipment and (2) the failure
      of most clinicians and institutional administrators to recognize the importance
      of posture and comfort to provide functional independence in wheelchair users.
      This review discusses seating for four groups of elderly persons: (1) the
      nonmobile, dependents who may be safety risks and are without energy or ability
      to wheel or walk by themselves; (2) mobile nonambulatory; and (3) ambulatory, but
      with special wheelchair needs. Research is needed in wheeled mobility in a number
      of areas: better matching of mobility to function, cheaper and more effective
      cushions, more modular seating systems, and better lifting and transfer devices.
      The American National Standards Institute in cooperation with Rehabilitation
      Engineering Society of North America has recently recommended standards for
      wheelchair performance that may be legislated in the next few years.

PMID- 8347075
TI  - Orthostatic tremor: delayed onset following head trauma.
AB  - Orthostatic tremor is a 14 to 16Hz (range 7 to 36Hz) tremor of uncertain etiology
      elicited within seconds of an isometric contraction. It is described as a
      shaking, cramping of the lower extremities upon standing and is relieved with
      movement or sitting. Typically patients are unable to stand in place for long
      periods of time secondary to instability and fatigue. A 73-year-old woman with
      orthostatic tremor following a history of head trauma is presented. Recognition
      of the characteristic history and electromyographic findings may lead to
      appropriate treatment for this annoying and sometimes incapacitating disorder.

PMID- 8347076
TI  - Analysis of influenza A virus nucleoproteins for the assessment of molecular
      genetic mechanisms leading to new phylogenetic virus lineages.
AB  - The nucleoprotein (NP) gene of influenza A viruses is decisive for separating two
      large individually evolving reservoirs in birds and humans. A phylogenetic
      analysis of the NP gene revealed that all mammalian influenza viruses originated-
      directly or indirectly--from an avian ancestor. The stable introduction of an
      avian influenza A virus into a mammalian species seems to be a relatively rare
      event, the latest one occurred in 1979 when such an avian virus was introduced
      into pigs in Northern Europe which gave rise to a new lineage. At least two
      concomitant events are required for such a new and stable introduction: (1) The
      new species has to become infected, and (2) a mutation in the polymerase complex
      has to establish a labile variant, which is prone to provide a large number of
      different variants, from which some can adapt rapidly to the new host (or to any
      unusual environments). Since such mutator mutations might be advantageous only
      during stress periods, variants with a less error prone polymerase might emerge
      again after adaptation. Examples for such fluctuations in terms of mutational and
      evolutionary rates are discussed in this brief review.

PMID- 8347077
TI  - A low oncogenic variant of Friend murine leukemia virus with strong
      immunosuppressive properties.
AB  - Friend leukemia complex (FLC) is known to induce immunosuppression but the use of
      FLC in studies of immune cells function is disadvantageous since the
      immunosuppression always is accompanied by an acute erythroleukemia. To obtain
      immunosuppressive variants of FLC with reduced leukemogenic potential, we
      isolated T-helper cells from FLC infected mice, and passed lysates of the cells
      to recipient uninfected mice. A group of these mice developed a condition
      distinct from the disease induced by FLC. A viral stock prepared from these mice,
      designated Fd-MIV for friend derived murine immunodeficiency virus, induced a
      profound suppression of the primary antibody response without acute
      transformation in adult NMRI mice. Terminally a wasting disease with weight loss,
      atrophy of the thymus and lymph nodes and renal disease was observed in some
      mice. Analysis of viral DNA and RNA from infected NIH 3T3 cells showed that Fd
      MIV contained at least two viral components, a 8.4 kb friend murine leukemia
      virus (F-MuLV) and a 7.4 kb mink cell focus (MCF)/xenotropic virus related
      genome. The 7.4 kb genome was not detected in Fd-MIV infected, immunocompromised
      mice indicating that the 8.4 kb genome might be responsible for the disease.

PMID- 8347078
TI  - Infection studies with canine distemper virus in harbour seals.
AB  - Infection studies in harbour seal (Phoca vitulina) were conducted with the Snyder
      Hill strain of canine distemper virus (CDV) that is virulent for dog and mink.
      The inoculated seals showed clinical symptoms which were to some degree similar
      to those observed in CDV infections of sensitive species of carnivores. Viral
      replication in lymphoid cells was followed by an extended period of
      immunosuppression. The results did not provide conclusive evidence for viral
      replication in surface epithelia of seals, and accordingly no spread of the
      infection to contact seals and mink was demonstrated. The pathogenicity of the
      infection did not increase upon a second viral passage in seal. The serological
      data showed that CDV-infected seals mounted an early virus specific antibody
      response. Overall, the results indicated that the harbour seal was not especially
      sensitive to CDV infection. The differences in the in vivo biological properties
      of CDV and PDV add to the distinction between these viruses at the genomic and
      antigenic levels.

PMID- 8347080
TI  - The intestine is a site of passage for potato leafroll virus from the gut lumen
      into the haemocoel in the aphid vector, Myzus persicae Sulz.
AB  - Four detection techniques, three of which gave reliable identification of the
      virus particles, were used to locate potato leafroll virus (PLRV) in the
      alimentary canal of its main aphid vector, Myzus persicae Sulz:
      immunofluorescence on cryostat sections, conventional transmission electron
      microscopy on ultrathin sections and immune electron microscopy with gold
      labeling, either prior to or after fixation-embedding. Each method clearly showed
      the presence of the virus in the intestine epithelium and its absence in cells of
      the other parts of the alimentary canal. Under the experimental conditions used,
      the intestinal cells seemed to be the pathway for PLRV transport from the gut
      lumen into the haemocoel. Electron microscopy examinations showed many virus
      particles close to the apical plasmalemma of the epithelial cells in the gut
      lumen of the intestine. Other particles were seen in shallow pit-like regions or
      surrounded by coated vesicles in the apical part of these cells. Thus the virus
      particles seemed to enter the epithelial cells of the intestine by a mechanism of
      endocytosis. In the cytoplasm of these cells, virions were also frequently
      observed in isolated--or more often aggregated--tubular vesicles. The latter
      could be involved in PLRV transport through the cell since they were observed
      fusing with different cell organelles. A few viral particles were also detected
      in lysosomes as well as in multivesicular bodies. Virus particles were observed
      between the plasmalemma and basal lamina of the intestine cells but not in the
      haemocoel, where probably they were quickly dispersed. Our results are discussed
      in relation to other reports which have shown hindgut and stomach as sites of
      passage from the gut lumen into the aphid's body cavity for PLRV and other
      circulative viruses.

PMID- 8347082
TI  - Parsnip yellow fleck and rice tungro spherical viruses resemble picornaviruses
      and represent two genera in a proposed new plant picornavirus family
      (Sequiviridae).
AB  - Parsnip yellow fleck and rice tungro spherical viruses, with monopartite ss RNA
      genomes, resemble picornaviruses in the polymerase and NTP-binding domains of
      their encoded polyproteins. Though in separate genera, they may comprise a new
      family.

PMID- 8347081
TI  - Productive expression state confers resistance of human immunodeficiency virus
      (HIV)-2-infected lymphoma cells against superinfection by HIV-1.
AB  - In the past, positive as well as negative results pertaining to HIV-1/HIV2
      interference have been obtained. Therefore, in the present study attention was
      paid to the viral expression state of preinfected cells at the time of exposure
      to secondary virus. A clonal HIV-2 infected HUT-78 cell line was derived by
      endpoint dilution and subsequently inoculated with cell-free HIV-1.
      Superinfection with HIV-1 was ruled out by Western blot and PCR analysis. The
      chronically HIV-2 infected cells used for these studies showed a highly
      productive expression state, as evidenced by immunoperoxidase staining (IPS),
      Western blot profile and levels of reverse transcriptase (RT) activity. We
      discuss several mechanisms of interference in productively infected cells, which
      may confer resistance to superinfection with secondary virus.

PMID- 8347079
TI  - Taxonomic relationships between distinct potato virus Y isolates based on
      detailed comparisons of the viral coat proteins and 3'-nontranslated regions.
AB  - Detailed comparisons were made of the sequences of the coat protein (CP) cistrons
      and 3'-nontranslated regions (3'-NTR) of 21 (geographically) distinct isolates of
      potato virus Y (PVY) and a virus isolate initially described as pepper mottle
      virus (PepMoV). Multiple sequence alignments and phylogenetic relationships based
      on these alignments resulted into a subgrouping of virus isolates which largely
      corresponded with the historical strain differentiation based on biological
      criteria as host range, symptomatology and serology. Virus isolates belonging to
      the same subgroup shared a number of characteristic CP amino acid and 3'-NTR
      nucleotide residues indicating that, by using sequences from the 3'-terminal
      region of the potyvirus genome, a distinction could be made between different
      isolates of one virus species as well as between different virus species. RNA
      secondary structure analysis of the 3'-NTR of twelve PVY isolates revealed four
      major stem-loop structures of which, surprisingly, the loop sequences gave a
      similar clustering of isolates as resulting from the overall comparisons of CP
      and 3'-NTR sequences. This implies a biological significance of these structural
      elements.

PMID- 8347083
TI  - Comparative analysis of the NS 1 gene sequences of dengue-1 viruses prototype
      Hawaii strain and Thai isolate TH-Sman, and determination of the intratypic
      variation of NS 1 protein among dengue-1 viruses.
AB  - In view of a previous report on significant antigenic and biophysical differences
      between the purified soluble complement-fixing antigens of dengue-1 virus strains
      Hawaii and TH-Sman, the NS 1 genes of both virus isolates were cloned, sequenced,
      and compared in an attempt to define the genetic basis for the observed
      differences. Sequence comparison revealed ten encoded amino acid differences
      between the NS 1 genes of both viruses. Three of these amino acid differences,
      which are associated with a change in charge distribution, are clustered within
      the major antigenic region previously defined by studies of recombinant dengue-1
      NS 1 protein expressed in E. coli. In parallel, the NS 1 sequences of both Hawaii
      and TH-Sman isolates were also aligned and compared with two other published
      dengue-1 NS 1 protein sequences to determine the intratypic variation of dengue-1
      NS 1 antigen. Pairwise comparisons between the encoded amino acid sequences
      revealed a variability of 1.1% to 3.1% difference in the NS 1 protein among
      dengue-1 strains, which is comparable to that reported for dengue-1 envelope
      protein (0.2% to 3.6% difference) but less than that of dengue-2 NS 1 protein
      (0.6% to 7.4% difference).

PMID- 8347084
TI  - Characterization of monoclonal antibodies to bovine enteric coronavirus and
      antigenic variability among Quebec isolates.
AB  - Twenty monoclonal antibodies (MAbs) were prepared against the Mebus strain of
      bovine enteric coronavirus, 14 of them reacting with the peplomeric S (gp 100)
      glycoprotein. Competition binding assays allowed the definition of at least 4
      distinct antigenic domains for the S glycoprotein, designated as A, B, C, and D;
      epitopes associated to neutralizing activity being located in sites A, B, and C.
      One MAb directed to the hemagglutinin HE (gp 140/gp 65) glycoprotein inhibited
      the hemagglutinating activity of the virus, but had no neutralizing activity.
      Comparison of Quebec enteropathogenic BCV isolates using polyclonal antiserum and
      MAbs directed to the S glycoprotein confirmed their close antigenic relationship,
      but also revealed the occurrence of at least three distinct antigenic subgroups.
      Antigenic domain D was highly conserved among BCV isolates, as well as non
      neutralizing epitopes assigned to antigenic domains A and C. The Minnesota strain
      of turkey enteric coronavirus could be distinguished from BCV isolates by MAbs
      directed to epitopes of antigenic domain C, whereas human coronavirus HCV-OC 43
      could be distinguished by MAbs directed to epitopes of antigenic domain A. The
      porcine hemagglutinating encephalomyelitis virus could be distinguished from the
      other hemagglutinating coronaviruses by neutralizing epitopes located on
      antigenic domains A, B, and C.

PMID- 8347085
TI  - Watermelon mosaic virus-Morocco is a distinct potyvirus.
AB  - The relationship of the Morocco isolate of watermelon mosaic virus (WMV) to WMV2,
      soybean mosaic virus (a virus closely related to WMV2) and the W strain of papaya
      ringspot virus (PRSV-W), formerly WMV1, was examined by comparing tryptic peptide
      profiles using high performance liquid chromatography. The profiles indicated
      that the coat protein sequence of WMV-Morocco differed substantially from those
      of the other potyviruses. This conclusion was supported by sequence data from
      five tryptic peptides from the coat protein of WMV-Morocco, which showed only 61
      68% identity to equivalent sequences in PRSV-W, WMV2 and zucchini yellow mosaic,
      another potyvirus infecting cucurbits. Based on the above data, and on known
      correlations between coat protein sequence similarities and potyvirus
      relationship, it is concluded that WMV-Morocco should be regarded as a distinct
      potyvirus.

PMID- 8347086
TI  - The skin, tongue, and brain as favorable organs for hog cholera diagnosis by
      immunofluorescence.
AB  - Hog cholera virus antigens were found densely distributed in skin and tongue of
      pigs experimentally infected with hog cholera virus. The finding described here
      warrants the usage of ear biopsies for hog cholera diagnosis on a herd basis.

PMID- 8347087
TI  - Proposed classification of the bipartite-genomed raspberry bushy dwarf
      idaeovirus, with tripartite-genomed viruses in the family Bromoviridae.
AB  - Raspberry bushy dwarf virus (RBDV) has an unusual combination of properties and
      has been classified as the sole member of a new plant virus genus, for which the
      name idaeovirus has been proposed. Particles of RBDV resemble those of
      ilarviruses (family Bromoviridae) in appearance and in being transmitted in
      association with pollen. RBDV has two genomic RNA species, RNA-1 (5,449 nt) and
      RNA-2 (2,231 nt). The particles also contain RNA-3 (946 nt), a subgenomic
      monocistronic coat protein mRNA which is derived from the 3' end of the
      bicistronic RNA-2. The single 190 K protein encoded by RNA-1 contains
      methyltransferase, helicase and polymerase domains. Evolutionary distance data
      obtained from multiple alignments of the amino acid sequence of the RBDV 190 K
      protein and corresponding proteins with replicative function from other plant
      viruses suggest that the closest affinities of RBDV are with the tripartite
      genomed viruses in the family Bromoviridae. We propose that the genus idaeovirus
      be included in the family Bromoviridae.

PMID- 8347088
TI  - [A study of sensitization and symptoms in adult asthmatics who keep cat and dog].
AB  - We studied hypersensitivity to cats and dogs in three hundred adult asthmatics
      who kept them. Some findings were noted as follows. 1) The mean duration for
      which cats were kept was 6.2 +/- 10.1 (1 S.D.) years and that for dogs was 4.2 +/
      9.6 (1 S.D.) years. 2) The positive rate in intradermal tests to dog dander was
      7% and to cat hair-epithelium 32%. The positive RAST (score > or = 2) rate to cat
      epithelium was 36.1%, to dog dander 31.6% and to dog epithelium 7.3%
      respectively. 3) Eleven to 18% of the dog keepers and 23 to 36% of the cat
      keepers whose RAST score were positive were aware of the relationship between
      pets and asthma, specifically concerning eye and nose symptoms. 4) Thirty percent
      of the cat and dog keepers had become sensitized to them after keeping them for
      under one year. The positive RAST rate was unchanged in those who kept Japanese
      native dogs but increased in those who kept foreign breeds after 3 to 6 years.
      The rate of sensitization rate to cats tended to increase along with the period
      for which they were kept. 5) Dog dander RAST scores among the foreign breed
      keepers were significantly higher than those among the native dog keepers. If the
      dog breed was the same, the RAST score was not higher if the dog was kept indoors
      than if it was kept outdoors. We concluded that a possible reason why the RAST
      scores were higher among those who kept foreign breeds was that foreign breeds
      have stronger allergenicity.

PMID- 8347089
TI  - [Clinical study of patients with nocturnal asthmatic attacks admitted to an
      emergency room].
AB  - Over the periods of a year, we studied the patients who were admitted to the
      emergency room at our hospital at night with asthmatic attacks. From July 1991 to
      June 1992, 10,932 patients were admitted to the internal department of our
      emergency room, 707 (6.5%) of them because of asthmatic attacks. These 707
      consisted of 364 patients (51.5%) with mild attacks, 242 (34.2%) with moderate
      attacks and 101 (14.3%) with severe attacks according to Mitsui's score. Most
      patients admitted before 23:00 and after 5:00, but more patients with severe
      attacks were admitted around midnight. A large part of the patients with moderate
      or severe attacks had chronic hypoxemia, and more than half of the patients'
      serum theophylline concentration was under the therapeutic rate. More than half
      patients were treated within 5 minutes. But within those who were not, 6 patients
      with mild attacks on admission needed hospitalization later. For prevention of
      life threatening attack, we should regard it as an important problem to follow up
      the patients who don't come to the hospital in the daytime in spite of frequent
      visits to the emergency room at night.

PMID- 8347090
TI  - [Study of serum phospholipase A2 activity in bronchial asthmatic patients].
AB  - We examined serum PLA2, lipids and platelets in 133 bronchial asthma patients who
      had not taken any glucocorticoids. Serum PLA2 was measured by radioimmunoassay.
      Serum PLA2 activity in the bronchial asthma patients was 384.2 +/- 114.7
      (pmol/ml/min), and in the control group (healthy subjects) it was 271.7 +/- 53.9;
      this is a statistically significant difference (p < 0.01). Serum PLA2 of the
      mixed type was higher than that of the atopic type (p < 0.05) with respect to
      age, those subjects in their 60s showed statistically higher serum PLA2 values
      than those in their 20s and 30s (p < 0.05). The serum PLA2 level was
      statistically higher in a patient with an attack (409.1 +/- 113.9) than without
      an attack (342.6 +/- 94.3) (p < 0.05). However, there was no significant
      difference in lipid and platelet levels according to attack status. In
      conclusion, the serum PLA2 level is not only higher in asthma patients with
      attacks, but is also higher in asthma patients without attacks when compared to
      the control group. Therefore, the measurement of serum PLA2 is significant in
      predicting attacks.

PMID- 8347091
TI  - [IgE, IgG1 and IgG4 antibodies against bodily and fecal extracts of
      Dermatophagoides farinae].
AB  - IgE, IgG1 and IgG4 antibodies against bodily (Dfb) and fecal (Dff) extracts of
      Dermatophagoides farinae (Df) were measured by enzyme linked immunosorbent assay
      (ELISA) in 33 asthmatic patients (AP), 27 healthy control subjects (HCS) and
      clinically healthy subjects with mite allergy (HS-MA) shown by positive skin
      reactions to house dust. Serum total IgE measured by radioimmunosorbent test, and
      IgE against Df was measured by the CAP system simultaneously. AP showed the
      highest mean value of total IgE and IgE against Df, Dfb and Dff. HS-MA showed the
      second highest value and HCS showed the lowest one. There were significant
      differences among these 3 groups. AP showed a significantly higher mean value of
      IgG1 and IgG4 than the other 2 groups. However, there was no significant
      difference between HS-MA and HCS. Antibody titers against Dfb and Dff correlated
      well. IgE, IgG1 and IgG4 titers obtained by ELISA also correlated with each other
      well. However, the results from the CAP system and IgE-ELISA did not agree in
      some cases indicating character differences between the CAP system and ELISA. In
      AP, the CAP system results agreed with those of ELISA. In HS-MA, however, many
      cases exhibited negative reactions to IgE-ELISA in spite of exhibiting positive
      reactions in the CAP system.

PMID- 8347092
TI  - [Immunological and physicochemical properties of Cry j II, the second major
      allergen of Japanese cedar pollen (Cryptomeria japonica)].
AB  - Cry j II, the second major allergen of Japanese cedar (sugi, Cryptomeria
      japonica) pollen was examined for the allergenicity by intradermal test and RAST.
      Nineteen of the 25 allergic patients examined, showed positive reaction to the
      Cry j II. Contents of Cry j II in the extracts of the pollen collected in various
      regions from 1977 to 1991 showed yearly variation ranging from 2.9 to 14 mg/100 g
      pollen, whereas the amount of Cry j I in the extract was comparatively stable at
      about 35 mg/100 g pollen. Physicochemical treatments of Cry j I and Cry j II
      suggested that specific human IgE antibodies and some mAbs bind to conformational
      epitopes which are denatured and destroyed by certain treatments.

PMID- 8347093
TI  - [The usefulness and limitations of the radioallergosorbent test in diagnosing
      food allergy in atopic dermatitis].
AB  - To clarify the diagnostic value of the radioallergosorbent test (RAST), the
      relationship between RAST and the oral food challenge test was evaluated. 263
      children with atopic dermatitis were challenged by egg, cow's milk or soy bean
      after their skin manifestations had been improved by elimination diet and
      environmental control. Of 200 cases with negative RAST results for egg white, 108
      cases (54.0%) showed no reaction in egg challenge tests. However, 65 cases
      (31.5%) had non-immediate reactions, while 29 cases (14.5%) had immediate
      reactions (within 2 hours of challenge). Of 16 cases with RAST score of 1 for egg
      white, 11 cases (68.8%) had non-immediate reactions and 2 cases (12.5%) had
      immediate reactions in egg challenge tests. Of 19 cases with RAST scores of 2 for
      egg white, 2 cases (10.5%) had no reaction, 6 cases (31.6%) had non-immediate
      reactions and 11 cases (57.9%) had immediate reactions in egg challenge tests. Of
      21 cases with RAST scores of 3 for egg white, 1 case (4.8%) had no reaction, 3
      cases (14.3%) had non-immediate reactions and 17 cases (81.0%) had immediate
      reactions in egg challenge tests. All 7 cases with RAST scores of 4 for egg white
      had immediate reactions in egg challenge tests. Almost the same relationship
      between RAST and challenge tests were found in test using cow's milk or soy bean.
      In conclusion, false negative results were seen in 46.0% of RAST for egg white,
      51.7% of RAST for cow's milk and 26.9% of RAST for soy bean.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8347094
TI  - [Skin reaction(s) to culture supernatant(s) from Dermatophagoides farinae (Df)
      stimulated lymphocytes, and their correlation with Df-induced interleukin 2
      responsiveness by lymphocytes from patients with bronchial asthma].
AB  - To investigate the inflammatory function of Dermatophagoides farinae (Df)
      activated lymphocytes, supernatants from cultures of the lymphocytes were
      intracutaneously injected into donors' forearms. Injection of the supernatants of
      Df-stimulated lymphocytes from mite-sensitized atopic individuals with such
      diseases as bronchial asthma induced a profound inflammatory reaction in the
      autologous skin, characterized by erythema extending more than 15 mm in mean
      diameter and edema. The inflammation was at its peak after approximately 20 min,
      which was followed by gradually re-growing erythema lasting for as long as 24
      hours after injection. Supernatants of unstimulated lymphocytes were also capable
      of inducing the same reaction, indicating the presence of in vivo activated
      lymphocytes, although the extent of the response was always smaller. The induced
      response in normal individuals was erythema of less than 15 mm in mean diameter.
      The supernatants obtained from cultures at 4 degrees C failed to induce such
      inflammation. The culture supernatants of ovalbumin-restimulated lymphocytes were
      also incapable of augmenting the response. The combined data show that the
      production of inflammatory response-inducing factor(s) from Df-stimulated
      lymphocytes was antigen specific. Significant skin reactions was correlated with
      the IL2 responsiveness of Df-stimulated lymphocytes. The skin reaction induced by
      factor(s) derived from Df-stimulated lymphocytes, which might be similar to the
      bronchial hyperreactivity of patients with bronchial asthma. The in vitro assay
      for Df-induced IL2 responsiveness by lymphocytes might reflect the in vitro
      immediate, late and/or delayed type hypersensitivity.

PMID- 8347095
TI  - The dysfunction of peripheral blood dendritic cells in patients with mixed
      connective tissue disease.
AB  - The morphological findings and functions of peripheral blood dendritic cells (DC)
      from patients with mixed connective tissue disease (MCTD) were compared with
      those of DC from normal subjects. DC from both groups possessed typical dendritic
      processes and showed HLA-DR antigens and C3bi receptor. The autologous mixed
      lymphocyte reaction (MLR) and autologous concanavalin A (Con A)-induced T cell
      proliferation using DC as stimulating cells and accessory cells were
      significantly depressed in patients with MCTD. In the allogeneic MLR and
      allogeneic Con A responses, DC from patients with MCTD were poorer stimulating
      cells and accessory cells. The dysfunction of DC also, as one of the various
      immune abnormalities, must play a role in the appearance of clinical features.

PMID- 8347096
TI  - Lung functions and chest radiographs in shipyard workers exposed to asbestos.
AB  - Lung functions and diffusing capacity for carbon monoxide were examined in 299
      shipyard workers occupationally exposed to asbestos, among whom there was an
      equal number of smokers and non-smokers. The workers were classified into groups
      according to the lung fibrosis profusion and the length and width of the pleural
      plaques in accordance with the 1980 ILO International Classifications of
      Pneumoconioses. With regard to the profusion of the parenchyma, workers
      classified in category 2 (subcategories 2/1 and 2/2) had significantly lower FVC
      and FEV1 values than the workers in categories 0 (P < 0.01) and 1 (P < 0.05).
      With an increase in the category of profusion there was a trend towards a fall in
      mean MEF25, MEF50 and MEF75 values, but it was not significant. Diffusing
      capacity for carbon monoxide was identical for all categories. There were no
      significant differences between the workers without pleural plaques and those
      with visible plaques in respect to lung function values. With an increase in the
      length and width of the plaques FVC, FEV1, MEF25 and MEF75 values tended to
      become lower. The results demonstrate that the changes detected on the
      radiographs of the lungs and pleura are the early indicators of possible asbestos
      disease in shipyard workers.

PMID- 8347097
TI  - Thoron activity level and radon measurement by a nuclear track detector.
AB  - Radon activity concentrations in the air were measured with LR-115 nuclear track
      detectors at three locations in Osijek. The respective equilibrium factors and
      the effective dose equivalents were determined. Indoor concentrations were from
      9.8 to 58.2 Bq m-3 and relative errors of the track etching method were near 19
      per cent. The indoor alpha potential energy of the radon and thoron progenies was
      measured with an ISD detector. Independent measurements, performed with a Radhome
      semiconductor detector, showed that the indoor thoron concentration was nearly 20
      per cent of the radon one.

PMID- 8347098
TI  - A selection of biological indicators in occupational exposure to toluene and
      xylene.
AB  - Results of a comparative study of occupational exposure to toluene and xylene are
      presented. The study was carried out in a group of 24 workers from a paint
      factory and aimed to determine the most appropriate exposure indicators for use
      in biological monitoring. Measurements included toluene and xylene in blood and
      their metabolites in urine. Toluene in blood proved to be the best indicator of
      toluene exposure, and both xylene in blood and its only major metabolite
      methylhippuric acid in urine to be reliable indicators of xylene exposure. The
      validity of hippuric acid and o-cresol as toluene exposure indicators has not
      been confirmed.

PMID- 8347099
TI  - Some ecological characteristics of a brook water.
AB  - The water of a mountain brook was analysed and selected water quality parameters
      were determined. The pristine mountain brook water contained the smallest numbers
      of microorganisms whereas in the polluted water body downstream, the values of
      chemical oxygen demand, biochemical oxygen demand after five days and the count
      of specific indicator organisms (faecal coliforms) were increased.

PMID- 8347101
TI  - [Protection of the Croatian population from accidental radioactive contamination
      of the food chain].
AB  - The paper indicates the importance of investigating radionuclide translocation in
      the human food chain, and the contribution of selected food components in total
      exposure of the population after accidental radioactive contamination. Data on
      radioactive contamination and risk assessment of the Croatian population after
      the Chernobyl nuclear accident are given and possibilities of decontamination of
      food chain components are discussed. Literature data on radionuclide removal from
      the human food chain are compared to the results of own investigations. Emphasis
      is placed on biologically most important radionuclides, 131I, 90Sr, 137Cs, and
      the most effective means of protection are sought. The preventive measures
      following a nuclear accident should be based on the cost-benefit principle i.e.
      the damage from applying radiation protection measures should not exceed the
      benefit from possible dose reduction.

PMID- 8347100
TI  - [Immunologic reactions, respiratory symptoms and ventilatory capacity in jute and
      sisal textile workers].
AB  - Allergic reactions in relation to respiratory symptoms and ventilatory capacity
      were studied in 41 textile workers employed in the processing of jute and sisal.
      Only 5.0% of the jute workers and 9.5% of the sisal workers demonstrated positive
      skin reactions to jute or sisal allergens. Increased IgE was found in 9.8% of the
      textile workers. Among 35 control workers 11.4% reacted with a positive skin
      reaction to the jute or sisal allergen and 2.9% had increased IgE. Chronic
      respiratory symptoms as well as changes in ventilatory capacity were found in
      textile workers with positive and negative skin tests. Our data suggest that
      immunological reactions are not likely to be responsible for the development of
      respiratory impairment in textile workers exposed to jute and sisal dust.

PMID- 8347102
TI  - Delayed effects of lead on the kidney--factor analysis.
AB  - A late, i.e. delayed, effect of lead on kidney function and blood pressure was
      studied in 23 workers with a history of occupational lead poisoning. Twenty lead
      exposed workers with no known history of lead poisoning were a positive control.
      Four important factors out of 11 combined variables derived from 22 single
      variables were identified by factor analysis. The first factor comprised the
      variables kidney function, blood pressure, age, duration of lead exposure and the
      number of previous lead poisonings. The second factor comprised the variables
      duration of lead exposure and biological indicators of lead exposure. The third
      factor correlated the frequency of previous lead poisonings with the renal blood
      flow, erythrocytic protoporphyrin and age. The fourth factor comprised the
      variables length of work service, creatinine clearance and erythrocytic
      protoporphyrin. The results confirm the presence of the adverse late effect of
      previous occupational lead poisoning on kidney function regardless of treatment.
      The phenomenon is not a single event but a complex interplay of past lead
      poisoning, duration of exposure to lead, "normal" age effect on an increase in
      systolic and diastolic blood pressure and blood creatinine and a decrease in
      renal function as revealed by decreased creatinine clearance and a slow down in
      renal flow time. The complexity of dealing with the confounding variable of age
      and lack of appropriate classification of renal function impairment may account
      for the conflicting results of chronic lead effect upon kidney function in the
      past. The kidney appears to be a critical target organ, reflecting the total lead
      body burden in chronic lead exposure and poisoning. Therefore monitoring of
      kidney function in lead exposed workers needs to be mandatory.

PMID- 8347103
TI  - [Plasma amino acid levels in alcoholics].
AB  - Plasma aromatic amino acid (AAA) and branched-chain amino acid (BCAA)
      concentrations were determined in 197 alcoholics. The BCAA/AAA molar ratio in
      patients with alcohol withdrawal symptoms was compared with the ratio in patients
      without such symptoms. The BCAA/AAA molar ratio in patients with emotional
      disturbance or with transient hallucination was significantly lower than that in
      patients without these symptoms. The BCAA/AAA molar ratio tended to be lower in
      patients with alcohol withdrawal convulsion or with delirium tremens as compared
      to patients without such symptoms. The BCAA/AAA molar ratio had a negative
      correlation with plasma total bilirubin and LDH and had a positive correlation
      with plasma choline esterase and albumin. Oral administration of amino acid
      preparations (Aminoleban EN) to the patients elevated the BCAA/AAA molar ratio
      and normalized liver function. These results indicate that abnormalities of amino
      acid metabolism caused by liver damage in alcohol dependence may have an
      important role in the pathogenesis of alcohol withdrawal syndrome.

PMID- 8347104
TI  - [Effect of ethanol on isometric tone of aorta from guinea pig].
AB  - Using aortic strips isolated from guinea pig, effects of ethanol on vascular
      smooth muscle tone were studied. Low concentrations (5, 50, 100 mM) of ethanol
      potentiated norepinephrine and serotonin-induced contractions, but not KCl
      induced one. Ethanol (100 mM) potentiated calcium-induced contraction in the
      presence of norepinephrine, but not that in the presence of KCl. Ethanol (100 mM)
      showed no effects on norepinephrine-induced contraction in the calcium-free
      medium. Ethanol (100 mM) augmented 45Ca uptake stimulated with norepinephrine,
      but not that with KCl. Ethanol at the higher concentration of 600 mM by itself
      induced contraction, which was inhibited by trifluoperazine or in the calcium
      free medium, but not by phentolamine, diphenhydramine, methysergide, indomethacin
      or nifedipine. Ethanol (600 mM) directly increased 45Ca uptake, which was not
      affected by nifedipine. These findings indicate that the low concentrations of
      ethanol potentiate receptor-mediated vascular smooth muscle contraction and the
      higher concentration of ethanol directly contracts it via facilitation of
      transmembranous calcium influx.

PMID- 8347105
TI  - [Alcohol and sudden death: a survey on alcohol-related deaths at tokyo
      Metropolitan Medical Examiner's Office (1989)].
AB  - Seven thousand three hundred seventy-six sudden or violent manner of deaths were
      inspected or autopsied at Tokyo Metropolitan Medical Examiner's Office in 1989.
      Out of these victims, 693 (9.4%) victims were regarded as heavy drinkers on the
      basis of the drinking habits and the autopsy reports and 196 (2.7%) victims
      without past problem drinking were thought to be drunk at death from the family
      statements or the blood alcohol analysis. The total 889 (12.1%) alcohol-related
      cases (autopsy was performed on the 489 cases) were studied from epidemiological
      and etiological viewpoints. The average age of the alcohol-related victims (male:
      811, female: 78) was 52 +/- 11 years. In middle-aged (45-54 years) men, 34% of
      the all sudden or violent deaths were alcohol-related. About half of the alcohol
      related victims were living alone and jobless and they often died at home,
      particularly in the bed. In the alcohol-related victims, the blood alcohol
      concentration (BAC) analysis revealed that the average BAC of female was
      significantly higher than that of male. (2.12 +/- 1.73 mg/ml vs. 1.33 +/- 1.75, P
      < 0.01). This difference may be associated with sex difference in ethanol
      metabolism, body composition and drinking habits. Among the major causes of the
      alcohol-related deaths, alcoholic liver diseases accounted for 226 (25%), gastro
      intestinal bleedings for 115 (13%), cardiovascular diseases for 105 (12%) and
      violent deaths (e.g., acute alcohol intoxication, falls, traffic accidents,
      suicide) for 329 (37%). By histopathological examination of the liver, about 30%
      of the alcoholic liver disease cases showed mainly fatty metamorphosis and 48%
      showed liver cirrhosis. Only 12% of the cirrhotics had either jaundice or
      ascites, suggesting hepatic failure. Alcoholic cardiomyopathy was suspected in
      only 11 cases. In conclusion, many people, particularly middle-aged men, lose
      their lives due to heavy drinking and there are many pathologically unexplainable
      sudden deaths of alcoholics.

PMID- 8347106
TI  - Occupational health and safety learning on the job.

PMID- 8347107
TI  - Sorrow and strength.

PMID- 8347108
TI  - What did we learn from the federal election?

PMID- 8347109
TI  - A message to enrolled nurses covered by federal awards.

PMID- 8347111
TI  - Consent issues in psychiatric nursing.

PMID- 8347110
TI  - Health care economics. Part 2: The Australian health care "jigsaw".
AB  - In this article we look at how the health care industry is organised in Australia
      and make some international comparisons. First, we examine how Australia has
      reached the present, rather confusing set of arrangements--what the Macklin
      inquiry has called the health "jigsaw". Then we outline the current arrangements-
      how responsibilities are divided between local, state and federal governments;
      and the contribution of the private sector. Finally, we present international
      data to provide some comparative perspective on Australia's health care
      arrangements.

PMID- 8347112
TI  - Putting stress into words: health, linguistic, and therapeutic implications.
AB  - When individuals are asked to write or talk about personally upsetting
      experiences, significant improvements in physical health are found. Analyses of
      subjects' writing about traumas indicate that those whose health improves most
      tend to use a higher proportion of negative emotion words than positive emotion
      words. Independent of verbal emotion expression, the increasing use of insight,
      causal, and associated cognitive words over several days of writing is linked to
      health improvement. That is, the construction of a coherent story together with
      the expression of negative emotions work together in therapeutic writing.
      Evidence of these processes are also seen in specific links between word
      production and immediate autonomic nervous system activity. Implications for
      therapy and for considering the mind and body as fluid, dynamic systems are
      discussed.

PMID- 8347113
TI  - The effects of distraction during exposure to phobic stimuli.
AB  - Theoretical conceptualizations regarding the role of attentional focus during
      exposure-based treatments for fear and anxiety suggest that distraction
      interferes with the mechanisms required for fear reduction, typically by
      preventing emotional and/or cognitive processing of the phobic stimulus and
      response. The present discussion reviews the current literature and demonstrates
      the paucity of empirical evidence supporting such notions. Seemingly conflicting
      findings are integrated upon close examination of the various qualitative
      dimensions of the distracters employed. These characteristics, which differed
      substantially across studies, include the nature of the attentional demand posed
      by the distracter (e.g. cognitive vs sensory demand) as well as the distracter's
      affective quality (e.g. neutral vs relaxing). The effects of differing dimensions
      of distraction on fear reduction, in addition to interaction with aspects of the
      exposure situation, are discussed. The need for further investigation of the
      qualitative dimensions of distraction, including their operational specification,
      is recognized. Finally, recommendations for future research are made.

PMID- 8347114
TI  - Effects of anxiety and awareness on colour-identification latencies for emotional
      words.
AB  - A modified Stroop task was used to examine the interference effects of subliminal
      and supraliminal emotional words on the colour-identification latencies of high
      and low trait anxious subjects. The subjects were randomly allocated to either an
      anxiety or relaxation mood induction procedure (MIP) before the modified Stroop
      task. Increased trait anxiety was associated with relatively greater interference
      in colour-identification latencies for subliminal threat stimuli. Reduced state
      anxiety was associated with relatively more interference of subliminal positive
      stimuli (mood-congruent effect), but also with greater interference of
      supraliminal threat stimuli (mood-incongruent effect). The results suggest that
      mood-congruent effects may be mediated by automatic processes, whereas controlled
      processes may give rise to mood-incongruent effects.

PMID- 8347115
TI  - Is optimism heritable? A study of twins.
AB  - Is optimism heritable? We gave the Attributional Style Questionnaire (ASQ), a
      measure of optimism, to 115 monozygotic twin pairs (MZ) and 27 dizygotic twin
      pairs (DZ). The intraclass correlations of the ASQ scores were 0.48 for MZ twins
      (P < 0.0001) and 0 for DZ twins. Though the sample size of DZ twins is small,
      these results suggest that there may be a substantial genetic effect on optimism.
      We speculate, however, that the mechanism for the transmission of this, and other
      complex personality traits, may be highly indirect.

PMID- 8347116
TI  - Habituation and dishabituation of male sexual arousal.
AB  - Sixteen men were tested under conditions where they viewed the same segment of
      erotic film on many occasions or engaged repeatedly in the same erotic fantasy.
      Decrements in penile tumescence and subjective sexual arousal over trials were
      accompanied by reports from Ss that they felt less absorbed in the events
      depicted in film or fantasy (and in the case of fantasy, that the images they
      formed became less vivid). Analysis of covariance showed that habituation
      (reduction in physiological and subjective measures of sexual arousal over
      trials) was less when allowance was made for the manner in which absorption (and
      in vividness of imagery in the case of fantasy) changed during erotic
      stimulation. Increases in sexual arousal when novel erotic stimulation was
      introduced following habituation, as well as the dishabituation found when the
      original stimulus was reinstated, also correlated with the extent absorption and
      vividness of imagery shifted under these conditions. The results are discussed
      with reference to whether habituation of male sexual arousal is mediated by
      changes that occur in absorption and other aspects of information processing
      during repeated erotic stimulation.

PMID- 8347117
TI  - Prospective associations among family form, family processes, and adolescents'
      alcohol and drug use.
AB  - The present study was designed to disentangle and define the unique contributions
      of family form and family processes to substance use and association with deviant
      peers among adolescents. Eighty adolescents and their mothers participated in the
      study; half were from divorced single-parent families and half were from families
      in which the parents were still married. Maternal assessments of interparental
      conflict and the quality of the mother-adolescent relationship were used to
      prospectively forecast adolescent reports of substance use and affiliation with
      deviant peers one year later. The results revealed that mother-adolescent
      conflict predicted adolescent alcohol use, and maternal acceptance-rejection
      predicted both drug use and affiliation with deviant peers. These findings
      support the hypothesis that family processes rather than family form forecast
      adolescents' substance use and deviant peer affiliation. Clinical implications of
      the findings are discussed.

PMID- 8347118
TI  - The representation of feared outcomes.
AB  - A list of negative outcomes (harmful events) was constructed to investigate the
      nature and organization of outcome concerns in anxiety. In Study 1, analysis of
      worry frequency ratings for the 116 negative outcomes revealed two major
      correlated factors corresponding to physical outcomes (harm or misfortune) and
      social outcomes (negative evaluation). These higher-order factors could be
      further subdivided into smaller discrete categories of related concerns. Ratings
      of worry frequency were higher for social outcomes. Trait anxiety was associated
      with both physical and social concerns, but stress and depression were primarily
      associated with social concerns. In Study 2, aversiveness ratings for the 116
      negative outcomes followed the same physical-social organization and formed
      similar lower-order categories. Unlike the worry frequency ratings, aversiveness
      ratings were higher for physical than social categories, and did not correlate
      substantially with trait measures of depression, anxiety or stress. In Study 3, a
      short (24-item) negative outcome questionnaire was developed to discriminate
      between concerns about physical and social outcomes. The Physical Scale
      correlated substantially with the Anxiety Sensitivity Index (ASI) but not the
      Fear of Negative Evaluation (FNE), whereas the Social Scale correlated with the
      FNE but not the ASI. The Penn State Worry Questionnaire (PSWQ), which assesses
      worry frequency but not content, correlated only with the Social Scale.
      Implications for theories of normal and clinical anxiety are discussed.

PMID- 8347119
TI  - Verbalization and environmental cuing in thought suppression.
AB  - Research on thought suppression has yielded a morass of conflicting results.
      While some studies show that suppression of a thought results in a rebound effect
      (i.e. a heightened frequency of this thought later on), other studies failed to
      demonstrate this phenomenon. The first aim of the present study was to
      investigate whether the method used to study stream of consciousness
      (verbalization vs thinking silently) affects the report of target thoughts in a
      thought suppression experiment. Second, the claim that environmental cuing (i.e.
      distraction by directing attention towards external cues) is the mechanism behind
      the recurrence of suppressed items was examined. Results indicated that the
      method used to monitor stream of consciousness did not modulate the report of
      target thoughts: in fact, no rebound effect occurred. However, results did
      support the suggestion that heightened frequencies of suppressed material are
      related to environmental cuing.

PMID- 8347120
TI  - Arousal training for children suffering from nocturnal enuresis: a 2 1/2 year
      follow-up.
AB  - Arousal Training is a fast, simple, and effective form of bibliotherapy for
      nocturnal enuresis with non-clinical children between 6 and 12 years of age. The
      parents act as therapists. They reward the operant behavior-pattern following the
      urine alarm. The success rate is 98% (N = 41), which is significantly high when
      compared to the control conditions (79%, N = 86). There was a response rate of
      100% and no drop-out from therapy. All parents (N = 127) completed and returned
      the record. The results of a follow-up of this bibliotherapy (N = 113) 2 1/2
      years later are presented. The success rate of Arousal Training was still
      significantly higher (92% continent) when compared to the urine device with
      specific instructions (77%) and urine alarm only (72%). Arousal Training is the
      treatment of choice for non-clinical enuretic children between 6 and 12 years of
      age.

PMID- 8347121
TI  - The utilisation of working memory by worry.
AB  - Sixty-eight undergraduate students were randomly allocated to one of four task
      conditions and required to worry about a topic of importance to them while
      simultaneously performing the task to which they had been allocated. The tasks
      differed in their ability to interfere with worrying. Generation of random
      letters was the only task to interfere significantly with the ability to worry.
      There was a nonsignificant tendency for articulatory suppression to produce some
      interference with worrying while visuo-spatial tasks did not affect the ability
      to worry. There was no difference in results between self-reported worriers and
      non-worriers. The results seem to indicate that worry primarily utilises the
      phonological aspect of the central executive of working memory.

PMID- 8347122
TI  - Preservation of the rate and profile of xenobiotic metabolism in rat hepatocytes
      stored in liquid nitrogen.
AB  - A simple procedure for cryopreservation of rat hepatocytes that allows recovery
      of viable cells retaining activities of phase I and phase II drug metabolism
      equivalent to freshly isolated cells is described. The cooling process was
      initiated 30 min after incubation of freshly isolated hepatocytes at 37 degrees
      in Krebs-Ringer bicarbonate buffer containing 15 mM glucose to allow for
      metabolic equilibration. At the end of this period, hepatocyte suspensions were
      supplemented with 1.7% albumin, 13.3% dimethyl sulfoxide, and the synthetic
      buffers, 3-[N-morpholino]propanesulfonic acid (MOPS) and N-[2
      hydroxyethyl]piperazine-N'-[2-ethanesulfonic acid] (HEPES). Hepatocytes were
      cooled in a stepwise manner to -196 degrees by holding the cells for 1 hr at -20
      degrees and then for 1 hr at -70 degrees before transfer into liquid nitrogen.
      After thawing and removal of damaged cells by centrifugation in Percoll, the
      total recovery of viable hepatocytes subjected to freezing was about 42%. The
      contents of ATP, ADP, and AMP were not altered significantly in cells stored in
      liquid nitrogen. The metabolic competence of cryopreserved hepatocytes was
      further confirmed by their ability to synthesize urea from NH4Cl and ornithine at
      the same high rate that was observed in freshly isolated cells (693 +/- 68 and
      740 +/- 68 nmol.mg dry wt-1 x hr-1, respectively). Similarly, cryopreservation
      did not affect drug-metabolizing systems as indicated by the metabolism of
      benzo[a]pyrene and 7-ethoxycoumarin, two model substrates. In both freshly
      isolated and cryopreserved hepatocytes, 7-ethoxycoumarin was O-deethylated to 7
      hydroxycoumarin at essentially the same rates (8.66 +/- 0.75 and 8.25 +/- 0.53
      nmol.mg dry wt-1.hr-1, respectively) and 7-hydroxycoumarin accumulated in
      hepatocyte suspensions almost exclusively in the conjugated form. The storage of
      hepatocytes in liquid nitrogen also did not affect the complex metabolism of
      benzo[a]pyrene to total oxygenated metabolites and, more importantly, to
      metabolites conjugated with glutathione, glucuronic acid, and sulfuric acid.
      Thus, cryopreserved hepatocytes represent a valid and convenient model to study
      drug biotransformation in intact cells.

PMID- 8347123
TI  - Metabolic activation of n-butyraldoxime by rat liver microsomal cytochrome P450.
      A requirement for the inhibition of aldehyde dehydrogenase.
AB  - n-Butyraldoxime (n-BO) is known to cause a disulfiram/ethanol-like reaction in
      humans, a manifestation of the inhibition of hepatic aldehyde dehydrogenase
      (AIDH). As with a number of other in vivo inhibitors of AIDH, n-BO does not
      inhibit purified AIDH in vitro, suggesting that a metabolite of n-BO is the
      actual inhibitor of this enzyme. In re-examination of the effect of n-BO on blood
      acetaldehyde levels following ethanol in the Sprague-Dawley rat, we found that
      pretreatment with substrates and/or inhibitors of cytochrome P450 blocked the n
      BO-induced rise in blood acetaldehyde in the following order of decreasing
      potency: 1-benzylimidazole (0.1 mmol/kg) > 3-amino-1,2,4-triazole (1.0 g/kg) >
      ethanol (3.0 g/kg) > phenobarbital (0.1% in the drinking water, 7 days) > SKF
      525A (40 mg/kg). Rat liver microsomes were shown to catalyze the conversion of n
      BO to an active metabolite that inhibited yeast AIDH. This reaction was dependent
      on NADPH and molecular oxygen and was inhibited by CO and 1-benzylimidazole.
      Hydroxylamine, postulated by others to be a metabolite of n-BO, inhibited AIDH
      via a catalase-mediated reaction and not through an NADPH-supported microsome
      catalyzed reaction. Using GLC-mass spectrometry, 1-nitrobutane (an N-oxidation
      product) and butyronitrile (a dehydration product) were identified as metabolites
      from microsomal incubations of n-BO. However, neither of these metabolic products
      inhibited AIDH directly or in the presence of liver microsomes and NADPH. We
      conclude that another NADPH-dependent, cytochrome P450-catalyzed metabolic
      product of n-BO is responsible for the inhibition of AIDH by n-BO.

PMID- 8347124
TI  - An investigation into the formation of stable, protein-reactive and cytotoxic
      metabolites from tacrine in vitro. Studies with human and rat liver microsomes.
AB  - Tacrine (1,2,3,4-tetrahydro-9-aminoacridine hydrochloride; THA) is known to
      undergo extensive oxidative metabolism to a variety of mono- and dihydroxylated
      metabolites in animals and humans. The potential for tacrine to undergo
      metabolism to stable, protein-reactive and cytotoxic metabolites has been
      investigated in incubations with human and rat liver microsomes. Using
      lymphocytes as sensitive markers to quantify cytotoxicity, THA (50 microM)
      underwent NADPH-dependent bioactivation to a cytotoxic metabolite(s). NADPH
      dependent cytotoxicity in the presence of rat and human microsomes was 9.8 +/-
      3.1% (P < 0.05 cf. -NADPH control) and 6.2 +/- 2.0% (P < 0.05 cf. -NADPH
      control), respectively. Stable and protein-reactive metabolites were also formed
      in microsomes from both species. These accounted for 28.2 +/- 12.7% and 1.22 +/-
      0.79% of incubated radioactivity in human microsomes and 6.4 +/- 2.2% and 0.4 +/-
      0.1% of incubated radioactivity in rat microsomes. In microsomes pooled from six
      human livers the NADPH-dependent cytotoxicity was 9.4 +/- 1.1%. Formation of
      stable and protein-reactive metabolites accounted for 29.2 +/- 2.3% and 1.2 +/-
      1.0% of incubated radioactivity. Reduced glutathione (500 microM) completely
      blocked NADPH-dependent cytotoxicity and inhibited protein-reactive metabolite
      formation by 60% (P < 0.05). Ascorbic acid (500 microM) inhibited the generation
      of cytotoxic and protein-reactive metabolites by 75% (P < 0.05) and 35% (P <
      0.05), respectively. Cyclohexene oxide was without effect. Human serum albumin
      was found to protect the lymphocytes against toxicity. In microsomes prepared
      from the livers of four donors known to have been smokers there were no
      significant differences in the generation of metabolites from THA compared with
      microsomes prepared from livers of non-smokers. Enoxacin, a specific inhibitor of
      cytochrome P450 1A2 significantly inhibited all routes of THA metabolism. We have
      therefore demonstrated that THA may be oxidatively metabolized to stable, protein
      reactive and cytotoxic metabolites in human and rat liver microsomes. A number of
      inhibitors may affect these process, whilst inhibition by enoxacin indicates a
      role for cytochrome P450 1A2 in THA metabolism.

PMID- 8347125
TI  - Cytochrome P450 in trypanosomatids.
AB  - Post-mitochondrial supernatant extracts prepared from bloodstream forms of
      Trypanosoma brucei brucei, T. cruzi epimastigotes, Leishmania donovani
      promastigotes and Crithidia fasciculata have been found to catalyse cytochrome
      P450-dependent reactions. Appreciable ethoxycoumarin deethylase and
      ethoxyresorufin deethylase activities were found in all of the above
      trypanosomatids, with T. cruzi epimastigotes having the highest activity (57.1
      and 10.7 pmol/min/mg protein, respectively). In all four species these reactions
      were inhibited by the cytochrome P450 inhibitors carbon monoxide, proadifen and
      metyrapone. In contrast to rat liver microsomes, the trypanosomatid extracts
      showed no detectable pentoxyresorufin depentylase or pentamidine hydroxylase
      activity. Both C. fasciculata and T. b. brucei post-mitochondrial supernatants
      showed carbon monoxide difference spectra consistent with the presence of
      cytochrome P450 (9.6 and 6.3 pmol/mg protein, respectively). An additional
      hemoprotein which gave a carbon monoxide difference peak at 420 nm was also
      detected in C. fasciculata and T. b. brucei microsomes and C. fasciculata
      mitochondria. Subcellular fractionation of both early and late log C. fasciculata
      showed that the ethoxycoumarin deethylase activity was enriched in the microsomal
      fraction.

PMID- 8347126
TI  - Comparison of the effects of L-carnitine, D-carnitine and acetyl-L-carnitine on
      the neurotoxicity of ammonia.
AB  - Although L-carnitine has been reported to have protective effects against ammonia
      toxicity, conflicting results have also been presented and the mechanisms
      underlying the protection, if any, are not clear. In the present study, we
      examined the effects of L-carnitine, D-carnitine and acetyl-L-carnitine on the
      neurotoxicity of ammonia. Administration of ammonium acetate (15 mmol/kg) to mice
      caused seizures, elevation of blood ammonia and urea concentrations, and marked
      alterations of brain energy metabolites. Pretreatment with either L-carnitine, D
      carnitine or acetyl-L-carnitine reduced the frequency of the seizures, prolonged
      the time until the first fit, lowered the levels of ammonia in the blood and
      brain, and suppressed the alterations of brain energy metabolites caused by
      hyperammonemia. there was no significant difference between L- and D-carnitine in
      the potency to inhibit the seizures. In addition, there was no difference between
      the two chemicals in the potency to decrease the ammonia contents in the blood
      and brain, or to suppress the alterations of energy metabolites in the brain.
      When compared with L-carnitine, however, acetyl-L-carnitine better preserved ATP
      in the brain, while it lowered ammonia in the blood and brain less markedly.
      These results show that L-carnitine and its analogues do have the potential to
      suppress the neurotoxicity of ammonia. Moreover, the results suggest that the
      protective effects of carnitine against the toxicity of ammonia are systemic,
      that the action of acetyl-L-carnitine may differ from that of L- or D-carnitine,
      and that the "classical" function of carnitine is not the sole mechanism
      underlying the suppression of the neurotoxicity of ammonia.

PMID- 8347127
TI  - An unexpected pathway for the metabolic degradation of 1,3-dialkyl-3
      acyltriazenes.
AB  - In the presence of NADPH, rat liver microsomes catalyzed the degradation of a
      series of 1,3-dialkyl-3-acyltriazenes, and the extent of the reaction was
      correlated with compound lipophilicity. In the case of two
      methylcarbamoyltriazenes, 1-(2-chloroethyl)-3-benzyl-3- (methylcarbamoyl)triazene
      (CBzM) and 1-(2-chloroethyl)-3-methyl-3-(methylcarbamoyl)triazene (CMM),
      microsomal metabolites were isolated. Identification of the CBzM metabolites as 1
      (2-chloroethyl)-3-benzyl-3-(hydroxymethylcarbamoyl)triazene and 1-(2-chloroethyl
      3-benzyl-3-carbamoyltriazine, and the CMM metabolite as 1-(2-chloroethyl)-3
      methyl-3-(hydroxymethylcarbamoyl)triazene indicated that the first metabolic step
      involves hydroxylation of the methylcarbamoyl substituent. Detailed studies of
      the metabolism of CBzM indicated that the Km for the reaction was 84 microM, and
      that metabolism was more efficient if microsomes were prepared from male than
      from female rats. During prolonged incubation, the metabolites of CBzM were also
      degraded. The degradation of CBzM and its metabolites was inhibited by SKF-525A
      and metyrapone, suggesting the involvement of a cytochrome P450 isozyme, and
      supporting the hypothesis that the process is oxidative rather than hydrolytic in
      both cases. Metabolic oxidation represents an alternative pathway to chemical or
      enzymatic hydrolysis for the in vivo decomposition of (methylcarbamoyl)triazenes.
      This mechanism may ultimately explain the antitumor efficacy and low acute
      toxicity of selected compounds.

PMID- 8347128
TI  - Highly cooperative inhibition of acetylcholinesterase by pentachlorophenol in
      human erythrocytes.
AB  - Pentachlorophenol (PCP) inhibited acetylcholinesterase (AchE) activity in human
      erythrocyte membranes with high cooperativity. The Hill coefficient for the
      inhibition was 4-5 in "untreated" membranes. Differences in the temperature (13,
      25 and 37 degrees) or treatment with 1% Triton X-100 did not clearly affect the
      cooperativity which, however, increased after the erythrocyte membranes were
      treated with 2-mercaptoethanol and iodoacetatic acid, suggesting that higher
      cooperativity in the inhibition of AchE by PCP may reflect conformational changes
      of AchE. Thus, PCP may be useful for the study of AchE in human erythrocytes.

PMID- 8347129
TI  - Mitomycin C stimulates the expression of human immunodeficiency virus long
      terminal repeat sequences in rat and human fibroblasts.
AB  - We have employed a recombinant plasmid, pBHIV1, carrying the long terminal repeat
      (LTR) sequences of the human immunodeficiency virus-1 (HIV-1) linked to the
      reporter chloramphenicol acetyl transferase (CAT) gene and to the aminoglycoside
      phosphotransferase (aph) gene as a selectable marker. We have introduced pBHIV1
      into rat 208F and human MRCSV40TGR fibroblasts and obtained stable geneticin
      resistant RFBHIV1-1 and SVTGHIV1-1 cells, respectively. Both transfectant cells
      express CAT activity from the HIV LTR promoter. The response to the
      antineoplastic drug mitomycin C was studied on the LTR regulated CAT activity in
      both cell lines. It was found that mitomycin C at 10 micrograms/mL concentration
      stimulates the expression of CAT from the HIV LTR 77-fold in rat RFBHIV1-1 and
      3.1-fold in human SVTGHIV1-1 cells.

PMID- 8347131
TI  - Ascorbate-dependent elevation of mRNA levels for cytochrome P450s induced by
      polychlorinated biphenyls.
AB  - Trichlorobiphenyl induced only CYP1A2 mRNA, while pentachlorobiphenyl induced
      both CYP1A2 and CYP2B1 mRNAs in rat liver. The mRNA levels for these P450s were
      elevated when ascorbic acid-deficient ODS rats (mutant rats with a hereditary
      osteogenic disorder) were fed a diet supplemented with ascorbic acid. The amount
      of CYP2B1 mRNA increased rapidly and reached a maximum level of approximately
      double within 24 hr of injection of pentachlorobiphenyl. Thereafter, the amount
      of its mRNA decreased to a steady level. This pattern was roughly paralleled by
      changes in the amount of CYP1A2 mRNA.

PMID- 8347132
TI  - The effect of 2-substituted thiazolidine-4(R)-carboxylic acids on non-protein
      sulphydryl levels and sulphurtransferase activities in mouse liver and brain.
AB  - 2-Substituted thiazolidine-4(R)-carboxylic acids (TD) were found to increase the
      concentration of non-protein sulphydryls (NPSH) and the activity of rhodanese
      (thiosulphate sulphurtransferase, EC 2.8.1.1) and 3-mercaptopyruvate
      sulphurtransferase (EC 2.8.1.2) in mouse liver. These properties suggest TDs are
      potentially hepatoprotective compounds. However TDs also cause depletion of NPSH
      in the mouse brain and this may be the reason for their toxic side effects on the
      central nervous system.

PMID- 8347130
TI  - Antihepatotoxic effects of major diterpenoid constituents of Andrographis
      paniculata.
AB  - The diterpenes andrographolide (I), andrographiside (II) and neoandrographolide
      (III) isolated from Andrographis paniculata were investigated for their
      protective effects on hepatotoxicity induced in mice by carbon tetrachloride or
      tert-butylhydroperoxide (tBHP) intoxication. Pretreatment of mice with the
      diterpenes (I, II & III; 100 mg/kg, i.p.) for 3 consecutive days produced
      significant reduction in malondialdehyde formation, reduced glutathione (GSH)
      depletion and enzymatic leakage of glutamic-pyruvate transaminase (GPT) and
      alkaline phosphatase (AP) in either group of the toxin-treated animals. A
      comparison with the known hepatoprotective agent silymarin revealed that I
      exhibited a lower protective potential than II and III, which were as effective
      as silymarin with respect to their effects on the formation of the degradation
      products of lipid peroxidation and release of GPT and AP in the serum. GSH status
      was returned to normal only by III. The greater protective activity of II and III
      could be due to their glucoside groups which may act as strong antioxidants.

PMID- 8347133
TI  - Quantitative determination of human aldose reductase by enzyme-linked
      immunosorbent assay. Immunoassay of human aldose reductase.
AB  - An antibody-sandwich enzyme-linked immunosorbent assay (ELISA) for evaluating
      tissue levels of aldose reductase was developed using a polyclonal antibody
      prepared against the recombinant enzyme expressed in a baculovirus system. The
      specificity of this antibody to aldose reductase was verified by
      immunoprecipitation, immunoblotting and ELISA. The polyclonal antibody did not
      crossreact with human aldehyde reductase, an enzyme in the same aldo-keto
      reductase family structurally and functionally related to aldose reductase. The
      sensitivity and specificity of this assay method enabled direct determination of
      aldose reductase level in various human tissues including the erythrocyte. The
      highest level of aldose reductase was detected in the kidney medulla among
      tissues investigated. More than a 2-fold variability in the erythrocyte aldose
      reductase was demonstrated among healthy individuals, indicating the
      heterogeneity of this enzyme expression in a human population. This assay system
      may be useful for direct measurement of the level of tissue aldose reductase in
      conjunction with the evaluation of the efficacy of aldose reductase inhibitors
      prescribed for the treatment of diabetic complications.

PMID- 8347134
TI  - Alterations in rat hepatic drug metabolism during pregnancy and lactation.
AB  - The hepatic microsomal drug metabolism during pregnancy and lactation was
      studied. Four days post partum, the concentrations of cytochrome P450 and
      cytochrome b5 were reduced by 50% when compared with pregnant rats, at day 10 of
      gestation. Within this time period the N-demethylation of aminopyrine, the rate
      of aldrin epoxidation and the N-demethylation of demethylnitrosamine was reduced
      by 53, 74 and 21%, respectively. However, the rates of ethoxyresorufin-O
      deethylation did not differ amongst both groups and the deethylation of 4
      nitroanisole and the 4-hydroxylation of aniline was increased by 71 and 31%,
      respectively in lactating rats. Furthermore, the activities of UDP
      glucuronyltransferase and glutathione S-transferase were increased by 21 and 27%,
      but those of epoxide hydrolase were reduced by 85%. Western immunoblot analysis
      of microsomal proteins obtained from pregnant and lactating rats shows that only
      proteins encoded by the genes of CYP2C6 and CYP3A1 are expressed at detectable
      levels, whereas the expression of CYP1A1, CYP1A2, CYP2A1, CYP2B1, CYP2E1 and
      CYP4A1 was not detectable in pregnant and lactating rats at a protein loading of
      3 micrograms total protein per well. In contrast, in northern blot hybridization
      experiments, detectable amounts of mRNA of the above named isoenzymes were
      measurable, but at varying intensities. Based on the northern blot hybridization
      analysis, an approximate 4-fold and 3-fold increase in CYP2A1 mRNA and CYP3A1
      mRNA was found, when lactating rats were compared with female controls or
      pregnant rats, at day 10 of gestation.

PMID- 8347135
TI  - Modulation by drugs acting on the autonomic nervous system of platelet-activating
      factor in the stomach of rats.
AB  - Platelet-activating factor (PAF), an ether linked choline glycerophospholipid, is
      a potent initiator of diverse physiological and pathological processes. We have
      reported that gastric endogenous PAF levels were reduced and the contents of each
      of its molecular species changed during water-immersion stress in rats (Sugatani
      J et al., FASEB J 3: 65-70, 1989 and Sugatani J et al., Lipids 26: 1347-1353,
      1991). In this study, we determined the effects of autonomic drugs on the level
      of gastric PAF, its molecular heterogeneity and formation of gastric erosions in
      unstressed rats and those subjected to water-immersion stress. Atropine, an
      anticholinergic drug, suppressed both the stress-induced changes and development
      of gastric lesions. 6-Hydroxydopamine-induced sympathectomy induced a small
      decrease in the gastric PAF levels and the addition of stress further decreased
      the PAF levels and development of gastric lesions. Carbamylcholine induced a
      transient decrease in the gastric PAF level of normal rats, which was not
      associated with gastric erosion formation. In contrast, the endogenous
      gastroprotective factor dopamine evoked transient dose- and time-dependent
      increases in the gastric PAF levels. These observations indicate that cholinergic
      muscarinic-receptor activation in rats led to decreases in gastric PAF levels and
      a prolonged and marked decrease in its level was associated with the development
      of gastric lesions, and that dopamine increases gastric PAF levels. Gastric
      endogenous PAF levels are closely associated with the autonomic nervous system
      and should be considered further in investigations of gastric function.

PMID- 8347136
TI  - Inhibition of melanogenesis in human melanoma cells by novel analogues of the
      partial histamine (H2) agonist nordimaprit.
AB  - A series of analogues of the weak histamine (H2) agonist S-[2-(N,N
      dimethylamine)ethyl] isothiourea (nordimaprit) was produced to investigate the
      possibility that bulky substituents on the tertiary amine of nordimaprit would
      enhance potency for depigmentation and killing of melanoma cells. Cell survival
      studies showed that neither an increase in lipophilicity nor an increase in size
      of these groups produced selective toxicity, with only the N,N-diisobutyl
      derivative being more effective than the N,N-diisopropyl derivative in killing
      the constitutively pigmented human melanoma cell line MM418. The most hydrophobic
      analogue, the N,N-dibenzyl derivative, was also the most toxic to all cell lines
      tested. The association of toxicity with lipophilicity was confirmed by the
      piperidine derivative having greater toxicity than the less hydrophobic
      morpholine analogue. The ability to decrease tyrosinase activity was lost when
      lipophilicity and size of the N-terminal groups were increased, but these
      analogues produced marked depigmentation, even greater than that found with
      either nordimaprit or the diisopropyl derivative. Surprisingly, an increase in
      tyrosinase activity was achieved, the most potent agent being the N-ethyl-N
      anilino analogue which caused complete depigmentation (0.6% of control) and
      elevated tyrosinase activity (148%) in MM418 cells after 1 month of treatment.
      This indicates that nordimaprit and its derivatives possess two different
      mechanisms of depigmentation, the first being tyrosinase dependent and the second
      being tyrosinase independent. The latter pathway is yet to be elucidated but
      appears to require a high degree of hydrophobicity.

PMID- 8347139
TI  - Studies on the effect of fenoprofen on the activation and oxidation of long chain
      and very long chain fatty acids in hepatocytes and subcellular fractions from rat
      liver.
AB  - We studied the effect of fenoprofen on the activation of palmitic acid (C16:0),
      lignoceric acid (C24:0) and cerotic acid (C26:0) in microsomal and peroxisomal
      fractions from rat liver. Fenoprofen was found to inhibit the formation of
      palmitoyl-CoA in both microsomal and peroxisomal fractions whereas the formation
      of lignoceroyl-CoA and cerotoyl-CoA was not inhibited at all. In freshly isolated
      rat hepatocytes palmitic acid beta-oxidation was progressively inhibited at
      increasing concentrations of fenoprofen, most probably due to its inhibitory
      effect on palmitoyl-CoA synthetase activity. On the other hand, fenoprofen was
      also found to inhibit the beta-oxidation of lignoceric acid and cerotic acid in
      rat hepatocytes. It is shown that the acyl-CoA oxidase activity with lignoceroyl
      CoA as substrate was inhibited by fenoprofen whereas the palmitoyl-CoA and
      pristanoyl-CoA oxidase activities were not inhibited by fenoprofen. This finding
      provides an explanation for the inhibitory effect of fenoprofen on lignocerate
      and cerotate beta-oxidation in hepatocytes.

PMID- 8347137
TI  - Differential role in lipid peroxidation between rat P450 1A1 and P450 1A2.
AB  - The role of cytochrome P450 (P450) in lipid peroxidation induced by NADPH or
      peroxide was investigated in a reconstituted system. When cumene hydroperoxide, t
      butyl hydroperoxide and hydrogen peroxide were used as initiators, the rates of
      malondialdehyde (MDA) formation were much higher in a reconstituted system
      containing P450 1A1 than those observed in a reconstituted system containing P450
      1A2. In contrast to peroxide-induced lipid peroxidation, P450 1A2 catalysed NADPH
      induced lipid peroxidation more effectively than did P450 1A1 regardless of the
      presence of ADP-Fe(NO3)3. Carbon monoxide inhibited NADPH-induced formation of
      MDA in a reconstituted system containing P450 1A2, but not P450 1A1. In addition,
      superoxide dismutase (SOD) was an effective inhibitor in a NADPH-induced lipid
      peroxidation system catalysed by P450 1A2 but not by P450 1A1. These results
      suggest that a peroxide-induced reaction might proceed readily with P450 1A1,
      whereas P450 1A2 mainly functions in NADPH-induced lipid peroxidation via
      generation of an active oxygen species. It is furthermore indicated that the
      difference in the effect of SOD in NADPH-induced lipid peroxidation depends on
      the P450 used.

PMID- 8347138
TI  - Triazolobenzodiazepines: a new class of stimulators of tissue-type plasminogen
      activator synthesis in human endothelial cells.
AB  - In our search for compounds that can stimulate endogenous fibrinolysis, we have
      found that certain triazolobenzodiazepines enhance the production of tissue-type
      plasminogen activator (t-PA) by vascular endothelial cells maintained in vitro,
      with no or even a lowering effect on plasminogen activator inhibitor type-1 (PAI
      1) production. The most active compounds tested, U-34599, U-46195 and U-51477,
      were studied in more detail and showed a time- and dose-dependent increase in the
      production of t-PA by human umbilical vein endothelial cells. At optimal
      stimulatory concentrations (about 10 microM), the three compounds stimulated t-PA
      expression about 2-fold after 24 hr and maximally about 4-fold after 48 hr of
      incubation; this maximal increase in t-PA synthesis was sustained at prolonged
      incubations of 72 or 96 hr. The triazolobenzodiazepine effects on t-PA production
      were accompanied by parallel increases in t-PA mRNA levels, without marked
      changes in PAI-1 or glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA
      concentrations. Numerous analogues of the three lead compounds were then tested
      to determine the relationship between benzodiazepine structure and the ability to
      stimulate t-PA production. No positive correlation was found between the ability
      of the various triazolobenzodiazepines to stimulate t-PA production and their
      affinity for the benzodiazepine receptor. In agreement with this, no specific
      binding of [3H]flunitrazepam, a specific ligand for benzodiazepine receptors, to
      endothelial cell membrane preparations was observed. Thus, it is unlikely that
      the triazolobenzodiazepines act through central-type benzodiazepine receptors to
      stimulate t-PA production. Similarly, no evidence was found for the presence of
      peripheral-type benzodiazepine receptors on endothelial cell membranes. The
      ability of the benzodiazepines to stimulate t-PA production, however, appeared to
      be related to their platelet-activating factor (PAF) antagonist activity. Despite
      this finding, several non-benzodiazepine PAF antagonists did not stimulate t-PA
      production. While the precise mechanism of action is not yet clear, selected
      benzodiazepine analogues possessing PAF antagonist activity stimulate the
      production of t-PA by endothelial cells in vitro.

PMID- 8347140
TI  - Interaction of fluoroethane chlorofluorocarbon (CFC) substitutes with microsomal
      cytochrome P450. Stimulation of P450 activity and chlorodifluoroethene
      metabolism.
AB  - The abilities of halothane and the fluoroethane chlorofluorocarbon (CFC)
      substitutes, FC-123, FC-133a, FC-124, FC-134a and FC-125, to stimulate cytochrome
      P450 activities and 2-chloro-1,1-difluoroethene (CDE) defluorination in hepatic
      microsomes from phenobarbital-treated rabbits were compared. At 1% (v/v) each,
      halothane and FC-123 similarly increased the consumption of NADPH and O2 by 300
      and 100%, respectively, over that in microsomes without substrate. FC-133a and FC
      124 were less effective, increasing NADPH and O2 consumption by 150-200 and 70%.
      FC-134a and FC-125 were the least effective, increasing NADPH and O2 consumption
      by only 70 and 50%, respectively. No metabolism of any fluoroethane could be
      detected under the incubation conditions used. Halothane and FC-123 were most
      effective in stimulating CDE metabolism with increases of CDE defluorination
      ranging from 1.5- to 2-fold. FC-133a and FC-124 enhanced CDE oxidation 89 and
      74%, respectively, and FC-134a and FC-125 had no effect. While CDE metabolism was
      enhanced in the presence of the fluoroethanes, no additional NADPH or O2 was
      consumed when halothane or FC-124 was incubated with CDE compared with
      incubations containing only halothane or FC-124. Log-log plots of NADPH
      consumption and CDE metabolism with the olive oil/gas partition coefficients of
      each fluoroethane showed linear relationships. These data demonstrate that the
      activity of the fluoroethanes in stimulating P450 activity and CDE metabolism is
      a function of their lipid solubility, and fluoroethane-enhanced CDE metabolism is
      related to the ability of these compounds to increase uncoupled P450 activity.

PMID- 8347142
TI  - Cytotoxic mechanisms of 5-fluoropyrimidines. Relationships with poly(ADP-ribose)
      polymerase activity, DNA strand breakage and incorporation into nucleic acids.
AB  - A comparative study of the cytotoxic mechanisms of 5-fluorouracil (FU) and 5
      fluoro-2'-deoxyuridine (FdUrd) was carried out in Chinese hamster ovary K1 (CHO
      K1) cells. The poly(ADP-ribose) polymerase (PADPRP) inhibitor, 3-aminobenzamide
      (3AB, 3 mM) enhanced the cytotoxicity of FU with a dose enhancement factor at 10%
      survival of 2. This enhancement was also evident when cells were grown in dThd
      free medium, but the IC50 for FU was reduced from 50 to 35 microM. In contrast,
      3AB did not enhance the cytotoxicity of FdUrd but exerted a small protective
      effect. The IC50 for FdUrd was reduced from 35 to 1.25 microM in dThd-free
      medium. A 55% reduction in NAD levels was seen within 6 hr of 5.0 microM FdUrd
      treatment in dThd-free medium, and this reduction persisted over 24 hr. This drop
      was prevented by co-incubation with 3AB, indicating that PADPRP activation was
      the cause of the NAD depletion. In contrast, FU treatment had little or no effect
      on NAD levels. Alkaline elution analysis of cells treated with up to 150 microM
      FU revealed no DNA strand breaks in mature DNA, but an increase in breaks in
      nascent DNA. Co-incubation with 3AB had little or no effect on strand break
      levels. FdUrd (up to 40 microM) produced a dose-dependent increase in both mature
      and nascent DNA strand breaks. Analysis using a "relative elution" formula
      demonstrated that 3AB increased the amount of FdUrd-induced strand breaks (at
      doses < or = 5-100 microM) in mature DNA. Whereas FU elution profiles for nascent
      DNA were biphasic, those for FdUrd were linear. Co-incubation with 3AB increased
      [3H]FU incorporation into both RNA (by 50%) and DNA (45%). 3AB also enhanced
      [3H]FdUrd incorporation (by 40%) into RNA but had no effect on incorporation into
      DNA. These data indicate that in addition to acting as an inhibitor of PADPRP,
      3AB exerts other metabolic effects.

PMID- 8347141
TI  - Valproate and mitochondria.

PMID- 8347143
TI  - The effect of desferrioxamine on iron metabolism and lipid peroxidation in
      hepatocytes of C57BL/10 mice in experimental uroporphyria.
AB  - The effects of the iron chelator desferrioxamine (DFx) on liver iron
      accumulation, malondialdehyde (MDA) production, porphyrin accumulation and
      uroporphyrinogen decarboxylase (URO-D; EC 4.1.1.37) activity were investigated
      over a period of 14 weeks in C57BL/10 mice, made porphyric by the administration
      of hexachlorobenzene (HCB) and iron-dextran (Imferon, IMF) or IMF alone. In
      addition, we measured the amount of low molecular weight (LMW) iron in liver
      tissue to determine a possible correlation with MDA production. These experiments
      showed that combined treatment with HCB + IMF, as well as IMF alone, resulted in
      porphyrin accumulation, increased MDA production and reduced URO-D activity,
      whereas HCB alone had no effect. DFx caused a reduction in hepatic porphyrins,
      this reduction being more distinct in the IMF group than in the HCB + IMF group.
      The effect of DFx on MDA production and URO-D activity was in agreement with the
      results on porphyrin accumulation. LMW iron pool measurements at 11 weeks
      correlated well with data on MDA production in all treated groups in that period
      (r2 = 0.84), suggesting both variables are interdependent. In conclusion, these
      results suggest an important role for iron in porphyrin accumulation, probably
      through its catalytic role in the generation of oxygen-related free radicals,
      resulting in direct damage to URO-D. The effectiveness of DFx in reducing
      porphyrin accumulation is probably the result of a reduction in LMW iron, thus
      diminishing the amount of iron available for a catalytic role in the generation
      of oxygen-related free radicals.

PMID- 8347144
TI  - Impairment of UDP-glucose dehydrogenase and glucuronidation activities in liver
      and small intestine of rat and guinea pig in vitro by piperine.
AB  - The effects of piperine, a major ingredient of black pepper, on UDP-glucose
      dehydrogenase (UDP-GDH) and glucuronidation potentials of rat and guinea pig
      liver and intestine were studied. Piperine caused a concentration-related strong
      inhibition of UDP-GDH (50% at 10 microM) reversibly and equipotently, in both
      tissues. Partially purified rat liver UDP-GDH was used to obtain the kinetic
      values at pH optima of 9.4 and 8.6. At pH 9.4: KmUDP-glucose = 15 microM, Vmax =
      5.2 nmol NADH/min/mg protein, Ki = 6 microM. With NAD, a Ki of 16 microM was
      obtained. At pH 8.6: Km = 35 microM, Vmax = 7.5 nmol, Ki = 15 microM. In all of
      these cases, piperine caused non-competitive inhibition. Data from structure
      activity comparisons of piperine analogs indicated that the presence of
      conjugated double bonds in the side chain of the molecule is a factor in piperine
      inhibition. However, the UDP-glucuronic acid (UDPGA) contents were decreased less
      effectively by piperine in isolated rat hepatocytes compared with enterocytes of
      guinea pig small intestine. Piperine at 50 microM caused a marginal decrease of
      UDPGA in hepatocytes when the rate of glucuronidation of 3-hydroxybenzo[a]pyrene
      (3-OH-BP) decreased by about 40%. The decrease obtained at 10 microM piperine in
      intestinal cells was comparable to that obtained at 50-100 microM in hepatocytes.
      UDP-glucuronosyltransferase (UGT) activities towards 3-OH-BP (UGT1A1) and 4-OH
      biphenyl (UGT2B1) were also determined. Piperine did not affect the rate of
      glucuronidation of 4-OH-biphenyl in rat liver, whereas that of 3-OH-BP was
      impaired significantly. In guinea pig small intestine, both these activities were
      inhibited significantly requiring less than 25 microM piperine to produce a more
      than 50% inhibition of UGT(s). The results suggested that (i) piperine is a
      potent inhibitor of UDP-GDH, (ii) inhibition is offered exclusively by the
      conjugated double bonds of the molecule, and (iii) piperine exerts stronger
      effects on intestinal glucuronidation than in rat liver.

PMID- 8347145
TI  - Trimethylamine N-oxygenation and N-demethylation in rat liver microsomes.
AB  - The in vitro oxidation of trimethylamine (TMA) to TMA N-oxide (TMAO) and
      dimethylamine (DMA) was studied in rat liver microsomes. Pretreatment of rats
      with phenobarbital, 3-methylcholanthrene, ethanol or pregnenolone 16 alpha
      carbonitrile had little or no effect on the liver microsomal metabolism of TMA to
      TMAO or DMA. Changing the atmosphere in the incubation vessel from 20% oxygen/80%
      nitrogen (air) to 100% oxygen had a selective stimulatory effect on the N
      oxygenation of TMA but did not affect TMA N-demethylation. In addition, the Km
      for TMA N-demethylation was 5-fold higher than for the N-oxygenation reaction.
      The results of these studies suggest that the enzyme systems responsible for N
      demethylation and N-oxygenation are different and that they are under different
      regulatory control. Carbon monoxide (CO/O2 = 80/20) had little or no inhibitory
      effect on either the N-demethylation or N-oxygenation of TMA by liver microsomes
      from control or pregnenolone 16 alpha-carbonitrile-treated rats. Additional
      studies indicated that methimazole, an inhibitor of FAD-containing monooxygenase
      (FMO), was a potent inhibitor of TMA oxidation. Preincubation of liver microsomes
      from control or pregnenolone 16 alpha-carbonitrile-treated rats at 37 degrees for
      10 min without NADP(H) (a procedure that irreversibly inactivated FMO activity)
      resulted in > 95% inhibition of TMA N-demethylation and N-oxygenation, and this
      inhibition was prevented by including a NADPH-generating system in the
      preincubation medium (a procedure for preventing the thermal inactivation of FMO
      activity). The data suggest that FMOs are the major enzymes responsible for N
      demethylation and N-oxygenation of TMA in rat liver microsomes.

PMID- 8347146
TI  - Fish oil preparations rich in docosahexaenoic acid modify platelet responsiveness
      to prostaglandin-endoperoxide/thromboxane A2 receptor agonists.
AB  - The effects of daily dietary supplementation for 6 weeks with either 4.5 g
      eicosapentaenoic acid (EPA) and 3.35 g docosahexaenoic acid (DHA) (group I,
      EPA/DHA = 1.33) or 3.5 g EPA and 6.4 g DHA (group II, EPA/DHA = 0.54) on platelet
      responsiveness to the stable prostaglandin (PG)-endoperoxide analogue 9,11
      dideoxy,9 alpha-11 alpha-methanoepoxy-PGF2 alpha (U 46619) were studied in
      healthy volunteers. Dose-response curves (DRC) of U 46619-induced platelet
      aggregation were analysed by computerized non-linear curve fitting. In group I,
      the concentration of U 46619 required for half-maximum platelet aggregation
      (EC50) remained unchanged, whereas the Hill coefficient decreased from 6.2 to 3.3
      (P < 0.02). In group II, characterized by a high intake of DHA, a considerable
      increase of EC50 from 0.3 to 1.4 microM was found (P < 0.02). These results
      suggest different effects of EPA and DHA on the platelet thromboxane/endoperoxide
      amplifying system. The considerable shift of the DRC in group II suggests a
      direct effect of DHA on the presentation of the endoperoxide receptor and/or post
      receptoral events.

PMID- 8347148
TI  - Fasting-induced depletion of glutathione in the aging mouse.
AB  - Previous results indicate that aging is associated with a general deficiency of
      glutathione (GSH). As fasting is also known to lower hepatic GSH levels, we
      investigated the combined effects of aging and 24 hr of food deprivation on
      liver, kidney and blood GSH and cyst(e)ine levels in C57BL/6N mice of ages 6
      (young), 12 (mature) and 24 (old) months. No age-related differences in baseline
      hepatic GSH were observed in these mice, consistent with previous findings where
      the deficiency in liver is not apparent until about 29 months of age. By 6 hr of
      fasting, an age-related reduction in hepatic GSH was evident, culminating in a 4
      fold greater decrease during maturation, and a 5-fold greater decrease during
      aging (P < 0.001) compared to young animals. Liver weight also declined,
      decreasing total liver GSH content by 24% in young, 44% in mature, and 56% in old
      mice. Renal GSH and hepatic cyst(e)ine concentrations were unaffected by fasting.
      In young and mature mice, depletion of hepatic GSH was accompanied by a
      concomitant increase in blood GSH and kidney cyst(e)ine levels after 6 hr of
      fasting, suggesting enhancement of hepatic GSH efflux. However, in old animals,
      GSH depletion was associated with decreased blood GSH and kidney cyst(e)ine.
      Altogether, these results suggest that the stress of fasting reveals aging
      changes in hepatic GSH homeostasis occurring well before the GSH deficiency of
      aging is observed. These aging changes are likely due to decreased GSH turnover
      resulting from impaired biosynthesis.

PMID- 8347147
TI  - Anti-HIV-1 activity and cellular pharmacology of various analogs of gossypol.
AB  - We previously reported that the racemic mixture and both enantiomers of gossypol
      inhibit the replication of human immunodeficiency virus-type 1 (HIV-1) (Lin et
      al., Antimicrob Agents Chemother 33: 2149-2151, 1989). The present study
      evaluates the activities of a variety of analogs of gossypol as well as a few non
      gossypol analogs. Compounds 2, 3, 10, and 13 were slightly more inhibitory than (
      )-gossypol to the replication of HIV-1 in cell culture. Compounds 4 and 8 were
      cytotoxic to human peripheral blood monocyte (PBM) cells, and compounds 2 and 3
      were cytotoxic to Vero cells but not PBM cells. The effects of the two
      enantiomers of gossypol on the cell volume and migration of H9 cells through the
      cell cycle were evaluated during 72 hr of incubation. The (-)-enantiomer of
      gossypol was more toxic to H9 cells than the (+)-enantiomer of gossypol as
      evidenced by cell destruction. Prior to cell destruction, there appeared to be no
      significant effect on cell cycle distribution with either enantiomer.

PMID- 8347149
TI  - Permeation and metabolism of anti-HIV and endogenous nucleosides in human immune
      effector cells.
AB  - Numerous anti-HIV drugs are synthetic analogs of endogenous nucleosides.
      Therefore it is of interest to see if a facilitated nucleoside transport system
      exists to mediate their uptake into human immune effector cells that are known
      HIV targets. Nucleoside permeation and metabolism in lymphocytes, macrophages and
      bone marrow cells isolated from healthy human volunteers were studied, using
      uridine as the prototype endogenous nucleoside. There are saturable broad
      specificity nucleoside transport systems in all three cell types, all of which
      were inhibited by dipyridamole. The Vmax and Km values for uridine transport were
      0.05 +/- 0.01 pmol/sec/10(6) cells and 18.4 +/- 4.2 microM, respectively, for
      lymphocytes, 0.04 +/- 0.01 pmol/sec/10(6) cells and 25.3 +/- 6.6 microM,
      respectively, for macrophages, and 0.03 +/- 0.01 pmol/sec/10(6) cells and 90.2 +/
      10.1 microM, respectively, for bone marrow mononuclear cells. Anti-HIV
      dideoxynucleosides such as azidothymidine (AZT), 2',3'-dideoxycytidine (DDC),
      2',3'-dideoxyinosine (DDI), 2',3'-dideoxyadenosine (DDA), and 2',3'
      dideoxythymidine (DDT) are not substrates of this nucleotide transport system;
      hence, little or no drug accumulated inside the cells after 60 sec. Equilibration
      of cells with uridine or dideoxynucleosides for 2 hr resulted in high levels of
      cellular uridine and DDA, low levels of cellular AZT, but undetectable levels of
      the other analogs in all three cell types. Active metabolite levels in
      lymphocytes as assayed by HPLC correlated with the drug permeation results. Our
      data demonstrated that DDC, DDI, and DDT are not substrates for the nucleoside
      transporter and cannot diffuse readily across the cell membrane of human immune
      effector cells. Future anti-HIV drug development efforts should consider drugs
      that are substrates of the nucleotide transporter to ensure rapid and complete
      uptake into target cells.

PMID- 8347150
TI  - Effect of O6-benzylguanine on the sensitivity of human colon tumor xenografts to
      1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU).
AB  - A number of trials were conducted to determine the effect of O6-benzylguanine
      pretreatment on the sensitivity of human colon tumor xenografts to the antitumor
      effects of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU). O6-Benzylguanine has been
      shown to inactivate the DNA repair protein, O6-alkylguanine-DNA alkyltransferase
      (AGT), which is primarily responsible for resistance to alkylnitrosoureas
      including BCNU. Colon tumor xenografts carried in nude mice were analyzed for
      their AGT content, and tumors with low, intermediate and high levels were chosen
      for further study. The AGT activity of HC-1, GC-3, VRC-5 and CX-1 human colon
      tumor xenografts was 16, 113, 180 and 367 fmol/mg protein, respectively.
      Treatment of mice consisted of vehicle alone, 6.25 to 50 mg/kg BCNU administered
      alone or BCNU (6.25 to 25 mg/kg) 1 hr after 120 mg/kg O6-benzylguanine on days 7
      and 14 post-inoculation. Toxicity studies revealed that pretreatment with O6
      benzylguanine increased the toxicity of BCNU, requiring administration of about 4
      fold less drug. The growth of the VRC-5 tumor at day 42 post-inoculation was
      inhibited by 39% following treatment with 12.5 mg/kg BCNU alone and 92% when BCNU
      was combined with O6-benzylguanine pretreatment. The combination of O6
      benzylguanine and BCNU (12.5 mg/kg) at day 42 resulted in an inhibition of HC-1
      and CX-1 tumor growth by 84 and 72%, whereas BCNU alone inhibited growth by 54
      and 14%, respectively. Therefore, the degree to which the antitumor effect of
      BCNU was increased by O6-benzylguanine pretreatment was dependent on the AGT
      activity, with a greater effect in tumors of intermediate or high activity. These
      data suggest that there is a role for O6-benzylguanine combined with BCNU in the
      treatment of human colon tumors.

PMID- 8347151
TI  - Muscarinic receptors in isolated guinea pig pancreatic ducts.
AB  - Biochemical and pharmacological characteristics of muscarinic cholinergic
      receptors in isolated guinea pig pancreatic ducts were determined in the present
      study. Duct homogenates bound 6.82 +/- 0.69 fmol of [3H]N-methylscopolamine
      ([3H]NMS)/micrograms of DNA with a Kd of 0.73 +/- 0.05 nM. The density of [3H]NMS
      binding sites in the excretory ducts was seven times greater than that in acini
      from the same pancreases. Competition binding studies with atropine, pirenzepine,
      11-[[2-[(diethylamino)methyl]-1-piperidinyl]acetyl]-5,11-dihydro-6H- pyrido[2,3
      b] [1,4]benzodiazepine-6-one (AF-DX 116), and 4-diphenylacetoxy-N-methyl
      piperidine methiodide (4-DAMP) indicated that both M2 and M3 subtypes of
      muscarinic receptors are present in these preparations of isolated pancreatic
      ducts. Electrophoretic analysis of [3H]propylbenzilylcholine mustard-labeled
      unreduced and reduced duct muscarinic receptors provided molecular mass estimates
      of 62.6 +/- 2.5 and 58.0 +/- 1.6 kDa, respectively. Deglycosylation of ductal
      muscarinic receptors with N-glycanase decreased their apparent molecular mass by
      approximately 4 kDa. These results demonstrate that isolated pancreatic ducts
      express both M2 and M3 muscarinic receptors, with the former subtype
      predominating.

PMID- 8347152
TI  - Effects of NB-598, a potent squalene epoxidase inhibitor, on the apical membrane
      uptake of cholesterol and basolateral membrane secretion of lipids in Caco-2
      cells.
AB  - Caco-2 cells grown on membrane filters were used as a model to study the effects
      of NB-598, an inhibitor of squalene epoxidase, on cholesterol absorption from the
      intestinal epithelia. NB-598 (10 microM) inhibited the synthesis of sterol and
      sterol ester from [14C]acetate without affecting the synthesis of other lipids
      such as phospholipids (PL), free fatty acids (FFA) and triacylglycerol (TG). When
      labeled lipid was apically loaded as a micellar lipid solution into Caco-2 cell
      cultures, NB-598 reduced basolaterally secreted radioactivity in cholesterol,
      cholesterol ester, PL and TG. Furthermore, NB-598 suppressed the basolateral
      secretion of apolipoprotein (apo) B. When microsomes prepared from control Caco-2
      cells were incubated with 10 microM NB-598, acyl CoA:cholesterol acyltransferase
      (ACAT) activity was inhibited slightly. After incubating Caco-2 cells with 10
      microM NB-598, a slight reduction in cellular ACAT activity was also observed.
      These results suggest that suppression of the secretion of particles containing
      apo B and reduction of cellular ACAT activity in the intestinal epithelia are
      part of the mechanism of the cholesterol-lowering effect of NB-598.

PMID- 8347153
TI  - Modulatory effect of hyperthermia on hepatic microsomal cytochrome P450 in mice.
AB  - It is widely known that the clearance of drugs is often compromised during
      episodes of infectious disease via a down-regulation of cytochrome P450 (P450) at
      a pre-translational step in enzyme synthesis. Etiocholanolone (ETC), a potent
      inflammatory agent, induces fever in humans and causes a decrease in the
      clearance of certain drugs that are metabolized by P450. On this basis it is
      widely believed that the fever per se rather than the immune modulation that
      occurs during infections may have a major role in depression of microsomal P450
      enzymes during viral infections in humans. In the present study, we demonstrated
      that although ETC did not induce hyperthermia in mice, it still evoked a
      depression of the levels of P450 in hepatic microsomes. Ethoxyresorufin O
      deethylase (EROD) was also inhibited significantly when hepatic microsomes were
      incubated with various concentrations of ETC in vitro. P450 levels and EROD
      activities remained unchanged following hyperthermia that was induced by a non
      inflammatory procedure using 2,4-dinitrophenol. Provided the response in rodents
      is similar to humans, these results indicate that the depression of drug
      biotransformation by ETC in humans is more likely to be caused by the direct
      effects of this agent or other mechanisms rather than by the fever it produces.
      This may suggest that the loss of drug metabolism in humans during infections is
      due to the activation of host defence responses rather than to the febrile nature
      of the illness.

PMID- 8347154
TI  - Inhibition of rabbit aortic angiotensin II (AII) receptor by CV-11974, a new
      nonpeptide AII antagonist.
AB  - The angiotensin II (AII) antagonistic action of CV-11974 (2-ethoxy-1-[[2'-(1H
      tetrazol-5-yl)biphenyl-4-yl]methyl] benzimidazole-7-carboxylic acid) was
      investigated in an AII-receptor binding assay using rabbit aortic membranes and
      an AII-induced contraction assay using rabbit aortic strips. A single class of
      [125I]AII-(Sar1,Ile8) binding sites was found in the membranes with a
      dissociation constant (Kd) of 0.15 nM and a receptor concentration (Bmax) of 86.9
      fmol/mg protein. CV-11974 markedly reduced Kd without affecting Bmax. The
      specific binding of [125I]AII-(Sar1,Ile8) in this preparation was inhibited
      completely by CV-11974 [the inhibition constant (Ki) = 0.64 nM], DuP 753 [an
      angiotensin II type I (AT1) receptor-selective antagonist] (Ki = 51 nM) and
      EXP3174 (an active metabolite of DuP 753) (Ki = 6.8 nM), but was not affected by
      PD123177 (an AT2 receptor-selective antagonist). These results suggest that the
      single binding site in rabbit aortic membranes is an AT1 receptor subtype. The
      affinity of CV-11974 to these AT1 receptors was approximately 80 and 10 times
      higher than that of DuP 753 and EXP3174, respectively. CV-11974 showed no
      appreciable affinity for the AT2 receptors found in bovine cerebellum. In the in
      vitro functional study, CV-11974 markedly reduced the AII-induced maximal
      contractile response of rabbit aortic strips (pD'2 = 9.97). In contrast, Compound
      7-H, which lacks the carboxyl group at the benzimidazole ring of CV-11974,
      inhibited the contraction in a competitive manner. The inhibition by CV-11974 was
      long lasting. These results suggest that CV-11974 is a potent and long-acting AT1
      receptor-selective, competitive antagonist. The carboxyl group at the
      benzimidazole ring plays an important role in the interaction between CV-11974
      and the AT1 receptor.

PMID- 8347155
TI  - 13-cis-retinoic acid and hepatic steatosis in rats.
AB  - The effect of administration of 13-cis-retinoic acid (100 mg/kg diet) on lipid
      metabolism was examined in male rats fed either a 20% casein + 0.3% methionine
      diet, a 20% casein diet, a 10% casein + 0.3% methionine diet, or a 10% casein +
      0.6% methionine diet for 10 days. Hepatic triglyceride concentrations of rats fed
      either 10% casein diet were 3-fold greater than animals receiving diets
      containing 20% casein. The addition of 13-cis-retinoic acid to the diet further
      increased the total hepatic lipid (43-56%) and triglyceride (approximately 2
      fold) concentrations in rats fed the 10% casein diets. 13-cis-Retinoic acid
      supplementation did not alter the total liver lipid or triglyceride
      concentrations in rats fed either of the 20% casein diets. Thus, under specific
      dietary conditions, the administration of 13-cis-retinoic acid resulted in a
      marked accumulation of hepatic lipids which did not appear to be related to the
      total methionine content of the diet nor to the hepatic concentrations of S
      adenosylmethionine and glutathione. In addition, all four groups of 13-cis
      retinoic acid-fed rats exhibited elevations in the concentration of serum
      triglycerides, and 10-20% reductions in serum cholesterol concentrations.

PMID- 8347156
TI  - Polyclonal amanitin-specific antibodies: production and cytoprotective properties
      in vitro.
AB  - The amanitins found in several mushroom species are responsible for many deaths
      every year. Based on its successful application to cardiac glycoside overdose,
      immunotherapy could be applicable to amanitin toxicity. Therefore, we produced
      polyclonal amanitin antibodies by immunizing rabbits with a novel conjugate of
      alpha-amanitin. Purified antibodies had an average association constant for alpha
      amanitin of 1.3 x 10(9) M-1. A partially protective effect of the antibodies
      against amanitin toxicity in vitro in Chang cells was evident at a molar ratio of
      antibody binding sites to alpha-amanitin of 4:1. Together with reported studies
      in vivo, these investigations indicate the potential of immunotherapy for
      amanitin poisoning.

PMID- 8347157
TI  - Non-ionophoretic elevation of intracellular Ca2+ by Lonidamine.
AB  - Lonidamine is an antispermatogenic and anticancer drug that is believed to act by
      inhibition of energy metabolism. In this study, the effects of Lonidamine on the
      concentration of intracellular free Ca2+ of several tumor cell lines were
      assessed because of the important role that cytosolic Ca2+ plays in cell
      viability and proliferation. The presence of 300 microM Lonidamine resulted in
      large elevations of cytosolic Ca2+ (> 100 nM) in AS-30D rat ascites hepatoma
      cells and in cultured EMT6 murine mammary adenocarcinoma cells but had little
      effect on cultured NCI-H345 human small cell lung cancer cells. The apparent EC50
      for Lonidamine was approximately 175 microM. The source of elevated cytosolic
      Ca2+ was primarily intracellular stores, and the effects of Lonidamine on Ca2+
      efflux from these stores did not appear to be due to an ionophoretic action of
      this compound or to a decline in the level of cellular ATP. These results
      indicate that the Ca2+ homeostasis of certain lines of tumor cells is
      specifically altered by Lonidamine at concentrations known to affect cell
      proliferation.

PMID- 8347158
TI  - Maintenance of xenobiotic metabolism and toxicity in rat hepatocyte cultures
      after cell preservation at 4 degrees.
AB  - Isolated rat hepatocytes were stored at 4 degrees in modified University of
      Wisconsin solution for 22-24 hr and then placed into culture. Satisfactory
      viabilities were obtained for all preparations. No loss of alcohol dehydrogenase
      or 7-ethoxy-3,4-dimethylcoumarin O-deethylase activity was observed in the cold
      stored relative to the control cultures. The protein and glutathione contents,
      allyl alcohol and precocene II (PII) toxicities were also similar, as was the PII
      mediated glutathione depletion. For the parameters measured, cultures of cold
      stored hepatocytes were identical to normal cultures.

PMID- 8347159
TI  - Alkylation of human albumin by the antimalarial artemisinin.
AB  - The interaction between artemisinin and human serum was studied in vitro using
      [3H]dihydroartemisinin and [14C]artemisinin. Approximately 20% of added drug was
      covalently bound to albumin in 24 hr. The results of electrospray ionization mass
      spectra showed that albumin had an M(r) value of 66,745 +/- 35 and the drug-bound
      albumin had an M(r) of 67,223 +/- 34. The binding was blocked 15 and 58% by
      iodoacetamide (IA) and N-ethylmaleimide, respectively, and 80% by the combination
      of IA and succinic anhydride. Hemin and Fe2+ increased the binding by 40 and 10%,
      respectively, whereas deferoxamine inhibited the binding by 10%. Therefore, we
      conclude that the binding between artemisinin and albumin probably involves thiol
      and amino groups via both iron-dependent and -independent reactions.

PMID- 8347160
TI  - Effect of anthracyclines on phospholipase A2 activity and prostaglandin E2
      production in rat gastric mucosa.
AB  - The purpose of this study was to investigate in rats the effects of three
      anthracyclines, pirarubicin, doxorubicin and epirubicin on gastric prostaglandin
      E2 (PGE2) metabolism and phospholipase A2 (PLA2, EC 3.1.1.4) activity. The level
      of the membrane precursor, arachidonic acid, and the stability of the membrane
      were investigated by analysis of the composition of fatty acids. Enzymatic
      activities involved in the turnover of membrane phospholipids such as
      lysophospholipase (LPase, EC 3.1.1.5) and acyl-CoA lysophosphatidylcholine:
      acyltransferase (ACLAT, EC 2.3.1.23), and in the detoxification of lipid
      hydroperoxides, selenium-dependent glutathione-peroxidase (GSH-PX, EC 1.11.1.9)
      were measured after injection of the drugs for 4 consecutive days. Pirarubicin
      does not give rise to any changes in these activities but doxorubicin and
      epirubicin decreased PGE2 production and the activities of PLA2, LPase and ACLAT.
      GSH-PX activity was not changed by any of the drugs. The decrease in PLA2
      activity does not seem to be related to variations in membrane lipid composition
      because the total phospholipids content was unchanged. The P/S
      (polyunsaturated/saturated) ratio increased in the doxorubicin group and
      decreased in the epirubicin group, and the unsaturation index was moderately
      modified. Arachidonic acid was increased only in the doxorubicin group. In vitro,
      PLA2 activity was not inhibited by the three drugs in the micromolar range. A
      marked inhibition was observed at 2.5 mM for pirarubicin and at 1.0 mM for
      doxorubicin and epirubicin. The Lineweaver-Burk representation showed that these
      inhibitions were of an uncompetitive type. Pirarubicin may therefore be
      considered to be an anthracycline without marked side-effects on gastric mucosa.
      However, the in vitro inhibition of PLA2 activity by anthracyclines does not
      fully explain the in vitro decrease in PLA2 specific activity observed after
      doxorubicin and epirubicin treatment, and in this context membrane structure
      modifications unconnected with the lipid composition can not be excluded. In vivo
      these phenomena may affect PGE2 synthesis, whose level was lower in the
      doxorubicin and epirubicin groups than in control group.

PMID- 8347161
TI  - Studies on the in vitro reactivity of clofibryl and fenofibryl glucuronides.
      Evidence for protein binding via a Schiff's base mechanism.
AB  - Clofibryl and fenofibryl acyl (ester) glucuronides (CAG and FAG) are major
      metabolites in humans of the hypolipidaemic drugs clofibrate and fenofibrate,
      respectively. We have investigated three inter-related aspects of the reactivity
      of CAG and FAG in human serum albumin (HSA) solution, human plasma and in buffer
      at pH 7.0: namely (a) rearrangement via acyl migration to glucuronic acid esters
      of clofibric acid (CA) and fenofibric acid (FA), (b) hydrolysis of the parent
      glucuronide and rearrangement products to yield CA and FA and (c) the formation
      of covalent adducts with albumin and plasma protein. CAG was more reactive than
      FAG in all media, especially the protein solutions. The reactivity of both
      glucuronides was accelerated in protein solution compared with buffer and this
      was more marked in plasma than in HSA solution. The predominant reaction during
      the initial stages of the incubation was formation of isomeric rearrangement
      products. In the protein solutions, CA and FA were the major reaction products
      after 24 hr, compared to the rearranged isomers in buffer. Protein binding of 14C
      to HSA was markedly higher after incubation of CAG and FAG labelled on the
      glucuronyl moiety compared with the label on the aglycone. This is consistent
      with the covalent binding of CAG and FAG to protein proceeding via the formation
      of a Schiff's base rather than by transacylation.

PMID- 8347162
TI  - The susceptibility of the malarial parasite Plasmodium falciparum to quinoline
      containing drugs is correlated to the lipid composition of the infected
      erythrocyte membranes.
AB  - The anti-malarial action of quinoline-containing compounds depends on various
      membrane-related processes, and drug resistance could depend, among other
      factors, on the membrane lipid composition. To verify this hypothesis, the
      constitution of phospholipid classes and the content of cholesterol of various
      strains of Plasmodium falciparum-infected human erythrocytes grown in in vitro
      cultures have been assessed in conjunction with drug susceptibility. It was found
      that uninfected erythrocytes in the culture serve as a major source for the
      increased lipid content of malaria-infected cells. Alterations of the
      phospholipid composition of infected cells that result from parasite lipid
      metabolism are also reflected in the constitution of uninfected red cells,
      implying lipid exchange between infected and uninfected cells. An inverse
      relationship between the content of acidic phospholipids and cholesterol has been
      observed. Some strains resistant to chloroquine and quinine were sensitive to
      mefloquine, and vice versa. Resistance to chloroquine or quinine was found to be
      directly related to the content of acidic phospholipids, while that of mafloquine
      displayed an inverse correlation. Concomitantly, the resistance to chloroquine
      was inversely related to the content of cholesterol, while the sensitivity to
      mefloquine decreased with cholesterol concentration. The possible mechanisms that
      could account for these observations are briefly discussed.

PMID- 8347163
TI  - Simultaneous measurements of glutathione and activated sulphate (PAPS) synthesis
      rates and the effects of selective inhibition of glutathione conjugation or
      sulphation of acetaminophen.
AB  - The aim of the present study was to examine the effects of the hepatotoxic drug
      acetaminophen (AA) on the synthesis rates of glutathione (GSH), activated
      sulphate (PAPS; adenosine 3'-phosphate 5'-phosphosulphate) and the AA metabolites
      AA-GSH and AA-sulphate after selective inhibition of GSH biosynthesis or
      sulphation in isolated rat hepatocytes. Selective inhibition of the two
      interdependent metabolic pathways was accomplished by buthionine sulphoximine
      (BSO) and 2,6-dichloro-4-nitrophenol (DCNP). The synthesis rates of GSH and PAPS
      were determined simultaneously by a previously described method based on trapping
      of radioactivity (35S) in the pre-labelled GSH and PAPS pools. Pre-incubation
      with 10 mM BSO for 30 min depleted GSH by 38% (P < 0.05) and PAPS by 27% (P <
      0.05). The depletion resulted in increased PAPS synthesis at low, non-toxic [5-19
      nmol/(10(6) cells.min)] (P < 0.05) and at high, toxic [7-30 nmol/10(6)
      cells.min)] (P < 0.05) AA concentrations. In both cases sulphur is diverted from
      GSH biosynthesis to sulphoxidation and PAPS synthesis, thereby maintaining the
      PAPS pool and preserving the sulphation capacity. This corresponds to the finding
      that AA sulphation was unaffected by BSO irrespective of AA concentration [6 vs 5
      and 20 vs 17 nmol/(10(6) cells.hr), respectively]. Even though the GSH synthesis
      was halved after BSO pre-incubation, the GSH conjugating capacity of AA was well
      preserved. Incubation with 200 microM DCNP and 5 mM AA diminished PAPS synthesis
      from 24 to 10 nmol/(10(6) cells.min) (P < 0.02) and reduced AA-sulphate synthesis
      by 67% compared to experiments without DCNP incubation [4.8 vs 14.7 nmol/(10(6)
      cells.hr)] (P < 0.05). GSH and AA-GSH synthesis rates did not change compared to
      control experiments in which sulphation was not inhibited [1165 vs 1487
      nmol/(10(6) cells.min), respectively] and [1.7 vs 1.7 nmol/(10(6) cells.hr),
      respectively]. This indicates that increased sulphur availability due to
      decreased PAPS synthesis is unable to raise the cysteine pool and stimulate the
      gamma-glutamyl cycle and GSH synthesis.

PMID- 8347164
TI  - Monoclonal antibody-directed assessment of toluene induction of rat hepatic
      cytochrome P450 isozymes.
AB  - Cytochrome P450 isozymes induced in rat liver by a range of concentrations of
      toluene were studied with monoclonal antibodies (MAbs) to specific P450 isozymes
      and by enzyme assays. Nitrosodimethylamine demethylase activity was significantly
      increased in microsomes from rats exposed to more than 1000 ppm of toluene, an
      increase that was dose-dependent. Anti-CYP2E1 significantly inhibited the
      metabolism of toluene to benzyl alcohol (BA) by about 50%, in microsomes from
      1000 to 4000 ppm toluene-exposed rats, at low substrate concentration (0.2 mM).
      With anti-CYP2B1/2, the rate of BA formation was decreased by 15-17% in
      microsomes from rats of 2000 and 4000 ppm toluene exposures at high substrate
      concentration (5.0 mM). On the other hand, anti-CYP2C11/6 inhibited the rate of
      formation of BA in all of the microsomes, but the extent of inhibition was
      progressively decreased from 55% in control to 33% in 4000 ppm exposure.
      Immunoblot analysis with anti-CYP2E1 and anti-CYP2B1/2 revealed stronger
      immunoreactive bands in microsomes from rats exposed to more than 1000 and 2000
      ppm of toluene, respectively. Stronger bands were also observed in microsomes
      from rats of 2000-4000 ppm toluene exposures with anti-CYP3A1/2, but no
      immunoreactivity appeared with anti-CYP1A1/2. These results suggest that toluene
      induces CYP2E1, CYP2B1/2 and CYP3A1/2, but reduces CYP2C11/6, and has no effect
      on CYP1A1/2.

PMID- 8347166
TI  - The relative effects of phylloquinone and menaquinone-4 on the blood coagulation
      factor synthesis in vitamin K-deficient rats.
AB  - Rats were made vitamin K-deficient by feeding them a 1:1 (w/w) mixture of a
      commercial vitamin K-depleted diet and boiled white rice. After one week of
      treatment the rats had developed severe vitamin K deficiency, resulting in
      Thrombotest values of 5-10% of the initial values. In this experimental system
      the efficacy of phylloquinone (K1) was compared with that of menaquinone-4 (MK-4)
      by measuring the extent to which the Thrombotest was normalized after the
      administration of varying doses of the respective vitamins. Oral administration
      of the vitamins showed that the efficacy of K1 was at least two-fold higher than
      that of MK-4. As comparable results were obtained after subcutaneous
      administration of the vitamins, we conclude that after oral administration the
      intestinal absorption had been quick and nearly complete. A less pronounced
      effect of K1 and MK-4 was found after colorectal administration. For both forms
      of vitamin K relatively high amounts (well above the physiological concentration)
      were required before significant effects on the Thrombotest could be observed.
      Therefore these data demonstrate the importance of sufficient dietary vitamin K
      consumption in rats. The efficacy of other menaquinones may be investigated in
      the same experimental animal model system.

PMID- 8347165
TI  - Evaluation of human blood lymphocytes as a model to study the effects of drugs on
      human mitochondria. Effects of low concentrations of amiodarone on fatty acid
      oxidation, ATP levels and cell survival.
AB  - Human lymphocytes were assessed as a cellular model for determining the effects
      of drugs on human mitochondria. Formation of total oxidized 14C-products was
      maximal with 1 mM [U-14C]palmitic acid, was linear for 90 min, linear with the
      number of lymphocytes, and decreased by 95% and 77% in the presence of 30 microM
      rotenone and 2 mM KCN. Seven drugs were tested which had previously been shown to
      inhibit beta-oxidation in animals; all decreased formation of total oxidized 14C
      products by human lymphocytes, but with different IC50 values: 35 microM with
      amiodarone, 2.75 mM with tetracycline and amineptine, 3.75 mM with tianeptine,
      and more than 10 mM for valproic acid and the ibuprofen enantiomers. Formation of
      [14C]CO2 either increased or decreased, in relation to the various effects of
      these drugs on coupling, beta-oxidation, and the tricarboxylic acid cycle. There
      was a general trend for some relationship between inhibition of fatty acid
      oxidation and loss of cellular ATP. Those compounds, however, which uncoupled
      oxidative phosphorylation (2,4-dinitrophenol, amiodarone, ibuprofen) and/or
      inhibited the mitochondrial respiratory chain (amiodarone, rotenone, KCN)
      resulted in comparatively higher ATP depletion. Amiodarone, a drug which produces
      several effects (uncoupling, inhibition of beta-oxidation, of the tricarboxylic
      acid cycle and of the respiratory chain), caused a dramatic decrease in cellular
      ATP and cell viability at low concentrations (20-100 microM). Both these effects
      were prevented by the addition of 5 mM glucose, a substrate for anaerobic
      glycolysis. We conclude that human lymphocytes may be a useful model for
      assessing the effects of drugs on human mitochondrial function. IC50 values
      determined with this model may not necessarily apply, however, to other cells.

PMID- 8347167
TI  - Integrated system for the screening of the specificity of protein kinase
      inhibitors.
AB  - Tyrosine protein kinases (TPKs) play a major role in the transformation of cells.
      They are currently used as molecular targets for new generations of anticancer
      compounds. Numerous TPKs have been described from various tissues using either
      classical molecular biochemical techniques or cloning strategies. As a natural
      extension of these discoveries, a large number of "specific" inhibitors have been
      described in the literature. The major problem with these inhibitors is that
      there is no simple way to compare their specificity and/or selectivity from one
      report to another. We have set up a simple, straightforward technique to compare
      the inhibitory potency of 14 classical inhibitors towards six well-described and
      at least partially purified protein kinases. This technique is based on a new
      assay, easy to carry out and non-restrictive in terms of the type of protein
      substrate used. It permits direct comparisons between the results obtained from
      various sources. Data obtained showed that, when assessed in this integrated
      system, specificity and selectivity of many "classical" inhibitors are often
      weak, thus demonstrating that a universal technique such as ours is essential for
      the molecular screening of new protein kinase inhibitors. Compounds showing
      specificity for this panel of protein kinases will be more easily targeted to
      some defined types of oncogene and of transformed cells.

PMID- 8347168
TI  - The effects of imipramine on the methylation of phosphatidylethanolamine (PE) in
      the cortical membranes of Wistar rats.
AB  - This study investigates the effect of imipramine (IMI) on the methylation of
      phosphatidylethanolamine (PE) in crude cortical membranes of rat brain in vitro
      and ex vivo. It was found that IMI enhanced the formation of phosphatidyl-N
      monomethylethanolamine (PME) and phosphatidyl-N,N-dimethylethanolamine (PDE) and
      inhibited the formation of phosphatidylcholine (PC) in the cortical membranes of
      rats in vitro. The same effect i.e. increased incorporation of methyl groups in
      PE and PME and decreased formation of PC was found in the cortical membrane of
      rats killed 1 hr after intraperitoneal administration of IMI at a single dose of
      10 mg/kg. Chronic treatment of rats with IMI for 14 days with a daily dose of 10
      mg/kg i.p. led to further inhibition of PC formation but did not affect the
      formation of PME and PDE and abolished the stimulating effect of IMI on the
      formation of PME and PDE in vitro.

PMID- 8347169
TI  - The role of c-Jun protein in thrombin-stimulated expression of preproendothelin-1
      mRNA in porcine aortic endothelial cells.
AB  - Treatment of porcine aortic endothelial cells with thrombin induced a time- and
      dose-dependent expression of preproendothelin-1 (PPET-1) mRNA. The thrombin
      induced expression of PPET-1 mRNA was markedly inhibited by calphostin C, a
      specific inhibitor of protein kinase C, and phorbol 12-myristate 13-acetate (TPA)
      induced the expression of PPET-1 mRNA dose-dependently, but 4 alpha-phorbol 12,
      13-didecanoate, an inactive enantiomer of phorbol ester, had no effect on the
      expression of PPET-1 mRNA. On the other hand, challenge of the endothelial cells
      with thrombin induced a marked and time-dependent increase in the binding
      activity of nuclear extract to the TPA-responsive element. Furthermore, thrombin
      elicits synthesis of c-Jun protein as well as triggering its dephosphorylation.
      From these results, it is concluded that thrombin-stimulated expression of PPET-1
      mRNA in porcine aortic endothelial cells can be induced not only by c-Jun protein
      synthesis but also by initial dephosphorylation in response to activation of
      protein kinase C.

PMID- 8347170
TI  - Inhibition of rat liver hydroxysteroid sulfotransferase activity by alkylamines.
AB  - Triethylamine, which was used as an elution solvent for column chromatography to
      purify chemically synthesized 3'-phosphoadenosine 5'-phosphosulfate (PAPS), was a
      potent inhibitor of rat liver sulfotransferase (ST) activities toward
      androsterone and dehydroepiandrosterone, but not ST activities toward cortisol
      and 2-naphthol. Examination of fourteen primary, secondary and tertiary amines
      revealed that a secondary amine, di-n-butylamine, and three tertiary amines,
      triethylamine, tri-n-propylamine and tri-n-butylamine, specifically inhibited ST
      activities toward androgen.

PMID- 8347171
TI  - Resistance to DL-alpha-difluoromethylornithine by clinical isolates of
      Trypanosoma brucei rhodesiense. Role of S-adenosylmethionine.
AB  - The ornithine decarboxylase (ODC) inhibitor DL-alpha-difluoromethylornithine
      (DFMO) has emerged as a new treatment for West African sleeping sickness but is
      less effective against East African sleeping sickness. We examined uncloned
      clinical isolates of Trypanosoma brucei rhodesiense, agent of the disease in East
      Africa, which were refractory to DFMO in laboratory infections, for
      characteristics that would explain their resistance. None of the isolates were
      from patients treated with DFMO. Two isolates took up [3H]DFMO at 50-70% lower
      rates than drug-sensitive strains but ODC activities, Ki values for DFMO,
      spermidine and spermine uptake rates, polyamine content and inhibition of
      polyamine metabolism by DFMO were statistically (P < 0.05) similar between
      sensitive and refractory isolates. One cloned strain, continuously passaged in
      vivo under DFMO pressure and included for comparison, had > 85% lower ODC
      activity and up to 14-fold higher putrescine uptake rates than sensitive
      controls. A statistically important trend was the metabolism of S
      adenosylmethionine (AdoMet): activities of AdoMet synthetase and AdoMet
      decarboxylase were 2- to 5-fold and 3- to 40-fold lower in resistant strains,
      respectively, while intracellular AdoMet pools (AdoMet + decarboxylated AdoMet)
      that were > 60-fold elevated in sensitive strains during DFMO treatment,
      increased only 9-fold in refractory isolates. The extreme elevation of the AdoMet
      pool in sensitive isolates from 0.7 to 44 nmol/mg protein and an intracellular
      pool concentration of approximately 5 mM may lead to an imbalance in methylation
      of proteins or other cell constituents as a consequence of DFMO action. These
      studies indicate that the metabolism of AdoMet is altered significantly in DFMO
      refractory isolates and suggest that differences in AdoMet metabolism may be
      responsible for increased tolerance to DFMO.

PMID- 8347172
TI  - Differing effects of the inhibition of poly(ADP-ribose) polymerase on the course
      of oxidative cell injury in hepatocytes and fibroblasts.
AB  - The effects of the two inhibitors of poly(ADP-ribose) polymerase, 3
      aminobenzamide (ABA) and benzamide (BA), on the oxidative killing of L929 mouse
      fibroblasts and primary cultures of rat hepatocytes were studied. The killing of
      L929 cells by tert-butyl hydroperoxide (TBHP) occurred by two mechanisms, one
      sensitive and the other insensitive to the antioxidant N,N'-diphenylphenylene
      diamine (DPPD). Cell killing by either mechanism was prevented by the ferric iron
      chelator deferoxamine. ABA and BA prevented the killing of L929 cells that
      occurred in the presence, but not in the absence, of DPPD. ABA and BA inhibited
      the activity of poly(ADP-ribose) polymerase by 85%. Protection was accompanied by
      the sparing of the depletion of both NAD and ATP, but there was no effect of
      either ABA or BA on the iron-dependent appearance of single-strand breaks in DNA.
      Depletion of ATP by treating the fibroblasts with 2-deoxyglucose and sodium azide
      did not result in any loss of viability. H2O2 similarly killed the L929 cells by
      a mechanism that depended on a source of ferric iron. However, DPPD had no effect
      on the cell killing, and ABA and BA completely protected the cells in the
      presence or absence of DPPD. H2O2 caused the appearance of single-strand breaks
      that were prevented by deferoxamine, but again not by ABA or BA. ABA and
      deferoxamine reduced, but did not prevent, the depletion of both NAD and ATP
      occurring with H2O2. With the cultured hepatocytes, ABA and BA inhibited poly(ADP
      ribose) polymerase at concentrations that were without effect on either the
      extent of cell killing or the depletion of NAD occurring with either TBHP, H2O2,
      or menadione. These data indicate that the relationship between oxidative DNA
      damage and the genesis of lethal injury is very different in the two types of
      cells. In the fibroblasts, the appearance of single strand breaks in DNA was
      accompanied by depletion of NAD and ATP and subsequently by the death of the
      cells. These events were mediated by the activity of poly(ADP-ribose) polymerase,
      as inhibition of the enzyme prevented their development. In the hepatocytes,
      inhibition of poly(ADP-ribose) polymerase was without effect on the oxidative
      death of the cells.

PMID- 8347173
TI  - Interaction of caffeine with acetaminophen. 1. Correlation of the effect of
      caffeine on acetaminophen hepatotoxicity and acetaminophen bioactivation
      following treatment of mice with various cytochrome P450 inducing agents.
AB  - The combination of caffeine with acetaminophen (APAP) is used widely in the
      treatment of headache. The effects of caffeine on APAP-induced hepatotoxicity and
      APAP bioactivation by liver microsomes from uninduced mice and from mice
      pretreated with various agents that induce cytochrome P450 were studied. When 1
      mM caffeine was included, the rate of glutathione-APAP conjugate (GS-APAP)
      formation was increased significantly by 33 and 39% in microsomes from
      phenobarbital (PB)- and dexamethasone (DEX)-treated mice, respectively, whereas
      this parameter was decreased 39 and 12% by caffeine in microsomes from beta
      naphthoflavone (beta NF)- and acetone-treated mice, respectively. A 5 mM
      concentration of caffeine increased GS-APAP formation by 47, 107 and 117% in
      microsomes from control, PB-, and DEX-treated mice, respectively, and decreased
      it 39 and 25% in microsomes from beta NF- and acetone-treated mice, respectively.
      Caffeine was a competitive inhibitor of APAP bioactivation in microsomes from
      beta NF- and acetone-treated mice. While caffeine increased APAP bioactivation in
      microsomes from uninduced, PB-, and DEX-treated mice, the apparent Km values for
      APAP were increased by caffeine, indicating that this enhancement was not due to
      a direct effect of caffeine on APAP binding to cytochrome P450 but may be due to
      an effect of caffeine on the substrate-enzyme complex. The variable effect of
      caffeine on APAP hepatotoxicity correlated with the effect of caffeine on APAP
      bioactivation by liver microsomes, regardless of pretreatment. Lack of
      correlation of aminopyrine N-demethylase, but good correlation of erythromycin N
      demethylase activity with the extent of caffeine enhancement of APAP
      bioactivation following PB or DEX treatment suggests that a murine P450 subfamily
      similar to the rat P450 3A subfamily may be the candidate in mediating the
      stimulatory effect of caffeine on APAP bioactivation and APAP-induced
      hepatotoxicity.

PMID- 8347174
TI  - Transport of 5-fluorouracil and uracil into human erythrocytes.
AB  - The transport of 5-fluorouracil (5-FU) and uracil into human erythrocytes has
      been investigated under initial velocity conditions with an "inhibitor-stop"
      assay using a cold papaverine solution to terminate influx. At 37 degrees and pH
      7.3, 5-FU influx was nonconcentrative; was partially inhibited by adenine,
      hypoxanthine, thymine, and uracil; and was insensitive to inhibition by
      nucleosides or inhibitors of nucleoside transport. Inhibition of the influx of 5
      FU or uracil by adenine (3.0 mM) did not increase when other pyrimidines or
      inhibitors of nucleoside transport were combined with adenine. 5-FU and uracil
      exhibited similar saturable (Km approximately 4 mM, Vmax approximately 500
      pmol/sec/5 microL cells) and nonsaturable (rate constant approximately 80
      pmol/sec/mM/5 microL cells) components of influx. 5-FU, uracil, adenine, and
      hypoxanthine were competitive inhibitors of each other's influx with Ki values
      matching their respective Km values for influx. We conclude that 5-FU and uracil
      enter human erythrocytes at similar rates via both nonfacilitated diffusion and
      the same carrier that transports adenine and hypoxanthine.

PMID- 8347175
TI  - Modulation of benzene induced toxicity by protein A.
AB  - Administration of benzene (i.p. 1.0 mL/kg body weight) for 3 consecutive days
      produced leucopenia and lymphocytopenia in female albino rats. In addition, the
      total iron content, lipid peroxidation and superoxide dismutase activity of the
      liver and bone marrow were significantly (P < 0.001) increased. Low molecular
      weight (LMW) bleomycin-detectable iron accumulated only in bone marrow. Prior
      administration of Protein A (PA), a multipotent immunostimulant and interferon
      inducer (60 micrograms/kg body weight, i.v. twice weekly for 2 weeks),
      ameliorated most of the adverse effects of benzene. PA restored the changes in
      hepatic histological architecture, reversed leucopenia and superoxide dismutase
      activity, lipid peroxidation, total iron content and LMW iron content of bone
      marrow were normalized. Isozymes of glutathione-S-transferase (alpha, pi, mu)
      which decreased following benzene exposure increased in PA pretreated benzene
      exposed rats. This study suggests that pretreatment with PA modulates the
      toxicity of benzene.

PMID- 8347176
TI  - Interaction of the orally active dianionic cephalosporin cefixime with the uptake
      system for oligopeptides and alpha-amino-beta-lactam antibiotics in rabbit small
      intestine.
AB  - The uptake of two orally active beta-lactam antibiotics of different chemical
      structure, the zwitterionic alpha-aminocephalosporin cephalexin and the dianionic
      carboxymethoxyimino-cephalosporin cefixime, by brush border membrane vesicles
      obtained from rabbit small intestine and their molecular interaction with the
      H+/oligopeptide transport system were investigated. The uptake of both compounds
      was stimulated by an inwardly directed H(+)-gradient with a profound pH-maximum
      for cephalexin at pH 6outside and pH 7.4inside whereas cefixime uptake was
      maximal below pH 5outside. Modification of histidyl residues of membrane proteins
      led to a complete loss of pH dependence of transport of both cephalosporins. The
      uptake of cephalexin was competitively inhibited by cefixime and dipeptides and
      vice versa that of cefixime by cephalexin and dipeptides. The uptake of cefixime
      was trans-stimulated by cephalexin and glycyl-L-proline whereas cephalexin uptake
      could only be trans-stimulated by glycyl-L-proline, not by cefixime.
      Photoaffinity labeling with [3H]benzylpenicillin as a direct photoaffinity probe
      of the H+/oligopeptide transport system demonstrated a direct molecular
      interaction of both cephalexin and cefixime with this transporter in the pH range
      of 5-8. Thermal pretreatment of membrane vesicles inhibited the cephalexin
      transport system temperature-dependently, whereas cefixime uptake was not
      inhibited, but stimulated. Taken together we conclude that dianionic
      cephalosporins like cefixime bind to the transport system shared by oligopeptides
      and alpha-amino-beta-lactam antibiotics. Their transport across the enterocyte
      brush border membrane, however, may occur to a significant extent by a different
      transport system.

PMID- 8347178
TI  - Glutathione and bile acid synthesis. II. Effect of hepatic glutathione content on
      the activity and mRNA levels of cholesterol 7 alpha-hydroxylase in the rat.
AB  - Hepatic cholesterol 7 alpha-hydroxylase (CH-7 alpha) activity in intact rats
      depleted of glutathione (GSH) was reduced significantly (P < 0.007) compared with
      that in untreated controls. Northern blot analysis of poly A+ mRNA isolated from
      GSH-depleted and control rat livers showed that there was a reduction in mRNA for
      CH-7 alpha in treated rats that was commensurate with the reduction in CH-7 alpha
      activity. The fact that the level of transferrin mRNA was unaltered by the
      depletion of GSH suggests that the change in steady-state CH-7 alpha mRNA content
      is specifically sensitive to GSH content. This observation extends previous in
      vitro findings and provides strong justification for a more detailed biochemical
      investigation into the interaction between GSH levels and the regulation of CH-7
      alpha mRNA levels.

PMID- 8347177
TI  - Reversal of 6-mercaptopurine and 6-methylmercaptopurine ribonucleoside
      cytotoxicity by amidoimidazole carboxamide ribonucleoside in Molt F4 human
      malignant T-lymphoblasts.
AB  - Cytotoxicity of 6-mercaptopurine (6MP) and 6-methylmercaptopurine ribonucleoside
      (Me-MPR) was studied in Molt F4 human malignant lymphoblasts. Both drugs are
      converted into methylthioIMP (Me-tIMP), which inhibits purine de novo synthesis.
      Addition of amidoimidazole carboxamide ribonucleoside (AICAR) circumvented
      inhibition of purine de novo synthesis, and thus partly prevented 6MP and Me-MPR
      cytotoxicity. Purine nucleotides, and especially adenine nucleotides, were
      recovered by addition of AICAR. Under these conditions, Me-tIMP formation
      decreased. The results of this study indicate that formation of Me-tIMP may be
      important for 6MP cytotoxicity in Molt F4 cells. These data suggest that
      depletion of adenine nucleotides is the main cause for Me-tIMP cytotoxicity.

PMID- 8347179
TI  - Efficacy of felbamate in childhood epileptic encephalopathy (Lennox-Gastaut
      syndrome).
AB  - BACKGROUND: The Lennox-Gastaut syndrome is a childhood disorder characterized by
      multiple types of seizures, mental retardation, characteristic
      electroencephalographic abnormalities, and resistance to standard antiepileptic
      drugs. Felbamate is an investigational antiepileptic drug with a preclinical
      profile that suggests it would be effective in patients with multiple types of
      seizures. In controlled clinical trials, felbamate was superior to placebo in
      reducing the frequency of refractory partial-onset seizures. METHODS: We studied
      the efficacy of felbamate in 73 patients ranging in age from 4 to 36 years who
      had the Lennox-Gastaut syndrome. During a 28-day base-line phase, the patients
      received their usual antiepileptic therapies. At the end of this phase, felbamate
      or placebo was administered for 70 days in addition to the current antiepileptic
      medications. The dosage of felbamate was titrated during the first 14 days of the
      treatment phase to a maximum of 45 mg per kilogram of body weight per day or 3600
      mg per day, whichever was less. The primary efficacy variables were the total
      number of seizures counted during a four-hour period of video recording, parents'
      or guardians' global evaluations of the patients' quality of life, and the total
      number of atonic seizures, as reported by parents or guardians. RESULTS: The
      patients treated with felbamate had a 34 percent decrease in the frequency of
      atonic seizures, as compared with a 9 percent decrease in the patients who
      received placebo (P = 0.01). The felbamate-treated patients had a 19 percent
      decrease in the total frequency of seizures, as compared with a 4 percent
      increase in the placebo group (P = 0.002). The global-evaluation scores were
      significantly higher in the felbamate group than in the placebo group from day 49
      to the end of the study. There were no significant differences in the frequency
      of seizures occurring during video monitoring, but there was a significant
      reduction (P = 0.017) in the number of tonic-clonic seizures during the
      maintenance period in the felbamate group. The types and frequency of side
      effects were similar in the two treatment groups. CONCLUSIONS: Felbamate is
      beneficial in patients with the Lennox-Gastaut syndrome.

PMID- 8347180
TI  - Therapeutic choices in the patient with coronary artery disease and left
      ventricular dysfunction.

PMID- 8347181
TI  - Fraud and malpractice in the context of clinical research. Working Party of the
      Medical Committee of the Association of the British Pharmaceutical Industry in
      May 1992.

PMID- 8347183
TI  - Ontario's move to limit out-of-province health care spending pays off in big way.

PMID- 8347182
TI  - Heparin in coronary artery disease: new uses for an old drug.
AB  - The role of heparin in the treatment of coronary artery disease remains unclear.
      Although of benefit in unstable angina and the prevention of acute occlusion
      following angioplasty, its value as adjunctive therapy in myocardial infarction
      is limited. Further studies are needed to assess the effect of heparin on
      angioplasty restenosis and late venous graft occlusion.

PMID- 8347184
TI  - Does integration of food animal production bode well for the future?

PMID- 8347185
TI  - Hemorrhagic complications attributable to certain drugs.

PMID- 8347186
TI  - A synthetic matrix metalloproteinase inhibitor decreases tumor burden and
      prolongs survival of mice bearing human ovarian carcinoma xenografts.
AB  - We have examined the effect of a synthetic low-molecular-weight matrix
      metalloproteinase inhibitor, [4-(N-hydroxyamino)-2R-isobutyl-3S- (thiopen-2
      ylthiomethyl)-succinyl]-L-phenylalanine-N-meth yla mide (BB-94), on human ovarian
      carcinoma xenografts growing in nude mice. The xenografts grew as thick
      intraperitoneal mucinous ascites containing free-floating tumor cell clumps. The
      ascites increased in volume, causing death approximately 3 weeks after
      introduction. Treatment with BB-94 caused resolution of ascitic disease. Tumor
      burden was dramatically reduced, and survival increased 5-6-fold. The increase in
      survival was dose dependent. The effects observed with BB-94 appeared to be due
      to its matrix metalloproteinase inhibiting effects, inasmuch as its inactive
      diastereoisomer had no effect on tumor biology. Following treatment with BB-94,
      free-floating clumps of tumor cells became surrounded by a capsule of host cells.
      These clumps of tumor cells typically formed one small (approximately 8 mm)
      avascular tumor of bright white appearance loosely attached to fat in the
      peritoneum. Tumor cells within these capsules often appeared to be necrotic. Gel
      substrate analysis demonstrated that activated Mr 92,000 type IV collagenase was
      present in the xenografts. We propose that inhibition of this enzyme causes the
      transition of ascites to solid tumors, concomitantly slowing tumor cell growth
      and allowing the development of tumor stroma.

PMID- 8347187
TI  - Glutaraldehyde for biopsy forceps.

PMID- 8347188
TI  - Unassisted peripheral nerve blocks.

PMID- 8347189
TI  - Thyroid eye disease.

PMID- 8347191
TI  - Outcome of patients with depressed left ventricular function.

PMID- 8347192
TI  - Treatment of Parkinson's disease.

PMID- 8347193
TI  - Low CSF pressure.

PMID- 8347194
TI  - Laparoscopic abdominoperineal resection of the rectum.

PMID- 8347190
TI  - Low back pain.
AB  - The studies reviewed here show that the duration and severity of individual
      episodes of back pain can be lessened, reducing recurrences and their cost in
      terms of suffering and lost work. Frank examines differential diagnosis; acute,
      chronic, and intractable pain; and service implications. Modern management
      emphasises self care, and bed rest should usually not be longer than 48 hours. A
      return to physical fitness and other activities, including employment, is
      actively encouraged. Medication has a role in facilitating these objectives. Two
      points are especially emphasised: strategies to manage low back pain must be long
      term and preventive; and the responsibility to keep fit, maintain an exercise
      programme, and remain relaxed so as to avoid physically stressing the spine is
      that of the individual, not of the professionals.

PMID- 8347195
TI  - Laparoscopic cholangiography: a simple inexpensive technique using readily
      available materials.

PMID- 8347197
TI  - Primary prevention of malignant melanoma: to know may not be enough.

PMID- 8347196
TI  - Galaptin-mediated adhesion of human ovarian carcinoma A121 cells and detection of
      cellular galaptin-binding glycoproteins.
AB  - Previously, we have shown that galaptin, an endogenous beta-galactoside-binding
      lectin, is present in extracellular matrix where it may participate in the
      adhesion of A121 human ovarian carcinoma cells to extracellular matrix via
      interaction with specific cell surface carbohydrate receptors. We now report that
      A121 cells adhere to polystyrene plates coated with polymerized human splenic
      galaptin. The carbohydrate-mediated specificity of this adhesive interaction was
      demonstrated by inhibition with lactose. Additionally, treatment of A121 cells
      with neuraminidase increased cellular adherence by 30%, while beta-galactosidase
      treatment of cells decreased adherence by 65%. These findings prompted us to
      isolate and identify the cell surface galaptin receptor. In a Western blot of
      A121 cell extracts separated by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, 125I-labeled polymerized galaptin bound [corrected] to a unique
      cellular protein having a molecular mass of 110 kDa. This receptor was enriched
      by affinity chromatography using polymerized galaptin-Sepharose. Treatment of
      this material with N-glycanase ablated its galaptin-binding activity. In related
      studies, A121 cells metabolically labeled with [3H]glucosamine demonstrated a
      radiolabeled polymerized galaptin-binding protein with an identical molecular
      mass of 110 kDa. These studies confirmed the glycoprotein nature of this putative
      endogenous cellular galaptin receptor. Further studies with antibodies directed
      against two lysosomal associated membrane proteins, lamp-1 and lamp-2,
      demonstrated specific reactivity in Western blots with the 110-kDa glycoprotein.
      Additionally, 125I-polymerized galaptin recognized a 110-kDa protein in Western
      blots of material immunoprecipitated from A121 cell lysates by lamp-1 and lamp-2
      antibodies. Finally, indirect immunofluorescence using antibodies directed
      against lamps detected cell surface antigenicity. Therefore, lamp-1 and/or lamp-2
      appear to be the putative cell surface receptors involved in the adhesion of
      ovarian carcinoma cells to extracellular matrix mediated by galaptin.

PMID- 8347198
TI  - HIV-related thrombocytopenia.

PMID- 8347199
TI  - The American Health Care System--Medicare.

PMID- 8347200
TI  - Postoperative pulmonary function abnormalities after coronary artery bypass
      surgery.

PMID- 8347201
TI  - Abruptio placentae and very high parity.

PMID- 8347202
TI  - Laparoscopic radical hysterectomy.

PMID- 8347203
TI  - Alpha-tocopherol levels in parkinsonian brains.

PMID- 8347204
TI  - Promoting healthy eating.

PMID- 8347205
TI  - Disagreeing on how to treat CFS patients.

PMID- 8347206
TI  - Bad teeth and myocardial infarction. Biological mechanisms for link.

PMID- 8347207
TI  - The thrifty genotype in non-insulin dependent diabetes.

PMID- 8347208
TI  - Non fund-holding a positive choice.

PMID- 8347209
TI  - Low back pain. Smoking linked to back pain.

PMID- 8347210
TI  - Nazi medicine.

PMID- 8347211
TI  - Nazi medicine.

PMID- 8347212
TI  - Aid to developing countries.

PMID- 8347213
TI  - Upper gastrointestinal bleeding in the critically ill.

PMID- 8347214
TI  - Primary pyogenic abscess of the psoas muscle.

PMID- 8347215
TI  - Cognitive neuropsychology is more than single-case studies.
AB  - S. M. Sokol et al. (1991) claim that "The Cognitive Neuropsychology Approach" (p.
      355) is limited to the single-case study design. The present article takes issue
      with this claim. Contrary to the beliefs of Sokol et al., we argue (a) that
      cognitive modularity is best studied by group design, (b) that the possibility of
      neural reorganization in patients should be tested through converging evidence
      from different populations using various methods, and (c) that cognitive
      neuropsychology can benefit from being a part of cognitive neuroscience where
      both neural and cognitive mechanisms underlying normal cognition are relevant.

PMID- 8347216
TI  - The 'do not resuscitate' decision.

PMID- 8347217
TI  - Sympathetic-nerve activity during sleep.

PMID- 8347218
TI  - Diltiazem in the prevention of coronary artery disease in heart-transplant
      recipients.

PMID- 8347219
TI  - Skeptical about importance of low levels of lead.

PMID- 8347220
TI  - Single-payer system.

PMID- 8347221
TI  - Re: Asbestos and cancer, 1934-1965.

PMID- 8347222
TI  - The effect of repositioning error on serial magnetic resonance imaging scans.

PMID- 8347223
TI  - 'Rubber dam usage related to restoration quality and survival'.

PMID- 8347224
TI  - Microvascular abnormalities in the mucosal prolapse syndrome.

PMID- 8347225
TI  - Neurogenic pulmonary edema.

PMID- 8347226
TI  - Isolation of Mycobacterium malmoense from HIV-positive patients.

PMID- 8347227
TI  - Benign relapsing meningo-encephalomyelitis.

PMID- 8347228
TI  - Obstetrical lumbosacral plexus injury.

PMID- 8347229
TI  - Eradication of Helicobacter pylori in recurrent duodenal ulcer.

PMID- 8347230
TI  - Drowning.

PMID- 8347231
TI  - Vaginosonography and chorionic villus sampling (CVS)

PMID- 8347232
TI  - Response to Graber editorial.

PMID- 8347233
TI  - Issues that hamper efforts to integrate information systems.

PMID- 8347234
TI  - Respiratory home care: the importance of multidisciplinary collaboration.

PMID- 8347235
TI  - The law and control of tuberculosis.

PMID- 8347236
TI  - Early systolic compliance peak/reflective-wave complex.

PMID- 8347237
TI  - Intravenous oxygenator use in adult respiratory distress syndrome.

PMID- 8347238
TI  - Management of the severely anemic Jehovah's Witness.

PMID- 8347239
TI  - Fine-needle aspiration of salivary glands: its utility and tissue effects.

PMID- 8347240
TI  - Ventricular aneurysmectomy and coronary artery ligation: an alternative method of
      treatment of ALCAPA syndrome.

PMID- 8347241
TI  - Late-onset rhegmatogenous-traction retinal detachment due to Candida
      chorioretinitis.

PMID- 8347242
TI  - Treatment of oral cancer by interstitial irradiation using iridium-192.

PMID- 8347243
TI  - Semen cryobanking for men with cancer.

PMID- 8347244
TI  - Labial tumors in angelfish.

PMID- 8347245
TI  - Pruritic urticarial papules and plaques of pregnancy.

PMID- 8347246
TI  - Comments on halothane gene carriers in pigs.

PMID- 8347247
TI  - [Characteristics and mechanisms of action of leukocyte depletion filters].
AB  - Since their creation, leukocyte depletion filters, used to prepare leukocyte-poor
      red cell or platelet concentrates, have been continuously evoluting: their volume
      has been reduced and their composition has been modified, polyester fibers have
      replaced cotton wool or cellulose acetate. In the same way, their capacity to
      remove leukocytes has increased. The mechanisms of cell separation are still
      unclear. Through published studies, different factors seem to be implicated, such
      as wetable surface of the filter, surface tension or charge density of fibers. It
      was also observed that removal of lymphocytes from red cell concentrates is
      rather based on trapping in the fiber network, and that removal of granulocytes,
      monocytes and platelets is partly due to activation and subsequent adhesion to
      the fibers. There have been few studies of the mechanism of leukocytes depletion
      from platelets concentrates.

PMID- 8347249
TI  - [Assessment of filtration performance].
AB  - The technique of filtration which has constantly been improved over past years
      makes it possible to obtain highly pure blood products (the rate of leukocyte
      depletion can reach 3 to 5 log). Several study groups (BEST, PSL) and
      international committees of experts have defined a number of standards with which
      leukocyte depleted blood products must comply. Assessment of filtration
      procedures is thus made necessary, it applies to the different steps of the
      filtration procedure: preparation techniques of red cell or platelet suspension,
      priming and rinsing of the filter. Likewise a number of parameters have to be
      checked: filtration time, temperature, age of suspensions. Moreover quality
      control procedures must be implemented, using adapted and validated measuring
      methods (Nageotte hemacytometer, for instance). The parameters to be monitored
      include the number of residual leukocytes, (mean value: 1 x 10(6), i.e. about 4
      WBCs/microliters), and the rate of hemoglobin or platelet recovery. Any new
      filtering equipment or material must satisfy strict requirements and standards
      including clinically acceptable limits as part of the same quality approach.
      Validation, in this case, consists in determining the maximal leukocyte content
      which the filter can absorb (capacity) and the average rate of leukocyte removal
      (efficacy). The constant monitoring of filtration performance contributes to
      improving the quality of red blood cell or platelet suspensions and thus meet
      clinicians' requirements for their patients.

PMID- 8347248
TI  - [Filtration technology].
AB  - The leukocyte removal technology of platelet and red blood cell concentrates is
      now based on the only method: the filtration. In order to perfectly control this
      technology, it is necessary to know the different parameters that interfere in
      the quality of the leukocyte removal. These different parameters are studied
      here. They are classified in two types: the parameters that are related to the
      concentrate to filtrate: method used for the preparation, age, state
      (temperature, aggregates), concentration of red blood cells, platelets and
      leukocytes; the parameters that are related to the leukocyte removal technology
      and to the different steps of its carrying out: filter type (composition, size,
      geometry), prefilter, priming of the filter, flow rate during the filtration,
      rinsing and centrifugation after the filtration, elimination of the air inside
      the filter and the filtered concentrate, sterile connections, and finally good
      behavior in front of the difficulties and hitchs that could occur during the
      filtration procedure.

PMID- 8347250
TI  - [Filtration of platelet concentrates. Technical aspects, quantitative results.
      Group PSL].
AB  - This work summarizes a multicentric study (20 Blood Transfusion Centers)
      concerning the use of different filters applied to platelet collection. The
      results are good with the different filters and platelets concentrates
      evaluation. Nevertheless, we have seen a great heterogeneity of platelet
      concentrates. This characteristic could explain the variability in filter
      performances. Maybe we have to adapt some type of filter with specific platelet
      concentrates. In conclusion, it is important to continue the evaluation of new
      platelet concentrate filters, in order to increase the performances and the
      filtration quality. Clinical trials seem to be useful in the future to appreciate
      the effects of filtered platelets on alloimmunization and CMV transmission.

PMID- 8347251
TI  - [Leukocyte depletion of blood products and anti-HLA immunization].
AB  - HLA alloimmunization and subsequent refractoriness to platelet transfusions are
      frequent complications of transfusion therapy in patients with hematologic
      malignancies. Contaminating leukocytes in red cell and platelet concentrates are
      responsible for primary HLA alloimmunization. In many clinical trials, it has
      been demonstrated that the use of leukocyte-poor blood products prepared by
      filtration could reduce HLA-alloimmunization from 40% to 15%. The immunogenic
      level cannot be determined accurately, but the previous studies show that a
      residual contamination below 1.10(6) leukocytes was efficient to prevent primary
      alloimmunization. Leukocyte depletion does not avoid secondary responses in
      patients having an history of pregnancies or transfusions. The UV-B irradiation
      of platelet concentrates, in combination with filtration, should further reduce
      alloimmunization in these presensitized patients.

PMID- 8347252
TI  - [Leukocyte depletion of blood products and transfusion tolerance].
AB  - Leukodepletion of red blood cell or platelet concentrates decreases significantly
      the number of febrile non hemolytic transfusion reactions. Filtration appears to
      be very efficient on red blood cell transfusion reactions while its effect with
      platelet concentrates remains variable.

PMID- 8347253
TI  - [Effect of leukocyte depletion on preservation of erythrocyte and platelet
      concentrates].
AB  - Early leukocyte depletion suppresses metabolic or cellular changes which they
      involve during red blood cell or platelet concentrates storage. The evolution of
      the cellular alteration control parameters and of the storage media content is
      modified by leukocyte concentration of blood products.

PMID- 8347254
TI  - Comparative analysis of DNA ploidy and proliferative index in fine needle
      aspirates of non-Hodgkin's lymphomas by image analysis and flow cytometry.
AB  - To determine the application of image analysis (IA) to fine needle aspiration
      (FNA) of non-Hodgkin's lymphomas, 78 cases, categorized according to the Working
      Formulation, were analyzed and compared with those analyzed by flow cytometry
      (FCM). Aspirated material was immediately fixed in either IA fixative (31 cases)
      or acetone, stored at -70 degrees C (47 cases) for periods up to 48 months and
      postfixed in IA fixative. IA assessed DNA index (DI), ploidy balance, degree of
      hyperdiploidy and proliferation index (PI). DNA index, % S + G2M and RNA index
      were obtained by acridine orange FCM. There were no significant differences in
      measured variables between fresh and stored cases. Statistically significant
      differences between low, intermediate and high grade lymphomas were present in
      all evaluated variables except DNA ploidy (DI) (P = .074) measured by IA. DI,
      however, showed a very high correlation with the DI obtained by FCM (r = .94).
      PIs, although generally lower, also had a high correlation with S + G2M (r =
      .85). We conclude that results obtained by IA were comparable to results by FCM
      and that frozen material can be used to retrospectively evaluate ploidy and
      proliferation. IA is especially suitable for the evaluation of low-volume
      specimens obtained by FNA.

PMID- 8347255
TI  - Comparison of DNA content in primary and lymph node metastases in prostate
      adenocarcinoma.
AB  - There is increasing evidence that nuclear DNA content has significant prognostic
      value for adenocarcinoma of the prostate. There also appear to be considerable
      differences in cellular DNA content between patient cohorts when primary tumor or
      pelvic lymph node metastases are measured. In addition, prostate adenocarcinoma
      is heterogeneous in DNA measurements; that adds confusion to studies
      incorporating fine needle aspiration biopsy samples. We compared cellular DNA
      content in 34 patients with available needle biopsies and pelvic lymph node
      metastases. Four groups of patients were identified: diploid-range primaries and
      metastases (8 patients), diploid-range primaries and aneuploid metastases (13),
      aneuploid primaries and metastases (10), and aneuploid primaries and diploid
      range metastases (2). Patients with diploid-range primary tumors had a longer
      interval to progression and death than did patients with aneuploid primary
      tumors, although neither was significant in this small series. Patients with
      diploid-range lymph node metastasis had a longer interval to progression (P =
      .04) and survival (P = .09) than did individuals with aneuploid metastases. We
      conclude that the cellular DNA content of prostate cancer metastases in this
      series of stage D1 patients was more powerful in predicting time to progression
      and ultimate survival than evaluation of needle biopsy specimens of the primary
      cancer.

PMID- 8347256
TI  - Textural analysis of lymphoid cells in serous effusions. A mathematical
      morphologic approach.
AB  - Nuclear texture of reactive and well-differentiated neoplastic lymphocytes from
      serous effusions was studied by an approach based on principles of mathematical
      morphology. Density features were obtained before and after gray level nuclear
      image transformation by morphologic closing (dilation followed by erosion) and
      application of a top-hat function, which detects light or dense spots with a
      determined width and contrast. Five cases of benign reactive lymphocytic serous
      effusions and 11 cases of effusions in well-differentiated lymphocytic lymphomas
      were analyzed retrospectively. Each lymphoid cell was characterized by 24
      densitometric features. Rank-order transformation was used for linear
      discriminant analysis given non-normal distributions of variables. In a first
      model formed by pooling all cells, discriminant function distinguished between
      110 reactive and 216 malignant lymphocytes in the learning set and between 111
      reactive and 226 malignant lymphocytes in the test set with better than 81%
      accuracy in both. In a second model, correct classification of cases as reactive
      or malignant was achieved in 5/5 reactive and 11/11 malignant lymphoid effusions.
      The results indicate that mathematical morphologic transformations of the gray
      level image may be an effective adjunct to other textural descriptors of cellular
      atypia, especially in the differential diagnosis of lymphoid serous effusions.

PMID- 8347257
TI  - Proliferation markers in non-Hodgkin's lymphoma. A comparative study between
      cytophotometric quantitation of Ki-67 and flow cytometric proliferation index on
      fine needle aspirates.
AB  - Proliferation markers appear to predict biologic behavior and responses to
      therapy in non-Hodgkin's lymphoma (NHL). We examined the value of the antibody
      against Ki-67, a marker for cycling cells, in 73 fine needle aspirates and
      compared these results with parameters of ploidy, DNA, RNA and proliferative
      index (PI) derived from acridine orange flow cytometry. NHLs were classified into
      three grades according to the Working Formulation. A fourth miscellaneous group,
      consisting of atypical lymphoid hyperplasia, was also analyzed. Ki-67 expression
      was quantitated on a single Cytospin sample from each FNA specimen using an image
      analysis quantitation software program based on measurement of optical density in
      the labeled structures. An average of 680 cells distributed through 10 random
      files was digitized per specimen. The mean Ki-67 positivity and PI calculated for
      each lymphoma grade were significantly different between grades (P < .0001),
      while the overall correlation between Ki-67 positivity and PI was high (r = .8).
      There was no correlation between grade and mean optical density of Ki-67, DNA and
      RNA, but Ki-67 positivity strongly correlated with PI (r = .8). These results are
      similar to those of previous studies performed on histologic sections of NHL in
      which the Ki-67-positive labeling index, measured by either visual scoring or
      image analysis, correlated positively with increasing grade of lymphoma according
      to both the Kiel classification and the Working Formulation. We conclude that Ki
      67 staining of NHL provides information equivalent to that of PI and is useful
      for small specimens, such as fine needle aspirates.

PMID- 8347258
TI  - DNA ploidy in human colorectal adenocarcinomas.
AB  - Image cytometric determination of DNA content was performed on 207 colorectal
      adenocarcinomas surgically resected from 205 patients. Of these 207 tumors, 193
      (93.2%) showed an aneuploid DNA distribution pattern, whereas the remaining 14
      (6.8%) exhibited a DNA pattern corresponding to that found in proliferating
      diploid populations. The DNA content of 20 of these colorectal carcinomas was
      also studied by flow cytometric measurements on deparaffinized, disintegrated
      material. Flow cytometric measurement detected aneuploidy in only 9 of these 20
      (45%) tumors, whereas 17 of the same 20 (85%) carcinomas showed aneuploidy when
      using image cytometric measurement on imprints. These results suggest that
      colorectal carcinomas are either aneuploid (vast majority) or proliferating
      diploid and that image cytometric DNA measurement on histologically controlled
      material is superior to flow cytometric measurement.

PMID- 8347260
TI  - Quantitative immunohistochemistry of parvalbumin expression in the rat diaphragm.
AB  - Parvalbumin is a calcium-binding protein involved in the mechanism of Ca++
      exchange between sarcoplasmic reticulum and the myofibrils. This characteristic
      promotes a direct correlation between the amount of parvalbumin and the velocity
      of contraction-relaxation of skeletal muscle fibers. To quantify the expression
      of parvalbumin in the rat diaphragm, transverse paraffin sections of this muscle
      were processed immunohistochemically using antiparvalbumin monoclonal antibody.
      The stained sections were inspected on an image analysis device to evaluate the
      intensity of the immunoreaction and to make morphologic measurements of the
      muscle fibers. The immunoreaction intensity data allowed the division of fibers
      in fast- and slow-twitch types. The rat diaphragm was characterized as a fast
      twitch muscle due to the presence of 59.8% of fast-twitch fibers. The fibers'
      lesser diameter values showed that the slow-twitch fibers had a small diameter as
      compared to the fast-twitch ones (P < .001). The method used suggests that
      immunohistochemistry for parvalbumin assisted by image analysis is a feasible
      technique to separate fast- and slow-twitch skeletal muscle fibers in paraffin
      sections and to characterize their morphologic profiles.

PMID- 8347259
TI  - Variations associated with disaggregation methods in DNA flow cytometry.
AB  - We investigated the variations in DNA ploidy by flow cytometry (FC) among cell
      suspensions acquired by different disaggregation methods from the same tumor
      specimens. Cell suspensions (n = 121) of 40 solid tumors were obtained by
      mechanical mincing (n = 33), enzymatic digestion (n = 19), in vitro fine needle
      aspiration (FNA) (n = 34) or scraping (n = 35) of the tumor tissues. Mechanical
      disaggregation gave the highest cell yield, whereas enzymatic digestion provided
      the best cell viability. The mean values for the G0/G1 coefficient of variation,
      DNA indices and percent S phase were not significantly different in cell
      suspensions obtained with the four methods. However, the yield of malignant cells
      ranged from 60.4 +/- 5.3% (SEM) (enzymatic) to 82.3 +/- 3.1% (scraping). Tissue
      aliquots of 32 tumors were disaggregated by three to four methods, and the
      combined results of DNA ploidy obtained from different cell preparations showed
      that 22 tumors were nondiploid, but concordance with an abnormal DNA peak was
      found in only 27.3% (6/22) of the DNA nondiploid tumors. Our results indicate
      that scraping tumor tissue appears to be the best method for DNA FC since it has
      the highest percentage (61.3) of DNA nondiploid clones. Also, we believe the
      multiple samplings may provide comprehensive information on the DNA ploidy of
      solid tumors.

PMID- 8347261
TI  - Image cytophotometric DNA histogram heterogeneity in adenocarcinoma of the
      breast.
AB  - In 36 breast carcinomas, DNA histograms derived from the edge of an invasive
      primary tumor were compared with those of a second area in the invasive tumor (n
      = 10) or of corresponding in situ (n = 22) and/or (nodal) metastatic (n = 6)
      components using image cytophotometry on formalin-fixed, paraffin-embedded
      sections. DNA aneuploidy (defined by comparison with diploid host stroma cells)
      was identified in the invasive areas of 26/36 (72%), the noninvasive foci of
      16/22 (73%) and the metastases of 5/6 (83%). Ploidy status of different areas of
      invasive tumor were concordant in all (10/10) cases; however, the in situ and
      invasive areas exhibited different DNA content determinations in 5/22 (23%), and
      metastases differed from the primary neoplasm in 3/6 (50%). Moreover clonal DNA
      content heterogeneity, defined as the presence of more than one discrete G0/G1
      population, was observed in 20/36 (56%) tumors examined. Clonal heterogeneity was
      generally manifest as bimodal DNA histograms in one (n = 11) or both (n = 4)
      components of a tumor. Also, most DNA histogram heterogeneity was due to the
      presence of diploid range (n = 11) or near-tetraploid (n = 6) neoplastic
      populations accompanying DNA aneuploid clones. The remaining heterogeneous cases
      were unimodal in both components analyzed but exhibited aneuploid stemlines with
      different DNA indices (n = 2) or a diploid range population in one histogram and
      an aneuploid population in the other (n = 3). We conclude that DNA content
      heterogeneity is frequent in breast carcinoma and, in large part, may be
      accounted for by near-diploid or near-tetraploid stemlines, which are difficult
      to resolve from benign host elements in flow cytometric histograms.

PMID- 8347262
TI  - Quantitative effects of intercellular signals on computer-simulated tumor
      patterns.
AB  - The behavior of tumor cells within a particular in vivo microenvironment is
      considered to be regulated by intercellular signals. Previous studies of computer
      simulations of tumor growth demonstrated a qualitative effect of autocrine and
      paracrine signaling factors on the resulting morphologic patterns. We
      investigated the quantitative effect of these intercellular signals when the
      evolving patterns were evaluated by a set of pattern analysis procedures,
      yielding 18 quantitative morphologic features. The results show that both
      autocrine and paracrine factors regulating either tumor cell proliferation,
      motility or death influenced at least 10 of the 18 features significantly (linear
      regression analysis; n = 50 for each experiment; P = < .01). Furthermore,
      multivariate analysis of 600 simulated patterns also demonstrated highly
      significant relationships between intercellular signals and quantitative features
      of the evolving pattern (P = < .001). The study showed that various pattern
      measurement features indicate a direct influence of intercellular signals on
      tumor patterns in computer simulations.

PMID- 8347263
TI  - Fine needle aspiration diagnosis of renal oncocytoma. A mathematical morphologic
      approach.
AB  - Differentiation between renal oncocytomas and well-differentiated oxyphilic cell
      renal carcinomas from fine needle aspiration cytology smears may present
      considerable difficulties. To better define diagnostic criteria, we used high
      resolution architectural characteristics of nucleus and cytoplasm based on
      mathematical morphologic concepts. Particulate structural elements were selected
      for their size and optical density by the so-called top-hat function. Spatial
      density, size distribution and a function of distance between particles were
      computed. We quantitated cellular samples from fine needle aspirates obtained
      from 10 renal oncocytomas and 5 well-differentiated oxyphilic cell renal
      carcinomas. In two of the former, cytologic diagnosis was doubtful. Subsequent
      removal of the tumor and its histologic examination established the final
      diagnosis in all cases. Stepwise discriminant analysis correctly classified all
      cases as oncocytomas or renal carcinomas, although the results need to be
      considered with caution due to the necessarily limited number of observations.
      Multivariate graphic representation by star glyphs clearly depicted the
      differences between oncocytoma and oxyphilic cell renal carcinomas and the
      abnormal characteristics of two oncocytoma cases misclassified initially.

PMID- 8347264
TI  - Effect of cooling rate and its interaction with pre-freeze and post-thaw tissue
      culture on the in vitro and in vivo function of cryopreserved pancreatic islets.
AB  - Rapid cooling destroys passenger lymphoid cells during cryopreservation. We now
      describe improved in vivo survival of rat islets after rapid cooling by adding
      pre-freeze tissue culture. Islets were equilibrated with 2M dimethylsulphoxide,
      cooled at 0.3 degrees, 20 degrees, or 70 degrees C/min, and stored at -196
      degrees C. The culture was kept at 37 degrees C for 2 or 72 h before and/or after
      preservation. When cooled at 0.3 degrees C/min, keeping the culture for 72 h gave
      the highest proportion of dye-excluding cells, but more than 50% were viable
      under all culture conditions. Islets cooled at 20 degrees or 70 degrees C/min
      (rapidly) required 72 h of culture for a survival rate of more than 50%. When
      islets were cultured for 72 h before cryopreservation, their in vitro insulin
      secretory ability was similar to that of slowly cooled islets and they were able
      to sustain normoglycaemia in diabetic animals, although more islets were needed.
      Extended tissue culture before freezing improves the survival of rapidly cooled
      islets and is therefore important for combined immunomodulation and
      cryopreservation.

PMID- 8347265
TI  - Transplantation of shipped donor livers.
AB  - Between September 1988 and November 1991, 201 donor hepatectomies and
      transplantations were performed. Fifty-four livers (26.9%) were harvested by
      other teams and shipped for transplantation; 147 livers (73.1%) were procured by
      teams from our transplant center. Comparing the maximal postoperative serum
      aminotransferases (s-AT), we evaluated the postischemic damage of shipped organs
      (AST 951 +/- 931 IU/l; ALT 820 +/- 666 IU/l) and nonshipped organs (AST 753 +/-
      1256 IU/l; ALT 636 +/- 896 IU/l); this did not differ significantly. Donor
      related factors, such as critical parameters (i.e., cardiac arrest, arterial
      hypotension, age over 50 years, or elevated preoperative s-AT), length of stay in
      the intensive care unit before harvesting, and cause of death showed similar
      patterns in both groups. The mean cold ischemia time in the group of shipped
      livers (12 h 10 min +/- 4 h 22 min) and in the nonshipped livers (10 h 6 min +/-
      3 h 53 min) did not differ significantly. Five cases (2.5%) of a primary non
      functioning graft presenting with significantly (P < 0.001) elevated s-AT (AST
      4944 +/- 2280 IU/l; ALT 3186 +/- 1918 IU/l) necessitated an early
      retransplantation. One organ was shipped and four organs were nonshipped, thus
      corresponding to their portion of all grafts. These data indicate that the
      transplantation of shipped livers is a safe procedure procedure, provided that
      procurement is done by experienced centers.

PMID- 8347266
TI  - The influence of primary non-function on the accuracy of ultrasound measurements
      in the diagnosis of renal allograft rejection.
AB  - Daily ultrasonographic measurements of transplant cross-sectional area were used
      to quantify allograft swelling as a diagnostic test for acute rejection in a
      series of 120 renal transplants. Initial graft function (IF) occurred in 86
      patients (72%) and primary non-function (PNF) occurred in the remaining 34 (28%).
      An increase in allograft cross-sectional area greater than or equal to 10% was
      defined as a positive ultrasound scan suggesting an acute rejection episode and
      was investigated by needle core biopsy. During periods of PNF, allografts with
      consistently negative ultrasound scans were submitted to needle core biopsy on a
      weekly basis. The diagnosis of rejection was based exclusively on the
      histological findings. In the IF group, agreement between ultrasound and
      histological diagnosis was good (k = 0.63, sensitivity 81%, specificity 83%,
      positive predictive value 76%, negative predictive value 86% and overall accuracy
      82%). In the PNF group, agreement between ultrasound and histology was only fair
      (k = 0.46, sensitivity 77%, specificity 70%, positive predictive value 69%,
      negative predictive value 78% and overall accuracy 73%). It is concluded that a
      degree of allograft swelling is sometimes associated with acute tubular necrosis,
      and this makes ultrasound measurements of transplant size a less useful technique
      of monitoring kidneys with PNF.

PMID- 8347267
TI  - Effect of enalapril on proteinuria after kidney transplantation.
AB  - We studied the effect of enalapril, an inhibitor of angiotensin-converting enzyme
      (iACE), on proteinuria and renal function in recipients of renal allografts.
      Twenty-two patients with post-transplant nephrotic syndrome were treated with
      incremental doses of enalapril for 1 year. Urinary protein excretion decreased
      after 2 months of treatment from a mean of 8.9 g/day (range 4.0-18.9 g/day) to
      4.5 g/day (range 0.4-10.0 g/day; P < 0.01) and remained significantly low for the
      rest of the study. However, in the same period, creatinine clearance did not
      change significantly; it went from 47.8 ml/min (range 17.1-110.3 ml/min) before
      treatment to 44.2 ml/min (range 16.5-88.5 ml/min) after 2 months of iACE therapy.
      Analysis of individual data showed that there was a significant reduction in
      proteinuria in 14 of the 22 patients and that the rate of deterioration of renal
      function did not increase in 17 of the 22 patients. We did not observe any
      serious side effects of enalapril administration. The results of our study prove
      that iACE can be used safely and effectively to reduce post-transplant
      proteinuria.

PMID- 8347268
TI  - Injury to cultured liver endothelial cells during cold preservation: energy
      dependent versus energy-deficiency injury.
AB  - Previously, we demonstrated an energy-dependent injury to cultured liver
      endothelial cells during cold incubation in University of Wisconsin (UW)
      solution. Here, the effects of Histidine-Tryptophan-Ketoglutarate (HTK) and Euro
      Collins (EC) solutions on these cells were studied. In HTK solution, 83% +/- 4%
      of the cells had lost viability after 9 h of incubation at 4 degrees C. The
      addition of cyanide (1 mM) to simulate hypoxic conditions protected the cells to
      the extent that only 9% +/- 1% of the cells lost viability over the same period;
      the addition of glucose (10 mM) led to increased cell injury. ATP levels were
      highest in the incubations with the most rapid loss of viability. In Krebs
      Henseleit buffer and EC solution, in contrast, cell injury increased upon
      addition of cyanide; the addition of glucose to Krebs-Henseleit buffer decreased
      injury. We conclude that the injury to cultured liver endothelial cells during
      cold incubation in HTK solution is energy-dependent, as it is in UW solution,
      whereas cells behave differently in EC solution and Krebs-Henseleit buffer.

PMID- 8347269
TI  - Is there an optimal time for the first cyclosporin dose in renal transplantation?
AB  - It is customary for patients undergoing kidney transplantation to receive their
      first dose of cyclosporin either just before or during the transplant operation.
      This ensures the early establishment of good levels of immunosuppression but
      might depress early graft function and contribute towards the development of
      acute tubular necrosis. In a controlled clinical trial, we have studied the
      effects of withholding cyclosporin for 12 h in patients undergoing cadaveric
      renal transplantation. Consecutive adult recipients of a cadaveric renal
      transplant were randomised to receive their first dose of cyclosporin (10 mg/kg
      p.o.) 6 h prior to transplant surgery or 12 h afterwards. All patients received
      azathioprine (1.5 mg/kg i.v.) and methylprednisolone (0.5 g i.v.) in addition
      during surgery. From the 2nd day onwards both groups were treated with an
      identical triple immunosuppressive regimen. The 27 patients who received their
      first dose of cyclosporin post-operatively had significantly better immediate and
      subsequent function than did the 26 patients who received their cyclosporin at
      the time of surgery. The delayed dosing was associated with improved graft
      survival and no increase in the frequency of rejection episodes. This regimen is
      recommended for all patients receiving triple therapy.

PMID- 8347270
TI  - Selection criteria for liver donation: a review.
AB  - An overview of the criteria that are currently being used for the selection of
      liver donors is presented. The validity of the different criteria is discussed.
      The potential benefits of introducing other modalities is dealt with.

PMID- 8347272
TI  - Percutaneous transhepatic embolization of an intrahepatic pseudoaneurysm
      following liver biopsy in a liver transplant patient.
AB  - A 41-year-old liver transplant patient had severe hemobilia from an intrahepatic
      pseudoaneurysm secondary to a liver biopsy. Selective intra-arterial embolization
      was not technically possible due to marked redundancy and tortuosity of the
      allograft hepatic artery. The pseudoaneurysm was localized by ultrasound and
      embolized using a direct percutaneous transhepatic approach. This is a novel way
      of approaching hemobilia in liver transplant patients after liver biopsy and may
      avoid the risks of arterial embolization.

PMID- 8347271
TI  - Protective effect of the PAF antagonist BN 52021 in an experimental renal warm
      ischemia model.
AB  - Platelet activating factor is involved in warm ischemic damage. We studied the
      effect of the PAF receptor antagonist BN 52021 in an experimental model of 60 min
      of renal warm ischemia in which the left kidney was flushed with Euro-Collins
      solution and a right nephrectomy was performed. Eighty Wistar rats were divided
      into a sham-operated group, two control groups, and four study groups, according
      to the dosage and route of BN 52021 administration. BN 52021 was used in the
      flush solution at concentrations of 0.1 and 0.5 mg/ml, or intravenously prior to
      ischemia at 5 and 10 mg/kg body weight. Creatinine clearance per 100 g body
      weight, fractional sodium excretion, and conventional histology were studied.
      Rats that received BN 52021 intravenously showed a significantly higher
      creatinine clearance than controls. Intravenous BN 52021 produced a higher
      acceleration of renal function recovery at 10 mg/kg than at 5 mg/kg body weight.
      Conventional histology was better in animals that received BN 52021 at 10 mg/kg
      body weight than in controls. Addition of BN 52021 to Euro-Collins flushing
      solution showed no protective effect. We conclude that intravenous BN 52021 shows
      a renal protective effect against warm ischemia.

PMID- 8347273
TI  - Homograft replacement of the aortic valve after liver transplantation.

PMID- 8347274
TI  - Copper and gene regulation in yeast.
AB  - The essential trace element copper is also highly toxic when accumulated at high
      intracellular levels. Copper detoxification in the yeasts S.cerevisiae and
      C.glabrata is carried out, in large part, by small, cysteine-rich metal binding
      proteins known as metallothioneins (MTs). The biosynthesis of yeast
      metallothioneins, the S.cerevisiae copper, zinc superoxide dismutase, and
      presumably other important copper homeostatic proteins, is transcriptionally
      induced by elevated environmental copper concentrations through the action of
      copper metalloregulatory transcription factors (MRTFs). Copper coordination
      drives the formation of a structure distinct from the apo-protein, whereupon the
      DNA binding function of MRTFs is activated. The copper MRTFs, ACE1 from
      S.cerevisiae and AMT1 from C.glabrata, directly interact with specific copper
      responsive cis-acting elements in the promotor regions of their respective target
      genes. The binding of copper, as a polynuclear cluster, to MRTFs provides a
      sensitive and rapid means of transducing the extracellular metal signal to
      activate gene transcription.

PMID- 8347275
TI  - An enzymatic method for zinc determination in serum.
AB  - In this study, serum Zn(2+) content was determined by a new enzymatic method. The
      method depends on the reactivation of apocarbonic anhydrase proportional to the
      Zn(2+) content of the sample. Carbonic anhydrase was purified from bovine
      erythrocytes by affinity chromatography. The Zn(2+) in its structure was removed
      by dialysis against pyridine 2,6-dicarboxylic acid, resulting in a pure apoenzyme
      with a yield of 100%. The activity of the enzyme was determined by its esterase
      effect on 4-nitrophenyl acetate. Zn(2+) levels were determined in the serum
      samples obtained from 100 healthy subjects, 10 patients with cirrhosis, 12
      diabetic patients and 15 patients with chronic renal failure by this enzymatic
      method and by atomic absorption for comparison. There was a good correlation
      between the two methods in all patients and controls and intraassay CV% was 2.4
      and 4.2 for enzymatic and atomic absorption methods, respectively and interassay
      CV% as 3.9 and 6.1 respectively.

PMID- 8347276
TI  - Synergistic bombesin and insulin stimulation of DNA synthesis in human fetal
      kidney in serum-free culture.
AB  - The respective influences of growth factors during kidney development can be
      directly evaluated using the chemically-defined serum-free culture system
      perfected in our laboratory. Since, in this culture model, conditions are minimal
      for growth and differentiation, DNA synthesis sharply decreases during the first
      48 h. The addition of epidermal growth factor (EGF, 100 ng/ml), insulin (5
      micrograms/ml) and transferrin (5 micrograms/ml) significantly restores this
      important cellular function. The objective of the present study was to determine
      the influence of bombesin, a potent mitogen, supplemented alone or in combination
      with insulin, transferrin and/or EGF. Cortical explants of human fetal kidneys
      (17-20 weeks) were maintained during 5 days in culture. When compared with 5 day
      controls (L-15 medium only), bombesin generated a maximal though weak effect on
      DNA synthesis at a concentration of 0.3 nM, corresponding to a stimulation index
      (SI) of 22%. When combined with either transferrin or EGF, or with transferrin
      plus EGF, bombesin did not alter the SI of individual factors. Insulin, in turn,
      greatly increased DNA synthesis (SI = 169%), while bombesin strongly potentiated
      this effect (SI = 275%). Transferrin also enhanced insulin SI from 169 to 240%.
      When added as a third factor, bombesin further potentiated the effectiveness (SI
      = 338%) of the combination insulin plus transferrin. These results indicate that
      bombesin controls cell proliferation in synergism with other regulators and hence
      may act as a competence growth factor during nephrogenesis.

PMID- 8347277
TI  - Transcriptional control of the platelet-derived growth factor subunit genes.
AB  - Platelet-derived growth factor (PDGF) is a potent mitogen consisting of
      heterodimers of two distinct but homologous polypeptide chains, denoted A and B.
      PDGF-like homodimers of the A- and B-chains have been isolated, as well as two
      distinct receptor types (alpha and beta), which discriminate among the PDGF
      isoforms. The PDGF A- and B-chains are encoded by distinct genes located on human
      chromosomes 7 and 22, respectively. Although PDGF has been implicated as an
      important participant in development, tissue repair, and numerous pathologic
      states including tumorigenesis, atherosclerosis and inflammation, the mechanisms
      which determine the rate of its synthesis are only beginning to be understood.
      Basal expression of the PDGF A- and B-chain genes has been characterized in a
      number of cell types and is directed in part by elements in the respective
      proximal promoter-regulatory regions of the two genes. In addition, the first
      intron of PDGF-B has been shown to contain both positive and negative regulatory
      elements. Transcription of the PDGF subunit genes is inducible by a wide variety
      of mitogenic growth factors, cytokines and other agonists. These agents produce a
      rapid increase in steady-state concentrations of PDGF A- and B-chain mRNAs,
      peaking within 4-8 h of stimulation. The inductive effects of protein kinase C
      activating phorbol 12-myristate 13-acetate (PMA), thrombin and transforming
      growth factor-beta (TGF-beta) are mediated through increases in the transcription
      rates of both genes. In addition, cAMP blocks the increases in transcription of
      the B-chain gene induced by thrombin and TGF-beta. Studies have demonstrated the
      importance of sequences immediately upstream of the B-chain transcription start
      site for induction in response to PMA-initiated megakaryocyte differentiation, an
      effect which is dependent on protein synthesis. However, cis-acting elements
      which mediate more rapid transcriptional induction seen in endothelial cells and
      astrocytes have yet to be identified in the proximal 5'-flanking sequences of
      either the A- or B-chain genes, suggesting that such events may be mediated by
      elements located outside of this region.

PMID- 8347278
TI  - Biological effects of saffron.
AB  - This review examines the literature data concerning the biological activities of
      saffron extract. Numerous studies have revealed that this substance possesses
      cytotoxic, anticarcinogenic and antitumor properties. A brief description of the
      other biological effects as well as chemical composition of the saffron extract
      is also included. Finally, these findings are interpreted and the possible
      mechanism of the antitumor effects of saffron extract are discussed.

PMID- 8347279
TI  - The IRE (iron regulatory element) family: structures which regulate mRNA
      translation or stability.
AB  - Iron regulatory elements (IREs) are a family of 28 nucleotide, non-coding
      elements which regulate the translation of ferritin mRNA (iron storage),
      erythroid delta-aminolevulinic acid synthase mRNA (heme synthesis) and the
      stability of the transferrin receptor (TfR) mRNA (iron uptake). IREs in the 5'
      end control translation (ribosome binding) and IREs in the 3' end control
      turnover (degradation). The specific regulator protein, the IRE-BP, is a member
      of the aconitase family but binds RNA only in the apo form without the Fe-S
      cluster. Cellular iron alters the IRE/IRE-BP interaction leading to translation
      of ferritin and eALAS mRNAs but degradation of the TfR mRNA. IRE function
      requires proximity to the 5' cap, achieved either by a short leader (eALAS) or a
      long, base-pairing flanking region (FL) (ferritin); a conserved triplet of FL
      base pairs enhances repression of ferritin mRNA. TfR mRNA has five AU-rich IREs
      which can also form an alternate structure with inter-IRE base pairs, in the
      absence of the IRE-BP. Ferritin IREs regulate both translation repression
      (negative control-IRE-BP dependent) and enhancement (positive control-initiation
      factor dependent); IRE-BP binding induces conformational changes in the FL. IREs
      use CAGUGU/C to form a hairpin loop with specific variations in the stem such as
      internal or bulge loops. A current structural model obtained using
      metallonucleases (1,10-phenanthroline-Cu, Fe-EDTA, Fe-bleomycin) and a
      preliminary analysis of the NMR spectrum, is a distorted helix with folds. The
      effect of cellular iron, Fe-S clusters and heme on the IRE-BP/RNA is not
      completely understood.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347280
TI  - Hypusine: its post-translational formation in eukaryotic initiation factor 5A and
      its potential role in cellular regulation.
AB  - The amino acid, hypusine [N epsilon-(4-amino-2-hydroxybutyl) lysine], a unique
      component of one cellular protein, eukaryotic translation initiation factor 5A
      (eIF-5A, old terminology eIF-4D), is formed post-translationally in two enzymatic
      steps: (i) transfer of the 4-aminobutyl moiety of the polyamine spermidine to the
      epsilon-amino group of a single specific lysine residue in the eIF-5A precursor
      protein to form an intermediate, deoxyhypusine, and (ii) subsequent hydroxylation
      in this 4-aminobutyl portion. Hypusine is produced soon after the translation of
      eIF-5A mRNA; the modification is essentially irreversible. Hypusine is found in
      all eukaryotes examined as well as in archaebacteria; it does not occur in
      eubacteria. The protein containing hypusine from each species displays a high
      degree of amino acid identity; the sequence of amino acids surrounding the
      hypusine residue is strictly conserved, suggesting the importance of the hypusine
      modification throughout evolution. Expression of one of the two yeast eIF-5A
      genes is required for survival and the lysine codon at the site of hypusine
      synthesis is vital for yeast growth. The precise cellular function of eIF-5A
      remains to be elucidated; however, eIF-5A stimulates methionyl-puromycin
      synthesis in a model assay for translation initiation and eIF-5A precursors
      containing lysine in place of hypusine are inactive in this assay. This provides
      evidence that the hypusine modification is needed for eIF-5A activity. In view of
      the important role of hypusine in eIF-5A and because of the narrow specificities
      of the enzymes involved in formation of this unusual amino acid, the hypusine
      biosynthetic steps offer promising targets for intervention in cellular
      proliferation. Spermidine analogs that are inhibitors of deoxyhypusine synthase
      in vitro also cause inhibition of hypusine formation in cells, together with a
      reduction in protein synthesis and in cell growth. In addition, certain metal
      chelating inhibitors of deoxyhypusine hydroxylase exhibit anti-proliferative
      effects by arresting mammalian cells at the G1/S boundary of the cell cycle.
      These results lay the foundation for the potential regulation of cellular events
      through the application of specific and potent inhibitors of hypusine
      biosynthesis.

PMID- 8347282
TI  - Using pressure measurements to evaluate different technologies.
AB  - Despite ongoing efforts to improve the prediction, prevention, and treatment of
      pressure ulcers, clinicians continue to face an overwhelming array of confusing,
      and sometimes conflicting, information about the technologies used to lower
      pressure. The purpose of this article is to explain the fundamental differences
      among units of pressure measurement and those pressures (capillary closing,
      tissue interface, internal cushion, and hydrostatic) that are commonly described
      in research as well as sales literature. A clearer understanding of these
      parameters will help clinicians make informed evaluations of distinct
      technologies, set realistic expectations for different products, and achieve
      desired outcomes cost-effectively.

PMID- 8347281
TI  - The evaluation of five specialized support surfaces by use of a pressure
      sensitive mat.
AB  - This study used two full-size pressure-sensitive mats to evaluate five patient
      support surfaces. The mats, containing 1,536 and 2,340 pressure measurement
      sites, respectively, made it possible to quantify the entire interface pressure
      distribution of each support surface. Measurements for groups of 64 and 32
      subjects were obtained in supine positions of 0 degree, 30 degrees, at maximal
      head elevations (50 degrees-60 degrees), and at lateral recumbency. Several
      statistical descriptors were calculated to characterize the interface pressure
      distributions. The support surfaces tested included: a powered-air overlay
      (ACUCAIR Continuous-Air-flow System), a low-airloss bed (FLEXICAIR MC3 Low
      Airloss Therapy), a continuous lateral-rotation low-airloss bed (RESTCUE Dynamic
      Air Therapy), an air-fluidized bed (CLINITRON II Air-Fluidized Therapy), and an
      integrated bed (prototype Advance 2000 Bed). An analysis of variance revealed
      that the interface pressure was significantly lower and weight-bearing area was
      significantly higher on the five surfaces, when compared to the standard hospital
      mattress.

PMID- 8347283
TI  - Lack of nutrition in AHCPR prevention guideline.

PMID- 8347284
TI  - A critique of the AHCPR's "Preventing pressure ulcers--a patient's guide" as a
      written instructional tool.
AB  - Preventing Pressure Ulcers--A patient's guide was released by the Agency for
      Health Care Policy and Research (AHCPR) in May 1992. Using criteria suggested by
      Falvo (1985), Redman (1988), Ruzicki (1989), and others, the guide was critiqued
      to determine how it compared to existing criteria for evaluating written tools.
      The AHCPR guidelines does not meet all the criteria; suggestions for improvement
      are provided.

PMID- 8347285
TI  - Exploring the validity of data-gathering instruments.
AB  - The validity of an instrument is another important issue for the clinician to
      consider when selecting a tool for use in data collection. Broadly defined,
      validity refers to the extent to which an instrument measures what it is supposed
      to be measuring. Although validity is a unitary concept, this article explores
      three common categories of validity: content, criterion-related, and construct
      validity.

PMID- 8347286
TI  - Kudos to Dr. Deloach for article on osteomyelitis.

PMID- 8347287
TI  - Collaboration produces results.

PMID- 8347288
TI  - Human immunodeficiency virus (HIV) infection. Does it increase susceptibility to
      adverse drug reactions?

PMID- 8347289
TI  - Oral contraceptives. Are drug interactions of clinical significance?
AB  - There is a large quantity of literature on drug interactions with oral
      contraceptive (OC) steroids although their incidence is not known. The potential
      clinical significance of some interactions makes it important for all prescribing
      doctors and dentists to have some knowledge of the topic. Interactions may be
      divided into those in which OC effectiveness is impaired, causing breakthrough
      bleeding or pregnancy, those in which OC activity is enhanced by other drugs and
      those in which OCs interfere with the metabolism or activity of other therapeutic
      agents. Consideration of their pharmacology indicates that impairment of OC
      effect is most likely to be due to interference with ethinylestradiol. This is
      because this compound is sulphated in the gut wall, hydroxylated and
      glucuronidated in the liver, and undergoes enterohepatic recirculation. The
      progestogens are only metabolised in the liver and have no significant
      enterohepatic recirculation. Protein binding interactions are rarely of clinical
      importance. OC plasma concentrations may be reduced by induction of hepatic
      metabolism in the case of griseofulvin, rifampicin (rifampin) and several
      anticonvulsant drugs; valproic acid (sodium valproate) does not have this effect.
      Antibiotics may interfere with enterohepatic recirculation of ethinylestradiol
      and reduce plasma levels of active hormone. This is probably only of significance
      in a subgroup of women who may sometimes be suspected on history, but cannot be
      identified by any diagnostic test. Reasons for differences between case reports
      and formal studies of interactions with antibiotics are discussed. Plasma
      concentrations of ethinylestradiol may be increased by ascorbic acid (vitamin C)
      and paracetamol (acetaminophen) which compete with it for sulphation in the gut
      wall. Theoretically, problems may arise if these agents are stopped suddenly.
      Imidazole antifungal agents can inhibit ethinylestradiol metabolism and increase
      its plasma concentrations but the clinical significance of this is unknown. OCs
      have been shown to inhibit metabolism of many therapeutic drugs and increase
      their plasma concentrations. This may be of clinical significance in the case of
      benzodiazepines which are hydroxylated in the liver, but clinical effects are
      less certain with the other agents. OCs may induce metabolism of other drugs
      which are glucuronidated, including some benzodiazepines and analgesics. The
      clinical significance of this type of interaction is also unknown. It is
      suggested that all prescribers should remember to ask about OCs when taking a
      drug history and to consider the possibility of interactions with other drugs.

PMID- 8347290
TI  - Risks and benefits of drugs used in the management of the hyperactive child.
AB  - Childhood hyperactivity is a common behavioural complaint. The therapeutic
      options for physicians caring for children with hyperactivity are considerable
      and varied; current recommendations call for a multidisciplinary approach,
      including when necessary the use of drug therapy. Central nervous system
      stimulants are the primary agents used in the therapy of hyperactivity. The
      majority of children with hyperactivity diagnosed using careful clinical criteria
      will demonstrate short term benefits in cognitive and behavioural terms, but long
      term efficacy remains controversial. There appears to be a subset of patients who
      do not demonstrate a beneficial response to stimulants, although there is
      controversy as to whether this may be dose dependent. The adverse effects of most
      concern are suppression of growth, the development of tics and the potential for
      abuse. Antidepressants and clonidine are useful agents for the therapy of
      patients resistant to stimulant therapy. Although the most frequent adverse
      events of antidepressant therapy are associated with the anticholinergic activity
      of these agents, the most common serious adverse events are associated with
      antidepressant overdose. Concern has been expressed because of case reports
      describing an association between antidepressant therapy for hyperactivity and
      sudden death. A number of other therapies have been used for hyperactivity.
      Although these therapies may be effective in subsets of patients with
      hyperactivity, there is little research detailing how to identify patients who
      might be expected to respond to such treatment.

PMID- 8347291
TI  - Epidemiology of drug-drug interactions as a cause of hospital admissions.
AB  - The purpose of this review was to focus on hospital admissions caused by a
      specific type of adverse drug reaction (ADR) that can be assumed to be avoidable
      in almost all cases: the drug-drug interaction (D-DI). To determine the
      epidemiology of D-DIs in hospital admissions, a review of the adverse drug
      reaction literature was undertaken to answer several questions: (a) what is the
      incidence of hospital admissions attributable to D-DIs?; (b) what percentage of
      drug-related hospital admissions are attributable to D-DIs?; (c) are there any
      patterns to the above findings, i.e. are some D-DIs or specific drugs more likely
      to have been associated with hospital admissions?; and (d) are there certain
      patient risk factors (e.g. age) that are associated with D-DIs that led to a
      hospital admission? Nine ADR studies were found that either included a D-DI
      category as a cause for hospital admissions, or provided sufficient information
      so that a causal relationship could be inferred. The incidence of hospital
      admissions due to D-DIs ranged from 0 to 2.8%. The data found in the studies we
      reviewed, however, were insufficient to allow meaningful quantification of
      specific drugs as usual causes for D-DI-related admissions, and because of the
      very small numbers of patients for which a D-DI was believed to be the cause it
      is not possible to provide a meaningful summary of risk factors specific for D-DI
      admissions. We cannot conclude that D-DIs are a significant problem. There is a
      need to view the quantification of D-DIs in relation to the number of medications
      prescribed by physicians, dispensed by pharmacists and taken by patients.

PMID- 8347294
TI  - Lymphocyte activation and effector functions. Editorial overview. The role of
      cell surface molecules.

PMID- 8347295
TI  - Transmembrane signalling through the T-cell-receptor-CD3 complex.
AB  - Recent data support the existence of activation motifs within different subunits
      of the T-cell-receptor-CD3 complex. This architecture generates a receptor
      composed of discrete modules, each capable of being coupled to an effector
      pathway. Although new T-cell specific protein tyrosine kinases have recently been
      identified, the nature of the proximal non-receptor protein tyrosine kinase
      linking the T-cell receptor complex to essential signalling effectors remains
      unknown. Developmentally regulated differences in T-cell-receptor-CD3 assembly or
      stability may lead to the expression of isoforms displaying different sets of
      activation motifs. Whether this may be the basis of differential signalling
      during T-cell development is still a matter of speculation.

PMID- 8347293
TI  - Inhaled corticosteroids in children. Is there a 'safe' dosage?
AB  - Inhaled corticosteroids are effective for the treatment of asthma. Because of the
      appreciation of the importance of airway inflammation in the pathogenesis of the
      disease, these drugs are being used more frequently not only in severe but also
      in moderate asthma. Treatment rarely has to be stopped because of topical adverse
      effects since oropharyngeal candidiasis and dysphonia are uncommon in children.
      However, paediatricians need to remain alert for the possibility of systemic
      adverse effects. With sensitive techniques, dose-dependent adrenal suppression
      has been documented in children treated with inhaled steroids but generally this
      effect has no clinical relevance. Although suppression of short term growth
      velocity has been reported, long term studies have shown that when growth
      impairment occurs in a child with asthma it is more likely to reflect poor asthma
      control than the administration of inhaled corticosteroids. Calcium
      supplementation may be necessary in children with asthma treated with inhaled
      steroids since this treatment may cause reduction in osteocalcin, a marker of
      osteoblast activity and bone formation. Other systemic adverse effects have been
      reported in case reports. The use of a large spacer device has been shown to
      reduce the incidence of both topical and systemic adverse effects from inhaled
      steroids and their use should be encouraged. In any child with asthma who really
      needs inhaled steroids, the lowest dose possible should be prescribed; however,
      the mistake of prescribing doses too low to be therapeutically effective should
      be avoided.

PMID- 8347297
TI  - The tyrosine kinase connection: how GPI-anchored proteins activate T cells.
AB  - How can crosslinking of cell-surface glycosylphosphatidylinositol-anchored
      proteins activate T cells when the proteins do not reach the cytosol? Recent
      results show that glycosylphosphatidylinositol-anchored proteins associate with
      tyrosine kinases of the src family. Kinase activity is stimulated when
      glycosylphosphatidylinositol-anchored proteins are crosslinked. How the proteins
      are linked across the membrane, however, remains an intriguing mystery.

PMID- 8347296
TI  - CD4, CD8 and the role of CD45 in T-cell activation.
AB  - CD4, CD8 and CD45 regulate the coupling of the T-cell receptor complex (CD3-TCR)
      to tyrosine kinase activation and phosphorylation of key substrates such as
      phospholipase C gamma 1. CD4 and CD8 contribute to activation signals through
      their cytoplasmic association with p56lck. Expression of the zeta-chain is
      required for functional synergy of the T-cell receptor with CD4 in the activation
      of phospholipase C gamma 1, which probably reflects an interaction between p56lck
      and zeta-associated kinase ZAP-70. CD45 expression is required for CD3-TCR
      signaling. CD45 may positively regulate signaling by dephosphorylating the
      carboxyl-terminal tyrosine of p56lck and p59fyn, and negatively regulate
      signaling by dephosphorylation of other TCR-associated substrates directly. One
      ligand for CD45 receptor has been identified as the B cell CD22 molecule. The
      positive and negative effects of CD45 are sensitive to the composition of CD45 in
      receptor complexes, and may be regulated by specific associations of CD45
      isoforms with other receptors such as CD3-TCR, CD2 and CD4.

PMID- 8347299
TI  - Antigen-presenting cell types.
AB  - Different antigen-presenting cells elicit responses in different T-cell
      populations for primary activation, secondary stimulation and cytotoxic effector
      functions. Maturing bone marrow derived dendritic cells may acquire and process
      antigens, transport them to lymph nodes and activate naive T cells located there.
      By contrast, follicular dendritic cells, acquiring antigen-antibody complexes,
      maintain 'memory' via B-cell activation. Effector memory T cells recognize
      various tissue cells bearing antigen and we speculate that they may also target
      specialized antigen-presenting dendritic populations.

PMID- 8347298
TI  - Regulation of B-cell activation and antigen presentation by Fc receptors.
AB  - Fc receptors are a family of membrane-associated and soluble glycoproteins that
      mediate a vast array of functions triggered by immune complexes. The structures
      of murine and human Fc gamma and Fc epsilon receptors have been elucidated and
      the motifs involved in the activities that they mediate characterized during the
      past year. B-cell activation and differentiation may be enhanced by different Fc
      receptor isoforms either through an increased presentation of antigen associated
      with IgG (Fc gamma RIIb2, Fc gamma RIII, Fc epsilon RII), or the induction of
      cytokine synthesis by mast cells (Fc epsilon RI, Fc gamma RIII) and natural
      killer cells (Fc gamma RIII). Conversely, the crosslinking of Fc gamma RIIb1 to
      membrane Ig inhibits B-cell activation. Soluble forms of Fc receptor also
      regulate antibody production by enhancing interleukin-4-induced IgE synthesis (Fc
      epsilon RII) or inhibiting IgG synthesis (Fc gamma R). Different structural
      motifs are responsible for the different biological activities of each Fc
      receptor isoform.

PMID- 8347292
TI  - Genetically determined adverse drug reactions involving metabolism.
AB  - Genetic factors represent an important source of interindividual variation in
      drug response. Relatively few adverse drug effects with a pharmacodynamic basis
      are known, and most of the well characterised inherited traits take the form of
      genetic polymorphisms of drug metabolism. Monogenic control of N-acetylation, S
      methylation and cytochrome P450-catalysed oxidation of drugs can have important
      clinical consequences. Individuals who inherit an impaired ability to perform one
      or more of these reactions may be at an increased risk of concentration-related
      toxicity. There is a strong case for phenotyping before starting treatment with a
      small number of drugs that are polymorphically N-acetylated or S-methylated.
      However, the issue of clinical significance is perhaps most relevant for the
      debrisoquine oxidation polymorphism, which is mediated by cytochrome CYP2D6 and
      which determines the pharmacokinetics of many commonly used drugs. Phenotypic
      poor metabolisers of debrisoquine (8% of Caucasian populations) taking standard
      doses of some tricyclic antidepressants, neuroleptics or antiarrhythmic drugs may
      be particularly prone to adverse reactions. Similarly, clinically relevant drug
      interactions between these drugs and other substrates of cytochrome CYP2D6 may
      occur in the majority of the population who are extensive metabolisers. However,
      it is clear that in the majority of cases there is a need for controlled
      prospective studies to determine clinical significance. Accordingly, routine
      debrisoquine phenotyping or genotyping before beginning drug treatment is
      difficult to justify at present, although it may be helpful in individual cases.
      When prescribing drugs whose metabolism is polymorphic alone or in combination,
      careful titration of the dose in both phenotypic groups is prudent. In some cases
      it will be preferable to use alternative therapy to avoid the risk of adverse
      drug reactions.

PMID- 8347300
TI  - T cell mediated immunosuppression.
AB  - Suppressor T cells down-regulate the activity of other cells in the immune
      system, and, albeit controversial, are believed to play a role in immunological
      tolerance and immunoregulation. Significant progress has been made in
      characterizing suppressor T cells and their receptors, and in elucidating
      mechanisms of immunosuppression. This knowledge is important for understanding
      the immune system and certain disease states and for favorably manipulating
      immunity.

PMID- 8347301
TI  - Sites of B-cell activation in vivo.
AB  - Novel techniques have made possible in situ analyses of the lymphocyte
      populations responding to antigen. In the spleen, antigen-specific T and B cells
      are first observed in the periarteriolar lymphoid sheath. Following conjugate
      formation between specific T and B lymphocytes, B-cell proliferation and
      differentiation takes place in two distinct sites, the periarteriolar lymphoid
      sheath-associated foci and germinal centers.

PMID- 8347302
TI  - Homing of naive, memory and effector lymphocytes.
AB  - Lymphocyte subsets home in a particular manner depending on their class, state of
      activation and 'allegiance' to certain tissues. Naive lymphocytes home
      preferentially through lymphoid tissues, whereas effector and memory cells home
      preferentially through non-lymphoid tissues and exist as phenotypically distinct
      subsets with preferential localization to gut, skin or other tissues. These
      migration pathways, which correlate with different functional properties of
      lymphocyte subsets, increase the efficiency of the immune system.

PMID- 8347303
TI  - Immune privilege as the result of local tissue barriers and immunosuppressive
      microenvironments.
AB  - As the cellular and molecular bases of immune privilege are elucidated
      experimentally, the phenomenon emerges as an active and dynamic exercise in
      immune regulation. Local tissue factors play a key role in the establishment and
      maintenance of privilege, particularly tissue cytokines and mediators within the
      local microenvironment, which modify both the induction and expression of
      immunity to antigens that are introduced into, or arise within, privileged sites.

PMID- 8347305
TI  - Lymphocyte activation and effector functions.

PMID- 8347304
TI  - Lifespans of naive, memory and effector lymphocytes.
AB  - Typical T and B lymphocytes in the secondary lymphoid organs are long-lived cells
      that are selected from a large pool of short-lived precursor cells in the primary
      lymphoid organs. The bulk of mature T and B cells are immunologically naive and
      remain in interphase for prolonged periods. Contact with specific antigen causes
      these naive cells to proliferate rapidly and differentiate into a mixture of
      short-lived effector cells and long-lived memory cells. Memory cells have a rapid
      turnover, and the survival of these cells appears to require persistent contact
      with antigen.

PMID- 8347306
TI  - 7-Chloromethyl-12-methylbenz(a)anthracene.
AB  - C20H15Cl, M(r) = 290.8, monoclinic, P2(1)/c, a = 20.449 (4), b = 11.473 (2), c =
      13.025 (2) A, beta = 108.91 (1)degree, V = 2890.9 A, Z = 8, Dx = 1.336 g cm-3,
      lambda (Cu K alpha) = 1.5418 A, mu = 21.14 cm-1, F(000) = 1216, T = 294 K, R =
      0.045, wR = 0.049, for 3471 diffractometer data [Io > or = 3 sigma (I)]. The ring
      system is puckered as a result of the bulkiness of the 12-methyl group.

PMID- 8347307
TI  - 3-[1-(Ethylamino)ethylidene]-6-methyl-3H-pyran-2,4-dione.
AB  - The structural results clearly indicate that 3-[1-(ethylamino)ethylidene]-6
      methyl-3H-pyran-2,4-dione exists as a keto-enamine tautomer in the solid state.
      The H atom bonded to N(9) refines with a normal temperature factor and the bond
      distance of the keto group [C(4)--O(13)] of 1.263 (1) A is elongated due to
      resonance. This resonance is also indicated by an averaging of the single bonds
      [C(2)--C(3), C(3)--C(4), C(4)--C(5) and C(8)--N(9)] and double bonds [C(3)--C(8)
      and C(4)--O(13)] in the crystal structure and by the fact that not only is the
      pyran ring planar [r.m.s. deviation 0.0212 (9) A] but also there is planarity for
      the whole molecule [r.m.s. deviation 0.074 (1) A]. A strong intramolecular
      hydrogen bond is found between the 4-oxo group and the amine H atom.

PMID- 8347308
TI  - Deconvolution of disoriented fiber diffraction data using iterative convolution
      and local regression.
AB  - Computationally efficient procedures are described for the deconvolution of
      disoriented fiber diffraction data to the resolution limit of measurable
      intensity in the patterns. The methods can be applied to diffraction data from
      imperfectly parallel arrays of one-dimensionally periodic rods or two
      dimensionally periodic sheets, randomly rotated about their unique axes, to
      derive a representation of the intensity distribution corresponding to perfectly
      parallel orientation. With use of angular convolution and local angular
      regression, a set of uniform cylindrically averaged squared structure factors are
      iteratively adjusted, subject to a minimum-wavelength constraint, until they
      produce a disoriented pattern that fits the observed diffraction data. The
      results from this deconvolution provide a measure of the properly scaled
      cylindrically averaged squared structure factors, which can be used with other
      structural information to construct a physically plausible trial model suitable
      for further refinement. Sample deconvolutions of simulated X-ray patterns from
      partially oriented gap junction membranes are presented and the results from
      point-model deconvolutions are compared to those from constrained deconvolutions
      that began with the transform of a physically plausible trial model.

PMID- 8347309
TI  - Frequency statistical method for evaluating cosine invariants of three-phase
      relationships.
AB  - A new variation on the established procedure to evaluate three-phase structure
      invariants through quadrupole relationships is described. This method differs
      from earlier algebraic formulations in that the cosine-invariant estimates are
      based on a conditional observed frequency distribution of magnitude of E
      magnitudes for the quadrupole, rather than on the values of the magnitudes
      themselves. Successful applications of this method to a number of structures that
      ranged in size from 84 to 317 independent non-hydrogen light atoms are given.

PMID- 8347311
TI  - Determinants and consequences of the diurnal rhythm of blood pressure.
AB  - The diurnal rhythm of blood pressure (BP) is influenced by both extrinsic and
      intrinsic factors, with the former usually being of greater significance. Non
      dippers, in whom the normal nocturnal fall of pressure is diminished, have been
      reported to show more target organ damage (left ventricular hypertrophy (LVH))
      than dippers, which may be explained by a higher average 24 h BP. Whether or not
      the pattern of BP (as opposed to the level) also is prognostically important is
      probable but unproven, given the known morning surge of the incidence of many
      acute cardiovascular events. The pathological significance of different diurnal
      patterns of BP change may depend both on the method of analysis and on the
      outcome measure used.

PMID- 8347310
TI  - Ambulatory blood pressure. A personal historical account.

PMID- 8347312
TI  - The influence of behavioral factors on the daily variation of blood pressure.
AB  - Blood pressure (BP) changes continually throughout the day and night in response
      to changes in activity and in the environment. Behavioral influences include
      posture, physical and mental activity, and emotional state. The absolute
      magnitude of these influences may show consistent differences according to
      demographic factors such as gender and environment (eg, at work or at home).
      Occupational stress appears to have a greater effect on the BP in men than in
      women, while domestic stress (eg, the number of children) influences BP more in
      women. Ambulatory BP recordings should be interpreted according to the behavioral
      setting in which they are made.

PMID- 8347313
TI  - Can simultaneous ambulatory blood pressure and activity monitoring improve the
      definition of blood pressure?
AB  - In this study we measured activity and sleep time, using a wrist actigraph, in a
      population of 319 patients referred for ambulatory blood pressure monitoring
      (ABPM). Mean waking and sleeping blood pressure (BP) and the diurnal BP variation
      derived with this technique were compared to daytime (defined variously as 7 AM
      to 8 PM, 7 AM to 10 PM, or 7 AM to midnight) and nighttime pressure. To study the
      relationship of actigraph-derived activity data to BP variability in more detail,
      30 patients underwent paired monitoring 1 to 18 (mean 8) days apart. Mean waking
      BP was then corrected for activity to determine whether this technique could
      improve reproducibility. Statistically but not clinically significant differences
      between waking and daytime BP were seen, with larger and potentially clinically
      relevant differences between sleeping and nighttime BP. The midnight to 7 AM time
      period gave the best estimate of observed sleeping time and the nocturnal dip of
      BP. The average correlation between activity and BP was 0.25 for systolic and
      0.34 for diastolic BP, but with wide variation in the strength of the
      relationship both between and within individual patients. On average, activity
      accounts for 20% of systolic and 26% of diastolic BP variation. Correcting the
      mean waking BP to a standard activity level reduced within-patient variation by
      6%/9%. This made no significant difference to overall reproducibility, perhaps
      because variability in this sample was low before adjustment, with the standard
      deviation of the difference equal to 8/4 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347315
TI  - Fourier analysis of blood pressure profiles.
AB  - This short review deals with the use of the Fourier technique to analyze diurnal
      blood pressure (BP) profiles obtained by noninvasive ambulatory monitoring. A
      Fourier series with four harmonics strikes an acceptable balance between the
      accuracy and complexity required to model the diurnal profile accurately in most
      subjects. A weighting procedure makes it possible to allow for the varying time
      intervals between consecutive pressure readings. Studies based on a single
      recording are insufficient to characterize an individual with respect to the
      statistical parameters describing the diurnal BP profile, regardless of whether
      they are obtained by Fourier analysis or by other methods. The Fourier approach
      provides the means to translate 24 h BP profiles into interpretable statistical
      parameters, such as the amplitude and acrophase of the overall model and the
      harmonics. These parameters can subsequently be used in further statistical
      analyses. In conclusion, the Fourier approach makes the description of complex,
      asymmetrical, and multiphasic BP profiles possible. By using the procedures of
      linear multiple regression, commonly provided by software packages, the
      calculations can be readily implemented on microcomputers without requiring
      advanced skills in mathematics or programming techniques.

PMID- 8347316
TI  - Spectral analysis of 24 h blood pressure recordings.
AB  - Spectral analysis of blood pressure and heart rate signals allows overall blood
      pressure and heart rate variabilities to be split into their different frequency
      components. When used to analyze 24 h discontinuous blood pressure recordings,
      the low sampling frequency that characterizes these devices allows only the slow
      fluctuations in day and night blood pressure to be adequately described by the
      spectral approach. Conversely, spectral analysis of continuous blood pressure
      recordings provides information both on fast and slow changes in blood pressure
      and heart rate. Because blood pressure and heart rate powers are characterized by
      a 1/f distribution over the 24 h, slow fluctuations in blood pressure and heart
      rate contribute most importantly to 24 h variance, while faster components
      provide only a minor contribution. However, spectral analysis of the latter has
      raised considerable interest due to the possible association of these components
      with cardiovascular regulatory mechanisms. It is now possible to perform 24 h
      dynamic spectral analysis of blood pressure and heart rate on continuous blood
      pressure recordings obtained noninvasively by a finger pressure device.

PMID- 8347314
TI  - Age-specific characteristics of nocturnal blood pressure in a general population
      in a community of northern Japan.
AB  - The age- and gender-specific profile of circadian blood pressure variation was
      examined by monitoring ambulatory blood pressure (ABP) in 477 untreated subjects
      in a rural community of northern Japan. Autoregressive spectral analysis
      demonstrated three major peaks at around 24, 12, and 8 h. We fitted a truncated
      Fourier series with three harmonics to the blood pressure (BP) data using least
      squares regression. More than half of the BP and pulse rate periodic curves were
      bimodal, one-third were trimodal, and the remainder were unimodal. The nadir of
      BP appeared between 00:00 and 01:30, and that of pulse rate occurred between
      00:30 and 02:00. The nadir of systolic and diastolic BP, as well as pulse rate,
      appeared earlier with increasing age, and the difference between subjects in
      their 20s and those in their 70s was about 1 h. The amplitude of 24 h BP
      decreased with increasing age in men, but not in women. This type of information
      on the circadian BP profile of a general population is useful for the diagnosis
      and treatment of hypertension.

PMID- 8347318
TI  - Analysis of blood pressure variability.

PMID- 8347317
TI  - The clinical utility of blood pressure load in hypertension.
AB  - The variability of blood pressure and its consequences suggests that ambulatory
      blood pressure (ABP) data should be analyzed not only by mean ambulatory blood
      pressure (MABP), but also by looking at blood pressure load (BPL, the percentage
      of measurements > 140/90 mm Hg while awake and > 120/80 while asleep). In one
      study, several hypertensive patients whose ambulatory diastolic blood pressure
      was < 90 mm Hg had a diastolic load near 50%. Studies have reported strong
      correlations between BPL and indices of target-organ changes such as left
      ventricular mass index (LVMI). It was necessary to lower office blood pressure to
      < 85 mm Hg to reduce BPL to a normal range of 15 to 20%. To further investigate
      the usefulness of BPL in the study of hypertension, more longitudinal studies of
      cardiovascular disease and blood pressure variability are needed.

PMID- 8347319
TI  - Defining normal ambulatory blood pressure.
AB  - Providing normal reference values and the means to interpret such values in
      practice is an urgent issue requiring consensus. Five basic approaches to
      defining normalcy for 24 h blood pressures (BP) are considered: 1) the
      relationship of ambulatory blood pressure (ABP) to morbidity and mortality, 2)
      the relationship of ABP to end-organ involvement, 3) ABP levels in normal
      populations, 4) the relationship of ABP to clinic BP, and 5) the relationship of
      24 h indices to risk. Although there now is considerable evidence demonstrating
      that ambulatory measurement correlates more strongly with end-organ damage, the
      first two approaches are scientifically the best. It will be some time before
      levels of normalcy can be derived. There is a large volume of data on population
      samples permitting derivation of normalcy for clinical practice. Rounded upper
      limits of normal can be calculated as 140/90 mm Hg for 24 h ambulatory pressure,
      150/90 mm Hg for daytime pressure, and 130/80 mm Hg for nighttime pressure. There
      are, however, considerable differences for age and gender which need to be taken
      into consideration.

PMID- 8347321
TI  - What is normal blood pressure? Comparison of ambulatory pressure level and
      variability in patients with normal or abnormal left ventricular geometry.
AB  - To assess the level and pattern of normal ambulatory blood pressure (ABP) using a
      non-BP standard to identify normality, we examined the level and variability of
      ABP during the waking day, at work, at home, and during sleep and looked at
      physician and technician BP measurements in 191 adults whose left ventricular
      (LV) geometry was classified by echocardiography. Clinic BPs were similar in the
      120 subjects with normal LV geometry and the 35 subjects with concentric LV
      remodeling. Pressures were only modestly higher in the 15 subjects with
      concentric LV hypertrophy than in the 21 with eccentric hypertrophy. In contrast,
      these subject groups differed with regard to their ABPs during the waking hours,
      at home, and especially at work. However, no difference in BP variability, as
      assessed by the standard deviation of awake systolic or diastolic BP, existed
      among the subject groups identified by LV geometric patterns. Comparison of
      patients with concentric LV hypertrophy, the LV pattern associated with the worst
      prognosis, with normotensive subjects with normal LV geometry suggests that awake
      ABPs in adults below 139/86 mm Hg might be considered normal, whereas values over
      149/95 mm Hg might be considered pathologic. Verification of these conclusions is
      needed, however, in larger series and with the use of additional measures of
      preclinical hypertensive disease.

PMID- 8347320
TI  - Defining normal ambulatory blood pressure in relation to target organ damage and
      prognosis.
AB  - It is premature to state that ambulatory blood pressure (ABP) values below a
      given level should be considered normal, and those above it abnormal, in terms of
      prognostic implications on cardiovascular (CV) morbidity. We do not know whether
      CV morbidity in hypertensive subjects with apparently normal ABP (white coat
      hypertension) is less than that in patients with higher ABP levels and similar to
      that of healthy normotensive subjects, or whether the effects of antihypertensive
      drug treatment on CV morbidity are superior to placebo in white coat
      hypertension. It is important to achieve agreement on a temporary working
      definition of normal ABP to be used to test two main hypotheses: 1) in subjects
      with white coat hypertension, CV morbidity is less than that in patients with
      higher ABP levels; and 2) drug treatment is not superior to placebo in reducing
      CV morbidity in white coat hypertension. Normal ABP values can be derived
      empirically from population based samples, in selected groups of healthy
      subjects, or from meta-analyses. However, the significance of the definition of a
      normal ABP range is the identification of clinically hypertensive patients at low
      risk of future CV morbid events. Using echocardiographic left ventricular (LV)
      mass as a surrogate outcome measure, we found that the coexistence of mean
      daytime ABP levels < 134 mm Hg systolic and < 90 mm Hg diastolic, regardless of
      gender (< 136/87 mm Hg in men and 131/86 mm Hg in women) identifies a subgroup of
      clinically hypertensive subjects with echocardiographic LV mass, and associated
      prevalence of left ventricular hypertrophy (LVH) similar to those found in
      healthy normotensive control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347322
TI  - Ambulatory blood pressure monitoring. Can a clinical role be defined?
AB  - Automated ambulatory blood pressure monitoring (ABPM) is a powerful research
      tool, but its clinical role has been difficult to define. This paper presents
      conclusions on the potential clinical benefits, risks, and costs of ABPM based on
      a comprehensive review of the scientific literature. Support is strongest for the
      uses of ABPM to improve blood pressure (BP) classification in suspected
      hypertensives and in patients with apparent drug resistance. Four policy options
      are discussed. Approval for limited clinical applications appears warranted
      provided it is accompanied by 1) quality control standards for ABPM laboratories,
      2) decision thresholds for equating office, self-monitored, and ABPM BP levels,
      and 3) steps to limit profit incentives and the high risk of overutilization.

PMID- 8347323
TI  - Ambulatory blood pressure monitoring can improve cost-effective management of
      hypertension.
AB  - Detection and treatment of arterial hypertension is effective, as shown by
      clinical trials and downward trends in cardiovascular disease. This process
      causes expenditures that progressively have increased because of inclusion of
      more patients with minimally elevated pressure who incur a higher cost of
      treatment. Average daily pressure is a more accurate predictor of outcome and
      morbidity than initial screening or occasional clinic monitoring of pressure.
      Noninvasive ambulatory blood pressure monitoring (ABPM), as a secondary
      screening, reveals that 20% to 60% of those initially labeled as hypertensive
      have average daily pressures low enough to delay the initiation of drug therapy.
      These observations permit the development of forecasting models comparing
      strategies for management of hypertension. Preliminary estimates show that use of
      ABPM might reduce the number of patients requiring drug treatment over a 6 year
      period, with reduced cumulative and yearly costs for this interval. Forecasting
      models using ABPM now should be tested in comprehensive health care systems to
      determine their effect on overall cost-effectiveness in the management of
      hypertension.

PMID- 8347324
TI  - Clinical usefulness of ambulatory blood pressure monitoring.
AB  - During the last decade, ambulatory blood pressure monitoring (ABPM) made a
      transition from a method reserved for clinical investigators to a technique
      considered useful by practicing physicians in assessing certain problems in
      hypertension. Recent recommendations of the National High Blood Pressure
      Education Program (NHBPEP) Working Group on Ambulatory Blood Pressure Monitoring
      suggested using ABPM for a number of clinical problems, including borderline
      hypertension without target organ damage, evaluation of drug resistance, and
      white-coat hypertension. We evaluated the clinical indications for ordering ABPM
      by Connecticut physicians both in hospital and community-based practices. Through
      specific questionnaires, the clinical indications used by referring physicians to
      order ABPM and their inclinations for future use of the methodology were
      assessed. Forty-seven of 70 physicians (65%) responded to the questionnaire,
      basing their answers on 237 patients. The majority of physicians were internists
      (57%) or cardiologists (25%). Leading indications for patient referral for ABPM
      included borderline hypertension (27%), assessment of drug therapy/BP control
      (25%), and possible white-coat hypertension (22%). Far fewer referrals were
      observed for severe hypertension or as a routine test for the diagnosis of
      hypertension. These data suggest that practicing physicians have become aware of
      the usefulness of ambulatory blood pressure recordings and are following the
      NHBPEP guidelines on referral for the study.

PMID- 8347325
TI  - Reproducibility of ambulatory blood pressure and assessing treatment withdrawal
      in hypertension trial.
AB  - Ambulatory blood pressure monitoring (ABPM), like casual blood pressure (BP), is
      imperfectly reproducible between visits. The reproducibility of ABPM is less than
      the reproducibility predicted from a simple model of random variation of BP. This
      suggests either increased technical error in the technique, an element of
      increased biologic variability, or both. In addition, ABP shows a between-day
      variation (add about 6 to 7 mm Hg diastolic, similar in magnitude to what is
      observed with casual BP) which cannot be obviated by the average of many within
      day measurements. The reliability of ABPM, although conventionally judged
      excellent at about RI = 0.75, is insufficient to avoid misclassification errors
      and regression to the mean when BP cutpoints are employed. About 40% of patients
      apparently failing treatment withdrawal at a threshold of +2 SD, or about 95 mm
      Hg diastolic ABP, will be false-positive failures when categorized by a single
      ABP. Despite the inconvenience, obtaining an average of two or more ABP
      measurements on different days may be cost-saving to a clinical trial because of
      the improved reproducibility; other costs may exceed $1000 per entrant.

PMID- 8347326
TI  - Ambulatory blood pressure monitoring in the design of studies on antihypertensive
      drug efficacy.
AB  - Ambulatory blood pressure monitoring (ABPM) provides advantages for studies of
      the efficacy of antihypertensive drugs in addition to demonstrating
      antihypertensive effects in daily life conditions. For example, ABPM is devoid of
      the "white coat" effect and can thus more precisely estimate the relative
      proportion of responders and nonresponders to treatment. It also may reduce the
      study size because of the greater reproducibility of 24 h average blood pressure
      (BP) (as compared to clinic BP) and the lack of a substantial placebo effect,
      which eliminates the need for a placebo group. Some disadvantages exist,
      including the inability of automatic ABPM to consistently provide accurate BP
      readings and to estimate BP variability. Finally, hourly average BPs are less
      reproducible than their average 24 h counterpart, which may make it more
      difficult to statistically demonstrate an antihypertensive effect throughout the
      24 h. Some of these disadvantages, however, may be reduced in the near future by
      new ABPM devices.

PMID- 8347327
TI  - Ambulatory blood pressure monitoring. A critique on clinical issues and clinical
      trials.

PMID- 8347328
TI  - A pilot clinical trial of the angiotensin-converting enzyme inhibitor ceranapril
      in Alzheimer disease.
AB  - This pilot clinical trial was a 15-week, double-blind, controlled, three-way
      crossover study evaluating cognitive effects of ceranapril in subjects with
      dementia of the Alzheimer type (age range 50-75 years). Computerized (CNTB) and
      noncomputerized cognitive test batteries revealed no significant results (p >
      0.05). On further analysis of the data, however, a study of longer duration
      and/or higher dosages may be warranted.

PMID- 8347329
TI  - Alzheimer disease and physician-assisted suicide.

PMID- 8347330
TI  - Cholinergic transmitter and neurotrophic activities in Lewy body dementia:
      similarity to Parkinson's and distinction from Alzheimer disease.
AB  - Senile dementia of Lewy body type or Lewy body dementia (LBD), characterized
      neuropathologically by the presence of Lewy bodies in the brainstem and cortex,
      and in most cases neocortical senile plaques (but few or no tangles), bears a
      closer resemblance to Parkinson's (PD) than to Alzheimer disease (AD) in its
      cholinergic neurochemical pathology. Thus, reductions in the biochemical activity
      of choline acetyltransferase were generally more extensive in neo- as opposed to
      archicortical regions in LBD (especially hallucinating cases) and in PD, whereas
      muscarinic receptor binding was significantly increased in LBD and PD but not in
      AD. Nerve growth factor receptor (P75) assessed immunocytochemically in the
      archicortex were decreased in PD and, to a lesser extent, in LBD in conjunction
      with reductions of neuronal numbers in the nucleus of Meynert (Ch4), but were
      relatively spared in AD. These observations indicate that although AD is
      primarily associated with dysfunction of cholinergic axonal input to the cortex,
      LBD and PD are more likely to involve degeneration of the basal forebrain
      cholinergic system. Relevance of the findings in terms of aetiopathology and
      cholinergic treatment strategies is discussed.

PMID- 8347331
TI  - Autopsy in dementing illness: who participates?
AB  - The frequency of occurrence of various types of dementing disorders has been
      ascertained primarily from autopsied series. Since autopsy is voluntary, it is
      unknown if these series are representative of the entire demented population. To
      assess this issue, all deaths occurring over a 5-year period in our Memory
      Disorders Clinic were reviewed, and clinical variables and diagnoses were
      compared between patients who were autopsied and those who were not. Sixty-nine
      patients died; 43% (n = 30) underwent autopsy, and 57% (n = 39) did not. Race (no
      black patients were autopsied), age of disease onset, age of presentation to the
      clinic, age of death, and interval between last clinic contact and death
      (significantly less for nonautopsied patients) were found to differ between the
      two groups. However, clinical diagnosis of dementia was similar in the two
      groups. The clinical diagnosis was confirmed in 84% of autopsied patients. These
      results suggest that there are no major differences between clinical diagnoses
      for autopsied and non-autopsied patients and that the frequency of occurrence of
      various dementias obtained through autopsied series are representative of the
      demented population.

PMID- 8347332
TI  - Lack of detectable radiation hypersensitivity in lymphoblastoid cells from
      multiple pedigrees of familial Alzheimer disease.
AB  - Recent reports suggest that cultivated nonneuronal cells from individuals with
      Alzheimer disease (AD) and other specific hereditary neurodegenerative disorders
      show hypersensitivity to DNA-damaging agents such as x-rays and radiomimetic
      chemicals. The hypothesis proposed is that a number of chronic neurologic
      degenerations, including AD, may be the result of accumulation of damaged DNA,
      resulting from a defect in DNA repair. We investigated this hypothesis by
      evaluating cells from individuals from pedigrees of familial Alzheimer disease
      (FAD) for hypersensitivity to x-irradiation. Sensitivity was assayed by viability
      measured by trypan blue dye exclusion and micronucleus formation. We tested B
      lymphoblastoid cell lines from nine patients and nine unaffected family members
      from pedigrees with FAD, three unrelated controls, three ataxia telangiectasia
      (AT) patients, and three Down syndrome individuals. The AT cell lines showed the
      expected reduced viability and increased micronucleus formation after x-ray
      treatment. The FAD and control lines showed marked heterogeneity with both
      assays. There was no significant differences between the FAD patients and
      controls. The wide variability in the response of cell lines from controls and
      patients indicates the need for more sensitive assays for detection of radiation
      sensitivity in cells from various neurologic disorders.

PMID- 8347333
TI  - A pilot study of oral physostigmine plus yohimbine in patients with Alzheimer
      disease.
AB  - Effective symptomatic treatment of Alzheimer's disease (AD) may require a
      combination of agents that augment cholinergic as well as noradrenergic
      neurotransmission. We conducted a pilot study of physostigmine plus oral
      yohimbine challenge in AD. Ten patients were enrolled in a 12-day double-blind
      protocol. Each patient received placebo q2h while awake for 5 days, followed by
      physostigmine 2 mg q2h while awake for 7 days. During each of these drug
      conditions, yohimbine challenges were administered at oral doses of 10 and 20 mg
      in a placebo-controlled manner. There was no significant improvement in
      Alzheimer's Disease Assessment Scale test performance for six patients for whom
      complete cognitive data were obtained for the 6 challenge days. Nine patients
      tolerated the protocol with no clinically significant changes in blood pressure,
      pulse, or electrocardiogram (ECG), and no cardiovascular, gastrointestinal, or
      autonomic toxicity. One patient complained of chest discomfort associated with
      tachycardia, a modest rise in blood pressure, and had t-wave inversion in a
      single precordial lead. These signs and symptoms resolved within a few hours.
      Serial ECG tracings and cardiac enzymes revealed no evidence of myocardial
      injury. This pilot study did not reveal major cognitive improvement with this
      regimen, but underscores the importance of careful cardiovascular monitoring
      during future combined cholinergic-noradrenergic therapies in AD.

PMID- 8347334
TI  - Magnetic resonance imaging of the spine in bone dysplasias and related disorders.
AB  - This article discusses the role of magnetic resonance imaging in orthopedic and
      neurosurgical complications of the spine in developmental disease of bone. The
      importance of a basic knowledge of spinal deformities in dysplasias and related
      disorders is stressed, and on the basis of a simple classification, a
      differential diagnostic list for each category is presented and illustrated with
      some common disorders.

PMID- 8347335
TI  - Congenital malformations of the spine.
AB  - The radiology of the congenital malformations of the spine has undergone
      significant advancement with the advent of newer modalities including computed
      tomography and, in particular, magnetic resonance imaging. Correlation with
      etiology and pathologic findings has improved. Congenital malformations have been
      classified according to neurulation and disjunction failures (dorsal) and those
      with persistent neurenteric connections with notochordal splitting (ventral). The
      most important benefit of the current state of imaging is the accurate
      morphologic representation of the malformation provided for the surgeon.

PMID- 8347336
TI  - Metabolic and degenerative diseases of childhood.
AB  - The metabolic and degenerative diseases of childhood are a diverse group of
      disorders with varied imaging features. Some of the disease processes have
      characteristic findings and some have no findings at all, but most present with
      nonspecific abnormalities in white matter. These patchy lesions, seen best on
      magnetic resonance scanning with T2 weighting, require a good history and a
      dialogue with the referring physicians to help in narrowing the differential
      possibilities. The major disease processes involving white matter are the
      dysmyelinating diseases, in which the abnormal white matter is the result of an
      inherited enzyme deficiency, and the demyelinating diseases, in which an acquired
      process such as infection destroys white matter. Several diseases result in gray
      matter abnormalities, including central pontine myelinolysis, MELAS syndrome
      (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like
      symptoms), Batten's disease, Leigh disease, and Wilson's disease.

PMID- 8347337
TI  - Magnetic resonance imaging of normal and abnormal brain development.
AB  - Magnetic resonance imaging (MRI) improves our ability to assess brain development
      and to detect anomalies of brain formation. MRI allows the assessment of brain
      development by analysis of the effects of myelination on the T1 and T2 relaxation
      times of the pediatric brain. This article discusses specific imaging strategies
      and the normal progression of signal intensity changes. Familiarity with this
      evolution of signal changes allows an estimation of the approximate stage of
      brain development. High-resolution multiplanar MRI provides good anatomic detail,
      with excellent distinction between gray and white matter. This technique allows
      improved detection of many classes of abnormalities of brain formation, some of
      which were previously detectable only at autopsy. These malformations and their
      imaging characteristics are discussed under the headings of: corpus callosal
      dysgenesis, intracranial lipomas, holoprosencephalies, septooptic dysplasia, the
      cephaloceles, the Chiari malformations, the Dandy-Walker complex, the cerebellar
      anomalies including Joubert's syndrome, and rhombencephalosynapsis, and the
      spectrum of neuronal migration anomalies.

PMID- 8347338
TI  - Intracranial infection in children.
AB  - This article discusses the neuroradiologic characteristics of central nervous
      system infections in children. These disorders are divided into two groups: those
      of congenital infections and those of infections in the infant and child.
      Congenital infections are referred to by the acronym TORCH. Inflammatory diseases
      in the infant and child encompass meningitis, cerebritis, and encephalitis. The
      heterogeneous etiologies often can be suggested by the neuroradiologic findings,
      as demonstrated with computed tomography and magnetic resonance imaging. This
      article also addresses the sequelae of destructive brain injuries.

PMID- 8347339
TI  - Neuroradiologic evaluation of pediatric craniocerebral trauma.
AB  - Although cranial computed tomography (CT) remains the initial diagnostic test in
      the evaluation and triage of the pediatric head-injury patient, magnetic
      resonance imagining (MRI) has become the next step in the diagnostic evaluation
      of those with focal or diffuse neurologic deficits. MRI is better able to
      demonstrate the extent and location of both hemorrhagic and nonhemorrhagic
      injury, thereby providing prognostic information. In nonaccidental head injury,
      MRI has proved valuable in detecting subtle subacute contusions and even not so
      subtle chronic subdural hematomas that may be difficult to see on CT or that can
      mimic enlargement of the subarachnoid space on CT.

PMID- 8347340
TI  - Magnetic resonance imaging of pediatric brain tumors.
AB  - When done with care, the visualization of brain tumors in children in most cases
      is easy. The challenge is in ability to predict tumor type and grade. Slightly
      less than half of pediatric brain tumors are in the posterior fossa.
      Astrocytomas, medulloblastomas, and ependymomas account for 95% of these tumors.
      Except for the large cysts and uniformly low T1 signal of pilocytic cerebellar
      astrocytomas, location and size are more important than specific imaging
      characteristics in predicting tumor type. Supratentorial tumors are even more
      variable in magnetic resonance imaging characteristics, and it is difficult to
      tell benign from malignant tumor in many cases. Although gadolinium enhancement
      is useful in defining tumor borders, it is not a completely reliable indicator of
      malignancy. As in the posterior fossa, location is important in deciding which
      type of tumor is more likely. Suprasellar tumors are usually craniopharyngiomas.
      Small temporal lobe tumors are often oligodendrogliomas or gangliogliomas.
      Astrocytomas are the most common tumor, and also variable, although most benign
      astrocytomas are near the midline.

PMID- 8347341
TI  - Pediatric spinal neoplasms.
AB  - Magnetic resonance imaging (MRI) is an accurate and noninvasive tool in the
      evaluation of children with spinal neoplasm. Localization and definition of site
      and extent of disease for treatment planning, the most important goals of
      neuroimaging in spinal neoplastic disease, have become more precise with MRI,
      because all spinal compartments can be seen without the need for subarachnoid
      puncture. Epidural and contiguous soft tissue disease, and associated vertebral
      abnormalities such as marrow replacement by metastatic processes, are readily
      confirmed during the same examination. In children, as in adults, gadolinium
      diethylenetriaminepentaacetic acid aids in separating intramedullary neoplasms
      from associated edema or syrinx, and is essential in the evaluation of intradural
      extramedullary spread of neoplasm. MRI is also useful in the exclusion of
      compressive lesions in children with systemic neoplasms and cord infarction or
      treatment-related transverse myelopathy.

PMID- 8347342
TI  - Structure of platelet-derived growth factor: implications for functional
      properties.

PMID- 8347343
TI  - A novel monoclonal antibody dependent on domain 5 of the platelet-derived growth
      factor beta receptor inhibits ligand binding and receptor activation.
AB  - Platelet derived growth factor (PDGF) induces activation of the protein tyrosine
      kinase domain of the PDGF receptor, resulting in receptor dimerization and the
      initiation of mitogenesis in responsive cells. In order to identify domains of
      the receptor involved in these processes, a panel of monoclonal antibodies (MAbs)
      against the extracellular region of the human PDGF receptor was developed and
      screened to identify which of these specifically block PDGF binding. One of
      these, MAb 2A1E2, binds PDGF beta receptor with high affinity and blocks PDGF BB
      binding in a whole cell binding assay with an IC 50 of 0.1 nM. Inhibition of
      binding results in the inhibition of ligand-induced receptor phosphorylation,
      dimerization and mitogenesis in cells expressing the PDGF beta receptor. MAb
      2A1E2 has been mapped to the fifth Ig domain of the PDGF beta receptor, implying
      that this domain is important for ligand binding, dimerization and/or activation.
      The potency of MAb 2A1E2 for inhibiting PDGF BB binding indicates that this
      antibody is ideally suited to identify and characterize PDGF BB-induced
      biological responses.

PMID- 8347344
TI  - Expression and regulation of insulin-like growth factor-I in the rat incisor.
AB  - Growth factors play an important role in the regulation of cell growth, division
      and differentiation. In this study the distribution and regulation of insulin
      like growth factor-I (IGF-I) in the continuously erupting rat incisor was
      determined by immunohistochemistry. Results were evaluated both visually and with
      a computer-based image analysis system. The distribution and intensity of IGF-I
      immunoreactivity varied with developmental stage of the rat incisor. Strong IGF-I
      immunoreactivity was observed in differentiating odontoblasts and ameloblasts.
      The most intense immunoreactivity was observed in secretory ameloblasts,
      secretory odontoblasts and in maturation ameloblasts. Staining was weak or absent
      in post-secretory ameloblasts but persisted in post-secretory odontoblasts. Weak
      to moderate immunoreactivity was also seen in cells of the stratum intermedium
      and in the reduced enamel epithelium. Surrounding alveolar bone showed strong IGF
      I immunoreactivity in osteoblasts and in the stratum basale and stratum spinosum
      of the adjacent labial gingival epithelium. In order to assess the role of GH in
      IGF-I expression, GH (65 micrograms/100 g bw) was administered for six days to
      dwarf GH deficient rats, producing a significant increase in body weight (P <
      0.01). Measurements at different stages of odontogenesis showed that the staining
      intensity of secretory ameloblasts (P < 0.01) and maturation ameloblasts (P <
      0.001) was significantly different between untreated and treated animals. These
      results indicate that IGF-I is present in cell populations of the enamel organ of
      the rat incisor found previously to exhibit growth hormone receptors, and that
      expression of IGF is GH dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347345
TI  - Increased basic fibroblast growth factor (bFGF) accumulation and distinct
      patterns of localization in isoproterenol-induced cardiomyocyte injury.
AB  - Basic FGF is a multifunctional protein which promotes regeneration in several
      tissues. To investigate involvement in cardiac injury-repair, bFGF accumulation
      and localization was examined in hearts of rats injected with a single high dose
      of isoproterenol. The bFGF content of cardiac extracts was analyzed at 6 and 24
      hours as well as 1, 4, and 6 weeks by western blotting of heparin-sepharose-bound
      fractions. The 18 kilodalton bFGF species showed an approximately 2-fold increase
      in extracts from treated animals compared to non-treated controls. A transient
      rise in a 21-23 kilodalton bFGF species was seen at 24 hours after treatment. An
      induction of bFGF mRNA was also observed in treated animals. To localize bFGF in
      vivo, immunofluorescent labelling with specific antibodies was used at 4-24 hours
      and 1-4 weeks after treatment. Simultaneous labelling for the cytoskeletal
      proteins vinculin or vimentin was employed to identify viable myocytes or non
      muscle interstitial cells, respectively. Necrotic myocytes, identified by loss of
      vinculin, displayed a pronounced increase in cytoplasmic anti-bFGF staining
      compared to adjacent normal myocytes. This increase occurred prior to and may
      play a role in promoting mobile cell migration and proliferation in areas of
      necrosis. Viable cardiomyocytes adjacent to fibrotic regions displayed strong
      pericellular anti-bFGF staining and, occasionally, were also stained by anti
      vimentin antibodies, suggesting reexpression of an embryonic phenotype and thus
      an attempt for regeneration. These data showing increased accumulation and
      distinct patterns of localization of bFGF in the hearts of isoproterenol-treated
      animals suggest that this growth factor plays a role in short-term as well as
      long term response of the myocardium to injury.

PMID- 8347346
TI  - Dose responsive effects of PDGF-BB, PDGF-AA, EGF, and bFGF on granulation tissue
      in a guinea pig partial thickness skin excision model.
AB  - A guinea pig partial thickness skin excision model was used to evaluate the
      effects of recombinant human PDGF-BB, PDGF-AA, EGF, and bFGF on granulation
      tissue (neodermis) formation. These growth factors tended to increase the
      thickness of the granulation tissue bed when assessed histologically at day 7.
      Using only four animals per group, PDGF-BB at 30 and 100 micrograms/ml
      consistently and significantly increased the thickness of the granulation bed 2-3
      times that of control. Except for the increased thickness, the granulation tissue
      appeared normal. PDGF-AA and EGF also significantly increased the granulation
      tissue thickness, and bFGF gave indications of an effect. There was no evidence
      of synergistic effects between PDGF-BB, EGF, and/or bFGF.

PMID- 8347347
TI  - Evaluation of PDGF-BB, PDGF-AA, bFGF, IL-1, and EGF dose responses in polyvinyl
      alcohol sponge implants assessed by a rapid histologic method.
AB  - Polyvinyl alcohol sponge implants were used in rats, mice, and guinea pigs to
      determine dose responses of growth factors. Eight differently treated sponges per
      rat or guinea pig (4/mouse) were injected with test material on alternate days
      and evaluated at day 8. Much of the observed response occurred in and around the
      capsule and was manifest as densely cellular granulation tissue. Including this
      capsular response in a single histologic slide ranking system provided a more
      sensitive and faster method of assessing growth factor effects than measurement
      of connective tissue ingrowth alone. Clear dose responsive effects were seen with
      recombinant human PDGF-BB, PDGF-AA, bFGF, and IL-1 beta, while EGF gave a lesser
      response. Lipopolysaccharide did not affect the connective tissue response, alone
      or in combination with PDGF-BB. PDGF-BB was tested in each species, and the dose
      response characteristics were qualitatively and quantitatively similar across
      species.

PMID- 8347348
TI  - Human macrophage colony-stimulating factor induces the differentiation of
      trophoblast.
AB  - When human cytotrophoblastic cells in the early stage of pregnancy were cultured
      in a serum-free medium in the presence of human macrophage colony-stimulating
      factor (M-CSF), the cytotrophoblastic cells fused and formed a typical
      syncytiotrophoblast which had a dense distribution of microvilli revealed under
      an electron microscope. On the other hand, cytotrophoblasts incubated with anti-M
      CSF antibody showed hardly any syncytiotrophoblast formation. Following this
      finding, we studied the differentiation of chorionic cells from the viewpoint of
      hormone secretion. When cytotrophoblasts were incubated in the presence of M-CSF,
      the supernatant of the culture showed an increase in human chorionic gonadotropin
      and human placental lactogen levels in proportion to the concentration of M-CSF
      added. When cytotrophoblasts were incubated in the presence of anti-M-CSF
      antibody or anti-fms antibody, human chorionic gonadotropin and human placental
      lactogen secretion were suppressed. Thus, M-CSF was morphologically and
      endocrinologically found to induce the differentiation of chorionic cells.

PMID- 8347349
TI  - Localization of the GTP-binding protein Gi alpha in myelomonocytic progenitor
      cells is regulated by proliferation (GM-CSF, IL-3) and differentiation (TNF)
      signals.
AB  - We have examined the role of Gi alpha in haemopoietic cells using the
      myelomonocytic progenitor cell lines FDC-P1 and WEHI-3B (JCS). During growth
      factor-dependent proliferation of FDC-P1 cells Gi alpha was found predominantly
      in the nucleus and associated with the plasma membrane. Following removal of
      growth factor, Gi alpha accumulated in the cytoplasm and at the plasma membrane.
      Treatment of FDC-P1 cells with pertussis toxin (PT) completely inhibited
      translocation of Gi alpha to the nucleus and reduced the sensitivity of FDC-P1
      cells to the proliferative effects of growth factors, indicating that
      translocation of Gi alpha plays a regulatory role in, but may not be essential
      for, cell division. Gi alpha initially associated with DNA during S/G2 of the FDC
      P1 cell cycle but separated from condensing chromosomes during mitosis. In
      contrast to FDC-P1 cells, WEHI-3B (JCS) cells proliferate in the absence of added
      growth factors but can be induced to differentiate by TNF-alpha. In proliferating
      JCS cells Gi alpha was again associated with the nucleus but when proliferation
      was inhibited by TNF-alpha, Gi alpha accumulated in the cytoplasm with none
      detected in the nucleus. Thus the cytokine regulated accumulation of Gi alpha at
      different intracellular sites correlated with the ability of the cell to progress
      through the proliferative cycle. When the tyrosine kinase inhibitor genistein was
      added to FDC-P1 cells prior to stimulation with IL-3 or GM-CSF, proliferation was
      almost completely inhibited but translocation of Gi alpha was not affected,
      suggesting that tyrosine phosphorylation was not involved in G protein
      translocation but was essential for cytokine induced cell division. Cholera toxin
      (CT) also inhibited proliferation of FDC-P1 cells but had no effect on
      translocation of Gi alpha to the nucleus. The near complete inhibition of cell
      division by genistein and CT without a corresponding effect on Gi alpha movement
      indicates that Gi alpha can be regulated independently of tyrosine kinase and
      adenylyl cyclase activities, respectively.

PMID- 8347350
TI  - Characterization of a saporin mitotoxin specifically cytotoxic to cells bearing
      the granulocyte-macrophage colony-stimulating factor receptor.
AB  - When granulocyte-macrophage colony-stimulating factor (GM-CSF) is chemically
      conjugated to the ribosome-inactivating protein saporin, the resulting protein
      conjugate is highly toxic for cells expressing the GM-CSF receptor. Structural
      and Western blot analyses of the purified conjugate establish that it contains
      equimolar amounts of the starting materials and is free of any contamination by
      the non-conjugated components. The resulting bifunctional reagent is specifically
      cytotoxic to cells expressing the GM-CSF receptor, but is ineffective to cells
      that do not express the receptor. The cytotoxic activity is inhibited in a dose
      dependent manner by GM-CSF, but not by any one of five other peptide growth
      factors. This is the first report of a mitotoxin for cells that express the GM
      CSF receptor and which promises to be a valuable tool to study the expression of
      the GM-CSF receptor in normal and pathological states.

PMID- 8347351
TI  - Bone morphogenetic protein-2 causes commitment and differentiation in C3H10T1/2
      and 3T3 cells.
AB  - C3H10T1/2 cells are an established mesenchymal stem cell line which can
      differentiate into muscle, fat and cartilage cells when treated with azacytidine.
      Bone morphogenetic protein-2 (BMP-2) caused a dose dependent differentiation of
      these cells into fat, cartilage and bone cells-low concentrations favoring
      adipocytes and high concentrations chondrocytes and osteoblasts. The
      differentiated phenotypes were stable in the absence of BMP-2. Furthermore, the
      addition of other growth factors during the differentiation process altered the
      frequency of the differentiated colony formation. Transfection of the C3H10T1/2
      cells with a BMP-2 cDNA also induced a phenotypic change from the parental
      fibroblast to adipocytes and osteoblasts. Our results in this model system
      indicate that a single protein factor can cause differentiation of a stem cell
      line to multiple phenotypes, that phenotypes induced can be regulated by factor
      concentration, and that other factors can also influence BMP-2 induced
      differentiation.

PMID- 8347352
TI  - Enhanced bFGF gene expression in response to transforming growth factor-beta
      stimulation of AKR-2B cells.
AB  - Treatment of quiescent cultures of mouse embryo-derived AKR-2B cells with
      transforming growth factor beta resulted in an induction of basic fibroblast
      growth factor (bFGF) mRNA and bFGF protein in the stimulated cells. In contrast
      to bFGF, acidic fibroblast growth factor (aFGF) was not induced by TGF beta. The
      mitogenic effect of transforming growth factor beta on AKR-2B cells may be
      mediated by the induction of bFCF in these cells.

PMID- 8347353
TI  - Videothoracoscopic surgery.
AB  - Although thoracoscopy has been used for diagnostic and minor therapeutic
      procedures for many years, there have been few reports of its use in performing
      major intrathoracic procedures which have traditionally required formal
      thoracotomy. We report our initial experience in this field. Fifty patients (M:F
      = 1.63:1, mean +/- SD age = 41.8 +/- 20.4 years, range = 14-80) underwent 54
      endoscopic intrathoracic operations. The procedures carried out included wedge
      excision of solid pulmonary mass (10), pleurectomy (25), lung biopsy (14), and
      miscellaneous procedures (5). Under general anaesthesia a laparoscope attached to
      a video monitor was introduced into the chest. One or two additional stab
      incisions were made as needed for the introduction of standard surgical or
      endoscopic instruments and staplers. There were no deaths. One patient developed
      a second pneumothorax 7 days after endoscopic pleurectomy, necessitating open
      pleurodesis. All patients were discharged home between 2 and 11 days after
      surgery (mean +/- SD = 3.8 +/- 2.0 days). Endoscopic thoracic surgery is a safe
      and useful technique for certain cases. It merits further investigation and
      assessment.

PMID- 8347354
TI  - Ischemic tolerance of the arrested heart during warm cardioplegia.
AB  - Normothermic blood cardioplegia has recently generated interest as an alternative
      method of myocardial protection during cardiopulmonary bypass (CPB) surgery. One
      disadvantage is the obligatory interruption of coronary flow during the distal
      coronary anastomosis. This study was designed to determine the safe normothermic
      ischemic time of the arrested and decompressed heart. Under normothermic CPB (37
      degrees C), initial cardioplegic arrest was induced with 750 cc of warm (37
      degrees C) hyperkalemic blood cardioplegia in 21 adult dogs. The heart then
      received warm blood cardioplegia either continuously (50 cc/min), every 5 min
      (250 cc each) or every 10 min (350 cc each) for a total equivalent ischemic time
      of 30 min (n = 7 in each group). Left ventricular pressure-volume (PV) loops were
      measured by micromanometer and conductance (volume) catheters before, at 60 and
      90 min after aortic cross-clamping. Systolic function was measured as the preload
      recruitable stroke work area derived from the stroke work-end diastolic volume
      relationship, and the diastolic stiffness constant (k) was derived from the
      exponential diastolic PV relationship. The q5 min group sustained minor
      deterioration in diastolic function while its systolic function was well
      maintained during recovery. There were significant reductions in both the
      diastolic and systolic functions in the q10 min group. The maximum drops in the
      septal wall pH during aortic cross-clamping were 0.05 +/- 0.02 (not significant),
      0.19 +/- 0.06 (P < 0.05), and 0.40 +/- 0.09 (P < 0.01) for the continuous, q5 min
      and q10 min groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347355
TI  - Laryngotracheal resection and reconstruction for postintubation subglottic
      stenosis. Lessons learned.
AB  - Between 1981 and June 1992, 26 consecutive patients with a postintubation
      subglottic stenosis (21 circumferential, 2 anterolateral) underwent the Pearson
      operation. Subglottic stenosis resulted from a complication of mechanical
      ventilation with endotracheal intubation with (n = 14) or without (n = 12)
      tracheostomy (median placement: 25 days). One patient had an associated
      laryngopharyngeal and tracheoesophageal fistula. Overall, the upper limit of the
      stenoses lay 1.8 +/- 0.3 cm below the vocal cords, falling in the range of 1 to 2
      cm in 88% of patients; they measured 2.9 +/- 0.8 cm in length and the diameter at
      the level of the maximum stenotic process was 0.5 +/- 0.1 cm. Operations were
      performed without dissection of the recurrent nerves and plicature of the
      membranous trachea. Because of scarred mucosa at a higher level, one vertical
      section of the posterior cricoid plate with interposition of autogenous costal
      cartilage and 2 subtotal cricoid plate resections with stenting were necessary.
      The mean length of resection was 3.6 +/- 0.8 cm (range: 2-5 cm) and 88% of them
      ranged within 2.8 and 5 cm. Twelve thyrohyoid and 3 supralaryngeal releases were
      performed. Six patients required postoperative tracheostomy, but all were
      extubated within 24 h. Good results were obtained in 24 (96%) surviving patients;
      1 failure and 1 postoperative death (sudden myocardial infarction) occurred. The
      results confirm that the Pearson operation is an adequate treatment for
      subglottic stenosis extending up to 1 cm below the vocal cords and measuring up
      to 6 cm in length. Dissection of both the recurrent nerves, plicature of the
      membranous trachea, postoperative decompressive tracheostomy and stenting are not
      necessary.

PMID- 8347356
TI  - Disability and distress following cardiac surgery in patients over 70 years of
      age.
AB  - We have reviewed the outcome in a consecutive series of 254 patients over the age
      of 70 undergoing cardiac surgery between 1987-89. Of the patients, 62% were male
      and the median age was 73 years. Operations included: coronary bypass 57%, valve
      replacement 26%, combinations 14% and other procedures 3%. The hospital mortality
      was 7.5% and late mortality was 13.8%. Complications included: intraaortic
      balloon 6%, resternotomy for bleeding 4%, permanent pacing 3%, chest infection
      14%, tracheostomy 5%, major cerebrovascular events 3% and minor 4%. Eighty-two
      percent left the intensive care unit within 24 h and 89% left hospital within 8
      days. Two questionnaires (York University) were sent to 207 patients believed to
      be alive in order to evaluate the change in their quality of life following
      surgery. Of the 207 questionnaires 197 (95%) were returned, 7 of which were from
      relatives of patients who had died and 7 were incomplete. The responses of 183
      assessable patients (at a mean follow-up of 36 months) were converted into Rosser
      disability (I-VIII) and distress (A-D) groups. There was a decrease in disability
      and distress in 60% and 67%, respectively, no change in 34% and 30% and
      deterioration in 6% and 3%. Cardiac surgery can be carried out in elderly
      patients with an acceptable early morbidity and mortality, and although many
      patients show sustained improvement in their quality of life, this was not
      demonstrated in about a third of patients. As the emphasis in the elderly should
      be on quality of life we ought to continue to concentrate on careful selection in
      this age group.

PMID- 8347357
TI  - Does modern cardiac surgery require conventional intensive care?
AB  - We considered that, with modern perfusion equipment and mildly hypothermic
      cardiopulmonary bypass, protracted post-operative ventilation in an intensive
      care unit (ITU) is no longer required after most cardiac operations. We used a
      three-bedded cardiac recovery area (CRA) within the operating suite for 1,000
      patients between January 1990 and June 1991. Forty-five patients with special
      needs were managed in the ITU. The time to extubation (T50%; range) for coronary
      bypass, aortic valve, mitral valve, and double-valve patients was 2.0 (0-42), 2.5
      (0-12), 3.0 (0-15), and 3.0 (1-36) hours, respectively. Recovery beds were re
      used allowing 5-6 operations daily. The difference in nursing staff complement
      for a CRA versus ITU bed was 4.5/7.8. Patient management was by nurse specialists
      supported by cardiac surgeons. Intervention by cardiac anaesthetists or
      intensivists was limited to specific ventilatory problems or renal failure. The
      early extubation policy failed in ten patients (five coronary, three aortic, one
      mitral and one double-valve patient) through poor pre-operative respiratory
      function, left ventricular failure or intra-operative events. The overall
      mortality in CRA was 1.4%. The mean duration of post-operative stay was 7 days
      (range 5-12). We conclude that a CRA staffed by nurse practitioners provides a
      safe and effective alternative to the anaesthetist-managed ITU. A rapid turnover
      of CRA beds removes the constraints of ITU bed availability.

PMID- 8347358
TI  - Chronic rejection following lung transplantation. Incidence, time pattern and
      consequences.
AB  - The long-term prognosis following lung transplantation (LTX) depends mainly on
      the development of chronic rejection which appears clinically as deterioration of
      the lung function while, histologically, obliterative bronchiolitis (OB) is
      found. However, it still remains questionable whether heart-lung (HL), double or
      single lung (DL/SL) transplants behave similarly with regard to incidence and
      time pattern. Eighty-two patients, transplanted until August 92, were analyzed.
      Early and late deaths within 180 days postoperatively were excluded. A total of
      64 patients at risk could be evaluated. By repeated lung function tests,
      obstructive airway disease was defined by a drop of 25% or more of the forced
      expiratory volume in one second (FEV1) in percent of the inspiratory vital
      capacity. RESULTS: The functional optimum after transplantation was reached after
      a comparable time-span postoperatively in all groups. Chronic deterioration of
      the lung function developed earlier following DLTX compared to HLTX and SLTX.
      Obstructive airway disease was diagnosed in 9/20 (45%) HL, 7/19 (37%) DL, and
      7/25 (28%) SL patients. Of these, 4 died and 4 had to be retransplanted for the
      disease while an additional 15 patients are currently under investigation. It is
      concluded that the development of obstructive airway disease represents a serious
      problem in all types of lung transplantation. There is a tendency to earlier
      development following DLTX--perhaps caused by the greatest immunological
      potential in this group of patients.

PMID- 8347359
TI  - Recovery of myocardial function. The ultimate target of coronary
      revascularization.
AB  - Recovery of myocardial contraction represents an important target of coronary
      revascularization and the preoperative recognition of viable akinetic
      (hibernating) myocardium is a crucial point of the preoperative investigation of
      patients with chronically depressed left ventricular function. In 14 patients
      dobutamine infusion during echocardiography was utilized to evoke the contractile
      reserve retained by viable akinetic segments. Redistribution of thallium(TI)-201
      after the rest injection was also used to assess the viability of akinetic areas.
      The wall motion response to dobutamine infusion predicted immediate postoperative
      improvement in 85 of 93 segments (sensitivity 91.3%) and identified 25 of the 32
      segments which did not exhibit early postoperative improvement (specificity
      78.1%). Rest redistribution of TI-201 demonstrated high sensitivity (93.0%) but
      low specificity (43.7%) for predicting the early recovery of regional wall
      motion. When late recovery was also considered, the specificity of this method
      increased to 64.0%. Rest distribution of TI-201 identifies viability which is not
      necessarily associated with the early recovery of function postoperatively. When
      the echo-dobutamine test is positive, on the other hand, the recovery of function
      usually occurs immediately after revascularization and the operative risk is
      expected to be low even in the presence of severely compromised left ventricular
      function.

PMID- 8347360
TI  - Iatrogenic clubbing of the fingers.
AB  - We report on a 39-year-old female who had been operated on for an atrial septal
      defect at the age of 14 years. On operation the inferior vena cava was
      iatrogenically misdirected into the left atrium. The cyanotic patient, in
      functional group IV of the NYHA classification, with polyglobulia and clubbing of
      the fingers was successfully reoperated after 25 years.

PMID- 8347361
TI  - Left and right ventricular diverticula, ventricular septal defect and ectopia
      cordis in a patient with Cantrell's syndrome.
AB  - A patient with Cantrell's syndrome is presented with ectopia cordis, ventricular
      septal defect and a left ventricular as well as a right ventricular diverticulum.
      One-stage correction was performed with resection of both diverticula. Closure of
      the ventricular septal defect was complicated due to exposure problems as a
      result of the malposition of the heart. Although the presentation of Cantrell's
      syndrome can be variable, one-stage repair is technically feasible and should be
      considered as the treatment of choice in this rare syndrome.

PMID- 8347362
TI  - Is lung cancer resection justified in patients aged beyond 70 years?

PMID- 8347363
TI  - Breast and cervical cancer screening of poor, elderly, black women: clinical
      results and implications. Harlem Study Team.
AB  - Our objective is to describe the clinical findings from a nurse-practitioner
      based breast and cervical cancer screening program for poor, elderly, black
      women. We designed a cross-sectional descriptive study set at an urban public
      hospital medical clinic. All women 65 years of age and older were eligible to be
      screened. We measured these main outcomes: rates of participation, abnormal
      tests, and neoplasia. Women were offered screening during a routine visit. Of 689
      women, 491 (71%) participated. Mammography was completed by 66% of women; one had
      stage 1 cancer, and 76% were negative. Among the women (24%) with abnormal
      mammograms, the overwhelming majority were diagnosed with benign lesions. For ten
      of 450 women completing Papanicolaou (Pap) smears, results were suspicious or
      positive for malignancy, for a prevalence rate of 22.2/1,000 (95% confidence
      interval [CI] = 8.6/1,000 to 35.8/1,000). Three were subsequently designated
      falsely positive; five had confirmed cervical neoplasia; and two had other
      reproductive malignancies. Two women with negative smears also had neoplasia: one
      with vulvar cancer and one with human papilloma virus (HPV) infection and
      cervical neoplasia, for a total of six cervical neoplasias. Interestingly, one
      fifth of women with a hysterectomy had an intact cervix, including one with
      cervical neoplasia. Nearly one-third of women with abnormal Paps or mammograms
      failed to complete follow-up. Success of screening programs for the elderly will
      depend on the risk group targeted, careful examination, degree of sensitivity and
      specificity of the tests, and acceptability of follow-up diagnosis and treatment.

PMID- 8347364
TI  - Cost-effectiveness of two nurse-led programs to teach breast self-examination.
AB  - The cost-effectiveness of breast cancer screening that includes breast self
      examination (BSE) has not been investigated, in part because the costs and
      effects of programs to teach BSE are not well known. I used data from a
      randomized, controlled trial and national surveys to compare the benefit, cost,
      and cost-effectiveness of two one-year, nurse-led programs to teach BSE in a
      medical practice setting. One program (Mammacare, or MAM) used manufactured
      silicone models to develop tactile skills; the other program (Traditional, or
      TRAD) stressed knowledge and examination techniques. I defined benefit as the
      marginal one-year increase in the number of women in an "average" adult primary
      care office practice who performed competent and frequent BSE. I defined cost as
      the marginal increase in the resources used to teach BSE and in the resources
      used as a result of performing BSE. Cost-effectiveness equaled the cost per
      competent, frequent BSE examiner added. The "average" practice was derived based
      on estimates from national surveys of physicians and medical practices. The MAM
      program's benefit was fivefold greater than the TRAD program's; its total cost
      was more than threefold greater; and its cost per competent, frequent examiner
      added was 32% lower. Yet, regardless of the program, one year following teaching
      only 15%-28% of women were competent, frequent performers. Cost-effectiveness was
      sensitive to the definition of benefit. Cost-effectiveness was also sensitive to
      some costs, but generally these sensitivities did not alter the relative cost
      effectiveness of the two programs. The cost of teaching BSE was substantial.
      Benefit, cost, and cost-effectiveness varied by program.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8347365
TI  - Risk for cardiovascular disease in the elderly and associated Medicare costs: the
      Framingham Study.
AB  - Studies of young, employed populations have established an association between
      risk factors for cardiovascular disease and health care costs, but an association
      has never been demonstrated in an elderly population. For the surviving elderly
      cohort (63 to 93 years of age) of the Framingham Heart Study (n = 1,053), we
      estimated a model regressing Medicare reimbursements per beneficiary over two
      years (1984 and 1985) on the two-year probability of cardiovascular disease at
      Exam 17 (1982 or 1983), controlling for other risk factors and prior health
      services use. Using the coefficient for the two-year probability for
      cardiovascular disease, we estimated Medicare cost ratios and dollar values
      associated with elevated compared with nonelevated risk for 12 risk profiles for
      cardiovascular disease. The average level of risk for cardiovascular disease in
      the elderly is associated with Medicare claims costs that are 19% higher (95%
      confidence interval [CI] = 10%, 29%) than those for persons with no elevated
      risk, equivalent to an average of $371 per elderly beneficiary or $9.3 billion
      per year in Medicare expenditures. Smoking is associated with 16% (95% CI = 8%,
      24%) higher Medicare costs than nonsmokers' costs. Systolic blood pressure of 160
      mm Hg is associated with 11% (95% CI = 6%, 16%) higher Medicare costs, compared
      with a systolic blood pressure of 140 mm Hg. A total blood cholesterol level of
      260 mg/dL is associated with 6% (95% CI = 3%, 9%) higher Medicare costs, compared
      with a total blood cholesterol of 180 mg/dL. Additional studies are needed to
      help calculate the cost-effectiveness of risk reduction for the elderly.

PMID- 8347367
TI  - Smokeless tobacco use among children: the New Hampshire Study.
AB  - Rural public school children initially in grades 4, 5, and 6 participated in a 36
      month follow-up study of substance abuse prevention. Children completed self
      report questionnaires at baseline and annually for three years after the
      introduction of prevention programs. We compared outcomes of (1) a comprehensive
      school curriculum ("Here's Looking at You, 2000"), (2) the curriculum plus a
      parenting course ("Parent Communication Course") and a community task force
      (Johnson Institute Model), and (3) control condition. Neither the curriculum nor
      the curriculum plus parent and community intervention had any effect on smokeless
      tobacco use by this preadolescent and young adolescent population. We used
      stepwise logistic regression to determine prediction models for smokeless tobacco
      use. Initiation of smokeless tobacco use is associated with sex, grade, and
      having friends who use drugs. Although regular use increases with grade, poor
      family relations, and low school satisfaction, the greatest risk factor was ever
      trying smokeless tobacco. We describe the culture of smokeless tobacco use in
      this population, and we discuss the implications of our research for smokeless
      tobacco use prevention.

PMID- 8347366
TI  - Demographic and educational differences in smoking in a tobacco-growing state.
AB  - National studies have documented an excessive rate of cigarette smoking in black
      men; however, a 1987 survey conducted in two urban areas in South Carolina
      documents a high rate of smoking in young white men with fewer than 12 years of
      education (67%; 95% confidence interval [CI] = 58.3, 75.7). Differences in
      smoking rates by educational level were significant only for those younger than
      40. Young blacks were less likely to smoke and smoked fewer cigarettes than
      whites. As a result, the population burden of cigarettes in young black men with
      fewer than 12 years of education was only 27% of the burden carried by their
      white peers. Television, physicians, and radio were all seen as likely sources of
      health information to prevent heart disease, but newspapers were less likely to
      be cited by those younger than 40 or by those with fewer than 12 years of
      education. Reported physician counseling for smoking cessation did not differ
      significantly by race, sex, or educational level of the patient, but reported
      counseling was higher for individuals with a personal history of cardiovascular
      disease (odds ratio [OR] = 2.32, CI = 1.27, 4.25) and somewhat lower for the
      elderly. We highlight the population burden of cigarettes, a predictor of the
      eventual disease burden attributable to smoking, as a useful priority measure for
      smoking intervention efforts.

PMID- 8347369
TI  - The costs and benefits of breast cancer screening.
AB  - The costs and benefits of breast cancer screening can be placed in the framework
      usually used for sensitivity and specificity. All those screened incur the costs
      associated with the test. In addition, only the segment of the true positives
      who, in the absence of screening, would die of their disease but with screening
      will survive to die of another cause truly benefit; all other true positives
      acquire lead time without benefit. In the Canadian National Breast Screening
      Study, simpler treatment of screen-detected cancer was not achieved. The true
      negatives benefited from reassurance, but the majority were not at risk of breast
      cancer anyway. The false negatives were disadvantaged from false reassurance, but
      in practice the percentage is low, and the consequences are not dire. There are
      major costs associated with the false positive state, including anxiety,
      unnecessary biopsies, and residual scarring; major endeavors are justified to
      reduce them and improve the specificity of screening. In practice, with no
      benefit demonstrated for women 40-49 years of age, the costs are too great to
      justify continuation of screening this age group merely in the hope that benefits
      will eventually be demonstrated. For women older than 50, the degree of benefit
      may have been overestimated, especially in an era when improvements in therapy
      affect screen-detected and nonscreen-detected cases alike. We may have
      overestimated the benefit-cost ratio of screening this age group also; thus,
      careful monitoring of the outcome of ongoing programs over the next few years is
      essential.

PMID- 8347368
TI  - Improvements in cholesterol-related knowledge and behavior and plasma cholesterol
      levels in youths during the 1980s.
AB  - This article examines cholesterol-related knowledge, cholesterol-related
      behaviors, and plasma cholesterol levels in 12-24-year-olds, using data collected
      from four community-based cross-sectional surveys conducted 1979-1980, 1981-1982,
      1985-1986, and 1989-1990. Participants included 1,552 individuals from randomly
      sampled households in two control cities (San Luis Obispo and Modesto,
      California) of the Stanford Five-City Project. Over the eleven-year study period,
      cholesterol-related knowledge improved in both control cities (P < .0002).
      Cholesterol-related behavior (P < .0003) and plasma cholesterol levels (P < .002)
      significantly improved only in San Luis Obispo (a college city with more 19-24
      year-olds and a better-educated population than Modesto). In general, knowledge
      and behavior scores and plasma cholesterol levels were lower in these 12-24-year
      olds than in 25-74-year-olds, although trends at all ages were similar over time
      and by demographic variables. Although the cholesterol-related interventions that
      began in the mid-1980s primarily targeted adults, these 12-24-year-olds'
      cholesterol-related knowledge improved (as did, to a lesser extent, their
      cholesterol-related behavior and plasma cholesterol levels). These findings have
      implications for upcoming youth-related cholesterol interventions.

PMID- 8347370
TI  - Mammography in West Virginia.
AB  - A questionnaire was sent in 1988 to all sites conducting mammographic studies
      registered with the radiologic licensing division of the West Virginia State
      Department of Health Laboratory Services to determine the number of women served
      and the costs of the procedures. The number of sites, 61, appears excessive in
      view of the small number of women many of them screened during the course of a
      year and the high charges. Copies of the report on the questionnaire results were
      sent to agencies and other groups within the state to urge initiation of a more
      cost-effective system; however, four years later the number of units had
      increased substantially, and no coherent plan had been formulated. The report was
      helpful to members of the state legislature in their decision to mandate
      insurance coverage for women according to the American Cancer Society guidelines.

PMID- 8347371
TI  - Mammography in the 1990s: a plea for objective doctors and informed patients.
AB  - Mammography screening is increasingly promoted as a means to avoid death from
      breast cancer. Although some randomized trials have shown a mortality benefit in
      the older screened groups, not all the results have been statistically
      significant; benefit has not been shown in younger age groups. Mammography
      detects smaller lesions than physical examination, but the only randomized trial
      comparing the mortality benefits of mammography and physical examination shows no
      benefit for mammography. The systemic nature of breast cancer raises questions
      about the theoretical mortality benefit of screening. Patients undergoing
      mammography may experience unexpected anxiety about the results. Candidates for
      screening should be routinely informed of these issues.

PMID- 8347373
TI  - Genetic metabolic disease: a paradigm for preventive health care.

PMID- 8347372
TI  - Preventing Vibrio vulnificus infections: who should bear responsibility?

PMID- 8347374
TI  - Inherited metabolic diseases: collaborating for the health of all children.

PMID- 8347376
TI  - Decrease of isoprene concentrations in blood during general anesthesia.
AB  - Isoprene is present in human breath and in human blood. The fact that isoprene
      concentrations in breath are linked to states of sleep and wakefulness led us to
      study its concentration in blood of 12 patients before, during, and after general
      anesthesia. Isoprene concentrations in blood of patients before anesthesia were
      3.3 +/- 1.6 micrograms/liter. During anesthesia, isoprene concentrations
      decreased to 0.9 +/- 0.5 micrograms/liter. One hour after the end of anesthesia
      isoprene increased to levels similar to or higher than the preanesthetic ones.

PMID- 8347375
TI  - Molecular genetic aspects of cardiomyopathy.
AB  - Cardiomyopathies are a major cause of mortality and morbidity and this spectrum
      of disorders tops the list of diseases leading to cardiac transplantation. While
      significant gains have been made during the past decade clinically, knowledge of
      the molecular aspects of these disorders has taken longer to advance. During the
      past 5 years, however, molecular genetic information on a variety of primary
      cardiomyopathies, such as familial hypertrophic cardiomyopathy and X-linked
      dilated cardiomyopathy, has been obtained. Other primary and secondary myocardial
      diseases are now under study with advances occurring more regularly. The purpose
      of this review is to outline the major advances thus far described for some
      primary and secondary cardiomyopathies, as well as detailing the slower progress
      seen for others.

PMID- 8347377
TI  - A glucokinase-like enzyme carries out glucose phosphorylation in capillaries of
      normal and spontaneously hyperglycemic rabbits.
AB  - We have studied glucose phosphorylation at increasing glucose concentrations (1,
      5, 10, 25, 50, and 100 mmol/liter) in capillaries of the choroidocapillary lamina
      from the eye of normal female albino rabbits (n = 10; body wt 1800-2000 g; mean
      +/- SEM morning glycemia: 147.77 +/- 4.02 mg/dl) and from the eye of
      spontaneously hyperglycemic rabbits (n = 5, body wt 1800-2000 g, mean +/- SEM
      morning glycemia; 211.00 +/- 10.76 mg/dl). In the 3000g supernatant of capillary
      homogenates, the glucose phosphorylating activity (NADP reduction measured as
      optical density change at 366 nm at pH 7.5) increased progressively with the rise
      of glucose concentration (r = 0.36; P < 0.05), approaching the peak at high
      glucose level (25 mmol/liter), with values ranging from 5.32 +/- 0.46 (SEM)
      nmol/min/mg protein to 7.14 +/- 0.74 (+34.21%, P < 0.01). When measured at a more
      alkaline pH (8.2) the glucose phosphorylation was higher than at pH 7.5 and
      retained the responsiveness to increasing glucose concentrations. These kinetic
      characteristics differ from those seen in most tissues and are somewhat
      reminiscent of those shown by hepatic glucokinase. Indeed, by subtracting the
      activity at 1 mmol/liter glucose from that at higher glucose concentrations, we
      calculated the "glucokinase component" which together with the "hexokinase
      component" form the total glucose phosphorylating activity. Glucose
      phosphorylation in capillaries from spontaneously hyperglycemic rabbits was lower
      than normal (values: 3.66 +/- 0.31 vs 5.32 +/- 0.46 of the normal rabbits; 
      31.20%; P < 0.05). This could contribute to the hyperglycemia by reducing glucose
      utilization. However, in these animals the enzyme activity retained the
      responsivity to increasing glucose concentrations (r = 0.41, P < 0.05).
      Therefore, the actual capillary glucose phosphorylation in these animals would
      depend upon both the enzyme level (which is reduced) and the glucose
      concentration (which is increased). Due to the in vivo inhibition of the
      hexokinase component, the glucokinase component may be predominant in vivo,
      making the stimulating effects of hyperglycemia much more pronounced than it
      would appear from our data in vitro. This may lead to glucose overutilization.
      These kinetic characteristics of glucose phosphorylation in capillaries might be
      relevant to the mechanisms leading to diabetic microangiopathy.

PMID- 8347378
TI  - Regulation of orotic acid biosynthesis and excretion induced by oral glutamine
      administration in mice.
AB  - Glutamine, the most abundant amino acid in blood and tissues, is degraded by the
      renal and splanchnic tissues, especially the small intestinal mucosa. Due to the
      activity of glutaminase, it may be broken down in these tissues and contribute to
      ammoniagenicity. Glutamine, either directly or through ammonia production, may
      act as a nitrogenous source for pyrimidine biosynthesis. We have evaluated the
      effect of glutamine on orotate metabolism in mice, by gavaging (ig) L-glutamine,
      1.0 to 4.0 mmol/100 g of body wt/day, during 6 weeks of experimentation.
      Glutamine at doses of 2.5 to 4.0 mmol/100 g of body wt caused a significant
      increase in plasma ammonia and urinary orotate. The regulation of the orotic acid
      biosynthesis and excretion was studied by testing the effects of various
      inhibitors in mice force-fed with glutamine (4 mmol/100 g of body wt, ig). The
      orotic aciduria was insensitive to acivicin (1 and 5 mg/100 g of body wt, ip), a
      specific inhibitor of the cytoplasmic carbamyl phosphate synthetase-II, thus
      pointing toward the mitochondrion as the principal source of carbamyl phosphate.
      Cycloheximide (15 and 100 mg/kg of body wt, ip) caused a significant decrease in
      urinary orotate indicating that the induction of orotate synthesis by glutamine
      may be associated with the translation of a specific protein. However, orotate
      excretion was significantly decreased by N-(phosphonoacetyl)-L-aspartate (PALA)
      (5 mg/100 g of body wt, ip) due to its inhibitory effect on the aspartate
      transcarbamylase activity. There was a significant increase of urinary orotate
      following ingestion of adenine supplemented diets (0.1% and 0.2%), suggesting the
      blockage of the utilization of orotate for nucleotide biosynthesis by glutamine.
      Since orotate synthesis may also be influenced by ornithine metabolism, we
      evaluated the effect of glutamine administration on various ornithine
      metabolizing enzymes. There was a decrease in hepatic ornithine decarboxylase
      activity with no change in hepatic ornithine aminotransferase activity following
      the administration of glutamine. This observation indicates that an increased
      metabolic utilization of ornithine is not responsible for the increase in orotate
      excretion, which may be caused principally through an effect of glutamine on
      mitochondrial carbamyl phosphate synthesis.

PMID- 8347379
TI  - Assay of acyl-CoA dehydrogenase activity in frozen muscle biopsies: application
      to medium-chain acyl-CoA dehydrogenase deficiency.
AB  - The acyl-CoA dehydrogenases (ACDs) are mitochondrial enzymes that dehydrogenate
      acyl-coenzyme A esters of different chain lengths. Inherited deficiencies of
      these dehydrogenases are commonly associated with muscle weakness and lipid
      storage. Numerous assays including spectrophotometric, fluorometric, chemical,
      and radiochemical procedures have been used, but there is need for a rapid,
      reproducible assay for the different acyl-CoA dehydrogenases in small frozen
      samples of human muscle biopsies. We describe a comparative study of dye-linked
      spectrophotometric assays of the long, medium, and short chain acyl-CoA
      dehydrogenases in frozen rat and human muscle samples. An optimal procedure is
      described confirming the value of glass-glass homogenization and assay of a 600g
      supernatant. Higher activities for all acyl-CoA dehydrogenases, citrate synthase,
      and cytochrome c oxidase were obtained in rat in contrast to human. The substrate
      linked dye reduction method was found superior to the ferricenium or electron
      transfer flavoprotein acceptor systems. Application of the phenazine ethosulfate
      DCPIP-linked method to medium-chain acyl-CoA dehydrogenase (MCAD) was studied in
      detail and the effect of immunoprecipitation of MCAD allowed for the
      determination of substrate specificity and the degree of crossover between long-,
      medium-, and short-chain ACD activity following immunoprecipitation. Finally, a
      comparison of the specificity and validity of the assay in a patient with MCAD
      deficiency was performed.

PMID- 8347381
TI  - Effects of insulin on free amino acids in plasma and the role of the amino acid
      metabolism in the etiology of diabetic microangiopathy.
AB  - To investigate if alterations of the amino acid metabolism may play a more
      important role in the etiology of diabetic microangiopathy than hitherto
      recognized, free amino acids in plasma were measured by means of high-performance
      liquid chromatography (HPLC) in healthy individuals (REF) and patients with
      insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes
      mellitus (NIDDM). Isoleucine and leucine in IDDM were within normal limits,
      whereas they were significantly higher in NIDDM (P < 0.01 and P < 0.001,
      respectively). This was not due to age differences. In order to evaluate the
      impact of insulin on amino acid metabolism, amino acids were also measured in
      pregnant women (PREG) undergoing glucose tolerance tests as a screening for
      pregnancy diabetes and in patients with polycystic ovary syndrome (PCO)
      undergoing euglycemic insulin clamp tests. Insulin considerably reduced the amino
      acid concentration. Isoleucine and leucine were particularly depressed. On the
      whole there was strong covariance between the three branched-chain amino acids,
      isoleucine, leucine, and valine (P < 0.0001). There was no covariance between
      amino acid and glucose or HbA1c concentrations. A protein meal strongly
      stimulated insulin production (+55 mIU/liter), whereas a galactose meal revealed
      only a minor increase in insulin response (+12 mIU/liter) in contrast to a
      tolerance test with the same amount of glucose (+67 mIU/liter). It is concluded
      that disturbed amino acid metabolism may be a more important causative factor in
      the etiology of diabetic microangiopathy than hitherto recognized and, in
      addition, that this may affect the therapeutic approach in both IDDM and NIDDM
      patients.

PMID- 8347382
TI  - In vivo kinetics of oxidatively modified HDL.
AB  - The kinetics of oxidatively modified high-density lipoprotein (HDL) in vivo were
      investigated. 125I-labeled oxidized (Ox) HDL and 131I-labeled native (N) HDL were
      injected simultaneously into control and WHHL rabbits. The fractional catabolic
      rates of 125I-labeled Ox-HDL were significantly greater than those of 131I
      labeled N-HDL in both control (2.52 +/- 0.36/day vs 0.94 +/- 0.02/day) and WHHL
      rabbits (4.07/day vs 1.32/day). Oxidized HDL was catabolized faster than native
      HDL and was taken up primarily by the liver, spleen, and kidney.

PMID- 8347380
TI  - Thiamin-responsive maple syrup urine disease in a patient antigenically missing
      dihydrolipoamide acyltransferase.
AB  - Maple syrup urine disease results from inherited defects in human nuclear genes
      for branched chain alpha-ketoacid dehydrogenase, a mitochondrial multienzyme
      complex. Thiamin pyrophosphate is necessary for complex activity and a thiamin
      responsive form of maple syrup urine disease is known. Here we demonstrate the
      use of [1-13C]leucine oxidation to [13C]O2 quantified in breath samples as a
      means of assessing whole body leucine oxidation. Analysis of cultured cells from
      this patient shows the antigenic lack of the E2 subunit, yet she gained branched
      chain alpha-ketoacid dehydrogenase activity in response to diet supplementation
      with pharmacologic doses of thiamin. These cultured cells were used to seek a
      molecular basis for the observed thiamin response. Despite normal thiamin
      transport in these cells, medium supplementation of up to 1000 thiamin/liter
      failed to increase complex activity or cause the antigenic appearance of the
      missing protein. This lack of response in cultured cells suggests that the
      observed whole body response to thiamin must be a tissue-specific effect in
      liver, muscle, or kidney. In addition, allele-specific detection of paternal and
      maternal mutations was used to genotype family members in this pedigree.

PMID- 8347383
TI  - Primary care and HIV infection in the 1990s.

PMID- 8347384
TI  - Dementia in general practice: the practical consequences of a more positive
      approach to diagnosis.
AB  - General practitioners are often reluctant to administer brief cognitive tests,
      and to question the relatives of patients who appear to be demented, for fear of
      causing distress. Diagnoses of dementia are therefore often based on guesswork,
      and non-demented patients may be rated as cognitively impaired in error. A
      randomly selected sample of 174 general practice patients aged 80 years and over
      were asked to complete a simple test of orientation and information in order to
      assess the usefulness and acceptability of such a procedure. If patients scored
      10 points or less out of 12, a relative or other knowledgeable informant was
      questioned about their changes in mental state and behaviour. Assessments proved
      acceptable to patients, relatives and doctors; diagnoses were revised in 29
      cases; and practical initiatives were proposed in 15 cases. Open discussions with
      patients and their families proved innocuous and have much to commend them.

PMID- 8347386
TI  - Does feedback improve the quality of cervical smears? A randomized controlled
      trial.
AB  - In a randomized controlled trial three methods of feedback of increasing
      intensity, directed at 183 doctors taking cervical smears, were compared with
      respect to their effects on the sampling quality of smears. Overall, feedback was
      found to have no influence on quality criteria in the crude data analysis.
      However, a significantly larger decrease in the percentage of smears lacking
      endocervical cells was found in the groups receiving monthly overviews of their
      results with peer comparison, when compared with the groups not receiving this
      type of feedback (odds ratio 0.75). Moreover, feedback appeared to have a clear
      effect on the presence of endocervical cells among doctors submitting a
      substantial number of smears in the intervention period, as opposed to those who
      submitted fewer smears. A positive correlation was also observed between the
      increase in the group mean of the proportions of smears containing pathological
      cells and the intensity of the feedback. However, this increase did not reach
      statistical significance. This study suggests that monthly feedback with peer
      comparison may have a positive relationship with some aspects of quality
      improvement in cervical screening.

PMID- 8347385
TI  - Elderly people's views of an annual screening assessment.
AB  - A survey was carried out in order to identify elderly patients' perceptions of
      their health status, their health worries and their opinions regarding health
      screening before and after the introduction of an annual screening programme. Pre
      and post-assessment self report, structured questionnaires and standardized,
      objectively scored, functional and medical assessments were used. The cohort was
      an age and sex stratified, 20% sample of those aged 75 years and over (133
      patients). Results showed that 96% of patients before the assessment and 98% of
      patients afterwards, considered the annual assessment useful. The domiciliary
      visit by the health visitors resulted in one third of those patients who
      perceived themselves to be in good health and three quarters of those who
      perceived themselves to be in poor health becoming less worried about their
      health. Only two patients became more worried. Half of those objectively assessed
      as being in the medium health risk group and 68% of those in the high health risk
      group became less worried about their health after screening. Despite the
      majority of patients having welcomed the assessment their visit resulted in
      false, and potentially harmful, reassurance for a considerable number of
      individuals objectively assessed as being at medium and high health risk. An
      adverse consequence of health screening in elderly people may be inappropriate
      reassurance for those objectively assessed to be at risk. However, screening
      procedures are a means to an end, not an end in themselves. The identification of
      those at high risk should see subsequent implementation of services,
      investigations and increased support to relieve suffering, so it may have been
      that patients felt less anxious because they were anticipating relief of their
      problems.

PMID- 8347387
TI  - Skin biopsies of pigmented skin lesions performed by general practitioners and
      hospital specialists.
AB  - The performance of skin biopsies by general practitioners has been examined in
      several recent studies. The aim of this study was to examine the difference
      between skin biopsies of pigmented skin lesions taken by general practitioners
      and those taken by hospital specialists. Reviewing all histopathology records at
      one hospital over a five year period revealed that there were 1000 patients who
      had had skin biopsies. General practitioners had carried out skin biopsies for
      55% of these patients. Hospital specialists excised significantly more lesions
      that had increased in size (P < 0.001) or changed in colour (P < 0.001). General
      practitioners excised more lesions that had bled (P < 0.001). Hospital
      specialists excised more of the 15 melanomas diagnosed (80%) (P < 0.05), and
      general practitioners excised more squamous papillomas (P < 0.01). Forty per cent
      of melanomas excised were not suspected by the clinician. General practitioners
      were able to detect the majority of suspicious lesions, but because of the
      uncertainty of clinical diagnosis, all specimen's should be submitted for
      histopathological diagnosis. It is important that future general practitioners
      are trained in both the diagnostic and technical aspects of skin biopsy if they
      intend to perform this minor operation.

PMID- 8347388
TI  - Analysis of referrals of mental health problems by general practitioners.
AB  - The majority of people in the community who have a psychiatric disorder will
      consult their general practitioner. Referrals from general practice to specialist
      services are, however, relatively rare. The filter between primary care and
      specialist care has been characterized by Goldberg and Huxley as the least
      permeable of the filters separating psychiatrists and other specialists from the
      populations they serve. These referrals form the subject of this study in the
      Netherlands. Using a large database of doctor-patient contacts, the proportion of
      mental health disorders resulting in a referral and the characteristics of the
      patient and general practitioner that are involved in such a referral have been
      determined. In addition, the type of mental health institution or specialist to
      which referrals were directed and the characteristics influencing this choice
      were examined. Only 6% of patients presenting with a psychiatric disorder during
      surgery hours were referred to specialist care. Younger patients, male patients
      and patients with severe diagnoses had a greater probability of being referred.
      The percentage of patients referred was higher in urban areas than in rural
      areas. Doctors with a limited task perception regarding mental treatment tended
      to refer more often. Although the diagnosis did have some relationship with the
      institutions to which patients were referred (psychotic conditions to psychiatric
      services and social/material problems to social workers), the most prevalent
      diagnoses (neurotic conditions and relationship problems) seemed to be more or
      less randomly distributed over the various possibilities. Preferences appeared to
      be related to the existence of regular meetings between general practitioners and
      specialists and a positive evaluation by general practitioners of the institution
      concerned.

PMID- 8347389
TI  - Continuing education for general practice. 1. Experience, competence and the
      media of self-directed learning for established general practitioners.
AB  - The arrangements under which continuing education for general practice is
      provided and attendance by general practitioners is rewarded have now been in
      operation for three years. More recently, reaccreditation has emerged as a
      significant issue for the profession. For these reasons it appears timely to
      review the whole basis of ongoing learning by established general practitioners.
      In this the first of two papers, learning by established professionals is
      considered in relation to the educational development of the learner, the role of
      experience and the goals of competence and performance. It is concluded that self
      directed learning based on experience should form the centre-piece of continuing
      education for general practice and that educational provision should adopt a
      complementary role in sustaining motivation to learn and by enabling learning
      from experience to be shared and enriched. A model of self-directed learning,
      connecting experience and competence through systematic application of three
      learning media, reading, reflection and audit, is proposed and related to
      appropriate educational participation by established general practitioners.

PMID- 8347390
TI  - Systematic care of diabetic patients.

PMID- 8347391
TI  - Heroin users on a methadone programme.

PMID- 8347392
TI  - Unrecognized ovarian failure after hysterectomy.

PMID- 8347393
TI  - Limited sequence divergence of HTLV-I of Indian HAM/TSP patients from a prototype
      Japanese isolate.
AB  - Nucleotide sequences of two HTLV-I proviruses isolated from Indian patients with
      HAM/TSP were analyzed. The sequence data of the env, pX, and LTR regions showed
      98-99% homologies with the prototype HTLV-I, ATK-1, isolated from a Japanese ATL
      patient, indicating that HTLV-I isolates in India and Japan are similar, with
      minor variations. However, certain small sequences of noncoding regions in the pX
      and LTR showed differences of 6.1 and 7.2%, respectively, thus the conclusion
      could vary depending on the regions and length of the sequences used for
      comparison.

PMID- 8347394
TI  - HTLV-I-associated myelopathy in south India.

PMID- 8347395
TI  - The prevalence of antibodies to the human T lymphotropic virus (HTLV) in Ghana,
      West Africa.
AB  - We conducted a population-based serosurvey of urban areas and rural regions of
      southern Ghana, West Africa. Subjects (3763) of all ages were enrolled from 25
      city and village sites and in studies of groups of special interest. "Positive"
      results were difficult to define because of a high frequency of results that were
      indeterminate on immunoblotting, the current standard for confirmation of HTLV-I.
      However, polymerase chain reaction results and HTLV type-specific discriminatory
      tests proved HTLV-I was present in Ghana. No HTLV-2 positivity was observed. By
      using strict criteria that considered indeterminate results as negative, the
      overall prevalence was found to be between 1 and 2% in all areas, with no
      difference by geographic location. Prevalence rose with age and was higher in
      adult women than men. However, in substudies of selected populations, we found
      HTLV prevalence among 124 persons with lymphomas and hematological malignancies
      was not different from that in the general population. Furthermore, the
      prevalence in prostitutes was similar to that in the general population and in
      pregnant women. HTLV-I is present in West Africa, but we were unable to associate
      HTLV-I seropositivity with malignancy or with prostitution.

PMID- 8347396
TI  - HIV-1 infection stimulates T cell invasiveness and synthesis of the 92-kDa type
      IV collagenase.
AB  - Tissue-specific localization of HIV-1-infected lymphoid cells may contribute to
      clinical manifestations of AIDS. Therefore we investigated the effect of HIV-1
      infection on mechanisms of T lymphocyte invasion, a process required for movement
      of cells into and out of the circulation. In the present study, we demonstrate
      that HIV-1-infected human lymphocytes secrete increased amounts of the human 92
      kDa type IV collagenase when compared to uninfected lymphocytes. Furthermore, HIV
      1-infected lymphocytes degrade the extracellular matrix proteins collagen IV and
      fibronectin, and they are more invasive through a reconstituted basement membrane
      when compared to uninfected cells. The addition of either antibody to the 92-kDa
      collagenase or TIMP-2, a type IV collagenase inhibitor, abolishes invasive
      activity. These data suggest that HIV-1-infected lymphocytes express phenotypic
      characteristics that are consistent with an enhanced ability to leave the
      circulation and to localize in target tissues. Local viral infection or the
      release of viral proteins, cytokines, or proteolytic enzymes in tissues may
      contribute to pathogenesis.

PMID- 8347397
TI  - Adaptation of two primary human immunodeficiency virus type 1 isolates to growth
      in transformed T cell lines correlates with alterations in the responses of their
      envelope glycoproteins to soluble CD4.
AB  - Two sCD4-resistant, primary viruses (P-08 and P-17) were compared with two sCD4
      sensitive, T cell line-adapted variants (C-08 and C-17) for their biochemical
      responses to sCD4. At 37 degrees C, neither primary virus shed gp120 within 8 hr
      at sCD4 concentrations of up to 500 nM, whereas C-08 and C-17 lost gp120 within
      minutes of addition of 5-10 nM sCD4. At 4 degrees C, however, P-17 and C-17 shed
      gp120 at similar rates in response to the same sCD4 concentration. Irrespective
      of the temperature, gp120 dissociation from both P-17 and C-17 was inhibited by
      CD4 MAbs 6H10 and 5A8, the latter of which blocks events subsequent to sCD4
      binding. Binding of sCD4 to P-17 was greater at 4 degrees C than at 37 degrees C,
      whereas the converse was found for C-17. Consistent with this, P-17 was
      neutralized much more potently by sCD4 at 4 degrees C than at 37 degrees C,
      whereas C-17 was slightly more sensitive to sCD4 at 37 degrees C than at 4
      degrees C. Resistance to neutralization by sCD4 is probably determined by kinetic
      parameters. We suggest that the acquisition of sCD4 neutralization sensitivity
      and the above biochemical responses to sCD4 are coincidental to the process by
      which some primary viruses adapt to growth in transformed T cells. Sequence data
      indicate that there are a limited number of amino acid differences between the
      Env glycoproteins of the primary viruses and their T cell line-adapted
      counterparts; the significance of the individual changes is under investigation,
      but both pairs of viruses have amino acid substitutions in a region of gp41
      thought to contact gp120.

PMID- 8347399
TI  - Glucocorticoids synergize with tumor necrosis factor alpha in the induction of
      HIV expression from a chronically infected promonocytic cell line.
AB  - In this study we have investigated the effects of glucocorticoids (GCs) on the
      expression of human immunodeficiency virus (HIV) in a chronically infected
      promonocytic cell line, U1. Although no increase in virus production was observed
      in U1 cells stimulated with physiological concentrations of GC alone,
      costimulation with dexamethasone plus tumor necrosis factor alpha (TNF-alpha)
      synergistically enhanced TNF-alpha-dependent HIV expression. Molecular analysis
      demonstrated that GCs plus TNF-alpha resulted in an accumulation of steady state
      HIV RNA secondary to either an increase in transcription or an increase in
      message stability. These findings may be of physiological relevance because GCs
      are used in the treatment of certain disorders associated with HIV infection and
      TNF-alpha levels have been reported to be elevated in the plasma and
      cerebrospinal fluid of certain HIV-infected individuals.

PMID- 8347400
TI  - Kaposi's sarcoma in an Indian woman infected with HIV-1 and HIV-2.

PMID- 8347401
TI  - Physiologic effects of maternal smoking on breast-feeding infants.
AB  - Women who smoke and breast-feed pose an unknown threat to their infants' health.
      In this pilot study, relationships between ingestion of nicotine in breast milk
      and physiologic effects in the infant were investigated. Infant physiologic
      effects measured were temperature, pulse, respiration, systolic blood pressure,
      and oxygen saturation. Five smoking and five nonsmoking mother-infant pairs were
      studied. Breast milk was analyzed for nicotine using gas chromatography. Breast
      milk from smoking mothers contained a mean of 33.1 ng/mL of nicotine while the
      breast milk from nonsmoking mothers contained a mean of less than 6.45 ng/mL of
      nicotine. Infant physiologic measures were taken before and 20 min after breast
      feeding. After breast-feeding, infants of smoking mothers had a significant
      change in respirations and oxygen saturation while infants of nonsmoking mothers
      had a significant change in pulse only. Results provide a scientific basis for
      counseling smoking, breast-feeding mothers.

PMID- 8347398
TI  - Biological cloning of functionally diverse quasispecies of HIV-1.
AB  - Twenty putative clones of HIV-1, derived by biological cloning from two different
      individuals, were characterized in vitro for functional activity and genotypic
      diversity. Many of the biological clones isolated by this method were genetically
      distinct, and could be further distinguished by differences in replication
      kinetics, host cell range, and/or cytopathicity. Our findings indicate that
      biological cloning by limiting dilution cultures is an effective method for
      isolating replication-competent, functionally diverse quasispecies of HIV-1.

PMID- 8347403
TI  - Health care delivery to farmworkers in the Southwest: an innovative nursing
      clinic.
AB  - The migrant and seasonal farmworkers of the United States constitute a medically
      underserved population with many health care needs. Barriers to health care among
      farmworker families include financial constraints, cultural factors, restrictive
      labor practices, and absence of accessible clinics in rural areas. The Migrant
      Health Outreach Program is a federally funded mobile nursing clinic created to
      deliver health care to farmworkers where they live and work. The Migrant Health
      Outreach Team, composed of family nurse practitioners, registered nurses, and
      health care workers, offers primary care including health care maintenance and
      treatment of acute and chronic illness. The mobile nursing clinic serves the
      target population of farmworkers as a successful alternative to a traditional
      medical clinic.

PMID- 8347402
TI  - Physical health measurement of the older adult: new instrumentation.
AB  - The Georgia Centenarian Study examines the biologic, psychologic, and social
      factors contributing to life satisfaction and successful aging in late adulthood.
      Three age groups are included, 60 through 69 years, 80 through 89 years, and 100+
      years. While the overall theoretical model includes multiple variables, physical
      health is viewed as critical to successful aging. This article presents an
      overview of physical health measurement for older persons. Some existing measures
      of physical health are included in the test battery for the Georgia Centenarian
      Study; however, the investigators determined the need for the inclusion of a new
      instrument. This article describes existing measures as well as the rationale and
      process of development of a new instrument.

PMID- 8347404
TI  - Facilitating the nurse practitioner's research role: using a microcomputer for
      data entry in clinical settings.
AB  - Data coding and entry can be a tedious and error-prone component of research.
      Statistical packages for a microcomputer are now available that enable the
      researcher to create data entry forms in a spread sheet format. In this article
      the use of software that can be used for data entry, manipulation, and analysis
      is discussed. In a practice setting these features are particularly useful,
      because the nurse practitioner can take the microcomputer to the clinical
      facility and enter data directly from client-provider interactions or from
      records. In clinical settings where client data are entered directly into a
      computer database as part of assessment and care giving, data can be downloaded
      onto this or similar programs for manipulation and analysis.

PMID- 8347405
TI  - Use of clozapine in primary care.
AB  - While clozapine represents a revolutionary advance in the treatment of
      schizophrenia, it carries with it a formidable side-effect profile.
      Agranulocytosis may indeed be life-threatening to a small number of patients. The
      nurse practitioner must be aware of this and other side effects in order to
      competently care for patients with psychiatric problems. It is also essential
      that there be a collaborative relationship between the nurse practitioner and a
      mental health provider. Only through appropriate consultation and referral will
      the needs of psychiatric patients be met in a timely and comprehensive manner.

PMID- 8347406
TI  - ERISA: a little discussed but formidable barrier to health care reform.
      Employment Retirement Income Security Act.

PMID- 8347407
TI  - Distinguishing between licensure proceedings and malpractice suits.

PMID- 8347408
TI  - 'Is half the profession apathetic to further learning?'.

PMID- 8347409
TI  - 'Images of your future'.

PMID- 8347410
TI  - The location of a disposable broken bur in the tongue.

PMID- 8347411
TI  - A retrospective study comparing duplication and conventionally made complete
      dentures for a group of elderly people.
AB  - The duplication technique is a well recognised method of replacing complete
      dentures. Advantages claimed for this technique are that patients adapt more
      easily to their new complete dentures and the numbers of treatment visits are
      reduced. The case notes of 100 patients were examined retrospectively, 50 of whom
      had had dentures constructed by undergraduates using a duplication technique and
      50 with a conventional technique. In addition, a questionnaire was sent to the
      patients to obtain their views on the replacement dentures. The 'duplication
      group' required fewer visits for the delivery of the dentures, but there was no
      statistical difference between the numbers of post-insertion visits, for the two
      groups, needed to make the dentures comfortable. The only identifiable reason for
      selecting a duplication technique was the failure of construction of new dentures
      by a conventional method in 15 patients. Apart from this the two groups appeared
      remarkably similar when comparing age of dentures being replaced, period of
      edentulousness, number of previous complete dentures and medical histories. As
      judged by the questionnaire more patients in the duplication group continued to
      wear their new dentures compared to the conventional group.

PMID- 8347412
TI  - The future role of dental therapists in the UK: a survey of District Dental
      Officers and General Practitioners in England and Wales.
AB  - A postal questionnaire concerning the opinion of the dental profession as to the
      future role of dental therapists in the UK was sent to a random sample of 30
      District Dental Officers and 70 General Dental Practitioners. In total 76
      questionnaires were returned, 26 from DDOs, 50 from GDPs, giving corrected
      response rates of 86.7% and 57.1% respectively. Returns revealed that 69.2% of
      District Dental Officers predicted a future role for dental therapists in the
      Community Dental Service. A total of 47.5% of General Dental Practitioners stated
      they would like to see therapists working in general dental practice, with 40% of
      this group willing to employ a therapist providing the current legislation was
      changed. The most popular predicted role in both services appears to be an equal
      division between the provision of clinical care and dental health education.
      Recently qualified General Dental Practitioners were more in favour of the
      employment of therapists than older members of the profession, which suggest that
      with time, the demand for this auxiliary in general dental practice could
      increase.

PMID- 8347413
TI  - Allergic contact dermatitis associated with the use of an Interlandi headgear in
      a patient with a history of atopy.
AB  - An allergic contact dermatitis (ACD) reaction associated with the use of an
      orthodontic headgear is described in a patient with a history of atopy. The
      problems relating to the differential diagnosis between these two conditions are
      discussed. This case highlights that during medical history taking specific
      questioning relating to nickel sensitivity should be undertaken to identify those
      patients who may be at risk.

PMID- 8347414
TI  - Facial sinus formation secondary to a parotid duct calculus.
AB  - A case of facial sinus formation secondary to calculus obstruction of the parotid
      duct is reported. The aetiology and management of this condition are discussed.

PMID- 8347415
TI  - Stasis dermatitis: practical pearls for the dermatologic nurse.
AB  - Stasis dermatitis is a common, chronic skin condition. Treatment requires
      attention to local skin-care measures, systemic factors contributing to pedal
      edema, and surgical/mechanical approaches to promote venous outflow and decrease
      pooling. Compliance problems can result when patients have a poor understanding
      of their treatment program, have anxiety regarding costs, or experience the
      discomfort associated with therapy. Understanding the pathophysiology of stasis
      dermatitis, and treatment options with emphasis on practical treatment can
      improve patient compliance.

PMID- 8347416
TI  - What's your assessment? Candidiasis.

PMID- 8347417
TI  - Skin care: burn survivor case study. Part 2.
AB  - A clinical methodology involving consultation, assessment, planning,
      implementation, and evaluation is important in meeting patients' skin care and
      cosmetic needs. Part Two of this three-part series examines how this systematic
      and practical approach was used in improving a burn survivor's skin quality.

PMID- 8347419
TI  - Personal appearance overlooked in wound care.

PMID- 8347418
TI  - Nursing perspectives: aseptic techniques in wound care.
AB  - The availability and use of gloves and antibiotics contribute to a false sense of
      security in providing wound care. The significance of nurses' attention to the
      principles of aseptic technique need to be re-established in nursing practice.

PMID- 8347420
TI  - Plasma membrane p180, which insulin receptor phosphorylates in vivo, is not a
      tyrosine kinase.
AB  - The earliest substrates to the transmembrane insulin receptor tyrosine kinase,
      that would function in insulin signalling, are likely to be associated with the
      plasma membrane. Rat liver plasma membrane 180,000 M(r) protein (p180) is a
      substrate to the insulin receptor in vitro [Goren et al. (1990) Cellular
      Signalling 2, 537-555]. The question as to whether p180 is a substrate in vivo
      was addressed. Half ml 0.9% NaCl or 500 micrograms insulin was injected into rat
      livers. Purified plasma membrane glycoproteins from the livers were assayed for
      in vitro phosphorylation reaction products and endogenous tyrosine-phosphorylated
      proteins. Membranes from insulin-injected rat livers contained phosphorylated
      p180 and phosphorylated insulin receptor beta-subunit, whereas saline-injected
      rat liver membranes contained neither. These data suggested that p180 is an in
      vivo substrate to the insulin receptor. In vitro p180 is tyrosine-phosphorylated
      in the absence of insulin. p180, therefore, may be the epidermal growth factor
      (EGF) receptor or another tyrosine kinase that could be part of a phosphorylation
      cascade initiated by insulin. Two different experiments suggested that p180 is
      not the EGF receptor: (i) two-dimensional gel electrophoresis (first dimension-
      non-equilibrium pH-gradient gel electrophoresis) indicated that p180 is a more
      basic glycoprotein than EGF receptor; and (ii) based on reverse-phase high
      pressure liquid chromatography, the tryptic-phosphopeptides of carboxymethyl
      Sepharose-purified phosphorylated-p180 were different from those of A431 cell
      phosphorylated-EGF receptor. Similarly, two different experiments demonstrated
      that p180 is not a tyrosine kinase: (i) gel-permeation chromatography separated
      the insulin receptor from p180 and only insulin receptor was autophosphorylated
      in vitro; and (ii) membrane proteins not bound to immobilized ATP contained p180.
      Thus, p180 can associate with the insulin receptor and be phosphorylated in vitro
      and in vivo; however, p180 does not function in an insulin receptor-mediated
      phosphorylation cascade.

PMID- 8347421
TI  - GTP[S] stimulates migration of electropermeabilized neutrophils via a pertussis
      toxin-sensitive G-protein.
AB  - Electropermeabilized neutrophils were used to study the role of G-proteins in
      neutrophil migration. Rabbit neutrophils, under specific conditions, retained
      their ability to migrate after electropermeabilization. Introduction of guanosine
      5'-[3-thio] triphosphate (GTP[S]) into the cell interior stimulated random
      migration and enhanced migration activated by a suboptimal concentration of
      formyl-methionyl-leucyl-phenylalanine (fMet-Leu-Phe) (10(-11) M). GTP[S] had no
      effect on random migration by intact cells, or on migration of intact cells
      activated with a suboptimal concentration of fMet-Leu-Phe, indicating that the
      effect of GTP[S] was intracellular. The effects of GTP[S] were inhibited by
      pertussis toxin and by guanosine-5'-[2-thio] diphosphate (GDP beta S) indicating
      that a pertussis toxin-sensitive G-protein was involved. GTP stimulated random
      migration to the same extent as GTP[S], but had only a small effect on migration
      activated by a suboptimal concentration of fMet-Leu-Phe (10(-11) M). Several
      other nucleotides tested had no effect on random migration or migration activated
      with 10(-11) M fMet-Leu-Phe. The results show that neutrophil migration can be
      potentiated by direct activation of a pertussis toxin-sensitive G-protein, and
      the results obtained with GTP suggest that possibly more than one G-protein is
      involved in this process.

PMID- 8347423
TI  - Workshop on risk assessment of human exposure to pathogenic micro-organisms.
      National Institute of Public Health & Environmental Protection. Bilthoven, The
      Netherlands.

PMID- 8347424
TI  - Use of microbial risk assessment in setting US drinking water standards.

PMID- 8347422
TI  - Activation of phospholipase D following perturbation of the human T lymphocyte
      antigen receptor/CD3 complex is dependent upon protein kinase C.
AB  - Perturbation of the T lymphocyte antigen receptor/CD3 complex or phorbol ester
      stimulation leads to activation of phospholipase D in the Jurkat T lymphocyte
      cell line. These observations suggested that phospholipase D activation might
      result from activation of protein kinase C. In other systems, phospholipase D
      activity has been shown to be under G-protein or protein kinase C control.
      Studies detailed here demonstrate that commonly used inhibitors of protein kinase
      C had unrelated, diverse effects on phospholipase D activity in T lymphocytes.
      However, protein kinase C down-regulation resulting from prolonged cellular
      exposure to phorbol esters led to abrogation of anti-CD3-stimulated phospholipase
      D activation. The results presented underline the complexity of studies employing
      inhibitors of protein kinase C, suggest interesting approaches to isolation of
      phospholipase D dependent signalling pathways, confirm that T cell antigen
      receptor-linked activation of phospholipase D is dependent upon protein kinase C
      activity and suggest that distant events of T lymphocyte activation are dependent
      upon the establishment of a positive feedback loop involving protein kinase C and
      phospholipase D which would result in the prolonged activation of protein kinase
      C required for certain lymphokine production.

PMID- 8347425
TI  - Fumonisins.
AB  - Fusarium moniliforme Sheldon is a common fungal contaminant of corn and produces
      a variety of mycotoxins. Among these are the recently discovered fumonisins,
      which are now known to cause certain animal diseases, namely
      leukoencephalomalacia in horses and pulmonary edema in swine. There is a
      significant association between their presence in corn and human esophageal
      cancer in southern Africa. Fumonisin B1 causes liver cancer in rats. Five other
      fumonisins--B2, B3, B4, A1 and A2, have been isolated; the last two are N
      acetates of fumonisins B1 and B2 and do not appear to be toxic. Several other
      Fusarium species are now known to produce fumonisins. Procedures for detection
      and determination of fumonisins include thin layer chromatography, liquid
      chromatography (with fluorescence derivatization), post-hydrolysis gas
      chromatography, immunochemical assay, and mass spectrometry. In addition to their
      natural occurrence in corn-based animal feeds and in home-grown African corn used
      for food, fumonisins are frequently found in commercial corn-based foods.
      Fumonisins are moderately heat-stable. No effective detoxification process has
      yet been developed for use with fumonisin-contaminated feeds.

PMID- 8347426
TI  - Heat and acid sensitivity of motile Aeromonas: a comparison with other food
      poisoning bacteria.
AB  - The present study was undertaken to compare the heat and acid sensitivity of
      aeromonads with those of other food-poisoning bacteria. It became obvious that
      aeromonads were more sensitive to heat than Escherichia coli O157:H7,
      Staphylococcus aureus, and Salmonella typhimurium. Aeromonads were killed in
      peptone water within 2 min at 55 degrees C, while the other bacteria survived
      heating at 55 degrees C for more than 15 min. Aeromonas cells were also less
      resistant to heat in hamburger steaks. These findings suggest that Aeromonas
      infection can easily be prevented by heat treatment, although correct handling of
      food is required to avoid recontamination since aeromonads are very common in
      various kinds of food. E. coli, S. aureus and S. typhimurium cells survived in
      buffer at pH 3.2 and in foods seasoned with vinegar. By contrast, Aeromonas cells
      were found to be highly sensitive to acid. However, the resistance of Aeromonas
      to acid may be sufficient to allow it to infect the gastrointestinal tract since
      Vibrio parahaemolyticus, which causes numerous outbreaks of food-poisoning every
      year in Japan, was susceptible to acid to the same extent as Aeromonas.

PMID- 8347427
TI  - Characterization and frequency distribution of species of lactic acid bacteria
      involved in the processing of mawe, a fermented maize dough from Benin.
AB  - Lactic acid bacteria involved in the natural fermentation of both home-produced
      and commercial mawe were investigated during a 72 h fermentation period.
      Lactobacillus spp. constitute the majority (94%) of the strains of the lactic
      acid bacteria isolated, among which 89% represent the Betabacterium group. They
      include L. fermentum (biotype cellobiosus) (41%), L. fermentum or L. reuteri
      (19%), L. brevis (26%), L. confusus (less than 2%), L. curvatus (less than 1%)
      and L. buchneri (less than 1%). Other isolated lactic acid bacteria were L.
      salivarius, Lactococcus lactis, Pediococcus pentosaceus, Pediococcus acidilactici
      and Leuconostoc mesenteroides. Several species were detected at the early stage
      of fermentation, but the final stage was dominated by L. fermentum (biotype
      cellobiosus) and L. fermentum or L. reuteri totalling 90% of the isolated
      strains. The trend was the same for both home-produced and commercial mawe. No
      strains of L. plantarum, generally reported as dominating lactic acid bacteria at
      the final stage of fermentation of most plant foods, were isolated.

PMID- 8347428
TI  - Distribution of Listeria spp. in confectioners' pastries from western France:
      comparison of enrichment methods.
AB  - Three hundred samples of pastry from 100 different suppliers in western France,
      including butter-cream, whipped dairy cream and custard filled cakes from each
      supplier, were collected and tested for the occurrence of Listeria spp. in 25 g
      samples. Listeria spp. were detected in 21.7% of he samples: Listeria
      monocytogenes in 13.7%, Listeria innocua in 10% and Listeria seeligeri in 2.3%.
      Thirteen samples were contaminated with two species simultaneously. The frequency
      of contaminated samples was not related to the composition of the pastry filling
      used, but it seemed to increase with the number of aerobic contaminant
      microorganisms in the dairy cream-based samples. The contamination rate was
      dependent on the place of manufacture. The numbers of Listeria spp. and Listeria
      monocytogenes were estimated on positive samples at the 25 g level as follows: <
      0.3/g, Listeria spp. in 47 samples, L monocytogenes in 27; 0.3-30/g, Listeria
      spp. in 13, L. monocytogenes in nine; 30-300/g, L. monocytogenes in one; 300
      3000/g; L. monocytogenes in three; 700,000/g, L. monocytogenes in one. Various
      detection methods were tested, including two enrichments broths tested in
      parallel: a modified LEB broth using 10 mg/l acriflavine-HCl and the UVM 1 broth,
      with incubation at 30 degrees C and streaking onto PALCAM agar. The enrichment
      procedures were: (a) primary enrichment of 25 g sample and plating after 48 h and
      7 days; (b) secondary enrichment by subculturing the primary enrichment broths
      incubated for 24 h and 6 days, into fresh enrichment broth, then plating after 24
      h incubation; (c) pre-enrichment of 25 g sample for 24 h in the basal enrichment
      broths without inhibitors, followed by subculturing in complete broths which were
      plated after 24 h and 6 days incubation. In all cases, UVM performed better than
      the LEB broth. It was unnecessary to extend the primary enrichment period beyond
      48 h. Secondary enrichments inoculated from 24-h incubated primary enrichments
      gave a slightly better isolation rate than primary enrichments. Secondary
      enrichments made from 6-day incubated primary enrichments gave no additional
      advantage. The pre-enrichment procedure had an efficiency higher than that
      obtained by primary enrichment.

PMID- 8347429
TI  - Characteristics and antagonistic activity of lactic acid bacteria isolated from
      chilled fish products.
AB  - In fish products, contrary to other foods, the commercial use of starter cultures
      is relatively unexploited. In this study, 61 isolates of lactic acid bacteria
      from lightly preserved, chilled fish products were characterized with special
      emphasis on their antagonistic activity and their possible use as starter
      cultures. The strains were phenotypically identified and characterized with
      regard to gas production, carbohydrate fermentations, production of off odours,
      H2O2-production, antagonistic activity and growth at 2, 5 and 10 degrees C.
      Growth at 10 degrees C was detected for all strains within 4 days. At 5 degrees
      C, 90% of the isolates were growing within 3-9 days. At 2 degrees C only 33% of
      the strains were growing within 9 days. Fourteen strains were selected for
      further testing of antagonistic activity against spoilage- and pathogenic
      bacteria at different pH in a disc assay. Two strains, a Leuconostoc spp. (V 6)
      and a Lactobacillus plantarum (LKE 5), differed from the other lactic acid
      bacteria by a very wide inhibitory spectrum for V 6 and by very distinct
      inhibition zones for LKE 5. The mechanisms of their inhibitory effects are
      discussed.

PMID- 8347430
TI  - Changes in the microflora on commercial beef trimmings during their collection,
      distribution and preparation for retail sale as ground beef.
AB  - A commercial process for ground meat production, from the collection of meat
      plant trimmings to the retailing of consumer packs of ground beef, was examined.
      The selected process compiled with current concepts of Good Manufacturing
      Practice. During storage for up to 18 days before grinding, most trimming
      developed a flora of lactobacilli, of up to 10(7) CFU/g. Numbers of coliforms and
      of Escherichia coli on stored trimmings increased little and not at all,
      respectively. Increased total counts, and numbers of both coliforms and E. coli
      in displayed product indicated loss of control of the temperature of the
      displayed packaged product. It appears that the need to store a product, taking
      into account the unpredictable fluctuations in supply and demand, will inevitably
      result in much ground beef carrying large numbers of spoilage bacteria.
      Furthermore, currently accepted Good Practice in the retail handling of ground
      beef does not adequately control either spoilage or the growth of pathogenic
      bacteria.

PMID- 8347431
TI  - Presence of Listeria monocytogenes, motile aeromonads and Yersinia enterocolitica
      in environmental samples taken from a supermarket delicatessen.
AB  - Environmental swab samples collected on three occasions from a supermarket
      delicatessen were examined for the presence of Listeria monocytogenes, motile
      aeromonads and Yersinia enterocolitica. Strains of Y. enterocolitica belonging to
      a pathogenic biotype were not recovered, but isolates of L. monocytogenes and
      motile aeromonads were found. Contaminated surfaces and items that came into
      direct contact with ready-to-eat food included a slicing machine, a knife and
      parsley that was to be used as a garnish. Most sites sampled near a display of
      processed meats requiring cooking, such as bacon and sausages, yielded positive
      results and could therefore act as a source of cross contamination for ready-to
      eat meats.

PMID- 8347432
TI  - Occurrence of Aeromonas spp. in samples of ground meat and chicken.
AB  - Aeromonas spp. was commonly isolated from ground meat and chicken samples at the
      retail level. The dominant species in ground meat were A. hydrophila and A.
      caviae. In chicken, A. sobria was common while A. caviae was isolated
      infrequently. Although A. hydrophila was isolated from 75% of ground meat samples
      and 62% of chicken samples, DL-lactate-positive A. hydrophila (genospecies 1) was
      isolated from only 25 or 37% or respective samples. Sorbitol-positive A.
      hydrophila (genospecies 3) was common in both ground meat and chicken.

PMID- 8347433
TI  - Local pharmacotherapy for impotence.

PMID- 8347434
TI  - Talking heads: a combined assault on atheroma.

PMID- 8347435
TI  - Hypothyroidism in the elderly: clinical assessment versus routine screening.
AB  - A total of 304 patients aged 65 years or over were prospectively studied over a
      four-month period to assess whether clinical findings or routine screening were
      more helpful in diagnosing biochemical hypothyroidism. The most useful symptom
      relevant to a possible diagnosis of hypothyroidism in the elderly was found to be
      dry skin. Dermatological signs and certain ECG abnormalities (especially atrial
      fibrillation) were helpful when querying a diagnosis of hypothyroidism. Almost
      50% of patients receiving amiodarone had abnormal thyroid function tests (TFTs).
      Routine screening for hypothyroidism does not seem justifiable from our available
      data although this conclusion may have been different had hospital clinicians and
      general practitioners followed their patients up more closely after an initial
      abnormal result was obtained.

PMID- 8347436
TI  - An integrated haematuria clinic.
AB  - The prognosis of bladder cancer is worsened by delay in its management. To reduce
      such delay we have organised a clinic where intravenous urography and cystoscopy,
      using a flexible cystoscope, are carried out at the patient's first visit. In a
      two-year period 321 patients attended this clinic. The results of investigation
      in 305 patients are reported. A total of 6% of patients with microscopic
      haematuria (n = 52) and 15% of patients with macroscopic haematuria (n = 253) had
      transitional cell carcinomata. This difference was not significant (P = 0.08, chi
      squared). The delay between referral and trans-urethral resection of tumour for
      patients with bladder tumours was reduced from a mean of 60 days to a mean of 33
      days by the institution of the clinic (P < 0.01, Mann-Whitney). We recommend that
      all patients referred to a urological service with haematuria, whether
      macroscopic or microscopic, should be investigated. The integration of that
      investigation in a single day decreases delays in diagnosis and management.

PMID- 8347437
TI  - The efficacy and sedative profile of astemizole and cetirizine in the treatment
      of grass pollen hayfever in general practice.
AB  - The antihistamines astemizole and cetirizine were compared for the treatment of
      grass pollen hayfever in 158 patients who received either astemizole (10 mg od)
      or cetirizine (10 mg od) for a four week period in a randomised double-blind,
      double-dummy, parallel group, comparative assessment. Patients visited their
      general practitioner (GP) on three occasions and at each visit the GP made an
      assessment of the severity of individual hayfever symptoms. Patients recorded
      daily throughout the study the severity of their hayfever symptoms and their
      level of daytime sedation on visual analogue scales in a diary card. The primary
      measure of efficacy was the overall symptom visual analogue scores recorded daily
      by the patients. The results demonstrate that these two antihistamines are
      equally effective treatments for hayfever, in terms of magnitude of symptom
      relief, speed of onset of symptom improvement and lack of sedative effect.

PMID- 8347438
TI  - The outcome of surgery of aneurysmal subarachnoid haemorrhage.
AB  - Aneurysmal subarachnoid haemorrhage is a challenging pathology which remains a
      cause of considerable mortality and morbidity. To demonstrate to general
      practitioners the results of surgery for this condition a retrospective study of
      160 consecutive cases who had undergone aneurysmal surgery was carried out. On
      admission 57% of cases had a good Hunt and Hess grade (grades I and II) and 43% a
      poor grade (grades III, IV and V). Twelve per cent of cases had a pre-existing
      hypertension and 73% of cases were treated with nimodipine. Angiography was
      performed from 0 to 73 days (median 3 days) after the bleed. Early surgery
      (within the first three days after the bleed) was performed in 41% of cases.
      Twenty-two per cent of cases rebled before surgery from 1 to 69 days after
      initial presentation (median seven days). Delayed cerebral ischaemia was
      diagnosed in 38% of cases, but only 15% of cases had evidence of low density on
      the CT scan. The outcome was determined at six months using the 'Glasgow outcome
      scale'. Fifty-five per cent of cases made a good recovery (back to normality),
      15% a fair recovery (moderately disabled but independent), 15% a poor recovery
      (severely disabled and dependent), and 15% died. The significant poor prognostic
      factors were: a poor pre-operative Hunt and Hess grade, the presence of an
      intracerebral haematoma or angiographic spasm, evidence of rebleeding and early
      surgery without treatment with nimodipine. Other factors which did not reach a
      statistical significance include: age, presence of subarachnoid and
      intraventricular blood on CT, timing of surgery, history of long-standing
      hypertension, intraoperative rupture, and the development of hydrocephalus or
      delayed ischaemia.

PMID- 8347439
TI  - Acarosan and the Acarex test in the control of house dust mite allergens in the
      home.
AB  - House dust mites are believed to be major triggers for allergic disease in atopic
      individuals. As part of a programme controlling dietary and aero-allergen
      exposure in high-risk infants, an acaricidal foam and powder (Acarosan) was
      applied to bedroom and main living room carpets, as well as upholstered
      furniture, on four occasions in the first year of life. Dust was assayed for mite
      antigen (Der p1) and these results compared with the semi-quantitative assay of
      guanine content (Acarex Test). After nine months mean Der p1 levels had decreased
      by 70% in the treatment group. Proportionally, the greatest fall occurred in
      those items that had the highest initial mite antigen content. The Acarex score
      does show a correlation with Der p1 levels, but cannot replace antigen assay when
      accurate data is required. A chemical acaricide may help reduce house dust mite
      antigen levels, but is not by itself sufficient to reduce levels below that
      considered critical for sensitisation.

PMID- 8347440
TI  - A survey of aspirin use in the pre-hospital treatment of suspected acute cardiac
      chest pain.
AB  - Recent large studies have demonstrated the value of early intervention with
      aspirin and thrombolysis in myocardial infarction for patients reaching hospital
      alive. Management of patients with suspected myocardial infarction prior to
      hospitalisation is an important area of acute cardiac care. Guidelines for good
      practice suggest the early administration of aspirin should be considered when an
      infarct seems likely. We have found aspirin less commonly used than other
      interventions prior to hospital admission in patients with suspected acute
      cardiac pain.

PMID- 8347441
TI  - Is there any relationship between pica and liver failure?
AB  - Pica is defined as the compulsive eating of anything and has been known for more
      than a hundred years. It is a worldwide problem which can be seen in every race,
      age, sex and geographic region. Its true incidence is not known and may be
      greater than expected. Although it is a widespread phenomenon, the causes and
      risk factors of pica are not well established. Clinical signs and symptoms of
      pica syndrome are numerous but liver disorder associated with this syndrome is
      not widely reported. We reported here liver disorder possibly related with pica.

PMID- 8347442
TI  - Potassium channel activators in the management of ischaemic heart disease: a
      focus on nicorandil.
AB  - The treatment of angina pectoris continues to pose challenges. Novel new
      compounds are a rarity, but the potassium channel activators represent a new
      class of drugs with novel mechanisms of action. Nicorandil will be the first
      available potassium channel modulator for treatment of angina, and the following
      review assesses its clinical potential.

PMID- 8347443
TI  - The management of rectal bleeding.
AB  - Rectal bleeding is a common symptom in the general population; it may signal the
      presence of serious gastrointestinal disease but more frequently is caused by
      minor and self-limiting local ano-rectal conditions. Appropriate and accurate
      evaluation of rectal bleeding requires an investigative approach which balances
      an appreciation of the need to provide an adequate explanation for the bleeding
      against over-investigation, excessive referral and wasted resources. As doctors
      of first contact, general practitioners (GPs) are frequently faced with difficult
      questions concerning the optimum management of rectal bleeding. This paper was
      prepared as a result of a series of interactive meetings with over 1,000 GPs from
      throughout the UK, which revealed wide variations in the possession and use of
      investigative equipment in the surgery, access to secondary care facilities,
      estimates of the prevalence and potential seriousness of rectal bleeding and the
      management strategies adopted in response to a series of case histories. We
      highlight a number of unresolved issues about the roles of GPs and hospital
      specialists in the management of rectal bleeding and the need for research
      directed at answering outstanding questions. In addition, a management strategy
      is proposed which might form the basis for a protocol for care, shared between
      general practice and the hospital.

PMID- 8347445
TI  - An unusual presentation of bilateral tubal ectopic pregnancy.
AB  - The diagnosis of ectopic pregnancy is sometimes difficult on clinical grounds
      because of the varied presentation. The clinical triad of amenorrhoea, abnormal
      vaginal bleeding and lower abdominal pain often raises the suspicion of the
      diagnosis. There are, however, instances where one or other feature of the triad
      may be absent.

PMID- 8347444
TI  - Endometriosis--the problems of intestinal obstruction.
AB  - Endometriosis is a relatively common condition in women of child-bearing age, and
      coincidental intestinal serosal involvement is frequently recognised. However,
      intestinal obstruction, although reported, is rare. We report what we believe is
      the first case with synchronous ileo-caecal and rectosigmoid obstructing
      endometriomas. Endometriosis as a cause of bowel obstruction is discussed and in
      particular the differential diagnosis from Crohn's disease and malignancy.

PMID- 8347446
TI  - Pericardial effusion--an uncommon complication of Salmonella enteritis.
AB  - A 62-year-old lady who was receiving corticosteroids for rheumatoid arthritis was
      admitted suffering from dehydration due to salmonella enteritis. Despite
      rehydration and appropriate chemotherapy she remained unwell and developed
      hypotension and elevation of her jugular venous pressure. Echocardiography and
      subsequent aspiration demonstrated a purulent pericardial effusion from which S
      typhimurium was cultured. Following aspiration and a change of antibiotic
      therapy, her condition improved dramatically.

PMID- 8347447
TI  - Gallstone cirrhosis: are we only seeing the tip of the iceberg?
AB  - Gallstones are common and their incidence increases with age. Fifty per cent of
      these stones are in the common bile duct (CBD) in the elderly. Most of them are
      silent but with time there is an increasing chance of developing symptoms which
      are more likely to be serious in the elderly. Failure to relieve mechanical
      obstruction of bile flow may lead to secondary biliary cirrhosis. It has been
      estimated that on average secondary biliary cirrhosis develops some seven years
      after the onset of obstruction from a stricture, four and half years after
      gallstone obstruction and 10 months after the onset of malignant stricture. The
      characteristic features are the pathological findings of portal-portal linkages,
      with a pattern of monolobular cirrhosis and the preservation of normal vascular
      relationships. Secondary biliary cirrhosis may lead to hepatic insufficiency and
      portal hypertension with the resultant complications, such as bleeding
      oesophageal varices, hypersplenism with pancytopenia, ascites and encephalopathy.
      We describe a patient in whom the diagnosis was not suspected until laparotomy
      and confirmed only at autopsy.

PMID- 8347449
TI  - Periorbital necrotizing fasciitis: trivial facial injury resulting in cardiac
      arrest.
AB  - Facial injuries in the context of alcohol abuse are a common presentation to
      casualty departments. While the majority are self limiting, the presence of
      periorbital or facial oedema should alert physicians to the development of
      periorbital necrotizing fasciitis. Here, a case illustrates this unusual
      manifestation of streptococcal infection, and emphasises the rapid onset and
      devastating systemic and local cosmetic consequences of this condition.

PMID- 8347448
TI  - Severe large and small bowel fibrosis clinically mimicking gross splenomegaly.
AB  - The case of an 18-year-old female, with mild left hypochondrial pain and an
      abdominal mass mimicking gross splenomegaly, with severe small and large bowel
      fibrosis and adhesions and numerous mononuclear cellular infiltrate on histology,
      is presented. A clear picture of intestinal obstruction only unfolded terminally.
      She died within 48 hours of presentation. Our patient illustrates the fact that
      severe intestinal adhesions may present with very mild symptoms and signs and
      therefore a high index of suspicion is necessary, to reduce the attendant high
      mortality in intestinal obstruction in our environment.

PMID- 8347450
TI  - The neuroleptic malignant syndrome: a missed diagnosis?
AB  - The neuroleptic malignant syndrome (NMS) is an idiosyncratic reaction to major
      tranquilizer drugs characterised by hyperpyrexia, extrapyramidal disorders and
      altered consciousness. First described in 1968 by Delay and Deniker, early case
      reports suggested a mortality of between 20 and 30%. Though the syndrome is now
      more widely recognised, the diversity of its clinical features may not always be
      appreciated and may lead to diagnostic confusion with other, more common,
      disorders. We report on two severe cases of NMS: in the first the diagnosis was
      initially thought to be sepsis from a urinary tract infection, and in the second
      the primary clinical diagnosis was of a mid brain infarction.

PMID- 8347453
TI  - Experimental allergic encephalomyelitis raises betaine levels in the spinal cord
      of strain 13 guinea-pigs.
AB  - Chronic relapsing experimental allergic encephalomyelitis, an animal model of
      multiple sclerosis, was induced in Strain 13 guinea-pigs by subcutaneous
      injection of spinal cord homogenate and Freund's incomplete adjuvant supplemented
      with Mycobacterium tuberculosis. High resolution 1H NMR spectra of CNS tissue
      extracts indicated that the levels of choline metabolites, particularly betaine,
      were elevated in the spinal cord tissue, the principal site of lesion formation
      in this guinea-pig strain. The spectra also show that N-acetylated compounds are
      slightly depleted in the disease. The results are discussed in relation to the
      biochemical interpretation of NMR spectra obtained in vivo from patients with
      multiple sclerosis.

PMID- 8347452
TI  - Esophageal cancer phospholipid characterization by 31P NMR.
AB  - Phospholipid extracts of surgical tissue specimens from 18 patients, consisting
      of normal esophagus, distal esophageal tumor and normal stomach, were analyzed
      using 31P NMR. The prominent phospholipids detected in these tissues included
      cardiolipin (CL), phosphatidylethanolamine plasmalogen, phosphatidylethanolamine
      (PE), phosphatidylserine (PS), sphingomyelin (SPH), phosphatidylinositol (PI),
      phosphatidylcholine plasmalogen and phosphatidylcholine (PC). Very small
      quantities of the phospholipids lysophosphatidylcholine, phosphatidic acid,
      phosphatidylglycerol, and an uncharacterized phospholipid at -0.13 delta also
      were detected in some of the 54 tissue specimens analyzed. The mean relative
      concentrations of these phospholipids, in mole percentages of total detected
      phosphorus, were determined from the acquired spectra and used to differentiate
      among the three tissue groups. The relative concentrations of the following
      phospholipids differed significantly (p < 0.001) among the respective tissue
      groups: normal esophagus vs esophageal tumor, PS, SPH, PI, PC; normal esophagus
      vs normal stomach, CL, PE, PS, SPH; esophageal tumor vs normal stomach, CL, PE.
      Membrane phospholipids implicated in modulating the growth and metastases of
      tumors of epithelial origin can be profiled to discriminate among normal
      esophagus, distal esophageal tumor and normal stomach using 31P NMR.

PMID- 8347454
TI  - A selective inversion recovery method for the improvement of 23Na NMR spectral
      resolution in isolated perfused rat hearts.
AB  - Shift-reagent-aided 23Na NMR spectroscopy allows differentiation of the
      intracellular (Na(i)) and extracellular sodium (Na(o)) signals. The goal of the
      present study has been to develop a 23Na NMR spectroscopic method to minimize the
      intensity of the shift-reagent-shifted Na(o) signal and thus increase Na(i)
      resolution. This is achieved by a selective inversion recovery (SIR) method which
      enhances the resolution between the Na(i) and Na(o) peaks in shift-reagent-aided
      23Na NMR spectroscopy. The application of SIR with Dy(TTHA), Tm(DOTP), or with
      low concentrations of Dy(PPP)2 results in both good spectral resolution and
      physiologically acceptable contractile function in the isolated, perfused rat
      heart model.

PMID- 8347451
TI  - Controllable graded cerebral ischaemia in the gerbil: studies of cerebral blood
      flow and energy metabolism by hydrogen clearance and 31P NMR spectroscopy.
AB  - A technique for remotely controlling the degree of carotid artery occlusion in
      the gerbil model of cerebral ischaemia has been developed. The technique relies
      on manually adjustable nylon snares around the carotid arteries, in conjunction
      with a computer-based monitoring system, to control the degree of occlusion. This
      has allowed us to determine the dependence of energy metabolism (as assessed by
      31P NMR spectroscopy) on blood flow in greater detail than was possible in our
      previous studies. Data obtained show that energy changes first appear at flows of
      25-30 mL/100 g/min, while at flows below 20 mL/100 g/min there is a major
      derangement of energy metabolism. The model was used to determine the sensitivity
      of cerebral energy metabolism to reduced cerebral blood flow under normothermic
      conditions and in mild hypothermia (30 degrees C). Hypothermia had a protective
      effect in that energy metabolites were maintained at flows significantly below
      the normothermic threshold.

PMID- 8347456
TI  - Use of computer simulations for quantitation of 31P ISIS MRS results.
AB  - The difficulties in quantitation of in vivo 31P spectra are exacerbated by the
      fact that, in general, coils with inhomogeneous B1 fields are used with in vivo
      samples. A general method for quantitation of in vivo 31P MRS results obtained
      with the ISIS localization method was developed using computer simulations. The
      simulation calculates the preparation of the sample magnetization throughout the
      sample by the ISIS pulse sequence, as well as the sensitivity of signal
      reception. The calculation accounts for both the B1 field and the B0 gradients
      applied to the sample. The sensitivity of the experiment is expressed by
      integration of the simulated signal over the sample, assuming a homogeneous
      sample. The primary advantage of this approach is that a separate localization
      experiment on a phantom of known concentration is not required each time
      parameters of the localization experiment, such as dimensions or location of the
      localized volume, are altered. In addition, the simulations indicate the degree
      of contamination (signal from outside of the localized volume) that occurs, and
      provide a means of comparing different executions of the ISIS experiment.
      Experiments were performed on phantoms to verify the simulations, and
      experimental results on human brain and liver are reproduced to show that this
      approach provides reasonable estimates of metabolite levels in terms of molar
      concentrations.

PMID- 8347455
TI  - The effect of oestrogen ablation on the phospholipid metabolite content of
      primary and transplanted rat mammary tumours.
AB  - The concentration of phospholipid metabolites was determined in chemical extracts
      from two types of rat mammary tumours and compared with proliferation data (S
      phase fraction). One of the tumours was an oestrogen-sensitive transplanted
      tumour. In this tumour the concentration of phosphocholine (PC) and
      glycerophosphorylcholine (GPC) correlated strongly with the S-phase fraction but
      not with the number of cells actively synthesizing DNA. Oestrogen ablation
      resulted in tumour regression. Regressing tumours contained less PC and more GPC
      than those actively growing. The other tumour was induced in rats by intravenous
      administration of N-methyl N-nitrosourea. Phosphoethanolamine (PE), PC and GPC
      levels were not associated with the S-phase fraction in this tumour. Oestrogen
      ablation resulted in tumour regression. There was no significant difference
      between the regressing and growing tumours in PE, PC or GPC content.

PMID- 8347457
TI  - A comparative study of 1H NMR lineshape fitting analyses and biochemical lipid
      analyses of the lipoprotein fractions VLDL, LDL and HDL, and total human blood
      plasma.
AB  - The purpose of this work was two-fold. In the first instance, 1H NMR spectra of
      the ultracentrifuged lipoprotein fractions (VLDL, LDL and HDL) from six
      volunteers with different clinical conditions were measured. The methylene
      regions of the experimental spectra were modelled in the frequency domain using
      non-linear lineshape fitting analyses. In this way the resolvable Lorentzian
      component structures of the methylene regions of these lipoprotein fraction
      spectra could be determined. Second, the lipoprotein fraction analyses were used
      to construct simplified component structures, which interpreted the lipoprotein
      fraction spectra well, and were feasible to use in the total plasma spectra
      analyses. The considerable overlap problem of the resonances was properly handled
      in this way. The NMR-based relative amounts of the lipoproteins (relative
      integrated intensities of the lipoprotein model signals) obtained were compared
      to the biochemically resolved relative molar percentages of the lipoprotein
      fractions and also of the lipid contents between the lipoprotein complexes. It
      was noticed that nearly all correlations were extremely good. Thus, it is
      suggested that the developed methodology could be used as a fast method to
      predict the relative amounts of the lipoproteins and also possibly the relative
      lipid contents between the major lipoprotein categories directly from the proton
      NMR spectrum of a total blood plasma sample. Furthermore, if internal or external
      reference for the integrated intensities of the proton NMR resonances were used,
      it should also be possible to obtain the absolute amounts of these quantities.

PMID- 8347458
TI  - Autoimmune disease and silicone breast implants.
AB  - An association between crystalline silica and immune disease has long been
      recognized. However, despite ongoing case reports of systemic autoimmune disease
      in silicone implant recipients, the available data has not been sufficient to
      prove or disprove a causal relationship. Silicone has been shown to "bleed" from
      the implants and can migrate to distant sites. There is evidence of cellular and
      humoral immune responses to silicone in vivo, but the role of these responses in
      the development of connective tissue disorders has not been determined. Further
      studies are necessary to elucidate the role of silicone, if any, in the
      pathogenesis of autoimmune connective tissue disease. Meanwhile, the implant
      population needs to be closely monitored; their clinical management should be
      based on a case by case evaluation.

PMID- 8347459
TI  - Clinical trials referral resource. Clinical trials using edatrexate.

PMID- 8347461
TI  - New MRI techniques effective in detecting implant leaks.

PMID- 8347460
TI  - Use of positron emission tomography in oncology.
AB  - Positron emission tomography is an imaging technique that produces images
      reflective of tissue biochemistry rather than anatomy. Utilizing different
      isotopes, many biochemical processes can be studied repetitively and non
      invasively in cancers in vivo. Malignant tissue is characterized by an
      accelerated rate of glycolysis. This biochemical characteristic of malignancy can
      be exploited by PET imaging with the radiopharmaceutical FDG. PET with FDG has
      been successful in imaging primary and metastatic cancer of the breast, colon,
      lung, head and neck, as well as sarcomas and lymphomas. PET FDG imaging has
      potential as a screening, diagnostic and staging tool in cancer. Recently, whole
      body PET techniques have been developed which permit imaging of the entire body
      during a single scanning session. PET also has tremendous potential as a cancer
      research tool to study serial estimates of tumor glycolysis, DNA turnover, oxygen
      metabolism, protein synthesis, and blood.

PMID- 8347462
TI  - Management of advanced cancers of the external nose.
AB  - Advanced carcinoma of the external nose is almost always associated with prior
      inadequate therapy. The first principle, therefore, in managing cutaneous
      malignancies of the nose is to achieve adequate tumor-free removal at the initial
      treatment. Recurrent carcinoma of the nose may require either hemirhinectomy or
      total rhinectomy to achieve tumor control.

PMID- 8347463
TI  - Screening mammography as public policy: who and how often?

PMID- 8347464
TI  - Management of supratentorial low-grade gliomas.
AB  - Low-grade gliomas are a clinically, radiographically, and pathologically diverse
      group of central nervous system neoplasms. Treatment decisions are based
      primarily on histologic tumor type and patient age. Pilocytic astrocytomas tend
      to occur in younger patients, are circumscribed, and amenable to cure with gross
      total resection. There is no role for the routine use of postoperative
      radiotherapy in these patients. In contrast, infiltrative tumors, including
      ordinary (nonpilocytic) astrocytomas, mixed oligoastrocytomas, and
      oligodendrogliomas occur in middle-aged patients and are generally not curable,
      even with gross total resection. Postoperative radiotherapy of these infiltrative
      tumors appears to improve survival, particularly in adults. Several ongoing
      clinical trials are addressing two issues: Observation vs radiotherapy and low
      dose vs high-dose radiotherapy in patients with ordinary astrocytomas,
      oligoastrocytomas, and mixed oligoastrocytomas.

PMID- 8347465
TI  - Induction of Theiler's murine encephalomyelitis virus (TMEV)-induced
      demyelinating disease in genetically resistant mice.
AB  - Theiler's murine encephalomyelitis virus-induced demyelinating disease, a murine
      model for multiple sclerosis, is the result of persistent infection which leads
      to a T cell-mediated immunopathology. Susceptible strains develop virus-specific
      DTH responses while resistant strains do not, and this response has been proposed
      as the basis for inflammation and demyelination. (C57BL/6 x DBA/2)F1 hybrid
      animals, normally resistant to TMEV-induced demyelinating disease, become
      susceptible when treated in vivo prior to infection with low dose
      cyclophosphamide. Comparable pretreatment of other resistant animals, C57BL/6 and
      CB6 (BALB/c x C57BL/6) F1 hybrids, does not render them susceptible (despite the
      H-2 identity of CB6F1 and B6D2F1 hybrids). Thus the "latent" susceptibility in
      B6D2F1 hybrids must be attributed to non-H-2 genes from the susceptible D2
      parent. Resistance can be restored to CY-treated B6D2F1 animals by the adoptive
      transfer of splenic cells (including T cell enriched populations) from non-CY
      treated donors. Resistance to TMEV-IDD in these animals, therefore, may involve
      active inhibition of a "latent" disease susceptibility.

PMID- 8347467
TI  - Characterization of an inhibitory factor derived from epithelial cells of the
      small intestine.
AB  - Rat small intestine epithelial cell (EC) culture conditioned media (ECCM)
      contains a factor that has inhibitory activity against: a) the response of
      freshly isolated lymphocytes to Concanavalin A (Con A) or IL-2, b) the
      proliferative response to antigen of primed lymphocytes, and c) the normal growth
      of transformed cell lines derived from several species. Inhibition is reversible,
      and not the result of a cytotoxic effect. The inhibitory activity is enterocyte
      derived, effective at low concentration (1-2% in growth media), and can be
      derived from freshly isolated EC. Biochemical analysis indicates the inhibitory
      activity is associated with a protein with an approximate molecular weight of 32
      kd, and an isoelectric point (PI) in the range of 3-5. The protein is trypsin
      sensitive, and labile with prolonged heating at 56 degrees C. The described
      activity differs from previously reported mucosally-derived inhibitory activities
      on the basis of molecular weight, and its ability to inhibit the growth of
      several cell lines. We suggest that this factor can provide the immunomodulatory
      activity necessary to produce the low level of intestinal T cell reactivity that
      is observed in vivo.

PMID- 8347466
TI  - Measurement of tumor necrosis factor alpha mRNA in small numbers of cells by
      quantitative polymerase chain reaction.
AB  - We have developed a method to quantitate TNF alpha-mRNA in small numbers of cells
      by reverse transcription followed by competitive polymerase chain reaction (RT
      PCR). RT-PCR allowed the accurate quantitation of TNF alpha-mRNA over a 1000-fold
      range of concentration. The recovery of RNA isolated from 1000 to 10,000 cells
      was optimized by reducing sample volumes and by adding 1 microgram yeast RNA.
      Using these modifications we accurately measured TNF alpha-mRNA in as little as
      10,000 U937 cells by RT-PCR. Then we measured TNF alpha-mRNA in lamina propria
      mononuclear cells isolated from uninflamed and inflamed colonic mucosa from
      patients with inflammatory bowel disease (IBD). A 9-fold increase (5.4 copies per
      cell) was found in mononuclear cells from the gut of the inflamed regions
      compared to those cells from the uninflamed regions (0.6 copies per cell). These
      findings demonstrated the utility of this method in measuring differences of
      expression of the TNF-alpha gene in small number of cells isolated from tissues.

PMID- 8347468
TI  - Distribution and quantitation of plasma cells, T lymphocyte subsets, and B
      lymphocytes in bronchus-associated lymphoid tissue of chickens: age-related
      differences.
AB  - Development of the lymphoid cell compartment in bronchus-associated lymphoid
      tissue (BALT) of specific pathogen free chickens was examined. Specifically, B
      lymphocytes, T cell subsets (CD4 and CD8), and IgA-, IgG-, and IgM-producing
      plasma cells were labeled using immunocytochemical methods. Immunoglobulin
      producing cells (IgPC) were quantitated, and comparisons of IgPC numbers were
      made among chickens of different ages, among immunoglobulin isotypes, and between
      lymphoid (BALT) and nonlymphoid (non-BALT) areas in the primary bronchus. At
      hatching, BALT was devoid of IgPC, but by 2 weeks of age cells producing IgA,
      IgG, and IgM were present. Initially, there were approximately equal numbers of
      IgA-, IgG-, and IgM-PC; after 2 weeks of age, however, IgG- and IgM-PC
      outnumbered IgA-PC. At all ages, IgPC were more numerous in non-BALT regions of
      the primary bronchus than in BALT regions. Small numbers of T and B lymphocytes
      were present in BALT from 1-day old chickens, but substantial populations of
      these cells were not seen until 1-2 weeks of age. T helper (CD4+) cells were
      found near B cell regions in BALT lymphoid nodules, while T cytotoxic/suppressor
      (CD8+) cells were more evenly distributed throughout the nodules and in the
      epithelium. B lymphocytes predominated in germinal centers and also overlapped
      CD4+ populations adjacent to germinal centers. Lymphocyte cell types needed to
      initiate and regulate immune responses are present in chicken BALT and may be
      involved in protecting poultry from respiratory pathogens.

PMID- 8347469
TI  - Immunoglobulin transfer from immune-reconstituted SCID mice to nursing neonates:
      blood distribution of antibody and association with perinatal virus protection.
AB  - Previous work in our laboratory has shown that fetal protection from maternal
      transmission of the murine lactate dehydrogenase-elevating virus (LDV) infection
      is mediated by adoptive transfer of maternal anti-viral immunity. In the present
      report, we have characterized reconstitution of immunity in immunodeficient SCID
      mice following transplantation with BALB/c spleen cells, and studied the fate and
      distribution of maternally-derived antibodies after passage to neonatal SCID mice
      by nursing. Immune-reconstituted SCID mice maintained stable immunity for up to 7
      months post-transplantation, during which time they produced nonneutralizing IgG
      anti-LDV antibodies and protected their offspring from maternally-derived LDV
      infection. Using IgG isotype and allotype assays, it was found that maternal IgG
      antibodies transferred from breast milk to nursing neonatal mice and appeared in
      their circulation. Weaning of SCID mice from immunocompetent mothers permitted
      the determination of blood immunoglobulin isotype half-lives (3.6-10.6 days) in
      the absence of endogenous antibody production. LDV infection was transferred to
      nursing mice by nonimmune LDV-infected mothers, but protection from nursing
      acquired LDV infection was associated with maternal viral immunity, breast milk
      transfer of IgG anti-LDV to nursing mice, and reduced breast milk virus titers.
      These findings show a nursing pathway for LDV infection, and demonstrate the
      potential of immune protection from this infection pathway.

PMID- 8347470
TI  - Inhibition of antigen-induced secretion in the rat jejunum by interferon
      alpha/beta.
AB  - Intestine from rats sensitized to egg albumin (EA) antigen responds to EA
      challenge with an increase in short-circuit current (Isc), indicative of
      predominantly chloride secretion. Here, we have examined the role of interferon
      alpha/beta (IFN alpha/beta) in the control of this event. Muscle-stripped jejunal
      segments from sensitized rats, mounted in Ussing chambers, displayed a reduced
      response to EA-challenge in the presence of IFN alpha/beta (100-1000 U/ml), when
      the cytokine was incubated with the tissue for > or = 60 min; serosal and luminal
      responses were significantly reduced by ca.32-47% and ca.50-80%, respectively.
      Preabsorption with an anti-IFN alpha/beta antibody abolished this inhibition. IFN
      alpha/beta did not influence the secretory response of the tissues to histamine,
      serotonin, bethanechol, or forskolin, suggesting that IFN alpha/beta does not
      affect the epithelium directly. IFN alpha/beta had no effect on Isc changes
      induced by electrical transmural stimulation of mucosal nerves in the tissue, nor
      did neuronal blockade with tetrodotoxin influence the action of IFN alpha/beta.
      These data indicate that the effect of IFN alpha/beta is not neuronally mediated.
      The normal anti-secretory actions of diphenhydramine (H1-antagonist) and
      piroxicam (cylooxygenase inhibitor) upon antigen-activation of mast cells, were
      not apparent in the presence of IFN alpha/beta. This suggests that IFN alpha/beta
      inhibits intestinal hypersensitivity by acting directly on mast cells. This
      hypothesis was confirmed by inhibition of antigen-induced release of the specific
      mucosal mast cell marker, rat mast cell protease II, in tissues treated with IFN
      alpha/beta. These findings suggest that IFN alpha/beta can function as an
      intestinal anti-inflammatory agent by stabilizing mucosal mast cells.

PMID- 8347471
TI  - Regional dichotomy of interleukin-4 and -5 regulation of senescent B cell
      responses specific for cholera toxin in Peyer's patches, lamina propria, and
      mesenteric lymph nodes.
AB  - The capacity of exogenous interleukin-4 (IL-4) and IL-5 to augment the antigen
      specific senescent Peyer's patch (PP), lamina propria (LP), and mesenteric lymph
      nodes (MLN) B cells was investigated in the present studies. CTx-primed
      lymphocytes in the PP, LP, and MLN were obtained from 4-and 24-month old C57BL/6J
      male mice, 14 days after oral immunization with cholera toxin (CTx). Cells were
      cultured optimally for 4 days either alone, with lipopolysaccharide (LPS), with
      LPS plus recombinant IL-4 or IL-5, or with LPS plus IL-4 or IL-5 plus monoclonal
      antibodies specific for the respective interleukin. Culture supernantants were
      tested for IgA and IgG anti-CTx antibodies by an ELISA assay. The data indicated
      impaired antibody responses of aged PP and MLN B cells by the lack of LPS plus IL
      4 induced enhancement of anti-CTx IgG antibody production as compared with the
      young group. For anti-CTx IgA production, aged LP and MLN B cells did not respond
      equally as well to LPS plus IL-5 stimulation as the young group. In contrast,
      aged PP B cells responded equally as well by anti-CTx IgA production to LPS plus
      IL-5 stimulation as the young group. Both anti-IL-4 and anti-IL-5 Mabs blocked
      the respective IL-4 and IL-5-induced enhancement of antigen-specific IgG or IgA
      antibody production. The findings suggest a regional dichotomy of IL-5 induced
      enhancement of aged IgA-producing B cells specific for CTx in the Peyer's
      patches, mesenteric lymph nodes, and lamina propria.

PMID- 8347472
TI  - Acquired immunodeficiency syndrome (AIDS)--data as at 30 June 1993.

PMID- 8347473
TI  - The current global situation of the HIV/AIDS pandemic.

PMID- 8347474
TI  - Molecular epidemiology studies of cancer in families.

PMID- 8347475
TI  - Fatigue in cancer patients.
AB  - In this paper an overview is presented on what is currently known of fatigue in
      cancer. Fatigue is considered to be a multi-dimensional concept, that should be
      measured as such. However, fatigue has been assessed mostly by single items in
      general symptom checklists. The few specific instruments that have been used in
      cancer patient populations are discussed. The majority of cancer patients, about
      70%, report feelings of fatigue during radio- or chemotherapy. Follow-up results
      show that, at least for some diagnoses, patients remain fatigued long after
      treatment has ended. Somatic and psychological mechanisms that have been proposed
      to explain fatigue are discussed. It is argued that the significance of the
      results obtained on fatigue as a symptom in cancer depends on comparison with
      other patient and non-patient populations. Also the occurrence of a response
      shift has to be considered, leading to under reporting of fatigue. Finally,
      possible interventions to decrease feelings of fatigue are presented.

PMID- 8347476
TI  - Tumour localisation kinetics of photofrin and three synthetic porphyrinoids in an
      amelanotic melanoma of the hamster.
AB  - In this study the localisation of porphyrinoid photosensitizers in tumours was
      investigated. To determine if tumour selectivity results from a preferential
      uptake or prolonged retention of photosensitizers, intravital fluorescence
      microscopy and chemical extraction were used. Amelanotic melanoma (A-Mel-3) were
      implanted in a skin fold chamber in Syrian Golden hamsters. Distribution of the
      porphyrin mixture Photofrin and three porphycenes, pure porphyrinoid model
      compounds, was studied quantitatively by intravital fluorescence microscopy.
      Extraction of tissue and blood samples was performed to verify and supplement
      intravital microscopic results. Photofrin accumulated in melanomas reaching a
      maximum tumour:skin tissue ratio of 1.7:1. Localisation of the different
      porphycenes was found to be highly tumour selective (3.2:1), anti-tumour
      selective (0.2:1), and non-selective (1:1) with increasing polarity of the
      porphycenes. The two non-tumour selective porphycenes had distinctly accelerated
      serum and tissue kinetics; serum halflife times being as short as 1 min. The
      specific localisation of the slowly distributed, tumour selective
      photosensitizers, occurred exclusively during the distribution from serum and
      uptake into tissues. For the most selective porphycene, the tumour selection
      process had a halflife of 260 +/- 150 min and led to a strongly fluorescent
      tumour edge edema. Accumulation of porphyrines by the amelanotic melanoma (A-Mel
      3) can be attributed to an enhanced uptake rate for lipophilic molecules in this
      subcutaneously growing neoplasm. The slow distribution of the two tumour specific
      photosensitizers and the strong fluorescence of these hydrophobic molecules in
      the tumour compartment with a high water content indicate a carrier role of serum
      proteins in the selection process. Enhanced permeability of the tumour
      vasculature to macromolecules appears to be the most probable reason for the
      tumour selectivity of these two sensitisers.

PMID- 8347477
TI  - Glutathione S-transferase expression in benign and malignant ovarian tumours.
AB  - Glutathione S-transferase sub-types alpha, mu and pi were assessed by
      immunocytochemistry in 109 biopsies of ovarian tissue, comprising malignant
      epithelial tissue in 86 cases and tissue of ovarian origin considered to be
      normal in 23. Glutathione S-transferase pi was the most prevalent, being present
      in all except one malignant epithelium studied and 83% of non-malignant tissue.
      There were no significant differences in the overall distribution of positive
      staining for alpha, mu and pi in the malignant and non-malignant biopsies,
      although the intensity of staining was greater in the malignant epithelium.
      Stromal staining was in general more pronounced in the malignant biopsies, and
      this was particularly prominent in the case of the alpha sub-type. Positive
      staining was seen more frequently in the less well-differentiated tumours, and a
      diffuse cytoplasmic pattern was the most common observation in tumours of
      moderate and poor differentiation. There was no significant association between
      survival and the presence or absence of sub-type staining of alpha and mu sub
      type. For the sub-type pi, patient survival was found to correlate with the
      intensity of staining (on a 0-(+++) scale). Those patients showing resistance to
      cytotoxic chemotherapy were found to have a higher intensity of staining for GST
      pi than responding patients.

PMID- 8347478
TI  - In vitro platinum drug chemosensitivity of human cervical squamous cell carcinoma
      cell lines with intrinsic and acquired resistance to cisplatin.
AB  - The platinum drug chemosensitivity of five human cervical squamous cell carcinoma
      cell lines (HX/151, HX/155, HX/156, HX/160 and HX/171) derived from previously
      untreated patients has been determined. Compared to our data obtained previously
      using human ovarian carcinoma cell lines, all five lines were relatively
      resistant to cisplatin, carboplatin, iproplatin and tetraplatin. One of the lines
      (HX/156) was exceptionally sensitive to the novel platinum (IV) ammine/amine
      dicarboxylates JM216 [bis-acetatoammine dichloro (cyclohexylamine) platinum (IV)]
      and JM221 [ammine dibutyrato dichloro (cyclohexylamine) platinum (IV)]. The range
      in IC50 values across the five lines was approximately 2.5-fold for cisplatin,
      carboplatin and iproplatin, 13-fold for tetraplatin and JM216, and 25-fold for
      JM221. No significant correlation (P > 0.05) was observed between platinum drug
      chemosensitivity and either glutathione levels or cadmium chloride sensitivity,
      an indicator of metallothionein levels. In addition, there was no significant
      correlation (P > 0.05) between cisplatin cytotoxicity and intracellular cisplatin
      accumulation or JM216 cytotoxicity and intracellular JM216 accumulation over the
      dose range 5-100 microM (2 h exposure). The exceptional sensitivity of HX/156 to
      JM216 appears, at least partially, to be a result of enhanced accumulation of
      JM216. An 8.6-fold acquired cisplatin resistant stable variant of HX/155 has been
      generated in vitro. Intracellular cisplatin accumulation was reduced by 2.4 +/-
      0.3-fold (mean +/- s.d.) in HX/155cisR across the dose range 1-100 microM (2 h
      exposure). Glutathione levels in HX/155cisR were elevated by 1.3-fold in terms of
      protein content and by 1.6-fold in terms of cell number. HX/155cisR was 1.9-fold
      resistant to cadmium chloride. Total platinum bound to DNA after cisplatin
      exposure (10, 25, 50 or 100 microM for 2 h) was 3.6 +/- 0.6-fold (mean +/- s.d.)
      lower in HX/155cisR. Hence the mechanism of acquired cisplatin resistance in
      HX/155cisR appears to be multifocal, with reduced intracellular drug accumulation
      and elevated glutathione and metallothionein levels combining to reduce DNA
      platination levels. While HX/155cisR was cross-resistant to tetraplatin and
      carboplatin, novel platinum (II) and (IV) ammine/amine complexes, including JM216
      and JM221, partially circumvented resistance (resistance factors of 1.5-2). Non
      cross-resistance was observed to iproplatin and nine non-platinum anticancer
      agents. Intracellular tetraplatin accumulation was reduced by 1.8 +/- 0.1-fold
      (mean +/- s.d.) in HX/155cisR across the dose range 1-100 microM (2 h exposure).
      In contrast, after JM216 exposure (1-100 microM for 2 h), no significant
      difference in intracellular platinum levels between HX/155 and HX/155cisR was
      observed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8347479
TI  - Sequence dependence of the hyperthermic potentiation of carboplatin-induced
      cytotoxicity and intracellular platinum accumulation in HeLa cells.
AB  - We have examined the enhancement of cytotoxic effects of cis-diammine-1,1
      cyclobutane dicarboxylate platinum(II) (carboplatin) by hyperthermia in HeLa
      cells using different regimes of timing and sequence. The results were compared
      with those obtained with cis-diamminedichloroplatinum(II) (cisplatin). We found
      that cisplatin simultaneously combined with heat was the most cytotoxic toward
      HeLa cells of the various timing and sequencing conditions studied. On the other
      hand, for carboplatin, drug treatment immediately following or during heat
      exposure showed the greatest effect. Intracellular platinum concentration in HeLa
      cells treated with heat before carboplatin showed a 2.75-fold increase over that
      in cells treated with the drug alone. The ratios for carboplatin given before, or
      during heating, were 0.67 and 1.42 respectively. Simultaneous exposure of cells
      to cisplatin and heat led to a 1.64-fold enhancement in cisplatin accumulation,
      compared to 0.92- and 1.24-fold increase for cells treated with cisplatin before
      and after heat respectively. Although each drug exposure prior to heat was less
      cytotoxic toward HeLa cells than any other heat/drug combination sequences, the
      platinum concentration was less than seen with each drug alone. Even though heat
      exposure prior to and during carboplatin showed a similar toxicity, platinum
      concentration in cells treated with heat prior to carboplatin was higher than
      that in cells treated with heat and carboplatin simultaneously. Thus, increased
      cytotoxicity cannot always be explained on the basis of intracellular platinum
      concentration. It is clear however that, differing from cisplatin, exposure of
      cells to heat prior to or during carboplatin administration results in the
      greatest cell kill.

PMID- 8347480
TI  - Structural and functional contributions to the G1 blocking action of the
      retinoblastoma protein. (the 1992 Gordon Hamilton Fairley Memorial Lecture).
AB  - The retinoblastoma gene product (RB) contributes to normal cell growth control.
      One of its functions is manifest as a block to exit from G1, which is carried out
      by an RB subspecies which is un- or underphosphorylated. After RB
      phosphorylation, a process which occurs towards the end of G1 in cycling cells,
      the block is lifted allowing a cell to enter S. Here, we review a series of
      results which speak to the elements of RB structure which contribute to this
      activity. Included is its internal colinear protein receptor domain (i.e. the
      'pocket').

PMID- 8347482
TI  - Pharmacology and antitumour effects of intraportal pirarubicin on experimental
      liver metastases.
AB  - Early liver metastases have a predominant portal blood supply. Intraportal
      (i.port.) vein administration of cytotoxics could theoretically achieve enhanced
      drug concentrations in tumour cells and be effective as adjuvant therapy after
      resection of colorectal carcinoma. Pirarubicin (which has a higher hepatic
      extraction than doxorubicin) was investigated on liver metastases of the VX2
      rabbit tumour, which were of less than 2 mm in diameter 7 days after cells
      injection into the portal vein. To evaluate antitumour activity, 24 rabbits were
      randomised into three groups 7 days after implantation: (a) control, (b) i.v.
      pirarubicin, (c) i.port. pirarubicin at doses of 2 mg kg-1 in both groups. Portal
      infusions led to no hematological or hepatic toxicity. Pharmacokinetic parameters
      showed a significantly reduced systemic exposure after i.port. administration.
      Fourteen days after treatment, livers and lungs were analysed. The mean number
      (+/- s.d.) of tumour foci was (a) 8.62 (+/- 5.4), (b) 4.62 (+/- 3.2), (c) 2.25
      (+/- 1.4) (P < 0.05 a vs c). The mean tumour area was (a) 6.31 (+/- 6.1), (b)
      1.31 (+/- 2.2), (c) 0.43 (+/- 0.4 cm2) (P < 0.05 a vs c) and the percentage (95%
      C.I.) of rabbits with lung metastasis was: (a) 87.5% (47-99%), (b) 75% (35-97%),
      (c) 12.5% (3-52%) (P < 0.02 b vs c). Intraportal pirarubicin seems to be well
      tolerated and more efficient than i.v. administration, particularly in preventing
      extrahepatic dissemination.

PMID- 8347481
TI  - Further evaluation of nicotinamide and carbogen as a strategy to reoxygenate
      hypoxic cells in vivo: importance of nicotinamide dose and pre-irradiation
      breathing time.
AB  - The combination of nicotinamide and carbogen breathing is awaiting clinical
      evaluation as a strategy to overcome tumour hypoxia and thus enhance radiation
      response. We have continued our evaluation of this approach in the murine SCCVII
      tumour with the aim of determining the importance of nicotinamide dose and the
      pre-irradiation breathing time (PIBT) for carbogen. For carbogen breathing alone
      maximal enhancement of radiation response was observed with PIBT's of between 5
      and 30 min. When nicotinamide (1,000 mg kg-1 IP) was administered 60 min prior to
      irradiation little or no variation in radiation response was observed for all the
      PIBT's examined (5-90 min). Indeed at all PIBT's the cell survival obtained for
      the carbogen nicotinamide and radiation combination was indistinguishable from
      that expected for a fully aerobic response. For PIBT's of 15 and 60 min we
      examined the influence of nicotinamide doses between 50 and 1,000 mg kg-1.
      Significant radiosensitizing effects were observed for all nicotinamide doses
      tested above 50 mg kg-1. Moreover for doses of 250 mg kg-1 and above the cell
      survival data was consistent with that expected for a fully aerobic response. No
      additional benefit accrued from raising the nicotinamide dose above 250 mg kg-1.
      These results indicate that significant radiosensitization may be expected even
      with clinically achievable nicotinamide doses when it is combined with carbogen
      breathing. Furthermore, the use of nicotinamide may reduce the critical
      importance of PIBT on the radiosensitization observed with carbogen.

PMID- 8347483
TI  - Insulin-like growth factor I activates the invasion suppressor function of E
      cadherin in MCF-7 human mammary carcinoma cells in vitro.
AB  - The calcium-dependent cell-cell adhesion molecule E-cadherin has been shown to
      counteract invasion of epithelial neoplastic cells. Using three monoclonal
      antibodies, we have demonstrated the presence of E-cadherin at the surface of
      human MCF-7/6 mammary carcinoma cells by indirect immunofluorescence coupled to
      flow cytometry and by immunocytochemistry. Nevertheless, MCF-7/6 cells failed to
      aggregate in a medium containing 1.25 mM CaCl2, and they were invasive after
      confrontation with embryonic chick heart fragments in organ culture. Treatment of
      MCF-7/6 cells with 0.5 microgram ml-1 insulin-like growth factor I (IGF-I) led to
      homotypic aggregation within 5 to 10 min and inhibited invasion in vitro during
      at least 8 days. The effect of IGF-I on cellular aggregation was insensitive to
      cycloheximide. However, monoclonal antibodies that interfered with the function
      of either the IGF-I receptor (alpha IR3) or E-cadherin (HECD-1, MB2) blocked the
      effect of IGF-I on aggregation. The effects of IGF-I on aggregation and on
      invasion could be mimicked by 1 microgram ml-1 insulin, but not by 0.5 microgram
      ml-1 IGF-II. The insulin effects were presumably not mediated by the IGF-I
      receptor, since they could not be blocked by an antibody against this receptor
      (alpha IR3). Our results indicate that IGF-I activates the invasion suppressor
      role of E-cadherin in MCF-7/6 cells.

PMID- 8347484
TI  - Detection of an oestrogen receptor-like protein in human meningiomas by band
      shift assay using a synthetic oestrogen responsive element (ERE).
AB  - When a ligand binding or enzyme immunoassay is used, meningiomas are found to be
      rich in progestin receptors (PR) whereas oestrogen receptors (ER) are virtually
      undetectable. A protein that can bind to an oestrogen responsive element (ERE)
      was detected in meningiomas, by using the band-shift assay. The binding of ER to
      the ERE is inhibited by the anti-ER monoclonal antibody ER-P31, which is directed
      to the A/B domain of the ER, indicating that the binding protein is an ER-like
      protein.

PMID- 8347486
TI  - Mechanism of muscle protein degradation in cancer cachexia.
AB  - Depletion of skeletal muscle mass in animals bearing an experimental model of
      cachexia, the MAC16 adenocarcinoma, occurs by a reduction in protein synthesis
      accompanied by a large increase in protein degradation. Serum from mice bearing
      the MAC16 tumour produced an increased protein degradation in isolated
      gastrocnemius muscle, as measured by tyrosine release, with a maximal effect
      occurring with serum from animals with a weight loss of between 11 and 20%. The
      response was specific to the cachectic state, since serum from mice bearing the
      MAC13 adenocarcinoma, which does not produce weight loss, did not increase
      tyrosine release from gastrocnemius muscle above that observed with serum from
      non tumour-bearing animals. The circulatory proteolysis-inducing factor was
      stable to heating at 60 degrees C for 5 min and was not inhibited by
      phenylmethylsulfonyl fluoride, suggesting that it was not a serine protease. The
      level of prostaglandin E2 (PGE2) in gastrocnemius muscle was significantly
      elevated after incubation with serum from cachectic mice bearing the MAC16
      tumour. Both indomethacin and the polyunsaturated fatty acid eicosapentaenoic
      acid (EPA) inhibited the rise in muscle PGE2 content in response to serum from
      cachectic mice and also inhibited muscle protein degradation. These results
      suggest that muscle protein degradation in cancer cachexia is associated with a
      rise in PGE2 content.

PMID- 8347485
TI  - Comparison of the potential therapeutic effects of interleukin 2 or interleukin 4
      secretion by a single tumour.
AB  - Engineering of a variety of rodent tumour cells to secrete either interleukin 2
      (IL-2), or interleukin 4 (IL-4), has been demonstrated to reduce their
      tumorigenicity. However the mechanisms of action of secreted IL-2 and IL-4 have
      not been compared in a single rodent tumour. Here we demonstrate that the weakly
      immunogenic murine fibrosarcoma FS29 had reduced growth rate and in some cases
      was rejected by syngeneic animals, when modified to secrete either IL-2 or IL-4,
      but not IL-5. Immunohistochemical analysis of tumour nodules undergoing
      regression showed stimulation of a largely lymphocytic infiltrate by IL-2 and a
      macrophage and granulocyte infiltrate, with a small number of lymphocytes by IL
      4. Indeed, secretion of low levels of IL-2 and IL-4 in combination resulted in
      optimal rejection, suggesting that the two cytokines might mobilise different and
      complementary effector cell mechanisms. Both IL-2 and IL-4-secreting cells failed
      to induce the rejection of admixed, unmodified FS29 cells. The loss of cytokine
      secreting cells from such admixtures occurred more rapidly for IL-2-secreting
      cells. Injection of IL-4-secreting, but not IL-2-secreting FS29 cells could
      protect mice from a delayed challenge with unmodified FS29 cells. These data
      suggest that IL-4 secretion stimulates the better long-term host anti-tumour
      response.

PMID- 8347488
TI  - Detecting fatty acids of dietary origin in normal and cancerous human breast
      tissue by 13C nuclear magnetic resonance spectroscopy.
AB  - Natural abundance 13C NMR was used to determine relative amounts of fatty acid
      subclasses present in fibroadipose tissue from the human breast in healthy and
      cancer patients and in breast carcinoma tissue. Resonances corresponding to the
      carbon atoms of triacylglycerides were obtained when adipose tissue constituted
      more than 10% of the carcinoma. Resonances corresponding to phospholipids and
      proteins were also observed when the percentage of adipose tissue was lower. No
      significant difference between the levels of unsaturated fatty acids in adipose
      tissue from cancer and non-cancer patients was found. However, significant
      differences in the levels of monounsaturated and saturated fatty acids of
      carcinoma compared to non-cancerous tissue was found, as was a nearly significant
      difference for the levels of polyunsaturated fatty acids in these two tissue
      types. These findings suggest an alteration of cellular lipid composition in
      neoplastic mammary tissue.

PMID- 8347487
TI  - Low density lipoprotein for cytotoxic drug targeting: improved activity of
      elliptinium derivative against B16 melanoma in mice.
AB  - Significant low density lipoprotein (LDL) uptake by tumour cells led to the use
      of LDL as a discriminatory vehicle for the delivery of cytotoxic drugs. In the
      current study, the lipophilic elliptinium derivative, elliptinium-oleate (OL
      NME), was incorporated into LDL to reach an incorporation level of 400 molecules
      per LDL particle. The OL-NME-LDL complex showed cytotoxic effects on normal human
      fibroblasts while the cytotoxicity was not observed on receptor-defective human
      fibroblasts, indicating the ability of the complex to be preferentially
      metabolised by the LDL receptor. In vivo metabolism of the complex was related to
      the LDL receptor pathway. The metabolic clearance was the same for native LDL
      (17.1 ml h-1) and OL-NME-LDL complex (16.2 ml h-1). LDL incorporated OL-NME
      enhanced the anti-tumour activity against murine B16 melanoma model; this
      resulted from increased efficacy for OL-NME-LDL at doses equal to free 9-OH-NME
      (157 vs 76 of Increase Life Span (ILS) (%) values after intraperitoneal (i.p.)
      drug injection on i.p. implanted tumour model and 45 vs -2 ILS (%) values after
      intravenous drug injection on subcutaneous implanted tumour model). These data
      suggest that LDL improves the potency of lipophilic cytotoxic drugs against
      tumours that express LDL receptor activity.

PMID- 8347489
TI  - Interaction of multidrug-resistant Chinese hamster ovary cells with amphiphiles.
AB  - The interaction of membrane-active amphiphiles with a series of MDR Chinese
      hamster ovary (CHO) cell lines was investigated. Cross-resistance to cationic
      amphiphiles was observed, which was effectively sensitised by verapamil. MDR
      cells showed collateral sensitivity to polyoxyethylene amphiphiles (Triton X
      100/Nonidet P-40), which reached a maximum at 9-10 ethylene oxide units.
      Resistant lines were also highly collaterally sensitive (17-fold) to
      dibutylphthalate. mdrl transfectants showed cross-resistance to cationic
      amphiphiles, but no collateral sensitivity to nonionic species. Triton X
      100/Nonidet P-40 inhibited 3H-azidopine photoaffinity labelling at low
      concentrations, perhaps reflecting a specific interaction with P-glycoprotein.
      Further investigation of the molecular basis of collateral sensitivity revealed
      that association of 3H-Triton X-100 with MDR cells reached steady state levels
      rapidly, and occurred by a non-mediated mechanism. The equilibrium level of X-100
      uptake was inversely related to drug resistance. Collateral sensitivity is thus
      not a result of decreased Triton X-100 association with the cell. The fluorescent
      probe merocyanine 540 was used to examine the MDR plasma membrane
      microenvironment for physicochemical changes. Increasing levels of drug
      resistance correlated with a progressive shift in the mean cell fluorescence to
      lower levels, which suggests that the packing density in the outer leaflet of MDR
      cells is increased relative to that of the drug-sensitive parent.

PMID- 8347490
TI  - Interferon plus tamoxifen treatment for advanced breast cancer: in vivo biologic
      effects of two growth modulators.
AB  - The effects of interferon-alpha (IFN) plus tamoxifen (TMX) in the treatment of
      advanced breast cancer were assessed. Changes of in vivo biologic determinants
      including hormone receptors, P24 protein, Ki-67 and growth factor expression were
      evaluated. Seven patients with advanced, heavily pretreated, breast cancer with
      accessible disease, underwent biopsy prior to and after sequential treatment with
      IFN and IFN plus TMX. Clinically 4/7 patients responded to treatment with one
      complete and three partial remissions. Apart from the favourable response rate
      the sequential in vivo changes in expression of tumour variables were of
      considerable interest. IFN treatment consistently increased the expression of the
      estrogen receptor (ER) and of the estrogen regulated protein P24 while decreasing
      the expression of the proliferation associated antigen Ki-67. Addition of TMX on
      the other hand resulted in a reduction of ER expression to pre-IFN levels and a
      rise in progesterone receptor (PR) expression. When the effect of either IFN or
      IFN plus TMX on the expression of two growth factors was assessed they were found
      to be somewhat variable. While PDGF expression tended to be suppressed, there was
      no clinical correlation with response to therapy. TGF beta expression was found
      in all patients prior to treatment and while all non-responders showed reduction
      of TGF beta following treatment, the alterations were variable amongst responders
      (including two patients with increased expression, one with no change, and one
      with decreased expression). It is concluded that both IFN and TMX exert multiple
      effects on the expression of tumour biologic variables and that while the study
      confirmed some of the predictions from in vitro models, the in vivo effect are
      more complex than has been appreciated from the models. From the clinical point
      of view, it might be expected that treatment which enhances the expression of ER
      in tumours should have a positive effect on the response to TMX.

PMID- 8347491
TI  - Congenital abnormalities in children with cancer and their relatives: results
      from a case-control study (IRESCC).
AB  - Several studies have revealed an excess of malformations in children with certain
      malignancies. A few environmental causes have been identified which may damage
      the foetus and lead to malformation and cancer. However, most of the numerous
      recognised cancer/malformation syndromes are genetically determined. This report
      describes a case-control study of 555 newly diagnosed children with cancer and
      1,110 matched controls, chosen from general practitioner lists (GP controls) and
      hospital admissions (H controls). Their parents were interviewed on topics of
      possible aetiological significance and medical records were checked to confirm
      reports at interview. The numbers of congenital malformations in the index and GP
      control children, and the relatives of the index children, the GP and H controls
      are described. There were more children with malformations among the cases
      (60/555) than among the GP controls (27/555), P < 0.001. The abnormalities in the
      cases included eight with specific chromosomal/genetic conditions (e.g. Down's
      syndrome, XY gonadal dysgenesis, Von Recklinghausen's neurofibromatosis,
      Goldenhar's syndrome) whereas only one GP control child had a chromosomal defect
      (P < 0.05). Five case children but no GP controls had neural tube defects; this
      is not statistically significant. No excess of malformations was found in the
      siblings of cases compared with GP and H control siblings. Case mothers had a
      small excess of malformations (22/555) compared with GP controls (8/555), P <
      0.05. Among more distant relatives the results were difficult to interpret
      because of the relatively small numbers in the diagnostic subgroups and because
      of apparent under reporting in grandparents, but no striking differences were
      seen between case and control relatives. The excess of malformations found in
      children with cancer, compared with controls, without a similar excess of
      malformations in their close relatives may indicate that in some (perhaps very
      roughly one in 20) cases antenatal events may lead both to the malformation and
      the malignancy.

PMID- 8347492
TI  - Interleukin-2 receptor and ovarian cancer.
AB  - Interleukin-2 receptor (IL-2R) can be detected in serum. We estimated the IL-2R
      in the serum of 78 women, of whom 30 were diagnosed as having malignant ovarian
      tumours, five had non ovarian tumours, one had a negative second look laparotomy,
      11 had benign ovarian tumours, three had uterine fibroids and 28 were age-matched
      controls. The results indicated that the serum IL-2R of these patients was
      significantly elevated in ovarian cancer patients compared to both controls (P <
      0.0001) and benign ovarian tumours (P < 0.0002). There were no significant
      differences in IL-2R levels between stage of disease and degree of
      differentiation within the ovarian tumour group.

PMID- 8347493
TI  - Smear misclassification in a cervical cancer screening programme.
AB  - A nested case-control study was undertaken in the Maribo County cohort of 27,811
      women with negative Pap smears. Sixty women who later developed invasive cervical
      cancer constituted the cases, and five matched controls were selected from the
      cohort for each case. A total of 633 previous, negative smears for the cases and
      controls were reviewed independently by two pathologists. The review showed
      misclassification to be frequent in these smears collected in the period 1966-82.
      Thirty-five smears were considered positive at the review. The misclassification
      was differential in respect to the women's later disease status. The odds ratio
      for patients compared with controls for having at least one positive smear was
      22.12 (95% CI 7.54-64.94). We were unable to identify specific characteristics of
      misclassified smears coming from later cases. Koilocytosis/dyskeratosis, herpes
      virus changed cells and hyperkeratosis were equally rare in smears from patients
      and controls. The Maribo County data indicate that the fraction of preventable
      cases of invasive cervical cancer in women aged 30-64 within the first 5 years
      after a negative smear could be increased from 62-72% to 83-86%, if
      misclassification of true positive smears could be eliminated. As a rough
      estimate, this would be at the cost of a 2% increase in the work load. It should
      be remembered that there is a large element of extrapolation in applying these
      results based on relatively poor quality specimens from 1966-82 as compared to a
      modern screening service.

PMID- 8347494
TI  - PS2 in breast cancer--alternative or complementary tool to steroid receptor
      status? Evaluation of 446 cases.
AB  - The oestrogen induced pS2 protein was measured in the cytosol of 446 breast
      cancer samples by an immunoradiometric assay. The relationships between pS2 and
      several clinical and biological parameters were evaluated. pS2 was not correlated
      to age, pT and nodal status, while it was higher in pre- than in peri- and post
      menopausal women. A statistically significant positive association was found
      between pS2 and ER, PgR and cathepsin D. However, the frequency of pS2 negative
      values in ER+ (25.6%), PgR+ (21.7%) and cathepsin D-(19.0%) cases suggests that
      pS2 provides information independent of the above parameters in a fairly high
      percentage of patients. The prognostic role of pS2 was evaluated in 267 cases
      (follow up time 24-102 months). pS2+ showed longer RFS (P = 0.016) and OS (P =
      0.004) than pS2-. pS2+ cases were significantly associated with a better
      prognosis in N+ but not in N- cases. Multivariate analysis showed that pS2 is an
      independent prognostic factor being the second most effective indicator for OS
      after nodal status and the third for RFS after nodal status and cathepsin D. From
      the present findings, we conclude that pS2 probably provides additional
      biological information to steroid receptor status and cathepsin D in patients
      with primary breast cancer.

PMID- 8347495
TI  - Failure to detect early breast cancer using in vitro nuclear magnetic resonance
      spectroscopy of plasma.
AB  - Water suppressed proton nuclear magnetic resonance (1H NMR) spectroscopy of human
      plasma has been described as successful in detection of malignancy. We designed a
      prospective study to test the hypothesis that in vitro NMR spectroscopy has a
      high sensitivity for detecting early breast cancer. One hundred and thirty-five
      women were referred for breast biopsy due to abnormal mammograms. One hundred of
      these were recruited through a population-based mammography screening project.
      Sixty-nine of 135 women were found to have breast cancer and their average line
      width of the methyl and methylene resonance in the plasma were compared to those
      women who had a benign or normal histopathology in the biopsy and to the line
      width for 100 healthy subjects from the same population. The mean line width at a
      half-height of the methyl and methylene resonances of the serum lipoprotein
      lipids in the NMR spectrum did not differ appreciably between the groups. The
      line width correlated highly with the serum triglycerides, but correction for the
      level of triglycerides did not improve the diagnostic accuracy of the line width.
      Receiver-operating characteristic analysis revealed a sensitivity of 61% and a
      false positive rate of 43% at the most beneficial cut-off of line width (39.7
      Hz). In vitro NMR spectroscopy in our hands was thus not a useful diagnostic tool
      in patients with early breast cancer.

PMID- 8347496
TI  - p53 immunoreaction in endoscopic biopsy specimens of colorectal cancer, and its
      prognostic significance.
AB  - The expression of p53 protein was immunohistochemically studied in formalin-fixed
      paraffin-embedded biopsy specimens of 203 colorectal carcinomas by use of a
      monoclonal antibody specific for the p53 protein. PAb1801. p53 protein expression
      with its reactivity localised in nuclei was found in 121 (59.6%) of the cancers.
      There was no correlation of p53 immunoreactivity with histological
      classification, wall invasion, lymphatic invasion, venous invasion, lymph node
      metastases, or peritoneal metastases. p53-positive cancers were more frequently
      associated with liver metastasis than p53-negative ones. Patients with p53
      positive tumours had significantly poorer prognoses than those with p53-negative
      tumours. The 5 year survival rate was 58.1% for patients with p53-positive
      tumours, and 76.3% for those with p53-negative tumours. In Dukes' stage C
      tumours, an especially good correlation was found between p53 immunoreactivity
      and prognosis. In addition, patients with p53-positive tumours had higher
      recurrence rates. The results indicate that p53 immunoreactivity may be a useful
      prognostic marker of colorectal cancers.

PMID- 8347497
TI  - Adjuvant therapy of ovarian cancer with radioactive monoclonal antibody.
AB  - Fifty-two patients with epithelial ovarian cancer were treated with yttrium-90
      labelled monoclonal antibody HMFG1 administered intraperitoneally following
      conventional surgery and chemotherapy as part of an extended phase I-II trial.
      The treatment was well tolerated and the only significant toxicity observed was
      reversible myelosuppression as previously described. Following conventional
      surgery and chemotherapy, 21 out of the 52 patients had no evidence of residual
      disease and were regarded as receiving treatment in an adjuvant setting. To date,
      two of these patients have died of their disease (follow-up 3-62 months, median
      follow-up 35 months). This extended phase I-II study suggests that patients with
      advanced ovarian cancer who achieve a complete remission following conventional
      therapy may benefit from further treatment with intraperitoneal radioactive
      monoclonal antibody.

PMID- 8347498
TI  - Over-expression of the c-myc proto-oncogene in colorectal carcinoma.
AB  - Alterations in the c-myc proto-oncogene in colorectal cancer were studied at the
      level of RNA expression, gene amplification and rearrangements. One hundred cases
      of colorectal cancer, stratified by Dukes' stage were examined. The level of
      messenger RNA expression was measured in tumours and matched normal mucosa from
      the same patient. Between 5 and 400 fold over-expression was found in 66% of
      tumours. Neither the presence nor the level of over-expression correlated with
      tumour staging. A significant correlation (P < 0.01) was found between over
      expression of c-myc in tumours and the presence of synchronous adenomas elsewhere
      in the colon. In contrast to other tumours, no rearrangements of the gene were
      found on Southern analysis of colorectal cancers. Similarly, amplification of the
      gene was not found in the cancers examined.

PMID- 8347499
TI  - Measurement of growth rate of lung metastases in 21 patients with bone or soft
      tissue sarcoma.
AB  - The volume doubling time (T2) of 52 lung metastases in 21 patients was calculated
      from measurements done on plain chest radiographs. Follow-up times ranged from 14
      to 819 days. The measurements were fairly well reproducible in the majority of
      patients, although considerable discrepancies in T2 estimates made by two
      independent observers were found in a few patients. The median doubling time was
      34.9 days (estimated 95% range 3.9 to 352 days). The variation of T2:s between
      patients was significantly (P = 0.0001) larger than that between T2: of multiple
      metastases in the same patients. The growth of the metastases seemed to be well
      described by a simple exponential function in all patients with more than two
      measurements, without evidence of Gompertzian growth. There seemed to be a linear
      correlation between the logarithm of T2 and log-survival time from diagnosis of
      metastatic disease, even if only one third of the variation of survival times
      between patients could be explained by differences in T2. T2 was not a
      significant factor for survival in Cox-analysis (P = 0.10).

PMID- 8347501
TI  - Tumours of the central nervous system and serum sialic acid concentration in men
      and women.
AB  - In a population-based study serum sialic acid level was examined in relation to
      subsequent development of central nervous system (CNS) tumours (229 cases).
      Significantly increased sialic acid concentration was found in men with a
      malignant CNS tumour diagnosed within 8 years of analysis, compared with
      corresponding matched controls. These findings suggest that the tumour existed at
      the time of examination which is supported by a negative linear association
      between sialic acid level and the time from screening to tumour diagnosis.

PMID- 8347500
TI  - A phase I study of intravenous bryostatin 1 in patients with advanced cancer.
AB  - Bryostatin 1 is a novel antitumour agent derived from Bugula neritina of the
      marine phylum Ectoprocta. Nineteen patients with advanced solid tumours were
      entered into a phase I study to evaluate the toxicity and biological effects of
      bryostatin 1. Bryostatin 1 was given as a one hour intravenous infusion at the
      beginning of each 2 week treatment cycle. A maximum of three treatment cycles
      were given. Doses were escalated in steps from 5 to 65 micrograms m-2 in
      successive patient groups. The maximum tolerated dose was 50 micrograms m-2.
      Myalgia was the dose limiting toxicity and was of WHO grade 3 in all three
      patients treated at 65 micrograms m-2. Flu-like symptoms were common but were of
      maximum WHO grade 2. Hypotension, of maximum WHO grade 1, occurred in six
      patients treated at doses up to and including 20 micrograms m-2 and may not have
      been attributable to treatment with bryostatin 1. Cellulitis and thrombophlebitis
      occurred at the bryostatin 1 infusion site of patients treated at all dose levels
      up to 50 micrograms m-2, attributable to the 60% ethanol diluent in the
      bryostatin 1 infusion. Subsequent patients treated at 50 and 65 micrograms m-2
      received treatment with an intravenous normal saline flush and they did not
      develop these complications. Significant decreases of the platelet count and
      total leucocyte, neutrophil and lymphocyte counts were seen in the first 24 h
      after treatment at the dose of 65 micrograms m-2. Immediate decreases in
      haemoglobin of up to 1.9g dl-1 were also noted in patients treated with 65
      micrograms m-2, in the absence of clinical evidence of bleeding or haemodynamic
      compromise. No effect was observed on the incidence of haemopoietic progenitor
      cells in the marrow. Some patients' neutrophils demonstrated enhanced superoxide
      radical formation in response to in vitro stimulation with opsonised zymosan (a
      bacterial polysaccharide) but in the absence of this additional stimulus, no
      bryostatin 1 effect was observed. Lymphocyte natural killing activity was
      decreased 2 h after treatment with bryostatin 1, but the effect was not
      consistently seen 24 h or 7 days later. With the dose schedule examined no
      antitumour effects were observed. We recommend that bryostatin 1 is used at a
      dose of 35 to 50 micrograms m-2 two weekly in phase II studies in patients with
      malignancies including lymphoma, leukaemia, melanoma or hypernephroma, for which
      pre-clinical investigations suggest antitumour activity.

PMID- 8347503
TI  - Phylogenetic analysis of some Aerococcus-like organisms from clinical sources:
      description of Helcococcus kunzii gen. nov., sp. nov.
AB  - 16S rRNA gene sequencing studies were performed on some unusual gram-positive
      catalase-negative cocci of unknown taxonomic position isolated from human
      clinical sources. Comparative analysis of the sequence data demonstrated that the
      clinical isolates represent a hitherto-unknown line of descent within the low-G+C
      content gram-positive bacteria. On the basis of the phylogenetic findings and the
      phenotypic distinctiveness of the organisms, it is proposed that they be
      classified in a new genus, Helcococcus, as Helcococcus kunzii sp. nov. The type
      strain of H. kunzii is NCFB 2900.

PMID- 8347502
TI  - Lymphocyte homing receptor (CD44) expression is associated with poor prognosis in
      gastrointestinal lymphoma.
AB  - Lymphocyte homing receptor (CD44) is involved in lymphocyte adhesion to
      endothelial cells of high endothelial venules (HEVs) and lymphocyte exit from the
      blood circulation, and it may be involved also in hematogenous dissemination of
      malignant lymphoma. Prognostic significance of lymphocyte homing receptor
      expression defined by Hermes-3 antibody was studied among 27 gastrointestinal
      lymphomas followed up for 8 to 20 years after the diagnosis. Lymphomas lacking or
      with very weak homing receptor expression (n = 14, 52%) were associated with 57%
      10-year survival rate as compared with only 15% among lymphomas that expressed
      CD44 more strongly (P = 0.02). We conclude that lack of lymphocyte homing
      receptor expression is common in gastrointestinal lymphoma, and that CD44
      expression is associated with unfavourable prognosis.

PMID- 8347504
TI  - Polyphasic taxonomy leading to the proposal of Moraxella canis sp. nov. for
      Moraxella catarrhalis-like strains.
AB  - The taxonomic position of a group of 16 Moraxella catarrhalis-like strains,
      isolated mainly from dogs, was examined by using morphological tests, biochemical
      tests, serology, ribotyping with oligonucleotide probes, polymerase chain
      reaction typing of the 16S rRNA gene and the 16S-23S rRNA gene spacer region,
      polyacrylamide gel electrophoresis of total proteins, fatty acid profiles, moles
      percent G+C, dot spot and in-solution DNA-DNA hybridizations, and DNA-rRNA
      hybridizations. It was found that these organisms constitute a distinct cluster
      within the genus Moraxella. Since they differ genotypically as well as
      phenotypically from previously described Moraxella species, a new species,
      Moraxella canis, is proposed to accommodate these isolates. The type strain is
      LMG 11194 (= N7 = CCUG 8415A).

PMID- 8347505
TI  - Phylogenetic diversity of phytopathogenic mycoplasmalike organisms.
AB  - By using specific primers, the 16S rRNA genes of Japanese mycoplasmalike
      organisms (MLOs) were amplified by polymerase chain reactions from MLO-enriched
      fractions of plants infected with each of six different MLOs. Each of the
      polymerase chain reaction fragments (length, 1,370 nucleotides) was directly
      sequenced in both strands by using 17 oligonucleotide primers. A phylogenetic
      tree constructed by using the sequence data showed that these Japanese MLOs are
      phylogenetically diverse microorganisms that fall into three groups, group I
      (onion yellows, tomato yellows, mulberry dwarf, and paulownia witches' broom
      MLOs), group II (tsuwabuki witches' broom MLO), and group III (rice yellow dwarf
      MLO). A high level of sequence homology (99%) between the Oenothera hookeri MLO
      and the severe strain of the western aster yellows MLO on the one hand and group
      I MLOs on the other indicates that the O. hookeri MLO and the severe strain of
      the western aster yellows MLO belong to group I and suggests that these MLOs,
      isolated from two geographically separated locations, descended from a very
      similar ancestor. Although group I contains phylogenetically identical MLOs, the
      organisms are transmitted by diverse insect vectors. The three MLO groups are
      more closely related to Acholeplasma laidlawii than to Mycoplasma gallisepticum.
      Thus, although MLOs are phylogenetically diverse, they are evolutionarily distant
      from other mollicutes. These data, together with other information (including
      phylogenetic relationships, vector specificity, plant-pathogenic properties, and
      habitat in plant phloem sieve tubes), suggest that MLOs could be classified into
      at least three phylogenetic groups (groups I through III).

PMID- 8347506
TI  - Molecular taxonomic studies of Actinomyces-like bacteria isolated from purulent
      lesions in pigs and description of Actinomyces hyovaginalis sp. nov.
AB  - The 16S rRNA gene sequence of some Actinomyces-like bacteria isolated from
      purulent lesions in pigs was determined. A comparative analysis of the rRNA
      sequence data revealed that the bacteria are members of the genus Actinomyces,
      but are phylogenetically distinct from Actinomyces suis. On the basis of our
      findings and the results of previous phenotypic studies it is formally proposed
      that the bacteria from pigs should be designated a new species, Actinomyces
      hyovaginalis.

PMID- 8347507
TI  - Moraxella lincolnii sp. nov., isolated from the human respiratory tract, and
      reevaluation of the taxonomic position of Moraxella osloensis.
AB  - A polyphasic taxonomic study was performed to determine the relationships of 10
      Moraxella-like strains isolated mainly from the human respiratory tract in
      Sweden. Two of the strains formed a separate subgroup on the basis of both their
      protein contents and their fatty acid contents. However, the overall protein and
      fatty acid profiles revealed that all 10 strains were highly related.
      Representative strains of the two subgroups exhibited high DNA binding values
      (98%) with each other and had an identical DNA base ratio (44 mol% G+C). DNA-rRNA
      hybridizations revealed that this taxon can be included in the genus Moraxella,
      which is only distantly related to phenotypically similar genera, such as the
      genera Neisseria and Kingella. The results of an extensive phenotypic analysis
      indicated that the general biochemical profile of the 10 strains conforms with
      the description of the genus Moraxella given in Bergey's Manual of Systematic
      Bacteriology. We therefore consider these organisms members of a new Moraxella
      species, for which the name Moraxella lincolnii is proposed. Furthermore, we also
      conclude that Moraxella osloensis belongs, genotypically as well as
      phenotypically, to the genus Moraxella.

PMID- 8347508
TI  - Serovar determination and molecular taxonomic correlation in Mycobacterium avium,
      Mycobacterium intracellulare, and Mycobacterium scrofulaceum: a cooperative study
      of the International Working Group on Mycobacterial Taxonomy.
AB  - A cooperative study was conducted by the International Working Group on
      Mycobacterial Taxonomy to correlate the agglutination serovar designations of
      Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum
      strains with the species ascriptions of these organisms according to molecular
      criteria and cultural properties and to assess the reproducibility of serovar
      determinations for a set of 63 reference strains of these species. Among the
      molecular criteria, the level of agreement between results obtained with nucleic
      acid probes and T-catalase serology results was 94% for strains of M. avium and
      M. intracellulare. Nucleic acid probes were not available for M. scrofulaceum,
      but none of the 10 strains ascribed to this species on the basis of catalase
      serology data reacted with a nucleic acid probe for M. avium or M.
      intracellulare. Ascription to a species on the basis of mycolic acid high
      performance liquid chromatography patterns was in agreement with catalase
      serology results in 86% of the cases examined. Most strains belonging to serovars
      1 through 6 and 8 through 11 were identified by molecular criteria as M. avium,
      most strains belonging to serovars 7, 12 through 20, 23, and 25 were identified
      as M. intracellulare, and most strains belonging to serovars 41 through 43 were
      identified as M. scrofulaceum, in agreement with common current practice.
      Evidence for assigning serovar 27 to M. scrofulaceum was obtained. However, two
      strains of a given serovar may, on occasion, be placed in different species. The
      dominant species assignments for strains belonging to serovars 21, 24, 26, and 28
      remain unresolved.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347509
TI  - Phylogeny of species in the family Neisseriaceae isolated from human dental
      plaque and description of Kingella oralis sp. nov [corrected].
AB  - Fourteen human periodontal isolates recovered from a purported Eikenella
      corrodens-selective medium containing 1 microgram of clindamycin per ml displayed
      biochemical traits which differed from those described for E. corrodens. These
      organisms were gram-negative rods which corroded agar. The isolates were oxidase
      positive and urease, indole, and esculin negative. They differed from E.
      corrodens in catalase, nitrate reduction, lysine decarboxylase, and ornithine
      decarboxylase activities. One isolate, strain UB-294, was presumptively
      identified as Kingella denitrificans. A second isolate, strain UB-204, differed
      from E. corrodens by being catalase positive and nitrate reduction negative.
      Twelve isolates, including strain UB-38T (T = type strain), were phenotypically
      similar to Kingella kingae except that they did not produce acid from maltose and
      were not beta-hemolytic. Essentially complete (1,480-base) 16S rRNA sequences
      were determined for strains UB-38T, UB-204, and UB-294 and the type strains of
      Neisseria animalis, Neisseria canis, Neisseria denitrificans, Neisseria elongata,
      Neisseria flavescens, Neisseria macaca, and Neisseria polysaccharea. These
      sequences were compared with the previously published sequences of six other
      species belonging to the family Neisseriaceae. On the basis of the results of the
      comparative sequence analysis, UB-294 was confirmed as a K. denitrificans strain,
      UB-204 was identified as a member of a new species which may belong in the genus
      Eikenella, and UB-38T was identified as a member of a new species of the genus
      Kingella, for which we propose the name Kingella oralis [corrected]. Since strain
      UB-204 was the only representative of a new species, it was not named.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8347510
TI  - Arhodomonas aquaeolei gen. nov., sp. nov., an aerobic, halophilic bacterium
      isolated from a subterranean brine.
AB  - Arhodomonas aquaeolei gen. nov., sp. nov., isolated from a petroleum reservoir
      production fluid, is described. The single isolate was an obligately halophilic,
      aerobic, gram-negative, oval rod-shaped bacterium that was actively motile by
      means of a single polar flagellum. It was catalase and oxidase positive. The
      isolate had a specific requirement for NaCl; growth occurred at NaCl
      concentrations between 6 and 20%, and optimal growth occurred in the presence of
      15% NaCl. This species metabolized primarily organic acids and required biotin
      for growth. The name Arhodomonas is proposed for the new genus, which was placed
      in the gamma subclass of the Proteobacteria on the basis of the results of a 16S
      rRNA sequence analysis. Although A. aquaeolei is most closely related to purple
      sulfur bacteria (the genera Ectothiorhodospira and Chromatium), it is not a
      phototrophic microorganism, which is consistent with its isolation from a
      subterranean environment. The major components of its cellular fatty acids were
      C16:0, C18:1, C19:0, C16:1, and C18:0 acids. The DNA base composition of the type
      strain is 67 mol% G+C. The type and only strain is strain HA-1 (= ATCC 49307).

PMID- 8347511
TI  - A test for measuring growth responses of mollicutes to serum and polyoxyethylene
      sorbitan.
AB  - A test is described that is useful for characterizing mollicutes in terms of the
      ability to maintain growth in medium containing 15 to 20% fetal bovine serum or
      in serum-free media with or without 0.04% Tween 80 (polyoxyethylene sorbitan).
      Representative Acholeplasma species maintained growth in serum-free medium, and
      about half of the strains tested grew well in Tween 80-supplemented medium.
      Representative Mycoplasma and Entomoplasma species did not maintain growth in
      either serum-free medium alone or when Tween 80 was added. Spiroplasma species
      and group representatives generally failed to sustain growth in serum-free medium
      with or without Tween 80, but at least four of the spiroplasmas tested maintained
      growth in serum-free medium. The representative Mesoplasma species grew in serum
      free media only when Tween 80 was added, as did Mycoplasma lactucae. Although the
      test has obvious determinative uses for members of the class Mollicutes, it does
      not supplant the conventional methodology for assaying the cholesterol
      requirements of these organisms.

PMID- 8347512
TI  - Ileal symbiont intracellularis, an obligate intracellular bacterium of porcine
      intestines showing a relationship to Desulfovibrio species.
AB  - A new genus and species of obligate intracellular-bacteria found in porcine
      intestines are described. Growth on any bacteriological medium deprived of living
      cells has not been demonstrated. The organism has been grown intracellularly in
      cell culture. The 16S rRNA gene sequence data, DNA probe results, and microscopic
      observations provide evidence that these bacteria differ from those in other
      described genera and that they belong to the delta subdivision of the class
      Proteobacteria. We have amplified and sequenced the 16S ribosomal DNA of four
      preparations of the intracellular bacterium from pigs. For this, intracellular
      organisms were released and purified from the infected cells without culture
      techniques. After DNA purification, the polymerase chain reaction with primers
      complementary to highly conserved eubacterial sequences was used to amplify
      regions of 16S ribosomal DNA which were subsequently cloned (in some cases) and
      sequenced directly by standard techniques. The sequences obtained from each
      preparation were identical and were most similar to that of a sulfate-reducing
      proteobacterium, Desulfovibrio desulfuricans ATCC 27774 (91% similarity). An
      oligonucleotide probe complementary to a hypervariable region of the 16S rRNA
      sequence of the bacterium hybridized with intracellular organisms obtained from
      porcine intestines. The bacterium is a gram-negative, curved rod with tapered
      ends. It multiplies intracellularly in the cytoplasm of ileal epithelial cells by
      septation. The vernacular name Ileal symbiont (IS) intracellularis is proposed
      for this bacterium. The type strain of IS intracellularis is strain 1482/89 grown
      in cell culture from a pig affected by proliferative enteropathy. It is deposited
      in the National Collection of Type Cultures, Colindale, London, as NCTC 12656.

PMID- 8347513
TI  - Proposal of six new species in the genus Aureobacterium and transfer of
      Flavobacterium esteraromaticum Omelianski to the genus Aureobacterium as
      Aureobacterium esteraromaticum comb. nov.
AB  - Twelve strains placed in the genera Flavobacterium, Pseudomonas, and
      Aureobacterium, including soil isolates, were characterized taxonomically. On the
      basis of morphological, physiological, and chemotaxonomic data, as well as DNA
      DNA hybridization data, we propose that 11 of these strains should be classified
      in the genus Aureobacterium as new combinations or new species, as follows:
      Aureobacterium esteraromaticum comb. nov. (type strain, IFO 3751 [= ATCC 8091]),
      Aureobacterium arabinogalactanolyticum sp. nov. (type strain, IFO 14344),
      Aureobacterium keratanolyticum sp. nov. (type strain, IFO 13309), Aureobacterium
      luteolum sp. nov. (type strain, IFO 15074 [= DMS 20143]), Aureobacterium
      schleiferi sp. nov. (type strain, IFO 15075 [= DMS 20489]), Aureobacterium terrae
      sp. nov. (type strain, IFO 15300), and Aureobacterium trichothecenolyticum sp.
      nov. (type strain, IFO 15077 [= JCM 1358]). Whereas the peptidoglycan type of
      members of this genus is considered to be B2beta, the new species A.
      keratanolyticum was shown to have a new peptidoglycan type, murein variation
      B2alpha. An emended description of the genus Aureobacterium is presented.

PMID- 8347514
TI  - Phenotypic and genomic analyses of human strains belonging or related to
      Bifidobacterium longum, Bifidobacterium infantis, and Bifidobacterium breve.
AB  - A numerical analysis based on phenotypic characteristics (89 enzymatic tests and
      49 carbohydrate acidification tests), in which experimental strips from
      Biomerieux-API, La Balme les Grottes, France, were used, was performed to
      characterize 82 new isolates belonging or related to Bifidobacterium longum,
      Bifidobacterium infantis, and Bifidobacterium breve. A total of 72 strains were
      isolated from child or adult feces, and the other strains were obtained from
      human vaginas and bronchi. In this study we also included 38 type and reference
      strains that were representative of all species of the genus Bifidobacterium and
      6 strains belonging to the genus Lactobacillus. DNA-DNA relationships between B.
      longum and B. infantis were determined by using 19 strains related to these
      species, as determined by the numerical analysis. The degree of DNA binding was
      determined by the S1 nuclease method. The phenotypic study revealed that there
      were six main clusters, which were subdivided into nine subclusters. Subcluster
      Va contained the type strains of B. longum and B. infantis. The DNA-DNA
      relatedness values of some of the new isolates were very similar to the DNA-DNA
      relatedness values of the type strain of B. longum. On the basis of these data,
      it was difficult to isolate B. infantis strains and then to define B. infantis as
      a single species separated from B. longum. Subclusters IVb to IVf comprised
      reference strains of B. breve. Cluster III and subcluster Ia were not identified.

PMID- 8347515
TI  - Mycoplasma corogypsi sp. nov., a new species from the footpad abscess of a black
      vulture, Coragyps atratus.
AB  - Strain BV1 was isolated from the exudate of the footpad abscess of a black
      vulture (Coragyps atratus). The colonies had a "fried-egg" appearance consistent
      with that of mycoplasmal species. Electron microscopic examination of the cells
      revealed irregular elongated or elliptical forms and smaller circular budding
      processes. Profuse growth was observed in Frey medium supplemented with 20% swine
      serum at 37 degrees C in a humidified atmosphere of 10% CO2 and air. Typical of
      mycoplasma, strain BV1 required sterol for growth and catabolized glucose but did
      not hydrolyze arginine or urea. The guanine-plus-cytosine content of the DNA was
      28 mol%. The organism demonstrated the ability to hemolyze, absorb onto, and
      agglutinate the erythrocytes from several animal species. Strain BV1 was
      serologically unrelated by the growth inhibition test to previously established
      Mycoplasma, Acholeplasma, Entomoplasma, and Mesoplasma species, as well as to
      strains belonging to these genera but not identified to species level. Moreover,
      BV1 had a 16S rRNA gene with a nucleotide sequence distinct from reported
      sequences of other mycoplasmas. This organism represents a new species for which
      the name Mycoplasma corogypsi is proposed. Strain BV1 (ATCC 51148T) is the type
      strain of Mycoplasma corogypsi sp. nov.

PMID- 8347516
TI  - DNA relatedness between field isolates of Mycoplasma F38 group, the agent of
      contagious caprine pleuropneumonia, and strains of Mycoplasma capricolum.
AB  - DNA-DNA hybridization experiments were carried out in order to clarify the
      taxonomic relationships between the F38 group of caprine mycoplasmas, the
      established etiologic agents of classical contagious caprine pleuropneumonia, and
      Mycoplasma capricolum, an organism associated with septicemia, arthritis, and
      mastitis in goats and sheep. The taxonomic status of the F38 group has been
      uncertain, principally because of the serological, genomic, and other properties
      which it shares with M. capricolum. Tritium-labeled DNAs from the M. capricolum
      type strain (California kid) and from prototype strain F38 were hybridized with
      unlabeled DNAs from these two strains and from four other isolates belonging to
      each group. The results showed consistent DNA relatedness values of about 70%
      between the F38 and M. capricolum groups, compared with levels of relatedness of
      about 90 and 85%, respectively, for the strains within each group. In addition,
      the results of comparisons of these 10 strains in which growth inhibition and
      immunofluorescence tests were used confirmed the previously reported serological
      relationships between the two groups and reinforced other observations concerning
      their shared genomic and cell membrane characteristics, indicating that there is
      a close taxonomic relationship. However, as the 70% DNA relatedness values
      between the M. capricolum and F38 groups also indicate a degree of genomic
      difference inconsistent with a relationship at the species level, we conclude
      that our findings support previous proposals for classification of the F38 group
      as a subspecies of M. capricolum.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347517
TI  - Proposal for designation of F38-type caprine mycoplasmas as Mycoplasma capricolum
      subsp. capripneumoniae subsp. nov. and consequent obligatory relegation of
      strains currently classified as M. capricolum (Tully, Barile, Edward, Theodore,
      and Erno 1974) to an additional new subspecies, M. capricolum subsp. capricolum
      subsp. nov.
AB  - A subspecies relationship with the existing species Mycoplasma capricolum is
      appropriate for the F38 group of mycoplasmas, the causative agent of classical
      contagious caprine pleuropneumonia. We believe that this classification is
      justified on the basis of the close DNA-DNA relationship recently reported for
      isolates belonging to the two groups and the other known serological and
      biological similarities and differences of these organisms. Strain F38T (T = type
      strain) and taxonomically indistinguishable strains are therefore proposed as
      members of a new subspecies of M. capricolum, M. capricolum subsp.
      capripneumoniae. Strain F38 (= NCTC 10192) is the type strain of M. capricolum
      subsp. capripneumoniae subsp. nov. As a consequence of this subdivision of the
      species M. capricolum, strains previously classified as M. capricolum are now
      necessarily relegated to subspecies status, as M. capricolum subsp. capricolum
      subsp. nov. Strain California kid (= ATCC 27343 = NCTC 10154) is the type strain
      of M. capricolum, as well as of M. capricolum subsp. capricolum. A taxonomic
      description of M. capricolum subsp. capripneumoniae and a brief amended
      description of M. capricolum subsp. capricolum are presented.

PMID- 8347518
TI  - Stenotrophomonas, a new bacterial genus for Xanthomonas maltophilia (Hugh 1980)
      Swings et al. 1983.
AB  - In consideration of the criticisms of the transfer of Pseudomonas maltophilia to
      the genus Xanthomonas proposed by J. Swings, P. De Vos, M. Van den Mooter, and J.
      De Ley (Int. J. Syst. Bacteriol. 33:409-413, 1983), a new generic name is created
      for this taxon. The name Stenotrophomonas is here proposed for the new genus,
      which includes a single species, Stenotrophomonas maltophilia. This proposal
      restores the genus Xanthomonas to its former definition (J. Bradbury, p. 199-210,
      in N. R. Krieg and J. G. Holt, ed., Bergey's Manual of Systematic Bacteriology,
      1984) The arguments on which this proposal is based are presented.

PMID- 8347519
TI  - Phylogenetic relationship of Chlamydia pneumoniae to Chlamydia psittaci and
      Chlamydia trachomatis as determined by analysis of 16S ribosomal DNA sequences.
AB  - The 16S ribosomal DNA sequence of Chlamydia pneumoniae was determined and
      compared with the corresponding gene sequences of Chlamydia psittaci and
      Chlamydia trachomatis. C. pneumoniae has been reported to exhibit little
      chromosomal DNA homology with the other chlamydial species, and its phylogenetic
      relationships within the genus Chlamydia have not been described. A polymerase
      chain reaction was employed to determine the 16S rRNA gene sequence of C.
      pneumoniae. Ten primers from the C. psittaci sequences were used to amplify a C.
      pneumoniae template in overlapping segments of the gene. Sequence data for 1,554
      bases indicated that the levels of homology of C. pneumoniae with C. psittaci and
      C. trachomatis were 96.19 and 94.07%, respectively. These data support the
      results of previous biochemical and developmental studies indicating that C.
      pneumoniae is more closely related to C. psittaci than to C. trachomatis.

PMID- 8347520
TI  - Phylogenetic position of Taylorella equigenitalis determined by analysis of
      amplified 16S ribosomal DNA sequences.
AB  - The 16S ribosomal DNA sequence of Taylorella equigenitalis (formerly Haemophilus
      equigenitalis), the causative organism of contagious equine metritis, was
      determined. A phylogenetic analysis of this sequence revealed a phylogenetic
      position of T. equigenitalis in the beta subclass of the class Proteobacteria
      apart from the position of Haemophilus influenzae, which belongs to the gamma
      subclass of Proteobacteria. A close phylogenetic relationship among T.
      equigenitalis, Alcaligenes xylosoxidans, and Bordetella bronchiseptica was
      detected; Spirillum volutans and Chromobacterium fluviatile (Iodobacter
      fluviatile) were in the same group but slightly removed. This relationship is
      surprising in view of the considerable differences in the G + C contents of the
      genomes of these bacteria.

PMID- 8347522
TI  - [Bone marrow transplantation].

PMID- 8347521
TI  - Evidence from Aeromonas for genetic crossing-over in ribosomal sequences.

PMID- 8347523
TI  - [Care of patients before, during and after bone marrow transplantation].

PMID- 8347524
TI  - [Psychosocial care on oncology].

PMID- 8347525
TI  - [Rooming-in--is it meaningful also for chronically ill children?].

PMID- 8347526
TI  - [The doctrine of healing children].

PMID- 8347527
TI  - [Total parenteral nutrition of premature and newborn infants].

PMID- 8347528
TI  - [New rules for education for the health care and nursing professions in
      Switzerland].

PMID- 8347529
TI  - ["The Einbeck recommendations"--the revised "Einbeck recommendations" give advice
      as to the limits of obligation to medical treatment of severely disabled newborn
      infants].

PMID- 8347530
TI  - [Poisonous and less poisonous plants. 8. Golden Rain (Laburnum anagyroides)].

PMID- 8347532
TI  - [The registered association Sterntaler--for the support of the department of
      pediatric surgery at the Johannes Gutenberg University in Mainz].

PMID- 8347533
TI  - Setting a standard.

PMID- 8347531
TI  - [Carl Gerhardt (1833-1902)].

PMID- 8347534
TI  - Phase I/II study of concurrent weekly carboplatin and radiation therapy in
      advanced head and neck cancer.
AB  - Thirty-two patients with locally advanced head and neck cancer have been treated
      with concurrent weekly carboplatin and conventional radiation therapy (RT) (2 Gy
      fractions 4-5 days/week to a total dose of 64-70 Gy over 7-8 weeks) in a Phase
      I/II study. Carboplatin was administered weekly during RT at doses of 75-150
      mg/m2/wk as a 1-hour infusion. The maximum tolerated dose of carboplatin was 130
      mg/m2/wk, with myelosuppression, predominantly neutropenia, being dose limiting.
      Other systemic toxicities were insignificant and no overlapping toxicity was
      evident. Ultimate locoregional control and survival probabilities were
      disappointing. It is suggested that either further studies using radiation and
      carboplatin at the dose 130 mg/m2/wk, or variations on dose and scheduling be
      performed prior to the instigation of Phase III studies.

PMID- 8347535
TI  - Multiple fractions daily for head and neck cancer: spinal cord effects and other
      late results.
AB  - Reports of late spinal cord damage after multiple fractions daily radiotherapy
      regimens for head and neck cancer are infrequent, but increasing. We have
      reviewed our experience of head and neck cancers treated thrice daily to examine
      this problem. Between 1982 and 1990, 65 patients with advanced head and neck
      cancer were treated by primary radiotherapy using three small fractions delivered
      on 5 days per week, with an inter-fraction interval of 3-4 hours during normal
      working hours. In 25 patients, the cervical spinal cord received > 39 Gy. In 13
      patients, 39.6 Gy was given in 1.1 Gy fractions, and five received 41.8 Gy in 1.1
      Gy fractions, two received 45.1 Gy in 1.1 Gy fractions and five received 45 Gy in
      1.5 Gy fractions. Eleven of these patients have survived over 2 years, and can be
      assessed for late spinal cord damage. Ten of these received 1.1 Gy fractions with
      no cord damage. The only 2-year survivor whose cord received 45 Gy in 1.5 Gy
      fractions has developed mild, non-progressive long tract signs. Other late side
      effects were equivalent to those after conventionally fractionated radiotherapy.
      Tumour control was good, especially for the larynx. We feel that, for
      radiotherapy given with three small fractions daily and an inter-fraction
      interval of 3-4 hours, the spinal dose should not exceed 40 Gy.

PMID- 8347536
TI  - Primary radiotherapy for subglottic carcinoma.
AB  - Between 1976 and 1990, 23 patients with subglottic carcinoma of the larynx were
      treated by one radiotherapist; these were reviewed. Primary radiotherapy was
      given using small parallel opposed wedged fields to the neck. No mediastinal
      radiotherapy was used. Mean follow up was 67 (9-165) months. Actuarial analysis
      showed a 2-year overall survival of 69.0% (78.3% excluding intercurrent deaths),
      and a 2-year disease free survival of 68.6%. Failure was due to persistent
      disease (5 patients) or recurrence (2 patients, both with disease T3, salvaged by
      surgery at 5 and 20 months). No patient developed clinical mediastinal relapse.
      These better than expected results support the use of primary radiotherapy to the
      neck alone avoiding conventional mediastinal radiotherapy. A national
      questionnaire sent to 67 consultant otolaryngologists sought information on
      perceived incidence, cure rate, and preferred mode of treatment and produced a
      67% response rate. The results confirmed our belief that surgeons have a
      pessimistic perception of the value of radiotherapy in this condition.

PMID- 8347537
TI  - Incidence and survival of malignant parotid tumours in the West Midlands region
      1977-1986.
AB  - The aim of this study was to describe the incidence and survival of patients with
      malignant parotid tumours resident in the West Midlands Regional Health
      Authority. The study population consisted of all patients with malignant tumours
      arising in the parotid gland and registered with the West Midlands Regional
      Cancer Registry between 1 January 1977 and 31 December 1986. Variables included
      in the analysis were: age, sex, date of diagnosis, side of origin, tumour
      histology, vital status and date of death. No temporal change in the incidence of
      parotid tumours was observed. More tumours originated within the left parotid
      gland (chi 2(1) = 4.0, P < 0.05). The 5-year actuarial survival for all tumours
      was 55.7%. When a Cox's proportional hazards regression model was fitted to the
      data, age at diagnosis (60-74 years) and histological type were found to be the
      critical determinants of outcome.

PMID- 8347538
TI  - Phase I study of hyperfractionated whole brain irradiation (HWBI) in the
      treatment of primary cerebral lymphoma.
AB  - The poor prognosis for primary cerebral lymphoma following conventional radiation
      therapy has generally been attributed to high local relapse rates despite initial
      local control. Hyperfractionated radiation therapy may improve the therapeutic
      ratio by allowing higher total radiation doses to be prescribed without exceeding
      the radiation tolerance of the central nervous system (CNS). Eight patients
      entered a study of hyperfractionated whole brain irradiation (HWBI) between
      October 1988 and May 1991. The prescribed dose was 64.8 Gy in 54 fractions over
      5.5 weeks. All patients were followed clinically and with computed tomographic
      scanning. Additional investigations to discriminate between lymphoma recurrence
      and radionecrosis included magnetic resonance imaging (MRI), thallium-201 single
      photon emission computed tomography (SPECT), and immunocytological examination of
      the cerebrospinal fluid (CSF). A complete remission as seen on CT scan was
      achieved in all cases. The overall median survival was 102 weeks. Six patients
      initially deteriorated neurologically without evidence of tumour recurrence.
      Three patients have died without evidence of recurrence at 18, 62 and 128 weeks.
      As of 31 May 1992, three patients remain alive, two with radiation brain injury
      at 147 and 184 weeks. Treatment toxicity prompted study closure in September
      1991. The hyperfractionation regimen used is reported by others to be free from
      significant morbidity. The pathogenesis of cerebral lymphomas (diffuse disease,
      angiotropism, subependymal involvement) may adversely affect CNS radiation
      tolerance.

PMID- 8347539
TI  - A phase II evaluation of human lymphoblastoid interferon (Wellferon) in relapsed
      high grade malignant glioma. Medical Research Council Brain Tumour Working Party.
AB  - During the 1980s a number of studies suggested there might be a role for
      interferon in the treatment of high grade gliomas. In the light of these reports
      a formal Phase II evaluation of human lymphoblastoid interferon (Wellferon) was
      undertaken in patients with high grade gliomas which had relapsed after
      conventional radiotherapy; 14 patients were treated and no objective clinical
      responses were seen. This indicates that the overall response rate to interferon
      therapy in this situation would be less than 20%. It is therefore concluded that
      interferon administration is unlikely to be of value in the management of
      relapsed high grade gliomas.

PMID- 8347540
TI  - Pelvic radiotherapy with concurrent 5-fluorouracil modulated by leucovorin for
      rectal cancer: a phase II study.
AB  - Combined modality treatment for cancer of the rectum has been shown to reduce
      recurrences and improve overall survival. We wished to find out if we could
      safely give concurrent radiotherapy and 5-fluorouracil (5-FU) modulated by
      leucovorin (LV) in 3 settings: pre-operatively, adjuvantly and in recurrent
      disease. A total of 39 patients were treated, 11 preoperatively, 17 adjuvantly
      and 11 with recurrent disease. There were 26 males and 13 females with a median
      age of 64 years. The median radiotherapy (RT) dose was 45 Gy/25 fractions/1.8 Gy
      per fraction (range 25-63 Gy). Chemotherapy consisted of LV 80 mg/m2 i.v.
      infusion over 1.5 hours followed by 5-FU 400 mg/m2 i.v. bolus, both given once a
      week. The median number of cycles was 8 (range 3-12). Diarrhoea was the main
      toxicity, and was encountered in 30 patients (77%): grade 1 in 3 (8%), grade 2 in
      12 (30%), grade 3 in 11 (28%), and grade 4 in 4 (10%). This required 18 (46%)
      patients to have modifications to their RT (20% had breaks and 26% ceased at
      doses < 45 Gy). Nine patients (23%) had modifications in the chemotherapy (10%
      had breaks and 13% received < 6 cycles). Encouraging responses were seen in the
      preoperative setting. Concurrent RT and 5-FU/LV, as given in this schedule,
      results in an unacceptable incidence of diarrhoea, limiting both the total dose
      of RT and chemotherapy that can be delivered, particularly in patients who have
      had previous surgery.

PMID- 8347541
TI  - Follow-up in stage I cutaneous malignant melanoma: an audit.
AB  - In Southampton, follow-up of patients with malignant melanoma is carried out in a
      single dedicated clinic. An audit has been performed to assess its objective
      value in diagnosing and treating tumour relapse and its subjective value as
      perceived by patients. Over a 10-year period, of 331 patients with Stage I
      disease 65 (20%) have developed tumour recurrence. Fifty-five first relapses were
      either local or in regional lymph nodes, and thus potentially curable; half were
      found within 3 months of the previous clinic visit. Seventy-two per cent of local
      and 47% of nodal recurrences were either symptomatic or detected initially by the
      patient. Whilst doctor-diagnosed nodal recurrences tended to be smaller and to
      involve fewer histologically positive nodes, subsequent survival was identical in
      those with patient-diagnosed nodal recurrences. The clinic makes inefficient use
      of medical time. Questionnaire responses indicate that 54% of patients suffer
      anxiety prior to clinic visits. Nevertheless follow-up was considered worthwhile
      by 95% of patients and regular visits were preferred to a 'walk in when
      necessary' system. The clinic appears to have an important educational role. A
      series of changes to current follow-up practice are proposed including: more
      frequent visits for high risk patients, changes in clinic personnel, and greater
      emphasis on patient education and self examination.

PMID- 8347542
TI  - Pneumothorax as a complication of tumour response to chemotherapy.
AB  - A patient with extensive pulmonary involvement by disseminated adenocarcinoma is
      presented. Response to chemotherapy resulted in the direct rupture of necrotic
      tumour tissue into the pleural cavity leading to a pneumothorax. The condition
      failed to improve with chest drainage and suction, necessitating surgical
      intervention. The development of the pneumothorax proved to be a fatal
      complication of treatment.

PMID- 8347543
TI  - Testicular seminoma metastasizing to palatine tonsil.
AB  - Patients presenting with Stage I seminoma of the testis have an excellent
      prognosis after treatment by orchidectomy and prophylactic radiotherapy to the
      paraaortic and pelvic lymph nodes. Only 2% subsequently recur but relapse in
      these cases has been reported in unusual sites such as the prostate and
      mesentery. We report a case of Stage I seminoma relapsing in another rare site
      for secondary malignant deposits, the palatine tonsil. This case further
      illustrates the favourable prognosis for this tumour even in cases of distant
      recurrence.

PMID- 8347544
TI  - Vertebral haemangioma presenting as Kasabach-Merritt syndrome.
AB  - A case of spinal cord compression due to vertebral haemangioma is described as
      presenting as part of the Kasabach-Merritt syndrome, which is characterized by
      bleeding disorder, thrombocytopenia and leukopenia. A dramatic improvement in
      neurological status and coagulation profile following surgical decompression and
      postoperative radiotherapy is reported. A brief review of the literature on the
      usefulness of radiotherapy is discussed.

PMID- 8347545
TI  - Non-Hodgkin's lymphoma: an unusual cause of myocardial infarction and
      hypercalcaemia.
AB  - Cardiac involvement is reported in 10%-20% of patients with lymphoma, but it is
      characteristically difficult to detect clinically or by investigation.
      Hypercalcaemia is a rare complication. Both complications usually occur late in
      the natural history of lymphoma. We report a case of non-Hodgkin's lymphoma, who,
      within 2 weeks of presentation, developed symptomatic hypercalcaemia and, 3 days
      later, died of an acute myocardial infarction. Autopsy showed, unexpectedly, the
      unusual finding of coronary artery compression by lymphomatous deposits.

PMID- 8347547
TI  - Strive to keep alive?

PMID- 8347546
TI  - The interaction of cisplatin and radiotherapy.

PMID- 8347548
TI  - Perception of transparency in stationary and moving images.
AB  - If two neutral density (ND) filters overlap partially, the luminance of the
      overlapping region is given by a multiplicative relationship (e.g., if the
      filters have 50% transmittance then on a 100 cd m-2 background, the luminance of
      each filter would be 50 cd m-2 but the luminance of the overlapping region would
      be 50% of 50 cd m-2, i.e. 25 cd m-2). Does the visual system respect this
      relationship? Two grey rectangles were overlapped to form a 'cross' and the
      luminance of the intersection was randomly varied. Naive subjects' ratings of
      transparency showed a surprising consistency with physics. A similar relationship
      is seen if two moving square-wave gratings are superimposed. When the
      intersection luminances were close to the multiplicative (25 cd m-2) case,
      component motion was seen, and values less than 25 cd m-2 and higher than 50 cd m
      2 caused a decline in perceived component motion. Two interpretations are
      offered. (a) The visual system has access to 'tacit knowledge' of transparency
      and shadows. (b) If you assume a log signal compression in the retina, then by
      multiplying the luminances you would null the Fourier energy from the 'blobs'
      (i.e. regions of overlap between the two gratings). This would prevent 'blob
      tracking' and lead to the perception of coherent motion. Since most researchers
      in the field had simply added the gratings linearly they would have inadvertently
      introduced extra Fourier energy in the blobs and this might account for all
      previous instances of coherent motion observed in such displays. Whatever the
      ultimate interpretation, the present results provide the first clear evidence
      that even the processing of certain primitive visual dimensions--such as motion-
      can be powerfully constrained by the perception of transparency (Ramachandran V.
      S. (1990) in: AI and the Eye, Wiley, Chichester; Stoner, G., Albright, T. and
      Ramachandran, V. S. (1990) Nature 344, 153-155). This is well in line with other
      recent results demonstrating that transparency can also constrain the processing
      of stereopsis (Nakayama, K., Shimojo, S. and Ramachandran, V. S. (1991)
      Perception 19, 497-513) and perceptual grouping (Ramachandran, V. S. (1990) in:
      AI and the Eye, Wiley, Chichester).

PMID- 8347550
TI  - The interaction of luminance, velocity, and shape information in the perception
      of motion transparency, coherence, and non-rigid motion.
AB  - The perception of luminance transparency for superimposed patterns depends on how
      luminance, figural, and topological conditions are simultaneously satisfied.
      Motion transparency or coherence for two superimposed patterns, which correspond
      to the perception of both patterns moving across one another or to the perception
      of compound motion of the regions of pattern intersection, depends on the
      relation between the local velocity, luminance, and shape information. This study
      analyzes how luminance, shape, and local velocity interact in the perception of
      motion transparency and coherence. Psychophysical experiments done with
      sinusoidally modulated bar patterns are presented which show that the perception
      of motion transparency or coherence can be described as the result of the
      interaction of two integration modules: the velocity-luminance and the velocity
      shape processes. The velocity-luminance process describes the integration of the
      local velocity with luminance information. When the luminance transparency rules
      are satisfied this process always generates the perception of motion transparency
      independently of the shape or contour information. On the other hand, when the
      luminance transparency rules are violated one can either perceive motion
      coherence or non-rigid motion; one perceives motion coherence when the patterns
      have small or zero amplitude, and non-rigid motion when the patterns have large
      amplitude. The velocity-shape process describes the integration of local velocity
      with shape information, and this depends on the relation between the error in the
      extraction of the local velocity and the magnitude of the contour amplitude. As a
      result of these experiments it is conjectured that the velocity-luminance and the
      velocity-shape processes do interact constructively or destructively. The
      constructive interaction occurs when the luminance transparency rules are
      satisfied. The destructive interaction occurs when the luminance transparency
      rules are violated, and such that, although the patterns contain sufficient shape
      information to solve the aperture problem and therefore generate the perception
      of motion transparency, one perceives non-rigid motion. This shows that global
      information describing the stratification of superimposed patterns can affect the
      integration of local velocity information with, for example, shape information,
      and this is not described by current motion theories.

PMID- 8347549
TI  - The role of early mechanisms in motion transparency and coherence.
AB  - Perceptual dissociation of moving plaid patterns into independently moving bar
      gratings occurs most readily when the grating signals are combined as if the bars
      were semi-transparent objects (Ramachandran, V. S. (1990) in: AI and the Eye.
      Wiley, Chichester, pp. 21-77. Stoner, G. R., Albright, T. D. and Ramachandran, V.
      S. (1990) Nature 344, 153-155). These and other examples of motion transparency
      are exploited to constrain the set of viable models for human motion processing.
      For example, one may exclude any fixed recombination of local motion signals into
      a plaid motion signal. Broad classes of linear and non-linear mechanisms for
      tracking blobs, corners, and other unambiguous plaid motion cues can also be
      ruled out because they fail to reproduce the experimental results even
      qualitatively. The shifting balance between the 'coherent plaid' and 'sliding
      gratings' percepts are attributed to processing stages before any integration or
      combination of local motion signals. The first essential stage is a roughly
      logarithmic nonlinearity before orientation filtering. In general, the resulting
      cross-products (at the intersections) code unambiguously for the true plaid
      motion vector, but these signals will be nulled for multiplicatively combined
      plaid components. Supporting evidence for this idea is obtained in our
      measurements of detection thresholds for the 'plaid' and 'sliding' percepts. The
      essential element of the second stage consists of 'end-stop' cells which detect
      the nullable intersection signal, and so produce a plaid-motion signal with the
      required characteristics. Finally, it is argued that the ecological role of the
      proposed mechanism lies in the ability to handle movement of patterned objects in
      lighting conditions dominated by complicated cast shadows.

PMID- 8347551
TI  - The computation of multiple matching doubly ambiguous stereograms with
      transparent planes.
AB  - Psychophysical experiments have been previously described Weinshall, D. (1989)
      Nature 341, 737-739; (1991) Vision Research 31, 1731-1748 that involved the
      perception of many transparent layers, corresponding to multiple matching, in
      doubly ambiguous random-dot stereograms. Additional experiments are described in
      the first part of this paper. In one experiment, subjects were required to report
      the density of dots on each transparent layer. In another experiment, the minimal
      density of dots on each layer, which is required for the subjects to perceive it
      as a distinct transparent layer, was measured. The difficulties encountered by
      stereo matching algorithms, when applied to doubly ambiguous stereograms, are
      described in the second part of this paper. Algorithms that can be modified to
      perform consistently with human perception, and the constraints imposed on their
      parameters by human perception, are discussed.

PMID- 8347552
TI  - Surface decomposition accompanying the perception of transparency.
AB  - At the retina, each location can have only one value of luminance or color. When
      transparency is perceived, however, different surface qualities can be
      redistributed to two or more apparently superimposed layers. The experiments
      described here explored the characteristics of this surface decomposition. It is
      shown that the surface decomposition occurs rapidly, it affects even early stages
      of visual processing, and it involves attributes such as texture and motion as
      well as color and brightness. In the first experiment, the recognition advantage
      for transparent overlapping digits demonstrated that the surface decomposition
      accompanying transparency occurs within 60 ms. In the second, the separation of
      overlying orthogonal grids due to surface decomposition was found to influence
      the strength of the McCollough effect, an effect attributed to early cortical
      processing. Finally, when a transparent surface appears to extend over areas that
      are physically identical to the background, qualities of the transparent overlay
      such as texture and motion, as well as color or brightness (e.g., the neon color
      effect) appear to spread to the illusory overlay.

PMID- 8347553
TI  - Analysis of somatic mutation activity in multiple V kappa genes involved in the
      response to 2-phenyl-5-oxazolone.
AB  - We have studied somatic mutation activity early in a response to 2-phenyl-5
      oxazolone coupled to ovalbumin (phOx-OVA). Although the V kappa Ox1 gene
      rearranged to J kappa 5 is known to predominate in this response, other closely
      related V kappa genes are involved. We compared the introduction of point
      mutations into V kappa Ox1 genes and into a set of related V kappa genes
      rearranged to the same J kappa segment at two time points after primary
      immunization. The result showed that quantitation of mutations in a single
      rearrangement substrate leads to an underestimation of the total mutational
      activity. There is pronounced somatic mutation activity early within genes that
      may be absent later in the response. We also show that multiple somatic mutations
      can be detected in B cells from draining lymph nodes after foot-pad injection
      with phOx-OVA already at day 7 after immunization. The data suggest a system in
      which mutation acts early in the response on a wide range of substrates and that
      selection and expansion of high affinity paratopes occurs later.

PMID- 8347554
TI  - V region dependent selection of persistent resting peripheral B cells in normal
      mice.
AB  - In this study, we compare the VH gene family repertoire of persistent long-lived
      splenic B cells with that of the whole splenic B cell compartment. Persistent
      long-lived B cells were obtained by two independent strategies. Firstly, we
      studied cells that persist in the peripheral pools with or without cell division.
      We have transferred mature lipopolysaccharide (LPS)-reactive splenic B cells into
      LPS non-responder recipients and studied the donor population that could be
      recovered in host mice at differing time intervals after cell transfer. Secondly,
      we studied non-cycling resting long-lived B cells. These cells were obtained in
      normal mice after cytostatic treatment with hydroxyurea and in mice transgenic
      for the HSV-1 thymidine kinase gene after treatment with the anti-herpetic
      ganciclovir. Studying the VH gene family usage at the single level by in situ
      hybridization, we found that persistent B cells show an increased expression of
      the VHJ558 family and a diminished representation of the VH7183 family. These
      results demonstrate that in a normal non-immunized mouse, B cell survival and
      persistence in the resting state results from V region dependent selection.

PMID- 8347555
TI  - The immunoaugmenting properties of murine IgD reside in its C delta 1 and C delta
      3 regions: potential role for IgD-associated glycans.
AB  - IgD receptor (IgD-R) bearing CD4+ T cells with immunoaugmenting properties in
      vivo are induced in mice within 24 h after a single injection of dimeric or
      aggregated IgD. In the present study, we sought to identify the region(s) of IgD
      responsible for upregulation of IgD-R and for the immunoaugmenting effect of IgD.
      IgD-R can be upregulated on CD4+ T cells in vitro and in vivo by glutaraldehyde
      aggregated mutant IgD or by fragments of enzymatically digested IgD molecules
      possessing either the C delta 1 domain (Fd delta) or the C delta 3 domain (Fc
      delta). Neoglycoproteins (D-galactose--BSA and N-acetyl-D-glucosamine--BSA), can
      competitively block upregulation of IgD-R by IgD in vitro. Furthermore, when
      injected 1 day before antigen, the aggregated IgD derived molecules, KWD1 (which
      lacks C delta 1), KWD6 (which lacks C delta 1 plus C delta-hinge), and Fab delta
      can all cause augmentation of antigen-specific primary and secondary antibody
      responses comparable to that achieved with intact aggregated IgD. Moreover, the
      immunoaugmenting effect of intact oligomeric IgD molecules in primary antibody
      responses is competitively blocked by simultaneous injection of monomeric forms
      of KWD6 and Fab delta. These results suggest that the binding of IgD to IgD-R,
      previously shown to be dependent on N-glycans present on Fd delta and Fc delta
      regions, also contributes to the upregulation of IgD-R and immunoagumentation.

PMID- 8347556
TI  - Functional and morphological characterization of 4F7+ spleen accessory dendritic
      cells.
AB  - Recently we have reported on the production of the mAb 4F7. This recognizes a
      molecule that is upregulated on dermal and epidermal dendritic cells after
      application of contact allergen. Furthermore, this antibody detects an antigen on
      spleen and lymph node dendritic cells. In this study, we characterize 4F7+ spleen
      dendritic cells and show that the mAb recognizes in situ few labeled cells in the
      white pulp of the spleen and approximately 1% of spleen single cell suspensions
      as evidenced by cell enrichment, immunoperoxidase staining and FACS analysis.
      Immunohistological characterization of the cells with mAbs revealed the
      expression of class II, class I MHC antigens, 33D1, CD11c, ICAM-1, and CD45
      molecules. After enrichment and cultivation for approximately 3 days, these cells
      showed no adherent properties. The capacity of 4F7+ spleen dendritic cells to
      activate allogeneic T cells in the primary mixed lymphocyte reaction was similar
      to freshly isolated Ia+ Langerhans cells. With regard to the induction of a
      proliferative response of CD4+ naive T cells that were incubated with
      concanavalin A or anti-CD3 mAb, 4F7+ spleen dendritic cells were two to three
      times more potent than spleen microphages and B cells. Furthermore, 4F7+ cells
      efficiently stimulated the antigen dependent proliferation of a T helper cell
      line. The mAb 4F7 will be useful for the purification of dendritic cells and for
      functional and molecular biological studies.

PMID- 8347557
TI  - MHC class II molecules bind indiscriminately self and non-self peptide homologs:
      effect on the immunogenicity of non-self peptides.
AB  - Synthetic peptides spanning the entire sequence of both human and mouse beta 2
      microglobulin (beta 2M) have been tested for their capacity to bind to three
      different mouse (I-Ad, I-Ed, and I-Ak) or human (DR1, DR2, and DR5) class II
      molecules. The results demonstrate that class II molecules do not discriminate
      between self and non-self peptides. When the immunogenicity of the human beta 2M
      peptides was measured by their ability to prime H-2d mice for in vitro T cell
      proliferation, it was found that peptides incapable of binding class II molecules
      in vitro were also non-immunogenic in vivo. Interestingly, however, several
      binders, including the human beta 2M peptide 1-16, the best binder in this series
      to Iad molecules, were found to be non-immunogenic. Since the corresponding mouse
      beta 2M peptide 1-16 was also capable of binding to Iad molecules, this suggested
      that lack of responsiveness to the non-self peptide could arise either from
      central or peripheral tolerance induced by the self homolog. Alternatively, lack
      of responsiveness could arise from other mechanisms, such as negative selection
      by other non-homolog sequences or lack of suitable T cell receptor genes. To
      discriminate between these possibilities, H-2d mice with disrupted beta 2M genes
      were immunized with the human beta 2M peptide 1-16. This peptide also failed to
      prime for T cell responsiveness in beta 2M-negative mice, suggesting that a hole
      in the T cell repertoire for this antigen was not mediated by negative selection
      or peripheral tolerance induced by self beta 2M peptides.

PMID- 8347558
TI  - Immunoglobulin gene rearrangement in B cell deficient mice generated by targeted
      deletion of the JH locus.
AB  - B lymphocyte differentiation is characterized by an ordered series of Ig gene
      assembly and expression events. In the majority of normal B cells, assembly and
      expression of Ig heavy (H) chain genes precedes that of light (L) chain genes. To
      determine the role of the Ig heavy chain protein in B cell development and L
      chain gene rearrangement, we have generated mice that cannot assemble Ig H chain
      genes as a result of targeted deletion of the JH gene segments in embryonic stem
      cells. Mice homozygous for this deletion are devoid of slg+ B cells in the bone
      marrow and periphery. B cell differentiation in these mice is blocked at the
      large, CD43+ precursor stage. However, these precursor B cells do assemble kappa
      L chain genes at a low level in the absence of mu H chain proteins. These data
      demonstrate that rearrangement and expression of the mu H chain gene is not
      absolutely required for kappa L chain gene rearrangement in vivo. Expression of
      mu chains may facilitate either efficient L chain gene rearrangement or the
      survival of cells that have rearranged light chain genes by promoting the
      differentiation of large, CD43+ to small, CD43- pre-B cells.

PMID- 8347559
TI  - Expression of recombinant rabbit IL-8 in Escherichia coli and establishment of
      the essential involvement of IL-8 in recruiting neutrophils into
      lipopolysaccharide-induced inflammatory site of rabbit skin.
AB  - In order to establish the pathophysiological roles of IL-8, rabbit IL-8 was
      expressed in Escherichia coli and purified to homogeneity by sequential
      chromatography on heparin agarose, CM-HPLC, and RP-HPLC. The purified recombinant
      rabbit IL-8 was homogeneous on SDS-PAGE and the ED50 of neutrophil chemotactic
      activity for rabbit peritoneal neutrophils was 2 ng/ml. The binding of 125I
      labeled rabbit IL-8 to rabbit neutrophils was inhibited by unlabeled human IL-8
      as well as rabbit IL-8 but not by another leucocyte chemotactic cytokine
      (chemokine), monocyte chemotactic and activating factor. Scatchard plot analysis
      of the binding of 125I-labeled rabbit IL-8 to rabbit peritoneal neutrophils
      revealed that the rabbit neutrophils have two affinity classes of receptors for
      IL-8 (Kd = 2.3 nM, 4.1 x 10(4) sites/cell; Kd = 18.0 nM, 11.4 x 10(4)
      sites/cell). It was found that a previously generated mouse anti-human IL-8 mAb,
      WS-4, inhibited the binding of 125I-labeled rabbit IL-8 to rabbit neutrophils,
      and blocked neutrophil chemotaxis in vitro in a specific and dose-dependent
      manner. An ELISA system for rabbit IL-8 was established using this mAb and guinea
      pig polyclonal antibodies to recombinant rabbit IL-8 to measure the levels of IL
      8 in rabbit plasma. Intravenous administration of lipopolysaccharide (LPS) (100
      micrograms) in rabbits caused the highest level of IL-8 in blood at around 2 h.
      Intravenous administration of WS-4 (10 mg) inhibited neutrophil infiltration at
      the site of LPS injection into the rabbit skin, suggesting that IL-8 is essential
      in the recruitment of neutrophils at sites of acute inflammation in vivo.

PMID- 8347560
TI  - Rapid acceleration of neutrophil apoptosis by tumor necrosis factor-alpha.
AB  - We demonstrate here that human necrosis factor-alpha, a potent neutrophil
      activator, induces rapid (within 3 h) apoptosis of these cells, i.e. neutrophils
      treated with this cytokine exhibit (i) light and electron microscopic changes
      characteristic to apoptotic cells, (ii) reduced propidium iodide binding to DNA,
      and (iii) the ladder form of DNA, as shown by agarose gel electrophoresis. These
      results suggest that apoptosis acceleration may be involved in processes by which
      neutrophils are prevented from damaging tissues.

PMID- 8347561
TI  - Mouse CD4 binds MHC class II with extremely low affinity.
AB  - Interaction of CD4 with MHC class II molecules plays a crucial role during thymic
      development and activation of single-positive CD4 T lymphocytes. The quantitation
      of this interaction is, therefore, important for understanding the role of CD4
      during these events. To this end, we have developed a rosette assay, which
      enabled us to study this molecular interaction. By coupling soluble mouse CD4
      onto beads, we could show specific binding of CD4 to MHC class II molecules on
      A20 B lymphoma cells. These binding studies revealed an extremely low affinity
      (Ka < or = 10(4) M-1) between CD4 and MHC class II molecules in mouse.

PMID- 8347562
TI  - MOUSE: a teachable program for learning in conformational analysis.
AB  - MOUSE is a teachable program which learns concepts of conformational analysis
      from examples obtained from WIZARD. The algorithms are presented, and a fully
      worked example is used to demonstrate how MOUSE learns about the so-called
      "pentane rule."

PMID- 8347563
TI  - Short-term learning in conformational analysis.
AB  - A method for learning short-term rules of conformational analysis is introduced.
      The technique works by discovering problems during the building of a conformation
      in Cartesian coordinate space, and builds an abstract critic suitable for
      reasoning in abstract symbolic space. The methods not only afford speed increases
      ranging from 1.0- to 2.3-fold in WIZARD (analysis completed in 100% to 43% of
      original run time), but can be modified to provide similar increases in other
      programs that use "template joining" and distance geometry. These methods also
      provide the basis for a long-term learning project.

PMID- 8347564
TI  - Cooperative effects in the transport of small molecules through an amorphous
      polymer matrix.
AB  - The transport of small molecules (penetrants) through polymer materials proceeds
      by a hopping mechanism: A penetrant typically dwells in a cavity of the polymer
      for a while and then performs a quick jump into an adjacent cavity. In this
      article we investigate a jump event in detail. Molecular graphics is used to
      identify if and how the motion of the penetrant is aided by the fluctuations of
      the polymer matrix. We employ both traditional molecular graphics techniques to
      show atomic motion and surface rendering methods to display the redistribution of
      penetrant-accessible volume in the polymer.

PMID- 8347565
TI  - A note on the low-dimensional display of multivariate data using neural networks.
AB  - A novel neural network technique has been proposed (Livingstone et al. J. Mol.
      Graphics 1991, 9, 115-118) which is useful for a low-dimensional display of
      multivariate data sets. The method makes use of the activity values of the hidden
      neurons in a trained three-layer feed-forward network to produce the low
      dimensional display. It was claimed that in contrast to conventional techniques,
      such as principal components analysis or nonlinear mapping, this technique could
      be used also to reconstruct, from a given point in the low-dimensional display,
      the corresponding multivariate input vector via the completely known weight
      matrices of a suitably trained network. We show here that this claim is
      unjustified in this general form. When previously unknown, grossly different
      input vectors are presented to the trained network, they can occupy, for example,
      exactly the same point in the low-dimensional display which is occupied also by a
      given training vector, if certain linear relationships between the vector
      components are fulfilled. Thus, an infinite set of different linearly dependent
      input vectors is projected onto one single point in the low-dimensional display.
      Reconstruction of a multivariate vector, starting from this point in the low
      dimensional display, is able to lead back to only one multivariate vector (in the
      example given, to the original training vector).

PMID- 8347566
TI  - SETOR: hardware-lighted three-dimensional solid model representations of
      macromolecules.
AB  - SETOR is designed to exploit the hardware lighting capabilities of the IRIS-4D
      series graphics workstations to render high-quality raster images of
      macromolecules that can undergo rotation and translation interactively. SETOR can
      render standard all-atom and backbone models of proteins or nucleic acids, but
      focuses on displaying protein molecules by highlighting elements of secondary
      structure. The program has a very friendly user interface that minimizes the
      number of input files by allowing the user to interactively edit parameters, such
      as colors, lighting coefficients, and descriptions of secondary structure via
      mouse activated dialogue boxes. The choice of polymer chain representation can be
      varied from standard vector models and van der Waal models, to a B-spline fit of
      polymer backbones that yields a smooth ribbon that approximates the polymer
      chain, to strict Cardinal splines that interpolate the smoothest curve possible
      that will precisely follow the polymer chain. The program provides a photograph
      mode, save/restore facilities, and efficient generation of symmetry-related
      molecules and packing diagrams. Additionally, SETOR is designed to accept
      commands and model coordinates from the standard input stream, and to control
      standard output. Ancillary programs provide a method to interactively edit
      hardcopy plots of all vector and many solid models generated by SETOR, and to
      produce standard HPGL or PostScript files. Examples of figures rendered by SETOR
      of a number of macromolecules of various classes are presented.

PMID- 8347567
TI  - The molecular surface package.
AB  - The Molecular Surface Package is a reimplementation, in C, of a set of earlier
      FORTRAN programs for computing analytical molecular surfaces, areas, volumes,
      polyhedral molecular surfaces, and surface curvatures. The software does not do
      interactive molecular graphics, but it will produce pixel maps of smooth
      molecular surfaces. The polyhedral molecular surfaces are suited to display on
      graphics systems with real-time rendering of polyhedra.

PMID- 8347568
TI  - Modeling and solution structure probing of the HIV-1 TAR stem-loop.
AB  - We present a model for the three-dimensional structure of the HIV TAR stem-loop,
      based on a modeling algorithm which makes use of the known X-ray coordinates of
      tRNAs to generate a model structure, which has then been tested experimentally in
      solution by enzymatic and chemical structure probing of ribo-oligonucleotides
      encompassing the TAR sequence. The modeling suggested that the structure of TAR
      was similar to that of the anti-codon loop of tRNA(Asp), having a loop of just
      three single-stranded residues with a mismatched adenine excluded from the
      helical stem on the 3' side of the loop. The structural probing is consistent
      with such a structure for the loop, and reveals an unusual structure around the
      5' uridine-rich bulge, which is the binding target for the transactivator protein
      Tat. These data may be useful in understanding the interaction of TAR with the
      Tat protein and may aid in the design of anti-AIDS drugs. The coordinates of the
      model are available on request.

PMID- 8347569
TI  - Molecular surface comparison: application to drug design.
AB  - An interactive system for the display and manipulation of molecular surface
      properties is presented. The property at the molecular surface is mapped onto the
      sphere by gnomonic projection. This representation allows direct comparison of
      the surface properties of pairs of molecules. The system allows the user to
      explore the similarities between a pair of molecules in an interactive manner,
      and provides extensive visual (color-coded field and field difference maps) and
      numerical (rms difference value) aids to complement the user's chemical
      intuition. Examples of the use of the system to study beta-lactam compounds and
      phosphodiesterase inhibitors are presented.

PMID- 8347570
TI  - Helix stop signals in proteins and peptides: the capping box.
AB  - The alpha-helix [Pauling, L., Corey, R. B., & Branson, H. R. (1951) Proc. Natl.
      Acad. Sci. U.S.A. 37, 205-211] is a common motif in both proteins and peptides.
      Despite intense investigation, predictive understanding of helices is still
      lacking. A recent hypothesis [Presta, L. G., & Rose, G. D. (1988) Science 240,
      1632-1641] proposed that the structural specificity of helices resides, in part,
      in those residues that flank helix termini. If so, then signals that arrest helix
      propagation--i.e., helix stop signals--should be found among these flanking
      residues. Evidence is presented for the existence of one such signal, a
      reciprocal backbone-side-chain hydrogen-bonding interaction, dubbed the capping
      box. In proteins, the capping box is found uniquely at helix N-termini. In
      peptides, the capping box can function as a helix stop signal, as shown in the
      work of Kallenbach and co-workers.

PMID- 8347571
TI  - A highly sensitive probe for guanine N7 in folded structures of RNA: application
      to tRNA(Phe) and Tetrahymena group I intron.
AB  - A nickel complex has been shown to promote conformation-specific oxidation of
      guanosine in polynucleotide RNA. In all cases, reaction was strictly dependent on
      the solvent exposure and surface properties of guanine N7. Modification of native
      tRNA(Phe) (yeast) was detected at G18, G19, G20, and Gm34 and concurred with
      predictions based on its crystal structure. Additional guanine derivatives became
      exposed to oxidation only after the tRNA unfolded in the absence of Mg2+.
      Reaction of the Tetrahymena group I intron RNA (L-21 ScaI) also compared
      favorably to its three-dimensional model by appropriately identifying guanosine
      residues in hairpin loops, duplex termini, and the essential cofactor binding
      site. These results complemented prior data generated by hydroxyl radical, and in
      combination they served to distinguish the solvent accessibility of sugar
      backbone and base positions in guanosine residues. Most importantly, this nickel
      complex exhibited greater selectivity than either dimethyl sulfate or RNase T1
      for characterizing tRNA(Phe) and intron RNA.

PMID- 8347572
TI  - Expression of CheA fragments which define domains encoding kinase,
      phosphotransfer, and CheY binding activities.
AB  - The histidine protein kinase CheA is a central component of the Escherichia coli
      chemotaxis system. The autophosphorylation activity of CheA is controlled by
      membrane-bound chemoreceptors and by the CheW coupling protein. CheA
      phosphorylates the CheY and CheB proteins which respectively control the
      direction of flagellar rotation and the level of receptor adaptation, thereby
      regulating the cells' chemotactic response. Genes encoding three polypeptide
      fragments of CheA were constructed and expressed in order to better define the
      functional organization of the wild-type protein. These fragments allowed the
      identification of regions of the protein responsible for CheY binding,
      phosphotransfer, and kinase activity. The kinase domain was expressed as a 30-kDa
      polypeptide corresponding to the central portion of the wild-type protein which
      contains sequences homologous to other histidine kinases. It was able to
      phosphorylate a 15-kDa amino-terminal phosphotransfer domain which was separately
      expressed and purified. This latter domain is capable of phosphotransfer to CheY
      despite the fact that it lacks the ability to stably bind CheY. CheY was
      immobilized to a dextran matrix through a single cysteine residue which was
      introduced into the protein at a position far removed from the active site. A
      stable binding site for CheY was mapped to a segment between the site of
      autophosphorylation and the kinase domain by using surface plasmon resonance to
      detect binding to the immobilized CheY. The region of the kinase which tightly
      binds the unphosphorylated substrate may play an important role in regulating the
      specificity of the signal transducing system.

PMID- 8347573
TI  - Ligand binding and slow structural changes in chlorocruorin from Spirographis
      spallanzanii.
AB  - Chlorocruorin is a cooperative respiratory pigment found in the blood of
      polychaete worms; its prosthetic group is a derivative of the iron protoporphyrin
      IX, in which the vinyl group at position 2 is substituted by a formyl group. The
      quaternary structure of chlorocruorins is complex: myoglobin-like subunits are
      grouped in tetramers and tetramers in dodecamers; 12 dodecamers are assembled in
      the 3500-kDa particle. Chlorocruorin from Spirographis spallanzanii displays the
      following overall functional properties: (i) the oxygen affinity is lower than in
      human hemoglobin, while that of CO is similar if not higher; (ii) the rates of
      combination with oxygen and carbon monoxide are low; and (iii) the off rate of
      oxygen is comparable to that of human hemoglobin, while the off rate of CO is 10
      times smaller. When CO is partially photolyzed with a long and powerful light
      flash (70 microseconds), rebinding is biphasic as in mammalian hemoglobins;
      however, the slowest rate is faster than that observed by stopped flow,
      suggesting that the unliganded protein decays from the liganded high affinity
      state (R) to an intermediate state before reaching the low affinity (T) state.
      Oxygen binding was followed by stopped-flow and flash photolysis. While partial
      photolysis yields a fast, second-order time course, stopped-flow experiments
      yield slow, biphasic, and non-second-order time courses. This pattern of
      reactivity was attributed to a slow conformational transition(s) which is (are)
      rare limiting with oxygen, but not with CO.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347574
TI  - Epsilon BP, a beta-galactoside-binding animal lectin, recognizes IgE receptor (Fc
      epsilon RI) and activates mast cells.
AB  - IgE-binding protein (epsilon BP) was originally identified in rat basophilic
      leukemia (RBL) cells by virtue of its affinity for IgE. epsilon BP is now known
      to be a beta-galactoside-binding lectin containing an S-type carbohydrate
      recognition domain. It is identical to a macrophage surface antigen, Mac-2, and
      lectins designated as CBP35, L-34, and RL-29, for which various functions have
      been suggested. Studies from other groups as well as ours have indicated that
      epsilon BP is secreted by cells such as macrophages and is present in
      extracellular fluids. We demonstrated previously that binding sites for epsilon
      BP are present on the surface of RBL cells. In this report, we show that epsilon
      BP binds to a small number of glycoprotein species on the surface of RBL cells.
      Significantly, one of these glycoproteins is the high-affinity IgE receptor (Fc
      epsilon RI). Preliminary studies showed that epsilon BP causes mediator release
      from RBL cells, possibly through cross-linking of Fc epsilon RI. The results
      suggest a function of epsilon BP as an activator of mast cells.

PMID- 8347575
TI  - Effects of mutations in the hinge region of serpins.
AB  - An expression system for alpha 1-antitrypsin in Escherichia coli was developed
      using a T7 RNA polymerase promoter. Addition of rifampicin to inhibit the E. coli
      RNA polymerase after induction of the T7 RNA polymerase gene resulted in about
      30% of newly synthesized protein being alpha 1-antitrypsin. This expression
      system was then used to examine the effect of mutations in the hinge region of
      alpha 1-antitrypsin on its activity. The mutations were based on ones in
      antithrombin III that had previously been shown to have adverse effects on
      activity. Mutation of Ala347 to threonine in alpha 1-antitrypsin did not affect
      the kinetic behavior of the protein with trypsin or human leukocyte elastase. In
      contrast, mutation of Gly349 to proline converted the majority of the protein
      into a substrate for both proteinases. The small fraction of this mutant that was
      active, however, had kinetic parameters that were indistinguishable from wild
      type alpha 1-antitrypsin. Cleavage within the reactive-site loop of wild-type
      alpha 1-antitrypsin causes a conformational change in the molecules (the S-to-R
      transition) and results in a marked increase in heat stability. This increase in
      heat stability was also seen upon cleavage within the reactive-site loops of both
      of the alpha 1-antitrypsin mutants. The results are discussed in terms of a
      kinetic mechanism for serpin-proteinase interactions, in which after the
      formation of an initial complex the serpin partitions between the formation of a
      stable complex and a cleavage reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347576
TI  - Structure-function relations in photosystem II. Effects of temperature and
      chaotropic agents on the period four oscillation of flash-induced oxygen
      evolution.
AB  - The characteristic period four oscillation patterns of oxygen evolution induced
      by a train of single-turnover flashes were measured in dark-adapted samples as a
      function of temperature and upon addition of chaotropic agents. The following
      results were obtained: (a) Within the range of 0 < theta < 35 degrees C, the
      ratio of the oxygen yield induced by the 4th and 3rd flashes of the train, Y4/Y3,
      and the oxygen yield induced by the 2nd flash, Y2, exhibit similar dependencies
      on the temperature in isolated thylakoids, PS II membrane fragments, and inside
      out vesicles. (b) Below a characteristic temperature theta c of 20-25 degrees C,
      the values of Y4/Y3 and Y2, which reflect (at constant S0 dark population) the
      probabilities of misses and double hits, respectively, remain virtually
      independent of temperature, whereas above theta c these parameters increase. (c)
      The dark decays of S2 and S3 via fast and slow kinetics due to reduction of the
      water oxidase by YD and other endogenous electron donor(s), respectively, exhibit
      comparatively strong temperature dependencies in thylakoids with the following
      activation energies: EA(S2fast) = 55 kJ/mol, EA(S3fast) = 50 kJ/mol, EA(S2slow) =
      85 kJ/mol, and EA(S3slow) = 75 kJ/mol. The activation energy of S0 oxidation to
      S1 by YDox was found to be markedly smaller with a value of EA(S0) = 30 kJ/mol.
      (d) Incubation with chaotropic agents at concentrations which do not
      significantly impair the oxygen evolution capacity leads to modifications of the
      oscillation pattern with remarkable differences for various types of agents: Tris
      and urea are practically without effect; guanidine hydrochloride affects Y4/Y3 in
      a similar way as elevated temperature but without significant changes of Y2 and
      the decay kinetics of S2 and S3; and anions of the Hofmeister series (SCN-, ClO4
      , I-) cause a drastic destabilization of YDox. Possible structure-function
      relations of the PS II complex are discussed on the basis of these findings.

PMID- 8347577
TI  - Pathway of proton uptake in the bacteriorhodopsin photocycle.
AB  - The time courses of chromophore reactions and proton uptake in the second half of
      the photocycle of the proton pump bacteriorhodopsin (BR) were examined. At pH >
      8.5, the kinetics are simplified by the fact that only the M and N intermediates
      accumulate. The relaxation kinetics after perturbation of M with a second, blue
      flash confirm that M<==>N equilibration is the only significant cause of the
      biphasic M decay. With this feature, the analysis of time-resolved difference
      spectra yields a scheme which contains two sequential N states connected by a
      nearly unidirectional reaction. The proton uptake from the bulk, as measured with
      the pH-indicator dye pyranine, occurs during the decay of the first N rather than
      the recovery of BR. The results thus suggest the model M2(-1)<==>N(-1) + H+ (from
      the bulk)<==>N(0)-->BR, where the superscripts indicate the protonation state of
      the protein relative to BR. M2(-1)-->N(-1) is reprotonation of the Schiff base
      from D96, N(-1) + H+ (from the bulk)-->N(0) is uptake of proton from the
      cytoplasmic side, and N(0)-->BR represents 13-cis to all-trans reisomerization of
      the retinal and other relaxations which regenerate the initial state. R227, a
      residue near D96, affects the deprotonation of D96 more than the subsequent
      proton uptake. According to the changed [M2(-1)]/[N(-1)] equilibrium in the R227Q
      protein, interaction between R227 and D96 is responsible for about 1 pH unit of
      the decrease in the pKa of D96 during the reprotonation of the Schiff base.
      According to the pH dependencies of the rate constants in the N(-1)<==>N(0)
      equilibrium in wild-type and R227Q, interaction with R227 lowers the pKa for
      proton uptake from the bulk by 0.5 pH unit, to 11. We conclude from the proton
      uptake kinetics that at physiological pH free energy is converted to proton
      electrochemical potential in this pump not only as protons are released on the
      extracellular side [Zimanyi, L., Varo. G., Chang, M., Ni, B., Needleman, R., &
      Lanyi, J. K. (1992) Biochemistry 31, 8535-8543] but also as protons are taken up
      on the cytoplasmic side.

PMID- 8347578
TI  - Photoreaction of the N intermediate of bacteriorhodopsin, and its relationship to
      the decay kinetics of the M intermediate.
AB  - Because the M photointermediate of recombinant T46V bacteriorhodopsin decays more
      rapidly and the N intermediate more slowly than in wild-type, the photoreaction
      of N could be examined without interference from M. We found that between pH 6
      and 9 the photoproducts of N included both earlier suggested M-like intermediate
      and red-shifted R state. However, when the photoexcitation of N was at
      wavelengths below 500 nm the amount of M-like product decreased with increasing
      pH, and at pH 9 virtually only R was produced. In the dark, T46V contains an N
      like conformer, in increasing amounts with increasing pH like wild-type but in 4
      5 times greater concentrations. The photoreaction of this thermally produced
      state is much like that of the N intermediate. It is associated with the
      appearance of a slowly decaying M, but we calculate that under most conditions
      used to follow M in the wild-type photocycle the amount of N-like conformer, and
      therefore the amplitude of this slow component, will not be significant. The
      results confirm the suggestion [Fukuda & Kouyama (1992) Biochemistry 31, 11740
      11747] that an M-like state is included among the photoproducts of N, but at the
      same time provide support to photocycle models in which the slow component of the
      biphasic M decay is attributed not to this secondary photoreaction or to a
      separate photocycle originating from a heterogeneous initial state, but to
      thermal equilibration between M and N in a single photocycle.

PMID- 8347579
TI  - Kinetic analysis of the induction period in lipoxygenase catalysis.
AB  - The dioxygenation of 50 microM linoleate at 0.1 microM (13S)
      hydroperoxylinoleate, 240 microM O2, pH 10, and 25 degrees C, catalyzed by
      varying amounts of soybean lipoxygenase-1, was studied with rapid kinetic
      techniques. The aim was to assess the effect of transient redistributions of the
      Fe(II) and Fe(III) enzyme forms on the shape of the reaction progress curves.
      Reactions initiated with iron(II) lipoxygenase show an initial increase in rate,
      the "kinetic lag phase" or "induction period". The duration of this induction
      period varies from approximately 1 s at [lipoxygenase] > 20 nM to 5 s at
      [lipoxygenase] = 3 nM. At [lipoxygenase] < 2 nM, the duration of the induction
      period in these curves is inversely proportional to [lipoxygenase]. The
      integrated steady-state rate equation for the single fatty acid binding site
      model of lipoxygenase catalysis [Schilstra et al. (1992) Biochemistry 31, 7692
      7699] also shows an induction period whose duration is inversely proportional to
      [lipoxygenase]. These observations, in combination with non-steady-state
      numerical simulations, lead to the conclusion that, at [lipoxygenase] < 2 nM, pre
      steady-state redistributions of enzyme intermediates occur fast with respect to
      the rate at which the concentrations of substrates and products change. At higher
      lipoxygenase concentrations, the pre-steady-state redistributions contribute
      significantly to the induction period. From a nonlinear least-squares fit to the
      steady-state rate equation of data obtained at lipoxygenase concentrations of 0.5
      and 1 nM, it was calculated that 1% of the linoleate radicals that are formed
      after hydrogen abstraction dissociate from the active site before enzymic oxygen
      insertion has occurred.

PMID- 8347580
TI  - Kinetic and equilibrium analysis of the interactions of actomyosin subfragment
      1.ADP with beryllium fluoride.
AB  - The hypothesis that the stable ternary complex formed between myosin subfragment
      1, MgADP and beryllium fluoride (BeF3-), denoted S-1 not equal to .ADP.BeF3-, is
      an analog of the intermediate state S-1**.ADP.P(i) has been tested in this work
      by examining the interactions of S-1 not equal to .ADP.BeF3- with actin.
      Equilibrium binding measurements revealed that actin bound weakly to the S-1 not
      equal to .ADP.BeF3- complex (Ka = 10(4) M-1) in the presence of 40 mM KCl. The
      stability of this complex was strongly salt-dependent. The association constant
      of BeF3- to the acto-S-1.ADP complex (KBe approximately 10(3) M-1) was 100-fold
      weaker than its binding to the S-1.ADP complex. While inhibiting the S-1 ATPase
      strongly, BeF3- had no effect on the Vmax value (10 +/- 1.0 s-1) of the actin
      activated ATPase of S-1. The rates of BeF3- binding and dissociation from the
      acto-S-1.ADP.BeF3- complex were determined by stopped-flow measurements. The
      hyperbolic dependence of the rates of BeF3- binding to acto-S-1.ADP (kobs) on
      BeF3- concentrations suggested that the acto-S-1.ADP.BeF3- complex was formed in
      at least two steps: binding followed by isomerization. The binding constant was
      1.2 x 10(3) M-1, and the maximum kobs was 2.5 s-1. The dissociation of BeF3- from
      the acto-S-1.ADP.BeF3- complex was monitored via decrease in the fluorescence of
      1-N6-ethenoadenosine diphosphate (epsilon ADP). The fluorescence decrease fitted
      two exponential terms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347581
TI  - Orientation of functional and nonfunctional PTS permease signal sequences in
      lipid bilayers. A polarized attenuated total reflection infrared study.
AB  - Synthetic peptides corresponding to the N-terminal 23 and 22 residues,
      respectively, of two integral plasma membrane proteins of Escherichia coli,
      namely the mannitol- and glucitol-specific permeases of the bacterial sugar
      phosphotransferase system, were incorporated into single planar phospholipid
      bilayers supported on germanium plates. Polarized attenuated total reflection
      infrared spectra were recorded, and order parameters were derived from the
      measured dichroic ratios. The order parameters of the two wild-type peptides
      which form amphiphilic alpha-helices in membranes were -0.4 to -0.5, indicating a
      preferential alignment of the alpha-helix long axis parallel to the membrane
      surface. Nonfunctional mutant peptides of the mannitol permease sequence in which
      serine-3 or aspartate-4 were substituted with prolines (S3P and D4P) or lysine
      (D4K), but which were still largely alpha-helical, exhibited peptide order
      parameters close to zero, indicating a high degree of disorder of these peptides
      in the lipid bilayers. The lipid was well ordered at low concentrations of
      peptides in the membranes but became disordered at high peptide concentrations.
      This effect of lipid disordering was more pronounced for the D4K mutant than for
      the wild-type mannitol peptide.

PMID- 8347582
TI  - Cold denaturation-induced conformational changes in phosphoglycerate kinase from
      yeast.
AB  - The temperature-dependent conformational equilibrium of 3-phosphoglycerate kinase
      has been studied in the temperature range from 1 to 30 degrees C by means of
      dynamic light scattering, small-angle X-ray scattering, differential scanning
      calorimetry, circular dichroism spectroscopy, and fluorescence spectroscopy. At
      28 degrees C and in the presence of 0.7 M guanidine hydrochloride (GuHCl), the
      radius of gyration (RG) and the Stokes radius (RS) are 2.44 and 3.09 nm,
      respectively. Decreasing the temperature effects unfolding of the molecule, a
      process that involves two stages. The two stages correspond to the successive
      unfolding of the N-terminal and C-terminal domains. The peak maxima of the excess
      heat capacity, determined from differential calorimetric scans, extrapolated to 0
      scan rate, are positioned at 16.5 degrees C for the N-terminal domain and at 6.3
      degrees C for the C-terminal domain. At 4.5 degrees C, the radius of gyration and
      the Stokes radius increase to 7.8 and 4.8 nm, respectively. The persistence
      length and the length of the statistical chain segment of the unfolded
      polypeptide chain are 1.74 and 3.48 nm, corresponding to five and ten amino
      acids, respectively. At 1 degrees C, the dimensions of the unfolded chain nearly
      agree with the predicted dimensions under theta conditions. Thus, the
      conformational changes upon cold denaturation can be described by a transition
      from a compactly folded molecule to a random coil. The conformation-dependent
      ratio rho = RGRS-1 increases from rho = 0.79 to rho = 1.63. The volume of the
      unfolded chain is 30 times larger than that of the folded chain in the native
      state.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347583
TI  - Cold denaturation of yeast phosphoglycerate kinase: kinetics of changes in
      secondary structure and compactness on unfolding and refolding.
AB  - Under mildly destabilizing conditions (0.7 M GuHCl), phosphoglycerate kinase from
      yeast undergoes a reversible two-step equilibrium unfolding transition when the
      temperature is lowered from 30 to 1 degree C (Griko, Y. V., Venyaminov, S. Y., &
      Privalov, P. L. (1989) FEBS Lett. 244, 276-278). The kinetics of the changes in
      compactness and secondary structure have been studied by means of dynamic light
      scattering and far-UV circular dichroism, respectively. It turned out that
      unfolding and refolding after an appropriate temperature jump (T-jump) was
      performed proceeded in substantially different ways. After a T-jump from 30 to 1
      degree C, a multiphasic unfolding behavior was observed, reflecting the
      independent unfolding of the N-terminal and C-terminal domains with time
      constants of about 7 and 45 min, respectively. A remarkable feature of the
      unfolding process is the simultaneous change of compactness and secondary
      structure. Refolding after a T-jump from 1 degree C to higher temperatures occurs
      in two stages. At the first stage an appreciable amount of secondary structure is
      formed rapidly within the dead time of the T-jump, while the overall dimensions
      of the polypeptide chain remain essentially unchanged. Thus, an extended folding
      intermediate is formed at an early stage of folding. Further information of
      secondary structure proceeds slowly within a time range of minutes in parallel
      with the increase of compactness. At 30 degrees C, both domains refold
      simultaneously, while at 15 degrees C, independent folding can be observed. These
      findings are discussed with respect to predictions of existing models of folding.

PMID- 8347584
TI  - Fluorescence anisotropy assays implicate protein-protein interactions in
      regulating trp repressor DNA binding.
AB  - The study of interactions between proteins and nucleic acids is central to the
      understanding of the control of genetic expression. Fluorescence anisotropy has
      been used to measure, in solution, the equilibrium binding profiles of a
      bacterial repressor protein, the tryptophan repressor (TR), to a fluorescently
      labeled oligonucleotide containing one of its target operator sequences.
      Investigation of the effects of changing concentrations of corepressor, operator
      DNA, and protein implicate TR oligomers in the regulation of DNA binding. These
      studies also demonstrate that the relatively straightforward technique of
      fluorescence anisotropy can be applied to the study of the interactions between
      proteins and nucleic acids. The fluorescence technique exhibits sufficient
      sensitivity to replace radioactive methods of detection in most cases. In
      addition, since it is a solution-based methodology, it offers a true equilibrium
      measure of the protein-nucleic acid equilibria, and the effects of changes in
      solution conditions such as salt and ligand concentration, pH, and temperature
      can be readily evaluated. Data acquisition is relatively simple and rapid, and
      the data are of sufficient quality for detailed thermodynamic analyses of complex
      systems. Given these attributes, fluorescence anisotropy will find multiple
      applications in the area of genetic regulation.

PMID- 8347585
TI  - Thermal stability of the DNA-binding domain of the Myb oncoprotein.
AB  - The DNA-binding domain of the c-myb protooncogene product consists of three
      homologous tandem repeats of 51-52 amino acids (denoted as R1, R2, and R3 from
      the N-terminal side). In order to analyze conformational and thermodynamic
      characteristics of the homologous repeats, we have examined the DNA-binding
      domain by circular dichroism (CD) and differential scanning calorimetry (DSC).
      The CD spectra for the three individual repeats are significantly different in
      the fine profiles, indicating subtle differences in their conformations. The
      melting analyses for the fragments show that the thermal stability of each
      fragment is different from one another, with the following order of stability:
      R1(Tm = 61 degrees C) approximately greater than R3(57 degrees C) >> R2(43
      degrees C), where R2 is much less stable than the other repeats. The denaturing
      process for the whole DNA-binding domain, measured by DSC, is characterized by a
      very broad transition ranging from 30 to 80 degrees C. The denaturation curve can
      be fit well by a three-state transition with one intermediate state. The
      transition temperature for the native-to-intermediate transition coincides with
      the melting temperature of R2, indicating that the intermediate state corresponds
      to the unfolding of unstable R2. The CD spectrum of the whole domain is almost
      identical to the sum of the individual spectra. Thus, these results suggest that
      the individual repeats in the whole DNA-binding domain behave independently in
      terms of conformation and stability. The addition of DNA to the DNA-binding
      fragment drastically changed the melting profile, in which the broad transition
      curve was replaced by a sharp peak at 58 degrees C.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8347587
TI  - Specific glycosylation site mutations of the insulin receptor alpha subunit
      impair intracellular transport.
AB  - The insulin receptor is a transmembrane protein found on multiple cell types.
      This receptor is synthesized as a 190-kDa proreceptor which is cleaved to produce
      mature alpha and beta subunits. The proreceptor contains 18 potential sites for N
      linked glycosylation: 14 on the alpha subunit and 4 on the beta subunit. The
      codons for asparagine in the first four sites at the amino terminus of the alpha
      subunit were mutated to code for glutamine. This mutant receptor cDNA was stably
      transfected into NIH 3T3 cells. The insulin receptor produced in these cells
      remained in the proreceptor form; no mature alpha and beta subunits were
      produced. The proreceptor was slightly smaller on SDS-PAGE gels than the wild
      type proreceptor and contained four less oligosaccharide chains by tryptic
      peptide mapping. The carbohydrate chains on the mutant proreceptor remained
      endoglycosidase H sensitive. However, in the presence of brefeldin A, these
      oligosaccharide chains could be processed to endoglycosidase H resistant chains.
      By immunofluorescence, the mutant proreceptor was shown to be localized to the
      endoplasmic reticulum. No insulin receptors could be found on the cell-surface
      either with cell surface labeling with biotin or with 125I-insulin binding. Thus,
      glycosylation of the first four N-linked glycosylation sites of the insulin
      receptor is necessary for the proper processing and intracellular transport of
      the receptor. This is in contrast to glycosylation at the four sites on the beta
      subunit which appear not to be important for processing but necessary for signal
      transduction. Therefore, N-linked glycosylation of the insulin receptor at
      specific sites has multiple distinctive roles.

PMID- 8347586
TI  - A new function of S-adenosylmethionine: the ribosyl moiety of AdoMet is the
      precursor of the cyclopentenediol moiety of the tRNA wobble base queuine.
AB  - Queuosine (Q) [7-(((4,5-cis-dihydroxy-2-cyclopenten-1-yl)amino)methyl)-7-deaz agu
      anosine] usually occurs in the first position of the anticodon of tRNAs
      specifying the amino acids asparagine, aspartate, histidine, and tyrosine. The
      hypermodified nucleoside is found in eubacteria and eucaryotes. Q is synthesized
      de novo exclusively in eubacteria; for eucaryotes the compound is a nutrient
      factor. In Escherichia coli the Q precursor (oQ), carrying a 2,3-epoxy-4,5
      dihydroxycyclopentane ring, is formed from tRNA precursors containing 7
      (aminomethyl)-7-deazaguanine (preQ1) by the queA gene product. A genomic queA
      mutant accumulating preQ1 tRNA was constructed. The QueA enzyme was overexpressed
      as a fusion protein with the glutathione S-transferase from Schistosoma japonicum
      and purified to homogeneity by affinity and anion-exchange chromatography. The
      enzyme QueA synthesizes oQ from preQ1 in a single S-adenosylmethionine- (AdoMet-)
      requiring step, indicating that the ribosyl moiety of AdoMet is transferred and
      isomerized to the epoxycyclopentane residue of oQ. The identity of oQ was
      verified by HPLC and directly combined HPLC/mass spectrometry. The formation of
      oQ was reconstituted in vitro, applying a synthetic RNA. A 17-nucleotide
      microhelix (corresponding to the anticodon stem and loop of tRNA(Tyr) from E.
      coli) is sufficient to act as the RNA substrate for oQ synthesis. We propose that
      QueA is an S-adenosylmethionine:tRNA ribosyltransferase-isomerase.

PMID- 8347588
TI  - Lifetime of the histone octamer studied by continuous-flow quasielastic light
      scattering: test of a model for nucleosome transcription.
AB  - An instrument for continuous-flow quasielastic light scattering is described that
      allows the translational diffusion coefficient of macromolecules to be determined
      as a function of time after the initiation of some time-dependent process by
      mixing. Control experiments are carried out using the proteins lysozyme and BSA
      to verify that flow of the solution does not lead to erroneous results. The
      instrument is used to determine the lifetime of the histone octamer. A solution
      of octamer that is artificially stabilized in 2.0 M NaCl is rapidly diluted to
      physiological ionic strength, and the Stokes diameter is determined as a function
      of the time, delta t, after mixing. We find that the octamers dissociate into
      their component H2A-H2B heterodimers and H(3)2H4 tetramers on a time scale that
      is faster than the earliest time point for which data were obtained, 1 s after
      mixing. This result argues against a simple mechanism for the progression of RNA
      or DNA polymerase through chromatin.

PMID- 8347589
TI  - Forward electron transfer from phylloquinone A1 to iron-sulfur centers in spinach
      photosystem I.
AB  - Forward electron transfer at room temperature from the secondary acceptor A1
      (phylloquinone) to the iron-sulfur centers FX, FB, and FA was studied by flash
      absorbance spectroscopy in different photosystem I (PSI) preparations in order to
      resolve the controversy concerning the kinetics of A1-reoxidation during forward
      electron transfer [half times of 15 ns [Mathis, P., & Setif, P. (1988) FEBS Lett.
      237, 65-68] and 200 ns [Brettel, K. (1988) FEBS Lett. 239, 93-98] were reported
      for PSI particles from spinach and Synechococcus sp., respectively]. The
      monophasic kinetics with t1/2 approximately 200 ns could be reproduced with PSI
      particles from another cyanobacterium (Synechocystis sp. PCC 6803). In so-called
      PSI-beta particles from spinach, containing all membrane-bound electron carriers
      and approximately 65 antenna chlorophylls per reaction center, the flash-induced
      absorbance increase around 370 nm, which is indicative of the formation of A1-,
      decays biphasically with t1/2 approximately 25 and 150 ns and relative amplitudes
      of approximately 65 and 35%, respectively. The difference spectra of these two
      phases were determined between 330 and 500 nm; they agree well below 380 nm but
      deviate significantly at higher wavelengths. The spectrum of the sum of the two
      phases is similar to the spectrum of the 200-ns phase in cyanobacteria. Upon
      chemical reduction of the terminal acceptors FA and FB, only the 25-ns phase is
      conserved and the absorbance changes remaining after its completion decay with
      t1/2 approximately 250 microseconds.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347590
TI  - Interaction and influence of phenylalanine-198 and threonine-199 on catalysis by
      human carbonic anhydrase III.
AB  - Site-directed mutants of human carbonic anhydrase III were used to examine the
      role of Thr-199 and its interaction with Phe-198 in the catalyzed hydration of
      CO2. Threonine-199 is a hydrogen bond acceptor for the zinc-bound water, and Phe
      198 forms part of the hydrophobic side of the active-site cavity of carbonic
      anhydrase III. Catalytic activity for a total of five single and double mutants
      at residues 198 and 199 was determined by stopped-flow spectrophotometry and 18O
      exchange between CO2 and water measured by mass spectrometry. The replacement Thr
      199-->Ala resulted in a 4-fold decrease in the kcat/Km for hydration of CO2. We
      tested the hypothesis that the 25-fold increase in the kcat/Km for hydration of
      CO2 accompanying the replacement Phe-198-->Leu in isozyme III is caused by
      changes in the interaction of Thr-199 with the zinc-bound water or the transition
      state for catalysis. Comparison of hydration of CO2 by the single and double
      mutants of isozyme III containing the replacements Thr-199-->Ala and Phe-198-
      >Leu was consistent with an interaction between these two sites.

PMID- 8347591
TI  - Mutational effects on the cooperativity of Ca2+ binding in calmodulin.
AB  - The importance of the aspartate ligand in the +Y Ca2+ coordinating position of
      two EF-hands of calmodulin has been investigated. Synthetic calmodulin genes were
      used to produce engineered proteins with the wild-type bovine sequence as well as
      with aspartate 58 in Ca(2+)-binding site II and/or aspartate 95 in site III
      changed to asparagine. The macroscopic Ca(2+)-binding constants of the intact
      calmodulins and of tryptic fragments comprising the N- and C-terminal domains
      were determined from titrations with Ca2+ in the presence of 5,5'-Br2BAPTA.
      Substitution of aspartate by asparagine in Ca(2+)-binding site II led to a slight
      increase in the total free energy change on Ca2+ binding, and the cooperativity
      of Ca2+ binding to the N-terminal sites was substantially increased. The change
      from aspartate to asparagine in site III decreased the Ca2+ affinity and also
      appeared to decrease the positive cooperativity between the sites in the C
      terminal domain. Thus, identical mutations in sites II and III were found to
      result in opposite effects. The data imply that involvement of liganding side
      chains in interactions other than direct calcium attraction and calcium
      coordination is of considerable importance for the Ca(2+)-binding process,
      particularly for the cooperativity.

PMID- 8347592
TI  - Physical properties of apolipoprotein A-I from the chicken, Gallus domesticus.
AB  - The amphipathic alpha-helices of exchangeable apolipoproteins (apo) function to
      simultaneously facilitate interaction with lipid surfaces and the aqueous
      environment. In contrast to mammalian apoA-I's, which self-associate in the
      absence of lipid, chicken apoA-I, which shares 66% sequence homology with human
      apoA-I, exists as a monomeric protein when dissociated from high-density
      lipoprotein (HDL). Sedimentation equilibrium studies conducted in the analytical
      ultracentrifuge yielded a weight-average molecular weight of 28,170.
      Corresponding sedimentation velocity and diffusion experiments gave rise to
      s0(20,w) = 2.23 S and D0(20,w) = 6.39 x 10(-7) cm2/s. A translational frictional
      ratio (f/fmin) of 1.18 and an axial ratio of 4.0 were also determined from this
      data. The Stokes radius (Rs,sed = 2.80 nm) and translational frictional ratio
      were subsequently used to calculate estimated molecular dimensions of 25.2 x
      100.8 A for chicken apoA-I. Circular dichroism (CD) studies revealed a highly
      alpha-helical structure predicted to be 74% by Provencher-Glockner analysis.
      Denaturation studies performed on lipid-free apoA-I and monitored by CD revealed
      a midpoint of denaturation of 0.64 M guanidine hydrochloride. From plots of delta
      G(app) versus guanidine hydrochloride concentration, a delta GDH2O of 1.86
      kcal/mol was determined. In other studies, a midpoint of temperature-induced
      denaturation for apoA-I of 57 degrees C was obtained. The effect of solvent pH on
      the secondary structure content of apoA-I revealed a significant loss of alpha
      helix below pH 4.0 and above pH 10, suggesting that lipid-free apoA-I may by
      partially stabilized by the formation of intra- or interhelix salt bridges
      between oppositely charged amino acid side chains.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8347593
TI  - Membrane interaction and self-assembly within phospholipid membranes of synthetic
      segments corresponding to the H-5 region of the shaker K+ channel.
AB  - The voltage-activated K+ channels are assumed to be formed by the coassembly of
      four polypeptide monomers. Each of these monomers is postulated to consist of six
      transmembrane segments (S1 to S6), and long N- and C-terminal domains. The highly
      conserved linker, H-5, between the fifth and the sixth transmembrane segments, is
      hypothesized to line the lumen of the K+ channel formed by the bundle of the
      transmembrane segments of the monomers. Herein we utilize the spectrofluorometric
      approach and investigate the interaction with phospholipid membranes of
      fluorescently-labeled synthetic peptides, whose sequences are derived from the H
      5 region. Binding experiments reveal that the peptides can strongly bind to
      phospholipid membranes with partition coefficients on the order of 10(4) M-1.
      However, a truncated peptide without four amino acids within the most conserved
      region (amino acids 432-435) did not bind to the membranes at all. Moreover, the
      single substitution of a conserved tryptophan at position 435 to serine reduced
      the partition coefficient of the peptide approximately 5-fold, which may account
      for a mutated K+ channel with this substitution not producing functional channels
      (Yool & Schwarz, 1991). Structural characterization using circular dichroism
      spectroscopy (CD) reveals that H-5 can partially adopt an alpha-helix structure
      in hydrophobic environments. Resonance energy transfer (RET) experiments reveal
      that the H-5-derived segments can self-assemble within the membrane but cannot
      coassemble with other unrelated membrane-bound peptides. The results herein
      support the hypothesis that H-5 segments are packed in close proximity and might
      participate in mediating the appropriate assembly of the core region of K+
      channel monomers.

PMID- 8347594
TI  - Cholesterol interacts with lactosyl and maltosyl cerebrosides but not with
      glucosyl or galactosyl cerebrosides in mixed monolayers.
AB  - Pure and mixed monolayers of mono- and dihexoside cerebrosides with cholesterol
      have been characterized at the air/water interface. Cholesterol oxidase was used
      as a reporter enzyme for the cholesterol-cerebroside interaction in the mixed
      monolayers. The cerebrosides either were derived from bovine brain extracts or
      were synthetic. The dihexoside cerebrosides were synthesized by coupling of the
      hepta-O-acetyl-alpha-lactosyl- or maltosylphosphoramidates with D-erythro-N
      acylceramides in dichloromethane, in the presence of trimethylsilyl triflate and
      molecular sieves, followed by hydrolysis of the acetate-protecting groups. All of
      the bovine-brain-derived cerebrosides [galactosyl cerebroside (GalCer, types I
      and II), glucosyl cerebroside (GlcCer), and lactosyl cerebroside (LacCer)] had
      very condensed force-area isotherms (compressibility values of 3-5 x 10(-3) m/mN
      at 20 mN/m), as did the synthetic N-stearoylmaltosylceramide (N-18:0 MaltCer).
      Shorter-chain synthetic cerebrosides (N-8:0 LacCer and N-8:0 MaltCer) had more
      expanded isotherms, with compressibility values of 15-17 x 10(-3) m/mN. When
      cholesterol was included in mixed monolayers of monohexoside cerebroside, it did
      not induce significant condensation of packing (indicating that cholesterol did
      not increase the order of the acyl chains). However, with dihexoside
      cerebrosides, a cholesterol-induced condensing effect was observed, which
      amounted to a 11-19% reduction in the observed mean molecular area. When
      cholesterol oxidase was used to titrate the stoichiometry of
      cholesterol/cerebroside in mixed monolayers, at which pure cholesterol clusters
      appeared, it was observed that in monohexoside cerebroside monolayers cholesterol
      clusters were present even below a 1:1 molar stoichiometry.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8347595
TI  - Activation of UDP-galactose:globotriaosylceramide alpha 1-3-galactosyltransferase
      during PC12D cell differentiation induced by galactosylceramide.
AB  - We measured the activities of UDP-galactose:globotriaosylceramide alpha 1-3
      galactosyltransferase (alpha-GalTase) and protein kinase C (PKC) in PC12D
      pheochromocytoma (PC12D) cells which were induced to differentiation by nerve
      growth factor (NGF), forskolin (FRK), staurosporine (STP), retinoic acid (RA), 2
      chloroadenosine (ClAd), and/or galactosylceramide (GalCer). NGF, STP, FRK, and RA
      were found to be stimulators for the PKC activity, whereas ClAd appeared to be an
      inhibitor of the enzyme. At the concentration of 25 microM, GalCer having normal
      fatty acids was found to be a stimulator, whereas GalCer having hydroxy fatty
      acids was ineffective in modulating the PKC activity. Interestingly, all
      stimulators of PKC activities, including GalCer having normal fatty acids,
      appeared to be activators for the alpha-GalTase activity. On the other hand,
      GalCer having alpha-hydroxy fatty acids had no effect and ClAd was found to be a
      potent inhibitor for the alpha-GalTase activity. These data suggest that alpha
      GalTase activity during PC12D cell differentiation may be regulated by a PKC
      dependent process.

PMID- 8347596
TI  - Affinity purification and binding analysis of the hemolymph juvenile hormone
      binding protein from Manduca sexta.
AB  - A high-affinity juvenile hormone binding protein was purified from the hemolymph
      of the tobacco hornworm, Manduca sexta, employing ammonium sulfate precipitation
      and affinity and size-separation chromatography. The naturally occurring
      enantiomer of juvenile hormone III (10R) was converted to juvenile hormone III
      acid and then covalently attached to aminohexyl-Sepharose 4B. Hemolymph from
      early fifth stadium (60 h postecdysis) larvae was used as the source of hJHBP.
      The yield of hJHBP was approximately 25% of the starting material, with 3.5 mg of
      highly purified, biologically active hJHBP recovered from 100 mL of hemolymph.
      Binding parameters were examined using equilibrium dialysis and highly purified,
      enantiomerically correct juvenile hormone I and II and racemic JH III. The
      equilibrium dissociation constants for juvenile hormone I and II were
      approximately 6 x 10(-10) M at 4 degrees C, while racemic juvenile hormone III
      displayed an equilibrium dissociation constant of 1.9 x 10(-9) M. At 25 degrees C
      the equilibrium dissociation constant for juvenile hormone I was 1.6 x 10(-9) M.
      Half-times of dissociation were also determined for the three homologs. The half
      time of dissociation was 30 s for juvenile hormone I, 20 s for juvenile hormone
      II, and 13 s for juvenile hormone III at either 4 or 25 degrees C. Using the new
      equilibrium dissociation constants, we calculate that better than 99% of the
      circulating juvenile hormone titer may be bound to this hemolymph protein.

PMID- 8347597
TI  - Expression and characterization of biologically active human hepatocyte growth
      factor (HGF) by insect cells infected with HGF-recombinant baculovirus.
AB  - A cDNA containing the entire coding sequence of human hepatocyte growth factor
      (HGF) [also known as scatter factor (SF)] was inserted into the genome of
      Autographa california nuclear polyhedrosis virus (baculovirus) adjacent to the
      polyhedrin promoter by homologous recombination. Insect cells (Spodoptera
      frugiperda) infected with the recombinant virus secrete relatively high levels (3
      8 mg/L) of biologically active HGF into the culture medium. The recombinant HGF
      induces pronounced morphological changes and scattering of primary cultures of
      rat, mouse, and human hepatocytes within 24 h after plating and stimulates DNA
      synthesis in these cells with the same magnitude as native HGF derived from human
      placenta or rabbit serum. The human recombinant HGF produced by the insect cells
      is N-glycosylated, binds to heparin like native HGF, and is recognized by
      polyclonal antiserums raised against human or rabbit HGF as assessed by
      immunoblot, ELISA, and immunoneutralization experiments. Metabolic radiolabeling
      with L-[35S]methionine (pulse-chase experiments) as well as Western blot analysis
      indicates that the recombinant HGF is synthesized and secreted by the infected
      insect cells as the unprocessed single-chain form (pro-HGF) when the cells are
      cultured in serum-free medium. However, when the infected insect cells are
      cultured in insect culture medium (Grace's medium) containing fetal bovine serum,
      the secreted HGF is present mainly in the mature heterodimeric form. Addition of
      serum to the baculovirus-expressed single-chain [125I]HGF in a cell-free system
      results in conversion to the heterodimeric two-chain form, and the activation is
      prevented by the serine protease inhibitor PMSF. Incubation of 125I-labeled pro
      HGF with rat liver or spleen extracts resulted in conversion of pro-HGF to the
      heterodimeric two-chain form. A truncated form of HGF containing the N-terminal
      portion of HGF (kringles 1-3) was also produced in the same expression system.
      This deleted HGF, by itself, did not have any detectable biological activity;
      however, it abrogated the stimulatory effects of full-length HGF on hepatocytes.
      This is the first successful production of bioactive recombinant HGF in large
      quantities, which will allow purification on the milligram scale of pro-HGF and
      will permit future studies to elucidate pathways involved in HGF activation by
      its target tissues.

PMID- 8347598
TI  - Structural organization and chromosomal assignment of the gene encoding the human
      heparin-binding epidermal growth factor-like growth factor/diphtheria toxin
      receptor.
AB  - Heparin-binding epidermal growth factor-like growth factor (HB-EGF) is a recently
      identified, potent smooth muscle cell mitogen of macrophage origin. It is
      expressed in a highly regulated fashion in vascular endothelial and smooth muscle
      cells, indicating a potentially important role for this gene in atherosclerosis.
      In addition, the HB-EGF precursor has recently been found to function as a
      receptor for diphtheria toxin. Using an HB-EGF cDNA probe, we cloned the human
      gene encoding HB-EGF. The HB-EGF gene contains six exons and five intervening
      sequences spanning 14 kb of DNA. By primer extension and S1 nuclease analysis, we
      located a major transcription start site (corresponding to an A residue) 14 bp
      beyond the 5' end of the HB-EGF cDNA. There were no TATAAA or CCAAT consensus
      sequences upstream of the transcription start site. The density of primer
      extension bands generated by RNA from endothelial cells treated with tumor
      necrosis factor-alpha (TNF-alpha) was 10 times higher than that of bands
      generated by the control, indicating that TNF-alpha increased the level of HB-EGF
      mRNA. Using transient reporter gene transfection experiments, we show that 2.0 kb
      of HB-EGF 5'-flanking sequence has promoter activity in bovine aortic endothelial
      cells. By analysis of DNA isolated from human-mouse somatic hybrid cell lines, we
      assign the HB-EGF gene to chromosome 5. By functional study, chromosome 5 has
      been associated with diphtheria toxin susceptibility.

PMID- 8347599
TI  - In vitro protein engineering using synthetic tRNA(Ala) with different anticodons.
AB  - The use of synthetic tRNA for in vitro protein engineering was tested in a
      coupled transcription/translation system prepared from Escherichia coli. DNA
      sequences similar to the natural tRNA(Ala/UGC) gene from E. coli but with
      different anticodons were synthesized in vitro, cloned into a DNA plasmid, and
      then transcribed in vitro with T7 RNA polymerase. The UGC alanine anticodon was
      changed to CUA corresponding to the UAG stop codon, CCU corresponding to the
      rarely used AGG arginine codon, and two four-nucleotide anticodons used to
      suppress stop codons. Bacterial dihydrofolate reductase was the test protein. Its
      cloned coding sequence was mutagenized at the GUG codon for valine-75 to
      correspond to the anticodons of the tRNA constructs, and then the plasmids were
      used to direct the synthesis of dihydrofolate reductase in the coupled
      transcription/translation system containing the corresponding synthetic tRNA. The
      results indicate that all four synthetic tRNAs were functionally active in the
      synthesis of full-length, enzymatically active dihydrofolate reductase protein.

PMID- 8347600
TI  - Self-splicing of the group I intron from Anabaena pre-tRNA: requirement for base
      pairing of the exons in the anticodon stem.
AB  - In the cyanobacterium Anabaena, the precursor to tRNA(Leu) has a 249-nucleotide
      group I intron inserted between the wobble and second bases of the anticodon; the
      intron self-splices during transcription in vitro [Xu, M. Q., Kathe, S. D.,
      Goodrich-Blair, H., Nierzwicki-Bauer, S. A., & Shub, D. A. (1990) Science 250,
      1566-1570]. By studying splicing of isolated pre-tRNA, we confirm that splicing
      occurs by the two-step transesterification mechanism characteristic of group I
      introns, resulting in excision of the intron and accurate ligation of the 5' and
      3' exons. The first step, guanosine-dependent cleavage of the phosphodiester bond
      at the 5' splice site, occurs with kcat congruent to 14 min-1 and kcat/Km = 5 x
      10(4) M-1 min-1 (32 degrees C, 15 mM MgCl2), unexpectedly efficient for a small
      group I intron. (kcat/Km is comparable to that of the Tetrahymena pre-rRNA
      intron, and kcat is an order of magnitude higher than any previously reported for
      a group I intron). The second step, ligation of the exons, is so slow (k = 0.3
      min-1) that it is rate-limiting for splicing in vitro except at very low
      guanosine concentrations. Disruption of the base pairs that make up the anticodon
      stem of the tRNA dramatically reduces the rate of the first step of splicing,
      while compensatory mutations that restore base pairing generally restore
      activity. We suggest that the very short P1 helix of this pre-tRNA, with only
      three base pairs preceding the 5' splice site, is unstable without the additional
      base pairs in the anticodon stem.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347601
TI  - Inhibition of human immunodeficiency virus-1 protease by a C2-symmetric
      phosphinate. Synthesis and crystallographic analysis.
AB  - The human immunodeficiency virus type 1 (HIV-1) protease is a potential target of
      acquired immune deficiency syndrome (AIDS) therapy. A highly potent, perfectly
      symmetrical phosphinate inhibitor of this enzyme, SB204144, has been synthesized.
      It is a competitive inhibitor of HIV-1 protease, with an apparent inhibition
      constant of 2.8 nM at pH 6.0. The three-dimensional structure of SB204144 bound
      to the enzyme has been determined at 2.3-A resolution by X-ray diffraction
      techniques and refined to a crystallographic discrepancy factor, R (= sigma
      parallel F(o) magnitude to - Fc parallel/sigma magnitude of F(o)), of 0.178. The
      inhibitor is held in the enzyme active site by a set of hydrophobic and
      hydrophilic interactions, including an interaction between Arg8 and the center of
      the terminal benzene rings of the inhibitor. The phosphinate establishes a novel
      interaction with the two catalytic aspartates; each oxygen of the central
      phosphinic acid moiety interacts with a single oxygen of one aspartic acid,
      establishing a very short (2.2-2.4 A) oxygen-oxygen contact. As with the
      structures of penicillopepsin bound to phosphinate and phosphonate inhibitors
      [Fraser, M. E., Strynadka, N. C., Bartlett, P. A., Hanson, J. E., & James, M. N.
      (1992) Biochemistry 31, 5201-14], we interpret this short distance and the
      stereochemical environment of each pair of oxygens in terms of a hydrogen bond
      that has a symmetric single-well potential energy curve with the proton located
      midway between the two atoms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347602
TI  - Time-resolved energy transfer measurements of donor-acceptor distance
      distributions and intramolecular flexibility of a CCHH zinc finger peptide.
AB  - Time-resolved frequency-domain fluorescence energy transfer measurements have
      been used to investigate the solution structure of a single-domain CCHH-type zinc
      finger peptide. These measurements reveal not only the range of accessible
      distances for a given donor-acceptor pair within the molecule but also the degree
      of conformational flexibility that occurs in solution. Two donor-acceptor (D-A)
      pair zinc finger peptides have been synthesized. A single tryptophan residue
      located at the midpoint of the sequence was the energy donor for two different
      acceptors. One acceptor, attached at the amino terminus was a 5-(dimethylamino)-1
      naphthalenesulfonyl (DNS) group; the second acceptor was a 7-amino-4-methyl
      coumarin-3-acetyl (AMCA) group, attached to the epsilon-amino function of a
      carboxy-terminal lysine residue. Distance distributions and the mutual site-to
      site diffusion coefficients were determined for these two D-A-labeled peptides
      under zinc-bound, metal-free, and denatured conditions. The D-A distance
      distributions determined for these two peptides under metal-free and zinc-bound
      conditions indicated a shorter distance and a unique conformation (narrow
      distribution) when metal was bound and a longer distance with greater
      conformational flexibility when metal ion was absent. No site-to-site diffusion
      was detected for the zinc-bound peptide, whereas an appreciable amount of
      diffusion was measured for both metal-free and denatured peptide. Anisotropy
      measurements on the peptides indicated increased flexibility of all regions of
      the peptide chain in the absence of zinc and a more compact, less flexible
      structure when zinc was bound. It was concluded from these results that the metal
      bound conformation represents a unique, well-defined structure. Comparison of
      distance distributions measured for metal-free and denatured peptide indicated
      that there is some residual structure present in the metal-free peptide.

PMID- 8347603
TI  - Stabilization of a protein by guanidinium chloride.
AB  - Guanidinium chloride is a commonly used denaturant to unfold native proteins and
      to determine their Gibbs free energy of stabilization, delta Gstab. Here we show
      that this denaturant has a dual role for the stability and the folding of the
      model protein ribonuclease T1. When present at low concentration (0-0.3 M),
      guanidinium chloride stabilizes the folded protein toward thermal and urea
      induced unfolding and decreases the rate of unfolding. At high concentration the
      function of guanidinium chloride as a denaturant dominates and ribonuclease T1 is
      cooperatively unfolded. Ribonuclease T1 is also strongly stabilized by other
      salts, such as NaCl, at low concentrations, and the dependence of the thermal
      stability on salt concentration is not linear. Such a complex behavior was not
      found in control experiments with pancreatic ribonuclease A. The stabilization in
      the presence of low concentrations of guanidinium chloride originates probably
      from the binding of guanidinium ions to one or a few cation binding sites that
      exist in native ribonuclease T1. It is not observed when an additional salt,
      NaCl, is present simultaneously. The favorable interaction of guanidinium
      chloride with the native protein leads to increased values for delta Gstab, when
      unfolding transitions induced by guanidinium chloride are analyzed on the basis
      of the two-state model by the linear extrapolation procedure. The noncoincidence
      of these delta Gstab values with stability data derived from urea-induced or
      thermal unfolding transitions does not imply that the two-state model is not
      appropriate but that the linear extrapolation to zero molar denaturant is
      incorrect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347604
TI  - Mobility at the TpA cleavage site in the T3A3-containing AhaIII and PmeI
      restriction sequences.
AB  - Lefevre et al. originally observed conformational transitions at the TpA step in
      the TTAA Pribnow box sequence of the trp promoter [Lefevre, J.-F., Lane, A. N., &
      Jardetzky, O. (1985) FEBS Lett. 190, 37-40]. In 500-MHz 1H NMR studies on the
      TnA(n)-containing DNA oligonucleotides [d(CGAGGTTTAAACCTCG)]2,
      [d(GCTCCTTTAAAGGAGC)]2, and [d(GCCGTTAACGGC)]2, we observe that, in addition to
      the H2 proton (which resides in the minor groove of DNA), the H8 proton of the
      first adenine (which resides in the major groove) is also broadened due to motion
      at the TpA junction. In analogous 16-mers where the T3A3 segment has been
      replaced by an A3T3 sequence, and therefore contains CA, GA, and AT steps (but no
      TA steps), all adenine proton resonances are narrow, indicating that the
      broadening occurs only at TpA steps. Assuming chemical exchange in the form of
      conformational dynamics, e.g., oscillation of the purine base about the
      glycosidic torsion angle, the experimental 500-MHz 1H T1 rho and 2D-NOESY data
      were used to constrain the correlation time of the internal motion to a range
      between the T1 and T1 rho minima. Calculated line shapes using a two-site
      exchange model indicate that the motion has an amplitude of 20-50 degrees with an
      associated tau c of ca. 1.6 x 10(-4) to 1.0 x 10(-5) s rad-1, respectively. The
      mobility appears to be a consequence of the structure at the TpA junction which
      is characterized by (1) a wide minor groove between two regions of narrow minor
      groove, (2) an unusual average orientation of the adenine heterocycle probably
      resulting from a poor base-stacking interaction of the adenine with the preceding
      thymine, and (3) a sharp discontinuity in the sugar conformation at the TpA step.

PMID- 8347605
TI  - Solution structure of cardiotoxin V from Naja naja atra.
AB  - Cardiotoxins are small proteins that are found in the venoms of snakes from the
      Elapidae family. These toxins are known to bind to and disrupt the organization,
      integrity, and function of the cell membrane. Most of the well-studied
      cardiotoxins cause depolarization of membrane potentials and/or lysis of red
      cells. In contrast, CTX V from Naja naja atra displays poor hemolytic activity
      but is proficient at inducing aggregation and fusion of sphingomyelin vesicles
      [Chien et al. (1991) J. Biol. Chem. 266, 3252-3259]. To determine whether the
      unique activity of this CTX is attributable to its tertiary structure, the
      solution structure of CTX V was determined by NMR methods. On the basis of these
      studies, this cardiotoxin has the same general topology as other members of the
      family, and thus its unusual properties do not arise from any gross structural
      differences that are detectable by solution NMR methods. Molecular dynamics
      calculations indicate that residues 36-50 show concerted fluctuations. On the
      basis of sequence similarity, we postulate that residues 30-34 are important in
      determining the specificity of cardiotoxins for fusion versus lysis of vesicles.

PMID- 8347606
TI  - Electrostatic calculations of side-chain pK(a) values in myoglobin and comparison
      with NMR data for histidines.
AB  - Site-specific titration curves for 12 histidine residues in carbon monoxy sperm
      whale myoglobin (MbCO) have been determined from two-dimensional (2D) double
      quantum NMR experiments. Eight of these histidine residues are observed to
      titrate over the accessible pH range, and pK(a) values have been determined;
      bounds on the titration midpoints of the remaining four histidines are also
      reported. Results for residues 48, 81, and 119 differ significantly from those
      estimated from earlier, one-dimensional studies, but they are in good agreement
      with values recently determined for metaquomyoglobin. These experimental values
      (plus those determined earlier for tyrosine titrations) are compared to
      predictions from crystal structures of myoglobin using a numerical Poisson
      Boltzmann model and a Monte Carlo treatment of the multiple-site titration. An
      extension of existing models is described that accounts for alternate tautomers
      for histidines. Calculations are reported using several choices for radii and
      charges, and for five crystal structures, in order to assess the sensitivity of
      the results to details of the calculations. In general, the agreement between
      calculated and observed titration behavior suggests that this theoretical model
      captures much of the electrostatic behavior in this system, even though it
      ignores conformational fluctuations and the differences in mean structures that
      may exist between crystal and solution. Interactions among titrating groups are
      often important; in general, these interactions lead to more gradual individual
      site titrations (the mean Hill coefficient is about 0.8), and in several cases
      the interactions are so strong that two side chains need to be considered as a
      unit and single residues may participate in two-step titrations. It is suggested
      that histidines involved in such two-step titrations and carboxylic acid residues
      with abnormally low pK(a) values in the native conformation may be involved in
      the acid-induced partial unfolding of MbCO.

PMID- 8347607
TI  - The G protein alpha s subunit incorporates [3H]palmitic acid and mutation of
      cysteine-3 prevents this modification.
AB  - We investigated whether alpha s could be acylated by palmitate by transfecting
      COS cells with the cDNA for the wild-type, long form of alpha s and metabolically
      labeling with [3H]palmitate or [35S]methionine. Cells were separated into
      particulate and soluble fractions and immunoprecipitated with a specific peptide
      antibody. [3H]Palmitate was incorporated into both endogenous and transfected
      alpha s. Inhibition of protein synthesis with cycloheximide did not block the
      radiolabeling of alpha s with [3H]palmitate. Hydroxylamine treatment caused a
      release of the tritium radiolabel, demonstrating that the incorporation was
      through a thioester bond. The tritium radiolabel was base-labile and comigrated
      with [3H]palmitate on thin-layer chromatography. The third residue of the wild
      type alpha s was mutated from a cysteine to an alanine by site-directed
      mutagenesis. This mutant was expressed in COS cells and localized to the
      particulate fraction as determined by immunoprecipitation of the [35S]methionine
      labeled cells. The cysteine-3 mutant did not undergo radiolabeling with
      [3H]palmitate, indicating that this residue is crucial for the modification.

PMID- 8347608
TI  - Structure of the altromycin B (N7-guanine)-DNA adduct. A proposed prototypic DNA
      adduct structure for the pluramycin antitumor antibiotics.
AB  - Altromycin B belongs to the pluramycin family of antitumor antibiotics, which
      also includes kidamycin, hedamycin, pluramycin, neopluramycin, DC92-B, and
      rubiflavin A. These potent antitumor compounds react with DNA in as yet
      imprecisely determined ways. In the present investigation, we have used gel
      electrophoresis methods in combination with nuclear magnetic resonance and mass
      spectrometry to determine the structure of the altromycin B-DNA adduct. High
      resolution gel electrophoresis demonstrated that guanine was the reactive base,
      and N7 was implicated from experiments in which N7-deazaguanine was used in place
      of guanine in a strand breakage assay. Experiments using supercoiled DNA
      demonstrated that altromycin B and related drugs intercalated into DNA, which
      implicated this as a common mechanism for binding of the pluramycin antibiotics
      to DNA. The altromycin B-guanine adduct was isolated from calf thymus DNA after
      thermal depurination of the alkylated DNA. Mass spectrometry confirmed that
      altromycin alkylated DNA through guanine, and 1H- and 13C-NMR was used to confirm
      the covalent linkage sites between altromycin B and guanine. On the basis of
      these results, we propose that altromycin B first intercalates into DNA via a
      threading mechanism, reminiscent of nogalamycin, to insert the disaccharide into
      the minor groove and position the epoxide in the major groove in proximity to N7
      of guanine. Nucleophilic attack from N7 of guanine leads to an acid-catalyzed
      opening of the epoxide, resulting in the altromycin B-DNA adduct. On the basis of
      these results, a general mechanism for the interaction of the pluramycin family
      of antibiotics with DNA is proposed.

PMID- 8347609
TI  - Structure of the complex between pyridoxal 5'-phosphate and the tyrosine 225 to
      phenylalanine mutant of Escherichia coli aspartate aminotransferase determined by
      isotope-edited classical Raman difference spectroscopy.
AB  - The azomethine (Schiff base) linkage between the epsilon-amino group of active
      site lysine 258 and the carbonyl moiety of enzyme-bound pyridoxal 5'-phosphate
      (PLP) normally exhibits absorbance maxima at ca. 360 (high-pH form) or ca. 430 nm
      (low-pH form). However, the absorbance maximum is shifted from 358 to 386 nm, a
      value which is similar to that of free PLP (lambda max = 388 nm), in a mutant
      form of Escherichia coli aspartate aminotransferase (AATase) in which tyrosine
      225, which normally donates a hydrogen bond to the phenolate function of PLP, has
      been replaced with phenylalanine (Y225F). This spectral shift suggested that PLP
      binds to Y225F as the free aldehyde. The following evidence from isotope-edited
      classical Raman spectroscopy proves conclusively that the near-UV spectrum is
      anomalous and that PLP is bound to Y225F as a Schiff base: (1) A strong cofactor
      peak at 1630 cm-1 in the holoenzyme-minus-apoenzyme difference spectrum of the
      unprotonated form of Y225F is red-shifted by 18 cm-1 in enzyme labeled with 15N
      at lysine 258 and other positions. (2) This isotope-induced red shift is similar
      to that observed in the unprotonated form of the model Schiff base, PLP-valine.
      (3) The Raman spectrum of Y225F is unchanged in H(2)18O, while peaks at ca. 1670
      cm-1 in the spectrum of free PLP or in that of a mutant of AATase in which Lys
      258 is replaced with Ala, are red-shifted by ca. 30 cm-1 in H(2)18O.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8347610
TI  - Influence of chemistry in immobilization of cobra venom phospholipase A2:
      implications as to mechanism.
AB  - Phospholipase A2 from Naja naja kaouthia venom was covalently coupled onto
      agarose beads using two different chemistries. The effect of micellar competitive
      inhibitors in the coupling media was evaluated. Enzyme bound to N
      hydroxysuccinimide-activated agarose, which is reactive primarily toward epsilon
      amino groups, had 20% activity retention against micellar
      diheptanoylphosphatidylcholine (DiC7-PC). Enzyme bound through carboxylic groups,
      using a modification of the carbodiimide method, had 50% retention. Similar
      relative activities were observed, for both conjugates, in monomeric dihexanoyl
      PC and in mixed micelles of Triton X-100 with dipalmitoyl-PC or
      dioleoylphosphatidylethanolamine. The soluble form of the enzyme showed
      premicellar activation against monomeric DiC7-PC, while the immobilized form
      showed interfacial recognition at concentrations around the critical micellar
      concentration. These results suggest that the enzyme activity lost upon
      immobilization is a result of the inherent chemical modification of the enzyme
      and that enzyme oligomerization and interfacial recognition are not cause-effect
      phenomena.

PMID- 8347611
TI  - Catalysis of a protein folding reaction: thermodynamic and kinetic analysis of
      subtilisin BPN' interactions with its propeptide fragment.
AB  - The in vivo folding of subtilisin is dependent on a 77 amino acid propeptide,
      which is eventually cleaved from the N-terminus of subtilisin to create the 275
      amino acid mature form of the enzyme (Ikemura et al., 1987). We have cloned,
      expressed, and purified large quantities of the 77 amino acid subtilisin
      propeptide. This has enabled us to characterize its participation in the
      subtilisin folding reaction by spectroscopic and microcalorimetric methods.
      Unfolded subtilisin, when returned to native conditions, is kinetically isolated
      from its native state. Folding of subtilisin with the native calcium site-A is
      extremely slow even in the presence of a high concentration of isolated
      propeptide. The folding of a calcium-free mutant subtilisin, however, is readily
      catalyzed by the isolated propeptide. The propeptide-subtilisin folding reaction
      can be described as the following equilibrium: P(u) + S(u)<==>P-S<==>Pf
      Sf<==>P(u) + Sf, where S(u) and P(u) are subtilisin and propeptide, respectively,
      which are largely unstructured at the start of the reaction; P-S is a collision
      complex of unfolded subtilisin and propeptide; Pf-Sf is the complex of folded
      subtilisin and propeptide; and Sf is folded subtilisin. The rate-limiting step in
      the folding reaction of calcium-free mutant subtilisin is formation of the
      initial collision complex, P-S. The rate at which P(u) and S(u) form a productive
      collision complex is approximately 500 M-1 s-1. The collision complex appears to
      be an early folding unit which, once formed, results in rapid isomerization to
      the fully folded complex. The rate constant for isomerization of the collision
      complex to the folded complex is > or = 0.5 s-1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347613
TI  - Dimerization of Thermomonospora fusca beta-1,4-endoglucanase E2.
AB  - Unboiled Thermomonospora fusca endoglucanase E2 electrophoresed on SDS
      polyacrylamide gels migrated in the range of 80-90 kDa, but when boiled it
      migrated in the 40-42-kDa range. Sedimentation equilibrium centrifugation as well
      as chemical cross-linking experiments confirmed that E2 is a dimer. The dimer was
      reversibly dissociated at low pH. The E2 dimer was stable up to 70 degrees C, but
      began to dissociate at this temperature after a 30-60-min incubation. A
      nondimerizing mutant was obtained using region-specific chemical mutagenesis. DNA
      sequencing of this mutant revealed a single base change that substituted Gly for
      Glu-263. Chemical modification of carboxylic acid residues in E2 disrupted the
      dimer interaction.

PMID- 8347612
TI  - Specificity studies on the heparin lyases from Flavobacterium heparinum.
AB  - An understanding of the substrate specificity study of the heparin lyases
      (heparinase and heparitinases) is crucial for elucidation of the sequence of
      heparin and heparan sulfate. Four chemically modified heparins have been used to
      study the substrate specificity of the three heparin lyases. These modified
      heparins include the N- and O-desulfated and then specifically N-sulfated or N
      acetylated derivatives of heparin and a modified heparin containing L
      galactopyranosyluronic acid residues. These chemically modified heparins were
      degraded to various extents by the three heparin lyases. Differences in degree of
      sulfation have profound impact on the ease of cleavage of glycosidic linkages.
      Heparin lyase I (EC 4.2.2.7) is selective in cleaving highly sulfated
      polysaccharide chains containing linkages to 2-O-sulfated alpha-L
      idopyranosyluronic acid residues. Heparin lyase III (EC 4.2.2.8) cleaves linkages
      that have reduced density of sulfation and that contain beta-D
      glucopyranosyluronic acid residues. The ability of heparin lyase III to act on
      linkages to unsulfated alpha-L-idopyranosyluronic acid residues is observed for
      the first time. Heparin lyase II (no assigned EC number) demonstrates an
      unparalleled, wide specificity for substrates comprised of linkages containing
      both alpha-L-idopyranosyluronic and beta-D- glucopyranosyluronic acid residues.
      Heparin lyase II can also act on substrates containing linkages to unnatural
      alpha-L-galactopyranosyluronic acid residues. The high level of specificity of
      heparin lyase I makes it particularly suitable for use in the sequencing of
      heparin and heparan sulfate, while caution must be exercised in using heparin
      lyases II and III to sequence heparin and heparan sulfate because of their
      relatively broad specificity.

PMID- 8347615
TI  - Disulfide arrangement and functional domains of beta-1,4-endoglucanse E5 from
      Thermomonospora fusca.
AB  - Thermomonospora fusca cellulase E5 contains six cysteine residues. The number and
      location of the disulfide bonds and the effect of reduction of the disulfides and
      modification of the resulting half-cystine residues on enzymatic activity were
      determined. No free sulfhydryl groups were found in E5. Reduction and subsequent
      labeling with iodoacetamide of E5 and of an enzymatically active 32-kDa
      proteolytic derivative of E5 (E5cd) showed that one of the three disulfides is
      accessible to reduction under nondenatured conditions while the other two are not
      accessible. Full reduction of the disulfides and complete carboxymethylation of
      the six cysteines decrease the specific activity of E5 on CMC by more than half,
      but reduction of only the exposed disulfide bond does not affect enzymatic
      activity or binding of E5 to cellulose. A 14-kDa proteolytic fragment of E5
      containing 120 amino acids from the N-terminus of the protein was shown to bind
      to crystalline cellulose. This confirms earlier evidence that the cellulose
      binding domain of E5 is located at the N-terminus of the protein. This 14-kDa
      fragment contains the accessible disulfide bond involving Cys93 and Cys100. The
      location of the two disulfide bonds in the other fragment (E5cd) was determined
      by cleaving it with cyanogen bromide under conditions that left the disulfide
      bonds intact. The resulting peptides were separated under both nonreducing and
      reducing conditions using RP-HPLC. Amino acid analysis of peptide peaks indicated
      that one disulfide linkage in E5cd joins Cys138 to Cys143 while the other joins
      Cys166 to Cys406.

PMID- 8347614
TI  - Disulfide arrangement and chemical modification of beta-1,4-endoglucanase E2 from
      Thermomonospora fusca.
AB  - Thermomonospora fusca endoglucanase E2 contains six cysteine residues scattered
      along the protein sequence. Four of the cysteine residues were shown to
      participate in two disulfide bonds while the last two form a third disulfide
      bond. Neither full reduction of the disulfides nor complete carboxymethylation of
      all six cysteines totally destroys enzymatic activity, but the activity of the
      reduced enzyme is much lower than the native enzyme and the iodoacetamide
      modified enzyme has very low activity. Reduction of only the accessible
      disulfides drastically decreases the enzyme's thermostability. One disulfide
      linkage joins Cys80 to Cys125, another joins Cys232 to Cys267, and the third
      joins Cys315 to Cys407. The first two bonds are similar to those in
      cellobiohydrolase II, which also belongs to cellulase family B (Rouvinen et al.,
      1990; Lao et al., 1991; Henrissat et al., 1989). Direct evidence for the
      involvement of carboxyl groups in catalysis by E2 was demonstrated by chemical
      modification with carbodiimide.

PMID- 8347616
TI  - The anion requirement for iron release from transferrin is preserved in the
      receptor-transferrin complex.
AB  - Rates of iron release from both sites of free transferrin at pH 7.4 are
      critically dependent upon ionic strength, because release appears to require
      binding of a simple nonchelating anion such as chloride to a kinetically active
      site of the protein. This site is distinct from the synergistic anion-binding
      site, occupancy of which is required for binding of iron to occur at all.
      Complexing of transferrin to its receptor also modulates release of iron, but in
      a more complex fashion. At extracellular pH, 7.4, receptor retards release, but
      at the pH of the endosome in which release occurs within the cell, 5.6, receptor
      accelerates release. The present study was undertaken to determine whether the
      kinetically active anion requirement is maintained at pH 5.6 and whether the
      effects of anion binding and receptor binding are independent of each other. A
      spectrofluorometric method was developed to monitor release of iron from C
      terminal monoferric human transferrin and its complex with the transferrin
      receptor. At pH 5.6, as at pH 7.4, profiles of iron release to pyrophosphate from
      free and from receptor-complexed monoferric transferrin show curvilinear
      dependence on pyrophosphate concentration, consistent with a previously described
      kinetic scheme and suggestive of a similar release mechanism in all cases.
      Furthermore, at pH 5.6 release rates depend upon anion (chloride) concentration
      in free and in receptor-complexed transferrin as in free transferrin at pH 7.4,
      extrapolating nearly to zero as chloride concentration approaches zero. The
      enhancing effect of receptor on release is displayed at all concentrations of
      chloride tested,indicating that the release-promoting effects of receptor and
      chloride are independent of each other.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347617
TI  - Functional methionines in the collagen/gelatin binding domain of plasma
      fibronectin: effects of chemical modification by chloramine T.
AB  - Chemical modification of plasma fibronectin (pFn) or its 40-kDa collagen/gelatin
      binding (CGB) domain by low concentrations of chloramine T (CT), a methionine
      specific oxidant, caused decreased binding affinity between pFn or the isolated
      CGB domain and Sepharose-immobilized denatured collagen or a Texas Red-labeled
      CNBr fragment CB7 from the alpha 1 chain of type I collagen. Kds obtained by
      fluid-phase fluorescence polarization binding assays increased upon oxidation
      about 17-fold for pFn and by 4-fold for the CGB domain. Comparison of CT-oxidized
      and native CGB domains by endogenous tryptophan fluorescence and CD spectra gave
      no indication of conformational changes. delta GH2O, the free energy of unfolding
      at infinite denaturant dilution, derived from guanidinium chloride denaturation
      curves, differed by less than 0.7 kcal/mol for the oxidized and native CGB
      domains, indicating essentially equivalent conformational stabilities. We show
      here that methionyl residues found at positions 412, 432, and 446 are the sites
      of the oxidative modification. Modification protection experiments carried out in
      the presence of gelatin demonstrated specific protection of otherwise oxidizable
      methionyl residues and preservation of high-affinity binding. These results
      implicate methionyl residues as functional in contributing to high-affinity
      binding interaction between fibronectin and gelatin.

PMID- 8347618
TI  - Synthesis and processing of D2 dopamine receptors.
AB  - Dopamine receptors belong to a superfamily of neurotransmitter receptors that are
      functionally coupled to guanine nucleotide binding proteins. In this study, we
      have used Chinese hamster ovary (CHO) cells stably transfected with the rat D2L
      receptor, in conjunction with specific anti-peptide antibodies that we have
      developed, in order to visualize this protein and the course of its synthesis.
      The newly synthesized receptor exists as a 45-kDa protein which undergoes further
      processing to a 75-kDa glycosylated receptor in the CHO cells. In pulse-chase
      experiments it was noticed that a 35-kDa precursor was present which disappeared
      after 30 min. In order to determine whether this 35-kDa protein represents an
      unprocessed form of the receptor, we have employed an in vitro translation system
      with cDNA constructs coding for both the murine D2 and D3 dopamine receptor
      isoforms. In the absence of processing, the D2 and D3 receptors have an apparent
      molecular mass of 35 kDa. The translated proteins were shown to be the full
      length receptors by immunoprecipitation with various anti-peptide antibodies and
      by the demonstration that they can undergo glycosylation to apparent molecular
      masses of approximately 45 kDa in an in vitro system.

PMID- 8347619
TI  - Real-time measurements of kinetics of EGF binding to soluble EGF receptor
      monomers and dimers support the dimerization model for receptor activation.
AB  - We have tested one aspect of the allosteric dimerization model for the activation
      of EGF receptor (EGFR) by EGF: whether EGF binding favors dimerization of the
      receptor. For this to be true, EGF molecules must bind with higher affinity to
      dimeric receptors than to monomeric receptors. We have tested this directly in a
      defined system using the soluble, extracellular ligand binding domain of EGFR
      monomers (sEGFR) and sEGFR dimers stabilized by treatment with a covalent cross
      linking agent. We describe real-time kinetic measurements of EGF binding to
      receptor monomers and dimers employing the method of total internal reflection
      (surface plasmon resonance). Our data show that sEGFR dimers bound EGF with 30-40
      fold higher affinity [KD = (2-3) x 10(-8) M] than did sEGFR monomers. The
      enhanced binding affinity of sEGFR dimers resulted mainly from a reduced off-rate
      with k(off) = 0.001 s-1 for sEGFR dimers as compared to k(off) = 0.06 s-1 for
      sEGFR monomers. These measurements indicate that dimerization of sEGFR increases
      its affinity for EGF by prolonging the amount of time that EGF remains bound to
      the receptor. This provides evidence that EGF binding stabilizes receptor
      dimerization and provides further support for the allosteric dimerization model
      as a mechanism for ligand induced receptor activation.

PMID- 8347620
TI  - Two upstream cysteines and the CAAX motif but not the polybasic domain are
      required for membrane association of Xlcaax in Xenopus oocytes.
AB  - We have analyzed the role of several protein motifs in controlling the membrane
      association of the xlcaax-1 protein in Xenopus oocytes. Xlcaax-1 is a maternally
      expressed protein that during development is associated with the basal lateral
      membrane of polarized epithelial cells. It is enriched in the tubule cells of the
      adult kidney and several other organs that are involved in osmoregulation. Xlcaax
      1 has a C-terminal CAAX sequence (CVVM) identical to that of N-ras, followed by
      two cysteines that are potential palmitoylation sites and a polybasic domain.
      Mutants were constructed that either deleted specific domains or changed specific
      amino acids of the consensus sequences in or near the CAAX motif. Synthetic mRNAs
      were injected into Xenopus oocytes and their protein products analyzed for their
      ability to associate with the oocyte plasma membrane. A mutation changing
      cysteine-588 of the CAAX box to serine or the inhibition of prenylation by
      lovastatin eliminated the membrane association of the protein. Mutation of either
      of the upstream cysteines (either 585 or 587) also inhibited the association of
      xlcaax-1 with the membrane. Unlike Ras, however, deletion of the polybasic domain
      had no effect on membrane binding. In addition, we show that xlcaax-1 binds ATP
      but not GTP.

PMID- 8347621
TI  - pH-dependent association of chromogranin A with secretory vesicle membrane and a
      putative membrane binding region of chromogranin A.
AB  - Chromogranin A is a low-affinity, high-capacity Ca2+ binding protein, postulated
      to be responsible for the Ca2+ buffering role of secretory vesicles, and has been
      found only in the soluble portions of the vesicular proteins. Contrary to the
      generally accepted notion of chromogranin A existing as a soluble matrix protein,
      chromogranin A bound to the secretory vesicle membrane at the intravesicular pH
      of 5.5 and freed from the membrane when the pH was raised to a more physiological
      pH of 7.5. Trypsin digestion studies of the vesicle membrane suggested that
      chromogranin A interacts with the protein component(s) on the intravesicular side
      of the membrane. Furthermore, in a study using 14 synthetic chromogranin A
      peptides which represent various portions of chromogranin A, a segment in the N
      terminal region (residues 18-37) was shown to bind to the vesicle membrane in a
      pH-dependent manner. The pH-dependent vesicle membrane binding property of
      chromogranin A appears to be of fundamental physiological importance with regard
      to the potential roles of chromogranin A in secretory vesicle biogenesis,
      particularly in segregating secretory vesicle membranes from others in the trans
      Golgi network, and also in transmitting extravesicular signals such as inositol
      1,4,5-trisphosphate or inositol 1,3,4,5-tetrakisphosphate for Ca2+ release or
      uptake to the inside of vesicles.

PMID- 8347622
TI  - Interactions of model human pulmonary surfactants with a mixed phospholipid
      bilayer assembly: Raman spectroscopic studies.
AB  - The temperature dependence and acyl chain packing properties of the binary lipid
      mixtures of dipalmitoylphosphatidylcholine-d62 (DPPC
      d62)/dipalmitoylphosphatidylglycerol (DPPG) multilayers, reconstituted with two
      synthetic peptides for modeling the membrane behavior of the SP-B protein
      associated with human pulmonary surfactant, were investigated by vibrational
      Raman spectroscopy. The synthetic peptides consisted of 21 amino acid residues
      representing repeating charged units of either lysine or aspartic acid separated
      by hydrophobic domains consisting of four leucines (KL4 or DL4, respectively).
      These peptides were designed to mimic the alternating hydrophobic and hydrophilic
      sequences defining the low molecular weight SP-B protein. Raman spectroscopic
      parameters consisting of integrated band intensities, line widths, and relative
      peak height intensity ratios were used to probe the bilayer order/disorder
      characteristics of the liposomal perturbations reflected by the reconstituted
      membrane assemblies. Temperature profiles derived from the various Raman
      intensity parameters for the 3100-2800-cm-1 carbon-hydrogen (C-H) and the 2000
      2300-cm-1 carbon-deuterium (C-D) stretching mode regions, spectral intervals
      representative of acyl chain vibrations, reflected lipid reorganizations specific
      to peptide interactions with either the DPPC-d62 or DPPG component of the
      liposome. For the multilamellar surfactant systems composed of either KL4 or DL4
      reconstituted with the binary DPPG/DPPC-d62 lipid mixture, the breadth of the gel
      to liquid crystalline phase transition temperatures TM, defined by acyl chain C-H
      and C-D stretching mode order/disorder parameters, increased from about 1 degree
      C in the peptide-free systems to over 10 degrees C. This breadth in TM indicates
      an increased lipid disorder and a distinct noncooperative chain melting process
      for the model liposomes. In comparing the interactions of the synthetic peptides
      with DPPG/DPPC mixtures and with DPPC liposomes alone, the negatively charged DL4
      peptide perturbs the DPPG component of the lipid mixture more strongly than the
      DPPC-d62 component; moreover, the DL4 peptide disrupts the structure of the DPPG
      lipid domains in the binary mixture to a greater extent than the KL4 peptide. The
      microdomain heterogeneity of the binary lipid mixture arising from lipid-peptide
      interactions is discussed in terms of the Raman spectral properties of the
      multilayers. The Raman data in conjunction with previous bubble surfactometer and
      animal studies (Cochrane & Revak, 1991) suggest that lipid domain structures are
      present in functional surfactants and that the dynamic bilayer microheterogeneity
      induced by the surfactant peptide or protein is essential for pulmonary
      mechanics.

PMID- 8347623
TI  - Subunit interactions in the carboxy-terminal domain of phytochrome.
AB  - We have produced defined fragments of the oat PhyA AP3 protein using an in vitro
      translation system and analyzed the quaternary structure of these fragments by
      size exclusion chromatography. Sequences between amino acids S599 and L683 are
      shown to dimerize by this in vitro assay and by a lambda repressor-based in vivo
      assay. A subset of this dimerization region, V623-S673, which has previously been
      identified as being involved in interdomain interactions on the basis of the
      behavior of overlapping constructs in a lambda repressor assay for protein
      protein interaction, is shown by both assays to be necessary but insufficient for
      dimerization. Sequences between L685 and R815, which are unable to dimerize by
      themselves, are shown to interact with sequences between S599 and L683. Sequences
      E1069-Q1129, also previously suggested to be involved in dimerization, are shown
      here not to be required for phytochrome dimerization. These results based on an
      in vitro assay have confirmed some of the results previously obtained using an in
      vivo assay and extend these earlier results by revealing new protein-protein
      interactions. This dissection of sequences involved in phytochrome dimerization
      taken together with previous work has enabled us to propose a model for the
      behavior of the dimerization region where the core structure involved in
      dimerization is located on both sides of a region around residue 750 found at the
      surface.

PMID- 8347624
TI  - Rate of oxidation of P680 in isolated photosystem 2 reaction centers monitored by
      loss of chlorophyll stimulated emission.
AB  - We have continued our studies of the primary photochemistry of isolated
      photosystem 2 reaction centers using femtosecond transient absorption
      spectroscopy. Experiments were performed over a wide range of excitation and
      probe wavelengths, using several data collection time scales. This has enabled us
      to resolve five different lifetimes ranging between 100 fs and 200 ps plus a
      nanosecond component. We demonstrate here and elsewhere [e.g., Durrant, J.R.,
      Hastings, G., Joseph, D. M., Barber, J., Porter, G., & Klug, D. R. (1992) Proc.
      Natl. Acad. Sci. U.S.A. 89, 11632-11636] that the kinetic spectra associated with
      all but two of these lifetimes are clearly distinguishable. We have previously
      reported that a 21-ps lifetime is associated with pheophytin reduction [Hastings,
      G., Durrant, J. R., Hong, Q., Barber, J., Porter, G., & Klug, D. R. (1992)
      Biochemistry 31, 7638-7647]. In this paper, we show that it is possible to
      spectrally and temporally resolve stimulated emission from PS2 reaction centers
      with great accuracy and that this stimulated emission is largely unaffected by
      those kinetic components which are faster than 21 ps. The observation of a
      distinct stimulated emission band allows us to distinguish charge-separated
      states from chlorin singlet states. In this way, we are able to show that the
      proportion of charge-separated states prior to the 21-ps component is between 0%
      and 25%. We also show that the shape of the spectrum which we obtain for the
      state P680+Ph- is essentially invariant between 100 ps and 9 ns, and is the same
      as that previously reported for P680+Ph- by other researchers.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8347625
TI  - Synthesis and damage specificity of a novel probe for the detection of abasic
      sites in DNA.
AB  - The abasic site (apurinic/apyrimidinic site) is the most common lesion in DNA and
      is suggested to be an important intermediate in mutagenesis and carcinogenesis.
      We have recently reported a novel assay for the detection and quantitation of
      abasic sites in DNA [Kubo, K., Ide, H., Wallace, S. S., & Kow, Y. W. (1992)
      Biochemistry 31, 3703-3708]. In this assay, the aldehyde group in an abasic site
      is first modified by a probe bearing a biotin residue, called the Aldehyde
      Reactive Probe (ARP) and then the tagged biotin is quantified by an ELISA-like
      assay. However, in the previous study, ARP was prepared only in a crude form, and
      no solid chemical data concerning the structure and specificity of ARP were
      reported. In this study, an improved method for the preparative synthesis of ARP
      has been established, and its structure has been unambiguously characterized
      using spectroscopic means. In order to elucidate the specificity of ARP to DNA
      damages, ARP was incubated with a variety of damaged bases or nucleosides and the
      reaction mixtures were analyzed by HPLC. Of the 14 compounds tested for their
      reactivity to ARP, 2-deoxyribose (a model compound for an abasic site) and 5
      formyluracil reacted with ARP. Interestingly, compounds bearing a formamide group
      such as formamidopyrimidine and deoxyribosylformamide did not react with ARP,
      indicating that ARP is specific to damages having an alkyl or allyl aldehyde
      group. Furthermore, the ability of ARP synthesized by the defined chemical route
      to detect abasic sites has been substantiated using natural DNA containing abasic
      sites. Potential applications and limitations of the ARP assay are discussed.

PMID- 8347626
TI  - Evidence for an imino intermediate in the T4 endonuclease V reaction.
AB  - Reductive methylation and site-directed mutagenesis experiments have implicated
      the N-terminal alpha-amino group of T4 endonuclease V in the glycosylase and
      abasic lyase activities of the enzyme. NMR studies have confirmed the involvement
      of the N-terminal alpha-amino group in the inhibition of enzyme activity by
      reductive methylation. A mechanism accounting for these results predicts that a
      (imino) covalent enzyme-substrate intermediate is formed between the protein N
      terminal alpha-amino group and C1' of the 5'-deoxyribose of the pyrimidine dimer
      substrate subsequent to (or concomitantly with) the glycosylase step. Experiments
      to verify the existence of this intermediate indicated that enzyme inhibition by
      cyanide was substrate-dependent, a result classically interpreted to imply an
      imino reaction intermediate. In addition, sodium borohydride reduction of the
      intermediate formed a stable dead-end enzyme-substrate product. This product was
      formed whether ultraviolet light-irradiated high molecular weight DNA or duplex
      oligonucleotides containing a defined thymine-thymine cyclobutane dimer were used
      as substrate. The duplex oligonucleotide substrates demonstrated a well-defined
      gel shift. This will facilitate high-resolution footprinting of the enzyme on the
      DNA substrate.

PMID- 8347627
TI  - Formation of a cleavasome: enhancer DNA-2 stabilizes an active conformation of
      NaeI dimer.
AB  - Cleavage of DNA by NaeI-type restriction enzymes is stimulated by a DNA element
      with affinity for the activator site of the enzyme: a cleavage-enhancer DNA
      element. Measurements of the mobility of NaeI activity in comparison with protein
      standards on gel permeation columns and glycerol gradients demonstrated that
      NaeI, without enhancer, can form a 70,000 MW dimer. The dimer, however, is
      inactive: it could not cleave the "resistant" NaeI site in M13mp18 DNA in the
      absence of enhancer. In cleavage assays, enhancer stimulated either DNA nicking
      or DNA cleavage, depending upon NaeI concentration, and reduced the NaeI
      concentration required for the transition from nicking to cleavage activity. A
      gel mobility-shift assay of the interaction of NaeI with enhancer showed the
      formation of two complexes. Results using different sized DNAs and different
      percentage acrylamide gels for gel mobility-shift analysis implied that the two
      complexes were caused by NaeI monomer and dimer structures rather than one and
      two DNA binding. Dimer formation increased with the affinity of enhancer for
      NaeI. UV cross-linking "captured" the NaeI-enhancer complex; electrophoretic
      analysis of the cross-linked products showed NaeI dimer bound to enhancer. These
      results imply a model for cleavage enhancement in which enhancer binding
      stabilizes an active NaeI dimer conformation ("cleavasome") that cleaves both DNA
      strands before dissociating.

PMID- 8347628
TI  - Assignment of 1H, 15N, and backbone 13C resonances in detergent-solubilized M13
      coat protein via multinuclear multidimensional NMR: a model for the coat protein
      monomer.
AB  - The major coat protein (gVIIIp) of bacteriophage M13 complexed with SDS detergent
      micelles was used as a model system to study the lipid-bound conformation of the
      protein. Conditions were found that allowed the recording of good quality of NMR
      spectra. By making extensive use of three-dimensional heteronuclear (13C, 15N)
      NMR, we obtained a complete set of resonance assignments for 1HN, 1H alpha, 1H
      beta, 13C alpha, CO, and 15N and partially assigned the rest of the 1H spectrum.
      Analysis of NOE and chemical shift data reveals that gVIIIp is composed of two
      alpha-helical domains, one ranging from Pro-6 to Glu20 and the other ranging from
      Tyr-24 all the way to the C-terminus Ser-50. In contrast to the results reported
      by Henry and Sykes [Henry, G.D., & Sykes, B.D. (1992) Biochemistry 31, 5285
      5297], at a high SDS to protein ratio the protein appears to be monomeric.

PMID- 8347630
TI  - Isoprenoid diphosphate utilization by recombinant human farnesyl:protein
      transferase: interactive binding between substrates and a preferred kinetic
      pathway.
AB  - The catalytic utilization of dimethylallyl, geranyl, farnesyl, and geranylgeranyl
      diphosphates in the reaction catalyzed by recombinant human farnesyl:protein
      transferase (hFPTase) has been examined in the presence of three different
      protein substrates, Ras-CVLS, Ras-CVIM, and Ras-CAIL. hFPTase catalyzed both
      farnesylation and geranylation of Ras-CVLS and of Ras-CVIM but not of Ras-CAIL.
      Geranylgeranylation was observed, but only when Ras-CVIM was the acceptor
      substrate. Steady-state initial velocity and dead-end inhibitor studies indicate
      that hFPTase-catalyzed geranylation, like bovine FPTase-catalyzed farnesylation,
      proceeds through a random order, sequential mechanism. Surprisingly, however,
      Michaelis constants for a given protein acceptor substrate varied depending upon
      which isoprenoid diphosphate was used as the donor substrate, showing that these
      substrates do not bind independently to the enzyme (under catalytic conditions).
      In addition, at very high concentrations of Ras-CVIM, substrate inhibition was
      observed in the presence of both FPP and GPP. Isotope partitioning studies showed
      that, at high concentrations of Ras-CVIM, more than 80% of the bound farnesyl
      diphosphate (FPP) can be trapped as product, suggesting that the binary complex
      is catalytically competent and that the ternary complex proceeds to product
      faster than it releases FPP. The release rate of FPP from the binary complex was
      calculated to be 0.05 s-1, which is only about eight times greater than kcat.
      Thus, the binding of FPP to the enzyme in the presence of the protein substrate
      is not an equilibrium situation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347629
TI  - Novel heteronuclear methods of assignment transfer from a diamagnetic to a
      paramagnetic protein: application to rat cytochrome b5.
AB  - 15N and 1H resonance assignments for backbone and side-chain resonances of both
      equilibrium forms of rat ferricytochrome b5 have been obtained, using a
      combination of novel heteronuclear assignment transfer methods from the known
      assignments of the diamagnetic protein [Guiles, R. D., Basus, V. J., Kuntz, I.
      D., & Waskell, L. A. (1992) Biochemistry 31, 11365-11375] and computational
      methods which depend on an accurate determination of the orientation of the
      components of the susceptibility tensor. The transfer of amide proton resonance
      assignments takes advantage of the apparent insensitivity of amide 15N resonances
      to pseudocontact effects, evident in overlays of 15N-1H heteronuclear correlation
      spectra. Amide-proton resonance assignments tentatively transferred from the
      known diamagnetic assignments to the paramagnetic form of the protein were
      confirmed using conventional assignment strategies employing 600-MHz COSY,
      HOHAHA, and NOESY spectra of the oxidized protein. As was observed in rat
      ferrocytochrome b5, more than 40% of all residues exhibited NMR detectable
      heterogeneity due to the two different orientations of the heme. Complete
      assignment of both forms enabled accurate determination of the orientation of the
      susceptibility tensor for both conformations of the heme. The orientation of the
      z-component of the susceptibility tensors for the two forms are
      indistinguishable, while the in-plane components appear to differ by about 6
      degrees. Differences in the orientation of the in-plane susceptibility components
      are undoubtedly due dominantly to the relative axial rotation of the heme of
      between 5 degrees and 10 degrees indicated by the NOESY contacts to the protein
      observed in the spectra of the ferrocytochrome [Guiles, R. D., Basus, V. J.,
      Kuntz, I. D., & Waskell, L. A. (1992) Biochemistry 31, 11365-11375; Pochapsky, T.
      C., Sligar, S. G., McLachlan, S. J., & LaMar, G. N. (1990) J. Am. Chem. Soc. 112,
      5258-5263].

PMID- 8347631
TI  - Activation of the silent progesterone receptor gene by ectopic expression of
      estrogen receptors in a rat fibroblast cell line.
AB  - We describe the construction and characterization of a novel estrogen (E2)
      responsive cell line, Rat1+ER, which ectopically expresses estrogen receptor
      (ER). Human ER cDNA was introduced by retrovirus-mediated gene transfer into the
      Rat1 cell line, which does not express functional ER endogenously. Rat1+ER cells
      express functional ER based on radioreceptor assays, immunoblotting, and
      transient transfection experiments using E2-responsive reporter plasmids. The
      effects of this ectopic ER expression were studied on three endogenous E2
      responsive genes, prolactin (PRL), progesterone receptor (PR), and epidermal
      growth factor receptor (EGFR). PRL, usually expressed in the lactotrophs of the
      pituitary, is not expressed at all in Rat1+ER cells, with or without E2 addition,
      and appears to require other factors for expression. In contrast, although PR is
      not expressed in Rat1 cells, it is induced in Rat1+ER cells upon the addition of
      E2. This induction appears to occur at the transcriptional level and is
      insensitive to cycloheximide treatment. This is one of the few examples where the
      expression of one gene activates an otherwise silent gene. Another contrasting
      observation is that, although EGFR is basally expressed in Rat1+ER cells, the
      addition of E2 has no effect. Our studies paint a complicated picture of E2
      regulation of endogenous genes: the activation of the PR gene may only require
      the presence of E2 and ER, whereas EGFR and PRL genes require factors in addition
      to ER for basal as well as E2-regulated expression.

PMID- 8347633
TI  - Role of prenylation in the interaction of the a-factor mating pheromone with
      phospholipid bilayers.
AB  - We have studied the interaction between phospholipids and a-factor (YIIKGVFWDPAC
      [Farn]OMe), S-alkylated forms of a-factor with the farnesyl group substituted by
      methyl, hexadecanyl, or benzyl groups, and truncated forms of this lipopeptide.
      Circular dichroism studies suggest that, despite its lack of farnesylation, S
      methyl-a-factor is incorporated into vesicles of dimyristoylphosphatidylcholine
      in a conformation similar to that which a-factor adopts in this membrane.
      However, studies of the intrinsic fluorescence of the Trp residues of these
      peptides indicate that this residue is more deeply imbedded into the bilayer in
      the case of the farnesylated peptide. The a-factor is more effective in raising
      the bilayer to the hexagonal phase transition temperature of
      dielaidoylphosphatidylethanolamine than is the S-methyl-a-factor. This bilayer
      stabilizing ability is also reflected in a-factor inhibiting leakage from
      vesicles of N-methyldioleoylphosphatidylethanolamine. Studies on a-factor analogs
      permit the conclusion that the bilayer-stabilizing effect of a-factor is not
      solely a consequence of its greater partitioning into the membrane but is also a
      consequence of the degree of penetration into the bilayer and the specific
      conformation of the peptide at the membrane interface. These results indicate
      that the farnesyl group alone, in the absence of cellular factors, bestows a
      particular physical interaction with membranes.

PMID- 8347632
TI  - The chemical step is not rate-limiting during the hydrolysis by phospholipase A2
      of mixed micelles of phospholipid and detergent.
AB  - The effect of detergents on the overall catalytic turnover by secreted
      phospholipase A2 (PLA2) on codispersions of the substrate phospholipid is
      characterized. The overall rate of interfacial catalytic turnover depends on the
      effective substrate "concentration" (mole fraction) that the bound enzyme "sees"
      at the interface. Therefore, besides the intrinsic catalytic turnover rate
      determined by the Michaelis-Menten cycle in the interface [Berg et al. (1991)
      Biochemistry 30, 7283], two other interfacial processes significantly alter the
      overall effective rate of hydrolysis: first, the fraction of the total enzyme at
      the interface; second, the rate of replenishment of the substrate. At low mole
      fractions (< 0.3), bile salts promote the binding of pig pancreatic PLA2 to
      zwitterionic vesicles, and the rate of hydrolysis increases with the fraction of
      the enzyme in the interface. At higher (> 0.3) mole fractions of the detergent,
      the bilayer is disrupted, and the rate of hydrolysis decreases by more than a
      factor of 10. The detergent-dependent decrease in the rate of hydrolysis of the
      sn-2-oxyphospholipids is much larger than that of sn-2-thiophospholipid, and
      therefore the element effect (O/S ratio) decreases from about 10 in bilayers to
      less than 2 in mixed micelles. This loss of the element effect in mixed micelles
      shows that the chemical step is no longer rate-limiting during the hydrolysis of
      mixed micelles formed by the disruption of vesicles by the detergent. Such
      effects were observed with phospholipase A2 from several sources acting on
      substrates dispersed in a variety of detergents including bile salts, 2
      deoxylysophosphatidylcholine, and Triton X-100.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347634
TI  - Contributions of hydration and steric (entropic) pressures to the interactions
      between phosphatidylcholine bilayers: experiments with the subgel phase.
AB  - The total repulsive interaction between electrically neutral, fluid bilayer
      membranes is thought to have a number of components, including a hydration
      pressure, due to the reorientation of water by the bilayer, and steric (entropic)
      pressures due to bilayer undulations, head group motion, and molecular
      protrusions. For fully hydrated, crystalline bilayers these three steric
      pressures should be relatively small, and the major repulsive pressure present
      should be the hydration pressure. Therefore, to isolate the contribution of
      hydration pressure to the total interbilayer interaction, we have measured
      pressure-distance data by X-ray diffraction analysis of osmotically stressed
      dipalmitoylphosphatidylcholine (DPPC) multilayers in the subgel phase, where wide
      angle and low-angle X-ray data show the bilayers are crystalline. As applied
      pressure was increased from 0 to 1 x 10(6) dyn/cm2, the interbilayer fluid space
      (df) decreased less than 1 A from its value at full hydration of 8.4 A. As the
      pressure was increased from 1 x 10(6) to 3 x 10(7) dyn/cm2, df decreased from
      about 8 to 4 A. For this range of df, the repulsive pressure decayed
      exponentially with df with a decay length of 1.4 A. Further increases in applied
      pressure did not appreciably decrease df, so that there was a sharp upward break
      in the pressure-distance curve at an interbilayer spacing of about 3 A. In
      contrast, pressure-distance relations for gel (L beta') phase and liquid
      crystalline (L alpha) phase bilayers had much softer upward breaks at df < 5 A
      and extended to larger df at zero applied pressure. However, the pressure
      distance curves for all three phases decayed exponentially with approximately the
      same decay length for 4 < df < 8 A. We interpret these data to mean the
      following: (1) the repulsion observed for df < 5 A is primarily a steric pressure
      whose range depends on head group motion; (2) the steric undulation pressure
      plays an important role in determining the hydration properties and the range of
      the total repulsive pressure for fluid membranes; (3) the same underlying
      mechanisms govern the repulsive pressure for all phases for 4 < df < 8 A; (4)
      these mechanisms include a pressure due to reorientation of water molecules; and
      (5) the hydration pressure component extents a maximum of about two water
      molecules from the bilayer surface for the subgel phase.

PMID- 8347635
TI  - Does American acculturation affect outcome of Mexican-American teenage pregnancy?
AB  - The purpose of this study was to determine whether pregnant Mexican-American
      teenagers who are acculturated to American lifestyles have different medical and
      psychosocial problems from those who are more recent immigrants. Consecutive
      pregnant Mexican-American (or Mexican) teenagers attending a university
      obstetrics clinic for teenagers were divided into two groups based on country of
      birth of parents and teen, citizenship, preferred language, and years of U.S.
      residence. There were 60 in the acculturated group (G1) and 56 in the recent
      immigrant group (G2). Acculturated teenagers were younger at first sexual
      intercourse, completed more years of schooling, and sought earlier prenatal care
      (p < 0.05 for all above). Both groups delivered full-term singletons of average
      birth weight (mean = 3337 g +/- 477 g). All G2 fathers were Mexican, older (p <
      0.05), more likely to be married to G2 teens (p < 0.001), and employed (p <
      0.01). The G1 fathers completed more years of schooling (p < 0.05), and 10% were
      non-Mexican. These data underscore the need to consider acculturation, as well as
      ethnicity in understanding the experience of pregnant teenagers.

PMID- 8347636
TI  - Self-efficacy and intent to use condoms among entering college freshmen.
AB  - We examined self-efficacy theory's ability to explain adolescents' intent to use
      condoms. In this study, 673 males and 404 females (mean age, 17.8 years) about to
      begin college, completed health surveys measuring self-efficacy regarding condom
      use. Perceived self-efficacy differed by gender and sexual experience. Regression
      analysis demonstrated that frequency of past condom use, perceived ability to
      talk with new partner about condoms and to enjoy sex using condoms explained 16%
      of sexually active males' intent to use condoms (p < 0.05). For sexually active
      females, explanators included frequency of past use and perceived ability to
      enjoy sex with condoms (R2 = 29.8%, p < 0.05). For never sexually active males,
      perceived ability to convince partner to use condoms and to buy condoms explained
      16.1% of intent (p < 0.05); among never sexually active females, only perceived
      ability to convince partner to use condoms was significant (R2 = 6.2%, p < 0.05).
      Efforts to increase condom use should enhance perceptions of ability to negotiate
      aspects of condom use.

PMID- 8347637
TI  - Contraceptive self-efficacy in college women.
AB  - We examined the relationship between the theory of self-efficacy and its effect
      on contraceptive use along with other variables in a predominantly white female
      college population. Written survey questionnaires were administered to 356
      subjects in college classrooms; the study sample was limited to those 250 female
      subjects who were age 17-25 years unmarried, and sexually active. The
      questionnaire was designed to measure contraceptive use, contraceptive self
      efficacy, demographic variables, and other variables associated with the college
      psychosocial environment (i.e., alcohol use, history of sexual assault, and
      future orientation in education and career plans). Contraceptive self-efficacy
      (CSE) was highly correlated with effective use (r = .4, p < 0.01). Highly
      effective contraceptive users had a significantly higher mean CSE score (p <
      0.01) than that of less effective users. Logistic regression analysis of
      effective contraceptive use resulted in a four-factor model that correctly
      classified 76.3% of users. Contraceptive self-efficacy was the most important
      predictor of contraceptive use for this sample. Lack of barriers to contraception
      was also important, with knowledge and length of time of sexual activity also
      included in the final regression model. Most demographic and future orientation
      variables were not significantly associated with effective use; variables
      measuring sexual experience and personal attitudes and perceptions about birth
      control were more significantly associated with effective use. A lack of
      interference from alcohol was highly associated with effective contraceptive use.
      Self-efficacy would seem to be important in predicting contraceptive use and
      effecting behavior change.

PMID- 8347638
TI  - Prevalence and longitudinal study of breast masses in adolescents.
AB  - This study examined the prevalence and outcome of breast masses in adolescent
      females and compared these teens to those without breast masses. A longitudinal
      study of adolescents with breast masses was conducted from October 1984 through
      January 1990. The prevalence of discrete breast masses in the 13-month study
      period was 13/400 (3.25%) among new female patients. The mean length and width of
      the masses were 2.8 and 1.9 cm; 86% had a solitary mass. Of 61 diagnosed with
      breast masses, 39 were followed for up to 40 months (mean, 7 months). Teens with
      a mass were older (16.8 versus 15.1 years, p < 0.001) and had a greater chance of
      a family history of breast disease (26% versus 10.5%, p < 0.05) than those
      without a breast mass. Of 39 teens returning for at least one follow-up visit, 10
      had a clinical diagnosis of "fibrocystic changes." Of these, the lesions resolved
      in six. Of the 29 teens with a discrete mass on examination, 7 underwent surgery
      and were found to have fibroadenomas. Nine of the 29 teens had masses which
      resolved over 1-12 months, six teens had masses which remained unchanged over 3
      40 months, while four had masses which became smaller, and two had masses which
      became larger. One teen with mastitis improved. Eighteen underwent
      ultrasonographic examination at the breast. Of the 12 teens found to have a solid
      mass on ultrasound, none had a mass that resolved on follow-up
      examination.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347639
TI  - Risks among inner-city young teens: the prevalence of sexual activity, violence,
      drugs, and smoking.
AB  - Boston University's Youth at Risk (URISK) program is working to reduce five high
      risk behaviors: violence, sexual activity, drinking, illicit drug use, and
      smoking, among inner-city public middle-school students, grades 6-8. To set
      program priorities and for subsequent program evaluation, students in four
      schools completed a self-report questionnaire. Violence (physical fighting or
      carrying a knife or a gun) and sexual activity were the most commonly reported
      risks, 54% and 38%, respectively, for such activity within the past year. Four
      fifths of the students reported risk in at least one of the five risk categories
      at some time; two-thirds reported current risk in at least one category. Among
      those reporting two or more current risks, over 90% included violence, and over
      80% included sexual activity. Except for smoking, risk rates were lower in
      females than in males. Risk rates for violence and drug use were similar among
      blacks and whites, while sexual activity was more common and drinking and smoking
      less common among blacks compared with whites. Rates for all high-risk behaviors
      were consistently lower for Hispanics than non-Hispanic whites. Risk rates for
      violence were similar for grades 6-8. Sexual activity increased mainly from the
      7th to the 8th grade. Drinking increased both from the 6th to the 7th grade and
      again from the 7th to the 8th grade. Drug use and smoking increased only from the
      6th to the 7th grade.

PMID- 8347640
TI  - Substance use among youth seen at a community-based health clinic.
AB  - Despite recent surveys reporting a decline in adolescents' use of alcohol and
      other drugs in the general population, substance abuse may actually be increasing
      among particular subgroups of high-risk youth. This study examined the prevalence
      of alcohol and other drug use reported by 1121 youth, ages 12-24 years, seen for
      an initial medical visit at a free community-based primary health clinic. The
      clinic, located in the Hollywood/Wilshire area of Los Angeles, serves both
      homeless (62%) and non-homeless (38%) youth. Bivariate and multivariate analyses
      revealed that the homeless youth were significantly more likely to report use of
      alcohol and illicit drugs (marijuana, stimulants, hallucinogens, and narcotics)
      and prior involvement in injecting drug use (IDU). Variables found to be
      significantly associated with substance use among the homeless youth included
      length of time homeless, an attempted suicide, physical and sexual abuse, and
      involvement in survival sex/prostitution. Among the non-homeless youth, age of
      first intercourse, a previous suicide attempt, and a history of physical and
      sexual abuse were significantly associated with substance use. These findings
      suggest that rates of alcohol and other drug use may be higher among youth seen
      at community-based primary health clinics, particularly homeless youth
      underscoring the need for screening for these risk variables.

PMID- 8347642
TI  - The evaluation of targeted outreach in an adolescent HIV/AIDS program.
AB  - PURPOSE: Most HIV infected youth are unaware of their serostatus. Among
      adolescents who know they are HIV positive, only a small percentage are currently
      receiving care in age-specific programs. Establishing effective links between
      prevention and service programs is critical in reaching this group of young
      people. METHODS: A specific outreach strategy was designed to develop more
      referrals from a wider variety of agencies to better serve youth at risk for HIV.
      A needs assessment of community-based agencies was the basis for: 1. overcoming
      barriers to care, 2. specifying the target population, 3. assessing existing
      referrals, and 4. selecting agencies for different levels of intensity of
      outreach. RESULTS: Six barriers faced by potential referring agencies were
      identified and corresponding solutions created which were incorporated into the
      outreach strategy. A comparison was made of referrals in the years before, during
      and after the outreach strategy was instituted. A significant difference by (chi
      2 analysis) was noted in the number of agencies (p < 0.05), number of individuals
      (p < 0.01), number of appointments kept (p < 0.01), and the number of HIV+ youth
      enrolled (p < 0.01) during the year when the plan was fully implemented compared
      to previous and subsequent years. CONCLUSIONS: Systematic targeted outreach
      programs are an efficient way to maximize the time and effort of outreach staff.
      The result was an increase in the number and diversifity of referrals. This
      strategy could be used by groups caring for adults or younger children who want
      to expand services to include adolescents or by groups providing HIV/AIDS care
      who want to specifically serve adolescents.

PMID- 8347641
TI  - Crack cocaine use and high-risk behaviors among sexually active black
      adolescents.
AB  - The recent spread of crack cocaine use among inner-city teenagers has been
      accompanied by dramatic increases in juvenile delinquency and sexually
      transmitted diseases (STDs) among teenagers. This study examined the prevalence
      of five factors which promote STDs, including human immunodeficiency virus (HIV),
      among a sample of sexually active black adolescent crack users and non-users from
      the San Francisco Bay Area. Significant differences were observed between these
      groups with respect to history of engaging in sexual intercourse under the
      influence of drugs or alcohol, exchanging sexual favors for drugs or money,
      condom use in the most recent sexual encounter, and having five or more sexual
      partners in the last year. Approximately 63% of all respondents reported engaging
      in at least one of these risk behaviors. In multiple logistic regression
      analysis, reporting one or more of these STD/HIV risk behaviors was significantly
      associated with crack use and having one or more relatives who used drugs.
      Intervention efforts need to address both individual and environmental risk
      factors in order to reduce teens' risk for STDs, including HIV.

PMID- 8347643
TI  - Adolescent health services in North Carolina's local health departments.
AB  - The purpose of this study was to assess availability of clinical health services
      and special adolescent health programs for those aged 10-19 years administered by
      local health departments in North Carolina, and to evaluate factors that were
      associated with the existence of specialized adolescent programs, comprehensive
      services, and school services. We used self-report surveys mailed to 100 county
      health directors. All counties responded. One in five (21%) North Carolina youth
      received one or more health department service in 1990. Thirty-four health
      departments have programs or services specifically designed for adolescents; 7
      health departments provide comprehensive services. The majority of health
      departments (85%) provide services in public schools, most often health education
      or counseling. Counties with more adolescents and with higher per capita income
      were more likely to have adolescent programs and more likely to provide
      comprehensive clinics. Health departments with school services served
      proportionally twice as many of their county's adolescents as those without
      school services. We concluded that few local health departments in North Carolina
      provide comprehensive health services to their youth. Community-wide
      participation and state support are needed to improve public sector access to
      comprehensive health care for adolescents in North Carolina and in other states
      with decentralized, county-controlled public health systems.

PMID- 8347644
TI  - Racial differences in blood pressure among urban adolescents.
AB  - The purpose of this study was to determine if there are racial differences in the
      blood pressure patterns among urban adolescents. Blood pressure (BP) was measured
      according to Task Force guidelines in health-screening and education sessions
      conducted in urban public and parochial high schools. The prevalence of BP > or =
      95th% (HBP) on initial screening was determined in a population of 3,349
      students. Differences in prevalence of HBP among race, sex, and age groups were
      tested for significance by chi 2 analysis. The overall prevalence of HBP in this
      urban adolescent population was 8.1%. Significant race differences were present
      in females (blacks = 6.6% versus non-Hispanics = 2.9%, p < 0.01). Within the
      black females, HBP occurred more frequently among the girls attending
      predominantly black public schools (7.7%) compared to an interracial parochial
      school (2.0%) p < 0.001. This difference could not be explained by weight,
      height, or the occurrence of obesity. The observed BP differences within black
      females, by school, may reflect a family-environment effect on cardiovascular
      risk.

PMID- 8347646
TI  - Anterior sacral meningocele presenting as a pelvic/abdominal mass in a patient
      with Marfan syndrome.

PMID- 8347645
TI  - Preliminary findings on the effects of sex hormones on bone metabolism in
      anorexia nervosa.
AB  - We performed tetracycline double-labeled bone biopsies and serial bone
      densitometry on four patients with anorexia nervosa to determine the effects of
      various conditions of sex hormone replacement and body weight status. We found
      negligible bone mineral apposition rate in two patients with anorexia nervosa who
      were taking estrogen and progestin pills while weighing only 79% of normal.
      However, bone mineral apposition rate was normal in two patients with anorexia
      nervosa who took no sex hormones and remained amenorrheic while weighing 87% of
      normal. Histomorphometric analysis revealed a decrease in intracortical
      trabecular area by 57% and an increase in active osteoblastic surface area by
      300%, comparing the subjects who were taking hormone replacement to those who
      were not. There was no direct evidence of increased resorption in any subject.
      Six months after biopsy, the two subjects taking sex hormones decreased lumbar
      bone mineral density by 1.9%, while the two taking no sex hormones remained
      amenorrheic, but increased bone mineral density by 1.3%. Therefore, we propose
      that sex hormone therapy in the presence of persistently low body weight might be
      of limited benefit for bone mineral apposition and density.

PMID- 8347647
TI  - Pervasive developmental disorders: a hidden disability in adolescence.

PMID- 8347648
TI  - A study of the sexual behavior of teenagers in south Brazil.
AB  - A study of sexual behavior among teenagers was carried out in a random sample of
      884 second degree school (high school) students of Porto Alegre (South Brazil) by
      means of a self-report questionnaire. The students' ages ranged from 13 to 22
      years old, and 59% of them were females. The students believed themselves well
      informed about physiologic phenomena involved in human reproduction (95.2%; 95%
      confidence interval (CI):93.5-96.5) and sexually transmitted diseases (STD)
      (82.1%; 95% CI:79.1-84.7). In addition, 42.4% (95% CI:39.0-45.8) said that they
      has had a sexual relationship. However, 51.5% (95% CI:45.9-57.0) did not use
      contraceptive precautions systematically, and 12% (95% CI:7.2-19.0) of girls had
      already undergone an abortion. Considering these results, it is important to
      stimulate programs for sexual education strictly focused on teenagers.

PMID- 8347649
TI  - Factors associated with preterm delivery among pregnant adolescents.
AB  - The purpose was to identify characteristics of pregnant adolescents associated
      with preterm delivery. We studied 126 poor, black, 12 through 18-year-old
      pregnant adolescents and compared the prevalence of potentially high-risk
      maternal characteristics and obstetric complications in those who bore preterm
      and term infants. Of the adolescents studied, 12 (9.5%) delivered prematurely.
      Five maternal characteristics--conception within 3 years of menarche, a low body
      mass index, a past history of physical or sexual abuse, a socially deviant father
      of the baby, and vaginal bleeding during the first 8 weeks of gestation--were
      associated with preterm delivery. A theoretical model is proposed and the
      therapeutic implication of the study findings.

PMID- 8347650
TI  - Impact of computerization on nursing: automated order entry, care planning, and
      implications for recruitment.
AB  - Very few empirical studies have been completed which verify the actual benefits
      of automation for nursing. This article provides an overview of the results and
      implications of five research studies undertaken at a Canadian Hospital to
      ascertain the impact of computerization on selected aspects of nursing. These
      studies found that nurses perceived few positive benefits for direct care givers
      when order entry, results reporting and care planning were automated. This
      article will be of particular interest to nurse administrators who are embarking
      on automation within their hospitals.

PMID- 8347651
TI  - Computerized hospitals: an attraction or deterrent to recruitment in nursing?
AB  - This article describes a survey of 202 nursing recruits at an 850 bed hospital
      newly computerized with an Integrated Hospital Information System (IHIS). The
      nurses answered questions concerning their demographic characteristics, their
      experience with computers, their attitudes to computers and whether the fact that
      the hospital was computerized affected their decision to apply for employment.
      Results of this study suggest that the nurses' decision to apply to this setting
      for employment did not depend upon the factor of computerization. The majority of
      recruits held positive attitudes towards computers and it appeared that nurse
      recruits might be part of an ever increasing computer-literate population. Those
      having less experience with computers indicated greater anxiety. Implications for
      recruitment strategies and education are that while no major deterrents may exist
      for recruitment, new nurses with no computer experience require special attention
      because they may have higher levels of anxiety about computers. In orientation
      they may need clarification of what computers can be expected to do in a nursing
      environment so that they do not form unrealistic expectations. They may need to
      be informed as to whether a hospital is using a more general Hospital Information
      System which serves the needs of all departments, or a Nursing Information System
      which is more closely directed to the nurses' own daily work, since it is the
      latter which will most affect their degree of contact with computers.

PMID- 8347652
TI  - A risk management approach to the security of hospital information systems.
AB  - Risk management in today's technologically advanced health care system demands
      proactive rather than reactive strategies. Risk management is defined as a
      planned program for liability control and involves the identification, analysis
      and evaluation of legal risks followed by strategies to reduce or eliminate these
      risks. The concept of risk management is most often associated with quality
      assurance and direct patient care activities. For current purposes, the risk
      management concept is borrowed from arena of patient care and applied to the
      security measures surrounding hospital information systems. In this context, risk
      management/liability control is viewed as proactive activities designed to
      protect both the hospital information system and the confidentiality of patient
      information.

PMID- 8347653
TI  - The policy & procedure manual: development of a computer-assisted process for
      review.
AB  - This article documents the successful development of a computer-assisted process
      for systematic review of nursing policies and procedures at The Queen Elizabeth
      Hospital, Toronto, Ontario. Through broad staff input, policies and procedures
      are research-based yet grounded in the reality of the facility's nursing
      practice. Client-related standards are written as measurable, realistic
      statements of desired client outcomes, and as such are standards for client care.
      Policies and procedures have been rated according to the Canadian Council on
      Health Facilities Accreditation criteria (client centered, high risk, high
      volume, problem prone, interservice, outcome-related), so that important policies
      are easily identified to provide focus for quality assurance activities. The
      review process is structured so that over the course of a year, all policies are
      circulated for review by all levels of nursing staff.

PMID- 8347654
TI  - Nursing informatics can streamline nursing care.

PMID- 8347655
TI  - A Canadian nursing minimum data set: a major priority.
AB  - Through a selected review of existing hospital and health care minimum data sets
      in the United States, the United Kingdom and Canada, the authors expose the
      nursing data gaps in those data sets. Nurses in the United States have responded
      to these data gaps through the development of a Nursing Minimum Data Set (NMDS).
      The NMDS is a tool for abstracting a uniform collection of essential nursing data
      from the patient record usually at hospital discharge. The nursing care data
      elements in the NMDS include: nursing diagnosis, nursing intervention, nursing
      outcome, and intensity of nursing care. A major factor influencing the move to
      generate an NMDS in Canada is the response to the need to contain rising health
      care costs while maintaining quality health care. The NMDS has profound
      implications for nurses in all practice settings through use of these data in:
      costing of nursing services; defending resource allocation to nursing; defining
      nursing's contribution to patient care; defining outcomes of nursing care;
      developing nursing knowledge; and continued growth of nursing as a profession.
      Initiatives in Canada directed at the development of an NMDS indicate a
      heightened awareness of the need for the collection, storage and retrieval of
      nursing data. However, nurses in Canada have yet to define the essential nursing
      data elements for inclusion in a national health information system for use in
      Canada.

PMID- 8347656
TI  - Thyroid hormone action on mitochondrial energy transfer.

PMID- 8347657
TI  - The ferredoxin:sulphite reductase gene from Synechococcus PCC7942.
AB  - The structural gene of the ferredoxin:sulphite reductase (EC 1.8.7.1) from the
      cyanobacterium Synechococcus PCC7942 (formerly 'Anacystis nidulans') was cloned
      and sequenced. The gene termed 'sir' was detected by heterologous Southern
      hybridisation with the structural gene cysI from Escherichia coli encoding the
      iron-sulphur haemoprotein of the NADPH:sulphite reductase. The open reading frame
      is comprised of 1875 bp encoding for a polypeptide of M(r) 70.028. The deduced
      amino acid sequence is 35.6% identical with the enterobacterial iron-sulphur
      haemoprotein. This putative fd-dependent sulphite reductase is only distantly
      related to the fd-dependent nitrite reductase (binary matching coefficient SAB:
      0.23) or with the NADPH-sulphite reductase (SAB: 0.32). Highly conserved residues
      are found within the two Cys clusters forming the reactive Fe4S4-sirohaem centre
      of the enzyme. Expression of the sir gene using a fusion vector gave a single
      gene product which is immunologically related with the fd-sulphite reductase from
      the wild-type bacterium.

PMID- 8347658
TI  - Functional stability of the a-subunit of the F0F1-ATPase from Escherichia coli is
      affected by mutations in three proline residues.
AB  - Site-directed mutagenesis was used to investigate the roles of three proline
      residues (Pro-103, Pro-122 and Pro-143) in the a-subunit of the E. coli F0F1
      ATPase. All three were found to have a role in stabilizing the a-subunit
      structure in that removal of the F1-ATPase from membranes prepared from each of
      the mutant strains resulted in the loss of passive proton translocation activity.
      Pro-103 is predicted to be within a transmembrane helix. Pro-122 and Pro-143 are
      located just outside the membrane and near two residues (Asp-124 and Arg-140)
      previously proposed to form a charge pair. The phenotype of mutants in which Pro
      122 or Pro-143 were replaced by alanine was similar to previously isolated
      mutants affected in Asp-124 and Arg-140. This suggested that the main effect of
      the mutations was to destroy the charge pair between Asp-124 and Arg-140. Double
      mutants resulting from all possible combinations of these four mutations were
      constructed and, with the exception of P122A + D124A, had a similar phenotype to
      the single mutants. This is consistent with the idea that all four single changes
      had the same effect on a-subunit structure. In contrast, combining the P122A or
      P143A changes with another mutation which caused a similar phenotype (D44N)
      resulted in a complete loss of oxidative phosphorylation.

PMID- 8347659
TI  - Each of three positively-charged amino acids in the C-terminal region of yeast
      mitochondrial ATP synthase subunit 8 is required for assembly.
AB  - Each of three conserved positively-charged residues in the C-terminal region of
      subunit 8 of yeast (Saccharomyces cerevisiae) mitochondrial ATP synthase was
      replaced with isoleucine. The assembly and functional properties of the resulting
      variants (substituted at Arg-37, Arg-42 and Lys-47) were examined using in-vitro
      systems to assay import into isolated mitochondria and to monitor assembly into
      ATP synthase, as well as an in-vivo rescue system using host yeast cells lacking
      endogenous subunit 8. Each such variant was found to be impaired in assembly in
      vitro, after import in the form of a chimaeric protein bearing a leader sequence
      with mitochondrial targeting function. Import precursors bearing a duplicated
      leader sequence, engendering enhanced delivery to mitochondria of the passenger
      variant subunit-8 proteins, enabled assembly of the (Lys-47-->Ile) variant to be
      detected in vitro but not that of (Arg-37-->Ile) or (Arg-42-->Ile) variants. The
      respiratory growth of subunit 8-deficient host cells could be rescued with the
      (Lys-47-->Ile) variant expressed allotopically in the nucleus. Such rescued cells
      were found to have an enhanced growth rate (comparable to that produced by non
      mutagenized parental subunit 8) when delivered to mitochondria with the
      duplicated-leader sequence, as compared to the single-leader sequence. This
      confirms that the impediment in the (Lys-47-->Ile) variant lies in the efficiency
      of its assembly, rather than a functional defect, as such, arising from the loss
      of that positive charge. In contrast, host cells were unable to be rescued by the
      (Arg-37-->Ile) and (Arg-42-->Ile) variants, even when they were endowed with the
      duplicated leader sequence. It is concluded that the positively-charged C
      terminal domain of subunit 8, common to fungal and mammalian homologues of this
      protein, plays a key role in its assembly into mitochondrial ATP synthase.

PMID- 8347660
TI  - Binding constants for a physiologic electron-transfer protein complex between
      methylamine dehydrogenase and amicyanin. Effects of ionic strength and bound
      copper on binding.
AB  - Two soluble proteins, methylamine dehydrogenase and amicyanin, form a
      physiologically relevant complex in which intermolecular electron transfer
      occurs. To characterize and quantitate the binding of these two weakly
      associating proteins, an ultrafiltration binding assay has been developed which
      involves brief centrifugation of mixtures of proteins in centrifuge concentrators
      followed by quantitation of proteins on each side of the filtration membrane by
      HPLC. Under low ionic strength conditions which are optimal for the redox
      reaction between these proteins, a Kd of 4.5 microM was measured for the
      methylamine dehydrogenase-amicyanin complex. The Kd increased by 8-fold in the
      presence of added salt. Apoamicyanin, which is known from crystallographic
      analysis to be structurally very similar to amicyanin, exhibited a much higher Kd
      and much less specific binding than did the holoprotein. Apoamicyanin also
      exhibited apparent self-association at low ionic strength which was not observed
      with amicyanin. These observations are correlated with the known crystal
      structures of these proteins, free and in complex, and with the available
      biochemical information on the interactions of these two proteins.

PMID- 8347661
TI  - Functional characterization of mitochondrial oxidative phosphorylation in saponin
      skinned human muscle fibers.
AB  - The conditions of treatment of human skeletal muscle fibers from M. vastus
      lateralis with saponin were optimized to achieve complete permeabilization of
      cell membrane at intact mitochondrial oxidative phosphorylation. After 30 min of
      incubation with saponin all lactate dehydrogenase, 50% of creatine kinase, 30% of
      adenylate kinase and less than 20% of citrate synthase was released into the
      permeabilization medium. These skinned fibers behave similar to isolated
      mitochondria from human skeletal muscle: (i) the respiration with mitochondrial
      substrates can be stimulated by ADP, (ii) inhibited by carboxyatractyloside and
      (iii) it is possible to detect fluorescence changes of mitochondrial NAD(P)H on
      additions of substrates, uncoupler and cyanide. From a comparison of rates of
      respiration per cytochrome aa3 content of isolated human skeletal muscle
      mitochondria and saponin-skinned muscle fibers it was possible to calculate that
      almost 85% of mitochondria in those fibers are accessible for the investigation
      of oxidative phosphorylation. As shown by the investigation of biopsy samples of
      two patients with undefined myopathies these fibers are a suitable object for the
      replacement of isolated mitochondria in the diagnosis of mitochondrial myopathies
      and encephalomyopathies.

PMID- 8347662
TI  - Inhibitory effect of NaN3 on the F0F1 ATPase of submitochondrial particles as
      related to nucleotide binding.
AB  - The inhibitory effects of NaN3 on the F0F1 ATPase of beef heart submitochondrial
      particles were investigated. It was shown that NaN3 inhibited the ATPase activity
      only in the presence of ATP or ADP and the inhibition proceeded slowly. Analysis
      of the time-course of the inhibition process lead to a conclusion that an ATP
      binding site which has an apparent Kd of 14.0 +/- 8.7 microM is responsible for
      the increase of NaN3 sensitivity. This value agreed well with the low Km of ATP
      hydrolysis characterized before (Muneyuki, E., and Hirata, H. (1988) FEBS Lett.
      234, 455-458) and in the range of so-called bi-site catalysis. The same
      conclusion was derived as for isolated F1 ATPase. From similar analysis, the Kd
      of this site for ADP was deduced to be 1.34 +/- 0.45 microM, which also agreed
      with that reported by Pedersen (Pedersen, P.L. (1975) Biochem. Biophys. Res.
      Commun. 64, 610-616) and also in the same range as reported for the low Km of ATP
      synthesis by activated submitochondrial particles. These results suggest that
      hydrolysis through the low Km mode of ATPase reaction leads the enzyme NaN3
      sensitive form and this reaction cycle corresponds to the low Km mode of ATP
      synthesis.

PMID- 8347663
TI  - Membrane-associated redox cycling of copper mediates hydroperoxide toxicity in
      Escherichia coli.
AB  - We are studying the action of tert-butylhydroperoxide (t-BOOH) on Escherichia
      coli as a model system for peroxide toxicity. In our previous report (De la Cruz
      Rodriguez, L.C., Farias, R.N. and Massa, E.M. (1990) Biochim. Biophys. Acta 1015,
      510-516), the respiratory chain was identified as a major target of t-BOOH. In
      the present paper, we study further the effect of t-BOOH on the NADH oxidase of
      the E. coli respiratory chain to clarify the mechanism of damage, especially
      regarding the identity and role of the metal ion involved. The results are: (a) t
      BOOH toxicity is mediated by membrane-bound copper ions; (b) a small pool of the
      membrane-bound copper is reduced from Cu(II) to Cu(I) in the presence of NADH and
      other respiratory substrates (succinate, D-lactate); (c) this reduction of copper
      occurs at 37 degrees C but not at 0 degrees C or when the membranes are
      inactivated by previous heating; (d) the Cu(I) generated by reduction of Cu(II)
      during membrane preincubation with NADH, is oxidized by t-BOOH with simultaneous
      inactivation of the NADH oxidase, whereas treatment with only t-BOOH (without
      NADH) has no effect on the oxidase. It is concluded that the effect of t-BOOH on
      the respiratory chain is mediated by redox cycling of copper. It is proposed that
      the damage results from activation of the hydroperoxide through its interaction
      with Cu(I) in a site-specific Fenton-type reaction.

PMID- 8347664
TI  - Transport of organic cation in renal brush-border membrane from rats with renal
      ischemic injury.
AB  - Transport of tetraethylammonium, an organic cation has been studied using renal
      brush-border membrane vesicles isolated from rats with ischemic and ischemia
      reperfusion injury. H+ gradient-dependent uptake of tetraethylammonium slightly,
      but significantly, decreased in brush-border membrane vesicles from ischemic
      kidneys. When the kidney was reperfused after ischemia, the extent of the
      decrease of tetraethylammonium uptake was much greater than that after ischemia
      alone. The Vmax value of tetraethylammonium uptake by brush-border membrane
      vesicles from reperfused kidneys was decreased compared with control, without any
      change in the Km value. The tetraethylammonium uptake by the vesicles from
      reperfused kidneys was decreases both in the presence and absence of the outward
      H+ gradient (driving force). Uptake of D-glucose in renal brush-border membrane
      vesicles was also decreased by ischemia and again, reperfusion caused a further
      decrease of the uptake. Reperfusion also induced marked changes in the enrichment
      and recovery of marker enzymes in the isolated brush-border membrane fraction
      compared with ischemia. These findings suggest that renal ischemic injury altered
      the transport properties of tetraethylammonium as well as D-glucose, and that
      reperfusion after ischemia induced further damages on these functions in the
      brush-border membrane.

PMID- 8347665
TI  - Voltage-sensitive fluorescence of amphiphilic hemicyanine dyes in neuron
      membrane.
AB  - Fluorescent amphiphilic hemicyanine dyes were adsorbed to the plasma membrane of
      isolated Retzius neurons of the leech. Voltage steps were applied to the neuron
      by the patch-clamp technique in whole-cell configuration. The change of
      fluorescence was observed as induced by the voltage jump. The relative changes of
      the excitation spectrum and of the emission spectrum of fluorescence were
      recorded. The complete set of spectral data for each dye was fitted by five
      parameters: shifts of the emission and the excitation spectrum, a change of
      fluorescence quantum yield and changes of the widths of the excitation and of the
      emission spectrum. The only common feature for all dyes was a blue-shift of the
      excitation spectrum and a drop of the yield when the neuron was stained from the
      outside and a positive voltage was applied to the inside. With respect to the
      shift of the emission spectrum and the changes of width qualitatively different
      results were obtained for different dyes. It is not attempted to assign a
      physical mechanism--probably a superposition of several mechanisms--of voltage
      sensitivity.

PMID- 8347666
TI  - The anticancer drug tamoxifen induces changes in the physical properties of model
      and native membranes.
AB  - The interactions of tamoxifen with lipid bilayers of model and native membranes
      were investigated by fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene
      (DPH) and by intramolecular excimer formation of 1,3-di(1-pyrenyl)propane
      (Py(3)Py). The effects of TAM of liposomes of DMPC, DPPC and DSPC are temperature
      dependent. In the fluid phase, TAM reduces dynamics of the upper bilayer region
      as observed by Py(3)Py and has no effect on the hydrophobic region as detected by
      DPH. In the gel phase, the effects of TAM evaluated by Py(3)Py are not
      discernible for DMPC and DPPC bilayers, whereas DSPC bilayers become more fluid.
      However, DPH detects a strong fluidizing effect of TAM in the hydrophobic region
      of the above membrane systems, where DPH distributes, as compared with the small
      effects detected by Py(3)Py. TAM decreases the main phase transition temperature
      but does not extensively broaden the transition thermotropic profile of pure
      lipids, except for bilayers of DMPC where TAM induces a significant broadening
      detected with the two probes. In fluid liposomes of sarcoplasmic reticulum lipids
      and native membranes, TAM induces an ordering effect, as evidenced by Py(3)Py,
      failing DPH to detect any apparent effect as observed for the fluid phase of
      liposomes of pure lipid bilayers. These findings confirm the hydrophobic nature
      of tamoxifen and suggest that the localization and effects of TAM are modulated
      by the order and fluidity of the bilayer. These changes in the dynamic properties
      of lipids and the non-specific interactions with membrane lipids, depending on
      the order or fluidity of the biomembrane, may be important for the multiple
      cellular effects and action mechanisms of tamoxifen.

PMID- 8347667
TI  - Induction of lipid-protein mismatch by xenobiotics with general membrane targets.
AB  - Many membrane-active xenobiotics, such as organic solvents or general
      anesthetics, are without specific target sites. A common, but as yet ill-defined
      physical mechanism of action is usually assumed. Displacement of 'boundary' lipid
      activators from functional membrane proteins by the induction of lipid/protein
      mismatch is now established as a candidate common physical mechanism. Multiple
      binding site kinetics demonstrate that xenobiotics can be strongly inhibitory at
      realistic membrane concentrations of below 4 mol%. A general equation for
      inhibition is derived.

PMID- 8347668
TI  - Effects of pH on the activity of the human red cell glucose transporter Glut 1:
      transport retention chromatography of D-glucose and L-glucose on immobilized Glut
      1 liposomes.
AB  - The facilitative glucose transporter Glut 1 from human red cells was
      reconstituted into liposomes that were size-fractionated and immobilized in an
      octyl sulfide-Sephacryl S-1000 column. D-[14C]Glucose was eluted later than L
      [3H]glucose from the Glut 1 liposome column (by delta V microliters), apparently
      because the D-glucose was transported through the liposomes. The corresponding
      difference with protein-free liposomes was delta V0. The Glut 1 transport
      retention chromatographic effect, delta VG = delta V - delta V0, 40-50
      microliters at pH 7, was nearly constant at pH 6-10 (400 mM NaCl, 23 degrees C,
      internal liposome volume approximately 240 microliters) but decreased steeply
      below pH 5 to become zero at pH 3.6. The decrease corresponded to a pKa of
      approximately 4.4 and was partly reversible above pH 4.7. Similarly, glucose
      exchange by non-immobilized freeze-thawed proteoliposomes with Glut 1 slowed down
      drastically as the pH was lowered from pH 5.5 to 4; and octyl glucoside
      solubilized Glut 1 lost half its activity in 15 min at pH 4.5 (low ionic
      strength, 2 degrees C) as shown by glucose exchange determinations at pH 7.2 The
      results suggest that Glut 1 is inactivated at low pH upon protonation of
      carboxylate groups of pKa approximately 4.4-4.8. It seems likely that carboxylate
      groups form hydrogen bonds to transported D-glucose.

PMID- 8347669
TI  - Destabilization of egg lecithin liposomes on the skin after topical application
      measured by perturbed gamma gamma angular correlation spectroscopy (PAC) with
      111In.
AB  - Unilamellar and oligolamellar liposomes were topically applied to the skin of
      porcine ears. Perturbed angular correlation spectroscopy of 111In-DTPA, initially
      entrapped into the liposomes, was used to study the release kinetics of the
      hydrophilic probe. After drying of the liposomal suspensions, a decrease of the
      time-integrated perturbation factor <G22(infinity)> within 30 min indicated
      destabilization of the liposomes and total marker release in the upper epidermal
      layers.

PMID- 8347670
TI  - Abscisic acid-lipid interactions: a phospholipid monolayer study.
AB  - Lipid monolayer studies were performed on a Langmuir trough in the absence and in
      the presence of the plant hormone abscisic acid (ABA). The ABA-induced effects on
      the lipid monolayers can be summarized as follows: (i) ABA as the free acid (pH
      below 5.3) increased the molecular area and slightly decreased the surface
      pressure in the collapse points of monolayers made of saturated, unsaturated and
      of mixed lipids; ABA as the anion showed only minor effects. (ii) The ABA-induced
      area increase of the lipid monolayers decreased when the surface pressure
      increased, but some ABA remained in the monolayers made of unsaturated
      phospholipids even at collapse pressure. (iii) The incorporation of ABA into the
      monolayers could be inhibited by adding the plant sterol beta-sitosterol to the
      monolayer forming phospholipids. (iv) There was no substantial difference of ABA
      action on plant phospholipids as compared with other phospholipids. (v) ABA had a
      much stronger influence on unsaturated phospholipids than on saturated ones. (vi)
      ABA decreased the phase-transition temperature of saturated phospholipids. These
      results, which agree with those obtained from phospholipid vesicle studies,
      indicate that the physical state of the lipid is important for the ability of ABA
      penetrating into the lipid monolayer. Finally, a possible relevance of these
      results is discussed in terms of the action of ABA on guard cell membranes of
      plants.

PMID- 8347671
TI  - Spin-label studies on phosphatidylcholine-polar carotenoid membranes: effects of
      alkyl-chain length and unsaturation.
AB  - Spin-labeling methods were used to study the structure and dynamic properties of
      phosphatidylcholine (PC)-dihydroxycarotenoid membranes as a function of
      phospholipid alkyl chain length, alkyl chain saturation, temperature and mol
      fraction of carotenoids. (1) Dihydroxycarotenoids, zeaxanthin and violaxanthin
      increase order and decrease motional freedom of the lipid alkyl chains in fluid
      phase PC membranes. The effect of carotenoids decreases as the alkyl chain length
      of saturated PC increases. (2) The abrupt changes of spin-label motion observed
      at the main-phase transition of the saturated PC membranes are broadened and
      shifted to lower temperatures. At a carotenoid concentration of 10 mol%, they
      disappear for short-chain PC membranes (12-14 carbons), but are still observed
      for long-chain PC membranes (18-22 carbons). (3) In fluid-phase PC membranes
      possessing short alkyl chains (12-14 carbons), the activation energy of the
      rotational diffusion of 16-doxylstearic acid spin label (16-SASL) is
      significantly lower at a carotenoid concentration of 10 mol%. The difference
      decreases as the alkyl-chain length increases. (4) The presence of unsaturated
      alkyl chains greatly reduces the effects of carotenoids on the mobility of the
      polar headgroups as observed with tempocholine dipalmitoylphosphatidic acid ester
      and on the order of alkyl chains near the polar headgroup region as observed with
      5-doxylstearic acid spin label (5-SASL). The effect of unsaturation is, however,
      moderate in the membrane center as shown with 16-SASL. Also, the effect of
      carotenoids on the order and motion of the rigid and highly anisotropic molecules
      dissolved in the PC membranes is significantly greater in saturated PC membranes.

PMID- 8347672
TI  - Diffusivity and structural polymorphism in some model stratum corneum lipid
      systems.
AB  - Mixtures of model stratum corneum lipids were prepared in water from cholesterol,
      six fatty acids and ceramides. The influence of composition on the polymorphism
      of these mixtures and also on the diffusivity of a model drug within them, Dlip,
      was determined. The former was obtained from X-ray diffraction and Fourier
      transform infrared spectrometry, and the latter from a diffusional release model.
      An L beta structure was formed for the composition approximating that of the
      extracellular lipids in intact human abdominal stratum corneum. Dlip was
      independent of water content in the range 20-40% w/w, with the bilayers showing
      one dimensional swelling without lateral expansion. Although removal of the
      ceramides did not result in a significant alteration in Dlip, crystalline
      cholesterol now appeared. The ceramides were, therefore, necessary for
      solubilization within the fatty acid bilayers of the large proportion of
      cholesterol present in the lipid fraction of intact SC. They were also
      responsible for a thermal L alpha-HII transition observed at approx. 68 degrees.
      At the concentration in which it exists in intact SC, cholesterol also had only a
      minimal effect on Dlip, but was necessary to suppress HII phase formation within
      the fatty acids and ensure an L beta structure. All lipid mixtures that had an L
      beta structure presented a diffusional barrier approx. 1 order of magnitude
      greater than that of an unstructured, isotropic lipid mixture. HII structures
      formed at cholesterol/fatty acid proportions less than approx 8:92 mol% and
      appeared more permeable than L beta ones. All the results indicate that the
      diffusional barrier within the model lipid mixtures is guaranteed essentially by
      the presence of an L beta phase. Although the ceramides and cholesterol exert no
      intrinsic influence on the magnitude of Dlip, their presence in necessary for the
      existence of an L beta phase at 33 degrees that is free of both crystalline
      cholesterol and HII character.

PMID- 8347673
TI  - Intersecting polymers in lipid bilayers: cliques, static order parameters and
      lateral diffusion.
AB  - We have modelled a macrolipid polymer composed of lipid molecules (monomers)
      embedded in a lipid bilayer or monolayer and polymerized via their polar groups.
      Because of fluctuations perpendicular to the plane of the bilayer, the polar
      region occupied by the polymer chain possesses sufficient space so that the
      polymer might exhibit 'self-intersection' if its conformational state is
      projected onto the plane of the bilayer/monolayer. We represent the plane of the
      bilayer/monolayer by a triangular lattice. Each site can be occupied by a monomer
      or be empty (and thus occupied by one of the unpolymerizable lipids which make up
      the bilayer/monolayer). A macrolipid is represented by a sequence of N monomers
      connected by N-1 bonds. Bonds may be either short (connecting nearest neighbour
      monomers) or long (between second neighbour monomers), in accord with the average
      properties of the spacers between the polymerized lipids. We have carried out
      computer simulation of this system using the Carmesin-Kremer bond stretching
      algorithm. Although no two monomers can occupy the same site, bonds may cross
      each other. We analyzed the dependence of <R2> and <R2G> approximately N2vc and
      <Nsc> + <Nmc> approximately N2 sigma c, where Nsc and Nmc are the number of bond
      crossings in the same macrolipid ('self-crossing') or in two different
      macrolipids ('mutual-crossing'). For single macrolipids, we confirmed that vc =
      3/4 and have found that sigma c approximately 0.52, which we consider supports
      that sigma c = 1/2. For the dense case with monomer concentration, c = 0.72, we
      found that vc = 1/2 and that sigma c approximately 0.52 supports that sigma c =
      1/2. In the semi-dilute regime (c = 0.2) we found crossover behaviour, although
      sigma c = 1/2. The total number of bond crossings thus scale like N, independent
      of concentration. We studied the connectivity of the system by calculating the
      weight averaged cluster, or 'clique', size. Cliques are defined as being composed
      of all macrolipids which exhibit at least one crossing bond with one other member
      of the clique. We found that while the average clique contains about two
      macrolipids at low concentrations, the clique size approaches the maximum
      possible value at high concentrations if the macrolipids are sufficiently long.
      In the latter case a transition appears to occur as the macrolipid length
      increases. This transition occurs at length = 40 when c = 0.72. These
      observations should have experimental consequences for the viscoelastic
      properties of the system.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8347675
TI  - Stress causes alteration in attachment of rat hepatocytes to matrix protein
      substratum.
AB  - The effect of different types of stress on the attachment of rat hepatocytes to
      various matrix protein substrata, such as collagen IV, fibronectin and laminin,
      was investigated. Study of the kinetics of attachment of adult hepatocytes
      subjected to heat-shock at 45 degrees C for 30 min showed significantly lower
      attachment to collagen IV, fibronectin and laminin substrata when compared to
      untreated controls. The alteration in attachment was observed after heat
      treatment for 10 min and the extent of alteration appeared to increase with
      duration of the heat-treatment, as well as with increase in temperature. Foetal
      rat hepatocytes, which appeared to attach much more readily than adult rat
      hepatocytes to these substrata, particularly to laminin, also showed
      significantly lower attachment to all three substrata after heat-treatment at 45
      degrees C for 30 min. This alteration in attachment appeared to be specific for
      matrix proteins as there was no significant effect on interaction of cells with
      non-matrix proteins, such as Con A and asialoglycoproteins. While the attachment
      of adult hepatocytes appeared to attain near control levels in about 4 h, the
      foetal cells recovered in about 2 h after heat-shock, indicating that the heat
      shock effect is reversible and the recovery is faster in foetal hepatocytes.
      Other stress-causing agents, such as heavy metals, also caused an alteration in
      attachment of hepatocytes to these matrix proteins. Attachment of adult and
      foetal hepatocytes to collagen substratum was reduced by 100-microM
      concentrations of heavy metals in the order Zn > Cd > La > As > Cu for adult
      cells and La > Zn > As/Cu > Cd for foetal cells. These heavy metals also caused
      significant reduction in attachment of adult hepatocytes to fibronectin and
      laminin, although the extent of inhibition was less than that for collagen
      substrata. However, these heavy metals did not significantly affect the
      attachment of foetal hepatocytes to laminin substratum indicating that the effect
      of heavy metals appeared to vary with the nature of the matrix protein
      substratum. On heat-shock, incorporation of [3H]leucine into cytoskeletal
      proteins such as cytokeratins CK8 and CK18 was reduced and significant amounts of
      two new proteins having an average molecular mass of 80 kDa and 90 kDa were found
      to be tightly associated with cytoskeletal proteins.

PMID- 8347674
TI  - Increased susceptibility of stored erythrocytes to anti-band 3 IgG autoantibody
      binding.
AB  - When human blood was stored in a citrate-phosphate-dextrose (CPD) solution at 4
      degrees C, the susceptibility of the erythrocytes to binding of autologous IgG
      increased. The autologous IgG binding was partially inhibited by purified Band 3
      glycoprotein and its oligosaccharides. The susceptibility of the erythrocytes to
      binding of 125I-labeled anti-band 3 IgG autoantibody similarly increased. The
      results indicate that the anti-band 3 binding sites composed of Band 3
      oligosaccharides were generated on the cell surface. The rate of the increase in
      the susceptibility of the stored cells to the antibody binding was lowered when
      blood was stored in a CPD solution containing L-ascorbic acid or erythorbic acid,
      suggesting involvement of an oxidative mechanism in the generation of the binding
      sites. The cytoplasmic glutathione level of erythrocytes gradually decreased
      during the blood storage. Storing blood in a CPD solution containing glutathione
      monoethylester or glutathione monoisopropylester resulted in partial prevention
      of the decrease in cytoplasmic glutathione level and of the increase in the IgG
      binding ability of the cells. Similar preventive effect of glutathione
      monoethylester was observed in the binding of 125I-labeled anti-band 3
      autoantibody to the stored erythrocytes. Thus, the increase in the susceptibility
      of the stored erythrocytes to anti-band 3 binding may be caused, at least
      partially, by an oxidative stress resulting in a decreased cytoplasmic
      glutathione level.

PMID- 8347676
TI  - An analysis of autologous glucocorticoid receptor protein regulation in AtT-20
      cells also reveals differential specificity of the BuGR2 monoclonal antibody.
AB  - When the anti-glucocorticoid receptor monoclonal antibody (BuGR2) was initially
      incorporated either into a new immunoassay strategy or into a traditional
      sedimentation analysis technique, both methods failed to reveal any change in the
      cellular content or distribution of BuGR2-reactive antigen following
      glucocorticoid treatment of AtT-20 cells. Furthermore, the immunoassay also
      generated strong positive signals with cytosol and nuclear extracts from a
      receptor-negative cell line (E8.2) derived from L929 cells. However, when the
      BuGR2 antibody was incorporated into a combined immunoprecipitation/Western blot
      analysis of AtT-20 cell extracts, only the glucocorticoid receptor protein
      produced a signal on the Western blot, even though other proteins had been
      specifically immunoprecipitated by BuGR2 antibody and were clearly present on the
      Western blot membrane. Applying the latter approach to AtT-20 cells chronically
      treated with glucocorticoid, we observed not only that the receptor protein
      rapidly and persistently (1-96 h) accumulated in the nucleus, but also that its
      total cellular content was first depleted (24 h) and then was progressively
      replenished (48-96 h). From these studies in AtT-20 cells we conclude: (i), the
      BuGR2 antibody can exhibit differential immunospecificity dependent upon whether
      antigen mixtures are denatured or not; (ii), glucocorticoid receptor protein
      resided almost exclusively in the nucleus during four days of glucocorticoid
      treatment and (iii), the same treatment regimen resulted in total receptor
      protein levels being regulated in a biphasic pattern. Together, these results
      suggest that receptor regulation in AtT-20 cells is a complex event, and that,
      since steroid was constantly present during our experiments, other factors are
      involved in regulation of receptor levels.

PMID- 8347677
TI  - An analysis of the substrate specificity of insulin-stimulated protein kinase-1,
      a mammalian homologue of S6 kinase-II.
AB  - The specificity determinants for insulin-stimulated protein kinase-I (ISPK-1)
      have been investigated with synthetic peptides based on naturally-occurring
      protein phosphoacceptor sequences. Peptides (Arg-Arg-Xaa-Ser-Xaa) that fulfill
      the consensus sequence for cyclic-AMP-dependent protein kinase (PK-A) are also
      phosphorylated readily by ISPK-1. The phosphorylation efficiency is improved by
      increasing the number of N-terminal arginine residues and by moving the arginyl
      cluster one residue further away from the serine, the nonapeptide (Arg)4-Ala-Ala
      Ser-Val-Ala being the best substrate among all the short peptides tested (Km = 15
      microM). Conversely, the substitution of either Thr for Ser or Lys for Arg is
      detrimental. Likewise, two flanking Pro residues and an Arg immediately N
      terminal to the Ser act as negative specificity determinants. While the
      specificity of ISPK-1 shows several similarities to that of PK-A, including an
      absolute requirement for basic residues on the N-terminal side of the target Ser,
      it differs in several other respects including (1), the detrimental effect of a
      Lys for Arg substitution which is still compatible with some phosphorylation by
      ISPK-1, but not PK-A; (2), the presence of C-terminal acidic residues which are
      tolerated very well by ISPK-1, but are detrimental to PK-A; (3), the effect of
      substituting Phe for Val in the peptide Arg-Arg-Ala-Ser-Val-Ala, which improves
      the efficiency of phosphorylation by PK-A (lowering the Km 4-fold), but has no
      effect on phosphorylation by ISPK-1. These differences in peptide substrate
      specificity may account in part for the different rates of phosphorylation of
      physiological substrates for ISPK-1 and PK-A, such as the G subunit of protein
      phosphatase-1.

PMID- 8347678
TI  - Identification of the product of the murine ST2 gene.
AB  - The murine ST2 gene is expressed in growth-stimulated BALB/c-3T3 cells. This gene
      encodes a protein that is similar to the extracellular portions of the
      interleukin-1 receptors (types 1 and 2). In this study, we prepared a polyclonal
      antibody against the recombinant ST2 protein produced in Escherichia coli. This
      antibody detected recombinant ST2 protein in the culture fluid of COS7 cells
      transfected with a mammalian expression vector (pEF-BOS) carrying ST2 cDNA. Using
      this antibody, we could detect the ST2 protein in the culture fluid of growth
      stimulated BALB/c-3T3 cells, and in the medium of continuously growing cells, but
      not in that of growth-arrested cells. ST2 proteins produced in COS7 cells and
      BALB/c-3T3 cells were N-glycosylated as predicted from nine putative N
      glycosylation sites in its deduced amino-acid sequence.

PMID- 8347679
TI  - A variety of calpain/calpastatin systems in mammalian erythrocytes.
AB  - Calpain and its endogenous inhibitor, calpastatin, were isolated from
      erythrocytes of various mammals and their properties were compared. It has been
      widely believed that mammalian erythrocytes contain only mu-calpain. However, rat
      and human erythrocytes were found to contain two species of calpain, identified
      as mu-calpain and m-calpain from their elution positions on DEAE-cellulose column
      chromatography and their Ca(2+)-requirements. Thus, it is apparent that rat and
      human erythrocytes contain not only mu-calpain, but m-calpain as well. On the
      other hand, rabbit erythrocytes contain only mu-calpain. Western blot analysis
      showed that human and rabbit erythrocytes contain predominantly 70-kDa
      calpastatin (erythrocyte-type), but unnegligible amounts of 110-kDa calpastatin
      (tissue-type) are also present. Rat erythrocytes were shown to contain a
      calpastatin with a molecular mass of approx. 100 kDa almost exclusively; this
      molecular mass was in perfect coincidence with the mass of the calpastatin in rat
      lung. These results strongly suggest that rat erythrocytes contain a tissue-type
      calpastatin. No essential change in the calpain/calpastatin system during
      maturation of rabbit reticulocytes into mature erythrocytes was observed.

PMID- 8347680
TI  - The functions of thrombospondin and its involvement in physiology and
      pathophysiology.
AB  - The thrombospondin family of molecules is expressed in many different tissues.
      Its expression is highly regulated by different hormones and cytokines and is
      developmentally controlled. It can bind to many different cell types, probably
      via an array of receptors which are similarly regulated. The level of
      thrombospondins in body fluids and their distribution in tissue change in
      correlation with various pathological states. It is linked to the growth of
      primary tumors and to metastasis, to development of the atherosclerotic plaque,
      to malaria infection and other diseases. The role(s) of thrombospondin(s) are by
      and large unknown, though specific interaction seem to affect particular cell
      functions. The wide-spread spatial and temporal regulation, multiple interactions
      and correlation with major diseases imply important roles in cell function and
      call for concerted effort to unravel the mystery.

PMID- 8347681
TI  - Amyloid formation by salmon calcitonin.
AB  - It is demonstrated using three independent methods that salmon calcitonin can
      form amyloid fibrils in vitro. Large aggregates are shown to exhibit a blue-green
      birefringence in cross polarised light after staining with congo red. Individual
      fibrils were observed using electron microscopy. These fibrils are approx. 50-60
      A in diameter and up to 20,000 A in length and are similar in appearance to those
      observed in Alzheimer's disease. Finally, X-ray diffraction studies of the large
      aggregates reveal the cross-beta conformation characteristics of the monomers in
      the fibre.

PMID- 8347682
TI  - Redox metabolism of vitamin C in blood of normal and malaria-infected mice.
AB  - As oxidative mechanisms have been suggested to be part of the host immune
      reaction against malarial parasites, we investigated the redox metabolism of the
      antioxidant vitamin C in the blood of control and malaria-infected mice. At the
      peak of infection (day 6) with the malaria parasite P. vinckei, plasma levels of
      ascorbate (AH-) were 10.8 +/- 0.9 micrograms/ml compared to 5.7 +/- 0.7
      micrograms/ml in control mice, though no significant change was observed in the
      plasma concentration of dehydroascorbate (DHA). The plasma redox ratio of vitamin
      C, [AH-]:[DHA], was 7.4 in control mice and 18.5 in infected mice on day 6 post
      inoculation. The increased AH- level in plasma of P. vinckei-infected mice was
      not due to differences in stabilities of either AH- or DHA in plasmas from
      control or P. vinckei-infected mice. DHA added to plasma was lost rapidly. In
      contrast, when added to whole blood. DHA was rapidly taken up and reduced to AH
      by blood cells from both normal mice and P. vinckei-infected mice. Most of the
      intracellular AH- derived from the exogenously added DHA was released into the
      plasma by blood cells from the infected but not normal mice. The observed release
      of AH- into the plasma by blood cells from infected mice was not caused by a
      plasma factor. Depletion of leukocytes from erythrocytes had no effect on the
      uptake and reduction of DHA by red blood cells, but the subsequent release of
      intracellular AH- occurred more rapidly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347684
TI  - Pan-sulfation of bile salts markedly increases hydrophilicity and essentially
      abolishes self- and hetero-association with lecithin.
AB  - In chronic liver disease, partially and to a lesser extent completely (pan
      )sulfated common bile salts are synthesized, yet little information is available
      concerning their physical-chemical characteristics. We studied solution
      properties of pan-sulfated common free, taurine and glycine-conjugated bile
      salts, and the interactions of taurodeoxycholate di-sulfate (TDC-S) with
      lecithin. By reverse-phase HPLC, pan-sulfated glycine and taurine-conjugated bile
      salts were very hydrophilic, with hydrophobic indices 1.7 to 2.5 units lower than
      their non-sulfated congeners. In contrast to non-sulfated species, pan-sulfated
      free and glycine-conjugated bile salts produced simple potentiometric titration
      curves without precipitation of bile salt below the pK'A of the carboxylic acids.
      By quasi-elastic light scattering, critical micellar concentrations of TDC-S fell
      from 28 mM in 0.15 M NaCl to 3 mM in 4.0 M NaCl, a value slightly higher than
      that of TDC. TDC-S formed very small micelles (hydrodynamic radii approx. 11A)
      that, in contrast to TDC, did not grow with increases in bile salt (7-66 mM) or
      NaCl (0.15-2.0 M) concentrations. TDC-S formed mixed micelles with lecithin in
      0.15 M NaCl, but with a micellar zone drastically reduced compared with that of
      the non-sulfated congener. However, in 4 M NaCl, the micellar zone of TDC-S
      expanded and approached that of the non-sulfated parent compound. Therefore,
      under physiological conditions, pan-sulfation of common bile salts should largely
      eliminate their capacity to form mixed micelles with membrane lipids.

PMID- 8347683
TI  - Tangier disease: isolation and characterization of LpA-I, LpA-II, LpA-I: A-II and
      LpA-IV particles from plasma.
AB  - Tangier disease (TD) is characterized by extremely low plasma levels of HDL, apoA
      I and apoA-II due to very rapid catabolism. However, the risk of premature
      coronary heart disease (CHD) is not markedly increased in TD. In order to gain
      insight into reverse cholesterol transport in TD, we isolated LpA-I, LpA-I:A-II,
      LpA-II and LpA-IV particles from fasting plasma of 5 TD patients. LpA-I
      composition was similar to control LpA-I, but TD LpA-I had more LCAT and CETP
      activity (respectively, 0.35 +/- 0.14 and 0.14 +/- 0.04 mumol of cholesterol
      esterified/h/micrograms of protein, and 7 +/- 2.5 and 1.4 +/- 0.3 mumol of
      cholesteryl ester transferred/h/micrograms of protein). In contrast, TD LpA-I:A
      II had abnormal composition, with a low molar ratio of apoA-I to apoA-II (0.2
      1.33). In addition, LpA-I:A-II in TD contained a substantial amount of apoA-IV
      compared with control, making this particle an LpA-I:A-II:A-IV complex. LpA-I:A
      II from normal plasma do not promote cholesterol efflux from adipocytes cells,
      whereas TD LpA-I:A-II:A-IV complexes promoted cholesterol efflux from these
      cells. Moreover LpA-I:A-II:A-IV complexes have more LCAT and CETP activity than
      control (respectively 1.2 +/- 0.16 and 0.05 +/- 0.01 mumol of cholesterol
      esterified/h/micrograms of protein and, 41 +/- 3.7 and 1 +/- 0.4 mumol of
      cholesteryl ester transferred/h/micrograms of protein). The LpA-II particle in TD
      represented in fact an LpA-II:A-IV complex (75% mol apoA-II and 22% mol apoA
      IV).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347686
TI  - Production of macrophage colony-stimulating factor (M-CSF) by human articular
      cartilage and chondrocytes. Modulation by interleukin-1 and tumor necrosis factor
      alpha.
AB  - A specific radioimmunoassay was employed to demonstrate that human articular
      cartilage and chondrocyte monolayers in organ and cell culture, respectively,
      produce macrophage colony-stimulating factor (M-CSF) in response to stimulation
      with interleukin-1 alpha (IL-1 alpha), IL-1 beta, tumor necrosis factor alpha
      (TNF alpha) and TNF beta. Optimum doses were 10-100 U/ml for IL-1 (0.06-0.6 nM IL
      1 alpha; 0.02-0.2 nM IL-1 beta) and 1-10 nM for TNF alpha. Low levels of M-CSF
      were observed in the supernatants of nonstimulated cultures while increased
      levels of M-CSF in response to IL-1 alpha and TNF alpha were detected following 2
      h exposure to the cytokines. IL-1 alpha and TNF alpha did not show synergy for
      the production of M-CSF when both cytokines were added to cultures. Actinomycin D
      and cycloheximide inhibited both the basal and IL-1 alpha-induced production of M
      CSF, suggesting a requirement for de novo RNA and protein synthesis. Cytokine
      induced M-CSF production was also inhibited by the antiinflammatory
      corticosteroid, dexamethasone, but not by the cyclooxygenase inhibitor,
      indomethacin. The cytokines IL-4, IL-6, platelet-derived growth factor, leukemia
      inhibitory factor, transforming growth factor-beta and interferons -alpha and 
      gamma, each had little or no effect on M-CSF levels, while basic fibroblast
      growth factor, lipopolysaccharide, and retinoic acid were each weak stimuli. We
      propose that chondrocyte M-CSF production in response to IL-1 and TNF alpha, and
      the concurrent destruction of cartilage by these cytokines, could provide a
      mechanism for the chronic nature of rheumatoid disease.

PMID- 8347685
TI  - Albumin Hawkes Bay; a low level variant caused by loss of a sulphydryl group at
      position 177.
AB  - A slow migrating minor albumin component, representing 5% of total circulating
      albumin, was detected by routine serum protein electrophoresis and
      immunofixation. After treatment with 5 mM dithiothreitol the abnormal component
      was found to migrate normally suggesting the attachment of some component to the
      free thiol at position 34. However, purification and analysis by SDS-PAGE showed
      that the abnormal component had a slightly lower apparent molecular weight than
      normal albumin. Limited tryptic cleavage indicated the abnormal site to be in the
      N-terminal third of the molecule. HPLC analysis of tryptic peptides from this
      domain showed the presence of a new peptide of sequence Ala-Ala-Phe-Leu- Leu-Pro
      Lys, indicating either a point mutation of 177 Cys-->Phe or the deletion of
      residues 166-177. DNA sequencing of PCR-amplified DNA confirmed the former Cys-
      >Phe substitution by indicating a point mutation of C to A at nucleotide position
      5185. It appears that the aberrant electrophoretic mobility of the variant might
      be due to a gross conformational change associated with the formation of a new
      disulphide bond between Cys-168 and Cys-124.

PMID- 8347687
TI  - Inhibition of protein kinase C activity in mucolipidosis type-4: a model for a
      new pathogenetic mechanism in inborn errors of metabolism.
AB  - Inhibition of protein kinase C [PK-C] activity by sphingosine and its derivatives
      has been suggested to play a role in the pathogenesis of sphingolipidoses. In the
      present study, PK-C activity and PK-C-mediated phosphorylation of endogenous
      substrates were studied in skin fibroblasts from patients with mucolipidosis type
      4 [ML-4], in which there is accumulation of the phospholipids
      phosphatidylcholine, lysophosphatidylcholine, phosphatidylethanolamine as well as
      gangliosides. Cytosolic PK-C activity in 5 ML-4 cell lines was comparable to that
      in control cells. PK-C activity in the particulate fraction of these cells was 84
      +/- 14 pmol 32P/mg protein per min compared with 267 +/- 26 in control cells.
      Increasing the concentrations of the activating lipids in the reaction mixture
      did not enhance PK-C activity in ML-4 cells, suggesting a non-competitive
      inhibition of the kinase. Following partial purification of the enzyme from the
      particulate fraction PK-C activity increased to 288 +/- 14 and 339 +/- 12 pmol
      32P/mg protein per min in ML-4 and control cells, respectively. The
      phosphorylation pattern of endogenous substrates in the particulate fraction of
      ML-4 cells differed from that in control cells both in the absence and in the
      presence of calcium and activating lipids. We suggest that PK-C may be involved
      in the pathogenesis of sphingolipidoses and that this may represent an example
      for a new type of pathogenetic mechanisms in inborn errors of metabolism.

PMID- 8347688
TI  - Substratum acidification and proteinase activation by murine B16F10 melanoma
      cultures.
AB  - Murine B16F10 melanoma cells, cultured within 0.7% agarose gels containing the
      fluorescent proteinase substrate acetamidofluorescein-BSA, catalyze the
      hydrolysis of the substrate in the region immediately surrounding the cell.
      Fluorescence ratio measurements on hydrolyzed substrate correlate with an average
      pH of 5.5 +/- 0.2 in the adjacent substratum region. Enzymatic activity within
      the gel is partially inhibited by leupeptin, pepstatin, phenylmethylsulfonyl
      fluoride. EDTA and by anti-human cathepsin B, suggesting potential roles for
      thiol-, aspartic- and metalloproteinases. The time-course of fluorescence
      intensity, correlated with substratum pH measurements, suggest that substrate
      hydrolysis is catalyzed by enzymes with pH optima of < 5.5. Invasion by these
      cells through thin barriers of reconstituted basement membrane gel (Matrigel) is
      totally blocked by the thiol proteinase inhibitor, leupeptin. It is suggested
      that secreted or cell-surface acid proteinase enzymes, activated by the cell
      mediated local hyperacidity, are involved in substrate hydrolysis and that these
      enzymes may be important in invasiveness by this cell-line.

PMID- 8347689
TI  - Identification of two new LDL-receptor mutations causing homozygous familial
      hypercholesterolemia in a South African of Indian origin.
AB  - South Africans of Indian origin have a high frequency of Familial
      Hypercholesterolemia (FH). Fibroblasts from a South African Indian FH homozygote,
      D, expressed about 30% of the normal number of LDL receptors. These receptors
      showed defective LDL binding. Sequence and haplotype analysis revealed that D had
      two different mutant LDL receptor alleles: FH Durban-1 is a point mutation
      [asp69(GAT) to tyr(TAT)] in ligand-binding repeat 2 and FH Durban-2 is a point
      mutation [glu119(GAG) to lys(AAG)] in ligand-binding repeat three of the LDL
      receptor. Single-strand conformational polymorphism analysis, which was used in
      the initial detection of these mutations, was also employed for subsequent
      population screening assays. These mutations were not detected in any of the
      South African Indian FH or hypercholesterolemic patients that were screened.

PMID- 8347691
TI  - Effects of monoclonal antibodies on alpha-staphylotoxin action against
      erythrocytes and model phospholipid membranes.
AB  - It was found that one of twenty tested monoclonal antibodies (MABs) existed which
      drastically enhanced ability of Staphylococcus aureus alpha-toxin (ST) to both
      lysis of human erythrocytes and increase of planar phospholipid bilayer
      conductance more than 10 and 1,000 times respectively. Other 19 MABs possessed
      only neutralized effect. The activation could only be observed if the activating
      MAB (AMAB) interacted with ST in solution but not in membrane. The one molecule
      of AMAB was able to activate approximately 2-4 molecules of ST. It was assumed
      that this activation was a result of the AMAB-induced transition of ST from a
      hydrophilic to an amphiphilic form. The activation could not be observed when the
      activity of AMAB/ST mixtures was tested on highly sensitive rabbit erythrocytes.
      All the tested MABs (including AMAB) were able to inhibit the ST-induced lysis of
      rabbit erythrocytes. The activating effects of AMAB on ST action in BLM and in
      human erythrocytes as well as their inhibiting influence on the ability of toxin
      to cause a lysis of rabbit erythrocytes indicate the presence of an ST-specific
      receptor on the membrane of rabbit erythrocytes.

PMID- 8347690
TI  - Pseudomonal elastase injection causes low vascular resistant shock in guinea
      pigs.
AB  - An intravenous injection of culture supernatants obtained from an elastase
      producing strain (IFO-3455) of Pseudomonas aeruginosa exhibited immediate fall of
      mean arterial blood pressure from 63.8 +/- 1.62 to 35.6 +/- 2.31 mmHg (P <
      0.001), increased heart rate from 249.6 +/- 3.86 to 272.6 +/- 2.18 beats/min (P <
      0.05), and increased respiratory rate from 44.8 +/- 2.33 to 68.6 +/- 1.60/min (P
      < 0.01) within 5 min in the anesthetized guinea pigs. In contrast, culture
      supernatants obtained from an elastase non-producing strain (PA-103) did not
      cause the cardio-respiratory alterations, even though the same dose of endotoxin
      was contained in the supernatants. Intravenous or intracardiac injection of
      purified Pseudomonas aeruginosa elastase (1.2 mg/kg) but not endotoxin (up to 2.0
      mg/kg) reproduced the immediate shock followed by death within 45 min in
      anesthetized or in conscious guinea pigs. Consistently, the shock-inducing
      ability of pseudomonal elastase was prevented by pretreatment with anti
      pseudomonal elastase rabbit F(ab')2 antibodies or with a synthetic inhibitor of
      pseudomonal elastase. Furthermore, intravenous injection of a non-lethal dose of
      pseudomonal elastase (0.8 mg/kg) immediately decreased peripheral vascular
      resistance when estimated from a change of perfusion pressure at hindquarter
      circulation from 74.0 +/- 1.00 to 52.6 +/- 1.76 mmHg (P < 0.05) in association
      with fall of arterial blood pressure and of cardiac output which was estimated
      from a change of regional aortic flow. The same low-resistant shock was also
      observed in rats. We speculate, therefore, that bacterial proteinases may play an
      important role in human septic shock.

PMID- 8347692
TI  - Outcome research: the gold standard for professional practice.

PMID- 8347693
TI  - Silent experts.

PMID- 8347694
TI  - Accuracy and response time comparisons of four skin temperature-monitoring
      devices.
AB  - Although technological improvements in skin surface temperature-measurement
      devices have progressed since they were first used clinically, the question of
      their accuracy and reliability for skin temperature monitoring still remains. The
      purpose of this study was to compare the accuracy and response time to
      temperature change for four temperature-monitoring devices: liquid crystal
      (Crystaline ST, Sharn, Inc, Tampa, Fla), two different thermistor sensors (RSP,
      Respiratory Support Products, Inc, Irvine, Calif, and SHER-I-TEMP, Sheridan
      Catheter Corp, Argyle, NY), and one thermocouple-based temperature sensor (Mon-a
      therm, Mallinckrodt, Inc, St. Louis, Mo). A temperature-controlled steel surface
      plate was used as the reference temperature source for test comparisons. The
      results showed that Crystaline ST (liquid crystal device) performed better in the
      accuracy and response time tests than the electronic thermistor and thermocouple
      temperature-sensor devices tested. Regression analysis of the reference
      temperature comparisons showed that although all four devices had high
      correlation coefficients Crystaline ST had the highest correlation (R = 0.99685).
      Also, the regression equation for Crystaline ST was closest to a perfect fit with
      reference temperatures, ie, slope = 1.00267 and intercept = 0.20333 (P = .0000).
      Crystaline ST responded consistently faster than the other devices for each
      change in temperature setting (5, 10, 15, and 20 degrees F). Crystaline ST
      responded within 3.5 to 4.4 seconds for every temperature gradient change tested.
      All three of the other sensor devices had increasingly longer response times as
      the temperature gradient increased.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347696
TI  - Outcome assessment in education programs.
AB  - This article describes the move toward outcome assessment as a tool to measure
      student achievement and overall program effectiveness. Methods are presented by
      which on-site accreditation reviewers can determine if nurse anesthesia faculty
      perform effective assessments and utilize the results of their findings to plan
      for improvement. Emphasis is placed on methods by which data from multiple
      sources are collected and analyzed by the faculty to enhance student learning.

PMID- 8347695
TI  - A system of airway risk management in obstetric anesthesia.
AB  - This article describes an airway management system designed to reduce the
      incidence of maternal and neonatal mortality and morbidity during cesarean
      section. This system was developed from a comprehensive topical review of the
      literature and implemented in a midwestern community hospital. The key features
      of the system include a strategy of early assessment and recognition of patients
      at risk for difficult intubation, and the establishment of management protocols
      designed to reduce the maternal risk associated with failed intubation.

PMID- 8347697
TI  - Intraoperative awareness and recall during total hip arthroplasty.
AB  - A case of intraoperative recall and awareness in a patient with sickle cell
      disease who had received midazolam, 10 mg at induction of anesthesia, is
      reported. The patient was on opioids which may also have caused tolerance.
      Although the use of midazolam may have been judged to provide adequate amnesia,
      this was clearly not the case. Upon analysis of the reasons for recall, we
      predicted from a two-compartment model that the estimated blood level was 88
      ng/mL-1; this level would have provided no amnesia. This case illustrates that
      recall can occur with the use of midazolam, especially if levels become
      subtherapeutic, and other measures should be taken to provide adequate anesthesia
      and amnesia.

PMID- 8347698
TI  - Patients who are susceptible to malignant hyperthermia.

PMID- 8347699
TI  - [Tuberculosis as health problem at the doorstep of the year 2000].

PMID- 8347700
TI  - [Colonization by Streptococcus group B in full term pregnancy and newborns in a
      community in Venezuela].
AB  - BACKGROUND: The aim of this study was to define the incidence of cervico-vaginal
      colonization by group B Streptococcus (SGB) in full term pregnancy as well as
      vertical and horizontal transmission in newborns attended in two public hospitals
      in Valencia, Venezuela. METHODS: An study cervico-vaginal exudates from 171 full
      term pregnant women was performed together with general obstetric survey.
      Oropharyngeal and nasal exudate studies in 118 newborns of the mothers studied
      were carried out during the first 12 hours after birth as was a neonatologic
      survey. RESULTS: The global percentage of maternal colonization by SGB were 32.7%
      while in the NB it was 45.8%. Among the NB colonized by SGB 73.2% were considered
      to have acquired the bacteria from the mother (vertical) with no significant
      differences in the data found in the two hospitals. The rate of horizontal
      colonization of the newborns was 42.3% in one hospital and only 8% in the second.
      CONCLUSIONS: There were no significant statistical differences between the rate
      of cervico-vaginal colonization in women attended in two public hospitals in
      Venezuela. No differences were observed in the rate of vertical colonization of
      newborns but to the contrary, that of the horizontal (nosocomial) colonization
      was of 42.3% and 8% in the Charity and University Hospitals, respectively.

PMID- 8347701
TI  - [Sexually transmitted diseases in a high risk subpopulation from the province of
      Soria].
AB  - BACKGROUND: Women who practise prostitution constitute a high risk group for
      acquiring sexually transmitted diseases (STD). The aim of this study was to know
      the frequency of these processes among prostitutes in the province of Soria.
      METHODS: A descriptive transversal study including 86 women who voluntarily went
      to a Family Planning Center (FPC) in Soria was carried out in the period between
      October 1986 to December 1991. Patients were submitted to: investigation of T.
      vaginalis, N. gonorrhoeae, G. vaginalis, C. trachomatis, S. agalactiae and yeast
      infections. Complete clinical history was obtained from all including
      sociodemographic variables and those of risk of infection. RESULTS: Of the 86
      women studied 12 (14%) had positive syphilis tests (treponemic and reaginic). In
      12 (14%) N. gonorrhoeae was isolated. The search for C. trachomatis was positive
      in 16 (18.60%). In 19 (22.10%) T. vaginalis was directly observed. Twenty-three
      (26.74%) presented some type of positive serology to B virus. Five (5.81%) were
      HIV-1 seropositive. Candida spp. was isolated in 27 (31.39%) as was G. vaginalis
      and S. agalactiae in 21 (24.41%). Clinical examination did not show any
      macroscopic lesion suggesting venereal disease. CONCLUSIONS: Infection by Candida
      spp. and G. vaginalis were found to be the most frequent. The seroprevalence of
      HIV-1 in this series was the lowest in the country having a clear relation with
      the use of intravenous drugs (IVDA). Sexually transmitted diseases maintain a
      high prevalence in high risk groups such as prostitutes thus requiring energic
      prevention plans, overall in the group of young IVDA prostitutes.

PMID- 8347702
TI  - [Microbiological characteristics and spectrum of infections of 108 Streptococcus
      anginosus isolated].
AB  - BACKGROUND: The aim of the present study was to assess the key microbiologic
      characteristics aid in the identification of Streptococcus anginosus in the
      laboratory and know the spectrum of clinical infections it produces. METHODS:
      From March 1991 to April 1992 all the isolated strains of clinical significant
      samples were collected. For identification the API 20 STREP (BioMerieux) system
      was used. The histories of the patients with infection by S. anginosus were
      retrospectively reviewed to collect clinical and microbiologic data of interest.
      RESULTS: The 108 strains of St. anginosus isolated were diminute colonies on
      sheep blood agar with CO2 enrichment. They had a characteristic smell, were beta
      hemolitic or non hemolitic and of the Lancefield group A, C, F, G or not
      groupable. All had invariable biochemical features in the API 20 STREP: produced
      acetone and alkaline phosphatase, hydrolized arginine, did not hydrolize hypurate
      nor did they ferment ribose. Streptococcus anginosus produced purulent infections
      of different localization: abdominal, head-neck, pleuro-pulmonary, muscle
      skeletal, skin and soft tissues and miscellaneous. Most of these infections were
      polymicrobial (81.5%). CONCLUSIONS: St. anginosus was easily identified in the
      laboratory by its morphologic characteristics and biochemical reaction in the API
      20 STREP. It produced a wide variety of supurative infections, some being severe:
      cerebral, pulmonary, hepatic, empyema abscess. The identification of this
      microorganism at a species level should contribute to better recognition as a
      pathogen of occassionally severe supurative infections.

PMID- 8347703
TI  - [Evaluation of intestinal pathogenicity of Yersinia spp. strains isolated from
      human feces].
AB  - BACKGROUND: Yersinia enterocolitica is a human pathogen which an acts on the
      intestine by basically enteroinvasive mechanism. Its virulence has been related
      with the presence of a plasmid of 40-50 MD which codes a series of properties.
      There are strains of Y. enterocolitica and of other species assimilated to the Y.
      enterocolitica group which lack the virulence plasmid. In these cases there is a
      problem in evaluating the pathogenic ability on the intestine of these bacterias
      when isolated in faeces. METHODS: A study of 30 Yersinia spp. strains including
      growth in a magnesium oxalate medium, Reg-Congo and agar (CR-MOX), sculine
      hydrolisis (Sc), pyrazinamidase activity (Pyz) and salicine fermentation (Sal)
      was performed. In addition, the presence of virulence plasmid (VP) was
      determined. RESULTS: Twenty-two strains identified as Y. enterocolitica presented
      the virulence pattern (CR-MOX+, Pyz-, Sal/Sc-) and 21 were VP+. Seven strains
      isolated were CR-MOX-, Pyz+, Sal/Sc+ and VP- being typed as Y. fredericksenii (6)
      and Y. kristensenii (1). The remaining strain was CR-MOX- and VP- but Pyz, Sal/Sc
      were also negative, being identified as Y. enterocolitica. CONCLUSIONS: By the
      tests referred the authors were able to identify and evaluate the pathogenicity
      of Yersinia spp. isolated in faeces. These techniques may be used in the
      microbiology laboratory as a method which aids to evaluate the diagnosis of
      intestinal infections caused by Yersinia spp.

PMID- 8347704
TI  - [Conjunctival ophthalmomyiasis caused by Oestrus ovis].
AB  - BACKGROUND: Microbiologic diagnosis of conjunctival ophthalmomyiasis. MATERIAL
      AND METHODS: Material extracted from three patients' conjunctiva who complained
      of sudden presence of foreign body and were diagnosed as conjunctival
      ophthalmomyiasis has been studied. Patients were recruited over two months from
      the Emergency Department. Diagnosis was performed through observation using the
      light microscope. RESULTS: Oestrus ovis first-instance larvas were observed in
      all the samples studied. CONCLUSIONS: This observation of similar cases in a
      short period of time and the low frequency of diseased people who lived in a
      urban environment makes necessary to think in this agent as cause of
      ophthalmomyiasis in our area and therefore perform an adequate differential
      diagnosis.

PMID- 8347705
TI  - [Pathogenesis, epidemiology, and microbiologic diagnosis of infections caused by
      verotoxin-producing enterohemorrhagic Escherichia coli].

PMID- 8347706
TI  - [Chronic polyarthritis].

PMID- 8347707
TI  - [Septicemia caused by capnophilic microorganism].

PMID- 8347708
TI  - [Bacillus cereus infection in orthopedic surgery].

PMID- 8347709
TI  - [Septicemia caused by Streptococcus agalactiae in a previously healthy adult].

PMID- 8347710
TI  - [Brucella abortus and myocardial involvement].

PMID- 8347712
TI  - [Detection of respiratory syncytial virus antigen in respiratory secretions].

PMID- 8347711
TI  - [Oligoarthritis and tenosynovitis caused by Haemophilus influenzae in a patient
      with myeloma].

PMID- 8347713
TI  - [Disseminated histoplasmosis in AIDS patient].

PMID- 8347714
TI  - [Periorbital abscess and paranasal sinusitis caused by Eikenella corrodens].

PMID- 8347717
TI  - Genomes and informatics.

PMID- 8347715
TI  - [Diarrhea following antibiotic treatment, Clostridium difficile, and quinolones].

PMID- 8347716
TI  - [Endocarditis caused by Capnocytophaga spputigena].

PMID- 8347718
TI  - An overview of human-computer interaction.
AB  - This article presents an overview of the field of human-computer interaction.
      This branch of computer science concerns the design, implementation and analysis
      of interactive computer systems. We show that this field is multidisciplinary in
      essence, involving social scientists as well as computer scientists, experts of
      application domains, graphics designers, etc. Once the fundamental aspects of
      human-computer interaction are presented, we take a practical approach in order
      to introduce the methods, tools and techniques that are available today for the
      design and implementation of interactive computer systems. Finally, we present
      the main directions of research in this domain.

PMID- 8347719
TI  - The fundamentals of object-oriented database management systems.
AB  - The purpose of this document is to characterize the two technologies (database
      and object-oriented technologies) which constitute the foundation of object
      oriented database management systems. The O2 Object-Oriented DataBase Management
      System is then described as an example of this type of system.

PMID- 8347720
TI  - Artificial intelligence approach in analysis of DNA sequences.
AB  - We present an approach for designing a knowledge-based system, called Sequence
      Acquisition In Context (SAIC), that will be able to cooperate with a biologist in
      the analysis of DNA sequences. The main task of the system is the acquisition of
      the expert knowledge that the biologist uses for solving ambiguities from gel
      autoradiograms, with the aim of re-using it later for solving similar
      ambiguities. The various types of expert knowledge constitute what we call the
      contextual knowledge of the sequence analysis. Contextual knowledge deals with
      the unavoidable problems that are common in the study of the living material (eg
      noise on data, difficulties of observations). Indeed, the analysis of DNA
      sequences from autoradiograms belongs to an emerging and promising area of
      investigation, namely reasoning with images. The SAIC project is developed in a
      theoretical framework that is shared with other applications. Not all tasks have
      the same importance in each application. We use this observation for designing an
      intelligent assistant system with three applications. In the SAIC project, we
      focus on knowledge acquisition, human-computer interaction and explanation. The
      project will benefit research in the two other applications. We also discuss our
      SAIC project in the context of large international projects that aim to re-use
      and share knowledge in a repository.

PMID- 8347721
TI  - An automatic approach for DNA sequencing.
AB  - Automation is perfectly suited to DNA sequencing, which requires many repetitive
      steps and the handling of many samples. It increases not only processing
      capability but also accuracy and reproducibility. We present an approach to
      automation of DNA sequencing that was developed at the level of a research
      laboratory, and describe several improvements to DNA sequencing methodology.

PMID- 8347722
TI  - Learning and alignment methods applied to protein structure prediction.
AB  - Learning techniques are able to extract structural knowledge specific to a
      selected set of proteins. We describe two algorithms that optimize scores
      expressing the propensity of a polypeptide sequence to adopt a local fold. The
      first algorithm generates secondary structure prediction rules based on a
      dictionary of geometrical patterns frequently found in the learning database. The
      second algorithm leads to scores that indicate the fit between an amino acid and
      a given local structural environment. Dynamic programming is then used to align
      structural information profiles by modifying the local mutation cost with the
      above learned functions. The main features of the system are exemplified on the
      structural prediction of the N-terminal domain of the CD4 antigen. Then the
      usefulness of additional 3-D information in the alignment is benchmarked on eight
      pairs of weakly homologous proteins.

PMID- 8347723
TI  - Inductive learning and biological sequence analysis. The PLAGE program.
AB  - Inductive learning, also called 'learning from examples', is a subfield of
      artificial intelligence. Inductive learning methods are able to deal with
      'structural descriptions'. These portray objects as composite structures
      consisting of various components. The use of structural descriptions to represent
      biological objects is appealing. For instance, they have been used by Rawlings et
      al [1] for symbolically and comprehensively representing the folding of proteins.
      This paper shows how inductive learning techniques may be used for extracting
      information from biological objects. We briefly describe some general techniques
      for describing objects in a structural way and for learning from these
      descriptions. We present details of a program that we developed, PLAGE, and show
      the application of this program for a study on signal peptides, which was done in
      collaboration with A Danchin [2,3]. Finally, we survey some other approaches and
      applications of inductive learning to molecular biology.

PMID- 8347724
TI  - Local predictability in biological sequences, algorithm and applications.
AB  - The goal of this paper is to propose an algorithm based on the k nearest
      neighbours to compute a local predictability measure in biological sequences.
      Some ideas about the usefulness of this measure are discussed on the basis of
      preliminary experimentations.

PMID- 8347726
TI  - Identification and simulation of new non-random statistical properties common to
      different eukaryotic gene subpopulations.
AB  - The nucleotide distribution in protein coding genes, introns and transfer RNA
      genes of eukaryotic subpopulations (primates, rodent and mammals) is studied by
      autocorrelation functions. The autocorrelation function analysing the occurrence
      probability of the i-motif YRY(N)iYRY (YRY-function) in protein coding genes and
      transfer RNA genes of these three eukaryotic subpopulations retrieves the
      preferential occurrence of YRY(N)6YRY (R = purine = adenine or guanine, Y =
      pyrimidine = cytosine or thymine, N = R or Y). The autocorrelation functions
      analysing the occurrence probability of the i-motifs RRR(N)iRRR (RRR-function)
      and YYY(N)iYYY (YYY-function) identify new non-random genetic statistical
      properties in these three eukaryotic subpopulations, mainly: i) in their protein
      coding genes: local maxima for i identical to 6 [12] (peaks for i = 6, 18, 30,
      42) with the RRR-function and local maxima for i identical to 8 [10] (peaks for i
      = 8, 18, 28) with the YYY-function; and ii) in their introns: local maxima for i
      identical to 3 [6] (peaks for i = 3, 9, 15) and a short linear decrease followed
      by a large exponential decrease both with the RRR- and YYY-functions. The non
      random properties identified in eukaryotic intron subpopulations are modelised
      with a process of random insertions and deletions of nucleotides simulating the
      RNA editing.

PMID- 8347725
TI  - Likelihood linkage analysis (LLA) classification method: an example treated by
      hand.
AB  - This paper describes a very general method of data analysis using a hierarchical
      classification. The data can be provided by observation, experiment or knowledge;
      their nature can be numerical, qualitative or logical. First, the classical view
      of the context of data representation, in which the algorithm of hierarchical
      ascendant construction of the classification tree is set, is treated in a
      synthetic manner. The main notion in our method is one of 'similarity'. This must
      be elaborated in the best way, taking into account the mathematical nature of the
      objects to be compared. Here we adopt a set of theoretical and combinatorial
      representation of the descriptive attributes, which are interpreted in terms of
      relations. Then we introduce a probability scale for similarity measurement by
      using a likelihood concept. The largest part of the paper concerns an
      illustrating example, moderately sized, detailing very minutely the different
      steps and the different calculations assumed by the method. The data structure
      handled with this example is the simplest possible. Then, general aspects and
      methodological extensions are evoked. We end by indicating the interest of the
      described approach in future works, in which we are involved, concerning
      typological organization of genetic sequences. We emphasize the 'explanation'
      aspect of the obtained results, with respect to a given description. For this
      purpose, classifications (on the object set and on the attribute set) on the one
      hand and machine learning techniques on the other, intervene efficiently.

PMID- 8347727
TI  - Analytical approaches to genomic evolution.
AB  - We model the non-local mechanisms of genomic evolution and propose methods for
      studying the evolutionary divergence of species based on these models. Mechanisms
      include the movement of segments of genomes within a single chromosome
      (transpositions), the reciprocal translocation of segments between two
      chromosomes, and the inversion of segments. Each of these is studied in the
      context of a different type of genomic data. We introduce the theory of
      phylogenetic invariants for evolutionary inference based on very long
      macromolecular sequences.

PMID- 8347728
TI  - ColiGene: object-centered representation for the study of E coli gene
      expressivity by sequence analysis.
AB  - ColiGene is an object-centered knowledge base for the study of gene expressivity
      in Escherichia coli by DNA sequence analysis. This system was developed with the
      knowledge base management system SHIRKA. Objects represented in ColiGene are
      biological structures such as genes or regulatory signals. They are organized in
      a hierarchical structure of classes, subclasses and instances. Navigation through
      the knowledge base and the building of queries are made using a graphical
      interface. The base is coupled with the data base ACNUC which structures a
      specialized collection of sequences: EcoSeq. Several tools are also associated to
      ColiGene, either for sequence analysis or for a more general purpose. Some
      biological results have been obtained using ColiGene which are summarized here.

PMID- 8347729
TI  - Interferon in chronic myeloid leukemia. A workshop report.
AB  - The therapeutic efficacy of interferon-alpha (IFN-alpha) in the treatment of
      chronic myeloid leukemia is currently being tested in a number of institutional,
      interinstitutional, and international trials. There is no doubt that responses
      are achieved in many patients, and in a small subset complete eradication of
      clonogenic cells may be possible. However, it has not yet been shown that overall
      survival of patients treated with IFN-alpha is better than that of those treated
      with conventional cytoreductive drugs. There are still controversial opinions on
      problems such as dosages and duration of treatment, combination with cytostatic
      agents, definition of responses, and relevance of cytogenic and molecular data.
      An international workshop discussed the data on interferon therapy and attempted
      to define the role of interferon today in the management of chronic myeloid
      leukemia.

PMID- 8347730
TI  - Primary thrombocythemia: diagnosis, clinical manifestations and management.

PMID- 8347731
TI  - Ubenimex in the treatment of acute nonlymphocytic leukemia in adults.
AB  - A multi-institutional randomized study for the evaluation of ubenimex (Bestatin)
      in the treatment of adult acute nonlymphocytic leukemia was performed. One
      hundred and ninety-five patients were registered from February 1988 to December
      1990. Patients who had reached complete remission by one or two courses of
      remission induction chemotherapy were divided into the ubenimex group or the
      control group by randomization. Patients of the ubenimex group started to receive
      30 mg ubenimex orally once a day when maintenance therapy began and continued as
      long as possible. Remission duration and survival were analyzed based on the data
      as of August 31, 1991. Remission duration of the ubenimex group was superior to
      that of the control group (generalized Wilcoxon test: p = 0.0338). Fifty percent
      remission duration was 508 days in the ubenimex group and 386 days in the control
      group. There has been no statistical difference in survival between the two
      groups as yet.

PMID- 8347732
TI  - IL-2, IL-3, and IFN-gamma differently affect in vivo frequencies of circulating
      precursors of cytotoxic T lymphocytes (CTL-P).
AB  - Experimental animal and human in vivo studies have previously demonstrated the
      impact of exogenous administration of various cytokines on frequencies of
      circulating myeloid and LAK precursor cells. For the first time we investigated
      whether exogenous cytokines, in the absence of antigenic challenge, may also
      influence frequencies of circulating antigen-specific cytotoxic T-lymphocyte
      precursor cells. We further asked whether triggering of autoimmune pathways as
      has been reported for several cytokines can be confirmed on the cellular level by
      demonstration of induction of autoreactive CTL-p. Limiting dilution analysis was
      used to determine alloreactive CTL-p frequencies in 31 patients with
      nonhematologic diseases before and after short-term systemic treatment with
      either rIL-2 (4.8 x 10(6) IU/m2 bid), rIL-3 (2.5, 5.0 or 10.0 micrograms/kg qd),
      rGM-CSF (5 micrograms/kg qd), rIFN-gamma (200 or 400 micrograms qd), or IFN-alpha
      (3 or 5 x 10(6) IU qod). Simultaneously, autoreactive CTL-p frequencies were
      determined by split-well analysis in 25 of these patients. We found that rIL-2
      significantly expands the circulating precursor pool of alloreactive CTL (p <
      0.05). rIL-3 affected CTL-p frequencies in a dose-dependent fashion. Low and
      intermediate doses of rIL-3 did not exhibit significant effects, whereas 10
      micrograms/kg rIL-3 led to expansion of alloreactive CTL-p in the same order of
      magnitude as did rIL-2. This effect was statistically significant when compared
      with rGM-CSF (p < 0.02), which apparently had no influence on alloreactive CTL-p
      frequencies. In contrast to rIL-2 and rIL-3, exogenous rIFN-gamma markedly
      reduced the circulating precursor pool of CTL. This again was statistically
      significant compared with rIFN-alpha (p < 0.03), which, like rGM-CSF, did not
      exhibit any effects on the level of alloreactive CTL-p. Frequencies of
      autoreactive CTL-p were invariably below the limit of detection in our system (<
      1/300,000). In conclusion, these data demonstrate that (a) short-term systemic
      administration of rIL-2, rIL-3, and rIFN-gamma differently affects the clone size
      of circulating precursors of alloreactive CTL in man, while rGM-CSF and rIFN
      alpha do not exhibit measurable effects, and (b) none of the cytokines
      administered is capable of uncovering detectable frequencies of autoreactive CTL
      p.

PMID- 8347733
TI  - Comparison of 5 vs 10 micrograms/kg per day of GM-CSF following dose-intensified
      chemotherapy with cisplatin, etoposide, and ifosfamide in patients with advanced
      testicular cancer.
AB  - Despite the increasing use of granulocyte-macrophage colony-stimulating factor
      (GM-CSF) for the treatment of chemotherapy-induced neutropenia, few studies have
      focused on the activity and toxicity of the different clinically used dosages of
      GM-CSF. Forty-four patients with "poor-risk" (advanced disease, according to the
      Indiana University classification) testicular cancer were treated with a dose
      intensified chemotherapy regimen of cisplatin (30 mg/m2), etoposide (200 mg/m2),
      and ifosfamide (1.6 g/m2), given on days 1-5 for a total of four cycles at
      planned intervals of 21 days. Patients (pts) received GM-CSF, either 10 (22 pts;
      70 cycles evaluable) or 5 micrograms/kg body wt. daily s.c. (22 pts; 72 cycles
      evaluable), starting the first day after chemotherapy for 10 consecutive days.
      Overall, 34 patients (78%) achieved a favorable response (CR or PR with negative
      tumor markers), six patients (14%) failed this chemotherapy regimen, and four
      patients (9%) died of therapy-related complications. The durations of both
      neutropenia and thrombocytopenia increased with the number of treatment cycles
      given. The duration of granulocytopenia after the fourth PEI cycle was
      significantly shorter for patients receiving 10 micrograms/kg than for those with
      5 micrograms/kg per day of GM-CSF (9 vs 13 days; p < 0.05). The median duration
      of thrombocytopenia < 20,000/microliters after the fourth cycle of PEI was also
      significantly reduced in favor of patients receiving 10 micrograms/kg of GM-CSF
      (4 vs 9 days; p < 0.02). However, there were no differences in the frequency of
      severe infections or in the achieved dose intensity. Five patients (11%)
      discontinued GM-CSF due to side effects (three anaphylactoid-type reactions, one
      myalgia and fever, one cutaneous toxicity). No difference in the frequency of
      side effects was seen between patients receiving 5 and those receiving 10
      micrograms/kg per day of GM-CSF. The dose of 5 micrograms/kg per day of GM-CSF
      may be sufficient to ameliorate neutropenia following standard-dose chemotherapy,
      while higher dosages of GM-CSF may be advantageous in patients receiving
      repetitive cycles of dose-intensified chemotherapy.

PMID- 8347734
TI  - Biotin labeling as an alternative nonradioactive approach to determination of red
      cell survival.
AB  - Biotin labeling of red cells was studied using different approaches to see if
      biotinylation is a useful label for determination of erythrocyte survival. Mouse
      red cells were labeled with biotin, either in vivo by injection or in vitro. In
      vivo labeled red cells were followed up in some mice without transfusing the
      labeled erythrocytes. Furthermore, in vivo labeled as well as in vitro labeled
      red cells were transfused into syngeneic mice. The biotin label allows an easy
      discrimination between labeled and unlabeled red cells during FACS analysis, and
      it is relatively stable for at least 50 days. All the three different approaches
      give similar results. Mean red cell life spans of in vivo or in vitro labeled red
      cells either transfused or followed up in vivo were between 44 and 52 days (T50
      mean 23.9 days) when red cell destruction was assumed to be only a result of
      senescence. Mean red cell life spans were between 8 and 18 days (T50 mean 9.5
      days) when a random destruction independent of red cell age was suggested. All
      the survival slopes are neither simple linear functions of time nor logarithmic
      functions, but they show an overlay of linear function by a logarithmic function
      where the components of both are unknown.

PMID- 8347735
TI  - Combined ankyrin and spectrin deficiency in hereditary spherocytosis.
AB  - Hereditary spherocytosis is characterized by a reduced spectrin content of the
      erythrocytes. However, the underlying primary defect remains unclear in the
      majority of cases. Genetic studies have revealed a linkage to the gene for
      ankyrin in some families. By means of ELISA we measured the ankyrin, spectrin,
      and band-3 contents in erythrocytes of 45 patients with typical spherocytosis.
      They were classified as having mild or moderate spherocytosis, according to
      clinical severity. Sixteen patients with mild spherocytosis showed slight
      reductions of ankyrin and spectrin contents. In contrast, 29 patients with
      moderate spherocytosis exhibited a clear reduction of both ankyrin and spectrin
      to about 60% of normal. Band 3 and lipid phosphorus, as measures for membrane
      surface area, were only slightly reduced to 85%. Our results, together with the
      molecular genetic data indicating the linkage between spherocytosis and the gene
      for ankyrin, suggest an ankyrin defect or deficiency as the primary lesion in
      most cases of spherocytosis.

PMID- 8347737
TI  - Pooling epidemiologic studies.

PMID- 8347736
TI  - Does depression cause heart disease?

PMID- 8347738
TI  - Depressed affect, hopelessness, and the risk of ischemic heart disease in a
      cohort of U.S. adults.
AB  - Major depression has been associated with mortality from ischemic heart disease
      (IHD). In addition, a symptom of depression--hopelessness--has been suggested as
      a determinant of health status. We studied the relation of both depressed affect
      and hopelessness to IHD incidence using data from a cohort of 2,832 U.S. adults
      age 45-77 years who participated in the National Health Examination Follow-up
      Study (mean follow-up = 12.4 years) and had no history of IHD or serious illness
      at baseline. We used the depression subscale of the General Well-Being Schedule
      to define depressed affect and a single item from the scale to define
      hopelessness. At baseline, 11.1% of the cohort had depressed affect; 10.8%
      reported moderate hopelessness, and 2.9% reported severe hopelessness. Depressed
      affect and hopelessness were more common among women, blacks, and persons who
      were less educated, unmarried, smokers, or physically inactive. There were 189
      cases of fatal IHD during the follow-up period. After we adjusted for demographic
      and risk factors, depressed affect was related to fatal IHD [relative risk = 1.5;
      95% confidence interval (CI) = 1.0-2.3]; the relative risks of fatal IHD for
      moderate and severe levels of hopelessness were 1.6 (95% CI = 1.0-2.5) and 2.1
      (95% CI = 1.1-3.9), respectively. Depressed affect and hopelessness were also
      associated with an increased risk of nonfatal IHD. These data indicate that
      depressed affect and hopelessness may play a causal role in the occurrence of
      both fatal and nonfatal IHD.

PMID- 8347739
TI  - Methods for pooled analyses of epidemiologic studies.
AB  - This paper presents a systematic methodology for the pooling and analysis of
      previously conducted epidemiologic studies. It discusses the methodologic issues
      to consider and the procedures to follow when conducting a pooled analysis of
      individual subject level data. I review random and fixed effects models to
      estimate pooled risks and the methods to examine whether heterogeneity in study
      specific effect estimates exists. Analytic strategies presented here can be used
      to assess sources of heterogeneity, particularly those originating from different
      study designs and methods. I describe methods for incorporating a qualitative
      assessment of the study design and data collection methods into the quantitative
      estimation of the overall effect. Finally, I make recommendations for future
      pooled analyses of epidemiologic studies.

PMID- 8347740
TI  - Gravidity, blood pressure, and hypertension among white women in the Second
      National Health and Nutrition Examination Survey.
AB  - Gravidity and parity have been hypothesized as possible protective factors for
      hypertension in women, but results of previous studies have been conflicting;
      none of three U.S. studies has clearly demonstrated this relation. We studied the
      association of number of pregnancies to blood pressure and hypertension in a
      cross-sectional study of 4,626 white women, ages 20-74 years, examined in the
      Second National Health and Nutrition Examination Survey. In univariate analyses,
      neither mean systolic blood pressure, mean diastolic blood pressure, nor
      prevalence of hypertension varied systematically with the number of pregnancies.
      In multivariate analyses that included age, body size, smoking, oral
      contraceptive use, education, poverty status, and alcohol use, systolic blood
      pressure declined modestly with greater gravidity. The association of gravidity
      with systolic blood pressure was stronger for younger premenopausal women. The
      odds of hypertension also declined with each additional pregnancy as compared
      with no pregnancies: there was an odds ratio of 0.90 (95% confidence interval =
      0.81-0.99) for premenopausal women and an odds ratio of 0.95 (95% confidence
      interval = 0.92-0.98) for postmenopausal women. These findings indicate a slight
      negative relation of number of pregnancies to both blood pressure and
      hypertension.

PMID- 8347741
TI  - Interpreting model coefficients when the true model form is unknown.
AB  - In this paper, we critically examine mathematical modeling. We outline the major
      assumptions required by modeling methods used in epidemiology and discuss in
      detail one fundamental assumption that is usually violated in epidemiologic
      studies: the assumption that the structural model form is correctly specified. We
      apply concepts from the econometrics literature to examine how epidemiologic
      inference may be affected when the structural model form is incorrectly
      specified. Because the structural model is almost always misspecified in
      practice, tests and confidence intervals for model coefficients do not refer to
      "true population parameters" in the ordinary sense. Rather, these statistics
      concern parameters that depend on features of study design, as well as the
      effects under study. In cohort studies analyzed with multiplicative rate models,
      model parameters are interpretable as approximations to log standardized rate
      ratios; unfortunately, such interpretations are not as accurate for other models
      and designs. We therefore conclude that model coefficients can serve as
      reasonable effect summaries in some, but not all, situations.

PMID- 8347742
TI  - How well do prediction equations predict? Using receiver operating characteristic
      curves and accuracy curves to compare validity and generalizability.
AB  - Although morbidity and mortality prediction equations are widely used in
      planning, clinical practice, and health risk appraisal, their validity and
      generalizability have been tested only in a limited way. Previous attempts lacked
      an absolute standard of performance and looked only at the equations' ability to
      predict who would become ill (sensitivity), not the equally important ability to
      predict who would remain healthy (specificity). We compared six all-cause
      mortality prediction equations using receiver operating characteristic curves and
      accuracy curves, which overcome the limitations of earlier methods and provide a
      concise visual representation of the results. We used equations from five
      prospective studies conducted in the United States (Tecumseh at 8 and 12 years of
      follow-up, Framingham, Chicago Gas, Chicago Western Electric, and Albany), each
      of which included cholesterol, smoking, and blood pressure as independent
      variables, to predict 12-year mortality in Tecumseh males age 40-54 years.
      Previous studies suggested that these equations predict equally well. Our
      analysis found that, although all predict better than chance, Albany, Chicago
      Western Electric, and Tecumseh at 8 years underestimate mortality. Receiver
      operating characteristic and accuracy curves are a promising technique for
      assessment of prediction equations.

PMID- 8347743
TI  - Use of two data sources to estimate odds ratios in case-control studies.
AB  - Information bias is among the most serious and common problems in epidemiology.
      Approaches have been developed to reduce information bias by correcting for known
      amounts of misclassification. Unfortunately, in most studies, the extent of
      exposure misclassification cannot be easily estimated. We discuss the application
      to case-control studies of an approach originally proposed by Hui and Walter in
      1980 to estimate the sensitivity and specificity of two independent
      classification schemes (Hui SL, Walter SD. Biometrics 1980;36:167-171). In this
      paper, we propose using the EM algorithm to provide a simple numeric technique
      for implementing their method that seems to converge for most real-world data.
      Our approach allows inclusion of a measure of non-independence of the two
      classification schemes, and we assess the influence of non-independence on the
      odds ratio. Finally, we provide a simple variance estimate for the odds ratio
      based on the delta method and maximum likelihood theory. We exemplify our results
      and method with data from a case-control study of sudden infant death syndrome in
      which data on some variables were obtained from both maternal interviews and
      medical records.

PMID- 8347744
TI  - Confounding by time since hire in internal comparisons of cumulative exposure in
      occupational cohort studies.
AB  - We use a simple, empirical model to describe the healthy worker effect mortality
      pattern. Under this simple model, internal comparisons of risk with increasing
      cumulative exposure will tend to be biased away from the null because of the
      healthy worker effect. We illustrate the potential magnitude of the bias in a
      simple situation and show that controlling for time since hire, by means of
      standard epidemiologic methods, eliminates the bias. Time since hire also is a
      concern of occupational epidemiologists because of the issue of induction time;
      sufficient time may not have elapsed among recently hired workers for an exposure
      to manifest its effect on disease occurrence. Provision for an adequate induction
      period can be addressed, like the concern raised in this paper, by restricting
      the analysis to workers first employed many years before the start of the follow
      up period.

PMID- 8347745
TI  - Physical activity and risk of endometrial cancer.
AB  - In a population-based case-control study of endometrial cancer, we interviewed
      268 cases and an equal number of matched controls regarding physical activity at
      work and outside of work. We also obtained self-ratings of overall physical
      activity levels. The results showed that nonretired women holding sedentary jobs
      or those reporting sedentary life-styles were at somewhat increased risk of
      endometrial cancer. The associations remained unchanged after adjustment for
      caloric intake and body mass index. Although an effect of physical inactivity on
      endometrial cancer risk is biologically plausible, our results show some
      inconsistencies, such as a lack of elevation in risk among women who were
      physically inactive outside of work.

PMID- 8347746
TI  - The accuracy of parental reports of their children's intake of fruits and
      vegetables: validation of a food frequency questionnaire with serum levels of
      carotenoids and vitamins C, A, and E.
AB  - It has been recommended that U.S. children increase their dietary intake of
      fruits and vegetables. Measuring diets of children to support and evaluate
      nutritional interventions can be a difficult task, however. We administered to 97
      parents of children age 6-10 years a food frequency questionnaire on their
      children's usual dietary intake over the previous 3 months. We then compared
      these reports by parents of their children's intakes of fruits and vegetables,
      and the derived estimates of intake of carotenoids and vitamins C, A, and E, with
      the children's serum levels of carotenoids and vitamins C, A, and E. The dietary
      reports of intakes of 35 fruits and vegetables showed Spearman rank-order
      correlations of 0.30 with serum carotenoids and 0.34 with serum vitamin C.
      Children in the highest quartile for intake of fruits and vegetables according to
      their parents' food frequency reports had 35% higher carotene levels and 31%
      higher vitamin C levels in their serum than did children in the lowest quartile
      for intake of fruits and vegetables. We conclude that parental reports of young
      children's diets using food frequency methods are accurate enough to be useful in
      nutritional screening and dietary surveillance of fruit and vegetable intake.

PMID- 8347747
TI  - The reproducibility and validity of a self-administered semiquantitative food
      frequency questionnaire in subjects from South Dakota and Wyoming.
AB  - Most validation studies of food frequency questionnaires have been done in
      populations capable of reporting their diet with unusual accuracy. In this study
      of ranchers and subjects selected at random, we compared nutrient intakes as
      assessed with multiple diet records with those assessed with a self-administered
      food frequency questionnaire (the Harvard-Willett instrument with 116 food
      items). One hundred thirty-eight subjects from South Dakota and Wyoming, 64 males
      and 74 females, completed at least one food frequency questionnaire and multiple
      1-day diet records (mean = 5 days) during a 6-month to 1-year period. Of invited
      subjects, 88% participated; 59% of participants had a high school education or
      less. For 22 dietary nutrients (excluding supplements) and alcohol, the median
      crude correlation between intakes based on diet records and the food frequency
      questionnaire completed before the diet records was 0.42; after adjustment for
      energy, age, and sex, and after correction for attenuation in the correlation
      coefficients due to error from a limited number of diet records, the median
      correlation was 0.52. Correlations for men and women were similar. The validity
      of the food frequency questionnaire in this population was similar to that
      reported previously and supports the use of self-administered food frequency
      questionnaires in studies of general populations.

PMID- 8347748
TI  - A meta-analysis of coffee, myocardial infarction, and coronary death.
AB  - This paper presents a meta-analysis of 22 studies of coffee use and myocardial
      infarction or coronary death. In the eight case-control studies, a fairly
      homogeneous increased risk was found among coffee users (geometric mean rate
      ratio of 1.42 for 5 cups per day vs none, with 95% confidence limits of 1.30,
      1.55, homogeneity P-value of 0.89). The 14 cohort studies tended to exhibit lower
      but very heterogeneous rate ratios, with a trend toward larger rate ratios in
      studies with longer follow-up periods and later publication dates (geometric mean
      rate ratio of 0.92 for the five cohort studies published up to 1981, 1.27 for the
      nine cohort studies published in 1986 or later; overall homogeneity P-value of
      0.0008). The evidence thus remains ambiguous regarding both the existence and
      size of a coffee effect, and although a rate ratio of over 1.5 for 5 cups per day
      appears unlikely, stronger effects for 10-cup-per-day drinkers cannot be ruled
      out.

PMID- 8347749
TI  - Comparison of early and late respondents to a postal health survey questionnaire.
AB  - We mailed a health survey to the 18,408 residents of a California retirement
      community and compared the 11,550 respondents on a number of characteristics by
      time of response. Early respondents were more likely to be the "worried well,"
      that is, healthy individuals who see their doctor regularly, receive disease
      detection screening, and follow healthful life-style practices. Late respondents
      tended to answer questions regarding their mental function and emotional status
      more negatively. Early and late respondents did not differ in the rates of death
      or hospitalization during the first 5 years of the study; nonrespondents had a
      higher incidence of hospitalization than respondents in year 1 and higher death
      rates in the first 3 years, but not thereafter.

PMID- 8347750
TI  - Telephone answering machines: the influence of leaving messages on telephone
      interviewing response rates.
AB  - We studied women 45-54 years of age from two communities who failed to return a
      mailed survey in an experiment to assess the impact on interviewing response
      rates of leaving messages on telephone answering machines at the time of
      telephone follow-up. There were 88 and 103 subjects assigned to the "message" and
      "no message" groups, respectively. After adjustment for age, interviewer, and
      community, leaving messages increased the rate of reaching a household by about
      15% and improved the overall interviewing response rate by about 15% as well.
      This improvement was more apparent in women from the higher socioeconomic status
      community.

PMID- 8347751
TI  - Combined estrogen and progesterone use and endometrial cancer.

PMID- 8347752
TI  - Measures of effect based on the sufficient causes model.

PMID- 8347753
TI  - Measures of effect based on the sufficient causes model.

PMID- 8347754
TI  - A moment in time.

PMID- 8347755
TI  - The history and current status of paramedical support for the ostomy patient.

PMID- 8347756
TI  - Alcohol and other drug abuse in elders.
AB  - With the growing population of older persons, ET nurses can expect an increasing
      number of elderly clients in their practice settings. Elderly persons are not
      immune to alcohol and other drug abuse. Detection of substance abuse in this
      population is complex and often missed. The purposes of this article are as
      follows: (1) examine barriers that may prevent nurses from addressing substance
      abuse among the elderly population; (2) suggest risks for psychoactive substance
      abuse in this population; (3) identify warning signs that should alert nurses to
      the problem; and (4) outline treatment options for substance-abusing clients.

PMID- 8347757
TI  - Interface pressure measurements of support surfaces with subjects in the supine
      and 45-degree Fowler positions.
AB  - In the past 20 years there has been a dramatic increase in different types of
      support surfaces to reduce the incidence of pressure ulcers. The purpose of this
      study was to determine the effect of static air overlays (Sof-Care and
      Tendercloud), replacement mattresses (Dermarest and Therarest), and a standard
      hospital mattress on tissue interface pressures in healthy subjects. A
      convenience sample of 25 subjects had tissue interface measurements obtained
      under the sacrum and heel bony prominences on the five support surfaces in the
      supine and 45-degree Fowler's positions. A repeated measures analysis of variance
      (p < 0.05) indicated that the Dermarest, Therarest, Sof-Care, and Tendercloud
      support surfaces reduced pressure significantly under the sacral bony prominence
      compared with the standard hospital mattress. Heel interface pressure
      measurements were significantly higher than sacral interface pressure
      measurements. There was no significant difference between supine and 45-degree
      Fowler's positions with respect to tissue interface pressures.

PMID- 8347758
TI  - Use of computer technology in ET nursing.
AB  - ET nurses frequently share ideas and products that suddenly make our job and
      patient care much easier. But little has been discussed in the Journal of ET
      Nursing to shed light on the speed, accuracy, efficiency, improved communication,
      and long-term cost-effectiveness that computer technology can bring to our chosen
      specialty. This article identifies use of computer technology in practice,
      education, and research. Such applications will bring about a change in present
      practice methods. Everett Roger's change theory can assist in the change process.
      Our mission is to provide state-of-the-art health care for individuals with
      wounds, ostomies, and incontinence. Computer technology can assist in that
      mission by increasing productivity and effectiveness of the ET nurse.

PMID- 8347759
TI  - Purple ulcers.

PMID- 8347760
TI  - Air support therapy.

PMID- 8347761
TI  - Braden Scale and clinical judgment.

PMID- 8347763
TI  - Twenty-five years in colon and rectal surgery: changes and progressions.

PMID- 8347762
TI  - Ileostomy complications.

PMID- 8347764
TI  - Effect of various cytokine combinations on induction of non-MHC-restricted
      cytotoxicity.
AB  - Efforts were directed to achieve an increased lymphokine-activated non-MHC
      restricted killing (LAK) activity greater than that induced by rIL-2 alone. Human
      peripheral blood (PB) and bone marrow (BM)-derived mononuclear cells (MC) were
      exposed in vitro to multiple cytokine combinations, including rIL-6, rIL-7, rIFN
      alpha and rIFN-gamma in the presence of either suboptimal or optimal doses of rIL
      2. Our results have shown that BMMC are a potential source for induction of
      increased LAK activity upon exposure to multiple cytokine combinations, whereas
      PBMC could not be successfully stimulated under the same conditions. Fifty-five
      to 62% of BM-derived samples stimulated with high dose rIL-2 + rIL-7 or rIL-2 +
      rIL-7 + rIL-6 + rIFN-gamma exhibited a higher degree of cytotoxicity than BM
      samples stimulated with rIL-2 alone. Exposure of PB-derived large granular
      lymphocytes (LGL) to various cytokine combinations led to increased proliferation
      after stimulation with suboptimal dose of rIL-2 in the presence of rIL-6 and rIL
      7. This increase was not observed in induction of cytotoxicity. We suggest that
      BMMC activated by multiple cytokine combinations could play an active role in
      improving antitumor response in vivo by contributing to the control of minimal
      residual tumor cell growth, particularly post-BM transplantation.

PMID- 8347765
TI  - The effects of thermal injury on serum interleukin 1 activity in rats.
AB  - Interleukin 1 (IL-1) is present in the blood of burned patients but its
      pathophysiologic role is not fully understood. Rat models would be useful
      research tools, if this cytokine could be identified in a complex fluid like
      blood. We describe a methodology, which revealed IL-1 activity from the serum of
      burned rats. Serum was collected from 37 rats with 30% total body surface burns
      and 9 unburned controls. To vary the burn response, the wounds of 17 rats were
      seeded with nonvirulent Pseudomonas aeruginosa at the time of injury. IL-1
      activity was assessed by its capacity to induce IL-2 secretion in murine lymphoma
      cells (LBRM-33-1A5). Only after the serum had been fractionated, concentrated,
      and dialyzed, was IL-1 activity uncovered. Sera from burned rats contained five
      times more IL-1 activity than those from control animals (p < 0.05). There was no
      difference in serum IL-1 activity between burned and burn-seeded animals. The IL
      1 activity was heat labile, and not produced by P. aeruginosa endotoxin, TNF
      alpha, or endogenous IL-2 in rat serum. These results confirm that serum IL-1
      levels are increased following thermal injury, and that there is no apparent
      relationship between IL-1 levels and infection. The serum preparation scheme
      presented in this study offers a reasonable approach to the measurement of serum
      IL-1 levels in rat models of disease and injury.

PMID- 8347766
TI  - Detection of oncostatin M in human plasma and serum by a sensitive enzyme
      immunoassay.
AB  - A sensitive and specific enzyme immunoassay was developed for detecting
      oncostatin M (OM) in human plasma and serum. The assay utilizes three anti-OM
      monoclonal antibodies that recognize mutually exclusive epitopes, including a
      neutralizing epitope. A sensitivity of 24 pg/ml was routinely obtainable. The
      assay showed no cross-reactivity with leukemia inhibitory factor (LIF) or
      interleukin-6 (IL-6), other members of the cytokine family that includes OM. The
      utility of the enzyme immunoassay (EIA) was demonstrated by detecting the time
      dependent accumulation of OM in plasma from lipopolysaccharide (LPS)-treated
      human whole blood. The concentration of OM in human sera from normal donors was
      generally below the detection limits of the assay. However, concentrations of OM
      greater than 25 pg/ml were found in 17 of 212 serum samples from apparently
      normal donors. The detection of OM in human plasma and serum demonstrates that
      the EIA could be a useful tool in examining the role of OM in physiologic and
      pathologic states.

PMID- 8347768
TI  - The distribution and nature of colour vision among the mammals.
AB  - 1. An oft-cited view, derived principally from the writings of Gordon L. Walls,
      is that relatively few mammalian species have a capacity for colour vision. This
      review has evaluated that proposition in the light of recent research on colour
      vision and its mechanisms in mammals. 2. To yield colour vision a retina must
      contain two or more spectrally discrete types of photopigment. While this is a
      necessary condition, it is not a sufficient one. This means, in particular, that
      inferences about the presence of colour vision drawn from studies of
      photopigments, the precursors of photopigments, or from nervous system signals
      must be accepted with due caution. 3. Conjoint signals from rods and cones may be
      exploited by mammalian nervous systems to yield behavioural discriminations
      consistent with the formal definition of colour vision. Many mammalian retinas
      are relatively cone-poor, and thus there are abundant opportunities for such
      rod/cone interactions. Several instances were cited in which animals having
      (apparently) only one type of cone photopigment succeed at colour discriminations
      using such a mechanism. it is suggested that the exploitation of such a mechanism
      may not be uncommon among mammals. 4. Based on ideas drawn from natural history,
      Walls (1942) proposed that the receptors and photopigments necessary to support
      colour vision were lost during the nocturnal phase of mammalian history and then
      re-acquired during the subsequent mammalian radiations. Contemporary examination
      of photopigment genes along with the utilization of better techniques for
      identifying rods and cones suggest a different view, that the earliest mammals
      had retinas containing some cones and two types of cone photopigment. Thus the
      baseline mammalian colour vision is argued to be dichromacy. 5. A consideration
      of the broad range of mammalian niches and activity cycles suggests that many
      mammals are active during photic periods that would make a colour vision capacity
      potentially useful. 6. A systematic survey was presented that summarized the
      evidence for colour vision in mammals. Indications of the presence and nature of
      colour vision were drawn both from direct studies of colour vision and from
      studies of those retinal mechanisms that are most closely associated with the
      possession of colour vision. Information about colour vision can be adduced for
      species drawn from nine mammalian orders.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8347767
TI  - A coordinate-free approach to the analysis of growth patterns: models and
      theoretical considerations.
AB  - Developmental biology holds keys to our understanding of morphological pattern
      formation whether these patterns are expressed in the fossil record or among
      extant species. Though much is known about osseous growth at the cellular level
      (e.g. Hall, 1991), we have minimal understanding of the coordinated processes
      that combine to produce a complex, three-dimensional form. We have proposed a
      framework for the coordinate-free representation of form, a statistical method
      for comparing and modelling growth trajectories for complex morphologies, and a
      means for the eventual elucidation of the role of growth in the evolution of
      morphology. Our method uses the coordinate locations of biological landmarks to
      represent form as a matrix of all possible linear distances between landmarks,
      the form matrix. When two forms are expressed in this way, comparison of these
      forms is accomplished by computing the ratios of like linear distances, the form
      difference matrix. When the forms being compared are from a growth series, the
      matrix of ratios is called a growth matrix. Patterns of growth for two groups can
      be compared by computing the growth difference matrix. We applied growth
      difference matrix analysis to the study of sexual dimorphism of ontogeny in the
      M. fascicularis craniofacial skeleton. Growth matrices describing growth in male
      and female M. fascicularis were presented along with the growth difference matrix
      that describes sexual dimorphism of growth to underscore the detailed information
      available from this analytical technique. The method is quite general and can be
      applied to two- or three-dimensional data sets of landmark coordinates (cross
      sectional or longitudinal) collected from almost any developing structure. The
      methods that we propose enable us to go beyond a mathematical summary of the
      comparison of forms and the comparison of growth patterns. We provide examples of
      how growth patterns might be used in the study of phylogenetic relationships. Our
      plans for use of this method in the study of evolutionary change assumes that
      morphological change in the craniofacial skeleton results from evolutionary
      change in developmental units (as defined by Atchley & Hall, 1991) that underlie
      morphological structure. We believe we have the basic tools to ultimately propose
      informed phylogenies based solely on developmental data. This task requires the
      identification of 'growth features' and the polarization of these features as
      primitive or derived. It is also advisable to determine a set of primitive growth
      features for the groups of interest. This will necessitate the inclusion of
      outgroups in our growth analysis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8347769
TI  - Changes in subset specificity of anti-T cell autoantibodies in systemic lupus
      erythematosus.
AB  - Relative reactivity of anti-lymphocyte autoantibodies (ALA) from patients with
      systemic lupus erythematosus (SLE) against CD4+ and CD8+ T cells was studied
      using C-dependent microcytotoxicity assay. Of 46 SLE sera screened for anti-T
      cell autoantibodies, 27 sera (59%) showed significant cytotoxic reactivity. Of
      these, positive correlation between the titer of anti-T cell antibody and CD4/CD8
      killing ratio (p < 0.01) was demonstrated. In time course study of individual
      patients, the CD4/CD8 killing ratio increased and decreased as the disease flared
      and subsided and was accompanied by parallel changes in the titer of anti-T cell
      antibody titer. Moreover, as sera were serially diluted, the CD4/CD8 killing
      ratio decreased in 5 out of 10 sera. These results suggest that discrepancy among
      reports concerning the subset specificity of anti-T cell antibodies may be due,
      in part, to differences in the titer of ALA in the sera studied and to the
      dilution of serum used.

PMID- 8347770
TI  - Morphological analysis of autoimmune disease in MRL-lpr,Yaa male mice with
      rapidly progressive systemic lupus erythematosus.
AB  - We analyzed morphologically autoimmune disease in MRL/MpJ mice bearing both the
      Yaa and lpr genes (MRL-lpr,Yaa mice), and compared it with that in MRL/MpJ
      lpr/lpr (MRL-lpr) mice, in order to examine the effect of the Yaa gene on lpr
      induced tissue-specific immunopathologies. MRL-lpr,Yaa male mice developed
      glomerulonephritis more rapidly than did MRL-lpr males. The glomerular damage in
      MRL-lpr,Yaa males, as evaluated by histologic and immunofluorescent methods, was
      significantly greater than that in age-matched MRL-lpr males. In contrast, no
      differences in the development of vasculitis and arthritis were noted between the
      two groups. Pathological examination of the dead mice revealed a similar
      incidence of lethal glomerulonephritis in the two groups. Lymphoid hyperplasia in
      the spleen consisted predominantly of unusual T cells (B220+, Thy-1+, CD4-, CD8-)
      in the two groups, and an increased number of B cells was not found in MRL
      lpr,Yaa mice. The histological nature of the autoimmune diseases was similar in
      MRL-lpr,Yaa and MRL-lpr males. These results indicate that the Yaa gene
      accelerates the development of glomerulonephritis but not that of vasculitis or
      arthritis, suggesting that the mechanisms underlying the initiation of
      glomerulonephritis are different from those leading to vasculitis or arthritis in
      MRL-lpr mice.

PMID- 8347771
TI  - Effect of syngeneic islet antigen administration on complement-dependent antibody
      mediated cytotoxicity to islet cells and diabetes onset in diabetes-prone BB/OK
      rats.
AB  - Diabetes-prone BB/OK rats aged 30 to 35 days were subjected to three sequential
      intrasplenic injections of unfractionated homogenate prepared from Langerhans'
      islets of newborn syngeneic BB/OK rats. Syngeneic islet antigen administration
      resulted in increased complement-dependent antibody-mediated cytotoxicity (C'AMC)
      to rat pancreatic islet cells in serum, compared to buffer-treated control
      animals as detected by 51Cr-release assay. However, the increase of anti-islet
      cell cytotoxicity neither impaired glucose tolerance nor affected the incidence
      of diabetes and the age at manifestation. In contrast to BB/OK rats developing
      diabetes, animals remaining long-term normoglycaemic did not show an enhancement
      of cytotoxicity to islet cells within twelve days after the first islet antigen
      injection as revealed retrospectively. In conclusion, humoral mediated anti-islet
      cell cytotoxicity is not decisively involved in pancreatic beta-cell destruction
      and promotion of diabetes development in BB/OK rats, but animals becoming
      diabetic seem to be characterized by a stronger immunological reactivity upon
      syngeneic islet antigen challenge as indicated by an increase of anti-islet C'AMC
      compared to long-term normoglycaemic rats.

PMID- 8347772
TI  - Molecular analysis of abnormal satellite I DNA from a BUF/Mna rat thymoma.
AB  - BUF/Mna rats develop spontaneous thymomas in an autosomal dominant manner. We
      constructed recombinant plasmid library of 90 and 185 base-paired (bp) satellite
      I DNA fragments isolated from BUF/Mna rat thymoma DNA. Four unusual clones
      containing 93, 95, 95, and 173 bp inserts were isolated by colony hybridization
      with Wistar rat satellite I DNA. Nucleotide sequence analysis of the inserts of
      the 4 clones revealed abnormal sequence organization and unusual subunit
      structure of the rat satellite I DNA. Sequence comparisons between normal and
      abnormal satellite I DNA suggested that the unusual subunit structure could be
      generated by the change of the Hinf I recognition sequence to an Eco RI cleavage
      site, in addition to random deletions, insertions and base substitutions. The
      heptanucleotide sequence TGGGAAC, which is strictly conserved in normal subunits,
      was completely lost in all these clones. Southern blot hybridization revealed the
      amplification of abnormal satellite I DNA in BUF/Mna rat thymomas.

PMID- 8347773
TI  - Autoantibodies in HIV-infected patients that modulate the cholinergic activity of
      heart and gut tissue.
AB  - In human immune deficiency virus (HIV) disease, direct infection of heart tissue
      with HIV and repeated intestinal infections with opportunistic pathogens are
      thought to be the main cause of cardiac disease and diarrhoea respectively. A
      role for autoimmune phenomena may also be involved in the pathogeny of HIV
      disease. In this study, we demonstrate that immunoglobulins from the A and G
      classes from HIV positive patients are able to interfere with the function of the
      muscarinic cholinergic receptors from heart and gut. Both IgA and IgG HIV+
      preparations decreased the tension of isolated atria and increased the tension of
      isolated ileum. The mechanical effect of carbachol was inhibited in both atria
      and ileum preparations, when they were preincubated with either IgA or IgG HIV+
      fractions. An inhibitor of muscarinic cholinergic receptors (atropine) impaired
      the negative inotropic action of HIV+ immunoglobulins (Ig) on the heart and
      prevented the positive inotropic effect of HIV+ Igs on ileum. HIV+ IgA fraction
      was approximately ten fold more potent to interfere with the cholinergic function
      as compared to the IgG fraction. These results suggest that antibodies present in
      HIV+ serum may also modulate muscle's cholinergic activity in the heart and ileum
      from HIV+patients.

PMID- 8347774
TI  - The induction of J11d antigen on double negative T cells of MRL/Mp-Lpr/Lpr mice
      by high dose calcium ionophore.
AB  - Mice homozygous for the lymphoproliferation (lpr) gene spontaneously develop
      autoimmune syndrome. These mice were characterized by the massive accumulation of
      double negative (DN) T cells. Although peripheral T cells in normal mice do not
      express J11d antigen, those abnormal DN T cells in autoimmune-prone mice express
      J11d antigen. In this study, the mechanisms that control the expression of J11d
      antigen are analyzed. High concentration of calcium ionophore alone induces the
      expression of J11d antigen, but not of CD4, CD8, and activation antigens such as
      interleukin 2 receptor as well as transferrin receptor by J11d- DN T cells from
      lpr mice. The expression of J11d antigen is primarily regulated at the
      transcription level rather than the post transcription level. Experiments using
      metabolic inhibitors reveal that the induction of J11d antigen requires the
      activation of not only a Ca2+/calmodulin- but also protein kinase C-dependent
      signaling pathway. Furthermore, J11d- DN thymocytes from control mice share the
      similar functional property with DN lpr T cells in J11d antigen inducibility.

PMID- 8347775
TI  - Adhesion of cerebral endothelial cells to lymphocytes from patients with multiple
      sclerosis.
AB  - To investigate the factors regulating the entry of lymphocytes into the brain, we
      assessed the adhesion in vitro of 51Cr labelled lymphocytes from peripheral blood
      of patients with multiple sclerosis (MS) to human cerebral endothelial cells, and
      evaluated the effect on the adhesion of endothelium activated by interferon-gamma
      (IFN-gamma), lipopolysaccharides (LPS), interleukin-1 (IL-1) and tumor necrosis
      factor (TNF). Patients with acute relapsing MS during an exacerbation showed
      significant increase in MNC adherence to cerebral endothelial cells as compared
      with controls (p < 0.001). MNC adherence to cerebral endothelial cells activated
      by IFN-gamma or LPS, was significantly increased as compared to the controls (p <
      0.01). MNC adherence to endothelial cells was not blocked by antibodies against
      the intercellular adhesion molecule-1 (ICAM-1), but was blocked by lymphocyte
      function-associated antigen-1 (LFA-1). The increased adherence observed in
      patients with acute relapsing MS during an exacerbation would modulate the
      migration of lymphocytes across the blood-brain barrier (BBB).

PMID- 8347776
TI  - Silicone and autoimmunity.

PMID- 8347777
TI  - Insulin autoimmune syndrome; HLA genes may be a marker of disease heterogeneity.

PMID- 8347778
TI  - Helicobacter pylori, dietary factors, and atrophic gastritis in five Japanese
      populations with different gastric cancer mortality.
AB  - In a cross-sectional study of 634 men aged 40 to 49 years, randomly selected from
      five areas of Japan with different rates of gastric cancer mortality, 121 men of
      624 evaluated were diagnosed as having atrophic gastritis through serum
      pepsinogen I < 70 ng/ml and the pepsinogen I (PGI)/pepsinogen II (PGII) ratio <
      3.0. We examined the relation of Helicobacter pylori (H. pylori) antibodies and
      dietary factors, including plasma level of antioxidant micronutrients, to the
      presence of atrophic gastritis. Presence of H. pylori IgG antibodies was
      associated with increased risk of atrophic gastritis (odds ratio [OR] = 1.9, 95
      percent confidence interval [CI] = 1.1-3.3). As the level of plasma beta-carotene
      increased, we found a steady decrease in the risk of atrophic gastritis (OR for
      second quartile = 0.7, third quartile = 0.6, fourth quartile = 0.4, with CI = 0.2
      0.8). Frequent intake of yellow vegetables also was associated with lower risk,
      while frequent intake of soybean products was related to increased risk. Although
      H. pylori antibodies, beta-carotene level, and intake of soybean products were
      all significant in the multivariate analysis, these factors did not explain the
      differences in atrophic gastritis prevalence among the five regions. The analysis
      of these risk factors in relation to each pepsinogen marker showed that although
      both H. pylori infection and low plasma beta-carotene were associated with the
      decreased level of serum PGI/II ratio, the former was derived from the increase
      of PGII, which is common in early stage of atrophic gastritis, and the latter
      from the decrease of PGI, which is specific to severe atrophic
      gastritis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347779
TI  - Helicobacter pylori infection and chronic atrophic gastritis among Japanese blood
      donors: a cross-sectional study.
AB  - To evaluate an association between Helicobacter pylori (H. pylori) infection and
      chronic atrophic gastritis (CAG), an established precursor of gastric cancer, we
      performed a cross-sectional study using IgG antibody against H. pylori and
      pepsinogens of blood donors in four prefectures in Japan. Although a geographic
      correlation between the age-adjusted prevalence rates for H. pylori infection and
      those for CAG was not seen, the age-adjusted odds ratios (OR) of H. pylori
      infection for CAG were high in each area (around five for men and from four to
      12.6 for women). The association between them weakened with advancing age; the
      ORs in the youngest age group (16-29 yrs) and in the oldest age group (50-64 yrs)
      were 12.5 and 2.8 for men, and 11.5 and 5.2 for women, respectively. These
      findings suggest that H. pylori infection is strongly associated with CAG, while
      there are some other factors interacting in the development of CAG. A prospective
      cohort study in which CAG and H. pylori infection are taken into account will be
      necessary to assess the risks of gastric cancer.

PMID- 8347780
TI  - Occupational physical activity, socioeconomic status, and risks of 15 cancer
      sites in Turkey.
AB  - A multiple-site case-control study of 15 cancers (stomach; colon; rectum; larynx;
      lung; melanoma; skin; female breast; male breast; cervix; ovary; uterus;
      prostate; testis; and bladder) was conducted to evaluate their association with
      occupational physical activity and socioeconomic status (SES). A hospital-based
      study population (3,486 male cases and 379 female cases, and 2,127 male and 244
      female controls) was established in an oncological treatment center in Istanbul,
      Turkey, from 1979-84. Assessment of physical activity and SES was based on job
      titles held by the study subjects. Two measures of physical activity were
      developed based on energy expenditure and 'sitting time' during working hours.
      Observed risks were adjusted for age, smoking, and SES. Elevated risks were
      observed among workers who held sedentary jobs for cancers of the colon (odds
      ratio [OR] = 1.6), rectum (OR = 1.3), melanoma (OR = 1.9), male breast (OR =
      1.4), prostate (OR = 5.0), and ovary (OR = 2.0). Cancers of the cervix and uterus
      showed significantly decreasing risks with decreased activity. Risks of cancers
      of the colon, rectum, larynx, ovary, and melanoma were enhanced after risks for
      physical activity indices were adjusted for SES, while the associations between
      physical activity and cancers of the prostate, cervix, and uterus were weakened
      after SES adjustment. Risks of melanoma rose significantly with both activity
      indices after SES adjustment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347781
TI  - Alcohol consumption and postmenopausal endometrial cancer: results from the Iowa
      Women's Health Study.
AB  - At least three case-control studies have examined the association between alcohol
      consumption and endometrial cancer; two studies showed inverse associations, and
      a third a positive association. To our knowledge, no prospective studies of this
      association have been reported. The association between alcohol and endometrial
      cancer was examined in the Iowa Women's Health Study (United States), a
      prospective study of postmenopausal women. Information on alcohol consumption and
      other variables was obtained through a mailed questionnaire in January 1986.
      Through December 1990, 167 incident endometrial cancer cases occurred in the at
      risk cohort of 25,170 women. Multivariate-adjusted relative risks (RR) and 95
      percent confidence intervals (CI) were computed using Cox proportional hazards
      regression controlling for age, body mass index (BMI), parity, age at menopause,
      and noncontraceptive estrogen use, and to determine multiplicative interactions.
      The RRs of endometrial cancer associated with < 4.0 and > or = 4.0 g of alcohol
      per day compared with abstainers were 0.7 (CI = 0.5-1.1) and 1.0 (CI = 0.7-1.6),
      respectively. No statistically significant association between endometrial cancer
      and consumption of either beer, wine, or liquor was observed. There was no
      interaction between alcohol and any other endometrial cancer risk factors,
      including BMI or noncontraceptive estrogen use. These data do not support an
      association between alcohol and endometrial cancer among postmenopausal women.

PMID- 8347782
TI  - The association of height, weight, menstrual and reproductive events with breast
      cancer: results from two prospective studies on the island of Guernsey (United
      Kingdom).
AB  - The association with breast cancer of menstrual and reproductive events, family
      history of breast cancer, and body size have been studied on two cohorts of 6,706
      volunteers on the island of Guernsey (United Kingdom), 168 of whom had breast
      cancer detected during follow-up. The median follow-up time of the non-cases was
      21 years in the first study and 10 years in the second. A time-dependent Cox
      regression model was fitted to the data with age as the time-dependent variable
      in order to represent the effect of changing menopausal status. Other variables
      examined in the model were age at menarche, parity, age at first birth, family
      history of breast cancer, height, weight (both directly measured), relative
      weight (weight [kg]/height[m]), and Quetelet's body mass index
      (weight[kg]/height[m]2). Interactions between age and all other covariates also
      were examined. Family history was found to be the most important risk factor for
      women aged less than 51 years (relative risk [RR] = 3.5, 95 percent confidence
      interval [CI] = 2.0-6.0), and intervals between menarche and first birth longer
      than 14 years were found to increase significantly the risk of breast cancer in
      women older than 61 years (RR = 2.4, CI = 1.3-4.4). Height was the only indicator
      of body size which was associated significantly with risk of breast cancer, the
      estimated regression coefficient indicating an increase in risk of about 70
      percent for women on the 90th centile of height relative to those on the 10th
      centile. A survey of the literature showed that the association between risk of
      breast cancer and height was found in those studies which used direct
      measurements of height but not in others which used self-reported values.

PMID- 8347783
TI  - Childhood leukemia incidence in the vicinity of La Hague nuclear-waste
      reprocessing facility (France).
AB  - The incidence of leukemia is examined in young people (aged under 25 years)
      living within a 35 km radius of the French nuclear-waste reprocessing plant
      operating in La Hague, Normandy. During the period 1978-90, a total of 23 cases
      was diagnosed, giving an incidence rate of 2.99 per 100,000 which is close to the
      expected rate. In the 'canton' in which the nuclear plant is located, three cases
      of leukemia were observed compared with 1.2 expected, giving a standardized
      incidence ratio of 2.5. This nonsignificant finding is compatible with no
      increased risk and also with a sevenfold excess risk. Therefore, it reinforces
      the necessity of conducting a case-control survey, which is now planned, to
      assess the part played by occupational radiation exposure in leukemia incidence
      for this French area.

PMID- 8347784
TI  - Alcoholic beverage consumption and risk of breast cancer in Spain.
AB  - The relation between alcoholic beverage consumption and risk of breast cancer was
      examined. We used data from a population-based, case-control study that included
      almost all incident cases occurring in five Spanish regions from February 1990 to
      July 1991. A total of 762 women between 18 and 75 years of age, with a
      histologically confirmed, first diagnosis of breast cancer, were compared with
      988 control women. Alcoholic beverage intake was measured by an interviewer
      administered, semiquantitative food-frequency questionnaire. We used
      'nondrinkers' as the reference category and divided the remainder into four
      categories according to alcohol intake. The multiple logistic analyses included
      not only alcohol intake but also possible confounding factors such as total
      caloric intake, age, socioeconomic status, and reproductive and medical
      histories. Even at moderate levels of alcohol intake (less than 8 g/day), a 50
      percent increase in risk of breast cancer was found. The trend across categories
      of intake was statistically significant for wine and distilled drinks, as well as
      total alcohol intake. Consumption of 20 g or more of alcohol per day was
      associated with a 70 percent elevation in breast cancer risk compared with that
      of nondrinkers (adjusted relative risk (RR) = 1.7, 95 percent confidence interval
      = 1.3-2.3). Although the magnitude of the RR observed in our study was modest,
      our findings provide further support for a positive association between alcohol
      consumption and risk of breast cancer.

PMID- 8347785
TI  - Incidence trends for cancers of the breast, ovary, and corpus uteri in urban
      Shanghai, 1972-89.
AB  - Incidence data from the Shanghai (People's Republic of China) Cancer Registry
      were used to assess the temporal trends of three major female cancers during 1972
      89. Rates for cancers of the breast, corpus uteri and, to a lesser extent, ovary
      rose over the study period. The increases in breast and ovarian cancer were most
      pronounced among women under age 50, whereas those for corpus uteri cancer were
      restricted generally to those aged 55 to 69 years. When considered by cohort year
      of birth, risk of breast and ovarian cancers rose among women born since 1925 and
      1935, respectively, but little evidence of cohort effect was apparent for corpus
      uteri cancer. Potential explanations for these patterns are explored.

PMID- 8347786
TI  - Prior medical conditions and the risk of adult leukemia in Shanghai, People's
      Republic of China.
AB  - A population-based case-control interview study of 486 adult leukemia cases and
      502 healthy controls was carried out in Shanghai, People's Republic of China
      during 1987-89 to evaluate the etiologic role of prior medical conditions,
      medications, and diagnostic X-rays. Risks were examined separately for 236 cases
      with acute non-lymphocytic leukemia (ANLL), 79 with chronic myeloid leukemia
      (CML), 81 with acute lymphocytic leukemia (ALL), and 21 with chronic lymphocytic
      leukemia (CLL). Little difference was found between cases and controls for prior
      history of diabetes, hypertension, allergic conditions, most medications, and
      diagnostic X-rays. A few significant associations were observed for appendectomy,
      tuberculosis, and for several other chronic disorders with specific leukemia cell
      types, but the odds ratio estimates for most of these ranged from two to three
      and, with the exception of the two specified above, were based generally on five
      or fewer exposed controls. In contrast to an association with childhood leukemia
      in Shanghai, prior use of chloramphenicol was not linked with ANLL or other forms
      of adult leukemia. Further research is needed to clarify the relation of specific
      medical conditions and exposures with particular subtypes of leukemia, and to
      examine reasons for the low incidence of CLL in China and other Asian
      populations.

PMID- 8347789
TI  - Oral contraceptives and malignant melanoma.

PMID- 8347787
TI  - Tobacco, ethanol, coffee, pancreatitis, diabetes mellitus, and cholelithiasis as
      risk factors for pancreatic carcinoma.
AB  - A hospital-based case-control study of pancreatic cancer was conducted in Athens
      in 1991-92. One hundred and eighty-one patients operated on for cancer of the
      exocrine pancreas in eight teaching hospitals formed the case series, whereas
      hospital patient controls and hospital visitor controls formed two independent
      comparison series. Cases and controls were matched by hospital, gender, and age
      in a 1:1:1 ratio, and every matched triplet was interviewed in person by the same
      researcher. Results indicate that tobacco smoking increased the risk of
      pancreatic cancer, whereas neither coffee drinking nor consumption of alcoholic
      beverages were associated with the disease. Diabetes mellitus, cholelithiasis,
      and pancreatitis were associated positively with risk of pancreatic cancer,
      whereas allergic asthma was inversely (but not significantly) related to the
      disease. There was a suggestion that earlier age at menarche was associated with
      increased risk of pancreatic cancer and that parous women were at lower risk. No
      consistent associations were noted with respect to gastrectomy, other medical
      conditions or operations, birth order, height, weight, broad occupational groups,
      or other reproductive variables. The two comparison series were remarkably
      similar with respect to the whole spectrum of the study variables.

PMID- 8347788
TI  - Smoking and bladder cancer risk in blacks and whites in the United States.
AB  - A population-based case-control study of bladder cancer (2,982 cases and 5,782
      controls) conducted in 10 areas of the United States examined the effect of
      smoking as a risk factor among Blacks and Whites, after adjustment for occupation
      and other potential confounders. Although the overall risk for smoking was
      slightly higher in Blacks than Whites (relative risk = 2.7 and 2.2,
      respectively), this difference was not statistically significant. Estimation of
      risk by dose and currency of exposure revealed no consistent racial disparities
      in smoking-related risks. Race-specific, attributable risk estimates indicated
      that nearly half of bladder cancers among both Blacks and Whites could have been
      prevented by elimination of smoking.

PMID- 8347790
TI  - Influence of Mg2+ on the in vitro responsiveness of adenylate cyclase from hearts
      of aging rats.
AB  - The influence of [Mg2+] on the basal or stimulated activity of adenylate cyclase
      from the hearts of young (1 month old) and aged (24 months old) rats has been
      investigated in vitro. The basal activity of cardiac adenylate cyclase, and its
      responsiveness to stimulatory or inhibitory effectors, declined with age. This is
      probably due to alterations at the catalytic moiety of the signal transduction
      system, such as an impairment in the affinity of the catalytic moiety for ATP and
      a lower capacity of the catalytic moiety to bind activated stimulatory (Gs) or
      inhibitory (Gi) guanine nucleotide binding proteins. Compared to the enzyme from
      the heart of aged rats, unstimulated adenylate cyclase from the heart of young
      rats was more sensitive to an increase in [Mg2+] in the incubation mixture, as
      shown by a greater increase in basal activity and in the affinity of the enzyme
      for ATP. An increase in [Mg2+] counteracted the inhibitory effect of spermine on
      adenylate cyclase more effectively in young rats than in aged rats. On the other
      hand, an increase in [Mg2+] facilitated the stimulation of adenylate cyclase by
      Gpp(NH)p, isoproterenol and forskolin more in aged rats than in young rats. GDP
      beta S prevented the positive effect of high [Mg2+] on the stimulation of
      adenylate cyclase by forskolin, suggesting that an increased [Mg2+] favors the
      activation of Gs or the formation of functional complexes between the catalytic
      moiety and Gs. We suggest that aging leads to a higher requirement for Mg2+ at
      the allosteric site on the catalytic moiety whose occupancy is essential for the
      full expression of stimulated activity.

PMID- 8347791
TI  - Age-related changes in cardiac mitochondrial energetics under the influence of
      calcium in rat.
AB  - Mitochondria extracted from the hearts of Wistar rats aged 6 and 24 months showed
      similar values for the respiratory control index (RCI), state 3 oxygen
      consumption (QO2) and ADP/O measured using glutamate or succinate as substrates;
      with the exception that the QO2 of the aged rats was lower than that of the young
      rats in the presence of glutamate. The consumption of O2 induced by 2
      oxoglutarate and ADP was similar in both age groups. Concentrations of external
      free Ca2+ ranging from 0.2 to 0.8 microM produced an increase in O2 consumption
      and ATP formation in the young mitochondria, with a maximum effect at 0.2 microM
      external free Ca2+. Little or no change in O2 consumption and ATP formation was
      evident in aged mitochondria following incubations in concentrations of external
      free Ca2+ ranging from 0.2 to 0.8 microM. The continuous rate of formation of
      ATP, measured in the presence of 0.2 microM external free Ca2+ using a
      luminescence method, confirmed the previous results. This study indicates that
      the cardiac mitochondrial phosphorylating system of aged rats is poorly sensitive
      to variations in external free calcium.

PMID- 8347792
TI  - Myocardial infarction, cardiac anatomy and ventricular loading.
AB  - To see whether the hypertrophic response of the surviving myocardium after
      infarction leads to a complete reconstitution of ventricular mass, the left
      coronary artery was ligated in rats and the animals killed one month later. In
      infarcts affecting an average of 38% of the free wall of the left ventricle, the
      ratio of wall thickness to chamber radius remained essentially constant. On the
      other hand, the ratio decreased significantly in the presence of infarcts
      involving an average of 60% of the ventricular wall. In addition, inadequate
      growth adaptations were detected in both groups of infarcts with respect to
      myocyte volume and length and to capillary volume and length. These defects in
      the regeneration of myocardial structures were associated with elevations in
      diastolic wall stress which were more prominent in the larger infarct group. The
      limited growth reaction of the myocyte and vascular compartments may be
      implicated in the persistence of cardiac dysfunction and failure late after
      infarction.

PMID- 8347793
TI  - Hibernating and stunned myocardium.
AB  - The term "hibernating" myocardium has been introduced to indicate the presence of
      regional asynergy due to persistent hypoperfusion, which can be reversed after
      revascularization. The mechanisms underlying the prolonged functional adaptation
      of myocardial cells to hypoperfusion are still not clear, although preliminary
      experimental data indicate that a reduced availability of intracellular Ca++ may
      play an important role. The identification of hibernating myocardium may have
      therapeutic implications, since it has been demonstrated that the
      revascularization of hibernating myocardial territories may lead to regional and
      global improvement of systolic left ventricular function. The noninvasive
      identification of hibernating myocardium can be accomplished by positron emission
      tomography, which demonstrates the presence of preserved metabolic activity in
      hibernating myocardial territories. However, exercise 201thallium scintigraphy,
      using the reinjection technique, with a quantitative regional analysis of
      201thallium uptake, has also been reported to provide information comparable to
      that obtained by positron emission tomography. "Stunning" of the myocardium
      indicates a condition of transient impaired regional systolic function, following
      an episode of ischemia. The mechanisms determining the slow recovery of function
      after ischemia are still not completely understood. Experimental data suggest in
      this case a reduced Ca++ affinity of the myofibrils and a reduced maximal calcium
      activated force.

PMID- 8347794
TI  - Developmental changes in the myosin composition of guinea pig ventricular muscle.
      Relation to thyroid state and mechanical properties.
AB  - In a variety of mammalian species, thyroid hormone regulates the contractile
      properties of the heart as well as the expression of the alpha and beta heavy
      chains of myosin. We have previously shown that the plasma levels of thyroid
      hormone reach a peak immediately after birth in guinea pigs and decline with
      maturation. We therefore studied age-related changes in the expression of the
      myosin heavy chains in the guinea pig ventricle in relation to the ventricular
      mechanical properties and the levels of thyroid hormone. The composition of the
      myosin heavy chains was characterized by gel electrophoresis and immunoblotting.
      Anti-beta-chain antibody stained equally myosins from newborns (0-5 days) and
      adults (75-90 days), while anti-alpha-chain positively decorated only the myosins
      of euthyroid newborns or of hyperthyroid adults, but not myosins of embryos,
      hypothyroid newborns or hypothyroid adults. Myosin of euthyroid adults was
      faintly stained by anti-alpha-chain. The alterations in the composition of myosin
      corresponded with the "thyroid state" of these groups. The plasma levels of total
      T3 were 24.3 +/- 2.7, 9.04 +/- 1.2 and 139.0 +/- 9.3 ng/dl (mean +/- SEM) in the
      euthyroid, hypothyroid and hyperthyroid adults, respectively. In euthyroid and
      hypothyroid newborns, the plasma levels of T3 were 56.5 +/- 11.9 and 26.5 +/- 9.8
      ng/dl, respectively. Within each age group the thyroid state corresponded with
      maximal twitch tension (Tmax), rates of development of tension and relaxation,
      time to peak tension and rate of activation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347795
TI  - Heterogeneity of smooth muscle in bovine coronary arteries.
AB  - The monoclonal antibodies TT-1 against troponin T and TI-1 against troponin I of
      cardiac muscle, together with Western blots and immunofluorescence techniques,
      were used to evaluate the presence of troponin-like antigens in the smooth muscle
      cells of bovine coronary arteries. The walls of the left coronary artery before
      the bifurcation, its circumflex and descending branches, the right coronary
      artery, and the small branches of coronary arteries and the intramural arterial
      vessels were found to be homogeneously stained by the TT-1 antibody. Conversely,
      with the TI-1 antibody, differences were observed in the distribution of the TnI
      like antigen among the smooth muscle cells of extramural and intramural vessels.
      Heterogeneity of the smooth muscle cells of the coronary artery was also evident
      in the medial layer of large vessels near the branching points, where an intimal
      thickening was consistently observed. Double immunofluorescence assays with anti
      troponin antibodies in vivo and in vitro indicated a distinct intracellular
      localization of troponin T and troponin I immunoreactivities in vascular smooth
      muscle cells. The data are compatible with the existence of distinct troponin
      like antigens in smooth muscle cells of bovine coronary arteries whose
      distribution is in part related to the extramural or intramural localization of
      blood vessels.

PMID- 8347796
TI  - Age-dependent changes in myocardial susceptibility to ischemic injury.
AB  - We studied the relation between age and the heart's ability to tolerate ischemia.
      Groups of 5-7 isolated Langendorff perfused hearts from neonatal (5 days old),
      immature (11-44 days old), and adult (54 days old) rats, were subjected to 60
      minutes of global ischemia and 60 minutes of reperfusion at 37 degrees C. Pre
      ischemic left ventricular developed pressure was 54 +/- 1, 56 +/- 2, 59 +/- 4, 80
      +/- 3, 91 +/- 9, 91 +/- 8, 94 +/- 3, 101 +/- 10, 107 +/- 8 and 132 +/- 4 mmHg in
      the 5, 11, 14, 18, 23, 26, 33, 40, 44, and 54 day old groups, respectively. Left
      ventricular developed pressure recovered to 65 +/- 13, 69 +/- 4, 103 +/- 14, 84
      +/- 10, 81 +/- 3, 59 +/- 11, 42 +/- 10, 34 +/- 6, 34 +/- 6 and 25 +/- 7%
      respectively. Ischemia-induced contracture was greater in adult hearts and the
      time-to-onset and the time-to-peak contracture decreased with increasing age.
      Leakage of creatine kinase after ischemia correlated poorly with the recovery of
      contraction. Left ventricular end-diastolic pressure, at the end of 60 minutes of
      reperfusion, increased in an age-dependent manner from a pre-ischemic value which
      was set at 2-8 mmHg to 14 +/- 4, 22 +/- 2, 21 +/- 5, 27 +/- 3, 47 +/- 16, 52 +/-
      7, 71 +/- 7, 81 +/- 9, 73 +/- 5, and 82 +/- 8 mmHg in the 5, 11, 14, 18, 23, 26,
      33, 40, 44, and 54 day old groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347797
TI  - Functional and molecular changes in FoF1 ATP-synthase of cardiac muscle during
      aging.
AB  - We have studied the functional and molecular changes of mitochondrial FoF1 ATP
      synthase of cardiac muscle during aging. ATP hydrolase activity was lower in
      sonic submitochondrial particles prepared from hearts of senescent rats (24
      months) than in those prepared from hearts of adult rats (12 months). Oligomycin
      sensitive proton conduction of cardiac submitochondrial particles was greater in
      senescent rats than in adult rats. The beta subunit of F1, detected
      immunologically in submitochondrial particles, was less in senescent rats than in
      adult rats. Exposure of cardiac submitochondrial particles from adult rats to
      free radicals, generated by 60Co, resulted in inactivation of ATP hydrolase
      activity and a decreased content of F1. The structural and functional alterations
      of mitochondrial FoF1 ATP synthase during aging may be expected to affect energy
      metabolism, and our results suggest that they could originate from the action of
      free radicals generated in the inner mitochondrial membrane.

PMID- 8347799
TI  - British Society for Clinical Cytology. Programme and abstracts of the 32nd annual
      scientific meeting. Leeds, U.K., 11-15 September 1993.

PMID- 8347798
TI  - Coronary hemodynamics during isometric handgrip and atrial pacing in patients
      with angina pectoris compared to healthy men.
AB  - The responses in coronary blood flow and the relative myocardial extraction of
      oxygen to atrial pacing (causing mainly an increase in heart rate) and isometric
      handgrip (causing mainly an increase in pressure) were studied in patients with
      angina and in young and middle-aged healthy men. The myocardial extraction of
      oxygen and coronary sinus flow were measured by catheterizing the coronary sinus,
      using a catheter with thermistors for the measurement of flow by thermodilution
      and electrodes for atrial pacing. In the healthy men the increase in the
      consumption of oxygen was covered entirely by an increased coronary blood flow
      during both provocations, with no change in the arteriovenous oxygen difference
      during handgrip and a decrease during pacing. There was no significant difference
      in the reaction between younger and older men. In the patients with angina the
      increased consumption of oxygen during pacing was covered by an increased
      coronary blood flow with an unaltered arteriovenous oxygen difference, while
      during handgrip both the coronary blood flow and arteriovenous oxygen difference
      increased. It is concluded that during handgrip, compared to the artificial
      increase in heart rate, the myocardium is more dependent upon an increased
      relative extraction of oxygen to cover an increase in the requirement for oxygen.
      This may be due to a higher intramyocardial pressure. Patients with coronary
      heart disease are more dependent than healthy men on an increase in the relative
      myocardial extraction of oxygen. This may be related to a lower effective
      perfusion pressure because of the coronary arterial obstructions or to an
      increased intramyocardial pressure and a relatively shorter duration of diastole
      because of the impaired cardiac function.

PMID- 8347801
TI  - Lesions in four parts of the basal forebrain change basic behaviour in rats.
AB  - Subdivisions of the basal forebrain (BF) are postulated to be differently
      involved in the regulation of behavioural functions. We compared 16 parameters of
      rat open field behaviour before, 10 days and 60 days after lesions in four BF
      subdivisions, the anterior and the posterior nucleus basalis magnocellularis
      (NBMa, NBMp), the vertical and the horizontal diagonal band nucleus (VDB, HDB)
      with sham-operated control rats. Every lesion type caused a significantly
      different pattern of significant behavioural changes. VDB and NBMp lesions both
      produced different patterns of ambulatory and exploratory hyperactivity, whereas
      NBMa lesions caused hypoactivity. Changes after HDB lesions were relatively
      small. The rate of habituation also shared changes that differed according to the
      lesion site. These changes in basic unlearned behaviour are likely to interact
      with more complex functions such as cognitive processes, learning and memory.

PMID- 8347802
TI  - Nitric oxide activates buccal motor patterns in Lymnaea stagnalis.
AB  - The mollusc, Lymnaea stagnalis, has been used as a model to study the mechanisms
      of nitric oxide (NO)-dependent processes in the CNS. Putative NO-containing
      neurones in Lymnaea are localized in the buccal ganglia, predominantly in areas
      where sensory neurones known to regulate feeding are found. The NO-generating
      substance, S-nitrosocysteine (S-NC, 5 x 10(-5)-10(-3 M) activates feeding
      movements of the buccal mass and modulates the activity of buccal motoneurones.
      An inhibitor of NO synthase, NG-methyl-L-arginine (10(-4) M) decreases the
      frequency of background buccal movements and has opposite effects to S-NC on the
      buccal motoneurones. We suggest that NO is a messenger in the CNS of Lymnaea and
      may be involved in coordination of feeding motor patterns.

PMID- 8347800
TI  - Maternal nicotine exposure enhances cutaneous axon reflexes in the neonatal rat.
AB  - Chronic nicotine exposure enhances axon reflexes in adult rats. Since smoking
      mothers expose their infants to nicotine, this study investigated whether late
      gestational and or lactational maternal nicotine exposure affects neonatal axon
      reflexes. Osmotic pumps, implanted subcutaneously in adult female rats, delivered
      either nicotine (5 mg kg-1 day-1) or saline. Axon reflex responses of infant
      progeny, evoked by iontophoresis of 2 mC acetylcholine, were measured by laser
      Doppler flowmetry. Nicotine-exposed infants showed significantly enhanced axon
      reflexes during both gestational and lactational nicotine exposure, which
      recovered after exposure ceased. Controls did not exhibit these changes. Maternal
      nicotine exposure reversibly sensitized nicotinic cholinoceptors on infant
      cutaneous sensory nerves, but not muscarinic cholinoceptors on vascular
      endothelium. This may result from upregulation of cutaneous nicotinic
      cholinoceptors.

PMID- 8347803
TI  - The localization of cholecystokinin mRNA in embryonic striatal tissue grafts:
      further evidence for the presence of non-striatal cells.
AB  - We have studied by in situ hybridization histochemistry the mRNA expression of
      preprocholecystokinin (CCK) in grafts of foetal striatal tissue neurones
      implanted into the ibotenic acid lesioned adult rat neostriatum. Animals were
      studied at 30 and 90 days after implantation. Using a 35S-labelled 'antisense'
      oligonucleotide (45-mer) probe complementary to the rat CCK cDNA we observed a
      dense hybridization signal for CCK mRNA in the striatal eminence in developing
      embryos and in all the striatal grafts examined; no CCK mRNA expressing cells
      were found in the normal neonatal or adult rat neostriatum. However, CCK mRNA was
      heavily expressed in other areas of the host brain including the somatosensory
      cortex, the claustrum, primary olfactory cortex and endopiriform cortex. The
      germinal cell layer of the striatal eminence is the source of origin for these
      non-striatal cell groups as well as for cells destined to form the neostriatum.
      The present results suggest that CCK mRNA expression provides an unambiguous
      marker for many of the non-striatal cells in 'striatal' grafts.

PMID- 8347804
TI  - Age-related changes of DRG neuronal attachment to extracellular matrix proteins
      in vitro.
AB  - Attachment of dorsal root ganglion (DRG) neurones from 3-month-old (young adult)
      and 24-month-old (aged) mice to the following substrates was evaluated after 6 h
      in culture: (1) poly-L-lysine (PL), (2) PL + type I collagen (CL-I), (3) PL +
      type IV collagen (CL-IV), (4) PL + laminin (LM) and (5) PL + fibronectin (FN). In
      the young adult mice, each substrate coated onto PL, significantly increased the
      ratio of attachment, compared with PL alone. In the aged mice, CL-I and LM, but
      not CL-N or FN improved the attachment. There was no difference in cell survival
      or neurite extension after 48 h in culture between the two groups of mice. These
      results suggest that ageing causes selective changes of the neuronal cell-surface
      receptors respective to extracellular matrix proteins such as CL-IV and FN.

PMID- 8347805
TI  - Event-related potentials and recognition memory within the 'levels of processing'
      framework.
AB  - Event-related potentials (ERPs) were recorded from nine subjects during an
      incidental memory paradigm. During the study phase subjects were engaged in two
      tasks requiring semantic and rhyming decisions. During the test phase, subjects
      were required to decide on each of 320 trials if the word was 'new' (never before
      presented) or 'old' (seen previously). Results showed that semantic old words
      were more often recognized than rhyming ones. ERPs to new words were more
      negative than ERPs to old words in the 400-800 latency range. ERPs to semantic
      old words were more positive than ERPs to rhyming ones in the same latency range.
      The difference between ERPs to semantic and rhyming old words confirms a
      relationship between ERPs and memory.

PMID- 8347806
TI  - Functional magnetic resonance imaging of Broca's area during internal speech.
AB  - Conventional gradient-echo magnetic resonance imaging (MRI) at 4 Tesla was used
      successfully to study the activity of Broca's area during internal speech word
      generation in healthy right-handed volunteers. Activity was demonstrated in the
      internal gray matter surrounding the ascending ramus of the lateral sulcus, deep
      to the cortical surface representation of Broca's area, in all the subjects.
      These studies demonstrate the capability of functional MRI to non-invasively map
      language related cognitive functions. Such functional mapping has value for both
      the study of basic neuroscience and neurosurgical planning.

PMID- 8347807
TI  - Proconvulsant and anticonvulsant effects of Evans blue dye in rodents.
AB  - The effect of i.c.v. administration of Evans blue to sound sensitive DBA/2 mice
      and to genetically epilepsy-prone rats was studied. In mice, Evans blue (3.3-52
      nmol) induced: hyperlocomotion, wild running, scratching, clonic muscle spasms,
      tonic seizure (latency 10-45 min), followed by death or recovery. The CD50 value
      for clonic seizures for Evans blue was 35(23-53) nmol. Pretreatment (45 min) with
      Evans blue (13-52 nmol, i.c.v.) dose-dependently reduced the incidence of sound
      induced seizures in DBA/2 mice (ED50 value against clonic seizures = 30 [15-58]
      nmol, i.c.v). In rats, Evans blue (104 nmol, i.c.v.) induced
      electroencephalographic seizures in the hippocampus and cortex and behavioural
      limbic seizures with a latency of 15-20 min. A reduction in the mean score (from
      5 to 2-3) for behavioural seizures was observed which lasted for 4-5 days in rats
      electrically-kindled daily in the hippocampal CA3 subsector. Sound-induced clonic
      seizures in kindled and non-kindled rats were reduced for 3-4 days after
      administration of Evans blue (104 nmol, i.c.v.).

PMID- 8347808
TI  - Different sensitivities of NMDA receptor channel subtypes to non-competitive
      antagonists.
AB  - Four kinds of heteromeric N-methyl-D-aspartate (NMDA) receptor channels, the
      epsilon 1/zeta 1, epsilon 2/zeta 1, epsilon 3/zeta 1 and epsilon 4/zeta 1
      channels, were expressed in Xenopus oocytes and their sensitivities to various
      non-competitive antagonists were examined. The epsilon 1/zeta 1 and epsilon
      2/zeta 1 channels were more sensitive to (+)MK-801 (dizocilpine) than the epsilon
      3/zeta 1 and epsilon 4/zeta 1 channels, whereas the sensitivities to
      phencyclidine (PCP), ketamine and N-allylnormetazocine (SKF-10,047) were only
      slightly variable among the four epsilon/zeta channels. Furthermore, the
      replacement by glutamine or arginine of the conserved asparagine residue in
      segment M2 of the epsilon 2 and zeta 1 NMDA receptor channel subunits reduced the
      sensitivities to PCP, ketamine and SKF-10,047, though to different extents. These
      results, together with previous findings, suggest that these non-competitive
      antagonists as well as (+)MK-801 and Mg2+ act on a common site.

PMID- 8347809
TI  - Inhibition of ischaemic tolerance in the gerbil hippocampus by quercetin and anti
      heat shock protein-70 antibody.
AB  - To clarify the role of heat shock protein-70 (HSP70) in ischaemic tolerance
      following pretreatment with sublethal cerebral ischaemia, we examined whether the
      induction of tolerance in the gerbil hippocampus is inhibited by quercetin, an
      inhibitor of HSP70 expression, or anti-HSP70 antibody. A 3 min period of
      forebrain ischaemia was induced following pretreatment with 2 min of ischaemia
      and 3 days of reperfusion. Quercetin or anti-HSP70 antibody was continuously
      infused into the left lateral ventricle using an implanted osmotic minipump
      started 3 h after or 2 h before the first ischaemia. The animals were killed 4
      days after the second ischaemia for histological observations. Both agents
      produced no neuronal damage in the brain following a single 2 min period of
      ischaemia. The neuronal density of the CA1 hippocampus in animals subjected to
      treatment with quercetin and anti-HSP70 antibody was significantly lower than
      vehicle-treated animals but were significantly higher than animals with a single
      3 min period of ischaemia. Thus, the present study showed that quercetin and anti
      HSP70 antibody prevent the induction of ischaemic tolerance. The result suggests
      that HSP70 expression, at least in part, plays a role in the induction of
      ischaemic tolerance.

PMID- 8347810
TI  - Timing the excitotoxic induction of heat shock protein 70 transcription.
AB  - The time course of heat-shock protein 70 (HSP70) transcriptional induction was
      compared with neuronal- and non-neuronal-specific mRNAs following intrastriatal
      quinolinate (QA) injection. Within one hour of QA exposure, immediate-early gene
      (IEG; c-fos) activation preceded slight increases in glutamic acid decaroxylase
      (GAD) mRNA levels. However, glial fibrillary acid protein (GFAP) and HSP70 mRNA
      levels remained constant. After one hour, HSP70 mRNA levels surged 6 fold during
      a delayed transcriptional phase that was induced between 4-12 hours. This phase
      was characterized by massive increases in c-fos and GFAP mRNAs while GAD
      transcripts fell drastically suggestive of neuronal death. Therefore HSP70 genes
      may play an important role in glial/immune activation following rapid excitotoxic
      damage by direct injections of quinolinate.

PMID- 8347811
TI  - Apomorphine induced hypothermia, stereotypy and changes in dopamine D2 mRNA
      expression.
AB  - The changes in DA-D2 receptor mRNA expression following apomorphine induced
      hypothermia and stereotypy were determined. Rectal temperatures and stereotypy
      were measured daily after apomorphine injection to Sprague-Dawley rats for 7
      days. DA-D2 mRNA expression was determined by Northern blot analysis. Apomorphine
      caused a dose dependent decrease and increase in rectal temperatures and
      stereotypy respectively. Northern blot analysis indicated a relative abundance of
      the DA-D2 receptor message at the high and a reduction at the lower dose of
      apomorphine. The result showed that the agonist activity could influence the
      expression of DA-D2 receptor mRNA.

PMID- 8347812
TI  - Correlation between peri-infarct DC shifts and ischaemic neuronal damage in rat.
AB  - The effect of peri-infarct depolarizations on ischaemic injury was studied in
      rats submitted to 3 h occlusion of the left middle cerebral artery (MCA). The
      number of depolarizations varied from 1 to 8 and infarct volume from 37 to 159
      mm3. The correlation between the two variables revealed a highly significant
      linear relationship (r = 0.800; p < 0.005), each depolarization accounting for an
      increase in infarct volume by about 13 mm3. The aggravating effect of repeated
      depolarizations was also demonstrated by the gradual increase in cortical DC
      shift duration, in EEG amplitude recovery time, and in EEG delta power with
      increasing number of depolarizations. Suppression of peri-infarct depolarizations
      is a rational approach for reducing the severity of ischaemic stroke.

PMID- 8347813
TI  - Protein kinase A inhibitors prevent the maintenance of hippocampal long-term
      potentiation.
AB  - The possible involvement of cAMP-dependent protein kinase A (PKA) in mechanisms
      of long-term potentiation of the Schaffer collateral-commissural input of rat CA1
      neurones was investigated using several inhibitors in vitro. If 10 microM H-8,
      100 nM KT5720 or 50 microM Rp-cAMPs was applied to the bath before a triple 100
      Hz/0.5 s tetanization, post-tetanic and short-term potentiation developed almost
      normally. However, from about 3 h after tetanization the long-term potentiation
      (LTP) of the field-EPSP declined with respect to the control in an irreversible
      manner. These data suggest that besides protein kinase C the synergistic
      activation of PKA is necessary for the maintenance of LTP.

PMID- 8347814
TI  - GABA-responses of CA3 neurones at epileptogenic threshold concentrations of
      convulsants.
AB  - Epileptogenic actions of convulsants are often attributed to weakened inhibitory
      synaptic mechanisms. This assumption was tested by studying GABA-induced
      postsynaptic membrane potential (MP) changes of CA3 neurones (guinea-pig) before
      and during exposure to bicuculline methoiodide (BMI), pentylenetetrazol (PTZ),
      penicillin (PEN) and caffeine (CAF). Under control conditions GABA ejections
      elicited polyphasic MP fluctuations (components I-III). After adding BMI, PTZ,
      PEN or CAF, early hyperpolarizations (component I) did not change at
      epileptogenic threshold concentrations. These convulsants, however, exerted
      differential effects on the depolarizing component II, but only threshold
      concentrations of penicillin strongly reduced the amplitude of this component.
      Simultaneously, component III was slightly accentuated. These findings indicate
      that changes of GABA responses are not an essential prerequisite for the
      generation of paroxysmal depolarizations.

PMID- 8347815
TI  - Electroencephalographic correlates of paced breathing.
AB  - Multichannel EEG, respiration, blood pressure and ECG were recorded during paced
      breathing at five frequencies in 18 subjects in order to elucidate the effects of
      paced breathing on power changes in alpha, beta and theta bands, and on
      rhythmical variability of these parameters. Mean power in the beta band and low
      frequency beta power variability (0.12-0.04 Hz) increased during paced breathing
      at frequencies of 0.25 and 0.20 Hz. The total variability of alpha power in the
      right parietal and occipital electrodes decreased during paced breathing at 0.1
      Hz compared with initial rest. The results point to increased cortical
      excitability during paced breathing at eupnoeic frequencies and to diminished
      cortical sensitivity to desynchronizing influences during paced breathing at 0.1
      Hz.

PMID- 8347816
TI  - Avian auditory pathways show met-enkephalin-like immunoreactivity.
AB  - Pathways associated with a recently defined region of the avian auditory
      thalamus, the shell of the nucleus ovoidalis (Ov), were examined for met
      enkephalin immunoreactivity. The presence of enkephalin-like immunoreactive (ELI)
      perikarya within the medial margin of the inferior colliculus (ICM), afferent to
      the Ov shell, implicated ICM as a source of ELI fibers within the Ov shell and
      tract. The shell also contained ELI perikarya and its targets, including the
      ventromedial hypothalamus and caudoventral paleostriatal complex, were
      characterized by ELI fields. These data suggest that enkephalinergic auditory
      pathways, in parallel with traditionally recognized auditory projections, target
      regions of the avian basal forebrain.

PMID- 8347817
TI  - Effects of formalin-induced pain on exploratory behaviour in rabbits.
AB  - We have used formalin to assess the long-term behavioural and hormonal effects of
      persistent pain in rabbits. Behaviour has been recorded over 10 min sessions both
      before and after 10 min, 4 and 24 hours after injection of formalin. A low dose
      of formalin (0.1 ml at 5%) elicited licking of the injected paw which lasted only
      a few minutes. Exploratory behaviour was greater than in the control (sham
      injected) animals in all post-injection sessions. Following a larger dose of
      formalin (0.5 ml at 8%) licking occurred in all post-injection sessions, while
      exploration was lower than the controls only immediately after injection. Twenty
      four hours after the formalin injection, testosterone levels were unaffected.
      Corticosterone levels increased over the course of the experiment but this
      increase was equal for the experimental and the control groups. Results suggest
      that different pain intensities and durations have opposite effects on
      exploratory behaviour in rabbits.

PMID- 8347819
TI  - Differential activation of c-fos in spinal neurones by distinct classes of
      noxious stimuli.
AB  - The laminar distribution of spinal cord neurones expressing immunoreactivity to
      the Fos protein was evaluated in the rat following chemical, thermal or
      mechanical noxious stimulation of the skin for 2 h. After stimulation by 20% or
      5% formalin, Fos-immunoreactive neurones prevailed in lamina I where they
      accounted for 64% and 59%, respectively, of the entire population of Fos
      immunoreactive spinal cells. Values in the remaining laminae were low (2-10%).
      Following thermal stimulation by radiant heat at 65 degrees C or 58 degrees C,
      Fos cells were concentrated in laminae I and IIo, amounting to 57% and 62%,
      respectively, in lamina I, and to 26% and 29% in lamina IIo. Values were lower
      than 10% in the remaining laminae. Following mechanical stimulation by pinching
      or needle prick, Fos-positive cells were regularly distributed throughout laminae
      I-V amounting to 25-26% in lamina I, and 10-20% in each of the remaining laminae.
      These findings suggest that the spinal neuronal groups upon by prolonged noxious
      stimulation differ according to the nature of the stimulus.

PMID- 8347818
TI  - Simultaneous demonstration of central projections of different peripheral nerves
      by anti-choleragenoid immunoglobulin markers.
AB  - This study demonstrates a fluorescent antibody technique where immunoglobulins
      (IgG) can be used as transganglionic tracers for the simultaneous demonstration
      of different primary afferent nerve projections to the spinal cord. Antiserum
      against choleragenoid (CTB) raised in goat or rabbit was mixed with CTB to obtain
      a solution consisting of IgG bound to CTB. The mixtures of rabbit and goat IgG
      bound to CTB were subsequently injected into the sciatic or femoral nerves.
      Following transganglionic transport, goat and rabbit IgG staining were
      demonstrated simultaneously in different areas of the L4 dorsal root ganglion, in
      the spinal cord and in the brain stem, using an immunocytochemical technique.
      When only goat anti-CTB antibodies or only CTB were injected into the sciatic
      nerve, no goat IgG immunoreactivity could be detected in the spinal cord.

PMID- 8347820
TI  - Cholesterol metabolism and violence: a study of individuals convicted of violent
      crimes.
AB  - To examine the relationship between plasma lipoproteins and apolipoproteins in
      men with convictions for violent offences, blood was obtained from 15 men with a
      history of violence who were serving prison sentences for violent offences, and
      25 age-matched male controls from the staff of the Argyll and Bute Psychiatric
      Hospital, who had no criminal records. The two groups did not differ in plasma
      total cholesterol concentrations, HDL-C, LDL-C, VLDL-C or in HDL subfractions.
      The most significant differences in the offenders were higher apoprotein AIV
      (3.62 vs 0.85: p = < 0.000001) and higher apoprotein E (7.70 vs 5.19: p = <
      0.0002).

PMID- 8347821
TI  - Plasma amyloid precursor protein is decreased in Alzheimer's disease.
AB  - Alzheimer's disease is characterized by amyloid deposits whose major protein
      component is beta A4. beta A4 is a product of the amyloid precursor protein
      (APP). APP was assayed in partially purified plasma samples from 16 sporadic
      Alzheimer's disease patients, 12 age-matched controls, 15 Down's syndrome
      individuals aged 19-36 years and 8 young to middle-aged controls (22-51 years).
      14 of the 16 Alzheimer's disease patients had decreased plasma APP when compared
      with age-matched controls. 14 of the 15 Down's syndrome individuals had similar
      levels of APP when compared with age-matched and elderly non-demented controls by
      immunoblotting, whereas one had levels of APP less than controls. Taken together
      with results from a previous report (Lancet 1992; 340: 453-454), the decreased
      plasma APP levels mirror the changes observed with cerebrospinal fluid APP levels
      in Alzheimer's disease.

PMID- 8347823
TI  - GangliosideGM1 expression during human spinal cord and neural crest development.
AB  - GangliosideGM1 represents a widespread component of the neural cell plasma
      membranes. Cholera toxin-B subunit binds selectively to GM1. Human spinal cords
      at post-conception (PC) weeks 6 to 11 were examined and early GM1 expression
      shown on the cell plasma membrane in the developing grey matter at PC week 6. GM1
      was demonstrated also in the marginal layer (white matter); on neural crest
      derivative plasma membrane, i.e. dorsal root (DRG) and sympathetic ganglia; along
      emerging fibres from DRG and neurite terminals innervating skeletal muscle.
      GangliosideGM1 is highly expressed in spinal cord primary cultures and is a
      stringent neural cell marker. GangliosideGM1 represents an early marker of neural
      differentiation in both spinal cord and neural crest derivatives.

PMID- 8347822
TI  - Immunocytochemical localization of 5-HT1A receptors in the rat immature
      cerebellum.
AB  - The serotonin 5-HT1A receptors were visualized in the cerebellar vermis of 8-day
      old and adult rats by immunocytochemistry using anti-5-HT1A receptor antibodies
      raised against a synthetic peptide corresponding to a highly selective portion of
      the receptor amino acid sequence (El Mestikawy et al, Neurosci Lett 118, 189-192,
      1990). The 5-HT1A receptor-like immunoreactivity was particularly abundant in the
      posterior lobules (IXB-X) of the immature vermis where it was found in the
      molecular-Purkinje cell layers. Immunostaining was confined to the plasmic
      membrane of the Purkinje cell somas, dendrites and perhaps axons (at their
      somatic emergence) suggesting that 5-HT receptors might participate in non
      junctional 5-HT neurotransmission in the immature cerebellum.

PMID- 8347824
TI  - Phosphorylated MAP1b, alias MAP5 and MAP1x, is involved in axonal growth and
      neuronal mitosis.
AB  - Microtubule-associated protein 1b, also named MAP5 and MAP1x, is essential for
      neuronal differentiation. In kitten cerebellum, this protein is partially
      phosphorylated. During early postnatal development, a phosphorylated form was
      localized prominently in growing parallel fibres and in mitotic spindles of
      neuroblasts in the germinal layer, whereas a non-phosphorylated MAP1b form was
      found in dendrites, perikarya and axons. The MAP1x epitope showed the same
      immunohistochemical distribution, as seen for phosphorylated MAP1b, while its
      recognition on immunoblots was independent of phosphorylation. It is concluded
      that post-translational modifications and conformation of MAP1b influence the
      immunological detection of MAP1b, and are essential in the neuronal growth
      processes and mitosis. The antibody against the phosphorylated MAP1b may
      represent a good marker to identify dividing neurones.

PMID- 8347825
TI  - CNTF promotes the survival of neonatal rat corticospinal neurons in vitro.
AB  - Corticospinal neurons were identified in cell cultures of neonatal rat cortex by
      immunostaining of cholera toxin B subunit (CTB), retrogradely transported from
      the cervical part of the spinal cord. The CTB-immunoreactive neurons were larger
      than the neurons in the overall (unstained) neuronal population and represented a
      small fraction of it (average of 0.3%) after 6 hours in vitro. The number of both
      total and CTB-labeled neurons declined progressively with time in culture. The
      neuronal death was, however, markedly faster in the CTB-labeled neuronal
      population than in the overall neuronal population. Ciliary neurotrophic factor
      (CNTF) promoted the survival of CTB-positive corticospinal neurons in a dose
      dependent manner; with CNTF, the death rate of the CTB-labeled neurons became
      identical to that of the overall population.

PMID- 8347828
TI  - Neuronal subpopulations in a reptilian thalamic reticular nucleus.
AB  - In reptiles, Caiman crocodilus, some neurons in the thalamic reticular nucleus
      are immunoreactive for parvalbumin. Utilizing double-labeling experiments with
      fluorescent tracers and indirect fluorescence immunocytochemistry, some of these
      parvalbumin immunoreactive neurons were found to project to the dorsal thalamus.
      Other thalamic reticular neurons not immunoreactive for parvalbumin were also
      found to terminate in the dorsal thalamus. These findings suggest that the
      thalamic reticular nucleus in Caiman contains at least two chemically, and
      perhaps functionally, distinct neuronal subpopulations.

PMID- 8347826
TI  - Corticosterone increases FGF-2 (bFGF) immunoreactivity in the substantia nigra of
      the rat.
AB  - The effects of acute and subchronic (7 days) administrations of the
      adrenocortical hormone corticosterone on basic fibroblast growth factor (bFGF,
      FGF-2) immunoreactivity were studied in the substantia nigra of the rat by
      semiquantitative immunocytochemistry coupled with image analysis. Corticosterone
      was able to increase FGF-2 immunoreactivity in different nigral subregions and
      cell types (astrocytes and neurones) depending on the duration of the treatment.
      These results open up the possibility that stress hormones can modulate the
      trophic state of the substantia nigra through an action on FGF-2.

PMID- 8347827
TI  - Iron(III) chloride injection increases nigral uric acid in guinea-pig.
AB  - The present study was carried out to determine if iron chloride (FeCl3)
      injections into the substantia nigra of guinea-pigs produced changes in nigro
      striatal uric acid levels. Two-weeks following unilateral injection of FeCl3 (185
      nmol Fe3+), ipsilateral uric acid levels were increased 176% over contralateral
      levels in the substantia nigra. No effect on striatal uric acid levels was
      observed. Iron chloride injection produced a 74% depletion of dopamine levels in
      the ipsilateral striatum. Ipsilateral/contralateral ratios were significantly
      decreased for striatal dopamine and significantly increased for nigral uric acid
      when compared with saline-injected controls. The results of this work indicate
      that FeCl3 injections into the substantia nigra of guinea-pigs produce a
      significant, localized increase in tissue uric acid levels two weeks after
      treatment.

PMID- 8347829
TI  - A mitochondrial DNA deletion in normally aging and in Alzheimer brain tissue.
AB  - By quantitative polymerase chain reaction (PCR) of total cellular DNA, the known
      4977 bp deletion in human mitochondrial DNA (mtDNA delta 4977) was not detected
      in rapidly dividing tissue such as placenta and lymphocytes, nor in brain tissue
      from fetuses and in frontal cortex from two individuals 24 and 56 years old.
      However, in frontal cortex from individuals 71-95 years 0.13% deleted/undeleted
      mtDNA was found, with no significant difference between Alzheimer patients
      (0.14%) and age-matched controls (0.12%). We hypothesize that the age-related
      accumulation of this deletion (and other expected deletions) contributes to the
      down-regulation of adenosine triphosphate (ATP) production in neurons and other
      non-dividing cells, a fundamental mechanism common to aging and Alzheimer's
      disease.

PMID- 8347830
TI  - Cellular localization of hydroxyindole-O-methyltransferase mRNA in the chicken
      pineal gland.
AB  - Hydroxyindole-O-methyltransferase (HIOMT), is the last enzyme of the melatonin
      biosynthesis pathway. We have applied immunocytochemistry and in situ
      hybridization to localize HIOMT producing cells, in the chicken epithalamus
      including the pineal gland. The selectivity of the hybridization signal over
      melatoninergic cells was ascertained by comparison with the immunolabelling.
      HIOMT transcripts could be observed in the two cell layers of the pineal
      follicles and in the pineal stalk, but not in other epithalamic regions. These
      results indicate that pineal modified photoreceptors and parafollicular
      pinealocyte-like cells represent the two populations of melatonin-producing cells
      of the chicken epithalamus.

PMID- 8347831
TI  - Induction of beta-amyloid precursor protein isoform mRNAs by bFGF in astrocytes.
AB  - All three major transcripts of beta-amyloid precursor protein (APP) were
      expressed in astrocytes. The ratio for APP695, APP751 and APP770 isoform mRNAs
      being 1:4:2. Treatment with bFGF and EGF produced upregulation of APP mRNAs in
      cultured astrocytes in varying proportions. In comparison with controls,
      increases in APP mRNAs in bFGF and EGF treated groups were about 4.5 and 2 fold,
      respectively. The elevation in mRNAs of KPI-containing isoforms APP751 and APP770
      was relatively more than the elevation in mRNA of APP695 isoform. Our findings
      provide further evidence for the involvement of astrocytes in a cascade of events
      leading to the development of senile plaques in Alzheimer's disease and Down's
      syndrome.

PMID- 8347833
TI  - Modulation of epithelial morphogenesis and cell fate by cell-to-cell signals and
      regulated cell adhesion.
AB  - Cell-cell and cell-extracellular matrix (ECM) interactions control many
      developmental decisions of epithelial cell fate and morphogenesis. Protein
      tyrosine kinases are one class of regulatory molecules that have been implicated
      in the modulation of these processes. Several protein tyrosine kinases co
      localize with cell-cell (cadherin) and cell-ECM (integrin) adhesion molecules at
      specific adhesion domains of epithelial cells. Protein tyrosine kinases may
      regulate epithelial development by modulating cell-cell and cell-ECM interactions
      and by relaying signals initiated by these interactions to other cellular
      components that determine cell structure and function.

PMID- 8347832
TI  - Compensation of a sensory deficit inflicted upon newborn and adult animals. A
      behavioural study.
AB  - Somatosensory deprivation (bilateral vibrissa clipping) was performed on newborn
      (P1) and adult (P80) rats and, on 10 successive days starting on day 81, the
      effect of sensory deprivation was tested in a rectangular maze versus controls.
      The maze performance (the time to reach the goal-box with food reward) of the P80
      animals was significantly poorer than that of P1 animals. The tests repeatedly
      demonstrated, however, that the maze performance achieved by the P1 animals was
      better than that of the controls. This behavioural study clearly revealed that
      early sensory deprivation induced (probably cross-modal) compensatory changes in
      other sensory systems.

PMID- 8347834
TI  - Transmembrane control of cadherin-mediated cell-cell adhesion.
AB  - The cadherin family of cell-cell adhesion molecules plays a central role in
      organization of cells into multicellular structures. An important feature of the
      action of cadherins is that they form a complex with cytoskeletal proteins, and
      the formation of this complex is crucial for their adhesive function. Cadherin
      mediated cell adhesion is thus controlled through the interaction with
      cytoplasmic proteins, and, for such control, phosphorylation of these proteins
      and also cadherins themselves might be involved. This regulatory mechanism of
      cell adhesion is perhaps fundamental to a variety of morphogenetic processes.

PMID- 8347835
TI  - Human cytotrophoblast invasion.
AB  - During early pregnancy, fetal chorionic villi that contact the uterine wall give
      rise to columns of mononuclear cytotrophoblasts that penetrate the superficial
      portion of the uterus. From these columns emanate cytotrophoblasts that invade
      deeply into the uterus and its arterioles. To investigate the molecular basis of
      this unusual, regulated invasive behavior, we used a combination of approaches
      that included an in vitro model of cytotrophoblast invasion and
      immunocytochemistry on uterine biopsy sections containing invading
      cytotrophoblasts. Our results showed interesting roles for: matrix-degrading
      metalloproteinases, adhesion receptors and their extracellular matrix ligands,
      and the class I molecule HLA-G.

PMID- 8347836
TI  - Extracellular matrix and gene expression in mammary epithelium.
AB  - Correct cellular environment is required for the differentiation of many cell
      types. In mammary epithelium the extracellular matrix as well as lactogenic
      hormones cooperate to direct accurate tissue-specific gene expression. Current
      evidence indicates that the promoters of milk protein genes contain elements that
      are regulated by both extracellular matrix and hormones. Some mechanisms by which
      the extracellular matrix might control transcription are considered.

PMID- 8347837
TI  - How to build a kidney.
AB  - Embryonic kidney is ideal for the study of epithelial morphogenesis--rich in
      developmental processes, accessible and clinically important. Interactions
      between mesenchyme and the epithelium invading it cause the epithelium to
      differentiate and branch to form the collecting ducts, and the mesenchyme to
      epithelialise into excretory nephrons. Molecular analyses reveal complex
      programmes of expression of transcription factors and morphoregulatory molecules,
      correlating with induction and morphogenesis. In developing nephrons especially,
      the detailed timing of this programme is now being explored and the functions of
      some molecules involved have been tested by inhibition experiments. New
      pharmacological methods of induction may also prove useful in solution of the
      mechanisms by which a kidney is formed.

PMID- 8347838
TI  - Heterotypic cellular cooperation in gut morphogenesis and differentiation.
AB  - The development of the gastrointestinal tract, like that of other organs, results
      from the association of intrinsic genetic endowment, endogenous regulatory
      mechanisms and environmental influences. The present chapter emphasizes the role
      of epithelial-mesenchymal interactions during development and crypt-villus
      migration. Arguments are given as to the role of basement membrane molecules as
      mediators for these cell interactions. Differential developmental expression of
      the various extracellular matrix components, which precedes the onset of
      differentiation markers, suggests that each of these molecules assumes a specific
      task. Yet, much work still remains to be done before knowing exactly how transfer
      of morphogenetic signals between epithelial and mesenchymal tissues occurs.

PMID- 8347839
TI  - Inter-organ communication between intestine and liver in vivo and in vitro.
AB  - The maintenance of body homeostasis requires a finely tuned system of interorgan
      communication. The intimate metabolic interrelation between intestine and liver
      is characterized by the unique anatomic position of both tissues using the portal
      vein as a private channel with the pancreas in optimal position to modulate
      hepatic metabolism. Gut-derived peptides (such as glucagon-like peptide-1) appear
      to be involved in the process of liver regeneration by regulating the release of
      pancreatic hormones (e.g. insulin). Extensive bowel resection or functional
      exclusion of small intestine may lead to severe liver dysfunction and even
      cirrhosis, which may be due to the lack of some intestine-derived and as yet
      unknown factor(s). Here a close cooperation between small intestinal mucosa and
      hepatocytes is demonstrated leading to the concept of a metabolic gut-liver unit.
      This metabolic interaction forms a wide spectrum ranging from the secretion of
      peptide hormones to changes in (portal-venous) substrate availability or
      hepatocyte cell volume. Further investigation and identification of the
      mechanisms of such regulatory processes may be facilitated by combined perfusion
      of isolated rat intestine and liver. Using this in vitro approach we could
      demonstrate the presence of metabolic interorgan communication between isolated
      perfused tissues independent of plasma borne hormones or extrinsic neural
      control.

PMID- 8347840
TI  - The acute retroviral syndrome and the pathogenesis of HIV-1 infection.
AB  - The acute retroviral syndrome associated with primary HIV-1 infection is
      characterized by clinical signs of immune activation, multi-system dysfunction,
      and high levels of cell-associated and plasma viremia, p24 antigenemia, and
      proviral burden. Clinical abnormalities associated with acute HIV-1 infection and
      measures of viral burden and replication generally decline in concert with
      seroconversion. Despite clearance of virus, patients experiencing severe forms of
      the acute retroviral syndrome appear to have a poorer prognosis than patients
      with asymptomatic primary infection. This accelerated natural history may be due
      to the virulence of strains causing symptomatic infection, sequelae of initial
      high-titer viremia and consequent high viral burden, or immune depletion through
      immunopathologic mechanisms accelerated by strong antigenic stimulus in primary
      infection. Early intervention with anti-retroviral and immune modulatory agents
      has the potential to alter the natural history of patients with this syndrome.

PMID- 8347841
TI  - The immune response to HIV: implications for vaccine development.
AB  - HIV infection is accompanied by a vigorous immune response to the virus
      consisting of humoral and cellular elements that effectively neutralize virus
      infectivity and lyse infected cells when analyzed in cell culture models.
      However, this immune response shows no evidence of being able to eliminate the
      infection. The inability to clear this infection places HIV in a category of
      viruses for which vaccines have yet to be successfully developed. Indeed,
      effective vaccines have emerged only for viruses where natural immunity is part
      of the pathogenic process; it is such immunity that became the guiding principle
      for the development of the respective vaccines. It follows that the unique
      features of HIV infection and pathogenesis are issues to consider carefully in
      formulating vaccine strategies, particularly those that relate to its
      susceptibility to immune attack on the one hand, and its mechanisms of immune
      escape on the other.

PMID- 8347842
TI  - Breast cancer surveillance--a cost-effective strategy.
AB  - The effectiveness of a surveillance program for breast cancer recurrence in
      extending survival is predicated on two assumptions: 1) most recurrences are
      detected at an early stage at surveillance visits; and 2) the early treatment of
      recurrence offers a better chance of cure or longer survival. However, the data
      suggest that neither of these two assumptions is correct, and that postoperative
      follow-up of patients with breast cancer is expensive and does not significantly
      extend survival.

PMID- 8347843
TI  - Cost-effectiveness of breast cancer screening: preliminary results of a
      systematic review of the literature.
AB  - There is now considerable concern that universal access to health care within
      realistic resource constraints requires some sort of cost-effectiveness analysis
      of given medical procedures and interventions. One such intervention is routine
      mammographic screening for breast cancer. Here, we report preliminary results
      from an ongoing project to conduct a systematic and comprehensive review and
      comparison of the published cost-effectiveness analyses of screening for the
      early detection of breast cancer. We examine 16 such studies, and compare two
      studies in detail to explain how differences in assumptions and in consideration
      of down-stream effects have caused the published results for apparently
      comparable breast cancer screening programs to span a broad range.

PMID- 8347844
TI  - Payment and coverage issues affecting medical oncology.
AB  - Medical oncologists continue to face significant issues in obtaining full payment
      for and coverage of their services by third-party payers. A number of issues
      raised by the Medicare fee schedule have, however, been at least partially
      resolved in a favorable manner. There continue to be problems in coverage of off
      label drug uses and services associated with clinical trials. The impending
      reform of the health care system may improve the situation or it may give rise to
      further difficulties.

PMID- 8347846
TI  - Human recombinant interferon-beta SER and tamoxifen: growth suppressive effects
      for the human breast carcinoma MCF-7 grown in the athymic mouse.
AB  - Tamoxifen is the endocrine treatment of choice for breast cancer. However,
      resistance to therapy and patient relapse inevitably occurs. In future treatment
      schedules, interferons could be administered with tamoxifen, in an attempt to
      prevent disease recurrence. Human recombinant interferon-beta SER (rIFN-beta SER)
      inhibited the growth in vitro of the estrogen receptor (ER) positive breast
      cancer cell line MCF-7 and the ER negative breast cancer cell line MDA-MB-231.
      This inhibitory effect was achieved at doses of 50 U/ml and above. The growth of
      MCF-7 tumors in estradiol-stimulated athymic mice was greatly inhibited by high
      dose rIFN-beta SER treatment (10(6)U/day). In spite of the impressive antitumor
      effects upon MCF-7 tumors, rIFN-beta SER had no effect upon ER levels within the
      tumors at either the RNA or protein level, as measured by Northern blotting and
      ER-EIA respectively. High dose rIFN-beta SER (10(6)U/day) did result in some
      inhibition in the growth in vivo of the tamoxifen-stimulated MCF-7 variant MCF-7
      TAM, although not to the same extent as was observed with the estradiol
      stimulated MCF-7 tumors. rIFN-beta SER was also administered to animals bearing
      MCF-7 tumors and treated with estradiol and tamoxifen. In the animals undergoing
      high dose therapy (10(6)U/day), tumor growth was completely suppressed.
      Furthermore, tumor growth continued to be suppressed in those animals in which
      the rIFN-beta SER therapy was halted and the tamoxifen capsule removed. No tumors
      were observed in spite of the environment of estradiol stimulation. Thus, the
      combination of interferon and tamoxifen was totally growth suppressive for MCF-7
      xenografts in nude mice.

PMID- 8347845
TI  - Predicting recurrence in axillary-node negative breast cancer patients.
AB  - This study attempted to identify the risk groups in axillary node negative breast
      cancer patients using validated first-generation prognostic clinical and
      pathologic factors. An updated 10-year follow-up in 407 such patients treated by
      surgery alone at Roswell Park between 1976-1987 showed a 10-year recurrence rate
      (RR) of 19% (95% confidence interval +/- 5%). Predictors of outcome were, in
      order of strength: (1) Tumor size (p = 0.0006); RR at 10 years was 2% +/- 4 for
      tumors < or = 0.5 cm, 6% +/- 7 for tumors 0.6-1.0 cm, 16% +/- 9 for 1.1-2 cm, 29%
      +/- 12 for 2.1-5 cm, and 40% +/- 31 over 5 cm; (2) Histologic differentiation (p
      = 0.017); poorly differentiated/anaplastic (P/A) tumors had a greater RR (24% +/-
      8) than well or moderately differentiated (W/M) tumors (13% +/- 8); (3) Age (p =
      0.046); patients < 35 showed a RR of 28% +/- 20, pts 35-50, 22% +/- 10, and pts >
      50,17% +/- 7 (p = 0.046). Cox Model analysis showed tumor size (4 groups)
      significant at < 0.0001, histologic differentiation (2 groups) significant at <
      0.0005 after allowing for size, and age (+/- 50) significant at < 0.05 after
      allowing for size and differentiation. Combining these variables into subgroups
      enables selecting groups at various risks of recurrence. Groups with low risk
      are: (1) patients with tumor < or = 1 cm, W/M (0% RR), (2) patients with ductal
      carcinoma in situ with microinvasion (0% RR), and (3) patients with tumors < or =
      1 cm, P/A (8% RR). In a suggestive finding in this last group, those over age 50
      achieved a RR of 3% +/- 6, while those age 50 or less had RR 14% +/- 15. With the
      exception of this last group, all should be considered highly curable using loco
      regional therapy alone, and might be spared the risks and costs of routine
      systemic adjuvant therapy. Groups with high risk are: (1) patients with tumors >
      2 cm (RR 32% +/- 12), and (2) patients with tumors 1.1-2 cm, P/A (RR 21% +/- 14).
      These should receive adjuvant therapy. Groups with intermediate risk are patients
      with tumor 1.1-2 cm, W/M (RR 12% +/- 12). In a suggestive finding, those in this
      group over age 50 had a RR of 11% +/- 12, while those up to 50 had a RR of 17% +/
      30. These patients should be considered to be prime candidates for clinical
      trials.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8347848
TI  - Candidate metastasis-associated genes of the rat 13762NF mammary adenocarcinoma.
AB  - Differential hybridization was used to isolate genes potentially involved in the
      process of metastasis. Ten complementary DNAs (cDNAs) that were differentially
      expressed between a highly metastatic (MTLn3) and a nonmetastatic (MTC.4) line of
      the rat 13762NF mammary adenocarcinoma were isolated and sequenced. Examination
      of the EMBL/GenBank database revealed that one of the genes had a high degree of
      homology (98.8%) to annexin I (also known as calpactin II). Quantitative analysis
      of Northern blot hybridizations showed that the annexin I-like sequence was
      expressed 4- to 7-fold higher in MTLn3 than in MTC.4 cells. Steady state mRNA
      levels were also low in MTLn2, a cell line of low metastatic potential closely
      related to MTLn3, but were not related to metastatic potential in colon
      adenocarcinoma or melanoma cells. Two of the cDNAs (designated 8.11 and 10.14)
      were found to be novel. The expression of 10.14 mRNA (3.2 kb) was 4-fold higher
      in MTLn3 than in MTC.4 cells. Sequencing of the 10.14 cDNA (2.2 kb) revealed a
      putative open reading frame of 583 amino acids that was also novel. Expression of
      8.11 mRNA (> 7 kb) inversely correlated with metastatic potential. Another
      differentially transcribed gene was highly homologous to ERK2 (extracellular
      signal related kinase 2), a mitogen-activated protein kinase (MAPK). Northern
      analysis of ERK2 expression revealed 3-fold higher amounts of a 1.3 kb mRNA in
      MTLn3 than in MTC.4 cells. Higher levels of ERK2 mRNA were generally seen in the
      more metastatic human colon but not in melanoma cell lines. We also corroborated
      the work of Taniguchi (Nucl Acids Res 19:6949, 1991) by independently identifying
      EF-1 alpha as a putative metastasis-associated gene.

PMID- 8347850
TI  - Assessing the cost effectiveness of adjuvant therapies in early breast cancer
      using a decision analysis model.
AB  - BACKGROUND: We have developed a decision analysis model that uses the results of
      available randomized controlled trials to model the natural history of early
      breast cancer and assess the potential clinical and financial effects of using
      adjuvant therapies. PATIENTS AND METHODS: The original model was used to assess
      the impact of chemotherapy in hypothetical groups of 45-year-old and 60-year-old
      node-negative, estrogen receptor-negative women. Using the 1992 Early Breast
      Cancer Trialists' Collaborative Group report, we have expanded and revised the
      model to assess: 1) the role of tamoxifen alone, chemotherapy alone, or combined
      therapy in pre-menopausal women, and 2) chemotherapy in elderly women with node
      negative, estrogen receptor-negative cancer. RESULTS: For pre-menopausal women,
      we found that chemotherapy increases quality adjusted life expectancy and
      survival by a substantial amount at a cost less than most accepted medical
      interventions. Combined therapy is beneficial and cost-effective in estrogen
      receptor-positive cancer. For the elderly, chemotherapy prolongs survival but to
      a lesser extent compared to younger women. The cost of this benefit is high but
      within the range of commonly reimbursed procedures for women under age 75 without
      other co-existing conditions. CONCLUSIONS: For most patients some form of
      adjuvant therapy is beneficial and cost-effective. The model builds upon the data
      derived from collaborative efforts assessing the effectiveness of adjuvant
      therapies. The model highlights the need for an equal commitment to assessing the
      economic and quality of life impacts of breast cancer treatments.

PMID- 8347851
TI  - Role of granulocyte-macrophage colony stimulating factor (GM-CSF) after
      autologous bone marrow transplantation for Hodgkin's disease.
AB  - Use of growth factors to augment hematopoietic recovery after cytotoxic therapy
      is a useful method for dose intensification. We wanted to evaluate the clinical
      and cost-effectiveness of granulocyte-macrophage colony stimulating factor (GM
      CSF; Leucomax) in patients undergoing autologous bone marrow transplantation
      (ABMT) for Hodgkin's disease. Twenty-four patients with Hodgkin's disease were
      treated with high-dose chemotherapy and ABMT. Patients were then randomized in a
      double-blind manner to receive GM-CSF intravenously (10 micrograms/kg) over 6 h
      or placebo until the absolute neutrophil count (ANC) was greater than 1000/mm3
      for 3 days. The study medication was stopped after 30 days. Patients treated with
      GM-CSF (n = 12) had shorter periods of neutropenia (median duration of an ANC of
      less than 1000 cells/mm3, 16 versus 27 days on placebo; p = 0.23), shorter
      periods of platelet-transfusion dependency (median duration, 13.5 versus 21 days
      on placebo; p = 0.03), shorter hospitalizations (median hospital stay, 32 versus
      40.5 days on placebo; p = 0.0004). Other clinical outcomes, such as frequency and
      severity of toxicities, development of pneumonia or infection, in-hospital death,
      and response rate were similar in the two groups. Actuarial long-term disease
      free survival was 58% for patients treated with GM-CSF and 50% for patients who
      received placebo after 38 months of follow up (p = 0.6).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8347849
TI  - Nm23 and breast cancer metastasis.
AB  - The majority of breast cancer patients succumb to metastatic disease. We
      summarize published and recent research concerning the nm23 gene in breast cancer
      metastasis. In a murine developmental study, nm23 expression increased with the
      functional differentiation of the mammary gland in nulliparous and pregnant
      animals. In human breast cancer, five studies have now demonstrated a significant
      association between reduced nm23 expression, at the RNA or protein levels, and
      aggressive tumor behavior. Nm23-negative tumor cells have been observed in comedo
      ductal carcinoma in situ lesions in two independent studies, indicating that
      decreases in nm23 expression begin prior to actual histologically identifiable
      invasion. Transfection studies, in which human nm23-H1 cDNA was expressed in the
      metastatic human MDA-MB-435 breast carcinoma cell line, indicate that nm23-H1
      suppresses in vivo metastatic potential by 50-90%. Finally, our data in melanoma
      and breast carcinoma transfection systems suggest that the biochemical mechanism
      of nm23 suppressive activity is likely not due to its nucleoside diphosphate
      kinase activity, association with GAP proteins, or secretion from cells.

PMID- 8347847
TI  - Mechanisms involved in the metastasis of cancer to bone.
AB  - The metastasis of cancer to bone is a frequent outcome of common malignancies and
      is often associated with significant morbidity due to osteolysis. Bone metastasis
      is also selective in that a disproportionately small number of malignancies
      account for the majority of tumors which spread to bone. While the mechanisms of
      bone destruction have been studied, those responsible for the site-specific
      nature of bone metastasis are poorly understood. As a metastatic target, bone is
      unique in that it is continuously being remodelled under the influence of local
      and systemic growth factors, many of which are embedded in the bone matrix. This
      review summarizes evidence for the hypothesis that the formation of metastatic
      tumors in bone is the consequence of a unique microenvironment where metastatic
      cells can alter the metabolism of bone, thereby regulating the release of soluble
      bone-derived growth factors as a consequence of bone resorption. These, in turn,
      can modulate the malignant phenotypic properties of receptive cells. Transforming
      growth factor-beta is one factor which can promote the growth and motility of
      Walker 256 cells, a rat cell line with a propensity to metastasize spontaneously
      to bone.

PMID- 8347853
TI  - First experiences and perspectives for the use of cytokines in the treatment of
      non-Hodgkin's lymphoma.
AB  - Numerous clinical trials have been carried out to investigate the therapeutic
      potential of cytokines in the management of non-Hodgkin's lymphoma (NHL).
      Relevant interferon-alpha activity is restricted to low-grade malignant NHL of
      both B and T cell subtypes, provided the tumor mass is low. Granulocyte
      macrophage colony stimulating factor (GM-CSF) accelerates hematopoietic recovery
      following myelosuppressive therapy, and reduces the risk and severity of
      infection. Thus, GM-CSF support makes does intensification feasible and may
      thereby contribute to an improvement of response rates and long-term survival.
      Among interleukins (IL) studied, IL-2, with or without lymphocyte activated
      killer cells, so far has only achieved stabilization of refractory NHL but this
      approach may still require further refinement. IL-3 has already been successfully
      applied in the treatment of NHL, augmenting neutrophil and platelet recovery
      after conventional salvage therapy or following autologous bone marrow
      transplantation. On the basis of these findings promising applications for the
      use of cytokines in the treatment of NHL can be envisaged.

PMID- 8347852
TI  - Granulocyte-macrophage colony stimulating factor (GM-CSF) in the treatment of
      hematological malignancies.
AB  - Acute myeloid leukemic (AML) cells not only express receptors for various
      cytokines but also produce hemopoietic growth factors themselves. Thus, they are
      able to stimulate their own activation and proliferation, a phenomenon known as
      autocrine growth. The cell cycle kinetics of AML blast cells are susceptible to
      stimulation by a variety of cytokines, including granulocyte-macrophage colony
      stimulating factor (GM-CSF), interleukin (IL)-3, granulocyte colony stimulating
      factor and stem cell factor. GM-CSF and IL-3 can markedly enhance the
      cytotoxicity of chemotherapeutic agents by increasing the proportion of AML cells
      in S-phase at any given time and by altering the metabolic status of the AML
      cells. A number of clinical studies involving the use of GM-CSF in association
      with chemotherapy in patients with AML are currently ongoing. In the next few
      years the first clinical results will become available indicating whether the use
      of cytokines holds any benefit for patients with AML.

PMID- 8347854
TI  - Future outlook for growth factors.
AB  - In the future improvements in the efficacy and safety profiles of the various
      growth factors in clinical use should be achievable through optimization of
      dosage schedules. The use of combinations of growth factors to provide
      hemopoietic support should enable considerable advances to be made in the
      treatment of hematological and non-hematological malignancies. Growth factors,
      such as granulocyte-macrophage colony stimulating factor may be used not only to
      maximize neutrophil recovery after myeloablative therapy, but also to mobilize
      peripheral blood stem cells prior to harvesting by leukapheresis. Growth
      inhibitory cytokines such as transforming growth factor-beta and macrophage
      inflammatory protein-1 alpha may be used to protect normal cells in the bone
      marrow and other sites where dose-limiting toxicities occur. Therefore, in the
      next few years, the whole approach to chemoradiotherapy will need to be
      reconsidered in the light of the dose intensification made possible by improved
      bone marrow support techniques and advances in other areas of supportive care.

PMID- 8347855
TI  - The molecular control of hematopoiesis.
AB  - Experiments both in vitro and in vivo have increased our understanding of how
      cytokines can act to influence the maintenance of the primitive hemopoietic
      populations and the production of mature blood cells. Such understanding helps us
      to use cytokines as therapeutic agents in order to manipulate the hemopoietic
      response to disease and its treatment.

PMID- 8347856
TI  - Proteolytic processing of the vitellogenin precursor in the boll weevil,
      Anthonomus grandis.
AB  - The soluble proteins of the eggs of the coleopteran insect Anthonomus grandis
      Boheman, the cotton boll weevil, consist almost entirely of two vitellin types
      with M(r)s of 160,000 and 47,000. We sequenced their N-terminal ends and one
      internal cyanogen bromide fragment of the large vitellin and compared these
      sequences with the deduced amino acid sequence from the vitellogenin gene. The
      results suggest that both the boll weevil vitellin proteins are products of the
      proteolytic cleavage of a single precursor protein. The smaller 47,000 M(r)
      vitellin protein is derived from the N-terminal portion of the precursor adjacent
      to an 18 amino acid signal peptide. The cleavage site between the large and small
      vitellins at amino acid 362 is adjacent to a pentapeptide sequence containing two
      pairs of arginine residues. Comparison of the boll weevil sequences with limited
      known sequences from the single 180,000 M(r) honey bee protein show that the
      honey bee vitellin N-terminal exhibits sequence homology to the N-terminal of the
      47,000 M(r) boll weevil vitellin. Treatment of the vitellins with an N
      glycosidase results in a decrease in molecular weight of both proteins, from
      47,000 to 39,000 and from 160,000 to 145,000, indicating that about 10-15% of the
      molecular weight of each vitellin consists of N-linked carbohydrate. The
      molecular weight of the deglycosylated large vitellin is smaller than that
      predicted from the gene sequence, indicating possible further proteolytic
      processing at the C-terminal of that protein.

PMID- 8347858
TI  - [Current and future perspectives of medical information network systems for
      community health using personal computers and IC cards].
AB  - Recent developments in computer and communication technology were studied in
      relation to medical information network systems, using computers and IC cards, to
      solve problems in community health. Trial use of personal computer network
      systems among physicians and IC card systems for personal health data management
      are already in existence in some parts of Japan. These trials were studied and
      analyzed based on a questionnaire survey of physicians and patients. Results of
      the study produced some useful points that should be considered when introducing
      these systems. These included: 1) details on expectations and specifications for
      these systems by physicians and patients, 2) easy access to valuable information
      is a key point for active network systems among physicians, 3) plausibility of
      improvement of communication between physicians and patients by using these
      systems, 4) recognition that an important problem concerns patient information
      privacy and must be considered before introducing these systems. A study of
      practical merits of these systems and methodology for realization indicates that
      participation by active and attractive providers of information can be expected
      to stimulate frequent use of the network system. The cost of introducing these
      systems can be partially borne by eliminating the large investment now allocated
      for processing requests for reimbursement of medical services. Investigation into
      the introduction of medical information systems provides a good opportunity to
      elucidate problems in the present medical systems.

PMID- 8347857
TI  - Comparison of two juvenile hormone radioimmunoassays.
AB  - Juvenile hormone from the hemolymph of adult worker honey bees of known age and
      behavioral status was extracted and analyzed by two different radioimmunoassays
      in two independent laboratories. The assays are different in hapten attachment,
      radiolabeled tracer, and the method by which bound and unbound hormone are
      separated. Despite these differences in the methods, hormone determinations were
      in excellent agreement at lower levels (0-50 ng/ml) but diverged as the hormone
      concentrations increased (> 50 ng/ml). The relative changes are in good
      agreement, with a correlation coefficient of 0.97.

PMID- 8347859
TI  - [Effectiveness of a nutritional education program in lowering blood cholesterol
      levels in a public health center].
AB  - An educational program for persons found to have high blood cholesterol during
      health examinations at the Nerima Public Health Center was begun in April, 1989.
      This program was differed from the usual program in two areas. First, new
      educational material was developed consisting of a check list of 30 items to
      assess eating patterns. By checking these items, participants could gain an
      understanding of what they should change in their eating behavior. Secondly, the
      table of restricted foods was not used. Participants were advised to achieve
      healthy eating patterns and followed up with a nutritional consultation that was
      held after three months, at which time they were interviewed regarding compliance
      and had their blood cholesterol levels measured. The effectiveness of the new
      educational program and the relationship between achievement of healthy eating
      patterns and reduction in blood cholesterol levels were analyzed. The main
      results were as follows: 1) In subjects (n = 79) who received the new education
      program in 1989-1990, serum cholesterol levels showed significant reduction, as
      compared with controls (n = 38) who received the usual education program in 1988
      1989. 2) Subjects were divided into three groups according to their changes in
      serum cholesterol levels,--normalized, improved and unimproved--and the number of
      items complied with were counted for analysis. The mean score of compliance was
      highest in the normalized group with significant difference between the
      normalized and the unimproved groups. 3) The items of the high compliance score
      in the normalized group were in order of high score "to decrease high-fat meats",
      "to decrease cakes", "to choose lean meats and poultry without skin" and "to eat
      vegetables at every meal".

PMID- 8347860
TI  - [A cross-sectional study on relationships between daily physical activity and
      concentration of serum cholesterol and body mass index in fifth grade elementary
      schoolchildren and their parents].
AB  - The purpose of this study was to estimate the effects of daily physical activity
      on serum total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C),
      body mass index (BMI) and atherogenic index (AI) in 240 fifth grade
      schoolchildren, their 174 fathers and 212 mothers. Information on daily physical
      activity was obtained by inquiry with a questionnaire and was also measured
      directly with a device sensing acceleration of physical movement. In
      schoolchildren, effect of physical activity on TC, HDL-C and AI was not apparent,
      but that on BMI was shown. In adult men, HDL-C differed by job classification and
      increased as the degree of physical labor increased from desk work to light and
      heavy work. Strength of physical activity using the quotient of total amount of
      measured physical activity divided by body weight had a significant positive
      correlation with serum HDL-C (r = 0.20, p < 0.05) and significant negative
      correlation with AI (r = -0.18, p < 0.05) in adult men. In adult women, daily
      physical activity did not have a significant correlation to TC, HDL-C, AI or BMI.
      These results appear to suggest that the effect of daily physical activity on
      serum cholesterol, AI, BMI of schoolchildren and adult women was smaller than
      that for adult men.

PMID- 8347861
TI  - [Effects of 12wk-exercise walking on serum lipids, lipoproteins and
      apolipoproteins in middle aged women--does menopause status influence training
      effects?].
AB  - The present study examined the effects of 12wk-exercise walking on serum lipids
      in pre- and post-menopausal women, to elucidate the influence of menopausal
      status on the training effects. Twenty one premenopausal women (42.2 +/- 5.6 yr)
      and seventeen postmenopausal women (56.7 +/- 6.9 yr) participated in a 12 wk
      walking program. Self-monitored exercise walking was performed 3 or 4 times per
      week in sessions of 45 minutes. Average intensity of the exercise was 57% HRmax
      in the premenopausal group (Pre-M) and 65.5% HRmax in the postmenopausal group
      (Post-M), respectively. After adjustment for age, baseline value of
      apolipoprotein AI (Apo AI) was significantly lower and total cholesterol (TC) and
      low density lipoprotein cholesterol (LDLC) were higher in Post-M than in Pre-M.
      After 12 weeks, percent body fat decreased significantly in both groups and BMI
      decreased in Pre-M. Physical fitness tended to increase only in Pre-M. The
      increase of high density lipoprotein cholesterol (HDLC) and the decrease of Apo
      AI, Apo B, TC/HDLC were significant in both groups. The decrease of TC, LDLC, Apo
      B and TG and the increase of HDLC were common changes in both groups, even after
      adjusting for baseline values, change in body composition, exercise intensity and
      total exercise time. Change volume of TG tended to be larger in Pre-M than in
      Post-M. Results of multiple regression analysis showed that the change in serum
      lipids, especially cholesterol, correlated to initial values, change in body
      composition and change in fitness, in Post-M but not in Pre-M.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8347862
TI  - [Functional capacity of the elderly: measurement by the TMIG Index of
      Competence].
AB  - The functional capacity of the elderly was assessed in a national representative
      sample of elderly community residents. A stratified multistage random sampling
      yielded, 2,240 eligible persons, and 80.8% of them (n = 1,810) were successfully
      interviewed. The respondents ranged in age from 65 to 96 years, and the average
      age was 72.5 years; 43.2% of them were men, and the remaining 56.8% were women.
      The TMIG Index of Competence, a standardized multidimensional 13-item index of
      competence, was used for measuring the functional capacity. The total score of
      the index (maximum 13 points) showed a negatively skewed leptokurtic
      distribution: 69.6% of the respondents scored 11 points or greater while the mean
      was 10.8 points. A multiple classification analysis of the total score utilizing
      age, gender, educational attainment, and size of community as independent
      variables showed significant effects of age and educational attainment; the score
      significantly decreased with age, and the highly educated elderly showed higher
      score than those with lower educational attainment. The results of this study
      show that the majority of the elderly living in the community are well in
      functional capacity though the capacity tends to decline with age. The
      distribution of total scores observed in this study can be considered as a
      national standard of distribution of functional capacity measured by the TMIG
      Index Competence.

PMID- 8347863
TI  - [Estimations of organ dose and health risk of the mass chest X-ray examinations
      in children].
AB  - In Japan, mass chest X-ray examinations are mandated by law for schoolchildren
      and students. Recently, questions of the justification of such X-ray examination
      have arisen. In this study the absorbed doses of each organ, and the health
      detriments from the mass chest X-ray examinations to schoolchildren and students
      were estimated. The doses of organs were measured by the TLDs (Mg2SiO4), slab
      phantom, and anthropomorphic phantom. The probability of fatal cancer, and the
      resultant reduction in life expectancy induced by mass chest X-ray examinations
      were calculated by the multiplicative risk projection model of the ICRP-1990. The
      absorbed doses of lung, thyroid glands, esophagus, stomach, breast, and red bone
      marrow in first-year elementary schoolchildren were 90, 30, 90, 60, 90, and 30
      muGy, respectively, and the doses in ovaries and testes were almost nil. Each
      organ dose of first-year students of junior high school was about 1.5 times that
      for elementary schoolchildren. The total radiation-induced lifetime cancer risk
      of schoolchildren and students was from 0.3 x 10(-5) to 0.9 x 10(-5) per person
      by the multiplicative risk projection model of the ICRP-1990 and a factor of 2
      for the DDREF (dose and dose rate effectiveness factor). The reduction in life
      expectancy by radiation induced fatal cancer was from 15 x 10(-5) years to 50 x
      10(-5) years per person. The results of this study suggest that subjects of mass
      chest X-ray examinations should be carefully selected from the viewpoint of
      radiation protection.

PMID- 8347864
TI  - [The effect of Habu toxoid--from the view point of public health center].
AB  - In order to clarify the effect of Habu Toxoid, serum sampling was performed with
      from July 1990 to February 1991, on 503 vaccinated subjects living in Amami
      Islands by staff of Naze health center. Sera were analyzed by Enzyme Linked
      Immunosorbent Assay (ELISA) for levels of serum antitoxin to venom, both anti
      Hemorrhagic Factor 1 (anti-HR1) and anti-Hemorrhagic Factor 2 (anti-HR2).
      Information on vaccinated subjects-age, sex, occupation, vaccination date,
      frequency, period and interval of vaccinations, years after final vaccination and
      past history of Habu bites-was obtained and analyzed with relation to serum
      antitoxin levels. The following results were obtained: 1) Serum antitoxin levels,
      both anti-HR1 and anti-HR2, of the Habu bitten group (N = 47) were significantly
      higher than that of the unbitten group (N = 456). This finding suggests that
      crude Habu venom injected by bites elevated the levels. Regardless of past
      history of Habu bites, levels of antibody to HR2 was significantly lower than
      that to HR1. 2) Among the unbitten group, detection of antitoxin was related to
      subjects' attributes. Production of antitoxin was related to being male, high
      frequency of vaccinations, long period of vaccinations and short period after
      final vaccination. 3) Among the unbitten group, anti-HR2 was found in high levels
      with the following factors: high frequency of vaccinations and short period after
      final vaccination. However among the well-vaccinated group (N = 153), differences
      in antitoxin levels by vaccination frequency were not recognized.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8347865
TI  - [Investigations on the quality of well water in the Sakata-Akumi areas of
      Yamagata-ken].
AB  - Samples of well-waters were collected from 1988 through 1992 from 40 shallow
      wells (non-confined ground water), with samples taken from the well at 16 m depth
      from the ground surface up to the bottom of the well. Wells were located in the
      Sakata Akumi area of Yamagata-ken. The water quality was analyzed for 29 items
      and the results are as follows: 1) In the rural area on the coast of the Sea of
      Japan, the soil consists of sand, mud and gravel, and dry field farming with
      cultivation of fruit and vegetables is carried on. Concentrations of nitrate and
      nitrite nitrogen (NO2+3-N) in the well waters (n = 12) in this area were found to
      be in the range of 2.3-19 mg/l with the average of 8.2 mg/l, probably mainly
      derived from agriculture. On the other hand, in the rural area where the
      indigenous rock consists mainly of andesite and basalt and where rice crops are
      cultivated, the concentrations of NO2+3-N in the well water (n = 21) were found
      in the range of 0.15-2.9 mg/l with the average of 0.69 mg/l. 2) The
      concentrations of NO2+3-N were analyzed monthly for a total of 20 times between
      1991 to 1992, from the Sea of Japan coastal region where the highest average of
      19 mg/l from all samples was obtained. Analysis shows that a remarkable seasonal
      variation exists, with a range of 25-33 mg/l seen in both April and May during
      the two years observation, but only 14-17 mg/l in other months.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8347866
TI  - [Correlating factors to physician utilization among elderly adults].

PMID- 8347867
TI  - Quantitative aspects of the matrix-assisted laser desorption mass spectrometry of
      complex oligosaccharides.
AB  - Comparative studies of the matrix-assisted laser desorption ionization of complex
      oligosaccharides were made using a range of mono, di- and tri-substituted benzoic
      acids, substituted coumarins and cinnamic acids. The best results were obtained
      with 2,5-dihydroxybenzoic acid (2,5-DHB). Detection limits using this matrix were
      in the range of 100 fmol for complex and high mannose sugars, some 2-fold better
      than those obtained with alpha-cyano-4-hydroxycinnamic acid and 10-fold better
      than with an earlier oligosaccharide matrix, 3-amino-4-hydroxybenzoic acid. The
      strongest signals were achieved with a matrix-to-sample ratio of about 5000:1.
      Little correlation was found between the measured peak height and sample loading
      when 3-amino-4-hydroxybenzoic acid was used as the matrix and the signal appeared
      to saturate at a sample level of around 30 pmol. However, good correlation was
      found between the amount of sample loaded onto the target and the response when
      an analogous compound was used as an internal standard and peak ratios were
      measured. In contrast to this, the use of 2,5-dihydroxybenzoic acid as the matrix
      enabled the oligosaccharide to be measured over the range 100 fmol to at least
      100 pmol with an excellent linear correlation between sample quantity and
      response and without the need of a standard. No evidence of saturation was found
      with this matrix. With 2,5-DHB (other matrices were not tested), the
      oligosaccharide signal strength was found to fall with increasing molecular
      weight in a linear manner and similar to that found previously with
      proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8347868
TI  - Ion trap and quadrupole mass spectra of lignin pyrolysates: how well do they
      compare?
AB  - Lignin samples from wheat straw, orchard grass, red clover and a synthetic lignin
      were subjected to pyrolysis gas chromatography/mass spectrometry using both
      quadrupole (QMS) and ion-trap detector (ITD). ITD mass spectra were comparable
      with those presented in the National Bureau of Standards (NBS) library and with
      those obtained by QMS as evaluated by discrepancy factors. Computer-assisted
      library searches for ITD spectra were successful for 22 of 47 compounds. The
      other 25 compounds were not present in the library. A typical program and mass
      spectra are shown. Statistical data are discussed.

PMID- 8347869
TI  - Mass spectrometric discrimination between per-O-acetylated aldopentoses applied
      to an oligosaccharide.
AB  - Unimolecular decomposition spectra of oxonium ions from peracetylated pentoses
      can be used for identification purposes. The fast-atom bombardment mass spectra
      of an oligosaccharide with a pentose residue at the non-reducing terminus also
      contain this oxonium ion, which allows identification of this monosaccharide
      residue by a tandem mass spectrometry experiment. The applicability of this
      method is demonstrated using a xylopentaose.

PMID- 8347870
TI  - Cost effectiveness of laparoscopic surgery: from whose perspective?

PMID- 8347871
TI  - Complete abdominal exploration is unnecessary during the treatment of
      cholelithiasis.
AB  - The development of laparoscopic and non-operative methods for the management of
      cholelithiasis has been based on the premise that abdominal exploration during
      cholecystectomy is unnecessary. In the current study, 305 patients undergoing
      complete abdominal exploration during routine cholecystectomy were evaluated to
      assess the incidence and significance of intraabdominal pathology found at the
      time of exploration. While 41 patients (13.4%) were found to have additional
      diagnosis at the time of exploration, the majority of these were either minor in
      nature or would easily have been recognized utilizing laparoscopic techniques.
      Only one patient would have had significant intraabdominal pathology missed by
      laparoscopic techniques. It can be concluded that abdominal exploration at the
      time of treatment of cholelithiasis is unnecessary and that laparoscopic
      cholecystectomy will not compromise patient care in this regard.

PMID- 8347872
TI  - Comparison of results of KTP/532 laser versus monopolar electrosurgical
      dissection in laparoscopic cholecystectomy.
AB  - A total of 641 laparoscopic cholecystectomies performed between January 1, 1991
      and December 31, 1991 were reviewed to compare the results of Potassium Titanyl
      Phosphate (KTP/532) laser versus monopolar electrosurgery in laparoscopic
      cholecystectomy. KTP laser dissection was used alone in 199 cases (31%), and
      monopolar cautery was used in 442 (69%). During this same time period, 41
      additional procedures were excluded because of conversion to open
      cholecystectomy. Procedures in which both modalities (N = 24) were used were also
      excluded from the study. Modality choice was dependent upon operating surgeon's
      preference. Data were analyzed with student t-test, chi-square with Yates
      correction, stepwise linear regression analysis, and correlation matrices. Five
      (2.5%) patients had five major complications when KTP laser dissection was used
      and 34 (7.7%) patients had 42 major complications when monopolar electrosurgical
      dissection was used (p < 0.05). Postoperative hospital stay with the KTP/532
      laser dissection group was 1.4 +/- 0.06 days and for the monopolar
      electrosurgical dissection group it was 1.7 +/- 0.08 days (p < 0.05). The
      duration of the procedures was identical with either modality. The use of the KTP
      laser for dissection of the gallbladder during laparoscopic cholecystectomy may
      be a safer procedure with significantly decreased complication rates and savings
      in length of hospital stay. Although initially a more expensive procedure, the
      savings in length of hospital stay and treatment of complications may offset the
      initial expenditure and be worthwhile.

PMID- 8347873
TI  - Laparoscopic cholecystectomy in patients aged 65 or older.
AB  - Laparoscopic cholecystectomy is replacing open cholecystectomy in the surgical
      management of gallstone disease in healthy individuals. However, the role of
      laparoscopic cholecystectomy in patients thought to be at higher risk for
      surgical morbidity is still being defined. The course of patients aged 65 or
      greater who underwent attempted and successful laparoscopic cholecystectomies
      were reviewed. Eleven patients (12%) were converted from laparoscopic to open
      cholecystectomy. For the 83 patients completing laparoscopic cholecystectomy, the
      median time of surgery was 115 min and the median length of postoperative stay
      was 1 day. Two patients required parenteral analgesia longer than 48 h. Seven
      patients were admitted and monitored postoperatively, although five of these were
      preoperatively planned. Five patients were readmitted within 30 days. One patient
      was admitted with a myocardial infarction, one a subphrenic abscess, one an
      incarcerated hernia, one with pyrexia and leukocytosis (for which no source was
      identified), and one for an elective urinary tract procedure. Laparoscopic
      cholecystectomy provides patients aged 65 or older the same benefits of shorter
      hospital stay and less pain than it provides younger patients. Age alone should
      not be a contraindication to attempted laparoscopic cholecystectomy.

PMID- 8347874
TI  - Stationary and automated laparoscopically assisted technologies.
AB  - The extent that laparoscopy may impact upon the practice of surgery remains to be
      clarified. One problem with these techniques is the maintenance of an adequate,
      stationary visual field in morphometrically different abdomens. This requires the
      attentive, trained, and skillful utilization of someone or something to operate
      the camera portal. Herein reported are the theory, advantages, disadvantages, and
      clinical utilization of mechanical and robotic arm systems to replace this second
      assistant during laparoscopic surgery.

PMID- 8347875
TI  - Digital blunt dissection technique to assist laparoscopic gonadectomy in
      inguinally located/adhered gonads.
AB  - Laparoscopic gonadal removal in two patients, one with XY gonadal dysgenesis and
      the other with complete androgen insensitivity is described. In both cases, the
      gonads were either located deep in the inguinal canal or adherent in that area.
      Digital blunt dissection using a finger passed through the lateral lower
      abdominal trocar incision site (12 mm) at the mid-clavicular line of the lower
      abdomen, combined with external palpation/elevation of the inguinal ring, allowed
      rapid dissection and isolation of the desired structures and vascular pedicles.

PMID- 8347876
TI  - Mechanical retraction in laparoscopic surgery: intraoperative cholangiography.
AB  - The utility of mechanical retraction in laparoscopic surgery is presented. The
      steps required for its utilization during intraoperative laparoscopic
      cholangiography are outlined.

PMID- 8347877
TI  - An overview of laparoscopic surgery.

PMID- 8347878
TI  - The impact of laparoscopic surgery on health care delivery. The learning curve:
      skills and privileges.

PMID- 8347879
TI  - The impact of laparoscopic surgery on health care delivery. Changes in the
      patterns of patient care.

PMID- 8347880
TI  - Patients' perspectives of laparoscopic surgery.

PMID- 8347881
TI  - Laparoscopic surgery: potential for health care cost reductions.

PMID- 8347882
TI  - The program on outcomes research in technology.

PMID- 8347883
TI  - Is laparoscopic technology developing too rapidly? Distinguishing experimental
      technology from state-of-the-art surgery: the industrial perspective.

PMID- 8347884
TI  - Is laparoscopic technology developing too rapidly? Distinguishing experimental
      technology from state-of-art surgery: the industrial perspective.

PMID- 8347885
TI  - Is laparoscopic technology developing too rapidly? Distinguishing experimental
      technology from state-of-art surgery: the industrial perspective.

PMID- 8347886
TI  - Is laparoscopic technology developing too rapidly? Distinguishing experimental
      technology from state-of-art surgery: the industrial perspective.

PMID- 8347887
TI  - Is laparoscopic technology developing too rapidly? Distinguishing experimental
      technology from state-of-the-art surgery: the clinician's viewpoint.

PMID- 8347888
TI  - Laparoscopic cholecystectomy and pregnancy.
AB  - The risk of operation during pregnancy is a concern to both patients and
      surgeons. Operative treatment for gallstone disease during pregnancy is therefore
      performed only when the severity of symptoms exceeds the tolerance of the
      patient. The insufflation of the abdomen during laparoscopy and the concerns
      regarding adequate exposure are significant in the performance of such
      operations. When the indications are appropriate, laparoscopic cholecystectomy
      can be conducted safely during the course of an intrauterine pregnancy.

PMID- 8347889
TI  - Laparoscopic excision of a mesenteric cyst.
AB  - Benign abdominal cystic tumors are rare. They include retroperitoneal,
      mesenteric, and omental cysts. Most of these lesions present with vague abdominal
      pain and nausea. Less commonly they will present with bowel obstruction due to
      external compression. The diagnosis of these tumors is by abdominal ultrasound or
      computed tomography. Surgical enucleation is the treatment of choice.
      Laparoscopic surgical techniques are replacing or complimenting open abdominal
      surgical procedures. As the indications for these techniques increase, newer
      applications will arise. Presented here is a case of laparoscopic excision of a
      mesenteric cyst.

PMID- 8347890
TI  - Laparoscopic treatment of an upper ureteral stone.
AB  - Extracorporeal shock wave lithotripsy, ureteroscopy and percutaneous lithotripsy
      have become standard procedures for treatment of ureteral stones. Often, open
      surgery becomes necessary. A case of bilateral ureteral stones with chronic
      obstruction is presented in which the successful treatment with laparoscopic
      ureterolithotomy on one side is described. Laparoscopic ureterolithotomy can be
      used as an alternative method for stone removal in the upper and middle ureter.

PMID- 8347891
TI  - Laparoscopic adrenalectomy.
AB  - Presented is a case of a laparoscopic adrenalectomy and a small series of
      adrenalectomies performed by more traditional approaches both anterior and
      posterior. The laparoscopic adrenalectomy compares favorably with operating time
      and estimated blood loss and resulted in a shorter hospital stay and decreased
      total disability.

PMID- 8347892
TI  - Small bowel obstruction following laser laparoscopic cholecystectomy: a case
      study.

PMID- 8347893
TI  - The evolution of laparoscopic instruments.

PMID- 8347894
TI  - Enhancement of antigen-specific humoral and cell-mediated immunity by electric
      footshock stress in rats.
AB  - The effect of footshock stress on the induction phase of sensitization to keyhole
      limpet hemocyanin (KLH) introduced intraperitoneally was studied in adult male
      Sprague-Dawley rats. Rats were shocked at Days -1, 0, 1, and 3 relative to
      sensitization with 50 micrograms KLH and 14 days later were intradermally
      injected with 25 micrograms KLH or were noninjected. Anti-KLH IgG levels were
      measured in serum by ELISA and were enhanced in stressed versus control rats
      shocked on Days 0 or 1; splenocyte proliferation to KLH in vitro was also found
      to be enhanced in shocked rats compared to that in nonshocked rats. Skin at the
      challenge sites was removed and histologically examined for infiltrate density.
      There was an increased infiltrate in animals shocked on Days 0 or 1 in comparison
      to nonshocked controls. The increased humoral and cell-mediated anti-KLH immunity
      in stressed rats is evidence for enhanced immune function by exposure to
      footshock proximal to the induction phase of the immune response. The possibility
      of a generalized increase in immune function in stressed rats is doubtful since
      splenocyte proliferation to the T-cell mitogens concanavalin A (Con A) and
      phytohemagglutinin and the B-cell mitogen lipopolysaccharide showed no alteration
      between control and stressed rats at the time of sacrifice.

PMID- 8347895
TI  - Splenic norepinephrine is decreased in MRL-lpr/lpr mice.
AB  - The MRL-lpr/lpr mouse, a genetic model of the human autoimmune disease systemic
      lupus erythematosus, has been studied extensively to determine the etiology and
      the pathological course of the disease in lymphoid organs. At approximately 8
      weeks of age, splenomegaly develops due to a massive increase in an abnormal
      population of T cells, resulting in a disruption of the normal splenic
      architecture. Part of the normal splenic architecture includes postganglionic
      noradrenergic sympathetic nerve fibers, which can exert influence on a variety of
      immunological functions. Noradrenergic innervation and norepinephrine content of
      spleens from both male and female MRL-lpr/lpr mice and MRL(-)+/+ congenic
      controls were examined at 6, 12, 18, and 24 weeks of age. Norepinephrine content
      is reduced in MRL-lpr/lpr male and female mice prior to the onset of observed
      splenomegaly and remains reduced at all ages examined. Remaining noradrenergic
      fibers are found in their usual compartments, but are greatly diminished compared
      with controls.

PMID- 8347896
TI  - Natural killer cell cytotoxicity and T-cell proliferation is enhanced by
      avoidance behavior.
AB  - Natural killer (NK) cell activity and mitogen-stimulated spleenocyte
      proliferation were measured in rats exposed to stress in the form of avoidable
      and unavoidable shock. Rats that could avoid shock exhibited higher NK activity
      than either unshocked controls or rats that could not avoid shock. The latter
      were yoked to the avoidance rats and thus received the same number and frequency
      of shocks as did the avoidance group. The increased NK activity in the avoidance
      group appears due to a higher number of NK cells in this group as compared with
      those in the control or unavoidable shock groups. Additionally, NK activity was
      found to be proportional to avoidance response rate, with a majority of animals
      exceeding the minimal temporal avoidance requirement. Mitogen-stimulated
      proliferation of spleenocytes was also increased several fold in the group that
      could avoid shock as compared with that which could not and controls. The
      difference in NK activity and mitogen-stimulated proliferation could not be
      ascribed to differences in cortisol levels. The results indicate that behavior
      which results in the avoidance of aversive stimuli can lead to significant
      enhancement of immune system competence.

PMID- 8347897
TI  - The inhibitory effect of interferon-alpha on the serotonin-induced impairment of
      human NK cell activity in whole blood.
AB  - Serotonin (5-HT) at a concentration of 10(-4) to 10(-10) M impaired the
      cytotoxicity of human natural killer cells in whole blood. 5-HT added at the
      onset of the short-term cytotoxic assay had a pronounced inhibitory effect. It is
      very likely that the 5-HT2 receptor is involved in the inhibition of cytotoxicity
      because ketanserin, an inhibitor of the 5-HT2 receptor, partially prevented the
      effect of 5-HT. Treatment with 10(2)-10(4) IU/ml of interferon-alpha before or
      after the application of 5-HT decreased its inhibitory effect on the
      cytotoxicity. Radioligand binding studies revealed that the antagonistic effect
      of interferon was not due to the competition for the 5-HT2 receptors.
      Cycloheximide, an inhibitor of protein synthesis, did not block the suppression
      of natural killer activity by 5-HT, but it exerted a blocking effect on the
      acquisition of resistance to 5-HT induced by interferon.

PMID- 8347898
TI  - Degradation of enkephalins by rat lymphocyte and purified rat natural killer cell
      surface aminopeptidases.
AB  - Enkephalins have been reported to induce an elevation in natural killer (NK) cell
      cytolytic function. In the central nervous system, the short-lasting biological
      activity of the enkephalins may be attributable to their rapid hydrolysis at the
      cell surface. In a similar manner, a potential mechanism for regulating the
      effects of enkephalins on NK cells is through their degradation at the cell
      surface. The purpose of this study was to determine if NK cells were capable of
      enzymatically degrading Met- and Leu-enkephalin and to determine the type(s) of
      enzymes responsible. We report that rat nylon wool enriched splenocytes, purified
      NK cells, and interleukin-2 activated NK (A-NK) cells were capable of hydrolyzing
      the N-terminal Tyr residue from Met- and Leu-enkephalin as determined by high
      performance liquid chromatography. The rate of Tyr cleavage from Met-enkephalin
      was approximately twice that of Leu-enkephalin for both splenocytes, NK, and A-NK
      cells. On a cellular basis, enkephalin degradation was four to five times greater
      with A-NK cells than with splenocytes. Only a Tyr cleavage product was detected,
      which suggested the possibility of an aminopeptidase activity. This was confirmed
      by the ability of bestatin, a specific inhibitor of cell surface aminopeptidases,
      to almost completely inhibit enkephalin degradation by splenocytes (85%) and A-NK
      cells (96%). A-NK cells were more sensitive to bestatin inhibition as indicated
      by their IC50 values (0.01 mM for splenocytes and 0.001 mM for A-NK cells). In
      addition, the chelator 1,10-phenanthroline was also capable of effectively
      inhibiting enkephalin degradation, suggesting that the enzyme responsible has the
      characteristics of a metalloprotease. In contrast to the effects of bestatin or
      phenanthroline, typical inhibitors of serine and thiol proteases were without
      effect.

PMID- 8347899
TI  - Comparative methylprednisolone pharmacokinetics in renal transplant patients
      receiving double- or triple-drug immunosuppression.
AB  - OBJECTIVE: To assess the pharmacokinetics of chronic methylprednisolone therapy
      in renal transplant patients receiving double-drug (methylprednisolone and
      azathioprine) and triple-drug (methylprednisolone, azathioprine, and
      cyclosporine) immunosuppression. DESIGN: Parallel, randomized trial. PATIENTS:
      Fourteen renal transplant recipients (aged 29-65 y) evaluated in a public,
      university-affiliated hospital clinic. INTERVENTIONS: All patients received their
      chronic oral dose of methylprednisolone via a 10-20-minute intravenous infusion.
      MAIN OUTCOME MEASURES: Serum methylprednisolone concentrations were determined by
      HPLC and were used to generate pharmacokinetic parameters for this drug. RESULTS:
      The mean daily methylprednisolone dosage was 19 +/- 19 mg in the double-drug
      group and 9 +/- 2 mg in the triple-drug group. Mean serum creatinine
      concentrations were 124 +/- 44 and 124 +/- 27 mumol/L, respectively. Mean
      methylprednisolone clearances were similar in both groups: 405 +/- 205 (double
      drug) and 373 +/- 365 mL/h/kg (triple-drug) (p > 0.05). Mean steady-state volume
      of distribution was 1.5 +/- 0.8 L/kg in the double-drug group and 1.3 +/- 0.8
      L/kg in the triple-drug group (p > 0.05). Plasma half-life ranged from 1.7 to 4.3
      h (mean 2.7) in the double-drug group versus 1.4 to 3.4 h (mean 2.6) in the
      triple-drug group (p > 0.05). CONCLUSIONS: These data indicate that cyclosporine
      had no definitive influence on methylprednisolone disposition. The results reveal
      a wide variation in methylprednisolone metabolism in renal transplant recipients
      receiving either a double- or triple-drug immunosuppressive regimen. Typically,
      methylprednisolone is prescribed according to a standardized dosing protocol that
      assumes minimal interpatient variation. Therefore, the pharmacokinetic
      variability noted in this study may have important clinical implications
      regarding the development of chronic toxicity (e.g., osteoporosis, hypothalamic
      pituitary-adrenal suppression) and the attainment of successful
      immunosuppression.

PMID- 8347900
TI  - Loss of efficacy during long-term cifenline therapy: development of
      antiarrhythmic resistance?
AB  - OBJECTIVE: To describe the possible development of antiarrhythmic resistance to
      cifenline, an investigational Class I agent. METHODS: Forty patients with chronic
      ventricular premature depolarizations (VPDs) underwent dose-ranging studies with
      cifenline, an investigational Class I antiarrhythmic agent. Patients had a
      minimum of 30 VPDs/h detected by ambulatory electrocardiographic (ECG) monitoring
      over a 48-hour baseline placebo lead-in period. Twenty-two patients (55 percent)
      who initially responded received long-term cifenline therapy. Ambulatory ECG
      monitoring over 24 hours was repeated during active cifenline therapy at three
      month intervals and during placebo reintroduction at six-month intervals.
      RESULTS: After an average follow-up of 28 months, VPD frequency during cifenline
      therapy was similar to that during initial baseline placebo therapy in 8 of the
      22 patients (36 percent) who initially responded. Placebo reintroduction
      following cifenline failure showed a VPD frequency similar to that with active
      therapy. All patients had further cifenline dosage increases without success.
      Plasma cifenline concentrations increased in all patients and were in the high
      therapeutic range. All 8 patients were switched to other Class I antiarrhythmic
      agents with successful VPD suppression during treatment with the first
      alternative drug. CONCLUSIONS: We conclude that antiarrhythmic resistance
      occurred with cifenline in these patients as (1) initial efficacy was established
      for a minimum of two years, (2) VPD frequency was similar during cifenline
      therapy and placebo reintroduction, (3) cifenline therapy failure continued
      despite further dosage titration, and (4) alternative Class I antiarrhythmic
      therapy was successful in all patients. Repeat intermittent ambulatory ECG
      monitoring is necessary not only to assess the continued need for antiarrhythmic
      drug therapy, but also to establish continued long-term efficacy.

PMID- 8347901
TI  - Effectiveness of an ambulatory care clinical pharmacist: a controlled trial.
AB  - OBJECTIVE: To compare two general medicine clinics to determine the effectiveness
      of an ambulatory care clinical pharmacist in assisting recognition of drug
      therapy problems for physicians and decreasing drug therapy costs. DESIGN:
      Controlled trial. SETTING: Two general medicine ambulatory care clinics
      associated with a large, tertiary-care teaching hospital. PATIENTS: Those with
      scheduled and completed appointments in the clinics during the two-week study
      period. METHODS: Medication profiles of patients attending clinic A (pharmacist
      intervention) and clinic B (no pharmacist intervention) were reviewed by the
      pharmacist prior to clinic appointments. Potential drug therapy problems were
      identified at each clinic, but interventions were performed only at clinic A.
      Postappointment audits determined the number of recommendations implemented at
      clinic A versus the number of drug therapy problems (potential interventions)
      recognized and addressed by clinic B physicians independently of pharmacist
      intervention. Potential and actual savings were extrapolated to one year from the
      two-week study period. RESULTS: Implementation of interventions at clinic A was
      greater than at clinic B (p < 0.001). Drug therapy cost savings at clinic A were
      annualized to yield $185 per intervention. Potential cost savings of $176,724, or
      four times the pharmacist salary costs, is projected. CONCLUSIONS: An ambulatory
      care pharmacist is effective in identifying drug therapy problems, resulting in
      significant cost savings to the institution.

PMID- 8347903
TI  - Use of ondansetron for control of projectile vomiting in patients with
      neurosurgical trauma: two case reports.
AB  - OBJECTIVE: To describe two cases of projectile vomiting that were treated
      successfully with ondansetron in patients with neurosurgical trauma. Causes and
      pharmacologic treatments for nausea and emesis are also discussed. DATA SOURCES:
      Patient data and literature citations from published case reports, review
      articles, and clinical research reports as identified by MEDLINE. DATA SYNTHESIS:
      Ondansetron, a potent and highly selective antagonist of serotonin at the 5-HT3
      (subtype 3)-receptor, possesses potent antiemetic effects. It has not been
      associated with the extrapyramidal adverse effects seen with traditional
      antiemetics. The occurrence of extrapyramidal reactions may limit the usefulness
      of conventional antiemetics in neurosurgical patients because such agents
      interfere with serial mental status examinations and lower the seizure threshold.
      Therefore, ondansetron may be preferable in this patient population. Two patients
      with head trauma and projectile vomiting were treated successfully with
      ondansetron following treatment failure with prochlorperazine. These represent
      the first reported cases of efficacious treatment with ondansetron in
      neurosurgical trauma patients. CONCLUSIONS: Ondansetron may be the preferred
      agent for controlling nausea and vomiting in patients with neurosurgical trauma.
      Controlled clinical trials are needed to evaluate its safety and efficacy in this
      patient population.

PMID- 8347902
TI  - Pharmacy practice acts: a five-year follow-up.
AB  - OBJECTIVE: To rereview the status of state pharmacy practice acts since 1987.
      Additionally, this report discusses adoption of the 1992 National Association of
      Boards of Pharmacy Model State Pharmacy Practice Act as the standard state
      pharmacy practice statute. DATA SOURCES: State codes for 50 states and the
      District of Columbia, with attention focused on the pharmacy practice acts;
      Puerto Rico and the Virgin Islands were excluded. CASE LAW SELECTION: Case law
      utilizing state pharmacy statutes was selected to demonstrate pharmacists'
      liability. DATA EXTRACTION: The focus on each statute was the statutory
      definition of the "practice of pharmacy." DATA SYNTHESIS: Twelve pharmacy laws
      (24 percent) contain no definition of the practice of pharmacy. Compounding (92
      percent), dispensing (100 percent), interpretation and evaluation of
      prescriptions (72 percent), consultation (85 percent), drug utilization review
      (69 percent), drug product selection (54 percent), drug administration (21
      percent), pharmacokinetic consultation and patient assessment (13 percent) were
      noted in the laws for the remaining 38 states and the District of Columbia.
      Significant pharmacy activities codified since 1987 include consultation, drug
      administration, pharmacokinetic consultation, and patient assessment. Statutes
      defining pharmacy practice impact the profession by affecting liability and by
      mirroring society's view of the role of the profession. CONCLUSIONS: States have
      enacted new statutes principally in the areas of progressive pharmacy practice
      functions since 1987. Enactment of the definition of professional practice
      contained in the National Association of Boards of Pharmacy Model State Pharmacy
      Practice Act would serve the pharmacy profession by: (1) creating a uniform
      professional purpose; (2) creating legal responsibility that reflects
      contemporary practice; (3) allowing pharmacists to enlarge the scope of their
      practice as the profession's societal role evolves; and (4) conserving revenues
      normally consumed by lobbying for constant legislative revisions.

PMID- 8347904
TI  - Cyclosporine-amiodarone interaction.
AB  - OBJECTIVE: To report a possible interaction between cyclosporine (CsA) and
      amiodarone in a kidney transplant recipient. CASE SUMMARY: A 66-year-old kidney
      transplant recipient with a history significant for hypertension, moderate mitral
      valve insufficiency, and decreased left ventricular function developed
      ventricular tachycardia posttransplant and was eventually treated with
      amiodarone. Maintenance immunosuppression included prednisone, azathioprine, and
      CsA. CsA concentrations before amiodarone initiation were stable (range 100-150
      ng/mL). After amiodarone initiation, the CsA concentration increased more than
      twofold. Following CsA dosage reduction, concentrations returned to the desired
      range. The patient did not experience any toxicity with the increased
      concentration of CsA. DISCUSSION: The possible mechanisms of an interaction
      between CsA and amiodarone are reviewed. Reports of this interaction in heart
      transplant recipients are also reviewed. Changes in protein binding, changes in
      metabolism, or both may explain the interaction. Both CsA and amiodarone are
      protein bound and metabolized by the cytochrome P-450 enzyme system. CONCLUSIONS:
      It is likely that there is an interaction between CsA and amiodarone. The exact
      mechanism of this interaction has not been fully determined. When CsA is
      administered concurrently with amiodarone, CsA concentrations should be monitored
      closely and the CsA dosage should be adjusted as necessary.

PMID- 8347905
TI  - Pulmonary complications following tricyclic antidepressant overdose in an
      adolescent.
AB  - OBJECTIVE: To report a case of pulmonary edema following a tricyclic
      antidepressant (TCA) overdose in an adolescent. CASE SUMMARY: A 14-year-old girl
      with a history of prior suicide attempts ingested 54 50-mg desipramine
      hydrochloride tablets (45 mg/kg ingestion). The patient developed a cardiac
      dysrhythmia and hypotension, which were successfully treated. She subsequently
      developed pulmonary edema and a clinical picture suggestive of adult respiratory
      distress syndrome (ARDS). She was successfully managed with fluid restriction,
      tracheal intubation, application of positive end-expiratory pressure (PEEP), and
      vasopressors. The patient was discharged without any clinical sequelae.
      DISCUSSION: Pulmonary complications secondary to TCA overdose have rarely been
      reported in children. We reviewed literature pertaining to the etiology,
      epidemiology, pathophysiology, and management of TCA-induced lung injury, as well
      as other case reports. We discuss the potential relationship between sequelae
      resulting from TCA ingestion (e.g., cardiac disturbances, hypotension, acidosis,
      gastric aspiration, pneumonia) and the development of ARDS and pulmonary edema,
      and relate this association to our patient. CONCLUSIONS: Pulmonary edema and a
      clinical picture suggestive of ARDS was noted in an adolescent girl who ingested
      a large quantity of desipramine. Her lung injury may have been the result of a
      variety of factors including hypotension, metabolic acidosis, possible
      aspiration, or a direct action on the lung parenchyma by desipramine. We
      attribute her favorable clinical outcome to early intervention consisting of
      tracheal intubation, PEEP, fluid restriction, and vasopressor therapy.

PMID- 8347906
TI  - High transdermal fentanyl requirements in a patient with chronic cancer pain.
AB  - OBJECTIVE: To report a case of high transdermal fentanyl dosage requirements in a
      patient with chronic cancer pain. DATA SOURCES: Clinical studies, review
      articles, and relevant laboratory information. CASE SUMMARY: A 42-year-old woman
      with cervical cancer was admitted for control of her pain. Her outpatient
      analgesic regimen was a continuous intravenous infusion of morphine sulfate (MS)
      via an ambulatory infusion device. Upon admission, supplemental doses of
      intravenous MS were administered in an effort to eliminate the pain. Transdermal
      fentanyl therapy was initiated on hospital day 1 at 100 micrograms/h and the MS
      continuous intravenous infusion dosage was increased. Over the next four days,
      the patient experienced episodes of inadequate pain control and the transdermal
      fentanyl dosage was increased in increments of 100 micrograms/h. On hospital day
      4 the MS continuous infusion was converted to patient-controlled analgesia (PCA).
      The patient reported acceptable pain control with a regimen of transdermal
      fentanyl 500 micrograms/h and MS via PCA and she was discharged home on hospital
      day 7. CONCLUSIONS: This patient's high transdermal fentanyl dosage requirement
      was related to disease progression. She experienced an acute pain episode that
      may have been effectively managed by increasing the dosage of her continuous
      intravenous MS infusion.

PMID- 8347907
TI  - Benzodiazepine withdrawal reaction in two children following discontinuation of
      sedation with midazolam.
AB  - OBJECTIVE: To report the occurrence of recurrent benzodiazepine withdrawal
      reactions in two very young children following discontinuation of sedation with
      midazolam. CASE SUMMARY: A 15-month-old boy with apneic episodes was sedated with
      midazolam for 12 days with constant infusion. Half a day after discontinuation of
      the midazolam the boy became restless, tachycardic, and hyperpyrexic. When
      midazolam was readministered, all symptoms disappeared. Four days later midazolam
      was again discontinued and within 12 hours the same signs and symptoms
      reappeared. Midazolam infusion was restarted, and the signs and symptoms
      disappeared for the second time. After thoracotomy, a 14-day-old boy received
      intravenous midazolam for sedation for 29 days. Within 12 hours after
      discontinuation of midazolam he became restless, developed a bulging stomach
      secondary to aerophagia, and was vomiting. Midazolam therapy was reinstituted and
      continued for another 2 months by constant infusion. Thereafter, the boy was
      successfully weaned from artificial ventilation in 5 days under sedation with
      midazolam. About 12 hours after discontinuation of midazolam the boy became
      restless, tachycardic, again developed a bulging stomach because of aerophagia,
      and vomited. When the child was sedated with clorazepate by continuous infusion,
      the signs and symptoms disappeared. DISCUSSION: Case reports describing
      benzodiazepine withdrawal reaction upon discontinuation of midazolam were
      reviewed and compared. The symptoms observed in the children we present resemble
      those mentioned in the three children and two adults reported previously. Unique
      in the very young children in this article is the occurrence of gastrointestinal
      symptoms, which most likely are the result of air being swallowed secondary to
      severe agitation. CONCLUSIONS: Midazolam withdrawal reactions in adults and
      children, particularly in an intensive care unit, can be significant.
      Considerable caution must be taken with relatively long-term administration and
      abrupt discontinuation of midazolam.

PMID- 8347908
TI  - Valproate-induced coma: case report and literature review.
AB  - OBJECTIVE: To report a case of hyperammonemia without hepatic dysfunction as a
      possible cause of lethargy, stupor, and coma in a woman after valproic acid (VPA)
      administration, and discuss the possible different mechanisms of ammonia
      elevation and coma. CASE SUMMARY: A woman diagnosed with complex partial seizures
      that secondarily generalize was treated with phenytoin (PHT) 250 mg/d for 18
      years. Three months before admission, this dosage was increased to 300 mg/d and
      phenobarbital (PB) 100 mg/d was added because the seizures were incompletely
      controlled. The patient developed a progressive inability to walk. She was
      diagnosed as having PHT intoxication. VPA therapy was begun while PHT was being
      tapered and progressive impairment of consciousness occurred. This evolved into a
      coma without focal neurologic signs, and was accompanied by isolated
      hyperammonemia without hepatic failure. DISCUSSION: Adverse effects attributable
      to VPA were reviewed in the literature. Occasionally, VPA may lead to severe
      secondary effects such as hepatic failure and coma. In these cases increased
      blood concentrations of transaminases, bilirubin, and ammonia have been found.
      Several reports have stressed the existence of hyperammonemic coma without
      biochemical evidence of hepatic failure, which is what occurred in our patient.
      This suggests that isolated hyperammonemia and hepatic failure after VPA
      treatment may have a different biochemical basis. CONCLUSIONS: VPA-induced coma
      with hyperammonemia and without evidence of hepatic failure should be considered
      in patients being treated with PHT or PB when VPA is administered concomitantly.
      This case report shows the importance of clinical monitoring and immediate drug
      discontinuation when drowsiness, gastrointestinal symptoms, or lethargy occur.

PMID- 8347909
TI  - Ondansetron in the treatment of intractable nausea associated with theophylline
      toxicity.
AB  - OBJECTIVE: To report the efficacy of ondansetron in the treatment of a patient
      poisoned with theophylline. PATIENT: A 36-year-old man who ingested 6 g of
      sustained-release theophylline. INTERVENTION: Ondansetron 8 mg intravenously
      after clinical failure of other antiemetics. RESULTS: Subjective relief of nausea
      within minutes, enabling the patient to tolerate multiple doses of activated
      charcoal and whole bowel irrigation. CONCLUSIONS: Ondansetron may offer an
      alternative to present antiemetic therapy in the poisoned patient.

PMID- 8347910
TI  - Effect of seven fluoroquinolones on the determination of serum creatinine by the
      picric acid and enzymatic methods.
AB  - OBJECTIVE: To investigate in vitro the interaction of seven fluoroquinolone
      antibiotics with the determination of serum creatinine by the picric acid and
      enzymatic methods. DESIGN: This blind, in vitro study assayed duplicate serum
      samples for creatinine by the picric acid and enzymatic methods with averaged
      spiked concentrations of 2.71, 13.56, 27.12, and 108.47 mumol/L of ciprofloxacin,
      fleroxacin, lomefloxacin, ofloxacin, 1-ofloxacin, sparfloxacin, and temafloxacin.
      Cefoxitin (in concentrations of 233.9, 1169.6, 1754.4, and 2339.2 mumol/L) was
      used as a positive control for the picric acid assay. SETTING: University
      affiliated hospital, Department of Pharmaceutical Services and Clinical Chemistry
      section of the Department of Pathology. MAIN OUTCOME MEASURE: The serum
      creatinine samples spiked with the seven substituted fluoroquinolones and
      cefoxitin were assayed by both the picric acid and enzymatic assays. Statistical
      analysis compared the spiked samples with blank serum by Student's t-test and
      concentration ranges were compared by analysis of variance. A statistically
      significant interference with serum creatinine was p < 0.05. RESULTS: None of the
      substituted fluoroquinolones interfered significantly with the determination of
      serum creatinine by either method. Cefoxitin significantly interfered with the
      determination of serum creatinine by the picric acid method. CONCLUSIONS:
      Fluoroquinolones do not interfere with the determination of serum creatinine by
      either the picric acid or enzymatic method.

PMID- 8347911
TI  - Zinc lozenges for treatment of common colds.

PMID- 8347912
TI  - Use of hydroquinone as a bleaching cream.

PMID- 8347914
TI  - Natural products and the athlete: facts and folklore.
AB  - OBJECTIVE: To contrast scientific facts with suggested manufacturers' claims
      regarding food supplements (natural products) marketed for enhanced athletic
      prowess. DATA SOURCES: A MEDLINE search was performed to obtain documentation
      supporting the claims of natural-product manufacturers. In addition, several
      references pertaining to pharmacognosy, natural products, herbs, pharmacy
      practice, and sports medicine were reviewed. Claims were obtained from
      promotional advertisements in bodybuilding magazines, product labels, and fact
      sheets for sales representatives in nutrition and health-food stores. DATA
      EXTRACTION: We reviewed all of the clinical trials, published between 1966 and
      1992, relative to the manufacturers' claims regarding these products. DATA
      SYNTHESIS: Pertinent human and/or animal studies supporting each natural product
      were compared with the manufacturers' claims. CONCLUSIONS: We found that there
      was no published scientific evidence to support the promotional claims for a
      large proportion of the products (8/19, 42 percent). Only 4 of 19 products (21
      percent) were associated with any documented human clinical trials supporting
      their promotional claims. Six of 19 agents (32 percent) had some scientific
      documentation to support their promotional claims; however, these products were
      judged to be marketed in a misleading manner.

PMID- 8347913
TI  - Vancomycin therapeutic drug monitoring: is it necessary?
AB  - OBJECTIVE: To review the literature and assess the validity of obtaining
      vancomycin serum drug concentrations in patients. DATA SOURCES: A MEDLINE search
      of the English literature and a bibliographic review of articles pertaining to
      vancomycin serum concentrations, their use, and the rationale of cited
      therapeutic ranges. STUDY SELECTION AND DATA EXTRACTION: Studies pertaining to
      the use of vancomycin concentrations in the clinical setting, methods for
      predicting these concentrations, and studies that reported efficacy or toxicity
      associated with vancomycin use and possible correlation of serum concentrations.
      DATA SYNTHESIS: The usefulness of vancomycin serum concentrations, the
      determination of a therapeutic range of values, and their correlation to
      antibacterial efficacy and drug toxicity in the clinical setting are
      controversial. Old reports of toxicities need to be critically examined due to
      lack of information and the actual frequency of toxic reactions. The efficacy of
      vancomycin's antibacterial effect and its correlation with reported therapeutic
      ranges may advocate obtaining a vancomycin trough concentration in certain groups
      of patients. CONCLUSIONS: Determination of serum vancomycin concentrations in the
      clinical setting and their usefulness in patient care is questionable and
      unnecessary in the majority of patients.

PMID- 8347915
TI  - Medication compliance in elderly outpatients using twice-daily dosing and unit-of
      use packaging.
AB  - OBJECTIVE: To determine the effect of unit-of-use drug packaging of medications
      on compliance among elderly outpatients treated with complex medication regimens.
      DESIGN: Nonblind, randomized, clinical trial. SETTING: Geriatric outreach health
      centers in urban public housing units for independent-living elderly people.
      PATIENTS: Thirty-one patients (aged > or = 60 y), each taking three or more
      prescribed medications. Patients were randomly assigned to one of three study
      groups: group 1 (n = 12), no change in dosing or packaging; group 2 (n = 10),
      conventional packaging with twice-daily dosing; group 3 (n = 9), unit-of-use
      packaging with twice-daily dosing. INTERVENTION: A unit-of-use package consisting
      of a two-ounce plastic cup with a snap-on lid containing all medications to be
      taken at the time of dosing. MAIN OUTCOME MEASURES: Medication compliance was
      assessed monthly for six months using tablet counts. RESULTS: Medication
      compliance was significantly better in group 3 (92.6 percent) using unit-of-use
      packaging compared with either group 1 (79 percent) or group 2 (82.6 percent) (p
      = 0.017). Compliance did not differ between groups 1 and 2. CONCLUSIONS: In this
      small study of elderly outpatients taking three or more medications, unit-of-use
      packaging and twice-daily dosing improved medication compliance compared with
      conventional packaging.

PMID- 8347916
TI  - Drug-induced alterations in serum creatinine concentrations.
AB  - OBJECTIVE: To provide a comprehensive review of drug-induced alterations in serum
      creatinine concentrations (SCrs). DATA SOURCES: Information was obtained from a
      MEDLINE search, reference lists from articles identified in the search, review
      articles, and abstracts. STUDY SELECTION: Emphasis was placed on clinical studies
      of direct relevance to clinical practitioners. DATA EXTRACTION: Literature was
      assessed for its methodology, results, discussion, and conclusion. DATA
      SYNTHESIS: Two analytical systems to assay SCr are commonly employed in clinical
      practice--the Jaffe-based and enzymatic methods. Several drugs have been reported
      to interfere with SCr results obtained with both analytical systems by producing
      assay interference. In addition, trimethoprim, cimetidine, and salicylates
      produce elevations in the SCr by altering the normal elimination pathways of
      creatinine. Phenacemide has been reported to increase creatinine elimination, but
      the mechanism of this effect is unknown. CONCLUSIONS: Pharmacists should
      recognize the clinical significance of drug-induced interference with SCr and
      propose alternative methods of determining concentrations in selected patients.

PMID- 8347917
TI  - Crossover comparison of drug information online database vendors: Dialog and
      MEDLARS.
AB  - OBJECTIVE: To compare Dialog EMBASE with the National Library of Medicine's
      (NLM's) MEDLARS MEDLINE, TOXLINE, and TOXLIT to evaluate differences among the
      databases and vendors in a method consistent with routine drug information
      practice. DESIGN: Crossover comparison. METHODS: NLM MEDLARS databases MEDLINE,
      TOXLINE, and TOXLIT were searched directly. EMBASE was searched via Dialog
      Information Services. MEDLINE was searched back to 1980; TOXLINE and TOXLIT were
      searched back to 1981, reflecting the different database structures. EMBASE was
      searched back to 1980. To control bias, searches were randomized; identical
      strategies were used during the same session and were performed by the same
      trained searcher. RESULTS: Twenty-six drug information requests were compared.
      The MEDLARS and Dialog databases were generally similar, with no significant
      differences in the number of potentially relevant references, English references,
      clinically relevant references, available abstracts, unique citations, time
      online, and number of questions answered. EMBASE searches were more costly (p =
      0.0005). TOXLIT was costlier than TOXLINE and MEDLINE (p = 0.0018). CONCLUSIONS:
      NLM MEDLARS databases were comparable to Dialog EMBASE. Although MEDLARS provided
      more total and English-language citations, the differences were small and did not
      influence the proportion of questions answered. The greatest difference between
      the vendors was the significantly lower cost of searching on MEDLARS. Although
      this difference may be partially offset by the significantly shorter search times
      on EMBASE, the mean 1.9 minutes saved would not recoup the mean $7.89 difference
      in cost. MEDLARS databases are less expensive for routine drug information
      requests.

PMID- 8347919
TI  - Omeprazole administration.

PMID- 8347918
TI  - Preventing and treating hypertension: can we do better?
AB  - Although controversy exists, the most recent reports from the NHBPEP provide new
      and beneficial facts and recommendations relative to hypertension. During the
      past 20 years, important advances have been made in this field, but there are
      still opportunities for improvement.

PMID- 8347920
TI  - Theophylline, ciprofloxacin, erythromycin: a potentially harmful regimen.

PMID- 8347921
TI  - Polynomial procedure for estimating first-order absorption rate constant.

PMID- 8347922
TI  - Comment: cefazolin versus ceftriaxone in lower respiratory tract infection.

PMID- 8347923
TI  - Comment: cefazolin versus ceftriaxone in lower respiratory tract infection.

PMID- 8347924
TI  - Role of the transcription activator virF and the histone-like protein YmoA in the
      thermoregulation of virulence functions in yersiniae.
AB  - The chromosome of Y. enterocolitica encodes a heat-stable enterotoxin, Yst, being
      related to STI. The capacity to produce Yst generally disappears during storage
      of the strains. In these strains, the yst gene is intact but remains silent. The
      pYV plasmid encodes the eleven secreted antihost proteins called Yops as well as
      the outer membrane protein YadA. The Yops are secreted by a novel, pYV-encoded
      secretion mechanism. This mechanism which does not involve the removal of an N
      terminal signal sequence, is encoded by the pYV virA and virC loci. The virC
      locus contains 13 genes called yscA-M. The virA locus encodes the LcrD membrane
      protein. The yop, yadA and ysc genes form the yop regulon controlled by
      transcriptional activator VirF. Transcription of the yop, yadA, ysc and virF
      genes is controlled by temperature. A chromosome-encoded histone-like protein,
      called YmoA, is involved in the thermoregulation of the yop regulon, which
      suggests that this thermoregulation could result from temperature-induced changes
      in DNA topology. The phenotype of ymoA mutants resembles that of osmZ or drdX
      mutants of E. coli but YmoA is not the Yersinia homologue of the E. coli histone
      H1. The YmoA histone is also involved in the silencing of the yst gene.

PMID- 8347925
TI  - Differential regulation of Bordetella pertussis virulence factors.
AB  - Bordetella pertussis, the causative agent of whooping cough, regulates its
      virulence factors coordinately according to environmental parameters such as
      temperature and certain chemicals. A regulatory locus has been characterized
      which is essential for this regulation. This bvg locus codes for a two-component
      regulatory system composed of the sensor protein BvgS and the transcriptional
      activator protein BvgA. It has been shown that the BvgA and BvgS proteins are
      sufficient for the transcriptional regulation of some virulence factors such as
      the filamentous haemagglutinin (FHA) involved in adhesion. The recent
      identification of new regulatory mutants demonstrates that the regulation of some
      virulence factors such as the pertussis toxin (PTX) and the adenylate cyclase
      toxin (CYA) is more complex and involves additional regulatory factor(s). This
      finding suggests that the regulation of the various virulence factors is
      coordinated at the highest level of regulation, but there may be differences in
      the fine regulation of some of the factors such as the adhesins and the toxins.

PMID- 8347926
TI  - Diffuse adherence of enteropathogenic Escherichia coli strains--processing of
      AIDA-I.
AB  - The adherence of pathogenic Escherichia coli to the mucosa of the small intestine
      is an important step in the development of diarrhoea. To study the molecular
      basis of the diffuse adherence (DA) pattern of E. coli strains expressing the
      classical serotypes of enteropathogenic E. coli (EPEC), strain 2787 (O126:H27)
      was investigated. By expression cloning, a plasmid-derived 6.0 kb DNA fragment
      was identified which conferred the DA phenotype on recipient K-12 strains. This
      fragment encoded the 100 kDa adhesin involved in diffuse adherence (AIDA-I) which
      by mild heat shock treatment was isolated from the surface of the wild-type and
      recombinant DA-positive strains. Analysis of the entire DNA fragment revealed two
      open reading frames coding for proteins of 45 kDa and 132 kDa, respectively. The
      132 kDa protein has been identified as the AIDA-I precursor protein which after
      cleavage of the signal sequence undergoes additional C-terminal processing for
      maturation to AIDA-I. Though the function of the cytoplasmic 45 kDa protein is
      not known, preliminary evidence indicates that authentic expression of the
      protein is a prerequisite for the correct processing of the 132 kDa precursor to
      AIDA-I. The AIDA-I precursor exhibits significant homology to the virG (icsA)
      protein of Shigella flexneri which apparently plays a major role in the events
      leading to the intercellular spread of invasive Shigella organisms.

PMID- 8347927
TI  - The attaching and effacing virulence property of enteropathogenic Escherichia
      coli.
AB  - Enteropathogenic Escherichia coli (EPEC) remain an important cause of infant
      diarrhoea in many parts of the developing world. Essential for virulence is their
      ability to adhere to the small intestinal mucosa and produce a striking
      'attaching and effacing' (AE) lesion characterised by localised destruction of
      brush border microvilli, intimate attachment of bacteria to the residual apical
      enterocyte membrane, often in a cuplike pedestal structure, and formation of a
      dense plaque of actin (and other) cytoskeletal filaments beneath adherent
      bacteria. Fluorescence actin staining (FAS test) has turned out to be a useful
      diagnostic test for the AE lesion and also led to the identification of a
      chromosomal gene, eae, which is necessary but, by itself, not sufficient to
      produce the AE lesion. The 94 kDa outer membrane protein encoded by eae may be
      the adhesin which promotes intimate bacterial attachment. The signal transduction
      pathway which leads to AE lesion formation has yet to be defined although EPEC
      induced increased levels in intracellular calcium and phosphorylation of specific
      cell proteins including myosin light chain suggest that EPEC, by binding to a
      specific host cell receptor, may be promoting a calcium second message which
      would a) activate the brush border protein villin to cause microvillar breakdown
      and b) stimulate protein kinase activity to cause the other cytoskeletal
      rearrangements.

PMID- 8347928
TI  - Identification of a fibronectin-binding protein as adhesin of Streptococcus
      pyogenes.
AB  - The role of streptococcal fibronectin-binding protein (Sfb protein) in the
      adherence of Streptococcus pyogenes to epithelial cells was analyzed by using a
      recombinant Sfb fusion protein which was constructed by fusion of the binding
      domain of Sfb protein to MS2 polymerase. Sfb fusion protein was overexpressed in
      Escherichia coli, purified from E. coli lysates by FPLC and analysed in binding
      experiments with 125I-labelled fibronectin and adherence studies with HEp2
      epithelial cells. Lysates from E. coli expressing the fusion protein as well as
      purified Sfb protein competitively inhibited fibronectin binding and epithelial
      cell adherence of S. pyogenes, whereas streptococcal lipoteichoic acid (LTA),
      previously suggested to be the adhesin of S. pyogenes, had no effects. Southern
      blot analysis of chromosomal DNA from various streptococci revealed that the gene
      coding for the binding domain of Sfb protein was also present in other S.
      pyogenes strains. These results indicate that fibronectin-binding protein is the
      major adhesin of S. pyogenes.

PMID- 8347929
TI  - Polymorphism of the streptokinase gene: implications for the pathogenesis of post
      streptococcal glomerulonephritis.
AB  - Recent studies of streptokinase genes from epidemiologically and clinically
      defined streptococci of groups A, C and G have provided evidence of the
      polymorphism of the streptokinase locus in the chromosome of pathogenic
      streptococci. This review considers genetic and pathogenetic data suggesting that
      there exists a causal relationship between nephritis strain-associated
      streptokinase production and the initial stages of post-streptococcal
      glomerulonephritis (PSGN). Currently available sequence information allows to
      recognize, in the middle of the streptokinase molecule, a major variable region,
      V1, of about 70 amino acid residues in which sequence identity drops to below 50%
      when the proteins from nephritogenic and non-nephritogenic strains are compared.
      The V1 regions, although showing microheterogeneity within either protein
      category, appear to be more hydrophobic and possess a higher content of ordered
      secondary structures in the "nephritogenic" molecules. As a working hypothesis,
      they may be considered the nephrotropic domain(s) with which streptokinases from
      nephritogenic strains bind to glomerular structures and activate plasminogen in
      situ, thus triggering the cascade of proteolytic processes leading to PSGN.

PMID- 8347930
TI  - Identification and characterization of surface proteins from Staphylococcus
      saprophyticus.
AB  - Staphylococcus saprophyticus, a well known cause of urinary tract infections,
      possesses several properties, such as hemagglutination of sheep erythrocytes,
      adherence to various cell types and production of urease, which may be virulence
      factors. In this contribution, we summarise the present knowledge about recently
      discovered surface proteins of Staphylococcus saprophyticus, a 95 kDa surface
      associated protein (Ssp) and the hemagglutinin, a 160 kDa surface polypeptide. We
      describe culture conditions conducive to production of these surface proteins and
      discuss the molecular and clinical implications of our findings.

PMID- 8347931
TI  - Variation and genetic control of surface antigen expression in mycoplasmas: the
      Vlp system of Mycoplasma hyorhinis.
AB  - Surface antigenic diversity in the swine pathogen Mycoplasma hyorhinis is
      generated by random combinatorial expression and high-frequency phase variation
      of multiple, size-variant membrane surface lipoproteins (Vlps) which represent
      the major coat proteins of this wall-less procaryote. The distinctive structural
      basis for Vlp variation was revealed in a family of several related but divergent
      vlp genes. These occur in one cluster as single chromosomal copies, each encoding
      a conserved domain for membrane insertion and lipoprotein processing, and a
      divergent external domain that changes size by deletion or insertion of
      repetitive intragenic coding sequences while retaining a distinctive charge
      motif. Lack of detectable changes in restriction fragment patterns or DNA
      sequence of vlp structural genes during phase transitions between ON and OFF
      expression states ruled out long range genomic rearrangements and frameshift
      mutations as a means of controlling Vlp phase variation. However, highly
      homologous vlp promoter regions contain a homopolymeric tract of contiguous
      adenine residues [poly(A)] upstream of the transcriptional start site which is
      subject to frequent mutations altering its length. These mutations are the only
      sequence changes detected during phase transitions, and are highly correlated
      with the expression state of each vlp gene. This suggests a mechanism of
      transcriptional control regulating Vlp phase variation by critical changes within
      the poly(A) region affecting the spacing between the -10 and -35 hexamers or a
      putative regulator binding site. The multiple levels of structural and antigenic
      diversity embodied in the vlp gene family may provide essential adaptive
      capabilities for this wall-less microbial pathogen.

PMID- 8347932
TI  - The ORF6 gene product of the P1 operon of Mycoplasma pneumoniae.
AB  - The P1 attachment protein gene of Mycoplasma pneumoniae is flanked by two open
      reading frames with a coding capacity for two proteins of 28 kDa (ORF4) and 130
      kDa (ORF6), respectively. An operon-like organization in the order ORF4-P1-ORF6
      was proposed by Inamine et al. (11). Instead of an expected 130 kDa protein, two
      proteins of 40 and 90 kDa were identified as the gene product of ORF6 which might
      arise from cotranslational cleavage (18). After purification of both proteins,
      the N-terminal amino acid of the 90 kDa protein was determined. Thus, we
      identified the putative cotranslational cleavage site before amino acid position
      455 (R) (15). Biochemical and immunological studies indicate that both proteins
      are membrane-associated, exhibiting surface-exposed regions (15). Since a wild
      type-derived mutant lacking the 40 as well as the 90 kDa protein shows reduced
      attachment to host cells we suggest that the ORF6 encodes for two proteins which
      contribute to proper adherence of M. pneumoniae to host cells.

PMID- 8347933
TI  - Entry of Shiga toxin into cells.
AB  - The effect of Shiga toxin with mutations in the A fragment has been tested on
      cells in order to get more information about the processing of the A fragment
      during entry into the cytosol. A mutant with a deletion between the A1 and A2
      domain in the A fragment is resistant to cleavage by trypsin and is less toxic
      than wild type toxin on both Vero and A431 cells. The results support the view
      that processing of the A fragment is important for the high toxicity of the wild
      type toxin. A number of cell lines are resistant to Shiga toxin although they
      bind the toxin. However, A431 cells can be sensitized by butyric acid treatment,
      and transport of Shiga toxin to the Golgi apparatus seems to be required for the
      intoxication in the sensitized cells. The role of retrograde transport through
      the Golgi apparatus to the endoplasmic reticulum (ER) will be discussed.

PMID- 8347934
TI  - Activation and secretion of Serratia hemolysin.
AB  - The hemolysin of Serratia marcescens (ShlA) is secreted into the culture medium
      and forms small pores of a defined size in erythrocytes and in black lipid
      membranes. The protein is synthesized as an inactive precursor of 1608 residues
      which is translocated across the cytoplasmic membrane by the Sec-export system.
      In the absence of the outer membrane protein ShlB, the ShlA protein (designated
      ShlA*) stays in the periplasm and displays about 0.1% of the activity of the
      secreted form. Secretion of ShlA with the help of ShlB is accompanied by its
      conversion to the hemolytic form. A ShlA derivative consisting of the N-terminal
      238 residues of ShlA is secreted by ShlB, showing that the secretion signal
      resides in the amino terminal part of ShlA. ShlA* can be activated in vitro by a
      cell lysate containing ShlB, the activated ShlA remains hemolytic upon removal of
      ShlB. The assumed covalent modification of ShlA* by ShlB occurs in the N-terminus
      of ShlA since an amino terminal fragment (M(r) 28,000) secreted by ShlB, and a
      trypsin fragment of ShlA (M(r) 15,000) are both able to convert ShlA* to a
      hemolytic protein. In contrast to the permanent modification of ShlA* by ShlB,
      ShlA activity achieved by complementation with the ShlA fragments is abolished
      upon removal of the fragments. Apparently, the N-terminal portion of ShlA
      contains the information for secretion through the outer membrane and for
      insertion into the erythrocyte membrane. This information is lacking in ShlA*
      formed in the absence of ShlB but contained in the ShlA fragments formed in the
      presence of ShlB. The latter bind to ShlA* and direct ShlA* into the erythrocyte
      membrane. The fragments themselves are too short to build pores. The HpmA
      hemolysin of Proteus mirabilis shows extensive homology to ShlA. In vitro
      activation of HpmA* by ShlB and complementation by the 28 kDa ShlA fragment
      indicates a common activation mechanism.

PMID- 8347935
TI  - The role of hemolysin(s) in the pathogenesis of Serpulina hyodysenteriae.
AB  - Serpulina (Treponema) hyodysenteriae, an anaerobic beta hemolytic spirochaete, is
      the etiologic agent of swine dysentery. Not much is known at present about the
      virulence factors of S. hyodysenteriae. However, the hemolysin production of this
      bacterium is generally accepted to be a virulence factor. To study the exact role
      of hemolysin production in the pathogenesis of swine dysentery, the gene encoding
      a hemolysin, tly, was cloned and its nucleotide sequence determined. After
      inactivation of this gene, the virulence of a tly-minus mutant in mice was
      tested. The mutant had reduced hemolysis indicating that the tly-encoded
      hemolysin was not the only hemolysin produced by S. hyodysenteriae. Mice infected
      with the tly-minus mutant had fewer cecal lesions than mice infected with the
      wild-type S. hyodysenteriae. It was concluded that the tly-encoded hemolysin
      might be an important virulence factor, but not the only one. Since it was
      demonstrated that spirochaetes can be transformed through electroporation, this
      has made a genetic approach to elucidate the pathogenesis of spirochaetal
      infections possible.

PMID- 8347936
TI  - Bordetella pertussis adenylate cyclase: a toxin with multiple talents.
AB  - The adenylate cyclase toxin of Bordetella pertussis is a secreted multifunctional
      protein, endowed with calmodulin-activated catalytic, haemolytic and cytotoxic
      activities. Residues and domains involved in different functions have been
      localized and several permissive sites, able to accommodate insertion of peptides
      without impairing the different functions of the toxin, have been identified. A
      400-bp region in the promoter upstream region of the cyaA gene, encoding the
      toxin, has been defined as the target of transcriptional activation.

PMID- 8347937
TI  - Listeria monocytogenes--a model system for studying the pathomechanisms of an
      intracellular microorganism.
AB  - Virulence of Listeria monocytogenes is determined by a cluster of five genes in
      the order plcA, hly, mpl, actA and plcB, which are coordinately regulated by a
      transcriptional activator, termed PrfA. The gene for PrfA is located in front of
      plcA. Mutations within each of these genes reduce the virulence considerably and
      render the mutants unable to properly multiply and/or spread within the infected
      host cells. Under growth-limiting conditions PrfA-dependent proteins are
      preferentially synthesised. These studies indicate the existence of additional
      PrfA-regulated proteins in L. monocytogenes. The synthesis of catalase,
      superoxide dismutase, LmaA and p60 is not under the control of PrfA. These
      proteins seem to be also associated with virulence of L. monocytogenes. P60
      related proteins are found as major extracellular proteins in all Listeria
      species but only p60 of L. monocytogenes is able to restore the failure of R
      mutants (exhibiting a drastically reduced synthesis of p60) to adhere to 3T6
      mouse fibroblasts. Adherence of L. monocytogenes to the epithelial Caco-2 cells
      seem to be independent of p60. The p60 protein of L. monocytogenes differs
      characteristically from the p60-related proteins of the nonvirulent Listeria
      species.

PMID- 8347939
TI  - Bacterial adherence and epithelial cell cytokine production.
AB  - Epithelial cell lines produce the cytokines IL-1 alpha, IL-6 and IL-8 when
      stimulated with Escherichia coli. The cytokine response is enhanced by P
      fimbriae. The epithelial cell lines also respond to stimulation with other
      cytokines. These in vitro findings were confirmed in vivo in patients with E.
      coli infection who secreted IL-6 and IL-8 into the urine. The observations
      suggest that epithelial cells play a more active role in the mucosal immune
      response than previously recognized.

PMID- 8347938
TI  - Analysis of virulence factors of Legionella pneumophila.
AB  - Legionella pneumophila, the causative agent of Legionnaires' disease is a
      facultative intracellular bacterium, which in the course of human infection
      multiplies in lung macrophages predominantly manifesting as pneumonia. The
      natural habitat of Legionella is found in sweet water reservoirs and man-made
      water systems. Virulent L. pneumophila spontaneously convert to an avirulent
      status at a high frequency. Genetic approaches have led to the identification of
      various L. pneumophila genes. The mip (macrophage infectivity potentiator)
      determinant remains at present the sole established virulence factor. The Mip
      protein exhibits activity of a peptidyl prolyl cis trans isomerase (PPIase), an
      enzyme which is able to bind the immunosuppressant FK506 and is involved in
      protein folding. The recently cloned major outer membrane protein (MOMP) could
      play a role in the uptake of legionellae by macrophages. Cellular models are
      useful in studying the intracellular replication of legionellae in eukaryotic
      cells. Human cell lines and protozoan models are appropriate for this purpose. By
      using U 937 macrophage-like cells and Acanthamoeba castellanii as hosts, we could
      discriminate virulent and avirulent L. pneumophila variants since only the
      virulent strain was capable of intracellular growth at 37 degrees C. By using
      these systems we further demonstrated that a hemolytic factor cloned and
      characterized in our laboratory, legiolysin (lly), had no influence on the
      intracellular growth of L. pneumophila.

PMID- 8347940
TI  - Induction of heat-shock proteins by bacterial toxins, lipid mediators and
      cytokines in human leukocytes.
AB  - We studied the influence of a lipid mediator (12-hydroxyeicosatetraenoic acid, 12
      HETE), cytokines (IL-6 and TNF-alpha) and different bacterial toxins (alveolysin;
      exfoliative toxin; toxic shock syndrome toxin 1, TSST-1 and erythrogenic toxin A,
      ETA) on the expression of heat shock proteins (hsps) in isolated human
      leucocytes. 12-HETE induces the expression of individual heat shock proteins (65-
      and 83 kDa) protein in human leukocytes (lymphocytes, monocytes, basophilic
      granulocytes; LMBs). As was shown by Western blotting (anti-hsp72), IL-6 or TNF
      alpha induced hsps preferentially in human LMBs and PMNs, respectively. Among the
      toxins, ETA and TSST-1 were potent inducers of hsps at low toxin concentrations
      (10 ng/ml). Alveolysin led to the expression of hsps at hemolytic concentrations
      (1 HU; 700 ng/ml) whereas at subhemolytic concentrations (7 ng/ml), no heat shock
      response was observed. The induction of heat shock proteins was also accompanied
      by increased mRNA levels for hsp70 as determined by PCR analysis. In contrast,
      exfoliative toxin led to a reduction of the hsp signal in PMNs as determined by
      Western blotting. Finally, it was demonstrated that PMNs which had been
      pretreated with TNF-alpha and therefore expressed intracellular hsps were more
      resistant to cytolytic attack by leukocidin than untreated cells.

PMID- 8347941
TI  - Possible role of bacterial heat-shock proteins in autoimmune diseases.
AB  - The immune system is continuously exposed to a variety of microbial antigens. It
      is unavoidable that such antigens may resemble autoantigens, being present in the
      host. It has appeared now that the immune system is accepting recognition of such
      "mimicry" antigens and even may have developed a tendency to focus its attention
      to such antigens. This paper discusses the findings of immune responses to heat
      shock proteins, as a family of proteins exhibiting extraordinary sequence
      conservation, creating a high degree of similarity between bacterial antigens and
      host antigens. On the basis of existing evidence, it is argued that immune
      responses directed at hsps are part of regulatory mechanisms which enable the
      immune system to safely contain potentially self-reactive lymphocytes.
      Furthermore, it is argued that by means of artificial immunization against hsps
      or selected determinants of hsps, a development of autoimmune diseases may be
      inhibited.

PMID- 8347943
TI  - Vaccines in salmonellosis control in animals.
AB  - 1. It has been demonstrated that it was possible, under the conditions of the
      former GDR (East Germany), to decisively decrease the occurrence of Salmonella in
      livestock by means of the consequent combination of a good management including
      hygienic measures and of immunoprophylactic measures. This is one of the most
      important conditions for reducing the risk of food poisoning in man. 2. If using
      Salmonella live vaccines, cross immunity can be put to use. 3. Amount and
      duration of Salmonella shedding by calves can be decreased using orally
      administered live vaccines. 4. The immunogenicity of the S. typhimurium mutant
      serving as vaccine strain for Zoosaloral "Dessau" was retained after its 60-MDa
      plasmid had been deleted.

PMID- 8347942
TI  - The cellular immune response against Yersinia enterocolitica in different inbred
      strains of mice: evidence for an important role of T lymphocytes.
AB  - Resistance of mice against infection with Yersinia enterocolitica has been shown
      to be related neither to the Ity locus coding for resistance against infection
      with Salmonella typhimurium and other pathogens nor to the H-2 locus. From other
      mouse infection models, e.g., murine leishmaniasis, there is evidence that a
      different T cell-dependent regulation of the host immune response in various
      inbred strains of mice determines the susceptibility to the infectious agent.
      However, until recently, little was known about the cellular immune response
      against Y. enterocolitica. Thus, in a first approach we used the highly virulent
      Y. enterocolitica strain WA of serotype O:8 and different inbred strains of mice
      (C57 BL/6, Balb/c and athymic T cell-deficient C57 BL/6 nude mice) to investigate
      the cell-mediated immunity against parenteral infection. Comparison of the median
      lethal dose and of the net-bacterial growth in the spleens of infected mice
      indicated that Balb/c mice could be considered as Yersinia-susceptible whereas
      C57 BL/6 mice were relatively resistant. However, in contrast to normal C57 BL/6,
      athymic T cell-deficient C57 BL/6 nude mice have proved to be highly susceptible
      to Yersinia infection suggesting that T cells are required for the elimination of
      the pathogen. This conclusion was supported by histomorphological and
      immunohistological results indicating that T lymphocytes were present in Yersinia
      induced tissue lesions. Moreover, the adoptive transfer of Yersinia-specific T
      cell lines and clones into naive animals mediated significant protection against
      the pathogen in both Yersinia-resistant C57 BL/6 and in Yersinia-susceptible
      Balb/c mice. These findings emphasize an important role of T lymphocytes in the
      host response against Y. enterocolitica infection.

PMID- 8347945
TI  - Dissection of pathogenetic determinants and their genomic positions for the
      evaluation of epidemic strains and infection routes.
AB  - The epidemiology of infectious diseases intends to disclose the infection routes
      and sources of the respective diseases in order to provide preventive measures.
      The success of such a task is directly dependent on the knowledge about the
      special biological quality and the environmental distribution of the causative
      agents. This will imply extensive laboratory analysis rather than statistical
      surveys. The laboratory analysis for epidemiological purposes comprises a set of
      sophisticated methods for the subdifferentiation of the isolates (e.g.
      serofermentative and electrotyping, genomic fingerprinting). These methods
      provide circumstantial evidence of genetic and thus, epidemiological relatedness.
      Also the dissection of the pathogenic personality of the respective infectious
      agents was shown to have epidemiologic implications. However, the virulence
      pattern and the pattern of the genomic position of the respective determinants
      were found to be well conserved. For this reason, the dissection of virulence
      factors in comparison to other clonal properties must be regarded only as an
      additional marker for epidemiological discrimination. Moreover, any form of
      epidemic virulence remains to be detected by future analysis.

PMID- 8347944
TI  - Survey on newly characterized iron uptake systems of Yersinia enterocolitica.
AB  - Iron assimilation systems have been shown to be important for virulence in
      Yersinia enterocolitica. In principle, iron transport in Y. enterocolitica is
      similarly organized as in Escherichia coli although some differences exist in the
      siderophores used. A TonB function was identified which in a tonB mutant was
      complemented by the E. coli tonB gene. Three outer membrane receptors for
      siderophores were cloned and sequenced: FoxA for ferrioxamine B and E, FcuA for
      ferrichrome and HemR for heme uptake. In addition, two receptors were identified
      by mutants: CccA for catechol cephalosporins and FyuA for yersiniabactin, the
      siderophore produced by virulent yersiniae. In addition, the FyuA protein is
      assumed to be the pesticin receptor.

PMID- 8347946
TI  - Properties of Vero cytotoxin-producing Escherichia coli isolated from human and
      non-human sources.
AB  - Vero cytotoxin-producing Escherichia coli (VTEC) are an important cause of
      disease in man and animals. In addition to the production of VT these strains may
      possess other properties that are required for full virulence. Examples of some
      recent molecular studies are reviewed. Use of oligonucleotide probes and the
      polymerase chain reaction provide methods for the identification and typing of
      different VT genes. Several VTEC have the ability to cause attaching and effacing
      lesions of the epithelial microvilli. Hybridization experiments with the eae
      probe (E. coli attaching and effacing) showed homology with VTEC of human origin
      of eight different O serogroups. Properties of VTEC from human infections have
      been compared to strains isolated from animals and foods.

PMID- 8347948
TI  - Variation in MR signal intensity across normal human knee cartilage.
AB  - Signal intensity (SI) of individual pixels on sagittal magnetic resonance (MR)
      images of normal human knee cartilage was quantified to investigate whether it
      was related to cartilage proteoglycan content. In five subjects, images were
      acquired with spin-echo sequences with a TR msec/TE msec of 1,000 or 700/20 and a
      three-dimensional gradient-echo (GRE) sequence (60/15). In a sixth subject, the
      GRE sequence alone was used with 15 degrees, 30 degrees, and 50 degrees flip
      angles. In all subjects, SI was maximal in pixel layers of the medial zone and
      minimal at both cartilage edges, resulting in the presence of a bell-shaped curve
      of interpixel (zonal) SI variation across the cartilage thickness. The magnitude
      of SI was dependent on the pulse sequence and flip angle, but the bell shape of
      the SI variation curve was independent of them. For example, in the medial tibial
      cartilage, the peak SI was highest with the 1,000/20 spin-echo sequence,
      intermediate with the 700/20 sequence, and lowest with the GRE sequence. The
      differences were statistically significant. The bell-shaped SI variation curve
      resembled the curve for zonal variation in cartilage proteoglycan content but not
      the curves for collagen or free water content. The physiologic basis for this
      resemblance and the potential usefulness of the findings for early diagnosis of
      diseases such as osteoarthritis are discussed.

PMID- 8347947
TI  - Hydrogen-1, sodium-23, and carbon-13 MR spectroscopy of cartilage degradation in
      vitro.
AB  - Viable bovine nasal cartilage was examined with magnetic resonance (MR)
      spectroscopy. Digestion of the proteoglycan matrix by papain or trypsin was
      accompanied by substantial changes in carbon-13, sodium-23, and hydrogen-1 MR
      spectra and relaxation parameters, with C-13 MR spectra showing the most
      pronounced changes. These results indicate the potential of MR spectroscopy (and
      imaging) for noninvasive evaluation of cartilage disease and monitoring of
      patients with degenerative joint diseases.

PMID- 8347949
TI  - Fatty replacement of bone marrow after radiation therapy for Hodgkin disease:
      quantification with chemical shift imaging.
AB  - The authors studied the long-term fatty replacement of bone marrow in 23 patients
      who had received radiation therapy for Hodgkin disease, with T1-weighted magnetic
      resonance imaging and quantitative chemical shift imaging. T1-weighted images
      revealed a mostly homogeneous high-signal-intensity pattern, in contrast to the
      hypointense pattern of nonirradiated marrow. The degree of fatty replacement was
      objectively assessed with chemical shift imaging, comparing patients to age
      matched healthy volunteers. The authors found an increase in relative fat signal
      of 37% in the thoracic spine and 34% in the lumbar spine. The relative fat signal
      of nonirradiated pelvic and femoral marrow was decreased by 8%, indicating marrow
      reconversion. No radiation dose dependence was found in the range from 25 to 50
      Gy. No signs of marrow regeneration were observed 15-126 months after radiation
      therapy. With chemical shift imaging, the degree of long-term radiogenic fatty
      replacement of the bone marrow can be quantified, confirming the lack of
      regeneration after radiation therapy for Hodgkin disease.

PMID- 8347950
TI  - Characterization of focal fatty change in the liver with a fat-enhanced inversion
      recovery sequence.
AB  - A T1-weighted inversion-recovery (IR) sequence was used to study 15 patients with
      possible fatty change in the liver. The inversion time (TI) was calculated for
      optimal suppression of normal liver signal (t-null). Conventional spin-echo (SE)
      and short TI IR (STIR) sequences were also performed. For seven documented benign
      focal fatty liver lesions, the T1-weighted IR (fat-enhanced) sequence clearly
      enabled differentiation of normal from fat-infiltrated liver, whereas three of
      these lesions were isointense to normal liver with all other sequences. The
      livers of the other nine patients (two normal, one with diffuse fatty change, two
      with metastatic disease, one with hemangioma, one with focal nodular hyperplasia,
      one with simple cyst, and one with micronodular cirrhosis) showed homogeneous
      reduction of liver signal with the fat-enhanced IR sequence.

PMID- 8347951
TI  - Noise reduction in three-dimensional phase-contrast MR velocity measurements.
AB  - The authors have developed a method to reduce noise in three-dimensional (3D)
      phase-contrast magnetic resonance (MR) velocity measurements by exploiting the
      property that blood is incompressible and, therefore, the velocity field
      describing its flow must be divergence-free. The divergence-free condition is
      incorporated by a projection operation in Hilbert space. The velocity field
      obtained with 3D phase-contrast MR imaging is projected onto the space of
      divergence-free velocity fields. The reduction of noise is achieved because the
      projection operation eliminates the noise component that is not divergence-free.
      Signal-to-noise ratio (S/N) gains on the order of 15%-25% were observed. The
      immediate effect of this noise reduction manifests itself in higher-quality phase
      contrast MR angiograms. Alternatively, the S/N gain can be traded for a reduction
      in imaging time and/or improved spatial resolution.

PMID- 8347952
TI  - Renal cancer staging: comparison of contrast-enhanced CT and gadolinium-enhanced
      fat-suppressed spin-echo and gradient-echo MR imaging.
AB  - Fifty-three consecutive patients with 61 solid or complex non-fat-containing
      renal masses compatible with renal cancer were examined with contrast-enhanced
      computed tomography (CT) and magnetic resonance (MR) imaging with pre- and
      postcontrast FLASH (fast low-angle shot) and fat-suppressed spin-echo sequences.
      CT and MR imaging were performed within a 1-month interval. CT and MR images were
      prospectively interpreted. Tumor detection and staging were determined in all
      patients. CT and MR imaging enabled detection of 54 and 58 of 61 renal tumors,
      respectively. CT and MR imaging showed 34 and 35 of 38 histologically proved
      renal tumors, respectively, in 31 patients. Tumor size on CT and MR images
      demonstrated good correlation and correlated well with the size of pathologic
      specimens of 34 of 38 resected tumors detected with CT and MR imaging (r = .99).
      Of the 31 tumors in 31 patients who underwent surgical resection, 24 were
      correctly staged with CT and 29 with MR imaging. CT and MR imaging both enabled
      correct staging of four of five additional tumors with biopsy proof of tumor
      stage. A moderate difference in staging was observed between CT and MR imaging (P
      = .05). CT showed 13 and MR imaging 15 of 15 tumor thrombi. CT and MR imaging
      both showed 11 of 11 cases of adenopathy. The results suggest that MR imaging is
      moderately better than CT for the detection and staging of renal cancer.

PMID- 8347953
TI  - Correlation of cine MR velocity measurements in the internal carotid artery with
      collateral flow in the circle of Willis: preliminary study.
AB  - The velocity-phase relationship intrinsic to phase-contrast magnetic resonance
      (MR) angiography permits the quantitative and qualitative assessment of blood
      flow. The ability to measure velocity and vessel cross-sectional area allows
      noninvasive assessment of volume flow rate (VFR) in the internal carotid artery
      (ICA). Phase-contrast techniques also demonstrate flow direction. Using two
      dimensional cine phase-contrast angiography, the authors evaluated VFR in the ICA
      and collateral flow about the circle of Willis in 15 patients with ischemic
      neurologic symptoms. The VFR in each carotid artery was correlated with the
      degree of stenosis and presence or absence of abnormal circle of Willis
      collateral flow. There was a correlation between a decrease in VFR and abnormal
      circle of Willis collateral flow. In addition, a correlation between severe
      stenosis and a decrease in VFR was found. In patients with ischemic neurologic
      symptoms without severe stenosis (< 70% diameter stenosis), no decrease in VFR
      was seen. It is hoped that flow quantification and directional flow imaging with
      phase-contrast angiography will help further characterize carotid artery
      occlusive disease by enabling assessment of VFR changes associated with ischemic
      neurologic symptoms. This study also supports the hypothesis that two mechanisms-
      hemodynamic and embolic--play a role in ischemic neurologic symptoms.

PMID- 8347954
TI  - Single-breath-hold venous or arterial flow-suppressed pulmonary vascular MR
      imaging with phased-array coils.
AB  - A method for acquiring pulmonary vascular magnetic resonance (MR) images with
      either venous or arterial flow suppression is described. The proposed method only
      marginally increases the overall imaging time compared with conventional flow
      suppression techniques. This enables an acquisition to be completed within a
      single breath hold with some selectivity as to flow direction. Instead of
      applying a spatially selective presaturation pulse before each radio-frequency
      (RF) excitation pulse, the flow presaturation pulse is applied once every 16-20
      RF excitation pulses. To avoid image artifacts and to maintain a steady state,
      each presaturation pulse interval is followed by a normal imaging segment but
      with data acquisition turned off. Overall imaging time is increased by two TR
      intervals for each presaturation segment. For a 256 x 128 matrix acquisition,
      venous flow presaturation increases overall imaging time by approximately 14 TR
      intervals, while arterial flow suppression increases imaging time by 10 TR
      intervals.

PMID- 8347956
TI  - Pulsatile flow artifacts in two-dimensional time-of-flight MR angiography:
      initial studies in elastic models of human carotid arteries.
AB  - Initial experimental and numerical analysis of artifacts due to pulsatile flow in
      two-dimensional time-of-flight (2D-TOF) magnetic resonance (MR) angiography are
      presented. The experimental studies used elastic models of the carotid artery
      bifurcation cast from fresh cadavers and accurately reproducing the twisting and
      tapering of the human blood vessels, allowing direct comparison of images with
      and without flow. Prominent image artifacts, including periodic ghosts and signal
      loss, were produced by pulsatile flow even though flow-compensated gradient
      waveforms were used. The dependence of artifacts due to partial saturation on
      pulse sequence parameters (TR and flip angle) was investigated theoretically for
      a simple pulsatile velocity profile and compared with experimental results from a
      model of a normal carotid artery. Signal reduction was observed proximal and
      distal to the stenosis in a model with a 70% internal carotid artery (ICA)
      stenosis and a model with 90% stenoses in both the ICA and the external carotid
      artery. Although this study deals exclusively with 2D-TOF imaging, the methods
      can also be applied to evaluate other MR angiography techniques.

PMID- 8347955
TI  - Flow pattern analysis in the abdominal aorta with velocity-encoded cine MR
      imaging.
AB  - The sites of deposition of atherosclerotic plaque on the aortic wall are
      considered to be influenced by secondary and retrograde flow patterns that cause
      regions of altered shear stress. To detect secondary flow patterns and areas of
      retrograde flow in the abdominal aorta, velocity-encoded cine (VEC) magnetic
      resonance (MR) imaging was performed at five different levels of the abdominal
      aorta in nine healthy volunteers. Net retrograde flow (expressed as a percentage
      of antegrade flow) increased from proximal to distal levels and was maximal
      (13.8% +/- 11.8) just distal to the origin of the renal arteries. An increase in
      the duration of retrograde flow over the cardiac cycle was observed from proximal
      to distal levels. Whereas retrograde flow was present at end systole and early
      diastole in each volunteer at every level, the duration and amount of retrograde
      flow during diastole showed high interindividual variation. Such differences
      suggest the possibility of variable vascular geometric risk factors in the
      population for the development of atherosclerotic plaque. The location of
      retrograde flow in the abdominal aorta demonstrated in vivo with VEC MR imaging
      was close to that obtained with in vitro flow visualization studies in models of
      the abdominal aorta.

PMID- 8347957
TI  - Frequency dependence of MR relaxation times. I. Paramagnetic ions.
AB  - T1 and T2 of paramagnetic ions in free and chelated form were measured over the
      range of clinical magnetic resonance imaging field strengths (0.02-1.5 T). T1
      values agreed with published data; however, to our knowledge, the field
      dependence of T2 has not been systematically studied before Mn2+, Cr3+, and Fe3+
      all showed T2 reduction at high field strengths, although reduction due to Fe3+
      was minimal. This is believed to be due to "contact" interactions, which have
      been previously noted for manganese. No such T2 reduction was seen in the
      chelates, except that dysprosium chelate (but not free ion) showed an anomalous
      decrease in T2 at high field strengths, which may possibly be explained by a
      dephasing effect caused by the large magnetic moment of Dy3+.

PMID- 8347958
TI  - Frequency dependence of MR relaxation times. II. Iron oxides.
AB  - The frequency dependence of T1 and T2 was measured for homogeneous suspensions of
      magnetite and iron oxyhydroxide particles in water with various concentrations of
      gelatin. The transverse relaxivity showed two types of behavior: (a) For magnetic
      particles, there was a rapid increase in T2 relaxivity with frequency, followed
      by a saturation plateau, which accorded with the Langevin magnetization function.
      From these curves, the magnetic moment of the particle domains was estimated to
      range from 0.8 to 6.3 x 10(4) Bohr magnetons. (b) For iron oxyhydroxide
      (ferritin, ferrihydrite, and akaganeite) particles, T2 relaxivity increased
      linearly with frequency, the slope of the increase characteristic for each
      particle. T2 relaxivity generally increased with increasing gelatin
      concentration, corresponding to the measured decrease in the water diffusion
      coefficient. For iron oxides, homogeneously distributed either as iatrogenic
      agents or endogenous biominerals, these findings may aid in the interpretation of
      in vivo relaxivity and the effect on MR imaging.

PMID- 8347959
TI  - Implementation of wavelet-encoded MR imaging.
AB  - Reconstructions of images from wavelet-encoded data are shown. The method of MR
      wavelet encoding in one dimension was proposed previously by Weaver and Healy.
      The technique relies on selective excitation with wavelet-shaped profiles
      generated by special radio-frequency waveforms. The result of the imaging
      sequence is a set of inner products of the image with orthogonal functions of the
      wavelet basis. Inversion of the wavelet data is accomplished with an efficient
      algorithm with processing times comparable with those of a fast Fourier
      transform. The experiments show that wavelet encoding by selective excitation of
      wavelet-shaped profiles is feasible. Wavelet-encoded images are compared with
      phase-encoded images that have a similar signal-to-noise ratio, and there is no
      discernible degradation in image quality due to the wavelet encoding. Potential
      benefits of wavelet encoding are briefly discussed.

PMID- 8347961
TI  - MR imaging of knee hyaline cartilage: evaluation of two- and three-dimensional
      sequences.
AB  - Magnetic resonance (MR) imaging of cadaveric knees was performed to determine
      optimal sequences for visualization of hyaline cartilage. Full-thickness
      cartilage lesions ranging in diameter from 1 to 5 mm and a partial-thickness
      cartilage lesion 15 mm in diameter were created in the femoral articular surfaces
      of three cadaveric knees. The knees were then imaged with a 1.5-T imager with
      various two-dimensional and high-resolution three-dimensional (3D) techniques.
      After imaging, the knee specimens were sectioned for evaluation. Measurements of
      cartilage thickness in fast spin-echo images correlated best with those in the
      gross specimen. Diffuse areas of cartilage thinning were also most accurately
      identified with fast spin-echo images. Small, focal cartilage defects were best
      delineated in 3D SPGR (spoiled GRASS [gradient-recalled acquisition in the steady
      state]) images.

PMID- 8347962
TI  - MR imaging of muscle and tender points in fibromyalgia.
AB  - Fibromyalgia is a syndrome manifested by chronic, diffuse musculoskeletal aching
      and soreness, palpable muscle tender points, and other symptoms. Standardized
      clinical diagnostic criteria have recently been developed. Skeletal muscle has
      been postulated as the end organ in this disease. Biochemical, histologic,
      electromyographic, and conventional radiographic studies have demonstrated no
      definitive abnormality. This study sought to establish whether magnetic resonance
      (MR) imaging could demonstrate any abnormality in these patients. Eighteen
      patients were entered in the study, 14 of whom were able to complete their
      examinations. T1-weighted, T2-weighted, gradient-echo, and STIR (short-tau
      inversion-recovery) sequences were performed in all patients, with selected
      patients examined with T1-weighted, gadopentetate dimeglumine-enhanced sequences.
      The trapezius and suboccipital regions were imaged in patients who, clinically,
      had active fibromyalgia. No abnormalities could be detected. The authors conclude
      that the conventional MR imaging used in this study was unable to depict any
      primary skeletal muscle abnormality in fibromyalgia.

PMID- 8347960
TI  - Three-dimensional MR imaging and display of intracranial disease: improvements
      with the MP-RAGE sequence and gadolinium.
AB  - Three-dimensional (3D) image rendering was performed in 14 patients who had
      undergone magnetic resonance (MR) imaging for focal brain lesions. The MR study
      included the magnetization-prepared rapid gradient-echo (MP-RAGE) sequence with
      64 or 128 partitions. Resultant contiguous sections 2.5 or 1.25 mm thick,
      respectively, were obtained. Images were acquired before and after administration
      of gadopentetate dimeglumine. Resultant 3D data sets were processed on a
      commercially available workstation. Correlative surgical observation was
      performed in four cases. All data sets were successfully processed into 3D
      images. The precontrast images proved superior to gadolinium-enhanced images for
      brain surface rendering. Postcontrast images proved superior for reconstruction
      of tumors and vascular structures. The 64-partition data set proved sufficient
      for all postprocessing. Coronal orientation was preferred to sagittal orientation
      for surface rendering because it provided optimal orthogonal orientation of
      sulcal and gyral brain surface features. Three-dimensional rendition allowed easy
      superposition of lesion, brain, vessels, and scalp features--all useful for
      surgical planning. The central sulcus was easily recognized in the midline
      partitions and traced mediolaterally for projection on the cortical surface. MP
      RAGE provides a 3D data set that can be obtained in just over 3 minutes, from
      which clinically useful 3D renderings are possible. The rapidity of acquisition
      and capability for 3D rendering provides additional clinical utility.

PMID- 8347963
TI  - "Keyhole" method for accelerating imaging of contrast agent uptake.
AB  - Magnetic resonance (MR) imaging methods with good spatial and contrast resolution
      are often too slow to follow the uptake of contrast agents with the desired
      temporal resolution. Imaging can be accelerated by skipping the acquisition of
      data normally taken with strong phase-encoding gradients, restricting acquisition
      to weak-gradient data only. If the usual procedure of substituting zeroes for the
      missing data is followed, blurring results. Substituting instead reference data
      taken before or well after contrast agent injection reduces this problem.
      Volunteer and patient images obtained by using such reference data show that
      imaging can be usefully accelerated severalfold. Cortical and medullary regions
      of interest and whole kidney regions were studied, and both gradient- and spin
      echo images are shown. The method is believed to be compatible with other
      acceleration methods such as half-Fourier reconstruction and reading of more than
      one line of k space per excitation.

PMID- 8347964
TI  - Phase-correction method for reduction of B0 instability artifacts.
AB  - View-to-view phase shifts due to B0 instability are corrected by applying a phase
      correction to the low-spatial-frequency views. The algorithm described herein
      assumes that the signal intensity in the space outside of an object represents
      only noise. A set of phases for the low-spatial-frequency views are calculated by
      minimizing, in the image, the intensity of the induced artifacts in the space
      outside of the object.

PMID- 8347965
TI  - On cerebral lactate production and blood flow in acute stroke.

PMID- 8347966
TI  - Overexertional lumbar and thoracic back pain among recruits: a prospective study
      of risk factors and treatment regimens.
AB  - A total of 395 male infantry recruits were evaluated in a prospective study of
      possible risk factors for overexertional back pain and the efficacy of drug
      treatment regimens for this syndrome. Recruits were classified into subgroups of
      lumbar or thoracic, and paraspinal or spinous process pain. Recruits were divided
      into three treatment groups: Ibuprofen, Paracetamol, and no drug treatment. Of
      the recruits, 18% were diagnosed as having overexertional back pain during the
      course of 14 weeks of training. By multivariate analysis low body mass index was
      found to be a risk factor for overexertional lumbar pain (p = 0.005) and
      increased lumbar lordosis a risk factor for overexertional thoracic pain (p =
      0.005). Of recruits with overexertional back pain, 65% were asymptomatic by the
      end of basic training. There was no statistically significant difference between
      cure rates according to treatment groups.

PMID- 8347967
TI  - Correlation of motor-evoked potentials, somatosensory-evoked potentials, and the
      wake-up test in a case of kyphoscoliosis.
AB  - The ability to monitor the descending motor pathways of the spinal cord during
      surgery is an important goal in neurophysiologic monitoring of spinal
      deformities. This report describes a case of a severe spinal deformity for which
      instrumentation and reduction carried a significant risk of neurologic
      complications. During the procedure, changes in neurologic status were monitored
      simultaneously using both SSEPs and tcMMEPs. The reliability of these two
      complimentary modalities was then verified by concurrent wake-up tests. This case
      provides documentation of the reliability of tcMMEP responses when an accurate
      assessment of motor function was necessary.

PMID- 8347968
TI  - Salvage reconstruction in acute and late sequelae from pyogenic thoracolumbar
      infection.
AB  - Nine patients treated surgically for complicated pyogenic osteomyelitis of the
      thoracolumbar spine are reported. All patients were treated with anterior
      debridement and stabilization with nonvascularized autogenous fibular strut
      grafts. In addition, seven underwent a posterior spinal fusion with
      instrumentation. The average length of follow-up was 25 months. There was no
      recurrence of infection, no pseudoarthrosis, and the fibular struts appeared
      incorporated in all patients. Seven patients had postoperative improvement or
      resolution of their back pain. The use of nonvascularized autogenous fibular
      strut grafts for reconstruction of the spine following debridement for vertebral
      osteomyelitis is an effective procedure. The advantages of using the fibula for
      grafting are its strength and length for spanning several vertebral segments, and
      it can provide multiple grafts.

PMID- 8347969
TI  - A prospective study of diagnostic epidural blockade in the assessment of chronic
      back and leg pain.
AB  - A consecutive series of 100 patients with back and leg pain were evaluated
      prospectively. All had a detailed clinical assessment together with
      radiculography and computed tomography (CT) of the lumbosacral spine. In
      addition, each patient underwent diagnostic epidural blockade that identified
      three kinds of response. Injection of local anaesthetic into the epidural space
      relieved the symptomatic pain--the positive result (51 patients). Local
      anaesthetic injection had no effect on the symptomatic pain--the negative result
      (30 patients). In 19 patients, saline injection into the epidural space relieved
      the symptomatic pain--the placebo result. The results of this investigation were
      assessed in the light of the number of inappropriate physical signs found on
      clinical examination, together with the result of the radiculogram and CT scan.
      No statistical correlation was found with any of these parameters.

PMID- 8347970
TI  - Magnetic resonance imaging of the postoperative intervertebral disk: the first
      eight months--clinical and legal implications.
AB  - Ten patients were followed prospectively after lumbar discectomy, both clinically
      and with MR imaging, from 2 days to 8 months. The usefulness of MR imaging is
      limited during the first 2-3 months postsurgery because of severe disruption of
      the intraspinal anatomic definition. Thus, abnormal MRI findings during this
      initial period do not correlate with the clinical symptom-free state of patients
      postsurgery. The use of MR imaging in symptomatic patients is therefore limited.

PMID- 8347971
TI  - Herniated thoracic disks: treatment and outcome.
AB  - The optimal surgical approach for thoracic disk herniation is controversial, and
      long-term follow-up is poorly documented. We retrospectively reviewed the records
      of 31 patients who underwent surgery for herniated thoracic disks at our
      institution during a 17-year period (1975-1992). Two patients had multiple disk
      herniations; 16 of 33 herniated disks occurred at or below the T10-11 level.
      There were three surgical approaches to diskectomy: laminectomy in four patients,
      transpedicular surgery in 12, and costotransversectomy in 15. Weakness resolved
      postsurgery in nine of 18 patients. One patient transiently deteriorated
      neurologically after a laminectomy, three had wound infections, and two required
      second operations for their herniated disks. Postsurgery half the patients with
      symptoms continued to have pain or weakness.

PMID- 8347972
TI  - CT analysis of pedicles and screw tracts after implant removal in thoracolumbar
      fractures.
AB  - Twenty-one burst fractures of the thoracolumbar junction were stabilized with a
      transpedicular fixator by surgeons experienced in this technique. Screws 5 or 6
      mm in diameter were used. After the removal of the device 1 year postsurgery,
      axial CT scans were obtained of the instrumented vertebrae. Eighty-two pedicles
      were examined. In 16 pedicles, medial or lateral cortical defects were found.
      Five screws had intruded into the spinal canal by a maximum of 3.5 mm. In 48
      pedicles a correlative comparison with the preoperative examinations was
      possible. Compared with the dimensions of the pedicles on the preoperative CT
      scans, 31 had increased in width, and 14 showed deformation indicative of
      fractures of the lateral pedicle wall. When the screw diameter exceeded 65% of
      the pedicles' outer diameter, 85% of the pedicles expanded. One of four screws
      had penetrated the anterior wall of the vertebra. Pedicle screw penetration on
      the left side above L2 poses potential risk of erosion of the aorta. The use of
      pedicle screws at the thoracolumbar junction by experienced surgeons carries some
      risk for malplacement and neurological damage. Mismatch between pedicle dimension
      and screw size results in pedicle expansion and lateral wall fractures, probably
      during screw insertion. Preoperative CT examinations should be used to help in
      choosing appropriate screw diameter presurgery.

PMID- 8347973
TI  - Trumpet laminectomy for lumbar degenerative spinal stenosis.
AB  - The clinical and radiologic results of trumpet laminectomy, an improved method of
      extensive laminectomy preserving the facet joints (n = 35), and extensive
      laminectomy (n = 15) were compared in patients with degenerative lumbar spinal
      stenosis. The results were evaluated using a rating system and serial radiographs
      and a follow-up of 2 to 10 1/2 years (mean, 5.2 years). The overall results
      corroborate the advantage of the trumpet laminectomy, demonstrating a lower
      incidence and lower grade of postoperative lumbar scoliosis as well as less
      symptom recurrence in the trumpet laminectomy group than in the extensive
      laminectomy group. Risk factors for postoperative spinal instability and
      scoliosis appear to be facet joint destruction and elderly females with a high
      level of physical activity.

PMID- 8347974
TI  - Role of the surgical position in the development of postoperative low back pain.
AB  - The aetiology of postoperative back pain is contentious. Although the role of the
      surgical position has not been fully established, the lithotomy position is often
      implicated. In order to investigate this common surgical complication further, a
      prospective study has been performed on 101 hysterectomy patients. The supine (52
      patients) and the lithotomy (49 patients) positions have been compared and
      contrasted within this series. Ten patients in the supine group (20%) and seven
      patients in the lithotomy group (14%) developed postoperative low back pain (p >
      0.1). The mean duration of symptoms postoperatively for the whole series was 7
      months. We conclude that postoperative backache is an under-estimated
      complication of surgery and that this problem occurs equally whether the supine
      or the lithotomy positions are used.

PMID- 8347975
TI  - Anterior lumbar interbody fusion for discogram concordant pain.
AB  - Twenty-two patients undergoing anterior lumbar interbody fusion (ALIF) for
      discogram concordant low-back pain were retrospectively evaluated by objective
      criteria. Results were poor in all two-level fusions. Among single-level fusions,
      there were 35% good, 18% fair, and 47% poor results. Patients with previous
      surgery or workmen's compensation did poorly as a group despite positive
      discography. Subjective results were difficult to assess.

PMID- 8347976
TI  - Cervical laminectomy and foraminotomy as surgical treatment of cervical
      spondylosis: a follow-up study with analysis of failures.
AB  - Ninety patients were followed after undergoing multilevel cervical laminectomy
      for cervical myeloradiculopathy secondary to cervical stenosis. Follow-up data
      was obtained by chart review and phone interview for all patients; 20% were
      examined at follow-up as well; 77% of patients were improved, 13% without change,
      and 10% worse at follow-up. No patients deteriorated in the immediate
      postoperative period. Greater than 50% of severely disabled patients had an
      excellent result, and 78% improved somewhat. It is concluded that cervical
      laminectomy is an effective procedure for treating patients with cervical
      spondylosis causing myeloradiculopathy. Reasons for failure of this procedure,
      although rarely identified on follow-up examination, are reviewed and briefly
      discussed.

PMID- 8347977
TI  - Short segment transpedicular Cotrel-Dubousset instrumentation: a porcine
      corpectomy model.
AB  - This study examines changes in stiffness in a three-level spinal construct
      utilizing transpedicular Cotrel-Dubousset instrumentation. In addition, we
      evaluated the effect of adding offset laminar hooks at the same level as the
      superior transpedicular fixation. Porcine lumbar spines (L-1 to L-5) were tested
      as: (a) intact spine, (b) intact spine with instrumentation, and (c) instrumented
      spine after L-3 corpectomy. Instrumented constructs were tested with and without
      laminar hooks placed at the level of superior transpedicular fixation. Constructs
      were tested in modes of axial compression and torsion in a MTS materials testing
      machine. The fully instrumented intact spines demonstrated a 28.0% stiffness
      increase over the intact spines in torsion (p < 0.005) and a 23.1% increase in
      the mode of axial compression (p < 0.0002). There was no statistically
      significant difference in axial or torsional stiffness in the instrumented intact
      spine constructs when hooks were added. In the corpectomy model, addition of the
      laminar hooks increased stiffness in axial compression an average of 26.9% (p <
      0.002) and in torsion an average of 28.1% (p < 0.0005). This increase in
      stiffness may aid in preventing the postoperative progression of kyphosis noted
      in studies utilizing similar constructs in clinical application for the treatment
      of lumbar burst fractures.

PMID- 8347978
TI  - Late presentation of infection as a complication of Dwyer anterior spinal
      instrumentation.
AB  - Delayed presentation of infection is a rare complication of anterior
      instrumentation and fusion for scoliosis. Three cases that followed the Dwyer
      procedure are reported. Pain was absent in these patients, but mild
      constitutional symptoms were present. An elevated erythrocyte sedimentation rate
      (ESR) is an important indicator of this complication. Two patients developed
      groin abscesses and sinuses as the hallmark of deep infection. Infection resolved
      after removal of instrumentation and local debridement.

PMID- 8347979
TI  - Eosinophilic granuloma of the spine with and without vertebra plana: long-term
      follow-up of six cases.
AB  - Vertebral eosinophilic granuloma is a rare condition frequently associated with
      vertebra plana. In this paper we present six patients with eosinophilic granuloma
      of the spine; three were without vertebra plana, which represents a diagnostic
      problem. The mean follow-up was 9 years, (range 2 to 23) and the mean age was
      10.8 years at diagnosis. All complained of pain with no neurological deficit. The
      lesions were located on the vertebral bodies of C4, T9, T10, L1, L2, and L5,
      respectively. Histologic confirmation of diagnosis was obtained in all patients,
      two by puncture and four by open biopsy. The patients with vertebra plana (T10,
      L1, and L5, respectively) were treated conservatively. Long-term follow-up
      demonstrated total healing of the vertebral body in two and partial rebuilding 8
      years after diagnosis in one. Patients without vertebra plana (C4, T9, and L2,
      respectively) underwent curettage and bone grafting. In the patient with T9
      location, a T8-10 anterior arthrodesis with autogenous rib graft was performed.
      The outcome was satisfactory in all.

PMID- 8347980
TI  - Lumbar stenosis with osteoporotic compression fracture and neurogenic
      claudication.

PMID- 8347981
TI  - Null red blood cell phenotypes: associated biological changes.

PMID- 8347982
TI  - Monoclonal antibodies against platelet glycoproteins.

PMID- 8347983
TI  - Fibrin glue in cardiothoracic surgery.

PMID- 8347984
TI  - Cryoprecipitate: uses and alternatives.

PMID- 8347985
TI  - Forensic identity testing using highly polymorphic DNA markers: current status
      and emerging technologies.

PMID- 8347986
TI  - Interaction of proteins with lipid headgroups: lessons from protein kinase C.

PMID- 8347987
TI  - Models of lipid-protein interactions in membranes.

PMID- 8347989
TI  - The effects of phosphorylation on the structure and function of proteins.

PMID- 8347988
TI  - Functional bases for interpreting amino acid sequences of voltage-dependent K+
      channels.

PMID- 8347990
TI  - What does electron cryomicroscopy provide that X-ray crystallography and NMR
      spectroscopy cannot?

PMID- 8347991
TI  - The design of metal-binding sites in proteins.

PMID- 8347992
TI  - Artificial neural networks for pattern recognition in biochemical sequences.

PMID- 8347993
TI  - The structure of the four-way junction in DNA.

PMID- 8347994
TI  - Realistic simulations of native-protein dynamics in solution and beyond.

PMID- 8347995
TI  - Hydrogen bonding, hydrophobicity, packing, and protein folding.

PMID- 8347996
TI  - Glycoprotein motility and dynamic domains in fluid plasma membranes.
AB  - The diffusion measurements of glycoproteins have further supported a fluid mosaic
      model of membrane structure, but the basis of the lower apparent diffusion
      coefficients in biological membranes remains incompletely understood. In the
      specific case of glycoproteins with a single alpha-helix spanning the membrane,
      studies indicate that the major frictional drag is in the external protein layer
      and not the bilayer. Only in the erythrocyte membrane does the internal protein
      layer clearly control the lateral diffusion coefficient of a glycoprotein with a
      large cytoplasmic domain. In cultured cells, the barriers to lateral
      displacements over long distances are primarily on the cytoplasmic surface and
      not in the external matrix. Active movements of individual or small groups of
      glycoproteins both forward and rearward on cells appear to result from the
      interactions with moving cytoskeletal structures. Membrane turnover as well as
      transient attachment to the cytoskeleton can produce dynamic domains in the
      membrane that would depend on motile activity. Recent technological advances
      enable simultaneous monitoring of specific cell functions and glycoprotein
      motility, making it possible to correlate membrane fluidity and active
      glycoprotein movements with cell function.

PMID- 8347997
TI  - Mechanisms of membrane fusion.

PMID- 8347998
TI  - Fast crystallography and time-resolved structures.

PMID- 8347999
TI  - The control of protein stability and association by weak interactions with water:
      how do solvents affect these processes?

PMID- 8348000
TI  - The two-dimensional transferred nuclear Overhauser effect: theory and practice.

PMID- 8348001
TI  - Should nurses walk away from the scene of an accident?

PMID- 8348002
TI  - Nurses must improve their knowledge of pharmacology.

PMID- 8348003
TI  - Prevention of falls among older people at home.
AB  - The high incidence of falls among older people and the subsequent high rates of
      potentially preventable morbidity and mortality highlight the need for early
      identification of risk factors. This article discusses the major contributory
      factors and the role of community nurses in accident prevention assessment of
      older people.

PMID- 8348004
TI  - Smoking control and cessation.
AB  - Over the last 30 years the prevalence of cigarette smoking in adults in the UK
      has fallen to around 30%. Smoking will still kill 100,000 people each year well
      into the next century. Smoking in children is related to whether their parents
      smoke. Moves to reduce smoking in adults will therefore reduce smoking in
      children. The Government should be urged to raise taxes on cigarettes and ban
      advertising. Smoking should be banned from all health care premises. Hospitals
      should be encouraged to appoint smoking cessation counsellors to work with both
      staff and patients.

PMID- 8348005
TI  - Use of thrombolytic therapy in acute myocardial infarction.
AB  - The use of thrombolytic therapy in the treatment of acute myocardial infarction
      is now common practice. This article examines the physiological basis of
      thrombolytic therapy, the contraindications to its use and the nursing care of
      patients undergoing such therapy.

PMID- 8348006
TI  - Evaluation in practice.
AB  - If the benefits of professional nursing are to be effectively articulated, the
      process of evaluation in practice must be fully exploited. Nurses in the Mid
      Staffordshire General Hospitals have developed methods to help them evaluate
      their practice. In this article the principles underpinning these developments
      are described.

PMID- 8348008
TI  - Nurses must maintain higher standards in hygiene.

PMID- 8348007
TI  - Current developments in interprofessional education.
AB  - The educational services, the health services and the personal social services
      are complex multiprofessional organizations which depend on both
      intraprofessional and interprofessional relationships. Such relationships within
      and between professional groups are being encouraged to enhance teamwork and
      collaboration between staff in the delivery of services to clients.

PMID- 8348009
TI  - A moral dilemma: killing and letting die.
AB  - Most health care professionals believe that there is a clear difference between
      killing and letting die, i.e. between active and passive euthanasia.
      Philosophers, however, have repeatedly attacked the moral validity of their
      argument. This article explores various related issues and theoretical approaches
      to the distinction between acts and omissions.

PMID- 8348010
TI  - Legal aspects of first aid and emergency care: 1.
AB  - The decision whether or not to intervene in a first-aid situation carries certain
      implications for nurses. This article, the first in a 3-part series, examines
      nurses's duty to act at the scene of an accident and the legal implications of
      intervention.

PMID- 8348011
TI  - Task-oriented hospital workers threaten the role of nurses.

PMID- 8348012
TI  - Theatre nursing in Uganda.

PMID- 8348013
TI  - The Ladies' Home Journal Club.

PMID- 8348014
TI  - Testing for HIV.

PMID- 8348015
TI  - Can proper condom use be evaluated?

PMID- 8348016
TI  - Your patient's health and environmental pollution. Great Lakes Health Effects
      Program.

PMID- 8348017
TI  - Radiology rounds. Radiography of the right upper abdominal quadrant showing the
      removal of the common bile duct stone by a wire basket.

PMID- 8348018
TI  - Dermacase. Atopic dermatitis.

PMID- 8348019
TI  - Stress and residents' lifestyle. Survey of family medicine residents at McGill
      University.
AB  - To study the effects of training on quality of life and work satisfaction, we
      distributed questionnaires to all McGill family medicine residents. Residents
      lacked leisure time and were concerned that the heavy workload would affect
      subsequent quality of care. However, they adapted well to the stress of training.
      A spouse or partner was an important source of support.

PMID- 8348020
TI  - Mother, doctor, wife.
AB  - Women physicians often play a triple role: mother, doctor, and wife. This
      situation can be extremely stressful. Understanding the stresses of each role and
      setting priorities to help make each role more fulfilling are important for
      balancing career and personal life.

PMID- 8348021
TI  - AIDS, the female patient, and the family physician.
AB  - Women constitute the most rapidly growing population with human immunodeficiency
      virus infection in Canada. Problems unique to women and related to HIV include
      gynecological disorders such as recurrent candidiasis, cervical dysplasia, and
      neoplasia. Women also face unique psychosocial issues related to their
      socioeconomic status, pregnancy, and sex. This article addresses these issues.

PMID- 8348023
TI  - Recurrent urinary tract infections in children.
AB  - Urinary tract infections are common in children and present in various ways.
      Diagnosis is based on findings of pyuria and bacteriuria. Management includes
      adequate and timely investigation, appropriate antibiotics, treatment of
      underlying contributing factors, and follow-up advice.

PMID- 8348022
TI  - Anxiety disorders. Focus on obsessive-compulsive disorder.
AB  - Obsessive-compulsive disorder was once thought to be rare. Recent epidemiologic
      surveys reveal the lifetime prevalence rate to be as high as 3%. We now have
      greater understanding of the neurophysiologic and neurochemical basis of this
      very crippling disorder. Although obsessive-compulsive disorder often starts in
      adolescence or early adulthood and can last a lifetime, effective treatment
      enables most patients to lead relatively normal lives.

PMID- 8348024
TI  - Dyspnea in dying patients.
AB  - Dyspnea is common in terminally ill patients and is often fairly difficult to
      control. If specific causes cannot be identified or treated, general measures to
      relieve symptoms should be used. Nondrug measures (eg, discussion and explanation
      with the patient) and drug measures (eg, morphine) can be used to control the
      dyspnea, although side effects, such as sedation, can be problematic.

PMID- 8348025
TI  - Familial testicular cancer. What role does heredity play?

PMID- 8348026
TI  - [The effect of bromocryptin on rotational activity in rats].
AB  - The experiments were made in rats with unilateral lesion to the nigrostriatal
      tract, which was induced by the highly active dopaminergic neurotoxin 1-methyl-4
      phenyl-pyridinium. The rotational activity of rats was evaluated after
      intragastric and subcutaneous bromocryptine given in a single dose of 10 mg/kg
      and 25 mg/kg one, two, three and four times. The highest effect of the drug was
      seen when it was used in the maximum dose of 25 mg/kg, but when the agent is
      repeatedly given in the above dose, it failed to enhance the rotational activity
      of rats. The findings may provide evidence for possibilities of increasing the
      doses of bromocryptine in practical medicine, and for designing the injectable
      dosage form of the drug.

PMID- 8348027
TI  - [The effect of the calcium channel blockers cinnarizine and flunarizine on the
      duration of hexobarbital-induced sleep i rats].
AB  - The effect of the calcium channel blockers cinnarizine (20 mg/kg) and flunarizine
      (10 mg/kg) on hexobarbital sleeping time in rats has been studied. We have found
      that cinnarizine when applied intraperitoneally once 1 h or 4 h before
      hexobarbital and repeatedly for 5 days once daily prolongs sleeping time
      significantly. When cinnarizine has been introduced simultaneously with
      phenobarbital (60 mg/kg) for 5 days once daily the sleeping time that was
      expected to be shortened by phenobarbital only has been obtained to return to
      control values. Flunarizine has not been found to affect sleeping time
      significantly either alone or in the presence of phenobarbital. Latencies have
      not been altered by any of both agents.

PMID- 8348028
TI  - [The effect of cerebrocrast and nicardipine on the blood supply and metabolism of
      the brain in cats with intracranial hemorrhage].
AB  - Intravenous cerebrocrast, 1 g/kg/min, and nicardipine, 0.5 g/kg/min, given to
      cats during 60 min one day after cerebral hemorrhage were found to produce an
      improvement of cerebral blood supply and oxygen consumption along with a moderate
      fall of blood pressure. The favourable effect of cerebrocrast on brain oxygen and
      carbohydrate metabolism was mediated by increased brain blood supply. As compared
      to cerebrocrast, nicardipine induced a more prolonged antihypertensive response
      and more pronounced effects on cerebral tissue metabolism, by substantially
      decreasing brain lactate production.

PMID- 8348030
TI  - [The anti-arrhythmia action of low-molecular polyvinylpyrrolidone in experimental
      arrhythmias].
AB  - The experiments on 258 albino rats and on 74 albino mice have established that
      low molecular polyvinylpyrrolidone (PVP) has antiarrhythmic effects. When
      administered intravenously on a adrenaline model of arrhythmia, PVP and ethmozine
      showed a very close activity, but PVP resulted in a lower incidence of mortality
      and proarrhythmia. The action of PVP was weaker than that of ethmozine when they
      were used in an aconitine model. Oral PVP acted on aconitine-induced arrhythmia
      stronger and longer than did ethmozine. It is advisable to study the mechanisms
      of antiarrhythmic activity of PVP.

PMID- 8348029
TI  - [Propofol suppresses sympathetic activity and inhibits the baroreceptor reflex in
      waking rats].
AB  - The effects of propofol on sympathetic nerve activity and on the baroreceptor
      reflexes were examined in male Wistar rats. Sympathetic nerve activity was
      recorded directly from a renal nerve electrode placed earlier; baroreceptor
      reflex activity was estimated by changes in blood pressure (BP) and heart rate
      (HR) induced by the vasopressor phenylephrine, or the vasodilator, nitroprusside.
      Awake animals were anesthetized with propofol (10 mg/kg iv bolus, followed by
      approximately 35 mg/kg/hr by infusion) for 30 min. During the first 3 minutes,
      propofol increased sympathetic nerve activity by 113%, while mean arterial
      pressure was lowered to 85% of control. After 20 minutes, both sympathetic nerve
      activity and blood pressure had declined by 14% below baseline. Heart rate was
      stable at the level of approximately 110% throughout. Propofol also attenuated
      the sensitivity of chronotropic and sympathetic components of the baroreceptor
      reflex (i.e., to 23-43% and 25-34%, respectively). Thus, propofol lowers blood
      pressure by a central mechanism attenuating sympathetic nerve activity and
      sensitivity of baroreceptor reflex.

PMID- 8348031
TI  - [The anti-arrhythmic action of exogenous creatine phosphate and its effect on
      myocardial electrophysiological parameters in acute heart failure].
AB  - The experiments on rats with overload heart failure have shown that creatine
      phosphate (CP) used in a single dose at the peak of severe signs of cardiac
      decompensation was found to produce a short-term normalization of rhythm and an
      increase in heart rate. With multiple doses, the agent slowed down the
      development of bradycardia, prevented arrhythmias and promoted the rise of
      longevity in the experimental animals. At the same time, exogenous CP failed to
      affect energy-dependent processes of re- and depolarization which were impaired
      in the myocardium in acute heart failure.

PMID- 8348032
TI  - [The use of L-DOPA for treating myocardial infarct patients].
AB  - Clinical and experimental studies showed a high therapeutic activity of L-DOPA in
      combination with traditional methods of infarction treatment. L-DOPA promoted a
      rapid disappearance of heart failure symptoms and accelerated reparative
      processes by restoring the activity of the sympathetic nervous system.
      Correctness of the experimentally developed basically new scheme for
      administration of neurotropic drugs to patients with infarction depending on the
      disease stage has been validated.

PMID- 8348033
TI  - [The new antidepressant tetrindole].
AB  - The antidepressive effects of tetrindole versus pyrazidole (pirlindole) and
      imipramine were studied in animal experiments. Tetrindole was found to be more
      active than pyrazidole and imipramine in a behavioral model of Porsolt, in
      antagonism with reserpine, in potentiation with 5-hydroxytryptophan, L-dopa and
      clonidine. The action of terindole is related to its ability to exert reversible
      inhibitory effects on MAO A activity. Tetrindole is less toxic than pyrazidole
      and imipramine.

PMID- 8348034
TI  - [Changes in left ventricular diastolic function and in tolerance to physical
      loading under the influence of finoptin in stenocardia patients].
AB  - A total of 45 patients aged 53.6 +/- 6.1 years who had Functional Class II-IV
      angina pectoris were examined. In patients with stable angina and normal left
      ventricular diastolic pressure, a moderate antianginal effect of finoptin was
      shown to be associated with decreased myocardial afterload. The normalizing
      effects of finoptin on baseline left ventricular diastolic dysfunction along with
      lower myocardial afterload resulted in an increase in coronary reserve and a more
      pronounced antianginal effect.

PMID- 8348035
TI  - [The effect of the experimental androgenization of the male on the physical and
      sexual development of his progeny].
AB  - The author estimated the impact of exogenous testosterone administration (1
      mg/kg) to the male rats on the postnatal development of their offspring. The
      males were copulated with intact females 48 and 2 days after injection. The
      treatment of the male rats with testosterone 2 days before mating caused
      disorders in the sexual development and behavior formation of offspring of both
      sexes. The exogenous testosterone effects on spermatoblasts of the father
      promoted to the development of disorders in the formation of behavioral and
      emotional activities only in the female offspring.

PMID- 8348036
TI  - [The antiaggregant activity of the synthetic antioxidant emoxipin].
AB  - The action of the synthetic antioxidant aemoxipin, 3-oxypyridime derivative on
      platelet aggregation was studied in 8 patients with ischemic heart disease and
      cardialgias. An hour later after an intravenous injection in a dose of 5-10
      mg/kg, aemoxipin reduced platelet aggregation by 25% (p < 0.05), inhibited the
      reaction of "release" and spontaneous platelet aggregation. The same effect of
      the drug was demonstrated in the aggregation caused by ADP action on platelets
      preliminarily activated by minimum adrenaline concentrations in a tube. Our
      results are in agreement with the data of other investigators concerning a
      direct, non-specific nature of aemoxipin action on cellular membranes.

PMID- 8348038
TI  - [A combination of immunostimulants as a method for correcting secondary
      immunodeficiencies].
AB  - The specific features of the action of combinations of immunostimulants
      (levamisole, prodigiozan, methyluracil) on a primary immune response to EB, GST
      and resistance to experimental infection have been studied. It has been shown
      that levamisole eliminates stimulation by methyluracil and prodigiozan of a
      primary immune response, lithium carbonate is also an antagonist of prodigiozan.
      Vitamin E increases the stimulating effect of prodigiozan rather than
      oxymethacil. The effect of vitamin A depends on the dose. Levamisole does not
      change the influence of prodigiozan and methyluracil on GST and, like
      prodigiozan, suppresses GST stimulated by lithium carbonate. The combination of
      prodigiozan and methyluracil to a large extent than the agent given alone
      increases resistance to an infection and efficiency of antibiotic therapy. The
      combination of methyluracil and levamisole increases only the effect of the
      antibiotic.

PMID- 8348037
TI  - [The effect of calcium antagonists on carbohydrate and lipid metabolism in
      diabetes mellitus].
AB  - The effect of calcium antagonists: nifedipine (corinfar, cordapheg), sensit,
      finoptin, foridon on carbohydrate and lipid metabolism was studied in intact and
      "alloxaned" rats as well as in non-insulin-dependent diabetes patients. It was
      found that the calcium channel blockers did not change glucose tolerance,
      normalized carbohydrate metabolism in some patients and decreased the level of
      triglycerides, B and pro-B lipoproteins. In some cases in intact and alloxane
      rats treated with finophin (isoptin), lactate decrease in blood and a tendency to
      insulin increase were often observed. The lipid metabolism was unchanged.

PMID- 8348039
TI  - [The enhancement of immune suppression by local laser irradiation in rats exposed
      to cyclophosphane].
AB  - The authors experimentally studied where low-energy laser radiation (LELR) can be
      used to enhance cyclophosphanum-induced immunodepression. Preliminary LELR of the
      adrenal region and cyclophosphanum, 4 mg/kg, resulted in a more profound decrease
      in the intensity of a primary immune response as compared to the controls
      received a pseudoradiation and the cytostatic in the same dosage. The findings
      suggest that laser radiation can be applied to the adrenal region in the clinical
      setting to reduce a dose of the cytostatic administered and hence adverse
      effects, by preserving the therapeutical level of immunodepression.

PMID- 8348041
TI  - [The pharmacokinetics and pharmacodynamics of trental in pregnant women with
      chronic placental insufficiency].
AB  - Examining the relationship between the pharmacokinetic characteristics of
      trental, its effect on platelet aggregation and adverse effects in pregnant
      females with chronic placental failure has allowed the optimal dosage regimen to
      be recommended in the third trimester in this abnormality. Its daily dose was
      found to be 400 mg (100 mg x 4).

PMID- 8348040
TI  - [The effect of new biologically active substances on effector T-lymphocytes in
      vitro].
AB  - Levamisole has been demonstrated to stimulate the activity of T effectors in
      patients with rheumatic arthritis directly and indirectly via production of the
      factors influencing effector functions. The organosilicon compound minval was
      beneficial both in patients and donors. Its activity was mediated by the
      production of factors in donors, whereas in patients it showed direct and
      indirect actions, being higher than that of levamisole. The bioflavonoid derived
      from the Rosa L. root was shown to exert no action on T-effector function.

PMID- 8348042
TI  - [The efficacy of hydroxycinnamic acids in toxic lesions of the liver].
AB  - The albino rat experiments studied the pharmacological action of oxycinnamic acid
      derivatives in acute tetrachloromethane-induced hepatic dystrophy and combined
      CCl4-ethanol-induced hepatic lesion. The tested agents were found to produce
      cholagogic, membrane-protective, and antioxidative effects in these hepatic
      abnormalities, thus improving the functional (cholate- and glycogen-synthetic)
      parameters of the liver.

PMID- 8348043
TI  - [The effect of nooglutil and piracetam on different forms of operant learning].
AB  - We studied effects of a new drug with nootropic action nooglutil (N-(5
      hydroxynicotinoil)-L-glutaminic acid, OHK-10) on initial stages of different
      forms of operant behaviour in rats, namely avoidance learning in Shuttle box, in
      Skinner box and on T-maze reflex with water reward. Comparing dates resulted from
      these three methods permitted evaluation of effects of the drugs on learning.
      Both drugs had no effects on avoidance response in shuttle box and T-maze reflex
      with water reward. Nooglutil enhanced escape and avoidance responses meanwhile
      piracetam improved only escape response.

PMID- 8348044
TI  - [The effect of dimephosphon on the barrier protective function of the skin during
      long-term local use].

PMID- 8348045
TI  - [The effect of nitroglycerin on the Ca2+ ion level in the cytoplasm of human
      lymphocytes].
AB  - Fluorescence was used to examine the effects of nitroglycerin (60 microM) on
      basal and mitogen-induced (ConA, 25 micrograms/ml) Ca2+ levels in the human
      lymphocytic cytoplasm. Calcium-blocking effect of nitroglycerin was markedly
      shown in the medium containing 1 mM CaCl2 and virtually absent in calcium-free
      buffer. It is concluded that nitroglycerin affects cellular Ca2+ entry. A 120
      minute preincubation led to a complete loss of the inhibitory effects of the drug
      on mitogen-induced Ca2+ responses of lymphocytes. Human lymphocytes are proposed
      as an experimental model for investigating the effects of nitrates and the
      mechanisms of their tolerance development.

PMID- 8348046
TI  - [The effect of antiparkinson preparations on the self-stimulation reaction of
      rabbits in a helium-oxygen environment under increased pressure].
AB  - The authors studied hypothalamic self-stimulation of 30 rabbits in hyperbaric
      heliox after intraperitoneal injections of L-DOPA, melanostatin, and cyclodol.
      The frequency of self-stimulation was decreased with 40 atm of heliox. After L
      DOPA administration, a reduction of self-stimulation was twice less than that in
      heliox without pharmaceuticals.

PMID- 8348047
TI  - [Bradycardia preparations--a new class of antianginal agents].

PMID- 8348048
TI  - [Aldehydes and brain functions].

PMID- 8348049
TI  - [The spatial memory of animals studied by using the radial maze in
      psychopharmacology and neurotoxicology].

PMID- 8348050
TI  - [The pharmacokinetic interaction of theophylline with preparations from other
      pharmacological groups].

PMID- 8348051
TI  - [Lithium ion modulation of the neuronal responses evoked by monoaminergic
      receptor agonists].
AB  - The authors studied the action of lithium ions on the responses of rat dorsal
      root ganglion neurons and frog spinal motoneurons evoked by monoamine agonists
      using the microelectrode technique. Lithium ions reversibly inhibit the
      depolarizing responses of spinal sensory neurons and motoneurons evoked by
      activation of muscarinic choline-, alpha 1-adreno-, and 5-hydroxytryptamine2
      receptors, but enhance the hyperpolarizing neuronal responses evoked by
      activation of 5-hidroxytryptamine1A receptors.

PMID- 8348052
TI  - Misclassification of genetic susceptibility biomarkers: implications for case
      control studies and cross-population comparisons.
AB  - Phenotype and genotype markers of genetic susceptibility are of increasing
      interest in case-control studies of cancer. It is well established that bias to
      the odds ratio is caused by less-than-perfect assay sensitivity and specificity
      and varies with risk factor prevalence. As such, the observed variation in odds
      ratio between studies of genetic markers and cancer risk may be real, or may be
      attributed, in part, to variation in assay accuracy or in risk factor prevalence
      (e.g., prevalence differences between racial groups). The latter can be a
      particular concern when the prevalence of the "at risk" polymorphism in one or
      more populations is either very high (e.g., > 85%) or very low (e.g., < 15%). For
      example, even very high sensitivity (e.g., 98%) can produce substantial bias to
      the odds ratio when the risk factor prevalence is high. Under some prevalence
      conditions, however, assays with only moderate accuracy are sufficient and result
      in minimal bias to the odds ratio. Understanding misclassification in the context
      of marker prevalence may help to explain disparate findings in the literature and
      should assist investigators in selecting markers that are appropriate for future
      studies.

PMID- 8348054
TI  - Diversity in the association between occupation and lung cancer among black and
      white men.
AB  - A population-based case comparison study of incident lung cancer and occupational
      risk factors was conducted in the tricounty Detroit metropolitan area. Nearly
      6000 lung cancer cases and a comparison group of 3600 colon cancer cases were
      interviewed. This report includes 3792 white and black male lung cancer cases and
      1966 black and white colon cancer referents. Cigarette smoking, age at diagnosis,
      and lifetime work history were assessed to determine the relationship between
      length of employment in specific occupations and industries and lung cancer.
      Diverse patterns of association between work history and lung cancer were
      observed for black and white men. Significant associations were seen between lung
      cancer and increasing length of employment in the following occupations: for
      white men, concrete and terrazzo finishers, grinding machine operators, heat
      treating machine operators, miscellaneous machine operators, truck drivers,
      driver sales, and laborers; for black men, farm workers, automobile mechanics,
      painting machine operators, furnace operators, and garbage collectors; for both
      black and white men, farmers, slicing and cutting machine operators, and garbage
      collectors. Distinct patterns for black and white men also were observed for
      length of employment by industry. This study clearly demonstrates the need to
      include black men in studies of occupational cancer etiology and to evaluate
      black and white men separately. It also indicates the necessity for cigarette
      smoking history to accurately assess workplace cancer risks. We propose
      guidelines for incorporating the use of biomarkers into further studies of
      occupational cancer epidemiology.

PMID- 8348053
TI  - A case-control study of element levels and cancer of the upper aerodigestive
      tract.
AB  - A population-based case-control study was conducted in western Washington state
      to investigate possible dietary risk factors for laryngeal, esophageal, and oral
      cancers. Using results from a food frequency questionnaire, past dietary intakes
      of iron, zinc, and calcium were estimated for 661 cases and 466 controls.
      Clippings were also taken from the nails of both halluces to determine
      concentrations of iron, zinc, calcium, chromium, and cobalt in 507 of the cases
      and 434 of the controls. After adjustment for smoking, alcohol, and dietary beta
      carotene and vitamin C intake, individuals who reported dietary intakes of iron
      and zinc in the upper quartile were less likely to develop cancers of the larynx
      and esophagus than were individuals with intakes in the lowest quartile [odds
      ratios (OR), 0.5 for iron and 0.1 for zinc]. However, there were no significant
      differences in zinc concentrations in nail tissue between subjects with these
      types of cancer and controls. Esophageal cancer cases had higher nail
      concentrations of iron and calcium than did controls (OR, 2.9 for high versus low
      quartiles of iron; OR, 2.6 for high versus low quartiles of calcium). Individuals
      who developed esophageal or oral cancer were more likely to have elevated cobalt
      concentrations in their nail tissue than were individuals without cancer (OR, 9.0
      and 1.9 respectively, for high versus low quartiles). The results of this study
      suggest that there may be differences in mineral intake or metabolism between
      individuals who develop some carcinomas of the upper aerodigestive tract and
      those who do not.

PMID- 8348055
TI  - Relation of endometrial cancer risk to past and contemporary body size and body
      fat distribution.
AB  - In a multicenter case-control study that included 403 cases and 297 controls, we
      examined the relation of past and contemporary body size, including body fat
      distribution, to the risk of endometrial cancer. The relative contributions of
      past and contemporary body size were assessed by examining weight and height
      histories provided by the subjects. Anthropometric indicators thought to reflect
      early environmental influences (e.g., height and sitting height), current weight,
      and fat distribution patterns were measured directly. Height was not a risk
      factor for endometrial cancer, but inexplicably, sitting height was inversely
      associated with risk. Weight during early adulthood appeared to be directly
      related to disease risk, but the association was explained by contemporary weight
      and thus weight gain during adulthood. While contemporary weight was associated
      with risk of endometrial cancer, the effect was restricted to those in the top
      quartile. Women whose measured weight at interview exceeded 78 kg had 2.3 times
      the risk of those weighing less than 58 kg (95% confidence interval, 1.4 to 3.7).
      Upper-body obesity (waist-to-thigh circumference ratio) was a risk factor
      independent of body weight. After adjustment for weight, the relative risks of
      endometrial cancer across increasing quartiles of upper-body obesity were 1.0,
      1.5, 1.8, and 2.6 (P for trend < 0.001). These data indicate that both obesity
      and the distribution of adipose tissue accumulated during adult life increase
      endometrial cancer risk substantially.

PMID- 8348057
TI  - Contribution of occupation and diet to white blood cell polycyclic aromatic
      hydrocarbon-DNA adducts in wildland firefighters.
AB  - Wildland (forest) firefighters are exposed to a wide range of carcinogenic
      polycyclic aromatic hydrocarbons (PAH) in forest fire smoke. PAH undergo
      metabolic activation and can subsequently bind to DNA. In this study, we
      investigated the association between occupational and dietary PAH exposures and
      the formation of WBC PAH-DNA adducts in a population of wildland firefighters. An
      enzyme-linked immunosorbent assay using an antiserum elicited against
      benzo(a)pyrene-modified DNA was used to measure PAH-DNA adducts in WBC obtained
      from 47 California firefighters at two time points, early and late in the 1988
      forest fire season. PAH-DNA adduct levels were not associated with cumulative
      hours of recent firefighting activity. However, firefighters who consumed
      charbroiled food within the previous week had elevated PAH-DNA adduct levels,
      which were related to frequency of charbroiled food intake. These findings
      suggest that dietary sources of PAH contribute to PAH-DNA adduct levels in
      peripheral WBC and should be evaluated when using this assay to assess
      occupational and environmental PAH exposure.

PMID- 8348056
TI  - Serum micronutrients and the subsequent risk of cervical cancer in a population
      based nested case-control study.
AB  - A nested case-control study was conducted in Washington County, MD, to determine
      whether low serum micronutrients are related to the subsequent risk of cervical
      cancer. Among the 15,161 women who donated blood for future cancer research
      during a serum collection campaign in 1974, 18 developed invasive cervical cancer
      and 32 developed carcinoma in situ during the period January 1975 through May
      1990. For each of these 50 cases, two matched controls were selected from the
      same cohort. The frozen sera of the cases and their matched controls were
      analyzed for a number of nutrients. The mean serum levels of total carotenoids,
      alpha-carotene, beta-carotene, cryptoxanthin, and lycopene were lower among cases
      than they were among controls. When examined by tertiles, the risk of cervical
      cancer was significantly higher among women in the lower tertiles of total
      carotenoids (odds ratio 2.7; 95% confidence limit, 1.1-6.4), alpha-carotene (odds
      ratio, 3.1; 95% confidence limit, 1.3-7.6), and beta-carotene (odds ratio, 3.1;
      95% confidence limit, 1.2-8.1) as compared to women in the upper tertiles and the
      trends were statistically significant. Cryptoxanthin was significantly associated
      with a lower risk of cervical cancer when examined as a continuous variable.
      Retinol, lutein, alpha- and gamma-tocopherol, and selenium were not related to
      cervical cancer risk. Smoking was also strongly associated with cervical cancer.
      These findings are suggestive of a protective role for total carotenoids, alpha
      carotene and beta-carotene in cervical carcinogenesis and possibly for
      cryptoxanthin and lycopene as well.

PMID- 8348058
TI  - Increased sensitivity for determination of polycyclic aromatic hydrocarbon-DNA
      adducts in human DNA samples by dissociation-enhanced lanthanide
      fluoroimmunoassay (DELFIA).
AB  - A competitive enzyme-linked immunosorbent assay (ELISA), the most frequently used
      immunoassay for the determination of polycyclic aromatic hydrocarbon-DNA adducts
      in human tissues, has been modified to achieve approximately a 6-fold increase in
      sensitivity. The new assay, a competitive dissociation-enhanced lanthanide
      fluoroimmunoassay (DELFIA) has utilized the same rabbit antiserum as the ELISA,
      antiserum elicited against DNA modified with benzo[a]pyrene. However, the
      alkaline phosphatase conjugate has been replaced with a biotin-europium-labeled
      streptavidin signal amplification system, and the release of europium into the
      solution forms a highly fluorescent chelate complex that is measured by time
      resolved fluorometry. The DELFIA has achieved a 5- to 6-fold increase in
      sensitivity for measurement of DNA samples modified in vitro with benzo[a]pyrene,
      for cultured cells exposed to radiolabeled benzo[a]pyrene, and for human samples
      from occupationally exposed workers. The assay has been validated by comparison
      of adduct levels determined by DELFIA, ELISA, and radioactivity in DNA from mouse
      keratinocytes exposed to radiolabeled benzo[a]pyrene. Human lymphocyte DNA
      samples from 104 Hungarian aluminum plant workers were assayed by ELISA and
      compared to blood cell DNA samples from 69 Italian coke oven workers assayed by
      DELFIA. The standard curves demonstrated that the limit of detection of 4.0
      adducts in 10(8) nucleotides for polycyclic aromatic hydrocarbon-DNA adducts by
      ELISA, using 35 micrograms of DNA/microtiter plate well, has been decreased to
      1.3 adducts in 10(8) nucleotides by DELFIA, using 20 micrograms of DNA/microtiter
      well. If 35 micrograms of DNA were used in the DELFIA, the calculated detection
      limit would be 0.7 adducts in 10(8) nucleotides.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348059
TI  - Increased sister chromatid exchange frequencies observed in a cohort of
      inhabitants of a village located at the boundary of an industrial dumping ground:
      phase I.
AB  - Since the mid-eighties, a sand pit located at the boundary of Mellery, a small
      village in Belgium, has been used as a dumping ground for industrial waste. After
      a particularly dry summer, many people complained of very foul smells coming from
      the dumping ground. An analysis of the environmental atmosphere detected alkanes
      and chlorinated saturated and unsaturated hydrocarbons in various concentrations.
      Consequently, the Belgian Ministry of the Environment requested additional
      measurements from the dumping site and the surrounding regions. Given the hazards
      and possible ill health effects associated with simultaneous exposure to low
      levels of many chemicals, biomarkers of personal exposure were measured in a
      representative group of people living in this village. The cytogenetic
      consequences of daily exposure to a mixture of genotoxicants were measured by the
      Sister Chromatid Exchange assay. The study included a group of 51 environmentally
      exposed persons (including 11 children) and 52 controls. A significant increase
      in Sister Chromatid Exchange frequency was detected among the inhabitants of the
      village compared to that of the control group, especially among the children
      living in Mellery as compared to the matched control children.

PMID- 8348060
TI  - Ornithine decarboxylase and polyamines in colorectal neoplasia and mucosa.
AB  - Ornithine decarboxylase (ODC) and polyamines are intimately involved in normal
      cellular proliferation and are likely to play a role in carcinogenesis. ODC
      activity and polyamine content were measured in tissue samples obtained during
      colonoscopy from 48 benign neoplastic polyps (20 tubular adenomas; 28 villous
      adenomas), 18 cancers (including 5 malignant polyps), and adjacent mucosa. ODC
      activity in polyp and cancer tissue specimens was higher than in adjacent mucosa
      in 75 and 83% of pairs, respectively. Similarly, putrescine, spermidine, and
      spermine contents were higher in the majority of polyps and cancers compared to
      adjacent mucosa. ODC activity and polyamine content in colonic mucosa from 10
      patients without a history of colorectal neoplasia were not different from
      adjacent mucosal values in the patients with neoplasia. In conclusion, ODC and
      polyamines are elevated in the majority of colorectal neoplasms, but amounts in
      normal mucosa do not differentiate between patients with cancer, benign
      neoplastic polyps, and normal subjects.

PMID- 8348061
TI  - Clinical and laboratory adverse effects associated with long-term, low-dose
      isotretinoin: incidence and risk factors. The Isotretinoin-Basal Cell Carcinomas
      Study Group.
AB  - Adverse effects associated with the long-term low-dose regimens of retinoids used
      in cancer chemoprevention studies are not well described. In order to examine the
      clinical and laboratory adverse effects of 3 years of intervention with
      isotretinoin (10 mg/day) and to assess potential risk factors for developing
      these, we collected adverse effect data on patients participating in a
      randomized, placebo-controlled trial designed to evaluate the effectiveness of
      isotretinoin in preventing the subsequent occurrence of new basal cell carcinoma.
      Our results showed a significantly higher incidence of adverse mucocutaneous
      effects and serum triglyceride elevations in the isotretinoin group (P < 0.001).
      Associated risk factors included male gender, very fair skin, and elevated
      pretreatment triglyceride levels. The toxicity observed, although less severe and
      less frequent, was similar to that seen with higher doses and should be weighed
      with adverse skeletal effects when considering long-term treatment of patients
      with moderate cancer risk.

PMID- 8348063
TI  - The Carotene and Retinol Efficacy Trial (CARET) to prevent lung cancer in high
      risk populations: pilot study with cigarette smokers.
AB  - In preparation for a phase IV lung cancer chemoprevention trial, we conducted a
      pilot trial of beta-carotene and retinol in high-risk smokers. Eligibility
      criteria were ages of 50-69 years, a smoking history of at least 20 pack-years,
      and either being a current smoker or having quit within the past 6 years.
      Participants were recruited by mailing an interest survey to 29,928 age-selected
      members of King County Medical Blue Shield. We randomized 1,029 women and men to
      one of four intervention arms: placebo, retinol, 25,000 international units/day;
      beta-carotene, 30 mg/day; or retinol plus beta-carotene. Participants were
      followed for side effects and adherence every 2 months either by a telephone call
      or a clinic visit. Blood was sampled for retinoid, carotenoid, and liver function
      analyses annually. beta-carotene and retinol were well tolerated during the
      follow-up period, which had a median of 1.5 years and a maximum of 3.3 years.
      Yellowing of the skin was seen in both beta-carotene arms. No differences were
      seen among arms or over time in incidence or severity of the other 15 monitored
      symptoms and signs or in serum liver function tests. Adherence was good: 83% of
      participants remained active on study at 1 year and 75% at 2 years. Serum beta
      carotene increased from a prerandomization median concentration of 170 to 2100
      ng/ml after 4 months of supplementation, and retinyl palmitate median levels more
      than tripled.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348062
TI  - The Carotene and Retinol Efficacy Trial (CARET) to prevent lung cancer in high
      risk populations: pilot study with asbestos-exposed workers.
AB  - Pilot studies are an essential component for major chemoprevention trials. Prior
      to initiating the multicenter Carotene and Retinol Efficacy Trial to assess the
      effectiveness of beta-carotene and retinol for preventing lung cancer, we
      conducted pilot studies in Seattle between 1985 and 1988 in two high risk
      populations: current and former heavy smokers and asbestos-exposed workers. The
      Asbestos Workers Pilot Study for the Carotene and Retinol Efficacy Trial
      demonstrated that recruitment of asbestos-exposed participants with relevant risk
      factors was feasible from identified sources. We documented negligible toxicity
      and high adherence with the protocol, schedule, and intervention. Results from
      the pilot led to extension of the placebo run-in period, changes in the
      eligibility criteria, improvements in recruitment strategies and scheduling,
      elimination of stratification by risk factors in randomization, modifications of
      study vitamin dosage and of side effects monitoring, and refinement of trial
      design parameters for Carotene and Retinol Efficacy Trial. The Smokers Pilot is
      reported in the accompanying article (G. E. Goodman et al., Cancer Epidemiol.,
      Biomarkers & Prev., 2: 389-396, 1993).

PMID- 8348064
TI  - Familial Barrett esophagus and adenocarcinoma of the gastroesophageal junction.
AB  - Barrett esophagus was found in seven members of a single family. Two of these
      patients also had adenocarcinoma of the gastroesophageal junction. Among family
      members who did not have Barrett epithelium, one had esophageal ulcerations with
      dysplasia in squamous epithelium and another had an esophageal stricture. The
      pattern of involvement suggests autosomal dominant inheritance of Barrett
      esophagus and/or gastroesophageal reflux disease in this family, with a strong
      predisposition for adenocarcinoma of the esophagus.

PMID- 8348065
TI  - Clinical review on features and cytogenetic patterns in adult acute myeloid
      leukemia with lymphoid markers.
AB  - Cytogenetic patterns in correlation with cytologic, biomolecular and clinical
      findings were studied in 45 adult patients with AML expressing at least one of
      the following lymphoid associated markers (LM): CD2, CD7, CD10, CD19, CD22, TdT.
      Four cytogenetic groups were recognized: group I, including 8 patients with 11q23
      rearrangements; group II including 5 patients with the Ph chromosome; group III,
      with 19 patients and aberrations of the "myeloid type" including 4 cases with
      aberrations of chromosome 13, 3 cases with 1q and 7q anomalies, 2 cases with
      trisomy 11q; group IV, including 13 patients with normal karyotype. Patients
      showing extensive lineage infidelity were encountered more frequently in
      cytogenetic groups I and II than in groups III and IV. Two of 4 cases with
      aberrations of chromosome 13 showed two or more lymphoid features either at
      immunophenotyping or at biomolecular analysis of the configuration of lg and TCR
      genes. Patients with 11q23 rearrangements and with the Ph chromosome were
      generally young, presented with high WBC count and had low complete remission
      rate. Survival in Ph chromosome positive patients was uniformly short. We
      conclude that, although there is no cytogenetic anomaly specific for AML with LM,
      chromosome findings may be clinically relevant in AML with LM. A morphologic,
      immunologic and cytogenetic classification of AML with LM may constitute a
      working basis for future studies aimed at a better definition of
      clinicopathological features and optimal treatment strategy for these leukemias.

PMID- 8348066
TI  - Rationale for the clinical use of immunotoxins: monoclonal antibodies conjugated
      to ribosome-inactivating proteins.
AB  - The use of chemotherapeutic drugs in combination with bone marrow transplantation
      to treat cancer patients has markedly improved the disease-free survival and cure
      rate. Part of the tumor cells, however, can escape from therapy due to
      resistance. Tumor-specific delivery of toxins that do not interfere with
      conventional drugs and are not cell cycle dependent seems to be a reasonable
      approach to overcome this problem. Natural ribosome-inhibiting-proteins (RIPs)
      from plants, bacteria and fungi which are extremely toxic inhibitors of protein
      synthesis are isolated and coupled to monoclonal antibodies (MoAbs) and receptor
      specific ligands, immunotoxins (ITs), to fulfil this purpose. ITs are very
      suitable to eliminate malignant cells in vitro and in vivo. RIPs contain two or
      three active sites: a binding site which can be absent in a part of the RIPs and
      can be replaced by the MoAb; a translocation site that facilitates transport into
      the cytosol after internalization, and a cytotoxic site that enzymatically
      inhibits protein synthesis. Binding site containing toxins induce strong
      nonspecific cytotoxicity when coupled to MoAbs. Recent developments in
      recombinant DNA techniques enable genetic elimination of the binding site to
      reduce nonspecific cytotoxicity of these toxins. In this review the structures
      and mechanisms of action of RIPs as well as factors that influence cytotoxicity
      of immunotoxins are discussed. Moreover the problems dealing with in vivo
      application of ITs such as blood clearance by instability of the IT and hepatic
      entrapment, and production of antibodies directed against MoAb and toxin are
      reviewed.

PMID- 8348067
TI  - IgE, Reed-Sternberg cells, and eosinophilia in Hodgkin's disease.
AB  - Tissues containing Hodgkin's disease tumors of the nodular sclerosis and mixed
      cellularity subtypes are frequently infiltrated by numerous degranulating
      eosinophils that release granule proteins such as eosinophil peroxidase and major
      basic protein. Until recently, the causes of the eosinophil infiltration and
      degranulation in Hodgkin's disease tumors were unknown. Analysis of Hodgkin's
      disease tissues by a sensitive and specific immunoperoxidase technique has now
      demonstrated the extensive presence of IgE in the Reed-Sternberg cells and
      adjacent cells of Hodgkin's disease tumors. Because eosinophils express a cell
      surface receptor (CD23) for IgE and degranulate in the presence of IgE deposits,
      the extensive eosinophilia that is frequently present in Hodgkin's disease tumors
      is, at least in part, attributable to the IgE deposits within the tumor. In this
      review, we discuss the possible mechanisms and biological significance of IgE
      related eosinophilia in Hodgkin's disease.

PMID- 8348068
TI  - Growth factors of the future.
AB  - Hematopoietic growth factors stimulate proliferation and enhance functional
      activity of hematopoietic cells. Erythropoietin, recombinant human (rh)
      granulocyte colony stimulating factor (CSF), rh granulocyte macrophage CSF and rh
      interferon have been proven to be a clinically useful therapy. Several other
      cytokines with other unique effects are being developed for possible clinical
      usage. The purpose of this manuscript is to review novel uses of current approved
      cytokines and potential application of experimental growth factors.

PMID- 8348069
TI  - Second malignancies following treatment in non-Hodgkin's lymphoma.
AB  - Second malignancies represent an important iatrogenic complication of the
      treatment of hematologic and other neoplasms. In this review we summarize the
      literature relating specifically to malignancies developing in the wake of
      treated non-Hodgkin's lymphoma (NHL). In these patients, the risk of
      myelodysplastic syndrome (MDS) and acute non lymphocytic leukemia (ANLL) is
      reported to be increased 10-105 fold over that of the general population. Factors
      in the development of MDS and ANLL include basic defects in cellular immunity in
      NHL patients as well as treatment with alkylating agents and low dose total body
      irradiation. Biologically these secondary MDS and ANLLs are characterized by
      specific cytogenetic abnormalities and results of treatment are poor. Currently
      bone marrow transplantation offers the only potential cure. There is no clear
      statistical evidence that solid tumors occur more frequently after NHL. However,
      bladder carcinoma, in cyclophosphamide treated patients, and lung cancer have
      been reported by some to occur with an increased incidence. Further investigation
      of the molecular events leading to the occurrence of second malignancies in NHL
      patients and the role played by oncogenes and tumor suppressor genes in this
      process is still needed.

PMID- 8348070
TI  - Cerebrospinal fluid neopterin levels in children with central nervous system
      leukemia.
AB  - Cerebrospinal fluid (CSF) neopterin levels were determined by high-pressure
      liquid chromatography in 48 normal children and in 15 children with meningeal
      relapse of hematologic malignancies (13 acute lymphoblastic leukemia and 2 high
      grade lymphomas). When meningeal relapse was diagnosed, all patients had CSF
      neopterin levels higher than mean normal value +2 standard deviations. No
      significant correlation between the blast count in the CSF and neopterin levels
      was observed. CSF data before relapse were available in 10 children: the
      neopterin values at relapse were significantly higher than values observed at
      diagnosis. In 3 patients, elevated neopterin levels preceded the occurrence of
      neurologic signs and the detection of blast cells in CSF by 15 to 30 days. In the
      absence of infection, the rise of CSF neopterin levels in patients with
      hematologic malignancies indicates an active phase of the disease. This could
      reflect a cell-mediated immunologic process induced by malignant cells. The
      measurement of CSF neopterin should be helpful in the monitoring of patients to
      detect early meningeal relapse.

PMID- 8348071
TI  - Modalities of in vitro IgM and IgG production by peripheral blood lymphocytes of
      chronic lymphocytic leukemia patients and healthy volunteers.
AB  - In vitro spontaneous and mitogen (LPS, rIFN alpha and PWM) or cytokine (rIL-2)
      induced IgM and IgG production by peripheral blood lymphocytes of 15 CLL patients
      and 16 healthy volunteers has been determined. This study has shown: (1) that
      there is no difference between healthy donors and CLL patients in respect to
      level and variability of spontaneous immunoglobulin production by their
      lymphocyte cultures; (2) that there is no correlation between the percentage of B
      cells in individual cell cultures obtained from CLL patients and the amount of
      spontaneously produced IgM or IgG; (3) that there is a correlation between
      spontaneous in vitro IgM production and IgM content in the serum of the patient;
      (4) that in CLL patients selective augmentation of IgM production could be
      obtained after stimulation with PWM or rIL-2, but only in those cultures which
      spontaneously produce more than 35 ng/ml of IgM and (5) that the number of
      lymphocyte cultures able to be stimulated to IgM production is about 10 times
      smaller when they originate from CLL patients than from healthy volunteers. These
      findings are in line with the view that B cells in CLL patients often do not
      differentiate due to the insufficiency of factor(s) secreted by their own
      activated T-cells, but that in essence they follow the same differentiation
      pathway as normal B-cells.

PMID- 8348072
TI  - Classification of Hodgkin's disease biopsies by a panel of four
      histopathologists. Report of 1,140 patients from the German National Trial.
AB  - First results from reviewing the diagnostic biopsies of Hodgkin's lymphomas (HL)
      are reported. Biopsies from 1,140 patients were evaluated by consensus diagnoses
      according to an extended classification of the British National Lymphoma
      Investigation. 95 of the recruited cases (8.3%) were omitted and not approved as
      Hodgkin's lymphoma. The remaining 1,045 biopsies were classified as follows:
      Lymphocytic predominance 31 (2.7%); Nodular sclerosis (NS) 660 (57.9%), Mixed
      cellularity (MC) 159 (13.9%); Lymphocytic depletion 8 (0.7%); unclassifiable
      Hodgkin's 148 (13.0%). The unproved Hodgkin's cases [95 (8.3%)] were divided into
      non-Hodgkin's lymphomas 32 (1.9%), uncertain due to inadequate techniques 32
      (2.8%), borderline between Hodgkin's- and Non-Hodgkin's lymphoma 23 (2.0%). Major
      dissent on this question involved 17 cases (1.5%) and 1 case which was non
      malignant. All unclassifiable, borderline or dissent cases were reassessed after
      the histologic techniques were improved, and immunophenotyping and clinical data
      reevaluated. The rate of agreement among the observers was about 81.6%, varying
      between 23.8% in grade 2 NS to 85.0% in both NS groups. Only 62.8% of all primary
      diagnoses were approved by the final diagnoses of the panel. Important
      differences in the classification of the British National Lymphoma Investigation
      concerns the NS-group and mainly its grade 2 subtype. MC was identical in both
      classifications. Clinico-pathologic correlation of actuarial survival times
      revealed a significantly worse outcome of MC vs NS, < 20% after 80 months
      observation. Only slightly significant better survivals were found in grade 1 vs
      grade 2 NS. Significant differences in unclear compared to all Hodgkin's, were
      found and the worst survival was in the NHL group.

PMID- 8348073
TI  - Interleukin 2- and interferon alpha induced natural killer cell activity as a
      marker of progression in hairy cell leukemia.
AB  - Hairy cell leukemia (HCL), a rare B-cell chronic lymphoproliferative disorder, is
      often accompanied by immune abnormalities. A marked impairment of the natural
      killer cell-mediated cytotoxicity (NK activity) has been reported in most
      patients at diagnosis. In the present report a long-term follow-up study of NK
      activity of splenectomized HCL patients is recorded. Among patients who persisted
      with stable disease two groups, one with normal NK activity, and another with low
      NK activity, could be recognized. Patients with progressive stage were
      characterized by a low NK cytotoxic activity. In vitro tests showed that
      interferon alpha (IFN-alpha) and interleukin 2 (IL2) could increase the NK
      activity to normal levels only in HCL patients with stable disease, while in
      progressive HCL these cytokines showed a significantly decreased effect. These
      results indicate that cytokine-induced NK cytotoxicity appears to be a valuable
      parameter in assessing the stage of HCL.

PMID- 8348074
TI  - Disseminated visceral fusariosis treated with amphotericin B-phospholipid
      complex.
AB  - Fusariosis, a rare infectious disease of the immunocompromised host, is
      relatively resistant to amphotericin B (AmB) or other antifungal agents. We
      describe a 5-year follow-up of a 40 year old woman with T-type acute
      lymphoblastic leukemia who following chemotherapy developed prolonged high fever,
      chills, night sweats, and severe weakness. Liver function tests were impaired and
      abdominal computerized tomography (CT) showed multiple lesions in the liver and
      abnormal structure of the spleen. A laparotomy revealed multiple granulomas
      containing Fusarium sp. in the liver, and the spleen was heavily infiltrated by
      the same fungus. The patient failed to respond to the conventional AmB dosage
      form (Fungizone) even after a total dose of 3.0 g was given, and developed
      significant renal impairment. AmB was complexed (in a mole ratio of 1:16) with a
      mixture of the phospholipids dimyristoyl phosphatidylcholine and dimyristoyl
      phosphatidylglycerol (mixed in 7:3 mole ratio). The resulting drug complex, AmB
      PLC, was then administered (1-4 mg/kg/day, total dose 4.2 g) and subsequently the
      patient was cured of all symptoms of fusariosis. There were only mild side
      effects and no nephrotoxicity was evident. On the contrary, marked improvement of
      the renal function tests occurred during AmB-PLC treatment. Eight months later,
      she developed a spinal lesion with dense consistency in L5 and S1, and after
      receiving another course of AmB-PLC (3.1 g) she recovered completely. In a 2 year
      follow-up period the patient had no further relapse of the fungal disease.
      Subsequent chemotherapy given for relapse of the leukemia was followed by a new
      fungal infection, which was treated with AmB-cholesteryl sulfate complex
      (Amphocil).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348075
TI  - HTLV-I associated and non-associated primary T-cell lymphoma of gastrointestinal
      tract.
AB  - The gastrointestinal (GI) tract is the common extranodal site for non-Hodgkin's
      lymphoma (NHL), and primary lymphoma of GI tract are mostly of B-cell origin. We
      have treated 16 patients with primary lymphoma of GI tract between 1981 and 1991,
      of whom 10 (62%) were of B-cell origin, while 6 (38%) were of T-cell origin. The
      incidence of T-cell phenotype in our hospital was considered to be much higher
      than that of previous reports and these 6 patients with primary T-cell lymphoma
      of GI tract were carefully studied. The primary sites were stomach in 4,
      ileocecum in 1, and duodenum in 1 case. Their T-cell nature was confirmed by
      immunohistochemical methods. All were peripheral T-cell lymphomas; one was CD 3+
      4- 8- and the other 5 were CD 3+ 4+ 8-. The antibody against human T-cell
      leukemia virus type I (HTLV-I) was positive in 3 cases (HTLV-I associated), but
      negative in 3 (HTLV-I non-associated). The integration of HTLV-I proviral DNA in
      HTLV-I associated patients was demonstrated by Southern blot analysis after DNA
      amplification by means of polymerase chain reaction (PCR). The clinical features
      of the HTLV-I associated and HTLV-I non-associated primary T-cell lymphoma of the
      GI tract were quite different. HTLV-I associated patients showed leukemic
      manifestations and tumor involvement of the skin at a later stage of the disease.
      These observations indicated that HTLV-I can play an important role in the
      occurrence of primary T-cell lymphoma of GI tract.

PMID- 8348077
TI  - Unusual rheumatological and cardiological manifestations of acute myelogenous
      leukemia in a patient with Klinefelter's syndrome.
AB  - We report the case of a 40-year-old man with Klinefelter's syndrome who presented
      with a complex multisystem illness, the predominant manifestations of which were
      rheumatological and cardiological. This disorder coincided with a diagnosis of
      acute myelogenous leukemia evolving out of a myelodysplastic syndrome and
      resolved completely after chemotherapy. It is concluded that the hematological
      malignancy probably played a causal role in the development of this unusual
      illness which was likely immunologically mediated.

PMID- 8348076
TI  - Six Colombian patients with adult T-cell leukemia/lymphoma.
AB  - Six Colombian patients with adult T-cell leukemia/lymphoma (ATL) are presented.
      The clinical and hematological features, the familial clusters of human T
      lymphotropic virus type 1 (HTLV-I) carriers and the prognoses of the Colombian
      ATL patients were similar to those previously reported for Japanese ATL patients.
      The only difference was the mean age of onset, which was more than 20 years
      younger than in Japanese patients. Three patients with ATL were suffering from
      strongyloidiasis. In one patient it was suggested that ATL developed after
      horizontal transmission from his wife. In addition, there was a familial case of
      ATL and HAM/TSP. It seems that in some areas of Colombia, not only HTLV-I
      infection and HAM/TSP but also ATL are highly endemic.

PMID- 8348078
TI  - Progression of essential thrombocythemia to blastic crisis via idiopathic
      myelofibrosis.
AB  - We report a 61-year-old man with essential thrombocythemia (ET) whose clinical
      course was followed for 12 years. The ET evolved into true idiopathic
      myelofibrosis (IM) 6 years after the initial diagnosis and progressed to myeloid
      blastic transformation 6 years later. The cytogenetic analysis showed a normal
      karyotype during the ET phase but subsequent analysis revealed an abnormal
      karyotype during the IM phase which evolved clonally at blastic crisis with
      constant involvement of chromosome 13q and chromosome 7. The close monitoring of
      essential events, using clinical, morphologic, immunologic and cytogenetic
      parameters, allowed us to carefully identify the transition from one chronic
      myeloproliferative disease (MPD) to another. This is only the second case
      reported showing a clinical evolution of this nature. The clinical and biological
      aspects of the disease are briefly discussed.

PMID- 8348079
TI  - Ultrastructural observations on a variant of acute promyelocytic leukemia.
AB  - A patient with acute leukemia is presented in whom the leukemic cells, as seen by
      light microscopy were typical promyelocytes. The cells had normal or slightly
      invaginated nuclei with typical cytoplasmic granules and the diagnosis was
      confirmed by cytochemistry. The clinical course was rapid and the patient died of
      disseminated intravascular coagulation and urosepsis within a few days of
      diagnosis. However, electron microscopic examination showed cells with extremely
      convoluted and lobulated nuclei with nuclear pockets and cytoplasmic bridges as
      well as the complete absence of cytoplasmic granules in the majority of the
      cells. Furthermore, the urine lysozyme (muramidase) was elevated. These findings
      suggest that the leukemia in this patient may be classified as a hypogranular
      variant of acute promyelocytic leukemia (APL), with monocytoid ultrastructural
      appearances.

PMID- 8348080
TI  - Identification of a specific pattern of "immediate-early" gene activation induced
      by estrogen during mitogenic stimulation of rat uterine cells.
AB  - Estrogen hormones are potent mitogens for certain target tissues, where they
      stimulate cell growth by inducing recruitment of quiescent cells in cycle and by
      fostering cell cycle progression. To define the molecular bases of the mitogenic
      action of these steroid hormones, the pattern of "immediate-early" gene
      expression was monitored during the early phases of estrogen stimulation of rat
      uterine cells in vivo. Nuclear run-on transcription and/or Northern blot RNA
      analysis indicate that c-jun, junB, jun-D, c-fos, TIS 1 (also called NGFI-B or
      nur/77) and TIS 8 (zif-268, krox24, egr-1, or NGFI-A) genes are all transiently
      activated in the uterus (up to 20-fold) within 30-120 min after treatment of
      adult ovariectomized rats with a mitogenic dose of 17b-estradiol. Conversely, JE
      gene mRNA accumulates progressively in estrogen-stimulated uterine cells, whereas
      TIS 11 and 21 genes are only slightly responsive to the hormone (less than
      twofold induction) and fos B,fra-1,fra-2,krox20 (egr-2), TIS 7 and 10, KC, and c
      rel mRNAs are undetectable in rat uterus either before or after estrogen
      treatment. Stimulation in the presence of cycloheximide shows that only c-jun,
      jun-D, c-fos, and JE gene activations are primary responses to the hormone in rat
      uterine cells. These findings establish the direct mitogenic role of estrogen and
      identify for the first time a specific genetic program activated by these steroid
      hormones during stimulation of target cell proliferation. Furthermore, since most
      of the activated genes encode for transcription factors, these results enable us
      to envision how the mitogenic signal transmitted by the hormone can be elaborated
      and amplified within target cells by the products of estrogen-responsive genes,
      leading to a cascade of growth-dependent gene regulation, cell cycle progression,
      and, ultimately, cell division.

PMID- 8348081
TI  - Binding studies of RU486 in different Reuber hepatoma variants.
AB  - The synthetic steroid RU486, which displays antiprogestin and antiglucocorticoid
      properties in different systems, inhibits cell growth in dexamethasone-sensitive
      H56 cells containing glucocorticoid receptors, as well as in dexamethasone
      resistant S-H56-125 cells displaying a very low level of dexamethasone binding.
      In order to better understand the mechanism of the antiproliferative effect, the
      binding of RU486 to these hepatoma cells was examined. Results revealed the
      presence of two different kinds of binding sites for RU486 in dexamethasone
      sensitive H56 cells whereas only one type of site was detected in the
      dexamethasone-resistant cells. These peculiar sites were also recognized by
      cortivazol during competition experiments. Thus, it seems that S-H56-125 cells
      contain an altered glucocorticoid receptor that binds RU486 and cortivazol but
      virtually not dexamethasone. The ability of RU486 to inhibit the growth of
      dexamethasone-resistant cells suggests this steroid may be used to treat tumor
      cells that develop glucocorticoid resistance after long-term treatment.

PMID- 8348083
TI  - [Epidemiologic situation of tuberculosis in the world--actual state, threats and
      perspectives].

PMID- 8348082
TI  - The stereochemistry of the recognition of nitrogen-containing heterocycles by
      hydrogen bonding and by metal ions.
AB  - An analysis of the stereochemistry of hydrogen bonding and metal binding to some
      nitrogen-containing heterocycles found in crystal structure determinations has
      shown that the interacting atom will generally lie in the plane of the
      heterocyclic ring system in a direction that approximately bisects the C-N-C
      angle of the heterocycle. The Cambridge Structural Database (CSD) of crystal
      structures of small molecules was used for this analysis because stereochemical
      data are available at high resolution and are amendable to comparative analysis.
      It was found that, for hydrogen bonding, a slight out-of-plane deviation of the
      binding atom is marginally more likely than an in-plane deviation. Metal ions
      appear to bind in a manner that is similar to that of hydrogen bonding to a
      protonated heterocycle, no matter what the chemical identity of the metal. The
      binding is more rigid, with less in-plane or out-of-plane deviation of the metal
      ion compared to the interaction with a hydrogen-bonding group. Some ab initio
      molecular orbital energy calculations give a measure of the energies involved
      when metal ions or hydrogen-bonding groups deviate from the plane of the ring
      system or from the line bisecting the C-N-C angle of the heterocycle. These
      results are compared with reported structural data (at lower resolution) for some
      acridine-oligonucleotide complexes and the surroundings of histidine rings in
      some protein crystal structures.

PMID- 8348084
TI  - [Evaluation of the epidemiologic situation of tuberculosis and effectiveness of
      the program for its control in Poland].

PMID- 8348085
TI  - [Tuberculosis in the central register for tuberculosis].
AB  - Applied methods and results of antituberculosis treatment of all registered
      patients in 1990 in Poland are presented. Tuberculosis prevention was achieved in
      91.9% of sputum-positive patients similarly, diagnostic mistakes were detected in
      10% patients with non-bacteriologically determined tuberculosis. In one year
      since registration 7.7% of sputum-positive patients and 3.9% of patients with non
      bacteriologically confirmed tuberculosis have been dying in one year since
      registration time. Majority of patients in Poland were treated too long because
      of tuberculosis.

PMID- 8348086
TI  - [Verification of tuberculosis prognosis in Poland to the year 2000].
AB  - In 1978 year a tuberculosis prognosis in Poland up to 2000 year was prepared in
      the Institute of Tuberculosis and Lung Diseases in Warsaw, according to
      epidemiological and epidemiologic-metric model (efficacy of "diagnosis-therapy
      program" from 60 to 90% and efficacy of BCG vaccination to 60%). The aim of study
      was to compare epidemiological data for registered tuberculosis cases in 1980
      1990 (incidence morbidity and mortality) with the same parameters presented in
      prognosis for 1980-1991). Efficacy of analyzed programme was similar to predicted
      values: for incidence of tuberculosis-64%, for morbidity-65% and for mortality
      66%.

PMID- 8348087
TI  - [Case finding program for tuberculosis with special reference to chest x-ray
      examination].
AB  - An analysis of tuberculosis case-finding programme in Poland in 1966-1991 was
      performed. The main methods applied in practice were--case-finding according to
      "symptoms" and according to results of "chest x-ray examination". About 90% of
      new cases were detected by above mentioned methods. Case-finding according to
      "symptoms" was increasing parallel to age of patients and reached 74% in group
      over 60 years. On the other hand, the efficacy of chest x-ray examination was
      decreasing parallel to age of patients one was calculated as 19%. The case
      finding method according to "symptoms" is suggested by authors as a basic and
      useful, especially in family doctor's practice. Chest x-ray examinations should
      be limited to high risk population.

PMID- 8348088
TI  - [Drug sensitivity of bacillus strains M. avium-intracellulare (MAIC), M. kansasii
      cultured from patients with mycobacteriosis before treatment].
AB  - The aim of study was to evaluate a drug sensitivity of M. avium-intracellulare,
      M. xenopi and M. kansasii cultured from 55 patients with mycobacterioses. The
      identification of strains was performed with morphological and biochemical tests
      and thin-layer chromatography. Resistance tests were done on egg L-J and agar
      media for selected drugs. It was documented that MAIC strains were non-sensitive
      on isoniazid and rifampicin, and other ones. The most active drug was cycloserine
      inhibiting growth of 80% but rifabutine--50% of strains. M. xenopi strains were
      sensitive for tested drugs including isoniazid and rifampicin (about 30%). M.
      kansasii strains were in 100% sensitive for cyclosporine, rifabutine, Davercin
      and ofloxacin and partly for isoniazid, streptomycin and Augmentin.

PMID- 8348089
TI  - [Analysis of drug sensitivity of M. tuberculosis strains isolated from patients
      treated for tuberculosis in 1982-1991].
AB  - Analysis of drug-sensitiveness of 822 M. tuberculosis strains isolated from
      patients with pulmonary tuberculosis treated in the Institute of Tuberculosis and
      Lung Diseases and in Pediatric Clinic of Medical Academy in Warsaw in 1982-1991
      years was performed for isoniazid (INH), streptomycin (SM), rifampicin (RMP) and
      ethambutol (EMB). Drug sensitivity test was done on a basis of complexed
      proportional method according to Conethi and resistance index method according to
      Mitchinson. Examined strains were determined as resistant when the resistance
      index was 4 for INH, SM. RMP and EMB. During analysis the increase of resistance
      strains percentage (mean 25%) was observed in sputum-positive tuberculosis
      patients hospitalized in the Institute of Tuberculosis and Lung Diseases. The
      highest number of resistant strains was noticed in relation to CNH and RMP.

PMID- 8348090
TI  - [Coexistence of pulmonary tuberculosis and alcoholism in Poland].
AB  - The aim of study was to determine a number of alcoholics in new diagnosed cases
      of bacteriological confirmed pulmonary tuberculosis in 1989-1990. Data were
      obtained from the Central Register of Tuberculosis. It was found that the number
      of alcoholics among new registered patients with tuberculosis increased from 8.8%
      to 10.5%. Young patients were more than 60% group. Results of treatment of severe
      types of pulmonary tuberculosis in alcoholics were also not so effective as in
      typical patients.

PMID- 8348091
TI  - [Tuberculosis as a cause of death in patients treated in the institute of
      tuberculosis in 1976-1991].
AB  - This study aimed at assessing the reasons why tuberculosis-which can be
      successfully treated today-is still the cause of death in some patients treated
      at the Institute of Tuberculosis in the last 15 years. The material consisted of
      clinical documentation and the results of autopsy of 30 patients who died of
      tuberculosis between 1976-1991. It was found that 19 out of 30 patients were not
      treated with antituberculous drugs or were treated only during few days because
      tuberculosis was diagnosed too late (in 15 patients after death). In 6 patients
      the treatment failed due to side effects of drugs and in 5 immunosuppressed
      patients, disease progressed despite the treatment. Difficulties in tuberculosis
      diagnosis were caused by atypical appearance of the disease in the chest X-ray
      (localization in the middle and lower lobes in 15 cases, absence of cavities in
      22 cases) and in the extrapulmonary regions (11 cases). The main obstacle was the
      failure to cultivate tubercle bacilli from numerous specimens of the sputum in 10
      out of 23 patients in whom the cultures were done.

PMID- 8348092
TI  - [Tuberculosis found in autopsies done in the Institute of Tuberculosis and Lung
      Diseases 1972-1991].
AB  - Between years 1972 and 1991 1500 autopsies were done in the Institute of
      Tuberculosis and Lung Diseases in Warsaw. Active tuberculosis was found in 119
      cases (7.9%). 56 patients died of tuberculosis. Tuberculosis was not diagnosed
      during life in 37% of all cases and in 39% of that in whom it was the cause of
      death. Tuberculosis was undiagnosed significantly more often in the years 1982
      1991 than in years 1972-1981. Tuberculosis was restricted to the lungs in 60.5%
      of cases, was found in the lungs and in the extrapulmonary sites in 37.8% and
      only outside lungs in 1.7%. This is in contrast with official polish statistics.
      The extrapulmonary tuberculosis was registered in only 4% of cases.

PMID- 8348093
TI  - [Tubercular meningitis and encephalitis in adults--own experience].
AB  - Diagnostic, clinical and therapeutical problems of tuberculous meningitis and
      encephalitis have been discussed on a basis of clinical observation of 67
      patients. In the early phase of disease the diagnosis is based on clinical
      parameters and results of cerebrospinal fluid examinations. Authors suggest a
      shortage of time treatment under 12 months.

PMID- 8348094
TI  - [Mycobacterial infection in patients with AIDS].
AB  - Bacteriological diagnosis of tuberculosis was performed in 104 HIV-positive
      patients, in majority AIDS patients hospitalized in AIDS Clinic of Infections and
      Parasitic Diseases Institute of Medical Academy. 390 samples were examined, e.d.
      3.75 from each patient (from 1 to 22 samples). M. Tuberculosis was diagnosed in
      14 patients and all of them were clinically observed because of pulmonary
      tuberculosis. The highest percentage of positive results was obtained from
      bronchial fluid evacuated during bronchoscopy.

PMID- 8348095
TI  - [Two cases of tuberculous pericarditis--diagnostic difficulties].
AB  - Some difficulties etiological diagnosis were presented in an example of two
      clinical cases. In the first patient with exudative pericarditis tuberculosis was
      determined in histopathological examination of lymph node (caseous necrosis).
      After antituberculotic treatment the majority of clinical symptoms was
      disappeared. In the second patient with chronic constrictive pericarditis the
      tuberculous etiology was accepted according to highly positive tuberculin
      reaction and signs of pericardial calcification. Patient was qualified to
      pericardiectomy.

PMID- 8348096
TI  - [Difficulties in interpreting values for PaO2, PaCO2 and pH values in
      arterialized capillary blood--case report].
AB  - Measurements of PaO2, PaCO2 and pH in arterialized capillary blood in patient
      with angiogenic disturbances in upper and lower extremities were out of value.
      Correct evaluation above mentioned parameters was possible only in arterial and
      arterialized earlobe blood.

PMID- 8348097
TI  - [Difficulties in diagnosing a case of chronic necrotic aspergillosis with an
      unfavorable course].
AB  - A case of chronic necrotic aspergillosis was discussed. Diagnostic and
      therapeutic difficulties were described in patient with an insufficiency of
      immune response mainly in polymorphonuclear leukocytes function.

PMID- 8348098
TI  - [Microbiological diagnosis of tuberculosis and lung diseases in the last 30
      years].

PMID- 8348099
TI  - [Role of the social committee against tuberculosis and lung diseases and the
      program for prevention of tuberculosis].

PMID- 8348100
TI  - [Grzegorz Bagdasarian (28.VII.1902-21.X.1991)].

PMID- 8348101
TI  - Consensus conference on measles.

PMID- 8348102
TI  - Food poisoning involving a chemical product--Quebec.

PMID- 8348104
TI  - Potential danger of placing dry ice into a commercial plastic screwcap biohazard
      safety shipping container.

PMID- 8348103
TI  - Decline in Haemophilus influenzae type B invasive infections at five Canadian
      pediatric centres.

PMID- 8348105
TI  - HIV antibody detection in oral fluids.

PMID- 8348107
TI  - Calcium phosphates in pharmaceutical tableting. 2. Comparison of tableting
      properties.
AB  - Ten calcium phosphates suitable for direct compression (dibasic calcium phosphate
      dihydrate, dibasic calcium phosphate anhydrous and hydroxylapatite) were
      investigated with respect to their compressional behaviour. Except for Di-Cafos A
      all products gave tablets with sufficient to good mechanical strength.
      Nevertheless, there were differences between the products. All tablets prepared
      from the different products showed a high friability. This seems to be a problem
      of the calcium phosphates in general. On the other hand, the influence of
      magnesium stearate on the mechanical strength of the tablets was negligible for
      all products investigated. Moreover, a considerable effect of the particle size
      on the tensile strength of the tablets was found. The ejection forces and
      residual pressures were high in general, but critical only in the case of
      hydroxylapatites. Heckel plots were used to differentiate between plastic
      deformation and brittle fracture of the particles. In the case of calcium
      phosphates the slope of the Heckel plots indicated the hardness of the particles
      rather than their deformation behaviour.

PMID- 8348106
TI  - Calcium phosphates in pharmaceutical tableting. 1. Physico-pharmaceutical
      properties.
AB  - Ten commercially available calcium phosphates used for direct tableting were
      evaluated. The particle size distributions, powder properties, sorption isotherms
      and pH values of aqueous slurries were compared. All samples showed good or at
      least sufficient flowability. Scanning electron micrographs illustrated the
      different kinds of manufacturing and gave hints on their expectable behaviour
      under compaction pressure. The sorption isotherms of identical chemical
      substances, which had been manufactured by different methods, differed strongly.
      This can be related to their specific surface areas. Most of the hydroxylapatites
      have large surface areas and can absorb up to more than 15% water at 93% relative
      humidity. Dibasic calcium phosphate dihydrate was non-hygroscopic and absorbed
      less than 1% water. With the exception of monobasic calcium phosphate monohydrate
      all calcium phosphates behaved quite neutral in water. Monobasic calcium
      phosphate monohydrate can be regarded as a solid acid. Although the calcium
      phosphates are usually stable substances, the role of crystal water in the case
      of dibasic calcium phosphate dihydrate and monobasic calcium phosphate
      monohydrate is problematic due to possible interactions with active ingredients.

PMID- 8348108
TI  - Kinetics and mechanism of the degradation of 1a-acetylmitomycin C in aqueous
      solution.
AB  - The acid-catalyzed degradation of mitomycin C is supposed to be governed, to a
      certain extent, by the protonation status of the aziridine nitrogen in the
      molecule as well as the protonation degree of the opened aziridine function in a
      key intermediate species, formed during mitomycin degradation. In order to obtain
      information about the contribution of the protonation degrees of these functions
      in controlling the degradation processes, we investigated the degradation of 1a
      acetylmitomycin C in acidic aqueous solutions. In the presence of 0.001 mol/l
      phosphate buffers five 1-hydroxy and mono-acetyl mitosenes are formed, whereas in
      1.0 mol/l acetate buffers a total of eight products could be identified, two of
      them being diacetyl mitosenes. Over the whole pH range studied the formation of
      1,2-Z-mitosenes prevails, indicating that, contrary to mitomycin C, a pH
      independent factor controls the ultimate 1,2-stereochemistry.

PMID- 8348109
TI  - The use of hypoglycaemic and cardiovascular drugs in 582 patients with diabetes
      mellitus. Description and quality assessment.
AB  - The medication of 582 patients taking insulin or oral hypoglycaemic agents has
      been analysed. A characterization is given of the patients and their antidiabetic
      medication. Subsequently, a description of the use of cardiovascular drugs, in
      comparison with an age-matched control group, is presented. The diabetic
      population investigated has an average age of 67 years. Most cardiovascular
      agents, with the exception of thiazide diuretics, are used to a larger extent in
      the diabetic group in comparison with the control group. Non-selective beta
      blockers, possibly hazardous in patients with diabetes mellitus, appear to be
      prescribed without restriction in the diabetic patients investigated. The results
      of this study suggest that the choice of drugs for the treatment of
      cardiovascular co-morbidity in patients with diabetes mellitus can be improved.

PMID- 8348110
TI  - Randomized double-blind study of nabumetone and piroxicam in the treatment of
      osteoarthritis in Dutch general practice: efficacy and tolerability.
AB  - To study nabumetone (1,000 mg once daily) by comparison with piroxicam (20 mg
      once daily) in patients with osteoarthritis, a randomized, double-blind trial was
      set up in 40 general practices. Evaluation was based on clinical outcome in 198
      patients. There was some evidence that nabumetone is associated with a lower and
      less severe occurrence of gastric pain, and with more withdrawals due to lack of
      efficacy. Although the differences between nabumetone and piroxicam were small in
      this study, these were clinically relevant. The general practitioner should
      balance the respective benefits of greater safety and tolerance against greater
      efficacy in meeting the requirements of an individual patient with
      osteoarthritis.

PMID- 8348111
TI  - Effect of pH on absorption of sufentanil citrate in a portable pump reservoir
      during storage and administration under simulated epidural conditions.
AB  - Sufentanil (5 micrograms/ml as citrate) was investigated for its stability when
      diluted with sodium chloride 0.9%, in 100 ml polyvinyl chloride portable pump
      reservoirs during administration under simulated epidural conditions at 32
      degrees C for 48 h. Sufentanil was absorbed into the polyvinyl chloride,
      resulting in a reduction of 10.9% of the concentration after 48 h. The absorption
      of sufentanil (5 micrograms/ml as citrate), alone and in combination with
      bupivacaine hydrochloride (2 mg/ml), was investigated when diluted with sodium
      chloride 0.9% in combination with a citrate buffer (pH 4.6), in the same
      reservoirs under similar conditions. There was no loss of sufentanil after 48 h
      in both experiments. The effect of the pH on the absorption of sufentanil in
      polyvinyl chloride was investigated at different pH values. After storage for 21
      days at 32 degrees C there was 5.1% loss of sufentanil at pH 4 and 80.6% loss at
      pH 6. The citrate buffer at the optimum pH (4.6) has a low, acceptable buffer
      capacity for epidural administration.

PMID- 8348112
TI  - Quality of life 3. Rheumatoid arthritis.
AB  - It has increasingly been recognized that for the evaluation of interventions in
      patients with rheumatoid arthritis not only physician-oriented variables, like
      laboratory or radiographic assessments but also patient-oriented variables such
      as quality of life are of importance. Many different arthritis-specific quality
      of life instruments have been developed in recent years using different or no
      definition at all about the concept 'quality of life'. In this review a generally
      accepted definition of quality of life, existing of three components, is
      presented. The interrelationship between quality of life and all the different
      variables used in assessing disease activity in rheumatoid arthritis is
      discussed.

PMID- 8348113
TI  - Direct gradient reversed-phase HPLC analysis and preliminary pharmacokinetics of
      nalidixic acid, 7-hydroxymethylnalidixic acid, 7-carboxynalidixic acid, and their
      corresponding glucuronide conjugates in humans.
AB  - A gradient reversed-phase high pressure liquid chromatographic analysis was
      developed for the direct measurement of nalidixic acid with its acyl glucuronide,
      7-hydroxymethylnalidixic acid with its acyl and ether glucuronides, and 7
      carboxynalidixic acid in human plasma and urine. The glucuronides and 7
      carboxynalidixic acid were not present in plasma after an oral dose of 1,000 mg
      nalidixic acid. The acyl glucuronides of 7-carboxynalidixic acid were not present
      in plasma and urine. The acyl glucuronides are stable in urine at pH 5.0-5.5. The
      subject's urine must therefore be acidified by the oral intake of 4 x 1 g of
      ammonium chloride per day. With acidic urine, hardly any nalidixic acid was
      excreted unchanged (0.2%). It was excreted as acyl glucuronide (53.4% of dose), 7
      hydroxymethyl-nalidixic acid (10.0%), the latter's acyl glucuronide (30.9%), and
      7-carboxynalidixic acid (4.2%).

PMID- 8348114
TI  - Effects of catechins on the mouse lung carcinoma cell adhesion to the endothelial
      cells.
AB  - We studied the effects of 5 kinds of catechins on the adhesion of mouse lung
      carcinoma 3LL cells to the monolayer of bovine lung endothelial cells. (-)
      Epicatechin gallate and (-)-epigallocatechin gallate were active in inhibiting
      the 3LL cell adhesion, while (+)-catechin and (-)-epicatechin were inactive. (-)
      Epigallocatechin showed a considerable cytotoxicity. These data suggest that the
      specific chemical structure is required to exert the inhibitory activity of
      catechins and the search for the cellular binding protein(s) bound to these
      inhibitory catechins would provide a clue to clarify the mechanism of
      interactions between tumor cells and endothelial cells.

PMID- 8348115
TI  - A cell cycle study of human mammary epithelial cells.
AB  - The growth regulation of human mammary epithelial cells (HMEC) cultured in a
      growth factor/hormone-enriched (e.g. EGF, insulin) medium with bovine pituitary
      extract as the only undefined supplement was studied. The doubling times of the
      cultures, in which the cells appear in colonies, was 55-72 h, and a considerable
      intercolonial heterogenecity in proliferative activity could be demonstrated.
      However, every colony, irrespective of the size of the growth fraction, comprised
      a sub-population of rapidly growing cells which had a mean generation time of
      approximately 22 h. When insulin was removed from the culture medium, HMEC
      proliferation was inhibited. This growth inhibition was shown to be a result of a
      cell cycle-specific block.

PMID- 8348116
TI  - Movement of cell-associated matrix during contact competition of cells in mixed
      cultures.
AB  - Co-cultured contacting heterotypic cell groups compete with one another for the
      attachment to the substratum. In the course of this competition one cell group
      can progressively push another from the substratum. Alterations to the
      distribution of cell-associated matrix structures in the course of contact
      competition were examined by immunomorphological methods in the paired cultures
      of two epithelial lines and those of fibroblasts and epithelia. It was found that
      matrix structures formed by the retreating cells withdrew from the substratum
      simultaneously with the cells. These results show that two forms of matrix
      structures should be distinguished: the usually immovable matrix upon which the
      cells crawl and the movable matrix that the cells carry with them when they move.

PMID- 8348117
TI  - The influence of maternal nicotine exposure on neonatal lung metabolism.
      Protective effect of ascorbic acid.
AB  - The aim of the present study was to establish whether ascorbic acid
      supplementation (1 mg/kg/body mass/day) during pregnancy and lactation will
      prevent the effect of maternal nicotine exposure (1 mg/kg/body weight/day) on
      neonatal lung carbohydrate, DNA and protein metabolism. The data show that the
      adult lung ascorbic acid content was reduced by 76% after exposure to nicotine.
      In contrast, maternal nicotine exposure during pregnancy and lactation has no
      effect on neonatal lung ascorbic acid content. However, ascorbic acid
      supplementation during pregnancy and lactation prevented the adverse effects of
      maternal nicotine exposure on neonatal lung carbohydrate, DNA and protein
      metabolism.

PMID- 8348118
TI  - Suppression of DNA synthesis and induction of apoptosis in rat prostate by human
      seminal plasma inhibin (HSPI).
AB  - In vivo administration of HSPI (10.7 kDa FSH suppressing peptide of prostate) to
      intact adult male rats was found to suppress the basal levels of incorporation of
      3H-thymidine into DNA of ventral and dorsolateral lobes of the prostate, in a
      dose-dependent manner. Interestingly, microscopic examination of the prostate
      histology of HSPI treated rats revealed a significantly increased incidence of
      apoptotic bodies which are indicative of cell death. In another experiment, HSPI
      was also found to suppress the active DNA synthesis in testosterone-induced
      regrowth of prostate in castrated rats. Thus HSPI can suppress the basal and
      stimulated DNA synthesis and also induce apoptotic cell death in rat prostate.

PMID- 8348119
TI  - In patients with common variable immunodeficiency, interleukin-6 and expression
      of its receptor on B-cells are normal.
AB  - In a group of patients suffering from common variable immunodeficiency (CVID),
      levels of interleukin-6 (IL6) were measured and found to be in the normal range
      or even increased, for single patients. IL6 production of peripheral blood
      mononuclear cells was shown to be in the normal range when corrected for monocyte
      number. To exclude the possibility that the Interleukin-6 receptor (IL6R) on B
      cells is missing, its expression was measured by assessing the binding of a
      Phycoerythrin-derivative of IL6 by flow cytometry and correlated with various
      markers for B-cells and T-cells. As compared with normal controls, no
      statistically significant deviation of the group as a whole nor for individual
      patients could be shown. It was concluded that lack of B cell differentiation in
      the presence of normal to high IL6 as shown for these patients is not due to
      inability of the B cells to detect IL6 in the serum.

PMID- 8348120
TI  - Association of plasmid pKT3 with cock spermatozoa in two different temperatures.

PMID- 8348121
TI  - Influence of recombinant bovine cytokines on proliferation of a bovine mammary
      epithelial cell line.

PMID- 8348122
TI  - A linear vector carrying human telomeres is replicated in unfertilized eggs of
      Xenopus laevis.

PMID- 8348123
TI  - Characterization of the major cytosolic glutathione transferase in two monkey
      kidney derived cell lines.

PMID- 8348124
TI  - The changing face of family care.

PMID- 8348125
TI  - Home management. Viability and liability.

PMID- 8348126
TI  - Cost cutting is out of place.

PMID- 8348128
TI  - The essence of aromatherapy.

PMID- 8348127
TI  - Safety first at bathtime.

PMID- 8348129
TI  - Visual care in old age.

PMID- 8348130
TI  - The painful truth.

PMID- 8348131
TI  - Volunteers across the years.

PMID- 8348132
TI  - As I was saying....

PMID- 8348133
TI  - The personal cost of caring.

PMID- 8348134
TI  - Call systems. The solution's as clear as a bell.

PMID- 8348135
TI  - Functional anatomy of the shoulder complex.
AB  - Recent research findings are incorporated in this review of the functional
      anatomy of the shoulder complex. The scapulothoracic mechanism is described,
      including a review of scapular motion and the structure and function of the
      sternoclavicular and acromioclavicular joints. New information regarding the
      resting position of the scapula on the thorax and the effect of aging and spinal
      posture on position has been presented. In the second part of the paper, the
      anatomy of the glenohumeral joint is reviewed, with emphasis on the articular,
      periarticular, and muscular mechanisms responsible for stability of this
      articulation. The article concludes with a discussion of the integrated function
      of the scapulothoracic and glenohumeral articulations in upper extremity
      elevation.

PMID- 8348136
TI  - Applied MRI anatomy of the shoulder.
AB  - Magnetic resonance imaging (MRI) of the shoulder is rapidly evolving as the
      choice diagnostic procedure for management of shoulder derangement, particularly
      for soft tissue injuries not well delineated by conventional radiography. With
      application of appropriate MRI protocol/sequences and familiarity with applied
      shoulder MRI anatomy, valuable diagnostic information may be derived that can
      greatly assist management/therapy of common problems, such as rotator cuff tears,
      impingement, and instability as well as less frequent causes of shoulder pain and
      dysfunction.

PMID- 8348137
TI  - Neurovascular injuries to the shoulder.
AB  - The throwing athlete is at risk for neurovascular injuries of the shoulder
      because of the excessive demands placed upon the shoulder by repetitive throwing
      motions. The most commonly recognized neurovascular compression syndromes are
      axillary artery occlusion, effort thrombosis, quadrilateral space syndrome, and
      thoracic outlet syndrome. Diagnosis is aided by the use of the Adson's test,
      costoclavicular maneuver, and hyperabduction maneuver. Initial treatment usually
      is nonoperative. Anticoagulation or thrombolytic therapy can be used for vascular
      occlusion. Surgery usually is reserved for patients suffering acute or chronic
      symptoms despite nonoperative treatment. With proper treatment, most patients are
      able to resume their previous athletic activities in a timely manner with minimal
      disability.

PMID- 8348138
TI  - Current concepts in the rehabilitation of the athletic shoulder.
AB  - The rehabilitative process of the overhead athlete represents a significant
      challenge to the clinician. Overhead athletes (thrower, tennis player, swimmer)
      repetitively subject their shoulder joints to high microtraumatic stresses that,
      due to the accumulative effects, may lead to a variety of shoulder injuries. This
      type of athletic patient exhibits uniquely specific physical characteristics,
      such as hypermobility of the anterior shoulder capsule, excessive external
      rotation, hypomobility of the posterior capsule, limited internal rotation, and
      generalized ligamentous laxity of the glenohumeral joint. However, the overhead
      athlete must exhibit functional stability for pain-free sports participation.
      Functional stability is accomplished through the proficient balance of static
      (passive) and dynamic (active) stabilizers. During the rehabilitation process,
      various concepts, such as neuromuscular control, proprioception, force couple
      efficiency, plyometrics, eccentrics, and scapular stability, can enhance dynamic
      functional stability for the overhead athlete. The evaluation and treatment of
      the shoulder patient is in perpetual change, and the purpose of this paper is to
      discuss several current concepts in the rehabilitative treatment of the athletic
      shoulder patient.

PMID- 8348139
TI  - Clinical examination of the shoulder complex.
AB  - A comprehensive and systematic approach to physical examination of the shoulder
      is described, with particular emphasis on findings pertinent to an athletic
      population. The format consists of initial impression, inspection, palpation,
      range of motion and strength testing, stability assessment, special tests,
      vascular examination, and general physical examination.

PMID- 8348140
TI  - The role of the scapula.
AB  - The scapular musculature is often neglected in designing a rehabilitation
      protocol for the shoulder. Weakness of the scapular stabilizers and resultant
      altered biomechanics could result in: 1) abnormal stresses to the anterior
      capsular structures of the shoulder, 2) increased possibility of rotator cuff
      compression, and 3) decreased performance. This article presents known facts
      about the biomechanics of the scapula and surrounding muscles and suggests
      methods for evaluation of scapular muscle weakness. Exercise techniques to
      maximally strengthen the scapular musculature are also described. As our ability
      to document strength of these muscles improves, we will be able to determine the
      effect of scapular strengthening on improving symptoms related to impingement and
      instability. Scapular strengthening exercises are usually nonstressful to the
      rotator cuff and are easily implemented into a rehabilitation program for the
      shoulder.

PMID- 8348141
TI  - Pushing the brain initiative.

PMID- 8348142
TI  - Gene therapy on the Sly.

PMID- 8348143
TI  - Trinucleotide repeat instability: when and where?

PMID- 8348144
TI  - Erythropoietin receptor mutations and Olympic glory.

PMID- 8348145
TI  - Genomic imprinting and gene activation in cancer.

PMID- 8348146
TI  - Angiotensinogen: a candidate gene involved in preeclampsia?

PMID- 8348147
TI  - Enhanced Fmr-1 expression in testis.

PMID- 8348148
TI  - Transgenic mice containing a human heavy chain immunoglobulin gene fragment
      cloned in a yeast artificial chromosome.
AB  - We have developed a method for the introduction of yeast artificial chromosomes
      (YACs) into transgenic mice. An 85 kilobase (kb) fragment of the human heavy
      chain immunoglobulin gene was cloned as a YAC, and embryonic stem cell lines
      carrying intact, integrated YACs were derived by co-lipofection of the YAC with
      an unlinked selectable marker. Chimaeric founder animals were produced by
      blastocyst injection, and offspring transgenic for the YAC were obtained.
      Analysis of serum from these offspring for human heavy chain antibody subunits
      demonstrated expression of the YAC-borne immunoglobulin gene fragment. Co
      lipofection may prove to be a highly-successful means of producing transgenic
      mice containing large gene fragments in YACs.

PMID- 8348149
TI  - Motheaten and viable motheaten mice have mutations in the haematopoietic cell
      phosphatase gene.
AB  - Mice with the recessive motheaten (me) or the allelic viable motheaten (mev)
      mutations express a severe autoimmune and immunodeficiency syndrome. We have
      shown that the basic defect in these mice involves lesions in the gene which
      encodes haematopoietic cell phosphatase (HCP). These mice thus provide excellent
      models for investigating the roles of phosphatases in haematopoiesis and the
      nature of the genetic and cellular events linking impaired haematopoiesis to
      severe immunodeficiency and expression of systemic autoimmunity.

PMID- 8348150
TI  - Direct detection of novel expanded trinucleotide repeats in the human genome.
AB  - Expansion of trinucleotide repeats can give rise to genetic disease. We have
      developed a technique, repeat expansion detection (RED), that can identify
      potentially pathological repeat expansion without prior knowledge of chromosomal
      location. Human genomic DNA is used as a template for a two-step cycling process
      that generates oligonucleotide multimers when expanded trinucleotide sequences
      are present at the level found in myotonic dystrophy and fragile-X patients. We
      have identified at least one new locus exhibiting trinucleotide expansion.
      Analysis of three families transmitting a long CTG repeat shows that the allele
      in these families corresponds to a locus on chromosome 18. RED constitutes a
      powerful tool to identify other diseases caused by this mechanism, particularly
      diseases associated with anticipation.

PMID- 8348151
TI  - Mitotic stability of fragile X mutations in differentiated cells indicates early
      post-conceptional trinucleotide repeat expansion.
AB  - We demonstrate here that somatic variation of CGG repeat length is based on a
      mosaic of cells with different but stable FMR-1 alleles and does not reflect
      permanent mitotic instability. The length of a particular allele in an individual
      cell was maintained in progeny cells establishing a clone. The mutation patterns
      of multiple repeats in the DNA of fetal tissues were identical and did not
      significantly change during proliferation in vitro. It is proposed that genotype
      mosaicism and expansion to full mutation are generated post-conceptionally by the
      same molecular mechanism in a particular window of early development.

PMID- 8348152
TI  - The full mutation in the FMR-1 gene of male fragile X patients is absent in their
      sperm.
AB  - Fragile X syndrome is characterized at the molecular level by amplification of a
      (CGG)n repeat and hypermethylation of a CpG island preceeding the open reading
      frame of the fragile X gene (FMR-1) located in Xq27.3. Anticipation in this
      syndrome is associated with progressive amplification of the (CGG)n repeat from a
      premutation to a full mutation through consecutive generations. Remarkably,
      expansion of the premutation to the full mutation is strictly maternal. To
      clarify this parental influence we studied FMR-1 in sperm of four male fragile X
      patients. This showed that only the premutation was present in their sperm,
      although they had a full mutation in peripheral lymphocytes. This might suggest
      that expansion of the premutation to the full mutation in FMR-1 does not occur in
      meiosis but in a postzygotic stage.

PMID- 8348154
TI  - Correction of lysosomal storage in the liver and spleen of MPS VII mice by
      implantation of genetically modified skin fibroblasts.
AB  - Genetic defects of lysosomal hydrolases result in severe storage diseases and
      treatments based on enzyme replacement have been proposed. In mice lacking beta
      glucuronidase, which develop a disease homologous to human mucopolysaccharidosis
      type VII (Sly syndrome), we have used autologous implants of genetically-modified
      skin fibroblasts for the continuous in vivo production of the enzyme. The human
      beta-glucuronidase cDNA was introduced with a retroviral vector into mutant mice
      skin fibroblasts grown in primary culture. Fourteen mutant mice were implanted
      intraperitoneally with these modified cells embedded into collagen lattices. All
      animals expressed beta-glucuronidase from the vascularized neo-organs that
      developed after implantation and accumulated the enzyme in their tissues. A
      complete disappearance of the lysosomal storage lesions was observed in their
      liver and spleen.

PMID- 8348155
TI  - Assignment of an autosomal sex reversal locus (SRA1) and campomelic dysplasia
      (CMPD1) to 17q24.3-q25.1.
AB  - We have mapped the autosomal sex reversal locus, SRA1, associated with campomelic
      dysplasia (CMPD1) to 17q24.3-q25.1 by three independent apparently balanced de
      novo reciprocal translocations. Chromosome painting indicates that the
      translocated segment of 17q involves about 15% of chromosome 17 in all three
      translocations, corresponding to a breakpoint at the interphase between 17q24
      q25. All three 17q breakpoints were localized distal to the growth hormone locus
      (GH), and proximal to thymidine kinase (TK1). Due to the distal location of the
      breakpoints, previously mentioned candidate genes, HOX2 and COL1A1, can be
      excluded as being involved in CMPD1/SRA1. The mouse mutant tail-short (Ts) which
      maps to the homologous syntenic region on mouse chromosome 11, displays some of
      the features of CMPD1.

PMID- 8348153
TI  - Nucleus basalis magnocellularis and hippocampus are the major sites of FMR-1
      expression in the human fetal brain.
AB  - The expression of the FMR-1 gene, which is implicated in fragile-X syndrome was
      investigated in human fetuses by in situ hybridization. In 8 and 9 week-old
      fetuses, FMR-1 mRNAs are expressed in proliferating and migrating cells of the
      nervous system, in the retina, and in several non-nervous tissues. In the brain
      of 25 week-old fetuses, FMR-1 mRNAs are produced in all nearly differenciated
      structures, with the highest level in cholinergic neurons of the nucleus basalis
      magnocellularis and in pyramidal neurons of hippocampus. The early transcription
      of FMR-1 gene and the distribution of FMR-1 mRNAs in human fetuses suggest that
      alterations of FMR-1 gene expression may contribute to the pathogenesis of
      fragile-X syndrome and especially the mental retardation.

PMID- 8348156
TI  - A cosmid contig and high resolution restriction map of the 2 megabase region
      containing the Huntington's disease gene.
AB  - The quest for the mutation responsible for Huntington's disease (HD) has required
      an exceptionally detailed analysis of a large part of 4p16.3 by molecular genetic
      techniques, making this stretch of 2.2 megabases one of the best characterized
      regions of the human genome. Here we describe the construction of a cosmid and P1
      clone contig spanning the region containing the HD gene, and the establishment of
      a detailed, high resolution restriction map. This ordered clone library has
      allowed the identification of several genes from the region, and has played a
      vital role in the recent identification of the Huntington's disease gene. The
      restriction map provides the framework for the detailed analysis of a region
      extremely rich in coding sequences. This study also exemplifies many of the
      strategies to be used in the analysis of larger regions of the human genome.

PMID- 8348157
TI  - A common mutation in the FACC gene causes Fanconi anaemia in Ashkenazi Jews.
AB  - Fanconi anaemia is an autosomal recessive disease for which four known
      complementation groups exist. Recently, the gene defective in complementation
      group C (FACC) has been cloned. In order to determine the fraction of Fanconi
      anaemia caused by FACC mutations, we used reverse transcription PCR and chemical
      mismatch cleavage (CMC) to examine the FACC cDNA in 17 FA cell lines. 4/17
      patients (23.5%) had mutations in this gene. Two Ashkenazi-Jewish individuals
      were homozygous for an identical splice mutation. Three additional Jewish
      patients bearing this allele were found upon screening 21 other families. We
      conclude that a common mutation in FACC accounts for the majority of Fanconi
      anaemia in Ashkenazi-Jewish families.

PMID- 8348159
TI  - International Continence Society. 23rd annual meeting, Rome, Italy, 8-11
      September 1993. Abstracts.

PMID- 8348158
TI  - Microsatellite mapping of a gene affecting horn development in Bos taurus.
AB  - The presence or absence of horns in Bos taurus is thought to be under the genetic
      control of the autosomal polled locus, characterized by two alleles: P dominant
      over p, and causing the polled or hornless phenotype. We have demonstrated
      genetic linkage between the polled locus and two microsatellite markers, GMPOLL-1
      and GMPOLL-2, and have assigned the corresponding linkage group to bovine
      chromosome 1. This confirms the existence of the postulated polled locus and the
      hypothesized inheritance pattern. It will allow marker assisted selection for the
      polledness trait in breeding programs and is a first step towards positional
      cloning and molecular study of a gene that has been subjected to both natural and
      artificial selection.

PMID- 8348160
TI  - An overview of the development of infertility research and treatment.
AB  - Before the invention of the microscope, knowledge of the anatomic factors in
      human reproduction was limited to the approximations available to the naked eye.
      Van Leeuwenhoek developed the microscope and also discovered the spermatozoa.
      With the availability of microscopy, and later biochemistry, the corpus luteum
      was described and the endocrine functions of the ovaries were partially
      elucidated. In recent times, too, imaging--by x-ray, sonography, and MRI, and
      through the laparoscope--has been the key to advances in our understanding of
      reproduction and, thus, of infertility and its treatment.

PMID- 8348161
TI  - Obesity affects circulating estradiol levels of premenopausal hirsute women
      receiving leuprolide acetate depot.
AB  - OBJECTIVE: To investigate the effect of premenopausal obesity on circulating
      levels of estradiol, estrone, free testosterone, androstenedione, DHEAS, and
      immuno- and bioactive FSH and LH. SETTING: University clinic. PATIENTS AND
      INTERVENTIONS: Premenopausal hirsute women, four obese and four nonobese,
      received leuprolide acetate depot [LD in monthly injections (7.5 mg, i.m.)] until
      estradiol levels decreased to menopausal values; single monthly injections of 15
      and then 22.5 mg LD were given if estradiol remained higher than menopausal after
      3 months. RESULTS: Estradiol levels of nonobese women reached menopausal values
      with the 7.5-mg dose, and those of obese women were not significantly reduced
      with any LD dose. Estrone declined to menopausal levels with 7.5 mg LD, while
      free testosterone and androstenedione were diminished with 7.5 mg, but not
      further with 15 or 22.5 mg. Bioactive LH and the bioactive/immunoactive LH ratio
      were maximally suppressed with 7.5 mg LD; however, LD did not change bioactive
      FSH levels or the bioactive/immunoactive FSH ratio. These findings were not
      related to adiposity. CONCLUSIONS: Premenopausal obesity affects circulating
      estradiol levels of hirsute women receiving LD. The effect does not reflect
      weight-related differences in circulating levels of androgens or bioactive
      gonadotropins. Premenopausal adiposity in hirsute women may influence the
      estrogenic milieu associated with desensitization to GnRH.

PMID- 8348162
TI  - Confidentiality and American semen donors.
AB  - Most American donor insemination programs include a policy of complete
      confidentiality concerning the donor of the semen. This is the result of a long
      legal tradition of American constitutional law. However, some slight abridgement
      of this body of legal decisions might be very much in the best interests of
      children arising from donor insemination, and even--in most cases, in fact--the
      donors themselves. With regard to the children, the factors involved are both
      those of genetic counseling, should the need arise, and psychological
      development. Of course, as at present, the donor must be relieved of all
      responsibility, both legal and financial.

PMID- 8348164
TI  - A comparative study of human chorionic gonadotropin, placebo, and bed rest for
      women with early threatened abortion.
AB  - OBJECTIVE: To compare the effect of hCG therapy with placebo or bed rest in women
      with threatened abortion. DESIGN: Random assignment, double-blind. SETTING:
      Community hospitals. PATIENTS AND INTERVENTIONS: Sixty-one women with viable
      pregnancies under 8 weeks' gestation on admission to hospital were randomly
      allocated to receive injections of hCG or placebo, or were advised to rest in
      bed. MAIN OUTCOME MEASURES: Abortion vs. continuation of pregnancy at 16 weeks'
      gestation. RESULTS: Thirty-one aborted: 6/20 on hCG, 10/21 on placebo, 15/20 on
      bed rest. hCG vs. bed rest, P < .01; placebo vs. bed rest, hCG vs. placebo--not
      significant. Plasma progesterone: continuing pregnancy > abortion, P < .01;
      continued with hCG vs. aborted on placebo, P < .001; continued with hCG vs.
      aborted with bed rest, P < .001. No significant differences in pregnancy/birth
      complications or infants' birth weight. Female/male ratio was 2:1. CONCLUSIONS:
      hCG is significantly better than bed rest.

PMID- 8348163
TI  - Ovulation induction with low doses of "pure" follicle stimulating hormone using a
      fixed protocol in patients with polycystic ovarian disease.
AB  - OBJECTIVE: Use of a low, fixed dose of purified FSH to induce ovulation in
      polycystic ovarian syndrome. DESIGN: Fixed protocol, using 75 IU/day of "pure"
      FSH starting on day 1-5 of menses. SETTING: University outpatient clinic.
      PATIENTS AND INTERVENTIONS: Seventeen patients, aged 18-38, with clomiphene
      resistant polycystic ovarian syndrome, for 23 cycles. All received 50 mg
      medroxyprogesterone to induce menstrual flow. "Pure" FSH given i.m. for eight to
      ten days. If follicle reached > or = 18 mm, hCG (5,000 IU) was given, in one-half
      of cases, in a single dose to induce rupture. MAIN OUTCOME MEASURES: Hormonal
      measurements (plasma LH, FSH, estradiol, testosterone, progesterone); daily,
      LH/FSH ratio; daily abdominal sonogram. RESULTS: I: No follicular growth (3
      cycles; 13%); II: Inadequate follicular growth (< or = 14 mm--6 cycles; 26%);
      IIIa: Follicle > or = 18 mm, hCG given; 100% ovulatory; IIIb: Follicle > or = 18
      mm, no hCG given; 2/7 ovulatory. Hyperstimulation: one (moderate) in IIIa; one
      (mild) in IIIb. CONCLUSIONS: Fixed protocol of low-dose, "pure" FSH produces good
      results, especially combined with hCG, which is effective up to 48 hours after
      last injection of FSH.

PMID- 8348165
TI  - Percentages of acrosome-reacted sperm in human semen close to liquefaction and
      following acrosome-reaction inducing treatment.
AB  - OBJECTIVES: To compare spermatozoa from normal and subnormal seminal specimens in
      their ability to undergo the acrosome reaction, as defined by the triple-staining
      method. METHODS: Normal (39) and abnormal (23) specimens were examined by
      staining promptly after liquefaction. In a total of 32 specimens, the reaction
      was examined before and after acrosome-reaction-inducing treatment, which was
      essentially incubation of isolated sperm in BWW containing 0.3% BSA and 4 mM
      calcium chloride. RESULTS: Percentage of vital acrosome-reacted sperm (true
      acrosome reaction) of untreated specimens: normal, 10.0 +/- 4.9%, abnormal, 5.3
      +/- 3.6% (P < .001). After treatment: increase in reacted sperm from normal
      specimens, 9.0 +/- 7.1% to 22.7 +/- 14.0% (P = .005); abnormal specimens, 5.4 +/-
      2.9% to 7.3 +/- 4.2% (NS). CONCLUSIONS: Low capability of sperm to undergo the
      acrosome reaction might be a decisive factor in the low fertility potential
      characterizing the majority of abnormal semen. Effort in infertility treatment
      should be directed to increasing the proportion of acrosome-reacted sperm.

PMID- 8348167
TI  - The umbilical cord: a study of 1,000 consecutive deliveries.
AB  - OBJECTIVE: To establish base-line data on cord length among Igbo parturients of
      Eastern Nigeria, especially relationship between age and parity, gestation
      length, sex and weight of newborn, placental weight. DESIGN: Retrospective
      analysis of 1,000 consecutive deliveries. SETTING: Mission hospital. MATERIALS
      AND METHODS: Placental length of umbilical cord, placental weight, and prenatal
      data. RESULTS: Cord length varied between 15 cm and 130 cm (mean, 51.5 cm). No
      relationship found to parity, maternal age, or sex of baby. Increase in cord
      length with birthweight and gestational age, up to term. Correlation between
      umbilical length and placental weight, with a variation according to lie of the
      fetus: longest in cord encirclement and unstable lie, shortest in breech
      presentation, transverse lie, and twin birth.

PMID- 8348166
TI  - A simple and efficacious criterion based on serum LH levels to time hCG
      administration for human in vitro fertilization.
AB  - OBJECTIVE: To test the efficacy of a simple criterion--LH level--for
      administration of hCG in an IVF program. DESIGN: Prospective, with retrospective
      analysis of other criteria for hCG administration. SETTING: University hospital
      IVF program. PATIENTS AND INTERVENTIONS: Eighty-four patients, in 110 cycles,
      were given 150-300 IU at 10-11 A.M. daily beginning on day 3 of the cycle. Serum
      LH measured daily 8:30-9:30 A.M., hCG administered on night of day LH level first
      exceeded J, defined as minimum value + (day 3 value-minimum) x 1/3. OUTCOME
      MEASURES: Pregnancy (after IVF + ET); serum concentrations of estradiol and LH.
      RESULTS: Total and ongoing pregnancy per cycle: 35% and 27% respectively. If hCG
      is administered one day early or late by the J criterion, the pregnancy rate is
      reduced. CONCLUSIONS: Pregnancies occurred over wide follicle diameter (14-21 mm)
      and estradiol level (229-2,050 pg/mL) ranges. LH is recommended for timing hCG
      administration.

PMID- 8348168
TI  - The importance of pre-freeze equilibration of glycerol in cryopreservation of
      human spermatozoa and the biochemical conversion of glycerol.
AB  - OBJECTIVE: To find optimal conditions for cryopreservation of human spermatozoa
      with glycerol as cryoprotectant. MATERIALS AND METHODS: Pooled semen from groups
      of three normal donors was allowed to liquefy for 30 minutes at 37 degrees C.
      Samples were subjected to a prefreeze equilibration interval of 0, 30, or 60
      minutes, with 5% or 10% glycerol, at 0 degrees C, 22 degrees C, or 37 degrees C.
      Samples were frozen in liquid nitrogen for 24 hours, thawed, and assessed for
      post-thaw motility. Uptake and metabolism of glycerol were studied using [3H]
      glycerol. Thin-layer chromatography of ethanol extracts of washed spermatozoa
      that had been incubated with the labeled glycerol was used to determine metabolic
      products. RESULTS: Overall best cryopreservation was obtained at 37 degrees C
      with 5% glycerol and 30 minutes' prefreeze incubation. Labeled glycerol was
      incorporated into both polar and nonpolar metabolites. Two chromatographic peaks
      were found associated with the spermatozoa, and one peak was found in the
      incubation medium.

PMID- 8348170
TI  - Consumers will have the last word on reform.

PMID- 8348169
TI  - An approach to pathogenesis of male infertility with anti-sperm antibodies.
AB  - OBJECTIVE: To determine subsets and functional characteristics of peripheral
      blood lymphocytes in men with infertility associated with anti-sperm antibodies.
      SUBJECTS AND METHODS: Blood from 28 infertile men with anti-sperm antibodies and
      34 fertile control males were tested for the lymphocyte subsets by indirect
      immunofluorescence and also for lymphocyte transformation responses to
      phytohemagglutinin (PHA), ConA, and pokeweed mitogen (PWM). Also studied were
      effects of seminal plasma on the lymphocyte transformation responses. RESULTS:
      Percentages of CD3, -4, and -8 cells and lymphocyte blastogenic responses to PHA
      and ConA were significantly lowered in patients. Percentage of B-cells, CD4/CD8
      ratio, and blastogenic response to PWM were increased. All seminal plasmas
      suppressed lymphocyte blastogenesis induced by PHA, PWM, and ConA, but the
      suppressive effect on PHA and PWM by patients' plasma was less than that of
      controls. CONCLUSIONS: The results suggest that number and function of T
      lymphocytes, especially CD8 cells, are lessened and those of CD4 and B-cells
      enhanced in the infertile patients. These factors would be conducive to
      development of an immunologic response to sperm.

PMID- 8348171
TI  - Close to home. Interview by Terese Hudson.
AB  - The hospital is an integral part of the community, according to James May, CEO
      and president of Legacy Portland (OR) Hospitals. May has put this principle to
      work concretely by loaning employees money for initial costs on homes near
      Emanuel Hospital and Health Center in northeast Portland. Now in its second year,
      the program has already helped 25 employees purchase homes in a 19-square-mile
      area targeted for redevelopment. Loans of up to $5,000 for homes with a purchase
      price of $65,000 or lower are available. The loans can be used for down payments,
      pre-paid reserves or closing costs. Legacy forgives 20 percent of a loan's
      outstanding balance each year to employees in good standing. This encourages
      employees to stay for at least five years. Only the interest payments on the
      outstanding balance are paid back to Legacy. May spoke recently with Senior
      Editor Terese Hudson about the program's genesis.

PMID- 8348172
TI  - Prepared for uncertainty?
AB  - National health care reform legislation will affect hospitals in ways as
      dissimilar as hospitals themselves. How prepared are they? Hospitals & Health
      Networks, in conjunction with Premier Hospitals Alliance, Westchester, IL,
      surveyed 402 CEOs and chief operating officers to gauge their responses to
      anticipated changes and garner their opinions on how reform will affect their
      hospitals.

PMID- 8348173
TI  - Next steps for nursing.

PMID- 8348174
TI  - Breaking down barriers. Cambridge Hospital ensures access to care for diverse
      community groups.
AB  - The American Hospital Association and the Baxter Foundation present the Foster G.
      McGaw Prize annually to a hospital that distinguishes itself in meeting the
      diverse health and social needs of its community. The winner receives $75,000;
      the three finalists each receive $10,000. This year's winner and finalists were
      chosen from more than 100 entries. Applicants were judged by a panel of 77
      hospital executives and a nine-member prize committee of health care experts.

PMID- 8348175
TI  - Constructive change. Strong strategic plans can help hospitals keep facility
      plans in line.

PMID- 8348176
TI  - Wake-up call. Many physicians don't become aware of managed care until it rolls
      into their neighborhood.
AB  - Though not yet embracing managed care with open arms, more physicians are
      realizing that it's a reality that they can't ignore. As a result, organizations
      both new and old are providing information on managed care for physicians.

PMID- 8348177
TI  - Linking their futures. Hospitals and physicians meet challenges posed by PHOs.
AB  - Attorneys and executives who have built PHOs say they aren't essential for risk
      contracting and integrated delivery systems, but are extremely helpful. But they
      add that skilled, careful planning is key to the ultimate success of any PHO.

PMID- 8348178
TI  - Albuquerque, New Mexico. Systems integration is prelude to development of AHPs
      (accountable health plans)

PMID- 8348179
TI  - Getting the message out. The AHA gears up to respond to the White House reform
      plan.

PMID- 8348180
TI  - Soviet crisis: a matter of perspective.

PMID- 8348181
TI  - Why so many women? Part 1. Systemic lupus erythematosus.
AB  - Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder
      that predominantly affects women. While numerous factors may account for the
      etiology of SLE, the influence of gender-based sex hormones on the prevalence of
      SLE and autoimmune disorders among women is currently being evaluated.

PMID- 8348182
TI  - Managing the patient with liver failure.
AB  - Liver failure affects virtually all aspects of body functioning, which challenges
      medical-surgical nurses to deliver effective comprehensive care. Managing
      patients with liver failure requires a thorough understanding of hepatic
      physiology and the pathophysiology of liver disease failure.

PMID- 8348183
TI  - Coping and emotion in women undergoing cardiac surgery: a preliminary study.
AB  - There is limited knowledge about how women manage the experience of cardiac
      surgery. This pilot study examined how women coped with surgery and their
      emotions in the perioperative period. There was no change in coping or emotion
      from the day before surgery to the fifth postoperative day, and coping was
      unrelated to emotion. Preoperative and postoperative confusion and distress were
      positively correlated. While preliminary, these results raise implications for
      medical-surgical nursing practice and research.

PMID- 8348184
TI  - Beating a path to nursing's door: scientific support for holistic practice.
AB  - Nursing has a long history of a holistic focus on patient care. The current
      emphasis on the need for holism indicates that the "world" is more aware of the
      value of nursing. To enhance this possibility, nurses need to use empirical
      evidence to support holistic practice.

PMID- 8348185
TI  - Post-anesthesia assessment: what medical-surgical nurses need to know.
AB  - Post-anesthesia patient assessment helps predict the acuity and nursing care
      needs of patients upon discharge to critical, general, or home care. The goals of
      postanesthesia assessment, with a focus on the potential respiratory,
      cardiovascular, neurologic, and other complications are discussed.

PMID- 8348186
TI  - Mourning: a concern for medical-surgical nurses.
AB  - Medical-surgical nurses working in a variety of settings with dying patients and
      their families play an important role in facilitating grieving. They can do much
      to help dying patients have a more peaceful death by listening to them. They can
      facilitate healing among families prior to death. They can help surviving family
      members begin a more healthy pattern of mourning. The tasks of mourning offer a
      useful guide for responding to the needs of the bereaved from a variety of
      cultural perspectives. Nurses can gain a greater sense of satisfaction in working
      with dying patients and grieving survivors by incorporating this framework into
      their practice.

PMID- 8348187
TI  - Surviving NCLEX-RN reexamination.

PMID- 8348188
TI  - Developing a nursing information systems department. Part I: Stating the vision.

PMID- 8348189
TI  - Independent contractor or employee?

PMID- 8348190
TI  - Understanding corticosteroids: pharmacologic and adverse effects.

PMID- 8348192
TI  - A comparison of ethical resources.

PMID- 8348191
TI  - Understanding corticosteroids. Estrogens' potential role in autoimmune diseases.

PMID- 8348193
TI  - Overcoming barriers to research utilization with researched-based practice
      guidelines.

PMID- 8348195
TI  - Tricyclic antidepressants versus electroconvulsive therapy: a review of the
      evidence for efficacy in depression.
AB  - The author examines the thesis that electroconvulsive therapy is superior to
      tricyclic antidepressants in treating nonpsychotic major depression. Every study
      published in English since 1960 comparing electroconvulsive therapy against
      tricyclics in treating this condition was reviewed. Because of numerous
      methodological weaknesses in the studies, the data is inadequate to support the
      claim that one treatment is superior to the other.

PMID- 8348194
TI  - Are controls in schizophrenia research "normal"?
AB  - The psychiatric assessment by structured interview and family history of mental
      disorder in normal volunteers recruited by advertisement for a study of brain
      structure and function in psychosis is described. Nine of 51 volunteers (17.6%)
      who passed a phone screen were excluded after a structured interview for major
      psychopathology. Of 35 completers, 10 (28.6%) had subthreshold mood or substance
      use but were included in the study. Only 16 subjects (45%) had a negative family
      history by FH-RDC. Diagnoses in family members included substance abuse (31%),
      mood disorder (11%), psychosis (9%), and other/undiagnosed (14%). Ventricular
      enlargement was evaluated by magnetic resonance imaging in two planes.
      Ventricular size was bimodally distributed in the males, and the group with
      larger ventricles was more educated and had higher scores on the 8
      (Schizophrenia) scale of the MMPI (F = 5.44, p = .0099). Our results suggest that
      'normal' volunteers for psychiatric research have personal or family
      psychopathology which motivates them to participate. As the sensitivity of
      biological instrumentation increases, the characteristics of the control group
      must be anticipated in the design and recruitment.

PMID- 8348196
TI  - Clinical correlates of valproate augmentation in refractory bipolar disorder.
AB  - We examined the clinical correlates of valproate (VPA) therapy in refractory
      bipolar disorder. Retrospective chart review was used to collect demographic and
      clinical data including present diagnosis, diagnosis at illness onset, duration
      of illness, number of hospitalizations, VPA dose, side effects, and maximum serum
      concentration. Global response was rated once patients serum VPA exceeded 50
      mg/dL. The charts of all inpatients admitted over a two-year period and treated
      with VPA for acute episodes of bipolar disorder in manic, mixed, or depressed
      phase were reviewed. Seventeen of these patients began VPA augmentation while
      hospitalized and became the cohort for review. Patients were excluded if VPA was
      started prior to admission or the patient was discharged less than one week after
      drug initiation. Patients were not excluded on the basis of EEG, CT, or
      neurological exam findings. Overall, 12 of 17 (71%) of the patients showed a
      moderate or marked improvement while 5 of 17 (29%) showed mild or no response.
      Responders were older and had a longer duration of illness with an increased
      number of hospitalizations. There was a strong trend for responders to achieve a
      higher serum VPA level. A significant positive correlation was found between
      response in acute mania and psychotic symptoms at first episode of illness.

PMID- 8348197
TI  - Barbiturate anticonvulsants in refractory affective disorders.
AB  - Despite an increasing literature demonstrating both acute and long-term positive
      psychopharmacological effects of both valproate and carbamazepine, phenytoin has
      remained a controversial intervention, and barbiturate anticonvulsants have
      generally received poor press with regard to psychotropic effects. In the present
      investigation, 27 seizure-free, affectively ill patients who received therapeutic
      trials of primidone and/or mephobarbital after failing on antidepressants,
      lithium, carbamazepine, valproate, and phenytoin were analyzed with regard to
      effects on illness severity and affective cycle rate over a period of as long as
      four years. Nine (33%) of the patients had a sustained positive therapeutic
      effect on affective state and/or psychotic symptoms to primidone and three (11%)
      had positive effects on mephobarbital after primidone failure. Four (15%) had
      brief positive effects that were not sustained, and the remaining 11 (41%) had no
      effects or negative effects to these agents. The theoretical and practical
      implications of this new and unexpected finding are discussed.

PMID- 8348198
TI  - Clinical correlates of self-mutilation among psychiatric inpatients.
AB  - The charts of 660 consecutive admissions to a university psychiatric hospital
      were examined. After excluding those with mental retardation, 32 patients who had
      mutilated themselves and 88 patients admitted for unsuccessful suicide attempts
      were identified. Women were significantly overrepresented among the mutilators,
      but the groups did not differ with respect to age. Most analyses were restricted
      to women, of whom 27 were self-mutilators and 51 were nonmutilating suicide
      attempters. Mutilators were less likely to receive diagnoses of major depression
      or adjustment disorder but were more likely to have a history of substance abuse
      and receive Axis II diagnoses. The mutilative behavior was generally repetitive.
      The most common form was superficial cutting of the arms and wrists. Reports of
      lifetime sexual or physical abuse were more common among mutilators. Mutilators
      also had frequent histories of suicide attempts distinct from their mutilation
      behavior, multiple hospitalizations, and transfer to state hospitals for longer
      term care. These findings suggest a chronic course with significant morbidity and
      associated features which may be of clinical significance.

PMID- 8348200
TI  - An open trial of methyltetrahydrofolate in elderly depressed patients.
AB  - 5-methyltetrahydrofolate (MTHF) is a naturally occurring substance involved in
      the synthesis of s-adenosyl-l-methionine (SAMe), a major source of methyl groups
      in the brain. To assess the efficacy of a gastro-resistant, oral preparation of
      MTHF, 20 elderly patients with a DSM-III-R diagnosis of depressive disorder and a
      HAM-D-21 score > or = 18 underwent 6-weeks of open-label treatment with 50 mg per
      day of oral MTHF. Of these 20 patients, 16 completed at least 4 weeks of
      treatment and showed a markedly significant improvement in their depressive
      symptoms at endpoint, with 81% of them being considered responders. There were no
      clinically relevant changes in the routine laboratory tests during the study, and
      no adverse events considered to be definitely drug-related were reported.

PMID- 8348199
TI  - Antidepressant side effects and physician prescribing patterns.
AB  - We studied the following questions: (1) Do physicians preferentially prescribe
      antidepressants (ADs) with the least side effects (SEs) of sedation, orthostatic
      hypotension, and anticholinergic activity; (2) Have there been any recent changes
      in prescribing patterns; and (3) Do patterns differ for psychiatrists and
      nonpsychiatrists. Data on psychiatrist and non-psychiatrist outpatient
      prescribing of specific ADs were obtained from the National Prescription Audit
      (NPA) for 1986 and 1989. In 1986, physicians did not minimize the use of ADs with
      the most of these SEs. The 1989 data indicate that psychiatrists made a major
      change toward prescribing more low SE ADs and less ADs with the most SEs. The
      data for nonpsychiatrists also suggest some movement in this direction. The
      availability of fluoxetine and the concomitant focus on SEs may have contributed
      to this shift. Further investigation is needed to clarify factors that influence
      physicians' choices of ADs.

PMID- 8348201
TI  - Presence of psychiatric morbidity in prison population in Kuwait.
AB  - This paper surveys the prevalence of psychiatric morbidity in a Kuwaiti prison.
      The rate of major psychosis was considerably lower than the rate reported in
      other prison studies. Twenty-five percent of the sample had generalized anxiety
      disorder of a reactive nature which was most probably related to imprisonment
      itself. There was a preponderance of individuals suffering from personality
      disorder, alcoholism, and drug abuse problems. Prisoners with a diagnosis of
      major psychosis had very little exposure to psychiatrists and the large number of
      recidivists reflects the lack of a probation service. Financial embezzlement and
      drug/liquor smuggling remain the crimes of choice in Kuwait. Some underlying
      sociocultural factors are discussed and the need for an alternative prison-based
      therapeutic community service is emphasized.

PMID- 8348202
TI  - Relationships between thyroid indices and symptoms of anxiety in depressed
      outpatients.
AB  - Scores on rating scales measuring symptoms of depression, panic anxiety, state
      anxiety, trait anxiety, and agoraphobic avoidance were correlated, using
      multivariate statistics, with total thyroxine- and thyrotropin-releasing hormone
      concentrations in outpatients with major depression. A significant inverse
      relationship was demonstrated between agoraphobic avoidance and total thyroxine
      concentrations in female patients. No other symptom ratings were significantly
      associated with these thyroid indices. The depressed patients scored in the
      clinically significant range for agoraphobic symptoms. Assessment of agoraphobic
      avoidance may help identify a clinically and biologically distinct subgroup of
      depressed patients.

PMID- 8348203
TI  - Identification of treatment-resistant depressives who respond favorably to
      carbamazepine.
AB  - Thirteen depressed patients with documented histories of failure to respond to
      tricyclic antidepressant medications who reported multiple partial seizure like
      symptoms were given open trials of carbamazepine. Eleven of the 13 showed
      moderate to substantial improvement in affective status that was accompanied by
      significant mean changes on the Beck or Hamilton depression scales. In addition,
      the mean number of reported partial seizure-like symptoms decreased significantly
      with treatment. Dichotic word listening performance was the only
      neuropsychological variable that was impaired at baseline and was also the only
      cognitive performance that improved following treatment. These preliminary
      observations suggest that there is likely to be a subgroup of treatment
      resistant, carbamazepine-responsive depressives who can be identified by
      evaluating for the presence of multiple partial seizure-like symptoms.

PMID- 8348204
TI  - Phenobarbital versus clonazepam for sedative-hypnotic taper in chronic pain
      patients. A pilot study.
AB  - A randomized, double-blind controlled trial is reported comparing phenobarbital
      and clonazepam for the purpose of sedative-hypnotic taper in inpatients with
      chronic, nonmalignant pain. After receiving the Minnesota Multiphasic Personality
      Inventory (MMPI) and a standardized psychiatric diagnostic interview, patients'
      baseline sedative-hypnotic use was assessed over 48 hours. Baseline use was
      converted into phenobarbital or clonazepam equivalents and administered in four
      doses daily using a blinded liquid pain cocktail. Baseline dose was maintained
      for two days and then tapered by 10% per day. Over the first week of taper,
      differences in mean and maximum Beck Anxiety and Benzodiazepine Withdrawal scores
      were not significant. However, when scales 1, 3, or 8 of the MMPI were taken as
      covariates, differences on the Withdrawal Scale only increased to a trend level
      for mean scores and to a significant level for maximum scores. These findings
      support the superiority of benzodiazepines over barbiturates for sedative
      hypnotic taper for symptoms of withdrawal but not of recurrent or rebound
      anxiety.

PMID- 8348205
TI  - Multiple personality disorder and borderline personality disorder. Distinct
      entities or variations on a common theme?
AB  - We report data from a comparison of 14 subjects with multiple personality
      disorder (MPD) and 13 subjects with borderline personality disorder (BPD). There
      were few significant differences between the groups. The authors discuss the
      concept of MPD as an epiphenomenon of BPD, and argue their fundamental
      similarity.

PMID- 8348206
TI  - A calendar savant with autism and Tourette syndrome. Response to treatment and
      thoughts on the interrelationships of these conditions.
AB  - A case of a calendar savant with infantile autism and Tourette syndrome is
      presented. Pharmacotherapy and comorbidity issues are discussed in terms of the
      interrelationships of these conditions and obsessive-compulsive disorder.

PMID- 8348207
TI  - Rational polypharmacy in schizophrenia.
AB  - Approximately 10 to 30% of patients with schizophrenia show poor response to
      neuroleptics alone. An initial evaluative and treatment approach to these
      patients is outlined, and the literature on adjunctive treatments, which seek to
      augment neuroleptic effects, is reviewed. The greatest evidence for efficacy has
      been shown for lithium, benzodiazepines, carbamazepine, reserpine, and
      electroconvulsive therapy, although individual patients may also respond to
      propranolol, clonidine, valproic acid, and L-dopa. Antidepressants may also be
      useful for treating comorbid depression in nonacutely psychotic patients. One
      general theme is that no one adjunctive treatment benefits all patients; indeed,
      only a minority of patients responds to any given agent. Therefore, the choice of
      specific treatments is best guided by the clinical characteristics of the
      individual patient. These observations raise the possibility that subgroups of
      schizophrenia exist; delineation of differences in clinical response to
      biochemically distinct agents may help elucidate such underlying differences
      between patient groups.

PMID- 8348209
TI  - Effect of streptozotocin-induced diabetes on electrically evoked erection in the
      rat.
AB  - This study was designed to investigate whether experimental diabetes in rats
      could functionally affect reflexogenic erection. Erection was elicited by means
      of electrical stimulation of the dorsal nerves of the penis and recorded as
      intracorporeal pressure. Rats were examined 1, 3 and 6 months after diabetes
      induction by streptozotocin. Three and 6 month diabetes caused a significant
      decrease of latency for erection and a slower phase of detumescence when compared
      to age-matched controls. In addition, a trend for a lower developed
      intracorporeal pressure was present in the 6 month diabetes group. Our results
      indicate that experimental diabetes is associated with alterations of
      reflexogenic erection.

PMID- 8348208
TI  - Pelvi-perineal rehabilitation for dysfunctioning erections. A clinical and
      anatomo-physiologic study.
AB  - We have studied penile structure in 24 cadaver specimens and 155 patients have
      been treated for organic impotence by physiotherapy. Special attention has been
      focused on the closure mechanism of the corpora cavernosa during erection. We
      have found that the leakage factor of the corpora cavernosa is, among other
      things, influenced by the ischiocavernous muscles. Based on the above, we propose
      a model for the anatomic and physiologic basis of interference of the
      ischiocavernous muscles in venous occlusion during penile erection. Moreover we
      suggest that patients with erectile dysfunction should undergo pelvi-perineal
      rehabilitation in order to strengthen and control ischiocavernous muscles.

PMID- 8348210
TI  - Intracavernosal kinetics of eicosanoids and endothelin during erection. Data from
      human and animal studies on intrapenile and systemic prostaglandins.
AB  - The release of mediator substances of the arachidonic acid cascade is closely
      related to the functional state of the endothelium. A significant lower
      prostacyclin/thromboxane A2 ratio in penile plasma of organogenic impotent
      patients in comparison to patients with psychogenic erectile dysfunction has been
      described in the literature. We observed the time-related liberation of
      prostacyclin, thromboxane A2 and the vasoactive peptide endothelin for 16 minutes
      of a drug-induced erection. We compared kinetics of patients with penile
      deviation and transsexualism, to patients suffering from severe organogenic
      impotence. We assessed the usefulness of the prostacyclin-to-thromboxane A2 ratio
      as a possible indicator of corporal degeneration. An animal model has been
      created to observe differences between rabbits under 100 days of standard diet
      alimentation, rabbits under cholesterol enriched diet and rabbits with hereditary
      hyperlipidemia type II A. Hyperlipidemia is suspected to be one possible factor
      causing organogenic impotence. Enzyme-immuno-assays were used for the
      determination of all substances. The systemic prostacyclin-to-thromboxane A2
      ratio differed significantly between control rabbits and rabbits with
      hyperlipidemia. Prostacyclin, thromboxane A2 and endothelin in corpus cavernosum
      plasma showed a typical profile during spontaneous and drug-induced erection. A
      significant difference between groups of patients suffering from organogenic or
      psychogenic impotence could not be found. The value of the determination of the
      studied substances in differential diagnosis seems to be dubious.

PMID- 8348211
TI  - Pudendal versus limb nerve electrophysiological abnormalities in diabetics with
      erectile dysfunction.
AB  - It is of some interest to diagnose polyneuropathy and/or sacral neuropathy in
      diabetic males with erectile dysfunction. Non-invasive electrophysiological
      measurements with surface electrodes, which are widely available, have been
      applied to determine the diagnostic yield of several electrophysiologic
      parameters for assessing polyneuropathy including the pudendal nerve in impotent
      diabetics. Latencies of the bulbocavernosus reflex and the pudendal somatosensory
      evoked potentials were measured in a group of 28 diabetic patients with an
      erectile dysfunction as their main complaint, as well as in a group of 20 potent
      males without systemic disease. In diabetic patients motor conduction
      measurements of one median and peroneal nerve and sensory conduction measurements
      of one median and sural nerve were also performed. In 15 patients abnormalities
      of the peripheral nerve conduction were demonstrated whereas abnormalities of the
      bulbocavernosus reflex and/or cortical somatosensory evoked potentials were
      demonstrated in eight. Five patients had both types of abnormalities. In the
      patient group no differences could be demonstrated between those with Type 1 or
      Type 2 diabetes. The only significant clinical/neurophysiological correlation was
      found between the absence of the bulbocavernosus reflex on clinical examination
      and its prolonged latencies on electrophysiological measurement. The study showed
      that a bigger yield of abnormal results was obtained when pudendal nerve function
      parameters were included in the evaluation of diabetics with erectile
      dysfunction. Considered separately, however, the battery of electrophysiological
      tests evaluating limb nerve function seems more sensitive in diagnosing
      neuropathy than electrophysiological assessment of pudendal nerve function alone.

PMID- 8348213
TI  - The success of microsurgical penile revascularization in treating arteriogenic
      impotence.
AB  - The treatment of arteriogenic erectile dysfunction with revascularization
      techniques has been controversial both in terms of its use and the type of
      surgical repair. Success rates reported in the literature are based almost
      exclusively on patient testimonial, without the use of objective post-operative
      criteria. At our institution from 7/88 through 8/91, 18 patients were treated for
      arteriogenic impotence using microsurgical penile revascularization. The patient
      population ranged in age from 23 to 64 years, and each patient underwent a
      complete history and physical examination, serum hormone testing, psychological
      evaluation of patient and partner, biothesiometry, penile plethysmography,
      nocturnal penile tumescence/rigidity testing with a Rigiscan device, and
      selective pudendal arteriography. One patient was status post a pelvic fracture,
      2 lacked identifiable risk factors, 2 had diabetes, 6 were heavy smokers, and 7
      had hypertension. Pre-operatively each patient had a suspicious medical history,
      abnormal plethysmography, abnormal Rigiscan testing, and a hemodynamically
      significant lesion on angiography. Revascularization was done by anastomosing the
      inferior epigastric artery to the deep dorsal veing and dorsal artery, or the
      deep dorsal vein alone if both arteries were atretic. Postoperatively, all 18
      patients underwent a personal interview, repeat penile plethysmography, and
      repeat Rigiscan testing. Six patients reports successful coitus and an additional
      four were having coitus with the aid of intracavernous pharmacotherapy. Seventy
      eight percent (14/18) had improved tracings on penile plethysmography, and 56%
      (10/18) had normal erectile capability by Rigiscan testing.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8348212
TI  - Prostaglandin E1 diluted solution: preparation technique and stability
      evaluation.
AB  - The authors describe their prostaglandin E1 dilution method for the treatment of
      male erectile dysfunction. Preparation stability was investigated. Results
      suggest that PGE1 diluted solution can last as long as 90 days, while decreased
      concentrations of PGE1 are detected after three months.

PMID- 8348214
TI  - Current trends in corpus cavernosum EMG. Conclusions of the 'First International
      Workshop on Smooth Muscle EMG Recordings/Leiomyogram' April 15 to 17, 1993 in
      Mannheim, Germany.

PMID- 8348215
TI  - Criteria for examiner-independent nocturnal penile tumescence and rigidity
      monitoring (NPTR): correlations to invasive diagnostic methods.
AB  - 78 patients (pts.) with erectile dysfunction (ED) underwent conventional
      diagnostic evaluation including NPTR monitoring with the Rigiscan, intracavernous
      drug testing, dynamic cavernosometry, doppler evaluation, pharmaco-angiography
      and neurologic tests. Only erections of the best rigidity recorded over three
      nights served for classification into three classes of rigidity. Patients with
      neurogenic impotence showed significantly poorer and fewer erectile events per
      hour than vasculogenic impotent men. Patients with arteriogenic ED had better
      erections than patients with venogenic or mixed arterio-venogenic ED. Severity of
      organic ED during conventional diagnostic work-up correlated to loss of rigidity
      during NPTR recordings, but no differential diagnosis between arteriogenic,
      venogenic or neurogenic impotence could be made with NPTR data alone. The
      presented criteria for NPTR evaluation permit a time-saving, examiner-independent
      analysis.

PMID- 8348216
TI  - The performance of the Rigiscan in the measurement of penile tumescence and
      rigidity.
AB  - The validity of the Rigiscan as a measure of both penile circumference and
      rigidity was assessed. In the first study, the Rigiscan was used simultaneously
      with a mercury-in-rubber strain gauge to monitor nocturnal penile tumescence. The
      Rigiscan was found to underestimate the circumference proportional to the degree
      of erection. In a second study a calibration system was developed which allowed
      independent variation of circumference and rigidity. Assessment of the Rigiscan
      with this system confirmed that circumference was underestimated, particularly at
      lower levels of rigidity, and also that different devices consistently recorded
      different degrees of rigidity. The use of this type of system for regular
      calibration is recommended, and other potential improvements in the device for
      research purposes are discussed.

PMID- 8348217
TI  - Erectile dysfunction in men under 40: etiology and treatment choice.
AB  - We undertook a retrospective review of 100 impotent men under age 40 to determine
      the underlying etiologic factors in the group and to evaluate the role of surgery
      in their care. Although patients ranged in age from 18 to 40 (mean--32.2 years),
      the number of patients increased steadily with advancing years. The majority of
      patients (72) had vasculogenic impotence (arteriogenic--15, venogenic--46, mixed-
      11), followed by psychogenic (13), neurogenic (12) and other causes (4). The
      differential diagnosis did not correlate with age. Contributing factors were
      present in 76%, trauma and substance abuse being most common. Essentially equal
      numbers of patients were treated surgically (40) and with intracavernous
      injection of vasoactive agents (39). Considerably fewer had a vacuum constriction
      device (5), oral medication (5), psychotherapy (4), other therapy (4), and none
      (3). The majority of patients referred to our tertiary urologic practice for
      treatment of vasculogenic impotence were sent by other urologists. Although the
      referral source did not appear to influence the choice of treatment, it probably
      has accounted for the preponderance of vasculogenic impotence in this series.

PMID- 8348218
TI  - Hypoglycemia in the neonate.
AB  - After a brief history of the development of neonatal hypoglycemia, this review
      emphasizes the current approach to the anticipation, diagnosis, and management of
      the neonate with a low plasma glucose concentration. Both transient and recurrent
      or persistent hypoglycemia are discussed. Current techniques for studying the
      neurophysiologic and endocrine-metabolic effects of significant hypoglycemia
      provide new approaches for establishing relevant definitions of significant
      hypoglycemia, its prognosis, and pathogenesis. The inadequacy of glucose oxidase
      strips for screening, the definition of high risk infants, new definitions for
      low plasma glucose concentrations and their treatment are discussed. New data
      concerning the hereditary aspects of hyperinsulinemia, the role of glucose
      transporters, and the ability of the neonate to respond to significantly low
      glucose values are presented as well.

PMID- 8348219
TI  - The evaluation of 24-hour spontaneous GH secretion in short children:
      relationship between mean concentration and pulsatile parameters.
AB  - In 116 short children (height < -1.6 SDs), the authors examined GH secretion over
      24 hours, by taking blood samples every 20 min and performing an
      electroencephalographic sleep control. The following GH parameters were
      evaluated: 24-h mean GH concentration (MGHC); maximum GH peak during the initial
      cycle of sleep (iMGHP), the nocturnal 12 h (nMGHP) or diurnal 12 h (dMGHP), the
      number of GH pulses over 24 h (NP), or nocturnal 12 h (nNP) or diurnal 12 h
      (dNP), the mean pulse amplitude over 24 h (MPA), or nocturnal 12 h (nMPA) or
      diurnal 12 h (dMPA). The subjects were divided into 3 groups: group 1, 12
      subjects with low responses to provocative tests and MGHC < 3 ng/ml; group 2, 36
      subjects with normal responses to provocative tests and MGHC < 3 ng/ml; group 3,
      68 subjects with MGHC > 3 ng/ml. MGHC was highly correlated (p < 0.001) with
      iMGHP (r = 0.80), nMGHP (r = 0.82), dMGHP (r = 0.59), MPA (r = 0.85), nMPA (r =
      0.86), dMPA (r = 0.56), NP (r = 0.70), nNP (r = 0.68), dNP (r = 0.46). By the
      analysis of the regression equations, the values corresponding to 3 ng/ml for
      MGHC were 11.08 ng/ml for iMGHP, 11.66 ng/ml for nMGHP, 5.21 ng/ml for dMGHP,
      7.29 ng/ml for MPA, 8.40 ng/ml for nMPA, 4.25 ng/ml for dMPA, 3.2 for NP, 2.41
      for nNP and 0.78 for dNP. By using these values as cut-off points, the diagnostic
      accuracy yielded 83.6% for iMGHP, 84.5% for nMGHP, 69.8% for dMGHP, 92.2% for
      MPA, 90.5% for nMPA, 81.9% for dMPA, 80.2% for NP, 77.6% for nNP, 71.5% for dNP.
      In conclusion, we found a strong correlation between mean GH secretion over 24 h
      and the number or amplitude of pulses: particularly, nocturnal pulsatile GH
      parameters show a higher correlation in comparison with diurnal pulsatile GH
      parameters, so that the examination of GH values during nocturnal hours may be
      considered a reliable index of GH secretory status.

PMID- 8348220
TI  - Final heights in 45,X Turner's syndrome with spontaneous sexual development.
      Review of European and American reports.
AB  - STUDY OBJECTIVE: To assess the effect of endogenous estrogen secretion on the
      final heights of patients with 45,X Turner's syndrome. DESIGN: European and
      American reports of patients with 45,X Turner's syndrome and spontaneous sexual
      maturation in which final heights were available were analyzed and compared with
      existing norms for untreated patients with Turner's syndrome. Subgroups of
      patients were compared as a means of distinguishing low from normal endogenous
      estrogen exposure, and the effect of the age of menarche was assessed. PATIENTS:
      Twenty-three cases were collected, including eight who became pregnant. One had
      full somatic maturation but did not menstruate. RESULTS OF ANALYSES: Mean height
      of all 23 patients was 140.8 cm +/- 8.07 (s.d.) vs 143.1 cm +/- 6.0 (p = 0.035)
      for literature norms for Turner's syndrome. Mean height of those who achieved
      pregnancy was 138.6 cm +/- 8.21 (p = 0.035 vs literature norm); of those with
      normal gonadotropins 137.5 cm +/- 6.03; and of those with high gonadotropins
      139.2 cm +/- 1.44 (p = 0.374). Age of menarche was available in 21 and showed no
      correlation with final height. CONCLUSIONS: Physiological and subphysiological
      endogenous secretion of estrogen in Turner's syndrome does not increase final
      height, suggesting that even low-dose exogenous estrogen would not increase
      ultimate stature in these patients.

PMID- 8348221
TI  - Auxological and biochemical parameters in assessing treatment of infants and
      toddlers with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.
AB  - We studied height velocity (HV), bone age progression (delta BA/delta CA),
      urinary pregnanetriol (PT) and plasma 17-hydroxyprogesterone (17-OH-P) during the
      first years of life in 12 patients with 21-hydroxylase deficiency, treated by
      cortisone acetate. In the well-controlled phases normal growth rate (SDS between 
      1 and +1), satisfactory bone age progression (delta BA/delta CA < or = 1) and no
      clinical sign of poor treatment were found; in the undertreatment phases enhanced
      growth rate, rapid bone age progression and, in some instances, signs of
      virilization were found; in the overtreatment phases, reduced growth rate was the
      only sign of poor treatment. Hormonal values were only weakly correlated to
      therapeutic control. Therefore, growth rate evaluation can represent the best
      method of monitoring treatment in very young patients with 21-hydroxylase
      deficiency.

PMID- 8348222
TI  - Growth hormone and insulin-like growth factor I plasma levels in patients with
      hypophosphatemic rickets.
AB  - The cause of the growth retardation present in patients with hypophosphatemic
      rickets has not been totally elucidated. There has been a previous report of a
      growth hormone deficit in a group of these patients. To verify this abnormality
      we studied two groups of patients with hypophosphatemic rickets, one with (n = 6)
      and the other without (n = 7) treatment with calcitriol and oral phosphates. All
      patients in both groups showed a normal growth hormone response (> 10
      micrograms/l) to standard stimulatory tests and normal IGF-I plasma levels. Mean
      IGF-I plasma levels were not significantly different (untreated 1.46 +/- 0.80
      U/ml, treated 1.25 +/- 0.69 U/ml) and the mean logarithmic deviation of IGF-I
      plasma levels from both groups did not differ from normal. In summary, we found
      no abnormalities of the growth hormone-IGF-I axis in our patients with
      hypophosphatemic rickets.

PMID- 8348223
TI  - A case report: familial hypoalphalipoproteinemia.
AB  - We studied an 8 year-old girl whose height was 129 cm (25-50th percentile),
      weight 30 kg (75th percentile), blood pressure 115/75 mm Hg (75th percentile) and
      had a calcified mass lesion in the left posterior mediastinum. In the
      histopathological investigation of this mass lesion, symptoms of complicated
      atherosclerosis, such as mural thrombus and diffused calcification, were
      observed. Lipid investigations were performed in this patient whose total
      cholesterol and triglyceride levels were in the normal ranges. HDL-cholesterol,
      apoprotein A-I and alpha band were low without any other lipid and lipoprotein
      abnormalities. During one year, in her monthly lipid analysis the mean levels of
      HDL-cholesterol, apoprotein A-I and alpha band were found to be 0.73 +/- 0.11
      mmol/l, 90 +/- 20 mg/dl and 23 +/- 5% respectively. Studies of her family
      revealed low levels of HDL-cholesterol, apoprotein A-I and alpha band in her
      mother and sister. We describe our investigation of this rare case of familial
      hypoalphalipoproteinemia.

PMID- 8348224
TI  - A case of mixed gonadal dysgenesis with 45 X/46 XY karyotype and aortic
      coarctation.
AB  - We report a case of mixed gonadal dysgenesis with 45 X/46 XY karyotype and aortic
      coarctation. An eight month-old patient was admitted to our endocrinology
      department for evaluation of ambiguous genitalia. On physical examination, a wide
      neck with a low posterior hairline, bifid scrotum, small phallus, testis in the
      right labioscrotal fold, single orifice and typical findings of aortic
      coarctation were present. The chromosome karyotype of the patient was 45 X/46 XY.
      On the laparotomy there was an infantile uterus, fallopian tubes, and a streak
      gonad on the left. The follow-up of the patient included sex assignment, genital
      reconstruction and cardiovascular treatment.

PMID- 8348225
TI  - Vaginal bleeding: presenting symptom of acquired primary hypothyroidism in a
      seven year-old girl.
AB  - A seven year-old girl who presented with vaginal bleeding and a right ovarian
      cyst was diagnosed as having acquired primary hypothyroidism. She had
      menstruation in spite of a delayed bone age, absence of pubertal growth spurt and
      lack of adrenarche. Elevated levels (age-matched) of gonadotropins, normal levels
      of estradiol, and hyperprolactinemia were documented. The clinical and laboratory
      findings were reversed by thyroxin treatment. The clinical presentation in this
      case, and other similar descriptions in the literature, support the mechanism of
      pseudo-precocious puberty in untreated hypothyroidism.

PMID- 8348226
TI  - Cushing's disease presenting as pubertal arrest.
AB  - The clinical features of Cushing's disease in childhood are usually abnormal fat
      distribution, moon face, growth failure and hirsutism. Laboratory studies include
      evidence of cortisol and ACTH hypersecretion. This report concerns a boy who
      presented only with arrested puberty and growth failure as physical evidence of
      Cushing's syndrome and showed rapid progression of puberty once pituitary
      adenomas were removed.

PMID- 8348227
TI  - A general strategy for glycoprotein oligosaccharide analysis.

PMID- 8348228
TI  - Analysis of bacterial glycoproteins.

PMID- 8348229
TI  - Isolation and fractionation of glycoprotein glycans in small amounts.

PMID- 8348230
TI  - High-mannose chains of mammalian glycoproteins.

PMID- 8348231
TI  - Release of O-linked glycoprotein glycans by endo-alpha-N-acetylgalactosaminidase.

PMID- 8348232
TI  - Immunological detection of glycoproteins on blots based on labeling with
      digoxigenin.

PMID- 8348233
TI  - Analysis of asparagine-linked oligosaccharides by sequential lectin-affinity
      chromatography.
AB  - Various immobilized lectins can be successfully used for fractionation and for
      structural studies of asparagine-linked sugar chains of glycoproteins (see Note
      9). This method needs < 10 ng of a radiolabeled oligosaccharide prepared from a
      glycoprotein by hydrazinolysis or by digestion with endo-beta-N
      acetylglucosaminidases. The fractionation and the structural assessment through
      the use of immobilized lectins make the subsequent structural studies much
      easier.

PMID- 8348234
TI  - Glycosyltransferases as tools in cell biological studies.

PMID- 8348235
TI  - Purification of the EGF receptor for oligosaccharide studies.

PMID- 8348237
TI  - Secreted mucus glycoproteins in cell and organ culture.

PMID- 8348236
TI  - Analysis of sulfated polysaccharide conjugates.

PMID- 8348238
TI  - Preparation of polyclonal antibodies to native and modified mucin antigens.

PMID- 8348239
TI  - The application of lectins to the study of mucosal glycoproteins.

PMID- 8348241
TI  - Scanning tunneling microscopy of biopolymers.

PMID- 8348242
TI  - Sequence and linkage analysis of N- and O-linked glycans by fast atom bombardment
      mass spectrometry.

PMID- 8348240
TI  - Detection of tumor-associated expression of carbohydrate-binding proteins
      (lectins). The use of neoglycoproteins and neoglycoenzymes in glycohistochemical
      and glycocytological studies.

PMID- 8348243
TI  - Gas chromatography and gas chromatography-mass spectrometry of glycoprotein
      oligosaccharides.

PMID- 8348244
TI  - Microscale sequencing of N-linked oligosaccharides of glycoproteins using
      hydrazinolysis, Bio-Gel P-4, and sequential exoglycosidase digestion.

PMID- 8348245
TI  - Analysis of sugar chains by pyridylamination.

PMID- 8348246
TI  - Analysis of carbohydrates in glycoproteins by high-performance liquid
      chromatography and high-performance capillary electrophoresis.

PMID- 8348247
TI  - The microanalysis of glycosyl-phosphatidylinositol glycans.

PMID- 8348248
TI  - Low IgG4 concentrations in infants with Haemophilus influenzae type b infections.
AB  - Haemophilus influenzae type b causes considerable morbidity and mortality in
      infants and young children. Immunity to this organism has been attributed in part
      to the formation, and increase with age, of antibodies to the capsular
      polysaccharide of the bacteria. A degree of immunodeficiency could explain why
      some infants and young children develop invasive haemophilus disease. In this
      study we investigated immunocompetence in ten infants with invasive haemophilus
      disease. We found normal lymphocyte mitogen responses, neutrophil iodination and
      bactericidal and fungicidal capacities in this group. While we found no
      deficiencies of any of the immunoglobulin classes, three patients had low
      concentrations of IgG4 and two of them had low concentrations of IgG2 as well.
      These findings suggest that in some infants who develop haemophilus infections,
      the measurement of IgG subclasses may reveal immune defects that would not
      otherwise be apparent.

PMID- 8348249
TI  - Increase in platelet count following short course therapy with recombinant alpha
      2b-interferon in immune thrombocytopenic purpura in childhood.
AB  - Two boys, aged three and seven years with immune thrombocytopenic purpura
      continued to show platelet counts below 20,000/mm3 inspite of treatment with high
      dose gammaglobulin and steroids. Alpha-2b-interferon injections were followed by
      normalisation of platelet counts in both patients. No side effects were seen.
      Alpha-interferon may be a safe and effective treatment for childhood-ITP.

PMID- 8348250
TI  - Development of immune response markers in the trachea in the fetal period and the
      first year of life.
AB  - Immunoglobulin (Ig)-producing cells, T cells (CD3) and epithelial expression of
      secretory component (SC) and HLA class II determinants (DR, -DP, -DQ) were
      studied by immunohistochemistry in 16 fetal and 15 postnatal specimens from the
      tracheal wall. Small amounts of secretory component (SC) was present in the
      tracheal surface and gland epithelium in the fetal period and increased towards
      term. A few IgM-, IgD- and IgG-producing cells were present in some fetal
      specimens but no IgA- and IgE-producing cells were found. Only very few CD3+ T
      cells were present in fetal specimens and intraepithelial T-cells were virtually
      absent until after birth. Premature infants that lived for 1 week had less SC
      epithelial expression than mature infants of the same age. The density of CD3+ T
      cells, IgA-, IgM-producing cells as well as the epithelial SC expression
      increased rapidly after birth. Epithelial MHC class II expression was absent in
      fetal specimens. HLA-DR was detected on the apical border of the surface
      epithelium one week after birth and was extensively expressed throughout the
      remaining postnatal period. Epithelial DP and PQ expression were virtually absent
      during this same period. These features probably reflect local activation of the
      immune system in response to environmental factors.

PMID- 8348251
TI  - Serum immunoglobulin G subclasses and serum immunoglobulin A in acute
      bronchiolitis in infants.
AB  - Serum IgG subclasses and Serum IgA were studied in 43 infants with acute
      bronchiolitis and 20 healthy infants. IgG subclasses were determined by a capture
      ELISA and IgA was quantified by turbidimetry. IgG1 concentrations were
      significantly lower in infants with bronchiolitis than in normal infants. The
      other IgG subclasses and IgA did not differ between the groups. The subgroups of
      infants with bronchiolitis who had previously suffered from otitis media or
      bronchitis, had significantly lower IgG2 than the other infants with
      bronchiolitis. The same was found for infants with bronchiolitis who had suffered
      from three or more lower respiratory tract infections. In infants who had
      suffered from upper or lower respiratory infections before the acute
      bronchiolitis, IgA was significantly higher than in infants without previous
      respiratory infections. Ten infants with bronchiolitis (23%) had IgG1 deficiency,
      that is values below the lower reference limit calculated in a population of
      healthy Norwegian infants. No healthy infants had any IgG1 deficiency. No infant
      with bronchiolitis had IgG2 or IgG3 deficiency. The low IgG1 values found in
      infants with acute bronchiolitis, may be one cause for infants to be more
      susceptible to RS virus infections.

PMID- 8348252
TI  - Responses of plasma vasoactive intestinal polypeptide to methacholine and
      exercise loading in children and adolescents with bronchial asthma.
AB  - Responses of plasma vasoactive intestinal polypeptide (VIP) to methacholine
      inhalation and to exercise loading were studied in asthmatic patients to clarify
      a significant role of the peptide. The mean of basal VIP in asthmatics was not
      significantly different from the normals. The levels were increased after FEV
      (1.0) (forced expiratory volume in a second) decreased to 80% of the baseline
      following methacholine inhalation and were returned to values similar to the
      baseline when FEV (1.0) recovered to 100%. Thirty minutes after the exercise,
      mean VIP was significantly lower in patients with the lowest FEV (1.0). These
      results suggest that VIPergic system contributes, at least partly, to relax
      constricted bronchioles in some patients with bronchial asthma.

PMID- 8348253
TI  - IgE levels in cord and capillary blood at 5 days of age.
AB  - We have determined the correlation between IgE in cord blood and capillary serum
      from 98 mature children at 5 days of age. Sixty-six per cent had no family
      history of atopy, 29% had a single and 5% a double disposition. The study showed
      a good correlation, rho = 0.75, p < 10(-5), between IgE levels in cord blood and
      capillary blood samples drawn on the 5th day of life in children both with and
      without a heredity of atopic diseases. There was no correlation between the
      concentrations of cord blood IgE and IgA.

PMID- 8348254
TI  - Prediction of allergy from family history and cord blood IgE levels. A follow-up
      at the age of 5 years. Cord blood IgE. IV.
AB  - Screening of total IgE in 1189 cord blood samples was conducted by Phadebas IgE
      PRIST in a one-year birth cohort 1983-1984 in Viborg, Denmark. 113 children with
      cord blood IgE levels > or = 0.5 kU/l and 138 children chosen at random among
      those with cord blood IgE levels < 0.5 kU/l were seen at a follow-up at 5 years
      of age. Based upon history and physical examination a diagnosis of definite atopy
      or no atopy was established. Allergy (IgE mediated) was defined as atopic disease
      combined with increased total IgE levels at 5 years of age. The cumulative
      prevalence of atopic disease was not influenced by cord blood IgE levels or
      atopic predisposition. Cord blood IgE levels had a low sensitivity as a predictor
      of atopic disease. A statistically significant correlation between serum levels
      of IgE at birth and at 5 years was however found (p < 0.001), and a significantly
      greater number of children with elevated cord blood IgE levels developed allergic
      disease before 5 years of age (p < 0.01). A cut-off limit of 0.3 kU/l was
      superior to the originally suggested limit of 0.5 kU/l. A total IgE level > 63
      kU/l (geometric mean + 1 SD) at the age of 5 years can be regarded as being an
      elevated level. A cord blood IgE level > or = 0.3 kU/l in combination with atopic
      predisposition was predictive of allergic disease, especially allergic bronchial
      asthma. With regard to allergic disease, the positive predictive value was 26%,
      the sensitivity 33% and the rate ratio for development of allergic disease
      4.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348255
TI  - Immune defense to dietary cow milk in healthy infants.
AB  - The healthy young infant is immunologically adapted to receiving vast amounts of
      antigens in diet. At the age of 6 months, nine infants were put on a CM
      elimination diet for 3 weeks and then challenged with CM. Gut immune response was
      evaluated indirectly with ELISPOT assay at 6 months, after CM elimination (Day 1)
      and challenge (Day 8), and at 11 months. CM elimination decreased the numbers of
      immunoglobulin secreting cells (ISC): in the IgM class from mean [95% CI] 4969
      [2555, 9653] at 6 months to 1716 [1024, 2873]/10(6) cells on Day 1 (t = 3.14, p =
      0.01); and in the IgG class from 5547 [3562, 8630] to 2684 [1383, 5208]/10(6)
      cells (t = 3.29, p = 0.01). CM challenge further reduced inter-individual
      variation, and at 11 months the scatter of ISC was comparable to that at 6
      months. Specific antibody-secreting cells of the IgA and IgG class were seen at 6
      months and again at 11 months, while specific IgM-secreting cells persisted
      throughout the dietary manipulation. The results indicate that diet profoundly
      affects the immune defense system, and further suggest that a focused immune
      response is vital in acquisition of tolerance to dietary antigens.

PMID- 8348256
TI  - Multicenter study with ketotifen (Zaditen) oral drop solution in the treatment of
      wheezy children aged 6 months to 3 years.
AB  - One hundred and seven chronically wheezing infants, aged 6 months to 3 years,
      completed a double-blind placebo controlled multicenter study. After a two-week
      baseline period the patients were randomized into two groups receiving twice
      daily either ketotifen or placebo for a period of 12 weeks. The ketotifen dosage
      was 0.5 mg for children younger than one year and 1 mg for the older. During the
      12-week treatment period the patients from the two groups demonstrated gradual
      improvement of the disease severity parameters, as compared with the baseline
      period. The amelioration was more marked in the ketotifen treated patients and
      during the 0-4, and 4-8 weeks of treatment a significant decrease was achieved in
      the percentage of days with a cough (p < 0.04) and in the number of wheezing
      episodes (p = 0.02). Moreover, a 50% reduction of the days and nights with cough
      and in the number of wheezing episodes occurred earlier in the ketotifen than in
      the placebo treated patients, i.e. after 1.2 vs 4.6; 4.4 vs 8.6 and 5.2 vs 7.2
      weeks, respectively. It should be stressed that the amelioration of the asthmatic
      morbidity in the ketotifen group was achieved with a significantly reduced need
      for the concomitant use of bronchodilators. The principal side effects observed
      were weight gain and transient sedation. It is concluded that ketotifen may be
      effective in the amelioration of asthma associated symptomatology and
      acceleration in the natural tendency for improvement in chronic wheezing infants.

PMID- 8348257
TI  - Systemic meningococcal infections in patients with acquired complement
      deficiency.
AB  - Congenital deficiency of the late components of the complement may predispose the
      individual to systemic meningococcal infection. Assuming that patients with
      acquired complement deficiencies may also have an increased risk of contracting
      meningococcal infections, a retrospective and prospective study to assess this
      association was conducted. Over 20 years (1970-1989), 30 patients with
      meningococcemia or meningococcal meningitis, proven by blood or CSF culture, were
      treated at the Beilinson Medical Center. Only one patient died of the infection.
      Risk factors were found in three patients (10%). One had a congenital deficiency
      of C7, and two had acquired complement deficiency due to systemic lupus
      erythematosus (SLE) and membranoproliferative glomerulonephritis (MPGN). These
      latter two patients had low serum concentration of C3 and C4 and reduced
      complement hemolytic activity before onset of the infection. Since the incidence
      of culture-proven systemic meningococcal infection in the Jewish population in
      central Israel is 1/100,000, and the prevalence of SLE and MPGN is, at most,
      250/100,000, the finding of two patients with meningococcal infection and these
      rare disorders is over 100 times the expected incidence. We conclude that
      patients with acquired complement deficiency are at significant risk of
      meningococcal infection.

PMID- 8348258
TI  - Sensitization and development of tolerance via the gut.

PMID- 8348260
TI  - Mechanisms of mucosal immunology and gastrointestinal damage.

PMID- 8348259
TI  - Age-related antibody response to food antigens.

PMID- 8348261
TI  - Intestinal permeability in children of different ages and with different
      gastrointestinal diseases.

PMID- 8348262
TI  - Fibre-optic techniques for investigation of gastrointestinal diseases in
      children.

PMID- 8348263
TI  - The immune system of the gastrointestinal tract.

PMID- 8348264
TI  - Markers of endothelial perturbation and damage.

PMID- 8348266
TI  - Antiribosomal P protein antibodies in different populations of patients with
      systemic lupus erythematosus.
AB  - We report a significantly increased prevalence of antiribosomal P protein
      antibodies in Malaysian Chinese patients (38%) with SLE compared to white
      Caucasian (13%) and Afro-Caribbean (20%) patients. The increased prevalence was
      not due to a generalized increase in autoantibody production because anti-dsDNA
      and anti-SSA antibodies were present in comparable frequencies in the three
      ethnic groups while anti-Sm and anti-SSB antibodies were rarely found in the
      Malaysian Chinese patients.

PMID- 8348265
TI  - Effects of glucocorticoids and chronic inflammatory stress upon anterior
      pituitary interleukin-6 mRNA expression in the rat.
AB  - During development of adjuvant arthritis (AA) in the rat, anterior pituitary
      interleukin-6 (IL-6) mRNA expression was increased. Following adrenalectomy and
      AA there was a further increase in the accumulation of pituitary IL-6 transcript.
      Corticosterone (B) replacement in adrenalectomized (ADX) animals resulted in a
      dose-dependent reduction in pituitary IL-6 mRNA accumulation, while in ADX plus
      AA animals these effects of B were less marked. Cyclosporine A (CsA) markedly
      reduced the AA-induced increase in IL-6 mRNA. These data are consistent with an
      immunologically-mediated activation of pituitary IL-6 mRNA in AA, which may
      contribute to the increased activity of the pituitary-adrenal axis seen in this
      condition.

PMID- 8348267
TI  - Lymphocyte subpopulations analysis in peripheral blood in polymyalgia
      rheumatica/giant cell arteritis.
AB  - The phenotypic characteristics of peripheral blood lymphocytes were investigated
      in 22 patients suffering from active polymyalgia rheumatica/giant cell arteritis
      (PMR/GCA) prior to steroid treatment. We observed a significant reduction in the
      absolute number and the relative percentage of CD4-, CD8+ and CD3+, CD16+ and/or
      CD56+ cells compared to controls. Fifteen patients were investigated
      prospectively over a 6-month period of prednisone therapy. At the end of the
      study CD4-CD8+ cells had increased significantly compared to baselines, CD3+
      CD16+ and/or CD56+ cells remained significantly lower when compared to controls.
      We did not observe any abnormalities in the absolute number and percentage of HLA
      DR+ T lymphocytes, CD5+ B cells and NK cell phenotypes before or during steroid
      treatment. Our study confirms that there was significant increase in the absolute
      number of CD8+ T cells during steroid treatment in the PMR/GCA patients, but
      indicates the persistence of an immunological alteration despite the control of
      disease manifestations.

PMID- 8348268
TI  - Mast cells in the synovium and synovial fluid in osteoarthritis.
AB  - SF and synovium from normal individuals and patients with OA, RA and traumatic
      arthritis (TA) were studied for the presence of mast cells (MC). When compared
      with normals, patients with OA had large numbers of intact and degranulated MC in
      the synovium and SF of diseased joints. The numbers of MC are comparable with
      those in RA where they have been implicated in the pathogenesis of joint damage.
      These data raise the possibility that in OA too MC may participate in the
      pathological processes in articular and periarticular tissues.

PMID- 8348269
TI  - Hepatitis C virus and essential mixed cryoglobulinaemia.
AB  - Clinical and laboratory evidence of liver involvement are frequently found in
      essential mixed cryoglobulinaemia (EMC). We looked for evidence of hepatitis C
      virus (HCV) infection in 37 patients with EMC. Anti-HCV antibodies (Ab) were
      found in 16/37 (43%) patients with EMC using the ELISA 2 test and the RIBA 2
      test. The 16 anti-HCV-Ab positive patients (group 1) were compared to the 21 anti
      HCV-Ab negative patients (group 2). Group 1 patients had more frequent cutaneous
      involvement (P = 0.02), clinical, biological and histologic hepatic involvement
      (P < 0.01), higher serum cryoglobulin and lower CH50 levels (P < 0.001). Serum
      hepatitis B virus markers were infrequent in both groups and no patient from
      either group had detectable serum HBV DNA. These preliminary results suggest that
      HCV may be another cause of mixed cryoglobulinaemia.

PMID- 8348270
TI  - A controlled study of sacroiliitis in Behcet's disease.
AB  - Radiographs of the sacroiliac joints of 34 patients with Behcet's disease were
      read blind by a senior radiologist. They were compared with those from 25
      controls, 14 of whom were healthy. The remainder (11) had other rheumatological
      disorders including six who had AS. One patient with Behcet's disease had
      radiologically proven sacroiliitis only but her history was atypical and she was
      B27 positive. All patients with AS had definite sacroiliitis. Five out of 34
      patients with Behcet's disease and four of 25 controls (three healthy, one with
      SLE) had equivocal sacroiliitis. Whilst appreciating that the numbers in this
      study are not large, we find no evidence of an increased prevalence of
      sacroiliitis in Behcet's disease.

PMID- 8348271
TI  - Pyogenic sacroiliitis in Qatar.
AB  - We describe our experience in handling six cases of pyogenic sacroiliitis. Two
      were males and four were females with a mean age of 24.9 years. None had a
      history of i.v. drug abuse. Blood cultures were positive in half of the patients.
      The sacroiliac joint aspirate was positive in one additional patient.
      Staphylococcus aureus was recovered from three of four culture positive cases.
      Bone and CT scans revealed abnormalities in all patients. Response to antibiotic
      therapy was satisfactory in all except one patient who had an early relapse.
      Early diagnoses and proper treatment would result in improved outcomes.

PMID- 8348272
TI  - Sacral stress fracture after liver transplantation.
AB  - Sacral insufficiency fractures have been related to osteoporosis and steroid
      therapy, however only one case has been reported following liver transplantation.
      We describe three patients who developed insufficiency fractures of the sacrum
      following liver transplantation, these fractures could be overlooked or confused
      with inflammatory processes involving the sacrum.

PMID- 8348273
TI  - Intra-articular inclusions of the cervical synovial joints.
AB  - Two hundred and ten cervical synovial joints from 15 adult vertebral columns were
      studied by dissection to determine the form, dispositions and prevalence of intra
      articular inclusions. Three types of inclusions were found. Fat pads occurred
      regularly in the atlanto-occipital joints but rarely in the zygapophysial joints.
      Capsular rims occurred occasionally at all levels. Fibro-adipose meniscoid
      occurred regularly in the atlanto-axial and zygapophysial joints. The function of
      fibroadipose meniscoids seems to be to protect the articular cartilages in
      gliding joints that subluxate during normal movement. Arguments are raised that
      these structures may act as a nidus for intra-articular fibrosis, and that
      meniscus extrapment may be a mechanism for torticollis.

PMID- 8348274
TI  - Normal paraspinal muscle electromyographic fatigue characteristics in patients
      with primary fibromyalgia.
AB  - Paraspinal muscle fatigue mechanisms were compared in 14 primary fibromyalgia
      patients and 14 age and sex matched normal subjects using a standardized 60-s
      isometric endurance test of the paraspinal muscles, during which surface
      integrated electromyographic (IEMG) activity was recorded. Fatigue-induced IEMG
      increases were similar for both groups during the initial 40 s (up to 112 +/- 20%
      and 111 +/- 6% of initial values in patients and normal subjects respectively).
      Thereafter, IEMG fell significantly in patients (P < 0.05) but only slightly in
      controls, so that at 58 s IEMG was 102 +/- 13% in patients and 109 +/- 12% in
      controls. If patients were divided according to body mass index (BMI, range 19-25
      in controls) those with a BMI < 26 (n = 5) showed IEMG changes similar to those
      of control subjects throughout the test, while obese patients with BMI > 26 (n =
      9) showed greater IEMG declines after 40 s than either normal subjects or in the
      fibromyalgia group as a whole. Paraspinal muscle fatigue mechanisms appear normal
      in primary fibromyalgia patients. Isometric force maintenance in overweight
      patients, despite IEMG declines, illustrates the action of intrinsic fatigue
      resistance mechanisms which were presumably utilized to a greater extent in these
      patients to cope with the extra load.

PMID- 8348275
TI  - Factors predicting death, survival and functional outcome in a prospective study
      of early rheumatoid disease over fifteen years.
AB  - Sixty-four survivors from a prospective study of early rheumatoid disease were
      assessed again at a mean of 15.2 years from presentation and their status
      compared with 29 patients who had died. Eleven of the dead and only two of the
      survivors had been treated with steroids. There was a small increase in mortality
      due to the disease itself but only one death was directly caused by it. As might
      be expected, those who died were older. In the first year of disease, they had
      lower haemoglobin levels, a lower body mass, higher sedimentation rates and
      higher levels of blood urea. One-fifth at entry to the study and two-fifths by
      the time of death, had poor functional capacity. Of 64 survivors, six had poor
      functional capacity at entry and nine after 15 years. Discriminant analysis was
      performed to identify the most powerful combination of early features predicting
      a poor functional outcome. A combination including early erosive change,
      seropositivity, poor grip strength and cervical subluxation predicted the outcome
      correctly in 73% of survivors. Almost 60% of survivors remained with or improved
      to normal function at 15 years suggesting that morbidity is not as bad as has
      been suggested in the past.

PMID- 8348276
TI  - An evaluation of the Health Assessment Questionnaire in long-term longitudinal
      follow-up of disability in rheumatoid arthritis.
AB  - We have used the Health Assessment Questionnaire (HAQ) to follow changes in
      disability in an unselected group of 245 patients with RA. The HAQ has been
      widely used in cross-sectional studies of disability in RA, but little is known
      about the dynamics of the change in HAQ score with long term follow-up. If it is
      to prove useful as a measure of health outcome it must not only be able to
      accommodate a wide range of disability but also show adequate sensitivity to
      change in disability. We administered the HAQ to 245 RA inpatients and
      outpatients at the beginning and end of a 5-yr period to address this important
      question. The mean change in individual HAQ score in the 175 patients for whom
      complete data was available was +0.18 (SD 0.66) over 5 yr, i.e. 0.03 units per
      year. It is likely that the observed rate of change in HAQ score is an under
      estimate of the true rate of progression of disability, as the scale failed to
      accommodate change in disability toward its upper limit. The inherent design of
      the HAQ creates several 'ceilings' in functional subcategories (such as lower
      limb function) which may be masked by the overall HAQ score. Longitudinal studies
      of disability using the HAQ as outcome measure should therefore be interpreted
      with caution, and close attention paid to the baseline HAQ score.

PMID- 8348277
TI  - Intramuscular methylprednisolone is superior to pulse oral methylprednisolone
      during the induction phase of chrysotherapy.
AB  - In a randomized double-blinded placebo-controlled trial, 41 patients with RA
      starting on i.m. sodium aurothiomalate (SAT) therapy were randomized to receive
      three doses of either 500 mg methylprednisolone (MP) orally and a placebo
      injection or 120 mg of i.m. depot methylprednisolone acetate (MPA) and oral
      placebo tablets at 4-weekly intervals. Disease activity was assessed by visual
      analogue scale (VAS) of pain, grip strength (GS), tender joint count (JC), and
      Health Assessment Questionnaire (HAQ). Laboratory assessment was by haemoglobin
      concentration (Hb) and ESR. A composite index of Disease Activity score (IDA) was
      constructed using all six measurements. The group receiving i.m. MPA showed
      greater improvement when compared with the group receiving oral MPA. These
      changes were statistically significant (P < 0.05) for ESR (weeks 2, 6, 8, 10,
      12), VAS (week 4, 6, 8), JC (weeks 2, 4, 6, 8, 10) and HAQ (weeks 2, 8, 10).
      Statistically significantly (P < 0.05) greater improvement in Hb was seen
      throughout all time points in favour of the group treated with i.m. MPA. Using
      the IDA score to summarize the results, patients treated with i.m. MPA had better
      disease remission from weeks 2-12. In all measures, except Hb, no statistically
      significant difference between the two groups was seen by 16 weeks. We conclude
      that 120 mg i.m. depot MPA is more effective at inducing improvement in disease
      activity than 500 mg of oral MPA in RA patients starting on SAT therapy.

PMID- 8348278
TI  - A double-blind study of the effectiveness of low level laser treatment of rotator
      cuff tendinitis.
AB  - Thirty-five patients with rotator cuff tendinitis were randomly allocated to
      active (CB Medico Master III 830 nm Ga As AL diode) laser or dummy laser
      treatment twice weekly for 8 weeks. Movement range, painful arc score, resisted
      movement score and responses to visual analogue scales for night pain, rest pain,
      movement pain and functional limitation were measured second weekly. All
      responses improved from baseline but there was no difference between the two
      groups. These results fail to demonstrate the effectiveness of laser therapy in
      rotator cuff tendinitis.

PMID- 8348279
TI  - A double-blind trial comparing subacromial methylprednisolone and lignocaine in
      acute rotator cuff tendinitis.
AB  - Fifty-five patients with shoulder pain due to rotator cuff tendinitis of less
      than 12 weeks' duration were randomized to receive either 40 mg
      methylprednisolone and lignocaine or lignocaine alone. No statistically
      significant difference could be discerned between the two groups during 12 weeks
      of follow-up.

PMID- 8348280
TI  - A 6-month randomized dose range study of OM-8980 in rheumatoid arthritis.
AB  - Sixty patients with active RA were evaluated over 6 months in a double-blind
      randomized dose range multicentre study comparing the efficacy and tolerance of
      three different doses of the slow-acting anti-rheumatic bacterial extract OM-8980
      (6, 24 and 48 mg of active principle). No patients were withdrawn during the
      study. At the end of the 6-month trial, significant improvements were observed
      for the different RA signs and symptoms (Ritchie index, morning stiffness,
      swollen joints, grip strength, ESR, pain scale and categories) as well as for the
      concomitant intake of symptomatic drugs in the 24-mg dose group with respect to
      the 6-mg group and without significant differences between the 24- and 48-mg
      groups. Tolerance was very good with nine minor and transient side effects (five
      itching and four diarrhoea) reported altogether by seven patients, without
      establishment of a dose-effect correlation. In conclusion, the two higher doses
      of OM-8980, 24 and 48 mg, were significantly more efficient than 6 mg, with the
      effect of the 24-mg dose being even slightly superior to the 48-mg dose,
      confirming the former as the optimal and well-tolerated dose for the treatment of
      RA.

PMID- 8348282
TI  - Recurrent polyarthritis in a young woman with an ileoanal pouch for ulcerative
      colitis.

PMID- 8348281
TI  - Methotrexate--the relationship between dose and clinical effect.
AB  - Methotrexate (MTX) is an effective anti-rheumatic drug. Despite its frequent use,
      the relationship between different MTX doses and clinical effects remain unclear.
      In a randomized double-blind study in patients with RA, the effects of four MTX
      doses (5 to 20 mg) was studied. MTX (5 mg) induced a significant effect on the
      Ritchie joint index, morning stiffness, pain, ESR and C-reactive protein. The
      effect of MTX on those variables was related to the dose in the range from 5 to
      20 mg MTX weekly. Interindividual differences in dose-response curves were
      observed. The study shows that MTX doses should be adjusted individually for each
      patient in order to improve efficacy and decrease dose-dependent side effects.

PMID- 8348283
TI  - Chronic idiopathic mediastinal fibrosis presenting with malaise, pleuritis and
      thoracic back pain.
AB  - A patient with chronic idiopathic mediastinal fibrosis (MF) without concomitant
      retroperitoneal fibrosis is reported. He presented with pleuritis, malaise and
      pain and stiffness in the thoracic spine. During the 3.5 years of observation no
      clinical signs of obstruction of adjacent visceral structures in the chest cavity
      have developed. The diagnosis was made by CT, X-rays of the chest remained normal
      throughout the observation period, except for thickening of the involved pleura.
      The administration of high doses of oral corticosteroids did not appear to
      influence either clinical symptoms or the manifestations of MF as seen by CT.

PMID- 8348284
TI  - Sclerotherapy as treatment of recurrent bleeding from upper gastrointestinal
      telangiectasia in CREST syndrome.
AB  - A case of CREST syndrome is reported with recurrent bleeding from oesophageal
      telangiectasia which required repeated blood transfusions. No other cause for the
      haemorrhage was found. This complication was effectively treated by sclerotherapy
      with no recurrence of bleeding over a 12-month period of follow up.

PMID- 8348285
TI  - British Society for Rheumatology meeting report. Special interest group for
      orthopaedic medicine/soft tissue rheumatism. 26 March 1992.

PMID- 8348286
TI  - Differentiating persistent from self-limiting symmetrical synovitis in an early
      arthritis clinic.

PMID- 8348287
TI  - Abnormal fibrinolysis in chronic low back pain.

PMID- 8348289
TI  - Muscular involvement in systemic rheumatoid vasculitis.

PMID- 8348288
TI  - Necrotizing glomerulonephritis as a complication of rheumatoid arthritis
      vasculitis.

PMID- 8348291
TI  - Salmonella lomita spondylodiscitis.

PMID- 8348290
TI  - Effects of intravenous aminopropylidene bisphosphonate in patients with
      refractory Paget's disease.

PMID- 8348292
TI  - Metabotropic receptor stimulation coupled to weak tetanus leads to long-term
      potentiation and a rapid elevation of cytosolic protein kinase C activity.
AB  - We have previously shown that short-term potentiation (STP) inducing weak tetanus
      induces long-term potentiation (LTP) when it is coupled with activation of
      metabotropic glutamate (mGlu) receptors by trans-(+/-)-1-amino-1,3
      cyclopentanedicarboxylic acid (t-ACPD) in rat CA1 slices. In the present study,
      we examined if this conversion of STP to LTP involves activation of protein
      kinase C (PKC). Two minutes but not 30 min after coupling, there was a
      significant increase in the activator-dependent PKC activity in the cytosolic
      fraction. STP induction or t-ACPD application did not change PKC activity. There
      was no activity increase in the membrane fraction. STP was also induced by a co
      application of gamma-amino-3-hydroxy-5-methyllisoxazole-4-propionic acid (AMPA)
      and N-methyl-D-aspartic acid (NMDA). Coupling this STP with t-ACPD, however, did
      not result in an LTP or PKC activity increase, indicating a requirement for
      synaptic activity. A rapid and transient (< 5 min) increase in cytosolic PKC
      activity was also seen after the induction of LTP by stronger tetanic
      stimulation. No LTP tested in the present study was accompanied by activator
      independent, persistent increases in PKC activity. STP induction depends on NMDA
      receptor activation, and the activation of mGlu receptors results in the
      production of intracellular second messengers. Our results therefore indicate
      that these separate components may add and bring about PKC activation and LTP.

PMID- 8348294
TI  - Regional and temporal variations in the accumulation of unesterified fatty acids
      and diacylglycerols in the rat brain during kainic acid induced limbic seizures.
AB  - These experiments tested the hypothesis that limbic seizures induced by kainic
      acid (KA) activate mechanisms (e.g. phospholipase) that degrade the cell
      membrane, causing a release and accumulation of free fatty acids (FFAs) and
      diacylglycerols (DGs) in brain areas susceptible to seizure-related damage. The
      possible link between these effects on lipids and the subsequent development of
      seizure-related brain damage was investigated by studying the temporal and
      regional relationship between alterations in lipids in the hippocampus, frontal
      cerebral cortex, amygdala, striatum and cerebellum, and the development and
      severity of seizures. Rats were treated with 10 mg/kg KA (s.c.) and sacrificed by
      head focused microwave irradiation at 1 h, 2 h, 24 h, or 7 days. Levels of FFAs
      and DGs were determined by gas liquid chromatography (GLC). Brain regions from
      control rats differed markedly in the content and composition of both FFA and DG
      pools. Changes in FFAs and DGs during KA-induced limbic seizures also varied from
      region to region and over time after drug treatment. The largest increases in
      FFAs in amygdala, striatum, cortex and hippocampus occurred during the peak of
      seizure activity. Although DG levels were altered in some areas at some time
      points, there was no apparent correlation between changes in DGs and seizure
      severity. However, increases in DGs occurred at later time points, coincident
      with the occurrence of neuronal cell loss in amygdala, cortex, hippocampus and
      striatum. These data indicate that limbic seizures activate the accumulation of
      FFAs through increased neuronal activity, while accumulation of DGs may be
      related to the development of seizure-related brain damage.

PMID- 8348293
TI  - Taurine transport in rat astrocytes adapted to hyperosmotic conditions.
AB  - [3H]Taurine uptake and release was characterized in astrocytes from rat cerebral
      cortex grown in normal and hyperosmotic culture conditions to investigate
      mechanisms of cell volume regulation and adaptation to states of altered
      osmolality. In high concentrations of taurine (1 mM), uptake was linear in both
      osmotic conditions for at least 30 min. The uptake rate in 1 mM taurine was not
      affected by exposure to hyperosmotic conditions. The mean +/- S.E.M. apparent
      binding constant for carrier-mediated taurine transport, Km, was not altered by
      hyperosmotic conditions (22.8 +/- 5.1 microM in iso-osmotic media, 21.3 +/- 11.9
      microM in hyperosmotic media). However, maximal velocity of uptake, Vmax (mean +/
      S.E.M.), of taurine was significantly lower in hyperosmotically treated
      astrocytes (0.175 +/- 0.035 nmol/mg protein.min) compared with the Vmax of iso
      osmotically treated astrocytes (0.299 +/- 0.026 nmol/mg protein.min). The
      diffusional transport rate, Kdiff, was not affected by growth in hyperosmotic
      conditions (0.221 +/- 0.033 microliter/mg protein.min in iso-osmotic media, 0.295
      +/- 0.043 microliter/mg protein.min in hyperosmotic media). Taurine release rate,
      expressed as a percent of the total cell content, was not affected by
      hyperosmotic exposure. However, astrocytes grown in hyperosmotic conditions
      contain nearly 60% more taurine than control cells. Thus, the absolute rate of
      taurine release (mean +/- S.E.M.) was significantly larger (P < 0.05) in
      hyperosmotic cells (0.1592 +/- 0.0082 nmol/mg protein.min) compared with control
      cells (0.0943 +/- 0.0096 nmol/mg protein.min). Quantitative analysis of these
      data indicate that maintenance of elevated taurine contents by cultured cerebral
      astrocytes exposed to hyperosmotic conditions is not due to alterations in rates
      of transport.

PMID- 8348295
TI  - Neuronal 'differentiation' of murine neuroblastoma cells induced by
      neocarzinostatin: neural cell adhesion molecules.
AB  - Neural crest tumor cells which have been pharmacologically induced in culture to
      undergo neuronal 'differentiation' have been proposed as a model for normal
      neural crest cell differentiation. We have previously reported that murine
      neuroblastoma cells treated with the antineoplastic agent neocarzinostatin (NCS)
      adopt the light microscopic appearance of differentiated neurons. After
      undergoing morphologic change, the cells no longer divide. As part of an effort
      to compare the process of differentiation in these cells with what is known about
      normal neural crest cells, we have examined the cellular distribution and isoform
      complement of neural cell adhesion molecules (NCAMs) in native and NCS-treated
      neuroblastoma cells. Our studies show that NCS induces profound changes in NCAM
      distribution. Immunohistochemical staining indicates that, in contrast to native
      neuroblastoma cells, more than 80% of treated cells display surface NCAM by 4
      days following treatment. Unlike the case for normal neurons, NCAM is uniformly
      distributed over the treated cell surface. Neuroblastoma cells treated with NCS
      are more avidly adherent to culture plates coated with NCAM than are control
      neuroblastoma cells, reflecting the homophilic binding characteristics of NCAM.
      Interestingly, Western blot analysis for NCAM demonstrates similar total cellular
      content of a single NCAM species in both control and treated neuroblastoma cells.
      Furthermore, this 120 kDa mol. wt. NCAM is an isoform of NCAM not found on
      normally differentiated cerebellar neurons. While the presence of NCAM on these
      treated murine neuroblastoma cells is evidence for 'differentiation' along
      neuronal lines, the isoform complement and cell surface distribution of NCAM in
      treated cells are not normal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348296
TI  - Interleukin-1 beta inhibits the endogenous expression of the early gene c-fos
      located within the nucleus of LH-RH neurons and interferes with hypothalamic LH
      RH release during proestrus in the rat.
AB  - The ability of central interleukin-1 beta (IL-1 beta) administration to modulate
      the hypothalamic LH-RH release as well as the endogenous expression of the c-fos
      protein located within the nucleus of LH-RH neurons was examined during the
      afternoon of proestrus in rats. In a first series of experiments, 50 or 100 ng IL
      1 beta were infused into the lateral ventricle of the rat brain at either 08.30,
      12.00, 14.30, or 17.00 h of proestrus. The animals were then perfused
      transcardially with a solution of 4% paraformaldehyde from 17.30 and 18.00 h. In
      a second series of experiments, the rats were equipped with an
      intracerebroventricular (i.c.v.) cannula in the lateral ventricle and a push-pull
      cannula into the median eminence (ME), and LH-RH secretion was measured during
      the afternoon of proestrus. The third experiment investigated the putative role
      of corticotropin-releasing factor (CRF) in modulating the inhibitory effect of IL
      1 beta on LH secretion by infusing CRF antagonists before the i.c.v.
      administration of the cytokine to gonadectomized male and female rats. The
      central infusion of 50 or 100 ng IL-1 beta at 12.00 h completely blocked the
      spontaneous expression of c-fos protein which normally occurs in the nucleus of
      LH-RH neurons between 17.30 and 18.00 h on proestrus. In contrast, 50 ng IL-1
      beta was less effective (P < 0.05) when administered at 08.30 h, and totally
      without effect when infused at 14.30 h. Infusion of 50 ng IL-1 beta also markedly
      suppressed the hypothalamic release of LH-RH in proestrus rats bearing a push
      pull cannula into the ME, and significantly decreased plasma LH levels in both
      gonadectomized male and female rats. Finally, we observed that the central
      administration of CRF antagonists did not modify the inhibitory effects of the
      cytokine on the activity of the hypothalamic-pituitary-gonadal (HPG) axis. These
      results provide the first direct evidence that IL-1 beta is a potent inhibitor of
      LH-RH neuronal activity during the proestrus LH surge in intact cycling rats. As
      central administration of this cytokine completely inhibited the endogenous
      expression of c-fos protein within the nucleus of LH-RH neurons, our findings
      also suggest that IL-1 beta acts at the level of LH-RH perikarya.

PMID- 8348297
TI  - Histamine phase shifts the circadian clock in a manner similar to light.
AB  - The mammalian circadian pacemaker in the suprachiasmatic nuclei (SCN) receives a
      dense input from histamine-containing neurons in the posterior basal
      hypothalamus. We applied histamine to SCN tissue in vitro and measured the
      subsequent rhythm in firing rate. Histamine caused a phase delay in the early
      subjective night and a phase advance in the late subjective night. The similarity
      of histamine- and photic-induced phase shifts indicates that histamine may play a
      role in the modulation of circadian clock photic input.

PMID- 8348298
TI  - Neurons in the inferior colliculus, auditory cortex and pontine nuclei of the FM
      bat, Eptesicus fucus respond to pulse repetition rate differently.
AB  - Single-neuron responses to pulse repetition rate in the inferior colliculus,
      auditory cortex and pontine nuclei of the FM bat, Eptesicus fuscus were studied
      under free-field stimulation conditions. The best frequency (BF) and minimum
      threshold (MT) of each neuron were first determined with a 4 ms pulse broadcast
      from a specific point (response center) of the bat's frontal auditory space at
      which the neuron had maximal spatial sensitivity. The neuron's intensity-rate
      function was then studied with a 4 ms BF pulse delivered at 10 dB increments
      above its MT in order to determine the best intensity to which the neuron
      discharged maximally. The neuron's discharge pattern and number of impulses to 32
      trials of 300 ms train stimuli, which consisted of different number of 4 ms BF
      and best intensity pulses (1, 2, 3, 8, 12, 19, 24, 29 pulses/train) and delivered
      at an interpulse interval of 1000, 250, 170, 100, 40, 25, 15, 12 and 10 ms (i.e.
      at a pulse repetition rate of 1, 4, 6, 10, 25, 40, 67, 83, 100 pulses/s), were
      sequentially recorded. All neurons recorded from the inferior colliculus,
      auditory cortex and pontine nuclei discharged phasically (1-3 impulses) but they
      responded to the pulse repetition rate in different manners. More than 63% of 38
      inferior collicular and 65 pontine neurons studied discharged impulses to each
      pulse within a train stimulus when the pulse repetition rate was up to 40
      pulses/s.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348299
TI  - Changes in extracellular adenosine during chemical or electrical brain
      stimulation.
AB  - The purpose of this study was to determine the changes in adenosine and adenosine
      metabolites during graded electrical stimulation or kainic acid-induced
      activation and to assess the role of adenosine in the cerebral blood flow (CBF)
      response to increased brain activity. A modified brain microdialysis technique
      was used to sample cerebral interstitial fluid (ISF), deliver drugs locally to
      the brain, electrically stimulate the brain, and measure local CBF (H2
      clearance). Microdialysis probes were implanted bilaterally in the caudate nuclei
      of ketamine-anesthetized rats. Graded electrical stimulation at 5, 15, and 30 Hz
      increased dialysate adenosine 1.5-fold, 2.3-fold, and 4.7-fold, respectively.
      Local infusion of kainic acid, an agonist of the excitatory amino acid
      neurotransmitter glutamate, produced a transient increase (2-fold) in dialysate
      adenosine and sustained increases in dialysate inosine (2-fold), hypoxanthine (4
      fold) and CBF (2.4-fold). When the adenosine receptor antagonist 8(p
      sulphophenyl)-theophylline (SPT, 10(-3) M) was co-administered with kainic acid,
      CBF increased only 1.6-fold, while the increase in dialysate adenosine was
      augmented by 40%. These data demonstrate that ISF adenosine increases during
      brain activation and suggest that adenosine contributes to active hyperemia in
      the brain.

PMID- 8348300
TI  - Interleukin-1 beta, but not interleukin-6, impairs spatial navigation learning.
AB  - The effects of the cytokines interleukin-1 and -6 (IL1 beta, IL6; 100 ng) on
      spatial learning were examined in the Morris water maze. Intracerebroventricular
      injection of IL1 or IL6 before the training on day 1 did not influence the
      acquisition of spatial navigation. However, IL1 administered at 60 min, but not
      immediately before the training, resulted in impaired performance of spatial
      navigation the following day. In contrast, IL6 administered at both times had no
      effect. In a second experiment the same doses of IL1 and IL6 increased the body
      temperature of rats in a time-related fashion. The temperature effect of IL1
      developed after a delay of 120 min, while the IL-6-effect was immediate.
      Comparable behavioral changes might accompany infections or inflammatory diseases
      and therapeutic cytokine administration.

PMID- 8348301
TI  - 2-Mercaptoethanol is a survival factor for olfactory, cortical and hippocampal
      neurons in short-term dissociated cell culture.
AB  - A medium originally designed for lymphocyte growth promoted robust survival of
      olfactory receptor neurons (ORNs) in short-term (4-day), dissociated cell
      culture. The key ingredient for survival of neurons in both serum and serum-free
      conditions was 2-mercaptoethanol (2-ME). Enhancement of survival may be thiol
      mediated because two other thiol compounds, 2-mercaptoethylamine and
      monothioglycerol, also increased ORN survival. Addition of 2-ME also
      significantly increased survival of embryonic cortical and hippocampal neurons in
      a serum-free medium, and embryonic cortical neurons in a serum-containing medium.
      After plating and growth in a serum-free medium containing 2-ME, survival of all
      three types of neurons was equivalent to, or greater than, survival in serum
      containing media. Thus, thiols such as 2-ME promote the survival of multiple
      types of neurons in short-term cell culture.

PMID- 8348302
TI  - The zitter rat: membranous abnormality in the Schwann cells of myelinated nerve
      fibers.
AB  - Ultrastructural alterations of the Schwann cells were chronologically examined in
      zitter and in control rats. The membranous abnormalities closely involving the
      nuclear membranes of the Schwann cells and mesaxons were constantly observed in
      the zitter rats. These structures consisted of scroll- or whirl-like unit
      membrane accumulations directly extending to the nuclear envelope. Occasionally,
      similar membranous structure were observed in association with the endoplasmic
      reticulum, lysosome or mitochondria in the cytoplasm of the Schwann cells. In the
      control rats, whirl-like membranous structures in the nuclear membranes of the
      Schwann cells were observed only intermittently at 1, 5 and at 7 days of age in
      the developing process. In conclusion, we postulate that the zitter rat, which is
      an established animal model for hypomyelination of the central nervous system
      (CNS), has some inherited abnormality related to the membrane biosynthesis and
      its regulation in Schwann cells as well as in oligodendrocytes.

PMID- 8348303
TI  - Electrotonic coupling between neurosecretory cells in the crayfish eyestalk.
AB  - Electrical coupling is described among neurosecretory cells in the crayfish X
      organ. By simultaneous impalements from pairs of neurons, only 30% were found to
      be coupled. All of them showed non-rectifying junctions. In all cases, electrical
      coupling corresponded to dye-coupling, as explored with intracellular injection
      of Lucifer yellow to one of the recorded cells. Some neurons were coupled to more
      than one neighbour. From dye fills it was apparent that the coupling site could
      be located far away from the cell body, immediately before the axonal branchings
      in the neuropile. The input resistance of the coupled neurons was consistently
      lower (24 +/- 16 M omega) than that of the non-coupled neurons (58 +/- 18 M
      omega). Synchronous synaptic activity was commonly recorded from coupled neurons,
      thus suggesting a functional significance of coupling in the integration of
      neurosecretory activity.

PMID- 8348304
TI  - Protein kinase inhibitors do not block the expression of established enhancement
      in identified Hermissenda B-photoreceptors.
AB  - One-trial conditioning of Hermissenda produces short- and long-term enhancement
      of generator potentials in identified type B-photoreceptors. The induction of
      short-term enhancement is blocked by kinase inhibitors and down-regulation of
      protein kinase C. We now report that established short- and long-term enhancement
      produced by one-trial conditioning is not reversed by the kinase inhibitors H-7
      or sphingosine. These results indicate that persistent protein kinase C activity
      is not required in the maintenance or expression of enhancement.

PMID- 8348305
TI  - Regulation of astrocyte proliferation by prostaglandin E2 and the alpha subtype
      of protein kinase C.
AB  - We found that astrocytes expressed the alpha subtype of protein kinase C.
      Treatment with 12-O-tetradecanoylphorbol 13-acetate (TPA) caused cultured
      astrocytes to proliferate. This effect of TPA was blocked by staurosporine, a
      potent protein kinase C inhibitor, suggesting the involvement of protein kinase C
      in astrocyte proliferation. Indomethacin, an inhibitor of prostaglandin
      formation, enhanced both the normal and TPA-induced proliferation of astrocytes.
      Authentic prostaglandin E2 blocked this effect of indomethacin and also partially
      blocked the effect of TPA, suggesting that the intracellular mechanisms involved
      in prostaglandin E2-regulated astrocyte growth might differ from those acting in
      protein kinase-dependent growth. The effect of prostaglandin E2 was blocked by a
      specific anti-prostaglandin E2 polyclonal antibody. Cultured astrocytes and
      microglia produced and released prostaglandin E2 in response to stimulants such
      as lipopolysaccharide, TPA, and lymphokines. Since the sensitivity of astrocytes
      and microglia to these stimuli was different, prostaglandin E2 may differentially
      regulate astrocyte proliferation under different physiological conditions, acting
      in an autocrine fashion for astrocytes and in a paracrine fashion for microglia.

PMID- 8348307
TI  - Angiotensin II in the spinal cord of the rat and its sympatho-excitatory effects.
AB  - Immunohistochemical studies have shown there is a dense angiotensin-like
      immunoreactivity of terminals in the sympathetic region of the thoracic and
      lumbar spinal cord. In the present study measurements were made of the
      concentration of angiotensin in the spinal cord of rats using radioimmunoassay
      following two different extraction procedures. These gave concentrations of
      angiotensin as mean of 108 and 161 pg.g-1 tissue wet weight. Angiotensin II given
      intrathecally or microinjected into the spinal cord caused an increase in
      postganglionic sympathetic nerve activity which was blocked by prior application
      of saralasin. Angiotensin III was without effect. Intracellular recordings from
      sympathetic preganglionic neurones in-vitro in slices of neonate rat spinal cord
      showed that angiotensin II produced an increase of excitability of the neurones
      by a slow depolarisation without the generation of action potentials. This effect
      still occurred in the presence of TTX. Angiotensin II also could increase
      synaptic activity, both EPSPs and IPSPs as well as a synaptically induced slow
      depolarisation being observed suggesting that presympathetic interneurones are
      also sensitive to the peptide. The evidence indicates that if angiotensin is
      released from nerve terminals surrounding sympathetic neurones it will enhance
      the gain of the neurone so that it could more easily be discharged by other
      excitatory inputs.

PMID- 8348306
TI  - B-50 (GAP-43) in Onuf's nucleus of the adult cat.
AB  - The nucleus of Onuf in the sacral spinal cord contains motoneurons that innervate
      the pelvic floor muscles and possess somatic and autonomic characteristics. We
      show in this study that in the intact adult cat, the immunocytochemical labelling
      of the nervous tissue-specific growth-associated protein, B-50 (GAP-43), which
      persists in Onuf's nucleus, differs markedly from that in the remaining 'purely
      somatic' motor nuclei of the sacral spinal cord. At the light microscopic level,
      an intense B-50 (GAP-43) immunoreactivity (B-50-IR) in the neuropil of Onuf's
      nucleus contrasts with a faint staining in the other spinal motor nuclei.
      Ultrastructurally, B-50-IR is found in Onuf's nucleus within some unmyelinated
      small diameter nerve fibres and numerous axon terminals on dendritic and somatic
      surfaces. Conversely, in all other motor nuclei only a few of these structures
      are stained. No other cellular profiles show B-50-IR in the tissue examined.
      According to the proposed functions of B-50 (GAP-43), its persistence in mature
      spinal axon terminals may indicate a latent capability of functional and
      structural remodeling, as well as an involvement in long-term enhancement in
      synaptic transmission. If so, these properties would be considerably more
      pronounced in Onuf's nucleus as compared to purely somatic motor nuclei.

PMID- 8348308
TI  - p34cdc2 homologue is located in nucleoli of the nervous and endocrine systems.
AB  - p34cdc2 protein kinase is a component of M phase-promoting factor (MPF), which
      plays an important role in controlling the mitotic and meiotic cell cycle.
      p34cdc2 contains a unique 16 amino acid sequence (PSTAIR) that is conserved from
      fission yeast to human. Using polyclonal anti-PSTAIR antibody, we detected the
      p34cdc2 homologue in the central nervous system of adult mice by western
      blotting. By immunohistochemical technique, we found that the p34cdc2 homologue
      was located in the nucleoli of neurons and glia in the central and peripheral
      nervous systems. In the central nervous system, positive cells were widely
      distributed from the cerebral cortex to the spinal cord. Immunoreactive cells
      were also detected in retina and pituitary. The evidence that the p34cdc2 is
      present in neurons which have lost the ability of cell division predicts another
      function of p34cdc2 family proteins besides the one that has generally
      recognized.

PMID- 8348310
TI  - Elevated concentrations of nerve growth factor in heart and mesenteric arteries
      of spontaneously hypertensive rats.
AB  - Considerable evidence indicates an enhanced sympathetic innervation of muscular
      resistance arteries in the spontaneously hypertensive rat (SHR) compared with its
      normotensive Wistar-Kyoto (WKY) control. Since nerve growth factor (NGF) is known
      to affect the growth of sympathetic nerves, we have utilized a sensitive two-site
      enzyme linked immunoassay for NGF to compare the NGF content of hearts and
      mesenteric arteries of developing SHR and WKY rats. NGF levels in hearts revealed
      similar, although not identical, patterns of expression. In both strains, NGF
      levels declined from postnatal day 15, the earliest age examined, to stabilize at
      adult levels by postnatal day 32. Adult SHR concentrations were similar to those
      in age matched WKY controls. In contrast, in the mesenteric vascular bed, NGF
      levels of SHR were greater than those of WKY controls at all ages above 15 days.
      Moreover, these changes in NGF occurred concomitantly with increases in vascular
      mass and medial smooth muscle hyperplasia in the SHR. Whether abnormal NGF levels
      are a cause or consequence of vascular smooth muscle growth has yet to be
      determined. These results are consistent with the hypothesis that the hyper
      noradrenergic innervation of SHR vascular tissues results from an early elevation
      of NGF gene expression.

PMID- 8348309
TI  - Protection of the axonal cytoskeleton in anoxic optic nerve by decreased
      extracellular calcium.
AB  - Since CNS white matter tracts contain axons, oligodendrocytes and astrocytes but
      not synapses, it is likely that anoxic injury of white matter is mediated by
      cellular mechanisms that do not involve synapses. In order to test the
      hypothesis, that anoxic injury of white matter is mediated by an influx of Ca2+
      into the intracellular compartment of axons, we compared the ultrastructure of
      axons in rat optic nerve exposed to 60 min of anoxia in artificial cerebrospinal
      fluid (aCSF) containing normal (2 mM) Ca2+, and in aCSF containing zero-Ca2+
      together with 5 mM EGTA. Optic nerves fixed at the end of 60 min of anoxia in 2
      mM Ca2+ exhibit extensive ultrastructural alterations including disruption of
      microtubules and neurofilaments within the axonal cytoskeleton, development of
      membranous profiles and empty spaces between the axon and the ensheathing myelin,
      and swelling of mitochondria with loss of cristae. Bathing the nerves in zero
      Ca2+ aCSF during anoxia protected the axons from cytoskeletal changes; after 60
      min of anoxia, optic nerve axons retained normal-appearing microtubules and
      neurofilaments. Membranous profiles were rare, and empty spaces between axons and
      myelin did not develop in anoxic optic nerves bathed in zero-Ca2+ aCSF.
      Disorganization of cristae in axonal mitochondria was observed in anoxic optic
      nerves even when Ca2+ was omitted from the medium. Because Ca(2+)-mediated injury
      is known to disrupt the axonal cytoskeleton, these results support the hypothesis
      that anoxia triggers an abnormal influx of Ca2+ into myelinated axons in CNS
      white matter.

PMID- 8348312
TI  - The paraventricular nucleus is uniquely responsive to the feeding stimulatory
      effects of steroid hormones.
AB  - The paraventricular nucleus is uniquely responsive to the feeding stimulatory
      effects of steroid hormones (Tempel, D.L., Kim, T. and Leibowitz, S.F. Brain
      Research 00: 000-000). This study tested the effects of hypothalamic as well as
      extrahypothalamic implants of the adrenal steroids, corticosterone (CORT) and
      aldosterone (ALDO), on food intake and macronutrient selection in sham-operated
      and adrenalectomized (ADX) rats 1 h after administration. Consistent with a
      previous experiment, implants of CORT and ALDO in the hypothalamic
      paraventricular nucleus (PVN) were effective in stimulating food intake. These
      tests, conducted at the onset of the active feeding cycle, showed PVN implants of
      CORT to potentiate specifically carbohydrate intake in ADX rats, while having no
      effect in sham rats. This was in contrast to PVN ALDO which predominantly
      stimulated fat intake in sham as well as ADX rats. Neither CORT nor ALDO had any
      effect on food intake after implantation into other hypothalamic or
      extrahypothalamic sites tested. These unresponsive hypothalamic sites were the
      dorsomedial and ventromedial nuclei, perifornical lateral hypothalamus, and
      arcuate nucleus. Extrahypothalamic sites including the dorsal CA1 region of the
      hippocampus, the central nucleus of the amygdala and the lateral septum were also
      unresponsive to steroid implants. These results identify the PVN, and the steroid
      receptors located within it, as having a specific function in mediating the
      action of CORT and ALDO on carbohydrate and fat intake, respectively.

PMID- 8348311
TI  - Regional blood-brain lactate influx.
AB  - Regional blood-to-brain lactate transport was studied in chloral hydrate
      anesthetized rats using the single pass, dual-label, indicator fractionation,
      right atrial injection method. Lactate influx was resolved into two components, a
      saturable, stereospecific (to the L-enantiomer) component and a non-saturable,
      non-stereospecific diffusional component. The saturable component was found to
      have a low efficiency and moderate capacity with transport affinity coefficients
      between 6 and 14 mM and transport maxima of 23-40 mumol/100 g/min in the various
      brain regions. Lactate transport was not inhibited by probenecid. The diffusional
      component was determined from D-lactate influx measurements and the regional
      linear diffusion coefficients ranged from 0.020 to 0.036 ml/g/min. At the usual
      levels of plasma lactate (1-1.5 mM) these two influx components were about equal.
      The relative contribution of the non-stereospecific diffusional component was
      increased at higher plasma lactate concentrations. Lactate clearance, estimated
      by the total apparent permeability x surface area products was between 6 and 8
      ml/100 g/min.

PMID- 8348313
TI  - Hyposmotic activation hyperpolarizes outer hair cells of guinea pig cochlea.
AB  - The electrophysiological responses of isolated guinea pig outer hair cells (OHCs)
      to hyposmotic activation were studied using the whole-cell patch-clamp technique.
      The cell swelling by hyposmotic activation hyperpolarized OHCs by 6.6 +/- 2.3 mV
      from the resting membrane potential of -58.5 +/- 5.9 mV (n = 48). This
      hyperpolarization was associated with an outward current (97.7 +/- 22.2 pA, n =
      15). The hyperpolarization was inhibited by 300 microM quinine, 5 mN Ba2+ and
      increasing the extracellular K+ to 30 mM from 5 mM. In the absence of
      extracellular Ca2+ (1 mM EGTA), the hyperpolarization during hyposmotic
      activation was also abolished while the following depolarization was preserved.
      50 microM GdCl3, which is known to block stretch-activated non-specific cation
      channels, inhibited the hyperpolarization reversibly. 50 microM GdCl3 also
      inhibited [Ca2+]i increase during hyposmotic activation as shown by the calcium
      sensitive dye fura-2. Simultaneously, the [Ca2+]i increase and the
      hyperpolarization during hyposmotic activation could be observed using the
      combined method of whole-cell patch clamp and fura-2 technique. It is concluded
      that the cell swelling by hyposmotic activation may activate the stretch
      activated non-specific cation channels in the OHCs which allow a Ca2+ influx. In
      turn, this [Ca2+]i increase leads to an activation of the Ca(2+)-activated K+
      channels at the basolateral membrane of OHCs which results finally in a
      reversible hyperpolarization of OHCs by K+ efflux.

PMID- 8348314
TI  - Time course of fiber outgrowth from fetal anterior hypothalamic heterografts.
AB  - Fetal anterior hypothalamic (AH) heterografts can restore circadian rhythmicity
      to animals rendered arrhythmic following ablation of the suprachiasmatic nucleus
      (SCN). Behavioral restoration of circadian activity typically begins between two
      and six weeks post-implantation. The time course of fiber outgrowth from fetal AH
      heterografts was examined to determine whether neuronal outgrowth from the
      implants precedes the typically observed effects of such implants upon circadian
      behavior. Fetal mouse or rat AH tissue containing the SCN was implanted into the
      third ventricle of SCN-lesioned hamsters. Using species-specific monoclonal
      antibodies generated against mouse or rat neuronal elements, fiber outgrowth into
      the host hypothalamus was examined at 2, 4, 7, 14, 30 and 45 days after
      implantation. Fibers were observed to have emerged from the implant at the
      earliest time point examined. Four days after surgery, individual fibers had
      extended up to 0.6 mm into the host neuropil. By 14 days post-implantation,
      outgrowth from the implant had formed a dense fiber plexus in the host
      hypothalamus. This observation demonstrates that neuronal integration of the
      implant with the host brain begins within 48 hours of implantation, and is
      extensively established well before a restoration of rhythmicity is typically
      observed. Thus, on the basis of the time course of fiber outgrowth, it is clear
      that neuronal contact between graft and host may mediate the observed restoration
      of circadian rhythmicity.

PMID- 8348315
TI  - The dorsal hippocampus modifies the negative feedback effect of glucocorticoids
      on the adrenocortical and median eminence CRF-41 responses to photic stimulation.
AB  - In the present study we have evaluated the role of the dorsal hippocampus on the
      negative feedback effect of glucocorticoids (GC) following photic stimulation. In
      hippocampectomized rats the recovery of serum corticosterone (CS) to basal levels
      following photic stimulation, was significantly attenuated in relation to sham
      hippocampectomized rats. The inhibitory effect of either systemic dexamethasone
      administration or CS implanted in the paraventricular nucleus (PVN), on the
      adrenocortical responses to photic stimulation, was completely prevented in
      hippocampectomized rats in comparison to sham operated animals. In rats with sham
      operation, the depletion of median eminence CRF-41 induced by photic stimulation,
      was prevented by pretreatment with CS PVN implants or systemic dexamethasone.
      These effects were reversed in rats with dorsal hippocampectomy. The results
      suggest that the dorsal hippocampus modulates the negative feedback of GC on the
      adrenocortical response following photic stimulation at the PVN level and this
      effect is mediated by median eminence CRF-41.

PMID- 8348316
TI  - Delayed detyrosination of alpha-tubulin from parallel fibre axons and its
      correlation with impaired synaptogenesis in hypothyroid rat cerebellum.
AB  - The biochemical basis of retarded differentiation and maturation of microtubules
      and impaired synaptogenesis in hypothyroidism has been investigated by studying
      the temporal and spatial relationship between alpha-tubulin detyrosination in the
      parallel fibre axons of rat cerebellum and alterations in the activity of the
      detyrosinating enzyme, TTCP (tubulinyl tyrosine carboxypeptidase) with the
      progress of synaptogenesis in the molecular layer. Detyrosination was monitored
      by following the disappearance of stain from cerebellar sections,
      immunocytochemically labeled with a monoclonal antibody (20C6) specific for alpha
      tubulin, tyrosinated at the C-terminal end. With respect to normal controls,
      detyrosination of alpha-tubulin from the parallel fibres of the molecular layer
      during synaptogenesis was not only delayed by about 5 days but also prolonged in
      the hypothyroid cerebellum. Correspondingly, the increase of TTCP activity in the
      developing thyroid deficient cerebellum was also delayed by about 1 week.
      Comparison of the developmental profile of TTCP activity in the normal and
      hypothyroid cerebellum during synaptogenesis revealed that the overall activity
      of the enzyme in the thyroid deficient cerebellum was reduced to almost half of
      that of the normal controls. These results establish that thyroid hormones are
      essential for the induction of TTCP, which catalyses detyrosination during the
      normal ontogenic development of rat cerebellum. Since our data also suggest that
      detyrosination precedes synaptic contacts to generate a class of differentiated
      microtubules functionally competent for synaptogenesis, the delayed
      detyrosination in the hypothyroid cerebellum may desynchronize the normal
      developmental program resulting in incomplete synaptogenesis.

PMID- 8348317
TI  - Extracellular gamma-aminobutyric acid levels in the rat caudate-putamen:
      monitoring the neuronal and glial contribution by intracerebral microdialysis.
AB  - Intracerebral microdialysis with high pressure liquid chromatography (HPLC)
      coupled to electrochemical detection was employed to characterize gamma
      aminobutyric acid (GABA) release and the effects induced by a preceding neuron
      depleting ibotenic acid (IBO) lesion in the rat caudate-putamen (CPu).
      Extracellular GABA overflow was monitored in the intact and excitotoxically
      lesioned CPu, either 7-10 days (acute) or more than 3 months post-lesioning
      (chronic), using loop type dialysis probes perfused at a rate of 2
      microliters/min. In the intact CPuu, basal GABA levels were 0.97 pmol/30
      microliters of dialysate in the awake animals and 0.76 pmol/30 microliters under
      halothane anaesthesia. In both the acute and chronic IBO lesioned CPu the
      extracellular GABA levels were reduced by 80% and 67%, respectively, under
      halothane anaesthesia. KCl added to the perfusion fluid at a concentration of 100
      mM resulted in dramatic increases in GABA overflow from baseline levels in the
      intact CPu (60- to 70-fold), which were almost totally abolished (> 95%) in the
      excitotoxically lesioned CPu. Veratridine administered at 75 microM, produced a
      45-fold increase in GABA overflow in the intact CPu, but failed to produce any
      effect in the lesioned CPu. The addition of nipecotic acid (0.5 mM), a GABA
      uptake blocker, increased basal extracellular GABA levels 6-15-fold in the intact
      CPu, while GABA overflow in either the acute or chronic lesioned CPu was not
      significantly altered. Although Ca(2+)-free conditions (with 20 mM Mg2+ added) or
      tetrodotoxin (TTX, 1 microM) did not alter the basal GABA overflow in the intact
      CPU under halothane anaesthesia, the omission of Ca2+ resulted in a 47% reduction
      in basal extracellular GABA levels in awake, freely moving animals. Nipecotic
      acid-induced GABA overflow was reduced by 22% under Ca(2+)-free conditions, and
      by 33% in the presence of 1 microM TTX. Moreover, KCl-evoked GABA overflow was
      reduced by 86% in Ca(2+)-free conditions and by 40% when administered in the
      presence of 1 microM TTX. These results indicate that the extracellular GABA
      levels recorded by intracerebral microdialysis in the CPu are derived
      predominantly from neuronal sources. Under baseline resting conditions only a
      small fraction (up to 20-30%) of the neuronal release was Ca(2+)-dependent and
      TTX-sensitive (i.e. possessing the characteristics of impulse-dependent vesicular
      release).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8348318
TI  - Induced resistance and susceptibility to cerebral ischemia in gerbil hippocampal
      neurons by prolonged but mild hypoperfusion.
AB  - Brief periods of non-lethal cerebral ischemia can induce resistance against
      subsequent lethal ischemia. In this study, asymptomatic gerbils after unilateral
      carotid artery ligation were subjected to 5 min of forebrain ischemia. The
      prolonged but mild hypoperfusion, by carotid occlusion, induced susceptibility at
      1 day and tolerance at 30 days to lethal ischemia in the hippocampal neurons. The
      neuroprotective effect correlated well with induction of heat shock protein 72 in
      the hippocampal neurons. These results suggested that neuronal cells possess a
      cellular response to sublethal hypoperfusion and can survive forthcoming ischemic
      stress.

PMID- 8348319
TI  - Responses of neurons in thalamic ventrobasal complex of rats to graded distension
      of uterus and vagina and to uterine suprafusion with bradykinin and prostaglandin
      F2 alpha.
AB  - This study examined the responses of somatic-responsive neurons in and near the
      ventrobasal complex (VB) of halothane/nitrous oxide-anesthetized and paralyzed
      estrous virgin rats to increasing levels of distension of the uterine horn and
      vaginal canal and to uterine suprafusion with PGF2 alpha and bradykinin (BK).
      While individual responses of single neurons to uterine and vaginal distensions
      were idiosyncratic, as a group the neurons responded in a graded fashion to
      graded distensions, producing stimulus-responses functions nearly identical to
      those produced by conscious rats making escape responses to the same stimuli
      [Berkley and Wood, Soc. Neurosci, Abstr., 15 (1989) 979; Berkley et al., Soc.
      Neurosci. Abstr., 16 (1990) 416]. In addition, most neurons responded vigorously
      to PGF2 alpha and BK, with responses to BK but not PGF2 alpha, reliably preceding
      the 'giant' uterine contractions that were also produced by these algogenic
      agents. These results indicate that certain neurons in and near VB may as a group
      be involved in some aspect of pain arising from female reproductive organs. The
      responses of these neurons to somatic and possibly other visceral stimuli,
      however, point to their potential additional involvement in other aspects of
      visceral and somatic nociception.

PMID- 8348320
TI  - Traumatic brain injury produces impairments in long-term and recent memory.
AB  - Traumatic brain injury (TBI) in humans typically produces neurological
      suppression and a longer lasting impairment of memory clinically defined as post
      traumatic amnesia. An animal model that reliably reproduces the physiological
      changes associated with TBI was used to assess the memory deficits following
      brain injury. Prior to TBI, rats were trained to perform one of four tasks that
      assessed either motor performance, long-term or recent memory. Rats were randomly
      assigned to one of three groups (anesthesia only, sham operation or fluid
      percussion). Following fluid percussion, used to produce TBI, rats were tested
      for 6 test sessions. The first session occurred 1-2 min after the experimental
      manipulation. The next 5 sessions followed the training schedule maintained prior
      to experimental manipulation. Differences in long-term memory occurred only in
      the first post-operative test session. Differences in recent memory performance
      were found across all 6 test sessions. The memory deficits were clearly
      dissociated from motor deficits. The similar memory deficits observed following
      human head injury and the experimentally produced TBI injury demonstrate that
      fluid percussion is a useful approach to examine underlying neurobiological
      mechanisms involved in head injury and possible clinical interventions.

PMID- 8348321
TI  - A subpopulation of large calbindin-like immunopositive neurones is present in the
      hippocampal formation in food-storing but not in non-storing species of bird.
AB  - The avian hippocampal formation (HP) is thought to play a role in the processing
      of spatial memory related to food-storing behaviour. The HP of two food-storing
      species (marsh tit (Parus palustris) and magpie (Pica pica)) and two non-storing
      species (great tit (Parus major) and jackdaw (Corvus monedula)) were compared
      following calbindin-like immunostaining. In the dorsal hippocampal region, both
      species of food-storing birds had larger calbindin-immunoreactive cells than did
      the two non-storing species. The fact that this association between storing
      behaviour and cell morphology is seen in two unrelated families of birds, the
      Paridae (marsh tit versus great tit) and Corvidae (magpie versus jackdaw)
      suggests that there may be a direct link between food-storing behaviour and the
      dorsal hippocampal calbindin-immunoreactive cell population.

PMID- 8348322
TI  - Morphine-evoked release of adenosine from the spinal cord occurs via a nucleoside
      carrier with differential sensitivity to dipyridamole and nitrobenzylthioinosine.
AB  - We have investigated the potential role of a bi-directional nucleoside carrier in
      the release of endogenous adenosine from spinal cord synaptosomes by examining
      the effects of dipyridamole and nitrobenzylthioinosine (NBI) on evoked release of
      adenosine. When 40 pmol adenosine were added to synaptosomes, only 70 +/- 2% was
      recovered, suggesting 30% uptake of adenosine. Dipyridamole (0.1-10 microM)
      reduced this uptake and also increased basal adenosine release, probably due to
      inhibition of the re-uptake of adenosine derived from released nucleotide. In
      contrast, NBI (0.1-10 microM) had no effect on either uptake of added adenosine
      or on basal release of adenosine. Addition of K+ (24 mM) and morphine (10 microM)
      produced a 50-60% increase in the release of adenosine, and this was reduced 35
      98% by both dipyridamole and NBI (0.01-10 microM). Dipyridamole (0.01-1 microM)
      had no effect on the release of nucleotides (detected as adenosine) induced by
      noradrenaline, 5-hydroxytryptamine (5-HT) and capsaicin (50 microM each),
      although 10 microM dipyridamole significantly reduced release evoked by
      noradrenaline and 5-HT. This latter effect of dipyridamole was determined not to
      be due to inhibition of ATP release when measured directly. Within the spinal
      cord, there is a removal system for adenosine which is dipyridamole-sensitive but
      NBI-insensitive. Release of adenosine, but not nucleotides, appears to occur via
      this carrier system. The inhibition of release by NBI, but its lack of effect on
      uptake, suggests the involvement of heterogeneous carrier molecules in adenosine
      uptake and release from the spinal cord.

PMID- 8348323
TI  - Cl-/HCO3- exchange function differs in adult and fetal rat hippocampal neurons.
AB  - We studied Cl-/HCO3- exchange function in acutely dissociated single hippocampal
      neurons from adult and fetal day 18 rat using a fluorescent intracellular pH
      (pHi) indicator dye. The presence of Cl-/HCO3- exchange activity was assayed by
      observing the elevation in pHi upon acute reversal of the Cl- gradient. Resting
      intracellular pH in acutely dissociated neurons of both adult and fetal tissue
      was significantly higher than that of cultured fetal hippocampal neurons (day 10
      12 in culture). Acute removal of extracellular Cl- caused a rapid and reversible
      increase in pHi by 0.25 pH units in adult neurons but had virtually no effect in
      similarly dissociated fetal neurons. Cl-/HCO3- exchange activity was also
      undetectable in fetal cultured hippocampal neurons. The mRNA for the anion
      exchanger AE3 is expressed abundantly in adult rodent neurons. AE3 is a potential
      candidate molecule for the observed Cl-/HCO3- exchange activity. In situ
      hybridization was used to monitor expression of the AE3 gene in these two age
      groups. We found that both adult and fetal neurons express AE3 mRNA. These
      results indicate that AE3 may not function as a Cl-/HCO3- exchanger in fetal
      neurons, in contrast to its possible role in the adult brain.

PMID- 8348324
TI  - Effect of ibuprofen on regional eicosanoid production and neuronal injury after
      forebrain ischemia in rats.
AB  - Post-ischemic metabolism of arachidonic acid by cyclooxygenase results in the
      elaboration of numerous eicosanoids and in the generation of free radicals.
      Accordingly, the effect of cyclooxygenase inhibition by ibuprofen on post
      ischemic eicosanoid production and delayed neuronal death was evaluated in Wistar
      Kyoto rats subjected to incomplete forebrain ischemia. In control (C) and
      ibuprofen-treated groups (n = 5 each), pre- and post-ischemic eicosanoid
      production in the caudate nucleus (CN) and dorsal hippocampus (HPC) were
      evaluated by microdialysis. The ibuprofen-treated animals were given ibuprofen,
      15 mg/kg i.v., prior to insertion of microdialysis probes. Forebrain ischemia was
      induced by bilateral carotid artery occlusion (BCAO) for 10 min with simultaneous
      hypotension to 35 Torr. The concentrations of thromboxane B2 (TxB2), 6-keto-PGF1
      alpha and PGF2 alpha in the microdialysate were measured by radioimmunoassay. In
      two additional concurrent groups of rats (n = 10 each), neuronal injury in the
      HPC, CN and cortex (parietal, temporal and entorhinal regions) was evaluated
      histologically three days after 10 min of forebrain ischemia with and without pre
      ischemic ibuprofen administration. In the control microdialysis group, levels of
      TxB2, 6-keto-PGF1 alpha and PGF2 alpha increased in both CN and HPC after probe
      insertion. These probe related increases were substantially reduced in the
      ibuprofen group. After ischemia and reperfusion in the control group, the levels
      of TxB2 and PGF2 alpha increased in both CN and HPC. Levels of 6-keto-PGF1 alpha
      increased in the CN but not in the HPC. The administration of ibuprofen
      substantially reduced post-ischemic TxB2 and PGF2 alpha levels in both CN and HPC
      and decreased 6-keto-PGF1 alpha levels in the CN. The results of these initial
      microdialysis studies left the possibility that, in the ibuprofen group, the
      reduction in eicosanoid levels after probe penetration might have influenced the
      subsequent post-ischemic eicosanoid production. Therefore, in an additional group
      of animals (n = 5), ibuprofen was administered after probe insertion. Only PGF2
      alpha levels were measured in this group. Increased levels of PGF2 alpha
      comparable to the original control group were detected after probe penetration.
      Nonetheless, after ibuprofen administration, the pre- and post-ischemic levels of
      PGF2 alpha were again significantly reduced. In the histologic evaluation groups,
      overall neuronal injury was significantly less in the ibuprofen treated animals.
      This protective effect of ibuprofen was most clearly evident in the CA3 sector of
      the HPC.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8348325
TI  - Down-regulation of phosphatidylinositol response to BDNF and NT-3 in cultures of
      cortical neurons.
AB  - The hydrolysis of phosphatidyl 4,5-bisphosphate (PI), which is involved in the
      transduction mechanism of neurotransmitters and growth factors, is stimulated by
      brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) in primary
      cultures of fetal brain neurons. In the present study we sought to examine the
      effect of pretreatment with these factors on their acute stimulation capabilities
      and, furthermore, to substantiate that the effects of BDNF and NT-3 reflect
      actions on neurons rather than glial cells. Pretreatment with BNDF and NT-3 for 4
      days followed by 1 day without growth factor abolished the effect of an acute
      stimulation with these factors. The growth factors were mutually effective so
      that BDNF pretreatment abolished the acute response to NT-3 and vice versa. In
      contrast, the effects of bFGF (basic fibroblast growth factor, a non-neurotrophin
      growth factor) also stimulating PI hydrolysis in these culture systems, were not
      reduced by neurotrophin pretreatment. Pretreatment with K-252b, at concentrations
      known to inhibit trk receptors, did not alter the acute stimulation of PI
      hydrolysis induced by the neutrophins. PI hydrolysis stimulated by BDNF and NT-3
      in cultures grown in presence of cytosine arabinoside C, containing > 95%
      neurons, was higher than in cultures containing non-neuronal cells, indicating
      that the neurotrophin stimulation occurs in neuronal cells. No stimulatory effect
      was detected in bFGF treated pure neuronal cultures. The findings suggest that
      prolonged exposure of responsive neurons to BDNF and NT-3 down-regulates their
      stimulatory effects on PI hydrolysis.

PMID- 8348326
TI  - Chronic exposure to environmental levels of lead impairs in vivo induction of
      long-term potentiation in rat hippocampal dentate.
AB  - This study examined the effects of chronic developmental lead (Pb) exposure in
      rats on hippocampal long-term potentiation (LTP). Male offspring were exposed to
      0.2% Pb acetate continuously from birth until testing at 85-105 days. Excitatory
      postsynaptic potential (EPSP) and population spike amplitudes were measured in
      the dentate hilar region in response to stimulation applied to the lateral
      perforant path. LTP was induced in control animals with an average maximal EPSP
      potentiation of 41%, which was significantly greater than the increase in EPSP
      amplitudes (2%) in exposed animals after tetanizing stimulation. Current-voltage
      curves in controls demonstrated significant increases in EPSPs and population
      spikes after application of pulse trains to induce LTP, while exposed rats
      exhibited no discernible change in responses. These findings suggest that
      induction or development of LTP in the dentate hilar region in vivo is impaired
      by chronic developmental exposure to environmentally relevant levels of Pb.

PMID- 8348327
TI  - Short periods of hypoxia activate a K+ current in central neurons.
AB  - The effect of hypoxia on ionic currents was studied in acutely dissociated
      substantia nigra neurons. Using an external solution containing 0 mM Na+ and 0.5
      mM Co2+, we found that overall whole-cell outward currents increased by 15-20%
      during 3-4 min of hypoxia. This current was voltage sensitive and could be
      completely blocked by TEA- and Cs+, suggesting that this is a K+ current. In cell
      attached patches with 150 mM K+ in the external solution, we recorded a large
      conductance outward current which was not observed during baseline and was
      reversibly activated by hypoxia. These results therefore provide the first direct
      evidence for the activation of K+ channels during O2 deprivation in central
      neurons.

PMID- 8348328
TI  - 5-HT uptake sites and 5-HT2 receptors in brain of antidepressant-free suicide
      victims/depressives: increase in 5-HT2 sites in cortex and amygdala.
AB  - The density (Bmax) of 5-HT2 receptors labelled with [3H]ketanserin was
      significantly increased in prefrontal cortex (by 67%) and amygdala (by 97%) from
      suicide/depressives in comparison with controls. There were no differences in Kd
      of [3H]ketanserin binding between the two groups. The density (Bmax) and affinity
      (Kd) of [3H]paroxetine sites were not significantly different in the
      suicide/depressives and controls. The ratio between the density of presynaptic 5
      HT uptake sites and postsynaptic 5-HT2 receptors in amygdala was significantly
      lower in suicide/depressives than in controls. The data confirm and extend some
      of the previous findings of increases in 5-HT2 receptors in post-mortem brains of
      suicide victims and depressives who died of natural causes and lend support to
      the view that an abnormality in brain serotonergic system is associated with
      depression and suicidal behaviour.

PMID- 8348329
TI  - Self-sustained spreading depressions in the chicken retina and short-term
      neuronal-glial interactions within the gray matter neuropil.
AB  - The chicken retina is an accessible piece of intact gray matter in which a self
      sustained form of the 'Spreading Depression' (SD) wave can be easily elicited and
      recorded for many hours with double barrel ion-sensitive electrodes in the
      extracellular space. The blockade of glial (Muller) cell potassium channels with
      barium chloride added to the perfusing Ringer depressed both the negative
      potential shift typical of SDs and the velocity of spread. Moreover, there was
      separation of the extracellular increase of potassium and the drop in the
      extracellular potential: the peak of the potassium wave was increased, as well as
      its duration whereas the potential wave could be depressed to zero or even
      inverted to positive. By contrast the transient extracellular calcium drop could
      not be separated from the extracellular potential wave but appeared related to
      it: no transient calcium drop was observed when the negative potential was
      completely depressed or inverted. Both, the amplitude of the extracellular
      potential and extracellular calcium activity appeared to be important factors
      controlling the velocity of spread.

PMID- 8348330
TI  - Strain-dependent differences in responsiveness of mice to nitrous oxide (N2O)
      antinociception.
AB  - N2O antinociception was assessed in eight inbred and two outbred mouse strains.
      Results indicated the following order of responsiveness among the 10 strains: A/J
      (most sensitive), C57BL/6ByJ, C57BL/6J, BALB/cByJ, C3H/HeJ, Swiss-Webster,
      CXBK/ByJ, ICR, CBA/J and DBA/2J (least sensitive). These results demonstrate
      significant strain-dependent differences in antinociceptive responsiveness to
      N2O. The weak antinociceptive response to N2O in the DBA/2J strain, which is
      sensitive to morphine and U-50, 488H, indicates some underlying neurobiological
      difference in the DBA/2J mouse that imparts resistance to N2O. The responsiveness
      of CXBK/ByJ mice to N2O indicates that mu-opioid receptors may not play an
      important role in N2O antinociception in mice.

PMID- 8348331
TI  - Radioimmunoligand characterization and immunohistochemical localization of
      dopamine D2 receptors on rods in the rat retina.
AB  - The retinal neurotransmitter dopamine (DA), elaborated from intrinsic
      dopaminergic neurons as amacrine and interplexiform cells, is known to modulate
      several complex functions mediated by D1 and D2 receptors in the vertebrate
      retina. In this paper, we characterized and localized DA receptors of the D2
      family on rod outer segments (ROS) of the rat retina by a radioimmunoligand
      binding assay and by immunohistochemistry. Anti-anti-DA conjugated antibodies (or
      anti-idiotypic antibodies Ab2) were used as ligand; BSA-glutaraldehyde-conjugated
      spiperone, eticlopride (D2 antagonists) and DA were used as displacers. The
      linear Scatchard transformation indicated that data were best fit to the one-site
      model. By using the peroxidase-antiperoxidase technique, an intense labeling was
      located on rods. These results supported the paracrine action of DA on the
      photoreceptor cell.

PMID- 8348333
TI  - Hormonal and metabolic effects of neuroglucopenia.
AB  - We examined the role of central neuroglucopenia, induced by
      intracerebroventricular (i.c.v.) administration of 2-deoxyglucose (2-DG), on
      glucose and amino acid kinetics in conscious dogs. Group 1 received i.c.v. 2-DG
      at 2.5 mg.kg-1 x min-1 for 15 min. Group 2 received an equal intravenous (i.v.)
      amount of 2-DG. In the i.c.v. group, plasma glucose levels rose from 106 +/- 4
      mg/dl to a peak of 204 +/- 12 mg/dl by 90 min. Blood lactate increased from 689
      +/- 1 to 2,812 +/- 5 mumol/l and blood alanine not change from basal (256 +/- 41
      mumol/l). The rate of hepatic glucose production, determined isotopically, was
      increased 2-fold over basal (P < 0.01). Significant increases (P < 0.001) over
      basal were also noted in plasma epinephrine, norepinephrine, insulin, glucagon
      and cortisol. Leucine rate of appearance (Ra) showed a 30% decrease from basal to
      2.4 +/- 0.05 mumol.kg-1 x min-1 (P < 0.01). In group 2 plasma glucose levels were
      not altered but plasma cortisol and glucagon showed a modest transient increase
      above basal (P < 0.05). No significant changes were noted in amino acid kinetics.
      These findings suggest that periventricular neuroglucopenia, in the absence of
      peripheral glucose deprivation, is accompanied by hyperglycemia secondary to
      enhanced hepatic glucose production with decreased glucose utilization and by
      increased hepatic uptake of gluconeogenic precursors. These, however, were not
      accompanied by increased whole body proteolysis as was previously seen with
      generalized glucopenia resulting from insulin-induced hypoglycemia.

PMID- 8348332
TI  - Mating activates androgen receptor-containing neurons in chemosensory pathways of
      the male Syrian hamster brain.
AB  - Fos-immunoreactivity is induced during mating in the male Syrian hamster in
      limbic areas that relay chemosensory information and contain receptors for
      gonadal steroid hormones. The induction of Fos is an index of neuronal
      activation. After mating, c-fos expression is greatest in subnuclei of the medial
      amygdaloid nucleus (Me), bed nucleus of the stria terminalis (BNST), and medial
      preoptic area (MPOA). The present study determined if individual neurons in these
      activated subnuclei contain androgen receptors. We aim to understand how
      essential chemosensory and hormonal signals are integrated to control copulation.
      Adult male hamsters (n = 6) were allowed to mate with a sexually receptive female
      for 30 min. They were perfused 1 h later with 4% paraformaldehyde and 40 microns
      frozen sections were processed for immunocytochemistry using antisera against Fos
      (Cambridge Research Biochemicals) and the androgen receptor (G.S. Prins). The
      brains of three non-mated males were also processed for Fos immunocytochemistry.
      Mating significantly increased the number of Fos-immunoreactive neurons within
      subnuclei of Me, BNST, and MPOA relative to non-mated males (P < 0.05). These
      nuclei contained abundant androgen receptors. In the corticomedial amygdala, 20
      40% of Fos-immunoreactive neurons in mated hamsters expressed androgen receptors.
      Although few androgen receptors are found in the anteromedial and postero
      intermediate subdivisions of the BNST, these areas exhibited 26% and 47% co
      localization, respectively. In posteromedial BNST, which contains large numbers
      of steroid receptor-containing neurons, androgen receptors were identified in 48%
      of Fos-immunoreactive neurons. In the MPOA, 54% of Fos-immunoreactive neurons
      expressed the androgen receptor throughout the rostrocaudal extent of the medial
      preoptic nucleus (MPN).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348335
TI  - Paired-pulse and frequency potentiation of cortical responses in developing rats.
AB  - The postnatal development of paired-pulse and frequency potentiations of the
      first positive and negative components (P1N1) of the cortical interhemispheric
      response (IHR) was studied in urethane anesthetized rats aged from 7 to 90 days.
      The paired-pulse potentiation appeared in the rat sensorimotor cortex starting
      from the age of 15 days. The magnitude of potentiation increased with age. The
      interpulse interval inducing maximum potentiation shortened from 125 ms in 15-day
      old rats to 70 ms in adult rats. Similar results concerning the paired-pulse
      responses were found for visual cortex but the maturation was somewhat delayed-
      potentiation first appeared at postnatal day (PND) 18. The frequency potentiation
      reached adult properties in the sensorimotor cortex by PND 25. There is no time
      coincidence in the development of the two potentiation phenomena studied, paired
      pulse potentiation appeared earlier than frequency potentiation.

PMID- 8348334
TI  - Effect of Pinellia ternata tuber on the efferent activity of the gastric vagus
      nerve in the rat.
AB  - Effect of intraduodenal infusion with the hot aqueous extract of Pinellia ternata
      tuber on the efferent discharges in the gastric branch of the vagus nerve was
      observed in the anesthetized rat. The infusion of the extract in doses of 2-15O
      mg per animal (c.a. 300 g, b.wt.) resulted in a dose-related increase in efferent
      activity of the vagal gastric nerve. The enhancement of the nerve activity
      following administration of 150 mg of this substance lasted longer than 90 min.
      It was observed that the suppressive effect on vagal gastric activity due to
      apomorphine and copper sulfate was antagonized by prior administration of the
      extract. From these observations it is suggested that Pinellia tuber acts as a
      facilitatory agent on gastric function.

PMID- 8348336
TI  - Stimulation-induced RSA-like field activity in region CA1 of the hippocampal
      slice: amplitude maxima and topography.
AB  - In the present experiment RSA-patterned stimulation was applied to afferents in
      the CA1 region of the hippocampal slice preparation and depth profiles of the
      resultant field activity were performed. RSA-patterned stimulation applied to the
      stratum lacunosum-moleculare region resulted in field activity through the CA1
      region with similar morphology, phase, and amplitude profiles to the type 1 RSA
      profile found in vivo. In contrast, RSA-patterned stimulation applied to the
      stratum oriens and midstratum radiatum regions did not result in field profiles
      characteristic of the RSA recorded in vivo. The results of the present study
      confirm predictions made by previous modelling experiments and CSD analyses
      performed in the freely moving animal, which suggest that the type 1 RSA profile
      is primarily the result of distal excitation onto CA1 pyramidal cells.

PMID- 8348338
TI  - Differential effects of NE, CLON, and 5-HT on feeding and macronutrient selection
      in genetically obese (ob/ob) and lean mice.
AB  - The effects of central injection of norepinephrine (NE), clonidine (CLON), and 5
      hydroxytryptamine (5-HT) on feeding and macronutrient selection in genetically
      obese (C57B1/6J, ob/ob) and lean mice (C57B1/6J, +/?) were examined. Mice were
      adapted to single-energy source diets of carbohydrate, protein, and fat and then
      injected with NE (20-80 nmol) or CLON (5-20 nmol) immediately prior to dark onset
      (17h00). Measurements of nutrient intake were determined 2 h postinjection. In a
      separate study, obese and lean mice were deprived of food for 1 h (1700-1800) and
      subsequently treated with 5-HT (35-140 nmol). The results of this study
      demonstrate that the hyperphagic effect of NE and CLON and the anorectic effect
      of 5-HT are dose dependent and nutrient selective. Specifically, at the onset of
      the nocturnal cycle, obese and lean mice exhibit a shift in diet choice resulting
      in an increased preference for carbohydrate and a reduction in the proportional
      intake of protein and fat. At this time, central injection of NE or CLON
      potentiates an already enhanced preference for carbohydrate; whereas injection of
      5-HT suppresses carbohydrate intake (kcal) in both phenotypes without altering
      fat or protein intake. However, in comparison to lean mice, obese mice showed
      significantly augmented hyperphagic responses to NE and CLON administration but
      decreased inhibition of feeding after 5-HT injection. This suggests that the
      stimulatory effect of alpha 2-noradrenergic mechanisms controlling feeding and
      carbohydrate ingestion is enhanced in obese mice, while the inhibitory influence
      of serotonergic mechanisms is attenuated.

PMID- 8348337
TI  - Aromatic amino acid decarboxylase (AADC) immunohistochemistry in vertebrate
      brainstem with an antiserum raised against AADC made in E. coli.
AB  - Aromatic L-amino acid decarboxylase (AADC) is involved in the biosynthesis of
      catecholamines and indolamines. AADC is present in the nervous system, in the
      chromaffin cells, and in non-neuronal tissues. We tested the capacity of a new
      polyclonal antibody, obtained by immunization of rabbits with a recombinant
      protein beta-galactosidase-AADC, to detect monoaminergic neurons in the brainstem
      as well as monoaminergic paraneurons in the adrenal medulla from goldfish, frog,
      skink, quail, and mouse. In the adrenal gland we found an immunoreactivity that
      was consistent with the distributions of the chromaffin cells previously
      reported. In the brainstem, groups of immunoreactive neurons and several labelled
      fibers were observed in the five species studied. The raphe region showed cell
      bodies and processes similar to those previously identified as monoaminergic by
      other authors. In addition, in medulla oblongata and isthmic tegmentum we found,
      in goldfish, skink, and quail, neuronal groups similar to mammalian D groups
      which contain AADC but are devoided of serotonin and catecholamines.

PMID- 8348339
TI  - Sleep-inducing function of noradrenergic fibers in the medial preoptic area.
AB  - The aim of the investigation was to find out the role of noradrenergic (NE)
      terminals of the medial preoptic area (mPOA), in the regulation of sleep
      wakefulness. Studies were conducted on free-moving adult male rats with
      chronically implanted cannulae in the mPOA. Sleep-wakefulness was assessed on the
      basis of EEG, EMG, and EOG recordings along with behavioral observations.
      Lesioning of catecholamine terminals (with 6-hydroxydopamine) in the mPOA
      produced an increase in quiet wakefulness. Prevention of NE fiber destruction, by
      pretreating the rats with imipramine, prevented this effect. This demonstrated
      that the increased quiet wakefulness produced by 6-OHDA was the result of NE
      fiber destruction. Changes in sleep-wakefulness were also assessed after
      microinjection of NE into the mPOA, in normal and ventral noradrenergic bundle
      (VNA)-lesioned rats. NE administration induced sleep in VNA-lesioned rats, and
      arousal in normal rats. The findings suggest that the NE terminals in the mPOA,
      projecting via VNA, play a role in the induction of sleep.

PMID- 8348340
TI  - Development of monoamine systems after neonatal anoxia in rats.
AB  - Neurochemical and morphological effects of neonatal anoxia on monoamine systems
      were studied after 100% N2 exposure for 25 min at 30 h postnatally (postnatal day
      2-P2). At 20 min after anoxia, reductions of tissue levels of cerebellar
      noradrenaline (NA) and striatal dopamine (DA) and metabolites were seen, while 5
      hydroxyindoleacetic acid (5-HIAA) was increased in cortex and cerebellum. At P7,
      NA increased in cerebellum, while serotonin (5-HT) and 5-HIAA decreased in cortex
      and cerebellum. At P21, increased hippocampal NA and striatal homovanillic acid
      (HVA) were found, while striatal 5-HT decreased and 5-HIAA increased in striatum
      and hippocampus. At P60, striatal 3,4-dihydroxyphenylacetic acid (DOPAC) and 5
      HIAA levels were found to be enhanced. No effects were seen on 5-HT, tyrosine
      hydroxylase, or DARPP-32 immunostaining in cortex, hippocampus, and striatum.
      Thus, the neonatal anoxia induced both acute and persistent neurochemical
      abnormalities in monoamine systems that were not accompanied by morphological
      changes detectable with the methods used. The monoamine alterations found could
      be critically connected to the behavioral disturbances observed in rats after
      neonatal anoxia. The findings may also be of relevance to dysfunctions seen in
      humans after perinatal oxygen deficiency, e.g., the attention deficit
      hyperactivity disorder syndrome.

PMID- 8348341
TI  - Hippocampal and entorhinal glucose metabolism in relation to cholinergic theta
      rhythm.
AB  - Hippocampal and entorhinal cortex glucose metabolism were studied by 14C-2
      deoxyglucose (2-DG) autoradiography in anesthetized rats with and without
      continuous theta rhythm (theta). 2-Deoxyglucose changes in specific
      cytoarchitectonic regions were precisely assessed by n innovative approach. In
      the absence of theta there were areas with a higher glucose metabolism
      corresponding to neuropile regions at CA3, dentate gyrus, and subiculum, while
      the cellular layers always showed lower values. In the presence of theta,
      provoked by intraventricular injections of anticholinesterases (i.e.,
      physostigmine) or curarimimetics (i.e., d-tubocurarine), 2-DG uptake showed two
      opposite significant changes in relation to controls: a) it increased in the
      outer zone of the molecular layer (inner blade) of the dentate gyrus, and in the
      stratum lacunosum-moleculare of CA3, suggesting an increase in perforant path
      input during theta rhythm; b) it decreased in the hilar dentate region. This
      noteworthy decrease in metabolic activity probably reflects an hilar inhibition
      by local circuits during theta rhythm generation.

PMID- 8348342
TI  - Effect of systemic morphine on neurons in the lateral reticular nucleus area of
      the rat.
AB  - The present study is undertaken to investigate the effect of systemic morphine on
      neurons in the lateral reticular nucleus (LRN) using extracellular recording
      techniques. The spontaneous activities of 64 neurons in the LRN area were tested
      with morphine (3-5 mg/kg, IV). Morphine excited 23 and inhibited 28 neurons
      tested, and 13 neurons were not affected. Of the 28 neurons inhibited, 20 were
      identified as nociceptive and the remaining 6 were nonnociceptive. Of the 23
      neurons excited by morphine, 18 were nociceptive and 5 were nonociceptive.
      Systemic naloxone (0.3-0.5 mg/kg) significantly reversed the morphine effect in
      15 out of 19 neurons excited and 19 out of 20 neurons inhibited by morphine.
      Thirteen out of 64 neurons were further identified as reticulospinal neurons, of
      which four were excited and four were inhibited by morphine. The remaining five
      were not affected. The results demonstrate that a similar proportion of neurons
      in the LRN area were either excited or inhibited by systemic morphine, and the
      majority of them are nociceptive neurons. It is suggested that different types of
      neurons in the LRN area may have different functions in morphine analgesia.

PMID- 8348343
TI  - A sex comparison of serotonin immunoreactivity and content in the ferret preoptic
      area/anterior hypothalamus.
AB  - Previous studies with rats raised the possibility that sexually dimorphic
      features of the medial preoptic area/anterior hypothalamus (POA/AH) may result,
      in part, from a sex difference in the serotonergic innervation of this region. We
      asked whether a similar phenomenon may occur in a carnivore, the ferret. A
      sexually dimorphic male nucleus of the dorsal POA/AH (Mn-POA/AH) has previously
      been characterized in Nissl-stained sections of the male ferret forebrain; this
      nucleus is absent in females. A nondimorphic ventral nucleus of the POA/AH is
      found in both sexes. In the present study numerous serotonin (5-HT)
      immunoreactive (ir) fibers were observed in the dorsal POA/AH of gonadectomized
      adult ferrets of both sexes. By contrast, in both sexes the ventral nucleus of
      the POA/AH had many fewer 5-HTir fibers. A similar difference in the distribution
      of immunoreactivity between dorsal and ventral POA/AH was observed for tyrosine
      hydroxylase (TH) localized in cell bodies and in nerve fibers and for H222ir
      estrogen receptors localized in cell nuclei. Likewise, in both sexes the content
      of 5-HT and dopamine (DA), measured by high pressure liquid chromatography with
      electrochemical detection, were significantly higher in the dorsal than the
      ventral POA/AH, thereby corroborating observed regional differences in 5-HTir and
      THir fibers, respectively. The present findings provide no support for the notion
      that sexually dimorphic cytoarchitectonic features of the dorsal POA/AH in
      ferrets are associated with a sex difference in the serotonergic innervation of
      this region.

PMID- 8348344
TI  - Improved yield of obese rats using a double coordinate system to locate the
      ventromedial or paraventricular nucleus.
AB  - This article describes a highly efficient method for making VMH and PVN-lesioned
      obese rats by using a newly developed coordinate system. In previous methods, the
      coordinates for creating VMH and PVN lesions were determined from single point,
      either the interaural line or the bregma. Because skull size varies, the use of
      two reference points resulted in greater consistency. We therefore developed a
      system for making VMH- and PVN-lesioned obese rats using both the interaural line
      and the bregma. With this new double coordinate system the success rate for
      producing obese rats varied from 52% to 92% for VMH lesions and from 36% to 61%
      for PVN lesions.

PMID- 8348345
TI  - Topographic organization of efferent projections of medial frontal cortex.
AB  - By using fluorescent retrograde tracers, we compared efferent projections of the
      medial frontal cortex to two subcortical areas: the superior colliculus, a
      somatic motor area, and the laterodorsal tegmental nucleus, a visceral motor
      area. Neurons projecting to the superior colliculus originated in layer V of the
      cingulate (Cg1 area) and medial agranular cortex, while neurons projecting to the
      laterodorsal tegmental nucleus originated in layers V and VI of the cingulate
      (Cg3 area) and infralimbic cortex. Thus, within the medial frontal cortex, the
      ventral portion (the Cg3 and infralimbic areas) may be a visceral motor area
      while the dorsal portion is a somatic motor region.

PMID- 8348346
TI  - A simple cannula assembly for chronic bilateral brain infusion in freely moving
      rats.
AB  - Osmotic minipumps provide a means for the chronic infusion of agents into the
      brain of the awake unrestrained animal. This paper describes the construction of
      a simple and inexpensive cannula assembly to be used with an osmotic minipump for
      the bilateral infusion of brain regions in the rat. The cannula/catheter assembly
      employs the use of a Y-joint, thereby allowing the investigator to use only one
      osmotic minipump per animal. This reduces the flow rate and decreases the cost of
      an experiment. Chronic infusion of the ventral septal area with saline using this
      system failed to alter the circadian rhythm of body temperature, except for a
      significant decrease in the amplitude of the rhythm.

PMID- 8348347
TI  - Effects of chronic desipramine administration on the locus coeruleus neuronal
      activity in the learned helplessness paradigm.
AB  - One week after inescapable shock (IS) exposure, animals showed an increased
      number of escape failures in the shuttlebox and a decreased noradrenergic (NA)
      transmission. The latter was assessed by electric activity of locus coeruleus
      (LC) neurons. Seven daily injections of desipramine (DMI) were effective in
      reducing the number of escapes failures in the shuttlebox, but such treatment did
      not modify the decreased electric activity of LC NA neurons observed 7 days after
      IS. These results are discussed in terms of the action of DMI on NA terminals in
      reversing the behavioral deficit induced by IS.

PMID- 8348348
TI  - Sex differences in salt preference and taste reactivity in rats.
AB  - Previous studies have shown that female rats consume significantly more sodium
      chloride (NaCl) than do age-matched males. The gustatory contribution to this sex
      difference was examined in the following experiments. In Experiment 1, female
      rats demonstrated a higher two-bottle preference for NaCl ranging from 0.03 M to
      1.0 M than did age-matched males. Next, to determine if the animal's sex modified
      gustatory sensitivity for NaCl, taste reactivity responses elicited by intraoral
      infusions (0.8 ml) of NaCl (0.03 M, 0.15 M, 0.3 M, and 1.0 M) were measured in
      age-matched male and female Sprague-Dawley rats. Intraoral infusions of NaCl were
      administered in ascending concentration order on successive days. During the
      intraoral infusion, the animal's oral motor taste reactivity responses were
      videotaped and subsequently analyzed to determine the number of ingestive and
      aversive responses. Intraoral infusions of 0.15 M and 0.3 M NaCl elicited
      reliably more ingestive responses and 1.0 M NaCl more aversive responses in
      females than in males. Because differences in taste reactivity were not found for
      all those concentrations for which female rats showed a higher preference than
      did males, changes in gustatory sensitivity contributes to, but does not appear
      to fully account for the female rats' preference for NaCl.

PMID- 8348349
TI  - Standards of practice for diagnostic radiology.

PMID- 8348350
TI  - Stenosis of the carotid bifurcation: subjective assessment compared with strict
      measurement guidelines.
AB  - Preliminary results of the North American Symptomatic Carotid Endarterectomy
      Trial (NASCET) have shown that endarterectomy is highly effective in preventing
      stroke in patients with 70% to 99% stenosis of the carotid bifurcation. These
      results are based on specific linear measurement criteria comparing the residual
      diameter of the lumen with that of the normal carotid beyond the bulb. These
      criteria may differ from subjective assessments of the severity of stenosis.
      Angiograms from 125 NASCET patients were analysed independently by three groups
      of reviewers. The first group consisted of three neuroradiologists, the second of
      two neurologists and one neurosurgeon and the third of three radiologists with
      neuroradiologic experience. The degree of stenosis was estimated, without
      measurement, as mild (1% to 29%), moderate (30% to 69%) or severe (70% to 99%),
      or the vessel was said to be occluded. These assessments were compared with the
      degree of stenosis as determined by the NASCET neuroradiologist on the basis of
      measurement. The subjective assessment of stenosis produced false-positive rates
      (for assessing stenosis of less than 70% as severe) ranging from 5% among the
      neuroradiologists to 16% among the radiologists. The false-negative rates (for
      assessing stenosis of 70% or more as less than severe) ranged from 12% to 22%.
      Therefore, a subjective rating of carotid stenosis may lead to erroneous
      estimation of the severity of disease. This problem has therapeutic implications,
      because carotid endarterectomy has been shown to benefit only patients with
      stenosis of greater than 70%, as assessed according to strict measurement
      guidelines.

PMID- 8348351
TI  - [Antegrade puncture of the superficial femoral artery: a pilot project].
AB  - Antegrade puncture of the femoral artery is often the first step in angioplasty
      or thrombolysis of the lower limb. Because of presumed complications, mostly from
      anecdotal literature, the common femoral artery is the preferred site of entry.
      From there, selective catheterization of the superficial femoral artery can be
      performed. This two-step procedure is sometimes long and difficult for both the
      patient and the radiologist. To improve the ease and the rapidity of this
      procedure, the author performed direct antegrade puncture of the superficial
      femoral artery during 25 consecutive antegrade approaches. The only local
      complication was hematoma, which developed in two patients but disappeared
      spontaneously. Aggravating factors were the size of the catheters used and
      fibrinolytic therapy in one of the affected patients. The results of this pilot
      study suggest strongly that direct antegrade puncture of the superficial femoral
      artery is safer than might be expected from the literature, which deals primarily
      with retrograde puncture. This approach must now be systematically compared with
      the "classic" common femoral artery approach.

PMID- 8348352
TI  - Excimer-laser-assisted angioplasty in chronic femoropopliteal occlusion: the
      significance of an intimal flap in predicting reocclusion.
AB  - Angioplasty assisted by excimer laser was performed on 27 chronic femoropopliteal
      occlusions, ranging from 2 to 30 cm in length, in 26 patients. Twenty-one (78%)
      of the procedures were successful initially. Of these, 12 (57% [44% of the
      total]) remained patent at follow-up 3 months later. In seven of the nine cases
      of reocclusion observed after 3 months (78%) a large intimal flap resulting from
      the angioplasty-induced dissection could be identified in the postprocedure
      angiogram. The authors stress the possible importance of such an intimal flap in
      limiting the success of laser-assisted angioplasty of long femoropopliteal
      occlusions.

PMID- 8348353
TI  - Same-day computed tomography during arterial portography and delayed high-dose
      iodine computed tomography: an efficient approach to imaging potentially
      resectable liver tumours.
AB  - Preoperative imaging in patients with potentially resectable liver tumours has
      traditionally been performed in specialized hepatobiliary centres. To assess the
      feasibility and value of establishing a same-day, pre-resectional hepatic imaging
      service, computed tomography during arterial portography (CTAP) and delayed high
      dose iodine computed tomography (DICT) were used to examine patients considered
      suitable for curative hepatic resection. The study group comprised 27 patients
      (14 from hospitals not affiliated with a university and 13 from two university
      affiliated hospitals) for whom pre-referral imaging showed tumour distribution
      amenable to resection. Among the patients from centres not affiliated with a
      university, seven had undergone ultrasonography (US) and equilibrium-phase CT,
      four had undergone US and unenhanced CT, two had undergone equilibrium-phase CT
      only and one had undergone bolus dynamic incremented CT (BDCT) only. For 12 of
      the patients coming from the university-affiliated centres, the pre-referral
      imaging had consisted of US and BDCT; the other had undergone US only. After CTAP
      and DICT, 20 (74%) of the 27 patients were reclassified as having unresectable
      disease: 7 (54%) of the 13 patients who had undergone BDCT before CTAP and DICT
      and 12 (92%) of the 13 patients who had undergone unenhanced or equilibrium-phase
      CT, as well as the patient who had undergone US only. By averting laparotomy in
      20 of the patients, CTAP and DICT resulted in short-term health care savings of
      about $160,000. These findings suggest that BDCT was underused in the hospitals
      not affiliated with university centres.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348354
TI  - A limited, low-dose computed tomography protocol to examine the sacroiliac
      joints.
AB  - Limited, low-dose, three-scan computed tomography (CT) was shown to be as
      accurate as a complete CT series in examining the sacroiliac joints and is
      suggested as an effective alternative to plain radiography as the primary means
      to detect sacroiliitis. The advantages include the brevity of the examination, a
      2-fold to 4-fold reduction in radiation exposure relative to conventional
      radiography and a 20-fold to 30-fold reduction relative to a full CT series. The
      technique was developed from studies of anatomic specimens in which the articular
      surfaces were covered with a film of barium to show clearly the synovial surfaces
      and allow the choice of the most appropriate levels of section. From the
      anteroposterior scout view the following levels were defined: at the first sacral
      foramen, between the first and second sacral foramina and at the third sacral
      foramen. In the superior section a quarter of the sacroiliac joint is synovial,
      whereas in the inferior section the entire joint is synovial. The three
      representative cuts and the anteroposterior scout view are displayed on a single
      14 x 17 in. (36 x 43 cm) film. Comparative images at various current strengths
      showed that at lower currents than conventionally used no diagnostic information
      was lost, despite a slight increase in noise. The referring physicians at the
      authors' institution prefer this protocol to the imaging routine previously used.

PMID- 8348355
TI  - Ossification of the hyoid bone during childhood.
AB  - Normal ossification of the hyoid bone was studied on the basis of postpartum
      radiographs of 10 stillborn children and radiographs of the cervical spine or the
      lateral neck of 86 children ranging in age from newborn to 16 years old. None of
      the patients was suspected of having any abnormality of skeletal ossification.
      Ossification of the hyoid was seen only after 30 weeks' gestation. The body of
      the hyoid was ossified in all infants older than 4 months, and the greater cornua
      were ossified in all those older than 6 months. Ossification of the lesser cornua
      did not appear in children less than 15 years of age. Normal measurements for the
      body of the hyoid and the greater cornua were determined.

PMID- 8348356
TI  - Abnormal ossification of the hyoid bone in cleidocranial dysplasia.
AB  - Radiographs of the hyoid region of 13 patients with cleidocranial dysplasia were
      reviewed. In all but one the hyoid bone was less ossified than normal. Delayed
      ossification, affecting the skull, the teeth, the pelvis and the extremities, is
      a known, frequent manifestation of this abnormality.

PMID- 8348357
TI  - Congenital absence of a pedicle in a cervical vertebra: report of two cases.
AB  - Two cases of congenital absence of a cervical vertebral pedicle are reported.
      This condition includes hypoplasia of the ipsilateral posterior arch and may
      predispose to spinal cord injury. The radiographic and computed tomography (CT)
      findings are reviewed, and the importance of the ipsilateral oblique radiographic
      view and of CT in diagnosis is stressed.

PMID- 8348359
TI  - Carpal instability in rheumatoid arthritis.
AB  - The authors examined prospectively the prevalence of and relations among patterns
      of carpal instability in 52 patients with proven rheumatoid arthritis.
      Posteroanterior, lateral and oblique radiographs of both wrists were obtained.
      Nineteen patients exhibited one or more patterns of instability. The most common
      isolated pattern was volar intercalated segmental instability, apparent in six
      patients. Five patients showed more than one pattern, most commonly a combination
      of ulnar translocation and volar carpal subluxation. Patients with active
      erosions or changes in the distal radioulnar joint were more likely to exhibit
      instability than those without such findings. Carpal instability is a frequent
      mechanical complication of rheumatoid arthritis. The radiologist should be aware
      of this possibility, so that a diagnosis can be made promptly and appropriate
      clinical management begun.

PMID- 8348358
TI  - Parosteal lipoma with hyperostosis: report of two pathologically proven cases
      evaluated by magnetic resonance imaging.
AB  - The authors describe two cases of parosteal lipoma, an infrequent benign tumour,
      associated with hyperostosis. The first patient presented with a mass in the
      posterior neck, the other with one in the proximal forearm. Radiologic diagnosis
      was facilitated by magnetic resonance imaging (MRI). The MRI images showed the
      characteristic features of a parosteal lipoma, as well as hyperostotic areas that
      remained of low signal intensity in both T1-weighted and T2-weighted sequences.
      MRI is both sensitive and specific for diagnosing these lesions and provides
      excellent depiction of the anatomic features before surgery.

PMID- 8348360
TI  - Injected silicone: radiologic appearance.
AB  - The authors describe the radiologic appearance of fluid silicone in the soft
      tissues of the gluteal area in a transsexual man. Thickening and striation of the
      soft tissues was observed in the trochanteric area in plain films. Serpiginous
      hyper-attenuated bands infiltrating the subcutaneous fat were seen with computed
      tomography. The patient was asymptomatic in the gluteal area.

PMID- 8348361
TI  - Spontaneous perirenal urinoma secondary to cervical carcinoma: diagnosis and
      management.
AB  - Formation of a urinoma secondary to obstruction by a tumour is rare. The authors
      report a case of perirenal urinoma secondary to cervical carcinoma; the urinoma
      was drained percutaneously. The diagnosis and management of this problem are
      reviewed.

PMID- 8348362
TI  - Computed tomography and ultrasonography findings for an adult with Shwachman
      syndrome and pancreatic lipomatosis.
AB  - The authors present a case of pancreatic lipomatosis in an adult patient with
      exocrine pancreatic insufficiency and bone marrow dysfunction (Shwachman
      syndrome). Ultrasonography demonstrated a morphologically normal pancreas,
      whereas computed tomography revealed diffuse pancreatic lipomatosis.

PMID- 8348363
TI  - Communicating intraosseous ganglion of the lunate.
AB  - The authors describe a symptomatic intraosseous ganglion of the lunate
      communicating directly with the scapholunate joint. The communication was
      demonstrated by arthrography and computed tomography. This case is believed to be
      the first reported in which the communication was shown by arthrography.
      Demonstration of such a communication can obviate the need for further imaging to
      diagnose the lesion. A review of intraosseous ganglia of the hand and their
      treatment is presented.

PMID- 8348364
TI  - Magnetic resonance imaging in the diagnosis of suprascapular nerve syndrome.
AB  - The authors report the findings in a case of early suprascapular nerve syndrome
      caused by a ganglion in the spinoglenoid notch. The diagnosis was established by
      magnetic resonance imaging. The exquisite soft-tissue detail provided by this
      modality allows differentiation among many causes of shoulder pain.

PMID- 8348366
TI  - Computed tomography of the sacroiliac joints in children.
AB  - Clinical assessment of the sacroiliac joints is difficult. Conventional
      radiography and radionuclide scanning have not afforded optimal sensitivity and
      specificity in the diagnosis of sacroiliac involvement in spondyloarthropathies.
      This report describes a technique for computed tomography of the sacroiliac
      joints in children; the method involves coronal scanning and allows assessment of
      the entire surface of the joints.

PMID- 8348365
TI  - Ethanol sclerosis of a mediastinal cyst.
AB  - The authors report a mediastinal cyst treated by aspiration and ethanol
      sclerosis, which were performed under ultrasonographic guidance. Mediastinoscopy
      and thoracotomy were thus avoided. One year later there had been no recurrence of
      the cyst or any symptoms.

PMID- 8348367
TI  - Residents' corner. Answer to case of the month #20. Cecal volvulus.

PMID- 8348368
TI  - Residents' corner. Case of the month #21.

PMID- 8348369
TI  - Female reproductive physiology and endocrinology of cattle.
AB  - Maximizing reproductive efficiency is of major economic importance to dairy and
      beef producers. The development of new and improved methods of increasing
      reproductive performance depends on our understanding of the physiologic and
      endocrinologic mechanisms controlling the reproductive process. This article
      reviews the mechanisms associated with puberty, estrous cycles, pregnancy,
      parturition, and postpartum return to estrus.

PMID- 8348370
TI  - Estrous behavior and detection in cattle.
AB  - Hormonal events determine the timing and maximum duration of estrous behavior,
      whereas environmental and social factors modulate or completely inhibit the
      expression of estrus. The efficiency of estrous detection can be improved on most
      livestock farms if more effort is given to visual observations of estrous
      behavior. Heat detection aids can be of value if used as a supplement to visual
      observations. Knowledge of factors that inhibit estrus can help producers avoid
      or minimize situations that make estrous detection difficult or impossible. Each
      livestock enterprise should have a customized heat detection program in place
      because blanket recommendations often fail when applied to many operations.

PMID- 8348371
TI  - Environmental stress effects on bovine reproduction.
AB  - Environmental stress is not limited to climatic factors but extends to nutrition,
      housing, and any stimuli that demand a response from the animal to adapt to new
      circumstances. Low energy and low or excessive protein levels in the diet are
      detrimental to reproduction. Likewise, high ambient temperatures and humidity
      alter the intricate balance of endocrine profiles, leading to lower intensity of
      estrous behavior, anestrus, embryonic death, and subsequent infertility. Most of
      these stress factors can be managed with modern technologies to achieve maximum
      production. Further research in vitamins and minerals under heat stress may add
      to the knowledge of efficient livestock production.

PMID- 8348372
TI  - Factors affecting fertility with artificial insemination.
AB  - Man's intervention in the natural processes of reproduction with the use of AI
      has allowed rapid genetic improvement in beef and dairy herds and has resulted in
      a marked increase in livestock productivity. In today's tough economic climate,
      high reproductive efficiency is of utmost importance for livestock enterprises to
      remain viable. Many factors affect the success of AI programs; of particular
      importance are the health and nutritional management of the herd and accurate,
      efficient heat detection. Good management combined with knowledge, technical
      expertise and careful attention to detail in the timing of insemination in
      relation to the period of estrus, semen handling, and correct semen placement in
      the uterus ensure the successful use of AI.

PMID- 8348373
TI  - Infertility due to abnormalities of the ovaries in cattle.
AB  - A careful physical examination of a cow or heifer suspected of having an ovarian
      problem often results in a specific diagnosis (e.g., freemartinism) or a workable
      list of differentials. When the diagnosis is uncertain, techniques such as rapid
      progesterone assays, ultrasonographic imaging, ova or embryo recovery, and
      cytogenetic evaluation can provide critical information for a well-based
      diagnosis and prognosis. Despite the wide array of problems that can afflict the
      bovine ovary, cystic ovaries probably are the most commonly diagnosed and treated
      ovarian abnormality. Cysts have a variable life span and sometimes occurs
      together with a CL. Hormonal therapy with either GnRH followed by PG
      approximately 9 to 14 days later, or GnRH alone, followed by good heat detection
      is the treatment of choice for cows with cysts. Other conditions associated with
      ovarian dyfunction and infertility include adhesions, developmental anomalies,
      and tumors. The life span of a CL in the cow can be shortened unintentionally by
      attempting to correct other problems (e.g., multiple injections of oxytocin for
      milk let-down), or lengthened by uterine pathology (e.g., pyometra, or uterus
      unicornis). The administration of GnRH or hCG to improve ovarian function and
      pregnancy rates in cows may be beneficial in selected herds.

PMID- 8348374
TI  - Abnormalities of the tubular genital organs.
AB  - Abnormalities of the tubular reproductive tract are responsible for decreased
      fertility in the cow. Typically, these are related to congenital defects such as
      segmental aplasia or to acquired conditions resulting from infections or trauma
      caused during breeding or parturition. Infection of the tubular tract may result
      in vaginitis, cervicitis, metritis, endometritis, pyometra, or salpingitis.
      Trauma to the tract may result in urovagina, pneumovagina, or prolapse of the
      vagina or uterus. Retained placenta may result in metritis. Potentially, all of
      these conditions, unless properly treated, may result in reduced fertility or, in
      the extreme, sterility. Judicial and properly timed use of antibiotics and
      ecbolic agents should return the tract to proper function with little or no
      reduction in fertility. Some conditions, such as prolapse, retained placenta, and
      pneumovagina, may call for manual or surgical intervention for successful
      resolution.

PMID- 8348375
TI  - Abnormal bovine parturition. Obstetrics and fetotomy.
AB  - The veterinarian is in a unique position to assist and improve the profitability
      of producers by educating clients on proper intervention and delivery techniques.
      This paper describes some procedures for intervention, evaluation, and management
      of dystocia by mutation, forced extraction, and fetotomy. In addition, a brief
      summary of the factors influencing dystocia is presented. When these techniques
      are used properly, losses due to dystocia are minimized.

PMID- 8348376
TI  - Infectious diseases causing bovine abortion and fetal loss.
AB  - This article provides a review of the major infectious diseases responsible for
      bovine abortion and fetal loss. Parameters necessary for disease recognition and
      diagnosis are emphasized.

PMID- 8348377
TI  - Female urogenital surgery in cattle.
AB  - Surgical manipulation of the female reproductive tract is part of routine bovine
      clinical practice. Most indications for urogenital surgery in cattle are for
      alleviation of dystocia or correction of injuries sustained during parturition.
      Less frequently, surgery is indicated for ovarian tumor removal, embryo transfer,
      or spaying of feeding heifers. This article discusses clinical assessment for
      selection of various surgical procedures of the bovine female genital tract.

PMID- 8348378
TI  - Fertility and infertility assessment by review of records.
AB  - The assessment of fertility and infertility in dairy herds requires accurate and
      complete data that are collected in a timely manner. The data must be entered in
      a record system that provides easy accessibility. An understanding of terminology
      and statistical calculations, along with knowledge of industry standards,
      reproductive physiology, and pathology is essential if problem solving is to
      occur. Problem solving begins by developing an understanding of the events
      influencing past reproductive performance. Progress is made by establishing a
      detailed reproductive management plan to monitor the current breeding herd and to
      identify potential problems before they occur. The introduction of microcomputers
      and on-farm record systems has greatly enhanced the veterinarian's ability to
      access and process data. For the first time in history, cowside health data
      collection systems integrated with production records are being used. This
      provides the opportunity to collect and summarize and analyze reproductive and
      production data as the events occur. Successful reproductive performance depends
      on effective and efficient management. For veterinarians to effectively and
      positively influence the reproductive performance of the herd, they must
      influence management. This requires working with dairy management to make changes
      in job assignments and description. Taking time to assess records with managers
      is an invaluable tool to convince dairy management of the necessity for change.

PMID- 8348379
TI  - Production medicine considerations for enhanced reproductive performance in beef
      herds.
AB  - The purpose of this article is to provide considerations that must be included in
      a production medicine program. Although no two programs are the same, each of
      these areas must be addressed to be effective. Use of current knowledge and
      technology as well as emerging knowledge and technology to provide input into
      management practices for enhancing performance is the underlying goal of any
      production medicine program. The veterinary practitioner can serve as a
      participant in establishing and maintaining such a program as part of the
      complete management team.

PMID- 8348380
TI  - Effect of estrogen deficiency on IGF-I plasma levels: relationship with bone
      mineral density in perimenopausal women.
AB  - Bone tissue is a source of growth factors; among them, insulinlike growth factor
      I (IGF-I) is probably an important local regulator of bone formation. This study
      has been carried out in order to assess the effects of natural menopause on
      plasma concentrations of IGF-I in the first 6 years after the cessation of
      gonadal function independent of age. We also examined the relationship between
      plasma IGF-I levels and bone mineral density (BMD) measured at the lumbar spine
      (LS), at the ultradistal radius (UDR), and at the junction of the distal and
      middle thirds of the radius (MR). Sixty-seven healthy nonobese women, aged 45-55,
      were studied (premenopausal n = 21; postmenopausal n = 46, from 1 to 6 years
      since menopause). Plasma IGF-I levels were measured by RIA, after acid-ethanol
      extraction. BMD of the forearm was measured by dual-photon densitometer and BMD
      of the LS was assessed by quantitative digital radiography. Mean values of IGF-I
      plasma levels were significantly reduced in postmenopausal women compared to the
      premenopausal group. Menopausal duration did not influence IGF-I plasma levels in
      postmenopausal women. We also found a positive correlation between IGF-I levels
      and BMD measured at MR both in pre- and postmenopausal women, while a correlation
      with LS and UDR-BMD was found only in fertile subjects. The results show that IGF
      I plasma levels decrease immediately after menopause, since significantly lower
      levels are reached in the first years. The correlations found between plasma IGF
      I levels and BMD suggest a possible role of reduced IGF-I in bone loss at
      particular skeletal sites.

PMID- 8348381
TI  - Combined treatment with calcitonin and 1,25-dihydroxyvitamin D3 for osteoporosis
      in women.
AB  - Twenty-two middle-aged women with severe osteoporosis were treated for 2 years
      with either 0.5 mg of synthetic human calcitonin subcutaneously three times per
      week combined with 0.5 micrograms of calcitriol and 0.5 g of calcium per day
      orally or calcium only. The treatment with calcitonin plus calcitriol (12
      patients) resulted in a significantly increased calcium absorption rate. The mean
      values for serum phosphate did not change during the treatment period and the
      mean values did not differ between the treatment groups, but the serum calcium
      and urinary Ca/Cr ratio increased somewhat in the group given the combined
      treatment. There was no evidence that the combined treatment improved the bone
      density in this study. It is possible that calcitriol, instead of increasing the
      effect of calcitonin by suppression of the parathyroid, might have counteracted
      its effect by increasing the bone resorption.

PMID- 8348382
TI  - Iron distribution in thalassemic bone by energy-loss spectroscopy and electron
      spectroscopic imaging.
AB  - Iron overload occurs frequently in thalassemia as a consequence of regular blood
      transfusions, and iron has been found to accumulate in bone, but skeletal
      toxicity of iron is not clearly established. In this study, bone biopsies of
      thalassemic patients were investigated by light (n = 6) and electron microscopy
      (n = 8) in order to analyze iron distribution and possible iron-associated
      cellular lesions. Sections (5 microns thick) were used for histomorphometry and
      iron histochemistry. Ultrathin sections were examined with an energy filtering
      transmission electron microscope. Iron was identified by electron energy loss
      spectroscopy (EELS), and iron distribution was visualized by electron
      spectroscopic imaging (ESI) associated with computer-assisted treatment (two
      window method). This study shows that EELS allows the detection of 4500-9000 iron
      atoms, and that computer-assisted image processing is essential to eliminate
      background and to obtain the net distribution of an element by ESI. This study
      shows also that stainable iron was present along trabecular surfaces,
      mineralizing surfaces, and on cement lines in the biopsies of all patients.
      Moreover, iron was detected by EELS in small granules (diffusely distributed or
      condensed in large clusters), in osteoid tissue, and in the cytoplasm of bone
      cells, but not in the mineralized matrix. The shape and size (9-13 nm) of these
      granules were similar to those reported for ferritin. As for iron toxicity, all
      patients had osteoid volume and thickness and osteoblast surface in the normal
      range. Stainable iron surfaces did not correlate with osteoblast surfaces, plasma
      ferritin concentrations, or the duration of transfusion therapy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8348383
TI  - Selective inhibition of collagen synthesis by fluoride in human pulp fibroblasts
      in vitro.
AB  - Human dental pulp cells were cultured in fluoridated mediums (0, 1, 10, 25 ppm)
      in order to study the biological effect of the ion regarding the cellular
      metabolism: cell growth, alkaline phosphatase (ALP) activity, and protein
      synthesis. The results indicated a decrease of the cell growth at 25 ppm and a
      dose-dependent decrease of the ALP activity. Type I collagen immunoperoxidase
      staining, radioimmunoassay quantitation, and analysis of type I and III collagens
      mRNA levels showed an inhibition of collagen production and gene expression. In
      contrast, fibronectin production and gene expression were not affected by
      fluoride. The treatment did not influence the qualitative pattern of the
      different mRNA species. Of the three collagen chains, the alpha 1(I) was the most
      affected. These data suggest that fluoride does not exert a general depletive
      effect on human dental pulp cells but rather a selective inhibition on collagen
      production.

PMID- 8348385
TI  - Effect of weight manipulation on bone loss due to ovariectomy and the protective
      effects of estrogen in the rat.
AB  - While characterizing the effects of estrogen on an ovariectomized (OVX) rat model
      of bone loss, we examined several weight-matching regimens [e.g., ad libitum
      (feed bins continually full), weight matched (rate of weight gain for OVX and
      Sham-OVX groups was equalized), and weight restricted (weight gain rates for all
      groups were equalized to that of estrogen-treated OVX rats)] for possible
      effects. Bone loss following ovariectomy is primarily the result of an increase
      in bone resorption and is extremely sensitive to the effects of estrogens. Thus,
      in all of our analyses, treatment with 17 beta-estradiol served as a positive
      control for the prevention of bone loss. Each weight-matching study had three
      groups: control (Sham-OVX), OVX, and OVX + 17 beta-estradiol (0.1 mg/kg/day), and
      lasted for either 2, 4, or 6 weeks. Throughout the study, each Sprague Dawley rat
      was weighed every other day, and following sacrifice, a femur was removed for
      bone mineral density (BMD) analysis at the distal metaphysis by single photon
      absorptiometry. Following 2 weeks of dietary modifications, no significant
      differences were detected in BMD among the ad lib or weight matched groups.
      However, an estradiol-preventable reduction in BMD in restricted OVX rats was
      detected at 2 weeks postovariectomy. Additionally, OVX rats in all three dietary
      regimens displayed an estrogen-preventable reduction in proximal femur BMD at 4
      and 6 weeks postovariectomy. These results indicate that a 4-week rat
      ovariectomized model of bone loss, under conditions of ad libitum feeding, shows
      great potential for pharmacologic manipulation.

PMID- 8348384
TI  - Lack of change of cancellous bone volume with short-term use of the new
      immunosuppressant rapamycin in rats.
AB  - Immunosuppressants have adverse effects on bone mineral metabolism in animal and
      human studies, with corticosteroids producing low-turnover osteopenia, and
      cyclosporin-A (CsA) producing high-turnover osteopenia. Rapamycin (RAPA) is a new
      immunosuppressant reported to be at least 10 times more potent than CsA, and acts
      via a different pathway to CsA and the other new immunosuppressant FK506. This
      study investigated the effects of RAPA on bone mineral metabolism in the rat.
      Forty-two, 10-week-old, male Sprague Dawley rats were divided into three groups,
      and treated according to the following protocol: group A (control) received RAPA
      vehicle by daily gavage for 14 days (n = 12); group B (high dose RAPA) received
      RAPA 2.5 mg/kg/day by daily gavage for 14 days (n = 15); group C (low dose RAPA)
      received RAPA 1.25 mg/kg/day by daily gavage for 14 days (n = 15). Rats were
      weighed and bled on days 0, 7, and 14 for measurement of blood ionized calcium,
      bone Gla protein (BGP), parathyroid hormone (PTH), and 1,25(OH)2D. Tibial bone
      histomorphometry was determined on day 14 after double-calcein labeling. Weight
      gain was similar in the two groups treated with RAPA compared with control
      animals. High-dose RAPA (group B) transiently depressed serum BGP levels on day
      7, with elevated blood ionized calcium levels on day 7, and lowered 1,25(OH)2D
      levels on day 14. Serum PTH levels were unchanged. Low-dose RAPA (group C) did
      not affect calciotropic hormones.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348386
TI  - Presence of lactate dehydrogenase-containing vesicles in an intramembranous
      ossifying tissue: new-born mouse calvaria.
AB  - Lactate dehydrogenase-containing vesicles have been isolated from the
      extracellular matrix of the calvaria of new-born mice. The calvariae,
      intramembranous ossification tissue, were removed from 2-day-old mice, followed
      by the separation of the extracellular matrix vesicle fraction after collagenase
      digestion. Lactate dehydrogenase-containing vesicles with a density different
      from that of matrix vesicles were detected in the matrix vesicle fraction.
      Lactate dehydrogenase in these vesicles did not result from cell lysis and
      vesicle capture during the preparation of the matrix vesicle fraction. The
      isoenzyme pattern of lactate dehydrogenase in lactate dehydrogenase-containing
      vesicles was nearly identical to that of cytosolic lactate dehydrogenase of the
      cell fraction. Other cytosolic enzymes were not detected in lactate dehydrogenase
      containing vesicles, suggesting the presence of a mechanism for specific uptake
      of cytosolic lactate dehydrogenase during the in vivo formation of the vesicles.
      This is the first report on the presence of lactate dehydrogenase-containing
      vesicles in the intramembranous ossification site.

PMID- 8348387
TI  - Regional and total body bone mineral content, bone mineral density, and total
      body tissue composition in children 8-16 years of age.
AB  - Normative values for total body bone mineral content (TBBM) and total body bone
      mineral density (TBMD) were derived from measurements on 234 children 8-16 years
      of age. In addition, bone mineral content (BMC) and bone mineral density (BMD)
      values for selected regions of interest and soft tissue (bone free lean and fat)
      for the total body are presented. Bone mineral and soft tissue values were
      determined by dual energy X-ray absorptiometry (DXA) using a Hologic QDR-2000 in
      the array mode. Results of a stepwise multiple regression analysis revealed a
      significant correlation between bone-free lean tissue (BFLT) and BMD (r2 = 0.80)
      in girls. Adding age to the equation accounted for an additional 2% of the
      variance (P < 0.05) and height accounted for another 1% of the variance (P <
      0.05). Body weight and fat tissue (FT) did not account for any additional
      variance. In boys BFLT correlated significantly with BMD (r2 = 0.75; P < 0.05);
      none of the other predictor variables accounted for additional variance. No
      significant differences were found in TBBM or TBMD between boys and girls at any
      age. There was a significant overall gender effect for only three regions of
      interest. Boys had greater BMC in the head region and had greater BMD in the
      upper limbs, but post hoc analysis revealed no significant differences for any
      specific age groups. Girls had greater overall BMD in the pelvis, but this
      difference was only significant at the 15-16-year age group. The changes in BFLT
      and FT over the age ranges were consistent with the growth literature.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8348389
TI  - Cellular immunodeficiency in Paget's disease of bone.

PMID- 8348388
TI  - Lack of effect of ipriflavone on osteoclast motility and bone resorption in in
      vitro and ex vivo studies.

PMID- 8348390
TI  - Ethical issues for cardiovascular physicians. Ethics Committee, Canadian
      Cardiovascular Society.

PMID- 8348391
TI  - Calcium antagonists in heart transplant recipients: effects on cardiac and renal
      function and cyclosporine pharmacokinetics.
AB  - OBJECTIVE: Cyclosporine increases transmembrane calcium flux in mesangial and
      vascular smooth muscle cells, which may explain cyclosporine-induced decreases in
      renal bloodflow and glomerular filtration rate. Calcium antagonists, thus, may
      play a role in the prevention/reversal of cyclosporine nephrotoxicity. DESIGN: In
      a single-blind, randomized, cross-over study the authors evaluated the effects of
      a one-week treatment with nifedipine 20 mg bid, diltiazem 120 mg bid or placebo
      on cardiac and renal functions of six stable heart transplant recipients treated
      chronically with cyclosporine. RESULTS: Both calcium antagonists lowered blood
      pressure compared with placebo, but only nifedipine increased cardiac output and,
      therefore, decreased total peripheral resistance significantly more than
      diltiazem. Nifedipine induced a significant increase in effective renal plasma
      flow and an insignificant increase in glomerular filtration rate, whereas
      diltiazem caused a reduction in these parameters. Cyclosporine pharmacokinetics
      were not affected by either calcium antagonist to a clinically significant
      extent. CONCLUSIONS: Nifedipine and diltiazem exert distinctly different cardiac
      and renal hemodynamic effects in cardiac transplants, which may have clinical
      consequences.

PMID- 8348392
TI  - Comparison of the short term efficacy and tolerability of lovastatin and
      simvastatin in the management of primary hypercholesterolemia.
AB  - OBJECTIVES: To compare the safety and efficacy of lovastatin and simvastatin in
      patients with primary hypercholesterolemia. METHODS: Fourteen Canadian centres
      participated in this double-blind, randomized, parallel-design study with a six
      week screening period, a four-week placebo baseline period and an 18-week active
      treatment period. Patients were included in the study if their total cholesterol
      (TC) was at least 6.2 mmol/L and total triglycerides (TG) were 4.0 mmol/L or less
      at baseline. Half of the patients were in stratum I (TC 6.2 to 7.8 mmol/L at
      baseline and placebo period) and half in stratum II (TC greater than 7.8 mmol/L).
      The initial dose of lovastatin or simvastatin (20 and 10 mg/day, respectively)
      was doubled if the patient's cholesterol was greater than 5.2 mmol/L after six
      and/or 12 weeks, to a maximum of 80 mg/day lovastatin or 40 mg/day simvastatin.
      Of 298 randomized patients, two had baseline data only (and were excluded from
      the efficacy analysis), while 77 were treated with lovastatin and 74 with
      simvastatin in stratum I, and 72 were on lovastatin and 75 on simvastatin in
      stratum II. RESULTS: In stratum I, both lovastatin and simvastatin lowered TC (
      26.0% in both the lovastatin and simvastatin groups), low density lipoprotein
      (LDL) cholesterol (-33.4% in lovastatin and -34.4% in simvastatin), TG (-11.4% in
      lovastatin and -16.2% in simvastatin), apolipoprotein (apo)-B (-24.8% in
      lovastatin and -26.3% in simvastatin) and the TC:high density lipoprotein (HDL)
      cholesterol ratio (from 6.65 to 4.73 in lovastatin and from 6.45 to 4.46 in
      simvastatin), and increased HDL cholesterol (+3.6% in lovastatin and +7.8% in
      simvastatin) and apo-A1 (+6.3% in lovastatin and +9.0% in simvastatin) with P <
      0.001 in all within-group tests except for HDL cholesterol (P < 0.05). Similar
      results were obtained in stratum II for TC (-30.7% in lovastatin and -30.3% in
      simvastatin), LDL cholesterol (-37.6% in lovastatin and -36.8% in simvastatin),
      TG (-21.9% in lovastatin and -16.9% in simvastatin), apo-B (-32.0% in lovastatin
      and -31.7% in simvastatin), TC:HDL cholesterol ratio (from 8.62 to 5.47 in
      lovastatin and from 8.96 to 5.77 in simvastatin), HDL cholesterol (+9.7% in
      lovastatin and +7.5% in simvastatin) and apo-A1 (+7.2% in lovastatin and +8.8% in
      simvastatin), with P < 0.001 in all within-group tests. Serious adverse events
      (clinical and laboratory) were reported in four patients in the lovastatin group
      and three in the simvastatin group. The most reported nonserious adverse effects
      were gastrointestinal tract (15 patients in the lovastatin group and 16 in the
      simvastatin group) and musculoskeletal (14 patients in the lovastatin group and
      11 in the simvastatin group). Medication was withdrawn in eight patients.
      CONCLUSIONS: Both lovastatin and simvastatin were found to be effective and well
      tolerated in each stratum. However, there were no significant differences between
      lovastatin and simvastatin in the treatment of moderate or severe primary
      hypercholesterolemia.

PMID- 8348393
TI  - Long term clinical outcomes following isolated mitral valve replacement.
AB  - OBJECTIVE: This study reviews the short and long term outcomes of patients who
      underwent isolated mitral valve replacement at the University of Alberta
      Hospitals during the past decade. DESIGN: Data were obtained retrospectively by
      review of patients' hospital charts, cardiologists' follow-up charts, contact
      with patients' physicians, and direct telephone or mail contact with patients
      and/or their surviving relatives. RESULTS: The clinical outcomes of 198
      consecutive patients (124 women and 74 men) who underwent isolated mitral valve
      replacement from January 1981 to December 1990 at the University of Alberta
      Hospital were reviewed. Overall early operative mortality was 11%. Deaths were
      mainly related to pump failure and previous mitral valve replacement. Late
      mortality was 17%. Follow-up data were available except in five patients. Average
      follow-up was 6.3 years. Overall cumulative survival was 72.9 +/- 3.4% at five
      years and 63.1 +/- 4.8% at 10 years. The cumulative freedom from complications
      was 64.3 +/- 3.9% and 36.4 +/- 4.9% at five and 10 years, respectively. Long term
      survival rates obtained after isolated mitral valve replacement are higher than
      those reported in series of medically treated patients with mitral valve disease.
      CONCLUSIONS: Mitral valve replacement can prolong survival as well as improve
      symptoms in patients with symptomatic mitral valve disease.

PMID- 8348394
TI  - Intractable ventricular arrhythmias during remodelling and healing after acute
      myocardial infarction.
AB  - A patient with extensive myocardial infarction, evidence of early ventricular
      remodelling, regional left ventricular (LV) dilation and aneurysm formation
      developed recurrent ventricular tachyarrhythmias and episodes of sudden death.
      The patient finally died 24 days post infarction despite effective anti
      remodelling therapy and appropriate anti-failure and anti-arrhythmic therapies.
      Remarkable findings at autopsy included normal LV size and a small LV apical
      aneurysm despite as much as 52% LV necrosis and further right ventricular
      necrosis. The case underscores the need for aggressive early infarct-limiting
      therapy to prevent early remodelling, LV aneurysm and possibly fatal ventricular
      tachyarrhythmias.

PMID- 8348395
TI  - Paradoxical embolism-in-transit: diagnosis and surgical treatment.
AB  - Paradoxical embolism-in-transit is an uncommon presentation of the
      thromboembolism complex. The advent of echocardiography has permitted its
      antemortem diagnosis and serves to guide treatment; this is illustrated by the
      case of a 51-year-old female who presented with paradoxical embolism-in-transit
      and pulmonary embolism following craniotomy. Echocardiography demonstrated mobile
      clot straddling the atrial septum and embolus in the right pulmonary artery.
      Surgery successfully removed all clots as demonstrated by intraoperative
      echocardiography, and the patient had an uneventful recovery.

PMID- 8348396
TI  - Right atrial myxoma originating from the eustachian valve.
AB  - An unusual case of multiple right atrial myxomas arising from the interatrial
      septum and the Eustachian valve is reported. The literature contains reports of
      only one other patient with a right atrial myxoma originating from the Eustachian
      valve.

PMID- 8348397
TI  - Unilateral "vanishing psoas": an anatomic variant.
AB  - We report five patients found to have obvious asymmetry of the psoas muscles on
      abdominal computed tomography (CT) examination. In all five patients, the upper
      portion of the psoas muscle was normal, but the lower portion was significantly
      reduced in size. In no patient was there neurological or other disease that might
      explain this finding. No patient exhibited signs or symptoms secondary to psoas
      asymmetry. Asymmetry of the psoas musculature is apparently a benign anatomical
      variant that may be recognized on CT examination and must be differentiated from
      pathological conditions.

PMID- 8348398
TI  - Cavernous hemangioma of the kidney. Case report.
AB  - Renal hemangiomas are rare neoplasms of the kidney, and the number of cases
      reported in the literature are about 200 since the original description by
      Virchow in 1867. Among these, only a few have been examined by the combination of
      ultrasound, computed tomography, and angiography. We present a demonstrative case
      diagnosed at our clinic and review the corresponding literature.

PMID- 8348400
TI  - Smooth muscle tumors of the inferior vena cava and right heart.
AB  - Four Chinese patients with extensive smooth muscle tumors of the inferior vena
      cava (IVC) and right heart are described. Two patients had primary IVC
      leiomyosarcomas and one had both IVC and cardiac metastases from uterine
      leiomyosarcoma. The remaining patient had extra-uterine intravenous
      leiomyomatosis, with extensive tumor calcification. Clinical presentation was
      variable, consisting of the Budd-Chiari syndrome, a new heart murmur, and signs
      of cerebral embolism. All the lesions were defined radiologically prior to
      surgical resection of cardiac tumors.

PMID- 8348399
TI  - Mesenteric panniculitis presenting as a multilocular cystic mesenteric mass: CT
      and MR evaluation.
AB  - Mesenteric panniculitis is a non-neoplastic, inflammatory process affecting the
      adipose tissue of the mesentery in adults with slight male predilection. Typical
      computed tomography (CT) or magnetic resonance imaging (MRI) findings are of
      either diffuse mesenteric infiltration or nodular mesenteric masses. We
      encountered a case of mesenteric panniculitis in a 26-year-old woman with the
      left upper quadrant pain and fullness, in which CT and MRI disclosed a large, ill
      defined, multilocular cystic mesenteric mass. After surgery, the diagnosis of
      mesenteric panniculitis was made. The cystic components were dilated lymphatics
      due to lymphatic and venous obstruction by the mesenteric panniculitis.

PMID- 8348401
TI  - Angulated needle placement in CT-guided percutaneous needle biopsy of the thorax.
AB  - Computed tomography (CT)-guided percutaneous needle biopsy is often necessary to
      evaluate small intrathoracic lesions. Not infrequently, an overlying structure
      such as a rib or vessel precludes insertion of the biopsy needle within the CT
      slice containing the lesion. Insertion and angulation of the needle at a site
      within an adjacent CT slice is then required. In order to determine the optimal
      skin-entry site and degree of angulation for biopsy needle insertion, we analyzed
      the geometric relationship between lesion depth, needle length, and needle
      angulation.

PMID- 8348402
TI  - Magnetic resonance imaging and computed tomography appearance of asymptomatic
      paravaginal cysts.
AB  - The magnetic resonance imaging (MRI) and computed tomography (CT) appearance of
      18 paravaginal cysts was reviewed. On MRI, serious cysts were hypointense on T1
      weighted and hyperintense on T2-weighted images. Cysts presumed to contain
      proteinaceous material were hyperintense on T1-weighted and T2-weighted sequences
      while hemorrhagic cysts exhibited varying stages of hemorrhage. On CT, a high
      attenuation cyst was presumed to contain proteinaceous material or hemorrhage.
      MRI and CT examination may reveal paravaginal cysts; their varied appearance must
      be recognized to avoid confusion with other lesions.

PMID- 8348403
TI  - Cranial magnetic resonance imaging in Lowe's syndrome.

PMID- 8348405
TI  - Magnetic resonance imaging of hemorrhagic acoustic neuroma.
AB  - A rare case report of a large hemorrhage acoustic neuroma is described with
      computed tomography and magnetic resonance imaging findings. Magnetic resonance
      imaging provides precise definition of the hemorrhage and relationship of the
      tumor to surrounding structures.

PMID- 8348404
TI  - Ossicles anterior to the proximal tibia.
AB  - Ossicles anterior to the anterior tibia are most usually seen in relation to the
      tibial tuberosity. While these are usually taken to represent sequelae of
      previous Osgood-Schlatter disease, they may, on occasion, represent normal
      variants in ossification of the tuberosity. Ossicles superior to the tuberosity
      may have similar origins. Representative examples are presented, as is a very
      large ossicle separated from the anterior tibia by a prolongation of the knee
      joint space. Theories of causation of such ossicles are discussed.

PMID- 8348406
TI  - Large epidermal cyst involving the ischiorectal fossa: MR demonstration.
AB  - A large subcutaneous mass was noted in the buttock of a 79-year-old man. Computed
      tomography (CT) and magnetic resonance imaging (MRI) showed a thin-walled cystic
      mass that involved the ischiorectal fossa. The content appeared hyperintense on
      T1-weighted images. T2-weighted images demonstrated a considerable amount of
      debris. At surgery an epidermal cyst with markedly keratinized squamous
      epithelium was found. It contained much keratin and cholesterin.

PMID- 8348407
TI  - Retroperitoneal extraosseous Ewing's sarcoma with renal involvement: US and MRI
      findings.
AB  - A case of retroperitoneal extraosseous Ewing's sarcoma (EES) with renal
      involvement, which simulated an exophytic renal mass, is reported. EES is a rare
      soft tissue tumor that can occur anywhere in the soft tissues, but is seen most
      commonly in the extremities. Although EES is histologically similar to osseous
      Ewing's sarcoma, it is usually found in older patients. EES should be included in
      the differential diagnosis of soft tissue tumors, especially in the second and
      third decade of life.

PMID- 8348408
TI  - Giant cell tumor of the plantar tendon sheath: role of MR imaging in diagnosis.
      Case report.
AB  - Giant cell tumor of the tendon sheath with characteristic magnetic resonance
      imaging findings is reported. The tumor was low intensity on T1-weighted and T2
      weighted images, and showed strong homogeneous enhancement. These findings were
      considered to represent the pathological features of fine hemosiderin granules
      and collagenization.

PMID- 8348409
TI  - Spectrum of CT and sonographic appearance of fatty infiltration of the liver.
AB  - This report presents the common and unusual appearances of fatty infiltration of
      the liver (FIL) on ultrasound (US) and computerized tomography (CT) from
      pathological, proven cases. Potential diagnostic pitfalls and methods of avoiding
      these pitfalls will be emphasized. Generalized and the geographic pattern of FIL
      are well recognized. Focal FIL and focal sparring of the liver have a number of
      atypical appearances. Focal sparring has several distinct patterns (pseudotumor,
      glove pattern and possible metastasis), which may be confused with other
      pathologies. Likewise, focal FIL may simulate a space-occupied mass. Among the
      more helpful features used to distinguish focal FIL from other abnormalities
      include its lack of mass effect, low density on CT combined with increased
      echogenicity on US.

PMID- 8348410
TI  - Normal anatomic variation: a never ending saga.

PMID- 8348411
TI  - Pancreatic adenocarcinoma presenting with ureteric metastases. Case report and
      review of literature.
AB  - We report a patient with pancreatic adenocarcinoma presenting with ureteric
      metastases. A low index of suspicion led to incomplete radiographic evaluation,
      and the etiology could not be established prior to laparotomy. The differential
      diagnosis of ureteric strictures is reviewed, with a view to providing a simple
      diagnostic flow chart that should prove satisfactory in all but the most
      exceptional cases.

PMID- 8348412
TI  - Canadian Ophthalmological Society. 56th Annual Meeting. June 27-29, 1993,
      Montreal, Quebec. Programme and abstracts.

PMID- 8348413
TI  - Heaven in the United States?

PMID- 8348414
TI  - Heaven in the United States.

PMID- 8348415
TI  - Ciprofloxacin advertising in CMAJ.

PMID- 8348416
TI  - Screening for genetic disease.

PMID- 8348417
TI  - Childhood sexual abuse.

PMID- 8348418
TI  - Vitamin D supplementation.

PMID- 8348419
TI  - CT scanning in meningitis.

PMID- 8348420
TI  - Nurse practitioners.

PMID- 8348421
TI  - Addressing the pharmaceutical industry's influence on professional behaviour.

PMID- 8348422
TI  - Development of residency program guidelines for interaction with the
      pharmaceutical industry. Education Council, Residency Training Programme in
      Internal Medicine, Department of Medicine, McMaster University, Hamilton, Ont.
AB  - Medical residency programs are likely to face increasing pressure to address
      their relations with the pharmaceutical industry. Our internal medicine residency
      program has developed guidelines that were adopted after extensive debate by
      residents and faculty members. The guidelines are based on the principles that
      residents and faculty should set the educational agenda and that the residency
      program should not allow gifts of any sort from industry to residents. Specific
      policies include obtaining and screening educational materials from the industry
      before residents are exposed to them, proscribing "drug lunches" and accepting
      industry sponsorship only when the residency program maintains complete control
      of the educational event being sponsored. The industry response to the guidelines
      was split; about half reacted negatively, and half found the guidelines
      acceptable. Our experience suggests that productive debate about guidelines for
      the interaction of residency programs with the pharmaceutical industry is
      possible and desirable and that explicit policies can clarify areas of ambiguity.

PMID- 8348424
TI  - Risk factors for extended disruption of family function after severe injury to a
      child.
AB  - OBJECTIVE: To identify risk factors for long-lasting disruption of family
      function following pediatric trauma that can be measured at the time of trauma.
      DESIGN: Prospective, exploratory study. Personal interviews were conducted at the
      time of admission and 6 months and 1 year after discharge. SETTING: Level I
      regional pediatric trauma centre. PARTICIPANTS: One hundred and five families
      (86% of those eligible) with a child admitted to hospital for severe trauma with
      an Abbreviated Injury Scale (AIS) score of 4 or higher or with two or more
      injuries in different body parts and AIS scores of 2 or higher were recruited; 13
      families were lost to follow-up at 6 months or 1 year, so their data were not
      included in the analyses. MAIN OUTCOME MEASURES: Family function status (normal
      or abnormal compared with function before the injury), demographic
      characteristics of the parents and child, injury severity, presence of maternal
      psychologic disorder, presence of child behaviour abnormality and functional
      status of the child. MAIN RESULTS: At 6 months and at 1 year 41 families (45%)
      and 21 families (23%) respectively reported that their family lives had not
      returned to normal. The relative odds for disruption of family life were about
      five times higher (95% confidence limits [CL] 1.4 and 19.7) and four times higher
      (95% CL 1.1 and 14.0) for single-parent families than for families with married
      parents living together at 6 months and 1 year respectively. The presence of
      maternal psychologic disorders at admission and increased age of the injured
      child were also significantly associated with extended disruption of family
      function. Injury severity and functional status at discharge were not good
      predictors of family function. CONCLUSIONS: Severe injury to a child places a
      heavy strain on normal family function. In particular, single parents and parents
      experiencing mental or emotional problems at the acute stage of the injury need
      help in coping with their reactions to the trauma and may benefit from individual
      or group counseling.

PMID- 8348426
TI  - Neural regeneration research offers hope.

PMID- 8348425
TI  - Elective repeat cesarean sections: how many could be vaginal births?
AB  - OBJECTIVE: To determine (a) the proportion of women undergoing elective repeat
      cesarean section without a trial of labour who were eligible for such a trial by
      the 1986 guidelines of the panel of the National Consensus Conference on Aspects
      of Cesarean Birth, (b) whether vaginal birth after cesarean section (VBAC) was
      discussed with these women and (c) the reasons cited for not having a trial of
      labour. DESIGN: Chart audit. SETTING: Level 2 perinatal care centre in a general
      teaching hospital. PATIENTS: All 313 women with a history of previous cesarean
      section who gave birth at the centre during 1989. RESULTS: Only 93 (30%) of the
      313 women underwent a trial of labour. According to the 1986 guidelines 71% were
      eligible. A further 13% would have been eligible according to the revised 1991
      guidelines. Of the 220 women who underwent elective repeat cesarean section, only
      24 (11%) had a discussion of VBAC noted in their hospital charts. However, of all
      117 patients whose charts indicated discussion of VBAC 93 (79%) chose to try it.
      Most of the women had either questionable indications or no indication noted for
      undergoing repeat cesarean section. CONCLUSION: Most of the women who underwent
      repeat cesarean section were eligible for a trial of labour. However, few charts
      noted a discussion of VBAC. Further physician and patient education is necessary
      to promote the appropriate use of VBAC and repeat cesarean section.

PMID- 8348427
TI  - DNA typing has become an important police tool.

PMID- 8348423
TI  - Report of the Canadian Hypertension Society Consensus Conference: 2. Diagnosis of
      hypertension in adults.
AB  - OBJECTIVE: To update recommendations for the diagnosis of mild hypertension in
      adults and to assess the role of echocardiography, self-measurement of blood
      pressure and ambulatory blood pressure monitoring. DATA SOURCES: Literature
      reviews of previous consensus conferences were updated with searches of MEDLINE
      for the period Jan. 1, 1988, to Nov. 15, 1991, and supplemented by reference
      lists and personal files. STUDY SELECTION: Panel members selected relevant
      articles and rated them according to methodologic criteria. DATA EXTRACTION: The
      data extracted concerned the measurement of blood pressure, the diagnosis of
      hypertension, the treatment of mild hypertension, and the reliability and
      validity of echocardiography, self-measurement of blood pressure and ambulatory
      blood pressure monitoring in the diagnosis of mild hypertension. The
      recommendations made were graded according to the level of evidence available,
      circulated to many experts and approved at a consensus conference. MAIN RESULTS:
      Previous recommendations for the accurate measurement of blood pressure remain
      mostly unchanged. Antihypertensive treatment should be prescribed for patients
      (including the elderly) with an average diastolic blood pressure of at least 100
      mm Hg, for those with isolated systolic hypertension (systolic blood pressure of
      at least 160 mm Hg and diastolic blood pressure of less than 90 mm Hg) and for
      patients with a diastolic blood pressure of 90 to 99 mm Hg and target-organ
      damage. Clinical judgement is required in treating patients with a diastolic
      blood pressure of 90 to 99 mm Hg without target-organ damage, and individual risk
      for cardiovascular disease must be taken into account. There is insufficient
      evidence to warrant the routine use of echocardiography, self-measurement of
      blood pressure or ambulatory blood pressure monitoring in diagnosis. CONCLUSIONS:
      Recent high-quality evidence supports several new recommendations for the
      diagnosis of mild hypertension in adults. Additional research is needed to
      determine the role of echocardiography, self-measurement of blood pressure and
      ambulatory blood pressure monitoring.

PMID- 8348428
TI  - SOGC says regulatory agencies stalling on approval of safe, effective
      contraceptives.

PMID- 8348429
TI  - Walk-jog prescription introduced by Toronto centre now a mainstay of cardiac
      rehabilitation.

PMID- 8348430
TI  - A Canadian doctor in Zaire.

PMID- 8348431
TI  - Canadian lawyer at Harvard a mainstay behind calls to change response to medical
      malpractice.

PMID- 8348432
TI  - Traditional Chinese medicine becoming another health care option for Canadians.

PMID- 8348433
TI  - The red face: historical considerations.

PMID- 8348434
TI  - The red face in domestic animals.

PMID- 8348435
TI  - The red face: flushing disorders.

PMID- 8348436
TI  - The red face: rosacea.

PMID- 8348437
TI  - The red face: atopic dermatitis.

PMID- 8348439
TI  - The red face: lupus erythematosus.

PMID- 8348438
TI  - The red face: seborrheic dermatitis.

PMID- 8348440
TI  - The red face: dermatomyositis.

PMID- 8348441
TI  - The red face: photogenodermatoses.

PMID- 8348442
TI  - The red face: physical erythemas.

PMID- 8348443
TI  - The red face: contact and photocontact dermatitis.

PMID- 8348444
TI  - The red face: chronic actinic dermatitis.

PMID- 8348445
TI  - The red face: erysipelas.

PMID- 8348447
TI  - The red face: cutaneous lymphomas.

PMID- 8348446
TI  - The red face: drugs, chemicals and other causes.

PMID- 8348448
TI  - Where are the transformational leaders?

PMID- 8348449
TI  - Development of a psychiatric home care program and the role of the CNS in the
      delivery of care.

PMID- 8348450
TI  - Response to Samulski.

PMID- 8348451
TI  - Mind-body connection: enhancing healing through imagery.

PMID- 8348452
TI  - Imagery: a strategic intervention to empower clients. Part I--Review of research
      literature.
AB  - This article is the first of a two-part series on the use of imagery in nursing
      practice. Imagery, an ancient healing technique, is a cognitive tool that acts as
      a communication mechanism among perception, emotion, and bodily change. Research
      has found that imagery can help reduce pain and stress, alter the course of
      disease, and improve clients' outlook on their illness. Imagery engenders a
      feeling of control and gives the client an effective tool for self-care. This
      article presents an overview of the history of imagery in medicine and nursing,
      discusses different types of imagery, and examines possible uses for imagery in a
      CNS's practice. Finally, recent research studies of imagery in nursing,
      psychology, and medicine are examined. The second article will help the nurse
      learn to use imagery in practice and will include a detailed imagery script.

PMID- 8348454
TI  - Informed consent and vulnerable subjects.

PMID- 8348453
TI  - Spiritual needs and interventions: comparing the views of patients, nurses, and
      chaplains.
AB  - Because of the current trend to use the term spiritual in a broad context that
      includes religious aspects as a component, along with others such as
      transcendence and relational aspects, it is essential to clarify what people mean
      when they use the term. The researchers designed a descriptive (qualitative)
      study to collect interview data to determine how patients, nurses, and chaplains
      currently are defining the phrases spiritual needs and spiritual interventions.
      The researcher interviewed and recorded the responses of 19 surgical patients, 12
      nurses, and 7 chaplains to identify their definitions and the specific
      interventions they thought nurses and chaplains should use to meet spiritual
      needs. The interviews were analyzed and definitions of spiritual needs were
      classified according to six categories: religious, values, relationships,
      transcendence, affective feeling, and communication. Respondents identified five
      common nursing interventions: prayer, scripture, presence, listening, and
      referral.

PMID- 8348455
TI  - Group functioning of a collaborative family research team.
AB  - Collaborative research teams are an attractive means of conducting nursing
      research in the clinical setting because of the many opportunities that
      collaboration can supply. These opportunities include a chance to: (1) network
      with other nurses who have similar interests, (2) share knowledge and expertise
      for designing clinical studies that directly affect daily practice, (3) develop
      instruments, (4) write grant proposals, (5) collect and analyze data, and (6)
      prepare manuscripts for publication. The effectiveness of research teams,
      however, is strongly influenced by group functioning. This article describes the
      functioning of a collaborative family interventions research team of nursing
      faculty members and CNSs at a large Midwestern university setting. The formation
      of the group and membership characteristics are described, along with strategies
      used to identify the research focus and individual and group goals. Aspects
      related to the influence of the group on members and the internal operations of
      the group are also addressed. Future strategies to be explored will focus on the
      size of the group and joint authorship issues. The authors also set forth a
      number of recommendations for development of collaborative research groups.

PMID- 8348456
TI  - Identification of confusion among the elderly in an acute care setting.
AB  - An exploratory, descriptive study was conducted in a large acute care hospital to
      determine: (1) the indicator/descriptors used by staff nurses to arrive at the
      diagnosis of confusion, and (2) which indicators/descriptors are perceived as
      most significant in such a diagnosis. In addition, because the literature
      frequently cites the occurrence of nurses stereotyping patients as confused and
      thereby treating them as confused (Libow's self-fulfilling prophecy), the third
      question explored was the type and quantity of information that was given to
      nurses at intershift report. A self-constructed interview schedule was used on a
      sample of 25 staff nurses who were primary caregivers of a confused patient on a
      given day. Content analysis revealed emergent themes of confusion in two domains:
      cognitive and behavioral. The findings from this study revealed nurses used
      cognitive descriptors more frequently to diagnose confusion; however, a large
      majority of nurses used a combination of both cognitive and behavioral
      descriptors for diagnosis. Nurses also used independent assessment based on their
      own observations rather than those from the night nurse in arriving at a nursing
      diagnosis of confusion. This investigation responds to the need to "confirm
      defining characteristics of the phenomenon of confusion" posited by Foreman. In
      addition, results from this study will provide a basis for a taxonomy on the
      phenomenon of confusion. It is hoped that such a taxonomical classification will
      enable nurses to assess the confused patient more effectively.

PMID- 8348458
TI  - Divorced?

PMID- 8348457
TI  - Product evaluation for cost containment.

PMID- 8348459
TI  - Factors that influence CNSs' decision about specialization.
AB  - Few studies have explored nurses' decision making relative to advanced practice.
      The purposes of this study were to determine when the decision to prepare as a
      CNS in a particular specialty is made and to identify the factors that influence
      that decision. A survey was completed by 257 CNSs. Results indicated that more
      than half (69%) decided on their specialty after graduation from a basic nursing
      program. The factors that influenced choice of specialty included experience in
      first position (47%), clinical role model (37%), and student experience (35%).
      Critical care was rated the most desirable specialty and psychiatric nursing the
      least preferred.

PMID- 8348461
TI  - Reverence for the old.

PMID- 8348460
TI  - Validating a compendium of goals and objectives for educating CNS students in
      ambulatory care.
AB  - In fall 1990, the Department of Veterans Affairs launched a Pilot Ambulatory Care
      and Education program that has as its major goal the shift from a traditional
      inpatient specialty-based focus of patient care and health professional education
      to a more forward-looking outpatient generalist-based focus of care and
      education. The generalist and specialist focus of the CNS role has been
      introduced in this innovative ambulatory care program. Formal and informal
      educational opportunities for interdisciplinary team members and students abound.
      This article describes the development and validation of a compendium of goals
      and objectives for educating CNS students in ambulatory care.

PMID- 8348462
TI  - Executive practice. Transition is risky business.

PMID- 8348463
TI  - Strategies to limit CNS malpractice liability exposure.
AB  - The number of nurses named as defendants in medical malpractice cases is
      increasing. The CNS may be especially vulnerable in this legal climate. The
      complexity and diversity of the CNS role expose the CNS to an increased risk of
      malpractice liability in a variety of situations. Malpractice judgments and
      verdicts are used to describe the legal milieu that the CNS practicing in the
      various roles may encounter. The CNS roles examined are that of: clinician,
      educator, consultant, and researcher. The liabilities inherent in each of the CNS
      roles are defined, as well as strategies to limit malpractice liability exposure.

PMID- 8348464
TI  - Case management: a model of CNS practice.
AB  - Case management has been widely implemented as a new health care delivery model.
      The case manager has the pivotal role in the model. The CNS, having the clinical
      expertise, clinical judgment, and leadership, best suits the case manager's role.
      As a case manager, the CNS enacts the five role components: expert practitioner,
      educator, consultant, researcher, and manger. Case management, therefore, can be
      considered as a model of CNS advanced practice.

PMID- 8348465
TI  - Extrapyramidal symptoms: a challenge for the consultant.

PMID- 8348466
TI  - Bill C-30 and Canadian Psychiatry.

PMID- 8348467
TI  - Psychiatric networks in Canada.

PMID- 8348468
TI  - The Greater Vancouver Mental Health Service Society: 20 years' experience in
      urban community mental health.
AB  - Caring for people in the community with persistent and disabling mental illnesses
      presents a major challenge to government, planners and mental health
      professionals. The success with which mentally disabled people are integrated
      into community life says much about the society in which we live. This article
      describes the experience of the Greater Vancouver Mental Health Service Society
      in offering community-based mental health services to persons with schizophrenia
      and other major mental disorders over the past 20 years. The key to its success
      lies in a decentralized, relatively non hierarchical organizational structure
      which allows committed and skilled multidisciplinary teams to work with patients
      and their families in their community. The resulting services are fully
      integrated within the fabric of the community and are responsive to local needs.
      Partnerships among professionals, patients, families and community agencies
      result in work that is creative, productive and effective.

PMID- 8348469
TI  - The Hamilton (McMaster) psychiatric network: the evolution of an integrated
      network of psychiatric services.
AB  - For 25 years, the Hamilton-Wentworth region has had a well integrated network of
      psychiatric services. The initial impetus for its establishment came from the
      founders of the Department of Psychiatry at McMaster University in 1967. They
      envisaged a regional network of services that integrated the resources of a
      community-focused university department with those of local community agencies
      and other mental health care professionals. Over the years, the evolution of the
      network has been shaped by changes in the size and composition of the faculty,
      the emergence of additional clinical services and community programs, new
      directions in the field of psychiatry and changing economic forces and social
      values.

PMID- 8348470
TI  - Psychiatric networks: they make sense, but do they work?
AB  - With a trend toward coordinated networks of mental health services, it is
      necessary to be able to assess their impact. This paper outlines an approach to
      network analysis, using a variety of methodologies to come up with a composite
      picture. Areas to examine include the network processes, such as its goals,
      functions, structures, outcomes, and the satisfaction of all involved.

PMID- 8348471
TI  - New onset rapid cycling bipolar disorder in an 87 year old woman.
AB  - New onset rapid cycling bipolar disorder is rare in late life. The authors report
      the case of an 87 year old woman who first developed this disorder at age 82 and
      was successfully treated with valproate and L-thyroxine. The contribution of
      aging, hypothyroidism and stroke to the etiology of this woman's disorder is
      discussed. The pharmacological management of rapid cycling bipolar disorder in
      the elderly is also reviewed.

PMID- 8348472
TI  - [Elements for understanding "schizophrenic vulnerability"].
AB  - Studies of the negative symptoms of schizophrenia seem to be of interest.
      However, the description of these symptoms is problematic. Some cognitive tests
      seem able to establish data that can be used to help discriminate among
      schizophrenic syndromes and to understand their different pathophysiology. Some
      of the main tests are described. Remarks concerning their value and the
      conditions of their interpretations are made.

PMID- 8348473
TI  - Clinical electroencephalography in a psychiatric service.
AB  - An audit of the use of clinical electroencephalography in a psychiatric service
      was carried out by examining the referrals for an EEG from the service over one
      year (11% of all referrals), comparing them with matched patient controls, rating
      the EEGs blindly and estimating the clinical value of the investigation for each
      patient; 37% were abnormal, 19% anomalous and 44% normal. The following two
      clusters of symptoms and signs were associated with EEG referral--the patients
      with "organic" mental state phenomena and/or CNS signs; EEG usually abnormal and
      the patients with behavioural changes that raise the suspicion of an organic
      process but, taken alone, are not compelling evidence of such (for example,
      impulsive behaviour, acute and atypical psychoses, perceptual or behavioural
      phenomena of the type associated with temporal lobe epilepsy in the absence of
      frank complex partial seizures); EEG usually normal or anomalous. Ninety-two
      percent of EEGs were judged to be of clinical value; 53% positive and 39%
      negative. Eight percent of referrals made no contribution to the clinical
      evaluation.

PMID- 8348474
TI  - [Psychological distress in a noninstitutionalized population of Quebec: normative
      results of the Quebec health survey].

PMID- 8348475
TI  - The teaching of case formulation in Canada.
AB  - Prompted by the Council on Education and Professional Liaison of the Canadian
      Psychiatric Association, the authors surveyed the program directors and senior
      residents of departments of psychiatry on the teaching of case formulation skills
      in Canada. The results showed that case formulation is taught formally in most
      departments and that students are expected to demonstrate these skills throughout
      their training. However, less than one-half of the teaching programs provide
      guidelines for case formulation. The residents, who expected case formulation
      skills to be assessed in the oral examinations of the Royal College, were
      unanimous in their view that the process should be standardized and that
      guidelines be provided. Both the program directors and the residents favoured a
      biopsychosocial format for recording case formulation, but they did not agree on
      the content of an ideal formulation.

PMID- 8348476
TI  - Formulation: a multiperspective model.
AB  - This paper presents a model of formulation that can be used by psychiatrists and
      other mental health professionals. A review of the literature indicates a need
      for a more comprehensive approach that can accommodate a variety of perspectives,
      suggest treatment and can be easily recalled. These issues are addressed by the
      multiperspective grid presented in this paper.

PMID- 8348477
TI  - Teaching biopsychosocial integration and formulation.
AB  - This paper describes the mental processes by which the psychiatrist organizes and
      integrates data to produce a case formulation. The biopsychosocial formulation
      uses three perspectives (biological, psychological and social) to view the data
      and integrates these viewpoints into one broad, complex and dynamic appreciation
      of the patient. Guidelines for creating and communicating a case formulation are
      proposed.

PMID- 8348478
TI  - Alcohol abuse and schizophrenia.

PMID- 8348479
TI  - Depression and patients with rheumatoid arthritis.

PMID- 8348480
TI  - Emergency psychiatric consultation to a children's aid society.

PMID- 8348481
TI  - Is borderline personality disorder a post-traumatic stress disorder of early
      childhood?

PMID- 8348482
TI  - Syndrome of exchanged doubles.

PMID- 8348483
TI  - CT scan failure to confirm Pick's disease: a case report of "pseudo
      pseudodementia".

PMID- 8348484
TI  - The palpable breast nodule: a cost-effectiveness analysis of alternate diagnostic
      approaches. The role of the needle aspiration biopsy.

PMID- 8348485
TI  - CDw75 antigen expression in human gastric carcinoma and adjacent mucosa.
AB  - BACKGROUND: The amount of sialic acid correlates with the invasiveness and
      metastasizing potential of several human tumors. The CDw75 epitope is a
      sialylated carbohydrate determinant generated by the beta-galactosyl alpha 2,6
      sialyltransferase, which can be viewed as a target for identifying biologically
      aggressive tumors. METHODS: The authors performed an immunohistochemical study of
      CDw75 epitope expression in 87 cases of gastric carcinoma and adjacent mucosa and
      331 metastases (329 lymph node metastases and 2 liver metastases) with the
      monoclonal antibody HH2. RESULTS: Normal-appearing mucosa, foci of intestinal
      metaplasia, and foveolar hyperplasia, adjacent to the carcinomas, were mainly
      nonimmunoreactive. Only a few parietal cells of the body mucosa were stained with
      HH2. Two of 12 cases with dysplasia showed CDw75 antigen expression in dysplastic
      glands. Forty-one cases (47.1%) were immunoreactive for CDw75 antigen in the
      primary tumors or metastases. A very close relationship was found between the
      expression of the antigen in primary tumors and their respective metastases. The
      expression of the antigen was correlated with an infiltrative growth pattern,
      lymphatic invasiveness, and aneuploidy. All but two immunoreactive cases had
      lymph node metastases or lymphatic permeation. No relationship was found between
      CDw75 antigen expression and the morphologic types of gastric carcinoma, amount
      of lymphoid infiltrate, vascular invasion, and penetration of the gastric wall.
      CONCLUSIONS: The authors conclude that CDw75 antigen expression can be used as a
      marker of malignant transformation of gastric epithelium and is a good indicator
      of the biologic aggressiveness of gastric carcinoma.

PMID- 8348486
TI  - X-linked agammaglobulinemia and gastric adenocarcinoma.
AB  - BACKGROUND: The incidence and mortality rate for cancer in patients with primary
      immunodeficiency diseases have increased greatly. Lymphomas constitute more than
      50% of tumors identified in the Immunodeficiency Cancer Registry, but solid
      tumors are frequent in these patients, especially gastric carcinomas. In addition
      to immunologic impairment, other local conditions such as chronic atrophic
      gastritis with intestinal metaplasia and pernicious anemia, usually observed in
      these patients, may play an important role in the genesis of gastrointestinal
      tumors. METHODS AND RESULTS: This report describes a 23-year-old patient with X
      linked agammaglobulinemia who had previously documented chronic atrophic
      gastritis with intestinal metaplasia, pernicious anemia, and parasitization with
      Giardia lamblia in whom an adenocarcinoma of the stomach developed. CONCLUSION:
      The authors believe that it may be useful to perform a periodic gastrointestinal
      evaluation for all patients with primary immunodeficiencies to establish early
      detection and treatment of these tumors.

PMID- 8348487
TI  - Clinical significance of dysplasia in gastric remnant biopsy specimens.
AB  - BACKGROUND: Dysplasia often is found in biopsy specimens from the gastric stump
      some 20 years after ulcer surgery. A high frequency of patients with severe
      dysplasia in the nonoperated stomach develop carcinoma but the clinical
      significance of dysplasia in the gastric stump is still confounding. METHODS: In
      the current study, two groups of patients were evaluated. One group of 22
      patients, found at the first investigation in an endoscopic screening study with
      moderate dysplasia in the gastric stump, were regularly followed up to 18 years
      with endoscopy and biopsies. In the second part of the investigation, the authors
      evaluated 17 patients from the same endoscopic screening study, who at any
      instance during the 18 years were found to have severe dysplasia in biopsy
      specimens from the gastric remnant. RESULTS: In three of the 22 patients with
      moderate dysplasia, stump carcinoma was diagnosed 2, 2, and 6 years,
      respectively, after the first endoscopic examination. Severe dysplasia was found
      in two other patients at one occasion but later investigations only revealed
      moderate dysplasia. The remainder of the patients in this group had either
      persisting moderate dysplasia or mild dysplasia at follow-up. Seven (41%) of the
      17 patients with severe dysplasia had stump carcinoma within a median time of 2
      years (range, 1-11). Two other patients had surgery based on suspicion of
      carcinoma, but had only severe dysplasia in the surgical specimen. Finally, three
      men died (after 1, 2, and 17 years, respectively) of unrelated disease without
      suspicion of stump carcinoma and five patients were followed between 6 and 18
      years without signs of malignant development. CONCLUSIONS: Patients with moderate
      and, especially, severe dysplasia in the gastric remnant are at high risk for
      gastric carcinoma. Severe dysplasia calls for endoscopic surveillance at short
      intervals. For patients with moderate dysplasia a close surveillance for 2 years
      followed by biannual evaluation appears sufficient.

PMID- 8348488
TI  - Clinicopathologically diagnosed residual tumor after resection for colorectal
      cancer. A 20-year prospective study.
AB  - BACKGROUND: A lack of comprehensive information exists on the nature, incidence,
      and prognostic significance of known residual tumor in colorectal cancer patients
      treated by bowel resection. This study aims to provide this information. METHODS:
      A prospective series of 1766 consecutive patients from the Concord Hospital
      Colorectal Cancer Registry (Concord, Australia) was used for the analysis.
      Residual tumor was defined as distant metastases diagnosed clinically or
      pathologically or tumor demonstrated histologically in a line of resection. The
      pathologic study was highly standardized. Patient follow-up ranged from 6 months
      to 20.5 years. Survival analysis was by the Kaplan-Meier method. Multivariate
      models were examined using Cox proportional hazards regression. RESULTS: The
      prevalence of residual tumor was 20.9% and the median survival was 11.6 months.
      In 4.5%, tumor transection alone occurred, 14.5% had distant metastases alone,
      and 1.9% had both. The difference in survival between the first two groups was at
      marginal statistical significance (P = 0.076). When each of these two groups was
      compared with the third group, significant differences were noticed (P = 0.001
      and P = 0.004, respectively). Five of 14 pathology variables examined had a
      significant effect on survival using univariate analysis. On multivariate
      analysis only tumor transection and distant metastases had significant
      independent effects. CONCLUSIONS: Known residual tumor was common in this series:
      one in five resections. Survival studies show that tumor transection, as defined,
      is a valid criterion for residual tumor. Survival is significantly reduced when
      tumor transection and distant metastases both are present. These findings should
      be heeded when staging colorectal cancer and when stratifying patients for
      postoperative adjuvant therapy.

PMID- 8348489
TI  - Bowel rest, intravenous hydration, and continuous high-dose infusion of
      octreotide acetate for the treatment of chemotherapy-induced diarrhea in patients
      with colorectal carcinoma.
AB  - BACKGROUND: A prospective trial was conducted involving 16 patients with
      colorectal adenocarcinoma using a regimen of continuous-infusion octreotide
      acetate (Sandostatin [octreotide acetate], Sandoz, East Hanover, NJ for the
      treatment of severe diarrhea induced by the weekly schedule of 5-fluorouracil (5
      FU) in combination with leucovorin who were refractory to opiate therapy.
      METHODS: Fifteen patients had tissue-documented metastatic colorectal
      adenocarcinoma. An additional patient was treated adjuvantly. Fifteen patients
      were treated with chemotherapy consisting of 5-FU and high-dose leucovorin. The
      octreotide acetate regimen used was a continuous infusion of 50 micrograms/h for
      12 hours followed by 100 micrograms/h for 12 hours and subsequently 150
      micrograms/h for 72 hours. All patients were previous failures of diphenoxylate
      atropine (Lomotil diphenoxalate], Searle, Chicago, IL) given 2.5 mg orally after
      each loose bowel movement, but no more than 20 mg in a 24-hour period. Opiate
      therapy was not continued beyond 48 hours. All patients also were treated with
      bowel rest (nothing by mouth) and intravenous fluid hydration as well as
      octreotide acetate. RESULTS: Complete resolution of diarrhea was seen in 15 of 16
      patients (94%). In 4 patients this was accomplished during the 100 micrograms/h
      infusion, and in 11 patients during the 150 micrograms/h infusion. Recurrence of
      diarrhea was seen in two patients after a complete cycle of octreotide acetate.
      Both patients were restarted at 150 micrograms/h for 72 hours of octreotide
      acetate with resolution of the diarrhea within 36 hours of the infusion. No
      toxicity related to octreotide acetate was seen in this trial. CONCLUSION: The
      continuous-infusion regimen of octreotide acetate 150 micrograms/h is an
      effective and safe schedule for the treatment of chemotherapy-induced diarrhea
      together with bowel rest and intravenous fluid hydration in a group of patients
      in whom the majority were treated with the weekly schedule of 5-FU and high-dose
      leucovorin.

PMID- 8348490
TI  - Hepatic gastrinoma.
AB  - A solitary hepatic tumor in a 50-year-old woman, which was observed as a
      hemangioma, ultimately was resected because it increased in size. The tumor
      volume doubling time was 28.8 months over the observed period of 30 months. The
      histologic diagnosis was carcinoid tumor. Immunohistochemical staining showed
      strong focal reactivity for gastrin and diffuse reactivity for pancreatic
      polypeptide, vasointestinal polypeptide, calcitonin, and parathormone.
      Preoperative gastric hyperacidity with diarrhea and a body weight loss of 7 kg,
      moderately controlled by cimetidine on admission, suggested high serum gastrin
      levels produced by the tumor. Her symptoms resolved after surgery, and she had a
      normal serum gastrin level with negative secretin stimulation test results. A
      review of six cases of hepatic gastrinoma suggests that surgical resection, if
      feasible, would be the treatment of choice.

PMID- 8348491
TI  - Effect of age on survival in acute leukemia. 1950-1990.
AB  - BACKGROUND: Four decades ago, survival of patients with acute leukemia was brief
      at any age. Since 1950, survival of children has increased remarkably but has
      changed little for the elderly. The nature and magnitude of this age difference
      in survival are not understood. METHODS: Median survival was determined in 2364
      Kansas residents diagnosed with acute leukemia from 1947 until 1990. Of this
      number, 1032 had acute lymphocytic leukemia and 1227 had acute myelocytic
      leukemia diagnosed between 1950 and 1989. These patients were stratified by age
      and decade of diagnosis. Survival was computed by life-table analysis with
      significance determined by log-rank, Wilcoxon, and Fisher exact tests. RESULTS:
      During the 40 years of the study, highly significant increases occurred in median
      survivals for all groups with either acute lymphocytic leukemia or acute
      myelocytic leukemia occurring in patients younger than 60 years of age (P <
      0.0001 for some age groups), but no significant increases for those 61 to 80
      years of age and those 81 years of age and older. Viewed in another dimension,
      for each decade from the 1960s to the present in acute lymphocytic leukemia and
      from the 1970s to the present in acute myelocytic leukemia, age at diagnosis was
      inversely correlated with median survival in a highly significant manner (P <
      0.001). CONCLUSIONS: Increasing age is inversely related to survival in patients
      with acute leukemia. The lack of significant improvement in median survival in
      the last 40 years for those older than 60 years of age stands in stark contrast
      to the remarkable improvement for younger patients. Acute leukemia in older
      patients demands new and probably different therapeutic strategies.

PMID- 8348492
TI  - A longitudinal study of oral ulcerative mucositis in bone marrow transplant
      recipients.
AB  - BACKGROUND: Few longitudinal studies have investigated the onset, duration, and
      resolution of ulcerative mucositis in bone marrow transplant recipients. This
      study prospectively followed a group of such patients on a daily basis to obtain
      data on the incidence of ulcerative mucositis, location and duration of lesions,
      severity with different conditioning regimens, and the relationship of such
      mucositis to the absolute neutrophil count. METHODS: Fifty-nine bone marrow
      transplant recipients on prophylactic acyclovir were examined daily for 26 days
      after marrow infusion, and all oral ulcerative lesions were recorded. RESULTS:
      Oral ulcers occurred in 76.3% of patients, began at a mean of 5 days after marrow
      infusion (day + 5), and lasted for a median of 6 days. More than 90% of patients
      showed complete resolution of ulcers on or before day + 15, and all showed
      resolution when the absolute neutrophil count was > 500 cells/ml. Persistence of
      ulcers was noticed in patients who had oral graft-versus-host disease and in some
      patients who initially developed more severe ulcerations. Ninety-six percent of
      ulcers were located on nonkeratinized mucosa. CONCLUSIONS: Ulcerative mucositis
      occurs in about 75% of bone marrow transplant recipients in the absence of herpes
      simplex virus infection. Most lesions occur on nonkeratinized mucosae which are
      vulnerable to trauma, especially if such mucosae are rendered atrophic by
      conditioning regimens. Oral ulcers may persist beyond day + 15 and after recovery
      of the neutrophil count in patients who initially develop more severe ulcerations
      or in patients who develop graft-versus-host disease.

PMID- 8348493
TI  - Giant basal cell carcinoma (T3). Who is at risk?
AB  - BACKGROUND: Giant basal cell carcinomas can cause extensive local invasion and
      disfigurement. This study determines in whom giant basal cell carcinomas develop.
      METHODS: Fifty patients with giant basal cell carcinomas (over 5 cm, T3) were
      compared with other groups of patients with small (< 2 cm, T1) or intermediate
      sized (2-5 cm, T2) basal cell carcinomas. The patients were treated at the Mayo
      Clinic between August 1986 and December 1990. RESULTS: Characteristics that were
      more common in giant basal cell carcinomas than in smaller lesions were duration,
      patient neglect, recurrence after previous treatment, aggressive histologic
      pattern, and history of radiation exposure. CONCLUSIONS: Patients who have a
      basal cell carcinoma with an aggressive histologic subtype, a recurrence after
      previous treatment, a history of radiation exposure, or a history of neglect are
      at risk for giant basal cell carcinoma.

PMID- 8348494
TI  - Evaluation of computed tomography in patients with peritoneal carcinomatosis.
AB  - BACKGROUND: Radiologic tests to determine the size and location of cancer on
      peritoneal surfaces are needed for patient management and for clinical research
      activity. METHODS: Computed tomography (CT) of the abdomen and pelvis were
      obtained on 45 patients with a diagnosis of peritoneal carcinomatosis before
      implementation of a complete exploratory laparotomy with biopsy or resection of
      all tissues suspicious of malignancy. CT findings and surgical findings were
      recorded and the data analyzed by dividing the abdomen into 9 regions or into 15
      anatomic sites. RESULTS: In an overall patient analysis, the sensitivity was 79%.
      In the nine different abdominal regions, sensitivity was greater than 80% in the
      right flank, left flank, and right lower and left lower abdominal regions.
      Sensitivity was lowest in the pelvis (60%). Negative predictive value in the
      pelvis was 20%. The volume of tumor present within an abdominal region or
      anatomic site greatly influenced the sensitivity. A sensitivity of only 28% was
      recorded when tumor nodules were less than 0.5 cm in thickness. This increased to
      90% when nodule thickness was greater than 5 cm. CONCLUSIONS: CT is not a
      reliable diagnostic test for low volume tumor on peritoneal surfaces, and the
      greatest inaccuracies were recorded in the pelvis. Its diagnostic value increased
      as tumor volume increased.

PMID- 8348495
TI  - Desmoid tumors of the trunk and extremity.
AB  - BACKGROUND: Twenty-six patients with desmoid tumors of the extremities (n = 20)
      or trunk (n = 6) have been treated since 1977. Nine of these were referred with
      primary tumors and 17 with recurrent tumors. METHODS: The tumor was removed in
      all patients, and 10 received adjuvant radiation. Five patients (19%) developed
      local recurrence; one of them was lost to follow-up, and the remaining four
      patients had the recurrence controlled with surgical resection or resection plus
      adjuvant radiation. RESULTS: All 25 patients who have been followed are alive and
      disease-free at a mean follow-up of 84 months (median, 81 months). None with
      extremity tumors (n = 20) required an amputation. The estimated survival rate for
      the entire group is 95% at 42 months. CONCLUSIONS: Desmoid tumor of the trunk or
      extremities treated with surgical resection, supplemented selectively by adjuvant
      radiation, can be controlled locally in the majority (96%) of patients.

PMID- 8348496
TI  - The palpable breast nodule. A cost-effectiveness analysis of alternate diagnostic
      approaches.
AB  - BACKGROUND: Traditionally, open biopsy has been considered the optimal procedure
      for the diagnosis of breast nodules. Fine-needle aspiration biopsy (FNAB) has
      been proposed as an alternate method for the diagnosis of many palpable breast
      lesions. METHODS: The authors compared the diagnostic utility of open biopsy and
      FNAB using decision tree and cost-effectiveness analyses. RESULTS: When compared
      with two-step excisional biopsy, FNAB achieved a savings of over $700 at the cost
      of 0.1% decrease in 10-year overall survival. CONCLUSIONS: These data indicate
      FNAB to be a reasonable alternative to open biopsy for the diagnosis of palpable
      breast lesions in many patients.

PMID- 8348497
TI  - Proliferative and nonproliferative breast disease in atomic bomb survivors.
      Results of a histopathologic review of autopsy breast tissue.
AB  - BACKGROUND: The risk of female breast cancer in association with radiation dose
      is well established, on the basis of follow-up studies of the atomic bomb
      survivors and other exposed populations. This association is especially strong
      for women exposed before 20 years of age and appears to be much weaker among
      women exposed after 40 years of age. METHODS: Breast tissue samples from 88 high
      dose and 225 low-dose autopsy cases from the Radiation Effects Research
      Foundation Life Span Study sample were examined in detail to determine whether
      nonproliferative and proliferative breast lesions are associated with radiation
      dose. RESULTS: Prevalence of proliferative disease in general and atypical
      hyperplasia in particular were positively associated with radiation dose. The
      associations were strongest for subjects who were between 40 and 49 years of age
      at the time of the bombing. CONCLUSIONS: It is hypothesized that the strongest
      association in women 40 to 49 years of age may be related to the age dependence
      of radiation-induced breast cancer, in that potential cancers induced in this age
      group by radiation exposure may receive too little hormonal promotion to progress
      to frank cancers.

PMID- 8348498
TI  - Role of male behavior in cervical carcinogenesis among women with one lifetime
      sexual partner.
AB  - BACKGROUND: The role of male behavior in the genesis of cervical cancer was
      examined. In India, where the incidence of cervical cancer is among the highest
      in the world, promiscuity among women is virtually unknown. In this study, the
      authors investigated the role of male behavior in cervical carcinogenesis among
      Indian women who had one lifetime sexual partner. METHODS: A case-control study
      was used. RESULTS: Premarital sexual relationships (relative risk [RR], 1.9;
      confidence interval, 1.2-3.2) and extramarital sexual relationships (RR, 2.7;
      confidence interval, 1.5-4.9) of husbands were risk factors. When husbands had
      sexual relationships both before and during the marriage, their wives' risk of
      getting cervical cancer increased by 6.9 (CI, 2.3-20.7). Risk also increased with
      husbands having three or more extramarital sexual partners (RR, 3.05; CI, 1.25
      12.6). Sexual contact with prostitutes before or after marriage, however, did not
      increase the risk. History of sexually transmitted disease before marriage (RR,
      2.9) or after marriage (RR, 5.9) was an important risk factor, which persisted
      after controlling for other factors. Sexual abstinence for 40 or more days after
      a wife's giving birth or having an abortion provided protection. Sex with
      uncircumcised men or men circumcised after age 1 year increased the risk of
      cervical cancer (RR, 4.1). Bidi smoking (bidi is a cheap smoking stick of 4-8 cm,
      consisting of a rolled piece of dried temburni leaf [Diospyres melanoxylon]
      containing 0.15-0.25 g of coarsely ground tobacco) for more than 20 years was a
      significant risk factor (RR = 2.4), whereas cigarette smoking was not a risk
      factor. CONCLUSIONS: Male sexual partners play a role in cervical carcinogenesis.

PMID- 8348499
TI  - Plasminogen activator inhibitors in endometrial adenocarcinoma.
AB  - BACKGROUND: Plasminogen activators (PA) play an important role in the mediation
      of pathologic processes, including cancer invasion. Levels of urokinase are
      increased in malignant endometrium compared with normal endometrium. The role of
      PA inhibitors (PAI) in the malignant process is not known. METHODS: PAI-1
      (endothelial type inhibitor) and PAI-2 (placental type inhibitor) in extracts of
      malignant (n = 14) and normal (n = 7) postmenopausal endometrium were measured.
      The results were correlated with the standard prognostic variables in endometrial
      carcinoma, namely, stage, histologic grade, depth of myometrial invasion, and
      estrogen receptor status of the tumor. RESULTS: PAI-1 was not detectable in
      normal endometrium and was present in small quantitities (0.11-1.54 ng PAI-1/mg
      protein) in 4 of 14 specimens of malignant endometrium. PAI-2 was present in 4 of
      7 normal and all (14 of 14) malignant endometrial cytosols. PAI-2 levels were
      higher in Stage II and III compared with Stage I cancers (P < 0.05) and in
      malignant endometrium that invaded the myometrium to more than half its depth
      compared with those with less than 50% invasion (P < 0.05). No significant
      correlation was found between PAI-2 and estrogen receptor levels (r = -0.32).
      CONCLUSIONS: Endometrial adenocarcinoma has higher levels of PAI-2 than does
      normal postmenopausal endometrium. Highest levels of PAI-2 were found in the
      poorer prognostic categories of endometrial cancer.

PMID- 8348500
TI  - Prostatic acid phosphatase in strumal carcinoids of the ovary. An
      immunohistochemical study.
AB  - BACKGROUND: Strumal carcinoids (SC) are ovarian tumors containing thyroid
      parenchyma admixed with carcinoid elements. Microscopically, the carcinoid
      component of SC usually presents a ribbon or trabecular pattern similar to the
      pattern exhibited by hindgut carcinoids. The authors designed an
      immunohistochemical study to ascertain further similarities of the carcinoid
      component of SC to rectal carcinoids. METHODS: Five cases of SC were examined by
      light microscopic study with hematoxylin and eosin and immunoperoxidase staining
      with a group of neurohormonal peptides, thyroglobulin, prostatic acid
      phosphatase, and prostate specific antigen. RESULTS: All tumors were positive for
      thyroglobulin, chromogranin, prostatic acid phosphatase (PAP), and glucagon. They
      were consistently negative for prostate specific antigen and variably positive to
      the other antibodies. CONCLUSIONS: The consistent positivity of the carcinoid
      component of SC to PAP immunostaining is a further similarity of these tumors to
      rectal carcinoids, in which positive immunostaining to PAP has been observed. The
      similarity is not well understood, however, as all evidence points to the origin
      of SC from germ cells in mature cystic teratomas without any embryologic
      relationship to the hindgut.

PMID- 8348501
TI  - Organization of type III collagen in benign and malignant ovarian tumors. An
      immunohistochemical study.
AB  - BACKGROUND: Abnormal interaction with the extracellular matrix is a basic
      property of malignant cells. Type III collagen is a major constituent of the
      extracellular matrix of soft tissues. METHODS: Deposition of the aminoterminal
      propeptide of type III procollagen (PIIINP) was studied in benign (n = 41),
      borderline (n = 4), and malignant (n = 32) human ovarian tumors using the avidin
      biotin-immunoperoxidase technique and affinity-purified antibodies to human
      PIIINP: It was then compared with the serum PIIINP concentrations of the patients
      at the time of operation. RESULTS: In malignant tumors, the distribution of
      PIIINP was irregular both close to the epithelial cancer cells and further away,
      in the stroma. Another feature typical of malignant tumors was the varying
      staining intensity of the PIIINP-positive fibers. The benign tumors were
      characterized by a regular organization and an intensive staining of PIIINP:
      Borderline tumors showed a slightly decreased staining intensity and altered
      PIIINP distribution. A significant positive correlation was found between the
      PIIINP concentration in serum and the degree of irregularity in the distribution
      of PIIINP: CONCLUSIONS: These preliminary results indicate that malignant
      transformation in ovarian tumors is associated with disintegration of adjacent
      collagenous structures and with alterations in type III procollagen metabolism,
      which also leads to increased serum PIIINP levels. They suggest that biochemical
      or immunohistochemical detection of the PIIINP antigen could be clinically useful
      in ovarian tumors.

PMID- 8348502
TI  - Daily alternating administration of high-dose alpha-2b-interferon and interleukin
      2 bolus infusion in metastatic renal cell cancer. A phase II study.
AB  - BACKGROUND: Both interleukin-2 (IL-2) and alpha-interferon (alpha-IFN) have some
      efficacy in renal cell cancer (RCC) as single agents. Additionally, there is some
      evidence for additive or synergistic antitumoral activity of IL-2 and alpha-IFN
      in vitro and possibly in vivo. Based on these data, the authors initiated a Phase
      II trial with a combination of recombinant IL-2 (rIL-2) and recombinant alpha-IFN
      (alpha-rIFN) in advanced RCC. METHODS: Thirty-six assessable patients with
      metastatic RCC were entered in this Phase II trial using a daily alternating
      schedule of alpha-rIFN and rIL-2. Over a period of 14 days, the patients received
      daily alternating treatment with 10 x 10(6) IU/m2 of recombinant alpha-2b
      interferon subcutaneously and 18 x 10(6) IU/m2 of rIL-2 as a 1-hour intravenous
      infusion. This treatment schedule was repeated every sixth week up to a maximum
      of four cycles. After the second cycle, patients were examined for response.
      Patients with stable disease or better received two additional cycles of therapy.
      Patients with progressive disease were available for other strategies. RESULTS:
      Thirty-six patients entered the trial and were assessable for toxic effects.
      Thirty of 36 patients completed at least two cycles and were assessable for
      response. Nine patients achieved an objective response: 2 had complete responses
      (CR) and 7 had partial responses (PR). Three patients had a minor response. No
      effect was observed in patients with local relapse or bone metastases. A relapse
      free survival length of 6 months or longer was seen in both patients with CR (12,
      23 + months) and in four of seven patients with PR (6, 7, 12, 12 months). The
      toxicity was moderate and included fever and nausea in most patients, and
      hypotension, fatigue, skin rash, and arthralgia in a minority of the patients. No
      Grade 4 and only occasionally Grade 3 toxicity was observed. Fluid retention was
      negligible. The monitoring of immunologic parameters showed a significant rebound
      lymphocytosis including cytotoxic (CD56+) cells; in responders the peak of
      lymphocytosis occurred up to 1 week later than in nonresponders. Peripheral
      lymphocytes obtained after therapy showed only a slight increase of natural
      killer cell and lymphokine-activated killer cell activity. During therapy, there
      was a great release of secondary cytokines as tumor necrosis factor-alpha, gamma
      interferon, and interleukin-6, with a peak level 2-4 hours after rIL-2 infusion.
      CONCLUSIONS: In conclusion, daily alternating administration of alpha-rIFN and
      rIL-2 is effective in RCC with less toxicity, and the response rate is comparable
      to those of other immunotherapeutic schedules, including adoptive
      immunotherapeutic schedules, including adoptive immunotherapy and combinations of
      high-dose IL-2 and alpha-IFN.

PMID- 8348503
TI  - Interferon-alpha-2b enhances the natural killer activity of patients with
      transitional cell carcinoma of the bladder.
AB  - BACKGROUND: Transitional cell carcinoma (TCC) of the bladder is associated with
      alterations in the immune system of the host. The authors demonstrated that in
      patients with bladder carcinoma there is a negative correlation between the
      levels of natural killer (NK) activity and the clinical evolution and pathologic
      stages of disease. METHODS: The authors investigated the effect of various doses
      of recombinant interferon-alpha-2b (IFN-alpha-2b) for variable periods of culture
      on the nonmajor histocompatibility-restricted cytotoxic activity of peripheral
      blood mononuclear cells (PBMNC) with or without CD16 and CD3-depleted populations
      from patients with superficial (confined to the mucosa or lamina propria) and
      infiltrative (those infiltrating beyond the lamina propria) TCC of the bladder
      using 4-hour 51-sodium chromate (51Cr)-release cytotoxicity assays against both
      NK-sensitive (K562) and NK-resistant (JY) tumor target cells. RESULTS: The normal
      NK activity detected in PBMNC from patients with superficial TCC of the bladder
      can be significantly enhanced by short-term (18-hour) incubation with recombinant
      IFN-alpha (P < 0.05). The depressed NK cytotoxic activity found in PBMNC from
      patients with infiltrative TCC can also be significantly enhanced, but not
      normalized, by short-term (18-hour) incubation with recombinant IFN-alpha (P <
      0.05). Short-term recombinant IFN-alpha-incubated PBMNC from patients with
      superficial, but not infiltrative, TCC of the bladder also showed marked
      cytotoxic activity against NK-resistant target cells. By selection with CD16 or
      CD3 monoclonal antibodies and complement, it was also found that the precursor
      and effector lymphocytes of this recombinant IFN-alpha-promoted cytotoxicity
      belong to NK lineage. In kinetic studies, it was found that the maximal levels of
      the recombinant IFN-alpha-promoted cytotoxic activity against NK-sensitive and NK
      resistant target cells in PBMNC from patients with TCC were reached after 18
      hours of culture. CONCLUSION: Recombinant IFN-alpha can enhance the nonmajor
      histocompatibility-restricted cytotoxic activity of PBMNC from patients with TCC
      of the bladder.

PMID- 8348504
TI  - Intravesical 4'-epi-doxorubicin (epirubicin) versus bacillus Calmette-Guerin. A
      controlled prospective study on the prophylaxis of superficial bladder cancer.
AB  - BACKGROUND: The selection of the most appropriate antineoplastic agent and
      optimal treatment schedule for the prophylaxis of superficial bladder cancer
      against tumor recurrences is the subject of continual investigations. METHODS: A
      controlled prospective trial involving 161 patients evaluated and compared the
      efficacy of intravesical epirubicin and bacillus Calmette-Guerin (BCG)
      administration as prophylaxis against recurrences after complete transurethral
      resection of superficial bladder cancer. The treatment schedule, consisting of
      one 6- or 8-week course of instillations (50 mg epirubicin or 150 mg BCG per
      instillation) followed by single maintenance doses to the responders at follow-up
      examinations, was modified for those of the initial responders who were at high
      risk for recurrence and who received an additional separate 4-week course of
      treatment 6 months after the start of therapy. RESULTS: Sixty percent of the
      patients treated with epirubicin, 68% of the patients treated with BCG, and 41%
      of the control subjects, who underwent resection only, remained free of
      recurrences for a mean follow-up of 32.9 months. The only significant difference
      was found between patients treated with BCG and control subjects, in favor of the
      former. Conversely, recurrence rate per 100 patient-months and mean interval to
      recurrence showed both drugs to be superior to resection alone regarding several
      tumor characteristics. However, a significant benefit in favor of BCG when
      compared with epirubicin was shown in those patients who had Stage T1 and Grade 3
      tumors at presentation. CONCLUSIONS: Intravesical epirubicin and BCG were
      superior to transurethral resection alone in the prophylaxis of superficial
      bladder cancer, but with respect to superficially invasive and high-grade tumors,
      BCG demonstrated a remarkable advantage.

PMID- 8348505
TI  - Squamous carcinoma presenting as an enlarged cervical lymph node.
AB  - BACKGROUND: Patients presenting with an enlarged cervical lymph node containing
      squamous cell carcinoma are a difficult problem for head and neck surgeons. In
      most cases, the primary site lies in the head and neck region. The advent of fine
      needle aspiration cytologic study means that this group of patients can be
      accurately identified in the clinic and investigated accordingly. METHODS: The
      current report studies the records of 267 such patients presenting to the Head
      and Neck Unit at The University of Liverpool over a 29-year period. RESULTS: The
      5-year survival rate for all patients presenting with a cervical lymph node
      metastasis was 27%. The 5-year survival rate for patients with a detected primary
      in the head and neck was 31% and the primary site was identified during the
      patient's life time in all but 36 patients (13%). In 53% of patients, the primary
      site was discovered during routine clinical examination, and in a further 16% it
      was discovered at panendoscopy. Most diagnostic tests proved relatively unhelpful
      but 10 patients in our series had the primary site discovered by radiograph and 9
      of these had carcinoma of the lung. In the current study when the primary site
      was discovered it was in the head and neck region in 74% of patients. Primary
      sites other than head and neck occurred in 11% of the patients and no 5-year
      survivors existed. Multivariate analysis suggested that open biopsy of the lymph
      node metastasis appeared to have an adverse effect on survival as did advanced
      age and advanced N stage. The late diagnosis of the primary site, if it proved to
      be in the head and neck region, on the other hand, had a positive association
      with survival. CONCLUSIONS: Patients presenting with a lymph node metastasis in
      the head and neck region from an unknown primary have a prognosis identical to
      that of other patients with head and neck squamous carcinoma with neck node
      metastases. The prognosis for patients in whom the primary site is never
      discovered or in whom the primary site is not head and neck, however, is
      disastrous. If the primary tumor proves to be in the head and neck region,
      treatment is worthwhile since almost a third of patients are cured of their
      disease. When the primary carcinoma is not in the head and neck region, treatment
      must be considered palliative.

PMID- 8348506
TI  - Clinicopathologic study of 212 cases of peripheral T-cell lymphoma among the
      Japanese.
AB  - BACKGROUND: Postthymic/peripheral T-cell malignancy shows significant
      histopathologic and clinical diversity, even in its prognosis, and the
      correlations remain to be debated. METHODS: The clinicopathologic features of 212
      Japanese patients with these neoplasms were investigated. RESULTS: There were 131
      male and 81 female patients, whose ages ranged from 2 to 90 years (mean, 51.7
      years). Lymphadenopathy was the most frequent clinical presentation, and the
      patients also had frequent skin lesions, hyperimmunoglobulinemia, hypercalcemia,
      and a rapid clinical course. Furthermore, the differences in the histologic
      features of each subcategory reflected the clinical pictures. The
      immunophenotypic analysis was indispensable in establishing a correct diagnosis,
      and the high-grade tumors often showed loss of pan-T antigens. CONCLUSIONS: The
      histopathologic classification proposed by Suchi et al., which has been
      incorporated into the updated Kiel classification, showed a good prognostic
      correlation.

PMID- 8348507
TI  - Some occupational exposures as risk factors for malignant lymphomas.
AB  - BACKGROUND: Malignant lymphomas (Hodgkin disease [HD] and non-Hodgkin lymphoma
      [NHL]) have been subject to several epidemiologic studies and found to be
      associated with various environmental exposures, especially solvents, wood, and
      phenoxy herbicides. METHODS: Various determinants for HD and NHL were evaluated
      in a case-referent study encompassing 31 cases of HD, 93 cases of NHL, and 204
      referents, all alive. Information on these determinants, mainly occupational
      exposures, was obtained by mailed questionnaires. RESULTS: Crude odds ratios were
      increased for various occupational exposures, i.e., exposures to solvents,
      pesticides, metal fumes, welding, and fresh wood, and nursing. Further analyses
      based on logistic regression indicated exposure to phenoxy herbicides and fresh
      wood among sawmill workers, lumberjacks, and paper pulp workers to be significant
      risk factors for HD. Welding, working as a lumberjack, nursing, and ex-smoking
      were associated with a significantly increased risk for NHL. Radiographic
      examinations were negatively associated with HD, as was office work for NHL.
      CONCLUSIONS: The results were mainly in agreement with the findings of earlier
      studies, but diverging associations also appeared.

PMID- 8348508
TI  - The appearance of Kaposi sarcoma during corticosteroid therapy.
AB  - BACKGROUND: Four epidemiologic types of Kaposi sarcoma (KS) are known: classic
      KS, endemic African KS, epidemic or acquired immunodeficiency syndrome-related
      KS, and KS associated with immunosuppressive therapy. In most of the latter
      patients, KS was reported to have developed after organ transplantation,
      particularly renal transplantation. Thirty-nine patients who have not had a
      transplant have been reported to have KS associated with corticosteroid therapy.
      METHODS: The authors studied 10 patients with the appearance of KS during
      corticosteroid therapy (6 men, 4 women; age range, 42-79 years) who were treated
      with corticosteroids for autoimmune disorders (5 patients), lymphoproliferative
      disorders (2 patients), and diseases unrelated to the immune system (3 patients).
      RESULTS: Genetically programmed susceptibility to corticosteroid-related KS was
      suggested by the descent of the study patients as well as most of those reported
      previously. The prognosis was guarded in all the study patients. CONCLUSIONS:
      Corticosteroids should be withdrawn to achieve clinical remission.

PMID- 8348509
TI  - Primary Hodgkin disease of the ileum complicating Crohn disease.
AB  - BACKGROUND: Primary gastrointestinal lymphoma currently is considered to be an
      uncommon complication of chronic inflammatory bowel disease. All tumors reported
      in which recently developed techniques, such as immunohistochemical markers, were
      used for lymphoma classification proved to be non-Hodgkin lymphomas.
      Gastrointestinal lymphomas developing in Crohn disease are a very heterogeneous
      group, with tumors of both B-cell and T-cell lineage represented, along with some
      tumors of equivocal phenotype. By contrast, gastrointestinal lymphomas
      complicating ulcerative colitis all have proved to be so-called polymorphic B
      cell lymphomas. METHODS: The current report describes another case of primary
      gastrointestinal lymphoma complicating chronic inflammatory bowel disease
      occurring in the ileum of a 34-year-old man with a 3-year history of Crohn
      disease. RESULTS: Histopathologic findings were in keeping with nodular
      sclerosing Hodgkin disease. Broad birefringent collagen bands divided the tumor
      into well-defined nodules consisting of typical Reed-Sternberg cells and lacunar
      variants admixed with a polymorphous lymphoid infiltrate. By immunohistochemical
      studies, Reed-Sternberg cells and lacunar variants stained positively for Leu-M1
      (CD15) and Ber H2 (CD30). The background lymphocytes were primarily of T-cell
      phenotype. CONCLUSIONS: To the knowledge of the authors, this article reports the
      first case of primary gastrointestinal Hodgkin disease in association with
      chronic inflammatory bowel disease that has been confirmed by immunohistochemical
      studies.

PMID- 8348510
TI  - Ifosfamide with mesna uroprotection and etoposide in recurrent, refractory acute
      leukemia in childhood. A Pediatric Oncology Group Study.
AB  - BACKGROUND: Ifosfamide has previously been shown to be active as a single agent
      and in combination with doxorubicin, etoposide, and teniposide in pediatric solid
      tumors and adult acute leukemia. The authors performed a dose-escalation trial of
      ifosfamide with a fixed dosage of etoposide, with mesna uroprotection, in
      children with multiply recurrent acute leukemia. METHODS: Chemotherapy was
      administered daily for 5 days. Etoposide 100 mg/m2 was followed by ifosfamide at
      an initial dosage of 1.6 g/m2. The ifosfamide was escalated in 20% increments to
      the maximum tolerated dosage in cohorts of three patients. Mesna 400 mg/m2 was
      given immediately before the ifosfamide and then at 3 and 6 hours after
      ifosfamide in the initial patients. Subsequent patients were treated with mesna
      400 mg/m2 just before ifosfamide, and then every 2 hours to a total dosage equal
      to the ifosfamide dosage. RESULTS: Forty-four heavily pretreated patients were
      entered on study. Forty were evaluable for toxicity and 36 for response as well.
      The maximum tolerated dosage of ifosfamide was 4.0 g/m2/d for 5 days (20
      g/m2/course). Overall, 10 patients achieved complete remission, and 3 achieved
      partial remission. Remissions were brief, although four patients went on to bone
      marrow transplant while in remission. One patient is still alive. CONCLUSIONS:
      The combination of etoposide and ifosfamide with mesna uroprotection showed
      promising activity in children with multiply recurrent acute leukemia.

PMID- 8348511
TI  - Response to neoadjuvant chemotherapy in children with pineoblastoma.
AB  - BACKGROUND: The outlook of children with pineoblastoma treated with radiation
      therapy alone is extremely poor, but neoadjuvant chemotherapy has been tried only
      in a few cases of this rare childhood brain tumor with poor prognosis. METHODS:
      Three consecutive children 3 to 7 years of age received neoadjuvant chemotherapy
      consisting of etoposide 100 mg/m2 days 1 to 3, cisplatin 100 mg/m2 day 1, and
      vincristine 1.5 mg/m2 day 1, repeated every 4 weeks. After four courses of
      chemotherapy, patients underwent craniospinal irradiation. The radiation doses to
      the primary site ranged from 5040 to 5440 cGy and craniospinal axis radiation
      dose was 2520 to 3060 cGy. RESULTS: After chemotherapy, mild myelosuppression
      occurred in all three and mild to moderate bilateral high-frequency sensorineural
      hearing loss occurred in two of the three patients. One patient remains in near
      complete resolution of the tumor at 2 years after diagnosis and another remains
      in CR for 5 years. One patient achieved PR for 5 months but eventually died of
      progressive tumor. CONCLUSIONS: This study suggests that the neoadjuvant
      chemotherapy as used here is effective and has acceptable toxicity.

PMID- 8348514
TI  - For sale! Nursing services.

PMID- 8348512
TI  - Testicular angiocentric lymphoma of postthymic T-cell type in a child with T-cell
      acute lymphoblastic leukemia in remission.
AB  - BACKGROUND: Angiocentric lymphoma developed in a 6.5-year-old boy with acute
      lymphoblastic leukemia of thymic origin in remission. He presented with
      unilateral testicular enlargement 17 months after diagnosis. METHODS AND RESULTS:
      Biopsy of the testis revealed an angiocentric, angiodestructive polymorphous
      cellular infiltrate accompanied by necrosis. The lymphoid component showed a
      mature T-cell immunophenotype (positive for CD2, CD3, CD5, CD7, CD4, CD8).
      CONCLUSIONS: Angiocentric lymphoma is a rare entity included in the spectrum of
      angiocentric immunoproliferative lesions, which preferentially involves
      extranodal sites. Although four cases of angiocentric immunoproliferative lesions
      have been reported in pediatric patients with acute lymphoblastic leukemia, this
      is the first reported occurrence of testicular involvement.

PMID- 8348513
TI  - Surgical lateral clearance in resected rectal carcinomas: a multivariate analysis
      of clinicopathologic features.

PMID- 8348515
TI  - Obstetrical triage.

PMID- 8348516
TI  - The birth of an alternative delivery centre.

PMID- 8348517
TI  - Sick and tired.

PMID- 8348519
TI  - Beyond comprehension.

PMID- 8348518
TI  - "It's not in my head".

PMID- 8348520
TI  - Growing up with violence.

PMID- 8348521
TI  - Evaluating the collaborative approach.

PMID- 8348522
TI  - [Removing a femoral catheter].
AB  - Nurses at the University of Ottawa Heart Institute are removing femoral sheaths
      on post-angioplasty patients. The authors describe this new technique and explain
      how nurses can benefit by doing it. They discuss practical considerations before
      delegating this sanctioned medical act to nurses. Prevention and management of
      complications are also discussed as are research projects to evaluate the
      technique.

PMID- 8348523
TI  - [Female student of a visible minority].
AB  - This article is the second on visible minority groups in schools of nursing and
      the profession. The survey was conducted in three institutions in the Ottawa
      region. The goal was to discover whether statistics reflect the current college
      and university nursing population. Of this population, 73.7 per cent
      participated. Results show clearly that the following questions must be answered
      by health professionals responsible for community services: Is the goal of equal
      representation of all ethnic groups at the college and university level
      realistic? How can educators identify reasons why certain ethnic groups lean
      toward nursing? Will it be necessary to consider several factors in order to
      clearly identify the visible minority representation? These questions and others
      will guide the authors in their subsequent surveys of minority representation in
      the health care professions.

PMID- 8348524
TI  - Pain management at home. Struggle, comfort, and mission.
AB  - This article presents findings from an exploratory, descriptive study that
      investigated the experiences of pain in the home from the perspective of the
      patient, the primary family caregiver, and the home care nurse. The following
      research questions are addressed: What are the special problems associated with
      pain management at home as identified by patients, caregivers, and nurses? What
      are the similarities and differences among patients, caregivers, and nurses
      regarding issues of managing pain at home? Qualitative techniques were used to
      collect and analyze data. The sample included 10 cancer patients with pain and
      their respective caregivers and nurses. After the in-depth interviews were
      transcribed, a multidisciplinary research team performed content analysis on the
      data. Overall, the findings suggest that patients approach pain management with a
      struggle for control, whereas self-denying caregivers seek to provide comfort,
      and nurses attempt to fulfill an urgent mission to eradicate pain.

PMID- 8348525
TI  - Experienced nurses' narratives of their being in ethically difficult care
      situations. The problem to act in accordance with one's ethical reasoning and
      feelings.
AB  - In previous interviews, experienced nurses have reported that their decisions in
      ethical matters depended "on the situation at hand." We interviewed 18 good,
      experienced cancer nurses to determine how they handled ethical decisions. They
      were asked to give an account of difficult situations that required ethical
      decisions to be made. The 60 narrated situations were interpreted step-by-step
      departing from the following two questions: What do nurses experience when being
      in ethically difficult care situations? What does the expression "it depends on
      the situation at hand how I act" mean? In complex situations, the nurses reported
      that the ethical situations that arose were regarded either as overwhelming or at
      the other end of the spectrum, as possible to grasp, and they expressed either
      loneliness or togetherness, respectively. When reporting overwhelming situations,
      the nurses mostly referred to themselves by using the word "one," i.e., "one
      would" and used "they" when referring to their coactors. When narrating
      situations possible to grasp, they used the terms "I" and "we." The most
      important situational factor that was revealed in these narratives was whether or
      not the nurses had a support group in which to share their thoughts. Without the
      support group, they reported difficulties acting in accordance with their ethical
      reasoning and feelings.

PMID- 8348526
TI  - Immunotherapy and neuropsychiatric toxicity. Nursing clinical management
      consideration.
AB  - Ensuring the safety of patients who receive immunotherapy is an essential element
      of nursing care. Communicating changes in mental status to the medical team is
      important feedback for modifying or discontinuing the cycle of immunotherapy.
      These observations are even more crucial if neuropsychiatric toxicity (NPT) has
      been exhibited in a previous cycle of treatment. If nurses are aware of
      associative factors of NPT they can be more alert for emerging cognitive
      dysfunction. Early intervention will also mean the nurse will take additional
      measures to ensure patient safety, such as suggesting possible pharmacological
      alternatives and closer observation, and encouraging family members to help with
      orientation. The nurse can further assist by helping alleviate the patient's or
      family's feelings of helplessness by assuring them that the NPT will begin to
      subside once treatment has been terminated.

PMID- 8348527
TI  - A comparison of American and Egyptian cancer patients' attitudes and unmet needs.
AB  - The purpose of this descriptive study was to compare and contrast similarities
      and differences in statements made by American and Egyptian cancer patients who
      expressed their attitudes toward cancer and reported their unmet needs. A total
      of 61 American and 66 Egyptian patients, who were receiving chemotherapy or
      radiotherapy, or a combination of the two treatments at the time of data
      collection, participated in the study. The American sample was drawn from
      patients at a large midwestern hospital, whereas the Egyptian sample was drawn
      from patients at the largest university hospital in Cairo, Egypt. Data were
      collected through a structured interview method in both patient populations.
      Analyses of responses showed five categories of attitudes for the American
      patients: (a) fighting spirit and adaptation, (b) fear/anxiety/disbelief, (c)
      hope, (d) passivity in plan of care, and (e) faith. For Egyptian patients, seven
      categories emerged: (a) stoicism and fatalism, (b) dependency, (c) compliance
      with the medical regimen, (d) anxiety/fear/insecurity, (e) powerlessness, (f)
      hope and optimism, and (g) family support. American cancer patients reported
      their unmet needs as (a) information, (b) needs related to treatment side
      effects, and (c) psychological support. Egyptian cancer patients reported their
      unmet needs as (a) relief from dependency, (b) relief from physical symptoms, and
      (c) information. These findings have implications for international oncology
      nursing, and imply the need for further research to determine if attitudes and
      unmet needs affect coping effectiveness and quality of life among cancer
      patients.

PMID- 8348528
TI  - Autologous bone marrow transplantation. A review of the principles and
      complications.
AB  - High-dose chemotherapy and autologous bone marrow transplantation (ABMT) is now
      used routinely in an attempt to cure patients with poor-prognosis malignant
      diseases. This aggressive and intensive treatment requires a highly trained
      health-care team. Nurses specializing in the care of these patients are essential
      to maintain patient well-being and ensure a good outcome. High-dose therapy leads
      to myelosuppression and tissue damage, and the resultant infections, bleeding,
      and organ toxicities are frequently either unusual or more severe than those seen
      with conventional-dose antineoplastic therapies. Organ toxicities can affect both
      short-term and long-term functional status. Disabling or even fatal consequences
      of treatment can occur during the transplant or months or years later. A
      specialized knowledge base and an understanding of the way this therapy affects
      the patient is required not only for the acute inpatient period, but also for the
      long term. A team approach to these complex patients with a central role for the
      nurse clinician will lead to optimal patient care.

PMID- 8348529
TI  - Oral- and pharyngeal-cancer patients' perceived symptoms and health.
AB  - The purpose of this study was to describe the perceived eating problems, general
      symptoms, and general health of a group of oral- and pharyngeal- cancer patients
      before surgery in order to facilitate nursing care planning. A total of 29
      patients (20 men and nine women) participated. Two groups were formed: in group
      1, 13 patients participated before and, in group 2, 16 patients participated
      after the presurgical radiotherapy. Questionnaires were used to collect data.
      Eating disabilities were evident in both groups. The patients who had had their
      radiation therapy experienced problems such as bad taste function, mouth dryness,
      difficulties in chewing, and mouth pain more frequently than those who had not
      been treated. Only five patients in group 2 ate solid food, compared with 10 in
      group 1. Shoulder and back pain and feelings of worry and anxiety were perceived
      as the most frequent general symptoms. Most of the patients perceived their
      general health as being rather good, but some indicated poor health, several
      symptoms, poor appetite, and/or severe eating problems. Patients with oral and
      pharyngeal cancer should be carefully assessed before surgery because of their
      disparity of symptoms and disabilities so as to identify those who need specific
      nursing interventions.

PMID- 8348530
TI  - Psychosocial and functional status of breast cancer patients. The influence of
      diagnosis and treatment choice.
AB  - This exploratory study examined breast cancer patients' psychosocial and
      functional status at the time of diagnosis and during the initial phase of
      treatment. The purpose was to better understand the impact of diagnosis and
      treatment on patients' physical state and psychosocial well-being. A convenience
      sample was drawn from a population of newly diagnosed stage 1 and 2 breast cancer
      patients undergoing either modified radical mastectomy or lumpectomy with
      radiation. Subjects completed instruments designed to measure uncertainty,
      quality of life, functional status, and reaction to diagnosis on two separate
      occasions: at the time of diagnosis, but before treatment selection and then
      approximately 8 weeks after surgery. Data obtained from 52 subjects indicated
      that patients' perceptual uncertainty and various aspects of their functional
      status declined over the initial course of treatment, but that quality of life
      was unaffected. The results also showed no relationship between type of breast
      cancer treatment and patients' uncertainty, quality of life, and functional
      status. Mastectomy and lumpectomy patients also responded in similar ways to the
      cancer diagnosis. Both groups experienced the same amount of distress and used
      conformational coping strategies to similar degrees. Clinical implications are
      discussed and recommendations are made for future research.

PMID- 8348531
TI  - Dependent care, caregiver burden, and self-care agency of spouse caregivers.
AB  - A convenience sample of 113 spouse caregivers was used to examine the
      relationships between dependent care, caregiver burden, and self-care agency.
      Subjects were the spouses of radiation oncology or chemotherapy patients in a
      large metropolitan hospital. The Denyes Self-Care Agency Instrument was used to
      measure self-care agency. The Task Scale was used to operationalize dependent
      care, and the Burden Scales were used to measure caregiver burden. Demographic
      data were collected on the number of weeks in the caregiver role, presence of
      health problems in the caregiver, gender, age, income, and education. In the
      total sample, subjective burden was negatively and significantly related to self
      care agency and objective burden, in addition, dependent care and objective
      burden were also negatively related. When the data were divided into subsamples
      based on gender, several of the relationships were in opposite directions. The
      most notable of these were the relationships between dependent care and self-care
      agency. It is evident that interventions should take these gender differences
      into account.

PMID- 8348532
TI  - The molecular pathology of cancer. Introduction.

PMID- 8348533
TI  - Models of pancreatic cancer.
AB  - Progress has been made in recent years in defining the spectrum of molecular
      changes seen in human pancreatic cancer. A range of animal models of this disease
      exists, and the nitrosamine induced tumours in the hamster show "clinical",
      morphological, immunophenotypic and, importantly, molecular similarities with
      human disease. This may prove to be an important model for testing therapeutic
      stratagems. In vitro systems for assessing pancreatic carcinogenesis and
      neoplasia are much less well developed. Although many human pancreatic primary
      carcinoma cell lines exist, it is difficult to culture normal human pancreatic
      cells effectively. Future studies will probably need to concentrate on the
      development of rodent systems (especially hamster), which can be more easily
      maintained. Studies in transgenic mouse systems have given new insights into the
      genesis of pancreatic neoplasia, and taken with those studies of acinar to ductal
      transdifferentiation, they cast new light on the possible origin of the tumour.
      This important issue remains unresolved, and its further understanding will
      require the generation of new data on the kinetic and spatial organization of the
      pancreas where key questions remain unanswered--whether there is a stem cell
      compartment in the organ not least among them. Progress in the cellular and
      molecular aspects of the disease are essential; so too are some important
      morphogenetic issues.

PMID- 8348534
TI  - In vitro models of human colorectal cancer.
AB  - Epithelial cell lines that differentiate in vitro have been isolated from
      hereditary and sporadic colorectal adenomas representing different stages in
      tumour progression, from small adenomas with a low malignant potential to large
      adenomas with a relatively high malignant potential. The majority of cell
      cultures derived from small adenomas senesced, whereas the larger adenomas were
      more likely to give rise to an immortal cell line. Karyotypic analysis has shown
      that specific abnormalities of chromosomes 1, 6, 7, 13, 14, 17, 18 and 22 occur
      in these adenoma cell lines. Abnormalities of chromosome 1 have been implicated
      in tumour progression and the in vitro immortalization of colorectal adenomas.
      Molecular and cellular changes involving abnormalities of chromosomes 1 and 18,
      TP53 and ras gene mutations and reduced response to the growth inhibitory effects
      of TGFB and sodium butyrate, which occur during tumour progression, suggest that
      the in vitro model has relevance to in vivo carcinogenesis.

PMID- 8348535
TI  - Molecular pathology of lymphomas.
AB  - Chromosomal translocations appear to be the initiating step in the development of
      malignancy in both B cell and T cell lymphomas. These results in the
      juxtapositioning of proto-oncogenes and transcriptional factors to the IG or TCR
      genes and lead to the deregulation of their expression. A survival advantage is
      provided to the lymphoid cells and contributes to neoplasm by permitting a clone
      to persist until other oncogenes such as c-myc are activated. This suggests a
      multistep progression to tumorigenesis. The occurrence of these translocations is
      assisted by obligatory DNA breaks and rearrangements of IG and TCR that have to
      occur for B and T cells to mature and function. The molecular alterations
      specific to lymphomas provide a potential specific target for therapy, including
      molecular manipulations. Animal modelling of lymphoma will provide the greatest
      possibilities for investigating the pathogenesis of lymphoma and future treatment
      modalities.

PMID- 8348536
TI  - Oncogenes, growth factors and control of the cell cycle.
AB  - Recent advances in the field of cell cycle progression have extended our
      knowledge of the mechanism(s) of cellular proliferation and have placed it on a
      solid molecular basis. This survey highlights some of these findings, selecting
      the most intriguing in the hope of providing new insights on cell cycle controls.
      We have considered two large groups of factors involved in cell cycle control:
      extracellular (environmental signals, ie growth factors, and their cellular
      receptors) and intracellular (oncogenes and anti-oncogenes), indicating which, to
      us, may be the most promising areas of investigation. These include the events
      occurring after the IGF1 receptor is activated by its ligand, the role of anti
      oncogenes in preventing the activation of growth factor receptors, the
      mechanism(s) by which some proto-oncogenes may short circuit the cell cycle and
      the use of peptide analogues and the antisense strategy to study and to regulate
      cellular proliferation.

PMID- 8348537
TI  - Models of colorectal tumour differentiation.
AB  - In vitro models in which colorectal tumour cells express differentiated and
      undifferentiated phenotypes have been developed and used to identify the
      molecular mechanisms of cellular and morphological differentiation of colorectal
      epithelial cells. Our data indicate that both cell-cell and cell-collagen
      interactions are required for the induction and maintenance of the glandular
      differentiation of colon carcinoma cell lines in vitro. These interactions are
      primarily mediated by two classes of adhesion molecules, E-cadherin and alpha
      2/beta 1 integrin. Both cell surface adhesion receptors are lost in poorly
      differentiated colorectal tumours, and these changes may explain in part the
      phenotype and behaviour in vivo. Further investigation of the molecular control
      of integrin and cadherin function, localization and level of cell surface
      expression will constitute the basis of new functional assessment of tumour
      differentiation and likely response to treatment in colorectal cancer.

PMID- 8348538
TI  - The molecular pathology of human breast cancer.
AB  - Perhaps one of the most exciting recent developments in breast cancer research is
      the steadily increasing number of small screen detected lesions which are
      available for study. These samples will allow a number of questions of key
      importance to the development and progression of breast cancer to be answered.
      For example, the relationship between a variety of benign and premalignant
      lesions and frankly invasive breast carcinomas can be examined to determine the
      sequence of progression, if indeed such a sequence exists. Subtypes of screen
      detected lesions may be identified in which different genetic events have
      occurred, and the relationship between these genetic events and progression may
      be established. Such studies could identify groups of women for whom no further
      treatment is required or those for whom adjuvant therapy, radiotherapy or further
      surgery is indicated. A number of genetic alterations have now been identified
      that seem to be independent indicators of prognosis. Such alterations include
      overexpression of c-erbB2 and mutation of TP53. Although there is still some
      debate about the statistical significance of data from a number of different
      groups, it seems certain that the status of a number of genes will provide
      prognostic information to augment existing criteria. There is an urgent need for
      an examination of a large panel of breast tumours for a number of key genetic
      alterations and for a critical evaluation of all the changes to existing clinical
      variables such as clinical stage, grade, survival and relapse times and growth
      factor receptors. Molecular pathology is providing new and exciting insights into
      the pathogenesis of human breast cancer, and molecular events associated with
      inherited breast disease, early stages, progression and metastasis of breast
      cancer are now becoming better understood.

PMID- 8348539
TI  - Human models of breast cancer.
AB  - Experimental systems using human mammary tissue, secretions and tumours may be
      based on in vitro culture or on growth of tissue or tumour fragments in the nude
      mouse. In the development of in vitro culture systems, a detailed
      characterization of the cultured cells within the framework of the epithelial
      cell lineages found in vivo is crucial. Monoclonal antibodies are useful tools
      for defining the profile of antigens expressed by the basal and luminal cells in
      the normal gland and in distinguishing subclasses between these two major groups.
      When these same reagents are used to characterize breast cancers, the majority
      are found to show the phenotype of luminal cells, with a small subset showing
      some evidence of basal markers. Luminal epithelial cells cultured from milk or
      reduction mammoplasty tissue have a short life span in vitro but can be
      immortalized using SV40TAg. Demonstrably malignant cells are difficult to culture
      from primary breast cancer, but ER+ and ER- cell lines showing the luminal
      phenotypes have been readily developed from metastases: some ER- breast cancer
      cell lines show a more undifferentiated phenotype, and these may have developed
      from tumours expressing basal markers. As with in vitro culture, it is difficult
      to obtain tumour growth in the nude mouse from primary breast cancer specimens,
      and established cell lines are also difficult to grow in this animal. We have
      focused our studies on cell lines with the luminal phenotype developed from milk.
      These non-tumorigenic cell lines differ from breast cancer cell lines (a) in
      being able to form organized three dimensional structures in the presence of an
      extracellular matrix and (b) in the correct glycosylation of the polymorphic
      epithelial mucin, which is expressed and aberrantly glycosylated in cancers.
      These cell lines are therefore being used to study the mechanisms underlying
      morphogenesis and the processing of PEM, and also as recipients for oncogenes and
      proto-oncogenes.

PMID- 8348540
TI  - Tissue reconstitution models of breast cancer.
AB  - Oncogenes have been expressed in mammary epithelium by reconstituting epithelium
      in vivo from mammary cells. Genetically manipulated primary cultures are
      transplanted into a mammary fat pad from which the natural epithelium has been
      removed, where they reform an epithelium in which a few cells express the
      oncogene. Genes can be expressed in other tissues in a similar way. A wide
      variety of oncogenes have a clearly observable effect on the pattern of growth of
      mammary epithelium. Expression of individual oncogenes usually produces stable,
      characteristic patterns of abnormal growth that can be regarded as preneoplastic
      states. Different oncogenes produce a very diverse variety of such growth
      patterns, by altering branching pattern, inducing formation of alveoli, causing
      epithelium to multilayer and/or altering hormone dependence. Myc and wnt1 seem to
      enable cells to overgrow neighbouring normal cells, suggesting that they promote
      clonal expansion, whereas others give focal lesions. Oncogene co-operation can be
      studied by introducing further oncogenes into preneoplastic epithelium, for
      example the introduction of ras into epithelium that already expresses activated
      myc gives tumours. The effects of both neu/c-erbB2 and myc on mouse mammary
      epithelium may mimic events in human breast, encouraging the hope that this will
      prove a way to model human breast cancer. The tissue reconstitution approach
      promises to reconstruct tumour development in more detail than the transgenic
      systems are able to, showing the development of focal lesions, the restraining
      effects of normal on transformed cells and the expansion of clones of
      hyperplastic cells at the expense of their normal neighbours.

PMID- 8348541
TI  - Influence of sulfate and carboxylate groups on the conformation of chondroitin
      sulfate related disaccharides.
AB  - 1H NMR and 13C NMR spectral parameters of eight sulfated uronic acid containing
      disaccharides 1-8 were used to determine the conformational preferences that
      depend on the pattern of sulfation. Three sulfated derivatives of benzyl beta-D
      Gal-(1-->4)-beta-D-GlcA (1), its 6'-sulfate 2, 4'-sulfate 3, and 4',6'-disulfate
      4 were used as models for the beta-(1-->4) glycosidic linkage of chondroitin
      sulfates and three sulfated derivatives of benzyl beta-D-GlcA-(1-->3)-beta-D-Gal
      (5), its 6-sulfate 6, 4-sulfate 7, and 4,6-disulfate 8 were used as models for
      the beta-(1-->3) glycosidic linkage of chondroitin sulfates. To determine the
      dependence of conformational preferences on the charged groups, the sulfated
      disaccharides 2, 3, and 4 were compared to their unsulfated parent compound 1,
      and 6, 7, and 8 were compared to their parent compound 5. The 3JH-5,H-6 coupling
      constants were determined by high-order analysis of the spin systems, and from
      these the preferred populations of the hydroxymethyl groups were calculated.
      Selective 1D NOEs and ROEs were measured from H-1' across the glycosidic linkage
      to obtain the average distance of the protons adjacent to the glycosidic linkage.
      Derivatives of beta-D-Gal-(1-->4)-beta-D-GlcA carrying a sulfate group in the 6'
      position (2) and in the 4'- and 6'-position (4) show a slight repulsive effect
      between the 6'-sulfate groups and the carboxylate group as expressed in small
      changes of the preferred populations of the glycosidic linkage and the
      sulfonyloxymethyl group. The 4-sulfate groups in 3 and 4 do not show a
      significant influence on the glycosidic linkage. However, the two sulfate groups
      in 4 exhibit a repulsive effect leading to a very high population of the gt
      conformation of the sulfonyloxymethyl group. In contrast hereto, the sulfate
      group at C-4 of beta-D-GlcA-(1-->3)-beta-D-Gal disaccharides 7 and 8 and the
      carboxylate group exert an attractive interaction that leads to a change of the
      conformation of the glycosidic linkage in 7 and 8 by about 30 degrees. The 6
      sulfate groups of the disaccharides 6 and 8 show a slight repulsive interaction
      with the carboxylate and/or 4-sulfate group. Changes in 13C NMR chemical shifts
      support the interpretation obtained from the NOE and ROE analysis.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8348542
TI  - Synthesis and NMR spectroscopic investigation of oligosaccharides containing Kdo
      and L-glycero-D-manno-heptopyranosyl residues.
AB  - The disaccharides O-(sodium 3-deoxy-alpha-D-manno-2-octulopyranosylonate)-(2-->8)
      sodium (allyl 3-deoxy-beta-D-manno-2-octulopyranosid)onate (8), O-L-glycero-alpha
      D-manno-heptopyranosyl-(1-->7)-sodium (allyl 3-deoxy-beta-D-manno-2
      octulopyranosid)onate (12), and O-alpha-D-mannopyranosyl-(1-->7)-sodium (allyl 3
      deoxy-beta-D-manno-2-octulopyranosid)onate (21) and the branched trisaccharides O
      L-glycero-alpha-D-manno-heptopyranosyl-(1-->7)-[O-(sodium 3-deoxy-alpha- and 
      beta-D-manno-2-octulopyranosylonate)-(2-->8)]-sodium (allyl 3-deoxy-beta-D-manno
      2-octulopyranosid)onate (15 and 16) and O-alpha-D-mannopyranosyl-(1-->7)-[O
      (sodium 3-deoxy-alpha-D-manno-2-octulopyranosylonate)-(2-->8)]-sodium (allyl 3
      deoxy-beta-D-manno-2-octulopyranosid)onate (24) were prepared. Per-O-acetylated
      mannopyranosyl or Kdo bromide derivatives were employed for the glycosylation
      steps under Helferich conditions, whereas the imidate derivative 9 was used for
      the coupling of the L-glycero-D-manno-heptopyranosyl residues. The
      oligosaccharides were fully characterized by NMR spectroscopic data. Their
      structures correspond to an artificial linkage pattern providing a potential
      cross-reactive epitope for antibodies directed against the inner-core-region of
      enterobacterial as well as chlamydial lipopolysaccharides.

PMID- 8348543
TI  - Structures of the amylopectins of waxy, normal, amylose-extender, and wx:ae
      genotypes and of the phytoglycogen of maize.
AB  - Average chain lengths and beta-amylolysis limits have been determined for the
      waxy and ae/wx genotypes of mature maize starch, and for the amylopectin
      fractions of normal and amylose-extender starches (prepared by precipitation with
      concanavalin A), rabbit-liver glycogen, phytoglycogen, and waxy rice starch. All
      amylopectin samples had similar A:B chain ratios of > 1 and the two glycogens had
      ratios of < 1. This finding led to average frequencies of substitution of B
      chains over the whole molecule of > 2 for the amylopectins and < 2 for the
      glycogens. An equation for the number of tiers for a molecule with various
      frequencies of substitution of B chains and chain lengths has been used to
      determine the effect of variation in average frequency of branching and average
      chain length on structure.

PMID- 8348544
TI  - Isolation and characterisation of hemicelluloses from sunflower hulls.
AB  - The hemicelluloses extracted from sunflower hulls by repeated alternating
      oxidative and alkaline treatments were purified by precipitation with Cetavlon
      and then ion-exchange chromatography on DEAE-trisacryl. The resulting fractions
      were examined by hydrolysis, methylation, GLC-MS, and NMR spectroscopy. The
      hemicelluloses are of the glucuronoxylan type with the following structure -->4)
      beta-D-Xylp-(1-->4)-[4-O-Me-alpha-D-GlcpA-(1-->2)]-bet a-D-Xylp-(1-->. The
      polysaccharides differed in the amount of branching; the ratio of the main
      fraction 4-O-MeGlcA:Xyl was 1:8-9.

PMID- 8348545
TI  - Structural characterization of endo-glycanase-generated oligoglycosyl side chains
      of rhamnogalacturonan I.
AB  - Rhamnogalacturonan I (RG-I) has been isolated from the walls of suspension
      cultured sycamore cells (Acer pseudoplatanus), and additional structural features
      of the polysaccharide were elucidated. Treatment of RG-I with a purified endo-(1-
      >5)-alpha-L-arabinanase released a series of arabinose-containing
      oligosaccharides with degrees of polymerization (dp's) between 2 and 20. These
      oligosaccharides were shown, by glycosyl-linkage composition analysis, to contain
      terminal, 5-, and (3-->5)-linked Araf residues. These results provide evidence
      that a branched arabinan is attached to the backbone of RG-I. RG-I was freed of
      95% of its arabinosyl residues by treating the polysaccharide with a combination
      of endo-(1-->5)-alpha-L-arabinanase and alpha-L-arabinosidase. No galacturonic
      acid was released by these enzymes, which is evidence that the arabinosyl
      containing portions of the side chains do not contain galactosyluronic acid
      residues. The galactose-containing portions of the side chains of RG-I were not
      fragmented by an endo-(1-->4)-beta-D-galactanase. However, approximately 85% of
      the galactose and small amounts of galacturonic acid were released by digestion
      of arabinose-depleted RG-I with a combination of endo- and exo-beta-D
      galactanases. The galacturonic acid may have been released by small amounts of an
      exo-alpha-galactosyluronidase contaminating the galactanases. Treatment of RG-I
      with this mixture of endo- and exo-glycanases resulted in a relatively size
      homogeneous, almost side chain-free backbone composed of the O-acetylated
      diglycosyl repeating unit -->4)-alpha-D-GalpA-(1-->2)-alpha-L-Rhap. A combination
      of 1H NMR spectroscopy and periodate oxidation established that the backbone
      repeating unit contained a single O-acetyl substituent on C-2 or C-3 of each
      galactosyluronic acid residue.

PMID- 8348546
TI  - The purification of commercially available endo-alpha-L-arabinanases and alpha-L
      arabinosidase for use in the structural analysis of pectic polysaccharides.

PMID- 8348547
TI  - NMR spectroscopy of nystose.

PMID- 8348548
TI  - A convenient synthesis of N-acetyllactosamine-linked oligosaccharides from phenyl
      3,6,2',3',4',6'-hexa-O-acetyl-2-deoxy-2-phthalimido-1-thio-beta-lactopy ranoside
      .

PMID- 8348549
TI  - A practical synthesis of 2-azidoethyl alpha-glycosides: useful spacer-arm
      glycosides for the synthesis of neoglycoconjugates.

PMID- 8348550
TI  - FABMS/derivatisation strategies for the analysis of heparin-derived
      oligosaccharides.
AB  - Derivatisation/FABMS strategies applicable to the structure analysis of low
      microgram quantities of heparin-derived oligosaccharides are described. Negative
      and positive FAB data from permethyl derivatives and positive FAB data from the
      products of subsequent methanolysis are reported for sulfated tetrasaccharides
      prepared by nitrous acid degradation of heparin. The preparation and FAB
      behaviour of acetylated derivatives of sulfated oligosaccharides are described
      for the first time, and the stability of the sulfate groups to base-catalysed
      acetylation is demonstrated. The acetylation/FABMS methodology, which yields high
      quality data, shows promise for the characterisation of a wide range of sulfated
      glycoconjugates.

PMID- 8348551
TI  - Electrosyntheses of disaccharides from phenyl or ethyl 1-thioglycosides.
AB  - Constant current electrolyses of the glycosyl donors phenyl and ethyl 2,3,4,6
      tetra-O-benzyl-1-thio-beta-D-glucopyranoside in dry acetonitrile in the presence
      of various primary and secondary sugar alcohols, performed in an undivided cell,
      gave beta-linked disaccharide derivatives selectively in good yields. Phenyl
      2,3,4,6-tetra-O-benzoyl-1-thio-beta-D-glucopyranoside gave the beta-glucosides
      exclusively in good to moderate yields.

PMID- 8348552
TI  - Synthesis of a tetrasaccharide donor corresponding to the O-specific
      polysaccharide of Shigella dysenteriae type 1.
AB  - O-(2,4-Di-O-benzoyl-3-O-chloroacetyl-alpha-L-rhamnopyranosyl)-(1--> 2)-O-(3,4,6
      tri-O-benzoyl-alpha-D-galactopyranosyl)-(1--> 3)-O-(2-acetamido-4,6-di-O-acetyl-2
      deoxy-alpha-D-glucopyranosyl)-(1--> 3)-2,4-di-O-benzoyl-alpha-L-rhamnopyranosyl
      trichloroacetimidate (1) was synthesized in a stepwise manner, using the
      following monosaccharide units: 2-(trimethylsilyl)ethyl 2,4-di-O-benzoyl-alpha-L
      rhamnopyranoside, 2-azido-4,6-O-benzylidene-3-O-chloroacetyl-2-deoxy-beta-D
      glucopyranosyl chloride, methyl 3,4,6-tri-O-benzoyl-2-O -(4-methoxybenzyl)-1-thio
      beta-D-galactopyranoside, and 2,4-di-O-benzoyl-3-O-chloroacetyl-alpha-L
      rhamnopyranosyl chloride. Compound 1 corresponds to a complete tetrasaccharide
      repeating unit of the O-specific polysaccharide of the lipopolysaccharide of
      Shigella dysenteriae type 1.

PMID- 8348553
TI  - Synthesis and antileukemic activity of certain D-fucopyranosyl nucleosides.
AB  - Based upon previously discovered antileukemic properties of 9-beta-D
      fucopyranosyladenine (1) in cell culture, four new nucleosides containing
      naturally occurring bases have been prepared from D-fucose. alpha-D-Fucopyranose
      tetraacetate was condensed with the silylated bases in either acetonitrile or 1,2
      dichloroethane with tin(IV) chloride as the catalyst. The intermediate blocked
      nucleosides were obtained in crystalline form and deacetylated with methanolic
      sodium methoxide. 1-beta-D-Fucopyranosyluracil (8), 1-beta-D-fucopyranosylthymine
      (9), 1-beta-D-fucopyranosylcytosine (10) as the hydrochloride salt, and 7-beta-D
      fucopyranosylguanine (11) were crystallized, and their structures were verified
      by spectroscopic techniques. Nucleosides 8 and 9 had only borderline activity
      against leukemia L1210 cells grown in culture, whereas nucleoside 11 had activity
      equal to 1. However, nucleoside 10 proved to be twice as active as either 1 or
      11. The antileukemic activity, which was due to the inhibition of cell division,
      was reversible by transfer of the arrested cells to fresh media or by the
      addition of cytidine.

PMID- 8348555
TI  - A convenient synthesis of beta-D-galactosyl disaccharide derivatives using the
      beta-D-galactosidase from Bacillus circulans.
AB  - beta-D-Gal-(1-->4)-beta-D-GlcNAc-OC6H4NO2-p (p-nitrophenyl N-acetyl-beta
      lactosaminide) and beta-D-Gal-(1-->6)-beta-D-GlcNAc-OC6H4NO2-p (p-nitrophenyl N
      acetyl-beta-isolactosaminide) were regioselectively synthesized from lactose and
      p-nitrophenyl 2-acetamido-2-deoxy-glucopyranoside, employing transglycosylation
      by the beta-D-galactosidase from Bacillus circulans and by controlling the
      concentration of organic solvent in the reaction system. The (1-->4)-linked
      disaccharide was formed exclusively when the concentration of organic solvent was
      high, whereas the (1-->6)-linked isomer was produced with a low concentration.
      Further utilization of the transglycosylation by the enzyme led to the
      regioselective formation of beta-D-Gal-(1-->4)-D-GalNAc and beta-D-Gal-(1-->4)
      beta-D-GalNAc-OC6H4NO2-p. With the enzyme, beta-D-galactosyl transfer occurred
      preferentially at the O-4 position of GlcNAc and GalNAc, regardless of the
      configuration of the hydroxyl group.

PMID- 8348554
TI  - Total synthesis of the carbohydrate-protein linkage region common to several
      mammalian proteoglycans.
AB  - A stereocontrolled synthesis of beta-D-GlcpA-(1--> 3)-beta-D-Galp-(1-->3)-beta-D
      Galp-(1-->4)-beta-D-Xylp-(1 --> O)-L-Ser-Gly, the common glycopeptide sequence of
      the carbohydrate-protein linkage region of most mammalian proteoglycans, was
      achieved by use of O-[2-(trimethylsilyl)ethyl 2,3,4-tri-O-benzoyl-beta-D
      glucopyranosyluronate] -(1-->3)-O-(2,4,6-tri-O-benzoyl-beta-D-galactopyranosyl)
      (1-->3)-O-(2,4, 6-tri -O-benzoyl-beta-D-galactopyranosyl)-(1-->4)-2,3-di-O
      benzoyl-alpha, beta-D- xylopyranosyl trichloroacetimidate as the key
      intermediate. Condensation of this glycosyl donor with suitably protected L-seryl
      glycine dipeptide segments, and peptide chain elongation, allowed the
      construction in high yield of complex structures of this linkage region.

PMID- 8348556
TI  - Structural investigation of the capsular polysaccharide produced by a novel
      Klebsiella serotype (SK1). Location of O-acetyl substituents using NMR and MS
      techniques.
AB  - The capsular polysaccharide of Klebsiella SK1 was investigated by methylation
      analysis, Smith degradation, and 1H NMR spectroscopy. The oligosaccharides (P1
      and P2) obtained by bacteriophage phi SK1 degradation of the polymer were studied
      by methylation analysis, and 1D- and 2D-NMR spectroscopy. The resulting data
      showed that the parent repeating unit is a branched pentasaccharide having a
      structure identical to the revised structure recently proposed for Klebsiella
      serotype K8 capsular polysaccharide. [Formula: see text] The 2D-NMR data showed
      that one third of the glucuronic acid residues in the SK1 polymer are acetylated
      at O-2, O-3, or O-4. FABMS studies confirmed the presence of monoacetylated
      glucuronic acid residues. Thus, the relationship between the Klebsiella K8 and
      SK1 polymers is akin to that found for Klebsiella polysaccharides K30 and K33,
      which have been typed as serologically distinct yet their structures differ only
      in the degree of acetylation.

PMID- 8348557
TI  - Pyrolysis of inulin, glucose, and fructose.
AB  - The pyrolytic behavior of inulin, a (2-->1)-linked fructofuranan, is described.
      Parallel investigations of the pyrolysis of glucose and of fructose were
      conducted to supplement the inulin results and to aid comparison with previous
      results from glucans. Effects of neutral and basic additives are emphasized. As
      with glucans, the addition of such additives (especially basic) increases the
      yields of the one-, two-, and three-carbon products (as well as of
      hexosaccharinolactones), while generally decreasing the yields of anhydro sugar
      and furan derivatives. The former products include glycolaldehyde, acetol,
      dihydroxy-acetone, acetic acid, formic acid, and lactic acid. Mechanistic
      speculations are made regarding the origins of these compounds, as well as of
      furan derivatives and saccharinic acid lactones. Parallels with alkaline
      degradation are considered.

PMID- 8348558
TI  - Comparison of the activity of two chondroitin AC lyases on dermatan sulfate.

PMID- 8348559
TI  - Cytokine combinations in immunotherapy for solid tumors: a review.
AB  - The use of cytokines alone or in combination with other cytokines or cytotoxic
      drugs has had a profound effect upon widely metastatic disease in many cases.
      However, despite the encouraging results in early trials, there is much room for
      improvement. Few responses to these combinations are complete, and toxicity has
      in some cases been quite severe. Changes in dose, route, or schedule of
      administration of the drugs, or the development of cytokine analogs may lead to
      more efficacious and less toxic regimens. In addition, new cytokines such as
      interleukin(IL)-7 and IL-12 are currently under investigation for potential use
      in future immunotherapy trials. These prospects and the use of cytokine
      combinations are promising advances in the treatment of human cancer.

PMID- 8348560
TI  - Cytotoxic cell function and phenotypic analysis of peripheral blood mononuclear
      cells in cancer patients treated with low-dose interleukin-2 and mitomycin C.
AB  - We previously found that the ability of peripheral blood mononuclear cells (PBM)
      of cancer patients to generate lymphokine-activated killer (LAK) cells became
      remarkably augmented after mitomycin C administration. On the basis of the
      clinical findings, we designed a treatment regimen comprised of 12 mg/m2
      mitomycin C i.v. on day 1 and 700 U/m2 recombinant interleukin-2 (IL-2) i.v.
      every 12 h from day 4 through day 8. Of 25 patients with advanced carcinoma, 9
      had a partial response and 3 had a minor response. Cytotoxic cell function,
      including natural killer activity, lymphokine-activated killer (LAK) activity,
      and the ability to generate LAK cells, and lymphocyte subsets in PBM was measured
      1 day before and after either the first or second course of this therapy. The
      relationship between these parameters and the clinical antitumor response to this
      treatment was examined. Although the cytotoxic activities were significantly
      augmented after either the first or second treatment course, no positive
      correlation was observed between the changes in these cytotoxic activities and
      the clinical response to this therapy, when patients who either showed a partial
      response or whose disease remission was partial or minor were defined as
      responders. Further, phenotypic analysis showed a significant increase in CD2+,
      CD3+, CD4+ and CD4+Leu8- cells after the first course, and CD25+ cells after
      either the first or second course of this treatment. The percentages of CD2+ and
      CD25+ cells were significantly elevated only in responders but not in
      nonresponders, suggesting the increase in these subsets was related to clinical
      response.

PMID- 8348561
TI  - Interleukin-5 induces tumor suppression by peritoneal exudate cells in mice.
AB  - The antitumor activity of peritoneal exudate cells (PEC) induced by murine
      interleukin-5 (mIL-5) was examined using Meth-A sarcoma cells transplanted into
      the peritoneal cavity of mice. Although in vitro treatment of Meth-A sarcoma
      cells with mIL-5 did not result in inhibition of their growth, treatment of mice
      intraperitoneally with mIL-5 (1 microgram/day) from day -5 to +5 (tumor cells
      were inoculated on day 0) led to a significant increase in survival or even
      rejection of tumor cells. This antitumor effect depended on the dose of mIL-5.
      Interestingly, there was identical therapeutic activity when the protocol of days
      -10 to -1 was used as opposed to -5 to +5. In addition, post-treatment with mIL-5
      from day +1 to +10 was ineffective. This suggests that the therapeutic activity
      of IL-5 is largely prophylactic. Under the former condition, the number of PEC
      was found to increase over 50-fold when compared to levels in control mice.
      Moreover, the antitumor effect of mIL-5 was completely abolished by subcutaneous
      injection of anti-mIL-5 monoclonal antibodies. The treatment of mice injected
      intraperitoneally with human IL-2 also resulted in an increase in survival. Winn
      assay experiments using PEC recovered from mIL-5-treated mice (1 microgram/day,
      from day -10 to -1) revealed that these PEC could mediate antitumor activity
      against Meth-A sarcoma cells. Furthermore, when the cured mice were re-injected
      with Meth-A sarcoma cells or syngeneic MOPC104E cells, they could reject Meth-A
      sarcoma cells but not MOPC104E cells, indicating that immune memory had been
      generated. These results suggest that IL-5 augmented the PEC tumoricidal activity
      but we have no indication that the tumoricidal activity was mediated through a
      mIL-5-dependent mechanism.

PMID- 8348562
TI  - Effect of allogeneic tumor cells, interleukin-2 and interleukin-6, on the growth
      of subcutaneous syngeneic tumors.
AB  - In the present study we demonstrate the ability of allogeneic M3 tumor cells to
      induce an antitumor response against the syngeneic tumor, when injected locally
      together with syngeneic B16 melanoma cells. The replacement of the allogeneic
      tumor cells with either syngeneic or allogeneic splenocytes had no effect on the
      growth of the syngeneic tumor. Systemic administration of both interleukin-2 (IL
      2) and IL-6 did not affect the antitumor response induced by allogeneic tumor
      cells. When mice, previously injected with B16 and M3 cells, were rechallenged
      subcutaneously with B16 tumor cells at a different anatomical site, an inhibitory
      effect in some, but not all, experiments was observed. Systemic injections of
      either IL-2 or IL-6 did not alter the antitumor effects of the allogeneic and
      syngeneic tumor-cell mixtures. The significance of our results in developing
      immunotherapy modalities based on active immunization with allogeneic tumor cells
      and selected cytokines is discussed.

PMID- 8348563
TI  - In vitro expansion and analysis of T lymphocyte microcultures obtained from the
      vaccination sites of cancer patients undergoing active specific immunization with
      autologous Newcastle-disease-virus-modified tumour cells.
AB  - In order to understand further the effects of Newcastle-disease-virus(NDV)
      modified tumour vaccines we investigated the feasibility of isolating lymphocytes
      from the site of injection of patients undergoing postoperative active specific
      immunization (ASI) with autologous NDV-modified tumour cells. Delayed-type
      hypersensitivity(DTH)-like reactions from five cancer patients were surgically
      removed, minced and the tissue particles were digested with collagenase and
      DNase. Lymphoid cells recovered were expanded in a highly efficient limiting
      dilution analysis system optimized for T cell growth [Moretta et al. (1983) J Exp
      Med 157: 743] and lymphocyte microcultures (clonal probability > 0.8) could be
      grown for up to 1 year. Analysis of the microcultures for phenotype and function
      showed that the majority were positive for CD4 (92%) and TCR alpha beta (96%).
      Concanavalin-A-induced production of interleukin-2 (IL-2), IL-6, interferon gamma
      and tumour necrosis factor alpha was detected in more than 70% of the
      microcultures. Lectin-dependent cytotoxicity was only very rarely observed. The
      general characteristics of the microcultures obtained support the notion of a DTH
      like reaction taking place at the site of tumour cell challenge. The possibility
      of in vitro expansion and cultivation of T lymphocytes from ASI vaccination sites
      should help to elucidate further the role of these cells in active specific
      immunization against autologous tumour cells.

PMID- 8348564
TI  - Synergetic effect of interleukin-2 and cellular cytotoxicity against a novel
      tumor-associated carbohydrate antigen Le(a)/Le(a) (dimeric Le(a)) mediated by
      monoclonal antibody NCC-ST-421 in adoptive immunization using SCID mice.
AB  - The murine IgG3 monoclonal antibody NCC-ST-421, raised against a human gastric
      cancer, shows strong reactivity with dimeric Le(a) (Le(a)/Le(a);
      V4FucIII4FucLc6Cer) expressed on gastrointestinal cancer cells. ST-421 reacted
      minimally with non-dimeric or simple Le(a) expressed on normal tissues. ST-421 is
      capable of mediating both antibody-dependent cellular cytotoxicity (ADCC) with
      human peripheral blood lymphocytes, and complement-dependent cytotoxicity with
      human complement. Interleukin-2 (IL-2) modulates the function of immunocytes, in
      particular inducing lymphokine-activated killer (LAK) cell activity and enhancing
      ADCC. We therefore employed combination immunotherapy with IL-2, LAK, and ST-421
      induced ADCC in vitro and in mice with severe combined immunodeficiency (SCID),
      using target tumor cells expressing Le(a)/Le(a) antigen. ADCC against human colon
      cancer cell lines in vitro was enhanced three to four times after preincubation
      with IL-2. Addition of IL-2 reduced the amount of ST-421 required for efficient
      ADCC 10- to 100-fold. ADCC was activated by IL-2 earlier (1 day) than the
      generation of LAK cells (3-4 days), and at lower concentration of IL-2. These
      effects were specific for ST-421, as demonstrated by experiments with irrelevant
      antibody or irrelevant target cells. An anti-(Fc receptor) antibody blocked the
      ADCC but not the LAK activity in vitro. The enhancement of ADCC by IL-2 may be
      caused by activation of effector cells expressing Fc receptors. In vivo
      experiments using SCID mice inoculated with human colon cancer showed a
      significant tumor-growth-suppressive effect after combined therapy using human
      peripheral blood lymphocytes, LAK, IL-2, and ST-421. In summary, adoptive
      immunization with human lymphocytes activated by IL-2 and ST-421 effectively
      suppressed growth of gastrointestinal cancer cells expressing Le(a)/Le(a).

PMID- 8348565
TI  - Induction of an immune network cascade in cancer patients treated with monoclonal
      antibodies (ab1). I. May induction of ab1-reactive T cells and anti-anti
      idiotypic antibodies (ab3) lead to tumor regression after mAb therapy?
AB  - The antitumor effector functions of unconjugated monoclonal antibodies in cancer
      therapy are complex. Direct cytotoxic mechanisms such as antibody-dependent
      cellular cytotoxicity, complement-dependent cytolysis and apoptosis have been
      suggested. Induction of anti-idiotypic (ab2) and anti-anti-idiotypic (ab3)
      antibodies as well as T cell (T2 and T3 respectively) responses have also been
      proposed to be of clinical importance. In this study induction of an immune
      network cascade in patients with colorectal carcinoma, treated with mAb 17-1A
      (ab1) was assessed. All patients developed anti-idiotypic antibodies (ab2) of the
      IgG class after treatment with ab1 and four of nine patients showed induction of
      mouse Ig reactive T cells [a proliferative response to F(ab')2 fragments of ab1].
      Patients with such a T cell response developed anti-anti-idiotypic antibodies
      (ab3), while those lacking the T cell reactivity failed to mount an ab3 response.
      Three of four patients with a T cell response achieved a tumor response to mAb
      therapy. Thus, all responding patients belonged to the group of individuals
      developing ab3. Induction of mAb(ab1)-reactive T cells as well as an immune
      network cascade might be important antitumor effector functions of mAb and should
      be considered in the future design of mAb-based therapy protocols in cancer
      patients.

PMID- 8348567
TI  - Endogenous myocardial protective (antiarrhythmic) substances.

PMID- 8348566
TI  - Critical factors for liposome-incorporated tumour-associated antigens to induce
      protective tumour immunity to SL2 lymphoma cells in mice.
AB  - Physical and immunogenic properties of reconstituted membranes designed for the
      presentation of tumour-associated antigens (TAA) to the immune system are
      described. Proteins and lipids of crude membranes of SL2 murine lymphosarcoma
      cells were partially solubilized with octylglucoside. Reconstituted membranes,
      consisting mainly of unilamellar vesicles with a diameter of 0.03-0.15 microns,
      were formed by detergent removal and were purified by floatation in a
      discontinuous sucrose gradient to remove non-lipid-bound protein. Subcutaneous
      immunization of syngeneic mice with reconstituted membranes or with purified
      reconstituted membranes induced protection against an intraperitoneal challenge
      with 10(3) viable SL2 cells. Reconstituted membranes were more immunogenic than
      crude membranes in immunoprotection experiments when compared on the basis of
      protein dose. Detergent removal was required to obtain an immunogenic
      presentation form of SL2 membrane antigens and to avoid toxicity associated with
      the detergent. Reconstitution of SL2 membranes in the presence of exogenous
      phospholipid slightly increased the fraction of protein that associated with the
      reconstituted membranes. However, the immunogenicity of the solubilized membrane
      TAA was not significantly affected by the presence of exogenous phospholipid. The
      reconstitution procedure described may be useful in identifying membrane factors
      required for the induction of immune responses against TAA. The versatility of
      the system may be employed to develop safe alternatives for whole-cell vaccines.

PMID- 8348568
TI  - Endogenous chemical mediators of ventricular arrhythmias in ischaemic heart
      disease.
AB  - The causes of ventricular arrhythmias in the acute setting of coronary artery
      disease (myocardial ischaemia and reperfusion) may be approached using two
      paradigms. One, the electrophysiological paradigm (disturbance of ionic
      homeostasis, electrogenesis, and conduction) has not been addressed in detail
      here. Instead, we have focused on the concept of a chemical paradigm of
      arrhythmogenesis. Many endogenous chemical substances (derived from the
      myocardium, nerves, blood plasma, platelets, leucocytes, and endothelium)
      accumulate in the ischaemic tissue or are produced during reperfusion and many of
      these have been suggested to modulate ventricular arrhythmias. Some substances
      may be arrhythmogenic and others may be antiarrhythmic. Together they determine
      whether or not arrhythmias occur. Potentially arrhythmogenic substances include
      potassium, catecholamines, cAMP, histamine, 5-HT, lysophosphatidylcholine,
      palmitylcarnitine, platelet activating factor, prostaglandins, leukotrienes,
      thromboxane A2, angiotensin II, endothelin, opioids, protons, calcium, and free
      radicals. We have considered each of these, with the objective of evaluating
      which are important in arrhythmogenesis in acute ischaemia and reperfusion. Two
      alternative models of arrhythmogenesis are possible in the context of the
      chemical paradigm: a series model (where one substance or its effects determines
      the arrhythmogenicity of another) and a parallel model (where numerous substances
      operate independently to cause ventricular arrhythmias). It is not yet clear
      which model is most appropriate; a combination of the two is possible, so a
      working prototype has been constructed which accommodates both. A set of criteria
      (hitherto lacking) for establishing whether a substance is sufficient and
      necessary for arrhythmogenesis is proposed. Some generalisations are given on
      approaches to establishment of these criteria for putative arrhythmogenic
      substances. Finally, we have considered how arrhythmogenic drug development may
      be influenced by using the chemical paradigm as an alternative to the
      electrophysiological paradigm of arrhythmogenesis.

PMID- 8348569
TI  - Severe neutrophil depletion by leucocyte filters or cytotoxic drug does not
      improve recovery of contractile function in stunned porcine myocardium.
AB  - OBJECTIVE: The contribution of neutrophils to myocardial injury during stunning
      remains controversial because of conflicting results in neutropenic animals. The
      goal of this study was to compare the recovery of function in stunned myocardium
      using two distinct methods for inducing neutropenia in pigs. METHODS: Three
      groups of pigs were studied: control (n = 6), and made neutropenic by either
      Leukopak blood filters (n = 7), or cyclophosphamide (n = 7, 50 mg.kg-1
      intravenously 4 d prior to study). In anaesthetised open chest pigs, with the
      heart paced at 110 beats.min-1, the left anterior descending coronary artery was
      perfused with an extracorporeal circuit at controlled coronary pressure (CP) and
      the regional coronary blood flow was measured. Systolic wall thickening was
      determined by sonomicrometry in the left anterior descending and circumflex
      coronary artery regions. The protocol consisted of 15 min of low flow ischaemia
      (CP = 40 mm Hg), followed by a staged reperfusion over 10 min back to baseline
      (CP = 90 mm Hg), and continued for 2 h. Blood filtration was initiated prior to
      ischaemia and stopped after 90 min reperfusion. RESULTS: In both treated groups
      during ischaemia and the initial 60 min of reperfusion the neutrophil count was
      severely depleted to < 5% compared to the control group. Aortic pressure,
      coronary blood flow during ischaemia, area at risk, and systolic wall thickening
      in the circumflex region were similar between groups. Recovery of systolic wall
      thickening in the left anterior descending region after reperfusion was
      equivalent in all three groups. In the filter group, arrhythmias during ischaemia
      and reperfusion were significantly less. CONCLUSION: As assessed in the pig model
      of myocardial stunning and using two different methods, severe neutropenia does
      not reduce the depression of contractile function.

PMID- 8348570
TI  - Role of neutrophils in myocardial stunning after brief ischaemia: the end of a
      six year old controversy (1987-1993)

PMID- 8348571
TI  - Regulation of intrarenal and circulating renin-angiotensin systems in severe
      heart failure in the rat.
AB  - OBJECTIVE: Activation of the intrarenal renin-angiotensin system may contribute
      to the pathophysiology of heart failure by accelerating the generation of
      angiotensin II at local sites within the kidneys. Activation of the local
      intrarenal renin-angiotensin system occurs in rats and with mild heart failure.
      The aim of the present study was to examine components of the circulating as well
      as the intrarenal renin-angiotensin system in rats with severe heart failure.
      METHODS: Six weeks after experimental myocardial infarction (heart failure, HF; n
      = 8) or sham operation (control, C; n = 6), haemodynamics and the circulating and
      intrarenal components of the renin-angiotensin system were studied. RESULTS: HF
      rats were characterised by large infarctions (scar tissue > 40% of the left
      ventricular circumference). In comparison to sham operated controls, large
      myocardial infarctions resulted in severe heart failure with decreased systolic
      [108(SEM 3) mm Hg v 132(3) in C; p < 0.001] and diastolic arterial blood pressure
      [83(3) mm Hg v 95(2) in C; p < 0.05], decreased left ventricular systolic
      pressure [109(3) mm Hg v 132(3) in C; p < 0.005] and increased left ventricular
      end diastolic pressure [27(2) mm Hg v 5(1) in C; p < 0.0001]. In rats with severe
      heart failure, the circulating renin-angiotensin system was activated, with an
      increase in plasma renin activity (3.5-fold, p < 0.05) and plasma angiotensin II
      concentration (threefold, p < 0.01). In parallel, the intrarenal renin
      angiotensin system was activated in severe heart failure. Increases occurred in
      renal renin mRNA level (1.7-fold, p < 0.01), renal angiotensinogen mRNA level
      (1.8-fold, p < 0.05), and renal angiotensin II concentration (twofold, p < 0.05)
      compared to C. Intrarenal angiotensin II concentrations exceeded plasma levels by
      a factor of 50 and were positively correlated with renal angiotensinogen mRNA
      levels (r = 0.874, p < 0.001), suggesting that local synthesis is the major
      source of angiotensin II found in the kidney. CONCLUSIONS: The intrarenal renin
      angiotensin system may be selectively activated in mild heart failure, while both
      circulating and intrarenal renin-angiotensin systems are induced as the extent of
      left ventricular function worsens.

PMID- 8348572
TI  - Reduction of experimental myocardial infarct size by infusion of lactosylphenyl
      Trolox.
AB  - OBJECTIVE: The aim was to determine if lactosylphenyl Trolox could improve
      myocardial resistance to ischaemia and reperfusion. Lactosylphenyl Trolox is
      derived by coupling p-aminophenyl-beta-D-lactopyranoside to Trolox. Trolox, a
      polar analogue of vitamin E, has been found to protect human cardiomyocytes
      against oxyradicals and to reduce myocardial damage by 66% in a canine ischaemia
      reperfusion model. METHODS: New Zealand white rabbits (weighing approximately 3.5
      kg) were subjected to 1 h ischaemia by ligation of the main branch of the
      anterior ventricular coronary artery. Approximately 1-2 min before release of
      ischaemia, a 30 ml bolus of saline (placebo control) or saline containing
      lactosylphenyl Trolox was injected into the right external jugular vein, followed
      by 3 h reperfusion. The area at risk was identified by staining with Evans Blue.
      Area of necrosis was indicated by tetrazolium red staining, confirmed by
      histopathology and quantified by planimetry. RESULTS: The control group (n = 6)
      had 46.6(SD 10.0)% necrosis of the area at risk but the lactosylphenyl Trolox
      treated groups (n = 6 per group) had reduced necrosis: 34.0(6.5)%, 17.4(8.2)%,
      and 6.9(3.6)% at doses of 2.5, 5.0, and 10 mumol.kg-1, respectively (each with p
      < 0.05 v control value). These translated to 48.6(14.0)%, 62.7(17.6)%, and
      85.3(7.8)% myocardial salvage, respectively. In contrast, the salvages achieved
      with 2.5 and 10 mumol.kg-1 of Trolox were 31.0(11.0)% and 62.1(18.9)%
      respectively (both p < 0.05 v lactosylphenyl Trolox). CONCLUSIONS: Lactosylphenyl
      Trolox reduces myocardial infarct size more effectively than Trolox in a rabbit
      model of ischaemia-reperfusion.

PMID- 8348573
TI  - Dobutamine restores the reduced efficiency of energy transfer from total
      mechanical work to external mechanical work in stunned porcine myocardium.
AB  - OBJECTIVE: In order to determine whether the relatively high oxygen consumption
      of stunned myocardium is related to decreased mechanical efficiency, myocardial
      oxygen consumption (MVO2) and its major determinants were studied in 10 open
      chest anaesthetised pigs. METHODS: According to the time varying elastance
      concept, MVO2 is determined by contractility (Emax) and total mechanical work
      (PLA), which is the sum of the external work (EW) and potential energy (PE).
      Mechanical efficiency (EW/MVO2) equals the product of EW/PLA (= efficiency of
      energy transfer or EET) and PLA/MVO2. Emax is the slope of the end systolic
      pressure-segment length relationship, determined by gradually clamping the aorta.
      PLA is the area enclosed by the end systolic pressure-segment length relationship
      and the pressure-segment length trajectory. EW is the area of the pressure
      segment length loop. Systemic haemodynamics, regional segment shortening, and
      MVO2 were determined at baseline, during stunning (two sequences of 10 min
      occlusion and 30 min of reperfusion), after a subsequent 50 beats.min-1 increase
      in heart rate by atrial pacing and additional infusion of 2 micrograms.kg-1.min-1
      dobutamine. RESULTS: Stunning decreased segment shortening from 18.2(SEM 1.9)% to
      10.2(1.5)%, MVO2 from 4.16(0.27) x 10(-2) to 2.84(0.25) x 10(-2) mumol.beat-1.g
      1, and Emax from 47(9) to 23(3) mm Hg.mm-1 (all p < 0.05). PLA decreased by
      13(4)%, as EW decreased by 42(6)%, and PE tended to increase. Although EET
      decreased from 0.58(0.04) to 0.40(0.03) (p < 0.05), there was no decrease in the
      mechanical efficiency, as an increase in PE caused an increase in PLA/MVO2 which
      compensated for the decrease in EET. Dobutamine infusion increased Emax and EW
      per beat to 120(23)% and 67(8)% of baseline, respectively, while MVO2 [4.12(0.53)
      mumol.beat-1.g-1] and EET [0.57(0.04)] returned to baseline. CONCLUSIONS: In
      stunned myocardium, mechanical efficiency is not decreased despite a decrease in
      EET. The increase in EET after dobutamine may explain the lack of the excessive
      increase in MVO2.

PMID- 8348574
TI  - Arteriovenous-shunt-mediated increase in venous return causes apparent right
      coronary arterial autoregulation.
AB  - OBJECTIVE: Reports of autoregulation in the right coronary vasculature have
      varied from non-existent to almost perfect. At least some of this discrepancy may
      be due to failure to account for changes in myocardial metabolism secondary to
      the method used to vary perfusion pressure. The aim of this study was to
      determine if the potent autoregulation reported when right coronary perfusion
      pressure was lowered by opening a large arteriovenous shunt was due to increased
      right ventricular myocardial oxygen consumption (MVO2) induced by augmented
      preload and afterload. METHODS: Two protocols were used to produce right coronary
      perfusion pressures of 100, 80, and 60 mm Hg in anaesthetised dogs. In both
      protocols the right coronary artery was cannulated and supplied with blood from a
      pressurised chamber. In protocol 1, right coronary perfusion pressure was
      decreased independently of aortic pressure, and in protocol 2, aortic pressure
      was decreased in parallel with right coronary perfusion pressure by opening a
      large arteriovenous shunt. Right coronary blood flow, central venous pressure,
      and pulmonary arterial pressure were measured, and right ventricular oxygen
      extraction and MVO2. Central venous pressure (right ventricular preload) and
      pulmonary arterial pressure (right ventricular afterload) did not change. In
      protocol 2, opening the arteriovenous shunt increased venous return, as shown by
      increased central venous pressure and pulmonary arterial pressure. This increased
      right ventricular MVO2 at the lower right coronary perfusion pressures and
      maintained right coronary blood flow at the level recorded when right coronary
      perfusion pressure was 100 mm Hg. CONCLUSIONS: This apparently potent
      autoregulation resulted from the shunt induced increase in oxygen consumption at
      low right coronary perfusion pressures, in contrast to the decreased right
      ventricular oxygen consumption and right coronary blood flow observed when right
      coronary perfusion pressure is selectively decreased.

PMID- 8348575
TI  - Interaction of sympathetic and parasympathetic nervous system on ventricular
      refractoriness assessed by local fibrillation intervals in the canine heart.
AB  - OBJECTIVE: The aim was to assess the effects of autonomic nerve stimulation on
      local ventricular refractoriness by measuring local ventricular fibrillation
      intervals. METHODS: In 10 dogs on cardiopulmonary bypass, ventricular
      fibrillation intervals were recorded simultaneously at up to 32 sites before and
      after neural stimulation. In four dogs (group 1) the response to bilateral
      stellate ganglion stimulation was measured before and after bilateral cervical
      vagotomy. In three dogs (group 2) bilateral stellate ganglion stimulation, vagal
      nerve stimulation, and combined vagal and stellate ganglia stimulation were
      performed. In three dogs (group 3) the same protocol was applied after total
      decentralisation of the autonomic nervous system. RESULTS: Bilateral stellate
      ganglion stimulation shortened the ventricular fibrillation interval at 44-50% of
      myocardial sites before and after vagotomy, whereas prolongation of the interval
      was observed at 14-18% of the sites. At higher stimulus strength shortening of
      the interval was measured at 85% of the sites in the intact and decentralised
      groups. No prolongation was observed. The shortening was largest in the
      decentralised group (11.1 ms). Dispersion in refractoriness increased in hearts
      from all groups, but not in each individual heart. Left, right, or bilateral
      vagal stimulation was without effect at about 75% of the tested sites. The fact
      that the response to autonomic nerve stimulation varies from site to site
      warrants our approach of simultaneous recordings at multiple sites. Dispersion in
      refractoriness was not affected by vagal stimulation. Combined autonomic
      stimulation had approximately the same effect on dispersion in refractoriness as
      bilateral stellate ganglion stimulation alone. However, vagal stimulation
      attenuated the responses to bilateral stellate ganglion stimulation by some 20%
      in the decentralised group. CONCLUSIONS: Vagal stimulation has minor effects on
      ventricular refractoriness, but this is not due to sparse innervation, since
      vagal stimulation is able to mitigate the effects of sympathetic stimulation in
      decentralised hearts.

PMID- 8348576
TI  - Differential cardiac responses induced by nicotine sensitive canine atrial and
      ventricular neurones.
AB  - OBJECTIVE: The aim was to study the locations and functions of atrial and
      ventricular nicotine sensitive neurones. METHODS: In anaesthetised open chest
      dogs, cardiovascular effects elicited by nicotine (100 micrograms in 0.1 ml 0.9%
      saline), administered at specific loci of in situ atrial and ventricular
      ganglionated plexi, were studied before and after decentralisation. RESULTS:
      Cardiovascular responses were elicited when 41% of atrial and 36% of ventricular
      ganglionated plexus loci were studied. Subsequently, ganglia were identified
      adjacent to active sites. When cardiovascular responses were elicited, either
      tachycardia or bradycardia was induced, depending on the locus investigated. When
      tachycardia occurred, atrial and/or ventricular forces were augmented. When
      bradycardia occurred, atrial forces were suppressed. Ventricular fibrillation was
      induced in two animals when ventricular ganglionated plexus loci were
      investigated. Cardiovascular responses were not elicited when up to 2000
      micrograms of nicotine were administered adjacent to intrinsic cardiac axons,
      indicating that responses were not primarily due to axonal effects. Control
      injections of saline (0.1 ml) into active loci did not elicit cardiovascular
      responses. Following acute decentralisation, responses initiated by nicotine were
      attenuated or eliminated. Depressor responses were no longer elicited following
      atropine administration, nor augmentor ones following propranolol administration.
      CONCLUSIONS: (1) The canine heart contains nicotine sensitive neurones which can
      induce either augmentor or depressor cardiac effects. (2) Nicotine sensitive
      atrial neurones modify primarily, but not exclusively, atrial tissues, whereas
      ventricular ones modify primarily, but not exclusively, ventricular tissues. (3)
      Nicotine sensitive intrinsic cardiac neurones can interact with central neurones
      to modulate the heart.

PMID- 8348577
TI  - Contribution of each wall to biventricular function.
AB  - OBJECTIVE: Common muscle fibres encircle both ventricles and the ventricles share
      a common septal wall. This close anatomical association suggests that regional
      ischaemia and structural integrity may alter systolic function in both the right
      and the left ventricle. To examine this possibility, we investigated the
      contribution of each wall to biventricular function. METHODS: Isolated hearts,
      obtained from anaesthetised rabbits, were perfused with physiological salt
      solution under constant pressure. Balloons were placed in the right and left
      ventricles to measure isovolumetric pressure, and pressure-volume curves were
      obtained. In separate sets of experiments, the left ventricular free wall, right
      ventricular free wall, or septum was made ischaemic, incised, or injected with
      glutaraldehyde, respectively. Pressure-volume curves were obtained again.
      RESULTS: After left ventricular free wall ischaemia (n = 11), right ventricular
      developed pressure decreased significantly from 27.9(SD 8.9) to 14.1(6.6) mm Hg
      (p < 0.05), and remained depressed when the left ventricular free wall was
      further damaged by glutaraldehyde. Cutting the left ventricular free wall (n = 6)
      decreased right ventricular developed pressure from 28.9(8.6) to 17.8(4.8) mm Hg
      (p < 0.05), while reapproximating the left ventricular free wall by suturing re
      established right ventricular developed pressure. After right ventricular free
      wall ischaemia (n = 7), right ventricular developed pressure decreased from
      26.8(6.6) to 24.1(5.7) mm Hg (NS) and left ventricular developed pressure was
      unaltered. Cutting the right ventricular free wall (n = 7) had no effect on left
      ventricular developed pressure. Cutting the septum (n = 7) had no obvious
      influence on right ventricular developed pressure, but dramatically decreased
      left ventricular developed pressure from 79.2(55.2) to 43.7(32.2) mm Hg (p <
      0.05). Injecting glutaraldehyde into the septum (n = 7) decreased both right and
      left ventricular developed pressures from 22.1(8.5) to 14.0(8.8) and from
      78.2(50.5) to 47.9(37.9), respectively. CONCLUSIONS: The results show that the
      heart should be viewed as a mechanical syncytium. The left ventricular free wall
      plays a critical role in right ventricular systolic function and may help to
      explain the right ventricular response to left ventricular ischaemia. On the
      other hand, in the isolated heart preparation, right ventricular free wall
      ischaemia has only a minimal effect on left ventricular systolic developed
      pressure. Altering ventricular septal function affects both right and left
      ventricular systolic function.

PMID- 8348578
TI  - Mechanical characteristics of the globally ischaemic heart.
AB  - OBJECTIVE: The aim was to study the effects of global ischaemia on the mechanical
      properties of the myocardium. METHODS: Myocardial ischaemia was achieved by
      incubating the hearts of 160 rats in normal saline at 37 degrees C for periods of
      up to 24 h. To obtain different degrees of contracture, excess pressure (up to
      150 mm Hg) was created in the left ventricles of subgroups of hearts. After
      incubation the hearts underwent mechanical loading. RESULTS: Ischaemic
      contracture of cardiomyocytes led to increased rigidity and strength of the
      myocardium. A pressure of 50 mm Hg or higher blocked the increase in strength and
      rigidity of the ischaemic myocardium. CONCLUSIONS: It appears likely that in a
      functioning heart cardiomyocyte contracture in an ischaemic zone can only develop
      during the diastolic phase. A decrease in diastolic duration and/or an increase
      in diastolic pressure in the left ventricle may prevent increases in strength and
      rigidity of the ventricular wall after an infarct and promote the development of
      aneurysm and possible cardiac rupture.

PMID- 8348579
TI  - Acute effects of ethanol on cardiac function and intracellular calcium in
      perfused rat heart.
AB  - OBJECTIVE: The aim was to evaluate effects of ethanol on cardiac function and
      intracellular Ca2+ ([Ca2+]i) in perfused rat hearts. METHODS: A Langendorff
      perfused rat heart preparation was used. Changes in [Ca2+]i were evaluated by
      surface fluorometry in hearts loaded with Indo 1-AM. RESULTS: Clinically relevant
      concentrations of ethanol (0.2 or 0.4% vol/vol) had no significant haemodynamic
      effects. High concentrations of ethanol (1, 2, 3, and 4% vol/vol) showed dose
      dependent decreases in developed pressure and the systolic peak and overall
      amplitude of the Indo 1 fluorescence transients (identical to [Ca2+]i), that were
      partially antagonised by high extracellular Ca2+ ([Ca2+]o = 4 mM). The ethanol
      concentrations that decreased developed pressure by 50% were 1.4 and 2.6% in the
      low (1.5 mM) and high [Ca2+]o, respectively. Four per cent ethanol decreased the
      amplitude of Indo 1 fluorescence transients to 54.5(SD 3.1) and 64.6(7.9)% of
      control values in the low and high [Ca2+]o, respectively. A relationship between
      the amplitude of Indo 1 fluorescence and developed pressure was fitted to a
      single sigmoid curve irrespective of [Ca2+]o. During ethanol washout, there was a
      dose dependent overshoot of the fluorescence ratio. CONCLUSIONS: Only high
      concentrations of ethanol depressed left ventricular function in a dose dependent
      manner by decreasing the amplitude of [Ca2+]i transients. High [Ca2+]o partially
      antagonised acute alcoholic cardiac depression by increasing the amplitude of
      [Ca2+]i transients. [Ca2+]i is a mediator of the acute cardiac effects of ethanol
      in perfused intact rat hearts.

PMID- 8348580
TI  - Differential regional responses of myocardial interstitial noradrenaline levels
      to coronary occlusion.
AB  - OBJECTIVE: The aim was to investigate the influence of coronary occlusion on
      myocardial interstitial noradrenaline levels in the ischaemic and non-ischaemic
      regions, using the dialysis technique. METHODS: In nine anaesthetised cats,
      regional ischaemia was produced by occlusion of the left anterior descending
      coronary artery for 90 min. Using the dialysis technique, dialysates were sampled
      from both the ischaemic region and the nonischaemic left circumflex coronary
      artery region. Dialysate noradrenaline concentrations, as an index of myocardial
      interstitial noradrenaline content, were measured by high performance liquid
      chromatography. Myocardial blood flows in the ischaemic and non-ischaemic regions
      were measured by the hydrogen clearance method. RESULTS: In the non-ischaemic
      region, neither myocardial blood flow nor dialysate noradrenaline concentration
      showed significant change. In the ischaemic region, myocardial blood flow
      decreased significantly, from 117(SEM 12) at control to 23(3) ml.min-1 x 100 g-1,
      and dialysate noradrenaline concentration increased significantly, from 56.8(4.5)
      pg.ml-1 at control to 528.8(155.4) pg.ml-1 at 0-30 min of occlusion,
      4212.0(1447.7) pg.ml-1 at 30-60 min, and 4179.8(1668.5) pg.ml-1 at 60-90 min. At
      0-30 min of the reperfusion period, dialysate noradrenaline concentration in the
      postischaemic region decreased significantly to 420.2(152.1) pg.ml-1.
      CONCLUSIONS: Coronary occlusion increased myocardial interstitial noradrenaline
      levels in the ischaemic region, but not in the non-ischaemic region.

PMID- 8348581
TI  - Parasympathetic control of cycle length dependence of endocardial ventricular
      repolarisation in the intact feline heart during steady state conditions.
AB  - OBJECTIVE: Parasympathetic modulation of the rate dependence of ventricular
      repolarisation in vivo during steady state conditions was investigated by
      analysing the effects of removing vagal activity in three groups of anaesthetised
      cats. METHODS: Bilateral vagotomy was performed while different levels of
      background sympathetic tone were present in the control periods of each group: in
      group 1 (n = 6), cardiac sympathetic nerves were intact; in group 2 (n = 7),
      bilateral stellate ganglionectomy was performed; and in group 3 (n = 7), beta
      adrenergic blockade (propranolol, 0.5 mg.kg-1) was performed after stellate
      ganglionectomy. The duration of a left ventricular endocardial monophasic action
      potential (APD) was measured during atrial pacing at 7-10 cycle lengths (CL). The
      APD/CL relation was fitted to a hyperbolic function: APD = CL/[(axCL)+b]. Two
      parameters were considered: APDmax (1/a, ie, APD extrapolated at infinite cycle
      length, a rate-independent measure of APD) and CL50 (bxAPDmax, ie, the cycle
      length at which 50% of APDmax is reached). RESULTS: In control conditions, APDmax
      and CL50 were longer in groups 2 and 3, when cardiac sympathetic effects were
      reduced or absent. Vagotomy reduced APDmax and CL50 similarly in groups 1 and 2
      (APDmax, -24% and -18%; CL50, -36% and -27%) (p < 0.05 v control). In group 3,
      vagotomy did not affect APDmax and CL50. CONCLUSIONS: No direct parasympathetic
      influence on the rate dependence of endocardial ventricular repolarisation was
      observed. The vagal modulation of sympathetic effects may take place either
      through vago-sympathetic reflexes or via the antagonism of circulating
      catecholamines distal to the beta receptor.

PMID- 8348582
TI  - Production of chronic congestive heart failure by rapid ventricular pacing in the
      rabbit.
AB  - OBJECTIVE: The aim was to produce a model of low output congestive heart failure
      by rapid pacing in rabbits. METHODS: To perform rapid pacing in rabbits, a custom
      made pacemaker was developed which is light (about 80 g) and can pace at up to
      400 beats.min-1 for more than two weeks. A thoracotomy was done and two
      electrodes were sutured onto the left ventricle. A central venous pressure line
      was chronically implanted. With the use of this pacemaker, rabbits were paced at
      350-400 beats.min-1 for several weeks. RESULTS: Central venous pressure increased
      from 1.4(SEM 0.2) to 6.4(0.5) mm Hg (p < 0.01, n = 14). After pacing for
      16.1(1.6) d, haemodynamic studies were performed under anaesthesia with thiamylal
      sodium. Left ventricular end diastolic pressure was higher in the paced rabbits
      (n = 10) than in the control rabbits which underwent sham operation but were not
      paced (n = 6), at -0.6(0.6) v 19.3(2.0) mm Hg (p < 0.01). Cardiac output [673(56)
      v 536(45) ml.min-1, p < 0.10] and +dP/dt [1433(97) v 722(51) mm Hg.s-1, p < 0.01]
      were lower in the paced rabbits (n = 7-8) than in the control rabbits (n = 6).
      The paced rabbits had more ascites [1.9(1.0) v 45.9(18.9) ml, p < 0.05] and
      pleural effusion [0.4(0.3) v 12.9(6.7) ml, p < 0.10] than control rabbits. Plasma
      noradrenaline was higher in the paced rabbits (n = 11) than in the control
      rabbits (n = 7), at 1.59(0.43) v 0.60(0.05) ng.ml-1 (p < 0.05). The ratio of wet
      heart weight or lung weight to body weight was higher (p < 0.01) in the paced
      rabbits than in the control rabbits. CONCLUSIONS: Chronic biventricular
      congestive heart failure can be produced in rabbits by rapid pacing.

PMID- 8348583
TI  - Velocity profiles and phasic flow patterns in the non-stenotic human left
      anterior descending coronary artery during cardiac surgery.
AB  - OBJECTIVE: The aim was to investigate the phasic characteristics of normal human
      left coronary artery flow and velocity profiles across the vessel. METHODS: The
      phasic characteristics of flow in the human left anterior descending coronary
      artery, the centreline flow velocities, and the velocity profiles were measured
      in 10 patients during corrective surgery for atrial septal defect after closure
      of the defect. None of these patients had any detectable coronary artery stenosis
      or left ventricular hypertrophy. Measurements were made with a 20 MHz 80 channel
      pulsed Doppler velocimeter. RESULTS: The velocity waveform displayed a diastolic
      predominant pattern with a systolic to diastolic velocity ratio of 0.29(SD 0.17).
      Reverse flow was observed in early systole in five patients and in mid to late
      systole in six patients. The values of peak Reynolds number, unsteadiness
      parameter, and pulsatility index were 504(198), 2.5(0.6), and 5.9(4.4)
      respectively. The velocity profiles during diastole showed considerable
      variability in shape, ranging from symmetrical to skewed to M shaped patterns.
      The peak wall shear rate was 765(250) s-1 on the epicardial wall of the vessel
      and 712(301) s-1 on the myocardial wall; the difference was not statistically
      significant. CONCLUSIONS: The velocity waveform displayed a diastolic-predominant
      pattern. Considerable variability in shape of the velocity profile was found and
      was perhaps due to the time evolution of the velocity profile within the
      diastolic time period.

PMID- 8348584
TI  - Non-invasive assessment of ventricular damage in rats with myocardial infarction.
AB  - OBJECTIVE: The aim was to evaluate whether two dimensional
      echocardiographic/Doppler (echo/Doppler) techniques could be used to detect left
      ventricular damage rapidly, accurately, and non-invasively in rats with a
      myocardial infarction. METHODS: Female Wistar rats were initially subjected to
      either a sham operation or surgery to induce a myocardial infarct by ligating the
      left main coronary artery. Following a minimum of six weeks to recover from the
      surgery, all rats were re-anaesthetised and cardiac and stroke indexes were
      determined at similar heart rates, using echo/Doppler techniques. Postmortem
      histological assessment of myocardial infarct size was compared with the non
      invasive detection of left ventricular wall motion abnormalities, left
      ventricular dilatation, and the presence of a left ventricular aneurysm found in
      the living animal. RESULTS: Rats with myocardial infarction (n = 8) showed a
      33(SEM 4)% reduction (p < 0.01) in cardiac index (due to a 33% reduction in
      stroke index) when compared to their non-infarcted counterparts (n = 5). In
      addition, a significant correlation (r = 0.84; n = 25; p < 0.01) was found
      between the assessment of left ventricular damage via non-invasive echo/Doppler
      measurements and the histological determination of infarct size. CONCLUSIONS:
      These results support the conclusion that two dimensional echo/Doppler techniques
      can be used to estimate rapidly and non-invasively the degree of left ventricular
      damage produced in living rats with myocardial infarction when compared to non
      infarcted controls.

PMID- 8348585
TI  - Electrophysiological and inotropic effects of H 234/09 (almokalant) in vitro: a
      comparison with two other novel IK blocking drugs, UK-68,798 (dofetilide) and E
      4031.
AB  - OBJECTIVE: The aim was to compare the electrophysiological and inotropic effects
      of the novel class III agents H 234/09, UK-68,798, and E-4031 in vitro. METHODS:
      The electrophysiological effects were investigated by recording transmembrane
      action potentials in the isolated ventricular muscle and Purkinje fibres of the
      rabbit; effects on force (adjusted to the maximum isoprenaline response) and
      refractoriness were investigated in the isolated cat papillary muscle. RESULTS:
      It was shown that all the drugs induced a concentration dependent prolongation of
      the action potential duration, which was much more pronounced in the Purkinje
      fibres than in the ventricular muscle. However, when compared at concentrations
      giving a 15% increase of the action potential duration in ventricular muscle, H
      234/09 was significantly less effective in the Purkinje fibres than the other two
      drugs. In the cat papillary muscle all drugs induced an increase in force
      development. This increase tended to parallel the increase in effective
      refractory period. However, at prolongations of effective refractory period of
      more than approximately 50% the increase in developed force levelled off.
      CONCLUSIONS: All the class III agents investigated showed a positive inotropic
      effect, which may be of advantage when compared to conventional class I
      antiarrhythmic agents, which have cardiodepressant actions. Compared to UK-68,798
      and E-4031, H 234/09 showed a less unfavourable profile in terms of dispersion of
      repolarisation, which theoretically may reduce the risk of arrhythmias associated
      with delayed repolarisation. However, this less unfavourable profile must, like
      the positive inotropic effect, ultimately be investigated in clinical trials.

PMID- 8348586
TI  - Estimation of left ventricular elastance without altering preload or afterload in
      the conscious dog.
AB  - OBJECTIVE: The aim was to determine the slope (EES) of the left ventricular end
      systolic pressure-volume line (ESPVL) without altering preload or afterload in
      conscious dogs. METHODS: Dogs (n = 10) were instrumented to determine left
      ventricular volume from ultrasonic left ventricular internal dimensions, and to
      measure left ventricular pressure using a micromanometer. Studies were performed
      one to two weeks after instrumentation while the animals were conscious. ESPVL
      was determined from variably loaded left ventricular pressure-volume (P-V) loops
      generated by the vena caval occlusion. Contractile state was increased by
      intravenous dobutamine (8 micrograms.kg-1 x min-1) and decreased by intravenous
      verapamil (10 mg) given after autonomic blockade. From a single normally ejecting
      beat, we calculated EES-single beat (mm Hg.ml-1) as peak isovolumetric pressure
      (Pmax) minus end systolic pressure divided by stroke volume. Sunagawa's technique
      was used to estimate Pmax by fitting the pressure during the isovolumetric
      contraction and relaxation as: P(t) = 1/2 X Piso[1-cos(omega t+c)]+LVEDP, where
      Piso = peak isovolumetric developed pressure, LVEDP = left ventricular end
      diastolic pressure, c = constant accounting for variations in phase angle, and
      omega = 2 pi/T in which T is duration of contraction. RESULTS: After dobutamine,
      EES increased, from 8.9(SEM 0.8) to 12.5(1.0) mm Hg.ml-1 (p < 0.05), and EES
      single beat increased from 9.1(0.9) to 12.0(1.4) mm Hg.ml-1 (p < 0.05).
      Conversely, after verapamil, EES decreased, from 11.1(1.2) to 6.3(1.1) mm Hg.ml
      1, (p < 0.05), and EES-single beat also decreased, from 9.6(1.0) to 7.3(1.2) mm
      Hg.ml-1, (p < 0.05). CONCLUSIONS: EES calculated from one beat is similar to EES
      determined from variably loaded left ventricular loops and responds appropriately
      to inotropic stimulation. This technique provides a reasonable method to
      calculate EES from left ventricular pressure and stroke volume without altering
      preload or afterload.

PMID- 8348587
TI  - Differences in ischaemia tolerance between hypertrophied hearts of adult and aged
      spontaneously hypertensive rats.
AB  - OBJECTIVE: The aim was to examine differences between the postischaemic
      functional and biochemical recovery of adult and aged hypertrophied hearts.
      METHODS: Isolated hypertrophied hearts of adult and aged spontaneously
      hypertensive rats (SHRadult; SHRaged) and normal hearts of age matched Wistar
      Kyoto rats (WKYadult; WKYaged) were perfused in an ejecting heart preparation.
      Haemodynamic function was monitored before and after 45 min of ischaemia.
      Coronary effluent samples and tissue biopsies were taken for biochemical
      analysis. RESULTS: After ischaemia, in SHRadult and WKYadult the maximum positive
      first derivative of the left ventricular pressure (dP/dtmax) was restored to 105%
      and 97% respectively of the preischaemic values. Left ventricular developed
      pressure recovered to 80% (SHRadult) and 97% (WKYadult), while cardiac output
      reached 71% (SHRadult) and 99% (WKYadult) of preischaemic levels. In SHRaged and
      WKYaged the dP/dtmax recovered to 26% and 60% respectively (both p < 0.05
      compared to the preischaemic values). The left ventricular developed pressure
      recovered to 36% in SHRaged and to 73% in WKYaged (both p < 0.05), while cardiac
      output was restored to 6% in SHRaged and 38% in WKYaged (both p < 0.05).
      Throughout reperfusion, left ventricular end diastolic pressure remained
      significantly elevated in SHRaged, and was associated with a prominent
      subendocardial underperfusion, suggesting an impaired diastolic functional
      recovery. Overall haemodynamic recovery was significantly better in the WKYaged
      than in the SHRaged. The preischaemic total adenine nucleotides content was
      comparable in all groups, but creatine phosphate levels were significantly lower
      in both aged groups than in adult groups. In all but the WKYadult, the total
      adenine nucleotides were depressed upon reperfusion, while creatine phosphate
      normalised, except in SHRaged. SHRaged lost more lactate dehydrogenase and tended
      to lose more xanthine and uric acid than other groups. CONCLUSIONS: The aged
      hypertrophied heart shows a higher vulnerability to ischaemic damage than the
      adult hypertrophied heart. This phenomenon is associated with subendocardial
      underperfusion, increased membrane damage and inadequate recovery of creatine
      phosphate levels.

PMID- 8348588
TI  - Increased fibrinolytic activity in the intima of atheromatous coronary arteries:
      protection at a price.
AB  - OBJECTIVE: The aim was to quantify and compare the fibrinolytic activity of
      normal blood vessels (saphenous vein, internal mammary artery, and aorta) and
      atheromatous arteries (coronary endarterectomy specimens). METHODS: Fibrinolytic
      activity was measured by fibrin plate and colorimetric assays on fresh samples of
      coronary endarterectomy core, internal mammary artery, human aorta, and saphenous
      vein from patients undergoing coronary artery bypass surgery. RESULTS:
      Fibrinolytic activity on fibrin plates ranked in the order endarterectomy cores >
      internal mammary artery > saphenous vein. The increased activity of
      endarterectomy cores was associated with an increased content of extractable
      tissue plasminogen activator and was suppressed by monoclonal antibody to tissue
      plasmogen activator. Paired comparisons of tissues from the same patients
      confirmed this increased activity in endarterectomy specimens relative to normal
      artery or vein. Urokinase activity was also increased in some endarterectomy
      specimens, but was more variable than tissue plasmogen activator. CONCLUSIONS:
      The increased fibrinolytic activity of endarterectomy cores may help preserve
      patency in atheromatous vessels, but at the possible price of increased intimal
      instability and fibrous proliferation.

PMID- 8348589
TI  - Eponyms and acronyms.

PMID- 8348590
TI  - Alternative splicing generates diversity of VD1/RPD2 alpha peptides in the
      central nervous system of Lymnaea stagnalis.
AB  - 1. Two giant peptidergic neurons, VD1 and RPD2, of the visceral ganglion and
      right parietal ganglion of Lymnaea stagnalis, respectively, play an important
      role in the modulation of complex physiological and behavioral adjustments that
      occur as a result of changes in O2 availability. 2. By cDNA cloning, we have
      identified two types of VD1/RPD2 transcripts expressed in VD1 and RPD2. In
      addition, these transcripts are also expressed in other neurons. 3. Both
      transcripts encode distinct yet related VD1/RPD2 preprohormones that may be
      cleaved to yield distinct but overlapping sets of neuropeptides. 4. Using the
      polymerase chain reaction technique, we could show the existence of additional
      splice variants. 5. Analysis of the organization of the VD1/RPD2 gene indicates
      that the alpha peptide coding region is interrupted by a number of introns. 6. We
      concluded that the mRNA segment encoding the alpha peptide domain of the VD1/RPD2
      preprohormones is alternatively spliced, thus generating different alpha
      peptides.

PMID- 8348592
TI  - The effect of osmotic gradients on the outward potassium current in dialyzed
      neurons of Helix pomatia.
AB  - 1. The effect of outward and inward water flows through the membrane on outward
      potassium currents of dialyzed Helix pomatia neurons was studied. 2. An outward
      water flow increased the peak and sustained outward potassium currents and
      accelerated the kinetics of their activation. An inward water flow had quite
      opposite effects--it decreased the peak and sustained potassium currents and
      delayed the kinetics of their activation. 3. The analysis of the effect of water
      flow on the conductance of potassium channels showed that an outward water flow
      increased both the potassium conductance at a given potential (gk) and the
      maximum potassium conductance (gkmax). An inward water flow again had the
      opposite effect--it decreased the potassium conductance at given potential and
      the maximum potassium conductance. 4. Neither an outward nor an inward water flow
      significantly affected the fraction of open potassium channels at a given
      potential [n infinity(V)]. 5. These data suggest that in dialyzed neurons the
      changes of outward potassium current during water flow through the membrane are
      due mainly to the changes in single-channel conductance and the time constant of
      current activation.

PMID- 8348591
TI  - Functional domains on chemically modified tau protein.
AB  - 1. Neurofibrillary tangles present in Alzheimer's disease and, in a lower
      proportion, in aged brains are formed mainly by paired helical filaments. The
      microtubule-associated protein tau is a major structural component of these
      filaments. In order to increase our understanding of the aberrant behaviour of
      tau protein leading to its assembly into paired helical filaments, studies were
      carried out using chemical modifications of brain tau protein. 2. Selective
      carbamoylation of tau with KCNO resulted in an irreversible modification of
      lysine residues on tau protein. The capacity of chemically modified tau protein
      to induce tubulin assembly, under standard in vitro microtubule polymerization
      conditions, decreased gradually in relation to the increase in concentration of
      the modifying reagent. 3. Interestingly, carbamoylated tau protein exhibited the
      capacity to self-assemble into polymeric structures resembling those of paired
      helical filaments, after incubating the modified protein at concentrations higher
      than 1.0 mg/ml, at 37 degrees C with KCNO. 4. The nature of polymers obtained
      from cabamoylated tau protein was analyzed by ultrastructural studies. The data
      provide new clues toward our understanding of the anomalous interactions of tau
      in Alzheimer's disease.

PMID- 8348593
TI  - Management of typical and dysplastic pulmonic stenosis, uncomplicated or
      associated with complex intracardiac defects, in juveniles and adults: use of
      percutaneous balloon pulmonary valvuloplasty with eight-month hemodynamic follow
      up.
AB  - To alleviate large fixed right ventricular (RV) outflow gradients, percutaneous
      balloon dilatation of pulmonic stenosis (PS) was performed in 38 patients with
      mean age of 14 +/- 14 years (median: 9 years, age range: 9 months to 63 years).
      There were 21 males and 17 females. Thirty-four patients had typical PS (5 of
      them also having other complex congenital cardiac anomalies, while 13 additional
      patients had a patent foramen ovale); 2 further subjects had subpulmonic, and 2
      dysplastic pulmonary valvular obstructions. Sixteen patients were in the New York
      Heart Association (NYHA) Class I, 15 in Class II, 6 in Class III, and 1 in Class
      IV. Electrocardiographic (ECG) evidence of right ventricular hypertrophy (RVH)
      was present in 29 patients (76%); 3 patients had right bundle branch block
      (RBBB). For the entire group, there was a marked decrease in the mean systolic
      transpulmonic gradient in the immediate post-valvuloplasty period (from 97 +/- 43
      to 26 +/- 17 mmHg; P < 0.0001). One patient expired 8 hours post-valvuloplasty
      (he was in the NYHA Class IV, and had severe RV failure). No other cardiovascular
      complications were encountered; the median hospital stay was 3 days (range: 1-10
      days). At an 8-month follow-up, 12 patients who were reevaluated invasively had a
      median transpulmonic gradient of 27 mmHg (range: 5-92 mmHg) as compared to their
      pre-valvuloplasty values of 84 mmHg (range: 49-142 mmHg; P < 0.004).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8348594
TI  - Safety of cardiac catheterization via peripheral vascular grafts.
AB  - There are few data concerning the complications and technical difficulties
      encountered when cardiac catheterization is performed using peripheral bypass
      grafts for vascular access. All cardiac catheterizations performed at our
      institution from January 1, 1984 to April 1, 1991 were retrospectively reviewed
      to assess the in-hospital clinical outcomes in patients who had arterial access
      for catheterization achieved via prosthetic graft puncture. Seventeen procedures
      had percutaneous puncture of a vascular graft from a total of 2,929 arterial
      catheterizations performed. The interval from graft placement to catheterization
      was 7.5 +/- 1.1 years. Arterial sheaths were employed in all cases and
      corresponded to the catheter size, with 5F systems used in 53% and 7F or larger
      systems used in the remaining patients. No intraprocedural or postprocedural
      complications were recognized. Technical difficulties were limited to the
      inability to selectively cannulate a nondominant right coronary artery in 1
      patient. We conclude that percutaneous introduction of an arterial sheath and
      left heart catheterization via remotely implanted vascular bypass grafts is not
      associated with an increased risk of procedural complications or technical
      difficulties.

PMID- 8348596
TI  - Assessment of thallium scintigraphy and echocardiography during dobutamine
      infusion for the detection of coronary artery disease.
AB  - Dobutamine infusion was performed in 16 patients following cardiac
      catheterization, and non-invasive assessment was performed with thallium SPECT
      and echocardiography. Dobutamine thallium scintigraphy was abnormal in 93% of
      patients with significant coronary artery disease. In addition, individual
      epicardial vessel involvement was identified by a corresponding perfusion defect
      with 88% sensitivity and 93% specificity. Dobutamine echocardiography revealed
      segmental wall motion abnormalities in 62% of patients with significant coronary
      disease. However, in six patients baseline segmental wall motion abnormalities on
      echocardiography improved during dobutamine infusion. Dobutamine thallium SPECT
      is a safe and useful test for the detection and localization of coronary artery
      disease. Dobutamine echocardiography is less useful in screening for coronary
      disease, but may detect areas of abnormally functioning myocardium having
      retained viability.

PMID- 8348595
TI  - Contrast echocardiography during cardiac catheterization in patients with
      congenital heart diseases.
AB  - Contrast echocardiography performed during cardiac catheterization has mostly
      been limited to a few published case reports. We studied 37 patients with
      congenital heart disease to assess the capability of the method to diagnose
      cardiac shunts and valve regurgitation. Injections of 5% dextrose in water
      through an angiographic catheter were made to evaluate septal integrity and valve
      competence compared with conventional contrast angiography. An overall
      sensitivity of 93% and specificity of 78% were found. In four cases of atrial
      septal defect and seven of mitral regurgitation, the sensitivity was 100%. It was
      slightly lower for eleven cases of ventricular septal defect (91%) and four of
      patent ductus arteriosus (75%). When assessing aortic, tricuspid and pulmonary
      valve competence, the method proved to be more sensitive than conventional
      angiography to detect mild regurgitation. Contrast echocardiography is a
      sensitive and safe technique that may be used in association with conventional
      angiography reducing the need for radiographic contrast and ionizing radiation
      time.

PMID- 8348597
TI  - Successful directional atherectomy of eccentric renal artery stenosis using the
      Simpson directional coronary atherocath as a primary therapy.
AB  - A 67-yr-old female patient with accelerated hypertension, severe peripheral
      vascular disease, diabetes mellitus, and coronary artery disease had an abnormal
      renal scan, renal angiogram, and renal vein renin determination with
      lateralization to the left kidney. Angiography demonstrated a very tight,
      eccentric plaque obstructing the left renal artery of approximately 99%. Because
      of the anatomy of the plaque, balloon dilatation was deemed inadvisable.
      Subsequently, a Simpson 7F graft DCA atherocath through a four-curved 10F right
      bypass graft guiding catheter was used to successfully debulk the left renal
      artery. After debulking, the artery was dilated with a 5 mm Meditech balloon on a
      wire through a Cobra guiding catheter. The patient's blood pressure responded
      immediately and there were no complications. A large amount of atherosclerotic
      plaque was removed from the renal artery.

PMID- 8348598
TI  - A unique scenario for coronary atherectomy.
AB  - Despite several attempts, balloon angioplasty of a slightly eccentric stenotic
      lesion in the proximal right coronary artery failed to result in any increase of
      luminal diameter. Following disruption and partial removal of a fibrous
      atherosclerotic cap using directional atherectomy, subsequent balloon angioplasty
      was highly successful.

PMID- 8348599
TI  - Early stent occlusion is not always caused by thrombosis.
AB  - Early occlusion of intracoronary stents has been exclusively attributed to
      thrombosis. Using intracoronary angioscopy, we have found 2 patients in whom this
      common and serious complication of coronary stenting was caused by obstructive
      intima dissection rather than thrombosis.

PMID- 8348600
TI  - Implantation of half Palmaz-Schatz stents in short aorto-ostial lesions of
      saphenous vein grafts.
AB  - Two cases are presented in which a half Palmaz-Schatz stent was implanted in a
      short lesion located in the ostium of a saphenous vein graft. Aorto-ostial
      stenoses are a technical challenge for balloon angioplasty and stenting. Short
      stents may offer several advantages as regards deployment, positioning,
      thrombogenicity, and restenosis.

PMID- 8348601
TI  - Diagnosis of stenosis in a pulmonary valve-conduit using an angioplasty guide and
      probing catheter.
AB  - A 42-year-old man who had undergone previous Blalock-Taussig anastomoses and
      placement of a homograft aortic valve-root conduit for tetralogy of Fallot
      presented with dyspnea at rest. Previous catheterization had shown homograft
      stenosis at the level of the pulmonic valve. Repeat catheterization necessitated
      the use of angioplasty guide and probing catheters to cross the stenosis, and
      pullback documented stenoses both across the homografted valve and within the
      homograft aortic root-native pulmonary artery conduit.

PMID- 8348602
TI  - Use of translesional coronary flow velocity for interventional decisions in a
      patient with multiple intermediately severe coronary stenoses.
AB  - Translesional pressure gradients are currently not performed routinely for most
      angioplasty procedures because of the technical limitations. With the use of an
      0.18 inch Doppler flow velocity guidewire, coronary flow velocity, both proximal
      and distal to a lesion, can be easily assessed. In branching arteries,
      significant lesions are characterized by a ratio of proximal to distal flow
      velocity of > 1.7, loss of the normal phasic diastolic predominant flow velocity
      pattern, and/or loss of distal hyperemia. We describe the use of coronary flow
      velocity in assisting important decision making in a young patient with a recent
      myocardial infarction and multiple coronary lesions. The decision for angioplasty
      of the hemodynamically significant stenosis was confirmed by translesional flow
      velocity measurements. A rational approach to coronary intervention in patients
      with multiple stenoses of intermediate severity appears to be facilitated by
      direct measurement of translesional flow dynamics.

PMID- 8348603
TI  - Aortic dissection with aortopulmonary artery fistula.
AB  - A case of aortic dissection complicated by aortopulmonary artery fistula is
      reported. Aggressive diagnostic and surgical management was associated with a
      favorable, long-term outcome.

PMID- 8348604
TI  - Double-lumen catheter assessment of aortic stenosis: comparison with separate
      catheter technique.
AB  - Hemodynamic assessment of aortic stenosis in the catheterization laboratory
      accurate determination of the transvalvular gradient. A commercially available
      double-lumen pigtail catheter can be used to obtain this gradient via a single
      arterial puncture. The catheter has several advantages over other methods used to
      measure the gradient in aortic stenosis, but it has not been critically
      evaluated. In order to assess the performance of this catheter compared to the
      traditional standard of separate catheters above and across the aortic valve, we
      studied 10 patients with aortic stenosis using both catheter systems. Aortic
      valve areas ranged from 0.34 cm2 to 1.1 cm2. Linear regression analysis confirmed
      excellent correlation between the two methods in measurement of the mean
      transvalvular gradient (r = 0.98) and calculation of the aortic valve area (r =
      0.99) using the Gorlin formula. We conclude that the double-lumen pigtail
      catheter provides accurate data in the hemodynamic evaluation of aortic stenosis.

PMID- 8348605
TI  - Endoluminal sealing of vascular wall disruptions with radiofrequency-heated
      balloon angioplasty.
AB  - Suboptimal luminal widening or acute closure secondary to arterial dissection
      remain significant risks of percutaneous transluminal balloon angioplasty. Non
      surgical techniques are often employed in an attempt to repair dissections either
      as temporary or definitive treatment. The aim of this study was to test the
      hypothesis that radiofrequency thermal balloon angioplasty at an operating
      temperature of 70 degrees C and low inflation pressure could seal dissections and
      perforations in a model of severe arterial wall damage. Dissections and
      perforations were created in renal (n = 4) and carotid (n = 4) arteries in four
      mongrel dogs. Endoluminal sealing was then attempted with conventional balloon
      angioplasty or radiofrequency thermal balloon angioplasty (2 atm at 70 degrees
      C). Contrast dye extravasation persisted in all cases following conventional
      balloon angioplasty but completely resolved with radiofrequency balloon
      angioplasty in all but one artery. Histologic examination of the arteries treated
      with radiofrequency balloon angioplasty showed extensive thermal injury,
      including transmural coagulation necrosis, flattening of the internal elastic
      lamina, and medial thinning. On the basis of these results, the utility of
      thermal balloon angioplasty for endoluminal sealing of dissections and
      perforations complicating angioplasty deserves further evaluation.

PMID- 8348606
TI  - Initial experience with a new balloon-on-a-wire catheter: the Bijou.
AB  - This paper presents our initial experience with a new low-profile balloon "on-a
      wire" catheter, the Bijou. The concept of this balloon is to provide an
      additional side lumen with the advantages of (1) the ability to measure pressure
      gradient, (2) the possibility of drug infusion, and (3) the ability to advance a
      steerable guidewire through this side lumen. The balloon has been tested in 15
      patients; 14 underwent an elective procedure for stable angina pectoris (with 2
      cases of restenosis) and one an emergency angioplasty in a case of acute
      myocardial infarction. The stenosis was located on the left anterior descending
      artery in 11 procedures, on the right in 3, on a marginal branch in 2, on the
      circumflex and a saphenous vein graft in 1. All stenoses could be dilated
      successfully (residual stenosis < 25%). The transstenotic pressure gradient felt
      from 49 +/- 13 mmHg to 7 +/- 4 mm Hg after angioplasty. Except for an
      uncomplicated dissection in 3 patients, no other complication was noted. With
      this new catheter, the double-lumen configuration adds the advantages of an "over
      the-wire" to an "on-a-wire" system.

PMID- 8348607
TI  - The use of a new wire in a 6-year-old coronary artery occlusion: the Jagwire
      recanalization guidewire.
AB  - Chronic total occlusions are difficult to treat, usually because they cannot be
      crossed with a guidewire or dilating catheter. A variety of angioplasty systems
      designed to facilitate coronary angioplasty of chronic total occlusions have been
      used. We report the case of a 6-year-old occlusion of the right coronary artery
      that was treated with the Jagwire, a new guidewire designed for use in
      challenging lesions. This device successfully crossed the lesion and resulted in
      a successful angioplasty. The patient's angina dramatically improved following
      the procedure.

PMID- 8348608
TI  - Caveat emptor: a clinician's guide to assessing the physiologic significance of
      arterial stenoses.

PMID- 8348609
TI  - Pulmonary valvuloplasty in adults using the Inoue balloon catheter.
AB  - This report describes a new balloon pulmonary valvuloplasty technique using the
      Inoue balloon catheter performed in 14 consecutive adult patients, aged 17-47
      years (mean 27). The mean right ventricular systolic pressure and the pulmonary
      valvular peak-to-peak systolic gradient decreased from 102 +/- 41 to 52 +/- 19 mm
      Hg (p = 0.001) and 81 +/- 40 to 7 +/- 7 mm Hg (p = 0.0002), respectively. An
      infundibular peak-to-peak systolic gradient either developed (n = 13) or
      increased (n = 1). None of the patients were treated with beta-adrenergic
      blockers before or after the valvuloplasty. Eight patients underwent repeat
      hemodynamic study 12-30 months (mean 17) after treatment, and had no evidence of
      valvular restenosis. The mean right ventricular systolic pressure and the mean
      infundibular peak-to-peak systolic gradient decreased, compared to the values
      immediately after valvuloplasty (54 to 40 mm Hg, p = 0.03, and 28 to 10 mm Hg, p
      = 0.03, respectively). The study suggests that pulmonary valvuloplasty in adults
      using the Inoue balloon catheter technique is feasible, safe, and effective.

PMID- 8348610
TI  - Processed Vg1 protein is an axial mesoderm inducer in Xenopus.
AB  - Vg1 is a TGF beta-related growth factor encoded by a maternal mRNA localized to
      vegetal blastomeres in Xenopus embryos. Vg1 precursor protein is abundant in
      vegetal cells, but the processed mature form has not been readily detected and no
      activity has been demonstrated for the putative Vg1 mature protein. We have
      engineered a BMP2-Vg1 fusion (BVg1) that promotes formation of mature Vg1 protein
      in vivo. Injection of BVg1 mRNA induces dorsal mesoderm in animal cap cells, and
      BVg1 expression in ultraviolet-ventralized embryos fully restores a normal dorsal
      axis. Blastomeres expressing BVg1 act as a Nieuwkoop center, the region that
      induces the Spemann organizer. our results lead us to suggest that localized
      posttranslational processing of Vg1 precursor protein on the future dorsal side
      of the embryo is a key step in generating dorsal mesoderm and the body axis in
      Xenopus.

PMID- 8348611
TI  - The maternal gene skn-1 encodes a protein that is distributed unequally in early
      C. elegans embryos.
AB  - The autonomous or cell-intrinsic developmental properties of early embryonic
      blastomeres in nematodes are thought to result from the action of maternally
      provided determinants. After the first cleavage of the C. elegans embryo, only
      the posterior blastomere, P1, has a cell-intrinsic ability to produce pharyngeal
      cells. The product of the maternal gene skn-1 is required for P1 to produce
      pharyngeal cells. We show here that the Skn-1 protein is nuclear localized and
      that P1 appears to accumulate markedly higher levels of Skn-1 protein than its
      sister, the AB blastomere. We have examined the distribution of Skn-1 protein in
      embryos from mothers with maternal-effect mutations in the genes mex-1, par-1,
      and pie-1. These results suggest that mex-1(+) and par-1(+) activities are
      required for the unequal distribution of the Skn-1 protein and that pie-1(+)
      activity may function to regulate the activity of Skn-1 protein in the
      descendants of the posterior blastomere P1.

PMID- 8348612
TI  - Macrophages are required for cell death and tissue remodeling in the developing
      mouse eye.
AB  - To identify and characterize tissue remodeling processes mediated by macrophages,
      we have generated transgenic mice in which diphtheria toxin is expressed from a
      macrophage-specific transgene. Expression of the transgene disrupts subsets of
      mature macrophages in both the eye and the peritoneal cavity and results in the
      persistence of two normally transient ocular tissues, the hyaloid vasculature and
      the pupillary membrane. Furthermore, the cells comprising the pupillary membrane
      appear alive up to 14 days after the structure is normally remodeled, suggesting
      that the macrophage actively elicits target cell death. Thus, these transgenic
      mice provide direct evidence for the active involvement of macrophages in
      developmentally programmed tissue remodeling and identify the hyaloid vessels and
      the pupillary membrane in the eye as targets of macrophage-mediated remodeling.

PMID- 8348613
TI  - Human wee1 maintains mitotic timing by protecting the nucleus from
      cytoplasmically activated Cdc2 kinase.
AB  - The wee1 tyrosine kinase and cdc25 tyrosine phosphatase of fission yeast play
      antagonistic roles in the induction of mitosis through cdc2 regulation. We show
      here that the human wee1-like tyrosine kinase is a nuclear protein that ensures
      the completion of DNA replication prior to mitosis in cells expressing otherwise
      catastrophic levels of cdc2 activators. Paradoxically, wee1-rescued cells display
      very high levels of mitotic cdc2 kinase activity. We account for this anomaly by
      our observation that the cdc2 activator, cdc25C, is a cytoplasmic protein that,
      like cyclin B1, enters the nucleus at the G2/M transition. Thus, cdc2 is likely
      to be activated in the cytoplasm and requires nuclear localization to initiate
      both cytoplasmic and nuclear mitotic transformations. The human wee1 kinase
      appears to coordinate the transition between DNA replication and mitosis by
      protecting the nucleus from this cytoplasmically activated cdc2 kinase.

PMID- 8348614
TI  - tRNA as a positive regulator of transcription antitermination in B. subtilis.
AB  - Most Bacillus tRNA synthetase genes are regulated by a common transcription
      antitermination mechanism but respond individually to limitation for the cognate
      amino acid. The mRNA leader regions of these genes exhibit extensive structural
      conservation, with a single codon specific for the appropriate amino acid at the
      identical position in each structure. Alteration of this sequence in the tyrS
      gene from UAC (tyrosine) to UUC (phenylalanine) resulted in loss of induction by
      tyrosine limitation and a switch to induction by phenylalanine limitation.
      Insertion of an extra base immediately upstream of the codon did not alter
      regulation, indicating a nontranslational mechanism. A nonsense codon resulted in
      an uninducible phenotype that was suppressible in a lysyl-tRNA nonsense
      suppressor mutant, indicating that tRNA acts as an effector.

PMID- 8348615
TI  - The mitochondrial receptor complex: a central role of MOM22 in mediating
      preprotein transfer from receptors to the general insertion pore.
AB  - The receptor complex in the mitochondrial outer membrane, which consists of at
      least seven different proteins, is responsible for the recognition and
      translocation of cytosolically synthesized preproteins. Two of its subunits,
      MOM19 and MOM72, function as surface receptors for preproteins. Four other
      subunits (MOM38, MOM30, MOM8, and MOM7) have been suggested to constitute the
      general insertion pore (GIP). Here we report on the structure and function of
      MOM22. MOM22 is anchored in the outer membrane by a single transmembrane segment.
      The highly negatively charged N-terminal domain is exposed to the cytosol and the
      C-terminal domain to the intermembrane space. MOM22 appears to be a central
      component of the receptor complex, required for the transfer of preproteins from
      the receptors to the GIP. We speculate that the negatively charged domain of
      MOM22 is involved in the transfer of positively charged signal sequences of
      preproteins.

PMID- 8348616
TI  - Nuclear export of proteins: the role of nuclear retention.
AB  - Proteins that shuttle between nucleus and cytoplasm are implicated in transport
      and signal transduction processes. Using assays based on interspecies
      heterokaryons and microinjection of Xenopus oocytes, we examined what structural
      features determine nuclear export of shuttling proteins. Three classes of
      proteins were studied: first, wild-type and mutant forms of nucleolin, one of the
      first shuttling proteins identified; second, artificial nuclear reporter proteins
      derived from cytoplasmic pyruvate kinase; and third, wild-type and mutant lamins
      differing in their abilities to be incorporated into the lamina. Our results show
      that a protein does not require positively acting export signals to be
      transported from nucleus to cytoplasm; instead, its shuttling ability is limited
      primarily by intranuclear interactions. We conclude that nucleocytoplasmic
      shuttling is a general phenomenon not restricted to proteins involved in
      nucleocytoplasmic transport.

PMID- 8348617
TI  - A 5' element of the chicken beta-globin domain serves as an insulator in human
      erythroid cells and protects against position effect in Drosophila.
AB  - We have characterized an element near the 5' boundary of the chicken beta-globin
      domain that insulates a reporter gene from the activating effects of a nearby
      beta-globin locus control region (5'HS2) when assayed in the human erythroid cell
      line K562. We show that the insulation mechanism is directional, that it operates
      at the level of transcription, and that it involves the alteration of chromatin
      structure over the promoter of the gene. The insulator has no significant
      stimulatory or inhibitory effects of its own. In transgenic Drosophila, the
      insulator protects the white minigene from position effects. The action of the
      insulator thus is not restricted to erythroid or mammalian cells, suggesting that
      such elements may serve an important and widely distributed function in the
      organization of chromatin structure.

PMID- 8348618
TI  - Odorant-selective genes and neurons mediate olfaction in C. elegans.
AB  - Olfaction is a versatile and sensitive mechanism for detecting volatile odorants.
      We show that the nematode C. elegans detects many volatile chemicals, which can
      be attractants, repellents, or attractants at low concentrations and repellents
      at high concentrations. Through laser ablation, we have identified chemosensory
      neurons that detect volatile odorants. Chemotaxis to volatile odorants requires
      different sensory neurons from chemotaxis to water-soluble attractants,
      indicating that C. elegans might have senses that correspond to smell and taste,
      respectively. Single neurons have complex sensory properties, since six
      distinguishable volatile odorants are sensed by only two types of sensory
      neurons. Chemotaxis to subsets of volatile odorants is disrupted by mutations in
      the odr genes, which might be involved in odorant sensation or signal
      transduction.

PMID- 8348619
TI  - Epidermal growth factor-induced actin remodeling is regulated by 5-lipoxygenase
      and cyclooxygenase products.
AB  - In a number of cell types, epidermal growth factor (EGF) evokes dramatic
      morphological changes, cortical actin polymerization, and stress fiber breakdown.
      The molecular processes by which increased EGF receptor tyrosine kinase activity
      results in actin reorganization and morphological changes are unresolved.
      Recently, we demonstrated that arachidonic acid metabolites function in EGF
      signal transduction. We now report that in A431 cells, HeLa cells, and rat-1
      fibroblasts, the EGF-induced cortical actin polymerization is produced by
      lipoxygenase metabolism, whereas in these cells stress fiber breakdown is
      mediated by cyclooxygenase metabolites. Also, the EGF-provoked rounding up in
      A431 cells is dependent on arachidonic acid metabolism. We conclude that
      leukotrienes and prostaglandins act in concert, as second messengers, to produce
      morphological effects and actin reorganization, providing a novel mechanism for
      directing growth factor-induced cytoskeletal changes.

PMID- 8348621
TI  - [Comparison of 2 methods of detecting slime production by coagulase-negative
      staphylococci].
AB  - In the series of 212 coagulase-negative staphylococci strains isolated from blood
      cultures, in which the slime production was tested by means of two methods--a
      method using agar with Congo red and a Christensen method--S. epidermidis, S.
      haemolyticus and S. hominis were identified most frequently (in 69.3%, 18.4% and
      6.6%, respectively). The slime production was detected by both methods in 28
      strains (13%) of four species, most often in S. epidermidis (in 17%). By
      comparing the Congo red agar method with the Christensen method the sensitivity
      and specificity of the former was determined (85% and 99%, respectively). Thus
      the Congo red agar method for the detection of slime production by staphylococci
      seems to be a reliable tool.

PMID- 8348620
TI  - TAP1-dependent peptide translocation in vitro is ATP dependent and peptide
      selective.
AB  - T cells detect infection of cells by recognizing peptide fragments of foreign
      proteins bound to class I molecules of the major histocompatibility complex (MHC)
      on the surface of the infected cell. MHC class I molecules bind peptide in the
      endoplasmic reticulum, and analysis of mutant cells has demonstrated that an
      adequate supply of peptides requires the presence of two genes in the MHC class
      II locus that encode proteins called transporters associated with antigen
      processing (TAP) 1 and 2. TAP1 and TAP2 are members of the ATP-binding cassette
      family of membrane translocators. In this study, we demonstrate in a cell-free
      system that TAP1 is part of an ATP-dependent, sequence-specific, peptide
      translocator.

PMID- 8348622
TI  - [Identification of reference strains of intestinal bacteria using the TNW, IDENTI
      and NIS 86 numeric identification systems].
AB  - A total of 176 reference strains including 63 species of Enterobacteriaceae
      mainly of clinical origin were tested by commercial diagnostic kits ENTEROtest 1
      & 2. The identification efficacy in both systems TNW and IDENTI was nearly in
      agreement 144 (81.8%), 142 (80.7%) respectively correctly identified strains. The
      NIS 86 system identified only 54 (30.7%) strains correctly.

PMID- 8348623
TI  - [Identification of mycobacteria species using genetic probes].
AB  - Using commercially available probes Gen-Probe (Accu-Probe, Epignost, Austria)
      labelled with acridinium ester, the authors identified 102 cultures of
      mycobacteria which are the causal agents of classical tuberculosis or cause
      mycobacterioses which are difficult to control by therapeutic measures. The
      cultures were isolated from sputum or lymph nodes and cultivated on Lowenstein
      Jensen medium. The authors proved a 100% sensitivity of the probe for isolates of
      M. tuberculosis and M. kansasii. In a group of 36 strains sent as suspect M.
      avium 33 strains reacted with the probe for the M. avium complex, 28 strains with
      the M. avium probe and 4 strains with the M. intracellulare. One isolate
      hybridized only with the probe for the M. avium complex. In one isolate a
      positive hybridization value was recorded with the M. gordonae probe and in one
      pigmented strain with the M. kansasii probe. One isolate did not hybridize with
      any of the probes used. In one instance a mixed culture of M. tuberculosis and M.
      avium was involved. The results of hybridization were interpreted in RLU values
      (relative light unit). Isolates above 30,000 RLU were evaluated positively, as
      recommended by the manufacturer.

PMID- 8348624
TI  - [Determination of IgG toxoplasma antibodies using ELISA with uniform serum
      dilutions].
AB  - The ELISA reaction with uniform serum dilution (1:400) for assessment of
      toxoplasmatic antibodies class IgG agreed in 100% when compared with commercial
      kits (VIRELISA and GULL Lab.). Both these tests disagreed with the standard
      complement fixation reaction in 7.5% of the specimens. This qualitative
      disagreement was confirmed also in a group of 400 sera where 7.14% of CFR
      negative specimens reacted positively in the described ELISA reaction.
      Quantitative correlation of results of CFR and ELISA IgG displays the usual
      scatter of values. Therefore individual CFR titres cannot be matched
      unequivocally with titres of optic density and thus it is not possible to assess
      empirically the stage of infection. To assess the stage of infection it is
      therefore necessary to make a supplementary assessment of IgM antibodies. In
      cases detected in time the decision can be based on a rise of IgG values in
      paired serum specimens examined in one reaction. Dynamics of formation of IgG
      antibodies and their chronological sequence with IgM antibodies displayed a
      typical course in patients with clinical toxoplasmosis. The described reaction is
      the basis of commercially manufactured kits ELISA IgG Toxo Micro II.

PMID- 8348625
TI  - [Transstadial transmission of Francisella tularensis in the tick, Ixodes ricinus,
      infected during the larval stage].
AB  - Based on previous studies which proved the decisive importance of the degree of
      bacteraemia of experimentally infected white mice for the degree of infection of
      ticks Ixodes ricinus the authors confirmed the possibility of transstadial
      transmission of Francisella tularensis from larvae via nymphs to imagos by the
      detection of germs in the ticks and by experiments attempting their transmission
      to white mice. This applied to imagos even one year after the infection of
      larvae. Transmission was recorded even in imagos which did not transmit the
      infection in the nymphal stage. F. tularensis was repeatedly detected in the
      faeces of nymphs and imagos, which along with possible consumption of infected
      ticks by hosts, indicates further possibilities of transmission of the infection
      in nature. The results of quantitative examinations of the degree of infection of
      ticks enable us to conclude that the germs reproduce in the ticks after feeding
      on the host.

PMID- 8348626
TI  - [Differentiation of serologic group A streptococci from group C and G using disks
      with various bacitracin levels].
AB  - It was revealed that a diameter of the inhibition zone of 10 mm or more
      surrounding a disk with 0.04 U bacitracin differentiates reliably strains of the
      serological group A form strains of group C and G with the exception of 7.3%
      strains of group C and G with a high susceptibility for bacitracin. The disks
      with a higher bacitracin content gives less reliable results.

PMID- 8348627
TI  - [Salmonella osteomyelitis in a 9-month-old infant].
AB  - The authors describe a case of salmonella pyarthritis with subsequent
      osteomyelitis caused by Salmonella enteritidis in a 9-month-old infant. The
      strain was isolated from punctate drawn from the knee joint.

PMID- 8348629
TI  - [A case of coccidioidomycosis in Plzen].
AB  - A case of the pulmonary form of coccidioidomycosis of a Czech patient infected in
      Arizona is described. The disease was diagnosed on the basis of serological
      tests. In addition to a review of the mycological, epidemiological and clinical
      picture of coccidioidomycosis criteria of laboratory mycological diagnostics are
      given. It is important to be aware of this mycosis in patients who have a history
      of recent visits to endemic areas in North, Central and South America.

PMID- 8348628
TI  - [Changes in the nomenclature of mycoses].
AB  - The author gives an account of a report of the Nomenclature Committee of the
      International Society for Human and Animal Mycology making the present
      terminology of mycoses more precise and unified. Changes recommended by the
      Committee are designed to eliminate the instability of currently used terms
      influenced by new names of mycological taxonomy as well as by clinical aspects
      and the pathology of mycoses. The essential feature of the changes is a
      recommendation for fungal disease names not based on the word derived from the
      taxon of the causative fungal genus but providing, in a narrow or broader way,
      information on the clinical and pathological entity caused by the fungus. The
      individual recommendations are supplemented by explanatory examples and a list of
      accepted and rejected fungal disease names is tabulated.

PMID- 8348630
TI  - [Lyme borreliosis: review of present knowledge].
AB  - The author reviews hitherto assembled knowledge on a bacterial disease, Lyme
      borreliosis transmitted by ticks. Initial information on Lyme borreliosis
      appeared at the beginning of the 20th century. In Czechoslovakia attention to the
      disease was paid since cca 1960. The infection occurs as a rule in the summer
      months during the period when ticks are parasitic and at that time the causal
      agent of the disease is transmitted to hosts. Information on the prevalence and
      incidence of Lyme borreliosis in Europe is not complete and so far we do not
      possess a standardized diagnostic method for assessment of circulating antibodies
      in the patients' serum and cerebrospinal fluid. The infectious disease is caused
      by the gram-negative spirochete Borrelia burgdorferi. The Borrelia cell has a
      similar morphological structure as cells of other gram-negative bacteria.
      Chemical analysis of the external membrane of B. burgdorferi revealed the
      presence of 46% proteins, 51% lipids and 3% carbohydrates. The typical shape of
      borrelias indicates marked ondulation of 8-14 periplasmatic flagellae along the
      cell body. Borrelias can be cultivated in vitro in modified Barbour-Stoenner
      Kelly medium at an optimal temperature of 30-37 degrees C. The change of
      morphology during cultivation is typical for B. burgdorferi. Clinically Lyme
      borreliosis is manifested in two stages. A typical manifestation of the early
      stage is a skin lesion--erythema migrans. The later stage is characterized above
      all by relapsing arthritis, CNS infection and chronic acrodermatitis chronica
      atrophicans. The disease is treated by administration of a number of antibiotics
      either by the oral route or by injection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348631
TI  - [Treatment of cellular immunodeficiency in diseases requiring surgery].

PMID- 8348632
TI  - [Serum sperm antibodies in women hospitalized for threatened abortion].
AB  - The authors examined the antispermatozoal activity of 123 sera of patients
      hospitalized at the Gynaecological and Obstetric Department in Plzen during the
      8th-9th week with diagnosis of imminent abortion. They revealed markedly higher
      antibodies against spermatozoa in particular in IgG, but also in IgA and IgM in
      17 (13%) patients, who eventually had spontaneous abortions. The authors
      investigated also the obstetric history in connection with the presence of
      antibodies against spermatozoa. The antibody levels were higher in primary
      pregnant women.

PMID- 8348633
TI  - [Selective reduction of multiple pregnancy in the 1st trimester: results and
      experience in 10 cases].
AB  - Ten patients with multiple gestations, all resulting from in vitro fertilization,
      underwent multifoetal pregnancy reduction. In four cases transvaginal puncture
      was performed, six patients underwent transabdominal pregnancy reduction. Seven
      women delivered, all three pregnancy losses occurred in the transvaginal punction
      group--there was one early loss after the procedure and two abortions in the late
      second trimester. There were 5 sets of twins and two singletons were delivered.
      Multifoetal pregnancy reduction represents an important addition to the
      management of unplanned multifoetal pregnancy resulting from infertility
      treatment. The procedure is not without risks and these must be weighted against
      expected benefits.

PMID- 8348634
TI  - [Pharmacologic prevention of postoperative cystitis].
AB  - For prevention of postoperative cystitis the authors tested currently used drugs
      which influence the adherence of bacteria to the urothelium, nitrofurantoin
      (FurantoinR), 3 x 1 tabl. per day and trimetroprim with clotrimoxazole
      (BiseptolR), one tablet in the evening before operation. They found that
      Furantoin reduced the frequency of the inflammation in patients subjected to
      abdominal operations from 12.3% in the control group to 2.3% and in those
      subjected to vaginal operations from 46.1% to 9.6%. The disadvantage of the drug
      is that it must be taken every day and that it is poorly tolerated by the
      patients. Biseptol is excreted more slowly and therefore 1 tablet before
      operation blocks the development for a maximum of 48 hours. In patients with
      abdominal operations the frequency of inflammation was similarly as in controls,
      12%, in patients with vaginal operations the number of inflammations declined to
      24.5%. Biseptol, 1 tablet before operation, is suitable only in patients where it
      is not assumed that the catheter will be inserted for a prolonged period.

PMID- 8348635
TI  - [Association of appendicitis with extra-uterine pregnancy].

PMID- 8348636
TI  - [Simultaneous appendectomy and gynecologic surgery].

PMID- 8348637
TI  - [The Lyon method of vaginal hysterectomy].

PMID- 8348638
TI  - [Retroperitoneal liposarcoma after gynecologic surgery].

PMID- 8348639
TI  - [Development and present status of diagnosis of incompetence of the uterine
      cervix].

PMID- 8348640
TI  - [The role of inborn chromosomal aberrations in the etiology of infertility].

PMID- 8348641
TI  - [Melatonin and oral contraception].

PMID- 8348642
TI  - [History of women's health care in Czechoslovakia. VII].

PMID- 8348643
TI  - [Czech senology--origins, traditions, development].

PMID- 8348644
TI  - [Maternal hyperphenylalaninemia].

PMID- 8348645
TI  - [Is restriction of physical activity indicated in the prevention of retinal
      detachment?].
AB  - The author evaluates the importance of different vitreoretinal factors and the
      role of indirect injury in the pathogenesis of detachment of the retina/DR/and
      holds the following view as regards subjects inclined to pursue physical
      activity. Numerous and frequent vitreoretinal risk factors are a forecast of DR
      only in a small fraction of patients. Indirect injury is not recognized as a
      cause of DR. Risk factors incl. medium-grade and high-grade myopia are not an
      indication for restriction of physical activity nor for Caesarean section in
      pregnant women. Restriction of physical activity acts as a psychic trauma and
      does not prevent the development of DR.

PMID- 8348646
TI  - [Immunologic mechanisms and the effect of immunosuppressive therapy in
      ophthalmology].
AB  - The authors mention some immunopathological mechanisms which participate in the
      beginning and maintenance of activity in so-called idiopathic endogenous uveitis.
      They draw attention to the possibility to influence these mechanisms by
      immunosuppressive treatment, mention its advantages and the feasibility of risk
      of undesirable side-effects. The authors assume that it is useful to use
      corticoids and cytotoxic substances as well as the more aimed action on immunity
      exerted by Cyclosporine A.

PMID- 8348647
TI  - [Personal experience with immunosuppressive therapy of endogenous uveitis].
AB  - The authors investigated 43 patients with the original diagnosis of endogenous
      idiopathic uveitis for a period of one year. Comprehensive ophthalmological,
      immunological and rheumatological examination revealed that in all investigated
      cases either systemic disease was involved or diseases associated with impaired
      immunity or endogenous idiopathic uveitis. The patients were treated by
      immunosuppressive therapy either by Prednisone alone or by a combination of
      Prednisone and Cyclophosphamide. In all instances remission was achieved,
      contrary to previous therapy employed in these patients. In the majority of
      patients/21 of 23 and 12 of 18 resp./remission persisted for at least one year.
      The authors discuss indications and pitfalls of immunosuppressive therapy based
      on recommendations found in the literature.

PMID- 8348648
TI  - [Retinal vein occlusion. I. Pathogenesis of circulatory changes].
AB  - In the pathogenesis of macular edema in venous occlusion of the retina, the
      majority of authors considers the high intracapillary pressure to be the decisive
      factor. The author's explanation is somewhat different and is based on two
      assumptions. The existence of the vascular autoregulatory mechanisms of the
      retina and the so-called disproportion between the arterial and the venous
      volume. When the critical level of the disproportion of the arterial and the
      venous volume is surpassed, the retinal autoregulation begins to fail which
      manifests itself by a marked retinal edema and an essential decrease in visual
      acuity.

PMID- 8348649
TI  - [Retinal vein occlusion. II. Collateral systems].
AB  - During the period of 6-12 months, in the majority of patients with occlusion of
      the branch of the retinal vein, the macular edema regresses and the intraretinal
      hemorrhages are resorbed. According to the author, this restoration of the
      circulatory conditions in the retina takes place especially due to the
      development of the veno-venous collaterals. The author presents an explanation of
      the mechanism of the regulation of the circulatory conditions in the retina
      during the development of the collaterals on the basis of the new approach to the
      explanation of the pathogenesis of the circulatory changes in occlusion of the
      branch of the retinal vein.

PMID- 8348650
TI  - [Retinal vein occlusion. III. Arteriolar constriction].
AB  - The author assumes that the process of the adjustment of the disproportion
      between the arterial and the venous volume can be favourably influenced by a
      decrease in the offered arterial volume to the venous occluded blood path. This
      can be achieved by a narrowing of the input arteriole with the help of the method
      of arteriolar constriction using the argon laser. The author is of the opinion
      that the method of arteriolar constriction finds its application especially in
      the treatment of severe prognostically unfavourable forms of occlusion of the
      branch of the retinal vein with presence of extensive hemorrhages in the retina.
      In such severe forms of occlusion, the author recommends to apply the arteriolar
      constriction already in the early acute phase of the disease.

PMID- 8348651
TI  - [Arteriolar constriction in the treatment of branch retinal vein occlusion.
      Initial experience].
AB  - The authors describe their first experiences in the treatment of 12 eyes with
      prognostically unfavourable occlusion of the retinal branch of the vein by
      application of the laser technique of arteriolar constriction. They introduced
      photocoagulation 1 to 4 weeks after the onset of the occlusion. The resulting
      visual acuity 6/12 and better was achieved in 83%, the worst resulting acuity
      6/18 in 17% two years after onset of the occlusion. In all the eyes, the achieved
      improvement was approximately by 4 lines of Snellens optotypes.

PMID- 8348652
TI  - [Local anesthesia in cataract surgery].

PMID- 8348653
TI  - [Treatment of microbial eye infections with antibiotics].

PMID- 8348654
TI  - [Use of lasers in ophthalmology. I. Laser diagnosis and non-photodisruptive
      therapy].

PMID- 8348656
TI  - [Vision and the military service].

PMID- 8348655
TI  - [Use of lasers in ophthalmology. II. Photodisruptive therapy].

PMID- 8348657
TI  - [Physical development in patients with acute lymphoblastic leukemia in
      childhood].
AB  - Acute lymphoblastic leukaemia (ALL) is one of the readily treatable neoplastic
      diseases of childhood. One of the late sequelae of treatment can be impaired
      growth. The authors followed up therefore a group of 63 patients where during
      childhood a diagnosis of ALL was made. The investigated group was treated
      according to two fundamental protocols--according to Pinkel's protocol and
      according to BMF protocols. All patients treated according to Pinkel's protocol
      had, as part of prevention of leukaemia of the CNS, radiotherapy of the skull,
      patients treated according to the BMF protocol only when the risk factor was
      higher than 0.8. The authors investigated in their patients the height and
      proportionality after termination of all antileukaemic therapy. They found that
      the height of children, adolescents and adults who suffered from ALL during
      childhood is average or less. A tendency towards obesity is typical. The authors
      did not observe a correlation with the total cumulative doses of cytostatics nor
      a marked correlation with radiotherapy. Impaired growth was more frequent when
      ALL was diagnosed before the age of 3 years and where the interval after
      completed therapy was shorter.

PMID- 8348658
TI  - [Bacterial meningitis in neonates. Retrospective study 1977-1991].
AB  - In 1977-1991 at the Paediatric Clinic in Hradec Kralove 43 neonates with
      bacterial meningitis (BM) were hospitalized. In 31 (72%) risk factors for the
      development of perinatal infection were detected. The aetiological agent was
      proved in 40 neonates, most frequently E. coli (46.5%), Streptococcus agalactiae
      (16.2%), Proteus (11.6%). In the second half of the investigation period (1984
      1991) there was a significantly higher ratio of G+ microorganisms, in particular
      Streptococcus agalactiae. In three neonates the diagnosis of BM was based on a
      positive cytological finding in cerebrospinal fluid. The total lethality was
      60.4%. The lethality was not significantly influenced by early diagnosis and
      treatment (within 48 hours), correct selection of antibiotic before knowing the
      cultivation finding and sensitivity. The total incidence of BM during the
      investigation period in the Faculty Hospital in Hradec Kralove was 0.51/1000, in
      mature neonates 0.36/1000 and 1.8/1000 in neonates with a low birth weight.

PMID- 8348659
TI  - [The importance of clinical symptoms in the diagnosis of bacterial meningitis in
      neonates].
AB  - In a group of 32 neonates with bacterial meningitis (BM) the authors investigated
      the frequency of clinical symptoms and compared it with the frequency in a
      control group of 27 neonates where BM was ruled out. The following were
      significantly more frequent in neonates with BM: elevated temperature (p < 0.01)
      and seizures (p < 0.05). In the control group impaired muscular tonus was
      significantly more frequent (p < 0.05). Temperature had the highest diagnostic
      sensitivity (93.7%), followed by seizures (62.5%); exanthema had the highest
      specificity (92.6%), followed by bulging (92%). Neither sensitivity nor
      specificity of any of the investigated clinical symptoms reached the required
      level of 96%.

PMID- 8348660
TI  - [Chronic recurrent parotitis in children--diagnosis and therapy].
AB  - The author presents a report on a group of 11 children with chronic recurrent
      parotitis, treated at the ENT department in Cadca. The author emphasizes the
      importance of sialography for establishment of the diagnosis of this disease and
      draws attention to therapeutic possibilities.

PMID- 8348661
TI  - [The present health and nutritional status of the pediatric population in the
      area of Orava].
AB  - 410 children aged 11-14 years and 311 adolescents aged 15-18 years were examined
      in the region Orava. This region was selected for the survey because of high
      unemployment rates. The survey was focused on changes in nutritional indices in
      children and adolescents, as a consequence of changed food consumption patterns,
      caused by increased food prices and global socio-economic regression. Biochemical
      markers showed negative trends in serum lipid levels, especially a high
      prevalence of hypercholesterolaemia as well as that of vitamin C hyposaturation.
      This finding is related to impaired structure of consumed food, intake of food
      items of lower nutritional value, low intakes of fruit and vegetables, as shown
      by the analysis of dietary data.

PMID- 8348662
TI  - [Severe Amanita phalloides poisoning in a 7-year-old girl].
AB  - Authors describe a case of a very severe poisoning, the prothrombin-time was less
      than 10% of the normal value and the child developed hepatic coma. We suppose,
      the favourable outcome may have been influenced by the treatment with Silymarin
      in combination with high doses of G-Penicillin.

PMID- 8348663
TI  - [Disorders of thermoregulation in children and their therapy].

PMID- 8348664
TI  - [Pulmonary surfactant factor--composition and metabolism. 1].

PMID- 8348666
TI  - [Changes in perinatal mortality in twins].
AB  - Perinatal mortality of twins born in South Moravian Region in the years 1983-1987
      was compared with that observed in the years 1970-1976. The perinatal mortality
      of twins decreased from 119,35 per thousand to 64,21 per thousand (the
      corresponding numbers for the whole population of the region in question are
      16.48 per thousand and 11.30 per thousand respectively). The mortality of twins
      shows no reasonable changes. The early neonatal mortality decreased from 98.32
      per thousand to 41.23 per thousand (the corresponding numbers in the whole
      population are 10.25 per thousand and 6.05 per thousand respectively). As in
      other countries the most important cause is the decrease of prematurity. This was
      observed both in the evaluation according to the birth weight and according to
      the gestational age as well as when the main cause of death was evaluated.
      Nevertheless also in the second sample a higher mortality of twins B than that of
      twins A was observed. The results of the leading clinics in the perinatal care
      show no more higher mortality of twins B namely due to the decrease of the number
      of RDS deaths. To achieve such object will be the nearest task in our perinatal
      care for the twins pregnancies and neonates.

PMID- 8348665
TI  - [Regulation of the synthesis and secretion of pulmonary surfactant. 2].

PMID- 8348667
TI  - [The intensive care unit in the pediatric department of a district hospital.
      Problems and experience].

PMID- 8348668
TI  - [Air pollution and the occurrence of recurrent respiratory tract diseases in
      children in the first years of life. II].
AB  - In 200 3-7-year-old children in two localities of Bratislava-city with different
      concentrations of NO2, SO2, dustiness with different bioclimatic factors and a
      different epidemiological position the authors investigated their effect on the
      frequency, incidence and types of relapsing respiratory diseases during different
      months in 1991. The different concentrations of the above substances in the
      atmosphere of the two localities did not affect the number of respiratory
      diseases nor their annual or monthly incidence. In the place with the increased
      NO2 concentration a significantly higher number of serious forms of respiratory
      diseases was found in the investigated group. In the locality with a more
      favourable oecological and epidemiological situation the adverse effect of
      monthly NO2 concentrations was manifested when it was potentiated by the SO2
      concentration and combined with dustiness and dust fall-out. The authors found a
      significant correlation between the incidence of relapsing respiratory diseases
      and the atmospheric temperature and its relative humidity in the course of
      different months of the year.

PMID- 8348669
TI  - [The sick building syndrome].

PMID- 8348670
TI  - [Problems of immunization in Europe].

PMID- 8348671
TI  - [The computer in the pediatric department].

PMID- 8348672
TI  - Quasi-elastic light scattering determination of the size distribution of extruded
      vesicles.
AB  - The size distribution of phospholipid vesicles prepared by the freeze thaw
      extrusion method were determined by the non-perturbing technique of quasi-elastic
      light scattering (QELS) and compared to latex particles of known size. Multiangle
      QELS experiments were performed to avoid errors due to the angular dependence of
      the scattering function of the particles. The experimentally determined
      autocorrelation function was analyzed by multiple mathematical procedures, i.e.
      single exponential, CUMULANT, exponential sampling, non-negatively constrained
      least square and CONTIN, in order to select suitable models for vesicle
      characterization. The most consistent results were obtained with CUMULANT, non
      negatively constrained least square and CONTIN. In many instances single
      exponential analysis gave comparable results to these procedures, which indicates
      the vesicles have a narrow distribution of sizes. The influence of filter pore
      size, extrusion pressure and lipid concentration on the size and size
      distribution of extruded vesicles was determined. Extrusion through 100-, 200-
      and 400-nm pore size filters produced a unimodal distribution of vesicles, with
      somewhat smaller diameters as the extrusion pressure increased. The larger the
      filter pore size, the more dependent the vesicle size was on applied pressure.
      The observed vesicle size was independent of the lipid concentration between 0.1
      and 10 mg ml-1.

PMID- 8348673
TI  - Effect of unilamellar vesicle size on ethanol-induced interdigitation in
      dipalmitoylphosphatidylcholine.
AB  - Unilamellar liposomes are widely used as model membranes to represent and study
      the properties of biological membranes and as potential drug delivery systems. It
      is well established that ethanol and other amphiphiles induce the interdigitated
      L beta I phase in multilamellar vesicles of dipalmitoylphosphatidylcholine
      (DPPC). However, all of the work on this phase has been performed using the hand
      shaken multilamellar preparations. In the present report, we have studied the
      induction of interdigitation in a series of unilamellar vesicles prepared by
      sonication and by extrusion. The methods used to characterize the vesicles were
      freeze fracture electron microscopy and quasielastic light scattering (QELS). Two
      fluorescence methods were used to detect interdigitation, the DPH fluorescence
      quenching method (Nambi, P., Rowe, E.S. and McIntosh, T.J. (1988) Biochemistry
      27, 9175-9182) and the pyrene-PC fluorescence method (Komatsu, H. and Rowe, E.S.
      (1991) Biochemistry 30: 2463-2470). It was found that sonicated vesicles are not
      stable in the presence of interdigitating concentrations of ethanol; they form
      higher aggregates at all temperatures examined. The behavior of the extruded
      vesicles was different from that of the SUV; each size studied was stable in the
      presence of ethanol, although they exhibited an increase in size. It was shown
      that extruded vesicles having a 200-nm or greater diameter become interdigitated
      in the presence of ethanol. The threshold concentration for interdigitation in
      vesicles is greater than that for MLVs and it decreases with increasing vesicle
      size, approaching the MLV value for the largest vesicles.

PMID- 8348674
TI  - Dithionite penetration through phospholipid bilayers as a measure of defects in
      lipid molecular packing.
AB  - The permeability of dithionite through bilayers was utilized to probe the
      structural defects in the bilayers of these lipids through their respective gel
      fluid and bilayer-hexagonal phase transitions. The water soluble dithionite ion
      penetrates intact bilayers very slowly. The rate of irreversible quenching of the
      fluorescence of NBD-PE labelled liposomes may thus be used as an indicator of the
      permeability of this ion through bilayers. The quenching rate has a fast and a
      slow component, the fast one corresponds to the quenching of fluorophores
      immediately accessible to the quencher, i.e. those on the outer surface of
      liposomes. The slower component represents the average rate of penetration of the
      quencher through the bilayer, to quench those fluorophores at the inner shells of
      the multilamellar vesicles. Both rates may be approximated by a single
      exponential function. The slow exponent is simply related to the permeability.
      The permeability of DMPC as a function of temperature shows a peak at the gel
      fluid phase transition at 24 degrees C, but returns to about the pre-transition
      value at temperatures above the phase transition. The permeability of egg PE
      shows a hump at 45 degrees C before the hexagonal phase transition at 65 degrees
      C is reached and becomes infinite at the hexagonal phase transition as all
      fluorophores are immediately accessible to the quencher. We believe that the
      permeability measured by this method relates more to the molecular packing
      defects which maximizes at the gel-fluid phase transition temperatures just below
      the bilayer-hexagonal phase transition, rather than the general packing order
      which simply changes with structural phases.

PMID- 8348675
TI  - Phase separated anionic domains in ternary mixed lipid monolayers at the air
      water interface.
AB  - A series of ternary mixed monolayers containing varying amounts of 1,2
      dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) and equimolar additions of 1
      palmitoyl-2-hydroxy-sn-glycero-3-phosphocholine (LYSO-PC) and palmitic acid (PA)
      were studied at the air-water interface. These mixed monolayers were used to
      model phospholipid biomembrane interfaces resulting from phospholipase A2 (PLA2)
      hydrolysis. Recent work [D.W. Grainger A. Reichert, H. Ringsdorf and C. Salesse
      (1989) Biochim. Biophys. Acta. 1023, 365-379] has shown that PLA2 hydrolysis of
      pure phospholipid monolayers results in formation of large PLA2 domains at the
      air-water interface. These domains are proposed to result from PLA2 adsorption to
      phase separated regions in the hydrolyzed monolayer. To elucidate the phase
      behaviour in these monolayer systems, surface pressure-area isotherms were
      measured for the ternary mixtures on pure water and buffered subphases.
      Fluorescence microscopy at the air-water interface was used to image fluorescent
      probe-doped monolayer mixtures during isothermal compressions. A water-soluble
      cationic carbocyanine dye was used to probe the interfacial properties of the
      mixed monolayers. Isotherm data do not provide unambiguous evidence for either
      phase separation or ideal mixing of monolayer components. Fluorescence microscopy
      is more revealing, showing that lateral phase separation of microstructures
      containing palmitic acid occurred only when monolayer subphases contained Ca2+
      ions at alkaline pH. At either low pH or on Ca(2+)-free subphases, phase
      separation was not observed.

PMID- 8348676
TI  - Spectroscopical characteristics of galactosylceramide-pyrene and ceramide-pyrene
      incorporated in model and in clathrin coated vesicles.
AB  - In order to control the ability of two pyrene-sphingolipids (ceramide-pyrene
      (Cpyr) and galactosylceramide-pyrene (GCpyr)) to monitor the changes in the lipid
      bilayer dynamics of cellular membranes, their incorporation in three populations
      of clathrin coated vesicles which differ in their structural characteristics
      (Bomsel et al. (1988) Biochemistry 27, 6808-6812) was studied by both absorbance
      and fluorescence spectroscopy. The method of injection of an ethanolic solution
      of probe was used. The analysis of the spectra recorded after injection into a
      free-membrane buffer allowed to discriminate two dispersion states (micellar or
      aggregated) of the probes. The micellar state was identified as the one suitable
      for the incorporation within the bilayer. Rising the temperature up to 18 degrees
      C for a membrane labeling with GCpyr and to 37 degrees C for a membrane labeling
      with Cpyr was found to be necessary because it allowed to slow down the
      aggregation process which inhibited the incorporation within the lipid bilayer.
      The excimer/monomer (E/M) fluorescence intensities ratio of GCpyr was found to be
      characteristic of each population of coated vesicles. Cpyr could not be used as a
      diffusion probe because it partly aggregated during the cooling step necessary to
      establish the E/M versus temperature plot in the heating mode. An important point
      which arises from these data is that the use of absorbance spectroscopy can avoid
      misinterpretation of the pyrene derivatives fluorescence spectra in terms of
      diffusion.

PMID- 8348677
TI  - Improved synthesis of (5Z)-7-(3-endo-[(benzenesulfonamido)
      bicyclo[2.2.1]heptyl]hept-5-enoic acid (S-145) derivatives and their iodine-125
      labeled radioligands for the study of thromboxane A2 receptor.
AB  - An improved synthetic scheme for (5Z)-7-(3-endo-[(benzenesulfonamido)
      bicyclo[2.2.1]heptyl)-h ept-5-enoic acid (S145) and its analogs has been
      designed. The procedure involves direct sulfonylation of 2-allyl-3
      aminobicyclo[2.2.1]heptane intermediate followed by ozonolysis and addition of a
      C5 carboxyl unit. The yield of the final product was significantly improved. (5Z)
      7-(3-endo-[(4-iodobenzenesulfonamido)-bicyclo [2.2.1]heptyl)hept-5-enoic acid (HS
      145) and (5Z)-7-(3-endo-[(4-hydroxy-benzensulfonamido)-bicyclo [2.2.1]heptyl)hept
      5-enoic acid (HS-145) were synthesized directly without any protection and
      deprotection steps. [125I](5Z)-7-(3-endo-[(4- iodobenzensulfonamido)
      bicyclo[2.2.1]heptyl)hept-5-enoic acid ([125I]HS-145) was prepared from IS-145
      through an organotin intermediate and [125I]sodium iodide with high specific
      radioactivity and good recovery of radioactivity. [125I](5Z)-7-(3-endo-[(4
      hydroxy 3-iodo-benzenesulfonamido)-bicyclo[2.2.1]-heptyl)hept-5-enoic acid
      ([125I]HS-145) was prepared by direct iodination with sodium iodide using a
      modified chloramine-T method. Both [125I]HS-145 and [125I]HS-145 were found to be
      valuable radioligands for studying thromboxane A2 (TXA2) receptor.

PMID- 8348678
TI  - Density fluctuations and rotational isomerization in phospholipid bilayers as
      studied by ultrasonic absorption spectroscopy.
AB  - Broadband ultrasonic absorption spectra are discussed for some aqueous solutions
      of single-walled phospholipid bilayer vesicles. It is shown that the excess
      absorption found with all samples can be represented by a sum of a Debye-type
      relaxation term with discrete relaxation time and a Fixman-Kawasaki term. The
      former term reflects the kinetics of structural isomerization of the hydrocarbon
      chains. The values of its relaxation time (0.09-0.56 ns) agree with those for
      pure n-alkanes of comparable length. The latter terms seems to be due to density
      fluctuations in the hydrocarbon part of the double layer. Fluctuation correlation
      lengths between 1 and 30 A result from the analysis of the ultrasonic spectra.

PMID- 8348680
TI  - Oxygen extraction is altered by endotoxin during tamponade-induced stagnant
      hypoxia in the dog.
AB  - The present study used a model of cardiac tamponade to investigate the effects of
      endotoxin on the oxygen extraction capabilities of the body during an acute
      reduction in blood flow, when blood volume and arterial oxygen content were
      maintained. In 21 pentobarbital anesthetized, mechanically ventilated dogs, two
      catheters were introduced into the pericardial space to induce cardiac tamponade,
      and simultaneously to measure the intrapericardial pressure. Oxygen uptake (VO2)
      was determined from the expired gases. Oxygen delivery (DO2) was calculated by
      the product of the thermodilution cardiac index and the arterial oxygen content.
      Eleven dogs received 2 mg/kg Escherichia coli endotoxin, followed by generous
      saline infusion (20 ml/kg.hr). Ten dogs served as a control group. In each dog,
      DO2 was progressively reduced by pericardial saline infusion at a rate of 40
      ml/hr for the first hour and 30 ml/hr thereafter. Critical O2 delivery (DO2crit)
      and critical O2 extraction ratio (O2ERcrit) were determined from a plot of
      VO2/DO2 for each individual dog. The DO2crit was greater in the endotoxic than in
      the control group (12.1 +/- 3.1 ml/kg.min vs. 9.6 +/- 1.6 ml/kg.min; P < 0.05).
      Endotoxin at the dose used did not alter VO2 (or critical VO2). Accordingly,
      O2ERcrit was significantly lower in the endotoxic than in the control animals
      (47.2% +/- 5.7% vs. 60.3% +/- 10.6%; P < 0.01). The mixed venous PO2 levels at
      DO2crit were higher in the endotoxic than in the control group (30.6 +/- 6.1 mm
      Hg vs. 25.4 +/- 5.2 mm Hg; P < 0.05). Arterial blood lactate concentration was
      higher in the endotoxic than in the control dogs.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8348679
TI  - Systemic hemodynamic and microvascular responses in spontaneously hypertensive
      rats during Escherichia coli bacteremia.
AB  - Renovascular hypertension profoundly alters skeletal muscle arteriolar responses
      to sepsis, yet systemic hemodynamics to sepsis are not affected by hypertension.
      In this study, we hypothesized that microvascular responses of skeletal muscle
      and systemic hemodynamics are changed during high- and low-cardiac-output
      Escherichia coli bacteremia in normotensive Wistar-Kyoto (WKY) and spontaneously
      hypertensive rats (SHR). During high-cardiac-output bacteremia, blood pressure
      and heart rate increased in WKY, but blood pressure decreased in SHR. During low
      cardiac-output bacteremia, blood pressure initially decreased in WKY, while in
      SHR, pressure dropped significantly and remained severely depressed. Heart rate
      increased by 50% in SHR, but only by 10-15% in WKY during low-cardiac-output
      bacteremia. Large A1 and A2 arterioles constricted in both WKY and SHR during
      both phases of bacteremia. Small A3 and A4 arterioles dilated in WKY during
      bacteremia, but this small arteriole dilation was blunted in SHR. However,
      nitroprusside, an endothelium-derived relaxing factor (EDRF)-independently acting
      vasodilator, caused maximal dilation of these small arterioles of SHR. We
      conclude that there are profound changes and differences in systemic hemodynamics
      during bacteremia between the normotensive and the genetically hypertensive
      groups, whereas despite a possibly decreased endothelium-dependent vasodilator
      responsiveness in small arterioles of SHR during bacteremia, overall blood flow
      changes in skeletal muscle were similar among the two groups.

PMID- 8348681
TI  - Comparison of gastric luminal and gastric wall PCO2 during hemorrhagic shock.
AB  - Measurement of gastric wall PCO2 has emerged as a promising monitor of perfusion
      deficits during low-flow states of circulatory shock. In the present study,
      gastric luminal PCO2 measured with the gastric tonometer was compared with the
      PCO2, measured directly in the wall of the stomach during hemorrhagic shock in
      two groups of five Sprague-Dawley rats. One group was pretreated with the H2
      blocker, ranitidine. During a 120-min interval of hemorrhage, tonometer PCO2
      increased from 60 +/- 7 mmHg to 90 +/- 10 mmHg, and time-coincident gastric wall
      PCO2 from 52 +/- 5 mmHg to 131 +/- 14 mmHg. Following reinfusion of shed blood,
      tonometer PCO2 remained elevated for an interval exceeding 60 min, but gastric
      wall PCO2 returned to control levels within approximately 10 min. Ranitidine
      pretreatment did not alter the relationships between gastric wall PCO2 and
      tonometer PCO2. These observations indicate that gastric luminal PCO2
      underestimates relatively rapid increases in gastric wall PCO2 during profound
      hemorrhagic shock in rats.

PMID- 8348682
TI  - (+)Naloxone potentiates the inotropic effect of epinephrine in the isolated dog
      heart.
AB  - Naloxone potentiates the inotropic effect of circulating catecholamines in the
      isolated canine heart. The stereospecificity of this response was evaluated with
      the aid of the less active (+)enantiomer of naloxone. The more common (-)isomer
      of naloxone increased the contractile response to epinephrine only at the higher
      dose tested (4 mg). This effect of naloxone was not observed at a tenfold lower
      dose (0.4 mg), indicating a very narrow dose-response range. (+)Naloxone was
      effective at the lower dose and was, therefore, equal to or better than (
      )naloxone in potentiating the inotropic effect of epinephrine. When introduced
      afterward, (-)naloxone did not add to the effect of (+)naloxone. These data
      suggest that naloxone modifies cellular responsiveness to catecholamines through
      a nontraditional opiate receptor, through a nonopiate receptor, or through a
      nonreceptor mechanism.

PMID- 8348683
TI  - Reevaluation of the linkage between acute hemorrhagic shock and bacterial
      translocation in the rat.
AB  - The present study was undertaken to determine the conditions under which acute
      periods of hemorrhagic shock induce bacterial translocation. Rats (at least six
      per group) were anesthetized intraperitoneally with the barbiturate,
      pentobarbital (50 or 65 mg/kg), or the inhalation anesthetic methoxyflurane.
      Following anesthesia, the femoral artery was catheterized, from which blood was
      withdrawn to maintain a mean arterial blood pressure of 30 mmHg for 30, 60, or 90
      min, followed by reinfusion of shed blood. Instrumented, but nonshocked animals
      served as controls. Rats were sacrificed at 0, 2, or 24 hr postshock, and
      quantitative bacterial cultures of the mesenteric lymph node complex (MLN),
      liver, and spleen were made. Within groups, the effects of heparinization were
      also determined. In pentobarbital-treated animals, regardless of the extent of
      heparinization, consistent translocation to both MLN and distant organs occurred
      when shock was prolonged for 90 min, and assessment of translocation was made 24
      hr after reinfusion of shed blood. Furthermore, a mortality rate of approximately
      30% was found in rats subjected to this protocol. The magnitude of translocation
      was less consistent, and did not differ from that in sham shock controls, under
      other conditions of shock and evaluation. In rats anesthetized with
      methoxyflurane, no mortality occurred, and no statistical significance between
      the incidence or degree of translocation in shocked animals vs. sham shock
      controls could be demonstrated, regardless of the shock protocol. In additional
      studies, effects of these anesthetics on intestinal morphology and superior
      mesenteric arterial (SMA) flow in the context of hemorrhagic shock were
      assessed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348684
TI  - Extracorporeal circulation: in vivo and in vitro analysis of complement
      activation by heparin-bonded surfaces.
AB  - Complement activation was analyzed during extracorporeal CO2 removal to compare
      heparin-coated with standard surfaces where systemic heparinization was required.
      In vivo studies were performed in adult sheep for up to 5 days under standardized
      conditions using a capillary membrane oxygenator. Applying assays for hemolytic
      complement function (CH50, APH50) and C3-derived split products, we found that
      complement activation was markedly reduced in sheep connected to an
      extracorporeal circuit where heparin was covalently bound by end-point
      attachment. In addition, incubation of human serum in a miniaturized circulation
      system revealed less complement activation by heparin-bonded surfaces, as
      evaluated by enzyme-linked immunosorbent assays for C3a and the activation
      specific protein-protein complexes, C1rsC1 inhibitor (classical pathway) and
      C3b(Bb)P (alternative pathway). Our results provide further evidence that
      biocompatibility can be improved by end-point attachment of heparin to the
      surfaces of the extracorporeal circuit.

PMID- 8348685
TI  - Comparison of effects of dopamine hydrochloride and dopexamine hydrochloride on
      abdominal and femoral hemodynamics in anesthetized dogs.
AB  - The effects of dopamine and dopexamine administered in graded intravenous bolus
      injections (0.1-51.2 micrograms.kg-1) were compared in the renal and femoral, and
      in a number of splanchnic vessels at the organ level simultaneously in
      anesthetized dogs. Hemodynamic data are presented for each artery as conductance,
      which was obtained by dividing mean flow by mean arterial pressure. The data were
      analyzed in two different ways: 1) by responses at intervals of 3 sec to 12.8
      micrograms dopamine or dopexamine during 1 min, and 2) by dose-response curves.
      Additionally, urine volume was measured during dopamine and dopexamine
      administration. During a period of 1 min after an injection of dopamine, early
      and late effects could be distinguished, while heart rate was unaltered. In the
      superior mesenteric, inferior mesenteric, splenic, common hepatic, renal, and
      femoral arteries, an early (at 18-21 sec) reduction in conductance was seen. The
      early reduction was often followed by an increase above the preinjection level.
      After dopexamine, the early reduction in conductance was not seen, except in the
      left gastric artery. In contrast to the effect of dopamine, dopexamine induced a
      more pronounced increase during the late phase. Contrary to dopamine, dopexamine
      increased the conductance in the common hepatic artery bed. It remains
      questionable whether dopaminergic receptors are present in this vascular bed.
      Dopamine raised blood pressure and urine production dose-dependently. Dopexamine
      decreased aortic pressure. Low dosages of dopexamine increased urine production,
      without raising renal blood flow. An advantage of dopexamine over dopamine could
      be that dopexamine does not stimulate alpha-adrenergic receptors.

PMID- 8348686
TI  - Molecular characterization of angiotensin II--induced hypertrophy of cardiac
      myocytes and hyperplasia of cardiac fibroblasts. Critical role of the AT1
      receptor subtype.
AB  - Increasing evidence suggests that angiotensin II (Ang II) may act as a growth
      factor for the heart. However, direct effects of Ang II on mammalian cardiac
      cells (myocytes and nonmyocytes), independent of secondary hemodynamic and
      neurohumoral effects, have not been well characterized. Therefore, we analyzed
      the molecular phenotype of cultured cardiac cells from neonatal rats in response
      to Ang II. In addition, we examined the effects of selective Ang II receptor
      subtype antagonists in mediating the biological effects of Ang II. In myocyte
      culture, Ang II caused an increase in protein synthesis without changing the rate
      of DNA synthesis. In contrast, Ang II induced increases in protein synthesis, DNA
      synthesis, and cell number in nonmyocyte cultures (mostly cardiac fibroblasts).
      The Ang II-induced hypertrophic response of myocytes and mitogenic response of
      fibroblasts were mediated primarily by the AT1 receptor. Ang II caused a rapid
      induction of many immediate-early genes (c-fos, c-jun, jun B, Egr-1, and c-myc)
      in myocyte and nonmyocyte cultures. Ang II induced "late" markers for cardiac
      hypertrophy, skeletal alpha-actin and atrial natriuretic factor expression,
      within 6 hours in myocytes. Ang II also caused upregulation of the
      angiotensinogen gene and transforming growth factor-beta 1 gene within 6 hours.
      Induction of immediate-early genes, late genes, and growth factor genes by Ang II
      was fully blocked by an AT1 receptor antagonist but not by an AT2 receptor
      antagonist. These results indicate that: (1) Ang II causes hypertrophy of cardiac
      myocytes and mitogenesis of cardiac fibroblasts, (2) the phenotypic changes of
      cardiac cells in response to Ang II in vitro closely mimic those of growth factor
      response in vitro and of load-induced hypertrophy in vivo, (3) all biological
      effects of Ang II examined here are mediated primarily by the AT1 receptor
      subtype, and (4) Ang II may initiate a positive-feedback regulation of cardiac
      hypertrophic response by inducing the angiotensinogen gene and transforming
      growth factor-beta 1 gene.

PMID- 8348687
TI  - Signal transduction pathways of angiotensin II--induced c-fos gene expression in
      cardiac myocytes in vitro. Roles of phospholipid-derived second messengers.
AB  - Angiotensin II (Ang II) causes a rapid induction of immediate-early genes and
      hypertrophy in the cardiac myocyte. However, the signaling mechanism of Ang II
      induced immediate-early gene expression in cardiac myocytes has not been
      characterized. Therefore, we examined signal transduction of Ang II in neonatal
      rat cardiac myocytes, using c-fos gene expression as a model system. Transient
      transfection of c-fos reporter gene constructs indicated that the serum response
      element is not only required but also sufficient for Ang II-induced activation of
      the c-fos promoter. Ang II is known to cause an increase in [Ca2+]i. We found
      that Ang II also causes a small increase in cAMP in cardiac myocytes. However,
      the Ca2+/cAMP response element of the c-fos gene was not sufficient to confer Ang
      II responsiveness to the c-fos promoter, and inhibitors of protein kinase A had
      no effects on Ang II-induced c-fos expression. On the other hand, chelating
      intracellular Ca2+ with BAPTA-AM inhibited Ang II-induced c-fos expression in a
      dose-dependent manner, suggesting that Ca2+ is required for Ang II-induced
      signaling. Measurements of phospholipid-derived second messengers revealed that
      Ang II increased production of inositol trisphosphate, diacylglycerol,
      phosphatidic acid, and arachidonic acids, resulting in a sustained increase in
      protein kinase C activity. This and other evidence suggest that Ang II activates
      phospholipase C, phospholipase D, and possibly phospholipase A2. All of these
      second-messenger systems are activated through the AT1 receptor. Pharmacological
      inhibition of phospholipase C or downregulation of protein kinase C significantly
      suppressed Ang II-induced c-fos expression. In conclusion, Ang II activates
      multiple phospholipid-derived second-messenger systems via the AT1 receptor in
      cardiac myocytes. Among these second-messenger systems, phospholipase C and
      protein kinase C seem essential for Ang II-induced c-fos gene expression, whereas
      Ca2+ may play a permissive role. Finally, the "Ang II response element" of the c
      fos gene maps to the protein kinase C-dependent portion of the serum response
      element.

PMID- 8348688
TI  - Rat angiotensin II (type 1A) receptor mRNA regulation and subtype expression in
      myocardial growth and hypertrophy.
AB  - Two subtypes of angiotensin II (Ang II) receptors (AT1 and AT2) are distinguished
      by using the respective specific antagonists. In the present study, we report the
      regulation of cardiac AT1 type A (AT1A) receptor mRNA levels and the expression
      pattern of AT1 and AT2 receptors in the growth of the heart and the development
      and regression of cardiac hypertrophy. The ventricular AT1A mRNA level and the
      density of Ang II receptors at the neonatal period were significantly increased
      (3.5-fold and 2.5-fold, respectively) and then downregulated with maturation. The
      cardiac hypertrophy established in spontaneously hypertensive rats or two-kidney
      one-clip renovascular hypertensive rats resulted in substantial increases in
      ventricular AT1A mRNA levels (threefold) and Ang II receptor densities (twofold)
      as compared with those in respective control rats, whereas the receptor affinity
      was similar. The proportion of AT1 and AT2 subtypes in the specific Ang II
      binding in ventricular membranes prepared from normal adult rats was nearly
      equal. This proportion did not change significantly in the development of
      myocardial hypertrophy. The regression of cardiac hypertrophy by the
      normalization of elevated blood pressure completely reversed the increased levels
      of AT1A mRNA and the receptor density to the control level. Thus, AT1 and AT2
      receptors are present in rat ventricular myocardium, and their expression is
      developmentally regulated and upregulated in response to hypertrophic change. Ang
      II action exerted through the increased number of Ang II receptors may contribute
      to the growth of the heart and thus to the maintenance of established hypertrophy
      as one of the hormones involved in hypertrophy development.

PMID- 8348689
TI  - Effects of adenosine and its analogues on isolated intracerebral arterioles.
      Extraluminal and intraluminal application.
AB  - We evaluated the responses of brain parenchymal arterioles to intraluminal and
      extraluminal application of adenosine and its analogues. Intracerebral arterioles
      (28.4- to 60.3-microns diameter) were isolated from Sprague-Dawley rats,
      cannulated with micropipettes, and perfused in vitro. Both extraluminal and
      intraluminal adenosine, 5'-(N-ethylcarboxamido)adenosine (NECA), R-N6
      (phenylisopropyl)adenosine (R-PIA), and S-N6-(phenylisopropyl)adenosine (S-PIA)
      elicited concentration-dependent dilation of these arterioles, but intraluminal
      application was less potent and efficacious than extraluminal application.
      Inosine was not vasoactive. A common order of agonist potency (NECA > adenosine >
      R-PIA > or = S-PIA) was determined for both extraluminal and intraluminal
      application. Theophylline (10 microM) caused a rightward shift of the adenosine
      concentration-response curve and a 50-fold reduction in potency. Intraluminal
      theophylline was one sixth as effective as extraluminal theophylline in
      antagonizing the extraluminal adenosine response, whereas intraluminal 8
      sulfophenyltheophylline, a polar theophylline derivative, was ineffective.
      Polyadenylic acid (PolyA, 1 microM), an adenosine polymer that does not penetrate
      the endothelium, induced a dilation of 44.2 +/- 5.3% when applied extraluminally
      but had no effect when infused intraluminally. The dilator effect of PolyA was
      antagonized by theophylline. We conclude that: (1) intraluminal adenosine and its
      analogues are effective dilators of intracerebral arterioles, (2) the dilator
      effects of both intraluminally and extraluminally applied adenosine are
      predominantly mediated by A2-type receptors, and (3) adenosine receptors
      mediating vasodilation are not present on the luminal surface of the endothelium.

PMID- 8348690
TI  - Myocardial oxygenation in dogs during partial and complete coronary artery
      occlusion.
AB  - Regional myocardial oxygenation was assessed during partial and complete coronary
      artery occlusion using near infrared spectroscopy. In eight open-chest dogs,
      partial occlusions resulting in an approximately 42% decrease in left anterior
      descending coronary artery (LAD) blood flow produced an approximately 21%
      decrease in tissue O2 stores (tissue oxyhemoglobin plus oxymyoglobin) and no
      change in the oxidation level of mitochondrial cytochrome aa3. An approximately
      81% reduction in LAD blood flow produced nadir levels of tissue oxyhemoglobin
      plus oxymyoglobin, maximal levels of deoxyhemoglobin plus deoxymyoglobin, a
      decline in tissue blood volume, and an approximately 39% decrease in cytochrome
      aa3 oxidation level. These changes were associated with an approximately 52%
      decrease from the preischemic baseline in mean transmural myocardial blood flow,
      measured by radiolabeled microspheres, and an approximately 41% decrease in
      myocardial O2 consumption. Complete occlusion resulted in further decreases in
      myocardial blood flow, O2 consumption, tissue blood volume, and cytochrome aa3
      oxidation state but also produced increases in tissue O2 stores to above the
      nadir levels noted during partial occlusion. These results indicate that
      decreases in O2 delivery during partial coronary occlusion increase O2 extraction
      to sustain mitochondrial O2 availability, but as little as a 52% reduction in
      myocardial blood flow produces maximal O2 extraction and depletion of tissue O2
      stores. Mitochondrial O2 availability is restricted further during complete
      occlusion because of limited O2 delivery and, possibly, decreases in tissue blood
      volume and O2 extraction.

PMID- 8348691
TI  - Modification of myogenic intrinsic tone and [Ca2+]i of rat isolated arterioles by
      ryanodine and cyclopiazonic acid.
AB  - The role of the sarcoplasmic reticulum (SR) in regulating myogenic tone and
      [Ca2+]i was examined with ryanodine and cyclopiazonic acid (CPA) in the rat
      skeletal muscle arteriole (A(sk)) and mesenteric arteriole (Ams). Arterioles were
      cannulated at both ends to control luminal pressure in a tissue bath. Luminal
      diameter was measured with a video-monitored microscopic system. Fura 2-AM was
      loaded to measure [Ca2+]i using the fluorescence intensity ratio at excitation
      wavelengths of 340 to 380 nm (F340/380). The myogenic response (luminal pressure
      was increased from 40 to 100 mm Hg) and the intrinsic tone at 40 mm Hg were
      observed in A(sk) but not in Ams. Ryanodine (10(-5) M decreased the steady-state
      diameter of A(sk) from 138 +/- 8 to 85 +/- 9 microns (P < .05) and increased the
      F340/380 ratio; these effects were reversed by nifedipine or Ca(2+)-free
      solution. Ryanodine shifted the [Ca2+]o-contraction response curve upward. CPA
      (10(-5) M) also decreased the steady-state diameter of A(sk) from 131 +/- 7 to 98
      +/- 11 microns (P < .05). In contrast, Ams responded to neither ryanodine nor
      CPA. Caffeine-induced contractions were significantly reduced by either ryanodine
      or CPA in both arterioles. These results indicate that SR dysfunction increased
      the susceptibility of the arteriolar tone to [Ca2+]o and enhanced the tone of
      A(sk). In conclusion, the SR function may play a critical role in regulating
      [Ca2+]i and the intrinsic tone of A(sk) that was myogenically active at
      physiological luminal pressure.

PMID- 8348692
TI  - ATP-dependent closure and reactivation of inward rectifier K+ channels in
      endothelial cells.
AB  - This report presents the results of a patch-clamp study examining the role of
      intracellular ATP in the regulation of endothelial inward rectifier K+ channels.
      Administration of ATP to the cytosolic surface of inside-out patches reversibly
      activated the K+ channel within seconds. ATP (1 mM) increased the mean open
      probability by a factor of 3.5, primarily by increasing the number of openings.
      Administration of the nonhydrolyzable ATP analogue ATP-gamma-S failed to modulate
      channel activity. Inhibition of ATP synthesis by administration of cyanide plus
      iodoacetate resulted in channel closure within 1 to 6 minutes. In experiments in
      which ATP was coadministered with the metabolic blockers, the channel activity
      continued unchanged for up to 30 minutes, but when ATP was removed, the activity
      rapidly decayed. We propose that normal functioning of the inward rectifier K+
      channel is ATP dependent. Phosphorylation of the channel molecule is probably
      essential for maintaining activity.

PMID- 8348693
TI  - Repeated dipyridamole administration enhances collateral-dependent flow and
      regional function during exercise. A role for adenosine.
AB  - Two main hypotheses concerning the mechanisms responsible for coronary collateral
      growth suggest the involvement of chemical or mechanical factors. Since we
      recently demonstrated that the development of the coronary collateral circulation
      is not closely related to the extent or duration of myocardial ischemia, we
      hypothesized that chronic repeated vasodilation and increased myocardial blood
      flow using dipyridamole would enhance collateral development in miniswine with an
      ameroid-occluded left circumflex coronary artery (LCx). Two days after surgical
      instrumentation, the animals received dipyridamole (n = 9), diltiazem as an
      adenosine-independent vasodilator (n = 8), or control vehicle (n = 7) 90 minutes
      per day, 5 days per week for 8 weeks. At 5 and 8 weeks, transmural blood flow and
      systolic wall thickening were measured during infusion of dipyridamole,
      diltiazem, or vehicle. Transmural blood flow increased similarly in the LCx and
      nonoccluded regions at 30 and 60 minutes during infusion of either vasodilator.
      Thus, we believe that similar mechanical stimulation resulted from dipyridamole
      and diltiazem infusion. There was no change in blood flow during administration
      of the vehicle. Systolic wall thickening in the collateral-dependent region was
      not altered by infusion of dipyridamole, diltiazem, or vehicle. Therefore, both
      vasodilators increased blood flow without eliciting ischemia. After 8 weeks of
      repeated treatment with each pharmacological agent, at least 24 hours after the
      last drug infusion, near maximal physiological capacity of the coronary
      collateral vessels was assessed during treadmill running (approximately 240 beats
      per minute). Transmural myocardial blood flow ratios, expressed as flow in the
      LCx divided by flow in the nonoccluded region of the left ventricle, were similar
      at rest for animals treated with dipyridamole (0.90 +/- 0.03), diltiazem (0.97 +/
      0.05), and control vehicle (0.89 +/- 0.02). However, collateral-dependent
      myocardial blood flow during exercise was greater (P < .05) in the dipyridamole
      treated animals (0.78 +/- 0.04) than in either diltiazem-treated (0.63 +/- 0.09)
      or vehicle-treated (0.62 +/- 0.02) animals. LCx systolic wall thickening at rest
      was similar in animals treated with dipyridamole (44.4 +/- 6.3%), diltiazem (42.2
      +/- 3.0%), and control vehicle (38.1 +/- 2.8%). During exercise, however,
      myocardial function in the collateral-dependent region was greater (P < .05) in
      the dipyridamole-treated (39.2 +/- 5.2%) compared with diltiazem-treated (23.9 +/
      4.0%) and vehicle-treated (26.9 +/- 2.9%) animals.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8348695
TI  - Attenuation of ecto-5'-nucleotidase activity and adenosine release in activated
      human polymorphonuclear leukocytes.
AB  - To examine whether activation of polymorphonuclear leukocytes attenuates release
      of adenosine through attenuation of their own ecto-5'-nucleotidase activity,
      human polymorphonuclear leukocytes were incubated with and without exposure to
      either N-formyl-methionyl-leucyl-phenylalanine (FMLP) or complement C5a. Ecto-5'
      nucleotidase activity of polymorphonuclear leukocytes was attenuated by both FMLP
      and complement C5a (22.7 +/- 3.6 vs 9.7 +/- 2.6 nmol/min per 10(7) cells at 10(
      6) M FMLP, P < .05; 21.5 +/- 2.2 vs 10.2 +/- 1.2 nmol/min per 10(7) cells at 5 x
      10(-7) g/mL complement C5a, P < .001), whereas cytosolic 5'-nucleotidase activity
      was not affected by either FMLP or complement C5a. These reductions of ecto-5'
      nucleotidase activity that were caused by both FMLP and complement C5a were dose
      and time dependent and were inhibited by superoxide dismutase. Desferrioxamine
      did not inhibit the decreases in ecto-5'-nucleotidase. In accordance with the
      decreases in ecto-5'-nucleotidase activity, release of adenosine was attenuated
      in the FMLP-pretreated and complement C5a-pretreated polymorphonuclear
      leukocytes, which were restored by concomitant administration of superoxide
      dismutase. The viability of FMLP-pretreated and complement C5a-pretreated
      polymorphonuclear leukocytes was markedly decreased compared with the untreated
      group after 60 minutes of hypoxia followed by 60 minutes of reoxygenation. Thus,
      we conclude that: (1) activation of polymorphonuclear leukocytes attenuates their
      own ecto-5'-nucleotidase activity and thereby reduces adenosine release, (2)
      reduction of ecto-5'-nucleotidase activity is attributable to generated
      superoxide anion in polymorphonuclear leukocytes, and (3) viability of
      polymorphonuclear leukocytes after hypoxia and reoxygenation largely depends on
      the extents of decreases in ecto-5'-nucleotidase activity.

PMID- 8348694
TI  - Loss of asymmetric distribution of sarcolemmal phosphatidylethanolamine during
      simulated ischemia in the isolated neonatal rat cardiomyocyte.
AB  - In the present study we have investigated the reorganization of the sarcolemmal
      phospholipids during the first 60 minutes of simulated ischemia ("ischemia") as
      induced by anoxia, volume restriction, and nutrient deprivation. Experiments were
      carried out on [3H]acetate-labeled neonatal rat cardiomyocytes and isolated
      (nonradiolabeled) sarcolemmal membranes obtained from the same culture system.
      After 60 minutes of "ischemia," cellular high-energy phosphate (ATP) levels had
      decreased to approximately 40% of the control values, but no significant
      phospholipid hydrolysis was detected. Labeling experiments using the nonpermeant
      (primary amine-containing phospholipid) probe trinitrobenzenesulfonic acid and
      nonlytic treatment with (different) exogenous phospholipases A2 were both
      indicative of a shifted transbilayer distribution of the hexagonalII phase
      preferring and fusion-promoting sarcolemmal phosphatidylethanolamine in favor of
      the outer membrane leaflet. This specific change in sarcolemmal phospholipid
      asymmetry preceded the loss of integrity of the sarcolemma, monitored by the
      release of lactate dehydrogenase as well as by scanning electron microscopy. It
      is proposed that, in addition to the previously reported lateral phospholipid
      reorganization, uncontrolled transbilayer movement of the non-bilayer-preferring
      phosphatidylethanolamine from the inner to the outer leaflet of the sarcolemma is
      an additional factor in destabilizing the lipid bilayer, eventually leading to
      the irreversible membrane damage seen after a prolonged period of ischemia.

PMID- 8348696
TI  - Effects of brief repetitive ischemia on contractility, relaxation, and coronary
      flow. Exaggerated postischemic diastolic dysfunction in pressure-overload
      hypertrophy.
AB  - The recovery of systolic and diastolic function during unstable angina may be
      modified by the repetition of brief episodes of ischemia and by the presence of
      left ventricular hypertrophy (LVH). We studied the effects of six consecutive 5
      minute cycles of no-flow ischemia and reperfusion followed by 25 minutes of
      recovery in isovolumic red blood cell-perfused hearts from aortic-banded rats
      with chronic LVH (n = 8) and sham-operated control rats (n = 8). At baseline
      (left ventricular end-diastolic pressure [LVEDP], 10 mm Hg), left ventricular
      developed pressure (123 +/- 5 versus 114 +/- 5 mm Hg/g) and coronary flow [2.5 +/
      0.3 versus 2.2 +/- 0.2 (mL/min)/g] were similar in LVH versus control rats.
      Repetitive ischemia was associated with progressive depression of postischemic
      recovery of left ventricular systolic function, and the recovery of left
      ventricular developed pressure after the final 25-minute reperfusion period was
      similar in LVH versus control rats (61 +/- 6% versus 72 +/- 4% of baseline, P =
      NS). Although there was no increase in isovolumic LVEDP during the initial cycle
      of transient ischemia, both groups showed a rapid and similar rise in LVEDP
      during subsequent ischemic cycles (delta 82 +/- 8 versus delta 89 +/- 7 mm Hg/g
      in response to the final ischemia cycle for LVH versus control rats,
      respectively; P = NS). The control hearts showed complete restoration of LVEDP to
      baseline during final reperfusion, whereas the LVH hearts showed prolonged and
      severe postischemic diastolic dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348697
TI  - Development of the cardiac coronary vascular endothelium, studied with
      antiendothelial antibodies, in chicken-quail chimeras.
AB  - The endothelium of the coronary vascular system has been described in the
      literature as originating from different sources, varying from aortic endothelium
      for the main coronary stems, endocardium for the intramyocardial network, and
      sinus venosus lining for the venous part of the coronary system. Using an
      antibody against quail endothelial cells (alpha-MB1), we investigated the
      development of the coronary vascular system in the quail (Hamburger and Hamilton
      stages 15 to 35) and in a series of 36 quail-chicken chimeras. In the chimeras,
      pieces of quail epicardial primordium and/or liver tissue were transplanted into
      the pericardial cavity of a chicken host. The results showed that the coronary
      vascular endothelial distribution closely followed the formation of the
      epicardial covering of the heart. However, pure epicardial primordium transplants
      did not lead to endothelial cell formation, whereas a liver graft with or without
      an epicardial contribution did have this capacity. The first endothelial cells
      were seen to reach the heart at the sinus venosus region, subsequently spreading
      through the inner curvature to the atrioventricular sulcus and the outflow tract
      and, last of all, over the ventricular surfaces. At these sites, the precursor
      cells and small vessels were seen to invade the sinus venosus wall, the
      ventricular and atrial myocardium, and the mesenchymal border of the aortic
      orifice. Connections with the endocardium of the heart tube were only observed in
      the right ventricular outflow region. Initially, the connections with the aortic
      endothelium were multiple, but later in development only two of these connections
      persisted to form the proximal part of the two main coronary arteries.
      Connections to the pulmonary orifice were never observed. Our transplantation
      data showed that the entire coronary endothelial vasculature originated from an
      extracardiac source. Moreover, using the developing subepicardial layer as a
      matrix, we showed that the endothelial cells reached the heart from the liver
      region. Ingrowth into the various cardiac segments was also observed.
      Implications for the relation to specific congenital cardiac malformations are
      discussed.

PMID- 8348698
TI  - Expression of basic fibroblast growth factor and its receptor by smooth muscle
      cells and endothelium in injured rat arteries. An en face study.
AB  - Release of endogenous basic fibroblast growth factor (bFGF) has been shown to
      initiate smooth muscle cell (SMC) proliferation following balloon catheter
      denudation in rat arteries. The mechanisms that contribute to the continued
      replication of the cells that subsequently form the neointima are not well
      understood. We have examined expression of bFGF and fibroblast growth factor
      receptor 1 (FGFR-1) in luminal SMCs as well as endothelium at various times after
      injury, which allowed us to study both replicating as well as quiescent cells.
      Using in situ hybridization on en face preparations, we were able to detect mRNA
      in luminal cells that was not observed by analysis of artery cross sections. We
      demonstrate that mRNA for bFGF was found in replicating SMCs and endothelial
      cells. bFGF mRNA was not detectable in either cell type at quiescence despite
      nuclear staining for bFGF. Expression of FGFR-1 mRNA was observed in replicating
      endothelial and SMCs at similar times after injury. These data provide evidence
      that in injured arteries the ligand/receptor system of bFGF and FGFR-1 may be
      involved in the continued proliferative response of SMCs leading to neointima
      formation. Furthermore, our results suggest a role for bFGF in reestablishing the
      endothelial lining in denuded vessels.

PMID- 8348699
TI  - The impact of obesity on hyperandrogenism and polycystic ovary syndrome in
      premenopausal women.

PMID- 8348700
TI  - Interindividual differences in the pituitary-thyroid axis influence the
      interpretation of thyroid function tests.
AB  - OBJECTIVE: We investigated interindividual differences in the shape, slope and
      setpoint of the pituitary-thyroid axis (PTA) in normal persons. Based on these
      physiological data we propose a novel bivariate concept for the interpretation of
      thyroid function tests which is less biased by interindividual differences in the
      PTA than the currently used univariate approach. DESIGN: In two separate trials
      (A and B), healthy volunteers were given small, increasing doses of T3 (7.5-45
      micrograms/day orally) over 5 days. The regulation characteristics of the
      individual PTAs and the effects of age and gender were assessed by general linear
      regression models. In addition, serum samples were collected from normal persons
      to establish the proposed bivariate approach for the interpretation of thyroid
      function tests. SUBJECTS: The regulatory characteristics of the PTA were
      determined in a total of 21 normal volunteers (eight females, 13 males; age 24-49
      years). Single blood samples were collected from 257 normal volunteers. The
      participants had no history of pituitary or thyroid disease. MEASUREMENTS: Free
      and total thyroid hormone and TSH concentrations were determined in the serum.
      All samples from one person were analysed in the same assay in duplicate.
      RESULTS: A log-linear relationship between T3 and TSH was found to describe best
      the individual PTA (multiple r = 0.96). However, significant differences in the
      setpoint (P < 0.001) and to a lesser degree in the slope (P < or = 0.05) of the
      PTA were detected; this variability was not dependent on age or gender. Since
      these findings invalidate the assumptions on which the current univariate
      interpretation of thyroid function tests is based, we propose a novel model for
      the evaluation of thyroid function tests derived from the experimentally
      determined shape and average slope of the PTA. CONCLUSIONS: The presence of
      significant age and gender-independent interindividual variations in the setpoint
      of the pituitary-thyroid axis raises conceptual problems with the current
      approach for interpreting thyroid function tests. An easy to use graphical
      bivariate representation of the normal ranges for thyroid function tests is
      presented and exemplified by the thyroid hormone and TSH measurements in a large
      reference population. This concept should improve the diagnostic accuracy in the
      borderline-normal, and particularly subclinical hypothyroid region of these
      hormone measurements.

PMID- 8348701
TI  - Serious, prolonged hypoglycaemia with glibenclamide in a patient with
      Mendenhall's syndrome.
AB  - Mendenhall's syndrome, characterized by familial insulin resistant diabetes,
      pineal hyperplasia and multiple somatic abnormalities, is associated with defects
      involving the alpha-subunit of the insulin receptor. The associated insulin
      resistant diabetes is extremely difficult to treat; insulin is required in very
      large doses to control hyperglycaemia and oral hypoglycaemic agents are
      ineffective. We report a case of severe, prolonged hypoglycaemia that occurred in
      a 24-year-old patient with Mendenhall's syndrome following therapy with
      glibenclamide. He had glibenclamide 10 mg daily for 1 week following which he was
      admitted to hospital in hypoglycaemic coma with blood glucose levels < 1.0
      mmol/l. This subject had undergone hypophysectomy at the age of 11 years. Prior
      to pituitary ablation, oral hypoglycaemic agents did not improve glycaemic
      control. Thus, previous hypophysectomy in this patient appears to have made it
      possible for glibenclamide to exert its hypoglycaemic effect. The occurrence of
      hypoglycaemia in this patient suggests alternative mechanisms for insulin action
      in conditions characterized by severe insulin resistance due to insulin receptor
      defects.

PMID- 8348702
TI  - Propranolol, diltiazem and cardiac and thyroid functions in hyperthyroidism.

PMID- 8348703
TI  - Glucokinase and non-insulin-dependent diabetes.

PMID- 8348704
TI  - Proinsulin, proinsulin intermediate and insulin in cystic fibrosis.
AB  - OBJECTIVE: We determined the changes in insulin, intact proinsulin and 32-33
      split proinsulin as markers of beta cell damage in assessing the state of
      carbohydrate intolerance in patients with cystic fibrosis. DESIGN: Measurements
      of insulin, proinsulin and 32-33 proinsulin concentrations in cystic fibrosis
      following oral glucose tolerance test (OGTT). SUBJECTS: Sixteen cystic fibrosis
      patients attending the chest outpatient clinic for follow-up, age range 14-42
      years, and 14 healthy controls matched for age and body mass index. MEASUREMENTS:
      Insulin, intact proinsulin and 32-33 split proinsulin were measured
      immunoradiometrically at 0, 30, 60, 90 and 120 minutes after an OGTT. Glucose and
      HbA1 were also measured. RESULTS: Cystic fibrosis patients were divided into two
      groups according to their OGTT results: those with diabetes mellitus or impaired
      glucose tolerance and those with normal glucose tolerance. Insulin concentrations
      and insulin/glucose ratios at 30 minutes were lower in both cystic fibrosis
      groups in comparison with the control. There was also a significant increase in
      the time to reach peak insulin levels in both cystic fibrosis groups. Fasting
      intact proinsulin concentrations and the proportion of proinsulin-like molecules
      were significantly higher in cystic fibrosis with diabetes mellitus or impaired
      glucose tolerance than in the control group, but not in the normal glucose
      tolerance cystic fibrosis group. There was no significant difference in the
      plasma concentrations of 32-33 split proinsulin amongst the three groups.
      CONCLUSIONS: Abnormal beta cell function in cystic fibrosis patients was
      reflected initially in a diminished 30-minute insulin response to oral glucose. A
      significant rise in fasting intact proinsulin and the proportion of proinsulin
      like molecules was seen only in cystic fibrosis patients who had progressed to
      impaired glucose tolerance or diabetes mellitus. Cystic fibrosis patients with
      normal glucose tolerance showed changes intermediate between the control and the
      other group.

PMID- 8348705
TI  - Elevated serum immunoreactive inhibin levels in peripubertal boys with chronic
      renal failure. Cooperative Study Group on Pubertal Development in Chronic Renal
      Failure (CSPCRF).
AB  - OBJECTIVE: Boys with chronic renal failure have delayed progress through puberty
      and have raised gonadotrophin and low testosterone levels indicative of disturbed
      hypothalamo-pituitary-testicular function. Most studies into the mechanisms
      underlying the dysfunction have concentrated on the LH-Leydig cell interaction.
      However, it is now possible to probe the FSH-Sertoli cell axis by measuring
      plasma immunoreactive inhibin, which is a marker of Sertoli cell function. This
      study investigated the FSH-Sertoli cell (immunoreactive inhibin) axis in boys
      with chronic renal failure on conservative and dialysis treatment as they
      progressed through puberty. The effect of renal transplantation in chronic renal
      failure was also investigated. DESIGN: Blood was drawn at 15-minute intervals
      between 2000 and 0700 h from 51 boys with chronic renal failure at various stages
      of puberty. The samples were divided into two pools, corresponding to the hormone
      secretion in the first and second part of the night. Single blood samples were
      drawn from a group of normal boys between 0800 and 1000 h. PATIENTS: A total of
      37 normal boys and 51 boys with chronic renal failure were examined immediately
      before and during puberty. Of a total of 80 pulse profiles taken in chronic renal
      failure, 36 were from transplanted and 44 from non-transplanted uraemic subjects.
      MEASUREMENTS: Immunoreactive inhibin, FSH and testosterone were measured using
      standard radioimmunoassays. The subjects were pooled into pubertal stages I,
      II/III and IV/V for analysis of hormone data. RESULTS: Early morning levels of
      immunoreactive inhibin like molecules (i-Inh) rose steadily with pubertal
      progression for all subject groups, those for boys with chronic renal failure
      being significantly elevated over normal boys from pubertal stage II/III onwards.
      Uraemic boys had higher levels than those who had been transplanted at all
      pubertal stages (P < 0.05). Early morning levels of FSH were significantly higher
      in uraemic patients with pubertal stages IV/V compared to our normal boys. There
      were no differences in i-Inh levels in plasma pooled from the samples taken
      between 2000 and 0115 h and 0130 and 0700 h for either treatment group at any
      stage of puberty. Testosterone levels rose in the second part of the profile from
      pubertal stages II/III onwards for both treatment groups. The proportional
      increase of testosterone was lower by mid puberty in uraemic than in transplanted
      children (percentage increases of 92 +/- 29 and 569 +/- 190 respectively, mean +/
      SEM). i-Inh failed to correlate with FSH at any Tanner stage or for any subject
      group. CONCLUSION: Peripubertal boys with chronic renal failure have highly
      elevated serum immunoreactive inhibin and FSH levels which are partially reduced
      by renal transplantation. There was no evidence of any relationship between i-Inh
      and FSH secretion in either normal boys or in uraemic or transplanted boys with
      the exception of a positive correlation in late pubertal patients after
      transplantation. Finally, despite problems associated with the current
      immunoassay for inhibin, this assay may still prove to be a useful marker of
      Sertoli cell function in testicular pathology.

PMID- 8348706
TI  - Premature ovarian failure: autoimmunity and natural history.
AB  - OBJECTIVE: We studied the association of clinical and latent autoimmune diseases
      with circulating steroid-producing cells autoantibodies (SCA) in patients with
      premature ovarian failure (Group I). We investigated the presence of SCA in
      patients with organ-specific autoimmune diseases but without hypogonadism (Group
      II). We assessed whether SCA can be considered markers of hypergonadotrophic
      hypogonadism. DESIGN: In Groups I and II blood samples were taken at diagnosis.
      In a subset of patients with SCA without hypogonadism blood samples were taken at
      least yearly for 6 years for immunological and functional tests. PATIENTS: Group
      I included 50 females, aged 16-39 years; Group II included 3677 patients, aged 6
      79 years, divided into Subgroup IIA (99 with Addison's disease alone or
      associated with other endocrinopathies or with hypoparathyroidism) and Subgroup
      IIB (3578 with insulin-dependent diabetes mellitus or thyroid autoimmune
      diseases). The follow-up group included nine subjects, aged 5-31 years (seven
      females and two males). MEASUREMENTS: SCA and other organ-specific autoantibodies
      were detected by standard indirect immunofluorescence using normal human tissues
      or passive haemagglutination tests. Gonadal functional tests included evaluation
      of FSH and LH levels by a RIA method; adrenocortical function included evaluation
      of cortisol and ACTH plasma levels by a RIA method. RESULTS: Three subgroups were
      identified in Group I on the basis of clinical autoimmune disease. 9/50 (18%)
      patients were found to have an Addison's disease (Subgroup IA) and in this
      subgroup SCA were present in 7/9 (78%); 10/50 (20%) had other autoimmune diseases
      (Subgroup IB) and SCA were found in 1/10 (10%); 31/50 (62%) did not have other
      clinical autoimmune diseases (Subgroup IC) and 1/31 (3%) had SCA. SCA were
      significantly increased in Subgroup IA vs IB (P = 0.017) and vs IC (P = 0.00002).
      In Group II, SCA were found in 20/3677 (0.5%); in particular, SCA were detected
      in 18/99 (18%) of the patients in Subgroup IIA and in 2/3578 (0.06%) of the
      patients in Subgroup IIB. The frequency of SCA in Subgroup IIA was found to be
      significantly increased with respect to that found in Subgroup IIB (P = 0.001 x
      10(-5)). During follow-up, 3/7 females (42.8%) but 0/2 males developed
      hypergonadotrophic hypogonadism with a latency period of 10, 13 and 15 years,
      respectively. Three females and two males lacked clinical Addison's disease at
      the beginning of the study, but during follow-up 1/3 female and 2/2 males
      developed clinical Addison's disease with a mean latency period of 13 months.
      CONCLUSIONS: The results confirm the strong relationship between premature
      ovarian failure and other clinical autoimmune diseases, as well as the strong
      link existing between primary ovarian failure, Addison's disease and antibodies
      to steroid-producing cells. The study also suggests that in females antibodies to
      steroid-producing cells are serological markers of both potential
      hypergonadotrophic hypogonadism, and Addison's disease; however, in males these
      antibodies may be considered only as markers of potential Addison's disease.

PMID- 8348707
TI  - Effect of varying concentrations of follicle stimulating hormone on the
      production of gonadotrophin surge attenuating factor (GnSAF) in women.
AB  - OBJECTIVE: We studied the time-course of production of gonadotrophin surge
      attenuating factor (GnSAF) in relation to varying serum concentrations of FSH in
      women. DESIGN: Normally cycling women were investigated in four cycles, i.e. a
      spontaneous cycle treated with placebo (cycle P) and three cycles treated with
      three different FSH dosages (1 ampoule, cycle 1; 3 ampoules, cycle 3 and 6
      ampoules, cycle 6). Placebo or FSH were given as a single i.m. injection on cycle
      day 2 (0900 h). The response of LH to an i.v. injection of 10 micrograms GnRH
      (GnSAF bioactivity) was investigated 4, 8, 12 and 24 hours after the injection of
      placebo or FSH. PATIENTS: Six normally ovulating women with long-standing
      unexplained infertility were studied. The women were used as their own controls
      during the cycle treated with placebo. MEASUREMENTS: Pituitary response to GnRH
      was calculated as the net increase in LH at 30 minutes (delta LH) above the basal
      value. RESULTS: Serum FSH concentrations increased after the injection of FSH in
      a dose dependent manner. Compared with cycle P, delta LH was significantly
      attenuated in cycle 3 and cycle 6 at 8, 12 and 24 hours and in cycle 1 at 12
      hours after the injection of FSH. Basal concentrations of oestradiol (E2) and LH
      did not differ significantly among the four cycles at any point except in cycle 6
      at 24 hours after the FSH injection when E2 values were significantly higher and
      LH values significantly lower than in cycle P. CONCLUSIONS: These results suggest
      that GnSAF bioactivity increases significantly as early as 8 hours from a single
      injection of FSH before any significant increase in serum E2 values. We conclude
      that in women the effect of FSH on the production of GnSAF in the early
      follicular phase is concentration dependent.

PMID- 8348708
TI  - Prevalence of subclinical hyperthyroidism and relationship between thyroid
      hormonal status and thyroid ultrasonographic parameters in patients with non
      toxic nodular goitre.
AB  - OBJECTIVE: Basal plasma T4, T3 and TSH concentrations are usually normal in
      patients presenting with non-toxic nodular goitre. Using the evaluation of TSH
      response to TRH in a large series of such patients living in an area with normal
      iodine intake, we evaluated the prevalence of subclinical hyperthyroidism and the
      relationship between thyroid hormonal status and ultrasonographic parameters.
      PATIENTS: A prospective study of 242 consecutive patients (group I), referred
      with non-autoimmune nodular goitre, normal plasma free T4, total T3 and TSH
      levels, without (subgroup IA, 222 patients) or with (subgroup IB, 20 patients)
      clear-cut autonomous area(s) on scintigraphy. These patients were compared to 135
      controls (group II). MEASUREMENTS: Plasma free T4 (FT4), total T3 (T3T) and TSH
      measurements. Evaluation of TSH response to TRH (delta level of increased TSH =
      peak TSH level during TRH test-basal TSH level), thyroid scintigraphy and
      morphological characteristics (number and total volume of nodule(s) and volume of
      extranodular tissue) determined by ultrasonography. RESULTS: In subgroup IA, (1)
      the mean (+/- SEM) basal TSH level (0.94 +/- 0.04 mU/I) and the mean value of
      increased TSH after TRH (4.92 +/- 0.34 mU/I) were lower (P < 0.001) than in group
      II (1.28 +/- 0.05 mU/I and 7.24 +/- 0.25 mU/I, respectively). The prevalence of
      SH (delta level of increased TSH below the mean -3 SD in controls) was 17.2%; (2)
      the mean FT4 level and the mean T3T value were not different (P > 0.05) from
      those of group II. In subgroup IB, (1) the mean basal TSH level (0.57 +/- 0.11
      mU/I) and the mean increment of TSH after TRH (2.81 +/- 0.62 mU/I) were lower (P
      < 0.001) than in subgroup IA. The prevalence of subclinical hyperthyroidism was
      75.0%; (2) the mean FT4 level (17.2 +/- 0.9 pmol/I) was not different from that
      in group II. However, the mean T3T value (1.99 +/- 0.01 nmol/I) was higher (P <
      0.001) than in group II (1.65 +/- 0.05). In group I, subgroup IA and IB, there
      were significant (P < 0.05, at least) correlations between the numbers of nodules
      and both basal TSH levels and delta values of increased TSH or FT4 levels or T3T
      values. No correlations were found between other ultrasonographic data and plasma
      thyroid parameters. CONCLUSIONS: This study demonstrates a high prevalence of
      subclinical hyperthyroidism in patients presenting with non-toxic nodular goitres
      and suggests that the number of nodules, but not their total volume, is an
      important factor in the development of this condition.

PMID- 8348709
TI  - Relation between phenotype and intra-cellular thyroid hormone effect in patients
      with altered peripheral thyroid hormone sensitivity.
AB  - OBJECTIVE: We wished to ascertain whether different phenotypic appearances in
      patients with altered cellular sensitivity to thyroid hormones were related to
      the type of altered intra-cellular thyroid hormone effect. DESIGN: Blood samples
      were obtained from two members of a family suffering from generalized thyroid
      hormone resistance (GTHR) for hormone assays and examination of the cellular
      thyroid hormone effect, and the results compared with results from other families
      with signs of altered peripheral thyroid hormone sensitivity. PATIENTS: Two
      members of a family with thyroid hormone resistance and nine normal persons were
      studied. MEASUREMENTS: Basal thyroid hormone function tests were measured. The
      thyroid hormone effect on mononuclear blood cells was determined by measuring the
      thyroid hormone stimulated oxygen consumption and glucose uptake. RESULTS: The
      two family members appeared phenotypically normal except for nodular goitre.
      Thyroid hormone stimulated glucose uptake was depressed whereas thyroid hormone
      stimulated oxygen consumption was normal. CONCLUSION: Comparison of the present
      results of the cellular examination in two patients with GTHR, with the results
      obtained in other families with altered peripheral thyroid hormone sensitivity,
      suggest that the classic GTHR (phenotype: normal or with goitre) is linked to
      impaired thyroid hormone stimulated glucose uptake, whereas in patients with
      osteopetrosis, the thyroid hormone insensitivity seems located at the
      mitochondrial level (impaired thyroid hormone stimulated oxygen consumption.

PMID- 8348710
TI  - Effects of growth hormone therapy on the developmental changes of follicle
      stimulating hormone and insulin-like growth factor-I serum concentrations in
      Turner's syndrome.
AB  - OBJECTIVE: The aim was to investigate whether, in the absence of gonads, GH could
      bring forward the age of neuroendocrine activation resulting in onset of puberty.
      DESIGN: In girls with Turner's syndrome, we evaluated the effects of GH therapy
      on developmental changes in FSH serum concentrations used as an indicator of
      neuroendocrine maturation in the absence of gonads. PATIENTS: Thirty-nine girls
      with Turner's syndrome aged 4.0-17.1 years were treated using GH (25 IU/m2 week)
      for 1 year. MEASUREMENTS: Serum levels of FSH and IGF-I were measured before
      initiation of GH therapy and 12 months later, after interruption of GH treatment
      for 2 days. RESULTS: Pretreatment FSH levels were low between 6 and 10 years and
      increased markedly at 10-11 years of age. This pattern was unchanged after 1 year
      of GH therapy. Pretreatment IGF-I levels were positively correlated with age and
      they were uniformly increased after 1 year of GH therapy. CONCLUSIONS: Our data
      suggest that GH and its effector, IGF-I, do not influence the timing of the onset
      of puberty through an effect on its neuroendocrine control.

PMID- 8348711
TI  - An audit of dynamic function tests: errors in the timing of blood specimens.
AB  - OBJECTIVE: The interpretation of dynamic endocrine investigations is dependent on
      the timing of blood sampled after a stimulus. We have studied the accuracy with
      which doctors adhered to a prescribed protocol. DESIGN: A new request form for
      dynamic tests was designed to include both the planned and the actual time of
      blood sampling in order to allow assessment of the variance of sample timing.
      MEASUREMENTS: We followed 152 investigation procedures comprising 791 planned
      specimens. A total number of 627 timing intervals could be analysed of which 366
      timing intervals did not differ from the planned interval. Protocols were divided
      into long and short (greater or less than 6 hours) and into those governed by
      clock times or 'stopwatch', i.e. minutes elapsed, intervals. RESULTS: A total of
      22% specimens were taken more than 10 minutes earlier or later than planned. Six
      per cent of specimens were taken more than 30 minutes earlier or later than
      planned. CONCLUSIONS: The data presented in this study suggest that in order to
      improve the interpretative accuracy of dynamic tests, it would appear prudent to
      pay more attention to the accuracy of sample timing. New dynamic test
      publications should include time tolerance for the normal response.

PMID- 8348712
TI  - Performing a factory visit.

PMID- 8348713
TI  - Development and isotype diversity of antibodies to inhalant and dietary antigens
      in childhood atopic eczema.
AB  - This study demonstrated that a major feature of childhood atopic eczema (AE) is
      the presence of serum IgG and IgE anti-house dust mite (anti-HDM) antibodies in
      almost all AE individuals. IgG anti-HDM antibodies, usually of the IgG1 isotype,
      became prevalent in AE children over the age of 4 years with the highest antibody
      levels in children in their early teens. In contrast, immunological sensitization
      to dietary antigens, notably milk and eggs, occurred in both AE children and age
      matched non-atopic control children, and was often associated with IgG4
      antibodies during early childhood. These became less prevalent with increasing
      age in control children but persisted in AE children, sometimes together with IgE
      antibodies. The later occurrence of anti-HDM antibodies in AE children could
      reflect immunological sensitization following inhalation of antigen, whereas
      sensitization to dietary antigens appears to be a natural event in early
      childhood.

PMID- 8348714
TI  - A wound healing model with sonographic monitoring.
AB  - The methods used hitherto for quantification of skin repair processes only allow
      an examiner a two-dimensional assessment of superficial wound healing. With the
      recent advent of high frequency B-scan ultrasonography in dermatology it has
      become possible to follow the course of healing and evaluate the healing
      processes in deeper layers of the skin. In this investigation 80 patients
      received cryosurgery for treatment of basal cell carcinomas on the face or neck
      region. As the size of cryosurgical defects can be precisely controlled they are
      potentially useful as standardized wound healing models. The course of wound
      healing after cryosurgery using a digital ultrasound scanner (DUB 20, Taberna pro
      medicum, Luneburg, Germany) was monitored. The usable depth of penetration of the
      echo signal is approximately 7 mm. The lateral resolution is approximately 200
      microns, the axial resolution approximately 80 microns. The cryolesion and the
      repair processes were examined ultrasonographically and clinically over a period
      of at least 3 weeks or until the wound had completely healed. The depth of
      invasion and lateral extent of the basal cell carcinoma as well as the size of
      the induced cryolesion can be determined by ultrasound. The exudative phase after
      cryosurgery, with developing oedema and necrosis, can be quantified on the basis
      of the reduced reflectivity in the corium. The repair processes taking place in
      the region of necrosis can be visualized in the ultrasound scan. The
      ultrasonically monitored wound healing model which we have demonstrated is
      particularly suitable for investigating the efficacy of drugs which promote
      healing.

PMID- 8348715
TI  - IgG subclasses in pemphigus in Indian and UK populations.
AB  - The autoimmune blistering disease pemphigus is more common in the Indian
      subcontinent than in the UK. This study of 19 patients from Oxford, UK and 39
      patients from New Delhi, India demonstrates that the incidence of the disease
      subtypes is different in the two countries. In the UK the commonest subtypes are
      pemphigus vulgaris and foliaceus with equal prevalence (both eight of 19), but in
      India pemphigus vulgaris is the most frequent (31 of 39), while pemphigus
      foliaceus is uncommon (three of 39) and with equal prevalence to the other
      subtypes. These populations also differ with a younger age at onset in the Indian
      patients (36.9 India; 52.7 UK) though the sex distribution is the same. Study of
      the immunopathology shows that the antibodies produced by patients in the two
      countries do not differ significantly, and are predominantly of the IgG4
      subclass. The antibody produced does not vary with the subtype of pemphigus or
      the age or sex of the patient. Although there are considerable differences
      between the two groups of patients this difference is not reflected by the
      subclass of auto-antibody response.

PMID- 8348716
TI  - Adherence of arthroconidia and germlings of anthropophilic and zoophilic
      varieties of Trichophyton mentagrophytes to human corneocytes as an early event
      in the pathogenesis of dermatophytosis.
AB  - The association (adherence) between human corneocytes and arthroconidia of
      Trichophyton mentagrophytes strains 121 and 126, and T. interdigitale strain 4
      was studied in vitro. Adherence of arthroconidia to corneocytes from either the
      palm and sole occurred and increased with time up to 6 h, by which time
      germination of arthroconidia had started. Significant differences were seen
      between the T. mentagrophytes strains and T. interdigitale in their adherence to
      corneocytes from the palm. When adherence values for plantar corneocytes were
      compared, significant differences were found between T. mentagrophytes and T.
      interdigitale. Not all corneocytes from either site had adherent arthroconidia,
      although there was a time-dependent increase in the numbers of corneocytes with
      adherent fungal cells. By scanning and transmission electron microscopy it was
      seen that there was a loose association between arthroconidia and corneocytes
      with no apparent damage to the corneocyte membrane. Adherence of germlings of T.
      interdigitale to corneocytes from the palm appeared to be mediated by germling
      outer cell wall fibrils. Hyphal branches and secondary germlings were observed to
      enhance the attachment of the parent hypha to adjacent corneocytes.

PMID- 8348717
TI  - Modulation of morphological differentiation of human endothelial cells in culture
      by the synthetic peptide YIGSR and cytochalasin B.
AB  - Matrigel is a solubilized tissue basement membrane gel extracted from the mouse
      Engelbreth-Holm-Swarm sarcoma. Cultures of human endothelial cells could be
      induced to undergo extremely rapid morphological differentiation into capillary
      like structures by Matrigel. The present study demonstrates the following: (a)
      Matrigel-induced tube formation by endothelial cells is laminin-dependent and,
      particularly, the YIGSR peptide site in the B1 chain of laminin may be necessary
      for endothelial cell differentiation resulting in capillary formation; (b)
      endothelial cells may be preprogrammed for rapid differentiation into blood
      vessels and do not require DNA, RNA or protein synthesis in order to undergo tube
      formation on Matrigel; and (c) microfilament assembly and function is important
      for Matrigel-induced tube formation.

PMID- 8348718
TI  - On naevi and melanomas in dysplastic naevus syndrome patients.
AB  - Cutaneous melanoma may occur as isolated, so-called 'sporadic' cases or in
      association with multiple atypical naevi and in familial clusters, in which case
      it is referred to as the familial dysplastic naevus syndrome (DNS). In this
      retrospective study (a) the number and body distribution of naevocytic naevi and
      (b) the body distribution of malignant melanoma (MM) in individuals with familial
      DNS were compared in order to study their association. In 45 patients with
      familial DNS aged 20-39 years naevus counts on trunk and lower extremities were
      compared with melanoma data and distributions from a second group of 43 patients
      from the same DNS families aged 12-66 years. Men had significantly more naevi of
      a size > or = 2 mm or > or = 5 mm on the back than women (P = 0.02). Women showed
      a tendency towards a greater number of naevi on the lower extremities than men,
      but in women no significant difference in naevi between the lower extremities and
      the back was found. The total number of naevi on the trunk and lower extremities
      in familial DNS patients was higher than that in the general population. In
      conclusion, it was found that predilection sites for melanoma in familial DNS
      patients of both sexes correspond with the distribution of naevi; in males naevi
      and melanoma counts and percentage distributions were higher on the back, in
      females both the back and the lower extremities were affected. These findings
      strongly suggest an association between naevus distribution and melanoma
      occurrence and site in familial DNS, analogous to earlier reports on sporadic
      melanoma.

PMID- 8348719
TI  - Aquagenic pruritus associated with juvenile xanthogranuloma.
AB  - While the relationship of aquagenic pruritus (AP) to haematoproliferative
      conditions is well-recognized, an association with histiocytic disorders has not
      previously been described. The case of a child with both AP and juvenile
      xanthogranulomata (JXG) is reported. The cutaneous lesions were typical of JXG,
      both clinically and histologically, and in addition there were radiological
      changes consistent with JXG in the lungs. AP is rare in childhood and the
      coincidental occurrence with unusually extensive JXG seems unlikely.

PMID- 8348720
TI  - Actinic comedonal plaque--a rare ectopic form of the Favre-Racouchot syndrome.
AB  - A 59-year-old woman with a single cuff-like plaque, consisting of multiple skin
      coloured to bluish cysts and comedones on her right forearm is reported. The
      solitary lesion resembled, morphologically and histologically, the Favre
      Racouchot syndrome. The above condition is another case of the previously
      described actinic comedonal plaque, which seems to be a rare entity within the
      spectrum of disease caused by actinic damage to the skin.

PMID- 8348721
TI  - Plane xanthomatosis with chronic lymphatic leukaemia.
AB  - A case of plane xanthomatosis in a 67-year-old woman, suffering from chronic
      lymphatic leukaemia, who developed asymptomatic yellow plaques on the neck, upper
      arms and chest is reported. Histology was suggestive of xanthelasma. Development
      of plane xanthomata has been reported in association with various haematological
      malignancies and with benign monoclonal gammopathies, but not previously with
      chronic lymphatic leukaemia.

PMID- 8348722
TI  - Multiple minute digitate hyperkeratoses.
AB  - A case of non-familial multiple digitate hyperkeratosis is reported. Digitate
      hyperkeratosis is a new, non-follicular disorder of keratinization and three
      different types have been distinguished in the literature: the familial type,
      with an autosomal dominant trait; the sporadic type; and the post-inflammatory
      type.

PMID- 8348723
TI  - Centroblastic transformation of chronic lymphocytic leukaemia with primary skin
      involvement--cutaneous presentation of Richter's syndrome.
AB  - The development of a large-cell non-Hodgkin's lymphoma in a patient suffering
      from chronic lymphocytic leukaemia is known as Richter's syndrome, representing
      one of the possible anaplastic transformations of the leukaemia. Cutaneous
      involvement is an extremely rare event. The case of a 45-year-old man with B-cell
      chronic lymphocytic leukaemia is reported. Five years later multiple cutaneous
      nodules developed on his extremities. Biopsies of the skin showed a diffuse large
      cell lymphoma, bearing the same cell surface immunoglobulin light chain isotype
      as the leukaemia, suggesting the original relationship between both neoplasms.

PMID- 8348724
TI  - Acquired ichthyosis and pyoderma gangrenosum in a patient with systemic lupus
      erythematosus.
AB  - A 25-year-old woman who was 20 weeks pregnant developed systemic lupus
      erythematosus with acquired ichthyosis and pyoderma gangrenosum. The course of
      these dermatoses suggests that an immunopathological mechanism was implicated in
      their pathogenesis.

PMID- 8348725
TI  - Neonatal lupus erythematosus with persistent telangiectasia and spastic
      paraparesis.
AB  - A case of neonatal lupus erythematosus with cutaneous and neurological features
      is reported. At 5 years of age, the patient retains residual telangiectatic
      lesions over the trunk and face and has mild spastic diplegia, originally
      detected at the age of 1 year. Persistent telangiectasia is now a recognized
      feature of neonatal lupus erythematosus. The pathogenesis of the neurological
      deficit is uncertain.

PMID- 8348726
TI  - Atypical Nekam's disease--keratosis lichenoides chronica associated with
      porokeratotic histology and amyloidosis.
AB  - A patient with atypical Nekam's disease is described. Although the histological
      appearances were lichenoid, the presence of porokeratosis and amyloid deposition,
      previously reported in this condition, argue against the view that Nekam's
      disease is a subset of lichen planus.

PMID- 8348727
TI  - Waldenstrom's macroglobulinaemia presenting with cold urticaria and cold purpura.
AB  - A case of Waldenstrom's macroglobulinaemia presenting with non-specific
      dermatological symptoms (cold urticaria and cold purpura) is described in a 37
      year-old female patient. Progressive telangiectasia and spider naevi were also
      observed. Involvement of the skin may be explained by the presence of
      macroglobulins with cryoprotein-like qualities. This facilitated an early
      diagnosis.

PMID- 8348728
TI  - Benign cephalic histiocytosis--study of a case.
AB  - Benign cephalic histiocytosis is a rare, benign, self-healing form of non-X
      histiocytosis. A case in a 3-month-old girl is reported. The papular eruption
      involved her face, neck, shoulders and upper trunk. Light and electron
      microscopic findings and clinical evolution confirmed the diagnosis. The
      differential diagnosis with the micronodular form of juvenile xanthogranuloma is
      discussed.

PMID- 8348729
TI  - Familial erythromelanosis follicularis faciei et colli--an autosomal recessive
      mode of inheritance.
AB  - Two cases of erythromelanosis follicularis faciei et colli in one family,
      affecting a brother and sister are described. In these cases erythromelanosis
      follicularis faciei et colli, a process of unknown aetiology, seems to have a
      clear hereditary component--autosomal recessive mode of inheritance--a feature
      which, as far as we know, has not been reported in the literature.

PMID- 8348730
TI  - Secondary localized cutaneous amyloid in Bowen's disease.
AB  - A case of Bowen's disease is described in which striking quantities of amyloid
      were detected in the papillary dermis visualized easily by routine haematoxylin
      and eosin staining. The material showed positive labelling with an antikeratin
      monoclonal antibody consistent with the proposed origin of the amyloid as
      degenerate keratinocytes. The pathobiology of amyloid associated with dysplastic
      squamous lesions is discussed.

PMID- 8348731
TI  - Milia cysts along the nasal groove in a child.
AB  - The occurrence of transverse linear milia cysts over the dorsum of the nose in an
      11-year-old girl is described. Two younger sisters of the proband had a
      conspicuous nasal groove at the same site without milia. The anatomical basis and
      the pathogenesis of the so-called 'transverse nasal crease' are reviewed.

PMID- 8348732
TI  - Bedding and eczema.

PMID- 8348734
TI  - Oral retinoids to treat black hairy tongue.

PMID- 8348733
TI  - How to reduce the discomfort caused by local anaesthetics.

PMID- 8348735
TI  - Phototoxicity at unusual sites during photochemotherapy.

PMID- 8348736
TI  - Bullous pemphigoid-like scabies.

PMID- 8348737
TI  - Twenty-nail dystrophy due to lichen planus in a patient with alopecia areata.

PMID- 8348738
TI  - Pitfalls in the measurement of soluble forms of cell surface receptors.

PMID- 8348739
TI  - Elevated serum levels of IL-8 in patients with HIV infection.
AB  - Serum levels of IL-8 were determined in HIV-infected individuals and the results
      were compared with those for HIV- controls. The IL-8 levels were measured by an
      ELISA with a MoAb and a polyclonal antibody to recombinant IL-8. The means and
      95% confidence intervals of IL-8 in sera of 36 HIV-infected individuals and 32
      matched controls were 275 and 216-349 pg/ml, and 8 and 4-14 pg/ml, respectively,
      showing a 34-fold increase in IL-8 in the circulation of HIV-infected
      individuals. This increase does not appear to be related to the disease state,
      infection or systemic medical agents. This finding suggests the possible
      involvement of IL-8 in the pathogenesis of HIV-induced disease.

PMID- 8348740
TI  - The acquisition of anti-pneumococcal capsular polysaccharide Haemophilus
      influenzae type b and tetanus toxoid antibodies, with age, in the UK.
AB  - Antibody levels specific for capsular polysaccharides of Streptococcus pneumoniae
      and Haemophilus influenzae type b (Hib) and to tetanus toxoid (TT), were measured
      in serum samples of 750 age-stratified subjects from the UK. The study subjects
      comprised healthy adult volunteers and hospitalized children undergoing elective
      surgery, excluding those with a history of infection or under investigation for
      immunological or haematological disorders. These antibody levels were calibrated
      by comparison with serum pool obtained from healthy adult volunteers, who were
      immunized with Hib polyribose-phosphate vaccine (Merieux). The data are intended
      to provide reference ranges to assist in the interpretation of specific antibody
      measurements in the clinical setting. Maternal IgG pneumococcal capsular
      polysaccharide (PCP) specific antibody levels, geometric-mean titre (GMT) 1/22,
      were lost by 6 months of age (GMT of 1/9). They remained low until 3-5 years (GMT
      of 1/20), and consisted principally of IgG1. Thereafter, IgG anti-PCP antibody
      titres increased steadily to adult levels (GMT of 1/275), of which 80% was IgG2.
      Anti-PCP antibody titres of the IgM isotype rose steadily from a GMT 1/21 (0-6
      months) to 1/420 (3-5 years), a level which was maintained until adulthood. Anti
      Hib antibody concentrations, determined by RABA, again demonstrated the decline
      in maternal antibody, from 0.18 micrograms/ml in the 0-6 month age cohort, to
      0.09 microgram/ml between 6 and 12 months. Geometric-mean antibody concentrations
      remained below 0.2 micrograms/ml until 3-5 years, then increased with age,
      attaining the mean adult level of 1.02 micrograms/ml. Anti-TT antibody
      concentrations were measured in the same sera, by ELISA. Two peaks in anti-TT
      antibody levels were seen in children of 0.059 IU/ml and 0.166 IU/ml
      corresponding to the schedule of routine childhood immunization in the first year
      and at 5 years of age.

PMID- 8348741
TI  - Treatment of murine macrophages with murine interferon-gamma and tumour necrosis
      factor-alpha enhances uptake and intracellular killing of Pseudomonas aeruginosa.
AB  - Murine interferon-gamma (MuIFN-gamma) and murine tumour necrosis-alpha (MuTNF
      alpha) are known to be potent immunomodulators of several aspects of the immune
      response, and they have been shown to exert profound effects on macrophages and
      monocytes. The purpose of this study was to determine the effects of MuIFN-gamma
      and MuTNF-alpha on the phagocytosis (uptake and intracellular killing) of
      opsonized Pseudomonas aeruginosa. Unstimulated peritoneal macrophages obtained
      from CBA/c mice were exposed to different concentrations of recombinant forms of
      the cytokines (rMuIFN-gamma and rMuTNF-alpha) for different periods of time.
      Phagocytosis was assayed using different concentrations of opsonized Ps.
      aeruginosa. In all cases the pretreatment of the cells with the cytokines
      increased significantly the uptake and the intracellular killing of bacteria in a
      dose-dependent manner. rMuTNF-alpha was effective only at 1000 U/ml. Combined
      treatment with the cytokines showed a less than additive effect with rMuIFN-gamma
      and rMuTNF-alpha at concentrations of 10 U/ml and 100 U/ml. In the in vivo
      experiments, peritoneal macrophages obtained from rMuIFN-gamma- or rMuTNF-alpha
      treated mice showed enhancement of the intracellular killing of opsonized
      bacteria in a dose-dependent manner.

PMID- 8348742
TI  - Elevation of heat shock protein synthesis and hsp gene transcription during
      monocyte to macrophage differentiation of U937 cells.
AB  - During the phorbol myristate acetate (PMA)-induced differentiation of U937 cells
      to a macrophage-like phenotype, the levels of the heat shock proteins hsp90,
      hsp72 and hsp65 increased dramatically to a peak level following 24 h of
      treatment, and then declined. In contrast, no significant increase was observed
      in the level of the constitutive hsp73 protein in this process. The observed
      increases in hsp levels were preceded by an increase in the transcription of each
      of the genes encoding these hsps, including both of the two genes which encode
      hsp90. The mechanism of this effect and the possible role of the hsps in the
      function of differentiated macrophages and in the differentiation process are
      discussed.

PMID- 8348743
TI  - Tumour necrosis factor production in vivo and in vitro in response to
      Paracoccidioides brasiliensis and the cell wall fractions thereof.
AB  - Tumour necrosis factor (TNF) was detected in serum from mice challenged with
      Paracoccidioides brasiliensis. The serum TNF levels of mice challenged with an
      avirulent strain were significantly higher than those of mice challenged with a
      virulent strain, and the same was observed for the TNF levels of mice challenged
      with a cell wall fraction (F1) from the two fungal strains. Fraction F1 consisted
      of chitin and beta-glucan; but although the chitin contents were similar for the
      two strains, the avirulent strain allowed a greater content of beta-glucan. The
      beta-glucan, purified from both strains, increased serum TNF levels in an
      identical dose-dependent manner, whereas purified chitin did not induce serum TNF
      levels. P. brasiliensis, the F1 fractions and beta-glucan induced macrophages to
      secrete TNF in vitro. The differences in TNF levels, induced by the different
      fungal strains, were correlated with the beta-glucan concentrations in the cell
      walls of both the avirulent and virulent strains of P. brasiliensis. These
      findings support a role for TNF in the pathogenicity of P. brasiliensis.

PMID- 8348744
TI  - Determination of soluble CD21 as a parameter of B cell activation.
AB  - In this study we established a novel solid-phase immunoassay for CD21 using the
      time-resolved fluorescence of lanthanide chelates. The capture assay was able to
      detect concentrations of as low as 100 pg of CD21 antigen per millilitre of
      sample and was used for quantitative determination of CD21 in lysates of
      different cell lines as well as in patient serum specimens. CD21 was measured in
      lysates of tonsils and cell lines of B, T cell and myelomonocyte lineage, and
      appeared to consist of monomeric antigen under the detergent conditions used.
      Elevated levels of soluble CD21 were observed in serum of patients with Epstein
      Barr virus (EBV) infection, a disease known to be associated with polyclonal B
      cell activation, and in infection with the lymphotropic rubella virus.
      Significantly increased levels were also found in malignancies which are
      associated with EBV. In patients with nasopharyngeal carcinoma (NPC), a
      correlation with the titre of EBV-specific IgA was observed, thus supporting a
      possible role of soluble CD21 as a marker for disease activity in certain
      malignancies. Our data suggest that measurement of soluble CD21 could serve as a
      marker for activation of the immune system and diseases involving the B cell
      lymphoid system. Possible mechanisms and functions of soluble CD21 are discussed.

PMID- 8348745
TI  - Production of IL-1 and IL-1 receptor antagonist and the pathological significance
      in lipopolysaccharide-induced arthritis in rabbits.
AB  - Injection of lipopolysaccharide (LPS) into rabbit knee joints provoked leucocyte
      infiltration and loss of proteoglycan (PG) from the cartilage. We investigated
      the role of IL-1 and IL-1 receptor antagonist (IL-1Ra) and its significance in
      the pathogenesis of LPS-arthritis. Production of IL-1 beta peaked at 6 h (196.7
      +/- 89.4 pg/joint) after injection of 10 ng of LPS, while IL-1Ra peaked at 9 h
      (34.5 +/- 13.4 ng/joint). The amount of IL-1Ra was 180-200-fold molar excess of
      IL-1, and a large amount of IL-1Ra was sustained for 1 week. Both IL-1 beta and
      IL-1Ra were mainly produced by synovial exudate cells. Arthritis was reproduced
      by rabbit IL-1 beta. LPS-induced leucocyte infiltration was inhibited 70-75% by
      rabbit IL-1Ra. Loss of PG in LPS-arthritis was prevented by IL-1Ra and also by
      neutrophil elastase inhibitor, and superoxide dismutase. In leucopenic rabbits,
      injection of LPS induced neither production of IL-1 beta nor loss of PG. Direct
      injection of inflammatory exudated cells in leucopenic rabbits reproduced loss of
      PG, and there was only a partial recovery by IL-1Ra. These results suggest that
      LPS-initiated IL-1 acts as a key mediator in LPS-arthritis and that endogenous IL
      1Ra may suppress a part of IL-1 activity at the site, but its amount was too low
      for suppression of the produced IL-1. Loss of PG is a sequela of infiltrated
      leucocytes and leucocyte-derived elastase, and superoxide anion may play a
      pivotal role in the destruction of cartilage.

PMID- 8348747
TI  - Early induction of IL-1 receptor antagonist (IL-1Ra) in infants and children
      undergoing surgery.
AB  - The cytokine response to injury or trauma is of interest in terms of both its
      mediation of the acute phase response and its possible relation to the
      immunological depression observed after major surgery. In this study, the
      production of cytokines IL-1 beta, tumour necrosis factor-alpha (TNF-alpha), IL-6
      and the naturally occurring inhibitor of IL-1, IL-1Ra, have been investigated in
      infants and children undergoing Swenson's pull-through operation for
      Hirschsprung's disease. Samples of peripheral blood were taken before, during and
      after surgery for the measurement of cytokines. IL-1Ra levels increased
      significantly (P < 0.01) at 2 h after commencement of surgery, with maximal
      levels for individual patients being attained between 3 h and 5 h (range 7.6-67.9
      ng/ml). The mean level of IL-1Ra was maximal (26.2 ng/ml) at 5 h and returned to
      baseline levels between 24 h and 72 h. There were no changes observed in the
      circulating levels of IL-1 beta in nine out of 11 patients following commencement
      of surgery. TNF-alpha levels did not increase in any of the patients studied. IL
      6 levels increased significantly (P < 0.02) 3 h after commencement of surgery,
      reaching maximum concentrations at 24 h (range 20-670 pg/ml), with levels falling
      between 48 h and 72 h. This study demonstrates, in vivo, the independent
      induction of IL-1Ra without a concomitant increase of IL-1 beta levels after
      major surgery. It also shows that IL-1Ra is the earliest cytokine produced in
      response to surgical stress.

PMID- 8348746
TI  - IL-2 enhances polyclonal IgM but not IgM-rheumatoid factor synthesis by activated
      human peripheral blood B cells.
AB  - IgM-rheumatoid factor (RF) is thought to be involved in the pathogenesis of
      rheumatoid arthritis (RA). Several cytokines are known to regulate immunoglobulin
      synthesis. In this study the effects of IL-2 on polyclonal IgM and IgM RF
      synthesis were compared. Cytokines were added to peripheral blood B cells from
      normal subjects and patients with RA after activation by Staphylococcus aureus
      Cowan 1 (SAC). The addition of IL-2, but not IL-4 or IL-6, resulted in
      significant enhancement of IgM synthesis in cultures from both healthy subjects
      and patients with RA. Similar degrees of enhancement were seen in both peripheral
      blood mononuclear cell and highly purified B cell cultures. IgM-RF was
      synthesized after activation in cultures from healthy subjects and spontaneously
      in cultures from RA patients. In contrast to polyclonal IgM synthesis, IL-2
      failed to augment IgM-RF synthesis in cell cultures from either healthy subjects
      or RA patients. This study demonstrates different effects of IL-2 on IgM and IgM
      RF synthesis.

PMID- 8348748
TI  - Immunohistochemical detection of co-localizing cytokine and antibody producing
      cells in the extrafollicular area of human palatine tonsils.
AB  - In vitro experiments have documented the role of cytokines in the regulation of
      the human humoral immune response. Which cytokines are operative in vivo and in
      which lymphoid compartment interactions between cytokine-producing T cells and
      antibody-forming B cells occur is still unclear. For that reason we studied human
      tonsils using immunohistochemical techniques. In tissue sections from tonsils in
      a resting stage after recurrent tonsillitis we observed cells producing IL-1
      alpha and tumour necrosis factor-alpha (TNF-alpha) which were exclusively
      localized in the mantle zone of the follicle and in the extrafollicular area.
      Furthermore, a high frequency of interferon-gamma (IFN-gamma)-producing cells was
      detected in the extrafollicular area, but not inside the follicles. Occasional IL
      2- and IL-4-producing cells were found in the extrafollicular area.
      Immunohistochemical detection of antibody isotypes revealed that B cells, IgM
      membrane-positive, were localized inside the follicles and mantle zones, whereas
      IgD-membrane-positive cells were mainly found in the mantle zones of secondary
      follicles. In contrast, plasma cells producing IgG1-4 and IgA1-2 were found in
      the extrafollicular area. No IgD and IgE antibody-forming cells were detected in
      tonsils, whereas IgM antibody-forming cells were detected in the extrafollicular
      area. The co-localization of cytokine-producing cells and antibody-forming cells
      in human tonsil suggests that T-B cell interactions, required for B cell
      differentiation and isotype switching, take place in the extrafollicular area.

PMID- 8348749
TI  - Effects of tumour necrosis factor-alpha (TNF-alpha), IL-1 beta and monocytes on
      lymphokine-activated killer (LAK) induction from natural killer (NK) cells and T
      lymphocytes.
AB  - Roles of monocytes and cytokines were investigated on LAK induction from T and NK
      cells. Monocytes augmented more T-LAK induction than did NK-LAK. Expression of IL
      1 beta, TNF-alpha and interferon-gamma (IFN-gamma)-mRNA and their cytokine
      production were superior in NK cells compared with T cells in parallel with their
      LAK activities. An increase of TNF-alpha, IL-1 beta and IFN-gamma production was
      induced by co-culturing NK or T cells with autologous monocytes. The augmentation
      of T cell cytokine production and T-LAK activity by monocytes was more prominent
      than that of NK cells. TNF-alpha and IL-1 beta were generated 24 h after IL-2
      stimulation, and these cytokines were able to almost substitute for monocytes in
      LAK induction. Conversely, LAK induction was almost completely suppressed by both
      anti-IL-1 beta and anti-TNF-alpha antibodies, if they were added within 24 h
      after the start of the LAK induction. IFN-gamma, which was produced at a later
      stage, scarcely affected LAK induction in spite of the cooperation with TNF
      alpha. The results obtained indicate conclusively that the superiority of NK-LAK
      depends on their superior productivity of both IL-1 beta and TNF-alpha, and that
      the up-regulation of LAK induction by monocytes is largely due to the enhanced
      generation of both cytokines.

PMID- 8348750
TI  - Clustering of neutrophil leucocytes in serum: possible role of C1q-containing
      immune complexes.
AB  - Clustering activity for neutrophil granulocytes was generated in pooled normal
      human serum (NHS) by incubation of the serum with preformed IgG aggregates, but
      not in heat-treated NHS (56 degrees C, 30 min), indicating that the function was
      complement-dependent. Judging from results of experiments with complement
      deficient sera, and serum depleted of C1q, factor D and properdin, recruitment of
      the complement system beyond C1 was not required for induction of the activity.
      Zymosan treatment of NHS resulted in some neutrophil clustering activity, but
      recombinant C5a had a limited effect. C1q added to heat-treated NHS in
      conjunction with performed IgG aggregates supported neutrophil clustering in a
      dose-dependent manner. The serum C1q inhibitor, a chondroitin 4-sulphate
      proteoglycan known to interact with the collagenous part of C1q, clearly reduced
      neutrophil clustering in heat-treated NHS supplemented with C1q and IgG
      aggregates. The C1q inhibitor also reduced the inherent neutrophil clustering
      activity of some sera from patients with systemic lupus erythematosus (SLE).
      Neutrophil clustering activity in SLE serum was earlier shown to be inversely
      related to the number of circulating neutrophils in vivo. Although the precise
      mechanisms remain unclear, we propose that C1q-containing immunoglobulin
      complexes mediate neutrophil clustering through C1q receptors, and that this
      might contribute to pathogenesis of immune complex diseases such as SLE.

PMID- 8348751
TI  - Elevated complement activities of sera from patients with high density
      lipoprotein deficiency (Tangier disease): the presence of normal level of
      clusterin and the possible implication in the atherosclerosis.
AB  - Clusterin (apolipoprotein J, SP-40,40), as well as apolipoprotein A-I (apo A-I)
      and apolipoprotein A-II (apo A-II), are apolipoprotein components of high density
      lipoprotein (HDL), but not of low density lipoprotein. In spite of the
      deficiencies of apo A-I, apo A-II and HDL in the sera of patients with Tangier
      disease, clusterin was found in them at normal level. While clusterin was present
      as the component of HDL with apo A-I in sera of normal donors, it was present as
      a protein which did not form a complex in sera of Tangier patients. SC5b-9 made
      from the sera of Tangier patients contained normal amounts of clusterin and was
      deficient in apo A-I, indicating that clusterin could be incorporated into the
      SC5b-9 complex without apo A-I. The complement activities of the sera of the
      patients were higher than those of normal donors. These results may be explained
      by the deficiencies of apo A-I, apo A-II and HDL in the patients, because they
      were suggested to be the inhibitors of the reactive haemolysis of complement. The
      elevated complement activities of the patients might be related to the severe
      atherosclerotic lesions in Tangier disease.

PMID- 8348752
TI  - Trichosanthin, an initiator of the alternative complement activation pathway.
AB  - Trichosanthin (TCS), a protein purified from the plant Trichosanthes Kirilowii
      Maxim, activates normal human serum complement via the alternative pathway, as
      shown by TCS-induced C3 conversion in normal serum and its prevention by
      depletion of factor B, but not with the addition of EGTA. Injection of TCS to
      BALB/c mice consumed the complement alternative pathway (APC) activity in serum,
      implying in vivo activation of the alternative pathway by TCS. Elevation of
      peripheral blood leucocyte count as well as protein exudation and neutrophil
      accumulation in the peritoneal cavities could be induced by peritoneal injection
      of TCS. The main effect of complement activation by TCS was demonstrated to be
      induction of neutrophil accumulation.

PMID- 8348753
TI  - Antimitochondrial autoantibodies in anti-glomerular basement membrane disease.
AB  - Anti-glomerular basement membrane (GBM) disease is characterized by the
      production of an autoantibody with very restricted specificity, with no evidence
      of polyclonal B cell activation. It was therefore surprising to find that in a
      solid-phase ELISA a proportion of anti-GBM sera showed significant binding to
      pyruvate dehydrogenase (PDH), a reactivity usually associated with the
      antimitochondrial autoantibodies (AMA) found in primary biliary cirrhosis (PBC).
      The specificity of this reactivity was confirmed by inhibition and competition
      experiments. The AMA found in anti-GBM sera were of much lower affinity than
      those found in PBC sera, and recognized a more restricted set of species (mainly
      the 55-kD and occasionally the 74-kD component of PDH). However, it was possible
      to block the binding in a Western blot of an anti-GBM serum to both the 55-kD and
      74-kD species with F(ab')2 fragments prepared from a PBC serum. Although AMA have
      been found in diseases other than PBC, such diseases have usually been
      characterized by polyclonal B cell activation. The stimulus to the production of
      AMA in anti-GBM disease, and their significance in pathogenesis (if any), are
      unknown.

PMID- 8348754
TI  - Inhibitor(s) of natural anti-cardiolipin autoantibodies.
AB  - IgG fractions were purified on Sepharose anti-human IgG column from eight sera of
      healthy donors, having no anti-cardiolipin (aCL) activity as measured by anti
      cardiolipin ELISA assay (aCL-ELISA). All the IgG fractions, after elution with
      4.9 M MgCl2, reacted with CL. The antigen-binding characteristics of the IgG
      fractions purified from normal human serum (NHS) were similar to those of IgG
      fractions purified from sera of four patients with the anti-phospholipid syndrome
      (APLS). Competition assay confirmed the specificity of the binding of the
      purified IgG fractions to CL. The same results have been achieved with IgG
      fractions purified on Sepharose Protein-A column. The binding to CL was
      completely inhibited by either whole NHS and sera from various animal species, or
      by beta 2-glycoprotein I (beta 2-GPI). Our results support the notion of the
      existence of both natural anti-CL antibodies and serum inhibitor(s) in sera of
      healthy individuals. It is conceivable that in part the pathogenesis of APLS
      entails defects in the natural inhibitors of aCL antibodies.

PMID- 8348755
TI  - Induction of phospholipid-binding antibodies in mice and rabbits by immunization
      with human beta 2 glycoprotein 1 or anticardiolipin antibodies alone.
AB  - Anticardiolipin (aCL) antibodies are autoantibodies present in high
      concentrations in patients with the antiphospholipid syndrome (APS), a disorder
      of recurrent thrombosis and pregnancy loss. What induces aCL antibodies is
      uncertain, but a recent report suggested that immunization of mice with beta 2
      glycoprotein 1 (beta 2 GP1) in Freund's complete adjuvant (FCA) resulted in aCL
      antibody production in the recipient mice. Since this observation might explain
      how autoantibodies might be induced by poor immunogens, such as phospholipids, we
      decided to explore the question further. In our first series of experiments, we
      found that aCL antibodies were induced in mice by beta 2GP1 mixed with adjuvants
      that did not contain lipids (Adju-Prime or aluminium hydroxide). This excluded
      the possibility that antibody induction occurred because beta 2GP1 formed
      complexes with lipids in FCA. We also found that aCL antibodies always appeared
      before anti-beta 2GP1 antibodies, excluding the possibility that aCL antibodies
      were directed to beta 2GP1 or were induced by formation of anti-idiotypic
      antibodies (to anti-beta 2GP1). In experiments, we found that immunization of
      mice with human IgG antibodies from patients with the APS (IgG-APS), also induced
      aCL antibodies. Immunization with pure bovine serum albumin (BSA) did not induce
      aCL antibodies. We propose that aCL antibodies are induced by proteins with high
      avidity for phospholipids. These proteins may be bound to phospholipids when
      introduced, or may bind circulating phospholipids, so transforming phospholipid
      molecules into immunogens. Similar mechanisms might explain autoantibody
      induction to other poor immunogens.

PMID- 8348756
TI  - Protection of islet cells from inflammatory cell death in vitro.
AB  - Islet cells cocultured with activated macrophages are lysed within 15 h in vitro.
      We showed previously that nitric oxide generated by macrophages is a major
      mediator of islet cell death. We have now probed several pathways to interfere
      with the chain of events leading to islet cell death. Scavenging of extracellular
      oxygen radicals by superoxide dismutase and catalase did not improve islet cell
      survival. Scavenging of extra- and intracellular oxygen radicals by two potent
      substances, citiolone and dimethyl-thiourea, also did not reduce islet cell
      lysis, while a lipid-soluble scavenger, probucol, provided partial protection.
      These findings argue against a synergistic action of nitric oxide and oxygen
      radicals in islet cell toxicity. The inhibition of poly(ADP-ribose)polymerase by
      3-aminobenzamide significantly improved islet cell survival. Selective inhibitors
      of cyclooxygenase, such as indomethacin or acetylsalicylic acid, did not improve
      islet cell survival. Full protection was seen in the presence of NDGA, an
      inhibitor of lipoxygenase, and partial suppression was caused by BW755c, an
      inhibitor of both lipoxygenase and cyclooxygenase. We conclude that inflammatory
      islet cell death caused by activated macrophages involves the activation of
      arachidonic acid metabolism and of poly(ADP-ribose)polymerase, but that
      scavenging of oxygen free radicals provides little protection from lysis.

PMID- 8348758
TI  - Anatomy, histology, and pathology of the cardiac conduction system--Part III.

PMID- 8348759
TI  - Percutaneous mitral balloon valvotomy in a patient with coexistent mitral
      stenosis and hypertrophic cardiomyopathy.

PMID- 8348757
TI  - Surface expression of adenosine deaminase in mitogen-stimulated lymphocytes.
AB  - Adenosine deaminase (ADA) expression on the surface of mitogen-stimulated
      lymphocytes was studied by flow cytometry. The gate for lymphocytes was located
      by cell size (forward scatter), cytoplasmic complexity (side scatter) and by
      expression of the markers CD2, CD4, CD8 and CD19. After mitogenic proliferation
      two populations appeared, one corresponding to non-stimulated cells, and the
      other consisting of larger cells which showed relatively high expression of
      adenosine deaminase on their surface. The increase was similar to that observed
      for CD71 expression, and paralleled the increase in 3H-thymidine incorporation.
      There was a correlation between ADA and CD71 expression (r = 0.92 for
      phytohaemagglutinin (PHA) and 0.97 for pokeweed mitogen (PWM)). These results
      suggest a role for ecto-adenosine deaminase in lymphocyte proliferation and/or
      triggering.

PMID- 8348760
TI  - Stroke and atrial fibrillation: to anticoagulate or not.
AB  - After reviewing these published studies, I think one can conclude that in the
      patient population with chronic and/or paroxysmal atrial fibrillation, warfarin
      is beneficial and the benefits outweigh the risks. However, it is important to
      point out that patients at high risk for embolic disease, for example, dilated
      cardiomyopathy patients, were rarely included in these trials. The five trials
      mentioned above do not address this patient population. Current opinion is that
      these individuals should receive anticoagulation despite the lack of objective
      evidence that anticoagulation is beneficial if the risk of bleeding is not
      excessive. The five trials also do not address the population of patients
      categorized as having "lone atrial fibrillation," that is, atrial fibrillation
      occurring in patients with no structural heart disease. The general consensus in
      the low embolic risk patient, (i.e., the patient < 60 years of age who has lone
      atrial fibrillation) is that the risk of anticoagulation is greater than the
      benefit. My final thought on the subject concerns the risk of pulmonary emboli in
      this patient population. My guess is that this group of patients is at high risk
      for small pulmonary emboli, which in many instances may be subclinical--for
      example, clots too small to result in persistent tachypnea or tachycardia. As far
      as I can tell, there are no randomized trials on the prevention of pulmonary
      emboli in patients with chronic or paroxysmal atrial fibrillation using
      anticoagulation or aspirin. I guess the systemic emboli trial data are sufficient
      to indicate a protective effect on the lungs as well as on the brain.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8348761
TI  - The noninvasive assessment of myocardial viability.
AB  - The major objective of noninvasive imaging for detection of myocardial viability
      is to assist in the improved selection of patients with coronary artery disease
      and severe left ventricular dysfunction who would benefit most from
      revascularization. The techniques most commonly used to identify viable
      myocardium are thallium-201 (201Tl) scintigraphy, positron emission tomography
      (PET) using a flow tracer in combination with a metabolic tracer, technetium-99m
      (99mTc) sestamibi imaging, and dobutamine echocardiography. On stress 201Tl
      scintigraphy, asynergic regions showing normal thallium uptake, an initial defect
      with delayed redistribution at 3-4 h, late redistribution at 24 h, or defect
      reversibility after reinjection of a second dose of 201Tl at rest all suggest
      preserved viability. The greater the final uptake of 201Tl in areas of regional
      myocardial dysfunction preoperatively, the greater the improvement in ejection
      fraction after coronary revascularization. Demonstration of uptake of fluoro-18
      deoxyglucose (FDG) in regions of diminished blood flow on PET imaging also
      correlates well with improved systolic function after revascularization. 99mTc
      sestamibi may also be useful for assessment of myocardial viability, particularly
      after thrombolytic therapy for acute myocardial infarction. Dobutamine
      echocardiography has good positive predictive value for viability determination,
      but absence of systolic thickening in an akinetic zone in response to intravenous
      infusion of the drug may still be associated with viable myocardium in 25-50% of
      segments. Of all the techniques cited above, quantitative resting 201Tl
      scintigraphy may be the best approach for distinguishing between viable and
      irreversibly injured myocardium.

PMID- 8348762
TI  - Comparison between diurnal distribution of onset of infarction in patients with
      acute myocardial infarction and circadian variation of blood pressure in patients
      with coronary artery disease.
AB  - We analyzed the diurnal distribution of the onset of infarction in 636 patients
      with acute myocardial infarction (MI) and compared it with the circadian
      variation of blood pressure in 57 patients with coronary artery disease (CAD). In
      addition, we studied the modification of the circadian blood pressure variation
      during treatment with antianginal medications in 20 patients with CAD. A marked
      diurnal periodicity (p < 0.05) was observed for the onset of MI, with peaks seen
      in the late morning, late evening, and very early morning. The blood pressure in
      the patients with CAD was elevated in the morning, reduced in the late evening,
      and was the lowest in the very early morning. The peaks of onset of infarction
      temporally corresponded to the characteristic feature of blood pressure profile
      observed in the patients with CAD, that is, the morning rise, the late evening
      decline, and the very early morning reduction. Antianginal medications
      significantly reduced the blood pressure, not only during the day (p < 0.02) but
      also at night (p < 0.05). These observations suggest that the decline in blood
      pressure, as well as the morning surge in blood pressure, may be closely related
      to the onset of MI. Therefore, when treating patients with CAD with antianginal
      medications which can potentially reduce blood pressure, the effects on the
      circadian variation of blood pressure should be considered.

PMID- 8348763
TI  - Plasma level changes of fibrinopeptide A after uncomplicated coronary
      angioplasty.
AB  - Fibrinopeptide A (FPA) is a small polypeptide cleaved from fibrinogen by
      thrombin, has a short half-life, and is considered a sensitive biochemical marker
      of thrombin activity, fibrin generation, and ongoing thrombosis. Increased plasma
      levels of FPA have been reported in various procoagulable and thrombotic medical
      and cardiovascular disorders, including acute myocardial infarction, unstable
      angina, and sudden cardiac death. However, activation of thrombosis by the
      arterial injury incurred during coronary angioplasty has not been systematically
      examined with use of plasma FPA measurements. To detect and monitor activation of
      thrombosis by coronary angioplasty, plasma levels of FPA were obtained by
      venipuncture and measured by radioimmunoassay before, immediately after, 24 to 48
      h later, and 1 and 3 months after uncomplicated coronary angioplasty. From
      December 1990 through June 1991, FPA was measured in 30 patients (28 men and 2
      women, aged 54 +/- 9 years) with coronary artery disease who were undergoing
      coronary angioplasty. The mean left ventricular ejection fraction was 55 +/- 7%.
      The dilated vessel was the left anterior descending coronary artery in 20
      patients (together with a second vessel in 2), the right coronary artery in 9,
      and the left circumflex in 1. The procedure was successful and free of major
      complications in all patients. Before angioplasty the FPA levels averaged 6.50 +/
      1.18 ng/ml. Shortly after angioplasty they rose to 20.20 +/- 7.91 ng/ml (p =
      0.08) despite intravenous heparin. At 24 to 48 h and after heparin had been
      discontinued for at least 4 h, the mean FPA levels were significantly higher
      (32.33 +/- 10.86 ng/ml) compared with baseline values (p = 0.025).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8348764
TI  - Plasma brain natriuretic peptide and atrial natriuretic peptide concentrations
      correlate with left ventricular end-diastolic pressure.
AB  - The present study was designed to investigate whether brain natriuretic peptide
      (BNP) and atrial natriuretic peptide (ANP) plasma concentrations correlate with
      left ventricular end-diastolic pressure (LVEDP), pulmonary capillary wedge
      pressure (PCWP), diastolic pulmonary arterial pressure (DPAP), right atrial
      pressure (RAP), or ejection fraction (EF). Plasma BNP and ANP levels were
      determined by commercial radioimmunoassays (Peninsula) after Sep Pak C18
      extraction in blood samples withdrawn from the pulmonary artery and the left
      ventricle or from the left ventricle and the femoral vein in 85 patients
      undergoing diagnostic cardiac catheterization. Linear and nonlinear regression
      analysis and the paired sample t-test were applied to the data. Pulmonary
      arterial plasma BNP and ANP levels showed a close nonlinear correlation with
      LVEDP (BNP: r = 0.94, p < 0.001; ANP: r = 0.81, p < 0.001), a significant linear
      correlation with PCWP, DPAP, and RAP, and a significant negative correlation with
      EF. ANP concentrations decreased significantly from the pulmonary artery to the
      left ventricle and from the left ventricle to the femoral vein (p < 0.001). BNP
      levels also decreased significantly between the left ventricle and the femoral
      vein (p < 0.001), but there was no significant difference between pulmonary
      arterial and left ventricular BNP concentrations. BNP and ANP concentrations
      correlated significantly between pulmonary arterial and left ventricular blood
      samples (BNP: r = 0.99, ANP: r = 0.93, p < 0.001) and between left ventricular
      and peripheral blood samples (BNP: r = 0.99, ANP: r = 0.94, p < 0.001). The
      present data suggest that peripheral plasma BNP and ANP levels are useful non
      invasive indices of cardiac performance.

PMID- 8348765
TI  - Prognosis in diabetics in whom the initial suspicion of acute myocardial
      infarction was not confirmed.
AB  - For 2,058 consecutive patients hospitalized for suspected acute myocardial
      infarction (AMI) but in whom AMI was later ruled out, we describe the prognosis
      with particular emphasis on diabetics. In all, a previous history of diabetes
      mellitus occurred in 290 (14%) of the patients. Compared with nondiabetics, they
      had a longer delay time between onset of symptoms and arrival in hospital. During
      1 year of follow-up, their mortality rate was 28% compared with 14% for
      nondiabetics (p < 0.001), and their reinfarction rate was 20% compared with 10%
      for nondiabetics. More diabetics died in association with a fatal myocardial
      infarction and more frequently had ventricular fibrillation preceding death. With
      the exception of reinfarction, no clear difference in terms of morbidity was
      observed between the two groups. We conclude that the prognosis in diabetics in
      whom AMI is ruled out is poor, with between one-quarter and one-third not
      surviving 1 year.

PMID- 8348766
TI  - Anatomy, histology, and pathology of the cardiac conduction system--Part V.
AB  - Although morphologic findings in many of the cardiac arrhythmias of acute and
      chronic disease have been elusive, the correlates of heart block (particularly
      atrioventricular block) are abundant. Pathologic features of sinoatrial,
      atrioventricular, and bundle-branch block are reviewed. Lev and Lenegre diseases
      (idiopathic bilateral bundle-branch fibrosis) are also reviewed.

PMID- 8348767
TI  - Anomalous inferior vena cava mimicking aortic dissection on transesophageal
      echocardiography.
AB  - Transesophageal echocardiography (TEE) is considered an excellent method for the
      diagnosis of aortic dissection, especially that involving the descending aorta.
      It has also proved useful in the evaluation of conditions mimicking aortic
      dissection, usually disclosing in these situations other types of severe aortic
      disease. We are not aware of any report dealing with venous abnormalities which
      presented diagnostic problems in a patient evaluated with TEE because of a
      suspected aortic dissection.

PMID- 8348768
TI  - Late rupture of left ventricular true aneurysm after acute myocardial infarction.
AB  - Left ventricular (LV) free wall rupture complicated with acute myocardial
      infarction (AMI) usually occurs in the early phase of AMI. True aneurysm of the
      LV is sometimes a complication of AMI but rarely ruptures. In our patient, a 72
      year-old woman, the LV free wall ruptured on Day 49 after the onset of AMI and
      the ruptured site was the thinnest wall of large true aneurysm of the LV. The
      large aneurysmal formation probably was due to corticosteroids used for
      pericarditis. More attention should be paid to late cardiac rupture and the use
      of corticosteroids.

PMID- 8348769
TI  - Richard Gorlin.

PMID- 8348770
TI  - Neuroscience of HIV infection: basic and clinical frontiers 1993. Vienna, June 2
      5, 1993. Abstracts.

PMID- 8348771
TI  - 29th annual meeting of the Italian Neuropathological Association. Verona, June 17
      19, 1993. Abstracts.

PMID- 8348773
TI  - Simultaneous analysis of cell surface antigens and DNA content by flow cytometry.
AB  - Cells obtained from the blood or bone marrow of patients with haematological
      malignancies can both be stained with fluorescent labelled monoclonal antibodies
      to determine an immunophenotype and permeabilized with 30% ethanol then stained
      with propidium iodide for simultaneous DNA analysis. In the technique described
      here, no evidence of selective depletion of the malignant cell population was
      demonstrated and decreases in the mean fluorescence intensity of the surface
      markers were insufficient to affect the sensitivity of flow cytometric analysis.
      The combined method is simple and robust enough to allow incorporation of DNA
      analysis into routine immunophenotyping of leukaemia and lymphoma cells.

PMID- 8348774
TI  - Use of a low pressure liquid chromatography system for haemoglobinopathy
      screening.
AB  - A closed low pressure liquid chromatography system (LPLC) is described which is
      suitable for haemoglobinopathy screening. The system (Glycomat) was originally
      developed for the quantitation of the glycated haemoglobin (HbA1). The same
      biochemical principles have been applied to the separation of haemoglobin A2
      (HbA2) and haemoglobin variants. The instrument offers three modes of use
      including a fast haemoglobin elution, a variant screen and a HbA2 assay for
      thalassaemia screening. The fast screen isolates all of the common haemoglobin
      variants except HbE which elutes with HbA. This mode is a more rapid alternative
      to the Sickledex test. The variant screen produces a wider separation of abnormal
      variants giving an identification and quantitation for each. The HbA2 assay
      separates this minor fraction from all other haemoglobins giving an accurate
      percentage. Abnormal variants are also separated. To validate the HbA2 assay 252
      samples were assayed by the cellulose acetate electrophoresis/elution method and
      LPLC with a correlation of 0.932. The system provides an accurate and sensitive
      alternative to traditional manual chromatography and electrophoresis methods. The
      automated sampler allows batches from 1-99 samples to be processed with
      significant savings in operator time.

PMID- 8348775
TI  - Bone marrow fibrosis: histomorphometric analysis and interobserver
      reproducibility of a simple optical method of assessing its intensity.
AB  - A histomorphometric analysis of the length of reticulin fibres per area of
      haemopoietic bone marrow was performed on 59 trephine iliac crest biopsies. The
      values obtained were found to correlate with the degree of fibrosis as determined
      by a simple optical method based on the degree of microscopic magnification
      required for recognition of the presence of reticulin fibres. The mean length of
      fibre (microns/10,000 micron2) for the three degrees of fibrosis defined by the
      optical method were: 241.8 +/- 16.6 for grade I, 713 +/- 85.6 for grade II, and
      1827.9 +/- 230.4 for grade III (P < 0.001). In a series of 67 biopsies, the
      overall interobserver agreement of the optical method was found to be good
      (Spearman's r = 0.99; P < 0.001) and there was good individual agreement for each
      of the three degrees of fibrosis (improved kappa test). There was a small amount
      of overlap between the extreme values of adjacent optical degrees. These results
      suggest that the optical method described here can be recommended as a practical
      technique for the routine evaluation of myelofibrosis.

PMID- 8348772
TI  - Comparative evaluation of three flow cytometers for reticulocyte enumeration.
AB  - Flow cytometric determination of reticulocytosis is progressively replacing the
      manual microscopic method. We evaluated three flow cytometers (Becton Dickinson
      FACScan, Coulter EPICS Profile II, Ortho Cytoron Absolute) for reticulocyte
      enumeration, using thiazole orange. For each sample, 30,000 cells were analysed.
      In order to comparatively evaluate the three instruments, reticulocytes were
      counted by manually gating the erythroid population and evaluating the gated
      population for fluorescence characteristics. The different instruments showed
      good linearity and precision. No carry-over was observed. Orthogonal regression
      analysis of reticulocyte counts of 100 healthy blood donor samples and 108
      haematological patient samples showed a good mutual comparability between all
      three instruments tested, although the paired t-test showed a significant
      difference between the Cytoron and both the FACScan and the Profile. Despite
      minor statistical differences, the three instruments can be considered equivalent
      for daily routine reticulocyte enumeration.

PMID- 8348776
TI  - Infectious mononucleosis complicated by haemolytic anaemia due to the Donath
      Landsteiner antibody and by severe neutropenia.
AB  - A young man developed infectious mononucleosis complicated by profound anaemia
      due to haemolysis. The Donath Landsteiner antibody was found in his serum. He was
      treated successfully by blood transfusion but subsequently developed severe
      neutropenia. Both complications have been reported previously but not in the same
      individual. No underlying immune deficiency could be identified.

PMID- 8348777
TI  - Multiple fungal infection in acute lymphoblastic leukaemia.

PMID- 8348778
TI  - Platelet cross matching.

PMID- 8348779
TI  - Severe thrombocytopenia in tuberculosis.

PMID- 8348780
TI  - Suppression of erythroid progenitor cells during malarial infection in Thai
      adults caused by serum inhibitor.
AB  - The bone marrows of 21 Thai adults infected with Plasmodium falciparum malaria
      were cultured for CFU-E and BFU-E by using AB serum, autologous serum
      (parasitaemia) and autologous serum (post-parasitaemia). Six patients had no
      complication and 15 patients had pulmonary, renal or haematologic complications.
      In the non-complicated cases, sera during parasitaemia did not suppress the post
      parasitaemia CFU-E and BFU-E. Post parasitaemia, there was suppression of CFU-E
      by parasitaemia sera. In the complicated cases, the autologous sera during
      parasitaemia suppressed the growth of both CFU-E and BFU-E both during and after
      parasitaemia (P < 0.05). The post-parasitaemia sera had neither a suppressive nor
      a stimulating effect. In the complicated cases, the progenitor cells cultured
      from the bone marrow post-parasitaemia were fewer in number than those cultured
      from the bone marrow during parasitaemia using the same sera. Two possible
      mechanisms of suppression are postulated, namely the reduction of erythropoietin
      or the increased tumour necrosis factor during malarial infection. Further
      studies to clarify this are being carried out.

PMID- 8348781
TI  - Alcohol induced burr cell (echinocytic) haemolytic anaemia and haemochromatosis.
AB  - A 51-year-old man with chronic alcoholic liver disease developed a severe
      haemolytic anaemia characterized by the presence of circulating burr-shaped cells
      (echinocytes). Several transfusions of packed red cells were ineffective in
      raising the haemoglobin concentration, showing that the abnormality was acquired
      by the transfused cells. Liver biopsies revealed haemochromatosis. Haematological
      parameters normalized four months after the patient stopped drinking alcohol, but
      burr cells were still present and erythrocyte life-span was still markedly
      shortened at one year follow-up. Since serum cholesterol, HDL-cholesterol, and
      Apo-AI and Apo-B lipoproteins were considerably decreased, the lipid composition
      of the red cell membrane was studied. Findings showed that echinocytosis occurred
      with no change in membrane cholesterol content, nor in cholesterol:phospholipid
      ratio, but with an alteration in the phosphatidylserine and phosphatidylinositol
      concentrations. While haemochromatosis was most likely the cause of the
      erythrocyte anomaly, alcohol intake was probably responsible for the acute onset
      of haemolytic anaemia with effects directly on the erythrocyte membrane as well
      as mediated by the progressive hepatic injury, with alterations in the plasma and
      successively in the intramembrane lipid composition.

PMID- 8348782
TI  - Should the drinking water of Truro, Nova Scotia, be fluoridated? Water
      fluoridation in the 1990s.
AB  - An epidemiological assessment of differences in caries and fluorosis prevalences
      between children in Truro (< 0.1 ppm) and Kentville (fluoridated at 1.1 ppm in
      1991), Nova Scotia, Canada, was completed in 1991. Out of a total of 429
      children, in grades 5 and 6, in the two towns in 1991, 219 (51%) were examined.
      Parents answered a self-administered questionnaire investigating the sources of
      drinking water used by the children since birth, residence history, use of
      fluoride supplements, dentifrices, and other fluoride products during the first 6
      yr of the life. The examination criteria differentiated between non-cavitated and
      cavitated carious lesions. Dental fluorosis was measured using the TSIF index.
      Examiner agreement was excellent. Of the children examined, 80 (36.5%) drank
      water (fluoridated or non-fluoridated) from municipal water systems during the
      first 6 yr of life. The children were assigned into five groups based upon
      residence history and exposure to fluoridated water during the first 6 yr of
      life. The percentage difference in mean DMFS scores between children in the
      fluoridated and non-fluoridated groups is 17% (delta DMFS1 = 0.7) when non
      cavitated carious lesions are included and 39% (delta DMFS2 = 1.1) when they are
      excluded. The differences are not statistically significant. The significant risk
      factors associated with the DMFS1 and DMFS2 scores identified by a stepwise
      multiple regression analysis are: education level of the father, gender, and
      number of years of reported use of toothpaste during the first 6 yr of life.
      Dental fluorosis (mainly TSIF score of 1) was present in 41.5% and 69.2% of the
      children in the non-fluoridated and fluoridated groups, respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8348783
TI  - Association between untreated caries and age, gender and dental attendance in
      adults.
AB  - The aim of the study was to examine the association between untreated caries on
      the crown and root of the tooth with the age, gender and dental attendance in a
      group of adult. Six general practitioners in the Greater Manchester area agreed
      to take part. Over a 6-week period they collected clinical and personal data on
      270 of their adult patients. No association was found between the mean number of
      coronal surfaces with caries and age; however, there was more root caries in
      people over 55 yr. More recurrent caries associated with a restoration was
      diagnosed than primary caries. There were proportionally more female than male
      regular attenders, and once attendance has been taken into account there were no
      gender differences for either coronal or root caries. Both coronal and root
      caries were associated with attendance, with irregular attenders experiencing
      more. Irregular attenders were three and a half times more likely to have caries
      on the root surfaces than regular attenders.

PMID- 8348784
TI  - Perceived need and use of oral health services among adolescents and adults in
      Tanzania.
AB  - The perceived need and use of oral health services among adolescents and adults
      in Tanzania were studied. One region from each of the country's five zones was
      chosen at random. Final sample selection (n = 1061) was done in the main towns of
      the selected regions. Participants were interviewed using a structured
      questionnaire which dealt with perceived need for dental treatment and use of
      oral health services and several demographic variables. Frequency tables were
      computed and analyzed. Odds ratios were calculated based on 2 x 2 tables and
      logistic regression models. The majority, 82% (95% CI: 79-85%) had sought
      treatment due to pain or for tooth extraction. Perceived need, dissatisfaction
      with own oral health status and use of oral health services were slightly more
      frequent among women. Bleeding gums had no explanatory value on the dependent
      variables. The strongest explanatory variable in a logistic regression model for
      perceived need and dissatisfaction with own oral health status was previous
      dental treatment with an estimated odds ratio of 6.4 (95% CI: 4.7-8.7) and 7.2
      (95% CI: 5.3-9.9), respectively. People living nearest a treatment facility
      tended to use the services more [odds ratio 1.3 (95% CI: 0.8-2.1)]. A very strong
      relation between previous dental problems and use of oral health services was
      found, namely an odds ratio of 68.8 (95% CI: 39.0-121.4). The findings in the
      study may be useful in the attempts to implement Tanzania's National Plan for
      Oral Health.

PMID- 8348786
TI  - Transmission of mutans streptococci to infants following short term application
      of an iodine-NaF solution to mothers' dentition.
AB  - In a randomized clinical trial, six applications of an I2-NaF or a placebo
      solution were administered to the mothers' dentition at the time of tooth
      emergence of her infant, to evaluate its effect on transmission of mutans
      streptococci (MS) to the infant. MS and other bacterial levels were periodically
      monitored in 48 mother-infant pairs until the child's third birthday. There were
      significant reductions in maternal salivary MS (P = 0.04), lactobacilli (P =
      0.04), total streptococci (P = 0.002), and total cultivable organisms (P = 0.004)
      immediately following treatment. In children, 3-yr incidence of MS colonization
      and the time of acquisition of MS or the caries experience did not differ
      significantly between the two groups. We conclude that short-term application of
      I2-NaF to the maternal dentition of predentate infants significantly lowers MS,
      lactobacilli, total streptococci, and total cultivable bacteria in mothers'
      saliva, but does not influence the incidence and the time of acquisition of MS or
      the caries experience in children.

PMID- 8348785
TI  - Use of health care services in two rural communities in Tanzania.
AB  - This study was undertaken to investigate the pattern of utilization of medical
      and dental health care services in rural Tanzania. Two hundred adults, 91 men and
      109 women aged 20 or over, were interviewed. Nearly all subjects reported using
      modern dental and medical health care services. Home remedy was the only
      indigenous method of treatment used for dental problems while for medical
      problems a traditional healer was the most commonly used indigenous alternative.
      The use of both indigenous and modern health care services was significantly
      lower for dental than for medical problems (P < 0.05). It seems that the pattern
      of utilization of health care services differs for medical and dental problems.
      This should be taken into account when planning comprehensive health care
      services for rural African societies.

PMID- 8348787
TI  - Simplified preventive dentistry program for Chilean refugees: effectiveness of
      one versus two instructional sessions.
AB  - A simplified dental health program for newly arrived refugees was evaluated. The
      efficacy of presenting the program in one instructional session or two was
      compared. 193 Chilean refugees, granted residency in Stockholm in Spring 1981 or
      in Spring 1982, participated. The subjects were divided into two groups. One
      group received a dental health program only at the first visit, in conjunction
      with the baseline examination, and the other group was recalled for a further
      session 3 months after the baseline examination. Both groups were recalled for
      evaluation 6 months after the initial visit. At follow-up the groups comprised 94
      and 65 subjects respectively. The mean relative reductions in gingivitis
      (relating GBI reduction to baseline GBI) were 33.2% (95% < I: 29.1 to 37.3%) in
      the single-visit group and 40.5% (95% < I: 35.9 to 45.8%) in the two-visit group.
      The reduction in periodontal pocket depth was mainly a reduction of shallow
      pockets. The maximum effect was attained after one instructional session.

PMID- 8348789
TI  - Concern for dental appearance among Norwegian young adults in region with low
      uptake of orthodontic treatment.
AB  - The purpose of the present study was to examine orthodontic concern among
      orthodontically untreated young adults living in an area where the relative
      number of children receiving treatment was only 15-20% and to compare orthodontic
      concern among these individuals with that of untreated persons from an area with
      a higher treatment frequency. All the subjects were clinically examined and
      impressions for dental study casts, radiographs and photographs were taken. The
      subject's occlusion was classified according to two methods: 1) allocation to one
      of four groups according to the national Need for Orthodontic Treatment Index
      (NOTI), and 2) allocation to one of three groups according to presence or absence
      of six Anterior Occlusal Traits (AOT). Frequencies of NOTI scores demonstrated
      that in the study group more individuals were in need of treatment relative to
      the comparison group. Reported concern was at the same level in both groups, and
      significantly related to NOTI and AOT scores. The individuals in the area with
      the low treatment frequency were generally less aware of their anterior traits
      compared to the individuals in the area with a higher treatment frequency. The
      results indicated that a long-term low uptake of orthodontic treatment among
      children in the particular area was not accompanied by a similar increase in
      concern about own dental appearance in early adulthood.

PMID- 8348788
TI  - Cross validation of a Brazilian version of the Dental Fear Survey.
AB  - The Dental Fear Survey (DFS), a paper and pencil instrument for assessing dental
      fear and avoidance, has been widely used and validated in fear studies in the US.
      However, before such instruments are used in countries and cultures dissimilar to
      the one in which it was developed, they should be cross-validated in that
      culture. The present study is an examination of the DFS response characteristics
      in a group of 374 Brazilian university students. Factor analysis of the DFS
      revealed three factors essentially identical to those found among university
      students in the US and in Singapore, as well as among US adult dental patients.
      Higher DFS scores were significantly associated longer intervals since last
      dental visit. These results are taken as evidence that the DFS performs in this
      Brazilian sample very much as it does in other samples; and is thus, a valid
      indicator of dental fear at least among Brazilian university students.

PMID- 8348791
TI  - Congenitally missing permanent mandibular incisors and their association with
      missing primary teeth in the southern Chinese (Hong Kong).
AB  - A radiographic survey of a random sample of 454 girls aged 5.9 +/- 0.5 yr and 521
      boys aged 5.8 +/- 0.4 y was undertaken to establish data on the incidence of
      congenitally missing mandibular incisor teeth amongst the Southern Chinese and to
      compare these figures with those of a similar previous study of 12-yr-olds so to
      eliminate factors such a trauma or extractions which may have artificially
      inflated the 12-yr-old incidence data. The proportion of 5-yr-old girls and boys
      affected by hypodontia in the permanent mandibular incisor region was 0.086 and
      0.046 respectively (a significant difference between sexes, P < 0.02), compared
      with 0.047 and 0.034 for the 12-yr-olds (a non-significant difference) so other
      factors must have contributed to the discrepancy between the two groups of
      children. A very strong correlation (P < 10(-25)) between missing primary and
      missing permanent mandibular incisors is present in this group, and this has
      implications for prognosis and treatment planning. A fundamental developmental
      defect is implied.

PMID- 8348790
TI  - Gingival and periodontal health in systemic lupus erythematosus.
AB  - This study compared the periodontal health of patients with SLE with that of
      healthy controls. Patients with systemic lupus erythematosus had significantly
      lower periodontal probing depths compared with healthy controls. It is possible
      that systemic drugs such as corticosteroids and NSAIDS may be responsible for
      these reduced probing depths but this study did not reveal a statistically
      significant effect of drugs. There is thus no evidence for a predisposition to
      increased periodontal disease in SLE.

PMID- 8348792
TI  - Subjective reports of oral dryness in an older adult population.
AB  - In this study of an older adult population almost one-fifth reported oral
      dryness. It was the most common of 22 oral symptoms and complaints. In a logistic
      regression analysis of predictors of oral dryness three variables had significant
      independent effects: income, taking prescribed medications and experiencing a
      stressful life change within the previous 6 months. Subjects with oral dryness
      had more decayed crown surfaces than those without but there was no association
      with decayed root surfaces. Nor were there any significant associations between
      reports of oral dryness and a number of indicators of periodontal health. Those
      with dryness were more likely to report other oral symptoms such as unpleasant
      taste, a burning sensation in the tongue and other parts of the mouth and pain
      from dentures. They were also more likely to report problems chewing food,
      problems with eating and communication and were more likely to be dissatisfied
      with their oral health. Given its prevalence and effects, oral dryness
      constitutes an important health issue among older adults.

PMID- 8348793
TI  - Oral health and treatment needs among patients in psychiatric institutions for
      the elderly.
AB  - The purpose of the study was to assess oral health and treatment needs among
      elderly in psychiatric institutions in a Danish county. The study serves as
      baseline for the evaluation of a newly established oral health care program in
      the county. The study population comprised the residents in eight institutions (n
      = 407). Two thirds of the residents were edentulous, 34% of the dentate had one
      or more root remnants, and 55% had untreated decay. The dentate with regular
      dental visiting habits had significantly less untreated decay than the irregular
      users. The oral hygiene was poor, but was not related to whether or not the
      elderly were assisted in daily oral hygiene. The evaluation of the program will
      show to what extent treatment takes place, and whether or not oral hygiene
      improves.

PMID- 8348794
TI  - Tooth loss and dental caries in an adult population in Navarra, Spain.

PMID- 8348796
TI  - Stress measures as predictors of periodontal disease--a preliminary
      communication.

PMID- 8348795
TI  - Dental caries and prevalence of mutans streptococci in a group of Cambodian
      children.

PMID- 8348797
TI  - The referee process.

PMID- 8348798
TI  - Phenomenology and psychopathology: was there ever a relationship?
AB  - The philosophical doctrine known as phenomenology is believed by many to have
      provided during the early 20th century the conceptual basis of the new
      descriptive language of psychiatry, the very language that made possible the
      development of systems such as the DSM-III-R. To ascertain whether this is in
      fact the case is essential to the solution of technical problems affecting
      current psychopathological descriptions. This report argues against the above
      mentioned belief, and suggests that the alliance between phenomenology and
      descriptive psychopathology was just a marriage of convenience, and that it was
      Karl Jaspers who made it appear as if his own views were based on Husserlian
      phenomenology. Indeed, a comparison of the clinical meaning and usage of mental
      symptoms before and after 1913 shows that Jaspers borrowed a great deal from 19th
      century alienists, and that calling his views phenomenological added little to
      their meaning.

PMID- 8348799
TI  - Alogia, attentional impairment, and inappropriate affect: their status in the
      dimensions of schizophrenia.
AB  - Previous factor analyses have shown that at least three factors are needed to
      encompass the positive and negative symptoms of schizophrenia. Despite marked
      similarities across studies, it remains unclear whether certain symptoms such as
      alogia, attentional impairment, and inappropriate affect are more closely related
      to negative or positive symptoms. An exploratory analysis was undertaken of the
      separate items on the Scale for the Assessment of Positive Symptoms (SAPS) and
      Scale for the Assessment of Negative Symptoms (SANS) that constitute the global
      rating of alogia, as well as the global ratings of attentional impairment and
      inappropriate affect in 90 schizophrenic patients. Findings indicate that
      inappropriate affect loads significantly with bizarre behavior and positive
      formal thought disorder on a disorganization factor, whereas attentional
      impairment loads significantly on psychotic, disorganization, and negative
      symptom factors. The global rating of alogia appears to comprise both positive
      and negative symptoms, with the item poverty of content of speech loading on the
      disorganization factor, and other items such as poverty of speech, blocking, and
      increased latency loading on the negative symptom factor. It is concluded that
      three dimensions are needed to characterize the symptoms of schizophrenia as
      measured by the SAPS/SANS. The use of three dimensions may be a robust way to
      further explore the relationship between signs and symptoms and their underlying
      mechanisms in schizophrenia.

PMID- 8348800
TI  - The relationship between DSM-III personality disorders and the five-factor model
      of personality.
AB  - Two hundred twenty-four first-degree relatives of patients with psychotic
      disorders were administered the Structured Interview for DSM-III Personality
      Disorders (SIDP) and completed a self-report instrument to assess dimensions of
      the five-factor model of personality. All of the DSM-III personality disorders
      were related to one or more dimensions of the five personality factors; however,
      the correlations were generally low. It seems that the five personality factors
      describe important features of DSM-III personality disorders, but are not
      sufficient to completely explain their characteristics. Future use of the five
      factor model in conjunction with personality disorder diagnoses may provide
      useful information for clinical work and research purposes.

PMID- 8348801
TI  - Attribution of antisocial symptoms in coexistent antisocial personality disorder
      and substance abuse.
AB  - Two methods for diagnosing antisocial personality disorder (ASPD) were compared
      based on whether antisocial symptoms that occurred when subjects also experienced
      alcohol- or other drug-related problems were counted toward the diagnosis of
      ASPD. From a family study of alcoholism and ASPD, 93 male subjects who met ASPD
      criteria in the absence of substance-related problems were contrasted with 312
      subjects who were diagnosed with ASPD regardless of whether criterion symptoms
      occurred along with substance-related problems. Subjects did not differ in types
      of antisocial behaviors, age of onset of behaviors, or comorbid psychiatric
      disorders except for alcoholism and drug abuse. A subgroup was contrasted on
      family history of psychiatric illness, with no differences noted between groups.
      Counting antisocial symptoms toward the diagnosis of ASPD regardless of whether
      symptoms occur during periods of substance abuse increases the observed
      population prevalence of the disorder, but does not change the observed
      phenomenology of ASPD or affect commonly accepted indicators of validity of
      diagnosis.

PMID- 8348802
TI  - DSM-III personality disorders in generalized anxiety, panic/agoraphobia, and
      obsessive-compulsive disorders.
AB  - In an earlier report, we stated that personality profiles of patients with panic
      disorder/agoraphobia (n = 187) and obsessive-compulsive disorder ([ODC] n = 51)
      were similar, albeit more pronounced in OCD, suggesting that the link between
      panic disorder/agoraphobia and DSM-III personality disorders (PDs) or traits may
      be nonspecific. The present report extends the comparative study of DSM-III
      PDs/traits, as assessed by the Personality Diagnostic Questionnaire (PDQ), by
      adding a third diagnostic group of 39 patients with generalized anxiety disorder
      (GAD). The personality assessment of panic disorder/agoraphobia and GAD patients
      yielded virtually identical results on the PDQ and Eysenck Personality Inventory
      (EPI). Because GAD lacks the prominent panic, phobic, and obsessive-compulsive
      symptoms of other anxiety disorders, the present findings provide strong support
      for a nonspecific link between panic disorder/agoraphobia and DSM-III PDs/traits
      and for the presence of common personality characteristics in anxiety disorders.

PMID- 8348803
TI  - Psychometric validation of the Tridimensional Personality Questionnaire:
      application to subgroups of eating disorders.
AB  - Eating disorder patients show extremes of the personality characteristics
      measured by the Tridimensional Personality Questionnaire (TPQ). For this reason,
      the TPQ was tested in four subgroups of eating disorder patients. Patients
      completed the TPQ and their responses were compared with a normative sample of
      women. Results indicated that the TPQ is an internally consistent and valid
      instrument to use with eating disorder patients.

PMID- 8348804
TI  - Association between borderline personality structure and history of childhood
      abuse in adult volunteers.
AB  - Childhood abuse has been implicated as a leading factor in the development of
      borderline personality disorder (BPD). Data in this report, drawn from an ongoing
      study of the therapeutic effect of fluoxetine in BPD patients, were gathered in
      an attempt to replicate previous findings indicating a history of physical abuse
      in 71% and sexual abuse in 67% of adult BPD subjects. Thirty-one subjects for a
      study of the pharmacological treatment of BPD or BPD traits met criteria for the
      study. Those who had been previously hospitalized for a psychiatric disorder, who
      had recently been suicidal, or who had recent histories of self-mutilation were
      excluded. Specific information about childhood abuse was gathered using questions
      from a previous study of abuse histories in BPD patients. All subjects were then
      interviewed in greater depth regarding past experiences of abuse as part of the
      ongoing study of the relationship of childhood attachment experience and adult
      psychopathology. Six of 31 subjects (19.4%) reported a definite history of
      childhood physical and/or sexual abuse. Four of these subjects met criteria for
      full BPD, and two met criteria for BPD traits. Three of 31 subjects reported a
      history of physical abuse (9.7%); five reported a history of sexual abuse
      (16.1%). Two of the six who reported abuse reported both physical and sexual
      abuse. A history of childhood abuse is not necessarily linked to the development
      of BPD or BPD traits in all individuals. The following hypothesis is suggested:
      BPD may represent a spectrum of symptomatic severity.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8348805
TI  - Correlates of dissociative symptomatology in patients with physical and sexual
      abuse histories.
AB  - Recent studies have demonstrated a high prevalence of sexual and physical abuse
      histories and high levels of dissociative symptoms in psychiatric inpatients. We
      examined whether severity, frequency, and age of onset of abuse correlated with
      subjects' levels of dissociative symptoms. Sixty-four women reporting a lifetime
      history of physical and/or sexual abuse were recruited from consecutive
      admissions to three wards of a psychiatric hospital. Subjects completed the Life
      Experiences Questionnaire (LEQ) and the Dissociative Experiences Scale (DES).
      Subjects' self-reports of severity, frequency, and age of onset of abuse were
      analyzed for correlations with DES score. More invasive sexual abuse was
      associated with more dissociation. Higher-frequency physical abuse was associated
      with more dissociation, but no conclusion could be drawn about the impact of
      frequent sexual abuse due to missing data. An inverse correlation was found
      between age of onset of abuse and degree of dissociative symptomatology. These
      preliminary findings are consistent with hypotheses linking more severe, more
      chronic, and earlier abuse to the greater development of dissociative symptoms.
      The findings further emphasize the importance of recognizing dissociative
      symptoms in the clinical setting, and of continued study into the effects of
      childhood trauma.

PMID- 8348806
TI  - Karen Horney's "resigned person" heralds DSM-III-R's borderline personality
      disorder.
AB  - It is shown here that what Karen Horney called the resignation solution to the
      problem of basic anxiety leads to psychopathology very similar to DSM-III-R's
      borderline personality disorder (BPD). Both the "resigned person" and the
      borderline personality show instability of self-image, social relationships, and
      mood, and live out the associated deficits with similar styles. While not
      specifically using the term "splitting", Horney showed how alternating expansive
      and self-effacing trends can coexist in the resigned person, and how these
      oscillations in self-other-world constitution influence the resigned person's
      behavior in a way similar to borderline splitting. Horney's descriptive and
      psychodynamic analysis of the resignation phenomenon elaborates and gives
      additional credibility to DSM-III-R's BPD as a diagnostic category.

PMID- 8348807
TI  - Reliability and validity of the Japanese version of the Tridimensional
      Personality Questionnaire among university students.
AB  - The Tridimensional Personality Questionnaire (TPQ) is a self-rating
      questionnaire, based on a general biosocial theory, for the clinical description
      and classification of both normal and abnormal personality variants. It was
      translated into Japanese and administered with the General Health Questionnaire
      (GHQ) and the 10-item version of the Social Desirability Scale (SDS) to 450
      university students on two occasions 2 months apart. Pearson Product-Moment
      Correlation Coefficients and kappa-coefficients between TPQ scale scores for the
      two occasions were significantly high, as were Cronbach's alpha-coefficients of
      TPQ scales and subcategories at the first wave. Correlations between the TPQ
      scale score and GHQ and SDS scores were negligible. The TPQ thus appears to have
      test-retest reliability and content validity among a Japanese student population;
      it is uninfluenced by psychiatric morbidity or social desirability.

PMID- 8348808
TI  - Grading depression severity by symptom scores: is it a valid method for
      subclassifying depressive disorders?
AB  - Recent diagnostic criteria such as the DSM-III-R and the 10th Revision of the
      International Classification of Diseases (ICD-10) have proposed that depression
      should be subcategorized according to severity. Among 75 inpatients with Research
      Diagnostic Criteria (RDC) major depressive disorder, the total number of
      criterion B items (N = 8) used as the measure of severity was validated against
      the global assessment scale (GAS) score for the worst week of the episode; the
      correlation between the two was r = -.232. This suggests that even if the total
      number of identified diagnostic items reflects a different aspect of severity,
      there should be caution about its use unless validated by further study.

PMID- 8348809
TI  - [The computer in journal preparation. Desktop publishing].

PMID- 8348810
TI  - [Prophylactic administration of anticoagulant therapy in electric cardioversion
      for atrial fibrillation or atrial flutter].

PMID- 8348811
TI  - [Vaclav Libensky. 7 June 1877, Prague--30 December 1938, Prague. Vaclav Libensky
      and his contribution to Czech cardiology].

PMID- 8348812
TI  - [Ischemic disease of the lower extremities (continued)].

PMID- 8348813
TI  - [Transesophageal echocardiography].

PMID- 8348814
TI  - Do preoperative branched-chain amino acids have a beneficial effect on the heart
      after cardiac surgery?
AB  - To verify the hypothesis, formulated on the basis of data emerging from animal
      experiments, that branched-chain amino acids (BCAA) exert a protective effect on
      the heart during ischaemia, eight patients immediately before aortocoronary
      reconstruction were provided 400 ml of a 3% BCAA solution. A control group
      comprised another eight patients. Per- and postoperative myocardial status and
      myocardial enzyme levels were assessed. Myocardial biopsy was performed during
      surgery to determine glycogen levels. Creatine kinase (CK) levels were invariably
      higher in the BCAA group, with statistically significant differences in samples
      obtained immediately after surgery (10.6 +/- 3.35 mu kat/l vs. 4.07 +/- 0.59, p <
      0.0004), in the evening after surgery (14.2 +/- 5.92 vs. 5.91 +/- 2.21, p < 0.06)
      and in the morning of the first postoperative day (18.0 +/- 10.1 vs. 7.5 +/-
      4.76, p < 0.025) when aspartate aminotransferase (AST) levels were likewise
      higher (1.35 +/- 0.28 vs. 1.00 +/- 0.26, p < 0.035). There were no differences
      between the groups in the number of defibrillations after ischaemia, myocardial
      glycogen content, peroperative ischaemia, incidence of arrhythmia and
      catecholamine support. We conclude that BCAA at the above indicated doses did not
      raise myocardial glycogen content or improve myocardial status after cardiac
      surgery. Their administration resulted in a rise in CK and AST in the
      postoperative period.

PMID- 8348815
TI  - The course of myocardial hypertrophy in hypertrophic cardiomyopathy. Results of a
      10-year follow-up.
AB  - Sixty-nine patients with hypertrophic cardiomyopathy were followed up for a
      minimum period of 10 years, with detailed quantitation of myocardial hypertrophy
      using two-dimensional echocardiography at a two-year interval. The parameters
      determined included maximum myocardial wall thickness, mean myocardial wall
      thickness (defined as the arithmetic mean of myocardial wall thickness values
      measured in ten areas of approximately the same size the LV and septal myocardium
      had been divided into), and the extent of hypertrophy (percentage of the
      myocardium affected by hypertrophy). Other echocardiographic parameters as well
      as clinical, ECG and Holter data were also assessed. Seven patients (10%) showed
      a gradual increase in mean myocardial wall thickness (associated with an increase
      in maximum myocardial wall thickness and in the extent of hypertrophy in two). By
      contrast, a progressive decrease in hypertrophy was observed in six patients
      (9%). In either case, the observed changes tended to involve areas in segments
      outside the zone of maximum wall thickness. Generally, the changes in hypertrophy
      were not related to the development of clinical or Holter manifestations, and
      were unaffected by verapamil or beta-blocker therapy. There was no death among
      these patients unlike the five deaths in a group with stationary hypertrophy.
      Based on their results, the authors conclude that changes in myocardial
      hypertrophy (regardless of whether there is progression or regression) probably
      make part of natural variations in the course of the disease, and have no
      clinical or prognostic implications for the majority of patients.

PMID- 8348816
TI  - [Preventive cardiology in the Czech Republic. Present status and perspectives].
AB  - Despite their proclaimed goals, prevention campaigns were little effective in the
      past. Now it is time to discard those highly publicized programmes. Preventive
      cardiology can be successful in reducing the incidence and mortality only on
      condition the endeavor of the public health system is combined with a well
      functioning service of general practitioners and family physicians. The
      nationwide model of prevention should be translated into practice by institutes
      of public health and hygiene and should improve, mainly by redefining the dietary
      habits and smoking cessation programmes, the risk profile of the entire
      population. It should be remembered that even a minor change in the risk profile
      in the whole population has society-wide implications and entails a significant
      decrease in the number of clinically manifest cases of the disease. While
      secondary prevention after myocardial infarction will continue to be the
      responsibility of the cardiologist, individualized intervention in persons at
      high risk, as part of primary prevention, can be provided generally only on
      condition it is performed by the general practitioner and the family physician.
      All multi-level models designed to refer patients and persons at risk step by
      step, according to the degree of risk, up the health system, as proposed by
      socialist health care, are not practicable. Today, the general practitioner can
      consult the expert directly should the need arise. Successful prevention will
      depend on the standard and education of the general practitioner on the one hand,
      and the performance of public health institutions on the other.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8348817
TI  - [The Williams syndrome in adulthood].
AB  - A case report of a 45-year-old woman with Williams syndrome who was indicated,
      because of increasing problems, for surgery of a supravalvular stenosis of the
      ascending aorta. In addition to lesions on the aorta, examination revealed
      multiple stenoses of branches of the pulmonary artery. The patient showed no
      facial changes or signs of mental retardation. The operation was performed in
      extracorporeal circulation by suturing a Dacron flap into the stenotic segment of
      the aorta, and reimplantation and reconstruction of the stenosed aortic arch
      branches. The procedure was uneventful and, four months after surgery, the
      patient is completely free of problems.

PMID- 8348818
TI  - The Victoria Declaration.

PMID- 8348819
TI  - Accelerated cholesterol synthesis in the monocytes of young myocardial infarction
      survivors.
AB  - The substantial role of monocytes in atherogenesis has been demonstrated
      recently. The feedback regulation of endogenous cholesterol synthesis in
      monocytes of young myocardial infarction survivors was determined and compared to
      that of age- and sex-matched controls. The cholesterol synthesis in monocytes of
      one half of patients was three times higher compared to that of controls whereas
      the other half showed a rate within the range of controls.

PMID- 8348820
TI  - The fuzzy boundaries of apperceptive agnosia.
AB  - Following a trauma that mainly involved the right hemisphere, a 21-year-old girl
      showed a profound impairment in visual object recognition, without language and
      intellectual deficit. Her elementary sensory functions were preserved and she
      performed in the normal range on visual matching tasks, on taks requiring to
      detect small differences between similar complex shapes and in copying drawings,
      without any evidence of a line by line approach. Her deficit emerged with tests
      that, though not implying identification of meaning, demanded to disentangle a
      form from a confused background and to achieve a highly structured description of
      the stimulus. In addition to this high-level perceptual processing disorder,
      there was a deficit in recovering from the visual store the shape of an object,
      also when the performance did not involve perceptual discrimination, e.g., in
      drawing from memory or telling the physical difference between two named stimuli.
      Knowledge of the semantic and contextual attributes of objects was intact. The
      case is taken as evidence that the borders of apperceptive agnosia may be ampler
      than usually thought and its distinction from associative agnosia less rigid,
      with some patients laying in-between the two syndromes.

PMID- 8348821
TI  - Focal retrograde amnesia in neurological disease: a critical review.
AB  - The condition of focal retrograde amnesia represents a new and challenging
      concept to our understanding of human memory disorders. Cases of both permanent
      and transient focal retrograde amnesia, dating from early clinical descriptions
      to more recent experimental reports, are critically reviewed. It is concluded
      that the condition of focal retrograde amnesia does represent a distinct and
      reliable neurological entity. Four sets of issues are discussed--methodological
      issues, conceptual issues, anatomical issues and therapeutic issues. Current
      evidence indicates an important role for temporal lobe structures in mediating
      focal retrograde amnesia. Both storage and retrieval deficits may contribute to
      the presence of focal retrograde amnesia, though available evidence points to a
      greater role for engram destruction/fragmentation rather than disruption of
      access mechanisms. In general, pharmacological and other therapies have had
      minimal effects in alleviating focal retrograde amnesia.

PMID- 8348822
TI  - Spatial memory in amnesia: evidence from Korsakoff patients.
AB  - Two experiments are reported which investigated a hypothesised disproportionate
      deficit in amnesic spatial memory. Korsakoff amnesic memory for the locations of
      objects or words placed on a grid was compared to control memory which had been
      attenuated by longer delays before testing. The effects of incidental versus
      intentional encoding of the locations were compared. No significant evidence of a
      disproportionate spatial memory deficit in Korsakoff amnesia was found,
      intentional instructions did not improve Korsakoff amnesic spatial memory scores,
      and there was no significant evidence of a trade-off of item memory and location
      memory specific to the Korsakoff amnesic group. Rather, intentional instructions
      significantly reduced item memory in both Korsakoff amnesics and normal controls,
      while having no effect on spatial memory. When location was scored by lenient
      criteria, there was no significant difference between groups for this measure,
      nor for recall and recognition memory for these items. Thus Korsakoff amnesic
      memory was very similar to that of control memory attenuated by longer delays
      before testing. The Korsakoff amnesic subjects' memory therefore differed
      quantitatively rather than qualitatively from that of control subjects' memory.

PMID- 8348823
TI  - Encoding deficits in untreated Parkinson's disease.
AB  - Short-term memory deficits are prominent in untreated Parkinson's Disease (PD)
      and speed of central processing is known to be abnormal. To investigate the
      relationship between these findings, a modification of the Brown-Peterson
      paradigm was given to newly diagnosed, untreated patients and healthy control
      subjects (HCS). The PD patients were impaired under conditions of long stimulus
      exposure but not when study time was short. Although patients displayed deficits
      in immediate recall, they were more impaired at longer test delays. They achieved
      fewer encoding operations per unit time, resulting in a divergence of group
      performance with increasing duration of stimulus exposure. Performance in the PD
      group did not associate with motor disability, disease duration or rating of
      depression. These results are discussed in terms of a unifying reduced central
      processing deficit that is evident in PD but is independent of physical symptoms.

PMID- 8348824
TI  - Impaired temporal context memory on anterograde but not retrograde tests in the
      absence of frontal pathology.
AB  - This study examined the memory performance of patient RK who developed
      substantial memory impairments due to a hypothalamic glioma but in the absence of
      any evidence of frontal disturbance. RK was evaluated on both tests of
      anterograde and retrograde memory for temporal context. In the first experiment
      he exhibited marked deficits on a list discrimination task even when recognition
      performance was well within control range. Experiment 2 confirmed this
      disproportionate impairment of temporal order memory and showed that RK's list
      discrimination deficit was as severe as that found in alcoholic Wernicke
      Korsakoff Syndrome patients. Experiment 3 showed that RK's temporal
      discrimination deficit was not a general deficit in discrimination because he
      performed normally on a spatial discrimination test of comparable difficulty to
      the temporal task. Experiment 4 examined RK's memory for deceased famous people
      and his ability to indicate the half decade in which they died. RK's performance
      was indistinguishable from controls whereas WKS patients were extremely impaired.
      This study adds to the view that frontal damage is not a necessary condition for
      impairment on anterograde measures of temporal context memory. However, further
      evidence from this study indicates that temporal judgments about pre-existing
      memories may depend on intact frontal lobe functioning.

PMID- 8348825
TI  - Selective impairment of retrieving people's names: a category specific disorder?
AB  - A patient with an extremely long-standing low grade glioma affecting the left
      temporal lobe is described. The patient was almost entirely unable to retrieve
      the names of current personalities, although in other respects identification was
      unimpaired and nominal functions were only mildly inefficient. In particular
      geographical features and historical figures were generally appropriately named.
      The problem was equally severe whether naming was to confrontation, from
      description or by generation. A similarly severe impairment was also found for
      the retrieval of new words that had come into the language in the last twenty
      years (eg. aids). The impairment of retrieving people's names was interpreted in
      terms of a long-standing inability to form new associations between meaning and
      phonological word-forms.

PMID- 8348826
TI  - A role for the hippocampus in card sorting?
AB  - This study examines the performance of three groups of patients with epilepsy on
      three measures typically used to assess the integrity of the frontal lobes: the
      Modified Wisconsin Card Sorting Test (MWCST), verbal fluency and the Stroop test.
      The groups comprised sixteen patients with clearly defined hippocampal sclerosis,
      thirteen patients with unilateral temporal lobe seizure onset and eighteen
      patients with unilateral frontal lobe onset. Results demonstrated that
      performance on the MWCST was most compromised by hippocampal sclerosis. These
      patients took longer to complete the task, achieved fewer categories and made
      more perseverative errors than patients in the other groups. In contrast, verbal
      fluency and performance on the Stroop test were less affected by the presence of
      hippocampal sclerosis. These results have both clinical and theoretical
      significance. It is argued that patients with hippocampal damage perform poorly
      on the MWCST because of the heavy working memory requirements of the test.
      Cautious use of this test as a tool to localise seizure origin in patients with
      complex partial seizures is therefore recommended. The findings are discussed in
      terms of Gray's (1982) model of the hippocampus as a comparator of actions.

PMID- 8348827
TI  - Factor analyses of pooled hand questionnaire data are of questionable value.
AB  - A number of researches have used factor analyses and principal components
      analyses on handedness questionnaire data in order to learn something about
      handedness. However, these researchers have analyzed pooled data from
      righthanders and lefthanders. The practice of pooling groups that are known in
      advance to be heterogeneous is highly questionable because it is not possible to
      disentangle the sources of variance that are contributed by within group
      differences from those that arise from between group differences. The factor
      structure and item loadings that result from pooled data are misleading and
      cannot inform meaningfully about the relation of hand preference to handedness.
      Similar problems can be anticipated in other neuropsychological applications of
      factor analysis, where data from heterogeneous groups is pooled.

PMID- 8348828
TI  - Operant conditioning after temporal lobe lesions in man: conditional and simple
      discrimination learning.
AB  - Temporal lobe lesions have been found to impair the acquisition of classical
      conditional discrimination learning in an eyelid conditioning paradigm, with
      sparing of simple eyelid conditioning. In the present study, subjects with left
      or right temporal resections were compared with normal controls on two operant
      conditioning tasks using a conditional and a simple discrimination paradigm
      analogous to the previously reported classical conditioning tasks. Subjects with
      right temporal lesions, and to a lesser extent those with left temporal lesions,
      were impaired relative to frontal lobe and control subjects in the acquisition of
      a conditional discrimination within an operant conditioning setting. A subsequent
      experiment showed that both left and right temporal lobe subjects were unimpaired
      on a simple operant discrimination task. These findings are compatible with
      theory relating hippocampal function to the learning of if-then rules.

PMID- 8348829
TI  - Laterality for facial expressions: does the sex of the subject interact with the
      sex of the stimulus face?
AB  - Seventy right-handed subjects (35 males and 35 females) were shown lateralized
      pictures of negative, neutral, and positive facial emotional expressions. For
      each emotional category, half of the pictures were of a male face showing the
      emotion, half were of a female face. The pictures were shown in the left visual
      half-field for half of the trials and in the right half-field for the other half
      of the trials. The question addressed was whether the sex of the stimulus face
      interacts with the sex of the subject for hemisphere differences in perception of
      facial emotions. Response accuracy and reaction time were measured. The pictures
      were shown from a slide projector with a high-speed shutter mounted to the lens
      to allow for tachistoscopic presentations. The results showed that the right
      hemisphere was more accurate and faster than the left in recognizing the stimulus
      faces, and that positive emotions were overall more easily recognized. The lack
      of a significant interaction between sex of the stimulus and sex of the subject
      indicates that these two factors are not interrelated or confounded in laterality
      research.

PMID- 8348830
TI  - Reaction time improvements with practice in brain-damaged patients.
AB  - This study investigated practice effects on reaction time (RT) in patients with
      unilateral brain damage and age-matched controls. Subjects performed a Sternberg
      type stimulus recognition task. Both RT and RT variability decreased in all
      subjects from a short initial session to a second session, 1 to 3 days later.
      Within the second session, however, RT remained constant in the controls, whereas
      it was further reduced in the patients. These findings argue against the
      assumption that brain-damaged patients generally show smaller practice effects on
      RT than controls, and instead suggest that it may be essential to provide
      patients with sufficient practice opportunities. To locate the processing stage
      where practice is effective, analyses were performed also on the intercept and
      slope parameters of the RT function. It is argued that the differential practice
      effects were due to the speeding of perceptual and/or response-related stages,
      rather than gains in memory search speed.

PMID- 8348831
TI  - Phonemic discrimination in callosal agenesis.
AB  - Children with callosal agenesis have congenital absence of the corpus callosum.
      Previous analyses of these subjects have shown that they have significant
      difficulty on rhyming tasks and tasks of explicit sound organisation. This study
      investigated whether such difficulties were also manifested on simpler tasks
      requiring the discrimination and repetition of similar sounding linguistic
      material. None of the acallosal children tested performed at a normal level
      across tasks. This suggests a possible impairment in the initial registration or
      analysis of auditory material and possible bases for this deficit are discussed.
      In cases of callosal agenesis in which impairments in auditory discrimination are
      more severe there may be a more profound impact upon language development.

PMID- 8348832
TI  - Evidence for an independent stimulus-centered spatial reference frame from a case
      of visual hemineglect.
AB  - Previous experiments with patients suffering from visual hemineglect have
      provided evidence relevant to the organization of the human spatial
      representation system. We examined the hypothesis that one reference frame used
      to represent the location of objects in the environment is based on the spatial
      extent of the stimulation that needs to be processed at a specific point in time;
      in current terminology, a stimulus-centered reference frame. The paradigm used
      was one of filtering, and variation of the location of the target within a
      horizontal array of items (stimulus-relative location) was independent of the
      target location relative to the subject and to stable reference points in the
      environment. Results showed that stimulus-relative target location provided an
      independent contribution to the magnitude of the neglect symptoms. This is taken
      as an indication that a stimulus-centered spatial reference frame contributes to
      the representation of the location of visual objects in human vision and that
      this representation may serve to direct visual attention.

PMID- 8348833
TI  - Interhemispheric integration of number stimuli: comparison of Arabic with Kanji
      numerals.
AB  - Thirty normal subjects were requested to add two numbers which were presented
      tachistoscopically. Two numbers were displayed either to one visual field or
      simultaneously one to the left and one to the right visual field. Arabic or Kanji
      numerals were used. Bilateral presentation was superior to unilateral
      presentation with both kinds of stimuli. In unilateral presentation, Arabic
      numbers were processed more proficiently in the left visual field and Kanji
      numbers in the right visual field.

PMID- 8348834
TI  - Silent myocardial ischemia.
AB  - The documentation of abnormalities related to myocardial ischemia, whether
      symptomatic or silent, is of central importance. Whenever this information is
      available, it should be used in the overall assessment of the patient at risk for
      adverse outcome. The level of concern for treatment of CAD should be based on the
      risk implications associated with the ischemia-related abnormalities detected
      during objective testing rather than on the presence or absence of pain. The
      exercise stress test is still the single most useful test to begin the evaluation
      of a patient with an analyzable ST segment. In persons suspected of having CAD,
      the detection of ischemic-type ST-segment depression, at a low workload (e.g., <
      120 beats/min or < 6.5 METS) of > 2 mm magnitude or persisting for more than 6
      min implies high risk for adverse outcome. Asymptomatic ischemia during everyday
      activities, detected by Holter monitoring, in the high-risk patient, most
      probably adds additional risk beyond the risk of an abnormal stress test alone.
      Left ventricular imaging by two-dimensional echocardiography, RNA, angiogram,
      vest, etc, showing an ejection fraction > or = 40%, reversible wall motion
      abnormalities in multiple regions and redistribution defects or a failure to
      increase ejection fraction during exercise even if the patient remains
      asymptomatic, also imply high risk. The presence of any of these abnormal
      findings, regardless of symptoms, should therefore prompt as high a degree of
      concern as with ischemia-related signals associated with pain. Thus any therapy
      chosen should be directed toward elimination of transient ischemia, not just
      relief of symptoms that may or may not be ischemia related. If this course is
      chosen, the efficacy of the therapeutic regimen and possible progression of CAD
      should be assessed with follow-up testing for ischemia. We believe that risk
      factor modification and aspirin should be considered for most, if not all,
      patients in whom ischemia, silent or symptomatic, is suspected or detected. If
      symptoms or ischemia suggesting low risk is present, anti-ischemic medical
      therapy may be considered, but follow-up is advised. If a high-risk ischemic
      signal, even without symptoms, is detected, medical therapy should be used to
      attempt to modify the signal. If the ischemic signal suggesting high risk
      persists despite medical therapy, revascularization should be considered. Until
      additional data from large clinical trials are available, this approach appears
      to have the greatest likelihood of modifying the adverse outcome of CAD.

PMID- 8348835
TI  - Current usefulness of the signal-averaged electrocardiogram.
AB  - Signal-averaged electrocardiography is a relatively simple, noninvasive technique
      by which valuable information can be gained to help in the management of patients
      with cardiovascular disease. The presence of late potentials on the SAECG is a
      good marker for the presence of an arrhythmogenic substrate that is believed to
      be the source of ventricular tachycardia in patients with coronary artery
      disease. The value of the detection of late potentials has been studied best
      after myocardial infarction, when the absence of late potentials makes the
      occurrence of an arrhythmic event very unlikely. The positive predictive value
      for an arrhythmic event to occur in the presence of late potentials is low,
      however, comparable to the predictive value of decreased left ventricular
      function, complex ventricular ectopy, or abnormal autonomic tone. This appears to
      have its explanation in the complex pathophysiology behind the occurrence of
      arrhythmic events. Improved accuracy for the SAECG is achieved when the result of
      the test is interpreted with consideration of the presence or absence of other
      predictive markers. A thorough understanding of the signal-averaged
      electrocardiogram makes optimal clinical use of the information gained from this
      easily acquired test possible.

PMID- 8348836
TI  - Mitral valve disease.

PMID- 8348837
TI  - Aortic valve replacement.

PMID- 8348838
TI  - Lateral inhibition and pattern formation in Dictyostelium.

PMID- 8348839
TI  - Cell cycle control during mammalian oogenesis.

PMID- 8348840
TI  - Axis determination in the avian embryo.

PMID- 8348841
TI  - Gene and enhancer trapping: mutagenic strategies for developmental studies.

PMID- 8348842
TI  - Genetic and molecular analysis of leaf development.

PMID- 8348843
TI  - Drosophila cell adhesion molecules.

PMID- 8348845
TI  - Racial inequality and child neglect: findings in a metropolitan area.
AB  - Despite contradictory evidence, child neglect is often believed to occur more
      frequently in the African American than in the Caucasian population. This article
      reports findings on the racial differences among 182 families referred for
      neglect in a large metropolitan area. Although almost all of the families were
      poor, African American families in the neglect sample suffered even more from
      economic inequality than those in the general population. Implications of the
      findings for social welfare policy and child welfare practice are discussed.

PMID- 8348844
TI  - Child welfare services for the catastrophically ill newborn: Part I--A confusion
      of responsibility.
AB  - The majority of these difficult bioethical decisions should properly be made by
      parents with input from physician and health care workers, utilizing the
      resources and guidance of infant ethics committees within the involved hospitals.
      The child protective service system should have the final authority, however, to
      assure that the decisions of the "caregivers" do not constitute abuse or neglect.
      This will require that the child welfare system sometimes walk the razor's edge
      between protecting the child's best interests and preserving, facilitating, and
      empowering families in these difficult circumstances. But this is an ethical
      dilemma the child welfare system negotiates daily, and is perhaps the reason used
      to justify assigning the child welfare system this responsibility. It will also
      require that the child welfare field have a consensus bioethical paradigm for
      treatment decision-making for children born with catastrophic illness. Consistent
      treatment decisions in the best interests of our most vulnerable children cannot
      be assured, or even expected, without such standardized guidelines.

PMID- 8348846
TI  - Development of an integrated case management program for vulnerable children.
AB  - Although case management is a recognized technique to organize and coordinate
      human services, its use with high-risk children is relatively new. This article
      describes the development of a case management program for children at the Center
      for the Vulnerable Child at Children's Hospital, Oakland, California, a health
      care setting that brings together health, social work, and child welfare
      services. Case management was introduced into multidisciplinary clinical programs
      for foster children, drug-exposed infants, and adolescent mothers and their
      infants. Case management activities differed in each of the clinical programs in
      relation to the unique characteristics of each population and the different
      obstacles encountered. A time management analysis indicated consequent
      differences in case management time allocations. The implications of these
      findings are discussed.

PMID- 8348847
TI  - Prognostic value of tumor "budding" in patients with colorectal cancer.
AB  - From 1970 to 1985, 663 patients underwent curative resection of colon and rectal
      adenocarcinomas. All surgical specimens were examined for tumor "budding,"
      defined as small clusters of undifferentiated cancer cells ahead of the invasive
      front of the lesion. Patients were divided into two groups according to degree of
      budding: none or mild (BD-1) and moderate or severe (BD-2). BD-1 occurred in 493
      patients (74.4 percent), and BD-2 was found in 170 patients (25.6 percent). More
      severe budding was associated with worse outcome: 71.1 percent of BD-2 patients
      had recurrence, compared with 20.0 percent of BD-1 patients (P < 0.005). The five
      year survival rate was worse in BD-2 than in BD-1 (22.2 percent vs. 70.7 percent;
      P < 0.001). The 10-year survival rate was also worse in BD-2 than in BD-1 (13.8
      percent vs. 50.6 percent; P < 0.001). The incidence of BD-2 rose with the Dukes
      stage. However, the five-year survival rate of Dukes B patients with BD-2 lesions
      was worse than that of Dukes C patients with BD-1 cancers (29.1 percent vs. 66.2
      percent; P < 0.001). Moreover, there was no difference in five-year survival
      among BD-1 patients with either Dukes B or C lesions (68.3 percent vs. 66.2
      percent). The presence of more severe budding appears to indicate a vigorous
      biologic activity of colorectal cancer. Thus, meticulous follow-up--and possibly
      adjuvant chemotherapy--may be beneficial for patients with marked budding,
      regardless of their Dukes stage.

PMID- 8348848
TI  - Is follow-up of colorectal cancer patients worthwhile?
AB  - Between 1978 and 1989, 1,045 of 1,399 patients (580 male and 474 female)
      underwent curative surgery for colorectal carcinoma. Of these patients, 350 (33
      percent) had recurrences, another 16 (1.5 percent) developed a metachronous
      colorectal cancer, and 23 (2 percent) had cancers of other organs. An isolated
      locoregional recurrence was found in 75/350 (21 percent). The remaining 275/350
      patients (79 percent) showed systemic dissemination of the carcinoma.
      Reoperations with curative intent were performed on 56/350 patients (16 percent).
      Only 21 of the 56 resected patients (38 percent), i.e., 21/350 (6 percent), were
      without recurrence at the end of the follow-up period on December 31, 1990.
      Despite a curative reoperation, 62 percent of the patients again developed
      recurrent growths. There is an imbalance between the efforts invested in tumor
      follow-up and the benefits gained. Further follow-up programs should be
      investigated in a controlled, prospective fashion.

PMID- 8348849
TI  - Adenocarcinoma complicating Crohn's disease.
AB  - We report on 14 cases of intestinal adenocarcinoma complicating Crohn's disease,
      seven occurring in the small bowel and seven in the large bowel. In both
      locations, two-thirds of patients were male. The average ages at the time of
      diagnosis of Crohn's disease and of cancer were similar between the two groups of
      patients: 28 and 48 years, respectively. The diagnosis of cancer was suspected or
      obtained preoperatively in only four cases of large bowel cancer; in two patients
      with large bowel cancer and five with small bowel cancer, the diagnosis was made
      at laparotomy. In the remaining cases, only careful histologic examination
      revealed the carcinoma. Six small bowel cancers were located in the ileum, and
      five colonic cancers were distal to the splenic flexure. Two small bowel and one
      large bowel cancer were multifocal and had surrounding mucosal dysplasia. All
      tumors, except one small bowel cancer, underwent resection. Survival correlated
      with stage of tumor at resection; no patient with regional or distant metastasis
      survived five years, in comparison with an 83 percent five-year actuarial
      survival rate of patients with tumor confined to the intestinal wall. Mean
      survival was six months for patients with small bowel cancer in comparison with
      65 months for patients with large bowel cancer, reflecting a tendency toward more
      advanced lesions in the small bowel cancer group.

PMID- 8348851
TI  - Cinedefecography and electromyography in the diagnosis of nonrelaxing
      puborectalis syndrome.
AB  - A prospective study was undertaken to assess the correlation between
      electromyography (EMG) and cinedefecography (CD) for the diagnosis of nonrelaxing
      puborectalis syndrome (NRPR). Clinical criteria for NRPR included straining,
      incomplete evacuation, tenesmus, and the need for enemas, suppositories, or
      digitation. EMG criteria included failure to achieve a significant decrease in
      electrical activity of the puborectalis (PR) during attempted evacuation. CD
      criteria included either paradoxical contraction or failure of relaxation of the
      PR along with incomplete evacuation. In addition, other etiologies for incomplete
      evacuation, such as rectoanal intussusception or nonemptying rectocele, were
      excluded by proctoscopy and defecography in all cases. One hundred twelve
      patients with constipation, 81 females and 31 males, with a mean age of 59
      (range, 12-83) years were studied by routine office evaluation, CD, and EMG.
      Forty-two patients (37 percent) had evidence of NRPR on CD (rectal emptying:
      none, 24; incomplete, 18). Twenty-eight of these patients (67 percent) also had
      evidence of NRPR on EMG. EMG findings of NRPR were present in 12 of 70 patients
      (17 percent) with normal rectal emptying. Conversely, 14 of 72 patients (19
      percent) with normal PR relaxation on EMG had an NRPR pattern on CD. The
      sensitivity and specificity for the EMG diagnosis of NRPR were 67 percent and 83
      percent, and the positive and negative predictive values were 70 percent and 80
      percent, respectively. Conversely, if EMG is considered as the ideal test for the
      diagnosis of NRPR, CD had a sensitivity of 70 percent, a specificity of 80
      percent, and positive and negative predictive values of 66 percent and 82
      percent, respectively. In summary, sensitivity, specificity, and predictive
      values of EMG and CD are suboptimal. Therefore, a combination of these two tests
      is suggested for the diagnosis of NRPR.

PMID- 8348850
TI  - Polyamines, diamine oxidase, and ornithine decarboxylase activity in colorectal
      cancer and in normal surrounding mucosa.
AB  - We investigated the polyamine levels [putrescine (Put), spermidine (Spd), and
      spermine (Spm)] and their metabolism by simultaneously considering the ornithine
      decarboxylase (ODC) and diamine oxidase (DAO) activities in human colorectal
      cancer and in normal surrounding tissue. Single and total polyamine levels were
      significantly higher in the neoplastic tissue than in the surrounding mucosa from
      the same patients. Furthermore, the ODC activity was significantly higher and the
      DAO activity significantly lower in the neoplastic tissue than in the surrounding
      mucosa. Polyamine levels and enzymatic activities did not correlate with the
      clinical and histologic characteristics of patients. In normal tissue samples, no
      correlation was found between single and total polyamine levels and enzymatic
      activities (both DAO and ODC). On the contrary, in colorectal neoplastic samples,
      significant and positive correlations were found between the levels of total
      polyamines, Spd, and Spm and the ODC activity. In the same specimens, DAO
      activity was related to Spd levels and the Spd/Spm ratio, but, in those cases,
      the correlation was negative. Thus, our findings suggest that, during the
      neoplastic growth of the colorectal mucosa, the balance between polyamine
      degradation and biosynthesis is disengaged from the control exerted by the two
      enzymes.

PMID- 8348852
TI  - Risk of sphincter damage and anal incontinence after anal dilatation for fissure
      in-ano. An endosonographic study.
AB  - Follow-up was performed two to six years after anal dilatation for fissure-in-ano
      in 32 consecutive patients who had not undergone additional anal surgery. All
      patients were interviewed and asked specifically about impairment of flatus or
      fecal control and its possible relation to the anal dilatation. Anal dilatation
      was followed by minor anal incontinence in 12.5 percent of the patients. Anal
      endosonographic follow-up was accepted by 20 patients, and sphincteric defects
      were found in 13 (65 percent) of those. Two patients with anal incontinence had
      internal sphincter defects. Sphincteric defects were also found in 11 of the 18
      continent patients who underwent sonography: internal sphincter defects in nine,
      external sphincter defect in one, and combined defects of both sphincter muscles
      in one. In conclusion, anal dilatation results in sphincter damage in more than
      half of patients, but few of them develop anal incontinence.

PMID- 8348853
TI  - Protective effect of RibCys following high-dose irradiation of the rectosigmoid.
AB  - Ribose-cysteine (RibCys) is a prodrug of L-cysteine that stimulates glutathione
      biosynthesis. Increased glutathione levels have been shown to have a protective
      effect against radiation-induced injury and oxidative stress. Surface oximetry
      has previously been used successfully to predict anastomotic leakage. PURPOSE:
      The following study was done to evaluate the protective effect of RibCys and the
      predictive value of PtO2 determinations in a swine model. METHODS: Domestic swine
      were divided into three groups: Group A served as a nonradiated control; Group B
      received 6,000 to 6,500 rad to the rectosigmoid; and Group C received RibCys (1
      g/kg) prior to receiving 6,000 to 6,500 rad. Radiated animals and controls
      underwent rectosigmoid resection after a three-week rest period. Intraoperative
      anastomotic PtO2 was checked with a modified Clark electrode. Anastomoses were
      evaluated radiographically at three and seven days; animals were sacrificed, and
      bursting strength was recorded at 10 days. RESULTS: Mean bursting pressures were
      243.8 +/- 59.4, 199.5 +/- 37.8, and 209.5 +/- 54.9 mmHg (NS) for Groups A, B, and
      C, respectively. Anastomotic PtO2 ranged from 19 to 98 mmHg and could not be
      correlated with anastomotic leaks or bursting pressure. There were 11/15
      radiation-related deaths and leaks (eight deaths and three leaks) in the radiated
      group and 4/12 radiation-related deaths and leaks (three deaths and one leak) in
      the group receiving radiation and RibCys (P < 0.04). CONCLUSIONS: 1) RibCys
      protected animals against radiation-related deaths and anastomotic leaks
      following high doses of pelvic irradiation; 2) anastomotic PtO2 levels did not
      correlate with anastomotic healing in this model.

PMID- 8348854
TI  - Endoluminal ultrasound is preferable to electromyography in mapping anal
      sphincteric defects.
AB  - Assessment of complex sphincteric defects in patients with fecal incontinence by
      digital rectal examination and intraoperative dissection can be difficult in the
      presence of excessive scarring. Adjunctive investigation such as endoluminal
      ultrasound (ELUS) and needle electromyography (EMG) may provide objective
      evidence of the nature and extent of the sphincteric defects. In a series of 11
      patients, ELUS of the anal canal with a 10-MHz transducer (focal zone of 1-4 cm)
      accurately detected defects in the external anal sphincter (EAS) in seven of
      seven patients, defects in the internal anal sphincter (IAS) in eight of eight
      patients, and integrity of both sphincters in two patients. These findings were
      confirmed by needle EMG of the EAS alone in five patients, by operative findings
      at a perineal sphincteroplasty operation in six patients, and by both in two
      patients. ELUS was associated with less pain than was needle EMG (pain score 4
      vs. 10, 10 being most painful) and provided high-resolution radial images of both
      the EAS and the IAS. Thus, ELUS seems preferable to EMG in mapping anal
      sphincteric defects and can be a useful anatomic adjunct to physiologic studies
      of anorectal function in patients with fecal incontinence.

PMID- 8348855
TI  - Laparoscopic-assisted full-thickness endoscopic polypectomy.
AB  - PURPOSE: To describe the procedure for endoscopically removing sessile colonic
      polyps with laparoscopic assistance. METHODS: Technique description and
      retrospective review of experience. RESULTS: The technique has been used to
      successfully remove polypoid colonic lesions in three patients. CONCLUSIONS:
      Laparoscopic-assisted polypectomy allows complete excision of moderate-sized
      sessile polyps and may spare selected patients a colonic resection.

PMID- 8348856
TI  - Prokinetic agents for lower gastrointestinal motility disorders.
AB  - Prokinetic agents are currently being investigated as potential therapies for
      motility disorders of the lower gastrointestinal tract. Cholinergic agonists such
      as bethanechol are known to improve postoperative ileus but are limited because
      of side effects. Dopamine antagonists such as domperidone appear to have maximal
      prokinetic effect in the proximal gastrointestinal tract and are effective for
      such conditions as gastroparesis and gastroesophageal reflux, but they appear to
      have little physiologic effect in the colon or in colonic motility disorders.
      Naloxone, an opioid antagonist, appears to hold promise in patients with
      irritable bowel syndrome, small intestinal pseudo-obstruction, and constipation.
      Erythromycin exerts its prokinetic effect by acting as a motilin agonist; it has
      been used in the treatment of diabetic gastroparesis and appears to improve
      symptoms of colonic pseudo-obstruction and postoperative ileus. Metoclopramide, a
      combined cholinergic agonist and dopamine antagonist, is currently used
      exclusively for proximal motility dysfunction. Cisapride appears to hold the most
      promise for patients with colonic motility disorders. In patients with
      postoperative ileus, cisapride is associated with an increased return of bowel
      function compared with placebo. In patients with chronic constipation, cisapride
      increases stool frequency and decreases laxative abuse in both adults and
      children. Hopefully, as an understanding of gastrointestinal motility increases,
      effective prokinetic agents will be developed that will improve symptoms of
      patients with large bowel motility disorders and may also help to predict those
      patients who benefit from surgical management for constipation.

PMID- 8348857
TI  - Combined therapy for cancer of the anal canal: a preliminary report. 1974.

PMID- 8348858
TI  - The colorectal surgeon's scientific and economic responsibility.

PMID- 8348859
TI  - Electrogalvanic stimulation for levator syndrome: how effective is it in the long
      term?
AB  - Levator syndrome is a symptom complex of severe pain and pressure in the
      anorectal area. Electrogalvanic stimulation (EGS) has been proposed as a
      treatment for this condition. Several reports have described EGS as up to 90
      percent "effective" in treating levator syndrome, but the length of follow-up was
      uncertain or short-term in these studies. The purpose of this study was to
      examine the long-term benefits of EGS in levator syndrome patients treated at one
      institution. All patients undergoing EGS for levator syndrome between 1985 and
      1991 were studied. Initial complaints, physical examination, number of
      treatments, procedure tolerance, and long-term benefit were determined through
      personal interviews and chart reviews. There were 52 patients (63 percent females
      and 37 percent males) with a median age of 54 years (range, 24-84 years). All
      patients presented with anorectal pain. Tenderness was localized by examination
      to the left in 43 percent, to the right in 23 percent, and bilateral in 8.6
      percent and was not localized in 2.6 percent. Fifty percent received fewer than
      four one-hour treatments, 33 percent received four to six treatments, and 17
      percent received more than six treatments. Seventy-seven percent felt that the
      treatment was painless. Follow-up results were as follow: number, 52; percent
      follow-up, 88; mean follow-up, 28 months (range, 0-71 months); symptoms relieved,
      19 percent; partial relief, 24 percent; no relief, 57 percent. Of four patients
      with a wrong diagnosis, three were ultimately diagnosed with recurrent pelvic
      cancer and one had an anal fissure. At our institution, EGS was a tolerable
      treatment, but a substantial number of patients received no benefit. An organic
      etiology of anorectal pain must always be excluded.

PMID- 8348860
TI  - Do general surgery residency programs adequately train surgeons to perform
      anorectal surgery?
AB  - The management of anorectal disease remains a major component in the practice of
      the general surgeon. To assess the adequacy of general surgery residencies in
      addressing this educational need, data were obtained from the Residency Review
      Committee (RRC) for surgery on the anorectal experience of all graduating
      residents in accredited United States programs for a recent five-year period
      (1987-1991). The mean number of anorectal procedures in which a resident
      participated throughout the residency was 30.0. This is then further subdivided
      by type of procedure. It is concluded that general surgery residency programs
      tend to provide an inadequate training experience in anorectal surgery.

PMID- 8348861
TI  - Incidence of surgical resection for Crohn's disease.
AB  - One hundred fifty-two of 399 Crohn's patients (38 percent) diagnosed over 20
      years, who lived within a geographically defined area at the time of diagnosis,
      underwent at least one operation. One hundred seventy-one resections were
      performed in 160 operations during a mean follow-up of 60 months. Forty-eight
      percent of patients had undergone their first resection within 10 years of
      diagnosis, and 39 percent of these had undergone a second resection within 10
      years of the first. There was no difference between smokers and nonsmokers in the
      timing of their surgery.

PMID- 8348862
TI  - Clinical assessment of the anal continence plug.
AB  - Recently, promising results with different modifications of an anal continence
      plug were reported in a pilot study. We have performed a clinical assessment of
      the plug preferred by the majority of patients in this study in an ambulatory
      group of patients incontinent to liquid and solid stool. Nine of 14 patients (64
      percent; 95 percent confidence interval: 35-87 percent) were continent when they
      used the plug. In 43 percent (18-71 percent), the plug occasionally slipped out,
      and 71 percent (42-92 percent) experienced discomfort to a varying degree, which
      caused 11 patients to withdraw from the study before the end of the planned study
      period. No correlation was found between the results of anorectal physiology
      studies and the benefit or inconvenience of using the plug. The overall
      conclusion is that the majority of patients would use the plug under special
      circumstances because it eliminates the fear of fecal leakage but that local
      discomfort, possibly due to the material, would prevent its daily use.

PMID- 8348863
TI  - Outcome of delayed hemorrhage following surgical hemorrhoidectomy.
AB  - Delayed hemorrhage following surgical hemorrhoidectomy is a well-recognized
      complication. Emergency treatment may include suture ligation, anal packing, or
      other means of tamponade. At the Lehigh Valley Hospital, 27 patients were seen
      with the complication of delayed hemorrhage over an eight-year period from 1983
      to 1990, for an incidence of 0.8 percent. Twenty-five patients (93 percent)
      underwent surgery primarily for hemorrhoidal disease; one patient had hemorrhoids
      removed in addition to a sphincterotomy for anal tissue, and the remaining
      patient had hemorrhoidectomy with fistulotomy. The mean interval from the
      operation to hemorrhage was six days. Treatment modalities included bedside anal
      packing in 20 patients (74 percent), observation alone in five patients (18
      percent), and suture ligation in the operating room in two patients. Anal packing
      was successful in controlling postoperative hemorrhage in 20/20 patients, but
      late complications requiring reoperation developed in 15 percent.

PMID- 8348864
TI  - Laparoscopic-assisted bowel surgery.
AB  - The use of laparoscopic surgical techniques is now being applied to a variety of
      operations traditionally performed in an open fashion. Twenty patients underwent
      laparoscopic-guided large and small bowel surgery at our institution from March
      1991 to April 1992. The indications for surgery included polyps, obstruction,
      bleeding, and perforation, and pathologic diagnoses included benign polyps,
      lipomas, inflammatory bowel disease, perforation of a jejunal diverticulum,
      colonic arteriovenous malformations, and adenocarcinoma. Mobilization of the
      colon, ligation of the mesentery, and closure of the mesenteric defect were
      performed using the laparoscopic equipment. One trocar site was enlarged to 3 cm
      to deliver the bowel through the abdominal wall. All anastomoses were hand-sewn.
      Postoperative hospitalization ranged from 2 to 31 days (median, five days). No
      mortality was noted, and morbidity was 20 percent. We conclude that laparoscopic
      guided bowel surgery is technically feasible and should translate into shorter
      hospitalization and less patient discomfort.

PMID- 8348865
TI  - Minimally invasive colectomy: are the potential benefits realized?
AB  - Laparoscopic surgical techniques have recently been applied to various types of
      colon resection. Early reports have focused on the technical feasibility of these
      procedures, and it has not yet been clearly shown that such procedures benefit
      the patient. We reviewed our experience with 28 attempted minimally invasive
      colectomies (MICs) performed over a nine-month period. Laparoscopic or
      laparoscopic-assisted resections were successfully completed in 24 of these
      patients. We compared the results of surgery in these 24 patients with a group of
      33 patients undergoing similar procedures at the same institution by the same
      surgeon in the nine months preceding the laparoscopic experience. The two groups
      of patients were similar with respect to age, weight, and the types of procedures
      performed. However, the postoperative length of stay for patients undergoing MIC
      (4.8 days) was significantly shorter than for those undergoing open colectomies
      (8.2 days). Patients undergoing MIC also regained bowel function significantly
      earlier than those undergoing open colectomy. The operative times for the
      minimally invasive procedures were significantly longer than for those undergoing
      open colectomy. No surgically related deaths were encountered, and morbidity was
      13 percent. None of the four patients converted from laparoscopic to open
      colectomy suffered complications as a result of the attempted laparoscopic
      procedure. We conclude that MIC can be safely performed and does appear to reduce
      the duration of postoperative ileus and decrease the length of postoperative
      hospitalization.

PMID- 8348866
TI  - Fecal diversion in the management of Crohn's disease of the colon.
AB  - The clinical course of 44 patients undergoing elective proximal fecal diversion
      for Crohn's disease of the colon is reported. Sustained disease remission was
      obtained in 31 patients (70 percent). Diversion was associated with a significant
      reduction in steroid requirements (P < 0.01) and a significant improvement in
      hemoglobin (P < 0.001), erythrocyte sedimentation rate (P < 0.001), and albumin
      (P < 0.05). Sixteen patients (36.4 percent) have required a proctocolectomy, 19
      patients (43.2 percent) remain defunctioned, and four patients (9 percent) have
      died. Five patients have had intestinal continuity restored, which has remained
      intact in four patients for a mean follow-up of 99 (range 21-153) months. Fecal
      diversion for Crohn's disease of the colon produces a high incidence of sustained
      disease remission, but for the majority of patients the prospect of future
      restoration of intestinal continuity is limited.

PMID- 8348867
TI  - Diagnostic laparoscopy: reducing the number of normal appendectomies.
AB  - A prospective, controlled study was conducted to determine whether a selective
      policy of diagnostic laparoscopy could reduce the number of unnecessary normal
      appendectomies in patients with acute right iliac fossa pain. The cohort
      consisted of patients admitted with acute right iliac fossa pain by the emergency
      department. Of 102 patients in the study group, 28 subsequently required a
      diagnostic laparoscopy when a definite diagnosis could not be reached after 8 to
      12 hours of observation. Of these, only 18 had inflamed appendices, which were
      removed. In the rest of the patients (10), the appendices were normal and
      unnecessary laparotomies were avoided. In the control group, wherein equivocal
      cases were laparotomized after a similar period of observation, there was a
      normal appendectomy rate of 15.7 percent (P < 0.05). There was no significant
      difference in the incidence of perforation between the control and study groups.
      Diagnostic laparoscopy in equivocal cases could thus significantly reduce the
      number of unnecessary appendectomies without compromising on the rate of
      perforation.

PMID- 8348868
TI  - Perineal rectosigmoidectomy in the elderly.
AB  - Between April 1989 and October 1991, 20 consecutive patients underwent perineal
      rectosigmoidectomy and coloanal anastomosis for full-thickness rectal prolapse.
      These 16 females and 4 males, with a mean age of 82 (range, 68-101) years, were
      evaluated by detailed functional assessment and physiologic testing. A grading
      scale from 0 to 24 was based upon the frequency and type of incontinence, 0
      representing full continence. The mean preoperative continence score was 14.5,
      while the mean postoperative continence score was 8.4. The mean length of
      resected rectosigmoid was 23 cm. There was one postoperative death and one
      significant complication, a postoperative pelvic hematoma that required
      reoperation. There were no full-thickness recurrences at a mean follow-up of 26
      months. Six of the 10 patients who underwent preoperative pudendal nerve terminal
      motor latency (PNTML) testing had evidence of severe neuropathy (latencies
      greater than 2.5 milliseconds). Prolonged PNTML, however, was not shown to be an
      accurate predictor of postoperative incontinence because four of the six patients
      with neuropathy regained excellent to good control. In conclusion, perineal
      rectosigmoidectomy is a safe operation for the treatment of full-thickness rectal
      prolapse in the elderly patient. Improved postoperative continence was noted in
      90 percent of patients, with improvement seen even in those patients with severe
      pudendal neuropathy.

PMID- 8348869
TI  - Toxic epidermal necrolysis--an unusual cause of colonic perforation. Report of a
      case.
AB  - Toxic epidermal necrolysis (TEN) is a rare and severe reaction to certain drugs
      that results in full-thickness epidermal necrosis of the skin. Other mucosal
      surfaces such as the oropharynx, esophagus, conjunctiva, and genitalia may also
      be affected. Specific involvement of the colon is distinctly unusual. A case of
      TEN that resulted in complete small bowel necrosis and colonic perforation is
      reported. Early and aggressive surgical resection dealt successfully with this
      complication and, along with supportive care, allowed resolution of the systemic
      condition to occur. Five additional cases of colonic necrosis complicating TEN
      are reviewed.

PMID- 8348870
TI  - Simple technique for anvil insertion in stapled circular colorectal anastomoses.
AB  - The benefits of circular stapling devices are obvious. The introduction of
      staplers with detachable anvils has simplified the stapling procedure even more
      than the original instruments. A simple technique for placing the anvil and
      pursestring are described.

PMID- 8348871
TI  - Pharmacologic treatment of colonic pseudo-obstruction.

PMID- 8348872
TI  - Relationship between parity and anal manometry.

PMID- 8348873
TI  - Limits of habituation and extinction: implications for relapse prevention
      programs in addictions.
AB  - Problems in the application of exposure techniques to the management of long term
      dishabituation in addicts are discussed in the light of human and animal
      evidence. Extinction and habituation of responses to drug cues or drug
      aftereffects are unstable and strongly dependent on context, thus limiting the
      effectiveness of cue exposure treatments in the prevention of relapse. Several
      strategies are suggested to improve the stability of extinction and habituation
      in order to enduringly prevent relapse in addictions. (i) Warning patients about
      the episodic resurgence of unexpected urges or cravings precipitated by
      conditioned contexts and exposing them to such contexts. (ii) To obtain a maximum
      protection against relapse, extinction should 'recreate' all the original
      learning contexts (i.e. all possible drug cues). (iii) The behavioral chains
      involved in self administering drugs ought to be incorporated into cue exposure
      treatments (without permitting consummatory responses) in order to decrease their
      signal value as cues for drugs.

PMID- 8348874
TI  - Triazolam and ethanol effects on human matching-to-sample performance vary as a
      function of pattern size and discriminability.
AB  - The effects of placebo, triazolam (2.0, 4.0 and 8.0 micrograms/kg) and ethanol
      (0.25, 0.5, 1.0 g/kg) on perceptual-motor performance were examined using a
      visual pattern matching-to-sample procedure in which pattern size and comparison
      stimulus discriminability were systematically varied. Baseline response rates and
      accuracy increased as the discriminability of the comparison stimuli increased.
      At the highest dose, both drugs decreased response accuracy. This disruption of
      accuracy was attenuated by increasing the discriminability of non-matching
      stimuli. Triazolam produced dose-related decreases in response rate while ethanol
      produced only slight decreases at the highest baseline rates of responding. Thus,
      triazolam produced response rate slowing at relatively lower doses than ethanol.

PMID- 8348875
TI  - Caffeine self-administration and withdrawal: incidence, individual differences
      and interrelationships.
AB  - In four prior studies, caffeine (100 mg) self-administration was assessed by
      greater self-administration of caffeinated coffee than decaffeinated coffee and
      caffeine withdrawal was assessed by placebo substitution using six double-blind
      tests in each subject. This paper collates data across these studies to examine
      the incidence and predictors of the occurrence of caffeine self-administration
      and withdrawal. Caffeine self-administration occurred in 31% of subjects when a
      consistency criterion was used (n = 41) and 27% when a statistical criterion was
      used. Caffeine withdrawal occurred in 35% and 49% of subjects with each criteria
      (n = 37). Subjects who had withdrawal headaches and drowsiness were 2.3-2.6 times
      more likely to self-administer the caffeinated coffee. Several variables (e.g.,
      average caffeine intake) did not predict caffeine self-administration or
      withdrawal.

PMID- 8348877
TI  - The dual use of opioids and temazepam by drug injectors in Glasgow (Scotland).
AB  - In recent years much attention has been drawn to the use of buprenorphine
      (Temgesic) by heroin injectors in Glasgow and elsewhere. Glasgow has also
      witnessed a parallel increase in use of the benzodiazapine temazepam, often used
      as a 'cocktail' with buprenorphine. This paper presents new evidence that,
      although buprenorphine use among Glasgow drug injectors may now be declining, the
      use of temazepam-opioid cocktails has continued.

PMID- 8348876
TI  - Tolerance to self-administration of cocaine in rats: time course and dose
      response determination using a multi-dose method.
AB  - To assess tolerance to cocaine in a self-administration paradigm, rats were
      trained to self-administer cocaine (0.25 mg/injection) on a fixed-ratio 2 (FR2)
      schedule of reinforcement. The development of tolerance was studied during
      chronic administration of cocaine (20 mg/kg per 8 h for 10 days), given either
      contingently (self-administered by the rats) or non-contingently (infused by the
      experimenter). Both contingent and non-contingent administration of cocaine
      produced comparable tolerance, as indicated by a faster rate of cocaine self
      administration (the average inter-reinforcer time, ISRT, decreased
      significantly). Tolerance developed by day 2 of the chronic regimen and reached a
      floor value (60% of baseline) from day 4 through day 10. Termination of chronic
      cocaine then resulted in recovery from tolerance, with ISRTs returning to
      baseline within 6 days of termination. A second set of experiments determined
      whether tolerance could be studied using a multi-dose method to obtain dose
      response data in a single session. A system of multiple pumps allowed testing of
      three doses of cocaine during a single experimental session. Cocaine dose
      response curves obtained from the multi-dose method: (i) did not differ from that
      obtained from a single-dose method; (ii) were reproducible; and (iii) were
      shifted to the right by Schering 23390. Rats were then subjected to a 7-day
      chronic regimen of infused cocaine (20 mg/kg per 8 h) or infused saline. At the
      end of this chronic cocaine period, they were tested with the multi-dose method.
      Chronic cocaine, as compared to chronic saline, shifted the cocaine dose-response
      curve to the right, indicating that the multi-dose method can be successfully
      applied to demonstrate tolerance to the effects of cocaine in a self
      administration paradigm.

PMID- 8348878
TI  - Street sale of heroin--a profitable way of making a living?
AB  - The aim of the study was to give an outline of the financial environment of
      heroin-sale at street level in Norway and the possibilities of making retail sale
      of heroin a living. Data were gathered through police records and interviews with
      informants at street level. Retail sale price has been nominally stable at 300
      Nkr (28 pounds, i.e., 1 pound = 11 Nkr) per end-user dose since 1978. This price
      is coupled to the price of one standard service by street prostitutes. Both the
      end-users and retailers formally make their living from social welfare payments.
      The retailer purchases from a wholesaler batches of up to 10 g of heroin at a
      cost of 50,000 Nkr (4800 pounds). At monthly intervals of delivery this yields
      120,000 Nkr (11,500 pounds) as net tax-free income per year, on top of the social
      welfare payments, even when the retailer and his accomplice consumes a third of
      the purchased quantity. Crime of gain on the part of the retailer is negligible,
      due to increased risk of also disclosing his drug trafficking.

PMID- 8348879
TI  - Helicobacter pylori infection--when and how to treat.

PMID- 8348880
TI  - Femidom--a condom for women.

PMID- 8348881
TI  - Slow-acting antirheumatic drugs.

PMID- 8348882
TI  - Gonadotropin releasing hormone analogues for endometriosis.

PMID- 8348883
TI  - Nebulisers in childhood asthma.

PMID- 8348884
TI  - Aldesleukin for metastatic renal cell carcinoma?

PMID- 8348885
TI  - Meters for measuring blood glucose at home.

PMID- 8348886
TI  - Clinical applications of endoscopic ultrasonography in gastroenterology--state of
      the art 1993. Results of a consensus conference, Orlando, Florida, 19 January
      1993.

PMID- 8348888
TI  - Ergonomics in gastrointestinal endoscopy: what do we need for the future?

PMID- 8348887
TI  - Endoscopic therapy is wonderful (probably); success brings new challenges.

PMID- 8348889
TI  - Dieulafoy's lesion of the duodenum; successful endoscopic therapy.

PMID- 8348890
TI  - Sclerotherapy of duodenal varices using a fibrin tissue sealant.

PMID- 8348891
TI  - Hydrocele following laparoscopic cholecystectomy.

PMID- 8348892
TI  - Videolaparoscopic treatment of Meckel's diverticulum.

PMID- 8348893
TI  - Simple release of an impacted Dormia basket during endoscopic bile duct stone
      extraction.

PMID- 8348894
TI  - Removal of a press-through package in the thoracic esophagus using two flexible
      endoscopes.

PMID- 8348895
TI  - Management of endoscopic impaction during routine ERCP using "the gastric grip".

PMID- 8348896
TI  - Isolated gastric tuberculosis: a case report.

PMID- 8348897
TI  - Colonic tuberculosis. An unusual endoscopic diagnosis.

PMID- 8348898
TI  - Endoscopic diagnosis and removal of Ascaris lumbricoides from the stomach.

PMID- 8348899
TI  - Developing a model of quality of life in epilepsy: the contribution of
      neuropsychology.
AB  - Three specific issues must be considered in the development of a quality-of-life
      in epilepsy model and psychometric instrument. These issues are: (a) whether to
      adopt a narrow versus broad model of quality of life, (b) whether to rely on
      patient self-reports of quality of life or reports garnered from proxies, and (c)
      whether to develop a generic versus disease-specific measure of quality of life.
      In reviewing these issues the contributions of the health services research
      field, research pertaining to the psychological and social effects of epilepsy,
      and especially neuropsychology, are pertinent.

PMID- 8348900
TI  - A procedure for developing a quality-of-life measure for epilepsy surgery
      patients.
AB  - In 1990, the NIH Consensus Conference Panel on epilepsy surgery called for the
      development and use of reliable and valid health-related quality-of-life (HRQOL)
      measures in epilepsy surgery studies. A HRQOL measure for epilepsy surgery
      patients has been developed and evaluated. The procedure, which could also be
      used to develop HRQOL measures for other neurological diseases, entails the
      following steps: (a) specify desired characteristics of the measure; (b) identify
      relevant HRQOL areas by reviewing the literature; (c) assemble generic core items
      and disease-specific supplementary items; (d) pilot test and revise the measure;
      (e) administer revised measure items to a large sample of epilepsy surgery
      patients; (f) perform item analysis to evaluate hypothesized item placement
      within scales; and (g) assess the reliability and validity of the scales. The
      product of this process, the Epilepsy Surgery Inventory (ESI)-55, is a self
      report measure of 11 dimensions of HRQOL. It is brief, comprehensive, and
      reliable; preliminary evidence supports its validity.

PMID- 8348901
TI  - A new quality-of-life inventory for epilepsy patients: interim results.
AB  - The process for developing and evaluating a comprehensive, self-report measure of
      quality of life in epilepsy (QOLIE) is described, and interim results for 64
      patients are reported. A test battery of 98 quality-of-life items was constructed
      with use of the RAND 36-Item Health Survey as a generic core and adding other
      quality-of-life items, the latter derived from a literature review and expert
      opinion on areas of importance to people with mild to moderate epilepsy.
      Seventeen scales tapping unique quality-of-life dimensions were identified from
      this QOLIE test battery. The battery was administered to 64 adults with mild to
      moderate epilepsy and their proxies (relative or close friend) on two separate
      visits 2-3 weeks apart. Patients also completed a neuropsychological test battery
      on the first visit. Interim analysis of these data demonstrated that 16 of 17
      scales on the QOLIE test battery are sufficiently reliable for group comparison:
      Cronbach's alpha for the 16 scales ranged from 0.73 to 0.88; test-retest
      reliability ranged from 0.56 to 0.88. Preliminary evaluation of validity
      confirmed hypothesized correlations between selected QOLIE scales and Profile of
      Mood State scales. Correlations between patient and proxy scores ranged from 0.29
      to 0.69 (all statistically significant at p < 0.005). A more detailed, final
      analysis of data for over 300 patients currently enrolled in the study will be
      published later.

PMID- 8348902
TI  - Research use of the new quality-of-life in epilepsy inventory.
AB  - Epilepsy is a heterogeneous disease with variable onset and prognosis. In
      general, patients with epilepsy have neuropsychological impairments. Their
      educational and occupational achievements may be lower than might be expected for
      their level of cognition. Some epilepsy patients suffer emotional distress,
      interictal behavioral disorders, and extreme social isolation. It is obvious that
      epilepsy and its sequelae impact on the patient's quality of life. What is not
      clear is the degree to which different factors contribute and the causes for
      extreme variance across patients. For example, the patients' perceptions of their
      disease affects quality of life more than actual seizure severity, but the
      mechanisms underlying this effect are not known. Quality-of-life research in
      epilepsy is in its infancy. In the future, such research will play an important
      role in assessing patient suffering, demonstrating the efficacy of treatments and
      interventions, and influencing medical economic decisions.

PMID- 8348903
TI  - Clinical uses of the quality-of-life in epilepsy inventory.
AB  - The quality-of-life in epilepsy (QOLIE) inventory was designed to assess adult
      epilepsy patients. Responses to a draft 99-question inventory administered to
      patients with low to moderate seizure frequency will be used to generate two or
      three separate instruments. The largest and most comprehensive of these will
      serve as a research tool for investigators and may be helpful in designing
      studies that compare the effects of approved or investigational antiepileptic
      drugs. This instrument may also be useful in documenting patient outcomes
      following expensive diagnostic studies, such as video-electroencephalogram
      monitoring, or other therapeutic interventions, such as epilepsy surgery. An
      intermediate-sized instrument may serve as a clinical tool for neurologists and
      epileptologists. A brief instrument may serve as a quick clinical survey for
      primary care physicians, neurologists, and specialists in epileptology. The
      abbreviated clinical inventories are intended to provide rapid assessment of
      quality-of-life issues in the office setting. Such assessments can help
      physicians and patients identify previously unrecognized problems and may lead to
      changes in care.

PMID- 8348904
TI  - Quality of life in epilepsy: the clinician's view.
AB  - Quality of life in patients with epilepsy may be impaired by seizures, side
      effects of medication, and psychosocial problems. Doctors tend to focus their
      attention on managing the seizures and the side effects, but may not be meeting
      all of the patient's needs because of differences between their perception of
      these concerns and the patient's. Further, psychosocial problems often are
      addressed only superficially or not at all during office visits. The challenge is
      to integrate quality-of-life issues into clinical practice and to better assess
      the patient's perception of the disorder, the seizures, and the medications, as
      they impact on cognitive function, emotional well-being, and social and economic
      functioning.

PMID- 8348905
TI  - A clinimetric approach to assessing quality of life in epilepsy.
AB  - Clinimetrics is a concept involving the use of rating scales for clinical
      phenomena ranging from physical examinations to functional performance.
      Clinimetric or rating scales can be used for defining patient status and changes
      that occur during long-term observation. The scores derived from such scales can
      be used as guidelines for intervention, treatment, or prediction of outcome. In
      epilepsy, clinimetric scales have been developed for assessing seizure frequency,
      seizure severity, adverse effects related to antiepileptic drugs (AEDs), and
      quality of life after surgery for epilepsy. The VA Epilepsy Cooperative Study
      seizure rating scale combines frequency and severity in a weighted scoring system
      for simple and complex partial and generalized tonic-clonic seizures, summing all
      items in a total seizure score. Similarly, the rating scales for systemic
      toxicity and neurotoxicity use scores weighted for severity for assessing
      specific adverse effects typically related to AEDs. A composite score, obtained
      by adding the scores for seizures, systemic toxicity, and neurotoxicity,
      represents the overall status of the patient at a given time. The Chalfont
      Seizure Severity Scale also applies scores relative to the impact of a given item
      on the patient, without factoring in seizure frequency. The Liverpool Seizure
      Severity Scale is a patient questionnaire covering perceived seizure severity and
      the impact of ictal and postictal events. The UCLA Epilepsy Surgery Inventory
      (ESI-55) assesses quality of life for patients who have undergone surgery for
      epilepsy using generic health status instruments with additional epilepsy
      specific items.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348906
TI  - PACS and digital imaging--new directions.

PMID- 8348907
TI  - Image segmentation: methods and applications in diagnostic radiology and nuclear
      medicine.
AB  - We review and discuss different classes of image segmentation methods. The
      usefulness of these methods is illustrated by a number of clinical cases.
      Segmentation is the process of assigning labels to pixels in 2D images or voxels
      in 3D images. Typically the effect is that the image is split up into segments,
      also called regions or areas. In medical imaging it is essential for
      quantification of outlined structures and for 3D visualization of relevant image
      data. Based on the level of implemented model knowledge we have classified these
      methods into (1) manual delineation, (2) low-level segmentation, and (3) model
      based segmentation. Pure manual delineation of structures in a series of images
      is time-consuming and user-dependent and should therefore be restricted to quick
      experiments. Low-level segmentation analyzes the image locally at each pixel in
      the image and is practically limited to high-contrast images. Model-based
      segmentation uses knowledge of object structure such as global shape or semantic
      context. It typically requires an initialization, for example in the form of a
      rough approximation of the contour to be found. In practice it turns out that the
      use of high-level knowledge, e.g. anatomical knowledge, in the segmentation
      algorithm is quite complicated. Generally, the number of clinical applications
      decreases with the level and extent of prior knowledge needed by the segmentation
      algorithm. Most problems of segmentation inaccuracies can be overcome by human
      interaction. Promising segmentation methods for complex images are therefore user
      guided and thus semi-automatic. They require manual intervention and guidance and
      consist of fast and accurate refinement techniques to assist the human operator.

PMID- 8348908
TI  - Data fusion in medical imaging: merging multimodal and multipatient images,
      identification of structures and 3D display aspects.
AB  - Data fusion in medical imaging can be seen into two ways (i) multisensors fusion
      of anatomical and functional information and (ii) interpatient data fusion by
      means of warping models. These two aspects set the methodological framework
      necessary to perform anatomical modelling especially when concerning the
      modelling of brain structures. The major relevance of the work presented here
      concerns the interpretation of multimodal 3D neuro-anatomical data bases. Three
      types of data fusion problems are considered in this paper. The first one
      concerns the problem of data combination which includes multimodal registration
      (multisensor fusion applied to CT, MRI, DSA, PET, SPECT, or MEG). In particular,
      the problem of warping patient data to an anatomical atlas is reviewed and a
      solution is proposed. The second problem of data fusion addressed in this paper
      is the identification of anatomical structures by means of image analysis
      methods. Two techniques have been developed. The first one deals with the
      analysis of image geometrical features to end up with the determination of a
      fuzzy mask to label the structure of interest. The second technique consists of
      labelling major cerebral structures by means of statistical image features
      associated with relaxation techniques. Finally, the paper presents a review of up
      to date 3D display techniques with a special emphasis on volume rendering and 3D
      display of combined data.

PMID- 8348909
TI  - European standardization efforts: an important framework for medical imaging.
AB  - For several years now, users have been waiting for standards allowing medical
      images to be exchanged, managed, stored and manipulated. Standards are
      prerequisites for the development of PACS and IMACS systems. It is because of the
      lack of standards that PACS have not yet widely been implemented. The ACR-NEMA
      committee (American College of Radiology--National Electronical Manufactures
      Association) are developing an image communication standard: DICOM 3.0. This
      should allow interconnection of different imaging modalities and other PACS
      nodes. Part of the DICOM 3.0 work will be demonstrated at RSNA 93 with
      involvement of Europe. In the European Standardization Committee (CEN), the
      technical committee responsible for the standardization activities in Medical
      Informatics (CEN TC 251), has agreed upon the directions and the scopes to be
      followed in this field. They are described in the directory of the European
      standardization requirements for health care informatics and programme for the
      development of standard adopted on 28 February 1991 by CEN TC 251. Top-down
      objectives describe the common framework and items like terminology, security,
      while the more bottom-up oriented items describe fields like medical imaging and
      multi-media. Since CEN TC 251 started working, an important coordination took
      place between Europe and the US and Japan, resulting in a common future approach.
      CEN TC 251 is setting the scene for a more technologically independent standard
      on a mid term basis. This standard will first have to be proto-typed before it
      can be published, because it must be possible to implement the standard, too much
      complexity will not be accepted by the industry. The European imaging
      standardization work based on the ISO/IPI standard, will be briefly explained; as
      well as the general framework model and object oriented model; the interworking
      aspects, and the relation to ISO standards. One should realize be realised that a
      standard is needed, which is not too ambitious. Because DICOM 3.0 will be ready
      soon, Europe has decided to support these activities and will concentrate on the
      next step to be taken.

PMID- 8348910
TI  - Digital fluoroscopic radiology: evaluation of the clinical impact.
AB  - The use of digital image intensifier radiography (DIIR) for examinations in
      projection radiography is becoming more common. Fluoroscopic controlled contrast
      studies (barium- or iodine-based), particularly of the gastrointestinal tract,
      can be performed quickly and easily with a considerable decrease in radiation
      exposure. A wide dynamic range permits a constant high image quality with fewer
      incorrect exposures. The limited spatial resolution of large image intensifier
      input screens is the major drawback of DIIR. Digital image acquisition enables
      post-processing, digital storage and transfer of images, thus allowing an
      integration into PACS-systems. Imaging capabilities and clinical applications are
      described here.

PMID- 8348912
TI  - A personal-computer semiautomated report-coding system for diagnostic
      mammography.
AB  - A computerized report-coding system for diagnostic mammography using a personal
      computer was developed. Four years' experience with the radiologist-oriented
      system is presented. The data input time for report generation is in most cases
      less than 30 seconds by radiologists familiar with keyboard entry. Suspicious and
      malignant findings are dictated in the conventional way. About 80% of the
      mammographic examinations at the university Breast Imaging Center were suitable
      for standardized reporting. Radiologist-generated reports using a personal
      computer might be an alternative to transcriptionist-oriented systems.

PMID- 8348911
TI  - HIPIN--a generic HIS/RIS-PACS interface based on clinical radiodiagnostic
      procedures.
AB  - Within the EurIPACS HIPIN topic a generic HIS/RIS-PACS interface will be
      designed, implemented and evaluated. It is generally agreed that integration with
      the HIS/RIS is essential for the acceptance of PACS in a clinical environment. An
      interface between HIS/RIS and PACS allows more efficient usage of both systems,
      better integration of data, better consistency checking on shared data and better
      security and error handling. Also the PACS performance is improved by using
      HIS/RIS information to steer the image migration within the PACS. In this paper
      the functional specifications of the interface are described. These
      specifications are based on descriptions of clinical radiodiagnostic procedures.
      The generic interface consists of a common part, and of site specific adapters.
      The common part is identical for all incarnations and performs message
      scheduling, processing and logging. The adapters are specific for each
      communication standard, e.g. ACR-NEMA or HL7, and for each hospital. The
      interface will be implemented at the radiology department of the Philipps
      University Hospital in Marburg (Germany) and at the orthopaedic and
      neuroradiology departments of the hospital of the Free University in Brussels
      (Belgium).

PMID- 8348913
TI  - Digital image communication.
AB  - Networks for digital image communication are an essential prerequisite for
      picture archiving and communication systems (PACS). The scenario of a 'filmless'
      radiology is based on the assumption that complete sets of medical images can be
      transferred throughout the hospital without a noticeable delay even though
      digital images represent data volumes of a thousand-fold greater size than, for
      example, office documents. This paper deals with an in-depth analysis of the
      anticipated image communication requirements in a future PACS environment. It
      gives a survey of technologies for data communication with emphasis on the basic
      concepts of established local area networks (LAN) and their limiting factors with
      respect to the specific PACS demands. Likewise, a description of a network
      particularly developed to satisfy the users-to-be of PACS systems is included.
      Furthermore, this paper treats the connection of image data with patients' data,
      i.e. the interlinking of PACS and RIS/HIS structures. Another topic of interest
      is the extension of the PACS structure beyond the limits of the individual
      hospital (extramural PACS operation). Moreover, current standardization attempts
      are discussed here.

PMID- 8348914
TI  - Expert systems as a support for radiological diagnosis.
AB  - Given the fact that despite high expectations, expert systems have still an
      almost negligible impact on the practice of medicine, the present trends and
      methods for medical expert systems are discussed. An analysis of the diagnostic
      process in radiology leads to a discussion about possible computer support and on
      the conditions of use and acceptance of such systems.

PMID- 8348915
TI  - Magnetic resonance imaging of the central nervous system in Behcet's disease.
AB  - Magnetic resonance imaging (MRI) was performed in 25 patients with Behcet's
      disease, of whom 15 had clinical involvement of the central nervous system (CNS).
      Brain MRI was abnormal in 11/15 with and in 1/10 without CNS involvement. The
      most common sites of MR lesions were the cerebral white matter and brainstem.
      Lesions were also seen in the basal ganglia, cerebellum, optic nerves and spinal
      cord. The cerebral white matter lesions were always asymptomatic and usually
      small, whereas the brainstem lesions were often symptomatic and sometimes
      extensive. Follow-up MRI in 2 patients presenting with brainstem syndromes and
      treated with immunosuppression showed resolution of a large lesion in 1 patient
      in whom there was clinical remission, and the development of marked brainstem
      atrophy in the other who became severely disabled. The pattern of MRI
      abnormalities may assist the diagnosis and suggests a role for MRI in monitoring
      the effect of treatment in patients with neurological Behcet's disease.

PMID- 8348916
TI  - Transient global amnesia: neuropsychological findings after single and multiple
      attacks.
AB  - We examined by neuropsychological tests 41 patients who had presented attacks of
      transient global amnesia (TGA; 31 had single and 10 multiple episodes), comparing
      them with 41 matched normal controls. Patients with single attacks showed only
      two impaired memory tasks with respect to controls (immediate and long-term
      verbal memory), while patients with multiple attacks showed more impaired tasks
      in memory and visuoperceptual ability. These data confirm that TGA is a benign
      syndrome, but could leave a few subclinical memory deficits probably exacerbated
      by repeated attacks.

PMID- 8348917
TI  - Impact of prematurity and intrauterine growth retardation on neonatal hemorrhagic
      and ischemic brain damage.
AB  - Low birth weight and intrauterine growth retardation are well-recognized risk
      factors for increased mortality, morbidity and poor neurologic outcome. Risk
      assessment is different considering true preterm (appropriate-for-gestational
      age, AGA) or growth-retarded (small-for-gestational-age, SGA) infants. Therefore,
      we carried out a study on the incidence of hemorrhagic (peri-intraventricular
      hemorrhage, PIVH) and ischemic (periventricular leukomalacia) brain lesions in
      two groups of AGA and SGA very-low-birth-weight (VLBW) infants. In the study
      period (1987-1990), 111 VLBW babies (< 1,500 g body weight) were serially studied
      at days 1, 3 and 7 and weekly until discharge by cerebral ultrasonography (ATL,
      MK 4, 7.5 MHz). 57 were VLBW-AGA babies (mean gestational age 28 weeks, mean body
      weight 1,106 g). 54 were VLBW-SGA babies (mean gestational age 31 weeks, mean
      body weight 990 g). PIVH was graded according to the system of Papile et al.
      Periventricular leukomalacia was defined as an echodensity (> 3 mm) adjacent to
      the lateral border of the ventricular body. We noted a higher incidence of PIVH
      in the AGA group (36.8%) than in SGA babies (18.5%; p < 0.01, Fisher test). The
      AGA subgroup < 1,000 g body weight had 72.2% PIVH compared to AGA babies > 1,000
      g (20.5%; p < 0.01). The same relationship was observed in SGA babies (34.8% in <
      1,000 g and 6.4% in > 1,000 g babies). Ischemic brain lesions (periventricular
      leukomalacia) were equally distributed between AGA and SGA babies (10.5 vs. 3.7%,
      p > 0.5) independently of body weight category.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8348918
TI  - Radiologic correlates of reaction time measurements in olivopontocerebellar
      atrophy.
AB  - We measured simple visual and auditory reaction time (RT) and movement time (MT)
      in 32 patients with olivopontocerebellar atrophy (OPCA) in comparison to 32
      control subjects. In addition, we followed 2 approaches to radiologic assessment
      by computed tomographic scans: subjective (by inspection of films) and objective
      (by measurement of 4 radiologic ratios at the level of the posterior fossa and 1
      ratio at the supratentorial level). All OPCA patients had various degrees of
      cerebellar atrophy and lengthened RT and MT in comparison to their controls.
      There were no significant differences in RT and MT performances in patients with
      mild-moderate versus those with severe cerebellar atrophy as assessed by
      inspection of their films. OPCA patients with severe versus mild-moderate atrophy
      evaluated by 3 measures, i.e., brainstem, brachium pontis and fourth ventricle
      ratios, presented few significantly lengthened RT and MT performances. In
      contrast, patients with severe atrophy revealed by the midbrain ratio had
      significantly lengthened RT and MT performances compared to those with mild
      moderate atrophy assessed by this ratio on 7 of 8 measures; the 8th measure
      showed a borderline significant difference. This could be explained by the fact
      that atrophy at the midbrain level is the only one which involves dopaminergic,
      noradrenergic and glutamatergic structures and pathways.

PMID- 8348920
TI  - Amyotrophic lateral sclerosis and frontal lobe dementia in Alzheimer's disease.
      Case report and review of the literature.
AB  - Clinicopathological data of a woman with a 3-year course of concurrent
      amyotrophic lateral sclerosis and dementia are presented. Dementia had occurred
      at time of onset of motor disturbances and presented as typical frontal lobe
      dementia. Pathology confirmed motor neuron disease of amyotrophic lateral
      sclerosis and frontal lobe atrophy. Multiple senile plaques were distributed
      cortically and in the hippocampus, where diffuse spread of neurofibrillary
      tangles was seen. Hence, this Alzheimer's dementia in a patient with sporadic
      amyotrophic lateral raises the question of a possible association between the two
      conditions.

PMID- 8348919
TI  - Botulinum toxin: preferred treatment for hemifacial spasm.
AB  - This paper retrospectively analyses the clinical data of 65 consecutive cases of
      hemifacial spasm. A benign etiology was clinically evident in the majority of
      cases. Neuroradiologic investigation ruled out serious intracranial pathology in
      atypical cases. Trials of oral medication in 26 patients were consistently
      unsuccessful. Fifty-one patients had repeated lid and facial muscle injections of
      botulinum toxin during a period of 8 years. The mean duration of effective relief
      from spasm following an initial treatment was 18.9 weeks. This effect did not
      diminish with repeated injections.

PMID- 8348921
TI  - Utilization behavior and concomitant motor neglect by bilateral frontal lobe
      damage.
AB  - We reported on a patient who had bilateral mesial frontal lesions, presumably of
      a primary cerebral malignant lymphoma. The patient presented with a combination
      of unusual behavioral disorders of the upper extremities, which has not yet been
      documented in the literature: bilateral utilization and imitation behaviors and
      motor neglect of the left arm. Utilization behavior was closely associated with
      bilateral manual grasping behavior and was caused by the bifrontal lesions.
      Damage to the right supplementary motor area resulted most likely in concomitant
      motor neglect of the left hand. Discussion includes differentiation from other
      related behavioral disorders.

PMID- 8348922
TI  - Kinesigenic dystonia as the first manifestation of multiple sclerosis with
      cervical and brainstem lesions.

PMID- 8348923
TI  - Pontine infarction with pure Millard-Gubler syndrome: precise localization with
      magnetic resonance imaging.

PMID- 8348924
TI  - Interrelationships between strains of Salmonella enteritidis.
AB  - In contrast to S. typhimurium [19], S. enteritidis is a serotype which has its
      primary food-animal reservoir in poultry. To date, phage typing has been of
      paramount importance in studying the epidemiology of this serotype and in
      particular, has demonstrated the involvement of both poultry meat and whole shell
      eggs in the transmission of S. enteritidis PT4 to humans. The findings discussed
      above describe various aspects of the serotype, particularly in relation to the
      involvement of both LPS and plasmids in its virulence and phage type identity
      (Fig. 2). These findings have led to an increased understanding of the biology of
      this serotype, which is of major importance in human food-poisoning in England
      and Wales at the present time.

PMID- 8348925
TI  - Levels of anti-pneumococcal antibodies in young children in Papua New Guinea.
AB  - Anti-pneumococcal polysaccharide antibody (anti-PPS) levels were measured in 153
      serum samples collected from children aged between 2 and 47 months living in the
      highlands of Papua New Guinea (PNG). Fifty-seven of the samples were collected
      during acute episodes of lower respiratory tract infection (ALRI). Total IgA and
      IgG increased steadily with age; however, no association was found between the
      levels of these antibodies and the health status of the child. Total IgM levels
      showed little relationship to the age of the child but under 12 months of age
      levels were somewhat higher on average in children with pneumonia. For most of
      eight pneumococcal serotypes tested, specific IgG levels were found to decline
      rapidly in the first 6-8 months, reaching a minimum at approximately 12 months of
      age. Serotype 3 was exceptional in having very low titres in the youngest
      children. A separate analysis of 24 cord sera suggested that antibodies to this
      serotype do not usually cross the placenta in PNG. Children with pneumonia tended
      to have lower levels of specific IgG than healthy controls of the same age.
      Specific anti-PPS IgA levels were found to increase steadily with age, but were
      not associated with health status.

PMID- 8348926
TI  - Factors associated with Paracoccidiodes brasiliensis infection among permanent
      residents of three endemic areas in Colombia.
AB  - The natural habitat of Paracoccidioides brasiliensis, the aetiologic agent of
      paracoccidioidomycosis, has not been determined. Consequently, the events leading
      to the acquisition of infection remain controversial. To identify factors
      associated with infection in endemic areas we conducted a survey in three rural
      communities in Colombia where we had previously diagnosed paracoccidioidomycosis
      in children. Permanent residents were surveyed taking into consideration
      environmental and occupational variables. Skin tests were used to classify
      subjects as infected or non-infected. Variables found associated with infection
      were: (i) community A: previous residence around Porce river and agriculture in
      vegetable gardens; (ii) community C: frequent use of specific water sources;
      (iii) community V: housekeeping activities, and (iv) total group: age > 25 years
      and contact with bats. Residents in communities with higher prevalence of
      infection were older, had more complex residence history, and referred more
      contact with armadillos than residents of communities with lower infection.

PMID- 8348927
TI  - The haemagglutinins of influenza A (H1N1) viruses in the 'O' or 'D' phases
      exhibit biological and antigenic differences.
AB  - Influenza A (H1N1) viruses when initially isolated in mammalian cell cultures
      (MDCK cells) had different agglutination reactions with chicken and guinea-pig
      erythrocytes compared to the same viruses after passage. On first isolation the
      virus HA resembled the 'O' phase viruses described originally by Burnet and Bull
      and agglutinated mammalian but not avian erythrocytes. After passage, the virus
      HA resembled a classical 'D' phase virus and agglutinated both avian and
      mammalian erythrocytes. Monoclonal and polyclonal antisera detected antigenic
      differences between the HAs of the viruses in the 'O' and 'D' phases. The 'O'
      phase virus HA reacted preferentially with antibodies in post infection human
      antisera. Viruses in the 'O' phase replicated poorly in the allantoic cavity of
      embryonated hens' eggs whilst 'D' phase virus replicated in both MDCK cells and
      in embryonated hens' eggs. At least three distinguishable subpopulations of
      influenza A (H1N1) viruses may co-exist in clinical throat swab material,
      including viruses possessing HAs in the 'O' and 'D' phases and other 'D' phase
      viruses cultivable in embryonated hens' eggs but antigenically distinguishable
      from the corresponding 'D' phase virus in MDCK cells.

PMID- 8348928
TI  - Dengue epidemic in the stage of Rio de Janeiro, Brazil, 1990-1: co-circulation of
      dengue 1 and dengue 2 serotypes.
AB  - During 1990 and 1991, dengue fever was detected in the State of Rio de Janeiro,
      Brazil. It occurred in two epidemic waves; one, from January to August 1990,
      caused predominantly by dengue virus type 1 (DEN-1) the other from October 1990
      to May 1991 caused by type 2 virus (DEN-2). Dengue was confirmed by virus
      isolation and/or IgM capture enzyme-linked immunosorbent assay (MAC-ELISA) in
      2109/5964 (35.4%) of the cases. DEN-2 virus was isolated from 180 patients. HAI
      tests indicated that of these previous infection with DEN-1 had occurred in 130
      (72%). The epidemic was classified as dengue fever, but severe and even fatal
      cases occurred in association with secondary infection.

PMID- 8348929
TI  - Protective efficacy of BCG vaccine against leprosy in southern Malawi.
AB  - This paper describes a matched case-control study to determine the efficacy of
      BCG vaccine in preventing the occurrence of leprosy in southern Malawi, a
      previously unstudied area. The BCG immunization rate amongst 145 individuals with
      leprosy was 44.8%, compared to 62.5% in 290 matched controls. The protective
      efficacy of BCG vaccine against leprosy in this region was estimated to be 63.6%;
      smallpox immunization had no effect. These findings support the view that BCG
      vaccine should be considered as a control measure in areas where leprosy is
      endemic.

PMID- 8348930
TI  - Acquisition and invasiveness of different serotypes of Streptococcus pneumoniae
      in young children.
AB  - Rates of acquisition and mean duration of nasal carriage of different serotypes
      of Streptococcus pneumoniae have been estimated by fitting a stochastic model to
      longitudinal carriage data in children from Papua New Guinea. Immunogenicity and
      two indices of relative invasiveness were determined for each serotype.
      Immunogenic serotypes were less frequently acquired and were carried for shorter
      periods, but no relationship between immunogenicity and invasiveness was apparent
      using either index of invasiveness. Frequent invasion was associated with a high
      acquisition rate and high frequency and prolonged duration of carriage. Carriage
      studies can provide a broad indication of which serotypes cause invasive disease
      but not the proportion of disease due to individual serotypes; some serotypes
      which cause invasive disease (e.g. serotype 46) are not found even in extensive
      carriage studies. The antibiotic resistance of carriage organisms, however, does
      approximate the resistance patterns of invasive organisms and thus may be used to
      monitor changing patterns of antimicrobial susceptibility in the community.

PMID- 8348931
TI  - Age-specific efficacy of pertussis vaccine during epidemic and non-epidemic
      periods.
AB  - A national survey was conducted of 3150 notified cases of whooping cough in order
      to determine age-specific pertussis vaccine efficacy by the 'screening' method.
      The cases were collected over two periods, one just prior to the start and one at
      the first peak of the whooping cough epidemic of 1989-90. Vaccination status was
      determined by a postal questionnaire to the reporting doctor and clinical data
      were also collected to provide efficacy estimates according to standardized case
      definitions. Overall, observed vaccine efficacy was high but differed between
      epidemic (87%) and non-epidemic (93%) periods (P = 0.03). Efficacy estimates were
      generally higher for typical or severe cases than for children with an atypical
      illness. Vaccine efficacy declined with age (P < 0.01) but estimates remained
      high up to the age of 8 years. This study will provide baseline data for
      comparison with efficacy observed from similar studies of children immunized at
      an accelerated schedule and from phase III studies of acellular pertussis
      vaccines performed elsewhere.

PMID- 8348932
TI  - High prevalence of thermostable direct hemolysin (TDH)-like toxin in Vibrio
      mimicus strains isolated from diarrhoeal patients.
AB  - A total of 17 isolates of Vibrio mimicus from patients, 29 from environment and 2
      from food was examined for toxigenicity. Sixteen (94%) clinical isolates and one
      (50%) from food produced TDH-like toxin, whereas none of the environmental
      isolates did so. The food from which V. mimicus with TDH-like toxin production
      was isolated, was one which had caused food poisoning. Only one environmental
      strain produced CT-like toxin, whilst ST-like toxin was not detected from any
      strains tested.

PMID- 8348933
TI  - Outbreak of nosocomial infections with two different MRSA-strains involved:
      significance of genomic DNA fragment patterns in strains otherwise difficult to
      type.
AB  - Methicillin-resistant Staphylococcus aureus isolates from an outbreak of 17 cases
      of wound infection in a municipal hospital were typed by conventional methods,
      phage typing by three sets of phages, reverse phage typing and plasmid profiles,
      as well as by genomic DNA fragment patterns obtained after Sma-I digestion and
      pulsed-field electrophoresis. These isolates were non-typable by phages, only
      some were typable by reverse phage typing and were not uniform in plasmid
      profile. Only the genomic DNA fragment patterns resulted in a clear
      discrimination of 2 strains (12 isolates for the first and 7 isolates for the
      second). Both strains were disseminated in different wards of the same hospital
      and one strain had obviously spread to another clinic in the same city.

PMID- 8348934
TI  - Social and geographical risk factors in Helicobacter pylori infection.
AB  - A correlation between childhood crowding and the later development of gastric
      cancer has been demonstrated by Barker and colleagues, who proposed that the
      relationship was the consequence of infection by an organism such as Helicobacter
      pylori. In order to test this hypothesis the presence of IgG antibodies to H.
      pylori in sera from blood donors in North Wales has been investigated. During
      donation sessions, donors answered questions relating to social conditions and
      domicile in childhood (at age 10 years) and adult life (the preceding 2 years). A
      stepwise logistic regression analysis of the data demonstrated significant
      independent relationships between seropositivity and the following factors:
      sharing a bed in childhood, housing density, locality of birth, adult social
      class and age.

PMID- 8348935
TI  - A miniaturized biotyping system for strain discrimination in Escherichia coli.
AB  - A two-tier miniaturized scheme of eight tests was devised for biotyping strains
      of Escherichia coli in microwell plates. Primary biotypes were defined by
      positive and negative reactions in tests for fermentation of raffinose, sorbose,
      dulcitol and 2-deoxy-D-ribose and for decarboxylation of ornithine when read
      after specified periods of incubation; subtypes were identified within primary
      biotypes according to results in secondary tests for rhamnose fermentation,
      lysine decarboxylation and motility. The method gave reproducible results on
      different occasions of testing. Among 100 E. coli strains from various sources,
      26 of the 32 possible primary biotypes and 56 full biotypes, as defined by
      results in both primary and secondary tests, were identified, thus demonstrating
      a high index of strain discrimination (D = 0.98). The scheme is recommended as a
      simple, reliable, inexpensive and efficient method of differentiating strains of
      E. coli.

PMID- 8348937
TI  - Mycobacterium bovis in the European badger (Meles meles): epidemiological
      findings in tuberculous badgers from a naturally infected population.
AB  - This study investigates the course of tuberculosis in a naturally infected badger
      population, its impact on the population and the risk of spread to other species
      in the light of capture data and post-mortem findings from 47 tuberculous
      badgers, stratified by age group and sex, accrued since 1975. The findings are
      compared with those for 260 badgers from the same population in whom no evidence
      of infection was detected. Detailed estimates of seasonal variations in
      bodyweight for uninfected male and female cub, yearling and adult badgers are
      presented and compared to the weights at post-mortem examination of the
      tuberculous badgers, in whom poor condition and weight loss were the principal
      presenting signs. Lesions were seen especially in the lungs and associated lymph
      nodes, and in the kidneys. Organisms were detected intermittently in faeces,
      urine, sputum and discharging bite wounds. Infected animals could survive for
      nearly 2 years and produce cubs successfully.

PMID- 8348936
TI  - An analysis of the diversity of Haemophilus parainfluenzae in the adult human
      respiratory tract by genomic DNA fingerprinting.
AB  - A method for typing Haemophilus species is described, based on the analysis of
      genomic DNA from Haemophilus parainfluenzae. The DNA was extracted by a rapid
      method and digested with the restriction enzyme BamHI to provide a characteristic
      'fingerprint'. The pattern of fragments in the ranges 1-1.6 kb, 1.6-2 kb and 2-3
      kb were used to produce a numerical profile of each isolate. In total 97 isolates
      were examined; 88 from throat swab material isolated from the 15 members of a
      British Antarctic Survey base and 9 type strains. Seventy-two of the 88 antarctic
      isolates were H. parainfluenzae and were found to be very diverse, comprising 41
      identifiable strains with up to 5 strains being isolated from a single throat
      swab sample. There was evidence for both carriage and transmission within the
      isolated community. The technique provided a highly discriminatory method for
      characterizing Haemophilus strains which is suitable for epidemiological studies.

PMID- 8348938
TI  - Management of graft-versus-host disease.

PMID- 8348939
TI  - In vitro inhibition of interleukin-2-induced defective polymorphonuclear
      chemotaxis by TNF inhibitor.
AB  - Patients undergoing immunotherapy with interleukin-2 experience multiple side
      effects and are highly susceptible to bacteremia. In a previous study, we
      confirmed that a profound deficiency of neutrophil chemotaxis is induced by
      interleukin-2 therapy. Migration in response to N-formyl-methionyl-leucyl
      phenylalanine (FMLP), being normal before therapy, was markedly impaired after
      the first cycle and further decreased after the third cycle of treatment. A
      direct effect of interleukin-2 on neutrophil chemotaxis is controversial.
      However, peripheral blood cells exposed to interleukin-2 secrete secondary
      cytokines. In particular, the release of tumor necrosis factor after interleukin
      2 injection has been proposed as an important regulatory mechanisms. When testing
      random migration and chemotaxis of neutrophils from normal subjects after
      incubation with the serum from treated patients, we found that this serum induced
      a defective chemotaxis similar to that of neutrophils from interleukin-2-treated
      patients. In order to assess the influence of tumor necrosis factor, we tested
      the effect of anti-tumor necrosis factor-alpha antibody on the chemotactic
      response of cells after incubation with the serum, and we observed a dose
      dependent reduction of neutrophil chemotaxis deficiency. These data suggest that
      TNF is counteracting the neutrophil chemotactic deficiency observed during IL-2
      treatment.

PMID- 8348940
TI  - High-dose cyclophosphamide, etoposide and BCNU (CVB) with autologous stem cell
      rescue in malignant lymphomas.
AB  - Eighteen patients with malignant lymphoma, 10 non-Hodgkin's and 8 Hodgkin's, were
      treated with high-dose CVB (cyclophosphamide 4 x 1.5 g/m2, etoposide 4 x 250-400
      mg/m2, carmustine 4 x 150-200 mg/m2), followed by autologous peripheral blood
      stem cells (PBSC, 13 patients) or bone marrow (BM, 5 patients) transplantation.
      At the time of autograft 6 patients were in complete remission (CR), 3 in partial
      remission (PR) and 5 in relapse (4 sensitive, 1 resistant), whereas 4 had
      progressive disease. All CR patients had poor prognostic features at
      presentation. PBSC were collected at the time of rapid hematologic recovery after
      intense chemotherapy by means of a cell separator. All patients engrafted. Median
      time to achieve > or = 0.5 x 10(9)/l polymorphonuclear cells (PMN) and > or = 50
      x 10(9)/l platelets was 13 days for both cell types in PBSC autografted patients,
      versus 20 and 28 days respectively in BM autografted patients. A significant
      advantage of PBSC over BM was found in terms of time needed to recover either PMN
      > or = 0.5 and PMN > or = 1 x 10(9)/l (p = 0.01). Autograft-related toxicity
      consisted mainly of moderate severity interstitial pneumopathy (3 patients), and
      veno-occlusive disease (1 patient) that resolved completely. Of the 12 patients
      autografted with detectable disease, 6 (50%) obtained a CR. Seven out of 18
      autografted patients (39%) had disease progression within 1 to 5 months of
      autograft. The projected progression-free survival is over 50% at 4 years and it
      was significantly longer in patients with sensitive disease than in those with
      resistant disease (p = 0.01). The efficacy and the low toxicity of CVB suggest
      that autograft with PBSC may be proposed for the primary treatment of poor
      prognosis malignant lymphomas.

PMID- 8348941
TI  - Cobalamin absorption and serum homocysteine and methylmalonic acid in elderly
      subjects with low serum cobalamin.
AB  - We prospectively studied 41 consecutive elderly patients with serum cobalamin
      (vitamin B12) levels lower than 125 pmol/l. The protein-bound cobalamin
      absorption test (PBAT) was performed in 34 of them and in 27 selected elderly
      control patients. The lower decision limit was 0.18% and an abnormal test was
      detected in only 9 (26%) of the 34 patients with low serum cobalamin level. When
      the PBAT was compared to the Schilling (Dicopac method) test, a concordant result
      was found in 80%. Serum methylmalonic acid and/or total homocysteine
      concentrations were elevated in 75% (26/35) of the patients with low serum
      cobalamin levels but also in 30% (5/17) of the control patients. Of the 12 and 9
      cobalamin-deficient patients with elevated serum levels of methylmalonic acid and
      homocysteine, normalization after cobalamin therapy was obtained in 11 and 5
      respectively. In conclusion, determination of serum metabolites and their
      response to cobalamin therapy are a sensitive index of significant cobalamin
      deficiency and a useful means of distinguishing between cobalamin and folate
      deficiency. The PBAT offers little advantage over the Schilling test in
      diagnosing cobalamin malabsorption in elderly patients.

PMID- 8348942
TI  - Quantitative and qualitative studies of red cell ferritin in refractory anemia of
      myelodysplastic syndrome.
AB  - The red cell ferritin (rFt) level in 10 patients with refractory anemia (RA) was
      measured and analyzed by column isoelectric focusing (IEF). The levels in 9 of
      the 10 patients (90.0%) were higher than the upper limit in healthy controls (MV
      +/- SD: male 14.3 +/- 10.3 ag/cell, female 7.5 +/- 3.6 ag/cell). The isoelectric
      point (pI) of rFt determined by IEF in healthy subjects ranged from 5.1 to 5.7.
      However, the pI ranges for RA patients varied widely; the pI value was thought to
      correlate with the severity of the morphological abnormalities of bone marrow
      (BM) erythroblasts. That is, the greater the proportion of morphologically
      abnormal erythroblasts with respect to all erythroid precursors, the lower the pI
      range for rFt. The rFt content was not related to serum iron, transferrin
      saturation, serum ferritin, reticulocyte count, red cell iron content, or BM
      erythroblast count. These data suggest that rFt synthesis in RA patients is
      influenced by factor(s) other than iron; this is considered an essential feature
      of erythropoiesis in myelodysplastic syndrome (MDS).

PMID- 8348943
TI  - Two new candidate mutations in type IIA von Willebrand's disease (Arg834-->Gly,
      Gly846-->Arg) and one polymorphism (Tyr821-->Cys) in the A2 region of the von
      Willebrand factor.
AB  - Recently, several von Willebrand factor gene mutations resulting in type IIA von
      Willebrand's disease have been reported. We examined 8 patients from Sweden and
      Denmark with this phenotype and found two new candidate mutations and a hitherto
      unknown amino acid polymorphism. One patient had a de novo occurring mutation
      resulting in substitution of glycine for arginine 834. Previous reports have
      demonstrated conversion of arginine 834 to tryptophan or glutamine in IIA
      patients. A 2nd patient had a G(4825)-->A transition, substituting arginine for
      glycine 846. The transition produces a sequence congruent with that of the
      pseudogene but several lines of evidence indicate that a sequencing error due to
      influence by the latter could be excluded. The remaining 6 patients had one of
      the earlier described substitution mutations: Ser743-->Leu and Ile865-->Thr. In
      addition, two sequence variations not linked to the phenotype were found, namely
      Tyr821-->Cys and Val802-->Leu.

PMID- 8348945
TI  - Philadelphia chromosome-positive chronic myelocytic leukemia with abnormal
      chromatin clumping (ACC) syndrome.

PMID- 8348944
TI  - Etoposide, doxorubicin, cyclophosphamide and high-dose betamethasone (EACB) as
      outpatient salvage therapy for refractory multiple myeloma.
AB  - Fifty-six patients with refractory multiple myeloma were treated with
      intermittent courses of etoposide, doxorubicin, cyclophosphamide and high-dose
      betamethasone (EACB) every 4th week. The overall response rate was 30%. Durable
      remissions exceeding 1 year were obtained in 12 of the 17 responding patients. A
      significant prolongation of the survival time was found for responding patients
      (median 13 months) compared to those patients who did not respond (median 9
      months) to EACB therapy (p = 0.01). A low frequency of neutropenic fever episodes
      was noted compared to other salvage treatment regimens. The EACB regimen was
      usually well tolerated and could be administered safely on an out-patient basis.
      This regimen might be an alternative especially for elderly patients unresponsive
      to initial therapy.

PMID- 8348946
TI  - Bone-marrow biopsy of the iliac bone followed by severe retroperitoneal
      hemorrhage.

PMID- 8348947
TI  - Haem administration in myelodysplastic syndromes: a possible mechanism of action.

PMID- 8348948
TI  - Repeated continuous administration of low doses of intravenous iron in anemic
      patients with active rheumatoid arthritis.

PMID- 8348949
TI  - Increase in number of bone marrow macrophages in patients with myelodysplastic
      syndromes.

PMID- 8348950
TI  - Rise in heat-shock protein level confers tolerance to energy deprivation.
AB  - Heat shock (44 degrees C for 10 min) or ATP depletion by an uncoupler (CCCP for
      20 min) is shown to result in stimulation of hsp68/70 synthesis in Ehrlich tumor
      cells. After 3 h of recovery, the cells become thermotolerant. Surprisingly,
      repeated ATP depletion caused by CCCP or rotenone (a respiratory inhibitor)
      treatment, had a much lower effect on cell viability. Both induction of tolerance
      to energy deprivation and hsp68/70 synthesis were totally suppressed by
      cycloheximide, an inhibitor of cytosolic protein synthesis. In tolerant cells,
      rotenone still induced ATP depletion; however, protein aggregation (the rise in
      Triton-insoluble proteins) was inhibited in these cells. It is suggested that
      cellular chaperones (e.g. hsp70) are involved in the protection of ischemic cells
      from necrosis, preventing protein aggregation under ATP deficiency.

PMID- 8348951
TI  - Molecular cloning and sequencing of the cDNA coding for a calcium-binding protein
      regucalcin from rat liver.
AB  - The cDNA of a Ca(2+)-binding protein regucalcin was cloned from a rat liver cDNA
      library which was constructed in lambda ZAPII by immunoscreening. Positive clones
      were obtained from which spanned the region of interest, and they gave a sequence
      of 1.7 kb by sequencing with the dideoxynucleotide method. Analysis of the
      sequence of the cloned cDNA showed that the cDNA encoded the complete amino acid
      sequence of the regucalcin molecule. Regucalcin was composed of 299 amino acid
      residues and its molecular weight was estimated to be 33,388 Da. The hydropathy
      profile of regucalcin showed a highly hydrophilic character. The nucleotide and
      amino acid sequences of regucalcin did not have statistically significant
      homology, as compared with the registered sequences which are found in the EMBL
      and GenBank databases containing several other Ca(2+)-binding proteins
      (calmodulin, calbindin-D28k and S-100 beta). The regucalcin molecule did not
      contain the EF-hand motif as a Ca(2+)-binding domain. The present study
      demonstrates that regucalcin is a unique Ca(2+)-binding protein in the liver of
      rats.

PMID- 8348952
TI  - Structure and dynamics of bacteriorhodopsin. Comparison of simulation and
      experiment.
AB  - Global features of the structure and dynamics of bacteriorhodopsin are
      investigated using molecular modelling, dynamical simulations and neutron
      scattering experiments. The simulations are performed on a model system
      consisting of one protein molecule plus intrinsic water molecules. The simulation
      derived structure is compared with neutron diffraction data on the location of
      water and with the available electron microscopy structure of highest resolution.
      The simulated water geometry is in good accord with the neutron data. The protein
      structure deviates slightly but significantly from the experiment. The low
      frequency vibrational frequency distribution of a low-hydration purple membrane
      is derived from inelastic neutron scattering data and compared with the
      corresponding simulation-derived quantity.

PMID- 8348953
TI  - Penetration of oligonucleotides into mouse organism through mucosa and skin.
AB  - Benzylamide 5'-32P-oligonucleotide derivatives were shown to penetrate into mice
      organism when administered by various routes; intranasally, per os,
      intravaginally and per rectum. In all cases, the compounds are rapidly
      accumulated in blood and guts. Analysis of the radioactive material from blood
      and pancreas revealed intact oligonucleotides. Although concentrations of
      oligonucleotides in tissues differ considerably by the various methods of
      administration, the efficiency of delivery is sufficient to consider all the
      routes as being of therapeutic value. Dose effect on the efficiency of
      oligonucleotide penetration into mice suggests the transport to be a saturable
      process. Application of an oligonucleotide lotion on mice ear helices results in
      reproducible accumulation of radioactivity in the animal tissues. Effectiveness
      of oligonucleotide delivery into mouse through skin can be improved by using
      electrophoretic procedure.

PMID- 8348954
TI  - Cyanide-reactive sites in cytochrome bd complex from E. coli.
AB  - Cyanide reacts with cytochrome bd from E. coli in an 'aerobically oxidized' state
      (mainly, an oxygenated complex b558(3+) b595(3+) d(2+)-O2), bringing about (i)
      decomposition of the heme d2+ oxycomplex (decay of the 648 nm absorption band)
      and (ii) extensive red shift in the Soret region accompanied by minor changes in
      the visible range assigned to ferric heme b595. MCD spectra show that the Soret
      red shift is associated with heme b595(3+) high-to low-spin transition. This is
      the first unambiguous demonstration that heme b595 can bind exogenous ligands. No
      reaction of cyanide with b558 is observed. In about 70% of the enzyme which forms
      the cyano complex, the spin-state transition of b595 decay of heme d oxycomplex
      match each other kinetically (keff ca. 0.002 s-1 at 50 mM KCN, pH 8.1, 25 degrees
      C). This points to an interaction between the two hemes. The concerted binding of
      cyanide to d3+ and b595(3+), perhaps as a bridging ligand, is probably rate
      limited by d2+ oxycomplex autoxidation. In the remaining 30% of the isolated bd,
      there is a rapid phase of cyanide-induced b595 spin-state transition which can be
      tentatively assigned to that proportion of the enzyme in which heme d is
      initially in the ferric rather than ferrous-oxy form.

PMID- 8348955
TI  - Agonist pharmacology of the neuronal alpha 7 nicotinic receptor expressed in
      Xenopus oocytes.
AB  - The potencies and efficacies of seven agonists at chick alpha 7 nicotinic
      receptors expressed in Xenopus oocytes were determined by whole cell recording.
      (+)-Anatoxin-a was the most potent agonist (EC50 = 0.58 microM) and acetylcholine
      was the least potent (EC50 = 320 microM). The rank order of agonist potencies
      was: (+)-anatoxin-a >> cytisine > (-)-nicotine > (+)-nicotine > DMPP > 1-acetyl-4
      methylpiperazine methiodide > acetylcholine. DMPP evoked only very small
      currents: comparison of maximally effective agonist concentrations showed that
      DMPP was only one-fifth as efficacious as other agonists. Previously published
      IC50 values for rat brain [125I]alpha-bungarotoxin sites show a similar agonist
      profile, and the identity of homo-oligomeric alpha 7 receptors with native alpha
      bungarotoxin-sensitive neuronal nicotinic receptors is discussed.

PMID- 8348956
TI  - A gene homologous to the reg gene is expressed in the human pancreas.
AB  - We have determined the nucleotide sequence of regl a human genomic DNA fragment
      homologous to the reg gene which is expressed in the exocrine pancreas and
      regenerating islets. Sequence comparisons of reg and regl suggested similar exon
      intron organisation. Based on this assumption, specific oligonucleotides for regl
      exons were used to demonstrate expression of the regl gene in pancreas and liver.
      The proteins encoded by reg and regl comprise 166 amino acids and differ by 22
      amino acids only.

PMID- 8348957
TI  - Mature carnitine palmitoyltransferase I retains the N-terminus of the nascent
      protein in rat liver.
AB  - Carnitine palmitoyltransferase I was isolated from octylglucoside extracts of rat
      liver mitochondrial outer membranes. This native enzyme was digested
      proteolytically with V8 protease. Five major peptides were obtained all of which
      were found in the amino acid sequence predicted from the full-length cDNA
      sequence of the protein. One peptide was found to correspond to the extreme N
      terminus of the deduced amino acid sequence. Therefore, the mature protein
      retains the N-terminus of the nascent protein after import into the mitochondrial
      membrane. Knowledge of the identity of the N-terminus of the mature protein
      allows a reappraisal of the role of the two main. N-terminal hydrophobic domains
      of the protein and of the possible topology of the protein within the membrane.

PMID- 8348958
TI  - Stimulation-induced expression of slow muscle myosin in a fast muscle of the rat.
      Evidence of an unrestricted adaptive capacity.
AB  - Fast muscles of the rat hind limb were stimulated continuously at 10 or 20 Hz for
      periods of 55-61 days by means of an implantable neuromuscular stimulator. Gel
      electrophoresis clearly demonstrated the presence in stimulated muscles of slow
      myosin light and heavy chains, although fast isoforms were still present in all
      cases. Thus, contrary to previous reports, induction of slow myosin isoforms does
      occur in this, as in other, mammalian species. The time course of the response to
      stimulation appears to be more extended than that seen in the rabbit.

PMID- 8348960
TI  - Purification of a novel factor which binds to the mouse alpha 2 (I) collagen
      promoter.
AB  - We have identified and purified a DNA binding protein which specifically binds to
      a segment of the mouse alpha 2 (I) collagen promoter between -420 and -399 bp
      upstream of the start of transcription. Purification included heparin-agarose and
      sequence-specific DNA-affinity chromatography, followed by SDS-PAGE and
      renaturation of the DNA binding activity after elution from SDS-polyacrylamide
      gel. The DNA binding activity resides in two species of 42 kDa and 40 kDa,
      respectively. The levels of DNA binding activity of this factor, which has been
      tentatively designated as ColF1, are considerably higher in nuclear extracts of
      NIH-3T3 fibroblasts than in nuclear extracts from epidermal cells, lymphoid cells
      and transformed NIH-3T3 fibroblasts.

PMID- 8348961
TI  - Reduced content of the quinone acceptor QA in photosystem II complexes isolated
      from thylakoid membranes after prolonged photoinhibition under anaerobic
      conditions.
AB  - The plastoquinone content of photosystem II complexes isolated from spinach
      photosystem II-enriched membranes subjected to strong photoinhibitory
      illumination under anaerobic conditions was determined by HPLC. A pronounced
      decrease of the plastoquinone content was found in the photoinactivated
      complexes. These results corroborate earlier models in which photoinhibitory
      illumination is suggested to eventually lead to release of doubly reduced and
      protonated QA from its site on the D2-protein.

PMID- 8348959
TI  - TRP-1 expression correlates with eumelanogenesis in human pigment cells in
      culture.
AB  - We have investigated the relationship in human cultured normal and malignant
      melanocytes between the accumulation of mRNAs encoding tyrosinase and tyrosinase
      related protein-1 (TRP-1), the activity of tyrosinase and the presence of
      melanin. Tyrosinase mRNA correlates with tyrosinase activity and with the
      presence of pheomelanin, eumelanin or both melanin types. In contrast TRP-1 mRNA
      is only detectable in cells containing eumelanin, which suggests a role for TRP-1
      in the eumelanin synthesis pathway.

PMID- 8348962
TI  - Kinetics of CO binding to putative Na(+)-motive oxidases of the o-type from
      Bacillus FTU and of the d-type from Escherichia coli.
AB  - The kinetics of CO reassociation with isolated Bacillus FTU o-type oxidase and
      with solubilized membranes of Escherichia coli (GO102 strain) containing the d
      type oxidase only, upon laser flash photolysis under reducing conditions, were
      studied. In both cases, kinetics are shown to be composed of three phases (tau 35
      70 microseconds, 0.25-0.5 ms and 2-5 ms). The spectra of the flash-induced
      absorbance changes of the first kinetic components proved to be characteristic of
      CO-o- and CO-b595 d-cytochrome complexes in Bac. FTU and E. coli, respectively.
      The spectra of the second and the third components appeared to be nearly the same
      in Bac. FTU and E. coli with peaks for the former at 436-437 and 590 nm and
      troughs at 419-420 and 569 nm; and for the latter with peaks at 436-437 and 558
      560 nm and troughs at 419-420 and 575-578 nm. The similarity between the putative
      Na(+)-pumping Bac. FTU o- and E. coli d-type oxidases and their difference from
      the H(+)-motive Bac. FTU caa3- and E. coli o-type oxidases are discussed.

PMID- 8348963
TI  - Kinetics of CO binding to H(+)-motive oxidases of the caa3-type from Bacillus FTU
      and of the o-type from Escherichia coli.
AB  - The kinetics of CO rebinding with isolated Bacillus FTU caa3-type oxidase and
      with solubilized Escherichia coli membranes (GO103 strain) containing the o-type
      oxidase as the main O2-reducing enzyme were studied under reducing conditions by
      laser flash photolysis of the CO-oxidase complexes. The spectra of the optical
      absorbance changes upon photolysis were characteristic of CO-caa3- and CO-o
      oxidase complexes in Bac. FTU and E. coli, respectively. Small quantities of d
      type oxidase in E. coli GO103 membranes were detected. The kinetics of CO
      reassociation with reduced caa3- and o-type oxidases were monophasic with tau 25
      30 ms in both cases.

PMID- 8348964
TI  - Model peptides to study the effects of P2 and P3 substitutions in statine
      containing HIV proteinase inhibitors.
AB  - Through a series of synthetic model peptides, we have examined the structural
      requirements of the P2 and P3 residues in statine-based HIV protease (PR)
      inhibitors. Results agree with the general observations that, the more bulky the
      P3 aromatic hydrophobic side chain, the more potent is the inhibitor. At P2, an
      isopropyl side chain is critical in maintaining potency. Three-dimensional
      modeling demonstrates that the steric bulk of a leucyl residue or the unfavorable
      energy transfer, from water to enzyme, for a basic amino acid residue at P2
      markedly compromises activity. A naphthylalaninyl-valyl P3-P2 substituted
      analogue inhibits PR with an IC50 value of 6 nM, and was also effective as an
      antiviral agent.

PMID- 8348965
TI  - Crystal structure of apo-glycolate oxidase.
AB  - The crystal structure of the apoform of the alpha/beta-barrel enzyme glycolate
      oxidase has been determined to 2.6 A resolution. Removal of the tightly bound
      cofactor FMN has a very strong influence on the protein structure; it is
      converted into a very flexible state, verging on a molten globule type of
      structure. The asymmetric unit contains two subunits with different conformations
      to each other and to the holo-enzyme. The secondary structures are preserved, but
      their mutual arrangement has changed to some extent introducing cavities into the
      protein. The largest structural shifts are, however, found in the loops.

PMID- 8348966
TI  - Identification of a putative active site residue in the exo-beta-(1,3)-glucanase
      of Candida albicans.
AB  - Recombinant exo-beta-(1,3)-glucanase from Candida albicans was expressed in
      Saccharomyces cerevisiae and purified. The enzyme contains a number of short
      blocks of sequence homology with several genes for cellulases of the family A
      glucanases including the conserved sequence motif NEP which has previously been
      shown to be important in the catalytic function of several cellulases. Site
      directed mutagenesis of this glutamic acid residue in the 1,3 glucanase (E230D,
      E230Q) decreased the enzymatic activity 15,000- and 400-fold, respectively. This
      suggests that the E of the NEP participates in catalysis of the exoglucanase and
      other related glucanases.

PMID- 8348967
TI  - Enzymatic catalysis as a process controlled by protein conformational relaxation.
AB  - Great progress in studies of protein dynamics in the past decade propels an
      essential alteration in our understanding of the enzymatic catalysis phenomenon.
      A careful analysis of assumptions made by the hitherto used conventional theory
      of chemical reactions shows that neither of them is in fact satisfied. One of the
      reasons is the presence of a slow interconformational dynamics within the protein
      native state. In consequence, the simple classical statement "enzymes accelerate
      reactions by decreasing the free energy of activation" represents only half of
      the truth. Enzymatic reactions actually proceed through 'gates' of relatively low
      free energy but it is not the process of activated gate crossing that limits the
      reaction rate, but the process of generally non-activated gate opening,
      controlled by the conformational relaxation. Possible consequences of this fact
      are pointed out.

PMID- 8348968
TI  - Rapid alteration of c-myc and c-jun expression in leukemic cells induced to
      differentiate by a butyric acid prodrug.
AB  - The novel prodrug of butyric acid (BA), pivaloyloxymethyl butyrate, has been
      shown, in vitro, to induce differentiation and inhibit leukemic cell
      proliferation. The prodrug affects the cells in vitro at lower concentration and
      at least 100 times faster than does (BA). We have compared the ability of BA with
      that of its prodrug AN-9 to modulate the expression of the early regulating
      genes, c-myc and c-jun, in HL-60 cells. Exposure of HL-60 cells to the prodrug
      resulted in a decrease of c-myc and an increase of c-jun expression. The prodrug
      elicited this effect at lower concentrations and at least 100 times faster than
      BA. Since changes in the expression of c-myc and c-jun occur minutes after
      exposure of the cells to the prodrug, these genes are likely to play a major role
      in the early stages of the differentiation pathway.

PMID- 8348970
TI  - Cephalopod alcohol dehydrogenase: purification and enzymatic characterization.
AB  - Octopus, squid and cuttle-fish organs were examined for alcohol dehydrogenase
      activity. Only one form was detectable, with properties typical of mammalian
      class III alcohol dehydrogenase. The corresponding protein was purified from
      octopus and enzymatically characterized. Ion-exchange and affinity chromatography
      produced a pure protein in excellent yield (73%) after 1600-fold purification.
      Enzymatic parameters with several substrates were similar to those for the human
      class III alcohol dehydrogenase, demonstrating a largely conserved function of
      the enzyme through wide lines of divergence covering vertebrates, cephalopods and
      bacteria. The results establish the universal occurrence of class III alcohol
      dehydrogenase and its strictly conserved functional properties in separate living
      forms. The absence of other alcohol dehydrogenases in cephalopods is compatible
      with the emergence of the ethanol-active class I type at a later stage, in
      lineages leading to vertebrates.

PMID- 8348969
TI  - Cytoplasmic triacylglycerols and cholesteryl esters are degraded in two separate
      catabolic pools in cultured human fibroblasts.
AB  - The sources and the catabolic pathways of cytoplasmic pools of triacylglycerols
      and cholesteryl esters have been comparatively investigated in cultured
      fibroblasts from normal subjects and from patients affected with neutral lipid
      storage disease (NLSD) and Wolman disease (WD). (i) Endogenously biosynthesized
      triacylglycerols and cholesteryl esters were degraded extra-lysosomally since
      they were catabolized at similar rates in normal and in WD fibroblasts. In NLSD
      fibroblasts, the degradation of endogenous triacylglycerols was severely
      deficient, whereas that of endogenous cholesteryl esters was in the normal range.
      (ii) Reconstituted high density lipoproteins (HDL) containing radiolabelled
      [3H]triolein and cholesteryl [14C]oleate were taken up by cultured fibroblasts
      and rapidly degraded in a non-lysosomal compartment. In NLSD fibroblasts the
      degradation of HDL-[3H]triolein was blocked whereas that of HDL-[14C]cholesteryl
      oleate was in the normal range. These data suggest that: (i) the cytoplasmic
      pools of triacylglycerols and cholesteryl esters originate from HDL uptake and
      from endogenous biosynthesis as well; (ii) cytoplasmic (non-lysosomal)
      triacylglycerols and cholesteryl esters are degraded by two separate catabolic
      pathways.

PMID- 8348971
TI  - Identification of a second membrane-active 13-residue peptide segment in the
      antimicrobial protein, bovine seminalplasmin.
AB  - Seminalplasmin (SPLN) is a 47-residue protein from bovine seminalplasma having
      broad-spectrum antibacterial activity. The protein has no hemolytic activity.
      SPLN interacts with lipid vesicles and its antibacterial activity appears to stem
      from its ability to permeabilize the bacterial plasma membrane. Analysis of
      SPLN's primary structure, with respect to its relative hydrophobicity and
      hydrophilicity, revealed a segment, PKLLETFLSKWIG, more hydrophobic than the rest
      of the protein. A synthetic peptide corresponding to this region had not only
      antibacterial activity but also hemolytic properties. Analysis of the SPLN
      sequence based on hydrophobic moment plots has revealed a second segment,
      SLSRYAKLANRLA, which could be membrane active. A synthetic peptide corresponding
      to this region shows only antibacterial activity with no hemolytic activity.

PMID- 8348972
TI  - Cis-acting elements in the promoter region of the human aldolase C gene.
AB  - We investigated the cis-acting sequences involved in the expression of the human
      aldolase C gene by transient transfections into human neuroblastoma cells
      (SKNBE). We demonstrate that 420 bp of the 5'-flanking DNA direct at high
      efficiency the transcription of the CAT reporter gene. A deletion between -420 bp
      and -164 bp causes a 60% decrease of CAT activity. Gel shift and DNase I
      footprinting analyses revealed four protected elements: A, B, C and D.
      Competition analyses indicate that Sp1 or factors sharing a similar sequence
      specificity bind to elements A and B, but not to elements C and D. Sequence
      analysis shows a half palindromic ERE motif (GGTCA), in elements B and D. Region
      D binds a transactivating factor which appears also essential to stabilize the
      initiation complex.

PMID- 8348973
TI  - Endotoxin induces rat lung ribonuclease activity.
AB  - Lipopolysaccharide (endotoxin), a component of Gram-negative bacteria, causes
      marked alterations in eukaryotic gene expression and cellular physiology. We show
      that within one hour of injection of endotoxin into adult rats there is an
      induction of ribonuclease activity in the lung. The degradation of RNA was
      prevented by treatment of the lung extract from endotoxin-injected rats with
      ribonuclease inhibitor (RNasin). We suggest that induction by endotoxin of
      ribonuclease activity is a novel mechanism by which cells could alter gene
      expression to meet an environmental challenge and caution that the presence of
      ribonuclease can hinder molecular biological analyses of tissue extracts from
      endotoxin-treated rats.

PMID- 8348974
TI  - Novel surface functional properties of polymannosyl lysozyme constructed by
      genetic modification.
AB  - The surface functional properties of glycosylated lysozyme were investigated by
      using polymannosyl and oligomannosyl enzymes at the position 49 by genetic
      modification [Nakamura, S. et al. (1993) J. Biol. Chem. 268, in press]. The
      polymannosyl lysozyme exhibited excellent emulsifying properties superior to
      those of commercial emulsifiers in addition to heat stability, while the
      oligomannosyl lysozyme did not. The surface tension of the polymannosyl lysozyme
      was greatly decreased correspondingly to the enhanced emulsifying properties,
      although that of oligomannosyl protein was not. The emulsifying activity and the
      emulsion stability of the polymannosyl lysozyme were stable in acidic pH or high
      salt conditions; in addition, they were greatly enhanced also by preheating the
      polymannosyl lysozyme. Thus novel surface functional properties of polymannosyl
      lysozyme in addition to heat stability suggest the direction of the design of new
      functional proteins by genetic modification.

PMID- 8348975
TI  - A left-handed crossover involved in amidohydrolase catalysis. Crystal structure
      of Erwinia chrysanthemi L-asparaginase with bound L-aspartate.
AB  - The crystal structure of L-asparaginase from Erwinia chrysanthemi in the presence
      and absence of L-aspartate was determined at 1.8 A resolution. Conserved residues
      in a left-handed crossover (a rare occurrence in protein structures) link pairs
      of dimers into the catalytically active tetrameric form of the enzyme. The
      structure of ErA containing bound aspartic acid shows that this unusual strand
      connectivity is an essential part of the active site architecture, responsible
      for releasing the product of the enzymatic hydrolysis. The orientation of the
      bound aspartate indicates for the first time a threonine residue as a catalytic
      nucleophile.

PMID- 8348976
TI  - Possible role of Na+ influx in phorbol ester-induced down-regulation of protein
      kinase C in HL60 cells.
AB  - Amiloride, an inhibitor of Na+/H+ exchange, inhibited down-regulation of protein
      kinase C in HL60 cells induced by tumor-promoting phorbol ester in dose-dependent
      manner judging from immunoblot analysis. This inhibition was observed with regard
      to type I (gamma), type II (beta), and type III (alpha) isozymes of protein
      kinase C. On the other hand, monensin, a Na+ ionophore, accelerated the down
      regulation of protein kinase C induced by phorbol ester. When we examined 22Na+
      uptake by HL60 cells, the higher uptake was observed after stimulation with
      phorbol ester compared to the control cells and this 22Na+ uptake was strongly
      inhibited by the addition of amiloride. However, monensin further stimulated the
      22Na+ uptake observed in phorbol ester-treated cells. These data suggest that the
      increase in intracellular Na+ concentration may be one of the triggers for the
      induction of down regulation of protein kinase C.

PMID- 8348977
TI  - Determination of the disulphide bridge arrangement of bovine histidine-rich
      glycoprotein.
AB  - Histidine-rich glycoprotein (HRG) was purified from bovine plasma and the
      disulphide bridge arrangement established. Disulphide-bridged peptides were
      obtained from peptic and tryptic degradation of native bovine HRG. Twelve half
      cystine residues were found in bovine HRG (compared to sixteen cysteines in human
      HRG), all involved in the formation of six disulphide bridges connecting Cys-1 to
      Cys-12, Cys-2 to Cys-3, Cys-4 to Cys-5, Cys-6 to Cys-11, Cys-7 to Cys-8, and Cys
      9 to Cys-10. Additional sequence analysis of 14C-carboxymethylated chymotryptic
      and Staphylococcus aureus V8 protease generated peptides and CNBr-fragments of
      bovine HRG yielded a partial amino acid sequence of bovine HRG constituting 78%
      of the sequence when compared to the human cDNA sequence.

PMID- 8348978
TI  - Properties of alpha 1-antitrypsin secreted by human adenocarcinoma cell lines.
AB  - alpha 1-Antitrypsin; (alpha 1-AT) produced by various human carcinoma (non
      hepatoma) cell lines were analyzed. Five out of eight cell lines secreted
      detectable amounts of alpha 1-AT into the conditioned media. All were
      adenocarcinoma cell lines. The tumor cell-derived alpha 1-ATs had higher
      molecular weights (MW) than the normal plasma form. Most of this difference was
      an overall reflection of altered N-glycosylation. As judged by binding of
      lectins, the glycosylation had shifted towards higher levels of triantennary
      oligosaccharides and higher levels of fucosylation. The conditioned media also
      contained lower MW alpha 1-AT species, possibly, proteolytically cleaved forms.

PMID- 8348979
TI  - Strontium binding to sarcoplasmic reticulum Ca(2+)-ATPase. Spectroscopic
      differentiation of the substeps involved.
AB  - We investigated the consequences of Sr2+ binding to the transport sites of
      sarcoplasmic reticulum (SR) Ca(2+)-ATPase for two fluorescent conformational
      probes located in different regions of the ATPase. Using SR vesicles in which Lys
      515 in the ATPase had been previously labeled with fluorescein 5'-isothiocyanate
      (FITC), we found that the Sr(2+)-induced a drop in the fluorescein fluorescence
      of this FITC-labeled ATPase shifted toward lower Sr2+ concentrations than the
      Sr(2+)-induced rise in Trp fluorescence for the same FITC-labeled ATPase. The
      curve describing the Sr(2+)-dependent rise in Trp fluorescence had a
      characteristic asymmetric shape, and the changes in Trp fluorescence occurred in
      parallel with the activation by Sr2+ of pNPP hydrolysis by the ATPase. Analysis
      of these results in terms of the simplest scheme describing the sequential
      binding of the two Sr2+ ions suggests that under the conditions of these
      experiments, i.e. at neutral pH in the presence of potassium, the Sr(2+)-induced
      rise in the Trp fluorescence mainly reflected the formation of ATPase with two
      ions bound to the transport sites, whereas the binding of a single Sr2+ ion was
      virtually sufficient to reduce the fluorescence of bound FITC to its minimal
      level.

PMID- 8348981
TI  - Enhancement of interleukin-2 (IL-2) production by 6 different cytokines:
      heterogeneity among IL-2 producing T cell clones.
AB  - The production of interleukin-2 (IL-2) by phytohemagglutinin (PHA)-stimulated
      human leukemia T cell lines was significantly increased by 6 different cytokines.
      The most effective cytokines were interleukin-1 alpha (IL-1 alpha) and IL-1 beta;
      less effective were interferon-alpha (IFN-alpha), tumor necrosis factor-alpha
      (TNF-alpha), IFN-beta and TNF-beta. The combinations of two cytokines had
      synergistic or additive effects and increased IL-2 production to a greater extent
      than either cytokine alone. Other cytokines tested, such as IL-3, IL-4, IL-6, IL
      7, IL-8 and IFN-gamma, had no effect on IL-2 production. However, a remarkable
      heterogeneity in sensitivity to the enhancing effects of the active cytokines was
      found among the IL-2-producing T cell lines studied. While IL-2 production in the
      most sensitive cell line, MOLT-16, was increased by all 6 active cytokines, other
      cell lines responded by increasing IL-2 production to stimulation with only some
      of the cytokines tested. The production of IL-2 in T cell line H9 was not
      enhanced by any of the cytokines used. These results show that several cytokines
      can increase IL-2 production by having a direct effect on the activated IL-2
      producing T cells, but also that the outcome of the regulatory effects of
      individual cytokines depends considerably upon the individual IL-2-producing T
      cell clone.

PMID- 8348980
TI  - Effects of anions on the Ca2+, H+ and electrical gradients formed by the
      sarcoplasmic reticulum ATPase in reconstituted proteoliposomes.
AB  - The chaotropic character of several ions determines their partition on membrane
      interfaces with aqueous media as predicted by the Hofmeister series. However,
      specific characteristics of each individual ion determine its ability to cross
      the membrane and to influence Ca2+, H+ and electrical gradients produced by the
      sarcoplasmic reticulum (SR) Ca2+ pump in reconstituted proteoliposomal vesicles.
      Specific effects of this kind may be relevant to a variety of biological systems,
      including the excitation-contraction coupling of muscle fibers in which SR plays
      a prominent role.

PMID- 8348982
TI  - Artificial mineralization in vitro--a model of tissue mineralization.
AB  - Calcium chloride and sodium hydrogen phosphate form precipitation zones in
      gelatin gel, gel supplemented with cartilaginous extract, articular cartilage
      slices, and in demineralized bone. The cartilaginous extract exerts a marked
      inhibitory effect on the crystal quantity and clustering. The pretreatment of
      cartilage slices with hyaluronidase increases the crystal frequency. The
      morphology of crystals formed in gelatin and in cartilage was similar but quite
      different from the precipitation pattern found in demineralized bone.

PMID- 8348983
TI  - Inhibition of growth of the lymphocyte lines by deferoxamine under various iron
      supply conditions.
AB  - Inhibition of growth of the lymphocyte lines by iron-binding agent deferoxamine
      under various iron-supply conditions was studied. Three different defined culture
      media, representing three different iron-supply conditions, were used: (1) ferric
      citrate (500 microM) medium, (2) transferrin (5 micrograms/ml) medium, and (3)
      low-iron medium (this medium without any iron compound added contains 0.6 microM
      contaminative non-transferrin iron). Mouse B cell line PLV-01, human T cell line
      Jurkat, and human B cell lines Raji and HSCE- were employed. Raji and HSCE- cells
      are able to grow in low-iron medium but PLV-01 and Jurkat cells do not grow in
      the medium. For all cell lines tested in ferric citrate medium, a 50% growth
      inhibition was achieved with 440-500 microM deferoxamine. In transferrin medium,
      deferoxamine concentrations of 4.4-5.5 microM were required for a 50% inhibition
      of PLV-01, Jurkat and HSCE- cells. For the same degree of inhibition of Raji
      cells, 39 microM deferoxamine was required. In the case of low-iron medium, a 50%
      inhibition of Raji and HSCE- cells was achieved with about 1.4-2.1 microM
      deferoxamine. The data demonstrate that the sensitivity of the lymphocyte lines
      to deferoxamine depends on iron-supply conditions. Under the same iron-supply
      conditions, individual cell lines can exhibit different sensitivity. However, the
      sensitivity does not correlate with the ability of the cell lines to grow in low
      iron medium.

PMID- 8348984
TI  - Activity of PDGF (A) gene in the human cell line derived from a renal carcinoma
      metastasis.
AB  - PDGF-like activity was investigated in conditioned media of cell cultures derived
      from 4 human renal carcinomas. Transient production of PDGF-like factor was found
      only in the cell line derived from a subcutaneously growing metastasis. Further
      analysis of this cell line showed an increase of PDGF (A) gene activity in one
      cellular clone.

PMID- 8348985
TI  - Changes in vascular pattern of chicken chorioallantois after cartilaginous
      extract, chondroitin sulfate and dextran sulfate treatment.
AB  - Cartilaginous extract, chondroitin sulfate C as well as dextran sulfate in
      gelatin pellets have an inhibitory effect on the development of fine capillaries,
      in contrast to pure gelatin pellets or pellets with sucrose. These results
      suggest an unspecific inhibitory effect of anionic saccharidic polymers on the
      development of chorioallantoic membrane vessels, because the chemical structure
      of dextran sulfate is (except anionic groups) different from chondroitin sulfate
      in the pure form or in the form of proteoglycans (in cartilaginous extract).

PMID- 8348986
TI  - Disassembly of microtubules due to low intensity ultrasound.
AB  - HeLa and MCF cell monolayers growing on glass cover-slips were sonicated using
      continuous wave ultrasound at low intensity levels approaching diagnostic
      conditions. The disassembly of cytoplasmic microtubules immediately after
      sonication was demonstrated using indirect immunofluorescence. The recovery from
      exposure to ultrasound, i.e. the reassembly of microtubules, was observed in the
      cultured cells 2 h after the sonication was discontinued.

PMID- 8348987
TI  - Enrichment of estradiol receptor from calf uterus.
AB  - A three-step procedure to enrich estradiol receptor protein from calf uterus
      nearly 30,000-fold has been described. Over-all yield is 12%. Control of the
      single steps has been performed by sodium dodecyl sulfate-electrophoresis,
      sucrose density gradient centrifugation, gel filtration and determination of
      receptor quantity. Immunological properties of the preparation obtained have not
      been controlled.

PMID- 8348988
TI  - Maintaining infection control during restorative procedures.
AB  - This report has listed criteria, example products, and pertinent information to
      aid clinicians in performing infection control procedures using products and
      techniques with verified efficacy. The goal is to provide optimal protection of
      clinicians and patients from cross-contamination in the dental environment.
      Subjects reviewed were face masks, eye protection, gloves, hand antiseptics,
      uniforms, vaccines, instrument cleaning, sterilization, environmental surface
      management, and contaminated waste management. The criteria proposed and the
      products listed were not intended to be all-inclusive or absolute. The omission
      of a product from this article or from the examples of products that did meet the
      criteria listed is not intended to disparage the product. No endorsement or
      approval of any product is made or intended by the author, editors, or publisher.
      The intent is to provide some direction at this time. Many new products and
      concepts now in development will bring changes in the future. The products
      referenced have been evaluated by independent researchers and clinicians in
      laboratory and clinical-use tests, and data are available upon request to support
      all recommendations.

PMID- 8348989
TI  - Adhesion and its application with restorative materials.
AB  - Significant progress has been made in the area of adhesion and esthetic
      restorative materials. Each generation of product development aims to address
      many of the previous inadequacies. Current resin-based dentin bonding agents are
      miles ahead of agents introduced only 10 years ago. The glass ionomer cement has
      undergone considerable evolution and barely resembles the original formulation.
      Whether these modified cement-resins will become established in the restorative
      practice remains to be seen. Or possibly, the glass ionomer cement will evolve
      itself out of existence into a new "class" of restorative. Numerous questions
      still remain unanswered in the area of adhesive materials. In particular, the
      confirmation of preliminary laboratory results with controlled clinical research
      often never surfaces, or is delayed beyond the commercial life of proprietary
      adhesive systems. Without such data, little confidence in adhesive behavior can
      be gained. More importantly, without a thorough understanding of the performance
      of adhesives in vivo, knowledge will never be gained relative to adhesive
      mechanisms that are necessary to further technology in this area.

PMID- 8348990
TI  - The significance of occlusion in restorative dentistry.
AB  - All occlusal therapy relates ultimately to the hinge position of the mandible. By
      consensus, the optimum hinge position is centric relation, the most
      anterosuperior position of the condyles in the glenoid fossae, articulating
      against the eminences, with the disks properly interposed. Also by consensus, the
      optimum occlusal scheme is mutual protection, in which the posterior teeth
      contact simultaneously and equally in centric occlusion, the canines disclude the
      posterior teeth in lateral excursions, and the anterior teeth disclude the
      posterior teeth in protrusion. Whenever CR cannot be used as the starting point
      of occlusal treatment, or when sufficient canine support is lacking, the
      clinician may have to prescribe a treatment condylar position other than CR or
      modify the occlusal scheme. Mutual protection occlusion is the simplest to
      develop and CR is the simplest starting point. Departures from these ideals
      create added complexities for the dentist. The greater the number of excursive
      contacts in the occlusal scheme, the more involved the equilibration of those
      contacts. A treatment condylar position other than CR may not be repeatable when
      needed, and two studies suggest that it may change over time. Without a stable,
      repeatable foundation supporting it, the occlusion may be in jeopardy. The
      removal of occlusal interferences, although not warranted as a routine
      prophylactic measure, is indicated under certain conditions. When beginning a
      significant amount of occlusal treatment, the clinicians may remove closing
      interference to achieve CR at the desired vertical dimension. They may remove
      excursive interferences that they do not want to perpetuate in the new scheme.
      Selective removal may alleviate the signs of trauma from occlusion. There may be
      periodontal justification for axializing and equilibrating occlusal forces.
      Nonaxial forces on teeth with cervical erosion should be reduced as a means of
      limiting further erosion and protecting cervical restorations. When occlusal
      disharmony has been shown to reactivate a TMD, an equilibration or a more
      extensive rehabilitation may be necessary in the second phase of TMD treatment.
      In the symptomatic phase of a TMD, however, only reversible measures are
      appropriate. In this time of fast-moving change in restorative techniques and
      products, all operative dentists should raise their consciousness of occlusal
      principles. Occlusal forces set limits on the selection of materials and often
      prescribe the design features needed for a successful outcome. With structurally
      or periodontally compromised teeth, the occlusal planning to minimize nonaxial
      forces lies at the heart of the restoration. Virtually all restorative dentistry
      is affected by the occlusal forces of the teeth in function.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8348991
TI  - Trouble shooting everyday restorative emergencies.
AB  - Restorative emergencies present themselves nearly every day in a general
      practice. Both patients and staff appreciate a designed triage protocol that is
      followed to route patients for treatment. Although most restorative emergencies
      do not require immediate attention, to patients, the problem is unsettling and
      they would want it evaluated as soon as possible. When the necessity for the
      immediate treatment of an emergency is confirmed, the office schedule is least
      disrupted when the practitioner and staff follow restorative treatment techniques
      that manage the dilemma. This article has attempted to provide the dentist with
      some methods of triage and treatment of restorative emergencies. There are other
      methods for treating patients with similar emergency needs. The manner that is
      chosen has to be the one that works at a clinically predictable level.

PMID- 8348992
TI  - Pins, dowels, and other retentive devices in posterior teeth.
AB  - Devices used to increase retention of restorations to severely damaged posterior
      teeth are described, with an emphasis on pins and dowels. Advantages and
      disadvantages of different techniques and measures to help prevent and correct
      problems are presented.

PMID- 8348993
TI  - Esthetic applications of restorative materials and techniques in the anterior
      dentition.
AB  - The esthetic expectations of our patients can be met by doing a thorough initial
      examination with emphasis on periodontal health, caries incidence, occlusion,
      possible orthodontic corrections, esthetic needs, and economic concerns. Through
      proper communication with the patient, a written treatment plan can be developed
      that uses the various techniques of bleaching, cosmetic recontouring, direct
      resin bonding, porcelain veneering, or crowning to meet the patient's restorative
      needs. The most conservative noninvasive techniques should be evaluated first.
      Often, bleaching and partial direct bonding are all that is needed. If the
      dentition is badly worn or discolored, then more extensive treatment is
      indicated. Patients frequently have concerns about longevity of restorations or
      require very high levels of esthetic correction, which can only be accomplished
      with more invasive techniques. When patients understand what can be accomplished
      and are involved in the treatment decision, then successful results are assured.
      Esthetic restorative dentistry is probably the most rewarding aspect of practice
      today, but it is also the most challenging. New materials appear and techniques
      change so rapidly that it is sometimes difficult to keep up. Practitioners should
      acquire a thorough knowledge of available methods and materials, learn the
      limitations of these materials and techniques, and master skills through
      continuing education (courses, journals, and newsletters) as well as chairside
      repetition as new procedures become available.

PMID- 8348994
TI  - Posterior composites. State-of-the-art clinical applications.
AB  - Composite resins have undergone a continuous evolution since the first patent
      developed by Bowen in the middle 1960s. Some current formulations are an order of
      magnitude more wear resistant than those first used in posterior teeth. In fact,
      some of them are nearly as wear resistant as amalgam with respect to generalized
      wear. Unfortunately, however, disproportionally little effort has been expended
      in improving the resins' manipulative characteristics. Consequently, posterior
      composite resins presently fall short as an overall substitute for amalgam as a
      restoration material.

PMID- 8348995
TI  - Dental amalgam. The state of the art and science.
AB  - When you balance the benefits and liabilities of a modern dental amalgam, it is
      one of the materials that comes closet to being an ideal restorative. Its
      numerous clinical advantages have, in the past, made it a standard in dental
      care. The profession's and public's awareness of the issues surrounding the
      mercury content, coupled with the biased reporting of the controversy by less
      than responsible journalists, have served to impung the material. The dental
      profession has used the material successfully in its present form for almost 100
      years. There are still valid questions about the material that require further
      scientific investigation. Investigators continue to make improvements in the
      alloy's strength and handling properties while limiting the mercury-release
      potential of the material. As we move into the twenty-first century, we are again
      told we will soon have a suitable replacement for dental amalgam. That is an
      often repeated promise for this multifunctional product. Time and sound research
      into the longevity and liabilities of all restorative materials as applied in the
      office of the general practitioner will tell us if amalgam is or is not going to
      disappear from the dental armamentarium in the near future.

PMID- 8348996
TI  - Conservative indirect restorations for posterior teeth. Cast versus bonded
      ceramic.
AB  - The practitioner today has a number of alternative restorative modalities from
      which to chose when faced with the necessity of restoring posterior teeth. The
      primary options with extensively broken down posterior teeth are cast gold and
      bonded ceramic inlays, onlays, and partial veneer restorations. The dentist and
      informed patient should make the choice of which modality is appropriate based on
      a number of criteria. Certainly, based on the criteria of basic physical
      properties, potential for marginal integrity and stability of that integrity,
      cast gold is the material of choice. In terms of conservation of tooth structure
      and systemic biocompatibility, both restoration types are excellent. With regard
      to effects on long-term pulpal health, much remains unknown with many of the
      materials used with bonded restorations at the present time. Conservative cast
      gold restorations have proved to be very successful in this regard over the long
      term. The potential for tooth strengthening with bonded restorations is certainly
      an exciting, but as yet, unproven, clinical reality. Thus, until those clinical
      data are available, the most predictable means of restoration of extensively
      broken down posterior teeth is with partial-coverage cast gold, protecting cusps
      at risk as required (Fig. 9). As mentioned previously, cast gold inlays are also
      a very conservative and predictable restoration (Fig. 10). Both cast gold and
      bonded ceramic restorations are technically demanding, but the details required
      to produce excellent gold castings are well defined, and can be learned readily.
      Much remains to be learned regarding the materials and the techniques used to
      fabricate bonded ceramic restorations. Priority issues would seem to be reaching
      a consensus regarding the details of tooth preparation and the development of
      improved luting resins with improved wear resistance. Simplified techniques to
      improve the quality of the fit of these types of restoration also are of
      paramount importance. The requirement for an esthetic, or, more properly, use of
      a tooth-colored restoration in a posterior tooth, should be evaluated carefully
      for each individual restoration. Often it is possible to restore a tooth with
      cast gold with minimal or no display of metal. The patient will then receive the
      long-term benefit of cast gold and not compromise on esthetics. It is our
      obligation as diagnosticians to educate our patients so that they are in a
      position to choose, when indicated, this most cost effective of restorative
      options.

PMID- 8348997
TI  - Resin-bonded prosthodontics. An update.
AB  - First-generation designs that covered a large area of enamel but had minimal
      retentive features still provided sufficient longevity to be classified as
      "permanent" type restorations. The goal of long-term service can be realized more
      consistently by incorporating second-generation designs with the ease of adhesive
      bonding.

PMID- 8348998
TI  - Restorative dentistry. Interactions with periodontics.
AB  - The integration of periodontal considerations with restorative planning is now
      the standard of care. Instilling motivation toward prevention continues to be one
      of our most challenging goals. A stable healthy periodontium and minimum
      restorative needs are the resulting rewards. With the use of available knowledge
      and microbial testing for both periodontitis and caries susceptibility, we now
      can offer our patients a higher likelihood of success in retaining natural teeth
      and implants.

PMID- 8348999
TI  - Adjunctive orthodontic therapy in restorative dentistry.
AB  - This article focuses on the interaction between the orthodontist and other dental
      specialists to facilitate combined treatment of permanent dentition and mutilated
      dentition. The importance of careful and precise treatment planning of such
      malocclusions, including a thorough restorative and periodontal treatment plan,
      is emphasized. Clinical examples that range from adjunctive minor orthodontic
      therapy to combined orthognathic surgery treatment are presented.

PMID- 8349000
TI  - Restorative considerations for special needs patients.
AB  - Individuals are living longer with more chronic and disabling conditions than
      previous generations of adults. In addition, they are retaining more of their
      natural dentition than ever before. As a result, it will be common for a dentist
      in practice in the next 20 to 30 years to care for many patients with special
      needs. These individuals offer unique challenges to the dental practitioner.
      Dentists must be knowledgeable in the oral aspects of various medical conditions
      and the systemic manifestation of oral diseases. In addition to the oral medicine
      aspects of practice, dentists must be skilled clinically to care for the unique
      restorative needs with which these patients present. As individuals age or become
      chronically ill, people deserve the opportunity to select from all that modern
      dentistry has to offer. Patients must be involved intimately in the decision
      making process. No dental professional should assume because a patient is old or
      chronically ill that he or she lacks the financial resources or the desire to
      maintain his or her oral health.

PMID- 8349001
TI  - The implant-supported single-tooth restoration. Preoperative evaluation and
      clinical procedure.
AB  - The implant-supported restoration is a relatively new and promising treatment
      modality. The CeraOne system offers a complete set of easy-to-use prosthetic
      components plus the all-ceramic and ceramometal restorative alternatives. No
      clinical signs of loosening have been reported since the adjunct of a torque
      controller that provides a tightening force of 32 Ncm to the abutment gold
      fixation screw. Even with these developments, however, a meticulous presurgical
      evaluation of the periodontium and careful fixture placement are still imperative
      for a successful esthetic and functional result.

PMID- 8349002
TI  - High-technology innovations--and limitations--for restorative dentistry.
AB  - Technology has brought some exciting advances to dentistry--restorations that can
      be produced in one appointment and fit as well as cast restorations; laser
      procedures that arrest early caries, etch enamel, and that the patient finds more
      comfortable; and improved diagnostic capabilities through computer-enhanced
      images. Dental applications of these technologies are in their infancy and most
      of the limitations discussed in this article will be eliminated in the near
      future. More and more applications and possibilities are continually evolving.
      Technology promises to enhance dentistry for the clinician and patient alike.

PMID- 8349003
TI  - c-Fos and related immediate early gene products as markers of activity in
      neuroendocrine systems.
AB  - Expression of c-Fos, or other immediate early gene products, by individual
      neurons can be used as a marker of cell activation, making staining of these
      proteins an extremely useful technique for functional anatomical mapping of
      neuroendocrine systems. Because these proteins are located in the nucleus,
      identification of the phenotype of the activated neuron using substances located
      within the cytoplasm can be accomplished with standard double-labeling
      immunocytochemical techniques. Although it is clear that neurons have the
      capacity to express a number of immediate early gene products, what remains to be
      established is whether there is a different pattern of expression following
      various stimuli. In our studies, we focus primarily on expression of one
      immediate early gene product, the c-Fos protein. We also include some experiments
      using expression of other members of the Fos family and Jun proteins as markers
      for neuronal activation. Our studies describe uses of c-Fos expression in both
      parvocellular and magnocellular hypothalamic systems to address the following
      issues: (a) identification of neuroendocrine cells activated by specific
      treatments and conditions, (b) ascertainment of functional differences in
      subpopulations activated by specific stimuli, (c) evaluation of neuronal activity
      in complex areas containing multiple neuroendocrine systems, (d) identification
      of other brain areas activated in conjunction with neuroendocrine systems
      following specific stimuli, (e) analysis of connectivity of activated
      neuroendocrine systems with other parts of the brain, and (f) identification of
      stimuli that decrease neuronal activity. The neuroendocrine systems studied
      include those that secrete arginine vasopressin (AVP), oxytocin (OT),
      corticotropin-releasing hormone (CRH), luteinizing hormone-releasing hormone
      (LHRH), and dopamine (DA). The use of c-Fos expression has permitted functional
      neuroanatomical mapping of these systems in response to specific stimuli such as
      cholecystokinin (CCK), hyperosmolality, and volume depletion, or during various
      physiological states such as the proestrous ovulatory luteinizing hormone (LH)
      surge and lactation. Although the use of c-Fos as a marker of neuronal activation
      will continue to be an extremely powerful technique, future studies will also be
      directed at relating immediate early gene expression to changes in neuroendocrine
      gene expression. To this end, we have shown that both c-Fos and c-Jun are
      expressed in neuroendocrine neurons in response to a number of stimuli, setting
      the stage for potential regulatory drive to genes containing AP-1 binding sites.

PMID- 8349004
TI  - Blood, pituitary, and brain renin-angiotensin systems and regulation of secretion
      of anterior pituitary gland.
AB  - In addition to increasing blood pressure, stimulating aldosterone and vasopressin
      secretion, and increasing water intake, angiotensin II affects the secretion of
      anterior pituitary hormones. Some of these effects are direct. There are
      angiotensin II receptors on lactotropes and corticotropes in rats, and there may
      be receptors on thyrotropes and other secretory cells. Circulating angiotensin II
      reaches these receptors, but angiotensin II is almost certainly generated locally
      by the pituitary renin-angiotensin system as well. There are also indirect
      effects produced by the effects of brain angiotensin II on the secretion of
      hypophyseotropic hormones. In the anterior pituitary of the rat, the gonadotropes
      contain renin, angiotensin II, and some angiotensin-converting enzyme. There is
      debate about whether these cells also contain small amounts of angiotensinogen,
      but most of the angiotensinogen is produced by a separate population of cells and
      appears to pass in a paracrine fashion to the gonadotropes. An analogous
      situation exists in the brain. Neurons contain angiotensin II and probably renin,
      but most angiotensin-converting enzyme is located elsewhere and angiotensinogen
      is primarily if not solely produced by astrocytes. Angiotensin II causes
      secretion of prolactin and adrenocorticotropic hormone (ACTH) when added to
      pituitary cells in vitro. Paracrine regulation of prolactin secretion by
      angiotensin II from the gonadotropes may occur in vitro under certain
      circumstances, but the effects of peripheral angiotensin II on ACTH secretion
      appear to be mediated via the brain and corticotropin-releasing hormone (CRH). In
      the brain, there is good evidence that locally generated angiotensin II causes
      release of norepinephrine that in turn stimulates gonadotropin-releasing hormone
      secreting neurons, increasing circulating luteinizing hormone. In addition, there
      is evidence that angiotensin II acts in the arcuate nuclei to increase the
      secretion of dopamine into the portal-hypophyseal vessels, inhibiting prolactin
      secretion. Central as well as peripheral angiotensin II increases CRH secretion,
      but there is little if any evidence that angiotensin II mediates the ACTH
      responses to other stressful stimuli.

PMID- 8349005
TI  - Activation of neutrophils NADPH oxidase by PMA: cytosol activity is translocated
      in phorbol-primed neutrophils.
AB  - 1. Translocation of cytosol activity in phorbol-primed neutrophils was studied.
      2. Prior exposure of PMA or FMLP could potentiate the oxidative response by
      subsequent heterogeneous stimulus, FMLP or PMA. 3. In FMLP-primed neutrophils,
      the cytosol had almost the same activity as resting one and cytosol activity was
      not eluted from the membrane. 4. In PMA-primed neutrophils, however, the cytosol
      had less activity and cytosol activity was correspondingly eluted from the
      membrane. 5. These observations suggested that cytosol activity was translocated
      in PMA-primed cells.

PMID- 8349006
TI  - Hormonal regulation of human apolipoprotein E gene expression in HepG2 cells.
AB  - 1. Hormonal regulation of apolipoprotein E (apoE) gene expression by insulin and
      thyroid hormone was studied in a human hepatoma cell line, HepG2. 2. Changes at
      the mRNA level, mRNA translation, in vivo synthesis and secretion were monitored.
      3. Both insulin and triiodothyronine were found to have no significant effect on
      apoE mRNA levels. 4. Insulin treatment caused an inhibition of: (a) the in vitro
      translation of endogenous apoE mRNA in a HepG2 cell-free system (25%), and (b)
      the incorporation of radioactivity into newly-synthesized apoE in an in vivo
      pulse-chase labeling experiment (32%). 5. Interestingly, apoE secretion rate was
      found to be significantly reduced with insulin (84%) suggesting that a major
      portion of newly-synthesized apoE may be shunted into a degradative pathway. 6.
      Using a similar experimental approach, triiodothyronine showed no significant
      effect on the rate of apoE synthesis or translation (6-15% decrease), however a
      slight reduction (20%) in secretion rate was shown. 7. Overall, apoE gene
      expression does not appear to be influenced by triiodothyronine significantly but
      is modulated by insulin at the translational and post-translational level.

PMID- 8349007
TI  - Isolation of chromaffin cell thapsigargin-sensitive Ca2+ store in light
      microsomes from bovine adrenal medulla.
AB  - 1. A subcellular fractionation procedure for bovine adrenal glands was designed
      with the aim to study the biochemical properties of Ca2+ stores in chromaffin
      cells. 2. The thapsigargin-sensitive compartment of Ca2+ stores was found to be
      highly enriched in a light microsomal fraction (LMF) on a 15-30% linear sucrose
      gradient, and was found to be essentially devoid of contamination by plasma,
      mitochondrial or secretory granule membranes. 3. A Ca(2+)-pumping ATPase was
      identified in this LMF as a 97 kDa protein forming an acid-stable, Ca(2+)
      dependent, thapsigargin-sensitive phosphorylated intermediate upon incubation
      with [gamma-32P]ATP, suggesting this protein to represent a SERCA-3 isoform of
      Ca2+ ATPases. 4. A major 162 kDa protein, previously demonstrated in the isolated
      chromaffin cells, was enriched in the LMF, distributing on sucrose gradients in
      parallel with the thapsigargin-sensitive Ca2+ uptake. 5. LMF appears to represent
      a part of the thapsigargin-sensitive Ca2+ store of chromaffin cells, and should
      be useful for further studies of the store properties at the subcellular and
      molecular level.

PMID- 8349008
TI  - Interaction of pyridoxal phosphate with thymidylate synthase: spectral and
      equilibrium dialysis studies.
AB  - 1. Changes in the spectrum of pyridoxal phosphate (PLP) were produced by adding
      an equimolar amount of native thymidylate synthase, but not by adding denatured
      enzyme or enzyme modified by sulfhydryl-blocking reagents. 2. The dissociation
      constant of the thymidylate synthase-PLP complex determined by equilibrium
      dialysis was 9 +/- 1.6 microM, the maximum number of PLP molecules bound per
      molecule of native thymidylate synthase was 2.5 +/- 0.4, and the Hill coefficient
      was 0.97. 3. No evidence of PLP binding was found with denatured thymidylate
      synthase, and only slight binding was observed when enzyme SH groups were blocked
      or when the active site was blocked with 5-fluorodeoxyuridylate (FdUMP) and
      methylene tetrahydrofolate. 4. The presence of dUMP, dTMP, or FdUMP interfered
      with the binding of PLP to thymidylate synthase, and the presence of equimolar
      amounts of PLP interfered with the binding of dUMP.

PMID- 8349009
TI  - Control of mucin molecular forms expression by salivary protease: differences
      with caries.
AB  - 1. A protease activity capable of degradation of the high mol. wt salivary mucus
      glycoprotein to a low mol. wt glycoprotein form was identified in human
      submandibular gland secretion. 2. The protease exhibited optimum activity at pH
      7.0-7.4, and gave on SDS-PAGE under reducing conditions two major protein bands
      of 48 and 53 kDa. The enzyme showed susceptibility to PMSF, alpha 1antitrypsin,
      and egg white and soybean inhibitors, a characteristic typical to serine
      proteases. 3. The activity of the protease towards the high mol. wt mucus
      glycoprotein was found to be 3.8-fold higher in submandibular gland secretion of
      caries-resistant individuals than that of caries-susceptible. Furthermore, the
      enzyme from both groups displayed greater activity against the mucus glycoprotein
      of caries-resistant subjects. 4. Since the low mol. wt salivary mucus
      glycoprotein form is more efficient in bacterial clearance than the high mol. wt
      mucin, the enhanced expression of this indigenous salivary protease activity
      towards mucin may be the determining factor in the resistance to caries.

PMID- 8349010
TI  - Okadaic acid inhibits insulin stimulation of both ornithine decarboxylase and
      spermidine transport in hepatocyte cultures.
AB  - 1. Okadaic acid inhibited basal ODC activity in rat hepatocytes in culture and
      prevented any increase in ODC activity and in the rate of spermidine uptake
      promoted by both insulin and hypotonicity. 2. The increase promoted by AIB was
      not counteracted by okadaic acid.

PMID- 8349011
TI  - Diffusion limited component of mitochondrial F1-ATPase.
AB  - 1. The possibility that the rate of ATP hydrolysis by F1-ATPase approaches the
      diffusion-controlled limits was investigated by measuring the values of kcat and
      kl (kcat/Km) as a function of increasing viscosity. 2. The values of kcat/Km
      decrease significantly with increasing viscosity; further such decrease was lower
      when Fl-ATPase hydrolyzed poor substrate such as Ca- and Mg-ITP or when the
      hydrolysis rates were measured at temperatures below 20 degrees C. 3. Viscosity
      also decreases kcat, but only at high concentrations of viscosogenic agents. 4.
      These results suggest that ATP hydrolysis is at least partly diffusion
      controlled, although a general nonspecific perturbation in the enzyme structure
      is also effected by viscosity.

PMID- 8349012
TI  - Subcellular and developmental studies of the tyrosyl protein sulfotransferase in
      rat brain.
AB  - 1. Tyrosyl protein sulfotransferase (TPS) activity in the newborn and mature rat
      brain was studied using the cholecystokinin derivative terbutyloxycarbonyl-Asp
      Tyr-Met-Gly-Trp-Met-Asp-PheNH2, BocCCK-8(ns), as the peptide substrate. 2. TPS
      activity was enriched 4 times in the microsomal and synaptic vesicular enriched
      fractions of rat cerebral cortex. 3. CCK-8 content, in the subcellular fractions
      and the peptide sulfation activity distribution was in accord with the hypothesis
      that tyrosyl protein sulfotransferase plays a key role in the maturation process
      of bioactive CCK. 4. TPS activity measured in membranes from newborn brain was
      2.5 times higher than the activity observed in the mature brain membranes with a
      Vmax = 0.83 +/- 0.05 and 0.31 +/- 0.02 respectively. The apparent KM for the
      sulfate donor, 3'-phosphoadenosine 5'-phosphosulfate (PAPS), was similar, 94 +/-
      4 nM and 90 +/- 6 nM and the KM for the peptide substrate, BocCCK-8(ns), was 234
      +/- 16 microM and 160 +/- 12 microM in the newborn and adult brain membranes
      respectively. 5. TPS activity reached normal mature values within 20 days of age.
      6. These data support the idea that tyrosyl protein sulfation is an important
      process in the secretion mechanism and in the CCK maturation.

PMID- 8349013
TI  - Characterization of sheep hepatocytes in primary culture.
AB  - 1. Primary cultures of isolated sheep hepatocytes were used to characterize
      metabolic functions of liver: gluconeogenesis, ureagenesis and protein synthesis.
      The rates of all three metabolic activities were linear over a 20 hr culture
      period. 2. Hepatocytes in the presence of glucagon increased the synthesis of
      urea by approx 30% (P < 0.05) and increased release of glucose into the medium by
      60% (P < 0.05). 3. In the absence of insulin, significantly more (35%; P < 0.05)
      glucose was released in the medium than in the presence of insulin. 4. Results
      help evaluate the primary culture of sheep hepatocytes as an appropriate
      experimental model to study nutritional and hormonal regulation of liver in the
      ruminant species.

PMID- 8349014
TI  - Adenosine effect on lactate and pyruvate production in the hypoxic guinea pig
      heart.
AB  - 1. It has been shown that adenosine stimulates glycolysis in some cells and this
      ability of adenosine was tested in the hypoxic guinea pig heart. 2. Adenosine (10
      microM) activated lactate production in the isolated perfused guinea pig heart
      under conditions of normoxia but did not under hypoxia. 3. Despite this, the
      nucleoside favorably influenced the energy metabolism of the hypoxic heart as
      revealed by the better posthypoxic functional recovery (98%) compared to the
      control without adenosine (78%). 4. Our findings suggest a role for the
      glycolytic pathway in this effect of the nucleoside as long as other cardiac
      energy-yielding pathways are strictly aerobic.

PMID- 8349015
TI  - Role of antiproteolytic heparin-binding serum protein(s) in modulating the levels
      of sialyl- and galactosyltransferase activity released during the incubation of
      rat jejunal slices.
AB  - 1. Sialyltransferase released into the medium during the incubation of rat
      jejunal slices in serum-free buffer, was susceptible to proteolytic degradation.
      Heat inactivated horse serum or its antiproteolytic heparin-binding fraction was
      found to be necessary in determining the activity of sialyltransferase released
      (Nadkarni et al., 1991). 2. In the present study, we have shown that heat
      inactivated rat serum (HRS) or its antiproteolytic heparin-binding fraction (HBF)
      had a role in determining the sialyltransferase activity released during jejunal
      slice incubations. 3. Galactosyltransferase was also released during incubations,
      but was not proteolytically degraded and the presence of HRS or HBF in
      incubations did not alter the levels of galactosyltransferase activity released.
      4. Trypsin activity in serum-free incubation medium was higher compared to medium
      containing HRS. 5. Addition of serum-free medium obtained from 4 hr incubations
      of the jejunal slices, to medium obtained from parallel incubations done in the
      presence of HRS, caused inhibition of sialyl- but not galactosyltransferase
      activity. 6. In jejunal homogenates stored at -20 degrees C, sialyltransferase
      activity was decreased during 0-45 days of storage, whereas galactosyltransferase
      activity remained fairly stable for upto 56 days. 7. Inclusion of HRS or HBF in
      homogenates resulted in higher sialyl- but not galactosyltransferase activity
      compared to serum-free homogenate samples. 8. The results suggest that HRS or its
      antiproteolytic heparin-binding proteins have a role in determining the
      sialyltransferase activity released from the jejunal slices. In contrast
      galactosyltransferase released was not susceptible to proteolysis, and HRS or HBF
      was not required to express its activity.

PMID- 8349016
TI  - Binding of drugs to human plasma proteins, exemplified by Sn(IV)-etiopurpurin
      dichloride delivered in cremophor and DMSO.
AB  - 1. The mode-delivery-effect upon the binding of Sn(IV)-etiopurpurin dichloride
      (SnET2) in human plasma has been studied by ultracentrifugation, combined with
      absorption and fluorescence spectroscopy. SnET2 was delivered to plasma either in
      Cremophore EL (CRM) or in dimethyl sulfoxide (DMSO). To facilitate
      interpretation, optical, conductivity and aggregation properties of SnET2 were
      obtained for various solutions. 2. The second order rate constant for the
      aggregation of SnET2 monomers seemed to be remarkably small, of the order of
      10(3) M-1 min-1. 3. SnET2 was bound as monomeric entities. Such entities had
      environmental-sensitive fluorescent properties dependent on the type of protein
      or solvent (DMSO, CRM, H2O) with which they interacted. 4. SnET2 showed saturable
      binding with high density subfraction(s) of high density lipoproteins and with
      one or more high density proteins. Complete or substantial saturation was
      achieved at the SnET2 level of 3.5 micrograms/ml. Such binding might be mediated
      by apolipoprotein D and alpha 1-acid glycoprotein. 5. There was little effect of
      SnET2 concentrations (3.5-35 micrograms SnET2/ml) upon the plasma binding of
      SnET2, irrespective of the mode of delivery. 6. The percentages of SnET2 bound to
      low density lipoproteins (LDL), high density lipoproteins (HDL), and high density
      proteins (HDP) were 10, 70 and 20%, respectively, for delivery in DMSO. The value
      for LDL also includes binding with very low density lipoproteins (VLDL). For
      delivery in CRM the corresponding values were 20, 50 and 30%. Apparently, CRM
      interacted with HDL entities and reduced their affinity for SnET2. 7. The
      distribution pattern of SnET2 among lipoproteins reflects interactions with
      apoproteins and/or with surface phospholipids rather than with core lipid
      constituents of lipoproteins. 8. Conductivity measurements showed that SnET2 was
      partly an ionic entity in water. 9. The plasma binding of SnET2 is compared with
      the corresponding binding of other drugs, both tetrapyrroles and
      nontetrapyrroles.

PMID- 8349017
TI  - Isolation and characterization of procoagulant from the venom of Vipera aspis
      aspis.
AB  - 1. A procoagulant protein was isolated from Vipera aspis aspis (Aspic viper)
      venom by Sephadex G-75, DEAE-Sephacel, Q-Sepharose and Sephadex G-150 column
      chromatography. 2. The purified protein has a molecular weight of 125,000 and an
      isoelectric point of 4.3. 3. This procoagulant decreased the clotting time of
      plasma from humans, however, direct fibrongen clotting activity was not detected.
      4. Diisopropyl fluorophosphate, a serine-protease inhibitor affected coagulant
      activity of purified protein significantly, while a factor Xa inhibitor (3-ABPE)
      possessed a slight inhibitory effect. 5. Bovine prothrombin incubated with
      isolated protein, phospholipid emulsion, bovine factor V and calcium ions
      drastically decreased the clotting time of fibrinogen and expressed hydrolytic
      activity against synthetic arginine esterase substrates. However, no hydrolytic
      activity these substrates was detected with the procoagulant alone indicating
      that this protein might participate in activation of prothrombin.

PMID- 8349018
TI  - Characterization of immunotrap assays for urokinase plasminogen activator and its
      inhibitors and measurements of these molecules in human plasma and mouse
      macrophage in culture.
AB  - 1. Immunotrap assays that can measure the activities of urokinase-type
      plasminogen activator (uPA) and its inhibitors (PAIs) were characterized. 2. Both
      human plasma and mouse macrophages in culture were found to contain much higher
      inhibitor activity than uPA-like activity. 3. The balance between pro- and anti
      fibrinolytic activities was quantitatively changed in the murine macrophages
      after the injection of thioglycollate. uPA-like materials were synthesized by the
      macrophages and secreted to the conditioned medium continuously, while PAI
      activity was unchanged during the same time period.

PMID- 8349019
TI  - Mitogenic activity and immunological properties of bolesatine, a lectin isolated
      from the mushroom Boletus satanas Lenz.
AB  - 1. A lectin has been purified from the mushroom Boletus satanas Lenz. 2. The
      protein, called bolesatine, is mitogenic for human T lymphocytes in a dose- and
      time-dependent manner. 3. Optimal mitogenic doses induce the release of
      interleukin-1 alpha and interleukin-2 from mononuclear cell cultures.

PMID- 8349021
TI  - The sheep erythropoietin gene: molecular cloning and effect of hemorrhage on
      plasma erythropoietin and renal/liver messenger RNA in adult sheep.
AB  - Erythropoietin (Epo) production was studied in adult sheep. Nine ewes, body
      weight (BW) 39 +/- 1.3 kg, were hemorrhaged a volume of blood equivalent to 1.6%
      BW, and sampled at 0, 2, 4, 6, 24 h. Oxygen content (O2 CT) decreased by 2.7 +/-
      0.6 ml/dl at 2 h. Plasma immunoreactive (IR) Epo was only significantly increased
      at 24 h, from 18.5 +/- 3.5 to 40 +/- 10.7 mU/ml (mean +/- SEM). A further 5 ewes
      were bled extensively (2793 +/- 82 ml) over 54 h, and killed for Epo mRNA
      determination. The O2 CT decreased from 12.3 +/- 1.6 to 4.1 +/- 0.6 ml/dl, and
      plasma Epo increased from 15 +/- 4 to 1675 +/- 287 mU/ml. The sequence of ovine
      Epo cDNA was derived from the kidney RNA of a severely bled sheep using reverse
      transcription/polymerase chain reaction (RT/PCR), and from an ovine Epo genomic
      clone. The cDNA encodes a peptide of 194 amino acids, including a 27 amino acid
      signal peptide. The deduced amino acid sequence of sheep Epo shows 82%, 78% and
      80% homology with mature Epos of human, mouse and monkey, respectively. The gene
      structure resembles closely those of human and mouse, with 5 exons and 4 introns.
      The expression of the ovine Epo gene in tissues from normal and hemorrhaged sheep
      was analysed by a competitive RT/PCR method. Epo mRNA was difficult to detect in
      liver from normal sheep, but was detectable at 0.01-0.04 amol/microgram total RNA
      in kidney from normal sheep. In the kidneys of severely bled sheep, the Epo mRNA
      levels (per micrograms total RNA) increased 400-1500-fold compared to that of
      normal kidneys, and were approximately 60-fold greater than those in the livers
      of the hemorrhaged sheep.

PMID- 8349020
TI  - Molecular mechanisms regulating prostaglandin action.

PMID- 8349022
TI  - The secretion of transforming growth factor-beta by bovine luteal cells in vitro.
AB  - Transforming growth factor-beta (TGF-beta), a multifunctional polypeptide growth
      factor, is produced by follicular cells in the ovary. However, there is little
      information indicating that TGF-beta is produced in the post-ovulatory follicle,
      i.e. the corpus luteum. In the present communication we present evidence that
      bovine luteal cells secrete large amounts of TGF-beta when maintained in moderate
      term monolayer culture. Using TGF-beta 1 and TGF-beta 2 subtype-specific
      antibodies to neutralize the bioactivity it was found that 80-90% TGF-beta
      activity in luteal cell conditioned medium (LCCM) is due to TGF-beta 1, whereas <
      or = 10% TGF-beta activity in LCCM is due to TGF-beta 2. TGF-beta subtype
      nonspecific antibodies effectively and completely neutralized all TGF-beta
      activity in LCCM. The ratio of TGF-beta 1:TGF-beta 2 as estimated on the basis of
      neutralization studies was supported by visual observation of TGF-beta 1 and TGF
      beta 2 protein bands on Western blotting. Using a modified and rapid mink lung
      epithelial cell bioassay and authentic TGF-beta to generate standard curves, the
      amount of TGF-beta secreted by luteal cells in vitro was quantitated. The
      concentration of luteal cell secreted proteins in the medium increased with time
      during 7 days of culture. Likewise, the TGF-beta concentration in LCCM increased
      during 7 days. To study the effect of duration of culture on the rate of TGF-beta
      secretion by luteal cells, conditioned medium was collected at 24 h intervals and
      replaced with fresh nutrient medium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349023
TI  - Biphasic effect of exogenous testosterone on follicle-stimulating hormone gene
      expression and synthesis in the male rat.
AB  - Effects of 2-week treatments with increasing doses of testosterone (T) on
      gonadotropin gene expression and secretion were studied in intact and acutely
      castrated male rats. T was administered in silastic capsules with lengths of 2,
      4, 8 or 16 cm, and control animals received empty capsules (eight per treatment).
      The treatments increased serum T up to 3-fold of control levels. In intact
      animals, the 2-8 cm capsules suppressed pituitary follicle-stimulating hormone
      beta (FSH beta) mRNA contents by 40-50% (p < 0.01), but 16 cm of T returned the
      levels back to control range. Castration alone increased the FSH beta mRNA level
      2.3-fold (p < 0.01) and, after T treatment, the FSH beta message returned to
      control levels indistinguishable from intact controls but higher than in intact
      animals receiving the same T dose. Pituitary luteinizing hormone-beta (LH beta)
      mRNA displayed a dose-dependent suppression in response to T, to 32-35% of
      controls (p < 0.01) with the 8 and 16 cm capsules. Castration increased this
      message 10-fold, and additional T treatment suppressed the levels to the range of
      T-treated intact animals. Pituitary common-alpha mRNA decreased to 30-31% of
      controls by 2, 4 and 8 cm of T (p < 0.01), but the highest dose of T increased
      the common-alpha contents, in comparison to the other doses, to 54% of controls
      (p < 0.01). Castration alone increased the common-alpha contents 4.4-fold, and
      there was a dose-dependent suppression of this parameter by T down to the range
      of T-treated intact rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349024
TI  - Calcitriol attenuates the thyrotropin-releasing hormone-stimulated inositol
      phosphate production in clonal rat pituitary (GH4C1) cells.
AB  - Three days pretreatment of the prolactin (PRL) secreting GH4C1 cells with 10 nM
      calcitriol attenuated both the basal and thyrotropin-releasing hormone (TRH)
      stimulated (1 microM, 5 s) inositol trisphosphate (IP3) production by 30 and 26%,
      respectively. The effect was detectable at 10 nM (basal) and 1 pM (TRH
      stimulated), and maximal at 1 microM (basal) and 10 nM (TRH), respectively.
      Calcitriol was at least 100 times more potent than calcidiol and 24
      hydroxycalcidiol, and the effect was reversible upon cessation of pretreatment.
      Calcitriol pretreatment (1 microM, 5 days) also decreased the levels of
      phosphatidyl-inositol, phosphatidylinositol 4-phosphate and phosphatidylinositol
      4,5-bisphosphate by 23, 55 and 32%, respectively. GTP gamma S-stimulated (100
      microM, 30 s) IP3 production was decreased by 45% after calcitriol pretreatment
      (10 nM, 5 days). Pertussis toxin (1 nM, 4 h) attenuated both the basal and TRH
      stimulated IP3 production, but this effect was omitted by calcitriol
      pretreatment. Thus, calcitriol specifically attenuates both the basal and TRH
      stimulated inositol phosphate production in GH4C1 cells. The mechanism, at least
      partly, involves decreased availability of phosphoinositides for phospholipase C.
      Calcitriol regulation of a pertussis toxin-sensitive G-protein might also play
      some role.

PMID- 8349025
TI  - Characterization of the ovine LH beta-subunit gene: the promoter directs
      gonadotrope-specific expression in transgenic mice.
AB  - The alpha- and beta-subunits of the gonadotropin hormones are expressed in the
      gonadotrope cells of the anterior pituitary. There are no adequate in vitro
      systems for the analysis of beta-subunit gene expression. In this study,
      therefore, transgenic mice have been used to investigate the regulation of
      expression of the ovine luteinizing hormone beta-gene (oLH beta) in vivo. oLH
      beta was isolated, characterized, and 1.9 kb of the promoter fused to the
      bacterial reporter chloramphenicol acetyl-transferase (CAT). Three lines of
      transgenic mice were generated. CAT enzyme was detected in the pituitary of two
      lines, whereas the third line did not express. Measurement of endogenous
      luteinizing hormone and follicle stimulating hormone levels in both expressing
      lines revealed small differences when compared to controls, but these did not
      affect the fertility of the animals. Immunostaining of the anterior pituitary
      revealed that the oLH beta CAT transgene was expressed specifically in
      gonadotrope cells.

PMID- 8349026
TI  - Gender-associated differences in the development of 5-aminolevulinate synthase
      gene expression in the harderian gland of Syrian hamsters.
AB  - The mRNA levels for aminolevulinate synthase (ALV-S), the rate-limiting enzyme in
      porphyrin synthesis, were studied in male and female Syrian hamsters during
      postnatal development. Sex-associated differences in the expression of ALV-S gene
      were evident at the end of the third week of postnatal development. Serum levels
      of luteinizing hormone (LH), testosterone, cortisol, thyroid hormones and insulin
      like growth factor were also studied in order to correlate their concentrations
      with the mRNA levels for ALV-S. Among these hormones, serum LH levels showed a
      positive correlation with the ALV-S mRNA levels. However, the expected negative
      correlation with testosterone levels was not clearly observed. Thus, in order to
      test the effects of testosterone on ALV-S gene expression, 11-day-old male and
      female Syrian hamsters and adult female hamsters were injected with 50 micrograms
      of testosterone for 4 days. Testosterone administration decreased the levels of
      ALV-S mRNA in the adult females but did not influence those of young females. The
      possible explanation for the insensitivity to testosterone during these postnatal
      stages might involve the maturational state of androgen receptors in the
      Harderian glands.

PMID- 8349027
TI  - The gill calcium transport cycle in rainbow trout is correlated with plasma
      levels of bioactive, not immunoreactive, stanniocalcin.
AB  - Stanniocalcin (STC) is an inhibitor of gill Ca2+ transport that is produced by
      the corpuscles of Stannius, endocrine glands in bony fish. In young rainbow trout
      (Oncorhynchus mykiss), there are cyclical changes in the rate of gill Ca2+
      transport, with alternating phases of accelerated and reduced uptake every 14
      days. Previous studies by our laboratory have established that the responsiveness
      of young trout to the inhibitory effects of exogenous STC is dependent on this
      cycle. Trout are highly responsive to STC at peaks of Ca2+ uptake and
      unresponsive at nadirs, which has led us to suggest that the gill Ca2+ transport
      cycle may be regulated by a reciprocal cycle in the levels of plasma STC. In this
      report, we have further characterized the gill Ca2+ transport cycle in salmonids
      and investigated the role of STC in its regulation. Our results showed that the
      cycle is synchronous and is likely a characteristic feature in all salmonids but
      that it varies in amplitude between species. Surprisingly, we observed no
      correlation between circulating levels of radioimmunoassayable STC and the rate
      of gill Ca2+ transport in trout. To address this apparent contradiction, trout
      fry were passively immunized with STC antiserum to determine if there were
      variable amounts of bioactive STC in the circulation, at times when trout were
      either more or less sensitive to exogenous STC. We observed that during the times
      when trout were responsive to STC treatment (i.e., cycle peaks), passive
      immunization had no effect on the rate of gill Ca2+ transport in fish from the
      same population, indicating that there were low levels of bioactive STC in the
      circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349028
TI  - Pituitary and hypothalamic insulin-like growth factor-I (IGF-I) and IGF-I
      receptor expression in food-deprived rats.
AB  - The present study was designed to evaluate a possible role for the insulin-like
      growth factor-I (IGF-I) system in mediating the suppression of growth hormone
      (GH) secretion observed in food-deprived rats by measuring IGF-I mRNA, receptor
      concentration and receptor mRNA in neuroendocrine tissues (hypothalamus and
      pituitary). Rats were deprived of food (food-deprived) for 72 h or had free
      access to food (fed). Tissues were processed for measurement of steady-state
      levels of: (a) IGF-I and IGF-I receptor mRNA (by solution hybridization/RNase
      protection assay); (b) IGF-I in serum and tissue extracts (by RIA) and (c) IGF-I
      displaceable [125I]IGF-I binding to plasma membrane preparations. Food
      deprivation resulted in decreased serum and liver levels of IGF-I. Kidney IGF-I
      mRNA levels were reduced 80% in food-deprived rats with a concomitant increase in
      IGF-I receptor concentration and mRNA levels. Refeeding of food-deprived rats
      fully normalized these perturbations. Pituitary IGF-I content was reduced 50% in
      food-deprived rats while IGF-I mRNA levels were unaffected. A modest increase was
      seen in pituitary IGF-I receptor concentration; however, IGF-I receptor mRNA
      levels were not changed. Hypothalamic IGF-I mRNA content was reduced in 72 h food
      deprived rats while IGF-I receptor binding capacity and mRNA were unaffected. In
      conclusion, IGF-I mRNA levels are decreased in liver, kidney and hypothalamus
      together with a reduction in plasma IGF-I in food-deprived rats but is unaffected
      in anterior pituitary. IGF-I receptor gene expression and binding capacity are
      coordinately regulated in kidney and hypothalamus, but not in the
      pituitary.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349029
TI  - Expression of human thyroid peroxidase in insect cells using recombinant
      baculovirus.
AB  - The baculovirus expression system was used to overexpress recombinant human
      thyroid peroxidase. Sf-9 cells infected with the recombinant virus AcMNPV-hTPO
      synthesized hTPO protein (hTPO-bac) immunogenic on Western blots when probed with
      either rabbit anti-TPO peptide sera or pooled human anti-TPO sera (MS12/89). hTPO
      bac was a major constituent of the membrane fraction from the infected cells,
      constituting 14.9% and 10.1% of the 1% deoxycholate-soluble and insoluble
      fractions, respectively, as judged by densitometry. Recombinant hTPO-bac was
      extracted from cellular membranes with 1% deoxycholate and partially purified by
      Sepharose 6B column chromatography. Specific immunoreactivity of MS12/89 to hTPO
      bac on microtiter plates was seen using ELISA. Detergent extract from wild-type
      virus-infected Sf-9 cells was used as background control antigen; no specific
      reactivity to either hTPO-bac or control antigen was seen with control sera. To
      determine antigenic potency, MS12/89 was incubated with increasing concentrations
      of various preparations of hTPO antigen and with ovalbumin as control. The
      capacity of the partially purified hTPO-bac to immunoneutralize human anti-hTPO
      standard at 50% inhibition of binding was 0.01 U/microgram hTPO-bac (NIBSC
      Units), compared with 0.5 U/microgram and 0.06 U/microgram for natural hTPO and
      CHO-hTPO, respectively. When ELISA was performed using clinical samples of human
      sera to detect hTPO autoantibodies, results using hTPO-bac correlated well with
      those using hTPO from Graves' thyroid tissue (r = 0.85, p = 0.02) and those using
      recombinant hTPO from Chinese hamster ovary cells (hTPO-CHO) (r = 0.85, p =
      0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349030
TI  - Thyrotropin regulates thyroglobulin mRNA splicing and differential processing.
AB  - Rat thyroid tissue and cultured rat thyrocyte lines contain two thyroglobulin
      (Tg) mRNAs: a 9 kb rTg-1 mRNA encoding the 330, kDa Tg monomer and a recently
      described 0.95 kb rTg-2 mRNA. These transcripts have identical 5' coding
      sequences (641 nucleotides); however, the 3' end of rTg-2 is comprised of coding
      and non-coding sequences not present in rTg-1. To determine if a single Tg gene
      encoded both mRNA species, a genomic clone was isolated which spanned the full
      length rTg-2 cDNA sequence. The promoter sequence and restriction map were the
      same as for the previously characterized rTg-1 gene, indicating that rTg-1 and
      rTg-2 mRNAs are splicing variants derived from the same Tg gene. The unique 3'
      end of rTg-2 mRNA comprised a single exon which was intronic with respect to rTg
      1 mRNA formation. The level of rTg-2 in cultured rat thyrocytes was more
      sensitive to thyrotropin (TSH) regulation than was rTg-1. rTg-2 mRNA was rapidly
      (and reversibly) depleted to nearly undetectable levels after TSH removal, unlike
      rTg-1. Conversely, TSH rapidly restored control levels of rTg-2 mRNA in such
      depleted cells. The data thus support a model of TSH-induced splicing and
      regulation of the two Tg mRNAs in the rat.

PMID- 8349031
TI  - Glucagon-like peptide-I and the control of insulin secretion in the normal state
      and in NIDDM.
AB  - Potentiation of glucose-induced insulin secretion by intestinal factors has been
      described for many years. Today, two major peptides with potent insulinotropic
      action have been recognized: gastric inhibitory peptide and truncated forms of
      glucagon-like peptide I, GLP-I(7-37) or the related GLP-I(7-36)amide. These
      hormones have specific beta-cell receptors that are coupled to production of cAMP
      and activation of cAMP-dependent protein kinase. Elevation in intracellular cAMP
      levels is required to mediate the glucoincretin effect of these hormones: the
      potentiation of insulin secretion in the presence of stimulatory concentrations
      of glucose. In addition, circulating glucoincretins maintain basal levels of
      cAMP, which are necessary to keep beta-cells in a glucose-competent state.
      Interactions between glucoincretin signaling and glucose-induced insulin
      secretion may result from the phosphorylation of key elements of the glucose
      signaling pathway by cAMP-dependent protein kinase. These include the ATP
      dependent K+ channel, the Ca++ channel, or elements of the secretory machinery
      itself. In NIDDM, the glucoincretin effect is reduced. However, basal or
      stimulated gastric inhibitory peptide and glucagon-like peptide I levels are
      normal or even elevated, suggesting that signals induced by these hormones on the
      beta-cells are probably altered. At pharmacological doses, infusion of glucagon
      like peptide I but not gastric inhibitory peptide, can ameliorate postprandial
      insulin secretory response in NIDDM patients. Agonists of the glucagon-like
      peptide I receptor have been proposed as new therapeutic agents in NIDDM.

PMID- 8349032
TI  - Impaired arteriolar myogenic reactivity in early experimental diabetes.
AB  - Hyperperfusion and an increase in capillary pressure has been implicated in the
      pathogenesis of diabetic microangiopathy. The existence of such alterations
      suggests that the myogenic response to increased intravascular pressure may be
      altered in diabetes. To examine this, in vivo studies were performed on the rat
      cremaster muscle microcirculation of age-matched control and STZ-induced (65
      mg/kg) diabetic rats (3-4 wk of diabetes). Anesthetized rats were enclosed in an
      airtight Plexiglas box with the cremaster muscle exteriorized into an organ bath
      containing Krebs' solution. To study myogenic responsiveness, box pressure was
      increased in steps of 10 mmHg from 0 to 30 mmHg for 2 min. Third-order arterioles
      of the control animals (lumen diameter 18 +/- 2 microns) responded to increased
      pressure with a rapid onset vasoconstriction. In contrast, the rate of
      development of the constriction was markedly attenuated in similar vessels (15 +/
      1 micron) of the diabetic animals, despite their ability to exhibit a similar
      maximal arteriolar constriction to that of the control animals. When 20 mmHg
      pressure steps were applied for only 10 s, arterioles of the diabetic animals
      constricted minimally, whereas those of the control animals constricted to 75% of
      the maximal response expected for that pressure increase (P < 0.01). Second-order
      arterioles of both groups of animals responded with a primarily passive
      distension to increased intravascular pressure suggesting that the impaired
      responsiveness of the third-order arterioles is not compensated for by an
      increase in the myogenic responsiveness of upstream vessels. Basal intravascular
      pressures, measured in first-, second-, and third-order arterioles, were similar
      in control and diabetic animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349033
TI  - Induction of hypoglycemia unawareness by asymptomatic nocturnal hypoglycemia.
AB  - Hypoglycemia has been incriminated as a possible factor responsible for
      development of the hypoglycemia unawareness phenomenon in patients with type I
      diabetes. Many patients with this condition, however, do not have a history of
      recent hypoglycemia. Because asymptomatic nocturnal hypoglycemia commonly occurs
      in type I diabetes, we tested the hypothesis that such episodes might be capable
      of inducing this phenomenon. Accordingly, autonomic and neuroglycopenic symptoms,
      counterregulatory hormone responses, and cognitive function were assessed during
      standardized insulin-induced hypoglycemia in 10 normal volunteer subjects on two
      occasions--once after induction of asymptomatic nocturnal hypoglycemia and once
      after control studies in which saline rather than insulin was infused overnight.
      Compared with control experiments, asymptomatic nocturnal hypoglycemia increased
      the threshold (required greater hypoglycemia for initiation) and reduced the
      magnitude of autonomic and neuroglycopenic symptoms, counterregulatory hormone
      responses, and cognitive dysfunction during subsequent hypoglycemia (all, P <
      0.05). These results indicate that asymptomatic hypoglycemia may induce
      hypoglycemia unawareness and, thus, may explain why not every patient with this
      condition has a history of prior hypoglycemia. Our results therefore support the
      concept that in type I diabetes this phenomenon may be largely attributable to
      antecedent hypoglycemia.

PMID- 8349034
TI  - Linkage analysis and molecular scanning of glucokinase gene in NIDDM families.
AB  - Mutations in the glucokinase gene are a major cause of maturity-onset diabetes of
      the young. To evaluate the contribution of this gene to the development of late
      onset NIDDM, linkage analyses between DNA polymorphisms at the glucokinase locus
      and NIDDM were performed in 79 multigenerational French families. In addition,
      all exons and the islet promoter region of glucokinase gene from 1 affected
      member from each family as well as from 17 unrelated women with previous
      gestational diabetes were amplified by polymerase chain reaction and screened for
      mutations by single-strand conformational polymorphism and DNA sequencing.
      Linkage of glucokinase and NIDDM was significantly rejected under all models
      tested. However, in 1 family, the lod score was 2.30, and we found a nucleotide
      substitution at the position -30 in the islet promoter region that cosegregated
      with diabetes. The proband of this family was a gestational diabetic individual.
      No other mutation in glucokinase was found in the 79 NIDDM families. We
      identified a missense mutation (TGG257-->CGG257) in exon 7 of glucokinase gene
      from 1 of 17 women with gestational diabetes, which was present in all diabetic
      members of her family. This family is likely to be a cryptic maturity-onset
      diabetes of the young, as 4 younger members, carrying this mutation, were
      subsequently found to be hyperglycemic. In conclusion, no evidence was obtained
      to incriminate glucokinase as a major gene for late age of onset NIDDM. Diabetic
      families with mutations in glucokinase must be carefully investigated, to
      differentiate cryptic maturity-onset diabetes of the young from late-onset NIDDM.
      Furthermore, pregnancy reveals diabetes in women carrying a glucokinase defect.

PMID- 8349035
TI  - Role of prostaglandin H2 as an endothelium-derived contracting factor in diabetic
      state.
AB  - This study investigated the possible involvement of prostaglandin H2, an
      acetylcholine-induced endothelium-derived contracting factor in rat aorta, in the
      development of abnormality of the vasculature in diabetes. Rings of thoracic
      aorta were prepared from control Wistar-Kyoto and STZ-induced diabetic rats to
      examine the changes in isometric tension. In 10(-7) M norepinephrine
      precontracted rings, acetylcholine induced relaxations, which were significantly
      impaired in diabetic rats. Inhibition of thromboxane A2-prostaglandin H2
      receptors with ONO-3708 (10(-6) M) prevented the development of the impairment of
      relaxation in diabetic rats. Thromboxane A2 synthesis inhibition with OKY-046
      (10(-5) M) did not affect the acetylcholine-induced relaxation in both control
      and diabetic rats. In aortic rings under resting tension, acetylcholine induced a
      contraction that was greater in diabetic than control rats, when the nitric oxide
      production was inhibited by NG-nitro-L-arginine methylester (10(-4) M). This
      acetylcholine-induced contraction was observed only in the rings with intact
      endothelium and was completely abolished by ONO-3708 (10(-6) M). The
      concentration of 6-keto-prostaglandin F1 alpha in the solution bathing diabetic
      rat aortic rings increased significantly after acetylcholine (10(-5) M)
      administration. Prostacyclin (10(-9)-10(-6) M) did not induce contractions at
      all. Prostacyclin is unlikely to mediate contractions because of its low
      contractile potency.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349036
TI  - Counterregulation during hypoglycemia is directed by widespread brain regions.
AB  - Previous studies have demonstrated the importance of the brain in directing
      counterregulation during insulin-induced hypoglycemia in dogs. The capability of
      selective carotid or vertebrobasilar hypoglycemia in triggering counterregulation
      was assessed in this study using overnight-fasted dogs. Insulin (21 pM.kg-1.min
      1) was infused for 3 h to create peripheral hypoglycemia in the presence of 1)
      selective carotid hypoglycemia (vertebral glucose infusion, n = 5), 2) selective
      vertebrobasilar hypoglycemia (carotid glucose infusion, n = 5), 3) the absence of
      brain hypoglycemia (carotid and vertebral glucose infusion, n = 4), or 4) total
      brain hypoglycemia (no head glucose infusion, n = 5). Glucose was infused via a
      leg vein as needed in each group to minimize the differences in peripheral
      glucose levels (2.6 +/- 0.1, 3.0 +/- 0.2, 2.7 +/- 0.1, and 2.5 +/- 0.1 mM,
      respectively). The humoral responses (cortisol, glucagon, catecholamines, and
      pancreatic polypeptide) to hypoglycemia were minimally attenuated (< 40%) by
      selective carotid or vertebrobasilar euglycemia. In addition, the increase in
      hepatic glucose production, as assessed using [3-3H]glucose, was attenuated by
      only 41 and 34%, respectively, during selective carotid or vertebrobasilar
      hypoglycemia. These observations offer support for the hypothesis that more than
      one center is important in hypoglycemic counterregulation in the dog and that
      they are located in brain regions supplied by the carotid and vertebrobasilar
      arteries, because significant counterregulation occurred when hypoglycemia
      developed in either of these circulations. Counterregulation during hypoglycemia,
      therefore, is probably directed by widespread brain regions that contain glucose
      sensitive neurons such that the sensing sites are redundant.

PMID- 8349037
TI  - Insulin does not induce the hydrolysis of a glycosyl phosphatidylinositol in rat
      fetal hepatocytes.
AB  - An inositol phosphoglycan that is the polar head group of a glycosyl
      phosphatidylinositol has been considered as a putative mediator of insulin
      action. To gain insight into the functions of this hormone during development,
      the relationships between insulin, insulin receptors, glycosyl
      phosphatidylinositol, and inositol phosphoglycan were studied. Glycosyl
      phosphatidylinositol was isolated and characterized in fetal liver as early as
      day 15 of intrauterine life. In isolated hepatocytes from fetal and adult rats
      labeled with [3H]glucosamine, [3H]galactose, or [3H]myo-inositol, these molecules
      were incorporated into glycosyl phosphatidylinositol. In hepatocytes labeled with
      [3H]glucosamine and then allowed to react with [1-14C]IAI, the [3H]glycosyl
      phosphatidylinositol was purified as the 14C-labeled amidinated lipid. Glycosyl
      phosphatidylinositol molecules from fetal and adult cells were sensitive to
      hydrolysis by a phosphatidylinositol-specific phospholipase C from B. cereus. The
      product of this hydrolysis inhibits the activity of a cAMP-dependent protein
      kinase, whereas this effect was abolished by nitrous acid deamination. In
      isolated hepatocytes from adult animals, an inverse correlation between
      extracellular insulin and the number of insulin receptors and the cellular
      content of glycosyl phosphatidylinositol was observed. However, in fetal
      hepatocytes insulin failed to reduce the glycosyl-phosphatidylinositol content
      when labeled either with [1-14C]isethionyl acetimidate or [3H]glucosamine,
      whereas insulin-like growth factor I produced a significant hydrolysis of
      glycosyl phosphatidylinositol. Fetal and adult hepatocytes were incubated with
      insulin or inositol phosphoglycan after which glycogen phosphorylase activities
      were determined. Inositol phosphoglycan mimicked the action of insulin on both
      forms of the enzyme from adult hepatocytes, whereas in fetal cells insulin did
      not change, and purified inositol phosphoglycan reduced the activities of
      glycogen phosphorylase. These findings suggest a dissociation between insulin
      receptor occupancy and the expected hormonal effects in fetal hepatocytes. This
      could be related to alterations at a postreceptor level.

PMID- 8349038
TI  - Signals derived from glucose metabolism are required for glucose regulation of
      pancreatic islet GLUT2 mRNA and protein.
AB  - Pancreatic islet GLUT2 mRNA is known to be regulated in vitro and in vivo by
      glucose. We have investigated several potential mechanisms mediating the response
      of islet GLUT2 to glucose. GLUT2 mRNA and protein were measured from isolated rat
      islets cultured for up to 24 h under selected conditions. Glucose at 11 mM
      stimulated GLUT2 mRNA 10-fold compared with 2 mM glucose, with no additional
      increase at 16.7 mM glucose, whereas maximal 4-fold induction of the protein was
      attained with 16 mM glucose. Time course studies showed a 2.5-fold induction of
      GLUT2 mRNA apparent after only 8 h of culture at 16.7 mM glucose. Glycolysis
      inhibitor mannoheptulose suppressed the stimulatory effect of 16.7 mM glucose on
      GLUT2 mRNA and protein. Metabolizable sugars mannose and glyceraldehyde enhanced
      transporter mRNA levels, in contrast with the lack of stimulation by
      nonmetabolizable 2-deoxy-D-glucose. Stimulation by different sugars and
      glycolysis inhibition led to analogous changes of proinsulin mRNA, suggesting
      that common signaling mechanisms are shared in glucose regulation of proinsulin
      and GLUT2 gene expression. Preexposure to mannoheptulose, however, failed to
      suppress glucose-stimulated insulin release. Tunicamycin, a glycoprotein
      synthesis inhibitor, did not block the effect of 16 mM glucose on GLUT2 mRNA
      levels. RNA and protein synthesis inhibitors actinomycin and cycloheximide
      abolished the enhancing effects of high glucose on GLUT2 mRNA. These findings
      indicate that glucose metabolism, but not glycoprotein synthesis or substrate
      interaction with the transporter protein, is instrumental in the stimulatory
      effects of glucose on beta-cell GLUT2 mRNA accumulation. In addition, ongoing RNA
      and protein synthesis are required for this effect.

PMID- 8349039
TI  - Regulation of apolipoprotein A-I-containing lipoproteins in IDDM.
AB  - In IDDM patients, serum high-density lipoprotein cholesterol concentrations have
      been reported to be normal or elevated. The spectrum of high-density lipoprotein
      particles is highly heterogeneous, but no data are available on the
      subpopulations of high-density lipoprotein in IDDM. We, therefore, studied the
      spectrum of high-density lipoprotein particles in 86 IDDM patients (51 men and 35
      women) 37 +/- 10 yr of age and in 74 sex-, age-, and body mass index-matched
      healthy nondiabetic subjects. The concentrations of high-density lipoprotein and
      HDL2 cholesterol were higher in the IDDM group than in the control subjects (P <
      0.01). The apoA-I-to-apoA-II ratio was higher in the IDDM patients than in the
      nondiabetic subjects (P < 0.001) because of an increased concentration of LpA-I
      particles (61 +/- 17 vs. 53 +/- 15, P < 0.01). LpA-I particles correlated
      positively with high-density lipoprotein and HDL2 cholesterol in the two groups.
      Postheparin plasma lipoprotein lipase activity was significantly higher in the
      IDDM group than in the control group (P < 0.001), whereas postheparin plasma
      hepatic lipase activities were similar in both groups. Plasma cholesteryl ester
      transfer protein activity was estimated in an in vitro isotopic assay using
      exogenous labeled donor (low-density) and acceptor (high-density) lipoproteins in
      the absence of native lipoproteins. We observed no difference in cholesteryl
      ester transfer protein activity between the groups, and no significant
      correlations existed between cholesteryl ester transfer protein activity and high
      density lipoprotein subpopulations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349040
TI  - Regulation of insulin-stimulated glycogen synthase activity by overexpression of
      glutamine: fructose-6-phosphate amidotransferase in rat-1 fibroblasts.
AB  - High glucose concentrations such as are seen in diabetes mellitus are known to
      have deleterious effects on cells, but the pathways by which glucose induces
      these effects are unknown. One hypothesis is that metabolism of glucose to
      glucosamine might be involved. For example, it has been shown that glucosamine is
      more potent than glucose in inducing insulin resistance in cultured adipocytes
      and in regulating the transcription of the growth factor transforming growth
      factor alpha in smooth muscle cells. The rate-limiting step in glucosamine
      synthesis is the conversion of fructose-6-phosphate to glucosamine-6-phosphate by
      the enzyme glutamine:fructose-6-phosphate amidotransferase. To test the
      hypothesis that this hexosamine biosynthesis pathway is involved in the induction
      of insulin resistance, we have overexpressed the enzyme glutamine:fructose-6
      phosphate amidotransferase in Rat-1 fibroblasts and investigated its effects on
      insulin action in those cells. We electroporated Rat-1 fibroblasts with
      expression plasmids that did and did not contain the gene for glutamine:fructose
      6-phosphate amidotransferase and measured glycogen synthase activity at varying
      insulin concentrations. Insulin stimulation was blunted in the glutamine:fructose
      6-phosphate amidotransferase-transfected cells, resulting in decreased insulin
      sensitivity reflected by a rightward shift in the dose-response curve for
      activation of synthase (ED50 = 7.5 nM vs. 3.4 nM insulin, in glutamine:fructose-6
      phosphate amidotransferase and control cells, respectively). Rat-1 fibroblasts
      incubated with 5.- mM glucosamine for 3 days exhibited a similar shift in the
      dose-response curve. The rightward shift in the dose-response curve is seen as
      early as 2 days after poration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349041
TI  - Relationship of proinsulin and insulin to cardiovascular risk factors in
      nondiabetic subjects.
AB  - Recent data suggest that proinsulin is strongly associated with cardiovascular
      risk factors in diabetic subjects. However, this relationship has not been
      examined in nondiabetic subjects. Therefore, we examined the relation of
      proinsulin to lipids, obesity (body mass index), and waist-to-hip ratio in 260
      nondiabetic individuals from the San Antonio Heart Study, a population-based
      study of diabetes and cardiovascular disease. Proinsulin was measured by
      radioimmunoassay, and insulin was measured by a Linco radioimmunoassay that does
      not cross-react with proinsulin. Fasting insulin was significantly associated
      with body mass index (0.42), waist-to-hip ratio (r = 0.30), triglyceride (r =
      0.29), high-density lipoprotein cholesterol (r = -0.20), and systolic blood
      pressure (r = 0.16) but not significantly related to diastolic blood pressure (r
      = 0.11). Fasting proinsulin was significantly associated with body mass index (r
      = 0.19), waist-to-hip ratio (r = 0.25), triglyceride (r = 0.41), systolic blood
      pressure (r = 0.19), and diastolic blood pressure (r = 0.15). Proinsulin was more
      strongly related to increased triglyceride than insulin despite its weaker
      relationship to obesity. In multivariate analyses, proinsulin continued to be
      significantly related to triglyceride concentrations (explaining 23.1% of the
      variance) and to systolic blood pressure (explaining 4.0% of the variance), even
      after adjusting for insulin. These observations suggest that proinsulin should be
      measured in addition to insulin in epidemiological studies. Proinsulin may be a
      marker for metabolic decompensation in prediabetic subjects.

PMID- 8349042
TI  - Pancreatic islet function in nondiabetic and diabetic BB rats.
AB  - A decreased acute insulin response to glucose in islet cell antibody positive
      humans predicts diabetes. Because the dominant mechanism leading to decreased in
      vivo acute insulin response to glucose remains unclear, perifused islets were
      examined before and after diabetes onset in BB rats to assess the role of glucose
      sensitivity on insulin secretion in individual islets. Islets from normal WF
      rats, diabetes-prone rats without inflamed islets, diabetes-prone rats with
      inflamed islets, and diabetic rats were studied at 2.0, 8.3, and 16.7 mM glucose.
      Immunoreactive insulin from WF islets at 16.7 mM glucose was 0.15 +/- 0.02 ng.0-7
      min-1 x islet-1 for the first phase and 1.00 +/- 0.05 ng.7-20 min-1 x islet-1 for
      the second phase of biphasic secretion, compared with basal secretion of 0.10 +/-
      0.03 ng.20 min-1 x islet-1 at 2 mM glucose. Diabetes-prone noninflamed islets
      showed a 0.20 +/- 0.03 ng first-phase secretion, a 1.32 +/- 0.13 ng second-phase
      secretion after 16.7 mM glucose, and 0.093 +/- 0.02 ng.20 min-1 x islet-1 at 2 mM
      glucose, indicating no intrinsic BB rat strain secretion abnormality. Diabetes
      prone inflamed islets had secretions of 0.35 +/- 0.02 ng during the first phase
      (P < 0.05 vs. WF) and 1.78 +/- 0.29 ng during the second phase (P < 0.05 vs. WF)
      after 16.7 mM glucose, with 0.24 +/- 0.08 ng.20 min-1 x islet-1 at 2 mM
      glucose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349043
TI  - Inositol glycan phosphate derived from human erythrocyte acetylcholinesterase
      glycolipid anchor and inositol cyclic 1,2-phosphate antagonize glucagon
      activation of glycogen phosphorylase.
AB  - In this study we examine the hypothesis that an inositol glycan phosphate can act
      similarly to insulin on intact cells. The inositol glycan phosphate used in this
      study (glycan alpha) was isolated previously from the glycoinositol phospholipid
      anchor of human erythrocyte acetylcholinesterase and was shown to have the
      structure glycine-ethanolamine-PO4-Man-Man-(N,N-dimethylethanolamine-PO4)Man-
      (N,N-dimethyl)GlcN-inositol-PO4. The cellular response investigated was the
      glucagon-stimulated activation of glycogen phosphorylase in rat hepatocytes. When
      hepatocytes were incubated with 20 nM glucagon for 4 min, the ratio of
      phosphorylase a activity to total phosphorylase increased from a basal value of
      0.49 +/- 0.02 to 0.82 +/- 0.03 (mean +/- SE, n = 15). Inclusion of either 100 nM
      insulin or 3-10 microM glycan alpha during the glucagon incubation significantly
      decreased the glucagon-stimulated activity ratio to 0.74 +/- 0.03 for either
      agent. Furthermore, hepatocyte preparations differed in their response to insulin
      and were divided into insulin-responsive and -resistant groups. Glycan alpha had
      a significant effect only in the insulin-responsive group for which the observed
      activity ratio for 10 microM glycan alpha plus glucagon (0.68 +/- 0.05) compared
      closely with that for insulin plus glucagon (0.70 +/- 0.04). For the insulin
      resistant group, the activity ratio in the presence of 10 microM glycan alpha was
      0.81 +/- 0.03, unchanged from the control with glucagon alone. Because glycan
      alpha contains an inositol phosphate group, the effect of inositol cyclic 1,2
      phosphate on the glucagon-stimulated activity ratio was determined.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8349044
TI  - Insulin resistance and insulin secretion are determinants of oral glucose
      tolerance in normal individuals.
AB  - Plasma glucose values after oral glucose challenge vary widely in nondiabetic
      subjects. We have now evaluated the role of insulin resistance in determining the
      plasma glucose response to oral glucose in 74 volunteer subjects with normal
      glucose tolerance. In these subjects, we determined the plasma glucose and
      insulin responses over a 3-h period to a 75-g oral glucose challenge, and the
      steady-state plasma glucose concentration during a continuous infusion of
      somatostatin, glucose, and insulin (a quantitative measure of insulin
      resistance). The plasma glucose response was defined as the incremental increase
      in plasma glucose concentration above the fasting value for 3 h after the oral
      glucose challenge. Multiple regression analysis was used to define the
      relationship between the dependent variable (plasma glucose response) and various
      predictors of this response. These analyses indicated that both the steady-state
      plasma glucose and the incremental insulin response during the first 30 min after
      the glucose load were significant predictors of the plasma glucose response. In
      those individuals in whom insulin action was impaired and the 30-min plasma
      insulin response was decreased, plasma glucose values reached higher levels. When
      standardized regression coefficients were determined, the incremental glucose
      response was directly correlated with steady-state plasma glucose (r = 0.700, P <
      0.001) and inversely with the insulin response during the first 30 min (r =
      0.268, P = 0.023). Furthermore, the correlation between steady-state plasma
      glucose and glucose response was significantly greater (P < 0.005) than that
      between the glucose response and 30-min insulin concentration.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8349045
TI  - Pre-exposure to glucosamine induces insulin resistance of glucose transport and
      glycogen synthesis in isolated rat skeletal muscles. Study of mechanisms in
      muscle and in rat-1 fibroblasts overexpressing the human insulin receptor.
AB  - Increased routing of glucose through the hexosamine-biosynthetic pathway has been
      implicated in the development of glucose-induced insulin resistance of glucose
      transport in cultured adipocytes. Because both glucosamine and glucose enter this
      pathway as glucosamine-6-phosphate, we examined the effects of preincubation with
      glucosamine in isolated rat diaphragms and in fibroblasts overexpressing the
      human insulin receptor (HIR-cells). In muscles, pre-exposure to glucosamine
      inhibited subsequent basal and, to a greater extent, insulin-stimulated glucose
      transport in a time- and dose-dependent manner and abolished the stimulation by
      insulin of glycogen synthesis. Insulin receptor number, activation of the insulin
      receptor tyrosine kinase in situ and after solubilization, and the total pool of
      glucose transporters (GLUT4) were unaffected, and glycogen synthase was activated
      by glucosamine pretreatment. In HIR-cells, which express GLUT1 and not GLUT4,
      basal and insulin-stimulated glucose transport were unaffected by glucosamine,
      but glycogen synthesis was markedly inhibited. Insulin-stimulated activation of
      protein kinases (MAP and S6) was unaffected, and the fractional velocity and
      apparent total activity of glycogen synthase was increased in glucosamine-treated
      HIR-cells. In pulse-labeling studies, addition of glucosamine during the chase
      prolonged processing of insulin proreceptors to receptors and altered the
      electrophoretic mobility of proreceptors and processed alpha-subunits, consistent
      with altered glycosylation. Glucosamine-induced insulin resistance of glucose
      transport appears to be restricted to GLUT4-expressing cells, i.e., skeletal
      muscle and adipocytes; it may reflect impaired translocation of GLUT4 to the
      plasmalemma. The glucosamine-induced imbalance in UDP sugars, i.e., increased UDP
      N-acetylhexosamines and decreased UDP-glucose, may alter glycosylation of
      critical proteins and limit the flux of glucose into glycogen.

PMID- 8349046
TI  - North-American twins with IDDM. Genetic, etiological, and clinical significance
      of disease concordance according to age, zygosity, and the interval after
      diagnosis in first twin.
AB  - In 224 twin pairs (132 monozygotic, 86 dizygotic, and 6 of uncertain zygosity) in
      whom the index twin had developed IDDM before 30 yr of age, 51 of the co-twins
      (38 monozygotic, 10 dizygotic, and 3 of uncertain zygosity) subsequently became
      diabetic. On the basis of concordance ratios, which were significantly discrepant
      (P < 0.01) between monozygotic and dizygotic twins, the substantial genetic role
      in IDDM etiology is confirmed. For the monozygotic co-twin of an IDDM case, the
      relative risk is significantly related to an early age at proband diagnosis (P <
      0.01 for 0-4 vs. 5-9 yr of age). However, among monozygotic co-twins at any age,
      IDDM risk decreases as time passes after the proband diagnosis (P < 0.01 for 0-23
      vs. > or = 24 mo after a proband diagnosis at 5-9 yr of age). Moreover, a
      structural-equation analysis suggests a profound contribution to liability (as
      much as 79%) from the twins' shared environment. Risk to like-sex male dizygotic
      co-twins is as high as that to monozygotic co-twins, significantly higher than
      that to like-sex female dizygotic co-twins (P < 0.005), and even higher than that
      to male co-twins in unlike-sex dizygotic pairs (P < 0.05). Overall, the risk to
      the dizygotic co-twin of a case is significantly higher (P < 0.001) than that to
      a non-twin sibling, as reported in the literature. The observed male excess is
      consistent with reported patterns of IDDM in experimental animals, and in certain
      circumstances in humans. Taken together, these observations suggest an important
      early acquired determinant of IDDM, independent of genetic determinants. On the
      basis of Kaplan-Meier IDDM-free survival curves, if the proband is diagnosed
      before 15 yr of age, the long-term risk to the co-twin is estimated at 44%
      (monozygotic) and 19% (dizygotic); it reaches 65% for the co-twin of a
      monozygotic proband diagnosed before 5 yr of age. An IDDM discordant period of no
      more than 3 yr was observed in 60% of the pairs destined to become concordant,
      offering a very brief window for intervention following the recognition of high
      risk.

PMID- 8349047
TI  - Insulin resistance in spontaneously hypertensive rats. Difference in
      interpretation based on insulin infusion rate or on plasma insulin in glucose
      clamp studies.
AB  - Isotopic glucose turnover was measured during euglycemic glucose clamp studies in
      spontaneously hypertensive rats and normotensive Wistar-Kyoto control rats, under
      pentobarbital sodium anesthesia. At an insulin infusion rate of 4 mU.kg-1 x min
      1, glucose disposal rate and hepatic glucose output were not significantly
      different in either group, at a plasma glucose of 6 mM. However, steady-state
      plasma insulin levels in spontaneously hypertensive rats were more than double
      those in Wistar-Kyoto rats (2.34 +/- 0.16 [mean +/- SE] vs. 6.78 +/- 0.58 nM, P <
      0.00005, n = 7 in each group). Additional studies (n = 30 in spontaneously
      hypertensive rats and n = 32 in Wistar-Kyoto control rats) were conducted to
      match insulin levels in the two groups over a wide range, using infusion rates of
      0.5-10 mU.kg-1 x min-1. When the responses of glucose disposal rate and hepatic
      glucose output to insulin were analyzed from the standpoint of plasma insulin
      levels, a highly significant difference was seen in the response to insulin
      between spontaneously hypertensive rats and Wistar-Kyoto rats, for both glucose
      disposal rate (P < 0.000005) and hepatic glucose output (P = 0.00007). The slope
      of the regression line for glucose disposal rate versus plasma insulin was lower
      in spontaneously hypertensive rats compared with Wistar-Kyoto rats (2.652 vs.
      4.864, P < 0.001), indicating that insulin stimulation of glucose disposal rate
      was reduced by 50% in spontaneously hypertensive rats.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8349048
TI  - No reason to regard a low number of bursts of muscle sympathetic nerve activity
      in IDDM as a sign of autonomic neuropathy.

PMID- 8349049
TI  - Corrigendum for limitations in the use of [2-14C]acetate for measuring
      gluconeogenesis in vivo.

PMID- 8349051
TI  - Teaching family medicine.

PMID- 8349050
TI  - Manuscript review in family medicine.

PMID- 8349052
TI  - Family medicine education: independent of specialists?

PMID- 8349053
TI  - Asserting our academic identity: diversity, quality, and scholarship.

PMID- 8349054
TI  - Identifying and communicating with patients who have poor literacy skills.

PMID- 8349055
TI  - Characteristics of strong departments of family medicine: results of a Delphi
      survey.
AB  - BACKGROUND: The establishment and support of strong university-based departments
      of family medicine is central to the success of family practice. The purpose of
      this study was to provide existing and developing departments of family medicine
      with information on the characteristics of strong established departments.
      METHODS: Chairs of existing departments were asked to identify the five strongest
      university-based departments in the country. Based on an 80% response rate, a
      select group of 24 chairs representing the strongest departments was surveyed
      using a Delphi technique. RESULTS: A systems and contingency model was used as
      the basis for organizing the Delphi responses. Seven core factors were identified
      and ranked by the chairs for each of the six systems and subsystems of the model
      describing university-based departments. CONCLUSIONS: Key ingredients that are
      common to most strong departments are the ability of the department to respond to
      the external environment, the presence of state and federal financial support,
      leadership and vision by the chair, strong clinically oriented faculty,
      management practices that keep everyone informed, and mutual support and respect
      within the department.

PMID- 8349056
TI  - Geriatric education and practice of family practice graduates: an alumni survey.
AB  - BACKGROUND: The goal of this research was to study the relationship between
      family practice residency training in geriatrics and subsequent postresidency
      geriatric practice patterns. METHODS: We surveyed all graduates of the University
      of Maryland Family Practice Residency Program through 1990 to determine their
      attitudes toward their geriatric training and the extent of their geriatric
      practice. Logistic regression analysis was used to identify factors associated
      with 1) making house calls, 2) making weekly nursing home visits, and 3) having a
      practice in which more than 25% of patients were older than age 65. RESULTS: The
      responses of 143 graduates were analyzed. Most respondents (58.8%) made house
      calls, and the majority (51%) saw nursing home patients weekly. Older respondents
      and those possessing Certificates of Added Qualifications in Geriatric Medicine
      (CAQGMs) were more likely to treat patients older than age 65. Respondents with
      larger nursing home practices rated their geriatric training more favorably.
      Multivariate logistic regression analysis found that the following factors were
      associated with making house calls: working in a group family practice (odds
      ratio [OR] = 3.88, 95% confidence interval [CI] = 2.58-5.84) and a rural practice
      location (OR = 2.71, 95% CI = 1.77-4.17). Physicians who had additional training
      after residency (OR = 0.16, 95% CI = 0.10-0.25) were less likely to make house
      calls. Factors associated with making weekly nursing home visits were: additional
      training after residency (OR = 0.31, 95% CI = 0.19-0.50) and working in a group
      family practice (OR = 2.43, 95% CI = 1.63-3.65). Attainment of a CAQGM was the
      only factor associated with having more than 25% geriatric patients in the office
      practice (OR = 6.00, 95% CI = 2.72-13.24). CONCLUSIONS: Most graduates of the
      University of Maryland Family Practice Residency Program maintain significant
      geriatric practices and value geriatric training, but whether favorable training
      experiences influence graduates' practices is unknown. Prospective studies of
      family practice residents are needed to clarify the influence of geriatric
      curricula on residents' future clinical practices.

PMID- 8349057
TI  - The family practice elective that saved two doctors.

PMID- 8349058
TI  - Satisfactions and dissatisfactions of graduating family practice residents.
AB  - BACKGROUND: This study was conducted to determine whether the types of
      professional satisfactions and dissatisfactions experienced by family practice
      residents in one program were characteristic of those experienced by residents
      from other programs. METHODS: Materials and procedures developed previously were
      used in a study of 23 residents from five family medicine programs. Respondents
      were interviewed in the spring of their graduation year. Transcripts of these
      interviews were examined for the presence of specific themes relating to
      professional satisfactions and dissatisfactions. RESULTS: Themes found in the
      interviews from all five programs were similar to each other and to the themes
      uncovered previously. Satisfactions were related to the interpersonal aspects of
      patient care, the intellectual aspects of medicine, the process of delivering
      care, and instances of intervention in critical situations. An additional source
      of satisfaction, not found previously, was derived from activities in certain
      specific content areas of family medicine. Dissatisfactions reflected concerns
      about the bureaucratic climate in which medicine is currently practiced, time
      demands of a medical career, frustrations with patient behavior, and negative
      feelings about the professional situation of the family practice resident.
      CONCLUSIONS: Having corroborated the existence of satisfaction and
      dissatisfaction themes found earlier, results of this research may provide
      information to educators about the professional identity of the family physicians
      they are training.

PMID- 8349059
TI  - Criteria for evaluating performance of third-year medical students.
AB  - BACKGROUND: Evaluating medical student performance in clinical settings is an
      aspect of teaching that educators sometimes find difficult. This study was
      conducted to determine evaluation criteria for clinical performance that were
      considered important by physician faculty. These criteria were subsequently used
      in the student evaluation process for a decentralized clerkship in family
      medicine. METHODS: In Phase I, physician faculty were surveyed to identify
      preferred criteria for evaluating student performance through an open-ended
      format. In Phase II, the identified items were refined. In Phase III, 45 items
      were presented to the faculty for rating importance on a visual analogue scale.
      RESULTS: Twenty-nine of 31 physicians responded. Factor analysis identified three
      factors that accounted for 76.6% of the variance: application of knowledge,
      relationship with patients, and therapeutics in family medicine. CONCLUSIONS:
      Results of the study suggest that physician faculty have internalized
      expectations of clinical competence in the discipline of family medicine that
      address the basic dimensions of cognitive ability, problem-solving skills, and
      interpersonal relationships.

PMID- 8349060
TI  - Rapid estimate of adult literacy in medicine: a shortened screening instrument.
AB  - BACKGROUND: This study was conducted to validate a shortened version of the Rapid
      Estimate of Adult Literacy in Medicine (REALM). This screening instrument is
      designed to be used in public health and primary care settings to identify
      patients with low reading levels. It provides reading grade estimates for
      patients who read below a ninth-grade level. The REALM can be administered in one
      to two minutes by personnel with minimal training. METHODS: Two hundred and three
      patients in four university hospital clinics (internal medicine, family practice,
      ambulatory care, and obstetrics/gynecology) were given the REALM and three other
      standardized reading tests: the reading recognition section of the Peabody
      Individual Achievement Test-Revised (PIAT-R), the Wide Range Achievement Test
      Revised (WRAT-R), and the Slosson Oral Reading Test-Revised (SORT-R). One hundred
      inmates at a state prison were also given the REALM twice, one week apart, to
      determine test-retest reliability. RESULTS: The REALM correlated well with the
      three other tests. (Correlation coefficients were 0.97 [PIAT-R], 0.96 [SORT-R],
      and 0.88 [WRAT-R].) All correlations were significant at P < .0001. Test-retest
      reliability was 0.99 (P < .001). CONCLUSIONS: The REALM provides an estimate of
      patient reading ability, displays excellent concurrent validity with standardized
      reading tests, and is a practical instrument for busy primary care settings.

PMID- 8349061
TI  - Abdominal obesity is associated with insulin resistance.
AB  - BACKGROUND: Recent evidence suggests that insulin resistance and hyperinsulinemia
      may account for many of the medical complications of obesity. This study was
      performed to determine whether a predominance of body fat in the abdominal region
      is associated with insulin resistance and hyperinsulinemia. METHODS: Two groups
      of nine obese women were matched for age and total obesity but differed
      significantly in the pattern of fat distribution as defined by the waist-to-hip
      circumference ratio (WHR). The high-WHR group had a WHR of 0.87 (+/- 0.01), and
      the low-WHR group had WHR of 0.77 (+/- 0.02) (P < .05). RESULTS: Plasma levels of
      glucose, free fatty acids, and insulin, measured hourly for eight hours while the
      subjects consumed a diet of regular food, were higher in the high-WHR group.
      CONCLUSION: The high-WHR group (abdominal obesity) was more resistant to the
      action of insulin. These results suggest that measurement of the WHR could help
      define the degree of medical risk for a given obese patient seeking treatment.

PMID- 8349062
TI  - Do family physicians treat obese patients?
AB  - BACKGROUND: The purpose of this study was to characterize what patient and
      physician factors increase the likelihood of physicians counseling weight loss in
      their overweight patients. METHODS: A retrospective chart survey of 418
      outpatient charts from 50 family medicine residents and faculty was conducted.
      RESULTS: Of the 267 patients who were overweight based on a body mass index score
      of more than 27, only 29.6% had been instructed to lose weight. Overweight
      patients with hypertension, diabetes, hypercholesterolemia, or coronary artery
      disease were instructed to lose weight 32.9% of the time. Patient age or sex and
      physician age, sex, or level of training did not affect the frequency of
      treatment. CONCLUSION: Physicians need to be more aggressive in their counseling
      of overweight patients.

PMID- 8349063
TI  - Comparative cytologic yield and quality of three Pap smear instruments.
AB  - BACKGROUND: Various sampling techniques of the cervix have established false
      negative rates ranging from 18% to 45%. A number of studies suggest that this
      false negative rate can be reduced by sampling techniques that are associated
      with higher yields of endocervical cells. METHOD: This study enrolled 301 women,
      each of whom had a Pap smear obtained using three different sampling instruments
      (a cervical brush, a plastic spatula, and a cotton swab) in random order.
      RESULTS: The cervical brush yielded a better endocervical sample than either of
      the other instruments (P < .001), and there was no difference between the swab
      and spatula. In addition, the recovery of endocervical cells increased with each
      additional sample taken, regardless of instrument used (P < .001), although the
      difference in yield between the second and third samples was not significant.
      CONCLUSIONS: To enhance the yield of endocervical cells in Pap smear sampling,
      consideration should be given to using the cervical brush routinely as a sampling
      instrument and to taking more than one sample per screening.

PMID- 8349064
TI  - [Inhibitors of proton pump, a new target: the visible vessel].

PMID- 8349065
TI  - [Use of an electronic barostat for measurement of motor response of the proximal
      stomach to feeding and different nervous stimuli in man].
AB  - Electronic barostat allows to measure volume variations of an intragastric air
      filled bag maintained at a low constant pressure level, reflecting gastric tone
      variations. The aims of the present study were to record physiologic variations
      of gastric tone in humans a) in the fasting state, with and without different
      stimuli, and b) in the fed state. The bag was placed into the proximal stomach of
      healthy subjects and connected to the barostat. Volume variations were recorded
      in the basal state and in response to a) a balanced liquid meal (200 mL, 200
      kcal, n = 8), b) sham feeding and sham feeding after cholinergic blockade
      (atropine 10 micrograms.kg-1 IV, n = 8), and c) graded antroduodenal distensions
      performed with a tandem balloon (n = 6). During fasting, the proximal stomach
      presented both a tonic and an intermittent phasic motor pattern (volume waves of
      1.2 min maximal period). Meal ingestion was rapidly followed by a dramatic fall
      in proximal gastric tone (> 200% of preprandial volume within 11 +/- 5 min).
      After a meal, the intragastric bag returned to preprandial volume after 92 +/- 12
      min (ranges: 75-110). Proximal gastric tone was not significantly modified by
      atropine or by sham feeding alone or after atropine. Antroduodenal distensions
      reproducibly induced volume dependent relaxations (r = 0.98, P < 0.001) with
      inhibition of the phasic activity. These results confirm the value of electronic
      barostat for the measurement of proximal gastric tone, and show that postprandial
      relaxation is not masked by a low volume liquid meal. Sham feeding does not
      appear to be an adequate stimulus to induce gastric relaxation. This suggests
      that vagal fibers involved in gastric relaxation are not the same (or have a
      higher stimulation threshold) than fibers involved in cephalic phase of gastric
      secretion.

PMID- 8349066
TI  - Orally administered omeprazole versus injection therapy in the prevention of
      rebleeding from peptic ulcer with visible vessel. A multicenter randomized study.
AB  - Endoscopic injection therapy significantly reduces the risk of bleeding relapse
      in patients with digestive hemorrhage due to peptic ulcers associated with a
      visible vessel. Profound and sustained acid inhibition by proton pump inhibitors
      may generate optimal conditions for clotting and prevent bleeding relapse. Over a
      one-year period, 52 patients presenting with digestive hemorrhage, in whom
      emergency endoscopy showed a peptic ulcer with a non-bleeding visible vessel,
      were enrolled in a multicenter randomized study comparing oral omeprazole, 40 mg
      per day (n = 31) vs adrenaline (1:10,000) plus polidocanol (1%) injection
      associated with oral ranitidine 300 mg per day (n = 21). Rebleeding occurred in
      15/52 (29%) patients: 8/31 (26%) in the omeprazole group with 6 major hemorrhages
      (19%), and in 7/21 (33%) in the injection group with 3 major hemorrhages (14%);
      the differences were not significant. No difference was observed between
      omeprazole and injection group in terms of volume of transfused blood (2.03 +/-
      1.5 vs 3.1 +/- 0.9 blood units), need for hemostatic surgery (9.6% vs 14.3%),
      mortality (19.3% vs 14.3%) and mean hospital stay (11.5 days both groups). This
      study suggests that oral omeprazole, 40 mg per day, has an efficacy comparable to
      injection therapy in reducing the bleeding relapse from non bleeding peptic
      ulcers associated with visible vessel.

PMID- 8349067
TI  - [Comparison of lansoprazole (30 mg) and omeprazole (20 mg) in the treatment of
      duodenal ulcer. A multicenter double-blind comparative trial].
AB  - The efficacy of lansoprazole (30 mg/d) and omeprazole (20 mg/d) has been assessed
      in active duodenal ulcer disease in 144 patients included in a multicentric,
      randomized, double-blind trial. After two weeks, the healing rates were 74% and
      58% in the lansoprazole and omeprazole groups, respectively (P = 0.049). After 4
      weeks, the healing rates were 94% in each group (NS). The delay to pain relief
      was 2 days for lansoprazole and 3 days for omeprazole (NS). Minor side effects
      occurred in 12% of the lansoprazole treated patients and in 13% of the omeprazole
      treated patients. No severe adverse events were reported. A slight increase in
      serum gastrin level was observed, similar in both groups (+35 UI/L and +19 UI/L
      for lansoprazole and omeprazole respectively). This study confirms previous
      results concerning the efficacy of both treatments in duodenal ulcer disease. The
      statistical difference observed for healing rates after 2 weeks could correspond
      to a faster efficacy for lansoprazole (30 mg) than for omeprazole (20 mg).

PMID- 8349068
TI  - [Diagnostic modalities and treatment of cancer of the pancreas. Evolution in the
      population in the department of Cote d'Or from 1976 to 1988].
AB  - There is no study establishing time trends for the diagnostic and therapeutic
      approaches to pancreatic cancer based on population data. The data of the
      Registry of Digestive Tumors of Cote-d'Or (France) were used to this end in 544
      cancers diagnosed between 1976 and 1988. The proportion of the histologically
      confirmed cases increased annually by 13.4% (P < 0.001). This was mainly due to
      progress in percutaneous biopsy (+25.7% per year between 1983 and 1988, P <
      0.001). As regards the diagnosis, ultrasonography was used more frequently
      (+21.9% per year, P < 0.001) as well as CT scan since its introduction in 1983
      (+19.6% per year, P < 0.001). Pancreatic cancer was diagnosed by sonography in
      16.7% of the cases in 1976 and 70.6% in 1988 (mean annual variation: +5.7%, P <
      0.001). The proportions for CT scan were 12.8% in 1983 and 23.5% in 1988 (mean
      annual variation: +3.5%, NS). There was no significant change in the use of
      retrograde cholangiopancreatography over time. Other diagnosis criteria were less
      frequently used: laparoscopy was no longer used after 1983 and intraoperative
      diagnosis was made less frequently (-2.5% per year, P < 0.001). Endoscopy or
      radiographic data were rarely used as a diagnosis criterion. These changes in
      approaches to the diagnosis of pancreatic cancer were not accompanied by any
      progress in diagnosis stage, therapeutic approach or survival suggesting that
      when clinical symptoms become evident, pancreatic cancer is already advanced.
      Therapeutic advances, early diagnosis in patient at risk or identification or
      reasons for pancreatic cancer are the only means of progress in this problem.

PMID- 8349069
TI  - A multifunction and programmable computerized barostat.
AB  - A new computerized barostat allowing digestive tone measurement but also
      programmed distensions is described. The apparatus consists of a pump, driven by
      a computer, which injects or aspirates air in a flacid bag placed in a part of
      the gastrointestinal tract when relaxation or contraction occurs. Several
      parameters can be programmed for tone measurement: mean pressure, window pressure
      and air flow rate. Isovolumic or isobaric distensions can be performed using
      three modes: linear, stepwise or step by step with intermediate deflation. The
      height (mL or mmHg) of the steps and the duration of the distensions and the
      deflations can also be programmed. Three automatic and one manual safety systems
      are included. In comparison with previously described barostats the main feature
      of this apparatus is that it is entirely computerized and can be used for
      programmed distensions.

PMID- 8349070
TI  - [Artificial nutrition and Crohn disease].

PMID- 8349071
TI  - [Liver regeneration].

PMID- 8349073
TI  - [Evolution of delta bilirubin/conjugated bilirubins ratio in serum after live
      transplantation].
AB  - Serum delta-bilirubin measured in relationship to total bilirubin could be a
      liver function test in hepatobiliary diseases and even a marker of early
      rejection after liver transplantation. Delta-bilirubin bound to albumin
      constitutes with mono and diglucuroconjugates, conjugated bilirubins. We
      determined the delta-bilirubin/conjugated bilirubins ratio and studied its value
      in various complications in 16 liver recipients. The results were compared with
      alanine aminotransferase activity and prothrombin index. Hyperbilirubinemia and a
      delta-bilirubin/conjugated bilirubins ratio lower than 40% were observed
      initially. After 15 days, the delta-bilirubin/conjugated bilirubins ratio evolved
      differently according to the functional state of the graft, which allowed to
      distinguish three patient groups: in patients with good graft function, the ratio
      increased regularly to reach 65% or more on the 30th day; in patients with
      dysfunctional episodes, the ratio was always less than or equal to 40% and did
      not increase after the 15th day; in other patients, the ratio was lower than 40%
      and dropped suddenly before death. After liver transplantation, the delta
      bilirubin/conjugated bilirubins ratio may be a simple liver function marker.
      Alone, however, it cannot be used to assess acute rejection.

PMID- 8349072
TI  - [Decrease of haptoglobin serum level in patients with chronic viral hepatitis C].
AB  - Serum levels of haptoglobin, an acute phase protein, in usually increased in
      patients with inflammation and decreased in patients with intravascular
      hemolysis. Changes in haptoglobin serum levels were also observed in patients
      with liver disease. The aim of this study was to evaluate the serum level of
      haptoglobin in patients with chronic viral hepatitis C. Haptoglobin serum levels
      were measured by rate nephelometry in 34 patients with histologically proven
      chronic viral hepatitis C and in 30 controls. Haptoglobin serum levels were lower
      in patients than in controls (0.56 +/- 0.36 versus 0.90 +/- 0.35 g/L, P < 0.001).
      In patients with chronic hepatitis but without cirrhosis, haptoglobin serum
      levels were decreased as well. Haptoglobin serum levels were positively
      correlated to prothrombin index (P < 0.001) and negatively correlated to the
      histology activity index of Knodell (P < 0.001), and especially to scores of
      fibrosis (P < 0.001) and periportal necrosis (P < 0.05). Red cell count, indirect
      bilirubin level, and reticulocyte count, as markers of hemolysis, were similar in
      patients and controls. We conclude that determination of haptoglobin serum levels
      may be useful in the evaluation and the follow-up of patients with chronic viral
      hepatitis C.

PMID- 8349074
TI  - [Hepatocyte regeneration].

PMID- 8349076
TI  - [Primary sclerosing cholangitis and autoimmune cochlear deafness: a new
      syndrome?].
AB  - Association of autoimmune cochlear hearing loss with primary sclerosing
      cholangitis is reported in two patients. Endocochlear sensorineural hearing loss
      was associated with the presence of anti-cochlear antibodies in the serum
      directed against the walls of vessels in the stria vascularis. The hearing loss
      appeared at the same time or shortly after the diagnosis of cholangitis. This
      association, which has never been described, may reinforce the theory of the role
      of immunologic factors in the pathogenesis of primary sclerosing cholangitis,
      possibly linked to or initiated by vasculitis.

PMID- 8349075
TI  - [Churg-Strauss syndrome with rectal localization and exudative enteropathy].
AB  - The authors report the case of a 61-year old patient with a Churg-Strauss
      syndrome revealed by abdominal pain. Investigations showed a diffuse inflammatory
      digestive tract involvement, documented by endoscopy associated with protein
      losing enteropathy. Deep rectal biopsy revealed vasculitis in an otherwise
      macroscopically normal rectum. Faced with acute and life-threatening course of
      disease, emergency medical treatment with steroids and cyclophosphamide led to
      rapid regression of clinical, biological and radiological abnormalities.

PMID- 8349077
TI  - [Reflexions on the diagnosis and treatment of common bile duct lithiasis at the
      time of laparoscopic surgery].

PMID- 8349078
TI  - [Liver abscess after endoscopic sclerotherapy of hemorrhagic stomach ulcer].

PMID- 8349079
TI  - ["Papillomatosis" or "adenomatosis" of the Wirsung duct].

PMID- 8349080
TI  - [Sweet's syndrome revealing colonic cancer].

PMID- 8349081
TI  - [Sic transit].

PMID- 8349082
TI  - [Diarrhea syndrome associated with the presence of Cyanobacterium-like bodies].

PMID- 8349083
TI  - [Prevention of hemorrhagic recurrences from rupture of esophageal varices by
      elastic ligations. Preliminary study].

PMID- 8349084
TI  - [Disclosure of autoimmune hepatitis by interferon].

PMID- 8349085
TI  - [Acute cytolytic hepatitis caused by amoxapine].

PMID- 8349086
TI  - [Acute hepatitis during treatment with fluoxetine].

PMID- 8349087
TI  - [Place of endorectal ultrasound endoscopy in the preoperative evaluation of
      villous tumors].

PMID- 8349088
TI  - [Colonoscopic screening in first degree relatives of patients with colorectal
      cancer].

PMID- 8349089
TI  - A rapid method for preparation of rough and smooth lipopolysaccharide from
      Bacteroides, Porphyromonas and Prevotella.
AB  - We describe a new method for lipopolysaccharide (LPS) preparation by water
      extraction at 100 degrees C and subsequent digestion with proteinase K. The crude
      LPS could be reliably used for immunoblotting since it retained a high level of
      antigenicity, and was free of SDS and proteinase K, both of which can cause
      problems. Two monoclonal antibodies which failed to react with LPS prepared by
      two conventional methods reacted well with our preparation. We used the new
      method to prepare LPS from 44 strains of bacteria formerly classified as
      Bacteroides, some of which have been reclassified as Porphyromonas or Prevotella.
      In general, yields were good, and electrophoretic profiles obtained with SDS-PAGE
      and silver staining enabled strains to be rated rough, semi-rough, or smooth.

PMID- 8349090
TI  - Neisseria meningitidis transferrin-binding protein 1 expressed in Escherichia
      coli is surface exposed and binds human transferrin.
AB  - A gene library of Neisseria meningitidis B15 P1.16 DNA was established in lambda
      Zap II and clones containing DNA encoding transferrin binding protein 1 (TBP-1)
      identified following hybridisation with a 63-bp DNA probe based on the codon
      assignment for the first 21 N-terminal amino acids of TBP-1. Sequencing of the
      cloned DNA demonstrated that all of the intergenic DNA (i.e. upstream of tbp-1
      running through to the 3' end of the transferrin-binding protein 2 gene) and
      approx. 15% of tbp-1 had been cloned. The complete gene was generated using a
      polymerase chain reaction, with the primer for the 3' end being based on tbp-A of
      N. gonorrhoeae, and the approx. 2.9-kb DNA product cloned into pGem-3Z. The
      expressed protein (approx. 100 kDa) reacted with antiserum to an N-terminal
      peptide of TBP-1. In addition, the native product was surface-expressed by
      Escherichia coli and bound human transferrin.

PMID- 8349091
TI  - Effect of anti-TNF-alpha treatment in an antibiotic treated murine model of shock
      due to Streptococcus pyogenes.
AB  - Experimentally, Gram-negative septic shock can be prevented by the prophylactic
      use of an anti-TNF-alpha monoclonal antibody. The clinical similarity between
      Gram-negative and Gram-positive septic shock suggested that anti-TNF-alpha
      therapy might have a wide application. Increased levels of TNF-alpha were seen in
      a murine model of septic shock due to Streptococcus pyogenes but administration
      of an anti-TNF-alpha monoclonal antibody had no beneficial effect on the outcome.

PMID- 8349092
TI  - Alcohol dehydrogenase (ADH2) from a mutant strain of Candida guilliermondii A80
      03: purification and characterization.
AB  - Alcohol dehydrogenase ADH2 was purified twice from Candida guilliermondii strain
      A80-03, by ion exchange column chromatography on DEAE-Toyopearl 650M. The enzyme
      was a dimer of M(r) 98,500. ADH2 had a broad substrate specificity, oxidizing
      secondary alcohols as well as primary alcohols. The enzyme was sensitive to
      several inhibitors, such as metal chelators and thiol reagents. Kinetic studies
      suggested that ADH2 oxidized ethanol by an iso ordered sequential mechanism.

PMID- 8349093
TI  - Degradation of meta-trifluoromethylbenzoate by sequential microbial and
      photochemical treatments.
AB  - m- and p-trifluoromethyl (TFM)-benzoates are incompletely degraded by aerobic
      bacteria that catabolize alkylbenzoates; biodegradation ceases after ring-fission
      with the accumulation of a trifluoromethyl muconate semialdehyde (2-hydroxy-6-oxo
      7,7,7-trifluorohepta-2,4-dienoate, TFHOD) which is resistant to biochemical
      attack. A bacterium (Strain V-1), isolated from sea-water, grew aerobically on
      benzoate or m-toluate. Cells grown on benzoate or m-toluate oxidized both
      compounds at similar relative rates. Catabolism involved benzoate 1,2-dioxygenase
      (decarboxylating) and meta-cleavage to yield muconate semialdehydes. Cells grown
      on benzoate metabolized m-TFM-benzoate to TFHOD. The ring-fission products from m
      toluate and TFHOD were degraded by sunlight, and equimolar fluoride was released
      from TFHOD. Sequential biochemical and photochemical treatment allowed the
      destruction of m-TFM-benzoate beyond the biochemically recalcitrant intermediate
      TFHOD.

PMID- 8349094
TI  - Eimeria refractile body proteins contain two potentially functional
      characteristics: transhydrogenase and carbohydrate transport.
AB  - cDNA encoding an immunogenic protein from partially sporulated oocysts of Eimeria
      acervulina was cloned and used to search for the homologous counterpart in
      Eimeria tenella. Monospecific antibodies were raised against the recombinant
      expression product. Using these antibodies, the parasite proteins were found to
      be localised in the refractile bodies. The derived amino-acid sequences were
      compared by computer using the SWISSPROT protein database. In addition to high
      homology between the Eimeria species, extensive similarity was found with
      pyridine nucleotide transhydrogenase from Escherichia coli. Comparison with the
      sugar signature database also resulted in a possible sugar binding domain present
      only in the Eimeria proteins. It is possible that the corresponding parasite
      proteins play a role in the recently discovered mannitol cycle of Eimeria.

PMID- 8349095
TI  - luxAB gene fusions with the arsenic and cadmium resistance operons of
      Staphylococcus aureus plasmid pI258.
AB  - pC101, a novel shuttle vector between Escherichia coli and Staphylococcus aureus
      carrying the lux genes encoding luciferase from Vibrio harveyi, selectable
      ampicillin and chloramphenicol markers and origins of replication for Gram
      negative and Gram-positive bacteria has been constructed. The inducibility of the
      arsenic and cadmium operon from S. aureus plasmid pI258 to different ions has
      been tested in E. coli and in S. aureus with two fusions in pC101: an arsB-luxAB
      and a cadA-luxAB transcriptional gene fusion. Patterns of induction are
      influenced by the host strain and are slightly different from previous reports
      using the blaZ gene as reporter gene.

PMID- 8349096
TI  - The biosynthetic genes for clavulanic acid and cephamycin production occur as a
      'super-cluster' in three Streptomyces.
AB  - The cosmid cloning vector pHC79 has been used to clone fragments of chromosomal
      DNA from the Streptomyces: S. clavuligerus, S. jumonjinensis and S.
      katsurahamanus. These strains all produce both the beta-lactam antibiotic,
      cephamycin and the beta-lactamase inhibitor, clavulanic acid. Although
      structurally related these two beta-lactams are known to be derived from
      different biosynthetic precursors. Hybridisation studies and restriction mapping
      have shown that the gene clusters encoding the two biosynthetic pathways are
      chromosomally adjacent in these strains, thus creating a 'super-cluster' of genes
      involved in both the production and enhancement of activity of a beta-lactam
      antibiotic.

PMID- 8349097
TI  - Distribution in the genus Streptomyces of a homolog to nusG, a gene encoding a
      transcriptional antiterminator.
AB  - The presence of the vbrA gene encoding the transcriptional antiterminator NusG
      equivalent protein of Streptomyces virginiae was tested for in 73 Streptomyces
      species by Southern hybridization. Fifty-five strains (75%) including S. griseus,
      S. lividans TK-21 and S. coelicolor A3(2) showed clear hybridization signals,
      indicating wide distribution of vbrA or vbrA homologs in Streptomyces species.
      With hybridization patterns against 3 different probes, i.e., probes covering
      vbrA alone, the downstream gene rplK alone, and both vbrA-rplK, the 55 strains
      were classified into 4 groups. In the groups I, II and III (total 50 strains)
      vbrA was found to be adjacent to rplK, indicating that the gene arrangement vbrA
      rplK is common in Streptomyces and that these genes may constitute a part of gene
      cluster encoding several components of the transcription and translation
      apparatus, as in Escherichia coli.

PMID- 8349098
TI  - Variance components/major locus likelihood approximation for quantitative,
      polychotomous, and multivariate data.
AB  - Pearson [Philos Trans R Soc Lond [A] 200:1-66, 1903], Mendell and Elston
      [Biometrics 30:41-57, 1974], and Rice et al. [Biometrics 35:451-459, 1979]
      approximated the likelihood of the multifactorial model on a dichotomous
      phenotype by a procedure of successive univariate computation and conditioning.
      Hasstedt [Pap: Pedigree Analysis Package, Rev. 3. 1989] and Demenais [Am J Hum
      Genet 49:773-785, 1991] extended the algorithm to include a major locus. Here I
      extend the algorithm to polychotomous, quantitative, and multivariate phenotypes,
      add a major locus to the model, and describe and evaluate the accuracy of an
      approximation of the resulting variance components/major locus model.

PMID- 8349099
TI  - Inheritance of plasma apolipoprotein B levels in families of patients undergoing
      coronary arteriography at an early age.
AB  - An elevated plasma level of apolipoprotein B (apoB), the major protein of low
      density lipoproteins, is a risk factor for coronary artery disease. This study
      tested the hypothesis, suggested by previous studies, that the apoB level is
      strongly influenced by a major gene. The study population included 832 family
      members of 116 subjects who had undergone elective coronary arteriography at an
      early age. The apoB level was adjusted for age, gender, body mass index, alcohol
      consumption, and cigarette smoking (R2 = 20%). ApoB levels revealed strong
      familial aggregation with correlations among spouses of 0.23, parent-offspring of
      0.16, and siblings of 0.21. Regressive models were used to examine inter
      individual variation in adjusted apoB levels. In the total sample, familial
      aggregation of the apoB level was consistent with two models: (1) a major gene
      model and (2) a polygenic model with a mixture of non-transmitted "types".
      Comparison of these two models in each family showed that 57 families supported
      the first model over the second. Segregation analysis in these 57 families
      conclusively favored a major gene model with codominant transmission. Genotypic
      means were 124, 164, and 208 mg/dl with relative frequencies of 45%, 44%, and
      11%. Linkage studies in these families can be used to clarify the molecular basis
      of apoB regulation. However, in the whole population the genetic control of apoB
      levels may be quite complex.

PMID- 8349100
TI  - Segregation analysis of autosomal dominant polycystic kidney disease.
AB  - The results of classical segregation analysis on 159 families with polycystic
      kidney disease (PKD) are presented. It had been previously estimated that about
      95% of autosomal dominant PKD (ADPKD) families have PKD1, the gene localized to
      chromosome 16p. The main purpose of the study was to determine if PKD shows any
      segregation distortion and to obtain new estimates of the age-dependent
      penetrance. Penetrance at the early ages of onset has increased during the last
      decade, presumably because of improvements in renal imaging and consequent
      earlier age of diagnosis. In the current study, the mean age of diagnosis was
      estimated to be 20 years, with a standard deviation (SD) of 15.94. Under the best
      fitting model (autosomal dominant), over 70% penetrance was estimated by age 30
      years, over 95% by 50 years, and 99% by 55 years. Thus, diagnosis of this disease
      at an early age is possible without total reliance on DNA typing. The segregation
      ratio defined through the transmission probability in our model was not
      significantly different from 0.50, but its confidence limits were broad: 0.36 to
      0.64. Neither transmission probability nor penetrance was significantly
      influenced by gender. The mutation rate was estimated to be 6.9 x 10(-5), in
      accordance with the previously observed high mutation rate for PKD. However, the
      mutation rate in our study may be overestimated because it neglects low
      penetrance alleles and phenocopies.

PMID- 8349101
TI  - Genetic analysis of drinking behavior in World War II veteran twins.
AB  - The objective of the present study was to investigate longitudinal changes in
      drinking behaviors of adult male twins and model these changes as a function of
      genetic and environmental influences. Alcohol data available for World War II
      veteran twins, first surveyed in 1967-69 and followed up during 1983-85, were
      used to examine components of variability in measures of alcohol consumption.
      Multivariate biometric analysis of these data indicated 1) longitudinal stability
      of drinking behaviors in this cohort, 2) a significant contribution of genetic
      factors to the observed stability that accounted for more than 80% of the stable
      variation in frequency and in quantity of alcohol consumed per drinking occasion,
      and 3) evidence for a significant contribution of shared environmental influences
      to drinking of specific beverages (e.g., wine). The implications of these results
      for issues of health in the elderly are considered.

PMID- 8349102
TI  - MORGAN's hypothesis of the genetic control of development.

PMID- 8349103
TI  - Isolation and characterization of SGE1: a yeast gene that partially suppresses
      the gal11 mutation in multiple copies.
AB  - Recessive mutations of GAL11 in Saccharomyces cerevisiae cause pleiotropic
      defects that include weak fermentation of galactose, alpha-specific sterility and
      slow growth on nonfermentable carbon sources. Recent experiments suggest that
      Gal11P functions as a "co-activator" that links transcriptional activators, such
      as Gal4p and Grf1p/Rap1p/Tuf1p, with the basic transcription machinery. In the
      present experiments we isolated a gene, SGE1, that suppresses gal11 for growth on
      ethidium bromide/galactose agar when the gene was present in two or more copies.
      The other gal11 phenotypes were not suppressed by SGE1 in the multiple-copy
      state. Multiple copies of SGE1 increased expression of galactose-inducible genes
      in gal11 yeast, presumably at the level of transcription. When SGE1 was disrupted
      in wild-type yeast, the expression of galactose-inducible genes decreased to 50
      60% of the wild-type level, presumably due to effect on transcription. Complete
      DNA sequence analysis revealed that SGE1 encodes a predicted protein of 543 amino
      acids. SGE1-specific mRNA of 1.8 kilonucleotides was detected by Northern
      analysis along the direction of the open reading frame. The gene mapped near
      RAD56, at the right end of chromosome 16.

PMID- 8349104
TI  - TSF1 to TSF6, required for silencing the Saccharomyces cerevisiae GAL genes, are
      global regulatory genes.
AB  - The Saccharomyces cerevisiae GAL1 and GAL10 genes are controlled in response to
      the availability of galactose and glucose by multiple activating and repressing
      proteins bound at adjacent or overlapping sites in UASG. Negative control
      elements in UASG, designated GAL operators GALO1 to GALO6, are required to
      silence basal level transcription of GAL1 and GAL10 when galactose is absent. We
      isolated and characterized recessive mutations in six nuclear genes, TSF1 to
      TSF6, that impair silencing of GAL1 and GAL10 gene expression. Surprisingly, the
      results of several experiments suggest that the TSF genes encode global
      regulatory factors. tsf1 to tsf6 mutations derepressed expression from yeast CYC
      GAL hybrid promoters (fused to lacZ) that harbor a variety of operator sequences,
      and caused pleiotropic defects in cell growth, mating, and sporulation. S1
      mapping and Northern blot results for tsf3 suggest that the molecular defect is
      at the transcriptional level. Mutant phenotypes were additive in certain
      combinations of tsf double mutants, implying that more than one silencing pathway
      is involved in TSF1 to TSF6 function. Most significantly, mutations in all six
      TSF1 to TSF6 genes activated expression from GAL1 and CYC1 promoters (fused to
      lacZ) lacking upstream activating sequences. Combined, the simplest
      interpretation of these results is that TSF1 to TSF6 encode factors that control
      the function of the basic RNA polymerase II transcriptional machinery.

PMID- 8349105
TI  - Isogenic strain construction and gene mapping in Candida albicans.
AB  - Genetic manipulation of Candida albicans is constrained by its diploid genome and
      asexual life cycle. Recessive mutations are not expressed when heterozygous and
      undesired mutations introduced in the course of random mutagenesis cannot be
      removed by genetic back-crossing. To circumvent these problems, we developed a
      genotypic screen that permitted identification of a heterozygous recessive
      mutation at the URA3 locus. The mutation was introduced by targeted mutagenesis,
      homologous integration of transforming DNA, to avoid introduction of extraneous
      mutations. The ura3 mutation was rendered homozygous by a second round of
      transformation resulting in a Ura- strain otherwise isogenic with the parental
      clinical isolate. Subsequent mutation of the Ura- strain was achieved by targeted
      mutagenesis using the URA3 gene as a selectable marker. URA3 selection was used
      repeatedly for the sequential introduction of mutations by flanking the URA3 gene
      with direct repeats of the Salmonella typhimurium hisG gene. Spontaneous
      intrachromosomal recombination between the flanking repeats excised the URA3 gene
      restoring a Ura- phenotype. These Ura- segregants were selected on 5-fluoroorotic
      acid-containing medium and used in the next round of mutagenesis. To permit the
      physical mapping of disrupted genes, the 18-bp recognition sequence of the
      endonuclease I-SceI was incorporated into the hisG repeats. Site-specific
      cleavage of the chromosome with I-SceI revealed the position of the integrated
      sequences.

PMID- 8349106
TI  - Chromosome rearrangements recovered following transformation of Neurospora
      crassa.
AB  - New chromosome rearrangements were found in 10% or more of mitotically stable
      transformants. This was shown for transformations involving a variety of
      different markers, vectors and recipient strains. Breakpoints were randomly
      distributed among the seven linkage groups. Controls using untransformed
      protoplasts of the same strains contained almost no rearrangements. A study of
      molecularly characterized Am+ transformants showed that rearrangements are
      frequent when multiple ectopic integration events have occurred. In contrast,
      rearrangements are absent or infrequent when only the resident locus is restored
      to am+ by a homologous event. Sequences of the transforming vector were
      genetically linked to breakpoints in 6 of 10 translocations that were examined
      using Southern hybridization or colony blots.

PMID- 8349107
TI  - Two types of sites required for meiotic chromosome pairing in Caenorhabditis
      elegans.
AB  - Previous studies have shown that isolated portions of Caenorhabditis elegans
      chromosomes are not equally capable of meiotic exchange. These results led to the
      proposal that a homolog recognition region (HRR), defined as the region
      containing those sequences enabling homologous chromosomes to pair and recombine,
      is localized near one end of each chromosome. Using translocations and
      duplications we have localized the chromosome I HRR to the right end. Whereas the
      other half of chromosome I did not confer any ability for homologs to pair and
      recombine, deficiencies in this region dominantly suppressed recombination to the
      middle of the chromosome. These deletions may have disrupted pairing mechanisms
      that are secondary to and require an HRR. Thus, the processes of pairing and
      recombination appear to utilize at least two chromosomal elements, the HRR and
      other pairing sites. For example, terminal sequences from other chromosomes
      increase the ability of free duplications to recombine with their normal
      homologs, suggesting that telomere-associated sequences, homologous or
      nonhomologous, play a role in facilitating meiotic exchange. Recombination can
      also initiate at internal sites separated from the HRR by chromosome
      rearrangement, such as deletions of the unc-54 region of chromosome I. When
      crossing over was suppressed in a region of chromosome I, compensatory increases
      were observed in other regions. Thus, the presence of the HRR enabled
      recombination to occur but did not determine the distribution of the crossover
      events. It seems most likely that there are multiple initiation sites for
      recombination once homolog recognition has been achieved.

PMID- 8349109
TI  - Molecular characterization and rescue of acatalasemic mutants of Drosophila
      melanogaster.
AB  - The enzyme catalase protects aerobic organisms from oxygen-free radical damage by
      converting hydrogen peroxide to molecular oxygen and water before it can
      decompose to form the highly reactive hydroxyl radical. Hydroxyl radicals are the
      most deleterious of the activated oxygen intermediates found in aerobic
      organisms. If formed, they can react with biological molecules in their
      proximity; the ensuing damage has been implicated in the increasing risk of
      disease and death associated with aging. To study further the regulation and role
      of catalase we have undertaken a molecular characterization of the Drosophila
      catalase gene and two potentially acatalasemic alleles. We have demonstrated that
      a previously existing allele, Catn4, likely contains a null mutation, a mutation
      which blocks normal translation of the encoded mRNA. The Catn1 mutation appears
      to cause a significant change in the protein sequence; however, it is unclear why
      this change leads to a nonfunctioning protein. Viability of these acatalasemic
      flies can be restored by transformation with the wild-type catalase gene; hence,
      we conclude that the lethality of these genotypes is due solely to the lack of
      catalase. The availability of flies with transformed catalase genes has allowed
      us to address the effect of catalase levels on aging in Drosophila. Though lack
      of catalase activity caused decreased viability and life span, increasing
      catalase activity above wild-type levels had no effect on normal life span.

PMID- 8349108
TI  - Genetic and molecular characterization of the Caenorhabditis elegans
      spermatogenesis-defective gene spe-17.
AB  - Two self-sterile mutations that define the spermatogenesis-defective gene spe-17
      have been analyzed. These mutations affect unc-22 and fail to complement each
      other for both Unc-22 and spermatogenesis defects. Both of these mutations are
      deficiencies (hcDf1 and hDf13) that affect more than one transcription unit.
      Genomic DNA adjacent to and including the region deleted by the smaller
      deficiency (hcDf1) has been sequenced and four mRNAs (including unc-22) have been
      localized to this sequenced region. The three non unc-22 mRNAs are shown to be
      sex-specific: a 1.2-kb mRNA that can be detected in sperm-free hermaphrodites and
      1.2- and 0.56-kb mRNAs found in males. hDf13 deletes at least 55 kb of chromosome
      IV, including all of unc-22, both male-specific mRNAs and at least part of the
      female-specific mRNA. hcDf1, which is approximately 15.6 kb, deletes only the 5'
      end of unc-22 and the gene that encodes the 0.56-kb male-specific mRNA. The
      common defect that apparently accounts for the defective sperm in hcDf1 and hDf13
      homozygotes is deletion of the spe-17 gene, which encodes the 0.56-kb mRNA.
      Strains carrying two copies of either deletion are self-fertile when they are
      transgenic for any of four extrachromosomal array that include spe-17. We have
      sequenced two spe-17 cDNAs, and the deduced 142 amino acid protein sequence is
      highly charged and rich in serine and threonine, but shows no significant
      homology to any previously determined protein sequence.

PMID- 8349110
TI  - Molecular variation of Adh and P6 genes in an African population of Drosophila
      melanogaster and its relation to chromosomal inversions.
AB  - Four-cutter molecular polymorphism of Adh and P6, and chromosome inversion
      polymorphism of chromosome II were investigated in 95 isogenic lines of an Ivory
      Coast population of Drosophila melanogaster, a species assumed to have recently
      spread throughout the world from a West African origin. The P6 gene showed little
      linkage disequilibrium with the In(2L)t inversion, although it is located within
      this inversion. This suggests that the inversion and the P6 locus have
      extensively exchanged genetic information through either double crossover or gene
      conversion. Allozymic variation in ADH was in linkage disequilibrium with In(2L)t
      and In(2R)NS inversions. Evidence suggests either that inversion linkage with the
      Fast allele is selectively maintained, or that this allele only recently
      appeared. Molecular polymorphism at the Adh locus in the Ivory Coast is not
      higher than in North American populations. New haplotypes specific to the African
      population were found, some of them connect the "WaS-like" haplotypes found at
      high frequencies in the United States to the other slow haplotypes. Their
      relation with In(2L)t supports the hypothesis that WaS recently recombined away
      from an In(2L)t chromosome which may be the cause of its divergence from the
      other haplotypes.

PMID- 8349111
TI  - The Drosophila sex determination gene snf is utilized for the establishment of
      the female-specific splicing pattern of Sex-lethal.
AB  - The Drosophila snf gene is a positive regulator of the sex determination gene Sex
      lethal in both the germline and the soma. Its role in the soma is only evident
      when the probability of Sex-lethal activation has been reduced. For instance, in
      an otherwise wild-type background, females homozygous for a weak snf mutation
      produce both male and female progeny; however, when mated to males hemizygous for
      a null allele of Sex-lethal, they produce only male progeny. We demonstrate that
      the lack of female progeny is due to aberrant Sex-lethal regulation in late
      embryogenesis. In these mutant embryos, there is little accumulation of the late
      female-specific spliced RNAs and proteins. In contrast, in early embryogenesis,
      Sex-lethal regulation is not affected. The accumulation of both the early Sex
      lethal transcripts and proteins is normal. These results suggest that the wild
      type product of snf plays an important role in establishing the female-specific
      RNA splicing pattern of Sex-lethal. Whether snf influences the female-specific
      splice site choice directly or indirectly remains to be determined.

PMID- 8349113
TI  - The genetic analysis of achiasmate segregation in Drosophila melanogaster. III.
      The wild-type product of the Axs gene is required for the meiotic segregation of
      achiasmate homologs.
AB  - The regular segregation of achiasmate chromosomes in Drosophila melanogaster
      females is ensured by two distinct segregational systems. The segregation of
      achiasmate homologs is assured by the maintenance of heterochromatic pairing;
      while the segregation of heterologous chromosomes is ensured by a separate
      mechanism that may not require physical association. AxsD (Aberrant X
      segregation) is a dominant mutation that specifically impairs the segregation of
      achiasmate homologs; heterologous achiasmate segregations are not affected. As a
      result, achiasmate homologs frequently participate in heterologous segregations
      at meiosis I. We report the isolation of two intragenic revertants of the AxsD
      mutation (Axsr2 and Axsr3) that exhibit a recessive meiotic phenotype identical
      to that observed in AxsD/AxsD females. A third revertant (Axsr1) exhibits no
      meiotic phenotype as a homozygote, but a meiotic defect is observed in
      Axsr1/Axsr2 females. Therefore mutations at the AxsD locus define a gene
      necessary and specific for homologous achiasmate segregation during meiosis. We
      also characterize the interactions of mutations at the Axs locus with two other
      meiotic mutations (ald and ncd). Finally, we propose a model in which Axs+ is
      required for the normal separation of paired achiasmate homologs. In the absence
      of Axs+ function, the homologs are often unable to separate from each other and
      behave as a single segregational unit that is free to segregate from heterologous
      chromosomes.

PMID- 8349112
TI  - The 3' regulatory region of the Abdominal-B gene: genetic analysis supports a
      model of reiterated and interchangeable regulatory elements.
AB  - The Abdominal-B (Abd-B) gene is one of three genes in the bithorax complex, a
      cluster of homeotic genes in Drosophila. During embryogenesis Abd-B is expressed
      in a complex pattern, producing four different transcript classes, each of which
      exhibits a unique spatial pattern of expression. Proper regulation of the class A
      transcripts is required for appropriate development of the fifth through eighth
      abdominal segments and is mediated, in part, by a 60-kb regulatory region located
      3' of the gene. We have isolated a new mutation, designated Abd-BCorset, which is
      caused by a deletion that leaves 15 kb of the 3' regulatory sequences immediately
      adjacent to the gene, but removes 45 kb of the more distant 3' regulatory
      elements. This mutation produces an unexpected homeotic segmental transformation
      of the fourth through seventh abdominal segments, and has been analyzed by
      genetic and molecular techniques. In situ hybridization to Abd-BCorset embryos
      shows a uniform and moderate level of the Abd-B class A transcript in the
      posterior abdomen, rather than the normal graded pattern of expression. Our
      analysis of the Abd-BCorset mutation has prompted a model of the 3' regulatory
      region of Abd-B based on reiterated cell type-specific elements controlled by
      adjacent position-sensitive activating elements. The gradient of Abd-B expression
      normally observed in the posterior abdomen appears to be achieved by varying the
      number of reiterated elements that are active in each segment.

PMID- 8349115
TI  - Codon usage bias and base composition of nuclear genes in Drosophila.
AB  - The nuclear genes of Drosophila evolve at various rates. This variation seems to
      correlate with codon-usage bias. In order to elucidate the determining factors of
      the various evolutionary rates and codon-usage bias in the Drosophila nuclear
      genome, we compared patterns of codon-usage bias with base compositions of exons
      and introns. Our results clearly show the existence of selective constraints at
      the translational level for synonymous (silent) sites and, on the other hand, the
      neutrality or near neutrality of long stretches of nucleotide sequence within
      noncoding regions. These features were found for comparisons among nuclear genes
      in a particular species (Drosophila melanogaster, Drosophila pseudoobscura and
      Drosophila virilis) as well as in a particular gene (alcohol dehydrogenase) among
      different species in the genus Drosophila. The patterns of evolution of
      synonymous sites in Drosophila are more similar to those in the prokaryotes than
      they are to those in mammals. If a difference in the level of expression of each
      gene is a main reason for the difference in the degree of selective constraint,
      the evolution of synonymous sites of Drosophila genes would be sensitive to the
      level of expression among genes and would change as the level of expression
      becomes altered in different species. Our analysis verifies these predictions and
      also identifies additional selective constraints at the translational level in
      Drosophila.

PMID- 8349116
TI  - Detecting marker-QTL linkage and estimating QTL gene effect and map location
      using a saturated genetic map.
AB  - A simulation study was carried out on a backcross population in order to
      determine the effect of marker spacing, gene effect and population size on the
      power of marker-quantitative trait loci (QTL) linkage experiments and on the
      standard error of maximum likelihood estimates (MLE) of QTL gene effect and map
      location. Power of detecting a QTL was virtually the same for a marker spacing of
      10 cM as for an infinite number of markers and was only slightly decreased for
      marker spacing of 20 or even 50 cM. The advantage of using interval mapping as
      compared to single-marker analysis was slight. "Resolving power" of a marker-QTL
      linkage experiment was defined as the 95% confidence interval for the QTL map
      location that would be obtained when scoring an infinite number of markers. It
      was found that reducing marker spacing below the resolving power did not add
      appreciably to narrowing the confidence interval. Thus, the 95% confidence
      interval with infinite markers sets the useful marker spacing for estimating QTL
      map location for a given population size and estimated gene effect.

PMID- 8349114
TI  - Compositional heterogeneity and patterns of molecular evolution in the Drosophila
      genome.
AB  - The rates and patterns of molecular evolution in many eukaryotic organisms have
      been shown to be influenced by the compartmentalization of their genomes into
      fractions of distinct base composition and mutational properties. We have
      examined the Drosophila genome to explore relationships between the nucleotide
      content of large chromosomal segments and the base composition and rate of
      evolution of genes within those segments. Direct determination of the G + C
      contents of yeast artificial chromosome clones containing inserts of Drosophila
      melanogaster DNA ranging from 140-340 kb revealed significant heterogeneity in
      base composition. The G + C content of the large segments studied ranged from
      36.9% G + C for a clone containing the hunchback locus in polytene region 85, to
      50.9% G + C for a clone that includes the rosy region in polytene region 87.
      Unlike other organisms, however, there was no significant correlation between the
      base composition of large chromosomal regions and the base composition at
      fourfold degenerate nucleotide sites of genes encompassed within those regions.
      Despite the situation seen in mammals, there was also no significant association
      between base composition and rate of nucleotide substitution. These results
      suggest that nucleotide sequence evolution in Drosophila differs from that of
      many vertebrates and does not reflect distinct mutational biases, as a function
      of base composition, in different genomic regions. Significant negative
      correlations between codon-usage bias and rates of synonymous site divergence,
      however, provide strong support for an argument that selection among alternative
      codons may be a major contributor to variability in evolutionary rates within
      Drosophila genomes.

PMID- 8349117
TI  - A class of population genetic questions formulated as the generalized occupancy
      problem.
AB  - In categorical genetic data analysis when the sampling units are classified into
      an arbitrary number of distinct classes, sometimes the sample size may not be
      large enough to apply large sample approximations for hypothesis testing
      purposes. Exact sampling distributions of several statistics are derived here,
      using combinatorial approaches parallel to the classical occupancy problem to
      help overcome this difficulty. Since the multinomial probabilities can be
      unequal, this situation is described as a generalized occupancy problem. The
      sampling properties derived are used to examine nonrandomness of occurrence of
      mutagen-induced mutations across loci, to devise tests of Hardy-Weinberg
      proportions of genotype frequencies in the presence of a large number of alleles,
      and to provide a global test of gametic phase disequilibrium of several
      restriction site polymorphisms.

PMID- 8349118
TI  - Empirical tests of some predictions from coalescent theory with applications to
      intraspecific phylogeny reconstruction.
AB  - Empirical data sets of intraspecific restriction site polymorphism in Drosophila
      have been gathered in order to test hypotheses derived from coalescent theory.
      Three main ideas are tested: (1) haplotype frequency in the sample contains
      information on the topological position of a given haplotype in a cladogram, (2)
      the frequency of a haplotype is related to the number of mutational connections
      to other haplotypes in the cladogram and (3) geographic location can be used to
      infer topological positioning of haplotypes in a cladogram. These relationships
      can then be used to better estimate intraspecific phylogenies in two ways: (1)
      rooting the phylogeny and (2) resolving ambiguities in a cladogram. This
      information will allow one to reduce the number of alternative phylogenies and
      incorporate the uncertainties involved in reconstructing intraspecific
      phylogenies into subsequent analyses that depend heavily on the topology of the
      tree.

PMID- 8349119
TI  - Substitution processes in molecular evolution. I. Uniform and clustered
      substitutions in a haploid model.
AB  - A computer simulation of the process of nucleotide substitutions in a finite
      haploid population subject to selection in a randomly fluctuating environment
      provides a number of unexpected results. For rapidly fluctuating environments,
      substitutions are more regular than random. A small mutation-rate approximation
      is used to explain the regularity. The explanation does not depend heavily on the
      particulars of the haploid model, leading to the conjecture that many symmetrical
      models of molecular evolution with rapidly changing parameters may exhibit
      substitutions that are more regular than random. When fitnesses change very
      slowly, the simulation shows that substitutions are more clumped than random.
      Here a small-mutation approximation shows that the clustering is due to the
      increase in fitness that accompanies each successive substitution with a
      consequent lowering of the effective mutation rate. The two observations taken
      together suggest that the common observation that amino acid substitutions are
      clustered in time is due to the presence of parameters that change very slowly.

PMID- 8349121
TI  - The effect of selection on the phenotypic variance.
AB  - We consider the within-generation changes of phenotypic variance caused by
      selection w(x) which acts on a quantitative trait x. If before selection the
      trait has Gaussian distribution, its variance decreases if the second derivative
      of the logarithm of w(x) is negative for all x, while if it is positive for all
      x, the variance increases.

PMID- 8349120
TI  - VNTR allele frequency distributions under the stepwise mutation model: a computer
      simulation approach.
AB  - Variable numbers of tandem repeats (VNTRs) are a class of highly informative and
      widely dispersed genetic markers. Despite their wide application in biological
      science, little is known about their mutational mechanisms or population
      dynamics. The objective of this work was to investigate four summary measures of
      VNTR allele frequency distributions: number of alleles, number of modes, range in
      allele size and heterozygosity, using computer simulations of the one-step
      stepwise mutation model (SMM). We estimated these measures and their probability
      distributions for a wide range of mutation rates and compared the simulation
      results with predictions from analytical formulations of the one-step SMM. The
      average heterozygosity from the simulations agreed with the analytical
      expectation under the SMM. The average number of alleles, however, was larger in
      the simulations than the analytical expectation of the SMM. We then compared our
      simulation expectations with actual data reported in the literature. We used the
      sample size and observed heterozygosity to determine the expected value, 5th and
      95th percentiles for the other three summary measures, allelic size range, number
      of modes and number of alleles. The loci analyzed were classified into three
      groups based on the size of the repeat unit: microsatellites (1-2 base pair (bp)
      repeat unit), short tandem repeats [(STR) 3-5 bp repeat unit], and minisatellites
      (15-70 bp repeat unit). In general, STR loci were most similar to the simulation
      results under the SMM for the three summary measures (number of alleles, number
      of modes and range in allele size), followed by the microsatellite loci and then
      by the minisatellite loci, which showed deviations in the direction of the
      infinite allele model (IAM). Based on these differences, we hypothesize that
      these three classes of loci are subject to different mutational forces.

PMID- 8349122
TI  - Variability among members of the Hor-2 multigene family.
AB  - The hordeins comprise the major prolamin storage proteins of barley. Two major
      and one minor gene families encode these alcohol-soluble proteins. The Hor-2 gene
      family encoding the B-hordeins has been estimated to contain 15-30 copies.
      Although several genes encoding B-hordeins have been cloned and sequenced, little
      is known about the mechanisms responsible for the generation of the enormous
      genetic variability at this locus. Polymerase chain reaction sequence
      amplification provided a simple technique that permitted the amplification of the
      Hor-2 gene family members from the genomes of several barley genotypes. Sequence
      analysis of clones permitted the identification of a region within the Hor-2
      structural gene that appears to undergo recombinational and slippage-like gene
      conversion events. In this report we describe variability of the B-hordein genes,
      possible mechanisms responsible for it, and implications this may have on the
      evolution of prolamin-encoding gene families.

PMID- 8349123
TI  - An AT-rich satellite DNA sequence, E180, in alfalfa (Medicago sativa).
AB  - A DNA fragment of approximately 750 bp was cloned from EcoRI-digested nuclear DNA
      of alfalfa (Medicago sativa). Southern blot and sequence analysis showed that the
      cloned DNA fragment represents a tetramer of a highly tandemly repeated DNA
      sequence of 185-188 bp (E180). The consensus sequence deduced from the four
      repeating units is 189 bp in length with an AT content of 67%. The copy number of
      the satellite DNA was estimated to be approximately 1.8 x 10(5) per genome and
      constitutes about 1% of the alfalfa genome. Sequence comparison revealed no
      identity to any repetitive DNA sequences that have been published to date.
      Digestion with HpaII and MspI indicated a high degree of methylation at the
      internal C of the restriction site CCGG within E180.

PMID- 8349124
TI  - Within-family selection at an otherwise unselected locus in dairy cattle.
AB  - Identification of allelic variants with economic importance is feasible via
      molecular genetic techniques. This information can be used to increase the
      frequency of favourable alleles in dairy cattle. The effect of selection on the
      genotype within families in the early stages of life is examined. Three different
      strategies are considered: (1) random mating of bull sires with bull dams and
      with cows, with embryo selection of young bulls and all cows; (2) random mating
      of bull sires with bull dams, with embryo selection of young bulls only; (3)
      minimizing or avoiding matings between homozygotes for the unfavourable allele,
      with embryo selection of young bulls. Selection strategies assume the use of
      reproductive technologies such as embryo transfer to produce large family sizes
      for within-family selection to be practiced. All the three strategies increase
      the frequency of the favourable allele rapidly. Strategy 1 gives the fastest
      increase in the frequency of the favourable allele. The increase in the frequency
      of the favourable allele is slower under random mating (strategy 2) than under a
      negative assortative mating (strategy 3). This is a novel example of increased
      selection response with negative assortative mating.

PMID- 8349125
TI  - Conservative genome size and rapid chromosomal evolution in the South American
      tuco-tucos (Rodentia: Ctenomyidae).
AB  - Genome size (the amount of DNA per cell) was measured by flow-cytometric analysis
      in seven species of a chromosomally variable rodent genus: Ctenomys boliviensis,
      C. conoveri, C. frater, C. leucodon, C. lewisi, C. opimus, and C. steinbachi. The
      mean genome size of these species was 7.19 pg DNA and little inter- and intra
      specific variation was observed. Genome size was not correlated with diploid
      number, suggesting that chromosomal evolution at this level is independent of
      total DNA content. A hypothetical taxonomic unit optimization procedure was
      carried out using genome size change on a Wagner tree derived from allozyme data.
      Allozyme evolution and genome size change are linked by a weak, but significant,
      negative correlation suggestive of preferential genic evolution in the absence of
      genome size evolution.

PMID- 8349126
TI  - Genetic maps of the sheep blowfly Lucilia cuprina: linkage-group correlations
      with other dipteran genera.
AB  - Linkage data and revised genetic maps for 72 autosomal loci in Lucilia cuprina
      are presented. Comparison of the linkage relationships of biochemically and
      morphologically similar mutations in Ceratitis capitata, Drosophila melanogaster,
      and Musca domestica supports the hypothesis that the major linkage elements have
      survived relatively intact during evolution of the higher Diptera. The
      relationship of the linkage groups of the mosquito Aedes aegypti to these species
      is less clear.

PMID- 8349127
TI  - Chromosomal rearrangements in rock wallabies, Petrogale (Marsupialia:
      Macropodidae). VIII. An investigation of the nonrandom nature of karyotypic
      change.
AB  - Although the nonrandom nature of many chromosome breaks is well known, few
      studies have investigated the potential significance of this breakage specificity
      in chromosome evolution. The macropod genus Petrogale is an ideal group in which
      to investigate this phenomenon, since it comprises a large number of chromosomal
      forms, many of which appear to have differentiated relatively recently. By
      exposing Petrogale cells to mutagenic agents it should be possible to compare the
      distribution and abundance of induced breaks with those that are known to have
      occurred in vivo during the chromosomal differentiation of the genus. In this
      study, breaks were induced in mitotic chromosomes from P. assimilis and P.
      mareeba by exposing synchronized cultured fibroblasts to low doses of gamma
      radiation. The results were remarkably similar for both species and the
      distribution of breaks among the chromosomes appeared to be nonrandom. It was
      found that chromosomes 5, 6, and (possibly) 10 had a substantially higher rate of
      breakage than expected. These are also the chromosomes that occur
      disproportionately among the rearrangements identified in Petrogale. While the
      distribution of breaks along the chromosome appeared uniform or normal for most
      chromosomes, a putative "hot spot" was identified near the centromere in
      chromosome 5 of P. mareeba and in a homologous position near the telomere of
      chromosome 5 in P. assimilis. In a further experiment, a 1- to 2-h pulse of
      mitomycin C was used to induce centric fusions in cultured fibroblasts of P.
      penicillata (2n = 22); 2408 cells were examined and 112 fusions were identified.
      While it was found that all chromosomes participated in forming fusions,
      chromosome 10 was found to be most frequently involved, being present in 28.6% of
      the identified fusions. This frequency is far greater than would be expected if
      fusions were to occur at random (10%). It is significant then that chromosome 10
      has been involved in five of the eight centric fusions that have been identified
      in Petrogale and that it is also the chromosome that has been most frequently
      rearranged in Petrogale. These results suggest that features of the karyotype may
      influence the distribution and frequency of chromosome breaks and therefore the
      rate and nature of chromosome evolution.

PMID- 8349128
TI  - Random amplified polymorphic DNA markers for DNA fingerprinting and genetic
      variability assessment of minute parasitic wasp species (Hymenoptera: Mymaridae
      and Trichogrammatidae) used in biological control programs of phytophagous
      insects.
AB  - Biological control of insects that feed on our crops has become more practical in
      recent years by mass release of egg parasitoid microhymenoptera. Trichogramma
      species are now commercially reared and spread in commercial fields to control
      specific insect pests. Microhymenoptera species are, however, very small and
      morphologically indistinguishable within species, although strains of a given
      species differ in their efficiency to control specific insect pests. Traditional
      taxonomy is unable to differentiate microhymenoptera species at the strain level.
      It is becoming increasingly important to develop a reliable system to monitor
      genetic variations both within and between strains of commercially important
      microhymenoptera, to detect genetic drift occurring during several generations of
      multiplication, to protect patents, and to certify the lots of commercially
      released microhymenoptera. We have developed a system based on DNA markers to
      rapidly characterize individuals of five species of microhymenoptera from the
      genus Anaphes and Trichogramma including a new species of Anaphes not previously
      described. The main components of our system are a rapid and simple DNA micro
      extraction method and fast DNA polymorphism analyses based on random amplified
      polymorphic DNA markers.

PMID- 8349129
TI  - Molecular characterization of a mouse Y chromosomal repetitive sequence amplified
      in distantly related species in the genus Mus.
AB  - This report describes a 1.1 kb long mouse Y chromosomal sequence designated 142
      4. It has a 42% GC content and is rich in short direct and inverted repeats. 142
      4 related sequences are repeated about 200 times in the Mus musculus Y chromosome
      and their distribution was visualized by in situ hybridization. 142-4 detected a
      restriction fragment length polymorphism that differentiated between the M. m.
      musculus type and the M. m. domesticus type Y chromosome. Southern blot analysis
      of DNAs isolated from a panel of mouse species showed that 142-4 related
      sequences were amplified in the Y chromosomes of M. minutoides, M. musculus, M.
      saxicola, M. spicilegus, and M. spretus but not in those of M. caroli, M. cookii,
      and M. pahari. These results suggest that 142-4 related sequences are
      evolutionarily unstable and their accumulation patterns do not correlate with the
      known phylogenetic relationships of mouse species in the genus Mus.

PMID- 8349130
TI  - Potential of trispecies bridge crosses and random amplified polymorphic DNA
      markers for introgression of Medicago daghestanica and M. pironae germplasm into
      alfalfa (M. sativa).
AB  - This report describes the production and cytology of the first interspecific
      hybrids between cultivated alfalfa (Medicago sativa L.) at the diploid level (2n
      = x = 16) and the diploid (2n = 2x = 16) perennial species M. daghestanica and M.
      pironae. An ovule-embryo culture technique was required to rescue hybrid embryos
      and all hybrids were diploid. Predominately bivalent chromosome pairing was
      observed at meiotic metaphase. All F1 hybrids were male and female sterile and no
      species backcross progeny could be produced. We discovered that trispecies
      hybrids could be efficiently recovered via crossing diploid F1 interspecific
      hybrids of M. sativa x M. rupestris with either M. daghestanica or M. pironae.
      Ovule-embryo culture was also required to recover these trispecies hybrids with
      recovery efficiency of trispecies hybrids about 10 times greater than for
      bispecies hybrids. Most chromosomes paired as bivalents in the trispecies
      hybrids. Importantly, progeny can be recovered from crossing the trispecies
      hybrids with M. sativa. Therefore, the M. sativa x M. rupestris hybrids provide a
      bridge cross to potential introgression of M. daghestanica or M. pironae
      germplasm. Analysis of randomly amplified polymorphic DNA (RAPD) markers in the
      trispecies hybrids indicates that RAPD markers offer considerable potential for
      assaying germplasm introgression following complex hybridization of the type
      reported here.

PMID- 8349131
TI  - Application of the random amplified polymorphic DNA technique for the detection
      of polymorphism among wild and cultivated tetraploid wheats.
AB  - Development of a high-density genetic linkage map of cultivated wheats using
      conventional molecular markers has lagged behind the other major food crops such
      as rice and tomato because of the large genome size and limited levels of genetic
      polymorphisms. Recently, random amplified polymorphic DNAs (RAPDs) have been
      suggested to provide an alternative to visualize more polymorphism. For the
      construction of a genetic linkage map in tetraploid wheats, one can use a
      strategy of intersubspecific crosses between the most dissimilar wild and
      cultivated tetraploid wheats that are easy to hybridize and result in fertile
      progeny. An assessment of the level of RAPDs among different accessions and
      varieties of wild and cultivated tetraploid wheats is required to fulfill this
      objective. We present here the data obtained using RAPD analysis of 40 primers in
      20 accessions of wild tetraploid emmer wheats (Triticum turgidum L. ssp.
      dicoccoides) and 10 genotypes of cultivated tetraploid durum wheats (Triticum
      turgidum L. ssp. durum) selected from geographically diverse locations. We have
      observed a higher level of polymorphism among different accessions of wild emmer
      wheat from Israel. Turkey, and Jordan than the group of cultivated American,
      Turkish, and Syrian durum wheats. These data have been used to generate a
      dendrogram suggesting the genetic relationships among these genotypes, and the
      most dissimilar genotypes are identified for future mapping and gene tagging
      work.

PMID- 8349132
TI  - [Acute myocardial infarct and pregnancy. Report of a case and review of the
      literature].
AB  - We present the case of a 39 year old woman with 36 weeks pregnancy and acute
      myocardial infarction seen at the Hospital ABC. Acute myocardial infarction
      during pregnancy is not very common and it's incidence has been calculated in
      1:10,000 pregnancies it takes place more often during the third trimester, so we
      have to keep it in mind for early diagnosis. Mortality increases when it occurs
      during the third trimester close to delivery, during labor or in the first 7 days
      post delivery. Initial management of this high risk patients has to be done in a
      intensive care unit and requires of the intervention of multiple specialists, to
      decrease maternal and fetal mortality.

PMID- 8349133
TI  - [McIndoe operation in a case of vaginal agenesis. Considerations on the subject].
AB  - Congenital absence of the vagina depends on partial or complete failure of
      Mullerian duct development. The ovaries develop normally and the fimbrial ends of
      the tubes are vestigial but there is no uterus, cervix or vagina. The urinary and
      genital systems and some skeletal portions developing from Mullerian ducts are so
      closely linked embryologically that congenital abnormality of kidney and bones is
      said to accompany genital defects in approximately 20% of cases. Several surgical
      techniques have been proposed but the gynecologist can have sufficient experience
      to choose the most suitable treatment according to the pecularities of each case.
      McIndoe Operation offers the best possible result opening a space between the
      ureta and the rectum and placing within in a large penile shaped mold draped with
      a split skin graft. This operation can result in a vagina that looks and feels
      absolutely normal but the most discouraging however is the time required for the
      completion of the whole treatment. There are several photos illustrating the
      procedure.

PMID- 8349135
TI  - [Conservative therapy of ectopic pregnancy with methotrexate].
AB  - Ectopic pregnancy (EP) treated by traditional methods, signifies an approximate
      lose of fertility capacity of the patient, of 50%. The early diagnosis allows
      conservative treatment with metotrexate (MTXE), with the objective of preserving
      the affected tube (salpynx) and its function. Early detection of EP, intact, was
      done, in 11 cases, with the following parameters: clinical picture,
      ultrasonography (Us) (empty uterus, adnexial mass and free fluid; adnexial ring
      or extrauterine embryo); quantitative determination of beta fraction of chorionic
      gonadotropin (CGH b) and laparoscopic observation, when the following
      characteristics were met: tubal pregnancy, no greater than 30 mm, intact tubarian
      serosa, lack of active bleeding and visualization of all pelvic cavity. MTXE 12.5
      mg, intrasacularly via laparoscopy in eight patients, and three by laparotomy.
      The ulterior control of the procedure was: careful surveillance during eight
      days, Us daily and CGH b in two occasions; ten patients evolutionated
      satisfactorily, two of them required additional dosis of MTXE, parenterally, 0.5
      mg/kg and citovorum factor, 0.1 mg/kg/4 days. The obtained conclusions are: 1.
      Conservative treatment with MTXE may be carried out provided the conditions
      established before, are met. 2. The patient's follow up must be precise and
      because of the high cost of the determination every third day of CGH b, Us may be
      used. Hysterosalpingography was done in five patients after six months of the
      procedure, and tubal permeability was seen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349134
TI  - [Ovulation induction with human menopausal gonadotropins in hypothalamic
      hypophyseal disfunction].
AB  - This is a report on the institutional experience of the use of Human Menopausal
      Gonadotropins (HMG) in anovulatory women diagnosed as hypothalamic-hypophysiary
      dysfunction of Group II of WHO with previous failure to chlomifen citrate
      therapy. In a period of three years 180 patients were gathered with 420 cycle of
      treatment, obtaining ovulation in 340 cycles (81%). The ovarian hyperstimulation
      syndrome (OHS) was present in 15 cases (3.5%). There were 115 pregnancies that
      correspond to 33.8% of oculatory cycles and to 63.8% of the amount of patients.
      Multiple pregnancy incidence was 10.4%, and the gestational loses rate was 26%;
      these results are similar to what has been reported in literature. It is
      concluded that this medication is a good option of treatment for this type of
      patients, provided that there are the necessary means to expert and adequate
      surveillance.

PMID- 8349136
TI  - [Guillain-Barre syndrome and pregnancy].
AB  - Guillain-Barre syndrome is a rare occurrence in pregnant women. We describe the
      case of a 21-year old woman, seen at "Nuevo Hospital Civil de Guadalajara" with a
      term pregnancy, who presented with limbs weakness and paresthesias, drowsiness
      and malaise. Her vital signs were normal but she was quadriparetic, there was
      muscular atrophy in the extremities and deep tendon reflexes were decreased.
      Spinal fluid analysis revealed a protein of 71.2 mg/dl, glucosa 48 mg/dl and no
      white cells and both Gram stain and routine cultures were negative. EMG studies
      reported poliradiculoneuritis; a C-section was done, and both the mother and a
      newborn girl did very well. Guillain-Barre syndrome should be suspected in
      similar cases in order to offer prompt intervention.

PMID- 8349137
TI  - Protection by vitamin E, selenium, and beta-carotene against oxidative damage in
      rat liver slices and homogenate.
AB  - Male Sprague-Dawley (SD) rats were fed a vitamin E and selenium deficient diet
      and diets supplemented with vitamin E, selenium, beta-carotene, and a combination
      of the three. Tissue slices and homogenate of liver were incubated at 37 degrees
      C with and without the presence of prooxidants. The effect of vitamin E,
      selenium, beta-carotene, and the combination of the three antioxidants on the
      oxidative damage to rat liver tissue was studied by measuring the production of
      oxidized heme proteins in both tissue slices and homogenate during spontaneous
      and prooxidant-induced oxidation. The diet with the combination of all three
      antioxidants showed a strong protective effect against oxidative damage to heme
      proteins in contrast to the antioxidant-deficient diet. In general, diets with
      vitamin E, selenium, and beta-carotene were less effective than the combination
      of all three antioxidants. The protective effect of antioxidants on the heme
      protein oxidation was correlated with their inhibitory effect on lipid
      peroxidation measured as the production of thiobarbituric acid-reactive substance
      (TBARS). The protection of antioxidants on heme proteins was also dependent on
      the type of oxidation inducer. Possible mechanisms of antioxidants against
      oxidation in liver tissues are discussed.

PMID- 8349138
TI  - Recognition of oxidized DNA bases by sera of patients with inflammatory diseases.
AB  - Chronic inflammatory conditions result from or contribute to many diseases.
      Prominent among them is systemic lupus erythematosus (SLE). Sera of SLE patients
      contain an array of various auto-antibodies (Ab), including antinuclear Ab of
      unknown etiologies. The most puzzling is formation of Ab directed against
      autologous DNA. Our hypothesis was that increased oxidant production causes
      oxidation of DNA bases, which provide antigenic determinants that elicit
      antioxidized DNA Ab. To test this hypothesis, we used oxidized DNA nucleoside (5
      hydroxymethyl-2'-deoxyuridine [HMdU]) conjugated to bovine serum albumin (HMdU
      BSA) as the antigen. The results of the enzyme-linked immunosorbent assay showed
      that these Abs are sensitively detectable in SLE sera and sera of various other
      inflammatory autoimmune diseases. The titers of anti-HMdU Ab were significantly
      higher (p < .01) than those present in the control sera. Anti-HMdU Ab were
      predominantly of the IgM isotype, with low levels of IgG and no IgA. Anti-HMdU Ab
      bound to the HMdU-BSA-coated wells in a concentration- and time-dependent manner.
      That binding was inhibited by HMdU-BSA and to a lesser extent by thymidine-BSA, a
      normal nucleoside conjugate. The specific binding appears to be inversely related
      to the age of the patients, but no significant differences were observed between
      the sexes of the same age.

PMID- 8349139
TI  - Interaction of viable group A streptococci and hydrogen peroxide in killing of
      vascular endothelial cells.
AB  - Previous studies have shown that the streptococcal hemolysin, streptolysin S, is
      capable of interacting with hydrogen peroxide (H2O2) to injure vascular
      endothelial cells (Free Radic. Biol. Med. 7:369-376; 1989). To extend these
      observations, intact group A streptococci (strain 203S) were examined for ability
      to injure endothelial cells alone and for ability to injure the same cells in the
      presence of sublethal concentrations of H2O2 (generated from glucose/glucose
      oxidase). While neither control bacteria nor bacteria that had been pretreated
      with poly-L-histidine to render them cationic were cytotoxic to endothelial cells
      by themselves under the conditions of the experiment, endothelial cells were
      injured by combinations of streptococcal cells and sublytic amounts of H2O2.
      Taken together, these data suggest that the sequelae which often occur following
      primary infection with group A streptococci may be the result of a combined
      assault of host inflammatory cells and the invading bacteria on the vascular
      lining cells of the host.

PMID- 8349140
TI  - Oxidation of heme proteins as a measure of oxidative damage to liver tissue
      slices.
AB  - Oxidative damage to heme proteins in rat liver tissue slices was studied. Tissue
      slices were incubated in Krebs-Ringer phosphate (KRP) buffer at 37 degrees C with
      and without the presence of prooxidants. The absorbance spectra (500-640 nm) of
      heme proteins of tissue slices obtained from both spontaneous and prooxidant
      induced oxidation were analyzed with a heme protein spectra analysis program
      (HPSAP) developed in this laboratory. The dominant heme proteins in a fresh
      nonperfused tissue slice were hemoglobin and reduced cytochromes of mitochondria.
      In an oxidized tissue slice, the major oxidized product was hemichrome.
      Bromotrichloromethane, t-butyl hydroperoxide, and ferrous ion accelerated the
      oxidative reactions, and the amount of oxidized products was dependent on the
      incubation time as well as the type and concentration of prooxidants.

PMID- 8349141
TI  - Boomerang effect between [Met]-enkephalin derivatives and human polymorphonuclear
      leukocytes.
AB  - [Met]-enkephalin or its precursor, pre-[Met]-enkephalin, were exposed to
      activated oxygen species produced by human phorbol myristate acetate (PMA)
      stimulated polymorphonuclear leukocytes (PMNs) and then analyzed by high-pressure
      liquid chromatography (HPLC). The chromatograms recorded at the tyrosine maximum
      wavelength (lambda em 300 nm and lambda ex 280 nm) showed the formation of new
      peptides by oxidation of methionyl residue in position 5 and ortho, meta, or para
      hydroxylation of phenylalanyl residue in position 4. The chromatograms recorded
      at the dityrosine maximum wavelength (lambda em 400 nm and lambda ex 325 nm)
      showed the formation of new dimeric peptides which contained two [Met]-enkephalin
      derivatives linked by a dityrosyl group. These new peptides were tested for
      chemiluminescence response to PMA-stimulated PMNs. [Met]-enkephalin, pre-[Met]
      enkephalin, and the methionyl-oxidized derivatives suppressed the PMA-induced
      respiratory burst of PMNs. Conversely, after hydroxylation by activated oxygen
      species released by stimulated PMNs, these peptides enhanced the PMA-induced
      respiratory burst of PMNs. In the same conditions, dimeric peptides had no
      effect.

PMID- 8349142
TI  - Hyperoxic lung injury in Fischer-344 and Sprague-Dawley rats in vivo.
AB  - Supplemental oxygen remains an important therapy for pulmonary insufficiency,
      despite the potential adverse effects of hyperoxic exposures. Recently, He et al.
      reported that hyperoxic ventilation more readily damaged isolated perfused lungs
      from Fischer-344 rats than from Sprague-Dawley rats (Am. J. Physiol. 259:L451),
      which correlates with the previously reported strain differences in hepatic
      responses to diquat-induced oxidant stress in vivo (J. Pharmacol. Exp. Ther.
      235:172). We therefore examined the differences in hyperoxic lung injury in
      Fischer-344 and Sprague-Dawley rats in vivo. Adult male rats were exposed to >
      95% O2 and were sacrificed after 24, 48, or 60 h. Control animals were maintained
      in room air. Dramatically greater increases in pleural effusions and
      bronchoalveolar lavage protein concentrations in response to hyperoxia were
      observed in the Fischer-344 rats than in the Sprague-Dawley rats (p < .05 at both
      48 and 60 h for both measurements). Additionally, the glutathione concentrations
      in alveolar lining fluid decreased from 800 microM to 115 microM in Fischer-344
      rats after 60 h of > 95% O2, but did not change in Sprague-Dawley rats. We
      conclude that the greater susceptibility of Fischer-344 than of Sprague-Dawley
      rats to hyperoxic lung injury in vitro reported previously also is observed in
      vivo and that this strain difference offers unique opportunities to study
      mechanisms of hyperoxic lung injury.

PMID- 8349143
TI  - Toxicity, single-strand breaks, and 5-hydroxymethyl-2'-deoxyuridine formation in
      human breast epithelial cells treated with hydrogen peroxide.
AB  - DNA damage induced by oxidants includes formation of DNA strand breaks as well as
      oxidative damage to DNA bases. We quantified both forms of DNA damage
      concurrently in two model human breast epithelial cell lines treated with
      hydrogen peroxide to compare the dose-dependent induction of each form of DNA
      damage with growth inhibition. Antioxidant defenses also were quantified. MCF-7
      breast cancer cells had relatively higher levels of non-protein thiols, oxidized
      glutathione (GSSG) reductase, catalase, and superoxide dismutase than did the MCF
      10A line of immortalized, but not transformed, human breast epithelial cells. The
      levels of antioxidant defenses were not predictive of endogenous oxidative DNA
      damage levels nor of toxicity and DNA damage induced by hydrogen peroxide. The
      endogenous levels of 5-hydroxymethyl-2'-deoxyuridine were higher in MCF-7 than
      MCF-10A cells. The cells were treated with 10-200 microM hydrogen peroxide for 15
      min at 37 degrees C in complete media. Low concentrations of hydrogen peroxide
      were growth stimulatory to both cell lines. At higher concentrations, growth
      inhibition by hydrogen peroxide was greater in MCF-7 than in MCF-10A cells.
      Accordingly, induction of both single-strand DNA breaks and 5-hydroxymethyl-2'
      deoxyuridine in DNA was greater in MCF-7 than MCF-10A cells. In both cell lines,
      the dose-dependent induction of single-strand breaks paralleled growth inhibition
      more closely than did formation of 5-hydroxymethyl-2'-deoxyuridine.

PMID- 8349144
TI  - Glutathione system of human retina: enzymatic conjugation of lipid peroxidation
      products.
AB  - The major aspects of the glutathione (GSH)-related antioxidant defense of human
      retina are presented. These include concentration of GSH and activities of some
      GSH-dependent enzymes: glutathione peroxidase, glutathione disulfide reductase,
      and glutathione S-transferase toward a broad spectrum substrate 1-chlor-2,4
      dinitrobenzene and a toxic product of lipid peroxidation (4-hydroxynonenal). The
      presence of a relatively high GSH concentration, GSH peroxidase activity, and GSH
      S-transferase specific activity toward 4-hydroxynonenal in human retina might
      constitute a central defense mechanism in inflammation-promoted oxidative stress
      and subsequent lipid peroxidation. The use of different substrates for the
      determination of the GSH peroxidase activity showed no statistically significant
      difference, thus suggesting the lack of Se-independent GSH peroxidase in human
      retina. Large individual variations were obtained for GSH concentration and the
      different activities tested; the apparent correlation with age of these findings
      is currently under investigation.

PMID- 8349145
TI  - Richard O. Recknagel.

PMID- 8349147
TI  - Trevor F. Slater.

PMID- 8349146
TI  - 32P-postlabeling assay for free radical-induced DNA damage: the formamido remnant
      of thymine.
AB  - A prominent lesion in DNA exposed to oxidative free radicals results from the
      degradation of thymine leaving a formamido remnant. A 32P-postlabeling assay has
      been developed for the detection of the formamido lesion. The assay is based on
      the circumstance that the lesion prevents hydrolysis by nuclease P1 of the
      phosphoester bond 3' to the damaged nucleoside. Thus, a nuclease P1 plus acid
      phosphatase digest of DNA generates mostly nucleosides whereas the formamido
      lesion is rendered as a modified dinucleoside monophosphate. Dinucleoside
      monophosphates, but not nucleosides, are apt substrates for 32P-postlabeling by
      polynucleotide kinase. The assay was applied to calf thymus DNA X-irradiated in
      oxygenated solution. The formamido lesion could be detected down to a dose of a
      few Gy.

PMID- 8349148
TI  - Interaction between allopurinol and copper: possible role in myocardial
      protection.
AB  - Allopurinol, a potent inhibitor of xanthine oxidase, is known to effectively
      protect the heart against damage in patients undergoing cardiac bypass surgery.
      There is still an ambiguity concerning the presence of xanthine oxidase in the
      human heart. Thus, the mechanism underlying the protective effect of allopurinol
      is unclear. Transition metal ions, such as iron and copper, can participate in
      single-electron reactions and mediate the formation of oxygen-derived free
      radicals. In this study the interaction between allopurinol and Cu(II) was
      investigated. Spectrophotometric investigation shows that allopurinol (0-0.8 mM)
      form a 1:1 complex with Cu(II) ions (0-0.8 mM) with a specific absorbance peak at
      364 nm. Also, the rate constant (k) for the copper-catalyzed aerobic oxidation of
      ascorbate was markedly decreased in the presence of allopurinol (from 0.068 min-1
      to 0.014 min-1). Allopurinol substantially reduced the copper-mediated and
      ascorbate-driven DNA breakage. Spectrophotometric measurements did not indicate a
      specific interaction between iron ions and allopurinol. It is suggested that the
      beneficial effects of allopurinol during reperfusion of the heart could stem from
      its chelation of copper, yielding a complex with low redox activity.

PMID- 8349149
TI  - Color Doppler sonography of ovarian masses: the importance of a multiparameter
      approach.

PMID- 8349150
TI  - Evidence supporting the superiority of intraperitoneal cisplatin compared to
      intraperitoneal carboplatin for salvage therapy of small-volume residual ovarian
      cancer.
AB  - PURPOSE: To examine the relative efficacy of cisplatin-based intraperitoneal (IP)
      therapy versus carboplatin-based IP therapy as salvage treatment of small-volume
      residual ovarian cancer. PATIENTS AND METHODS: We retrospectively examined the
      surgically defined response rates of patients with ovarian cancer treated at the
      Memorial Sloan-Kettering Cancer Center on four organoplatinum-based salvage IP
      trials (cisplatin/etoposide, cisplatin/cytarabine, carboplatin/etoposide,
      carboplatin/etoposide + recombinant human erythropoietin). Additional criteria
      for inclusion in this analysis were: (a) small-volume residual disease
      (microscopic disease only or largest residual tumor mass < or = 0.5 cm) when IP
      therapy was initiated; (b) prior response to organoplatinum-based systemic
      therapy; (c) laparotomy evaluation for response to the IP salvage program.
      RESULTS: The surgically documented complete response rate for patients with
      microscopic disease treated with cisplatin-based or carboplatin-based therapy was
      46% (6/13) versus 38% (6/16), respectively (P > 0.25). In contrast, the
      surgically documented overall and complete response rates for patients with small
      volume macroscopic disease treated with cisplatin or carboplatin were 71% (12/17)
      versus 32% (6/19) (P < 0.05, chi 2 test with Yates' correction), and 41% (6/17)
      versus 11% (2/19) (p < 0.1), respectively. CONCLUSION: In agreement with
      experimental data demonstrating that the concentration of platinum within tumor
      is higher following equimolar doses of cisplatin, compared to carboplatin, we
      have observed, in this retrospective analysis, a higher surgically documented
      response rate for patients with small-volume residual macroscopic ovarian cancer
      receiving salvage cisplatin-based IP therapy. While a randomized trial will be
      required to definitively address the question of the relative effectiveness of
      the two commercially available organoplatinum agents for IP treatment of ovarian
      cancer, our data suggest that cisplatin is the superior agent for regional
      therapy in this disease.

PMID- 8349152
TI  - Parovarian fibroma with heterotopic bone formation of probable wolffian origin.
AB  - Parovarian neoplasms of wolffian duct origin are very unusual. This article
      presents the first report of a case of parovarian fibroma with heterotopic bone
      formation of probable wolffian duct origin. The tumor cells present among mature
      collagen bundles were fibroblast-like cells, while those at the sites of cellular
      proliferation were either undifferentiated mesenchymal cells or had
      differentiated into osteoblasts. In the bone matrix, the tumor cells had
      differentiated into osteoblasts and connective tissue had ossified.

PMID- 8349151
TI  - Uterine leiomyosarcoma and endometrial stromal sarcoma: lymph node metastases and
      sites of recurrence.
AB  - This study was undertaken to examine the incidence and conditions under which
      lymph node metastases are present and patterns of recurrence in women with
      uterine leiomyosarcoma (LMS) and endometrial stromal sarcoma (ESS), excluding
      malignant mixed mesodermal tumors. From 1981 through 1991, 21 women with LMS and
      10 women with ESS were treated. Retroperitoneal lymph node dissections were
      performed in 15 women with LMS and 7 women with ESS. In the women with LMS, 4/15
      (26.7%) had lymph node metastases; in each there was disseminated intra-abdominal
      disease. In the 7 women with ESS, there were no lymph node metastases present.
      Ten women (47%) with LMS developed recurrences, and 3 (14%) had persistent
      disease. In the 10 women with ESS, 3 (30%) had recurrences, and 1 (10%) had
      persistent disease. In total, recurrences involved the lung in 84% of cases. Of
      the 13 women with recurrences, 7 had undergone lymph node sampling, and all were
      negative; 4 additional women had no evidence of adenopathy on abdominal-pelvic CT
      scan. Lymph node metastases were found only with extrauterine disease, and in all
      of these cases there was rapid progression of the sarcoma. Women without
      extrauterine disease did not have lymph node metastases detected; however, there
      was still a high rate (40%) of distant failure. Knowledge of lymph node status
      had minimal impact on the clinical management of women with uterine LMS and ESS.

PMID- 8349153
TI  - Complete hydatidiform mole coexistent with a twin live fetus: clinical course of
      four cases with complete cytogenetic analysis.
AB  - Twin gestations can occur in which one twin is a normal gestation (46
      chromosomes: 23 maternal and 23 paternal origin) and in which the other twin is a
      complete hydatidiform mole (46 chromosomes all of paternal origin). Case reports
      of four such combined pregnancies that presented to a single institution are
      provided. All cases had documentation of clinical information, cytogenetic
      analysis, and fetal and placental pathology. Three of the four pregnancies were
      terminated for medical indications despite information documenting the presence
      of a normal fetus. All three of these patients required subsequent chemotherapy.
      The fourth case was followed conservatively and resulted in the birth of a normal
      infant at 38 weeks gestation. We speculate that the factors that led to the need
      for termination of the pregnancy (aggressive growth of trophoblast) may predict
      the need for further therapy. A true assessment of the antenatal and malignant
      sequelae risks associated with these rare gestations awaits the collection of a
      larger series of patients.

PMID- 8349154
TI  - Isolated parenchymal splenic metastasis in epithelial ovarian cancer.
AB  - Metastatic parenchymal splenic disease in patients with ovarian cancer is
      unusual. It is most commonly seen in the presence of large-volume upper abdominal
      disease when parenchymal involvement occurs by surface extension. A patient with
      isolated parenchymal splenic metastasis and no peritoneal disease in the abdomen
      at primary surgery is described.

PMID- 8349155
TI  - Ovarian carcinoma presenting with inguinal metastatic lymphadenopathy 33 months
      prior to intraabdominal disease.
AB  - Ovarian carcinoma normally presents at an advanced stage of disease, with
      symptoms of gastrointestinal disturbances. We report a case of ovarian carcinoma
      presenting with metastatic inguinal lymphadenopathy which preceded any evidence
      of intraabdominal disease by 33 months. This is the first report of such a case.
      It defies the expected presentation and course of ovarian malignancies. The case
      is all the more rare when the incidence of inguinal node involvement in ovarian
      cancer is considered. The management of this patient and theoretical explanations
      are discussed.

PMID- 8349156
TI  - Squamous cell carcinoma arising in a mature cystic teratoma with metastasis to
      the paraaortic nodes.
AB  - Accurate surgical staging is critical to the management of early ovarian cancers.
      A patient with squamous cell carcinoma arising from a mature cystic teratoma was
      found to have paraaortic nodal metastasis as her only evidence of extraovarian
      disease. Extended field radiation therapy to the pelvis and paraaortic nodes with
      concomitant cisplatin and adjuvant chemotherapy failed to control her disease.
      Inadequate surgical staging may explain the recurrences in apparent stage I
      disease.

PMID- 8349157
TI  - Genetic risk in ovarian cancer.

PMID- 8349158
TI  - Interleukin-6 (IL-6) functions as an autocrine growth factor in cervical
      carcinomas in vitro.
AB  - Many factors have been implicated in the etiology of cervical neoplasia, with
      human papilloma virus being the latest in a long line of agents that may on their
      own or in combination exert various initiating and promoting effects on cervical
      cells, resulting in their transformation. However, for such altered cells to
      become invasive, it is clear that they must undergo alterations in their rate of
      turnover, state of differentiation, and motility. We have investigated the
      production of the multifunctional cytokine interleukin-6 (IL-6) by five new
      cervical carcinoma cell lines (XH1, EH2, DE3, JE6, and SM7) and the commercially
      available CaSki cell line, and have studied the effects of this cytokine on the
      growth of the cells in vitro. All the cell lines produce biologically active IL-6
      in amounts varying between 0.35 to 2.0 ng/ml. In the presence of goat anti-sera
      to IL-6 all the tumor cell lines showed inhibition of growth. IL-6 acts as an
      autocrine growth factor for in vitro cervical tumor cell growth.

PMID- 8349159
TI  - DNA flow cytometric analysis of clinical stage I endometrial carcinomas with
      lymph node metastases.
AB  - Twenty-one (8%) of 264 consecutive evaluable patients with clinical stage 1
      endometrial carcinoma had histologic evidence of pelvic and/or para-aortic lymph
      node metastases. DNA flow cytometry was performed on both the primary tumor and
      nodal metastasis. Seventeen of 21 sets could be analyzed. Overall, 11 (65%) of
      the primary carcinomas were aneuploid. Nine of 17 (53%) had consistent ploidy
      patterns when the primary tumor and lymphatic metastasis were compared. The
      remaining 8 (47%) had aneuploid primaries with diploid nodal metastases. Five
      (83%) of the 6 patients with diploid primary tumors were alive without evidence
      of disease compared to 3 of 11 (27%) patients with aneuploid tumors (P < 0.05).
      Other predictors of disease outcome included tumor histology, lymph vascular
      space invasion, and depth of myometrial invasion. Ploidy status of the lymphatic
      metastasis was not important in terms of overall survival. All 8 patients with
      para-aortic nodal metastases had aneuploid primary carcinomas compared to 4 (44%)
      of 9 patients with pelvic node involvement only (P < 0.01). Mean survival was 31
      months for patients with para-aortic node metastases compared to 51 months for
      patients with only pelvic node metastases. Comparison of survival curves among
      these two groups demonstrated a significant survival advantage in patients with
      regional nodal metastases (P = 0.032). S-phase fraction of both the primary tumor
      and lymphatic metastasis did not correlate with survival or predict disease
      outcome. DNA index of the primary tumor, as a continuous variable, was inversely
      proportional to survival, demonstrating poorer survivorship with incremental
      increases of DI. Ploidy status of the lymph node metastasis was an inconsistent
      reflection of the primary tumor's expression and behavior and, therefore, little
      additional information was gained by knowledge of the lymphatic ploidy status.

PMID- 8349160
TI  - Evaluation of DNA ploidy in endometrial cancer.
AB  - We performed a study to evaluate the relationships between the surgical stage
      (FIGO, 1989), histological tumor grade, myometrial invasion, peritoneal cytology,
      lymph node metastasis and prognosis, and DNA ploidy determined by flow cytometry
      in paraffin-embedded blocks of resected cancer lesions from 76 patients with
      uterine corpus cancer (adenocarcinoma endometrial type) who had been surgically
      treated in our hospital. The coefficient of variation was 5.00% on average (3.40
      to 5.30%) in DNA histograms of the 76 patients. DNA aneuploid was detected in 18
      patients (24%) and tended to be more frequently found in association with
      advanced surgical stage, higher histological tumor grade, deeper myometrial
      invasion, positive lymph node metastasis, and positive peritoneal cytology.
      Kaplan-Meier method was used to analyze the relationship between prognosis and
      DNA ploidy in 76 patients with uterine corpus cancer, in 36 with surgical stage
      III, and in 26 with surgical stage IIIa, resulting in prognosis which was
      significantly better in patients with DNA diploid. The results of multivariate
      analysis also indicate that DNA ploidy is an independent prognostic factor of
      uterine corpus cancer. These results suggest that DNA ploidy should be an
      important parameter for predicting prognosis of uterine corpus cancer.

PMID- 8349161
TI  - Mitomycin-C plus a 3-day continuous intravenous infusion of 5-fluorouracil: an
      inactive salvage regimen for platinum-resistant ovarian carcinoma.
AB  - In a Phase II trial, patients with refractory ovarian cancer were given 10 mg/m2
      mitomycin-C i.v. every 8 weeks and 1000 mg/m2/day 5-fluorouracil for 3
      consecutive days by continuous intravenous infusion repeated every 4 weeks.
      Sixteen heavily pretreated patients with platinum-resistant disease were treated
      and no major responses were observed. Only 2 patients required subsequent dose
      reduction for myelotoxicity. No sign of gastrointestinal toxicity was seen. This
      regimen is inactive as salvage treatment for refractory ovarian cancer.

PMID- 8349163
TI  - Failure to enhance the in vivo killing of human ovarian carcinoma by sequential
      treatment with dequalinium chloride and tumor necrosis factor.
AB  - Dequalinium chloride (DECA) is a cationic, lipophilic compound with structure
      similar to the dye rhodamine 123. DECA is selectively accumulated and retained
      within the mitochondria of carcinoma cells where it acts as a mitochondrial
      poison by blocking mitochondrial enzymes which can then disrupt cellular energy
      production, eventually resulting in cell death. In this manner it is similar to
      the antimitochondrial effects observed with tumor necrosis factor (TNF). We have
      previously shown that DECA can synergize the in vitro antitumor effects of TNF
      against a panel of human ovarian cancer cell lines. Those drug studies have been
      extended to a xenogenic tumor system with a resultant increase in animal
      survival. Athymic mice were injected intraperitoneally with 2.0 x 10(7) PA-1
      human ovarian cancer cells and DECA +/- TNF treatments begun either on Days 3 or
      7 postinjection. Peritoneal tumor implantation was not histologically confirmed
      by Day 3 postinjection but confirmed by Day 7 following tumor cell injection.
      Single-agent DECA (5 mg/kg; qod) increased animal survival by 37% (P = 0.002)
      whereas recombinant human TNF (0.5 micrograms/mouse; qod) only increased survival
      by 13% (P = 0.27) relative to control animals for those animals treated 3 days
      post-tumor-injection. Sequential DECA/TNF enhanced animal survival by 45% (P =
      0.0002) in similarly treated animals. When drug treatment was initiated 7 days
      following tumor injection, DECA increased survival by 23% (P = 0.04) while TNF
      had no effect on prolonging animal survival (3% increase; P = 0.79). Combination
      DECA/TNF increased survival by 23% (P = 0.04). In the UCI-101 ovarian tumor
      model, single-agent DECA increased survival by 28% (P = 0.04) while TNF treatment
      stimulated tumor growth (11% decrease in survival; P = 0.006). Combination DECA +
      TNF resulted in a 41% increase in survival (P = 0.003). No statistical
      differences were detected between survival rates for single-agent DECA vs DECA +
      TNF except for the UCI-101 tumor which showed potentiation due to the in vivo
      stimulatory effects of TNF.

PMID- 8349162
TI  - Absence of prohibitin gene mutations in human epithelial ovarian tumors.
AB  - Multiple loss of heterozygosity (LOH) studies of ovarian cancers have found a
      high incidence of chromosome 17 loss in these tumors. Several authors have
      suggested that the region commonly deleted encompasses 17q12-21. In addition,
      this region has recently been reported to be linked to the familial
      breast/ovarian cancer syndrome. Recently the human prohibitin gene was mapped to
      region 17q12-22. Prohibitin causes arrest of DNA synthesis by fibroblast and HeLa
      cells and prohibitin shows significant homology to a gene (Cc) thought to be
      important for the regulation of development of Drosophila melanogaster. These
      findings have led many to consider the prohibitin gene a potential tumor
      suppressor gene. In addition, sequence analysis of exon 4 of human prohibitin
      gene revealed mutations in 4 of 23 sporadic breast carcinomas. Because of the
      proposed function for prohibitin, its alterations in breast cancers, and the fact
      that its location on 17q falls within a commonly deleted region in ovarian
      cancers, we have undertaken an analysis of the sequence of prohibitin in
      epithelial ovarian cancers. Using several polymorphic DNA probes, we identified
      20 epithelial ovarian tumors which demonstrated LOH for the region that contains
      the prohibitin gene. To evaluate whether mutations of prohibitin may be important
      in ovarian carcinogenesis, we have sequenced exons 4 and 5 of this gene using the
      technique of genomic amplification with transcript sequencing. Only normal exon 4
      and 5 sequence was observed among the 20 tumors screened. These results
      demonstrate that this region of the prohibitin gene is not mutated in epithelial
      ovarian cancers and suggest that the prohibitin gene does not play a role in
      ovarian carcinogenesis. Sequencing of further exons and introns are needed to
      confirm this latter hypothesis.

PMID- 8349164
TI  - The etiology and management of diarrhea in the gynecologic oncology patient.
AB  - PURPOSE: We determined the etiology and evaluated the usefulness of diagnostic
      tests in 42 gynecologic oncology patients with diarrhea. METHODS: All inpatients
      who developed diarrhea during treatment for gynecologic cancer were prospectively
      evaluated during the 12-month study period ending June 1992. Diarrhea was defined
      as five or more loose stools per 24 hr lasting for 48 hr or more. Diagnostic
      tests were complete blood cell count; electrolytes; stool for occult blood, white
      blood cells, and Clostridia difficile toxin; and stool culture for Shigella,
      Salmonella, Yersinia, and Campylobacter. RESULTS: During the study period 351
      women with gynecologic cancer received inpatient care. Forty-two (12%) patients
      developed diarrhea. One patient had three episodes and another had two episodes
      of diarrhea. There were 39 evaluable patients; 3 patients were excluded due to
      incomplete tests. The only cause of bacterial-associated diarrhea was C.
      difficile, which occurred in 4 of 39 (10.3%) patients. No patient had community
      acquired diarrhea, and 1 patient had diarrhea due to Crohn's Disease. Surgery was
      performed on 265 patients; 29 of 265 (10.9%) developed postoperative diarrhea.
      Eighty-six patients had medical treatment and 13 (15.1%) developed diarrhea. The
      distribution by admission status of patients with diarrhea did not differ
      statistically from the patients without diarrhea. The four patients with C.
      difficile-associated diarrhea received appropriate therapy at the time of
      diagnosis. Nevertheless, the mean (SD) duration of C. difficile-associated
      diarrhea (342 (103) hr) was significantly longer than the mean (SD) duration of
      diarrhea not associated with this pathogen (79 (32) hr). The difference between
      the sample means is 263 hr with a 95% confidence interval for the difference
      between the means of 218 and 308 hr. Electrolyte abnormalities occurred in 20
      patients (51%). Fecal leukocytes were present in 11 (28%) patients and occult
      blood in 5 (12.8%) of the 39 patients. Neither study was predictive for the
      presence of C. difficile. CONCLUSION: Hospital-acquired diarrhea in gynecologic
      oncology patients is common, although specific bacterial pathogens requiring
      antibiotic therapy account for only 10% of cases. Diagnostic tests for infectious
      causes besides C. difficile are infrequently useful and may be omitted unless the
      condition persists more than 72 hr.

PMID- 8349165
TI  - The role of DNA index as a prognostic factor in early cervical carcinoma.
AB  - The value of DNA index as a prognostic factor in early cervical cancers was
      investigated. A total of 124 patients who underwent radical hysterectomy for
      stages IB-IA cervical cancers from 1/1982 to 12/1985 were included. Paraffin
      blocks were available in only 98 patients for the analysis. After dewaxing,
      rehydrating, and enzyme disaggregation, cells were subjected to dual parameter
      flow cytometry. Tumor DNA index was calculated and the results were correlated
      with 5-year survival, stage, grade, tumor size, nodal metastasis, surgical
      margins, and lymphovascular invasion. There were 1% hypoploid, 7.3% diploid,
      72.9% aneuploid, 16.7% tetraploid, and 2.1% hyperploid. At the end of 5 years,
      there were 69 alive and 27 dead patients with mean DNA indices of 1.50 +/- 0.3
      and 1.70 +/- 0.3, respectively. t Test analysis revealed that mean DNA index of
      deceased patients was significantly higher than that of alive ones (P = 0.008).
      Survival analysis demonstrated the prognostic significance of DNA index 1.70 (P =
      0.017). Median survival of patients with DNA index of 1.70 or greater was 36
      months in contrast to 73.5 months for those with DNA index less than 1.70.
      Multivariate analysis subsequently confirmed DNA index of 1.70 as an independent
      prognostic indicator with a hazard ratio of 2.05.

PMID- 8349166
TI  - Intraperitoneal (ip) cisplatin-mitoxantrone-interferon-alpha 2b in ovarian cancer
      patients with minimal residual disease.
AB  - Forty-one ovarian cancer patients with less than 2 cm residual disease after
      systemic cisplatin-based chemotherapy received 4 courses of an ip regimen
      including cisplatin (75 mg/m2), mitoxantrone (20 mg/m2), and interferon-alpha 2b
      (30 mil IU/m2). The most important side effects were abdominal pain and fatigue.
      Overall 15/41 patients (37%) required narcotic analgesia for severe abdominal
      pain. In 1 case laparotomy was necessary due to bowel obstruction. Grade 3-4
      myelotoxicity was observed in 18/41 patients (28 courses). No treatment-related
      death occurred. Pathological complete response (pCR) was achieved in 23/37 (62%)
      evaluable patients. Four-year disease-free survival was 50%, and no relapse
      occurred after 32 months. The estimated 4-year progression-free survival (PFS)
      and overall survival were 35 and 60%, respectively. Patients who achieved pCR
      showed significantly better survival than the others (P < 0.000). At multivariate
      Cox's analysis pCR achievement was the most important predictor of PFS (P <
      0.005) and survival (P < 0.02). Age (< or = 60 vs > 60) and CA-125 serum levels
      at entry (normal vs increased) also showed independent predictive value. On the
      basis of multivariate analysis results we created a risk model for survival and
      PFS based on age and CA-125 at entry. We identified three subgroups of patients
      with significantly different outcomes. With this new ip combination long-term
      disease-free survival is achieved in a significant part of ovarian cancer
      patients with small tumor burden. A longer follow-up is needed to see whether it
      can cure some of these patients, and further comparisons with other ip or
      systemic regimens are needed to draw definitive conclusions about its role in
      these patients.

PMID- 8349168
TI  - A comparison between loop diathermy conization and cold-knife conization for
      management of cervical dysplasia associated with unsatisfactory colposcopy.
AB  - Eighty-six women with cervical dysplasia and unsatisfactory colposcopy were
      managed with excisional conization--43 with outpatient loop diathermy conization
      under local anesthesia and 43 matched controls with cold-knife conization as
      inpatients under general anesthesia. Both groups were similar in terms of age,
      parity, and severity of dyskaryosis on initial cytology, treatment success rates,
      and completeness of excision. However, loop diathermy conization was
      significantly quicker (2.8 +/- 2.9 min vs 14 +/- 18.6 min) and associated with
      less intraoperative blood loss (3.3 +/- 2.8 ml vs 79.1 +/- 74.6 ml) (P < 0.01)
      than cold-knife conization. Furthermore, the proportion of women with at least
      one complication was significantly less following loop (4.7%) than cold-knife
      conization (20.9%) (P < 0.05). We conclude that outpatient loop diathermy
      conization performed under local anesthesia is quicker and causes less
      intraoperative blood loss and immediate postoperative complications than cold
      knife conization for management of cervical dysplasia associated with
      unsatisfactory colposcopy.

PMID- 8349167
TI  - Comparison of antigen expression on fresh and cultured ascites cells and on solid
      tumors of patients with epithelial ovarian cancer.
AB  - The antigenic phenotype of malignant cells from ascites of patients with
      epithelial ovarian cancers was examined and compared to that of their primary and
      metastatic sites. Cell-surface antigens on frozen sections of primary and
      metastatic tumors and frozen cell pellets from ascites were analyzed with a panel
      of murine monoclonal antibodies using the indirect immunoperoxidase method. In
      addition, ascites cells cultured with and without autologous cell-free ascitic
      fluid were evaluated by immunofluorescence. The pattern of antigen expression
      detected on fresh and cultured ascitic epithelial cells was shown to be identical
      to the expression in autologous solid tumor tissues. When placed in culture,
      malignant epithelial cells generally persisted for a minimum of one, but no more
      than five, passages. Addition of autologous ascitic fluid to cultures of ascites
      cells did not alter the phenotype of the epithelial tumor cell population and did
      not enhance the growth of these cells. From one culture of ascites cells a
      permanent malignant epithelial ovarian cancer cell line (designated SK-OV-8) was
      established. The demonstration that epithelial tumor cells found in ascites of
      patients with epithelial ovarian cancer have the identical antigenic phenotype as
      their solid tumor counterpart, at least for the panel of antigens studied, may be
      useful in planning imaging and therapeutic trials with monoclonal antibodies.

PMID- 8349169
TI  - Aborted exenterative procedures in recurrent cervical cancer.
AB  - Preparation for pelvic exenteration is a traumatic experience for every patient,
      especially so when the procedure has to be aborted because of advanced disease.
      This occurred in 111 of 394 patients who underwent exploration for possible
      pelvic exenteration for recurrent cervical cancer at the University of Texas M.
      D. Anderson Cancer Center between 1970 and 1990. We reviewed these cases to
      better delineate preoperative factors predictive of unresectability.
      Distributions of initial stages and pathological diagnoses were similar to those
      for all cases of primary cervical cancer. The median time from primary therapy to
      recurrence was 12 months. The reasons for aborting the procedure included the
      presence of peritoneal disease in 49 patients (44%), for which the only
      preoperative finding with significant correlation was the presence of a pelvic
      mass (P = 0.03). Other reasons for aborting the procedure included nodal disease
      in 45 patients (40%), related to a short interval from primary therapy (P =
      0.008) and the notation of fibrosis on preoperative exam (P = 0.01), parametrial
      fixation in 15 patients (13%), and hepatic lesions or bowel involvement in 5
      patients (4.5%). Peritoneal cytology was negative in 61 of 79 patients (77.2%)
      and was of predictive value only in patients with adenocarcinoma. In conclusion,
      disseminated disease can seldom be detected during preoperative work-up.
      Evaluation of nodal status with computed tomography, lymphangiogram and directed
      fine-needle aspiration, and examination of peritoneal cytology in cases with
      adenocarcinoma, are the best available means of reducing the number of aborted
      procedures.

PMID- 8349171
TI  - Immunoreactive endothelins in human follicular fluid.
AB  - Endothelin levels were measured by means of [125I]endothelin-1,2,3
      radioimmunoassay in the follicular fluids of 22 mature ovarian follicles of 11
      patients, obtained during ovum pickup. In all but 1 of the follicles, endothelin
      levels were detectable and ranged between 0.2 and 3.6 pg/ml (mean 1.47 +/- 0.99).
      In this preliminary study, no correlation was found between follicular endothelin
      levels and oocyte fertilization or the hormonal ovarian response during the
      follicular phase.

PMID- 8349170
TI  - Relationship between mean arterial pressure and parameters derived from blood
      flow velocity waveforms in the systemic circulation of fetal sheep.
AB  - In 8 fetal sheep under anesthesia, we examined the relationship between the fetal
      aorta blood flow velocity waveform and fetal mean arterial pressure after
      administration of norepinephrine and angiotensin II. It was hypothesized that the
      pulsatility index (PI) of the waveform would change during fetal hypertension.
      Measurements were performed using a 20-MHz Doppler transducer on the aorta
      directly beneath the diaphragm and a catheter inserted via the femoral artery
      into the abdominal aorta. Further instrumentation included a Doppler transducer
      and an electromagnetic flowmeter on the common umbilical artery and a catheter in
      the inferior vena cava. Fetal hypertension was induced by bolus administration of
      either norepinephrine or angiotensin II or by infusion of norepinephrine. With
      the Doppler transducer on the common umbilical artery, it was possible to study
      external iliac artery blood velocity waveforms in 4 fetal lambs, whereas aorta
      blood velocity waveforms were recorded in 7 fetal lambs. The measurements of
      external iliac artery PI and mean arterial pressure were characterized by a
      linear regression with a correlation coefficient of 0.72, whereas the
      measurements of aorta PI and mean arterial blood pressure were characterized by a
      linear regression with a correlation coefficient of 0.40. However, notable
      changes were observed in the aorta blood velocity waveform, which were not
      expressed by a substantial increase in the aorta PI. These changes can be
      described as a narrowing of the systolic peak and an earlier occurrence of the
      first dicrotic notch.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349172
TI  - Ambivalence during early pregnancy among expectant mothers.
AB  - Ambivalence during the early stages of pregnancy is a known phenomenon, among
      expectant mothers as well as among applicants for abortion. The conflict of
      wanting or not wanting to have a child must be solved in the decision-making
      process that precedes the choice of whether to interrupt a pregnancy or carry it
      to full term. The time limit for this decision making process is reduced by the
      medical abortion methods now available. Hasty early abortions as well as delayed
      abortions create problems and should be avoided. The present Swedish study, based
      on 123 semistructured interviews conducted among expectant mothers, focuses on
      this ambivalence during early pregnancy. Fifty-five percent of the interviewees
      reported that the current pregnancy was planned, 14% had become pregnant in spite
      of using contraceptives. Fifteen percent had considered an abortion during the
      current pregnancy. Ten in-depth interviews revealed how women contemplating
      abortion dealt with their ambivalence and finally decided to continue the
      pregnancy. The study shows that no one but the pregnant woman herself can arrive
      at the informed analysis necessary for a well-considered decision about the
      future of her pregnancy. However, all pregnant women should be offered the
      opportunity to talk about their situation, their thoughts and feelings to a
      neutral listener, in order to make that decision.

PMID- 8349173
TI  - Collagenolytic effect of disintegrated bacterial cell extracts on the human
      amniotic membrane at term pregnancy.
AB  - Bacterial ascending from the cervix may infect the membranes and amniotic fluid,
      contributing to their premature rupture. In the present in vitro study, isolated
      amniotic membranes were exposed to different concentrations of disintegrated
      bacterial cells. Collagenolysis was estimated by the ratio of acid
      soluble/insoluble hydroxyproline. The amniotic membrane proteins were separated
      by electrophoresis after incubation with 14C proline and disintegrated bacterial
      cells. The proportion of soluble hydroxyproline increased with the bacterial
      concentration used, and the radioactivity decreased in proteins of the 30- to 80
      kD range. The data support the notion that bacteria contain collagenolytic
      enzymes affecting human amniotic membranes.

PMID- 8349174
TI  - Serum levels of creatine kinase and its isoenzymes during the 1st postpartum day
      in healthy newborns delivered vaginally or by cesarean section.
AB  - The purpose of this study is to investigate the relationship of creatine kinase
      (CK) and its isoenzyme levels in the newborn to the mode of delivery, time
      interval from birth (divided in four 6-hour time periods), parity and sex of the
      neonates. During the 1st postpartum day, serum levels of CK and its isoenzymes
      (CK-MM, CK-MB, CK-BB) were determined from 115 healthy full-term neonates born
      consecutively either by spontaneous vaginal delivery (VD, n = 85) or by elective
      cesarean section (CS, n = 30). The multiple regression analysis was applied.
      Total CK levels were positively correlated with VD (p < 0.0003). This was mainly
      attributed to a rise in the CK-MM activity which presented a similar pattern to
      CK. CK-MB activity was also positively correlated with VD. In contrast, CK-BB was
      negatively correlated to the postpartum time period. Neonatal sex and parity did
      not influence CK and its isoenzyme levels significantly. In conclusion, VD
      contributes significantly to an increase in CK levels during the 1st day of
      extrauterine life.

PMID- 8349175
TI  - Effects of testosterone on the development of endometrial tumors in female rats.
AB  - Long-term treatment of mature virgin female rats with a high dose of testosterone
      (24 weeks at a total dose of 300 mg) was associated with the development of
      endometrial adenomatous hyperplasia and resulted in a high incidence of
      adenocarcinoma when administered in combination with 7,12-dimethyl
      benz[a]anthracene (DMBA; 2 mg in 0.1 ml sesame oil) introduced into the uterine
      cavity. Adenomatous hyperplasia occurred in all testosterone-treated rats, both
      with and without ovaries. Testosterone may promote the induction of endometrial
      tumors by DMBA.

PMID- 8349176
TI  - Developmental steps for radionuclide hysterosalpingography.
AB  - The active oviductal transportation capacity was studied in 73 infertile women by
      the use of a new deposition technique of radioactive particles into the internal
      cervical os. The main reason for this study was that a previous observation had
      shown that such a transportation capacity was lacking in 41% of the infertile
      patients with a normal hysterosalpingogram. The examination was performed in the
      immediate preovulatory phase, i.e. on days -3 to 0 before the ovulation, as
      measured by the basal body temperature during two preceding cycles. The
      deposition of 99mTc-labelled albumin particles of 0.2-1.0 micron at the internal
      cervical os and the interpretation of the radionuclide images are described in
      detail. The results show that the bilateral active tubal transportation capacity
      was present in 42 patients. An impaired transportation capacity was diagnosed in
      22 patients. In 9 patients, the particles never reached the uterine cavity, or
      all activity leaked back to the vagina.

PMID- 8349177
TI  - Tumor necrosis factor in plasma and peritoneal fluid of women with and without
      endometriosis.
AB  - To determine whether in vivo levels of tumor necrosis factor a in plasma and
      peritoneal fluid differ in infertile subjects with and without endometriosis,
      peripheral blood and peritoneal fluid samples were collected in 94 women
      undergoing laparoscopy for infertility. Quantitative determinations of tumor
      necrosis factor a were performed by an enzyme immunoassay test. Tumor necrosis
      factor a levels were below the detection limit (10 pg/ml) in plasma and
      peritoneal fluid of 42 (91%) and 30 (90%) patients with endometriosis and 40
      (83%) and 31 (91%) subjects without the disease, respectively. In our series,
      plasma and tumor necrosis factor a levels were not different in infertile women
      with and without endometriosis.

PMID- 8349178
TI  - Natural volume handwashing urethrocystometry: a physiological technique for the
      objective diagnosis of the unstable detrusor.
AB  - A group of 163 patients attending with a naturally full bladder had
      urethrocystometric assessment during provocation with a handwashing test. The
      results were compared with those from a similar group of 169 patients who were
      subjected to a handwashing test following the infusion of 500 ml of saline with
      fast-fill cystometry. The latter group was found to have an unacceptably high
      number of false-positive results. Also, the results appear to indicate that urine
      loss due to uncontrolled detrusor contraction may be mainly due to premature
      activation of the micturition reflex. A fall in the intraurethral pressure was
      found in 79% and a rise in detrusor pressure in 49% of the patients presenting
      with a prior history of an unstable bladder. Natural urethrocystometry appears to
      be a useful and informative technique for objectively assessing patients with a
      prior history of bladder instability.

PMID- 8349179
TI  - Effects of hyaluronate, strontium and prolonged incubation on different sperm
      parameters.
AB  - The aim of this study was to evaluate the effect of hyaluronate and strontium
      with short and prolonged incubation periods on different sperm parameters. For
      sperm intended for in vitro fertilization good progressive motility, a high
      percentage of normal form, a suitable linear velocity and a low acrosome-reacted
      proportion of sperm are required. The semen washing procedure in the self
      migration method with medium containing hyaluronate Ca2+ after 3 h of incubation
      complies better with these criteria.

PMID- 8349180
TI  - Magnetic resonance imaging angiography in a case of eclampsia.
AB  - We experienced a typical case of eclampsia. After the onset of eclampsia, we
      performed magnetic resonance imaging angiography (MRI angiography) to estimate
      the function of the cerebral artery. MRI angiography showed that spasm occurred
      in many cerebral arteries. The spasm was still observed in some arteries 13 day
      after the onset of eclampsia. Vasospasm of eclampsia was clearly, easily and
      noninvasively confirmed in this case by MRI angiography. This observation
      suggests that MRI angiography is very useful and informative for diagnosis and in
      treatment of eclampsia.

PMID- 8349181
TI  - Transvaginal sonography in the diagnosis and management of cervical incompetence.
AB  - Cervical incompetence remains a controversial area in obstetric management. The
      development of transvaginal sonography has resulted in a clearer image of the
      internal cervical os, a development which may indirectly have beneficial effects
      on outcome. However, the rapid development of cervical dilatation in some cases
      necessitates frequent ultrasound monitoring.

PMID- 8349182
TI  - Involvement of the local immune response in a case of advanced cervical cancer in
      a patient with systemic lupus erythematosus.
AB  - Although patients with systemic lupus erythematosus (SLE) have frequently
      accompanying malignancies, there are few documented cases in the literature of
      advanced cervical cancer patients with SLE. This report describes a case of
      advanced cervical cancer in a 39-year-old patient with a 20-year history of SLE
      (FIGO stage IIIb) and evaluates the immunological response of the tumor. The
      clinical course of this patient with SLE, with rapid growth of cervical cancer
      and a poor prognosis, may suggest that T cells play a key role in the growth of
      cancer.

PMID- 8349183
TI  - Effect of smoking on maternal glucose metabolism.
AB  - Maternal smoking, studied in late pregnancy, was found to be associated with
      lower blood glucose values, both during fasting and after an intravenous glucose
      load. As a correlation between blood glucose levels and infant birth weight has
      been reported, it is possible that smoking during pregnancy might reduce fetal
      growth through an effect on maternal glucose metabolism.

PMID- 8349184
TI  - Cryopreservation of human platelets using dimethyl sulfoxide and glycerol
      glucose: effects on "in vitro" platelet function.
AB  - BACKGROUND: The technique of freezing blood platelets could be very useful in the
      transfusion support of thrombocytopenic patients. The best method of platelet
      cryopreservation still remains an object of debate, though it has been suggested
      that dimethyl sulfoxide (DMSO) is more effective than glycerol-glucose as a
      cryopreservative. However, few studies have directly compared platelets
      cryopreserved with different methods. METHODS: We compared "in vitro" function of
      platelets cryopreserved with 5% dimethyl sulfoxide (DMSO) or 3% glycerol-glucose
      at -140 degrees C. Platelet aggregation and release reaction were studied with a
      Lumi aggregometer, thromboxane B2 (TxB2) production by radioimmunoassay, and Ca++
      movement by the Fura 2 method. RESULTS: Cryopreservation with both of the methods
      dramatically reduced the ability of platelets to release ATP and to aggregate in
      response to single agonists. In contrast, cryopreserved platelets maintained
      their ability to aggregate after stimulation with paired agonists and to produce
      TxB2. Cytoplasmic Ca++ increase induced by thrombin was observed in the glycerol
      preserved platelets, while it was nearly absent in the DMSO-preserved ones.
      CONCLUSIONS: We suggest that cryopreservation with glycerol-glucose or DMSO
      induces similar defects of platelet function. The damage is severe, but platelets
      are still able to respond to strong stimulation.

PMID- 8349186
TI  - Use of recombinant human erythropoietin (rh-EPO) in the treatment of anemia in
      hemodialysis patients: a multicenter Italian experience.
AB  - BACKGROUND AND METHODS: After the phase I-II clinical trials in 1986, several
      studies on the use of rHuEPO in the treatment of anemia of renal failure have
      been carried out and the drug has been introduced into clinical practice. In the
      present article we analyze the results of recombinant human erythropoietin (rh
      EPO) therapy administered intravenously (i.v.) to 759 patients in several italian
      dialysis centers. RESULTS AND CONCLUSIONS: Data analysis confirms the
      erythropoietic efficacy of the drug (mean Hct increase from 22.1 +/- 2.8 to 31.5
      +/- 3.0%) as well as the generalized Italian position toward a cautious
      correction of anemia (the increase is achieved in 6 months). Such a therapeutic
      approach is consistent with the chronic anemia of the dialysis patient. Low doses
      are widely used (40-100 IU/kg x three times a week). Analysis of adverse events
      seems to point out that some correlate directly with the drug and are therefore
      difficult to eliminate (flu-like syndrome). On the other hand, certain adverse
      events seem to correlate with the modalities of drug use (dosage, time required
      for the Hct increase). The possible advantages of subcutaneous administration are
      also described.

PMID- 8349185
TI  - Reduction of plasma fibrinolytic activity following high-dose cyclophosphamide is
      neutralized in vivo by GM-CSF administration.
AB  - BACKGROUND: GM-CSF has broad clinical applicability as a potent myelopoietic
      stimulator. However, its function is not restricted to the myelopoietic system
      and several observations suggest that GM-CSF may interfere with the hemostatic
      balance. In order to assess whether GM-CSF has any influence on hemostasis, we
      evaluated some coagulative and fibrinolytic parameters in patients treated with
      GM-CSF following chemotherapy. METHODS: Fibrinolytic activity (FA), fibrinogen
      and D-dimer were evaluated before and after high-dose cyclophosphamide in 6
      patients additionally treated with GM-CSF and in 5 control patients; moreover,
      tissue plasminogen activator (tPA) was assayed in those treated with GM-CSF.
      Comparative in vitro analysis was performed on cultured endothelial cells before
      and after exposure to GM-CSF. RESULTS: Control patients showed a significant
      decrease in plasma FA after chemotherapy compared to basal values (FA/mm2: 15.6
      +/- 2.1 at day + 2 and 20.8 +/- 19 at day + 4 vs. 103.8 +/- 64.2 at day 0; p <
      0.005); conversely, no FA reduction was observed in GM-CSF-treated subjects. In
      this latter group a marked increase in tPA antigen was seen, consistent with
      enhanced FA. No significant changes in plasma D-dimer and fibrinogen values were
      detected in the two groups. tPA, urokinase-type plasminogen activator, PAI-1 and
      procoagulant activity were evaluated in vitro on cultured human endothelial cells
      and found to be unchanged following GM-CSF addition. CONCLUSIONS: The results
      demonstrate that high-dose chemotherapy may negatively influence plasma FA. This
      adverse side effect is neutralized by GM-CSF administration. The discrepancy
      found between in vitro and in vivo GM-CSF activity on hemostatic may be explained
      by in vivo GM-CSF stimulation of cell types other than endothelial cells.

PMID- 8349187
TI  - Serum erythropoietin level and marrow erythroid infiltration predict response to
      recombinant human erythropoietin in myelodysplastic syndromes.
AB  - BACKGROUND AND METHODS: In 38 patients with myelodysplastic syndromes (MDS) the
      values of serum erythropoietin were measured at diagnosis and compared with the
      haemoglobin level. A highly significant inverse relationship was found between
      these two parameters, suggesting that the physiologic mechanism of erythroid
      progenitor cell recruitment is preserved in MDS. Fourteen transfusion-dependent
      patients were treated with recombinant human erythropoietin at the dose of 150
      U/Kg three times weekly for at least 2 months. RESULTS AND CONCLUSIONS: Under
      recombinant human erythropoietin, three patients became transfusion-independent
      and 5 had a transient decrease of their transfusion requirement. Two patients
      under prolonged treatment at the same dose of erythropoietin remain in complete
      remission after 12 and 15 months respectively. A direct relationship between
      response to erythropoietin treatment and degree of bone marrow erythroid
      hyperplasia, coupled to an inverse correlation between response to erythropoietin
      and baseline serum erythropoietin levels were noted. Based on these findings,
      recombinant human erythropoietin may represent an effective treatment modality
      for selected patients with MDS.

PMID- 8349188
TI  - Recombinant human erythropoietin in the treatment of myelodysplastic syndromes.
      An interim report.
AB  - BACKGROUND: It has recently been demonstrated that erythropoietin increases
      hemoglobin levels in anemia secondary to chronic renal failure. Some recent
      experiences have suggested a possible role in the treatment of anemia in patients
      with myelodysplastic syndrome (MDS). METHODS AND RESULTS: From April, 1990 to
      March, 1991, 16 patients (11 males and 5 females, median age 58.5 years) affected
      by low-risk myelodysplastic syndromes (MDS) were treated with recombinant human
      erythropoietin (rHuEPO) to ameliorate Hb levels and reduce transfusional
      requirement. All patients received high doses of rHuEPO (400 U/Kg s.c. twice
      weekly for 3 months). A partial response, defined as a stable increase in Hb
      levels > 1g/dL and/or a reduction in transfusional need > 50% lasting at least 3
      months, was achieved by 5/16 patients. Those who responded received an additional
      course of treatment with rHuEPO at an increased dosage (600 U/Kg twice weekly for
      3 months), and one of these five showed a progressive rise in Hb level up to
      normalization, while the other 4 remained stable. The treatment was well
      tolerated and no adverse reactions were observed. CONCLUSIONS: These results
      suggest that some patients with MDS may benefit from rHuEPO treatment.

PMID- 8349189
TI  - Transient aplasia preceding adult acute lymphoblastic leukemia.
AB  - A 62-year-old woman developed common acute lymphoblastic leukemia (ALL) after
      spontaneous recovery from transient marrow aplasia. Although the mechanisms
      underlying bone marrow suppression in acute leukemia are obscure, it is important
      to know that transient aplasia may be observed as a prodromal feature in ALL in
      adult patients as well as in children.

PMID- 8349190
TI  - Gaucher's disease associated with monoclonal gammapathy of undetermined
      significance: a case report.
AB  - We report a case of adult-type Gaucher's disease associated with monoclonal
      gammapathy of undetermined significance. Bone marrow infiltration by Gaucher's
      cells and spleen infiltration by Gaucher cells and plasma cells was observed on
      cytohistologic examination. Splenectomy induced complete recovery of cytopenias
      and a marked reduction of the monoclonal protein.

PMID- 8349192
TI  - Thrombocytopenic purpura and hepatitis C virus infection.

PMID- 8349191
TI  - Leukemic dermal infiltrate at the exit site of a central venous catheter.
AB  - This report describes the case of a minimally differentiated acute myeloid
      leukemia (FAB M0) diagnosed in a 55-year-old woman. During a second chemotherapy
      induced complete remission, a subcutaneous nodule appeared at the scar of a
      recently removed Hickman catheter, which when biopsied revealed leukemic
      infiltration of the dermis and hypodermis. The patient had a bone marrow relapse
      three weeks later. The authors review similar recent reports and emphasize the
      importance of recognizing this particular type of cutaneous leukemic relapse.

PMID- 8349193
TI  - Eosinophilic leukemia and classical Kaposi's sarcoma: a serious combination of
      illnesses.

PMID- 8349194
TI  - Immune reconstitution after bone marrow transplantation: expansion of
      primed/memory T cells rather than recapitulation of ontogeny.

PMID- 8349195
TI  - Control of erythropoietin production in man.

PMID- 8349196
TI  - Pyruvate kinase (PK) deficiency in Jordan.
AB  - BACKGROUND AND METHODS: The clinical and biochemical aspects of two cases of PK
      deficiency associated with chronic hemolytic anemia in two unrelated patients are
      reported. The residual erythrocyte PK enzymes in both patients were characterized
      by the recommended methods of the International Committee for Standardization in
      Hematology (ICSH). RESULTS AND CONCLUSIONS: Patient (W.Q.) had 60% residual PK
      activity and may be considered homozygous on the basis of consanguinity in the
      family. This patient suffered from moderate hemolytic anemia that improved after
      splenectomy. The enzymatic properties were: low activity, moderate thermal
      stability, reduced affinity for phosphoenol-pyruvate (PEP), and normal
      electrophoretic mobility. Patient (E.O.) had 42% residual PK activity and may be
      considered compound heterozygous since his parents are not related. He suffered
      from moderate hemolytic anemia. The enzymatic properties were: low activity,
      moderate thermal stability, reduced affinity for PEP and minimal retardation in
      electrophoretic migration. Theses two cases of PK deficiency are the first to be
      discovered in Jordan and probably the first in any Arab country.

PMID- 8349197
TI  - Vitamin B12 transport proteins in patients with HIV-1 infection and AIDS.
AB  - BACKGROUND: Low vitamin B12 levels (B12) are often observed in patients infected
      with human immunodeficiency virus type 1 (HIV-1). The causes underlying this
      finding are thought to be intestinal malabsorption and/or abnormalities in the
      vitamin plasma binding proteins (BP). MATERIAL AND METHODS: Serum levels of B12
      and BP were studied in eighty HIV-1-positive patients, 55 of whom met the
      diagnostic criteria for AIDS. Subjects were divided into various subgroups: non
      AIDS HIV-1 positive versus AIDS; low serum B12 levels (DB12, < 150 pmol/L) versus
      normal serum B12 levels (NB12); and the results obtained were compared both
      between groups and with respect to a reference population (RF) of normal
      volunteers. RESULTS: Low levels of serum B12 were found in 14 patients (17.5%),
      without differences between the AIDS and non-AIDS subgroups. The levels of
      holohaptocorrin (holoHP) were lower in the DB12 group than in the NB12 and RF
      groups (p < 0.01), and no differences were found between the AIDS and non-AIDS
      groups. The levels of apotranscobalamin (apoTC) were higher in the AIDS group
      than in the non-AIDs and RF subjects (p < 0.01), but no differences were found
      between the DB12 and NB12 groups. Likewise, no differences were noted in the
      levels of holoTC between the DB12 and NB12 groups. A positive correlation between
      neutrophil counts and free serum haptocorrin levels (apoHP) (rs = 0.36; p =
      0.002), and a negative one between the former and the levels of apoTC (rs = -0.3;
      p = 0.009) were observed. Furthermore, a positive correlation was detected
      between the erythrocyte sedimentation rate and the levels of apoHP and TC.
      CONCLUSIONS: Low serum levels of HP in HIV-1 positive patients could lead to the
      low levels of serum vitamin B12 frequently observed in this patient population,
      while the high levels of TC could merely represent a non-specific marker of
      inflammation (acute phase, reactant).

PMID- 8349198
TI  - A two-generation reproduction study in rats with methyl bromide-fumigated diets.
AB  - Crj:CD(SD) rats were fed basal (control) diet or methyl bromide-fumigated diet
      containing 80, 200 or 500 ppm total bromine for two successive generations (18 wk
      for each generation). Compared with controls, food consumption was significantly
      lower in F1 parental females of the 500-ppm group during the second half of the
      dosing period, and F2 female pups of the 500-ppm group showed lower body weights
      throughout the lactation period. No other treatment-related changes were found at
      any dietary level of total bromine in either parental animals (F0, F1) or their
      offspring (F1, F2) for any of the parameters studied (i.e. clinical signs,
      oestrous cycle, sperm count and morphology, mating, fertility, gestation,
      parturition, litter size, pup viability, organ weights, and gross or
      histopathological examination). It was concluded that residues of 200 and 500 ppm
      total bromine in diets fumigated with methyl bromide are the no-observed-effect
      level and the minimum toxic level, respectively, for both parental rats and their
      offspring, and that bromine residues do not affect reproductive performance at
      dietary levels of up to 500 ppm.

PMID- 8349199
TI  - Effect of oral aluminium citrate on short-term tissue distribution of aluminium.
AB  - Aluminium (Al) concentrations in the plasma, bone, lung, liver, kidney, spleen,
      duodenum and brain of rats were measured 2, 4 and 24 hr after a single oral dose
      of 0.46 mmol as Al citrate (1:5 molar ratio). Compared with control animals, very
      high concentrations were found at 2 hr post-administration in plasma (539
      micrograms/litre) and in all tissues except the brain where Al did not change
      throughout the 24-hr period. The increased levels in the liver (161 ng/g) and
      lung (89.7 ng/g) at 2 hr were maintained until 4 hr and then decreased. At 24 hr
      the plasma value decreased to 24.6 micrograms/litre as compared with the peak
      value of 539 micrograms/litre. In a typical soft tissue such as the kidney the
      peak at 2 hr of 682 ng/g decreased to 241 ng/g, which was still more than 10-fold
      greater than the control level. Uniquely, in the case of bone Al increased
      throughout the period of the experiment. Our results indicate that Al in the
      citrate form is readily absorbed and that it appears to equilibrate rapidly
      between plasma and the intracellular compartments of most soft tissues but does
      not readily permeate the blood-brain barrier. In a group of rats previously given
      silicic acid in the drinking water and co-administered with the Al dose, the
      tissue Al distribution pattern at 4 hr post-administration was modified in
      comparison with the test animals not loaded with silicic acid. Al concentrations
      in plasma and soft tissues were significantly reduced except for the spleen, in
      which Al increased, and there was complete inhibition of the very high Al
      uptake/deposition in bone.

PMID- 8349200
TI  - Histological and serum biochemical effects of 1-isothiocyanato-3-
      (methylsulphinyl)-propane in the F344 rat.
AB  - 1-Isothiocyanato-3-(methylsulphinyl)-propane (IMSP or iberin) is one of the major
      glucosinolate hydrolysis products found in cruciferous vegetables. The toxicity
      of IMSP after oral administration is unknown. This study examined the
      histological lesions and serum biochemical alterations resulting from
      intragastric administration of IMSP to male Fischer F344 rats. Rats were
      administered IMSP in corn oil by gavage at concentrations of 0.1, 0.3, 0.6, 1.0
      and 2.0 mmol/kg body weight. Rats were anaesthetized and exsanguinated, and
      perfusion fixed at 4, 24 and 72 hr after dosing. IMSP caused a dose-dependent
      decrease in body weight for the first 24 hr after dosing. Multifocal haemorrhages
      and erosions of the mucosal portion of the stomach were grossly and
      histologically evident after 4 hr in rats dosed with more than 0.3 mmol IMSP/kg
      body weight, with severity increasing with dose. Mucosal lesions resolved by 72
      hr in all but the 2 mmol/kg group. No significant lesions were observed in the
      liver or kidney. No physiologically significant haematocrit, electrolyte, blood
      urea nitrogen, creatinine or serum enzyme activity changes were observed. Urine
      collected after a dose of 1 mmol IMSP/kg body weight accounted for 1% of the
      IMSP, demonstrating that the compound was absorbed from the gastro-intestinal
      tract.

PMID- 8349201
TI  - Contribution of phenolic and quinonoid structures in the mutagenicity of the
      edible mushroom Agaricus bisporus.
AB  - The objectives of this work were to establish the contribution of agaritine in
      the mutagenicity of ethanolic extracts from Agaricus bisporus and to examine the
      possible involvement of phenolic and quinonoid compounds in the mutagenic
      response to mushrooms. The mutagenic profile of agaritine in the Ames test, in
      the absence of an activation system, was different from that of the mushroom
      ethanolic extracts. Incorporation of rat hepatic cytosolic fractions as the
      activation system increased the mutagenicity of the mushroom ethanolic extracts
      in Salmonella typhimurium strain TA 104 but did not influence the mutagenicity of
      agaritine. It was concluded that agaritine is not the principal mutagenic
      component in the mushroom. The cytosol-induced mutagenicity of the mushroom
      extracts required NADPH, and was inhibited by dicoumarol and menadione. Moreover,
      the mutagenic response in the presence of cytosolic fractions was inhibited by
      superoxide dismutase, catalase, glutathione and dimethyl sulfoxide, thus
      implicating reactive oxygen species. Finally, tyrosinase, the enzyme converting
      mushroom phenols to quinones, increased the mutagenicity of the mushroom
      extracts. Collectively, the above results indicate that phenolic and quinonoid
      compounds, presumably through the generation of reactive oxygen species, may play
      a significant role in the mutagenicity of mushroom extracts.

PMID- 8349202
TI  - Percutaneous absorption of diazinon in humans.
AB  - Diazinon is an organophosphorus insecticide which, through general use, comes
      into contact with human skin. To investigate its percutaneous absorption, human
      volunteers were exposed for 24 hr to 14C-labelled diazinon applied in acetone
      solution (2 micrograms/cm2) to the forearm or abdomen, or in lanolin wool grease
      (1.47 micrograms/cm2) to the abdomen. Complete void urine samples were collected
      daily for 7 days. Percutaneous absorption ranged from 2.87 +/- 1.16% (mean +/-
      SD, n = 6) to 3.85 +/- 2.16% of the applied dose, and there were no statistically
      significant differences with regard to site or vehicle of application. In rhesus
      monkeys, over the 7 days after iv dosing (2.1 microCi [14C]diazinon, 31.8
      micrograms) a total of 55.8 +/- 6.8% (n = 4) of the dose was excreted in the
      urine, and 22.6 +/- 5.2% was eliminated in the faeces (78.4% total
      accountability). In in vitro percutaneous absorption studies with human abdominal
      skin, 14.1 +/- 9.2% of the applied dose accumulated in the receptor fluid over 24
      hr of exposure to 0.25 microgram/cm2 (acetone vehicle). The calculated mass
      absorbed was the same (0.035 microgram/cm2) for both in vitro and in vivo
      absorption through human skin.

PMID- 8349203
TI  - Effects of nivalenol on hepatic drug-metabolizing activity in rats.
AB  - Effects of nivalenol (NIV), a trichothecene mycotoxin, on hepatic drug
      metabolizing activity and aflatoxin B1 (AFB1) metabolism were investigated in
      male rats. In rats fed the diets containing 6-12 ppm NIV for 2 or 4 wk, decreases
      in initial feed uptake, terminal weight gain and organ weights were evident. An
      increase in cytochrome P-450 activity was observed in the hepatic microsomes, and
      Western blot analysis revealed a transient increase in P4502B1/2, together with a
      slight induction of P4501A2. The activity of cytosolic glutathione S-transferase
      (GST) enzymes was also enhanced in the rats, and Western blot analysis
      demonstrated an elevation of GST 1-2. The formation of aflatoxin B1-DNA adducts
      (AFB1-DNA) was increased in experiments using hepatic microsomal preparations
      from rats fed the NIV diet, whereas supplementation with cytosol prepared from
      NIV-treated rats reduced the microsomal potential for adduct formation. In in
      vivo experiments, the AFB1-DNA concentration in NIV-treated rats was lower than
      that in the controls. These results suggest that activities of cytochrome P-450
      and GST enzymes were increased in rats fed NIV for several weeks. Alteration of
      these phase I and phase 2 enzyme levels resulted in the modulation of AFB1
      adduction to DNA in vitro and in vivo.

PMID- 8349204
TI  - Effect of red palm oil on some hepatic drug-metabolizing enzymes in rats.
AB  - Red palm oil (RPO) from Elaeis guineensis is being considered for use as an
      edible oil in India as it is one of the richest natural sources of carotenoids.
      The effect of RPO on the host detoxification system, which is a vital mechanism
      in cancer prevention, was studied in three separate batches of Wistar/NIN inbred
      albino rats, and compared with controls, groundnut oil (GNO) and refined bleached
      deodorized palmolein oil (RBDPO). The first batch of 36 rats (12 from each group)
      comprised the adult males (26 wk old) of the third generation (F2b) from a
      multigeneration reproduction study in which three groups were fed 10% GNO or RPO
      or RBDPO for three generations continuously. Phase II glutathione-S-transferase
      (GSH-T) activity was measured in the liver cytosol of these rats after they had
      twice completed the process of mating, gestation, lactation and weaning, because
      GSH-T is one of the principal detoxifying enzymes involved in conjugating
      reactions of phase II metabolism. The fourth generation (F3b) weanling rats of
      the three groups, receiving GNO, RPO or RBDPO, were continued on the 10% oil diet
      for 9 wk, after which cytosolic GSH-T activity was measured. In the second
      experiment, eight male weanling Wistar/NIN inbred albino rats, 5 wk old, weighing
      100-120 g, were fed 10% GNO, RPO or RBDPO for 4 wk in a 20% protein synthetic
      diet. Liver cytosolic GSH-T, reduced glutathione, microsomal total cytochrome P
      450, aminopyrine N-demethylase and ethoxyresorufin-O-deethylase activity were
      measured to elucidate the effect of RPO on some phase I and phase II reactions.
      Significantly higher levels of GSH-T were observed in F2b and F3b rats given RPO
      than in those given GNO or RBDPO. In the second experiment, GSH-T induction was
      also noted, together with increased levels of reduced GSH. Phase I enzymes and
      total cytochrome P-450 levels were comparable between groups, indicating that no
      induction attributable to RPO had occurred. Thus, enhancement of one of the
      detoxifying phase II enzymes, in conjunction with the lack of induction of those
      activating phase I enzymes that are known to metabolize phenobarbitone and
      polycyclic aromatic hydrocarbons, suggests that RPO affords protection against
      chemical carcinogens, probably because of its carotenoid content.

PMID- 8349205
TI  - Cu(II)-dependent degradation of DNA by riboflavin.
AB  - Riboflavin, in the presence of Cu(II), caused breakage of calf thymus DNA and
      supercoiled pBR322 plasmid DNA. The rate of such DNA degradation was several
      times greater than that caused by riboflavin alone. The reaction was inhibited
      under anaerobic conditions, but oxygen could be replaced by the addition of H2O2.
      Riboflavin reduced Cu(II) to Cu(I), which was shown by using the Cu(I)
      sequestering reagent neocuproine, to be an essential intermediate in the DNA
      degradation reaction. Results obtained with scavengers of active oxygen species
      and their production by riboflavin and Cu(II) indicated that the species
      predominantly responsible for DNA breakage is singlet oxygen.

PMID- 8349206
TI  - Microdiffusion method with solid state detection of cyanogenic glycosides from
      cassava in human urine.
AB  - A method for quantitative determination of cyanogenic glycosides in human urine
      is described. It is based on enzymatic cleavage of the glycosides, microdiffusion
      of the hydrogen cyanide formed, solid state detection by colour formation on a
      picrate-impregnated sheet, and subsequent rating of the coloured spot by the
      absorption of transmitted light at 540 nm with a thin-layer (TLC) densitometer.
      The method has been tested using normal as well as pathological urines containing
      glucose, protein, leucocytes, blood and bacteria. The method allows
      quantification of urinary linamarin above 70 mumol/litre, in 40 microliters
      urine. In Mozambican subjects consuming insufficiently processed cassava the mean
      urinary linamarin levels were 211 mumol/litre, indicating for the first time that
      substantial amounts of the main cyanogenic glycoside in cassava may be absorbed
      from the human gut and excreted intact in the urine.

PMID- 8349207
TI  - Management of metatarsus adductovarus.
AB  - A retrospective analysis of 795 patients treated for metatarsus adductovarus by a
      standardized outpatient approach by one of the authors (D.S.W.) from 1970 to 1983
      was conducted to evaluate the efficacy of a straight metal bar and attached
      reverse last shoe protocol. Criteria for inclusion were developed excluding those
      milder cases in which spontaneous resolution was expected and indeed occurred.
      Nearly uniform excellent results were encountered, with a 99% likelihood of
      obtaining a fully corrected foot. Surgical intervention was deemed necessary in
      under 1% of cases seen. The authors also examined birth weights and rank in
      relation to metatarsus adductovarus. Those children with the deformity had a mean
      birth weight of 7.6 pounds, without statistical variance from normal average
      birth weights. We were unable to establish any statistical association with birth
      rank. In light of the results of this study, which compare favorably with serial
      casting, we recommend this approach as a more economical and less disruptive and
      cumbersome technique for parent, patient, and physician.

PMID- 8349208
TI  - Distal blood pressure as a predictor for the level of amputation in diabetic
      patients with foot ulcer.
AB  - The predictive value of distal blood pressure measurements for the level of
      amputation was studied prospectively in 161 consecutive diabetic patients with
      foot ulcers. The patients were treated as outpatients except for periods of
      surgery and when complications requiring hospital care occurred. All patients
      were treated pre- and postoperatively by the same multidisciplinary foot care
      team. Either ankle or toe blood pressure measurement was available in 86% of the
      patients. Incompressible arteries, ulcer or gangrene at the measuring site,
      previous amputation, poor general condition, and an emergency situation were
      factors that excluded standardized ankle and toe blood pressure measurements in
      24% and 27% of the patients, respectively. An absolute lower ankle pressure level
      of 50 mm Hg was found, below which a minor amputation was never sufficient to
      achieve healing. An ankle pressure below 75 mm Hg was seldom sufficient, and at
      or above that pressure level, the ankle pressure had no predictive value in this
      respect. At a toe pressure below 15 mm Hg, a minor amputation was seldom
      sufficient. Ankle and toe pressure indices gave no further information.

PMID- 8349209
TI  - Transcutaneous oxygen tension in the dysvascular foot with infection.
AB  - Eight adult insulin-requiring diabetics with peripheral vascular disease were
      admitted with foot infection and signs of systemic sepsis. Transcutaneous oxygen
      tension was measured at the foot and ankle prior to surgery. None of the values
      were sufficient to support wound healing. Four of the patients underwent open ray
      resection and four open midfoot amputation. After resolution of the local
      infections, transcutaneous oxygen tensions were repeated. Seven of the eight
      patients exhibited an appreciable increase in the value following decompression
      of the foot infection, sufficient to support wound healing.

PMID- 8349210
TI  - An anatomical study of the tarsal tunnel using low pressure compartmental
      infusion.
AB  - The anatomy of the tarsal tunnel is demonstrated using a low-pressure
      compartmental infusion technique. This is done by infusing colored radiopaque
      contrast material into three fresh cadaveric specimens. Thin section photography
      and computed tomography are then used to identify the boundaries and contents of
      the tarsal tunnel as it traverses the ankle, hindfoot, and midfoot. The tarsal
      tunnel is shown to communicate proximally with the deep posterior compartment of
      the leg and distally with the intermediate compartment of the forefoot. The
      relationships of the structures contained within the tarsal tunnel are shown in
      detail.

PMID- 8349211
TI  - Microvasculature of the tibialis anterior tendon.
AB  - Subcutaneous rupture of the tibialis anterior tendon is an uncommon condition for
      which the etiology is unclear. The existence of a hypovascular zone has been
      proposed as an etiology for rupture of the tibialis anterior tendon. To
      investigate this possibility, the microvascular anatomy of the tibialis anterior
      tendon was studied using a modified Spalteholz technique. The vascular supply to
      the tibialis anterior tendon arises from proximal and distal ventral vinculae.
      Muscular branches of the anterior tibial artery, proximally, and the medial
      tarsal arteries, distally, form an intratendinous, longitudinal, competent blood
      supply. The tendon also receives a rich vascular blood supply from the synovial
      sheath. The blood supply appears adequate throughout the course of the tibialis
      anterior tendon, and no hypovascular region was noted at the common site of
      rupture 1 to 3 cm proximal to its insertion. No relationship was noted between
      increasing age and alteration in blood supply.

PMID- 8349212
TI  - Management of giant cell tumor of the tarsal bones: a report of nine cases and a
      review of the literature.
AB  - Giant cell tumor of the tarsal bones is uncommon and therapeutic options are ill
      defined. We report on nine cases of giant cell tumors of the tarsal bones treated
      by excision of the complete bone in 6 cases, partial excision in 1 case, and
      curettage and bone grafting in two cases. There was no recurrence at an average
      25.8-month follow-up. Function after calcanectomy was satisfactory. Excision of
      the talus may or may not be followed by arthrodesis, but arthrodesis is essential
      after excision of all the other tarsal bones except the calcaneus. We advocate
      aggressive surgical measures in these cases; amputation should be reserved for
      recurrences only. Satisfactory function may be expected after excision of tarsal
      bones.

PMID- 8349213
TI  - Reflex sympathetic dystrophy in an adolescent.
AB  - The clinical course of an adolescent with reflex sympathetic dystrophy of the
      foot is presented. The potential problems of establishing objective diagnostic
      criteria for reflex sympathetic dystrophy are related to the dynamic nature of
      the disorder. Serial radiographic studies, radionuclide scans, and quantitative
      densitometric measurements may be useful in combination; isolated cold stress
      testing and laser Doppler fluxmetry are useful in assessing thermoregulation and
      vasomotor instability. A regimen of amitriptyline and phenytoin plus physical
      therapy with stress loading was useful in this patient, but in many patients the
      course is progressive, leading to chronic pain and debilitation.

PMID- 8349214
TI  - The safety of the Esmarch tourniquet.
AB  - The use of an Esmarch bandage as a tourniquet in surgery has been criticized.
      Many authors claim that the pressures under the Esmarch are inconsistent and may
      be extremely high. We have seen few, if any, problems from the use of an Esmarch
      in surgery of the foot and ankle. The purpose of this study was to evaluate the
      pressures generated under the Esmarch tourniquet in a situation that mimics its
      clinical application, and to determine whether pressures of appropriate magnitude
      and consistency are obtained in order to recommend its continued use in surgery.
      Ten volunteers performed numerous applications of the Esmarch. The number of
      wraps and the width of the Esmarch bandage used were varied. The Esmarch was
      applied as it would be for a surgical case. Pressures directly beneath the
      Esmarch were recorded 8 cm proximal to the distal tip of the medial malleolus.
      Considering all volunteers and all pressures generated, a 3-in Esmarch applied
      with three wraps gave a mean pressure (+/- SD) of 225 +/- 46 mm Hg. A 3-in
      Esmarch applied with four wraps gave a mean pressure of 291 +/- 53 mm Hg. A 4-in
      Esmarch applied with three wraps gave a mean pressure of 233 +/- 35 mm Hg, and a
      4-in Esmarch with four wraps gave a mean pressure of 284 +/- 42 mm Hg. The
      maximum pressures generated by any individual were as follows: 3-in three wraps,
      321 mm Hg; 3-in four wraps, 413 mm Hg; 4-in three wraps, 328 mm Hg; and 4-in four
      wraps, 380 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349215
TI  - Bilateral accessory soleus: a report on four patients with partial fasciectomy.
AB  - Four young adults (average age 24 years) presented with complaints of posterior
      ankle pain after running. Bilateral accessory soleus muscles were diagnosed using
      magnetic resonance imaging or CT scan. Symptoms were present an average of 3
      years before diagnosis. Two patients had previous surgery (ankle arthroscopy,
      tarsal tunnel release, and leg compartment release) before diagnosis and
      treatment. Obliteration of Kager's triangle (posterior ankle fat pad) was present
      on six out of eight lateral ankle radiographs. Posteromedial prominence was
      present on four out of eight ankles. Operative exploration confirmed the presence
      of five muscles and fasciectomy was performed. Follow-up (17 to 29 months) showed
      good relief of symptoms in all patients and return to long-distance running for
      three patients. Dissection of 47 preserved cadavers revealed three accessory
      soleus muscles in the 94 extremities (two muscles were bilateral in one cadaver).

PMID- 8349216
TI  - Neurilemoma of the lateral plantar nerve producing tarsal tunnel syndrome: a case
      report.

PMID- 8349217
TI  - American Orthopaedic Foot and Ankle Society women's shoe survey.

PMID- 8349218
TI  - Forskolin and congeners.

PMID- 8349219
TI  - Steroidal oligoglycosides and polyhydroxysteroids from echinoderms.

PMID- 8349220
TI  - [Opening address of the elected president on the occasion of the 42d Congress of
      the German Society of Oro-, Maxillary- and Facial Surgery].

PMID- 8349221
TI  - [Comparison of osteoplasty of the maxillary cleft with and without simultaneous
      osteotomy in patients with maxillary clefts].

PMID- 8349222
TI  - [Special problems of Le-Fort-I osteotomy after bone repair of maxillary clefts].

PMID- 8349223
TI  - [Dysgnathism operations in patients with previously operated lip-maxilla-palate
      clefts].

PMID- 8349224
TI  - [Effect of bone repair after maxillary advancement surgery in cleft-induced forms
      of dysgnathism].

PMID- 8349225
TI  - [Historical development and current status of osteoplasty of lip-jaw-palate
      clefts].

PMID- 8349226
TI  - [Bone repair and secondary implant management of the maxillary cleft].

PMID- 8349227
TI  - [Endosseous implants in maxillary bone repair].

PMID- 8349228
TI  - [Assessment of cleft-induced maxillary segmental malocclusion by a "Dysgnathism
      Index" with further development of the 3D Dysgnathism Index based on 3D CT
      reconstruction].

PMID- 8349229
TI  - [Has spongiosa bone repair produced good results?].

PMID- 8349230
TI  - [Harvesting iliac crest bone spans in 172 maxillary cleft repairs: a
      retrospective study].

PMID- 8349231
TI  - [Autogenous transplants for maxillary cleft repair: iliac crest or skull bone].

PMID- 8349232
TI  - [Osteogenic value of the autologous skull bone transplant--comparative histologic
      and histomorphometric studies].

PMID- 8349233
TI  - [Long-term results in adulthood after early childhood rib removal for primary
      bone repair of lip-maxillary-palatal clefts].

PMID- 8349234
TI  - [Complications after removal of autologous bone transplants for repair of lip
      maxillary-palatal clefts].

PMID- 8349235
TI  - [Spontaneous bone formation in the maxillary cleft--an alternative to bone
      repair?].

PMID- 8349236
TI  - [Value of the laser in oro-maxillary-facial surgery].

PMID- 8349237
TI  - [Photodynamic laser therapy and fluorescence diagnosis in squamous epithelial
      cancer of the oral cavity].

PMID- 8349238
TI  - [Laser therapy of skin changes in the face and mouth mucosa].

PMID- 8349239
TI  - [The CO2 laser in oro-maxillary-facial surgery].

PMID- 8349240
TI  - [Osteotomy with the experimental laser system].

PMID- 8349241
TI  - [Development, morphology and growth of alveolar stumps in maxillary clefts as the
      basic principles of osteoplasty].

PMID- 8349242
TI  - [Principles of the laser technique for medicine].

PMID- 8349243
TI  - [Opening address of the president on the occasion of the 42d Congress of the
      German Society of Oro-, Maxillary- and Facial Surgery in Munich].

PMID- 8349244
TI  - [Effect of interdisciplinary cleft therapy on the nature and timing of maxillary
      cleft repair].

PMID- 8349245
TI  - [Bone repair in unilateral cleft: when? With what?].

PMID- 8349246
TI  - [A decade of maxillary cleft repair in an international comparison].

PMID- 8349247
TI  - [15 years of surgical orthodontic experience with two types of maxillary cleft
      repair].

PMID- 8349248
TI  - [Periodontal incision as surgical approach in maxillary cleft repair].

PMID- 8349249
TI  - [Comparative results of tertiary repair with the Boyne flap or with the
      vestibular mucoperiosteal rotational flap].

PMID- 8349250
TI  - [Bone selection in the area of the mandibular symphysis for secondary cleft
      repair].

PMID- 8349251
TI  - [The discovery of individual physiognomy in modern art].

PMID- 8349252
TI  - [Osteoplasty of lip-maxillary-palatal clefts with formed and compressed
      spongiosa].

PMID- 8349253
TI  - [Long-term results of unilateral lip-maxillary-palatal clefts with primary
      osteoplasty].

PMID- 8349255
TI  - [Evaluation of the growth of the facial skull after primary bone transplantation
      within the scope of bilateral maxilla-palate repair at the age of three years].

PMID- 8349254
TI  - [Comparative long-term studies of growth behavior after lip-maxillary closure
      with and without primary osteoplasty].

PMID- 8349256
TI  - [Clinical results of secondary osteoplasty of maxillary clefts in mixed dentition
      with lip-maxillary-palatal clefts].

PMID- 8349257
TI  - [Roentgen findings after secondary and tertiary osteoplasty of lip-maxillary
      palatal clefts].

PMID- 8349258
TI  - [Results of secondary maxillary cleft repair in patients with lip-maxillary
      palatal clefts with special reference to cleft-related small incisors].

PMID- 8349259
TI  - [Maxillary bone repair as a portion of the total surgical concept in closure of
      lip-maxillary-palatal clefts].

PMID- 8349260
TI  - [Bone repair of the maxillary cleft as a prerequisite for rhinoplasty].

PMID- 8349261
TI  - [Resorption after bone repair of maxillary clefts--how to prevent it for the long
      term?].

PMID- 8349262
TI  - [Transplant resorption in early and late bone repair with and without orthodontic
      closure of the space].

PMID- 8349263
TI  - [Results of secondary bone repair in lip-maxillary-palatal clefts].

PMID- 8349264
TI  - [Results of secondary maxilla-palate repair (4 years old) as residual defect
      osteoplasty].

PMID- 8349265
TI  - [Growth of the facial skull in adult patients with unilateral lip-maxillary
      palatal clefts after early and late secondary bone repair of the maxillary cleft
      in comparison with normal probands of the same age].

PMID- 8349266
TI  - [Bone repair of lip-maxillary-palatal cleft patients in adulthood].

PMID- 8349267
TI  - [Indications for bone repair within the scope of revision osteotomy of the
      maxilla in patients with lip-maxillary-palatal clefts].

PMID- 8349268
TI  - [Maxillary osteotomy and simultaneous osteoplasty in patients with lip-maxillary
      palatal clefts].

PMID- 8349269
TI  - [Cervical intervertebral disk prolapse. Diagnosis, differential diagnosis and
      surgical therapy].
AB  - Among the so-called cervical spine syndromes cervical disc prolapse represents a
      well defined disease entity which should be kept in mind considering treatment
      resistant painful neck and shoulder as well as neurological dysfunctions of this
      region. Differential therapy consists of conservative measures and especially a
      variety of surgical procedures for cervical disc syndromes. Under all
      circumstances decision for surgery has to take into consideration the individual
      psychological situation (e.g. expectations of the patient) and social factors
      (e.g. the patient's occupation). Therefore a close cooperation of the family
      doctor and the surgeon is required. The aim of this article is to point out the
      neurosurgical aspects as well as the point of view of the general practitioner at
      the same time.

PMID- 8349270
TI  - [Degree of familiarity with carcinoma in situ of the testis. A study of a
      representative selection of established urologists].
AB  - METHOD: By a telephone poll conducted among 143 selected representative
      urologists in private practice throughout the west German Lander. BASIC REMARKS:
      Via a search for carcinoma in situ of the testicles (CIS, or testicular intra
      epithelial neoplasia, TIN), active early detection of testicular germ cell tumors
      is now possible. RESULTS: Among 143 urologists questioned, 62 claimed to be
      familiar with testicular CIS. However, only 52% were able correctly to answer one
      question as to its significance, and only 33% could correctly answer a question
      on the diagnosis of CIS. Only 28% of all those questioned were able to answer
      correctly 2 questions about CIS. Knowledge about CIS proved to be inversely
      correlated with the interval in years since obtaining a licence to practice as a
      specialist. CONCLUSION: The poll reveals that, at the present time, too few
      urologists are familiar with carcinoma in situ of the testicles, and the
      possibilities of active early detection of testicular tumors.

PMID- 8349271
TI  - [Obesity--how dangerous are the diets?].

PMID- 8349272
TI  - [Weight reduction with alternative diets. Principles, philosophy, side effects,
      effectiveness. Part 1: Generally used reducing diets (as a comparison) and
      alternative diets A].

PMID- 8349273
TI  - [Detection of occult blood in stool. Methodologic studies of the validity of this
      test principle with various test systems].

PMID- 8349274
TI  - [The value of diuretics in monotherapy of hypertension].
AB  - AIM: To represent the usefulness of thiazide diuretics as monotherapy of primary
      hypertension. MAIN POINTS: Moderate doses of thiazide diuretics can produce a
      reduction in blood pressure equal to that of beta blockers, calcium antagonists
      and ACE inhibitors, and achieve an equally high response rate. The advantages and
      disadvantages of the specific action profile of these diuretics are described.
      Discussions about the reduction in cardiovascular mortality is represented and
      practical conclusions drawn. The specific indications for monotherapy with
      thiazide diuretics include systolic, diastolic and isolated systolic hypertension
      in the elderly hypertensive, and hypertension in NYHA III and IV cardiac
      insufficiency. Suggestions for their use in practice are given.

PMID- 8349275
TI  - [Autotransfusion and concentrates or donor blood and fresh plasma? Legal pitfalls
      in the medical decision making paths (Part 1 of two)].

PMID- 8349276
TI  - [Creutzfeldt-Jakob epidemic startles France. The cause is apparently a
      contaminated growth hormone--parallels to "bovine psychosis"].

PMID- 8349277
TI  - Social recognition in ovariectomized and estradiol-treated female rats.
AB  - The behavioral phenomenon of social recognition has been extensively investigated
      in male rats. The present paper provides an insight into the recognition capacity
      of female rats studied throughout a sequence of hormonal states: after
      ovariectomy, after estradiol treatment, and several weeks after the termination
      of estradiol therapy. Investigatory behavior of the female oriented toward a
      juvenile male, 22-24 days old, was recorded during the 5-min exposure period.
      Reexposure was performed 30 or 120 min after the initial exposure. Reduction of
      the investigation time during reexposure to the same juvenile was used as a
      recognition criterion. It was found that: (a) Three weeks after ovariectomy, the
      investigation time of females was decreased upon reexposure to the same juvenile
      at 30 min. At this time point the investigation time of females reexposed to a
      novel juvenile was similar to that observed during the initial exposure. Both the
      same as well as a novel juvenile were thoroughly reinvestigated by females when
      120 min elapsed between exposures. (b) Three weeks later, administration of
      estradiol dipropionate to ovariectomized animals (always 100 micrograms per
      animal at Days 10 and 3 before the testing) resulted in reduced investigation
      time during reexposure to the same juvenile at both 30 and 120 min. (c) Original
      time-response relations in the investigation appeared 6 weeks after the
      termination of estradiol treatment. These findings suggest that the presence of
      estradiol may be crucial for female recognition of males 120 min after a brief
      encounter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349278
TI  - Effects of corticosterone on social behavior of male lizards.
AB  - Adrenal corticoid release is a major component of the stress response which can
      affect many body functions including behavior. The purpose of our studies was to
      examine the effects of corticosterone (B) on both the agonistic and courtship
      components of social behavior in male side-blotched lizards (Uta stansburiana).
      Of particular interest was the effect of B on plasma testosterone (T), a hormone
      known to influence aggression, and the importance of this action on the
      behavioral effects of B. Experiments included either castrated males, hormone
      (either B, T, or B + T)-implanted intact males, or sham males. Behavioral
      observations were recorded when these males were challenged with "immigrant"
      males; measurement of plasma steroids confirmed the efficacy of implants in
      elevating B and T. Castration, B implantation, and combined B and T implantation
      significantly reduced aggressive behavior to varying degrees, while T implants in
      intact animals had no effect. B implants significantly decreased plasma T levels
      (from 1.87 to 0.33 ng/ml), but this decrease was not essential for the inhibitory
      effect of B on aggression since B + T implantation also reduced aggression, even
      though plasma T was elevated above normal (67.6 ng/ml). In contrast, B
      implantation did not affect male courtship and copulatory behavior when males
      were presented with estrogenized females. These results suggest that the effect
      of B on social behavior is not through just a single route, that of decreasing
      plasma T, and that B can affect various intra- and intersexual behaviors
      differently.

PMID- 8349279
TI  - Effects of the nonsteroidal aromatase inhibitor, fadrozole, on the sexual
      behavior of male cynomolgus monkeys (Macaca fascicularis).
AB  - In many vertebrates, castration and hormone replacement and, more recently, the
      use of aromatase inhibitors, have shown that male sexual activity is mediated by
      the aromatization of testosterone (T) to estradiol (E2). In macaques, however,
      the systemic administration of E2, either alone or in combination with androgen,
      failed either to maintain or to restore the sexual activity of castrated males.
      The present study examines the effects of administering the nonsteroidal
      aromatase inhibitor, Fadrozole, either alone or combined with E2, to castrated, T
      treated male cynomolgus monkeys at a dose of 0.25 mg/kg/day. This dose inhibited
      by over 98% the conversion of T to E2 and the subsequent accumulation of the
      latter in hypothalamic cell nuclei. Castrated males bearing sc Silastic impants
      of T were each tested with an ovariectomized, E2-treated female partner before,
      during, and after being given minipumps delivering either Fadrozole or water (240
      1-hr tests). Within 2 weeks, Fadrozole significantly reduced ejaculatory activity
      and male sexual motivation in the absence of changes in plasma T levels, which
      remained in the upper range for intact males. Additional estradiol treatment
      produced small but significant increases in ejaculations by three of the six
      males only, and measures of male sexual motivation remained unchanged (120
      tests). The present results, which stand in contrast to our previous findings in
      macaques, support the view that aromatization of T is important for ejaculatory
      activity and sexual motivation in a male primate. They also suggest that
      exogenous E2, which reaches the brain from the systemic circulation, does not
      fully duplicate the behavioral effects of E2 produced locally in the brain by the
      aromatization of T.

PMID- 8349280
TI  - Effects of testosterone propionate upon the sexual and aggressive behavior of
      adult male marmosets (Callithrix jacchus) castrated as neonates.
AB  - In New World monkeys of the family Callitrichidae (marmosets and tamarins),
      females frequently give birth to dizygotic twins. Twins share a placental
      circulation throughout fetal development and are hemopoietic chimeras. Despite
      this, there is no masculinization (freemartinism) in females which develop next
      to a male co-twin. It has been suggested that the organizing effects of
      testicular androgen upon sexual differentiation of the brain occur mainly during
      early postnatal development in male callitrichids, rather than in utero. However,
      this report demonstrates activation of masculine copulatory behavior by
      testosterone propionate (TP) administered to adult male marmosets (N = 8) which
      were castrated in infancy (between Days 1-7). Effects of neonatal castration upon
      aggressive behavior during pair tests with females (high frequencies of
      aggression) and intact adult males (low frequencies of aggression) were also
      reversed by TP treatment in adulthood. While early postnatal androgen secretion
      plays an important role in behavioral development in marmosets, it appears that a
      substantial degree of neural sexual differentiation occurs in utero in males of
      this callitrichid species.

PMID- 8349281
TI  - Differential perinatal testosterone secretory capacity of wild house mice testes
      is related to aggressiveness in adulthood.
AB  - Testosterone secretory capacity of testicular Leydig cells was determined in
      fetal males of an aggressive and a nonaggressive genetic selection line of wild
      house mice. They were studied at Days 15-18 of gestation and on the first day
      after birth. A previously described morphometric method was used to quantify 3
      beta-hydroxy steroid dehydrogenase (3 beta-HSD)-stained Leydig cells in
      testicular sections to determine testosterone secretory capacity, which may be
      considered to reflect circulating plasma testosterone in the fetus. The results
      of this study show that the testosterone secretory capacity of Leydig cells in
      the testis changes differentially during intrauterine development in males of the
      aggressive and nonaggressive selection lines. The peak secretory capacity is
      reached at Day 17 of gestation for the males of the aggressive selection line,
      while the peak for the nonaggressive males is reached on the first neonatal day.
      The larger anogenital distance observed in aggressive males suggests a higher
      prenatal testosterone level in these males. The importance of the difference in
      timing of the perinatal 3 beta-HSD peak top individual variation in adult
      aggressive behavior is discussed.

PMID- 8349282
TI  - Glucocorticoids facilitate mineralocorticoid-induced sodium intake in the rat.
AB  - We confirm and extend the finding that glucocorticoids facilitate
      mineralocorticoid-induced sodium intake in the rat. First, we report that
      subcutaneous injections of dexamethasone (DEX) increase deoxycorticosterone
      induced sodium intake. Second, we demonstrate that continuous intravenous
      infusions of either DEX or corticosterone or the TYPE II glucocorticoid receptor
      agonist RU28362 increases the sodium intake of aldosterone-treated rats. And
      third, we measured urine sodium loss and found that rats were in positive sodium
      balance while receiving aldosterone and the glucocorticoid agonist, suggesting
      that the increased intake of sodium was primary to renal sodium loss. When taken
      together with the fact that glucocorticoids can increase the TYPE I aldosterone
      preferring receptor population in the brain, the results suggests a role for the
      glucocorticoid hormones in the arousal of sodium appetite in the rat.

PMID- 8349283
TI  - Postpartum aggression in mice: the role of ovarian hormones.
AB  - The development of aggression during the immediate postpartum period was
      investigated in Rockland-Swiss albino female mice. Aggression was low immediately
      following delivery and increased with advancing lactation. The majority of
      females delivered during the dark cycle, however, whether females delivered or
      were tested during the light or dark cycle did not influence aggression. Females
      ovariectomized on Gestation Day 18 displayed aggression sooner than sham-operated
      controls. Estrogen treatment restored typical postpartum docility in prepartum
      ovariectomized females. Ovariectomy also increased the number of nursing bouts,
      but not total nursing time, when compared to sham-operated females. These
      findings suggest that peripartum estrogen stimulation, directly or through
      influencing nursing activity, prevents aggression in females immediately
      postpartum.

PMID- 8349284
TI  - Effects of progesterone and dihydrotestosterone on stimulation of androgen
      dependent sex behavior, accessory sex structures, and in vitro binding
      characteristics of cytosolic androgen receptors in male whiptail lizards
      (Cnemidophorus inornatus).
AB  - Progestins often act as potent antiandrogens in male birds and mammals.
      Experiments with lizards find that progestins can both inhibit (when given in
      high dosages) or stimulate (when given in low dosages) male-typical sex behavior
      in gonadectomized individuals. This study shows that in the little striped
      whiptail lizard exogenous progesterone (P) facilitates androgen-dependent sex
      behaviors in males yet fails to stimulate seasonal activation of androgen
      dependent accessory sex structures. Analysis of androgen receptors (AR) in brain
      and kidney cytosol of the little striped whiptail lizard reveals similarities
      with the AR of the mouse. The data indicate that despite the ability of P to
      mimic the actions of androgens in activating sex behaviors in males of this
      species, the characteristics of the AR are conserved with respect to other
      vertebrate species.

PMID- 8349285
TI  - Redundant use of luminance and flashing with shape and color as highlighting
      codes in symbolic displays.
AB  - Three visual search experiments evaluated the benefits and distracting effects of
      using luminance and flashing to highlight subclasses of symbols coded by shape
      and color. Each of three general shape/color classes (circular/blue, diamond/red,
      square/yellow) was divided into three subclasses by presenting the upper half,
      lower half, or entire symbol. Increasing the luminance of a subclass by a factor
      of two did not result in a significant improvement in search performance.
      Flashing a subclass at a rate of 3 Hz resulted in a significantly shorter mean
      search time (48% improvement). Increasing the luminance of one subclass (by a
      factor of five) while simultaneously flashing another significantly improved
      search times by 31% and 43% respectively, compared with nonhighlighted search
      conditions. In each experiment, the search times for nonhighlighted target
      subclasses were not affected by the presence of brighter and flashing targets.
      The failure of the initial experiment to find a significant performance
      improvement caused by increasing symbol luminance suggested that a larger
      luminance increase was necessary for this code to be effective. The overall
      results suggest that using luminance and flashing to highlight subclasses of
      color- and shape-coded symbols can reduce search times for these subclasses
      without producing a distraction effect by way of a concomitant increase in the
      search times for unhighlighted symbols.

PMID- 8349286
TI  - Disruption and maintenance of skilled visual search as a function of degree of
      consistency.
AB  - The present experiment was conducted to investigate the effects of varying
      degrees of task consistency on the performance and maintenance of skill in a
      semantic-category visual search task. Four groups of participants first received
      6000 trials of consistent mapping (CM) training on two different categories. The
      participants then performed 4000 trials in which one of the previously trained
      categories remained 100% consistent, whereas the other previously trained
      category became either 100%, 67%, 50%, or 33% consistent. This second phase of
      the experiment allowed for the examination of disruption of the search skill as a
      function of degree of consistency. Subsequent to the degree of consistency
      manipulation, 100% consistency was restored and participants performed another
      4200 CM trials. Results indicate that performance was disrupted by inconsistency
      and that disruption increased as consistency decreased. On the return of task
      consistency, performance improved rapidly to predisruption levels, though some
      performance disruption was evident. Theoretical and practical implications are
      discussed.

PMID- 8349287
TI  - Modeling strategic behavior in human-automation interaction: why an "aid" can
      (and should) go unused.
AB  - Task-offload aids (e.g., an autopilot, an "intelligent" assistant) can be
      selectively engaged by the human operator to dynamically delegate tasks to
      automation. Introducing such aids eliminates some task demands but creates new
      ones associated with programming, engaging, and disengaging the aiding device via
      an interface. The burdens associated with managing automation can sometimes
      outweigh the potential benefits of automation to improved system performance. Aid
      design parameters and features of the overall multitask context combine to
      determine whether or not a task-offload aid will effectively support the
      operator. A modeling and sensitivity analysis approach is presented that
      identifies effective strategies for human-automation interaction as a function of
      three task-context parameters and three aid design parameters. The analysis and
      modeling approaches provide resources for predicting how a well-adapted operator
      will use a given task-offload aid, and for specifying aid design features that
      ensure that automation will provide effective operator support in a multitask
      environment.

PMID- 8349288
TI  - Real-time expert systems interfaces, cognitive processes, and task performance:
      an empirical assessment.
AB  - In this experiment we investigated the effect of different real-time expert
      system interfaces on operators' cognitive processes and performance. The results
      supported the principle that a real-time expert system's interface should focus
      operators' attention on where it is required most. However following this
      principle resulted in unanticipated consequences. In particular, it led to
      inferior performance for less critical, yet important cases requiring operators'
      attention. For such cases operators performed better with an interface that let
      them select where they wanted to focus their attention. Having a rule generation
      capability improved performance with all interfaces but did so less than
      hypothesized. In all cases performance with different interfaces and a rule
      generation capability was explained by the effect of the interfaces on cognitive
      process measures.

PMID- 8349289
TI  - Repetitive motion disorders: the design of optimal rate-rest profiles.
AB  - Repetitive motion disorders of the upper extremities are the primary cause of
      lost time in hand-intensive industries. Typical remedies include the introduction
      of job aids and the redesign of the job. An alternative approach is considered
      here. Procedures are developed that can be used to determine the parameters of a
      job (e.g., the rate of work and the number and duration of the rest breaks) that
      minimize repetitive motion disorders and maximize productivity. It is shown that
      in theory the job parameters can be set so that one can achieve not only a
      decrease in repetitive motion disorders but also an increase in productivity. The
      application of the procedures to an actual manufacturing job requiring high
      repetitive, high-force hand motions is discussed in detail.

PMID- 8349290
TI  - Operation of controls on consumer products by physically impaired users.
AB  - The self-reliance of the physically impaired can be seriously jeopardized by
      their inability to operate everyday products, especially if both upper
      extremities are impaired. To determine the difficulties impaired users encounter
      in operating consumer product controls, on-site video recordings were made of
      subjects suffering from arthritis or a muscular disease. Subjects' force exertion
      was compared with that of a group of nonimpaired users. The resulting inventory
      allowed the analysis of the manipulation problems faced by impaired subjects and
      the development of design recommendations. In this study the force exerted by the
      subjects and that required to operate the controls were measured. A comparison of
      the results of these force measurements led to a number of conclusions. This
      study led to the following design recommendations: the amount of force required
      to operate controls should be kept as low as possible; the user should not be
      required to make two manipulations at the same time, such as simultaneously
      pushing and rotating a control device; pushing is preferable to rotating; and
      there should be a great degree of freedom to manipulate controls.

PMID- 8349291
TI  - Cognitive function at high altitude.
AB  - The effects of altitude on human performance and cognition were evaluated in a
      field study performed on Mount Denali in Alaska during the summer of 1990.
      Climbers performed a series of perceptual, cognitive, and sensory-motor tasks
      before, during, and after climbing the West Buttress route on Denali. Relative to
      a matched control group that performed the tasks at sea level, the climbers
      showed deficits of learning and retention in perceptual and memory tasks.
      Furthermore, climbers performed more slowly on most tasks than did the control
      group, suggesting long-term deficits that may be attributed to repeated forays to
      high altitudes.

PMID- 8349292
TI  - Headphone localization of speech.
AB  - Three-dimensional acoustic display systems have recently been developed that
      synthesize virtual sound sources over headphones based on filtering by head
      related transfer functions (HRTFs), the direction-dependent spectral changes
      caused primarily by the pinnae. In this study 11 inexperienced subjects judged
      the apparent spatial location of headphone-presented speech stimuli filtered with
      non-individualized HRTFs. About half of the subjects "pulled" their judgments
      toward either the median or the lateral-vertical planes, and estimates were
      almost always elevated. Individual differences were pronounced for the distance
      judgments; 15% to 46% of stimuli were heard inside the head, with the shortest
      estimates near the median plane. The results suggest that most listeners can
      obtain useful azimuth information from speech stimuli filtered by
      nonindividualized HRTFs. Measurements of localization error and reversal rates
      are comparable with a previous study that used broadband noise stimuli.

PMID- 8349293
TI  - Developmental maturation of the B-cell antigen receptor.

PMID- 8349295
TI  - Expression of protein tyrosine kinases in the Ig complex of anti-mu-sensitive and
      anti-mu-resistant B-cell lymphomas: role of the p55blk kinase in signaling growth
      arrest and apoptosis.
AB  - The src family of non-receptor protein tyrosine kinases (PTKs), including the
      blk, fyn, lyn and lck kinases, is expressed in B-lineage cells, may associate
      with the immunoglobulin receptor complex and, therefore, play a role in signal
      transduction via membrane IgM. To establish which of these PTKs is involved in
      growth inhibition of B-cell lymphomas by anti-mu, we examined the expression
      pattern and state of activation of these kinases in nine B-cell lymphomas.
      Tyrosine-phosphorylated p55blk was constitutively expressed in all growth
      inhibitable lymphomas; furthermore, anti-mu caused a relative increase of
      tyrosine phosphorylation in p55blk and a 2- to 3-fold increase in its kinase
      activity in these cells within minutes. In contrast, p55blk was not present in
      three of five anti-mu-resistant lymphomas and there was no detectable increase of
      blk activity in one of the resistant cell lines tested. Thus, we proposed that
      activatable blk kinase in the IgM complex is essential for the growth inhibitory
      effect of anti-mu. To test this hypothesis, CH31 lymphoma cells were treated with
      antisense oligos for the blk kinase and found to be resistant to anti-mu-mediated
      growth inhibition and subsequent apoptosis. These studies implicate the blk
      kinase as an integral part of the growth inhibitory pathway leading to arrest and
      apoptosis. Transfectants of blk gene constructs are being generated to further
      test this hypothesis.

PMID- 8349294
TI  - The mouse B-cell antigen receptor: definition and assembly of the core receptor
      of the five immunoglobulin isotypes.
AB  - We have shown that the core antigen receptor of all five isotypes is composed of
      immunoglobulin in association with a common heterodimeric alpha/beta sheath. The
      stoichiometry of the association is unknown although preliminary evidence points
      to it being an IgH2L2 [alpha/beta]2 association. Studies with chimaeric molecules
      indicate that much of the immunoglobulin-sheath interaction must occur through
      the carboxyterminal end of the molecule with particular importance being given to
      the linker-transmembrane region. The glycosylation of the alpha chain differs
      according to the isotype with which it is associated. There are two sites for N
      linked glycosylation on the alpha chain (Asn-30 and Asn-40); both sites are used.
      Mutation of Asn-30 alone decreases but does not abolish surface expression of the
      antigen receptor complex. Mutation of both sites prevents expression of the
      surface IgM[alpha/beta] complex but not of a surface IgD[alpha/beta] complex.
      Moreover, the pattern of alpha glycosylation is considerably affected by changes
      in the linker region between C mu 4 and the transmembrane, giving further support
      to the importance of this region in immunoglobulin-sheath interaction. Unlike
      IgM, IgD and IgG2b do not require alpha/beta for transport to the cell surface
      and can be expressed on the surface without either sheath or glycosyl
      phosphatidylinositol anchor. This finding may reflect that the IgD transmembrane
      region is significantly less hydrophobic than that of IgM; however, it should be
      noted that is not clear whether naked IgD exists in vivo. In fact, we have found
      that the alpha/beta sheath is necessary in order to facilitate efficient
      internalization and presentation of antigen by membrane immunoglobulin. The
      sheath presumably also plays a major role in potentiating transmembrane
      signalling. However, mutant receptors that do not associate with the alpha/beta
      sheath are nevertheless able to trigger phosphorylation of cellular proteins on
      tyrosine residues following cross-linking. Also, in addition to the alpha/beta
      sheath, other transmembrane proteins associate with the B-cell antigen receptor
      although they are not required in order to potentiate surface transport. It may
      be interaction with one of these other associated transmembrane proteins or,
      alternatively, interaction between the immunoglobulin cytoplasmic tail and, say,
      the cytoskeleton, that enables antigen receptors lacking the alpha/beta sheath to
      give rise to cellular signalling.

PMID- 8349296
TI  - Association of Src-family kinase Lyn with B-cell antigen receptor.
AB  - Antigen is thought to cross-link membrane-bound immunoglobulins (Igs) of B cells,
      causing proliferation and differentiation or the inhibition of growth. Compelling
      evidence suggests that protein-tyrosine phosphorylation is involved in signal
      transduction for cell proliferation and differentiation. Indeed cross-linking of
      membrane-bound IgM (mIgM) induced a rapid increase in tyrosine phosphorylation of
      at least 10 distinct proteins in B cells. The Src-family protein tyrosine kinase
      Lyn (p56lyn and p53lyn) is expressed preferentially in B cells. The Lyn protein
      and its kinase activity could be coimmunoprecipitated with both IgM and IgD from
      detergent lysates. Cross-linking of membrane-bound IgM with antibody induced down
      regulation of the Lyn protein. From these data we concluded that Lyn is
      physically associated with mIgs. Further evidence showed that cross-linking of
      mIgM induced rapid increase in the kinase activity of Lyn and association of Lyn
      with 85-kDa noncatalytic subunit of phosphatidylinositol 3-kinase. Thus, Lyn is
      likely to participate in B-cell antigen receptor-mediated signaling. As a novel
      signaling molecule downstream of Lyn, we identified src homology 3-containing,
      transcription factor-like molecule p75HS1.

PMID- 8349297
TI  - Antigen receptors on T and B lymphocytes: parallels in organization and function.

PMID- 8349298
TI  - Signal transduction pathways involved in B-cell induction.

PMID- 8349299
TI  - The B-cell antigen receptor: structure and function of primary, secondary,
      tertiary and quaternary components.

PMID- 8349300
TI  - Immunochemotherapy of human colon carcinoma xenografts in nude mice using
      combinations of idarubicin-monoclonal antibody conjugates.
AB  - Tumour cell heterogeneity is probably a principal cause of treatment failure and
      represents a formidable barrier for effective antibody-targeted chemotherapy.
      Idarubicin (Ida), a more potent and less cardiotoxic analogue of daunomycin, has
      been demonstrated to specifically target and eradicate homogeneous, cloned,
      murine tumour cell populations in vitro and in vivo when coupled to monoclonal
      antibodies (MoAb); however, the antitumour activity of Ida-MoAb conjugates
      against human tumour xenografts remains to be established. In this study, the
      value of cotargeting conjugates to different human tumour-associated antigens
      within a solid tumour has been assessed by comparing the effects of combinations
      of Ida-anti-colon carcinoma MoAb conjugates with any one Ida-anti-colon carcinoma
      MoAb conjugate used alone. Individual Ida-MoAb conjugates have previously been
      evaluated for their specific binding and cytotoxicity to one of two different
      human colon carcinoma xenografts (Colo 205 or LIM2210) in vitro, although their
      efficacy alone or in combination required assessment in vivo. Combinations of the
      most effective Ida-MoAb conjugates were demonstrated to enable a greater number
      of complete tumour regressions than the most efficacious Ida-MoAb conjugate
      administered alone in vivo; some combinations inhibited control tumour growth by
      up to 95%. This study suggests that Ida-MoAb conjugates can be effective against
      subcutaneous human tumours in nude mice, although it is unlikely that any single
      conjugate will eradicate all the tumour cells in a solid tumour, and the value of
      'cocktails' of drug-MoAb conjugates against some xenografts (i.e. LIM2210)
      appears to be limited.

PMID- 8349301
TI  - Inhibition of burn-associated suppressor cell generation by glycyrrhizin through
      the induction of contrasuppressor T cells.
AB  - The inhibitory effect of glycyrrhizin (GR), an anti-inflammatory Chinese herbal
      drug extracted from licorice roots, on the generation of suppressor T cells in
      thermally injured mice (TI-mice) was investigated. The burn-associated suppressor
      T cell (BTs cell) activity was demonstrated in splenic mononuclear cells (SMNC)
      from mice 2 to 8 days after thermal injury when suppressor cell activity was
      assayed in a one-way mixed lymphocyte reaction. However, when TI-mice were
      treated with GR, SMNC harvested 6 days after thermal injury showed no suppressor
      cell activity. This activity of GR demonstrated a dose-response effect, with a
      dose of 10 mg/kg exhibiting peak levels of the activity. Since GR had no direct
      inactivating activities against BTs cells in vitro, the inhibitory effect of
      SMNC, derived from TI-mice treated with GR, on the activity of BTs cells was
      examined in the same mixed lymphocyte reaction system, and the results showed
      that the SMNC from GR-treated mice 6 days after thermal injury counteracted the
      activity of BTs cells. The type of cell responsible for this inhibition of BTs
      cell activities was a CD3+, L3T4+, Vicia villosa lectin-adherent T cell with the
      same phenotypic properties previously exhibited by contrasuppressor cells. These
      results suggest that GR may regulate the generation of BTs cells through the
      induction of contrasuppressor cells. Since there are many reports describing
      septic infections due to the appearance of BTs cells in postburn patients, it may
      be possible to apply GR or blood preparations containing contrasuppressor cell
      populations induced by GR in healthy volunteers into immunosuppressed burn
      patients to avoid infections.

PMID- 8349302
TI  - Killing by cytotoxic T cells and natural killer cells: multiple granule serine
      proteases as initiators of DNA fragmentation.
AB  - The vectorial secretion of the contents of highly specialized cytoplasmic
      granules is of pivotal importance to the killing by cytotoxic T cells and natural
      killer cells. The purification and biochemical characterization of some of the
      granule constituents, in particular the pore-forming protein perforin, had
      engendered the notion that the killing of cellular targets was largely an osmotic
      phenomenon analogous to the insult delivered by complement attack. However, the
      apparent absence of membrane perforation in various examples of lymphocyte
      mediated killing, and the observation that perforin alone could not account for
      apoptosis associated with programmed cell death, suggested that perforin activity
      represented, at best, only a part of the whole mechanism. More recently, the
      characterization of a large family of granule serine proteases (granzymes) has
      provided evidence that these molecules may collaborate in the killing process by
      inducing a 'suicide' pathway in target cells, resulting in DNA fragmentation.
      However, the serine proteases are inactive alone, their natural substrates have
      not been defined and they require access into the target cell cytoplasm via
      perforin-induced pores to exert their deleterious effects. Thus, we propose that
      the cytotoxic granule-mediated mechanism comprises at least two interdependent
      arms, perforin and serine proteases, that together are capable of inflicting cell
      death by osmotic shock and/or nuclear collapse.

PMID- 8349303
TI  - The maintenance of self-tolerance.
AB  - Two signal models for lymphocyte activation build on the Talmage/Burnet concept
      that receptor diversity is generated within the immune system by a random
      process, and that individual lymphocytes carry a single receptor on their surface
      that determines their specificity. Such models cannot use a concept of signal one
      anergy (or deletion) to explain the maintenance of self-tolerance in terms of the
      Bretscher/Cohn theory if they abandon the concept of associative recognition.

PMID- 8349304
TI  - Detection of mosaic protein mRNA in human astrocytes.
AB  - Mosaic proteins consist of a group of proteins that may be comprised of one or
      more types of a variety of different structural modules and have a diverse range
      of functions. We have examined primary human astrocyte cultures for the presence
      of three mosaic proteins, B2I and the complement proteins factor H and properdin.
      Using the polymerase chain reaction and an enhanced chemiluminescence detection
      technique, we were able to show that mRNA transcripts for each of these proteins
      are expressed in human astrocytes.

PMID- 8349305
TI  - Patterns of resistance to Candida albicans in inbred mouse strains.
AB  - Candida albicans infections were established in eight inbred strains of mice.
      Using established histological criteria, only two strains (AKR and CBA/CaH) were
      found to exhibit severe lesions. The remainder showed only mild tissue damage.
      Deaths occurred in three strains: CBA/CaH, A/J and DBA/2. The last two strains
      lack the important complement component C5. Colony counts in the brain varied
      widely between strains and showed no correlation with the extent or severity of
      tissue destruction. However, strains lacking C5 had a significantly greater
      fungal burden in the brain than C5-sufficient mice. The data are discussed in
      relation to concepts of susceptibility and resistance to C. albicans in
      experimental infections in mice.

PMID- 8349306
TI  - Origin and maintenance of germ-line V genes.
AB  - The distribution of nucleotide variability within the upstream of germ-line
      VH186.2-related variable genes was studied. The data in this report of work in
      progress indicate non-random selection for variability in the second antigen
      contact or complementarity-determining region (CDR2) for 12 such genes isolated
      using the polymerase chain reaction (PCR) technique from genomic C57BL/6 mouse
      liver DNA. The translated protein sequences of these and three additional
      previously published genes also display a pronounced Wu-Kabat peak of amino acid
      variability in CDR2. In the CDR1 and CDR2 regions of this set of related germ
      line genes, there are few [corrected] silent nucleotide changes, and most amino
      acid replacements (or non-synonymous changes) are non-conservative. In contrast,
      there is selection against amino acid replacement in the framework regions (FW),
      as indicated by the significant number of silent (or synonymous) mutational
      changes from the VH186.2 reference sequence. This is surprisingly similar to the
      Wu-Kabat variability patterns observed in somatically mutated immune response
      antibodies. These data could imply similar diversification mechanisms acting on B
      cell-expressed V genes in the soma (i.e. in a germinal centre) and in the germ
      line DNA of male and/or female germ cells. While always possible, we consider
      this unlikely. Similarly, we consider as unlikely an explanation based on a
      classical Darwinian model involving simple stepwise whole animal selection prior
      to reproduction for each VH and VL gene now phylogenetically stored in the V
      segment arrays of the genomic DNA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349307
TI  - Manipulation of autoimmune diseases with T-suppressor cells: lessons from
      experimental SLE and EAE.

PMID- 8349308
TI  - Antibodies to carcinogen-DNA adducts in mice chronically exposed to polycyclic
      aromatic hydrocarbons.
AB  - Antibodies specific for polycyclic aromatic hydrocarbon (PAH)-DNA adducts have
      previously been reported in human sera. In this study, we examined the
      association between mixed PAH exposure and PAH-DNA adduct specific antibodies in
      BALB/c mice. Mice were treated either by i.p. injection or by intragastric (i.g.)
      intubation with a mixture of seven different PAHs [benzo(a)pyrene (BP),
      benz(a)anthracene (BA), fluoranthene (FA), dibenz(a,h)anthracene (DBA), 3-methyl
      cholanthrene (MC), chrysene (Ch), benzo(b)fluoranthene (BF)] at three doses (0,
      15, 150 micrograms of each PAH) twice a week for 8 weeks. Sera were screened by
      direct ELISA for antibodies recognizing DNA modified by diolepoxides or epoxides
      of each PAH injected. In i.p. treated mice, the sera were slightly more reactive
      to DNAs modified with diolepoxides of BP, BA, or Ch or an epoxide of DBA than to
      unmodified DNA. In i.g. treated mice, the sera were more reactive to DNAs
      modified with diolepoxides of BA or BF than to unmodified DNA. For some PAHs, a
      dose-response effect was observed between sera reactivity to PAH metabolites and
      the dose of PAH administered. However, there was considerable variation in the
      immune responses among individual mice within each treatment group. When tested
      by competitive ELISA, none of the sera could discriminate between modified and
      unmodified DNA. This animal study suggests that an assessment of previous
      carcinogen exposure by measuring DNA adduct-specific antibodies requires further
      validation prior to its application to the human monitoring of carcinogen
      exposure.

PMID- 8349309
TI  - Production of a monoclonal antibody inhibiting the killer activity.
AB  - We established the hybridoma producing the monoclonal antibody (mAb) 3C3 by
      immunizing rats with mouse natural killer (NK)-like cells. The 3C3 mAb seemed to
      react mainly with T cells and T-lineage cell lines. The 3C3 antigen also seemed
      to be coincidentally expressed on a part of asialo GM1+ cells from nude mice,
      suggesting its expression on NK cells. Treatment of effector cells with 3C3 mAb
      markedly inhibited the killer activity against RL male-1 cells, but less so
      against YAC-1 cells, in vitro. It is suggested that the cell surface molecule
      defined by 3C3 mAb was closely associated with the killer activity of T cells and
      NK cells.

PMID- 8349310
TI  - The fate of protein antigen in earthworms: study in vivo.
AB  - Parenteral administration of antigen induces in the earthworms Lumbricus
      terrestris and Eisenia foetida the formation of antigen-binding protein. Labelled
      antigen was efficiently digested in the coelomic fluids of both species since the
      total amount of radioactivity in the coelomic fluids decreased. Antigen
      internalized in the free coelomocytes of both species was present in a TCA
      precipitable form, although the decline of total radioactivity was higher than in
      the coelomic fluid, indicating that the TCA-nonprecipitable fragments are rapidly
      released from coelomocytes into the coelomic fluid. Within the first 24 h after
      administration, labelled antigen was detected throughout all tissues except for
      the epidermis and cuticle, and after 4 days it was found in the chloragogenic
      tissue around the gut, dorsal vein and typhlosole.

PMID- 8349311
TI  - Inhibition of normal natural killer cytotoxicity by sera from hemophilic
      patients.
AB  - In this study we searched for circulating antibodies or other serum factors that
      could account for the natural killer (NK) defect observed in hemophiliacs (He)
      infected with the human immunodeficiency virus (HIV). We analyzed the effect of
      negative or positive sera for HIV from He on normal NK activity. We showed that
      sera from He interfered with normal NK cytotoxicity. The inhibitory activity was
      higher in HIV+ sera and increased as the HIV disease progressed. HIV- sera also
      inhibited NK function, although to a lesser extent than HIV+, and it was probably
      due to isoimmunization through replacement treatment with plasma-derived
      concentrates. For each individual, no direct correlation was found between NK
      inhibition (NK-INH) of sera and the NK activity of He peripheral blood
      mononuclear cells (PBMC). Furthermore, He serum was poorly inhibitory on
      autologous PBMC. Preincubation of allogenic effector or target cells with He sera
      revealed that the inhibitory effect was the result of the reaction with these
      cells. A positive correlation was found by comparing NK-INH of whole He sera with
      the serum levels of circulating immune complexes. When the NK-INH assay was
      performed using the same concentration of DEAE-purified IgG from N, HIV- or HIV+,
      we found that HIV+ AIDS IgG was more inhibitory than the others.

PMID- 8349312
TI  - Changes in the level of perforin and its transcript during effector and target
      cell interactions.
AB  - Perforin is a cytoplasmic granule protein expressed in cytotoxic lymphocytes, and
      is capable of lysing target cells. This protein is induced as cytotoxic T cells
      are activated, and the mRNA expression is modulated by various stimulators. These
      observations suggest possible changes in the level of perforin transcripts and
      protein when killer lymphocytes meet specific target cells leading to target cell
      death. To address this question, we examined three murine T-cell clones and
      primary human NK cells in perforin expression. When the cytotoxic lymphocytes
      were exposed to sensitive targets, perforin mRNA disappeared within 5 to 30 min
      and appeared within an hour thereafter. Among the murine T cell clones, L3 and
      OE4 showed two phases of mRNA decrease while human NK cells and the third murine
      T cell clone, AB.1, showed only one phase of mRNA loss during a 240 min period.
      The data indicate that when cytotoxic lymphocytes receive signals from a
      sensitive target, the cells rapidly degrade previously accumulated perforin mRNA
      and synthesize new transcripts. Interestingly, heat shock protein 70 mRNA was
      induced as the perforin mRNA levels recovered, while P55 Il-2 receptor mRNA was
      downregulated within 5 min after exposure to targets. The perforin protein level
      also rapidly decreased immediately after the interaction with the target,
      followed by a recovery, and then another decrease as seen in primary human NK
      cells, OE4 and L3 cells. However, in the AB.1 clone, no change in perforin
      content was detectable, despite the loss of perforin mRNA.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8349313
TI  - Anti-Mlsa-like effect of CBA/J anti DBA2 antibody in in vitro MLRs between Mls
      incompatible combinations.
AB  - Antisera from CBA/J (H-2k,Mlsa) mice hyperimmunised with DBA2 (H-2d,Mlsa) and/or
      AKR (H-2k,Mlsa) splenocytes, can block in vitro MLRs against Mlsa determinants.
      These two antisera are furthermore specifically cytotoxic against targets
      expressing H-2 components but not against Mlsa-bearing targets. In these
      experimental models the anti-Mlsa-like effects of CBA/J anti-DBA2 and CBA/J anti
      AKR antibodies seem to be associated with an autoreactive immune response in
      CBA/J mice elicited by DBA2 and AKR splenocytes, respectively. In this report we
      propose that anti-Mlsa antibodies can also be generated in a situation in which
      Mlsa is presented as 'altered self' in conjunction with allo-determinants.

PMID- 8349314
TI  - Increased expression of C1q receptors on neutrophils from inflammatory joint
      fluids.
AB  - C1q receptor (C1qR) expression was determined by immunofluorescence flow
      cytometry on neutrophils from paired peripheral blood and synovial fluid samples
      from 21 patients with rheumatoid arthritis (RA) and 13 patients with other
      articular diseases (OAD). In both patient groups the levels of C1qR on
      circulating neutrophils were similar to that observed for normal control
      subjects, whereas on synovial fluid neutrophils significantly higher levels of
      receptor expression were observed. The mean percentage increases observed were:
      RA patients 47%, OAD patients 72%. C1q-bearing immune complexes were most
      prevalent in patients with RA, with the highest concentrations being found in
      synovial fluid samples. No correlation between immune complex levels and
      neutrophil C1qR expression was noted. Upregulation of C1qR expression is a
      feature of activated neutrophils from inflammatory joint fluids.

PMID- 8349315
TI  - A modified PABC immunoassay for the quantitation of DNA dependent RNA polymerase
      I: a procedure applicable to other proteins present in minute amounts and/or
      isoforms.
AB  - An indirect enzyme linked immunoassay (ELISA) has been developed to measure the
      amount of RNA polymerase I (E.C.2.7.7.6) in silkmoth tissue cell extracts.
      Subunit specific monoclonal antibodies (MABs) were immobilized on the solid
      substrate by a variation of the widely used Protein-Avidin-Biotin-Capture (PABC)
      technique. The use of the commercially available biotinylated anti-mouse antibody
      as a bridge to bind the monoclonal antibody eliminates the need for the
      biotinylation of the monoclonal antibody in the laboratory. The RNA polymerase in
      solution was captured by the monoclonal antibody and was measured by the
      successive binding of rabbit polyclonal antibody and alkaline phosphatase
      conjugated anti-rabbit antibody. This procedure is more reliable, reproducible
      and leads to greater sensitivity compared to the direct binding of the monoclonal
      antibody to the microtiter plate. RNA polymerase I captured by the antibodies
      from tissue extracts was measured at levels of 0.5 ng/well. This assay system can
      be utilized as a general procedure to quantitate the levels of proteins present
      at very low levels and that are found in different isoforms containing multiple
      and/or shared subunits.

PMID- 8349316
TI  - Distinct patterns of protective antibodies are generated against Borrelia
      burgdorferi in mice experimentally inoculated with high and low doses of antigen.
AB  - We have studied the development of clinical arthritis and the generation of
      protective antibodies in two normal, inbred strains of mice either infected by
      ticks or experimentally (subcutaneous) inoculated with increasing numbers of
      Borrelia burgdorferi organisms. AKR/N mice developed only mild and DBA/2 mice
      only marginal clinical arthritis irrespective of the route of infection or the
      numbers of spirochetes (10-10(8)) inoculated. In contrast, immunodeficient SCID
      mice developed severe chronic arthritis under similar conditions, but with a
      delayed onset at lower numbers of needle-inoculated spirochetes or after tick
      bite. AKR/N and DBA/2 mice inoculated with either 10(4) (and fewer) B.
      burgdorferi organisms or via experimentally infected ticks generated antibodies
      with specificities for a variety of B. burgdorferi antigens except those to the
      outer surface proteins A and B (OspA, OspB). In contrast, mice inoculated with
      more than 10(4) spirochetes (10(5)-10(8)) developed in addition antibodies to
      OspA and OspB. Most notably, all three types of immune sera taken from DBA/2 mice
      showed similar capacities to confer protection on SCID mice against subsequent
      challenge with viable B. burgdorferi organisms. The data not only demonstrate
      that the quality of humoral immune responses to B. burgdorferi in mice is
      determined by the antigenic load, they also indicate the existence of further
      protective antibodies with specificities distinct from OspA and OspB.

PMID- 8349317
TI  - Susceptibility to pristane-induced arthritis is altered with changes in bowel
      flora.
AB  - Pristane-induced arthritis (PIA) is unique among the animal arthritides in that a
      non-infectious, non-antigenic oil induces a chronic immune based arthritis with a
      prolonged delay between exposure to the inciting agent and development of the
      disease. Mice with pristane-induced arthritis have elevated T cell and humoral
      responses to the 65 kDa heat shock protein derived from Mycobacterium bovis
      (hsp65) and in common with several other models of autoimmune diseases the
      incidence of PIA is markedly suppressed by preimmunisation with hsp65 in Freund's
      incomplete adjuvant (Thompson et al. (1990) Eur. J. Immunol. 20, 2479). Recent
      studies have investigated how autoimmune reactions to heat shock proteins are
      involved in the development of arthritis. Arthritic CBA/Igb mice given pristane
      alone develop antibodies to both hsp65 and GroEl (bacterial 60 kDa heat shock
      proteins) and to hsp58 (the mammalian equivalent). Moreover, the splenic T cells
      of such mice proliferate vigorously in response to both bacterial and mammalian
      60 kDa heat shock proteins. Remarkably, the anti-hsp65 antibody response in
      normal mice rises rapidly with age, directly correlating with the age related
      incidence of PIA. In addition, specific pathogen free mice (SPF) maintained in an
      isolator have negligible anti-hsp65 responses but these convert to positive
      responses if the animals are exposed to the open part of the animal facility
      (Thompson et al. (1992) Arthritis Rheum. 35, 139).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8349318
TI  - Flow regulation of vascular tone. Its sensitivity to changes in sodium and
      calcium.
AB  - Our hypothesis is that flow-through hydraulic drag or shear stresses the
      extracellular elements in the vascular wall. When the endothelium is intact, this
      results in the release of endothelium-derived relaxing factor and other
      substances, eg, prostanoids, from the endothelium. As in some reports, after
      inhibition of nitric oxide synthase, flow effects are still observed although
      diminished; the shear effect is extended mechanically to the subendothelial
      tissues. Shear causes conformational changes in the glycosaminoglycans by
      extending them from a randomly coiled aggregated state to a more elongated
      condition along the line of flow. This elongation and the consequent exposure of
      an increased number of cationic binding sites on the glycosaminoglycans lead to
      changes in sodium binding. The extent of the conformational change is influenced
      by the concentration of calcium, an ion that not only competes with sodium at
      specific binding sites but possibly cross-links the polysaccharide chains of the
      protein saccharide complex. These complex interactions might account for the
      cooperative, nonantagonistic interaction of sodium and calcium over the
      physiological concentration range. Sodium binding is influenced by changes in
      external sodium concentration, and this presumably accounts for the sodium
      sensitivity of the flow response. Although glycosaminoglycans are possibly the
      most studied in this regard, they are not the only candidates. Other
      extracellular proteins, either in conjunction with glycosaminoglycans or
      independently, might be involved. By mechanisms not yet identified, these changes
      are signaled to the cell. We have proposed that in part, at any rate, this may be
      related to the sodium concentration gradient.

PMID- 8349319
TI  - Possible genetic influence on the strength of human muscle nerve sympathetic
      activity at rest.
AB  - Large reproducible interindividual differences in the strength of human muscle
      nerve sympathetic activity have been demonstrated previously without satisfactory
      explanation. We undertook the present study to investigate whether a genetic
      influence may be a factor of importance. Microneurographic recordings of
      sympathetic impulse traffic were made in the peroneal nerve in nine pairs of
      monozygotic male twins and eight pairs of age-matched male subjects without
      family relationship. The strength of the sympathetic activity was quantitated as
      number of sympathetic bursts per 100 heart beats and bursts per minute. Group
      mean values of muscle sympathetic activity, heart rate, and blood pressure were
      similar in the two groups. Intrapair differences (mean +/- SEM) of sympathetic
      activity were 5.4 +/- 1.7 bursts per 100 heart beats (1.7 +/- 0.5 bursts per
      minute) for the twins and 19.4 +/- 3.2 bursts per 100 heart beats (11.8 +/- 2.5
      bursts per minute) for the control subjects (P < .01 for both). The degree of
      reproducibility between twins is similar to that reported previously between
      repeated recordings in the same subject. The finding may indicate that the
      strength of sympathetic outflow to muscle is controlled genetically. If so, we
      speculate that this may contribute to the heritability of blood pressure in both
      normotensive and hypertensive subjects.

PMID- 8349320
TI  - Excitatory sympathetic reflex in NaCl-sensitive spontaneously hypertensive rats.
AB  - We have previously demonstrated blunted reflex responses of lumbar sympathetic
      nerve activity during volume expansion in NaCl-sensitive spontaneously
      hypertensive rats maintained on basal (1% NaCl) diets compared with NaCl
      resistant spontaneously hypertensive rats, Wistar-Kyoto rats, and Sprague-Dawley
      rats. The current study tested the hypothesis that chronic ingestion of a high
      (8%) NaCl diet further blunts cardiopulmonary reflex function in the NaCl
      sensitive spontaneously hypertensive rat. After 3 weeks of a 1% or 8% NaCl diet,
      male rats of all four strains were instrumented with femoral arterial and venous
      cannulas and lumbar nerve recording electrodes at 10 weeks of age. Two days
      later, conscious rats were infused with whole blood to expand blood volume. NaCl
      sensitive spontaneously hypertensive rats maintained on a 1% NaCl diet had
      blunted responses of nerve activity to acute volume expansion compared with
      control strains. NaCl-sensitive spontaneously hypertensive rats maintained on an
      8% NaCl diet had increases in nerve activity responses to volume expansion. In a
      second experiment, the volume expansion protocol was repeated in anesthetized
      NaCl-sensitive spontaneously hypertensive rats that had been subjected to
      sinoaortic denervation after 3 weeks of a 1% or 8% NaCl diet. After sinoaortic
      denervation, an increase in nerve activity was again observed during volume
      expansion in animals fed the 8% NaCl diet. In animals fed the 1% NaCl diet,
      changes in nerve activity were variable. The excitatory response was
      significantly reduced after bilateral vagotomy. These studies suggest that blood
      pressure regulation in NaCl-sensitive spontaneously hypertensive rats is a
      complex interaction of excitatory and inhibitory sympathetic reflex systems that
      is altered by high dietary NaCl exposure.

PMID- 8349322
TI  - Enhancement of intracellular sodium by vasopressin in spontaneously hypertensive
      rats.
AB  - The arginine vasopressin-induced increase in intracellular sodium concentration
      was augmented in cultured rat vascular smooth muscle cells derived from 12-week
      old spontaneously hypertensive rats (SHR) compared with those from 12-week-old
      normotensive Wistar-Kyoto (WKY) rats. This difference was enhanced by treatment
      with a Na+,K(+)-ATPase inhibitor, ouabain. The calcium-free state did not affect
      the basal intracellular sodium concentration but completely blocked the arginine
      vasopressin-induced increase in intracellular sodium concentration in both cell
      groups. The arginine vasopressin-mobilized cytosolic free calcium was enhanced in
      SHR compared with WKY rats. This enhancement was diminished but not completely
      inhibited in the calcium-free state. Also, arginine vasopressin-produced
      intracellular alkalinization was augmented in SHR. Pretreatment of both cell
      groups with a calmodulin antagonist, N-(6-aminohexyl)-5-chloro-1
      naphthalenesulfonamide, completely blocked arginine vasopressin-induced
      intracellular alkalinization and increased intracellular sodium concentration.
      Scatchard analysis showed that the V1 receptor number of either quiescent or
      proliferative cells of SHR was five to seven times greater than that of WKY rats,
      without any change in receptor affinity. These findings therefore indicate that
      the arginine vasopressin-induced increase in intracellular sodium concentration
      is augmented in vascular smooth muscle cells of SHR mediated through the
      enhancement of the mobilization of cytosolic free calcium and the activity of
      sodium-hydrogen exchange, which depends on an increase in V1 receptor number.

PMID- 8349321
TI  - Obesity-induced hypertension. Renal function and systemic hemodynamics.
AB  - This study examined the control of renal hemodynamics and tubular function, as
      well as systemic hemodynamics, during obesity-induced hypertension in chronically
      instrumented conscious dogs. Mean arterial pressure, cardiac output, and heart
      rate were monitored 24 hours a day using computerized methods, water and
      electrolyte balances were measured daily, and renal hemodynamics were measured
      each week during the control period and 5 weeks of a high-fat diet. After 7 to 10
      days of control measurements, 0.5 to 0.9 kg of cooked beef fat was added to the
      regular diet, and sodium intake was maintained constant at 76 mmol/d throughout
      the study. After 5 weeks of the high-fat diet, body weight increased from 24.0 +/
      1.0 to 35.9 +/- 4.9 kg, mean arterial pressure increased from 83 +/- 5 to 100 +/
      4 mm Hg, cardiac output increased from 2.86 +/- 0.27 to 4.45 +/- 0.55 L/min, and
      heart rate rose from 68 +/- 5 to 107 +/- 9 beats per minute. Associated with the
      hypertension was an increase in cumulative sodium balance to 507 +/- 107 mmol
      after 35 days and a rise in sodium iothalamate space, an index of extracellular
      fluid volume, to 131 +/- 4% of control. Sodium retention was due to increased
      tubular reabsorption, because glomerular filtration rate and effective renal
      plasma flow increased throughout the 5 weeks of the high-fat diet, averaging 135
      +/- 4% and 149 +/- 19% of control, respectively, during the fifth week of the
      high-fat diet.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349323
TI  - Rested-state contractions and rest potentiation in spontaneously hypertensive
      rats.
AB  - To gain further insight into the excitation-contraction coupling mechanisms in
      hypertrophy, we studied rested-state contractions, rest decay curves, and rest
      potentiation under different experimental conditions using papillary muscles of
      spontaneously hypertensive rats (SHR) and age-matched normotensive Wistar and
      Wistar-Kyoto (WKY) rats. Under constant stimulation at 1.1 Hz, contractility and
      relaxation were not significantly different in hypertensive when compared with
      normotensive animals. Rested-state contraction (the first beat after a rest
      interval of 15 minutes) increased to 159.2 +/- 23% and 123.5 +/- 7.5% of prerest
      values in Wistar and WKY rats, respectively, whereas in SHR it did not differ
      from prerest values (92.8 +/- 9.8%). Ryanodine, used to preferentially inhibit
      sarcoplasmic reticulum function, eliminated the differences in rested-state
      contractions observed between hypertensive and normotensive rats. Maximal rest
      potentiation (the first beat after a rest interval of 1 minute) was also
      significantly higher in Wistar and WKY rats than in SHR. These differences
      persisted at low extracellular Na+, when Ca2+ efflux via the Na(+)-Ca2+ exchanger
      was inhibited. Rest decay curves (the decay in contractility from maximal rest
      potentiation to rested-state contraction) showed a similar pattern in the three
      rat strains. The results suggest that the altered inotropic responses of the SHR
      arise from an alteration in calcium handling by the sarcoplasmic reticulum.
      Experiments on saponin-skinned trabeculae indicated that fractional calcium
      release induced by caffeine was significantly reduced in the SHR. We conclude
      that the altered inotropic response observed in SHR may reflect a diminished
      release of calcium from the sarcoplasmic reticulum.

PMID- 8349324
TI  - Potassium preserves endothelial function and enhances aortic compliance in Dahl
      rats.
AB  - It has recently been proposed that in rat models of genetic hypertension,
      supplemental dietary potassium preserves release of endothelium-derived relaxing
      factor independently of its capacity to either attenuate hypertension or increase
      plasma potassium. To test this hypothesis in Dahl salt-sensitive rats given
      sodium chloride (4%) for 3 weeks, we supplemented dietary potassium (2.1%) with
      either KCl (n = 16) or KHCO3 (n = 16). Compared with unsupplemented rats (n =
      16), rats supplemented with either potassium salt had a lower mean arterial
      pressure and a greater release of endothelium-derived relaxing factor, as
      assessed from acetylcholine-induced relaxation of precontracted aortic rings.
      However, the maximum relaxation response to acetylcholine correlated inversely
      with blood pressure (r = -.82, P < .001), not only in the KCl (r = -.68, P <
      .002) and KHCO3 (r = -.77, P < .001) groups but also in unsupplemented rats (r = 
      .86, P < .001). With potassium supplementation, plasma potassium concentrations
      measured between 4 and 6 PM did not increase, but those measured between 4 and 6
      AM did increase (P < .05). In isolated ring segments, aortic compliance was
      greater in both the KCl and KHCO3 groups than in unsupplemented rats (0.015 and
      0.017 vs 0.009 mm2/mm Hg) (P < .01). This greater compliance could not be related
      to differences in blood pressure, plasma potassium, or collagen or elastin
      content of the aortic wall.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349325
TI  - Renal sodium excretion in sons of hypertensive parents.
AB  - The objective of this study was to evaluate whether renal excretion of sodium is
      impaired and whether tubular reabsorption of sodium is increased in normotensive
      white men with a familial predisposition to develop essential hypertension. We
      compared 11 normotensive sons of two hypertensive parents (SOHT) with 11
      normotensive sons of two normotensive parents (SONT); renal sodium handling was
      assessed after 1 week of low-sodium diet (10 mmol/d) and after 1 week of high
      sodium diet (200 mmol/d). The SOHT were on average 5.5 years older than the SONT
      (46.9 +/- 5.2 [SD] vs 41.4 +/- 4.1, P = .012). On the sixth day of each diet,
      mean urinary sodium excretion did not differ between the two groups (12.9 +/- 6.3
      vs 12.7 +/- 6.7 mmol/d on low-sodium diet, P = .930; 197 +/- 25 vs 200 +/- 27
      mmol/d on high-sodium diet, P = .817). On the seventh day of each diet, baseline
      means for filtered load of sodium, absolute excretion of sodium, fractional
      excretion of sodium (an index of total tubular sodium reabsorption), and
      fractional excretion of lithium (an inverse index of proximal tubular sodium
      reabsorption) also did not differ between the groups. To assess renal sodium
      handling under non-steady-state conditions, we infused 2 L normal saline
      intravenously over a 2-hour period. The means for absolute excretion of sodium,
      fractional excretion of sodium, and fractional excretion of lithium increased
      from baseline, but the increases did not differ in magnitude between the
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349326
TI  - Divergent hemodynamic and hormonal responses to varying salt intake in
      normotensive subjects.
AB  - Blood pressure responses to 1 week of low-salt (20 mmol sodium/d) and high-salt
      (300 mmol sodium/d) intake were investigated in a single-blind randomized study
      in 163 white, nonobese normotensive subjects (65 women and 98 men; mean age, 38
      +/- 1.2 years). The individuals were classified as salt sensitive when mean
      arterial blood pressure rose by at least 5 mm Hg during high-salt intake, as salt
      resistant when mean arterial blood pressure changed by less than 5 mm Hg, and as
      "counterregulator" when mean arterial blood pressure fell by at least 5 mm Hg
      during the high-salt diet. Reexamination of 31 subjects showed that this approach
      to the testing of salt sensitivity was reliable and reproducible. Thirty subjects
      (18.4%) were classified as salt sensitive, 108 (66.3%) as salt resistant, and 25
      (15.3%) as counterregulators. Multiple regression analysis revealed that age,
      body weight, and family history of hypertension contributed significantly to the
      change in blood pressure after the diets. Salt sensitivity was more frequent in
      older subjects and in those with a positive family history of hypertension. An
      increase in blood pressure after salt restriction was more likely in younger
      individuals and in those with a negative family history of hypertension. Plasma
      renin activity and plasma aldosterone concentrations were lower in salt-sensitive
      compared with salt-resistant and counterregulating subjects. The rise in plasma
      renin activity during salt restriction was most pronounced in counterregulating
      subjects. Plasma norepinephrine concentrations were not different among the
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349327
TI  - Salt-dependent renal effects of an angiotensin II antagonist in healthy subjects.
AB  - This study was designed to evaluate in healthy volunteers the renal hemodynamic
      and tubular effects of the orally active angiotensin II receptor antagonist
      losartan (DuP 753 or MK 954). Losartan or a placebo was administered to 23
      subjects maintained on a high-sodium (200 mmol/d) or a low-sodium (50 mmol/d)
      diet in a randomized, double-blind, crossover study. The two 6-day diet periods
      were separated by a 5-day washout period. On day 6, the subjects were water
      loaded, and blood pressure, renal hemodynamics, and urinary electrolyte excretion
      were measured for 6 hours after a single 100-mg oral dose of losartan (n = 16) or
      placebo (n = 7). Losartan induced no significant changes in blood pressure,
      glomerular filtration rate, or renal blood flow in these water-loaded subjects,
      whatever the sodium diet. In subjects on a low-salt diet, losartan markedly
      increased urinary sodium excretion from 115 +/- 9 to 207 +/- 21 mumol/min (P <
      .05). The fractional excretion of endogenous lithium was unchanged, suggesting no
      effect of losartan on the early proximal tubule in our experimental conditions.
      Losartan also increased urine flow rate (from 10.5 +/- 0.4 to 13.1 +/- 0.6
      mL/min, P < .05); urinary potassium excretion (from 117 +/- 6.9 to 155 +/- 11
      mumol/min); and the excretion of chloride, magnesium, calcium, and phosphate. In
      subjects on a high-salt diet, similar effects of losartan were observed, but the
      changes induced by the angiotensin II antagonist did not reach statistical
      significance. In addition, losartan demonstrated significant uricosuric
      properties with both sodium diets.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349329
TI  - Alcohol use and blood pressure in an unacculturated society.
AB  - Alcohol intake has been associated with higher blood pressure in acculturated
      populations but not in unacculturated societies. We performed a cross-sectional
      survey of a random community sample of 5023 male Yi rural farmers and 1656 Yi and
      2173 Han men living in an urban setting. Average alcohol intake among drinkers
      was 36.4 g/d in Yi farmers, 56.5 g/d in Yi migrants, and 38.7 g/d in Han men. Age
      adjusted mean diastolic blood pressure was 66.9, 70.5, and 71.7 mm Hg,
      respectively. Diastolic blood pressure was higher at higher alcohol intakes in
      all three groups (all P < .001). After adjustment for age, body mass index, heart
      rate, smoking, and physical activity, the change (95% confidence interval) in
      diastolic blood pressure for each standard drink was 0.50 (0.38-0.62), 0.31 (0.18
      0.43), and 0.24 (0.07-0.40) mm Hg for Yi farmers, Yi migrants, and Han men,
      respectively. The percentage of variance in diastolic blood pressure explained by
      alcohol intake was 5% for Yi farmers, 4% for Yi migrants, and 2% for Han men. In
      a random sample of 831 men, these associations were independent of urinary
      sodium, potassium, calcium, and magnesium and sodium-potassium ratio. In the Yi
      farmers, associations were less strong for systolic blood pressure and no longer
      significant after adjustment. Approximately 33% of hypertension could be
      attributed to daily alcohol use in the Yi groups compared with 9.5% in the Han
      people.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349328
TI  - Elevated renovascular tone in young spontaneously hypertensive rats. Role of
      cytochrome P-450.
AB  - The present study examined the role of cytochrome P-450 metabolites of
      arachidonic acid in elevating renal vascular resistance in young spontaneously
      hypertensive rats (SHR). Differences in vascular tone were assessed in the
      preglomerular vasculature of 3- to 4-week-old prehypertensive SHR (n = 11) and
      normotensive Wistar-Kyoto (WKY, n = 10) and Wistar-Lewis (n = 10) rats. Pressure
      diameter relations to changes in renal perfusion pressure were compared using the
      juxtamedullary nephron microvascular preparation perfused in vitro with a
      physiological salt solution. At a pressure of 60 mm Hg, the basal diameters of
      the interlobular arteries and proximal and distal afferent arterioles of the SHR
      averaged 43 +/- 2, 17 +/- 0.3, and 11 +/- 0.4 microns, respectively. The
      diameters of the interlobular arteries and afferent arterioles were 9% to 14%
      smaller than those of corresponding vessels in WKY and Wistar-Lewis rats.
      Addition of P-450 inhibitors, ketoconazole (100 mumol/L) or 7-ethoxyresorufin (1
      mumol/L), to the perfusate dilated the afferent arteriole of SHR by 7% to 12%,
      whereas it increased the diameter by only 0% to 6% in control rats and
      significantly reduced the differences in the pressure-diameter relation in the
      preglomerular vasculature of SHR and control rats. Inhibitors of P-450 eliminated
      the contractile response of afferent arterioles to increases in renal perfusion
      pressure in all three groups. Removal of calcium from the perfusate eliminated
      differences in the diameters of the preglomerular vasculature in SHR and
      normotensive rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349331
TI  - Cardiac weight in hypertension induced by nitric oxide synthase blockade.
AB  - Wistar rats given a nitric oxide synthase inhibitor, NG-nitro-L-arginine-methyl
      ester (L-NAME), for 4 weeks develop time- and dose-dependent hypertension without
      cardiac hypertrophy. This initial study of the relation between left ventricular
      weight and L-NAME-induced hypertension has now been extended by giving 50 mg/kg
      per day L-NAME to Wistar rats (n = 30) for 8 weeks and comparing results with
      those from control rats (n = 10) and two-kidney, one clip rats (n = 14). Although
      L-NAME rats and two-kidney, one clip rats had increased systolic blood pressures
      during the last 3 weeks of the experiment (202 +/- 24 and 224 +/- 16 mm Hg,
      respectively), the ratio of left ventricular weight to body weight of L-NAME rats
      (2.12 +/- 0.32 mg/g) was not statistically different from that of control rats
      (1.93 +/- 0.13 mg/g), whereas that of two-kidney, one clip rats was increased
      (2.85 +/- 0.20 mg/g). The plasma renin activity of L-NAME rats was not
      significantly different from that of control rats. Two L-NAME rat subgroups were
      defined according to the presence of left ventricular hypertrophy (ratio of left
      ventricular weight to body weight > 2.19 mg/g, control mean +2 SD) (6 of 25) or
      its absence (19 of 25). Systolic blood pressure, plasma renin activity, and
      cardiac angiotensin converting enzyme activity of L-NAME rats with left
      ventricular hypertrophy were significantly higher than those of the subgroup
      without.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349330
TI  - Effects on blood pressure of omega 3 fats in subjects at increased risk of
      cardiovascular disease.
AB  - This study was conducted to compare the effects of omega 3 fatty acids, taken as
      fish or fish-oil supplements in the setting of a high- or low-fat dietary
      background, on blood pressure and heart rate in men with moderate cardiovascular
      risks. One hundred twenty men were randomly allocated to five high-fat (40% of
      daily energy) and two low-fat (30% of energy) groups to undertaken a 12-week
      dietary intervention period involving fish, fish oil, or a combination of these.
      Sodium intake was restricted to less than 90 mmol/d. The five high-fat groups
      were assigned to take either 6 or 12 fish-oil capsules daily, fish or a
      combination of fish oil and fish, or placebo capsules. The two low-fat groups
      took either fish or placebo capsules. Fish meals were devised to provide 1.3 g of
      eicosapentaenoic acid daily, equivalent to that contained in 6 fish-oil capsules.
      Subjects were instructed to eat a selection of fish that provided an average of
      3.65 g/d (range, 3.2 to 4.1 g/d) of total omega 3 fatty acids. Subjects were seen
      at regular intervals during the baseline and dietary intervention periods for
      measurement of weight, blood pressure, heart rate, dietary compliance, urinary
      electrolyte excretion, platelet phospholipid fatty acids, blood glucose, and
      insulin concentration. There was a greater fall in both systolic and diastolic
      blood pressures in subjects allocated fish or fish oil, particularly in the low
      fat groups, compared with control subjects. However, there was no significant
      group effect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349332
TI  - Chlorothiazide. How the thiazides evolved as antihypertensive therapy.

PMID- 8349333
TI  - 1993 guidelines for the management of mild hypertension. Memorandum from a World
      Health Organization/International Society of Hypertension meeting. Guidelines
      Subcommittee of the WHO/ISH Mild Hypertension Liaison Committee.

PMID- 8349334
TI  - Paediatric trauma in the rural developing world: low cost measures to improve
      outcome.
AB  - We reviewed 181 injured children admitted to a rural African hospital from 1987
      to 1990 to ascertain factors influencing survival and functional outcome. Burns
      were the most common (39 per cent), occurred in the youngest patients, and were
      due to domestic scalding in 54 per cent of cases. Of the patients, 65 per cent
      presented more than 24 h after injury and 81 per cent presented without any
      previous treatment. Major disability occurred in 14 per cent of survivors and was
      associated with Injury Severity Score (ISS), extremity injury, and delayed
      presentation. Mortality was associated with the ISS. The mean ISS was 6.3. An ISS
      of 20-25 was associated with 75 per cent mortality. Trauma caused 8 per cent of
      hospital deaths in the 5-19 years age group. To reduce the mortality and
      disability from paediatric trauma in the rural developing world, we recommend:
      (i) prevention strategies targeting domestic burns in younger children, (ii)
      increased attention to care of extremity injuries and burns, and (iii) increased
      use of non-medical health care providers in more remote areas.

PMID- 8349336
TI  - A simple and safe method for preservation of the injured spleen.
AB  - A total of 29 patients sustaining closed injuries of the spleen was evaluated
      after repair of the organ; 11 were children. The injuries were classified as
      grade II, 5; grade III, 22; and grade IV, 2. The spleens were repaired with
      figure-of-eight, 0 chromic catgut stitches placed at right-angles to the rupture
      using a liver needle. A thin layer of Surgicel was placed over the tear and each
      free side of the stitch. Haemorrhage from the spleen was controlled with this
      technique in 27 patients. Two patients with grade IV injury underwent ligation of
      the lower pole vessels and hemisplenectomy combined with patching and suture.
      Postoperative bleeding occurred in two patients with grade III injury, who then
      underwent splenectomy. The splenic function after splenorrhaphy was established
      to be perfect and there were no deaths. This modified technique of repair is a
      simple and safe method for preservation of the injured spleen.

PMID- 8349335
TI  - The paediatric cervical seat belt syndrome.
AB  - During a 9-year period, 541 children were admitted with injuries sustained as
      passengers in motor vehicle accidents. Of these, seven (1.3 per cent) had the
      cervical seat belt syndrome. Five children had fractures or fracture-subluxations
      of the proximal cervical spine, while two had injuries of the lower cervical
      spine. Head injuries occurred in four children, severe cervical spinal cord
      injuries in three, while a fracture of the larynx and recurrent laryngeal nerve
      palsies occurred in one child. All children were wearing three- or four-point
      restraints. In the former group, the neck injuries probably resulted from flexion
      of the neck over the poorly fitting sash of an adult-type lap-sash belt, while in
      the latter group, the injuries probably resulted from hyperflexion of the neck
      while the torso was securely restrained. One child died from a severe head injury
      and a complete cervical cord injury. Satisfactory spinal alignment and stability
      were achieved in the surviving children by non-operative treatment. However, only
      three children recovered completely from their injuries. Two require continuing
      care for cervical spinal cord damage and one has persistent tracheal stenosis and
      paralysis of the vocal cords.

PMID- 8349337
TI  - Hepatic trauma: experience of 110 cases.
AB  - A total of 110 patients with hepatic injuries was treated at a major urban trauma
      centre between June 1988 and December 1991. The mechanism of injury was blunt
      trauma in 86 patients (78 per cent). Non-operative treatment was given in six
      patients (5 per cent). Simple hepatorrhaphy, use of topical haemostatic agents or
      peritoneal drainage alone were performed in 79 (72 per cent) cases. Extensive
      hepatorrhaphy, hepatotomy with selective vascular ligation, resection and
      debridement or resection, perihepatic packing and major vascular ligation were
      undertaken, often in combination, in 25 (23 per cent) cases. Percutaneous
      arterial embolization was carried out in one case. The mortality rate was 18 per
      cent. The most frequent postoperative complications related to hepatic injury
      were intra-abdominal abscess (7 per cent) and coagulopathy (5 per cent);
      prolonged biliary leak (3 per cent), late haemorrhage (2 per cent) and hepatic
      necrosis (1 per cent) were also observed.

PMID- 8349339
TI  - The AO classification of long bone fractures: an early study of its use in
      clinical practice.
AB  - Over a period of 6 months, 543 long bone fractures were classified using the AO
      classification system. Factors important in determining the management of
      fractures occurring in three regions; hip, forearm and tibia, were identified. In
      hip fractures, we found that the anatomical configuration of the fracture, and
      therefore its classification, generally determined management. However, there
      were other factors that influenced the more specific form of surgical treatment
      used. In forearm fractures, the age of the patient was the most important factor
      determining treatment, while many factors, including consultant preference,
      determined the treatment of tibial fractures. While we found the system useful
      for audit purposes, we also found that it was unnecessarily complicated and often
      fell short of playing a useful role in the planning of management.

PMID- 8349338
TI  - Fractures of the scapula associated with traumatic paralysis: a pathomechanical
      indicator.
AB  - In this study, 25 cases of fracture of the scapula associated with traumatic
      paralysis were reviewed. The vast majority of the patients were young males,
      victims of high-speed traffic accidents. Of the vertebral injuries in this
      population, 76 per cent occurred in the thoracic region, 20 per cent in the lower
      cervical region and only one in the lumbar region. Complete paralysis was
      documented in 84 per cent of the patients. The characteristics of spinal column
      failure are determined by the anatomical configuration and the direction and
      energy of the impact. Important information about the latter can be extrapolated
      from careful analysis of the associated fractures.

PMID- 8349340
TI  - Valgus reduction of trochanteric fractures.
AB  - A total of 663 patients in whom a Dynamic Hip Screw was inserted for internal
      fixation of an intertrochanteric femoral fracture were studied prospectively to
      determine the optimum position of reduction. Results show that those fractures in
      which a valgus reduction was performed had a reduced incidence of fixation
      failure. For those fractures fixed in a varus position, 28 per cent of screws cut
      out from the femoral head. A valgus reduction is, therefore, to be recommended in
      preference to fixation in an anatomical position and a varus position must be
      avoided.

PMID- 8349341
TI  - Preoperative traction for hip fractures in the elderly: a clinical trial.
AB  - A consecutive series of 100 patients with femoral neck fractures were assessed by
      a mental test score on admission. The 67 scoring within the normal range were
      randomly assigned to skin traction or no traction between admission and
      operation. Using pain assessment scales and records of analgesic consumption,
      there was found to be little difference between the two groups. The conclusion
      was that skin traction offered no benefits in pain control for the patient and
      therefore should not be used routinely.

PMID- 8349342
TI  - Surgical treatment of acetabular posterior wall fractures.
AB  - This is an analysis of 52 fractures of the posterior wall of the acetabulum
      treated operatively and reviewed 2-15 years after injury. In 48 cases the
      fracture was associated with posterior dislocation of the hip, which was treated
      by closed reduction soon after the injury. In all but two of the cases there was
      a displaced single or comminuted fragment resulting in a large defect in the
      posterior acetabular wall; they were treated by open reduction and internal
      fixation to restore joint congruity and stability. In the remaining two cases,
      the fragment was small but trapped in the joint and was excised. A strict
      correlation was found between accurate reduction of the fracture and the clinical
      and radiological results, which were excellent or very good in 85 per cent and
      87.5 per cent of the patients, respectively. Surgical and late complications were
      peroneal palsy in four patients, ectopic ossification restricting hip movement in
      two cases, aseptic necrosis in three, and osteoarthritis in another three cases.

PMID- 8349343
TI  - Operative treatment of displaced intra-articular glenoid fractures.
AB  - Operative treatment is indicated in displaced intra-articular glenoid fractures.
      We report the results of treating 14 such fractures with open reduction and
      stable internal fixation. With an average follow-up period of 30.5 months, all
      fractures healed. All shoulders are rated good according to Rowe's scoring
      system. Complication was minimal, apart from those which resulted from the
      concomitant chest injuries. We therefore conclude that the operative treatment
      for these fractures gives good and predictable results. Special attention should
      be paid to treat the complications resulting from the common association of chest
      injuries in these patients.

PMID- 8349344
TI  - Recurrent anterior glenohumeral joint dislocation and torsion of the humerus.
AB  - Two computerized axial tomographic sections, one taken just below the coracoid
      process and the other about 2.5 cm proximal to the interepicondylar line, were
      used to determine glenoid version and humeral torsion in 19 patients with
      recurrent anterior glenohumeral joint dislocation and in 23 controls. Analysis of
      interobserver variation revealed the method to be reliable. There was no
      difference in glenoid version between the two groups. However, humeral torsion
      was greater in patients (153 degrees) than in controls (144 degrees). It appears
      that increased humeral torsion may predispose to glenohumeral joint dislocation.

PMID- 8349345
TI  - Transfer of multiply-injured patients for neurosurgical opinion: a study of the
      adequacy of assessment and resuscitation.
AB  - A total of 21 consecutive referrals with multiple injuries (Injury Severity Score
      (ISS) 17-66), admitted into the Regional Neurosurgical Unit (RNSU) over a 1-year
      period from August 1989, was analysed to evaluate the risks associated with
      transfer of such patients from district general hospitals within the North West
      Thames Region. Injury assessment was deficient in nine cases. Four developed
      hypovolaemic shock during transfer, and in five resuscitation was inadequate.
      Four had minor head injuries and two had no head injury; of these cases, one
      died. There were four fatalities: the mean ISS in this group was 42, and in all
      cases deficiencies in resuscitation and assessment before transfer were
      identified. There were seven major missed injuries. All patients had
      musculoskeletal injuries and 16 required orthopaedic intervention within 6 h.
      Interhospital transfer of this group of patients carries significant risks, may
      be unnecessary, and may delay other surgical priorities.

PMID- 8349346
TI  - Selective conservatism in the management of penetrating abdominal bull-gore
      injuries.
AB  - In a retrospective analysis it was found that not all patients with penetrating
      bull-gore injuries of the abdomen need exploration by formal laparotomy. A policy
      of selective conservatism was followed in the management of 18 out of 20 patients
      with bull-gore injuries of the abdomen in whom peritoneal breach was established
      either on presentation or by digital exploration of the wound. Formal laparotomy
      was reserved for specific clinical indications. Out of the 18 cases, 14 (78 per
      cent) were successfully treated non-operatively with wound excision, simple
      closure of the wound, and careful repeated clinical evaluation. There was no
      mortality in this group. Four cases (22 per cent) were explored; three of these
      had indications for exploration on presentation and the fourth was explored 4
      days after admission. The latter was the only death that occurred in the series;
      the cause of death was probably pulmonary embolism. Omental and/or bowel
      evisceration occurred in 11 out of 18 cases (61 per cent). However, this was not
      considered an indication for exploration and all 11 cases were treated by simple
      replacement of omentum or bowel into the abdominal cavity. Penetrating abdominal
      bull-gore injuries can be managed safely by a policy of selective conservatism,
      reserving formal laparotomy for specific clinical indications.

PMID- 8349347
TI  - Traumatic section of the median nerve: an unusual complication of Colles'
      fracture.

PMID- 8349348
TI  - Isolated cervical nerve root injury treated successfully by operative
      decompression.

PMID- 8349349
TI  - Simultaneous dislocations of the carpometacarpal and metacarpophalangeal joints
      of the thumb.

PMID- 8349350
TI  - Acinetobacter sp. osteomyelitis of the femur: a late sequel of unrecognized
      foreign body implantation.

PMID- 8349351
TI  - Fracture-dislocations of the spine that may spare the cord: an explanation.
AB  - The combination of severe fracture-dislocation of the spine with little or no
      damage to the spinal cord and its roots is rare. There is a characteristic
      pattern of bony injury that seems most likely to result from a combination of
      extension and longitudinal compression and may not endanger the neural tissue.
      The usual clinical features of severe injury of the spine may be lacking and the
      radiological interpretation is difficult. Although the reports suggest that these
      injuries are stable in deformity this may not always be so and the spine should
      be afforded the usual protection.

PMID- 8349352
TI  - Vascular injury by an intertrochanteric fracture fragment.

PMID- 8349353
TI  - Hidden dangers in apparently stable neck injuries.

PMID- 8349354
TI  - Balloon angioplasty catheters for endovascular tamponade after vascular trauma.

PMID- 8349355
TI  - Insertion of distal screws in interlocking intramedullary nails.

PMID- 8349356
TI  - A PC program to aid in the choice of the design matrix in multiple linear
      regression.
AB  - A PC program, DESIGN, which can be used to evaluate and compare alternative
      choices of the design matrix, X, in the general linear model y = X beta + epsilon
      is described, illustrated and made available to interested readers. Given X, the
      program (1) computes various measures of the 'stability' of X and X'X and (2)
      determines the precisions of estimates of the model parameters, beta, and of
      predicted values, y, at the given design points. Examples focusing on polynomial
      regression are given.

PMID- 8349357
TI  - Design and integration of a graphic interface for an expert system in oncology.
AB  - We describe a graphic user interface for an expert system in oncology. The main
      objectives of our work has been to facilitate the adaptation of the system to
      different clinical environments and potentiate the factors which more directly
      determine the acceptance of the system by its users. We present the design
      principles derived from the features of the clinical domain chosen and from the
      objectives of the system. These principles are reflected on the design of the
      screen and of the interaction and in the style of integration of the interface
      with the other components of the system. Underlying the application we describe
      is a graphic user interface management system which provides facilities for the
      fast prototyping and integration of interfaces. We describe here those features
      of this tool which make the practical application of the design principles we
      consider possible.

PMID- 8349358
TI  - An ACSL simulation of the respiratory system.
AB  - A simulation program for the respiratory system using ACSL (Advanced Continuous
      Simulation Language) is presented. The underlying model is based on the
      representation of ventilation as a phasic air movement in lungs during the
      respiratory cycle. The translation of the model with ACSL instructions is
      described in particular for continuous processes, such as respiratory gas
      exchanges, and discrete events, such as changes of respiratory phase. The
      advantages of using ACSL are discussed, and the utility of such a simulation
      program in both research and education is demonstrated.

PMID- 8349359
TI  - Interpretation of low kappa values.
AB  - The use of the kappa statistic is commonly accepted as a measure for
      interobserver variability. However, in some situations, the interpretation of
      kappa should be handled with care. In this study 21 obstetricians were asked to
      segment and classify 13 cardiotocographic recordings for the major fetal heart
      rate (FHR) patterns acceleration, baseline FHR level, deceleration and undefined
      segments. In two cases the kappa statistic showed a poor group agreement. These
      low kappa values, however, were mainly due to the high proportion of baseline
      segments indicated by the referees. This finding will be exemplified by a
      discussion of one of the cases.

PMID- 8349360
TI  - Modeling and simulating the evolution of resistance against antibiotics.
AB  - An epidemiological model is proposed for the spread of resistance against
      antibiotics in populations of bacterial pathogens. The host population, which is
      assumed to be constant, is divided into three compartments, viz. susceptible,
      hosts infected by an antibiotic-sensitive strain and hosts infected by a
      resistant strain. It is further assumed that susceptibles can be infected by
      either strain and that there is a possibility for cross-infection between hosts
      infected by the two strains. The rate of cross-infection can be enhanced by
      mutations or the transfer of plasmids conferring resistance. Equilibrium analysis
      was performed in order to determine which of the strain 'wins' the competition by
      the host. It is assumed that the eventual shift in the competition between the
      two strains is due to treatment by antibiotic (selective pressure).

PMID- 8349361
TI  - Heart failure. Unfinished business--a possible role for vasodilators.

PMID- 8349362
TI  - Balloon pulmonary valvoplasty: factors determining short- and long-term results.
AB  - Balloon pulmonary valvoplasty was performed in 139 patients (age 2-44 years) with
      pulmonary valve stenosis. The right ventricular peak systolic pressure decreased
      from 137.1 +/- 46.8 mmHg to 76 +/- 51.3 mmHg (P < 0.001) and the right ventricle
      to pulmonary artery peak systolic gradient decreased from 116.3 +/- 49 mmHg to
      54.4 +/- 51.9 mmHg (p < 0.001). There was no significant change in systemic
      artery systolic pressure. The right ventricular peak systolic pressure to
      systemic artery systolic pressure ratio decreased from 1.13 +/- 0.41 to 0.63 +/-
      0.42 (P < 0.001). Patients with incomplete immediate relief of obstruction (right
      ventricle to pulmonary artery peak systolic gradient > 35 mmHg) had higher pre
      dilatation right ventricular peak systolic pressure (161.1 +/- 45.3 mmHg vs. 93.9
      +/- 38.8 mmHg, P < 0.001) and higher right ventricular peak systolic pressure to
      systemic artery systolic pressure ratio (1.31 +/- 0.42 vs 0.98 +/- 0.33, P <
      0.001) pre-dilatation and were older (17.2 +/- 8.6 years vs. 12.8 +/- 9.7 years,
      P < 0.01). The residual right ventricle to pulmonary artery peak systolic
      gradients in the majority of patients were infundibular, which regressed at
      follow up even in patients who did not receive long-term oral beta blockers.
      Follow up catheterisation in 79 patients after 13 +/- 8.7 months showed a further
      fall in right ventricular peak systolic-pressure (P < 0.001) and right ventricle
      to-pulmonary artery peak systolic gradient (P < 0.001).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8349363
TI  - Arterial duct morphology with reference to angioplasty and stenting.
AB  - We studied the angiographic morphology of the arterial duct in neonates with
      congenital heart diseases. We defined the variations in ducto-aortic angle,
      number of tortuosities and site of insertion into the aorta of the duct in five
      diagnostic groups: (i) patent arterial duct (unobstructed) (n = 27), (ii)
      coarctation of the aorta (n = 24), (iii) pulmonary stenosis (n = 23), (iv)
      pulmonary atresia (n = 19) with or without ventricular septal defect, (v)
      hypoplastic left heart syndrome (n = 3). In the patent arterial duct group the
      angles ranged from 80 to 139 degrees, mean 107 degrees; in the coarctation group,
      76 to 136 degrees, mean 104 degrees; in the pulmonary stenosis group, -60 to 111
      degrees, mean 43 degrees; in the pulmonary atresia group, -55 to 115 degrees,
      mean 25 degrees; in the hypoplastic left heart syndrome 92 to 105 degrees, mean
      98 degrees. The angles for the pulmonary atresia and stenosis groups were
      significantly less than those for the coarctation and patent ductus groups (P <
      0.001). A ventricular septal defect in patients with pulmonary atresia or
      pulmonary stenosis was significantly associated with a smaller angle, a more
      proximal and a more tortuous duct (P < 0.01). The varying morphology of the duct
      in neonates with congenital heart lesions, especially with right heart
      obstruction requires special attention when attempting catheter techniques of
      ductal stenting. In particular the angle of approach and the presence of
      tortuosities may increase the difficulty of endovacular stenting.

PMID- 8349364
TI  - Reliability and accuracy of measurement of transductal gradient by Doppler
      ultrasound.
AB  - Simultaneous continuous wave Doppler echocardiography, aortic and pulmonary
      artery pressure measurements were performed during cardiac catheterization in 46
      patients with patent ductus arteriosus. Doppler-derived systolic, mean and
      diastolic transductal gradients correlated well with those measured by
      catheterization, respectively (r = 0.972, SEE = 6.8 mmHg; r = 0.965, SEE = 5.4
      mmHg; r = 0.939, SEE = 6.2 mmHg), and there were clinically acceptable agreements
      between the two technical measurements. It is concluded that Doppler
      echocardiography is a reliable and accurate technique for noninvasive estimation
      of transductal gradients.

PMID- 8349365
TI  - Xamoterol in sinus node disease.
AB  - A pharmacological alternative to pace-maker implantation would be useful in some
      patients with sinoatrial disorder particularly since the single lead ventricular
      system usually fitted has disadvantages. Xamoterol, a cardioselective beta
      receptor partial agonist, has been shown to increase heart rate both in animals
      and in man. We, therefore, studied the effects of Xamoterol in patients with
      sinoatrial disease in a double blind, cross-over trial in 10 patients. Mean heart
      rates and number and duration of pauses were compared during the treatment phases
      of the trial with Holter monitoring. Mean heart rates were significantly
      increased between 01:00 h and 05:00 h (P < or = 0.02) and between 05:00 h and
      09:00 h (P < or = 0.01) on Xamoterol. The number of sinus pauses were eliminated
      or reduced on Xamoterol in six patients, but there was an increased frequency in
      three patients. Xamoterol, therefore, does increase the heart rate and reduce the
      number of pauses in sinoatrial disorder, but only in some patients.

PMID- 8349366
TI  - Long-term efficacy of heparin exercise treatment for patients with chronic effort
      angina: evaluation by exercise Tl-201 myocardial scintigraphy.
AB  - To determine the effects of heparin exercise treatment on the coronary collateral
      flow reserve, exercise thallium-201 myocardial perfusion images were obtained
      with the same work-load before and late after heparin exercise treatment (17 +/-
      2 months, mean +/- S.E.). In six patients with stable effort angina, to develop
      the collateral circulation, treadmill exercise was performed 20 times for 2-3
      weeks with pretreatment with a single intravenous dose of heparin (5000 IU). The
      coronary collateral flow reserve was measured quantitatively as a severity score
      by analysis of exercise thallium-201 myocardial perfusion images. The severity
      score was decreased from 11,976 +/- 1722 to 5531 +/- 1967 (P < 0.05) long after
      heparin exercise treatment. The ST segment depression at the time of peak
      exercise was also decreased from 0.15 +/- 0.02 mV to 0.05 +/- 0.02 mV. In an
      additional five medically treated patients, these indexes remained unchanged
      during 18 +/- 3 months of follow-up period. These findings demonstrate that the
      coronary collateral flow reserve is significantly enhanced with heparin exercise
      treatment. These preliminary results lend support for heparin exercise treatment
      as one of the possible therapeutic modalities for treating patients with chronic
      stable effort angina.

PMID- 8349367
TI  - Peripartum versus idiopathic dilated cardiomyopathy in young women--a comparison
      of clinical, pathologic and prognostic features.
AB  - Clinicopathologic features of 13 women with peripartum cardiomyopathy were
      compared to 13 women aged 19 through 38 with idiopathic dilated cardiomyopathy.
      No presenting clinical or pathologic variable distinguished either group.
      However, the clinical course differed between the groups. Eleven of 13 patients
      with idiopathic dilated cardiomyopathy had a poor clinical outcome, defined as
      persistent heart failure or death. Patients in this group succumbed one year or
      more after disease onset. Five of 13 patients with peripartum cardiomyopathy had
      poor outcome, with death occurring 9 months or less after disease onset. The
      clinical course of peripartum cardiomyopathy appears distinct from that of
      idiopathic dilated cardiomyopathy in young women.

PMID- 8349369
TI  - Dissecting left subclavian artery aneurysm: an unusual presentation of
      coarctation of the aorta.
AB  - We report a patient with coarctation of the aorta who presented with acute
      dissection of a large left subclavian artery aneurysm. The patient underwent
      successful reconstructive surgery.

PMID- 8349368
TI  - Surgical removal of a lipoma of the heart.
AB  - In a 29-year-old woman echocardiography revealed a tumour originating from the
      anterior wall of the right ventricle. Noninvasive findings aroused suspicion of a
      lipoma. The tumour was removed under cardiopulmonary bypass, the resulting defect
      in the right ventricular wall being covered with a Goretex patch. Histological
      examination classified the tumour as a rhabdomyolipoma.

PMID- 8349370
TI  - Rapid progression of septal hypertrophy in an adult with hypertrophic
      cardiomyopathy and excimer laser-treated coronary artery disease.
AB  - We present the case of a 55-year-old man with rapid progression from asymmetrical
      septal hypertrophy to hypertrophic obstructive cardiomyopathy over a 1-year
      period leading to persistent anginal symptoms despite adequate treatment of his
      concomitant coronary artery disease. The potential mutagenic side effects of XeCl
      excimer laser-radiation that was used to remove the arteriosclerotic plaque from
      the left anterior descending coronary artery may have contributed to the sudden
      increase in septal thickness.

PMID- 8349371
TI  - Spectral Doppler flow profiles in neonates with obstructive lesions of the aortic
      arch.
AB  - The aim was to assess the value of continuous and pulsed wave Doppler ultrasound
      in the detection and differentiation of obstructive lesions of the aortic arch in
      neonates. In 31 neonates with proven arch obstruction (pre- or juxtaductal
      coarctation in 19 patients; postductal coarctation in five patients; interrupted
      aortic arch in four patients; aortic arch atresia in three patients), continuous
      wave Doppler interrogation of the descending aorta from the suprasternal notch
      revealed a high velocity jet (greater than 2.2 m/s) directed away from the
      transducer in 12 patients. Of these, four neonates had preductal coarctation, and
      five postductal coarctation. The remaining three patients had arch interruption
      or atresia. Image guided pulsed Doppler ultrasound recordings were obtained from
      the arch upstream from the obstruction, the descending aorta distal to the
      obstruction, and from the arterial duct. Patients with coarctation had a
      prominent diastolic flow directed away from the transducer in the arch upstream
      from the obstruction, representing a diastolic coarctation gradient, or diastolic
      steal either by the patent arterial duct or by collateral vessels. In contrast,
      patients with arch interruption or atresia had only a systolic flow signal in the
      proximal arch. Ductal flow was either bidirectional (preductal coarctation, arch
      interruption, arch atresia), continuous right to left flow from pulmonary artery
      to aorta (one case each of juxtaductal coarctation and arch atresia), or
      continuous left to right flow from aorta to pulmonary artery (postductal
      coarctation). In neonates wide patency of the duct often precludes the
      development of a large pressure drop across a coarctation. Conversely, a high
      velocity signal may be recorded from a patent but restrictive duct. In
      conjunction with imaging, pulsed Doppler velocity profiles from the arch and
      patent duct permit a meaningful interpretation of the haemodynamics of arch
      obstruction.

PMID- 8349372
TI  - Causes of syncope in children: a prospective study.
AB  - We prospectively evaluated 80 patients with syncope, between January 1991 and
      January 1992 to determine the causes of syncope in children. There were 35 male
      and 45 female patients, whose mean age was 10.5 years. A single syncopal attack
      had occurred in 30 patients and multiple attacks in 50. A cardiovascular cause
      was established in 22 (27.5%) patients and a noncardiovascular cause in 36 (45%).
      The cause remained unknown in 22 patients (27.5%). Vasovagal syncope was the
      leading cause of syncope in these patients with an incidence of 32.5%. These
      findings suggest that every patient who has even one syncopal attack should be
      promptly investigated since the underlying cause could be a life-threatening one.

PMID- 8349373
TI  - Primary cardiac sarcomas. A report of three cases and a review of the current
      literature.
AB  - Primary cardiac sarcomas are uncommon but they may mimic a wide range of common
      cardiac pathologies by their modes of presentation. Surgery is the mainstay of
      treatment for non-metastatic disease however, the incidence of tumour recurrence
      and late metastases is high. For metastatic disease, the response to chemotherapy
      and radiotherapy is poor and surgery should be reserved for palliation where
      appropriate. The emphasis should be on early diagnosis of primary cardiac
      sarcoma, enabling prompt and relevant management.

PMID- 8349374
TI  - Unilateral pulmonary artery agenesis: a rare cause of haemoptysis and pleuritic
      chest pain.
AB  - Haemoptysis and pleuritic chest pain are common presentations of cardiopulmonary
      disease. While a number of common disorders may explain these symptoms,
      occasionally unusual causes may emerge which should be considered in the
      differential diagnosis especially if pulmonary embolism is unlikely; so that
      inappropriate anticoagulation or thrombolytic therapy is avoided. We present a
      case of unilateral pulmonary artery agenesis, who presented with pleuritic chest
      pain and haemoptysis, and was initially treated as a case of pulmonary
      thromboembolism.

PMID- 8349375
TI  - Comparative study of gallopamil versus nifedipine in patients with ischemic heart
      disease.
AB  - In order to compare the anti-ischemic activity of gallopamil and nifedipine, a
      cross-over, double-blind, randomised trial was carried out in 30 male out
      patients with a history of stable exertional angina, proven coronary disease and
      a positive stress test (ST-segment depression > or = 1 mm). After a first 1-week
      wash-out period on placebo, the patients were randomised to gallopamil, 150
      mg/day (50, 50 and 50) or nifedipine, 30 mg/day (10, 10 and 10) for 28 days.
      After a second 1-week wash-out period active treatments were crossed for another
      28 days. At the end of each drug or placebo period, a physical examination,
      laboratory tests and a stress test were performed. Oral short-acting nitrates
      were permitted throughout the trial periods. Twenty-one patients finished all
      periods of the study. Both drugs reduced the maximum ST-segment depression during
      the exercise test: from 2.45 +/- 0.97 mm (placebo) to 1.95 +/- 0.82 mm
      (gallopamil, P < 0.05) and from 2.50 +/- 0.93 mm (placebo) to 1.75 +/- 0.84 mm
      (nifedipine, P < 0.05). Gallopamil but not nifedipine increased stress tolerance
      significantly: from 486 +/- 156 s (placebo) to 598 +/- 138 s (gallopamil, P <
      0.05) and from 509 +/- 113 s (placebo) to 567 +/- 191 s (nifedipine, NS). No
      significant differences were found between drugs. Both calcium antagonists,
      gallopamil and nifedipine, showed similar efficacy in treating myocardial
      ischemia.

PMID- 8349376
TI  - Atenolol or nicardipine alone is as efficacious in stable angina as their
      combination: a double blind randomised trial.
AB  - BACKGROUND: Beta blockers and calcium antagonists are widely used in the
      management of angina pectoris in the belief that the combination is more
      efficacious than either drug alone. METHODS: This double blind randomised
      crossover placebo controlled study compares the effects of nicardipine, atenolol
      and their combination in 30 patients with chronic stable angina. Each treatment
      period lasted 6 weeks with dose titration after 3 weeks. Symptom limited
      treadmill exercise testing and radionuclide ventriculography at rest was carried
      out at the end of each treatment period. RESULTS: Total exercise duration and
      time to 1-mm ST-segment depression was significantly prolonged by nicardipine and
      atenolol when compared to placebo, the combination offered no additional benefit.
      Time to onset of angina was significantly prolonged by nicardipine and the
      combination but not by atenolol. Indices of left ventricular function were not
      significantly affected by any treatment other than an increase in left
      ventricular end diastolic volume on atenolol and the combination. CONCLUSIONS:
      Nicardipine and atenolol are equally effective in prolonging exercise duration
      and time to onset of ischemia in patients with chronic stable angina while the
      combination appeared to offer no additional benefit. Nicardipine prolonged the
      time to onset of angina significantly; again there was no further improvement
      with the combination. Neither drug appears to have an important effect on the
      parameters of diastolic function studied in patients with chronic stable angina.

PMID- 8349377
TI  - Effects of atenolol and diltiazem on exercise tolerance and ambulatory ischaemia.
AB  - Twenty-five normotensive patients with stable angina, angiographically documented
      coronary disease and normal left ventricular function were randomized to a
      crossover study comparing atenolol 100 mg x 1, sustained-release diltiazem 120 mg
      x 2, and their combination. A maximal symptom limited bicycle exercise test and a
      24-h ambulatory electrocardiographic (ECG) monitoring were performed at the end
      of each treatment period. Exercise duration was increased equally in the
      different treatment groups. Time to onset of 1-mm ST-segment depression was
      longer with atenolol (P < 0.02) and combination therapy (P < 0.01) than with
      diltiazem. The maximal ST-segment depression was decreased with atenolol (P <
      0.05) and combination therapy (P < 0.02), whereas, time to onset of angina was
      prolonged only with combination therapy (P < 0.03). The number of ischaemic
      episodes during ambulatory monitoring was lower with atenolol and combination
      therapy than with diltiazem (P < 0.01). The difference between atenolol and
      diltiazem was mainly due to lower ischaemic activity with atenolol between 06:00
      h and 12:00 h (P < 0.05). Anginal frequency (P < 0.01) and nitroglycerin
      consumption (P < 0.05) were lower with combination therapy than with monotherapy.
      Thus, while comparable effects were achieved on clinical variables, atenolol
      appeared to be more effective than diltiazem, reducing myocardial ischaemia
      during exercise and ambulatory monitoring. With combination therapy, both
      clinical and electrocardiograph signs of ischaemia were improved.

PMID- 8349378
TI  - Coronary artery vasomotion in cardiac transplant patients with normal coronary
      angiograms.
AB  - In 18 consecutive transplant patients with normal coronary angiograms and without
      calcium blocker therapy, and in 20 controls, we measured the diameters of the
      left anterior descending artery using quantitative coronary angiography.
      Measurements were effected on the frames recorded 5 min or more after intravenous
      administration of 0.4 mg methylergometrine, and 2 min after subsequent 2 mg bolus
      intracoronary isosorbide dinitrate administration. The arterial vasodilatory
      capacity was defined as the ratio of the difference of the largest and smallest
      arterial diameters and the smallest diameter. We observed normal vasoconstriction
      of the different coronary arterial segments. Coronary arterial diameter decrease
      from basal state was about 8% and was more pronounced at the distal segments of
      the left anterior descending artery. There was no difference of vasodilatory
      capacity between transplant patients and controls for the proximal and middle
      portion of the left anterior descending artery, while the difference was highly
      significant for the distal portion. In eight patients, the decrease of the
      vasodilatory capacity was beyond the lower limit of the normal range of values.
      The significance of those quantitative angiographic abnormalities is still
      unproven. They could be due to early vasomotor capacity blunting after
      transplantation and to late structural alterations of distal coronary vessels in
      cardiac transplant patients.

PMID- 8349379
TI  - The effect of lorcainide on arrhythmias and survival in patients with acute
      myocardial infarction: an example of publication bias.
AB  - Ninety-five patients with suspected acute myocardial infarction were randomly
      allocated on admission to hospital on a double blind basis to treatment with
      lorcainide, a Class 1C anti-arrhythmic drug, or matching placebo. Treatment was
      continued for 6 weeks. Twenty-four-hour ECG tape recordings were made immediately
      on admission, on the sixth or seventh day after admission, and again just before
      the end of the treatment period. Lorcainide was shown to be an effective anti
      arrhythmic agent. The study was not designed to evaluate the effect of lorcainide
      on survival, but there were nine deaths among the 49 patients treated with
      lorcainide compared with only one in the patients given placebo. These findings
      are consistent with the results of the First and Second Cardiac Arrhythmia
      Suppression trials (CAST and CAST-II). This study was carried out in 1980 but was
      not published at the time: it now provides an interesting example of 'publication
      bias'.

PMID- 8349380
TI  - Electrocardiographic assessment of infarct size: comparison between QRS scoring
      of 12-lead electrocardiography and dynamic vectorcardiography.
AB  - Myocardial infarct size is one of the most important predictors of prognosis in
      patients suffering an acute myocardial infarction. It can be assessed by
      enzymatic and electrocardiographic methods. The present report compares dynamic
      vectorcardiographic monitoring, serial plasma enzyme activity measurements and
      QRS scoring according to Palmeri as techniques for infarct size estimation. We
      report the results from 74 patients with acute myocardial infarction, who
      participated in a randomized trial of treatment with alteplase. A good
      correlation was found between myocardial infarct size by estimation from
      enzymatic measurement and from dynamic vectorcardiography. Dynamic
      vectorcardiography correlated more closely with enzymatically estimated infarct
      size in patients with Q-wave infarction, regardless of infarct location, than did
      QRS scoring of the conventional 12-lead electrocardiogram. Furthermore, dynamic
      vectorcardiography requires no time-consuming analysis and can be used for on
      line monitoring of patients with ongoing infarction to estimate the size of an
      acute infarction while it is developing.

PMID- 8349381
TI  - Cardiomyopathy secondary to sinus tachycardia.
AB  - We describe a case of cardiomyopathy resulting from a tachycardia of high-right
      atrial origin indistinguishable from sinus tachycardia. The symptoms and
      angiographic appearances improved dramatically with beta blockade.

PMID- 8349382
TI  - Atrial permanent pacing for sinus node dysfunction with absent right superior
      vena cava.
AB  - In patients with sinus node dysfunction and normal atrioventricular conduction,
      single chamber atrial pacing (AAI or AAIR mode) represents the most physiological
      treatment. Sinus node dysfunction is recognised in association with an absent
      right superior vena cava, and we present a case in which complete resolution of
      symptoms was achieved with endocardial atrial permanent pacing.

PMID- 8349383
TI  - Anomalous coronary arteries.

PMID- 8349384
TI  - Percutaneous transluminal coronary angioplasty or coronary by-pass surgery in the
      management of chronic angina pectoris.
AB  - The treatment modalities for patients with chronic stable angina have expanded
      since the introduction of percutaneous revascularization procedures such as
      percutaneous transluminal coronary angioplasty. In selected patients, these
      percutaneous procedures provide an excellent alternative to surgical
      revascularization; in other patients, percutaneous transluminal coronary
      angioplasty is an excellent alternative to medical therapy. Selection of the
      optimal therapy depends on the specific coronary anatomy, left ventricular
      function, clinical setting, and the need for complete revascularization. Also,
      the availability of bailout devices, such as stents for the dilatation procedure,
      needs to be considered in higher risk patients or higher risk lesions. Currently,
      randomized trials that are being completed will allow comparison of surgical
      versus angioplasty approaches and will improve our ability to tailor therapy for
      specific subsets of patients.

PMID- 8349385
TI  - The anti-arrhythmic effect of D-Ala 2, Leu 5, Arg 6-enkephalin and its possible
      mechanism.
AB  - We studied antiarrhythmic action of D-Ala 2, Leu 5, Arg 6-enkephalin (dalargin)
      in experiments on male rats. Dalargin is reported to prevent heart rhythm
      disturbance and heart electrical stability decrease in experimental coronary
      occlusion, postinfarction, cardiosclerosis and emotional stress. Dalargin
      prevents acute myocardial ischaemia-induced increase of cAMP content in blood
      serum and cardiac muscle, as an indirect feature of its antiadrenergic activity.
      D-Ala 2, Leu 5, Arg 6-enkephalin leads to a decrease of cAMP content in
      myocardium and blood plasma, which presumably indicates a decrease of sympathetic
      tone. The data strongly suggest that cGMP content increase and somatostatin level
      decrease in cardiac muscle play a significant role in antiarrhythmic action of
      dalargin.

PMID- 8349386
TI  - Conceptions of alcoholism among Koreans and Americans.
AB  - Ethnographic research has occasionally reported the presence (or absence) of the
      disease concept of alcoholism in non-Western cultures. But the problem of
      differences in the nature of the concept of alcoholism between cultures in which
      it exists has not been seriously investigated. This study contrasts beliefs about
      alcoholism among samples of Koreans and Americans at a university in the United
      States. The findings suggest that the concept of alcoholism is present in both
      cultures, but Koreans tend to restrict their disease to the physiological
      consequences of long-term alcohol use, while Americans accept a definition which
      is couched largely in social and behavioral terms. It thus appears that, in
      contrast to America, alcohol consumption in Korea is relatively high, but
      alcoholism is rare. The implications of these findings for drinking behaviors,
      and the diagnosis and treatment of alcoholism, are discussed.

PMID- 8349387
TI  - Population estimates of intravenous drug users and HIV infection in Los Angeles
      County.
AB  - This study applies multiple-capture models to drug treatment data and the
      synthetic estimation method to arrestee data to provide estimates of the number
      of IVDUs in Los Angeles County in 1989. Based on the 5% HIV-prevalence rate
      currently found in IVDUs in Los Angeles, it is estimated that there could be as
      many as 9,500 HIV-infected IVDUs. The estimates of IVDUs are generally higher
      than those obtained by back-calculation methods which often undercount IVDU
      related AIDS cases and do not consider deaths for causes other than HIV
      infection.

PMID- 8349388
TI  - The characteristics of recovering chemically-dependent Manitoba nurses.
AB  - Information about potential risk factors and characteristics of chemically
      dependent nurses is imperative to the development of primary and secondary
      prevention strategies. However, little is known about nurses who become dependent
      on chemicals, especially outside of the United States. In Canada, there is a
      dearth of studies. The purpose of this descriptive replication study is to
      provide information about the characteristics of chemically-dependent nurses in
      Manitoba, Canada, and to determine whether these characteristics are unique to
      one Canadian province or resemble an international profile. The study utilized an
      anonymous mailed survey to collect quantitative data from 22 recovering nurses.
      The majority of characteristics of the Manitoba nurses were similar to those
      found in American studies, thus adding further support to patterns emerging in
      the data base.

PMID- 8349389
TI  - Worksite smoking control, discouragement, and cessation.
AB  - Smoking control, discouragement, and cessation were investigated at three
      comparable chemical plants. One plant was randomly assigned to smoking cessation
      only while the other two plants were assigned to a comprehensive program of
      smoking control, discouragement, and cessation. Three weeks later, smoking
      cessation was provided at all three sites. Results are consistent with a previous
      investigation of the comprehensive program carried out at two oil refineries. Not
      only was there a greater rate of participation in the smoking cessation program
      with the comprehensive program, 4 months after completion of smoking cessation
      treatment revealed significant changes on all outcome variables in the expected
      direction and suggest the superiority of a comprehensive program of smoking
      control, discouragement, and cessation over cessation alone.

PMID- 8349390
TI  - Sexual risk behavior among injection drug-using human immunodeficiency virus
      positive clients.
AB  - This study examined sexual risk behavior of 154 seropositive Hispanic injection
      drug-using clients who were a subsample of a larger study. The results revealed
      that while nearly 71% followed safe sex practices at a 6-month follow-up, the
      other 29% were following risky sexual behaviors. Among males who were 25 years of
      age or younger, slightly over 58% were practicing unsafe sex. Among females,
      those in the 31-35 age group were all following risky sexual behaviors.
      Generally, those who lived with their sexual partners, females, and younger
      clients tended to follow risky sexual behaviors. These findings are very
      significant in the light of the heterosexual transmission of Human
      Immunodeficiency Virus (HIV). Educational and case management programs are needed
      to provide such clients with an understanding of the possibility of HIV
      transmission to their sexual partners and to their children in case of
      pregnancies.

PMID- 8349391
TI  - Which lesson components mediate refusal assertion skill improvement in school
      based adolescent tobacco use prevention?
AB  - Any of three components of current school-based refusal assertion training might
      mediate improvement of seventh grade students' ability to refuse tobacco use
      offers: 1) teaching students knowledge of ways to say "no," 2) engaging students
      in the practice of refusal assertion, or 3) motivating students to perform
      refusal assertion in a socially skilled way. A 3-condition true field
      experimental "component study" of the differential effects of these three
      components yielded improvement in role-played behavioral skill to refuse tobacco
      offers that was evident in both the Knowledge and Practice conditions but not in
      the Motivation condition. In these same two conditions, skills training led to a
      significant decrease in students' intention to use smokeless tobacco in the
      future but not cigarettes. A focus on engaging students in Knowledge and Practice
      components of refusal assertion training appears warranted.

PMID- 8349392
TI  - Reasons given by college students for drinking: a discriminant analysis
      investigation.
AB  - Based on self-reported levels of alcohol consumption, 473 college students (295
      female and 178 male) were placed into at-risk or not-at-risk groups. Using
      reasons given for drinking as the independent variables, discriminant analysis
      procedures were conducted separately on the males and females to determine if a
      function could be found which would discriminate between the groups. For the
      female group, 11 of 22 reasons defined a discriminant function which accounted
      for 36% of the variance between the groups (p < .001). This function was also
      able to correctly classify 71% of the holdout sample. For the males, five of the
      22 reasons defined a discriminant function which accounted for 36% of the
      variance between the groups (p < .001). This function was able to correctly
      classify 69% of the holdout sample.

PMID- 8349393
TI  - Affect and outcome in short-term group therapy for loss.
AB  - Affect and work variables were monitored for 12 of 16 groups involved in a
      controlled outcome study of psychoanalytically oriented short-term group therapy.
      Groups were conducted by experienced therapists for outpatients who experienced
      difficulties adapting to personal losses through death, separation, or both.
      Postsessional ratings of positive and negative affect were provided by individual
      patients, therapists, and other patients. Psychodynamic work was rated
      independently using a content analysis system. Patients who had experienced
      separation were more inhibited in their affective expression. Rating sources
      agreed that positive affect increased over time. Direct relationships were found
      between positive affect and favorable outcome. Concerning negative affect, the
      strongest predictors of favorable outcome involved the interaction of affect and
      work. Implications of these findings are discussed in terms of the cathartic
      hypothesis.

PMID- 8349395
TI  - The impact of unstructured games of fantasy and role playing on an inpatient unit
      for adolescents.
AB  - Games of fantasy and role playing such as Dungeons and Dragons (1983) have become
      increasingly popular among adolescents and young adults. This article reviews the
      negative impact of such games on an adolescent inpatient treatment setting. The
      unrestricted play of such games contributed to the disruption of a treatment
      setting, resistances to treatment, reinforcement of character pathology,
      disruption of individual treatments, and to the normalization of violence. When
      such games begin to be played on a psychiatric inpatient unit or are prominent in
      discussions of individual patients, treaters should examine them in the context
      of their potential to reinforce and foster resistance and maladaptive patterns of
      relating to the environment. Treaters are also encouraged to attempt to
      understand the meaning and risks of such games in the context of an individual
      patient's psychiatric difficulties and of group dynamics, both within the patient
      group and between patients and treaters.

PMID- 8349394
TI  - Group psychotherapy with bipolar patients: a review and synthesis.
AB  - Contrary to traditional thinking, a review of the recent literature has suggested
      that bipolar patients can be treated in homogeneous therapy groups in conjunction
      with concomitant lithium management. Important psychodynamic and interpersonal
      features are reviewed that have received empirical support and have enhanced our
      understanding of these patients. Goals for bipolar groups include educating
      patients on the nature of the disease, helping them learn ways of coping with its
      symptoms, and encouraging them to discuss relevant psychodynamic and
      interpersonal issues. To achieve these goals, therapists have used techniques
      involving education, support, and facilitation of group discussions. Further
      clinical and empirical work needs to be done to evaluate the effectiveness and
      process of these bipolar groups, particularly in the inpatient setting.

PMID- 8349396
TI  - Varieties of learning in an experiential group.
AB  - Variously described as enhancing sentence, supporting professional identity,
      providing insight and introducing the resident to covert group processes, the
      experiential group has been a part of residency education for over 25 years. This
      article specifically focuses on and identifies the potential areas for learning
      about group process in such an experience. These areas are organized around the
      contribution of individual psychological, social-psychological, and group-as-a
      whole issues in the group. Actualization of the learning depends on the
      psychological state and level of emotional preparedness of the individual member,
      the consultant's orientation and style, the composition and development of the
      group, and its relationship to the organization in which it takes place. An
      example is provided to highlight the areas of potential learning, and there is a
      discussion of some applications to the patient role and the practice of group
      psychotherapy.

PMID- 8349397
TI  - Control and power in supervision.
AB  - This article explores the dynamics of the supervisory process focusing on the
      factors effecting the balance of power between the supervisor and supervise. The
      assignment of inherent roles, issues of transference, countertransference, and
      the parallel process with all the risks involved for both parties are reviewed.
      Recent developments in the shifting supervisory equilibrium are analyzed and
      specific suggestions are offered to avoid the common pitfalls present in many
      contemporary supervisor situations.

PMID- 8349398
TI  - Employment barriers and work motivation for Navajo rehabilitation clients.
AB  - The Navajo nation provides vocational rehabilitation (VR) services to Navajo
      clients residing on and off the Navajo reservation. To evaluate motivation among
      disabled Navajo workers participating in VR programs, this study investigated the
      sociocultural meanings of work and its importance in the self-identity of
      contemporary Navajo workers and clients who apply for these services. Selected
      sociocultural variables that focused on cultural identity and perceptions as well
      as attitudes towards work were included as part of an assessment designed to
      predict motivation for employment success. The results of this study suggest that
      VR counsellors who work with Native American clients should recognize
      sociocultural history and the cultural perceptions of work as important factors
      in the rehabilitation and vocational planning process.

PMID- 8349400
TI  - Community-based rehabilitation cadres: their motivation for volunteerism.
AB  - Volunteer workers, or cadres, are critical to the successful implementation of
      community-based rehabilitation (CBR) programmes. To date, relatively little
      research has examined the importance of motivation in health volunteers in
      general, and especially CBR workers. This paper reports the major findings of a
      field study in rural Indonesia. A multimethod design within a broad qualitative
      research framework which focused on the personal experiences of CBR volunteers
      was utilized. Descriptive data were obtained from written questionnaires, focus
      groups and key informant interviews. Research findings indicated that volunteer
      cadres perform considerable duties and face numerous difficulties in the course
      of their CBR activities. Incentives also play an important role in determining
      the motivation and ultimate performance of volunteer cadres. Developing an
      understanding of what it is like to be a volunteer CBR cadre has important
      implications for rehabilitationists interested in developing and sustaining CBR
      programmes and is clearly critical to any evaluation of CBR.

PMID- 8349399
TI  - Perceiving oneself as 'disabled' or as having a 'disabling condition': a
      discriminant function analysis.
AB  - Using discriminant function analysis, information obtained in telephone
      interviews with a national, random sample of 1000 Americans with self-ascribed
      disabling conditions was analysed to cast light on differences between
      individuals who did and did not consider themselves 'disabled'. Maximum
      separation between the two groups was attained by an equation of six descriptors.
      In the order of their importance they were (1) the belief that others who knew
      them well considered them disabled, (2) self-rated severity of disability, (3)
      identification with others with disabilities, (4) gender, (5) perceived extent of
      limitations, and (6) needing equipment to walk. Somewhat different equations were
      generated for sampled men and women. An appreciation of these results in terms of
      a person's fit with his or her environment is offered.

PMID- 8349401
TI  - Adults with physical disabilities in institutional care: do they have a choice?

PMID- 8349402
TI  - Clinical application of contact lens telescopes.

PMID- 8349403
TI  - Employment rates for compensatable spinal injuries in Australia.

PMID- 8349404
TI  - Handicapped parents with non-handicapped dependants.

PMID- 8349405
TI  - Facilitating discrimination learning for persons with developmental disabilities.

PMID- 8349406
TI  - Depression and anxiety in families with a mentally handicapped child.

PMID- 8349407
TI  - Disability and the law of employment.
AB  - Following disappointment in Canada with the results of human rights legislation
      and a revival of interest in quota systems for the employment of disabled people,
      the author made a study of the quota system operating in Japan. This article
      describes the system and some of its problems. The author then seeks to assess
      the potential of a quota law that includes strong financial incentives for
      compliance. The author concludes that laws to compel the employment of disabled
      people have little potential for achievement, and that they may well be counter
      productive. The most promising avenues for the improvement of employment
      opportunities for disabled people lie outside the use of the law. However, some
      legal changes could help, and these are mentioned in the conclusion.

PMID- 8349408
TI  - Parental attitudes to out-of-home placement of young children with developmental
      disabilities.
AB  - The study tested the research construct that parental inclination to apply for
      out-of-home placement for their young children with developmental disabilities
      (up to 5 years) was a function of their stress levels, sense of coherence, and
      social support received from formal and informal resources. Sixty-one parents
      (out of 80) of children diagnosed as developmentally disabled in the central
      western part of Israel participated in the study. The construct above was
      confirmed, as the sense of coherence and informal social support moderated the
      levels of stress and parental consideration of out-of-home placement for the
      young child. In brief, parents that favoured raising their developmentally
      disabled children at home had high levels of sense of coherence and a strong
      informal support system. Findings are interpreted with respect to practice and
      previous research.

PMID- 8349409
TI  - Comparison of 55% TFA/CH2Cl2 and 100% TFA for Boc group removal during solid
      phase peptide synthesis.
AB  - Two parallel syntheses of 40 C-terminal amide peptides, ranging in length from 4
      to 20 residues, have been carried out using simultaneous multiple peptide
      synthesis. All synthetic steps, other than the removal of the Boc group, were
      performed simultaneously under identical experimental conditions. The two sets of
      peptides were deprotected with either 55% TFA/DCM for 30 min or 100% TFA for 5
      min. The purity of the peptides obtained when deprotecting with 55% TFA/DCM was,
      on average, 9% higher than with 100% TFA. The major impurity obtained during
      synthesis when 100% TFA was used for Boc removal corresponded to the omission of
      the second amino-acid residue added. Volumetric measurements of the swelling of
      the resin in the different deprotection solvents were carried out. These showed
      that the omission analogs generated are probably due to insufficient swelling of
      the resin, resulting in limited solvent transfer of 100% TFA into the resin and,
      in turn, incomplete Boc removal.

PMID- 8349410
TI  - Synthesis and biological activity of a destruxin analogue: D-Lac-6 destruxin E.
AB  - A general strategy for the synthesis of destruxin analogues is described and
      applied to a particular example, D-Lac-6 destruxin E. The tetrapeptide Boc-Ile-N
      MeVal-N-MeAla-beta-Ala-OMe (2) was chosen as the basic starting compound, and its
      preparation was optimized. This fragment was then coupled with the compound
      (D)Lac-Pro, and the resulting peptide was cyclized by the DEPC or DPPA/HOBt/DMAP
      methods at 21 and 30% yield, respectively. The biological activity of the
      analogue obtained was established by injection to an insect host.

PMID- 8349412
TI  - Recombinant human brain-derived neurotrophic factor (rHuBDNF). Disulfide
      structure and characterization of BDNF expressed in CHO cells.
AB  - Three disulfide linkages of recombinant human brain-derived neurotrophic factor
      (BDNF) were determined by peptide sequence analysis and characterized by mass
      spectrometry. The three disulfide bonds for BDNF expressed in Chinese hamster
      ovary cells include Cys-13-Cys-80, Cys-58-Cys-109 and Cys-68-Cys-111, and the
      disulfide structure was homologous to that of nerve growth factor.

PMID- 8349411
TI  - Surface-induced conformational switching in amphiphilic peptide segments of
      apolipoproteins B and E and model peptides.
AB  - The conformational and surface-binding properties of a synthetic peptide
      corresponding to Tyr-apolipoprotein B-100(1000-1016) amide, SP-4, which was
      previously shown to mimic the focal accumulation pattern of LDL on the healing de
      endothelialized rabbit aorta [Shih et al. (1990) Proc. Natl. Acad. Sci. USA 87,
      1436-1440], have been investigated. SP-4 behaves as an amphiphilic alpha-helical
      peptide at the air-water interface and bound to siliconized quartz slides.
      However, its N alpha-acetylated analogue formed beta-sheet structures at the air
      water interface. Nonhomologous peptide models of SP-4 also exhibited mixed alpha
      helical and beta-sheet surface-binding behavior. Peptides corresponding to the
      cationic apolipoprotein (apo) B/E receptor binding regions of apoE (SP-2) and
      apoB (SP-11) were also studied. SP-2 behaved as an amphiphilic alpha helix, but,
      surprisingly, SP-11 formed surface-induced beta-sheets. These results demonstrate
      that all of the peptides studied have surface-binding properties, and suggest
      further that either alpha-helical or beta-sheet peptide structures may determine
      the binding of LDL to the arterial wall or the apoB/E receptor.

PMID- 8349413
TI  - The beta-bend ribbon spiral. Synthesis and conformational analysis in solution
      and in the crystal state of depsipeptides containing alpha-hydroxyisobutyric
      acid.
AB  - The synthesis and conformational analysis in solution (by FTIR absorption and 1H
      NMR) and in the crystal state (by X-ray diffraction) of three Hib-containing
      depsipeptides have been performed. In the crystal state Z-Aib-Hib-Aib-OMe is
      folded into a type-III beta-bend, while the conformation adopted by Z-Aib-Hib)2
      Aib-OMe is a beta-bend ribbon spiral, characterized by two type-III beta-bends
      with Aib(1)-Hib(2) and Aib(3)-Hib(4) as corner residues, respectively. Both
      independent molecules in the asymmetric unit of t-Boc-L-Ala-Hib-L-Ala-OMe
      crystals are folded into a type-II beta-bend. For the Aib-Hib depsipeptides the
      conformation adopted in the crystal state is also that largely prevailing in
      solution, whereas for t-Boc-L-Ala-Hib-L-Ala-OMe the beta-bend conformation is
      significantly less populated in solution. A comparison is also made with: (i) the
      published crystal-state conformations of fully protected -(Aib)3-, -(Aib)5-, and 
      L-Ala-Aib-L-Ala- sequences and the beta-bend ribbon spiral generated by (Aib-L
      Pro)n oligomers, and (ii) with the herewith described solution preferred
      conformation of Z-L-Ala-Aib-L-Ala-OMe. The possible use of Hib as an isosteric
      replacement for Aib in the design of conformationally constrained depsipeptides
      is briefly discussed.

PMID- 8349414
TI  - H-Gly-His psi (NHCO)Lys-OH, partially modified retro-inverso analogue of the
      growth factor glycyl-L-histidyl-L-lysine with enhanced enzymatic stability.
AB  - A partially retro-inverso analogue of the natural growth factor GHK was
      synthesized, in which the -CONH- bond between histidine and lysine was modified
      as -NHCO-. This modification is not expected to perturb the spatial distribution
      of the side-chains, and therefore the binding processes, compared to the native
      peptide. In the synthesis of the analogue two possible systems for deblocking of
      N pi-Bom group of histidine have been applied and compared. An alternative method
      is also described for the incorporation of malonyllysine into the peptide chain.
      When evaluated with respect to resistance toward degradation by human plasma in
      vitro, the new peptide analogue showed approximately a ten-fold increase in
      stability versus the parent peptide.

PMID- 8349415
TI  - Binding of calcium to synthetic peptides containing gamma-carboxyglutamic acid.
AB  - The Ca2+ binding properties of various gamma-carboxyglutamic acid (gla)
      containing synthetic peptides with counterpart sequences in human protein C were
      investigated employing potentiometry with a Ca(2+)-selective electrode and
      titration calorimetric techniques. The shortest peptides, FL(gla)(gla)LR,
      DF(gla)(gla)AK, and the oxidized form of the cyclic hexapeptide CI(gla)(gla)IC,
      each of which contains one pair of gla residues, have a weak affinity for Ca2+,
      with some peptides probably involved in intermolecular bridging of the Ca2+. The
      best example of this is the oxidized form of the peptide, CI(gla)(gla)IC, where
      one g-atom of Ca2+ interacts with 2 mol of peptide (n = 0.5) with a Kd value of
      1.6 mM. A second g-atom of Ca2+ interacts with 2 mol of this same peptide (n =
      0.5) and is characterized by a Kd of 8.8 mM. A longer peptide containing this
      same sequence, viz. L(gla)R(gla)CI(gla)(gla)IC, possesses two binding sites (n =
      2.0) for Ca2+ of Kd = 16.1 mM, as well as a tighter site (n = 1), of Kd = 0.4 mM.
      An increase in stoichiometry of tight binding sites as the peptide is elongated
      is observed from binding data obtained on a 38-residue peptide that possesses all
      nine of the gla-residues of protein C in their proper sequence positions. The
      strongest Ca2+ binding sites (n = 3-4) possess an average Kd of 0.4 mM, followed
      by another class of sites (n = 5-10, average Kd = 1.5-3.0 mM). The affinity and
      stoichiometry of these stronger sites mimic those observed for binding of Ca2+ to
      the gla region of prothrombin fragment 1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349416
TI  - Identification and suppression of decomposition during carbodiimide-mediated
      reactions of Boc-amino acids with phenols, hydroxylamines and amino acid ester
      hydrochlorides.
AB  - N-tert-Butoxycarbonylamino acids (Boc-Xaa-OH) were coupled with p-nitrophenol
      (HONp) in dichloromethane using N,N'-dicyclohexylcarbodiimide (DCC) and N-ethyl
      N'(3-dimethylaminopropyl)carbodiimide hydrochloride (EDC), and the products were
      identified and quantitated by high-performance liquid chromatography. Boc-Xaa-OH
      with Xaa = Val was coupled also with pentafluorophenol (HOPf) and hydroxy
      containing additives (HOR), and the products were similarly determined as the
      methylamides. EDC-mediated reactions of Boc-Xaa-OH gave 8-25% of Boc-Xaa-Xaa-OR
      as well as Boc-Xaa-OR for R = Ph, Np, Pf, benzotriazole (Bt) and 5-norbornene
      endo-2,3-dicarboxamide; DCC-mediated couplings, 5-7% for R = Np and Bt. No dimer
      was formed in couplings with N-hydroxysuccinimide or 3-hydroxy-4-oxo-3,4-dihydro
      1,2,3-benzotriazine. Dimerization was eliminated from DCC-mediated reactions by
      the addition of 1 equiv. of N-methylmorpholine, from the EDC-mediated reactions
      by carrying them out in pyridine. Dimerization is attributed to formation of the
      intermediate 2-alkoxy-5(4H)-oxazolone that undergoes fragmentation to the N
      carboxyanhydride, which reacts with the alcohol giving amino acid ester. Ester
      produces dimer by aminolysis of the O-acylisourea. Decomposition (1.4%) was also
      detected by analysis for H-Val-Phe-OMe in DCC-mediated reactions of Boc-valine
      with H-Phe-OMe, and was demonstrated to be caused by the hydrochloride of the
      ester salt that had been neutralized with N-methylmorpholine. Decomposition was
      eliminated by the addition of 5% of pyridine, which also had the beneficial
      effect of suppressing N-acylurea formation.

PMID- 8349417
TI  - SCF-MO study of the polyhydration of N,N'-dimethylmalonamide.
AB  - The effect of hydration on the conformation of the N,3 nylons has been studied
      using AM1 SCF-MO on the model molecule N,N'-dimethylmalonamide (NNMA). The
      polyhydration model has been used, so that only the water molecules directly
      bonded to solute molecule are considered. The study reveals that, although
      hydration induces dramatic changes in the torsional angles of the molecule, the
      new conformation still remains in the helical region of the Ramachandran map.

PMID- 8349418
TI  - On the side-reaction of N-alkylation of amino groups during hydrogenolytic
      deprotection in alcohol-containing solvents.

PMID- 8349419
TI  - Infectious crystalline keratopathy.

PMID- 8349420
TI  - Ocular infections in the acquired immunodeficiency syndrome.

PMID- 8349421
TI  - Acute retinal necrosis and similar retinitis syndromes.

PMID- 8349422
TI  - Ocular microsporidiosis.

PMID- 8349423
TI  - Rapid diagnostic tests for infectious ocular disease.
AB  - There is a current and ongoing need for the rapid, accurate diagnosis of ocular
      infection and the prompt initiation of appropriate therapy to prevent visual
      loss, maximize use of health care resources, and reduce physicians' medicolegal
      liability. For the busy clinician, and ideal rapid diagnostic test to determine
      ocular pathogens would be one whose result is available before the patient leaves
      the doctor's office, so that optimal treatment can be promptly instituted. Today,
      the major rapid diagnostic tests available to the busy clinician are the clinical
      examination and the stained microscopical smear of conjunctival and corneal
      specimens. The latter technique is grossly underutilized and would contribute
      significantly to improved accuracy in early diagnosis of ocular infections. In
      the near future, improved enzyme immunoassays and simplified PCR kits will
      provide for highly sensitive and specific diagnostic capabilities for detecting
      ocular pathogens in the laboratory and, possibly, office settings.

PMID- 8349424
TI  - Role of the fluoroquinolones in ophthalmology.

PMID- 8349425
TI  - New horizons in antibacterial antibiotics.

PMID- 8349426
TI  - Contact lens-related infectious keratitis.
AB  - Infectious keratitis is the most serious complication of contact lens use.
      Virtually all contact lens wearers are at risk. Initial therapy consists of
      frequent broad-spectrum fortified antibiotic drops after appropriate laboratory
      workup. Pseudomonas and Acanthamoeba species are the most important causes of
      contact lens-associated ulcers. Acanthamoeba keratitis produces significant
      ocular morbidity, and treatment is not always effective. Recent studies have
      provided new insights regarding the incidence, risk factors, and pathogenesis of
      contact lens-related infectious keratitis. Extended-wear soft contact lens
      wearers are at greatest risk. With our present understanding of the pathogenesis
      and risk factors of contact lens-related infectious keratitis, daily-wear
      schedules are strongly advised. Even under the best of lens care conditions,
      infectious keratitis may still occur. It is therefore imperative that patients be
      informed to remove their lenses and seek medical evaluation if any discomfort
      develops.

PMID- 8349427
TI  - Postoperative endophthalmitis: pathogenesis, prophylaxis, and management.

PMID- 8349428
TI  - Postoperative chronic microbial endophthalmitis.

PMID- 8349429
TI  - The ocular manifestations of Lyme disease.
AB  - Lyme disease (with its ocular manifestations) is a worldwide disorder that is
      rapidly increasing in frequency. It is a treatable, multisystemic disease that
      presents in three stages of severity. It can present with unusual forms of
      conjunctivitis, keratitis, cranial nerve palsies, optic nerve disease, uveitis,
      vitritis, and other forms of posterior segment inflammatory disease. A patient
      with any of these ocular manifestations should be questioned for exposure to an
      area endemic for Lyme disease, tick bites, skin rash, or arthritis. Such patients
      should undergo serological testing. If the clinical presentation is suggestive of
      Lyme disease, a course of oral antibiotics should be used (unless the patient
      gives a history of adequate therapy). Topical corticosteroids can be used for
      anterior segment inflammation. An antibiotic therapeutic trial can be used for
      posterior segment or neuroophthalmic disease. Systemic corticosteroids without
      concomitant antibiotics should not be used in the treatment of ocular Lyme
      disease. If ocular Lyme disease is discovered and treated early, response to
      therapy is usually satisfactory.

PMID- 8349430
TI  - Chloroquinoxaline sulfonamide: a sulfanilamide antitumor agent entering clinical
      trials.
AB  - Chloroquinoxaline sulfonamide (CQS) has been developed to the clinical trial
      stage based on its activity in the Human Tumor Colony Forming Assay (HTCFA). In
      the HTCFA, CQS demonstrated inhibition of colony formation against breast, lung,
      melanoma and ovarian carcinomas. The mechanism of action of CQS is unknown. It
      does not appear to inhibit folate metabolism as does the structurally similar
      sulfaquinoxaline. Preclinical toxicology studies in dogs and rats have shown that
      CQS is toxic to lymphoid organs, bone marrow, gastrointestinal tract, pancreas,
      CNS, adrenal glands and testes. Toxicity was generally reversible with the
      exception of testicular atrophy in dogs and rats which occurred late and was not
      reversible within the study time frame. The pharmacokinetic data indicate that
      CQS binds to serum proteins in a dose and species specific manner. Terminal half
      lives appear to vary between species from 60 hours in mice, 15 hours in rats, and
      45-132 hours in dogs. Preliminary data indicate a longer terminal half-life in
      humans. Two phase I trials are ongoing using a 60 min infusion schedule once
      every 28 days. The starting dose for each trial was 18 mg/m2.

PMID- 8349431
TI  - Cytotoxicity of crotoxin on murine erythroleukemia cells in vitro.
AB  - The cytotoxic effect of crotoxin, a heterodimeric phospholipase A2 from the venom
      of Crotalus durissus terrificus, was examined on murine erythroleukemia cells in
      vitro. Crotoxin cytocidal effect on cell growth had an EC50 of approximately 0.1
      0.2 microM (3.0-5.0 micrograms/ml) in serum-free medium. Cytotoxicity was
      independent of cell growth since both quiescent and proliferating cells had
      similar sensitivities to the toxin. Dissociation of the crotoxin complex and
      phospholipase A2 activity of its subunit B are required for cytotoxicity, since
      the covalently linked crotoxin complex or the specific alkylation of the active
      site on the subunit B abolish the cytotoxic activity on murine erythroleukemia
      cells. Specific interaction between crotoxin and murine erythroleukemia cells
      appears to be required since the homologous phospholipase A2 from Crotalus atrox
      venom, with a higher phospholipase A2 specific activity than crotoxin, was 86
      fold less potent than crotoxin. The data in this report show that the cytotoxic
      effect of crotoxin on murine erythroleukemia cells is consistent with the
      specific binding of the toxin resulting in cytocidal action mediated by the
      phospholipase A2 activity of crotoxin subunit B.

PMID- 8349432
TI  - A phase I clinical and pharmacokinetic study of the oral and the oral/intravenous
      administration of menogaril.
AB  - Thirty-five patients with advanced refractory cancer were enrolled on this phase
      I study of menogaril administered orally every 4 weeks at dosages ranging from 85
      mg/m2 to 625 mg/m2. An additional 12 patients received alternating oral and IV
      doses of menogaril (250 mg/m2 IV; 250-500 mg/m2 oral) with accompanying blood and
      urine sampling for pharmacokinetics analysis. Nausea and vomiting were the dose
      limiting toxicities at the 625 mg/m2 dosage level; vomiting was inadequately
      relieved by prophylactic antiemetics at this dosage level. Other toxicities
      included sporadic leukopenia at all dosage levels; at dosages of 500 mg/m2 and
      625 mg/m2, leukopenia < 3000/microliters occurred in 7 of 24 patients. Anemia and
      thrombocytopenia were much less frequent toxicities. Among the patients receiving
      IV menogaril, peripheral vein phlebitis, leukopenia and anemia were the
      predominant toxicities. No antitumor responses were observed, yet one patient
      with non-small cell lung cancer experienced a 30% reduction in metastatic tumor
      nodules. For the patients receiving alternating oral and IV menogaril,
      comparative pharmacokinetic analyses were performed by HPLC. After oral
      administration, maximum plasma concentrations were achieved in an average of 6
      hours; maximum plasma concentrations were less than one-quarter of those achieved
      after intravenous administration. The harmonic mean (+/- SD) terminal disposition
      half-life after oral dosing was 29.3 +/- 9.2 hours; mean systemic bioavailability
      was 33.6 +/- 10.5% after oral dosing. Forty-eight hours after an oral dose, mean
      cumulative urinary excretions of menogaril and the primary metabolite, N
      demethylmenogaril, were 4.00 +/- 0.96% and 0.44 +/- 0.16%, respectively. Because
      of the poor tolerance of oral menogaril and minimal evidence of biological
      activity, this schedule of drug administration is not recommended for phase II
      evaluation. Based on this and other published studies of oral menogaril, frequent
      chronic low-intermediate dosages of the drug may be given orally with potentially
      better tolerance and antitumor activity.

PMID- 8349433
TI  - Phase I trial of dihydrolenperone in lung cancer patients: a novel compound with
      in vitro activity against lung cancer.
AB  - Antitumor activity of the butyrophenone dihydrolenperone in non-small cell lung
      cancer was initially suggested by in vitro screening against tumor cells derived
      from fresh surgical samples using the human tumor colony-forming assay. We have
      completed a directed phase I trial in patients with lung cancer. Thirty-two
      patients with lung cancer have completed 25 courses of therapy at doses of 10 to
      60 mg/square meter orally on a twice daily schedule. Twenty-three men and 9 women
      with a median age of 55 (range 24-69) were entered. Twenty-four were performance
      status 0 or 1 and 8 were 2. The maximum tolerated dose was 50 mg/square meter
      orally twice daily and the dose limiting toxicity was somnolence. Of the 32
      patients, 18 developed symptomatic hypotension (grade 1 or 2). There was no
      significant hematologic, renal, or hepatic toxicity. In vitro drug testing using
      the MTT [3-(4,5- dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide
      (thiazolyl blue)] assay confirmed 50% inhibition of non-small cell and small cell
      lung cancer cell line growth at 70-450 micromolar concentrations. Plasma
      dihydrolenperone levels were at least 75-fold less than levels at which in vitro
      activity was observed. We conclude: 1) the maximum tolerated dose in our study is
      50 mg/square meter orally twice daily, 2) the dose-limiting side effect of
      dihydrolenperone is somnolence, and 3) the concentrations of dihydrolenperone
      observed in plasma are significantly lower than those associated with in vitro
      activity.

PMID- 8349434
TI  - Phase II study of alpha-interferon and 13-cis-retinoic acid in metastatic
      melanoma.
AB  - The combination of alpha-interferon and 13-cis-retinoic acid has shown
      significant activity against a number of human tumors. We conducted a phase II
      trial to test whether the combination would have a major response rate of 30% or
      more in patients with refractory, metastatic melanoma. Eleven patients were
      treated on the study. Alpha-interferon was administered subcutaneously three
      times a week at a dose of 10 million U/m2 and 13-cis-retinoic acid was
      administered orally at a dose of 1 mg/kg/day. No patient achieved a partial or
      complete remission. The combination of alpha-interferon and 13-cis-retinoic acid
      is unlikely to have significantly higher therapeutic activity than alpha
      interferon alone.

PMID- 8349435
TI  - Amonafide treatment of refractory esophageal cancer. A Southwest Oncology Group
      study.
AB  - Amonafide, a synthetic benzisoquinolinedione, was evaluated for treatment of
      squamous esophageal cancer. Eleven men and 5 women were eligible with a median
      performance status of 1 and median age of 63 years. Six had no prior treatment.
      All patients had measurable disease. Therapy consisted of amonafide 300 mg/m2d
      days 1-5 every 21 days. Thirty-five courses of therapy were delivered. The median
      number of courses received was two. Sixteen patients are evaluable for toxicity.
      Thirteen are evaluable for response. Toxicity was severe. Seven patients were
      hospitalized for toxicity. Six patients had grade IV granulocytopenia; two, grade
      IV thrombocytopenia. Angioedema developed in one patient; severe exfoliative
      dermatitis in another. A single partial response, with the decrease in size a
      supraclavicular node, was noted in a previously untreated patient. Amonafide, in
      this dose and schedule, is associated with occasionally severe toxicity
      precluding its likely use in squamous cell esophageal carcinoma.

PMID- 8349436
TI  - A phase II trial of deoxyspergualin in recurrent squamous cell head and neck
      cancer.
AB  - Fifteen patients with recurrent squamous cell head and neck cancer were treated
      with deoxyspergualin. There were no objective responses in 14 evaluable patients.
      The most common toxicity was reversible hypotension, which prompted dose
      reduction in nine patients. Deoxyspergualin is not recommended for the treatment
      of squamous cell head and neck cancer.

PMID- 8349437
TI  - Phase II trial of 13-cis-retinoic acid plus interferon-alpha in recurrent head
      and neck cancer.
AB  - 13-cis-retinoic acid (isotretinoin) and interferon-alpha have limited activity as
      single agents in advanced cancer. Preclinical data indicate that these agents
      have different mechanisms of action and, in combination have greater activity
      (that is, the ability to modulate growth and differentiation) in a number of
      malignant cell types than either agent alone. In clinical trials, the new
      biological regimen of 13-cis-retinoic acid and interferon-alpha was shown to have
      major activity in advanced squamous cell carcinoma of the skin and cervix. We
      conducted a phase II trial of this regimen in recurrent squamous cell carcinoma
      of the head and neck. Of the 21 evaluable patients, none had a complete response,
      and only one had a partial response (5%). Two patients had minor responses, four
      had stable disease, and 14 experienced disease progression. Five patients
      developed grade 3 toxic effects, including skin toxicity, fatigue, headache, and
      anorexia/weight loss. The median survival duration was 25.5 weeks (range, 4-95).
      The combination of 13-cis-retinoic acid and interferon-alpha at this dose and
      schedule is ineffective for the treatment of recurrent squamous cell carcinoma of
      the head and neck.

PMID- 8349438
TI  - Multicenter phase II study of brequinar sodium in patients with advanced
      gastrointestinal cancer.
AB  - Eighty-six patients with advanced colorectal, gastric or pancreatic carcinoma and
      no prior exposure to chemotherapy were treated with brequinar sodium. Brequinar
      was administered at a median weekly dose of 1200 mg/m2 intravenously. The
      toxicity was moderate, with thirty patients (35%) experiencing grade 3 or 4
      toxicity. Objective responses were observed in 1/32 evaluable colorectal and 2/29
      evaluable gastric carcinoma patients. There were no objective responses in 17
      evaluable pancreatic cancer patients. We conclude that, at this dose and
      schedule, brequinar does not have sufficient activity in these gastrointestinal
      malignancies to warrant further evaluation.

PMID- 8349440
TI  - Phase II trial of doxorubicin and trifluoperazine in metastatic breast cancer.
AB  - Pre-clinical and clinical studies have shown that trifluoperazine (TFP) can
      modulate multidrug resistance. We have performed a Phase II trial of TFP and
      doxorubicin in doxorubicin-naive patients with metastatic breast cancer. We
      hypothesized that TFP would inhibit the development of doxorubicin resistance,
      resulting in an increased rate of complete response or a prolongation in response
      duration. Twenty patients with metastatic breast cancer were treated every 3
      weeks with TFP 5 mg by mouth every 6 hours on days 0-5 and doxorubicin 60
      mg/m2/96 hr on days 1-4 by continuous intravenous infusion. The first 5 patients
      were treated with TFP 15 mg by mouth every 6 hours, but the dose was reduced to 5
      mg every 6 hours when grade 3-4 extrapyramidal toxicity was noted in 3 of the
      first 5 patients. Thereafter, neurologic toxicity was grade 0-2. No complete and
      9 partial responses were produced in 20 patients (45%). The median response
      duration was 17 weeks (range 7-112). The combination of trifluoperazine and
      doxorubicin did not seem to produce a response rate or duration markedly
      different than that expected for doxorubicin alone in patients with metastatic
      breast cancer. Alternative trial designs may be necessary in future clinical
      trials investigating the inhibition of acquisition of drug resistance.

PMID- 8349439
TI  - Phase II study of etoposide and alpha-interferon in patients with advanced
      measurable colorectal carcinoma.
AB  - Based on encouraging in vitro and in vivo data, 14 consecutive patients with
      measurable metastatic previously untreated colorectal carcinoma were treated with
      a combination of intravenous etoposide and subcutaneous alpha-interferon.
      Etoposide was given at 60 mg/m2 intravenously on days 1-5 and alpha-interferon at
      5 million units/m2 subcutaneously on days 1-5; courses were repeated every 21
      days. All 14 patients were evaluable for response and toxicity. None of the
      patients achieved a complete or partial remission. Toxicity of this combination
      was moderate. Our data suggest that this combination is ineffective against
      colorectal carcinoma.

PMID- 8349441
TI  - New formulation intravenous melphalan in the treatment of patients with
      metastatic renal cancer.

PMID- 8349442
TI  - The Ethiopian immigrations to Israel--Medical, epidemiological and health
      aspects.

PMID- 8349443
TI  - The demography of the Ethiopian community in Israel.

PMID- 8349444
TI  - A medical care program for Ethiopian Jewish migrants in Addis Ababa.
AB  - In May 1990, the Ethiopian Jews--who for centuries had lived as peasants in
      isolated rural villages in northwestern Ethiopia--migrated en masse to Addis
      Ababa. In July, 39 deaths occurred in this community of approximately 22,000
      people. When this was reported in Israel the Ethiopian Jews already living there
      staged a demonstration at the Knesset claiming that their relatives in Ethiopia
      were being neglected by the Jewish organizations providing aid to the Ethiopian
      people. In response, the American Jewish Joint Distribution Committee rapidly
      developed a comprehensive medical program during a 3-week period commencing on
      August 20. During the ensuing months there was a rapid fall in the mortality rate
      in the Jewish community. On 24-25 May 1991, as rebel armies were preparing to
      enter the city, almost the entire Jewish population remaining in Ethiopia was
      airlifted to Israel.

PMID- 8349445
TI  - Health profile of Ethiopian immigrants in Israel: an overview.
AB  - The health profile of two groups of Ethiopian immigrants in Israel was evaluated.
      Trichophytosis and active trachoma were observed in 5%-8.7% of prepubertal
      children. Among adults 13% had corneal opacities and 10.4% had cataracts. Goiter,
      spastic bronchitis, valvular heart disease, leprosy and onchocerciasis were
      prevalent. Malnutrition was common, with average body weights ranging from 72.4%
      to 85.2% of normal. Anemia was observed in 6.3% of young children and 70% of all
      immigrants. Fifty percent of children over 12 years and 98% of adults over 40
      years of age had been exposed to hepatitis B virus; 9.8%-11.8% were HBsAg
      carriers. Tuberculin tests were positive in 9.8%-13%; and intestinal parasites
      were identified in 86%-98%. Hospitalization was required for 15.7% of immigrants
      arriving during the period 1978-90, and for 3.7% of those arriving in mid-1991
      (Operation Solomon).

PMID- 8349446
TI  - Prevalence of diabetes mellitus in Ethiopian immigrants: comparison of Moses and
      Solomon immigrations.
AB  - The prevalence of diabetes mellitus and the distribution of serum glucose levels
      among 254 immigrant Ethiopian Jews (Operation Solomon) were studied immediately
      after their arrival in Israel in 1991. No case of diabetes was found. Although
      the body mass index of this population was higher than those obtained in
      Operation Moses, the serum glucose levels in almost all age-groups were
      significantly lower.

PMID- 8349447
TI  - Prevalence of glucose intolerance in young male Ethiopian immigrants.
AB  - The prevalence of intolerance to glucose was compared between young immigrant
      Ethiopian Jews shortly after their arrival to Israel, a similar group of
      Ethiopians 2-3 years after their arrival to Israel, and young Israeli students. A
      relatively high prevalence of glucose intolerance was found in both Ethiopian
      groups, but we could not demonstrate any deterioration in glucose tolerance after
      2-3 years of Israeli life-style in the Ethiopian groups. In spite of high blood
      glucose levels in response to 75 g glucose load, when compared to Israeli
      students the Ethiopians' fasting insulin levels and insulin response to 75 g of
      glucose was relatively low, suggesting a higher glucose threshold for insulin
      secretion. However, in the Ethiopians, impaired glucose tolerance was associated
      with hyperinsulinemia, suggesting that similar to some other populations glucose
      intolerance is associated with insulin resistance.

PMID- 8349448
TI  - Comparison of glucose tolerance, lipids and blood pressure in young male
      Ethiopians from two different immigrations, 1989 and 1991.
AB  - The prevalence of glucose intolerance and hypertension was compared between a
      group of 87 young Ethiopian males (age 21.6 +/- 2.8 years) from the post Moses
      immigration of 1989 (group 1) and 89 age-matched Ethiopian males (age 21.4 +/-
      3.1) from the Solomon immigration of 1991 (group 2). Both groups demonstrated a
      relatively high, for age, prevalence of glucose intolerance: 5% and 8% in groups
      1 and 2 respectively (not significant). However, group 1 had a higher glucose
      level 2 h after an oral glucose tolerance test (P < 0.05) and a higher level of
      HbA1C (P < 0.05) and fructosamine (P = 0.07), concomitant with a lower fasting
      insulin (P < 0.005), when compared with group 2. Group 2 had a significant
      increase in both systolic and diastolic blood pressure when compared with group 1
      (P < 0.05, P < 0.005 respectively). Group 2 had higher blood pressure levels and
      higher fasting insulin than group 1, suggesting a relationship between insulin
      levels and blood pressure in this population.

PMID- 8349449
TI  - Lipids and lipoproteins among Ethiopian immigrants: comparison of operations
      Solomon and Moses.
AB  - Lipid and lipoprotein levels and body mass index were compared between two
      immigrations of Ethiopian Jews to Israel. Those who came in Operation Moses in
      1984-85 were survivors of a long trek across hundreds of kilometers and severe
      food deprivation. Those who immigrated in Operation Solomon in 1991 were bussed
      from their villages to Addis Ababa where public health care and food were
      provided and a few months later they were airlifted to Israel. Total cholesterol
      among the Operation Solomon immigrants was higher than those obtained in
      Operation Moses in the different age-groups studied, in both sexes. High density
      lipoprotein-cholesterol was significantly higher and triglycerides lower in
      Operation Solomon compared with those of Operation Moses. Body mass indices of
      the Ethiopians in both immigrations were significantly lower than in the Israeli
      born population but those who arrived in 1991 were heavier than those in the 1984
      85 Operation Moses. The data on the Ethiopian Jews who arrived in Operation
      Solomon were not affected by the environmental hardships experienced by those who
      arrived in the 1984-85 Operation Moses. Therefore their exposure to a Western
      life-style, such as smoking, contraceptive use, change in diet and its effect on
      arteriosclerosis, diabetes mellitus and coronary heart disease will be of great
      interest.

PMID- 8349450
TI  - Blood pressure and body mass index in Ethiopian immigrants: comparison of
      operations Solomon and Moses.
AB  - Blood pressure, height and weight of 122 male and 143 female Ethiopian Jews who
      immigrated to Israel in Operation Solomon (1991) were measured and compared with
      those of Ethiopian immigrants who arrived in Israel in 1984-85 (Operation Moses).
      Although the body mass indices of the Operation Solomon immigrants were much
      higher than those of Operation Moses, no significant differences were found in
      blood pressure measurements in any age-group or in either sex. Blood pressure in
      Operation Solomon immigrants increased with age and correlated with body mass
      index and triglyceride serum levels among males, but not females. No correlation
      was found between cholesterol levels and blood pressure measurements.

PMID- 8349451
TI  - Descriptive epidemiology of malignant tumors in Ethiopian Jews immigrating to
      Israel, 1984-89.
AB  - This descriptive epidemiological study analyzes the frequency of cancer after the
      arrival of Ethiopian immigrants as reported to the Israel Cancer Registry from
      1984 to 1989. The study cohort comprised 8,272 individuals (estimated 4,253 males
      and 4,019 females) with 27,966 and 26,848 person-years observed for males and
      females, respectively. Overall cancer incidence in this migrant cohort was low
      for both genders compared to cancer incidence among Jews born in Israel. The
      standardized incidence ratio (SIR) (in percentage) for cancers at all sites was
      39 [95% confidence interval (CI) = 22-64] and 63 (95% CI = 41-92) for males and
      females, respectively. Male primary liver cancer and female thyroid cancer had
      high SIRs. All other sites had either average or low SIRs. No cases of neoplasms
      were reported in the respiratory system. Except for primary liver cancer,
      digestive neoplasms had an inverse male: female ratio.

PMID- 8349452
TI  - Endemic goiter in Ethiopian Jews--possible pathogenetic factors.
AB  - Goiter size, thyroid function tests and thyroid cytology were studied in 100
      immigrant Ethiopian Jews, 1-12 months after arrival in Israel on Operation
      Solomon (1991), who were referred for evaluation of goiter. Female-to-male ratio
      was 2.2:1. Hypothyroidism was rare (1%) whereas hyperthyroidism was frequently
      diagnosed (11%). Elevated thyroglobulin (TG) serum levels were found in 36% of
      the patients. Antithyroid antibodies were not detected. Thyroid cytology revealed
      rich colloid goiters in all patients. Thyroid carcinomata and chronic lymphocytic
      thyroiditis were not diagnosed. Both hyperthyroidism and elevated TG levels were
      found only in female patients and were equally distributed in patients maintained
      on either Israeli or Ethiopian diets. It is suggested that the major factors in
      the pathogenesis of endemic goiter in Ethiopian Jews are genetic and/or food
      goiterogens, with only a minor role for iodine deficiency.

PMID- 8349453
TI  - The prevalence of ectoparasites in Ethiopian immigrants.
AB  - Newly arrived Ethiopian immigrants in Israel were screened for ectoparasitic
      insects and mites. Of 304 individuals examined 65.1% were infested with the head
      louse (Pediculus humanus capitis). The infestation rate among children varied
      between 65 and 100%. Children aged 6-11 years were the most infested group and no
      differences between girls and boys were found. The infestation rate in children
      was significantly higher than that found in adults. Approximately 39% of those
      examined were infested with the body louse (Pediculus humanus humanus). The rate
      of infestation with this parasite was higher in adults than in children and
      higher in females than males. Ten percent of the immigrants examined were
      infested with the scabies mite (Sarcoptes scabiei) and 4.3% with the human flea
      (Pulex irritans).

PMID- 8349455
TI  - Tuberculosis case finding and treatment in Ethiopian immigrants to Israel, 1989
      91.
AB  - In addition to the immigrants from Ethiopia who arrived in Israel during the
      period 1980-90, a particularly large number immigrated in 1991 including a
      concentrated group (Operation Solomon). The procedures and problems involved in
      tuberculosis case-finding and treatment in Ethiopia and in Israel are described.
      The prevalence rate of cases of active tuberculosis in those who immigrated in
      1991 was 1.3/100 persons as compared with 1.9/100 in the 1984-85 immigration
      (Operation Moses). Among the 1991 immigrants the number of cases reported was
      261. In 89% the site was pulmonary. After screening and treatment in Israel there
      were very few cases of relapse or death and few contact cases in the host
      population. Follow-up of case reporting from 1983 is updated and demonstrates
      that the majority of cases are detected and treated within 2-3 years of
      immigration. Since 1980, 771 cases of tuberculosis were reported in all
      immigrants from Ethiopia.

PMID- 8349454
TI  - Intestinal parasitic infection in operation Solomon immigrants.
AB  - Previous studies have documented a high infection rate of intestinal parasites in
      Ethiopian immigrants to Israel. As a result, current treatment recommendations
      are for mass treatment without prior screening tests. However, the group of
      15,400 Ethiopian immigrants who arrived in Israel in May 1991 (Operation Solomon)
      represents a somewhat different population from those who had immigrated earlier.
      The 1991 immigrants had spent 9-12 months in Addis Ababa before their evacuation;
      the conditions there, together with the provision of medical care, may have
      resulted in lower infection rates for intestinal parasites. The purpose of this
      study was to determine the prevalence of intestinal parasites in these recent
      immigrants to assess whether mass treatment would still be appropriate. Random
      stool specimens were obtained from 80 residents of a population of 650 Ethiopian
      immigrants who were cared for at a Jerusalem clinic. Specimens were examined at
      the Ministry of Health Laboratory. Of the 80 specimens 45 had sufficient quantity
      of stool to perform the standard Richie concentration method. Pooling results
      from all 80 individuals revealed 60 (75.0%) positive specimens, 53 (66.3%) with
      at least one pathogenic parasite, and 21 (26.3%) with multiple pathogenic
      parasites. These data provide the first systematic information on intestinal
      parasitosis in immigrants from Operation Solomon and suggest that mass treatment
      in this group is appropriate.

PMID- 8349456
TI  - Mycobacterium bovis lymphadenitis complicating BCG immunization in an infant with
      symptomatic HIV-1 infection.
AB  - A 3-month-old infant with HIV-1 infection who recently immigrated from Ethiopia
      developed regional lymphadenitis and systemic symptoms subsequent to BCG
      immunization. She was suffering from axillary lymphadenitis ipsilateral to the
      BCG vaccination site, failure to thrive, unresolving fever and
      hepatosplenomegaly. Acid-fast bacilli were seen on staining and Mycobacterium
      bovis was isolated from the regional lymph node. The infant responded promptly to
      triple antituberculous therapy but died 2 months later from overwhelming
      pneumonia and respiratory failure. This case emphasizes the iatrogenic hazards of
      BCG immunization in HIV-1 infected infants. With the increasing prevalence of
      pediatric HIV-1 infection, indiscriminate BCG immunization programs should be
      reconsidered. While infants with asymptomatic HIV-1 infection at risk for
      tuberculosis should be immunized, BCG immunization should be withheld in those
      with symptomatic disease.

PMID- 8349457
TI  - Imported malaria from Ethiopia--end of an era?
AB  - The immigration of Ethiopian Jews to Israel in the 1980s resulted in the
      importation of over 2,000 cases of malaria, a major challenge to clinicians and
      public health officials alike. In contrast, in the massive airlift from Ethiopia
      in May 1991 and in the sporadic immigration that followed it, malaria prevalence
      was extremely low, reflecting the routing of the more recent immigrants through
      nonendemic areas. The dramatic fall in the appearance of new imported malaria
      cases should not lead to complacency, however, as malaria may still appear in
      Ethiopians and other immigrants as well as in Israelis returning from regions of
      the world where the disease is still highly prevalent. A corollary of this caveat
      is that vigilance in finding and eliminating Anopheles breeding places in Israel
      must not be allowed to falter.

PMID- 8349458
TI  - Management of chloroquine-resistant Plasmodium falciparum malaria in a pregnant
      Ethiopian immigrant--a case report.
AB  - Plasmodium falciparum malaria is infrequently recognized in Israel as a cause of
      infection during pregnancy. We expect that with increasing frequency physicians
      in Israel will confront patients with malaria. Special concern should be given to
      malaria in pregnancy because of its serious complications. Thus, prompt diagnosis
      and treatment are essential. While chloroquine is safe for use in pregnancy, drug
      resistance is common, especially with Plasmodium falciparum. There is concern
      about the safety of other antimalarial agents during pregnancy. We recently
      observed a case of chloroquine-resistant Plasmodium falciparum malaria during
      pregnancy in a new immigrant primigravida from Ethiopia. Malaria in patients from
      endemic regions is less severe than in nonimmune hosts. Therefore, we elected to
      follow the patient's parasitemia periodically without additional antimalarial
      treatment until after delivery.

PMID- 8349459
TI  - Serological markers for hepatitis B and treponemal infection among HIV carriers
      from Ethiopia.
AB  - A group of 52 HIV carriers among immigrants who arrived in Israel from Ethiopia
      in Operation Solomon, 1991, is described. A control group was randomly chosen
      from the same population. HBV serology and treponemal antibodies were obtained
      from both groups. The frequency of HBV markers was similar in both groups (70%
      among the HIV carriers and 78.8% in the controls). HBsAg was more frequently
      found among HIV carriers (20%) than in the control group (8.6%). Treponemal
      antibodies were common among HIV carriers (31%), and infrequent in the controls
      (3%). These data indicate that HIV infection in this community is linked to
      treponemal infection and that these carriers handle HBV less efficiently then HIV
      negative subjects.

PMID- 8349460
TI  - Seroprevalence of antibodies against Toxoplasma gondii among recently immigrating
      Ethiopian Jews.
AB  - Sera from 144 Ethiopian immigrants who arrived in Operation Solomon, 1991, living
      in three absorption centers in the Jezreel Valley were tested for antibodies
      against Toxoplasma gondii. Antibodies were found in 34% of the test group, with a
      rise in prevalence with age from 0% in the first decade to 46% in the > 40 age
      groups. The prevalence in the Ethiopians was higher than in Jewish kibbutz
      members (22.8%) and lower than in Arab villagers (55.8%). During the reproductive
      years (age 20-39) the rate of seroconversion is 1% per year, and screening of
      pregnant Ethiopian women for antibodies to T. gondii should be considered.

PMID- 8349461
TI  - Plastic surgery findings in Ethiopian immigrants.
AB  - We have encountered infrequent and unfamiliar types of morbid conditions
      requiring plastic surgery. We present here our clinical experience with five
      illustrative cases and discuss the typical features of each condition and its
      treatment.

PMID- 8349462
TI  - Obstetric performance in Ethiopian immigrants compared with Israeli parturients.
AB  - It was the aim of this study to evaluate the obstetric performance of Ethiopian
      Jewish immigrants in comparison to the general Jewish obstetric population. The
      study was performed at the Soroka Medical Center, Beer Sheva, which manages the
      busiest delivery ward in Israel. Between 1988 and 1991 a total of 20,047 non
      Ethiopian women (Group N) and 431 parturients of Ethiopian origin (group E)
      delivered at the Soroka Medical Center. Group E included a significantly higher
      percentage of grandmultiparous women than group N. Among diseases complicating
      pregnancy there was a statistically significant higher incidence of severe
      pregnancy-induced hypertension (PIH) in group E than in group N. Mild PIH and
      chronic hypertension were of comparable prevalence in both groups. The prevalence
      of class A diabetes mellitus was significantly lower in group E than in group N;
      the same trend was also observed for diabetes class B but without reaching
      statistical significance. There was no significant difference between the groups
      in the prevalence of polyhydramnios, postdatism and poor obstetric history, or
      fetal distress, s/p cesarean section, and prolapse of cord. Statistical analysis
      indicated a tendency towards significance for higher prevalence of premature
      rupture of membranes in group N. Malpresentations and malpositions were of
      similar prevalence in both groups. The incidence of premature delivery in group E
      showed a higher relative risk, suggesting a tendency of significance. The
      incidence of meconium-stained amniotic fluid in group E was significantly higher
      than in group N. There was no significant difference in the prevalence rates of
      placental complications such as placenta previa and abruption of placenta between
      the groups. The mode of delivery, the prevalence of complications during the
      third stage of labor, birthweight of infants and perinatal mortality were similar
      for both groups. In conclusion, the obstetric performance in Ethiopian Jewish
      immigrants is surprisingly similar to that of Israeli Jewish parturients. The
      only prominent pathology that does not seem to be related to life-style and
      nutrition is pregnancy-induced hypertension.

PMID- 8349463
TI  - Periodontal status among adult immigrants from rural Ethiopia.
AB  - Dental research has emphasized the importance of understanding the epidemiology
      and etiology of periodontal disease, the second most prevalent dental pathology.
      The World Health Organization includes periodontal health prevalence, according
      to the Community Periodontal Index of Treatment Needs (CPITN), in its Global Oral
      Data Bank. Recent immigrants to Israel from Ethiopia offer a unique and important
      opportunity for investigation. Seventy adults aged 35-45 years were examined.
      Dividing the dentition into six sextants (according to CPITN), on average, two
      sextants were found to be healthy and only 1.18 sextants revealed shallow or deep
      pockets. These results demonstrate a relatively healthy periodontal status, as
      compared both to Israeli adults and data from the WHO Data Bank. Periodontal
      health has traditionally been related to regular dental visits (professional
      teeth cleaning) and home oral hygiene maintenance (toothbrushing and flossing).
      This population of immigrants had never visited dentists or hygienists nor used
      toothbrushes or dental floss. The periodontal health of this population is
      therefore of particular interest.

PMID- 8349464
TI  - Psychopathological aspects of the Ethiopian immigration to Israel.
AB  - Of the 352 adult Ethiopian Jews who live in the city of Netanya and who
      immigrated to Israel during the last few years, 87 were examined for evaluation
      of psychopathology symptoms and also to verify which factors of their immigration
      and which absorption conditions were related to their psychopathology. The
      Physician's Outpatient Psychopathology Scale (211-POPS), as well as three other
      self-rating scales--The Satisfaction Scale, The Events en route to Israel Scale,
      and The Frequency of Visits to Family Physician Clinics Scale--were completed
      with the assistance of well-trained Ethiopian interviewers in the homes of the
      Ethiopian immigrants. The results prove that a high incidence of psychopathology
      still existed even after 5 years of residence in Israel. The main topics of
      dissatisfaction (more than 60% of the sample), in order of severity, were their
      level of fluency in Hebrew, their financial situation, the attitude of the
      religious institutions towards the Ethiopian community, and the degree of
      observance of religious customs in Israel. It was found that a high level of
      psychopathology was related to a high level of suffering on the journey to
      Israel. It was also found that psychopathology usually declined with the length
      of residence in Israel. A high incidence of psychopathology was found to be
      related to an increase in age and to a low level of education.

PMID- 8349465
TI  - Psychiatric diagnoses in hospitalized adolescent and adult Ethiopian immigrants
      in Israel.
AB  - In 1984-85 Operation Moses brought a mass immigration of Jewish Ethiopians to
      Israel. Many of these immigrants were children and adolescents who came on their
      own having left their families behind. Since that time the adolescent department
      at the Geha Psychiatric Hospital has had the major responsibility of caring for
      those Ethiopian adolescents who required psychiatric hospitalization. The present
      study compares the diagnoses and reasons for admission of Ethiopian adolescents
      in Israel with those of Ethiopian adults and Israeli adolescents. The results of
      this comparison show that Ethiopian adolescents in hospital had significantly
      higher rates of dissociative disorders than the other two groups and
      significantly lower rates of the major functional psychoses than Ethiopian adults
      and Israeli adolescents. In addition the Ethiopian adolescents had relatively low
      levels of nonspecific depressive symptoms and anxiety symptoms and were
      hospitalized for significantly shorter periods of time than the other two groups.

PMID- 8349466
TI  - Health education for Ethiopian immigrants in Israel, 1991-92.
AB  - A health education program was developed to address the immediate needs of 20,000
      Ethiopian immigrants to Israel in 1991. This modular program included: the use of
      health services, nutrition, prescription medication use, prevention of home
      accidents, first-aid and personal hygiene. Using an anthropological orientation,
      the program attempted to bridge the cultural gap regarding the health promotion
      skills of this population that had moved from a developing country to a new,
      Western society in Israel. The program was implemented throughout the country by
      specially trained veteran Ethiopian immigrants, some of whom were also health
      professionals, using newly developed visual tools. Over 4,300 adults participated
      in the program between August 1991 and August 1992. The program was positively
      accepted by the participants, who expressed their satisfaction with the content
      and materials. The tools developed were deemed successful in their cultural
      sensitivity, flexibility to local needs, and clarity. We suggest that various
      modules of the program continue to be implemented in order to address the rapidly
      changing health behavior needs of the Ethiopian immigrants in Israel, and that
      new modules be developed.

PMID- 8349467
TI  - Health education for the Ethiopian community in the Negev.
AB  - The importance of health education as part of health enhancement programs is well
      accepted. The encounter with the Ethiopian Jews introduced a new set of problems,
      requiring a novel approach to old concepts. A project that was carried out during
      the last decade is presented. Three target populations were identified: the
      Ethiopian population with 851 participants, medical and community teams with 843
      participants, and 138 Ethiopian instructors. An effort was made to make the
      interaction between these groups more coherent. The project included 65 series of
      activities: lectures, workshops, staff meetings and conferences. The major topics
      included medical, emotional, anthropological and behavioral issues. The project
      was initiated for immigrants of Operation Moses (1984-85), and reinforced in
      Operation Solomon (1991). A follow-up is presently underway to aid in the
      absorption of this unique community.

PMID- 8349468
TI  - A culturally specific educational program to reduce the risk of HIV and HBV
      transmission among Ethiopian immigrants to Israel: a preliminary report on
      training veteran immigrants as health educators.
AB  - We describe an educational intervention project that was designed to lower the
      risk of transmission of human immunodeficiency virus and hepatitis B virus among
      the Ethiopian immigrants of the 1991 Operation Solomon. The importance and
      uniqueness of this program lies in its attempt to integrate into one program two
      different sets of traditions and concepts, in a culturally acceptable manner to
      the target population. On the one hand were the traditions of the Ethiopian
      community and its concepts about health and disease; on the other, were the
      biomedical model and empowering/participatory methods needed for intervening in
      this sensitive and difficult area. We also describe a model for training people
      from within the community to bridge the cultural gap in a relatively short period
      of time.

PMID- 8349469
TI  - Waves of immigration to Israel.

PMID- 8349470
TI  - MR-angiography during spontaneous attacks of cluster headache: a case report.
AB  - Magnetic resonance (MR) angiography was performed during and between two
      spontaneous and untreated attacks in a 24-year old male patient with episodic
      cluster headache. The ipsilateral ophthalmic artery was observed to be markedly
      dilated during both attacks. No changes were seen in the internal carotid artery
      or any of the main arterial branches on either side. A repeat MR-angiography two
      weeks later when the patient was in clinical remission showed no abnormalities.
      Our present case report suggests that the MR technique provides a useful method
      for non-invasive angiography during spontaneous attacks of cluster headache.

PMID- 8349471
TI  - Effectiveness of a piroxicam fast dissolving formulation sublingually
      administered in the symptomatic treatment of migraine without aura.
AB  - In this study we evaluated the efficacy of a new preparation (Fast Dissolving
      Dosage Form--FDDF) of piroxicam (40 mg in a single sublingual dose) in the acute
      treatment of migraine. The study plan was of single blind type versus placebo and
      involved 40 patients with migraine without aura (according to the IHS
      Classification criteria) who had to take Piroxicam FDDF (or placebo) within 2
      hours from the beginning of a migraine attack. Pain intensity and associated
      symptoms were evaluated in the basal condition and then monitored at serial
      intervals for 24 hours. In the group of patients treated with the active drug (n
      = 20), a significant reduction of pain intensity (Visual Analogue Scale) was
      observed after only 15 minutes (P = 0.0034). After an hour, headache has
      disappeared in 15 patients, become mild in 4 and remained unchanged in only one
      subject. Associated symptoms also quickly disappeared after Piroxicam FDDF
      administration and headache recurred in only two patients within the 24 hour
      period. Sublingual administration of Piroxicam FDDF was well tolerated: no
      systemic side-effects were reported and only two subjects complained about mouth
      dysesthesias which were described as mild and short-lasting. In conclusion,
      Piroxicam FDDF has been shown in this preliminary study to have striking efficacy
      in the acute treatment of migraine. The treatment is characterized by quick
      onset, long duration and good tolerability.

PMID- 8349472
TI  - The role of life event stress, coping and social support in chronic headaches.
AB  - A group of chronic headache sufferers (migraine and tension-type headache) was
      compared with two individually matched control groups of nonheadache subjects in
      terms of life event stress, and the stress moderating factors of coping skills
      and social support. The headache group did not differ from the control groups on
      the measures of life event stress or coping but significant differences arose on
      the measure of social support with the headache group achieving lower scores than
      the control groups. The findings were interpreted as suggesting that clinicians
      and researchers should pay more attention to social aspects of headaches, and
      that interventions aimed at teaching headache sufferers to mobilize social
      support should be considered as components of treatment packages.

PMID- 8349473
TI  - The relationship between perceived stress, social support and chronic headaches.
AB  - A group of chronic headache sufferers (migraine and tension-type headache) was
      compared with a group of nonheadache control subjects in terms of two domains of
      social support (social integration and functional support), perceived social
      support, sources of social support, and perceived stress. Headache sufferers and
      controls were not differentiated with respect to number of social relationships,
      sources of support and availability of support. In contrast, headache sufferers
      were significantly less satisfied with the support available to them and scored
      lower on all four types of functional support measured (appraisal, esteem,
      belonging and tangible). Support measures did not show a linear relationship with
      headache chronicity, and were at their lowest at an intermediate point in the
      headache history rather than at an early or late point. Headache sufferers scored
      higher on perceived stress than control subjects and differences between the
      groups increased as a function of headache chronicity. The findings were
      interpreted as suggesting that clinicians and researchers should focus greater
      attention on the social dimension of headaches.

PMID- 8349474
TI  - Headache in the writings of Moses Maimonides and other Hebrew sages.
AB  - In the history of philosophy, theology, and medicine, Maimonides shares the
      limelight with Arabic scholars such as Ibn Rushd, Ibn Sinna and Ibn Zuhr,
      chronologically between the great intellectuals of classical Greece and Rome and
      those of the later Middle Ages and early Renaissance. Maimonides was a very great
      philosopher and theologian, usually underrated by the historians. He was also an
      outstanding medical practitioner and teacher. Moses Maimonides had an incredible
      literary ability and an encyclopedic knowledge. He wrote extensively in the
      fields of theology, mathematics, law, philosophy, astronomy, ethics, and, of
      course, medicine. His medical writings are varied, comprising extracts from Greek
      medicine, a series of monographs on health in general and several diseases in
      particular, and a pharmacopoiea. The present essay extracts, primarily from
      Maimonides' medical writings, his pronouncements dealing with headache. Since
      most of Maimonides' pronouncements about headache in his Medical Aphorisms were
      derived from Graeco-Roman medical writers such as Hippocrates, and especially
      Galen, in regard to these statements Maimonides was merely a compiler--not an
      innovator. Some of his concepts about the causes of headaches being related to a
      dysequilibrium of the body humors are clearly medieval in origin. Other
      statements demonstrate this concern with preventive medicine and the maintenance
      of a healthy regimen of daily living. Medications to treat illness should only be
      used if non-medicinal means such as diet and exercise are not effective. The
      heritage of Maimonides' writings is being more and more appreciated.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8349475
TI  - Taurine levels in plasma and cerebrospinal fluid in migraine patients.
AB  - Taurine is the amino acid with the highest concentration in the human body. Its
      physiologic functions are not yet well understood. As a neurotransmitter or
      neuromodulator it may display inhibitory functions. We have measured taurine
      levels in plasma and cerebrospinal fluid of migraine patients during attacks,
      comparing them with controls. Patients with migraine had significantly higher
      concentrations than controls. No sex or age influence over the amino acid levels
      were observed. Plasma taurine levels in patients with classic migraine correlated
      negatively with severity of headache. Central taurine liberation during migraine
      crisis may be due to spontaneous depolarization or a defensive reaction in the
      context of cerebral homeostatic processes.

PMID- 8349476
TI  - Painful intervertebral dysfunction: Robert Maigne's original contribution to
      headache of cervical origin. The Quebec Headache Study Group.
AB  - Professor Robert Maigne, a French Orthopedic Medicine and Functional
      Rehabilitation specialist, has put forward new concepts leading to a better
      understanding of common pain of spinal origin. Maigne explains that pain in the
      spine is due to an intervertebral dysfunction of the mobile segment which
      consists of the intervertebral disc, ligaments and the facet joints. Any benign
      mechanical dysfunction of the mobile segment can induce a pain radiating in the
      dermatome at the same level as the vertebral problem. Maigne also described signs
      found in the skin (cellulalgia), in the muscles (myalgic bands) and in the bony
      insertions of tendons (tenalgia). These signs are to be found in the same
      dermatome, myotome and sclerotome as the spinal dysfunction. For headache of
      cervical origin due to painful intervertebral dysfunction, the most frequent
      dysfunctional mobile segment is located at the C2-C3 level. This induces pain
      mostly in the posterior parts of the head and cellulalgia in the C2 and C3
      dermatomes. Painful tumefaction is also found over the posterior aspects of the
      facet joints on palpation at this level. These findings are key elements for the
      diagnosis of painful intervertebral dysfunction. The recognition of these signs
      is changing our understanding of the role of the cervical spine in headaches.
      Painful intervertebral dysfunction is very frequently found in chronic daily
      headaches.

PMID- 8349477
TI  - Comparison of the efficacy between flunarizine and nifedipine in the prophylaxis
      of migraine.
AB  - BACKGROUND: Several calcium channel blockers have been evaluated in controlled
      clinical studies and some hold considerable promise for future. Efficacy in
      migraine prophylaxis has been claimed for drugs belonging to all three classes of
      calcium channel blockers (nifedipine-like, verapamil-like, and flunarizine-like),
      but the extent and quality of the evidence varies, and a comparison of efficacy
      between different calcium channel blockers has not been reported. OBJECTIVE: The
      objective of the study is to assess the comparison of efficacy and safety of
      flunarizine and nifedipine in migraine prophylaxis. PATIENTS AND METHODS: The
      study was conducted in a prospective, double-blind, randomized controlled trial,
      parallel group design. 78 patients were studied for a 1-month period during which
      all patients received placebo followed by a 3-month experimental period. Headache
      response to medication was measured monthly by compilation of migraine-scores
      derived from quantitative data recorded by patients in a daily diary. Student's t
      test was used to compare results from the flunarizine (10 mg) and nifedipine (20
      mg) group for each month. RESULTS: Both groups showed a significant reduction in
      the migraine-scores after 3-months. No significant differences were detected
      between groups, but there was a clinical significantly different reduction of
      migraine-scores between the groups in the first month after the run-in period
      (58% vs 38%). It shows that the beneficial effect of flunarizine was more rapidly
      manifest than that of flunarizine. Tachycardia more frequently occurred in the
      nifedipine group than in the flunarizine treatment group. CONCLUSION: It
      concluded that flunarizine is a potentially more useful agent in the prophylaxis
      of migraine headache.

PMID- 8349478
TI  - The potential effectiveness of moclobemide, the new monoamine oxidase inhibitor,
      in the prophylaxis of migraine.

PMID- 8349480
TI  - Investigating the role of osteopathic manipulation in the treatment of asthma.

PMID- 8349479
TI  - Helping-not hurting--residents with substance use disorders.

PMID- 8349481
TI  - To sleep, perchance...

PMID- 8349482
TI  - Diagnosis and management of asthma: a brief review of two asthma expert panel
      reports.
AB  - During the past decade, asthma morbidity and mortality have increased noticeably.
      Although the reasons for the increase are not clear, the prevalence of asthma has
      been reported to be increasing not only in the United States but also in other
      countries throughout the world, including the United Kingdom, New Zealand, and
      Australia. Asthma mortality rates and morbidity trends are increasing despite
      what appears to be major scientific advances in our understanding of asthma and
      in the face of a multitude of new therapeutic modalities. This article presents a
      brief overview of the pathogenesis and diagnosis of asthma, and highlights the
      major management recommendations of two expert panel reports.

PMID- 8349483
TI  - Research secures the future of osteopathic medicine: Part 2: Readdressing the
      function and structure of colleges of osteopathic medicine.
AB  - Many problems exist within the contemporary medical education process in general
      and the osteopathic medical profession in particular. Part 2 of this series
      suggests that the single greatest impediment to solving these problems is an
      institutional infrastructure that is not congruent with the institution's
      functions, as defined in its mission statement. (This mission statement generally
      entails two primary goals: education and research). Two major divisions within
      the core's infrastructure are suggested: medical education and medical research.
      By restructuring their infrastructure, colleges of osteopathic medicine can more
      effectively address and support their primary functions of education and
      research.

PMID- 8349484
TI  - 'Blueprint' for creating classroom facilities in teaching hospitals.
AB  - Classroom facilities in teaching hospitals have evolved from simple rooms with
      blackboards to sophisticated amphitheaters with high-tech audiovisual equipment.
      This article presents a "blueprint," which was used in an osteopathic hospital,
      to renovate existing space into classrooms that are conducive to learning.

PMID- 8349485
TI  - Unexpected adverse effects of Freon 11 and Freon 12 as medication propellants.
AB  - Metered-dose inhalers are frequently used in treating pulmonary diseases
      associated with bronchoconstriction, chiefly asthma and chronic bronchitis. These
      aerosolized medications are not without the potential for adverse effects. The
      author describes two patients who likely had adverse reactions to the Freon
      propellants used in the inhalers. These reactions are reported in order to alert
      physicians to their possible occurrence and to suggest a rational treatment
      approach.

PMID- 8349487
TI  - Freud's brain: toward a unified neuropsychodynamic model of personality and
      psychotherapy.
AB  - Neuropsychological findings and principles are not by themselves sufficient to
      provide definitive answers to broad questions of personality, psychopathology, or
      psychodynamics, nor should they be seen as attempting to usurp other approaches.
      This review has briefly noted some of the directions in which neuropsychology is
      being applied to psychoanalysis and psychodynamic personality theory, as well as
      to clinical practice. The purpose of any model is to try to weave disparate
      observations and findings into a coherent theoretical framework that can be
      productively employed for further clinical and research purposes. To this end,
      the neuropsychodynamic approach can contribute. Man--as Freud recognized--is
      neither "organic" or "functional." He is both, and our commitment to
      psychological knowledge must entail a search for unities.

PMID- 8349486
TI  - Insight, empathy, and internalization: elements of clinical change.

PMID- 8349488
TI  - The impact of incest on identity formation in women.
AB  - In conclusion, the purpose of this paper was to elucidate some of the long-term
      impacts of the incest trauma on women. This includes its impact on identity
      formation. The process of idealization and the creation of an idealized image as
      a defensive and adaptive strategy to cope with overwhelming trauma was
      highlighted. This initially successful coping mechanism later causes problems in
      limiting the individual's self-perception and restricting her relationships with
      others. This is frequently manifested in problems that the adult survivor
      presents in regard to interpersonal relationships, as well as revictimization and
      an inhibition in identifying and expressing certain aspects of herself. The goal
      of treatment is therefore twofold. I am in agreement with Alpert (1991), van der
      Kolk (1987), and others who stress the importance of the validation and
      integration of the trauma and related affects through the recovery and reliving
      of past memories. Additionally, an analysis of the character structure that the
      person developed to cope with overwhelming and damaging experiences is essential.
      The achievement of a more cohesive, integrated sense of self for an adult
      survivor of incest can only be accomplished through the working through of past
      traumas and the understanding of its effect on identity development and character
      structure. This aspect of the treatment process was best expressed by one of my
      patients, who said, "the first part of my analysis dealt with remembering and
      reliving what happened to me, the second part is dealing with who I had to become
      and not become as a result of it." She later added that she felt the second part
      is even more difficult and challenging.

PMID- 8349489
TI  - The application of the core conflictual relationship theme method to Japanese
      psychoanalytic psychotherapy.

PMID- 8349490
TI  - What constitutes our understanding of a patient?
AB  - A number of approaches to the search for methodology in the human sciences are
      reviewed. Heidegger's use of Husserl's phenomenology led to his exploration of
      the background practices on which he believed all our understanding is based.
      This use of phenomenology was adopted by Sartre and R. D. Laing, and existential
      psychiatrists and psychoanalysts in their emphasis on the here-and-now encounter
      between the patient and the therapist, along with various embellishments and
      emendations on Heidegger's notion of what it meant to live authentically or
      inauthentically. Foucault maintained that there is a politics embedded in all the
      human sciences such as psychiatry and psychoanalysis, and this politics revolves
      around the use of power and its operations, including the actual use of the human
      sciences in the culture and what the different theories imply in the way of an
      ideology. Lacan emphasized this when he challenged the prevailing ideology of
      United States psychoanalysis, in which adaptation was seen as the crucial task of
      the ego. The existence of background practices and outer horizons required for
      any understanding in the human sciences leads to a situation that questions the
      use of empirical methods to establish what is accepted as "truth" in the human
      sciences. A predominant alternative, that of hermeneutics, has gained acceptance
      by eminent analysts such as Gill and certain interpersonal theorists. But the
      term hermeneutics is used in many ways by many authors and runs the danger of a
      relativism and a nihilism. This leads to a discussion of the value of various
      philosophical positions in throwing light on our search for a methodology in the
      human sciences. A review of arguments invoking the "end of philosophy" such as
      those of Rorty reveals that they are paradoxical and based on premises which in
      turn represent a philosophy. This debate remains unresolved. In general the
      postmodern view sees "truth" as more relative and emphasizes the role of social
      and cultural aspects of prevailing ideologies in constituting and determining
      what we call truth and understanding, including the "understanding" of a patient
      in psychotherapy. An example of the postmodern blend of philosophy and
      psychoanalysis is presented by Arlow's emphasis on unconscious fantasies and his
      insightful comments on how these unconscious fantasies organize and determine
      what we experience from the very beginning of life. This I believe is most
      consistent with Rescher's philosophical notion of "conceptual idealism," also
      briefly reviewed in this paper.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8349491
TI  - Separation-individuation issues in sister transference.

PMID- 8349492
TI  - Ferenczi, RN, and the struggle for equal ground.

PMID- 8349493
TI  - Unconscious communication in Birdy.

PMID- 8349494
TI  - Ivar Johansson, 1891-1988: a brief biography.

PMID- 8349496
TI  - Body dimensions and carcass measurements of cattle selected for postweaning gain
      fed two different diets.
AB  - Genetic and phenotypic parameters among nine body dimensions and two measures of
      growth rate were estimated from measurements on 709 Angus and Hereford bulls and
      heifers born in 1984 and 1985. Height and width at hips, height at withers, body
      length, girth, head length and width, muzzle width, and cannon bone circumference
      were measured at weaning and again after 168-d postweaning gain tests. The cattle
      were from the final two calf crops of a 20-yr study to examine the response to
      selection for postweaning gain when fed either a high-concentrate diet or an all
      hay diet. Sources of variation included year of birth, breed, sire within breed,
      diet, age of dam, and the linear regression on calf age. Parameter estimates
      among the body dimensions and carcass measurements were also calculated using a
      subsample of 318 Hereford and Angus bulls fed until they achieved > or = 7 mm of
      subcutaneous fat. Yearling measurements from calves fed the high-concentrate diet
      were larger than those from calves fed the all-hay diet. Sire within breed, age
      of dam, and the regression on age of calf affected all measurements (P < .001) at
      both measurement times. Dietary energy concentration influenced all body
      measurements taken at the end of test. Heritabilities of all body measurements
      were moderate to high. The highest genetic correlations with gain were for cannon
      bone circumference, body length, and heart girth. The heritabilities of all body
      dimensions were sufficient to indicate that selection progress was possible, but
      the low genetic correlations with gain and carcass traits suggested that this may
      not be desirable.

PMID- 8349495
TI  - Ruminal escape protein for lightweight feedlot calves.
AB  - Effects of supplemental ruminal escape protein (REP) were evaluated in an 84-d
      growth study involving 140 feedlot steers (198 kg) and in a site of digestion
      study involving four steers (149 kg). Dietary treatments were as follows: 1)
      basal diet; 2) basal diet plus 2% of a REP blend (1/3 blood meal, 1/3 meat and
      bone meal, and 1/3 feather meal); 3) basal diet plus 4% REP; and 4) basal diet
      plus 6% REP. The basal diet contained 18% alfalfa hay, 10% sudangrass hay, 61%
      steam-flaked corn, 2.5% yellow grease, 6% molasses, and 2.5% supplement. The
      basal diet contained 12.2% CP, and urea was the sole source of supplemental N.
      There was a quadratic effect (P < .05) of REP supplementation on rate and
      efficiency of gain. The greatest response was with 2% REP, which increased rate
      and efficiency of gain by 13.4 and 8.4%, respectively, over that of the basal
      diet. Protein supplementation had a quadratic effect (P < .05) on the NE value of
      the diet. The addition of 2% supplemental REP increased the NE of the diet by
      6.6%. In the site of digestion trial, supplemental REP linearly increased (P <
      .01) passage of nonammonia and amino acid N to the small intestine. Compared with
      estimated amino acid requirements and with muscle composition, postruminal
      supplies of arginine, histidine, lysine, methionine, and phenylalanine were the
      limiting amino acids in the basal diet. Excess bypass protein, by placing an
      additional demand on arginine for detoxification of ammonia, may limit growth and
      performance.

PMID- 8349497
TI  - Carcass traits and the occurrence of dark cutters in pregnant and nonpregnant
      feedlot heifers.
AB  - The objective of this study was to determine whether the occurrence of dark
      cutters and selected carcass traits differ between pregnant and nonpregnant
      feedlot heifers. Feedlot heifers (n = 8,292) were identified at slaughter as
      being either nonpregnant, pregnant with a moderate-sized fetus (midgestation), or
      pregnant with a large fetus (late gestation). This was based on visual appraisal
      of a gravid uterus at the evisceration table. After chilling (24 to 72 h),
      carcass data were collected. Cattle originated from 23 different commercial
      feedyards located within a 350-km radius of a commercial slaughter facility
      located in southwest Kansas. Across slaughter lots, the incidence of pregnancy
      varied from 0 to 25% with an overall mean of 4.74%. Carcass traits of heifers
      with moderate or large fetuses did not differ (P > .15). Compared with carcasses
      from nonpregnant heifers, carcasses from pregnant heifers were 4.5 kg lighter (P
      < .01), had .11 cm more fat thickness (P < .01), and exceeded the number of
      carcasses that graded Choice or Prime by 6% (P < .01). Carcasses from pregnant
      heifers had higher maturity scores (P < .01) and there was no incidence of dark
      cutters (P < .01) compared with a 1.7% incidence of dark cutters in carcasses
      from nonpregnant heifers. Any economical advantage in the pregnant heifers due to
      their higher percentage of Choice carcasses and lower incidence of dark cutters
      may be offset by their increased carcass fat thickness and lower dressing
      percentage.

PMID- 8349498
TI  - Cow weights and reproduction on native rangeland and native rangeland
      complementary forage systems.
AB  - Replicated cow herds of 15 Angus x Hereford (AH) and 15 Brahman x Hereford (BH)
      F1 cows each were placed on native rangeland (NR) or native rangeland
      complementary forage (NRCF) systems. The NR was 8.1 ha of sagebrush-mixed prairie
      per cow-calf unit and the NRCF used the same mixed prairie complemented by .4 ha
      of double-cropped winter wheat and summer annual forage replacing about 30% of
      the mixed prairie for each cow unit. Calving seasons, spring for NR and fall for
      NRCF, were selected to complement the respective forage systems. Cow weights,
      reproductive performance, and population demographics were measured through seven
      calf crops to investigate their relationship to forage systems and cow breed
      types. Seasonal average cow weights increased from 484 +/- 7 (SE) kg during calf
      crop 1 to a peak weight of 568 +/- 8 kg at calf crop 5. Average weight of AH cows
      was 514 +/- 3 kg, compared with 539 +/- 3 kg for the BH cows (P < .01). Angus x
      Hereford and BH cows were 38 and 44 kg heavier, respectively, on the NRCF system
      than on the NR system. The average percentage of reproduction for AH cows was 90
      +/- 2%, compared with 87 +/- 2% for the BH cows (P < .13). Both breeds had
      approximately 87 (AH) to 89% (BH) reproductive rate on the NR system. In
      contrast, AH cows had 94 +/- 2% reproduction on the NRCF system, compared with 84
      +/- 2% for the BH cows.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349499
TI  - Linear body measurements of cattle before and after 20 years of selection for
      postweaning gain when fed two different diets.
AB  - At weaning and again after postweaning gain tests, height and width at hips,
      height at withers, body length, girth, head length and width, muzzle width, and
      cannon bone circumference measurements were obtained from Angus and Hereford
      bulls and heifers born in 1964, 1984, and 1985 (n = 989). The cattle were from
      the initial and final two calf crops selected for postweaning gain when fed
      either a high-concentrate diet or an all-hay diet. Analysis of variance and
      canonical discriminant analysis were used to examine the relationships among body
      measurements and major sources of variation (breed, year of birth, sire within
      breed and year, diet, sex of calf, age of dam, and the regression on age of
      calf). Canonical discriminant analysis indicated that one underlying variate
      explained nearly 90% of the total variation among the weaning measurements,
      whereas three variates were required to account for that proportion in the end-of
      test measurements. At both measurement times, the first canonical variate was
      associated with year of birth, the second with sex of calf, and the third with
      dietary energy. Correlations between each canonical variate and the original body
      measurements indicated that year of birth (variate 1) was most closely associated
      with body length and cannon bone circumference at weaning and with body length
      and height at hips (but not withers) at end of test. Sex of calf (variate 2) was
      associated most closely with width of muzzle and head. Diet (variate 3) was
      associated with heart girth. Faster-growing cattle were longer in body, but not
      necessarily taller.

PMID- 8349500
TI  - Paternal half-sib heritabilities and genetic, environmental, and phenotypic
      correlation estimates from randomly selected Hereford cattle.
AB  - Growth and carcass data were collected during 10 yr at the Fort Keogh Livestock
      and Range Research Laboratory in Miles City, MT from a Hereford herd selected at
      random. The objective was to compare genetic parameter estimates from this
      randomly selected herd with estimates from published selection studies. Only
      bulls were included in the data set. Bulls were slaughtered between 14 and 17 mo
      of age. Genetic parameters were estimated by the paternal half-sib procedure.
      Data were subdivided into three subgroups: 1) all bulls that had birth weights,
      2) bulls with complete records for growth traits, and 3) bulls with complete
      carcass and growth records. The heritability estimate for birth weight on 736
      progeny from 86 sires was .18. The second group included 616 progeny representing
      85 sires and heritability estimates were weaning weight, .17; daily gain from
      birth to weaning, .20; final test weight, .42; and daily gain on test, .47. The
      third group included 401 progeny from 75 sires and heritability estimates were
      carcass weight, .38; longissimus muscle area, .51; marbling, .31; slaughter
      weight, .42; and dressing percentage, .25. Thus, these estimates of heritability
      were in quite good agreement with previously published values, with a tendency
      for these estimates to be lower for early growth weights. Phenotypic and
      environmental correlations were in good agreement and genetic correlations were
      in general agreement with the data reviewed. Estimates of heritabilities from
      this herd selected at random were not larger than previous estimates from
      selected herds.

PMID- 8349501
TI  - Genetic and environmental parameters for mature weight and other growth measures
      in Polled Hereford cattle.
AB  - Variances and covariances were estimated for birth weight (BWT), weaning weight
      (WW), yearling gain (YG), yearling weight (YW), yearling height (YH), relative
      growth from birth to weaning (RGW) and weaning to yearling (RGY), and mature
      weight (MW). Field records on 572,446 Polled Hereford cattle were analyzed.
      Because multiple dam weights were collected on a cow the MW used in the analysis
      was calculated using a nonlinear regression correction factor computed by fitting
      a quadratic with a plateau to the data. If the cow had an observation(s) beyond
      the inflection point (IP), the closest weight to that point was used. If the cow
      only had observation(s) before the IP the closest weight to that point was
      nonlinearly adjusted to the plateau. The IP for this data set was 1,506 d and the
      plateau was 554.7 kg. Heritabilities and genetic and environmental correlations
      were calculated from the appropriate (co)variances and phenotypic correlations
      were computed. Heritability estimates for BWT, WW, YG, YW, YH, RGW, RGY, and MW
      were .49, .24, .23, .30, .59, .24, .15, and .52, respectively. Genetic
      correlations between MW with BWT, WW, YG, YW, YH, RGW, and RGY were .64, .80,
      .76, .89, .73, -.29, and .35, respectively, environmental correlations were .15,
      .43, .05, .40, 1.03, .32, and -.10, respectively, and phenotypic correlations
      were .33, .32, .28, .46, .70, .00, and .07, respectively.

PMID- 8349502
TI  - Direct and correlated responses to divergent selection for serum cholesterol
      concentration on day 56 in swine.
AB  - Divergent selection for serum cholesterol concentration on d 56 was practiced in
      a four-breed, composite population for three generations. High and Low lines,
      representing high and low levels of serum cholesterol, respectively, were each
      maintained with approximately 10 males and 25 females per generation. Pigs from a
      contemporary Control line were evaluated only in the last generation. In the last
      generation, mean serum cholesterol concentration was significantly different
      among lines (107.1, 85.6, and 65.5 mg/dL for High, Control, and Low lines,
      respectively). Realized heritability was .31, .33, and .31 for high, low, and
      divergent selection (SE = .03), respectively. Terminal evaluation indicated that
      average birth and weaning (28 d of age) weight was lower (P < .05) for Low pigs
      (1.25 and 6.25 kg, respectively) than for High pigs (1.43 and 7.10 kg,
      respectively) and was intermediate for Control pigs (1.34 and 6.53 kg,
      respectively). At 56 d of age, High (15.1 kg) and Control (13.5 kg) pigs were
      heavier (P < .05) than Low pigs (11.9 kg). However, pigs sampled after 56 d did
      not differ (P > .05) in average daily gain, 164-d weight, feed consumption, or
      feed efficiency. Serum cholesterol concentration at 165 d of age was
      significantly different among lines (110.1, 98.5, and 85.6 mg/dL for High,
      Control, and Low pigs, respectively), although differences were smaller than at
      56 d of age. When slaughtered at approximately 106 kg (188 to 195 d of age), Low
      pigs had significantly shorter carcasses than High and Control pigs (77.5 vs 78.7
      and 78.9 cm, respectively). Low pigs had significantly more fat at the first rib
      (5.70 vs 5.28 cm) than High pigs. Lines did not differ significantly for fat
      thickness at the last rib, last lumbar vertebrae or 10th rib, or for longissimus
      muscle area. At 60 d of gestation, ovulation rate, measured as number of corpora
      lutea, was lower (P < .05) for High (9.84 eggs) than for Low (11.79 eggs) or
      Control (11.17 eggs) gilts. Differences in ovulation rate were reflected in
      smaller but nonsignificant differences in number of fetuses (7.97, 9.00, and 8.55
      fetuses for High, Low, and Control, respectively).

PMID- 8349503
TI  - Energy metabolism of growing pigs after transportation, regrouping, and exposure
      to new housing conditions as affected by feeding level.
AB  - An experiment was performed to evaluate alterations of energy metabolism with
      time in 10 groups of 16 barrows just after transportation. Ten-week-old pigs were
      fed at once (four groups; LF) or twice (three groups; MF) maintenance level (35
      and 75 g.kg-.75.d-1, respectively), or allowed ad libitum access to feed (three
      groups; HF). The 13.5-d experimental period was divided into two balance periods.
      Heat production (HP) decreased with time. The changes in HP with time were
      different among feeding level groups (P < .001); the LF group had the greatest
      decrease. Metabolizable energy intake remained constant with time for the LF and
      MF groups and decreased for the HF group. Requirements for maintenance energy and
      efficiency of ME for growth decreased with time. Feeding level influenced (P <
      .001) energy retention (ER) during the total experimental period. The LF group
      had a negative ER (-65 kJ.kg-.75.d-1), whereas in the MF and HF groups positive
      values for ER were obtained (346 and 757 kJ.kg-.75.d-1, respectively). At all
      feeding levels, animals had a positive protein gain. The level differed between
      feeding levels (P < .001). Differences among groups (P < .001) were observed in
      energy retained as fat. Data from the present experiment show that young pigs are
      not in a steady state of energy metabolism during the 2 wk after transportation.
      During this period, the relationship between metabolic rate and feed intake
      alters with time.

PMID- 8349504
TI  - Evidence of increasing thermal requirement in young, unadapted calves during 6 to
      11 days of age.
AB  - Changes in thermal demand in restrictively fed, unadapted, young calves were
      studied during the first days after transportation. Twenty-three 6-d-old Holstein
      Friesian male calves were assigned to one of four ambient temperature treatments:
      5, 9, 13, or 18 degrees C. Calves were fed at a constant level below the
      maintenance requirement (300 kJ of ME.kg-.75.d-1). After arrival, heat production
      (HP) and energy and nitrogen balance were measured for each calf for 5.5 d. At
      ambient temperatures of 5 and 9 degrees C, HP was increased compared with
      temperatures of 13 and 18 degrees C (P < .001). As a consequence, energy
      retention was decreased at low ambient temperatures (P < .05). At temperatures of
      5 and 9 degrees C, body fat mobilization was increased compared with that at
      temperatures of 13 and 18 degrees C (P < .001). Energy retained as protein was
      not affected by ambient temperature. During the experimental period, HP decreased
      with time. Ambient temperature affected this decrease (P < .001), indicating that
      the relationship between HP and ambient temperature changed with time. The rate
      of increase in HP below the lower critical temperature was not affected by time,
      averaging 9.5 kJ.kg-.75.d-1.C degrees-1. Lower critical temperature, however,
      increased with time by .89 C degrees/d (P < .05). The changing relation between
      HP and ambient temperature with time in young, unadapted calves after
      transportation is thus reflected in an alteration in thermal requirement with
      time.

PMID- 8349506
TI  - Tissue-specific activity of pentose cycle oxidative enzymes during feeder lamb
      development.
AB  - Relationships between pentose cycle oxidative activity and differential fat
      growth were evaluated. Rambouillet wether lambs (n = 60) were slaughtered
      serially at 0, 40, 80, and 120 d on feed (15 lambs/group). Rack dissection and
      kidney fat weights were collected, and longissimus muscle i.m. fat content was
      determined. Postmortem longissimus muscle, s.c. fat, intermuscular fat (INT), and
      kidney fat (KP) samples were assayed in vitro for glucose-6-phosphate
      dehydrogenase (G6PDH) and 6-phosphogluconate dehydrogenase (6PGDH) activity
      (nanomoles.minute-1.gram of tissue-1), and samples were subjected to
      electrophoresis (PAGE) to separate tissue-specific isoforms. Allometric
      coefficients for rack components indicated that s.c. fat was the earliest
      maturing, slowest-growing depot, INT was the latest-maturing, fastest-growing
      depot, and i.m. fat was intermediate (P < .05). Kidney fat grew faster than
      carcass weight and, as carcass weight increased, the growth rate of KP
      accelerated (P < .05). Enzyme activities increased until 40 d on feed and
      declined thereafter. Activities differed across tissues and time on feed end
      points (P < .05). Ratios of G6PDH:6PGDH, reflecting flux through the oxidative
      phase of the pentose cycle and, therefore, lipogenic activity, suggested growth
      patterns similar to those indicated by allometric analysis, except in the i.m.
      fat depot. Development of i.m. fat initially was intermediate to KP and INT, but
      G6PDH:6PGDH ratios increased with time on feed, suggesting a different regulatory
      mechanism and maturing pattern. Multiple forms of G6PDH were detected with PAGE,
      and although polymorphism was not detected, a tissue-specific isoform was
      isolated for INT fat.

PMID- 8349505
TI  - Effects of exogenous porcine somatotropin on the carcass composition, hormonal
      and metabolic profiles, lipogenic capacity, and binding of insulin to erythrocyte
      receptors of fast- versus slow-growing swine.
AB  - Twenty barrows were designated as fast-growing (FG) and their littermates
      designated as slow-growing (SG) based on birth, weaning, and 56-d weight. Half of
      each group received 70 micrograms of porcine somatotropin (pST)/kg BW daily
      beginning at 40 kg BW. At 60 and 105 kg BW, blood was collected every .5 h for 12
      h beginning 1 h before pST injection, fat biopsies were taken for in vitro
      lipogenic activity, and insulin erythrocytes were isolated for receptor binding.
      Swine treated with pST had elevated ADG (.95 vs .88 kg/d; P < .1) and reduced
      days to slaughter (61 vs 67; P < .1). The pST-treated pigs had less average
      backfat (2.73 vs 3.96 cm; P < .01), larger longissimus muscle areas (32.3 vs 28.2
      cm2; P < .05), and a higher percentage of muscle (56.3 vs 50.3%; P < .01) than
      control pigs. Exogenous pST increased protein (17.4 vs 13.2%; P < .05) and
      decreased fat (22.9 vs 37.1%; P < .05). The FG pigs had higher ADG (.98 vs .86
      kg/d; P < .01) and required fewer days to slaughter (57 vs 71; P < .01) than SG
      pigs. Administration of pST increased (P < .01) average pST levels (1.7 vs 14.0
      ng/mL) in FG and SG pigs at 60 kg BW. At 105 kg BW, pST was higher (P < .01) in
      pST-FG than in pST-SG swine (46.0 vs 19.3 ng/mL) but was not different between FG
      and SG control swine (1.9 vs 1.8 ng/mL). Administration of pST increased
      concentrations of IGF-I (510.0 vs 160.0 ng/mL) and nonesterified fatty acids (182
      vs 109 muEq/L, P < .01) in FG and SG swine. Over sample periods and growth rates,
      pST reduced (P < .05) CO2 production and lipid synthesis (.345 and 1.85 vs .575
      and 2.71 mumol of glucose incorporated.g-1.2 h-1). At 60 kg BW, FG swine had less
      (P < .01) CO2 production and lipid synthesis (.299 and 1.83 vs .921 and 3.61
      mumol.g-1.2 h-1) than did SG swine. Exogenous pST increased (P < .05) binding to
      insulin erythrocyte receptors (7.25 vs 6.34%).

PMID- 8349507
TI  - Foodservice industry market profile study: in-plant beef fat trim level survey
      and cutting yields.
AB  - Fifty foodservice purveying companies were sampled in 12 U.S. cities evenly
      distributed across six geographical regions. Beef whole muscle cuts (WMC) and
      portion control items (PCI) from the primal rib and loin were evaluated for
      surface fat levels. Fat thicknesses were measured on WMC before and after
      fabrication, whereas additional PCI were measured for fat trim levels before
      distribution. The average initial fat thickness was 11.9 mm (174 Short Loin and
      180A Strip Loin) and 15.6 mm (184 Top Sirloin Butt); maximum fat thicknesses
      ranged from 16.2 mm (strip loin) to 22.2 mm (top sirloin butt). After
      fabrication, average fat thicknesses were 6.2, 5.1, and 4.0 mm for resulting
      products from the short loin, strip loin, and top sirloin butt, respectively. The
      average initial fat thickness for the strip loin was greater (P < .05) in
      Southeast and Northeast regions than in Mountain/Desert, Midwest, and Southwest
      regions. In contrast, average trimmed fat thicknesses for products from the strip
      loin and top sirloin butt were lower (P < .05) in the Southeast and Northeast
      than in all other regions. Average fat trim levels for PCI were 3.0 (1112A Ribeye
      Roll steak, Lip-On), 5.3 (1173B/1174B T-Bone/Porterhouse steak), 5.0 (1180A Strip
      Loin steak), and 4.0 mm (1184B Top Sirloin steak). Maximum fat trim levels were
      4.4 (IMPS 1112A), 7.4 (IMPS 1173B/1174B), 6.9 (IMPS 1180A), and 5.5 mm (IMPS
      1184B). The PCI had average and maximum fat trim levels in compliance with USDA
      (1988) recommendations for fat trim specifications.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8349508
TI  - Dietary versus postmortem supplementation of vitamin E on pigment and lipid
      stability in ground beef.
AB  - Effects of dietary supplementation and postmortem addition of vitamin E on
      pigment and lipid stability in raw ground beef were examined in this study. Six
      Holstein steers were fed a control diet for 232 or 252 d and six Holstein steers
      were supplemented with 1,500 IU of vitamin E per animal daily for 232 or 252 d.
      Three aliquots of ground beef from each longissimus lumborum were allotted to the
      following postmortem treatments: no addition (NO), white mineral oil (OIL), and
      white mineral oil containing sufficient D-alpha-tocopherol to equal the mean
      difference of alpha-tocopherol concentration between beef from supplemented and
      control steers (OIL + E). Metmyoglobin percentages and 2-thiobarbituric acid
      reactive substances values were determined at d 1, 3, 5, 7, and 9 after
      postmortem treatment. Dietary vitamin E supplementation delayed metmyoglobin
      increase and highly suppressed lipid oxidation in ground beef during 9 d of
      display compared with the control. The postmortem addition of vitamin E (OIL + E)
      was slightly effective in retarding the oxidation of pigment and lipid,
      especially compared with the OIL treatments. Endogenous vitamin E improved
      pigment and lipid stability much better than exogenous vitamin E.

PMID- 8349509
TI  - Intramuscular collagen characteristics of ram, wether, and zeranol-implanted ram
      lambs.
AB  - Eighteen spring-born Columbia ram, wether, and zeranol-implanted ram lambs were
      studied to determine the influence of castration or zeranol implants on
      intramuscular collagen (IMC) properties and muscle shear force values. Warner
      Bratzler shear force values for longissimus muscle were greatest for ram lambs,
      intermediate for implanted rams, and least for wethers (P < .05). Nonreducible
      collagen crosslink concentration was greater in IMC of rams and implanted rams (P
      < .05). The IMC from rams compared with that from wethers contained
      proportionately more Type III than Type I collagen (P < .05); values for
      implanted rams were intermediate. Heat-soluble muscle collagen concentration was
      greater for rams and implanted rams than for wethers (P < .05); however,
      insoluble collagen concentration did not differ by treatment. Muscle collagen
      concentrations were not different for rams, wethers, or implanted rams. Increased
      shear force values in rams were associated with elevated collagen crosslink
      concentration and increased proportion of Type III collagen. Greater
      concentration of soluble collagen in ram IMC neither diminished nor diluted IMC
      crosslinking. The proportion of heat-labile collagen in the fractions did not
      reflect the IMC crosslinking profile for ram and wether lambs. Zeranol
      implantation modified IMC characteristics of rams such that shear force values
      and some collagen properties were similar to those of wethers.

PMID- 8349510
TI  - Enrichment of omega-3 fatty acids in suckling pigs by maternal dietary fish oil
      supplementation.
AB  - This study was designed to determine whether substituting menhaden fish oil (FO)
      for lard (LA) in a practical sow diet was a suitable method for enriching newborn
      pigs with omega-3 polyunsaturated fatty acids (n-3 PUFA). On d 107 of gestation,
      18 crossbred sows were randomly allotted to one of three experimental diets, in
      which FO was substituted for LA at 0, 3.5, and 7% of the diet. On d 1, 7, 14, and
      21 after farrowing samples of milk and serum from the sows and pig serum were
      collected for fatty acid analysis. The content of n-3 PUFA in the serum of sows
      fed FO increased six-fold over that in serum of LA-fed sows P < .0001). Feeding
      FO decreased the levels of arachidonic acid in maternal serum by approximately
      50% (P < .0001). Similar changes were reflected in the fatty acid profiles of
      sow's milk. Pig serum n-3 PUFA levels were elevated over 5- and 10-fold within 24
      h of birth in those litters born to sows fed 3.5 and 7% fish oil, respectively.
      Eicosapentaenoic acid levels in pig serum increased linearly (P < .01) during the
      first 2 wk postnatally in pigs suckling FO-feds sows and accounted for as much as
      12% of the total fatty acids present on d 21. In conclusion, we have demonstrated
      that feeding FO to sows during late gestation and lactation enriches the newborn
      pig with n-3 PUFA.

PMID- 8349511
TI  - Effect of dietary lysine levels formulated by altering the ratio of corn:soybean
      meal with or without dried whey and L-lysine.HCl in diets for weanling pigs. NCR
      42 Committee on Swine Nutrition.
AB  - A regional cooperative study (NCR-42 Committee) evaluated the efficacy of
      supplemental dried whey and L-lysine.HCl in a corn-soybean meal-based diet for
      weanling pigs. The experiment involved five research institutions using a total
      of 960 crossbred pigs weaned between 3 and 4 wk of age. The experiment was
      conducted as a randomized, complete block design in 15 replications with a
      minimum of two replicates per station. Two diets were formulated to contain
      either .95 or 1.10% lysine by altering the ratio of corn:soybean meal (C-SBM).
      Two other diets were formulated to the same lysine levels but with 20% dried whey
      (C-SBM-DW). Supplemental L-lysine.HCl was added to each diet mixture as another
      variable, increasing the lysine level of each diet by .15%. There were station
      effects (P < .01) for each trait, but no station x treatment interactions (P >
      .15). Feed intakes and weight gains were greater (P < .01) for pigs fed diets
      containing dried whey, and there was a greater response (26 vs 10%) to the C-SBM
      DW diet that contained 1.10% lysine than to the C-SBM-DW diet at the .95% lysine
      level. Performance was not improved when L-lysine.HCl was added to either the .95
      or 1.10% lysine C-SBM diets, and it elicited a small, but nonsignificant, gain
      response when it was added to the C-SBM-DW diets. These results suggest that gain
      and feed performance responses of weanling pigs improved when diets contained
      dried whey. Lysine was not the limiting factor in either the C-SBM or C-SBM-DW
      diet formulated to either .95 or 1.10%. Another factor in dried whey was assumed
      to be responsible for its growth promotion effect.

PMID- 8349512
TI  - Evaluation of animal protein supplements in diets of early-weaned pigs.
AB  - Three growth assays were conducted to determine the efficacy of replacing dried
      skim milk and(or) dried whey in diets of starting pigs with commercially
      available spray-dried porcine plasma, spray-dried porcine blood, spray-dried
      bovine plasma, or spray-dried extracted meat protein. In Exp. 1, 236, 24-d-old
      crossbred pigs were fed diets containing either skim milk and whey or porcine
      plasma from 0 to 14 d postweaning and whey or porcine plasma from 14 to 28 d.
      Although pigs fed diets containing porcine plasma had greater ADFI and ADG than
      those fed milk products from 0 to 7 d, no differences were observed from d 0 to
      14 or from 14 to 28 d postweaning. In Exp. 2, 204, 21-d-old pigs were fed corn
      soybean meal-based diets using the following supplemental protein source
      combinations: skim milk and whey; skim milk, whey, and casein; porcine plasma,
      whey, and lactose/starch (10%); porcine plasma and lactose/starch (24.4%); or
      whey. A common diet (1.25% lysine, 10% whey) was fed from 14 to 35 d postweaning.
      Pigs fed diets containing porcine plasma consumed more feed and had greater ADG
      than others (P < .05) from 0 to 14 d and from 0 to 35 d. Both ADG and ADFI were
      highest when the diet contained 10.3% porcine plasma, 20% whey, and 10% added
      lactose. Experiment 3 used 150, 21-d-old pigs to compare the inclusion of skim
      milk, porcine plasma, porcine blood, bovine plasma, or meat extract in diets fed
      from 0 to 14 d postweaning. A common diet (the same as in Exp. 2) was fed from 14
      to 35 d. Pigs fed porcine plasma had greater ADFI (P < .05) from 0 to 14 d than
      pigs fed other treatments. Also, pigs fed porcine plasma had greater ADG (P <
      .05) from 0 to 14 d than pigs fed all other diets except porcine blood. Pigs fed
      porcine blood had the largest ADFI (P < .05) from 14 to 35 d compared with pigs
      fed other diets. These experiments indicate that porcine plasma is a protein
      supplement superior to skim milk in diets of starting pigs and that porcine blood
      has a positive influence on subsequent growth performance.

PMID- 8349513
TI  - Utilization of medium-chain triglycerides by neonatal pigs: effects of
      emulsification and dose delivered.
AB  - Four trials were conducted using 86, 24-h-old pigs to evaluate the utilization of
      medium-chain triglycerides (MCT). Effects of emulsification and amount of MCT fed
      were examined. After a 4-h period during which feed was withheld, pigs were force
      fed MCT (containing 75% octanoate and 25% decanoate), marking time 0 of the
      experiment. Blood samples were obtained at 1 and 2 h for subsequent medium-chain
      fatty acid (MCFA) analysis. In Trials 1 (six pigs/treatment) and 2 (four
      pigs/treatment) the response to three emulsifying agents was compared to a
      nonemulsified (NE) control. Twenty milliliters of a 30% (vol/vol) emulsion of MCT
      or 6 mL of NE MCT was administered. Concentrations of MCFA at 1 h in pigs
      receiving a Tween 80 (polyoxy-ethylene [20] sorbitan monooleate) emulsion were 3-
      to 19-fold higher than concentrations in animals administered a gum arabic/gum
      tragacanth emulsion, a lecithin emulsion, or NE MCT. Trials 3 (eight
      pigs/treatment) and 4 (six pigs/treatment) were conducted to determine the plasma
      MCFA concentrations resulting from feeding increasing levels of NE (3, 6, 9, or
      12 mL of MCT) or emulsified MCT oil (2, 4, 6, or 8 mL in a 30% Tween 80
      emulsion). Plasma octanoate concentrations measured at 1 h increased linearly (P
      < .05) with increasing MCT dosage through 9 mL of NE and 6 mL of emulsified MCT.
      A transient narcosis was observed in 8 of 12 animals that received 6 or 8 mL of
      emulsified MCT and was most pronounced 1 to 2 h after feeding, which roughly
      corresponded to peak plasma MCFA concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349514
TI  - Emulsification and fatty-acid chain length affect the utilization of medium-chain
      triglycerides by neonatal pigs.
AB  - Three experiments were conducted using 52 pigs between 22 and 35 h of birth to
      determine the effects of emulsification and fatty-acid chain length on
      utilization of medium-chain triglycerides (MCT). After a 4-h period during which
      feed was withheld, pigs were force-fed 6 mL of nonemulsified (NE) MCT or 20 mL of
      a 30% (vol/vol) Tween 80-(polyoxy-ethylene [20] sorbitan monooleate) MCT
      emulsion, marking time 0, and serial blood samples were drawn throughout 8 h for
      analysis of medium-chain fatty acid (MCFA) concentrations by HPLC. In Exp. 1,
      pigs received either NE or emulsified Tri-C4, -C5, -C6, or -C7. The emulsified
      treatments were discontinued due to deaths caused by coma resulting from high
      concentrations (up to 12 mM) of plasma MCFA. Concentrations in pigs fed
      emulsified MCT were 2.5-fold higher than those in pigs fed NE MCT. In pigs fed NE
      MCT, concentrations of even-chain-length MCFA were higher than those of odd-chain
      length MCFA (P < .001), with a tendency for C6 to be higher than C4 (P < .1). In
      Exp. 2 and 3, pigs received an equimolar mixture of MCT in either emulsified or
      NE form. In Exp. 2, the mixture contained Tri-C4 through Tri-C7; whereas, in Exp.
      3 the mixture contained Tri-C4, -C6, -C8, and -C10. A three-way interaction
      (emulsion x fatty acid x sample time; P < .05) was observed in both
      experiments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349515
TI  - Effects of the beta-adrenergic agonist clenbuterol in cows: lipid metabolism,
      milk production, pharmacokinetics, and residues.
AB  - The effects of the beta-adrenergic agonist clenbuterol on lipid metabolism, milk
      production, pharmacokinetics, and residues were studied in six lactating Brown
      Swiss cows. Four of these were treated with the growth-promoting dose of 5
      micrograms of clenbuterol/kg of BW, mixed within the concentrate, and
      administered twice a day for 3 wk. The remaining two cows served as controls. All
      animals were in their third phase of lactation and were fed diets containing corn
      silage, hay, and concentrate according to individual milk production level and
      body weight. Milk and blood samples were collected for analysis following a rigid
      time schedule. Milk production and milk contents (triglycerides, protein, and
      lactose) were quantitatively identical in both treated and control animals,
      whereas significant qualitative changes occurred in the fatty acid composition of
      milk lipids in clenbuterol-treated animals. Compared with the controls, the
      relative amount (percentage of total fatty acids) of unsaturated fatty acids,
      particularly oleic acid (cis-delta 9-octadecaonate, 18:1), increased considerably
      with a simultaneous decrease of the transition chain length fatty acids (lauric
      acid [12:0] and myristic acid [14:0]). Plasma glucose and FFA concentrations were
      elevated. Concentrations of insulin-like growth factor I remained unchanged. We
      conclude that the physiological effect of clenbuterol is limited to the
      repartitioning effect in body composition, and that milk production is affected
      only slightly by clenbuterol. An immediate increase of clenbuterol concentrations
      in plasma (3.4 +/- 2.0 ng/mL) and milk (10.8 +/- 4.7 ng/mL) could be observed at
      the commencement of treatment. Clenbuterol concentration peaked after 10 d and
      remained constant until the end of the treatment.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8349516
TI  - Effects of lactation on fetal survival and development in rabbit does mated
      shortly after parturition.
AB  - Primiparous rabbit does were mated within 12 h after parturition (d 0). They were
      immediately weaned (Group W; n = 31) or allowed to suckle 10 young rabbits (Group
      L; n = 32). Blood samples were collected at d 0, 7, 17, and 28. Feed intake and
      live weight were measured weekly and pregnant does (Group W, n = 24; Group L =
      25) were slaughtered at d 28. Feed intake was 78% higher in L than in W females
      throughout gestation (P < .001). However, L females lost weight during the second
      half of gestation (-243 +/- 25 g) compared with W females, which gained weight
      (246 +/- 20 g). The weights of carcass, skin, and adipose tissues were severely
      reduced at d 28 in the L group (P < .01). Ovulation rate (11.0 +/- .3 corpora
      lutea) and early embryonic mortality (< d 15) were similar in both groups (12.3
      +/- 2%), whereas late embryonic mortality (> or = d 15) was higher in L than in W
      does (13.9 +/- 3 vs 3.9 +/- 1%; P < .01). Fetal weight was reduced by nearly 20%
      in L compared with W females (P < .01). Plasma concentrations of progesterone
      were lower in L than in W females at d 7 and 17 (P < .001), whereas
      concentrations of estradiol were similar in both groups throughout gestation.
      These results indicate that fetal survival and development can be impaired in
      lactating females.

PMID- 8349518
TI  - Influence of initial length of uterus per embryo and gestation stage on prenatal
      survival, development, and sex ratio in the pig.
AB  - The effects of uterine length per embryo and stage of gestation on prenatal
      survival, development, and sex ratio were determined by systematically
      restricting embryos to 5, 10, 15, 20, 25, 30, 35, 40, 45, or > 50 cm of initial
      uterine length per potential embryo and examining the reproductive tracts at d
      17, 23, 29, 35, or 41 of gestation. At d 3 the mean length of a uterine horn was
      169 +/- 35 cm, with a range of 80 to 255 cm. The mean total number of corpora
      lutea (CL) was 12.4 +/- 2.34. Ovulation rate tended to be correlated with the
      length of uterine horns (r = .38; P > .1). Prenatal survival was highly
      correlated with initial assigned uterine space from 5 to 25 cm/CL (r = .95; P <
      .05). Prenatal survival was not affected by space (r = .53; P < .1) when space
      was > 25 cm/CL. In all groups, regardless of space available, some prenatal loss
      occurred before d 17. In sections with < 25 cm/CL, a second loss took place
      between d 29 and 35. Before d 35, there was no significant effect of restriction
      on either fetal length or weight, but after d 35, fetuses from sections with > 25
      cm/CL were longer and heavier than those from sections with less space (P < .05).
      Greater uterine space was occupied by larger fetuses (P < .05). Male fetuses
      occupied more uterine space than female fetuses did in both crowded and roomy
      sections (P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349517
TI  - Metabolic and endocrine changes associated with undernutrition in the
      peripubertal gilt.
AB  - The effect of feed restriction on circulating metabolites and metabolic and
      gonadotropic hormones was determined in Large White gilts. From 25 kg BW and 80 d
      of age, control gilts (CTRL, n = 10) were fed close to ad libitum intake, whereas
      restricted-fed gilts (REST, n = 10) were offered approximately 50% of the CTRL
      diet. Estrus was detected with a mature boar. Serial blood samples were collected
      at approximately 160 and 210 d of age from 0800 to 2000. A meal was supplied at
      0900, and an i.v. injection of GnRH (80 ng/kg BW) was given at 1600. The gilts
      were slaughtered at 220 d of age. No REST and four CTRL gilts exhibited their
      first estrus between the two series of blood samplings. Feed intake, daily gain,
      and fat content of the carcass were reduced by 50% in REST gilts (P < .001).
      Preprandial concentrations of free fatty acids were significantly lower in CTRL
      gilts at 210 d of age than at 160 d and than in REST gilts at both ages. Within
      the CTRL group, concentrations were lower (P < .05) at both ages in gilts
      pubertal before 210 d than in others. After the meal, plasma insulin and urea
      increased in all gilts, whereas glucose increased and free fatty acids decreased
      in all except the 210-d CTRL gilts. The afternoon concentration of cortisol was
      slightly higher (P = .09) in REST than in CTRL gilts. The number of pulses and
      mean and interpulse concentrations of growth hormone did not show any clear
      variation with feed level and age.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349519
TI  - The effect of thiopentone-sodium anesthesia and surgery, relocation, grouping,
      and hydrocortisone treatment on the blood levels of cortisol, corticosteroid
      binding globulin, and catecholamines in pigs.
AB  - Eight crossbred, ovariectomized gilts (Swedish Landrace x Swedish Yorkshire x
      Hampshire), with a mean age of 7.5 mo, were studied during anesthesia and
      surgery, control-sampling, relocation, and grouping during a period of 3 wk.
      Acute treatment with a hydrocortisone injection (5 mg, i.v.) was also given.
      Blood samples were taken frequently (every 10 min) during the intensive part of
      the experimental days. The blood samples were analyzed for catecholamines (CA),
      adrenaline (A) and noradrenaline (NA), cortisol, and corticosteroid-binding
      globulin (CBG). The surgical period with anesthesia and surgery showed
      significant effects on CA, cortisol, and CBG. The A level increased immediately
      after the surgery. A biphasic increase in the cortisol level was observed on the
      day of surgery; the greatest increase was seen when the animals had regained
      consciousness after surgery but still were drowsy and staggering. The CBG level
      decreased on the day after the surgery. The study showed that the levels of the
      analyzed substances were back to normal 2 d after surgery. During relocation and
      grouping there was a short, significant increase in CA and cortisol levels,
      whereas the CBG level was not affected. Treatment with hydrocortisone
      significantly increased the cortisol level, but no change was seen in plasma CA
      or CBG levels. In conclusion, anesthesia and surgery induced significant effects
      on the levels of CA, cortisol, and CBG in gilts and the animals needed 2 d to
      recover before regaining their normal condition. During relocation and a limited
      grouping period, the significant increases in CA and cortisol levels were of
      short duration and CBG did not change.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349520
TI  - Stimulation of development of in vitro-matured and in vitro-fertilized bovine
      embryos by platelets.
AB  - In vitro-fertilized bovine embryos were incubated in Menezo's B2 medium (MB2)
      supplemented with 2 mg/mL of BSA. In Exp. 1, eight-cell stage embryos were
      allotted to one of the following groups: control medium (MB2), MB2 with 20 ng/mL
      of platelet-activating factor (PAF), 1 x 10(7) bovine blood platelets
      (Platelets), oviductal cells (BOEC), BOEC and 20 ng/mL of PAF (BOEC+PAF), or BOEC
      and 1 x 10(7) platelets (BOEC+Platelets). In Exp. 2, eight-cell embryos were
      allotted to one of the following groups: control medium (MB2), MB2 with 1 x 10(7)
      platelets (Platelets), 1 x 10(7) platelets and 10 micrograms/mL of platelet
      derived growth factor antibody (Platelets+anti-PDGF), 1 x 10(7) platelets and 1
      microgram/mL of indomethacin (Platelets+Indomethacin), or 1 x 10(7) platelets and
      3 micrograms/mL of mianserin (Platelets+Mianserin). Embryos were incubated at 39
      degrees C in 5% CO2 in groups of five until 8 d after in vitro fertilization
      (IVF). In Exp. 1, Platelets stimulated embryo development to the morula,
      blastocyst, and expanded blastocyst stages. Embryo development was greatest in
      the BOEC+Platelets group on d 7 and 8 after IVF. Only embryos incubated in the
      BOEC+Platelets treatment group reached the hatched blastocyst stage on d 8. In
      Exp. 2, embryos incubated in the Platelets treatment group had the greatest (P <
      .05) proportion develop beyond the eight-cell stage. Embryos incubated in the
      Platelets + anti-PDGF group had less (P < .05) development beyond the eight-cell
      stage and to the morula stage. These results indicate that the stimulatory
      effects of PDGF on bovine embryo development may be derived from both the
      oviductal epithelium and platelets.

PMID- 8349521
TI  - Assessment of protein quality in heat-treated soybean products using the growth
      responses of lambs and calves and a nylon bag-rooster assay.
AB  - Three studies were conducted to evaluate N and amino acid (AA) availability from
      processed soybean (SB) products. In Exp. 1 and 2, treatments consisted of corn
      cottonseed hull basal diets plus SB products including SB meal (SBM); ground, raw
      SB (RSB); or extruded SB (ESB). In Exp. 1, 15 Suffolk (28.6 kg) and 15 Louisiana
      native breed (16.3 kg) ewe lambs were used in a 35-d growth trial. Although breed
      affected (P < .10) DMI and ADG of lambs, the diets did not (P > .10). In Exp. 2,
      12 Suffolk wether lambs (34.0 kg) were used in a 3 x 3 multiple-square Latin
      square design N metabolism trial. Lambs fed RSB tended (P = .13) to retain more N
      than those fed ESB, but N retained by lambs fed RSB and ESB was similar (P > .10)
      to that of lambs fed SBM. In Exp. 3, four crossbred steer calves (240 kg) were
      used in a 4 x 4 Latin square design N metabolism trial with the above treatments
      plus heat-damaged SB (HDSB). Calves fed RSB and ESB retained similar (P > .10)
      amounts of N. Compared with calves fed RSB and ESB, calves fed SBM retained more
      (P < .10) N. Calves fed HDSB retained less (P < .10) N than those fed other
      diets. The individual SB products and the total mixed diets used in Exp. 3 were
      incubated intraruminally in nylon bags and the residual DM recovered and
      precision-fed to cecectomized roosters to estimate its intestinal AA
      digestibility. Digestibility of residual AA seemed to be relatively uniform
      across AA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349522
TI  - Combined analysis of tall fescue steer grazing studies in the Eastern United
      States.
AB  - The mixed-models procedure (MMP) was used to analyze pooled data sets from 12
      independent studies conducted during the last 13 yr at nine locations in seven
      states to provide combined estimates of daily gains by beef steers (Bos taurus)
      grazing tall fescue (Festuca arundinacea Schreb.) pastures free of (E-) or
      infested (E+) at different levels with the endophytic fungus Acremonium
      coenophialum. Treatments included low-infestation (< or = 5% E+), moderate
      infestation (> or = 20 to < or = 35% E+), and high-infestation (> or = 50 to < or
      = 97% E+) tall fescue pastures, and, in tall fescue-clover (Trifolium spp.)
      mixtures, pastures at the same E+ levels with approximately 25 and 10% clover in
      spring and summer stands, respectively. Spring, summer, and combined
      spring+summer data were analyzed separately. The MMP permitted estimation of the
      fixed effects of treatments over a broad inference space of future years and
      different tall fescue pastures over a wide geographic range; detected
      relationships that had not been apparent in the individual studies, such as the
      interactions between clover presence and E+ infestation levels; and provided a
      more coherent body of information than did the results obtained from each
      discrete study. Logistical and financial constraints that force undesirable
      compromises in the conduct of future grazing and other expensive or time
      consuming research may be avoided by using MMP within the context of cooperative
      projects.

PMID- 8349523
TI  - Maintenance requirements in metabolizable energy of adult, nonpregnant,
      nonlactating Charolais cows.
AB  - The objective of this study was to determine the maintenance requirements in
      metabolizable energy (MEm) of adult, nonlactating, nonpregnant Charolais cows. A
      feeding trial was conducted using 12 cows fed at one of two feeding levels (75
      [L] and 113 [H] kcal of ME.kg BW-.75.d-1) for 116 d. Body composition was
      estimated from subcutaneous adipocyte diameter. Body weight changes averaged -468
      and +46 g/d, respectively. Diet DM digestibility averaged .496. The L cows spent
      less time eating and ruminating but had other behavioral characteristics similar
      to those of H cows. Estimates of MEm were calculated from BW or body composition
      changes and amounted to 109 and 124 kcal of ME.kg BW-.75.d-1, respectively. Heat
      production (HP) was then measured over 67 d in a second trial on two L and two H
      cows from the feeding trial and planes of feeding were switched after 14 d.
      Estimates of MEm varied from 112 to 105 kcal.kg BW-.75.d-1. Within animal, day-to
      day variations in heat production were high (4.6% on average) and prevented the
      detection of any precise changes of HP with time on treatment. None of the trials
      showed any significant effect of level of feeding on MEm.

PMID- 8349524
TI  - Regulation of fatty acid synthase gene expression: an approach for reducing fat
      accumulation.
AB  - Fatty acid synthase (FAS) catalyzes the last step in the fatty acid biosynthetic
      pathway. The tissue concentration of FAS, which is affected by a number of
      hormonal and dietary factors, is a key determinant for the maximal capacity of a
      tissue to synthesize fatty acids by the de novo pathway. The complete nucleotide
      sequence of the avian and rat FAS transcripts has been cloned. In addition, a 1.5
      kb cDNA that represents the thioesterase domain of the pig FAS protein plus the
      entire 3'-untranslated region of the transcript was isolated from a porcine liver
      cDNA library. Using these FAS cDNA tools, FAS mRNA transcripts have been found in
      most tissues, including adipose, liver, lung, brain, kidney, and small intestine.
      Moreover, the abundance of FAS mRNA in a tissue determines the rate of FAS
      protein synthesis, and ultimately the tissue content of FAS protein. In the
      liver, the rate of FAS gene transcription dictates the level of FAS mRNA, whereas
      the FAS mRNA content of adipose tissue seems to be determined by factors that
      affect gene transcription and mRNA stability. Adaptive changes in the abundance
      of FAS mRNA seem to occur primarily in hepatic and adipose tissues, whereas FAS
      expression in other tissue types is resistant to nutritional and hormonal
      manipulations. This review presents the concept that the tissue-specific
      adaptation in FAS gene expression can be exploited to develop a tissue-specific
      inhibitor of FAS gene expression and, hence, reduce the tissue capacity for fat
      accretion through the de novo biosynthetic pathway.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8349525
TI  - Improved cloning vectors and transformation procedure for Lactococcus lactis.
AB  - Four shuttle vectors (pMIG 1, 2, 2H and 3) have been constructed based on the
      broad host-range plasmid pCK1. All the pMIG vectors possess a multiple cloning
      site containing 12 or more unique restriction enzyme sites, and are stably
      maintained at either high or low copy number in Lactococcus lactis and in
      Escherichia coli. By cloning the E. coli pUC replicon into one of these vectors a
      plasmid was constructed which can replicate to high copy number in recA strains
      of E. coli. The broad host-range of the pCK1 replicon may enable these cloning
      vectors to be used in a number of Gram-positive bacteria. One of these vectors
      was used to optimize an electroporation procedure for transformation of a
      commonly used plasmid-cured strain MG1363 of L. lactis which routinely yielded 1
      x 10(7) to 5 x 10(7) transformants micrograms-1 supercoiled DNA using stored,
      snap-frozen cells. This transformation efficiency was obtained by growing the
      cells in medium containing the cell wall weakening agent glycine, to an upper
      limit of 2.5% w/v. Although growth of L. lactis strain MG1363 was inhibited by
      the use of 0.5 mol l-1 sucrose as an osmotic stabilizer, the presence of sucrose
      in the electroporation buffer was critical for high transformation efficiency.
      Other variables which were tested for their effect on the efficiency of
      transformation were cell concentration, DNA concentration, pulse time and field
      strength. These results provide a model procedure which can be followed to
      optimize conditions for the genetic transformation of various strains of L.
      lactis.

PMID- 8349526
TI  - Potential problems in the use of oligonucleotide probes for staphylococcal
      enterotoxin genes.
AB  - Oligonucleotide probes unique to the five major enterotoxin genes of
      Staphylococcus aureus were synthesized and used to detect DNA sequences
      homologous to these genes in 27 non-clinical isolates of Staph. aureus isolated
      from nasal swabs of 74 healthy human volunteers. Genomic DNA from all 27 isolates
      reacted with at least one of the probes. In a phenotypic assay for toxin
      production by a reverse passive latex agglutination test however, only 15 of the
      27 isolates produced enterotoxin in culture. The results raise the possibility
      that a number of Staph. aureus isolates harbour DNA sequences that are apparently
      silent or mutant copies of the enterotoxin genes. This complicates the
      identification of enterotoxin producers by tests which depend on oligonucleotide
      or DNA hybridization.

PMID- 8349527
TI  - A note on lactobacilli and beta-glucuronidase activity in the intestinal contents
      of mice.
AB  - A comparison was made of caecal beta-glucuronidase activity in the caecal
      contents of mice with or without lactobacilli as members of the normal
      microflora. Male mice that did not have lactobacilli as intestinal inhabitants
      had approximately 52% more caecal beta-glucuronidase activity than their female
      counterparts. Colonization of male mice by lactobacilli reduced the beta
      glucuronidase activity to that of female mice.

PMID- 8349528
TI  - The effects of transgalactosylated oligosaccharides on gut flora metabolism in
      rats associated with a human faecal microflora.
AB  - The effect on various caecal bacteria and their metabolic activities of feeding
      diet containing transgalactosylated oligosaccharides (TOS) with or without
      Bifidobacterium breve (administered in the drinking water) was investigated in
      rats colonized with a human faecal microflora. TOS (5% w/w in diet) or TOS plus
      B. breve, given for 4 weeks, induced increases in caecal concentration of total
      anaerobic bacteria, lactobacilli and bifidobacteria, and decreases in numbers of
      enterobacteria. Caecal pH was significantly reduced by feeding TOS, as were the
      activities of beta-glucuronidase and nitrate reductase. In contrast, beta
      glucosidase activity was increased in TOS-fed rats. Dietary TOS was also
      associated with decreased conversion, by caecal contents, of the dietary
      carcinogen 2-amino-3-methyl-3H-imidazo[4,5-f] quinoline (IQ) to its genotoxic 7
      hydroxy derivative.

PMID- 8349529
TI  - Prokaryote envelope diversity.

PMID- 8349530
TI  - Composition of the envelope layers of Saccharomyces cerevisiae in relation to
      flocculation and ethanol tolerance.

PMID- 8349531
TI  - Cell envelope diversity and dynamics in yeasts and filamentous fungi.

PMID- 8349532
TI  - On mechanisms of oral microbial adhesion.

PMID- 8349533
TI  - Current trends and future prospects in prokaryotic envelope research: a
      microscopist's view.

PMID- 8349534
TI  - Envelope structure and the development of new vaccines.

PMID- 8349535
TI  - Formation and dispersal of bacterial biofilms in vivo and in situ.

PMID- 8349536
TI  - Coaggregation of human oral bacteria: potential role in the accretion of dental
      plaque.

PMID- 8349537
TI  - Sensitivity of biofilms to antimicrobial agents.

PMID- 8349538
TI  - LexA cleavage and other self-processing reactions.

PMID- 8349539
TI  - Coordinated regulation of amino sugar-synthesizing and -degrading enzymes in
      Escherichia coli K-12.
AB  - The intracellular concentration of the enzyme glucosamine-6-phosphate synthase,
      encoded by the gene glmS in Escherichia coli, is repressed about threefold by
      growth on the amino sugars glucosamine and N-acetylglucosamine. This regulation
      occurs at the level of glmS transcription. It is not due just to the presence of
      intracellular amino sugar phosphates, because mutations which derepress the genes
      of the nag regulon (coding for proteins involved in the uptake and metabolism of
      N-acetylglucosamine) also repress the expression of glmS in the absence of
      exogenous amino sugars.

PMID- 8349540
TI  - Minimum domain of the Shiga toxin A subunit required for enzymatic activity.
AB  - The minimum sequence of the enzymatic (A) subunit of Shiga toxin (STX) required
      for activity was investigated by introducing N-terminal and C-terminal deletions
      in the molecule. Enzymatic activity was assessed by using an in vitro translation
      system. A 253-amino-acid STX A polypeptide, which is recognized as the
      enzymatically active portion of the 293-amino-acid A subunit, expressed less than
      wild-type levels of activity. In addition, alteration of the proposed nicking
      site between Ala-253 and Ser-254 by site-directed mutagenesis apparently
      prevented proteolytic processing but had no effect on the enzymatic activity of
      the molecule. Therefore, deletion analysis was used to identify amino acid
      residue 271 as the C terminus of the enzymatically active portion of the STX A
      subunit. STX A polypeptides with N-terminal and C-terminal deletions were
      released into the periplasmic space of Escherichia coli by fusion to the signal
      peptide and the first 22 amino acids of Shiga-like toxin type II, a member of the
      STX family. Although these fusion proteins expressed less than wild-type levels
      of enzymatic activity, they confirmed the previous finding that Tyr-77 is an
      active-site residue. Therefore, the minimum domain of the A polypeptide which was
      required for the expression of enzymatic activity was defined as StxA residues 75
      to 268.

PMID- 8349541
TI  - Isolation and characterization of an Escherichia coli strain with a high
      frequency of C-to-T mutations at 5-methylcytosines.
AB  - We used a genetic selection system to isolate a strain of Escherichia coli with a
      high frequency of C-to-T transition mutations at the second C of the sequence
      CCAGG. Cytosines in other sequences do not mutate to thymine at a high frequency
      in this strain, and the frequencies of other base substitution mutations are not
      increased to the same extent. The gene responsible for the mutator phenotype has
      been mapped to 43 min on the E. coli chromosome. Several lines of evidence
      indicate that this gene is distinct from the very short patch repair gene vsr.

PMID- 8349542
TI  - An oxygen-dependent coproporphyrinogen oxidase encoded by the hemF gene of
      Salmonella typhimurium.
AB  - The 8th step in the 10-step heme biosynthetic pathway of Salmonella typhimurium
      is the oxidation of coproporphyrinogen III to protoporphyrinogen IX. On the basis
      of genetic studies, we have suggested that this reaction may be catalyzed by
      either of two different enzymes, an oxygen-dependent one encoded by hemF or an
      oxygen-independent enzyme encoded by hemN. Here, we report the cloning of the S.
      typhimurium hemF gene and its DNA sequence. The predicted amino acid sequence of
      the HemF protein is 44% identical to that of the coproporphyrinogen oxidase
      encoded by the yeast HEM13 gene. The wild-type S. typhimurium strain LT-2
      produces an oxygen-dependent coproporphyrinogen oxidase activity detectable in
      crude extracts, which is not found in hemF mutants and is overproduced in strains
      carrying the hemF gene on a multicopy plasmid. the hemF gene is the second gene
      in an operon with an upstream gene with an unknown function, whose amino acid
      sequence suggests a relation to amidases involved in cell wall synthesis or
      remodeling. The upstream gene and hemF are cotranscribed from a promoter which
      was mapped by primer extension. A weaker, hemF-specific promoter is inferred from
      the behavior of an omega-Cm insertion mutation in the upstream gene. Although
      this insertion decreases expression of beta-galactosidase about 7.5-fold when
      placed upstream of a hemF-lacZ operon fusion, it still allows sufficient HemF
      expression from an otherwise wild-type construct to confer a Hem+ phenotype. The
      hemF operon is transcribed clockwise with respect to the genetic map.

PMID- 8349543
TI  - Patterns of gene expression in Bacillus subtilis colonies.
AB  - Bacillus subtilis 5:7, a derivative of macrofiber-producing strain FJ7, carries
      the lacZ reporter gene within Tn917 at an unknown location in the host genome.
      Expression of the host gene carrying lacZ within colonies of 5:7 was observed by
      examining growth under different conditions in the presence of 5-bromo-4-chloro-3
      indolyl-beta-D-galactopyranoside (X-Gal). At a high plating density small
      colonies arose that expressed the host gene early and throughout the colony,
      whereas at a low density large colonies were produced that expressed the host
      gene late in development and only in cells forming a ring pattern close to the
      colony periphery. A highly regulated spatial and temporal gene expression pattern
      was observed in growth from cross-streaks, suggesting that gene expression is
      responsive to concentration gradient fields established by neighboring growth.
      Colonies cultured on agar blocks revealed that expression was governed by
      depletion of a medium component and also by the geometry of the substrate upon
      which the colonies grew. At least three factors influenced the control of
      expression: (i) the concentration of a diffusible component of the medium
      exhausted by cell growth, (ii) a spatial-temporal factor related to growth within
      the colony, and (iii) the geometry of the growth substrate.

PMID- 8349544
TI  - Interplay between the membrane-associated UhpB and UhpC regulatory proteins.
AB  - Expression of the Escherichia coli uhpT gene, encoding the sugar phosphate
      transport protein, is induced by extracellular glucose-6-phosphate and requires
      the function of the uhpABC regulatory genes. The UhpA and UhpB proteins are
      related to the response-regulator and sensor-kinase proteins of two-component
      regulatory systems, whereas the UhpC protein is related to UhpT and homologous
      transport proteins. To investigate the role of segments of the membrane
      associated UhpB and UhpC regulatory proteins, a series of mutations were
      constructed in vitro by insertion of a 12- or 24-bp oligonucleotide linker at 44
      sites within the uhpABCT locus. The effect of these mutations on regulation of a
      uhpT-lacZ transcriptional reporter was assayed with the mutated uhp alleles in
      single copy on the chromosome. All but one of the insertions in uhpA or uhpT were
      inactive for transcription activation or transport, respectively. In contrast,
      about half of the insertions in uhpB and uhpC retained Uhp expression, and
      insertions at four sites in uhpB and at one site in uhpC conferred high-level
      constitutive expression. The constitutive mutants in UhpB resulted from
      insertions in the nonpolar amino-terminal half of the protein, and all insertions
      in that half of UhpB affected Uhp expression in some manner, which suggests that
      the transmembrane segments of UhpB might negatively regulate the kinase activity
      of the carboxyl portion. The constitutive behavior of all but one of these uhpB
      alleles was dependent on the presence of active forms of both UhpA and UhpC,
      which suggests that UhpB and UhpC act jointly as a complex in the signaling
      process.

PMID- 8349545
TI  - Nucleotide sequence and characterization of the traABCD region of IncI1 plasmid
      R64.
AB  - A 3.6-kb BglII-SmaI segment of the transfer region of IncI1 plasmid R64drd-11 was
      sequenced and characterized. Analysis of the DNA sequence indicated the presence
      of four genes, traA, traB, traC, and traD, in this region. The expression of the
      traB, traC, and traD genes was examined by maxicell experiments and that of the
      traA gene was examined by constructing the traA-lacZ fusion gene. The
      introduction of frameshift mutations into the four genes indicated that the traB
      and traC genes are essential for conjugal transfer in liquid medium and on a
      solid surface. Both were also required for the formation of the thin pilus, which
      is the receptor for phages I alpha and PR64FS. Upstream of the traA gene, a
      promoter sequence for sigma 70 of E. coli RNA polymerase was identified by S1
      nuclease mapping and primer extension experiments.

PMID- 8349546
TI  - OmpF assembly mutants of Escherichia coli K-12: isolation, characterization, and
      suppressor analysis.
AB  - This paper describes a novel genetic method used to isolate mutations that alter
      proper assembly of OmpF in the outer membrane. The thermolabile nature of
      assembly intermediates allowed selection of temperature-sensitive mutations
      within the ompF gene. A variant allele of ompF (ompF-Dex) was used because it
      provided a convenient selectable phenotype (Dex+). Assembly mutants were isolated
      in two steps. First, amber mutations were obtained that mapped in ompF-Dex. This
      resulted in a Dex- phenotype. Starting with these Dex- strains, Dex+ revertants
      were isolated. Mutants that displayed a temperature-sensitive Dex+ phenotype were
      further characterized. Three such mutants possessed a single substitution within
      ompF that reverted the nonsense codon to a sense codon which replaced W214 with
      either an E or Q and Y231 with a Q residue in the mature OmpF protein. All three
      mutant OmpF proteins showed an assembly defect. This defect led to a substantial
      reduction in the amount of stable OmpF trimers with the concomitant increase of a
      high-molecular-weight form of OmpF which migrated at the top of the gel.
      Suppressor mutations were sought that corrected the assembly defect of OmpF.
      These extragenic suppressor mutations were mapped at 45 min on the Escherichia
      coli chromosome. The suppressor mutations displayed no allele specificity and
      were recessive to the wild-type allele. In the presence of a suppressor, mutant
      stable trimers appeared in an almost normal manner. The appearance of stable
      trimers concurred with a substantial loss of the high-molecular-weight OmpF
      species. At this stage, it is not clear whether the high-molecular-weight species
      of OmpF is a normal assembly intermediate or a dead-end assembly product. The
      results presented in this study raise the intriguing possibility of a chaperone
      like activity for the wild-type suppressor gene product.

PMID- 8349547
TI  - Complementation analysis and regulation of CO2 fixation gene expression in a
      ribulose 1,5-bisphosphate carboxylase-oxygenase deletion strain of Rhodospirillum
      rubrum.
AB  - A ribulose 1,5-bisphosphate carboxylase-oxygenase (RubisCO) deletion strain of
      Rhodospirillum rubrum that was incapable of photolithoautotrophic growth was
      constructed. Photoheterotrophic growth, however, was possible for the R. rubrum
      RubisCO deletion strain when oxidized carbon compounds such as malate were
      supplied. The R. rubrum RubisCO-deficient strain was not complemented to
      photolithoautotrophic growth by various R. rubrum DNA fragments that contain the
      gene encoding RubisCO, cbbM. When the R. rubrum cbbM deletion strain harbored
      plasmids containing R. rubrum DNA inserts with at least 2.0 kb preceding the
      translational start site of the cbbM gene, RubisCO activity and RubisCO antigen
      were detected. Lack of RubisCO expression was therefore not the cause for the
      failure to complement the cbbM mutant strain. Interestingly, DNA fragments
      encoding either of two complete Calvin-Benson-Bassham CO2- fixation (cbb) gene
      operons from Rhodobacter sphaeroides were able to complement the R. rubrum
      RubisCO deletion strain to photolithoautotrophic growth. The same R. rubrum DNA
      fragments that failed to complement the R. rubrum cbbM deletion strain
      successfully complemented the RubisCO deletion strain of R. sphaeroides, pointing
      to distinct differences in the regulation of metabolism and the genetics of
      photolithoautotrophic growth in these two organisms. A number of cbb genes were
      identified by nucleotide sequence analysis of the region upstream of cbbM.
      Included among these was an open reading frame encoding a cbbR gene showing a
      high degree of sequence similarity to known lysR-type CO2 fixation
      transcriptional activator genes. The placement and orientation of the cbbR
      transcriptional regulator gene in R. rubrum are unique.

PMID- 8349549
TI  - Staphylococcus aureus has clustered tRNA genes.
AB  - The polymerase chain reaction (PCR) was used to detect large tRNA gene clusters
      in Bacillus subtilis, Bacillus badius, Bacillus megaterium, Lactobacillus brevis,
      Lactobacillus casei, and Staphylococcus aureus. The primers were based on
      conserved sequences of known gram-positive bacterial tRNA(Arg) and tRNA(Phe)
      genes. This PCR procedure detected an unusually large tRNA gene cluster in S.
      aureus. PCR-generated probes were used to identify a 4.5-kb EcoRI fragment that
      contained 27 tRNA genes immediately 3' to an rRNA operon. Some of these 27 tRNA
      genes are very similar, but only 1 is exactly repeated in the cluster. The 5' end
      of this cluster has a gene order similar to that found in the 9- and 21-tRNA gene
      clusters of B. subtilis. The 3' end of this S. aureus cluster exhibits more
      similarity to the 16-tRNA gene cluster of B. subtilis. The 24th, 25th, and 26th
      tRNA genes of this S. aureus tRNA gene cluster code for three similar, unusual
      Gly-tRNAs that may be used in the synthesis of the peptidoglycan in the cell wall
      but not in protein synthesis. Southern analysis of restriction digests of S.
      aureus DNA indicate that there are five to six rRNA operons in this bacterium's
      genome and that most or all may have large tRNA gene clusters at the 3' end.

PMID- 8349548
TI  - kil-kor regulon of promiscuous plasmid RK2: structure, products, and regulation
      of two operons that constitute the kilE locus.
AB  - The kil-kor regulon of IncP plasmid RK2 is a complex regulatory network that
      includes genes for replication and conjugal transfer, as well as for several
      potentially host-lethal proteins encoded by the kilA, kilB, and kilC loci. While
      kilB is known to be involved in conjugal transfer, the functions of kilA and kilC
      are unknown. The coregulation of kilA and kilC with replication and transfer
      genes indicates a possible role in the maintenance or broad host range of RK2. In
      this work, we found that a fourth kil locus, designated kilE, is located in the
      kb 2.4 to 4.5 region of RK2 and is regulated as part of the kil-kor regulon. The
      cloned kilE locus cannot be maintained in Escherichia coli host cells, unless
      korA or korC is also present in trans to control its expression. The nucleotide
      sequence of the kilE region revealed two potential multicistronic operons. The
      kleA operon consists of two genes, kleA and kleB, predicted to encode polypeptide
      products with molecular masses of 8.7 and 7.6 kDa, respectively. The kleC operon
      contains four genes, kleC, kleD, kleE, and kleF, with predicted products of 9.2,
      8.0, 12.2, and 11.3 kDa, respectively. To identify the polypeptide products, each
      gene was cloned downstream of the phage T7 phi 10 promoter and expressed in vivo
      in the presence of T7 RNA polymerase. A polypeptide product of the expected size
      was observed for all six kle genes. In addition, kleF expressed a second
      polypeptide of 6 kDa that most likely results from the use of a predicted
      internal translational start site. The kleA and kleC genes are each preceded by
      sequences resembling strong sigma 70 promoters. Primer extension analysis
      revealed that the putative kleA and kleC promoters are functional in E. coli and
      that transcription is initiated at the expected nucleotides. The abundance of
      transcripts initiated in vivo from both the kleA and kleC promoters was reduced
      in cells containing korA or korC. When korA and korC were present together, they
      appeared to act synergistically in reducing the level of transcripts from both
      promoters. The kleA and kleC promoter regions are highly homologous and contain
      two palindromic sequences (A and C) that are the predicted targets for KorA and
      KorC proteins. DNA binding studies showed that protein extracts from korA
      containing E. coli cells specifically retarded the electrophoretic mobility of
      DNA fragments containing palindrome A. Extracts from korC-containing cells
      altered the mobility of DNA fragments containing palindrome C. These results show
      that KorA and KorC both act as repressors of the kleAand kleC promoters. In the
      absence of korA and korC, expression of the cloned kleA operon was lethal to
      E.coli cells, whereas the cloned kleC operon gave rise to slowly growing,
      unhealthy colonies. Both phenotypes depended on at least one structural gene in
      each operon, suggesting that the operons encode genes whose products interact
      with critical host functions required for normal growth and viability. Thus, the
      kilA, kilC, and kilE loci of RK2 constitute a cluster of at least 10 genes that
      are coregulated with the plasmid replication initiator and the conjugal transfer
      system. Their potential toxicity to the host cell indicates that RK2 is able to
      establish a variety of intimate plasmid-host interactions that may be important
      to its survival in nature.

PMID- 8349551
TI  - Physical genome map of the unicellular cyanobacterium Synechococcus sp. strain
      PCC 7002.
AB  - A physical restriction map of the genome of the cyanobacterium Synechococcus sp.
      strain PCC 7002 was assembled from AscI, NotI, SalI, and SfiI digests of intact
      genomic DNA separated on a contour-clamped homogeneous electric field pulsed
      field gel electrophoresis system. An average genome size of 2.7 x 10(6) bp was
      calculated from 21 NotI, 37 SalI, or 27 SfiI fragments obtained by the
      digestions. The genomic map was assembled by using three different strategies:
      linking clone analysis, pulsed-field fragment hybridization, and individual clone
      hybridization to singly and doubly restriction-digested large DNA fragments. The
      relative positions of 21 genes or operons were determined, and these data suggest
      that the gene order is not highly conserved between Synechococcus sp. strain PCC
      7002 and Anabaena sp. strain PCC 7120.

PMID- 8349550
TI  - Purification and characterization of a primary-secondary alcohol dehydrogenase
      from two strains of Clostridium beijerinckii.
AB  - Two primary alcohols (1-butanol and ethanol) are major fermentation products of
      several clostridial species. In addition to these two alcohols, the secondary
      alcohol 2-propanol is produced to a concentration of about 100 mM by some strains
      of Clostridium beijerinckii. An alcohol dehydrogenase (ADH) has been purified to
      homogeneity from two strains (NRRL B593 and NESTE 255) of 2-propanol-producing C.
      beijerinckii. When exposed to air, the purified ADH was stable, whereas the
      partially purified ADH was inactivated. The ADHs from the two strains had similar
      structural and kinetic properties. Each had a native M(r) of between 90,000 and
      100,000 and a subunit M(r) of between 38,000 and 40,000. The ADHs were NADP(H)
      dependent, but a low level of NAD(+)-linked activity was detected. They were
      equally active in reducing aldehydes and 2-ketones, but a much lower oxidizing
      activity was obtained with primary alcohols than with secondary alcohols. The
      kcat/Km value for the alcohol-forming reaction appears to be a function of the
      size of the larger alkyl substituent on the carbonyl group. ADH activities
      measured in the presence of both acetone and butyraldehyde did not exceed
      activities measured with either substrate present alone, indicating a common
      active site for both substrates. There was no similarity in the N-terminal amino
      acid sequence between that of the ADH and those of fungi and several other
      bacteria. However, the N-terminal sequence had 67% identity with those of two
      other anaerobes, Thermoanaerobium brockii and Methanobacterium palustre.
      Furthermore, conserved glycine and tryptophan residues are present in ADHs of
      these three anaerobic bacteria and ADHs of mammals and green plants.

PMID- 8349552
TI  - Roles of the GcvA and PurR proteins in negative regulation of the Escherichia
      coli glycine cleavage enzyme system.
AB  - When Escherichia coli was grown in medium containing both inosine and glycine,
      the PurR repressor protein was shown to be responsible for a twofold reduction
      from the fully induced glycine cleavage enzyme levels. This twofold repression
      was also seen by measuring beta-galactosidase levels in cells carrying a lambda
      gcvT-lacZ gene fusion. In this fusion, the synthesis of beta-galactosidase is
      under the control of the gcv regulatory region. A DNA fragment carrying the gcv
      control region was shown by gel mobility shift assay and DNase I footprinting to
      bind purified PurR protein, suggesting a direct involvement of the repressor in
      gcv regulation. A separate mechanism of purine-mediated regulation of gcv was
      shown to be independent of the purR gene product and resulted in an approximately
      10-fold reduction of beta-galactosidase levels when cells were grown in medium
      containing inosine but lacking the inducer glycine. This additional repression
      was dependent upon a functional gcvA gene, a positive activator for the glycine
      cleavage enzyme system. A dual role for the GcvA protein as both an activator in
      the presence of glycine and a repressor in the presence of inosine is suggested.

PMID- 8349553
TI  - Surface properties of the conidiospores of Phanerochaete chrysosporium and their
      relevance to pellet formation.
AB  - The conidiospores of the white rot basidiomycete Phanerochaete chrysosporium tend
      to aggregate during swelling and germination in agitated liquid medium; as time
      passes, the initial aggregates tend to associate together and to capture
      conidiospores that remain isolated. The surface chemical compositions of the
      conidiospores and of developed hyphae were analyzed by X-ray photoelectron
      spectroscopy. The data were interpreted by modelling the surface in terms of
      proteins, polysaccharides and hydrocarbonlike compounds. The surface molecular
      composition of the dormant conidiospores was estimated to be about 45% proteins,
      20% carbohydrates, and 35% hydrocarbonlike compounds. There was an increase in
      the polysaccharide content during germination. Later, when the hyphae were
      developed, the polysaccharide content became still higher, and the protein
      content dropped. The initial step of aggregation is attributed to polysaccharide
      bridging; its occurrence cannot be explained by a change of the overall
      hydrophobicity or electrical properties of the conidiospores.

PMID- 8349554
TI  - Expression analysis of cloned chromosomal segments of Escherichia coli.
AB  - The novel transcription system of bacteriophage T7 was used to express
      Escherichia coli genes preferentially with a new low-copy-number plasmid vector,
      pFN476, to minimize toxic gene effects. Selected E. coli chromosomal fragments
      from an ordered genomic library (Y. Kohara, K. Ikiyama, and K. Isono, Cell 50:495
      508, 1987) were recloned into this vector, and their genes were preferentially
      expressed in vivo utilizing its T7 promoter. The protein products were analyzed
      by two-dimensional gel electrophoresis. By using DNA sequence information, the
      gel migration was predicted for the protein products of open reading frames from
      these segments, and this information was used to identify gene products
      visualized as spots on two-dimensional gels. Even in the absence of DNA sequence
      information, this approach offers the opportunity to identify all gene products
      of E. coli and map their genes to within 10 kb on the E. coli genome; with
      sequence information, this approach can produce a definitive expression map of
      the E. coli genome.

PMID- 8349555
TI  - Thioredoxin-thioredoxin reductase system of Streptomyces clavuligerus: sequences,
      expression, and organization of the genes.
AB  - The genes that encode thioredoxin and thioredoxin reductase of Streptomyces
      clavuligerus were cloned, and their DNA sequences were determined. Previously, we
      showed that S. clavuligerus possesses a disulfide reductase with broad substrate
      specificity that biochemically resembles the thioredoxin oxidoreductase system
      and may play a role in the biosynthesis of beta-lactam antibiotics. It consists
      consists of two components, a 70-kDa NADPH-dependent flavoprotein disulfide
      reductase with two identical subunits and a 12-kDa heat-stable protein general
      disulfide reductant. In this study, we found, by comparative analysis of their
      predicted amino acid sequences, that the 35-kDa protein is in fact thioredoxin
      reductase; it shares 48.7% amino acid sequence identity with Escherichia coli
      thioredoxin reductase, the 12-kDa protein is thioredoxin, and it shares 28 to 56%
      amino acid sequence identity with other thioredoxins. The streptomycete
      thioredoxin reductase has the identical cysteine redox-active region--Cys-Ala-Thr
      Cys--and essentially the same flavin adenine dinucleotide- and NADPH dinucleotide
      binding sites as E. coli thioredoxin reductase and is partially able to accept E.
      coli thioredoxin as a substrate. The streptomycete thioredoxin has the same
      cysteine redox-active segment--Trp-Cys-Gly-Pro-Cys--that is present in virtually
      all eucaryotic and procaryotic thioredoxins. However, in vivo it is unable to
      donate electrons to E. coli methionine sulfoxide reductase and does not serve as
      a substrate in vitro for E. coli thioredoxin reductase. The S. clavuligerus
      thioredoxin (trxA) and thioredoxin reductase (trxB) genes are organized in a
      cluster. They are transcribed in the same direction and separated by 33
      nucleotides. In contrast, the trxA and trxB genes of E. coli, the only other
      organism in which both genes have been characterized, are physically widely
      separated.

PMID- 8349556
TI  - Integration and gene replacement in the Lactococcus lactis lac operon: induction
      of a cryptic phospho-beta-glucosidase in LacG-deficient strains.
AB  - Insertions, replacement mutations, and deletions were introduced via single or
      double crossover recombination into the lacE (enzyme IIlac) and lacG (phospho
      beta-galactosidase) genes of the Lactococcus lactis chromosomal lacABCDFEGX
      operon. LacG production was abolished in strains missing the lacG gene or
      carrying multicopy insertions in the lacE gene that affected expression of the
      lacG gene. However, these LacG-deficient strains could still ferment lactose
      slowly and were found to contain an enzymatic activity that hydrolyzed the
      chromogenic substrate o-nitrophenyl-beta-D-galactopyranoside phosphate. Induction
      of this phospho-beta-glycohydrolase activity coincided with the appearance of a
      new 55-kDa protein cross-reacting with anti-LacG antibodies that had a size
      similar to that of LacG but a higher isoelectric point (pI 5.2) and was not found
      in wild-type cells during growth on lactose. Since the phospho-beta
      glycohydrolase activity and this protein with a pI of 5.2 were highly induced in
      both mutant and wild-type cells during growth on cellobiose that is likely to be
      transported via a phosphoenolpyruvate-dependent phosphotransferase system, we
      propose that this induced activity is a phospho-beta-glucosidase that also
      hydrolyzes lactose-6-phosphate.

PMID- 8349557
TI  - Genetic analysis of double-strand break repair in Escherichia coli.
AB  - We had reported that a double-strand gap (ca. 300 bp long) in a duplex DNA is
      repaired through gene conversion copying a homologous duplex in a recB21 recC22
      sbcA23 strain of Escherichia coli, as predicted on the basis of the double-strand
      break repair models. We have now examined various mutants for this repair
      capacity. (i) The recE159 mutation abolishes the reaction in the recB21C22 sbcA23
      background. This result is consistent with the hypothesis that exonuclease VIII
      exposes a 3'-ended single strand from a double-strand break. (ii) Two recA
      alleles, including a complete deletion, fail to block the repair in this recBC
      sbcA background. (iii) Mutations in two more SOS-inducible genes, recN and recQ,
      do not decrease the repair. In addition, a lexA (Ind-) mutation, which blocks SOS
      induction, does not block the reaction. (iv) The recJ, recF, recO, and recR gene
      functions are nonessential in this background. (v) The RecBCD enzyme does not
      abolish the gap repair. We then examined genetic backgrounds other than recBC
      sbcA, in which the RecE pathway is not active. We failed to detect the double
      strand gap repair in a rec+, a recA1, or a recB21 C22 strain, nor did we find the
      gap repair activity in a recD mutant or in a recB21 C22 sbcB15 sbcC201 mutant. We
      also failed to detect conservative repair of a simple double-strand break, which
      was made by restriction cleavage of an inserted linker oligonucleotide, in these
      backgrounds. We conclude that the RecBCD, RecBCD-, and RecF pathways cannot
      promote conservative double-strand break repair as the RecE and lambda Red
      pathways can.

PMID- 8349558
TI  - Cloning and assessment of mycobacterial promoters by using a plasmid shuttle
      vector.
AB  - We have constructed a promoter selection vector for mycobacteria to analyze the
      sequences involved in mycobacterial transcriptional regulation. The vector pSD7
      contains extrachromosomal origins of replication from Escherichia coli as well as
      from Mycobacterium fortuitum and a kanamycin resistance gene for positive
      selection in mycobacteria. The promoterless chloramphenicol acetyltransferase
      (CAT) reporter gene has been used to detect mycobacterial promoter elements in a
      homologous environment and to quantify their relative strengths. Using pSD7, we
      have isolated 125 promoter clones from the slowly growing pathogen Mycobacterium
      tuberculosis H37Rv and 350 clones from the fast-growing saprophyte Mycobacterium
      smegmatis. The promoters exhibited a wide range of strengths, as indicated by
      their corresponding CAT reporter activities (5 to 2,500 nmol/min/mg of protein).
      However, while most of the M. smegmatis promoters supported relatively higher CAT
      activities ranging from 100 to 2,500 nmol/min/mg of protein, a majority of those
      from M. tuberculosis supported CAT activities ranging from 5 to only about 100
      nmol/min/mg of protein. Our results indicate that stronger promoters occur less
      frequently in the case of M. tuberculosis compared with M. smegmatis. To assess
      the extent of divergence of mycobacterial promoters vis-a-vis those of E. coli,
      the CAT activities supported by the promoters in E. coli were measured and
      compared with their corresponding activities in mycobacteria. Most of the
      mycobacterial promoter elements functioned poorly in E. coli. The homologous
      selection system that we have developed has thus enabled the identification of
      mycobacterial promoters that apparently function optimally only in a native
      environment.

PMID- 8349559
TI  - The Rhizobium meliloti rhizopine mos locus is a mosaic structure facilitating its
      symbiotic regulation.
AB  - The Rhizobium meliloti L5-30 mos locus, encoding biosynthesis of the rhizopine 3
      O-methyl-scyllo-inosamine, is shown to be a mosaic structure. The mos locus
      consists of four open reading frames (ORFs) (ORF1 and mosABC) arranged in an
      operon structure. Within this locus, several domains of homology with other
      prokaryotic symbiotic genes (nifH, fixA, fixU, and nifT) are present, suggesting
      that this locus may represent a hot spot for rearrangement of symbiotic genes.
      Unusually, these domains are present in the coding as well as noncoding regions
      of the mos locus. Proteins corresponding to those encoded by mosABC, but not
      ORF1, have been detected in nodule extracts by using antibodies. As ORF1 shows
      extensive homology with the 5' region of the nifH gene (P.J. Murphy, N. Heycke,
      S.P. Trenz, P. Ratet, F.J. de Bruijn, and J. Schell, Proc. Natl. Acad. Sci. USA
      85:9133-9137, 1988) and a frameshift mutation indicates that expression of this
      ORF is not required for mos activity, we propose that the mos locus has acquired
      a duplicated copy of nifH, including the promoter region, in order to become
      symbiotically regulated. Surprisingly, since the functions are likely different,
      MosA has an amino acid sequence similar to that of the DapA protein of
      Escherichia coli. The central domain of MosB has extensive homology with a range
      of diverse proteins involved with carbohydrate metabolism in either antibiotic or
      outer-cell-wall biosynthesis. This region is also common to the regulatory
      proteins DegT and DnrJ, suggesting a regulatory role for MosB. The structure of
      MosC is consistent with its being a membrane transport protein.

PMID- 8349561
TI  - Generation of restriction map of Enterococcus faecalis OG1 and investigation of
      growth requirements and regions encoding biosynthetic function.
AB  - A defined synthetic medium was used to determine the amino acid requirements of
      Enterococcus faecalis OG1 and to demonstrate the absence of a requirement for
      exogenous purines or pyrimidines. Genomic libraries prepared from strain OG1 were
      transduced into Escherichia coli auxotrophic mutants, and cloned DNAs which
      complemented pyrC, pyrD, purF, purL, and guaAB mutations were identified. These
      and other cloned DNAs with known functions were localized on a restriction map of
      OG1 which was generated with SfiI (5 fragments), AscI (9 fragments), and NotI (15
      fragments); the size of the OG1 chromosome was revised from a previous estimate
      of approximately 2,750 kb to 2,825 kb. The synthetic medium and the restriction
      map should be useful for studying enterococcal metabolic functions and the
      relationships between chromosomally encoded genes.

PMID- 8349560
TI  - Characterization of genes for synthesis and catabolism of a new rhizopine induced
      in nodules by Rhizobium meliloti Rm220-3: extension of the rhizopine concept.
AB  - Rhizopines are selective growth substrates synthesized in nodules only by strains
      of rhizobia capable of their catabolism. We report the isolation and study of
      genes for the synthesis and catabolism of a new rhizopine, scyllo-inosamine
      (sIa), from alfalfa nodules induced by Rhizobium meliloti Rm220-3. This compound
      is similar in structure to the previously described rhizopine 3-O-methyl-scyllo
      inosamine from R. meliloti L5-30 (P.J. Murphy, N. Heycke, Z. Banfalvi, M.E. Tate,
      F.J. de Bruijn, A. Kondorosi, J. Tempe, and J. Schell, Proc. Natl. Acad. Sci. USA
      84:493-497, 1987). The synthesis (mos) and catabolism (moc) genes for the Rm220-3
      rhizopine are closely linked and located on the nod-nif Sym plasmid. The mos
      genes are directly controlled by the NifA/NtrA regulatory system. A comparison of
      the sequence of the 5' regions of the two mos loci shows very extensive
      conservation of sequence as well as strong homology to the nifH coding region.
      Restriction mapping and hybridization to DNA from the four open reading frames
      (ORFs) of the L5-30 mos locus indicate the absence of mosA and presence of the
      other three ORFs (ORF1 and mosB and -C) in Rm220-3. We suggest that the L5-30
      mosA gene product is involved in the conversion of scyllo-inosamine to 3-O-methyl
      scyllo-inosamine. Restriction fragment length polymorphism analysis of the moc
      regions of both strains shows that they are very similar. Regulation studies
      indicate that the moc region is not controlled by the common regulatory gene
      nifA, ntrA, and ntrC. We discuss the striking similarities in gene structure,
      location, and regulation between these two rhizopine loci in relation to the
      rhizopine concept.

PMID- 8349562
TI  - Gene components responsible for discrete substrate specificity in the metabolism
      of biphenyl (bph operon) and toluene (tod operon).
AB  - bph operons coding for biphenyl-polychlorinated biphenyl degradation in
      Pseudomonas pseudoalcaligenes KF707 and Pseudomonas putida KF715 and tod operons
      coding for toluene-benzene metabolism in P. putida F1 are very similar in gene
      organization as well as size and homology of the corresponding enzymes (G. J.
      Zylstra and D. T. Gibson, J. Biol. Chem. 264:14940-14946, 1989; K. Taira, J.
      Hirose, S. Hayashida, and K. Furukawa, J. Biol. Chem. 267:4844-4853, 1992),
      despite their discrete substrate ranges for metabolism. The gene components
      responsible for substrate specificity between the bph and tod operons were
      investigated. The large subunit of the terminal dioxygenase (encoded by bphA1 and
      todC1) and the ring meta-cleavage compound hydrolase (bphD and todF) were
      critical for their discrete metabolic specificities, as shown by the following
      results. (i) Introduction of todC1C2 (coding for the large and small subunits of
      the terminal dioxygenase in toluene metabolism) or even only todC1 into biphenyl
      utilizing P. pseudoalcaligenes KF707 and P. putida KF715 allowed them to grow on
      toluene-benzene by coupling with the lower benzoate meta-cleavage pathway.
      Introduction of the bphD gene (coding for 2-hydroxy-6-oxo-6-phenylhexa-2,4
      dienoate hydrolase) into toluene-utilizing P. putida F1 permitted growth on
      biphenyl. (ii) With various bph and tod mutant strains, it was shown that enzyme
      components of ferredoxin (encoded by bphA3 and todB), ferredoxin reductase (bphA4
      and todA), and dihydrodiol dehydrogenase (bphB and todD) were complementary with
      one another. (iii) Escherichia coli cells carrying a hybrid gene cluster of
      todClbphA2A3A4BC (constructed by replacing bphA1 with todC1) converted toluene to
      a ring meta-cleavage 2-hydroxy-6-oxo-hepta-2,4-dienoic acid, indicating that
      TodC1 formed a functional multicomponent dioxygenase associated with BphA2 (a
      small subunit of the terminal dioxygenase in biphenyl metabolism), BphA3, and
      BphA4.

PMID- 8349563
TI  - Subcellular localization of seven VirB proteins of Agrobacterium tumefaciens:
      implications for the formation of a T-DNA transport structure.
AB  - Plant cell transformation by Agrobacterium tumefaciens involves the transfer of a
      single-stranded DNA-protein complex (T-complex) from the bacterium to the plant
      cell. One of the least understood and important aspects of this process is how
      the T-complex exits the bacterium. The eleven virB gene products have been
      proposed to specify the DNA export channel on the basis of their predicted
      hydrophobicity. To determine the cellular localization of the VirB proteins, two
      different cell fractionation methods were employed to separate inner and outer
      membranes. Seven VirB-specific antibodies were used on Western blots
      (immunoblots) to detect the proteins in the inner and outer membranes and soluble
      (containing cytoplasm and periplasm) fractions. VirB5 was in both the inner
      membrane and cytoplasm. Six of the VirB proteins were detected in the membrane
      fractions only. Three of these, VirB8, VirB9, and VirB10, were present in both
      inner and outer membrane fractions regardless of the fractionation method used.
      Three additional VirB proteins, VirB1, VirB4, and VirB11, were found mainly in
      the inner membrane fraction by one method and were found in both inner and outer
      membrane fractions by a second method. These results confirm the membrane
      localization of seven VirB proteins and strengthen the hypothesis that VirB
      proteins are involved in the formation of a T-DNA export channel or gate. That
      most of the VirB proteins analyzed are found in both inner and outer membrane
      fractions suggest that they form a complex pore structure that spans both
      membranes, and their relative amounts in the two membrane fractions reflect their
      differential sensitivity to the experimental conditions.

PMID- 8349564
TI  - Characterization of twenty-six new heat shock genes of Escherichia coli.
AB  - Most organisms respond to heat by substantial alteration of the pattern of gene
      expression. This has been particularly well studied with Escherichia coli
      although the response has by no means been completely characterized. Here we
      report the characterization of 26 new heat shock genes of E. coli, termed hsl,
      discovered by global transcription analysis with an overlapping lambda clone
      bank. We have measured the molecular weights of the corresponding heat shock
      proteins and mapped each of them to within a few kilobases on the E. coli genome.
      In vitro, 16 of them can be activated by the E sigma 32 RNA polymerase, which
      specifically transcribes heat shock genes. In vivo expression kinetics of seven
      of eight examined new proteins were found to be similar to those of the four most
      studied heat shock proteins, DnaK, DnaJ, GroEL (MopA), and GroES (MopB). In the
      course of this work, we confirmed that the catalytic subunit of the ATP-dependent
      Clp protease (also known as Ti protease), ClpP, is derived from a larger
      precursor protein. Possible assignments of some of the hsl genes to known
      proteins are discussed.

PMID- 8349565
TI  - Cloning and characterization of a region of the Enterococcus faecalis conjugative
      plasmid, pCF10, encoding a sex pheromone-binding function.
AB  - In order to investigate the mechanism by which peptide sex pheromones induce
      expression of the conjugation functions of certain Enterococcus faecalis
      plasmids, a biological assay was developed to measure the ability of cells
      carrying the conjugative plasmid pCF10 to bind the sex pheromone cCF10. The data
      indicated that pCF10 endows its host E. faecalis cell with the ability to
      specifically remove (apparently by irreversible binding) cCF10 activity from
      culture medium. The pCF10 DNA encoding this ability was localized to a 3.4-kb
      segment within a region involved in negative control of expression of conjugal
      transfer functions. This segment also encoded ability to bind the pheromone
      inhibitor peptide iCF10. DNA sequencing revealed three open reading frames, which
      have been denoted prgW (pheromone responsive gene W), prgZ, and prgY. The deduced
      product of prgW resembled regulatory proteins from other bacteria and eucaryotes,
      with a very high degree of identity within a putative DNA-binding domain. The
      prgY gene actually extended into an adjacent region of pCF10 and could encode a
      protein with significant similarity to a protein called TraB, believed to be
      involved in shutdown of pheromone cAD1 production by cells carrying the pheromone
      inducible hemolysin plasmid pAD1, according to F.Y. An and D.B. Clewell (Abstr.
      Gen. Meet. Am. Soc. Microbiol. 1992, H70, 1992). The prgZ gene product showed
      significant relatedness to binding proteins encoded by oligopeptide permease
      (opp) operons in gram-positive and gram-negative bacteria and is highly similar
      to a pAD1-encoded protein, TraC, which is believed to mediate sex pheromone cAD1
      binding (K. Tanimoto, F. Y. An, and D. B. Clewell, submitted for publication). A
      Tn5 insertion into prgZ abolished cCF10 binding ability.

PMID- 8349567
TI  - The outer membranes of Brucella spp. are not barriers to hydrophobic permeants.
AB  - The patterns of susceptibility to hydrophobic and hydrophilic drugs and the
      uptake of the fluorescent probe N-phenyl-naphthylamine in Brucella spp.,
      Haemophilus influenzae, Escherichia coli, and deep rough Salmonella minnesota
      mutants were compared. The results show that the outer membranes of smooth and
      naturally rough Brucella spp. do not represent barriers to hydrophobic permeants
      and that this absence of a barrier relates at least in part to the properties of
      Brucella lipopolysaccharide.

PMID- 8349566
TI  - Characterization of the traC determinant of the Enterococcus faecalis hemolysin
      bacteriocin plasmid pAD1: binding of sex pheromone.
AB  - pAD1, a conjugative, 60-kb, hemolysin-bacteriocin plasmid in Enterococcus
      faecalis, encodes a mating response to a small peptide sex pheromone, cAD1,
      secreted by potential recipient bacteria. A gene, traC, encoding a 60.7-kDa
      protein with a typical amino terminal signal peptide, was identified within a
      region that appears to encode a product that binds to exogenous pheromone. A
      cloned segment of DNA containing traC resulted in specific binding of cells to
      synthetic cAD1. The putative traC product has strong similarity to a product of
      the E. faecalis plasmid pCF10 as well as oligopeptide binding proteins of
      Escherichia coli, Salmonella typhimurium, and Bacillus subtilis.

PMID- 8349568
TI  - A 20-kilodalton protein preserves cell viability and promotes CytA crystal
      formation during sporulation in Bacillus thuringiensis.
AB  - The effect of a 20-kDa protein on cell viability and CytA crystal production in
      its natural host, Bacillus thuringiensis, was studied by expressing the cytA gene
      in the absence or presence of this protein. In the absence of the 20-kDa protein,
      B. thuringiensis cells either were killed during sporulation (strain cryB) or
      produced very small CytA crystals (strain 4Q7). Expression of cytA in the
      presence of the 20-kDa protein, however, preserved cell viability, especially in
      strain cryB, and in both strains yielded bipyramidal crystals of the CytA protein
      that were larger than those of wild-type B. thuringiensis. These results suggest
      that the 20-kDa protein promotes crystal formation, perhaps by chaperoning CytA
      molecules during synthesis and crystallization, concomitantly preventing the CytA
      protein from interacting lethally with the bacterial host cell.

PMID- 8349569
TI  - Identification of Mycoplasma pirum genes involved in the salvage pathways for
      nucleosides.
AB  - Genes encoding enzymes involved in the salvage pathway for nucleosides have been
      cloned and sequenced from the mollicute Mycoplasma pirum. One of them, encoding
      deoxyriboaldolase, was functionally identified by complementation of an
      Escherichia coli mutant. These genes are clustered, suggesting an operon
      organization, and they are immediately followed by the putative gene for the
      triose phosphate isomerase, an enzyme used during glycolysis.

PMID- 8349570
TI  - Genes for the establishment and maintenance of lysogeny by the temperate
      coliphage 186.
AB  - To identify the genes in coliphage 186 that are required for lysogeny, we
      isolated clear-plaque mutants. Complementation studies and DNA sequencing
      identified two genes, the cI gene for the immunity maintenance repressor and the
      cII gene, which is required only for the establishment of lysogeny. One mutant
      carried a change in the LexA-binding site controlling expression of the
      antirepression protein Tum.

PMID- 8349571
TI  - Immunocytochemical analysis of poly-beta-hydroxybutyrate (PHB) synthase in
      Alcaligenes eutrophus H16: localization of the synthase enzyme at the surface of
      PHB granules.
AB  - Antibodies raised against the Alcaligenes eutrophus poly-beta-hydroxybutyrate
      (PHB) synthase polypeptide were used for immunocytochemical localization of the
      synthase enzyme in whole cells and purified PHB granules. The data presented
      demonstrate for the first time that the synthase enzyme is located on the surface
      of the PHB granule rather than being incorporated inside the granule during its
      formation. From these basic observations and data from the recent literature, a
      model of granule assembly is proposed.

PMID- 8349572
TI  - Vi I typing phage for generalized transduction of Salmonella typhi.
AB  - Salmonella typhi Vi typing phages were used to transduce temperature-sensitive
      (Ts) mutants of Salmonella typhi. Antibiotic resistance and Ts+ markers were
      transduced at high frequency (> 10(-4) per virulent phage). Several markers were
      cotransduced by phage Vi I, suggesting that it may be useful for mapping studies
      of the S. typhi genome.

PMID- 8349573
TI  - Complementation of a Chlamydomonas reinhardtii mutant defective in the nuclear
      gene encoding the chloroplast coupling factor 1 (CF1) gamma-subunit (atpC).
AB  - Chlamydomonas reinhardtii strain atpC1 is a mutant defective in the nuclear gene
      that encodes the CF1 ATP synthase gamma-subunit polypeptide. Photoautotrophic
      growth was restored to atpC1 after it was transformed with wild-type DNA.
      Transformed strains were acetate-independent and arsenate-sensitive, similar in
      phenotype to the progenitor wild-type strain from which atpC1 was generated.
      Three transformed strains were examined in detail. Southern blot analyses
      demonstrated that the transformants were complements and not revertants. The
      transforming DNA integrated into the nuclear genome in a nonhomologous manner and
      at a low copy number. Northern blot analyses showed that the gamma-subunit mRNA
      in the complemented strains was expressed at the same relative level as that of
      wild-type. Western blots of total protein showed that whereas atpC1 was unable to
      synthesize any CF1 gamma-subunit, all three complemented strains could.
      Furthermore, the Western blot analyses demonstrated that the mutation in atpC1
      had a pleiotropic effect on the accumulation of the CF1 beta-subunit which was
      relieved upon complementation. Cell extracts from atpC1 did not have any CF1
      dependent catalytic activity, whereas extracts from all of the complemented
      strains and the wild-type strain had identical activities.

PMID- 8349574
TI  - Effects of Zn2+ on the activity and binding of the mitochondrial ATPase inhibitor
      protein, IF1.
AB  - Zn2+ caused a noninhibitory binding of IF1 to mitochondrial membranes in both
      rabbit heart SMP and intact rabbit heart mitochondria. This Zn(2+)-induced IF1
      binding required the presence of at least trace amounts of MgATP and was
      essentially independent of pH between 6.2 and 8.2. Addition of Zn2+ after the
      formation of fully inhibited IF1-ATPase complexes very slowly reversed IF1
      mediated ATPase inhibition without causing significant IF1 release from the
      membranes. When Zn2+ was added during the state 4 energization of ischemic
      mitochondria in which IF1 was already functionally bound, it slowed somewhat
      energy-driven ATPase activation. This slowing was probably due to the fairly
      large depressing effect Zn2+ had upon membrane potential development, but Zn2+
      did not decrease the degree of ATPase activation eventually reached at 20 min of
      state 4 incubation. Zn2+ also preempted normal IF1 release from the membranes,
      causing what little inhibitor that was released to rebind to the enzyme in
      noninhibitory IF1-ATPase complexes. The data suggest that IF1 can interact with
      the ATPase in two ways of through two kinds of sites: (a) a noninhibitory
      interaction involving a non-inhibitory IF1 conformation and/or an IF1 docking
      site on the enzyme and (b) an inhibitory interaction involving an inhibitory IF1
      conformation and/or a distinct ATPase activity regulatory site. Zn2+ appears to
      have the dual effect of stabilizing the noninhibitory IF1-ATPase interaction and
      possibly a noninhibitory IF1 conformation while concomitantly preventing the
      formation of an inhibitory IF1-ATPase interaction and possibly an inhibitory IF1
      conformation, regardless of pH. While the data do not rule out direct effects of
      Zn2+ on either free IF1 or the free enzyme, they suggest that Zn2+ cannot
      interact readily with either the inhibitor or the enzyme once functional IF1
      ATPase complexes are formed.

PMID- 8349576
TI  - Nucleotide excision repair, a tracking mechanism in search of damage.

PMID- 8349575
TI  - Concerning the mechanism of increased thermogenesis in rats treated with
      dehydroepiandrosterone.
AB  - Dehydroepiandrosterone (DHEA) treatment of rats decreases gain of body weight
      without affecting food intake; simultaneously, the activities of liver malic
      enzyme and cytosolic glycerol-3-P dehydrogenase are increased. In the present
      study experiments were conducted to test the possibility that DHEA enhances
      thermogenesis and decreases metabolic efficiency via transhydrogenation of
      cytosolic NADPH into mitochondrial FADH2 with a consequent loss of energy as
      heat. The following results provide evidence which supports the proposed
      hypothesis: (a) the activities of cytosolic enzymes involved in NADPH production
      (malic enzyme, cytosolic isocitrate dehydrogenase, and aconitase) are increased
      after DHEA treatment; (b) cytosolic glycerol-3-P dehydrogenase may use both NAD+
      and NADP+ as coenzymes; (c) activities of both cytosolic and mitochondrial forms
      of glycerol-3-P dehydrogenase are increased by DHEA treatment; (d) cytosol
      obtained from DHEA-treated rats synthesizes more glycerol-3-P during incubation
      with fructose-1,6-P2 (used as source of dihydroxyacetone phosphate) and NADP+;
      the addition of citrate in vitro further increases this difference; (e)
      mitochondria prepared from DHEA-treated rats more rapidly consume glycerol-3-P
      added exogenously or formed endogenously in the cytosol in the presence of
      fructose-1,6-P2 and NADP+.

PMID- 8349577
TI  - Binding of wild type and chimeric arrestins to the m2 muscarinic cholinergic
      receptor.
AB  - Arrestins play an important role in regulating the activity of the G protein
      coupled receptors rhodopsin and the beta 2-adrenergic receptor. Recently, we
      described the expression and functional characterization of visual arrestin using
      an in vitro translation system. Here we report the expression of beta-arrestin
      and development of a direct binding assay to study the interaction of arrestins
      with a muscarinic cholinergic receptor. In vitro translated beta-arrestin was
      found to specifically bind to purified reconstituted human m2 muscarinic
      cholinergic receptor (hm2 mAChR) in an agonist- and phosphorylation-dependent
      manner. Visual arrestin also bound to the hm2 mAChR, albeit to a lesser extent
      and with lower affinity. In an attempt to dissect the major domains responsible
      for determining the receptor binding specificity of arrestin and beta-arrestin,
      we generated several chimeric arrestins. One contained the first 340 residues of
      beta-arrestin followed by residues 346-404 of arrestin (BRV4), another consisted
      of the first 207 residues of beta-arrestin and residues 214-404 of visual
      arrestin (BV3), and a third had residues 1-43 of beta-arrestin replaced by
      residues 1-47 of arrestin (VIN1). All of these arrestins were able to
      specifically bind to the activated and phosphorylated form of both the hm2 mAChR
      and rhodopsin, with a clear preference for the muscarinic receptor. The Kd values
      for beta-arrestin, BRV4, BV3, VIN1, and visual arrestin binding to the hm2 mAChR
      were 0.48 +/- 0.06, 0.51 +/- 0.19, 1.38 +/- 0.26, 1.13 +/- 0.26, and 7.2 +/- 1.2
      nM, respectively. These data demonstrate that: 1) beta-arrestin binds to the hm2
      mAChR in an activation- and phosphorylation-dependent fashion, 2) visual arrestin
      has 15-fold lower affinity for the hm2 mAChR as compared to beta-arrestin, and 3)
      the N-terminal half of beta-arrestin plays a key role in determining receptor
      binding specificity. The use of in vitro translated arrestins to directly assess
      receptor binding may serve as a viable approach for elucidating the specificity
      and molecular mechanisms involved in receptor-arrestin interaction.

PMID- 8349578
TI  - Myosin light chain phosphorylation does not increase during yeast phagocytosis by
      macrophages.
AB  - We have studied the role of myosin II light chain phosphorylation in yeast
      phagocytosis by J774 cells. J774 cells, which are mouse cells of
      monocyte/macrophage lineage, ingest opsonized yeast particles, and the rate of
      internalization is linear for 60 min at 37 degrees C. Immunoprecipitation of
      myosin II from cells labeled with 32P, using an affinity-purified antibody to
      myosin II purified from J774 cells, demonstrated phosphorylation of both the
      myosin heavy chain and the 20-kDa light chain (PMLC) prior to the addition of the
      opsonized yeast. However, the levels of heavy chain and PMLC phosphorylation did
      not change during the linear phase of yeast uptake by J774 cells. Other
      experiments demonstrated that the amount of myosin II associated with the
      cytoskeleton did not change during phagocytosis, further supporting the
      observation that PMLC phosphorylation does not increase during phagocytosis. In
      contrast, F-actin increased by 1.6-fold during the linear phase of phagocytosis.
      Two additional approaches were used to analyze in greater detail the role of
      myosin II phosphorylation in phagocytosis. First, antibodies to myosin light
      chain kinase (MLCK), the enzyme that phosphorylates PMLC, were electroinjected
      into J774 cells. These antibodies, which inhibit MLCK activity, inhibited
      chemotaxis as previously described but had no effect on phagocytosis. Second,
      quantitation of phagocytosis and chemotaxis following treatment with the
      phosphoprotein phosphatase inhibitor okadaic acid demonstrated that chemotaxis
      was much more sensitive than phagocytosis to okadaic acid treatment; at 0.3
      microM okadaic acid, there is a substantial increase in myosin phosphorylation
      and chemotaxis is inhibited by 60%, whereas phagocytosis is unaffected. These
      data indicate that PMLC phosphorylation and, by implication, myosin II are not
      involved in yeast phagocytosis. They also suggest that PMLC phosphorylation
      displays a high degree of specificity with respect to mediating energy-dependent
      cellular processes in macrophages.

PMID- 8349579
TI  - The A3 adenosine receptor is the unique adenosine receptor which facilitates
      release of allergic mediators in mast cells.
AB  - Mast cells release the mediators of the immediate hypersensitivity reaction.
      Adenosine is known to modulate this process, but the receptor responsible for
      this is not the classical A1 or A2 adenosine receptors. This study was undertaken
      to determine whether the unique adenosine receptor (AR) previously postulated in
      a cultured mast cell line (RBL-2H3 cells) is the recently cloned A3AR. The
      receptors were quantitated by the agonist 125I-labeled APNEA
      (aminophenylethyladenosine), an A3AR agonist, which yielded Bmax and Kd values of
      826 fmol/mg protein and 34 nM, respectively. A variety of adenosine analogs
      competed for 125I-APNEA binding sites with the following potency series: (R)
      phenylisopropyladenosine = 5'-N-ethylcarboxamide adenosine > (S)
      phenylisopropyladenosine. 125I-APNEA binding was relatively insensitive to the
      xanthine amine congener (XAC, 1 microM), a selective antagonist for the A1AR.
      Functionally, activation of these A3AR stimulated the production of inositol
      1,4,5-triphosphate, leading to an increase in the level of intracellular Ca2+.
      Furthermore, while activation of these receptors alone produced little secretory
      response in RBL-2H3 cells, it enhanced antigen-induced secretion by 2-2.5-fold.
      Northern blotting studies using poly(A+) RNA from RBL-2H3 cells detected two
      transcripts of 2.0 and 3.5 kilobases, which hybridized to an A3AR cDNA but not to
      the A1 or A2AR cDNA probes. These data indicate that the unique AR that
      potentiates the secretory response to antigen in RBL-2H3 cells is exclusively the
      A3AR.

PMID- 8349580
TI  - Inhibition of the cellular secretion of cholesteryl ester transfer protein by a
      variant protein formed by alternative splicing of mRNA.
AB  - Alternative splicing of mRNA is often used as a regulatory switch, determining
      whether a functional protein is made or not. The plasma cholesteryl ester
      transfer protein (CETP) mediates the transfer of cholesteryl esters from high
      density lipoproteins to other lipoproteins. In addition to the mRNA encoding
      plasma CETP, human tissues contain an alternatively spliced variant in which exon
      9-derived sequences are omitted. To determine a possible regulatory role of
      alternative splicing, COS cells were co-transfected with full-length and exon 9
      deleted cDNAs. The exon 9-deleted protein was poorly secreted and inhibited the
      secretion of full-length CETP, due to formation of an intracellular heteromeric
      complex between full-length and exon 9-deleted proteins. The findings suggest a
      novel use of alternative splicing to generate a poorly secreted protein variant,
      which complexes with the active form and prevents its secretion by cells.

PMID- 8349581
TI  - Thrombin exosite for fibrinogen recognition is partially accessible in
      prothrombin.
AB  - The procoagulant alpha-thrombin is produced by the proteolytic cleavages of a
      minimum of two peptide bonds Arg274-Thr275 and Arg323-Ile324 in prothrombin. The
      Arg323-Ile324 cleavage is required for the expression of the active site of
      thrombin (Morita, T., Iwanaga, S. Suzuki, T. (1976) J. Biochem. (Tokyo) 79, 1089
      1108; Hibbard, L. S., Nesheim, M. E., and Mann, K. G. (1982) Biochemistry 21,
      2285-2292). It is not yet clear to what extent the proteolytic events are
      responsible for exposing protein recognition exosites on thrombin. We employed
      high resolution NMR spectroscopy to examine interactions of prothrombin and
      thrombin with synthetic hirudin peptides targeted toward the fibrinogen
      recognition exosite of thrombin. The hirudin tail synthetic analogues (acetyl
      Asp55-Phe-Glu-Glu-Ile-Pro-Glu-Glu-Tyr-Leu-Gln65/G ly65-OH) exhibited similar NMR
      relaxation enhancements (line broadening patterns and transferred nuclear
      Overhauser effects) with human prothrombin as with human alpha-thrombin,
      indicating that both proteins bind the peptide in a similar manner. The protein
      induced relaxation enhancements are specific to the interaction of the hirudin
      peptides with the fibrinogen recognition exosite of thrombin since no significant
      effects were observed with either human serum albumin or with human gamma
      thrombin, which has an impaired recognition exosite. The binding affinities were
      determined from NMR relaxation time measurements, which gave approximate Kd
      values of 500 microM and < 100 microM for prothrombin and alpha-thrombin,
      respectively. Since the hirudin tail fragment binds specifically to the
      fibrinogen recognition exosite in alpha-thrombin, this exosite appears to be
      partially accessible in prothrombin in a proenzyme form.

PMID- 8349582
TI  - Human ABR encodes a protein with GAPrac activity and homology to the DBL
      nucleotide exchange factor domain.
AB  - We have previously cloned a segment of a gene, ABR, homologous to the BCR gene,
      which encodes a protein consisting of three distinct functional domains. In the
      present study, genomic ABR sequences were used to isolate human ABR cDNAs.
      Surprisingly, the two types of ABR cDNAs identified differed only in their most
      5' coding sequences. These are predicted to encode proteins of 93.5 and 92.3 kDa
      molecular mass. ABR showed a differential expression pattern in various mouse
      tissues, analogous to that of BCR, and the highest level was found in brain.
      Similar to BCR, ABR contains a region with homology to DBL, vav, and CDC24, which
      are likely to or have been shown to encode GTP exchange factors. A domain of ABR
      with similarity to GAPrho was expressed as a fusion protein in Escherichia coli
      and was shown to have GAP activity toward rac. Although both ABR and BCR have GAP
      activity, ABR lacks homology to the serine/threonine kinase domain of BCR.
      Therefore, ABR is likely to have cellular functions overlapping with but also
      distinct from those of BCR.

PMID- 8349583
TI  - The tricarboxylic acid cycle in Dictyostelium discoideum. Systemic effects of
      including protein turnover in the current model.
AB  - The current model for the tricarboxylic acid cycle in Dictyostelium discoideum is
      based on extensive experimental studies of enzyme kinetics in vitro and of
      metabolite fluxes measured in vivo. In the previous papers (Shiraishi, F., and
      Savageau, M. A. (1992) J. Biol. Chem. 267, 22912-22918; 22919-22925; 22926-22933;
      22934-22943) of this series we have carried out extensive analyses of the current
      model within the framework of biochemical systems theory with a view toward
      understanding the behavior of the integrated system. The model was found to be
      ill determined with respect to at least three of its features. In this paper we
      propose a minimal modification in the model that is consistent with previous
      experimental data but also includes recycling of amino acids for protein
      synthesis, one of the neglected features identified as important in the previous
      analysis. We again perform an analysis within the framework of biochemical
      systems theory to determine the systemic consequences of this change. The results
      show that the robustness of the modified model, as determined by the parameter
      sensitivities, is improved by 2 orders of magnitude over that of the previous
      model. Analysis of the dynamics shows that the turnover times for the pools of
      alanine, glutamate, and aspartate are reduced by 2 orders of magnitude and made
      more physiologically realistic. The distribution of flux is no longer rigidly
      fixed, and problems previously centered on the metabolism of pyruvate have been
      partially alleviated. Continued discrepancies lead us to question the degree to
      which kinetic data obtained with purified enzymes in vitro faithfully reflect the
      kinetic behavior of the integrated enzyme system in vivo. We must continue to re
      examine the manner in which the kinetics of reactions in vivo are represented and
      to reassess the physical conditions that prevail in vitro and in vivo. Results in
      this paper direct our attention toward specific aspects of the system where these
      efforts should be focused. Thus, a minimal modification of the previous model has
      led to several improvements that make it more representative of the tricarboxylic
      acid cycle in D. discoideum, and the analysis in this paper leads to further
      predictions for improving the model.

PMID- 8349584
TI  - A vectorized sequence-coupling model for predicting HIV protease cleavage sites
      in proteins.
AB  - What kind of peptide sequences can be cleaved by HIV protease, and what kind
      cannot be? This is a crucially important problem in designing effective
      inhibitors against HIV protease as potential drugs for AIDS therapy. To tackle
      this problem, a sequence-coupling and vectorized model is proposed for predicting
      the cleavability of oligopeptides by proteases with multiple and extended
      specificity subsites. In comparison with existing methods, the new method has
      proved to be an improvement in both the accuracy of the model and the rationality
      of the statistical treatment. Meanwhile, the Monte Carlo sampling procedure
      introduced here has also proved to be very useful in dealing with the situation
      when the experimental data are insufficiently sampled for complete statistics.
      Owing to its very high rate of correct prediction, it is expected that the new
      method can be a useful technique for helping to find effective inhibitors of HIV
      protease, which is one of the targets in designing potential drugs against AIDS.
      The principle of the new method can also be applied to analyzing the specificity
      of any multi-subsite enzyme.

PMID- 8349586
TI  - Isolation and analysis of the gene and cDNA for a human Mu class glutathione S
      transferase, GSTM4.
AB  - We have isolated the human gene and cDNA that encode the fourth member of the Mu
      class glutathione S-transferases (GSTs). The complete gene sequence (GenBank
      M96233) and the cDNA sequence (M96234) are reported and named GSTM4. The gene,
      located on chromosome 1, is comprised of eight exons with an organization similar
      to that of other Mu class genes. GSTM4 differs from a partial gene sequence,
      termed GSTmu2 (Taylor, J. B., Oliver, J., Sherrington, R., and Pemble, S. E.
      (1991) Biochem. J. 274, 587-593), in exons 3 through 5 by only 11 nucleotides
      within introns. The cDNA for GSTM4 was isolated from a library derived from the
      cervical carcinoma cell line, HeLa. Northern blots demonstrate the presence of
      GSTM4 mRNA in human heart, placenta, lung, brain, liver, skeletal muscle,
      pancreas, testis, cerebral cortex, uterus, ovary, a lymphoblastoid cell line, and
      four carcinoma cell lines. The deduced amino acid sequence of GSTM4 is 87%
      (GSTM1), 83% (GSTM2), and 70% (GSTM3) identical to the previously described human
      Mu class GSTs. The polypeptide encoded by the GSTM4 cDNA, produced in a bacterial
      expression system, conjugates 1-chloro-2,4-dinitrobenzene to GSH with a specific
      activity of 1.39 +/- 0.21 mumol/min/mg.

PMID- 8349585
TI  - Detection and characterization of cellular EGR-1 binding to its recognition site.
AB  - Most of what is known of the Egr-1 DNA binding site GCGGGGGCG was originally
      identified by experiments using DNA sequences and bacterially expressed or in
      vitro translated EGR-1 protein. Here we report the binding of cellular EGR-1
      protein derived from HeLa, mouse and human fibroblasts to its consensus sequence.
      Binding is strongly but transiently stimulated in these cells by serum, phorbol
      ester, or by okadaic acid, an inhibitor of protein serine/threonine phosphatases
      1 and 2A, suggesting the regulation of this gene expression and its DNA binding
      activity to be under the control of protein kinase(s) and phosphatase(s). When
      EGR-1 synthesis is stimulated under the above conditions, binding of the
      transcription factor Sp1 to its recognition site in the Egr-1 promoter is reduced
      with a concomitant appearance of EGR-1 DNA binding. This is likely a result of
      competition between Sp1 and the newly synthesized EGR-1, since there is a partial
      overlap in the binding sequences recognized by these proteins. In cotransfection
      experiments EGR-1 activated transcription through multiple copies of GCGGGGGCG 5'
      to a minimum promoter of c-fos. Interestingly, EGR-1 is shown to down-regulate
      the transcription of its own gene expression, whereas Sp1 activated Egr-1 gene
      expression. The detection of cellular EGR-1 binding to the Egr-1 consensus
      sequence in the different cell types provides a model for studying the mechanism
      by which an immediate-early gene is regulated by various ligands.

PMID- 8349587
TI  - Microheterogeneity around the reactive lysine residue in the myosin heavy chain
      from rabbit skeletal muscle.
AB  - A molecule of myosin subfragment 1 (S1) from rabbit skeletal muscle has one
      highly reactive lysine residue, Lys-83 (RLR), in the heavy chain, which is
      rapidly and stoichiometrically modified by trinitrobenzenesulfonate. Our previous
      kinetic study (Komatsu, H., Emoto, Y., and Tawada K. (1993) J. Biol. Chem. 268,
      7799-7808) showed that although MgPPi reduces the maximum number of
      trinitrophenylated RLR down to about 0.5 mol/mol of S1, this half-stoichiometric
      modification of RLR is not the result of any heterogeneity in the primary
      structure of S1. However, this result conflicts with a previous report in which
      the half-stoichiometric trinitrophenylation has been reported to be related to
      Pro/Ser microheterogeneity at the 78th residue position in the heavy chain of
      rabbit skeletal muscle myosin. To resolve the conflict, we isolated peptides
      containing both the 78th residue and RLR from the two different preparations of
      S1, one whose RLR was trinitrophenylated in the presence of MgPPi and the other
      whose RLR was not trinitrophenylated in the presence of MgPPi, and then we
      determined the amino acid sequences of the peptides. We found the same Pro/Ser
      microheterogeneity at the 78th position in the peptides from these S1s and thus
      concluded that this microheterogeneity has no correlation to the half
      stoichiometric trinitrophenylation of RLR.

PMID- 8349588
TI  - Abnormal regulation of low density lipoprotein-sensitive events in a cholesterol
      transport mutant.
AB  - We have isolated and characterized Chinese hamster ovary cell mutants defective
      in the intracellular transport of low density lipoprotein (LDL)-derived
      cholesterol (Dahl, N. K., Reed, K. L., Daunais, M. A., Faust, J. R., and Liscum,
      L. (1992) J. Biol. Chem. 267, 4889-4896). Mutant 2-2, which exhibits a
      cholesterol transport defect indistinguishable from the Niemann-Pick C phenotype,
      shows impaired but not absent LDL-mediated suppression of 3-hydroxy-3
      methylglutaryl (HMG)-CoA reductase activity. In parental cells, LDL suppression
      of HMG-CoA reductase is modulated by two mechanisms, decreased gene transcription
      and accelerated protein turnover. Using the chimeric protein HMGal as a reporter
      protein for LDL-mediated turnover and Northern blot analysis to monitor HMG-CoA
      reductase mRNA levels, we have dissected the contributions of these two
      regulatory responses to LDL-mediated suppression of HMG-CoA reductase activity.
      Kinetic modeling using the kinlsq program showed the following. Mutant 2-2
      exhibits normal LDL-mediated acceleration of HMGal degradation, coupled with
      relatively abnormal regulation of mRNA. This suggests that the LDL-cholesterol
      signaling pathway to the nucleus is defective relative to the signal that results
      in HMG-CoA reductase turnover. In addition, LDL-mediated acceleration of HMGal
      turnover occurs well before LDL stimulation of cholesterol esterification in
      mutant 2-2, whereas these events occur synchronously in the parental cell line.
      This suggests that more than one pathway or mechanism exists for LDL-cholesterol
      signaling to the endoplasmic reticulum.

PMID- 8349589
TI  - Kinetics of ligand binding to Pseudoterranova decipiens and Ascaris suum
      hemoglobins and to Leu-29-->Tyr sperm whale myoglobin mutant.
AB  - The kinetics of binding of O2, CO, and NO to the octameric, two-domain
      hemoglobins of the parasitic nematodes Pseudoterranova decipiens and Ascaris suum
      were determined on nanosecond and picosecond time scales using flash photolysis.
      The two nematode hemoglobins have very similar kinetic properties. On the
      picosecond time scale, they exhibit an unusual behavior in showing a geminate
      reaction with oxygen that is biphasic and dependent on the flash intensity. The
      geminate reaction with NO is also faster and more complete than for sperm whale
      myoglobin; however, in contrast to the O2 reaction, it is homogeneous. In
      addition, the oxygen dissociation rate of P. decipiens hemoglobin, 0.0035 s-1, is
      as low as that of A. suum hemoglobin, 0.004 s-1 (Gibson, Q. H., and Smith, M. H.
      (1965) Proc. R. Soc. Lond. B Biol. Sci. 163, 206-214). A mutant of sperm whale
      myoglobin suggested by sequence alignment of the nematode hemoglobins, Leu-29-
      >Tyr, did not have kinetic properties similar to them.

PMID- 8349590
TI  - Comparative studies of cardiac and skeletal sarcoplasmic reticulum ATPases.
      Effect of a phospholamban antibody on enzyme activation by Ca2+.
AB  - Vesicular fragments of skeletal (LSR) and cardiac (CSR) sarcoplasmic reticulum
      were compared with the aim of defining the effect of a monoclonal phospholamban
      (Pl) antibody (Ab). The Pl Ab has no effect on LSR, while enhancing the Ca2+
      transport rates of CSR at Ca2+ concentrations below saturation. We found no
      direct effect of the Pl Ab on Ca2+ binding by the ATPase in the absence of ATP.
      Equilibrium measurements of Ca2+ binding yield positively cooperative isotherms
      which are best fit with a two-interacting sites equation. LSR and CSR display
      nearly identical affinities for Ca2+, and no effect of the Pl Ab is observed.
      Taking advantage of a stable CrATP-enzyme complex, we demonstrated that the
      stoichiometric ratio of occluded Ca2+ to catalytic sites is 2 in either LSR or
      CSR and that the addition of Pl Ab does not affect the Ca2+ concentration
      dependence of Ca2+ occluded after equilibration of the system. Interestingly, the
      cooperative interaction between the two Ca2+ sites is lost in the occluded state,
      with only one of the two sites acquiring lumenal exposure. The concentration
      dependence of Ca2+ inhibition of CSR ATPase phosphorylation with Pi is also
      unaffected by the Pl Ab. Contrary to the lack of Pl Ab effect on reactions
      measured at equilibrium, enhancement of phosphorylated intermediate formation by
      the Pl Ab is obtained in kinetic experiments in which nonsaturating Ca2+ and ATP
      are added to CSR preincubated with EGTA. Therefore, Ab binding to Pl reduces
      specifically the activation energy for a slow transition triggered by Ca2+
      binding, with consequent enhancement of overall kinetics under conditions
      enhancing the rate-limiting contribution of this transition.

PMID- 8349591
TI  - Mechanism of inactivation of S-adenosylhomocysteine hydrolase by (Z)-4',5'
      didehydro-5'-deoxy-5'-fluoroadenosine.
AB  - S-Adenosyl-L-homocysteine (AdoHcy) hydrolase, an enzyme important in the
      regulation of biological methylation reactions, was shown by McCarthy et al.
      (McCarthy, J.R., Jarvi, E.T., Matthews, D.P., Edwards, M.L., Prakash, N.J.,
      Bowlin, T.L., Mehdi, S., and Bey, P. (1989) J. Am. Chem. Soc. 111, 1127-1128) to
      be inactivated by (Z)-4',5'-didehydro-5'-deoxy-5'-fluoroadenosine (ZDDFA). In
      this study we have shown that the mechanism of this inactivation of AdoHcy
      hydrolase (NAD+ form) includes a rapid addition of water to the 5'-position of
      ZDDFA and elimination of fluoride ion, resulting in the formation of the 5'
      carboxaldehydes 3 and 4. The 5'-carboxaldehydes 3 and 4 are then oxidized in a
      slower step to the 3'-keto-5'-carboxaldehydes 5 and 6 by reduction of the enzyme
      bound NAD+ to NADH. Evidence in support of this mechanism includes the
      observation that the first step in this mechanism (i.e. elimination of fluoride
      ion and formation of the 5'-carboxaldehydes 3 and 4) can be catalyzed by apo
      AdoHcy hydrolase and the NADH form of AdoHcy hydrolase. Incubation of ZDDFA with
      either the apo or NADH form of AdoHcy hydrolase resulted in rapid release of
      fluoride ion (determined by 19F NMR) and formation of the 5'-carboxyaldehydes 3
      and 4 (determined by high performance liquid chromatography). The carboxaldehydes
      3 and 4 were synthesized independently and were shown to be potent inhibitors of
      the NAD+ form of the enzyme. When the relative first-order rates of fluoride ion
      release (determined by 19F NMR) from ZDDFA, NAD+ reduction to NADH, and
      inactivation of the NAD+ form of the enzyme were compared, the release of
      fluoride ion was found to be approximately 20 times faster than NAD+ reduction or
      enzyme inactivation. Incubation of ZDDFA with the NAD+ form of AdoHcy hydrolase
      was shown to afford the 3'-keto-5'-carboxaldehydes 5 and 6, which were also
      formed upon incubation of the enzyme with the 5'-carboxaldehydes 3 and 4. The 3'
      keto-5'-carboxaldehydes 5 and 6 were shown to be tightly (but not covalently)
      bound to the enzyme, since these products could be released by treatment of the
      ZDDFA-inactivated enzyme with HClO4 or other denaturing agents.

PMID- 8349592
TI  - Orientation of cholera toxin bound to target cells.
AB  - Cholera toxin (CT) consists of a pentameric B subunit that binds to specific cell
      surface receptors identified as ganglioside GM1 and an A subunit that activates
      adenylylcyclase. The A subunit consists of A1 and A2 peptides linked by a
      disulfide bond; A2 acts to connect A to B, whereas A1 is an ADP
      ribosyltransferase that modifies the alpha subunit of the stimulatory G protein
      (Gs). How the toxin is oriented when it binds to the cell surface and the related
      issue of the mechanism by which A1 gains access to Gs alpha are not known. In the
      present study, we used subunit-specific antibodies and their corresponding Fab
      fragments to assess their affects on holotoxin binding to target cells and their
      immunoreactivity to cell-bound toxin. Our results suggest that CT binds with A1
      facing away from the membrane. Our hypothesis is further supported by the ability
      to assemble active CT on the cell surface of cultured human intestinal and
      neurotumor cells by the sequential addition of purified B and A subunits. We also
      observed that when cells containing bound CT were incubated at 37 degrees C, both
      subunits rapidly became inaccessible to their respective antibodies. We propose
      that the holotoxin binds with its A subunit facing away from the membrane and
      must enter the cell in order for A1 to be released, gain access to Gs alpha, and
      activate adenylylcyclase.

PMID- 8349593
TI  - Transduction of mitogenic activity of platelet-derived growth factor (PDGF) AB by
      PDGF-beta receptor without participation of PDGF-alpha receptor in vascular
      smooth muscle cells.
AB  - In cultured rat vascular smooth muscle cells, platelet-derived growth factor
      (PDGF) beta receptor was expressed at a high level, whereas PDGF-alpha receptor
      was not detected. PDGF-BB showed a high binding activity at 4 degrees C in the
      cells and was not displaced by PDGF-AA or -AB. This result indicates that PDGF-AB
      as well as PDGF-AA does not bind to the cells lacking PDGF-alpha receptor at 4
      degrees C. However, at 37 degrees C, PDGF-AB bound to the cells and induced the
      internalization of PDGF-beta receptor. DNA synthesis was also stimulated
      potentially by PDGF-AB as well as PDGF-BB in the cells, although PDGF-AA was
      completely inactive. At 37 degrees C, PDGF-AB caused tyrosine phosphorylation of
      a group of proteins including PDGF-beta receptor and phospholipase C-gamma 1, but
      at a slower rate than PDGF-BB. At 4 degrees C, PDGF-AB did not stimulate protein
      tyrosine phosphorylation, whereas PDGF-BB did. A chemical cross-linking
      experiment showed that PDGF-beta receptor was dimerized by PDGF-AB as well as
      PDGF-BB. These results indicate that PDGF-beta receptor binds PDGF-AB without
      participation of PDGF-alpha receptor at 37 degrees C (but not at 4 degrees C),
      and PDGF-AB as well as PDGF-BB acts as a potent mitogen in the vascular smooth
      muscle cells.

PMID- 8349594
TI  - Cloning, nucleotide sequence, and expression of a p-hydroxybenzoate hydroxylase
      isozyme gene from Pseudomonas fluorescens.
AB  - A gene encoding for a putative isozyme of p-hydroxy-benzoate hydroxylase (PHBH)
      has been isolated from Pseudomonas fluorescens (ATCC 13525). A comparison of the
      translated amino acid sequence with that of the known PHBH from P. fluorescens
      revealed that the new enzyme contains 3 additional amino acids and has 73%
      absolute homology to the previously known enzyme; conservation of secondary and
      active-site structures implied that the isozyme and known enzyme share the same
      general tertiary structure. Subsequent expression of the isozyme in Escherichia
      coli produced an enzyme with a specific activity about half that of the
      previously characterized PHBHs from P. fluorescens and Pseudomonas aeruginosa; in
      addition, somewhat weaker binding affinities for both NADPH and p-hydroxybenzoate
      were observed. Speculations are made on the reason for the existence of the
      isozyme, which does not appear to be expressed routinely in P. fluorescens.

PMID- 8349595
TI  - OmpF-Lpp signal sequence mutants with varying charge hydrophobicity ratios
      provide evidence for a phosphatidylglycerol-signal sequence interaction during
      protein translocation across the Escherichia coli inner membrane.
AB  - Using inverted Escherichia coli inner membrane vesicles we have analyzed the
      phosphatidylglycerol dependence of translocation of an OmpF-Lpp fusion protein
      carrying a signal sequence with varying positive charge at the N terminus and a
      hydrophobic core of varying length. It is shown that there is a direct
      relationship between the phosphatidylglycerol requirement of translocation and
      the requirement within the translocation process for positive charges on the
      signal sequence. This provides further evidence that the negative head group of
      the lipid is required for functional interaction with the positively charged N
      terminus of the signal sequence.

PMID- 8349596
TI  - The regulatory gene, hXBP-1, and its target, HLA-DRA, utilize both common and
      distinct regulatory elements and protein complexes.
AB  - hXBP-1 is a transcription factor of the leucine zipper (b-zip) family important
      in the expression of the class II major histocompatibility complex gene, DRA.
      Studies with mouse-human hybrids have mapped hXBP-1 hybridizing fragments to
      human chromosomes 5 and 22 and the frequent detection of two mRNA transcripts
      suggested that hXBP-1 may be a member of a small gene family. To analyze the
      structure and regulation of hXBP-1 further, cosmid clones from both chromosomes
      were isolated. Mapping and sequence analyses reveal that chromosome 22 contains
      the functional hXBP-1 gene while chromosome 5 contains a processed pseudogene.
      hXBP-1 promoter analysis has revealed that cis-active elements within the 5'
      untranslated region of hXBP-1 are essential for full promoter activity. One such
      element, hX2, is identical to the hXBP-1 target sequence in the DRA promoter.
      Mutagenesis of the hX2 site substantially decreases promoter activity. This
      element interacts with four distinct protein complexes in mature B cells and
      cross-competition experiments show that two of these complexes (complex 1 and
      complex 4) also interact with the hXBP-1 target sequence (X2) from the DRA
      promoter. The similarities of the hXBP-1 promoter and of the DRA promoter (the
      gene that the hXBP-1 protein regulates) are further emphasized by the fact that a
      Y box element is located 3' of both hX2 and X2.

PMID- 8349597
TI  - Dissection of the human acetylcholinesterase active center determinants of
      substrate specificity. Identification of residues constituting the anionic site,
      the hydrophobic site, and the acyl pocket.
AB  - Substrate specificity determinants of human acetylcholinesterase (HuAChE) were
      identified by combination of molecular modeling and kinetic studies with enzymes
      mutated in residues Trp-86, Trp-286, Phe-295, Phe-297, Tyr-337, and Phe-338. The
      substitution of Trp-86 by alanine resulted in a 660-fold decrease in affinity for
      acetythiocholine but had no effect on affinity for the isosteric uncharged
      substrate (3,3-dimethylbutylthioacetate). The results demonstrate that residue
      Trp-86 is the anionic site which binds, through cation-pi interactions, the
      quaternary ammonium of choline, and that of active center inhibitors such as
      edrophonium. The results also suggest that in the non-covalent complex, charged
      and uncharged substrates with a common acyl moiety (acetyl) bind to different
      molecular environments. The hydrophobic site for the alcoholic portion of the
      covalent adduct (tetrahedral intermediate) includes residues Trp-86, Tyr-337, and
      Phe-338, which operate through nonpolar and/or stacking interactions, depending
      on the substrate. Substrates containing choline but differing in the acyl moiety
      (acetyl, propyl, and butyryl) revealed that residues Phe-295 and Phe-297
      determine substrate specificity of the acyl pocket for the covalent adducts. Phe
      295 also determines substrate specificity in the non-covalent enzyme substrate
      complex and thus, the HuAChE F295A mutant exhibits over 130-fold increase in the
      apparent bimolecular rate constant for butyrylthiocholine compared with wild type
      enzyme. Reactivity toward specific butyrylcholinesterase inhibitors is similarly
      dependent on the nature of residues at positions 295 and 297. Amino acid Trp-286
      at the rim of the active site "gorge" and Trp-86, in the active center, are
      essential elements in the mechanism of inhibition by propidium, a peripheral
      anionic site ligand. Molecular modeling and kinetic data suggest that a cross
      talk between Trp-286 and Trp-86 can result in reorientation of Trp-86 which may
      then interfere with stabilization of substrate enzyme complexes. It is proposed
      that the conformational flexibility of aromatic residues generates a plasticity
      in the active center that contributes to the high efficiency of AChE and its
      ability to respond to external stimuli.

PMID- 8349598
TI  - Co-ordinate and restricted expression of the ProXaaArg/Lys-specific GalNAc
      transferase and the GalNAc beta 1,4GlcNAc beta 1,2Man alpha-4-sulfotransferase.
AB  - Asn-linked oligosaccharides terminating with the sequence SO4-4GalNAc beta
      1,4GlcNAc beta 1,2Man alpha (S4GGnM) are present on the glycoprotein hormones
      lutropin and thyrotropin, pro-opiomelanocortin, and tissue factor pathway
      inhibitor. The peptide motif ProXaaArg/Lys (PXR/K), which is recognized by a
      PXR/K-specific GalNAc-transferase, is present in each of these glycoproteins 6-9
      residues NH2-terminal to an Asn glycosylation site. Both the PXR/K-specific
      GalNAc-transferase and a GalNAc beta 1,4GlcNAc beta 1,2Man alpha (GGnM)-4
      sulfotransferase are required for synthesis of the S4GGnM sequence. Glycoproteins
      which do not contain the PXR/K motif but bear Asn-linked oligosaccharides
      terminating with GGnM or sialic acid alpha 2,3/6GGnM have also been described,
      suggesting a distinct GalNAc-transferase may be responsible for their synthesis.
      We have examined a number of tissues and cultured cell lines for the transfer of
      sulfate to the trisaccharide acceptor GGnM and transfer of GalNAc to
      oligosaccharide acceptors on protein which do, human chorionic gonadotropin
      (hCG), and do not, transferrin (Trf), contain the PXR/K motif. The PXR/K-specific
      GalNAc-transferase and the GGnM-4-sulfo-transferase are expressed in salivary
      gland, pituitary, lacrimal gland, kidney, and brain, and in the cell lines AtT
      20, 293, SHSY5Y, and alpha T3. In contrast Bowes, EL-4, and B16L6 cell extracts
      transferred GalNAc to oligosaccharides acceptors on Trf but not on hCG. A number
      of tissues and cell lines displayed transfer of GalNAc to both hCG and to Trf
      suggesting that two distinct GalNAc-transferases were present. The GGnM-4
      sulfotransferase was expressed in tissues and cell lines which expressed the
      PXR/K-specific GalNAc-transferase but not in cell lines expressing exclusively
      the Trf-specific GalNAc-transferase. Thus, the PXR/K-specific GalNAc-transferase
      and the GGnM-4-sulfotransferase are coordinately expressed in a number of tissues
      other than pituitary. The Trf-specific GalNAc-transferase may account for the
      presence of beta 1,4-linked GalNAc on glycoproteins which do not contain the
      PXR/K motif.

PMID- 8349599
TI  - Purification and properties of selenoprotein W from rat muscle.
AB  - Following injection with [75Se]selenite, a low molecular weight 75Se
      selenocysteine containing protein was purified from rat muscle. The purification
      procedure involved ammonium sulfate fractionation, Sephadex G-50 gel filtration,
      cation exchange chromatography on CM-Sephadex, and reverse phase high pressure
      liquid chromatography using a C-18 Vydac column. Four forms of the protein were
      separated by the cation exchange and reverse phase chromatography steps. Matrix
      assisted laser desorption/ionization time-of-flight mass spectrometry of the four
      proteins revealed masses of 9550 +/- 1, 9596 +/- 1.2, 9858 +/- 1.3, and 9898 +/-
      1.1 daltons. Glutamate, glycine, lysine, leucine, and valine are the major amino
      acids in this protein. About 0.92 g atoms of selenium was found per g mol of
      protein, and this selenium was present as selenocysteine. Thus, this appears to
      be a new selenoprotein, and we have named it selenoprotein W.

PMID- 8349600
TI  - Phosphorylation of the human 46-kDa mannose 6-phosphate receptor in the
      cytoplasmic domain at serine 56.
AB  - The human 46-kDa mannose 6-phosphate receptor (MPR46) is phosphorylated in its
      cytoplasmic domain at serine residues. Substitution of cytoplasmic serines (at
      positions 35 and 56) with alanine, expression of mutant receptors in baby hamster
      kidney cells, and phosphopeptide mapping revealed that serine 56 is
      phosphorylated. Mutant MPR46 and wild-type MPR46 were found to be similarly
      distributed between the cell surface and intracellular membranes. Phosphate
      incorporation in the presence of cycloheximide indicates that phosphorylation
      occurred on pre-existing MPR46. Similar half-lives for the wild-type and mutant
      receptor proteins (approximately 43 h) and the receptor-associated phosphate (1.4
      h) were found. The mutant receptors were internalized at the same rate as the
      wild-type receptors. Expression of mutant MPR46 and wild-type MPR46 in mouse L
      cells deficient in 300-kDa mannose 6-phosphate receptors did not affect the
      sorting of newly synthesized cathepsin D to lysosomes. Phosphorylation of
      cytoplasmic serine 56 is therefore essential neither for stability nor for cell
      surface expression and transport activities of MPR46.

PMID- 8349601
TI  - Charge pair interactions stabilizing ferredoxin-ferredoxin reductase complexes.
      Identification by complementary site-specific mutations.
AB  - Ferredoxin reductase (Fd-reductase) supplies electrons to mitochondrial steroid
      hydroxylase cytochrome P450 enzymes via a [2Fe-2S] ferredoxin. Chemical labeling
      studies with bovine Fd-reductase have implicated Lys-243 as important in binding
      to bovine ferredoxin (Hamamoto, I., Kazutaka, K., Tanaka, S., and Ichikawa, Y.
      (1988) Biochim. Biophys. Acta 953, 207-213). We have used site-directed
      mutagenesis to examine the role of charged residues in this region of human Fd
      reductase in ferredoxin binding. Mutant proteins were expressed in Escherichia
      coli and were assayed for activity by ferredoxin-mediated electron transfer to
      cytochrome c. Replacement of Lys-242 (homologous to Lys-243 in bovine Fd
      reductase) with Gln and replacement of Arg-241 with Ser had little effect (2.7-
      and 3.6-fold increased Km, respectively). In contrast, mutants at positions 239
      and 243 (R239S and R243Q) exhibited markedly lower affinity for ferredoxin (17.5-
      and 1,600-fold increased Km, respectively). Studies were also carried out with
      two ferredoxin charge mutants shown previously to have lowered affinity for Fd
      reductase (Coghlan, V. M., and Vickery, L. E. (1991) J. Biol. Chem. 266, 18606
      18612). Comparisons of the binding of ferredoxin mutants D76N and D79N to Fd
      reductase mutants R239S and R243Q suggest that Arg-239 and Arg-243 of Fd
      reductase each interact directly with both Asp-76 and Asp-79 of ferredoxin during
      formation of the complex between the two proteins. These results support the
      hypothesis that specific electrostatic interactions involving this region are
      important in stabilizing the ferredoxin-Fd-reductase complex.

PMID- 8349602
TI  - Regulation of tyrosine phosphorylation in neutrophils by the NADPH oxidase. Role
      of reactive oxygen intermediates.
AB  - Neutrophils possess a multicomponent NADPH-oxidase that produces large quantities
      of superoxide, which can in turn generate other reactive oxygen intermediates.
      Superoxide and its dismutation product, hydrogen peroxide, are powerful oxidants.
      Because the activity of certain tyrosine kinases and phosphatases can be affected
      by their redox state, we considered the possibility that endogenously generated
      reactive oxygen intermediates (ROI) may alter phosphotyrosine formation and
      thereby function as intra- or intercellular messengers in neutrophils. Exposure
      of human neutrophils to exogenous oxidants such as diamide induced marked
      tyrosine phosphorylation of several cellular proteins. More importantly,
      activation of the NADPH oxidase in permeabilized neutrophils, by direct
      stimulation of GTP-binding proteins, also resulted in enhanced tyrosine
      phosphorylation. The latter was NADPH-dependent, paralleled by production of
      superoxide, and was inhibited by diphenylene iodonium, an inhibitor of the
      flavoprotein component of the oxidase. Neutrophils, from a patient with chronic
      granulomatous disease, which are deficient in the production of ROI, demonstrated
      no such phosphotyrosine accumulation. We conclude that ROI produced by the NADPH
      oxidase can regulate tyrosine phosphorylation in granulocytes, possibly by
      effects of oxidation-sensitive tyrosine kinases and/or phosphatases.

PMID- 8349603
TI  - Generation and characterization of a competitive antagonist of human hepatocyte
      growth factor, HGF/NK1.
AB  - Our previous studies have suggested that a derivative of hepatocyte growth factor
      (HGF), HGF/NK2, containing the coding sequences for the N-terminal hairpin and
      first two kringle domains, is sufficient to mediate high affinity binding to the
      HGF receptor. Here, we wished to test directly whether HGF/NK1 (N-terminal
      hairpin and first kringle domains) could bind the receptor and/or mediate
      receptor signaling. HGF/NK1 was expressed in Escherichia coli and purified to
      homogeneity using heparin-affinity and fast protein liquid cation-exchange
      chromatography. Biological characterization of HGF/NK1 showed that it can compete
      for binding to the HGF receptor on human lung carcinoma A549 cells and to a
      soluble form of the HGF receptor. HGF/NK1 is inefficient at promoting
      autophosphorylation of the HGF receptor, although some activity was detected at
      very high concentrations. HGF/NK1 fails to exhibit mitogenic properties even at
      very high concentrations. However, HGF/NK1 can act as a potent competitive
      antagonist in this assay. Our data demonstrate directly that a receptor binding
      determinant of HGF is located within the N-terminal 32-212 residues of HGF.
      HGF/NK1 will serve as a powerful tool for (i) generating neutralizing antibodies,
      (ii) in determining x-ray crystallographic and nuclear magnetic resonance
      structures, and (iii) for in vivo studies as an HGF antagonist.

PMID- 8349604
TI  - Polyamine-like actions of peptides derived from conantokin-G, an N-methyl-D
      aspartate (NMDA) antagonist.
AB  - Conantokins-T and -G are highly conserved polypeptides derived from Conus venoms.
      The N-methyl-D-aspartate (NMDA) antagonist properties of these compounds have
      been attributed to a potent noncompetitive inhibition of polyamine responses.
      Substitution of the highly conserved gamma-carboxyglutamate residues as well as
      modification of the N and C termini of conantokin-G abolished the inhibition of
      polyamine responses at the NMDA receptor complex. However, several of these
      modified polypeptides closely mimicked the neurochemical profile of polyamines at
      the NMDA receptor complex. One of these derivatives, Tyr0-conantokin-G, was found
      to be the most potent compound exhibiting polyamine-like actions at the NMDA
      receptor complex described to date, approximately 7-fold more potent than
      spermine. Circular dichroism studies demonstrate a significant alpha-helical
      content in conantokin-G (27% in aqueous medium). However, this alpha-helicity is
      not sufficient for the NMDA antagonist action of the parent peptide and is
      neither necessary nor sufficient for the polyamine-like behavior of several
      conantokin-G analogs. The modified conantokin-G derivatives described in this
      report should be useful probes for examining the role of both polyamines and the
      polyamine recognition site in the operation of the NMDA receptor complex.

PMID- 8349605
TI  - Molecular cloning and characterization of cDNAs for the gamma- and epsilon
      subunits of mitochondrial F1F0 ATP synthase from the sweet potato.
AB  - Mitochondrial F1F0 ATP synthases purified from dicotyledonous plants contain six
      different subunits named alpha, beta, gamma, delta, delta', and epsilon. Our
      previous N-terminal amino acid sequence analyses indicated that the gamma- and
      epsilon-subunits of the sweet potato mitochondrial F1 correspond to the gamma-
      and epsilon-subunits of animal mitochondrial F1, respectively (Kimura, T.,
      Nakamura, K., Kajiura, H., Hattori, H., Nelson, N., and Asahi, T. (1989) J. Biol.
      Chem. 264, 3183-3186). A cDNA clone for the gamma-subunit of the sweet potato
      mitochondrial F1 was identified by oligonucleotide hybridization selection of a
      cDNA library, and a cDNA clone for the epsilon-subunit was isolated by reverse
      polymerase chain reaction and hybridization selection of a cDNA library by the
      polymerase chain reaction product. The 1.4-kilobase long cDNA for the gamma
      subunit contained a 978-base pair open reading frame coding for a precursor for
      the gamma-subunit. The mature gamma-subunit is composed of 281 amino acids, and
      its sequence showed significantly higher similarities with the gamma-subunit of
      animal mitochondrial F1 and bacterial F1 compared with the gamma-subunit of
      chloroplast CF1 from plants. The precursor for the gamma-subunit contained N
      terminal presequence of 45 amino acid residues. By contrast, the 0.46-kilobase
      long cDNA for the epsilon-subunit contained a coding sequence of 207-base pairs
      for the mature epsilon-subunit of 69 amino acid residues that is preceded by an
      ATG codon suggesting that the epsilon-subunit is synthesized without the
      cleavable presequence for mitochondrial import. The amino acid sequence of the
      epsilon-subunit of sweet potato mitochondrial F1 showed similarities of 25 and
      36% amino acid positional identity with the epsilon-subunits of mitochondrial F1
      from yeast and bovine, respectively.

PMID- 8349607
TI  - A point mutation of alanine 163 to threonine is responsible for the defective
      secretion of high molecular weight kininogen by the liver of brown Norway
      Katholiek rats.
AB  - To clarify the mechanism of the secretion defect of high molecular weight
      kininogen (HK) and low molecular weight kininogen (LK) by the liver of Brown
      Norway (B/N) Katholiek rats causing plasma kininogen deficiency, we cloned cDNAs
      for HK from cDNA libraries of the livers of B/N Katholiek and B/N Kitasato rats.
      A point mutation of G to A at nucleotide 487 was found in the cDNA of B/N
      Katholiek rats by sequence analysis of the cDNAs (including the entire HK-coding
      region) obtained from both strains. Both B/N Katholiek and B/N Kitasato rat cDNA
      fragments were introduced into a eukaryotic vector, pRc/CMV, to construct their
      respective expression plasmid, which was used to transfect COS-1 cells. At 24 h
      of incubation, the culture medium of COS-1 cells transfected with the B/N
      Katholiek rat cDNA contained only 10% of the HK antigen that was found in COS-1
      cells transfected with the B/N Kitasato rat cDNA. More HK antigen was retained in
      the former cells. Moreover, cells transfected with B/N Katholiek rat cDNA, in
      which the A at nucleotide 487 was artificially replaced by G, secreted a
      significant amount of HK into the medium. These results suggest that a point
      mutation of G to A at nucleotide 487, which causes a substitution of Ala163 to
      Thr in the heavy chain of HK and LK, is responsible for the defective secretion
      of HK and LK by the liver of B/N Katholiek rats.

PMID- 8349606
TI  - Effect of tethered peptidylchloromethylketone inhibitors on thermal stability and
      domain interactions of urokinase and other serine proteases.
AB  - The melting of several serine proteases that had been reacted with different
      peptidylchloromethylketone (cmk) inhibitors was studied by fluorescence
      spectroscopy and calorimetry. These inhibitors, which cross-link the two domains
      of the proteases, invariably increased the melting temperature by as much as 28.5
      degrees C. The magnitude of the effect was dependent on the size and composition
      of the peptide moieties. The delta G of unfolding of tosyl-Phe-cmk-chymotrypsin
      was 13.5 kcal/mol compared to only 8.3 kcal/mol for chymotrypsin. Binding of cmk
      inhibitors also protected the two interacting domains of urokinase from acid
      induced decooperation and caused them to merge into a highly cooperative
      structure upon refolding at low pH. Fluorescence-detected melting curves of Glu
      Gly-Arg-cmk-urokinase indicated that unfolding/refolding at pH 4.5 is
      characterized by dramatic hysteresis; the cooling curves fell close to those
      obtained upon heating or cooling of the uninhibited enzyme. Upon second heating,
      the melting curves were similar to those of the original. The hysteresis effects
      are interpreted as follows. The tethered tripeptide binds to the active site,
      causing the protein to melt at much higher temperature in a single cooperative
      step, as if the two domains are merged into one cooperative unit. Upon cooling,
      the unfolded protein, with the inhibitor still attached, refolds at the same
      temperature as the underivatized protein. Only after the native structure is
      formed does the peptide moiety again bind and stabilize toward a second heating.
      At lower pH, second heating produced biphasic or triphasic melting curves that
      were attributed to differential protonation of acid-titratable groups on the
      enzyme and/or inhibitor at the time of refolding. Similar effects were observed
      with other trypsin-like proteases, indicating that the hysteresis and bi- and
      triphasic refolding at low pH are rather general for this class of enzyme.

PMID- 8349608
TI  - Rapid activation of GLUT-1 glucose transporter following inhibition of oxidative
      phosphorylation in clone 9 cells.
AB  - Exposure of Clone 9 cells to inhibitors of oxidative phosphorylation results in a
      rapid and striking stimulation of facilitated glucose transport (7.5-fold at 2 h)
      that is mediated by the GLUT-1 transporter. We have previously shown that this
      rapid stimulation of glucose transport occurs in the absence of any detectable
      increase in cell GLUT-1 or GLUT-1 mRNA content. To determine whether this early
      enhancement of transport is attributable to a translocation of glucose
      transporters to the plasma membrane, or instead to an activation of transporters
      already present in the plasma membrane, we have employed four different
      approaches to determine whether the stimulation of transport is accompanied by a
      corresponding increase in plasma membrane GLUT-1 sites: 1) immunofluorescence
      microscopy; 2) quantitation of GLUT-1 sites in plasma membrane fractions isolated
      by differential centrifugation and subsequent Western blotting; 3) cell surface
      biotinylated followed by isolation of plasma membranes and quantitation of GLUT-1
      sites by Western blotting; and 4) quantitation of GLUT-1 sites in plasma membrane
      fractions by [3H]cytochalasin B binding. Each of these experimental approaches
      led to the same conclusion, namely that the large stimulation of glucose
      transport observed during the early phase of the response to azide is associated
      with only a slight increase in the abundance of GLUT-1 sites in the plasma
      membrane. These results strongly suggest that activation of GLUT-1 sites pre
      existing in the plasma membrane is the dominant mechanism mediating the early
      glucose transport response to inhibition of oxidative phosphorylation.

PMID- 8349609
TI  - Lipopolysaccharide stimulates both nuclear localization of the nuclear factor
      kappa B 50-kDa subunit and loss of the 105-kDa precursor in RAW264 macrophage
      like cells.
AB  - Nuclear factor kappa B (NF-kappa B) is an important regulator of gene expression
      in cells of the immune system. One such gene, tumor necrosis factor, is induced
      by bacterial lipopolysaccharide (LPS) in macrophages, and this induction has been
      shown to be mediated in part by NF-kappa B activation in murine macrophages. In
      this study, immunochemical analysis was used to follow LPS activation of the NF
      kappa B 50-kDa subunit in the RAW264 macrophage-like cell line. The recombinant
      NF-kappa B 50-kDa subunit was used as an immunogen to produce a rabbit antiserum,
      which was then affinity-purified using a portion of the NF-kappa B 50-kDa subunit
      that does not have homology to other members of the c-rel gene family. Untreated
      macrophages had little NF-kappa B in the nucleus as detected by Western
      immunoblotting. The protein was predominantly localized in the cytoplasmic
      fraction. Interestingly, NF-kappa B was found as the 50-kDa mature protein and
      105-kDa precursor. After LPS treatment, there was a rapid nuclear translocation
      of NF-kappa B as detected by immunoblot analysis. There was also a rapid decrease
      in the amount of the cytoplasmic 105-kDa protein. This may indicate that the 105
      kDa protein is a reservoir for the 50-kDa protein and that one of the actions of
      LPS is to increase the rate of 105-kDa precursor processing.

PMID- 8349610
TI  - Activation of dynamin GTPase by acidic phospholipids and endogenous rat brain
      vesicles.
AB  - Dynamin is a GTPase thought to play a role in endocytosis based on genetic
      analysis of its homolog in Drosophila melanogaster shibire. Previous studies have
      stressed an in vitro association with microtubules, though additional evidence
      suggests that dynamin associates with membranous organelles. In an analysis of
      the enzymatic and membrane binding properties of dynamin, we have found that the
      acidic phospholipids, phosphatidylserine, phosphatidylglycerol, and
      phosphatidylinositol, are able to stimulate GTP hydrolysis in a manner similar to
      activation previously shown with microtubules. A neutral phospholipid,
      phosphatidylcholine, had no effect on dynamin GTPase. Activation of dynamin was
      biphasic, with a decrease in activity back to basal levels with increased
      concentrations of either microtubules or liposomes. A comparison between GTPase
      stimulation induced by microtubules and that by phospholipids suggests that ionic
      interactions between the basic C-terminal domain of dynamin and the negatively
      charged microtubule or phospholipid head group are important. In support of this,
      GTPase stimulation by these agents in combination was not additive. A salt
      extracted membrane fraction from brain tissue also activated dynamin GTPase,
      though to a lower extent than pure phospholipids. These results suggest that
      membrane components could be responsible for some aspects of the regulation of
      dynamin function in vivo.

PMID- 8349611
TI  - Isolation and heterologous expression of cloned cDNAs for two rabbit nasal
      microsomal proteins, CYP2A10 and CYP2A11, that are related to nasal microsomal
      cytochrome P450 form a.
AB  - Nasal microsomal P450 form a (NMa), a major cytochrome P450 isozyme in rabbit
      olfactory and respiratory nasal mucosa with high activity toward a variety of
      odorants and environmental toxicants, was previously purified to electrophoretic
      homogeneity from rabbit nasal microsomes. In the present study, a cDNA library
      constructed from poly(A)+ RNA from rabbit respiratory nasal mucosa was screened
      with antibodies to P450 NMa, and five immunopositive clones were isolated and
      characterized. Sequence analysis indicated that the clones encode two highly
      similar P450s that contain 494 amino acid residues, with the first 20
      corresponding to P450 NMa, and differ from each other in only 8 residues
      scattered throughout the polypeptide chains. On the basis of structural homology
      the two proteins are designated as CYP2A10 and CYP2A11 and are the first members
      of the P450 2A subfamily to be identified in nasal tissue. Genomic blot analysis
      indicated that 2A10 and 2A11 are apparently not allelic variants. Both genes are
      expressed in liver and lung as well as in nasal tissues, as judged by RNA blot
      analysis, but the relative levels of the two mRNAs differ. Both enzymes were
      partially purified after expression of the cDNAs in Escherichia coli and shown to
      catalyze the oxygenation of a variety of substrates, including ethanol and
      procarcinogens such as N-nitrosodiethylamine and phenacetin. P450 2A10 is
      generally more active than P450 2A11 and strikingly so in the conversion of
      testosterone to androstenedione.

PMID- 8349612
TI  - Structural organization and genomic sequence of mouse syndecan-1 gene.
AB  - Syndecan-1 is an integral membrane proteoglycan, which binds several
      extracellular matrix components and growth factors. Its expression follows
      morphogenetic rather than histological patterns during embryonic development and
      is regulated by epithelial-mesenchymal interactions during organogenesis.
      Malignant transformation has been shown to suppress syndecan-1 expression. In
      order to understand better the regulation of syndecan-1 expression, we have
      determined the structural organization of mouse syndecan-1 gene. Several genomic
      clones were isolated, covering the entire 23-kilobase (kb) syndecan-1 gene. All
      five exons, four introns, and the 5'- and 3'-flanking regions were sequenced. The
      first intron was very long (17,582 base pairs (bp)) if compared with the others
      that were only a few hundred nucleotides in length. The first exon contained only
      the signal sequence and exons II-IV all the glycosaminoglycan binding sites. The
      fifth exon resided both transmembrane and cytoplasmic domains, which are known to
      be conserved among the members of the syndecan family. This genomic structure
      explains why these members could have heterologous extracellular domains and
      homologous transmembrane and cytoplasmic domains. Syndecan-1 gene was shown by
      primer extension analysis to have three transcription initiation sites which were
      confirmed by polymerase chain reaction. These initiation sites were found to
      locate -217, -266, and -591 bp from described cDNA (Saunders, S., Jalkanen, M.,
      O'Farrell, S., and Bernfield, M. (1989) J. Cell Biol. 108, 1547-1556). Within the
      5'-end of the gene a 2000-bp-long CpG nucleotide-rich sequence resembling a CpG
      island was found, which started from the transcription initiation sites and ended
      in the first intron. At the 3'-end of the gene an other polyadenylation signal
      sequence was revealed 638 bp downstream from the first one. The two mRNAs (2.6 kb
      and 3.4 kb) were shown to be produced by alternative polyadenylation.

PMID- 8349613
TI  - Self-assembly and calcium-binding sites in laminin. A three-arm interaction
      model.
AB  - Laminin, a four-arm glycoprotein, polymerizes in vitro into networks similar to
      those found in basement membranes. We have dissected this calcium-dependent
      assembly by analyzing proteolytic fragment binding using equilibrium gel
      filtration, ultracentrifugation, and electron microscopy. The cathepsin G
      fragment C1-4 (three short arms) was found to aggregate with a critical
      concentration similar to that for laminin. Like laminin polymerization, this
      assembly was inhibited by the smaller elastase short arm fragments E4 (B1 domains
      VI and V) and E1' (A-B2 short arm complex). Fragment E4 bound directly to E1' in
      a calcium-dependent manner (KD = 1.4 microM). In contrast, homologous self
      interactions of short arm fragments and all interactions of long arm fragments
      were considerably weaker or nonexistent. While electron micrographs of E1' or E4
      alone contained mostly monomers, those of E1'/E4 mixtures contained dimers and
      oligomers with E1' dimers connected to each other through their A and B2 arms,
      often with visible E4 molecules at their junctions. 45Ca2+ bound principally to
      fragment E1' with localization to the end of the B2 chain. These data support a
      model in which polymerization requires the interaction of all three ligands, one
      from each short arm, with calcium activating assembly by binding to the B2 short
      arm.

PMID- 8349614
TI  - Identification of the major phosphorylation sites of the Raf-1 kinase.
AB  - Treatment of cells with various growth factors and mitogens results in the rapid
      hyperphosphorylation and activation of the Raf-1 kinase. To determine if
      phosphorylation events affect Raf-1 activity, we have initiated experiments to
      identify the phosphorylation sites of Raf-1. In this report, we find that Ser43,
      Ser259, and Ser621 are the major sites of Raf-1 which are phosphorylated in
      mammalian cells and in Sf9 insect cells infected with a recombinant baculovirus
      encoding human Raf-1. Mutant Raf-1 proteins lacking kinase activity are also
      phosphorylated on these sites in vivo, indicating that these phosphorylation
      events are not a consequence of autophosphorylation. Furthermore, we find that
      Thr268 is the predominant Raf-1 residue phosphorylated in in vitro autokinase
      assays. In addition, we have examined the biochemical activity of baculovirus
      expressed Raf-1 proteins containing mutations at these phosphorylation sites. In
      in vitro protein kinase assays Ser259 mutant proteins were 2-fold more active
      than wild-type Raf-1 and Ser621 mutant proteins were inactive as kinases.
      Analysis of the residues surrounding Ser259 and Ser621 indicates that RSXSXP may
      be a consensus sequence for the kinase responsible for phosphorylation of Raf-1
      at these sites. Interestingly, these RSXSXP sequences are completely conserved
      throughout evolution in all Raf family members.

PMID- 8349615
TI  - Stimulation of neutrophils with a chemoattractant activates several novel protein
      kinases that can catalyze the phosphorylation of peptides derived from the 47-kDa
      protein component of the phagocyte oxidase and myristoylated alanine-rich C
      kinase substrate.
AB  - Novel protein kinases that may participate in the signal transduction pathways of
      neutrophils were sought by a procedure based on the ability of these enzymes to
      undergo renaturation and catalyze the phosphorylation of a peptide substrate
      fixed in a gel. We report that neutrophils contain four uncharacterized protein
      kinases with molecular masses of about 69, 63, 49, and 40 kDa, which are rapidly
      activated upon stimulation of these cells with the chemoattractant fMet-Leu-Phe.
      These kinases can catalyze the phosphorylation of a peptide that corresponds to
      residues 297-331 of the 47-kDa subunit of the NADPH oxidase system (p47-phox). A
      peptide that corresponds to residues 153-178 of the human myristolyated alanine
      rich C kinase substrate (MARCKS) protein was also a substrate for the 69- and 63
      kDa kinases. The time course for the activation of these enzymes was similar to
      the phosphorylation of p47-phox and MARCKS in intact neutrophils. In contrast,
      stimulation of these cells with 4 beta-phorbol 12-myristate 13-acetate, the
      calcium ionophore A23187, or the combination of these agonists did not activate
      these enzymes. Activation of the 63- and 40-kDa protein kinases was blocked by
      pertussis toxin, calyculin A, and staurosporine. Several other unidentified
      protein kinases were also active with these peptides but did not exhibit enhanced
      activity after cell stimulation with this method.

PMID- 8349616
TI  - Site-specific methylation inhibits transcriptional activity of platelet-derived
      growth factor A-chain promoter.
AB  - Expression of the platelet-derived growth factor (PDGF) A-chain gene is
      temporally and spatially restricted in development and highly regulated in
      selected normal and tumor cell lines. Because DNA methylation appears to be
      important in regulating tissue specific gene expression, we tested the influence
      of in vitro methylation of the human PDGF A-chain promotor on its activity in
      vivo in transient transfection assays. We now report that PDGF A-chain promoter
      activity is strongly repressed by DNA methylation in a DNA sequence-specific
      manner and that the repression of promoter activity by methylation requires a
      methyl CpG-binding protein(s). We also report that incubation of HeLa cells with
      5-azacytidine sharply increases levels of endogenous PDGF A-chain gene
      transcripts. These results indicate that the promoter activity of the PDGF A
      chain gene is sharply and selectively reduced by in vitro DNA methylation and
      that DNA methylation in vivo also may reduce its function in selected cell lines.

PMID- 8349617
TI  - Cell type-specific regulation of SL-1 and SL-2 genes. Induction of the SL-2 gene
      but not the SL-1 gene by human keratinocytes in response to cytokines and
      phorbolesters.
AB  - The stromelysin-2 (SL-2) gene is transcriptionally active in normal human
      keratinocytes and encodes a secreted, catalytically competent but latent matrix
      metalloproteinase. Phorbolester induction resulted in the emergence of SL-2 (but
      not SL-1 transcripts), whereas the opposite was true for human mucosal
      fibroblasts. Expression of keratinocyte SL-2 was also induced by the two
      keratinocyte growth factors, transforming growth factor-alpha and epidermal
      growth factor, by the proinflammatory cytokine, tumor necrosis factor-alpha, but,
      somewhat surprisingly, not by interleukin-1 beta. The latent SL-2 proenzyme was
      isolated from 12-O-tetradecanoylphorbol-13-acetate-induced keratinocytes by
      immunoaffinity chromatography using a cross-reactive antibody raised against
      human SL-1. This procedure led to the recovery of a single M(r) 54,000 molecular
      species at a level of approximately 0.2 microgram/ml of culture medium. Amino
      terminal sequencing identified the protein as SL-2 and verified the predicted
      signal sequence cleavage site. Conformational activation of latent SL-2 precursor
      by SDS gave rise to a full-length, uncleaved (M(r) 54,000) active form and at the
      same time exposed a cryptic thiol group. By contrast, organomercurial activation
      resulted in autolytic truncation of the molecule with loss of M(r) approximately
      10,000 propeptide. SL-2 shared with (human fibroblast) SL-1 the ability to cleave
      casein, to "superactivate" fibroblast type procollagenase, and to form apparently
      binary, SDS-resistant complexes with tissue inhibitor of metalloproteinases-1.

PMID- 8349618
TI  - Molecular and biochemical characterization of herbicide-resistant mutants of
      cyanobacteria reveals that phytoene desaturation is a rate-limiting step in
      carotenoid biosynthesis.
AB  - Mutant strains of the cyanobacterium Synechococcus sp. PCC 7942 that are
      resistant to the herbicides norflurazon and fluridone were analyzed. These
      herbicides inhibit phytoene desaturase, a key enzyme in the carotenoid
      biosynthetic pathway. In three mutants the phenotype was related to specific
      point mutations in pds, the gene encoding phytoene desaturase. Since the
      resistance was manifested in a cell-free carotenogenic assay, it is evident that
      the predicted amino acid changes in the target protein alter the enzyme-herbicide
      interactions. In addition, the mutations also reduced the in vitro activity of
      phytoene desaturase. Increased levels of the substrate phytoene, accompanied by a
      reduction in colored carotenoids, were detected in cells of each of the mutant
      strains. A correlation was established between the degree of increase in the
      steady-state levels of phytoene and the extent of reduction in total carotenoid
      content in the cells. These two phenomena in turn are correlated with the rate of
      enzymatic activity of phytoene desaturase that was measured in vitro. Hence we
      deduce that phytoene desaturation is a rate-limiting step in carotenogenesis in
      cyanobacteria. Support for this conclusion is obtained from analysis of cells of
      an additional mutant strain, which overexpress phytoene desaturase due to a
      deletion mutation in the promoter region of pds. Cells of this mutant contained
      more colored carotenoids than the wild-type and were resistant to herbicides that
      inhibit phytoene desaturase.

PMID- 8349619
TI  - Tumor-specific overexpression of a novel keratinocyte lipid-binding protein.
      Identification and characterization of a cloned sequence activated during
      multistage carcinogenesis in mouse skin.
AB  - Differential screening of cDNA libraries from chemically induced malignant mouse
      skin squamous cell carcinomas (SCCs) identified sequences, including one called
      mal1, that were up-regulated in their expression at both the benign papilloma and
      the malignant SCC stages during tumor development. The mal1 plasmid cDNA clone
      was used to screen lambda phage cDNA libraries made from chemically induced
      papillomas and SCCs. Two size classes (655 and 933 nucleotides excluding the
      poly(A) tail) of full-length cDNAs were isolated. The corresponding mRNAs differ
      in their 3'-untranslated region by 278 nucleotides as a result of utilizing two
      alternative polyadenylation signals. Both transcripts were expressed
      simultaneously, showing the same expression patterns, with the smaller one being
      the predominant species. Most tissues examined showed a weak expression of mal1
      mRNA. High levels of mal1 transcripts could be detected in adipose and mammary
      tissues and tongue epithelia and predominantly in epidermis. The expression
      observed in epidermis was up-regulated dramatically during tumor formation.
      Computer-assisted sequence analysis revealed one open reading frame that encoded
      a protein of 135 amino acid residues with extensive homology to members of the
      lipid-binding protein family. Residues determining the proposed beta-clam
      structure of these proteins and the structure of the lipid-binding region were
      shown to be conserved in the mal1 gene. In vitro translation of mal1 RNA yielded
      a polypeptide of the predicted size of 15 kDa that was immunoprecipitable with an
      anti-rat liver fatty acid-binding protein antiserum. Based on the sequence
      analysis and antigenic properties of mal1, we conclude that it encodes a novel
      member of the lipid-binding protein family.

PMID- 8349620
TI  - Differential effect of brefeldin A on the biosynthesis of heparan sulfate and
      chondroitin/dermatan sulfate proteoglycans in rat ovarian granulosa cells in
      culture.
AB  - The subcellular localization of the enzymes involved in the glycosylation of
      proteoglycans was studied in rat ovarian granulosa cells by interfering with the
      normal traffic in the Golgi apparatus using brefeldin A. Cell cultures were
      metabolically labeled with [35S] sulfate and [3H]glucosamine, and the
      radiolabeled macromolecules were analyzed by ion-exchange and gel chromatography
      in combination with chondroitinase or heparitinase treatment. In the absence of
      brefeldin A, the cells synthesized both dermatan sulfate proteoglycans (DSPGs)
      and heparan sulfate proteoglycans (HSPGs) which were isolated from the culture
      medium, the plasma membrane, and intracellular compartments. However, in the
      presence of brefeldin A, the synthesized proteoglycans were almost exclusively
      HSPGs and were found only in the intracellular compartment. Analyses of HSPGs
      synthesized in the presence of brefeldin A indicated that: (i) the HS chains are
      synthesized on the same core protein as for the normal HSPGs, (ii) the chains are
      two to three times the normal molecular size; and (iii) a significant proportion
      of the HS chains are normally sulfated. Brefeldin A induces a disassembly of the
      proximal part of the Golgi complex, resulting in a redistribution of cis-, medial
      , and trans-Golgi resident enzymes back to the endoplasmic reticulum (ER), and
      blocks the transport of proteins to the trans-Golgi network. Our results indicate
      that the complete set of enzymes involved in the biosynthesis of HS chains are
      localized in the ER/proximal part of the Golgi complex, whereas the enzymes
      involved in the elongation/sulfation of DS chains are exclusively located in the
      trans-Golgi network. Furthermore, our results indicate that the enzymes involved
      in the biosynthesis of HS chains are specific to HS core proteins, since no DS
      core proteins were substituted with HS chains in the presence of brefeldin A.

PMID- 8349621
TI  - Expression of alternatively spliced epidermal growth factor-like domains in
      aggrecans of different species. Evidence for a novel module.
AB  - The carboxyl-terminal globular domain of human aggrecan has been shown previously
      to contain an alternatively spliced epidermal growth factor (EGF)-like module. We
      have used reverse transcription/polymerase chain reactions on cartilage-derived
      RNAs to investigate the heterogeneity in the EGF-like domain content of aggrecans
      from five species (mouse, rat, dog, bovine, and human). A novel alternatively
      spliced EGF-like module was detected in human aggrecan, establishing the presence
      of two of these domains. Highly homologous domains are present in aggrecans of
      other species, and the expression of these modules is identical (4-8%). They
      share significant homology with EGF-like domains of differentiation proteins and
      coagulation factors and have a putative calcium binding site. In contrast to this
      novel domain (EGF2), the previously described EGF-like module (EGF1) is expressed
      at a high level exclusively in human aggrecan. The expression of the two EGF-like
      domains in human aggrecan appears to be independent. Although the function of
      these domains is not understood, the uniform expression of the EGF2 domain may
      indicate a general role of this aggrecan module, while the expression of the EGF1
      domain may reflect species specificity.

PMID- 8349622
TI  - Specific nuclear protein binding to a negative regulatory element on the human
      CYP1A1 gene.
AB  - Employing reporter gene/CYP1A1 chimeric plasmids, we previously identified a 275
      base pair (bp) cis-element (-833 to -558; NRE275) that down-regulated the CYP1A1
      promoter. In the present study, this negative regulatory activity was further
      localized to two subfragments of 105 bp (-833 to -728; NRE105) and 170 bp (-728
      to -558; NRE170), each of which exhibited activity with a heterologous
      promoter/enhancer. Co-transfection studies demonstrated a dependence on cellular
      trans-acting factors present at limiting concentrations. Electrophoretic mobility
      shift assays revealed the presence of protein(s) that specifically bound to
      NRE275, NRE105, and NRE170. Based upon competition studies, the protein(s) that
      bound to NRE105 appeared to recognize sites similar to those recognized by the
      NRE170-binding proteins. DNase I footprint analysis of NRE105 demonstrated
      nuclear protein binding to a 21-bp palindrome (-794 to -774). Protection was also
      observed along conserved guanine/cytosine-rich sequences that flank the
      palindrome, but in a strand-specific manner. Guanine residues involved in protein
      binding were identified by methylation interference experiments. Based on
      transient expression assays with each of the three NRE105 components, all three
      appear to be necessary for complete negative regulatory activity. However, it is
      clear the palindrome is the most important sequence with the guanine/cytosine
      rich elements playing an ancillary role.

PMID- 8349624
TI  - Copurification of casein kinase II with 20 S proteasomes and phosphorylation of a
      30-kDa proteasome subunit.
AB  - The 20 S proteasome is a multicatalytic protease that has been implicated in
      several processes including ATP/ubiquitin-dependent proteolysis. However, the ATP
      requirement(s) related to proteasome function is undefined. We demonstrate that a
      protein kinase activity copurifies through multiple steps utilized to isolate
      latent 20 S proteasomes from human erythrocytes. The kinase phosphorylates serine
      residues within a single 30-kDa proteasome subunit. The activity is not sensitive
      to cyclic AMP or protein kinase inhibitor, indicating that it is not a cyclic AMP
      dependent kinase. It is sensitive to nanomolar levels of heparin and is able to
      utilize both ATP and GTP as phosphodonors, similar to casein kinase II activity.
      Moreover, a polyclonal antibody specific for casein kinase II recognizes the
      alpha' subunit of casein kinase II in the 20 S preparation and specifically
      immunoprecipitates the proteasome-phosphorylating activity. These characteristics
      suggest that the proteasome kinase is similar or identical to casein kinase II.
      It is suggested that phosphorylation of the 30-kDa proteasome subunit by casein
      kinase II may be involved in regulating the activity and/or assembly of
      proteasome complexes.

PMID- 8349623
TI  - Thromboxane A2 stimulates vascular smooth muscle hypertrophy by up-regulating the
      synthesis and release of endogenous basic fibroblast growth factor.
AB  - We have shown previously that thromboxane A2 stimulates hypertrophy of cultured
      rat aortic smooth muscle cells defined as protooncogene expression and protein
      synthesis without DNA synthesis or cellular proliferation (Dorn, G.W., II,
      Becker, M.W., Davis, M.G. (1992) J. Biol. Chem. 267, 24897-24905). Since
      endogenous growth modulators could possibly regulate vascular smooth muscle
      growth to this vasoconstrictor, we tested the hypothesis that thromboxane
      stimulated vascular smooth muscle hypertrophy was due to increased expression of
      endogenously produced basic fibroblast growth factor (bFGF). The thromboxane
      mimetic (15S)-hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5Z,13E-dienoic acid
      (U46619) (1 microM) increased cultured rat aorta derived smooth muscle cell
      immunoreactive bFGF content by 331 +/- 40% over untreated controls after 24 h. Co
      incubation of vascular smooth muscle cells with a specific antisense
      oligodeoxynucleotide (AS) against codon 60 of bFGF coding sequence reduced
      thromboxane-stimulated bFGF expression by 72 +/- 5% and prevented thromboxane
      stimulated hypertrophy (nonsense oligonucleotide had no effects). Addition of
      exogenous bFGF (20 ng/ml) restored growth to AS-treated/thromboxane-stimulated
      vascular smooth muscle cells. Furthermore, addition to the culture medium of
      neutralizing antibody against bFGF inhibited U46619-stimulated vascular smooth
      muscle hypertrophy by 69 +/- 17%, whereas nonimmune IgG had no effect. Since
      protein tyrosine phosphorylation is a cell signal associated with growth,
      thromboxane-stimulated tyrosine phosphorylation was also examined. Exposure to 1
      microM U46619 for 10 min increased vascular smooth muscle immunoreactive
      phosphotyrosine content of 130-144-, 86-, 80-, 75-, and 58-kDa proteins. The
      tyrosine kinase inhibitor herbimycin A (5 microM) prevented thromboxane
      stimulated tyrosine phosphorylation, but not thromboxane-stimulated hypertrophy,
      suggesting that tyrosine phosphorylation was not required for thromboxane
      stimulated vascular smooth muscle growth. These results indicate that increased
      expression and release of endogenous bFGF, but not direct tyrosine
      phosphorylation, mediates the hypertrophic vascular smooth muscle response to
      thromboxane.

PMID- 8349625
TI  - Preferential formation of C3b-IgG complexes in vitro and in vivo from nascent C3b
      and naturally occurring anti-band 3 antibodies.
AB  - Naturally occurring anti-band 3 antibodies appear to have tissue homeostatic
      functions in the clearance of senescent red cells and in eliciting selective
      phagocytosis of oxidatively stressed red cells by mediating C3b deposition under
      conditions that favor the alternative complement pathway (Lutz, H. U., Bussolino,
      F., Flepp, R., Fasler, S., Stammler, P., Kazatchkine, M. D., and Arese, P. (1987)
      Proc. Natl. Acad. Sci. U.S.A. 84, 7368-7372). They overcome the notoriously low
      affinities of naturally occurring antibodies by having affinity for C3 which
      renders these antibodies preferred targets of nascent C3b. Anti-band 3 antibodies
      preferentially formed covalently linked C3b-IgG complexes, when C3 was activated
      randomly by trypsin. IgG depleted of anti-band 3 antibodies had almost lost the
      ability to form C3b-IgG complexes. Likewise, anti-band 3 antibodies, but not anti
      spectrin antibodies, preferentially formed C3b-IgG complexes on oxidatively
      stressed red cells in the presence of a 10(3)-fold excess of other serum IgG,
      when complement deposition was initiated by antibody binding in diluted serum.
      Moreover, anti-band 3 antibodies preferentially formed C3b-IgG complexes at a
      10(5)-fold excess of other IgG on in vivo aging red cells, since C3b-IgG
      complexes from senescent red cells contained exclusively anti-band 3 antibodies
      with an affinity for C3. Thus, the low titer, low affinity naturally occurring
      antibody became functionally relevant by preferred generation of C3b-IgG
      complexes that can nucleate alternative complement pathway C3 convertases and
      represent the most effective opsonins (Fries, L. F., Siwik, S. A., Malbran, A.,
      and Frank, M. M. (1987) Immunology 62, 45-51).

PMID- 8349626
TI  - Adenovirus DNA polymerase is phosphorylated by a stably associated histone H1
      kinase.
AB  - Adenovirus DNA polymerase (AdPol) exists as a complex with the preterminal
      protein (pTP) and is essential for both initiation and elongation stages of viral
      DNA replication. Recent evidence from our laboratory indicates that AdPol is a
      phosphoprotein and that the major in vivo phosphorylation site, serine 67, occurs
      within the consensus substrate recognition sequence for cdc2 kinases. In this
      study, we found that a protein kinase which also exhibits histone H1
      phosphorylation activity is stably associated with AdPol. AdPol forms a
      multimeric complex with this histone H1 kinase and pTP in HeLa cells infected
      with adenovirus or coinfected with recombinant vaccinia viruses encoding AdPol
      and pTP. The associated protein kinase and the p34cdc2 kinase phosphorylate AdPol
      at the same sites which are utilized in vivo, suggesting that the p34cdc2 kinase
      or a related kinase may be involved in the in vivo phosphorylation of AdPol.
      Serine 67 is also one of the major in vitro phosphorylation sites, and the
      substitution of alanine for serine at this position abolishes DNA replication
      initiation activity of AdPol.

PMID- 8349627
TI  - The human S mu bp-2, a DNA-binding protein specific to the single-stranded
      guanine-rich sequence related to the immunoglobulin mu chain switch region.
AB  - We have cloned the cDNA encoding the human homologue of S mu bp-2, which binds to
      single-stranded DNA with 5'-phosphorylated guanine-rich sequences related to the
      immunoglobulin mu chain switch (S mu) region. The deduced amino acid sequences of
      the mouse and human S mu bp-2 are 76.5% homologous and contain motifs conserved
      among helicases. We have identified a domain essential for DNA binding at
      residues 638-786. The binding domain is less conserved (63% homologous) than the
      putative catalytic domain of N-terminal half containing most of the helicase
      motifs (85% homologous). The human and mouse S mu bp-2 have similar, although
      slightly different, binding specificities. Although the mouse S mu bp-2
      preferentially binds to the mouse S mu motif (GGGGT), the human S mu bp-2 binds
      equally well to the human (GGGCT) and mouse S mu motifs. The human S mu bp-2 gene
      was mapped to chromosome 11 q13.2-q13.4 by in situ hybridization.

PMID- 8349628
TI  - Cytokine regulation of low density lipoprotein receptor gene transcription in
      HepG2 cells.
AB  - Elevated plasma levels of cytokines have been demonstrated in inflammatory,
      malignant, and infectious diseases. These disease states are often associated
      with abnormal lipid metabolism and reductions in plasma cholesterol levels. To
      determine if inflammatory cytokines could influence hepatic lipid metabolism, we
      evaluated low density lipoprotein (LDL) receptor function and gene expression in
      cytokine stimulated HepG2 cells, a hepatoblastoma-derived cell line which shares
      many functional similarities with normal hepatocytes. Tumor necrosis factor-alpha
      (TNF) and interleukin-1 beta (IL-1) increased LDL binding to HepG2 cells in a
      dose-responsive manner. Other cytokines including macrophage-colony stimulating
      factor, granulocyte macrophage-colony stimulating factor, and gamma-interferon
      had no significant effects on LDL binding. Increased binding in response to TNF
      or IL-1 was paralleled by increased steady-state levels of LDL receptor mRNA.
      Evaluation of LDL receptor mRNA half-life revealed no significant change in mRNA
      stability between control and TNF- or IL-1-stimulated cells. A fusion gene
      construct consisting of 1563 base pairs of the 5'-flanking DNA of the human LDL
      receptor gene was coupled to a luciferase reporter gene, transfected into HepG2
      cells, and promoter activity was assayed after TNF and IL-1 challenge to the
      cells. TNF and IL-1 increased promoter activity 200-400%, while treatment with
      LDL inhibited promoter activity by 70-85%. TNF or IL-1 co-incubation with LDL
      could not override transcriptional inhibition by LDL. Pretreatment with
      cycloheximide prevented induction of LDL receptor mRNA by TNF, but not by IL-1,
      suggesting stimulation of LDL receptor transcription by TNF requires protein
      synthesis. We propose that TNF and IL-1, acting via distinct signal transduction
      pathways, increase surface LDL receptors by increasing gene transcription. Our
      findings suggest that cytokine-induced hypocholesterolemia may be related to TNF
      and/or IL-1 stimulation of hepatic LDL receptor gene expression and function.

PMID- 8349629
TI  - Single amino acid substitutions affecting the substrate specificity of the
      Escherichia coli K-12 nucleoside-specific Tsx channel.
AB  - The Tsx protein from the Escherichia coli outer membrane is a channel-forming
      protein containing a nucleoside-specific binding site. The antibiotic albicidin
      enters the cell via this substrate-specific channel. Because albicidin is toxic
      for E. coli at a very low external substrate concentration, the Tsx channel is
      likely to contain a binding site for this antibiotic. To identify residues
      involved in the Tsx substrate-specific channel activity, we devised a selection
      scheme to isolate albicidin-resistant tsx mutants synthesizing Tsx proteins with
      defects in their nucleoside uptake function. We recovered seven distinct
      albicidin-resistant tsx alleles, six point mutations and a 39-base pair
      duplication. The mutants with a duplication of residues 21-33 of Tsx or with
      single amino acid substitutions of residue Gly28 (to Arg) and Ser217 (to Arg) are
      completely deficient in nucleoside uptake at a low substrate concentration.
      Substitutions of Phe27 to Leu, Gly28 to Glu, Gly239 to Asp, and Gly240 to Asp
      result in a Tsx protein partially defective in nucleoside transport. These mutant
      proteins still permit nonspecific diffusion of serine indicating that the
      mutations do not result in a block of the Tsx channel. Our results are discussed
      in terms of a model for the topological organization of the Tsx protein within
      the outer membrane of E. coli.

PMID- 8349630
TI  - A peptide from ICAM-2 binds to the leukocyte integrin CD11a/CD18 and inhibits
      endothelial cell adhesion.
AB  - Numerous leukocyte functions depend on adhesive intercellular interactions. The
      leukocyte-specific integrins CD11a/CD18 (lymphocyte function-associated antigen-1
      (LFA-1)) and CD11b/CD18 (complement type 3 receptor (Mac-1)), which bind to the
      intercellular adhesion molecules ICAM-1 and ICAM-2, play a key role in adhesion.
      Little is known about the binding in molecular detail. We have now defined a
      peptide region from the first immunoglobulin domain of ICAM-2 that is
      specifically involved in binding to CD11a/CD18. A synthetic peptide from this
      part of ICAM-2, covering residues 21-42, bound to purified CD11a/CD18 and
      inhibited the adhesion of endothelial cells to this integrin. It also inhibited
      the binding of B lymphoblastoid cells to endothelial cells. Leukocytes bound to
      the peptide coated on plastic. Several shorter peptides from the same region
      showed less or no activity.

PMID- 8349631
TI  - Receptor accessory factor enhances specific DNA binding of androgen and
      glucocorticoid receptors.
AB  - Protein-protein interactions are common among transcriptional activators and may
      have important consequences for gene regulation. Using the mobility shift assay,
      we have identified a factor that enhances specific DNA binding of truncated rat
      androgen (AR) and glucocorticoid (GR) receptors by 25- and 6-fold, respectively,
      through the formation of heteromeric complexes. This factor, designated receptor
      accessory factor, or RAF, also potentiates DNA binding of full-length human GR.
      RAF is temperature and trypsin sensitive and is present in a variety of cultured
      mammalian cells. By gel filtration RAF has a predicted molecular mass of 130 kDa.
      RAF enhancement of AR-DNA binding is optimal with androgen response element DNA.
      RAF appears to interact directly with AR because 1) deoxycholate, which
      interferes with protein-protein but not protein-DNA interactions, prevents
      RAF.AR.DNA complex formation, 2) RAF activity is recovered from an androgen
      response element DNA affinity column only in the presence of AR, and 3) RAF
      increases the size of an AR.DNA complex by gel filtration. Mutagenesis of
      truncated AR fragments indicates that a region in the NH2-terminal domain is
      required for RAF to enhance AR-DNA binding. The interaction of RAF with AR and GR
      suggests that RAF might influence the ability of these nuclear receptors to
      activate transcription.

PMID- 8349632
TI  - Characterization of two allelic variants of a human pregnancy-specific
      glycoprotein gene.
AB  - The pregnancy-specific glycoproteins (PSGs) of the human placenta are a group of
      proteins that together with the carcinoembryonic antigens comprise a subfamily
      within the immunoglobulin superfamily. To study the control of PSG expression, we
      isolated and characterized PSG genes and identified cis-acting DNA elements in
      the 5'-flanking gene regions essential for PSG expression. Two overlapping PSG
      cosmid clones, which contain two allelic variants of a PSG gene (PSG12 and PSG12
      psi), were isolated from an unamplified library made from a single individual.
      Cosmid 1 contains exons 1 (5'/L) and 2 (L/N) of the PSG12 gene located downstream
      of a previously identified PSG1-I gene. Cosmid 6 contains a portion of the PSG1-I
      gene lacking exons 1 and 2 upstream of a complete PSG12 psi transcription unit.
      Sequence comparison indicates that exons 5'/L and L/N in PSG12 and PSG12 psi are
      99% identical, except that the L/N exon in the PSG12 psi gene contains a stop
      codon. Both PSG12 and PSG12 psi transcripts were detected in the human placenta,
      indicating that both genes are actively transcribed. However, the PSG12 psi gene
      may represent an allelic pseudogene variant of the PSG12 gene, because all
      identified PSGs contain a functional N-domain. Primer extension analysis showed
      that the PSG12 gene starts at a cluster of sites located at -106 to -104 base
      pairs with respect to the translation start site. In transient transfection
      assays using a chloramphenicol acetyltransferase reporter gene, we demonstrated
      that the -835 to -34 DNA region upstream of the translation start site of PSG12
      or PSG12 psi contained both positive and negative elements that control PSG
      expression. Deletion analysis showed that nucleotides -172 to -34 in the PSG12
      gene could function as a promoter. Gel retardation analysis showed that protein
      factors in human placental cell extract formed four complexes (I, II, IIa, and
      III) with the PSG12(-172/-34) DNA. Site-directed mutagenesis that prevents
      protein factor binding to the PSG12 promoter resulted in a marked reduction in
      transcription activation, locating the core enhancers at nucleotides -148 to -141
      and -60 to -55. Mutagenesis studies also showed that the ACAGC repeats at
      nucleotides -84 to -68 in the PSG12 5'-flanking are essential for expression of
      the PSG12 gene in human placental cells.

PMID- 8349633
TI  - Conserved cysteine residues are critical for the enzymatic function of the
      lymphocyte-specific tyrosine protein kinase p56lck.
AB  - We have evaluated the possibility that conserved cysteine residues are critical
      for the enzymatic function of p56lck. Through oligonucleotide-directed
      mutagenesis, 5 Lck residues (cysteines 217, 224, 378, 464, and 475) were
      individually mutated to alanines, and the effects of these substitutions were
      tested in various in vitro and in vivo assays. We found that mutation of either
      of 2 cysteines located in the carboxyl portion of the kinase domain (cysteines
      464 and 475) abolished the catalytic function of Lck. In addition, it was noted
      that alteration of cysteine 475 resulted in a dramatic reduction of the half-life
      of p56lck. These cysteine residues are highly conserved throughout the tyrosine
      protein kinase family, suggesting that they may play important functions in
      catalysis and/or substrate recognition.

PMID- 8349635
TI  - Identification of the phosphorylated region responsible for the permissive
      activation of protein kinase C.
AB  - Protein kinase C (PKC) appears to require phosphorylation in order to function as
      an effector-dependent kinase (Pears, C., Stabel, S., Cazaubon, S., and Parker, P.
      J. (1992) Biochem. J. 283, 515-518). By site-directed mutagenesis of the PKC
      alpha cDNA, it has been shown that a region including 3 threonine residues (Thr
      494, Thr-495, and Thr-497), present in the catalytic domain, is involved in
      controlling PKC activity. Substitution of these 3 threonine residues by alanine
      residues leads to the expression, in COS-1 cells, of an unphosphorylated protein
      with an apparent molecular mass of 76 kDa, similar to that determined for the
      primary translation product. The biochemical characterization of this PKC alpha
      mutant reveals that it is a functional phorbol ester-binding protein but retains
      no kinase activity. Coexpression of this PKC alpha mutant and wild type PKC beta
      demonstrates that the mutant has a dominant effect upon PKC beta phosphorylation.
      The location of this region and its phosphorylation in relation to PKC function
      are discussed.

PMID- 8349634
TI  - Identification of TFIID components required for transcriptional activation by
      upstream stimulatory factor.
AB  - A TATA box-binding initiation factor, TFIID, plays a central role in the
      transcriptional regulation by activators. Using anti-TFIID tau (a TATA box
      binding component of native TFIID) immunoaffinity chromatography, nine
      polypeptides (230, 110, 85, 62, 58, 42, 28, 22, and 21 kDa) were identified as
      native Drosophila TFIID components that are tightly associated with TFIID tau. To
      verify the functional activity of the purified TFIID complex, template DNA and
      other transcription factors were reconstituted with purified TFIID bound to the
      antibody-Sepharose matrix. Immobilized TFIID mediated not only basal
      transcription but transcriptional activation by upstream stimulatory factor
      (USF). On the other hand, recombinant TFIID tau immobilized on the same antibody
      Sepharose matrix could not mediate activation by USF. These results suggest that
      one or more of these additional polypeptides are required as functional TFIID
      subunits for activator-dependent transcription in conjunction with TFIID tau. As
      further evidence of the relevance of the Drosophila TFIID components identified
      in this analysis, including the previously unrecognized p230 (Dynlacht, B. D.,
      Hoey, T., and Tjian, R. (1991) Cell 66, 563-576), protein blot analysis showed
      that TFIID tau interacts specifically and exclusively with p230. This suggests
      that p230 is an integral subunit of TFIID and that it may play a major role in
      tethering other subunits to TFIID tau.

PMID- 8349636
TI  - Mechanism of site-specific recombination. Logic of assembling recombinase
      catalytic site from fractional active sites.
AB  - The active nucleophilic species in the strand cleavage and strand exchange steps
      of site-specific recombination by the Flp protein are the active site tyrosine
      (Tyr-343) of Flp and the 5'-hydroxyl of Flp-nicked DNA, respectively. The target
      phosphodiester, activated by Flp, can be cleaved by an exogenous nucleophile
      derived, for example, from H2O2. Flp variants that are defective in the phosphate
      activation step and cannot sustain Tyr-343-mediated cleavage also fail to elicit
      H2O2-mediated cleavage. An Flp mutant lacking Tyr-343, (Flp(Y343F)), can carry
      out both the strand cleavage and strand exchange reactions in the presence of a
      age and strand exchange reactions in the presence of a tyrosine analog. These
      results are consistent with a cis-activation/trans-nucleophilic attack paradigm
      for strand breakage and strand union. The proposed model conceptually unifies the
      chemistry and enzymology of the two partial reactions of recombination. The
      mechanism of Flp action has strong implications for phosphoryl transfer reactions
      in other site-specific DNA recombination systems and in RNA splicing.

PMID- 8349638
TI  - Heterogeneity of recombinant human antithrombin III expressed in baby hamster
      kidney cells. Effect of glycosylation differences on heparin binding and
      structure.
AB  - To determine the effects of differences in glycosylation on the structure and
      functional properties of recombinant human antithrombin (rHAT), we have
      characterized the properties of the recombinant protein overexpressed by baby
      hamster kidney cells. Three forms of rHAT, I-III, were isolated which differed in
      affinity for heparin. Form I had the lowest affinity and contained a high
      proportion of highly branched complex carbohydrate. Form II had higher affinity
      and contained both complex and high mannose-type chains. Form III had the highest
      affinity and was similar to form II in the type of carbohydrate present, but had
      a lower level of glycosylation, consistent with the absence of carbohydrate at
      one of the four glycosylation sites. 1H NMR spectra of plasma HAT and rHAT forms
      I-III suggested very similar protein structures for all forms. Heparin
      pentasaccharide produced almost identical NMR perturbation difference spectra.
      The only functional difference found was in the rates of inactivation of factor
      Xa. Forms II and III gave second order rate constants similar to that of plasma
      HAT, whereas form I gave a biphasic inhibition, with the first phase having a
      rate about four times that of the other forms. We conclude that carbohydrate
      heterogeneity does not alter the structure of the HAT polypeptide or the heparin
      induced conformational change, but does affect the heparin affinity and can alter
      the rate of proteinase inhibition.

PMID- 8349637
TI  - RecA binding to bulge- and mismatch-containing DNAs. Certain single base
      mismatches provide strong signals for RecA binding equal to multiple base bulges.
AB  - Studies from several laboratories have demonstrated that RecA protein can
      recognize a variety of perturbations in the DNA helix. Here, using a
      nitrocellulose filter binding assay, it was observed that RecA bound to bulge
      containing DNAs more effectively than non-bulged DNA. The degree of binding of
      RecA protein to bulged DNA was dependent on the conformation of the bulged bases
      and the kinking angles produced by the bulges as determined by the type and
      number of bases in the bulge. Although a single base mismatch does not kink DNA,
      RecA protein showed preferential binding to DNAs containing certain single base
      mismatches. An A.C mismatch flanked by A.T base pairs in a 28-base pair (bp) DNA
      facilitated the binding of RecA protein to the same high level as when the 28-bp
      DNA contained a 4-base cytosine bulge. Chemical probing techniques were used to
      examine the structure of DNA within the RecA filament. It was found that upon
      binding of RecA protein, the DNA helix becomes accessible over at least 14 bp,
      and the degree of sensitivity agrees with the binding efficiency of RecA protein.

PMID- 8349640
TI  - Lysine 84 is at the subunit interface of lac repressor protein.
AB  - Mutations have been generated at the Lys84 site of the lac repressor to explore
      its predicted role in inducer binding and/or subunit interaction. Four single
      mutations, Lys84-->Ala, Lys84-->Leu, Lys84-->Arg, and Lys84-->Glu, have been
      generated by site-specific mutagenesis. In addition, the mutation Tyr282-->Asp,
      which results in a monomeric repressor, has been coupled with these four single
      mutants to generate the four corresponding double mutants. Unchanged inducer
      binding affinities in all Lys84 mutants except Lys84-->Arg suggest that Lys84
      does not contribute energy to inducer binding and is not found in the inducer
      binding site as previously proposed (Sams, C. F., Vyas, N. K., Quiocho, F. A.,
      and Matthews, K. S. (1984) Nature 310, 429-430). Interestingly, the double
      mutants with hydrophobic side chains at the Lys84 site are tetramers, while those
      with charged side chains remain monomers. This result agrees with the recent
      model of the lac repressor (Nichols, J. C., Vyas, N. K., Quiocho, F. A., and
      Matthews, K. S. (1993) J. Biol. Chem. 268, 17602-17612), in which Lys84 is mapped
      by sequence alignment to the same face of the subunit as Tyr282. More detailed
      inducer binding, operator binding, and immunoblotting studies show that all the
      mutations at Lys84 have quaternary structures that deviate from wild-type
      protein, providing supportive evidence for the model placing this residue on the
      surface of the monomer subunit. Substitution of Lys84 by Ala or Leu results in
      100-200-fold decreased association and dissociation rate constants for inducer
      binding and biphasic character. This decrease can be rescued at least partially
      in the respective double mutants at elevated pH, at which wild-type repressor
      shows a 10-fold decrease in affinity and cooperativity in inducer binding. In all
      substitutions with Ala or Leu, immunoblotting patterns with monoclonal antibody,
      an assay sensitive to alterations in quaternary structure, are distinct from wild
      type repressor. Although substitution with Arg at position 84 yields a protein
      with 10-fold lower inducer binding affinity, the mutant shows decreased pH
      dependence of inducer binding. Substitution at this site with Glu results in
      cooperativity at neutral pH with no change in inducer binding at elevated pH. In
      addition, operator binding affinity of this mutant is affected by elevated pH, a
      phenomenon not observed in wild-type repressor. These changes in inducer and
      operator binding properties appear to be related to the altered quaternary
      structure of these mutants at Lys84.

PMID- 8349639
TI  - Model of lactose repressor core based on alignment with sugar-binding proteins is
      concordant with genetic and chemical data.
AB  - Using primary sequence similarity to arabinose-binding protein, D-glucose/D
      galactose-binding protein, and ribose-binding protein (Vyas, N. K., Vyas, M. N.,
      and Quiocho, F. A. (1991) J. Biol. Chem. 266, 5226-5237; Mowbray, S. L., and
      Cole, L. B. (1992) J. Mol. Biol. 225, 155-175), the core domain (residues 62-323)
      of the bacterial regulatory protein lac repressor has been aligned to these sugar
      binding proteins of known structure. Although the sequence identity is not
      striking, there is strong overall homology based on two separate matrix scoring
      systems (minimum base change per codon (MBC/C) and amino acid homology per
      residue (AAH/R)) (mean score: MBC/C < 1.25, AAH/R > 5.50; random sequences: MBC/C
      = 1.45, AAH/R = 4.46). Similarly, the predicted secondary structure of the
      repressor exhibits excellent agreement with the known secondary structures of the
      sugar-binding proteins. Using this primary sequence alignment, the tertiary
      structure of the core domain of the lac repressor has been modeled based on the
      known structures of the sugar-binding proteins as templates. While the structure
      deduced for the repressor is hypothetical, the model generated allows a
      comparison between the predicted tertiary arrangement and the wealth of genetic
      and chemical data elucidated for the repressor. Important residues involved in
      operator and sugar binding and in protein assembly have been identified using
      genetic methods, and placement of these residues in the model is consistent with
      their known function. This approach, therefore, provides a means to visualize the
      core domain of the lac repressor that allows interpretation of genetic and
      chemical data for specific residues and rational design of future experiments.

PMID- 8349641
TI  - Isolation and characterization of a cDNA encoding rat liver cytosolic epoxide
      hydrolase and its functional expression in Escherichia coli.
AB  - A cDNA of 1992 base pairs encoding the complete rat liver cytosolic epoxide
      hydrolase has been isolated using a polymerase chain reaction-derived DNA
      fragment (Arand, M., Knehr, M., Thomas, H., Zeller, H. D., and Oesch, F. (1991)
      FEBS Lett. 294, 19-22) known to represent the 3'-end of the cytosolic epoxide
      hydrolase mRNA. Sequence analysis revealed an open reading frame of 1662
      nucleotides corresponding to 554 amino acids (M(r) = 62,268). The DNA sequence
      obtained did not display significant homology to the sequences of microsomal
      epoxide hydrolase or leukotriene A4 hydrolase or to any other DNA included in the
      EMBL Data Bank (release 32). On Northern blotting of rat liver RNA, a single mRNA
      species was detected that was strongly induced on treatment of the animal with
      fenofibrate, a potent peroxisome proliferator. The most significant structure of
      the deduced protein is a modified peroxisomal targeting signal (Ser-Lys-Ile) at
      the carboxyl terminus that is regarded to be responsible for the unusual dual
      localization of the cytosolic epoxide hydrolase in peroxisomes as well as in the
      cytosol. In addition, a leucine zipper-like motif was identified at the amino
      terminus. Its possible implication for the observed dimeric structure of
      cytosolic epoxide hydrolase is discussed. The isolated cDNA was expressed in
      bacteria to yield a catalytically active enzyme. Specific activity of the crude
      lysate obtained exceeded that of rat liver cytosols from maximally induced
      animals by a factor of 8.

PMID- 8349642
TI  - Molecular cloning and expression of murine liver soluble epoxide hydrolase.
AB  - A clofibrate-induced mouse liver cDNA library was prepared and used to isolate
      the coding sequence for soluble epoxide hydrolase. A 1668-base pair (bp) clone
      was isolated and found to contain a 1269-bp open reading frame coding for 423
      amino acids. Subsequent RNA polymerase chain reaction resulted in the isolation
      of 396 bp of additional 5'-sequence. Translation of the resulting 1659-bp open
      reading frame produced a 553-residue protein (62,527 Da) containing deduced
      peptide segments that matched the amino acid sequences of six peptide fragments
      isolated previously from CNBr digests of pure murine soluble epoxide hydrolase.
      Neither the DNA nor the protein sequence showed significant similarity to other
      currently published sequences. Structural analysis of the soluble epoxide
      hydrolase coding region suggested at least one potential regulatory motif.
      Expression of the composite cDNA in COS-7 cells resulted in a 5-10-fold increase
      in soluble epoxide hydrolase activity and a similar increase in soluble epoxide
      hydrolase protein amount compared to mock-transfected or vector control
      transfected cells. Treatment of C57BL/6J mice with clofibrate led to an
      approximately 4-fold increase in both soluble epoxide hydrolase enzyme activity
      and steady-state mRNA levels.

PMID- 8349643
TI  - Isolation and characterization of LIP5. A lipoate biosynthetic locus of
      Saccharomyces cerevisiae.
AB  - A number of mutants with pleiotropic effects on mitochondrial metabolism have
      been isolated in yeast Saccharomyces cerevisiae, and for many the biochemical
      function that is impaired is not yet known. We report here the isolation and
      characterization of the LIP5 gene involved in lipoic acid metabolism which
      complements the g189 mutant (Tzagoloff, A., and Dieckmann, C. L. (1990)
      Microbiol. Rev. 54, 211-225). DNA sequence analysis of complementing yeast
      genomic DNA revealed an open reading frame predicting a protein of 414 amino
      acids. The protein sequence deduced from the gene shares 43% identical residues
      with the product of the Escherichia coli lip gene, which codes an enzyme involved
      in lipoic acid synthesis. The LIP5 mutant is not capable of synthesizing lipoic
      acid but still possesses the activity necessary for attachment of lipoic acid to
      protein. Relative to the E. coli lip gene product, the LIP5 protein has an amino
      terminal extension with characteristics of mitochondrial targeting signals. Cells
      carrying a disrupted copy of the LIP5 gene show slow growth on ethanol-rich media
      and barely detectable growth on glycerol-rich media. Unlike other strains with
      defects in the tricarboxylic acid cycle, LIP5 mutants undergo a high frequency of
      mitochondrial DNA deletions.

PMID- 8349644
TI  - Separation of splicing factor SF3 into two components and purification of SF3a
      activity.
AB  - Components required for the splicing of nuclear messenger RNA precursors in vitro
      have been isolated from HeLa cells. Here we describe the separation of splicing
      factor SF3 into two components, SF3a and SF3b. Both activities are required
      together with several other protein factors and U1 and U2 small nuclear
      ribonucleoproteins for the assembly of a presplicing complex which represents the
      first ATP-dependent step in the assembly of the active spliceosome. SF3a has been
      purified to homogeneity by a combination of ion-exchange chromatography, gel
      filtration, and glycerol gradient sedimentation. It consists of a complex of
      three polypeptides of 60, 66, and 120 kDa. The association of SF3a activity with
      these polypeptides has been confirmed by immunoprecipitation and depletion
      experiments using a monoclonal antibody directed against the 66-kDa subunit.

PMID- 8349645
TI  - Cloning and expression of PTP-PEST. A novel, human, nontransmembrane protein
      tyrosine phosphatase.

PMID- 8349646
TI  - Modification of a free Fe-S cluster cysteine residue in the active iron
      responsive element-binding protein prevents RNA binding.
AB  - The iron-responsive element-binding protein (IRE-BP) binds to specific RNA stem
      loop structures called iron-responsive elements (IREs), which mediate the post
      transcriptional regulation of a variety of genes involved in iron metabolism. The
      IRE-BP is cytosolic aconitase, and a [4Fe-4S] cubane cluster is required for
      aconitase activity but is associated with loss of IRE binding affinity. Chemical
      modification of the IRE-BP can abrogate RNA binding and the 3 cysteines predicted
      to coordinate the Fe-S cluster in the IRE-BP could be targets for modification.
      We report the expression of recombinant IRE-BP in which the three putative
      cluster cysteines (Cys-437, Cys-503, and Cys-506) have been mutated to serine
      residues. Replacement of any or all of these cysteine residues results in a
      complete loss of aconitase activity. While all of the mutants bind RNA,
      substitution of Cys-437 specifically renders the IRE-BP resistant to inactivation
      by low concentrations of N-ethylmaleimide or diamide. These results identify Cys
      437 as the target of in vitro regulation of RNA binding in the IRE-BP and suggest
      that, in the RNA-binding form of the protein, Cys-437 is free and therefore
      available for modifications that inhibit RNA binding.

PMID- 8349647
TI  - Targeting of histone tails by poly(ADP-ribose).
AB  - After Zn2+ finger-mediated binding to a DNA break, poly(ADP-ribose) polymerase
      becomes automodified with long polymers of ADP-ribose. These nucleic acid-like
      polymers may facilitate DNA repair by noncovalently interacting with neighboring
      proteins. Using a novel screening technique, we have identified histones as the
      predominant poly(ADP-ribose)-binding species in human keratinocytes, rat
      hepatocytes, frog eggs, and yeast. Polymer binding is confined specifically to
      the histone domains responsible for DNA condensation, i.e. histone tails. Our
      results indicate that polymers of ADP-ribose are targeted to sites of DNA strand
      breaks by poly(ADP-ribose) polymerase and subsequently function to alter
      chromatin conformation through noncovalent interactions with histone tails.

PMID- 8349648
TI  - Expression, characterization, and crystallization of oxygen-avid Ascaris
      hemoglobin domains.
AB  - The Ascaris perienteric hemoglobin is 10(4) times more oxygen-avid than mammalian
      hemoglobins. Inspection of its primary structure fails to explain this
      extraordinary association with oxygen. The Ascaris hemoglobin gene encodes a 40
      kDa, two-domain globin; the two domains (D1 and D2) are 63% identical, and each
      is capable of binding a single heme. The native protein is an octamer. At the end
      of D2 is a highly charged carboxyl-terminal extension containing four direct
      repeats of HKEE. We have expressed the two domains separately in E. coli. Both
      individual domains are extremely oxygen-avid. D2, with attached COOH-terminal
      tail, is capable of multimerization, whereas D1 remains a monomer. Recombinant D1
      readily forms diffractable, red, prismatic crystals. We conclude that: 1) the
      basis of the hemoglobin's oxygen avidity rests in an isolated heme pocket and
      does not involve inter-domain interactions and 2) multimerization is mediated
      through sequences in the second domain, most probably via the charged COOH
      terminal tail.

PMID- 8349649
TI  - Activation of recombinant murine cytotoxic cell proteinase-1 requires deletion of
      an amino-terminal dipeptide.
AB  - Murine cytotoxic cell proteinase-1 (granzyme B) is a member of a family of novel
      serine proteinases that have been implicated to participate in destruction of
      target cells by cytotoxic T lymphocytes. Comparison of the sequence of the cDNA
      with the sequence of the protein isolated from cytoplasmic granules of cytotoxic
      T lymphocytes suggested that this protein may be synthesized as a preproenzyme
      containing an amino-terminal activation dipeptide. Here we show that this
      activation dipeptide regulates the activity of the enzyme in hydrolysis of its
      preferred substrate tert-butyloxycarbonyl-Ala-Ala-Asp-thiobenzyl ester. Lysates
      of COS cells transfected with a vector expressing the unmodified cytotoxic cell
      proteinase-1 cDNA were unable to hydrolyze this substrate, whereas lysates of
      cells transfected with a construct in which the activation dipeptide codons has
      been deleted were able to hydrolyze the substrate. In each case Western blotting
      of the lysates revealed a form of the proteinase with an apparent molecular
      weight of 27,000. We conclude that the activation dipeptide regulates activity of
      the enzyme. This is the first report of production of an enzymatically active
      recombinant cytotoxic T cell serine proteinase. The strategy for successful
      expression of an activated form of cytotoxic cell proteinase-1 may be applicable
      to other members of this proteinase family.

PMID- 8349650
TI  - Kappa B site-dependent induction of gene expression by diverse inducers of
      nuclear factor kappa B requires Raf-1.
AB  - The transcription factor nuclear factor kappa B (NF-kappa B) is sequestered in
      the cytoplasm of most cell types where it is complexed with its inhibitor (I
      kappa B). A large variety of agents, including growth factors, the tumor promoter
      phorbol 12-myristate 13-acetate, and the cytokine tumor necrosis factor alpha,
      initiate signal transduction pathways that converge upon the NF-kappa B-I kappa B
      complex, resulting in the dissociation of I kappa B and the translocation of NF
      kappa B to the nucleus. It has been demonstrated that the phosphorylation of I
      kappa B is associated with NF-kappa B activation, although the kinase(s)
      responsible for this process in vivo remain unknown. Here we demonstrate that
      expression of activated forms of the GTP-binding protein Ras or of the
      serine/threonine kinase Raf-1 results in the activation of transcription
      specifically through kappa B sites. This activation appears to be dependent on NF
      kappa B, since co-expression of I kappa B alpha eliminates both Ras- and Raf-1
      induced transcription. In addition, through the use of a dominant negative form
      of Raf-1, we show that Raf-1 is a common component utilized by multiple inducers
      in kappa B site-driven gene expression. These results illuminate a signal
      transduction pathway in which NF-kappa B/Rel family members participate and also
      implicate a pathway responsible for kappa B site-dependent gene expression during
      cell growth and in immune and inflammatory responses.

PMID- 8349651
TI  - Intramolecular electron transfer rate between active-site copper and topa quinone
      in pea seedling amine oxidase.
AB  - The equilibrium between the two substrate-reduced forms of pea seedling amine
      oxidase, one containing Cu(II) and reduced 3-(2,4,5-trihydroxyphenyl)-L-alanine
      (topa) cofactor and one containing Cu(I) and topa semi-quinone, was investigated
      by visible spectroscopy as a function of temperature. To determine the rate of
      interconversion between the two species, temperature jump relaxation studies were
      performed on the substrate-reduced enzyme near room temperature. The yellow
      radical species was found to approach its equilibrium concentration with a
      maximum rate constant of 43,000 +/- 3,000 s-1. This rapid equilibration is
      attributed to intramolecular electron transfer between copper and topa. The data
      indicate that the Cu(I)/topaSQ species is a kinetically competent intermediate in
      the reaction of amine oxidases with substrates. Furthermore, the extremely rapid
      electron transfer rate (kET congruent to 20,000 s-1) suggests that the topa
      cofactor is in close proximity to the copper atom.

PMID- 8349652
TI  - Phosphorylase kinase, a metal ion-dependent dual specificity kinase.
AB  - Phosphorylase kinase is shown to be a dual specificity kinase. The specificity of
      phosphorylation is determined by divalent cation. Mg2+ causes seryl
      phosphorylation of phosphorylase b, but Mn2+ activates tyrosine phosphorylation
      of angiotensin II. In contrast to seryl phosphorylation, the tyrosine kinase
      activity of holoenzyme is not regulated by Ca2+. Preincubation of the holoenzyme
      with Ca2+, Mg2+ and ATP that causes autophosphorylation activates tyrosine kinase
      activity. The tyrosyl kinase activity is a property of the gamma subunit.
      Addition of varying amounts of Mn2+ to a truncated form of the gamma subunit of
      phosphorylase kinase containing MgATP inhibits serine kinase but activates
      tyrosine kinase activity. This result along with an oxidative reaction caused by
      Cu2+ and site-directed mutagenesis of the putative catalytic base inhibiting both
      serine and tyrosine kinase activity suggest that one active site is involved in
      both activities. Kinetic studies with Mn2+ and ATP show that Km for nucleotide is
      not changed with a seryl or tyrosyl substrate. The Vm values are different, and
      the value for tyrosyl phosphorylation is similar to other tyrosyl kinases. We
      propose two conformations for the active site; one favors seryl phosphorylation,
      and the second tyrosyl phosphorylation is caused by the binding of divalent
      cation at a second metal ion binding site.

PMID- 8349653
TI  - Role reversal for substrates and inhibitors. Slow inactivation of D-amino acid
      transaminase by its normal substrates and protection by inhibitors.
AB  - D-Amino acid transaminase, which catalyzes the synthesis of D-alanine and D
      glutamate for the bacterial cell wall, is a candidate for the design of specific
      inhibitors that could be novel antimicrobial agents. Under the experimental
      conditions usually employed for enzyme assays, kinetic parameters for its
      substrates were determined for short incubation periods, when intermediates and
      products do not accumulate and the enzyme activity is linear with time. Such
      kinetic analyses indicate that the enzyme accepts most D-amino acids but D
      aspartate and D-glutamate are the best substrates. Under a different type of
      experimental conditions when the enzyme is exposed to D-alanine, intermediates,
      and products for periods of hours, it slowly becomes inactivated (Martinez del
      Pozo, A., Yoshimura, T., Bhatia, M. B., Futaki, S., and Manning, J. M. (1992)
      Biochemistry 31, 6018-6023). We now report that D-aspartate, D-glutamate, and L
      alanine also lead to slow inactivation. Methylation or amidation of the alpha
      COOH group of D-alanine prevents inactivation, indicating that decarboxylation is
      required for inactivation; the slow release of CO2 from substrate is
      demonstrated. The alpha-methyl analog of D-alanine, D-aspartate, and D-glutamate
      do not lead to inactivation, showing that the alpha-hydrogen of the substrate is
      required, i.e. that some processing is required. Lys145, which binds pyridoxal 5'
      phosphate in the wild-type enzyme, is not involved in the inactivation since two
      active site mutant enzymes, K145Q and K145N, are also inactivated. Reactivation
      of the inactive enzyme at acidic pH is accompanied by the release of ammonia
      corresponding to 1 mol/mol of dimeric enzyme. Competitive inhibitors, amine
      containing buffers, and thiols effectively impede the inactivation. This reversal
      in the roles of substrates and inhibitors, i.e. when a substrate can be an
      inactivator and an inhibitor can act as a protector, occurs during a time period
      not usually used to measure steady-state kinetics or initial velocities of enzyme
      reactions and could have physiological relevance in cells.

PMID- 8349654
TI  - Deamidation of HPr, a phosphocarrier protein of the phosphoenolpyruvate:sugar
      phosphotransferase system, involves asparagine 38 (HPr-1) and asparagine 12 (HPr
      2) in isoaspartyl acid formation.
AB  - Histidine-containing protein, HPr, of the phosphoenolpyruvate:sugar
      phosphotransferase system in Escherichia coli, when incubated at elevated
      temperatures forms many species of protein. The two major species are HPr-1 and
      HPr-2, which have been shown to lack one or two amides, respectively (Anderson,
      B., Weigel, N., Kundig, W., and Roseman, S. (1971) J. Biol. Chem. 246, 7023
      7033). The formation of HPr-1 and HPr-2 is shown to be pH-dependent and does not
      occur readily below pH 6. Investigation of the identities and properties of the
      two residues that deamidate involved creation of site-directed mutants at the 6
      glutamine and 2 asparagine residues of HPr; description of their deamidation
      species by isoelectric focusing; determination of their relative antibody binding
      properties; assay of their phosphoacceptor and phosphodonor activities;
      characterization of tryptic and V8-protease peptides; obtaining two-dimensional
      nuclear magnetic resonance spectra of HPr, HPr-1, and several mutants. It was
      determined that the sequential deamidation of Asn-38 and Asn-12 yields HPr-1 and
      HPr-2. Both residues exist as Asn-Gly pairs, and both deamidations probably form
      isoaspartyl acid. HPr from Bacillus subtilis and Staphylococcus carnosus which
      also have Asn-Gly at residues 38 and 39 form HPr-1 species presumably by
      deamidation. HPr from Streptococcus faecalis which does not have Asn-38 does not
      form a HPr-1 species. The E. coli mutant HPrs, N12D and Q51E, residues that may
      be involved in the active site, had impaired phosphohydrolysis properties and
      decreased phosphoenolpyruvate:sugar phosphotransferase system activity.

PMID- 8349655
TI  - Primary structure of alpha-tocopherol transfer protein from rat liver. Homology
      with cellular retinaldehyde-binding protein.
AB  - alpha-Tocopherol transfer protein (alpha TTP) present in rat liver cytosol
      specifically binds this vitamin and enhances its transfer between separate
      membranes. We previously reported purification of alpha TTP and showed that two
      isoforms exist in rat liver, of which the isoelectric points are 5.0 and 5.1,
      respectively (Sato, Y., Hagiwara, K., Arai, H., and Inoue, K. (1991) FEBS Lett.
      288, 41-45). In the present paper, we have isolated a cDNA clone with 2194 base
      pairs encoding alpha TTP from a rat liver cDNA library. The amino acid sequence
      deduced from the cDNA contained all the sequences of the peptide fragments
      obtained by digestion of the purified protein with endoproteinase Lys-C. The
      isolated cDNA was found to encode the isoform with a pI of 5.0 on the basis of
      the cross-reactivity of the recombinant protein expressed in Escherichia coli
      with the isoform-specific monoclonal antibody. From the longest open reading
      frame of the cloned cDNA, one isoform of rat liver alpha TTP is predicted to be
      composed of 278 amino acid residues of calculated molecular weight 31,845. Both
      Western and Northern blot analyses revealed that alpha TTP is expressed
      exclusively in the liver in rats. alpha TTP has been found to exhibit a
      structural homology with the cellular retinaldehyde-binding protein present only
      in visual tissues.

PMID- 8349656
TI  - Effect of microbial and mite proteases on low and high molecular weight
      kininogens. Generation of kinin and inactivation of thiol protease inhibitory
      activity.
AB  - Kinin release from guinea pig plasma high molecular weight kininogen (HMWK)
      induced by various microbial and mite proteases has been demonstrated previously
      (Molla, A., Yamamoto, T., Akaike, T., Miyoshi, S., and Maeda, H. (1989) J. Biol.
      Chem. 264, 10589-10594; Maruo, K., Akaike, T., Matsumura, Y., Kohmoto, S., Inada,
      Y., Ono, T., Arao, T., and Maeda, H. (1991) Biochim. Biophys. Acta 1074, 62-68).
      In this paper, we describe the effects of various microbial and mite proteases on
      low molecular weight kininogen (LMWK) and HMWK from human plasma. A protease from
      the house dust mite Dermatophagoides farinae (Df-protease) directly liberated
      kinin from both LMWK and HMWK to a significant degree. The Km, kcat, and kcat/Km
      values for kinin generation from LMWK were 3.24 microM, 0.61 s-1, and 1.9 x 10(5)
      M-1 x s-1, respectively, and those for kinin generation from HMWK were 0.56
      microM, 0.12 s-1, and 2.1 x 10(5) M-1 x s-1, respectively; kcat/Km values for Df
      protease were comparable with that for glandular kallikrein. In contrast,
      microbial proteases showed only weak kinin-releasing activity from both human
      plasma kininogens. Four of ten different microbial proteases liberated kinin from
      LMWK, and only serratial 56-kDa protease released kinin from HMWK. Furthermore,
      Df-protease markedly inactivated the thiol protease inhibitory activity of LMWK
      and HMWK, whereas all microbial proteases (as well as the endogenous protease
      trypsin) did not affect this inhibitory activity of both kininogens from human
      plasma.

PMID- 8349657
TI  - Age-dependent structural changes in intact human lenses detected by synchrotron
      radiation X-ray scattering. Correlation with Maillard reaction protein
      fluorescence.
AB  - To understand alterations in the spatial organization of the crystallins, the
      major determinant of lens transparency, the x-ray scattering by intact normal
      human lenses from individuals 6-82 years of age was measured using synchrotron
      radiation. The angular dependence of the integrated scattering intensity is
      consistent with short-range order within the crystallin assemblies. A significant
      change in the scattering patterns of the lenses occurs after 55 years of age, in
      parallel with an increase of the fluorescence of the urea-insoluble crystallin
      fraction. This correlation suggests a gradual derangement of the short-range
      order as a result of cross-linking of the crystallin subunits by advanced
      Maillard reaction products that are generated by the continuous reaction of
      sugars, such as glucose or fructose, with proteins.

PMID- 8349658
TI  - Tyrosine 69 of the first epidermal growth factor-like domain of human factor IX
      is essential for clotting activity.
AB  - Epidermal growth factor (EGF)-like domains are present in many extracellular
      proteins including clotting factor IX. Those EGF-like domains with the consensus
      amino acid residues Asp/Asn, Asp/Asn, Asp*/Asn*, Tyr/Phe (where * denotes a beta
      hydroxylated residue) bind calcium. Previous NMR studies of the isolated first
      EGF-like domain of human factor IX suggested that the first 3 consensus residues
      Asp-47, Asp-49, and Asp-64 were direct ligands for calcium. We now show from
      mutagenesis studies that Tyr-69 is not a direct ligand for calcium but is
      essential for the clotting activity of intact factor IX, specifically for the
      factor VIIIa-dependent activation of factor X. Surprisingly, Tyr-69 is not
      required for beta-hydroxylation of Asp-64.

PMID- 8349659
TI  - Hydrogen bonding interactions with the Schiff base of bacteriorhodopsin.
      Resonance Raman spectroscopy of the mutants D85N and D85A.
AB  - The bacteriorhodopsin (bR) mutants Asp-85-->Asn (D85N) and Asp-85-->Ala (D85A)
      have a red-shifted chromophore absorption and exhibit no proton pumping (Otto,
      H., Marti, T., Holz, M., Mogi, T., Stern, L., Engel, F., Khorana, H. G., and
      Heyn, M. P. (1990) Proc. Natl. Acad. Sci. U.S.A. 87, 1018-1022) consistent with
      the hypothesis that Asp-85 functions as a counterion and proton acceptor for the
      retinal Schiff base (Braiman, M. S., Mogi, T., Marti, T., Stern, L. J., Khorana,
      H. G., and Rothschild, K. J. (1988) Biochemistry 27, 8516-8520). Resonance Raman
      spectroscopy reveals that these mutants contain a mixture of all-trans and 13
      cis/C = N syn chromophores, similar to dark-adapted purple membrane and acid
      induced or deionized blue membrane. At high NaCl concentrations, both mutants
      adopt a predominantly all-trans chromophore structure similar to acid purple
      membrane. A comparison of the Schiff base C = NH+ stretch frequency (vC = N) and
      deuterium isotope shift for D85N, D85A as well as various forms of bR, including
      light-adapted bR, blue membrane, and acid purple membrane, provides information
      about hydrogen bonding interactions to the Schiff base. D85N has as strong a
      hydrogen bond as light-adapted bR despite the loss of the negative charge at
      residue 85. In contrast, D85A has a weaker hydrogen bond. These results can be
      explained if a direct interaction exists between the Schiff base and Asn-85 in
      D85N and between the Schiff base and a substituted water molecule in D85A. Many
      of the properties of wild type bR, D85N, D85A, blue membrane, and acid purple
      membrane can be explained on the basis of changes in the local hydrogen bonding
      near the Schiff base.

PMID- 8349660
TI  - Tumor necrosis factor-alpha (TNF-alpha) signal transduction through ceramide.
      Dissociation of growth inhibitory effects of TNF-alpha from activation of nuclear
      factor-kappa B.
AB  - Tumor necrosis factor-alpha (TNF-alpha) exerts pleiotropic biologic effects.
      Although TNF-alpha appears to activate a number of signal transduction pathways,
      the role of second messengers in mediating the different effects of TNF-alpha are
      not well defined. In this study, we investigated the role of ceramide as an
      intracellular mediator of TNF-alpha action. In Jurkat T cells, TNF-alpha caused
      early activation of the sphingomyelin cycle with peak hydrolysis of sphingomyelin
      observed at 30 min following addition of TNF-alpha. In this cell line, TNF-alpha
      caused potent activation of nuclear factor-kappa B (NF-kappa B) and exerted
      potent cytostatic/cytocidal activity. C2-ceramide mimicked the effects of TNF
      alpha on cell growth in a dose-dependent manner, but C2-ceramide was unable to
      induce activation of NF-kappa B under multiple conditions investigated. C2
      ceramide, however, enhanced activation of NF-kappa B in response to TNF-alpha
      with peak effects observed at a concentration of C2-ceramide of 5 microM. Thus,
      ceramide functions as a selective mediator of the cytostatic/cytotoxic effects of
      TNF-alpha and plays a positive feedback role in activation of NF-kappa B. TNF
      alpha signaling, therefore, involves multiple second-messenger pathways that
      function independently or coordinately to transduce distinct functions of TNF
      alpha.

PMID- 8349661
TI  - Characterization, cloning, and in vitro expression of the extremely thermostable
      glutamate dehydrogenase from the hyperthermophilic Archaeon, ES4.
AB  - Glutamate dehydrogenase (GDH) from the hyperthermophilic Archaeon ES4 (optimal
      growth temperature 98 degrees C and maximum growth temperature 110 degrees C) was
      purified to homogeneity. The purified native enzyme had an M(r) of 270,000 +/-
      5,000 and was shown by gel filtration and SDS-polyacrylamide gel electrophoresis
      to be a hexamer with identical subunits of M(r) = 46,000 +/- 3,000. The hexameric
      subunit composition was also evident from electron micrographs, which show a
      triangular antiprism structure very similar to that of bovine GDH. The enzyme is
      exceptionally thermostable, with a half-time of inactivation of 3.5 h at 105
      degrees C. Differential scanning calorimetry revealed a tm for denaturation of
      113 degrees C, and a tm for activation at 60 degrees C. Antigenic cross-reaction
      with ES4 GDH was observed with the purified GDH from the thermophilic Archaea,
      Pyrococcus furiosus and Thermococcus litoralis as well as with bovine and yeast
      GDHs. The genome of ES4 was shown to contain a single copy of the gdhA gene, and
      this was cloned and sequenced. The deduced amino acid sequence of the GDH from
      ES4 corresponded to the NH2-terminal amino acid sequence obtained from the pure
      protein. From the nucleotide sequence the ES4 protein is composed of 420
      residues. It has a relatively high hydrophobicity and a low number of sulfur
      containing residues compared with mesophilic GDHs. Relatively high homology (52%)
      exists between the deduced amino acid sequence of ES4 GDH and Clostridium
      difficile GDH. Of the two distinct families of GDH sequences known, ES4 GDH
      belongs to the same family as vertebrates, C. difficile, and other Archaea. The
      gdhA gene of ES4 was expressed in vitro in a rabbit reticulocyte cell-free
      lysate, thus providing a system for structural studies of the mechanisms of
      thermostability in hyper-thermophilic proteins.

PMID- 8349662
TI  - Isotope effects and alternative substrate reactivities for tryptophan 2,3
      dioxygenase.
AB  - Tryptophan 2,3-dioxygenase (EC 1.13.1.12) is a hemoprotein which catalyzes the
      first step in the oxidative degradation of tryptophan. The reaction is believed
      to proceed by addition of O2 across the 2,3-bond of the indole ring, followed by
      decomposition of the resultant dioxetane to give N-formylkynurenine. A primary
      D2O isotope effect of 4.4 on Vmax/Km was observed at the pH optimum, pH 7.0. This
      implies that abstraction of the indole proton is at least partially rate
      determining. An inverse secondary isotope effect of 0.96 was observed for L-[2
      3H]tryptophan at this pH. The secondary isotope effect signals the formation of
      the C-O bond at C-2. As the rate of proton abstraction increased with increasing
      pH, the D2O isotope effect decreased to 1.2 at pH 8.5 and the secondary isotope
      effect increased to 0.92. The rate-determining steps therefore change with
      increasing pH, and bond formation at C-2 becomes more rate-limiting. The
      secondary isotope effect did not change significantly with varying O2
      concentration so that substrate binding is primarily ordered with O2 binding
      first. The specificity of the enzyme towards substituted tryptophans shows that
      substitution of the phenyl ring of the indole is sterically unfavorable. Steric
      hindrance is highest at the 4- and 7-positions, while the 5- and 6-positions are
      less sensitive. 6-Fluoro-L-tryptophan was more reactive than tryptophan, and the
      increased reactivity can be explained by an electronic effect that enhances of
      the rate of C-O bond formation at C-2.

PMID- 8349663
TI  - Characterization of the effects of a thymine glycol residue on the structure,
      dynamics, and stability of duplex DNA by NMR.
AB  - A duplex DNA containing a single thymine glycol (5,6-dihydroxy-5,6
      dihydrothymidine) has been studied by NMR and other methods. Oxidative stress,
      ionizing radiation, and other causes can induce the oxidation of thymine to
      thymine glycol. The presence of thymine glycol is known to have significant
      biological consequences, and there are repair enzymes for thymine glycol in a
      wide range of organisms. These studies have been carried out on the DNA duplex of
      d(C1G2C3A4G5Tg6C7A8G9C10C11) paired with d(G22C21G20T19C18A17G16T15C14G13G12),
      with Tg indicating thymine glycol. The presence of thymine glycol lowers the
      thermal stability of duplex DNA. The NMR results indicate that thymine glycol
      induces a large, localized structural change in duplex DNA with the thymine
      glycol base being extrahelical as well as the opposing base on the complementary
      strand. This structural information is consistent with the biological
      consequences of thymine glycol in DNA.

PMID- 8349664
TI  - Partial purification and characterization of a (glycosyl) inositol phospholipid
      specific phospholipase C from peanut.
AB  - We have isolated a glycosyl inositol phospholipid (GIP) anchor-hydrolyzing
      activity from peanut seeds by a series of column chromatographic steps. The
      activity has a pH optimum below 6.0, requires calcium, and is inhibited by
      sulfhydryl reagents. It cleaves the GIP anchors of solubilized
      acetylcholinesterase from bovine erythrocytes and variant surface glycoprotein
      from Trypanosoma brucei. On the other hand, it does not act on membrane-bound GIP
      anchored substrate or on inositol-acylated GIP anchor of human erythrocyte
      acetylcholinesterase. The only product released from [3H]myristate-labeled
      variant surface glycoprotein following treatment with the activity from peanut
      was 3H-labeled diacylglycerol. Together, these findings identify the activity
      from peanut seeds as a GIP anchor-hydrolyzing phospholipase C. The enzyme has
      been found to hydrolyze not only protein GIP anchors but also
      phosphatidylinositol, whereas it shows no activity against other phospholipids.
      The water-soluble products of phosphatidylinositol hydrolysis by peanut
      phospholipase C were characterized as a mixture of inositol 1,2-cyclic phosphate
      and inositol phosphate.

PMID- 8349665
TI  - Vaccinia virus ribonucleotide reductase expression and isolation of the
      recombinant large subunit.
AB  - The vaccinia virus gene encoding the 87-kDa protein that comprises the large
      subunit of ribonucleotide reductase (vvR1) was cloned into a bacterial expression
      vector under the control of an inducible promoter. Culture of Escherichia coli
      cells harboring the recombinant plasmid under standard induction conditions (0.4
      mM isopropyl beta-D-thiogalactopyranoside, 37 degrees C) resulted in synthesis of
      a completely insoluble product. Production of soluble vvR1 was achieved by
      growing bacteria at low temperature (15 degrees C) during the induction period,
      initiating induction at low cell density, and using a low concentration (0.05 mM)
      of the inducer isopropyl beta-D-thiogalactopyranoside. Hydroxyurea, an inhibitor
      of ribonucleotide reductase, increased production of soluble vvR1 in a dose
      dependent manner. Recombinant vvR1 was purified from a high salt extract of the
      E. coli lysate in four steps, the last utilizing an affinity column consisting of
      the carboxyl-terminal seven amino acids of the vvR2 protein linked to an
      insoluble resin. Using purified recombinant vvR2 to reconstitute active enzyme,
      we determined that maximizing the rate of CDP reduction required pH 8.0-8.8, 50
      mM dithiothreitol, and 2 mM ATP. Specific activity of purified vvR1 was 122
      nmol/min/mg. Limited proteolysis of the vvR1 protein revealed protease-resistant
      fragments approximately 30 and 58 kDa in size. To our knowledge, this study
      represents the first expression, solubilization, and isolation of a recombinant
      "eukaryotic" form of ribonucleotide reductase large subunit.

PMID- 8349666
TI  - Use of bismannose photolabel to elucidate insulin-regulated GLUT4 subcellular
      trafficking kinetics in rat adipose cells. Evidence that exocytosis is a critical
      site of hormone action.
AB  - The subcellular trafficking of tracer-tagged GLUT4 between the plasma membranes
      and low-density microsomes of rat adipose cells has been studied. Cell-surface
      GLUT4 have been initially tracer-tagged in the insulin-stimulated state with the
      [3H]bismanose photolabel 2-N-4-(1-azi-2,2,2-trifluoroethyl)benzoyl-1,3-bis-(D
      mannos- 4-yloxy)-2- propylamine. The half-time for internalization of tracer
      tagged GLUT4 when insulin is removed by collagenase treatment is similar to that
      observed for the decrease in immunodetectable GLUT4 in the plasma membranes and
      the decrease in glucose transport activity in the intact cells. In contrast,
      internalization of tracer-tagged GLUT4 also occurs when cells are maintained in
      the continuous presence of insulin even though the plasma membrane level of
      immunodetectable GLUT4 and glucose transport activity in the intact cells are
      unaltered. These data show, for the first time, that insulin has little, if any,
      effect on the rate constant for GLUT4 endocytosis, but instead, primarily
      increases the rate constant for exocytosis. Tracer-tagged GLUT4 that is returned
      to the low-density microsomes can be restimulated with fresh insulin to recycle
      to the plasma membranes and to a steady-state distribution level that is the same
      as that observed in cells that are maintained in the continuous presence of
      insulin. These data suggest that the cells' entire complement of GLUT4 is
      involved in the recycling process. Following insulin stimulation of adipose cells
      initially in the basal state, the increase in immunodetectable GLUT4 in the
      plasma membranes precedes the increase in accessibility of GLUT4 to exofacial 2-N
      4-(1-azi-2,2,2-trifluoroethyl)benzoyl-1,3-bis(D-mannos-4 -yloxy)-2- propylamine
      photolabeling, and this in turn precedes the increase in cellular glucose
      transport activity. Such time course data suggest that there may be plasma
      membrane intermediate states in the GLUT4 trafficking pathway. The kinetic
      properties of GLUT4 translocation and its recycling have been interpreted in
      terms of a subcellular trafficking model that identifies exocytosis, possibly
      involving-hypothetical "docking" and "fusion" steps, as the critical site of
      hormone action.

PMID- 8349667
TI  - Cloning and site-directed mutagenesis of human ADP-ribosylarginine hydrolase.
AB  - Mono-ADP-ribosylation of arginine is a reversible modification of proteins with
      NAD:arginine ADP-ribosyltransferases and ADP-ribosylarginine hydrolases
      catalyzing the opposing reactions in the cycle. ADP-ribosylarginine hydrolases
      differ in their dithiothreitol (DTT) requirements. Rat and mouse hydrolases
      require DTT for maximal activity, but calf, guinea pig, and human hydrolases are
      DTT-independent. To define the molecular basis for these differences, brain ADP
      ribosylarginine hydrolases were cloned. Deduced amino acid sequences of mouse and
      rat hydrolases were 94% identical with 5 conserved cysteines. The human hydrolase
      sequence was 83% identical to that of rat but contained only 4 cysteines with
      cysteine 108 in rat corresponding to serine 103 in human. To investigate the role
      of rat cysteine 108, human and rat wild-type hydrolases and mutants, in which
      serine 103 in human was replaced by cysteine (S103C) and cysteine 108 in rat was
      replaced by serine (C108S), were expressed in Escherichia coli. Affinity-purified
      anti-rat brain hydrolase antibodies reacted with recombinant wild-type rat
      hydrolase, but only weakly with the C108S mutant. They did not react with human
      wild-type or the S103C mutant. Human hydrolase and rat C108S were DTT
      independent; human S103C was, however, DTT-dependent. These data clearly show
      that cysteine 108 in rat hydrolase plays a critical role in DTT dependence and
      may be important in immunoreactivity.

PMID- 8349668
TI  - Steady state kinetics of mannitol phosphorylation catalyzed by enzyme IImtl of
      the Escherichia coli phosphoenolpyruvate-dependent phosphotransferase system.
AB  - The kinetics of mannitol phosphorylation catalyzed by enzyme IImtl of the
      bacterial P-enolpyruvate-dependent phosphotransferase system are described for
      three different physical conditions of the enzyme, (i) embedded in the membrane
      of inside-out (ISO) oriented vesicles, (ii) solubilized and assayed above the
      critical micellular concentration (cmc) of the detergent, and (iii) solubilized
      and assayed below the cmc of the detergent. The kinetic characteristics of enzyme
      IImtl, after solubilization of cytoplasmic membranes or after purification from
      these membranes are comparable. The mannitol-dependent kinetics at saturating
      concentration of P-HPr were biphasic both for the solubilized enzyme assayed
      above the cmc and for the enzyme in ISO vesicles. In contrast, the mannitol
      dependent kinetics was monophasic for the solubilized enzyme assayed below the
      cmc. In the latter case, the maximal rate was about twice as high as observed
      with the two other conditions. The contribution of the high affinity phase to the
      maximal rate is lower for enzyme IImtl in ISO vesicles than for the solubilized
      enzyme. At limiting concentrations of P-HPr, the kinetics is not according to the
      expected "ping-pong" mechanism.

PMID- 8349669
TI  - A method to study complex enzyme kinetics involving numerical analysis of
      enzymatic schemes. The mannitol permease of Escherichia coli as an example.
AB  - An analysis of complex kinetic mechanisms is proposed that consists of two steps,
      (i) building of an kinetic scheme from experimental data other than steady-state
      kinetics and (ii) numerical simulation and analysis of the kinetics of the
      proposed scheme in relation to the experimental kinetics. Procedures are
      introduced to deal with large numbers of enzymatic states and rate constants, and
      numerical tools are defined to support the analysis of the scheme. The approach
      is explored by taking the mannitol permease of Escherichia coli as an example.
      This enzyme catalyzes both the transport of mannitol across the cytoplasmic
      membrane and the phosphorylation of mannitol. The challenge is to deduce the
      transport properties of this dimeric enzyme from the phosphorylation kinetics. It
      is concluded that (i) the steady-state kinetic behavior is largely consistent
      with the proposed catalytic cycle of the monomeric subunit, (ii) the kinetics
      provide no direct support but also do not disprove a coupled translocation of the
      binding sites on the two monomeric subunits. The approach reveals the need for
      further experimentation where the implementation of experimental results in the
      scheme conflict with the experimental kinetics and where specific experimental
      characteristics do not show up in the simulations of the proposed kinetic scheme.

PMID- 8349670
TI  - Role of the COOH-terminal acidic region of A1 subunit in A2 subunit retention in
      human factor VIIIa.
AB  - Factor VIIIa is a heterotrimer of A1,A2 and A3-C1-C2 subunits which is labile due
      to a relatively weak affinity interaction between the A2 subunit and the Me(2+)
      linked A1/A3-C1-C2 dimer. Previously we speculated that the acidic region at the
      COOH terminus of the A1 subunit was involved with the A2 subunit retention. This
      region, delineated by factor VIII residues 337-372, was chemically synthesized.
      Both the peptide, designated FVIII337-372, and an IgG fraction prepared from
      rabbit anti-FVIII337-372 antiserum inhibited the reconstitution of factor VIIIa
      from A1/A3-C1-C2 dimer plus A2 subunit. A primary component of the inhibitory
      activity of the peptide was attributed to its acidic nature based upon similar
      inhibition of factor VIIIa reconstitution using a synthetic polymer of aspartic
      acid. Trypsin cleaved the peptide at Arg359 and the resultant two fragments were
      isolated. Inhibitory activity was associated with the NH2-terminal fragment which
      contained 10 of the 13 acidic residues present in the original peptide. The
      fluorescence of a dansylated FVIII337-372 was enhanced 2-fold by A2 subunit and
      this effect was reversed by addition of excess unmodified peptide. The inhibitory
      activity of FVIII337-372 was attenuated by the presence of Ca2+. Ca2+ also
      inhibited the reconstitution of factor VIIIa in the absence of peptide and
      increased the rate and extent of factor VIIIa decay, suggesting that Ca2+
      effectively shielded charges important for the intersubunit interactions. The
      above results support a role for this acidic region in the association of A2
      subunit with A1/A3-C1-C2 dimer.

PMID- 8349671
TI  - Analysis of microsomal cholesteryl ester hydrolases by radiation inactivation.
AB  - Radiation inactivation by high energy electrons, a method for determining the
      size of a protein without prior purification, was used to study the acid and
      neutral cholesteryl ester hydrolase (CEH) activities of rat liver microsomes. The
      same preparations were also assayed for the microsomal, "nonspecific"
      carboxylesterases using o-nitrophenyl acetate as substrate. Non-specific esterase
      activity surviving radiation could be fit to a single exponential function, the
      slope of which yielded a target size of 47 +/- 5 kDa (mean +/- S.D., n = 7).
      Surviving CEH activity assayed at pH 5 could also be fit to a single exponential
      that yielded a target size of 71 +/- 14 kDa (n = 5). In contrast, the surviving
      CEH activity assayed at pH 7 was more complex. The data from six experiments were
      described as the sum of two exponentials, indicating that most of the activity is
      due to an entity that is three to four times larger and a minor amount to one
      that is half the size of the pH 5 enzyme. The results are consistent with the
      suggestion that the acid and neutral microsomal CEH activities are due to
      distinct enzymes, which are not the "nonspecific" carboxylesterases. Their sizes
      also differ from those previously determined for lysosomal acid lipase and other
      lipases in the liver.

PMID- 8349672
TI  - Nitric oxide-independent, thiol-associated ADP-ribosylation inactivates aldehyde
      dehydrogenase.
AB  - Nitric oxide inhibits the activity of glyceraldehyde-3-phosphate dehydrogenase
      and stimulates NAD-dependent automodification of a cysteine (Dimmeler, S.,
      Lottspeich, F., and Brune, B. (1992) J. Biol. Chem. 267, 16771-16774). Another
      NAD-utilizing dehydrogenase that has a catalytic cysteine, aldehyde dehydrogenase
      (ALDH), was also inhibited by nitric oxide. Unlike glyceraldehyde-3-phosphate
      dehydrogenase, ALDH was modified in a nitric oxide-independent process by ADP
      ribose, but not by NAD. Modification, which proceeded to > 2 mol ADP-ribose.mol
      ALDH-1, was associated with an exponential decrease in enzyme activity to less
      than 10% of control. Two types of evidence suggested modification of the ALDH
      active site: 1) ADP-ribose inhibited ALDH competitively (Ki = 0.46 mM) with
      respect to NAD (Km = 0.11 mM) in brief incubations and 2) the presence of
      substrates protected ALDH from both modification and inhibition by ADP-ribose.
      The ALDH-ADP-ribose bond was sensitive to base and mercuric ion and stable to
      acid and neutral hydroxylamine, properties shared with the ADP-ribosylcysteine
      linkage synthesized enzymatically by pertussis toxin. These data demonstrate a
      novel means of inactivation of an NAD-dependent enzyme, namely the affinity-based
      modification of the enzyme NAD site by ADP-ribose, and suggest that nonenzymatic
      ADP-ribosylation may be responsible for modification of cysteine residues.

PMID- 8349673
TI  - Isolation of an autoinhibitory region from the regulatory beta-subunit of
      phosphorylase kinase.
AB  - An equimolar mixture of the regulatory alpha- and beta-subunits of phosphorylase
      kinase has been shown to inhibit its catalytic gamma-subunit (Paudel, H.K., and
      Carlson, G.M. (1987) J. Biol. Chem. 262, 11912-11915). The possible presence of
      an autoinhibitory sequence within those regulatory subunits has been evaluated by
      peptide isolation and characterization following chemical and proteolytic
      cleavage of an isolated equimolar mixture of those subunits; the peptides
      generated were tested for their ability to inhibit the activity of a complex of
      the gamma-subunit and calmodulin. An isolated inhibitory fragment, hereafter
      referred to as I-peptide, was sequenced and found to correspond to residues 420
      436 of the beta-subunit (KRNPGSQKRFPSNCGRD). This sequence showed homology with
      the kinase's natural substrate, phosphorylase b. A synthetic peptide based on
      this sequence was constructed and used to study the mechanism of inhibition.
      Kinetic analysis of the inhibition of the gamma-subunit-calmodulin complex by the
      I-peptide revealed a competitive pattern versus the homologous substrate
      phosphorylase b and an uncompetitive pattern versus MgATP, suggesting an ordered
      binding of substrates, with the nucleotide binding first. In addition to its
      ability to inhibit, the I-peptide was also a substrate for the gamma-subunit
      calmodulin complex, with a relatively good Km but poor Vmax. The parallel
      inhibition of free gamma-subunit and the gamma-subunit-calmodulin complex by
      progressively increasing concentrations of I-peptide provided further evidence
      that the peptide inhibits by interacting directly with the catalytic subunit and
      not with the stimulatory calmodulin molecule. The results of this study are
      consistent with previous findings from this laboratory showing that the
      conformation of the beta-subunit changes following activation of phosphorylase
      kinase through a variety of mechanisms.

PMID- 8349674
TI  - The presence of UDP-N-acetylglucosamine:alpha-3-D-mannoside beta 1,2-N
      acetylglucosaminyltransferase I activity in Spodoptera frugiperda cells (IPLB-SF
      21AE) and its enhancement as a result of baculovirus infection.
AB  - A Golgi preparation from Spodoptera frugiperda (IPLB-SF-21AE) cells was incubated
      in the presence of the mannosidase II inhibitor, swainsonine, with the
      oligosaccharide, M(alpha 1,3)[[M(alpha 1,3)[M(alpha 1,6)]M(alpha 1,6)]] M(beta
      1,4)Gn(beta 1,4)Gn (M5Gn2), the preferred substrate for the enzyme, UDP-N
      acetylglucosamine:alpha-3-D-mannoside beta 1,2-N-acetylglucosaminyltransferase I
      (Gn-TI). This resulted in formation of the product, Gn(beta 1,2)M(alpha
      1,3)[[M(alpha 1,3)[M(alpha 1,6)]M(alpha 1,6)]]- M(beta 1,4) Gn(beta 1,4)Gn
      (Gn(I)M5Gn2). A significantly increased (> 4-fold) rate of conversion of M5Gn2 to
      Gn(I)M5Gn2 occurred with insect cell-derived Golgi preparations that had been
      infected with a recombinant baculovirus for 66 h, a time at which significant
      amounts of complex-type oligosaccharides were assembled on a heterologous
      protein, human plasminogen, expressed in this system. Coupled with previous
      results (Davidson, D.J., Bretthauer, R.K., and Castellino, F.J. (1991)
      Biochemistry 30, 9811-9815) that demonstrated the occurrence of virally induced
      activation of a specific M6-mannosidase in IPLB-SF-21AE cells, it is clear that
      viral infection of lepidopteran insect cells makes available enzymes that provide
      and utilize the substrate, M5Gn2-protein. This is a key feature in the
      explanation of the previous original observations made by this laboratory, that
      lepidopteran insect cells are capable of assembly of complex-type
      oligosaccharides on glycoproteins.

PMID- 8349675
TI  - Molecular dynamics simulation of NO recombination to myoglobin mutants.
AB  - Molecular dynamics simulations on two coupled electronic surfaces are employed to
      investigate the geminate recombination of nitric oxide to mutants of sperm whale
      myoglobin. A model for the ground and the excited states is constructed based on
      experimental data. The crossing between the surfaces is treated using the Landau
      Zener formula. The reaction probability and the recombination curves are
      calculated directly by histogramming the results of an ensemble of trajectories.
      The experimental trend is reproduced in which the picosecond recombination rate
      of different mutants increases in the order Phe29 > Leu29 > Val29 > Ala29.
      Furthermore, in accord with the experiment on significantly longer time scales an
      opposite trend is obtained, in which the recombination rate for Ala29 is larger
      than for Phe29. These results are explained by constrained diffusion of the
      ligand in the heme pocket. The average and the transient volume of the heme
      pocket is modified by the 29 mutants.

PMID- 8349676
TI  - Overexpression of human lipoprotein lipase in transgenic mice. Resistance to diet
      induced hypertriglyceridemia and hypercholesterolemia.
AB  - Lipoprotein lipase (LPL) is a key enzyme in the hydrolysis of triglyceride-rich
      lipoproteins. To determine the role of LPL in lipoprotein metabolism, we
      established three transgenic mouse lines overexpressing the human LPL gene; the
      highest expressor line, which transcribed human LPL mRNA in the heart, skeletal
      muscles, and adipose tissue, was used in this study. The transgenic mice had 5-
      and 1.7-fold higher LPL activity in adipose tissue and post-heparin plasma,
      respectively. Plasma triglyceride levels in transgenic mice were 24.2% of that in
      control mice, and gel filtration chromatography showed that very low density
      lipoprotein (VLDL) triglycerides were much reduced in transgenic mice. In the
      chemical analysis of plasma lipoproteins isolated by ultracentrifugation, we
      found that LDL particles were cholesterol-rich and HDL2 cholesterol was increased
      1.4-fold in transgenic mice as compared to control mice. When we injected 125I
      VLDL intravenously into transgenic mice, the clearance of 125I-VLDL and the
      conversion of VLDL to LDL was markedly enhanced as compared to control mice.
      Furthermore, the clearance of chylomicrons, estimated by both the fat loading and
      retinyl palmitate loading tests, was significantly enhanced in transgenic mice.
      After sucrose feeding, no increase in VLDL was observed in transgenic mice. When
      fed a high cholesterol diet, the development of hypercholesterolemia was
      suppressed in transgenic mice. These results suggested that LPL determined not
      only hydrolysis of triglyceride-rich lipoproteins but also lipolytic conversion,
      and that overexpression of LPL acted to protect against diet-induced
      hypertriglyceridemia as well as hypercholesterolemia.

PMID- 8349677
TI  - Interactions between pyruvate carboxylase and other mitochondrial enzymes.
AB  - Although pyruvate carboxylase associated with both mitochondrial aspartate
      aminotransferase and malate dehydrogenase, it had a higher affinity for the amino
      transferase. Furthermore, the aminotransferase enhanced dissociation of malate
      dehydrogenase from pyruvate carboxylase. Glutamate dehydrogenase did not
      associate with pyruvate carboxylase alone, but it apparently associated with the
      pyruvate carboxylase-aminotransferase complex, and malate dehydrogenase
      associated with the resulting ternary complex. Citrate synthase and other
      proteins tested did not associate with pyruvate carboxylase. However, citrate
      synthase associated with the pyruvate carboxylase-malate dehydrogenase complex.
      Apparently as a consequence of these heteroenzyme interactions, the rate of the
      pyruvate carboxylase reaction was slightly greater when coupled with malate
      dehydrogenase or both malate dehydrogenase and citrate synthase than when coupled
      with citrate synthase alone. In addition, in the presence of both coupling
      enzymes, the rate of conversion of pyruvate to citrate was higher than predicted
      on the basis of the Michaelis-Menten relationship of the two coupling enzymes.
      Therefore, binding of malate dehydrogenase to pyruvate carboxylase enhances
      pyruvate carboxylase activity. Association of citrate synthase with the malate
      dehydrogenase-pyruvate carboxylase binary complex does not alter activation of
      pyruvate carboxylase but results in citrate synthase being more reactive than
      free citrate synthase with oxalacetate.

PMID- 8349678
TI  - Identification of the region on the class I histocompatibility molecule that
      interacts with the molecular chaperone, p88 (calnexin, IP90).
AB  - During early stages in their biogenesis, murine class I histocompatibility
      molecules interact transiently with a molecular chaperone of the endoplasmic
      reticulum designated p88. Using a series of mutant class I heavy chains we mapped
      the region of the heavy chain that interacts with p88. Domain deletion mutants of
      the H-2Db and H-2Kb molecules revealed that most of the extracellular portion of
      the heavy chain and the bulk of the cytoplasmic domain were not required for the
      association. However, replacement of the transmembrane segment and cytoplasmic
      domain with a glycosyl phosphatidylinositol anchor from Q7b resulted in a heavy
      chain that was incapable of interaction with p88. These results suggested that
      the primary site of interaction with p88 is within a region containing the
      transmembrane segment and several flanking amino acids of the class I heavy
      chain. This finding was supported by replacing the glycosyl phosphatidylinositol
      anchor of the noninteracting Q7b protein with segments of the Db heavy chain
      containing the putative interaction site and showing that the hybrids were
      capable of associating with p88. The apparent lack of interaction between
      segments of p88 and the class I heavy chain that are present within the lumen of
      the endoplasmic reticulum was also observed when the association between p88 and
      the alpha chain of the T cell receptor was examined. The full-length
      transmembrane alpha chain formed a complex with p88, whereas a soluble variant
      consisting of most of the luminal portion of the alpha chain exhibited only
      minimal interaction. Thus, p88 is capable of associating with nascent integral
      membrane proteins through transmembrane interactions that are unavailable to the
      major soluble chaperone of the endoplasmic reticulum, BiP (GRP78).

PMID- 8349679
TI  - Activity of both Raf and Ras is necessary for activation of transcription of the
      human T cell receptor beta gene by protein kinase C, Ras plays multiple roles.
AB  - Transcription of the T cell receptor beta gene is up-regulated during T cell
      activation. We have previously defined the elements within the TcR beta gene
      enhancer responsible for increased transcription in response to phorbol esters,
      which mimic part of the pathway for T cell activation. Using a reporter construct
      (beta E2 x 4) containing four copies of this inducible element, activation was
      achieved by the addition of phytohemagglutinin or phorbol esters. Activation was
      observed after 2 h of treatment, was maximal by 8 h, and could be blocked by the
      protein synthesis inhibitor cycloheximide. Coexpression of v-Ha-Ras-, v-Raf-, and
      v-Src-activated beta E2 x 4, and constitutively active mutants of protein kinase
      C also increased transcription from this construct. Calcium ionophore generated
      signals which synergized with both Ras and protein kinase C. Expression of a
      truncated Raf protein which has been shown to act in a dominant negative manner,
      was able to inhibit activation of beta E2 x 4, demonstrating that Raf plays an
      important role in T cell signaling. A dominant negative mutant of v-Ha-Ras
      inhibited all methods of activation tested, including transfection with v-Raf.
      Thus, Ras activity appears to be necessary at more than one point in the
      transduction of signals from T cell receptor to nucleus.

PMID- 8349680
TI  - The propeptide is required for in vivo formation of stable active yeast
      proteinase A and can function even when not covalently linked to the mature
      region.
AB  - The PEP4-encoded aspartate protease proteinase A from Saccharomyces cerevisiae is
      synthesized as a zymogen (Ammerer, G., Hunter, C. P., Rothman, J. H., Saari, G.
      C., Valls, L. A., and Stevens, T. H. (1986) Mol. Cell. Biol. 6, 2490-2499;
      Woolford, C. A., Daniels, L. B., Park, F. J., Jones, E. W., van Arsdell, J. N.,
      and Innis, M. A. (1986) Mol. Cell. Biol. 6, 2500-2510). We constructed a mutant
      form, lacking the propeptide. This form, still containing the signal peptide, was
      translocated into the endoplasmic reticulum, but the mature region was
      subsequently completely degraded. When a plasmid encoding only the propeptide
      after the signal peptide was introduced into a strain producing the mature
      region, a subpopulation of mature region molecules was rescued from the
      degradation and gained activity. Increased activity was found when the mature
      region was co-produced with increased amounts of propeptide, whereas truncated
      propeptides, lacking residues at its C terminus, were less efficient in the
      interaction with the mature region. We propose that the mature region of
      proteinase A cannot fold into its stable active conformation in the absence of
      the propeptide and that the propeptide can promote folding of the mature region,
      even when the propeptide and the mature region are not covalently linked.

PMID- 8349681
TI  - Characterization of the molecularly cloned murine alpha-globin transcription
      factor CP2.
AB  - We recently cloned human and murine cDNAs that encode CP2, a transcription factor
      that interacts with the murine alpha-globin promoter. In this report, we
      exploited our ability to express CP2 in bacteria and eukaryotic cells to further
      investigate factor activities in vitro and in vivo. CP2 expressed in bacteria was
      significantly enriched and used in a series of DNase I footprinting and
      electrophoretic gel shift assays. The results suggest that CP2 binds a hyphenated
      recognition sequence motif that spans one DNA helix turn. In addition, the
      enriched bacterial protein activated transcription of alpha-globin promoter
      templates approximately 3- to 4-fold in vitro. We then tested the effect of
      elevating CP2 levels 2.5- to 5.5-fold in vivo using both transient and stable
      transformation assays. When a reporter construct comprised of the intact murine
      alpha-globin promoter driving the bacterial chloramphenicol acetyltransferase
      (CAT) gene was introduced into these overexpressing cells, we observed a 3- to 6
      fold increase in CAT activity when compared to cells expressing normal levels of
      CP2. These results define the CP2 factor binding site in more detail and help
      characterize the activities of the factor in vivo.

PMID- 8349682
TI  - Histidine 296 is essential for the catalysis in Lactobacillus plantarum D-lactate
      dehydrogenase.
AB  - Two His residues, His-205 and His-296, in Lactobacillus plantarum D-lactate
      dehydrogenase are highly conserved in the D-isomer-specific 2-hydroxyacid
      dehydrogenase family, suggesting that they are candidates for the catalytic His
      in the enzyme. The substitution of His-296 with Tyr by means of site-directed
      mutagenesis induced a drastic decrease in the reaction rate, while a His-205 to
      Tyr substitution induced no large change in the catalytic properties. In pyruvate
      reduction, the Tyr-296 enzyme showed a slightly increased Km below pH 6.0 but no
      significant pH dependence above pH 6.0, where the wild-type enzyme showed an
      increased Km value. In D-lactate oxidation, in contrast, the Tyr-296 enzyme
      showed a greatly increased Km value for D-lactate and strong pH dependence. An
      additional substitution of His-296 with Gln induced more complete loss of the
      catalytic activity. In contrast to the Tyr-296 enzyme, the Gln-296 enzyme showed
      a greatly increased Km value and a strong pH-dependent reaction rate even in
      pyruvate reduction. Unlike the wild-type or His-205 enzyme, both the Tyr-296 and
      Gln-296 enzymes showed significant resistance against diethyl pyrocarbonate.
      These results clearly indicate that His-296 is essential for the catalysis by D
      lactate dehydrogenase, as in the case of His-195 in L-lactate dehydrogenase.

PMID- 8349684
TI  - Purification and characterization of active human interleukin-1 beta-converting
      enzyme from THP.1 monocytic cells.
AB  - Interleukin-1 beta-converting enzyme (ICE) was purified from dialyzed cytoplasmic
      extracts of THP.1 human monocytic cells by a combination of DEAE-5PW and SP-5PW
      ion exchange and C4 reverse phase high performance liquid chromatography.
      Sequence information from tryptic and Asp.N peptides on the isolated 20-kDa (p20)
      and a 10-kDa (p10) proteins enabled the subsequent cloning of ICE (Thornberry, N.
      A., Bull, H. G., Calaycay, J. R., Chapman, K. T., Howard, A. D., Kostura, M. J.,
      Miller, D. K., Molineaux, S. M., Weidner, J. R., Aunins, J., Elliston, K. O.,
      Ayala, J. M., Casano, F. J., Chin, J., Ding, G. J.-F., Egger, L. A., Gaffney, E.
      P., Limjuco, G., Palyha, O. C., Raju, S. M., Rolando, A. M., Salley, J. P.,
      Yamin, T.-T., Lee, T. D., Shively, J. E., MacCross, M., Mumford, R. A., Schmidt,
      J. A., and Tocci, M. J. (1992) Nature 356, 768-774) and localized the active site
      Cys. Immunoblots with ICE specific antibodies and NH2-terminal sequencing
      indicated that ICE active column fractions contained in addition to p20 and p10
      an alternatively processed form of the p20 protein (p22) containing an extra 16
      amino acids NH2-terminal to the p20. Furthermore, immunoblot analysis of the ion
      exchange column effluent showed that p20 and p22 were found together in three
      separate fractions distinguished by differences in p10: an intact p10 with
      complete ICE activity, a COOH-terminally truncated form of p10 with decreased ICE
      activity, and an absence of p10 with no ICE activity. These results indicate that
      the p10 protein is essential for ICE activity and that the ICE holoenzyme
      contains an intact p10 subunit paired with a p20 or p22 catalytic subunit.

PMID- 8349683
TI  - Intestinal bile acid absorption. Na(+)-dependent bile acid transport activity in
      rabbit small intestine correlates with the coexpression of an integral 93-kDa and
      a peripheral 14-kDa bile acid-binding membrane protein along the duodenum-ileum
      axis.
AB  - The anatomical localization of the Na+/bile acid cotransport system from rabbit
      small intestine was determined using brush border membrane vesicles prepared from
      eight different segments of the small intestine. Na(+)-dependent transport
      activity for bile acids, both for [3H]taurocholate and [3H]cholate, was found in
      the distal segment 8 only representing the terminal 12% of the small intestine.
      In contrast, the Na(+)-dependent D-glucose transporter and the H(+)-dependent
      oligopeptide transporter were found over the whole length of rabbit small
      intestine in all segments. Photoaffinity labeling with 7,7-azo- and 3,3-azo
      derivatives of taurocholate with subsequent fluorographic detection of labeled
      polypeptides after one- and two-dimensional gel electrophoresis showed that an
      integral membrane polypeptide of M(r) 87,000 is present in the entire small
      intestine, whereas an integral membrane protein of M(r) 93,000 together with a
      peripheral membrane protein of M(r) 14,000 are exclusively expressed in the
      distal small intestine correlating with Na(+)-dependent bile acid transport
      activity. Photoaffinity labeling with the cationic bile acid derivative 1-(7,7
      azo-3 alpha,12 alpha-dihydroxy-5 beta[3 beta-3H]cholan-24-oyl)-1,2- diaminoethane
      hydrochloride and 7,7-azo-3 alpha,12 beta-dihydroxy-5 beta[12 alpha-3H]cholan-24
      oic acid did not result in a specific labeling of the above mentioned proteins,
      demonstrating their specificity for physiological bile acids. Photoaffinity
      labeling of the 93- and 14-kDa bile acid-binding proteins was strongly Na(+)
      dependent. Significant labeling of the 93- and 14-kDa proteins occurred only in
      the presence of Na+ ions with maximal labeling above 100 mM [Na+] showing a
      parallel [Na+] dependence to transport activity. Inactivation of Na(+)-dependent
      [3H]taurocholate uptake by treatment of ileal brush border membrane vesicles with
      4-nitrobenzo-2-oxa-1,3-diazol chloride led to a parallel decrease in the extent
      of photoaffinity labeling of both the 93- and 14-kDa protein. Sequence analysis
      of the membrane-bound 14-kDa bile acid-binding protein surprisingly revealed its
      identity with gastrotropin, a hydrophobic ligand-binding protein exclusively
      found in the cytosol from ileocytes and thought to be involved in the
      intracellular transport of bile acids from the brush border membrane to the
      basolateral pole of the ileocyte. In conclusion, the present studies suggest that
      both an integral 93- and a peripheral 14-kDa membrane protein, identified as
      gastrotropin, and both exclusively expressed in the terminal ileum, are essential
      components of the Na+/bile acid cotransport system in rabbit terminal ileum.

PMID- 8349685
TI  - The sequence-specific high mobility group 1 box of TCF-1 adopts a predominantly
      alpha-helical conformation in solution.
AB  - The High Mobility Group (HMG) 1 box is a protein motif that mediates DNA binding
      in a novel family of transcription-regulating proteins. Several members of this
      family, including the lymphoid-specific proteins TCF-1 and LEF-1 and the
      mammalian sex-determining factor SRY, carry a single HMG box with affinity for
      the minor groove of the heptamer motif AACAAAG or variations thereof. To initiate
      studies on the structural characteristics of the TCF-1 HMG box, we have expressed
      the 87-amino acid HMG box in milligram quantities in Escherichia coli and
      purified the soluble peptide to > 95% homogeneity. The peptide bound DNA with the
      same specificity as the complete protein and was capable of inducing DNA bending.
      Circular dichroism (CD) analysis revealed the TCF-1 HMG box to adopt an
      approximately 60% alpha-helix/40% random coil conformation in solution. In the
      presence of an equimolar amount of double-stranded DNA containing the cognate
      motif, the CD spectrum changed significantly, implying the induction of a
      structural modification upon DNA/protein association.

PMID- 8349686
TI  - A hinge region mutation in C1-inhibitor (Ala436-->Thr) results in nonsubstrate
      like behavior and in polymerization of the molecule.
AB  - C1-inhibitor(Mo), a dysfunctional C1-inhibitor molecule produced in two kindred
      with type II hereditary angioedema, has a mutation at the P10 position (Ala436 to
      Thr). Like most serpins with hinge region mutations (P14, P12, P10), C1
      inhibitor(Mo) loses its inhibitory activity. However, unlike the other hinge
      region mutations, this mutant is not converted to a substrate. As shown by
      nondenaturing gel electrophoresis, gel filtration, sucrose density gradient
      ultracentrifugation, and electron microscopy, C1-inhibitor(Mo) exists in both
      monomeric and multimeric forms. Polymerization probably results from reactive
      center loop insertion into the A sheet of an adjacent molecule. Native C1
      inhibitor(Mo) was shown to have a thermal stability profile intermediate to those
      of intact and of cleaved normal C1-inhibitor. Native C1-inhibitor(Mo) did not
      bind to monoclonal antibody KII, which binds only to reactive center-cleaved
      normal C1-inhibitor. It did, however, react with monoclonal antibody KOK12, which
      recognizes complexed or cleaved C1-inhibitor but not intact normal C1-inhibitor.
      Native C1-inhibitor(Mo), therefore, exists in a conformation similar to the
      complexed form of normal C1-inhibitor.

PMID- 8349687
TI  - Interferon-gamma induces receptor dimerization in solution and on cells.
AB  - The extracellular domain (ECD) of the human interferon-gamma (IFN gamma) receptor
      was stably expressed in Chinese hamster ovary cells and purified to homogeneity.
      Scatchard analysis of 125I-IFN gamma binding to ECD preparations revealed the
      formation of a ligand-receptor complex which displayed a Ka of 6.4 +/- 0.9 x
      10(8) M-1. Two types of complexes were identified by sucrose density gradient
      ultracentrifugation. The stoichiometry of the major ECD-ligand complex was
      determined by high performance liquid chromatography gel filtration. When IFN
      gamma was incubated with a 2-fold molar excess of ECD, a 190-kDa complex was
      isolated that contained 2 mol of ECD per 1 mol of IFN gamma. IFN gamma also
      induced dimerization of IFN gamma receptors expressed at the cell surface as
      detected by chemically cross-linking receptor bound ligand and analyzing cell
      lysates by SDS-polyacrylamide gel electrophoresis and immunoblotting. Finally,
      labeled forms of ECD bound to cells preincubated at 4 degrees C with excess
      amounts of IFN gamma indicating that the ligand could associate with more than
      one receptor molecule in the absence of chemical cross-linking agents. These
      results demonstrate that IFN gamma effects dimerization of its receptor under
      physiologic conditions and suggest that IFN gamma receptor dimerization may be an
      important event in inducing IFN gamma-dependent biologic responses.

PMID- 8349688
TI  - Guanine nucleotide-specific phosphate transfer by guanine nucleotide-binding
      regulatory protein beta-subunits. Characterization of the phosphorylated amino
      acid.
AB  - One major substrate protein was phosphorylated with [gamma-32P]GTP in membranes
      of human leukemia (HL-60) cells. The phosphoprotein comigrated with beta-subunits
      of heterotrimeric GTP-binding proteins (G proteins) in different gel systems.
      Upon solubilization of the phosphorylated membranes, the phosphoprotein could be
      immunoprecipitated by a G protein beta-subunit-specific antiserum. The beta
      subunit phosphorylation was transient and was found to be specific for GTP and
      its analog, guanosine 5'-O-(gamma-thio)triphosphate. When phosphorylated
      membranes were incubated with various nucleotides, the bound phosphate was
      specifically removed by GDP, suggesting that the phosphate can be retransferred
      onto GDP. Divalent cations, preferentially Mg2+ and Mn2+, were required for both
      phosphorylation and dephosphorylation. The phosphorylation was stable against
      treatment with NaOH but sensitive to treatment with heat, HCl, and hydroxylamine.
      Moreover, treatment of the membranes with the histidine-modifying agent, diethyl
      pyrocarbonate, resulted in a loss in phosphate incorporation. The data suggest
      that G protein beta-subunits are involved in a guanine nucleotide-specific
      enzymatic activity transferring the gamma-phosphate from GTP to GDP, presumably
      at G protein alpha-subunits, via a phosphohistidine intermediate.

PMID- 8349689
TI  - Nonenzymatic glycation alters protein structure and stability. A study of two eye
      lens crystallins.
AB  - We have investigated the effect of nonenzymatic glycation (fructation) in vitro
      on the structure and stability of two proteins that are glycated in vivo as a
      consequence of high endogenous levels of sugar. We find that whereas fructation
      leads to the structural destabilization of the monomeric gamma-crystallin from
      the core of the eye lens, it leads to an increase in stability in the multimeric
      alpha-crystallin of the lens cortex. Thus, while glycated gamma-crystallin shows
      (a) a longer wavelength of fluorescent emission, indicating a greater exposure of
      its aromatic side chains to the medium; (b) a reduced secondary structural
      content; and (c) a more facile denaturation by thermodynamic and chemical means,
      alpha-crystallin displays the opposite behavior. Furthermore, alpha-crystallin
      shows an increased tendency toward multimeric aggregation upon fructation. We
      interpret these differences in the broad context of the effects of neutralization
      of positive charges on protein structure and stability. Fructation tends to
      destabilize gamma-crystallin, by effecting a significant reversal in the balance
      of charges in the protein, at physiological pH. alpha-Crystallin is a multimeric
      protein whose pI is lower than its pH of optimum stability. Fructation in this
      case effectively neutralizes the cationic charges and promotes conformational
      order. This study indicates that although glycation brings about similar changes
      in the covalent chemical structures of proteins, its influence on the three
      dimensional structures of different proteins can be different.

PMID- 8349690
TI  - Rab GDP dissociation inhibitor as a general regulator for the membrane
      association of rab proteins.
AB  - Rab proteins comprise a family of small GTPases that serve a regulatory role in
      membrane traffic. These proteins are in part cytosolic and in part associated
      with the membranes of specific exocytic and endocytic organelles. Smg p25A/rab3A
      GDI, a cytosolic protein which inhibits the dissociation of GDP from smg
      p25A/rab3A, Sec4p, and rab11, has also been found to prevent association of rab3A
      with the membrane. In this study, we have used Madin-Darby canine kidney cells
      permeabilized with the bacterial toxin streptolysin O to test the general
      activity of rab3A GDI in modulating the membrane association of various small GTP
      binding proteins. Rab3A GDP dissociation inhibitor (GDI) removed from the
      membrane all rab proteins we have tested and inhibited the membrane binding of in
      vitro translated rab proteins. However, rab3A GDI had a limited effect on the
      membrane association of a mutant rab5 protein which contained a farnesylated
      cysteine motif. Finally, we found that, although rab3A GDI resides primarily in
      the cytosol, it is also associated with compartments of the exocytic and
      endocytic pathways. Since rab3A GDI can modulate the membrane association of
      various rab proteins, we propose to rename it rab GDI.

PMID- 8349691
TI  - Phosphorylation of the insulin receptor substrate IRS-1 by casein kinase II.
AB  - IRS-1, a principal substrate of the insulin receptor, is phosphorylated on
      serine, threonine, and tyrosine residues in a variety of tissues during insulin
      stimulation. Casein kinase II, an insulin-sensitive serine/threonine kinase,
      catalyzed the in vitro incorporation of 1 to 2 mol of phosphate/mol of
      recombinant rat IRS-1. Two-dimensional phosphopeptide mapping of IRS-1
      phosphorylated by casein kinase II in vitro and IRS-1 immunoprecipitated from
      intact Chinese hamster ovary cells demonstrated multiple common phosphopeptides,
      suggesting that overexpressed IRS-1 is a substrate for casein kinase II in these
      cells. Moreover, the common phosphopeptides that appeared to be insulin-sensitive
      in intact cells comprised 22% of casein kinase II-catalyzed 32P incorporation
      into IRS-1 in vitro. These data suggest that casein kinase II mediates a portion
      of the insulin-stimulated serine/threonine phosphorylation of overexpressed IRS-1
      in vivo. By using phosphoamino acid analysis, strong cation exchange analysis,
      manual Edman degradation, and automated amino acid sequencing, Thr-502 was
      identified as the major casein kinase II-catalyzed phosphorylation site in rat
      IRS-1. Furthermore, Ser-99, an additional site labeled at low yield, appeared to
      be contained in an insulin-sensitive phosphopeptide. Thus, casein kinase II
      catalyzed phosphorylation of IRS-1 may be a component of the intracellular
      insulin signalling cascade.

PMID- 8349692
TI  - Multiple domains of the N-formyl peptide receptor are required for high-affinity
      ligand binding. Construction and analysis of chimeric N-formyl peptide receptors.
AB  - Binding of the chemotactic tripeptide fMet-Leu-Phe (fMLP) to its receptor on
      phagocytes activates these cells through a G protein-coupled pathway. To
      delineate the structural requirement of the N-formyl peptide receptor (FPR) for
      ligand binding and signaling, we constructed chimeric receptors between FPR and a
      recently identified granulocyte receptor, FPR2 (Ye, R. D., Cavanagh, S. L.,
      Quehenberger, O., Prossnitz, E. R., and Cochrane, C. G. (1992) Biochem. Biophys.
      Res. Commun. 184, 582-589). FPR2 shares 69% sequence homology with the FPR; yet
      it binds fMLP with a low affinity (Kd = 430 nM), as compared with the high
      affinity (Kd = 1 nM) displayed by the FPR. This property of the FPR2 was utilized
      for mapping the FPR ligand binding domains. Seven chimeric FPR/FPR2 receptors
      were generated by sequential replacement of the FPR segments with the
      corresponding regions from FPR2. Three reciprocal FPR2/FPR chimeric receptors
      were also constructed by selective substitution of the FPR segments into FPR2.
      These chimeric receptors were stably expressed in transfected fibroblasts and
      analyzed for their ligand binding and transmembrane signaling properties.
      Replacement of the FPR domains, including the first and the third extracellular
      loops, resulted in 275- and 85-fold decrease in ligand binding affinity,
      respectively. Introduction of both domains into the FPR2 significantly increased
      ligand binding affinity (Kd = 18 nM), whereas substitution of the domains
      containing the first or third extracellular loop alone improved ligand binding to
      a lesser degree (Kd = 90 and 372 nM, respectively). In contrast, substitution of
      either the amino or the carboxyl-terminal regions with those of the FPR2 had
      little effect on ligand binding affinity. An analysis of the sequences of the two
      receptors revealed several key residues in the first and the third extracellular
      loops of the FPR and their adjacent transmembrane domains that may be essential
      for binding of fMLP. We propose that multiple domains of the FPR are required for
      high-affinity ligand binding, with a major determinant located in the first
      extracellular loop and its adjacent transmembrane domains.

PMID- 8349693
TI  - Rhodopsin is the major in situ substrate of protein kinase C in rod outer
      segments of photoreceptors.
AB  - Phorbol ester treatment of 32P-labeled retinas results in a light-dependent
      alteration in the phosphorylation state of rhodopsin. Previously we reported that
      phorbol myristate acetate causes an increase in the phosphorylation state of
      rhodopsin in retinas exposed to a brief flash of light, with the greatest
      increase in phosphorylation observed at lower (< or = 10%) bleach levels (Newton,
      A. C., and Williams, D. S. (1991) J. Biol. Chem. 266, 17725-17728). Here we show
      that phorbol myristate acetate causes a decrease in the phosphorylation of
      rhodopsin after exposure to levels of illumination that result in maximal
      bleaching of the visual receptor. In contrast, no rhodopsin phosphorylation is
      detected in control or phorbol ester-treated retinas in the dark. Partial
      proteolysis revealed that phorbol esters alter the phosphorylation of the
      carboxyl-terminal domain of rhodopsin. Rhodopsin is the major protein whose
      phosphorylation state is affected significantly by phorbol esters in situ,
      although a number of rod outer segment cytosolic and membrane proteins are
      phosphorylated by protein kinase C in vitro. Our data indicate that a major
      target of protein kinase C in rod outer segments is rhodopsin.

PMID- 8349694
TI  - Platelet-derived growth factor increases the turnover of GTP/GDP on ras in
      permeabilized fibroblasts.
AB  - The potent mitogen platelet-derived growth factor (PDGF) induced a rapid increase
      in Ras.GTP in permeabilized human and murine fibroblasts. The effect was
      initiated by both PDGF-AA acting exclusively through PDGF alpha-receptors, and by
      PDGF-BB interacting with both alpha- and beta-type receptors. The dose-response
      curves suggest that both receptor types mediate the response. PDGF-dependent Ras
      activation, measured as increased formation of Ras.GTP, was rapid and reversible.
      At 37 degrees C the effect had a duration of around 10 min. The PDGF-dependent
      increase in Ras.GTP was followed by a simultaneous increase in Ras.GDP. Under no
      experimental condition could a relative increase in Ras.GTP be detected. 0.5
      microM GDP and 0.5 microM GTP were equally potent competing for the formation of
      Ras.[alpha-32P]GTP upon PDGF stimulation. Furthermore, when the basal nucleotide
      exchange rate on Ras was elevated by omission of Mg2+ from the medium, PDGF had
      no further effect on the formation of Ras.GTP. We therefore conclude that PDGF
      activates Ras through a mechanism leading to an increased nucleotide exchange on
      Ras.

PMID- 8349695
TI  - Ebulin 1, a nontoxic novel type 2 ribosome-inactivating protein from Sambucus
      ebulus L. leaves.
AB  - A novel type 2 ribosome-inactivating protein (RIP) that we named ebulin 1 has
      been isolated from leaves of Sambucus ebulus L. (Caprifoliaceae). In vitro ebulin
      1 strongly inhibited protein synthesis by rabbit reticulocyte lysates, rat brain,
      and rat liver cell-free systems but did not affect in vitro plant nor bacterial
      protein synthesis. Ebulin 1 is composed of two subunits, a catalytic A subunit
      (M(r) 26,000) and a D-galactose-binding lectin B subunit (M(r) 30,000). Amino
      terminal amino acid sequence homology revealed the novelty that the ebulin 1 A
      chain shares a high degree of homology not with the A-chain of other type 2 RIPs
      but rather with the Cucurbitaceae type 1 RIP briodin S and the anti-human
      immunodeficiency virus type I proteins trichosanthin and TAP 29. Upon treatment
      with acid aniline the rRNA from ebulin 1-treated rabbit reticulocyte ribosomes
      released the RNA fragment which is diagnostic of RIP catalytic action. Ebulin 1
      was nontoxic to mice up to 2 mg/kg of body weight and did not inhibit protein
      synthesis in cultured NHC human epithelial cells which are highly sensitive to
      ricin.

PMID- 8349696
TI  - Regulation of atrial natriuretic peptide clearance receptors in mesangial cells
      by growth factors.
AB  - Rat mesangial cells can express both 130-kDa guanylyl cyclase-coupled and 66-kDa
      non-coupled atrial natriuretic peptide (ANP) receptors (ANPR-A and ANPR-C,
      respectively). Exposure of mesangial cells, grown in 20% fetal calf serum, to
      0.1% serum for 24 h increased total ANP receptor density more than 2-fold (Bmax =
      87 versus 37 fmol/mg of cell protein) without changing binding affinity (Kd = 94
      versus 88 pM). Radioligand binding and cross-linking studies demonstrated that up
      regulation of ANP binding after serum deprivation was entirely due to an increase
      in ANPR-C, with little or no change in ANPR-A. Inhibition of protein synthesis
      with cycloheximide blocked up-regulation after serum deprivation. Steady-state
      ANPR-C mRNA level was increased 15-fold by serum deprivation, as judged by
      Northern blotting. There was no change in ANPR-A mRNA. Platelet-derived growth
      factor and phorbol myristate acetate, when added to low serum medium, blocked or
      reversed the effect of serum deprivation on ANPR-C. We conclude that synthesis
      and expression of ANPR-C but not ANPR-A is suppressed by serum, platelet-derived
      growth factor, and phorbol myristate acetate. Suppression of ANPR-C in vivo could
      contribute to mesangial cell proliferative responses to growth factors.

PMID- 8349697
TI  - Mutations in the carboxyl-terminal propeptide of the pro alpha 1(I) chain of type
      I collagen result in defective chain association and produce lethal osteogenesis
      imperfecta.
AB  - Fibroblast cell strains from three infants with perinatal lethal osteogenesis
      imperfecta (OI) carry unique mutations in COL1A1 (the gene encoding the pro alpha
      1(I) chain of type I procollagen) that impair chain association. The three
      mutations are: substitution of arginine for leucine at position 170 in the
      carboxyl-terminal propeptide, substitution of histidine for aspartic acid at
      position 59 of the propeptide, and a 6-base pair deletion that results in loss of
      2 amino acid residues, glutamic acid and tyrosine, at positions 119 and 120 of
      the propeptide. In each cell strain the rate of association of the abnormal chain
      into molecules is slowed and formation of interchain disulfide bonds is impaired.
      The substitution at residue 59 alters the most highly conserved region of the
      propeptide and has a much greater effect on the incorporation of pro alpha 2(I)
      chains into disulfide-bonded trimers than the other two mutations. The molecules
      that contain the abnormal chains are extensively overmodified by post
      translational modifying enzymes, yet have a normal thermal stability. These
      findings extend the range of lethal mutations in the type I collagen genes and
      help to identify regions of the carboxyl-terminal propeptide that may be
      important for chain-chain recognition and molecular assembly.

PMID- 8349698
TI  - BiP binds type I procollagen pro alpha chains with mutations in the carboxyl
      terminal propeptide synthesized by cells from patients with osteogenesis
      imperfecta.
AB  - Of 20 fibroblast cell strains from patients with osteogenesis imperfecta (OI), a
      disease caused by mutations in the genes encoding type I procollagen, three had
      increased synthesis of BiP (GRP78), an hsp70-related, endoplasmic reticulum
      resident protein. All three strains carry unique mutations in pro alpha 1(I)
      chains which impair type I procollagen chain association. Immunoprecipitation and
      pulse-chase experiments show that BiP (immunoglobulin heavy chain-binding
      protein) stably binds pro alpha 1(I) chains in these three cell strains after a
      brief lag. Ascorbate, which increases procollagen synthesis, increases BiP
      synthesis and content in these three strains and not in the others. In one of
      these three strains, BiP content is constitutively elevated prior to ascorbate
      treatment, and BiP is less inducible. This strain also has relatively high levels
      of synthesis and content of GRP94, another endoplasmic reticulum-resident stress
      protein. Pretreating each of the three cell strains to increase their BiP content
      reduces subsequent ascorbate-mediated BiP induction. BiP synthesis in the 17
      other OI strains examined, which had a variety of type I procollagen mutations,
      was normal. These results suggest that BiP is induced by and binds procollagen
      with specific types of mutations: ones in the carboxyl-terminal propeptide that
      interfere with chain association. The recognition by BiP of such procollagen in
      OI cell strains shows that BiP plays a role in the physiological response to the
      production of some disease-producing abnormal proteins.

PMID- 8349699
TI  - N-glycosylation of prostaglandin endoperoxide synthases-1 and -2 and their
      orientations in the endoplasmic reticulum.
AB  - Using site-directed mutagenesis, we have determined that Asn68, Asn144, and
      Asn410 of ovine prostaglandin endoperoxide (PGH) synthase-1 are N-glycosylated. A
      fourth consensus N-glycosylation sequence at Asn104 is not glycosylated.
      Glycosylation of PGH synthase-1 at Asn410 and at either Asn68 or Asn144 was
      required for expression of both the cyclooxygenase and the peroxidase activities
      of the enzyme. Inactive PGH synthase-1 glycosylation site mutant proteins do not
      appear to achieve their native conformations. However, the native enzyme, once in
      an active conformation, does not appear to require attached carbohydrate for
      cyclooxygenase or peroxidase activities. N-Glycosylation consensus sequences
      corresponding to the three glycosylation sites of ovine PGH synthase-1 are
      conserved in the deduced amino acid sequences of PGH synthases-2. Using site
      directed mutagenesis, we determined that there is an additional site of N
      glycosylation in murine PGH synthase-2 located at Asn580. This site is N
      glycosylated in about 50% of PGH synthase-2 molecules, resulting in two peptide
      bands on SDS-polyacrylamide gel electrophoresis (72 and 74 kDa). Glycosylation of
      PGH synthase-2 is necessary for expression of enzyme activity, but glycosylation
      of PGH synthase-2 at Asn580 per se does not affect activity. Assuming that the N
      glycosylation sites of PGH synthase-1 are on the luminal side of the endoplasmic
      reticulum (ER), and that the site of tryptic cleavage of ovine PGH synthase-1
      (Arg277) is on the cytoplasmic side of the ER, we propose that both the NH2 and
      COOH termini of PGH synthase-1 are located in the lumen of the ER and that there
      are two transmembrane domains located between Asn144 and Arg277 and between
      Arg277 and Asn410, respectively. A similar orientation is predicted for PGH
      synthase-2.

PMID- 8349700
TI  - Covalent modification of proteins by arachidonate and eicosapentaenoate in
      platelets.
AB  - The posttranslational modification of proteins by fatty acids has been shown to
      involve long chain-saturated fatty acids, predominantly palmitate. In the present
      study, we demonstrated by metabolic labeling of human platelets with
      [3H]arachidonate and [3H]eicosapentaenoate that these polyunsaturated fatty acids
      can also become covalently linked to proteins. The extent of binding of
      arachidonate to proteins was somewhat less than that of palmitate. Arachidonate
      binding to platelet proteins was not significantly influenced by the inhibition
      of cyclooxygenase and lipoxygenase. This finding and the high performance liquid
      chromatography analysis of radiolabeled products removed from proteins by
      selective cleavage techniques established that arachidonate, and not its
      metabolic products, was the protein-linked radiolabeled moiety in
      [3H]arachidonate-labeled platelets. A 7.5-fold higher concentration of unlabeled
      palmitate competed to a small extent with [3H] arachidonate for protein labeling.
      Both arachidonate and eicosapentaenoate were bound to proteins almost exclusively
      through ester linkages. It was further demonstrated that 61 and 66% of total
      protein-linked arachidonate and eicosapentaenoate, respectively, were bound via
      thioester bonds. In contrast, 91% of the binding of palmitate to proteins
      occurred via thioester linkages. As demonstrated by SDS-polyacrylamide gel
      electrophoresis and fluorography, the patterns of palmitoylated and
      arachidonoylated proteins were similar but not identical, with selected proteins
      only palmitoylated or only arachidonoylated. [3H]Eicosapentaenoate labeled the
      same set of proteins as [3H]arachidonate. The fluorographic pattern of 3H
      arachidonoylated proteins was not changed by cyclooxygenase and lipoxygenase
      inhibitors. The binding of a polyunsaturated fatty acid to a protein in place of
      a saturated fatty acid could significantly influence the hydrophobic interactions
      of the protein and, thereby, have important functional implications.

PMID- 8349701
TI  - Specific binding of heterogeneous ribonucleoprotein particle protein K to the
      human c-myc promoter, in vitro.
AB  - A homopurine/homopyrimidine-like sequence is found 100-150 base pairs upstream of
      the human c-myc promoter P1. This element, termed the CT-element, has been shown
      to augment expression from P1, and it serves as a positive transcriptional
      element when coupled to a heterologous promoter in vivo and in vitro. Synthetic
      oligonucleotides comprising this element were used to form DNA-protein complexes
      in electrophoretic mobility shift assays. By using conventional and affinity
      methods, 61- and 34-kDa proteins were shown to be associated with these
      complexes. Amino acid sequence analysis and immunological methods have identified
      these proteins as heterogeneous ribonucleoprotein particle (hnRNP) proteins K and
      A1. Surprisingly, hnRNP protein K binds to the pyrimidine-rich strand of the CT
      element in a sequence-specific manner as well as to the double-stranded molecule.
      Cotransfection of vectors encoding hnRNP protein K in the sense or anti-sense
      orientations with reporter plasmids driven by wild-type or mutant CT-elements
      demonstrates that hnRNP protein K augments gene expression in a cis-element
      dependent manner. Taken together, these results suggest that hnRNP protein K may
      play a role in the transcriptional regulation of the human c-myc gene.

PMID- 8349702
TI  - Structure/function relationships in hexokinase. Site-directed mutational analyses
      and characterization of overexpressed fragments implicate different functions for
      the N- and C-terminal halves of the enzyme.
AB  - Hexokinases are comprised of two highly homologous approximately 50-kDa halves
      and are product-inhibited by glucose-6-P. Four amino acid residues, Ser603,
      Asp657, Glu708, and Glu742, located in the C-terminal half of the tumor
      mitochondrial enzyme have been shown to be essential for enzyme function (Arora,
      K. K., Filburn, C. R., and Pedersen, P. L. (1991) J. Biol. Chem. 266, 5359-5362).
      Here we have assessed also the role of the N-terminal half of the same enzyme.
      Site-directed mutagenesis of residues predicted to interact with glucose in the N
      terminal half, i.e. Ser155, Asp209, and Glu260, to Ala, have no effect on
      hexokinase activity. In addition, inhibition by hexose mono- and bisphosphates is
      unchanged for each of the mutant enzymes. Significantly, the overexpressed N
      terminal polypeptide is devoid of catalytic activity but does have the capacity
      to bind ATP-agarose and be released with ATP and glucose-6-P. In contrast, the
      overexpressed C-terminal polypeptide is catalytically active and shows the same
      product inhibition pattern as the complete 100-kDa parent enzyme. These results
      emphasize that the N-terminal half of tumor hexokinase is essential neither for
      catalysis nor product modulation. Rather, the N-terminal half may play another
      role, perhaps in modulation of the ATP/glucose-6-P-dependent binding of the
      enzyme to tumor mitochondria or by acting as a spacer between the outer
      mitochondrial membrane and the C-terminal catalytic unit.

PMID- 8349703
TI  - Requirement of phenylalanine 343 for the preferential delta 4-lyase versus delta
      5-lyase activity of rat CYP17.
AB  - Site-directed mutagenesis of a domain (amino acids 343-348) within the conserved
      region of rat CYP17 was performed to investigate species-specific differences
      between rat and human/bovine delta 4-versus delta 5-lyase activity. This domain
      displays substantial deviations between the rat and human/bovine/pig sequences
      and includes Arg346, which is known to be essential for delta 4-lyase (Kitamura,
      M., Buczko, E., and Dufau, M. L. (1991) Mol. Endocrinol. 5, 1373-1380) and delta
      5-lyase activities. Analysis of the delta 4-lyase activity of mutant rat CYP17
      cDNA expressed in nonsteroidogenic COS-1 cells revealed that substitution of Phe
      at position 343 in the rat with Ile of the human/bovine sequence resulted in a
      reduction in delta 4-lyase activity to levels in the range of the delta 5
      supported reaction. This Phe343-->Ile mutant CYP17 did not exhibit changes either
      in delta 5-supported lyase activity or in delta 4- and delta 5-hydroxylase
      activities. Substitution of Asn344, Ser347, and His348 in rat CYP17 with the
      corresponding bovine amino acids Ser, Asn, and Arg did not enhance this effect.
      Thus, the reduced activity of the bovine CYP17 delta 4-lyase reaction can be
      mimicked in part in the rat polypeptide by the substitution of Phe343 with the
      bovine counterpart, Ile. Unlike the bovine CYP17-catalyzed reaction, the rat
      Phe343-->Ile mutant exhibited a low level lyase activity (kcat) that did not
      discriminate between delta 4- and delta 5-substrates. These results suggest that
      the presence of Phe343 enhances the delta 4-supported lyase activity possibly
      through stabilization of a delta 4-specific interaction.

PMID- 8349704
TI  - VMA13 encodes a 54-kDa vacuolar H(+)-ATPase subunit required for activity but not
      assembly of the enzyme complex in Saccharomyces cerevisiae.
AB  - Previous purifications and characterizations of the Saccharomyces cerevisiae
      vacuolar proton-translocating ATPase (V-ATPase) have indicated that this enzyme
      is a multisubunit complex composed of at least eight subunits of 100-, 69-, 60-,
      42-, 36-, 32-, 27-, and 17-kDa (Kane, P. M., Yamashiro, C. T., and Stevens, T. H.
      (1989) J. Biol. Chem. 264, 19236-19244). We report the cloning and
      characterization of an additional V-ATPase subunit, the 54-kDa subunit, which is
      encoded by the VMA13 gene. VMA13 was isolated by complementation of the growth
      phenotypes associated with the vma13 mutation, which was originally described as
      cls11 (Ohya, Y., Umemoto, N., Tanida, I., Ohta, A., Iida, H., and Anraku, Y.
      (1991) J. Biol. Chem. 266, 13971-13977). The nucleotide sequence of the VMA13
      gene predicted a hydrophilic polypeptide with a calculated molecular mass of
      54,415 daltons. The VMA13 54-kDa gene product resides on the vacuolar membrane
      and co-purified with the active V-ATPase complex. Characterization of a null
      vma13 mutant (delta vma13) revealed that the Vma13 polypeptide is essential for V
      ATPase activity. However, the Vma13 polypeptide is not required for targeting of
      the other V-ATPase subunits (100-, 69-, 60-, 42-, 27-, or 17-kDa subunits) to the
      vacuolar membrane as shown by the association of these subunits with vacuolar
      membranes isolated from delta vma13 cells. The nature of the V-ATPase "complex"
      in delta vma13 mutant is, nevertheless, fundamentally different from the wild
      type enzyme. This is evidenced by the fact that the inactive V-ATPase complex
      from delta vma13 cells is less stable than the wild-type enzyme. Taken together,
      these results indicate that VMA13 encodes the 54-kDa subunit of the V-ATPase and
      that this subunit is essential for activity, but not assembly, of the enzyme
      complex.

PMID- 8349705
TI  - Functional characterization of a human brain cholecystokinin-B receptor. A
      trophic effect of cholecystokinin and gastrin.
AB  - We have cloned a human brain cholecystokinin (CCK)-B receptor cDNA and
      characterized its function by introducing it into Chinese hamster ovary (CHO)
      cells. The deduced amino acid sequence was highly conserved as compared with
      those of the gastrin receptors in Mastomys enterochromaffin-like cells (90%) and
      canine parietal cells (89%). Human brain CCK-B receptors possessed slightly but
      significantly higher affinities for CCK-8 than for gastrin I, while both ligands
      bound equally to Mastomys enterochromaffin-like cell-derived gastrin receptors.
      Both CCK-8 and gastrin I markedly augmented phosphoinositide hydrolysis and
      cytosolic free calcium levels in the CHO transfectants, indicating that the
      cloned CCK-B receptor could functionally couple with intracellular signaling
      molecules. Moreover, CCK-8 and gastrin I dose-dependently increased [3H]thymidine
      incorporation of the CHO transfectants in serum-free medium and promoted cell
      growth. The CCK-B receptor mRNA was abundantly expressed in particular areas of
      the human brain and stomach, such as the cerebral cortex and mucosa of the
      gastric fundus. This is the first demonstration of trophic effects of CCK and
      gastrin through the normal human brain CCK-B receptor. The availability of this
      receptor cDNA will help to clarify the precise role of CCK in the central nervous
      system as well as digestive organs.

PMID- 8349706
TI  - Biosynthesis of reovirus-specified polypeptides. Analysis of ribosome pausing
      during translation of reovirus S1 and S4 mRNAs in virus-infected and vector
      transfected cells.
AB  - The steady-state distribution of translating ribosomes on the reovirus s1 and s4
      mRNAs was determined using a sensitive primer extension inhibition assay and cDNA
      clones of the reovirus S1 and S4 genes. Positions of significant ribosome pausing
      included the sites of initiation and termination of translation, both in vivo in
      reovirus-infected mouse fibroblast L cells and in vitro in rabbit reticulocyte
      lysates. The patterns of ribosome pausing detected in vivo and in vitro were
      comparable. Ribosomes were far less uniformly distributed along the polycistronic
      s1 mRNA than they were along the monocistronic s4 mRNA. During reovirus
      infection, ribosome pausing was detected at the initiation codons of the s1 mRNA
      sigma 1 and sigma 1ns open reading frames and the s4 mRNA sigma 3 open reading
      frame, direct evidence that initiation is a slow step of translation in vivo.
      Quantitative analysis of reovirus mRNA translation in infected and transfected
      cells suggested that ribosomes paused longer at an AUG initiation codon present
      in strong context than one present in weak context. These results suggest that
      the dynamics of ribosome movement during translation of the reovirus s1 and s4
      mRNAs are similar in vivo and in vitro and that the relative ribosome pause at an
      AUG initiation codon may be affected by the flanking nucleotide context of the
      AUG codon.

PMID- 8349707
TI  - An antigenic polysaccharide from Campylobacter coli serotype O:30. Structure of a
      teichoic acid-like antigenic polysaccharide associated with the
      lipopolysaccharide.
AB  - A water-soluble antigenic polysaccharide of high M(r) associated with the
      lipopolysaccharide has been isolated from phenol-water extraction of cells of
      Campylobacter coli serotype O:30. The polysaccharide and oligosaccharide
      degradation products formed on O-dephosphorylation and by periodate oxidation
      followed by reduction have been investigated by one- and two-dimensional 1H, 13C,
      and 31P NMR. It is concluded that the antigenic polysaccharide has a teichoic
      acid-like structure with a poly-Ribitol phosphate, [5-Ribitol-1-P]n, backbone
      with side chains at O-2 of O-(6-deoxy-beta-D-talo-heptopyranosyl)-(1-->4)-(2
      acetylamino-2-deoxy-beta-D- glucopyranosyl) units. The structure is unusual in
      Gram-negative bacteria and is unique in possessing 6-deoxy-D-talo-heptose as a
      constituent sugar. Evidence for the relationship of the antigenic polysaccharide
      to the lipopolysaccharide of low M(r) is discussed.

PMID- 8349709
TI  - The anticodon and discriminator base are important for aminoacylation of
      Escherichia coli tRNA(Asn).
AB  - A gel shift assay that distinguishes the aminoacylated form from the deacylated
      form of tRNAs was used to study the requirements for aminoacylation of
      Escherichia coli tRNA(Asn) in vivo. tRNA(Asn) derivatives containing single base
      changes in their anticodons or discriminator bases were constructed, and the
      extent of in vivo aminoacylation was determined directly. Substitution of U35
      with C35 or U36 with C36 abolished aminoacylation of the tRNA. Substitution of
      G34 with C34 converted tRNA(Asn) into a lysine acceptor. Thus, each of the
      anticodon nucleotides are important for aminoacylation of tRNA(Asn). Substitution
      of discriminator base G73 with A73 affected the extent of aminoacylation in vivo
      indicating that the discriminator base also contributes to aminoacylation of
      tRNA(Asn).

PMID- 8349708
TI  - Heparin-binding epidermal growth factor-like growth factor expression in cultured
      fetal human vascular smooth muscle cells. Induction of mRNA levels and secretion
      of active mitogen.
AB  - Heparin-binding EGF-like growth factor (HB-EGF) is a recently identified potent
      mitogen for smooth muscle cells (SMC). To explore whether SMC can also synthesize
      HB-EGF, cultured fetal human vascular SMC (FHVSMC) were analyzed for the
      production of HB-EGF mRNA and active growth factor. It was found that in FHVSMC,
      HB-EGF has the characteristics of an early response gene in that (i) the addition
      of fresh 10% fetal calf serum to serum-starved FHVSMC led to a rapid and
      transient rise in HB-EGF mRNA levels with a maximal induction of 12-14-fold
      occurring within 2-4 h, (ii) the phorbol ester, 12-O-tetradecanoylphorbol-13
      acetate (TPA) also elevated HB-EGF mRNA levels rapidly and transiently with a
      maximal induction of 7-8-fold occurring at 2-4 h, and (iii) cyclohexamide at 40
      micrograms/ml markedly increased basal, serum-, and TPA-induced HB-EGF mRNA
      levels. In addition, HB-EGF mRNA levels were increased 7-11-fold by addition of
      either HB-EGF itself, platelet-derived growth factor, or basic fibroblast growth
      factor, all potent SMC mitogens. Besides synthesizing HB-EGF mRNA, FHVSMC were
      found to release into conditioned medium a bioactive HB-EGF-like protein that
      cross-reacted with anti-HB-EGF antibody.

PMID- 8349710
TI  - Use of transgenic mice to map cis-acting elements in the liver fatty acid-binding
      protein gene (Fabpl) that regulate its cell lineage-specific, differentiation
      dependent, and spatial patterns of expression in the gut epithelium and in the
      liver acinus.
AB  - Axial pattern formation is sustained in the mammalian gut epithelium despite
      rapid and continuous renewal of its four principal cell lineages. The mouse and
      rat liver fatty acid-binding protein (L-FABP) genes (Fabpl) represent an
      excellent model for understanding the mechanisms that determine differentiation
      dependent, cell lineage-specific, and distinct regional patterns of expression
      along the crypt-to-villus and duodenal-to-ileal axes of the gut, as well as
      within the liver acinus. We have used transgenic mice to map cis-acting elements
      in rat Fabpl that control these patterns of gene expression. Seven transgenes
      were analyzed, representing sequential deletions of the 5'-nontranscribed domain
      of Fabpl linked to the human growth hormone (hGH) gene beginning at its
      nucleotide +3 (L-FABP/hGH+3). Several pedigrees of mice containing each one of
      the L-FABP/hGH+3 transgenes were examined at the end of their 8th and 20th weeks
      of postnatal life using immunocytochemical and RNA hybridization analyses. A
      remarkably compact sequence spanning nucleotides -132 to +21 of Fabpl is
      sufficient to establish and maintain a distribution of reporter mRNA and protein
      in villus-associated enterocytes located along the duodenal-to-ileal axis of the
      gut that resembles the pattern of expression of the endogenous Fabpl gene. L-FABP
      132 to +21/hGH+3 is also expressed in surface and pit mucous cells of gastric
      units and in enterocytes located in the colonic homologs of small intestinal
      villi, the surface epithelial cuffs. This pattern of transgene expression in the
      stomach and colon recapitulates that of the intact endogenous donor rat Fabpl but
      not that of mouse Fabpl, which is silent in these proximal and distal segments of
      the gastrointestinal tract. Analysis of mice containing L-FABP-4000 to +21/hGH+3,
      L-FABP-1600 to +21/hGH+3, L-FABP-596 to +21/hGH+3, L-FABP-246 to +21/hGH+3, and L
      FABP-186 to +21/hGH+3 indicate that Fabpl's cephalocaudal gradient is influenced
      by cis-acting suppressors of cecal and colonic expression located between
      nucleotides -4000 and -1600 and by cis-acting activators of cecal and colonic
      expression located between nucleotides -597 and -351. L-FABP-132 to +21/hGH+3 is
      precociously activated in proliferating and nonproliferating epithelial cells
      located in intestinal crypts. The suppressor(s) of L-FABP accumulation in crypt
      epithelial cell populations are not represented between nucleotides -4000 and
      +21, indicating that different cis-acting sequences regulate regional and
      differentiation-dependent patterns of Fabpl expression.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8349711
TI  - Functional consequences of alterations to hydrophobic amino acids located in the
      M4 transmembrane sector of the Ca(2+)-ATPase of sarcoplasmic reticulum.
AB  - Those hydrophobic residues between Ile298 and Ile315 in transmembrane segment M4
      of the Ca(2+)-ATPase of sarcoplasmic reticulum, not previously mutated, were
      mutated systematically in ways that would alter their size or polarity, and
      functional consequences were measured. Fourteen residues in this sequence are
      organized as juxtapositions of large, hydrophobic (Val, Leu, Ile) and small (Ala,
      Gly) residues, and these were altered so that large residues were substituted for
      small and vice versa. Several mutants exhibited diminished Ca2+ transport, but
      mutants A305V and A306V lost all Ca2+ transport function. In both cases, the
      mutants were phosphorylated with ATP in the presence of Ca2+ and with inorganic
      phosphate only in the absence of Ca2+, indicating that the Ca(2+)-binding sites
      were intact. Reduced Ca2+ affinity, as measured by Ca2+ dependence of
      phosphorylation from ATP, was observed for mutant A305V. In both mutants, the ADP
      insensitive phosphoenzyme intermediate (E2P) decayed slowly relative to the wild
      type enzyme, suggesting that the E2P to E2 conformational transition was
      impaired, slowing the rate of the phosphatase reaction. Double mutants which
      reversed the order of Val304 and Ala305 and Ala306 and Ile307, resulted in the
      same phenotype as the single Ala mutations. These results, combined with our
      previous demonstration that Glu309 is a Ca2+ binding residue, that Pro312 is
      involved in E1P to E2P conformational changes, and that Gly310 is involved in E2P
      to E2 conformational changes, support the hypothesis that transmembrane segment
      M4 plays a key role in the Ca2+ transport function of the Ca(2+)-ATPase through
      its involvement in both the binding of Ca2+ and the subsequent conformational
      changes which bring about the translocation of Ca2+ to the lumen of the membrane.

PMID- 8349713
TI  - The multiple roles for ATP in the Escherichia coli UvrABC endonuclease-catalyzed
      incision reaction.
AB  - The biochemical properties of the Escherichia coli UvrA tandem ATPase site
      mutants in nucleotide excision repair have been studied. In these and earlier
      studies it was found that ATP binding is required for protein-protein and
      nucleoprotein association reactions, whereas the dissociation reactions are
      driven by the hydrolysis of ATP. The self-association of UvrA to form the
      reactive dimeric species UvrA2 is driven by nucleotide binding, but its
      dissociation from DNA requires ATP hydrolysis. Similarly, ATP binding drives
      those allosteric changes in DNA topology during UvrA2-nucleoprotein formation
      (Oh, E.Y., and Grossman, L. (1986) Nucleic Acids Res. 14, 8557-8571). The
      manifestation of the UvrB-associated cryptic ATPase requires UvrA and DNA in a
      helicase-catalyzed supercoiling reaction. The UvrA2B helicase activity requires
      ATP hydrolysis by the C-terminal ATPase site of UvrA in addition to UvrB. ATP
      hydrolysis by the C-terminal ATPase site of UvrA also participates in the
      localization of damaged sites contributing to the formation of damage-specific
      high affinity nucleoprotein complexes. The levels of complementation to UV
      survival by the ATPase site mutants of UvrA (Thiagalingam, S., and Grossman, L.
      (1991) J. Biol. Chem. 266, 11395-11403) correspond to its ability to self-bind
      and translocate in combination with the UvrB subunit in its search for damaged
      sites during the preincision mode of nucleotide excision.

PMID- 8349712
TI  - The structures and biological activities of the lipo-oligosaccharide nodulation
      signals produced by type I and II strains of Bradyrhizobium japonicum.
AB  - Bradyrhizobium japonicum produces lipo-oligosaccharide signal molecules that
      induce deformation of root hairs and meristematic activity on soybeans. B.
      japonicum USDA135 (a Type I strain) produces modified chitin pentasaccharide
      molecules with either a terminal N-C16:0- or N-C18:1-glucosamine with and without
      an O-acetyl group at C-6 and with 2-O-methylfucose linked to C-6 of the reducing
      N-acetylglucosamine. An additional molecule has N-C16:1-glucosamine and no O
      acetyl group. All of these molecules cause root hair deformation on Vicia sativa
      and Glycine soja. The C18:1-containing molecules were tested and found to induce
      meristem formation on G. soja. USDA61 (a Type II strain) produces eight
      additional molecules. Five have a carbamoyl group on the terminal N
      acylglucosamine. Six have chitin tetrasaccharide backbones. Three have a terminal
      N-acyl-N-methylglucosaminosyl residue. In four molecules, the reducing-end N
      acetylglucosamine is glycosidically linked to glycerol and has a branching
      fucosyl, rather than a 2-O-methylfucosyl, residue. One molecule has a terminal N
      acylglucosamine that has both acetyl and carbamoyl groups (one each).

PMID- 8349714
TI  - Role of microtubules in transferrin receptor transport from the cell surface to
      endosomes and the Golgi complex.
AB  - Transferrin receptor (TfR) follows complex pathways of transport after
      endocytosis from the cell surface. Most TfR is transported to endosomes and
      returns rapidly to the cell surface. In addition, approximately 10% of the
      internalized receptor recycles through the Golgi complex. To examine the role of
      microtubules in TfR traffic, K562 cultured human leukemia cells treated with
      nocodazole to depolymerize microtubules were studied. Nocodazole caused a 50%
      increase in the level of surface TfR, which was due to a change in receptor
      dynamics. The endocytosis rate in treated cells was 20% of control, indicating
      that TfR endocytosis via clathrin-coated vesicles was slowed, whereas the
      recycling of internalized receptors to the cell surface was unaffected. In
      contrast, nocodazole had little effect on the transport of TfR from the cell
      surface to the Golgi complex. Thus, the fragmentation and dispersal of the Golgi
      complex caused by microtubule depolymerization, which does not interrupt
      secretory traffic through this organelle, also does not block recycling through
      the Golgi. The decreased TfR endocytosis via coated vesicles and the increased
      TfR transport to the Golgi caused by nocodazole suggest that either (i)
      endocytosis via coated vesicles is not the rate-limiting step in transport to the
      Golgi or (ii) coated vesicles are not a part of this pathway. Finally, because
      nocodazole inhibits traffic from endosomes to lysosomes, surface-to-Golgi
      transport probably does not involve a lysosomal intermediate.

PMID- 8349715
TI  - A video-based system for the estimation of the inertial properties of body
      segments.
AB  - A system for the estimation of the inertial properties of human body segments
      using advanced video technology and computer image processing was developed. The
      system is based on the photogrammetric technique, where three-dimensional
      information is determined from two separate two-dimensional video images. The
      inertial properties are calculated using an image-processing algorithm which
      provides volumetric information, coupled with a database of anatomical densities
      provided in the literature. In order to determine the accuracy of the system and
      its limitations, the system estimates of the inertial properties of solid bodies
      were compared to theoretically calculated values. The application of the system
      to kinesiological studies is illustrated by measuring the inertial properties of
      the shank of three subjects, and comparing the results to data generated using
      regression equations provided in the literature. Human factors, such as segment
      boundaries identification and color thresholds selection, were found to introduce
      the largest errors. A proper selection of the optical setting can reduce the
      errors to levels of 5% or better. On the average, the system overestimated the
      inertial properties of solid objects by 2.51% for mass, 1.21% for center of mass,
      4.53% for transverse moments of inertia and 3.65% for longitudinal moment of
      inertia. The video-based estimates of the mass and center of mass of the shank
      were comparable to values obtained from anthropometric-based regression
      equations. The predictions of the transverse moment of inertia of the shank
      varied considerably among the methods. The findings suggest that a video-based
      system represents a promising technique for estimating inertial properties of
      human body segments for individual subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349717
TI  - Sagittal-plane mobility of the cat cervical spine.
AB  - The present study was conducted to evaluate the nature of sagittal-plane motion
      across cervical vertebral joints and to identify the centers of rotation for each
      joint in anaesthetized cats X-rayed in a range of head-neck postures. Relative
      positions of adjacent pairs of vertebrae were assessed by constructing
      transparent templates for each vertebra that could be overlaid onto different X
      rays, and then by digitizing the locations of three markers attached at a
      distance from each template. The finite centers of rotation for each joint were
      estimated using a rigid-body method. The errors associated with the estimates
      were quantified further by using a method in which the positions of digitized
      markers were fitted to concentric circles using a least-squares approach. The
      center of rotation between the skull and C1 was located at the cranial articular
      facets between the two bones. The center of rotation between C1 and C2 was
      situated near the tip of the odontoid process close to the site of attachment of
      the transverse ligaments. Centers of rotation for the other cervical vertebral
      joints were located in the region of the intervertebral disc. A similar range of
      values was obtained for centers of rotation when extended or flexed postures were
      used for the calculations, suggesting that the centers of rotation may not move
      markedly throughout a range of sagittal-plane rotations of approximately 90
      degrees at the skull-C1 joint and about 15-30 degrees at the other cervical
      joints. These results showed that all cervical joints rotated during sagittal
      plane motion. A minimal representation of the musculoskeletal mechanics of the
      feline neck probably requires multiple segments, each corresponding to a single
      vertebral bone.

PMID- 8349716
TI  - Effects of arch height of the foot on angular motion of the lower extremities in
      running.
AB  - It has been suggested that a relationship exists between the height of the medial
      longitudinal arch of the foot and athletic injuries to the lower extremities.
      However, the functional significance of arch height in relation to injury is not
      well understood. The purpose of this study was to determine the influence of arch
      height on kinematic variables of the lower extremities that have been associated
      with the incidence of injury in running in an attempt to gain some insight into a
      functional relationship between arch height and injury. The three-dimensional
      kinematics of the lower extremities were measured during running for 30 subjects
      using high-speed video cameras. A joint coordinate system was used to calculate
      the three-dimensional orientation of the ankle joint complex for a single stance
      phase. Simple, linear regression analyses showed that arch height does not
      influence either maximal eversion movement or maximal internal leg rotation
      during running stance. However, assuming that knee pain in running can result
      from the transfer of foot eversion to internal rotation of the tibia, a
      functional relationship between arch height and injury may exist in that the
      transfer of foot eversion to internal leg rotation was found to increase
      significantly with increasing arch height. A substantial (27%), yet incomplete,
      amount of the variation in the transfer of movement between subjects was
      explained by arch height, indicating that there must be factors other than arch
      height that influence the kinematic coupling at the ankle joint complex.
      Additionally, the transfer of movement is only one factor of many associated with
      the etiology of knee pain in running.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349718
TI  - Numerical simulation of leaflet flexure in bioprosthetic valves mounted on rigid
      and expansile stents.
AB  - Recent studies suggest that flexural stresses induced during the opening phase
      may be responsible for much of the mechanical failures of bioprosthetic heart
      valves. Sharp leaflet bending is promoted by the mounting of valves on rigid
      stents that do not mimic the systolic expansion of the natural aortic root. We,
      therefore, hypothesized that flexural stresses could be significantly reduced by
      incorporating a flexible or expansile supporting stent into the valve design.
      Using our own non-linear finite element code (INDAP) and the pre- and post
      processor modules of a commercial finite element package (PATRAN), we simulated
      the opening and closing behaviour a trileaflet bovine pericardial valve. The
      leaflets of this valve were assumed to be of uniform thickness, with a non-linear
      elastic behaviour adapted from experimentally obtained bending stiffness data.
      Our simulations have shown that during maximal systolic valve opening, sharp
      curvatures are induced in the leaflets near their commissural attachment to the
      supporting stent. These areas of sharp flexure experience compressive stresses of
      similar magnitude to the tensile stresses induced in the leaflets during valve
      closure. By incorporating a stent with posts that pivot about their base, such
      that a 10% expansion at the commissures is realized, we were able to reduce the
      compressive commissural stressing from 250 to 150 kPa. This was a reduction of
      40%. Conversely, a simple pliable stent with stent posts that deflect inward and
      outward under load did not achieve a significant reduction of compressive
      stresses. This numerical analysis, therefore, supports the theory that (i) high
      flexural and compressive stresses exist at sites of sharp leaflet bending and may
      promote bioprosthetic valve failure, and (ii) that proper design of the
      supporting stent can significantly reduce such flexural stresses.

PMID- 8349719
TI  - Forces in gastrocnemius, soleus, and plantaris tendons of the freely moving cat.
AB  - The purpose of this study was to gain an insight into the mechanisms of force
      sharing among muscles in a functional group. Tendon force measurements were
      obtained simultaneously from gastrocnemius, soleus, and plantaris muscles of 10
      cats during a variety of different locomotor tasks using strain gauge based force
      transducers. In particular, tendon forces were measured for conditions where
      movement speed was altered systematically, and where movement speed was kept
      constant but external resistance to walking was varied systematically. The
      results show that forces in the gastrocnemius and plantaris tendons increase with
      increasing intensities of movement, independent of intensity being altered by
      varying speed or external resistance. In contrast, peak soleus forces, on an
      average, remained nearly the same for all conditions; however, substantial
      modulations in soleus force were observed for consecutive stride cycles. These
      results suggest that soleus forces are not limited by peripheral (contractile)
      conditions but by central mechanisms and, further, that these central mechanisms
      depend on speed of movement and resistance to movement.

PMID- 8349720
TI  - Direct calculation of the surface-to-volume ratio for human cancellous bone.
AB  - There are many diseases which cause detrimental changes in the trabecular
      structure of cancellous bone, leading to mechanical failure of the tissue. One
      approach to understanding the mechanisms of these diseases is to create idealized
      models that recreate the morphology of the tissue. This paper presents a partial
      development of such a model. Further histological methods must be developed
      before a complete definition of morphologically valid models is possible. In a
      histological section of cancellous bone, the orientation and length of the
      trabecular surfaces determine how a line drawn across the bone section will
      intersect the bone-marrow interface. The distribution of the average length
      between intersections for a set of parallel lines is defined as the mean
      intercept length distribution. In this paper, the average surface morphology and
      volume of the average structure of cancellous bone is determined from an
      examination of the mean intercept length. The average structure of cancellous
      bone contains a repeated structural element (SE). As a result, the basic bone
      structure is analogous to a brick wall made from many similar bricks. For a group
      of 107 specimens, a strong relationship between structural element volume (SE.V)
      and bone volume fraction (BV/TV) is demonstrated, SE.V = 0.017 kappa (BV/TV)-2.05
      mm3, R2 = 0.93, with kappa a model-dependent constant. For the same specimens,
      the structural element surface (SE.S) showed the relationship, SE.S = 0.144 kappa
      (BV/TV)-1.35, R2 = 0.92. As a result of the inverse square dependence of
      structural element volume on bone volume fraction, it is predicted that
      cancellous bone strength is inversely proportional to structural element volume.

PMID- 8349721
TI  - Hip joint loading during walking and running, measured in two patients.
AB  - The resultant hip joint force, its orientation and the moments were measured in
      two patients during walking and running using telemetering total hip prostheses.
      One patient underwent bilateral joint replacement and a second patient,
      additionally suffering from a neuropathic disease and atactic gait patterns,
      received one instrumented hip implant. The joint loading was observed over the
      first 30 and 18 months, respectively, following implantation. In the first
      patient the median peak forces increased with the walking speed from about 280%
      of the patient's body weight (BW) at 1 km h-1 to approximately 480% BW at 5 km h
      1. Jogging and very fast walking both raised the forces to about 550% BW;
      stumbling on one occasion caused magnitudes of 720% BW. In the second patient
      median forces at 3 km h-1 were about 410% BW and a force of 870% BW was observed
      during stumbling. During all types of activities, the direction of the peak force
      in the frontal plane changed only slightly when the force magnitude was high.
      Perpendicular to the long femoral axis, the peak force acted predominantly from
      medial to lateral. The component from ventral to dorsal increased at higher force
      magnitudes. In one hip in the first patient and in the second patient the
      direction of large forces approximated the average anteversion of the natural
      femur. The torsional moments around the stem of the implant were 40.3 N m in the
      first patient and 24 N m in the second.

PMID- 8349722
TI  - Trabecular bone modulus and strength can depend on specimen geometry.
AB  - We performed a series of uniaxial compression tests on wet bovine trabecular bone
      to compare both modulus and strength when measured using 2:1 aspect ratio (10 mm
      long, 5 mm diameter) cylinders (n = 30) and 5 mm cubes (n = 29). We also compared
      the correlation coefficients in the resulting modulus-density and strength
      density regressions and the standard errors of the estimate. When comparing the
      mean values of modulus and strength for each group, the confounding variations in
      apparent density were accounted for with an analysis of covariance. The Fisher's
      Z transformation was used to compare the correlation coefficients statistically.
      Results from the analysis of covariance indicated that the modulus and strength
      of the cubes were higher by 36% (p < 0.01) and 18% (p < 0.05), respectively, with
      respect to the 2:1 cylinder values. The correlation coefficients in the modulus
      density and strength-density regressions were not sensitive to the regression
      model (linear versus power law). However, correlation coefficients for both
      modulus-density and strength-density regressions were higher (p < 0.05) for the
      2:1 cylinders (r = 0.90, modulus; r = 0.94, strength) than for the cubes (r =
      0.57, modulus; r = 0.82, strength). In addition, the standard errors of the
      estimate in both modulus and strength were substantially lower for the 2:1
      cylinders. These data indicate that both modulus and strength can depend on the
      specimen geometry when using conventional compression testing techniques. We
      conclude, therefore, that inter-study comparisons of modulus and strength may be
      invalid if these confounding effects of different specimen geometries are not
      addressed. Our data also indicate that density can better explain the observed
      variance in modulus and strength when 2:1 cylinders are used as opposed to cubes.
      Using this phenomenon as a rationale for choosing a standard specimen gometry, we
      recommend that the 2:1 cylinder be used as a standard specimen in studies
      designed to determine the effects of various treatments on the uniaxial
      compressive modulus and strength of trabecular bone.

PMID- 8349723
TI  - Age and dose-dependent carcinogenic effects of N-nitrosomethylurea administered
      intraperitoneally in a single dose to young and adult female mice.
AB  - Female Swiss-derived SHR mice aged 3 ("young") and 12 months ("adult") were
      exposed to a single i.p. administration of N-nitrosomethylurea (NMU) at one of
      four doses: 0, 10, 20, or 50 mg/kg. The mean survival time of the young mice so
      treated was 440, 325, 398 and 182 days, and of the adult mice 221, 249, 191, and
      168 days respectively. The incidence of all kinds of tumours in young mice was
      40%, 64%, 77%, and 40%, of malignant tumours 33%, 43%, 57% and 20% of lung
      adenomas 7%, 14%, 40%, and 20% and of papillomas of the forestomach 0%, 14%, 23%,
      and 3% respectively. In adult mice these figures were for all kinds of tumours
      52%, 52%, 56%, and 50%, for malignant tumours 44%, 52%, 52%, and 40%, for lung
      adenomas 7%, 0%, 8%, and 20%, for papillomas of the forestomach 0%, 0%, 12%, and
      0% respectively. The exposure of adult female mice to various doses of NMU did
      not significantly increase the incidence of tumours or of malignant tumour
      incidence in comparison to age-matched controls. At the same time the latency of
      fatal tumours was shorter in the adult groups than in the young groups.
      Histoautoradiography of tissues of intact young and adult mice showed that there
      are no statistically significant age-related differences in the labelling index
      of forestomach epithelium, endometrium and lung alveolar wall epithelium. Only
      the labelling index of hepatocytes was decreased in the liver of adult mice in
      comparison to young ones. Comparison of the present experimental results with the
      data available on DNA synthesis and on O6-methylguanine repair in target tissues
      suggests a requirement for individual monitoring of age-related changes of
      biomarkers in exposure to carcinogenic agents. The analysis of data on the dose
      dependence of the carcinogenic effect of NMU against the background of a
      multistage model suggests an age-related accumulation of stochastically damaged
      cells for some tissues.

PMID- 8349724
TI  - Antiproliferative activity of casodex (ICI 176.334) in hormone-dependent tumours.
AB  - The nonsteroidal antiandrogen casodex has been described as a peripherally
      selective drug for the treatment of prostatic cancer. In this study we determined
      its activity in various models of hormone-dependent malignancies including those
      of the prostate and the breast. Analysis of endocrine effects in rats after 15
      days of treatment revealed a strong reduction of the weights of prostates and
      seminal vesicles and a significant rise of testosterone serum levels as a result
      of the interference with central feedback mechanisms. The growth of androgen
      sensitive human LNCaP/FGC prostate cancer cells was strongly inhibited by
      casodex. Unlike hydroxyflutamide, casodex was also active in hormone-depleted
      medium. The inhibitory effect was overcome by addition of testosterone
      propionate, which indicates an androgen-receptor-mediated mode of action. In rats
      bearing Dunning R3327-G prostate carcinomas casodex exerted a strong antitumour
      effect at the beginning of therapy. However, after 4 weeks of treatment tumours
      resumed growth whereas diethylstilboestrol-treated tumours remained static. In
      MXT-M3.2 mouse mammary tumours with significant quantities of androgen receptors
      casodex was also effective in inhibiting tumour growth. After 6 weeks of
      treatment, tumour weights were reduced by 69% whereas uterine weights were
      significantly increased, possibly because of a progestin-like activity of the
      drug. Csodex is very active in various models of hormone-dependent carcinomas.
      However, the limited duration of action in prostatic tumours and the incomplete
      growth inhibition in mammary tumours suggest that it should be used only
      combination with other endocrine therapies.

PMID- 8349725
TI  - Expression of lectin-specific cellular glycoconjugates during oral
      carcinogenesis.
AB  - The binding pattern of two lectins, concanavalin A (ConA) and peanut agglutin
      (PNA), in various phases of tumour progression in the oral epithelium was
      studied. These included non-dysplastic, dysplastic and neoplastic lesions as well
      as normal tissue. ConA and PNA showed intense staining in the basement membrane
      of all types of lesions. Little difference was observed in the staining patterns
      between different stages of oral carcinogenesis, either with ConA or PNA. ConA
      showed mild cytoplasmic and membrane staining in all types of lesions while PNA
      showed moderate to intense staining in both the cytoplasm and membrane of lower
      layer cells in all histological groups. The present study therefore shows that
      these lectins have limited value in the elucidation of oral carcinogenesis and
      are of insignificant diagnostic value.

PMID- 8349726
TI  - Report from the 34th annual meeting of the American Society of Hematology,
      December 4-8, 1992.

PMID- 8349727
TI  - NDC1: a nuclear periphery component required for yeast spindle pole body
      duplication.
AB  - The spindle pole body (SPB) of Saccharomyces cerevisiae serves as the centrosome
      in this organism, undergoing duplication early in the cell cycle to generate the
      two poles of the mitotic spindle. The conditional lethal mutation ndc1-1 has
      previously been shown to cause asymmetric segregation, wherein all the
      chromosomes go to one pole of the mitotic spindle (Thomas, J. H., and D.
      Botstein. 1986. Cell. 44:65-76). Examination by electron microscopy of mutant
      cells subjected to the nonpermissive temperature reveals a defect in SPB
      duplication. Although duplication is seen to occur, the nascent SPB fails to
      undergo insertion into the nuclear envelope. The parental SPB remains functional,
      organizing a monopolar spindle to which all the chromosomes are presumably
      attached. Order-of-function experiments reveal that the NDC1 function is required
      in G1 after alpha-factor arrest but before the arrest caused by cdc34. Molecular
      analysis shows that the NDC1 gene is essential and that it encodes a 656 amino
      acid protein (74 kD) with six or seven putative transmembrane domains. This
      evidence for membrane association is further supported by immunofluorescent
      localization of the NDC1 product to the vicinity of the nuclear envelope. These
      findings suggest that the NDC1 protein acts within the nuclear envelope to
      mediate insertion of the nascent SPB.

PMID- 8349728
TI  - Identification and characterization of a sphere organelle protein.
AB  - Sphere organelles are nuclear structures in amphibian oocytes that are easily
      visible by light microscopy. These structures are up to 10 microns in diameter
      and have been described morphologically for decades, yet their function remains
      obscure. The present study defines a protein component of the sphere organelle,
      named SPH-1, which is recognized by a mAb raised against purified Xenopus laevis
      oocyte nucleoplasm. SPH-1 is an 80-kD protein which is localized specifically to
      spheres and is undetectable elsewhere on lampbrush chromosomes or in nucleoli. We
      show using confocal microscopy that SPH-1 is localized to the cortex of sphere
      organelles. Furthermore, we have isolated a cDNA that can encode SPH-1. When
      epitope-tagged forms of SPH-1 are expressed in X. laevis oocytes the protein
      specifically localizes to spheres, demonstrating that the cloned cDNA encodes the
      sphere antigen. Comparison of the predicted amino acid sequence with sequence
      databases shows SPH-1 is related to p80-coilin, a protein associated with coiled
      bodies; coiled bodies are nuclear structures found in plant and animal cells. The
      sphere-specific mAb stains X. laevis tissue culture cells in a punctate nuclear
      pattern, showing that spheres or sphere antigens are present in somatic cells as
      well as germ cells and suggesting a general and essential function for spheres in
      all nuclei.

PMID- 8349729
TI  - A cytosolic complex of p62 and rab6 associates with TGN38/41 and is involved in
      budding of exocytic vesicles from the trans-Golgi network.
AB  - TGN38/41, an integral membrane protein predominantly localized to the trans-Golgi
      network, has been shown to cycle to the plasma membrane and return to the TGN
      within 30 min. (Ladinsky, M. S., and K. E. Howell. 1992. Eur. J. Cell Biol. 59:92
      105). In characterizing the proteins which associate with TGN38/41, a peripheral
      62-kD protein, two forms of rab6 and two other small GTP-binding proteins were
      identified by coimmunoprecipitation. However, approximately 90% of the 62-kD
      protein is cytosolic and is associated with the same subset of small GTP-binding
      proteins. Both the membrane and cytoplasmic complexes were characterized by
      sizing column fractionation and velocity sedimentation. The membrane complex was
      approximately 250 kD (11.6 S) consisting of the cytosolic complex and a
      heterodimer of TGN38/41 (160 kD). The cytosolic complex was approximately 86 kD
      (6.1 S) consisting of p62 and one small GTP-binding protein. Preliminary evidence
      indicates that phosphorylation of the p62 molecule regulates the dissociation of
      the cytosolic complex from TGN38/41. Functionally the cytosolic p62 complex must
      bind to TGN38/41 for the budding of exocytic transport vesicles from the TGN as
      assayed in a cell-free system (Salamero, J., E. S. Sztul, and K. E. Howell. 1990.
      Proc. Natl. Acad. Sci. USA. 87:7717-7721). Interference with p62, rab6 or TGN38,
      and TGN41 cytoplasmic domains by immunodepletion or competing peptides completely
      inhibited the budding of exocytic transport vesicles. These results support an
      essential role for interaction of the cytosolic p62/rab6 complex with TGN38/41 in
      budding of exocytic vesicles from the TGN.

PMID- 8349730
TI  - Signal transducing molecules and glycosyl-phosphatidylinositol-linked proteins
      form a caveolin-rich insoluble complex in MDCK cells.
AB  - GPI-linked protein molecules become Triton-insoluble during polarized sorting to
      the apical cell surface of epithelial cells. These insoluble complexes, enriched
      in cholesterol, glycolipids, and GPI-linked proteins, have been isolated by
      flotation on sucrose density gradients and are thought to contain the putative
      GPI-sorting machinery. As the cellular origin and molecular protein components of
      this complex remain unknown, we have begun to characterize these low-density
      insoluble complexes isolated from MDCK cells. We find that these complexes, which
      represent 0.4-0.8% of the plasma membrane, ultrastructurally resemble caveolae
      and are over 150-fold enriched in a model GPI-anchored protein and caveolin, a
      caveolar marker protein. However, they exclude many other plasma membrane
      associated molecules and organelle-specific marker enzymes, suggesting that they
      represent microdomains of the plasma membrane. In addition to caveolin, these
      insoluble complexes contain a subset of hydrophobic plasma membrane proteins and
      cytoplasmically-oriented signaling molecules, including: (a) GTP-binding proteins
      -both small and heterotrimeric; (b) annex II--an apical calcium-regulated
      phospholipid binding protein with a demonstrated role in exocytic fusion events;
      (c) c-Yes--an apically localized member of the Src family of non-receptor type
      protein-tyrosine kinases; and (d) an unidentified serine-kinase activity. As we
      demonstrate that caveolin is both a transmembrane molecule and a major phospho
      acceptor component of these complexes, we propose that caveolin could function as
      a transmembrane adaptor molecule that couples luminal GPI-linked proteins with
      cytoplasmically oriented signaling molecules during GPI-membrane trafficking or
      GPI-mediated signal transduction events. In addition, our results have
      implications for understanding v-Src transformation and the actions of cholera
      and pertussis toxins on hetero-trimeric G proteins.

PMID- 8349732
TI  - Beta and gamma actin mRNAs are differentially located within myoblasts.
AB  - Actin is of fundamental importance to all eukaryotic cells. Of the six mammalian
      actins, beta (beta) and gamma (gamma) cytoplasmic are the isoforms found in all
      nonmuscle cells and differ by only four amino acids at the amino-terminal region.
      Both genes are regulated temporally and spatially, though no differences in
      protein function have been described. Using fluorescent double in situ
      hybridization we describe the simultaneous intracellular localization of both
      beta and gamma actin mRNA. This study shows that myoblasts differentially
      segregate the beta and gamma actin mRNAs. The distribution of gamma actin mRNA,
      only to perinuclear and nearby cytoplasm, suggests a distribution based on
      diffusion or restriction to nearby cytoplasm. The distribution of beta actin
      mRNA, perinuclear and at the cell periphery, implicates a peripheral localizing
      signal which is unique to the beta isoform. The peripheral beta actin mRNA
      corresponded to cellular morphologies, extending processes, and ruffling edges
      that reflect cell movement. Total actin and gamma actin protein steady-state
      distributions were identified by specific antibodies. gamma actin protein was
      found in both stress fibers and at the cell plasma membrane and does not
      correspond to its mRNA distribution. We suggest that localized protein synthesis
      rather than steady-state distribution functionally differentiates between the
      actin isoforms.

PMID- 8349731
TI  - A role for the dystrophin-glycoprotein complex as a transmembrane linker between
      laminin and actin.
AB  - The dystrophin-glycoprotein complex was tested for interaction with several
      components of the extracellular matrix as well as actin. The 156-kD dystrophin
      associated glycoprotein (156-kD dystroglycan) specifically bound laminin in a
      calcium-dependent manner and was inhibited by NaCl (IC50 = 250 mM) but was not
      affected by 1,000-fold (wt/wt) excesses of lactose, IKVAV, or YIGSR peptides.
      Laminin binding was inhibited by heparin (IC50 = 100 micrograms/ml), suggesting
      that one of the heparin-binding domains of laminin is involved in binding
      dystroglycan while negatively charged oligosaccharide moieties on dystroglycan
      were found to be necessary for its laminin-binding activity. No interaction
      between any component of the dystrophin-glycoprotein complex and fibronectin,
      collagen I, collagen IV, entactin, or heparan sulfate proteoglycan was detected
      by 125I-protein overlay and/or extracellular matrix protein-Sepharose
      precipitation. In addition, laminin-Sepharose quantitatively precipitated
      purified dystrophin-glycoprotein complex, demonstrating that the laminin-binding
      site is accessible when dystroglycan is associated with the complex. Dystroglycan
      of nonmuscle tissues also bound laminin. However, the other proteins of the
      striated muscle dystrophin-glycoprotein complex appear to be absent,
      antigenically dissimilar or less tightly associated with dystroglycan in
      nonmuscle tissues. Finally, we show that the dystrophin-glycoprotein complex
      cosediments with F-actin but does not bind calcium or calmodulin. Our results
      support a role for the striated muscle dystrophin-glycoprotein complex in linking
      the actin-based cytoskeleton with the extracellular matrix. Furthermore, our
      results suggest that dystrophin and dystroglycan may play substantially different
      functional roles in nonmuscle tissues.

PMID- 8349733
TI  - Moving and stationary actin filaments are involved in spreading of postmitotic
      PtK2 cells.
AB  - We have investigated spreading of postmitotic PtK2 cells and the behavior of
      actin filaments in this system by time-lapse microscopy and photoactivation of
      fluorescence. During mitosis PtK2 cells round up and at cytokinesis the daughter
      cells spread back to regain their interphase morphology. Normal spreading edges
      are quite homogenous and are not comprised of two distinct areas (lamellae and
      lamellipodia) as found in moving edges of interphase motile cells. Spreading
      edges are connected to a network of long, thin, actin-rich fibers called
      retraction fibers. A role for retraction fibers in spreading was tested by
      mechanical disruption of fibers ahead of a spreading edge. Spreading is inhibited
      over the region of disruption, but not over neighboring intact fibers. Using
      photoactivation of fluorescence to mark actin filaments, we have determined that
      the majority of actin filaments move forward in spreading edges at the same rate
      as the edge. As far as we are aware, this is the first time that forward movement
      of a cell edge has been correlated with forward movement of actin filaments. In
      contrast, actin filaments in retraction fibers remain stationary with respect to
      the substrate. Thus there are at least two dynamic populations of actin polymer
      in spreading postmitotic cells. This is supported by the observation that actin
      filaments in some spreading edges not only move forward, but also separate into
      two fractions or broaden with time. A small fraction of postmitotic cells have a
      spreading edge with a distinct lamellipodium. In these edges, marked actin
      polymer fluxes backward with respect to substrate. We suggest that forward
      movement of actin filaments may participate in generating force for spreading in
      postmitotic cells and perhaps more generally for cell locomotion.

PMID- 8349734
TI  - Myosin and paramyosin of Caenorhabditis elegans embryos assemble into nascent
      structures distinct from thick filaments and multi-filament assemblages.
AB  - The organization of myosin heavy chains (mhc) A and B and paramyosin (pm) which
      are the major proteins of thick filaments in adult wild-type Caenorhabditis
      elegans were studied during embryonic development. As a probe of myosin
      paramyosin interaction, the unc-15 mutation e73 which produces a glu342lys charge
      change in pm and leads to the formation of large paracrystalline multi-filament
      assemblages was compared to wild type. These three proteins colocalized in wild
      type embryos from 300 to 550 min of development after first cleavage at 20
      degrees C on the basis of immunofluorescence microscopy using specific monoclonal
      antibodies. Linear structures which were diversely oriented around the muscle
      cell peripheries appeared at 360 min and became progressively more aligned
      parallel to the embryonic long axis until distinct myofibrils were formed at 550
      min. In the mutant, mhc A and pm were colocalized in the linear structures, but
      became progressively separated until they showed no spatial overlap at the
      myofibril stage. These results indicate that the linear structures represent
      nascent assemblies containing myosin and pm in which the proteins interact
      differently than in wild-type thick filaments of myofibrils. In e73, these
      nascent structures were distinct from the multi-filament assemblages. The
      overlapping of actin and mhc A in the nascent linear structures suggests their
      possible structural and functional relationship to the "stress fiber-like
      structures" of cultured vertebrate muscle cells.

PMID- 8349735
TI  - Directional instability of kinetochore motility during chromosome congression and
      segregation in mitotic newt lung cells: a push-pull mechanism.
AB  - Most models of mitotic congression and segregation assume that only poleward
      pulling forces occur at kinetochores. However, there are reports for several
      different cell types that both mono-oriented and bi-oriented chromosomes
      oscillate toward and away from the pole throughout mitosis. We used new methods
      of high resolution video microscopy and computer-assisted tracking techniques to
      measure the positions over time of individual kinetochores with respect to their
      poles during mitosis in living newt lung cells. The results show that
      kinetochores oscillate throughout mitosis when they are tethered to spindle poles
      by attachment to the plus-ends of kinetochore microtubules (kMTs). Oscillations
      were not sinusoidal. Instead, kinetochores abruptly (as quick as 6 s or less)
      switched between persistent (approximately 1.5 min average duration) phases of
      poleward (P) and away from the pole (AP) movement. This kinetochore "directional
      instability" was a property of motility at the plus-ends of kMTs since
      fluorescent marks on the lattice of kMTs have previously been observed to exhibit
      only relatively slow P movement. Each P and AP phase consisted of one or a few
      constant velocity domains (approximately 1.7 microns/min average velocity).
      Velocities of P and AP phases were similar from prometaphase through mid
      anaphase. Kinetochores occasionally switched to an indeterminant (N) phase of no
      or confused motion, which was usually brief compared to the durations of P and AP
      phases. Net chromosome displacements that occurred during congression to the
      equator or poleward movement during anaphase were primarily generated by
      differences in the durations and not the velocities of P and AP movements.
      Careful analysis of centromere deformation showed that kinetochore P movement
      produced pulling forces while kinetochore AP movement produced pushing forces.
      These data show that kinetochore directional instability is fundamental to the
      processes of chromosome congression and segregation. We argue that tension at the
      kinetochore attachment site is a key factor which controls the switching between
      P and AP phases of kinetochore motion.

PMID- 8349736
TI  - Phosphorylation of nuclear and flagellar basal apparatus proteins during
      flagellar regeneration in Chlamydomonas reinhardtii.
AB  - The antiphosphoprotein monoclonal antibody MPM-2 was used to investigate protein
      phosphorylation during flagellar regeneration in Chlamydomonas reinhardtii. MPM-2
      recognizes a phosphorylated epitope and detects several Chlamydomonas proteins by
      Western immunoblot analysis. Two MPM-2 reactive proteins (34 and 90 kD) increase
      in Western immunoblot intensity after flagellar excision and decrease in
      intensity during flagellar regeneration. Immunofluorescence and immunogold
      labeling revealed MPM-2 staining within the nucleus, especially towards the
      nuclear periphery, the flagellar basal apparatus, and the nucleus-basal body
      connector after flagellar excision. Comparison of MPM-2 reactivity in wild-type
      cells and in the mutant bald-2, which lacks functional basal bodies, demonstrates
      that the 34-kD protein is localized in the nucleus and the 90-kD protein is
      localized in the flagellar basal region. MPM-2 reactivity is observed in cells
      competent for flagellar regeneration. However, when cells were treated with the
      kinase inhibitor, staurosporine, MPM-2 reactivity did not increase after
      flagellar excision and flagellar regeneration was impaired. These observations
      suggest that phosphorylation of the 34- and 90-kD proteins may be important for
      flagellar regrowth. Possible roles for phosphorylation in flagellar regeneration
      include transcriptional activation and transport of flagellar precursors to the
      base of the growing flagella.

PMID- 8349737
TI  - Functional heterogeneity is associated with the cell cycle status of murine
      hematopoietic stem cells.
AB  - Hematopoietic stem cells (HSCs) are characterized by their ability to
      differentiate into all hematopoietic cell lineages while retaining their capacity
      for self renewal. One of the predictions of this model is the existence of a
      heterogeneous pool of HSCs, some members of which are destined to become lineage
      restricted progenitor cells while others function to renew the stem cell pool. To
      test whether HSCs are heterogeneous with respect to cell cycle status, we
      determined the fraction of phenotypically defined murine HSCs (Thy1.1lo Lin-/lo
      Sca-1+) that contain > 2n amount of DNA as measured by propidium iodide staining,
      Hoechst dye uptake and [3H]thymidine labeling; that fraction is 18-22%. In
      contrast, in the developing fetal liver, 40% of HSCs are in the S/G2/M phases of
      the cell cycle. Those HSCs which exhibit a low level of staining with rhodamine
      123 are almost exclusively in G0/G1 (97%) whereas only 70% of HSCs which stain
      brightly for rhodamine 123 are in G0/G1. The injection of 100 G0/G1 HSCs rescued
      90% of lethally irradiated mice in contrast to 100 S/G2/M HSCs, which protected
      only 25% of lethally irradiated recipients. Enhanced long-term donor-derived
      multilineage reconstitution of the peripheral blood was observed in recipients of
      100 G0/G1 HSCs compared to recipients of 100 S/G2/M cells. These data indicate
      that a significant proportion of HSCs are actively proliferating during steady
      state hematopoiesis and that this subpopulation of cells exhibits reduced stem
      cell activity.

PMID- 8349739
TI  - Heparin-binding EGF-like growth factor stimulation of smooth muscle cell
      migration: dependence on interactions with cell surface heparan sulfate.
AB  - Heparin-binding EGF-like growth factor (HB-EGF), but not EGF, binds to cell
      surface heparan sulfate proteoglycan (HSPG). This was demonstrated in (a) the
      binding of 125I-HB-EGF to mutant CHO cells deficient in HS production was
      diminished by 70% compared to wild-type CHO cells, (b) the binding of 125I-HB-EGF
      to CHO cells and bovine aortic smooth muscle cells (BASMC) was diminished 80% by
      heparitinase or chlorate treatment, and (c) 125I-EGF did not bind to CHO cells
      and its binding to BASMC was not diminished at all by heparitinase and only
      slightly by chlorate treatment. Accordingly, the role of HB-EGF interactions with
      HSPG in modulating bioactivity was examined. Heparitinase or chlorate treatment
      of BASMC diminished the ability of HB-EGF to stimulate BASMC migration by 60-80%.
      A similar inhibition of migration occurred when BASMC were treated with a
      synthetic peptide (P21) corresponding to the sequence of the putative heparin
      binding domain of HB-EGF. As a control for BASMC viability, and for specificity,
      it was found that heparitinase and P21 did not inhibit at all and chlorate
      inhibited only slightly the stimulation of BASMC migration by PDGF AB. Since
      heparitinase, chlorate, and P21 treatment also diminished by 70-80% the cross
      linking of 125I-HB-EGF to the EGF receptor, it was concluded that the interaction
      of HB-EGF, via its heparin-binding domain, with cell surface HSPG was essential
      for its optimal binding to the EGF receptor on BASMC and hence for its optimal
      ability to stimulate migration.

PMID- 8349738
TI  - Thrombospondin causes activation of latent transforming growth factor-beta
      secreted by endothelial cells by a novel mechanism.
AB  - Thrombospondin (TSP) forms specific complexes with transforming growth factor
      beta (TGF-beta) in the alpha granule releasate of platelets and these TSP-TGF
      beta complexes inhibit the growth of bovine aortic endothelial cells (BAE). In
      these studies, we report that TSP stripped of associated TGF-beta (sTSP) retained
      growth inhibitory activity which was partially reversed by a neutralizing
      antibody specific for TGF-beta. Since BAE cells secrete latent TGF-beta, we
      determined whether sTSP activates the latent TGF-beta secreted by BAE cells.
      Cells were cultured with or without sTSP and then the conditioned medium was
      tested for the ability to support TGF-beta-dependent normal rat kidney (NRK)
      colony formation in soft agar. Medium conditioned with sTSP showed a dose- and
      time-dependent ability to stimulate BAE-secreted TGF-beta activity, reaching
      maximal activation by 1-2 h with 0.4 micrograms/ml (0.9 nM) sTSP. The sTSP
      mediated stimulation of TGF-beta activity is not dependent on serum factors and
      is not a general property of extracellular matrix molecules. The sTSP-mediated
      stimulation of TGF-beta activity was blocked by a mAb specific for sTSP and by
      neutralizing antibodies to TGF-beta. Activation of BAE cell secreted latent TGF
      beta by sTSP can occur in the absence of cells and apparently does not require
      interactions with cell surface molecules, since in conditioned medium removed
      from cells and then incubated with sTSP, activation occurs with kinetics and at
      levels similar to what is seen when sTSP is incubated in the presence of cells.
      Serine proteases such as plasmin are not involved in sTSP-mediated activation of
      TGF-beta. Factors that regulate the conversion of latent to active TGF-beta are
      keys to controlling TGF-beta activity. These data suggest that TSP is a potent
      physiologic regulator of TGF-beta activation.

PMID- 8349741
TI  - Shape-selective separation of polycyclic aromatic hydrocarbons by reversed-phase
      liquid chromatography on tetraphenylporphyrin-based stationary phases.
AB  - The reversed-phase chromatographic behavior of planar and non-planar polycyclic
      aromatic hydrocarbons (PAHs) is investigated on tetraphenylporphyrin and two
      metallotetraphenylporphyrin [Sn(IV), In(III)] bonded stationary phases using
      methanol-water and acetonitrile-water as mixed solvent mobile phases. Large
      differences in the capacity factors of aromatic solute pairs having the same
      number of carbon atoms, but differing in three-dimensional shape (e.g.,
      triphenylene/o-terphenyl and perylene/alpha, alpha'-binaphthyl), suggest that the
      three tetraphenylporphyrin-based supports possess shape selectivity toward small
      planar aromatic solutes. Capacity factors for planar PAH solutes on these
      supports are significantly greater than for non-planar polyaryls having the same
      number of carbon atoms.

PMID- 8349740
TI  - Homophilic adhesion between Ig superfamily carcinoembryonic antigen molecules
      involves double reciprocal bonds.
AB  - Both carcinoembryonic antigen (CEA) and neural cell adhesion molecule (NCAM)
      belong to the immunoglobulin supergene family and have been demonstrated to
      function as homotypic Ca(++)-independent intercellular adhesion molecules. CEA
      and NCAM cannot associate heterotypically indicating that they have different
      binding specificities. To define the domains of CEA involved in homotypic
      interaction, hybrid cDNAs consisting of various domains from CEA and NCAM were
      constructed and were transfected into a CHO-derived cell line; stable
      transfectant clones showing cell surface expression of CEA/NCAM chimeric-proteins
      were assessed for their adhesive properties by homotypic and heterotypic
      aggregation assays. The results indicate that all five of the Ig(C)-like domains
      of NCAM are required for intercellular adhesion while the COOH-terminal domain
      containing the fibronectin-like repeats is dispensable. The results also show
      that adhesion mediated by CEA involves binding between the Ig(V)-like amino
      terminal domain and one of the Ig(C)-like internal repeat domains: thus while
      transfectants expressing constructs containing either the N domain or the
      internal domains alone were incapable of homotypic adhesion, they formed
      heterotypic aggregates when mixed. Furthermore, peptides consisting of both the N
      domain and the third internal repeat domain of CEA blocked CEA-mediated cell
      aggregation, thus providing direct evidence for the involvement of the two
      domains in adhesion. We therefore propose a novel model for interactions between
      immunoglobulin supergene family members in which especially strong binding is
      effected by double reciprocal interactions between the V-like domains and C-like
      domains of antiparallel CEA molecules on apposing cell surfaces.

PMID- 8349742
TI  - An efficient preparative chromatographic method for the separation and
      purification of low molecular weight naphthalenesulfonic acid mixtures.
AB  - These studies describe an efficient preparative method of separating and
      purifying polar mixtures of low molecular weight (mol wt) sulfonic acid
      derivatives containing one to six sulfonic acid moieties and possessing mol wt
      differences ranging from less than 100 and up to 650. This gel permeation
      chromatography procedure successfully separates materials with similar charges,
      requires no prepurification step, uses inexpensive apparatus, and employs water
      as the eluant. This technique has quantitative recovery and is potentially
      applicable to other anionic separations.

PMID- 8349743
TI  - Unrelatedness of groups of yeasts within the Candida haemulonii complex.
AB  - Isoenzyme and protein profiles of clinical isolates initially identified as
      Candida haemulonii demonstrated the presence of two distinct groups. DNA
      relatedness studies with representative cultures confirmed the presence of two
      species. Physiological features that can be used to separate two groups within C.
      haemulonii are reported.

PMID- 8349744
TI  - Direct detection of Mycobacterium tuberculosis in respiratory specimens in a
      clinical laboratory by polymerase chain reaction.
AB  - The emergence of epidemic multiple-drug-resistant (MDR) strains of Mycobacterium
      tuberculosis in conjunction with an increase in the number of reported cases of
      tuberculosis (TB) represents a major public health problem. In light of a recent
      outbreak of MDR M. tuberculosis at our center, we began the development of a
      polymerase chain reaction (PCR) assay for the rapid diagnosis of pulmonary TB
      using two sets of primers, one based on the IS6110 repeated sequence of M.
      tuberculosis and the other based on the protein antigen b (PAB). Reaction
      conditions were first optimized as to the appropriate extraction protocol and the
      concentrations of primer pairs, nucleotides, and MgCl2. Following a preliminary
      evaluation of the assay with clinical specimens, extraction and amplification
      procedures were further modified. PAB and IS6110 primers detected between 2 and
      23 and 0.023 and 0.23 CFU of M. tuberculosis, respectively, in pooled, M.
      tuberculosis-negative sputa by our optimized PCR assay. After routine processing
      for mycobacteria, 734 specimens were subsequently amplified. DNA for
      amplification was obtained by boiling and beating the sediments with Tween 20.
      For each reaction, DNA (10 microliters) was added to an amplification mixture
      containing 12 pmol of IS6110 primers, 20 pmol of PAB primers, 2 mM MgCl2, 200
      microM nucleotides, and 2.5 U of Taq polymerase and the mixture was then
      amplified for 40 cycles. The sensitivity and specificity of our PCR assay were
      87.2 and 97.7%, respectively. We were unable to interpret the results for seven
      specimens (1%). In our experience, PCR proved to be a useful rapid diagnostic
      test for TB in a clinical setting and a valuable epidemiological tool for
      determining exposure groups in the hospital setting. Our findings also underscore
      the need for the systematic optimization of PCR assay conditions.

PMID- 8349745
TI  - Ability of clinical laboratories to detect antimicrobial agent-resistant
      enterococci.
AB  - To test the ability of clinical laboratories to detect antimicrobial resistance
      among enterococci, we sent four vancomycin-resistant enterococcal strains and one
      beta-lactamase-producing enterococcus to all 93 nongovernment, hospital-based
      clinical laboratories in New Jersey; 76 (82%) participated in the study. Each
      organism was tested by the laboratory's routine antimicrobial susceptibility
      testing method. The proportion of laboratories that correctly reported that an
      isolate was resistant to vancomycin varied according to the resistance level of
      the isolate: high-level resistance (MIC for Enterococcus faecium = 512
      micrograms/ml), 96% of laboratories correct; moderate-level resistance (MIC for
      E. faecium = 64 micrograms/ml), 27% correct; low-level resistance (MIC for
      Enterococcus faecalis = 32 micrograms/ml), 16% correct; and intrinsic low-level
      resistance (MIC for Enterococcus gallinarum = 8 micrograms/ml), 74% correct. The
      beta-lactamase-producing E. faecalis isolate was identified as resistant to
      penicillin and ampicillin by 66 and 8% of laboratories, respectively, but only
      three laboratories recognized that it was a beta-lactamase producer. This survey
      suggests that many laboratories may fail to detect antimicrobial agent-resistant
      enterococci.

PMID- 8349746
TI  - Application of indirect immunofluorescence to detection of Dientamoeba fragilis
      trophozoites in fecal specimens.
AB  - An indirect fluorescent-antibody (IFA) assay was carried out to examine for the
      presence of Dientamoeba fragilis trophozoites in preserved fecal specimens.
      Antiserum to D. fragilis trophozoites was raised in a rabbit with a dixenic
      culture of D. fragilis (ATCC 30948) from the American Type Culture Collection.
      After absorption with Klebsiella pneumoniae and Bacteroides vulgatus, the immune
      rabbit serum was used for examination by the IFA assay. A total of 155 clinical
      samples were tested; 42 with no parasites, 9 with D. fragilis, and 104 with other
      parasites. The IFA assay identified seven D. fragilis organisms. Two specimens
      with doubtful IFA assay readings showed very scanty amounts of D. fragilis
      trophozoites on stained smears. There were no false-positive IFA assay readings.
      The IFA assay appeared to be a promising method because of its speed in
      screening. The specificity of the IFA assay indicates that other diagnostic tests
      such as an enzyme-linked immunosorbent assay could be developed to identify D.
      fragilis antigens in fecal specimens.

PMID- 8349748
TI  - Virulence-associated plasmids in Rhodococcus equi.
AB  - Twenty-three strains of Rhodococcus equi from independent clinical cases were
      analyzed for the presence of virulence plasmid DNA. Of the clinical isolates, 19
      contained an 85-kb plasmid and the remaining 4 contained a 90-kb plasmid. All of
      the isolates expressed 15- to 17-kDa antigens and were virulent in mice.
      Restriction enzyme and Southern blot analyses showed large regions of DNA
      homology between the 85- and 90-kb virulence plasmids. It was concluded
      tentatively that there are at least two virulence plasmids in R. equi and that
      they have a common origin.

PMID- 8349747
TI  - Major outbreak of pertussis in northern Alberta, Canada: analysis of discrepant
      direct fluorescent-antibody and culture results by using polymerase chain
      reaction methodology.
AB  - A major outbreak of 5,683 cases of pertussis occurred in northern Alberta,
      Canada, from December 1989 to January 1991. The outbreak highlighted a number of
      problems with current methods of pertussis diagnosis. In particular, an
      exceptionally high proportion of direct fluorescent-antibody (DFA)-positive,
      culture-negative specimens (88.4%) was identified. We took this opportunity to
      use polymerase chain reaction (PCR) methodology to examine whether the low
      culture rates were due to specimens containing dead organisms or whether the DFA
      results represented high numbers of false-positive results. A set of primer
      sequences within a Bordetella pertussis-specific repetitive element was used to
      amplify proteinase K extracts of B. pertussis DNA recovered from 279 submitted
      slides inoculated at the point of collection with nasopharyngeal material
      obtained from pernasal swabs. The PCR data corroborated the culture results:
      84.6% of DFA-positive, culture-negative specimens were similarly PCR negative. At
      least three different bacterial species that were significantly cross-reactive
      with the commercial DFA reagent were identified in clinical specimens and in pure
      culture, providing one possible explanation for the false-positive DFA results.
      These results and other limitations of current diagnostic techniques underline
      the urgent need for a new DFA reagent with improved specificity and a
      standardized means of measuring the patient antibody response for the diagnosis
      of pertussis.

PMID- 8349749
TI  - Preliminary evaluation of recombinant Onchocerca volvulus antigens for
      serodiagnosis of onchocerciasis.
AB  - Serodiagnostic assays for onchocerciasis based on native antigens are hampered by
      the scarcity of antigen, and they suffer from poor specificity. The present study
      was designed to evaluate the diagnostic utility of recently described recombinant
      Onchocerca volvulus antigens OC 3.6 and OC 9.3 in enzyme immunoassays. The
      recombinant proteins were expressed as glutathione S-transferase fusions and were
      tested in several enzyme immunoassay formats to measure immunoglobulin G (IgG)
      and IgG4 antibodies with sera from patients with onchocerciasis in Nigeria and
      with various types of control sera. The best results were obtained by measuring
      IgG4 antibodies to the fusion proteins. Forty of 42 (95%) serum specimens from
      patients with onchocerciasis were reactive with OC 3.6; the reactivity with OC
      9.3 was 81%. Results obtained with sera from experimentally infected chimpanzees
      suggest that OC 3.6 might be especially useful for detecting prepatent infections
      in humans, while OC 9.3 mainly detects mature, patent infections. Sera from
      individuals in Nigeria and the United States residing in areas nonendemic for
      onchocerciasis were uniformly nonreactive with these antigens in IgG and IgG4
      assays, as were sera from patients with bancroftian filariasis, brugian
      filariasis, loiasis, ascariasis, schistomiasis, and dracunculiasis. These results
      suggest that enzyme immunoassays based on the recombinant antigens OC 3.6 and OC
      9.3 are useful for the diagnosis of onchocerciasis.

PMID- 8349750
TI  - Characterization of two DNA probes specific for Serpulina hyodysenteriae.
AB  - Two DNA probes, one 1.1- and one 0.75-kb probe, specific for Serpulina
      hyodysenteriae were isolated from a genomic library generated from virulent S.
      hyodysenteriae 5380. These probes are highly specific and react with all S.
      hyodysenteriae strains tested. Under stringent conditions, the DNA probes did not
      react with the nonpathogenic species Serpulina innocens or with other species of
      enteric bacteria, including Escherichia coli. Both probes are able to detect S.
      hyodysenteriae in colony blot hybridizations, and when applied to fecal
      specimens, they can detect 10(4) S. hyodysenteriae cells in 0.1 g of seeded fecal
      matter. Both probes can detect S. hyodysenteriae in fecal specimens from swine
      with clinical signs of swine dysentery after experimental challenge and from
      swine from a herd with an acute outbreak of swine dysentery. These probes have
      application as a diagnostic tool in veterinary microbiology.

PMID- 8349751
TI  - Routine application of high-performance liquid chromatography for identification
      of mycobacteria.
AB  - Mycolic acid analysis by high-performance liquid chromatography (HPLC) was
      introduced in our laboratory as the routine technique for identifying all
      clinical isolates of mycobacteria referred to us. HPLC identified 96.1% of the
      1,103 strains analyzed, whereas the biochemical procedures and/or the commercial
      DNA probes identified 98.3% of strains, for an overall agreement of 94.4%.
      Compared with the probes, there was 100% specificity and 98.9% sensitivity for
      Mycobacterium tuberculosis identification. HPLC allowed early detection and
      identification of the rare mycobacterial species M. haemophilum, M. malmoense, M.
      shimoidei, and M. fallax as well as uncharacteristic strains of M. simiae. After
      18 months of routine use, HPLC proved to be reliable, easy to perform, rapid, and
      less costly than other identification methods.

PMID- 8349752
TI  - Diagnosis of Helicobacter pylori infection in adults and children by using the
      Malakit Helicobacter pylori, a commercially available enzyme-linked immunosorbent
      assay.
AB  - Malakit Helicobacter pylori (Biolab, Limal, Belgium) is a second-generation
      enzyme-linked immunosorbent assay (ELISA) for the detection of Helicobacter
      pylori infection. We evaluated its ability to diagnose H. pylori infection in 489
      asymptomatic pregnant women, 427 asymptomatic children, and 95 symptomatic
      children. 87 asymptomatic adults (17.8%), 31 asymptomatic children (7.3%), and 27
      symptomatic children (28.4%) were seropositive. We observed an increase in H.
      pylori infection with age. 13C-urea breath tests were performed for all
      seropositive and 100 randomly selected seronegative asymptomatic adults. They
      were also performed for all seropositive and 65 randomly chosen seronegative
      asymptomatic children. Breath tests were positive for 86 of 87 (98.9%)
      seropositive adults, 30 of 31 seropositive children (96.8%), and no seronegative
      individual. Compared with those of culture, the sensitivity and specificity of
      the Malakit Helicobacter pylori were both 96%. We conclude that the Malakit
      Helicobacter pylori is equally suitable for adults and children. Therefore, this
      ELISA can be proposed as an important alternative to other more time-consuming
      and/or more expensive diagnostic tests for the detection of H. pylori.

PMID- 8349753
TI  - Direct detection of Mycobacterium tuberculosis in sputum by polymerase chain
      reaction and DNA hybridization.
AB  - A polymerase chain reaction (PCR) assay for the rapid diagnosis of pulmonary
      tuberculosis was developed by using oligonucleotide primers to amplify a fragment
      of IS6110, an insertion sequence repeated multiple times in the chromosome of
      Mycobacterium tuberculosis. Sediment obtained from sputa processed by the N
      acetyl-L-cysteine-NaOH method was suspended in a simple lysis buffer and was
      heated at 100 degrees C for 30 min prior to amplification. A dUTP-uracil N
      glycosylase PCR protocol was used to prevent false-positive test results because
      of the carryover of products from previous amplification reactions. The 317-bp
      amplicon was detected by direct gel analysis and Southern blotting and then
      hybridization with a biotin-labeled internal probe. Hybrid molecules were
      detected by using a commercially available avidin-alkaline phosphatase
      chemiluminescent substrate system (Tropix, Inc., Bedford, Mass.). The analytical
      sensitivity of the assay was 10 fg of purified mycobacterial DNA. The limits of
      detection by culture (Middlebrook 7H11 agar and Lowenstein-Jensen medium) and by
      PCR were equivalent in terminal dilution experiments for organism suspensions and
      positive sputa. An internal control was used to detect the presence of
      amplification inhibitors in each negative reaction mixture. DNA was purified from
      inhibitory specimens by phenol-chloroform extraction and ethanol precipitation.
      PCR results were compared with results of microscopy and conventional culture for
      the detection of M. tuberculosis in 313 sputum specimens. There were 124
      specimens that were positive for M. tuberculosis by conventional methods and 113
      (91%) that were positive by PCR. PCR detected 105 of 110 (95%) of the smear
      positive and 8 of 14 (57%) of the smear-negative specimens. There were no false
      positive results by PCR (specificity, 100%). This PCR assay innovations that make
      application of this new technology feasible in clinical microbiology
      laboratories.

PMID- 8349754
TI  - Evidence of multiple taxa within commercially available reference strains of
      Corynebacterium xerosis.
AB  - Attempts to identify coryneform isolates resembling Corynebacterium xerosis can
      lead clinical microbiologists to identification schemes with conflicting
      descriptions which result in confusing C. xerosis with Corynebacterium striatum.
      For the present study we purchased all available American Type Culture Collection
      and National Collection of Type Cultures reference cultures of C. xerosis (n =
      10) and C. striatum (n = 4) and analyzed them as follows: (i) analysis of
      biochemical reactions in conventional tests and in the Rapid CORYNE system, (ii)
      whole-cell fatty acid analysis by using the gas-liquid chromatography research
      software of Microbial ID, Inc., and (iii) analysis of DNA homology in dot blot
      hybridizations. Three C. xerosis strains were indistinguishable from the C.
      striatum strains in whole-cell fatty acid analyses and DNA hybridizations and
      shared very similar biochemical reactions. The remaining seven strains of C.
      xerosis clustered into five groups on the basis of fatty acid patterns, DNA
      hybridizations, and biochemical tests. No reference strain of C. striatum fit the
      species description in Bergey's Manual of Systematic Bacteriology. The type
      strains of both C. striatum and C. xerosis fit their respective descriptions by
      the Centers for Disease Control and Prevention. This study suggests that the 10
      commercially available reference strains of C. xerosis represent six different
      taxa which should be assigned to new species.

PMID- 8349755
TI  - Reproducibility of lysis-centrifugation cultures for quantification of
      Mycobacterium avium complex bacteremia.
AB  - While quantitative mycobacterial blood cultures have been accepted as the
      standard for evaluating response to various Mycobacterium avium complex (MAC)
      treatment regimens, variability in this methodology has not been evaluated in a
      rigorous fashion. We thus studied the reproducibility of quantitative MAC
      cultures by a lysis-centrifugation culture system within and among five
      institutions. To measure the intralaboratory variation in mycobacterial colony
      counts, colony counts from duplicate blood specimens collected from 52 AIDS
      patients with MAC bacteremia were determined. Colony counts ranged from 0 to
      50,000 CFU/ml. Nonparametric analyses revealed there was no significant
      difference in colony counts between the 52 duplicate specimens. The agreement
      between the intralaboratory paired specimens, as measured by the intraclass
      correlation coefficient, was 0.997. To measure the interlaboratory variation,
      multiple 10-ml aliquots from 12 patients were distributed to five institutions
      and processed within 24 to 32 h by lysis-centrifugation. For the 12 specimens
      distributed to the five laboratories, two-way analysis of variance for repeated
      measures revealed no significant difference in an individual patient's colony
      counts between laboratories (P > 0.2). We conclude that quantitation of
      mycobacterial colony counts by the lysis-centrifugation system is reproducible
      within and between institutions. Clinical trials evaluating response to
      therapeutic interventions for MAC can use multiple laboratories for quantitation
      of mycobacteremia. Furthermore, a 24- to 32-h delay in processing appeared to
      have no impact on reproducibility.

PMID- 8349756
TI  - Effects of fixation and varying target length on the sensitivity of polymerase
      chain reaction for detection of human T-cell leukemia virus type I proviral DNA
      in formalin-fixed tissue sections.
AB  - In this study, the fixation condition most suitable for maintaining the
      sensitivity of the polymerase chain reaction (PCR) was investigated by using the
      alpha-tubulin gene sequence, and the PCR procedure most effective for detecting
      human T-cell leukemia virus type I (HTLV-I) proviral sequences in fixed, embedded
      tissues of adult T-cell leukemia patients was explored. First, the sensitivity of
      the PCR targeting a 286-bp alpha-tubulin sequence was studied in tissue sections
      fixed in several fixatives for various periods at 25 or 4 degrees C. For
      histological examination, fixation with 10% buffered formalin at a lower
      temperature for a shorter period was found to be preferable to retain the
      sensitivity. And the HTLV-I sequence was detected in only 7 of 18 specimens
      (38.9%) when the 374-bp sequence of the gag region was targeted, but the rate
      increased to 77.8% (14 of 18 specimens) when the length of the target sequence
      was reduced to 120 bp within the same region. Therefore, the one-round PCR
      targeting a shorter sequence is preferable for application of PCR to archival
      fixed tissue specimens, the fixation condition of which may not be ideal for DNA
      preservation.

PMID- 8349757
TI  - A phaeohyphomycotic cyst and peritonitis caused by Phialemonium species and a
      reevaluation of its taxonomy.
AB  - Two cases of human fungal infections caused by members of the genus Phialemonium,
      a genus proposed by Gams and McGinnis (1983) for fungi intermediate between the
      genera Acremonium and Phialophora, are presented. The first case was a
      phaeohyphomycotic cyst on the foot of a renal transplant recipient. The fungus
      was detected by direct examination and histopathology and was recovered by
      several procedures over 4 months. It was flat, glabrous, and white becoming
      yellow with the production of a diffusible yellow pigment; it had conidiophores
      that were mostly solitary and lateral and terminal phialides and adelophialides
      with distinct collarettes producing cylindrical to curved conidia. The isolate
      resembled both Phialemonium dimorphosporum and Phialemonium curvatum, although
      its characteristics were more consistent with those of the latter. The second
      case was peritonitis in a renal transplant recipient. The fungus was white-to
      cream colored and yeast like, but later became black with a green diffusible
      pigment, and produced obovoid conidia; it was easily identified as Phialemonium
      obovatum. Difficulties encountered in the identification and taxonomy of members
      of this genus highlight the need for standardized conditions, e.g., potato
      dextrose agar culture incubated at 24 to 25 degrees C for morphologic
      comparisons, to control significant variations due to culture conditions.

PMID- 8349758
TI  - Diagnosis of Mycobacterium avium bacteremia by polymerase chain reaction.
AB  - We describe a rapid polymerase chain reaction (PCR)-based test for diagnosing
      Mycobacterium avium directly from blood specimens. Blood was collected in
      anticoagulant (EDTA) from patients who also had blood cultures performed by the
      lysis-centrifugation method. Blood samples were centrifuged on a Ficoll-Hypaque
      gradient to purify peripheral blood mononuclear cells. The purified cells were
      washed and incubated in the presence of Chelex-100 (a divalent cation-binding
      resin), boiled to release mycobacterial DNA, and then amplified with M. avium
      specific PCR primers. Amplification was detected by hybridization with
      radiolabelled probe, and the results were compared with the culture results. The
      PCR assay gave positive results for 12 of 15 specimens that were taken from
      patients with positive cultures for M. avium complex (sensitivity, 80%). The
      three PCR-negative specimens in this group showed evidence of PCR inhibition. The
      PCR assay gave positive results for 32 of 228 specimens taken from patients with
      negative cultures (specificity, 86%). Of these 32 PCR-positive culture-negative
      specimens, 27 were also positive when amplified with primers specific for the
      genus Mycobacterium, suggesting that PCR may be more sensitive than culture.

PMID- 8349759
TI  - Antigen detection and immunological typing of Haemophilus ducreyi with a specific
      rabbit polyclonal serum.
AB  - A rabbit polyclonal serum was raised against the 29-kDa species-specific marker,
      as well as the 30- to 34-kDa immunotype-specific markers of Haemophilus ducreyi
      described elsewhere (E. Roggen, S. De Breucker, E. Van Dyck, and P. Piot, Infect.
      Immun. 60:590-595, 1992). These antigens were purified from a cocktail of H.
      ducreyi isolates by sodium dodecyl sulfate-polyacrylamide gel electrophoresis.
      The immune serum reacted in enzyme-linked immunosorbent assay (ELISA)
      preferentially with H. ducreyi, at a titer as high as 50,000. To make it specific
      to H. ducreyi, nonspecific antibodies were removed by adsorption on a mixture of
      Haemophilus spp., Escherichia coli, Candida albicans, and Corynebacterium spp. In
      the 29- to 34-kDa region of immunoblot profiles from H. ducreyi isolates (n =
      450), the adsorbed serum revealed essentially the same antigens as did a pool of
      well-characterized human sera. Yet, eight different immunotypes were observed.
      With this rabbit polyclonal serum, an ELISA-based antigen detection test was
      developed. The adsorbed serum reacted specifically with all H. ducreyi isolates
      tested (n = 450), but not with other bacterial species (n = 15). This test was
      evaluated with a limited number of clinical specimens from African patients with
      culture-proven chancroid and no evidence for any other ulcerating etiology (n =
      10) and a number of chancroid-negative control patients from Belgium (n = 20).
      Within this context, the test yielded a sensitivity and specificity of 100%.

PMID- 8349760
TI  - Growth and survival of Serratia marcescens under aerobic and anaerobic conditions
      in the presence of materials from blood bags.
AB  - Several patients receiving blood transfusions during the summer of 1991 developed
      bacteremia after the transfusion. In all cases, the infection was caused by
      Serratia marcescens. The same strain of Serratia marcescens was isolated from the
      patients and from the outer surface of unfilled blood bags. The transport
      containers for the blood bags were made anoxic by using a catalyst in order to
      prevent microbial growth. The survival and growth of S. marcescens K202, which
      was isolated from the blood bags, was studied at different oxygen concentrations
      in deionized water containing materials derived from the blood bags. The rate of
      survival and growth of S. marcescens was highest under anaerobic conditions, in
      which growth occurred with all materials and even in deionized water alone. In
      contrast, S. marcescens did not survive in control cultures under semi-anaerobic
      and aerobic conditions. Growth was observed, however, under both aerobic and semi
      anaerobic conditions in the presence of each of the tested blood bag materials.
      These findings indicate that the conditions in the transport containers for the
      blood bags were favorable for the survival and growth of S. marcescens.

PMID- 8349761
TI  - Identification and characterization of Lyme disease spirochetes, Borrelia
      burgdorferi sensu lato, isolated in Korea.
AB  - Lyme disease spirochetes, Borrelia burgdorferi sensu lato, were identified and
      characterized for the first time in Korea. Four isolates, designated Konkuk-1,
      Konkuk-2, Kangwon-3, and KM-4, were made from midgut suspensions of three Ixodes
      ticks and heart tissue from one mouse, Apodemus agrarius, collected from Chungbuk
      and Kangwon provinces. The four Korean isolates and B. burgdorferi sensu lato
      from other geographic areas and biological sources were compared by using sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis for protein profiles, Western
      blot (immunoblot) analysis for reactivities with monoclonal and polyclonal
      antibodies, and agarose gel electrophoresis for plasmid profiles. Two typing
      schemes using polymerase chain reaction identified three of the isolates as
      members of group VS461 and one, Kangwon-3, as Borrelia garinii. These results
      demonstrate the potential for human Lyme disease to occur in some provinces of
      Korea.

PMID- 8349762
TI  - Cloning of a DNA sequence unique to Clostridium botulinum group I by selective
      hybridization.
AB  - Nucleic acid sequences were isolated from a strain of Clostridium botulinum type
      A by a selective hybridization method known as deletion enrichment. Nontoxigenic
      C. sporogenes was used to produce a C. botulinum type A sequence-enriched
      library. A probe, pCBM44, which showed specific hybridization to a 4.0-kb HindIII
      fragment present in all of the C. botulinum type A strains tested was isolated,
      and there was no hybridization to any strains of C. sporogenes. Upon further
      investigation, pCBM44 was found to hybridize to all of the group I proteolytic C.
      botulinum strains tested (toxin types A, B, and F) but not to hybridize to groups
      II, III, and IV (toxin types B, C, D, or E). The probe did not cross-react with
      nine other Clostridium spp. Such a probe, which differentiates between
      nontoxigenic C. sporogenes and neurotoxigenic C. botulinum group I strains,
      should prove extremely useful.

PMID- 8349763
TI  - Bacteroides fragilis strains express multiple capsular polysaccharides.
AB  - Previous studies by our group have demonstrated that the capsule of Bacteroides
      fragilis type strain NCTC 9343 consists of two chemically distinct
      polysaccharides, designated PS A and PS B. These polysaccharides can be isolated
      as an aggregate from the surface of the organism and give a complex
      multiprecipitin profile when they are reacted with homologous antiserum in an
      immunoelectrophoresis assay. Following structural analysis of PS A and PS B, we
      have determined that the complex precipitin profile is formed as a result of the
      differing electrophoretic and antigenic properties associated with each of these
      polymers. Presently, we have examined the capsular polysaccharides of 13 other
      strains of B. fragilis according to methods used for the prototype strain. The
      capsules of these strains were extracted, partially purified, and analyzed by
      immunoelectrophoresis at pH 7.3. Following reaction with homologous polyclonal
      antisera, each of the capsular preparations tested yielded a complex precipitin
      profile similar to that of the prototype strain. When reacted by
      immunoelectrophoresis with polyclonal antiserum to 9343 or with monoclonal
      antibodies to PS A and PS B, these capsular preparations appeared to be
      antigenically diverse; some preparations (50%) showed complete or partial cross
      reaction. These results suggest that the dual polysaccharide motif seen with the
      prototype strain is a common feature of B. fragilis strains. In addition, the
      antigenic heterogeneity of B. fragilis capsular polysaccharides could be used for
      the development of a serological typing scheme.

PMID- 8349764
TI  - Identification of Actinobacillus actinomycetemcomitans by leukotoxin gene
      specific hybridization and polymerase chain reaction assays.
AB  - Eleven strains of Actinobacillus actinomycetemcomitans isolated from cases of
      systemic infections, local abscesses, and periodontitis were identified by
      genetic assays using the leukotoxin gene as the target. We have developed a
      polymerase chain reaction (PCR) assay, based on the leukotoxin structural gene of
      this pathogen, which clearly identified all tested strains of A.
      actinomycetemcomitans and separated them from the closely related Haemophilus
      aphrophilus as well as other bacterial species. Furthermore, DNA-DNA
      hybridization was performed with the cloned partial leukotoxin structural gene
      (lktA) as a probe, which again clearly distinguished A. actinomycetemcomitans
      from H. aphrophilus, parts of the normal oral flora, and species harboring RTX
      (repeats in toxin) family-related cytotoxins. The PCR fragment amplified from the
      leukotoxin structural gene gave results similar to those given by the cloned
      leukotoxin gene when used as a probe in hybridization experiments. The
      hybridization and PCR assays described here are fundamental improvements for the
      identification of A. actinomycetemcomitans.

PMID- 8349765
TI  - Detection of Toxoplasma gondii in venous blood from AIDS patients by polymerase
      chain reaction.
AB  - Detection of Toxoplasma gondii in blood by means of the polymerase chain reaction
      (PCR) may facilitate the diagnosis and follow-up of cerebral toxoplasmosis in
      patients with AIDS. We evaluated this approach with seven patients with tissue
      culture-proven parasitemia, 14 patients with presumptive cerebral toxoplasmosis,
      and 17 healthy human immunodeficiency virus-positive controls. Each sample of
      blood was assayed on three different occasions by a PCR assay based on detection
      of the gene encoding the P30 surface protein. A positive PCR diagnosis required
      positivity in at least two of the three PCR tests. None of the controls had a
      positive PCR diagnosis, but six of the seven patients with parasitemia did.
      Cerebral toxoplasmosis was confirmed in 13 of the 14 patients with a presumptive
      diagnosis; diagnosis by PCR was positive before treatment for 9 of these 13
      patients, whereas tissue culture was positive for only 1 patient. During
      treatment, blood samples were taken from 14 patients at regular intervals until
      day 12. PCR diagnosis became negative on ethidium-stained gels, but persistent
      signals were observed after hybridization, in some cases, for up to 12 days after
      initiation of therapy. PCR on venous blood could thus be a sensitive and
      noninvasive method for the diagnosis of cerebral and disseminated toxoplasmosis
      in AIDS patients and could be a potential tool for monitoring the effects of
      treatment.

PMID- 8349766
TI  - Curvilinear-gradient high-performance liquid chromatography for identification of
      mycobacteria.
AB  - Over a 1-year period, 502 mycobacterial cultures submitted to the Microbial
      Diseases Laboratory were identified by high-performance liquid chromatography
      (HPLC) in parallel with standard biochemical methods. Identification by HPLC
      using a curvilinear gradient was achieved by comparing the chromatograms of the
      unknown cultures to chromatograms for known reference strains, together with
      calculation of peak height or peak area ratios, as necessary. The overall
      agreement between HPLC and biochemical identification was 97.2%. In addition, 7
      of 12 cultures of Mycobacterium bovis were identified by HPLC as the BCG strain.
      Of 111 cultures biochemically identified as members of the M. avium complex
      (MAC), 108 were confirmed as MAC by DNA probe and 106 were confirmed by HPLC. Of
      the latter 106, 58 probe-positive strains were identified as M. avium, 38 were
      identified as M. intracellulare, and 10 were identified as Mycobacterium sp.
      strain "X" by HPLC. Of the remaining five nonchromogenic cultures, four had MAC
      like chromatograms that did not match any in our library sufficiently to permit
      definitive identification. Of the latter four, two were confirmed as MAC strains
      by DNA probe and two were not. The last of the cultures biochemically identified
      as MAC (1 of 111) was a mixture of MAC and non-MAC strains. Overall, only 2 of
      502 cultures yielded results by HPLC that differed from those obtained by
      standard biochemical methods. The HPLC result was confirmed in both cases by an
      independent national reference laboratory. In the 12 instances in which HPLC did
      not provide identification, the chromatograms were either uninterpretable or did
      not match available reference chromatograms. These findings show that the
      identification obtained by HPLC concurs well with that obtained by both the
      standard biochemical methods and the DNA probes. Thus, identification by HPLC
      provides mycobacteriology laboratories with a reproducible and specific method
      for accurate and timely identification of most medically important mycobacteria.

PMID- 8349767
TI  - Development and evaluation of a blood-free medium for determining growth curves
      and optimizing growth of Rochalimaea henselae.
AB  - Two strains of Rochalimaea henselae were used to optimize a blood-free growth
      medium. Seven agar bases, four broths, and combinations of eight supplements were
      evaluated. Acceptable growth was achieved in media containing Fildes solution and
      hemin, with the best growth demonstrated in brucella broth or on brucella agar
      with 6 to 8% Fildes solution and 250 micrograms of hemin per ml. R. henselae
      utilized hemin in concentrations six times that utilized by Rochalimaea quintana.
      Erythrocyte membrane was necessary to achieve the full growth-promoting effect of
      rabbit blood.

PMID- 8349769
TI  - Confirmation of positive results for chlamydial antigen by the Chlamydiazyme
      assay: value of repeated testing and a blocking antibody assay.
AB  - We studied the specificity of the Abbott Chlamydiazyme test for detection of
      Chlamydia trachomatis antigen by means of a specific blocking antibody test. A
      total of 457 previously positive specimens were tested; 22 did not block in the
      blocking antibody test, 39 did not repeat as positive, and 396 were confirmed as
      positive. The distribution of A492 values obtained with specimens which did not
      repeat as positive was nonrandom and was concentrated between the cutoff values
      and 0.400. The positive predictive value of the Chlamydiazyme assay after initial
      testing was 86.7% (396 of 457), but the positive predictive value increased to
      94.7% (396 of 418) if specimens which were not repeatedly positive were
      considered negative. We recommend routinely repeating the Chlamydiazyme assay for
      all specimens which give A492 values between the cutoff and 0.400 to eliminate
      many false-positive results. Use of the blocking antibody reagent can then be
      reserved for confirming only specimens which are repeatedly positive.

PMID- 8349768
TI  - Detection of adenovirus in clinical specimens by polymerase chain reaction and
      liquid-phase hybridization quantitated by time-resolved fluorometry.
AB  - In addition to tests for the group-specific hexon antigen of adenoviruses,
      adenoviruses can be detected in clinical specimens by hybridization assays
      utilizing the widely shared base sequences of the region of the hexon gene that
      codes for the group-reactive determinants. We have developed a liquid-phase
      hybridization system with biotin- and europium-labeled probes which are reacted
      after DNA amplification of a 161-bp region of the hexon gene and which are
      quantitated by time-resolved (TR) fluorometry in streptavidin-coated microtiter
      wells. Polymerase chain reaction (PCR)-TR fluorometry is not a rapid test in the
      usual sense, but it is highly useful for specimens with inherent toxicity or with
      low virus yield, such as organ minces and specimens obtained late in the course
      of an illness. In a survey of 103 specimens tested by this method, including
      urine, stool, and tissue suspensions, the agreement with the hexon-specific TR
      fluoroimmunoassay antigen test for positive specimens was 100% and the
      sensitivity compared with that of virus culture was 91%. The PCR-TR fluorometry
      system was also shown to be advantageous as a quantitative measure of PCR
      products.

PMID- 8349770
TI  - Recovery of Borrelia burgdorferi by filtration.
AB  - Bacterial contamination frequently interferes with successful recovery of the
      Lyme spirochete from cultures of tissue from Borrelia burgdorferi-infected
      humans, rodents, or ticks. We used 0.20- and 0.45-microns-pore-size syringe-tip
      filters to recover spirochetes from cultures contaminated with other bacteria.
      Low concentrations (1 to 10/ml) of B. burgdorferi organisms could be recovered
      from cultures seeded with 1 x 10(8) to 4 x 10(8) Staphylococcus aureus,
      Streptococcus faecium, Escherichia coli, or Bacillus subtilis organisms per ml.
      We also used this technique to recover B. burgdorferi from contaminated
      environmental and clinical cultures of B. burgdorferi. We conclude the filtration
      is an efficient method for recovering Lyme spirochetes from contaminated samples
      and increasing the number of successful isolations of B. burgdorferi.

PMID- 8349771
TI  - Total cellular fatty acid composition of cultured Pneumocystis carinii.
AB  - Oleic acid makes up > 50% of the total fatty acids of Pneumocystis carinii grown
      on WI-38 cells. Oleic acid levels increased in parallel with increasing
      trophozoites over 7 days in culture. The fatty acid composition of P. carinii
      resembles that of certain fungi but differs from those of lung surfactant lipid,
      host cells, and fetal bovine serum.

PMID- 8349772
TI  - Inhibition of Acanthamoeba species by Pseudomonas aeruginosa: rationale for their
      selective exclusion in corneal ulcers and contact lens care systems.
AB  - Cocultivation of Acanthamoeba castellanii and Acanthamoeba polyphaga with live
      Pseudomonas aeruginosa and with broth filtrates of P. aeruginosa proved equally
      lethal to the Acanthamoeba spp. The P. aeruginosa-induced amebicidal activity is
      apparently toxin mediated and has two operative modes: it can function through
      binding of P. aeruginosa to the ameba membrane and in the presence of one or more
      P. aeruginosa exoproducts.

PMID- 8349773
TI  - Catheter-related Rahnella aquatilis bacteremia in a pediatric bone marrow
      transplant recipient.
AB  - Rahnella aquatilis, a rarely encountered member of the family Enterobacteriaceae,
      was twice isolated from the blood of a pediatric bone marrow transplant
      recipient. This is the first report of a pediatric case of R. aquatilis
      bacteremia, and it was probably related to inappropriate handling of a Hickman
      catheter.

PMID- 8349774
TI  - Novel Campylobacter-like organism resembling Helicobacter fennelliae isolated
      from a boy with gastroenteritis and from dogs.
AB  - We isolated a Campylobacter-like organism resembling Helicobacter fennelliae from
      a 5 1/2-year-old boy with gastroenteritis. Similar strains had been found
      previously in fecal specimens from healthy and diarrheic dogs. These isolates
      could be differentiated from H. fennelliae by a lack of catalase and
      arylsulfatase activities. This group of organisms seems to be homogeneous by a
      nonradioactive dot blot DNA hybridization assay.

PMID- 8349775
TI  - Sensitivity of culture compared with that of polymerase chain reaction for
      detection of Helicobacter pylori from antral biopsy samples.
AB  - Polymerase chain reaction (PCR) was used to test the sensitivity of standard
      bacteriological culture of Helicobacter pylori. The tests were concordant in 97%
      of cases. PCR did not detect more treatment failures after triple treatment than
      did the standard culture method. In the present study, culture was as sensitive
      as PCR for the detection of H. pylori.

PMID- 8349776
TI  - Synergy characterization for Enterococcus faecalis strains displaying moderately
      high-level gentamicin and streptomycin resistance.
AB  - Synergy of 14 Enterococcus faecalis strains displaying moderately high-level
      aminoglycoside resistance (MICs, 500 and 256 to 1,000 micrograms/ml for
      gentamicin and streptomycin, respectively) was characterized by time-kill
      studies. All strains proved resistant to penicillin plus the respective
      aminoglycoside. Strains with moderately high-level aminoglycoside resistance
      should be considered to exhibit high-level resistance in severe infections.

PMID- 8349777
TI  - Levofloxacin disk potency and tentative interpretive criteria for susceptibility
      tests.
AB  - Levofloxacin disk susceptibility test criteria were evaluated by testing 350
      bacterial isolates. Either 5- or 10-micrograms disks could be used
      satisfactorily. A 5-micrograms levofloxacin disk with zone size breakpoints of <
      or = 12 mm for resistance (MIC, > or = 8.0 micrograms/ml) and > or = 16 mm for
      susceptibility (MIC, < or = 2.0 micrograms/ml) is recommended.

PMID- 8349778
TI  - Whole-cell repetitive element sequence-based polymerase chain reaction allows
      rapid assessment of clonal relationships of bacterial isolates.
AB  - Repetitive element sequence-based polymerase chain reaction (rep-PCR) enables the
      generation of DNA fingerprints which discriminate bacterial species and strains.
      We describe the application of whole-cell methods which allow specimens from
      broth cultures or colonies from agar plates to be utilized directly in the PCR
      mixture. The rep-PCR-generated DNA fingerprints obtained with whole-cell samples
      match results obtained with genomic DNA templates. Examples with different gram
      negative bacteria (e.g., Citrobacter diversus, Escherichia coli, and Pseudomonas
      aeruginosa) and gram-positive bacteria (e.g., Staphylococcus aureus and
      Streptococcus pneumoniae) are demonstrated. Rapid specimen preparation methods
      enable rep-PCR-based fingerprinting to be completed in several hours and,
      therefore, allows the timely analysis of epidemiological relationships.

PMID- 8349779
TI  - Ramoplanin susceptibility testing criteria.
AB  - Ramoplanin and mupirocin are two antimicrobial agents that may be applied
      topically. They had similar potencies against susceptible gram-positive cocci,
      but they differed in their spectra of activity. In plastic microdilution trays,
      the in vitro activity of ramoplanin was slightly diminished but that activity was
      restored by the addition of bovine serum albumin (0.02%). Susceptible strains
      were defined as those for which MICs of ramoplanin were < or = 2.0 micrograms/ml
      (without bovine serum albumin) and which had > or = 11-mm zones around 60
      micrograms ramoplanin disks. Criteria for a resistant category cannot be defined
      at this time.

PMID- 8349780
TI  - Use of immunoelectron microscopy to demonstrate Francisella tularensis.
AB  - Three immunoelectron microscopy (IEM) methods were employed to show laboratory
      cultivated Francisella tularensis. By the IEM assays, F. tularensis was
      distinguished from four antigenically distinct gram-negative bacteria. IEM should
      be a valuable tool for confirming presumptive isolates of F. tularensis and may
      potentially be useful for demonstrating other medically important bacteria.

PMID- 8349781
TI  - Evaluation of the L-pyrrolidonyl-beta-naphthylamide hydrolysis test for the
      differentiation of members of the families Enterobacteriaceae and Vibrionaceae.
AB  - A simple, rapid, and inexpensive spot test incorporating the substrate
      pyrrolidonyl naphthylamide was used to examine pyrrolidonyl peptidase activity
      among 800 bacterial strains belonging to the families Enterobacteriaceae and
      Vibrionaceae. The pyrrolidonyl naphthylamide test was found to be particularly
      useful in separating Citrobacter spp. (100% positive) from Salmonella spp. (0.4%
      positive) and Escherichia coli (0% positive). Furthermore, it would appear to
      offer a safer alternative to the traditional potassium cyanide test for
      differentiating citrobacters from salmonellae.

PMID- 8349782
TI  - Analysis of serotype-specific antibodies to Trichosporon cutaneum types I and II
      in patients with summer-type hypersensitivity pneumonitis with monoclonal
      antibodies to serotype-related polysaccharide antigens.
AB  - Summer-type hypersensitivity pneumonitis is the most prevalent type of
      hypersensitivity pneumonitis in Japan. We constructed a sandwich enzyme-linked
      immunosorbent assay system for diagnosis of summer-type hypersensitivity
      pneumonitis in which monoclonal antibodies were used to bind serotype-related
      polysaccharides to plastic plates, and this system was proven to have sufficient
      sensitivity and specificity.

PMID- 8349783
TI  - Identification of M types of group A streptococci.

PMID- 8349784
TI  - Usefulness of DNA fingerprinting in combating tuberculosis.

PMID- 8349785
TI  - Oxidatively modified low density lipoprotein is a chemoattractant for human T
      lymphocytes.
AB  - Oxidatively modified low density lipoprotein (Ox-LDL) is a known chemoattractant
      for monocytes. Here we demonstrate, using a modified Boyden chamber assay, that
      human peripheral blood T lymphocytes, but not B lymphocytes, also respond
      chemotactically to Ox-LDL, showing a threefold increase over control and an
      optimum response at 10 micrograms/ml. Copper and endothelial cell-oxidized LDL
      and beta-VLDL were used and gave similar results. The activity was not
      chemokinetic and native LDL possessed no chemoattractant activity. The
      chemoattractant activity was found to reside in the lipid fraction of Ox-LDL.
      Lysophosphatidylcholine is a major phospholipid component of Ox-LDL and is known
      to be chemotactic for monocytes. We show that lysophosphatidylcholine is also
      chemotactic for T lymphocytes with a maximal fourfold increase at 10 microM.
      Nonmetabolizable analogues of lysophosphatidylcholine had no such chemotactic
      effect. Thus, Ox-LDL, by virtue of its lysophosphatidylcholine content, may
      contribute to the recruitment of both T lymphocytes and monocytes into developing
      atherosclerotic lesions.

PMID- 8349788
TI  - A circulating substance cross-reacting with antiimidazoline antibodies. Detection
      in serum in relation to essential hypertension.
AB  - It has been shown in various mammal species that clonidine, a well known
      centrally acting hypotensive agent, acts through the activation of imidazoline
      receptors (IRs) in the nucleus reticularis lateralis (NRL) of the brainstem.
      Specific binding sites sensitive to imidazolines and insensitive to
      catecholamines have been detected in rat and bovine, as well as human brains. An
      endogenous ligand, other than catecholamines, should exist for these IRs. Such a
      ligand could play a role in the pathophysiology of human essential hypertension.
      Therefore, we developed two RIAs with polyclonal and monoclonal anticlonidine
      antibodies. These antibodies presented specificity spectra similar to that of the
      IRs: they bound imidazolines and not catecholamines at all. These RIAs were used
      to detect imidazoline-like immunoreactivity in the human serum. Immunoreactive
      substance was measured in 26 normotensive subjects' sera, and specificity of
      interaction between antibodies and sera was verified. None of the known
      endogenous substances tested so far were able to interact with the two
      antibodies. Immunoreactivity in 32 essential hypertensive patients' sera proved
      higher in approximately 30% of cases. Values of immunoreactivity positively
      correlated with the mean arterial pressure values. This study demonstrates the
      existence of an "imidazoline-like" immunoreactive substance in the human serum
      with high levels in some hypertensive patients.

PMID- 8349786
TI  - Rapid in vivo transport and catabolism of human apolipoprotein A-IV-1 and slower
      catabolism of the apoA-IV-2 isoprotein.
AB  - Apolipoprotein (apo) A-IV is a polymorphic, intestinally derived apolipoprotein
      that is genetically linked to and similar in structure to apoA-I, the major
      apolipoprotein in high density lipoproteins (HDL). ApoA-IV plays a potentially
      important role in lipoprotein metabolism and reverse cholesterol transport, but
      its in vivo metabolism is poorly understood. In order to gain insight into
      factors modulating apoA-IV metabolism in humans, the in vivo kinetics of the two
      major human apoA-IV isoproteins apoA-IV-1 and apoA-IV-2 were investigated in
      normolipidemic human subjects. 131I-apoA-IV-1 and 125I-apoA-IV-2 were
      reassociated with autologous plasma and injected into study subjects. Analysis of
      the kinetic data revealed a rapid mean fractional catabolic rate (FCR) for apoA
      IV-1 of 2.42 +/- 0.11 d-1. The mean production, or transport, rate of apoA-IV-1
      was 16.3 +/- 1.4 mg/kg per d. Plasma apoA-IV concentrations were highly
      correlated with apoA-IV production rate (r = 0.84, P < 0.001) and not correlated
      with apoA-IV fractional catabolic rate (r = 0.25, P = NS). The mean FCR of apoA
      IV-2 was 2.21 +/- 0.10 d-1. In the ten subjects in whom 131I-apoA-IV-1 and 125I
      apoA-IV-2 were simultaneously injected, the FCR of apoA-IV-2 was significantly
      slower by paired t test (P = 0.003). The FCR of apoA-IV-2 in an apoA-IV-2/2
      homozygote was only 1.49 d-1, substantially slower than in all other subjects. We
      conclude that: (a) apoA-IV is a rapidly catabolized apolipoprotein in humans,
      with a fractional catabolic rate more than 10 times greater than that of apoA-I;
      (b) apoA-IV has a high absolute transport rate similar to that of apoA-I; (c)
      plasma levels of apoA-IV are primarily determined by apoA-IV production rate in
      normolipidemic subjects; and (d) the fractional catabolic rate of the common
      variant apoA-IV-2 is slower than that of the wild-type apoA-IV-1.

PMID- 8349787
TI  - Identification of the fetal liver cytochrome CYP3A7 in human endometrium and
      placenta.
AB  - Placenta and endometrium carry out steroidogenic biotransformation reactions such
      as 6-beta-hydroxylation of cortisol, a reaction characteristic of the dominant
      family of cytochromes P450 in human liver, CYP3A. To investigate the possible
      role in these extrahepatic tissues of the CYP3A microsomal hemoproteins, we
      analyzed placental and endometrial microsomes on Western blots developed with an
      anti-human CYP3A antibody. We found an immunoreactive 51,500 D protein that
      migrated between CYP3A3 (HLp) and CYP3A5 (HLp2) identical with CYP3A7 (HFLa).
      CYP3A7, a form found prominently in human fetal liver microsomes, was first
      isolated as a liver 16-alpha-dehydroepiandrosterone-sulfate hydroxylase. Northern
      blot analysis of total RNA isolated from placenta or from endometrium
      demonstrated a single band that cross-hybridized with a CYP3A7 cDNA.
      Amplification of the same RNA samples with the use of primers specific for
      CYP3A7, produced a 552-bp segment that had the predicted size and the same DNA
      sequence as does liver CYP3A7 cDNA. Hybridizable endometrial CYP3A7 mRNA was
      detected more frequently (six of seven samples) and in higher amounts
      (approximately 12-fold higher) in pregnant compared with nonpregnant women (4 of
      12 samples). In addition, during the secretory phase of the menstrual cycle
      CYP3A7 expression was sixfold higher than in the one sample from the
      proliferative phase that had detectable CYP3A7 mRNA. Moreover, the amounts of
      placental and endometrial CYP3A7 mRNA and protein increased substantially from
      the first to the second trimester of pregnancy. We conclude that placenta and
      endometrium express the same P450 as is found in fetal liver. These tissues
      represent a previously unrecognized and quantitatively important site for 6-beta
      hydroxylation and 16-alpha-hydroxylation of specific steroid precursors, possibly
      for protection of the fetus from the toxic effects of endogenous steroids and
      foreign substrates.

PMID- 8349789
TI  - Altered renal kallikrein and renin gene expression in nephrotic rats and
      modulation by converting enzyme inhibition.
AB  - Urinary kallikrein excretion (UKE) is decreased in rats with passive Heymann
      nephritis (PHN), but increases after converting enzyme inhibition (CEI). Although
      CEI potentiates bradykinin activity, neither the effect of CEI on kallikrein
      secretion nor the abnormal renal kallikrein metabolism in PHN has been examined
      previously. To determine the mechanism by which CEI increases UKE, normal rats
      and PHN received enalapril, 40 mg/kg per d orally for 4 d. UKE was 85% lower in
      PHN than in normals and increased in both groups after CEI, although UKE in PHN
      remained significantly less than in normals. Kallikrein mRNA was significantly
      lower in PHN compared to normals but not in PHN treated with CEI and did not
      change in normal rats. Renin mRNA was significantly lower in PHN, and was
      stimulated by CEI only in normals. Renal kallikrein and renin content were not
      different and were not altered by CEI. Both kallikrein and renin genes appear to
      be transcriptionally suppressed in rats with PHN and the depressed kallikrein
      mRNA levels can be reversed by CEI. The modest increase in UKE despite
      normalization of kallikrein mRNA after CEI suggests that there is also a
      posttranscriptional defect in synthesis and/or secretion of kallikrein.

PMID- 8349790
TI  - Ulcerative colitis: a genetically heterogeneous disorder defined by genetic (HLA
      class II) and subclinical (antineutrophil cytoplasmic antibodies) markers.
AB  - Newly described distinct associations of HLA class II genes with ulcerative
      colitis (UC) (DR2) and Crohn's disease (CD) (DR1/DQ5) provide strong evidence for
      genetic heterogeneity of susceptibility between these two forms of inflammatory
      bowel disease. A familial distribution of antineutrophil cytoplasmic antibodies
      (ANCAs, a subclinical marker of UC) in UC families has further implied the
      existence of heterogeneity within UC. To test the hypothesis that the
      heterogeneity within UC indicated by ANCAs has a genetic basis that resides
      within the HLA region, we studied 89 UC cases and an ethnically matched control
      group (n = 50). Serological and molecular typing techniques were applied to
      define HLA class II genes (DR, DQ). ANCAs were detected using an enzyme-linked
      immunosorbent assay, and positive values were confirmed by indirect
      immunofluorescence. We observed that ANCA-positive UC patients (n = 70) had a
      significantly increased frequency of DR2 compared with ANCA-negative controls (n
      = 46) (44% vs 22%, P = 0.01). In contrast, the frequency of DR2 in ANCA-negative
      UC cases (21%) was virtually identical to that in controls (22%, P = 0.9).
      Furthermore, the ANCA-negative UC patients had an increase in the DR4 allele
      compared with ANCA-positive UC (P = 0.004). Thus, with the combination of a
      subclinical marker (ANCAs) and molecular genetic markers, genetic heterogeneity
      has been demonstrated within UC: ANCA-positive UC associated with DR2, and ANCA
      negative UC likely associated with DR4.

PMID- 8349791
TI  - Adenoviral-mediated gene transfer to rabbit synovium in vivo.
AB  - Currently, treatment for rheumatoid arthritis and other inflammatory
      arthropathies is often ineffective in ameliorating the progression of the
      disease, particularly the invasive destruction of cartilage and bone by
      rheumatoid synovium. Multiple aspects of this inflammatory process are mediated
      by the synovial lining cells (synoviocytes). Genetic modification of these cells
      in vivo represents a potential method for the treatment of these conditions. In
      this report, we describe a novel technique for the genetic transduction of
      synovial lining cells in vivo using recombinant adenoviral vectors and
      intraarticular injection techniques. Purified high titer suspensions of a
      recombinant adenoviral vector containing the gene for Escherichia coli beta
      galactosidase (AdCMVlacZ) were directly injected into the hind knees of New
      Zealand white rabbits. Synovial tissues were then examined for transgenic lacZ
      expression using a combination of in situ staining for beta-galactosidase
      activity, immunohistochemical staining, and transmission electron microscopy.
      High efficiency gene transfer and lacZ expression was observed in both type A and
      type B synoviocytes throughout the articular and periarticular synovium of the
      rabbit knee, with continued expression of transgenic lacZ detected for > or = 8
      wk after infection.

PMID- 8349792
TI  - Evidence for the role of nitric oxide in macula densa control of glomerular
      hemodynamics.
AB  - There is evidence that nitric oxide, an endothelium-derived relaxing factor, may
      be produced by the macula densa, as well as by blood vessels, within the kidney.
      To examine the role of nitric oxide in macula densa control of glomerular
      hemodynamics directly, we performed in vitro microperfusions of both rabbit
      afferent arterioles (with the glomerulus intact) and adherent tubular segments
      consisting of portions of the thick ascending limb, macula densa, and early
      distal tubule. While keeping afferent arteriolar pressure constant at 60 mmHg, we
      examined the effect of Nw-nitro-L-arginine methyl ester (L-NAME), an inhibitor of
      nitric oxide synthesis, added to a macula densa perfusate. When the macula densa
      perfusate was changed from low to high NaCl, the diameter of the arterioles
      decreased from 16.3 +/- 1.0 to 14.0 +/- 1.1 microns (n = 10; P < 0.001). Addition
      of 10(-5) M L-NAME to the high NaCl solution further decreased the diameter to
      11.9 +/- 1.1 microns (P < 0.001). In contrast, when macula densa perfusion was
      maintained with the low NaCl solution, addition of L-NAME had no effect. L-NAME
      induced constriction was completely reversed by adding 10(-3) M L-arginine (the
      precursor of nitric oxide) but not D-arginine (an inactive isomer) to the macula
      densa perfusate. We confirmed that perfusing the macula densa with L-NAME did not
      affect the vasodilator action of acetylcholine added to the lumen of the afferent
      arteriole, indicating that NO synthesis by the arteriole was not altered. Thus,
      our findings suggest that the macula densa may produce nitric oxide, which in
      turn modulates the afferent arteriolar constriction induced by high
      concentrations of NaCl at the macula densa.

PMID- 8349794
TI  - Just (don't) do it.

PMID- 8349793
TI  - A gene differentially expressed in the kidney of the spontaneously hypertensive
      rat cosegregates with increased blood pressure.
AB  - The role of the kidney in initiating hypertension has been much debated. Here we
      demonstrate that a recently identified gene of yet unknown function, termed SA,
      which is differentially expressed in the kidney of the spontaneously hypertensive
      rat, cosegregates with an increase in blood pressure in F2 rats derived from a
      cross of the spontaneously hypertensive rat with normotensive Wistar-Kyoto rats,
      accounting for 28 and 21% of the genetic variability in systolic and diastolic
      blood pressures, respectively. Further, the genotype at this locus appears to
      determine the level of expression of the gene in the kidney. The findings provide
      strong evidence for a primary genetic involvement of the kidney in hypertension.

PMID- 8349795
TI  - Murine models for study of lipoprotein metabolism and atherosclerosis.

PMID- 8349796
TI  - Insulin-like growth factor-1 stimulation of lymphopoiesis.
AB  - We show that treatment of adult mice with recombinant human insulin-like growth
      factor 1 (rhIGF-1) induces striking modifications in lymphocyte number and
      function. 9-mo-old male mice received rhIGF-1 (4 mg/kg per d) or its excipient by
      subcutaneous infusion from osmotic minipumps for 7 or 14 d. Mice were weighed
      daily and bled at sacrifice; the spleen and thymus were harvested and single cell
      suspensions were made for analysis of cell phenotype and cell number. The
      responses of splenocytes to mitogens (concanavalin A, lipopolysaccharide, and
      pokeweed mitogen), alloantigens and dinitrophenyl ovalbumin were measured. After
      either 7 or 14 d of treatment, rhIGF-1 had an overall whole-body anabolic effect,
      resulting in increased body and organ weights with prominent increases in the
      weight of the spleen and thymus. Furthermore, the rhIGF-1 treated mice were
      normoglycemic but had reduced blood urea nitrogens, again reflecting the anabolic
      activity of rhIGF-1. The increased spleen and thymus weights were associated with
      a large increase in the number of lymphocytes in both organs. In addition to an
      increase in T cells, specifically CD4+ T cells, a dramatic increase in splenic B
      cells was also observed. This increase was accompanied by an enhanced
      responsiveness to dinitrophenyl ovalbumin resulting in increased immunoglobulin
      production. However, despite the increases in cellularity, there was a decrease
      in the in vitro responses of spleen cells to mitogens after 7 d of rhIGF-1
      treatment. In contrast, treatment with rhIGF-1 for 14 d increased both the cell
      number and mitogenic responses of splenocytes suggesting that some time is
      required for the cells populating the peripheral organs to gain mitogenic
      responsiveness. It is clear from these data that rhIGF-1, at doses that have
      whole-body anabolic activity, can expand cell number in lymphoid tissue in a
      normal adult mouse. These dual effects of rhIGF-1, of increasing lymphocyte
      number and activity, indicate that, in a normal adult animal, rhIGF-1 can cause
      major changes in lymphoid tissues that are of potential benefit to the
      functioning of the immune system.

PMID- 8349797
TI  - Electrical properties of the rabbit cortical collecting duct from obstructed and
      contralateral kidneys after unilateral ureteral obstruction.
AB  - Electrophysiological techniques were used to determine the electrical properties
      of the collecting duct (CD) cell in the isolated cortical collecting duct from
      obstructed (UUOOK) and contralateral (UUOCK) kidneys in rabbits 24 h after
      unilateral ureteral obstruction (UUO); results were compared with those from sham
      operated kidneys. The lumen-negative transepithelial voltage and the basolateral
      membrane voltage (VB) were decreased in the UUOOK, and increased in the UUOCK.
      The transepithelial conductance (GT) was decreased in parallel with an increase
      in the fractional apical membrane resistance (fRA) and a decrease in apical
      membrane conductance in the UUOOK. By contrast, the GT was increased in parallel
      with increases in apical and basolateral membrane conductances in the UUOCK. The
      amiloride-sensitive changes in apical membrane voltage (VA), GT and fRA were
      lower in the UUOOK, but greater in the UUOCK. The changes in VA and GT upon
      raising the perfusate K+ concentration and upon addition of luminal Ba2+ were
      decreased in the UUOOK, and increased in the UUOCK. Addition of ouabain to the
      bath resulted in a smaller depolarization of VB in the UUOOK, but in a greater
      depolarization in the UUOCK. Upon lowering bath Cl-, the change in basolateral
      membrane electromotive force (delta EMF) was increased in the UUOOK, and
      decreased in the UUOCK. Reversely, upon raising bath K+, the delta EMF was
      decreased in the UUOOK, and increased in the UUOCK. We conclude: (a) the
      conductances of Na+ and K+ in the apical membrane, and active Na(+)-K+ pump
      activity and relative K+ conductance in the basolateral membrane are decreased in
      the UUOOK, and increased in the UUOCK; (b) the relative basolateral membrane Cl-
      conductance was increased in the UUOOK, and decreased in the UUOCK.

PMID- 8349798
TI  - An inbred line of transgenic mice expressing an internally deleted gene for type
      II procollagen (COL2A1). Young mice have a variable phenotype of a
      chondrodysplasia and older mice have osteoarthritic changes in joints.
AB  - Studies were carried out on a line of transgenic mice that expressed an
      internally deleted COL2A1 gene and developed a phenotype resembling human
      chondrodysplasias (Vandenberg et al. 1991. Proc. Natl. Acad. Sci. USA. 88:7640
      7644. Marked differences in phenotype were observed with propagation of the
      mutated gene in an inbred strain of mice in that approximately 15% of the
      transgenic mice had a cleft palate and a lethal phenotype, whereas the remaining
      mice were difficult to distinguish from normal littermates. 1-d- and 3-mo-old
      transgenic mice that were viable showed microscopic signs of chondrodysplasia
      with reduced amounts of collagen fibrils in the cartilage matrix, dilatation of
      the rough surfaced endoplasmic reticulum in the chondrocytes, and decrease of
      optical path difference in polarized light microscopy. The transgenic mice also
      showed signs of disturbed growth as evidenced by lower body weight, lower length
      and weight of the femur, decreased bone collagen, decreased bone mineral, and
      decreased resistance of bone to breakage. Comparisons of mice ranging in age from
      1 d to 15 mo demonstrated that there was decreasing evidence of a
      chondrodysplasia as the mice grew older. Instead, the most striking feature in
      the 15-mo-old mice were degenerative changes of articular cartilage similar to
      osteoarthritis.

PMID- 8349799
TI  - T lymphocyte ontogeny in adenosine deaminase-deficient severe combined immune
      deficiency after treatment with polyethylene glycol-modified adenosine deaminase.
AB  - Adenosine deaminase (ADA) deficiency causes severe combined immune deficiency
      (SCID) by interfering with the metabolism of deoxyadenosine, which is toxic to T
      lymphocytes at all stages of differentiation. Enzyme replacement with
      polyethylene glycol-modified ADA (PEG-ADA) has been previously shown to correct
      deoxyadenosine metabolism and improve mitogen-induced T lymphocyte proliferation.
      We studied the biochemical and immunologic effects of PEG-ADA in two infants with
      ADA-deficient SCID. While in a catabolic state, higher doses of PEG-ADA than
      previously described were required to normalize deoxyadenosine metabolism. After
      biochemical improvement, the patients recovered immune function in a pattern
      similar to that observed in normal thymic ontogeny and in patients with
      immunological reconstitution after bone marrow transplantation. Immune
      reconstitution was marked by the sequential appearance in the peripheral blood of
      phenotypic T lymphocytes corresponding to successive stages of thymic
      differentiation. Functional reconstitution was marked by the successive
      appearance of mitogen responses dependent on exogenous in vitro IL-2, mitogen
      responses not requiring exogenous IL-2, antigen-specific responses dependent on
      exogenous IL-2, and finally, antigen-specific responses not requiring exogenous
      IL-2. Natural killer function was tested in one patient and normalized with PEG
      ADA therapy. Optimal PEG-ADA therapy appears to normalize thymic differentiation
      in ADA-deficient SCID, resulting in normal antigen-specific immune function.

PMID- 8349800
TI  - Altered aldose reductase gene regulation in cultured human retinal pigment
      epithelial cells.
AB  - Aldose reductase (AR2), a putative "hypertonicity stress protein" whose gene is
      induced by hyperosmolarity, protects renal medullary cells against the
      interstitial hyperosmolarity of antidiuresis by catalyzing the synthesis of
      millimolar concentrations of intracellular sorbitol from glucose. Although AR2
      gene induction has been noted in a variety of renal and nonrenal cells subjected
      to hypertonic stress in vitro, the functional significance of AR2 gene expression
      in cells not normally exposed to a hyperosmolar milieu is not fully understood.
      The physiological impact of basal AR2 expression in such cells may be limited to
      hyperglycemic states in which AR2 promotes pathological polyol accumulation, a
      mechanism invoked in the pathogenesis of diabetic complications. Since AR2
      overexpression in the retinal pigment epithelium has been associated with
      diabetic retinopathy, the regulation of AR2 gene expression and associated
      changes in sorbitol and myo-inositol were studied in human retinal pigment
      epithelial cells in culture. The relative abundance of aldehyde reductase (AR1)
      and AR2 mRNA was quantitated by filter hybridization of RNA from several human
      retinal pigment epithelial cell lines exposed to hyperglycemic and hyperosmolar
      conditions in vitro. AR2 but not AR1 mRNA was significantly increased some 11- to
      18-fold by hyperosmolarity in several retinal pigment epithelial cell lines. A
      single cell line with a 15-fold higher basal level of AR2 mRNA than other cell
      lines tested demonstrated no significant increase in AR2 mRNA in response to
      hypertonic stress. This cell line demonstrated accelerated and exaggerated
      production of sorbitol and depletion of myo-inositol upon exposure to 20 mM
      glucose. Therefore, abnormal AR2 expression may enhance the sensitivity of cells
      to the biochemical consequences of hyperglycemia potentiating the development of
      diabetic complications.

PMID- 8349801
TI  - Human neutrophil-mediated fungistasis against Histoplasma capsulatum.
      Localization of fungistatic activity to the azurophil granules.
AB  - Human neutrophils (PMN) demonstrated potent fungistatic activity against
      Histoplasma capsulatum (Hc) yeasts in a sensitive microassay that quantifies the
      growth of yeasts by the incorporation of [3H]leucine. At a PMN:yeast ratio of
      1:2, PMN inhibited the growth of yeasts by 37%. Maximum inhibition of 85% to 95%
      was achieved at a PMN/yeast ratio of 10:1 to 50:1. Opsonization of the yeasts in
      fresh or heat-inactivated serum was required for PMN-mediated fungistasis, but
      ingestion of the yeasts was not required. Recognition and phagocytosis of
      opsonized yeasts was via PMN complement receptor (CR) type 1 (CR1), CR3, and
      FcRIII (CD16). PMN fungistatic activity was evident by 2 h, was maximum at 24 h,
      and persisted up to 5 d. In contrast, yeasts multiplied within monocytes to a
      greater extent than in culture medium alone. PMN from three patients with chronic
      granulomatous disease (CGD) inhibited the growth of Hc yeasts by an average of
      97%, compared with 86% in three normal controls. Furthermore, preincubation of
      PMN with the lysosomotropic agent NH4Cl inhibited fungistatic activity in a
      concentration-dependent manner. Finally, experiments with subcellular fractions
      of PMN demonstrated that the principal component of the fungistatic activity of
      PMN was localized in the azurophil granules. These data demonstrate that human
      PMN possess potent fungistatic activity against Hc yeasts and further show that
      fungistasis is mediated by antimicrobial agents contained in the azurophil
      granules.

PMID- 8349802
TI  - The effect of oxidized lipids in the diet on serum lipoprotein peroxides in
      control and diabetic rats.
AB  - The levels of oxidized serum lipoproteins are increased in humans and animals
      with diabetes. We have examined the contribution of dietary oxidized lipids on
      the levels of oxidized lipoproteins. In both control and streptozocin induced
      diabetic rats, the oxidized lipid content of mesenteric lymph chylomicrons (CM)
      increased when increasing quantities of oxidized lipids were administered
      intragastrically. However, at all levels of administered oxidized lipids, the
      quantity of oxidized lipids in CM was greater in the diabetic animals. These
      results indicate that oxidized lipids are absorbed and packaged into CM and
      suggest that there is increased absorption of oxidized lipids in diabetic
      animals. In nondiabetic rats fed a fat-free diet, the levels of oxidized lipids
      in their serum lipoproteins were very low. When oxidized lipids were added to the
      diet, the quantity of peroxides in serum lipoproteins increased about fivefold.
      In diabetic animals fed a fat-free diet, there were also very low levels of
      oxidized lipids in their serum lipoproteins, and there was no difference between
      control and diabetic rats. However, when diabetic animals were fed a diet
      containing oxidized lipids, the quantity of oxidized lipids in their serum
      lipoproteins increased 16-fold and were significantly greater than in controls.
      Thus, in both control and diabetic rats the quantity of oxidized lipids in the
      diet largely determines the levels of oxidized lipids in circulating
      lipoproteins. However, in diabetic animals the effect of diet is more pronounced.
      Together with the CM studies, these results demonstrate that dietary oxidized
      lipids make a major contribution to the levels of oxidized lipids in circulating
      lipoproteins and indicate that increased absorption of oxidized lipids in
      diabetic animals may play a role in the elevation of oxidized lipoproteins
      observed in this disorder.

PMID- 8349803
TI  - Influence of grass pollen immunotherapy on cellular infiltration and cytokine
      mRNA expression during allergen-induced late-phase cutaneous responses.
AB  - We have studied the influence of grass pollen immunotherapy on cellular
      infiltration and cytokine mRNA expression during allergen-induced late-phase
      cutaneous responses. In a double-blind, placebo-controlled trial of immunotherapy
      in 40 adult hay fever sufferers, clinical improvement was accompanied by a
      decrease in the size of the late-phase skin response. When the immunotherapy
      treated group was compared with the placebo group, analysis of skin biopsies
      obtained 24 h after intradermal allergen revealed a significant reduction in the
      number of infiltrating CD3+ (P = 0.04) and CD4+ (P = 0.009) cells and a trend for
      a decrease in EG2+ eosinophils (P = 0.08). Treatment did not influence allergen
      induced recruitment of CD8+ cells, neutrophils, or macrophages. Unexpected
      increases in expression of CD25 (P = 0.006) and HLA-DR (P = 0.007) were observed
      in the actively treated group. In situ hybridization using a panel of riboprobes
      demonstrated "TH2-type" (IL-4, IL-5) cytokine mRNA responses in both groups of
      patients. In contrast, significant hybridization for IL-2 (8/16 patients, P =
      0.02) and for interferon-gamma (6/16 patients, P = 0.04) was observed only in the
      actively treated group. These findings indicate that immunotherapy is associated
      with suppression of allergen-induced CD4+ T lymphocyte infiltration, but among
      the cells that are recruited, there is upregulation of CD25 and HLA-DR. At least
      in this model, immunotherapy does not appear to affect expression of TH2-pattern
      cytokines in response to allergen exposure, but expression of mRNA for Th1-type
      cytokines was enhanced in half of the patients. The results support the view that
      immunotherapy may possibly be working through induction of T cell tolerance.

PMID- 8349804
TI  - Endothelium-mediated coronary blood flow modulation in humans. Effects of age,
      atherosclerosis, hypercholesterolemia, and hypertension.
AB  - The effects of age, atherosclerosis, hypertension, and hypercholesterolemia on
      vascular function of the coronary circulation were studied by subselective
      intracoronary infusions of acetylcholine, which releases endothelium-derived
      relaxing factor, and papaverine, which directly relaxes vascular smooth muscle,
      in normal patients (n = 18; no risk factors for coronary artery disease), in
      patients with evidence of early atherosclerosis but normal cholesterol levels and
      normal blood pressure (n = 12), in patients with hypertension without left
      ventricular hypertrophy (n = 12), and in patients with hypercholesterolemia (n =
      20). Papaverine-induced maximal increases in coronary blood flow were
      significantly greater in normals, but no differences were noted between the
      groups of patients with early atherosclerosis, with hypertension, and with
      hypercholesterolemia. The capacity of the coronary system to increase blood flow
      in response to acetylcholine was similar in normal and normocholesterolemic
      patients with epicardial atherosclerosis and/or hypertension but was
      significantly impaired in patients with hypercholesterolemia, irrespective of
      evidence of epicardial atherosclerotic lesions. Age (r = -0.62, P < 0.0001) and
      total serum cholesterol levels (r = -0.70; P < 0.0001) were the only significant
      independent predictors of a blunted coronary blood flow response to
      acetylcholine. Thus, hypercholesterolemia and advanced age selectively impair
      endothelium-mediated relaxation of the coronary microvasculature in response to
      acetylcholine, whereas endothelial dysfunction is restricted to epicardial
      arteries in age-matched normocholesterolemic patients with evidence of coronary
      atherosclerosis and/or hypertension.

PMID- 8349805
TI  - Human keratinocytes are a major source of cutaneous platelet-derived growth
      factor.
AB  - PDGF has been implicated as one of the principal mitogens involved in cutaneous
      wound healing. While it has been previously reported that both platelets and
      monocytes are a source of PDGF in human dermal wound repair, the production of
      PDGF by human keratinocytes has not yet been described. In this manuscript, we
      report the production of PDGF by cultured human keratinocytes. Both PDGF A and B
      chain mRNA can be detected in cultured cells. While only PDGF-AA polypeptide is
      found in significant levels in keratinocyte-conditioned culture media, all three
      PDGF isoforms (AA, AB, and BB) are present in detergent-solubilized cell
      extracts. No evidence of PDGF receptor expression was observed in cultured
      keratinocytes when analyzed for either mRNA levels or polypeptide expression,
      suggesting that PDGF does not play an autocrine role in keratinocyte growth.
      Analysis of cryosections of human cutaneous wounds by immunostaining for PDGF
      showed that both PDGF A and B chain is constitutively expressed in normal
      epidermis, as well as in newly reconstituted wound epidermis. No evidence for
      PDGF receptor polypeptide expression in the epidermis was detected by
      immunostaining of cryosections.

PMID- 8349806
TI  - Extracellular proteolysis in the adult murine brain.
AB  - Plasminogen activators are important mediators of extracellular metabolism. In
      the nervous system, plasminogen activators are thought to be involved in the
      remodeling events required for cell migration during development and
      regeneration. We have now explored the expression of the plasminogen
      activator/plasmin system in the adult murine central nervous system. Tissue-type
      plasminogen activator is synthesized by neurons of most brain regions, while
      prominent tissue-type plasminogen activator-catalyzed proteolysis is restricted
      to discrete areas, in particular within the hippocampus and hypothalamus. Our
      observations indicate that tissue-type plasminogen activator-catalyzed
      proteolysis in neural tissues is not limited to ontogeny, but may also contribute
      to adult central nervous system physiology, for instance by influencing neuronal
      plasticity and synaptic reorganization. The identification of an extracellular
      proteolytic system active in the adult central nervous system may also help gain
      insights into the pathogeny of neurodegenerative disorders associated with
      extracellular protein deposition.

PMID- 8349807
TI  - Glomerular filtration and tubular reabsorption of albumin in preproteinuric and
      proteinuric diabetic rats.
AB  - Microalbuminuria (26-250 mg/d) is considered to be an indicator of incipient
      diabetic nephropathy in humans in insulin-dependent diabetes (IDD). However,
      before microalbuminuria is observed, glomerular alterations, such as
      glycosylation of the glomerular basement membrane and glomerular hyperfiltration,
      in IDD may result in increased filtration of albumin before any observed increase
      in albumin excretion. Glomerular and tubular albumin kinetics were examined in
      streptozotocin (65 mg/kg body wt, i.v.) diabetic, Munich-Wistar rats at 7-10
      (untreated) and 50-70 d (poorly controlled with small doses of insulin) after the
      onset of diabetes and compared with nondiabetic controls. Additional rats in each
      condition received acute lysine treatment to prevent tubular protein
      reabsorption. Urinary albumin excretion and nonvascular albumin distribution
      volumes were measured in the renal cortex and compared with morphometric
      measurements of interstitial space and the proximal tubule to assess
      intracellular uptake of albumin in the proximal tubule. Urinary albumin excretion
      under anesthesia was not different in 7-10-d IDD versus controls (19 +/- 3 vs. 20
      +/- 3 micrograms/min) but increased in the 50-70-d IDD (118 +/- 13
      micrograms/min, P < 0.05). Lysine treatment resulted in increased albumin
      excretion compared with respective nontreatment in 7-10-d IDD (67 +/- 10
      micrograms/min, P < 0.05) but not in controls (30 +/- 6 micrograms/min) or in 50
      70-d IDD (126 +/- 11 micrograms/min). Glomerular filtration rate was increased
      both in 7-10-d IDD (2.7 +/- 0.1 ml/min, P < 0.05) and in 50-70-d IDD (2.6 +/- 0.1
      ml/min, P < 0.05) compared with control (2.2 +/- 0.1 ml/min). Calculated urinary
      space albumin concentrations increased early in IDD with 2.5 +/- 0.4 mg% in 7-10
      d IDD and 4.9 +/- 0.6 mg% in 50-70-d IDD compared with control (1.4 +/- 0.3 mg%).
      The increase in filtration of albumin is in excess of that attributable to
      hyperfiltration before increased albumin excretion early in diabetes. In 50-70-d
      IDD, absolute tubular reabsorption of albumin is decreased, correlating to the
      decrease in brush border height of the proximal tubule.

PMID- 8349808
TI  - Suppression of growth hormone (GH) secretion by a selective GH-releasing hormone
      (GHRH) antagonist. Direct evidence for involvement of endogenous GHRH in the
      generation of GH pulses.
AB  - To study the potential involvement of growth hormone-releasing hormone (GHRH) in
      the generation of growth hormone (GH) pulses in humans we have used a competitive
      antagonist to the GHRH receptor, (N-Ac-Tyr1,D-Arg2)GHRH(1-29)NH2(GHRH-Ant). Six
      healthy young men were given a bolus injection of GHRH-Ant 400 micrograms/kg body
      wt or vehicle at 2200 h and nocturnal GH concentrations were assessed by every 10
      min blood sampling until 0800 h. Integrated total and pulsatile GH secretion were
      suppressed during GHRH-Ant treatment by 40 +/- 6 (SE) % and 75 +/- 5%,
      respectively. GHRH-Ant suppressed maximum (7.6 +/- 2.2 vs 1.8 +/- 0.5
      micrograms/liter; P < 0.001) and mean (3.3 +/- 1.0 vs 1.1 +/- 0.2
      micrograms/liter; P = 0.02) GH pulse amplitudes. There was no change in
      integrated nonpulsatile GH levels, pulse frequency, or interpulse GH
      concentration. GHRH-Ant 400 micrograms/kg also suppressed the GH responses to
      intravenous boluses of GHRH 0.33 micrograms/kg given 1, 6, 12, and 24 h later by
      95, 81, 59, and 4%, respectively. In five healthy men, the responses to 10-fold
      larger GHRH boluses (3.3 micrograms/kg) were suppressed by 82 and 0%, 1 and 6 h
      after GHRH-Ant 400 micrograms/kg, respectively. These studies provide the first
      direct evidence that endogenous GHRH participates in the generation of
      spontaneous GH pulses in humans.

PMID- 8349809
TI  - Effects of carbonic anhydrase inhibition on ventilation-perfusion matching in the
      dog lung.
AB  - Lung carbonic anhydrase (CA) permits rapid pH responses when changes in regional
      ventilation or perfusion alter airway and alveolar PCO2. These pH changes affect
      airway and vascular resistances and lung compliance to optimize the balance of
      regional ventilation (VA) and perfusion (Q) in the lung. To test the hypothesis
      that these or other CA-dependent mechanisms contribute to VA/Q matching, we
      administered acetazolamide (25 mg/kg intravenously) to six anesthetized and
      paralyzed dogs and measured VA/Q relationships before and after CA inhibition by
      the multiple inert gas elimination technique. Four other groups of dogs were
      studied to control for possible confounding effects of time under anesthesia and
      nonselective CA inhibition by acetazolamide: (a) saline placebo as a control for
      duration of anesthesia, (b) 4% CO2 inhalation to mimic systemic CO2 retention,
      (c) 1 mg/kg benzolamide (a selective renal CA inhibitor) or 0.5 meq/kg HCl to
      mimic systemic metabolic acidosis, and (d) 500 mg/kg 4,4'-dinitrostilbene-2,2'
      disulfonate (an inhibitor of red cell band 3 protein) to mimic the respiratory
      acidosis arising from an intracapillary block to rapid mobilization of plasma
      HCO3- in CO2 exchange. Acetazolamide increased VA/Q mismatch and reduced arterial
      PO2 measured at equilibrium but these did not occur in the control group. There
      was no deterioration in VA/Q matching when systemic respiratory acidosis produced
      either by CO2 inhalation or 4,4'-dinitrostilbene-2,2'-disulfonate or metabolic
      acidosis (benzolamide or HCl) were imposed to mimic the effects of acetazolamide
      apart from its inhibition of lung CA. These results support the concept that lung
      CA subserves VA/Q matching in the normal lung.

PMID- 8349810
TI  - A novel superantigen isolated from pathogenic strains of Streptococcus pyogenes
      with aminoterminal homology to staphylococcal enterotoxins B and C.
AB  - Streptococcus pyogenes (group A Streptococcus) has re-emerged in recent years as
      a cause of severe human disease. Because extracellular products are involved in
      streptococcal pathogenesis, we explored the possibility that a disease isolate
      expresses an uncharacterized superantigen. We screened culture supernatants for
      superantigen activity with a major histocompatibility complex class II-dependent
      T cell proliferation assay. Initial fractionation with red dye A chromatography
      indicated production of a class II-dependent T cell mitogen by a toxic shock-like
      syndrome (TSLS) strain. The amino terminus of the purified streptococcal
      superantigen was more homologous to the amino termini of staphylococcal
      enterotoxins B, C1, and C3 (SEB, SEC1, and SEC3), than to those of pyrogenic
      exotoxins A, B, C or other streptococcal toxins. The molecule, designated SSA,
      had the same pattern of class II isotype usage as SEB in T cell proliferation
      assays. However, it differed in its pattern of human T cell activation, as
      measured by quantitative polymerase chain reaction with V beta-specific primers.
      SSA activated human T cells that express V beta 1, 3, 15 with a minor increase of
      V beta 5.2-bearing cells, whereas SEB activated V beta 3, 12, 15, and 17-bearing
      T cells. Immunoblot analysis of 75 disease isolates from several localities
      detected SSA production only in group A streptococci, and found that SSA is
      apparently confined to only three clonal lineages as defined by multilocus enzyme
      electrophoresis typing. Isolates of one of these lineages, (electrophoretic type
      2) are strongly associated with TSLS. The data identify SSA as a novel
      streptococcal superantigen that appears to be more related structurally to
      staphylococcal enterotoxins than to streptococcal exotoxins. Because abundant SSA
      production is apparently confined to only three streptococcal clonal lineages,
      the data also suggest that the SSA gene has only recently been acquired by S.
      pyogenes.

PMID- 8349811
TI  - Angiotensin II increases glucose utilization during acute hyperinsulinemia via a
      hemodynamic mechanism.
AB  - To determine whether hemodynamic changes can modulate insulin action in vivo, we
      administered angiotensin II (AII) to normal men under three separate, euglycemic
      conditions. First, in the presence of physiological hyperinsulinemia
      (approximately 115 microU/ml), infusion of AII at rates of 2, 10, and 20 ng/min
      per kg caused significant elevations of blood pressure, whole-body glucose
      clearance, and plasma insulin concentrations in an AII dose-dependent manner.
      Second, in the presence of plasma insulin concentrations that stimulate glucose
      transport maximally (approximately 5,000 microU/ml), AII infusions increased
      whole-body glucose clearance without enhancing glucose extraction across the leg.
      Third, in the presence of basal insulin concentrations (approximately 13
      microU/ml), AII infusions had no effect on whole-body glucose turnover or leg
      glucose extraction. Thus, AII enhanced whole-body glucose utilization without
      directly stimulating glucose transport in a major skeletal muscle bed. To
      evaluate a possible hemodynamic mechanism for the effects of AII on glucose
      utilization, we measured blood flow to two areas that differ in their sensitivity
      to insulin: the kidneys and the leg. We found that AII redistributed blood flow
      away from the predominantly insulin-independent tissues of the kidney and toward
      the insulin-sensitive tissues of the leg during both sham and hyperinsulinemic
      glucose clamps. The redistribution of flow had no effect on whole-body glucose
      turnover when leg glucose uptake was unstimulated (sham clamps). However, when
      leg glucose uptake was activated by insulin, the redistribution of flow caused a
      net increase in whole-body glucose utilization. Our findings indicate that
      hemodynamic factors can modulate insulin action in vivo. Furthermore, our results
      suggest that variable activity of the renin-angiotensin system may contribute to
      inconsistencies in the association between insulin resistance and hypertension.

PMID- 8349812
TI  - Parathyroid hormone-like protein is a secretory product of atrial myocytes.
AB  - Parathyroid hormone-like protein (PLP) was originally identified from tumors
      associated with hypercalcemia. Recently, it has been found to be expressed in a
      stretch-responsive manner in several types of smooth muscle. We studied adult rat
      heart muscle for the presence of the PLP. Using immunohistology and the PCR, we
      demonstrated the presence of PLP and its mRNA in all heart chambers.
      Immunoelectron microscopy demonstrated PLP in secretory vesicles of atrial
      mycocytes. Using immunoassay, we demonstrated that atria contained a higher
      concentration of PLP than ventricles. Furthermore, primary cultures of both
      chambers released PLP into conditioned medium, with atria secreting more than
      ventricles. Considered with studies of the role of PLP in other tissues, our
      observations suggest that the production and secretion of PLP by cardiac myocytes
      represents a calcium-related regulatory function for this stretch-responsive
      polypeptide in the cardiovascular system. PLP in the heart may be the calcium
      counterpart for the atrial natriuretic-sodium regulatory axis of the
      cardiovascular system.

PMID- 8349813
TI  - Modulation of cholinergic neural bronchoconstriction by endogenous nitric oxide
      and vasoactive intestinal peptide in human airways in vitro.
AB  - Human airway smooth muscle possesses an inhibitory nonadrenergic noncholinergic
      neural bronchodilator response mediated by nitric oxide (NO). In guinea pig
      trachea both endogenous NO and vasoactive intestinal peptide (VIP) modulate
      cholinergic neural contractile responses. To identify whether endogenous NO or
      VIP can modulate cholinergic contractile responses in human airways in vitro, we
      studied the effects of specific NO synthase inhibitors and the peptidase alpha
      chymotrypsin on contractile responses evoked by electrical field stimulation
      (EFS) at three airway levels. Endogenous NO, but not VIP, was shown to inhibit
      cholinergic contractile responses at all airway levels but this inhibition was
      predominantly in trachea and main bronchus and less marked in segmental and
      subsegmental bronchi. To elucidate the mechanism of this modulation we then
      studied the effects of endogenous NO on acetylcholine (ACh) release evoked by EFS
      from tracheal smooth muscle strips. We confirmed that release was neural in
      origin, frequency dependent, and that endogenous NO did not affect ACh release.
      These findings show that endogenous NO, but not VIP, evoked by EFS can inhibit
      cholinergic neural responses via functional antagonism of ACh at the airway
      smooth muscle and that the contribution of this modulation is less marked in
      lower airways.

PMID- 8349815
TI  - Structural changes underlying compensatory increase of diffusing capacity after
      left pneumonectomy in adult dogs.
AB  - To determine if the functional compensation in diffusing capacity of the
      remaining lung following pneumonectomy is due to structural growth, we performed
      morphometric analysis of the right lung in three adult foxhounds approximately 2
      yr after left pneumonectomy (removal of 42% of lung) and compared the results to
      those in normal adult dogs previously studied by the same techniques. Diffusing
      capacity was calculated by an established morphometric model and compared to
      physiologic estimates at peak exercise in the same dogs after pneumonectomy. The
      major structural changes after left pneumonectomy are hyperinflation of the right
      lung, alveolar enlargement, and thinning of the alveolar-capillary tissue
      barrier. These changes confer significant functional compensation for gas
      exchange by reducing the overall resistance to O2 diffusion. The magnitude of
      compensation in diffusing capacity estimated either morphometrically or
      physiologically is similar. In spite of morphometric and physiologic evidence of
      functional compensation, there is no evidence of significant growth of structural
      components. After pneumonectomy, morphometric estimates of diffusing capacity are
      on average 23% higher than physiologic estimates in the same dogs at peak
      exercise. We conclude that the previously reported large differences between
      morphometric and physiologic estimates of diffusing capacity reflects the
      presence of large physiologic reserves available for recruitment.

PMID- 8349814
TI  - Dietary fatty acids regulate hepatic low density lipoprotein (LDL) transport by
      altering LDL receptor protein and mRNA levels.
AB  - The concentration of LDL in plasma is strongly influenced by the amount and the
      type of lipid in the diet. Recent studies in the hamster have shown that dietary
      fatty acids differentially affect circulating LDL levels primarily by altering
      receptor-dependent LDL uptake in the liver. To investigate the mechanistic basis
      of this effect, rates of receptor-dependent LDL transport in the liver were
      correlated with LDL receptor protein and mRNA levels in hamsters fed safflower
      oil or coconut oil and varying amounts of cholesterol. Hepatic LDL receptor
      activity was significantly lower in animals fed coconut oil than in animals fed
      safflower oil at all levels of cholesterol intake (26, 53, and 61% lower at
      cholesterol intakes of 0, 0.06, and 0.12%, respectively). These fatty acid
      induced changes in hepatic LDL receptor activity were accompanied by parallel
      changes in hepatic LDL receptor protein and mRNA levels, suggesting that dietary
      fatty acids regulate the LDL receptor pathway largely at the mRNA level.

PMID- 8349817
TI  - Interleukin-8 and the neutrophil response to mucosal gram-negative infection.
AB  - Urinary tract infections activate a mucosal inflammatory response, which includes
      cytokine secretion and neutrophil influx. The mechanisms involved in the
      neutrophil influx have not been identified. Interleukin-8, a potent
      chemoattractant for neutrophils, is produced by urinary tract epithelial cell
      lines in vitro. This study analyzed the human IL-8 response to deliberate
      Escherichia coli infection of the urinary tract. Urine and serum samples were
      obtained before and after intravesical instillation of E. coli. Neutrophil
      numbers were determined on uncentrifuged urine, and IL-8 levels were measured by
      ELISA. A urinary IL-8 response was found in all patients after bacterial
      instillation, but no serum IL-8 was detected. There was a strong correlation
      between urinary IL-8 levels and urinary neutrophil numbers. The same E. coli
      strains used to colonize the patients stimulated IL-8 production in urinary tract
      epithelial cells. The level of IL-8 secreted by epithelial cell lines was
      influenced by the fimbrial properties of the E. coli. These results demonstrated
      that E. coli elicit a mucosal IL-8 response in humans, and suggested that IL-8 is
      involved in the onset of pyuria. Epithelial cells may be an important source of
      IL-8 during urinary tract infection.

PMID- 8349818
TI  - A molecular map of G protein alpha chains in microdissected rat nephron segments.
AB  - Membrane-associated guanine nucleotide binding proteins regulate many receptor
      mediated signals. Heterogeneity of biochemical and functional properties in
      nephron segments could be due to differences in G protein expression. To
      ascertain whether such heterogeneity of G proteins is present in various nephron
      segments, this study examines the distribution and relative abundance of G
      protein alpha chains in microdissected medullary thick ascending limb, cortical
      collecting tubules, outer medullary collecting tubules, proximal inner medullary
      tubules, and distal inner medullary tubules. Reverse transcription and polymerase
      chain reactions were employed using oligonucleotides encoding highly conserved
      regions of all known alpha chains. The cDNA was sequenced for alpha chain
      identification. The alpha i2 versus alpha s distribution was different in the
      outer medullary collecting tubules, when compared with the medullary thick
      ascending limb (P < 0.001) or the cortical collecting tubule, the proximal inner
      medullary tubules, and the distal inner medullary tubules (P < 0.05). These
      latter four segments did not significantly differ from each other. A similar
      analysis was applied to the frequently used line of kidney cells, LLC-PK1, whose
      exact cellular origin remains unclear. Interestingly, we detected both alpha i2
      and alpha i3, while only alpha i2 was detected in the rat distal nephron. No
      alpha o or alpha z reverse transcription PCR products were detected. In contrast
      alpha 11 and alpha 14 members of the more recently described alpha q family were
      detected in the outer medullary collecting tubules and the proximal inner
      medullary tubules, respectively. We conclude that the majority of nephron
      segments have a relatively constant distribution of G protein alpha chains.

PMID- 8349816
TI  - Coincidence of genetic loci for plasma cholesterol levels and obesity in a
      multifactorial mouse model.
AB  - We have examined backcross progeny derived from a cross of Mus spretus with
      C57BL/6J, that range from 1 to 50% carcass lipid (n = 215), and from 22 to 130
      mg/dl plasma total cholesterol (n = 238). Statistical analysis revealed that
      distal mouse chromosome 7 exhibits significant linkage both to plasma total
      cholesterol (likelihood of the odds [LOD] 5.8) and to carcass lipid (LOD 3.8). A
      locus on chromosome 6 also shows significant linkage to plasma total cholesterol
      (LOD 5.6), but no linkage to carcass lipid. Neither chromosomal region contains
      any previously mapped genes likely to influence lipoprotein metabolism,
      indicating that novel genetic factors contributing to plasma lipoprotein levels
      have been identified.

PMID- 8349820
TI  - V3-specific neutralizing antibodies in sera from HIV-1 gp160-immunized volunteers
      block virus fusion and act synergistically with human monoclonal antibody to the
      conformation-dependent CD4 binding site of gp120. NIH-NIAID AIDS Vaccine Clinical
      Trials Network.
AB  - Sera from 11 volunteers immunized with a recombinant HIV-1 gp160-expressing
      vaccinia virus (HIVAC-1e; Oncogen/Bristol-Myers Squibb, Seattle, WA) and boosted
      with baculovirus-derived rgp160 (VaxSyn; MicroGeneSys, Inc., Meriden, CT) were
      evaluated for functional serum antibodies and their epitopes. Sera obtained prior
      to boosting had undetectable HIV-1-specific IgG and neutralizing activity, and
      did not block HIV-1 from binding or fusing to CD4+ MT-2 cells. 14 d after
      boosting, sera from each volunteer contained HIV-1-specific IgG titers of 1:40 to
      1:1,280. Five of these sera also contained neutralizing antibodies, where most or
      all neutralizing activity was blocked by a synthetic peptide corresponding to
      amino acids 307-330 of the V3 loop of gp120, indicating that neutralizing
      antibodies were mostly V3 loop-specific. All sera obtained after boosting
      contained HIV-1 binding/fusion-inhibition antibodies, and a significant portion
      of their activity was blocked by the V3 loop peptide, a result consistent with
      the presence of antibodies against the region of the V3 loop that participates in
      fusion. Three sera with V3 loop-specific neutralizing and fusion-inhibition
      antibodies were studied further. In competitive antibody binding experiments,
      antibodies reactive with the conformation-dependent, CD4 binding site of gp120
      were undetectable in each serum. When evaluated in combination with a monoclonal
      antibody to the CD4 binding site of gp120, two sera demonstrated synergism in
      neutralizing assays, and all three sera demonstrated synergism in binding/fusion
      inhibition assays, further indicating that the functional antibodies were
      primarily V3 loop-specific. The synergism also suggests that a vaccine that
      elicits strong serum antibody responses to both regions of gp120 may improve the
      potential for inducing protective immunity.

PMID- 8349819
TI  - The human 230-kD bullous pemphigoid antigen gene (BPAG1). Exon-intron
      organization and identification of regulatory tissue specific elements in the
      promoter region.
AB  - The 230-kD bullous pemphigoid antigen (BPAG1), a hemidesmosomal protein, is
      encoded by a gene at the human chromosomal locus 6p11-12. We have elucidated the
      exon-intron organization of the entire human BPAG1 gene, including approximately
      2.6 kb of 5'-flanking DNA. Seven overlapping genomic clones, spanning
      approximately 20 kb, contained the entire approximately 9 kb coding sequence of
      BPAG1 and consisted of 22 separate exons, which varied from 78 to 2,810 bp in
      size. The 5' flanking region of DNA, upstream from the ATG initiation codon for
      translation, was found to contain several putative transcriptional response
      elements. Most interestingly, two motifs potentially conferring keratinocyte
      specific expression to the gene were detected. The presence of such elements was
      suggested by approximately 20-fold higher expression of a
      promoter/chloramphenicol acetyl transferase (CAT) construct in normal human
      epidermal keratinocytes that express the endogenous gene, as compared to several
      non-expressing cell types. Transient transfections with 5'-deletion clones of the
      promoter/reporter gene (CAT) constructs identified a region containing a putative
      tissue specific element, KRE2, which also conferred tissue specificity to the
      expression of the truncated promoter downstream from this element, however, a
      mutated derivative of KRE2 was not functional. Detailed knowledge of the
      structure and regulation of the BPAG1 gene will aid in further elucidation of
      diseases affecting the cutaneous basement membrane zone.

PMID- 8349821
TI  - Deficiency of dystrophin-associated proteins in Duchenne muscular dystrophy
      patients lacking COOH-terminal domains of dystrophin.
AB  - Dystrophin, the protein product of the Duchenne muscular dystrophy (DMD) gene, is
      a cytoskeletal protein tightly associated with a large oligomeric complex of
      sarcolemmal glycoproteins including dystroglycan, which provides a linkage to the
      extracellular matrix component, laminin. In DMD, the absence of dystrophin leads
      to a drastic reduction in all of the dystrophin-associated proteins, causing the
      disruption of the linkage between the subsarcolemmal cytoskeleton and the
      extracellular matrix which, in turn, may render muscle cells susceptible to
      necrosis. The COOH-terminal domains (cysteine-rich and carboxyl-terminal) of
      dystrophin have been suggested to interact with the sarcolemmal glycoprotein
      complex. However, truncated dystrophin lacking these domains was reported to be
      localized to the sarcolemma in four DMD patients recently. Here we report that
      all of the dystrophin-associated proteins are drastically reduced in the
      sarcolemma of three DMD patients in whom dystrophin lacking the COOH-terminal
      domains was properly localized to the sarcolemma. Our results indicate that the
      COOH-terminal domains of dystrophin are required for the proper interaction of
      dystrophin with the dystrophin-associated proteins and also support our
      hypothesis that the loss of the dystrophin-associated proteins in the sarcolemma
      leads to severe muscular dystrophy even when truncated dystrophin is present in
      the subsarcolemmal cytoskeleton.

PMID- 8349822
TI  - Small elevations of glucose concentration redirect and amplify the synthesis of
      guanosine 5'-triphosphate in rat islets.
AB  - Recent studies suggest a permissive requirement for guanosine 5'-triphosphate
      (GTP) in insulin release, based on the use of GTP synthesis inhibitors (such as
      myocophenolic acid) acting at inosine monophosphate (IMP) dehydrogenase; herein,
      we examine the glucose dependency of GTP synthesis. Mycophenolic acid inhibited
      insulin secretion equally well after islet culture at 7.8 or 11.1 mM glucose (51%
      inhibition) but its effect was dramatically attenuated when provided at < or =
      6.4 mM glucose (13% inhibition; P < 0.001). These observations were explicable by
      a stimulation of islet GTP synthesis derived from IMP since, at high glucose: (a)
      total GTP content was augmented; (b) a greater decrement in GTP (1.75 vs. 1.05
      pmol/islet) was induced by mycophenolic acid; and (c) a smaller "pool" of
      residual GTP persisted after drug treatment. Glucose also accelerated GTP
      synthesis from exogenous guanine ("salvage" pathway) and increased content of a
      pyrimidine, uridine 5'-triphosphate (UTP), suggesting that glucose augments
      production of a common regulatory intermediate (probably 5-phosphoribosyl-1
      pyrophosphate). Pathway-specific radiolabeling studies confirmed that glucose
      tripled both salvage and de novo synthesis of nucleotides. We conclude that steep
      changes in the biosynthesis of cytosolic pools of GTP occur at modest changes in
      glucose concentrations, a finding which may have relevance to the adaptive
      (patho) physiologic responses of islets to changes in ambient glucose levels.

PMID- 8349823
TI  - Hypercholesterolemia in low density lipoprotein receptor knockout mice and its
      reversal by adenovirus-mediated gene delivery.
AB  - We employed homologous recombination in embryonic stem cells to produce mice
      lacking functional LDL receptor genes. Homozygous male and female mice lacking
      LDL receptors (LDLR-/- mice) were viable and fertile. Total plasma cholesterol
      levels were twofold higher than those of wild-type litter-mates, owing to a seven
      to ninefold increase in intermediate density lipoproteins (IDL) and LDL without
      a significant change in HDL. Plasma triglyceride levels were normal. The half
      lives for intravenously administered 125I-VLDL and 125I-LDL were prolonged by 30
      fold and 2.5-fold, respectively, but the clearance of 125I-HDL was normal in the
      LDLR-/- mice. Unlike wild-type mice, LDLR-/- mice responded to moderate amounts
      of dietary cholesterol (0.2% cholesterol/10% coconut oil) with a major increase
      in the cholesterol content of IDL and LDL particles. The elevated IDL/LDL level
      of LDLR-/- mice was reduced to normal 4 d after the intravenous injection of a
      recombinant replication-defective adenovirus encoding the human LDL receptor
      driven by the cytomegalovirus promoter. The virus restored expression of LDL
      receptor protein in the liver and increased the clearance of 125I-VLDL. We
      conclude that the LDL receptor is responsible in part for the low levels of VLDL,
      IDL, and LDL in wild-type mice and that adenovirus-encoded LDL receptors can
      acutely reverse the hypercholesterolemic effects of LDL receptor deficiency.

PMID- 8349824
TI  - Dominant negative mutations of the scavenger receptor. Native receptor
      inactivation by expression of truncated variants.
AB  - The bovine scavenger receptor was truncated at amino acid 266 or 310 to delete
      either all or part, respectively, of the collagen-like domain. The truncated
      receptors were inactive in the binding and internalization of acetyl (Ac) low
      density lipoprotein (LDL). Coexpression of truncated receptor with the native
      receptor dramatically reduced the percentage of cells internalizing fluorescently
      labeled Ac LDL, compared with cells expressing the native receptor alone. The
      mutant truncated at amino acid 266 was most effective in receptor inactivation,
      resulting in a 42% or 80% decrease in the percentage of cells expressing active
      receptor when transfected in a 1:1 or 1:2 molar ratio (native:mutant),
      respectively, with native receptor. Degradation of 125I-Ac LDL was reduced up to
      90% when the native and truncated mutant receptors were coexpressed. Scavenger
      receptor inhibition was specific because the activity of the LDL receptor was not
      altered. Transient transfection of the mouse macrophage cell line P388D1 with
      truncated scavenger receptor resulted in a 65% decrease in the uptake and
      degradation of Ac LDL but did not decrease the degradation of beta-migrating very
      low density lipoprotein, which is LDL receptor-mediated. These results
      demonstrate that expression of truncated bovine scavenger receptor inactivates
      both the native bovine and murine scavenger receptors, producing a dominant
      negative phenotype in vitro.

PMID- 8349825
TI  - Effects of lovastatin and dietary cholesterol on sterol homeostasis in healthy
      human subjects.
AB  - We measured biliary and fecal sterol outputs in 12 human subjects on a metabolic
      ward in four randomly allocated, 6-7 wk periods: (a) lovastatin (40 mg b.i.d.) +
      low cholesterol diet (mean 246 mg/d), (b) lovastatin + high cholesterol diet
      (mean 1,071 mg/d), (c) low cholesterol diet alone, (d) high cholesterol diet
      alone. In addition to lowering serum LDL cholesterol, lovastatin significantly
      lowered biliary secretion of cholesterol, fecal output of endogenous neutral
      sterols, cholesterol balance, and systemic cholesterol input (the sum of
      cholesterol synthesis and absorbed dietary cholesterol). The high cholesterol
      diet significantly lowered cholesterol balance, but significantly increased
      systemic cholesterol input and fecal output of acidic sterols. There was no
      significant interaction between lovastatin and dietary cholesterol for any
      parameter measured. Judging from these data, the primary action of lovastatin is
      to lower cholesterol synthesis and systemic cholesterol input, the main
      compensatory response being reduced biliary cholesterol secretion. Conversely,
      increased dietary cholesterol appears to increase systemic cholesterol input, the
      major compensatory response being increased bile acid synthesis. There appears to
      be no interaction between these two perturbations of systemic cholesterol input.

PMID- 8349826
TI  - 39-kD protein inhibits tissue-type plasminogen activator clearance in vivo.
AB  - Tissue-type plasminogen activator (t-PA) is a plasma serine protease that
      catalyzes the initial and rate-limiting step in the fibrinolytic cascade. t-PA is
      widely used as a thrombolytic agent in the treatment of acute myocardial
      infarction. However, its use has been impaired by its rapid hepatic clearance
      from the circulation following intravenous administration. Studies with both rat
      hepatoma MH1C1 cells (G. Bu, S. Williams, D. K. Strickland, and A. L. Schwartz,
      1992. Proc. Natl. Acad. Sci. USA. 89:7427-7431) and human hepatoma HepG2 cells
      (G. Bu, E. A. Maksymovitch, and A. L. Schwartz. 1993. J. Biol. Chem. 28:13002
      13009) have shown that binding of t-PA to its clearance receptor, the low density
      lipoprotein receptor-related protein/alpha 2-macroglobulin receptor, is inhibited
      by a 39-kD protein that copurifies with this receptor. Herein we investigated
      whether administration of purified recombinant 39-kD protein would alter t-PA
      clearance in vivo. We found that intravenous administration of purified 39-kD
      protein to rats prolonged the plasma half-life of 125I-t-PA from 1 min to
      approximately 5-6 min. The plasma half-life of t-PA enzymatic activity was
      similarly prolonged following intravenous administration of purified 39-kD
      protein. In addition we found that the 39-kD protein itself was rapidly cleared
      from the circulation in vivo. Clearance of 125I-39-kD protein was a biphasic
      process with half-lives of 30 s and 9 min and the liver was the primary organ of
      clearance. Preadministration of excess unlabeled 39-kD protein slowed 125I-39-kD
      protein clearance in rats in a dose-dependent manner, suggesting that specific
      clearance receptors were responsible for this process. Administration of
      increasing doses of unlabeled 39-kD protein along with labeled 39-kD protein
      resulted in a decrease in the amount of labeled 39-kD protein associating with
      the liver and a concomitant increase in the amount of labeled 39-kD protein
      associating with the kidneys, indicating two clearance mechanisms exist for the
      39-kD protein.

PMID- 8349827
TI  - Glycosylation-dependent cell adhesion molecule 1 (GlyCAM 1) mucin is expressed by
      lactating mammary gland epithelial cells and is present in milk.
AB  - Glycosylation-dependent cell adhesion molecule 1 (GlyCAM 1) is a mucinlike
      endothelial glycoprotein that acts as an adhesive ligand for L selectin by
      presenting one or more O-linked carbohydrates to the lectin domain of this
      leukocyte cell surface selectin. The GlyCAM 1 glycoprotein has been previously
      shown to be expressed specifically by the endothelial cells of peripheral and
      mesenteric lymph nodes and in an unknown site in lung. Here we report that this
      protein is also expressed during lactation by mammary epithelial cells. Northern
      blot analysis has shown that the mRNA for GlyCAM 1 appears to be induced during
      pregnancy in a manner similar to that previously described for hormonally induced
      milk proteins. In situ hybridization analysis reveals that the site of GlyCAM 1
      synthesis in the mammary gland is in the epithelial cells that produce these same
      milk proteins. Immunohistochemistry of mammary glands using antisera directed
      against GlyCAM 1 peptides demonstrates that these epithelial cells contain GlyCAM
      1 protein, and that this protein is also found lumenally in the milk of the
      secreting mammary gland. Analysis of murine milk shows that immunoreactive GlyCAM
      1 is found in the soluble whey fraction. Finally, labeling analysis of milk
      GlyCAM 1 has demonstrated that this form of the glycoprotein lacks the sulfate
      modified carbohydrate that has recently been shown to be required for the ligand
      binding activity to L selectin. The nonsulfated mammary GlyCAM 1 is unable to
      interact with L selectin, consistent with the hypothesis that milk GlyCAM 1 has a
      different function than endothelial GlyCAM 1. These data thus suggest that milk
      GlyCAM 1 is a hormonally regulated milk protein that is part of the milk mucin
      complex. In addition, the finding that the mammary form of GlyCAM 1 contains
      different carbohydrate modifications than the endothelial form suggests that this
      glycoprotein may be a scaffold for carbohydrates that mediate functions in
      addition to cell adhesion.

PMID- 8349828
TI  - Immunochemical and molecular characterization of anti-RNA polymerase I
      autoantibodies produced by tight skin mouse.
AB  - Autoantibodies against nuclear proteins like RNA polymerase I (RNA pol I) are
      produced in a number of rheumatic autoimmune diseases. Production of antibodies
      specific for the 190-kD subunit of RNA pol I appears to be characteristic in the
      patients with systemic sclerosis. Previous investigations have shown that the
      tight skin (TSK) mouse is an experimental model for systemic sclerosis. In the
      present study we show that the TSK mice produce high titers of anti-RNA pol I
      antibodies, both of IgM and IgG classes. To characterize the immunochemical
      properties of these antibodies we obtained a large panel of hybridomas from these
      mice. Analysis of these hybridomas revealed that clonal frequency of autoreactive
      B cells specific for RNA pol I are higher in the TSK mice that in the controls.
      mAbs obtained from the TSK mice were specific for the 190-kD subunit and cross
      reacted with Escherichia coli and phage T7 RNA polymerases (155-, 150-, and 107
      kD polypeptides). We have also demonstrated that these antibodies bind better to
      the phosphorylated enzymes. The anti-RNA pol I mAbs were divided into three
      groups in terms of their functional property. The first group of antibodies
      increased the catalytic activity of the enzyme whereas the antibodies of the
      second group inhibited the enzymatic activity. Competitive inhibition RIAs showed
      that these two groups of antibodies bound to distinct epitopes. The third group
      of antibodies was neutral and had no activity on the enzyme function. These
      results suggest that TSK mouse anti-RNA pol I antibodies recognize three or more
      conserved epitopes. To understand the molecular basis of the generation of such
      autoreactive antibodies we analyzed their V gene repertoire. Northern analysis of
      RNAs of 14 TSK hybridomas showed that the VH genes encoding these antibodies were
      mainly from VH J558 family. It is possible that these genes were derived from a
      single germline gene or from a set of related genes of a single subgroup.

PMID- 8349830
TI  - Assessment of pain in cervical dentinal sensitivity studies. A review.
AB  - Traditionally cervical dentinal sensitivity (CDS) has been evaluated mainly
      subjectively on the basis of the individual patient's subjective response, e.g.,
      in the form of verbal rating and visual analogue scales and questionnaires. The
      stimuli used for evaluating this response can be grouped into 4 main categories:
      mechanical, chemical, electrical and thermal. This review of the literature,
      however, indicates that there are problems in evaluating patient subjective
      response to these various test stimuli used in the assessment and treatment of
      CDS. Opinions also vary as to the reliability of some of these methods of
      assessment, although recently, efforts have been made to develop controlled
      reproducible stimuli more suited to the evaluation of CDS. Currently no single
      method of eliciting and assessing CDS may be considered ideal. Further research
      is required to evaluate suitable methodology for the quantification of realistic
      test stimuli under controlled clinical conditions, whereby the subjective
      response may be objectively measured by the investigator.

PMID- 8349829
TI  - Bioenergetic abnormalities associated with severe left ventricular hypertrophy.
AB  - Transmurally localized 31P-nuclear magnetic resonance spectroscopy (NMR) was used
      to study the effect of severe pressure overload left ventricular hypertrophy
      (LVH) on myocardial high energy phosphate content. Studies were performed on 8
      normal dogs and 12 dogs with severe left ventricular hypertrophy produced by
      banding the ascending aorta at 8 wk of age. Spatially localized 31P-NMR
      spectroscopy provided measurements of the transmural distribution of myocardial
      ATP, phosphocreatine (CP), and inorganic phosphate (Pi); spectra were calibrated
      from measurements of ATP content in myocardial biopsies using HPLC. Blood flow
      was measured with microspheres. In hypertrophied hearts during basal conditions,
      ATP was decreased by 42%, CP by 58%, and the CP/ATP ratio by 32% in comparison
      with normal. Increasing myocardial blood flow with adenosine did not correct
      these abnormalities, indicating that they were not the result of persistent
      hypoperfusion. Atrial pacing at 200 and 240 beats per min caused no change in
      high energy phosphate content in normal hearts but resulted in further CP
      depletion with Pi accumulation in the inner left ventricular layers of the
      hypertrophied hearts. These changes were correlated with redistribution of blood
      flow away from the subendocardium in LVH hearts. These findings demonstrate that
      high energy phosphate levels and the CP/ATP ratio are significantly decreased in
      severe LVH. These abnormalities are proportional to the degree of hypertrophy but
      are not the result of persistent abnormalities of myocardial perfusion. In
      contrast, depletion of CP and accumulation of Pi during tachycardia in LVH are
      closely related to the pacing-induced perfusion abnormalities and likely reflect
      subendocardial ischemia.

PMID- 8349831
TI  - Suppression of subgingival Actinobacillus actinomycetemcomitans in localized
      juvenile periodontitis by systemic tetracycline.
AB  - The current study assessed the clinical and microbiological effects of systemic
      antimicrobial therapy alone in Actinobacillus actinomycetemcomitans-infected
      adolescents with periodontal disease. The study involved 6 localized juvenile
      periodontitis patients 13-18 years of age, who harbored high numbers of A.
      actinomycetemcomitans in subgingival plaque samples. The periodontal lesions were
      microbiologically monitored by selective culture, and clinically assessed for
      probing pocket depth and periodontal attachment level 3 months prior to baseline,
      and at 3, 6, 12, and 24 months posttreatment. Tetracycline-HCl (250 mg/QID) was
      prescribed until 1 week after subgingival A. actinomycetemcomitans was no longer
      detectable or for a maximum of 8 weeks. During 3 months prior to treatment,
      pocket depth was unchanged, and was then significantly reduced from an average of
      7.1 mm to 5.1 mm 12 months after treatment (p = 0.02). The mean change in
      clinical attachment level was a gain of 1.4 mm between baseline and 12 months (p
      = 0.02). 3 of the 6 patients were still infected with A. actinomycetemcomitans
      after 8 weeks of antibiotic therapy and 4 subjects were infected at 12 months.
      Numbers of A. actinomycetemcomitans were still suppressed in most lesions. There
      was a strong association between mean numbers of A. actinomycetemcomitans in
      periodontal pockets and mean change in probing attachment level at any given time
      point. For 22 available comparisons, derived from all time points, there was a
      strong association (r = 0.68) between subgingival A. actinomycetemcomitans and
      change in probing attachment level.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349832
TI  - The periodontally-involved root surface.
AB  - Recent years have seen much research on the periodontally-involved root surface.
      Many of these studies have produced results which suggest that plaque
      contaminants of the root surface are only superficially placed, and capable of
      being removed by gentle means. Further research has attested to the difficulties
      in rendering periodontally-involved root surfaces free of calculus deposits by
      instrumentation, yet clinical studies show that periodontal disease can be
      managed by root planing. It is concluded that root surface debridement is best
      assessed on the basis of the healing response and that it should aim to disrupt
      plaque on and remove plaque from the periodontally-involved root surface rather
      than to remove part of the root surface itself.

PMID- 8349833
TI  - Treatment of periodontal furcation defects. Coronally positioned flap with or
      without citric acid root conditioning in class II defects.
AB  - A total of 27 mandibular, buccal class II furcation defects were treated in 16
      subjects using a coronally positioned flap procedure, with or without citric acid
      conditioning of the root surfaces. The effect of the therapies was evaluated from
      a series of soft and hard tissue measurements. Mean improvements were slightly
      greater for acid treated than for non-acid treated defects. However, none of the
      mean differences reached statistical significance, indicating that citric acid
      conditioning may not be a necessary part of the regenerative, coronally
      positioned flap procedure in mandibular furcations.

PMID- 8349835
TI  - Periodontal attachment loss assessed by linear and area measurements in vitro.
AB  - The aim of the present study was to investigate the relationship between linear
      and area measurements of periodontal attachment loss, and to determine the root
      surface area on different tooth-types. Extracted permanent teeth were collected
      in a national survey including a systematic random sample of 500 Norwegian
      dentists. The response rate was 70%. Altogether 329 teeth were received, 81 of
      them (excluding 3rd molars) were subjected to both linear and area measurements
      of attachment loss. Using a dissecting microscope (10 x), 4 to 8 duplicate linear
      measurements were recorded per tooth. The areas of both lost and remaining
      periodontal attachment were measured by a method based on controlled release of
      Cu and Co metal ions from coatings applied to the root surface. Linear loss of
      attachment for single-rooted teeth (n = 63) was mean = 44.0% and the area loss
      mean = 49.2%. The corresponding measurements for multi-rooted teeth (n = 18) were
      mean = 30.3% and mean = 35.1%, respectively. The correlation between linear and
      area loss was r = 0.78 for single-rooted and r = 0.75 for multi-rooted teeth (p <
      0.01). The lower correlation in multi-rooted teeth is probably due to the more
      complex root anatomy. It is concluded that there is a strong correlation between
      linear loss of attachment and area of periodontal support lost for teeth with
      early to moderate loss of attachment, and that linear measurements tend to
      underestimate the remaining periodontal attachment.

PMID- 8349834
TI  - Long-term control of diabetes mellitus and periodontitis.
AB  - The purpose of this study was to evaluate the association between long-term
      control of diabetes mellitus (DM) and periodontitis. A total of 75 diabetics
      (Type I or II) aged 20-70 years with long-term records of their diabetic control
      were selected for the study. The following periodontal variables were recorded in
      a randomized half-mouth examination: plaque, calculus (+/-), probing depth (pd)
      and attachment loss (al). The mean of glycosylated hemoglobin measurements
      (HbAlc) over the past 2-5 years was used to indicate the long-term control of DM.
      The study participants were divided into well-, moderately- and poorly-controlled
      diabetics. An increase in the prevalence, severity and extent of periodontitis
      with poorer control of diabetes was observed. The extent of calculus also
      increased with poorer control. In a multiple regression analysis, calculus and
      long-term control of diabetes were significant variables when pd > or = 4 mm was
      used as the dependent variable. Age was a significant predictor for al > or = 3
      mm but not for pd > or = 4 mm. Sex, duration and type of DM were not significant
      variables in the regression models. Less than 2% of sites with no calculus
      demonstrated pd > or = 4 mm. When calculus was present, the frequency of pd > or
      = 4 mm increased from 6% in the well-controlled diabetics to 16% in the poorly
      controlled ones. We conclude that periodontitis in diabetics is associated with
      long-term metabolic control and presence of calculus.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8349836
TI  - The immediate effects of smoking on gingival fluid flow.
AB  - The aim of the present study was to examine the immediate effect of smoking a
      cigarette on gingival crevice fluid (GCF) flow-rate. The study involved 17
      healthy volunteers (6 male, 11 female) aged 19-57 years (mean 34.5 years) who
      regularly smoked cigarettes. All were periodontally healthy. GCF was collected at
      the mesio-buccal aspects of the right and left maxillary 2nd premolar teeth,
      using filter-paper strips left in place for 3 min. Samples were taken at baseline
      and subsequently at 10 min intervals for 70 min. Each subject sham smoked an
      unlit standard cigarette for 7 min after the 20 min recording, and smoked the
      same cigarette for 7 min to within 1 cm of the filter, following the 40 min
      recording. The results showed that following sham smoking (30 min recording) GCF
      volume increased by a mean of 16.7% (p = 0.057), and following smoking (50 min
      recording) GCF volume increased by a mean of 89.7%, over the previous recording
      (p < 0.0001). The increase following smoking was greater than that following sham
      smoking (p < 0.0001). Flow-rate returned to near resting levels within the
      experimental period. The results indicate that smoking produces a marked
      transient increase in GCF flow-rate, which might reflect changes in blood flow
      known to be produced by nicotine.

PMID- 8349837
TI  - A skin window study of neutrophil migration in subjects with localized juvenile
      periodontitis.
AB  - This study investigated the effect of a chemoattractant, N-formyl-methionyl
      leucyl-phenylalanine (FMLP), upon skin window migration of neutrophils into
      filters in 5 patients with a history of localized juvenile periodontitis (LJP)
      and 8 controls. On 2 occasions, each subject had 2 superficial skin abrasions
      made on the inner aspect of the forearm. Initial periodontal treatment was
      carried out on the disease group between the visits. On one skin window filters
      were placed that were soaked in physiological saline, and on the other filters
      soaked with FMLP. Leading fronts and cell densities were measured in each filter.
      At visit 1, LJP subjects had significantly lower leading fronts and cell
      densities. At visit 2, the differences were insignificant. The leading fronts for
      the LJP group were significantly improved on the second visit. No difference was
      observed between saline and FMLP. The findings of this study indicate that
      neutrophil migration is reduced in LJP patients where treatment is not involved,
      and that FMLP has no effect on neutrophil migration from the skin windows under
      the conditions of this study.

PMID- 8349838
TI  - The use of topical flurbiprofen as an adjunct to non-surgical management of
      periodontal disease.
AB  - Non-steroidal anti-inflammatory drugs (NSAIDs) have been used as systemic and
      topical preparations to control chronic periodontal disease in both animal and
      clinical human trials. Equivocal findings have failed to confirm whether any one
      NSAID is particularly efficacious, although flurbiprofen appears to be one of the
      most promising. 49 patients were allocated at baseline to test (25) and control
      (24) groups in a 12-month, controlled clinical trial. The groups were of similar
      age and sex distributions. During the first 3 months, both groups were given oral
      hygiene instruction and received scaling and root planning. The test patients
      were prescribed a 1% w/w flurbiprofen toothpaste to use 2 x daily for the entire
      12 months. Control subjects were prescribed a placebo dentifrice. Plaque scores,
      bleeding scores, crevicular fluid flow, probing pocket depths and attachment
      levels were assessed at baseline and at 3, 6, 9 and 12 months. Radiographs were
      taken at baseline and 12 months using a modified intraoral, repositionable film
      holder. Both the flurbiprofen and placebo showed significant improvements in the
      clinical parameters over 12 months and there were no significant differences
      between the groups. Flurbiprofen-treated patients however, demonstrated a
      significantly greater proportion of sites (8.0%) with bone gain when compared to
      the placebo group (3.3%). There were no significant differences between the
      groups in the number of sites showing bone loss or no change. It is concluded
      that the 1% w/w flurbiprofen toothpaste exerts a small, yet significant effect on
      bone metabolism in the absence of any apparent effects on clinical parameters.

PMID- 8349839
TI  - Evaluation of peri-implant sulcular temperature.
AB  - Sulcular temperatures were measured on 35 clinically stable and restored
      osseointegrated dental implants and compared to 50 remaining natural teeth in 9
      partially-edentulous adults using the PerioTemp temperature probe (ABIO-DENT,
      Inc., Danvers, MA USA). Replicate peri-implant sulcular measurements showed a
      mean difference of 0.1 +/- 0.15 (SD) degrees C. Implant temperatures varied from
      0.41 to 3.9 degrees C below sublingual temperatures measured on each patient, and
      maxillary implants were significantly cooler than mandibular implants (p < 0.001,
      t-test). A posterior-to-anterior temperature gradient was found in both the
      maxilla and mandible, with anterior implants significantly cooler than posterior
      fixtures. No significant differences were found in sulcular temperatures of
      osseointegrated dental implants and natural teeth located in anatomically
      equivalent oral sites. Similarly to natural teeth, sulcular temperature may serve
      as a valuable diagnostic tool in evaluating dental implant status.

PMID- 8349840
TI  - Immunocytochemical staining of AII-amacrine cells in the rat retina with
      antibodies against parvalbumin.
AB  - The rod dominated rodent retina is the preferred tissue for in vitro studies of
      mammalian retinal physiology and pharmacology. The rod pathway through the rat
      retina was investigated, therefore, in order to find out whether its organization
      follows the mammalian "plan." AII-amacrine cells of the rat retina were injected
      with Lucifer Yellow to characterize the morphology of this bistratified
      interneuron of the rod pathway. When sections or whole mounts of the rat retina
      were stained with antibodies against the calcium binding protein parvalbumin
      (PV), two different amacrine cell types were labeled: the AII-amacrine cell and a
      widefield amacrine cell. They occur at a ratio of 12:1. Weak label was also
      observed in ganglion cells. The density of PV-labeled AII-cells decreases from
      approximately 7,000 cells/mm2 in upper central retina to 2,000 cells/mm2 in
      peripheral retina. Their cell bodies form a regular mosaic, and the dendritic
      arbors of three neighbouring AII-amacrine cells overlap (coverage of 3).

PMID- 8349842
TI  - Contact-spacing among astrocytes is independent of neighbouring structures: in
      vivo and in vitro evidence.
AB  - We have examined the morphology of astrocytes and the arrays they form in two
      situations, in retinas from which ganglion cells and blood vessels have been
      caused to degenerate, and in vitro. These observations were made to test whether
      the regularity of the spacing of astrocytes within normal central nervous tissue
      results from interaction among astrocytes, or from interaction between astrocytes
      and other elements of that tissue. Both in the partially degenerated cat retina,
      and in cultures of astrocytes from neonatal rat cortex, astrocytes make and
      maintain contact with neighbouring astrocytes, yet space their somas apart,
      giving regularity to the arrays. These results support the hypothesis that the
      regularity observed in arrays of astrocytes in intact tissue results from an
      interaction among astrocytes, independent of neighbouring structures, and lead us
      to suggest that the cell-cell interactions involved in contact spacing serve to
      distribute astrocytes through the central nervous system, and may, in other
      tissues, underlie the formation of epithelia.

PMID- 8349841
TI  - Electron microscopic analysis of the rod pathway of the rat retina.
AB  - Two immunocytochemical markers were used to label the rod pathway of the rat
      retina. Rod bipolar cells were stained with antibodies against protein kinase C
      and AII-amacrine cells with antibodies against parvalbumin. The synaptic
      circuitry of rod bipolars in the inner plexiform layer (IPL) was studied. Rod
      bipolar cells make approximately 15 ribbon synapses (dyads) in the IPL. Both
      postsynaptic members of the dyads are amacrine cells; one is usually the process
      of an AII-amacrine cell and the other one frequently provides a reciprocal
      synapse. No direct output from rod bipolar cells into ganglion cells was found.
      AII-amacrine cells make chemical output synapses with cone bipolar cells and
      ganglion cells in sublamina a of the IPL. They make gap junctions with cone
      bipolar cells and other AII-amacrine cells in sublamina b of the IPL. The rod
      pathway of the rat retina is practically identical to that of the cat and of the
      rabbit retina. It is very likely that this circuitry is a general feature of
      mammalian retinal organization.

PMID- 8349843
TI  - Immunoelectron microscopic analysis of a novel carbohydrate differentiation
      antigen (CDA-3C2) in the developing rat olfactory and otic systems.
AB  - A carbohydrate differentiation antigen (CDA-3C2) exhibits a highly specific and
      restricted pattern of expression during rat embryogenesis. In the periphery of
      the embryo, this antigen is associated transiently with the lateral ectoderm but
      is retained only in the olfactory and otic epithelium throughout morphogenesis.
      At the light microscopic level, CDA-3C2 immunoreactivity appears mostly along
      cell periphery and in the extracellular matrix. The aim of the present study was
      to determine the specific cellular and subcellular distribution of CDA-3C2 in
      vivo in order to identify potential sites of cellular and tissue function of the
      antigen during embryogenesis. There was a strikingly similar subcellular
      distribution of CDA-3C2 in the developing otic and olfactory systems, found
      mostly along cell membranes, microvillar projections and acellular secretions of
      the epithelium. Mature sensory components of the epithelia were not
      immunoreactive, whereas supportive cells and their secreted structures were
      densely stained. The highly coincident nature of CDA-3C2 in both sensory
      epithelia suggests that this carbohydrate epitope, and possibly its carrier
      macromolecule, participate in a morphogenetic function common to these two
      sensory epithelia.

PMID- 8349844
TI  - Developmental plasticity in cerebellar tactile maps: fractured maps retain a
      fractured organization.
AB  - Plasticity following deafferentation has been repeatedly demonstrated in
      topographic sensory maps in the mammalian brain. In this paper we investigated
      the developmental plasticity of the fractured somatotopic map found in the
      tactile regions of the rat cerebellum. At various stages of postnatal development
      between postnatal days 1 and 30, we cauterized the infraorbital branch of the
      trigeminal nerve, which innervates the upper lip, furry buccal pad, and vibrissae
      that are represented within cerebellar folium crus IIa. The organization of the
      crus IIa map was then examined 2 to 3 months after denervation. We found that
      tactile receptive fields had reorganized throughout the denervated area but
      maintained a fractured somatotopy. Comparison of the reorganization in different
      animals showed that the denervated upper lip region was consistently and
      predominantly replaced by representation of the upper incisors. Analysis of
      evoked field potentials revealed an alteration, in denervated animals, of the
      response of the granule cell layer to brief tactile stimulation. This response in
      normal animals consists of two components at different latencies. Animals
      lesioned later in development were less likely to have the short latency
      component. This result suggests a difference in the developmental sensitivity of
      different cerebellum-related pathways to nerve lesions.

PMID- 8349846
TI  - Sequential differentiation of sensory innervation in the mystacial pad of the
      ferret.
AB  - The mystacial pad of the ferret has an elaborate sensory innervation provided by
      three types of terminal nerves that arise from the infraorbital branch of the
      trigeminal nerve. Deep and superficial vibrissal nerves innervate nearly
      exclusive targets in the large follicle-sinus complexes (F-SCs) at the base of
      each tactile vibrissa. Dermal plexus nerves innervate the fur between the
      vibrissae. Each type of nerve provides a similar variety of sensory endings,
      albeit to different targets. In this study, Winkelmann and Sevier-Munger reduced
      silver techniques revealed that most of the endings differentiate postnatally in
      an overlapping sequence like that observed previously in the rat. Afferents from
      the deep vibrissal nerves begin to differentiate first, followed successively by
      those from superficial vibrissal nerves and the dermal plexus. Within each type
      of nerve, Merkel endings begin to differentiate first, followed successively by
      lanceolate endings and circumferential endings. In the ferret, the
      differentiation of the intervibrissal fur and its innervation is slightly delayed
      but substantially overlaps the development of the vibrissal innervation, whereas
      in the rat it occurs almost entirely later. There was no evidence of a transient
      exuberant or misplaced innervation or other secondary remodeling. Differentiating
      afferents and endings are located only in the sites normally seen in the adult,
      suggesting a high degree of afferent-target specificity. In the ferret,
      innervation is virtually lacking in one target--the inner conical body of the F
      SCs, which is densely innervated in the rat. This lack was due to a failure of
      innervation to develop rather than to a secondary elimination of a transient
      innervation.

PMID- 8349845
TI  - Spatial distributions of chemically identified intrinsic neurons in relation to
      patch and matrix compartments of rat neostriatum.
AB  - The spatial distributions and dendritic branching patterns of chemically
      identified subpopulations of striatal intrinsic neurons, defined by
      immunoreactivity for choline acetyltransferase (ChAT), neuropeptide Y or
      parvalbumin, were studied in relation to patch and matrix compartments of rat
      neostriatum. ChAT-immunoreactive cells and fibers showed an uneven pattern of
      distribution in the striatum. ChAT immunoreactivity was higher in the
      dorsolateral part and lower in the ventromedial part of the striatum. This
      regional gradient pattern is the inverse of the overall pattern of calbindin D28k
      immunoreactivity. However, in small regions close to the lateral ventricle and
      globus pallidus, areas containing fewer ChAT-immunoreactive cells and fibers
      coincided with those containing low calbindin D28k immunoreactivity. Neuropeptide
      Y immunoreactivity was uniform in the neostriatum. Certain neuropeptide Y cells
      (about 20%) were also immunoreactive for calbindin D28k, indicating that at least
      a small population of calbindin D28k-immunoreactive cells are medium aspiny
      cells. Parvalbumin immunoreactivity was not uniform in the striatum. A higher
      density of parvalbumin immunoreactivity was found in the neuropil in lateral and
      caudal parts than in the medial part. Small regions with weaker parvalbumin
      immunoreactive neuropil partially corresponded to calbindin D28k poor patches.
      Larger cells immunoreactive for parvalbumin were preferentially located in
      lateral and caudal parts of the striatum. Cells immunoreactive for ChAT,
      neuropeptide Y or parvalbumin showed basically similar distribution patterns in
      relation to the patch and matrix compartments. Most stained cells were located in
      the matrix, but some were located at the borders of patches and a few were inside
      patches. Most primary dendrites of stained cells in the matrix or patches
      remained confined to these compartments, but cells on the borders invariably
      extended dendrites into both compartments. The striatal intrinsic neurons form
      chemically differentiated neuronal circuits within the matrix, and the patches
      and those whose dendrites cross the borders may contribute to associational
      interconnections between the two compartments, unlike the spiny projection
      neurons whose dendrites are confined to one or the other compartment.

PMID- 8349847
TI  - Distribution of transitory corpus callosum axons projecting to developing cat
      visual cortex revealed by DiI.
AB  - Functional studies of the development of the corpus callosum in the cat have
      shown that an intact callosum during postnatal month 1 is necessary for normal
      visual development. In vivo tracing techniques have not provided enough
      information on corpus callosum connectivity to fully evaluate the evidence for a
      morphological mechanism for the functional effects of neonatal callosum section.
      However, lipophilic in vitro membrane tracers permit a more detailed search for
      such evidence because the entire limit of many cells can be labeled
      simultaneously. To investigate the morphological basis for the observed
      functional results in cats, the corpus callosum was labeled in vitro with the
      carbocyanine dye, DiI. Crystals of DiI were placed in the midsagittal callosum in
      tissue from 2 to 277-day-old cats. Tissue was coronally sectioned 3-22 months
      later. Sections were photographed and reconstructed to show the overall
      distribution of corpus callosum projections, as well as the locations of
      individual corpus callosum axons and their presumed terminals. The distribution
      of corpus callosum projections, examined in cortical areas 17-19, 7, and
      posterior medial lateral suprasylvian cortex, changes significantly during
      development. During postnatal week 1, callosal axons extend throughout these
      cortical areas to layer I. Numerous varicosities on callosal axons are located en
      passant and at axon terminals in layer I. During postnatal week 2, the density of
      callosal projections is reduced in all cortical areas, although many axons still
      extend to layer I. By postnatal month 2, the callosal axons extending to layer I
      are predominantly near the border with adjacent cortical areas; in the nonborder
      regions of these areas, many axons extend to layer VI while a much smaller number
      of axons extend to layers II-V. By postnatal month 3, the callosal projections to
      supragranular layers are almost exclusively restricted to cytoarchitectonic
      border regions; in the remaining regions, including medial area 17, there are
      occasional axons extending to the supragranular layers and only a moderate number
      of axons extending to infragranular layers. Thus, a substantial number of
      elaborately formed transitory corpus callosum axons, distributed throughout
      visual cortex, exist for several weeks during postnatal development; in area 17,
      these axons are found in central through peripheral visual field representations.
      The transitory callosal axons appear to have axon terminals in layer I as well as
      en passant terminals while extending through layers II-VI. If some of these
      terminals were to form synapses, there would be extensive opportunities for the
      corpus callosum to provide input to layers I-VI throughout visual cortex during
      the period of development in which cortical microcircuitry is being established.

PMID- 8349848
TI  - Organization and synaptic connections of cholinergic fibers in the cat superior
      colliculus.
AB  - The cat superior colliculus (SC) receives a dense cholinergic input from three
      brainstem nuclei, the pedunculopontine tegmental nucleus, the lateral dorsal
      tegmental nucleus, and the parabigeminal nucleus (PBG). The tegmental inputs
      project densely to the intermediate gray layer (IGL) and sparsely to the
      superficial layers. The PBG input probably projects only to the superficial
      layers. In the present study, the morphology of choline acetyltransferase (ChAT)
      immunoreactive axons and synaptic endings in the superficial and deep layers of
      the SC was examined by light and electron microscopy to determine whether these
      cholinergic afferents form different types of synapses in the superficial and
      deep layers. Two types of fibers were found within the zonal (ZL) and upper
      superficial gray layers (SGL): small diameter fibers with few varicosities and
      larger diameter fibers with numerous varicosities. Quantitative analysis
      demonstrated a bimodal distribution of axon diameters, with one peak at
      approximately 0.3-0.5 micron and the other at 0.9-1.0 micron. On the other hand,
      ChAT-immunoreactive fibers in the IGL were almost all small and formed discrete
      patches within the IGL. Two types of ChAT-immunoreactive synaptic profiles were
      observed within the ZL and upper SGL using the electron microscope. The first
      type consisted of small terminals containing predominantly round synaptic
      vesicles and forming asymmetric synaptic contacts, mostly on dendrites. The
      second type was comprised of varicose profiles that also contained round synaptic
      vesicles. Their synaptic contacts were always symmetric in profile. ChAT
      immunoreactive terminals in the IGL patches contained round or pleomorphic
      synaptic vesicles, and the postsynaptic densities varied from symmetric to
      asymmetric, including intermediate forms. However, no large varicose profiles
      were observed. This study suggests that cholinergic fibers include at least two
      different synaptic morphologies: small terminals with asymmetric thickenings and
      large varicose profiles with symmetric terminals. The large varicose profile in
      the superficial layers is absent in the IGL. This result suggests that the
      cholinergic inputs that innervate the superficial layers and the patches in the
      IGL of the cat SC differ in their synaptic organization and possibly also in
      their physiological actions.

PMID- 8349849
TI  - Quantitative autoradiographic localization of [125I]insulin-like growth factor I,
      [125I]insulin-like growth factor II, and [125I]insulin receptor binding sites in
      developing and adult rat brain.
AB  - Insulin-like growth factors I and II (IGF I and IGF II) and insulin itself, which
      are structurally related polypeptides, play an important role in regulating brain
      growth and development as well as in the maintenance of its normal functions
      during adulthood. In order to provide a substrate for the better understanding of
      the roles of these growth factors, we have investigated the anatomical
      distribution as well as the variation in the density of [125I]IGF I, [125I]IGF
      II, and [125I]insulin receptor binding sites in developing and adult rat brain by
      in vitro quantitative autoradiography. The distributional profile of [125I]IGF I,
      [125I]IGF II, and [125I]insulin receptor binding sites showed a widespread but
      selective regional localization throughout the brain at all stages of
      development. The neuroanatomic regions which exhibited relatively high density of
      binding sites with each of these radioligands include the olfactory bulb, cortex,
      hippocampus, choroid plexus, and cerebellum. However, in any given region,
      receptor binding sites for IGF I, IGF II, or insulin are concentrated in
      anatomically distinct areas. In the cerebellum, for example, [125I]IGF II
      receptor binding sites are concentrated in the granular cell layer, [125I]insulin
      binding sites are localized primarily in the molecular layer, whereas [125I]IGF I
      receptor binding sites are noted in relatively high amounts in granular as well
      as molecular cell layers. The apparent density of sites recognized by each
      radioligand also undergoes remarkable variation in most brain nuclei, being
      relatively high either during late embryonic (i.e., IGF I and IGF II) or early
      postnatal (i.e., insulin) stages and then declining gradually to adult levels
      around the third week of postnatal development. These results, taken together,
      suggest that each receptor-ligand system is regulated differently during
      development and thus may have different roles in the process of cellular growth,
      differentiation, and maintenance of the nervous system. Furthermore, the
      localization of [125I]IGF I, [125I]IGF II, and [125I]insulin receptor binding
      sites over a wide variety of physiologically distinct brain regions suggests
      possible involvement of these growth factors in a variety of functions associated
      with specific neuronal pathways.

PMID- 8349851
TI  - Impaired motor axon regeneration in the C57BL/Ola mouse.
AB  - The delayed Wallerian degeneration which occurs in the C57BL/Ola mouse is
      associated with impaired motor axon regeneration. Following sciatic nerve crush,
      recovery of the sciatic functional index was delayed and incomplete when compared
      with recovery in C57BL/6J mice. After facial nerve crush, recovery of whisker
      movement in Ola mice was also delayed, and there was a prolonged period of
      partial recovery, not seen in 6J mice. Regeneration rate of the motor axons was
      measured by the axonal transport technique in sciatic nerve and was approximately
      0.7 mm/d for Ola mice, and 4.0 mm/d for 6J mice. Combining these results from our
      previous work, we conclude that regeneration of both sensory and motor axons is
      impaired when Wallerian degeneration does not follow its usual time course after
      injury.

PMID- 8349850
TI  - Distribution of GAP-43 mRNA in the adult rat brain.
AB  - Regional distribution of gene expression of the axonal growth-associated protein,
      GAP-43, was studied in adult rat brains by in situ hybridization autoradiography
      to determine the features of mature neuronal populations that synthesize GAP-43
      protein. Such synthesis appears to correlate with axonal growth during maturation
      and regrowth after axotomy. In most adult neurons, the sharp decline in GAP-43
      gene expression implies a reduced capacity for axonal growth. Neurons capable of
      extending axonal knobs in the absence of injury may indicate a "plasticity"
      underlying dynamic processes of interaction between neurons and their synaptic
      targets. Antisense and sense (control) riboprobes were used on serial sections in
      the three principal axes, and the magnitude of hybridization signal was examined
      to determine regional patterns. GAP-43 mRNA levels are pronounced in diverse
      neuronal groups including the locus coeruleus, raphe nn., dopaminergic nigral and
      ventral tegmental nn., mitral cells, hippocampal CA3, inferior olivary n., vagal
      motor n. and other parasympathetic preganglionic neurons, select thalamic midline
      and intralaminar nn., several specific nn. of the hypothalamus and basal
      forebrain, the granular layer of cerebellar cortex, the infragranular neocortex,
      and the granular olfactory paleocortex; there is a substantial range in the
      magnitude of expression. Regions revealing minimal signal include most thalamic
      sensory relay nuclei, the granule neurons of the olfactory bulb and dentate
      gyrus, and the caudate and putamen. Possible concomitants of GAP-43 expression
      include regulation of ion flux and neurotransmitter release. Those neurons with
      long, extensively dispersed and numerous synaptic connections display the
      strongest signals and may possess the greatest propensity for continuous growth
      and turnover of their axon terminals, in contrast to short-axon and specific
      projection neurons exhibiting minimal levels. These data may enable inferring
      which populations display normal or experimentally induced axonal growth.

PMID- 8349852
TI  - Localization and differential expression of FMRFamide-like immunoreactivity in
      the nematode Ascaris suum.
AB  - By immunocytochemical and immunohistochemical methods, FMRFamide-like
      immunoreactivity (FLI) was localized to many neurons and processes in the Ascaris
      nervous system, including the head, tail, and lateral lines. Some of these cells
      were identified; they included sensory neurons, interneurons, and motor neurons.
      FLI was also present in the pharyngeal neurons and in their varicosities near the
      surface of the pharynx. By HPLC analysis of extracts, only a subset of the
      FMRFamide-like peptides (FLPs) expressed in Ascaris heads, and heads from which
      the pharynx had been removed, were expressed in the pharynx. Furthermore, FLPs
      appeared to be differentially expressed in female heads and tails and male heads
      and tails. Acetone and acid methanol differentially extracted subforms of FLI
      from Ascaris heads and from C. elegans.

PMID- 8349853
TI  - Syndromes associated with melanocytic nevi.
AB  - Melanocytic nevi have been reported in association with several congenital
      syndromes. This review describes the clinical and cutaneous manifestations of six
      syndromes associated with congenital melanocytic nevi, two associated with
      acquired nevi, and six associated with melanocytic nevi in which insufficient
      evidence exists to classify them as congenital or acquired. It is important to
      recognize these associations to evaluate and counsel patients with melanocytic
      nevi. Early recognition will also facilitate timely intervention.

PMID- 8349854
TI  - Asymmetric periflexural exanthem of childhood.
AB  - BACKGROUND: We report an expanded series of patients with a distinctive childhood
      exanthem. OBJECTIVE: Our goal was to describe a new clinical entity. METHODS:
      This is a clinical study. Twenty-one patients, mostly seen in the spring and late
      fall, are described. RESULTS: The mean age at onset was 21 months. The eruption
      began in the periflexural area (close to the axilla, in which an enlarged lymph
      node was noted in most cases) and spread in an asymmetric pattern, leading to a
      more generalized eruption in 11 patients. Complete resolution occurred in 3 to 6
      weeks. CONCLUSION: An inoculation disease was first suspected, but a systemic
      viral exanthem seems more probable. We propose to name this eruption asymmetric
      periflexural exanthem of childhood.

PMID- 8349855
TI  - Cutaneous T-cell lymphoma associated with HIV infection.
AB  - BACKGROUND: Mycosis fungoides-type cutaneous T-cell lymphoma is uncommon in
      association with human immunodeficiency virus type 1 (HIV-1) infection. Reported
      patients have a high incidence of CD8+ T-cell lymphomas and erythroderma, are
      usually severely immunocompromised, and rapidly die. Chronic, more typical patch
      plaque mycosis fungoides-type cutaneous T-cell lymphoma in association with HIV-1
      infection has not been reported. OBJECTIVE: We report two cases of stage 1B
      epidermotropic mycosis fungoides-type cutaneous T-cell lymphoma in HIV-1-infected
      men with no history of the acquired immunodeficiency syndrome. METHODS: Clinical
      and laboratory data, including lesional immunophenotypic and immunogenotypic
      findings of two patients with HIV-1-associated cutaneous T-cell lymphoma, were
      studied. RESULTS: Immunohistochemical analysis of skin determined the lesional
      infiltrate of one patient to be CD8+ (Leu-2+), CD7- (Leu-9-), and Leu-8- with
      germline lesional skin and blood T-cell receptor genes. The other was CD4- (Leu
      3+), CD2- (Leu-5-), CD7- (Leu-9-), and Leu-8- with beta-chain T-cell receptor
      gene rearrangement in lesional skin and blood. Circulating Sezary cells were not
      detected in either patient. Peripheral CD4/CD8 T lymphocyte numbers did not
      appear to correlate with cutaneous disease activity or the predominant lesional T
      cell subtype. Both patients were responsive to standard therapies and have
      experienced prolonged survival in excess of that generally reported for HIV-1
      associated systemic peripheral and cutaneous T-cell lymphomas. CONCLUSION: In the
      absence of severe immunodeficiency, HIV-1-infected patients with concomitant
      cutaneous T-cell lymphoma may follow a more typical slowly progressive course.

PMID- 8349856
TI  - Cutaneous neoplasms in a military population of HIV-1-positive patients. Military
      Medical Consortium for the Advancement of Retroviral Research.
AB  - BACKGROUND: In HIV-1-positive patients there have been no prospective studies
      that show an increase in cutaneous neoplasms. OBJECTIVE: We observed HIV-1
      positive patients to determine whether or not there was an increased incidence of
      cutaneous malignancies. METHODS: A total of 724 HIV-1-positive patients were
      examined during a 36-month period for the development of cutaneous malignancies.
      RESULTS: The most common cutaneous neoplasm found was Kaposi's sarcoma,
      especially in patients with late-stage disease. Basal cell carcinomas were the
      next most frequent tumor. We have also seen three malignant melanomas and two
      squamous cell carcinomas. Five patients had malignant lymphoma. One patient had a
      primary lymphoma of subcutaneous soft tissue; in one patient multiple cutaneous
      lesions developed. CONCLUSION: The distribution and prevalent types of cutaneous
      neoplasms in HIV-1-positive patients appear to differ from those found in other
      immunosuppressed populations. This may be the result of the different patterns
      and periods of immunosuppression in these patients and/or associated
      cocarcinogens to which these patients frequently are exposed.

PMID- 8349857
TI  - Cultured keratinocyte allografts and wound healing in severe recessive dystrophic
      epidermolysis bullosa.
AB  - BACKGROUND: Patients with recessive dystrophic epidermolysis bullosa (RDEB)
      frequently have painful erosions that are slow to heal. There is no definitive
      treatment; therefore any therapy that improves wound healing would be beneficial
      to these patients. OBJECTIVE: Our purpose was to assess the effects of cultured
      allogeneic keratinocytes on wound healing in RDEB. METHODS: Ten patients with
      RDEB and dermatome-induced superficial dermal wounds were studied. Cultured
      keratinocyte grafts were applied to part of the wound, with another part left
      ungrafted. Both sites were assessed clinically and microscopically, particularly
      with regard to basement membrane zone reconstitution. RESULTS: Apart from minor
      differences in keratinocyte differentiation and a moderate analgesic effect
      induced by the graft, there were no other distinguishing findings in wound
      healing in the grafted and nongrafted sites. CONCLUSION: There was little
      clinical benefit from cultured keratinocyte allografts in wound healing in RDEB.
      However, this study showed that RDEB keratinocytes have an inherent capacity to
      express some type VII collagen epitopes transiently during wound healing,
      although this was not associated with the detection of anchoring fibrils.

PMID- 8349858
TI  - Lack of selective attendance of participants at skin cancer/melanoma screening
      clinics.
AB  - BACKGROUND: Whether persons who come for skin cancer/melanoma screening are those
      at highest risk for the disease remains a debatable issue. OBJECTIVE: Our purpose
      was to evaluate the appropriateness of self-selection of persons attending
      screening clinics. METHODS: We studied the frequency of malignant and/or
      premalignant clinical diagnoses according to certain demographic characteristics
      as a measure of selective attendance among 2463 persons screened in the regions
      of Arnhem and Eindhoven in 1990. RESULTS: The referral rates for tentative
      malignant and/or premalignant diagnoses were more or less similar in men (11.8%)
      and women (9.6%); in persons with symptoms (11.6%) and those who were symptom
      free (9.3%); in attendants from the towns in which the screenings were held
      (11.4%) and those coming from distant communities (9.0%); and in persons who
      attended for specific skin lesions (10.7%) and those who opted for general skin
      examination (8.8%). The referral rate was 9.2% in persons younger than 70 years
      of age against 18.5% in those 70 years of age or older (p < 0.001). Most
      presumptive melanoma diagnoses (15 of 22) were recorded in persons 50 years of
      age or older. CONCLUSION: Our findings suggest that participants of free skin
      cancer/melanoma screening clinics, on average, are unable to estimate their own
      risk profile properly.

PMID- 8349859
TI  - Psoriasis in Australian twins.
AB  - BACKGROUND: Occurrence of psoriasis has been found to be strongly genetically
      controlled in Northern European and U.S. twin and family studies. OBJECTIVE: Our
      purpose was to assess cumulative incidence and heritability of psoriasis in the
      Australian population. METHODS: Australian twins reporting psoriasis on a
      screening questionnaire received from 3808 pairs were mailed a detailed
      instrument designed to validate the diagnosis, supplemented by telephone
      interview and examination of medical records. RESULTS: Only 94 of 160 subjects
      who screened positive were confirmed to have psoriasis. The cumulative incidence
      of confirmed psoriasis was 2% in 30- to 60-year-old subjects. The monozygotic
      twin casewise concordance for confirmed psoriasis was 35% (12 of 34 pairs), and
      the dizygotic twin concordance 12% (5 of 43 pairs), giving an estimated
      heritability of 80%, was similar to that found in a genetic reanalysis of three
      previous twin studies. A case-control analysis of psoriasis-discordant twin pairs
      found no evidence for influences of alcohol or coffee intake, overweight, birth
      weight, or personality in the origin of psoriasis. CONCLUSION: Occurrence of
      psoriasis in the Australian population is highly heritable, but identical twins
      are often discordant; the factor responsible for the onset of disease in one twin
      and not the other is unclear.

PMID- 8349860
TI  - Hereditary palmoplantar keratoderma, type papulosa, in Croatia.
AB  - BACKGROUND: Hereditary palmoplantar keratoderma (HPPK), type papulosa, is rare,
      and epidemiologic data are sporadic and inconsistent. An epidemiologic population
      study of this disease has not been performed previously. OBJECTIVE: We performed
      a large population study on prevalence of HPPK, type papulosa, in Croatia.
      METHODS: The data were collected from medical records of dermatology departments
      throughout Croatia; 14 patients and their relatives were examined.
      Histopathologic studies were performed in 11 of these 14 patients. RESULTS: Fifty
      five patients were identified and the prevalence was 1.17 per 100,000
      inhabitants. All 55 patients belonged to 20 different families. An autosomal
      dominant mode of inheritance was confirmed in 13 families. All 14 patients
      examined by the authors had both palmar and plantar lesions; the volar aspects of
      fingers were also involved. Thickened nails were observed in four patients, and
      no significant skin lesions were found elsewhere. CONCLUSION: HPPK, type
      papulosa, is rare, and its prevalence in Croatia is about four times lower than
      HPPK, Unna-Thost type. It should be considered a distinct entity.

PMID- 8349861
TI  - Topical treatment of New World cutaneous leishmaniasis in Belize: a clinical
      study.
AB  - BACKGROUND: Many studies have been performed during the past decade to find an
      effective topical therapy for cutaneous leishmaniasis (CL). OBJECTIVE: Our
      purpose was to evaluate the effect of paromomycin ointment (P-ointment)
      containing 15% paromomycin sulfate and 12% methylbenzethonium chloride on
      Belizean patients with New World CL. METHODS: Fifty-three patients were treated
      twice daily for 14 to 21 days with P-ointment. RESULTS: Sixty-eight percent of
      the patients healed, 6% had a delayed cure, and 26% did not respond. No toxic
      effects from the ointment were observed. CONCLUSION: Topical paromomycin is as
      efficacious in the treatment of New World CL as other currently accepted
      modalities that are potentially more toxic.

PMID- 8349862
TI  - Diet and dermatology. The role of dietary manipulation in the prevention and
      treatment of cutaneous disorders.
AB  - The role of dietary manipulation and vitamins in the prevention and treatment of
      certain skin diseases is reviewed. Manipulation of nutrition by either diet
      restriction or supplementation can effect cutaneous disorders such as skin
      cancer, wound healing, atopic dermatitis, psoriasis, and dermatitis
      herpetiformis.

PMID- 8349863
TI  - Cutaneous mucormycosis resembling superficial granulomatous pyoderma in an
      immunocompetent host.
AB  - Primary cutaneous mucormycosis is uncommon and occurs mainly in immunosuppressed
      or diabetic patients or after localized trauma. We report a case of cutaneous
      mucormycosis in an immunocompetent man in whom no definite precipitating factors
      could be identified; initially, superficial granulomatous pyoderma was suspected
      clinically. The lesion was successfully treated with debridement, local wound
      care, parenteral administration of amphotericin B, and ultimately by surgical
      excision and split-thickness skin grafting.

PMID- 8349864
TI  - Necrobiotic xanthogranuloma without periorbital lesions.
AB  - Cutaneous necrobiotic xanthogranuloma is rare and closely resembles widespread
      necrobiosis lipoidica. It is important to recognize this skin disorder because of
      its strong association with paraproteinemia and, in some cases, with a
      hematologic malignancy. We describe two patients with necrobiotic xanthogranuloma
      who are unusual in that they had no periorbital involvement, a feature previously
      believed to be diagnostic of this condition.

PMID- 8349865
TI  - Penile squamous cell carcinoma arising from balanitis xerotica obliterans.
AB  - Squamous cell carcinoma arising from balanitis xerotica obliterans is rarely
      reported. We describe an 83-year-old man in whom metastatic penile squamous cell
      carcinoma developed after 18 years of observation for balanitis xerotica
      obliterans. It is important to recognize the possibility of this uncommon
      complication of balanitis xerotica obliterans, because survival of patients with
      squamous cell carcinoma depends on early diagnosis and treatment.

PMID- 8349866
TI  - Vascular nodules and plaques resembling chronic mucocutaneous candidiasis in a
      patient with a low interleukin 2 level.
AB  - A 21-year-old woman had a lifelong history of widespread friable vascular nodules
      and plaques. Her condition had previously been diagnosed as chronic mucocutaneous
      candidiasis because of her clinical appearance. Routine studies of immune
      function were performed in addition to a comparison of cytokine secretion in
      mononuclear leukocytes of our patient and normal controls. Interleukin 2
      secretion by phytohemagglutinin-stimulated mononuclear leukocytes was deficient
      when compared with six healthy donors (< 300 pg/ml vs 2108 +/- 336 pg/ml).
      Interleukin 2 deficiency may be a causative factor in cases of unusual vascular
      proliferation. Treatment with methotrexate, which increases interleukin 2
      activity and inhibits neovascularization in vitro, was helpful in our patient.

PMID- 8349868
TI  - Neonatal pemphigus vulgaris in a child born to a woman in remission.
AB  - We describe the tenth reported case of neonatal pemphigus that mimicked Bart's
      syndrome and review previously published cases. Unlike previous cases, the child
      was born with significant blistering to a mother who was in complete remission
      throughout the pregnancy. High antepartum maternal titers of anti-intercellular
      space antibodies, increased maternal disease activity, and maternal disease that
      requires high doses of corticosteroids or use of combined therapy correlate with
      poor fetal outcome, including intrauterine death.

PMID- 8349867
TI  - Severe megaloblastic anemia in a patient receiving low-dose methotrexate for
      psoriasis.
AB  - Severe megaloblastic anemia with a normal white blood cell and platelet count
      developed in a patient with psoriasis vulgaris who was receiving long-term, low
      dose methotrexate. We believe she had methotrexate-induced folate deficiency
      anemia with isolated inhibition of the erythrocytic bone marrow line. We review
      hematologic toxicity from low-dose methotrexate. Physicians caring for patients
      who receive low-dose methotrexate should be aware that an increase in the
      erythrocyte mean corpuscular volume may be a useful indicator of folate
      deficiency and impending toxicity. In addition, folate supplementation may
      prevent this toxicity (even in patients who do not appear clinically to be folate
      deficient), although whether methotrexate efficacy diminishes is controversial.

PMID- 8349869
TI  - Linear Kaposi's sarcoma in HIV disease.

PMID- 8349870
TI  - Pigmented fungiform papillae of the tongue.

PMID- 8349871
TI  - Acute reversible central nervous system toxicity associated with low-dose oral
      cyclosporine therapy.

PMID- 8349872
TI  - Erythema gyratum repens: direct immunofluorescence microscopic findings.

PMID- 8349874
TI  - Fixed drug eruption caused by diphenhydramine.

PMID- 8349873
TI  - Paronychia: a sign heralding an exacerbation of pemphigus vulgaris.

PMID- 8349875
TI  - Mupirocin treatment of exudative venous ulcers.

PMID- 8349876
TI  - Hypothalamus-pituitary-adrenal axis suppression by superpotent topical steroids.

PMID- 8349877
TI  - Beta-adrenergic blocking drugs and psoriasis: the role of an immunologic
      mechanism.

PMID- 8349878
TI  - Ectrodactyly-ectodermal dysplasia-clefting syndrome with scalp dermatitis.

PMID- 8349879
TI  - The spectrum of dermal elastolysis.

PMID- 8349880
TI  - Sterility of refrigerated injectable collagen syringes.

PMID- 8349881
TI  - Sterility of refrigerated injectable collagen syringes.

PMID- 8349882
TI  - Metastatic signet-ring cell melanoma.

PMID- 8349883
TI  - Mechanisms of hyperosmotic acclimation in Xenopus laevis (salt, urea or
      mannitol).
AB  - The acclimation of the clawed toad Xenopus laevis to hyperosmotic solutions of
      NaCl (balanced solution of sea salt), urea or mannitol was studied. The animals
      could not be acclimated to salt solutions more concentrated than 400 mosm.1-1.
      Urea was tolerated till 500 mmol.1-1. Plasma osmolality was always hyperosmotic
      to the environmental solution, but with diminished osmotic gradient at the
      highest tolerated solutions. Plasma urea concentration approached 90 mmol.1-1,
      similar in the three solutions of acclimation. Urine volume was very small under
      all conditions. Serum aldosterone and corticosterone did not differ
      significantly, although there was a slight tendency towards lower aldosterone in
      the NaCl solution. In vivo water uptake in tap water acclimated animals was very
      small, and was higher in the other groups. Only the salt- and urea-acclimated,
      but not the tap water and mannitol-acclimated groups responded with a clear
      increase following injection of oxytocin or theophylline. In vitro urea fluxes
      were similar and invariable in both directions under all conditions. No
      significant effect of theophylline was observed. Sodium transport measured by the
      short-circuit technique in vitro was lower in salt- and mannitol-acclimation
      conditions, and was stimulated significantly under all conditions in response to
      serosal oxytocin or theophylline. It is concluded that Xenopus laevis can
      osmoregulate at a limited range of external solutions. It is limited in the
      increase of its plasma urea concentration; the transport properties of the skin
      do not change very much upon acclimation, except for the hydroosmotic response to
      oxytocin.

PMID- 8349885
TI  - Diurnal variation in thermal and metabolic parameters of the golden hamster
      (Mesocricetus auratus).
AB  - The purpose of this study is to examine diurnal variation in several thermal and
      metabolic parameters of the golden hamster, Mesocricetus auratus. Metabolic rate,
      core temperature, and evaporative water loss were measured during night and day
      at several ambient temperatures. Wet minimal thermal conductance, dry minimal
      thermal conductance, basal metabolic rate, minimal net heat production and the
      lower critical temperature difference were estimated from these measurements. Wet
      and dry minimal thermal conductance, evaporative water loss, core temperature,
      basal metabolic rate, and lower critical temperature difference were greater
      during the active phase than during the resting phase. The diurnal variation in
      wet minimal thermal conductance was much smaller than that predicted from
      published allometric equations. The diurnal variation in wet minimal thermal
      conductance was 9% of the 24-h mean. The diurnal variation in dry minimal thermal
      conductance was 26% of the 24-h mean. The higher active-phase core temperature
      and basal metabolic rate may function to enhance peak metabolic performance
      during the active phase. The lower resting phase metabolism and core temperature
      may reduce energetic costs. The greater active-phase lower critical temperature
      difference may be a result of the greater active-phase basal metabolic rate.
      Diurnal variation in minimal thermal conductance may be caused by changes in
      peripheral circulation.

PMID- 8349884
TI  - Contractile responses in rat extensor digitorum longus muscles at different times
      of postnatal development.
AB  - Some contractile properties of small bundles (100-200 microns diameter) of muscle
      fibres isolated from the extensor digitorum longus muscle of rats at different
      times of development were compared. An increase of resting potential was observed
      in these muscles from -26.9 mV at 1 day of age to -72.6 mV at 3 months. Twitch
      tension and duration of postnatal muscles 1-7 days were diminished by reducing
      [Ca]o (substituted by Mg2+) or adding inorganic cations (Ni2+, Cd2+, La3+),
      unlike in the oldest animals (14 days-3 months postnatal) where twitch responses
      were unaffected. In the latter, potentiation of the twitch tension was even
      recorded in the presence of Ni2+ (0.5-1 mmol.1-1) and Cd2+ (0.5-2 mmol.1-1).
      Properties of activation and inactivation of the developed tension following
      elevation of [K]o to 15-200 mmol.1-1 were analysed at the same stages of
      postnatal development. In contrast to the tension-membrane potential curves for
      activation, which presented an average negative shift of -17.6 mV between 1 day
      postnatal and 3 months of age, a voltage dependence of inactivation similar to
      that encountered in adult extensor digitorum longus muscles, was already reached
      at 7 days of age. These results suggest an asynchronism in the maturation of the
      potential-dependent characteristics of the depolarization-contraction coupling
      mechanism. Furthermore, during the first week postnatal, in relation with poorly
      developed membrane systems and low [Ca]i-recycling capability, [Ca]o plays a
      fundamental role in maintaining contraction by replenishing the intracellular
      calcium pool.

PMID- 8349886
TI  - Effects of water restriction on digestive function in two macropodid marsupials
      from divergent habitats and the feral goat.
AB  - The effects of water restriction on digestive function in the euro (Macropus
      robustus erubescens) found in the arid zone of inland Australia, the eastern
      wallaroo (M.r.robustus) from more mesic regions of eastern Australia, and the
      feral goat (Capra hircus) found throughout the range of M. robustus, were
      compared in order to examine some physiological adaptations required by
      herbivores for the exploitation of arid environments. Eight animals of each
      species were held in individual metabolism cages in temperature-moderated rooms
      and given a chopped hay diet ad libitum. Half the animals were restricted to 40
      ml water.kg-0.80.day-1. This was 40%, 32% and 57% of voluntary drinking water
      intake in the euro, wallaroo and goat, respectively. All species responded to
      water restriction by reducing faecal, urinary and evaporative water losses in
      association with reductions in feed intake. All animals increased urine
      osmolality and electrolyte concentrations but not to maximal levels, while packed
      cell volume and plasma osmolality and electrolyte concentrations were unaffected
      by water restriction. The euro displayed a suite of characteristics that
      separated it from the wallaroo in terms of physiological adaptation, including
      lower voluntary water intake, an increase in fibre digestibility and maintenance
      of nitrogen balance during water restriction, and lower faecal water efflux
      associated with a consistently lower faecal water content (54% versus 59% water
      in the wallaroo during water restriction, P < 0.05). The euro's colon was 37%
      longer (P < 0.01) than that of the wallaroo. The goat had the lowest faecal water
      efflux (P < 0.05) and the longest colon (P < 0.001). Water restriction did not
      affect water content in digesta, nor short-chain fatty acid concentrations or
      production rates in vitro. Total body water, as a proportion of body mass, was
      depressed (P < 0.05) in the macropodids, but not in the goat. The reduction in
      dietary nitrogen intake, which accompanied water restriction, was partially
      compensated by an increase in urea degradation in the gut from 68% to 76% of urea
      synthesis water-restricted macropodids. These responses to water restriction are
      discussed in relation to those reported in other macropodid and ruminant species.

PMID- 8349887
TI  - Allied dental education: past, present, and future.

PMID- 8349888
TI  - Overview of allied health issues in contemporary health care.

PMID- 8349889
TI  - The future of allied dental education: creating a professional team.

PMID- 8349890
TI  - The future of allied health in higher education: where does it belong?

PMID- 8349891
TI  - Validation of a motor skills performance theory with applications for dental
      education.
AB  - While several investigations assessing applications of contemporary motor
      learning theory to preclinic laboratory instruction have been successful, they
      provide only indirect and incomplete validation of theoretical constructs. This
      study's purpose was to further evaluate the validity of salient constructs
      through the use of a validation technique called verbal self-reporting, and to
      describe applications for dental education. Subjects were videotaped completing a
      preparation. Later, the tape was replayed and a structured interview used to
      stimulate recall of mental processes that occurred during the preparation.
      Transcribed self-reports were classified by two calibrated raters into categories
      corresponding to the constructs of interest. Results confirm many of the
      constructs' characteristics. Subjects reported that they a) defined the desired
      outcome in detail before beginning production; b) defined performance strategies
      that would be useful for different aspects of the preparation; c) constantly
      generated knowledge of results during the course of production in order to
      directly assess the adequacy of the product; and d) generated knowledge of
      performance as an indirect assessment of product acceptability especially when
      visual access was impeded. These results support previous applications of the
      theory to dentistry and have important implications for the improvement of
      instruction in preclinic laboratory courses.

PMID- 8349892
TI  - The evolution of dental education--a European perspective.

PMID- 8349893
TI  - APEX: an experiential education program.

PMID- 8349894
TI  - A time for change of tooth numbering systems.
AB  - Tooth numbering provides dentists with an essential shortcut in clinical record
      keeping. Today, three systems are favored worldwide: the Zsigmondy/Palmer system,
      the universal system, and the FDI two-digit system. Histories of these tooth
      numbering methods are traced, and the strengths and deficiencies of each are
      discussed. The FDI two-digit system-used throughout the world, but not in the USA
      is the only method that makes visual sense, cognitive sense, and computer sense.
      It deserves consideration by American dentists as our official tooth numbering
      system.

PMID- 8349895
TI  - Curriculum guidelines for behavioral science. Section on Behavioral Sciences of
      the American Association of Dental Schools.

PMID- 8349896
TI  - Hair today, gone tomorrow.

PMID- 8349898
TI  - Navigating through tissue expansion terminology.

PMID- 8349897
TI  - Intracutaneous butterfly suture with absorbable synthetic suture material.
      Technique, tissue reactions, and results.
AB  - BACKGROUND: Tension on surgical wound edges is often an obstacle to proper
      closure and good cosmetic results in dermatologic surgery. OBJECTIVE: A buried,
      butterfly-shaped, interrupted suture has been developed to remedy this. The
      suture is anchored very broadly in the corium, the knot is below the corium. The
      butterfly suture can be supplemented by a temporary running suture or by close
      set, superficially placed interrupted sutures. METHODS: This technique was
      studied in a follow-up of 876 operations, with histologic study of 60 scars
      resulting from the suture. In particular, the specific advantages and
      disadvantages of two synthetic suture materials were compared: monofilament
      (polydioxanon) and polyfilament (polyglactin 910). RESULTS: Polydioxanon sutures
      were found to be clinically superior. It was important, however, that the suture
      knot be deeply anchored and that the surgeon be experienced. CONCLUSION: Cosmetic
      results of 18,000 procedures with this suture over a period of 6 years were found
      to be clearly better than those of surgery with conventional sutures.

PMID- 8349899
TI  - Scalp extension.
AB  - BACKGROUND: Surgery to correct extensive alopecia requires increasing the surface
      of hair-bearing scalp and removing bald scalp. Two commonly used methods, scalp
      expansion and scalp reduction, have disadvantages. OBJECTIVE: To describe a new
      method, scalp extension, that employs a thin sheet of bioplastic (an extender)
      stretched and attached with hooks to the galea after scalp reduction. METHODS:
      The surgical technique is described and the results compared with those of
      patients who have undergone scalp reduction and scalp expansion. A study of the
      first fifteen cases treated is presented. RESULTS: During the few weeks that the
      extender is implanted, the constant tension it exerts on the galea causes a
      progressive stretching of the scalp. Data from the first fifteen cases treated
      reveal eradication of more extensive bald areas than with scalp reduction, making
      it possible to cut the number of operations necessary in half while considerably
      shortening total treatment time. The absence of major side effects, along with
      the absence of any deformation of the scalp (unlike scalp expansion), explains
      the excellent acceptability of the instrument by patients. CONCLUSION: Scalp
      extension appears to be a useful adjunctive technique in hair replacement and
      reconstructive surgery, and has distinct advantages over standard scalp reduction
      and tissue expansion techniques.

PMID- 8349900
TI  - Transcranial eosinophilic granuloma manifested by a subcutaneous scalp mass.
      Differential diagnosis in children.
AB  - BACKGROUND: The differential diagnosis of nodular scalp lesions in a child is
      surprisingly extensive. OBJECTIVE: To present a case of eosinophilic granuloma
      that was manifested by a scalp mass in a pediatric patient. METHODS: The case is
      presented and the relevant literature is reviewed. CONCLUSIONS: The seriousness
      of some of these lesions requires a thorough evaluation, including noninvasive
      imaging, and carefully planned surgical intervention so that effective diagnosis
      and treatment are ensured. Surgical exposure of unsuspected central nervous
      system connections may lead to infection, hemorrhage, seizures, or other
      significant morbidity and mortality.

PMID- 8349901
TI  - Duplex scanning and light reflection rheography in the assessment of the severity
      of short saphenous vein incompetence.
AB  - BACKGROUND: Duplex ultrasound assessment of veins in the popliteal fossa is an
      accepted alternative to venography. Light reflection rheography provides
      additional quantitative information on venous reflux in chronic venous
      insufficiency. OBJECTIVE: To use duplex ultrasound and light reflection
      rheography to study the venous reflux patterns in the popliteal fossa in a group
      of patients. METHODS: Duplex ultrasound examination and light reflection
      rheography were used in the assessment of the severity of short saphenous vein
      incompetence. RESULTS: The study revealed that any associated deep venous reflux
      which was detectable beyond the saphenopopliteal junction represented a more
      advanced stage of superficial venous insufficiency. CONCLUSIONS: Light reflection
      rheography, as a semiquantitative test, provided useful additional information to
      duplex scan findings in assessing venous reflux of the popliteal fossa. Short
      saphenous vein reflux with functional deep venous incompetence was associated
      with shorter venous refilling times and clinically represented a more advanced
      stage of primary varicose vein disease.

PMID- 8349902
TI  - The prevention of cutaneous necrosis following extravasation of hypertonic saline
      and sodium tetradecyl sulfate.
AB  - BACKGROUND: Most authors have recommended treating extravasation during
      sclerotherapy by infiltrating the area with 0.9% sodium chloride and/or procaine.
      OBJECTIVE: To evaluate interventions in the prevention of necrosis following
      intradermal injection of 23.4% sodium chloride and 3% sodium tetradecyl sulfate.
      METHODS: Following intradermal 23.4% sodium chloride (Study I) or 3% sodium
      tetradecyl sulfate (Study II), subjects (Sprague-Dawley rats) received either no
      treatment or injections of 0.9% sodium chloride, sterile water, 1% procaine, or
      hyaluronidase. Groups were compared regarding incidence and size of necrosis.
      RESULTS: In study I, hyaluronidase treated groups had significantly fewer and
      smaller areas of necrosis than other groups. In study II, the hyaluronidase group
      developed significantly fewer ulcers than the 0.9% sodium chloride group. The
      0.9% sodium chloride group had significantly larger ulcers than other groups.
      CONCLUSION: In the model studied, hyaluronidase was the only effective treatment
      in the prevention of necrosis. Following 3% sodium tetradecyl sulfate, 0.9%
      sodium chloride was associated with larger ulcers than other groups.

PMID- 8349903
TI  - Postsclerotherapy hyperpigmentations. Chromated glycerin as a screen for patients
      at risk (a retrospective study).
AB  - BACKGROUND: Chromated glycerin reportedly causes less post-sclerotherapy
      hyperpigmentations than polidocanol. OBJECTIVE: To investigate whether replacing
      polidocanol with chromated glycerin lowers the incidence of postsclerotherapy
      hyperpigmentation. METHODS: Retrospective study of 134 records of patients
      treated for leg telangiectasia. At the first session only chromated glycerin was
      injected. From the second session on treatment was continued--according to the
      response--either with chromated glycerin or with the stronger polidocanol.
      RESULTS: Chromated glycerin caused strong sclero-inflammatory reaction in 27% of
      patients, who were therefore treated with chromated glycerin only; in the
      remaining 73%, chromated glycerin was replaced with polidocanol, because of mild
      (or absent) reaction. Postsclerotherapy hyperpigmentation developed in three
      patients, all treated with chromated glycerin, while no postsclerotherapy
      hyperpigmentation developed in the patients treated with polidocanol.
      CONCLUSIONS: Single "trial" session with chromated glycerin permits to select
      patients at risk of developing postsclerotherapy hyperpigmentation, and treat
      these with a milder sclerosant. This approach also reduced the incidence of early
      postsclerotherapy hyperpigmentation compared with similar series treated with
      polidocanol alone.

PMID- 8349904
TI  - The effect of pre-education on patient compliance with full-body examination in a
      public skin cancer screening.
AB  - BACKGROUND: Public skin cancer screening has become increasingly common in recent
      years. However, currently there is no standardized procedure for these
      screenings. Full body skin examination as opposed to examination of sun-exposed
      areas offers several advantages, including the opportunity to diagnose early
      melanoma in areas normally covered by clothing. Disadvantages of full body skin
      examination include patient resistance because of inconvenience and concerns
      about privacy and modesty. The additional time involved in full body skin
      examination may also be an impediment. OBJECTIVE: In a randomized double-armed
      study, we studied whether patients were more likely to develop a positive
      attitude towards full body skin examination if they were advised beforehand, in
      writing, of the logic underlying the need for a complete examination. METHODS:
      Patients presenting to a public skin cancer screening were divided into two
      groups. Group A (N = 111) received a written explanation of the need for full
      body skin examination and Group B (N = 175) received no information. Patients
      were then surveyed, after the screening, about their attitudes towards full body
      skin examination. RESULTS: Those who received pre-education were less likely (P <
      .05) to be concerned about a genital examination. Those who were concerned about
      a genital exam were compared with those who were not concerned about a genital
      exam, the former patients were: 1) younger (P < .05); 2) more concerned about
      privacy (P < .001); and 3) preferred a physician of the same sex (P < .001).
      CONCLUSION: Providing patients with information about the need for full body skin
      examination decreases concern about undergoing a skin genital exam and may
      minimize resistance to full body skin examination in public skin cancer
      screenings.

PMID- 8349905
TI  - A visit to the office of Dr. Emanuel Marritt.

PMID- 8349906
TI  - Re: Acu-Guard.

PMID- 8349907
TI  - Re: Punch biopsy.

PMID- 8349908
TI  - Wound healing. An overview.

PMID- 8349909
TI  - Basics of cutaneous wound repair.
AB  - BACKGROUND: Cutaneous wound repair consists of multiple integrated networks of
      cell-matrix-cytokine interactions. It is generally believed that a better
      understanding of these networks will lead to improved care of cutaneous wounds,
      whether freshly made by the surgeon's scalpel or previously existing and not
      healing secondary to underlying abnormalities. OBJECTIVE: This review is intended
      to update the readership in some of the salient aspects of wound repair networks.
      METHODS: To facilitate the review of multiple integrated networks, cutaneous
      wound repair was arbitrarily divided into three phases: inflammation, tissue
      regeneration including re-epithelialization and granulation tissue formation, and
      tissue reorganization. RESULTS: Throughout the entire process of wound repair it
      is clear that cells produce or alter various cytokines and extracellular matrix.
      The cytokines and matrix in turn alter the behavior of the producer cells
      (autocrine response) or neighbor cells (paracrine response). CONCLUSION: The
      dynamic reciprocity among cells, cytokines, and matrix material helps explain how
      integrated wound healing networks are sequential as well as tightly controlled.

PMID- 8349910
TI  - Growth factors and wound healing.
AB  - BACKGROUND: Over the last decade, there has been an exponential increase in our
      knowledge of the biology of growth factors. The hope has been and remains that
      these potent biologic agents will effect a fundamental improvement in the way we
      treat wounds. OBJECTIVE: We will discuss the biology of growth factors and the
      dramatic effects these proteins have on cell proliferation, cell chemotaxis, and
      on the formation of extracellular matrix molecules. RESULTS: Growth factors are
      extremely potent biologic agents that show promise in accelerating wound repair
      in both animal and human studies. They improve granulation tissue, enhance
      tensile strength, and promote reepithelialization. Cosmetic effects are also to
      be expected by antagonizing and blocking the action of these peptides.
      CONCLUSION: Growth factors are likely to become an important therapeutic tool for
      the dermatologic surgeon.

PMID- 8349911
TI  - Occlusive dressings.
AB  - BACKGROUND: Although occlusive dressings speed epithelialization, reduce
      inflammation and tenderness, reduce the chance of infection, stimulate healing of
      chronic wounds, and produce less scarring, they are still underutilized by
      physicians and nurses. The principal reasons for their underutilization are fear
      of infection, the time needed for instructing patients in their use, a lack of
      knowledge about occlusive dressings, and the general unavailability and high cost
      of the dressings. METHODS: This chapter describes the principles which help in
      selection of the proper dressing, discusses the mechanisms of action of occlusive
      dressings, lists some novel new occlusive dressings, and emphasizes some of the
      drawbacks of occlusive dressings for chronic wounds. CONCLUSION: While occlusive
      dressings have become an important treatment protocol, their role in opening the
      minds of clinicians to the possibility of controlling the repair process may be
      their greatest contribution to medical science.

PMID- 8349912
TI  - Wound care after office procedures.
AB  - A knowledge of wound healing physiology and how it is influenced by wound
      dressings is valuable information for all dermatologists. Such knowledge enables
      the dermatologist to give authoritative advice on postoperative wound care and
      more importantly, to use wound dressings as a complement to good planning and
      surgical technique in order to optimize the conditions for rapid healing
      following office surgical procedures.

PMID- 8349913
TI  - A review of topical agents for wounds and methods of wounding. Guidelines for
      wound management.
AB  - This article reviews the effects of antiseptics, antimicrobials, hemostatic
      agents and surgical methods on the incidence of wound infection and the process
      of wound healing. A set of guidelines is provided to help decide what to apply
      topically to wounds and which method of wounding to select in order to achieve
      the best possible outcome in wound healing.

PMID- 8349914
TI  - Keloids and hypertrophic scars.
AB  - BACKGROUND: Keloids and hypertrophic scars are benign fibrous growths which
      usually occur after trauma in predisposed individuals. Their etiology, clinical
      manifestations and treatment are diverse. OBJECTIVE: The purpose of this article
      is to review the pertinent literature concerning keloids and hypertrophic scars
      as well as present my own perspective on the subject. It is my hope that the
      information contained herein will help both the dermatologist and dermatologic
      surgeon better understand and manage these vexing lesions. METHODS: Medline
      literature search as well as original material. RESULTS: There is no one right
      way to treat all keloids and hypertrophic scars. Treatment results have been
      variable. CONCLUSION: The management of keloids and hypertrophic scars can be
      difficult and frustrating for both patient and physician. A better understanding
      of keloid pathogenesis may lead to improved therapies by which keloid growth and
      regrowth may be obviated.

PMID- 8349915
TI  - Lasers for the stimulation or inhibition of wound healing.

PMID- 8349916
TI  - Electrical stimulation to heal dermal wounds.
AB  - BACKGROUND: Numerous human and animal efficacy studies have demonstrated that
      electrical stimulation of the correct charge, density and total energy causes
      dramatically improved healing of dermal wounds. The investigations of biological
      actions (in vitro, animal, and human) demonstrate several effects that go a long
      way to explaining why electrical stimulation works. OBJECTIVE: To discuss recent
      research and advances in electrical stimulation of wound healing. RESULTS: Based
      on the latest scientific understanding of the wound healing process, one would
      expect a beneficial outcome from a therapy what decreases edema, debrides
      necrotic tissue, attracts neutrophils and macrophages, stimulates receptor sites
      for growth factors, stimulates growth of fibroblasts and granulation tissue,
      increases blood flow, stimulates neurite growth, induces epidermal cell
      migration, prevents post-ischemic oxygen radical-mediated damage, inhibits
      bacteria, and reduces numbers of mast cells. CONCLUSION: Taken together, the
      efficacy studies and the "mechanism of action" studies provide compelling,
      scientific evidence that electrical stimulation is safe and effective for
      promoting the healing of dermal wounds.

PMID- 8349917
TI  - Essentials of pressure ulcer treatment. The diabetic experience.
AB  - BACKGROUND: Diabetes accounts for over half of the lower extremity amputations in
      the United States. However, ulcers of the diabetic foot can often be treated
      successfully and amputations avoided. OBJECTIVE: To review treatment of diabetic
      foot ulcers. RESULTS: Physicians must recognize the critical clinical and
      diagnostic features of ischemic and neuropathic ulcers. Therapy is directed
      towards vascular repair in the ischemic ulcer and relief of weight bearing
      through casting and shoes with molded insoles in the neuropathic ulcer. Sound
      principles of wound care apply to all ulcers. CONCLUSION: For successful
      preventive foot care patients and physicians need to understand how and why
      ulcers form and the rationale for the types of footwear and care necessary to
      prevent ulcers.

PMID- 8349918
TI  - Venous ulceration.
AB  - BACKGROUND: In the last few years, interest in the pathogenesis and treatment of
      venous ulceration has been rekindled by novel observations in fibrinolysis and an
      explosive growth in wound care products, respectively. OBJECTIVE: The purpose of
      this work is to summarize the salient clinical features of venous ulceration, its
      proposed pathogenesis, and conventional as well as future treatment modalities.
      RESULT: Venous ulceration is an increasingly common condition. Its pathogenesis
      is related to failure of the calf muscle pump, and treatment is directed at
      effective leg compression, avoidance of contact dermatitis, and proper wound
      care. CONCLUSION: There is increased interest in both the pathogenic steps
      involved in venous ulceration and in treatment modalities. We suspect that
      incremental progress will occur in these areas in the next few years.

PMID- 8349919
TI  - Inflammatory ulcers.
AB  - A large number of diseases can eventuate in cutaneous ulceration. This article
      will review inflammatory disorders which by their nature can directly produce
      cutaneous breakdown and ulcer formation. Major emphasis is given to those
      disorders where recent knowledge has improved our understanding of the condition
      or where new therapeutic agents or maneuvers have become available. This later
      group consists of vasculitis, disorders caused by small vessel thrombi or embolus
      and pyoderma gangrenosum.

PMID- 8349920
TI  - Topical hyperbaric therapy for problem skin wounds.
AB  - BACKGROUND: Hyperbaric oxygen remains the sole treatment capable of inducing
      growth of new blood vessels. However, systemic hyperbaric oxygen therapy risks
      central nervous system and pulmonary toxicity. OBJECTIVE: To describe topical
      hyperbaric oxygen therapy for the treatment of recalcitrant open wounds. METHODS:
      Topical and systemic hyperbaric oxygen treatments are described and contrasted
      from one another. Applications of topical hyperbaric oxygen therapy are
      described. CONCLUSION: Topical hyperbaric oxygen therapy is useful only for open
      wounds. The advantages of topical hyperbaric oxygen therapy include low cost, the
      lack of systemic oxygen toxicity, and effectiveness, allowing this treatment to
      be prescribed for many patients early in the course of their disease rather than
      as a last resort.

PMID- 8349921
TI  - Biologic skin substitutes.
AB  - BACKGROUND: The ideal skin substitute should closely approximate the skin in
      function. The substitute should be readily available, easily sterilized and
      stored, and relatively inexpensive. OBJECTIVE: To describe recent developments in
      the area of biologic skin substitutes. RESULTS: Considerable advances have been
      made in keratinocyte and fibroblast culturing when used in conjunction with a
      biodegradable material as a substrate. CONCLUSION: There is no skin substitute
      that perfectly mimics autologous skin. However, recent developments show promise.

PMID- 8349922
TI  - Perforating dermatoses: a review and report of four cases.
AB  - Perforating dermatoses, an often overlooked entity comprised of Kyrle's disease,
      perforating folliculitis, reactive perforating collagenosis, elastosis perforans
      serpiginosa, and acquired perforating dermatosis, are succinctly described,
      focusing attention on their clinical features, histopathology, treatment, and
      pathogenesis. The literature on these facets has been extensively reviewed. In
      addition, three fresh cases of Kyrle's and one of perforating folliculitis have
      been incorporated to illustrate these conditions.

PMID- 8349924
TI  - Double cross lip flaps for reconstruction of the lower lip.
AB  - Squamous cell carcinoma of the lower lip is a common tumor. Of the many methods
      available for reconstructing lower lip defects after radical excision, we found
      double cross lip flaps from each lateral side of the upper lip philtrum rotated
      into the defect of the lower lip to be an effective method, not only functionally
      but also cosmetically. The main reason why satisfactory results were obtained by
      this procedure is that the anatomical structure (skin-orbicularis oris muscle
      mucosa, vermilion) of the upper lip is very similar to that of the lower lip. Our
      experience is with double cross lip operations in the management of lower lip
      cancers are described.

PMID- 8349923
TI  - Significance of elevated serum squamous cell carcinoma (SCC)-related antigen and
      lactate dehydrogenase (LDH) levels in senile erythroderma following eczema.
AB  - Clinical and laboratory tests were used to evaluate fourteen patients with senile
      erythroderma following eczema, and the results were compared with those from four
      patients with psoriatic erythroderma, two with Sezary syndrome, and twelve with
      prurigo chronica multiformis or nummular dermatitis. Characteristic laboratory
      findings included elevated serum squamous cell carcinoma-related antigens (SCC
      RAg), high lactate dehydrogenase (LDH), peripheral-blood eosinophilia, and a
      decreased peripheral blood lymphocyte percentage. Following treatment, titers of
      SCC-RAg and LDH resumed normal levels with remission. In patients with senile
      erythroderma following eczema, serum IgE was quite high and varied but, in a few
      instances, was within the normal range. SCC-RAg and LDH may thus be considered
      useful as markers for evaluating disease conditions of the skin of patients with
      senile erythroderma following eczema.

PMID- 8349926
TI  - A case of CD8+ T cell lymphoma occurring during treatment for in situ malignant
      melanoma of the palate.
AB  - A 53-year-old Japanese male noticed pigmented lesions on his right upper gingiva
      and hard palate in February of 1986. Histological examination revealed in situ
      malignant melanoma. Chemotherapy, beta-interferon, and oral BCG were given.
      However, tumors subsequently developed in the nasal cavity in March of 1989. The
      patient died in April of 1990 after developing Garcin's syndrome and the syndrome
      of inappropriate secretion of antidiuretic hormone (SIADH). Autopsy revealed
      aggressively infiltrating, whitish tumor masses invading the hard palate, the
      nasal cavity, the paranasal sinuses, the base of the skull, cranial nerves I-X,
      and the pituitary body, as well as severe necrosis of the soft palate. However,
      there was no evidence of malignant melanoma. Instead, these oval tumor cells had
      atypical nuclei and scanty cytoplasm. They contained no melanin granules, were
      negative for S-100 protein, and were also negative for various melanoma
      associated antigens. They were positive for CD2, CD3, and CD8 by avidin-biotin
      peroxidase complex immunohistochemistry. It was concluded that the patient had
      CD8+ non-Hodgkin's malignant lymphoma (diffuse, large cell type) of the
      nasopharyngeal region, which was preceded by in situ malignant melanoma of the
      palate.

PMID- 8349925
TI  - Trichilemmal carcinoma occurring in a lesion of solar keratosis.
AB  - A case of trichilemmal carcinoma occurring in a lesion of solar keratosis was
      reported. A 92-year-old woman had an erythematous plaque on her face that
      contained a reddish nodule. Histological examination of the nodule revealed
      typical features of trichilemmal carcinoma accompanied by those of solar
      keratosis in the marginal zone. The histological features of the erythematous
      plaque corresponded with those of solar keratosis. However, in situ the carcinoma
      developed in the epithelium of a hair follicle as well as in the interfollicular
      epidermis in the lesion of solar keratosis. We considered it likely that bowenoid
      malignant transformation occurred in both interadnexal and adnexal epithelium
      because of actinic damage, and a trichilemmal carcinoma arose. The paper also
      discussed the histogenesis of trichilemmal carcinoma.

PMID- 8349927
TI  - Warty dyskeratoma with multiple lesions.
AB  - A 63-year-old man with multiple nodules and pathological findings of acantholysis
      is reported as a case of warty dyskeratoma presenting with multiple lesions. The
      number of nodules is the highest in the records as far as we know. We conclude
      that warty dyskeratoma originates from the hair follicle.

PMID- 8349928
TI  - Necrotizing fasciitis appearing with petechiae as the first clinical sign.
AB  - A 64-year-old Japanese man with necrotizing fasciitis is reported. He developed
      an Enterobacter agglomerans infection in his left leg without any known causative
      surgery or trauma, although he had acute myelocytic leukemia as a predisposing
      condition. Uncommonly, the first clinical sign was petechiae. Surgical
      debridement could not be performed because of pancytopenia due to his original
      disease and chemotherapy. The patient died, and an autopsy was performed. Severe
      intravascular coagulation was observed in the cutaneous infected tissues, while
      little or no disseminated intravascular coagulation was observed in the major
      internal organs. The local microorganism factors such as necrotoxins were
      suspected to cause the intravascular coagulation in the infected tissues.

PMID- 8349930
TI  - References to contemporary papers on acoustics.

PMID- 8349929
TI  - Congenital giant pigmented nevus associated with angiolipoma.
AB  - We report a 20-year-old-Korean woman with a congenital giant pigmented nevus and
      angiolipoma. She was admitted our department with a large, dark, pigmented lesion
      on the right flank and abdomen and a slowly growing mass on the right flank area
      since birth. On biopsy, the specimen taken from the giant pigmented patch showed
      typical findings of compound nevus. The right flank mass was surgically removed.
      The specimen was composed of mature fat cells with an increased vascular
      component. These findings are compatible with angiolipoma.

PMID- 8349931
TI  - Emerging concepts in mold allergy: what is the role of immunotherapy?

PMID- 8349932
TI  - Inhaled corticosteroids and severe viral infections. Executive Committee.
      American Academy of Allergy and Immunology.

PMID- 8349933
TI  - A double-blind, placebo-controlled evaluation of sublingual immunotherapy with
      standardized cat extract.
AB  - BACKGROUND: In light of the controversial status of sublingual immunotherapy in
      patients with allergic rhinitis, we undertook a double-blind study of this form
      of treatment. METHODS: Forty-one subjects with cat allergy presenting as
      rhinoconjunctivitis underwent 105 days of sublingual immunotherapy, with 20
      subjects receiving a standardized cat extract (total dose approximately 4,500,000
      allergy units) and 21 a matching placebo. Effectiveness of treatment was assessed
      by changes in symptoms and nasal-blockage index during 90 minutes of exposure in
      an apartment containing cat dander, which was performed before and after the
      course of treatment. Changes in cat-specific IgG and IgE levels and skin-test
      reactions were also monitored. RESULTS: Although there were fewer symptoms and
      less nasal obstruction on cat dander exposure at the end of the study the changes
      were not significantly different in those receiving active or placebo treatment.
      Specific IgG and IgE levels and prick skin test results did not change
      significantly during the course of the study. CONCLUSIONS: We conclude that
      sublingual immunotherapy with high-dose standardized cat extract was no more
      effective than placebo in reducing symptoms or affecting immunologic measures of
      cat sensitivity.

PMID- 8349934
TI  - Assessment of risk factors for IgE-mediated sensitization to tetrachlorophthalic
      anhydride.
AB  - Two groups of workers with occupational asthma caused by tetrachlorophthalic
      anhydride (TCPA) have been reported on; in only one report was specific anti-TCPA
      antibody demonstrated. We received a request to investigate respiratory problems
      among workers at a plant where solenoid coils are manufactured with the use of
      epoxy resin and where a new TCPA hardener had been introduced in 1988. In
      response, we conducted a cross-sectional evaluation of 52 current workers and
      assayed serum samples from 49 workers for TCPA-human serum albumin-specific IgE
      and IgG by ELISA. Mean airborne TCPA concentrations ranged from 0.21 to 0.39
      mg/m3 in 1989 and May 1990 but were considerably lower (less than 0.009 to 0.13
      mg/m3) by July 1990 when ventilation was introduced. Workers were classified in
      four departments as molders (most directly working with TCPA), those
      intermittently exposed to TCPA, coil assemblers, and office workers. There was a
      high prevalence of reported work-related respiratory symptoms (from 27% to 39%).
      The mean decline in FEV1 over the shift in the molders (down 4.1%) was
      significantly different from the change in the office group (increased 2.5%).
      Intrashift change in FEV1 was inversely correlated with log personal TCPA
      concentration (r = -0.47). Of 49 current workers, 15 (31%) had elevated serum
      TCPA-human serum albumin-specific IgE antibody levels and 19 (39%) had elevated
      specific IgG levels. The prevalence of specific IgE was highest in the mold and
      intermittent groups (54%), in comparison with the coil assembly (25%) and office
      (0%) groups. Those workers who were IgE positive were significantly less likely
      to be current smokers and had worked significantly longer since 1988. Of those
      hired in 1988 or after, the proportion of workers who were IgE positive increased
      with duration of employment category (p value for trend 0.022). Since ventilation
      was installed and TCPA exposures reduced to less than 0.1 mg/m3, there has been a
      marked decrease in symptoms and no new cases of occupational asthma among newly
      hired workers at the plant.

PMID- 8349935
TI  - Release of chemical mediators and inflammatory cell influx during early allergic
      reaction in the nose: effect of furosemide.
AB  - BACKGROUND: We evaluated the effect of furosemide on allergen-induced rhinitis in
      a double-blind, crossover, placebo-controlled experiment. METHODS: Fourteen
      patients with rhinitis who were allergic to house dust were nebulized with an
      intranasal dose of 20 mg of furosemide or placebo before allergen challenge with
      an extract of Dermatophagoides pteronyssinus (100 BU). Clinical evaluation and
      nasal lavages with normal saline solution were performed at baseline; after
      placebo-furosemide nebulization, and at 10, 30, and 60 minutes after allergen
      challenge. Number of sneezes and a composite symptom score were recorded to
      evaluate clinical response. Prostaglandin E2 (PGE2), PGD2 peptide leukotrienes
      and 15-hydroxy, 5,8,11,13-eicosatetraenoic acid (15-HETE) were measured by
      radioimmunoassay in nasal lavages. Cells were counted and classified as
      epithelial cells, neutrophils, eosinophils, and others. RESULTS: No differences
      in either clinical symptoms or cell influx after allergen challenge were found
      between furosemide and placebo groups. PGE2 levels did not change after
      provocation, and furosemide had no effect on its production. Ten minutes after
      antigen challenge there was a marked increase of PGD2 (p < 0.01), peptide
      leukotrienes (p < 0.01), and 15-HETE (not significant) on both study days.
      However, no significant differences in the release of eicosanoids were found
      between furosemide and placebo groups. CONCLUSIONS: Our observations in the nasal
      mucosa suggest that furosemide has no effect on the release of proinflammatory
      and bronchoconstrictor metabolites (PGD2, peptide leukotrienes, and 15-HETE). In
      contrast to bronchial asthma, allergen-induced rhinitis was not effectively
      prevented by furosemide.

PMID- 8349936
TI  - Receiver operating characteristic analysis: a useful method for a comparison of
      the clinical relevance of two in vitro IgE tests.
AB  - BACKGROUND: The objectives of this study were to demonstrate the usefulness of
      Receiver Operating Characteristic (ROC) analysis in the definition of a positive
      threshold in the comparison of two in vitro tests for detecting IgE antibodies
      and to determine the clinical relevance of specific IgE tests according to the
      sensitivity and specificity determined by ROC analysis. METHODS: Specific IgE
      levels were compared with the use of both MATRIX (Abbott Laboratories, Chicago,
      Ill.) and PHADEZYM (Pharmacia, Uppsala, Sweden) tests in 109 patients: 86
      allergic patients and 23 control subjects. All allergic patients had a clinical
      history of allergy to mite, cat, grass pollen, or birch pollen and positive skin
      prick test results to the suspected allergen. Using various levels of specific
      IgE, we determined the points of the ROC curves with the best ratio of true
      positives to false positives for four aeroallergens (i.e., mite, cat, grass
      pollen, and birch pollen). RESULTS: Except for mite allergen there was no
      correspondence between the positive threshold values determined by ROC analysis
      with MATRIX and PHADEZYM tests. In terms of class, when ROC analysis was used,
      the threshold was class III with the MATRIX test and class II with PHADEZYM test
      for cat, grass pollen, and birch pollen and class III for mite. According to the
      threshold value, sensitivity and specificity for MATRIX and PHADEZYM tests were
      similar except for cat, for which the PHADEZYM test had a lower sensitivity
      (0.71) than the MATRIX test (0.90). With mite allergen the predictive value of
      only one positive MATRIX test result was 0.96. The specificities of MATRIX and
      PHADEZYM tests were 100% in both nonatopic and atopic control groups.
      CONCLUSIONS: We conclude that ROC analysis is a reliable method for comparing IgE
      in vitro tests and that it emphasizes the lack of correspondence between
      arbitrary units given for each in vitro test. ROC analysis appears to be a good
      method for helping to standardize IgE in vitro tests.

PMID- 8349937
TI  - Diagnostic tests in enzyme allergy.
AB  - BACKGROUND: Allergies to enzymes occur frequently in enzyme manufacturing plants.
      In epidemiologic studies the number of exposed subjects with symptoms is
      considerably higher than the number of sensitizations as assessed by skin tests
      or RAST. It was the aim of this study to evaluate the sensitivity and specificity
      of skin prick tests, enzyme allergosorbent test, and immunoprint with enzymes by
      using the results of bronchial provocation tests as the "gold standard." METHODS:
      We performed 82 bronchial provocation tests with nine different enzymes in 42
      chemical plant workers, all of whom had reported work-related symptoms. All tests
      with the exception of bronchial provocation tests were also performed in 10
      atopic and 10 healthy control subjects. RESULTS: Thirteen workers showed positive
      results to bronchial provocation tests (50% or greater fall in specific airway
      conductance) with an enzyme at a maximal concentration of 10 mg/ml. Equivocal
      test results, that is, tests with a 30% or greater and less than 50% fall in
      specific airway conductance were seldom. Skin prick tests with nondialyzed
      aqueous enzyme extracts at a concentration of 10 mg/ml yielded a sensitivity of
      100% and a specificity of 93%. Control subjects had no cutaneous reactions to
      enzymes. Discrepancies between skin tests and bronchial provocation tests
      occurred in 5 of 82 tests, all with a positive skin test and a negative bronchial
      provocation test. False-positive skin tests were considered more likely in four
      subjects and a false-negative bronchial challenge more likely in one case. Enzyme
      allergosorbent test was 62% sensitive and 96% specific, and atopic control
      subjects showed positive results in two cases. Results of immunoprint with
      amylase showed one main band at pH 3.4; this band was also found in exposed
      subjects without further signs of sensitization, but was not found in control
      subjects. All but one person with positive results to bronchial provocation tests
      with enzymes showed bronchial hyperresponsiveness. We identified 13 subjects with
      bronchial hyperresponsiveness, but without occupational allergy: five of these
      had sensitizations to nonoccupational allergens and the remainder showed
      bronchial hyperresponsiveness without any detectable cause. CONCLUSIONS:
      Occupation-related symptoms were not indicative of occupational allergy.
      Bronchial provocation tests and skin prick tests with nondialyzed aqueous enzyme
      extracts were appropriate techniques for the diagnosis of enzyme allergy.

PMID- 8349938
TI  - Nasal cholinergic hyperresponsiveness in atopic subjects studied out of season.
AB  - BACKGROUND: Atopic individuals have previously been shown to have an autonomic
      imbalance consisting of heightened cholinergic responsiveness in the lung, skin,
      and eyes, and beta-adrenergic hyporesponsiveness in the lungs, eyes, and
      vasculature. This array of abnormalities is often accompanied by nonspecific
      bronchial hyperresponsiveness, as well as alpha-adrenergic hyperresponsiveness in
      individuals with asthma. METHODS: To determine whether atopic individuals have
      intrinsic nasal airway hyperresponsiveness to methacholine, 21 nonatopic subjects
      and 37 subjects with allergic rhinitis were studied. All subjects were studied
      out of their allergy seasons, and all allergy-related medications were
      discontinued before the study began. Subjects underwent nasal challenge with
      methacholine (1 to 25 mg), and lavaged nasal secretions were analyzed for total
      protein, the plasma marker albumin, and the glandular marker lactoferrin.
      RESULTS: Atopic subjects demonstrated increased glandular responsiveness to
      methacholine as evidenced by an increase in the secretion of lactoferrin in
      response to individual doses of methacholine. Although the maximal lactoferrin
      secretion did not increase, glandular sensitivity to methacholine was heightened
      because the dose of methacholine required to induce lactoferrin secretion
      achievable by 60% of the study population was significantly lower in the atopic
      group. The volume of lavaged secretions recovered and congestion scores were also
      higher in the atopic group as compared with the normal control group.
      CONCLUSIONS: These data strongly suggest that atopic individuals have intrinsic
      nasal glandular hyperresponsiveness to cholinergic stimulation.

PMID- 8349939
TI  - Relative potencies and time course of changes in adenosine 5'-monophosphate
      airway responsiveness with inhaled furosemide and bumetanide in asthma.
AB  - A randomized, double-blind, placebo-controlled study was conducted to compare the
      effects of two chemically unrelated "loop" diuretics, furosemide (40 mg) and
      bumetanide (2 mg) on the bronchoconstrictor response to inhaled adenosine 5'
      monophosphate (AMP) in 12 subjects with asthma. In eight additional volunteers
      with asthma, we also carried out a separate randomized, double-blind study to
      examine in more detail the time course of change in bronchial reactivity to
      inhaled AMP after administration of nebulized furosemide and bumetanide. Inhaled
      loop diuretics significantly increased the provocative concentration of AMP
      causing a 20% fall in forced expiratory volume in 1 second (FEV1) from the value
      of 21.2 mg/ml (range, 2.5 to 96.9 mg/ml) after placebo administration to 83.4
      mg/ml (range, 11.3 to 345.0 mg/ml) (p < 0.01) and 33.8 mg/ml (range, 4.7 to 120.9
      mg/ml) (p < 0.05) after administration of furosemide and bumetanide,
      respectively. After placebo administration, the provocative concentration of AMP
      causing a 20% fall in FEV1 (PC20 AMP) at 10, 30, and 120 minutes did not differ
      significantly; their geometric mean (range) values were 57.8 mg/ml (10.9 to 341.0
      mg/ml), 55.0 mg/ml (13.2 to 304.1 mg/ml), and 52.8 mg/ml (14.4 to 252.2 mg/ml),
      respectively. When compared with placebo, inhaled furosemide significantly
      reduced the airway responsiveness to AMP at all time points; the PC20 AMP values
      at 10, 30, and 120 minutes were 154.6 mg/ml (29.4 to 658.7 mg/ml) (p < 0.01),
      142.6 mg/ml (25.5 to 639.9 mg/ml) (p < 0.01), and 103.9 mg/ml (12.5 to 605.5
      mg/ml) (p < 0.05), respectively. The PC20 values for AMP after pretreatment with
      bumetanide were significantly increased up to 110.2 mg/ml (25.9 to 639.0 mg/ml)
      (p < 0.01) and to 92.0 mg/ml (21.6 to 531.7 mg/ml) (p < 0.05) at 10 and 30
      minutes, respectively. At 120 minutes, inhaled bumetanide failed to affect AMP
      airway responsiveness; the PC20 AMP was not significantly different from that of
      placebo, with a value of 71.5 mg/ml (22.6 to 318.0 mg/ml). We conclude that
      comparable equidiuretic doses of furosemide and bumetanide are effective in
      attenuating the airway response to AMP, with furosemide being approximately 2.5
      times more potent than bumetanide (p < 0.01). The time course of change in
      bronchial reactivity to AMP is similar for both drugs with a peak effect at 10
      minutes. It is possible that the mechanism(s) underlying the protective effects
      of inhaled loop diuretics in asthma may be distinct from those responsible for
      their diuretic properties.

PMID- 8349940
TI  - Analysis of rat urine proteins and allergens by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and immunoblotting.
AB  - BACKGROUND: In rats, urine has been identified as a major source of the allergens
      that cause laboratory animal allergy, an important occupational health problem.
      METHODS AND RESULTS: Urinary proteins and allergens of Wistar rats were studied
      by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting.
      Proteins excreted by male and female rats during puberty were similar and of low
      molecular weight. In adulthood, moderate increases in diffuse staining of 26 and
      21 kd occurred in female urine. In males the 17 kd protein increased dramatically
      and the 23 and 21 kd proteins moderately. The urine excretion of high-molecular
      weight proteins (75 to 63 kd) increased with age in males (females not studied).
      Immunoblot studies with six sera showed allergens in urine of male and female
      rats of all ages, three of which were present in all urine (75, 68, and 21 kd).
      Three allergens (17, 16, and 15 kd) in female urine may be allergenically similar
      to the 17 kd allergen in adult male urine. Adult male urine allergens were
      studied further with sera from 83 rat-hypersensitive subjects. Major allergens
      were identified at 23, 21, and 17 kd, and all sera had IgE to one or more of
      these proteins. Twenty-seven percent had IgE to 68 and 63 kd allergens. Minor
      allergens were identified at 75, 51, and 44 kd. CONCLUSIONS: Rat urine is an
      important source of the major allergens associated with rat hypersensitivity. Age
      and sex markedly influence the protein and allergenic constituents of rat urine.

PMID- 8349941
TI  - Basidiospore allergen release: elution from intact spores.
AB  - BACKGROUND: We sought to test the hypothesis that allergens are readily released
      by intact basidiospores in vitro and that different species release allergens in
      different patterns that are related to spore wall structure. METHODS: To assess
      basidiospore allergen releasability, basidiospore allergens were extracted from
      disrupted spores and eluted from intact spores, and the allergenic potency of the
      extracts and eluates was compared in Calvatia cyathiformis, Psilocybe cubensis,
      Lentinus edodes, and Pleurotus ostreatus. RESULTS: There was a significant
      species difference; on the basis of dry weight, the yield of extract and eluates
      from P1. ostreatus greatly exceeded the yield from C. cyathiformis extract and
      eluates. As measured by RAST inhibition, the allergenic potency of P1. ostreatus
      and L. edodes spore eluates reached the potency of disrupted spore extract in
      less than 4 hours. Allergen potency of Ps. cubensis and C. cyathiformis eluate
      approached the potency of disrupted spore extract only after 8 and 24 hours.
      Allergen staining intensity in sodium dodecyl sulfate polyacrylamide gel
      electrophoresis IgE immunoblot correlated with RAST activity. C. cyathiformis and
      Ps. cubensis spores have thick walls, whereas P1. ostreatus and L. edodes spore
      walls are thin and hyaline (nonpigmented). Thus spore allergen release may relate
      to spore wall characteristics. CONCLUSIONS: These studies indicate that intact
      basidiospores of all four species release allergens, but the release patterns
      differ by species, and these differences may be clinically significant.

PMID- 8349942
TI  - Activation of CD4+ T cells, increased TH2-type cytokine mRNA expression, and
      eosinophil recruitment in bronchoalveolar lavage after allergen inhalation
      challenge in patients with atopic asthma.
AB  - BACKGROUND: We have examined whether the local eosinophilia provoked by
      inhalational allergen challenge of patients with atopic asthma is associated with
      the appearance, in vivo, of activated TH2-type T helper lymphocytes. METHODS:
      Fifteen patients with atopic asthma had bronchial wash and bronchoalveolar lavage
      (BAL) 24 hours after allergen or diluent challenge separated by at least 21 days.
      RESULTS: There was an increase in eosinophils in both bronchial wash (p = 0.01)
      and BAL (p = 0.02) after allergen challenge but not after diluent challenge.
      Activation of CD4+ BAL T cells was suggested by an increase in the expression of
      CD25 shown by flow cytometry after allergen challenge, when compared with diluent
      (p = 0.02). There was no evidence of activation of CD8 T cells. By in situ
      hybridization after allergen challenge as compared with diluent, increases were
      shown in the numbers of cells expressing mRNA for interleukin-4 (IL-4) (p =
      0.005), IL-5 (p = 0.01), and granulocyte-macrophage colony-stimulating factor (p
      = 0.03) but not IL-3, IL-2, or interferon-gamma. In situ hybridization of BAL
      cells after immunomagnetic separation of CD2-positive and CD2-negative cell
      populations showed that IL-4 and IL-5 mRNAs were associated with T lymphocytes
      after allergen challenge. BAL and bronchial wash eosinophilia closely correlated
      with maximal late fall in forced expiratory volume in 1 second after allergen
      challenge. CONCLUSION: Cytokines produced by activated TH2-type CD4+ T cells in
      the airway may contribute to late asthmatic responses by mechanisms that include
      eosinophil accumulation.

PMID- 8349943
TI  - Defective interleukin-2 and interferon-gamma gene expression in response to
      antigen in a subgroup of patients with common variable immunodeficiency.
AB  - Patients with common variable immunodeficiency (CVID) are heterogeneous in the
      clinical manifestations of the disease and in the underlying mechanisms leading
      to the immunodeficiency. The impairment of B-cell function can be due to an
      intrinsic defect of the B cells, a deficiency in the function of the antigen
      presenting cell, or a dysfunction in the course of T-cell activation. In the
      present report we have focused our attention on T-lymphocyte activation in three
      patients with CVID. Numbers of T and B cells, as well as CD4 and CD8 T cell
      subsets, were within the normal range. The patients' B cells secreted IgM but did
      not secrete IgG and IgA in response to B-cell stimuli in vitro. Addition of
      allogeneic T cells was followed by an increase in IgM production but had no
      effect on the other immunoglobulin isotypes. Examination of T-cell function
      revealed impaired proliferative response, interleukin-2 (IL-2) and interferon
      gamma gene expression and IL-2 release after antigenic stimulation, whereas T
      cell proliferation, as well as IL-2 gene expression and release in response to
      stimulation via anti-CD3, were comparable to those of healthy control subjects.
      Anti-CD3-induced IFN-gamma gene activation in T cells from two patients was
      comparable to that of control subjects, whereas T cells from the third patient
      showed reduced expression of IFN-gamma mRNA. In contrast to the decreased IL-2
      and IFN-gamma mRNA levels, IL-2R transcripts examined in parallel were normal in
      CVID T cells on stimulation with antigen. The defect in IL-2 and IFN-gamma mRNA
      expression after stimulation with antigen, but not with anti-CD3, suggests an
      abnormality confined to T-cell activation by the T-cell receptor.

PMID- 8349945
TI  - Reduction of allergic reactions in patients undergoing long-term hemodialysis.

PMID- 8349944
TI  - Therapy for patients with recurrent infections and low serum IgG3 levels.

PMID- 8349946
TI  - Anaphylaxis to latex in intravenous fluids.

PMID- 8349947
TI  - Effects of acetate on human immune system.
AB  - The immunopharmacologic effects of Ringer's acetate on healthy persons and cancer
      patients were investigated. Enhancement of in vivo polyclonal antibody production
      in peripheral blood lymphocytes from healthy subjects and cancer patients was
      elicited after the intravenous administration of 500 ml Ringer's acetate
      solution. Allogeneic mixed lymphocyte reaction(MLR) and natural killer(NK)
      activity were also increased in the majority of healthy individuals and cancer
      patients when administered Ringer's acetate solution but not Ringer's lactate
      solution.

PMID- 8349948
TI  - In vitro and in vivo comparative studies on immunosuppressive properties of
      cyclosporines A, C, D and metabolites M1, M17 and M21.
AB  - Cyclosporine A (CsA) and its major metabolites: M1, M17 and M21 and two
      analogues: cyclosporines C (CsC) and D (CsD), were studied for their capacity to
      interfere with different in vitro activation pathways. Their inhibition
      potentials against the reaction of Graft-versus-Host (GvH) were also studied. The
      results showed: CsA, CsC and metabolite M17 were the most active compounds upon
      the inhibition of lymphocyte proliferation induced by different mitogens (ConA,
      PHA, PWM) and also on the proliferation of mixed lymphocyte cultures (MLC). The
      same results were observed concerning the direct activation by protein kinase C
      using a combined action of phorbol ester + calcium ionophore. In vivo using local
      GvH reaction, CsA and CsC proved more active than M17 in the two different
      combinations: H-2d --> (H-2b x H-2d)F1 and H-2k --> (H-2b x H-2k)F1 CsD and two
      metabolites M1 and M21 showed no or weak immunosuppressive effects. Overall, the
      immunosuppressive potency of six compounds could be schematized as: CsA > or =
      CsC > M17 > M1 > or = CsD > M21.

PMID- 8349949
TI  - Inhibition of interleukin 2 driven proliferation of mouse CTLL2 cells, by
      selected carbamate and organophosphate insecticides and congeners of carbaryl.
AB  - The anticholinesterase (antiCHE) insecticides, a large family of pesticides used
      extensively throughout the world, inhibit serine hydrolases by carbamylating or
      phosphorylating a serine residue at the catalytic site. These insecticides are
      viewed as potential inhibitors of serine hydrolase-dependent immune functions
      including interleukin 2 (IL2) signalling. Previous studies in our laboratory have
      demonstrated that carbaryl (an antiCHE insecticide) produces a marked
      concentration-dependent inhibition of IL2 driven 1) proliferation of mouse CTLL2
      cells, 2) proliferation of human natural killer (NK) cells, and 3) enhancement of
      target cell killing by human NK cells. In the present study, we examined the
      potential of 8 antiCHE insecticides (4 carbamates and 4 organophosphates) to
      inhibit IL2-dependent proliferation of mouse CTLL2 cells. The order of potency
      for T cell inhibition was carbaryl = dichlorvos > methiocarb > carbofuran >
      paraoxon > mevinphos > aldicarb = monocrotophos. In view of the relatively high
      inhibitory potency of carbaryl (a carbamate with low cholinergic toxicity), 3
      metabolites and 5 congeners of carbaryl were tested for potency to inhibit CTLL2
      proliferation. The data indicate a significant contribution of the 1-naphthol
      leaving group to inhibition of T cell proliferation by carbaryl, and are
      consistent with inhibition of a serine hydrolase(s) as a mechanism contributing
      to the observed inhibition of IL2-dependent proliferation.

PMID- 8349950
TI  - The effect of two glucan carboxymethyl derivatives with various substitution
      degrees on cyclophosphamide immunosuppression in mice.
AB  - Carboxymethylglucan (CMG) in two different degrees of substitution of
      carboxymethyl groups (0.56 and 0.89) was administered to cyclophosphamide (CY)
      treated (200 mg/kg) C57B1/6 mice in three doses (10, 50, and 100 mg/kg) 24 h
      after CY. The influence of CMG administration on the cell suppression caused by
      CY was observed in the subsequent days. The cellularity of spleen, bone marrow
      and peripheral blood was quantified on days 2, 5, 8, 11, 15, and 21 after CY
      treatment. CY treated mice developed a significant decrease in peripheral blood
      cell counts, and spleen and bone marrow cellularity during the initial 5 days,
      followed by recovery in the next 15 days, with an overshoot reaction in spleen
      cellularity and erythrocyte levels. The initial cellularity depression and the
      following recovery was modified by both carboxymethyl derivatives of glucan.
      Cyclophosphamide treated mice exhibited less pronounced immunosuppression and
      more rapid hematopoietic recovery when administered with CMG, although this
      reaction was only of a modest degree. The effects were not dose dependent and the
      differences between the two glucans were not significant.

PMID- 8349951
TI  - Inhibiting effects of serotonin and serotonin antagonists on the migration of
      mononuclear leucocytes.
AB  - The effect of serotonin and the serotonin antagonists ketanserin, methiotepine
      and ICS-205-930 on the migration of leucocytes was studied by using the sealed
      capillary migration technique. The migration of mononuclear leucocytes was
      inhibited by serotonin at 10(-4) and 10(-6)-10(-10)mol/l. An inhibition of the
      mononuclear leucocyte migration was also caused by ICS-205-930 at 10(-4)mol/l,
      ketanserin at 10(-4) and 10(-8)-10(-10)mol/l and methiotepine at 10(-4) and 10(
      6)-10(-8)mol/l. No inhibiting effects of serotonin or the serotonin antagonists
      were found on the migration of polymorphonuclear leucocytes. Thus, both serotonin
      and serotonin antagonists may inhibit mononuclear leucocyte migration.

PMID- 8349952
TI  - Enhancement of immunoglobulin A production in Peyer's patches by oral
      administration of a traditional Chinese medicine, xiao-chai-hu-tang (Shosaiko
      to).
AB  - The Peyer's patches contain a large number of precursor cells committed to the
      production of immunoglobulin A (IgA) and play an important role in IgA response
      in the mucosal immune system. We investigated the induction of IgA producing
      cells in Peyer's patches by plaque forming cell assay after oral administration
      of a traditional Chinese herbal medicine, Xiao-chai-hu-tang (Japanese name:
      Shosaiko-to). The number of total IgA producing cells in the Peyer's patches
      detected by the protein-A plaque assay was increased about two-fold by Shosaiko
      to administration and the numbers of both anti-SRBC and anti-HRBC IgA producing
      cells were also increased by such a treatment. On the other hand, when SRBC alone
      were administered orally, only the number of anti-SRBC IgA producing cells was
      increased. Further, we examined T-cell subpopulations in the gut-associated
      lymphoid tissues after oral administration of Shosaiko-to by flowcytometry.
      Marked alternations in T cell subpopulations were not detected in the Peyer's
      patches, though TcR gamma delta+T-cells in the intraepithelial lymphocytes and
      Thy1.2-TcR alpha beta+T cells in the mesenteric lymph nodes were slight
      increased. These results showed that orally administered Shosaiko-to acts as a
      polyclonal B-cell activator which induces IgA production in the mucosal immune
      system.

PMID- 8349954
TI  - Influence of arecoline on immune system: III. Suppression of B cell-mediated
      immune response in mice after short-term exposure.
AB  - Arecoline, a major alkaloid of arecanut was examined to explore its modulatory
      influence on B cell-mediated immune response in a murine model system. The in
      vivo and in vitro effects were evaluated at sub-toxic concentrations of
      arecoline. The number of primary antibody forming cells (AFC) and
      hemagglutinating and hemolysis antibody titers to Sheep Red Blood Cells (SRBC)
      were evaluated in male mice. Arecoline exposure for a week invoked dose-dependent
      effect on primary antibody forming cells to SRBC with a maximum reduction at the
      dosage of 20 mg/kg bw, a moderate reduction at 10 mg/kg bw and no effect at 5
      mg/kg bw dose level. HA and HL antibody titers to SRBC were suppressed markedly
      at arecoline dosage of 20 mg/kg bw and moderately at a dose of 10 mg/kg bw, given
      daily for 1, 2 or 3 weeks. The inhibitory effect of arecoline was not dependent
      on the duration of treatment. Like the primary antibody response, the secondary
      HA and HL antibody titers were also decreased after arecoline exposure. The
      administration of arecoline dosages 10 and 20 mg/kg bw daily for 4 days following
      SRBC immunization also, exerted dose-dependent suppression of primary antibody
      response. Similarly, when treated after 12 h following immunization, significant
      reduction in response was observed with arecoline dosage of 20 mg/kg bw. While
      moderate suppression of antibody response was noticed at the dose level of 10
      mg/kg bw, there was no alteration in response at a dosage of 5 mg/kg bw.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8349953
TI  - Immunotoxic effects of mercuric compounds on human lymphocytes and monocytes. IV.
      Alterations in cellular glutathione content.
AB  - The major goal of this investigation was to determine if the sensitivity of
      lymphocytes and monocytes to mercury (Hg++) was related to intracellular
      glutathione (GSH) levels and the thiol redox status [GSH/glutathione disulfide
      (GSSG)]. To isolate cells based upon their GSH content, T and B-cells were
      stained with monochlorobimane (MCB) and separated into high and low fluorescent
      groups by FACS analysis. Cells with high GSH fluorescence were found to be
      resistant to both the cytotoxic and immunotoxic effects of HgCl2 as evidenced by
      cell viability and their responsiveness to mitogen, respectively. In contrast,
      cells with low levels of GSH were extremely sensitive to mercury. To further
      examine the relationship between GSH level and mercury exposure, T-cells, B-cells
      and monocytes were treated with different doses of HgCl2 for 12 hrs. All cells
      exhibited a dose-dependent decrease in GSH content with a concomitant reduction
      in GSSG levels. However, the GSH/GSSG ratio in these cells remained constant, or
      increased following exposure to mercury. GSH levels were also reduced in
      monocytes following exposure to HgCl2; in this case, GSSG levels remained
      constant and a decline in the GSH/GSSG ratio was observed. For all cell types,
      mercury did not inhibit the activities of GSH reductase and GSH peroxidase,
      enzymes responsible for oxidation/reduction of GSH and GSSG, respectively.
      Results of the study clearly show that susceptibility to the immunotoxic effects
      of HgCl2 is, in part, dependent upon GSH levels and further that mercury inhibits
      GSH generation by lymphocytes and monocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8349956
TI  - Meetings on endocrinology at Pisa, 28-29 June 1993. Abstracts.

PMID- 8349955
TI  - Triazolobenzodiazepines exert immunopotentiating activities on normal human
      peripheral blood lymphocytes.
AB  - Previous studies have demonstrated that benzodiazepines (BDZ) (e.g. diazepam)
      inhibit immune responsiveness. Since these drugs are largely used in psychiatric
      patients it is of great importance to verify the existence of different types of
      BDZ, which are not suppressive for the immune system. In this framework, our
      results indicate that alprazolam and triazolam, two triazolo-BDZ, do not modify
      in vitro phagocytosis and killing exerted by normal human polimorphonuclear cells
      and monocytes. On the contrary, they significantly enhance T lymphocyte-dependent
      antibacterial activity in normal donors. These data support the concept that
      triazolo-BDZ and, in particular, alprazolam may represent more appropriate drugs
      for the treatment of psychiatric patients (e.g. patients with phobic disorders
      and/or migraine) who display immunodeficits.

PMID- 8349957
TI  - 21st annual meeting of the European Thyroid Association. Cardiff, Wales, U.K.,
      July 4-9, 1993. Abstracts.

PMID- 8349958
TI  - Hand surgery and the medical liability issue.

PMID- 8349960
TI  - Dislocation of the distal phalanx epiphysis in toddlers.
AB  - Two cases of physeal fracture dislocation of the distal phalanx are reviewed.
      Each injury occurred in a toddler, was originally undiagnosed, and appeared years
      later as a dorsal mass in a fore-shortened digit with decreased distal
      interphalangeal joint motion. In each case x-ray films revealed a dislocated
      epiphysis, accounting for the enlarging dorsal prominence and the phalangeal
      growth disturbance. These cases demonstrate that dislocation of the distal
      phalanx epiphysis can occur with a crush injury and may be difficult to detect
      before development of the ossification center. Careful physical examination and a
      high index of suspicion will increase the likelihood of early diagnosis. Early
      open reduction may prevent the late complications of deformity and stiffness.

PMID- 8349959
TI  - Niebauer trapeziometacarpal arthroplasty: a long-term follow-up.
AB  - A retrospective review of long-term follow-up of Niebauer trapeziometacarpal
      arthroplasty for treatment of disabling arthritis of the basal joint was
      performed. Thirty implants in 27 patients were reviewed, with an average follow
      up of 9 years (minimum, 4 years). All surgical procedures were performed by the
      senior author. Eighty-eight percent of the patients were subjectively pleased and
      would undergo the procedure again. Postoperative subluxation occurred in 83% of
      the patients. This was not painful unless the prosthesis dislocated. Subluxation
      increased with time. One case of silicone synovitis necessitated implant removal;
      however, this was also after removal of a previous Eaton prosthesis. In the light
      of our results, we believe that the Niebauer trapeziometacarpal arthroplasty is a
      worthwhile procedure with a rare incidence of particulate synovitis. In 24 of 27
      patients, pain was relieved and satisfactory motion and stability were achieved.

PMID- 8349961
TI  - Bilateral os centrale carpi: a rare congenital variant.

PMID- 8349962
TI  - Magnetic resonance imaging to visualize the internal anatomy in the Baller-Gerold
      syndrome.
AB  - The Baller-Gerold syndrome is identified by radial aplasia with craniosynostosis.
      Only 12 cases have been reported previously in the literature; none of the
      reports describe surgical treatment for the radial aplasia. We report the case of
      a 10-month-old female infant with this syndrome, including severe bilateral
      radial clubhands. A radial anlage, which was tethering growth of the ulna, was
      suspected on physical examination and confirmed with magnetic resonance imaging.
      Resection of the anlage resulted in dramatic improvement in elbow extension, but
      additional follow-up will be necessary to determine the complete functional
      effect of the procedure.

PMID- 8349963
TI  - Acute calcific tendinitis in a child: a case report.

PMID- 8349964
TI  - Distal unicondylar fractures of the proximal phalanx.
AB  - The records of 38 consecutive patients (38 fractures) who underwent treatment for
      distal unicondylar fractures of the proximal phalanx were reviewed to evaluate
      fracture characteristics, mechanism of injury, treatment options, and functional
      outcomes. Four classes of fracture pattern were defined radiographically. Most
      fractures occurred during ball sports and involved an axial splitting of extended
      digits, with the condyle closet to the midline of the hand fracturing most
      commonly. We believed that the fracture occurred as a result of tension loading
      due to a distraction force from the collateral ligament. All fractures healed.
      Follow-up examination averaged 3 years. Five of seven nondisplaced fractures
      treated with splinting and four of ten displaced fractures treated with reduction
      and single Kirschner wire fixation displaced. Fractures treated with multiple
      Kirschner wire fixation had the best final joint motion. Class IV fractures with
      a small palmar coronal fragment had the poorest final motion. A short period of
      post-operative immobilization did not adversely affect final proximal
      interphalangeal joint motion. We recommend multiple Kirschner wire or miniscrew
      fixation of these fractures as the most predictable method of treatment. Final
      proximal interphalangeal joint motion is not uniformly excellent in patients with
      these fractures.

PMID- 8349965
TI  - Biomechanical analysis of mallet finger fracture fixation techniques.
AB  - A biomechanical study was conducted to determine the best fixation technique for
      mallet finger fracture among four commonly used methods. Considerations were
      technical complications, biomechanical properties, and maintenance of reduction.
      Techniques tested included Kirshner wire, figure-of-eight wire, tension band
      wire, and tension band suture. Technical complications were frequent with both
      the Kirschner wire and tension band wire techniques. Biomechanical testing
      yielded significantly greater energy absorbed to failure and a trend toward
      greater peak loads to failure for both the figure-of-eight wire and tension band
      suture techniques. Irreversible loss of reduction during testing occurred in all
      of the Kirschner wire-fixed fractures, in 60% of the tension band wire-fixed
      fractures, and in 50% of the figure-of-eight wire-fixed fractures. No
      irreversible failure occurred in the tension band suture group.

PMID- 8349966
TI  - Primary non-Hodgkin's lymphoma presenting in the upper extremity: a case report.

PMID- 8349967
TI  - Treatment and prevention of "hook nail" deformity with anatomic correlation.
AB  - The hook nail deformity is a relatively common complication after fingertip
      amputation. It can be corrected or prevented with a carefully performed surgical
      procedure. The nail plate is removed. The redundant nail bed that is folded over
      the tip of the terminal phalanx is carefully removed with an additional 2 mm that
      is supported by the terminal phalanx so that wound healing will not draw the nail
      bed over the tip of the phalanx again. The fingertip is then resurfaced by a V-Y
      advancement flap, with precautions taken to avoid all tension in the flap.

PMID- 8349968
TI  - Color flow Doppler: imaging the upper extremity.
AB  - Dynamic values of key vessel diameter, blood velocity, and flow rate in the upper
      extremity were obtained in 20 healthy volunteers by means of color flow Doppler
      imaging with a 7.5 MHz transducer. Recordings were made of the brachial, radial,
      posterior radial recurrent, ulnar, and digital arteries. Radial and ulnar vessels
      were evaluated at both wrist and midcarpal levels. Diameter and velocity changes
      were followed throughout the cardiac cycle, and a true mean flow was computed.
      Mean diameters of the digital vessels ranged from 0.9 mm in the small finger to
      1.3 mm in the thumb. Brachial flows ranged from 4.6 to 89.9 ml/min, radial flows
      from 0.9 to 15.3 ml/min, and ulnar flows from 0.6 to 79.9 ml/min. At the
      midcarpal level, flows ranged from 0.2 to 68.4 ml/min for the ulnar artery and
      from 0.8 to 42.9 ml/min for the radial artery. Variability between individuals
      was also demonstrated in artery dominance: eleven ulnar dominant, seven radial
      dominant, and two equal (within 25% of each other). The accuracy and ease of use
      of this technique in measurement of vessels are limited when vessels are less
      than 1.5 mm in diameter although the technique provides quantitative values to
      0.5 mm.

PMID- 8349969
TI  - Radial and ulnar artery repairs: assessing patency rates with color Doppler
      ultrasonographic imaging.
AB  - This study was undertaken to evaluate the patency rate of radial and ulnar artery
      repairs performed with use of the magnification afforded by the operative
      microscope. Color Doppler ultrasonographic imaging was chosen as a reproducible,
      noninvasive technique to evaluate patency and graphically display vascular flow
      characteristics. Twenty-eight consecutive patients with 35 arterial injuries form
      the study group. Twenty-four patients with 31 arterial lacerations were available
      for enrollment in the protocol. Follow-up ranged from 1 to 40 months (average, 10
      months). Eighteen male and six female patients sustained 13 radial and 18 ulnar
      artery lacerations, all sharp. Four patients required interposition vein
      grafting. Overall patency after repair was found to be 84%, with 82% of single
      vessels and 86% of double vessels patent. The patency of single vessels repaired
      without the use of vein grafts was 100%. These results indicate that microscope
      assisted repairs of the radial and ulnar arteries remain patent at a higher rate
      than is commonly cited.

PMID- 8349970
TI  - Ex vivo perfusion with anticoagulated blood decreases ischemia/reperfusion
      injury.
AB  - Rat muscle flaps (cutaneous maximus) were subjected to 4 hours of room
      temperature ischemia followed by 44 hours of cold (4 degrees C) ischemia before
      transplantation. Experimental flaps underwent a 15-minute ex vivo perfusion with
      heparinized-citrated blood between the warm and cold ischemic treatments; control
      flaps were not perfused. After 1 or 48 hours of recirculation, muscle
      dehydrogenase activity was found to be higher in the perfused flaps, indicating
      better muscle viability. Lipid peroxidation was lower in the perfused flaps,
      indicating a reduction in free radical generation. Histologic assessment revealed
      that perfused flaps underwent less injury than unperfused flaps. The findings of
      this study indicate that replacement of standing blood with anticoagulated blood,
      with the use of a brief ex vivo perfusion protocol, has a significant protective
      effect against ischemic injury. The experimental design mimics a realistic point
      of intervention and presents a paradigm for the clinical treatment of amputated
      extremities.

PMID- 8349971
TI  - Evaluation of sympathetic control of digital blood flow.
AB  - A noninvasive strain-gauge method of measuring blood flow in the digit was used
      to assess the influence of the sympathetic system in the digit. The sympathetic
      system was stimulated by the sudden application of ice to the neck, thus avoiding
      in the hand local reflexes and responses to cold. Seventeen normal subjects
      responded in similar fashion. Maximum flow reduction ranged from 26% to 92%, with
      a mean of 61%. This method should be useful diagnostically and for research when
      sympathetic reactivity, in contrast to basal sympathetic tone, needs to be
      determined.

PMID- 8349972
TI  - Sonographic evaluation of pseudoaneurysm of a digital artery: a case report.

PMID- 8349973
TI  - The functional significance of the long extensors and juncturae tendinum in
      finger extension.
AB  - To determine the role of the long extensors and soft tissues in the extension and
      interaction of the fingers, we applied traction to the extensors and measured the
      angles of the finger joints. The tendons, juncturae tendinum and intertendinous
      fascia, and the web between the fingers were sequentially sectioned, and the
      effects on the joints were again determined with tendon traction. Traction
      produced hyperextension of the metacarpophalangeal joints and some extension of
      the interphalangeal joints, although the latter remained partially flexed,
      producing a clawhand. Cutting the long extensor tendons had no effect on the
      interaction between adjacent fingers. Traction on the extensor digitorum communis
      to the index and the extensor indicis proprius produced the same extension of
      index finger joints and adjacent digits. Traction on the extensor digitorum
      communis to the index produced 32% of the maximal extension of the long finger MP
      joint. We reduced this to 22% by cutting the juncturae and intertendinous fascia
      and to 5% by cutting the web. The interaction between fingers was greater on the
      ulnar half of the hand because of the juncturae but was similarly reduced by
      ablative cuts of these structures.

PMID- 8349974
TI  - Extensor pollicis longus rupture at the tip of a prominent fixation screw: report
      of three cases.
AB  - Rupture of the extensor pollicis longus tendon at the tip of a prominent fixation
      screw occurred in two cases after fixation of fractures of the radial shaft and
      in one case after fixation of a fracture of the scaphoid. Patients were referred
      because of their inability to extend the thumb. Active thumb extension was
      restored in two patients by screw removal and tendon transfer. The third patient
      elected nonoperative care. Close scrutiny of good-quality intraoperative x-ray
      films after internal fixation about the wrist may detect screws that are too
      prominent and thereby prevent rupture of the extensor pollicis longus tendon.

PMID- 8349975
TI  - Factors affecting results after flexor tendon repair in zone II: a multivariate
      prospective analysis.
AB  - A stepwise multiple regression procedure was used to examine the influence of 12
      to 13 independent variables on five outcome variables, 1 year after flexor tendon
      repair in zone II, in a consecutive series of 135 patients treated with early
      controlled motion. Of the included variables, controlled interphalangeal joint
      range of motion 3 weeks postoperatively was the single most influential factor
      with regard to final active interphalangeal joint range of motion. Together with
      age, swelling, the number of digits, and the number of tendons injured, it
      accounted for 18% to 19% of the total variance in active range of motion; 14% to
      15% of the variance in extension deficits and 41% of the variance in grip
      strength could be accounted for by variables included in the study. A large part
      of the variance in all the outcome variables was probably related to the
      psychological and biologic characteristics of the patient.

PMID- 8349976
TI  - Osteoblastoma of the scaphoid: a case report.

PMID- 8349977
TI  - Intraosseous ganglion of carpal scaphoid: a case report.

PMID- 8349978
TI  - Acute carpal tunnel syndrome caused by tophaceous gout.

PMID- 8349979
TI  - The patchy configuration of scaphoid avascular necrosis.
AB  - The proximal poles of five patients with presumed avascular necrosis of the
      scaphoid, mostly the result of nonunion, were analyzed histologically for true,
      pathologically confirmed avascular necrosis of bone. Each specimen was reviewed
      both qualitatively by an experienced bone pathologist and quantitatively with the
      use of a computerized image analysis system. Avascular necrosis was found to be
      variable from one specimen to another as well as within each specimen. Midcentral
      levels showed a statistically significant greater degree of avascular necrosis
      than either adjacent palmar or dorsal zones. Both viable and nonviable areas of
      avascular bone were found in an unpredictable, irregular (patchy) distribution,
      often in direct apposition to one another. It is apparent from this study that
      random biopsy alone cannot accurately predict the histologic status of the entire
      specimen; the clinician must rely on other methods to determine scaphoid
      viability.

PMID- 8349980
TI  - Long-term follow-up of scaphoid-trapezium-trapezoid arthrodesis.
AB  - A series of 19 consecutive patients who underwent scaphoid-trapezium-trapezoid
      arthrodesis for chronic scapholunate instability or isolated arthrosis was
      reviewed. The average follow-up of 14 patients was 62 months. Eight of these 14
      patients had significant residual symptoms and/or functional limitations at
      follow-up, and 11 had complications, including radiocarpal arthrosis (six
      patients), trapeziometacarpal arthrosis (four patients), and nonunion (three
      patients). Fusion without reduction of the scaphoid to a normal orientation was
      predictive of a poor result, but normal scaphoid positioning did not preclude
      development of arthrosis. Development of a painful degenerative thumb carpal
      metacarpal joint may occur as an isolated phenomenon after scaphoid-trapezium
      trapezoid arthrodesis.

PMID- 8349981
TI  - Asymptomatic SLAC wrist: does it exist?
AB  - Twenty-five patients (30 wrists) had x-ray evidence of scapholunate advanced
      collapse. Twenty-two wrists had no pain; 12 of these were diagnosed and treated
      for carpal tunnel syndrome. Eight wrists had mild pain. All patients were
      reevaluated an average of 2 years later. At that time, 20 wrists were totally
      free of symptoms and 10 had occasional pain, especially with increased activity
      (no patients required analgesics). No patient had undergone surgical management
      for the scapholunate advanced collapse. We believe that there are some patients
      (especially older and low-demand persons) in whom x-ray evidence of arthritis and
      clinical findings do not correlate. In these circumstances surgical intervention
      for treatment of the arthritis may not be warranted.

PMID- 8349982
TI  - Biomechanical analysis of radial wedge osteotomy for the treatment of Kienbock's
      disease.
AB  - Biomechanical analysis of force transmission through the lunate was performed
      with the use of a two-dimensional mathematical model to evaluate the usefulness
      of radial wedge osteotomy, a procedure that decreases radial inclination, in the
      treatment of Kienbock's disease. The forces acting on the carpal bones were
      compared before and after radial wedge osteotomy in 29 patients with Kienbock's
      disease. The average osteotomy angle was 9.6 degrees. The total force through the
      lunocapitate joint at the midcarpal level was decreased by 23%, while the total
      force through the radiolunate and ulnolunate joints at the radioulnocarpal level
      was decreased by 10% and 36%, respectively. These changes correlated directly
      with the osteotomy angle and demonstrate decompression of the lunate by radial
      wedge osteotomy.

PMID- 8349983
TI  - Preoperative factors and outcome after lunate decompression for Kienbock's
      disease.
AB  - Preoperative factors and outcome were studied after lunate decompression for
      Kienbock's disease. Twenty-three patients treated with radial shortening or
      scaphoid-trapezium-trapezoid fusion were evaluated. The mean follow-up was 59
      months. Neither good nor excellent outcomes were found with either lunate
      preserving procedure when the preoperative radioscaphoid angle was greater than
      60 degrees. Outcomes in the radial shortening osteotomy group were superior to
      those in the group treated with scaphoid-trapezium-trapezoid fusion. Lunate
      collapse was not prevented by either treatment method. Lunate index, carpal
      height, and staging did not correlate with outcome. Measurement of radioscaphoid
      angle provides predictive information regarding the outcome of stage III
      (Decoulx/Lichtman) Kienbock's disease treated with radial shortening or scaphoid
      trapezium-trapezoid fusion.

PMID- 8349984
TI  - A modified extensor carpi ulnaris tenodesis with the Darrach procedure.
AB  - Fourteen patients with pain and limited forearm rotation were treated with a
      modified Darrach procedure involving a distally based slip of the extensor carpi
      ulnaris tendon. Seven patients had Colles' fractures, four had rheumatoid
      arthritis, and three had primary osteoarthritis of the distal radioulnar joint.
      Patients were assigned to one of two groups: rheumatoid arthritis or Colles'
      fracture/osteoarthritis. The average age was 50 years. Follow-up averaged 54
      months (range, 12 to 96 months). The average amount of ulnar resection was 10 mm
      (range, 6 to 20 mm). In the Colles' fracture/osteoarthritic group, average grip
      strength (a percentage of the uninvolved hand) improved from 26% preoperatively
      to 74% postoperatively, and in the rheumatoid arthritis group it improved from
      67% to 144%. Distal ulnar instability of the dorsal side was not observed on x
      ray examination. Patients were satisfied with pain relief, and all returned to
      their original work.

PMID- 8349985
TI  - Treatment of posttraumatic radioulnar synostosis with excision and low-dose
      radiation.
AB  - Two cases of posttraumatic radioulnar synostosis treated with excision and low
      dose radiation are presented. Routine postoperative hand therapy was employed.
      Nearly full range of motion was restored in both cases. No wound healing problems
      were encountered. We suggest that low-dose radiation may be a useful method of
      prophylaxis against recurrence after excision of radioulnar synostosis.

PMID- 8349986
TI  - Intratendinous ganglia of the hand.
AB  - We report a series of seven patients with 10 intratendinous ganglia that were
      treated operatively. One ganglion was in the abductor pollicis longus tendon. The
      rest were in tendons of the fourth extensor compartment, and all of them were
      associated with tenosynovitis. The average age of the patients at operation was
      55 years. One patient was treated by resection of the tendon with tendon
      transfer. The other patients were treated by excision of the ganglion with repair
      of the tendon or tenosynovectomy. The mean length of postoperative follow-up time
      was 6 years. One patient experienced a recurrence. Three of the six patients with
      preoperative dorsal tenosynovitis had tenosynovitis postoperatively. We speculate
      that the ganglia arose secondary to tenosynovitis. When an intratendinous
      ganglion is diagnosed, tenosynovectomy is recommended, with resection of the
      intratendinous ganglion and longitudinal tendon repair when needed.

PMID- 8349987
TI  - The influence of age and gender on radial height.
AB  - Radial height was measured on carefully standardized posteroanterior x-ray films
      of the wrist in 25 male and 25 female patients. The range of radial height (10 to
      18 mm) was the same for both male and female patients, with slightly different
      means for each sex. In females the mean was at the upper limit of the previously
      reported range, whereas in males the mean was outside the reported range. Our
      results suggest that previously published measurements underestimate radial
      height. Inasmuch as radial height may be used in planning management of distal
      radial fractures, it is important to redefine these measurements. We also believe
      that the wide range of normal makes comparison with a noninjured contralateral
      wrist essential for accurate assessment of radial shortening in each individual
      patient.

PMID- 8349988
TI  - The change in ulnar variance with grip.
AB  - The effect of grip on ulnar variance was evaluated in 66 symptom-free wrists of
      53 volunteers. Zero-rotation posteroanterior x-ray films were taken of each wrist
      before and after exertion of a grip force measured with a Jamar dynamometer. The
      volunteers were randomly divided into two groups. Group I subjects (35 wrists)
      were asked to exert a constant grip force of 11.3 kg. Group II subjects (31
      wrists) were asked to exert a maximum grip effort, which resulted in a mean grip
      force of 30 kg (range, 22.8 kg to 53.6 kg). Group I demonstrated a mean increase
      in ulnar variance of 1.27 mm and group II showed a mean increase of 1.95 mm. The
      minimum increase in ulnar variance observed was 0.25 mm. The changes observed
      were statistically significant. The results confirm that a relative increase in
      ulnar variance occurs with grip. There may be an etiologic role for daily
      activities that involve repetitive grip and forearm rotation in development of
      the ulnar impaction syndrome.

PMID- 8349989
TI  - Anatomy of the oblique retinacular ligament of the index finger.
AB  - The available literature includes conflicting descriptions of the anatomy and
      function of the oblique retinacular ligament. We have studied this ligament in
      the index finger to better define its presence, configuration, points of
      attachment, length, and relationship to the proximal interphalangeal joint axis.
      Twenty fresh frozen index fingers were dissected. Five additional specimens were
      decalcified, mounted, sectioned transversely at 1 mm intervals and studied under
      the microscope. An oblique retinacular ligament was identified on the radial side
      of the index finger in 95% and on the ulnar side in 90% of the specimens. The
      radial oblique retinacular ligament was usually longer and more developed than
      the ulnar oblique retinacular ligament. Proximally, the ligament arose from the
      middle third of the proximal phalanx and the A-2 pulley whereas, distally, it
      inserted into the lateral extensor band with a fan-shaped expansion centered 4 to
      6 mm distal to the proximal interphalangeal joint line. In 70% of the specimens,
      the oblique retinacular ligament was supplemented by a contribution from the
      proximal cruciform pulley (C-1). Histologic cross sections also confirmed the
      presence of the oblique retinacular ligament but not the supplemental
      contribution arising from the C-1 pulley. The relationship of the oblique
      retinacular ligament to the proximal interphalangeal joint axis is dependent on
      the proximal interphalangeal joint position; the ligament lies palmar to the
      proximal interphalangeal joint axis only when the proximal interphalangeal joint
      is flexed.

PMID- 8349990
TI  - Carpal Aspergillus osteomyelitis: case report and review of the literature.

PMID- 8349991
TI  - A technique for maximizing biceps recovery in brachial plexus reconstruction.
AB  - In 21 cadaver dissections the intramuscular anatomy of the musculocutaneous nerve
      and the relative relationship of the motor and sensory components of this nerve
      were evaluated. Nearly one half of the fibers entering the musculocutaneous nerve
      terminate in cutaneous receptors. We report five cases in which biceps
      reinnervation was performed by a surgical technique that minimizes the period of
      denervation by using motor nerves (medial pectoral nerves) very close to the
      biceps muscle. This technique also redirects the cutaneous portion (lateral
      antebrachial cutaneous nerve) of the musculocutaneous nerve into the biceps
      muscle to ensure that the motor fibers are not directed toward cutaneous
      receptors.

PMID- 8349992
TI  - Carpal tunnel syndrome: surgical and nonsurgical treatment.
AB  - A retrospective study was performed to evaluate treatment for carpal tunnel
      syndrome. Two hundred sixty-five patients were treated over a 4 1/2-year period.
      Only patients in whom studies showed abnormal nerve conduction (a median nerve
      sensory latency greater than 3.6 msec or a median distal motor latency greater
      than 4.3 msec) were included in the evaluation. Nonsurgical treatment consisted
      of patient education, wrist splinting, B vitamins, nonsteroidal anti-inflammatory
      medication, steroid injections, and job change or modification when possible. A
      follow-up history, physical examination, and repeat nerve conduction studies were
      performed at 3- to 9-month intervals, depending on the severity of symptoms and
      the degree of abnormal latencies. Surgery was performed on 77 patients and 95
      hands. The remaining 188 patients were treated nonsurgically. Both surgically and
      nonsurgically treated patients considered the results to be satisfactory.

PMID- 8349994
TI  - Posterior interosseous nerve: an anatomic study of potential nerve grafts.
AB  - Anatomic dissection of the posterior interosseous nerve in 26 cadaver forearms
      was performed to assess variability in location, diameter, and branching patterns
      of the nerve. The purpose of our study was to determine the anatomic reliability
      of the posterior interosseous nerve at the distal forearm level as a potential
      donor nerve graft for segmental digital nerve loss. The nerve was located in a
      separate fascicle sheath in the deep radial aspect at the fourth dorsal
      compartment in all specimens. It ranged from 1 to 5 mm in diameter with one to
      five fascicles present (15 of 26 specimens had a single fascicle). Ten additional
      specimens were dissected for assessment of potential length of nerve available
      for grafting, and this ranged from 5 to 10 cm. These nerves were believed to be
      of sufficient diameter for grafting of digital-level nerve injuries. There is
      minimal morbidity when a donor graft is obtained in the same limb as the
      recipient area, and there is no known donor deficit as a result of posterior
      interosseous nerve procurement at wrist level.

PMID- 8349993
TI  - Recurrent carpal tunnel syndrome due to tuberculoid leprosy in an Asian
      immigrant.

PMID- 8349995
TI  - Is this scapholunate joint and its ligament abnormal?
AB  - There is confusion in the literature with respect to evaluation of the
      scapholunate joint space and ligament. Because routine x-ray films of the wrist
      commonly do not profile the scapholunate joint perfectly, determination of the
      joint space width often is inaccurate. One method that invariably will allow a
      good profile of the scapholunate joint involves the use of fluoroscopically
      controlled views in different positions of the wrist. However, when abnormal
      width is suspected, in all examinations the wrist in question should be compared
      with the opposite wrist and the findings carefully correlated with clinical
      symptoms. Additional arthrographic findings, which have not been discussed in the
      literature before, are described. Midcarpal arthrography identifies and
      illustrates a variety of appearances of the scapholunate ligament. The reason for
      these different appearances and whether they are normal variations or pathologic
      findings is not known. This article is designed to stimulate further clinical and
      x-ray research to clarify normal and abnormal features of the scapholunate joint
      and ligament.

PMID- 8349996
TI  - The markings of the Semmes-Weinstein nylon monofilaments.

PMID- 8349997
TI  - Dead languages in the living hand.

PMID- 8349998
TI  - Aspirin and coronary artery diseases.

PMID- 8349999
TI  - Medical liability--international scene.

PMID- 8350000
TI  - Maternal deaths--a ten-year study.
AB  - In a 10-year retrospective study of maternal deaths at RG Kar Medical College,
      Calcutta there were 651 maternal deaths with 410 in first 5-year period and 241
      in second 5-year period. The leading causes of deaths were due to abortion,
      toxaemia, haemorrhage (antepartum and postpartum) and jaundice in pregnancy.
      Direct causes were responsible for death in 77.6% cases, indirect causes in 17.5%
      cases and unrelated causes in 4.9% cases. Majority (557) were unbooked and mostly
      multigravida (434) cases. Most of them (251) were in the age group of 20-25
      years. Haemorrhage was the single most common cause to claim 188 lives. It was
      also noted that 155 deaths occurred within 12 hours of hospital admission.

PMID- 8350001
TI  - A prospective study of closure techniques of abdominal incisions in infants and
      children.
AB  - In a prospective study of layered versus mass closure of abdominal incisions in
      infants and children, 34 cases underwent wound closure by layered and mass
      closure technique on an alternate basis. All the patients were assessed for their
      nutritional status and haemoglobin level pre-operatively, and wound complications
      were compared with respect to closure technique, nutritional status and normal
      haemoglobin level. Presence of protein energy malnutrition and anaemia did not
      increase the risk of wound complications with either of the technique.

PMID- 8350002
TI  - Interrelationship among prognostic factors in carcinoma breast.
AB  - Presentation of breast cancer at an advanced stage is a rule than exception in
      rural West Bengal. It was observed that 65.6% of fresh cases presented with
      history of breast lump with a duration of over 12 months. Of the total 32 cases,
      27 (84.4%) had breast lump of more than 5 cm size and had 4 or more
      pathologically positive axillary nodes. In 28 cases (87.5%) largest node measured
      was 2 cm or more. In histology of breast specimen, 12 (37.5%) showed high degree
      of lymph vessel invasion while 31 (96.9%) had at least some lymphatic invasion.
      Blood vessel invasion of high degree was observed in 18 cases (56.2%) while 29
      cases (90.6%) showed at least some blood vessel invasion.

PMID- 8350003
TI  - Hypertension care in general practice: an opinion survey.
AB  - An opinion survey was conducted among 60 general practitioners from different
      parts of West Bengal with 6 prefixed questions covering some practical issues of
      hypertension. Fifty-eight doctors responded. In the opinion of the majority, 160
      mm of Hg (systolic) and 90 mm of Hg (diastolic) are the cut off pressure to
      diagnose hypertension. Forty-eight per cent of the practitioners opined that a
      period of observation is necessary before antihypertensives were started. Eighty
      seven per cent of the practitioners would start their patients on
      antihypertensive drugs well before the blood pressure reached 160/104 mm of Hg.
      High diastolic pressure was thought to be dangerous by 50% doctors and both high
      systolic and diastolic pressures were thought to be dangerous by 43% doctors.
      Fifty-two per cent practitioners opined that 140/90 mm of Hg should be the target
      blood pressure after treatment. Most of them (63%) opined that antihypertensive
      treatment should be continued life long. Practitioner's opinion were analysed in
      the light of current international literatures on basic therapeutic approaches to
      hypertension with emphasis on certain issues of controversy.

PMID- 8350004
TI  - Myelodysplastic syndrome.

PMID- 8350005
TI  - Rare pelvic abdominal lump--a diagnostic dilemma.

PMID- 8350006
TI  - Extra-uterine pregnancy following uterine conception.

PMID- 8350007
TI  - Shigellosis--an overview.

PMID- 8350008
TI  - Cataract blindness--magnitude of the problem and its management in developing
      country like India.

PMID- 8350009
TI  - Elective term: should it be a requirement for undergraduate-medical education in
      India?

PMID- 8350010
TI  - Lymphangioma circumscriptum of the vulva.

PMID- 8350011
TI  - Eczema/dermatitis.

PMID- 8350012
TI  - [Reperfusion-induced arrhythmia and oxidative stress].
AB  - Although recognized and reproduced in numerous animal models, reperfusion
      arrhythmias were not studied extensively in humans until the advent of methods of
      coronary reperfusion during the acute phase of myocardial infarction. Usually of
      ventricular origin, these arrhythmias are polymorphic and constitute imperfect
      but useful markers of coronary reperfusion. Their electrophysiologic mechanisms
      are complex and their molecular mechanisms unelucidated. Predisposing conditions
      are the duration and severity of the ischemia, biochemical modifications such as
      heterogeneous uptake of extracellular potassium, magnesium deficit, intracellular
      calcium overload and release of arrhythmogenic lipid metabolites or
      prostaglandins. The autonomic nervous system also plays a part by an increase in
      the number and response of alpha-adrenoceptors. Furthermore, experimental studies
      provide theoretical and pharmacologic arguments for the participation of free
      oxygen radicals (superoxide anion (02.-, hydroxyl radical OH.) in reperfusion
      arrhythmias in the animal. By its complexity, human myocardial infarction differs
      markedly from the animal models studied; it probably involves, apart from the
      free oxygen radicals, multiple thrombotic, humoral and nervous factors whose
      respective role in the production of reperfusion arrhythmias remains to be
      established. Some enlightenment should be obtained by analysis of rhythmic events
      during proposed controlled studies using anti-free radical agents to prevent
      these post-myocardial infarct acute events.

PMID- 8350013
TI  - [Primary aorto-digestive fistulas. Four cases and review of the literature].
AB  - Four cases, three fatal and one with long term recovery, of patients treated
      surgically for primary aorto duodenal fistulas are reported. The involved lesion
      was an infrarenal aortic aneurysm. Two patients had an extra-anatomic vascular
      procedure and two patients an in situ repair. In connection with these cases, two
      hundred and fifty three primary aorto enteric fistulas were reviewed in the
      world's literature. The difficulties in the diagnosis and treatment are pointed
      out. Emergency operation should be performed in all cases of gastrointestinal
      bleeding associated with an abdominal aneurysm. The best diagnostic approach is
      CT scan combined to gastro-duodenoscopy. Overall mortality in our review of the
      literature was seventy one per cent. Closure of the enteric component should be
      performed with lateral repair. Management of the aortic component remains
      controversial: closure of the aorta and axillo-bi femoral by pass or in situ
      repair. The operative mortality in our review of the literature was thirty seven
      per cent. Interposition of viable tissue is necessary according to the risk of
      recurrent infection and bleeding with consequent death (twelve per cent). So,
      long term control is of paramount importance.

PMID- 8350014
TI  - [In vitro effects of ionic and non-ionic contrast media on erythrocyte
      aggregation].
AB  - An in vitro model was designed to examine the effect of three contrast media
      (CM): two non ionic (Iohexol, Iopamidol) and one ionic (Ioxaglate) molecules on
      erythrocyte aggregation. Red blood cells were suspended in a chemically defined
      medium (Albumin: 10 g/l), Immunoglobulins: 12 g/l, Fibrinogen: 1.5 g/l)
      supplemented with various proportions of CM (10-25% V/V). Control samples
      contained NaCl or Saccharose solutions with a nearly similar osmolality.
      Erythrocyte aggregation at constant hematocrit (HT = 40%) was determined by the
      analysis of the light backscattered by blood suspension during the aggregation
      process. As compared to control samples, non ionic CM induced a weak decrease in
      erythrocyte aggregation, when the ionic molecule caused a marked increase in the
      aggregation, which was related to CM concentration. A different interaction of
      ionic and non ionic CM with erythrocyte membranes has been shown by fluorescence
      studies. After addition of CM, it was noted a fluorescence quenching of
      lipophilic probes (TMA-DPH and DPH) embedded in erythrocyte membranes. This
      quenching probably due to benzene ring and iodine atoms of contrast media
      markedly varied according to the used fluorescent probe and the CM. In the
      presence of ionic CM, the fluorescence quenching is more important than that
      induced by non ionic CM. Thus, besides osmolality and viscosity of CM which play
      a role in erythrocyte aggregation, some intrinsic properties of CM such as the
      ionic or non ionic nature could influence erythrocyte membrane-contrast medium
      interactions and consequently erythrocyte aggregation.

PMID- 8350015
TI  - [Arterial thrombosis of the arm and hemorrhagic rectocolitis. Report of a case].
AB  - Several cases of arterial thrombosis associated with inflammatory enterocolitis
      affections have been reported. In all but one case reported in the literature the
      outcome was favorable. A 40 year old woman developed thrombosis of the radial and
      ulnar arteries during an acute episode of ulcerative colitis. The course of the
      thrombotic lesions was irreversible and all fingers of the right hand had to be
      amputated. The corticotherapy as a possible predisposing factor for these
      thromboses is discussed, but their onset during an inflammatory episode suggests
      a role for the inflammatory enterocolitis. A thrombocytosis (807,000
      platelets/mm3) could have predisposed to their onset, and in this case the
      hemostatic disturbances and fibrinolysis associated with the ulcerative colitis
      could have played a major role.

PMID- 8350017
TI  - [Pulsatile vaginal expansion: Case report of an internal iliac aneurysm detected
      after an injury].
AB  - After a pelvic trauma, in a 78 years old women, systematic radiograms showed a
      polycyclic mass in the left side of the pelvis. This finding was confirmed by B
      mode ultrasound echography. The vaginal touch found a pulsatile and expanding
      mass. At surgery, the diagnosis of a fissuring aneurysm of the internal iliac
      artery was confirmed, and a curative treatment was undertaken. Reviewing the
      literature, the authors emphasize the diagnostic usefulness of rectal and vaginal
      touch, and the importance of an early diagnosis using noninvasive imaging
      techniques. Surgery is the only treatment for isolated internal iliac aneurysms.

PMID- 8350016
TI  - [Ehlers-Danlos syndrome type IV, revealed by a primary dissecting aneurysm of the
      left subclavian artery].
AB  - The authors report an unusual dissecting aneurysm of the left subclavian artery
      occurring in a patient suffering from the Ehlers-Danlos syndrome. Clinical
      history and skin biopsy permitted this diagnosis. Surgical treatment associated
      resection of the aneurysm, ligation of the proximal part of the subclavian artery
      and a prosthetic bypass between carotid and subclavian artery. Spontaneous
      dissecting aneurysm is a rare disease and one must think before surgery to
      arterial dysplasia. Technical features of the surgical treatment are discussed.

PMID- 8350018
TI  - [Presentation of a clinical hemoviscosimeter].
AB  - A clinical hemoviscosiSImeter is presented. It is a Couette type viscometer which
      is automatic and driven by a microcomputer. It was designed and realized in the
      laboratory. The measurement of blood viscosity requires 1 ml of anticoagulated
      blood adjusted at 45% of hematocrit. Experiments are performed at a constant
      temperature (37 degrees C) according to a well-established protocol: gentle
      mixing of the blood sample followed by a 3 minute rest just before each of the
      following measurement modes begins. Under steady state flow conditions, 12
      viscosity measurements are realized in a range of shear stress rate step of 1 s-1
      is applied. The elastothixotropic response of the blood sample is then obtained.
      Such a hemorheological test, called "hemorheogram", requires 15 minutes. Given to
      the clinician, the hemorheogram results include the absolute blood viscosities at
      the shear stress rates of 0.1 s-1, 1 s-1, 10 s-1, 70 s-1, the thixotropy index
      and the plasma viscosity. Finally, results to be kept in the laboratory files
      consist of the whole data issued from the patient hemorheogram including the
      relative blood viscosities (blood viscosity/plasma viscosity) at the same shear
      strers rate values.

PMID- 8350019
TI  - [Medical editing].

PMID- 8350020
TI  - [Evaluation of the risk of restenosis after peripheral angioplasty: critical
      reflections].

PMID- 8350021
TI  - [Silent myocardial ischemia].
AB  - The frequency of silent myocardial ischemia (SMI) is 2 to 5% in an asymptomatic
      population, 25 to 30% after a myocardial infarction and 40% in stable angina.
      Although the prognosis of coronary insufficiency is related to the number of
      stenosed vessels and to left ventricular function, the presence of a silent
      ischemia constitutes an additive risk factor. The beneficial effect bypass
      surgery in terms of survival has been demonstrated in high risk patients (main
      coronary artery stenosis, three branch lesions with left ventricular
      insufficiency), while in the absence of symptoms those of medical treatment, and
      coronary angioplasty, have still to be demonstrated.

PMID- 8350022
TI  - Freeze-fracture studies on the cross-bridge angle distribution at various states
      and the thin filament stiffness in single skinned frog muscle fibers.
AB  - To give information about the changes of cross-bridge (myosin head) orientation
      during muscle contraction, mechanically skinned frog muscle fibers were rapidly
      frozen at various states, and the cross-bridges were observed on freeze-etch
      replicas. The number of cross-bridges per unit length of thick filament in
      relaxed state was less than one-third of that in contracting and rigor states.
      The interval between adjacent cross-bridges was maximum around 35 nm, a value
      close to the crossover repeat of actin helix. The cross-bridge angle
      distribution, as measured with a digital image processor, showed a peak around 90
      degrees in all the states examined. The proportion of cross-bridges with angles
      around 90 degrees decreased either after stretch or after release of fibers in
      rigor state. The axial spacing of actin monomers in the thin filament was found
      to increase with increasing rigor force, to give the thin filament stiffness
      (times unit length) of about 1.8 x 10(4) pN. These results are discussed in
      connection with the mechanical properties of cross-bridges.

PMID- 8350023
TI  - Morphometric studies on the juxta-insular and tele-insular acinar cells of the
      pancreas in normal and streptozotocin-induced diabetic rats.
AB  - In the present study on the exocrine pancreas, stereological techniques were
      applied at the level of electron microscopy to confirm morphological differences
      between juxta-insular and tele-insular acinar cells of normal rats and to
      evaluate the effect of B cell secretion on these differences in streptozotocin
      diabetic rats. As no similar data have been previously published, we conducted a
      systematic sampling analysis with special reference to the acinar cell volume,
      the granule content and the nuclear size. In the normal rats, the juxta-insular
      acinar cell had an average volume of 918 microns3 and contained 420 zymogen
      granules which occupied 10.2% of the cell. In tele-insular acini, the average
      cell volume was estimated at 755 microns3 and the cell contained 231 zymogen
      granules which amounted to 6.8% of the cell. The juxta-insular acinar cell was
      18% larger in size and contained 45% more zymogen granules, but no difference was
      observed in the size of zymogen granules. In addition, the numerical density of
      cell nuclei was slightly larger in the tele-insular acini in spite of the
      similarity in the volume density and diameter of the nuclei in the cells of the
      two areas. In the streptozotocin-induced diabetic rats, no differences were
      observed in the cell volume and the zymogen granule content between the juxta-
      and tele-insular acini. These data suggest that the morphological inhomogeneity
      in the pancreatic acini is caused by the influence of B cell secretion on the
      activity of the juxta-insular acini.

PMID- 8350024
TI  - Institutes of public health and medical schools: grasping defeat from the jaws of
      victory?

PMID- 8350025
TI  - Assessing the scientific quality of review articles.

PMID- 8350026
TI  - Coffee and tea consumption and the prevalence of coronary heart disease in men
      and women: results from the Scottish Heart Health Study.
AB  - STUDY OBJECTIVES: The aim was to determine if there was a relationship between
      coffee or tea consumption and the prevalence of coronary heart disease in
      Scotland. DESIGN: The relationship between self reported coffee and tea
      consumption and the prevalence of coronary heart disease (history, symptoms, or
      electrocardiographic evidence) was investigated using multiple logistic
      regression analysis in the Scottish Heart Health Study (SHHS), a cross sectional
      study. SETTING: Twenty two Scottish districts were surveyed for the SHHS between
      1984 and 1986. SUBJECTS: A total of 10,359 men and women aged 40-59 years were
      studied. MEASUREMENTS AND MAIN RESULTS: Of the 9740 subjects who were assigned a
      category, 21.8% (2122) were classified as having indications of coronary heart
      disease. Men and women were combined in the odds ratio analysis because they
      showed almost identical patterns in the prevalence of coronary heart disease
      across the coffee and tea quarters (grouped according to consumption). Those who
      did not drink coffee had a significantly higher (p < 0.05) prevalence of coronary
      heart disease than the three groups for coffee drinkers. Adjustments for risk
      factors including cigarette smoking, total blood cholesterol, and diastolic blood
      pressure did not remove the significance of the odds ratios. There was a positive
      dose-response effect between tea consumption and coronary heart disease which was
      removed after adjustment for various risk factors. CONCLUSIONS: These findings do
      not support a positive relationship between coffee or tea consumption and
      coronary heart disease in this British study where most coffee consumed is
      instant coffee.

PMID- 8350027
TI  - Impact of social network on cardiovascular mortality in middle aged Danish men.
AB  - STUDY OBJECTIVE: To estimate quantitatively (the aetiological fraction) the
      impact of poor social network on premature death from cardiovascular disease in
      middle aged, white men. DESIGN: The causality of the relationship has already
      been discussed in a large review, and it is assumed to be well documented. The
      numerical estimation of the impact was based on a review of all published cohort
      studies on the relationship between social network and mortality in white, middle
      aged men. RESULTS: The studies reviewed are all of high epidemiological quality
      and present a consistent and stable dose-response pattern. The aetiological
      fraction was estimated to be 30%, with a plausible range of 20-40%. CONCLUSIONS:
      Social network was an important, independent, risk factor for cardiovascular
      disease in white, middle aged men. It had a strong impact on mortality,
      comparable to that of traditional risk factors. Social network should have a more
      central role in future epidemiological research into cardiovascular disease. The
      factors that result in a strong social network should be identified and
      strategies applicable in preventive work should be developed.

PMID- 8350028
TI  - Negative social events, stress, and health in Hong Kong.
AB  - STUDY OBJECTIVE: To investigate the association, if any, between negative social
      events and physical illness. DESIGN: Comparison of major social events and
      indices of disease. SETTING-Hong Kong, 1962 to 1985. SUBJECTS: Patients treated
      in hospital for attempted suicide, coronary heart disease, and diabetes mellitus.
      MEASUREMENTS AND MAIN RESULTS: Major events were selected from the annual Hong
      Kong Year Book, and grouped in one of 18 categories by a panel of 10 assessors.
      Weights were assigned to each category according the likely stress produced.
      Individual events were then scored and multiplied by the category weights to
      produce an overall stress score from which a total stress score for each year was
      derived. Annual stress scores were then compared with hospital attendance rates
      for the three medical conditions. CONCLUSIONS: The study has shown that: (1) the
      stress induced in the community by major negative social events in Hong Kong had
      been increasing; and (2) this stress is associated with attempted suicide but not
      with diabetes mellitus or coronary heart disease.

PMID- 8350029
TI  - Time trends in mortality in forestry and construction workers in Finland 1970-85
      and impact of adjustment for socioeconomic variables.
AB  - STUDY OBJECTIVE: This study aimed firstly to describe the development of cause
      specific mortality in forestry workers, farmer/forestry workers, and skilled and
      semiskilled construction workers between 1970 and 1985 in Finland, and to compare
      this with mortality in the total working male population. The second aim was to
      evaluate how well the cause-specific mortality differences between the
      occupations could be explained by differences in socioeconomic status, marital
      status, or in the region of residence. DESIGN AND SETTING: This is a follow up
      study based on the 1970, 1975, and 1980 census records in Finland linked with all
      death certificates for 1971-75, 1976-80, and 1981-85 respectively. Log-linear
      regression analysis was used. SUBJECTS: All economically active men in Finland
      aged between 35 and 64 years in 1971-85 were studied. The number of person-years
      in the period totals about 10 million. MAIN RESULTS: Semiskilled construction
      workers had the highest mortality rate almost independent of the cause of death.
      The mortality of forestry workers was the second highest. Compared with the
      reference population, however, the differences were small with regard to
      neoplasms and cardiovascular diseases. With regard to other diseases, only the
      mortality of semiskilled workers was fairly high. Differences in mortality as a
      result of accidents were the highest. Both suicide and accidental death rates
      were high in semi-skilled construction workers and forestry workers. During the
      study total mortality fell by about 30% but mortality differences between groups
      did not decline. CONCLUSIONS: The high mortality of forestry and semiskilled
      construction workers is partly explained by socioeconomic factors such as marital
      status and housing conditions. These factors do not, however, explain the high
      suicide and accident mortality rates of forestry workers or semiskilled
      construction workers. More research is needed to explain these findings.

PMID- 8350030
TI  - High mortality in lower salaried Norwegian men: the healthy worker effect?
AB  - STUDY OBJECTIVE: This study aimed to examine whether the high mortality in lower
      salaried men in Norway was related to an inflow into this group of unskilled
      workers with high mortality. DESIGN: Individual information on occupation was
      derived from the 1970 and the 1980 censuses and linked to mortality data for the
      period 1980-5 by the official, individual identification numbers. PARTICIPANTS:
      The study population included Norwegian men aged 20-64 years in 1980. All men
      enumerated in the 1980 census (and who were registered in the 1970 census) within
      the two occupational groups, unskilled workers and lower salaried employees, were
      included. MEASUREMENTS AND MAIN RESULTS: The subjects were allocated to the two
      occupational groups according to the official Norwegian classification of
      socioeconomic status. Mortality was measured by standardised mortality ratios
      (SMR). The findings suggest that a fairly large number of unskilled workers with
      high mortality move into the lower salaried employee group. This transition
      produces a higher SMR in lower salaried employees and, simultaneously, an
      artificially but modestly lower SMR in unskilled workers. The difference in SMR
      between the two groups is thereby exaggerated by 44%. The difference among the
      elderly was smaller. CONCLUSION: Occupational mobility consistent with "the
      healthy worker effect" increases the SMR of lower salaried men and, at the same
      time, reduces slightly the SMR of unskilled workers.

PMID- 8350031
TI  - Trends in body mass index and prevalence of obesity in Swedish women 1980-89.
AB  - STUDY OBJECTIVE: To assess changes in the body mass index (BMI, weight
      (kg)/height2 (m2)) and in the prevalence of obesity in Swedish women during the
      1980s. DESIGN: Data from two successive cross sectional surveys were used.
      SETTING: The whole of Sweden. SUBJECTS: A total of 7419 women from a 1980-81
      survey (response rate 84.6%) and 6306 women from a 1988-89 survey (response rate
      80.3%), aged 16-84 years, and forming a representative sample of Swedish women.
      MEASUREMENTS AND MAIN RESULTS: The results were based on self reported weight and
      height during interview. The mean BMI of the whole population, adjusted for age,
      education level, socioeconomic group, region, and nationality, increased by 0.17
      kg/m2 (p = 0.0056) over the eight year period. The increase was particularly
      pronounced in the group aged 25-34 years (0.74 kg/m2; p < 0.0001, which
      corresponds to more than 2 kg for a woman 168 cm tall). The higher mean BMI was
      also reflected in the relative increase in the prevalence of obesity (BMI > 28.6
      kg/m2) by 19% (odds ratio (OR) = 1.19; 95% confidence interval (CI): 1.04, 1.37)
      and of the combination of overweight and obesity (BMI > 23.8 kg/m2) by 12% (OR =
      1.12; 95% CI 1.03, 1.23) in the whole female population. CONCLUSIONS: During the
      1980s the mean BMI and the prevalence of overweight and obesity in adult Swedish
      women increased. An influence of the sociocultural environment on the body weight
      in women was stronger than that in men.

PMID- 8350033
TI  - Evidence for longevity differences between left handed and right handed men: an
      archival study of cricketers.
AB  - STUDY OBJECTIVE: The aim was to examine the relationship between handedness and
      longevity. DESIGN: This was an archival (retrospective) survey of a cohort of
      adult men who had played 'first-class cricket'. SETTING: The United Kingdom
      PARTICIPANTS: The subjects consisted of all of the deceased players included in
      an encyclopedia of 'first-class cricket' whose bowling hand had been recorded (n
      = 3165). The study also considered a further 2314 players, born before 1951 but
      still alive at the time the book was published (1984). MEASUREMENTS AND MAIN
      RESULTS: Using the bowling hand as an indicator of handedness it was possible to
      compare the lifespans of 2580 right handed men and 585 left handed men. The
      average life spans of the two groups differed by 25 months (right = 65.62, left =
      63.52), a highly significant difference (p = 0.006). An examination of cause of
      death (where noted) strongly indicated that the left handed men were more likely
      to die prematurely in accidents or in warfare. As a consequence, when these
      unnatural deaths were removed from the sample the longevity difference between
      the right handers and left handers was considerably reduced. There was no
      evidence that these results related to any longitudinal change in the proportion
      of right handers to left handers across the time course of the sample.
      CONCLUSION: The study found clear evidence that left handedness was associated
      with a decrease in longevity among a cohort of adult, athletic men. A major
      factor responsible for this result seemed to be a differential likelihood of
      accidental death or death during warfare.

PMID- 8350032
TI  - Magnitude and causes of mortality differences between married and unmarried men.
AB  - STUDY OBJECTIVE: To determine the effect of marital status on mortality for men.
      In particular, to examine whether subgroups of unmarried men (widowed, single,
      and divorced/separated men) have a similar mortality to married men. DESIGN:
      Cohort study. SETTING: Whitehall civil service, London, between 1967 and 1969.
      PARTICIPANTS: A total of 18,403 men aged 40-64 years with 18 years' follow up.
      MEASUREMENTS AND MAIN RESULTS: Cause-specific mortality rates and risk factors at
      baseline were determined. Overall mortality was greater for all groups of
      unmarried men. Patterns of mortality were different in the subgroups of unmarried
      men. Widowed men had a significantly greater risk of dying from ischaemic heart
      disease (relative risk (RR) 1.46, 95% confidence interval (CI) 1.08, 1.97) which
      persisted after exclusion of deaths that occurred in the first two years.
      Divorced men had greater cancer mortality (RR 1.49; 95% CI 1.06, 2.10) that could
      not be explained simply by their greater consumption of cigarettes. The initial
      increased mortality for single men was no longer evident after adjustment for
      other risk factors, suggesting that single status in itself may not increase the
      risk. The risk for single men may have been underestimated, however, by over
      adjustment for possible intermediary factors. CONCLUSIONS: Previous studies,
      which have examined total mortality only or have grouped all unmarried men, have
      masked interesting differences in the cause of death between subgroups of
      unmarried men. The extent to which the findings are explicable by psychosocial
      factors or the role of other environmental factors, which may also differ in
      relation to marital status, is unclear. Future work should not assume that all
      unmarried men have similar mortality risks and must examine the life course of
      each subgroup to advance our understanding of the possible causal role of marital
      status in disease aetiology.

PMID- 8350034
TI  - Paralytic poliomyelitis in children under 6 years in Pondicherry: a community
      survey.
AB  - STUDY OBJECTIVES: To assess the amount of poliomyelitis and its epidemiological
      features including risk factors. DESIGN: This was a retrospective study of cases
      of paralytic poliomyelitis among children 0-6 years of age. SETTING: Pondicherry,
      India, 1983-89. SUBJECTS: A total of 47,960 children aged less than 6 years.
      MEASUREMENTS AND MAIN RESULTS: In 1989, 469 field workers undertook a door to
      door survey of children 0-6 years old to identify those with limb paralysis. This
      was followed by clinical examination to establish the cause, supplemented by case
      notes held by the Child Development Services. Altogether 203 cases of limb
      paralysis were identified, 188 of which were judged a result of paralytic
      poliomyelitis. The prevalence of poliomyelitis in 1989 was 3.9/1000 among
      children below 6 years of age. There was a male preponderance with a male:female
      ratio of 1.4:1. The prevalence was least in infants (1/1000) and highest in
      children aged 2 to 3 years (6.4/1000). The age at onset was less than 12 months
      in 42% of cases and less than 3 years in 98%. The median age at onset was 13.4
      months. Time series analysis showed a high occurrence of cases from May to
      September between 1983 and 1989. The legs were affected in 97%. About 41% of
      children had received three doses of oral polio vaccine. There was a history of
      intramuscular injection, possibly provoking a paralytic attack, in 54% of cases.
      CONCLUSION: This retrospective community study involving the staff of the
      Integrated Child Development Services provided valid data about poliomyelitis
      with little additional cost and minimum training. Because the study covered a
      whole population of children under 6 years, rather than a sample, the data will
      help in monitoring and surveillance of poliomyelitis and also in planning
      strategies for effective control.

PMID- 8350035
TI  - Economics of a reduction in smoking: case study from Heartbeat Wales.
AB  - STUDY OBJECTIVE: This study aims to apply economic principles and techniques in
      evaluating a health promotion programme. DESIGN: This study is an economic
      appraisal of the Heartbeat Wales no smoking intervention programme. The costs
      incurred over the four year period 1985-89 have been identified and estimates
      have been made of the likely future impact of the reduced smoking prevalence
      within Wales in terms of reduced morbidity and displaced mortality in three
      disease groups--coronary heart disease, lung cancer, and chronic bronchitis.
      SETTING: Wales, UK. RESULTS: The net present value of benefits is considerably
      greater than costs in terms of both the NHS and the economy as a whole in Wales.
      In addition, the net costs per life year saved shows that the programme generates
      additional working life years at relatively low cost. Because not all the
      benefits can be fully attributed to the programme 'impact rates' ranging from 100
      to 10% have been applied to the level of benefits. The evidence suggests that
      even if only 10% of the benefits could be attributed to the programme there is
      still a positive net present value of benefits. The relative efficiency of this
      programme has not been considered here. CONCLUSION: Large scale benefits to the
      NHS and the economy as a whole can be derived from reductions in smoking.

PMID- 8350036
TI  - Factors affecting response to an invitation to attend for a health check.
AB  - OBJECTIVE: To describe the characteristics of general practice patients who fail
      to respond to an invitation to attend for a health check, in relation to
      demographic variables, risk factor status, health status, and attitudes to
      behaviour modification. DESIGN: Postal questionnaire before invitation to attend
      a health check and subsequent record of attendance. SETTING: Five urban general
      practices in Bedfordshire, UK. SUBJECTS: A total of 2678 patients aged 35-64
      years were invited for a health check in 1989-90. RESULTS: The number of patients
      who did not attend was low overall but was higher among men than women (21 v 15%,
      p < 0.001), and in unmarried than married patients (24 v 16%, p < 0.001). Failure
      to attend was also higher among people in manual than in non-manual occupations
      (21 v 15%, p < 0.001), in people living in rented accommodation than in
      homeowners (29 v 16%, p < 0.001), and in those without access to a car than in
      car users (27 v 16%, p < 0.001). There was no difference in non-attendance rate
      according to age at completion of full time education. After adjustment for age,
      sex, marital state, and social class, the odds ratio for non-attendance was 1.74
      (95% confidence interval (CI) 1.41, 2.14) for smokers; 1.07 (95% CI 0.76, 1.51)
      for heavy drinkers; 1.91 (95% CI 1.41, 2.58) for those with a less healthy diet;
      and 1.50 (95% CI 1.09, 2.07) for those who were obese. Patients who had visited
      their general practice more frequently and those who indicated a willingness to
      change their behaviour were significantly more likely to attend the health check.
      CONCLUSIONS: Health check attendance was lowest among patients who rarely
      attended the surgery and those who reported higher risk behaviour. Attendance was
      not, however, confined to the 'worried well'. Equal numbers of those with and
      without chest pain attended, as did at least three quarters of those in each risk
      group. This high rate of attendance reflects the time and effort invested in
      systematic recruitment. The development of a robust recruiting strategy is
      essential if substantial numbers, and particularly those at highest risk, are to
      be reached.

PMID- 8350037
TI  - Diagnostic delay, clinical stage, and social class: a hospital based study.
AB  - STUDY OBJECTIVE: To measure delay in admission to a large hospital and to study
      the role of social class and other potential determinants of delay. DESIGN:
      Interview of a 10% sample of newly diagnosed patients admitted to medical or
      surgical wards, and all those admitted for external hernia or colon cancer
      between June 1989 and May 1990. SETTING: The largest hospital in an Italian
      region of five million inhabitants. SUBJECTS: The study population consisted of
      330 patients with a range of different medical and surgical conditions, 83
      patients with external hernias, and 97 patients with colon cancers. MEASUREMENTS
      AND MAIN RESULTS: After patient interview and discharge from hospital, the
      clinical record was consulted for information on the length of stay and the
      diagnosis, and in particular for the staging of hernia or colon cancer (according
      to the protocol of the Jefferson Medical College). Multiple logistic regression
      was used to estimate odds ratios and 95% confidence intervals. There was an
      association between advanced disease at hospital admission and the patient's
      educational level. In each of the three groups of patients, those with the
      highest educational level had a 30% or lower probability of being admitted to
      hospital with advanced disease compared with those with the lowest education
      level (after allowance for sex, age, area of residence, and marital status).
      CONCLUSION: Lower social class was associated with a more advanced clinical stage
      of hernia or colon cancer, and with a higher probability of urgent admission to
      the hospital for a newly diagnosed disease. Delay in seeking care, did not
      however, seem to explain the social class differentials for disease stage.

PMID- 8350038
TI  - Patterns of hospital care for patients with HIV infection and AIDS.
AB  - OBJECTIVE: The aims were to describe the use of inpatient resources by patients
      with HIV infection and patients with AIDS; to examine trends in service use over
      time; and to provide data for planners concerned with service provision for HIV
      infection. SETTING: An inner London health district reporting 9% of AIDS cases
      nationally. DESIGN: Data on survival times and inpatient and day care use of
      resources were derived from existing patient records or collected prospectively
      between 1983 (when the first case of AIDS was diagnosed in the district) and 31
      March 1990. SUBJECTS: A total of 488 HIV positive patients of whom 396 had been
      diagnosed as having AIDS were studied. MEASUREMENTS AND MAIN RESULTS: Inpatient
      days consumed per annum; trends in the number of bed days per person year with
      AIDS; the lifetime inpatient use per AIDS patient; and the influence of survival
      on service use estimates were determined. Altogether 16.4% of a total 17,785
      hospital inpatient days were attributable to HIV positive patients who did not
      fulfil the criteria for AIDS. For patients with AIDS, there was an initial
      increase in the intensity of inpatient use in 1987 when a dedicated HIV ward was
      opened. After 1988, however, inpatient use fell to 30.8 bed days per person year
      with AIDS. Patients diagnosed after April 1987 had noticeably longer survival
      times than those diagnosed earlier (a median of 17-18 months compared with a
      median of 10-11 months). From 214 lifetime service use records, it was estimated
      that patients with short survival (less than six months) would consume 36 days of
      inpatient care, while those expected to survive longer would consume
      approximately twice that number of days, irrespective of how much longer they
      survived. CONCLUSIONS: The data indicate less intensive use of inpatient care by
      AIDS patients over time, and hence the apparent ability to manage an increasing
      AIDS patient workload without a comparable increase in occupied bed days.
      Increases in the size of that workload and changes in the survival profile of
      patients, together with a relatively constant rate of service demand by longer
      survivors, however, will continue to place increasing strains on finite inpatient
      resources. Further research is needed to establish the extent to which the
      greater use of outpatient and community services can offset this.

PMID- 8350039
TI  - Do inaccuracies in small area deprivation analyses matter?
AB  - OBJECTIVE: To assess the accuracy of computerised matching of postcode to
      enumeration district (ED) and to determine whether any mismatching reduces the
      validity of methods to distinguish socioeconomic differences in "small area"
      deprivation studies. DESIGN: Computerised and manual matching of postcodes to EDs
      were compared and the census based Townsend deprivation score was compared with
      socioeconomic data on individual families. SETTING: County of Northumberland,
      England, 1989. SUBJECTS: Random sample of 301 families with a child aged less
      than 15 months. MAIN RESULTS: With computerised matching only 47% of postcodes
      were matched to the correct ED. Eighty per cent of the deprivation scores of the
      computer matched EDs, however, approximated (+/- 2) to the deprivation score of
      the actual ED. When EDs were divided into quintiles according to the deprivation
      score, accurate manual matching showed that 75% of families in the most deprived
      EDs were classed as deprived compared with 4% in the most affluent EDs. With the
      inaccuracies introduced by computer matching of postcodes, the corresponding
      figures were 56% and 12% respectively. CONCLUSIONS: Computerised matching of
      postcodes to EDs is highly inaccurate, but this has little effect on the
      allocation of deprivation scores. The socioeconomic inequalities shown by the
      deprivation score are blunted, but not eradicated, by this mismatching.

PMID- 8350040
TI  - Multi method approach to the assessment of data quality in the Finnish Medical
      Birth Registry.
AB  - OBJECTIVE: To assess comprehensively the validity of the data in the Finnish
      Medical Birth Registry (MBR) by the combined use of several controls and internal
      analysis of the data. DESIGN: The MBR data were individually linked to a medical
      record sample (n = 775) and to all perinatal death certificates in 1987. The data
      were also compared with annual hospital statistics. The distributions of birth
      weights and gestational ages were examined. SUBJECTS: All stillborn and liveborn
      babies registered in the MBR in 1987 (n = 59,370). SETTING: The nationwide MBR
      data were compared with medical records from one third of the Finnish hospitals,
      with statistics for all hospitals, and with nationwide cause of death registry
      data. MEASUREMENTS AND MAIN RESULTS: With regard to most variables, the data
      quality was good or satisfactory (agreement with medical records 95% or more).
      Allowing for minor deviations in variables with continuous scales improved the
      agreement rates further. Explanations could be deduced for items with poor
      agreement values. For most variables, the amount of missing data was less than
      1%. With the exception of caesarean sections, medical procedures were registered
      in only 30 to 72% of the cases, and the proportion varied strongly between the
      hospitals. Common diagnoses (32 to 86%) and primary causes of death (59 to 78%)
      were also poorly recorded. CONCLUSIONS: Combined use of several control materials
      and internal analyses was successful in investigating the whole data content. The
      data in the MBR were generally valid but diagnoses and most data on medical
      procedures were not of sufficiently good quality.

PMID- 8350041
TI  - Improving mortality data in South Africa: review of next of kin statements to
      determine cause of death in police certification.
AB  - STUDY OBJECTIVE: The study aimed to improve mortality data by finding ways of
      reducing the large number of deaths certified as being from "ill-defined" causes
      (ICD 780-798) in South Africa. This problem is attributable to the absence of
      cause of death information in many cases where the police issue the death
      certificate. DESIGN AND SETTING: A total of 600 consecutive death certification
      records at the Salt River State Mortuary, Cape Town were reviewed. MEASUREMENTS
      AND MAIN RESULTS: Altogether 347 (58%) deaths were from unnatural causes, 111
      (18%) were certified by a doctor, 83 (14%) were certified as being the result of
      natural causes after a necropsy, and 59 (10%) were certified by the police as
      being from natural causes. Analysis of sworn statements obtained from the next of
      kin of all those certified dead by the police rather than a doctor provided a
      clear cause of death in 72.9%, and a history of recent contact with health
      services (less than one week previously) in 47.5%. All infants certified dead by
      the police had a history consistent with diarrhoeal disease. CONCLUSIONS: The
      method of death certification may be an indicator of access to health care and
      reviewing sworn statements to determine the cause of death should improve the
      quality of mortality data in the developing world.

PMID- 8350042
TI  - High frequency of normal DJH joints in B cell progenitors in severe combined
      immunodeficiency mice.
AB  - The severe combined immunodeficiency (scid) mouse has a defective V(D)J
      recombinase activity that results in arrested lymphoid development at the pro-B
      cell stage in the B lineage. The defect is not absolute and scid mice do attempt
      gene rearrangement. Indeed, approximately 15% of all scid mice develop detectable
      levels of oligoclonal serum immunoglobulin and T cell activity. To gain more
      insight into the scid defect and its effect on V(D)J rearrangement, we analyzed
      DJH recombination in scid bone marrow. We determined that DJH structures are
      present in scid bone marrow and occur at a frequency only 10-100 times less than
      C.B-17+/+. The scid DJH repertoire is limited and resembles fetal liver DJH
      junctions, with few N insertions and predominant usage of reading frame 1.
      Moreover, 70% of the DJH structures were potentially productive, indicating that
      normal V(D)J recombinants should be arising continually.

PMID- 8350043
TI  - Hck tyrosine kinase activity modulates tumor necrosis factor production by murine
      macrophages.
AB  - The hematopoietic cell kinase (hck) is a member of the src family of tyrosine
      kinases, and is primarily expressed in myeloid cells. Hck expression increases
      with terminal differentiation in both monocyte/macrophages and granulocytes and
      is further augmented during macrophage activation. Recent evidence has implicated
      src-related tyrosine kinases in critical signaling pathways in other
      hematopoietic lineages. Herein we demonstrate that manipulation of the level of
      hck expression in the murine macrophage cell line BAC1.2F5 alters the
      responsiveness of these cells to activation by bacterial lipopolysaccharide (LPS)
      but does not affect survival or proliferation. Overexpression of an activated
      mutant of hck in BAC1.2F5 cells augments tumor necrosis factor (TNF) production
      in response to LPS, whereas inhibition of endogenous hck expression, by antisense
      oligonucleotides, interferes with LPS-mediated TNF synthesis. Together, these
      observations suggest that hck is an important component of the signal
      transduction pathways in activated macrophages.

PMID- 8350044
TI  - The bone marrow of multiple myeloma patients contains B cell populations at
      different stages of differentiation that are clonally related to the malignant
      plasma cell.
AB  - One of the distinguishing features of multiple myeloma (MM) is the proliferation
      of a clonal plasma cell population in the bone marrow (BM). It is of particular
      interest that the tumor plasma cells appear to be restricted to the
      microenvironment of the BM and are rarely detected in the peripheral system, yet
      the disease is found widely disseminated throughout the axial skeleton.
      Furthermore, isolation of MM tumor cell lines has proven to be quite problematic
      due to their slow growth rate. These observations have instigated the search for
      earlier cells in the B cell lineage that are clonally related to the plasma cell
      tumor and that may represent the growth fraction of the tumor. We used allele
      specific oligonucleotides (ASO) derived from the third complementarity
      determining region of the rearranged tumor immunoglobulin heavy chain gene to
      detect isotypes clonally related to the plasma cell tumor. By reverse
      transcribing RNA from the BM with a panel of CH primers (mu, delta, alpha, and
      gamma), followed by ASO-polymerase chain reaction amplification, we demonstrate
      the existence of preswitch isotype species that are clonally related to the
      myeloma tumor. Furthermore, we show that separation of the BM cells into CD45+
      and CD38+ cell populations results in a lineage-specific expression of the
      clonally related RNA molecules, with the C mu and C delta in the CD45+, and C
      gamma in the CD38+ population. Interestingly, clonally related C alpha
      transcripts are also derived from the CD45+ fraction. These results confirm the
      presence of B cell populations clonally related to the plasma cell tumor and are
      consistent with models that propose the existence of myeloma precursors.

PMID- 8350045
TI  - Human natural killer (NK) alloreactivity and its association with the major
      histocompatibility complex: ancestral haplotypes encode particular NK-defined
      haplotypes.
AB  - As ancestral haplotypes of the major histocompatibility complex (MHC) appear to
      define identical MHC haplotypes in unrelated individuals, unrelated individuals
      sharing the same ancestral haplotype should also share the same NK-defined
      allospecificities that have recently been shown to map to the human MHC. To test
      this prediction, multiple cell lines from unrelated individuals sharing the same
      ancestral haplotypes were tested for the NK-defined allospecificities. It was
      found that cells sharing the same ancestral haplotypes do have the same NK
      defined specificities. Furthermore, the NK-defined phenotype of cells that
      possess two different ancestral haplotypes can be predicted from the NK-defined
      phenotypes of unrelated cells that are homozygous for the ancestral haplotypes
      concerned. Although the group 1 and 2 NK-defined allospecificities can be
      explained to some extent by HLA-C alleles, evidence is presented that additional
      genes may modify the phenotype conferred by HLA-C.

PMID- 8350046
TI  - IP-10, a -C-X-C- chemokine, elicits a potent thymus-dependent antitumor response
      in vivo.
AB  - IP-10 is a member of the -C-X-C-chemokine superfamily of proinflammatory
      cytokines whose secretion is induced by interferon gamma (IFN-gamma) and
      lipopolysaccharide (LPS). To date no function has been described for IP-10. We
      have genetically engineered tumor cells to secrete high levels of murine IP-10
      and demonstrate that while IP-10 has no effect on the growth of these tumor cells
      in culture, it elicits a powerful host-mediated antitumor effect in vivo. The IP
      10 antitumor response is T lymphocyte dependent, non-cell autonomous, and appears
      to be mediated by the recruitment of an inflammatory infiltrate composed of
      lymphocytes, neutrophils, and monocytes. These results document an important
      biologic property of IP-10 and raise the possibility that some of the T cell
      directed effects of IFN-gamma and LPS may be mediated by this chemokine.

PMID- 8350047
TI  - Passive immunization of mice against D factor blocks lethality and cytokine
      release during endotoxemia.
AB  - D factor, also known as leukemia inhibitory factor, is a pleiotropic cytokine
      whose role during acute injury and inflammation is not known. Intraperitoneal
      administration of Escherichia coli endotoxin induced D factor gene expression in
      mice, and passive immunization against D factor protected them from the lethal
      effects of endotoxin and blocked endotoxin-induced increases in serum levels of
      interleukin 1 and 6. Peak levels of tumor necrosis factor and interferon gamma
      were not affected. These results indicate that D factor is an essential early
      mediator of the inflammatory cytokine response and therefore may be important in
      the pathogenesis of the many inflammatory conditions, such as sepsis, arthritis,
      allograft rejection, and cancer immunotherapy.

PMID- 8350048
TI  - Evidence for a bone marrow B cell transcribing malignant plasma cell VDJ joined
      to C mu sequence in immunoglobulin (IgG)- and IgA-secreting multiple myelomas.
AB  - Multiple myeloma is a B cell malignancy characterized by the expansion of plasma
      cells producing monoclonal immunoglobulins (Ig). It has been regarded as a tumor
      arising at the B, pre-B lymphocyte, or even stem cell level. Precursor cells are
      presumed to proliferate and differentiate giving rise to the plasma cell clonal
      expansion. Antigenic features and specific Ig gene rearrangement shared by B
      lymphocytes and myeloma cells have supported this hypothesis. However, the
      existence of such a precursor is based upon indirect evidence and is still an
      open question. During differentiation, B cells rearrange variable (V) regions of
      Ig heavy chain genes, providing a specific marker of clonality. Using an anchor
      polymerase chain reaction assay, these rearranged regions from five patients with
      multiple myeloma were cloned and sequenced. The switch of the Ig constant (C)
      region was used to define the B cell differentiation stage: V regions are linked
      to C mu genes in pre-B and B lymphocytes (pre-switch B cells), but to C gamma or
      C alpha in post-switch B lymphocytes and plasma cells (post-switch B cells).
      Analysis of bone marrow cells at diagnosis revealed the presence of pre-switch B
      cells bearing plasma cell V regions still joined to the C mu gene. These cells
      were not identified in peripheral blood, where tumor post-switch B cells were
      detected. These pre-switch B cells may be regarded as potential myeloma cell
      precursors.

PMID- 8350050
TI  - Interleukin 7 is produced by murine and human keratinocytes.
AB  - Interleukin 7 (IL-7) was originally identified as a growth factor for B cell
      progenitors, and subsequently has been shown to exert proliferative effects on T
      cell progenitors and mature peripheral T cells as well. Constitutive IL-7 mRNA
      expression so far had been demonstrated in bone marrow stromal cell lines,
      thymus, spleen, and among nonlymphoid tissues in liver and kidney. Here we show
      that both murine and human keratinocytes express IL-7 mRNA and release IL-7
      protein in biologically relevant amounts. The physiological or pathological
      relevance of keratinocyte-derived IL-7 is presently unknown. Our finding that
      keratinocytes can produce IL-7 in concert with reports that IL-7 is a growth
      factor for in vivo primed antigen-specific T cells, as well as for T lymphoma
      cells suggests, however, that keratinocyte-derived IL-7 is important in the
      pathogenesis of inflammatory skin diseases and cutaneous T cell lymphoma.

PMID- 8350049
TI  - Selective long-term elimination of natural killer cells in vivo by an anti
      interleukin 2 receptor beta chain monoclonal antibody in mice.
AB  - The interleukin 2 receptor beta chain (IL-2R beta) is preferentially expressed in
      natural killer (NK) cells, but is not detected in a majority of resting T and B
      cells. We recently established a novel monoclonal antibody (mAb) to murine IL-2R
      beta and examined in vivo the effect of the mAb in mice. We found that
      intraperitoneal injection of the anti-IL-2R beta mAb into adult mice resulted in
      a selective in vivo elimination of splenic NK function in various mouse strains.
      The reduction of NK cell function is associated with complete disappearance of
      NK1.1+ cells in C57BL/6 mice. Other lymphocyte subsets in the thymus and spleen
      were uncompromised. T cell function was not affected by the mAb treatment as
      judged by allogeneic cytotoxic T cell induction. The single injection of anti-IL
      2R beta mAb caused a long-term elimination of splenic NK cells, lasting for at
      least 5 wk. We also found that NK and/or NK precursor cells become susceptible to
      the mAb treatment only after birth, suggesting that functional maturation of NK
      cells in terms of IL-2R beta expression is a later event in the course of NK cell
      development. The use of the anti-IL-2R beta mAb will be useful in defining the
      physiological role of NK cells in host defense as well as dissecting their
      developmental pathway in vivo.

PMID- 8350051
TI  - Human interferon-inducible protein 10: expression and purification of recombinant
      protein demonstrate inhibition of early human hematopoietic progenitors.
AB  - Human interferon-inducible protein 10 (IP-10), a member of the family of the
      small secreted proteins called intercrine cytokines or chemokines, is secreted by
      interferon gamma-stimulated T cells, monocytes, endothelial cells, and
      keratinocytes. We have begun to explore the biological properties of IP-10 by
      cloning and overexpression in baculovirus and in bacterial protein expression
      systems. A 9.9-kD protein was secreted by infected insect cells, which on sodium
      dodecyl sulfate-polyacrilamide gel electrophoresis comigrated with keratinocyte
      IP-10 and with f(22-98), a bacterial recombinant fragment lacking the signal
      sequence but containing all other residues of IP-10. All three reacted with
      antibodies recognizing residues 10-98 (alpha IP-10) and 77-98 of IP-10 (alpha
      22), demonstrating that it is secreted by keratinocytes and insect cells after
      removal of the signal sequence but without proteolysis of the COOH-terminal end.
      Purified rIP-10 suppresses in vitro colony formation by early human bone marrow
      progenitor cells which need r-steel factor (rSLF) and rGM-CSF or rSLF and r
      erythropoeitin (rEPO). The inhibition is dose dependent, is complete at
      concentrations > or = 50 ng/ml, is prevented by preincubation of rIP-10 with
      alpha IP-10, but not by alpha 22, and is seen with highly purified CD34+ cells,
      suggesting direct effect of rIP-10 on the progenitors. Combination of rIP-10 and
      other chemokines at inactive concentrations inhibited colony formation in a
      synergistic manner. rIP-10 did not affect colony formation in the absence of any
      growth factors or in the presence of rEPO or rGM-CSF but in absence of rSLF. The
      effects of IP-10 may be relevant to normal marrow function and might be harnessed
      to protect human hematopoietic progenitors from the cytotoxic effects of
      chemotherapy.

PMID- 8350052
TI  - Antibodies against major histocompatibility complex class II antigens directly
      inhibit the growth of T cells infected with Theileria parva without affecting
      their state of activation.
AB  - We have analyzed the effect of antibodies (Abs) directed against major
      histocompatibility complex (MHC) class II Abs on the proliferation of Theileria
      parva-infected (Tpi) T cells. Anti-MHC class II Abs exert a direct effect on Tpi
      T cells causing an acute block in their proliferation. The inhibition does not
      involve apoptosis and is also entirely reversible. The rapid arrest of DNA
      synthesis caused by anti-MHC class II Abs is not due to interference with the
      state of activation of the T cells since the transcriptional activator NF-kappa B
      remains activated in arrested cells. In addition, interleukin 2 (IL-2), IL-2R,
      and c-myc gene expression are also unaffected. By analyzing the cell-cycle phase
      distribution of inhibited cells, it could be shown that cells in all phases of
      the cell cycle are inhibited. The signal transduction pathway that results in
      inhibition was shown to be independent of protein kinase C and extracellular
      Ca2+. Tyrosine kinase inhibitors, however, partly reduced the level of inhibition
      and, conversely, phosphatase inhibitors enhanced it. The possible relevance of
      this phenomenon in other systems is discussed.

PMID- 8350053
TI  - Human keratinocytes release the endogenous beta-galactoside-binding soluble
      lectin immunoglobulin E (IgE-binding protein) which binds to Langerhans cells
      where it modulates their binding capacity for IgE glycoforms.
AB  - A better understanding of the pathophysiological role of Langerhans cells (LC) in
      atopic diseases is dictated by the characterization of the structures involved in
      immunoglobulin (IgE)-binding on their cell surface. We previously reported that
      human LC express the high affinity receptor for IgE (Fc epsilon RI), as well as
      the low affinity receptor for IgE (Fc epsilon RII/CD23). In the present study, we
      document the presence of a third IgE-binding structure on human LC, the IgE
      binding protein (epsilon BP), an endogenous soluble beta-galactoside binding
      lectin. Immunohistochemical studies performed on normal human skin revealed an
      anti-epsilon BP reactivity in the cytoplasm of keratinocytes and in that of
      acinous cells of eccrine sweat glands. epsilon BP was also found on the cell
      surface of LC, as shown by anti-epsilon BP/anti-CD1a double labeling and flow
      cytometric analysis. Anti-epsilon BP binding to the surface of LC was completely
      abolished by preincubation with lactose and restored by addition of recombinant
      human epsilon BP, indicating that epsilon BP binds to LC surface by virtue of its
      lectin property. Immunoblot analysis of anti-epsilon BP-reactive material in
      keratinocytes and purified LC disclosed a protein with an apparent molecular
      weight of 33,000 consistent with epsilon BP. Interestingly, mRNA transcripts for
      epsilon BP were detected only in keratinocytes but not in purified LC isolated
      from normal skin. epsilon BP was found to be released in culture supernatants of
      keratinocytes. Incubation of LC with these supernatants resulted in epsilon BP
      binding to LC surface via protein-carbohydrate interaction. Most importantly, we
      could show that binding of human myeloma IgE to LC was inhibited by epsilon BP.
      In contrast, neuraminidase-treated human myeloma IgE binds to LC only in the
      presence of epsilon BP. In situ binding studies revealed that keratinocytes,
      although containing epsilon BP intracytoplasmatically, failed to exhibit any IgE
      binding properties. Collectively, our results suggest that human keratinocytes
      produce the beta-galactoside-binding lectin epsilon BP, which subsequently binds
      to the surface of LC where it is functional in modulating their binding capacity
      for IgE glycoforms.

PMID- 8350055
TI  - Somatic variation precedes extensive diversification of germline sequences and
      combinatorial joining in the evolution of immunoglobulin heavy chain diversity.
AB  - In Heterodontus, a phylogenetically primitive shark species, the variable (VH),
      diversity (DH), joining (JH) segments, and constant (CH) exons are organized in
      individual approximately 18-20-kb "clusters." A single large VH family with > 90%
      nucleic acid homology and a monotypic second gene family are identified by
      extensive screening of a genomic DNA library. Little variation in the nucleotide
      sequences of DH segments from different germline gene clusters is evident,
      suggesting that the early role for DH was in promoting junctional diversity
      rather than contributing unique coding specificities. A gene-specific
      oligodeoxynucleotide screening method was used to relate specific transcription
      products (cDNAs) to individual gene clusters and showed that gene rearrangements
      are intra- rather than intercluster. This provides further evidence for
      restricted diversity in the immunoglobulin heavy chain of Heterodontus, from
      which it is inferred that combinatorial diversity is a more recently acquired
      means for generating diversity. The observed differences between cDNA sequences
      selected and the sequences of segmental elements derived from conventional
      genomic libraries as well as from VH segment-specific libraries generated by
      direct PCR amplification of genomic DNA indicate that the VH repertoire is
      diversified by both junctional diversity and somatic mutation. Taken together,
      these findings suggest a heretofore unrecognized contribution of somatic
      variation that preceded both extensive diversification of the germline repertoire
      and the combinatorial joining process in the evolution of humoral immunity.

PMID- 8350054
TI  - I-E+ nonobese diabetic mice develop insulitis and diabetes.
AB  - The development of type I diabetes in the nonobese diabetic (NOD) mouse is under
      the control of multiple genes, one or more of which is linked to the major
      histocompatibility complex (MHC). The MHC class II region has been implicated in
      disease development, with expression of an I-E transgene in NOD mice shown to
      provide protection from insulitis and diabetes. To examine the effect of
      expressing an I-E+ or I-E- non-NOD MHC on the NOD background, three I-E+ and
      three I-E- NOD MHC congenic strains (NOD.H-2i5, NOD.H-2k, and NOD.H-2h2, and
      NOD.H-2h4, NOD.H-2i7, and NOD.H-2b, respectively) were developed. Of these
      strains, both I-E+ NOD.H-2h2 and I-E- NOD.H-2h4 mice developed insulitis, but not
      diabetes. The remaining four congenic strains were free of insulitis and
      diabetes. These results indicate that in the absence of the NOD MHC, diabetes
      fails to develop. Each NOD MHC congenic strain was crossed with the NOD strain to
      produce I-E+ and I-E- F1 mice; these mice thus expressed one dose of the NOD MHC
      and one dose of a non-NOD MHC on the NOD background. While a single dose of a non
      NOD MHC provided a large degree of disease protection to all of the F1 strains, a
      proportion of I-E+ and I-E- F1 mice aged 5-12 mo developed insulitis and
      cyclophosphamide-induced diabetes. When I-E+ F1 mice were aged 9-17 mo,
      spontaneous diabetes developed as well. These data are the first to demonstrate
      that I-E+ NOD mice develop diabetes, indicating that expression of I-E in NOD
      mice is not in itself sufficient to prevent insulitis or diabetes. In fact, I-E-
      F1 strains were no more protected from diabetes than I-E+ F1 strains, suggesting
      that other non-NOD MHC-linked genes are important in protection from disease.
      Finally, transfer of NOD bone marrow into irradiated I-E+ F1 recipients resulted
      in high incidences of diabetes, indicating that expression of non-NOD MHC
      products in the thymus, in the absence of expression in bone marrow-derived
      cells, is not sufficient to provide protection from diabetes.

PMID- 8350056
TI  - Diversification, not use, of the immunoglobulin VH gene repertoire is restricted
      in DiGeorge syndrome.
AB  - Immunoglobulin (Ig) genes were isolated from unamplified conventional as well as
      polymerase chain reaction-generated cDNA libraries constructed from the
      peripheral blood cells of a patient with complete DiGeorge syndrome. Comparison
      of the sequences of 36 heavy chain clones to the recently expanded database of
      human VH genes permitted identification of the germline VH genes that are
      expressed in this patient as well as placement of 19 of these genes in a
      partially resolved 0.8-mb region of the human VH locus. The pattern of VH gene
      use does not resemble the fetal (early) repertoire. However, as in the fetal
      repertoire, there are a number of cDNAs derived from germline genes that
      previously have been identified as autoantibodies. Two D mu sequences also were
      identified, as was another sequence resulting from a unique recombination event
      linking JH to an unidentified sequence containing a recombination signal sequence
      like heptamer. All of the DiGeorge cDNAs are closely related to germline VH
      genes, showing little or no evidence of somatic mutation. In contrast, comparably
      selected IgM VH sequences derived from normal adult and age-matched human
      libraries, and from a second DiGeorge syndrome patient in whom the degree of
      thymic dysfunction is much less severe, exhibit considerable evidence of somatic
      mutation. The absence of somatic mutation is consistent with the atypical
      development of functional antibody responses associated with complete DiGeorge
      syndrome and implicates a role for T cells in the generation of diversity within
      the B cell repertoire.

PMID- 8350057
TI  - A first or dominant immunization. I. Suppression of simultaneous cytolytic T cell
      responses to unrelated alloantigens.
AB  - A first or dominant immunization with one antigen markedly inhibited specific
      cytolytic T lymphocyte (CTL) responses to a second unrelated alloantigen without
      suppressing antibody responses to other antigens. Suppression was induced
      rapidly, became systemic, and could be transferred passively with only serum.
      Suppression did not result from elimination of cells capable of responding to the
      second antigen. The mechanisms responsible for this "priority of the first
      response" may be the same that help protect the fetus during pregnancy, promote
      renal allograft survival after multiple blood transfusions, and prevent effective
      CTL-mediated immunity to variants of tumor cells or infectious agents that arise
      during tumor progression or chronic infections.

PMID- 8350058
TI  - A first or dominant immunization. II. Induced immunoglobulin carries transforming
      growth factor beta and suppresses cytolytic T cell responses to unrelated
      alloantigens.
AB  - Fresh sera from mice immunized by bearing an immunogenic tumor or by repeated
      injections of allogeneic spleen cells or xenogeneic erythrocytes powerfully
      suppress cytolytic T cell responses in one-way mixed lymphocyte cultures.
      Suppression is not antigen specific, though is mediated by immunoglobulin (Ig)G
      specific for the immunizing antigen. Suppression caused by IgG mimics that caused
      by active transforming growth factor beta (TGF-beta). IgG associates with or
      carries latent TGF-beta; however, suppression caused by the complex of IgG-TGF
      beta requires macrophages (M phi), whereas active TGF-beta alone does not. Also,
      IgG dissociated from TGF-beta does not cause suppression, suggesting that M phi
      may take up Ig-TGF-beta, process the complex, and deliver active TGF-beta to
      lymphocytes. Indeed, suppression by immune serum was prevented by antibody to Fc
      receptors, by saturating Fc receptors with heterologous IgGs, and by antibodies
      against TGF-beta. The overall findings reveal a previously unrecognized
      regulatory circuit whereby IgG produced in response to one antigen
      nonspecifically downregulates cytolytic T lymphocyte responses to unrelated
      antigens. The findings introduce the intriguing possibility that TGF-beta
      delivered by IgG and processed by M phi may mediate important biological effects
      in processes such as wound healing, tumor growth, and some autoimmune diseases.

PMID- 8350059
TI  - Human keratinocyte growth factor effects in a porcine model of epidermal wound
      healing.
AB  - Keratinocyte growth factor (KGF) is a member of the fibroblast growth factor
      (FGF) family (hence the alternative designation FGF-7). It is produced by stromal
      cells, but acts as a mitogen for epithelial cells. We examined the effects of
      topically applied KGF on healing of wounds in a porcine model. In partial
      thickness wounds, KGF stimulated the rate of reepithelialization (p < 0.0002),
      associated with a thickening of the epidermis (p < 0.0001). Epidermis from KGF
      treated full-thickness wound sites was significantly thicker (0.31 +/- 0.22 mm)
      compared with mirror image control sites (0.18 +/- 0.12 mm) (p < 0.0001).
      Moreover, the majority (77%) of KGF-treated wounds exhibited epidermis with a
      deep rete ridge pattern as compared with control sites. These effects were
      observed as early as 14 d and persisted for at least 4 wk. KGF treatment also
      increased the number of serrated basal cells associated with increased deposition
      of collagen fibers in the superficial dermis adjacent to the acanthotic
      epidermis. Electron microscopy revealed better developed hemidesmosomes
      associated with thicker bundles of tonofilaments in the serrated cells. The
      pattern of epidermal thickening observed in KGF-treated wounds resembled
      psoriasis. Psoriasis is a disease associated with epidermal thickening,
      parakeratosis as well as hyperproliferation that extends beyond the basal layer.
      In striking contrast to psoriasis, KGF-treated wounds exhibited normal
      orthokeratotic maturation, and proliferation was localized to the basal cells.
      Our present findings have significant implications concerning the role of KGF as
      a paracrine modulator of epidermal proliferation and differentiation.

PMID- 8350060
TI  - Positive selection of V beta 8+ CD4-8- thymocytes by class I molecules expressed
      by hematopoietic cells.
AB  - A small subset of T cells of mature phenotype express the alpha/beta T cell
      receptor, but not CD4 and CD8 coreceptors (alpha/beta double-negative [DN]
      cells). The repertoire of V beta usage of alpha/beta DN cells is strongly biased
      towards V beta 8 expression, suggesting that the formation of the population is
      subject to selection. We now report that deficiency of class I expression leads
      to a strongly depressed frequency of V beta 8+ DN cells, but has little effect on
      V beta 8- DN cells. Studies of hematopoietic chimeras between class I+ and class
      I- mice demonstrated that expression of class I molecules by hematopoietic cells
      is necessary and sufficient for selection of most V beta 8 DN cells. The lack of
      a role for class I expression by thymic epithelial cells suggests that the
      mechanism of selection of these cells by class I differs significantly from the
      mechanism of selection of conventional T cells. Models to explain the selection
      of these cells as well as their possible function in vivo are discussed.

PMID- 8350061
TI  - Functional GATA-3 binding sites within murine CD8 alpha upstream regulatory
      sequences.
AB  - Genes encoding the accessory molecules CD8 and CD4 are activated early in
      thymocyte development, generating CD4+8+ double positive intermediates, which
      give rise to two functionally distinct mature T cell subsets that express either
      CD4 or CD8. The mechanisms that govern the activation or suppression of the CD8
      gene are likely to be central to the T cell development program. To identify the
      key regulatory factors, we have initiated an analysis of the transcriptional
      regulation of the murine CD8 alpha gene. We have identified three CD8+ cell
      specific DNAase I hypersensitive sites (HSS) located upstream of the murine CD8
      alpha gene. In vitro mobility shift analysis of the -4.0-kb HSS region has
      revealed multiple binding sites for the T cell-restricted transcription factor
      GATA-3. In vitro translated murine GATA-3 binds specifically to both CD8 GATA
      sites, and coexpression of this factor in transient transfection assays
      transactivates a reporter construct containing these sequences. These results
      provide the first evidence for the role of a T cell-restricted factor in the
      regulation of either CD8 or CD4 genes.

PMID- 8350062
TI  - The regulated expression of B lineage associated genes during B cell
      differentiation in bone marrow and fetal liver.
AB  - The expression of B lineage associated genes during early B cell differentiation
      stages is not firmly established. Using cell surface markers and multiparameter
      flow cytometry, bone marrow (BM) cells can be resolved into six fractions,
      representing sequential stages of development; i.e., pre-Pro-B, early Pro-B, late
      Pro-B/large Pre-B, small Pre-B, immature B, and mature B cells. Here we
      quantitate the levels of several B lineage associated genes in each of these
      fractions by RT-PCR, demonstrating different patterns of expression. We find that
      expression of terminal deoxynucleotidyl transferase (TdT), lambda 5, and VpreB is
      predominantly restricted to the Pro-B stages. Rag-1 and Rag-2 expression is also
      tightly regulated, and is found largely in the Pro-B through small Pre-B stages.
      Mb-1 is present from Pro-B throughout the pathway at high levels. Finally, Bcl-2
      is expressed at high levels only at the pre-Pro-B and mature B stages, whereas it
      is low during all the intermediate stages. We also correlate this expression data
      with an analysis of the onset of Ig gene rearrangement as assessed by amplifying
      D-JH, VH-DJH, and VK-JK. Finally, we report differences in gene expression during
      B lymphopoiesis at two distinct ontogenic timings, in fetal liver and adult BM:
      both TdT and the precursor lymphocyte regulated myosin-like light chain are
      expressed at high levels in the Pro-B cell stage in bone marrow, but are absent
      from the corresponding fraction in fetal liver. In contrast, lambda 5, VpreB, Rag
      1, and Rag-2 are expressed at comparable levels.

PMID- 8350063
TI  - Induction of murine peritoneal gamma/delta T cells and their role in resistance
      to bacterial infection.
AB  - Previous studies have reported an association of gamma/delta T cells with
      microbial infection in both human lesions and murine infectious disease models.
      In this study we provide a comprehensive analysis of the conditions under which
      the induction of gamma/delta T cells occurs at a site of infection. We found a
      site-specific induction of gamma/delta T cells after the injection of Listeria
      monocytogenes in the peritoneal cavity of C3H mice. No changes were seen in the
      splenic or lymph node populations after these injections. Both the proportion and
      the absolute number of gamma/delta T cells increased in the peritoneal cavity.
      Additionally, when peritoneal T cells from Listeria-immune mice were restimulated
      in vitro, the induced gamma/delta T cells exhibited a greater expansion potential
      than the alpha/beta T cells. Neither the induced gamma/delta T cells nor those
      from normal mice expressed CD4 or CD8 on the cell surface. Thy-1 was expressed on
      only 29% of normal peritoneal gamma/delta T cells, but after intraperitoneal
      Listeria injection 65% of induced gamma/delta T cells expressed. Thy-1, Pgp-1 and
      CD45R expression on both normal and induced gamma/delta T cells was consistent
      with an activation phenotype. Significant increases in peritoneal gamma/delta T
      cells were not seen until 5-7 d after Listeria injection. The proportion of the
      CD3+ population expressing the gamma/delta T cell receptor remained elevated for
      6-7 wk, while the absolute numbers of peritoneal gamma/delta T cells declined
      gradually over this time period, reflecting a decrease in both the number of
      lymphocytes and the percentage of these that were CD3+. Peak numbers of
      gamma/delta T cells were seen at day 10 with live microbes such as Listeria. A
      variety of microbes, toxins, mitogens, antigens, cytokines, and nonspecific
      inflammatory agents were evaluated for their ability to induce gamma/delta T
      cells in the peritoneal cavity. Both Gram-positive and Gram-negative bacteria as
      well as Mycobacteria were able to induce gamma/delta T cells that showed
      increased in vitro expansion potential. An exotoxin from a Gram-positive
      organism, listeriolysin-o, and the lipopolysaccharide (LPS) endotoxin from a Gram
      negative organism were also effective. gamma/delta T cell responses to LPS were
      under lps gene control. Peak numbers of gamma/delta T cells were observed at day
      3 after injection with exotoxins and endotoxins. Modifications that abrogated the
      virulence of a bacterial strain also eliminated the inductive effect for
      gamma/delta T cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350065
TI  - Control of Aedes dorsalis with sustained-release methoprene pellets in a
      saltwater marsh.
AB  - The efficacy and persistence of sustained-release methoprene (Altosid) pellets
      were evaluated in a tidal, saltwater marsh primarily against Aedes dorsalis.
      Pellets were applied prior to marsh inundation at 3.4 kg/ha. They provided > 99%
      control through the July and August high tide series (up to 42 days
      posttreatment), 86.4% control during the November high tide series (131 days
      posttreatment) and 66.6% control during the February high tide series (240 days
      posttreatment). Proportions of partially emerged adults increased over the course
      of the study, constituting 0, 0.7, 16.2 and 18.9% of the unsuccessfully emerging
      mosquitoes in July, August, November and February, respectively. Sixty-six
      percent of the completely emerged mosquitoes from the treated region of the marsh
      were found dead on the water surface, compared with only 0.7% from the control
      region. This implies that exposure to low concentrations of methoprene impairs
      the ability of the completely emergent mosquito to fly.

PMID- 8350064
TI  - Intercellular interactions and cytokine responsiveness of peritoneal alpha/beta
      and gamma/delta T cells from Listeria-infected mice: synergistic effects of
      interleukin 1 and 7 on gamma/delta T cells.
AB  - Peritoneal gamma/delta T cells from Listeria-immune mice show an enhanced
      potential to expand when restimulated with antigens or mitogens in vitro (see
      companion paper [Skeen, M. J., and H. K. Ziegler. 1993. J. Exp. Med. 178:971]).
      When cocultured with peritoneal alpha/beta T cells, the gamma/delta T cell
      population expanded preferentially even when the in vitro stimulus was specific
      for the alpha/beta T cell population. Purified gamma/delta T cells did not
      respond to alpha/beta T cell-specific stimuli. If isolated T cell subsets were
      recombined in cell mixing experiments, the resulting proliferative response was
      greater than additive. Irradiated alpha/beta T cells could enhance the
      proliferation of responding gamma/delta T cells, but the effect was
      unidirectional; i.e., irradiated gamma/delta T cells did not stimulate responding
      gamma/delta T cells. This effect appeared to be cytokine mediated and did not
      require cell-cell contact. Both recombinant interleukin 2 (rIL-2) and rIL-7 could
      support the expansion of the gamma/delta T cells, while rIL-7 was only minimally
      stimulatory for the alpha/beta T cells. The magnitude of the response by
      gamma/delta T cells to rIL-7 exceeded the response to other in vitro stimuli,
      including immobilized anti-T cell receptor monoclonal antibody, and was 50-100
      fold greater than the alpha/beta T cell response to IL-7. This unique sensitivity
      of gamma/delta T cells to IL-7 was strongly enhanced by the presence of accessory
      cells. These cells could be replaced by rIL-1, establishing a synergy for IL-1
      and IL-7 as factors that could uniquely stimulate this gamma/delta T cell
      population. Isolated peritoneal gamma/delta T cells from Listeria-immune mice
      react to heat-killed Listeria preparations in the presence of macrophages
      accessory cells in a non-H-2-restricted manner. Considered collectively, these
      results suggest a potential mechanism by which gamma/delta T cells can
      predominate in epithelial tissues and at sites of infection.

PMID- 8350067
TI  - Anthropophilic and zoophilic phlebotomine sand flies (Diptera, Psychodidae) from
      Thailand.
AB  - As a result of extensive surveys of sand flies carried out during 1987-90 in
      Thailand, species including a man-biter, Phlebotomus hoepplii, and cattle-biters,
      P. argentipes and P. major major, were discovered in Kanchanaburi Province. The
      human-baited catches revealed a low density of P. hoepplii and the biting
      occurred during 2100-2300 hours. Phlebotomus hoepplii was also found feeding on
      buffalo and inhabiting Pha-Thai Cave, Lampang Province. Phlebotomus argentipes
      was also a common cave-dweller and therefore had a wider distribution than P.
      major major, which was only collected in Sara Buri and Kanchanaburi provinces.
      The 3 species inhabited forest environments close to foothills and on stream
      banks. Although there is yet no evidence that they are involved in leishmaniasis
      transmission, the bionomics of the species are of importance and should be
      studied further.

PMID- 8350066
TI  - Isolation of Jamestown Canyon and snowshoe hare viruses (California serogroup)
      from Aedes mosquitoes in western Massachusetts.
AB  - Three isolates of Jamestown Canyon virus and one isolate of snowshoe hare virus
      (California serogroup) were obtained from adult Aedes females collected in
      western Massachusetts in 1982. Jamestown Canyon virus was isolated from Aedes
      abserratus/punctor once, and from Aedes intrudens twice. Snowshoe hare virus was
      isolated from Aedes stimulans group mosquitoes. La Crosse encephalitis (LAC)
      virus was not isolated from 1,552 adult Aedes triseriatus, nor from 22,557 Aedes
      triseriatus larvae. However, sera from 1/178 eastern chipmunks, 5/31 gray
      squirrels, and 8/144 white-tailed deer had neutralizing antibody to LAC virus. No
      sentinel rabbits placed at sites yielding virus isolates seroconverted to CAL
      viruses in either year.

PMID- 8350069
TI  - In situ hybridization mapping of histone genes in Anopheles albimanus.
AB  - The histone genes of Anopheles albimanus were mapped by in situ hybridization to
      6 bands in Region 34A on the right arm of chromosome 3. A genomic library was
      made by cloning fragments of 15 to 23 kb (derived from partial EcoRI digestion)
      into the phage vector, EMBL4, and probed with the histone gene repeat of
      Drosophila melanogaster. Thirty-two phages containing histone gene sequences were
      isolated from about 10(5) plaque-forming units (pfu). Complete EcoRI digestion of
      DNA from 5 of the 32 recombinant phages and the genomic DNA of An. albimanus
      yielded a single 3.84-kb fragment that contained sequences homologous to the 5
      histone genes of D. melanogaster. This 3.84-kb unit of mosquito histone genes was
      subcloned into puc19 plasmid, and the resulting clone (palbi34A) was used for in
      situ hybridization to salivary gland chromosomes.

PMID- 8350068
TI  - Evaluation of 1-octen-3-ol and carbon dioxide as black fly (Diptera: Simuliidae)
      attractants in Arkansas.
AB  - Carbon dioxide and 1-octen-3-ol were evaluated individually and in combination as
      black fly attractants. Significantly greater numbers of Cnephia pecuarum were
      collected in traps baited with CO2 and CO2 + octenol as compared with octenol
      alone or no bait. While greater numbers of C. pecuarum were collected in traps
      baited with the combination of CO2 and octenol as opposed to CO2 alone, results
      were only significantly different (P > or = 0.05) in one test. In contrast,
      significantly (P > or = 0.05) more adults of Simulium meridionale were collected
      in traps baited with CO2 alone. Octenol alone was not an effective attractant for
      the black fly species collected in the course of this study. In addition, use of
      octenol in conjunction with CO2 may impair representative sampling of black fly
      species present in a given area.

PMID- 8350070
TI  - Compatibility of cyclopoid copepods with mosquito insecticides.
AB  - Larvivorous copepods (Macrocyclops, Mesocyclops and Acanthocyclops) were tested
      for their sensitivities to commonly used mosquito larvicides and adulticides. The
      cyclopoids were not harmed by Bacillus thuringiensis (H-14) (B.t.i.) or
      larviciding oil. Control of mosquito larvae in field trials was accelerated by
      applying B.t.i. at the same time cyclopoids were introduced to a breeding site.
      Among adulticides tested, the cyclopoids were least sensitive to permethrin.
      Field trials demonstrated that permethrin does not harm cyclopoids when applied
      at label specifications.

PMID- 8350071
TI  - Small plot evaluation of a sustained-release sand granule formulation of
      methoprene (SAN 810 I 1.3 GR) for control of Aedes Taeniorhynchus.
AB  - A sand granule formulation of methoprene (SAN 810 I 1.3 GR) was tested in outdoor
      intermittently flooded pools as a pre- and postflood treatment for the control of
      Aedes taeniorhynchus. In field test 1, pre- and postflood treatments were equally
      effective. Inhibition of emergence in mosquitoes exceeded 90% for one and 3
      flood/dry cycles when SAN 810 I 1.3 GR was applied at rates of 2.8 and 5.6 kg/ha,
      respectively. In field test 2, > 90% inhibition of emergence was achieved only
      when SAN 810 I 1.3 GR was applied postflood at 5.6 kg/ha.

PMID- 8350072
TI  - Effect of photoperiod on longevity and metabolic rate in Anopheles
      quadrimaculatus.
AB  - The effect of photoperiod on longevity of nondiapausing members of a species in
      the mosquito species complex Anopheles quadrimaculatus was tested in laboratory
      experiments. First-generation adults reared from 2 field collections showed the
      same trends: those reared under short photoperiod (8 h light: 16 h dark) lived
      longer than did those reared under long photoperiod (16 h light: 8 h dark). Adult
      metabolic rates were not consistently related to longevity. In adults reared from
      the first collection, metabolic rates were higher in long-photoperiod individuals
      but in adults reared from the second collection, metabolic rates were higher in
      short-photoperiod individuals. Longevity appears to be another of many insect
      features that are affected similarly by temperature and photoperiod.

PMID- 8350073
TI  - Mating and nutritional state affect the reproduction of Aedes albopictus
      mosquitoes.
AB  - Mated female Aedes albopictus mosquitoes that were maintained after emergence
      without carbohydrate were more likely to develop eggs after a small blood meal
      than were unmated females maintained on the same diet. The effect was due to male
      accessory gland substances transferred to the female during mating. Neither the
      endogenous reserves of protein and lipid nor the number of eggs developed per
      volume of ingested blood differed between mated and unmated females, suggesting
      that the utilization of existing reserves was altered by mating. Methoprene
      administered to both mated and unmated females that ingested small blood meals
      reduced the likelihood that egg development would occur. Small volumes of blood
      were more likely to trigger oogenesis in both mated and unmated females if their
      abdomens were additionally distended.

PMID- 8350074
TI  - Runnelling to control saltmarsh mosquitoes: long-term efficacy and environmental
      impacts.
AB  - Aedes vigilax is a problem mosquito species prevalent in subtropical Australian
      coastal wetlands. We evaluate the long-term impacts of runnelling, an
      environmentally benign habitat modification method, on mosquitoes and the wetland
      environment. Runnelling uses shallow channels to enhance flushing of the marsh.
      The method successfully reduced larval numbers to below nuisance levels for the
      6.5 year study period. We did not detect any significant difference in the
      wetland environment between runnelled and unmodified parts of the study area.
      However, the spatial extent of the effects may have extended beyond the modified
      area.

PMID- 8350075
TI  - Field evaluations in malaise and canopy traps of selected targets as attractants
      for tabanid species (Diptera: Tabanidae).
AB  - Various configurations of an inflated vinyl beach ball covered with black fabric
      were evaluated in Malaise and canopy (modified Manitoba) traps for possible use
      as an insecticide-impregnated visual target (T) for Tabanidae. In Malaise traps,
      T attracted 2x more flies than no T. When inflated with carbon dioxide, T was not
      significantly different from T filled with air, no matter which type of trap it
      was in. In canopy traps, 2 or 4 white spots applied to T did not increase its
      attractiveness to tabanids. When treated with octenol, T was 2-5x more attractive
      than an untreated T in canopy traps. However, when an octenol treatment was aged
      for 48 h, it was less effective than a fresh treatment. Overall, the 3 most
      frequently collected species, in order of abundance, were: Tabanus lineola
      hinellus, Hybomitra vicina and Chrysops atlanticus. Significantly more T. l.
      hinellus and H. vicina were collected at T with octenol than at T without
      octenol. Attempts to detect an insecticidal effect on flies captured in both
      types of trap that had been baited with Ts treated with permethrin were
      unsuccessful.

PMID- 8350076
TI  - Unreliable supply of potable water and elevated Aedes aegypti larval indices: a
      causal relationship?
AB  - We investigated the hypothesis that a deficient supply of piped water was causing
      a high prevalence of water storage containers, which in turn, become important
      aquatic habitats of Aedes aegypti in a small town in Venezuela. The House (71.2%)
      and Breteau indices (229) were considerably elevated. Prevalent positive
      containers were: metal drums, small disposable containers (bottles, tins, etc.),
      tires, house plants (flowers in vases and plants in pots with earth) and tanks.
      Most people reported frequent interruptions in the supply of piped water and
      considered it to be unreliable. The frequency of interruptions in the supply of
      water was positively correlated with the House and Container indices, and with
      the number of positive containers, water-storage devices and positive water
      storage devices per house. Even people who considered that they had an adequate
      supply of water kept numerous water storage containers. Most people (60%) said
      they would not stop storing water even in the event of the establishment of a
      reliable supply of piped water.

PMID- 8350077
TI  - Identification of blood meals in Aedes aegypti by antibody sandwich enzyme-linked
      immunosorbent assay.
AB  - A comparative study of 3 ELISA protocols was performed for host blood meal
      identification in Aedes aegypti. In the sandwich-B ELISA, which used a
      combination of heavy and heavy+light chain conjugates, specificity was improved
      to such a degree that conjugates no longer required cross-adsorption with
      heterologous sera. Using the sandwich-B assay, human blood meals in laboratory
      reared Ae. aegypti could be detected longer after feeding (100% at 32 h and 80%
      at 42 h) than with a direct assay (100% at 20 h). Efficacy of the sandwich-B and
      direct ELISAs in field analyses was studied in parallel) using 80 field collected
      mosquitoes from Thailand. The sandwich-B assay was superior (88% detection rate)
      to the direct assay (41% detection rate) and was thus selected as the method of
      choice for future field studies.

PMID- 8350078
TI  - Indoor low-volume insecticide spray for the control of Anopheles albimanus in
      southern Mexico. Village-scale trials of bendiocarb, deltamethrin and cyfluthrin.
AB  - A comparative insecticide village-scale trial was carried out to determine the
      efficacy of low-volume (LV) indoor spray of bendiocarb, deltamethrin and
      cyfluthrin for the control of Anopheles albimanus in a coastal plain of southern
      Mexico. Low-volume spray was conducted with knapsack mist-blowers, giving an
      average discharge rate of 215 ml/min, which deposited droplets of 50-100 microns.
      Using this technique, 25 houses were treated/sprayman/day as compared with 8
      houses/sprayman/day using conventional hand compression pumps. Indicators of LV
      mortality showed a residual activity of 10 wk as compared with 13 wk of activity
      for wettable powder (WP) (bendiocarb). When comparing expenditures, LV spray
      costs were 43% less when using bendiocarb, 83% less with deltamethrin and 74%
      less with cyfluthrin with respect to the conventional WP spray of the same
      insecticides. Low-volume spray time was reduced by one-third, with respect to WP.
      Malaria incidence was reduced by 53 and 56%, respectively, in the bendiocarb LV
      and deltamethrin LV treated villages as compared with the untreated village.

PMID- 8350079
TI  - Investigations on possible resistance in Aedes vexans field populations after a
      10-year application of Bacillus thuringiensis israelensis.
AB  - In the Upper Rhine Valley (Germany), Bacillus thuringiensis var. israelensis has
      been widely used against floodwater mosquitoes over an area of approximately 500
      km2 for more than 10 years. The susceptibility of larvae of Aedes vexans field
      populations in 3 untreated (Lake Constance) and 3 treated areas (Upper Rhine
      Valley) was assessed by means of bioassays with B.t.i. (Bactimos WP, 6,000
      AAU/mg), following WHO guidelines. Log-probit analyses and statistical
      evaluations of the data showed that the LC50 values as well as slopes of
      bioassays of the larvae deriving from the different areas showed no significant
      differences. Two populations in the treated area were even more susceptible than
      populations from the untreated areas. These results have been confirmed by
      resistance ratios, which were less than one in all tests carried out.

PMID- 8350080
TI  - Bloodfeeding behavior of Anopheles gambiae s.l. and Anopheles funestus in Kilifi
      District, Kenya.
AB  - Blood meal samples were tested by ELISA for 534 Anopheles gambiae s.l. and 76
      Anopheles funestus collected from 25 sites in Kilifi District, Kenya. Human IgG
      was detected in 94.4% of the An. gambiae s.l. and in 90.8% of the An. funestus.
      No samples were positive for cow and only a few were positive for goat. Both
      species fed predominantly on humans irrespective of host availability. At these
      sites on the Kenyan coast, the high degree of human-feeding by malaria vectors
      contributes to the efficiency of malaria parasite transmission and the high
      incidence of severe malaria.

PMID- 8350081
TI  - Application of radar rainfall estimates for surveillance of Aedes taeniorhynchus
      larvae.
AB  - A preliminary investigation of land-based radar rainfall estimates for
      surveillance of Aedes taeniorhynchus larvae was conducted from January 1 to May
      21, 1991 in Collier County, FL. Rainfall estimates from the National Weather
      Service RADAP II radar system, supplemented with tide gauge data, served as
      criteria for larval inspection. Rain, rain+tide and tide, respectively, triggered
      48, 26 and 26% of the 14 proposed inspection trips. This system detected 7/8
      larval broods found by Collier Mosquito Control District surveillance; the only
      brood not detected consisted of stragglers from an earlier brood exposed to cool
      weather and methoprene. A QUICKBASIC program that extracts Cartesian coordinates
      and rainfall estimates from RADAP II B-SCAN data was developed.

PMID- 8350082
TI  - Temperature and flow rate effects on mass median diameters of thermally generated
      malathion and naled fogs.
AB  - The effects of temperature and flow rate on mass median diameters (mmds) of
      thermally generated aerosol clouds were studied. Number 2 fuel oil alone,
      undiluted and diluted malathion 91, and undiluted naled were examined. There was
      a significant flow rate x temperature interaction on the mmds of diluted
      malathion fogs: i.e., differences among flow rates depended on temperature and
      vice versa.

PMID- 8350083
TI  - Survey of dirofilariasis in Arkansas.
AB  - A card survey was sent to 340 veterinarians in the Urban, Delta, Highland and
      Coastal Plain regions of Arkansas. Veterinarians were asked to indicate numbers
      of dogs tested, confirmed Dirofilaria immitis positive, diagnostic techniques,
      frequency and period tested. A significantly greater percentage of dogs tested D.
      immitis positive in the Delta region as compared with the Urban region. There
      were no significant differences in the percentage of treated dogs on prophylaxis
      or the types of diagnostic tests among regions.

PMID- 8350084
TI  - Aedes aegypti in New Jersey.

PMID- 8350085
TI  - Structures of sesquiterpene polyol esters from Celastrus stephanotiifolius with
      potential tumor-promotion inhibitor activity.
AB  - Esters of eight new ([1],[4-6], and [8-11]) and five known sesquiterpenenoid
      polyalcohols have been isolated from Celastrus stephanotiifolius. Their
      structures were established on the basis of chemical reactions and spectral
      analysis. The structural elucidation indicated that the structures of some
      related compounds should be revised. The isolated sesquiterpenes were observed to
      inhibit Epstein-Barr virus early antigen activation significantly at low doses.

PMID- 8350086
TI  - Studies on inhibitors of skin tumor promotion, XII. Rotenoids from Amorpha
      fruticosa.
AB  - As a part of screening studies for chemopreventive agents (anti-tumor-promoters),
      six North American plants belonging to the Amorpha genus were tested using an in
      vitro assay system. Of these plants, Amorpha fruticosa exhibited strong
      inhibitory effects on Epstein-Barr virus early antigen (EBA-EA) activation
      induced by the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA). Also
      six rotenoids, amorphispironone [1], tephrosin [2], amorphigenin [3], 12a
      hydroxyamorphigenin [4], 12a-hydroxydalpanol [5], and 6'-O-D
      glucopyranosyldalpanol [6], were isolated from the leaves of A. fruticosa. Among
      these retenoids, 1 and 2 exhibited remarkable inhibitory effects of EBV-EA
      activation induced by TPA. Further, 1 and 2 exhibited significant anti-tumor
      promotion effects on mouse skin tumor promotion in an in vivo two-stage
      carcinogenesis test. These investigations suggested that these rotenoids might be
      valuable anti-tumor-promoters.

PMID- 8350087
TI  - Cytotoxicity of artemisinin-related endoperoxides to Ehrlich ascites tumor cells.
AB  - A series of artemisinin-related endoperoxides was tested for cytotoxicity to
      Ehrlich ascites tumor (EAT) cells using the microculture tetrazolium (MTT) assay.
      Artemisinin [1] had an IC50 value of 29.8 microM. Derivatives of
      dihydroartemisinin [2], being developed as antimalarial drugs (artemether [3],
      arteether [4], sodium artesunate [5], artelinic acid [6], and sodium artelinate
      [7]), exhibited a somewhat more potent cytotoxicity. Their IC50 values ranged
      from 12.2 to 19.9 microM. The presence of an exocyclic methylene fused to the
      lactone ring, as for artemisitene [9], led to higher cytotoxicity than 1. From
      the two epimeric 11-hydroxyartemisinin derivatives, the R form 12 showed a
      considerably higher cytotoxicity than the S form 13. Opening of the lactone ring
      of 1 dramatically reduced the cytotoxicity. The ether dimer 8 of 2 was the most
      potent cytotoxic agent, its IC50 being 1.4 microM. The variations in cytotoxicity
      between the structurally related compounds mostly correlated well with the
      theoretical capacity of radical formation and stabilization. In some cases
      lipophilicity or the presence of an electrophilic moiety seemed to have a
      determinant influence on cytotoxicity. The artemisinin-related endoperoxides
      showed cytotoxicity to EAT cells at higher concentrations than those needed for
      in vitro antimalarial activity, as reported in the literature.

PMID- 8350088
TI  - A novel amino acid glycoside and three amino acids from Allium sativum.
AB  - A novel amino acid glycoside (-)-N-(1'-deoxy-1'-beta-D-fructopyranosyl)-S-allyl-L
      cysteine sulfoxide [1], was isolated from a hydrophilic extract of the leaves of
      Allium sativum (Alliaceae), together with three known compounds: (+)-S-allyl-L
      cysteine sulfoxide [2],(+)-S-methyl-L-cysteine sulfoxide [3], and (+)-S-(trans-1
      propenyl)-L-cysteine sulfoxide [4]. The latter two substances were isolated for
      the first time from garlic. The structure elucidation of 1 was performed by
      extensive chemical, spectroscopic (ir, fabms, 1D and 2D(1)H- and (13)C-nmr
      measurements) and chromatographic experiments. For the first time, detailed nmr
      data and the unambiguous assignment of all (13)C-nmr data for compounds 2-4 were
      reported. Compound 1, the amino acid glycoside, revealed a significant inhibition
      of in vitro platelet aggregation induced by ADP and epinephrine, whereas none of
      the amino acids tested displayed any activity.

PMID- 8350089
TI  - 30-, 31-, and 32-hydroxybullatacinones: bioactive terminally hydroxylated
      annonaceous acetogenins from Annona bullata.
AB  - From Annona bullata, three more pairs of new ketolactone Annonaceous acetogenins
      were isolated by bioactivity-directed isolation. They are hydroxylated adjacent
      bistetrahydrofuran (THF) acetogenins and are named (2,4-cis and trans)-32
      hydroxybullatacinone (1 and 2), (2,4-cis and trans)-31-hydroxybullatacinone (3
      and 4), and (2,4-cis and trans)-30-hydroxybullatacinone (5 and 6). The structures
      were elucidated by analysis of the 1H- and 13C-nmr spectra of 1-6 and their
      acetates and the ms of their tri-trimethylsilyl (TMSi) derivatives as compared
      with bullatacinone [7]. This is the first time that Annonaceous acetogenins with
      OH groups at successive positions near the end of the aliphatic chain have been
      reported. All of the new compounds showed potent activities in the brine shrimp
      lethality test and against human solid tumor cells in culture, with selectivities
      exhibited especially toward the colon cancer cell line (HT-29).

PMID- 8350090
TI  - Isolation of a dihydrobenzofuran lignan from South American dragon's blood
      (Croton spp.) as an inhibitor of cell proliferation.
AB  - Dragon's blood is a red viscous latex extracted from the cortex of various Croton
      spp. (Euphorbiaceae), most commonly Croton lechleri, Croton draconoides (or
      Croton palanostigma), and Croton erythrochilus. It is used in South American
      popular medicine for several purposes, including wound healing. Bioassay-guided
      fractionation of dragon's blood, using an in vitro test system for the
      stimulation of human umbilical vein endothelial cells, has resulted in the
      isolation of a dihydrobenzofuran lignan, 3',4-O-dimethylcedrusin or 4-O
      methyldihydrodehydrodiconiferyl alcohol [2-(3',4'-dimethoxyphenyl)-3
      hydroxymethyl-2,3-dihydro-7-methoxybenzo furan-5- propan-1-ol] [1] as the
      biologically active principle. A related compound, 4-O-methylcedrusin [2-(3',4'
      dimethoxyphenyl)-3-hydroxymethyl-2,3-dihydro-7-hydroxybenzo furan-5- propan-1-ol]
      [2], and the alkaloid taspine [3], also isolated from dragon's blood, were not
      active in the same assay. A cell proliferation assay, measuring the incorporation
      of tritiated thymidine in endothelial cells, showed that compound 1 did not
      stimulate cell proliferation, but rather inhibited thymidine incorporation, while
      protecting cells against degradation in a starvation medium.

PMID- 8350091
TI  - The structures of aplysinamisines I, II, and III; new bromotyrosine-derived
      alkaloids from the Caribbean sponge Aplysina cauliformis.
AB  - Three new bromotyrosine-derived alkaloids, aplysinamisines I [4], II [5], and III
      [6], were isolated from the sponge Aplysina cauliformis collected in Puerto Rico
      and their chemical structures elucidated on the basis of spectroscopic methods.
      Compounds 4-6 showed marginal antimicrobial activity, and aplysinamisines II [5]
      and III [6] displayed modest cytotoxicity.

PMID- 8350092
TI  - Evaluation of marine sponge metabolites for cytotoxicity and signal transduction
      activity.
AB  - Twenty-four metabolites derived from marine sponges were evaluated for their
      cytotoxicities against two human tumor cell lines, non-small cell lung carcinoma
      A549 and colon adenocarcinoma HT-29, and against one murine leukemia cell line, P
      388, and evaluated for their ability to effect signal transduction in a newly
      developed cell adhesion assay using an EL-4 cell line. The compounds included
      latrunculin A [1], batzelline A [2], chondrillin [3], aureol [4],
      epihippuristanol, theonellamine B, discorhabdins A and C, kabiramide C, dercitin,
      meridine, manzamines A, B, and C, 8,15-diisocyano-11(20)-amphilectene and the
      corresponding C-15 formamide, a 20-carbon acetylenic alcohol, 4,5-dihydro-6"
      deoxybromotopsentin, epispongiadiol, isospongiadiol, puupehenone, reiswigin A,
      and demethyl- and demethyloxyaaptamine. Latrunculin A [1], batzelline A [2],
      chondrillin [3], and aureol [4] expressed the desired profile of a greater than
      five-fold level of cytotoxicity against A549 relative to P-388, and an effect in
      the cell adhesion assay. In this group of compounds, cytotoxicity toward A549 was
      equal to or more pronounced than against HT-29. Latrunculin A was evaluated in an
      sc-implanted human A549 lung tumor xenograft mouse model and yielded a T/C of
      146%. Batzelline A was evaluated in the cancer cell line panel at the National
      Cancer Institute and found to express selective cytotoxicity against several
      melanoma cancer cell lines.

PMID- 8350093
TI  - Bioactive and other sesquiterpenoids from Porella cordeana.
AB  - Bioassay-directed fractionation of the MeCOEt extract of Porella cordeana yielded
      drimenin [1] and aristolone [4], which were moderately toxic towards DNA-repair
      deficient mutants of Saccharomyces cerevisiae. Three inactive sesquiterpenes, 7
      ketoisodrimenin [2], 7-ketoisodrimenin-5-ene [3], and norpinguisanolide, were
      also obtained. Compounds 2 and 3 are new.

PMID- 8350095
TI  - Two novel steroidal glycoside sulfates from the starfish Cosmasterias lurida.
AB  - Two novel steroidal monoglycoside sulfates, luridosides A [1] and B [2], have
      been isolated from the starfish Cosmasterias lurida. These compounds co-occur
      with one known steroidal monoglycoside, pycnopodioside C [3]. The structures of
      the new metabolites were determined from spectral data and comparison with those
      of related steroids.

PMID- 8350094
TI  - Antiplatelet effects and vasorelaxing action of some constituents of Formosan
      plants.
AB  - Various xanthones as well as quercetin have been shown to exhibit antiplatelet
      activity. A series of anthraquinones analogues structurally related to xanthones
      and a series of quercetin-related compounds were tested for their antiplatelet
      effects. Emodin, frangulin B, kaempferol tetraacetate, quercetin-3-O-galactoside
      octaacetate, rhamnazin triacetate, and rhamnetin tetraacetate were found to be
      potent antiplatelet agents, and 1,8-dihydroxy-6-methoxy-3-methylanthraquinone 8-O
      rhamnosyl-(1-->2)-glucoside, rhamnustrioside undecaacetate, rutin decaacetate,
      and quercetin-3-O-(6-O-alpha-L-arabinopyranosyl)-beta-D-galactopyranos ide
      decaacetate showed significant antiplatelet effects. Quercetin showed
      vasorelaxing action in rat thoracic aorta.

PMID- 8350096
TI  - Flavonoids from Koelreuteria henryi and other sources as protein-tyrosine kinase
      inhibitors.
AB  - The EtOH extract of Koelreuteria henryi was investigated in a search for natural
      products with potential protein-tryrosine kinase (PTK) inhibitory activity. The
      PTK inhibitory activity of the crude fractions was determined by measuring their
      inhibition of p56lck partially purified from bovine thymus using angiotensin I as
      a substrate. Analysis of those fractions that exhibited significant activity led
      to the isolation of kaempferol and quercetin, in addition to two kaempferol
      glycosides, kaempferol-O3-alpha-rhamnopyranoside [1] and kaempferol-O3-alpha
      arabinopyranoside [2]. This study represents the first report on the isolation of
      flavonols and their PTK inhibitory activities from the genus Koelreuteria. Eight
      other flavonoids were also examined to study the role of the hydroxy groups on
      the B ring on PTK inhibitory activity.

PMID- 8350098
TI  - Pieter Camper (1721-89).

PMID- 8350097
TI  - A combined clinical and neurophysiological approach to the study of patients with
      tremor.

PMID- 8350100
TI  - Reductions in parietal and temporal cerebral metabolic rates for glucose are not
      specific for Alzheimer's disease.
AB  - Reduction in the regional cerebral metabolic rate for glucose (rCMRglc) in the
      parietal and temporal regions has been shown in Alzheimer's disease (AD). The
      specificity of these findings for this disease state is uncertain. We repeatedly
      measured rCMRglc with positron emission tomography and [18F]2-fluoro-2-deoxy-D
      glucose in the resting state in a 68 year old man with slowly progressive
      dementia who, during life, was initially diagnosed as having dementia of the
      Alzheimer type, then Parkinson disease with dementia, but was found to have only
      Parkinson's disease at necropsy. Metabolic ratios (rCMRglc/mean grey CMRglc) were
      significantly (p < 0.05) reduced in parietal and temporal regions, as well as in
      the prefrontal and premotor areas. This pattern was similar in regional
      distribution and magnitude of the defect to that seen in patients with probable
      AD. These results suggest that reductions of glucose metabolism in association
      neocortex in AD are not specific to the disease process, but may be related to
      the dementia state.

PMID- 8350101
TI  - Successful treatment of childhood onset symptomatic dystonia with levodopa.
AB  - Three patients with childhood onset symptomatic dystonia responded to levodopa.
      None fulfilled criteria for a diagnosis of "dopa responsive dystonia" (Segawa's
      disease). One may have had athetoid cerebral palsy for almost 25 years. All
      obtained dramatic and sustained benefit from levodopa therapy. A therapeutic
      trial of levodopa is advised in all patients in whom dystonia has developed in
      childhood or early adult life, regardless of suspected aetiology or duration of
      symptoms.

PMID- 8350099
TI  - Management of raised intracranial pressure.
AB  - This review has been written at an unfortunate time. Novel questions are being
      asked of the old therapies and there is an abundance of new strategies both to
      lower ICP and protect the brain against cerebral ischaemia. In the United
      Kingdom, the problem is to ensure that appropriate patients continue to be
      referred to centres where clinical trials of high quality can be undertaken. One
      of the success stories of the past decade has been the decline in the number of
      road accidents as a result of seat belt legislation, improvements in car design
      and the drink/driving laws. Hence, fortunately there are fewer patients with head
      injuries to treat and it is even more important that patients are appropriately
      referred if studies to assess efficacy of the new strategies are not to be
      thwarted. The nihilistic concept that intensive investigation with ICP monitoring
      for patients with diffuse head injury or brain swelling following evacuation of a
      haematoma or a contusion has no proven beneficial effect on outcome, requires
      revision. A cocktail of therapies may be required that can be created only when
      patients are monitored in sufficient detail to reveal the mechanisms underlying
      their individual ICP problem. Ethical problems may arise over how aggressively
      therapy for intracranial hypertension should be pursued and for how long. There
      has always been the concern that cranial decompression or prolonged barbiturate
      coma may preserve patients but with unacceptably severe disability. Some patients
      may be salvaged from herniating with massive cerebral infarction with the use of
      osmotherapy but is the outcome acceptable? Similar considerations apply to some
      children with metabolic encephalopathies. Where such considerations have been
      scrutinised in patients with severe head injury, the whole spectrum of outcomes
      appears to be shifted so that the number of severe disabilities and persistent
      vegetative states are not increased. However, it is important to be sensitive to
      such issues based on experience of the particular cause of raised intracranial
      pressure in a given age group.

PMID- 8350102
TI  - Assessing tremor severity.
AB  - A clinical rating scale which measured the severity of tremor in 20 patients (12
      with essential tremor and 8 with "dystonic" tremor) was assessed at specific
      anatomical sites for both inter and intra-rater reliability using four raters.
      The scores obtained with the scale were compared with the results of upper limb
      accelerometry, an activity of daily living self-questionnaire and estimates of
      the tremor induced impairment in writing and drawing specimens. The results show
      that, for the purposes of routine assessment and therapeutic trials, a clinical
      rating scale can produce reliable results which are a more valid index of tremor
      induced disability than standard postural accelerometry.

PMID- 8350103
TI  - Diurnal effects of motor activity and fatigue in Parkinson's disease.
AB  - Wrist motor activity was monitored continuously in 65 patients with Parkinson's
      disease (PD) to assess the influence of disease severity and excessive fatigue on
      the diurnal motor activity pattern. Mildly or moderately affected PD patients had
      a similar diurnal pattern to that of 68 healthy controls, with a late morning
      peak; however, mean levels of motor activity were lower. The most severely
      affected patients showed an overall flattened diurnal pattern. Results refute the
      existence of end of day deterioration, but instead suggest a "depressed morning
      start" in the most severely affected patients with PD. Excessive fatigue was not
      reported at a particular time of day and did not influence the diurnal motor
      activity pattern.

PMID- 8350104
TI  - Neuropsychological abnormalities in AIDS and asymptomatic HIV seropositive
      patients.
AB  - Neuropsychological and immunological parameters were studied in 36 AIDS patients
      with early disease and without clinical, laboratory, and neuroradiological signs
      of CNS impairment, and also in 33 asymptomatic HIV seropositive subjects. Many
      AIDS patients performed abnormally on timed psychomotor tasks, tasks involving
      sequencing and "set-shifting", and memory tasks stressing attention, learning,
      active retrieval, and monitoring of information. Asymptomatic HIV seropositive
      subjects as a group did not perform significantly worse than controls. However,
      on the basis of a cut off number of pathological performances on
      neuropsychological tasks, 52.8% of AIDS and 30.3% of asymptomatic HIV
      seropositive subjects had cognitive impairment, compared with 3.9% of HIV
      seronegative controls. Low values of CD4+ cells and of CD4+/CD8+ ratio and high
      titres of P-24 antigen in the blood prevailed among subjects with cognitive
      impairment, especially in the asymptomatic HIV seropositive group.

PMID- 8350105
TI  - Bilateral occipital calcification, epilepsy and coeliac disease: clinical and
      neuroimaging features of a new syndrome.
AB  - Twenty patients affected by bilateral occipital cortical-subcortical
      calcification (BOC) are described, 19 (95%) had epilepsy. In 8 of 16 cases
      studied, intestinal biopsy revealed coeliac disease. Fourteen patients had
      occipital partial epilepsy with a relatively benign outcome, while 4 patients
      were affected by a severe form of epilepsy, with very frequent, drug-resistant,
      generalised and partial seizures with mental deterioration. One patient had a
      single episode of convulsive status epilepticus at four months of age. The
      neurological examination was normal in all patients. CT showed flocculo-nodular,
      cortico-subcortical BOC, without enhancement and without lobar or hemispheric
      atrophy. MRI was normal. The clinical and neuroimaging features of these patients
      are different therefore from those with the Sturge-Weber Syndrome. The study
      confirms a high prevalence of coliac disease in patients with BOC, but the
      relationship between these two pathologies still needs to be clarified.

PMID- 8350106
TI  - Compressive radial nerve palsy induced by military shooting training: clinical
      and electrophysiological study.
AB  - Ten recruited soldiers developed acute left wrist drop and numbness on the back
      of the thumb after a three hour military shooting training. Neurological
      examination disclosed decreased muscle power (0-2/5) of left wrist dorsiflexion,
      hypalgesia and hypaesthesia on the radial side of the left hand, and diminished
      brachioradialis reflex. Electrophysiological studies showed prolonged distal
      latency, reduced amplitude and slowness of left radial nerve motor conduction
      velocity between the axilla and elbow. Electromyography (EMG) revealed
      fibrillation potentials at rest, polyphasic motor unit and an incomplete
      interference pattern at volition over the extensor digitorum communis and
      brachioradialis. Nine patients recovered completely clinically and
      electrophysiologically between nine and 12 weeks after the onset of the palsy.
      Sensation recovered faster than the weakness. One patient failed to recover after
      three months, possibly because of the longer duration of nerve compression.
      Longer nerve compression time and sustained, decreased muscle power with signs of
      active denervation in EMG are indicators of poor prognosis.

PMID- 8350107
TI  - Excessive closure of the right eye: a new sign of infarction in the territory of
      the ipsilateral right middle cerebral artery.
AB  - In right middle cerebral territory infarction a new sign, excessive closure of
      the right eye ipsilateral to the lesion and mild closure of the left eye on
      command, was noted. The excessive ipsilateral eye closure was not observed on
      spontaneous eye closure.

PMID- 8350108
TI  - Horner's syndrome in Wegener's granulomatosis: report of four cases.
AB  - Four patients with active Wegener's granulomatosis had Horner's syndrome, which
      was the only neurological involvement in one. Two others had multiple
      mononeuropathy and one a multiple cranial neuropathy. Horner's syndrome occurred
      in the active stage and improved with treatment of Wegener's granulomatosis.

PMID- 8350109
TI  - Mitochondrial encephalomyopathy: variable clinical expression within a single
      kindred.
AB  - The clinical manifestations of mitochondrial encephalomyopathy are described in
      four generations of a single kindred. The age of onset of major neurological
      disturbance varied from 3-70 years. In some patients, deafness was the only
      manifestation; in others, recurrent bouts of status epilepticus associated with
      focal neurological deficits and headache, caused severe disability or death.
      Examples of all three adult forms of mitochondrial encephalomyopathy: MELAS,
      MERFF and Kearns Sayre syndrome, were represented within the kindred. Associated
      features included deafness, short stature, non-insulin-dependent diabetes
      mellitus, migraine, peptic ulceration and severe constipation. The nt 3243 A-G
      MELAS mutation was detected in two members of the kindred. This study highlights
      the diversity of clinical expression of a mitochondrial mutation within a single
      kindred.

PMID- 8350110
TI  - Transcranial Doppler detection of anterior cerebral artery vasospasm.
AB  - The performance of transcranial Doppler in the detection of anterior cerebral
      artery vasospasm and vasospasm in patients after subarachnoid haemorrhage was
      analysed. Transcranial Doppler and cerebral angiography were performed within the
      same 24 hours on each of 41 patients with acute subarachnoid haemorrhage.
      Sensitivity and specificity of transcranial Doppler to classify middle cerebral
      arteries, anterior cerebral arteries, and patients with angiographic vasospasm
      were determined at mean velocities of 120 and 140 cm/s. Accuracy of transcranial
      Doppler was better at 140 than at 120 cm/s. For the middle cerebral artery,
      sensitivity was 86%, specificity 98%. For the anterior cerebral artery,
      sensitivity was 13%, specificity 100%. Among all patients, sensitivity was 45%,
      specificity 96%. Among patients with anterior communicating artery aneurysms,
      sensitivity was 14%, specificity 90%. Therefore, transcranial Doppler accurately
      differentiates between middle cerebral arteries with and without vasospasm on
      angiography, but has a very low sensitivity for detecting anterior cerebral
      artery vasospasm and vasospasm in patients with anterior communicating artery
      aneurysms. Since vasospasm may involve anterior cerebral arteries while sparing
      middle cerebral arteries, especially after rupture of an anterior communicating
      artery aneurysm, caution should be exercised in using negative transcranial
      Doppler results to make treatment decisions based on the assumed absence of
      vasospasm.

PMID- 8350111
TI  - Sir Charles Bell 1774-1842.

PMID- 8350112
TI  - Angiotropic intravascular large-cell lymphoma with massive cerebral extension.
AB  - Angiotropic intravascular large-cell lymphoma (AILL) is a rare, generally fatal
      disease characterised by a multifocal proliferation of neoplastic mononuclear
      cells within small blood vessels. The diagnosis of a patient was made at
      necropsy. The malignant cells had infiltrated the periventricular areas of the
      brain.

PMID- 8350113
TI  - Acute disseminated encephalomyelitis presenting as a solitary brainstem mass.
AB  - A 36 year old woman presented with a subacute brainstem syndrome. MRI showed a
      solitary, gadolinium enhancing brainstem mass, which on biopsy showed perivenous
      inflammation and demyelination compatible with acute disseminated
      encephalomyelitis.

PMID- 8350114
TI  - Pure progressive aphemia.
AB  - Aphemia, also called anarthria or severe apraxia of speech, is a rare disorder of
      speech production usually resulting from vascular lesions affecting the inferior
      premotor cortex of the left hemisphere. A patient presenting with aphemia as the
      sole manifestation of primary progressive aphasia (PPA) is reported.

PMID- 8350115
TI  - Vigabatrin and depression.
AB  - Ten patients who developed a major depressive episode in association with
      vigabatrin treatment for intractable epilepsy are reported. The depression
      usually occurred early in the course of treatment, but when delayed followed a
      recent increase in dose. Depressive symptoms occurred at doses varying between
      1.5 g and 4 g a day, often but not always when patients were experiencing a
      decrease in their seizure frequency. Most patients had a history of affective
      disturbance, sometimes in association with other GABAergic drugs. The
      observations support a possible role for GABAergic mechanisms in the biology of
      mood disorders.

PMID- 8350116
TI  - Dementia with leucoaraiosis and dural arteriovenous malformation: clinical and
      PET case study.
AB  - A case of rapidly progressive dementia with diffuse leucoaraiosis on CT was
      attributable to a supratentorial dural arteriovenous malformation. Positron
      emission tomography (PET) showed low cerebral blood flow and high oxygen
      extraction ratio throughout the cerebral hemispheres indicating a state of
      chronic haemodynamic compromise which could predispose to the development of a
      vascular dementia. CT images of dilated intracerebral veins suggested that a
      venous drainage overload rather than a vascular steal phenomenon might be
      involved in the pathophysiology of the dementia of vascular origin.

PMID- 8350117
TI  - Syndrome of transtentorial herniation: is vertical displacement necessary?
AB  - MRI from a comatose patient with a massive acute subdural haematoma showed most
      of the features of transtentorial herniation described in the classic pathology
      literature. In addition to encroachment on the perimesencephalic cisterns,
      infarction in the anterior and posterior cerebral artery territories, ischaemic
      change in the lower diencephalon, and ventricular enlargement were visualised.
      Despite the clinical syndrome and these secondary changes due to compression,
      there was only approximately 2 mm of downward displacement of the upper brainstem
      compared with 13 mm horizontal displacement. Although tissue shifts adjacent to
      the tentorial aperture cause brainstem and vascular compression, these changes
      may occur with minimal downward herniation.

PMID- 8350118
TI  - 'Pinocchio syndrome': a peculiar form of reflex epilepsy?

PMID- 8350119
TI  - Acute non-lymphoblast leukaemia presenting as a Guillain-Barre syndrome.

PMID- 8350120
TI  - Polyunsaturated fatty acids in peroxisomal disorders: a hypothesis and a proposal
      for treatment.

PMID- 8350121
TI  - Herpes simplex encephalitis in a patient with complex partial epilepsy:
      confirmation by the polymerase chain reaction with necropsy studies.

PMID- 8350122
TI  - Accuracy of clinical diagnosis of idiopathic Parkinson's disease.

PMID- 8350123
TI  - Memory representations underlying motor commands used during manipulation of
      common and novel objects.
AB  - 1. While subjects lifted a variety of commonly handled objects of different
      shapes, weights, and densities, the isometric vertical lifting force opposing the
      object's weight was recorded from an analog weight scale, which was instrumented
      with high-stiffness strain gauge transducers. 2. The force output was scaled
      differently for the various objects from the first lift, before sensory
      information related to the object's weight was available. The force output was
      successfully specified from information in memory related to the weight of common
      objects, because only small changes in the force-rate profiles occurred across 10
      consecutive lifts. This information was retrieved during a process related to
      visual identification of the target object. 3. The amount of practice necessary
      to appropriately scale the vertical lifting and grip (pinch) force was also
      studied when novel objects (equipped with force transducers at the grip surfaces)
      of different densities were encountered. The mass of a test object that subjects
      had not seen previously was adjusted to either 300 or 1,000 g by inserting an
      appropriate mass in the object's base without altering its appearance. This
      resulted in either a density that was in the range of most common objects (1.2
      kg/l) or a density that was unusually high (4.0 kg/l). 4. Low vertical-lifting
      and grip-force rates were used initially with the high-density object, as if a
      lighter object had been expected. However, within the first few trials, the
      duration of the loading phase (period of isometric force increase before lift
      off) was reduced by nearly 50% and the employed force-rate profiles were targeted
      for the weight of the object.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350125
TI  - Gustatory neural coding in the amygdala of the alert macaque monkey.
AB  - 1. Neurons in the amygdala are implicated in mediating hedonic appreciation,
      emotional expression, and conditioning, particularly as these relate to feeding.
      The amygdala receives projections from the primary taste cortex in monkeys,
      offering a route by which it could gain access to the gustatory information
      required to guide feeding behavior. We recorded the activity of 35 neurons in the
      amygdala of alert rhesus macaques in response to a range of gustatory intensities
      and qualities to characterize taste-evoked activity in this area. 2. The stimulus
      array comprised 26 chemicals, including four concentrations of each of the four
      basic taste stimuli, a series of other sugars, salts, and acids, monosodium
      glutamate, and orange juice. 3. Neurons responsive to taste stimulation could be
      found in a 76-mm3 region of the amygdala, centered 9.1 mm lateral to the midline,
      14.9 mm anterior to the interaural line, and 25.7 mm below the surface of the
      dura. They composed 7.2% (35/484) of the cells tested for gustatory sensitivity
      in the amygdala. 4. The mean spontaneous activity of taste cells was 8.2 +/- 2.3
      (SE) spikes per second. This rather high level provided an opportunity for
      reductions from spontaneous rate that was used regularly in the amygdala. When
      these negative response rates were included, the mean breadth-of-tuning
      coefficient of this sample of taste cells was 0.82. There was no strong evidence
      for gustatory neuron types, nor were functionally similar cells located together
      in a chemotopic arrangement. 5. Responses across 1.5 log units of stimulus
      concentration were nearly flat, with increasing excitation in some neurons
      largely offset by increasing inhibition in others. Taking the absolute value of
      the evoked activity, concentration-response functions rose monotonically to all
      basic stimuli except HCl, but were not sufficiently steep to account for human
      psychophysical data. The neural response to HCl did not rise with stimulus
      concentration within the range used. 6. Neural patterns representing the taste
      qualities of the basic stimuli were less sharply separated in the amygdala than
      at lower-order gustatory relays. Glucose elicited activity patterns that were
      most distinct from those of the nonsweet chemicals; those associated with NaCl
      were next most distinct. There was no clear separation between the patterns
      generated by chemicals that humans describe as sour and bitter. Monosodium
      glutamate evoked responses that did not correlate well with those of any basic
      stimulus, implying that its quality cannot be subsumed under the four basic
      tastes.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350124
TI  - Converging influences from visual, auditory, and somatosensory cortices onto
      output neurons of the superior colliculus.
AB  - 1. Physiological methods were used to examine the pattern of inputs from
      different sensory cortices onto individual superior colliculus neurons. 2.
      Visual, auditory, and somatosensory influences from anterior ectosylvian sulcus
      (AES) and visual influences from lateral suprasylvian (LS) cortex were found to
      converge onto individual multisensory neurons in the cat superior colliculus. An
      excellent topographic relationship was found between the different sensory
      cortices and their target neurons in the superior colliculus. 3. Corticotectal
      inputs were derived solely from unimodal neurons. Multisensory neurons in AES and
      LS were not antidromically activated from the superior colliculus. 4. Orthodromic
      and antidromic latencies were consistent with monosynaptic corticotectal inputs
      arising from LS and the three subdivisions of AES (SIV, Field AES, and AEV). 5.
      Superior colliculus neurons that received convergent cortical inputs formed a
      principal component of the tecto-reticulospinal tract. Thus there appears to be
      extensive cortical control over the output neurons through which the superior
      colliculus mediates attentive and orientation behaviors. 6. Two other
      multisensory circuits were identified. A population of multisensory superior
      colliculus neurons was found, which neither received convergent cortical input
      nor projected into the tecto-reticulo-spinal tract. In addition, multisensory
      neurons in AES and LS proved to be independent of the superior colliculus (i.e.,
      they were not corticotectal). While it is likely that these three distinct
      multisensory neural circuits have different functional roles, their constituent
      neurons appear to integrate their various sensory inputs in much the same way.

PMID- 8350126
TI  - Electrophysiological characterization of different types of neurons recorded in
      vivo in the motor cortex of the cat. I. Patterns of firing activity and synaptic
      responses.
AB  - 1. Patterns of firing activity and characteristics of antidromic and synaptic
      responses to stimulation of the pyramidal tract at peduncular level [peduncular
      pyramidal tract (PP)] and the ventrolateral thalamic nucleus (VL) were studied in
      neurons of area 4 gamma of the motor cortex of awake, chronic cats using
      intracellular microelectrode techniques. The results offer a new functional
      classification of neocortical neurons based on electrophysiological properties of
      the 640 recorded cells. 2. Four classes of neurons were distinguished: (class i)
      inactivating bursting (ib) neurons (n = 60) including fast antidromic response PP
      (fPP) (n = 0), slow antidromic response PP (sPP) (n = 11), and no antidromic
      response PP cells (nPP) (n = 49); (class ii) noninactivating bursting (nib)
      neurons (n = 79), including fPP (n = 23), sPP (n = 0), and nPP cells (n = 56);
      (class iii) fast-spiking (fsp) neurons (n = 56), including fPP (n = 0), sPP (n =
      0), and nPP cells (n = 56); and (class iv) regular-spiking (rsp) neurons (n =
      445), including fPP (n = 96), sPP (n = 38), and nPP cells (n = 311). (Neurons in
      each classification were further separated by their antidromic responses to PP
      stimulation: fast PP (fPP) slow PP (sPP), or nPP cells, the latter not responding
      antidromically to electrical stimulation of the peduncle.) 3. Recurrent
      monosynaptic excitatory postsynaptic potentials (EPSPs) followed antidromic
      spikes elicited by PP stimulation in most (96%) fPP but much fewer (24%) sPP
      cells. In fPP cells, it was possible to separate the PP EPSPs into two
      monosynaptic EPSP components that were generated by other fPP and sPP cells,
      respectively. VL stimulation evoked monosynaptic EPSPs in 100% of fPP cells (vs.
      63% of sPP cells) and antidromic action potentials in 16% of fPP cells (vs. 12%
      of sPP cells). 4. Firing activity consisted of single spike discharges in most PP
      cells; however, noninactivating bursting was observed in 19% of fPP cells, and
      inactivating bursting was observed in 23% of sPP cells (see below). In 18% of ib
      and 11% of nib/nPP neurons, VL stimulation elicited antidromic action potentials.
      Other bursting neurons proved to be PP cells with characteristic differences in
      axonal conduction velocity (see above). All PP cells among the nib cells were
      fPP, and all PP cells among the ib cells were sPP cells. All fsp neurons were
      found to be nPP cells, and none could be activated antidromically by VL
      stimulation. Thus the fsp pattern of discharge distinguished a unique class of
      nPP cells.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350128
TI  - The relationship of monkey frontal eye field activity to saccade dynamics.
AB  - 1. In this study, we compared the temporal waveforms of the activity of monkey
      frontal eye field movement neurons with the dynamics of saccadic eye movements.
      2. Movement neurons in the frontal eye field were selected according to
      previously published criteria. They had little or no response to visual stimuli
      in a fixation task, and equivalent activity before visually guided and memory
      guided saccades. We studied corticotectal neurons and corticopontine neurons
      identified by antidromic excitation, as well as neurons whose projections were
      not identified. 3. These neurons had a peak activation at a mean of 13 ms before
      the saccade began. However, rather than falling off rapidly as the saccade ended,
      most neurons continued to fire after the saccade, returning to baseline at a mean
      of 93 ms after the end of the saccade. 4. We measured the decrement in activity
      for these neurons during the saccade. Although a few neurons showed decrements of
      > 60% of their peak activity level, the average activity dropped only 16.9%, with
      some neurons actually showing a rise in activity during the saccade. If we
      ignored the latency between peak in activity and saccade start and measured the
      fall in activity for a period equal to one saccade duration after the peak, the
      average drop in activity was still only 34.9%. Thus the activity of these neurons
      did not appear to be closely related to dynamic motor error, which falls from its
      maximum value to zero over the time course of a saccade. 5. These results suggest
      that a focus of movement activity within the topographic map in the frontal eye
      field specifies the amplitude and direction for an impending saccade, whereas the
      peak of movement activity signals the time to initiate a saccade. 6. Unlike the
      superior colliculus, the activity of frontal eye field movement neurons does not
      appear to be related to dynamic events that occur during the saccade, such as
      motor error.

PMID- 8350127
TI  - Electrophysiological characterization of different types of neurons recorded in
      vivo in the motor cortex of the cat. II. Membrane parameters, action potentials,
      current-induced voltage responses and electrotonic structures.
AB  - 1. Electrical properties of four functional classes [inactivating bursting (ib),
      noninactivating bursting (nib), fast spiking (fsp), and regular spiking (rsp)] of
      neurons in the motor cortex of conscious cats were studied with the use of
      intracellular voltage recording and single-electrode voltage-clamp (SEVC)
      techniques. Evaluations were made of action potentials and afterpotentials,
      current-voltage (I-V) relationships, and passive cable properties. Values of
      membrane potential (Vm), input resistance (RN), membrane time constant (T0), and
      firing threshold (T50) were also measured. The data were used to extend the
      electrophysiological classifications of neurons described in the companion paper.
      2. Average values of Vm (from -63 to -66 mV), action-potential amplitudes (from
      72 to 77 mV), and firing threshold (-54 mV) were not statistically different in
      different types of neurons. However, the magnitude of intracellularly injected
      depolarizing current required to induce spike discharge at 50% probability varied
      significantly (from 0.6 to 1.1 nA) among cell types. The mean RN and T0 measured
      at Vm varied between 8.3 and 19.8 M omega, and 7.2 and 15.1 ms, respectively, in
      the cell classes. 3. Action potentials were overshooting. Their mean duration at
      half amplitude varied from 0.25 to 0.73 ms among different cell types. Three
      types of action-potential configurations were distinguished. Type I action
      potentials found in nib and rsp neurons were relatively fast and had a
      depolarizing afterpotential (DAP) as well as fast and slow after
      hyperpolarizations (fAHPs, sAHPs). Type II action potentials found in ib and rsp
      cells had relatively slow rise and decay phases, DAPs, and sAHPs. Their fAHPs
      were small or absent. Type III action potentials were found exclusively in fsp
      cells, had very short durations, prominent fAHPs, but no sAHPs. 4. Steady-state I
      V relationships were determined by measuring voltage responses to 0.2- to 1.0-nA
      hyperpolarizing, rectangular current pulses at different membrane potentials.
      Both RN and T0 exhibited nonlinear behavior over wide ranges of membrane
      potential; however, between -65 and -75 mV, the I-V relationships varied little,
      and they appeared constant in most cells. The steady-state values of RN increased
      with decreasing, and decreased with increasing the membrane potential in all but
      fsp cells. The I-V relationships were virtually linear in fsp neurons. 5.
      Transient I-V relationships were studied by measuring voltage responses to
      depolarizing and hyperpolarizing, rectangular current pulses of increasing
      amplitude from a preset membrane potential of -70 mV.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8350129
TI  - Nociceptive responses in the neostriatum and globus pallidus of the anesthetized
      rat.
AB  - 1. Extracellular recordings were made from neurons in the neostriatum (caudate
      nucleus-putamen, CPu) and globus pallidus (GP) of anesthetized rats. Few cells
      (3%) were classified as low-threshold-mechanoreceptive (LTM) neurons. The
      majority (97%) of somatosensory CPu and GP neurons responded differentially or
      exclusively to noxious mechanical stimulation of the skin. Nociceptive neurons
      were classified into the following three groups on the basis of their response
      properties to noxious mechanical stimulation: wide-dynamic-range (WDR) neurons
      (21%); nociceptive-specific (NS) neurons (67%); and inhibited (INH) neurons
      (13%). 2. No differences in the response properties or in the proportions of WDR,
      NS, and INH neurons were found in the CPu compared with the GP. Nociceptive
      neurons were located most often along the CPu-GP border. Additionally, neurons of
      similar functional classification were often clustered within 200-400 microns of
      each other along a single microelectrode track. 3. The receptive fields of
      nociceptive CPu and GP neurons were often large and bilateral; some receptive
      fields encompassed the entire body. The trigeminal region, especially the
      perioral area, was included in the receptive fields of nociceptive neurons more
      often (62 of 63 cells) than any other part of the body. However, no preference
      for any particular division of the trigeminal nerve was observed in the receptive
      fields. Some neurons had receptive fields that were discontinuous. 4. Noxious
      pinching of the skin significantly increased the spontaneous neuronal discharge
      of WDR and NS neurons by an average of 482 and 221%, respectively. There were no
      significant differences between the discharge adaptation rates of WDR and NS
      neurons. Afterdischarge activity was observed in some WDR and NS neurons. INH
      neurons decreased their resting activity levels by an average of 43% after a
      noxious pinch. 5. The von Frey stimulus threshold of WDR neurons (11.0 g/mm2) was
      significantly lower than that of NS neurons (33.6 g/mm2) and INH neurons (32.6
      g/mm2). Mean stimulus thresholds of WDR, NS, and INH neurons determined by using
      calibrated forceps were 1.6, 4.8, and 2.2 g/mm2, respectively. 6. Individual
      stimulus-response functions of nociceptive neurons were best fit by a negatively
      accelerating (logarithmic) curves. However, WDR neurons had significantly steeper
      slopes than NS neurons. 7. The results demonstrate that a large proportion of
      somatosensory neurons within the neostriatum and globus pallidus (especially
      along the CPu-GP border) receive nociceptive information. These data are
      discussed in relation to several putative afferent nociceptive pathways
      projecting to the CPu and GP.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350130
TI  - Dynamics of reflex cocontraction in hermit crab abdomen: experiments and a
      systems model.
AB  - 1. Both stretch and release of the ventral superficial muscles (VSM) in the
      abdomen of the hermit crab, Pagurus pollicarus, activate the VSM motoneurons in
      the intact animal and in the isolated abdomen. 2. This reflex was studied by
      recording intracellularly from muscle fibers innervated by single motoneurons
      during stretch and release of the VSM. The three motoneurons of the right fourth
      segment respond to both stretch and release with a phasic burst lasting
      approximately 250 ms. The burst in the two tonic motoneurons has two components,
      a short burst lasting 10-20 ms, with a latency from the beginning of stretch of
      60-90 ms, and a longer burst of variable length, with a latency of 120 ms. Ramp
      stretches of different amplitudes and velocities were used to show that the first
      component is proportional to the absolute value of the second derivative of force
      and the second component to the absolute value of the first derivative of force.
      3. Stretch and release of the VSM also simultaneously evoke phasic bursts in the
      motoneurons of the dorsal superficial muscles and the VSM circular muscles
      (functional antagonists of the longitudinal VSM), as well as in contralateral
      homologues of the same segment and in ipsilateral homologues of the next anterior
      segment. The effect of this coactivation is to stiffen the abdomen in response to
      perturbations in any direction. 4. Stretch or release of phasic mechanoreceptors
      in the VSM evokes this reflex. Isometric electrical stimulation of the isolated
      muscle also activates them, showing that they are transducing changes in force
      and suggesting that they operate to increase muscle stiffness by positive
      feedback. 5. A mathematical systems model of this reflex, composed of two
      parallel pathways activating the motoneurons, was constructed. The first pathway
      produces a signal proportional to the absolute value of the second derivative of
      force, the second pathway a signal proportional to the first derivative of force.
      The sum of the signals from the two pathways is filtered by an adaptation
      process, which is followed by a low-pass filter representing muscle activation
      kinetics. The muscle activation signal is then fed back to multiple muscle force.
      6. Simulations using this model generate the phasic bursts to stretch and release
      as well as reproducing the frequency dependence of this reflex. The predominant
      action of this reflex is to enhance muscle stiffness.

PMID- 8350131
TI  - The representation of stimulus familiarity in anterior inferior temporal cortex.
AB  - 1. The inferior temporal (IT) cortex plays an important role in both short- and
      long-term memory for visual patterns. Most previous studies of IT neurons have
      tested their responses in recency memory tasks, which require that the memory
      lasts only the length of a single behavioral trial, which may be < 1 s. To
      determine the role of IT neurons in longer lasting memories, we measured their
      responses to initially novel stimuli as the stimuli gradually became familiar to
      the animal. 2. Two rhesus monkeys were trained on a delayed matching to sample
      (DMS) task with several intervening stimuli between the sample and the final
      matching stimulus on each trial. The purpose of the task was to ensure that the
      animal attended to the stimuli and held them in memory, at least temporarily.
      Unlike in several previous studies, the focus was not on within-trial effects but
      rather on the incidental memories that built up across trials as the stimuli
      became familiar. Each cell was tested with a set of 20 novel stimuli (digitized
      pictures of objects) that the monkey had not seen before. These stimuli were used
      in a fixed order over the course of an hour-long recording session, and the
      number of intervening trials between repetitions of a given sample stimulus was
      varied. 3. The responses of about one-third of the cells recorded in anterior
      ventral IT cortex declined systematically as the novel stimuli became familiar.
      After six to eight repetitions, responses reached a plateau that was
      approximately 40% of the peak response. Virtually all of these cells also showed
      selectivity for particular visual stimuli and thus were not "novelty detectors"
      in the sense of cells that respond to any novel stimulus. Rather, the responses
      of these cells were a joint function of familiarity and specific object features
      such as shape and color. A few cells showed increasing responses with repetition
      over the recording session, but these changes were accompanied by changes in
      baseline firing rate, suggesting that they were caused by nonspecific effects. 4.
      The decrement in response with familiarity was stimulus specific and bridged >
      150 presentations of other stimuli, the maximum tested. For some cells the
      maximum decrement in response occurred for those stimuli that initially elicited
      the largest response. There was no significant change in response to stimuli that
      were already familiar. 5. The same cells that showed familiarity effects also
      showed reduced responses to the matching stimuli at the end of each trial,
      compared with the responses to the samples.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350132
TI  - Encoding of head acceleration in vestibular neurons. I. Spatiotemporal response
      properties to linear acceleration.
AB  - 1. Extracellular recordings were made in and around the medial vestibular nuclei
      in decerebrated rats. Neurons were functionally identified according to their
      semicircular canal input on the basis of their responses to angular head
      rotations around the yaw, pitch, and roll head axes. Those cells responding to
      angular acceleration were classified as either horizontal semicircular canal
      related (HC) or vertical semicircular canal-related (VC) neurons. The HC neurons
      were further characterized as either type I or type II, depending on the
      direction of rotation producing excitation. Cells that lacked a response to
      angular head acceleration, but exhibited sensitivity to a change in head
      position, were classified as purely otolith organ-related (OTO) neurons. All
      vestibular neurons were then tested for their response to sinusoidal linear
      translation in the horizontal head plane. 2. Convergence of macular and canal
      inputs onto central vestibular nuclei neurons occurred in 73% of the type I HC,
      79% of the type II HC, and 86% of the VC neurons. Out of the 223 neurons
      identified as receiving macular input, 94 neurons were further studied, and their
      spatiotemporal response properties to sinusoidal stimulation with pure linear
      acceleration were quantified. Data were obtained from 33 type I HC, 22 type II
      HC, 22 VC, and 17 OTO neurons. 3. For each neuron the angle of the translational
      stimulus vector was varied by 15, 30, or 45 degrees increments in the horizontal
      head plane. In all tested neurons, a direction of maximum sensitivity was
      identified. An interesting difference among neurons was their response to
      translation along the direction perpendicular to that that produced the maximum
      response ("null" direction). For the majority of neurons tested, it was possible
      to evoke a nonzero response during stimulation along the null direction always
      had response phases that varied as a function of stimulus direction. 4. These
      spatiotemporal response properties were quantified in two independent ways.
      First, the data were evaluated on the basis of the traditional one-dimensional
      principle governed by the "cosine gain rule" and constant response phase at
      different stimulus orientations. Second, the response gain and phase values that
      were empirically determined for each orientation of the applied linear stimulus
      vector were fitted on the basis of a newly developed formalism that treats
      neuronal responses as exhibiting two-dimensional spatial sensitivity. Thus two
      response vectors were determined for each neuron on the basis of its response
      gain and phase at different stimulus directions in the horizontal head
      plane.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350133
TI  - Relative contribution of rod and cone inputs to bipolar cells and ganglion cells
      in the tiger salamander retina.
AB  - 1. The relative contribution of rod and cone inputs to bipolar and ganglion cells
      were studied by comparing the response-irradiance relations, spectral
      sensitivities, and response waveforms of these neurons recorded from the
      isolated, flat-mounted tiger salamander retina under dark-adapted conditions. 2.
      Bipolar cells could be differentiated both on the basis of the polarity of the
      light response and on their relative rod/cone input. Thus some depolarizing
      bipolar cells appeared more strongly influenced by rod input (DBCR), whereas
      others were more influenced by cone input (DBCC). Similarly, hyperpolarizing
      bipolar cells could be divided into those that received rod-dominant input (HBCR)
      or cone-dominant input (HBCC). 3. The light onset response of sustained-ON
      ganglion cells reflected both rod-dominant input from DBCRs and cone-dominant
      input from DBCCs. 4. OFF ganglion cells displayed both a rod-dominant sustained
      light offset response and a cone-dominant transient light offset response,
      suggesting input from both HBCRs and HBCCs. 5. In ON-OFF ganglion cells, the
      light onset response was strongly rod dominated and was presumably mediated by
      DBCRs, whereas the light offset response displayed both rod and cone influence,
      suggesting input from HBCRs and HBCCs. The contribution of cones to the light
      onset response of ON-OFF ganglion cells was only observed in the presence of a
      rod-adapting background light. 6. A suppression of the light offset responses of
      OFF and ON-OFF ganglion cells was observed, which was dependent both on the
      wavelength and irradiance of the light stimulus. 7. These results indicate that
      the photoreceptor inputs to bipolar cells in the tiger salamander retina are
      segregated such that they form separate rod-dominant and cone-dominant pathways.
      Thus the response properties of the different types of ganglion cells are
      influenced not only by the excitatory and inhibitory inputs they receive from the
      bipolar and amacrine cells but also whether these inputs are provided through rod
      dominant or cone-dominant pathways. The functional implications of these findings
      are discussed.

PMID- 8350134
TI  - Reduced control of motor output in a human hand muscle of elderly subjects during
      submaximal contractions.
AB  - 1. The effect of age on the motor output of the first dorsal interosseous muscle
      of 22 (6 female, 16 male) human subjects was investigated. The purpose of the
      study was to determine the effect of age on the control of muscle force and the
      associated changes in the discharge behavior and mechanical properties of single
      motor units. 2. Each subject performed three tasks requiring isometric abduction
      of the left index finger: a maximum voluntary contraction (MVC), a constant-force
      task, and a threshold task. The ability to control force was assessed during the
      constant-force task by quantifying the variation in isometric force about four
      submaximal target forces (5, 20, 35, and 50% MVC). The threshold task involved
      sustaining the discharge of the isolated motor unit at a low, steady rate for
      approximately 3 min. 3. The discharge behavior and the mechanical properties of
      single motor units were determined during the threshold task by measuring the
      interimpulse intervals and the peak amplitude and time to peak of the spike
      triggered average force. 4. The data indicated that age had an effect on the
      variation of force about submaximal target forces (range: 5-50% MVC), and that
      these force variations, when calculated relative to the target force, were
      greater at lower force levels in the elderly subjects.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8350135
TI  - Small-caliber afferent inputs produce a heterosynaptic facilitation of the
      synaptic responses evoked by primary afferent A-fibers in the neonatal rat spinal
      cord in vitro.
AB  - 1. The effect of brief primary afferent inputs on the amplitude and duration of
      the synaptic potentials evoked in ventral horn (VH) neurons by the activation of
      other unconditioned primary afferents was studied by current-clamp intracellular
      recording in the neonatal rat hemisected spinal cord in vitro. Low-frequency (1
      Hz) trains of stimulation were applied to a lumbar dorsal root (Conditioning
      root) for 20-30 s. Test excitatory synaptic potentials (EPSPs) were evoked by
      single electrical shocks applied to an adjacent Test dorsal root. 2. Test and
      Conditioning inputs were generated at stimulation strengths sufficient to
      activate A beta-, A delta- and C-afferent fibers successively. At A delta- and C
      fiber strength the EPSPs lasted for 4-6 s, and, during the repetitive
      Conditioning inputs, these summated to produce a progressively incrementing
      cumulative depolarization that slowly decayed back to the control Vm over tens of
      seconds. 3. Dorsal root conditioning produced heterosynaptic facilitation,
      defined as an enhancement of Test EPSPs above their DC matched controls, in 7 out
      of 20 neurons. To facilitate the unconditioned afferent input, the intensity of
      conditioning stimulation had to exceed the threshold for the activation of thin
      myelinated (A delta) afferents: conditioning at A beta-fiber strength had no
      effect, whereas A delta- and C-fiber strength conditioning were equally
      effective. 4. Heterosynaptic facilitation of only A beta- or A delta-fiber-evoked
      Test EPSPs was observed, no enhancement of C-fiber strength Test EPSPs could be
      demonstrated. The facilitation manifested as increases in the EPSP peak
      amplitude, area or the number of action potentials evoked. 5. Conditioning trials
      that produced heterosynaptic facilitation generated cumulative depolarizations
      larger than those produced by ineffective conditioning trials (9.1 +/- 3.1 vs.
      3.3 +/- 0.5 mV after 20 s conditioning at resting Vm, mean +/- SE, n = 6 and 13,
      respectively; P < 0.05). The slope of the Vm trajectory during the summation of
      the conditioning EPSPs was higher in trials resulting in heterosynaptic
      facilitation, at 0.31 +/- 0.10 mV/s in neurons with heterosynaptic facilitation
      and 0.06 +/- 0.02 mV/s in cells without heterosynaptic facilitation (P < 0.05).
      5. Four of the 20 VH neurons in our sample responded to A delta/C-fiber
      conditioning with action-potential windup: all 4 also displayed heterosynaptic
      facilitation. 6. Heterosynaptic facilitation decayed after the completion of the
      conditioning stimulus with a time course that was parallel to but not
      superimposable on that of the slow Vm depolarization evoked by the
      conditioning.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350137
TI  - Inhibition in ON-OFF directionally selective ganglion cells of the rabbit retina.
AB  - 1. We have investigated the inhibitory mechanisms modulating the extracellularly
      recorded responses of ON-OFF directionally selective (DS) ganglion cells of the
      rabbit retina. Our investigations used both moving spots and apparent motion. The
      latter was produced by both prolonged light steps, which simulate movement of an
      edge, and light flashes, which simulate movement of a spot or slit. 2. Within the
      excitatory receptive-field center of DS ganglion cells, apparent motion with
      prolonged light steps elicits null-direction inhibition whose strength rises to
      90% of maximum in 160 +/- 110 ms (7 cells) and then decays slowly, remaining
      above baseline longer than 2,000 ms for short interslit distances. 3. Prolonged
      light steps are generally effective for inhibiting any given excitatory receptive
      field locus from an ovate-shaped area that extends asymmetrically in the
      direction that would be previously traversed by null-direction moving objects.
      This inhibitory area is typically larger than one-half the size of the receptive
      field center. The strength of the inhibition is greater at short than long
      distances within this area. 4. The rise and fall times of the null-direction
      inhibition elicited by apparent motion using prolonged light steps are somewhat
      faster at large than short interslit distances. 5. Short light flashes (at
      sufficiently long interslit delays) elicit inhibition not only from the same
      asymmetric, ovate-shaped inhibitory field as long steps of light, but also from
      loci completely surrounding the second slit. This implies that the asymmetric,
      null-direction-specific inhibition is due to a temporally sustained mechanism.
      The symmetric inhibition elicited by short flashes may be due to the presence of
      the antagonistic surround mechanism within the receptive-field center. The
      apparent absence of this surround inhibition for preferred-direction apparent
      motion during prolonged light steps may be due to masking by facilitation that is
      strongly evoked by long steps, but not flashes of light (see accompanying paper).
      6. The relatively slow rise time and sustained time course of the inhibition
      elicited by null-direction apparent motion within the excitatory receptive field
      center appears to distinguish it from the inhibition elicited by stimulation
      within the receptive field surround, which has a much faster rise time and more
      transient time course. However, the sustained, null-direction inhibitory
      mechanism that can be elicited by prolonged light steps within the excitatory
      receptive field center extends into the surround on the side of the receptive
      field center previously traversed during null-direction motion.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8350136
TI  - Multiple potassium conductances and their role in action potential repolarization
      and repetitive firing behavior of neonatal rat hypoglossal motoneurons.
AB  - 1. The role of multiple potassium conductances in action potential repolarization
      and repetitive firing behavior of hypoglossal motoneurons was investigated using
      intracellular recording techniques in a brain stem slice preparation of the
      neonatal rat (0-15 days old). 2. The action potential was followed by two
      distinct afterhyperpolarizations (AHPs). The early one was of short duration and
      is termed the fAHP; the later AHP was of longer duration and is termed the mAHP.
      The amplitudes of both AHPs were enhanced by membrane potential depolarization
      (further from EK). In addition, their amplitudes were reduced by high
      extracellular K+ concentration, suggesting that activation of potassium
      conductances underlies both phases of the AHP. 3. Prolongation of the action
      potential and blockade of the fAHP were observed after application of 1)
      tetraethylammonium (TEA) (1-10 mM) and 2) 4-aminopyridine (4-AP) (0.1-0.5 mM).
      Calcium channel blockers had little or no effect on the fAHP or action potential
      duration. 4. The size of the mAHP was diminished by 1) manganese, 2) lowering
      external Ca2+, 3) apamin, and 4) intracellular injection of ethylene glycol
      bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA) suggesting that
      influx of calcium activates the potassium conductance that underlies the mAHP. 5.
      The mAHP was unaffected by nifedipine (20 microM), but was strongly reduced by
      focal application of omega-conotoxin GVIA, suggesting that N-type calcium
      channels represent the major calcium influx pathway for activation of the calcium
      dependent K+ conductance underlying the mAHP. 6. Repetitive firing properties
      were investigated by injecting long-duration depolarizing current pulses. Steady
      state firing rose linearly with injected current amplitude. The slope of the
      firing frequency-current (f-I) relationship averaged approximately 30 Hz/nA in
      control conditions. Blockade of the conductance underlying the mAHP caused a
      marked increase in the minimal repetitive firing frequency and in the slope of
      the f-I plot, indicating a prominent role for the conductance underlying the mAHP
      in controlling repetitive firing behavior. 7. We conclude that action potential
      repolarization and AHPs are due to activation of pharmacologically distinct
      potassium conductances. Whereas repolarization of the action potential and the
      fAHP involves primarily a voltage-dependent, calcium-independent potassium
      conductance that is TEA- and 4-AP-sensitive, the mAHP requires the influx of
      extracellular calcium and is apamin sensitive. Activation of the calcium
      activated potassium conductance greatly influences the normal repetitive firing
      of neonatal hypoglossal motoneurons.

PMID- 8350138
TI  - Facilitation in ON-OFF directionally selective ganglion cells of the rabbit
      retina.
AB  - 1. We have investigated the facilitation of extracellularly recorded responses of
      ON-OFF directionally selective (DS) ganglion cells of the rabbit retina to two
      slit preferred-direction apparent motion produced by both prolonged light steps,
      which simulate movement of an edge past two apertures, and light flashes, which
      simulate movement of a spot or slit. 2. Within the excitatory receptive-field
      center of DS ganglion cells, apparent motion with prolonged light steps elicits
      preferred-direction facilitation whose rise time (220 +/- 150 ms, average rise to
      90% of maximum for 6 cells) is typically longer than the rise time of the
      excitatory response elicited by each slit. The decay time to baseline of
      facilitation during prolonged light steps is generally longer than 500 ms and
      hence greatly exceeds the typical duration of the excitatory response elicited by
      the slits. 3. Prolonged light steps are generally effective for facilitating any
      given excitatory receptive-field locus from a roughly ovoid area that typically
      extends on the order of 100-200 microns in the preferred direction, which is less
      than one-half the size of the excitatory receptive-field center. Within 100
      microns, facilitation can occur for motion diagonal to the preferred-null axis as
      long as the projection of the motion on the preferred-null axis points in the
      preferred direction. 4. The time course of preferred-direction facilitation
      between two slits does not appear to have a strong systematical dependence on the
      interslit distance over the range in which facilitation is effective. 5. Short
      light flashes are ineffective for eliciting facilitation and, at sufficiently
      long interslit delays, elicit inhibition all around the test slit. This
      inhibition may be due to the antagonistic surround mechanism within the receptive
      field center, which is effectively elicited by short-duration stimuli. 6. The
      effect of preferred-direction facilitation is addition-like, rather than
      multiplication-like. That is, the facilitatory effect of the first slit appears
      as the addition of a fixed value to the response-versus-contrast curve of the
      second slit, rather than a multiplication of the curve by a constant factor. The
      functional relationship between strength of facilitation and contrast of the
      first slit is sigmoidal, however, and thus nonlinear. 7. Experiments with long
      light steps show that the interaction between excitation and preferred-direction
      facilitation is largely segregated between the ON and OFF pathways.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8350139
TI  - CA3 neuron excitation and epileptiform discharge are sensitive to osmolality.
AB  - 1. The clinical signs of rapidly developing overhydration commonly include
      generalized tonic-clonic seizure, which can be combatted by raising plasma
      osmolality. How cortical neurons respond to osmotic imbalance has been addressed
      only recently. In the CA3 cell region of hippocampal slices, lowered osmolality (
      40 mOsm) rapidly swelled cells, increasing field potential amplitude over a
      period of 8 min and thereby elevating field effects and associated neuronal
      synchronization. 2. Over a longer time course (10-30 min), spontaneous excitatory
      postsynaptic potential (EPSP) amplitude gradually increased in 7 of 10 CA3
      neurons recorded intracellularly. In nine additional CA3 cells, hyposmolality
      gradually induced combinations of action potential discharge, endogenous
      bursting, and increased synchronized synaptic input. All of these effects
      reversed in normosmotic ACSF. 3. Hyperosmotic artificial cerebrospinal fluid
      (ACSF) using mannitol reduced field potentials and dramatically lowered CA3
      excitability by reducing spontaneous EPSP amplitude and associated bursting.
      Again, the gradual onset (10-30 min) of changes in spontaneous EPSP amplitude
      appeared independent of field potential changes, which were already maximal by 8
      min. 4. Cutting mossy fibers did not affect the excitability changes induced by
      osmotic stress noted above. The EPSP/inhibitory postsynaptic potential (IPSP)
      sequence evoked from mossy fibers or stratum oriens was unaltered by osmotic
      change and so did not represent osmosensitive afferent input to CA3 neurons.
      Furthermore, as measured at the soma, resting membrane potential, cell input
      resistance, and the action potential threshold were unchanged in all cells. It
      followed that, because the CA3 neurons themselves were not responsive, a
      recurrent excitatory pathway could not represent the osmosensitive
      input.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350140
TI  - Position-specific adaptation in complex cell receptive fields of the cat striate
      cortex.
AB  - 1. Responses of complex cells in cat striate cortex were studied with flashed
      light slit stimuli. The responses to slits flashed in different positions in the
      receptive field were assessed quantitatively before and after periods of
      prolonged stimulation of one small region of the receptive field. This type of
      prolonged stimulation resulted in reduced responsivity over a limited zone within
      the complex cell receptive field. 2. The adaptation-induced responsivity
      decrement was generally observed in both the ON and OFF response profiles but
      could also be restricted to one or the other. In general, the magnitude of the
      response decrements was greatest in the ON response profiles. The adaptation
      induced response decrement did not necessarily spread throughout the receptive
      field but was restricted to a small region surrounding the adapted receptive
      field position (RFP). Adaptation spread equally widely across the ON and OFF
      response profiles despite the smaller adaptation effects in the OFF profile. 3.
      The adaptation effects from repeated stimulation at a single RFP did not spread
      symmetrically across the receptive field, and a given cell's preferred direction
      of motion indicated the direction of the asymmetric spread of the adaptation.
      RFPs that would be stimulated by a light slit originating at the point of
      adaptation and moving in the preferred direction (preferred side) showed greater
      adaptation-induced response decrements than did RFPs that would be stimulated by
      a light slit moving in the opposite direction from the point of adaptation
      (nonpreferred side). There was significant enhancement of responses at some RFPs
      on the non-preferred side of the point of adaptation. This asymmetric spread of
      adaptation could be caused by adaptation of inhibitory connections that
      contribute to complex cell direction selectivity. 4. The asymmetry of adaptation
      was significantly different for the ON and OFF response profiles. The asymmetric
      spread of adaptation for the ON response profile was similar to that observed
      previously in simple cells with greater decrements in the preferred direction
      side of the point of adaptation. However, the OFF response profiles showed less
      directional asymmetry in the spread of adaptation and showed greater decrements
      at RFPs in the nonpreferred direction side of the point of adaptation. 5. The
      similarity between the spread of adaptation in simple and complex cells suggests
      that the adaptation in these cells is occurring through a common mechanism. The
      directional asymmetry of the spread of adaptation is likely due to a local
      postsynaptic mechanism of adaptation rather than presynaptic transmitter
      depletion.

PMID- 8350141
TI  - Activity of medullary reticulospinal neurons during fictive locomotion.
AB  - 1. The pattern of discharge of medullary reticulospinal neurons, identified by
      antidromic stimulation applied at the L1-L2 segment of the spinal cord, was
      studied during fictive locomotion, occurring spontaneously, or evoked by
      stimulation of the mesencephalic locomotor region in high-decerebrate, paralyzed
      cats. Unitary recordings were made in the medial reticular formation (P5.0-14.0
      mm; L0.5-2.0 mm), and the fictive locomotor pattern was monitored by recording
      the electroneurogram (ENG) of representative flexor and extensor muscle nerves
      from each of the four limbs. 2. In total, 117 reticulospinal neurons were
      recorded in 15 cats. Among these, 73.5% (86/117) modified their discharge at the
      onset of locomotion. These cells were divided into three subpopulations: 34/86 of
      the cells always maintained a fixed temporal relationship with the activity of
      one of the recorded nerves (ENG-related = 39.6%); the pattern of discharge of
      42/86 cells was related to the locomotor rhythm [(LR-related-48%)] but was not
      temporally correlated with any of the recorded nerves; and the remaining 10 cells
      increased their firing frequency at the onset of locomotion but remained tonic
      (TONIC-11.6%). 3. Of the ENG-related neurons, 64.8% were temporally correlated to
      extensor nerve activity, whereas the remaining 35.2% were correlated to flexor
      nerves. These neurons were either related to forelimb (55.9%) or hindlimb (44.1%)
      nerves lying either ipsilateral (38.2%) or contralateral (61.8%) to the recording
      site. A few neurons (n = 3; 8.8%) were related to nerve activity of more than one
      limb. 4. The pattern of discharge of the LR-related neurons, although not
      correlated to the activity of any one recorded nerve, could be preferentially
      related to the locomotor rhythm in either the forelimbs (12/23) or hindlimbs
      (11/23). 5. ENG- and LR-related reticulospinal neurons were intermingled in the
      medial reticular formation. In both cases, cells related to the forelimbs were
      located more dorsally than those related to the hindlimbs. It is suggested that
      both the ENG- and LR-related neurons represent a single functional population of
      reticulospinal neurons that is part of an intrinsically organized reticulospinal
      system that functions to coordinate the activity of the skeletal musculature. 6.
      The present results show that the majority of reticular neurons projecting as far
      as the lumbar spinal cord are phasically modulated during locomotion, even in the
      absence of phasic peripheral afferent inputs. Moreover, the complexity of the
      discharge patterns in paralyzed animals was found to be similar to that observed
      in the intact cat.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350142
TI  - Nonlinear dynamics in a model neuron provide a novel mechanism for transient
      synaptic inputs to produce long-term alterations of postsynaptic activity.
AB  - 1. A mathematical model of a bursting molluscan neuron has been found to possess
      multiple modes of electrical activity, such as periodic beating (tonic firing),
      periodic bursting (bursts of action potentials separated by quiescent periods),
      and potentially chaotic bursting, all at a single set of parameters. The multiple
      modes correspond to multiple stable attractors, whose existence is an emergent
      property of the nonlinear dynamics of the system. 2. Transient synaptic inputs
      can switch the activity of the neuron between different modes. These mode
      transitions, which do not require any changes in the biochemical or biophysical
      parameters of the neuron, provide an enduring response to a transient input, as
      well as a mechanism for phasic sensitivity (i.e., temporal specificity). 3. These
      results provide new insights into the role of nonlinear dynamics in information
      processing and storage at the level of the single neuron.

PMID- 8350143
TI  - Responses of neurons in primary visual cortex are modulated by eye position.
AB  - 1. We tested the effects of eye position on the visual excitability of 88 neurons
      in the primary visual cortex of awake cats trained in oculomotor tasks. For most
      cells, we examined responses evoked by retinotopically identical stimuli for
      centered gaze, 8 degrees to the left of center, and 8 degrees to the right of
      center. 2. An effect of eye position was observed for 40% of the cells. For 13%,
      responsiveness varied by a factor of 2 or more. Most commonly, response was
      maximal with gaze shifted to one side, minimal when shifted to the opposite side,
      and intermediate for centered fixation. The exceptions were four cells for which
      excitability varied symmetrically with fixations to either side of center. 3.
      Variability in excitability associated with eye position is a wide-spread
      phenomenon, having been observed in the lateral geniculate nucleus, V1, and
      extrastriate cortex. These results are consistent with the belief that such
      variability is utilized in constructing a head-centered frame of reference from a
      retinotopic input.

PMID- 8350144
TI  - Effect of spatial configuration on motion aftereffects.
AB  - Sensitivity to motion was measured by the percentage of trials on which an
      observer reported seeing motion of briefly presented high-contrast sinusoidal
      gratings moving over a range of velocities. The psychometric curve was remeasured
      following adaptation to a grating moving in one direction for an extended period
      of time. Adaptation shifted the minimum of the psychometric curve toward the
      direction of the direction of the adapting stimulus. The shift was smaller when
      the adapting field was larger than the test. In a second set of experiments we
      measured the effect of motion adaptation on contrast thresholds for moving
      gratings of different sizes. Threshold elevation was maximal when adapting and
      test sizes matched. We present a mechanistic model of the motion aftereffect that
      consists of independent multiplicative gain controls in motion-sensing mechanisms
      tuned to different rates of motion. In addition, we discuss a model of size
      effects in motion adaptation that invokes diffuse inhibitory connections among
      motion-sensing mechanisms.

PMID- 8350145
TI  - Signal sampling and propagation through multiple cell layers in the retina:
      modeling and analysis with multirate filtering.
AB  - The retina is a multilayered structure. Each layer consists of one or more
      classes of cell, each at its own density and with its own anatomic and
      physiologic properties. Signals converge from many cells in one layer onto single
      cells in another layer, and a signal from a single cell diverges to many cells in
      the next layer. In this methods paper we develop a general approach to retinal
      analysis and modeling that incorporates multiple cell classes, their densities,
      and related anatomic properties. The method is based on multirate filtering, a
      branch of signal processing in which signals of different sampling rates are
      manipulated. By drawing a correspondence between cell density and signal sampling
      rate, we define multirate models that incorporate different cell densities,
      convergence, divergence, variation in dendritic field shape, cell-to-cell
      variation in synaptic weights, and other anatomic features. We develop the
      multirate approach and apply it to the cat cone-->cone bipolar CBb1-->on-beta
      ganglion cell pathway as an example. We calculate the spatial frequency responses
      of the CBb1 and on-beta cells based on the cone spatial frequency response and
      find that the attenuation of high frequencies in the cones prevents aliasing that
      would otherwise occur in CBb1 and on-beta cells. We compare the calculations with
      cat psychophysics. We show that the optics of the cat eye are insufficient in
      themselves for the prevention of aliasing in these cells; additional attenuation
      by the cone-cone gap junctions and the cone aperture is necessary. By including
      this postreceptoral filtering, we demonstrate that the highest spatial frequency
      that can be passed by the retina without aliasing is determined not always only
      by the densities of cones, bipolar cells, and ganglion cells but also by the
      synaptic and the dendritic weighting between these cells.

PMID- 8350146
TI  - Optics of the harbor porpoise eye in water.
AB  - A two-dimensional ray-tracing model for the harbor porpoise eye is constructed
      from new measurements, mainly on two enucleated eyes, and from data found in the
      literature. Model calculations show that the crystalline lens has too much
      refractive power to focus light on the retina. The cornea has a high refractive
      index and acts as a diverging lens of considerable refractive power. The cornea
      corrects the eye to near emmetropia for axial and temporal (caudal) directions of
      view. The eye is approximately 5-D myopic for nasal (frontal) directions of view.
      The iris serves a dual role as a stop: the iris determines the shapes of bundles
      of light that enter the lens and the iris blocks light that leaves the lens
      anterior to its equator.

PMID- 8350147
TI  - Loci of achromatic points throughout the life span.
AB  - Mixtures of monochromatic lights that appear achromatic were measured for 50
      normal, trichromatic observers ranging in age from 11 to 78 years. Stimuli were
      presented to one eye as a 1 degree-diameter, 1-s flash (10-s interstimulus
      interval) in Maxwellian view. We found the achromatic locus by varying the
      intensity ratio of each observer's spectral unique blue and unique yellow while
      maintaining constant overall retinal illuminance. Measurements were made for
      three levels of retinal illuminance (10, 100, 1000 trolands). Additional
      verification of the position of the achromatic locus in color space was obtained
      for 23 subjects with the use of a mixture composed of 600-nm light and its
      spectral complement. There were no significant changes in the achromatic loci as
      a function of age. The mean achromatic locus in CIE chromaticity space was x, y =
      0.31, 0.31 or u',v' = 0.21, 0.46. These results suggest that partial compensation
      for age-related changes in visual mechanisms occurs in a way that preserves
      constancy of the achromatic locus across the life span.

PMID- 8350148
TI  - Modeling the contrast-sensitivity functions of older adults.
AB  - To determine whether a parabolic template is a good description of the contrast
      sensitivity functions (CSF's) exhibited by older adults, the curve-fitting method
      of Pelli et al. [J. Opt. Soc. Am. A 3(13), P56 (1986)] was applied to contrast
      sensitivity data from 100 older subjects (ages 53-85 years). Although the method
      resulted in reasonable fits for most subjects, closer inspection revealed that
      this technique may be problematic. A significant number of observers had
      functions that were nonparabolic, and for many subjects the error tended to be
      concentrated at the peak of the CSF. In addition, in contrast to the study of
      Pelli et al., the peak contrast sensitivities of the subjects were only weakly
      related to Pelli-Robson contrast sensitivity and letter acuity. The data were
      also fitted with an asymmetric function of variable shape. Whereas this function
      provided a better fit to the nonparabolic CSF's, it resulted in inferior fits to
      most of the remaining data. These results demonstrate that the spatial CSF's of
      older adults cannot be described by a single parametric curve such as a parabola
      or a function of an exponential and that Pelli-Robson contrast sensitivity and
      letter acuity are not adequate predictors of their peak contrast sensitivities.

PMID- 8350149
TI  - Phenomenological model for interpreting the clinical significance of the in vitro
      optical transfer function.
AB  - We describe a methodology to predict the outcome of clinical tests caused by
      changes made to the optical elements of the human eye. This formalism, called the
      expected visual outcome model, is based on in vitro measurements of the optical
      transfer function and takes into account a simple model of human threshold
      performance. The clinical tests under consideration are high-contrast visual
      acuity and contrast sensitivity. Using the expected visual outcome, we describe a
      useful performance index called the predicted visual acuity graph, which can be
      measured clinically. The theoretical results are compared with visual function
      measured in patients with pseudophakic (multifocal and monofocal) implants.

PMID- 8350150
TI  - Parametric representation of Stiles-Crawford functions: normal variation of peak
      location and directionality.
AB  - Evidence suggests that the psychophysically determined Stiles-Crawford effect of
      the first kind (SCE) reflects waveguide properties of human photoreceptors. The
      peak of the SCE data set is assumed to reflect the principal alignment
      tendencies, and the spread (e.g., rho value, the curvature or width at half
      height) is assumed to reflect the directionality (i.e., interreceptor differences
      in alignment) of the population of photoreceptors being tested. As such,
      disruption of the normal SCE can be used and/or has been used (1) to document
      early natural history of retinal pathology involving the photoreceptors, (2) to
      provide a firm rationale for therapeutic intervention, and (3) to provide a
      method for monitoring therapies designed to alter the natural course of retinal
      disease processes. We report large-sample norms for foveal SCE peak location and
      spread (horizontal peak location, nasal 0.51 +/- 0.72, horizontal rho value 0.047
      +/- 0.013, vertical peak location, superior 0.20 +/- 0.64, vertical rho value
      0.053 +/- 0.012), compare these norms with values determined in other
      laboratories, and discuss the various mathematical forms used for the empirical
      description of SCE data sets.

PMID- 8350151
TI  - Heterogeneity in retinal disease and the computational model of the human-rod
      response.
AB  - Abnormal rod-receptor activity can be quantitatively assessed in humans by
      fitting a computational model of the rod's response to the leading edge of the a
      wave of the electroretinogram. One purpose of the present study was to compare
      two procedures for fitting the model to the electroretinogram. A computationally
      simpler method gives comparable results to the more labor-intensive method used
      previously. This finding holds for both normal observers and patients with
      retinodegenerative disease that affects the receptors unevenly. A second purpose
      of the present study was to consider the effects of a heterogeneous disease
      process on the parameters of the model. a waves from a heterogeneous retina are
      computer simulated and are fitted with the receptor model. This analysis suggests
      that the model will overestimate the change in the healthiest rods and will
      underestimate the percentage of the rods that are significantly affected.

PMID- 8350152
TI  - Temporal properties of letter identification in retinitis pigmentosa.
AB  - The effect of stimulus duration on the visual acuity of individuals with
      retinitis pigmentosa (RP) was assessed by using Sloan letters of 100% contrast
      and durations ranging from 15 ms to 3.8 s. In addition, contrast thresholds for
      identifying Sloan letters (0.7 log minimum angle of resolution; 20/100 Snellen
      equivalent) were measured over the same range of durations in the same subjects
      with RP. Compared with results from a control group of subjects with normal
      vision, the subjects with RP showed losses in visual acuity at all stimulus
      durations, with a slightly though significantly greater reduction in visual
      acuity at short durations. The letter-contrast thresholds of the subjects with RP
      were elevated above the normal range to the same degree at all durations.
      Analysis of the results in the format of letter contrast sensitivity functions
      indicates that temporal summation for letter identification was normal for these
      subjects with RP and that their relatively greater acuity loss at short exposure
      durations was most likely related to their elevated letter contrast thresholds.

PMID- 8350153
TI  - Fractal analysis of steady-state-flicker visual evoked potentials: feasibility.
AB  - Electrophysiological models of visual evoked potential recording have assumed
      that response variability is caused predominantly by random noise added to a true
      steady signal. Since neuronal geometry has a fractal structure, neural activity
      may demonstrate deterministic nonlinear dynamics, i.e., chaos. We recorded
      several-minute time-series traces of the visual evoked potential magnitude in
      response to full-field flicker from three glaucoma patients and one normal
      subject. When plotted in phase space, the steady-state response derived from a
      lock-in amplifier shows an apparent so-called strange attractor (extended
      nonrepeating loops) rather than the pattern expected from a signal-plus-noise
      model (a fuzzy dot). The fractal dimension of this attractor may be a more
      sensitive indicator of early optic-nerve damage than are visual evoked potential
      latency or amplitude measures.

PMID- 8350154
TI  - Axial eye-length measurement by wavelength-shift interferometry.
AB  - A simplified noncontact measuring technique for axial eye length was developed.
      According to this method, the wavelength shift of a single-mode laser-diode beam
      that is irradiated onto the eyeball causes a phase shift in the interference
      fringes of reflections from the retina and the cornea. Then the optical distance
      between the cornea and the retina is obtained from the phase-shift measurement.
      High-speed axial eye-length measurements can be performed by using a laser diode
      on a pulse-modulation drive and signals from the reference light path as an
      analog-to-digital-conversion trigger. Compared with the technique that uses
      partially coherent light, this technique is inferior in terms of measurement
      accuracy but superior in its wide, measurable range of 16-32 mm. The results of
      measurements of 21 adults showed that 2 standard deviations of measurement was 2
      sigma = +/- 0.11 mm.

PMID- 8350155
TI  - Effects of aging in retinal image quality.
AB  - The retinal image quality characterized by the modulation-transfer function of
      the eye was measured for two groups of subjects aged in the late twenties and mid
      sixties, respectively. In both groups, we obtained modulation transfer functions
      by using a double-pass method under the same experimental conditions: 4-mm
      artificial pupil, paralyzed accommodation, and objective control of the
      refractive state and centering. Results showed lower values of modulation in the
      retinal image for older subjects compared with the younger subjects. The
      modulation transfer function ratio is similar to that previously found for
      contrast-sensitivity measurements with subjects in the same age groups. These
      results suggest that a significant fraction of the loss in spatial vision with
      age has an optical origin. Apart from the well-known increase in intraocular
      scattering, there also appears to be an increment in ocular aberration that
      causes an additional reduction in the contrast of retinal images.

PMID- 8350156
TI  - Eye-tracking laser Doppler velocimeter stabilized in two dimensions: principle,
      design, and construction.
AB  - We developed an eye-tracking laser Doppler velocimeter to minimize eye-movement
      artifacts in the study of ocular hemodynamics in humans. The instrument
      compensates for both horizontal and vertical eye motions by using galvanometer
      mirrors controlled by a dual-Purkinje eye tracker. The performance of the
      instrument is demonstrated in a preliminary study of retinal arterial blood
      velocity in a normal subject. The subject's fixation point was adjusted manually
      to oscillate through a 2.3-deg span at 0.3 Hz. In spite of this motion the
      pulsatile velocity waveform of the heart cycle could be continuously recorded.
      Without eye tracking the velocity waveform was lost after the initiation of
      movement.

PMID- 8350157
TI  - Clinical microscopy of the cornea utilizing optical sectioning and a high
      numerical-aperture objective.
AB  - A doublet contact element was added to a long-working-distance objective to
      increase the numerical aperture to 0.75 and to maintain the focus during in vivo
      examination of the eye. Optical sectioning by use of confocal slits permits
      visualization of weakly scattering structures within the cornea. With
      photographic film and a 1/60-s exposure time to limit the effect of eye movement,
      an effective optical section half-thickness of approximately 20 microns was
      realized. Structures observed in the cornea include epithelial cells (surface,
      wing, and basal cells), nerve-fiber bundles in the subepithelial region,
      keratocytes and inflammatory cells in the stroma, and endothelial cells.

PMID- 8350159
TI  - Hybrid model of Monte Carlo simulation and diffusion theory for light reflectance
      by turbid media.
AB  - Light reflectance by semi-infinite turbid media is modeled by a hybrid of Monte
      Carlo simulation and diffusion theory, which combines the accuracy of Monte Carlo
      simulation near the source and the speed of diffusion theory distant from the
      source. For example, when the turbid medium has the following optical properties-
      absorption coefficient 1 cm-1, scattering coefficient 100 cm-1, anisotropy 0.9,
      and refractive-index-matched boundary--the hybrid simulation is 7 times faster
      than the pure Monte Carlo simulation (100,000 photon packets were traced), and
      the difference between the two simulations is within 2 standard deviations of the
      Monte Carlo simulation.

PMID- 8350158
TI  - Method for measuring visual resolution at the retinal level.
AB  - To measure the intrinsic resolving capacity of the retinal and neural levels of
      vision, we devised a method that creates two lines with controllable contrast on
      the retina. The line separation can be varied at will, down to values below those
      achievable with conventional optical techniques. Implementation of the method
      with use of a He-Ne laser leads to a procedure that permits analysis of the
      performance of the human visual apparatus.

PMID- 8350160
TI  - Pigment tests evaluated by a model of chromatic discrimination.
AB  - Clinical color-vision tests are evaluated within the framework of a model of
      chromatic discrimination in terms of cone excitation. The motivation for this
      study was to derive a method for evaluation of test design, test sensitivity, and
      observer performance. The discrimination model is based on the assumption that
      chromatic discrimination is mediated in two independent channels, one for short
      wavelength cones and one for long- and middle-wavelength cones. Luminance
      dependent templates are derived for each channel, and they describe chromatic
      discrimination behavior of the young color-normal observer. The templates
      incorporate receptor- and opponent-level gain controls. We show how the
      chromaticities of clinical tests can be calculated in cone-excitation units and
      how discrimination behavior on the tests can be plotted on the templates. The
      tests include the Farnsworth-Munsell 100-hue, the Farnsworth Panel D-15, the
      Farnsworth Panel D-15 desaturated, the American Optical Hardy-Rand-Rittler, the
      Farnsworth F2 plate, the Standard Pseudoisochromatic Plates, Part II, the
      Ishihara, and the Minimalist tests. Clinical-test data collected on young color
      normal observers at different illumination levels show the validity of the
      techniques.

PMID- 8350161
TI  - Chromatic and luminance sensitivity in diabetes and glaucoma.
AB  - The effects of glaucoma and diabetes on the sensitivities of the opponent and
      achromatic systems were investigated by measuring thresholds along theoretically
      defined axes in a three-dimensional color space. Thresholds were measured along
      two equiluminant chromatic axes and one achromatic axis in patients with diabetes
      or glaucoma and in glaucoma suspects. The results were compared with measures of
      sensitivities of short- and middle-wavelength-sensitive-cone pathways [S (Stiles
      pi 1) and M (Stiles pi 4), respectively] and with measures of hue discrimination
      by use of the Farnsworth-Munsell 100-hue test. The glaucoma suspects and diabetic
      patients showed preferential S-cone-pathway sensitivity losses. For glaucoma
      patients, however, these losses were associated with significant decreases in the
      sensitivity of the L-M opponent system and with decreased sensitivity to
      achromatic contrast.

PMID- 8350162
TI  - Longitudinal comparison of temporal-modulation perimetry with white-on-white and
      blue-on-yellow perimetry in ocular hypertension and early glaucoma.
AB  - We obtained data over 3 years on temporal-modulation perimetry (TMP), standard
      automated [white-on-white (W/W)] perimetry, and short-wavelength-sensitive [blue
      on-yellow (B/Y)] perimetry in ocular hypertensive (OH) patients and patients with
      early glaucomatous visual-field loss (EG). Evidence of visual-field defects was
      obtained with the use of both B/Y perimetry and TMP in the majority of OH and EG
      eyes that demonstrated progression on W/W perimetry as well as in all stable EG
      eyes. Using the nerve-fiber-bundle pattern to compare testing procedures, we
      determined that these defects were generally as extensive or more extensive than
      the concurrent W/W abnormalities. In terms of location over the 3 years of
      testing, TMP and B/Y defects were reasonably consistent in the EG eyes, somewhat
      less consistent in the OH eyes demonstrating progression, and both inconsistent
      and infrequent in the stable OH eyes. The greatest degree of overlap occurred
      between the location of defects obtained by use of the higher TMP frequencies (8
      and 16 Hz) and that of defects obtained by use of B/Y perimetry. Since these two
      methods are thought to isolate different visual mechanisms subserved by different
      visual pathways, these results suggest that early glaucomatous visual-field
      damage as revealed by TMP and B/Y perimetry may not be specific to a single
      visual pathway.

PMID- 8350163
TI  - Analysis of Rayleigh match data with psychometric functions.
AB  - Color matches have been used for a variety of purposes, yet the psychometric
      properties of color-matching data have not been thoroughly investigated. A method
      is given for generating psychometric functions for the two ends of the color
      matching range by use of a perceptual dimension for stimulus magnitude based on
      ratios of cone quantal catches. The analysis was applied to Rayleigh match data
      gathered from 250 naive observers with an automated protocol. Slopes of the
      psychometric functions were significantly shallower for anomalous trichromats
      than for normal trichromats, consistent with the assumption that stimulus
      magnitude is based on ratios of cone quantal catches. These results indicate that
      the tester's criterion for response consistency can strongly affect Rayleigh
      match widths. The analysis may also be useful for other perceptual tasks, such as
      contrast matching and spatial alignment.

PMID- 8350164
TI  - Application of the spatiochromatic visual evoked potential to detection of
      congenital and acquired color-vision deficiencies.
AB  - Visual evoked potentials were recorded in response to spatiochromatic stimuli
      modulated in different directions in cone-activation color space from subjects
      with congenital and acquired color defects. This technique was effective for
      detection and classification of both mild and severe forms of congenital
      deficits. Results suggest that the visual evoked potential is useful for early
      identification of color abnormalities in acquired deficits such as diabetes and
      that it is sensitive enough to detect regional retinal losses of sensitivity
      (e.g., as in central serous choroidopathy). The spatiochromatic visual evoked
      potential provides a systematic and sensitive indication of different color
      vision anomalies.

PMID- 8350165
TI  - Multivariate assessment of computer-analyzed corneal topographers.
AB  - Methodological aspects of multivariate statistical models to describe and to
      assess data from computer-analyzed corneal topographers (CACT) are considered.
      The data generated by repeated curvature mappings of calibrated steel balls are
      discussed in detail with the objective of formulating the basic questions and
      suggesting directions to assess data from clinical applications of CACT. The
      interpretation of seemingly straightforward concepts such as accuracy and
      precision is revisited with the objective of understanding its meaning in future
      clinical and experimental applications of CACT. Some of the statistical problems
      related to the analysis of corneal astigmatism based on CACT data are also
      discussed.

PMID- 8350166
TI  - Quantification of monocular optokinetic nystagmus asymmetries and motion
      perception with motion-nulling techniques.
AB  - When tested monocularly, strabismic and amblyopic subjects often show asymmetries
      of optokinetic nystagmus (OKN), with OKN being more readily elicited by temporal
      to-nasal than by nasal-to-temporal stimulus motion. We tested five visually
      normal subjects and ten strabismic and/or amblyopic subjects by use of motion
      nulling stimuli, which consisted of superimposed temporal-to-nasal and nasal-to
      temporal sinusoidal-grating components with a summed contrast of 100%. Both the
      direction of OKN and the subject's perceived direction of motion (PDM) were
      tested. Most normal subjects showed symmetrical OKN and PDM, but a rightward OKN
      bias was observed in one of the visually normal subjects. Temporal-to-nasal eye
      movement biases were seen in most strabismic and amblyopic subjects, whereas PDM
      biases were smaller and less frequent. The primary purpose of this study was to
      demonstrate the feasibility of quantifying OKN and PDM asymmetries in a diverse
      group of visually abnormal adults by use of the motion-nulling technique.
      Application of this technique to larger and more homogeneous clinical populations
      may contribute to the continued differentiation and characterization of variants
      of the visual disorders associated with strabismus and amblyopia and with other
      defects of binocular vision.

PMID- 8350167
TI  - Binocular enhancement of visual acuity.
AB  - Using a computerized test system, we compared binocular and monocular visual
      optotype acuity, varying both contrast and contrast disparity between the two
      eyes. When contrast was the same in the two eyes, binocular acuity was better
      than best monocular acuity by an average of 0.045 log minimum angle of
      resolution, or 11%. When contrast differed in the two eyes, binocular acuity in
      most but not all cases was still better than the monocular acuity of the eye that
      received the higher contrast. This binocular advantage became smaller but
      remained significant as contrast disparity became larger. These results are most
      simply explained by threshold contrast summation of high-spatial-frequency letter
      components.

PMID- 8350168
TI  - Contrast sensitivity and disability glare in the middle years.
AB  - Spatial contrast sensitivity and disability glare were measured in a large sample
      (n = 90, 30 per decade) of middle-aged subjects, aged 21-50 years, who had clear
      media and were ophthalmologically normal. We found no significant differences in
      the contrast sensitivities as a function of age in the middle years for (1)
      gratings generated on a monitor; (2) interference gratings generated in the
      retinal plane; (3) gratings in the presence of glare; and (4) mesopic increment
      thresholds with and without glare. The large sample size provides sufficient
      statistical power (0.8) for one to conclude that contrast sensitivity, optical
      quality, and foveal neural sensitivity are unlikely to vary more than 0.1 log
      unit between the ages of 21 and 50 in ophthalmologically normal subjects with
      clear media.

PMID- 8350170
TI  - The stability of temporary prosthetic base materials. I: Introduction, angular
      changes and dimensional stability.
AB  - The bases of occlusal rims and trial dentures should fit both the cast and the
      mouth accurately. The retention of shape and dimension of strips and sheets of
      grey and pink shellac, filled cold cure acrylic resin and wax were tested
      following moulding over stylised upper edentulous casts. The thermoplastic
      materials were softened over a flame or in a water bath. Specimens were prepared
      with and without folding along the long axes of the strips. The angles formed by
      the strips, the gap between the palate of the baseplates and casts and the linear
      dimension of the sheets were measured after moulding, after immersion in water at
      37 and 45 degrees C and after 24 h at room temperature. The least angular change
      was shown by unfolded grey shellac, softened over a flame and moulded by finger
      pressure over an unwarmed cast, followed by folded specimens softened in water
      and moulded with the fingers over a prewarmed cast. The least gap developed
      beneath pink shellac softened in water and moulded by finger pressure over a
      warmed cast. The smallest dimensional change was shown by grey shellac softened
      in water and moulded by finger pressure over a warmed cast. Thus, optimally
      manipulated shellac materials exhibit less change after moulding than cold cure
      acrylic resin or modelling wax.

PMID- 8350169
TI  - Acoustic myography in the assessment of human masseter muscle.
AB  - The feasibility of examining electro-mechanical activity of the human masseter
      muscles using non-invasive recording techniques was examined in six healthy
      dentate adults (aged 34-57 years). Electrical activity of the muscle was examined
      by surface electromyography (EMG) and the mechanical activity, in the form of
      muscle sounds, was examined by acoustic myography (AMG). Bilateral recordings of
      EMG and AMG were made simultaneously using composite probes which were placed on
      the skin over the masseter muscles. A standardized pressure was applied to the
      probes via adjustable rods attached to a safety helmet. Pressures were monitored
      by strain gauges placed between the ends of the rods and the probes. With the
      subject seated, recordings of AMG and EMG were obtained during maximal jaw
      clenching for 4 s and the raw signals were stored on a computer. Of three maximal
      contractions performed, the last two were used in the analysis. The raw amplified
      signals underwent frequency analysis by fast Fourier Transform. Total activity
      was also assessed after amplification, full-wave rectification and integration,
      and repeatability of the results was assessed. The AMG frequency range was 6-15
      Hz and was similar to values for other human skeletal muscles. The integrated
      values for EMG and AMG were repeatable on both sides of the face (IEMG, right r =
      0.99, left r = 0.99; IAMG right r = 0.70, left r = 0.71). Simultaneous recordings
      of AMG and EMG from the masseter muscles may be useful for assessing electro
      mechanical muscle function but further validation studies are required before the
      technique can be used clinically.

PMID- 8350171
TI  - Elementary identification of a gnathosonic classification using an autoregressive
      model.
AB  - This was an investigation to determine the feasibility of an autoregressive (AR)
      model for establishing characteristic parameters from recorded occlusal sounds
      and develop their classification. Thirty four normal subjects with intact natural
      dentitions were selected for the study. The subjects' occlusal sounds from both
      sides of their faces respectively were sampled, and the gnathosonic
      classification (Class A, B and C) was established by observing the original
      recorded wave pattern and measuring the duration. Then, a 20 order AR model was
      calculated with the collected data, and the AR model coefficients were found to
      be similar to the indices of Bayes' discriminatory analysis. The total
      conformation rates of the modelled left and right occlusal sounds to the
      classification, estimated by Bayes' discriminant functions were 97.06% and 88.24%
      respectively. AR coefficients representing the characteristics of human occlusal
      sounds can be helpful in their classification and allow computer diagnosis of
      occlusal disorders.

PMID- 8350172
TI  - Measurement of the viscosity of irreversible hydrocolloids.
AB  - Three techniques have been used to assess the shear rate dependence of the
      viscosity of mixed alginate impression materials prior to setting. Two methods
      used a cone-plate viscometer, and one method was a capillary extrusion technique.
      Data from the three sets of experiments have been critically compared. It has
      been shown that an unset alginate material exhibits Bingham behaviour.

PMID- 8350173
TI  - Longitudinal study on occlusal force distribution in lower distal-extension
      removable partial dentures with conus crown telescopic system.
AB  - The purpose of this study was to examine longitudinal changes of the occlusal
      force distribution in lower distal-extension removable partial dentures with the
      conus crown telescopic system. Occlusal force applied to the denture and forces
      transmitted to the retainers were measured on several separate occasions from the
      insertion of new dentures to about 3 months after. The occlusal force
      distribution ratio to the retainers was calculated when a load of 20 N was
      applied to the denture. The results are summarized as follows: (i) The more
      posterior the loading point of occlusal force, the smaller was the ratio. When
      the occlusal force was applied to the most anterior artificial tooth, the ratio
      was 65-100% of the occlusal force. (ii) As the denture wearing time proceeded,
      the ratio was decreased. The smaller the ratio, the greater was the rate of its
      decrease.

PMID- 8350174
TI  - The production of shellac and its general and dental uses: a review.
AB  - An historical review of the general uses of shellac is presented and the various
      manufacturing processes, properties and chemical composition are discussed. The
      applications, advantages and disadvantages of shellac and its uses in dentistry
      are outlined.

PMID- 8350175
TI  - Taurodontism and length of teeth in patients with oligodontia.
AB  - Taurodontism and a reduced tooth length are reported to occur in patients with
      oligondontia. The aim of this study was to evaluate the occurrence of these
      factors in Dutch patients with oligodontia. Panoramic radiographs of 117 patients
      with oligodontia and 91 controls were collected. Taurodontism of the mandibular
      first molars was recorded and the length of cuspids, bicuspids and first molars
      of the mandible were measured. In patients with oligodontia 28.9% showed
      taurodontism of one or two mandibular first molars. The prevalence of
      taurodontism in normal Dutch subjects was 9.9%. No significant differences were
      found between the two sexes in both groups. Neither was there a significant
      difference in the unilateral and bilateral occurrence of taurodontism. The
      present findings supported the hypothesis that taurodontism may be the result of
      an ectodermal defect and a manifestation of developmental instability in patients
      with oligodontia. The length of mandibular cuspids and first molars in females
      were significantly reduced. In males only the lower right first molar was
      significantly reduced. The reduced length of the teeth may also be the result of
      a defect in ectodermal cells. Both taurodontism and a reduced length are of
      importance considering dental therapy.

PMID- 8350176
TI  - Complications in the tissue integrated prostheses components: clinical and
      mechanical evaluation.
AB  - Cases demonstrating complications in osseointegrated implant supported prostheses
      are described. These complications occurred in the prostheses framework or
      veneer, in the fixation screw, in the abutment post or screw as well as in the
      implant body. The two main reasons for the complications were lack of passive
      fitting between the restoration and the abutment; and destructive occlusal
      contacts. The destructive occlusal contacts may develop during the time of wear
      of the prostheses material or by changes in the opposite restoration. Overloading
      or bending moments exerted on the prostheses via these occlusal contacts resulted
      in loosening or fracture in one of the implant-prostheses components. The benefit
      of acrylic resin or composite material in reducing stresses in the light of the
      possible long-term, harmful occlusal changes that might develop as a result of
      their wear should be considered.

PMID- 8350177
TI  - Variables affecting the fracture toughness of resin-based inlay/onlay systems.
AB  - The fracture toughness of five different resin-based inlay/onlay materials was
      investigated by means of critical stress intensity factor (KIC) using the SEN
      three-point bending test procedure (BS 5447: 1977). KIC values were determined
      from specimens prepared by both the direct and indirect techniques. Tests were
      performed immediately, after 1 day, 1 month and 3 month time intervals. Also,
      fractured surfaces of specimens were observed using SEM photographs.

PMID- 8350178
TI  - Anterior digastric muscle responses to sudden unloading of the mandibular
      elevator muscles in younger and older adults.
AB  - The digastric motor responses in the unloading reflex were investigated in a
      sample of 10 younger and eight older dentate subjects. The occurrence of the pre
      collapse digastric activity (PDA) and the reflex events (burst of activity)
      following the mandibular unloading (DB) were studied separately. PDA was nearly
      consistent in half of the subjects of both groups. DB was clearly identified in
      60% of the younger subjects, but in 54.2% of the older subjects. The mean latency
      of DB found in the younger subjects was 32.4 +/- 9.5 ms but 34.5 +/- 8.8 ms in
      the older subjects. For the latencies found we can infer that they are related to
      polysynaptic pathways. Also a slight tendency for decreased frequency of
      occurrence and increased latencies of DB is observed in the older age group.

PMID- 8350179
TI  - Reproducibility of tooth tapping rhythm in young and elderly dentate subjects.
AB  - The reproducibility of tooth tapping frequencies was measured in young and
      elderly dentate subjects. Six rates of tapping, i.e. 40, 60, 90, 120, 160 and 200
      times per min, were practised to the accompaniment of a metronome for 15 s before
      recording. After a 15-s break, subjects were asked to reproduce the same rate of
      tapping without metronome accompaniment, and these movements were recorded. It
      was determined that the young subjects regulated tooth tapping frequencies by
      controlling velocity of mandibular movement. On the other hand, the elderly
      subjects regulated tooth tapping frequency by controlling opening width.

PMID- 8350180
TI  - Electrochromic behaviour of carotenoid molecules in nerve cell membranes: a
      resonance Raman study.
AB  - It was found that, following the depolarization of cell membranes of frog sciatic
      nerve, the 1521 and 1156 cm-1 resonance Raman (RR) bands of carotenoids showed an
      increase in intensity of 20%, 15% and 4% at excitation wavelengths of 488, 496.5
      and 514.5 nm respectively. None of the bands revealed any change with excitation
      at 441.6, 457.9, 472.7 and 476.5 nm. These results can be explained by an
      electrochromic shift of the excitation profile of the RR bands by about 0.5 nm to
      the red. A dependence of the 1521 cm-1 band intensity on transmembrane potential
      was obtained. Under the effect of lanthanum ions, which are known to modify the
      surface charge of the membrane, the intensity of the Raman bands decreased by 15%
      20% (excitation, 488.0 nm). The results obtained indicate that RR spectroscopy of
      carotenoids can be used to monitor changes in the transmembrane potential and
      surface charge of nerve cell membranes.

PMID- 8350181
TI  - Photosensitization with anticancer agents. 16. The photo-oxidation of hypocrellin
      A. A mechanism study using 18O labelling.
AB  - Hypocrellin A was selected as a representative structure to investigate the
      mechanism of photo-oxidation of perylenequinonoid pigments (PQPs). It was found
      that singlet oxygen plays a key role in the photo-oxidation of PQPs. The
      following processes were determined to be involved in the photo-oxidation of PQPs
      using 18O atom labelling. After the PQP is photoexcited, it tautomerizes and
      dissociates to produce the anion, which reacts with singlet oxygen generated
      during irradiation, resulting in the formation of an endoperoxide. The
      endoperoxide then rearranges to form a dioxetane which undergoes cycloreversion
      to produce the final product, a di-alpha-naphthoquinone. The factors affecting
      the photo-oxidation of hypocrellin A were also investigated, including the pH of
      the solution, nature of the solvent, irradiation wavelength and hydration
      phenomena. Of these factors, the extremely strong effect of pH on the photo
      oxidation of hypocrellin A may be used as a basis for the selective localization
      of hypocrellin A in tumor tissue. On the basis of the proposed mechanism for the
      photo-oxidation of PQPs, it may be possible to design and synthesize an optimal
      tumor-selective PQP photosensitizer for the photodynamic therapy of human tumors.

PMID- 8350182
TI  - Photoinduced proton transport mechanism in merocyanine-dye-probed planar lipid
      membranes.
AB  - Planar lipid membranes were used to study photovoltage generation after the
      incorporation of various merocyanine dyes. These dyes undergo photochemical
      isomerization on illumination and can act as a photon-driven facilitated proton
      transport system under suitable conditions. This system has the advantage of
      preventing back recombination of the photodissociated charges, thus improving its
      storage capacity. A sufficiently high photovoltage, with a long storage time and
      good reproducibility, was obtained with these dyes. The spectral studies indicate
      the formation of a 1:1 complex between dye and lipid molecules. Our results show
      that the strength and stability of complex formation increase with the
      hydrophobicity of the dye which, in turn, increase the magnitude and storage of
      the photovoltage generated in the system.

PMID- 8350183
TI  - Experimental studies on the mechanisms of tiaprofenic acid photosensitization.
AB  - Red blood cell lysis and histidine degradation, photosensitized by tiaprofenic
      acid (TIA), were investigated. Photohaemolysis was markedly enhanced in
      oxygenated solutions, but was also intense in the presence of nitrogen.
      Photohaemolysis was inhibited by butylated hydroxyanisole and reduced
      glutathione, but was unaffected by sodium azide, superoxide dismutase and
      mannitol. The TIA-induced photo-oxidation of histidine was greatly enhanced in
      the presence of oxygen and almost completely inhibited in solutions bubbled with
      nitrogen. Sodium azide, butylated hydroxyanisole and reduced glutathione
      inhibited the photodegradation of histidine. Phototoxicity to histidine was
      unaffected by mannitol and superoxide dismutase. The overall results suggest that
      molecular mechanisms involving free radicals and singlet oxygen are responsible
      for TIA-photosensitized reactions. These two in vitro models (photohaemolysis and
      histidine degradation) represent different mechanisms of phototoxicity, but
      complement one another in the investigation of potential phototoxic substances.

PMID- 8350185
TI  - Stereochemical factors in the transport and binding of photosensitizers in
      biological systems and in photodynamic therapy.
AB  - The uptake and biological activity of porphyrins and phthalocyanines in tumours
      were correlated with the geometrical features of the photosensitizer molecules.
      The data suggest that a critical distance of approximately 1.2 nm between oxygen
      atoms (originating in SO3-, COO- or OH substituents) characterizes a biologically
      active photosensitizer for photodynamic therapy. We propose that tubulin, which
      is available in large amounts during mitosis, is the main receptor molecule which
      binds these photosensitizers. Basic amino acid residues or tightly bound cations
      in tubulin or homologous proteins may act as binding sites on the receptor
      molecule.

PMID- 8350184
TI  - Photosensitization with methylene-linked porphyrin dimers.
AB  - The photodynamic therapy (PDT) efficacy of a series of porphyrin dimers linked by
      methylene groups was evaluated using the radiation-induced fibrosarcoma (RIF)
      tumor model. Longer chain length led to greater efficacy and increased dimer
      hydrophobicity. This result was correlated with the persistence of porphyrins in
      plasma, but not with tissue levels.

PMID- 8350186
TI  - Biochemical and morphological changes in Escherichia coli irradiated by coherent
      and non-coherent 632.8 nm light.
AB  - Irradiation of Escherichia coli cells with either coherent or non-coherent 632.8
      nm light (4 J cm-2) causes a transient acceleration of cell proliferation, which
      is maximal about 60 min after the end of the phototreatment. The stimulatory
      effect is dose dependent and is especially evident in the case of defective E.
      coli strains which are in the logarithmic phase of growth, while it becomes less
      important when cells are exposed to non-coherent 600-700 nm light. Stimulated
      cells exhibit biochemical and morphological changes, such as an intensified
      synthesis of cytoplasmic membrane proteins, increased cell volume and ribosomal
      content, which are suggestive of an enhanced cell metabolism.

PMID- 8350187
TI  - Quantum yield and skin filtering effects on the formation rate of lumirubin.
AB  - Photocyclization of bilirubin to lumirubin in the skin of jaundiced infants
      exposed to blue-green light irradiation is considered to be the most important
      process for bilirubin elimination from the organism. The quantum yield phi LR of
      the bilirubin-->lumirubin photoreaction has been recently measured and found to
      vary with the excitation wavelength, with a peak at about 520 nm. The quantum
      yield phi ZE for the strongly competing reversible configurational
      photoisomerization of bilirubin has also been recently shown to be wavelength
      dependent and to decrease significantly in the long-wavelength part of the
      absorption band of bilirubin. These new data are taken into account to model the
      bilirubin photochemistry in vivo by using a simplified skin optical model based
      on the Kubelka-Munk theory. The rate kappa LR of formation of lumirubin has been
      evaluated for the case of a four-layer skin and for monochromatic and narrow-band
      coloured fluorescent lamps. The effects of long-wavelength increase in phi LR,
      decrease in phi ZE and skin optical losses all combine to shift significantly the
      optimal rate of formation of lumirubin towards the green. These results suggest
      that a significant improvement in phototherapy might be obtained with the
      introduction of new lamps emitting in the blue-green spectral region between 490
      and 510 nm.

PMID- 8350188
TI  - Inhibition of dimer excision in repeatedly UV-irradiated Escherichia coli: its
      requirement for RecA protein and de novo protein synthesis.
AB  - In UV-irradiated Escherichia coli dimer excision was found to be inhibited by
      predamage (M. Sedliakova, F. Masek and J. Brozmanova, FEBS Lett., 23 (1972) 325
      326) or overproduction of RecA protein, which suggests that the coating of the
      dimers by this protein may make them inaccessible to the excision nuclease (M.
      Sedliakova, K. Kleibl and F. Masek, Mutat. Res., 191 (1987) 13-16). We measured
      the levels of RecA protein and dimer excision in cells irradiated with (i) a
      single dose of 50 J m-2, (ii) two separate doses of 30 and 50 J m-2, post
      incubated with chloramphenicol; (iii) two separate doses of 30 and 50 J m-2, post
      incubated without chloramphenicol. Dimer excision was complete in the first two
      cases, but in the latter it was inhibited by 40%. At the time of active dimer
      excision, there were marked differences in RecA protein content between the cells
      irradiated with a single dose and cells irradiated with two separate doses (both
      post-incubated without chloramphenicol), which might account for the differences
      in dimer excision. However, relatively small differences in RecA protein content
      were found in cells irradiated with two doses and post-incubated with or without
      chloramphenicol, which could therefore not account for the differences in dimer
      excision. The data suggest that the inhibition of dimer excision involves some
      short-lived component(s) other than RecA protein.

PMID- 8350189
TI  - Studies on pharmacokinetics of sulfonated aluminum phthalocyanine in a
      transplantable mouse tumor by in vivo fluorescence.
AB  - The pharmacokinetic properties of sulfonated aluminum phthalocyanine (A1PCS) in
      mouse bearing transplantable S180 tumors were determined by an in vivo method. In
      vivo fluorescence measurements were made on the hind legs of mice, one leg
      bearing a tumor and the other, without a tumor, being used as a control. These in
      vivo data were compared with the results obtained from in vitro extraction
      fluorescence experiments. The results obtained by the two methods showed
      remarkable agreement, both procedures demonstrating that the concentration of
      A1PCS in the tumor was substantially higher than that in muscle. In both cases,
      the maximum tumor to muscle A1PCS concentration ratio occurred at 24-36 h after
      drug administration. The agreement between the in vivo and in vitro measurements
      shows that the in vivo fluorescence technique can be used successfully in
      pharmacokinetic studies of metallo-phthalocyanines in a superficial tumor model.
      The in vivo technique has the advantages of being rapid and convenient.

PMID- 8350190
TI  - Functional identification of al-3 from Neurospora crassa as the gene for
      geranylgeranyl pyrophosphate synthase by complementation with crt genes, in vitro
      characterization of the gene product and mutant analysis.
AB  - In this work the Neurospora crassa al-3 gene function was determined.
      Geranylgeranyl pyrophosphate (GGPP) synthase activity was measured in al-2 FGSC
      313 and al-3 RP100 FGSC 2082 mutant strains by in vitro synthesis methods. This
      experiment showed that al-3 RP100 mutant expresses a reduced GGPP synthase
      activity. The mutated al-3 gene was cloned and sequenced; a single missense
      mutation was found changing serine into asparagine. Genetic complementation was
      performed by Escherichia coli transformation, with clusters of crt genes from
      Erwinia uredovora. Carotenoid accumulation was observed in E. coli transformants
      when the N. crassa al-3 gene substitutes the GGPP synthase gene (crtE) in the
      carotenogenic crt cluster. Cell-free studies with E. coli transformants gave
      direct evidence of the function of the al-3 protein as GGPP synthase and
      indicated that a short-chain prenylpyrophosphate, such as dimethylallyl
      pyrophosphate, is the genuine substrate.

PMID- 8350191
TI  - Phototransformations of porphyrins in aqueous and micellar media.
AB  - Porphyrin photoproducts with absorption maxima at 640 and 660 nm are formed in
      aqueous and micellar solutions during light exposure. Changes in the
      dimethoxyhaematoporphyrin (DMHp) Soret band on irradiation suggest that the
      photoproduct (640 nm) formation is conditioned by the "sandwich"-type self
      associates. The formation of the photoproduct (660 nm) in micellar
      haematoporphyrin (Hp) and photosan-3 (PS) solutions and its formation in small
      amounts in phosphate-buffered solution (PBS), is related to the presence of
      covalently linked porphyrin structures and/or interaction with surfactant
      molecules. PS is the most photostable of the three investigated porphyrins. Its
      photostability is probably due to the presence of covalently linked "sandwich"
      type aggregates.

PMID- 8350192
TI  - Fluorescence properties of subtilisins and related proteinases (subtilases):
      relation to X-ray models.
AB  - The fluorescence properties of six subtilases with known X-ray structure were
      determined using the same experimental conditions and instrumentation. The steady
      state and nanosecond lifetime measurements were performed on purified samples of
      phenylmethanesulphonyl-inhibited proteinases in the presence of 20 mM CaCl2 which
      stabilizes the molecules. The tryptophan emission quantum yield strongly depends
      on the local environment and varies from 0.02 to 0.10. The efficiency of tyrosine
      to-tryptophan energy transfer also varies (0%-70%) in the different enzymes; the
      most efficient transfer was observed for thermitase. Experiments with nanosecond
      excitation indicated that the tryptophan fluorescence of subtilases decays with
      two exponential components. The X-ray models of the six proteinases were analysed
      in the region of the tryptophyl residues and were used to explain the observed
      properties.

PMID- 8350193
TI  - Artificial sunlight irradiation induces ultraweak photon emission in human skin
      fibroblasts.
AB  - Photons participate in many atomic and molecular interactions and changes in the
      physical universe. In recent years sophisticated detection procedures for the
      measurement of ultraweak photons in a variety of different cells have been
      performed leading to the conclusion that plant, animal and human cells emit
      ultraweak photons. Using an extremely low-noise, high-sensitive photon-counting
      system, which allows maximal exploitation of the potential capabilities of a
      photomultiplier tube, ultraweak photons were quantitated in human skin
      fibroblasts. It was found that light from an artificial sunlight source induces
      ultraweak photon emission in these cells. However, the results demonstrate that
      this induction is significantly lower in normal fibroblasts compared with those
      obtained from a donor suffering from xeroderma pigmentosum disease group A, a
      disease characterized by deficient repair of DNA. The largest increase in
      ultraweak photon emission after UV exposure was measured in mitomycin-C-induced
      post-mitotic xeroderma pigmentosum cells which showed 10-20 times higher
      ultraweak photon intensities than mitotic UV-irradiated normal cells. These data
      suggest that xeroderma pigmentosum cells tend to lose the capacity of efficient
      storage of ultraweak photons, indicating the existence of an efficient
      intracellular photon trapping system within human cells.

PMID- 8350194
TI  - In vivo photoproduct formation during PDT with ALA-induced endogenous porphyrins.
AB  - The administration of 5-aminolevulinic acid (ALA) in tumor-bearing nude mice
      leads to the formation of the fluorescent, photounstable photosensitizer
      protoporphyrin IX in tumor tissue. On-line fluorescence spectroscopy during
      photodynamic therapy (PDT) shows the in vivo formation of chlorintype
      photoproducts of protoporphyrin. The fluorescence of protoporphyrin as well as
      its photoproducts is bleached completely at the end of the PDT (100 J cm-2, 630
      nm). These findings were also verified using ultrashort laser pulses and time
      correlated single-photon counting. A photinduced shortening of the decay times
      and decrease in the integral fluorescence intensity were measured in vivo due to
      the photodestruction of the endogenous photosensitizer protoporphyrin IX in the
      tumor.

PMID- 8350195
TI  - Effect of in vivo He-Ne laser irradiation on biogenic amine levels in rat brain.
AB  - In order to elucidate the metabolic modifications induced in rat brain by low
      power He-Ne laser irradiation in vivo, the variations in the biogenic amine
      levels in cortex, striatum and hippocampus were studied. Noradrenaline (NA),
      dopamine (DA) and serotonin (5-HT) were evaluated by HPLC-EC on irradiated rats,
      untreated rats (controls) and rats which had undergone restraint stress
      (stressed). The results obtained on groups of four to eight rats assayed
      individually showed that irradiation caused a strong increase in 5-HT in striatum
      and hippocampus, a small but significant decrease in NA in cortex, and DA levels
      were not significantly affected. Restraint stress per se led to a considerable
      decrease in 5-HT and DA in striatum and hippocampus, but did not significantly
      alter the NA levels.

PMID- 8350196
TI  - The cationic meso-substituted porphyrins: an interesting group of
      photosensitizers.

PMID- 8350197
TI  - Reflections on type I photodynamic damage.

PMID- 8350198
TI  - Nontransplant surgical options for management of the short bowel syndrome.

PMID- 8350199
TI  - Gastric volvulus after anterior gastropexy.

PMID- 8350201
TI  - Repaired peroxisome assembly: the future begins now.

PMID- 8350200
TI  - Candy bezoar: an unusual cause of food bolus bezoar.

PMID- 8350202
TI  - DNA-based diagnosis of Wilson disease.

PMID- 8350203
TI  - Corticosteroid drugs and inflammation: the endothelial-leukocyte interface as a
      target for therapeutics.

PMID- 8350204
TI  - Rectal polyps in Proteus syndrome.

PMID- 8350205
TI  - Incidence of gastroesophageal reflux with casein and whey-based formulas.

PMID- 8350206
TI  - Helicobacter pylori infection in children.

PMID- 8350207
TI  - Portal hypertensive gastropathy in children.
AB  - We endeavored to determine the frequency and clinical characteristics of portal
      hypertensive gastropathy (PHG) in children with cirrhotic and noncirrhotic portal
      hypertension. Medical records of all patients with portal hypertension undergoing
      upper GI endoscopy during a 7-year period were retrospectively reviewed. PHG was
      defined as absent, mild, or severe by previously established criteria. Twenty-two
      patients with portal hypertension (17 cirrhotic, 5 noncirrhotic) were identified.
      In the group of 17 cirrhotic patients, PHG was noted in four at initial endoscopy
      (three mild, one severe) and in seven (two mild, five severe) during follow-up.
      Severe PHG was seen in one patient with noncirrhotic portal hypertension at
      presentation; in two patients, mild PHG developed during follow-up. In the 14
      patients in whom PHG was noted, gastric mucosal disease developed in nine in whom
      no sclerotherapy was performed and in five patients treated with sclerotherapy.
      The size of varices, history of variceal bleeding, and presence or absence of
      hypersplenism did not appear to be related to the development of PHG. None of
      seven patients with mild PHG and two of seven patients with severe PHG bled from
      their gastric mucosa. We conclude that PHG is commonly observed in children with
      cirrhotic and noncirrhotic portal hypertension. Mild PHG appears to have little
      clinical significance, while severe PHG may cause bleeding. PHG may develop with
      or without sclerotherapy.

PMID- 8350208
TI  - The diagnostic and therapeutic role of endoscopic retrograde
      cholangiopancreatography in children.
AB  - We performed 121 endoscopic retrograde cholangiopancreatographies (ERCPs) in 92
      patients (60 girls and 32 boys), aged 4 months to 19 years, as part of diagnostic
      evaluation for suspected pancreatic or biliary tract disease or as therapeutic
      intervention. ERCP was successful in 116 attempts. The most common indications
      were recurrent pancreatitis (35 children), nonresolving acute pancreatitis (20),
      unexplained elevated amylase or lipase (19), postcholecystectomy syndrome (14),
      and elevated biliary tract enzymes (12). One hundred and one ERCPs were performed
      for more than one indication. The most common findings included chronic
      pancreatitis (26 cases), pancreas divisum (14), dilated pancreatic duct (10),
      gallstones or sludge (8), and abnormal common bile duct (8). Complications were
      uncommon and usually minor. ERCP is a safe and helpful procedure in the
      evaluation of suspected pancreatic and biliary tract disease in children and
      frequently allows for nonoperative treatment of these disorders.

PMID- 8350209
TI  - Ulcerative colitis in children 10 years old or younger.
AB  - The onset and course of ulcerative colitis diagnosed in 38 children at or before
      10 years of age were reviewed. The mean age at onset was 5.9 years. A family
      history of inflammatory bowel disease was present in 24% of patients, and 13% had
      a history of cow milk allergy in infancy. Initially, by radiologic or
      colonoscopic studies, 71% had total colonic disease, 13% had left-sided colitis,
      and 6% had proctitis; extensive examination was not performed in 4 patients. Four
      patients (11%) presented with severe colitis, 14 (37%) with moderate colitis, and
      20 (53%) with mild colitis. The most frequent symptoms were abdominal pain (94%),
      diarrhea (84%), and rectal bleeding (84%). Between 2 and 10 years after
      diagnosis, 89% of children had total colonic disease and 11% had left-sided
      disease. All four patients with severe disease at onset responded to medical
      therapy with one having a colectomy 15 years later with pathology consistent with
      Crohn's disease. Of those with moderate disease, half had infrequent moderate
      recurrences and half had intermittent mild disease. One patient had colectomy at
      21 years for intractable disease. Of the 20 with mild disease, 16 continued to
      have intermittent mild recurrences, 1 had chronic mild disease, 2 had moderate
      recurrent disease, and 1 has remained asymptomatic for 5 years. Psychiatric
      disturbances requiring therapy were identified in 5 (13%) children. Results are
      encouraging: after the first 2 years of illness, two thirds of the children have
      had subsequent mild colitis with infrequent relapses and three quarters consider
      their life to be of good quality.

PMID- 8350210
TI  - Effects of cerulein and epidermal growth factor on pancreatic growth in the
      reserpinized rat model.
AB  - This study was undertaken to determine the effect of reserpine on rat pancreatic
      growth, to evaluate if reserpine-caused alterations can be prevented by epidermal
      growth factor (EGF) and/or cerulein treatment, to evaluate the time course of rat
      pancreas recovery after reserpine, and to determine if EGF and/or cerulein
      treatment can accelerate such a recovery. In the first experiment, three groups
      of male Sprague-Dawley rats (250-265 g) were used. Ad libitum-fed control animals
      received the reserpine vehicle, and one experimental group received reserpine (1
      mg kg-1 day-1 for 7 days) while the other, pair-fed group received the reserpine
      vehicle with a reduced amount of food to result in malnourishment. Rats from each
      of these three groups were also assigned to one of four treatments consisting of
      saline, EGF (10 micrograms kg-1), cerulein (1 microgram kg-1), or a combination
      (same doses) twice a day for 7 days. In the morning of the 8th day, after an
      overnight fat, rats were killed. In the second experiment, rats were selected and
      treated with reserpine or the vehicle as described in experiment 1; after the 7
      day treatment, a first cohort of animals was allowed a 30-day recovery period.
      Three other groups (an ad libitum-fed control, a pair-fed, and a reserpine group)
      were allowed a 6-day recovery period during which they were treated
      subcutaneously, twice a day, with either saline, EGF (10 micrograms kg-1),
      cerulein (1 microgram kg-1), or a combination (same doses). On the morning of the
      31st or 7th day, after an overnight fat, rats were killed. After death, all
      pancreata were examined for weight and protein, amylase, chymotrypsinogen, RNA,
      and DNA content. In the ad libitum-fed control group, EGF caused pancreatic
      hypertrophy, whereas cerulein was associated with hypertrophy and hyperplasia. In
      the pair-fed malnourished group, the EGF effect was limited to slight increases
      in pancreatic weight and cell mass whereas cerulein caused hypertrophy; EGF plus
      cerulein caused pancreatic hyperplasia. In the reserpine group, EGF had no
      effect, whereas cerulein caused pancreatic hypertrophy and an increase in DNA
      content above the reserpine control. After 30 days of recovery, pancreata of pair
      fed animals and those of reserpine-treated animals were comparable with those of
      the ad libitum-fed control rats with the exception of amylase levels, which
      remained reduced in the reserpine group.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350211
TI  - Influence of orally administered epidermal growth factor on normal and damaged
      intestinal mucosa in rats.
AB  - The effect of orally administered epidermal growth factor (EGF) on the mucosal
      growth and hydrolase activity of normal and damaged small intestine was examined
      in rats. Adult rats fed EGF daily at 10 times the estimated daily intake of EGF
      from human milk showed increases in specific activity but not total activity of
      various brush-border hydrolases with unaffected mucosal protein content and
      villus-to-crypt ratios through day 9. Ingestion of EGF for 13 days resulted in
      significant decreases in mucosal protein content without changes in villus height
      or hydrolase activity. The effect of oral EGF on recovery of damaged intestine
      was studied in rats fed a liquid diet supplemented with EGF at 0, 1, 10, or 20
      times the estimated daily intake from human milk after treatment with
      methotrexate (MTX) to induce acute intestinal injury. Animals treated with MTX
      showed significant reductions in body weight and small intestinal villus height,
      mucosal protein content, and hydrolase activities through day 6 posttreatment.
      Daily ingestion of EGF did not affect the MTX-induced reductions in mucosal
      protein content and hydrolase activity by day 3 but caused significant increases
      in mucosal disaccharidase and leucine aminopeptidase activity by day 6 at the 1-
      or 10-times human milk EGF levels. Similar changes were not observed in MTX
      treated rats fed the 20-times human milk level of EGF. These studies suggest that
      oral EGF is capable of modulating mucosal protein levels and stimulating
      enterocyte hydrolase expression during repair of the intestinal mucosa.

PMID- 8350212
TI  - Is histological diagnosis of neuronal intestinal dysplasia related to clinical
      and manometric findings in constipated children? Results of a pilot study.
AB  - Neuronal intestinal dysplasia (NID) of the colon has been reported in adults and
      children with chronic constipation. However, it is unknown whether these
      histological abnormalities are related to the severity of symptomatology or the
      findings of anorectal manometry. We studied 57 children (2 weeks to 17 years old,
      33 boys) who had chronic constipation and/or soiling or obstructive symptoms
      early in life and evaluated anamnestic data, symptoms, outcome after 6 months of
      conventional therapy, rectal biopsies for signs of dysganglionosis, and results
      of anorectal manometry. In cooperative patients, defectaion dynamics were
      recorded during manometry with simultaneous surface electromyogram of the
      external anal sphincter. In 30 older patients, severity of constipation was
      assessed by measurement of colonic transit time with radiopaque markers.
      Histology confirmed Hirschsprung's disease in nine (excluded from further
      analysis), hyperganglionosis of the plexus submucosus (classic NID) in six,
      heterotopic ganglion cells without hyperganglionosis (abortive NID) in 18, and no
      signs of dysganglionosis in 24 patients. The rectoanal inhibitory reflex was more
      often absent or abnormal in children with classic NID (six of six) and abortive
      NID (11 of 17) compared with children with normal histology (four of 22) (p <
      0.001). All other manometric parameters analyzed, colonic transit times, and
      clinical outcomes were not related to histological diagnosis. In contrast, the
      severity of constipation and outcome was significantly worse in children with
      abnormal defecation dynamics. These results suggest that histological signs of
      NID in the submucous plexus are of uncertain value in assessing the clinical
      picture and should not influence decisions concerning further treatment,
      especially surgical interventions.

PMID- 8350213
TI  - Feeding resistance and gastroesophageal reflux in infancy.
AB  - Resistance to oral feedings occurring during the course of chronic
      gastroesophageal reflux (GER) in infants has received little attention in the
      literature. Accordingly, we reviewed the clinical courses of 600 infants of < 24
      months of age with GER seen over an 8-year period to determine the prevalence and
      course of this problem. After excluding infants with severe neurologic disease,
      craniofacial disorders, or a history of esophageal surgery, 25 infants were found
      to have resistance to oral feedings that was severe enough to warrant tube
      feedings for nutritional support. Sixteen of these 25 infants had a history of
      resistance to oral feeding antedating a diagnosis of GER, whereas nine developed
      resistance to feeding during the course of therapy. Gestational age, age at onset
      of GER symptoms, severity of GER, presence/severity of esophagitis, type of
      medical therapy, need for fundoplication, or postfundoplication complications
      were similar in these two groups. When the clinical records of these 25 infants
      were compared to an age- and sex-matched infant population with GER but without
      feeding resistance, no differences were noted in severity of GER or the
      presence/severity of esophagitis. However, failure to thrive and the need for
      fundoplication were significantly more common in the feeding resistance group (p
      < 0.001). Among those infants with neurodevelopmental evaluation, mild delay was
      seen more commonly in the infants with feeding resistance but fell short of
      statistical significance (p = 0.08). Our observations suggest that resistance to
      oral feedings is an uncommon but severe problem associated with GER in
      infancy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350214
TI  - Chromium and parenteral nutrition in children.
AB  - Chromium (Cr) dosage was assayed in i.v. nutrition, serum, and losses of five
      children on total parenteral nutrition for > or = 4 weeks. The Cr supply (4.7 +/-
      1.2 micrograms/kg/day) was above recommended levels (0.5 microgram/kg/day). Serum
      (18.2 +/- 1.8 micrograms/L) and urine (37.4 +/- 10.5 micrograms/L) were also
      higher than control values (0.7-0.9 microgram/L and 0.2-0.8 microgram/L,
      respectively). Serum and urine Cr concentrations displayed a positive
      correlation. Serum Cr and Fe showed a negative correlation. These results confirm
      the potential toxicity of Cr previously reported in animals. Cr levels of i.v.
      nutrition solutes should be checked thoroughly.

PMID- 8350215
TI  - Dietary intake and nutritional treatment in childhood Crohn's disease.
AB  - Dietary intake was assessed in 24 children with active Crohn's disease. Seventeen
      of the children were sex and height matched with healthy siblings of other
      patients. The mean energy intake was 1,764 KJ/day (420 kcal/day) lower in
      patients during relapse than controls (p < 0.05). All 24 children entered a
      randomised controlled trial of high-dose steroids compared to an elemental diet.
      The elemental diet was well tolerated orally in most cases; only one patient
      required nasogastric administration. There was a similar improvement in disease
      activity and duration of remission in both groups regardless of the site of
      disease. Subsequent growth velocity was significantly better in the group treated
      with the elemental diet despite a greater and more sustained increase in energy
      intake in the group treated with steroids. Reintroduction of specific foods in
      the elemental diet group initially caused symptoms in three children but were
      subsequently tolerated. During remission, there was no significant difference in
      energy intake, but vegetables were consumed significantly less frequently (p <
      0.01) and confectionery significantly more frequently (p < 0.05) when patients
      were compared with their own siblings.

PMID- 8350216
TI  - Relationship between plasma triglycerides and apolipoprotein CII in infants
      during the first year of life.
AB  - Plasma triglyceride and apolipoprotein CII (apo CII) levels were measured in
      normal full-term infants and low-birth-weight infants at birth (from umbilical
      cord blood at 0 weeks), as well as at 2, 3, 4, 8, 24, and 48 weeks of age, and
      the relationship between plasma triglyceride and apo CII levels was studied. In
      both full-term and low-birth-weight infants, the plasma triglyceride and
      apoprotein CII levels were very low at birth, but they increased rapidly
      thereafter in the full-term infants and somewhat more slowly in the low-birth
      weight infants. Both triglyceride and apoprotein CII levels became stable from 3
      weeks of age in full-term infants and from 8 weeks in low-birth-weight infants.
      When the logarithmic values of triglyceride and apoprotein CII levels were
      compared, they showed a close correlation, and slopes of regression lines were
      0.62 in full-term infants aged 0-2 weeks, 1.04 in full-term infants aged 3-48
      weeks, 0.56 in low-birth-weight infants aged 0-4 weeks, and 1.04 in low-birth
      weight infants aged 8-48 weeks. These results suggest that there may be some
      differences in triglyceride transport between full-term infants aged 0-2 weeks
      and 3-48 weeks as well as between low-birth-weight infants aged 0-4 weeks and 8
      48 weeks.

PMID- 8350217
TI  - Breast-feeding habits among Jewish and Arab mothers in Hadera County, Israel.
AB  - A survey of breast-feeding habits of Jewish and Arab mothers was carried out in
      Hadera county in Israel. Jewish mothers breast-fed their babies approximately 3
      months, while Arab mothers did so for 5 months. The rate of breast-feeding among
      Jewish and Arab mothers was 84% and 94.4%, respectively. The results indicated
      that education, previous experience, enjoyment, husband's encouragement, previous
      information about the importance of breast-feeding, belief that breast-feeding
      strengthens the mother-child relationship, and the convenience of breast- over
      bottle-feeding were all factors that had an impact on breast-feeding habits among
      Jewish but not Arab mothers. Breast-feeding as a means of birth control,
      religion, and impairment of the breast's shape were factors that had no effect on
      either Arab or Jewish mothers. Complications during pregnancy and cesarean
      delivery decrease the probability of breast-feeding in Arab and Jewish mothers.
      Jewish mothers stopped breast-feeding because of insufficient milk, fatigue, work
      obligations, and physician's recommendation. Among Arab mothers the main reasons
      were insufficient milk, physician's recommendation, baby's refusal, and nipple
      problems. Jewish mothers who decided not to breast-feed stated that the reasons
      were previous experience with insufficient milk, nipple problems, and unpleasant
      feelings. The few Arab mothers who did not breast-feed cited medical or nipple
      problems.

PMID- 8350218
TI  - The nutritional value of a whey hydrolysate formula compared with a whey
      predominant formula in healthy infants.
AB  - Forty-five healthy infants were included in a double-blind randomized prospective
      study comparing the nutritional value of two formulas. One group received a whey
      predominant formula (n = 20); the other group received a whey hydrolysate formula
      (n = 25). Four infants of the whey hydrolysate group were dropped because they
      refused the formula. Although the mean daily volume intake was smaller with the
      whey hydrolysate formula compared with the whey-predominant formula (p < 0.001),
      the weight gain in the two groups after 13 weeks was identical (27.2 g/day in
      both groups; the mean difference in weight gain between the groups after 13 weeks
      was only 8 g). Length gain at 13 weeks was 10.4 cm in the whey-predominant
      formula group and 10.8 cm in the whey hydrolysate formula group (p = NS). After
      13 weeks, blood was sampled for hemoglobin, hematocrit, red blood cell count,
      white blood cell count, lymphocytes, glycemia, proteins, albumin, prealbumin,
      calcium, phosphorus, urea, creatinine, iron, iron-binding capacity, zinc, and
      vitamins A and E. Except for the iron-binding capacity, zinc, urea (in plasma as
      well as in urine) (all three were higher in the whey hydrolysate group), no
      significant differences were found. According to these results, exclusive feeding
      of the whey hydrolysate formula from birth to 3 months of age to healthy infants
      appears to result in an adequate nutritional status, as assessed at 3 months of
      age.

PMID- 8350219
TI  - Zinc supplementation in very-low-birth-weight infants.
AB  - Inadequate zinc intake may lead to poor growth and developmental outcome in very
      low-birth-weight (VLBW; < 1,500 g) infants. Fifty-two infants (mean birth weight,
      1,117 +/- 287 g; mean gestational age, 29 +/- 2.9 weeks) were randomly allocated
      to two groups. SUPP infants received a regular term formula plus zinc supplements
      (4.4 mg/L; final content, 11 mg/L); PLAC infants received the same formula plus
      placebo (final content, 6.7 mg/L). Infants started their formula at 1,853 +/- 109
      g and consumed the formula for 6 months. All subjects were evaluated at 3, 6, 9,
      and 12 +/- 0.75 months corrected-for-gestational-age. At each evaluation, weight,
      length, and head circumference were measured, a Griffiths developmental
      assessment was performed, and a blood sample was taken. Higher plasma zinc levels
      (p < 0.05) were found in the SUPP group at 1 and 3 months, and improved linear
      growth velocity was found in the SUPP group over the study period for the whole
      group as well as for girls alone. Maximum motor development scores were higher (p
      = 0.018) in the SUPP (98 +/- 10) than the PLAC (90 +/- 8) group, indicating that
      increased zinc intake in early infancy may be beneficial to VLBW infants.

PMID- 8350220
TI  - Ocular implications of long-term prednisone therapy in children.
AB  - We compared 23 patients (ages 4 to 18 years) who were receiving long-term oral
      prednisone therapy with 31 normal controls (ages 7 to 16 years). Indications for
      corticosteroid treatment included renal transplant in 11 patients, nephrotic
      syndrome in 7, glomerulonephritis in 4, and vasculitis without renal disease in
      1. The mean duration of prednisone therapy was 5.0 +/- 3.5 years, and the mean
      dose at the time of examination was 0.29 +/- 0.18 mg/kg/day. Mean intraocular
      pressure was 16.0 +/- 3.0 mm Hg (range, 12 to 25 mm Hg) in the prednisone group
      and 15.4 +/- 2.1 mm Hg (range, 12 to 20 mm Hg) in the control group. The
      difference between the means was 0.6 mm Hg (P = 0.35). Posterior subcapsular
      cataracts were present in seven (30%) of the prednisone patients, but in none of
      the controls (P = .001). None of the cataracts were visually significant. We
      found no evidence that pediatric patients on long-term, low-dose prednisone have
      higher intraocular pressures (IOPs) than normal children, although they are more
      likely to develop posterior subcapsular cataracts.

PMID- 8350221
TI  - Progressive overcorrection after inferior rectus recession.
AB  - We reviewed 67 cases of inferior rectus muscle recession. In 14 cases, the
      hypotropia was corrected to a satisfactory alignment in the immediate
      postoperative period followed by a progressive overcorrection (hypertropia).
      Patients with thyroid eye disease were at highest risk for progressive
      overcorrection, as 9 of 18 (50%) developed the problem. Patients undergoing
      adjustable suture were at a higher risk for development of the overcorrection, as
      1 of 35 (3%) surgeries done with standard techniques had the overcorrection while
      13 of 32 (41%) done on an adjustable suture had the problem. However, the actual
      act of adjustment was found not to be a predisposing factor. Also, operating upon
      multiple muscles was found not to be a risk factor for the complication. Once
      progressive overcorrection occurred, it was more difficult to correct when the
      patient had thyroid eye disease. We also reviewed 77 consecutive cases of
      superior, lateral, and medial rectus muscle recessions and found no cases of
      progressive overcorrection.

PMID- 8350222
TI  - Conjunctival reaction using adjustable sutures: a comparison of the cinch and bow
      knot methods.

PMID- 8350223
TI  - The effect of torsional muscle dysfunction and surgery on eye position under
      general anesthesia.
AB  - Under general anesthesia, normal eyes exhibit 2.0 degrees to 2.5 degrees of
      extorsion. To investigate the effect of torsional muscle dysfunction and surgery
      on eye position under general anesthesia, we measured the torsional change before
      and after torsional muscle surgery in 26 eyes of 18 patients with clinical
      torsional muscle dysfunction. Under general anesthesia, compared with normals,
      eyes with preoperative intorter overaction or extorter underaction demonstrated a
      significant intorsional change (P < .01). However, eyes with intorter underaction
      or extorter overaction did not demonstrate a significant extorsional change.
      Postoperatively, while patients remained under general anesthesia, intorter
      weakening procedures produced measurable extorsion while intorter strengthening
      procedures and extorter weakening procedures produced measurable intorsion.
      Superior oblique tenotomy produced a greater net torsional change than inferior
      oblique weakening surgery (P < .01). Under general anesthesia, eyes with
      preoperative torsional muscle dysfunction exhibit torsion in the direction
      consistent with the dysfunction. After surgery on the torsional muscles, a
      measurable torsional effect can be demonstrated while the patient is still under
      general anesthesia.

PMID- 8350224
TI  - A comparison of the success rates of resident and attending strabismus surgery:
      discussion.
AB  - Residency training involves surgery by resident surgeons at various levels of
      experience and proficiency, supervised by an experienced attending physician. We
      reviewed the results of strabismus surgery performed at four institutions with
      two residency training programs. Five hundred twenty-two cases with follow up
      greater than 6 weeks were evaluated. These cases included 315 attending
      procedures and 207 resident procedures under direct attending supervision.
      Success was defined as a strabismic deviation of 8 prism diopters or less.
      Average postoperative follow up was 57 weeks and did not differ between groups.
      There was no statistical difference between the resident success rate of 58%
      (121/207) and the attending success rate of 69% (217/315) after adjusting for
      population differences. The average final deviation of the patients
      postoperatively was 7 delta for the attending group and 10 delta for the resident
      group. Amblyopia was significantly more frequent in the resident cases (P <
      .001). Adjustable sutures were used significantly more often in attending cases
      (P < .0001). This study supports the premise that resident strabismus surgery is
      as successful as attending surgery. (Abstract reproduced from Wisnicki HJ, Repka
      MX, Raab E, et al. A comparison of the success rates of resident and attending
      strabismus surgery.

PMID- 8350225
TI  - Secondary exotropia: a retrospective analysis of matched cases.
AB  - Secondary exotropia, that is exotropia following surgery for esotropia, remains
      frustratingly common, even among experienced strabismologists. In this study, we
      have compared a group of secondary exotropia cases with a matched group of cases
      of residual esotropia. Of the factors analyzed, only the presence of an A- or V
      pattern preoperatively (P = .0077), the presence of limited postoperative
      adduction (P < .001), and postoperative binocular function (P = .0073) identified
      the secondary exotropes. The presence of reduced adduction postoperatively in
      subjects with secondary exotropia was a poor prognostic sign with 11 of the 13
      cases requiring further surgery for poor cosmesis. The authors suggest two
      subclassifications of secondary exotropia.

PMID- 8350226
TI  - Augmented surgery for esotropia associated with high hypermetropia.
AB  - Historically, surgical formulas for the management of accommodative esotropia
      have been based on the residual deviation with full hypermetropic correction.
      This "standard surgery" has resulted in a high incidence of undercorrection. In
      response to the large number of undercorrections with standard surgery, the
      authors have devised a formula for augmenting the amount of rectus recession
      based on the average of the near deviation with and without correction. In this
      study, we compare augmented surgery to standard surgery in patients who underwent
      bilateral medial rectus recessions for residual esotropia after prescribing full
      hypermetropic spectacle correction. Seventy patients with acquired esotropia
      after 6 months of age, and hypermetropia of +3.00 or more, were retrospectively
      studied. Thirty of these patients had undergone standard surgery, while 40 had
      augmented surgery. The follow up on each group was at least 1 year. Of the 30
      patients in the nonaugmented group, 22 (74%) had postoperative deviations of 10
      prism diopters or less with 8 (26%) showing a significant undercorrection. Of the
      40 patients who received augmented surgery, 35 (88%) had postoperative deviations
      of 10 delta or less and 5 (12%) were exotropic while wearing full hypermetropic
      correction. Of the 5 patients with a consecutive exodeviation while wearing full
      hypermetropic correction, 2 corrected to orthotropia by reducing the spectacle
      correction by +1.50 diopters and +1.25 D (93% success), 2 were converted to
      orthotropia by removing +3.00 spectacle correction (97% success), and 1 continued
      to have an intermittent exodeviation even after removing spectacle correction.
      This brought the overall success rate for augmented surgery to 98%.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8350228
TI  - Macular hypoplasia in familial cataracts.

PMID- 8350227
TI  - Posterior lenticonus: clinical patterns and genetics.
AB  - Posterior lenticonus is an uncommon abnormality in the shape of the crystalline
      lens, characterized by a spheroidal or conical protuberance affecting the
      posterior lens surface. It may be unilateral or bilateral. A male infant with
      bilateral posterior lenticonus is described, whose mother was found to have
      bilateral sutural cataracts. The association of cataracts with posterior
      lenticonus and the genetics of the condition are discussed.

PMID- 8350229
TI  - Ocular and systemic characteristics of Duane syndrome.
AB  - The clinical features of 63 patients with Duane syndrome are described in this
      report. All data in the study were gathered retrospectively except for
      measurements of vertical palpebral fissure and axial eye length, which were
      investigated prospectively. The following new aspects of the syndrome are
      emphasized: 1) In most cases with heterotropia, the angle of deviation was not
      large (< or = 25 prism diopters). 2) Visual acuity of 0.66 (20/30) or better was
      recorded in 94% of the affected eyes. 3) Smaller palpebral fissure (by 1 mm or
      more) of the affected eye was measured in primary position among 9 of 40 (22%)
      unilateral cases. 4) The axial length of the affected eye (mean, 22.8 +/- 0.6 mm)
      was not significantly different from the uninvolved eye. 5) Two cases of
      heterochromia iridis (3.2%) were found among the Duane syndrome patients. 6) A
      4.8% prevalence of high-tone hearing loss was detected, in addition to 4.8% of
      sensorineural deafness.

PMID- 8350230
TI  - Insertion site dynamics and histology in a rabbit model after conventional or
      suspension rectus recession combined with ipsilateral antagonist resection.
AB  - We have used a rabbit model to study insertion movement, rotational forces,
      disinsertion forces, and histology of the surgically created insertion site after
      recession of the inferior rectus (IR) using a conventional (CONV) or suspension
      (SUS) technique combined with an ipsilateral superior rectus (SR) resection.
      During the 5-week observation period, the CONV and SUS recessed IR showed an
      initial posterior movement followed by an anterior movement while all resected SR
      had an initial posterior movement which remained stable. SR rotational forces
      increased and IR remained constant throughout the 5-week observation period.
      There were no rotation force differences between the SUS and CONV recession
      techniques. Disinsertion forces showed an initial large decrease in force
      followed by a gradual increase to preoperative levels by 3 postoperative weeks.
      Disinsertion force differences between the CONV and SUS recessions were observed
      for 5 weeks after surgery. Histologic analysis showed a delayed inflammatory
      response on the SUS recession compared to the CONV recession and at the middle of
      the insertion compared to the poles which was minimized by 3 weeks after surgery.

PMID- 8350232
TI  - Visual loss in infantile osteopetrosis.
AB  - Osteopetrosis should be considered in an infant with unexplained visual loss. In
      particular, the possibility of this diagnosis must be intimated to the
      radiologist involved in the investigation of the child.

PMID- 8350231
TI  - Aneurysmal bone cyst: report of a case mimicking orbital tumor.
AB  - Aneurysmal bone cysts are rare bone tumors which normally affect the vertebral
      region or long bones. Involvement of facial bones is uncommon. Although
      nonneoplastic, these lesions are expansile and may cause local destruction of
      bone and soft tissues. When making the diagnosis, it is imperative to consider
      the clinical, radiologic, and histologic features of the entity to avoid
      confusion with other possibly malignant giant cell tumors. We report an unusual
      case involving the orbit in a 2 1/2-year-old girl.

PMID- 8350233
TI  - Pseudodistichiasis as a manifestation of anhidrotic ectodermal dysplasia.

PMID- 8350234
TI  - Caution, nurse practitioners.

PMID- 8350235
TI  - The eyes have it: visual attention as an index of infant cognition.
AB  - The purpose of this article is to provide the pediatric nurse practitioner with
      an introduction to the literature on the use of visual-attention measures to
      screen for cognitive deficits in the infant. These measures rely on an infant's
      preference for novelty, that is, the tendency to look at a new stimulus rather
      than a stimulus the infant has already seen. Individual differences in novelty
      preference among infants are related to later intelligence. Novelty preference
      measures may be particularly useful as an adjunct to developmental assessment of
      infants with motor impairment, because these infants may not have the motor
      skills to perform tasks of traditional sensorimotor-based assessments.

PMID- 8350236
TI  - Anemia as an indicator of nutrition in children enrolled in a Head Start program.
AB  - A retrospective chart review was conducted on the records of 467 children who
      were enrolled in the Head Start program in Alachua County, Florida, which is one
      of four counties in Florida cited among the 150 worst "hunger counties" in the
      United States by the Harvard University School of Public Health. The children
      were examined in the 1989-1990 school year by a team of nurse practitioners, and
      the data were analyzed to determine the incidence and distribution of anemia.
      Twenty-five percent of the sample was white, and 75% was black. One half of the
      white children and 20% of the black children attended schools in rural areas. The
      mean sample hematocrit value was 35.7%. Twenty-one percent of the sample had
      hematocrit values of less than 34.0%. More black children were anemic in both
      rural and urban groups. Black males had the highest rate of anemia at 27.3%;
      white females had the lowest rate of anemia at 9.8%. These data show that anemia
      is a serious problem among children from low-income families and suggest that
      government nutrition programs such as food stamps and WIC are not meeting the
      needs of these children.

PMID- 8350237
TI  - Developmental issues in deaf children.
AB  - This article presents an overview of the development of deaf children. The
      central difficulty for these children is acquiring language; however, delays in
      language development are not inevitable. Deaf children of deaf parents are less
      likely to experience problems in this and other areas of development than are
      deaf children of hearing parents, although this latter group represents 90% of
      the population of deaf children. Much more needs to be known about the
      development of deaf children and the environmental strategies that maximize the
      development of children with a major sensory deficit. The implications for
      caregiving to deaf children and their families are discussed.

PMID- 8350238
TI  - Values, knowledge, and attitudes about acquired immunodeficiency syndrome in
      rural adolescents.
AB  - Adolescents are prone to participate in high-risk behaviors, thus placing
      themselves at greater risk for human immunodeficiency virus/acquired
      immunodeficiency syndrome. This study describes knowledge, attitudes, values,
      health locus of control, and risk-taking potential of 1,048 rural adolescents.
      The subjects had more correct knowledge than incorrect knowledge about human
      immunodeficiency virus/acquired immunodeficiency syndrome. The adolescents'
      personal values of an exciting life and pleasure were related to their likelihood
      of participating in high-risk behaviors; their attitude score was negatively
      related to their likelihood of participating in risk behaviors.

PMID- 8350239
TI  - Pica.

PMID- 8350240
TI  - Menstrual disorders during adolescence.

PMID- 8350241
TI  - Knee pain in school-aged girls.

PMID- 8350242
TI  - Health care reform--the current debate.

PMID- 8350243
TI  - Fermenter cultivation of intestinal spirochaetes.
AB  - We cultivated 6 strains of intestinal spirochaetes in a laboratory fermenter
      under constant conditions (medium, physical-chemical parameters) in a permanent
      gas flow. It has been possible to demonstrate that the application of the
      fermenter technique for the cultivation of spirochaetes is a suitable method
      which can be easily standardized.

PMID- 8350244
TI  - Taxonomy of lactic acid bacteria from spoiled, vacuum packaged vienna sausages by
      total soluble protein profiles.
AB  - To resolve the taxonomic status of sixty-one lactic acid bacteria isolated from
      spoiled, vacuum packaged vienna sausages, a computer assisted analysis of total
      soluble protein profiles was undertaken. Sixty-two% of the strains in the study
      were recovered in fourteen clusters at the 72% similarity level, indicating high
      degree of heterogeneity among the strains examined. Two clusters representing
      Leuconostoc species were the largest and most homogeneous, containing twenty
      strains between them. One cluster contained both typical Lactobacillus sake and
      Lactobacillus curvatus strains, indicating the inability of protein profiles to
      consistently differentiate between all strains of these two species. The presence
      of an independent Lactobacillus curvatus grouping and the clustering of some
      atypical strains with Lactobacillus sake isolates, however, indicated that the
      atypical strains may be closely related to Lactobacillus sake.

PMID- 8350245
TI  - Physical and functional characterization of the cloned lys1+ gene of
      Schizosaccharomyces pombe.
AB  - The alpha-aminoadipate pathway for the biosynthesis of lysine is present in yeast
      and other higher fungi. The lys2 and lys5 mutants of Saccharomyces cerevisiae as
      well as the lys1- and lys7-mutants of Schizosacharomyces pombe are blocked at the
      alpha-aminoadipate reductase step of this pathway. The cloned lys1+ gene in the
      plasmid pLYS1 isolated from a S. pombe genomic library complemented lys1-mutant
      of S. pombe. The cloned LYS2 gene in the plasmid YEp620 and the LYS5 gene in the
      plasmid pSC5 of S. cerevisiae exhibited heterologous complementation of lys1- and
      lys7-mutants, respectively, of S. pombe. The homologous lys1+ transformed cells
      exhibited five fold higher alpha-aminoadipate reductase activity while the
      heterologous lys1+ and lys7+ transformed cells exhibited much less activity than
      the wild type cells. The DNA insert of the plasmid pLYS1 was determined to be
      16.7 kb long and the lys1+ gene has been subcloned within a 9.1 kb Clal-Clal DNA
      insert of the recombinant plasmids pLYS1B and pLYS1C. The restriction pattern for
      12 enzymes of the 9.1 kb DNA insert, (Apal, Aval, BamHI, Clal, EcoRI, EcoRV,
      HindIII, Hpal, Pstl, Pvull, Sphl, and Xbal), exhibited no obvious similarity to
      that of the LYS2 gene of S. cerevisiae. A 1.7 kb EcoRI-HindIII DNA fragment of
      pLYS1B and pLYS1C complemented the lys1-131 mutation in an integrative
      transformation. Although the lys1+ gene of S. pombe is isofunctional to the LYS2
      gene of S. cerevisiae, the restriction sites, and expression of these two genes
      exhibited considerable divergence.

PMID- 8350246
TI  - Occurrence and characterization of lectins in actinomycetes.
AB  - 25 species of actinomycetes were tested for the occurrence of lectins. Using a
      battery of normal and desialized erythrocytes, each species was screened for 3
      types of lectin activity i.e. surface bound, extracellular and intracellular. As
      many as 13 species showed one or more types of activity; some of them were
      characterized with regard to their biological action spectrum and sugar
      specificity.

PMID- 8350247
TI  - Influence of the different amino acid substitutions in Escherichia coli
      thioredoxin on the growth of bacteriophages T7 and f1.
AB  - We have constructed three mutants in the thioredoxin (trxA) gene changing its
      catalytic core between Cys-32 and Cys-35. Oligonucleotide-directed mutagenesis
      was carried out to replace conservative Gly-33 or Pro-34 by leucine, lysine,
      glutamine, phenylalanine or tryptophane. The mutants were characterized using an
      in vivo assay based on the ability of cell (mutants in the chromosomal trxA gene)
      to support growth of T7 and filamentous f1 phages. The results indicate that the
      smaller group side-chain in the position 33 and 34 of amino acid residues are
      indispensable for the growth of phages.

PMID- 8350248
TI  - Brachymetatarsia. Axial lengthening by using the callus distraction technique.
AB  - The authors present a modified approach to the ilizarov callus distraction
      technique for bone lengthening on a patient with brachymetatarsia. This approach
      has certain advantages and disadvantages that will be discussed along with
      historical methods of treating brachymetatarsia. The actual case history,
      surgical technique, and perioperative care of the patient are described in
      detail.

PMID- 8350249
TI  - Talonavicular coalition. Objective gait analysis.
AB  - Talonavicular coalitions, a rarely reported fusion between the talus and
      navicular, are often an incidental radiographic finding that may be asymptomatic
      or associated with peroneal spasm. The authors present a review of literature and
      case report based on clinical evaluation and instrumented gait analysis.
      Specifically, a patient presenting with a bilateral talonavicular coalition was
      objectively evaluated with kinetic, kinematic, muscle dynamometry, and
      pedobarographic testing to understand the biomechanical limitations related to
      this pathology. An excessive passive component of ankle torque, a high first
      metatarsophangeal joint plantar pressure, and a diminished time in the midstance
      portion of stance phase were measured and compared to those of healthy
      individuals.

PMID- 8350250
TI  - Efficacy of disinfectants against fungi isolated from skin and nail infections.
AB  - Commercial disinfectants classified as fungicides may not be effective against
      commonly encountered fungi within reasonable periods. Cell suspensions of
      clinical fungal isolates were exposed to use-dilutions of various disinfectants.
      Quaternary ammonium compounds, iodophors, and phenolics were not fungicidal
      against all test fungi within 60 min of exposure. Trichophyton mentagrophytes,
      Epidermophyton floccosum, and Aspergillus fumigatus were among the more resistant
      fungi. Disinfectants that possess low-level activity should not be used for
      disinfection of medical instruments that come in contact with the patient. The
      only reliable and safe measure is to use high-level disinfectants such as the
      glutaraldehydes, which are fungicidal in 15 to 30 min.

PMID- 8350251
TI  - Reducing two-dimensional rearfoot motion variability during walking.
AB  - Although three-dimensional movement analysis is the preferred method of assessing
      rearfoot motion during gait, the high cost of equipment and the time required to
      use it often make it unreasonable or impractical in a clinical setting. The
      authors discuss a method of minimizing the variability of rearfoot motion
      measurements during walking, using two-dimensional analysis when three
      dimensional is not available to the clinician.

PMID- 8350252
TI  - Antimicrobial therapy of skin and soft tissue infection in children.
AB  - Skin and soft tissue infection and cutaneous abscesses are common in children.
      They may be polymicrobial in nature, especially when located proximal to mucous
      membranes. A general knowledge of the common causative bacterial organisms in
      these infections enables the physician to empirically institute antimicrobial
      therapy before culture results are available. This review assesses the number and
      types of aerobic and anaerobic bacteria that occur in skin and soft tissue
      infections in children. Staphylococcus aureus and Streptococcus pyogenes were
      recovered from infections occurring at all body sites, but predominated in
      infections of the leg, neck, and hand. Group D streptococci, Enterobacteriaceae,
      Neisseria gonorrhoeae, Bacteroides fragilis, and Prevotella species were isolated
      mostly from infections of the external genitalia and perirectal areas; pigmented
      Prevotella and Porphyromonas and Haemophilus influenzae can be isolated from
      infections of the head and neck. Management of skin and soft tissue infections in
      children should include surgical and medical therapy.

PMID- 8350253
TI  - Metatarsus proximus and digital divergence. Association with intermetatarsal
      neuromas.
AB  - A retrospective radiologic study was performed to determine whether there is an
      increased finding of metatarsus proximus and digital divergence in patients with
      a confirmed diagnosis of intermetatarsal neuroma when compared with an
      asymptomatic group. The study included 48 patients with pathologic confirmation
      of neuroma and 100 asymptomatic patients. Results of the study revealed no
      statistical relationship between the radiologic findings of metatarsus proximus
      and digital divergence and the physical occurrence of neuromas. An unexpected
      finding was an increased intermetatarsal angle of the affected interspace in the
      neuroma group.

PMID- 8350254
TI  - Fibromyalgia. Part I. Review of the literature.
AB  - Fibromyalgia presents with generalized body pain, multiple tender points, and
      associated ancillary symptoms, including fatigue and nonrestorative sleep. The
      abnormal sleep pattern is the most common accepted etiology for this condition.
      The diagnosis may be made on the basis of a classic presentation of symptoms and
      clinical findings. The treatment of fibromyalgia includes aerobic exercise and
      the use of tricyclic antidepressants to modulate the sleep disorder with less
      than excellent results. In spite of the frustrations in treating this condition
      successfully, many patients are relieved to be provided with a diagnosis and to
      obtain sympathetic and supportive care from their physicians.

PMID- 8350255
TI  - Fibromyalgia. Part II. Prevalence in the podiatric patient population.
AB  - This study was designed to determine the prevalence of fibromyalgia in the
      podiatric patient population. A total of 355 consecutive patients in a podiatric
      outpatient clinic were evaluated to determine whether they met the criteria for
      this condition. Eight of the 355 patients were diagnosed with the condition.
      Thirty-five of 355 patients presented with plantar heel or arch pain. Seven of
      these 35 patients satisfied the criteria for fibromyalgia. This small study
      indicates that fibromyalgia may be more prevalent in podiatric patients than
      previously realized and must be considered in patients presenting with foot pain,
      especially if that pain is in the area of the plantar aspect of the heel or arch.

PMID- 8350256
TI  - Magnetic resonance imaging of tendon pathology about the foot and ankle. Part I.
      Achilles tendon.

PMID- 8350257
TI  - Survey of diabetic patients in a podiatric clinical setting.

PMID- 8350258
TI  - Alternative treatment for diabetic neuropathic ulcerations.

PMID- 8350259
TI  - The role of the motor cortex in the control of accuracy of locomotor movements in
      the cat.
AB  - 1. The impulse activity of single neurones in the motor cortex (MC) was recorded
      extracellularly, using movable varnish-insulated tungsten microelectrodes, in six
      adult, freely moving cats. Neuronal activity was recorded while the cats walked
      on a flat floor, as they stepped over a series of barriers, and as they walked on
      the flat rungs of a horizontal ladder. The mean discharge rate (mR) and the depth
      of frequency modulation (dM) in each cell were estimated over 10-100 steps. 2.
      The activity of ninety-eight MC cells (Including thirteen pyramidal tract
      neurones (PTNs)) was recorded during stepping over barriers 25 cm apart. The mR
      in 66% and the dM in 61% of these cells changed by more than 20% during
      locomotion with barriers compared to locomotion on the flat (an increase was more
      often the case). 3. The activity of nine cells was recorded during stepping over
      barriers 12 cm apart, and the activity of twenty-seven cells (including five
      PTNs) during walking with barriers only 6 cm apart. The mR in 67% and in 59% of
      the cells, respectively, and the dM in 56% and in 67% of the cells, respectively,
      were greater in these locomotor tasks than during locomotion on the flat. 4. The
      activity of twenty cells was recorded during walking and compared in experiments
      with different distances between barriers. The mR in 50% and the dM in 75% of the
      neurones progressively increased when the distance between successive barriers
      was diminished. 5. The discharge rates of thirteen cells were compared in two
      different locomotor tasks: (i) when the cat stepped over barriers requiring
      hyperflexion of the limbs and (ii) when it walked on the flat with loads attached
      to the distal forelimbs causing a hyperactivity of flexor muscles. The activity
      of nine cells was different during stepping over the barriers compared to
      locomotion with loadings on the forelimbs. 6. The activity of 108 cells (twenty
      four PTNs) was recorded during walking along a horizontal ladder with flat rungs.
      The mR of 61% and the dM of 72% of cells changed by more than 20% during
      locomotion on the ladder compared with that on the flat (most often they
      increased). 7. The position of the peak rate relative to the step cycle did not
      differ in the majority of cells (in 78-91% depending on the task) during
      locomotion on the flat, with the barriers or on the ladder.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8350260
TI  - Spatial facilitation and depression within one motor nerve terminal of frogs.
AB  - 1. Perfused macropatch electrodes were used to stimulate and simultaneously
      measure release from two sites on the same terminal of the frog cutaneous
      pectoris muscle. 2. It was found that release occurring at one site often
      affected release at an adjacent site 50 microns away, either enhancing it
      ('spatial facilitation') or depressing it ('spatial depression'). Spatial
      facilitation (or depression) was defined as the release produced by a test pulse
      at the second site (test electrode) when preceded by a pulse at the first site
      (prepulse electrode) divided by the release produced by the test pulse alone. 3.
      Spatial facilitation varied with the time interval between the prepulse and the
      test pulse. Peak spatial facilitation, which on the average was 2.14, occurred
      with an interval of 1-3 ms. With longer intervals spatial facilitation decayed
      with a time constant between 3-6 ms. When the time interval between the prepulse
      and the test pulse was zero (no delay), the release after the test pulse was
      always depressed. 4. When Ca2+ was omitted from the perfusate of the prepulse
      electrode, spatial facilitation was abolished. When a brief hyperpolarizing pulse
      followed the depolarizing prepulse with zero delay spatial facilitation was also
      abolished. 5. Electrotonic spread or Ca2+ diffusion within the axon terminal are
      excluded as coupling agents for spatial facilitation. It is suggested that the
      coupling agent may possibly be related to a hypothetical release-promoting
      factor.

PMID- 8350261
TI  - Confocal microfluorimetry of Ca2+ signals evoked in Xenopus oocytes by
      photoreleased inositol trisphosphate.
AB  - 1. The subcellular characteristics of inositol 1,4,5-trisphosphate (InsP3)
      induced Ca2+ liberation were studied in Xenopus oocytes by the use of confocal
      microfluorimetry to monitor Ca2+ signals from minutely localized region of the
      cell in response to photorelease of InsP3 from a caged precursor. 2. Photorelease
      of increasing amounts of InsP3 by progressively longer light flashes evoked
      transient Ca2+ responses that appeared abruptly at a certain threshold duration,
      and then grew steeply over a narrow range of flash durations to reach a maximum.
      Further lengthening of flash duration gave no increase in size of the Ca2+
      signals, but their rate of rise continued to increase and their duration became
      longer. Simultaneous measurements of Ca(2+)-activated Cl- currents showed a
      slightly higher threshold than the Ca2+ signal, and a more graded dependence upon
      flash duration. 3. The threshold flash durations required to evoke Ca2+ and
      membrane current signals grew by more than 100-fold as the area of the oocyte
      exposed to photolysis light was reduced from a square of 140 microns to 5
      microns. 4. Ca2+ signals evoked by photoreleased InsP3 began following a dose
      dependent latency that was as long as several seconds with low intensity light,
      but shortened to about 50 ms at maximum intensity. The extrapolated minimum
      latency with infinite photorelease of InsP3 was about 30 ms. 5. InsP3-evoked
      membrane currents began 30 ms or longer after the corresponding Ca2+ signals,
      whereas currents evoked by photorelease of Ca2+ from a caged precursor began
      within 5 ms of the onset of the light flash. 6. No differences in duration of
      InsP3-evoked Ca2+ signals were apparent when the confocal measuring spot was
      positioned close to the plasma membrane or about 10 microns more deeply into the
      oocyte. At both locations the Ca2+ signals were more prolonged than the
      associated membrane current signals. 7. Ca2+ signals to a test light flash were
      suppressed for about 2 s following a conditioning suprathreshold flash, but
      recovered almost completely after 6 s. The associated membrane current signals
      were facilitated at short intervals, suppressed at intervals between 0.5 and 3 s,
      and subsequently recovered more slowly than the Ca2+ signals. 8. Photorelease of
      InsP3 during 30 s exposures of low intensity evoked trains of repetitive Ca2+
      spikes. The overall amplitudes of these responses changed little with increasing
      in frequency, and became smaller and superimposed on a more sustained elevation
      of Ca2+.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350262
TI  - Modulation of respiratory activity of neonatal rat phrenic motoneurones by
      serotonin.
AB  - 1. The effects of serotonin on phrenic motoneurones were studied in an in vitro
      preparation of the isolated brainstem and spinal cord from neonatal rats. 2.
      Serotonin (5-HT; > or = 5-10 microM) increased inspiratory-modulated phrenic
      nerve activity and produced a small amount of tonic activity during expiration.
      Inspiratory-modulated activity of the fourth cervical ventral root also
      increased, but was accompanied by robust tonic activity, which often obscured the
      rhythmic activity. 3. Serotonin, in both normal and tetrodotoxin-containing
      medium, depolarized phrenic motoneurones and increased cell input resistance.
      Serotonin also increased inspriatory-modulated firing as well as the response of
      phrenic motoneurones to injected current. The y-intercept of the relationship
      between firing frequency and injected current (f-I) was increased, but the slope
      was not affected. There was no bistable firing behaviour. 4. Under voltage clamp
      conditions, 5-HT produced a tonic inward current of 0.07-0.37 nA. This current
      increased with less negative holding potentials and decreased with more negative
      holding potentials (-75 to -90 mV) but did not reverse. 5. In addition, 5-HT
      decreased inspiratory-modulated synaptic current by 23 +/- 6%. The degree of
      attenuation was not affected by holding potential. The time course of the
      decrease in inspiratory-modulated synaptic current was similar to the changes
      seen in tonic inward current and input resistance. 6. Depolarization, tonic
      inward current, and shift in the f-I relationship produced by 5-HT were
      antagonized by the 5-HT2/1C receptor antagonist ketanserin and mimicked by the 5
      HT2/1C agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane HCl (DOI). However,
      the 5-HT induced decrease in inspiratory-modulated synaptic current was not
      reduced by ketanserin nor mimicked by DOI. 7. We conclude that exogenously
      applied 5-HT simultaneously increases cell excitability and decreases inspiratory
      modulated synaptic current in phrenic motoneurones via different types of
      receptors. When these responses occurred simultaneously, the increase in
      excitability predominated and the net effect was an augmentation of inspiratory
      modulated phrenic motoneurone activity.

PMID- 8350263
TI  - Spatial integration and sensitivity changes in the human rod visual system.
AB  - 1. The factor by which increment threshold rises with increasing background
      intensity is less if the target is small than if it is large. The difference is
      usually attributed to a reduction in the area over which visual signals are
      integrated as the visual system light adapts. Recently, however, it has been
      argued that the difference in slope may instead be caused by an increase in the
      gain of the local response function with light adaptation. 2. To test this
      hypothesis in the rod-driven visual system, we compared monoptic, small and large
      target increment thresholds, and dichoptic, large target brightness matches,
      measured as a function of background intensity in a typical, complete achromat,
      who has no cone vision. 3. The dichoptic brightness matches were made using a
      large target of a similar intensity to the threshold intensity of the small
      target. If local intensity is important, the large target brightness matching
      curve should be more similar to the shallow, small target threshold curve. But,
      if changes in spatial integration are important, the brightness matching curve
      should be similar to the steeper, large target threshold curve. 4. The slope of
      the large (1.85 deg) target increment threshold functions measured with either
      200 or 50 ms test flashes were steeper than those of the small (10 min of arc)
      target functions by 0.10 (on logarithmic co-ordinates) or about 15%. 5. The
      logarithmic slopes of the dichoptic brightness curves were also slightly steeper
      than the small target increment functions. This is contrary to the local response
      (only) hypothesis, which predicts that the brightness curve should have the same
      slope as the small target function because the luminance of the targets in the
      two cases is the same. 6. We conclude that there must be a change in spatial
      integration in the rod visual system during light adaptation, over and above that
      due to local gain changes.

PMID- 8350264
TI  - Long-term changes in synaptic strength along specific intrinsic pathways in the
      cat visual cortex.
AB  - 1. The dense system of horizontal connections that arise and course within the
      striate cortex are thought to inform single cells about stimuli arising in
      disparate points in visual space and to modulate responses evoked from within the
      receptive field. To learn whether or not the strength of the horizontal
      connections could vary over the long term, and if such changes could affect the
      integration of vertical, interlaminar inputs, we have recorded intracellularly
      from the superficial layers in slices of the adult cat's visual cortex. 2. The
      monosynaptic EPSP evoked by stimulating horizontal fibres showed long-term
      facilitation in twelve of the twenty cells that were conditioned by repetitively
      pairing synaptic responses with depolarizing pulses of current; the maximum
      increase observed was 200%. Strong inhibition present in the postsynaptic
      response usually indicated that facilitation would not occur. 3. In instances
      where horizontal input evoked both mono- and polysynaptic EPSPs, both early and
      late events showed facilitation, with the most dramatic enhancement contributed
      by the polysynaptic components. 4. For the twenty-eight cells whose responses to
      stimulation of interlaminar as well as horizontal pathways were assessed, all
      were found to receive non-overlapping inputs from each source. Conditioning
      produced long-term changes in the strength of the interlaminar inputs. 5. Changes
      in synaptic strength were usually confined to the conditioned pathway, though in
      four out of twenty-six times we observed heterosynaptic facilitation of
      polysynaptic EPSPs. 6. The conditioning protocol led to lasting depression rather
      than facilitation in three out of eleven instances; the reduction was only
      observed in the multisynaptic components. 7. We suggest that the synaptic changes
      observed here may be related to certain dynamic changes in receptive field
      properties that have been characterized in vivo.

PMID- 8350265
TI  - Activation of muscarinic K+ current in guinea-pig atrial myocytes by a serum
      factor.
AB  - 1. Atrial myocytes obtained by enzymatic perfusion of hearts from adult guinea
      pigs and cultured for 0-14 days were studied using the whole-cell voltage-clamp
      technique. 2. Superfusion of the myocytes with diluted sera (1:100 to 1:10,000)
      from different species (human, horse, guinea-pig) evoked an inward rectifying K+
      current. The voltage-dependent properties of this current were identical to those
      of the K+ current activated by acetylcholine (IK(ACh)). Current density in the
      presence of horse serum (1:100) approximately corresponded to the non
      desensitizing fraction of IK(ACh) during superfusion with 1-2 x 10(-6) M ACh. 3.
      During a maximal serum-evoked current, application of ACh (10(-6) M) failed to
      evoke additional K+ current. After switching superfusion from serum-containing to
      serum-free solution, the K+ current decayed 1-2 orders of magnitude slower than
      ACh-activated IK(ACh). During the decay of the serum-evoked current, a
      proportional increase in responsiveness to ACh was recorded. During submaximal
      activation of K+ current by serum, a saturating concentration of ACh resulted in
      a total current that was identical to the current evoked by ACh alone minus the
      desensitizing component. Thus, activation of K+ current by serum caused
      desensitization of IK(ACh). From these results it is concluded that sera contain
      a factor that activates the same population of K+ channels as ACh. 4.
      Irreversible activation of IK(ACh) by ACh in myocytes dialysed with the GTP
      analogue GTP-gamma-S abolished sensitivity to serum and vice versa. 5. The effect
      of serum was not modified by atropine (10(-6) M) which completely blocked the
      response to 2 x 10(-6) M ACh. Furthermore, theophylline (1 mM), which completely
      inhibited IK(ACh) activation by adenosine (100 microM), failed to inhibit the
      effect of serum. Thus, neither muscarinic nor purinergic (A1) receptors are
      involved. 6. The peptide somatostatin (10(-6) M) and the alpha 1-agonist
      phenylephrine (1 microM) which previously have been shown to cause activation of
      IK(ACh) channels, in the present study failed to evoke any measurable current,
      which excludes the involvement of the corresponding receptors. 7. Pre-incubation
      of the cells with pertussis toxin completely abolished IK(ACh) evoked by ACh,
      adenosine and serum, suggesting that the activating factor, like the classical
      agonists, causes opening of IK(ACh) channels via a G protein (Gi, GK). 8. The
      potency of serum to activate IK(ACh) was not reduced by dialysis, suggesting the
      molecular mass of the unknown factor to be > or = 5 kDa. No activating potency
      was found in the dialysing solutions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350266
TI  - The role of the motor cortex in the control of vigour of locomotor movements in
      the cat.
AB  - 1. The impulse activity of single neurones in the motor cortex (MC) was recorded
      extracellularly using movable varnish-insulated tungsten microelectrodes in four
      adult freely moving cats. The cats walked inside the experimental box with
      various loadings in the swing or stance phases of the step cycle. The mean
      discharge rate (mR) and the depth of frequency modulation (dM) in each neurone
      were estimated over 10-100 steps. 2. The activity of thirty-one cells (including
      eighteen pyramidal tract neurones (PTNs)) was recorded during uphill walking on a
      10 deg inclined floor. The mR in 68%, and the dM in 77% of neurones changed by
      less than 20% during uphill locomotion compared to walking on a level surface. 3.
      The activity of the same neurones was also recorded during downhill walking, also
      on a 10 deg inclined plane. The mR in 69% and the dM in 78% of neurones changed
      by less than 20% during downhill locomotion compared with walking on a level
      surface. 4. The activity of twenty-three (the left hemisphere) cells (sixteen
      PTNs) during walking with the floor swaying to the right (R) and to the left (L)
      was compared to activity during locomotion on a stable surface. The mR in 83% and
      the dM in 83% of cells in R-steps, and in 82 and 77% of cells, respectively, in L
      steps changed by less than 20%. 5. The activity of thirty-seven cells was studied
      during locomotion at various speeds. The mR in 68% and the dM in 38% of cells
      changed by less than 20% during fast and slow locomotion compared to middle-speed
      locomotion. The dM in 46% of neurones increased with the transfer from slow to
      fast walking. 6. The activity of thirty-one MC cells was recorded during
      locomotion with loads of 85 g attached to the distal part of each elbow. The mR
      in 52% and the dM in 48% of neurones changed by more than 20%. 7. The activity of
      twenty-eight cells (six PTNs) was studied in steps when an animal turned. The
      swing of the limb contralateral to the recorded MC was shorter (condition 1) in
      turning steps in one direction, and was longer (condition 2) in turning steps in
      the opposite direction. The mR in 50% and the dM in 50% of cells in condition 1
      and in 52% and 59%, respectively, of cells in condition 2 changed by more than
      20%.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350267
TI  - Inter-individual variability in the dynamics of natural accommodation in humans:
      relation to age and refractive errors.
AB  - 1. To study the relationship between accommodation under natural viewing
      conditions, age and refractive errors, we have measured time courses of
      accommodation in thirty-nine human subjects aged 5-49 years using a newly
      developed technique. The technique is based on infrared photoretinoscopy and
      involves fully automated on-line image processing of digitized video images of
      the eyes with a sampling rate of 5.3 Hz. 2. The distance between the subject and
      the video camera was about 1.3 m. Head movements of the subject required little
      restriction because the eyes were automatically tracked in the video image by the
      computer program. All subjects were tested under binocular viewing conditions. 3.
      Both refraction of the right eye and pupil diameter were measured with a
      precision of 0.2-0.4 dioptres (D) and 0.1 mm, respectively, and were plotted on
      line. The data were subsequently automatically analysed. 4. Automated infrared
      photoretinoscopy proved to be very convenient and easy to handle in both children
      and adults. 5. The maximal speed of accommodation for a target at a distance of 5
      D declined in the subjects with age (from up to 21.7 D s-1 for accommodation and
      32.7 D s-1 for subsequent accommodation to a distant target ('near to far
      accommodation') in children down to 2-18 D s-1 in adults). There was a striking
      inter-individual variability in the maximum possible speed of accommodation and
      near to far accommodation. 6. Speed of accommodation and of near to far
      accommodation was correlated for each subject. However, in most of the subjects,
      the process of near to far accommodation was faster than accommodation (P <
      0.005, if averaged over all subjects). This correlation was independent of age.
      7. The accommodation-induced pupillary constriction (pupillary near response) was
      absent in children for a 4 D target; even at 10 D, there was no reliable
      pupillary response. The pupillary near response increased to about 1.6 mm D-1 of
      accommodation at the age of 47. Since a pupillary near response could still be
      elicited in presbyopic subjects unable to accommodate, the ratio of pupillary
      constriction per dioptre of accommodation approached infinity. 8. The magnitude
      of the pupillary near response was highly variable even among subjects of the
      same age but was typical for each subject. There was a correlation (P < 0.01) to
      refractive error: corrected myopes had weaker pupillary near responses than
      emmetropes or hyperopes.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350268
TI  - Phase-dependent dynamic responses of respiratory motor activities following
      perturbation of the cycle in the cat.
AB  - 1. Electroneurographical (ENG) activities of a phrenic nerve, a thyroarytenoid
      (TA) branch of a recurrent laryngeal nerve, and a triangularis sterni (TS) branch
      of an internal intercostal nerve were recorded in decerebrate, vagotomized and
      paralysed cats. A superior laryngeal nerve (SLN) was stimulated electrically. Our
      objective was to evaluate transient changes in motor activity following a brief
      perturbation of the respiratory cycle by SLN stimulation. 2. Each motor nerve
      recorded represents a separate phase of the respiratory cycle. We measured the
      duration of phrenic ENG activity for inspiratory phase duration (TI) and
      similarly the duration of TA and TS ENG activity for the duration of stages I and
      II of expiration, respectively. Changes in the duration of the total respiratory
      cycle (TTOT) were also measured. Therefore, the changes in TTOT were accounted
      for directly by changes in each phase of the respiratory cycle. 3. Perturbation
      during the inspiratory phase inhibited phrenic activity either reversibly or
      irreversibly (premature termination of inspiration) depending on the strength and
      timing of the stimulus. Reversible inhibition of inspiration was associated with
      a transient activation (< 100 ms) of the TA nerve followed by a reactivation of
      the phrenic nerve, but the duration of the subsequent stages I and II of
      expiration remained the same. Thus, the prolongation of TTOT was completely
      accounted for by the lengthening of TI. 4. Premature termination of inspiration
      was followed by either a shortening (the first half of inspiration) or a
      lengthening (the second half of inspiration) of the duration of stage I
      expiration and consistently by a shortening of the duration of stage II
      expiration. The magnitude of these changes in the durations of stages I and II of
      expiration was phase dependent. Changes in the duration of all three phases of
      motor activity contributed to the changes in TTOT. 5. Perturbation during stage I
      expiration prolonged this stage but did not affect the duration of the succeeding
      stage (stage II expiration). The increase in the duration of stage I expiration
      appeared constant and not dependent on the time when the perturbation was
      delivered in stage I expiration. Thus, the change in TTOT was less phase
      dependent during stage I expiration than during inspiration and stage II
      expiration and was accounted for by changes in the duration of TA activity alone.
      6. Perturbation during stage II expiration inhibited TS activity and evoked TA
      activity transiently.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350269
TI  - A statistical analysis of acetylcholine receptor activation in Xenopus myocytes:
      stepwise versus concerted models of gating.
AB  - 1. The kinetic properties of single channel currents from fetal-type
      acetylcholine receptors in embryonic Xenopus myocytes (60 h old) have been
      analysed by a maximum-likelihood method. 2. At very high acetylcholine (ACh)
      concentrations (up to 5 mM) the effective opening rate appears to saturate at
      approximately 30,000 s-1. 3. The kinetics were analysed according to the standard
      concerted scheme that postulates a single channel-opening conformational change
      after two agonists are bound, and a rarely invoked stepwise scheme that
      postulates semi-independent conformational changes in two distinct gating
      domains. Both models assume that agonist cannot escape from a channel (or domain)
      that is in its activated conformation. 4. With either activation scheme the
      kinetic analyses indicate that ACh binds at a rate of approximately 2 x 10(8) s-1
      M-1 and dissociates from doubly liganded receptors at a rate of approximately
      28,000 s-1, and that the activation process is asymmetric, i.e. the binding
      (concerted model) or gating (stepwise model) transitions are not equal and
      independent. 5. In eighteen of twenty-seven file-by-file comparisons, the
      likelihood of the stepwise model was greater than that of the concerted model. In
      seven such comparisons, the likelihood of the concerted model was greater than
      that of the stepwise model, and in two there was no difference. Log likelihood
      ratio distributions were obtained from three files (those with the most events)
      by multiple cycles of resampling and fitting. The means of these distributions
      were significantly greater than zero, indicating that the stepwise scheme was as
      good as, or better than, the concerted scheme in describing receptor activation.
      6. According to the stepwise view, two binding sites must be occupied and two
      'gates' activated for conduction to occur. Although equivalent binding is not an
      essential aspect of stepwise activation, the binding sites can be identical and
      have a low affinity for ACh (Kd approximately 130 microM). Either the
      isomerization rates of the gating domains are different, or they are influenced
      by the conformational status of its counterpart, with activation increasing
      approximately 3-fold and deactivation decreasing approximately 10-fold if the
      complementary domain is in the active conformation. Stepwise activation predicts
      that the decay of the endplate current is determined by five rates.

PMID- 8350270
TI  - Responses to sympathetic nerve stimulation of the sinus venosus of the toad.
AB  - 1. The changes in membrane potential produced by sympathetic nerve stimulation
      were recorded from sinus venosus preparations of the toad, Bufo marinus, in which
      beating had been prevented by the dihydropyridine calcium antagonist, nifedipine.
      2. Supramaximal sympathetic stimuli initiated long-lasting excitatory junction
      potentials which started with the same latencies, some 1 to 2 s, as did
      sympathetic tachycardias recorded from beating preparations. 3. Brief trains of
      stimuli increased the amplitude of excitatory junction potentials and shortened
      their latency of onset. Similarly when excitatory junction potentials were
      facilitated their latency of onset was shortened. 4. The time courses of
      excitatory junction potentials were prolonged by cooling the preparation but
      unchanged when the neuronal uptake of catecholamines was inhibited. 5. In
      arrested preparations, beta-adrenoceptor activation causes a hyperpolarization,
      as did the inhibition of phosphodiesterases or the activation of adenylate
      cyclase. This contrasts with the depolarization produced by sympathetic nerve
      stimulation which could be mimicked by the rapid application of either adrenaline
      or noradrenaline but not by beta-adrenoceptor activation, phosphodiesterase
      inhibition or by adenylate cyclase activation. 6. The results are discussed in
      relation to the idea that neuronally released adrenaline activates a set of
      adrenoceptors which are linked to a set of channels by a pathway that does not
      involve cyclic AMP.

PMID- 8350271
TI  - Afferent and efferent components of the cardiovascular reflex responses to acute
      hypoxia in term fetal sheep.
AB  - 1. We studied the effects of acute isocapnic hypoxia on arterial and central
      venous pressures, carotid and femoral blood flows and heart rate in intact and
      carotid denervated fetal sheep between 118 and 125 days gestation, after pre
      treatment with either saline, atropine or phentolamine. Electrocortical activity
      (ECoG) and the incidence of fetal breathing movements (FBM) were also compared
      between intact and carotid denervated fetuses. 2. There were no significant
      differences between intact and denervated fetuses in any variable measured during
      normoxia. Soon after the onset of hypoxia a marked bradycardia occurred in
      intact, but not in denervated fetuses. Femoral blood flow and femoral vascular
      resistance (perfusion pressure/femoral blood flow) increased in intact, but not
      in denervated fetuses. Carotid blood flow increased in both groups of fetuses
      during hypoxia, but carotid vascular resistance did not change. During hypoxia,
      the incidence of FBM and low-voltage ECoG was similarly reduced in both groups of
      fetuses. 3. Atropine produced a rise in fetal heart rate during the control
      period in intact but not in denervated fetuses. At the onset of hypoxia atropine
      prevented the initial bradycardia seen in intact fetuses. In denervated fetuses a
      further increase in heart rate occurred throughout the hypoxia. 4. All denervated
      fetuses treated with phentolamine died during the hypoxic challenge, but nine out
      of fourteen intact fetuses treated with phentolamine survived. 5. In intact
      fetuses which survived hypoxia after treatment with phentolamine, the increase in
      arterial blood pressure was smaller and the increase in femoral resistance did
      not occur. In these fetuses a rise in heart rate occurred in hypoxia. Carotid
      vascular resistance decreased during hypoxia after administration of
      phentolamine. 6. Our results indicate that the initial cardiovascular responses
      of the late gestation sheep fetus to hypoxia are reflex, and that the carotid
      chemoreceptors provide the afferent limb of this reflex. The bradycardia is
      mediated through a muscarinic pathway, as it is blocked by atropine. The femoral
      vasoconstriction is mediated through an alpha-adrenergic mechanism, mediated both
      neurally by a carotid chemoreflex and via catecholamines released directly from
      the adrenal medulla. Both these components are blocked by phentolamine. 7. The
      differences in survival between intact and denervated fetuses during hypoxia
      after phentolamine suggest that the carotid chemoreflex response to hypoxia
      involves mechanisms in addition to vagal efferents to the heart and alpha
      adrenergic actions at peripheral blood vessels.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350272
TI  - Metabolic acidosis and breathlessness during exercise and hypercapnia in man.
AB  - 1. A previous study showed that when combined with exercise in normal subjects,
      hypercapnic and hypoxic ventilatory stimuli did not have a specific effect on the
      intensity of the sensation of breathlessness in addition to their stimulation of
      ventilation. The aim of the present study was to assess the significance of
      another reflex ventilatory stimulus, metabolic acidosis, in the genesis of this
      sensation. 2. Six subjects performed progressive exercise tests (mean workload,
      103 W; range, 88-125 W) with normal acid-base status. Following NH4Cl-induced
      metabolic acidosis (mean change in base excess, -3.6 mmol l-1; range, -0.3 to 
      6.8 mmol l-1) exercise was repeated (mean workload, 91 W; range, 53-116 W) such
      that the combined ventilatory stimulation resulted in levels of ventilation (mean
      maximum, 65 l min-1) 'matched' to those resulting from exercise alone. A third,
      'matched ventilation', exercise test was performed during metabolic acidosis but
      with end-tidal PCO2 controlled to a normal level (mean workload, 56 W; range, 17
      103 W). Breathlessness was assessed using a visual analogue scale (VAS). 3.
      Progressive hypercapnic ventilatory stimulation was given before (mean maximum
      end-tidal PCO2 (PET,CO2), 61 mmHg) and during metabolic acidosis (mean maximum
      PET,CO2, 57 mmHg) to achieve the same peak level of ventilation (mean maximum, 59
      l min-1). Breathlessness was assessed with the VAS. 4. As ventilation increased
      during a test, there were no statistically significant differences in the
      increasing breathlessness scores with metabolic acidosis compared to control, for
      either exercise (mean VAS, 22 mm vs. 24 mm) or progressive hypercapnia (mean peak
      VAS, 31 mm vs. 32 mm). 5. These results do not support the idea that metabolic
      acidosis is associated with a change in the relationship between the intensity of
      breathlessness and ventilation; this is similar to results found with other
      reflex ventilatory stimuli. 6. These findings are consistent with the hypothesis
      that the degree of reflex ventilatory activation is an important determinant of
      the intensity of the sensation of breathlessness in healthy humans, irrespective
      of the exact nature of ventilatory stimulus.

PMID- 8350273
TI  - Effect of endothelin-3 on vasopressin release in vitro and water excretion in
      vivo in Long-Evans rats.
AB  - 1. The endothlins (ETs) are a family of homologous peptides originally isolated
      and purified from cultured porcine endothelial cells. Although initial studies
      focused on the ETs as potent vasoconstrictor substances, recent findings support
      a role for ET in vasopressin (AVP) secretion and action. We used cultured
      explants of the hypothalamo-neurohypophysial complex (HNC) to examine the effects
      of ET-3 on AVP release. 2. ET-3 produced a significant and concentration
      dependent rise in AVP release from the explants of Long-Evans rats at 48 h,
      independent of medium osmolality. AVP release during two sequential control
      periods did not differ, and osmotically stimulated AVP release was comparable to
      that exhibited by HNC explants from Sprague-Dawley rats. ET-3 (1 nM) induced a 3
      fold rise in AVP that was completely blocked by rabbit antiET serum, which did
      not alter basal AVP secretion. 3. Clearance experiments were performed in
      anaesthetized water-loaded rats given a non-pressor dose of ET-3 (0.40 nmol (kg
      body weight)-1 intravenously). The means of body weight, arterial blood pressure,
      plasma Na+ concentrations, and plasma osmolalities did not differ between the
      first and second periods nor among the groups. Despite no changes in renal plasma
      flow and inulin clearance, free water clearance significantly increased in the ET
      treated group. This response could not be attributed to changes in osmolal
      clearances or Na+ reabsorption. The concurrent administration of antiET serum not
      only blocked this effect, but was associated with the free water clearance
      falling significantly below the pretreatment level. 4. Taken together, our in
      vivo and in vitro findings support the hypothesis that ET-3 stimulates AVP
      secretion. Furthermore, our data are consistent with the site of action of ET-3
      residing within the blood-brain barrier, though an independent effect by a higher
      concentration of ET at neural loci outside the barrier cannot be totally
      excluded. Finally, the subpressor dose of ET-3 amplifies free water excretion
      independent of systemic and renal haemodynamics, Na+ excretion, osmolal
      clearance, or circulating AVP levels.

PMID- 8350275
TI  - Changes in contractile properties by androgen hormones in sexually dimorphic
      muscles of male frogs (Xenopus laevis).
AB  - 1. Male frogs (Xenopus laevis) were castrated then given either empty or
      testosterone-filled implants to produce animals with low or high levels of
      circulating testosterone. Eight weeks later the contractile properties of an
      androgen-sensitive forelimb flexor, the flexor carpi radialis muscle (FCR), were
      measured in vitro. Another forelimb flexor muscle, the coracoradialis, and a
      hindlimb muscle, the iliofibularis, were analysed similarly. 2. Plasma
      testosterone levels were 0.9 +/- 0.3 ng/ml (+/- S.E.M.) in castrated frogs with
      blank implants (C) and 61.3 +/- 4.7 ng/ml in castrates with testosterone implants
      (CT). Unoperated males, sampled at various times of the year, ranged between 10.8
      and 51.0 ng/ml. 3. With direct electrical stimulation of the FCR, contraction
      time of the isometric twitch was not affected by testosterone levels. Relaxation
      times were affected, however. Half- and 90% relaxation times were 27 and 42%
      longer, respectively, for CT compared to C muscles. 4. Testosterone also had no
      effect on the contraction time of twitches elicited by stimulation of the FCR
      nerve. Half- and 90% relaxation times were 51 and 76% longer, respectively, for
      CT compared to C muscles. 5. Tetanus tension, elicited by direct stimulation of
      the FCR at 50 Hz, was 86% greater in CT compared to C muscles. The average cross
      sectional area of FCR muscle fibres was 84% greater in CT muscles. These results
      implied that testosterone treatment had no effect on specific muscle tension. 6.
      Stimulation of the FCR nerve at 50 Hz resulted in 53% less tension than the same
      stimulus applied directly to CT muscles. In C muscles the difference was only
      14%. This suggested that testosterone treatment reduced synaptic efficacy. 7. In
      CT muscles, direct or nerve stimulation of fibres in the shoulder region of the
      FCR elicited twitches that contracted and relaxed more slowly than fibres in the
      elbow region. In C muscles there was no difference in contraction or relaxation
      time between fibres in the shoulder and elbow regions. 8. Testosterone treatment
      had little effect on contraction and relaxation times or tension levels of
      coracoradialis or iliofibularis muscles.

PMID- 8350274
TI  - Synaptic and intrinsic conductances shape picrotoxin-induced synchronized after
      discharges in the guinea-pig hippocampal slice.
AB  - 1. A computer model was constructed of the guinea-pig hippocampal region in
      vitro, containing 100 pyramidal neurones. This approach has contributed to the
      understanding of brief (usually less than 100 ms) epileptic events known as
      'interictal spikes'. The present study addresses the cellular mechanisms of more
      prolonged epileptic events, lasting 200 ms and more, that may represent short
      duration seizures. Each neurone was simulated with a nineteen-compartment model
      using six voltage-dependent ionic conductances. The neurones were randomly
      interconnected with excitatory synapses, each synapse exerting a fast voltage
      independent alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)
      component and a slower voltage-dependent N-methyl-D-aspartate (NMDA) component.
      Each neurone received input from twenty other neurones. 2. This model was able to
      generate, in response to synaptic noise or to stimulation of one neurone, a
      series of synchronized population bursts, the initial (primary) burst being
      longer than later (secondary) bursts, terminating in a prolonged after
      hyperpolarization. The simulated after-discharge potentials resemble those
      recorded experimentally from pyramidal neurones during perfusion of the
      hippocampal slice with media containing picrotoxin, a blocker of synaptic
      inhibition mediated by GABAA receptors. 3. Simulated after-discharges agree with
      the following experiments: over a certain range of total NMDA conductance,
      blockade of AMPA receptors will prevent the occurrence of synchronized firing,
      whereas, blockade of NMDA receptors will, in contrast, abolish the secondary
      bursts, leaving a shortened and somewhat smaller primary burst. Dendritic
      potential oscillations occur in phase with somatic oscillations. When
      interneurones (some generating GABAA-mediated IPSPs, others generating GABAB
      IPSPS) are included in the model, the occurrence of synchronized events was
      suppressed, the most significant suppressant effect coming from GABAA IPSPS. 4.
      The model predicts that: a dendritic calcium spike occurs during each secondary
      burst; AMPA receptors serve to maintain the synchrony of secondary bursts, as
      well as to initiate the primary burst; and that with sufficient total NMDA
      conductance, synchronized firing can occur even with AMPA receptors blocked. 5.
      The model suggests, in addition, that the duration of the initial burst is
      determined in part by the experimentally observed delay between Ca2+ entry and
      peaking of the after-hyperpolarization (AHP) conductance, and hence reflects
      properties of the individual pyramidal neurones. Specifically, a pattern of a
      long initial burst followed by brief secondary bursts is elicited in single-cell
      simulations by injection of a steady depolarizing current into the apical
      dendrite. The same pattern is produced when the single-cell model includes only
      calcium and calcium-dependent conductances.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350276
TI  - Permeability of disrupted cerebral microvessels in the frog.
AB  - 1. This study reports the results of varying the hydrostatic pressure on
      measurements of permeability coefficient to the low molecular weight impermeant
      dye carboxyfluorescein (MW = 376) in single leaky cerebral microvessels. A
      mathematical model, that solved the convective diffusion equations used to
      analyse the measurements, showed that the measurements were consistent with
      leakiness being due to 22 nm wide parallel-sided slits between endothelial cells.
      2. Microvessels on the surface of the frog's brain were cannulated with a
      micropipette and perfused with an artificial cerebrospinal fluid containing the
      dye. Vessels were occluded with a glass microneedle and the rate of change in dye
      concentration in a 12 microns length section was measured using video-intensified
      microscopy. 3. It was found that the rate of dye loss at all points along the
      occluded microvessel segment could be accounted for by a model for convection and
      diffusion, and that changes in dye concentration at a point remote from the
      segment entrance can give a good measure of diffusive permeability. 4. When
      series of measurements were carried out on a single vessel, permeability rose
      over the course of 20 min. Mean permeability for all measurements was 3.01 x 10(
      5) cm sec-1, n = 64 (mode, 2.0; range, 0.48-9.6). The hydrostatic pressure
      applied during the perfusion had no effect on the measured permeability. 5. The
      dye concentration along the vessel axis was measured at the steady state and was
      shown to respond to changes in hydrostatic perfusion pressure in a way predicted
      by the model. This indicates that hydrostatically driven bulk flow can be
      important, and thus convection may account for effects previously ascribed to
      vesicular transcytosis. 6. The possible anatomical basis for the porous pathway
      is discussed in the light of recent observations on the presence of 0.5 microns
      perijunctional gaps, the possibility of transendothelial channels, and the
      unzipping of tight junctions to leave a 22 nm wide slit.

PMID- 8350277
TI  - Calcium accumulation by organelles within Myxicola axoplasm.
AB  - 1. 45Ca2+ accumulation into inulin-inaccessible compartments within cytoplasm
      from the giant axon of Myxicola infundibulum was measured as a function of free
      calcium, pH, and time. Accumulation reached a maximum after 1 h and remained
      stable for at least 3 h. 2. At 0.5, 5, and 50 microM [Ca2+], in the presence of 1
      mM ATP or 5 mM succinate, steady-state calcium uptake had a bell-shaped
      dependence on pH with a maximum near pH 7. Uptake was abolished by the proton
      uncoupling reagent carbonyl cyanide p-trifluoromethoxy-phenylhydrazone (FCCP, 4
      micrograms ml-1). 3. Uptake of the membrane permeant cation, [14C]
      tetraphenylphosphonium (TPP+), also had a bell-shaped dependence on pH with a
      maximum pH approximately 7, suggesting a pH dependence of the electrical
      potential of a membrane enclosed cytoplasmic compartment. Cyanide (2 mM)
      inhibited TPP+ uptake. 4. Inositol 1,4,5-trisphosphate (IP3, 10 microM), reduced
      steady-state calcium accumulation by 20-22% at 0.5 microM free calcium, pH 7 (P <
      0.01, n = 16) and at 5 microM free calcium, pH 8 (P < 0.0005, n = 35). No effects
      of IP3 were found at other pH or calcium concentrations. 5. Neither guanosine 5'
      triphosphate (GTP) nor inositol 1,3,4,5-tetrakisphosphate (IP4) had an effect on
      calcium uptake (5 microM [Ca2+], pH 8). 6. At 0.5 microM free calcium; vanadate
      (10 microM) inhibited 20-30%, of the 45Ca2+ accumulation, thapsigargin (33 nM)
      inhibited 20-30%, and cyanide (2 mM) plus oligomycin B (2 micrograms ml-1), or
      valinomycin (1 microM), inhibited 70-80%. The fraction of uptake sensitive to
      thapsigargin fell as the free calcium increased; however, the sensitivity of
      uptake to cyanide plus oligomycin B was approximately 80% for 0.5, 5.0, and 50
      microM [Ca2+]. 7. Thapsigargin had no additional inhibiting effect in the
      presence of cyanide plus oligomycin B. IP3 had no effect in the presence of
      cyanide plus oligomycin B or other mitochondrial inhibitors. 8. Results suggest
      the presence of both mitochondrial (70-80%) and non-mitochondrial (20-30%)
      calcium pools in this system (at 0.5-5.0 microM Ca2+). The apparent non
      mitochondrial uptake (sensitive to thapsigargin, or IP3) is not detectable in the
      presence of mitochondrial inhibitors. We interpret these results as evidence of
      functional communication between mitochondrial and non-mitochondrial calcium
      stores.

PMID- 8350278
TI  - Contralateral projections of thoracic respiratory interneurones in the cat.
AB  - 1. Retrograde neuronal transport following small iontophoretic injections of
      horseradish peroxidase was used to investigate the location of neurones
      projecting to the thoracic ventral horn of the cat. 2. A concentration of
      labelled neurones was seen in the contralateral medial ventral horn at the
      immediately opposite rostrocaudal position. 3. The participation of respiratory
      interneurones in the projection was investigated by means of spike-triggered
      averaging, as follows. 4. Spike trains of single interneurones whose firing
      patterns were related to the central respiratory cycle were recorded
      extracellularly in the thoracic ventral horn of anaesthetized, paralysed cats.
      Firing patterns were defined by the construction of cycle-triggered histograms.
      5. Spike-triggered averaging of the signal from an extracellular tungsten
      microelectrode in the opposite ventral horn was performed to test for the
      presence of axonal, terminal or focal synaptic potentials. 6. At least one of
      these types of potential was found for 34/55 units. Terminal potentials were
      found for thirty-one units, accompanied by focal synaptic potentials for twenty
      seven units. Potentials were found for units with all types of firing patterns.
      Units whose activity elicited these potentials were generally located in the
      medial half of the ventral horn. 7. We conclude that at least 60% of the
      respiratory interneurones project to the immediately opposite ventral horn.

PMID- 8350279
TI  - Functional identities of thoracic respiratory interneurones in the cat.
AB  - 1. Spike-triggered averaging was used to reveal focal synaptic potentials (FSPs)
      in the thoracic ventral horn resulting from impulses in individual respiratory
      interneurones situated in the contralateral ventral horn of the same segment (T6
      or T7) in anaesthetized paralysed cats. 2. FSPs were of two types, negative-going
      or positive-going, and were of the same sign at each of several sites for each
      unit. These two types were interpreted as indicating excitatory or inhibitory
      actions respectively. 3. The positive-going FSPs were almost all the result of
      activity in the most strongly modulated, phasic respiratory interneurones,
      whereas most of the negative-going ones were derived from neurones with a
      continuous tonic component in their firing patterns. 4. Positive-going FSPs
      (particularly those from inspiratory neurones) were generally found at more
      ventral sites in the ventral horn than negative-going ones. 5. It is suggested
      that an important role for the phasically active interneurones is to provide
      phasic inhibition, which is combined with largely tonic excitation to produce
      strong respiratory modulation in the activity of other neurones in the thoracic
      spinal cord, particularly in motoneurones. However, some groups of respiratory
      interneurones, such as a group of tonic inspiratory ones which are located more
      dorsally than the phasic inspiratory ones, may not receive such phasic
      inhibition.

PMID- 8350281
TI  - The effect of endotoxin-induced fever on thermoregulation in the newborn rabbit.
AB  - 1. Metabolic responses of endotoxin-injected newborn rabbits were measured in a
      closed circuit calorimeter at a constant environmental temperature within their
      thermoneutral range. Oxygen consumption and colonic temperatures were then
      measured over a range of environmental temperatures from 21.0 to 40.0 degrees C
      and the responses of endotoxin-injected rabbits compared with non-injected litter
      mates. 2. To measure their preferred thermal environment, endotoxin-injected and
      non-injected litter mates were allowed to settle on a thermal gradient and their
      colonic temperatures measured. 3. In a constant environmental temperature of 37
      degrees C, rises in oxygen consumption and colonic temperature following
      endotoxin injection were found to be biphasic. Oxygen consumption rose from 21 ml
      kg-1 min-1 to a maximum 35 ml kg-1 min-1 and colonic temperature rose from 39.0
      to 39.8 degrees C. 4. The maximal rate of oxygen consumption was the same in both
      injected and non-injected animals, 53 ml kg-1 min-1, being provoked at the same
      environmental temperature of 24 degrees C. Minimal rates of oxygen consumption
      were also similar for the two groups but in the injected animals they were
      achieved at an environmental temperature of 39 degrees C, 2 degrees C higher than
      for non-injected animals. 5. We conclude that newborn rabbits challenged with a
      pyrogen have both behavioural and physiological responses. The thermogenic
      response is consistent with a change in sensitivity to feedback information
      rather than a simple shift in the central thermoregulatory set point. We find no
      evidence to support the view that in the febrile response a higher body
      temperature necessitates an increase in metabolic rate, the so-called Q10 effect.

PMID- 8350280
TI  - Agonist-independent effects of muscarinic antagonists on Ca2+ and K+ currents in
      frog and rat cardiac cells.
AB  - 1. The whole-cell patch clamp and intracellular perfusion techniques were used
      for studying the effects of atropine and other muscarinic acetylcholine receptor
      (mAChR) antagonists on the L-type calcium currents (ICa) in frog and rat
      ventricular myocytes, and on the mAChR-activated K+ current (IK(ACh)) in frog
      atrial myocytes. 2. In frog ventricular myocytes, atropine (0.1 nM to 1 microM)
      reversed the inhibitory effect of acetylcholine (ACh, 1 nM) on ICa previously
      stimulated by isoprenaline (Iso, 2 microM), a beta-adrenergic agonist. However,
      in the concomitant presence of Iso, ACh and atropine, ICa was > 50% larger than
      in Iso alone. 3. The effects of atropine were then examined in the absence of
      mAChR agonists. After a preliminary stimulation of ICa with Iso (0.1 or 2
      microM), atropine induced a dose-dependent stimulation of ICa. EC50 (i.e. the
      concentration of atropine at which the response was 50% of the maximum) and Emax
      (i.e. maximal stimulation of ICa expressed as percentage increase in ICa with
      respect to the level in Iso alone) were respectively 0.6 nM and 35%. The
      stimulatory effect of atropine on ICa was not voltage dependent. 4. Atropine (1
      microM) had no effect on frog ICa (i) under basal conditions, (ii) upon
      stimulation of ICa by the dihydropyridine agonist (-)-Bay K 8644 (1 microM), or
      (iii) when ICa had been previously stimulated by intracellular perfusion with
      cyclic AMP (3 microM). However, atropine increased ICa after a stimulation by
      forskolin (0.3 microM). Therefore, an increased adenylyl cyclase activity was
      required for atropine to produce its stimulatory effect on ICa. 5. The order of
      potency of mAChR antagonists to reverse the inhibitory effect of ACh on Iso
      elevated ICa in frog ventricle was atropine > AF-DX 116 >> pirenzepine. In the
      absence of ACh, mAChR antagonists produced their stimulatory effect on Iso
      elevated ICa with the same order of potency. 6. Intracellular substitution of
      Gpp(NH)p (5'-guanylylimidiphosphate) for GTP (420 microM) induced a strong
      inhibition of frog ICa in the presence of Iso (2 microM). This effect was
      attributed earlier to the spontaneous and irreversible activation of the GTP
      binding regulatory protein (G protein), Gi, responsible for adenylyl cyclase
      inhibition. Atropine (1 microM) slowed down by a factor of 2 the rate of ICa
      inhibition induced by Gpp(NH)p. 7. In frog atrial myocytes, intracellular
      perfusion with 1 mM Gpp(NH)p induces spontaneous activation of IK(ACh). This
      effect was attributed earlier to the spontaneous and irreversible activation of
      the G protein, GK.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350282
TI  - Regional cerebral blood flow during volitional expiration in man: a comparison
      with volitional inspiration.
AB  - 1. Positron emission tomographic (PET) imaging of regional cerebral blood flow
      (rCBF), using a new 3-dimensional technique of data collection, was used to
      identify areas of neuronal activation associated with volitional inspiration and
      separately with volitional expiration in five normal male subjects. A comparison
      of the activated areas was also undertaken to isolate regions specific for one or
      other active task. 2. Scans were performed during intravenous infusion of H2(15)O
      under conditions of (a) volitional inspiration with passive expiration, (b)
      passive inspiration with volitional expiration and (c) passive inspiration with
      passive expiration. Four measurements in these three conditions were performed in
      each subject. Breathing pattern was well matched between conditions. 3. Regional
      increases in brain blood flow, due to increased neural activity associated with
      either active inspiration or active expiration, were derived using a pixel by
      pixel comparison of images obtained during the volitional and passive ventilation
      phases. Data were pooled from all runs in all subjects and were then processed to
      detect statistically significant (P < 0.05) increases in rCBF comparing active
      inspiration with passive inspiration and active expiration with passive
      expiration. 4. During active inspiration significant increases in rCBF were found
      bilaterally in the primary motor cortex dorsally just lateral to the vertex, in
      the supplementary motor area, in the right lateral pre-motor cortex and in the
      left ventrolateral thalamus. 5. In active expiration significant increases in
      rCBF were found in the right and left primary motor cortices dorsally just
      lateral to the vertex, the right and left primary motor cortices more
      ventrolaterally, the supplementary motor area, the right lateral pre-motor
      cortex, the ventrolateral thalamus bilaterally, and the cerebellum. 6. Using this
      modified and more sensitive PET technique, these findings essentially replicate
      those for volitional inspiration obtained in a previous study. For volitional
      expiration the areas activated are more extensive, but overlap with those
      involved in volitional inspiration. 7. The technique used has been successful in
      demonstrating the regions of the brain involved in the generation of volitional
      breathing, and probably in the volitional modulation of automatic breathing
      patterns such as would be required for the production of speech.

PMID- 8350283
TI  - Sound and vibration sensitivity of VIIIth nerve fibers in the frogs Leptodactylus
      albilabris and Rana pipiens pipiens.
AB  - 1. Responses of 73 fibers to dorso-ventral vibration were recorded in the
      saccular and utricular branchlets of Rana pipiens pipiens using a ventral
      approach. The saccular branchlet contained nearly exclusively vibration-sensitive
      fibers (33 out of 36) with best frequencies (BFs) between 10 and 70 Hz, whereas
      none of the 37 fibers encountered in the utricular branchlet responded to dorso
      ventral vibrations. 2. Using a dorsal approach we recorded from the VIIIth nerve
      near its entry in the brainstem and analyzed responses to both sound and
      vibration stimuli for 65 fibers in R. pipiens pipiens and 25 fibers in
      Leptodactylus albilabris. The fibers were classified as amphibian papilla (AP),
      basilar papilla (BP), saccular or vestibular fibers based on their location in
      the nerve. Only AP and saccular fibers responded to vibrations. The AP-fibers
      responded to vibrations from 0.01 cm/s2 and to sound from 40 dB SPL by increasing
      their spike rate. Best frequencies (BFs) ranged from 60 to 900 Hz, and only
      fibers with BFs below 500 Hz responded to vibrations. The fibers had identical
      BF's for sound and vibration. The saccular fibers had BFs ranging from 10 to 80
      Hz with 22 fibers having BFs at 40-50 Hz. The fibers responded to sound from 70
      dB SPL and to vibrations from 0.01 cm/s2. 3. No differences in sensitivity,
      tuning or phase-locking were found between the two species, except that most BP
      fibers in R. pipiens pipiens had BFs from 1.2 to 1.4 kHz, whereas those in L.
      albilabris had BFs from 2.0 to 2.2 kHz (matching the energy peak of L.
      albilabris' mating call). 4. The finding that the low-frequency amphibian papilla
      fibers are extremely sensitive to vibrations raises questions regarding their
      function in the behaving animal. They may be substrate vibration receptors,
      respond to sound-induced vibrations or bone-conducted sound.

PMID- 8350284
TI  - Visual performance of the toad (Bufo bufo) at low light levels: retinal ganglion
      cell responses and prey-catching accuracy.
AB  - The accuracy of toad snapping towards moving worm dummies under various levels of
      dim illumination (from absolute threshold to "moonlight") was video-recorded and
      related to spike responses of retinal ganglion cells exposed to equivalent
      stimuli. Some toads (at ca. 16 degrees C) successfully snapped at dummies that
      produced only one photoisomerization per 50 rods per second in the retina, in
      good agreement with thresholds of sensitive retinal ganglion cells. One factor
      underlying such high sensitivity is extensive temporal summation by the ganglion
      cells. This, however, is inevitably accompanied by very long response latencies
      (around 3 s near threshold), whereby the information reaching the brain shows the
      dummy in a position where it was several seconds earlier. Indeed, as the light
      was dimmed, snaps were displaced successively further to the rear of the dummy,
      finally missing it. The results in weak but clearly supra-threshold illumination
      indicate that snaps were aimed at the advancing head as seen by the brain, but
      landed further backwards in proportion to the retinal latency. Near absolute
      threshold, however, accuracy was "too good", suggesting that the animal had
      recourse to a neural representation of the regularly moving dummies to correct
      for the slowness of vision.

PMID- 8350285
TI  - Amine modulation of electrical coupling in the pyloric network of the lobster
      stomatogastric ganglion.
AB  - 1. The neurons of the pyloric network of the lobster (Panulirus interruptus)
      stomatogastric ganglion organize their rhythmic motor output using both chemical
      and electrical synapses. The 6 electrical synapses within this network help set
      the firing phases of the pyloric neurons during each rhythmic cycle. We examined
      the modulatory effects of the amines dopamine (DA), serotonin (5HT) and
      octopamine (Oct) on coupling at all the electrical synapses of the pyloric
      network. 2. Electrical coupling within the pacemaker group [anterior burster (AB)
      to pyloric dilator (PD), and PD-PD] was non-rectifying, while coupling at the
      other electrical synapses [AB to ventral dilator (VD), PD-VD, lateral pyloric
      (LP) to pyloric (PY), and PY-PY] was rectifying. 3. Dopamine decreased or
      increased the coupling strength of all the pyloric electrical synapses: the sign
      of the effect depended upon which neuron was the target of current injection. For
      example, DA decreased AB-->PD coupling (i.e., when current was injected into the
      AB) but increased coupling in the other direction, PD-->AB. Dopamine decreased AB
      to VD coupling when current was injected into either neuron. Serotonin also had
      mixed effects; it enhanced PD-->AB coupling but decreased AB to VD and PD to VD
      coupling in both directions. Octopamine's only effect was to reduce PD-->VD
      coupling. 4. Dopamine increased the input resistance of the AB neuron but
      decreased the input resistance of the PD and VD neurons. Serotonin reduced the
      input resistance of the VD and PY neurons, while Oct did not significantly change
      the input resistance of any pyloric neuron. 5. The characteristic modulation of
      electrical coupling by each amine may contribute to the unique motor pattern that
      DA, 5HT and Oct each elicit from the pyloric motor network.

PMID- 8350286
TI  - Reaction to surface waves by Xenopus laevis Daudin. Are sensory systems other
      than the lateral line involved?
AB  - The turning response to surface waves of clawed toads (Xenopus laevis) with an
      inactivated lateral line was reinvestigated to examine whether sensory systems
      other than the lateral line ("second systems") are involved. Two methods were
      used to block the lateral line input: selective and reversible inactivation of
      the lateral line periphery using CoCl2 or chronic destruction with thermocautery.
      The time-course of the response recovery (response frequency, turning accuracy
      and reaction time) was recorded. Following CoCl2 inactivation 10 out of 13
      animals did not respond to surface waves for at least 2 days. The remaining 3
      animals gave sporadic turning responses. It is assumed that in these individuals
      a "second system" is permanently involved in the detection of surface waves
      parallel to the lateral line. Five days after the chronic destruction of the
      lateral line all animals again turned to the centre of surface waves. It is
      suggested that by this time the "second system" had become capable of
      substituting for the missing lateral line input. The response frequency and the
      accuracy of the turning response of lesioned animals varied considerably among
      individuals but was always lower than in untreated animals (tested up to 120
      days).

PMID- 8350287
TI  - Theoretical and empirical considerations on the relation between 'body image',
      body scheme and somatosensation.
AB  - The authors first discuss possible interactions between the hitherto neglected
      neurophysiological and neuropsychological factors and the traditionally accepted
      cognitive and affective factors in 'body image' formation. They then report on a
      study of the relation between body size perception (video distortion technique,
      image marking procedure, kinaesthetic size estimation apparatus) and
      somatosensation (thermal, pain and vibration thresholds) in young women. Included
      in the study were questionnaires on eating behaviour and motivation, body
      attitude or body satisfaction, and depressive mood and thoughts. Neither the
      somatosensory nor the questionnaire variables explained the difference between
      'overestimators' and 'underestimators' of body size. However, these variables did
      explain the difference between 'good perceivers' and 'poor perceivers' (degree of
      deviation from actual body size) in the video distortion technique, with a
      somewhat larger contribution by the somatosensory variables. The latter finding,
      although clearly preliminary, should stimulate further investigations of the
      relationship between somatosensory variables and body size perception.

PMID- 8350288
TI  - Beta-endorphin response to exercise and mental stress in patients with ischemic
      heart disease.
AB  - We compared symptomatic, hemodynamic and opioid responses of heart disease
      patients to exercise testing and a stressful public speaking task. Plasma beta
      endorphins were measured at rest and immediately post stress. Nineteen of 50
      patients had angina during exercise; 31 had asymptomatic ischemia. No patient had
      angina during the speech, but two had ECG changes and 39% had radionuclide
      changes indicating ischemia. Patients with asymptomatic ischemia on exercise had
      a significantly greater beta-endorphin response than those with angina. Public
      speaking elicited a significantly larger beta-endorphin increase relative to
      change in double product (an index of stress) than did exercise. CONCLUSIONS: (1)
      Patients with silent vs painful ischemia experience a greater beta-endorphin
      response to exercise. (2) beta-endorphin response to a speech stressor is greater
      than to exercise when controlled for an index of stress. (3) Increased beta
      endorphin response to a speech stressor may partially explain the predominance of
      silent ischemia during psychological stress.

PMID- 8350289
TI  - The physiological stress response and the role of cognitive coping in migraine
      patients and non-headache controls.
AB  - Our study investigated physiological response specificity and cognitive coping in
      migrainous patients during an achievement task situation. Thirty-three migrainous
      subjects and thirty-two non-headache controls were subjected to 40 min of
      demanding cognitive tasks and 20 min of recovery during which cranial and
      peripheral vasomotor responses were registered as well as electrodermal and
      myographic activity. Subjects of both groups were randomly assigned to two
      experimental conditions, a so-called 'spontaneous processing condition' and the
      'positive coping treatment'. In this treatment condition subjects received a
      short training in the conscious use of positive self-statements in stress
      situations. Though a specific pattern of cranial vasomotor responses in migraine
      subjects could be verified by group statistics, this pattern was only found in
      very few individuals. Reliable differences between groups could not be identified
      in other physiological variables either. The hypothesis that the predicted
      cranial vasomotor specificity in migraine subjects correlates with negative
      cognitive coping habits in migraine subjects best revealed in the 'spontaneous
      processing' condition, was not corroborated. The treatment variation regarding
      coping produced somewhat paradoxical effects, more relaxed and positive self
      evaluation (subjective level) and more arousal (physiological level). Results are
      discussed for their impact on the psycho-biological model of migraine.

PMID- 8350291
TI  - Measurement reliability of cardiovascular reactivity change scores: a comparison
      of intermittent and continuous methods of assessment.
AB  - Cardiovascular reactivity testing is a widely used measure of risk for
      hypertension and coronary heart disease. Evidence for the reliability of the
      measures, however, is weak. If the measures (usually change scores) are
      unreliable, the usefulness of testing is limited, since relationships with other
      measures, such as disease outcomes, may be obscured. This study examines the
      reliability of blood pressure change, using both a traditional method of
      assessment (Colin ABPM) which provides intermittent readings, and a non-invasive
      method that samples the complete distribution of pressures (Ohmeda Finapres).
      While the reliability for the Colin was found to be good for absolute level of
      individual measurements, it was extremely poor for change scores. The Finapres,
      however, yielded high reliabilities for change scores as well as absolute levels,
      due to the large number of readings taken during baseline and stressor
      conditions. Implications for reactivity testing methodology are discussed.

PMID- 8350290
TI  - Mood state as a predictor of treatment outcome after in vitro
      fertilization/embryo transfer technology (IVF/ET).
AB  - The association between mood state and treatment outcome after In Vitro
      Fertilization/Embryo Transfer (IVF/ET) was assessed in a prospective sample of
      330 women, of whom 113 were first time participants (inductees) and 217 were
      repeat cycle women (veterans). Initial evaluation of mood state indicated a
      significantly higher level of depression amongst veterans than inductees and a
      significantly greater proportion of veterans (25%) with clinically elevated
      depression scores compared with inductees (15%) and community norms (approx.
      12%). Up to 12 months after initial assessment and after controlling for the
      number of treatment cycles, a significant difference was observed in the course
      of pregnancy over time between depressed and non-depressed women. Depressed women
      exhibited a lower pregnancy rate for the first treatment cycles than non
      depressed women. The results and their implications are discussed.

PMID- 8350292
TI  - Anger inhibition and family history as modulators of cardiovascular responses to
      mental stress in adolescent boys.
AB  - Sixty boys aged 12-16 took part in an experiment in which physiological and
      subjective measures were obtained at rest and in response to mental arithmetic
      and mirror drawing tasks. Blood pressure was recorded from biological parents,
      and subjects were subsequently categorized as being at high family risk for
      cardiovascular disease if either parent had a history of coronary heart disease
      or hypertension, or a resting blood pressure > or = 140/85 mmHg. Twenty boys were
      classified as high family risk and forty as low risk. A significant interaction
      between family risk and a disposition towards anger inhibition was observed, with
      the greatest systolic blood pressure responses to tasks being recorded in high
      risk boys who reported high levels of anger inhibition. This effect was
      maintained after controlling for initial blood pressure level, age and body mass.
      The cardiac baroreceptor reflex was inhibited during tasks, and was lower in high
      than low family risk subjects. The results suggest that the tendency to inhibit
      anger expression interacts with familial factors in determining reactivity
      patterns that may be indicative of raised risk of future cardiovascular disease.

PMID- 8350293
TI  - The Asthma Symptom Profile: a psychophysically based scale for assessment of
      asthma symptoms.
AB  - The Asthma Symptom Profile (ASP) assesses phasic changes in three dimensions of
      asthma symptoms: intensity, unpleasantness, and quality of sensations.
      Quantification data on verbal descriptors were gathered from 46 adult asthmatics
      for each of these scales, using bimodality scaling: i.e., with numerical
      estimates and drawing lines varying length. Close agreement was obtained between
      these two modalities. The ASP was analyzed before and after a bronchodilator in
      44 asthmatics using ipratropium bromide (IB). Forty of these subjects were also
      tested in a placebo condition. Although ASP changes produced by IB were no
      greater than those produced by the placebo, correlations with changes in
      spirometry variables were significant. There were no significant differences in
      correlations with line drawings vs. numerical ratings. The ASP appears to be
      useful measure of phasic changes in asthma symptoms. Asthmatics with mild airway
      obstruction do not appear to be able to discriminate small changes in airway
      function.

PMID- 8350294
TI  - Coping with breast cancer over time and situation.
AB  - This study examines the variability and stability of coping in cancer subjects
      over time and situation. In a prospective longitudinal design 74 breastcancer
      patients have been followed for 3-5 yr at 3-6 monthly intervals. A variety of
      measures related to coping and adjustment were taken. This report limits itself
      to the findings of an instrument developed for this study, the Bernese Coping
      Modes in which 26 coping modes were rated by observers. Results confirm arguments
      in favour of both variability and stability in coping activity over time and
      situation. Two measures support stability: rank values and a multivariate measure
      (MDS) with three constant dimensions: (1) support and acceptance; (2) denial; (3)
      diversion by thought and action. Evidence for variability is: the potential range
      of coping modes and a large variety of additional modes at most observation
      times. Subsequently time measures of coping were attributed to eight predefined
      illness stages as distinct clinical situations. Thus variability or richness of
      coping further increased. The implications of these findings for measurement in
      coping research are discussed.

PMID- 8350295
TI  - Investigation of the reliability and factor structure of a questionnaire for
      assessment of the premenstrual syndrome.
AB  - Data are presented from 696 women who completed a 35-item retrospective self
      report PMS questionnaire. Item analysis resulted in the elimination of six items
      which predominantly reflected physical symptomatology. The resultant (29-item)
      questionnaire demonstrated a coefficient alpha value of 0.94 corresponding to a
      very high level of internal consistency and split-half reliability. It is argued
      that discrepancies in previous PMS research based on questionnaire data may, in
      part, be due to inadequate attention being devoted to achieving homogeneity of
      the PMS construct. A high level of internal consistency is a necessary condition
      for global PMS scores to be meaningful. Factor analysis of the revised
      questionnaire resulted in a two factor model corresponding to 'dysphoria' and
      'dysfunction'. This leads to a simple four quadrant typology of PMS which may
      further understanding of this 'purer' PMS construct.

PMID- 8350296
TI  - 6-month aerobic exercise training program had no effect on cardiovascular
      responsivity to a mental arithmetic test in healthy middle-aged adults.

PMID- 8350297
TI  - Psychosocial factors in the progression of cervical intraepithelial neoplasia-
      CIN.

PMID- 8350299
TI  - Regulation of parental alloreactivity by reciprocal F1 hybrids. The role of
      lactation.
AB  - Adult reciprocal F1 hybrids differ in their susceptibility to parental graft
      versus host (GvH) reactions. These reactions were lower when the donor strain was
      syngeneic with the maternal one. Splenocytes from the member of the reciprocal
      pair in which the GvH reactions were lower also induced a decreased response of
      parental cells in cytotoxicity assays and in mixed lymphocyte reactions (MLR).
      The treatment with anti-CD8 plus complement was able to abrogate the different
      stimulatory ability of the reciprocal F1 spleen populations. Foster-nursing of F1
      hybrids on mothers from the paternal strain was able to induce permanent
      alterations in the ability of their splenocytes to induce both parental anti-F1
      MLR and CTL. The stimulatory ability was indistinguishable from that observed in
      the reciprocal F1 combination nursed on its own mother. Moreover, lactation was
      able to alter the ability of CD8+ spleen cells to regulate CTL and parental anti
      F1 MLR. The results reported herein show the existence of a maternal effect
      acting though milk capable of altering the regulation of parental alloreactive T
      reactions towards self histocompatibility antigens.

PMID- 8350298
TI  - An immunohistologic analysis of murine uterine T cells between birth and puberty.
AB  - Murine uterine T cells were analysed on the basis of surface phenotype expression
      from birth to adulthood. T cells were rare in the uterus from birth until 2 weeks
      of age. In genetically immunocompetent mice, mature T cells expressing either TCR
      alpha/beta or TCR gamma/delta were first present as a major cell population at 3
      weeks of age. The ratio of TCR alpha/beta to TCR gamma/delta was 1:1 at 3 weeks
      of age and this ratio did not change during sexual maturation. Almost all uterine
      T cells were CD8+ and the majority of these cells expressed CD8 alpha/beta rather
      than CD8 alpha/alpha. Cells expressing Thy1.2 were less frequent than cells
      expressing CD3 while cells expressing CD5 were rare. No major changes in T cell
      subsets occurred at puberty. Further, the microbial flora of the mice did not
      alter the time of appearance, frequency or subset distribution of uterine TCR+
      cells. In the uteri of immunodeficient mice of genotype scid/scid TCR+ cells were
      found in low numbers and the initial appearance of TCR+ cells was delayed until 5
      weeks of age.

PMID- 8350300
TI  - Apical expression of an antigen common to rabbit yolk sac endoderm and kidney
      proximal tubule epithelium.
AB  - The tissue distribution, molecular weight, and biochemical nature of an antigen
      detected by a mouse monoclonal antibody designated 283D3 and raised against
      rabbit visceral yolk sac endodermal cells, has been investigated. The antigen is
      located on the luminal side of apical tubules and large sub-apical vesicles in
      rabbit yolk sac endoderm and proximal kidney tubule epithelial cells. It is
      expressed in a similar polarised fashion in epithelial cells lining the
      epididymis. Western blotting showed the antigen to comprise proteins of molecular
      weight 330-380 kDa. The antigen has been affinity purified from yolk sac and
      kidney and is predominantly protein in nature with a small percentage of N-linked
      carbohydrate. In terms of tissue distribution and molecular weight it has close
      similarity to Heymann nephritis antigen but differs in not being confined to
      coated pits. Its function is not known, but the association with endocytic
      elements implies a possible role in non-specific protein absorption.

PMID- 8350301
TI  - Impaired antibody diffusion within the cytoplasmic membrane-fibrous sheath
      interspace of the human sperm tail.
AB  - Monoclonal and polyclonal antibodies specific for the fibrous sheath (FS) were
      used to assess their diffusion within the subcytoplasmic membrane space of the
      human sperm tail. Using indirect immunofluorescence (IIF) and immunogold electron
      microscopy (IEM), the staining of the entire FS with these antibodies was
      observed only when the spermatozoa were completely demembranated by detergents or
      dried onto slides. Partial damage to sperm cytoplasmic membranes by freezing and
      thawing resulted in segmental staining of the FS. The IEM of such spermatozoa
      with the antibodies revealed the distribution of gold particles on the FS in
      denuded areas only and adjacent segments which retained their cytoplasmic
      membrane were not stained. These results indicate that partial disruption of the
      sperm plasma membranes does not lead to free diffusion of antibodies within the
      cytoplasmic membrane-FS interspace. This property appears to be unique to sperm
      cells and is due to their specialized structural organization.

PMID- 8350302
TI  - Paternity patterns and risk of preeclampsia in the last pregnancy in multiparae.
AB  - Few authors have published investigations regarding a possible association
      between preeclampsia and changing paternity. This study employs an
      epidemiological approach to explore the relationship between severe preeclampsia
      and changes in paternity patterns among multigravidae in a Caribbean community
      (Guadeloupe, French West Indies). Multiparae who were diagnosed with preeclampsia
      or eclampsia with fetal complications (transfer of their infants in the Neonatal
      Department) and controls were examined (134 mothers' interviews). Information
      concerning paternity for the index and previous pregnancies was collected from
      three groups: women with pregnancy-induced hypertension (PIH); women with chronic
      hypertension (CH); and a control group consisting of women without hypertension
      during pregnancy. In 21/34 (61.7%) of PIH mothers, the father of the current
      pregnancy was different than that of the former, compared to 4/40 (10%) among CH
      and 10/60 (16.6%) in the controls (P < 0.0001). Moreover, considering three and
      four consecutive pregnancies, there was a significant trend (P < 0.005 and P <
      0.02) for an increase in PIH with having a different father in each successive
      pregnancy. Patterns of changing paternity were significantly correlated with
      pregnancy-induced hypertension in multiparae but not with chronic hypertension
      and controls.

PMID- 8350303
TI  - Secretory monoclonal IgA antibody to human sperm produced by gastrointestinal
      immunization inhibits human sperm activity and mouse in vitro fertilization.
AB  - BALB/c mice were immunized intragastrically with human sperm. Cells from the
      Peyer's patches and spleens of the immunized mice were for the preparation of
      hybridomas secreting antisperm monoclonal IgA (mcIgA). The specific ratio of IgA
      secreting cells in Peyer's patches was much higher than that in spleen. The
      binding site on human sperm of 9 of 19 mcIgA was in the post-acrosomal region
      using an immunofluorescent assay. Two of eight selected mcIgA caused strong human
      sperm agglutination and three of them produced significant inhibition of mouse in
      vitro fertilization. No mcIgA tested caused obvious human sperm immobilization or
      inhibited mouse in vivo fertilization. In vitro assembly of selected mcIgA in
      ascites with mouse secretory component (SC) caused no significant changes in
      effects on sperm function and in vitro fertilization. By use of Western blotting,
      dimer or higher polymers were demonstrated in all selected mcIgAs and
      corresponding protein antigens in 6 of 8 selected mcIgAs. These results suggest
      that human sperm function may be inhibited and fertilization rate reduced by
      specific secretory IgA to human sperm and that secretory immunity to protein
      antigens of human sperm could be induced by intragastrointestinal immunization.

PMID- 8350304
TI  - Effect of prostaglandin synthesis inhibitors on spontaneous and endotoxin-induced
      abortion in mice.
AB  - The putative role of prostaglandin E2 (PGE2) in suppressing rejection of the
      'fetal allograft' (resorption) in C3H/HeJ and CBA/J allopregnant mice was tested
      by administration of the prostaglandin synthesis inhibitors indomethacin (INDO)
      and acetylsalicylic acid (ASA). When the resorption rate was low, INDO fed at a
      dose of 15 micrograms/ml in drinking water after implantation had a slight
      augmenting effect when the endogenous resorption rate was < 30%, but had no
      effect when the endogenous rate was higher or when bacterial lipopolysaccharide
      (LPS) was given. ASA fed at 50 micrograms/ml had no augmenting effect and did not
      increase sensitivity to the abortogen LPS in either CBA/J (LPS sensitive) or
      C3H/HeJ (LPS resistant) mice. Both INDO and ASA fed to CBA/J mice significantly
      reduced endogenous PGE2 extractable from the uteri of hormonally pseudopregnant
      mice after deciduoma induction. Feeding INDO at doses up to 30 micrograms/ml from
      day 2.5 of pregnancy impaired but failed to completely block implantation in
      CBA/J mice, and with daily administration, some of the mice became sick: all of
      the implants in sick mice resorbed. INDO at doses of 150-200 micrograms per day
      known to inhibit implantation in vivo by sufficiently blocking PGE2 synthesis,
      was injected on one or more days beginning after the time of implantation. This
      failed to cause abortion in CBA/J mice and although some mice became ill,
      provided this happened after day 8.5 of pregnancy when sensitivity to the
      abortogenic effects of injected LPS decreased substantially in these mice, all
      implants in the sick mice were 'healthy' (i.e. non-resorbing). We were unable to
      increase the rate of resorption in syngeneically pregnant CD1 mice above 13% with
      15 ml INDO in drinking water. Our data do not support the view that PGE2
      represents an important intrauterine suppressor molecular blocking the processes
      mediating embryo death at the time of abortion. Spontaneous abortion in DBA/2
      mated CBA/J mice appears to be determined by the level of bacterial LPS
      (endotoxin) and treatment with antibiotics or intralipid (which enhances
      endotoxin clearance), reduces the abortion rate. A sufficient dose of INDO may
      cause abortion, but the data taken together suggest this may be due to effects on
      the gut whereby permeability to bacterial LPS is increased.

PMID- 8350305
TI  - Graves' autoimmune serum inhibits gonadal steroidogenesis: development of a
      Leydig cell bioassay to identify broad spectrum anti-endocrine autoantibodies.
AB  - In order to establish an assay for the detection of autoimmune sera with broad
      spectrum activity, we have investigated the effect of unselected normal and
      Graves' disease sera upon steroidogenesis by gonadal cells. Steroidogenesis was
      enhanced by the addition of normal serum in a 3-h primary Leydig cell bioassay,
      but was inhibited by the majority of Graves' sera. The inhibition was not related
      to clinical thyroid parameters, such as the severity of the TSH-binding
      inhibition index, and was not overcome by other agonists or second messenger
      supplements. Although pituitary TSH preparations bound to and stimulated Leydig
      cells, TSH receptor mRNA was not detectable and pure recombinant TSH failed to
      bind or stimulate, indicating contamination of pituitary TSH with LH. The binding
      of hCG to the Leydig cell luteinizing hormone receptor was not perturbed by the
      Graves' autoimmune sera, indicating that cross-reactive anti-TSH receptor
      antibodies were not responsible for the inhibition. By use of intermediates in
      the stimulatory pathway, the site of Graves' serum inhibition was identified to
      be distal to hormone receptor/adenylate cyclase coupled responses and proximal to
      supply of cholesterol for steroidogenesis.

PMID- 8350306
TI  - The relationship between spinal and peripheral osteoarthritis and bone density
      measurements.
AB  - OBJECTIVE: To determine the influence of osteoarthritis (OA) on bone density
      measurements and whether OA at one site is associated with OA at other sites.
      METHODS: Nonrandomized, cross sectional observational study; secondary analysis
      of a general population database. Sixty-four subjects derived from a longitudinal
      study of long distance runners and community controls had a complete peripheral
      radiographic evaluation for osteoarthritic changes in hands, knees, and lumbar
      spine. Forty-four of these were studied in 1984 with quantitative computed
      tomography (QCT) of L1, and 54 were studied in 1988 with 153-Gd dual photon
      absorptiometry (DPA) in the spine and total body. Thirty-four subjects had all
      measurements done. RESULTS: Total body and lumbar spine DPA were positively
      correlated with radiological scores of OA in the spine and knees, with
      coefficients ranging between 0.467 to 0.530 (p < 0.001 in all cases). This
      correlation was principally associated with spinal spurs and knee sclerosis.
      Results of stepwise multiple linear regression modeling for QCT included age,
      spine sclerosis, knee sclerosis and knee spurs as the main predictors of bone
      mineral density (BMD). For DPA measurements, spine spur score was a useful
      regressor for all the models. Altogether, the percentage of variance accounted
      for by individual radiological OA variables was 27.4% for lumbar QCT, 27.3% for
      lumbar BMD, 7.3% for total spine BMD, and 45.2% for total body BMD. OA scores at
      different sites were not correlated, although repeated assessment at the same
      site showed very close correlation. CONCLUSIONS: All methods used to determine
      BMD showed a highly significant positive correlation between lumbar and knee
      radiological OA and bone mineral content both in the spine and the total body.
      Thus, our results support the hypothesis that OA is negatively correlated with
      osteopenia. OA, as seen in this population, was not a generalized condition, but
      rather, was site specific.

PMID- 8350307
TI  - The inhibitory effect of tenidap on leukocyte-endothelial cell adhesion.
AB  - OBJECTIVE: Adhesion of neutrophils to vascular endothelial cells (EC) and
      neutrophil chemotaxis are essential processes which enable neutrophils to
      infiltrate the tissues. They represent potentially important targets for
      therapeutic intervention in inflammatory diseases. This study was conducted to
      test the effect of tenidap sodium on neutrophil adhesion and chemotaxis. METHODS:
      Adhesion of 51Cr sodium chromate labelled neutrophils to umbilical vein EC
      monolayers was assayed in 96-well microtiter plates. Neutrophil chemotaxis was
      measured in Boyden microchemotaxis chambers. RESULTS: Tenidap sodium caused a
      dose related inhibition of neutrophil adhesion to EC, with 50 microM tenidap
      resulting in 51.8 +/- 4.0% (mean +/- SEM) inhibition of unstimulated adhesion and
      46.1 +/- 2.6% inhibition of formyl-methionyl-leucyl-phenylalanine (FMLP)
      stimulated adhesion. A marked reduction in neutrophil chemotaxis in response to
      FMLP was also observed, with 50 microM and 100 microM tenidap leading to 83.4 +/-
      8.5% and 92.1 +/- 8.5% (mean +/- SEM) inhibition respectively. The effect of
      tenidap on neutrophil adhesion to EC was not seen when neutrophils were
      preincubated with tenidap and then washed before adding to EC monolayers,
      suggesting an action upon surface molecules or in the cell membrane. Aspirin,
      indomethacin and phenylbutazone did not inhibit leukocyte adhesion, indicating
      that this action of tenidap may not be a consequence of inhibition of
      cyclooxygenase. The potency of tenidap was reduced by inclusion of serum or
      plasma in the culture medium, presumably due to protein binding. CONCLUSION: It
      is possible that inhibition of leukocyte-EC adhesion by tenidap sodium may
      contribute to the antiinflammatory effects of the drug.

PMID- 8350308
TI  - Influence of interferon-gamma on isolated chondrocytes from human articular
      cartilage. Dose dependent inhibition of cell proliferation and proteoglycan
      synthesis.
AB  - The effect of human recombinant interferon-gamma (IFN-gamma) on cultured human
      cartilage cells was studied by 2 variables: cell proliferation and proteoglycan
      synthesis. Cell proliferation was determined from 3H-thymidine incorporation
      rates in monolayer cultured chondrocytes. Proteoglycan synthesis was determined
      from 35S incorporation rates in monolayers and in chondrocytes cultured in
      agarose gel. IFN-gamma concentrations used in these experiments ranged from 10(
      6) micrograms/ml (0.025 U/ml) to 10(-2) micrograms/ml (250 U/ml). The lowest
      concentrations are comparable with the synovial fluid levels in inflamed joints
      of patients with rheumatoid arthritis. At these concentrations, IFN-gamma was
      found to induce a dose dependent decrease of cell proliferation and of
      proteoglycan synthesis in monolayer cultured human chondrocytes. The decrease of
      proteoglycan synthesis was ascribed both to an inhibition of the proteoglycan
      protein core production and to a downregulation of the glycosaminoglycan chain
      elongation.

PMID- 8350310
TI  - The use of outcome measures to evaluate clinical rheumatology curriculum changes.
AB  - OBJECTIVE: Five years ago we sought to change the comprehensive educational
      program of our rheumatology clinical training period for internal medicine
      residents and develop a model to measure the outcome of the curriculum change.
      METHODS: During the month-long clinical training period in rheumatology, internal
      medicine residents participated in 10 interactive lectures on basic rheumatology
      with the faculty and worked through 26 case studies and radiographs of different
      rheumatic diseases with the faculty. Separate pre and posttests were developed
      and administered to the residents, both as evaluative and educational tools.
      Residents' performance on the rheumatology questions on the American Board of
      Internal Medicine (ABIM) examination were compared before and after the
      curriculum change. RESULTS: Comparison of pre to posttest results documented
      significant (p < 0.0001) improvement in the average resident score. Resident
      performance on the rheumatology questions of the ABIM examination improved
      markedly (average percentile rank for the 3 years before this change--55.7%
      versus the first 4 years after the change--82.5%; p < 0.05). CONCLUSION: This
      comprehensive educational program for internal medicine residents during the
      rheumatology clinical training period resulted in significant short and longterm
      increases in rheumatology knowledge base.

PMID- 8350309
TI  - A randomized trial of physicians and physical therapists as instructors of the
      musculoskeletal examination.
AB  - OBJECTIVE: To evaluate the effectiveness of physicians vs physical therapists as
      instructors of the musculoskeletal examination to second year medical students.
      METHODS: A randomized trial conducted over 3 consecutive years in a physical
      diagnosis course at The University of North Carolina. During the first (baseline)
      year, medical students received education about the musculoskeletal examination
      from a lecture and supervision by clinical preceptors. This increased in the
      second and third (intervention) years where random halves of each class received
      supplementary clinical instruction which included a structured manual, a
      videotape, and supervised practice with either general internal medicine
      physicians or physical therapists. Outcomes were measured from student
      performance on a practical test of clinical skills, and by written student
      evaluations of the supplementary instruction. RESULTS: As measured on the
      clinical examination, performance during the intervention years improved over
      that during the baseline year in both intervention groups. Measures of medical
      students' clinical skills did not correlate with measures of academic aptitude.
      CONCLUSIONS: Clinical education about the musculoskeletal examination should be
      structured and systematic. Medical students prefer clinical education that is
      active, provides clear directions, and gives them performance feedback.

PMID- 8350311
TI  - Modelling the population health impact of musculoskeletal diseases: arthritis.
AB  - OBJECTIVE: A model adjusting for reductions in quality and quantity of life was
      developed to estimate the population health impact of musculoskeletal diseases.
      METHODS: Using arthritis as the prototype, prevalence, mortality, and severity
      data from a variety of sources were combined to model a hypothetical cohort of
      1,000 individuals through life. Quality adjusted life years and population health
      expectancy were calculated for those with arthritis and compared to the general
      population. RESULTS: Without adjusting for quality of life, a cohort of 1,000
      women and 1,000 men at age 15 years could expect 65,010 and 58,735 life years,
      respectively. Adjusting for quality of life, women with arthritis could expect
      61,719 life years, and men 57,123 life years. The unadjusted population health
      expectancy was 65.0 for girls and 58.7 for boys (at age 15 years). Adjusting for
      quality of life, the population health expectancies were 61.7 and 57.1, years for
      women and men, respectively. CONCLUSION: Using this model, the typical adult
      woman with arthritis can expect to lose 3.3 healthy years of life, and a man, 1.6
      healthy years of life. Overall, the model provided a general methodology for
      determining the population health impact of musculoskeletal diseases. In
      addition, it is hoped that the methodology will stimulate further research into
      this area, raise awareness about the uses and limitations of currently available
      data, and provide a useful model for monitoring the impact of interventions.

PMID- 8350312
TI  - The development of systemic sclerosis (scleroderma) following augmentation
      mammoplasty.
AB  - We describe 3 patients developing systemic sclerosis (scleroderma) following
      breast augmentation with paraffin injections, and saline and silicone gel filled
      implants. Although previously considered inert, silicone appears capable of
      inducing human adjuvant disease including scleroderma in the susceptible
      individual. The occurrence of systemic sclerosis following the use of silicone
      implants however, appears to be uncommon.

PMID- 8350313
TI  - Primary pulmonary hypertension in a patient with systemic lupus erythematosus:
      partial improvement with cyclophosphamide.
AB  - Pulmonary hypertension was diagnosed in a patient with SLE after her 5th
      delivery. Time of onset and absence of thromboembolism and severe interstitial
      lung disease suggested primary pulmonary hypertension. Administration of
      vasodilators did not decrease pulmonary artery pressure which amounted to 82/30
      mm Hg. Cyclophosphamide infusions, 0.5 g/m2 monthly for 6 months followed by
      once/3 months, in combination with 7.5 mg prednisolone daily resulted in decrease
      of pulmonary artery pressure to 66/34 mm Hg after 6 months of treatment
      persisting for 30 months. Intermittent infusions of cyclophosphamide with low
      dose prednisolone may be effective in primary pulmonary hypertension in SLE,
      suggesting an immune mediated pathogenesis.

PMID- 8350314
TI  - Reactive arthritis induced by Vibrio parahaemolyticus.
AB  - We describe a case of reactive arthritis after Vibrio parahaemolyticus infection.
      V. parahaemolyticus is the principal bacteria involved in the causation of
      foodborne gastroenterocolitis outbreaks in Japan. Several bacteria have been
      recognized as being involved in the development of reactive arthritis and this is
      the first report of reactive arthritis induced by V. parahaemolyticus.

PMID- 8350315
TI  - Vascular steal mimicking compression myelopathy in Paget's disease of bone: rapid
      reversal with calcitonin and systemic steroids.
AB  - Neurologic manifestations of Paget's disease of bone are primarily a result of
      mechanical compression on cranial nerves, spinal cord and roots. Less recognized
      is a myelopathy from "vascular steal" to highly vascularized and hypermetabolic
      pagetic bone. We describe a case of presumed ischemic myelitis in a patient with
      Paget's disease and aortic stenosis that was rapidly reversed with subcutaneous
      calcitonin and intravenous dexamethasone.

PMID- 8350316
TI  - Axillary lymphadenopathy due to Swanson implants.
AB  - We describe a case of unilateral axillary lymphadenopathy in an elderly woman
      with a long history of rheumatoid arthritis, 7 years status post placement of
      Swanson silastic elastomer implants in her right hand with good surgical outcome
      and with no outward reason for adenopathy. Though there was concern for
      malignancy, pathologic evaluation of the lymph node revealed foreign body giant
      cells reacting to silastic from her hand implants and no evidence of malignancy.
      This is only the 10th such case reported, despite the number of implants placed.

PMID- 8350317
TI  - Chronic diffuse sclerosing osteomyelitis of the humerus: novel treatment with
      calcitonin.
AB  - We describe a 51-year-old woman with a 20-year history of pain and swelling in
      her left upper arm. Radiographic appearance was suggestive of chronic
      osteomyelitis but confirmation necessitated surgical exploration. A diagnosis of
      sclerosing osteomyelitis was made on histology which responded poorly to the
      prolonged antibiotics. She subsequently made a dramatic symptomatic and
      radiological improvement after starting to take calcitonin, even in low dosage.

PMID- 8350318
TI  - Acute calcific periarthritis of the finger joints: a syndrome of women.
AB  - We describe a 33-year-old woman with acute calcific periarthritis (ACP) of the
      interphalangeal joint of the thumb and review 42 reported cases of ACP involving
      the finger joints. A computer assisted literature search for reported cases of
      ACP involving the finger joints was performed. Clinical features of our case and
      those fulfilling the criteria for entry into this study were analyzed.

PMID- 8350319
TI  - Photopheresis for scleroderma? Let's abandon the innuendos and get to the data.

PMID- 8350320
TI  - Microfocal radiography with macroradiographs in osteoarthritis.

PMID- 8350321
TI  - Hypersensitivity vasculitis and Henoch-Schonlein purpura: a comparison between
      the 2 disorders.

PMID- 8350322
TI  - Behcet's disease presenting as mediastinal mass.

PMID- 8350323
TI  - Specific increase of IgG antibody to 65 kDa heat shock protein but not to crude
      mycobacterial extract in RA.

PMID- 8350324
TI  - Augmentation mammoplasty: beauty or the beast?

PMID- 8350325
TI  - Folic acid supplementation during methotrexate therapy: it makes sense.

PMID- 8350326
TI  - Issues in rheumatology education: challenges for the nineties.

PMID- 8350327
TI  - Serial soluble interleukin 2 receptor levels in rheumatoid arthritis: differences
      in response to glucocorticoid treatment and chrysotherapy.
AB  - OBJECTIVE: To analyze the changes in soluble interleukin 2 receptor (sIL-2R)
      levels following treatment of patients with rheumatoid arthritis (RA). METHODS:
      Serial measurements of sIL-2R levels were made over 24 weeks in 40 patients with
      RA, treated with intramuscular (im) gold plus 3 im injections of either 120 mg
      methylprednisolone acetate or placebo. RESULTS: sIL-2R levels were reduced in the
      glucocorticoid treated group in contrast to the gold only group, where levels
      initially increased. At 24 weeks, mean sIL-2R levels did not significantly differ
      from pretreatment levels in either group, despite improvements in clinical
      measures. CONCLUSIONS: In our study, sIL-2R levels do not correlate with short
      term clinical measures of disease activity. Their significance for longer term
      prognostic use remains to be determined.

PMID- 8350328
TI  - Variability of immunologic and clinical features in patients with rheumatoid
      arthritis studied over 24 hours.
AB  - Disease activity measures in patients with rheumatoid arthritis (RA) are
      influenced by many factors. Bedrest has been long recognized to effect decreased
      disease activity. In addition, most patients note maximal levels of pain and
      stiffness in the early morning hours with improvement in the afternoon. Cytokines
      and hormones with circadian rhythms may also contribute to variability in disease
      status during the day. Our purpose was to investigate variability of clinical and
      immunologic measures over a 24-h period of hospitalization in patients with RA.
      Production of rheumatoid factors and immunoglobulins, joint counts and
      questionnaire evaluations were measured 3 to 6 times over a 24-h period of
      hospitalization in 10 patients with RA who were not receiving steroids or second
      line drugs. Total joint counts were significantly decreased as soon as 4 h after
      admission, and continued to decrease during the 24-h period of observation.
      Significant decreases in mononuclear cell proliferation and antibody synthesis
      were also observed. Our findings are consistent with the presence of decreased
      levels of immunostimulatory mediators in hospitalized patients especially during
      late afternoon or evening hours.

PMID- 8350329
TI  - Low dose leucovorin does not interfere with the efficacy of methotrexate in
      rheumatoid arthritis: an 8 week randomized placebo controlled trial.
AB  - OBJECTIVE: To determine if simultaneously administered low dose leucovorin
      interferes with the efficacy of methotrexate (MTX). METHODS: An 8-week double
      blind placebo controlled study of leucovorin (1 mg) in 16 patients with
      rheumatoid arthritis receiving chronic MTX was performed at a single academic
      center. RESULTS: A flare of disease activity was not observed. Clinical variables
      of arthritis activity did not change in the leucovorin treated population.
      CONCLUSIONS: Low dose leucovorin when taken simultaneously with MTX did not
      interfere with the efficacy of MTX in a short term 8 week trial.

PMID- 8350330
TI  - Immunosuppression by the disease modifying antirheumatic drug bucillamine:
      inhibition of human T lymphocyte function by bucillamine and its metabolites.
AB  - OBJECTIVE: Bucillamine: N-(2-mercapto-2-methyl-propanoyl)-L-cysteine has recently
      been suggested to be effective in the treatment of rheumatoid arthritis (RA). The
      molecular structure of this compound is similar to that of D-penicillamine,
      except that bucillamine has 2 free sulfhydryl groups in its structure whereas D
      penicillamine has only one. The goal of our studies was to determine whether
      bucillamine exerted immunosuppressive effects in vitro. METHODS: The effect of
      bucillamine and its metabolites on mitogen induced proliferation and IL-2
      production by human T cells was examined. RESULTS: Bucillamine, and its
      metabolites SA 679, and SA 981 inhibited mitogen induced T cell responses. The
      inhibitory effect of bucillamine and SA 679, in which one sulfhydryl group is S
      methylated, was markedly augmented in the presence of CuSO4, and the effect was
      completely prevented by the addition of catalase. The capacity of SA 981, the
      internal disulfide of bucillamine, to inhibit T lymphocyte responses was not
      dependent on the presence of CuSO4. SA 672, in which both sulfhydryl groups are S
      methylated, did not inhibit T cell proliferation. CONCLUSION: Our results suggest
      that bucillamine has 2 distinct inhibitory effects on T cell function. One is the
      ability to generate H2O2 in the presence of CuSO4 and is attributable to its free
      thiol groups. The other is related to a separate inhibitory mechanism, that is
      not dependent on CuSO4 or the reduced thiol groups. These 2 immunosuppressive
      effects may account for the potency of bucillamine in suppressing rheumatoid
      inflammation.

PMID- 8350332
TI  - Bone marrow microenvironment of patients with systemic lupus erythematosus.
AB  - In an attempt to clarify the hematologic abnormality in systemic lupus
      erythematosus (SLE), we studied the bone marrow microenvironment of 8 women with
      this disease. The number of fibroblast colonies was similar to that of healthy
      control individuals. Culture supernatants of monocytes obtained from the patients
      with SLE showed a diminished production of the hemopoietic growth factor required
      to stimulate bone marrow fibroblasts. As the activity of the humoral factor
      released from SLE monocytes was diminished, such a reduction may play a role in
      the pathogenesis of the hematologic abnormality seen in SLE.

PMID- 8350331
TI  - Sjogren's syndrome in patients with interstitial cystitis.
AB  - OBJECTIVE: Patients with interstitial cystitis, a chronic nonbacterial
      inflammation of the bladder, were investigated for the presence of systemic
      autoimmune diseases, in particular for Sjogren's syndrome (SS). METHODS: Ten
      patients were included in the study on the basis of a diagnosis of interstitial
      cystitis according to usual criteria. They underwent clinical and laboratory
      investigations including those for keratoconjunctivitis (KCS) and focal
      lymphocytic sialoadenitis (FLS). RESULTS: In 2 patients both KCS and FLS were
      present allowing the diagnosis of primary SS according to classification
      criteria. Additionally, in 6 patients one of the 2 hallmarks of primary SS was
      present, KCS in 3 and FLS in 3. CONCLUSION: Interstitial cystitis is a new
      example of a disease that occurs in association with SS, supporting the concept
      that interstitial cystitis is an autoimmune cystitis. The clinical relevance of
      the finding is that a high index of suspicion for SS is indicated in patients
      with interstitial cystitis.

PMID- 8350333
TI  - An assessment of the Health Assessment Questionnaire functional ability index
      among women with systemic lupus erythematosus.
AB  - The validity of the Health Assessment Questionnaire (HAQ) functional ability
      instrument was tested in 120 women with definite systemic lupus erythematosus
      (SLE) from rheumatology clinics at 2 local tertiary care institutions.
      Reliability and validity results for this population of women (mean age: 41 years
      +/- 13; age at diagnosis 33 years +/- 13) indicate that (1) the HAQ was
      internally reliable (standardized alpha = 0.9443) with no interitem correlation
      exceeding (r = 0.75); (2) confirmatory factor analysis identified 2 predominant
      factors among the HAQ components suggestive of large limb gross movements (e.g.,
      walking, arising) and small limb fine movements (e.g., the ability to eat and
      firmly grip objects). Cumulatively, the 2 factors accounted for 64% of the
      variation in HAQ ability response. The HAQ response was also valid when compared
      to the overall disability index (r = 0.65 to 0.82) and other common disease
      variables that were reported by the patient and collected by the physician at the
      time of clinical examination. In addition, when stratified by active and inactive
      disease as defined by the Lupus Activity Criteria Count, inactive patients
      reported lower disability components (dress, arise, eat, walk, hygiene, reach,
      grip and activity) than active patients. These findings confirm the valid use of
      the HAQ as a measure of disability, when compared with other clinical measures of
      disease status and activity, in female patients with SLE.

PMID- 8350334
TI  - Quality of life of women with systemic lupus erythematosus: a comparison with
      women with rheumatoid arthritis.
AB  - We assessed the quality of life and health status of 50 women with systemic lupus
      erythematosus (SLE) and compared them with 50 age matched women with rheumatoid
      arthritis (RA) using open ended questions, the Quality of Life Scale (QOLS-S),
      Arthritis Impact Measurement Scales (AIMS), Rheumatology Attitudes Index, and 2
      measures of disease activity. The patients with SLE expressed more concerns about
      their disease and potential for managing it than the patients with RA. However,
      there were no differences between the groups on the QOLS-S. Both were highly
      satisfied with many aspects of their lives. The best predictor of life quality in
      both groups was psychological distress followed by social and physical
      functioning in the group with RA and perception of global impact of the disease
      in the group with SLE.

PMID- 8350335
TI  - Gamma delta + T cells from patients with psoriatic and rheumatoid arthritis
      respond to streptococcal antigen.
AB  - OBJECTIVE: To investigate cellular immune responses to streptococcal antigens in
      patients with psoriatic arthritis (PsA). To specifically examine responses of the
      gamma delta + T cell subset. METHODS: Proliferation of PsA synovial fluid
      lymphocytes (SFL) and peripheral blood lymphocytes (PBL) cultured with
      streptococcal antigen was measured using a 3H thymidine (3HTdr) uptake assay
      system. gamma delta + T cells from PsA PBL and SFL were phenotyped by flow
      cytometry. Following culture with streptococcal antigen, gamma delta + enriched
      SFL were sorted by automated flow cytometry and 3HTdr uptake measured. RESULTS:
      Patients with PsA and the control group did not differ significantly in their PBL
      responses to 2 strains of streptococci, one of which was isolated from a patient
      with guttate psoriasis (Strep 1) and the other from a patient with rheumatic
      fever (Strep 2). There was also no difference in their responses to a cell wall
      preparation derived from the former strain. SFL from 8 of 9 patients with PsA
      responded to both streptococcal strains as did SFL from 3 patients with
      rheumatoid arthritis (RA). gamma delta + SFL from 7 patients with PsA 3 patients
      with RA responded only to the psoriasis associated strain. CONCLUSIONS: PsA PBL
      and SFL responded to stimulation by streptococcal antigen but this reactivity was
      not disease specific. We have demonstrated that gamma delta + T cells from PsA SF
      proliferated when cultured with a psoriasis associated strain of streptococcus
      (Strep 1). However, RA gamma delta + SFL responded similarly suggesting that
      gamma delta + T cell reactivity to streptococcal antigen may be a feature of
      inflammatory arthritis.

PMID- 8350336
TI  - Higher relative risk of spondyloarthropathies among B27 positive Indonesian
      Chinese than native Indonesians.
AB  - We assessed the prevalence of HLA-B27 among ethnic Indonesian and Indonesian
      Chinese patients with ankylosing spondylitis (AS) or related
      spondyloarthropathies, and also among healthy controls. HLA-B27 was found in 23
      (62.2%) of 37 Chinese patients and 4% of 176 Chinese healthy controls (p <
      0.001). In contrasts only 2 (8.3%) of 24 native Indonesian patients and 13 (9%)
      of 145 healthy controls were HLA-B27+, indicating the lack of association of HLA
      B27 with spondyloarthropathies in native Indonesians. These findings also suggest
      that HLA-B27 Chinese Indonesians carry a greater relative risk of developing AS
      and related spondyloarthropathies than native Indonesians, although the
      prevalence of HLA-B27 in the general population is more than 2 times higher in
      native Indonesians.

PMID- 8350337
TI  - Fatigue in ankylosing spondylitis--why is it ignored?
AB  - OBJECTIVE: Fatigue in ankylosing spondylitis (AS) is largely ignored by
      physicians and classical texts. By contrast, patients frequently allude to it as
      a major complaint. METHODS: To address the situation, 3 studies were performed:
      (1) Symptoms were defined in a cross sectional evaluation of 1950 consecutive
      patients with AS. (2) From each of the 3 groups who specified a particular main
      symptom (pain, stiffness or fatigue), a random cohort of 20 was selected and all
      60 were prospectively followed over a 14-day period. (3) An additional 100
      patients [50 randomly selected with AS and 50 with rheumatoid arthritis (RA)]
      took part in a comparative prospective study. RESULTS: In the first study for
      those with a definitive major symptom, 34% (n = 670) described pain while
      stiffness and fatigue were reported by 25% (n = 492) and 6% (n = 124),
      respectively. Thirty-two percent (n = 616) could not distinguish between the 3.
      Strikingly, when prospectively studied over a 2-week period, over 50% of the
      patients revealed that fatigue was the main symptom. Moreover, in the cohort
      which expressed pain as their major problem initially, fatigue had the highest
      prevalence (mean fatigue value versus mean stiffness, p = 0.009; fatigue versus
      pain, p < 0.001). In the direct comparison between patients with RA and those
      with AS, the RA cohort had statistically more fatigue and pain than the AS cohort
      (p = 0.002, p = 0.007, respectively) with a similar amount of stiffness expressed
      by both groups (n = 0.149). In both subsets, pain had the least impact on the
      patients (mean 2.60 and 1.87, respectively). CONCLUSION: Our data reveal that
      fatigue should be considered a major problem for patients with AS, worthy of
      further exploration in terms of both etiology and therapy.

PMID- 8350338
TI  - Serial measurement of soluble interleukin 2 receptor levels: an early indicator
      of treatment response for Lyme disease.
AB  - Detection of antibodies produced in response to infection with Borrelia
      burgdorferi provides a valuable aid for diagnosing Lyme disease. However, anti
      Borrelial antibody titers are of little value in determining treatment success or
      providing evidence of persistent infection as levels of specific antibodies can
      remain elevated even after successful treatment. Pretreatment and posttreatment
      measurement of soluble interleukin 2 receptor (sIL-2R) levels was evaluated for
      use in predicting treatment response in Lyme disease. Results indicate that
      serial measurement of serum sIL-2R levels can provide an early indicator of
      response to treatment and outcome.

PMID- 8350339
TI  - A multicenter study of tenoxicam and diclofenac in patients with osteoarthritis
      of the knee.
AB  - OBJECTIVE: To conduct the first Canadian study of the comparative efficacy and
      safety of tenoxicam and diclofenac in patients with primary osteoarthritis (OA)
      of the knee. METHODS: Tenoxicam 20 mg per os once daily (po od) was compared to
      diclofenac (Voltaren) 50 mg per os 3 times a day (po tid) in a 12-week, double
      blind, randomized, controlled, multicenter, parallel trial. The primary outcome
      measure was the pain dimension of the WOMAC OA Index. Following an initial
      screening visit and a 3 to 7 day NSAID-free washout period (i.e., baseline),
      patients were assessed at Weeks 2, 4 and 12; assessments including some 15
      efficacy variables and safety variables. RESULTS: Ninety-eight patients
      [tenoxicam (n = 48), diclofenac (n = 50)] participated in the trial.
      Statistically significant (p < or = 0.05) improvements in all 3 dimensions of the
      WOMAC OA Index and six efficacy variables were noted in both treatment groups. No
      significant between drug differences were noted on any efficacy variable.
      Significantly fewer patients reported adverse events in the tenoxicam group (21
      vs 33, p = 0.03). CONCLUSION: Tenoxicam is efficacious and well tolerated in
      patients with OA of the knee. In this group of patients it was similar in
      efficacy and superior in tolerability to diclofenac 150 mg/day (50 mg tid). Thus
      the benefit/risk ratio of tenoxicam was superior to that of diclofenac in this
      study.

PMID- 8350340
TI  - Heritability of hostility-related emotions, attitudes, and behaviors.
AB  - Hostility-related variables have been categorized as to kinds of emotions,
      attitudes, and behaviors. Relatively few studies have explored whether genetic
      factors contribute to individual differences in these variables. Moreover, the
      majority of this research has involved male subjects. The present study utilized
      the twin method to evaluate the influence of genetic factors on hostility-related
      emotions, namely, trait anger and irritability, hostility-related attitudes,
      namely cynical hostility and suspiciousness, and hostility-related behaviors,
      namely, physical, verbal, and indirect aggression in adult women. Responses on
      the measure of trait anger showed evidence of significant heritability. However,
      evidence for a genetic component to responses on the irritability scale was less
      clear. There was no support for the notion of a genetic component to the measure
      of suspiciousness, and the evidence of a genetic contribution for cynical
      hostility was not significant. It was expected that due to environmental
      influences for women, only certain forms of aggression would show genetic
      variance, namely, verbal and indirect as opposed to physical forms. The results
      were generally congruent with these expectations.

PMID- 8350341
TI  - An analysis of relationships among environmental noise, annoyance and sensitivity
      to noise, and the consequences for health and sleep.
AB  - The complex relationship among long-term exposure to environmental noise, self
      reports of health, and sleep was investigated in a multifactorial design. Forty
      seven women and 35 men living beside a street with moderate to heavy traffic took
      part. They answered questions concerning health complaints, usual sleep patterns,
      sleep the actual week of testing, their subjective responses to noise,
      psychosocial relations, anxiety, stressful life events, type A behavior, and
      attitudinal factors that could explain their responses to noise. No detrimental
      relations among objective noise levels, health, and sleep could be shown. There
      were, however, strong correlations between the subjective noise responses of
      annoyance and sensitivity and health complaints. Only women revealed a
      relationship between poor sleep quality and sensitivity. The stronger
      relationship among noise sensitivity, health complaints, and poor sleep quality
      for women than for men could be explained by the degree of exposure to noise as
      evidenced by their longer residence and greater time spent at home.

PMID- 8350342
TI  - Cognitive function and cardiovascular responsivity in subjects with a parental
      history of hypertension.
AB  - College-age subjects with and without a parental history of hypertension
      completed a battery of tests of cognitive function on two separate occasions.
      Pulse rate and blood pressure were measured during performance of each task. In
      one session, subjects were told that their performance was being evaluated and
      videotaped from behind an observation mirror (Evaluation Condition). In the other
      session, subjects were told that their performance was not being observed
      (Nonevaluation Condition). Regardless of Evaluation Condition, Parental History
      subjects exhibited slower search of short-term memory than Non-Family History
      subjects during the first but not the second testing session. Parental History
      subjects displayed greater elevations in pulse rate than Nonparental History
      subjects during task performance. The results were interpreted as providing
      evidence that pathophysiological mechanisms associated with essential
      hypertension are not the only viable explanations of lower levels of cognitive
      performance exhibited by hypertensive subjects.

PMID- 8350343
TI  - Chemical analyses as validators in smoking cessation programs.
AB  - This review addresses the use of chemical analyses to validate the smoking status
      of a participant in a smoking cessation program. Pharmacokinetic and chemical
      validation literature leads to the conclusion that chemical analyses are most
      reliably used to confirm abstinence from smoking rather than as quantitative
      measures of nicotine intake or smoking activity. Analytical methodologies used in
      smoking validation studies are reviewed with their advantages and disadvantages.
      Close collaboration of behavioral scientists and analytical chemists is
      encouraged to validate the smoking status of participants in a smoking cessation
      program.

PMID- 8350344
TI  - Stress caused by rheumatoid arthritis: relation among subjective stressors of the
      disease, disease status, and well-being.
AB  - Two integrated studies, examining the chronic stressors specific to the disease
      rheumatoid arthritis, are described. Pain, limitation, and dependence were rated
      as the most annoying chronic stressors of the disease. Pain was measured with the
      Visual Analog Scale and the McGill Pain Questionnaire. Both pain scores were only
      weakly related to the medical assessment variables. New scales were developed to
      measure perceived limitation and dependence. Perceived limitation was inversely
      related to both mobility and self-care, but this association was not strong.
      Perceived dependence was unrelated to any of the health status measures. All
      three stressors were associated with indicators of quality of life even after
      controlling for interaction with clinical assessment and functional status
      variables. It was concluded from these studies that patients with rheumatoid
      arthritis must cope simultaneously with pain, limitation, and dependence.

PMID- 8350345
TI  - Factors related to the adoption of exercise among older women.
AB  - The role of exercise in promoting health is well documented; however, older women
      have the lowest rates of aerobic exercise of any community group. This paper
      examines psychological variables relevant to women's initial adoption of
      exercise. While the evidence is limited, it appears that middle-aged and older
      women have positive attitudes to exercise but seem unable or unwilling to take
      action. The influence of practical barriers and of broader social attitudes is
      considered. It is concluded that social psychological variables have had limited
      success in explaining sex differences in physical activity. An understanding of
      practical and societal constraints on behavior choice in a broader social context
      may provide direction for the development of strategies to improve the exercise
      levels of this community group.

PMID- 8350346
TI  - The evolution of the thrombospondin gene family.
AB  - Thrombospondin-1 is an adhesive glycoprotein that is involved in cellular
      attachment, spreading, migration, and proliferation. To date, four genes have
      been identified that encode for the members of the thrombospondin gene family.
      These four genes are homologous to each other in the EGF-like (type 2) repeats,
      the calcium-binding (type 3) motifs, and the COOH-terminal. The latter has been
      reported to be a cell-binding domain in thrombospondin-1. Phylogenetic trees have
      been constructed from the multisequence alignment of thrombospondin sequences
      from human, mouse, chicken, and frog. Two different algorithms generate
      comparable results in terms of the topology and the branch lengths. The analysis
      indicates that an early form of the thrombospondin gene duplicated about 925
      million years ago. The gene duplication that produced the thrombospondin-1 and -2
      branches of the family is predicted to have occurred 583 million years ago,
      whereas the gene duplication that produced the thrombospondin-3 and -4 branches
      of the family is predicted to have occurred 644 million years ago. These results
      indicate that the members of the thrombospondin gene family have existed
      throughout the evolution of the animal kingdom and thus probably participate in
      functions that are common to most of its members.

PMID- 8350347
TI  - Distribution of polymorphic gene duplication at the Gpdh locus in natural
      populations of Drosophila melanogaster.
AB  - The glycerol-3-phosphate dehydrogenase (GPDH, E.C. 1.1.1.8) gene of Drosophila
      melanogaster contains a tandem duplication of a 4.5-kb-long DNA fragment. Survey
      of the Gpdh gene region by the Southern blot analysis revealed the following
      features of this gene duplication: (1) The duplication was not observed in
      chromosome lines that carry In(2L)t, a cosmopolitan chromosomal inversion in this
      species. The duplication and the inversion are in linkage disequilibrium. (2) The
      duplication is polymorphic in the Japan and US natural populations examined. Its
      frequency is 0.26 on an average in In(2L)t-free chromosomes. (3) Triplication is
      absent or has not become frequent in the populations surveyed. Possible
      evolutionary factors of this duplication polymorphism are discussed.

PMID- 8350348
TI  - Evolution of the dec-1 eggshell locus in Drosophila. II. Intraspecific DNA
      sequence analysis reveals length mutations in a repetitive region in D.
      melanogaster.
AB  - The dec-1 eggshell gene in Drosophila melanogaster encodes follicle cell proteins
      required for proper eggshell assembly. As shown by Southern and Northern analyses
      the dec-1 gene occurs in four alleles (Fc1-4) among wild-type strains. Its second
      exon has a distinct feature in the form of 12 repeats with 78-91 nucleotides; the
      first five show nearly 100% homology. DNA sequence comparison of the repeated
      region of the alleles revealed that the length polymorphisms are caused by
      changes in the numbers of the first five repeats. The results suggest that the
      alleles have been generated by unequal intragenic crossing-over and/or slippage
      during DNA replication and that the allelic length variants have arisen
      independently. The possibility that the most common allele, FC1, has a selective
      advantage over the other alleles is discussed.

PMID- 8350349
TI  - The phylogeny of echinoderm classes based on mitochondrial gene arrangements.
AB  - Previous analyses have demonstrated that, among the echinoderms, the sea star
      (class: Asteroidea) mitochondrial genome contains a large inversion in comparison
      to the mitochondrial DNA of sea urchins (class: Echinoidea). Polymerase chain
      reaction amplification, DNA cloning, and sequencing have been used to examine the
      relationships of the brittle stars (class: Ophiuroidea) and sea cucumbers (class:
      Holothuroidea) to the sea stars and sea urchins. The DNA sequence of the regions
      spanning potential inversion junctions in both brittle stars and sea cucumbers
      has been determined. This study has also revealed a highly modified tRNA cluster
      in the ophiuroid mitochondrial genome. Our data indicate mitochondrial gene
      arrangement patterns that group the sea cucumbers with sea urchins and sea stars
      with brittle stars. This use of molecular characters clarifies the relationships
      among these classes.

PMID- 8350350
TI  - Domains within the mammalian ornithine decarboxylase messenger RNA have evolved
      independently and episodically.
AB  - Ornithine decarboxylase (ODC) is the first enzyme in the polyamine biosynthetic
      pathway. We have studied the evolutionary history of the mammalian ODC mRNA,
      focusing on the rate of accumulation of sequence divergence within specific
      subregions of the molecule. The phylogenetic relationships among the mRNAs from
      several mammalian species, including two mouse species, rat, hamster, and human,
      were determined based upon the numbers of synonymous substitutions in pairwise
      comparisons of mRNA coding regions. The separation times for the mRNAs were very
      similar to those for the corresponding species, suggesting that ODC is encoded by
      orthologous genes in the different species. Analysis of divergence patterns in
      four subregions, or domains, of the mRNA (the 5'-untranslated region, the coding
      region, and two domains of the 3'-untranslated region) showed that the domains
      have evolved in a noncoordinate fashion. Furthermore, evolution of each subregion
      has been episodic, with periods of both rapid and slow sequence divergence. We
      suggest that the episodic pattern of ODC mRNA evolution may indicate the
      existence of selection pressures that were exerted in a time- and domain-specific
      manner during mammalian speciation.

PMID- 8350351
TI  - Molecular analysis of ependymins from the cerebrospinal fluid of the orders
      Clupeiformes and Salmoniformes: no indication for the existence of an euteleost
      infradivision.
AB  - Ependymins represent the predominant protein constituents in the cerebrospinal
      fluid of many teleost fish and they are synthesized in meningeal fibroblasts.
      Here, we present the ependymin sequences from the herring (Clupea harengus) and
      the pike (Esox lucius). A comparison of ependymin homologous sequences from three
      different orders of teleost fish (Salmoniformes, Cypriniformes, and Clupeiformes)
      revealed the highest similarity between Clupeiformes and Cypriniformes. This
      result is unexpected because it does not reflect current systematics, in which
      Clupeiformes belong to a separate infradivision (Clupeomorpha) than Salmoniformes
      and Cypriniformes (Euteleostei). Furthermore, in Salmoniformes the evolutionary
      rate of ependymins seems to be accelerated mainly on the protein level. However,
      considering these inconstant rates, neither neighbor-joining trees nor DNA
      parsimony methods gave any indication that a separate euteleost infradivision
      exists.

PMID- 8350353
TI  - Sequence homology between a bacterial metalloproteinase and eukaryotic matrix
      metalloproteinases.
AB  - The origin and evolution of matrix metalloproteinases represent an exciting
      subject of study. Recently, various reports have searched for a relationship
      between bacterial and eukaryotic metalloproteinases. In this report, we
      constructed a phylogenetic tree using the amino acid sequence of one bacterial
      metalloproteinase and eight eukaryotic matrix metalloproteinases and performed
      multiple alignments with some of these sequences. We concluded that there is a
      familial relationship between members of the four major branches represented in
      the tree.

PMID- 8350352
TI  - Development of artificial neural filters for pattern recognition in protein
      sequences.
AB  - Four different artificial neural network architectures have been tested for their
      suitability to extract and predict sequence features. For optimization of the
      network weights an evolutionary computing method has been applied. The networks
      have feedforward architecture and provide adaptive neural filter systems for
      pattern recognition in primary structures and sequence classification. The
      recognition and prediction of signal peptidase cleavage sites of E. coli
      periplasmic protein precursors serves as an example for filter development. The
      primary structures are represented by seven physicochemical residue properties.
      This amino acid description provides the feature space for network optimization.
      The properties hydrophobicity, hydrophilicity, side-chain volume, and polarity
      allowed an accurate classification of the data. A three-layer network
      architecture reached a learning success of 100%; the highest prediction accuracy
      in an independent test set of sequences was 97%. This network architecture
      appears to be most suited for the analysis of E. coli signal peptidase cleavage
      sites. Further suggestions about the design and future applications of artificial
      neural networks for protein sequence analysis are made.

PMID- 8350354
TI  - A differential molecular clock in enolase isoprotein evolution.

PMID- 8350355
TI  - Tamoxifen: how boldly to go where no women have gone before.

PMID- 8350356
TI  - Breast cancer and silicone implants: psychological consequences for women.

PMID- 8350357
TI  - Media coverage of cancer risks may mislead.

PMID- 8350359
TI  - European Cancer Center links basic and clinical science.

PMID- 8350358
TI  - AIDS-related cancers emerging as a second epidemic.

PMID- 8350360
TI  - Dutch cancer care is (was?) well supported.

PMID- 8350361
TI  - Scientists gain insight into cancer gene relationships.

PMID- 8350362
TI  - AIDS-related malignancies: the emerging epidemic.
AB  - The incidence of three malignancies has increased in conjunction with the
      epidemic of human immunodeficiency virus (HIV) disease, and they are currently
      considered acquired immunodeficiency syndrome (AIDS)-defining conditions. These
      are Kaposi's sarcoma, associated with AIDS since the onset of the epidemic in
      1981; intermediate or high-grade B-cell lymphoma, which became AIDS-defining in
      1985; and cervical carcinoma in HIV-infected women, formally recognized as an
      AIDS-defining diagnosis on January 1, 1993. Approximately 40% of all patients
      with AIDS have developed cancer during the course of HIV infection. Further, as
      survival has improved in HIV disease, the incidence of these malignancies has
      increased. It is thus expected that greater numbers of patients with AIDS-related
      lymphoma and cervical cancer will be diagnosed in the years ahead. The
      epidemiologic factors associated with neoplastic disease differ among patients
      with the three AIDS-related malignancies. The pathogenesis of neoplastic disease
      also differs. The specific etiologic steps in the development of AIDS-related
      Kaposi's sarcoma and lymphoma are currently unknown. However, a great deal of
      information has already been acquired, which may have bearing on the pathogenesis
      of malignant disease in general, as well as the elucidation of future therapeutic
      modalities. The specific epidemiologic, etiologic, and clinical characteristics
      of the AIDS-related malignancies will be described herein. It is hoped that this
      review will serve to outline our current understanding of this area, to introduce
      the questions and controversies which are apparent in the field, and to mention
      those areas in which future research might be focused.

PMID- 8350363
TI  - Cardiac and thromboembolic morbidity among postmenopausal women with early-stage
      breast cancer in a randomized trial of adjuvant tamoxifen. The Stockholm Breast
      Cancer Study Group.
AB  - BACKGROUND: Tamoxifen, which binds to estrogen receptors, is widely used as
      adjuvant therapy after surgery for early-stage breast cancer. Our previous
      randomized trial of adjuvant tamoxifen therapy for breast cancer showed a
      significant decrease of new, contralateral breast cancers in patients who
      received tamoxifen. Tamoxifen may also influence risk factors for cardiac and
      thromboembolic disease (e.g., serum cholesterol and antithrombin III). PURPOSE:
      The purpose of this study was to assess morbidity from cardiac and thromboembolic
      disease among 2365 postmenopausal patients with early-stage breast cancer in the
      Stockholm randomized trial of adjuvant tamoxifen (40 mg daily for 2 or 5 years)
      versus no adjuvant endocrine therapy. Patients were entered in the study from
      November 1976 through December 1988. METHODS: In our retrospective study, the
      analysis of morbidity was based on data from a computerized, population-based
      register of hospital admissions and discharge diagnoses. Mortality data were
      obtained from the Swedish National Central Bureau of Statistics. In the Stockholm
      study, treatment with tamoxifen was initiated within 4-6 weeks of modified
      radical mastectomy or breast-conserving surgery including axillary lymph node
      dissection and postoperative radiation therapy to the breast. In that randomized
      trial, 755 patients at low risk of death from breast cancer received adjuvant
      tamoxifen only; 760 received no treatment. In addition, 628 high-risk patients
      were randomly assigned to receive adjuvant chemotherapy plus tamoxifen (173
      patients) or postoperative radiotherapy plus tamoxifen (151) or, as a control, to
      receive chemotherapy (171) or postoperative radiation therapy (133), both without
      tamoxifen or other endocrine therapy. Median follow-up was 6 years. RESULTS:
      Tamoxifen therapy resulted in a statistically significant reduced incidence of
      hospital admissions due to cardiac disease. The relative hazard (tamoxifen for 2
      or 5 years versus control) was 0.68 (95% confidence interval [CI] = 0.48-0.97; P
      = .03). In the randomized comparison of 5 versus 2 years of tamoxifen, there was
      a statistically significant difference favoring the longer treatment (relative
      hazard = 0.37; 95% CI = 0.15-0.92; P = .03). There was little difference between
      the tamoxifen and control groups in terms of admissions due to thromboembolic
      disease. CONCLUSIONS: These findings suggest that long-term adjuvant treatment
      with tamoxifen may result in substantial reduction of cardiac morbidity in
      patients with low risk of death from breast cancer as well as in women in
      chemopreventive studies who have high risk of developing breast cancer.
      IMPLICATIONS: Our results support continuation of ongoing trials of tamoxifen
      therapy in these two groups of subjects.

PMID- 8350364
TI  - Silicone controversy: a survey of women with breast cancer and silicone implants.
AB  - BACKGROUND: During the past 3 years, there has been a highly publicized debate
      concerning the potential medical complications of silicone breast implants. There
      have been no studies that have addressed the effect of this controversy on women
      with a history of breast cancer who have undergone breast reconstruction with
      silicone implants. PURPOSE: This study was undertaken to understand the concerns
      of such women regarding their breast reconstructions and to assess what impact
      the silicone implant controversy had on them. METHODS: One hundred seventy-four
      randomly selected women who had undergone reconstructive surgery with silicone
      implants subsequent to mastectomy for treatment of breast cancer were interviewed
      by telephone from February through May 1992. (A moratorium on use of silicone
      breast implants, imposed by the Food and Drug Administration, extended from
      January through April 1992.) These women, a subset of 359
      mastectomy/reconstruction patients of one university-based plastic surgeon, had
      their first permanent prostheses placed between 1985 and 1990. The interview
      included questions designed to elicit information about women's experiences with
      reconstruction and reactions to the controversy. RESULTS: All study participants
      were aware of the controversy surrounding silicone implants. Seventy-six percent
      stated that breast reconstruction helped them cope with cancer, and only 16% had
      regrets about reconstruction. Many respondents had misconceptions about the
      nature of possible complications from silicone implants. Fifty-five percent were
      worried about the implants, yet only 13% considered having them removed as a
      result of the controversy. Only 27% indicated they would be completely likely to
      choose silicone implants again. The majority of women were unwilling to accept
      substantial risks of complications from implants, but there was variability in
      the level of risk that respondents would tolerate. CONCLUSIONS: A majority of
      women who have had breast reconstruction using silicone implants after treatment
      of breast cancer believe that implants helped them cope with the cancer. However,
      a sizeable proportion of such women are worried about possible medical
      complications that may develop as a consequence of silicone breast implants. Many
      would likely not choose these implants today. IMPLICATIONS: The true risks
      associated with silicone implants will ultimately be known. In the meantime,
      health care providers need to address patients' concerns about these implants.
      Information and guidance regarding the potential benefits and risks of breast
      implant devices should be provided to women with breast cancer who are
      considering treatment options.

PMID- 8350365
TI  - Apoptosis in toremifene-induced growth inhibition of human breast cancer cells in
      vivo and in vitro.
AB  - BACKGROUND: Antiestrogens inhibit the stimulative effects of estrogens on breast
      cancer growth, but the mechanism(s) by which they trigger tumor regression are
      not completely understood. Growth retardation and tumor regression can be
      achieved by enhanced cell death and/or arrested cell proliferation. PURPOSE: Our
      aim was to investigate the effect of a new antiestrogen, toremifene, on human
      breast cancer cells grown either in culture or as tumors in nude mice. METHODS:
      The growth and morphology of in vitro cultured cells of the human breast cancer
      cell line MCF-7 were monitored by time-lapse video. MCF-7 cells and ZR-75-1 human
      breast cancer cells were grown as tumors in nude mice and subsequently examined
      by electron microscopy. The integrity of DNA isolated from these cells was
      determined by standard gel electrophoretic techniques. Northern blot
      hybridization analysis was used to determine the steady-state levels of the mRNAs
      for testosterone-repressed prostatic message-2 (TRPM-2), tumor growth factor beta
      1 (TGF beta 1), and pS2 (a small, cysteine-rich protein of unknown function).
      RESULTS: Time-lapse video microscopy of the cell cultures indicated that
      treatment with 7.5 microM toremifene for 3 days caused approximately 60% of the
      cells to exhibit morphologic characteristics typical of cells undergoing
      programmed death, or apoptosis. The number of mitoses gradually decreased to zero
      over a 3- to 4-day period. Estrogen withdrawal for the same length of time
      resulted in an approximately equal number of apoptoses and mitoses. These changes
      were not associated with the pattern of DNA fragmentation, detectable as ladders
      in agarose gels, that is characteristic of the DNA of cells undergoing apoptosis.
      Elevated levels of TRPM-2 and TGF beta 1 mRNAs were observed in in vitro or in
      vivo grown tumor cells treated with 5-10 microM toremifene. Elevated levels of
      TRPM-2, but not TGF beta 1, mRNA were observed in the tumor cells after estrogen
      withdrawal. The steady-state level of pS2 mRNA in the tumor cells dropped in
      response to either toremifene treatment or estrogen withdrawal. CONCLUSION:
      Toremifene causes growth inhibition of estrogen-sensitive breast cancer cells by
      inducing some cells to undergo apoptosis and by inhibiting other cells from
      entering mitosis. The higher than normal amounts of TRPM-2 and TGF beta 1 protein
      that would likely result from the elevated levels of TRPM-2 and TGF beta 1 mRNAs
      measured in these cells after toremifene treatment may have an important role in
      the growth inhibition process. IMPLICATION: Apoptosis as an active, targeted
      process provides a potential new therapeutic approach for treating breast cancer.

PMID- 8350366
TI  - Unregulated and independent expression of collagenase and transin related to
      tumor progression.

PMID- 8350367
TI  - Videos as an educational intervention for childhood asthma among urban blacks.

PMID- 8350369
TI  - Depression in primary care: guideline overview. Agency for Health Care Policy and
      Research.

PMID- 8350368
TI  - Cold preservation of enteric free flaps.

PMID- 8350370
TI  - Managed care now and forever.

PMID- 8350371
TI  - The NIH agenda for women's health.

PMID- 8350372
TI  - Low birthweight in African Americans: does intergenerational well-being improve
      outcome?
AB  - The primary antecedent of infant mortality is low birthweight. Vital statistics
      data have shown that women of low socioeconomic status, regardless of race, are
      at greater risk for delivering low birthweight infants; however, prevailing data
      show that black women of the same socioeconomic status as white women have a
      twofold higher risk of giving birth to an infant weighing < 2500 g and a
      threefold risk of delivering a very low birthweight infant weighing < 1500 g.
      There is also evidence that intergenerational effects on birth outcome exist.
      However, virtually all studies of the effect of socioeconomic status on perinatal
      outcome have been cross-sectional; the effect of sustained intergenerational well
      being has not been measured. To address this gap, this study was designed to
      demonstrate that in an African-American population with sustained high
      socioeconomic status and equal risk factors, the birthweight distribution and
      other reproductive outcomes are the same as those for comparable US white
      populations. Preliminary findings are reported here.

PMID- 8350373
TI  - The health status of African-American elderly.
AB  - This article reviews the health status of African-American elderly, based on a
      computerized search of the medical literature from 1987 to 1991, as well as
      careful review of the report of the Secretary of Health's Task Force on Black and
      Minority Health. Black Americans have a higher prevalence of malignancies,
      diabetes, hypertension, obesity, homicide, and unintentional injury than white
      Americans. These problems contribute to a high mortality rate in young blacks and
      a greater prevalence of problems with activities of daily living in elderly
      blacks. Despite the high disease burden among young blacks, blacks are living
      progressively longer. As the number of elderly blacks increases, health-care
      practitioners will need to increase risk factor reduction in young-old blacks.
      Additionally, there will be a need for increased support of physical functioning
      in elderly African American.

PMID- 8350374
TI  - Retention of traditional premedical students in a medical career pathway compared
      with students in a combined baccalaureate-medical degree program.
AB  - This study compared the retention in medical career pathways of students enrolled
      in a combined baccalaureate-medical degree program to traditional premedical
      students at Brown University. Whereas 84% of the combined-degree students went on
      to medical school, only 36% of the traditional premedical students did. Among
      underrepresented minority students, the proportions were 74% and 39%,
      respectively. Scholastic Aptitude Test (SAT) scores accounted for some of the
      difference, yet even when SAT scores were controlled using a multiple logistic
      regression model, students enrolled in the combined-degree program were more than
      eight times as likely to continue in a medical career pathway.

PMID- 8350375
TI  - Risk and outcome of aspiration pneumonia in a city hospital.
AB  - Because aspiration pneumonia contributes significantly to morbidity and mortality
      in hospitalized patients, this study was undertaken to identify risk factors for
      morbidity and mortality associated with aspiration pneumonia. Patients with a
      discharge diagnosis of aspiration pneumonia in 1985 and 1990 were studied.
      Factors associated with death from aspiration pneumonia were: altered mental
      status, cerebrovascular accident, endotracheal intubation, tachycardia, and
      hypoxemia. Fever, cough, and unilateral infiltrates on chest radiograph were
      associated with survival. Attention to proper positioning of comatose patients,
      aggressive treatment of gastroesophageal reflux, and strict attention to
      endotracheal tubes and tracheostomies should decrease the morbidity and mortality
      associated with aspiration pneumonia.

PMID- 8350376
TI  - Diabetes-related complications of pregnancy.
AB  - Diabetes mellitus is a major medical complication of pregnancy and is associated
      with an increased risk of maternal and perinatal morbidity and mortality.
      Although recent advances have improved outcomes dramatically, the increased
      incidence of congenital malformations remains a significant problem. In the past,
      it was believed that pregnancy worsened microvascular complications, and women
      with vasculopathy were counseled to avoid or terminate pregnancies. Recent
      evidence suggests that normalization of blood glucose levels and current
      management strategies can lead to improved outcomes even in women with
      vasculopathy. Today, with the exception of coronary artery disease, women with
      diabetes may be counseled toward a more favorable outcome. This article discusses
      preconception planning and contemporary treatment methods.

PMID- 8350377
TI  - The clinical and radiological evaluation of primary brain neoplasms in children,
      Part II: Radiological evaluation.
AB  - Data collected over the past 8 years on the radiological appearance of common
      pediatric primary brain neoplasms are presented. An emphasis is placed on the
      newer radiological imaging modality of magnetic resonance imaging (MRI). Part I
      of this article emphasized the clinical evaluation of these brain neoplasms.
      Three hundred eighty-five children with known brain neoplasms ranging in age from
      newborn to 18 years were evaluated with one or all of the following radiological
      modalities: MRI, computed tomography (CT), water-soluble myelography (WSM), WSM
      with CT, and angiography. Contrast-enhanced MRI and CT scans both were accurate
      in delineating these brain neoplasms although MRI provided better resolution and
      delineation than CT. Angiography provided information on the vascularity of the
      neoplasms and their relationship to prominent arterial and venous structures.
      Water-soluble myelography with CT and gadolinium-enhanced MRI of the spine were
      equally accurate in demonstrating metastatic spread to the spinal canal and
      spinal cord. Magnetic resonance imaging with gadolinium was more accurate than CT
      with contrast in demonstrating recurrent or residual neoplasm at the operative
      site and metastatic spread to the brain. Magnetic resonance imaging with
      gadolinium is the best radiological modality to fully evaluate pediatric brain
      neoplasms.

PMID- 8350378
TI  - Assessed diversity within a regional organization of student representatives
      group.
AB  - This pilot study assessed diversity within an Organization of Student
      Representatives (OSR) group attending the 1990 Annual Meeting of the Southern
      Region Group on Student Affairs. In contrast to the Southern Region medical
      student population, the OSR group had a higher rate of students who were older,
      female, non-science majors in college, and in preclinical years of medical
      school. While the findings suggest that barriers are being overcome,
      underrepresented minority students also were underrepresented in the OSR group. A
      larger study should be conducted to determine OSR minority representation
      nationwide.

PMID- 8350379
TI  - Purtscher's retinopathy: a case of visual impairment associated with multiple
      trauma.
AB  - This case study describes a patient with multiple trauma associated with acute
      visual impairment. Funduscopic examination revealed scattered and confluent
      cotton wool exudates bilaterally. This retinopathy was first described by Othmar
      Purtscher, an Austrian ophthalmologist, in 1910, which he later referred to as
      "angiopathia retinae traumatica."

PMID- 8350380
TI  - Idiopathic peripheral gangrene in Nigeria.
AB  - A severe, acutely evolving peripheral gangrene of unknown etiology has been
      reported sporadically from different parts of Africa. This case report describes
      such a case of fulminant gangrene of the extremities following a febrile
      diarrheal illness associated with abdominal pain, polyarthropathy, and altered
      hemostatic function in a black adolescent male. A model of autoimmune causation
      for this uncommon clinical syndrome is proposed with guidelines for therapy.

PMID- 8350381
TI  - Genotoxicity studies in semiconductor industry. 1. In vitro mutagenicity and
      genotoxicity studies of waste samples resulting from plasma etching.
AB  - Solid waste samples taken from the etching reactor, the turbo pump, and the waste
      air system of a plasma etching technology line in semiconductor production were
      studied as to their genotoxic properties in a bacterial repair test, in the
      Ames/Salmonella microsome assay, in the SOS chromotest, in primary mouse
      hepatocytes, and in Chinese hamster V79 cell cultures. All three waste samples
      were found to be active by inducing of unscheduled DNA-synthesis in mouse
      hepatocytes in vitro. In the bacterial rec-type repair test with Proteus
      mirabilis, waste samples taken from the turbo pump and the vacuum pipe system
      were not genotoxic. The waste sample taken from the chlorine-mediated plasma
      reactor was clearly positive in the bacterial repair assay and in the SOS
      chromotest wit Escherichia coli. Mutagenic activity was demonstrated for all
      samples in the presence and absence of S9 mix made from mouse liver homogenate.
      Again, highest mutagenic activity was recorded for the waste sample taken from
      the plasma reactor, while samples collected from the turbo pump and from the
      waste air system before dilution and liberation of the air were less mutagenic.
      For all samples chromosomal damage in V79 cells was not detected, indicating
      absence of clastogenic activity in vitro. Altogether, these results indicate
      generation of genotoxic and mutagenic products as a consequence of chlorine
      mediated plasma etching in the microelectronics industry and the presence of
      genotoxins even in places distant from the plasma reactor. Occupational exposure
      can be expected both from the precipitated wastes and from chemicals reaching the
      environment with the air stream.

PMID- 8350382
TI  - Immunoelectrophoretic pattern of native mucosal intracellular glycoproteins of
      hog healthy and drug-intoxicated stomachs and of hog body fluids.
AB  - Naturally occurring glycoproteins have been extracted from fundic and antral
      mucosal tissue of the hog stomach by means of nondegrading techniques. Major and
      retarded glycoprotein fractions separated by gel filtration were further
      dissociated from appreciable amounts of noncovalently bound proteins by CsCl
      density gradient centrifugation. Antisera to glycoprotein fractions of fundic and
      antral regions of the stomach were prepared in rabbits. The major fractions from
      both gastric regions have similar molecular mass (approximately 2 x 10(6)),
      sedimentation coefficient (approximately 31.5 s), and specific viscosity
      (approximately 1.6). Purified fractions from each region were further separated
      into two subfractions by affinity chromatography on wheat germ lectin.
      Glycoprotein subfractions from antrum and fundus differ appreciably in their
      carbohydrate and amino acids content, share antigenic determinants, but do not
      cross-react with anti-hog serum protein antisera. Further diversity in native
      mucin glycoproteins was observed by the use of one-(D) and two-dimensional (2D)
      immunoelectrophoresis; subfractions that cross-react with specific anti-hog
      gastric glycoproteins were found to contain three or more components. D
      Immunoelectrophoretic analyses demonstrated (1) in vivo degradation of
      glycoprotein components of the major fundic fraction isolated from mucosal tissue
      of alcohol/acetyl salicylate-intoxicated hog stomachs and (2) in vitro catabolism
      of major fundic glycoproteins by corresponding mitochondrial lysosomal (ML) acid
      hydrolases. Furthermore, 2D-immunoelectrophoretic analyses showed that (1) hog
      synovial fluid and plasma proteins have similar prosthetic moieties as either
      reacted with anti-hog serum proteins antisera. Nonetheless, locations, shapes,
      and staining intensities of the immunoprecipitate lines differed, which is
      indicative of different structures of the carbohydrate moieties of components of
      synovial fluid and plasma proteins, and (2) only a minor fraction of hog
      cerebrospinal fluid cross-reacted with anti-hog serum protein antisera. This is
      contrary to the generally accepted deduction based on high-resolution 2D
      electrophoresis, indicative of different compositional patterns of plasma and
      cerebrospinal fluids.

PMID- 8350383
TI  - Percutaneous absorption of PCBs from soil: in vivo rhesus monkey, in vitro human
      skin, and binding to powdered human stratum corneum.
AB  - Polychlorinated biphenyls (PCBs) are ubiquitous and persistent environmental
      pollutants. The major resident site for these PCBs is the soil, and human skin is
      frequently in contact with soil. Our objective was to determine the percutaneous
      absorption of the PCBs Aroclor 1242 and Aroclor 1254 from soil. PCB-contaminated
      soil was prepared at levels of 44 ppm Aroclor 1242 and 23 ppm Aroclor 1254. PCB
      concentrations on skin were 1.75 micrograms/cm2 for Aroclor 1242 and 0.91
      microgram/cm2 for Aroclor 1254. In vivo percutaneous absorption in the rhesus
      monkey was determined by urinary and fecal [14C]-PCB excretion for a 5-wk period
      following topical dosing. Absorption of Aroclor 1242 was determined in vitro with
      human skin for comparative purposes. In vivo in the rhesus monkey the
      percutaneous absorption of Aroclor 1242 was 13.8 +/- 2.7 (SD)% of the dose and
      the absorption of Aroclor 1254 was 14.1 +/- 1.0%. These absorption amounts are
      similar to the absorption of Aroclor 1242 and 1254 from other vehicles (mineral
      oil, trichlorobenzene, acetone). With in vitro percutaneous absorption through
      human skin, most of the Aroclor 1242 and Aroclor 1254 resided in the skin and the
      amounts were dependent upon dosing vehicle (water > mineral oil > soil). Both
      PCBs readily partitioned from water into soil and human powdered stratum corneum.
      By difference the partitioning favored both PCBs going from soil into stratum
      corneum. These data emphasize the role of soil in percutaneous absorption and
      provide information for appropriate risk assessment.

PMID- 8350384
TI  - Toxicity of 1,1,1-trichloro-2-propanone in Sprague-Dawley rats.
AB  - 1,1,1-Trichloro-2-propanone (1,1,1-TCP) has been identified as a chlorination by
      product in finished drinking water supplies. Since little was known of its oral
      toxicity, exposure studies were conducted with male and female Sprague-Dawley
      rats (10 males and 10 females/group) exposed by corn oil gavage at 0, 16, 48,
      161, or 483 mg/kg for 10 d or 0, 30, 90, or 270 mg/kg for 90 d. Evaluations
      included mortality, clinical signs, body weight, food consumption, ophthalmology,
      hematology, clinical chemistry, urinalysis, organ weights, gross pathology, and
      histopathology. In the 10-d study, severe toxicity was observed at the highest
      dose level, since most treated animals (8/10 males and 7/10 females) died.
      Toxicity was also noted at 161 and 48 mg/kg. At 161 mg/kg, 2 males died and an
      increase in liver weights in both sexes was observed. Acanthosis and
      hyperkeratosis of the forestomach was present in males and females at 48 mg/kg
      and above. In the 90-d study, toxicity was significant at 270 mg/kg, with
      acanthosis and hyperkeratosis of the forestomach evident in most animals and
      ataxia in about one-half of them. Retinal degeneration, increased serum
      potassium, and increased blood urea nitrogen were present in females and
      increased blood calcium in males at that same dose level. Acanthosis and
      hyperkeratosis were observed in both sexes, and retinal degeneration was
      prominent in 2 females at 90 mg/kg. It was concluded that 16 mg/kg was the NOAEL
      (no observed adverse effect level) for the 10-d study while 30 mg/kg was the
      NOAEL for the 90-d exposure of Sprague-Dawley rats to 1,1,1,-trichloro-2
      propanone.

PMID- 8350385
TI  - Down-regulation of muscarinic receptors and the m3 subtype in white-footed mice
      by dietary exposure to parathion.
AB  - The effect of ad libitum dietary exposure (as occurs in the field) to parathion
      for 14 d was investigated on the muscarinic acetylcholine receptor (mAChR) in
      brains and submaxillary glands of adults of a field species, the white-footed
      mouse Peromyscus leucopus. Immunoprecipitation using subtype selective antibodies
      revealed that the relative ratios of the m1-m5 mAChR subtypes in Peromyscus brain
      were similar to those in rat brain. There was little variability in
      acetylcholinesterase (AChE) activity in control mice brains but large variability
      in 39 exposed mice, resulting from differences in food ingestion and parathion
      metabolism. Accordingly, data on radioligand binding to mAChRs in each mouse
      brain were correlated with brain AChE activity in the same mouse, and AChE
      inhibition served as a biomarker of exposure reflecting in situ paraoxon
      concentrations. Exposure to parathion for 14 d reduced maximal binding (Bmax) of
      [3H]quinuclidinyl benzilate ([3H]QNB), [3H]-N-methylscopolamine ([3H]NMS), and
      [3H]-4-diphenylacetoxy-N-methylpiperidine methiodide ([3H]-4-DAMP) by up to
      approximately 58% without affecting receptor affinities for these ligands.
      Maximal reduction in Bmax of [3H]QNB and [3H]-4-DAMP binding occurred in mice
      with highest AChE inhibition, while equivalent maximal reduction in Bmax of
      [3H]NMS occurred in mice with only approximately 10% AChE inhibition, without
      further change at higher parathion doses. This is believed to be due to the
      hydrophilicity of [3H]NMS, which limits its accessibility to internalized
      desensitized receptors. In submaxillary glands (mAChRs are predominantly m3
      subtype), there were significant dose-dependent reductions in [3H]QNB binding and
      m3 mRNA levels in exposed mice, revealed by Northern blot analyses. The reduction
      in m3 receptors is suggested to result mostly from reduced synthesis at the
      transcription level, rather than from translational or posttranslational events.
      The data suggest that down-regulation of mAChRs occurs after dietary exposure for
      14 d to sublethal concentrations of parathion in a field rodent species, and that
      significant though incomplete recovery in AChE and mAChRs occurs in 7 d following
      termination of exposure.

PMID- 8350386
TI  - 110/140 laminin-binding protein immunoreactivity in spinal dorsal root ganglia: a
      capsaicin-insensitive reduction induced by constriction injury of the sciatic
      nerve in rats.
AB  - The distribution of 110/140 laminin-binding protein (110/140 LBP) in the spinal
      dorsal root ganglia (DRG) and its regulation by partial constriction of the
      sciatic nerve was studied in adult rats. The cross-sectional area of neurons with
      110/140 LBP-immunoreactivity (-I) showed an approximately normal frequency
      distribution. The 110/140 LBP-I was observed in neuronal cell bodies exclusive of
      the nucleus. Following sciatic nerve constriction, the 110/140 LBP-I was
      downregulated in the ipsilateral L4-5 DRG. DRG neurons with a cross-sectional
      area > or = 1600 microns 2 were preferentially affected. Neonatal capsaicin
      treatment, a procedure that selectively destroys a subpopulation of DRG neurons
      with fine unmyelinated axons, had no effect on the reduction of 110/140 LBP in
      the DRG induced by sciatic nerve constriction. Western immunoblot analysis
      confirmed a reduction of 110/140 LBP on the side ipsilateral to the constriction.
      These results demonstrate a LBP within primary sensory neurons and its
      suppression by peripheral nerve injury. The data support a role for LBP in the
      adult nervous system.

PMID- 8350387
TI  - Microtubule-associated protein MAP1B expression precedes the morphological
      differentiation of oligodendrocytes.
AB  - The microtubule-associated protein MAP1B is believed to play an important role in
      the outgrowth of neurites from neurons (Tucker and Matus, Dev Biol 130: 423-434,
      1988). We have investigated the possibility that MAP1B might participate in the
      formation of processes in cultured oligodendrocytes by an analysis of the
      expression of MAP1B during oligodendrocyte progenitor development. The appearance
      of the antigens recognized by the monoclonal antibodies A2B5, O4, and O1 which
      define distinct stages in the maturation of progenitors, was compared with the
      developmental expression of MAP1B. MAP1B is first detectable in O4+
      preoligodendrocytes prior to the acquisition of galactocerebroside and
      immediately before they develop the complex process-bearing morphology
      characteristic of terminally differentiated myelin-forming oligodendrocytes in
      the CNS. In contrast, astrocytes have negligible amounts of MAP1B. These results
      demonstrate that the expression of MAP1B precedes the development of the mature
      oligodendrocyte phenotype and suggest that interactions between microtubules and
      MAP1B might have a role in the formation and stabilization of myelin-forming
      processes.

PMID- 8350388
TI  - Testosterone regulation of the regenerative properties of injured rat sciatic
      motor neurons.
AB  - We have previously demonstrated that systemic administration of testosterone
      differentially regulates the regenerative properties of injured hamster facial
      motor neurons, which are androgen receptor-containing cranial motor neurons. In
      this investigation, the hypothesis that testosterone alters the regenerative
      properties of rat sciatic motor neurons, which are androgen receptor-containing
      spinal motor neurons, was tested using fast axonal transport of radioactively
      labeled proteins to assess sciatic nerve regeneration. Adult castrated male rats
      were subjected to crush axotomy of the sciatic nerve at the level of the gemelli
      tendons (mid-thigh). One-half of the axotomized animals received subcutaneous
      implants of testosterone propionate (TP), with the remainder of the animals sham
      implanted with blank capsules. The outgrowth distances of the leading axons were
      measured at 5, 6, 7, and 11 days postoperative. Linear regression analysis was
      accomplished, with the slope of the line representing the regeneration rate and
      the x-intercept the initial delay of sprout formation. Systemic administration of
      testosterone resulted in a 13% increase in the rate of regeneration, relative to
      the control, -TP group. Outgrowth distances were significantly increased in the
      +TP group only in the later stages of regeneration. However, TP did not shorten
      the delay in sprout formation in regenerating sciatic motor neurons, but instead
      produced a small prolongation in the delay time. This pattern of hormonal
      regulation of the regenerative properties of spinal motoneurons is similar to
      that previously found in cranial motoneurons. The prolongation of the initial
      delay may have been a factor in the lack of significant outgrowth distances
      during the early stages of regeneration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350389
TI  - Glial progenitor cells of the nerve fiber layer of the olfactory bulb: effect of
      astrocyte growth media.
AB  - There are two morphologically distinct types of glial cells (i.e., ensheathing
      cells and astrocytes) in the nerve fiber layer (NFL) of the adult mammalian
      olfactory bulb. Ensheathing cells provide ensheathment for olfactory axons,
      whereas astrocytes occupy the interfascicular spaces of the olfactory NFL. During
      embryonic development, however, only one type of glial cell is found in this
      layer of the olfactory bulb, namely, the ensheathing cell. Even though
      ensheathing cells take up residence within the CNS, they are actually derived
      from the olfactory placode. Far less is known about the developmental origin of
      interfascicular astrocytes, which arise either from the glial progenitor cells
      that give rise to ensheathing cells or from astrocyte precursor cells that
      migrate into the NFL from deeper layers of the bulb primordium. In the present
      study, enriched populations of ensheathing cells were grown in vitro in media
      known to promote the growth and differentiation of astrocytes to determine
      whether ensheathing cell progenitors could differentiate into astrocytes. These
      media failed to induce the appearance of astrocytes in the ensheathing cell
      cultures. It was concluded that the astrocytes of the NFL most likely arise from
      progenitor cells that migrate into this layer from deeper parts of the developing
      bulb.

PMID- 8350390
TI  - Protease production by cultured microglia: substrate gel analysis and immobilized
      matrix degradation.
AB  - The production of collagen-degrading proteases by cultured neonatal rat microglia
      was examined using an immobilized fibronectin-gelatin matrix coupled to a
      fluorescent marker and by substrate gel analysis. When microglia were plated onto
      the surface of the matrix and incubated under resting (nonstimulated) conditions,
      a small but visible amount of immobilized matrix was degraded. Treatment with
      lipopolysaccharide (LPS) or interleukin-1 (IL-1) significantly increased the
      number of microglia demonstrating substrate degradation. Substrate-SDS
      polyacrylamide gel electrophoresis of samples of supernatants from untreated
      cultured microglia indicated the presence of a 72 and a 92 kD metalloproteinase
      with characteristics corresponding to collagenases. Supernatants from untreated
      astrocyte cultures were shown to have primarily a 72 kD metalloproteinase.
      Proteinase activity increased on stimulation of the microglia with LPS and IL-1
      in a dose-dependent fashion. These results indicate that cultured microglia
      release active proteases capable of degrading the extracellular matrix in a
      localized region. The production of proteases by activated microglia may have
      important physiological and pathophysiological consequences within the restricted
      extracellular matrix of the CNS.

PMID- 8350391
TI  - Interleukin-2 as a neurotrophic factor for supporting the survival of neurons
      cultured from various regions of fetal rat brain.
AB  - Interleukin(IL)-2 supported the survival and enhanced neurite extension of
      cultured hippocampal neurons prepared from embryonic 18-day-old rats. This
      neurotrophic effect was observed at concentrations of 2 to 200 U/ml, and almost
      all the neurons could survive for more than 2 days in the presence of 200 U/ml of
      IL-2. This viability-promoting effect of IL-2 on the neurons was completely
      blocked with anti-IL-2 antibodies. IL-2 also supported the survival of cultured
      cortical, striatal, and septal neurons. These results indicate that IL-2 has a
      survival-promoting effect on a wide variety of neurons. On the other hand, IL-2
      did not affect the choline acetyltransferase (ChAT) activity of striatal neurons,
      suggesting that this cytokine does not act as a differentiation factor for
      striatal cholinergic neurons.

PMID- 8350392
TI  - Acylation of lysophosphatidylcholine by brain membranes.
AB  - Brain microsomes catalyze the acylation of lysophosphatidylcholine (lysoPtdCho)
      in the presence and absence of added CoA derivatives. The catalytic activity is
      distributed widely in various subcellular fractions from rat or bovine cerebral
      cortex as measured by the conversion of 1-[14C]palmitoyl-sn-glycero-3
      phosphocholine to [14C]PtdCho. Analysis of this latter compound revealed that the
      dipalmitoyl derivative is the predominant molecular species, which is formed in
      this reaction by transacylation between two [14C]lysoPtdCho molecules. This
      lysoPtdCho: lysoPtdCho transacylation reaction was enhanced several-fold by the
      addition of oleoyl-CoA, which also is an effective donor of acyl groups in the
      acyl-CoA: lysoPtdCho acyltransferase-catalyzed reaction. Measurements of the
      initial velocity of the transacylation reaction were used to determine kinetic
      constants. Apparent Km values for lysoPtdCho in the presence and absence of
      oleoyl-CoA were 29 microM and 104 microM, respectively, and the corresponding
      maximal velocities were 0.11 and 1.06 nmol.min-1.mg-1, respectively. Oleoyl-CoA
      at 4 microM produced half-maximal stimulation of the transacylation reaction. CoA
      also stimulated the rate of conversion of [14C]lysoPtdCho to [14C]PtdCho, either
      in the presence or absence of oleoyl-CoA, with a half-maximal effect of CoA at 80
      microM. These results may be important in understanding the regulation of PtdCho
      synthesis and the mechanism by which acyl group composition of this compound is
      controlled.

PMID- 8350393
TI  - Axon growth is enhanced by NCAM lacking the VASE exon when expressed in either
      the growth substrate or the growing axon.
AB  - The neural cell adhesion molecule NCAM exists as several related peptides formed
      by alternative splicing of the single NCAM gene. Here the ability of NCAM
      containing and lacking the alternatively spliced VASE exon to act as a permissive
      growth substrate was tested by examining retinal axon outgrowth on normal L cell
      fibroblasts and L cells expressing stably transfected 140 kD NCAM +/- VASE. L
      cells expressing either NCAM form were a more permissive substrate than control L
      cells. At higher substrate cell densities, greater axon outgrowth occurred on
      substrate cells expressing NCAM - VASE than on those expressing NCAM + VASE.
      Similar experiments tested retinal axon growth on neuronal substrates by
      utilizing clonal B35 cells, C3 cells that are NCAM lacking variants of B35, and
      C3 cells into which 140 kD NCAM +/- VASE has been restored by transfection. Axon
      growth on C3 cells transfected with NCAM - VASE was greater than that on all
      other substrates including cells transfected with NCAM + VASE. In these
      experiments C3 cells and transfected C3 expressing NCAM + VASE cell promoted
      similar outgrowth. The influence on neurite growth of the NCAM isoform of the
      neurite itself was tested by examining neurite formation using combinations of C3
      cells and C3 NCAM transfectants both in the growth monolayer and as responding
      cells. C3 cells were able to extend neurites, indicating NCAM is not required for
      neurite growth. However, C3 derivatives transfected with NCAM +/- VASE had
      greater neurite outgrowth. The most extensive neurite growth was found when NCAM 
      VASE was expressed by both substrate cells and the responding neurite growing
      cells. Thus NCAM enhances axon or neurite outgrowth when present either in the
      growth substrate or on the growing axon. NCAM - VASE has a significantly greater
      growth promoting capability than NCAM + VASE. The expression of NCAM + VASE by
      more mature neural cells could thus be a significant factor in the reduced
      axonation capabilities of mature neurons.

PMID- 8350394
TI  - Assembly and composition of intracellular particles formed by Moloney murine
      leukemia virus.
AB  - Assembly of type C retroviruses such as Moloney murine leukemia virus (M-MuLV)
      ordinarily occurs at the plasma membranes of infected cells and absolutely
      requires the particle core precursor protein, Pr65gag. Previously we have shown
      that Pr65gag is membrane associated and that at least a portion of intracellular
      Pr65gag protein appears to be routed to the plasma membrane by a vesicular
      transport pathway. Here we show that intracellular particle formation can occur
      in M-MuLV-infected cells. M-MuLV immature particles were observed by electron
      microscopy budding into and within rough endoplasmic reticulum, Golgi, and
      vacuolar compartments. Biochemical fractionation studies indicated that
      intracellular Pr65gag was present in nonionic detergent-resistant complexes of
      greater than 150S. Additionally, viral RNA and polymerase functions appeared to
      be associated with intracellular particles, as were Gag-beta-galactosidase fusion
      proteins which have the capacity to be incorporated into virions. Immature
      intracellular particles in postnuclear lysates could be proteolytically processed
      in vitro to mature forms, while extracellular immature M-MuLV particles remained
      immature as long as 10 h during incubations. The occurrence of M-MuLV-derived
      intracellular particles demonstrates that Pr65gag can associate with
      intracellular membranes and indicates that if a plasma membrane Pr65gag receptor
      exists, it also can be found in other membrane compartments. These results
      support the hypothesis that intracellular particles may serve as a virus
      reservoir during in vivo infections.

PMID- 8350395
TI  - Mutations that alter an Arg-Gly-Asp (RGD) sequence in the adenovirus type 2
      penton base protein abolish its cell-rounding activity and delay virus
      reproduction in flat cells.
AB  - The adenovirus penton base protein has a cell rounding activity and may lyse
      endosomes during virus entry into the cytoplasm. We found that penton base that
      was expressed in Escherichia coli also caused cell rounding and that cells
      adhered to polystyrene wells that were coated with the protein. Mutant analysis
      showed that both properties required an Arg-Gly-Asp (RGD) sequence at residues
      340 to 342 of penton base. In flat adherent cells, virus mutants with amino acid
      substitutions in the RGD sequence were delayed in virus reproduction and in the
      onset of viral DNA synthesis. In nonadherent or poorly spread cells, the kinetics
      of mutant virus reproduction were similar to those of wild-type adenovirus type
      2. Expression of the mutant phenotype exclusively in the flat cells that we
      tested supports a model in which penton base interacts with an RGD-directed cell
      adhesion molecule during adenovirus uptake or uncoating.

PMID- 8350397
TI  - Identification, sequence, and transcriptional mapping of lef-3, a baculovirus
      gene involved in late and very late gene expression.
AB  - A trans-acting gene required for late viral gene expression in transient
      expression assays was identified in the genome of Autographa californica nuclear
      polyhedrosis virus. A genomic library of A. californica nuclear polyhedrosis
      virus DNA lacking a clone spanning the region from 43 to 48 map units (mu) was
      unable to activate gene expression from a reporter plasmid when the reporter gene
      was driven by a baculovirus late or very late promoter in transient expression
      assays. The genomic region responsible for activating reporter gene expression
      was further mapped to 43.4 to 45.2 mu of the viral genome. The nucleotide
      sequence of this region was determined and shown to contain several small open
      reading frames (ORFs) and one major ORF, named lef-3, for late expression factor
      3. The lef-3 ORF was predicted to encode a polypeptide of 385 amino acids and
      with a molecular mass of 44,529 daltons. No homolog to the lef-3 ORF was found in
      existing data bases. Further analysis showed that only the lef-3 ORF in the
      region from 43.4 to 45.2 mu was necessary for late gene activation in the assays
      used. The temporal regulation of lef-3 transcription was studied by Northern
      (RNA) blot hybridization; lef-3 was found to be an early gene that was
      transcribed primarily as a 2.0-kb mRNA. Primer extension analysis and S1 nuclease
      protection assays revealed that lef-3 transcription initiated about 280 bp
      upstream of the first ATG codon and terminated near a polyadenylation signal, 130
      bp downstream of the last codon of the lef-3 ORF.

PMID- 8350396
TI  - Large E1B proteins of adenovirus types 5 and 12 have different effects on p53 and
      distinct roles in cell transformation.
AB  - The formation of complexes between oncoproteins of DNA tumor viruses and the
      cellular protein p53 is thought to result in inactivation of the growth
      suppressor function of p53. In cells transformed by nononcogenic human adenovirus
      type 5 (Ad5), the 55-kDa protein encoded by E1B forms a stable complex with p53
      and sequesters it in the cytoplasm. However, the homologous 54-kDa protein of
      highly oncogenic Ad12 does not detectably associate with p53. Yet in Ad12
      transformed cells, p53 is metabolically stable, is present at high levels in the
      nucleus, and contributes to the oncogenicity of the cells. Such properties have
      previously been described for mutant forms of p53. Here, we show that stable p53
      in Ad12-transformed cells is wild type rather than mutant and that stabilization
      of p53 is a direct consequence of the expression of the Ad12 E1B protein. We also
      compared the effects of the E1B proteins on transformation of rodent cells by
      different combinations of oncogenes. A synergistic interaction was observed for
      the gene encoding the 54-kDa E1B protein of Ad12 with myc plus ras oncogenes,
      resembling the effect of mutant p53 on myc plus ras. In contrast, the Ad5 55-kDa
      E1B protein strongly inhibited transformation by myc plus ras but stimulated
      transformation by E1A plus ras. The data are explained in terms of different
      interactions of the two E1B proteins with endogenous p53. The results suggest
      that in cultured rat cells, endogenous wild-type p53 plays an essential role in
      cell proliferation, even in the presence of myc plus ras. The dependence on p53
      is lost, however, when the adenovirus E1A oncogene is present.

PMID- 8350399
TI  - Effects of the tom1 mutation of Arabidopsis thaliana on the multiplication of
      tobacco mosaic virus RNA in protoplasts.
AB  - For the multiplication of RNA viruses, specific host factors are considered
      essential, but as of yet little is known about this aspect of virus
      multiplication. To identify such host factors, we previously isolated PD114, a
      mutant of Arabidopsis thaliana, in which the accumulation of the coat protein of
      tobacco mosaic virus (TMV) in uninoculated leaves of an infected plant was
      reduced to low levels. The causal mutation, designated tom1, was single, nuclear,
      and recessive. Here, we demonstrate that the tom1 mutation affects the
      amplification of TMV-related RNAs in a single cell. When protoplasts were
      inoculated with TMV RNA by electroporation, the percentage of TMV-positive
      protoplasts (detected by indirect immunofluorescence staining with anti-TMV
      antibodies) was lower (about 1/5 to 1/10) among PD114 protoplasts than among wild
      type protoplasts. In TMV-positive PD114 protoplasts, the amounts of the positive
      strand RNAs (the genomic RNA and subgenomic mRNAs) and coat protein reached
      levels similar to, or slightly lower than, those reached in TMV-positive wild
      type protoplasts, but the accumulation of the positive-strand RNAs and coat
      protein occurred more slowly than with the wild-type protoplasts. The parallel
      decrease in the amounts of the coat protein and its mRNA suggests that the coat
      protein is translated from its mRNA with normal efficiency. These observations
      support the idea that the TOM1 gene encodes a host factor necessary for the
      efficient amplification of TMV RNA in an infected cell. Furthermore, we show that
      TMV multiplication in PD114 protoplasts is severely affected by the coinoculation
      of cucumber mosaic virus (CMV) RNA. When PD114 protoplasts were inoculated with a
      mixture of TMV and CMV RNAs by electroporation, the accumulation of TMV-related
      molecules was approximately one-fifth of that in PD114 protoplasts inoculated
      with TMV RNA alone. No such reduction in the accumulation of TMV-related
      molecules was observed when wild-type protoplasts were inoculated with a mixture
      of TMV and CMV RNAs or when wild-type and PD114 protoplasts were inoculated with
      a mixture of TMV and turnip crinkle virus RNAs. These observations are compatible
      with a hypothetical model in which a gene(s) that is distinct from the TOM1 gene
      is involved in both TMV and CMV multiplication.

PMID- 8350398
TI  - Deletion mutation analysis of the adenovirus type 2 E3-gp19K protein:
      identification of sequences within the endoplasmic reticulum lumenal domain that
      are required for class I antigen binding and protection from adenovirus-specific
      cytotoxic T lymphocytes.
AB  - Adenovirus E3-gp19K is a transmembrane glycoprotein, localized in the endoplasmic
      reticulum (ER), which forms a complex with major histocompatibility complex (MHC)
      class I antigens and retains them in the ER, thereby preventing cytolysis by
      cytotoxic T lymphocytes (CTL). The ER lumenal domain of gp19K, residues 1 to 107,
      is known to be sufficient for binding to class I antigens; the transmembrane and
      cytoplasmic ER retention domains are located at residues ca. 108 to 127 and 128
      to 142, respectively. To identify more precisely which gp19K regions are involved
      in binding to class I antigens, we constructed 13 in-frame virus deletion mutants
      (4 to 12 amino acids deleted) in the ER lumenal domain of gp19K, and we analyzed
      the ability of the mutant proteins to form a complex with class I antigens,
      retain them in the ER, and prevent cytolysis by adenovirus-specific CTL. All
      mutant proteins except one (residues 102 to 107 deleted) were defective for these
      properties, indicating that the ability of gp19K to bind to class I antigens is
      highly sensitive to mutation. All mutant proteins were stable and were retained
      in the ER. Sequence comparisons among adenovirus serotypes reveal that the ER
      lumenal domain of gp19K consists of a variable region (residues 1 to 76) and a
      conserved region (residues 77 to 98). We show, using the mutant proteins, that
      the gp19K-specific monoclonal antibody Tw1.3 recognizes a noncontiguous epitope
      in the variable region and that disruption of the variable region by deletion
      destroys the epitope. The monoclonal antibody and class I antigen binding
      results, together with the serotype sequence comparisons, are consistent with the
      idea that the ER lumenal domain of gp19K has three subdomains that we have termed
      the ER lumenal variable domain (residues 1 to ca. 77 to 83), the ER lumenal
      conserved domain (residues ca. 84 to 98), and the ER lumenal spacer domain
      (residues 99 to 107). We suggest that the ER lumenal variable domain of gp19K has
      a specific tertiary structure that is important for binding to the polymorphic
      alpha 1 and alpha 2 domains of class I heavy (alpha) chains. We suggest that the
      ER lumenal conserved domain of gp19K may interact with some conserved protein,
      perhaps the highly conserved alpha 3 domain of class I heavy chains. Finally, the
      ER lumenal spacer domain may allow the ER lumenal variable and conserved domains
      to extend out from the ER membrane so that they can interact with class I heavy
      chains.

PMID- 8350400
TI  - Reovirus M2 gene is associated with chromium release from mouse L cells.
AB  - In this study, we investigated the interaction of reovirus particles with cell
      membranes by using a 51Cr release assay. We confirmed prior observations (J.
      Borsa, B. D. Morash, M. D. Sargent, T. P. Copps, P. A. Lievaart, and J. G.
      Szekely, J. Gen. Virol. 45:161-170, 1979) that intermediate subviral particles
      (ISVPs) of reovirus type 3 strain Abney (T3A) induced the release of 51Cr from
      preloaded L cells and showed that the intact virion and core forms did not.
      Reovirus type 1 strain Lang (T1L) ISVPs were found to be less efficient at 51Cr
      release than T3A ISVPs. Reassortants between these strains indicated that the
      51Cr release phenotype segregates with the M2 gene segment. Biochemical studies
      indicated that the ISVPs' acquisition of the capacity to induce 51Cr release
      followed the cleavage of the viral M2 gene product mu 1/mu 1C to fragments delta
      and phi during virion conversion to ISVP but did not directly correlate with this
      cleavage. These studies suggest that the reovirus M2 gene product (in its cleaved
      form) plays a role in interacting with cell membranes.

PMID- 8350401
TI  - A new regulatory element that augments the Tax-dependent enhancer of human T-cell
      leukemia virus type 1 and cloning of cDNAs encoding its binding proteins.
AB  - The Tax protein of human T-cell leukemia virus type 1 (HTLV-1) trans activates
      the 21-bp enhancer of HTLV-1. A sequence of more than two copies of the 21-bp
      enhancer is efficiently activated by Tax, but one copy is not activated
      extensively. Another sequence (TRE-2, positions -163 to -117) adjacent to the 21
      bp enhancer in the long terminal repeat of HTLV-1 can enhance a single copy of
      the 21-bp enhancer activity in trans activation by Tax. This sequence contains
      motifs related to the Ets- and NF-kappa B-binding sequences, but mutations at
      these sites indicated that neither is responsive to cooperation with the 21-bp
      enhancer. A deletion mutation of TRE-2 identified 25 bases at positions -158 to 
      134 (TRE-2S) as an essential sequence, and TRE-2S was sufficient to give maximum
      cooperation with one copy of the 21-bp enhancer in trans activation by Tax
      protein. Using TRE-2S as a probe, we screened a cDNA library of HUT102 cells by
      the Southwestern (DNA-protein) procedure and isolated two cDNA clones, THP-1 and 
      2. These two clones encode TRE-2S-binding proteins, and they differ by only an
      extra 17 amino acids in THP-2. Both THP proteins contain five zinc finger motifs
      which are strikingly similar to those of the GLI family, an amplified gene
      product in glyoma cells. The binding site of THP-1 and -2 was GAACCACCCA in TRE
      2S, which is highly homologous to the GLI-binding site. These results suggest
      that binding of THP to TRE-2S may be involved in cooperation with one copy of the
      21-bp enhancer in responding to Tax trans activation.

PMID- 8350402
TI  - Reactivation of transcription from a vaccinia virus early promoter late in
      infection.
AB  - We have studied the kinetics of RNA synthesis from the vaccinia virus 7,500
      molecular-weight gene (7.5K gene) which is regulated by early and late promoters
      arranged in tandem. Unexpectedly, after a first burst of RNA synthesis early in
      infection, transcription was reactivated late in infection. Reactivation was not
      dependent on the location of the promoter in the genome or on the presence of the
      upstream late regulatory sequences. The mRNA synthesized from the reactivated
      promoter in the late phase had the same 5' and 3' ends as the molecules
      transcribed in the early phase. Interestingly, these molecules were efficiently
      translated despite the absence of the poly(A) leader characteristic of late
      mRNAs. Reactivation appears to be dependent on virus assembly since it is
      prevented by rifampin, a specific inhibitor of morphogenesis. Finally, analysis
      of various other early genes showed that reactivation is not unique to the 7.5K
      early promoter.

PMID- 8350403
TI  - Hepatitis B virus genotype A rarely circulates as an HBe-minus mutant: possible
      contribution of a single nucleotide in the precore region.
AB  - The emergence of HBe-minus hepatitis B virus (HBV) mutants, usually through a UAG
      nonsense mutation at codon 28 of the precore region, helps the virus to survive
      the anti-HBe immune response of the host. Host and viral factors that predispose
      to the emergence of such mutants are not well characterized. The fact that the
      precore region forms a hairpin structure essential for the packaging of viral
      pregenomic RNA may explain the extremely high prevalence of the UAG mutation at
      codon 28. It converts a wobble U-G pair in the packaging signal between
      nucleotide 3 of codon 15 (CCU) and nucleotide 2 of codon 28 (UGG) into a U-A
      pair. Since genotype A of HBV has a CCC sequence at codon 15, the UAG mutation
      would, instead, disrupt a C-G pair present in the wild-type virus. This
      alteration was shown by transfection experiments to greatly compromise the
      packaging of pregenomic RNA. The implication of this finding was elucidated by
      molecular epidemiological studies. Genotype A was found to be the most prevalent
      genotype in the wild-type virus populations in France but was found in only 1 of
      the 46 isolates of HBe-minus mutants found there. These mutants were contributed
      chiefly by genotype D, the second most prevalent genotype in France, which is
      characterized by a CCU sequence at codon 15. The role of the single nucleotide at
      codon 15 was confirmed by the finding of the single genotype A isolate in which
      both wild-type and mutant viruses were present. Interestingly, nearly all of the
      mutants had a codon 15 sequence of CCU instead of the CCC present in the wild
      type viruses. Our results suggest that genotype A of HBV rarely circulates as HBe
      minus mutants, probably because of a requirement for a simultaneous sequence
      change at codon 15. These data, together with the virtual absence of genotype A
      in the Chinese samples examined, may provide some insights into the uneven
      prevalence of HBe-minus mutants in the world.

PMID- 8350404
TI  - Glycoprotein E1 of hog cholera virus expressed in insect cells protects swine
      from hog cholera.
AB  - The processing and protective capacity of E1, an envelope glycoprotein of hog
      cholera virus (HCV), were investigated after expression of different versions of
      the protein in insect cells by using a baculovirus vector. Recombinant virus
      BacE1[+] expressed E1, including its C-terminal transmembrane region (TMR), and
      generated a protein which was similar in size (51 to 54 kDa) to the size of E1
      expressed in swine kidney cells infected with HCV. The protein was not secreted
      from the insect cells, and like wild-type E1, it remained sensitive to endo-beta
      N-acetyl-D-glucosaminidase H (endo H). This indicates that E1 with a TMR
      accumulates in the endoplasmic reticulum or cis-Golgi region of the cell. In
      contrast, recombinant virus BacE1[-], which expressed E1 without a C-terminal
      TMR, generated a protein that was secreted from the cells. The fraction of this
      protein that was found to be cell associated had a slightly lower molecular mass
      (49 to 52 kDa) than wild-type E1 and remained endo H sensitive. The high-mannose
      units of the secreted protein were trimmed during transport through the
      exocytotic pathway to endo H-resistant glycans, resulting in a protein with a
      lower molecular mass (46 to 48 kDa). Secreted E1 accumulated in the medium to
      about 30 micrograms/10(6) cells. This amount was about 3-fold higher than that of
      cell-associated E1 in BacE1[-] and 10-fold higher than that of cell-associated E1
      in BacE1[+]-infected Sf21 cells. Intramuscular vaccination of pigs with
      immunoaffinity-purified E1 in a double water-oil emulsion elicited high titers of
      neutralizing antibodies between 2 and 4 weeks after vaccination at the lowest
      dose tested (20 micrograms). The vaccinated pigs were completely protected
      against intranasal challenge with 100 50% lethal doses of HCV strain Brescia,
      indicating that E1 expressed in insect cells is an excellent candidate for
      development of a new, safe, and effective HCV subunit vaccine.

PMID- 8350405
TI  - Maturation of dimeric viral RNA of Moloney murine leukemia virus.
AB  - We have analyzed the dimeric RNA present in Moloney murine leukemia virus
      (MoMuLV) particles. We found that the RNA in newly released virions is in a
      conformation different from that in mature virions, since it has a different
      electrophoretic mobility in nondenaturing agarose gels and dissociates into
      monomers at a lower temperature. On the basis of these results, we suggest that
      the RNA initially packaged into nascent virions is already dimeric but that the
      dimer undergoes a maturation process after the virus is released from the cell.
      In further experiments, we tested the possibility that this maturation event is
      linked to the maturation cleavage of the virion proteins, which is catalyzed by
      the viral protease (PR). We found that the dimeric RNA isolated from PR- mutant
      virions resembles that from immature virions: it has a lower electrophoretic
      mobility and a lower sedimentation rate, and it also dissociates at a lower
      temperature than does RNA from mature wild-type virions. When Kirsten sarcoma
      virus is rescued by a PR- mutant or by a somewhat leaky cysteine array mutant of
      MoMuLV, its RNA also exhibits a electrophoretic mobility lower than that in the
      wild-type pseudotype. These results suggest that the maturation of dimeric RNA in
      released virus particles requires the cleavage of the Gag precursor and the
      presence of an intact cysteine array in the released nucleocapsid protein.

PMID- 8350406
TI  - Inhibition of African swine fever virus binding and infectivity by purified
      recombinant virus attachment protein p12.
AB  - The African swine fever virus protein p12, involved in virus attachment to the
      host cell, has an apparent molecular mass of 17 kDa in sodium dodecyl sulfate
      polyacrylamide gel electrophoresis under nonreducing conditions. We have also
      identified 12- and 10-kDa forms of the p12 protein in infected Vero cells and
      found that the mature 17-kDa protein is the only form present in virus particles.
      The p12 protein has been produced in large amounts in Spodoptera frugiperda
      insect cells infected with a recombinant baculovirus. A 17-kDa protein that
      possessed the biological properties of the viral protein was produced, since it
      bound to susceptible Vero cells and not to receptor-negative L cells, which do
      not support virus replication. The binding of the baculovirus-expressed protein
      p12 to Vero cells was specifically blocked by virus particles. In addition, the
      recombinant protein purified by immunoaffinity chromatography blocked the
      specific binding of virus particles to susceptible cells and prevented infection,
      demonstrating that the p12 protein mediates the attachment of virions to specific
      receptors and indicating that blocking the p12-mediated interaction between
      African swine fever virus and receptors in Vero cells can inhibit infection.
      However, although antibodies specific for protein p12 are induced in natural
      infections and in animals inoculated with inactivated virus or recombinant
      protein p12, these antisera did not inhibit virus binding to the host cell or
      neutralize virus infectivity.

PMID- 8350407
TI  - Sequences responsible for the distinctive hemolytic potentials of Friend and
      Moloney murine leukemia viruses are dispersed but confined to the psi-gag-PR
      region.
AB  - Friend and Moloney murine leukemia viruses (F- and M-MuLV) induce distinct
      diseases in hematopoietic tissues following inoculation of newborn mice of
      susceptible strains. F-MuLV induces erythroleukemia preceded by severe early
      hemolytic anemia; M-MuLV induces thymomas and only very mild hemolysis. The major
      viral determinant of severe early hemolytic anemia residues in the env gene, but
      sequences located outside this gene can modulate this effect. By means of genetic
      chimeras of F- and M-MuLV, we have found that although they are confined to the
      5' portion of the env gene intron, sequences that determine the distinctive
      hemolytic potentials of F- and M-MuLV are widely distributed over a region
      spanning the RNA encapsidation domain, the gag gene, and the portion of the pol
      gene encoding the viral protease. Within this large region, two fragments of M
      MuLV, a 1.3-kb region encoding the matrix, pp12, and capsid proteins and a 0.8-kb
      region encoding the nucleocapsid and the viral protease, were capable,
      individually, of partially attenuating the capacity of F-MuLV for induction of
      severe early hemolytic anemia. In association, these two fragments conferred
      complete attenuation. Moreover, a second pair of adjacent fragments within this
      large region appeared to behave cooperatively to confer complete attenuation; a
      0.36-kb region roughly corresponding to the encapsidation domain, although not
      detectably altering hemolytic potential on its own, deepened the attenuation
      conferred by the adjacent 1.3-kb region. Whether capable of inducing severe early
      hemolytic anemia or not and despite different efficiencies of induction of
      recombinant polytropic viruses, all chimeric viruses retained the
      erythroleukemogenicity of the F-MuLV parent.

PMID- 8350409
TI  - Sindbis virus membrane fusion is mediated by reduction of glycoprotein disulfide
      bridges at the cell surface.
AB  - We have examined the role of thiol-disulfide exchange reactions during the
      penetration of cells by Sindbis virus. The protein-protein association that form
      the rigid icosahedral lattice of the Sindbis virus envelope have been shown to be
      stabilized by disulfide bridges, and reduction of these critical disulfide
      bridges during cell penetration may be the mechanism by which the rigid protein
      lattice is disrupted prior to fusion (R. Anthony and D. T. Brown, J. Virol.
      65:1187-1194, 1991; R. Anthony, A. Paredes, and D. T. Brown, Virology 190:330
      336, 1992). Reduction of disulfide bridges occurs at near neutral pHs via thiol
      disulfide exchange reactions, and these reactions can be blocked by covalent
      modification of the thiol involved. In this study, the effects of the reducing
      agent 2-mercaptoethanol on Sindbis virus-mediated cell-cell fusion from without
      and the effects of the membrane-impermeable thiol-alkylating reagent 5,5'
      dithiobis(2-nitrobenzoic acid) on Sindbis virus penetration were determined. The
      presence of exogenous reducing agent was found to induce fusion from without
      under conditions unfavorable to both typical Sindbis virus-mediated fusion from
      without and cysteine-mediated thiol-disulfide exchange reactions. In addition,
      the thiol-alkylating reagent was found to inhibit Sindbis virus entry when
      present during infection. These results are consistent with a model for Sindbis
      virus entry in which reduction of critical disulfide bridges at the cell surface
      disrupts the rigid protein-protein associations of the envelope, allowing
      membrane fusion and release of the viral genome into the cell.

PMID- 8350408
TI  - Transformation by the fos or jun oncogene does not increase AP-1 DNA-binding
      activity.
AB  - The c-fos and c-jun proto-oncogenes encode components of the transcription factor
      AP-1. To determine whether transformation by the v-fos or v-jun oncogene results
      in alterations in the level or regulation of this factor, we have characterized
      AP-1 DNA-binding activity in nuclear extracts prepared from v-fos- and c-fos
      transformed rat fibroblast cell lines and v-jun-transformed chicken embryo
      fibroblasts under various growth conditions. During proliferation, the level of
      AP-1 DNA-binding activity does not differ among the v-fos, c-fos, or v-jun
      transformed cells and their normal progenitors, despite constitutive
      overexpression of the corresponding oncoproteins. Therefore, although necessary,
      it is not likely that an increase in DNA binding is sufficient for fos or jun
      transformation. Normal rat and chicken fibroblasts demonstrate very low levels of
      AP-1 DNA-binding activity when quiescent, and upon serum stimulation a biphasic
      increase is observed. A similar cyclical pattern is seen in v-fos-transformed
      cells, but in v-jun-transformed cells AP-1 DNA-binding activity does not
      fluctuate in response to serum stimulation, which suggests that this level of
      control may be exerted through the Jun component of the AP-1 complex.

PMID- 8350410
TI  - Activation of the human T-cell leukemia virus type I enhancer is mediated by
      binding sites for Elf-1 and the pets factor.
AB  - Infection with human T-cell leukemia virus type I (HTLV-I) is associated with
      adult T-cell lymphoma/leukemia. This disease occurs in only a small minority of
      people infected with HTLV-I and manifests itself many years after infection.
      Therefore, it appears that a fine balance exists between HTLV-I and the host T
      cell factors with which it interacts. HTLV-I encodes a transactivating protein,
      Tax, which activates viral transcription via cellular mechanisms which are
      incompletely understood. As viral gene expression is negligible during latency,
      it is doubtful that Tax controls the initial transition to the replicative state.
      Tax-independent cellular factors which control HTLV-I transcription, and
      presumably latency, have received little study. Recently, the product of the
      chicken proto-oncogene ets-1 has been shown to bind to the HTLV-I enhancer and
      modestly activate transcription in certain cell types (S. C. Gitlin, R. Bosselut,
      A. Gegonne, J. Ghysdael, and J. N. Brady, J. Virol. 65:5513-5523, 1991). However,
      the functional significance of the ets-binding site in the intact enhancer has
      not previously been shown. We now demonstrate that site-specific mutation of the
      purine-rich ets-binding site significantly diminishes inducible enhancer
      function, but not Tax response, in the human Jurkat T-cell line. Similarly,
      mutation of the peri-ets (pets) site, not previously noted in the HTLV-I
      enhancer, markedly inhibits inducible enhancer function but not Tax response.
      Further, we show that the predominant protein binding the purine-rich HTLV-I
      enhancer element in human T cells is not ets-1 but Elf-1, a member of the ets
      family which is very similar to the Drosophila morphogen E74. Regulation of HTLV
      I through Elf-1/pets enhancer motifs resembles that seen with human
      immunodeficiency virus type 2 (D. M. Markovitz, M. Smith, J. Hilfinger, M. C.
      Hannibal, B. Petryniak, and G. J. Nabel, J. Virol. 66:5479-5484, 1992; J. M.
      Leiden, C.-W. Wang, B. Petryniak, M. Smith, D. M. Markovitz, G. J. Nabel, and C.
      B. Thompson, J. Virol. 66:5890-5897, 1992), another human pathogenic retrovirus
      with a relatively long incubation period.

PMID- 8350411
TI  - Human immunodeficiency virus type 1 Vpu protein induces degradation of chimeric
      envelope glycoproteins bearing the cytoplasmic and anchor domains of CD4: role of
      the cytoplasmic domain in Vpu-induced degradation in the endoplasmic reticulum.
AB  - The human immunodeficiency virus type 1 (HIV-1) Vpu protein is a transmembrane
      phosphoprotein which induces rapid degradation of CD4 in the endoplasmic
      reticulum (ER). To identify sequences in CD4 for Vpu-induced degradation, we
      generated four chimeric envelope glycoproteins having the ectodomain of HIV-1
      gp160, the anchor domain of CD4, and 38, 25, 24, and 18 amino acids (aa) of the
      CD4 cytoplasmic domain. Using the vaccinia virus-T7 RNA polymerase expression
      system, we analyzed the expression of chimeric proteins in the presence and
      absence of Vpu. In singly transfected cells, the chimeric envelope glycoproteins
      having 38, 24, and 18 aa of the CD4 cytoplasmic domain were endoproteolytically
      cleaved and biologically active in the fusion of HeLa CD4+ cells. However, one of
      the chimeras having 25 aa of the CD4 cytoplasmic tail was retained in the ER
      using the transmembrane ER retention signal and was defective in membrane fusion.
      Furthermore, biochemical analyses of the coexpressing cells revealed that the Vpu
      protein induced degradation of the envelope glycoproteins having 38, 25, and 24
      aa of the CD4 cytoplasmic tail and degradation occurred in the ER. Consequently,
      the fusion-competent glycoproteins did not induce the formation of syncytia in
      HeLa CD4+ cells expressing Vpu. However, the HIV-1 gp160 and chimeric envelope
      glycoprotein having the membrane-proximal 18 aa of the CD4 cytoplasmic tail were
      stable and fusion competent in cells expressing Vpu. In addition, we examined the
      stability of CD4 molecules in the presence of Vpu. Coexpression analyses revealed
      that the Vpu protein induced degradation of CD4 whereas mutant CD4 having the
      membrane-proximal 18 aa of the cytoplasmic domain was relatively stable in the
      presence of Vpu. Taken together, these studies have elucidated that the Vpu
      protein requires sequences or sequence determinants in the cytoplasmic domain of
      CD4 to induce degradation of the glycoproteins in the cell.

PMID- 8350412
TI  - Role of the His-Cys finger of Moloney murine leukemia virus integrase protein in
      integration and disintegration.
AB  - Retroviral integrases mediate site-specific endonuclease and transesterification
      reactions in the absence of exogenous energy. The basis for the sequence
      specificity in these integrase-viral DNA recognition processes is unknown.
      Structural analogs of the disintegration substrate were made to analyze the
      disintegration reaction mechanism for the Moloney murine leukemia virus (M-MuLV)
      integrase (IN). Modifications in the target DNA portion of the disintegration
      substrate decreased enzymatic activity, while substitution of the highly
      conserved CA in the viral long terminal repeat portion had no effect on activity.
      The role of the His-Cys finger region in catalysis was addressed by N
      ethylmaleimide (NEM) modification of the cysteine residues of M-MuLV IN as well
      as by mutations. Both integration activities, 3' processing, and strand transfer,
      were completely inhibited by NEM modification of M-MuLV IN, while disintegration
      activity was only partially sensitive. However, structural analogs of the
      disintegration substrates that were modified in the target DNA and had the
      conserved CA removed were not active with NEM-treated M-MuLV IN. In addition,
      mutants made in the His-Cys region of M-MuLV IN were examined and found to also
      be completely blocked in integration but not disintegration activity. These data
      suggest that the domains of M-MuLV IN that are required for the forward
      integration reaction substrate differ from those required for the reverse
      disintegration reaction substrate.

PMID- 8350413
TI  - A heptanucleotide sequence mediates ribosomal frameshifting in mammalian cells.
AB  - Ribosomal frameshifting is an essential requirement for replication of many
      viruses and retrovirus-like elements. It is regarded as a potential target for
      antiretroviral therapy. It has been shown that the frameshifting event takes
      place in the -1 direction within a sequence, the slippery sequence, which is
      usually followed by structured RNA. To distinguish between the basic sequence
      requirements and the modulating elements in intact cells, we have established a
      sensitive assay system for quantitative determination of ribosomal frameshifting
      in mammalian cell culture. In this assay system, the gag and pol genes of human
      immunodeficiency virus type 1 are replaced by the genes for the functional
      enzymes beta-galactosidase and luciferase, respectively. The sensitivity of the
      test system allows us to demonstrate for the first time that the slippery
      sequence, a heptanucleotide, is sufficient to mediate a basal level of ribosomal
      frameshifting independent of its position within a gene. The stem-loop sequence
      serves only as a positive modulator. These data indicate that frameshifting could
      also occur during translation of cellular genes in which a slippery sequence is
      present within the reading frame. The resulting putative transframe proteins
      might have a functional importance for cellular processes.

PMID- 8350414
TI  - Functional analysis of interactions between Tat and the trans-activation response
      element of human immunodeficiency virus type 1 in cells.
AB  - Transcriptional trans-activation of the human immunodeficiency virus type 1 long
      terminal repeat requires that the virally encoded Tat effector interacts with its
      target trans-activation response element (TAR) RNA stem-loop. Although the
      arginine-rich region of Tat from amino acids 49 to 59 is sufficient to bind to
      TAR RNA in vitro, the RNA-binding domain of Tat has not been defined in vivo.
      Human immunodeficiency virus type 1 also encodes the Rev protein, which acts
      through an RNA stem-loop called the Rev-response element to transport unspliced
      and singly spliced viral RNA species from the nucleus to the cytoplasm. To map
      the RNA-binding domain of Tat, we performed assays that relied on Rev function
      using the heterologous RNA-tethering mechanism of Tat and the TAR. By examining
      the effects of selected targeted mutations of Tat on the abilities of hybrid
      Tat/Rev proteins to rescue the expression of unspliced mRNA via the TAR, we
      demonstrated that residues throughout the N-terminal 59 amino acids of Tat are
      required for binding of Tat and TAR RNA in vivo.

PMID- 8350416
TI  - Evidence that the structural conformation of envelope gp120 affects human
      immunodeficiency virus type 1 infectivity, host range, and syncytium-forming
      ability.
AB  - We investigated how amino acid changes within and outside the V3 loop of the
      envelope glycoprotein of human immunodeficiency virus type 1 influence the
      infectivity, host range, and syncytium-forming ability of the virus. Our studies
      show that on the genomic backgrounds of the human immunodeficiency virus type 1
      strains SF2 and SF13, a reciprocal exchange of full-loop sequences does not alter
      the syncytium-forming ability of the viruses, indicating that a determinant(s)
      for this biological property maps outside the loop. However, specific amino acid
      substitutions, both within and outside the V3 loop, resulted in loss of
      infectivity, host range, and syncytium-forming potential of the virus.
      Furthermore, it appears that a functional interaction of the V3 loop with regions
      in the C2 domain of envelope gp120 plays a role in determining these biological
      properties. Structural studies of mutant glycoproteins show that the mutations
      introduced affect the proper association of gp120 with the transmembrane
      glycoprotein gp41. Our results suggest that mutations that alter the structure of
      the V3 loop can affect the overall conformation of gp120 and that, reciprocally,
      the structure of the V3 loop is influenced by the conformation of other regions
      of gp120. Since the changes in the replicative potential, host range, and
      fusogenic ability of the mutant viruses correlate well with the changes in gp120
      conformation, as monitored by the association of gp120 with gp41, our results
      support a close relationship between envelope gp120 structural conformation and
      the biological phenotype of the virus.

PMID- 8350415
TI  - V3 loop of the human immunodeficiency virus type 1 Env protein: interpreting
      sequence variability.
AB  - Two different states of human immunodeficiency virus type 1 are apparent in the
      asymptomatic and late stages of infection. Important determinants associated with
      these two states have been found within the V3 loop of the viral Env protein. In
      this study, two large data sets of published V3 sequences were analyzed to
      identify patterns of sequence variability that would correspond to these two
      states of the virus. We were especially interested in the pattern of basic amino
      acid substitutions, since the presence of basic amino acids in V3 has been shown
      to change virus tropism in cell culture. Four features of the sequence
      heterogeneity in V3 were observed: (i) approximately 70% of all nonconservative
      basic substitutions occur at four positions in V3, and V3 sequences with a basic
      substitution in at least one of these four positions contain approximately 95% of
      all nonconservative basic substitutions; (ii) substitution patterns within V3 are
      influenced by the identity of the amino acid at position 25; (iii) sequence
      polymorphisms account for a significant fraction of uncharged amino acid
      substitutions at several positions in V3, and sequence heterogeneity other than
      these polymorphisms is most significant at two positions near the tip of V3; and
      (iv) sequence heterogeneity in V3 (in addition to the basic amino acid
      substitutions) is approximately twofold greater in V3 sequences that contain
      basic amino acid substitutions. By using this sequence analysis, we were able to
      identify distinct groups of V3 sequences in infected patients that appear to
      correspond to these two virus states. The identification of these discrete
      sequence patterns in vivo demonstrates how the V3 sequence can be used as a
      genetic marker for studying the two states of human immunodeficiency virus type
      1.

PMID- 8350417
TI  - Detection of Leishmania RNA virus 1 proteins.
AB  - Polyclonal antiserum was raised against the peak viral fraction of a sucrose
      gradient from LRV1-4-infected cells and used in Western immunoblot analysis to
      identify viral proteins from various isolates. Consistent with this result, in
      vitro-translated protein from cloned RNA was immunoprecipitated with the same
      antiserum. The putative capsid at times appeared as a doublet; relative amounts
      of the two species varied, depending on the method of purification.

PMID- 8350418
TI  - Evidence for a base-paired region of hepatitis B virus pregenome encapsidation
      signal which influences the patterns of precore mutations abolishing HBe protein
      expression.
AB  - In two natural HBe-minus hepatitis B virus mutants, expression of HBe protein was
      abrogated by a nonsense mutation at precore codon 28 and a frameshift mutation at
      codon 29, respectively. Both mutants contained an additional nucleotide
      substitution(s) which was found by transfection experiments to be required for
      efficient packaging of pregenomic RNA. The observed mutational profiles were
      consistent with the presence of a base-paired region of the pregenome
      encapsidation signal overlapping the HBe-coding sequence. Results obtained with
      artificial mutants with significant changes in the primary sequence suggested
      that base pairing is required but insufficient for efficient pregenome packaging.
      However, the predicted first four base pairs of the stem are dispensable.

PMID- 8350419
TI  - The major capsid protein VP2 of minute virus of mice (MVM) can form particles
      which bind to the 3'-terminal hairpin of MVM replicative-form DNA and package
      single-stranded viral progeny DNA.
AB  - The capsids of minute virus of mice (MVM) consist of two closely related
      proteins, VP1 and VP2. We inactivated the VP1 gene in an infectious clone of MVM
      DNA by frameshift mutation. After transfection of mutated DNA, capsids consisting
      of VP2 only were made. They can package negative-strand DNA, and they
      specifically bind MVM 3'-terminal hairpin DNA.

PMID- 8350420
TI  - Bovine herpesvirus 1: immune responses in mice and cattle injected with plasmid
      DNA.
AB  - Mice and cattle injected with plasmids encoding bovine herpesvirus 1 (BHV-1)
      glycoproteins developed gene-specific antibody responses capable of neutralizing
      BHV-1. The ability of animals to respond serologically to DNA injections was in
      part dependent on the quantity of DNA injected and was also negatively affected
      by carrier DNA. Calves injected with a plasmid encoding BHV-1 gIV developed
      significant antibody titers to gIV and shed less virus than did the control calf
      after challenge. This report indicates the potential of DNA injection as a method
      of vaccination.

PMID- 8350421
TI  - The small subunit of the vaccinia virus early transcription factor contacts the
      transcription promoter DNA.
AB  - The vaccinia virus early transcription factor (VETF), in addition to the viral
      RNA polymerase, is required for efficient transcription of early genes in vitro.
      VETF is a heterodimeric protein that binds specifically to early gene promoters.
      In order to localize the VETF DNA binding domain, we have used photoreactive
      oligonucleotide probes with the sequence of the vaccinia virus growth factor
      promoter. The probes consisted of double-stranded oligonucleotides incorporating
      radiolabeled dAMP and 5-bromo-dUMP into sequences of the promoter known to
      contact VETF. Irradiation of a DNA probe having these nucleotides located
      upstream of the transcription start site in the presence of VETF resulted in the
      transfer of label to a polypeptide that comigrated with the small subunit of
      VETF. The label transfer reaction was shown to occur with the recombinant VETF
      small subunit in the absence of the large subunit. These results indicate that
      the small subunit comprises at least part of the VETF DNA binding domain and
      contacts the promoter in the region upstream of the transcription start site.

PMID- 8350423
TI  - Regional adenosine attenuates postischemic spinal cord injury.
AB  - PURPOSE: Operations on the thoracic and thoracoabdominal aorta are associated
      with postoperative paraplegia rates as high as 20% to 30%. Attempts to reduce
      this complication have focused on decreasing the energy needs of the spinal cord
      with protective agents such as hypothermia and barbiturates or on increasing
      blood flow with various shunts. This study explores the hypothesis that perfusion
      of the spinal cord with hypothermic solutions or with adenosine will prevent or
      ameliorate paraplegia. METHODS: New Zealand white rabbits underwent 40 minutes of
      infrarenal aortic isolation. The infrarenal aorta is the primary source of spinal
      cord blood supply in the New Zealand white rabbit. Control rabbits sustained
      aortic occlusion without any protective measures. The remaining animals were
      randomized into three groups that underwent aortic cross-clamping with various
      protective adjuncts. Group I received regional aortic hypothermia perfusion,
      group II received systemic adenosine, and group III received regional aortic
      perfusion with high-dose adenosine. RESULTS: Neurologic function was graded
      according to the Tarlov scale (0 = no movement, 1 = slight movement, 2 = sits
      with assistance, 3 = sits alone, 4 = weak hop, 5 = normal hop). After 96 hours
      animals were euthanized, and spinal cords were harvested for histologic
      examination. The nonparaplegic animals in group I had a mean Tarlov score of 1.5,
      whereas those in group III had a mean score of 3.4. Histologic studies on spinal
      cord tissue revealed no significant differences between the study groups.
      CONCLUSIONS: These data demonstrate that administration of regional adenosine
      attenuates ischemic injury associated with aortic occlusion in this experimental
      model.

PMID- 8350422
TI  - Transcomplementation of simian immunodeficiency virus Rev with human T-cell
      leukemia virus type I Rex.
AB  - A molecular clone of the simian immunodeficiency virus SIVSMM isolate PBj14,
      lacking the ATG initiation codon for Rev protein (PBj-1.5), did not produce virus
      or large unspliced or singly spliced viral RNA upon transfection of HeLa cells.
      Low but significant levels of virus and large viral RNA production were observed
      upon transfection of PBj-1.5 into HeLa Rev cells expressing the rev gene of human
      immunodeficiency virus type 1. Furthermore, abundant virus and large viral RNA
      production occurred upon transfection of PBj-1.5 into HeLa Rex cells expressing
      the rex gene of human T-cell leukemia virus type I. Virus produced from HeLa Rex
      and HeLa Rev transfections was infectious, produced large amounts of virus, and
      was cytopathic for Rex-producing MT-4 cells. In contrast, no or only low levels
      of virus production were observed upon infection of H9 cells. These studies show
      that a defective SIV rev gene can be transcomplemented with human
      immunodeficiency virus type 1 Rev and with high efficiency by human T-cell
      leukemia virus type I Rex, and they suggest that rev-defective viruses could
      serve as a source for production of a live attenuated SIV vaccine.

PMID- 8350424
TI  - Cigarette smoke alters chylomicron metabolism in rats.
AB  - PURPOSE: Cigarette smoking may exert its atherogenic effect by delaying the
      plasma clearance of dietary fat and cholesterol, allowing more time for their
      interaction with the artery wall. To study the effects of smoke on chylomicron
      metabolism in rats, we examined the metabolic effects of smoke on both whole
      animals and chylomicron particles in vitro. METHODS: Carbon 14- and hydrogen 3
      labeled chylomicrons were injected intravenously into smoke-treated rats and
      control rats that were not exposed to smoke (sham smoked). Plasma clearance,
      hepatic uptake, and heart binding were measured. In a second set of experiments,
      chylomicron particles were exposed to cigarette smoke in vitro by either: (1)
      passing smoke through chylomicrons suspended in saline solution (SCM) or (2)
      passing smoke through saline solution alone, then mixing the saline solution with
      chylomicrons (CM + SS). Normal (non-smoke exposed) rats were infused with either
      SCM, CM + SS, or control chylomicrons (CCM). Plasma clearance, hepatic uptake,
      and heart binding were again measured. RESULTS: The initial plasma clearance time
      of labeled chylomicrons did not differ between smoke-treated and control animals.
      However, hepatic uptake of chylomicron cholesterol was slower in smoke-treated
      animals (46.1% +/- 0.9% of injected dose) than in controls (61.5% +/- 2.1%, p <
      0.001). In contrast, more labeled chylomicrons remained in the heart of smoke
      treated rats than controls (0.89% +/- 0.18% vs 0.45% +/- 0.05%, p < 0.05).
      Disappearance of 14C-labeled cholesterol from blood was delayed in rats injected
      with SCM (half-life = 9.0 +/- 0.4 minutes) and CM + SS (half-life = 8.0 +/- 0.4
      minutes), compared with the time in rats injected with CCM (6.6 +/- 0.3 minutes,
      p < 0.05). Hepatic uptake of SCM (40.6% +/- 1.9% of injected dose) and CM + SS
      (45.0% +/- 1.9%) was less than that of CCM (60.7% +/- 4.4%, p < 0.05). In
      addition, the binding to the heart increased from 0.97% +/- 0.29% (CCM) to 2.45%
      +/- 0.30% with the infusion of SCM (p < 0.05). The binding in the heart of CM +
      SS (0.95% +/- 0.04%) was not different from that of CCM. CONCLUSIONS: These data
      demonstrate for the first time that cigarette smoke exposure prolongs chylomicron
      residence time in tissues (heart) and delays hepatic uptake of chylomicron
      cholesterol in rats. The effect is present when either the animal or the
      chylomicron particle is exposed to smoke. We hypothesize that prolonged binding
      of relatively cholesterol-rich chylomicron remnants to endothelial surfaces could
      create a more atherogenic postprandial milieu.

PMID- 8350425
TI  - Distribution of c-myc oncoprotein in healthy and atherosclerotic human carotid
      arteries.
AB  - PURPOSE: Smooth muscle cell (SMC) proliferation is a central event in the
      development of arteriosclerotic plaque. Regulation of this proliferative process
      is controlled in part by the action of specific peptide growth factors that may
      influence early cell-cycle regulatory gene expression. Such "early" response
      genes include the protooncogene c-myc, which has been implicated in the induction
      of cell proliferation and differentiation. We compared the distribution of the c
      myc protooncogene product in healthy and atherosclerotic human carotid arteries
      to determine its cellular and tissue localization. METHODS: Samples of six
      carotid artery plaques from six patients were rapidly frozen in liquid nitrogen
      at the time of carotid endarterectomy. Three nondiseased human carotid arteries
      obtained at organ harvest from brain-dead organ donors were similarly prepared.
      Frozen sections were labeled with a polyclonal rabbit anti-c-myc antibody that
      recognizes the 64 kd c-myc human protein. The percentages of cells positive for c
      myc (c-myc index) and the intensity of antibody labeling were determined.
      RESULTS: Normal human carotid artery demonstrated minimal, isolated cell
      staining, with single scattered grains of immunocytochemical staining product
      seen in SMC nuclei. The myc index was 14.7% +/- 3.5% positive cells. In
      comparison, SMCs from carotid plaque showed a significant predominance of c-myc
      immunoreactive cells (89.8% +/- 4%; p < 0.001). The intensity of c-myc staining
      was greater in plaque SMCs, with many of the cells demonstrating confluence of
      immunocytochemical precipitate throughout 50% of SMC nuclei. CONCLUSIONS:
      Although the exact role of enhanced expression of the c-myc protooncogene in
      atherosclerosis is unclear, a cooperative influence of abnormal early cell-cycle
      gene expression and humoral factors may initiate the atherogenic process. The c
      myc gene and other protooncogenes are early molecular markers of cell-cycle
      activity, which may be important in the development of atherosclerosis and
      occlusive vascular disease.

PMID- 8350426
TI  - Endothelin production by hypoxic human endothelium.
AB  - PURPOSE: The physiologic significance of endothelin remains incompletely defined.
      Procoagulant and antifibrinolytic activities are increased in hypoxic cultured
      human umbilical venous endothelial cells (HUVEC). We examined the effect of
      hypoxia on HUVEC endothelin-1 production in vitro to determine whether a
      correlation existed between the procoagulant and antifibrinolytic response to
      hypoxia previously observed and an increase in vasoconstrictor peptide secretion
      by hypoxic HUVEC. METHODS: Cultured HUVEC were rendered hypoxic (PO2 = 40 mm Hg)
      or control (PO2 = 120 mm Hg) for 24 hours. Media were either standard, 5 gm
      glucose/L (high glucose), or contained 500 units superoxide dismutase/ml (SOD).
      Endothelin-like immunoreactivity for endothelin-1 (ET-IR) in conditioned media
      was measured by radioimmunoassay and expressed as mean femtomoles per milliliter
      (+/- SD) per 100,000 cells. Viability of HUVEC was assessed by trypan blue
      exclusion. Significance was determined by use of Student's t test. RESULTS:
      Conditioned media from hypoxic cells contained 76% more ET-IR than was found in
      control counterparts (p < 0.004). The addition of high glucose or SOD did not
      diminish ET-IR; a trend to higher ET-IR was present in both these groups versus
      standard media (303% and 226%, respectively, p < 0.03). CONCLUSIONS: Thus 24
      hours of hypoxia caused an increase in conditioned-media ET-IR in cultured HUVEC.
      Because SOD or greater substrate availability did not diminish endothelin
      presence in conditioned media, it seems that hypoxic induction of endothelin-1
      production or secretion is signaled in a fashion unrelated to cell toxicity from
      the hypoxic period.

PMID- 8350427
TI  - Transfemoral endovascular aortic graft placement.
AB  - PURPOSE: The purpose of this study was to develop an endovascular system for
      transfemoral placement of straight aortic grafts and bifurcated aortoiliac
      grafts. METHODS: Both types of graft consist of barbed, self-expanding stents
      attached to a woven polyester fabric. Survival studies of straight-graft function
      were performed in six large mongrel dogs. Digital subtraction fluoroscopic
      equipment was used to guide insertion and record angiograms at 0, 1, and 3
      months. Bifurcated grafts were inserted in an additional eight dogs, four with
      distal stents and four without. Straight grafts were inserted into six cadaveric
      aortas (five atherosclerotic and one aneurysmal; age 68.7 + 5.7 years) to assess
      stent attachment. RESULTS: Angiograms obtained immediately after straight-graft
      insertion showed placement to be within 4.6 + 1.6 mm of the intended level.
      Follow-up angiograms at 1 and 3 months showed no migration, no leakage, and
      patency of all six grafts. After bifurcated graft insertion there were no
      angiographic signs of perigraft leakage, with or without distal stents. The mean
      force required to displace straight grafts 10 mm from their original position in
      cadaveric aortas was 1388 + 127 g. CONCLUSION: These preliminary results show
      that straight and bifurcated endovascular grafts can be positioned accurately and
      securely in the abdominal aorta.

PMID- 8350428
TI  - Saphenous vein angioscopy: a valuable method to detect unsuspected venous
      disease.
AB  - PURPOSE: The presence of preexisting saphenous vein lesions adversely affects
      graft patency. Despite careful preoperative venous duplex examination and
      meticulous intraoperative evaluation, clinically significant saphenous vein
      disease may remain undetected. We evaluated angioscopy as a means to better
      detect these vein lesions. METHODS: Ninety saphenous vein remnants, obtained at
      bypass surgery, were perfusion fixed for subsequent angioscopic and histologic
      evaluation. The specimens were categorized by independent examiners on the basis
      of the angioscopic or light microscopic findings. Of the 90 vein remnants, 66
      were normal by angioscopic criteria. Fifty-three (80%) of these angioscopically
      normal vein segments were normal histologically, and all 24 angioscopically
      abnormal saphenous vein remnants showed disease on microscopic examination.
      RESULTS: Angioscopy correctly identified sclerotic vein segments (n = 20) by
      irregular white plaques, whereas postphlebitic veins (n = 3) demonstrated
      multiple lumens, fibrous strands, and thickened opaque valve cusps on angioscopic
      evaluation. Absence of an angioscopic lumen was confirmed histologically in
      occluded veins (n = 2). Angioscopy failed to identify thick-walled (n = 10) and
      varicose (n = 2) vein segments as abnormal; one sclerotic segment was normal
      angioscopically, thereby lowering the sensitivity of angioscopy. CONCLUSIONS:
      Angioscopy detected unsuspected preexisting saphenous vein disease in five
      patients undergoing arterial reconstruction with saphenous vein. Because the use
      of angioscopy is a reliable means of prospectively assessing the vein for most
      preexisting lesions, its routine use may ultimately improve graft patency.

PMID- 8350429
TI  - Periodic hemodynamics (flow motion) in peripheral arterial occlusive disease.
AB  - PURPOSE: The occurrence of periodic blood flow variations (flow motion) in health
      and disease is controversially discussed. This is partly due to not reporting the
      incidence and to performing the analysis solely visually. We have therefore
      studied flow motion with computerized methods. METHODS: We used a computerized
      Prony spectral line estimator program to analyze the frequencies of resting skin
      blood flow variations, as determined by laser Doppler flowmetry on the thumb and
      great toe, in 50 male control subjects (group a), in 50 patients with mild
      peripheral arterial occlusive disease (PAOD stages I and II; group b), and in 25
      patients with severe PAOD (stages III and IV; group c). RESULTS: The median
      ankle/arm pressure ratio was 1.10 in the control group, 0.72 in the mild PAOD
      group, and 0.66 in the severe PAOD group. Slow wave flow motion was detected in
      19% of all thumbs from groups a and b (systolic arm pressures > 100 mm Hg) and in
      12% of the toes in the control group. Patients with mild PAOD exhibited slow wave
      flow motion in 46% of the toes. Patients with severe PAOD showed slow waves in
      77% of the toes. The median flow motion frequencies were about 1.6 cycles/min for
      groups a and b, when present. The median frequency in group c was significantly
      higher at 4.0 cycles/min, though still in the range of slow waves. The median
      peak-to-through amplitude was between 17% and 20% of mean flow for all groups.
      CONCLUSIONS: We conclude that evaluation of flow motion requires computerized
      frequency analysis and that slow wave flow motion is a perfusion pattern
      characteristic of PAOD rather than of normal perfusion states. This finding has
      potential implications for diagnostic and therapeutic approaches in arterial
      occlusive disease.

PMID- 8350430
TI  - Cryopreserved venous allografts: effects of immunosuppression and antiplatelet
      therapy on patency and function.
AB  - PURPOSE: Experiments were designed to determine the function of the endothelium
      and smooth muscle in cryopreserved and fresh canine saphenous vein allografts.
      METHODS: Reversed interposition saphenous vein grafts were implanted into the
      femoral arteries of two groups of dogs: group 1 received one freshly harvested
      saphenous vein allograft and group 2 received one cryopreserved saphenous vein
      allograft. The contralateral femoral artery in each group was replaced with a
      freshly harvested autogenous saphenous vein. Animals received oral cyclosporine
      alone (n = 3) or in combination with aspirin (325 mg/day; n = 20). RESULTS: Four
      weeks after surgery, none of the cryopreserved grafts was patent in the group
      treated with cyclosporine alone. All grafts were patent in animals treated with
      cyclosporine and aspirin. At 4 weeks, blood flow through cryopreserved allografts
      was significantly greater than in freshly harvested allografts. Platelet
      deposition was comparable in cryopreserved and freshly harvested allografts
      immediately after implantation and at 4 weeks. Rings cut from the grafts were
      suspended for the measurement of isometric force in organ chambers. alpha
      Adrenergic agonists and endothelin caused concentration-dependent contractions in
      fresh autografts and allografts. After submaximal contraction with prostaglandin
      F2 alpha in these same grafts, calcium ionophore and thrombin caused relaxations
      in rings with endothelium, and nitric oxide caused relaxations in rings without
      endothelium. Cryopreserved allografts did not respond to any of the agonists
      tested. Histologic examination of the tissue indicated smooth muscle cells in
      cryopreserved grafts; evidence of rejection was observed in all allografts.
      CONCLUSION: These results indicate that cryopreserved allografts remain patent
      with antiplatelet and immunosuppressive therapy in spite of loss of functional
      smooth muscle.

PMID- 8350431
TI  - Alloxan diabetes alters the rabbit transarterial wall oxygen gradient.
AB  - PURPOSE: Atherosclerotic vascular occlusive disease is the most common
      complication of diabetes mellitus and accounts for 75% of deaths in diabetic
      patients. Determining the initiator and continuing stimulus for the cellular
      events in the formation of atherosclerotic lesions in diabetic patients could
      lead to the prevention of this common and deadly complication. Diabetes-induced
      arterial wall hypoxia is proposed as an initiator and continuing stimulus for
      atherosclerotic vascular occlusive disease. METHODS: Transarterial wall oxygen
      gradient measurements were performed on the infrarenal aorta with an oxygen
      microelectrode 14 to 16 weeks after the induction of alloxan diabetes in rabbits.
      RESULTS: Both insulin-treated and untreated alloxan diabetic rabbits revealed
      significantly decreased oxygen tensions throughout the arterial wall compared
      with control rabbits. There was no significant difference in the transarterial
      wall oxygen gradient between the two groups of diabetic rabbits. This effect was
      noted despite no difference in the partial pressure of oxygen in arterial blood
      or visual evidence of atherosclerotic lesion formation in the three groups.
      CONCLUSIONS: These findings suggest that diabetes induces arterial wall hypoxia
      independent of insulin therapy and before the formation of atherosclerotic
      lesions. Diabetes-induced arterial wall hypoxia may contribute to the formation
      of atherosclerotic lesions.

PMID- 8350433
TI  - Persistent sciatic artery: embryology, pathology, and treatment.
AB  - PURPOSE: The purpose of this article is to describe the embryologic development
      and anomalous persistence of the sciatic artery, pathologic changes that may
      occur in the persistent sciatic artery, and management of complications related
      to these pathologic changes. METHODS: Two patients with persistence of the
      sciatic artery treated in the authors' experience are reported. In addition, the
      computerized data base of the University of Mississippi Medical Center was
      searched for patients with other lower extremity arterial aneurysms, and their
      records were reviewed for possible aneurysm of a persistent sciatic artery. A
      review of the literature was undertaken to determine the embryologic development
      of the persistent sciatic artery, the pathologic changes that have been observed
      in the sciatic artery, clinical findings associated with these pathologic
      changes, and methods of treatment. RESULTS: Two patients with persistence of the
      sciatic artery were treated by the authors. No other cases were identified in 43
      patients with 66 lower extremity aneurysms treated at our institution. The first
      patient presented with acute lower extremity ischemia caused by thrombosis of a
      sciatic artery aneurysm and was treated successfully with intraarterial
      thrombolytic therapy followed by interposition graft repair. In the second case
      an incidental unilateral persistent sciatic artery was identified in a patient
      with bilateral Buerger's disease presenting with digital gangrene of the
      contralateral extremity in whom below-knee amputation was eventually required.
      Bilateral tibial artery occlusion was observed on arteriography. Histologic
      examination of the amputated limb confirmed findings typical of Buerger's
      disease, and no microemboli were seen. DISCUSSION: The sciatic artery is a
      continuation of the internal iliac artery and is the primary blood supply to the
      lower limb bud during early fetal development. The sciatic artery normally
      involutes during fetal development, but remnants persist as the popliteal and
      peroneal arteries after the superficial femoral artery develops and establishes
      continuity with the popliteal artery. Persistence of the sciatic artery as the
      major blood supply to the lower extremity in adults is a rare vascular anomaly
      that may be of surgical significance. Failure to appreciate the persistent
      sciatic artery as the major inflow into the lower extremity may lead to
      inappropriate bypass of apparent occlusive disease of the superficial femoral
      artery. The persistent sciatic artery is also frequently aneurysmal, which may
      cause critical limb ischemia resulting from thrombosis or embolization of
      aneurysm thrombus. Options for vascular reconstruction include interposition
      graft replacement and standard femoropopliteal bypass grafting if the common
      femoral artery is sufficiently developed to provide adequate inflow. As with
      other peripheral arterial aneurysms resulting in thrombosis and extensive distal
      arterial embolization and thrombosis, intraarterial thrombolytic therapy may be
      useful in selected cases before definitive surgical revascularization.

PMID- 8350432
TI  - The preferential use of the external iliac artery as an inflow source for redo
      femoropopliteal and infrapopliteal bypass.
AB  - PURPOSE: It is believed that secondary operations involving the inguinal region
      are associated with a significant morbidity that includes infection, lymphatic
      obstruction, lymphorrhea, and neurovascular injury. To prevent these potentially
      important complications we have avoided a redo groin incision in 38 patients with
      severely symptomatic disease who had primary (23 cases) or secondary (15 cases)
      femoropopliteal bypass thrombosis during the past 3 years. METHODS: All patients
      were candidates for prosthetic bypasses because of lack of a suitable vein.
      Twenty-nine external iliac-to-popliteal bypasses (18 above-knee; 11 below-knee)
      and nine external iliac-to-infrapopliteal bypasses (five anterior tibial; two
      posterior tibial; two peroneal) were performed with 6 mm polytetrafluoroethylene
      ringed grafts in 38 patients. Adjunctive distal arteriovenous fistulas were
      constructed in all infrapopliteal bypasses. The external iliac artery was exposed
      via a retroperitoneal approach. The second incision was placed just below the
      scarred area and deepened to the level of the medial border of the sartorius
      muscle. A tunnel that connected both incisions was easily created by blunt
      dissection alongside the anterolateral border of the femoral artery. RESULTS:
      Four popliteal bypasses occluded at 4, 6, 10, and 28 months after operation. The
      remaining 25 grafts are patent (mean 14 months). Three of the infrapopliteal
      bypasses occluded at 0, 2, and 3 months after operation. The remaining six grafts
      are patent with follow-up from 4 to 18 months (mean 12 months). Only one patient
      had a superficial wound infection at the below-knee popliteal incision, which
      healed with local treatment. All other patients had an uneventful postoperative
      course. CONCLUSIONS: Thus we believe this approach to be simple, safe, and
      durable and should be used preferentially to avoid the difficult and hazardous
      dissection of a previously operated groin.

PMID- 8350434
TI  - Late nonfatal and fatal cardiac events after infrainguinal bypass for
      femoropopliteal occlusive disease during a thirty-one-year period.
AB  - PURPOSE AND METHODS: In patients with peripheral vascular disease the
      complications of associated coronary artery disease have always been a leading
      cause of morbidity and mortality. Therefore we evaluated the risk for late
      cardiac morbidity and mortality in 376 consecutive patients after infrainguinal
      bypass. Follow-up was complete for 373 patients (99.3%) with a mean follow-up
      period of 5.9 years. After operation all but four patients were treated with
      lifelong warfarin (Coumadin therapy.) RESULTS: During follow-up 129 patients
      (34.3%) had 183 late cardiac events. Of these patients, 79 (61.2%) died of late
      cardiac events and 13 (10.0%) required either coronary angioplasty or bypass. The
      risk of late cardiac events was 34% at 5 years and increased to 56% at 15 years.
      Multivariate analysis demonstrated that age, cardiac disease, and impaired renal
      function at the time of operation were associated with an increased risk of
      cardiac events during follow-up. Independent predictors of cardiac death were
      age, cardiac disease, hypertension, diabetes, and impaired renal function.
      Morbidity and mortality was particularly high in patients with critical ischemia.
      The subset of patients with claudication had a life expectancy that appeared to
      be similar to that of a matched sample of the normal population. CONCLUSIONS: Our
      findings clearly demonstrate that some patients undergoing infrainguinal bypass
      are at high risk for late cardiac events of which many are fatal, whereas others
      may have an almost normal life expectancy. Most important, the occurrence of
      cardiac events may be predicted by simple and readily obtainable clinical
      variables at the time of the initial infrainguinal bypass procedure. Because
      these events were related to late cardiac death, this may be the key for
      angiographic evaluation and possible prevention of cardiac death.

PMID- 8350435
TI  - Should the Cell Saver Autotransfusion Device be used routinely in all infrarenal
      abdominal aortic bypass operations?
AB  - PURPOSE: The purpose of this study was to attempt to identify a group of patients
      undergoing infrarenal aortic bypass in whom blood loss is consistently less than
      2 units, making the routine use of autotransfusion devices unnecessary. METHODS:
      Four groups of patients were prospectively studied as follows: abdominal aortic
      aneurysm (AAA) repair with tube graft (n = 21), AAA repair with bifemoral or
      biiliac bypass (n = 19), and aortobifemoral bypass (AFB) or biiliac bypass for
      occlusive disease either with Cell Saver Autotransfusion Device (Haemonetics
      Corp., Braintree, Mass.) (n = 18) or without Cell Saver (n = 18). The latter two
      groups were randomized on an alternating basis. RESULTS: The following parameters
      were obtained on all patients: preoperative hemoglobin values, estimated blood
      loss, Cell Saver return volumes, intraoperative and postoperative homologous
      blood transfused, postoperative hemoglobin values on the day of surgery and on
      postoperative days 1 and 4, complications, and length of hospital stay. In
      comparing the groups undergoing AFB with Cell Saver and AFB without Cell Saver by
      the above parameters, we found no statistically significant differences, except
      for a higher hemoglobin level on postoperative day 1 in the group undergoing AFB
      with Cell Saver (mean 11.86 vs 10.74, p = 0.02). The estimated blood loss and
      Cell Saver return volumes were less for those patients undergoing AFB for
      occlusive disease compared with those undergoing AFB for aneurysmal disease.
      Interestingly, estimated blood loss and Cell Saver return volumes for patients
      with AAA with tube graft and patients undergoing AFB with Cell Saver were
      similar. CONCLUSIONS: We conclude that routine setup and use of rapid
      autotransfusion devices may not be necessary in every patient undergoing routine
      aortofemoral bypass for occlusive disease. Furthermore, the possibility that some
      patients may undergo AAA repair with tube grafts without use of the Cell Saver
      may be deserving of further investigation.

PMID- 8350436
TI  - Expression and sequence of the gene for tissue inhibitor of metalloproteinases in
      patients with abdominal aortic aneurysms.
AB  - PURPOSE: The tissue inhibitors of metalloproteinases (TIMPs) are major inhibitors
      of several enzymes that are destructive to connective tissue, and TIMP-1 has been
      reported to be deficient in the wall of abdominal aortic aneurysms. This
      deficiency could represent failure of expression resulting from either local
      tissue conditions or mutation in the primary structure of the gene (or one of its
      regulatory elements). METHODS: Southern blotting techniques were used to examine
      the possibility of global deletions or inserts in the gene (14 patients);
      Northern blot techniques were performed to examine the expression of the mRNAs in
      cultured fibroblasts under basal conditions (six patients); and sequence analysis
      of the cDNA derived from fibroblast mRNAs was done after amplification by
      polymerase chain reaction (six patients). RESULTS: The Southern blots revealed a
      normal distribution of the known alleles of the gene without unique restriction
      length polymorphisms. Fibroblast expression of TIMP mRNA was normal under basal
      conditions. Sequence analysis of the cDNAs revealed an identical-point
      polymorphism in two of the six patients (a single base pair substitution of C-->T
      at the third position in codon 101), but the amino acid was conserved.
      CONCLUSION: The studies reported here do not support the hypothesis that
      deficiency of TIMP-1 in specimens of aorta of patients with abdominal aortic
      aneurysms results from a primary genetic defect.

PMID- 8350437
TI  - Long-term results of semiclosed endarterectomy of the superficial femoral artery
      and the outcome of failed reconstructions.
AB  - PURPOSE: The optimal method of treatment of superficial femoral artery occlusive
      disease has yet to be established. Therapeutic options include percutaneous
      transluminal angioplasty for short lesions and reversed or in situ autologous
      saphenous vein bypass for long lesions. Currently, staged revascularization with
      polytetrafluoroethylene as an initial conduit and autologous vein for secondary
      procedures is suggested. An alternative to these procedures is endarterectomy of
      the occluded superficial femoral artery, followed by a femoropopliteal bypass in
      cases of endarterectomy failure. Our results with this procedure are reviewed in
      this article. METHODS: From 1980 until 1990, 259 endarterectomies of the
      superficial femoral artery were attempted, 231 of which were successfully
      performed in 197 patients (145 men and 52 women), with an average age of 64 years
      (range 40 to 82 years). The indication for successfully performed endarterectomy
      was claudication in 186 patients (80%), rest pain in 21 (9%), and gangrene in 24
      (11%). The postoperative mortality rate was 0.8% with a complication rate of 10%.
      RESULTS: Eighty-two failures occurred during follow-up, of which 33 were treated
      with peripheral bypass. Five additional bypasses were performed because of
      occlusions distal from the endarterectomized segment. The 5-year primary overall
      patency rate of successfully performed endarterectomy was 71% (SE 3.6). The 5
      year overall secondary bypass patency rate was 61% (SE 11.3). The combined
      endarterectomy and bypass patency rate (tertiary patency) was 79% (SE 3.3) after
      5 years and 45% (SE 7.6) after 10 years. The overall amputation rate was 5.6% and
      the amputation rate was 1.6% in patients treated for claudication. CONCLUSIONS:
      The combination of endarterectomy and peripheral bypass provides a valuable
      alternative to the current treatment of superficial femoral artery occlusive
      disease.

PMID- 8350438
TI  - Practice guidelines: lower extremity revascularization.

PMID- 8350439
TI  - Percutaneous transfemoral insertion of a stented graft to repair a traumatic
      femoral arteriovenous fistula.
AB  - This case report describes a new approach to repair a femoral arteriovenous
      fistula with a transluminally placed intraarterial graft-covered stent. A balloon
      expandable stented polytetrafluoroethylene graft was inserted percutaneously to
      obliterate an arteriovenous fistula after a bullet injured the left superficial
      femoral artery and vein of an 18-year-old man. Follow-up duplex ultrasonography
      at 5 months demonstrated patency and luminal integrity of the involved artery and
      vein, with resolution of the associated pseudoaneurysm. Additional follow-up will
      be needed to further substantiate the utility of this minimally invasive
      procedure in the treatment of traumatic arterial injuries.

PMID- 8350440
TI  - Penetration of the wall of an abdominal aortic aneurysm by a Greenfield filter
      prong: a late complication.
AB  - This is a case report of a 68-year-old woman in whom a late and previously
      unreported complication developed that resulted from penetration of an aortic
      aneurysm by the prong of a stainless steel Greenfield filter. This complication
      came into view 7 years after placement of the filter, at the time of aneurysm
      resection. Enlargement of the aneurysm had occurred at a rapid rate. The patient
      was symptom free before surgery.

PMID- 8350441
TI  - Abdominal aortic pseudoaneurysm after blunt trauma.
AB  - A 4-year-old male child was admitted with a large 12 x 15 cm suprarenal abdominal
      aortic pseudoaneurysm 7 months after an episode of blunt abdominal trauma.
      Aneurysmorrhaphy was performed through a left thoracoabdominal approach with
      Dacron patch aortoplasty. This report summarizes this case and reviews the
      literature on abdominal aortic pseudoaneurysms after blunt abdominal trauma.

PMID- 8350442
TI  - Aorta-left renal vein fistula syndrome caused by rupture of a juxtarenal
      abdominal aortic aneurysm: novel pathologic mechanism for a unique clinical
      entity.
AB  - Spontaneous aorta-left renal vein fistula (ALRVF) caused by abdominal aortic
      aneurysm (AAA) is a rare form of intravascular aneurysm rupture. The literature
      series of ALRVF, updated here to 19 reported cases, demonstrates that patients
      with ALRVF present with a unique clinical syndrome characterized by abdominal or
      left flank pain (84%), a pulsatile abdominal mass (63%), abdominal bruit or
      murmur (63%), hematuria (100%), and nonfunction of the left kidney on functional
      imaging studies (100% of patients studied). Operative findings in ALRVF syndrome
      have included a large AAA (mean diameter 9.2 cm), with frank rupture in only
      three; in 17 of 19 patients (89%) the ALRVF was associated with a retroaortic
      left renal vein anomaly. The patient presented here had a large juxtarenal AAA
      with rupture into the left retroperitoneal space. The wide aneurysm neck and
      expanding hematoma created an avulsion of the second left lumbar vein from its
      junction with an anatomically normal (preaortic) left renal vein; the resulting
      renal vein tear allowed development of an arteriovenous communication that was
      responsible for the clinical presentation of ALRVF syndrome. The disease found
      here demonstrates a novel mechanism for the production of ALRVF syndrome in
      patients with juxtarenal AAA and otherwise normal pararenal venous anatomy.

PMID- 8350443
TI  - A piece of my mind. Primary caring.

PMID- 8350444
TI  - Preparedness for practice. Young physicians' views of their professional
      education.
AB  - OBJECTIVE: To describe the views of young physicians (younger than age 45 years)
      regarding the appropriateness of specific aspects of medical training that have
      often been criticized as inadequate. DESIGN: Proportional analysis of survey
      data, stratified by medical school type and graduate medical education specialty
      and adjusted for demographics. SETTING: National sample of 4756 allopathic and
      osteopathic physicians trained in allopathic residencies representing a variety
      of practice settings. DEPENDENT VARIABLES: Overall satisfaction with medical
      training, including medical school through residency and fellowship; satisfaction
      with preparedness for five aspects of practice and six types of patients; and
      satisfaction with the amount of time spent in each of six training settings.
      RESULTS: Eighty percent of young physicians reported that their formal medical
      training did an excellent or good job of preparing them for medical practice.
      Much smaller proportions (21% to 78%) reported excellent or good preparation to
      treat specific conditions or types of patients, and few (3%) reported being well
      prepared to manage business aspects of practice. Large proportions (35% to 63%)
      would prefer to have received more training in settings outside of hospitals,
      including managed care settings (67%). Significant differences in preparedness
      were observed by type of training; those trained in general and family practice
      reported better preparedness along many dimensions than did those trained in
      general internal medicine. CONCLUSIONS: Young physicians generally confirm
      critiques of medical training noted by scholars and commissions. Health care
      reform is likely to increase the urgency for remedial action.

PMID- 8350445
TI  - ECFMG assessment of clinical competence of graduates of foreign medical schools.
      Educational Commission for Foreign Medical Graduates.
AB  - OBJECTIVE: To develop an assessment of clinical competence of graduates of
      foreign medical schools and to determine the reliability and validity of the
      assessment and the feasibility of large-scale administration. DESIGN: The
      Educational Commission for Foreign Medical Graduates (ECFMG) clinical competence
      study included (1) clinical encounters with standardized patients to assess
      history taking, physical examination, and communication skills; (2) laser
      videodisk pictorials to assess identification and interpretation of diagnostic
      procedures; (3) written clinical vignettes to assess diagnosis and management
      skills; and (4) assessment of spoken English. A uniform method of operating the
      test centers and of training the standardized patients was developed. SETTING:
      Medical schools and their primary teaching hospitals and affiliated hospitals.
      PARTICIPANTS: Six hundred twenty-four first-year residents, of whom 525 are
      graduates of foreign medical schools. MAIN OUTCOME MEASURES: Scores, reliability
      coefficients, validity measures, feasibility of multisite administration, trends
      of scores over time, and acceptability by examinees. RESULTS: The ECFMG clinical
      competence assessment was conducted at four geographically separate test centers.
      Reliability coefficients were high (.85) for the integrated clinical encounter
      and were in a reasonable range (.71 to .82) for all test components. The
      assessment adds to the predictability of the residents' performance in the
      hospital over that of current ECFMG certification examinations. Test security was
      addressed by demonstrating no consistent pattern of change in scores over testing
      dates. Virtually all examinees thought the assessment was appropriate.
      Standardized patients were able to assess spoken English accurately. CONCLUSION:
      The feasibility of conducting a reliable and valid test of clinical competence
      for graduates of foreign medical schools was demonstrated for this test
      population.

PMID- 8350446
TI  - Competency assessment of primary care physicians as part of a peer review
      program.
AB  - OBJECTIVE: To design and test a program that assesses clinical competence as a
      second stage in a peer review process and to determine the program's reliability.
      DESIGN AND SETTING: A three-cohort study of Ontario primary care physicians.
      PARTICIPANTS: Reference physicians (n = 26) randomly drawn from the Hamilton,
      Ontario, area; volunteer, self-referred physicians (n = 20); and physicians
      referred by the licensing body (n = 37) as a result of a disciplinary hearing or
      peer review. MAIN OUTCOME MEASURES: Standardized patients, structured oral
      examinations, chart-stimulated recall, objective structured clinical examination,
      and multiple-choice examination. RESULTS: Test reliability was high, ranging from
      0.73 to 0.91, and all tests discriminated among subgroups. Demographic variables
      relating to the final category were age, Canadian or foreign graduates, and
      whether or not participants were certified in family medicine. CONCLUSIONS: The
      study demonstrated the feasibility, reliability, and validity of a multicomponent
      examination in the peer review process.

PMID- 8350447
TI  - Institutional responsibility in graduate medical education and highlights of
      historical data.

PMID- 8350448
TI  - Educational programs in US medical schools.
AB  - As described in the introduction, the data presented in this report can be viewed
      in both a historical and an environmental context. From a historical perspective,
      there has been change in many areas of medical education. The number of
      applicants to medical schools has risen sharply in the past few years, a result
      seemingly inconsistent with the dissatisfaction with medicine expressed by many
      physicians and with the uncertainties about the eventual outcomes of health
      system reform. The number of minority applicants and enrollees is slowly rising,
      but at rates below the goals identified by such initiatives as the Association of
      American Medical Colleges' "Project 3000 by 2000." Even with the expansion of the
      applicant pool, however, most medical schools do not anticipate enrollment
      increases. Medical school tuition also continues to increase significantly, in
      both public and private schools. The number of faculty members in the clinical
      disciplines also has continued to rise, although the rate of increase has become
      less marked. The decrease in the number of basic science faculty members that
      occurred this year will need to be monitored to ensure that appropriate faculty
      resources are available for teaching, especially with the initiatives to
      introduce more active learning formats during the basic science years. The
      medical curriculum continues to evolve at differing rates across schools. Many
      "innovations" have become part of the curricular repertoire; for example, medical
      schools have incorporated educational formats, such as problem-based learning or
      computer-assisted instruction, which emphasize active student learning, although
      in a number of cases they are limited to a small portion of the curriculum. In
      addition, the availability of clinical experiences during the first 2 years of
      the curriculum, especially those located in ambulatory settings, gives students
      an early glimpse of the world of actual medical practice. The use of standardized
      patients provides system and structure in the teaching and evaluation of clinical
      skills. Therefore, a look at medical education as a whole in the historical
      context reveals many positive changes (for example, an increase in student
      diversity over time, the introduction of alternative instructional formats, and
      attempts to evaluate student clinical competence more reliably). Within the
      context of environmental expectations, however, many challenges still remain.
      Medical schools are experiencing pressure to solve perceived problems with the
      specialty distribution of their graduates and with the specialty distribution of
      the general physician population, even though factors outside the control of the
      medical school, such as reimbursement and the practice environment, also
      influence specialty choice.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8350450
TI  - Improving access to health care through physician workforce reform. Directions
      for the 21st century.

PMID- 8350449
TI  - The elusive generalist physician. Can we reach a 50% goal?
AB  - National attention has focused on the goal of attaining 50% primary care
      practitioners to facilitate patient access and cost-effectiveness. To determine
      how long it might take to achieve this goal, we used the Bureau of Health
      Professions' aggregate physician supply model to forecast the generalist
      specialist balance. Assuming that 30% of graduates will enter generalist practice
      after 1993 (the percentage in the mid-1980s), the number of generalists would
      increase from 174,940 in 1990 to 232,000 in 2040 (77 per 100,000 population), but
      the percentage would remain at about 30%; specialists would continue to make up
      about 70% of all active physicians, but their total number would grow from
      345,600 to 537,000 (178 per 100,000 population). If 50% of graduates were to
      enter generalist practices, by the year 2040 the number of generalists would grow
      to 373,000, or 124 per 100,000 (48.4% of all physicians). If entry into
      generalist practice falls to 20%, as suggested by recent medical student
      preferences, the number of generalists would peak at 192,000 (26.4%) in 2010 and
      would fall to 160,000 (21%) by 2040, resulting in 53 generalists and 201
      specialists per 100,000 population. We discuss the implications of these findings
      on aggregate physician supply and on policy initiative affecting the ratio of
      generalists to specialists. Reform proposals affecting the specialty mix should
      clearly identify the desired future ratio of generalists and specialists per
      capita.

PMID- 8350451
TI  - Reforming graduate medical education. Summary report of the Physician Payment
      Review Commission.

PMID- 8350452
TI  - Comparing physician workforce reform recommendations.

PMID- 8350453
TI  - US medical school finances.

PMID- 8350454
TI  - 25 years in continuing medical education. The silver anniversary of the AMA PRA.

PMID- 8350455
TI  - The Maintenance of Competence Program of the Royal College of Physicians and
      Surgeons of Canada.

PMID- 8350456
TI  - Allied health accreditation faces major changes.

PMID- 8350457
TI  - The mammalian medical center for the 21st century.

PMID- 8350458
TI  - Potential impact of health system reform on medical education. Task Force on
      Health Systems and Medical Education.

PMID- 8350459
TI  - Medical workforce planning and medical education. Attaining consensus.

PMID- 8350461
TI  - Medical education and financial assistance programs sponsored by US government
      agencies.

PMID- 8350460
TI  - Medical schools in the United States and Canada.

PMID- 8350462
TI  - The lesson.

PMID- 8350463
TI  - How to avoid being manipulated by patients: notes from the county jail.

PMID- 8350464
TI  - [Evaluation of the renal function during hypotensive anesthesia induced by
      nitroglycerin, prostaglandin E1 or nitroglycerin+prostaglandin E1].
AB  - We investigated the renal function perioperatively in 32 female patients who
      underwent mastectomy with hypotensive general anesthesia induced by nitroglycerin
      (NG), prostaglandin E1 (PGE1) and NG+PGE1. Urine output in PGE1 group (11
      patients) was significantly larger than that in NG group (9 patients). It could
      be attributed to the increase of glomerular filtration rate. On the other hand,
      the value of beta 2-microglobulin in urine in NG group and the value of N-acetyl
      beta-D-glucosaminidase in urine in NG+PGE1 group (12 patient) were abnormal in
      some patients. These changes were not significant, but the disturbance of renal
      tubule could be possible. In summary, PGE1 was effective in the maintenance of
      the renal function.

PMID- 8350466
TI  - [Effects of prostaglandin E1 on temperature gradients between hand and foot
      during epidural anesthesia].
AB  - We studied the effects of prostaglandin E1 (PGE1) on hand-foot temperature
      gradients (foot temperature-hand temperature) induced by lumbar epidural
      anesthesia. Thirty-six ASA class 1 patients undergoing rotatory acetabular
      osteotomy were randomly assigned to receive 0 gamma (n = 13), 0.005 gamma (n =
      10) and 0.02 gamma (n = 13) of PGE1. Thermometric probes were placed on the palm
      and sole of each patient. Bladder temperature was also monitored to evaluate the
      change of core temperature. Epidural catheter was indwelled at the level between
      L2 and L3 prior to induction and 2 % lidocaine was administered epidurally. All
      patients were warmed by water blanket at 37 degrees C and fluids for infusion
      warmed at 37 degrees C. Humidity and moisture exchanger was placed in breathing
      circuit. Hand-foot temperature gradients of patients given 0 and 0.005 gamma of
      PGE1 increased to 2.8 +/- 1.5 and 2.3 +/- 2.3 degrees C at extubation,
      respectively. In contrast, temperature gradient of patients given 0.02 gamma of
      PGE1 was 0.0 +/- 1.8 degrees C (P < 0.01). There was no difference among the
      values of bladder temperature in each group. The effects of PGE1 on mean arterial
      pressure, heart rate and central venous pressure were minimal. These data suggest
      that 0.02 gamma of PGE1 administration is effective to reduce hand-foot
      temperature gradient during epidural anesthesia.

PMID- 8350465
TI  - [Does rate of urine flow influence the difference between bladder temperature and
      nasopharyngeal temperature during cardiac surgery with cardiopulmonary bypass?].
AB  - Recently, bladder temperature (BT) monitoring is employed instead of rectal
      temperature because it is possible to keep the probe clean. The relationship
      between BT and core temperature is different in patients with steady state
      compared with those with rapid changes in temperatures. This study evaluated BT
      compared with nasopharyngeal temperature (NPT) reflecting brain temperature
      during cardiac surgery with induced hypothermia using cardiopulmonary bypass.
      During the steady state, after induction of anesthesia and immediately before
      cooling or rewarming, BT was equivalent to NPT independent of urine flow rate. In
      rapid cooling or rewarming phase of cardiopulmonary bypass, BT was not equivalent
      to NPT. BT preceded NPT in case of a very high urine flow rate, and with a lower
      urine flow rate delayed BT lagged behind NPT. During rapid changes in core
      temperature during cardiopulmonary bypass, the difference of BT to NPT depends on
      urine flow rate.

PMID- 8350467
TI  - [Interaction of midazolam and thiopental in amnestic effect].
AB  - Interaction of midazolam and thiopental in amnestic effect was studied in 30
      adult patients who underwent elective surgery of lower extremities under epidural
      or spinal anesthesia in combination with oxygen, nitrous oxide and low
      concentration of sevoflurane. Combination of midazolam 2.0-3.0 mg (0.041 +/-
      0.006 mg.kg-1) and thiopental 3-5 mg.kg-1 produced amnestic effect in 87% of
      patients. No side effects, such as decrease in O2 saturation, upper airway
      obstruction, cardiovascular depression and delayed emergence were observed with
      this small dose of midazolam. Administration of midazolam 2.0-3.0 mg before
      epidural, or spinal anesthesia in the operating room under observation of
      anesthesiologists, followed by thiopental 3-5 mg.kg-1, was safe and comfortable
      to the patients.

PMID- 8350468
TI  - [Left ventricular function during hypoxia--II: Effects of intramyocardial pH].
AB  - We investigated the effects of intramyocardial acidosis on cardiac function
      during hypoxia in mongrel dogs (n = 50). Intramyocardial pH in subendocardium of
      left ventricle was measured continuously using a pH electrode. During hypoxia
      (PaO2 = 20 mmHg) caused by inhalation of low oxygen fraction, intramyocardial pH
      decreased significantly following initial enhancement. Intramyocardial pH
      correlated significantly with arterial pH, base excess, lactic acid (LA) levels,
      coronary venous PcO2, and coronary venous-arterial PcO2 difference. There were
      significant correlations between intramyocardial pH with maximum rate of rise of
      left ventricular pressure (LV dp/dt max), left ventricular end-diastolic pressure
      (LVEDP), LVEDP/LVP and the time constant of exponential isovolumic left
      ventricular pressure fall. High arterial LA levels tended to cease myocardial LA
      uptake and production, turning LA balance into zero. LV dp/dt max was low in such
      a condition. Myocardial LA production decreased intramyocardial pH, but LV dp/dt
      max was maintained at high levels of LA production. These observations suggest
      that myocardial LA production maintains left ventricular function with the
      increase of ATP by acceleration of anaerobic glycolysis. In conclusion, during
      hypoxia, intramyocardial acidosis was caused by the increase of arterial LA
      level, myocardial anaerobic glycolysis and ATP breakdown, and it worsened left
      ventricular contractile function and relaxation. Arterial LA levels can play a
      major part in intramyocardial acidosis, but the increase in myocardial LA
      production might be beneficial to left ventricular contractile function.

PMID- 8350469
TI  - [Influence of bilateral stellate ganglion block on hemodynamics].
AB  - This study was designed to investigate the influence of bilateral stellate
      ganglion block (SGB) on hemodynamics in 15 mongrel dogs. Following general
      anesthesia, each dog received SGB with 1.5% mepivacaine. Cardiovascular effect of
      bilateral SGB was assessed by measuring mean artery pressure (MAP), heart rate
      (HR), cardiac output (CO), right atrial pressure (RAP), mean pulmonary artery
      pressure (MPAP), pulmonary capillary wedge pressure (PCWP) and common carotid
      arterial blood flow (CCAF). These were measured directly by a Swan-Ganz catheter
      and ultrasonic blood flow meter, during the first 15 minutes after SGB. A
      decrease of MAP and HR was observed after bilateral SGB. CO decreased for 13%
      compared with the control value. However, this change was not statistically
      significant. There was a significant increase in the bilateral CCAF, but the
      degree of the increase of CCAF was greater after unilateral SGB than after the
      bilateral SGB.

PMID- 8350470
TI  - [Influences of anesthetic method on post-cholecystectomy pain--a comparison
      between epidural and general anesthesia].
AB  - This study was designed to compare the influence of epidural anesthesia with that
      of general anesthesia on postoperative pain state and management. We studied 16
      patients who underwent elective laparotomy-cholecystectomy with epidural
      anesthesia without general anesthesia or with general anesthesia (nitrous oxide
      isoflurane). Following bolus epidural injection with 3 micrograms.kg-1 of
      buprenorphine in 0.25% bupivacaine 4-7 ml at the end of surgery, all patients
      received continuous epidural buprenorphine administration at the rate of 12
      micrograms.h-1 for 48 hours. Pain relief was assessed for 72 hours after surgery
      using visual analogue scale. Postoperative rest pain of the epidural group
      remained at a lower state of pain than that of the general anesthesia group not
      only for 48 hours (P < 0.005) but also until 72 hours (P < 0.005) after surgery.
      We concluded that the epidural anesthesia produces a greater postoperative pain
      relief than general anesthesia.

PMID- 8350471
TI  - [Anesthetic management of a patient with Alzheimer's disease].
AB  - We gave anesthesia to a 60-year-old female patient in stage III (end stage) of
      Alzheimer's disease for sigmoidectomy. She had myoclonus and parkinsonism and it
      was not possible to communicate with her verbally. After induction of anesthesia
      with thiopental, she had a catheter inserted into epidural space. Without
      endotracheal intubation, anesthesia was maintained with nitrous oxide, oxygen and
      isoflurane under spontaneous ventilation supplemented with mepivacaine from the
      epidural catheter. No muscle relaxant was used. Recovery from the anesthesia was
      uneventful. No complication was observed during anesthesia and postoperatively.

PMID- 8350472
TI  - [Anesthetic management of a patient with carcinoid syndrome].
AB  - Anesthetic management of a 75-year-old female with carcinoid syndrome is
      reported. She had a tumor on the ileum and multiple metastatic tumors in the both
      lobes of the liver. Levels of both plasma serotonin and urinary 5-hydroxyindole
      acetic acid (5-HIAA) were significantly elevated before the operation. Although
      she was treated with somatostatin-analogue percutaneously, the levels of these
      hormones did not decrease significantly. The partial resection of the small
      intestine was scheduled under general anesthesia. Before induction of general
      anesthesia, hydrocortisone and ulinastatin were administered intravenously to
      prevent the release of chemical mediators. Anesthesia was induced with ketamine,
      diazepam, and vecuronium, and maintained with nitrous oxide, oxygen and
      enflurane. There was mild bronchospasm at the beginning of the surgery and the
      blood pressure was unstable during the operation, but anesthetic course was
      relatively uneventful. Although the patient recovered from anesthesia smoothly,
      she developed respiratory acidosis 45 minutes after extubation. She was intubated
      again and ventilated artificially with pressure support ventilation whose support
      level was 15 cmH2O for only three hours. We conclude that we should pay much
      attention not only during anesthesia but also after surgery, especially to
      respiratory system in patients with carcinoid syndrome.

PMID- 8350473
TI  - [A case of abortive malignant hyperthermia during funnel chest surgery].
AB  - We experienced a case of abortive malignant hyperthermia during funnel chest
      surgery. Although a 5-year-old boy had muscle rigidity after the intravenous
      injection of succinylcholine chloride, the tracheal intubation was easy. The boy
      had high body temperature, metabolic acidosis, hyperkalemia and myoglobinuria
      during nitrous oxide-oxygen-sevoflurane anesthesia. We immediately came to the
      diagnosis of abortive malignant hyperthermia, gave intravenous injection of
      dantrolene sodium and started body surface cooling. Postoperative course was
      uneventful. It is necessary to pay a particular attention to possible malignant
      hyperthermia in patients with funnel chest surgery.

PMID- 8350474
TI  - [Perioperative management of patients on long-term administration of psychotropic
      drugs].
AB  - We experienced perioperative management of thirty two surgical patients
      complicated with either schizophrenia or depression on long-term administration
      of psychotropic drugs during a period of three years from 1989 through 1991. They
      underwent various operative procedures under either general anesthesia or
      epidural anesthesia. Mental confusion was most frequently encountered in
      immediate postoperative period. The longer the patients had been treated with
      psychotropic drugs, the more postoperative complications were observed. We lost
      four patients within two weeks postoperatively. They all underwent laparotomy and
      had been treated with psychotropic drugs for a prolonged period. No significant
      association between the types of anesthesia and postoperative complications was
      observed. Surgical patients on long-term administration of psychotropic drugs
      should be managed carefully particularly during postoperative period.

PMID- 8350475
TI  - [A case of pulmonary alveolar proteinosis--evaluation of a Swan-Ganz catheter in
      bilateral lung lavage].
AB  - Lung lavage, known to be effective for alveolar proteinosis, brings about
      significant hypoxemia immediately after evacuation of lavage fluid. Impeding
      blood flow of even a distal branch of a pulmonary artery by using a Swan-Ganz
      catheter (SGC) successfully prevented this hypoxemia. And this SGC procedure
      could be safely carried out to make lavage of each lung successively in one day.

PMID- 8350476
TI  - [Anesthetic management of a patient for giant pulmonary bulla drainage].
AB  - Recently it is claimed that the drainage procedure may be a useful method for
      giant pulmonary bulla in compromised patients. We reported the anesthetic
      managements of three patients with giant bulla for these procedures. We chose
      epidural anesthesia in order to prepare for the postoperative analgesia and the
      expansion of surgical procedure. In selecting circulatory support method, care
      was taken to choose dobutamine that would cause no suppression of hypoxic
      ventilatory drive. There is no doubt that right ventricular function is
      particularly important in patients with chronic obstructive lung disease. We
      measured right ventricular ejection fraction by thermodilution method and end
      tidal CO2 by nasal cannula. These measurements may be useful methods for
      perioperative monitoring.

PMID- 8350477
TI  - [A severe case of reexpansion pulmonary edema in an asthmatic patient].
AB  - A 60-year-old man with poorly controlled bronchial asthma was proposed for an
      emergency appendectomy. His preoperative chest X-P revealed that his left lung
      was completely collapsed with pneumothorax, but its onset was unclear. Following
      the left thoracocentesis, appendectomy was performed under general anesthesia
      (oxygen-halothane). About one hour after the thoracocentesis, pinkish foamy
      tracheal secretion was massively drained and its protein concentration was 3.8
      g.dl-1.PaCO2 was 95 mmHg and PaO2 was 69 mmHg (FIO2 1.0). His chest X-P showed
      signs of pulmonary edema in his left lung and infiltrating shadow was observed in
      his right lung. IMV with PEEP, aminophylline and prednisolone improved his
      respiratory status and on the 11 th day he was weaned from the respirator. In a
      case of pneumothorax with unclear duration like ours, it is necessary to consider
      the possibility of the reexpansion pulmonary edema.

PMID- 8350478
TI  - [Severe theophylline toxicity in a pregnant asthmatic patient].
AB  - A 32 year old pregnant woman who had taken large doses of theophylline for
      asthmatic attack was brought to our emergency medical center with convulsion and
      respiratory disturbance. Serum theophylline concentration was 52 micrograms.dl-1
      on admission. We intubated the patient to control convulsion and respiration and
      performed cesarean section. Serum theophylline concentration of the newborn was
      almost at the same level as that of her mother. Baby was placed on ventilator for
      several days and discharged without trouble. We must consider the pregnancy as a
      major risk factor of theophylline toxicity.

PMID- 8350479
TI  - [The anesthetic management of cesarean section for multiple pregnant patients].
AB  - Anesthetic management of cesarean section for twenty multiple pregnant patients,
      who were pregnant with triplet or quadruplet, was compared with that for 325
      single pregnant patients and 21 twin pregnant patients. For anesthetic methods,
      spinal anesthesia was chosen most frequently in the multiple pregnant patients,
      as in single and twin (more than 75 percent). In multiple pregnant patients, the
      incidence of emergency operation was less. In multiple pregnant patients who
      received spinal anesthesia, gestational age was lower; birth weight was lighter;
      length of fundus uteri was longer; and blood loss including amniotic fluid was
      larger. In triplets, the third infants' UID-time was prolonged and their Apgar
      score was lower.

PMID- 8350480
TI  - [The sprotte needle decreases the incidence of postspinal headache].
AB  - Postspinal headache (PSH) is the most frequent complication of spinal anesthesia.
      The factors responsible for the development of PSH include needle size, shape of
      the needle tip, patient's age, sex, infusion volume and period of resting. The
      purpose of this study is to compare the incidence of PSH between two different
      types of needle, Sprotte needle and Quincke needle. The Sprotte needle is
      characterized by a round profiled tip equipped with a lateral orifice. Our
      investigation by questionnaires revealed that the incidences of PSH after using
      either 22G Sprotte needle or 21-25G Quincke needle were 0% and 38.8%,
      respectively. We conclude that the Sprotte needle decrease the incidence of PSH.

PMID- 8350481
TI  - [A newly devised bandage for hemostasis after vascular puncture].

PMID- 8350482
TI  - [A suggestion to prevent misuse of drugs].

PMID- 8350483
TI  - [Reevaluation of spinal anesthesia in elderly people--an evaluation of
      circulatory changes].
AB  - Appropriate methods of anesthesia for the elderly people are being discussed as
      the ratio of elderly people in our society increases. During spinal anesthesia,
      hypotension was frequently observed in patients with hypertension,
      arteriosclerosis, coronary deficiency, and so on. It is also difficult to pass
      the needle between degenerated vertebrae. However, general inhaled anesthesia
      accompanies the respiratory complications and consciousness derangement after
      surgical operations more frequently than after spinal anesthesia. In this study,
      circulatory conditions during spinal anesthesia in elderly people (30-91 years
      old) were analyzed in 109 cases of spinal anesthesia. Hypotension occurred about
      10 minutes and 40-60 minutes after injection of anesthetics and was frequent in
      patients of high aged group, but tachycardia was not observed among them. In
      addition, their blood pressure in the recovery room could not recover to the
      level before anesthesia. It is thought that hypotension during spinal anesthesia
      was induced by the vascular dilatation caused by sympathetic nerve block and the
      deficiency of reflective venous constriction in upper extremities and abdominal
      organs. Tachycardia may also produce hypotension. However, the reflexive
      vasoconstriction and tachycardia are thought to be poor on account of
      arteriosclerosis and down regulation of beta-receptor in elderly people.
      Therefore, during spinal anesthesia in the elderly people, the catecholamine
      released by the surgical stimulation could not increase blood pressure
      effectively. To prevent hypotension during spinal anesthesia in elderly people,
      it is advisable to employ the treatment for upregulation of beta-receptor before
      anesthesia and the administration of alpha . beta-receptor, epinephrine and
      dopamine for control of blood pressure during spinal anesthesia.

PMID- 8350485
TI  - [Anesthesia with epidural spinal cord stimulation--I). Its application to general
      anesthesia].
AB  - Epidural spinal cord stimulation (SCS) has been used for the relief of pain. We
      tried to apply SCS for general anesthesia. The subjects were 76 patients,
      undergoing thoracotomy (3 cases), thoraco-laparotomy (4), laparotomy (57) and
      others (12). A monopolar electrode was introduced to the epidural space via a
      Touhy needle. The conditions of the electrical stimulation were 12.5-50 Hz, 1.0
      ms and 2-8 V. The voltage was adjusted to give comfortable sensation to the
      patients. After the electrode had been introduced, induction of anesthesia and
      tracheal intubation were performed with thiopental, diazepam and pancuronium or
      vecuronium. Anesthesia was maintained with nitrous oxide (70%-50%) and SCS. Nine
      patients inhaled low concentrations of enflurane in addition to nitrous oxide,
      and 39 patients received injection of vasodilators because of hypertension. All
      the patients were not awake during operation, and recovered their consciousness
      soon after the end of operations. SCS was continued for 17 hrs after operation.
      During 24 hrs after operation, 16 patients required no analgesics, 32 patients
      once and others twice or more. We conclude that SCS added to general anesthesia
      is useful to control pain, not only intraoperatively, but also postoperatively.

PMID- 8350484
TI  - [Combined spinal and epidural analgesia for caesarean section].
AB  - We compared the combined spinal and thoracic epidural analgesia with 2% lidocaine
      for caesarean section, with spinal analgesia using 2% lidocaine, tetracaine or
      dibucaine, and also with lumbar epidural analgesia. The analgesia at high
      thoracic level could be achieved with combined spinal and epidural analgesia more
      easily than with others. The frequency of side effects with the combined spinal
      and epidural analgesia, such as hypotension, decrease of fetal heart rate and so
      on, was less than that with others. In conclusion, the combined spinal and
      thoracic epidural analgesia with 2% lidocaine is more useful for caesarean
      section, than the spinal analgesia or the lumbar epidural analgesia alone.

PMID- 8350486
TI  - [Heart rate response to intravenous atropine during cervical and lumbar epidural
      anesthesia].
AB  - The authors evaluated the effect of cervical and lumbar epidural anesthesia on
      the heart rate response to intravenous atropine 0.01 mg.kg-1 in conscious humans
      with cervical epidural anesthesia (n = 40), with lumbar epidural anesthesia (n =
      15) and without epidural anesthesia (n = 25). During cervical and lumbar epidural
      anesthesia using 1.5% lidocaine, levels of loss of cold sensation were C3-T7 and
      T7-S1, respectively. Heart rate increased by 14 +/- 10% (mean +/- SD) and 20 +/-
      14% after intravenous atropine 0.01 mg.kg-1 in the patients with cervical and
      lumbar epidural anesthesia, respectively. These magnitudes of positive
      chronotropic effects were significantly less as compared with those in the
      patients without epidural anesthesia (32 +/- 11%). Nine of 40 patients (23%) with
      cervical epidural anesthesia showed heart rate increases of less than 3 beats.min
      1 following atropine 0.01 mg.kg-1. And 30 of 40 patients (75%) required
      supplementary atropine 0.01 mg.kg-1 to increase heart rate for more than 20
      beats.min-1 from baseline values. The present study suggests that the heart rate
      response to intravenous atropine is blunted in patients during cervical and
      lumbar epidural anesthesia, and that a larger dose of intravenous atropine may be
      required to accelerate the heart rate in most patients during cervical epidural
      anesthesia.

PMID- 8350487
TI  - Electron-equivalent dose for the effect of gadolinium neutron capture therapy on
      the growth of subcutaneously-inoculated Ehrlich tumor cells in mice.
AB  - The present in vivo study estimates the dose resulting from the gadolinium
      neutron capture reaction and the gadolinium enhancement extent of the thermal
      neutron effect. The assay is based on the time required from cell inoculation to
      the formation of tumors with an arbitrary size of 200 mm2. Mice were inoculated
      subcutaneously with Ehrlich tumor cells with or without meglumine gadopentetate
      (1.2 mg 157Gd/0.2 ml), and were exposed to 1.1 x 10(12) thermal neutrons cm-2(n
      8), or 3 MeV electrons at three dose levels (each n 10). To reach 200 mm2 in
      size, it took 18.8 days for tumors treated with neutrons only and 34.7 days for
      those treated with gadolinium and neutrons. From the time-dose relation obtained
      with 3 MeV electrons, the equivalent doses corresponding to delays of 34.7 and
      18.8 days were 15.0 and 7.4 Gy, respectively. Thus, gadolinium enhanced the
      thermal neutron effect two-fold (15.0/7.4) in the present study.

PMID- 8350488
TI  - Expressions of N-myc and ras oncogene products in neuroblastoma and their
      correlations with prognosis.
AB  - Thirty-six neuroblastomas were studied to determine the clinical significance of
      the N-myc gene product, N-myc, and the ras gene product, p21. The expressions of
      both gene products were analyzed immunohistochemically using formalin-fixed
      paraffin sections. Neuroblastoma cells were positive for N-myc expression in 13
      cases and for p21 expression in 19 cases. N-myc expressions showed no significant
      relation to any clinical prognostic factor, whereas p21 expression was well
      correlated with clinical staging and Shimada's classification. There was a
      tendency for p21 expression to be low in N-myc(+) tumors, whereas p21 expression
      was frequently detected when N-myc expression was absent. The survival rate for N
      myc(-) patients was significantly higher than for N-myc(+) patients (P < 0.01).
      The survival rate for p21(+) patients was significantly higher than for p21(-)
      patients (P < 0.001). In addition, N-myc(+) and p21(-) patients showed a strong
      tendency towards a poor prognosis, whereas a combination of p21(+) and N-myc(-)
      indicated a good prognosis (P < 0.01). The results suggest that expressions of N
      myc and p21 detected by immunohistochemical staining could be among the most
      reliable prognostic indicators in neuroblastoma patients.

PMID- 8350489
TI  - A study of pharyngeal symptoms caused by bronchofiberscopy.
AB  - We investigated the occurrence of pharyngeal symptoms in 100 patients who had
      undergone bronchofiberscopies by conducting a post-examination survey of the
      patients. Eighty-four patients complained of having a problem. Seventy-five
      patients, including 26 with dysphagia, complained of pharyngeal symptoms. The
      proportion with pharyngeal symptoms whose symptoms appeared on the day of
      examination was a high 89.4%. In 70.6% of cases, the duration of symptoms was
      less than four days. The pharyngeal symptoms were particularly common among
      patients who had undergone a bronchofiberscopy on a previous occasion or whose
      examination lasted for 15 min or more. A greater dysphagia incidence was noted
      among patients who had required an endotracheal tube (P = 0.03) and among those
      whose examination had lasted for 15 min or more (P = 0.01). Based on the results,
      we are now studying methods of alleviating pharyngeal symptoms, including
      dysphagia.

PMID- 8350490
TI  - Bone marrow transplantation for hematological diseases in Hokkaido--June 1985 to
      December 1991.
AB  - Bone marrow transplantation (BMT) was started in Hokkaido in 1985. In the present
      report we have reviewed the clinical outcome of patients treated with BMT for
      hematological diseases in Hokkaido. Fifty-eight allogeneic and 19 autologous
      transplants were registered by December 1991. The underlying diseases consisted
      of 47 leukemias, 14 lymphomas, 10 aplastic anemias and six myelodysplastic
      syndromes. Among the allogeneic BMT cases, 55 were human leucocyte antigen (HLA)
      identical and three were mismatched. Among the autologous BMT patients, two
      received their marrow purged with 4-hydroperoxycyclophosphamide and five, with
      monoclonal antibodies and complements. The conditioning regimens used for
      malignancies were chiefly cyclophosphamide (CY) plus total body irradiation, or
      busulfan plus CY. In many cases, cytokines were used for rapid recovery of
      decreased leukocytes. Engraftment was observed in 50 out of 52 evaluated
      allogeneic and 18 out of 19 autologous transplants. Ten allogeneic patients
      suffered from severe acute graft-versus-host diseases (GVHD), and extensive
      chronic GVHD appeared in 16 patients. Relapses were observed in four cases of
      allogeneic BMT and six of autologous BMT. The major complications were
      interstitial pneumonitis (IP) and severe infections. Long-term survival rates
      were almost 60% in both allogeneic and autologous transplants. Mild acute GVHD
      and limited chronic GVHD increased the survival rates. The results indicated that
      substantial problems such as GVHD, IP and relapses must be controlled in the near
      future for an improved outcome to be made possible.

PMID- 8350492
TI  - Interhospital differences in cancer survivals in Japan. The Research Group for
      Population-based Cancer Registration in Japan.
AB  - The present study was an investigation of variations in cancer survival rates
      among hospitals in Japan, focusing in particular on the number of hospital beds
      as an institutional characteristic. Using data from 11 population-based cancer
      registries, the three-year survival rates for stomach cancer (n 1665), colorectal
      cancer (n 1090) and lung cancer (n 895) patients diagnosed in 1985 were
      calculated according to three different hospital categories (100-299, 300-499,
      500+ beds). Cox's proportional hazards model was conducted, with adjustments for
      sex, age, clinical stage at diagnosis and treatment status, excluding patients
      who had been detected by screening (asymptomatic cases). The stomach and lung
      cancer patients treated in small hospitals (100-299 beds) were at a significantly
      higher risk of death than those treated in large hospitals (500+ beds) (hazard
      ratio (HR) = 1.36, 95% confidence interval (CI) = 1.11-1.65; HR = 1.41, 95% CI =
      1.13-1.77, respectively). Similar findings were observed among colorectal cancer
      patients although they were not statistically significant. The findings can
      provide some information useful for the development of future public health
      policies aimed at controlling cancer mortality rates in our country.

PMID- 8350494
TI  - [An approach to evaluation methods for laboratory work].
AB  - Evaluation methods were proposed for quality control, normal range calculation
      and laboratory diagnosis. As a quality control method, the Xbar-R control chart
      should be evaluated with an error detection chart or with operating
      characteristic functions. Normal range calculation was evaluated by three
      parameters, accuracy, precision and robustness which represents stability against
      abnormal data contamination. Prior to evaluating the laboratory diagnosis,
      patient data were plotted on a three dimensional chart, a star map, to determine
      whether apparent clusters were formed. Laboratory diagnosis is a process of
      reduction of multivariate medical information, and it develops new parameters
      related to the pathological state of the patient. The method was evaluated using
      entropy calculation or average count of abnormal parameters.

PMID- 8350491
TI  - Anticarcinogenic activity of green tea polyphenols.
AB  - The main physiologically active polyphenol in green tea extract is (-)
      epigallocatechin gallate (EGCG). Green tea extract has an advantage over EGCG as
      a cancer chemopreventive agent for humans, as is apparent from the Japanese
      custom of injesting green tea on a daily basis. Green tea extract similarly
      inhibited protein kinase C activation by teleocidin, a tumor promoter, as did
      EGCG. In addition, EGCG and green tea extract showed inhibitory effects on the
      growth of lung and mammary cancer cell lines with similar potencies. An
      experiment using the estrogen-dependent MCF-7 cell line showed the mechanisms of
      action of these compounds to be inhibiting the interaction of estrogen with its
      receptors. Considering our previous results of a single application of EGCG to
      mouse skin inhibiting the specific binding of 3H-12-0-tetradecanoylphorbol-13
      acetate (3H-TPA) and 3H-okadaic acid, we postulated that EGCG and compounds in
      green tea extracts would block the interaction of tumor promoters, hormones and
      growth factors with their receptors: a kind of sealing effect. The sealing effect
      would account for reversible growth arrest, and may be induced by various kinds
      of compound.

PMID- 8350493
TI  - Laryngeal metastasis from a pulmonary papillary adenocarcinoma: a case report.
AB  - Metastases to the larynx from distant primaries are very rare. The present
      article reports a case of metastatic papillary adenocarcinoma of the larynx of
      lung origin. The patient was a 59-year-old female non-smoker, who had a history
      of adenocarcinoma of the right lung. For the laryngeal tumor, we performed a
      partial laryngectomy following biopsy. The tumor of the larynx was a papillary
      adenocarcinoma resembling the lung tumor, both demonstrating positive
      immunohistochemical staining for pulmonary surfactant apoprotein. The findings
      emphatically indicated the laryngeal tumor to be metastasis from the primary
      papillary adenocarcinoma of the lung. The present case report presents the
      clinical findings, course of disease and histopathological findings with brief
      reviews of the literature.

PMID- 8350495
TI  - [Standardization in clinical laboratory--its national and international
      activities].
AB  - In order to obtain comparability among laboratory results obtained by different
      laboratories, standardization is necessary in all steps related to clinical
      laboratory practice. Standardization in clinical laboratory is a consensus
      process among professional, industrial and governmental organizations. Everyone
      concerned in clinical laboratory practice should try to follow those consensus
      proposed. The International Organization for Standardization (ISO) is a key
      international body which is represented by many different national organizations.
      World Health Organization (WHO) plays an important role in medical field, but
      many non-governmental organizations (NGO) such as the World Association of
      Societies of Pathology (WASP), the International Federation for Clinical
      Chemistry (IFCC) and others also contribute significantly. In 1975, the National
      Committee for Clinical Laboratory Standards (NCCLS) was established in USA and
      has been the most active. In 1985, The Japanese Committee for Clinical Laboratory
      Standards (JCCLS) was established as some other CCLS in different European
      countries. National activity for establishing many reference materials in Japan
      is briefly reviewed.

PMID- 8350496
TI  - [Thyroid diseases after Chernobyl accident].
AB  - Radioactive iodine is released at every atomic-bomb testings and nuclear plants
      accidents and radioactive iodine is taken up by thyroid glands (internal
      radiation). In addition to the internal radiation, radioactive fallout causes the
      external radiation and thyroid glands are known to be sensitive to the external
      radiation. Furthermore, patients with radiation-induced thyroid disease can
      survive for a long time regardless of the treatment. The survey of thyroid
      diseases, therefore, is very sensitive and reliable ways to investigate the
      effects of radiation caused by atomic bomb explosion, testing and various types
      of nuclear plants' accidents. Our group from Nagasaki University was asked
      investigate the thyroid diseases and joined to the Sasakawa Project. In order to
      investigate the effects of radiation on thyroid disease, it is essential 1) to
      make a correct diagnosis in each subject, 2) to calculate a correct radiation
      dose in each subject and finally, 3) to find out the correlation between the
      radiation dose and thyroid diseases including age-, sex- and area-matched
      controls. We have established 5 centers (1 in Russia, 2 in Belarus, 2 in Ukraine)
      and supplied the most valuable ultrasonography instruments, commercial kits for
      the determination of serum free T4 and TSH level and for the autoantibodies,
      instrument for urinary iodine measurements, syringes, tubes, refrigerators, etc.
      We visit each center often and asked peoples at centers to come to Japan for
      training. Protocol of investigation is essentially the same as that in Nagasaki,
      and we are planning to investigate more than 50,000 children within 5 years. We
      are hoping to show a definite conclusion in the near future.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8350497
TI  - [Basis of cytokines--history and present status].
AB  - Cytokines are high molecular-weight substances which actively promote homeostasis
      and defend from exogenous agents. In 1965, Kasakura, et al, and Gordon, et al
      independently published articles describing an unknown substance (blastogenic
      factor) which was produced in the cultured media of lymphocytes and stimulated
      lymphocytic proliferation. In those days, since almost all immunologists believed
      that only antigens stimulated lymphocytic proliferation, the idea that this
      soluble factor actually had a positive role in lymphocytic proliferation was
      viewed suspiciously. Later, it was found that immune responses are constructed of
      mutual intercellular stimulations between T and B lymphocytes and macrophages. In
      the 1970s, several kinds of cytokines were found. Cytokines include lymphokines
      and monokines. These were named for substances produced from lymphocytes and
      monocytes, respectively. In 1972, at the second lymphokine workshop in
      Switzerland, a new term, "interleukin", was accepted as the name of an active
      substance which reacts mutually among leukocytes. Specific interleukins (IL) are
      numbered, e.g. IL-1, 2, 3 and so on. Later, a new term, BRM (biological
      responsive modifiers), was added to denote substances including not only
      cytokines but also other high weight molecules acting on various kinds of cells
      and tissues. Among the various kinds of cytokines, CSF (colony stimulating
      factor), Epo (erythropoietin), IL, TNF, and interferon are well known. In
      particular, CSF and Epo have been widely used for granulopenia and renal anemia
      with remarkable effects.

PMID- 8350498
TI  - [Erythropoietin determination in clinical medicine].
AB  - Erythropoietin (EPO) is a prime stimulating factor for red cell production. EPO
      is a glycoprotein which has a molecular weight of 34,000, and is mainly produced
      by the kidney. EPO stimulates the differentiation and proliferation of erythroid
      progenitor cells in the bone marrow. The rate of production of EPO is regulated
      primarily by renal oxygen availability. Because anemia reduces renal oxygen
      availability, anemic stress accelerates EPO production in the kidney. Recently,
      EPO has mainly been determined by radioimmunoassay. Serum EPO titer is usually
      inversely correlated with hemoglobin concentration, as typically shown in iron
      deficiency anemia. Serum EPO titers in aplastic anemia are much higher than those
      in iron deficiency anemia relative to the hemoglobin concentration. Serum EPO
      titers in anemia caused by malignancies sometimes differ considerably among
      patients. Serum EPO in renal anemia usually show low titers irrespective of the
      degree of anemia. Serum EPO titers in untreated polycythemia vera are lower than
      those in treated polycythemia vera or secondary polycythemia. Determination of
      serum EPO is useful in differential diagnosis of polycythemia vera. Recombinant
      human EPO has been used to treat various anemias including renal anemia,
      refractory anemia, anemia in malignancies and secondary anemia. Determination of
      serum EPO titers is also valuable in many other situations of clinical medicine.

PMID- 8350499
TI  - [Clinical application of new cytokines].
AB  - Recent progress of molecular biology and gene technology has developed a novel
      approach of clinical treatment. Several recombinant cytokines are already applied
      to clinical field. In this symposium, I introduced clinical application of some
      cytokines including GM-CSF, interleukin (IL)-1 and IL-3. The clinical benefits of
      IL-1 are; 1) IL-1 has an anti-tumor effect especially on cutaneous lymphoma and
      brain tumors, and 2) IL-1 has a function as hematopoietic growth factor for very
      immature hematopoietic stem cells. In the clinical Phase I/II study, IL-1 has
      been shown to have anti-tumor effect on cutaneous T-lymphoma via immune
      mechanisms. The side effects of IL-1 were variable including fever, fatigue, skin
      redness and so on, but they were all tolerable. The clinical phase studies of GM
      CSF and IL-3 are now on going. The preliminary studies show that GM-CSF has
      granulo-poietic activity but not thrombo-poietic activity, and that IL-3 has
      multi-hematopoietic activity. These cytokines may be useful for treatment of
      disorders of hematopoietic stem cells such as aplastic anemia and myelodysplastic
      syndrome. The side effects of both cytokines are resemble, but all are tolerable.

PMID- 8350500
TI  - [Cellular electrophysiological basis of proarrhythmic and antiarrhythmic effects
      of ischemia-related lipid metabolites].
AB  - Lysophosphatidylcholine, an amphiphilic lipid metabolite, accumulates in the
      ischemic myocardium and plays a pivotal role in the production of arrhythmias. To
      clarify its cellular ionic mechanism(s), we investigated the effect of 1
      palmitoyl-lysophosphatidylcholine (LPC) on the guinea pig ventricular myocytes,
      using whole cell- and patch-voltage clamp methods. In whole cell recordings,
      extracellular application of LPC (20-100 microM) depolarized the resting
      potential within several minutes and produced automatic action potential
      discharges from the resting and plateau potentials. Such effects were attributed
      mostly to the decrease in inward going rectifier K current (Ik1). Single channel
      recordings in the cell attached mode revealed that this decrease in Ik1 is
      secondary to the reduction of the single channel conductance and not due to
      decreased open probability. LPC (5-50 microM) also decreased the excitatory Na+
      current (INa) in an all-or-nothing manner, depending upon the concentration used.
      Such decreases in the resting potential and peak INa could be responsible for the
      marked retardation of conduction velocity and therefore production of reentry.
      Another amphiphilic lipid metabolite, a long-chain acylcarnitine or 1
      palmitoylcarnitine (PALC), had LPC-like depressant effects on INa, albeit the
      effect was reversible in the majority of cells tested. On the other hand, a short
      chain acylcarnitine, 1-propionylcarnitine (PROC) did not affect the INa by itself
      even at a high concentration (50-500 microM), whereas it prevented the LPC's
      depressant effect on INa. Like PROC, the middle-chain acylcarnitine, e.g., 1
      hexanoylcarnitine (HEXC) did not decrease the INa, but prevented the LPC's
      deleterious effects on INa, albeit the latter effect was much weaker than that of
      PROC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350502
TI  - [Physiology of cardiac performance].
AB  - We previously proposed i) Emax (end-systolic maximum elastance of the ventricle)
      as an index of contractility independent of preload and afterload and ii) PVA
      (systolic pressure-volume area of the ventricle) as a measure of the total
      mechanical energy generated by the ventricular contraction. Emax is defined as
      the slope of the end-systolic pressure-volume relation, which is relatively
      linear within the normal working range of the left ventricle. A working pressure
      volume point starts from the end-diastolic pressure-volume curve, comes close to
      or slightly exceeds the end-systolic pressure-volume line, and returns to the end
      diastolic curve. Thus, the end-diastolic and end-systolic pressure-volume curves
      envelop a family of pressure-volume trajectories of variously loaded contractions
      in a stable contractility. Emax increases with enhanced contractility and
      decreases with depressed contractility. PVA is an area between the end-diastolic
      and end-systolic pressure-volume curves on the origin side of the systolic
      pressure-volume trajectory. PVA linearly correlates with myocardial oxygen
      consumption regardless of ventricular loading conditions in a given Emax and this
      load-independent oxygen consumption-PVA relation is elevated with an enhanced
      Emax. Consequently, Emax and PVA have proved to be key measures and concepts in
      the physiology of cardiac performance.

PMID- 8350501
TI  - [Molecular basis for cardiac functions].
AB  - Cardiac functions are regulated by both contractile proteins and calcium
      regulatory proteins. Alterations of these are considered involved in impaired
      contractile and diastolic functions in hypertrophied hearts. In this study, we
      analyzed molecular changes during the development of cardiac hypertrophy. Cardiac
      hypertrophy was induced by constricting the pulmonary artery in rabbits or the
      aorta in rats. In rabbit right ventricular hypertrophy, protein synthesis was
      increased to 1.8 times the control 2-4 days after pulmonary constriction. This
      increase in protein synthesis could be classified as an increase in both capacity
      and efficiency of synthesis. beta-cardiac myosin heavy chain (beta-MHC) isoform
      was predominantly expressed and alpha-MHC was suppressed in pressure overload
      hypertrophy. The switch from alpha- to beta-MHC occurred at the mRNA level.
      Ca(2+)-ATPase of sarcoplasmic reticulum (SR) is important because it regulates
      intracellular Ca2+ levels during relaxation. In pressure-overload hypertrophy,
      the SR Ca(2+)-ATPase was markedly decreased in both the enzyme activities and
      mRNA levels, while in thyrotoxic hearts both were increased. Interstitial cells
      also undergo phenotypic modulation which was demonstrated by the induction of
      nonmuscle-type MHC in pressure-overload hypertrophy. The signal transduction
      system in cardiac hypertrophy was examined by stretching cardiac myocytes grown
      on deformable membranes. In our analysis, stretching myocytes stimulated protein
      kinase C, MAP-II kinase and S6 kinase, all of which may lead to the induction of
      fetal-type cardiac genes and accelerated protein synthesis. These analyses of
      subcellular adaptation in cardiac hypertrophy provide important insights into
      understanding molecular mechanisms of cardiac functions.

PMID- 8350503
TI  - [Morphological and functional study by echocardiography].
AB  - Echocardiography can measure various parameters of left and right ventricle
      function during either systolic or diastolic phase. Many parameters of cardiac
      function are obtained by B-mode, M-mode and Doppler images. Recently, invasive
      techniques, such as trans-esophageal echography, intra-luminal echography,
      contrast echography of the left ventricular muscle and stress echography were
      developed. In the future, 3-dimensional echography and acoustic tissue
      characterization will be developed for quantitative measurement of cardiac
      functions.

PMID- 8350504
TI  - [A trial approach to the ideal control-management and systematization of clinical
      laboratory].
AB  - Clinical laboratory examinations have continued to expand with the increase in
      demand for medical care. However, recent high-technology, medical care has made
      introduction of a new system of quality control in the clinical laboratory
      indispensable. First, regarding personnel (clinical laboratory technicians),
      reducing staff hours led to a drop in the employment of newcomers and subsequent
      aging of the staff. Next, introducing a system to save labor is extremely
      expensive, making the cost effectiveness very poor and consequently making it
      difficult to introduce such a system in many laboratories. This symposium was
      initiated to assist the search for ways in which the present clinical laboratory
      can survive despite rising personnel expenses and reagent costs, while reducing
      medical expenses. And at the same time developing a guide to establishing our
      ideal for the clinical laboratory of the 21st century.

PMID- 8350505
TI  - [The present situation of the computer system for the clinical laboratory in
      Japan].
AB  - We report the present situation of the computer system utilization for the
      Clinical Laboratory in Japan. For this studies, the data were calculated to our
      purpose from the materials for statistics published by the Ministry of Health and
      Welfare, Japan Society of Medical Technologist, and so on. The results were as
      follows, 1) computer systems were used on the 85% of all hospitals, and the most
      of them were used for the medical office work included the payment office. At
      clinical laboratory, there was very few use the computer systems, which account
      for 25%. 2) In the field of the clinical laboratory, there was mostly used at
      clinical chemistry, next field was hematology, serology, urinalysis, and
      microbiology, respectively. 3) Total system for the hospital, including ordering
      system were used only 0.06% (208 cases) of all hospitals in Japan. We calculated
      the number of beds with a hundred thousand population, the spread of the computer
      system, the number of the out-patients, in-patients, and the utilization ratio of
      beds, then we compared with that data for all of the prefecture included Tokyo,
      Osaka and Kyoto. As a result of the calculation, the prefecture which the number
      of bed with a hundred thousand population was much more than another zone were
      the utilization ratio of beds was less than another area, and there was worth at
      the spread of computer system. We think there areas had the smaller hospitals
      than that of having highly spread of computer system.

PMID- 8350506
TI  - [Hardware].
AB  - For effective management of clinical laboratory in spite of a shortage of medical
      technologists, we modified conventional analytical instruments on the market, and
      developed the automatic transport mechanism and the robotic analytical
      instruments to suit the operational needs of our laboratory. Consequently, we
      succeeded in designing a system in which the results for 89% of all the tests
      ordered were reported within 60 minutes after the time when the specimens were
      received at the laboratory. As a result of this laboratory automation system,
      medical technologists were spared from their routine work, and their expertise
      was now diverted to the other duties like examination for microbes in hospital
      facilities, evaluation for sterilization of surgical instruments, and maintenance
      of measuring apparatuses in the operating rooms. In addition, the technologists
      also became involved in preventive health activities for university personnel
      such as: periodical healthy check, and screening programs for adult diseases, and
      the like. Some became engaged in the health management programs for radiological
      department workers. Thus, the introduction of this laboratory automation system,
      enabled the medical technologists to cooperate in hospital operation activities
      and to contribute to the prevention of iatrogenic disorders.

PMID- 8350507
TI  - [Perspective for clinical laboratory management and its systematization--effects
      of the systematization of clinical laboratory management].
AB  - There are a large number of ideas concerning the systematization of clinical
      laboratory management. Therefore many types of laboratory systems have been
      constructed. As our hospital is not large, we adopted a small scale laboratory
      system. In introducing it, we expected not only an increase in value-added labor
      productivity by automating laboratory tests, but also an improvement in
      technologist's cost awareness. Consequently, new system equipment has itself
      performed the former in many sections, but not the latter. Improvement in cost
      awareness was caused by the technologist's routine work in managing reagent and
      material stocks. We found that this soft-type systematization has been more
      important than the advanced hard-type system.

PMID- 8350508
TI  - [Future of administration and management in clinical laboratory].
AB  - Some problems in administering and managing clinical laboratories relate to
      technology, safety and health. Total systematization will help resolve these
      problems, and includes several new ideas, such as total investigation, total
      automation, total safety, total flexibility, total standardization, total
      estimation and a totally open-door. Patient-orientation is also important. In our
      physiological department, this aim was obtained to some extent by the
      introduction of computerization, optical data filing system and personnel
      arrangement.

PMID- 8350510
TI  - [A clue for discovery and recent progress in gene abnormalities].
AB  - With the striking progress in analytic technology for detecting gene
      abnormalities, genetic analysis, such as polymerase chain reaction (PCR), has
      become a routine procedure in laboratory medicine. Consequently, the role of
      laboratory medicine in detecting genetic disease is increasing. However, in the
      process of genetic analysis maintaining consistency with clinical expression is
      necessary. In this symposium, the discussion includes the following items: (1)
      Genetic analysis of Maple Syrup Urine Disease (MSUD), (2) Analytic study of
      abnormal antithrombin III (TOYAMA), (3) Diagnostic procedures for anemia
      attributed to RBC membrane protein abnormality, (4) Genetic analysis of LDH-M
      subunit deficiency, (5) Development of a new prospect for hereditary
      hyperlipidemia, (6) Genetic analysis of hormone resistance syndromes: T3 receptor
      abnormality, and (7) Etiologic genetic analysis of pituitary cretinism. In
      general, DNA analysis in these cases can demonstrate wide variations in gene
      structural abnormalities. In MSUD, for instance, enzyme abnormalities, which
      occur in enzyme complex of various kinds include E1 alpha, beta, or E2.
      Currently, the cell fusion method, and PCR-SSCP method, miss-match PCR-DGGE
      method and so on are commonly used analytic methods. To sum up the issues
      discussed at this symposium, the most important function of genetic analysis is
      to clarify the relationship between the many clinical phenotypic expressions and
      the essential abnormality in the structure of the gene and/or function of the
      controlling proteins.

PMID- 8350509
TI  - [Assay of erythropoietin in serum with short term enzyme linked immunosorbent
      assay method--the clinical significance: Part 2--:Relation to serum iron, UIBC
      and ferritin in renal failure and hematological disorders].
AB  - With a newly developed short term enzyme linked immunosorbent assay kit (TOYOBO
      Co.), in which 2 kinds of anti-EPO monoclonal antibodies were used, we assayed
      EPO concentration in sera from patients with renal failure and hematological
      disorders. In this report, the EPO data were analysed in relation to serum iron
      concentrations, with ferritin and UIBC. In the patients with renal failure, there
      was no significant correlation between EPO concentration and serum iron,
      ferritin, nor UIBC concentration. On the other hand, in the patients with
      hematological disorders, there were two types. One was in patients with iron
      deficiency anemia, whose serum EPO was negatively correlated to serum iron (r = 
      0.64) and ferritin (r = -0.59), but positively related to UIBC (r = 0.27). The
      another was the pattern in patients with aplastic anemia, leukemia and MDS, whose
      serum EPO positively correlated to iron and ferritin but negatively correlated to
      UIBC. In the patients with aplastic anemia serum EPO had good correlation to
      serum iron (r = 0.62), ferritin (r = 0.60) and UIBC (r = -0.46). The relationship
      of EPO to iron in the patients with leukemia (r = 0.54), and EPO to ferritin in
      the patients with MDS (r = 0.42) show significantly positive correlation
      coefficient.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350511
TI  - [Gene analysis of maple syrup urine disease (MSUD)].
AB  - Maple syrup urine disease (MSUD), an autosomal recessive hereditary metabolic
      disorder, is due to defective oxidative decarboxylation of the branched-chain
      alpha-ketoacids (BCKAs) derived from transamination of the three branched-chain
      amino acids, valine, leucine and isoleucine. The oxidative decarboxylation of
      three BCKAs is catalysed by the branched-chain alpha-ketoacid dehydrogenase
      (BCKDH) complex. BCKDH consists of three catalytic components: E1, E2 and E3. The
      E1 component is further composed of two subunits, E1 alpha and E1 beta. To
      clarify the mechanisms involved in MSUD, measurements of the enzyme activity in
      cultured cells, measurements of the generation time in cultured cells,
      complementation analysis and immunoblot analysis were performed. To further
      elucidate the molecular mechanisms of MSUD, we and others isolated and
      characterized cDNAs encoding BCKDH-E1 alpha, E1 beta, E2 and E3. The human genome
      structures of BCKDH -E1 alpha, E1 beta and E2 were also characterized. Gene
      mutations in E1 alpha, E1 beta and E2, respectively, were identified at the
      molecular level in three cases of classical MSUD. It became clear that the
      molecular mechanisms of MSUD involved not only the function of each subunit but
      also the protein-protein interactions between each subunit. In an attempt to
      further analyse the molecular basis of MSUD, we carried out complementation
      analyses by somatic cell hybridization, and identified the affected component of
      BCKDH complex in the MSUD patient. Furthermore, to rapidly screen for gene
      mutations, we used PCR-SSCP analysis. Seventeen patients with MSUD were examined
      using these methods. Defects of E1 alpha, E1 beta and E2 subunits were suspected
      in 8, 5, and 4 patients, respectively, by complementation analysis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8350512
TI  - [Abnormal antithrombin III: abnormalities of heparin or protease binding domain].
AB  - Two patients with abnormal antithrombin III manifested abnormality in heparin
      binding activity (abnormal antithrombin III "Toyma") or protease binding activity
      (abnormal antithrombin III "Aomori"). Antithrombin III "Toyama" is hereditarily
      homozygous with Arg47 to Cys47 (TGC-->TGT) mutation, and antithrombin III
      "Aomori" is hereditarily heterozygous with Arg393 to His393 (CGT-->CAT). The
      former is classified as type II-c, and the latter as type II-b according to
      Lane's classification2). Both patients showed cerebral thrombosis after age 20.
      Heparin cofactor II activity in the former case was slightly higher than normal.
      Oral anticoagulant therapy was used in the both cases. These cases were examined
      by biological and immunological assay, heparin sepharose column chromatography,
      binding activity to cultured porcine endothelial cells, restriction fragment
      length polymorphysm and polymerase chain reaction. The authors developed an
      antithrombin III assay method to be able to estimate real activity without the
      influence of heparin cofactor II activity11), and to apply the low molecular
      weight heparin to prevent relapse of thrombosis, and finally to find an
      anticoagulant substance in an interesting case of hepatocellular carcinoma
      (Edmondson type 1) producing normal antithrombin III30).

PMID- 8350513
TI  - [Erythrocyte membrane abnormality and hemolytic anemias].
AB  - Screening for hemolytic anemia was established in Fukuoka University Hospital
      based on automated analyses of enzymes and glycolytic intermediates in suspicious
      blood specimens. Using the screening system, we found more than ten hemolytic
      anemias due to abnormalities of membrane proteins, glycolytic enzymes and
      hemoglobin in the last two years. In the present report, we summarize the
      screening system for hemolytic anemias and present two types of hemolytic anemia
      due to abnormalities of band 3 protein and deficiencies in band 4.2 protein.

PMID- 8350514
TI  - [Diagnostic clue and genomic analysis of LDH-M subunit deficiency].
AB  - Lactate dehydrogenase (LDH) M(A) subunit deficiency was first discovered by
      urinary discoloration and a discrepancy of laboratory data. Since then, five
      other families with this disorder have been reported in the Japanese population.
      The response of pyruvate concentration after forearm ischemic work is specific
      for LDH-M subunit deficiency. During strenuous exercise ATP production is
      significantly impaired and muscle tissue is damaged. A genetic study revealed a
      deletion of 20 base-pairs in exon 6 of the LDH-M gene in four families that were
      homozygous and one family that was heterozygous for LDH-M subunit deficiency.
      This mutation results in a frame-shift translation and premature termination. In
      addition to this mutation, we found a nonsense mutation at codon 328 in exon 7 in
      an individual heterozygous for LDH-M subunit deficiency, and a deletion of 3 base
      pairs, TGT at codon 127 in exon 3 in a proposita who was homozygous and in her
      parents who were heterozygous for LDH-M subunit deficiency in the fifth family.
      Therefore, molecular heterogeneities were revealed in genetic mutations of LDH-M
      subunit deficiency.

PMID- 8350515
TI  - [New approach to pathogenesis of genetic hyperlipoproteinemias].
AB  - Genetic hyperlipoproteinemias are produced by defects or abnormalities of several
      enzymes, apolipoproteins and transfer proteins relating to lipoprotein
      metabolism. Abnormalities of the LDL receptor cause familial hypercholesterolemia
      (FH) and the deficiency of cholesteryl-ester transfer protein (CETP) causes
      familial hyperalphalipoproteinemia. Here, abnormalities of the LDL-receptor genes
      and CETP gene are described. More than 70 mutants of LDL-receptor gene have been
      reported, and we discovered 4 mutants in the Hokuriku district of Japan. Compared
      with FH-Tonami-1, FH-Tonami-2 showing a partial defect of the LDL-binding domain
      of the receptor, is a genetically determined mild type of FH. Only 10% of the LDL
      receptor abnormalities in FH have been clarified, and the causes of the remaining
      90% are unknown at present. CETP catalyzes the transfer of cholesteryl ester from
      HDL to other lipoproteins. We found a familial hyperalphalipoproteinemia produced
      by the CETP deficiency. A point mutation in the splice donor site of intron 14 in
      the CETP gene was found in all Japanese patients with CETP deficiency. CETP
      deficiency produces an antiatherogenic lipoprotein profile in high HDL
      cholesterol level and low IDL- and LDL-cholesterol levels. We developed a rapid
      screening method for the splicing defect of CETP gene, by means of primer
      specific restriction map modification. The frequency of the mutated allele in the
      general population was estimated to be 0.81%, and the mutant was frequent in
      Japanese subjects with hyperalphalipoproteinemia. In summary, the detection of
      gene abnormalities is essential for understanding lipoprotein abnormalities and
      clinical manifestations in genetic hyperlipoproteinemias.

PMID- 8350516
TI  - [Genetic analysis of hormone resistance].
AB  - Thyroid hormone resistance is a syndrome defined as impaired tissue response to
      thyroid hormone which would be excessive under normal circumstances. Although it
      has long been speculated that this defect was caused by an abnormality at the
      site of the nuclear receptor for thyroid hormone, isolation of complementary DNA
      encoding thyroid hormone receptors has only recently enabled us to directly
      examine this hypothesis. Thyroid hormone receptors are coded on two separate
      genes, THRA and THRB. Both genes give rise to multiple receptor subtypes through
      alternative splicing or different usage of promoters. Tight linkage between THRB
      locus and resistant phenotype was demonstrated in one affected family, and
      subsequently, more than 30 genetic abnormalities of the THRB gene were isolated.
      No abnormalities have been demonstrated on the THRA gene. Denaturing gradient gel
      electrophoresis was used to screen abnormalities on the THRB gene of affected
      families, and the results also strongly supported the hypothesis that thyroid
      hormone resistance is caused by an abnormal THRB gene. Molecular analysis of
      thyroid hormone resistance will facilitate understanding of the pathophysiology
      of this syndrome and the molecular mechanism of thyroid hormone action.

PMID- 8350517
TI  - [Molecular pathology of congenital pituitary hypothyroidism--discovery of new
      clinical entities].
AB  - Congenital pituitary hypothyroidism (pituitary cretinism) results in severe
      mental and growth retardation when it is not treated soon after birth. Since the
      introduction of neonatal mass screening of thyrotropin (TSH), most congenital
      hypothyroidism has been detected except for pituitary and hypothalamic
      hypothyroidism. In 1971, we reported the first familial case of congenital
      isolated TSH deficiency and thereafter began intensively investigating the
      molecular pathology of congenital pituitary hypothyroidism. After determining the
      entire structure of the human TSH beta gene, we identified the molecular
      pathology in this patient. Recently, we reported a familial case of congenital
      combined pituitary hormone deficiency (PIT1 abnormality). To examine the PIT1
      gene, which encodes pituitary specific transcription factor, Pit-1/GHF-1, we
      determined its genomic structure. Sequence comparisons using PCR amplified PIT1
      gene sequences revealed only one nonsense mutation in the patient, and
      established that this alteration caused the combined deficiencies of TSH, GH and
      PRL. We also discuss other recent progress in molecular pathology of congenital
      pituitary hypothyroidism.

PMID- 8350518
TI  - [The past and future of the clinical microbiology].
AB  - The purpose of clinical microbiology is to provide accurate information about
      microorganisms in a given specimen. This information is of significance to the
      patient as well as to the clinician. In this symposium, we discussed ways in
      which the microbiological laboratory has contributed to controlling infectious
      diseases as well as the advanced technology needed in the laboratory of the to
      future to quickly identify suitable chemotherapy. First, Dr. Kudo reviewed the
      past activities of microbiological laboratories. Then Dr. Machida, Dr. Okada and
      Dr. Kanno discussed the current situation and existing problems in clinical
      microbiology. Following that, Dr. Inamatsu presented a paper on the clinician's
      view of which microbiological examinations are useful inpatient treatment.
      Lastly, Mr. Sugahara discussed advanced technology in the field of clinical
      microbiology, and Dr. Kobayashi described the activity of microbiological
      laboratory as a part of an infection control unit in the hospital.

PMID- 8350519
TI  - [The role of the clinical microbiology laboratory in the past].
AB  - Over the past 150 years, since Koch first isolated the tubercle bacillus,
      clinical microbiologists have used culturing techniques to demonstrate of the
      presence of pathogenic microorganisms associated with infectious diseases in
      clinical specimens. The development of medicine and chemotherapy and the
      improvement of sanitary conditions resulted in a marked decrease in infectious
      diseases. In stead of infections due to virulent pathogens, opportunistic
      infections in the compromised hosts by non-virulent or weakly virulent bacteria
      have been on the rise. As a result, determining the pathogenicity of an isolated
      bacteria becomes important. The past two decades have seen extensive efforts to
      exploit the potential of automation in clinical microbiology and to develop
      increasingly rapid procedures. New technology, such as molecular genetics, has
      also been introduced into clinical microbiology. For more correct and precise
      diagnoses of infectious diseases, the clinical microbiology laboratory should be
      enlarged as an "Infectious Disease Laboratory" to include an extended work on not
      only the detection of pathogens from the specimens of infectious disease, but
      also serodiagnostic tests and immunological tests of hosts. The "Infectious
      Disease Laboratory" would also play a key role in the control of nosocomial
      infection working with the infection control committee and infectious disease
      clinicians.

PMID- 8350520
TI  - [Current state and problems in the microbiology laboratory--organizing the
      laboratory].
AB  - The microbiological laboratory in the hospital has many roles including the rapid
      and precise identification of pathogenic bacteria in specimens, their
      antimicrobial susceptibility tests, microbial antigen detection using
      immunological methods and DNA hybridization methods, surveillance of bacterial
      milieu of the hospital environment, monitoring quality control of microbiological
      methods, to educate microbiological skills of staffs, the economical management
      of laboratory and so on. The last two issues are our major concerns. Improvement
      of the microbiological skills of the staff is most important in the laboratory,
      but is a time-consuming. From our experience, a technical expert, intermediately
      skilled technicians and beginners should always work in the laboratory, together.
      On the other hand, the economical management of the microbiological laboratory is
      also another concern. Although the mechanization of procedures comes to mind, it
      is hard to improve the economical conditions in the laboratory. Because of the
      control of the machines is not completely automatic and requires the knowledges
      and decisions of technical experts, the work force and running cost can not be
      reduced. As the technical expert can economize in the use of media or tests for
      identification of pathogens, good training of beginners into skillful successors,
      is important.

PMID- 8350521
TI  - [Changes in causative agents and the limitations of microbiological technique].

PMID- 8350522
TI  - [Usefulness of microbiological test in clinical decision making--from the view
      point of clinician].
AB  - During the last 50 years, there have been changes in the types of infectious
      diseases causing death in Japan. Endemic diseases have decreased and nosocomial
      infection during the therapeutic course of various diseases have increased.
      Progress of various new medical technology for cancer therapy and transplantation
      are supported by developed infection control, and the target of microbiological
      tests has changed from endemic organisms to resident organisms. To manage
      infectious diseases, clinicians collect considerable information. Microbiological
      tests are only one part and sometimes are used to assess therapeutic results. In
      this situation, microbiological tests sometimes only reconfirm or guide changes
      in therapeutic strategy if the initial empiric therapy was inappropriate. Then,
      well designed statistical data are necessary for appropriate empiric therapy.
      Surveillance of hospital infection is another important role of the
      microbiological laboratory. To improve the functioning of the microbiological
      laboratory, we need not only automatic and rapid systems, but also effective
      communication with clinicians to respond to their needs with clinically useful
      data.

PMID- 8350523
TI  - [The development of an information network for new techniques in clinical
      microbiology].
AB  - In accordance with changes in our life styles and our social and biological
      environment, the techniques and methods of clinical microbiology must change and
      develop. New techniques, such as selected zone culture, direct drug
      susceptibility test, ATP bio-luminescence assay on membrane filter and expiratory
      gas analysis are among these developments. To ensure equal development among
      medical laboratories, an information network concerning these new microbiological
      methods in needed. An enormous quality of information can be contained and
      managed usefully by a two dimensional bar-code system. Clinical microbiology must
      not only contribute to clinical medicine but also respond to changes in the
      social and biological environment, and must include cost effectiveness, and
      preservation of natural resources. Using the new techniques effectively and
      introducing automatic systems will facilitate practical, useful and rapid
      clinical microbiological diagnoses.

PMID- 8350524
TI  - [Clinical microbiology in the 21 century].
AB  - The number of compromised patients has remarkably increased, with the recent
      advancement of medical treatment. This fact may account for the increase in the
      rate of hospital infection. Occupational infection of health care workers from
      blood-borne virus is another problem. During the recent increase in hospital
      infections, clinical microbiology laboratories in many countries performed
      expanded routine work and research. These situations were studied through
      questionnaires sent to countries with membership in the Hospital Infection
      Society. An inquiry into the tasks of clinical microbiology in the 21 century was
      made in order to establish more effective and useful system of the laboratories.

PMID- 8350525
TI  - [Turning point in quality control in Japan--current status & problems and future
      issues].
AB  - Some authorities suggest that quality control in Japan is now at a turning point.
      During the 30 years since its introduction in the 1960s, quality control has
      improved dramatically, and a number of new quality control techniques have been
      designed and applied to routine examination. In actual practice, however, people
      tend to become insensitive to abnormalities or to ignore them, causing an
      increase in the number of abnormal results. This article will review a survey of
      quality control and describe the current status, problems and future issues in
      quality assurance.

PMID- 8350526
TI  - [Turning point in quality control: problems at present and themes in future].
AB  - Quality control in clinical laboratory has a longer than forty-year history after
      its introduction. At present, quality control has been considered as one of
      essential tools to evaluate the quality of clinical laboratory data. However,
      several problems to be solved have still remained. I clarify the problems at
      present and declare the themes in future. Problems of internal quality control
      (IQC): Analytical precision of clinical laboratory test has remarkably improved
      recent years because of the advancement of technologies including analytical
      procedures and instruments. However, analytical accuracy has not attained the
      subjects. Furthermore, QC procedures have been converting into subjects and it
      has been generally considered that using a lot of QC material and QC method is a
      good manner. As a result, fundamental control procedures such as material
      control, reagent control and instrument maintenance have been ignored. Problems
      of external quality control (EQC): It has been considered that EQC serves as an
      indicator of analytical accuracy and shows the average analytical performance of
      all participants. However, some problems have remained as follows: (1) Problem of
      samples for proficiency testing. (2) Problem of classification of peer group. (3)
      Problem of target value. (4) Problem of evaluation criteria. In general, various
      IQC methods have been used without careful consideration. However, I would like
      to emphasize that we have to select the best QC method which can detect the error
      to be checked according to the method performance. For this reason, we have to
      grasp the purpose of QC and be careful to not change the subjects into the QC
      procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350527
TI  - [Review of quality control program for clinical microbiology developed by the
      Tokyo Metropolitan Government].
AB  - There are limitations or disadvantages in previous nation wide external quality
      control (QC) programs. Therefore, the Tokyo Metropolitan Government and the Tokyo
      Medical Association (TMA) initiated the first regional annual external QC program
      in 1982. The QC results in chemistry, hematology and immunology have shown rapid
      improvement. By contrast, some serious problems in microbiology have been
      revealed. METHODS AND RESULTS: The Tokyo Metropolitan external QC programs
      consist of so-called "open" and "blind" surveys. Simulated specimens were
      prepared for open and blind surveys and all laboratories were asked to examine
      the specimens using routine procedures. All participants were required to report
      not only their test results such as codes for computer analysis, but also to
      describe the process. Written answers included the following subjects,
      procedures, culture characteristics and others: number and type of selective
      media, incubation conditions, colonial morphology, microscopic and biochemical
      characteristics of the microorganisms, etc. The survey reports on the
      identification of some kinds of pathologic organism were inaccurate.
      Discrepancies between the number of media used for routine procedures and the
      number used in open survey were detected. CONCLUSIONS: Previous nationwide
      external QC programs using frozen-dried organisms have been valuable in promoting
      general improvement in clinical microbiology in Japan, but they have revealed
      only gross errors. Our 10-year experience has convinced us that additional
      important information is obtained when using simulated specimens for open and
      blind surveys. The turnaround time and other aspects of the reporting of results
      should be monitored. Due to possible legal ramifications of QC surveys,
      laboratories are now more afraid of making errors than before. The continuing
      education of laboratory personnel is essential.

PMID- 8350528
TI  - [Difficulties and problems in external quality control of immunoassay].
AB  - Present status and problems in external quality control of immunoassays were
      described. Despite the increasing popularity of these methods, there are many
      difficulties in achieving good analytical performance. Consequently, immunoassay
      results demonstrate poor interlaboratory comparability. To exclude these
      difficulties, several changes should be made, for example, preparation of common
      reference standards, consent methods to give values to laboratory working
      standards, reference methods, matrix of test samples similar to actual clinical
      samples etc, before constructing suitable external quality control systems.

PMID- 8350529
TI  - [Significance and availability of small scale quality control programs].
AB  - Characteristics of small scale or regional quality control (QC) programs are
      quick responses to resolving QC problems and cooperation. In this paper, we
      illustrated and discussed the positive results of the regional QC program in
      Shizuoka prefecture as a model for small scale QC assurance programs. Kitamura's
      allowable limitations for analytical error in internal QC were estimated from the
      physiological and technical variation of individual assays and compared with the
      coefficient of variation (CV) of each analyte in clinical laboratories. CV of
      analytes in 80% of the laboratories cleared Kitamura's allowable limitation with
      the exception of alkaline phosphatase and calcium. Many laboratories are now
      making extensive efforts toward clearing the allowable limitation in these two
      items. Many working groups (WG), such as enzymes, immunochemistry, and ion
      selective electrode WG, are very active in resolving problems found by QC
      programs. The results obtained in these working groups were effectively
      communicated to the clinical laboratories and bedside physicians. These responses
      in small QC program are surely complementary to large scale QC programs such as
      the QC program of the Japan Medical Association.

PMID- 8350531
TI  - [Quality assurance for histodiagnosis and cytodiagnosis with a model of
      proficiency testing].
AB  - A quality assurance (QA) program for histopathology and cytology has not yet been
      completed although an inhouse quality control for technical standardization is
      being tested. The fact that a strict Performance Improvement Program of CAP
      (College of American Pathologists) for cytology is required separately from other
      laboratory tests emphasizes the importance of cytology, since erroneous cytology
      reports would directly cause incorrect clinical diagnosis. The results of
      questionnaires gathered by the QA Committee of the Japan Association of
      Registered Clinical Laboratories on preparation techniques, workload limits of
      pathologists and technologists, double diagnostic systems, error detection
      programs, and specialization of personnel are presented. In addition to pathology
      and cytology proficiency testing provided by CAP survey, a model of blind QC
      (quality control) in our laboratory is discussed; for diagnostic standardization
      of histopathology, reexamination of randomly selected cases by another
      pathologist and reexamination of previously diagnosed cases by the same doctor
      are periodically performed. For error detection of cytoscreening, cytologists are
      obligated to reexamine random samples of 1 to 10% of negative gynecological
      slides. Evaluation of sufficiency of slides as required by the Bethesda System is
      referred to diagnostic interpretation.

PMID- 8350530
TI  - [Standardization in hematology and the use of the data in clinical laboratories].
AB  - Recently developed automated blood cell counters provide accurate and precise
      data on complete blood count (CBC). The results of nationwide surveys obtained
      using them are usually better than those obtained by biochemical tests. The
      precision of CBC counting has been improved owing to the efforts of laboratories
      and manufacturers. As for hemoglobinometry, the cyanmethemoglobin and
      oxyhemoglobin methods used in blood cell counters gave different results for
      fresh and artificial blood in control surveys. Now instead of the oxyhemoglobin
      method, the sodium lauryl sulfate-hemoglobin method is used to minimize the
      variation among different counters. The biggest problem at present is the lack of
      control blood which can be used for any blood cell counter. Another problem is
      the laboratory report sent to clinicians, which gives only numerical data.
      However, other comments and normal reference values should also be presented.
      Sufficient care may not be taken for normal reference values; they vary
      considerably among different laboratories. Also, most laboratories and
      manufacturers now use various conventional units for CBC, but the SI unit should
      be used for comparison of the data. In conclusion, nationwide unification of CBC
      values should be established in the near future with cooperative efforts by
      laboratories and manufacturers.

PMID- 8350532
TI  - [Problems of survey materials in external quality control survey].
AB  - In the past over twenty years the Japan Medical Association Quality Control
      Survey Committee has experienced various types of problems in preparing a large
      amount of different control survey materials with some matrix effects. This may
      have caused inappropriate evaluation for some of the participated laboratory. Not
      only the participated laboratories but also some industrial companies should
      participate to identify the exact matrix effects, so that the Committee may be
      able to avoid some inappropriate decisions on evaluation of the reported results.
      However, at the present time, no standard is available for the identification of
      matrix effects. The Japanese Committee for Clinical Laboratory Standards, in
      1991, organized the research group on external quality control, and suggested a
      proposal to identify some matrix effects of survey materials for a particular
      assay system.

PMID- 8350533
TI  - [Who manages medical machines and tools in the home? Control of these medical
      devices is difficult under the cost containment plan of the health insurance
      system].
AB  - In 1978, on the 30th anniversary of WHO, Dr. H. Maller who was the Secretary
      General said, "Down with HIGH BLOOD PRESSURE" in the elderly social welfare.
      Since then, many kinds of sphygmomanometers and blood sugar testers have been
      produced and sold on a commercial basis. However, there is no one controls the
      quality standards of these devices. Eighty practitioners from all over the
      country tested the blood pressure of 13,000 patients, using 6 kinds of electric
      sphygmomanometer, such as MATUSITADENKOU EW-252, MATUSITASANGYOU ZH881-A, OMURON
      HEM703C, SHARPE NB-650, TERUMO ES-P100 and TAKEDA MEDICAL US-731. Results of the
      examination were not good. Fifty to 75% of the devices were accurate, but
      difficult for many patients to use. Data from blood sugar testers, ANTSENSE,
      GULTEST, GULCO. SYSTEM and GULUCOTEX, were compared. In one test, there was a 110
      mg/dl difference between ANTSENSE (it's constantly high) and GULCO. SYSTEM (it's
      generally low); the difference was 33.7mg/dl on average, but no accidents have
      happened. Recently, to economize health insurance costs in Japan, the government
      has cut the fee paid for biochemical devices. As a result, we are concerned that
      incorrect management of these machines and tools may occur.

PMID- 8350534
TI  - [A proposal to convert our view from precision into accuracy in routine
      analysis].
AB  - Recently, measurement systems in clinical chemistry have been improved to be more
      precise in analysis than those in 1980s. As a result, several advances in
      instruments and reagents have been brought such as incorporating microprocessors
      into hardwares of instruments and developing ready-to-use reagents, and the
      precision level of measurement systems is now sufficient for routine analysis. In
      the near future, however, we will have to focus on the accuracy of measurement
      systems to obtain accurate and commutable laboratory data. We report a present
      status of the precision in routine analysis and our activity in data maintenance
      for accurate analysis by reference methods.

PMID- 8350535
TI  - [Granule-accumulation in VERO cells used for determination of antitoxin titration
      by micro cell culture method: II. Nature of granules and influence on the potency
      testing of diphtheria toxoid].
AB  - Accumulation of granules occurs in VERO cells when mouse serum was added in high
      concentration. The nature of the granule and influence of the granule
      accumulation on the potency testing of diphtheria antitoxin were studied. The
      concentration of triglyceride in VERO cells increased 15 folds after 24 hours of
      incubation by the addition of undiluted mouse serum. Kinetical study of the
      increase of triglyceride and electron microscope observation suggested that the
      accumulated granules might be oil droplets with an average diameter of 0.27
      micron. The end point reaction of neutralization of diphtheria toxin by the
      standard antitoxin was analyzed by the addition of mouse serum to the micro cell
      culture using VERO cells. The mean values of the end point reactions in the cell
      cultures added with high concentrations of mouse serum were -2.324, -2.338 and 
      2.346, while that of the control group was -2.343. The variance of these mean
      values in the experiment and control groups were 0.0017, 0.0024, 0.0017 and
      0.0021, respectively. A test of homogeneity of variance for these data showed no
      significant difference between them. Furthermore, antitoxin titer of the serum
      specimens of mouse immunized with diphtheria toxoids determined by the micro cell
      culture method were compared with that obtained by rabbit skin test; a high
      correlation between the antitoxin titers by the two techniques was recognized.
      The results were comparable with those of guinea-pig sera. From these results it
      is evident that little influence, if any, was observed in the potency testing of
      diphtheria antitoxin using VERO cells, in spite of the remarkable accumulation of
      granules.

PMID- 8350536
TI  - Timing is everything: the growing need for emergency nurse practitioners.

PMID- 8350537
TI  - Cost consciousness and the emergency nurse.

PMID- 8350538
TI  - Daddy's little girl.

PMID- 8350539
TI  - More on family presence during resuscitation.

PMID- 8350540
TI  - Violence in the emergency department: a daily challenge.

PMID- 8350541
TI  - Introduction of standardized protocols into one pediatric emergency department.

PMID- 8350542
TI  - Greetings from the "Trauma Center of Somalia".

PMID- 8350543
TI  - A 31-year-old woman with acute inferior myocardial infarction, cardiac arrest,
      and subsequent thrombolysis.

PMID- 8350544
TI  - Diagnosis of ventricular tachycardia: a case presentation.

PMID- 8350545
TI  - Driving practices, risk-taking motivations, and alcohol use among adolescent
      drivers: a pilot study.
AB  - OBJECTIVE: To explore risk-taking motivations, driving practices, and alcohol use
      in rural adolescent drivers. DESIGN: Descriptive correlational study, that used
      three self-administered questionnaires: Risk Taking Questionnaire, Driving
      Practices Questionnaire, and Short Michigan Alcohol Screening Test. METHODS: Test
      instruments were administered to 23 adolescent drivers, aged 16 to 18 years,
      recruited by school guidance counselors. RESULTS: Risky driving practices were
      associated with alcohol use (r = 0.73) and greater risk-taking motivations (r =
      0.75). The mean score on the Short Michigan Alcohol Screening Test (4.23)
      reflected alcoholic tendencies. Male gender was moderately associated with risky
      driving practice (r = 0.54). CONCLUSION: Drinking alcohol and risky driving may
      represent a broader risk-taking syndrome. In identifying injury-susceptible
      individuals, gender may be less useful than identification of driving practices.
      Injury alone may an indicator of risk-taking behavior, but when injury is
      combined with alcohol use the index of suspicion increases. Emergency nurses can
      screen injured adolescents for risk-taking motivations and discuss injury history
      and perceived injury susceptibility. Awareness is the first step in initiating
      self-protective measures.

PMID- 8350546
TI  - Psychosocial support of trauma patients in the emergency department by nurses, as
      indicated by communication.
AB  - OBJECTIVE: To test the hypothesis that a difference exists between the perception
      of the nurse and that of the observer regarding the extent of verbal and
      nonverbal communication that occurs between nurses and trauma victims (and their
      families) in the emergency setting. DESIGN AND SETTING: Typical descriptive
      design study completed in a large metropolitan emergency and trauma center in
      central Michigan. METHODS: Verbal and nonverbal interaction between nurses and
      trauma victims and their families were observed by one of two researchers and
      scored with the Moore-Schwartz Data Collection Tool. The nurses then self
      reported these same items. RESULTS: Significant differences existed between the
      researchers' scores and the nurses' self-report scores. This was demonstrated by
      the Spearman Rank Correlation Coefficient (0.2361, p = 0.05), the Wilcoxon Signed
      Ranks Test (61.50, p = 0.0004), and the test (-3.35, p = 0.01). The Spearman Rank
      Correlation Coefficient also demonstrated significant relationships between the
      nurses' self-report scores and age (0.3716, p = 0.05), gender (-0.360, p = 0.05),
      and educational level (-0.4209, p = 0.05). No relationship was found between the
      nurses' self-report scores and the trauma score or age of the patient, or years
      of emergency department nursing experience. CONCLUSION: Nurses report that they
      are communicating verbally and nonverbally with trauma victims and their families
      in the emergency setting, but often were not observed to be doing so. Emergency
      nurses may not be delivering the holistic care and psychosocial support that they
      believe they are.

PMID- 8350547
TI  - Emergency nursing on the Kenyan-Somali border.

PMID- 8350548
TI  - The forgotten vital sign: temperature patterns and associations in 642 trauma
      patients at an urban level I trauma center.
AB  - OBJECTIVES: (1) Identify compliance with the standard of practice that trauma
      patients have body temperature measurement recorded. (2) Describe the range of
      temperatures in a sample of trauma patients. (3) Identify associations between
      temperature and other clinical and trauma variables. DESIGN: Descriptive analysis
      of a cohort of trauma victims. METHODS: We identified patients with traumatic
      injuries during a 14-month period with a computer-based trauma registry. Patient
      charts were reviewed for demographic information, injury data, assessment data,
      and outcomes. The ED chart, nursing notes, and trauma flow sheets were reviewed
      in search of a documented temperature assessment. RESULTS: A cohort of 642 trauma
      patients was identified during the study period. Thirty-two percent were admitted
      to an ICU; 17% went directly to surgery. The mortality rate was 3.4% (n = 22).
      Most patients were male (65%), young (mean age, 34 +/- 18 years), and victims of
      blunt trauma (93%). Seventy-seven percent of patients had a temperature
      measurement recorded in the emergency department. Patients with minor injuries
      were more likely to have had their temperature measured (79%) than those with
      moderate (64%) or severe (64%) injuries (p = 0.0009). Among the 495 patients with
      recorded temperatures, temperatures ranged from 26.5 degrees to 39 degrees C,
      with a mean of 36.7 degrees +/- 1.1 degrees C. Ten percent of the patients had
      temperatures less than 36 degrees C. Temperature correlated negatively with ISS
      (r = -0.20; p = 0.0001) and positively with RTS (r = 0.37; p < 0.0001).
      CONCLUSIONS: We conclude that a significant proportion of trauma patients brought
      to a level I trauma center are hypothermic, with temperatures lower in patients
      more severely injured and in patients who die. Yet temperature measurement, a
      simple and standard nursing procedure, is often ignored in trauma resuscitation.

PMID- 8350549
TI  - Changing from heparin to saline flush solutions: a research utilization model for
      implementation.

PMID- 8350550
TI  - Development of a criteria-based performance appraisal for emergency department
      staff nurses.
AB  - Developing a criteria-based performance appraisal tool is a rewarding effort, but
      not one to be taken lightly. It took weeks. At times, the project loomed as
      "mission impossible." A reflection of its success is the fact that other ED staff
      members (e.g., charge nurses, clerks, triageurs, and lab assistants) now want
      criteria-based performance appraisals for their positions. We have just finished
      a job description and criteria-based appraisal for laboratory assistants.

PMID- 8350551
TI  - From the emergency department to the telemetry unit: is a registered nurse needed
      to transport?

PMID- 8350552
TI  - Evaluation of two reusable wound irrigation systems.

PMID- 8350553
TI  - Triage form and body charts.

PMID- 8350554
TI  - A tPA ninety-minute protocol.

PMID- 8350555
TI  - Triage assessment and nursing record.

PMID- 8350556
TI  - Massive transfusion protocols.

PMID- 8350557
TI  - The "discovery doctrine" in nursing malpractice.

PMID- 8350559
TI  - Weekly educational conferences.

PMID- 8350558
TI  - Warm-weather injuries.

PMID- 8350560
TI  - The febrile child in the emergency department.

PMID- 8350561
TI  - Trauma quality management: closing the loop.

PMID- 8350562
TI  - A 3-year-old with bradycardia.

PMID- 8350564
TI  - Code blue perspectives.

PMID- 8350563
TI  - Emergency nurses' response to Hurricane Andrew's devastation in southern Florida.

PMID- 8350565
TI  - A tourist's view of emergency care "al' Italia": lessons learned.

PMID- 8350566
TI  - A look at our new emergency department: Soldiers and Sailors Memorial Hospital,
      Penn Yan, New York.

PMID- 8350567
TI  - [In Egypt mothers trust in Daya. Interview by Arja Laiho].

PMID- 8350568
TI  - [Dear midwives].

PMID- 8350569
TI  - [Teamwork of clients at Lapinlahti maternity counseling center--experiences from
      the ITU-project].

PMID- 8350570
TI  - [Assessment of the current status of maternity care. Interview by Arja Laiho].

PMID- 8350571
TI  - [Report of water bubbles relieving pain of women in labor].

PMID- 8350572
TI  - [Artificial intraocular lenses in patients with cataracts and glaucoma].
AB  - The authors evaluated 52 glaucomatous eyes in which, after the extracapsular
      cataract extraction, artificial posterior lens has been implanted. In 32 patients
      glaucoma has been treated for 2-6 years. In 7 patients of this group, it was not
      possible to control the intraocular pressure before surgery and in these cases
      simultaneous trabeculectomy, extracapsular cataract extraction and the
      implantation of artificial posterior lens were performed. In 13 patients, anti
      glaucomatous surgery had been performed before, and in 7 cases, glaucoma was
      diagnosed in the preoperative period. We considered our results as satisfactory
      since in 67% visual acuity was over 0.5; 29% of the patients did not require anti
      glaucomatous treatment, whereas 71% took anti-glaucomatous drugs in reduced
      doses. In our opinion, glaucoma is not a contraindication for artificial lens
      implantation, although surgery can be technically more difficult.

PMID- 8350573
TI  - [Intraocular lens implantation in the glaucomatous eye].
AB  - Cataract extraction with intraocular lens implantation was performed in 32 eyes
      of 32 patients in the years 1990-1992. Surgery was performed in 10 eyes with well
      controlled intraocular pressure without any antiglaucomatous operation, in 10
      because of inadequate control with simultaneous trabeculectomy, in 7 after
      earlier filtering procedures and in 5 with secondary glaucoma. Surgical technics,
      intra- and postoperative complications and the results are discussed. Visual
      acuity in 18 eyes was 0.5-1.0, in 10 eyes 0.1-0.4 and in 2 it was 0.05. The
      follow-up for all the eyes yielded normal intraocular pressure, in most cases
      without additional pharmacological treatment.

PMID- 8350574
TI  - [Early and late observations of intraocular pressure in patients with implanted
      intraocular lens].
AB  - The aim of the paper was to evaluate intraocular pressure changes that follow the
      implantation of posterior intraocular lens. In two examined groups of patients (I
      group--sulcus ciliaris, II group--intracapsular implantation) the decrease of
      average intraocular pressure values was observed in the early days after surgery,
      then during 3 months, it gradually returned to the initial values. This decrease
      was less marked in the first group of patients. Long-term observation showed the
      stabilization of intraocular pressure at a level similar to the mean values
      before surgery.

PMID- 8350575
TI  - [Possible advantages of visual evoked potentials and computerized static
      perimetry in early diagnosis of glaucoma].
AB  - Aim of the studies was to evaluate usefulness of the visual evoked potentials and
      static perimetry in diagnosis of an early glaucoma. There were 12 examined cases,
      divided into 3 equal groups: 1) patients suspected for glaucoma basing on the
      characteristic picture of the optic disc, 2) patients after acute glaucoma in one
      eye with no history of the disease in the fellow eye, 3) patients with open angle
      glaucoma diagnosed in one eye. Abnormal results of the examinations were found
      only in the second group. The authors concluded that visual evoked potentials and
      static perimetry could be helpful in proper diagnosis of many difficult cases
      suspected for glaucoma.

PMID- 8350576
TI  - [Diagnostic and therapeutic problems of juvenile glaucoma].
AB  - The material comprised 27 patients, aged 6-15 years, treated for juvenile
      glaucoma. Non-typical first symptoms, good visual acuity in the majority of the
      cases, the lack of anatomical changes of anterior segment of the eye and the
      elongation of the anatomic axis, difficulties in the evaluation of optic disc
      changes, especially in myopic eyes, and the lack of correlation of these changes
      with the results of visual field examination, little reliable in children, and
      also very often the normal intraocular pressure values, delay the diagnosis and
      make it much more difficult. The repetition of tests and the indication of the C
      factor make the diagnosis much easier. During the follow-up, intraocular pressure
      was well-controlled in 87% of the cases, 10% of them with additional optic
      treatment.

PMID- 8350577
TI  - [Glaucoma after congenital cataract extraction in children].
AB  - The clinical material comprised 45 eyes in 33 children aged from 5 months to 8
      years. In the period of 5 days to 7 years after congenital cataract surgery, an
      increased intraocular pressure has been observed. Antiinflammatory treatment,
      optic, cyclocryotherapy, synechia-lysis, anterior vitrectomy, YAG-laser and
      trabeculectomy were applied, depending on the mechanisms that caused the increase
      of intraocular pressure. In 1-5 years follow-up, the control of intraocular
      pressure, using the pharmacological treatment and/or surgery, was obtained in
      88.4% of the cases. On admission, the enlargement of the eyeball was observed in
      26.6% of children, whereas in every fifth of them the cupping of the optic disc
      was recorded.

PMID- 8350578
TI  - [Trabeculotomy and goniotomy in congenital glaucoma].
AB  - The authors evaluated efficiency of antiglaucomatous surgery in 73 eyes of 50
      children, staying under clinical control in the years 1969-1991. It was showed
      that after trabeculectomy, as the primary procedure, intraocular pressure was
      normalized much more often (40.9%) than after goniotomy (20.2%). In cases
      operated many times using different technics, more effective was goniotomy.
      Better visual acuity was found in cases with intraocular pressure well controlled
      after one surgical procedure. The most common complications connected with
      surgery were discussed.

PMID- 8350579
TI  - Trabeculectomy with 5-fluorouracil in complicated glaucoma.

PMID- 8350580
TI  - [Laser trabeculoplasty in open-angle glaucoma treatment--long term results of
      treatment].
AB  - The authors present the results of open-angle glaucoma treatment, in the cases
      where laser trabeculoplasty was the basic treatment. The follow-up of 53 treated
      patients (72 eyes) was approximately a little more than 3 years. The
      stabilization of the basic eye functions, i.e. the visual acuity in 76.4% and the
      visual field in 84.7% of the cases, was obtained. As a result of the treatment, a
      decrease of intraocular pressure below 21 mm Hg was obtained in 84.7% of the
      cases whereas the outflow facility factor c > 0.15 was observed in 72.2% of the
      examined eyes. The low outflow facility factor is one of the causes of the
      failures.

PMID- 8350581
TI  - [Surgical treatment of absolute and secondary glaucoma with rubeosis iridis].
AB  - An analysis of 52 cases of patients operated with cyclo-diathermy under the
      scleral flap has been presented. The scleral flap was situated depending on the
      changes in the angle of the anterior chamber of the eye. The thickness of the
      prepared flap was 3/4 of thickness of the sclera. The flap was over ciliary body,
      in one third of the eyeball. Diathermic puncture was performed in 3 rows while
      perforating puncture, draining off the aqueous humor from the posterior chamber,
      was performed 2 mm from the limbus. In 45 cases, intraocular pressure was
      normalized after the first operation, in 4 cases after the second one, whereas in
      3 cases the pressure was kept at the level of 30-40 mm Hg.

PMID- 8350582
TI  - [Microsurgical modification of Allen's glaucoma operation].
AB  - The modified anti-glaucomatous operation, introduced its classical version by
      Allen, has been presented in this paper. The microsurgical version could be
      defined as micro-cyclodialysis with basal iridectomy, combined with the
      restoration of the anterior chamber. The surgery was performed in simple glaucoma
      and glaucoma in aphakic eyes. The details of the surgery and the illustrations of
      its respective phases have been presented. The results were based on clinical
      observation of 41 patients. The satisfactory results, up to 6 months, were
      obtained in 85.3% of the patients. Later the percentage decreases to 78%. For 10
      aphakic eyes stabilization was obtained in 9 cases.

PMID- 8350583
TI  - [Doctor of medicine Maria Stankiewicz-Strozewska (1935-1992). Obituary].

PMID- 8350584
TI  - [Preventive antibiotic administration for prevention of nosocomial septicemia in
      very small premature infants (VLBW infants)--preventive vancomycin administration
      against infections with coagulase negative streptococci--prevention of
      translocation with oral cefixime therapy in intestinal colonization with
      pathogenic gram-negative pathogens].
AB  - VLBW-infants below 1500 g of birth weight have a quite high risk to acquire a
      nosocomial sepsis. 20-40% of all infants exhibit signs of nosocomial infection
      once during neonatal intensive care. The rate of infection is related to
      technique and amount of used invasive devices as to gestational age. Coagulase
      negative staphylococci (CONS) and gram-negative organisms contribute most to
      these cases of sepsis. In a three phase study we tried to demonstrate the
      efficacy of different mechanisms to change the rate of nosocomial sepsis. During
      the first phase a strict hygienical protocol was enforced as isolation, care with
      sterile gloves and aseptic techniques in introducing and maintaining i.v. lines.
      In a second phase we started a randomized controlled study of prophylactic
      vancomycin (10 mg/kg/day in two doses). In a third phase we added an oral
      antibiotic regime with cefixime for all patients with positive cultures for
      gramnegative organisms under the hypothesis of translocation from the gut as the
      way of infection. During the first phase 23.7% of 76 patients enrolled acquired
      CONS-sepsis, 0.52% gramnegative sepsis. During the second phase (41 patients) 6
      patients in the control group acquired CONS-sepsis, none in the vancomycin-group.
      The rate of gramnegative infections was not different (4 and 3 cases). During the
      third phase (vancomycin plus cefixime eventually in cases of positive stool
      cultures) no case of nosocomial sepsis occurred (35 patients, 11 positive
      cultures). The management used in phase 3 reduced the rate of nosocomial
      infections in VLBW-infants drastically.

PMID- 8350585
TI  - [Effect of body position and positioning changes on lung function of ventilated
      premature and newborn infants].
AB  - We studied 21 intubated premature infants (wts 800-2800 g) with respiratory
      distress syndrome between day 2 and 10 to evaluate the effect of body position on
      lung mechanics and gas exchange. The dynamic compliance of the total respiratory
      system was similar in the prone and supine position. When the infant was turned
      from the supine or the prone position to the other one, a significant improvement
      of oxygenation was seen temporarily. Positioning did not significantly affect the
      dynamic compliance, the minute volume or pCO2. In circulatory stable premature
      infants a change of the body position probably alters the regional ventilation to
      perfusion ratio and leads to a reduction of intrapulmonary venous admixture.

PMID- 8350586
TI  - [Which therapy is necessary for prenatally diagnosed multicystic kidney
      dysplasia?].
AB  - Multicystic dysplastic kidneys (MCD) were found in 17 of 114 neonates with
      prenatal diagnosis of urinary tract malformations. Distribution of side and of
      sex was not different. Contralateral malformations were present in 3 infants. One
      of them with contralateral renal dysplasia and cardiac malformation died at the
      age of 4 weeks. All other children so far have a normal renal function. Three
      neonates presented with a palpable abdominal mass, 2 infants had urinary
      infections during the first year of life. Two neonates had obstruction of the
      contralateral kidney caused by the giant MCD which relieved after nephrectomy.
      Hypertension or development of malignancy were not noted. Nephrectomy was
      performed in 10 infants at the mean age of 3.2 months. Six infants had
      conservative treatment and a complete regression was noted in 5 of them within a
      period of 8 to 18 months. Prenatal diagnosis of MCD enables early recognition of
      contralateral urinary malformations and of problems caused by the MCD itself.
      Conservative treatment is recommended in all asymptomatic patients. Studies of
      the natural history may show that regression of MCD is the rule and could account
      for many cases with apparent unilateral renal agenesis.

PMID- 8350587
TI  - [Protracted croup syndrome. Bacteriologic findings and therapeutic consequences].
AB  - BACKGROUND: Croup normally is characterized by acute onset and a self limited
      course of only few days. In 1990 and 1991 at the University Children's Hospital
      Freiburg an unexpected high number of patients were hospitalized for prolonged
      Croup syndrome. Expanded microbiological investigations were used to uncover
      etiologic factors. METHODS: Of a total of 138 inpatients with Croup 60 (17 in
      their first year of life, 21 in the second year of life and 22 infants older than
      2 years) had bacteriological (37 nasopharyngeal-, 4 tracheal-aspirates or 19
      throat swabs), and virological (antigen detection in nasopharyngeal aspirates, n
      = 28) tests. Of these patients 48% were hospitalized longer than 3 days (mean
      4,7; range 1-18 days). RESULTS: Bacteria found: B. catarrhalis 24/11 (total/pure
      culture), S. pneumoniae 15/6, H. influenzae 10/3, S. group A 5/4 and S. aureus
      4/1. Sixteen specimen yielded more than one pathogen, one specimen was sterile.
      Nasopharyngeal secretions had the most reliable results: Pure cultures (72%) and
      associations of two pathogens (87%) were found in these aspirates, and only 26%
      of the unspecific mixed findings (p < 0.005; chi 2-Test). Of the patients
      hospitalized longer than 3 days 27.6% had positive cultures for H. influenzae,
      whereas only 6.5% of those hospitalized shorter (p < 0.05; chi 2-Test). The only
      microorganism with an age-bound distribution was B. catarrhalis found
      predominantly (54.2%) in the 2nd year of life, with 62% of patients positive (p <
      0.05; chi 2-Test). Virus found: RSV (n = 3), Parainfluenza 2 (1) and
      Parainfluenza 3 (1). CONCLUSIONS: Nasopharyngeal aspirate is the most reliable
      specimen for a bacteriologic diagnosis in Croup. In the second year of life B.
      catarrhalis is present in most Croup cases, and H. influenzae was associated with
      a prolonged course of the disease. An appropriate antibiotic therapy therefore
      must cover these two pathogens.

PMID- 8350588
TI  - [Sedation versus general anesthesia in pediatric endoscopy].
AB  - Upper endoscopy was performed in 567 patients: 237 under general anesthesia, 261
      in intravenous sedation with midazolam and etomidat (mean dosage 0.26 mg/kg
      bodyweight), 69 without any premedication. In these many patients defended
      strongly and some investigations have to been interrupted. On the other hand
      general anaesthesia needed much more time and personnel and produced more costs.
      In our experience sedation with midazolam and etomidat is most comfortable for
      patient and endoscopist and the time needed is shorter than in general
      anaesthesia. Therefore we recommend this method even in therapeutic endoscopy,
      except only in sclerotherapy of esophageal varices.

PMID- 8350589
TI  - Constitutional interstitial deletion of 17(p11.2) (Smith-Magenis syndrome): a
      clinically recognizable microdeletion syndrome. Report of two cases and review of
      the literature.
AB  - We present two patients, a 12 year old Turkish and a 7 year old Italian girl,
      with severe mental retardation, multiple congenital malformations and a
      constitutional interstitial deletion of the short arm of chromosome 17, del(17)
      (11.2). The main clinical features of this syndrome which is also referred to as
      the Smith-Magenis syndrome consist of a broad flat midface with brachycephaly,
      broad nasal bridge, brachydactyly, speech delay, hoarse deep voice and peripheral
      neuropathy. Behavioural abnormalities include hypermotility, self mutilation and
      sleep disturbances. The remarkable consistency of the main clinical features of
      the 59 patients documented so far permits the clinical diagnosis of this
      syndrome; a fact which is of importance, since many of the reported patients-
      including ours--were considered normal on earlier cytogenetic studies.

PMID- 8350590
TI  - [Echocardiographic diagnosis of congenital diverticuli of the right and left
      ventricle].
AB  - A congenital diverticulum of the ventricle is a very rare cardiac lesion which is
      almost always associated with additional cardiovascular anomalies. In the
      majority of cases a diverticulum of the heart has been diagnosed during cardiac
      catheterization for evaluation of additional cardiovascular anomalies. We report
      noninvasive echocardiographic diagnosis of a congenital cardiac diverticulum in
      two patients. Noninvasive imaging of the diverticulum facilities planning of
      cardiac catheterization, angiographic imaging and surgical treatment of this rare
      anomaly.

PMID- 8350591
TI  - Respiration and heart rate variation in normal infants during quiet sleep in the
      first year of life.
AB  - Forty-three all-night sleep recordings have been performed on 19 control infants
      of the ages 6 weeks, 6 months and 1 year. During eight hour periods 22
      physiological parameters were sampled by a personal computer based monitoring
      system and stored on an optical disk. This paper reports on spectral analysis of
      breathing and heart rate patterns during the first and last episode of quiet
      sleep at three different age groups. The results demonstrate that the respiratory
      rate during quiet sleep decreases (6 weeks: 37.2 +/- 5.4; 6 months: 30.1 +/- 4.9;
      1 year: 24.1 +/- 1.8; adults (mean age 25.1 +/- 2.8 years; n = 10): 14.8 +/- 1.8;
      values are means +/- one standard deviation in breaths/min) and the respiratory
      coefficient Pm/Ps (higher values of Pm/Ps indicate lower respiratory variability)
      increases with age (6 weeks: 2.3 +/- 0.7; 6 months: 3.2 +/- 1.1; 1 year: 3.4 +/-
      1.0; adults: 4.5 +/- 1.0). The calculation of the heart rate in beats per minute
      (bpm) and heart rate variability (%) revealed the following results: 6 weeks:
      127.4 +/- 11.5 bpm, 3.8 +/- 1.5%; 6 months: 119.4 +/- 17.3 bpm, 4.2 +/- 1.7%; 1
      year: 110.3 +/- 21.5 bpm, 5.8 +/- 2.3%; adults: 59.2 +/- 8.5 bpm, 4.3 +/- 2.2%. A
      comparison of the cardiorespiratory data from the first and last quiet sleep
      period showed no significant differences within either age group.

PMID- 8350592
TI  - [Variability of corticosterone methyl oxidase (type II) deficiency. Presentation
      of three case reports].
AB  - We report on three cases of Corticosterone Methyl Oxidase Typ II deficiency in
      two siblings and one boy. All three children were presented with typical symptoms
      of a saltlosing syndrome (vomiting, poor drinking, weight loss, hypotonia).
      Hyponatremia and hyperkalemia, low plasma aldosterone concentrations when related
      to high plasma-renin-activities suggested deficiency in the final steps of
      aldosterone biosynthesis. Variable degrees of enzyme deficiency and no relation
      of biochemical findings to the clinical symptoms were observed. Clinical symptoms
      became less severe with age. Diagnosis of CMO II-deficiency was established by an
      abnormal high ratio of 18-hydroxycorticosterone to aldosterone, by measurement of
      their precursors and metabolites in plasma and urine. In one sibling negative
      values may have been caused by suppression of the renin-angiotensin-system due to
      high sodium replacement therapy.

PMID- 8350593
TI  - [Holt-Oram syndrome in combination with reciprocal translocation, lung hypoplasia
      and cardiomyopathy].
AB  - A now two years old girl had developed respiratory insufficiency shortly after
      birth requiring prolonged artificial ventilation. A hypo- and dysplasia of the
      right lung was identified as the underlying cause. Further diagnostic evaluation
      revealed a malformation of bones, i.e. shortness of the humerus, aplasia of the
      radius, shortness of the ulna and a congenital anlage of four metacarpal bones in
      fixed malposition. In addition, an atrial septal defect of the sinus venous type
      with left-to-right shunting was present. This, in combination with the sceletal
      abnormalities pointed to the diagnosis of Holt-Oram syndrome. In her first year
      of life the patient also developed a hypertrophic non-obstructive cardiomyopathy.
      Cytogenetic analysis of her family revealed a reciporke translocation between
      chromosome 1 and 11 (t -1, -11 (1p13, 11q13)) in the patient herself, her father
      and the father and a sister of her father. However, this finding as well as the
      hypertrophic cardiomyopathy has to be regarded as being independent from Holt
      Oram syndrome.

PMID- 8350594
TI  - [Persistent pulmonary hypertension in the newborn infant caused by aneurysm of
      the vein of Galen].
AB  - A male full-term neonate is described in whom cardiac insufficiency developed
      within 24 hours post partum. Ultrasound revealed an arterio-venous fistula of the
      vein of Galen. The patient's condition did not allow surgical correction and he
      died on the 22nd day of life. Persistent pulmonary hypertension was an important
      accompanying feature. The literature is reviewed with respect to the prognosis
      and the up to now seldom reported complication of persistent pulmonary
      hypertension of the newborn (PPHN).

PMID- 8350595
TI  - Cell-cell and cell-matrix interactions in the skin.

PMID- 8350596
TI  - Cellular selection in the genesis of multicellular organization.

PMID- 8350597
TI  - Undifferentiated keratinocytes control growth, morphology, and antigen expression
      of normal melanocytes through cell-cell contact.
AB  - BACKGROUND: Melanocytes in the normal human epidermis are generally dendritic and
      neither proliferate nor express melanoma-associated antigens. In culture, on the
      other hand, melanocytes are bi- to tripolar, proliferate with 2 to 4 day doubling
      times, and express melanoma-associated antigens. This observation prompted us to
      investigate the regulatory role of keratinocytes for growth, morphology, and
      antigen expression of melanocytes. EXPERIMENTAL DESIGN: Melanocytes and
      keratinocytes were cultured under three different co-culture conditions: (a)
      separated by a semiporous membrane, (b) in monolayer cultures allowing direct
      contact between cells, and (c) in three-dimensional epidermal reconstructs.
      RESULTS: Melanocytes separated from keratinocytes by semiporous membranes
      remained di- and tripolar and could not proliferate in medium optimal for
      keratinocytes. When cell-cell contact was established between melanocytes and
      undifferentiated, but not differentiated, keratinocytes, melanocytes proliferated
      at a rate similar to keratinocytes and they developed multiple dendrites. In co
      cultures allowing the multi-layered growth of keratinocytes, melanocytes were
      nonproliferative when juxtaposed to undifferentiated keratinocytes in the basal
      layer, but proliferated when surrounded by differentiated keratinocytes in the
      intermediate and upper layers. Expression of melanoma-associated antigens on
      melanocytes decreased to similar levels as in normal skin when melanocytes were
      in direct contact with undifferentiated, but not differentiated, keratinocytes.
      CONCLUSIONS: Undifferentiated, but not differentiated, keratinocytes control
      growth, morphology, and antigen expression of melanocytes through direct cell
      cell contact. These results suggest that the phenotypic characteristics of nevus
      and melanoma cells in the dermis, i.e., proliferation and expression of tumor
      associated antigens, may be due to their loss of contact with undifferentiation
      keratinocytes.

PMID- 8350598
TI  - A potential role for N-cadherin in mediating endothelial cell-smooth muscle cell
      interactions in the rat vasculature.
AB  - BACKGROUND: The cadherins are a family of calcium-dependent cell adhesion
      molecules that play a critical role in morphogenetic cell interactions in the
      embryo. N-cadherin has been identified in neural and non-neural tissues,
      including developing muscle; however, there are few reports of N-cadherin
      expression in adult mammals. We attempted to identify N-cadherin in the rat
      vasculature and to ask whether it has a role in mediating vascular cell
      interactions. EXPERIMENTAL DESIGN: Vascular tissues were isolated from Fischer
      rats and analyzed immunohistochemically and by Western blotting using pan
      cadherin and N-cadherin antibodies. Anti-N-cadherin antibodies were used in an in
      vitro cell adhesion assay to determine if N-cadherin mediates interactions
      between smooth muscle cells (SMC) and endothelial cells (EC). RESULTS: Western
      blot analysis of vascular tissues reveals a 135 kilodalton (kd) band that is
      recognized by anti-N-cadherin antibodies. N-cadherin localizes in the rat aorta
      to the endothelium and to the smooth muscle cell layer beneath the internal
      elastic membrane. A cell adhesion assay demonstrates that rat SMCs and ECs adhere
      to each other in a Ca(2+)-dependent manner, and an anti-N-cadherin antibody
      inhibits approximately 25% of this adhesion. CONCLUSIONS: Our data indicate that
      N-cadherin is expressed in large vessels of the rat and is capable of mediating
      EC-SMC adhesion in vitro. It is noteworthy that N-cadherin localizes to a
      population of SMCs in the rat aorta adjacent to ECs suggesting that N-cadherin
      may mediate EC-SMC interactions in vivo.

PMID- 8350599
TI  - Clinicopathologic study of dextran sulfate sodium experimental murine colitis.
AB  - BACKGROUND: We undertook this study in order to fully characterize the clinical
      and histopathology features of the dextran sulfate sodium (DSS) model of
      experimental murine colitis and to discover the earliest histopathologic changes
      that lead to colitis. EXPERIMENTAL DESIGN: Acute colitis was induced in Swiss
      Webster mice by 7 days of oral DSS with animals sacrificed daily. Chronic colitis
      was induced by: (a) 7 days of oral DSS followed by 7 days of H2O (for 1, 2, and 3
      cycles) and (b) 7 days of oral DSS followed by 14 and 21 days of H2O. In each
      experimental group, the entire colons were examined histologically and correlated
      with clinical symptoms. RESULTS: Acute clinical symptoms (diarrhea and/or grossly
      bloody stool) were associated with the presence of erosions and inflammation.
      More importantly, the earliest histologic changes which predated clinical colitis
      was loss of the basal one-third of the crypt (day 3), which progressed with time
      to loss of the entire crypt resulting in erosions on day 5. The earliest changes
      were very focal and not associated with inflammation. Inflammation was a
      secondary phenomena and only became significant after erosions appeared. Animals
      treated with only 7 days of DSS followed by 14 and 21 days of H2O developed a
      chronic colitis with the following histologic features: areas of activity
      (erosions and inflammation), inactivity, crypt distortion, florid epithelial
      proliferation and possible dysplasia. These changes were similar to animals given
      3 cycles of DSS. The clinical disease activity index correlated significantly
      with pathologic changes in both the acute and chronic phases of the disease.
      CONCLUSIONS: The mechanism of DSS colitis is presently unknown. However, the
      finding of crypt loss without proceeding or accompanying inflammation suggests
      that the initial insult is at the level of the epithelial cell with inflammation
      being a secondary phenomena. This may be a good model to study how early mucosal
      changes lead to inflammation and the biology of the colonic enterocyte. Chronic
      colitis induced after only 7 days of DSS may serve as a useful model to study the
      effects of pharmacologic agents in human inflammatory disease and mechanisms of
      perpetuation of inflammation. Finally, we believe that this model has the
      potential to study the dysplasia cancer sequence in inflammatory disease.

PMID- 8350600
TI  - Origin of urinary fibronectin.
AB  - BACKGROUND: Fibronectin (FN) is a major component of the glomerular extracellular
      matrix and it is also abundant in plasma. In physiologic conditions, FN fragments
      are excreted into urine. Increased urinary FN excretion has been observed in
      renal diseases raising the question whether urinary FN could reflect changes in
      the renal extracellular matrix. This study examines whether urinary FN is
      filtered from plasma or derived from the kidney and it attempts to specify the
      potential renal source of urinary FN. EXPERIMENTAL DESIGN: (a) To investigate
      whether urinary FN is filtered from plasma, labeled, biotinylated FN (b-FN) was
      injected into rats and urine samples were specifically analyzed for b-FN by an
      immunoblot procedure. (b) To specify the renal source of urinary FN and to
      evaluate possible alterations of this protein during passage into final urine,
      tubular fluid was collected from distinct localizations of the nephron by
      micropuncture techniques. The samples were analyzed for endogenous FN by a highly
      sensitive immunoblot system, and the pattern was compared with that normally
      found in final urine. RESULTS: (a) Urine samples collected over a period of 5
      days after injection of b-FN contained no labeled FN. Control experiments in rats
      with highly elevated glomerular permeability confirmed that the plasma levels of
      injected b-FN were sufficiently high since b-FN was detected in urine in this
      condition. (b) The FN fragment pattern, with two protein bands at 75 and 45
      kilodaltons, that is normally found in final urine, was already present in
      samples taken from the early proximal tubule and the distal tubule. CONCLUSIONS:
      The fibronectin fragments normally found in urine originate from the kidney and
      are not derived from plasma. Since these fragments are already observed in early
      proximal tubular fluid, the glomerulus is the probable source of urinary FN. The
      FN fragment pattern of early proximal tubular fluid is not substantially altered
      during passage into final urine, thus reflecting glomerular FN release in urine.
      It is suggested that examination of urinary FN excretion could be helpful in the
      assessment of altered glomerular extracellular matrix in pathologic conditions.

PMID- 8350601
TI  - Contemporary perspectives on sport psychology.

PMID- 8350602
TI  - Blood lactate accumulation in top level swimmers following competition.
AB  - The purposes of this study were to evaluate the significance of blood lactate
      values after competitions and the blood lactate-swimming speed relationship to
      swimming performances. Auricular blood samples (N = 421) were collected in 203
      top level Italian swimmers (116 males and 87 females) at the end of competitions
      performed in a 25 m swimming pool. The distribution of all lactate values
      differed between males and females. The lowest lactate values occurred in
      swimmers performing the longest distances both in males (1500 m) and females (800
      m). In swimmers performing freestyle events a relationship between V-4 mM
      (swimming speed at 4 mmol/l blood lactate value) and competition velocities was
      observed, in males, at 200, 400 and 1500 m and, in females, at 400 and 800 m. The
      predicted velocity corresponding to the competition lactate value assessed by the
      individual blood lactate-swimming speed relationship was found to be highly
      related to the actual competition velocity. Results suggest that blood lactate
      values in swimmers are a useful indication of individual aptitudes.

PMID- 8350603
TI  - Changes in physical fitness profile in female basketball players during the
      competitive season including explosive type strength training.
AB  - Ten female basketball players served as subjects in order to examine changes in a
      physical fitness profile during a 22-week official competitive season. Specific
      explosive type strength training (1-2 sessions per week) was utilized throughout
      the season. The present findings showed that the entire competitive season led to
      no systematic changes in the maximum oxygen uptake (from 48.0 +/- 6.6 to 47.0 +/-
      6.0 ml.kg-1.min-1), in anthropometric characteristics or in maximal isometric
      force of the leg extensor muscles (from 2567 +/- 490 to 2622 +/- 747 N). However,
      significant (p < 0.05) increases occurred during the season both in the average
      power output during the first 15 s work in an anaerobic jumping test and in the
      maximal vertical jumping heights in the squat jump (from 21.7 +/- 2.3 to 24.2 +/-
      2.4 cm) and in the counter movement jump (from 24.9 +/- 2.6 to 26.3 +/- 2.9 cm).
      A considerable change occurred also in the shape of the isometric force-time
      curve of the leg extensor muscles so that the times to produce submaximal force
      level shortened (p < 0.05). The individual changes during the competitive season
      both in the power output and in the times of rapid force production correlated
      negatively (p < 0.05) with the individual initial values recorded before the
      season. The present findings suggest that the prolonged competitive season in the
      present female basketball players seemingly placed sufficient demands on the
      athletes in energy production through aerobic processes to maintain their level
      of VO2max.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350604
TI  - Effect of water temperature on performance, lactate production and heart rate at
      swimming of maximal and submaximal intensity.
AB  - The effect of water temperature on performance effort, monitored heart rate and
      lactate production during freestyle swimming at maximal and submaximal speed has
      been studied. Fifteen male sprint swimmers performing 100 m swimming and fifteen
      comparable endurance competitors performing 30 min swimming at submaximal speed
      served as subjects. Water temperature in separate events was 20, 26 and 32
      degrees C. At maximal performance there was a direct relationship between any two
      of the following parameters: water temperature, average swimming speed, heart
      rate during the competition and plasma lactate concentration after the event.
      Thus, the best effort (speed 1.704 m/s), the highest peak heart rate (185
      beats/min) and the highest lactate level (19.8 mmol/l) were observed at 32
      degrees C (all mean values). In contrast, these values were markedly lower at 20
      degrees C. At the submaximal effort, water temperature was related to peak heart
      rate only. The highest peak heart rate (144 beats/min) was again obtained at 32
      degrees C, while the lactate concentration (4.2-5.2 mmol/l) was independent of
      temperature. Water temperature appears to have a direct effect on performance
      effort, heart rate and lactate production during swimming at maximal intensity,
      whereas this effect seems to fade at submaximal efforts.

PMID- 8350605
TI  - Predictions of maximum oxygen uptake from treadmill walking and running.
AB  - The purpose of this study was to determine if maximal oxygen uptake (VO2 max)
      could be accurately predicted with the Astrand-Ryhming (AR) method in conjunction
      with equations reported by the American College of Sports Medicine (ACSM) that
      estimate the oxygen cost of submaximal walking and running. Fifty-three subjects
      (28 males and 25 females) performed three treadmill tests to determine VO2 max
      and heart rate and oxygen costs of submaximal walking and running. The results
      indicated that when ACSM estimates of the oxygen cost of walking and running were
      used with the AR method, reasonably accurate predictions of VO2 max were obtained
      for the present group of subjects. Correlations between actual and predicted VO2
      max values of r = 0.82 and r = 0.86 and standard errors of estimate 0.47 and 0.53
      L.min-1 were determined for treadmill walking and running, respectively. These
      errors are similar to others reported using the AR method with different exercise
      modes.

PMID- 8350606
TI  - Cardiorespiratory response to walking in trained and sedentary pregnant women.
AB  - In order to test whether trained (n = 10) and sedentary (n = 29) pregnant women
      have different responses to weight-bearing exercise in the second trimester
      (range 23 to 28 weeks of gestation), subjects walked continuously on a treadmill
      for 26 minutes: at low intensity for 10 minutes, then an intermediate stage,
      followed by moderate intensity for 10 minutes. In the trained group, the mean
      heart rate was lower (p < 0.02) with both low [104.0 +/- 4.5 (SD) versus 117.4 +/
      2.3 bpm] and moderate intensity exercise (128.4 +/- 5.7 versus 145.2 +/- 2.9
      bpm) and the associated mean stroke volume was higher (105 +/- 16 versus 84 +/-
      17 ml; 103 +/- 15 versus 86 +/- 18 ml, respectively) (p < 0.02). The mean cardiac
      output, blood pressure and oxygen consumption were the same in the two groups (p
      > 0.02) at the same absolute workloads. The potential implications of these
      findings for exercise prescriptions for pregnant women, research evaluation and
      exercise testing are discussed.

PMID- 8350607
TI  - Spectral analysis of heart rate variability in athletes.
AB  - The objectives of the study were to characterize power spectrum pattern of the
      heart rate variability and assessment of the relative contributions of
      sympathetic and parasympathetic cardiac nervous system control in athletes.
      Thirty-three male athletes, swimming (1), canoeing (10), cycling (6), athletics
      (4), football (3), roller-skating (2) and volleyball (7) aged 23.4 +/- 5.5 years,
      with a mean athletic level of 18 hours/week (8-45) and 33 sedentary healthy
      control subjects were included. Ecg signals were recorded after a period of 15
      minutes in supine rest with controlled breathing at 15 cycles/min. Signal
      acquisition was done at 300 samples/sec. From 512 consecutive heart beats, we
      calculated mean average, standard deviation, maximum and minimum R-R intervals
      and, after computing the fast Fourier transform, total spectrum power, low
      frequency (LF), high frequency (HF) components and its ratio (LF/HF). The average
      R-R interval was 987.7 +/- 168.8 ms and 762.7 +/- 125.3 ms, the variance was 5.44
      and 2.51 ms2 and ratio of R-R interval maximum/minimum (E/I ratio) 1.53 +/- 0.16
      and 1.41 +/- 0.16, respectively for athletes and control group. Differences
      between groups were significant (p < 0.01) for all parameters, with higher
      variability in the athletes. Both spectral bands (LF and HF) had higher power in
      athletes (LF = 925 +/- 920 and HF = 2258 +/- 2349 ms2) than in the control group
      (LF = 442 +/- 446 and HF = 1179 +/- 1542 ms2) (p < 0.01). There were no
      significant differences for LF/HF ratio, or normalized LF (LF%) or normalized HF
      (HF%) between groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350608
TI  - The effects of a walking program on body composition and serum lipids and
      lipoproteins in overweight women.
AB  - Few prospective studies have been conducted with women to examine the effects of
      walking on body composition and serum lipid profiles. Overweight women were
      randomly assigned to either an exercise EX (no. 18) or a nonexercise NEX (no. 18)
      group. The EX group participated in five 45 min sessions/week of brisk walking at
      62 +/- 2% VO2max for 15 weeks. Statistical analysis (2 x 3 repeated measures
      ANOVA) revealed that the pattern of change in total body weight [F(2.68) = 6.65,
      p = 0.002] but not body fat percentage, was significantly different between EX
      and NEX groups; NEX subjects had a 1.6 +/- 0.5 kg gain in contrast to no change
      in EX subjects. The pattern of change in serum triglycerides, total cholesterol,
      and LDL-C was not significantly different between groups. The interaction
      statistic for HDL-C, however, was significant [Pillais Trace (2.33) = 3.73, p =
      0.035] with HDL-C tending to rise in the NEX group in contrast to a small
      decrease in the EX group. Change in kilocalorie intake was positively correlated
      with change in HDL-C, total cholesterol, and body weight. Change in body weight
      also correlated positively with change in HDL-C. Our findings suggest that
      moderate exercise training alone may not be a sufficient stimulus to affect body
      composition and serum lipid profiles favorably in overweight women.

PMID- 8350609
TI  - Effect of a protein-sparing diet on responses to exercise in obese subjects.
AB  - We have studied muscular work efficiency and VO2 peak in seven obese individuals
      (body mass index: 38.9 +/- 5.8 kg.m-2) before and after twelve days of a low
      caloric diet (protein-sparing modified fast) providing about 2460 kJ/day.
      Respiratory gas exchanges were measured at rest and during an exercise protocol
      through a rubber mask connected to a pneumotachograph and a mass spectrometer. A
      significant reduction in body mass was observed with the diet therapy (109 +/- 12
      vs 105 +/- 14 kg; p < 0.02). No significant differences were observed in VO2 peak
      (1.78 +/- 0.32 vs 1.88 +/- 0.43 l/min, p > 0.05) and work efficiency (26 +/- 5 vs
      24 +/- 4%, p > 0.05), after the diet protocol. It is concluded that the low
      caloric diet used had no effect on muscular work efficiency.

PMID- 8350610
TI  - Somatotype of Italian rugby players.
AB  - Our aim was to collect lacking first-hand data on Italian rugby players. The
      Heath/Carter anthropometric somatotype method was applied to 28 "A" League
      performers (RP) aged 25 +/- 3.9 years of age. Their somatotypes and dimensions
      were compared with those found in previous studies on athletes involved in the
      same sporting activity, with data collected on 25 "sedentary" young Italians, and
      with Bailey et al.'s study on Canadians (1982). On average, the RP group resulted
      as being endomorphic mesomorphs (3.1 +/- 1.1 - 5.6 +/- 1.3 - 1.4 +/- 1.1), a
      result that is congruent with international data. They differed significantly
      from the balanced mesomorph CG (2.3 +/- 1.0 - 4.5 +/- 1.2 - 2.5 +/- 1.4) for all
      the measurements taken, apart from bi-epycondylar width. The peculiar somatotype
      scores found are congruent with the needs of rugby, an aerobic-anaerobic
      discipline which requires performers with great muscular power associated with a
      capacity to furnish energy, mainly through the anaerobic metabolism.

PMID- 8350611
TI  - Triathlon competition induced a transient immunosuppressive change in the
      peripheral blood of athletes.
AB  - This study was designed to determine whether or not physical and psychological
      stress of triathlon competition causes an immunosuppressive change in the
      peripheral blood of athletes, if it does occur, how long does it take to recover.
      Fifteen healthy men, aged 19 to 40, volunteered for this study. Peripheral blood
      was drawn four times at approximately the same time on the following days; one
      day before the race, immediately after, one day and eight days after, and served
      for determining circulating leucocyte and lymphocyte subset counts, in vitro
      lymphocyte proliferative response and natural killer activity. The results showed
      that triathlon competition caused considerable changes in the cell counts of
      peripheral blood leucocyte and lymphocyte subsets, and a transient reduction in
      vitro lymphocyte proliferative response and natural killer activity, all of which
      returned to pre-race levels in one to eight days after the race.

PMID- 8350612
TI  - No effect of endurance exercise on serum bilirubin in healthy athletes and with
      congenital hyperbilirubinemia (Gilbert's syndrome).
AB  - Twenty male athletes, mean age 26 years, were studied by a work load test with
      cycle-ergometer, with increasing power output for 60 minutes until an intensity
      corresponding to 70% of the individual maximal heart rate was achieved. Ten of
      them had familial hyperbilirubinemia (Gilbert's syndrome) and ten had been
      considered as healthy controls. The diagnosis of Gilbert's syndrome was made
      using the following criteria: unconjugated hyperbilirubinemia, no systemic
      symptoms, no overt or clinically recognizable haemolysis, normal liver function
      tests. Blood levels of free fatty acids (FFA) showed a progressive significant
      increase after muscular exercise in both healthy and Gilbert's syndrome subjects
      (p < 0.001). The increase was more evident in controls compared to Gilbert's
      syndrome subjects (p < 0.05). Total and fractionated bilirubin showed no change
      in both groups. In conclusion, a competitive mechanism between bilirubin and FFA
      is probably responsible for the lower increase in plasma FFA in Gilbert's
      syndrome.

PMID- 8350613
TI  - The stages of exercise behavior.
AB  - The stages of change model has shown promise in advancing knowledge about smoking
      behavior change and other negative addictive behaviors. The model was applied to
      the study of exercise, a healthy rather than unhealthy behavior. A stages of
      exercise behavior questionnaire was administered to a sample of 235 employees.
      Next, the ability of a second questionnaire measuring physical activity behavior
      to differentiate employees according to stage of exercise was tested. Results
      revealed that 51% of employees were participating in no physical activity
      (Precontemplation, Contemplatation) and 49% were participating in occasional or
      regular physical activity (Preparation, Action, Maintenance). Scores on physical
      activity behavior items significantly differentiated employees among the stages.
      This model developed on smoking and other behaviors can be generalized to
      exercise behavior. Understanding the stages of exercise behavior could yield
      important information for enhancing rates of participation in physical activity.

PMID- 8350614
TI  - Interleukin-4 and its receptor; modulating effects on immature and mature
      hematopoietic cells.

PMID- 8350615
TI  - Retinoid acid supports granulocytic but not erythroid differentiation of myeloid
      progenitors in normal bone marrow cells.
AB  - In the new context of the use of retinoic acid (RA) therapy as an inducer of
      leukemic differentiation and a selective inhibitor of human myeloid leukemia cell
      growth, we undertook to explore the potential physiological role of retinoids on
      the proliferation and differentiation of normal bone marrow myeloid progenitors.
      The effects of continuous exposure of all-trans-RA, its naturally occurring
      isomer, 13-cis-RA, and its metabolite 4-oxo-all-trans-RA were studied on the
      growth of normal human bone marrow cells in soft agar, directly and after liquid
      culture. Retinoids enhanced the total number of granulocytic colony and
      macrocluster formation in the presence of exogenous colony-stimulating factor (n
      = 9). Dose-response curve were bell-shaped, with a maximal increment between
      concentration of 0.5 and 0.05 nM. In all cases, a concomitant decrease of
      macrophagic colonies was noted. The positive effect on granulocytic colony
      formation was observed with each of the retinoids tested (all-trans, 13-cis and 4
      oxo-all-trans) (n = 5). On erythroid colony formation, all-trans-RA had the
      opposite effect. Constant suppression of CFU-E and BFU-E colony formation and
      coloring was observed in a dose-related fashion from 0.1 to 10 microM (n = 5).
      Thus, in granulocytic, as in erythroid colony formation, retinoids affected both
      proliferation and differentiation parameters. However, after short-term
      suspension culture in the presence of all-trans-RA, an increase of both CFU-GM
      and BFU-E colonies, was observed. These results suggest a specific effect of
      retinoids on late myeloid precursors and places retinoids as possible candidates
      for enhancement of normal granulocytic differentiation.

PMID- 8350617
TI  - Detection of P210bcr-abl in mature granulocytes from Ph1-positive chronic
      myelogenous leukemia patients by an immunoblotting method.
AB  - Previously, p210bcr-abl has been detected in Philadelphia-chromosome-positive
      chronic myelogenous leukemia (CML) blast crisis and established cells originating
      from blasts. It has not been detected in mature granulocytes in the chronic
      phase. Protein degradation tends to occur during protein extraction, due to the
      activities of protease and phosphatase within these cells. Protein was,
      therefore, extracted in a cell lysis buffer containing alpha 1-antitrypsin and a
      high concentration of Na3VO4 as inhibitors. In mature granulocytes in the chronic
      phase, p210bcr-abl was detected and the level of tyrosine phosphorylation
      estimated by immunoblotting, using the enzyme-labeled antibody method with anti-c
      abl and anti-phosphotyrosine antibodies. p210bcr-abl was phosphorylated on
      tyrosine residues in blast crisis cells and K562 cells derived from CML blast
      crisis, whereas it was dephosphorylated in mature granulocytes from chronic phase
      CML patients. This suggests that p210bcr-abl in mature granulocytes has no
      tyrosine kinase activity, or it is extremely weak, and dephosphorylation of
      p210bcr-abl is associated with differential maturation of immature cells in the
      chronic phase of CML.

PMID- 8350616
TI  - Further evidence for the existence of a clonal Ph-negative stage in some cases of
      Ph-positive chronic myelocytic leukemia.
AB  - The Ph chromosome abnormality is involved in the pathogenesis of almost all
      patients with chronic myelocytic leukemia (CML). Previous studies on the B
      lymphoid cell lineage in two patients with Ph-positive CML suggest that there may
      also be a clonal Ph-negative stage in CML and that the Ph-positive stage arises
      by subclonal expansion. To determine whether this is a frequent or a rare
      occurrence, 14 additional glucose-6-phosphate dehydrogenase (G6PD)-heterozygous
      patients with CML were studied. In five of these patients there was a
      statistically significant excess of Ph-negative B-lymphoid cell lines expressing
      the same G6PD type expressed in the corresponding CML clone. In no case was an
      excess of B-lymphoid lines expressing the opposite G6PD type recovered. These
      data provide further evidence that in some patients the Ph chromosome arises in a
      pluripotent stem cell from a pre-existing Ph-negative clone that enjoys a growth
      advantage.

PMID- 8350618
TI  - Human acute myeloid leukaemia cells express adhesion proteins and bind to bone
      marrow fibroblast monolayers and extracellular matrix proteins.
AB  - Adhesion protein expression by acute myeloid leukaemia (AML) cells may affect
      bone marrow stromal localization and determine exposure of leukaemic cells to
      stromal derived myeloid growth factors. We have analysed the surface expression
      by myeloid leukaemic cells of proteins with known adhesive function and the
      ability of AML cells to adhere to bone marrow fibroblasts and the extracellular
      matrix proteins fibronectin and laminin. Cells from all six patients tested
      adhered to bone marrow fibroblast monolayers (mean binding 28.8 +/- 12.8%) and to
      purified fibronectin in five cases studied (mean binding 33.8 +/- 15.3%). Cells
      from four patients with AML also adhered to laminin (mean binding 20.9 +/- 4.0%).
      AML cells from the majority of patients with leukaemia at diagnosis or relapse
      expressed the ligand pair LFA-1 and ICAM-1, the CD2 ligand LFA-3, alpha and beta
      chains of the integrins VLA-4, VLA-5 and VLA-6, and the hyaluronate receptor
      CD44. Antibodies to CD11a, CD18, VLA-4 alpha, and VLA-5 alpha failed to inhibit
      binding of AML cells to bone marrow fibroblasts but anti-VLA-5 alpha antibodies
      inhibited AML cell binding to fibronectin by approximately 50%. The ability of
      AML cells to adhere to bone marrow fibroblasts and extracellular matrix proteins
      such as fibronectin and laminin may to help explain the capacity of AML cells to
      persist in the marrow during periods of apparent complete remission and to
      subsequently proliferate under the influence of locally secreted myeloid growth
      factors.

PMID- 8350619
TI  - SIL-TAL1 deletion in T-cell acute lymphoblastic leukemia.
AB  - The TAL1 gene on chromosome 1 encodes a hematopoietic transcription factor.
      Disruption of TAL1 via chromosomal translocation or a site-specific deletion has
      been reported in up to 30% of T-cell acute lymphoblastic leukemias (T-ALL). Here
      we used a polymerase chain reaction (PCR) assay to identify the 90 kb SIL-TAL1
      deletion in a group of 19 cutaneous T-cell lymphomas and a series of 142 T-ALL
      patients (76 children, 66 adults). While none of the T-cell lymphoma exhibited a
      SIL-TAL1 recombination, seven T-ALL cases showed a type d1 and two patients a
      type d2 deletion. Of pediatric T-ALL, 9% (7/76) and of adult patients only 3%
      (2/66) were characterized by this genomic lesion. The deletion correlated with
      commitment to the T-cell receptor (TCR) alpha beta lineage, but lacked
      association with a distinct maturation stage. Sequence analysis of SIL-TAL1
      breakpoints revealed marked heterogeneity at the junctional region among the nine
      patients due to random deletion and insertion of N-region nucleotides or
      templated P-nucleotide addition mediated via illegitimate V(D)J recombinase
      action. Clonospecific oligomer probes in conjunction with PCR allowed the
      detection of minimal residual disease in one out of four patients monitored
      during complete hematologic remission.

PMID- 8350620
TI  - Constitutive expression of GM-CSF mRNA by CML blast cells is correlated with
      endogenous megakaryocytic colony formation.
AB  - Purified blast cells from peripheral blood of 12 patients, with chronic
      myelogenous leukemia (CML) in chronic phase, were analyzed for the constitutive
      expression of the granulocyte-macrophage colony-stimulating factor (GM-CSF)
      transcript. Seven out 12 patients exhibited the specific 1.0 kb GM-CSF mRNA. Six
      from these patients presented an increased level of spontaneous megakaryocytic
      colony formation. Using an immunocytochemical procedure, the presence of GM-CSF
      was detected in a large proportion (52% to 72%) of the blast cells of the three
      patients studied, who were selected for the high expression of GM-CSF mRNA
      transcripts. Because the role of GM-CSF in the regulation of human
      megakaryocytopoiesis is well documented, we investigated the inhibiting effect of
      anti-GM-CSF antibodies on the spontaneous megakaryocytic colony growth of three
      of the patients expressing the GM-CSF transcript. Addition of anti-GM-CSF had a
      high neutralizing effect ranging from 60% to 70% inhibition of endogenous
      megakaryocytic colony growth. As the GM-CSF synthesis by leukemic cells is often
      induced by interleukin-1 (IL-1), we also investigated the effect of anti-IL-1
      antibody on the spontaneous megakaryocytic colony growth of the same three
      patients. No significant inhibiting effect was observed, showing that the role of
      GM-CSF in the spontaneous colony formation is not mediated by IL-1. In addition,
      patients who constitutively expressed the GM-CSF transcript and showed endogenous
      megakaryocytic colony growth were those having a significantly higher platelet
      count than the group of patients without GM-CSF transcript and with no endogenous
      megakaryocytic colonies. In conclusion, these results suggest that GM-CSF, but
      not IL-1, participates in the production of spontaneous megakaryocytic colony
      formation observed in some CML patients. The true autocrine or paracrine nature
      of this stimulation remains to be established.

PMID- 8350621
TI  - Dynamics of interaction between DNA-specific antitumor agents and serum-contained
      cytokines in the initiation of ML-1 human myeloblastic leukemia cell
      differentiation.
AB  - When added to RPMI-1640 medium containing fetal bovine serum, DNA-directed
      antineoplastic agents such as cytosine arabinoside (araC), daunorubicin, and
      actinomycin D induce the monocytic differentiation of ML-1 human myeloblastic
      leukemia cell populations to an extent that depends upon both drug and serum
      concentration. Differentiation is not induced in the absence of serum or when
      antibodies to tumor necrosis factor-alpha and transforming growth factor-beta are
      added to the cultures, indicating that these serum-contained cytokines
      participate in initiating the differentiation process. The drug- and cytokine
      dependent cell maturation, which results in the inhibition of leukemic cell
      growth, is achieved at much lower concentrations of drug than is required for
      growth-inhibition through drug-mediated cell kill. RNA- and protein-targeted
      agents cannot replace DNA-specific agents in the process of differentiation
      induction. The DNA-specific agents render the leukemic cells responsive to the
      low concentrations of differentiation-inducing cytokines that are present in
      serum, causing them to mature, and subsequently, to cease growth. This
      sensitization may be a component of the clinically selective action of DNA
      specific antitumor agents.

PMID- 8350622
TI  - Clinical impact of breakpoint position within M-bcr in chronic myeloid leukemia.
AB  - We have analyzed the M-bcr breakpoint position in 133 Philadelphia-positive
      chronic myeloid leukemia patients and correlated the findings with clinical,
      hematologic, and cytogenetic data. We also investigated the splicing pattern of
      the BCR-ABL mRNA in 30 patients, using reverse transcriptase PCR. No
      statistically significant differences were found between breakpoint position
      within M-bcr and clinical parameters at diagnosis, the karyotypic evolution
      pattern, or the leukemic phenotype during blast crisis. Furthermore, the
      breakpoint position within M-bcr did not correlate with the duration of chronic
      phase or survival time. When the splicing pattern of the BCR-ABL mRNA was
      compared with the results of the genomic breakpoint mapping, it was found that
      approximately 60% (8/14) of the patients with a 5' break expressed b2a2 fusion
      mRNA, whereas all patients (10/10) with a 3' break expressed b3a2 BCR-ABL mRNA.

PMID- 8350623
TI  - Prognostic features and survival in young adults with early/intermediate chronic
      lymphocytic leukemia (B-CLL): a single institution study.
AB  - Information regarding natural history and prognostic factors for
      early/intermediate B-cell chronic lymphocytic leukemia (B-CLL) in young adults is
      limited. We analysed 62 young adults (< or = 50 years old) with
      early/intermediate B-CLL who were seen at our institution during initial
      diagnosis over a 15-year period. These patients had been followed for a median
      duration of 7 years. Median age for the entire group was 44 years and 72% were >
      or = 40 years old. Actuarial median survival from initial diagnosis for the
      entire group was 140 months. Upon univariate analysis, significant survival
      advantage was observed in patients with Rai stages 0 and 1 versus stage II
      disease (median survival 140 versus 60 months, p = 0.01) and in those with
      lymphocyte doubling time (LDT) of > 1 year versus < or = 1 year (median survival
      150+ versus 94 months, p = 0.06). Similarly there was a trend towards longer
      survival in patients with a leucocyte count of < or = 50,000/microliters when
      compared to those with higher counts although the difference was not
      statistically significant. The bone marrow infiltration pattern was not
      prognostically useful. Upon multivariate analysis, only Rai stage and LDT were
      prognostically useful. Patients who did not respond to initial therapy with
      alkylating agents had the worst prognosis, with a median survival of only 19
      months. Assessment of presenting clinical stage, LDT, and degree of initial
      treatment response may prompt earlier consideration of alternative therapeutic
      modalities such as purine nucleoside analogs or bone marrow transplantation in
      younger patients with early/intermediate B-CLL.

PMID- 8350624
TI  - Long-term follow-up of treatment and potential cure of adult acute lymphocytic
      leukemia with MOAD: a non-anthracycline containing regimen.
AB  - A total of 55 previously untreated adults with acute lymphocytic leukemia (ALL),
      median age 38 years (range 15-73 years), were treated with MOAD (methotrexate,
      vincristine, L-asparaginase, and dexamethasone). This regimen includes five
      phases--induction, consolidation, cytoreduction, maintenance, and central nervous
      system (CNS) prophylaxis with parenteral high-dose methotrexate. Of the 55
      evaluable patients, 42 achieved complete remission 76%), with a median CR
      duration of 12+ months (range 0.5-195+ months). The median survival in remission
      is 22+ months (range 1-198+ months), with 33% of remitters continuing in long
      term remissions (> 5 years). Two out of four patients who developed CNS leukemia
      did so without marrow relapse, were successfully treated for that complication,
      and continue in total complete remission at 8+ and 16+ years. Another patient
      with extramedullary relapse (breast) was treated with radiation to that site and
      remains in total CR at 16+ years. Expected toxicities included myelosuppression
      during the induction phase of treatment, with 65% of patients requiring
      intravenous antibiotics. Mucositis was the next most frequent toxicity and
      required dose-reduction in seven patients. Minimal toxicity was seen during the
      post-remission phases of treatment. L-Asparaginase toxicity was more prominent
      during intravenous administration (24 patients) than when the intramuscular route
      of administration (30 patients) was used. The remission rate and long-term
      survivorship achieved with this regimen, without the use of an anthracycline, is
      comparable to that of other regimens for adult ALL. MOAD was well-tolerated by
      young and old adults with ALL. Aseptic necrosis of bone, successfully treated in
      each instance, occurred in four long-term disease-free survivors. The effect of
      this complication and its treatment on quality of life has been negligible.

PMID- 8350625
TI  - Soluble Fc gamma RIII is present in lower concentrations in the serum of patients
      with acute myelogenous leukemia (AML): a retrospective study.
AB  - Fc gamma RIII is a low affinity immunoglobulin G receptor expressed by
      neutrophils, natural killer cells, and macrophages. Soluble forms of Fc gamma
      RIII have been identified in serum, plasma, and other body fluids. Previous
      studies showed that Fc gamma RIII appeared late in myeloid differentiation. This
      retrospective study was designed to measure the concentration of soluble Fc gamma
      RIII in serum from patients with acute myelogenous leukemia (AML), a disease
      generally characterized by granulocytopenia and an increase in circulating
      myeloblasts and occasionally promyelocytes. Frozen serum samples from patients
      with AML and from age-matched normal donors were obtained from the Biological
      Carcinogenesis Branch Repository of the National Cancer Institute. We used an
      ELISA to measure the concentration of soluble Fc gamma RIII in these serum
      samples and observed significantly lower concentrations of soluble Fc gamma RIII
      in the serum of AML patients. The mean concentration of soluble Fc gamma RIII was
      9.5 nM in normals (n = 48) and 5.4 nM in AML patients (n = 46), (p < 0.0005).
      Whether this difference is due to defects in granulopoiesis in these patients or
      to other parameters of the disease is unknown at this time. Our retrospective
      study should provide the basis for subsequent investigation of patients with AML
      to correlate soluble Fc gamma RIII concentrations with the clinical status of the
      patients.

PMID- 8350627
TI  - Efficacy and toxicity of 9-beta-D-arabinofuranosylguanine (araG) as an agent to
      purge malignant T cells from murine bone marrow: application to an in vivo T
      leukemia model.
AB  - 9-beta-D-Arabinofuranosylguanine (araG), an analog of deoxyguanosine which is not
      degraded by purine nucleoside phosphorylase, has been previously shown in in
      vitro studies by our laboratory to be effective in purging malignant T cells from
      human bone marrow (1). We now describe studies in a murine model of T-cell acute
      lymphoblastic leukemia (ALL) in which we tested whether bone marrow, contaminated
      with malignant T cells and purged ex vivo with araG, could reconstitute both the
      lymphoid and myeloerythroid lineages in the absence of leukemic relapse. The
      model utilized 6C3HED tumor cells, derived from a Thy 1.2+ malignant murine T
      cell line, which were shown to cause lethal leukemia in C3H/HeN mice. Intravenous
      injection of 10(6) 6C3HED cells resulted in 100% mortality within 18 days, with
      autopsy revealing tumor infiltration of multiple organs. 100% of non-leukemia
      bearing lethally irradiated C3H/HeN mice transplanted with syngeneic bone marrow,
      treated ex vivo with 100 microM of araG for 18 hours, survived > 365 days post
      transplant with full lymphohematopoietic reconstitution. Evidence of araG's
      ability to purge bone marrow of malignant tumor cells without causing significant
      toxicity to normal marrow derived hematopoietic progenitor cells was documented
      in experiments in which 75% of lethally irradiated mice transplanted with
      syngeneic bone marrow, contaminated with 6C3HED tumor cells and treated ex vivo
      with 100 microM araG for 18 hours, survived for > 250 to > 400 days. Death in 25%
      of mice was secondary to infection which developed before marrow reconstitution
      occurred. Reconstitution of the lymphoid, myeloid, and erythroid lineages with
      donor cells in surviving mice was documented. The data presented indicate that
      araG may effectively purge bone marrow of malignant T cells without irreversible
      toxicity to hematopoietic stem cells. This purging regimen is recommended for
      consideration for clinical trials in patients with T-cell malignancies undergoing
      autologous bone marrow transplantation and may also be a viable option for T-cell
      depletion as a strategy to prevent graft-versus-host disease.

PMID- 8350626
TI  - Mixed phenotype murine leukemias.
AB  - Cell lines were derived from eight individual leukemias induced by X-rays in NFS
      mice. First typed as null cells (surface immunoglobulin negative, Thy-1
      negative), they turned out to have a mixed phenotype with myeloid cytochemical
      markers, pre-B surface antigens and molecular markers of pro-B lymphocytes. They
      represent murine models for mixed phenotype (pro-pre-B-myeloid) leukemias.

PMID- 8350628
TI  - New xenografts of human megakaryoblastic cell line (MEG-01) for evaluating anti
      tumor agents.
AB  - A human megakaryoblastic cell line (MEG-01) was successfully transplanted into
      athymic nude mice. MEG-01 cells (5 x 10(7)) were inoculated subcutaneously in KSN
      nu/nu mice, none of which were pretreated with irradiation or chemotherapeutic
      agents. All mice developed solid tumors at the site of injection after incubation
      for 10-14 days reaching a size of 200-400 mm2 (product of cross-sectional
      diameters) after 30 days. These tumors, designated as MEG-01/nu, were
      transplanted into other nude mice. The transplanted tumors infiltrated the liver
      and spleen, and leukemic megakaryoblastic cells appeared in the blood of some
      transplanted mice. Cells resuspended from MEG-01/nu tumors exhibited almost the
      same megakaryocytic characteristics as the original MEG-01 cells, and underwent
      in vitro differentiation to a mature form of megakaryocyte upon addition of
      phorbol diesters. MEG-01/nu was evaluated for sensitivity to cytosine
      arabinoside, vincristine, and daunorubicin in vitro and in vivo. Daunorubicin
      exhibited significant anti-tumor activity against MEG-01/nu in vivo, while
      cytosine arabinoside did so in vitro. Vincristine showed no activity against
      these cells. This cell line may provide a useful model for testing the in vivo
      efficacy of anti-tumor agents and immunotoxins, and for studying the
      pathophysiological mechanisms of human megakaryoblastic leukemia.

PMID- 8350629
TI  - In vivo development of an acetyldinaline resistant subline of the BN rat acute
      myelocytic leukemia (BNML).
AB  - The cytostatic drug acetyldinaline [ACD, CI-994, 4-acetylamine-N-(2-aminophenyl)
      benzamide] shows an extreme antileukemic effect in the Brown Norway (BN) rate
      model for acute myelocytic leukemia (BNML) with only minor toxicity for normal
      pluripotent hemopoietic stem cells. So far, the mode of action is unknown. A
      resistant subline (BNML/ACD-R) was developed in vivo in the BNML model. Leukemic
      rats received repeated oral administrations of ACD. When the leukemia relapsed
      after initial remission-induction with ACD, the cells were transferred to new
      recipients which were again treated. In total, the animals received 247 oral
      administrations of ACD (33 x 2 mg/kg per day and 214 x 5 mg/kg per day) before
      full resistance was reached. The cell line was transferred 17 times in total.
      Treatment of the final resistant cell line with therapeutically highly active
      doses of 23.7 mg/kg per day and 11.85 mg/kg per day ACD for 5 days, that resulted
      in an increase of life span (ILS) of 57 and 18 days, respectively, when applied
      to the sensitive parent BNML line (BNML/S), resulted in only 10 and 3 days ILS,
      respectively. These results indicate that a significant degree of resistance has
      been achieved, which can be overcome partially by increasing the dose of ACD.
      Whether the development of a resistant subpopulation of the BNML is a result of
      acquired resistance or whether a naturally resistant subpopulation has been
      selected out after prolonged treatment with ACD remains to be established. The
      currently available resistant subline BNML/ACD-R now offers the possibility for
      further studies on the mechanism of action of ACD.

PMID- 8350630
TI  - Absence of amplification of MDM2 gene, a regulator of p53 function, in
      myelodysplastic syndromes.
AB  - The MDM2 gene is a gene whose product binds to p53 and regulates its function.
      Amplification of MDM2 has been found in human sarcomas, where it leads to
      inactivation of p53. In 64 cases of generally advanced myelodysplastic syndromes,
      we found no amplification or rearrangement of MDM2 gene by Southern analysis.
      MDM2 RNA was also normal in the 15 cases where Northern analysis was made. Thus,
      amplification of MDM2 is not seen or must be very rare in myelodysplastic
      syndrome (MDS). Because P53 gene mutations are not frequent in MDS, inactivation
      of p53 seems to be, overall, a rare pathogenetic event in MDS.

PMID- 8350631
TI  - Identification of an altered immunoglobulin heavy-chain gene rearrangement in the
      central nervous system in B-precursor acute lymphoblastic leukemia.
AB  - In B-precursor acute lymphoblastic leukemia (ALL), the nucleotide sequence of the
      complementarity determining region III (CDRIII) in the rearranged immunoglobulin
      heavy chain gene (IgH) has been used as a molecular fingerprint to identify the
      leukemic cells. In a child with B-precursor ALL without central nervous system
      (CNS) disease at diagnosis and a subsequent isolated CNS relapse, we examined the
      stability of the rearranged IgH by comparing the nucleotide sequences of the
      CDRIII in the leukemic cells from the marrow at diagnosis to the sequences in the
      leukemic cells from the cerebrospinal fluid at relapse. Whereas two of the three
      IgH sequences isolated from the leukemic cells at CNS relapse were identical to
      sequences originally isolated from the marrow lymphoblasts at diagnosis, the
      third CNS sequence was similar but not identical to the third marrow sequence.
      The third IgH sequence identified in the CNS differed from the marrow sequence
      only at the variable gene segment adjoining the CDRIII. Using a detection method
      based on the polymerase chain reaction, the altered IgH sequence identified in
      the leukemic cells from the cerebrospinal fluid was noted to be present in the
      CNS at a higher frequency than the related diagnostic sequence and was not
      detected in the marrow either at diagnosis or at CNS relapse. These findings
      indicate that the clonal pattern of leukemia in the CNS may differ from that in
      the marrow.

PMID- 8350632
TI  - Interferon alpha and gamma alter the binding of progenitor cells to fibronectin
      of patients with CML.

PMID- 8350633
TI  - Molecular evidence of minimal residual disease after treatment for leukaemia and
      lymphoma: an updated meeting report and review.
AB  - The very rapid development in the last few years of techniques based on use of
      the polymerase chain reaction (PCR) for characterizing molecular lesions in
      leukaemia and lymphoma now offers the opportunity for monitoring residual disease
      at a sensitivity of one malignant cell in 10(5) or 10(6) normal cells. Maximal
      specificity is presumably achieved when the DNA sequences amplified are truly
      leukaemia-specific, such as BCR/ABL in chronic myelogenous leukemia, RARA
      PML/RARA in t(15;17) acute myelogenous leukemia, DEK/CAN in t(6;9) AML, PBX1/E2A
      in t(1;19) acute lymphoblastic leukemia (ALL), or TAL-1 deletions in other T
      ALLs. Comparable sensitivity may be achieved by using immunoglobulin heavy chain
      (IGH) and T-cell receptor (TCR) gene rearrangements if a clonospecific probe can
      be generated. However, the presence of similar sequences in IgH genes from normal
      B lymphocytes may decrease the specificity. For clinical purposes the crucial
      issues are the following. Can PCR techniques be used for confirmation of
      diagnosis and evaluation of extent of disease? Can PCR data obtained in remission
      provide information about the probability of cure or of relapse? Can techniques
      be developed to quantitate the PCR product and thereby increase its predictive
      value? These and other issues were addressed at the 4th Workshop of the Molecular
      Biology/BMT Study Group that took place in Bristol UK on 9-10 May 1992.

PMID- 8350634
TI  - Dr. Melvin C. Millet, early Mayo partner and urologist.

PMID- 8350635
TI  - Oligodendrocyte injury is an early event in lesions of multiple sclerosis.
AB  - The ultrastructural features of 11 stereotaxic brain biopsy specimens that
      demonstrated inflammatory primary demyelination consistent with acute multiple
      sclerosis were examined. Uniform widening of inner myelin lamellae (biphasic
      myelinopathy) and degeneration of inner glial loops ("dying-back"
      oligodendrogliopathy) were early pathologic abnormalities that antedated complete
      destruction of myelin sheaths. Perivascular inflammatory cells (lymphocytes,
      macrophages, and occasional plasma cells) were in intimate contact with
      degenerating myelin sheaths. The response of astrocytes was prominent, even in
      areas of minimal demyelination. Oligodendrocytes were morphologically preserved
      in early lesions but proliferated at the periphery of active lesions. Thinly
      myelinated axons indicative of central nervous system-type remyelination by
      oligodendrocytes were observed primarily at the edge of plaques. Disturbances of
      the myelinating function of oligodendrocytes--unaccompanied by death of these
      cells--may be among the earliest pathologic features in multiple sclerosis.

PMID- 8350636
TI  - Myocardial revascularization before abdominal aortic aneurysmorrhaphy: effect of
      coronary angioplasty.
AB  - Percutaneous transluminal coronary angioplasty (PTCA) has assumed an increasing
      role in the preoperative preparation of patients with an abdominal aortic
      aneurysm (AAA). The influence of this modality on perioperative morbidity and
      long-term outcome has not been substantiated. To determine the effect of PTCA, we
      analyzed a cohort of 2,452 patients who underwent repair of an AAA between 1980
      and 1990 at our institution. We compared the cardiac morbidity, mortality, and
      survival of patients who had preoperative coronary revascularization by PTCA or
      coronary artery bypass grafting (CABG). The overall perioperative mortality for
      the 2,452 patients was 2.9%. Preoperative coronary revascularization was
      necessary in 100 patients (4.1%)--86 had CABG and 14 had PTCA. Of these 100
      patients, 95% had cardiac symptoms. Patients selected for PTCA, in comparison
      with CABG, had significantly less three-vessel disease but not significant
      differences in cardiac history or ejection fraction. During the study period, the
      use of PTCA increased significantly. The perioperative rate of myocardial
      infarction for patients with prior CABG was 5.8% in comparison with 0% for those
      with prior PTCA. No hospital deaths occurred in either group. The median interval
      between coronary revascularization and repair of an AAA was 10 days for PTCA and
      68 days for CABG. The 3-year survival was not statistically different between
      CABG (82.8%) and PTCA (92.3%) groups. The rate of late cardiac events (at 3
      years) was 56.5% in the PTCA group and 27.3% in the CABG group. We conclude that
      PTCA as part of a highly selective approach to coronary revascularization before
      repair of an AAA minimizes cardiac-related events and death.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8350637
TI  - Clinical features and differential diagnosis of aortic dissection: experience
      with 236 cases (1980 through 1990).
AB  - Acute aortic dissection is the most common fatal condition that involves the
      aorta; nevertheless, despite major advances in noninvasive diagnosis, the correct
      antemortem diagnosis is made in less than half the cases. To promote continued
      improvement in the prompt recognition of aortic dissection, we present a review
      of the Mayo Clinic experience with 235 patients who had 236 substantiated aortic
      dissections. At the time of initial assessment, 158 patients (67%) had acute and
      78 patients (33%) had chronic aortic dissection. Hypertension was the most common
      predisposing factor (78% of patients overall). The acute onset of severe chest
      pain was the most common initial complaint (74%), but 33 patients (15%) had
      painless aortic dissection and abnormal chest roentgenographic findings. Less
      common manifestations included congestive heart failure, syncope, cerebrovascular
      accident, shock, paraplegia, and lower extremity ischemia. The initial clinical
      impression was aortic dissection in 62% of patients overall. In 17 patients
      (28%), the correct diagnosis was not made before postmortem examination. Although
      the clinical features of aortic dissection have gained wider appreciation, the
      diagnosis still remains unsuspected in a substantial number of patients. In a
      patient who has a catastrophic illness and unexplained symptoms that could be of
      vascular origin, especially in the presence of chest pain, aortic dissection
      should always be included in the differential diagnosis.

PMID- 8350638
TI  - Herpes zoster-associated meningoencephalitis in patients with systemic cancer.
AB  - We reviewed the experience at the Mayo Clinic with neurologic complications
      related to herpes zoster in patients with systemic cancer. Aside from pain, the
      most common neurologic complication was zoster-associated meningoencephalitis,
      which occurred in 9 of 1,125 patients. In these nine patients, the most common
      underlying malignant lesions were chronic lymphocytic leukemia and lymphoma. All
      patients in whom meningoencephalitis developed had trigeminal zoster or
      disseminated zoster. The primary neurologic symptoms were headache, confusion,
      and somnolence. Nuchal rigidity and fever were uncommon. The response to
      treatment with acyclovir was generally favorable.

PMID- 8350639
TI  - Quantification of human plasma apolipoproteins C-I, C-II, and C-III by
      radioimmunoassays.
AB  - We have developed radioimmunoassays for the quantification of apolipoproteins
      (apo) C-I, C-II, and C-III in human plasma. The apo C proteins were isolated from
      very low-density lipoproteins of patients with hypertriglyceridemia, fractionated
      on a Sephacryl column, and purified by diethylaminoethyl cellulose anion-exchange
      chromatography followed by reverse-phase fast protein liquid chromatography. The
      assays were sensitive, specific, and reproducible, and the standards demonstrated
      parallel immunoreactivity with plasma samples. Patients with hypertriglyceridemia
      (triglyceride level more than 2,200 mg/liter)--14 patients with diabetes and 12
      with type V hyperlipoproteinemia--were compared with age- and sex-matched control
      subjects. In comparison with the control groups, levels of apoproteins C-I, C-II,
      and C-III were significantly increased in both disease groups, but the ratios of
      the C peptides to triglycerides were significantly lower, an indication of a
      relative deficiency of C apoproteins in hypertriglyceridemic states. Independent
      radioimmunoassays for each of the C apolipoproteins would help to study their
      individual roles in triglyceride-rich lipoprotein metabolism.

PMID- 8350640
TI  - Postoperative irradiation for tonsillar carcinoma.
AB  - From January 1975 through July 1987 at the Mayo Clinic, 16 patients received
      postoperative adjuvant radiation therapy for squamous cell carcinoma of the
      tonsil (pathologic stage I in 4 patients, stage III in 3, and stage IV in 9).
      Follow-up was continued for a minimum of 2 years or until death. At 5 years,
      overall survival was 74% and disease-free survival was 68% for the entire group
      of patients. The local-regional control rate at 5 years was 83% for 12 patients
      with pathologic stage III or IV disease; the 5-year disease-free survival rate
      was 74%. The results with use of postoperative irradiation for stage III or IV
      tonsillar cancer seem superior to those for a similar historical group of
      patients who underwent surgical treatment only. Because the number of patients
      was small and the analysis was retrospective, our study may have included some
      undetected bias.

PMID- 8350641
TI  - Ancillary therapies in the management of lung cancer: photodynamic therapy, laser
      therapy, and endobronchial prosthetic devices.
AB  - Endoscopic therapy for cancer that involves the tracheobronchial tree is
      currently available for two distinct types of lesions: radiographically occult
      superficial squamous cell carcinoma and advanced malignant tumors that cause
      severe airway obstruction. Photodynamic therapy, which uses a photosensitizing
      agent, is effective for managing early superficial squamous cell carcinoma.
      Neodymium:yttrium-aluminum-garnet laser therapy has been effective in the
      palliative management of patients with advanced or recurrent malignant
      obstructive airway lesions, either alone or in combination with intraluminal
      radiation therapy. Most recently, endobronchial prosthetic devices (stents) have
      been used in patients with advanced airway obstruction. The use of each of these
      modalities in the management of lung cancer is reviewed.

PMID- 8350642
TI  - Chronic diarrhea in diabetes mellitus: mechanisms and an approach to diagnosis
      and treatment.
AB  - In this study, our aim was to develop a practical strategy to facilitate the
      management of patients with diabetes mellitus and chronic diarrhea in a tertiary
      referral practice. We reviewed the pertinent English-language literature of the
      past 30 years that described the pathophysiologic mechanisms and treatment of
      patients with diabetic diarrhea and retrospectively reviewed the medical records
      of all patients with diabetic diarrhea examined at the Mayo Clinic during 1990.
      Three typical case studies are described to illustrate the diverse mechanisms
      that lead to chronic diarrhea in patients with diabetes. No report in the
      literature has systematically evaluated all the putative mechanisms of chronic
      diarrhea in any group of patients with diabetes. In our tertiary referral
      practice, diabetic diarrhea was frequently due to celiac sprue, bacterial
      overgrowth in the small bowel, or fecal incontinence in conjunction with
      anorectal dysfunction; however, in almost 50% of the patients, these causes were
      excluded, and abnormal intestinal motility or secretion was postulated to be one
      of the likely causes of the diarrhea. These data suggest a practical algorithm
      based on three sequential assessments: first, tests of blood and stool specimens
      and flexible sigmoidoscopy to detect evidence of malabsorption or disease in the
      distal colon; second, small bowel aspirate and biopsy if the results of initial
      blood or stool tests are abnormal or anorectal function tests if those test
      results are normal; and, finally, measurement of gastrointestinal transit or
      therapeutic trials with opioids, clonidine hydrochloride, and, rarely,
      cholestyramine resin or octreotide acetate (or both methods). The mechanisms
      whereby abnormal neural function due to diabetes results in altered digestive,
      secretory, absorptive, or motor function necessitate further elucidation. The
      management of chronic diarrhea in patients in a tertiary referral practice,
      however, can be based on a practical algorithm to determine the cause and to
      adopt specific treatment to correct it.

PMID- 8350643
TI  - Early thrombotic stenosis of aortic bioprosthetic valves: report of two cases.
AB  - Thrombotic stenosis of a Carpentier-Edwards porcine bioprosthesis occurred in two
      patients within 3 months after aortic valve replacement. Both patients underwent
      successful replacement of the aortic prosthesis. Although previously reported,
      this complication of aortic porcine bioprostheses is uncommon.

PMID- 8350644
TI  - Georg von Bekesy--audiology and the cochlea.

PMID- 8350645
TI  - Giant pseudodiverticulum of the sigmoid colon.

PMID- 8350646
TI  - Near the conflagration: the wide duty to warn.
AB  - The "duty to warn" has become fixed in US law since the 1976 case of Tarasoff v
      Regents of the University of California. In that case, the California Supreme
      Court decided that psychotherapists whose patients make a specific, serious
      threat of violence against a specific, clearly identifiable potential victim have
      a duty to warn the intended victim, directly or indirectly, of the threat.
      Tarasoff inspired several successful and unsuccessful lawsuits. A recent Vermont
      case has extended the duty to warn in that state to a threat of damage to
      property when persons may be physically harmed. The duty to warn is explicitly
      based on considerations of social utility and, as such, is attractive for courts
      to expand because an apparently minimal effort by therapists will often prevent
      substantial harm to victims. Some states have codified the duty to warn in a
      statute, but other states have refused to adopt the Tarasoff reasoning. In the
      absence of clear legal decisions to the contrary, psychotherapists may well
      anticipate that the duty to warn operates in their states.

PMID- 8350647
TI  - Multiple sclerosis: new insights from old tools.

PMID- 8350648
TI  - Myocardial revascularization before repair of an aortic aneurysm.

PMID- 8350649
TI  - Percutaneous endoscopic gastrostomy.

PMID- 8350650
TI  - The radiation-sensitive mutant rad-8 of Caenorhabditis elegans is hypersensitive
      to the effects of oxygen on aging and development.
AB  - A mutant of rad-8, originally isolated on the basis of its hypersensitivity to
      ultraviolet radiation, is also hypersensitive to oxygen and methyl viologen, a
      superoxide-anion generator. Oxygen also retarded development and reduced
      fecundity in a concentration-dependent fashion in rad-8 but not in wild type. In
      addition, the mean life span of rad-8 (but not wild type) was progressively
      shortened when animals incubated in increasing oxygen concentrations. This cross
      hypersensitivity to both UV radiation and free radicals provides further evidence
      that DNA damage may be important in the aging process.

PMID- 8350651
TI  - Estimation of reference intervals from a SENIEUR protocol compatible aged
      population for immunogerontological studies.
AB  - Because many laboratory values change with age, the study of healthy aging as
      well as diagnosis of disease in geriatric patients requires specific age
      corrected reference intervals. We have established such reference intervals for a
      healthy population aged 65-74 years by selection of a sample group applying the
      clinical criteria of the SENIEUR protocol and we have compared them with those of
      a young control group (20-33 years) fulfilling the same criteria. Significant or
      minor elevations were seen, e.g. for plasma concentrations of fasting glucose,
      urea, total and LDL-cholesterol, triglycerides, gamma-glutamyl-transferase,
      alkaline phosphatase, erythrocyte sedimentation rate and serum neopterin levels.
      These reference intervals can be used for selecting a SENIEUR compatible
      population aged between 65 and 74 years. Additionally, plasma lipid parameters
      (cholesterol, triglycerides) are proposed to be included in the SENIEUR protocol.

PMID- 8350652
TI  - Influence of electrical stimulation on enzymatic activity of old rat muscles
      during hindlimb suspension.
AB  - 1. The purpose of this study was to determine the effects of electrical
      stimulation on the muscles of older rats (21-24 months old) during suspension
      hypokinesia/hypodynamia. The rats' hindlimbs were suspended for three weeks,
      after which the activities of three enzymes were measured in the extensor
      digitorum longus, the medial gastrocnemius and the soleus muscles. 2. The
      activity of phosphofructokinase decreased in the soleus muscle and in the white
      part of the medial gastrocnemius muscle. Malate dehydrogenase and beta
      hydroxyacyl-CoA-dehydrogenase showed decreased activity in the red part of the
      medial gastrocnemius muscle. 3. When electrical stimulation was applied, the
      activity of the glycolytic enzyme phosphofructokinase increased substantially in
      all studied muscles. The activity of the malate dehydrogenase and beta
      hydroxyacyl-CoA-dehydrogenase enzymes was not influenced by electrical
      stimulation in the majority of the studied muscles. 4. These results suggest that
      our electrical stimulation model not only prevents loss of phosphofructokinase
      activity of aged muscles but increases the activity of anaerobic glycolysis
      metabolism without affecting the oxidative and fatty acid pathways.

PMID- 8350653
TI  - Phencyclidine-binding sites in mouse cerebral cortex during development and
      ageing: effects of inhibitory amino acids.
AB  - The binding of N-[1-(2-thienyl)cyclohexyl]-[3H]piperidine ([3H]TCP) to the
      phencyclidine-binding sites in the N-methyl-D-aspartate (NMDA) receptor complex
      associated ion channel was characterized in cerebral cortical membranes from 3
      day-old to 24-month-old mice. The binding was saturable, exhibiting only one
      binding component during the whole life-span studied. The maximal binding
      capacity Bmax, calculated per protein content, decreased during postnatal
      development until 3 months of age, remaining thereafter constant in ageing mice,
      thus indicating the greatest availability of phencyclidine-binding sites in the
      immature cerebral cortex. The binding constant KD increased during the first
      postnatal week, remained thereafter unchanged and increased again during the
      second year of life, indicating a decreased affinity of the receptor sites for
      the ligand. The general properties of the binding; potentiation by glutamate and
      NMDA, as well as by glycine in a strychnine-insensitive manner, prevailed during
      development and ageing, certain of these effects being however less pronounced in
      the immature brain. Taurine and beta-alanine stimulated TCP binding, acting
      probably at the glycine modulatory site. The actions of these inhibitory amino
      acids were weak and inconsistent when compared to that of glycine. Since NMDA
      receptors have been suggested to be involved in neuronal plasticity and learning
      and memory processes, these modifications in the properties of cortical
      phencyclidine-binding sites might be of importance in the regulation of
      excitatory amino acid functions during development and ageing.

PMID- 8350654
TI  - Cross-sectional Gompertzian analysis: the development of a Gompertz mortality
      ratio (GMR) and its applicability.
AB  - Many conventional epidemiological analyses of the distribution and aetiology of
      disease employ standardised mortality ratios (SMRs) as a basis upon which to
      evaluate comparative studies of disease in populations. However SMRs, whilst
      constructed to control for age and sex, are not capable of incorporating other
      variables such as life expectancy which has been demonstrated to be of crucial
      importance in understanding the changing relationships between mortality from
      different causes. The development of a Gompertz mortality ratio (GMR) and its
      application to recent mortality from amyotrophic lateral sclerosis (ALS) in the
      Counties of England and Wales illustrates the value of substituting GMRs for SMRs
      in the analysis of competitive relationships between conditions, especially those
      associated with enhanced life expectancy.

PMID- 8350656
TI  - Ageing in the autonomic nervous system: a result of nerve-target interactions? A
      review.
AB  - There are few generalisations that can be made regarding the changes that occur
      in autonomic nerves during ageing. Old age has different effects, including loss
      of neurones, loss of axon branches and alterations in neurotransmitters and other
      intracellular features. However, these age-related events are associated with
      particular and often small groups of neurones and are frequently species
      specific. Changes occur at different periods during development and maturity
      without any obvious age-stage at which neurodegenerative changes come to
      predominate. Some of the observations regarding neuronal changes in old age can
      be interpreted as the result of altered interactions between neurones and their
      peripheral target tissues. Recent studies in my laboratory support this
      contention. The neurotrophic theory has been used to explain such interactions
      during early development and it seems possible that, for example, alterations in
      the access of neurones to target-derived growth factors may underlie some of the
      changes that have been observed in old age. Plasticity in the mature autonomic
      nervous system may also be governed by similar relationships between nerves and
      their target tissues.

PMID- 8350655
TI  - Cell proliferation by cell cycle analysis in young and old dietary restricted
      mice.
AB  - The effect of dietary restriction (DR) on cell proliferation determined by cell
      cycle analysis in tissues of young and old mice was investigated. Using the
      percentage of S-phase cells as an index of cell proliferation, we found that DR
      inhibited cell proliferation in spleen and thymus in young mice. No significant
      changes were found in bone marrow and kidney in the ad libitum (AL) or DR mice
      regardless of age. In old mice, the DR effect was observed in spleen only. When
      age increased, a parallel decline in cell proliferation was evidenced by a
      reduced % of S-phase cells. DR produces a greater cell cycle effect in the young
      mice than in the old mice. The present data suggests that inhibition of cell
      proliferation by DR may be affected by type of tissue, age, length of DR, and
      capacity or rate of cell proliferation.

PMID- 8350657
TI  - Influence of photosensitizers and light on the life span of Drosophila.
AB  - The life span of adult Drosophila melanogaster fruit flies changed when they were
      fed two different photosensitizers. Methylene blue decreased the median life span
      by 49% when present in the food at a concentration of 0.001 M. Another
      photosensitizer, riboflavin, produced no changes in life span under the same
      conditions of a 12:12 h light/dark cycle at a daytime light intensity of 1000
      lux. Flies exposed to constant darkness lived 43.2% longer than those exposed to
      constant light at a light intensity of 2000 lux. Under these conditions,
      riboflavin increased the life span of the flies exposed to constant light by as
      much as 25%. We conclude that riboflavin confers some degree of protection
      against the effects of constant light exposure. The completely different results
      obtained with riboflavin and methylene blue suggest a possible mechanism for
      photoageing involving photodynamic action mediated through the production of
      singlet oxygen.

PMID- 8350658
TI  - Energy restriction suppresses microsomal Ca(2+)-ATPase activities in various
      organs in C57BL/6 female mice in both euthermic and torpor states.
AB  - C57BL/6 female mice were fed a daily control diet (n = 5, 3.9 g/day, 95
      kcal/week) or ER diet (n = 5, 2.3 g/day, 48 kcal/week) at 1800 h from 6 weeks of
      age. Telemetry, conducted at 6 months of age, confirmed that all ER mice entered
      daily torpor (core body temperature less than 31 degrees C) for 6.63 +/- 2.34
      h/day while control mice were euthermic (> 35 degrees C). In vitro activities of
      microsomal Ca(2+)-ATPase were determined in the brain, liver, salivary gland and
      kidney from these mice at 6 months of age. Assays were performed at three
      incubation temperatures of 37 degrees C, 31 degrees C and 25 degrees C. In assays
      at 37 degrees C, the activities of Ca(2+)-ATPase in the brain and salivary gland
      from ER mice were lower than those in corresponding organs from control mice. The
      suppression became profound as the incubation temperature decreased. On the other
      hand, at 37 degrees C Ca(2+)-ATPase activities in the liver and kidney from ER
      mice were not lower than those in corresponding organs from control mice, but
      decreased significantly at low temperatures. Microsomal Ca(2+)-ATPase activities
      thus appeared to be reduced in ER mice, although it remains unknown whether the
      present results represent reduced in vivo capacities to regulate cytosolic Ca2+
      concentrations.

PMID- 8350659
TI  - The effects of age on immune responses in the antigen-instilled dog lung.
      Antibody responses in the lung and lymphoid tissues following primary and
      secondary antigen instillation.
AB  - To evaluate the effects of age on immunity induced by lung immunization, 11 aged
      (12-17 years; median age = 14) and 12 young (2-5 years) male Beagle dogs were
      instilled with 10 mg of keyhole limpet hemocyanin (KLH) in the right cardiac lung
      lobe and 10(10) sheep red blood cells (SRBC) in the left cardiac lung lobe. Five
      aged and six young dogs were sacrificed at day 9 after primary antigen
      instillation. The remainder were given challenge antigen instillations of KLH and
      SRBC at day 21 and sacrificed 7 days later. Serum, bronchoalveolar lavage fluid
      and lung tissue from immunized and control lobes, tracheobronchial, mesenteric
      and popliteal lymph nodes, spleen, and blood were taken at sacrifice. Anti-KLH
      IgA, IgG and IgM antibody production by cells in lung tissue and lavage fluid
      from the KLH-exposed lobe was lower at primary immunization and challenge in aged
      than young dogs. Lavage fluid IgA and IgG levels from the KLH exposed lobe at
      primary immunization and challenge were lower in aged versus young dogs, while
      IgM levels were lower only after primary immunization. Localized lung immune
      memory responses were also markedly lower in aged dogs when compared with young
      dogs. Anti-SRBC responses were similar to the anti-KLH responses. Our data show
      that systemic immune responses are significantly lower in aged dogs following
      primary antigen instillation, but not after antigen challenge in the lung. This
      was not the case for localized lung immune responses, which were significantly
      lower in aged dogs even following antigen challenge. The data also show that
      antibody production by lavage cells is a good index of interstitial lung cell
      antibody production.

PMID- 8350660
TI  - Hypotonic fragility of outer membrane and activation of external pathway of NADH
      oxidation in rat liver mitochondria are increased with age.
AB  - Great importance is attached to structural and functional deterioration of
      mitochondria as a reason for ageing of an organism; the attention of many
      scientists has been concentrated on such questions as age changes in the system
      of oxidative phosphorylation, damage of mitochondrial DNA by free radicals
      generated in the respiratory chain and inclusion of some fragments of
      mitochondrial DNA into the nuclear genome. Mitochondrial high amplitude swelling
      in a cell under some extreme conditions can possibly play a very important role
      in mechanisms of deterioration of energy transformation function, in activation
      of lipid peroxidation and mitochondrial DNA damage as a result of outer membrane
      disruption and release of enzymes from the intermembrane space (e.g. superoxide
      dismutase amd adenylate kinase). In this work the age changes of the hypotonic
      fragility of the outer membrane of rat liver mitochondria and the activation of
      the external, rotenone-insensitive pathway of NADH oxidation have been examined.
      It is shown that the obligatory condition for activation of rotenone-insensitive
      NADH oxidation is a break in the outer membrane and that the rate of NADH
      oxidation substantially increases in the presence of physiological concentrations
      of Mg2+ which cause a multiple increase in the affinity of the inner membrane to
      cytochrome c. Research on the rate of rotenone-insensitive NADH oxidation with
      respect to the osmotic pressure, the ionic strength of the medium, the presence
      of Mg2+ ions and cytochrome c in the medium has demonstrated a considerable
      increase in the hypotonic fragility of the outer membrane of liver mitochondria
      with age in male rats. In female rats the age changes were insignificant. It is
      supposed that the damage to the outer membrane of mitochondria in cells can serve
      as one of the possible explanations of both decrease in the reliability of an
      aged organism under extreme conditions and sex differences of life-span.

PMID- 8350661
TI  - Stimulation by the antioxidant thioproline of the lymphocyte functions of old
      mice.
AB  - Diet supplementation with thioproline (thiazolidine-4-carboxylic acid), an
      intracellular sulfhydryl antioxidant and free radical scavenger, may slow the
      aging process of metazoans and prolongs their life span. In the present
      experiment Swiss mice fed thioproline (0.07%, w/w) from 13 to 22 months of age
      were used. Six- and 22-month-old mice fed standard diet were used as controls.
      Two important functions of lymphocytes, the proliferative response to the mitogen
      Concanavalin A (Con A) and the mobility, both spontaneous and directed to a
      chemoattractant gradient (chemotaxis), were analyzed in lymphocytes from axillary
      nodes, spleen and thymus. Mobility and chemotaxis were studied by Boyden's
      technique, using filters of 3 microns pore diameter, 3 h of incubation and fmet
      leu-phe at 10(-8) M as chemoattractant. The proliferative response was estimated
      as 3H-thymidine incorporation in lymphocytes incubated for 72 h in the presence
      of Con A (1 and 5 micrograms/ml). The results show a decrease in mobility,
      chemotaxis and lymphoproliferative response in old mice in comparison to adults.
      However, a significant increase in these functions was observed in old mice fed
      thioproline. The advantage of using this antioxidant for immunostimulation during
      aging, a stage of life characterized by a decreased immune response, is
      discussed.

PMID- 8350662
TI  - Fructose 2,6-bisphosphate: changes during neonatal maturation and aging of rat
      and potential role in regulation of glucose utilization.
AB  - During the 6 days following birth, tissue levels of fructose-2,6-P2 in rat brain,
      liver, muscle, heart and kidney did not significantly change. However, by the
      tenth day postpartum fructose-2,6-P2 levels in brain, heart, and skeletal muscle
      increased approximately 50% and attained adult values. During maturation of
      liver, adult levels of fructose-2,6-P2 were not achieved until 3-4 weeks after
      birth or approximately at the time of maximum rates of gluconeogenesis. Renal
      fructose-2,6-P2 levels in the neonate were initially elevated and 2-3 weeks after
      birth decreased approximately 2.5-fold to adult values. With the exception of the
      pons-medulla, which showed no significant changes in fructose-2,6-P2 amounts,
      levels of this regulatory sugar from aging brain regions were generally
      decreased. The fructose-2,6-P2 levels from heart atria of old rats (24-30 month)
      were also significantly decreased. In diaphragm, the fructose-2,6-P2 levels were
      increased at 12 months of age and at 27 months of age were twice the level at 3
      months. The fructose-2,6-P2 levels during the aging of liver, skeletal muscle
      (EDL and soleus), spleen, thymus, kidney, testis and lung were not significantly
      altered.

PMID- 8350663
TI  - Developmental aspects of Bufo bufo embryo glutathione transferases.
AB  - The expression of glutathione transferase isoenzymes has been studied during the
      development of Bufo bufo embryo. By analysing the GSH-affinity purified materials
      in terms of substrate specificities, SDS-PAGE pattern, HPLC elution profile, we
      conclude that, up to stage 22, no significant changes in the expression of
      glutathione transferases isoenzymes occurred during Bufo bufo embryo development.
      At stage 25 the distribution of glutathione transferases was found to be slightly
      different from those of all other foregoing stages. A marked decrease of
      embryonic glutathione transferases subunits with a parallel appearance of new
      structurally and immunologically different subunits was noted in toad liver and
      kidney. Toad ovary continued to express embryonic glutathione transferase
      subunits.

PMID- 8350664
TI  - Effects of long-term elevated serum levels of growth hormone on life expectancy
      of mice: lessons from transgenic animal models.
AB  - In this study, we characterize transgenic mice carrying fusion genes, in which
      the genes coding for human (h) or bovine (b) growth hormone (GH) have been put
      under the transcriptional control of the mouse metallothionein I (MT) or the rat
      phosphoenolpyruvate carboxykinase (PCK) promoter as models for investigating the
      long-term effects of elevated GH on life expectancy. Circulating GH
      concentrations ranged from 3000 to 900,000 ng/ml, from 320 to 2960 ng/ml and from
      34 to 1050 ng/ml in transgenic mice belonging to the MThGH, the PCKbGH and the
      MTbGH groups, respectively, and were high on a short-, medium-, and long-term
      basis. As a consequence of excess GH in their serum, GH transgenic mice exhibited
      drastically reduced life span which was primarily due to severe kidney lesions
      (glomerular hypertrophy, sclerosis and hyalinosis associated with tubulo
      interstitial changes) consistently found in these animals. Alterations of the
      liver observed in transgenic mice included both hepatocellular megaly and various
      degrees of regressive, regenerative and fibrotic changes. In older MTbGH and
      PCKbGH transgenic mice, hepatocellular neoplasms including both adenoma and
      carcinoma were frequently found in addition to non-neoplastic changes. Our study
      points out the suitability of GH transgenic mice to evaluate the effects of
      various levels of GH in long-term studies without having to take antibody
      production against the heterologous hormone into account. Findings in GH
      transgenic animals suggest that the long-term benefits and risks of GH therapy
      should be carefully evaluated.

PMID- 8350665
TI  - Endothelin-1-induced gastric ulcer is attenuated by cetraxate.
AB  - We investigated the effect of the anti-ulcer drug cetraxate on the development of
      the gastric ulcer induced by the submucosal injection of endothelin-1 in the rat
      gastric body, and its effects on gastric mucosal hemodynamics and tissue
      oxygenation by Laser doppler flowmetry and tissue spectrophotometry. Endothelin-1
      induced gastric ulcer (ulcer length: 11.85 +/- 0.89 mm, mean +/- SEM, n = 4)
      which was strongly attenuated by cetraxate (ulcer length: 3.27 +/- 0.3 mm, mean
      +/- SEM, n = 8, p < 0.0001). Cetraxate maintained also tissue oxygenation without
      causing any significant effect on the endothelin-1-induced changes in gastric
      mucosal blood flow and volume. These results show that cetraxate exerts its
      cytoprotective action partly by maintaining mucosal oxygenation.

PMID- 8350666
TI  - Identification of specific pathways of communication between the CNS and NK cell
      system.
AB  - The specific signals and pathways utilized by the natural killer (NK) cell system
      and the central nervous system (CNS) that results in the conditioned response
      (CR) is not clearly understood. Single trial conditioning of the NK cell activity
      provides us with a model to probe the mechanisms of communication between two
      major systems (Immune and CNS) which are involved in the health and disease of
      the individual. The studies show that the IFN-beta molecules possess the
      properties attributed to the unconditioned stimulus (US). IFN-beta can penetrate
      the CNS and evoke the elevation of NK cell activity in the spleen. This
      unconditioned response (UR) can be linked to a specific conditioned stimulus
      (CS). Specific odors such as camphor provide a neural pathway for the CS to
      associate with the US. Evidence is presented that in conditioning there are two
      locations where memory develops. The CS/US association is made centrally and its
      memory is stored at a central location, but the memory for the specificity of the
      odor is presumably stored in the olfactory bulbs. The CS recalls the CR by
      triggering the olfactory neural pathway which, in turn, signals the hypothalamic
      pituitary axis to release mediators that modulate the activity of NK cells in the
      spleen. These results imply that through conditioning one has direct input into
      the regulatory hypothalamus that controls the internal environment of the
      organism and the health and disease of the individual. Consequently, it is not
      inconceivable that through this approach we might be able to alter the course of
      a disease process.

PMID- 8350667
TI  - Atrial natriuretic factor enhances the hydroosmotic response of toad bladder to
      submaximal doses of vasopressin.
AB  - Using the toad urinary bladder, we examined the effects of submaximal levels of
      atrial natriuretic factor (ANF) upon the hydroosmotic water flux caused by
      physiologic concentrations of vasopressin (VP). Pretreatment with ANF prior to
      the addition of VP (10(-9)M) significantly enhanced water transport (123 +/- 23%)
      compared to tissues exposed to VP alone. Pre-treatment with ANF also
      significantly enhanced the hydroosmotic response (143 +/- 43%) to cyclic-3',5'
      adenosine monophosphate (cyclic-AMP). When the concentration of VP was
      progressively increased during time course experiments, an inhibitory effect of
      ANF on water transport followed the early stimulatory response to this peptide.
      The data support a novel, dose-dependent modulatory role for ANF early in the
      response of transporting epithelia to VP. Moreover, the stimulatory effect of
      submaximal doses of ANF to cyclic-AMP mediated water transport suggest the
      possibility that modulation by ANF may occur at a site following the VP receptor
      linked adenylate cyclase system.

PMID- 8350668
TI  - External ions and direct membrane effects of enkephalins on Amoeba proteus.
AB  - We have shown that amphiphilic hormones like vasopressins and endorphins increase
      water permeability and activate the contractile vacuole (CV) in Amoeba by direct
      action on the plasma membrane. Using our standard CV assay, the effects of nine
      opioids, morphine, naloxone and 7 enkephalin derivatives, have been compared in
      normal, ion-containing growth medium (Chalkley's) and in glass-distilled water.
      While the absence of external ions does not affect the activity of molecules with
      net positive charges, opioids with no net charge are devoid of action in glass
      distilled water. This shows that, in addition to amphiphilicity, which permits
      insertion into the lipid core of the membrane, electrostatic interactions with
      ions and with negative charges of phospholipids membrane and glycocalyx, the
      thick glycoproteic cell coat of Amoeba, are important in the direct action of
      these compounds.

PMID- 8350669
TI  - Effects of a short term hindlimb suspension on central and peripheral
      norepinephrine turnover in rats.
AB  - The loss of appropriate cardiovascular reflexes which contributes to the
      cardiovascular deconditioning observed after an exposure to actual or simulated
      microgravity (in man or animals) is well known, but the mechanisms responsible
      remain unclear. This protocol, a 2.5 h hindlimb suspension in rats, was
      undertaken to study the early adaptation of the sympathetic neurons involved in
      arterial pressure regulation: we determined central norepinephrine (NE) turnover
      in the brainstem catecholaminergic cell groups responsible for the central
      cardiovascular regulation i.e. A1, A2 (rostral and caudal), A5 and A6 cell groups
      and peripheral NE turnover in target organs (heart and kidneys). The NE turnover
      in suspended rats significantly decreased in rostral A2 (48% p < 0.001), caudal
      A2 (52% p < 0.001) and A5 (40% p < 0.05) cell groups while it was unchanged in A1
      and A6 cell groups compared with rats attached to the suspension device but
      maintained in the horizontal position. The short term hindlimb suspension did not
      alter the NE turnover in cardiac atria and ventricles or in kidneys nor did it
      alter the blood variables studied (hematocrit, osmolality, plasma sodium,
      potassium, proteins and renin concentration). We concluded that a 2.5 h hindlimb
      suspension reduced noradrenergic neuron activity in A2 and A5 cell groups
      involved in the central control of arterial pressure and particularly in the
      baroreceptor reflex mechanisms. This duration was probably not sufficient to
      modify the NE turnover in the two peripheral organs studied.

PMID- 8350670
TI  - Serotonin stimulates steroidogenesis in rat preovulatory follicles: involvement
      of 5-HT2 receptor.
AB  - The role of serotonin (5-HT) in the regulation of steroidogenesis in the ovary
      via 5-HT2 receptor was studied in normal cycling rats and their preovulatory
      follicles. Oral administration of ketanserin (KET), a selective 5-HT2 antagonist,
      at 10 mg/kg BW at 1100h on the day of proestrus resulted in a marked decrease in
      serum estradiol levels immediately after the administration. 5-HT stimulated
      estradiol secretion by preovulatory follicles incubated for 5 hrs in Krebs-Ringer
      bicarbonate buffer. 5-HT (2.5 microM) -enhanced estradiol secretion was inhibited
      by KET (1-100 microM) in a dose-dependent manner. Secretion of progesterone and
      testosterone was also inhibited by about the same order of magnitude as
      estradiol. Addition of pregnenolone (1 microgram/ml) prevented the KET-inhibited
      progesterone production. Both testosterone and estradiol increased at the same
      ratio by the addition of progesterone (1 microgram/ml). The inhibition of
      secretion of these hormones was overcome by dbcAMP (0.1 mM). The present study
      suggests that 5-HT stimulates steroidogenesis in the metabolic pathway prior to
      pregnenolone in rat preovulatory follicles and the action of 5-HT could possibly
      be mediated by a 5-HT2 receptor.

PMID- 8350672
TI  - Isotonic and hypertonic saline act as stressful stimuli for oxytocinergic system
      of the pituitary, hypothalamus and spinal cord.
AB  - We have recently demonstrated that immobilization stress leads to an increase in
      the spinal cord oxytocin content in the rat. The current experiments were
      undertaken to determine if other stressors have similar effect on the spinal cord
      oxytocin levels. Male Long Evans rats were injected either with isotonic or
      hypertonic saline and sacrificed either 15 minutes or 3 hours after saline
      injection. Oxytocin content of the neurohypophysis, hypothalamus and spinal cord
      were determined by specific radioimmunoassay in Sep-pak extracted samples. The
      results demonstrate that both isotonic and hypertonic saline act as stressful
      stimuli and reduce oxytocin content of the pituitary and hypothalamus when the
      rats were sacrificed within 15 minute following the injection. Spinal cord
      oxytocin content was also affected by isotonic and hypertonic saline
      administration; oxytocin content decreased if rats were sacrificed after a short
      period (15 min) and increased if rats were sacrificed after a long period (3
      hours). These results, together with those reported earlier, support the
      hypothesis that stressors, in general, affect the spinal cord oxytocin content.

PMID- 8350671
TI  - Hemolytic mechanism of cytolysin produced from V. vulnificus.
AB  - The characteristics of hemolytic action of cytolysin produced from V. vulnificus
      were investigated in mouse erythrocytes. The cytolysin bound erythrocyte
      membranes in temperature-independent manner and then lysed cells temperature
      dependently. Hemoglobin release by the cytolysin was completely inhibited by the
      presence of raffinose or melezitose, but K+ release was not affected. The
      cytolysin-induced hemolysis was always accompanied with the conversion of
      membrane-bound cytolysin into an oligomer of 210 kDa, corresponding to a tetramer
      of native cytolysins. Nonesterified cholesterol inactivated the cytolysin by
      converting active monomeric cytolysin into inactive oligomer. The results suggest
      that the cytolysin lyses erythrocytes due to the formation of small pores on
      erythrocyte membrane by cholesterol-mediated oligomerization of the cytolysin.

PMID- 8350673
TI  - Chronopharmacology of amlodipine in rats.
AB  - The present study was undertaken to examine whether plasma concentrations of
      amlodipine, a calcium antagonist, and its diuretic effects vary with the time of
      dosage. Pharmacokinetic study; 20 mg/kg of amlodipine was given orally to rats at
      10 am (day trial) or 10 pm (night trial), and blood samples were obtained during
      a 24-hour period. Pharmacodynamic study; two doses (10 and 20 mg/kg) of
      amlodipine were given orally at 10 am or 10 pm by a cross-over design, and urine
      was collected for 12 hours after dosage. Rats were maintained under condition of
      light from 7 am to 7 pm. The following results were obtained; The tmax of
      amlodipine was shorter and the Cmax was greater in the night trial than in the
      day trial. Its diuretic effects were greater in the night trial. These results
      suggest that the pharmacokinetic and pharmacodynamic profiles of amlodipine vary
      with its time of dosage.

PMID- 8350674
TI  - Predictability of the covalent binding of acidic drugs in man.
AB  - Although metabolism via glucuronide conjugation has generally been considered a
      detoxification route for carboxylic acids, the newly discovered chemical
      reactivity of these conjugates, leading to covalent binding with proteins, is
      consistent with the toxicity observed for drugs containing the carboxylic acid
      moiety. Here we report that degradation rates (intramolecular rearrangement and
      hydrolysis) for 9 drug glucuronide metabolites show an excellent correlation (r2
      = 0.995) with the extents of drug covalent binding to albumin in vitro.
      Furthermore, this binding capacity is predictable based on chemical structure of
      the acid and depends on the degree of substitution at the carbon alpha to the
      carboxylic acid. The in vivo covalent binding in humans for these drugs is also
      predictable (r2 = 0.873) when the extent of adduct formation is corrected for the
      measured plasma glucuronide concentrations. These results suggest that the
      structure of a carboxylic acid drug may predict the degree to which the
      corresponding acyl glucuronides will form covalent adducts that probably/possibly
      lead to toxicity. This information could be a useful adjunct in drug design.

PMID- 8350675
TI  - In vitro hepatic thyroid hormone deiodination in iron-deficient rats: effect of
      dietary fat.
AB  - The effects of different dietary fats on thyroid indices were studied in weanling
      iron-deficient rats. Rats were fed one of five different diets (safflower oil
      with a casein protein source, safflower oil with defatted beef as the protein
      source, prime rib, beef tallow with casein and stearate with casein). Both
      dietary fat and iron status (adequate, CN; deficient, ID; or iron-deficient
      replete, ID-replete) had significant effects on body weight and hemoglobin
      concentrations. The tallow-fed animals weighed the least relative to animals fed
      the other fats; ID rats were smaller than CN rats. The tallow- and stearate-fed
      animals had the highest hemoglobin concentrations. Type of dietary fat affected
      plasma thyroxine (T4), but not plasma triiodothyronine (T3) or rate of
      deiodination of reverse T3 (rT3). Iron deficiency decreased plasma concentrations
      of T3 and T4 and increased in vitro hepatic rT3 deiodination, suggesting that the
      ID animals tend to metabolize thyroid hormones via deactivating pathways. The
      alterations in thyroid hormone metabolism associated with iron deficiency are
      reversible with iron repletion.

PMID- 8350676
TI  - A method for continuous blood sampling during cold water immersion.
AB  - A technique, consisting of a pre-calibrated, catheter-peristaltic pump
      combination, for continuous blood sampling was tested using six volunteers during
      a 20 min immersion in cold water at 14.7 +/- 0.9 degrees C. The device offered
      the advantage of continued collection of blood samples from an antecubital vein
      during the experiment with little discomfort for the subjects and in sufficient
      volume for assay of plasma constituents eg. catecholamines.

PMID- 8350677
TI  - Decreased nocturnal plasma melatonin levels in patients with recurrent acute
      intermittent porphyria attacks.
AB  - Acute intermittent porphyria (AIP) is a hereditary disease characterized
      biochemically by a defect in the heme pathway enzyme porphobilinogen deaminase.
      There is wide variability in the neurologic clinical expression of AIP, and the
      disorder remains latent in most gene carriers. The natural history of the disease
      and results in a porphyric rat model suggest a significant relationship between
      tryptophan metabolites and clinical expression of the disease. In the present
      study, we examined urine and blood tryptophan metabolite levels in AIP women
      before, during and after acute attacks and treatment by heme arginate. Heme
      arginate treatment promptly decreased total tryptophan levels (from 69 +/- 9, to
      44 +/- 5, mean +/- SEM, mumole/l, p < 0.001), serotonin blood levels (from 629 +/
      103, to 356 +/- 80, nmole/l, p < 0.01) and the urinary excretion of 5-HIAA (from
      3.9 +/- 0.6, to 2.2 +/- 0.4, mumole/mmole creatinine, p < 0.01). The plasma level
      of melatonin was found much lower than the normal control level at night (86.2 +/
      70.3, vs the normal range, 409 +/- 78.9, pmole/l +/- SEM) and day time (38.8 +/-
      22.0, vs 75 +/- 13.7). Heme arginate treatment did not influence melatonin
      levels. Our results support the involvement of abnormal tryptophan metabolism in
      the pathophysiology of AIP acute attacks. Low melatonin plasma levels in
      porphyric women suggest that the defect of the pineal hormone may be responsible
      for the recurrent aspect of porphyric attacks. A desynchronization of biological
      rhythms in AIP patients may increase the inducibility of hepatic ALA synthase to
      environmental risk factors and, specially, to sex steroid hormones.

PMID- 8350678
TI  - EDTA-insensitive deacylation of phosphatidylinositol in porcine platelet
      membranes.
AB  - Pathways for EDTA-insensitive degradation of phosphatidylinositol (PI) were
      investigated in porcine platelet membranes and cytosol. The incubation of
      platelet membranes with [3H]glycerol-labeled PI in the presence of 2mM EDTA
      produced [3H]lysoPI and aqueous radioactive products, but not radioactive neutral
      lipids. The degradation in the membranes was optimal at pH8.0-9.0, while EDTA
      insensitive hydrolysis was also observed in cytosol with optimal pH at pH7.0-9.0.
      The major water-soluble product was identified as glycerophosphoinositol. Under
      the conditions, [14C]arachidonate was released from 1-stearoyl-2-[14C]arachidonyl
      PI without accumulation of [14C]lysoPI. The deacylation activity preferred PI to
      phosphatidylcholine and phosphatidylethanolamine. Collectively, these results
      suggest that PI can be converted to lysoPI by phospholipase A2 in the absence of
      free Ca2+, providing the substrates for lysoPI-specific phospholipase C
      characterized earlier in porcine platelet membranes (Murase and Okuyama (1985)
      J.Biol.Chem. 260, 262-265).

PMID- 8350679
TI  - Stimulation or inhibition of A431 cell growth by EGF is directly correlated with
      receptor tyrosine kinase concentration but not with PLC gamma activity.
AB  - EGF-induced hydrolysis of phosphatidylinositol 4, 5, biphosphate was compared in
      A431 cells with respect to their growth response to EGF. A431 cells which express
      4- to 5-fold more EGF receptors than A431-4 cells were growth inhibited, while
      A431-4 cells were growth stimulated by EGF within the same dose range. Treatment
      of A431 cells with EGF resulted in a 2-fold increase in cellular IP3 levels and
      the effect in A431-4 cells was not as obvious. In the presence of tyrosine kinase
      inhibitor coumaric acid (0.2 approximately 2 microM), A431 cell growth was
      stimulated, rather than inhibited, by EGF in a dose-dependent manner. In
      contrast, the stimulation of A431-4 cell growth by EGF was reduced under the same
      conditions. Furthermore, in the presence of coumaric acid (up to 0.5 microM), EGF
      induced production of inositol phosphates in A431 cells was not obviously
      affected. Taken together, the results suggest that EGF-induced growth inhibition
      of A431 cells may be due to a quantitative changes of EGF-receptor tyrosine
      kinase activity in areas other than the recruitment and activation of
      phosphatidylinositol-specific phospholipase C gamma.

PMID- 8350681
TI  - Electric shock: a potentially hazardous approach to treating venomous snakebites.

PMID- 8350680
TI  - Cerebrospinal fluid dynorphin-converting enzyme activity is increased by
      voluntary exercise in the spontaneously hypertensive rat.
AB  - The activity in cerebrospinal fluid (CSF) of dynorphin-converting enzyme (DCE)
      has been studied after voluntary exercise in the spontaneously hypertensive (SH)
      rat. The exercise consisted of spontaneous running in wheels for 4-5 weeks and
      the average running distance during the last two weeks was 4.0 km/24h. CSF
      samples were obtained under anaesthesia from the cisterna magna after penetration
      of the atlanto-occipital membrane. DCE transforms the members of the dynorphin
      family of opioid peptides into Leu-enkephalin-Arg6. In the present investigation
      a radioimmunoassay was used for quantitation of Leu-enkephalin-Arg6 release from
      dynorphin A1-17 and dynorphin B1-13. The rats that were running had a DCE
      activity (vs. both substrates) in CSF that was approximately 6-12 times higher
      than in animals not given the running opportunity. A statistically significant
      correlation between the two prodynorphin-derived substrate peptides was found in
      terms of DCE activity. We therefore propose that a single enzyme activity may be
      responsible for the hydrolysis of dynorphin B1-13 and dynorphin A1-17.
      Furthermore, a significant correlation was also found between running activity
      and DCE activity 12-14 h before the CSF was withdrawn. Besides measurement of DCE
      activity by radioimmunoassay, the formation of Leu-enkephalin-Arg6 was identified
      by reversed-phase micro-column liquid chromatography and plasma desorption mass
      spectrometry. The experiment shows that voluntary exercise affects opioid
      peptidergic mechanisms.

PMID- 8350682
TI  - Medicine and the performing arts.

PMID- 8350683
TI  - Odyssey: the history of performing arts medicine.
AB  - The first publication to summarize the occupational diseases of musicians was
      Ramazzini's Diseases of Tradesmen in 1713. While there was sporadic interest in
      performing arts medicine during the 1800s, the first book devoted to the subject,
      Singer's Diseases of the Musical Profession, was published in 1932. During the
      1960s and 1970s, both physicians and performers became more interested in arts
      medicine. When pianists Gary Graffman and Leon Fleisher publicly discussed their
      career-ending hand problems in the early 1980s, a huge, previously unknown group
      of injured musicians was brought to light. Since that time, publication in the
      field has dramatically increased, numerous conferences have been held, and
      clinics catering to the needs to performers have been set up in various large
      cities. Although we still do not have all the answers to the problems faced by
      performing artists, arts medicine is now a recognized discipline, reaching out to
      performers, arts educators, arts administrators, and instrument manufacturers.

PMID- 8350684
TI  - Upper extremity disorders in performing artists.
AB  - Studies in the past decade have shown that a significant proportion of
      instrumentalists report musculoskeletal problems severely affecting their musical
      performance. Musicians endure daily intensive use of their upper extremities,
      frequently placing them in bizarre positions. Their training schedules are
      rigorous and long term Predisposing factors to, and treatment for, overuse
      syndromes, tendinitis, and tendon trauma commonly encountered by musical
      performers are discussed at length. Nerve entrapment has also surfaced as a major
      problem in musicians, and the means of evaluation and treatment and the role of
      surgery are put forth. Techniques for studying and analyzing the difficulties
      faced by instrumentalists are summarized.

PMID- 8350685
TI  - Myofascial pain: the great mimicker and potentiator of other diseases in the
      performing artist.
AB  - The performing artist often sustains a variety of neuromusculoskeletal problems
      that interfere with the ability to play or perform. Although many of these
      conditions occur as a result of overuse or misuse; other causes should be kept in
      mind--particularly when pain problems persist, recur, or do not respond to usual
      therapeutic measures. Chief among these are myofascial pain syndromes. These are
      quite common but are often overlooked, despite the fact that they can cause,
      potentiate the dysfunction of, and mimic other conditions. This article presents
      an overview of myofascial pain and dysfunction--particularly as it pertains to
      neuromusculoskeletal pain and disability in musicians and performing artists.

PMID- 8350686
TI  - Applied ergonomics: adaptive equipment and instrument modification for musicians.
AB  - Failure or difficulty in treating musicians' overuse injuries is often due to
      overlooking aggravating roles of activities of daily living. Numerous devices are
      available for people with limited or painful hand function to protect joints and
      minimize stress of daily activities. The occupational therapist can evaluate the
      patient and determine which adaptations are appropriate. Instruments may be
      modified to render them more ergonomic and less likely to cause injuries; this is
      especially true for wind instruments. Biomechanically and ergonomically correct
      seating can minimize back and neck strain. Orthotics, such as modified chin and
      shoulder rests for the violin, may minimize the stress and strain of holding an
      instrument. Just as there is a drive to make buildings and public transportation
      barrier-free to the physically disabled, musical instruments can be made barrier
      free with adaptations like terminal devices for upper extremity prostheses.
      Principles of industrial and occupational medicine, especially regarding
      ergonomics and adaptive equipment, can be applied to the musical patient for
      treatment and prevention of injuries.

PMID- 8350687
TI  - The treatment of overuse injury syndrome.
AB  - The emphasis on performance injury has shifted from epidemiology to prevention.
      Rest treatment, modified or radical, followed by rehabilitation, remains the
      cornerstone of treatment. The basic features, details of management, and side
      effects of these treatment phases are discussed at length, followed by a detailed
      description of the author's experience with 176 musicians seen for overuse injury
      syndrome. Forty-one patients were not prescribed rest treatment, refused rest
      treatment, or quit rest treatment early; 45 patients were prescribed a modified
      rest treatment program, of whom 87% were cured of symptoms; and 90 patients were
      prescribed radical rest treatment, with a final success rate of 87% also.

PMID- 8350688
TI  - Addressing stress-related illness in professional musicians.
AB  - The health profession has become increasingly aware of the frequent incidence of
      work-related injuries and illnesses occurring among professional musicians.
      Although all workers run risks of stress-related health problems, performers must
      work under especially stressful conditions. Musicians must perform before the
      public; they must perform under the constant critical scrutiny of conductors; and
      they are expected to perform perfectly. Stressors, some unique to the music
      profession, some shared with other working populations, can come from the
      environment in which musicians must work, from psychological pressures, and from
      factors intrinsic to a performing career. In response to the increasing incidence
      and awareness of the health problems of professional musicians, music medicine, a
      new medical specialty, has come into being. Physicians who treat performers can
      act as resources to educate their patients about work-related stress and to refer
      them to appropriate mental health professionals. They can be instrumental in
      helping musician patients return to performing careers with a new ability to
      handle work-related injuries and stress.

PMID- 8350689
TI  - Life in the orchestra.
AB  - The concert soloist and conductor are prominent figures within the orchestra.
      Their roles make extraordinary demands on them--demands that must often be
      fulfilled while dealing with the problems of travel. Maintaining one's skill is a
      constant concern. The orchestra musician is also constantly on guard to maintain
      performance excellence. Unusual work patterns, obsession with the job, and job
      stress can put pressure on home life. The strong emotional personality of the
      orchestra musician must adapt to the conductor's desires and musical tradition.
      The player must coordinate performance with other group members. Other factors
      contribute to an environment with rigid boundaries and to the isolation of
      orchestra members as a group. With the development of performing arts medicine,
      injuries are less stigmatized and better treated, and performance stress is
      better managed. A patient's view of medicine is offered here.

PMID- 8350690
TI  - Consent to treatment: application to performing arts medicine.
AB  - Because treatment outcomes may have an effect on performing artists' livelihood,
      physicians should involve these patients in the treatment planning phase by
      obtaining informed consent. Treatment without consent is a battery. Physicians
      have several available lines of defense against an allegation of failure to
      obtain informed consent, including reasonable documentation of treatment plan
      discussions with patients; the "so what!" defense, which states that the patient
      would have agreed to treatment despite the risks; and the "unduly alarming"
      defense, which contends that based on past experience with a particular patient,
      proper disclosure would cause undue emotional distress. Alert compliance with the
      laws governing consent for treatment and sound medical judgment are every
      physicians' legal, ethical, and moral duty.

PMID- 8350691
TI  - Foot care for the patient with diabetes.

PMID- 8350692
TI  - Imaging case of the month. Tuberculous osteomyelitis, discitis, and epidural
      abscess.

PMID- 8350693
TI  - Treatment of panic disorder: summary of the NIH consensus statement.

PMID- 8350694
TI  - Panic disorder: a commentary.

PMID- 8350695
TI  - Epidemiology & Disease Control Program. March, 1993. Tips for vaccine
      administration.

PMID- 8350697
TI  - The female athlete triad: disordered eating, amenorrhea, osteoporosis.

PMID- 8350696
TI  - Mitochondrial DNA sequence polymorphism, VO2max, and response to endurance
      training.
AB  - Mitochondrial DNA sequence variation was determined in 46 sedentary young adult
      males who took part in ergocycle endurance training programs in two laboratories
      to assess whether mitochondrial DNA variants were associated with individual
      differences in maximal oxygen uptake (VO2max) and its response to training.
      VO2max was obtained from a progressive ergocycle test to exhaustion. White blood
      cell mitochondrial DNA was characterized with the restriction fragment length
      polymorphism (RFLP) technique using 22 restriction enzymes and human
      mitochondrial DNA as a probe for hybridization. Multiple mitochondrial DNA
      variants were detected with 15 of the enzymes. Some subjects exhibited many
      RFLPs, while others showed no variation. These RFLPs (morphs) were generated by
      base substitutions located in gene regions coding for mitochondrial proteins as
      well as in the noncoding regions. Carriers of three mitochondrial DNA morphs, two
      in the subunit 5 of the NADH dehydrogenase gene and one in the tRNA for
      threonine, had a VO2max (ml.kg-1.min-1) in the untrained state significantly
      higher than noncarriers, while carriers of one mitochondrial DNA morph in subunit
      2 of NADH dehydrogenase had a lower initial VO2max. Endurance training increased
      VO2max by a mean of 0.5 l of O2, with individual differences ranging from gains
      of 0.06 to 1.03. After adjustment for training site and initial VO2max, a lower
      response was observed for three carriers of a variant in subunit 5 of the NADH
      dehydrogenase detected with HincII (mean gain of 0.28 l; P < 0.05). These results
      suggest that sequence variation in mitochondrial DNA may contribute to individual
      difference in VO2max and its response to training.

PMID- 8350698
TI  - The effect of intense interval exercise on iron status parameters in trained men.
AB  - Iron and iron-binding proteins play a critical role in the physiology of many
      human systems, including the immune system. Intense interval exercise in trained
      men (mean [SD] age = 31.5 [4.5] yr; VO2max = 64.3 [3.8] ml.kg-1.min-1) is
      associated with significant modulation of iron status parameters. The
      concentration of red blood cells, hemoglobin, and transferrin all increased
      significantly immediately post-test (P < 0.01), increases which can largely be
      attributed to hemoconcentration. Serum iron was elevated by approximately 25%
      both immediately and 1 h post-test (P < 0.08). Maximum post-test serum iron
      values (either immediately or 1 h post-test) were significantly elevated with
      respect to rest (P < 0.01). Transferrin concentration was also significantly
      elevated at 24 h post-test (P < 0.05). Transferrin saturation was not
      significantly altered by this protocol (P > 0.10). Despite a trend toward
      elevation at 24 h post-test, ferritin concentration was not significantly
      different from the resting value at any sampling point. Intense interval exercise
      appears to be associated with significant modulation of iron status, the
      biological importance of which remains to be determined.

PMID- 8350699
TI  - Fatigability of human quadriceps femoris muscle following anterior cruciate
      ligament reconstruction.
AB  - The responses of quadriceps femoris muscles to an electrically elicited fatigue
      test were recorded from both lower extremities of 18 patients who had recently
      undergone unilateral, anterior cruciate ligament reconstruction. The fatigue test
      consisted of 40 pps, 13-pulse electrical trains that were repeated once per
      second for 3 min. The intensity of stimulation was set for each extremity to
      produce 20% of the maximum voluntary isometric contraction of the uninvolved
      muscle. The uninvolved quadriceps femoris muscle showed a significantly greater
      rate of decline in force over the first minute than the involved muscle (0.803%.s
      1 for uninvolved muscle vs 0.620%.s-1 for involved muscle). Similarly, the
      average forces produced over the last minute were significantly lower for the
      uninvolved than the involved quadriceps femoris muscle (uninvolved = 42.6%,
      involved = 50.4% of their original forces). These surprising results showed that
      the involved quadriceps femoris muscles were more endurant than the uninvolved
      muscles. It is suggested that the increases in endurance of the involved muscle
      may have been due, in part, to greater recruitment of Type I fibers with
      electrical stimulation or selective Type II fiber atrophy in the involved muscle.

PMID- 8350701
TI  - Iron status and diet in athletes.
AB  - Plasma ferritin (F) concentrations were measured (range 12-245 ng.ml-1) as an
      indicator of iron status in 24 male and 45 female healthy, nonanemic athletes.
      Usual food intake was assessed using a self-completed but supervised food
      frequency questionnaire. Linear regression was applied to determine the
      relationship between log F (as data was skewed) and average daily intake of iron
      (Fe), meat (M), protein (Pr), carbohydrate (CHO), fat (Fa), fiber (Fi), and
      kilojoules (Kj). There were negative correlations between F and each of Kj (P <
      0.01) and CHO (P < 0.001), and a positive correlation between F and Pr/Kj (P <
      0.01). No significant relationship existed between F and any of Fe, M, Fa, or Fi.
      These data suggest that iron or meat intake may not be important determinants of
      iron status in these athletes. Instead, the percentage of protein in the diet may
      be more influential on F, as may the (negative) effect of Kj and CHO intake, or
      at least their reflection of energy expenditure.

PMID- 8350700
TI  - Physiologic responses to shoveling and thermal stress in men with cardiac
      disease.
AB  - To investigate the effect of temperature stress on responses to static-dynamic
      work in patients with ischemic heart disease (IHD), 10 men with IHD shoveled
      gravel for 30 min in a warm (29 degrees C), neutral (24 degrees C), and cold (-8
      degrees C) environment (on separate days). A pace of 15 lifts.min-1 was set, and
      the load per lift approximated 5.5 kg. Heart rate (HR), oxygen consumption (VO2),
      and systolic (SBP) and diastolic blood pressures (DBP) were evaluated at 5-min
      intervals. Arrhythmias and ST-segment depression were evaluated by ambulatory
      electrocardiographic monitoring. At 30 min, VO2, SBP, and DBP were higher (P <
      0.05) in the cold environment, and HR was higher (P < 0.05) in the warm
      environment compared with the neutral environment. HR increased (P < 0.05) from 5
      to 30 min in all three conditions. The increase in HR was greater (P < 0.05) in
      the warm environment. None of the subjects reported angina or demonstrated
      electrocardiographic ST-segment changes during shoveling in any environment. The
      results indicate that low-risk patients with stable IHD show modest temperature
      induced alterations in hemodynamic and VO2 responses during 30 min of moderate
      intensity (50-60% of peak VO2) static-dynamic work without adverse
      electrocardiographic responses or symptomatology.

PMID- 8350702
TI  - Fractures, physical activity, and growth velocity in adolescent Belgian boys.
AB  - The relationship of fractures to physical activity and growth velocity in stature
      and metacarpal II bone dimensions was investigated in adolescent Belgian boys.
      Peak fracture incidence occurred between 12 and 14 yr of age and preceded the age
      at peak height velocity. The peak fracture rate occurred during mid adolescence
      (+/- 2 SD of the age at peak height velocity) and was twice as high as the rates
      before and after this period. The majority of fractures occurred during active
      participation in sports and general physical activities. The age at peak growth
      velocity for metacarpal cortical thickness, an indirect measure of bone mineral
      content, was about 6 months later than the ages at peak height velocity and peak
      growth velocity for metacarpal length. Peak fracture incidence occurred during a
      period when the amount of time spent in sports physical activity was low compared
      with later years. A lag in cortical bone thickness and mineralization, relative
      to linear skeletal growth, and unknown factors associated with active
      participation in sports, rather than an increase in the amount of physical
      activity, appear to be the predominant factors associated with the increased
      fracture incidence in Belgian boys during the growth spurt.

PMID- 8350703
TI  - Effects of prior exercise or ammonium chloride ingestion on muscular strength and
      endurance.
AB  - Previous studies linked muscular fatigue with a decrease in blood pH. This study
      investigated if the means of altering pH affected the extent of muscular fatigue.
      Drug-induced and exercise-induced acidosis were compared to test the hypothesis
      that exercise-induced acidosis impairs subsequent muscular performance more than
      chemically induced acidosis. In eight male subjects acidosis was induced by
      ingesting 0.3 g.kg-1 ammonium chloride (AC) for one trial, by upper body exercise
      (UBE) for another trial, and after placebo (PL) treatment. They then completed a
      performance test (PT) of 50 maximal, bilateral isokinetic knee extensions. Whole
      blood pH before (pHpre) and after (pHpost) the PT was 7.412, 7.264, and 7.261 for
      PL, UBE, and AC, respectively; both AC and UBE decreased pH similarly compared
      with PL. Peak torque and total work during the PT were similar for PL and AC, and
      were significantly greater than after UBE. Six subjects performed a fourth trial
      after combined AC and UBE treatments causing a pHpre of 7.081, but there was no
      greater performance impairment than that caused by UBE alone. The results
      dissociate the extent of the impairment from the magnitude of the disruption in
      blood pH.

PMID- 8350705
TI  - Physical activity and immune function in elderly women.
AB  - The relationship between cardiorespiratory exercise, immune function, and upper
      respiratory tract infection (URTI) was studied in elderly women utilizing a
      randomized controlled experimental design with a follow-up of 12 wk. Thirty-two
      sedentary, elderly Caucasian women, 67-85 yr of age, who met specific selection
      criteria, were randomized to either a walking or calisthenic group; 30 completed
      the study. Twelve highly conditioned elderly women, 65-84 yr of age, who were
      active in endurance competitions, were recruited at baseline for cross-sectional
      comparisons. Intervention groups exercised 30-40 min, 5 d.wk-1, for 12 wk, with
      the walking group training at 60% heart rate reserve and the calisthenic group
      engaging in mild range-of-motion and flexibility movements that kept their heart
      rates close to resting levels. At baseline, the highly conditioned subjects
      exhibited superior NK (119 +/- 13 vs 77 +/- 8 lytic units, P < 0.01) and T (33.3
      +/- 4.9 vs 21.4 +/- 2.1 cpm x 10(-3) using PHA, P < 0.05) cell function, despite
      no differences in circulating levels of lymphocyte subpopulations. Twelve weeks
      of moderate cardiorespiratory exercise improved the VO2max of the sedentary
      subjects 12.6%, but did not result in any improvement in NK cell activity or T
      cell function. Incidence of URTI was lowest in the highly conditioned group and
      highest in the calisthenic control group during the 12-wk study, with the walkers
      in an intermediate position (chi-square = 6.36, P = 0.042). In conclusion, the
      highly conditioned elderly women in this study had superior NK and T cell
      function when compared with their sedentary counterparts.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8350704
TI  - Effect of training and anabolic-androgenic steroids on drug metabolism in rat
      liver.
AB  - The effects of anabolic-androgenic steroid administration and exercise training
      on various aspects of hepatic function were investigated in sedentary and trained
      (treadmill for 12 wk) male and female rats treated orally with fluoxymesterone or
      methylandrostanolone (2 mg.kg-1 body weight, 5 d.wk-1 for 8 wk). The mean values
      of serum alanine aminotransferase, aspartate aminotransferase, alkaline
      phosphatase, total and direct bilirubin, and total- and high-density lipoprotein
      cholesterol remained within normal range in all groups of male animals. The same
      is true for female rats, except for an increase in alkaline phosphatase activity
      in the steroid-treated groups. Hepatic microsomal aniline p-hydroxylase activity
      was reduced in male and increased in female rats by either steroid, whereas no
      significant effect was detected on 7-ethoxycoumarin deethylase activity. The
      levels of cytochrome P-450 and cytochrome b5 were markedly decreased by the
      anabolic-androgenic steroid treatment in male rat microsomes, but neither the
      steroid administration nor exercise training induced significant changes in the
      cytochrome levels of female rat livers. Taking into account the significant
      increase in microsomal protein yield elicited by fluoxymesterone or
      methylandrostanolone treatment both in males and females, it is noteworthy that
      the total monooxygenase activities and cytochrome P-450 content, expressed on a
      per gram liver basis, were significantly increased in female whereas they were
      apparently unchanged in male rats. In conclusion, the present data show that the
      prolonged ingestion of high doses of anabolic-androgenic steroids, either with or
      without concurrent exercise training, can modify in a sex-dependent manner the
      capacity of rat liver to metabolize drugs without affecting classical serum
      indicators of hepatic function.

PMID- 8350706
TI  - Changes of vinculin and extracellular matrix components following blunt trauma to
      rat skeletal muscle.
AB  - The purpose of the present study was to determine changes in the localization of
      vinculin, Type IV collagen, laminin, and fibronectin during the damage-repair
      process in the skeletal muscle over several days following acute blunt trauma. A
      single blunt trauma to the gastrocnemius muscle of the rat was induced by
      applying 1.57 J of kinetic energy to one leg. By day 2 after trauma, vinculin had
      disappeared rapidly from the intracellular submembraneous region corresponding to
      the costamere, whereas Type IV collagen and laminin persisted around the
      degenerating myofibers (corresponding to the basement membrane). Fibronectin
      could be observed filling the widened endomysium and in the ruptured myofibers.
      In the early phase of muscle regeneration (day 5 after trauma), newly synthesized
      vinculin, Type IV collagen, and laminin formed ring-like structures around the
      regenerating myotubes. Fibronectin could also be observed filling the widened
      endomysium around the regenerating myotubes. Further, when small newly formed or
      splitted myofibers were observed in the areas of regenerating myofibers (day 10
      after trauma), vinculin, Type IV collagen, laminin, and fibronectin were
      localized in specialized regions corresponding to the costamere, basement
      membrane, and endomysium. These results demonstrated that restoration of the
      costamere, basement membrane, and endomysium are essential to the maturation of
      regenerating myofibers after injury.

PMID- 8350707
TI  - Training effects on maternal and fetal glucose uptake following acute exercise in
      the rat.
AB  - The purpose of the present study was to determine the effects of chronic maternal
      exercise on glucose uptake in maternal tissues after one bout of treadmill
      running during late gestation in the rat and to determine the effects on glucose
      accumulation in the fetus and placenta. Trained pregnant animals (PR) ran at 30
      m.min-1, on a 10 degrees incline for 1 h on day 20 of gestation with a similarly
      treated trained nonpregnant group (NPR). Immediately after the run the animals
      were infused with a bolus of 1 g.kg-1 body wt as a 50% dextrose solution mixed
      with 2-deoxy-D-[1-3H] glucose through a carotid catheter. Sedentary pregnant (P)
      and nonpregnant animals (C) were also infused with the solution after no food and
      water for the same time frame. After 60 min, tissues were analyzed for
      radioactivity. Radioactive tracer was augmented in the red gastrocnemius and
      soleus of the PR group and the soleus of P rats. However, tracer accumulation in
      the fetus and placenta of the trained animals was not different than P animals.
      These results indicate that acute exercise in trained animals increased glucose
      uptake in maternal skeletal muscles without compromising conceptus glucose
      accumulation.

PMID- 8350709
TI  - Overtraining in endurance athletes: a brief review.
AB  - Overtraining is an imbalance between training and recovery, exercise and exercise
      capacity, stress and stress tolerance. Stress is the sum of training and
      nontraining stress factors. Peripheral (short-term overtraining, STO) or
      peripheral and central fatigue may result (long-term overtraining, LTO). STO
      lasting a few days up to 2 wk is termed overreaching. STO is associated with
      fatigue, reduction, or stagnation of the 4 LT performance capacity (performance
      at 4 mmol lactate or comparable criterion), reduction of maximum performance
      capacity, and brief competitive incompetence. Recovery is achieved within days,
      so the prognosis is favorable. LTO lasting weeks or months causes overtraining
      syndrome or staleness. The symptomatology associated with overtraining syndrome
      has changed over the last 50 yr from excitation and restlessness (so-called
      sympathetic form) to phlegmatic behavior and inhibition (so-called
      parasympathetic form). Increased volume of training at a high-intensity level is
      likely the culprit. The parasympathetic form of overtraining syndrome dominates
      in endurance sports. Accumulation of exercise and nonexercise fatigue,
      stagnation, or reduction of the 4 LT performance capacity, reduction in maximum
      performance capacity, mood state disturbances, muscle soreness/stiffness, and
      long-term competitive incompetence can be expected. Complete recovery requires
      weeks and months, so the prognosis is unfavorable. Other optional or further
      confirmation requiring findings include changes in blood chemistry variables,
      hormone levels, and nocturnal urinary catecholamine excretion. Based on the
      findings reported, recommendations for training monitoring can be made, but their
      relevance in the practice must still be clarified.

PMID- 8350708
TI  - The epidemiology of leisure physical activity in an adolescent population.
AB  - A cohort of 1245 adolescents, 12-16 yr old and participating in a prospective
      study of risk factors for injury, were surveyed annually to assess past year
      leisure physical activity. This report describes the development and
      reproducibility of the questionnaire and provides the descriptive epidemiology of
      leisure physical activity in adolescents. The questionnaire was self-administered
      twice, a year apart, and had a 1 yr test-retest rank order correlation of 0.55.
      The past year estimate of leisure activity was also shown to be related to
      fitness (rho = -0.37), which was defined as the time needed to complete a 1-mile
      run. Males reported significantly more activity than females (P < 0.05) and
      whites reported more activity than nonwhites (P < 0.05). However, socioeconomic
      status was not found to be a determinant of activity levels in either males or
      females. In females, a negative association between activity and age was found (P
      < 0.05); however, this association was not evident in males. In summary, an
      activity questionnaire has been developed and was shown to be both reproducible
      and feasible. Therefore, it was used to examine habitual leisure physical
      activity patterns of adolescents.

PMID- 8350710
TI  - Isometric strength, sprint power, and aerobic power in individuals with a spinal
      cord injury.
AB  - This study investigated in rather specific wheelchair tests the relationships
      among estimates of isometric upper-body strength (Fiso), sprint power (P30),
      aerobic power (VO2peak), and maximal power output (POaer) in a group of 44 men
      (age 34 +/- 12 yr) with longstanding spinal cord injuries ranging from C4/C5 to
      L5. Fiso was defined as the maximum force that could be exerted on the blocked
      rims of a stationary wheelchair ergometer. The estimation of P30 involved the
      measurement of the mean power during a 30-s all-out sprint test on the same
      wheelchair ergometer. VO2peak and POaer were determined as the peak oxygen uptake
      and highest sustained power output during a discontinuous progressive maximal
      exercise test on a motorized treadmill, while subjects used their own daily use
      wheelchair. Fiso ranged from 1.5 N.kg-1 (mean of both arms) in the group with
      quadriplegia to 3.4 N.kg-1 in the group with lowest-lesions, and P30 ranged from
      0.5 to 1.5 W.kg-1 among the subjects. VO2peak ranged from 13.6 ml.kg-1.min-1 in
      the group with quadriplegia to 31.3 ml.kg-1.min-1 in the group with lowest
      lesions, and POaer ranged from 0.4 to 1.1 W.kg-1. Strong positive relationships
      (r = 0.81-0.92) were demonstrated among all variables. Regression equations among
      variables were calculated: P30 = 0.51 Fiso - 0.18 (R2 = 0.75); POaer = 0.34 Fiso 
      0.02 (R2 = 0.66); POaer = 0.67 P30 + 0.11 (R2 = 0.81); VO2peak = 6.52 Fiso +
      4.15 (R2 = 0.76); VO2peak = 12.03 P30 + 7.43 (R2 = 0.77); VO2peak = 16.81 POaer +
      6.44 (R2 = 0.84).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350711
TI  - Physiological predictors of short-course triathlon performance.
AB  - The purpose of this study was to investigate if selected physiological variables
      were related to triathlon performance. Eighteen male and seven female triathletes
      competed in a short-course triathlon (1-km swim, 30-km cycle, 9-km run) and
      underwent physiological testing within 14 d. VO2max and ventilatory threshold
      (VT) were measured on a cycle ergometer, treadmill, and tethered swim apparatus.
      Leg flexion and extension strength were measured on a Cybex II isokinetic
      dynamometer. Multiple linear regression did not improve the prediction of
      triathlon performance over that provided by simple correlations. Swim performance
      was related to relative swim VO2max in both males (r = -0.48) and females (r = 
      0.93) as well as the resistance pulled at swim VT (r = -0.81) and absolute leg
      flexion strength (r = -0.77) in females. No physiological variables were
      significantly related to cycling time in either gender. Running time was related
      to relative VO2max (r = -0.88) in females and velocity at run VT in both females
      (r = -0.88) and males (r = -0.73). Relative swim VO2max (r = -0.98), velocity at
      run VT (r = -0.89), and absolute leg flexion strength (r = -0.80) were related to
      overall performance in female triathletes. The only significant predictor of
      overall triathlon time for males was velocity at run VT (r = -0.78). It therefore
      appears that in short-course triathletes physiological variables in swimming and
      running are important to overall performance. Differences in sample size, group
      variability, and level of performance between males and females may account for
      the reported differences in the physiological predictors of performance between
      genders.

PMID- 8350712
TI  - Physiological responses during simulated competition.
AB  - Laboratory studies with competitive athletes often use graded exercise protocols
      to elicit physiologic responses. This pattern of power output is different than
      ordinarily employed by athletes during competition. To understand the physiologic
      responses during competition, we studied 24 athletes (speed skaters, cyclists,
      triathletes) during simulated competition, a 5-km time trial on a racing bicycle
      attached to a windload simulator, and during cycle ergometer graded exercise
      testing (N = 8). During the time trial the velocity pattern was similar to real
      world competitions, and the subjects indicated that the time trial was
      perceptually similar to competition. Physiologic responses were of significantly
      greater magnitude vs graded exercise (VO2max: 3.46 +/- 0.73 vs 3.27 +/- 0.79
      l.min-1; VEmax: 138 +/- 27 vs 119 +/- 22 l.min-1; HRmax 184 +/- 11 vs 175 +/- 11
      beats x min-1; HLa 14.8 +/- 3.7 vs 11.9 +/- 2.1 mM). All physiologic measures
      increased steadily throughout the time trial (km 0, 1, 2, 3, 4, and 5: VO2 =
      1.03, 2.95, 3.42, 3.69, 3.82, and 3.92 l.min-1; HR = 93, 175, 181, 185, 189, and
      194 beats.min-1; VE = 31, 99, 120, 129, 145, and 156 l.min-1; HLa = 2.9, 5.6,
      7.2, 9.2, 10.6, and 13.5 mM). In six subjects (speed skaters), the peak values
      observed during time trial for HR (188 +/- 6 vs 191 +/- 5 beats.min-1) and HLa
      (16.4 +/- 3.1 vs 17.0 +/- 4.2 mM) were not significantly different than observed
      during real world competition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350713
TI  - Tilt table testing in the evaluation and management of athletes with recurrent
      exercise-induced syncope.

PMID- 8350714
TI  - Metabolic changes in the rat brain after acute and chronic ethanol intoxication:
      a 31P NMR spectroscopy study.
AB  - In this work, 31P phosphorus NMR (31P NMR) studies of the brain have been
      conducted in rats acutely and chronically intoxicated with ethanol. In both
      groups, changes in levels of high-energy phosphates were observed: increase of
      phosphocreatinine (PCr)/beta AaTP and PCr/inorganic phosphate (Pi) in acute and
      long-term ethanol exposure, and decrease of Pi/beta ATP after acute ethanol
      administration. These changes in high-energy phosphates, indicative of a
      reduction of adenosine triphosphate (ATP) and PCr consumption (PCr+ ADP+ H+ ATP+
      Cr; ATP ADP+ Pi), suggest a reduction of cerebral metabolism both in acute and
      chronic ethanol exposure. In addition, in the group of rats chronically
      intoxicated with ethanol, there were variations in phosphodiester peak
      intensities (decrease of phosphomonoester (PME)/phosphodiester (PDE), increase of
      PDE/beta ATP), suggesting increased breakdown of membrane phospholipids. These
      changes could provide a metabolic explanation for the development of cerebral
      atrophy in chronic alcoholism.

PMID- 8350715
TI  - Resolution of phospholipid molecular species by 31P NMR.
AB  - Phosphorus-31 NMR chemical shifts of phospholipids (PLs) solubilized in bile
      salts were studied with respect to variations in the structure of the acyl
      substituents. The presence of double bonds in the acyl chains of
      phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylglycerol
      (PG), and phosphatidic acid (PA) induced small but consistent upfield shifts
      relative to the corresponding disaturated acyl PL signals. The magnitudes of the
      unsaturation-related upfield shifts were approximately twice as large in sodium
      cholate as in sodium deoxycholate. Chemical shift separations of PC, PE, and PG
      dipalmitoyl-dioleoyl species pairs increased slightly at lower temperatures.
      Resolution of the PC species pair was maximized and nearly independent of cholate
      to-PL ratio at values greater than about 100 in 2% cholate. Only the PA species
      resolution varied significantly over the pH range 6.5 to 9.5, in the vicinity of
      its pK2. Shift differences for a homologous series of disaturated acyl PCs showed
      a logarithmic dependence on chain length. Spectra for a variety of PC standards
      were used to interpret the composite PC signals from egg yolk extract, soybean
      extract and whole human amniotic fluid. The 31P NMR analyses were consistent with
      published chromatographic studies. Interpretation of composite PL signals in the
      cholate system is simplified for mixtures having restricted acyl chain length and
      degree of unsaturation.

PMID- 8350716
TI  - The proton NMR spectrum in acute EAE: the significance of the change in the
      Cho:Cr ratio.
AB  - We have studied by nuclear magnetic resonance spectroscopy the evolution of the
      proton spectral changes in acute experimental allergic encephalomyelitis. We
      found an in vivo elevation in the ratio between the peaks assigned to "choline
      containing compounds" (Cho) and creatine plus phosphocreatine (Cr). This was
      associated with an increase in choline, betaine, and phosphorylcholine (PC) as
      well as a reduction in N-acetylaspartate (NAA), aspartate, N
      acetylaspartatylglutamate and inositol in vitro. Histological examination
      revealed inflammation with no evidence of demyelination or neuronal loss. We
      conclude that the increase in the ratio of Cho:Cr was due to an increase in the
      concentrations of PC, betaine, and choline in association with inflammation, and
      not as others have suggested, with demyelination. The reported reduction in NAA
      may be due to dysfunction of neurones rather than their loss.

PMID- 8350717
TI  - Limits to neural stimulation in echo-planar imaging.
AB  - Simple electrical circuits are used to model neural stimulation. The stimulation
      current is evaluated for a variety of magnetically induced waveforms and for
      sinusoidal stimulation as a function of frequency. Experimental results obtained
      using a small scale magnetic stimulator show that the transient response rather
      than the steady-state behavior determines the stimulation characteristics thus
      suggesting a nonlinear model. We show that a nonlinear circuit changes a steady
      state current solution into a repeated transient solution and thereby better
      explains our experimental results. Our model also shows that for very short times
      and high frequencies, contrary to the current widely held view, neural
      stimulation is independent of the magnetic field switching rate dB/dt, but
      depends on the final magnetic field value, Bm. At lower frequencies and rise
      times, there may be a small advantage in using square wave over sine wave
      gradient modulation for whole body echo-planar imaging (EPI). It is found that
      the peak stimulation fields Bm, for both sinusoidal and trapezoidal waveforms are
      equal for equal risetimes. This means that for a given image array size and
      imaging time, trapezoidal modulation EPI ultimately can be made to operate below
      the neural triggering threshold while the equivalent sine modulation EPI version
      transcends the threshold.

PMID- 8350718
TI  - Quantitative interpretation of magnetization transfer.
AB  - Magnetization transfer contrast (MTC) experiments using off-resonance irradiation
      have been performed with an agar gel model by systematically varying offset
      frequency, amplitude of the RF irradiation and gel concentration. The
      experimental results are shown to be quantitatively modelled by a two-pool system
      consisting of a liquid pool with a Lorentzian line shape and a small semisolid
      pool with a Gaussian lineshape. The fitted model yields physically realistic
      fundamental parameters with a T2 of the semisolid pool of 13 microseconds.
      Further analysis shows that the off-resonance irradiation MTC experiment had
      significant limitations in its ability to saturate the semisolid pool without
      directly affecting the liquid component.

PMID- 8350719
TI  - Spin-spin relaxation in experimental allergic encephalomyelitis. Analysis of CPMG
      data using a non-linear least squares method and linear inverse theory.
AB  - We have used the CPMG pulse sequence to measure proton T2 values and water
      content in spinal cord and brain samples from Hartley guinea pigs inoculated to
      produce experimental allergic encephalomyelitis (EAE). Relaxation data were
      fitted using minuit, a non-linear curve fitting routine. Three exponentials
      provided the best fit to spinal cord data (10 ms (13%), 76 ms (57%), 215 ms
      (30%)) and two exponentials for brain tissue (10 ms (4%), 92 ms (96%)). Least
      squares algorithms were also used to analyse the spinal cord data in terms of
      discrete and smooth distributions of relaxation times. The discrete least squares
      solutions consisted of three to five isolated spikes between 0.010 and 0.300 s.
      This type of solution was difficult to interpret in terms of water reservoirs.
      Smooth solutions consisted of two broad peaks, a small peak with a T2 near 0.010
      s and a larger peak near 0.100 s. The integral ratio of the larger to the smaller
      peak was 7.092 +/- 1.782 for normal tissue, and increased to a maximum of 16 with
      increasing parenchymal cellular infiltration and demyelination. The short T2 peak
      has been assigned to water in the hydration layers of the myelin sheath. The
      width of the longer T2 peak was sensitive to tissue heterogeneity. The least
      squares and smooth distribution analysis models could be used to distinguish
      samples with extensive parenchymal infiltration from normal tissue, even though
      only a maximum of 60% of the tissue was affected.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8350720
TI  - Echo-planar spin-echo and inversion pulses.
AB  - The echo-planar k-space trajectory can be used as the basis for any two
      dimensional selective pulse. The main application is spectral-spatial pulses,
      which must be based on the echo-planar trajectory. In this paper we show how echo
      planar spin-echo (EPSE) pulses may be designed.

PMID- 8350721
TI  - An asymmetric slice profile: spatial alteration of flow signal response in 3D
      time-of-flight NMR angiography.
AB  - We introduce an asymmetric slice profile technique, which alters the spatial
      response of the flow signal in 3D time-of-flight NMR angiography. By gradually
      increasing the flip angle from the inflow to the outflow portions of the slab,
      the inflow refreshment effect is distributed over a wide slab thickness. The
      asymmetric slice profile is simply produced by using a Gaussian RF excitation
      with an overlapping presaturation. The spatial distribution of steady flow signal
      in a phantom study demonstrated an essential agreement with a numerical
      simulation. 3D time-of-flight NMR angiography of volunteers' heads using this
      technique provided a smooth vascular depiction over a wide slab thickness.

PMID- 8350722
TI  - Blood flow measurement using variable velocity encoding in the RR interval.
AB  - Velocity-encoded phase imaging using asynchronous gating requires input of a
      velocity encoding value to set the velocity sensitivity of the pulse sequence.
      The raw data interpolation and reconstruction scheme that the pulse sequence uses
      forces the encoding value to be constant throughout the RR interval. The sequence
      and the raw data interpolation scheme were modified to allow two velocity
      encodings during the RR interval. Two-hundred cm/s encoding was used in systole,
      and 30 cm/s in diastole. Changing the encoding in diastole significantly improved
      the accuracy and precision of ascending aorta flow measurements.

PMID- 8350724
TI  - Automatic, localized in vivo adjustment of all first- and second-order shim
      coils.
AB  - The implementation of a "fast, automatic shimming technique by mapping along
      projections" (FASTMAP) on a 2.1-Tesla whole-body system is described. The method
      provides a localized adjustment of all first- (X, Y, Z) and second-order (Z2, ZX,
      ZY, X2-Y2, 2XY) coils in 2 min. The time savings are achieved by mapping the
      magnetic field along six projections rather than from whole-imaging data sets. An
      analysis of noise error propagation suggests that in 64-ml volumes the residual
      linewidths obtained with the method are negligible when the signal-to-rms-noise
      ratio is above 30. The initial application of the method to localized 13C, 31P,
      and 1H spectroscopy of the human brain resulted in linewidths of approximately 2
      Hz for 13C (144-ml volume), approximately 2.5 Hz for 31P (36-ml volume) and
      approximately 4 Hz for 1H (36-ml volume) with symmetric and reproducible
      lineshapes.

PMID- 8350723
TI  - Nonaxial whole-body instant imaging.
AB  - We demonstrate that whole-body, single-shot imaging is practical for imaging out
      of the central plane, including oblique axes. The technique is illustrated by
      images of the heart in the cardiac long- and short-axis and by coronal images of
      the brain. Secondary gradients can produce additional image distortion and
      ghosting in these images. These artifacts are a direct consequence, predictable
      by Maxwell's equations, of the large gradients used in echo planar imaging. We
      show that these effects are, in general, made smaller by working at a high
      magnetic field.

PMID- 8350725
TI  - Nonmagnetic hyperbaric chamber for in vivo NMR spectroscopy studies of small
      animals.
AB  - A description is given of the design, construction, and initial use of a
      polycarbonate resin hyperbaric chamber for in vivo NMR spectroscopy studies of
      anesthetized, ventilated rats in a horizontal bore 4.7 Tesla magnet. The chamber
      and its associated equipment, initially used for hyperbaric studies of rats in
      states of extreme hypercapnia, are also well suited for conventional hyperbaric
      studies, such as those related to hyperbaric oxygen therapy, oxygen toxicity, and
      diving. Basic technical challenges that required innovations involved: a)
      preservation of magnetic field homogeneity; b) avoidance of a metallic chamber
      body that would overload gradient and RF coils; c) physiological monitoring; and,
      d) remote control and stabilization of electromagnetic and physiologic factors
      (especially ventilatory stability) during pressure changes. A small paramagnetic
      bulk magnetic susceptibility shift from chamber-associated hyperbaric oxygen was
      observed when chamber oxygen tensions were only one atmosphere. High-quality NMR
      imaging and spectroscopy were demonstrated during hyperbaric conditions.

PMID- 8350726
TI  - Gadolinium-DTPA enhanced MRI demonstrates uterine vascular changes associated
      with artificially induced decidualization and ovoimplantation in rats.
AB  - Gadolinium-DTPA enhanced magnetic resonance (MR) imaging has been used to
      demonstrate uterine vascular changes during ovoimplantation and artificially
      induced decidualization in rats. Evans blue dye and Gd-DTPA were injected i.v.
      into rats 10 h after unilateral decidualization was induced by injection of
      sesame oil into the lumen of one uterine horn. Animals were killed various times
      later and uteri were removed, T1-weighted proton imaging was performed, and mean
      image intensities for stimulated and control uterine horns were calculated by
      computer-assisted image analysis. Macroscopic bluing confined to stimulated horns
      was apparent 5 min after tracer injection and increased in intensity until the
      experiment was terminated at 320 min. Analysis of MR images showed that mean
      image intensity of control horns did not change significantly at any time after
      injection of the Gd-DTPA and Evans blue whereas mean image intensity of
      stimulated horns increased significantly by 5 min after injection, peaked at 20
      min, and returned to values not different from controls by 320 min. T1-weighted
      images of day 6 pregnant rats injected with Gd-DTPA and Evans blue revealed
      patterns of image enhancement that matched those of macroscopic bluing. Uterine
      concentrations of radioactivity after injection of 153Gd-DTPA indicated that
      increased extracellular fluid volume (ECFV) produces the image enhancement of
      stimulated horns since the tracer permeates the extracellular fluid of both
      horns. Gd-DTPA-enhanced MR imaging of uteri after deciduogenic stimulation
      revealed significant image enhancement for stimulated horns at both 9 and 27 h
      after stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350727
TI  - Spatially localized 31P NMR measurements of longitudinal relaxation rates in the
      canine myocardium.
AB  - FLAX-ISIS spatial localization was combined with inversion recovery to enable the
      measurement of spatially localized T1 values. This approach was applied to the
      transmural determination of creatine phosphate longitudinal relaxation times in
      the canine myocardium. By examining five voxels spanning the left myocardial
      wall, we observed that transmural T1 values for creatine phosphate ranged from
      3.61 +/- 0.20 in the endocardium to 4.00 +/- 0.20 in the epicardium at 4.7 Tesla.
      As such, the canine myocardium exhibits no transmural variation in the T1 values
      of creatine phosphate. This simple approach can be extended to enable the in vivo
      measurement of transmural enzymatic rates.

PMID- 8350728
TI  - Stability and nonreactivity of ergothioneine in human erythrocytes studied by 1H
      NMR.
AB  - The N(CH3)3 resonance of ergothioneine in 1H spin-echo Fourier transform (SEFT)
      NMR spectra of red blood cells is usually a large singlet and it has been common
      practice to use this apparently unchanging resonance as an intensity reference.
      Recently, Reglinski et al. (Magn. Reson. Med. 6, 217-223 (1988)) have questioned
      this practice, reporting changes seen in the resonance in response to oxidative
      stress induced by arsenicals. We propose that the changes in the ergothioneine
      resonance that were reported are artifacts due to alterations in osmolality and
      magnetic susceptibility induced by the addition of nonisotonic solutions to red
      blood cell suspensions. These factors change the specific intensity of the
      intracellular resonances of all compounds. Ergothioneine was observed not to take
      part in any chemical reactions with arsenicals in free solution or in intact
      erythrocytes, and we conclude that ergothioneine may still be used as an internal
      intensity reference in 1H SEFT NMR spectra, bearing in mind the above physical
      factors.

PMID- 8350729
TI  - K-space substitution: a novel dynamic imaging technique.
AB  - A rapid dynamic imaging sequence has been developed in which only the 32 phase
      encoding steps that encode low spatial frequencies are collected for each dynamic
      image. These are substituted into a previously acquired, 128 x 128 raw data set
      prior to image reconstruction. In this way the dynamic information is retained
      while the overall appearance is improved in comparison with images obtained by
      zero filling to 128 x 128, leading to better qualitative evaluation. The limited
      k-space sampling means that the technique is most effective for large homogeneous
      areas of signal change since fine changes in contrast are imperfectly recorded.

PMID- 8350730
TI  - Use of a projection reconstruction method to decrease motion sensitivity in
      diffusion-weighted MRI.
AB  - Diffusion-weighted MRI is a clinically useful technique, but its utility is
      compromised by high sensitivity to patient motion. Use of radial-scan data
      acquisition and projection reconstruction, rather than the conventional Fourier
      imaging method, can substantially reduce the sensitivity to global translational
      motion of the object. The basis of this concept and a demonstration of the
      technique in an animal imaging experiment are presented.

PMID- 8350731
TI  - In vivo degradation of silicones.
AB  - 29Si nuclear magnetic resonance (NMR) spectroscopy is applied to study the
      degradation of polysiloxanes (silicones) in vivo. Our results with animal models
      show that silicone migrates from the implant to the liver (29Si resonance at -20
      ppm) and new silicon containing compounds form after the silicones are introduced
      into the rats. The new 29Si resonances in the chemical shift range of -40 to -85
      ppm are related to hydrolyzed silicone, those at -90 to -115 ppm are indicative
      of the presence of silica (SiO2), and the peaks observed at -120 to -150 are
      related to high coordinated silicon complexes. These resonances are not present
      in the 29Si spectra of the silicones before implantation. Our findings
      demonstrate that silicones are not metabolically inert.

PMID- 8350732
TI  - Incorporating prior biases in network models of conceptual rule learning.
AB  - A series of simulations is reported in which extant formal categorization models
      are applied to human rule-learning data (Salatas & Bourne, 1974). These data show
      that there are clear differences in the ease with which humans learn rules, with
      the conjunctive the easiest and the biconditional the hardest. The original
      ALCOVE model (an exemplar-based model), a configural-cue model, and two-layer
      backpropagation models did not fit the rule-learning data. ALCOVE successfully
      fit the data, however, when prior biases observed in human rule learning were
      implemented into weights of the network. Thus, current empirical learning models
      may not fare well in situations in which learners enter the concept-formation
      situation with preconceived biases regarding the kinds of concepts that are
      possible, but such biases might nevertheless be captured within these models. By
      incorporating preexperimental biases, ALCOVE may hold promise as a comprehensive
      category-learning model.

PMID- 8350733
TI  - Declarative and nondeclarative memory in opposition: when prior events influence
      amnesic patients more than normal subjects.
AB  - Amnesic patients and normal subjects read the names of nonfamous persons. Then,
      after being told that all the names were nonfamous, subjects judged the fame of
      names on a mixed list of new famous names, old nonfamous names, and new nonfamous
      names. Finally, they took a recognition memory test involving old and new
      nonfamous names. In this way, declarative (explicit) memory and nondeclarative
      (implicit) memory were placed in opposition. That is, recollection that a name
      had been recently presented (and was therefore nonfamous) opposed the
      facilitatory effect by which prior presentation ordinarily increases the tendency
      to judge that name as famous. Normal subjects exhibited good recognition memory
      and no fame-judgment effect--that is, no difference in fame judgments for new and
      old nonfamous names. By contrast, for the amnesic patients recognition memory was
      poor, but a strong fame-judgment effect occurred--that is, amnesic patients
      judged old nonfamous names as famous. The results provide additional evidence
      that the fame-judgment effect is supported fully by nondeclarative (implicit)
      memory and is independent of the limbic/diencephalic brain structures damaged in
      amnesia.

PMID- 8350734
TI  - Evidence for implicit scaling in comparative judgment.
AB  - In two experiments, we examined the effects of manipulating the density of
      stimuli on comparison difficulty in a comparative judgment task. In Experiment 1,
      subjects was slower at judging the relative size of a pair when the members were
      adjacent items in the linear order than when the members were separated by items
      of intervening magnitudes. In Experiment 2, the advantage of choosing the larger
      rather than the smaller of two large stimuli (e.g., the congruity effect)
      increased when the linear order included many small items. In contrast, the
      advantage of choosing the smaller of two small items increased when the linear
      order included many large items. The applicability of the range-frequency theory
      (Parducci, 1965) to these results is discussed.

PMID- 8350735
TI  - The separability of space and time: dimensional interaction in the memory trace.
AB  - The speeded-classification paradigm, adapted from the study of perceptual
      interactions, was used to examine interactions among features of the short-term
      memory trace. In each of four experiments, a trial began with the presentation of
      a pair of stimuli, each member of which occurred either first or second in time
      and above or below a fixation point. One of the two stimuli was then presented
      again, and the task was to classify its prior temporal (Experiments 1 and 3) or
      spatial (Experiments 2 and 4) position. The main question of interest asked
      whether subjects could selectively attend to one of these occurrence dimensions
      while ignoring irrelevant variation along the other. The results suggested that
      whereas subjects can selectively ignore temporal or spatial variation when no
      recall of the irrelevant dimensions value is required, they suffer interference
      when values on both dimensions must be remembered. The obtained patterns of
      interference are consistent with postperceptual interactions of the spatial and
      temporal components of the memory trace.

PMID- 8350737
TI  - How apparent motion affects mental rotation: push or pull?
AB  - Subjects were timed as they judged whether a small bar perpendicular to one side
      of a clockhand would point left or right if the hand was pointing upward (i.e.,
      at the 12:00 position). The clockhand was shown in two successive orientations 30
      degrees apart, so that it was perceived to jump from one to the other, but the
      bar was included at only one of the two orientations. Analysis of reaction times
      as a function of angular orientation showed that the subjects "mentally rotated"
      the clockhand to the upright position before making their decisions. When the bar
      appeared on the second presentation, the jump had no significant influence on
      mental rotation but when it appeared on the first presentation, the estimated
      orientation from which the clockhand was mentally rotated was "dragged" in the
      direction of the jump.

PMID- 8350736
TI  - Memory for position and dynamic representations.
AB  - Memory for the position of an object is biased. When asked to judge whether an
      object has changed its position with respect to a position shown a few
      milliseconds before, observers tend to detect the displacement more often when
      the displacement is not in the expected direction (downward for a falling
      object). The hypothesis proposed by Freyd (1983, 1987) states that the internal
      representation of an object is intrinsically dynamic. Therefore, the forces
      perceived as acting on the object affect the representation. Quantitative
      predictions of this model were tested in three experiments by measuring memory
      distortion for the position of an object on an inclined plane. Angle of
      inclination and retention interval were varied. The results for different
      inclinations support the physical model. The time course of the memory distortion
      suggests a new view about the relation between this phenomenon and very short
      term memory.

PMID- 8350738
TI  - Rate of imagery processing in two versus three dimensions.
AB  - A series of five experiments was conducted to test the optimal speed for
      performing two- and three-dimensional imagery tasks. Subjects were required to
      keep track of the location of a pathway in an imagined matrix, as the directions
      of its successive movements were described verbally. Matrices varied in size and
      in number of spatial dimensions, with two-dimensional matrices drawn on cardboard
      and three-dimensional ones built from wooden blocks. When subjects were able to
      dictate the rate of presentation of the terms describing the pathway, they
      preferred slower rates for three-dimensional than for two-dimensional stimuli. In
      subsequent experiments, very fast presentation rates had a larger detrimental
      effect on performance with three-dimensional matrices than with two-dimensional
      matrices. A comparison of the patterns of performance for subjects who generally
      scored high with the patterns for those who scored low showed a stronger effect
      of dimensionality for poor performers, suggesting that individual differences
      mediate performance on the task.

PMID- 8350739
TI  - A case study of anomaly detection: shallow semantic processing and cohesion
      establishment.
AB  - Although the establishment of a coherent mental representation depends on
      semantic analysis, such analysis is not necessarily complete. This is illustrated
      by failures to notice the anomaly in questions such as, "When an airplane
      crashes, where should the survivors be buried?" Four experiments were carried out
      to extend knowledge of what determines the incidental detection of the critical
      item. Detection is a function of the goodness of global fit of the item
      (Experiments 1 and 2) and the extent to which the scenario predicts the item
      (Experiment 3). Global good fit appears to result in shallow processing of
      details. In Experiment 4, it is shown that if satisfactory coherence can be
      established without detailed semantic analysis, through the recruitment of
      suitable information from a sentence, then processing is indeed shallow. The
      studies also show that a text is not understood by first producing a local
      semantic representation and then incorporating this into a global model, and that
      semantic processing is not strictly incremental.

PMID- 8350740
TI  - A translation-based generation effect in bilingual recall and recognition.
AB  - Two experiments were performed with incidental study procedures in which
      generation effects were observed for relatively balanced French-English bilingual
      subjects on measures of both free recall and recognition. Experiment 1 used a
      within-subject design, and Experiment 2 used a between-subject design. In both
      experiments, reading translations and reading same-language repetitions generally
      resulted in similar amounts of retention. Experiment 2 and Experiment 3 also
      showed that the generation effect was abolished under intentional study
      procedures because of an enhancement of reading-based retention. The results
      suggested that previous failures to obtain a translation-based generation effect
      may have been due to the use of intentional study procedures. The pattern of
      effects was explained in terms of a single-code model of bilingual linguistic
      representation and an individual-item processing interpretation of the generation
      effect.

PMID- 8350742
TI  - "That man's father is my father's son": the roles of structure, strategy, and
      working memory in solving convoluted verbal problems.
AB  - Normative data (N = 896) collected on solutions to the traditional reasoning
      problem "Brothers and sisters have I none,/That man's father is my father's son"
      was the platform for a set of experiments to investigate the roles of problem
      structure, subject strategy, and working memory in error making in a class of
      verbal problems. The normative data revealed that the modal, but incorrect
      response to the brothers and sisters problem was "himself," whereas the correct
      response of "son" was given by only 17% of subjects for the traditional version
      above, rising to 40% for a reordered novel version. This problem's structure,
      identified as a double-modifier structure, was found to produce similar response
      patterns across a range of verbal problems. Results from (1) syntactical
      structure manipulations (e.g., "My father's son is the father of that man"), and
      (2) efforts to teach subjects to use a linear strategy (a sequence of steps),
      interpreted within a framework of Just and Carpenter's (1992) capacity theory of
      comprehension, suggested that working memory overload varies across within
      structure modifications and subjects. Furthermore, this overload may be
      compounded by subjects' choices of strategy.

PMID- 8350741
TI  - Checklist procedures and the cost of automaticity.
AB  - Automaticity is usually discussed in terms of its benefits. Automaticity has,
      however, a cost that manifests itself in procedures that are highly routinized
      but require close attention, such as verbal checklist procedures. In such
      procedures, errors occur because the routine leads to automaticity. In three
      paper-and-pen experiments, we tested this manifestation and investigated ways to
      decrease automaticity in verbal checklist procedures. In the experiments,
      subjects proofread sets of multiplication problems to detect erroneous
      operations, simulating the checklist procedure. In Experiments 1 and 2, two
      conditions were compared: a fixed-order condition (in which each set contained
      operations in the same order) and a varied-order condition (in which the
      operations were in a different order in each set). In Experiment 1, proofreading
      times were measured to establish the role of fixed sequential order as a
      consistent environment promoting the emergence of automaticity. In Experiment 2,
      we introduced errors into the material, and in Experiment 3 we introduced
      "alerting" conditions to interfere with the development of automaticity. The
      results indicated that the subjects in the varied-order and alert conditions
      detected significantly more errors than did those in the fixed-order condition.
      The implications of the findings for current theories of automaticity are
      discussed as well as those for the design of checklist procedures.

PMID- 8350744
TI  - Influence of manipulated category knowledge on prototype classification and
      recognition.
AB  - The recognition and classification of category members was explored, following a
      variable number of learning trials. In Experiment 1, subjects received 1 or 9
      learning trials, followed by a recognition-then-classification test containing
      old, new, prototype, and foil patterns. In Experiment 2, subjects received 1, 6,
      or 12 trials, and made either classification or recognition judgments. In each
      experiment, classification accuracy for all item types was at near-chance
      performance after a single trial but steadily increased with increased learning
      trials. On the transfer test, oldness judgments were highest for the category
      prototype after a single trial. However, with increased learning trials, oldness
      judgments increased for old instances and decreased for the category prototype
      and new instances. We suggest that false recognition of the category prototype,
      especially after a single learning trial, need not reflect an abstraction
      process. We discuss the possibility that an abstracted prototype may emerge with
      additional learning as an unfamiliar, ideal point.

PMID- 8350743
TI  - Why do pictures produce priming on the word-fragment completion test? A study of
      encoding and retrieval factors.
AB  - Three experiments examined why pictures produce priming on the word-fragment
      completion test, despite the fact that there is no match between the physical
      features of the picture and the word fragment. Pictures and words were presented
      as primers, and performance on the word-fragment completion test was measured;
      encoding and retrieval conditions were varied. Experiments 1 and 2 examined the
      role of picture labeling by increasing the presentation rate and by introducing a
      shadowing task during encoding; labeling appears to play a role in priming. In
      Experiment 3, the word fragments were presented for 500 msec, and subjects were
      required to provide a solution immediately. Word priming was unaffected, but
      picture priming was eliminated, suggesting that word fragments enable efficient
      recovery of perceptually similar primes (i.e., words), but slower and less direct
      recovery of conceptually similar but physically dissimilar primes (i.e.,
      pictures).

PMID- 8350745
TI  - Effects of phonological similarity and concurrent irrelevant articulation on
      short-term-memory recall of repeated and novel word lists.
AB  - The extent to which phonological similarity of list words impairs short-term
      memory recall was investigated in two experiments. Experiment 1 showed that the
      phonological-similarity effect occurred both when list words were repeatedly
      sampled from a small set and when they were new on every trial, both when word
      order information was required and when it was not. Furthermore, the adverse
      effect of phonological similarity on recall was apparent on the initial lists
      recalled, did not change over trials, and cannot be attributed to increasing
      levels of proactive inhibition across lists. In Experiment 2, subjects were
      required to count repeatedly to six during list presentation. Concurrent
      irrelevant articulation lowered recall and abolished the phonological-similarity
      effect for both repeated and novel word lists.

PMID- 8350747
TI  - Membrane fusion techniques. Part A.

PMID- 8350746
TI  - Choosing versus rejecting: why some options are both better and worse than
      others.
AB  - A previously unobserved pattern of choice behavior is predicted and corroborated.
      In line with the principle of compatibility, according to which the weighting of
      inputs is enhanced by their compatibility with output, the positive and negative
      dimensions of options (their pros and cons) are expected to loom larger when one
      is choosing and when one is rejecting, respectively. Subjects are presented with
      pairs of options, one of which--the enriched option--has more positive as well as
      more negative dimensions than does the other, impoverished, option. Because
      positive dimensions are weighted more heavily in choosing than in rejecting, and
      negative dimensions are weighted more heavily in rejecting than in choosing, the
      enriched option tends to be chosen and rejected relatively more often than the
      impoverished option. These findings are extended to nonbinary decision problems,
      and their implications for the rational theory of choice and for everyday
      decisions are discussed.

PMID- 8350748
TI  - Fusion of semispherical membranes.

PMID- 8350749
TI  - Measurement of interbilayer adhesion energies.

PMID- 8350750
TI  - Forces between phospholipid bilayers and relationship to membrane fusion.

PMID- 8350751
TI  - Lipid mixing assays to determine fusion in liposome systems.

PMID- 8350753
TI  - Electrofusion.

PMID- 8350754
TI  - Membrane electrofusion: a paradigm for study of membrane fusion mechanisms.

PMID- 8350752
TI  - Chemically induced fusion of erythrocyte membranes.

PMID- 8350756
TI  - Polyethylene glycol and electric field-mediated cell fusion for formation of
      hybridomas.

PMID- 8350755
TI  - Electrofusion of cells: hybridoma production by electrofusion and polyethylene
      glycol.

PMID- 8350757
TI  - Selective B lymphocyte--myeloma cell fusion.

PMID- 8350758
TI  - Biochemical and morphological assays of virus entry.

PMID- 8350759
TI  - Fusion assays monitoring intermixing of aqueous contents.

PMID- 8350760
TI  - Preparation, properties, and applications of reconstituted influenza virus
      envelopes (virosomes).

PMID- 8350761
TI  - Intermembrane lipid-mixing assays using acyl chain-labeled coumarinyl
      phospholipids.

PMID- 8350762
TI  - Electron microscopy of virus--liposome fusion.

PMID- 8350764
TI  - Phosphorus-31 nuclear magnetic resonance in membrane fusion studies.

PMID- 8350763
TI  - Fluorescence lifetime measurements to monitor membrane lipid mixing.

PMID- 8350765
TI  - Fusion of spherical membranes.

PMID- 8350766
TI  - Surface chemical techniques in membrane fusion.

PMID- 8350767
TI  - Extrathymic pathways of T-cell differentiation: a primitive and fundamental
      immune system.
AB  - In addition to an intrathymic pathway of T-cell differentiation, extrathymic
      pathways of T-cell differentiation have recently been demonstrated to occur in
      multiple sites in mice. Such sites include the sinusoids of the liver, the
      intraepithelial region of the intestine, and the omentum of the peritoneal
      cavity. Although these extrathymic pathways are minimal at a young age, they
      become predominant with aging. Extrathymically differentiated T cells display
      many properties distinct from those of regular T cells of thymic origin. For
      instance, they consist of a considerably large proportion of gamma delta T cells
      as well as alpha beta T cells, contain double-negative CD4-CD8- cells and self
      reactive oligoclones, constitutively express the II-2 receptor beta-chain, and
      have an alpha alpha homodimer of CD8 if they carry it. Cumulative evidence
      reveals that the extrathymic pathways comprise a primitive and fundamental immune
      system in the body and play a pivotal role in immune reactions under conditions
      of aging, bacterial infections, malignancies, autoimmune diseases, and pregnancy.

PMID- 8350769
TI  - Cytotoxic effect of hemolytic culture supernatant from Enterococcus faecalis on
      mouse polymorphonuclear neutrophils and macrophages.
AB  - We reconfirmed that the LD50s of hemolytic Enterococcus faecalis strains were
      significantly less than those of nonhemolytic E. faecalis strains in normal mice.
      Hemolysin produced by E. faecalis lysed human, horse, rabbit, and mouse
      erythrocytes, but not cow and sheep erythrocytes. Sphingomyelin comprises a part
      of the lipid composition of the erythrocyte membrane of all mammalian species
      tested. But phosphatidylcholine exists only in human, horse, rabbit, and mouse.
      These two lipids inhibited lysis of horse erythrocytes by hemolytic E. faecalis.
      Phosphatidylcholine is probably the binding component on the membrane of
      erythrocytes for E. faecalis hemolysin. The hemolytic culture supernatant lysed
      not only erythrocytes but also mouse polymorphonuclear neutrophils (PMNs) and
      macrophages.

PMID- 8350768
TI  - Comparison of the virulence for mice of Mycobacterium avium and Mycobacterium
      intracellulare identified by DNA probe test.
AB  - The virulence of various serovars of Mycobacterium avium and M. intracellulare
      identified by DNA probe test was compared with each other. We found species- and
      serovar-dependencies of M. avium complex (MAC) virulence to mice in terms of
      mortality, incidence of lung lesions and bacterial load in the visceral organs,
      as follows. First, human- or environment-derived M. intracellulare was more
      virulent for mice, as compared to M. avium isolated from patients or
      environmental sources. Second, the virulence of MAC isolates belonging to
      serovars 1, 8, 9 (M. avium), 14 and 16 (M. intracellulare) is in the order of
      serovars 16 > 14 > 8 > 1 > 9. These aspects were different from those for MAC
      virulence to human and bird, swine and cattle.

PMID- 8350770
TI  - Development and evaluation of capture enzyme-linked immunosorbent assays for
      detection of immunoglobulin G and M antibodies to group A streptococcal antigens.
AB  - Capture enzyme-linked immunosorbent assays (ELISAs) were developed to detect
      immunoglobulin G and M antibodies to group A streptococcal (GAS) antigens,
      streptolysin O, streptokinase, and group A carbohydrate. The sensitivities and
      the specificities of the IgM capture ELISAs to each GAS antigen were high enough
      to distinguish the patients with GAS infections (diagnosed as GAS pharyngitis or
      scarlet fever) from the control groups (healthy people and patients with
      pharyngitis from whom GAS could not be isolated). On the other hand, the
      specificities of the IgG capture ELISAs were not very effective in diagnosis of
      GAS infections. When the capture ELISA and an indirect ELISA detecting IgM
      antibodies to group A carbohydrate were compared, false-positive reactions due to
      rheumatoid factor occurred in the indirect ELISA, but did not occur in the
      capture ELISA. These results indicate that the capture ELISA works better than
      the indirect ELISA in detecting the IgM antibody, and that the IgM capture ELISA
      to GAS antigen provides a rapid and highly reliable serodiagnosis for GAS
      infections employing only a single serum.

PMID- 8350771
TI  - Isolation of scrapie agent from the placenta of sheep with natural scrapie in
      Japan.
AB  - A five-month-pregnant Suffolk sheep histologically diagnosed as spontaneous
      scrapie was studied. Western blot analysis was performed with rabbit serum
      against the sheep scrapie-associated fibrils (SAF). In the proteinase K (pk)
      treated parental brain and spleen samples, three major bands (15 K, 18 K, and 23
      K) were detected. These major bands were not detected from the placenta.
      Infectious agents were isolated in mice from the brain samples but not from the
      placental homogenates. In another case of a three-month-pregnant Corriedale sheep
      without any clinical sign of, but histologically diagnosed as scrapie, was also
      studied in a similar approach. In the parental brain samples, three major bands
      (15 K, 18 K and 23 K) were detected. SAF protein was not detected in the parental
      spleen and placenta. No bands reactive with the antiserum were detected in any
      other samples from the fetal brain and spleen in both cases. However, infectious
      agents were isolated in mice from both brain and placental homogenates. Since the
      placenta is an important site of natural infection, it is worthwhile to study
      these tissues for the epidemiological study of scrapie infection.

PMID- 8350773
TI  - Neurologic abnormalities in two dogs suspected Lyme disease.
AB  - A 2-year-old mongrel dog developed neurological signs following tick bite. These
      included astasia, persistent tonic convulsions and hyper-reflexia. Both serum IgG
      and IgM antibody titers against Borrelia burgdorferi were positive in enzyme
      linked immunosorbent assay (ELISA). The neurological signs subsided after high
      dose penicillin and streptomycin treatment. A strain of spirochetes (P427a) was
      isolated from the midgut of Ixodes persulcatus feeding on the dog. Morphological
      characteristic, immunological property and protein profile revealed that the
      isolate was B. burgdorferi. Similarly, a 2-year-old Labrador retriever dog
      developed neurological signs after tick bite and showed a positive IgG antibody
      titer against B. burgdorferi. Antibiotic treatment was effective also in this
      case. These findings suggest that neurological symptoms shown in both dogs were
      caused by infection with B. burgdorferi.

PMID- 8350772
TI  - Cholera toxin inhibits lethal hit stage of natural killer cell-mediated
      cytotoxicity.
AB  - Cytolytic process which was affected by cholera toxin (CT) resulting in the loss
      of natural killer (NK) cell activity was analyzed. Conjugate formation assay,
      membrane phospholipid methylation assay and serine esterase (granzyme A) release
      assay were used to determine the stage of the CT-induced inhibition of NK cell
      mediated cytotoxicity. A human NK cell line YT cell-mediated cytotoxicity was
      completely abolished by CT pretreatment or addition of CT to the assay system.
      The conjugate formation assay revealed that the binding between YT cells and
      target cells was not affected by CT. The defined triggering stage which is
      coupled with membrane phospholipid methylation was not affected by CT treatment,
      either. On the other hand, the lethal hit stage which is represented by serine
      esterase (SE) release was completely inhibited by CT treatment of YT cells.
      Therefore, CT inhibits the stage after binding and triggering--i.e., lethal hit
      stage of NK cell-mediated cytotoxicity. The results also suggest that there
      exists a CT-sensitive negative cytotoxic signal transduction pathway as well as
      usual positive signal transduction pathway and these pathways might cross talk
      each other in the NK cell cytotoxic process.

PMID- 8350774
TI  - Diabetes and its complications may be caused by inadequate circulation. A new
      concept.
AB  - Students of diabetes have noted that the so-called vascular complications of the
      disease appear with little or no consistency. Uncontrolled patients may have no
      vascular problems. Contrarywise obsessive compulsive individuals who follow every
      dietary regimen perfectly and take their prescriptions faithfully may have
      horrendous vascular difficulties. These experiences brought me to the conclusion
      that the 'complications' were really a component of the disease rather than the
      result of it. In an effort to find a unified concept of the disease it seemed
      reasonable to conclude that inadequate circulation to the islets may be a cause
      of the chemical constellation that we call diabetes. Vascular pathology may
      appear haphazardly in various arteries. Thus some will develop cerebrovascular
      disease, others coronary manifestations while still other patients will
      experience peripheral vascular symptoms. Is it not possible that defective
      circulation to the pancreas might be an aetiological factor in the development of
      diabetes? These observations lend credence to the concept that arterial pathology
      may actually precede the appearance of clinical diabetes.

PMID- 8350775
TI  - The glutathione cycle is the creative reaction of life and cancer. Cancer causes
      oncogenes and not vice versa.
AB  - Life is definable as a chemical reaction which obeys exponential growth and dies
      if reversed. Such a reaction must be the commencement of all life so that every
      evolved form of it inherits these characteristics. As no single reaction known
      has these two features, life must be a combination of two or more reactions which
      whilst obeying all the classical laws of physics and chemistry assume an
      exponential form and effectively act as being irreversible. The reactions of
      glutathione--oxidation and reduction--when combined in sequence as a cyclical
      process fulfill these criteria. The cyclic changes of glutathione from reduced to
      oxidised to reduced forms must therefore be the reaction which creates life and
      is responsible for cancer's growth. 434 mHz electromagnetic radiation stimulates
      cancer growth rate by forcing this cycle into activity. Proof of this hypothesis
      is the long-term control of cancer in 11 patients treated with oxidised
      glutathione and 434 mHz radiation. Genetic material does not contain any energy
      system with exponential form, neither is it self-replicating. Genetic material
      will only reproduce if placed within an immortal cell in which all controls of
      the glutathione system have been lost, as in a cancer cell. Oncogenes must be the
      product of cancer and not the reverse.

PMID- 8350776
TI  - DNA triboluminescence and carcinogenesis.

PMID- 8350777
TI  - Stimulation causing the double effect as in dyspraxia, a universal mechanism of
      disease, and auto-electrocution, the fatal factor.
AB  - Almost every action in the body involves the nervous system which uses
      electricity for its speed and versatility. Operating and controlling muscular
      activity is a major function of the nervous system. Muscles are paired so every
      normal contraction requires a reciprocal relaxation of its doppelganger (Newton
      said 'Equal and opposite'). Minor failures of co-operation, i.e. neuromuscular
      dysfunction make common survivable diseases. Multiple and major stimuli can
      create chaotic conflicts within these couplings and lead to fatalities.
      Excessive, abnormal, even ordinary stimulation will cause the (irritable?)
      partner(s) which should relax also to contract. Thus function is impaired or
      impossible. In the limbs faulty neuromuscular co-ordination is obvious as
      stiffness, Parkinson's Disease, Erb's Palsy etc. Less evident, it is even more
      important in the cardiovascular, gastrointestinal, genitourinary and respiratory
      systems.

PMID- 8350778
TI  - Could development of malignant mesothelioma be induced by Yersinia enterocolitica
      infection?
AB  - Two out of 458 hospitalized patients with Yersinia enterocolitica infection
      developed malignant mesothelioma of pleura viz. pericard; both died after a few
      months. Malignant mesothelioma of the pleura is commonly related to asbestos
      exposure, whereas pericardiac mesothelioma is an extremely uncommon neoplasm. The
      possible promotion of malignant mesothelioma by the Yersinia enterocolitica
      infection should not be disregarded, as the infection may launch chronic
      immunological reactions resembling those observed among asbestos workers.

PMID- 8350779
TI  - Dorsal root ganglia may be reservoirs of viral infection in multiple sclerosis.
AB  - There are presently two competitive theories that attempt to explain the etiology
      of multiple sclerosis (MS). Briefly summarized, they are: 1. An infection,
      probably of viral type, may attack the oligodendroglia of the central nervous
      system; or, 2. An autoimmune process may begin with an infection of the
      peripheral lymphatic immune system, producing antibodies that cross the blood
      brain barrier, leading to myelinoclasia. Since 1935, research has been directed
      toward myelin of the central nervous system and the myelin sheaths of peripheral
      nerve; however, dorsal root and cranial sensory ganglia (DRG) have apparently not
      been studied. The present hypothesis states that an infectious agent (probably
      viral) finds privileged sanctuary in the dorsal root and cranial sensory ganglia
      (DRG): thereafter periodically invading the spinal cord, brain, or peripheral
      nerve. Previously reported erratic spinal fluid viral titers and cultures can be
      explained by differences in the anatomy of the DRG in which there is a variable
      and limited contact of spinal fluid with sensory ganglia. Clues to this
      hypothesis were noted by the author during routine neurological examinations of
      patients with MS, in which sensory signs and symptoms were frequently
      encountered. This clinical observation has also been reported by others who found
      such symptoms in 75% of MS patients, ranking second only to incoordination.

PMID- 8350780
TI  - Abnormal fluctuations of acetylcholine and serotonin.
AB  - Abnormal fluctuations of acetylcholine and serotonin might cause, or be
      correlated with, a variety of symptoms. This communication cites evidence which
      suggests that fluctuations of serotonin might have a causative role in migraine,
      mania, and depression and that fluctuations of acetylcholine might have a
      causative role in epilepsy, catalepsy, and Kleine-Levin attacks.

PMID- 8350781
TI  - Louis Bolk revisited: I. Is the human lung a retarded organ?
AB  - The human lung shows permanent retention of certain features (such as the absence
      of an infracardiac lobe, or the subdivision of the lobes in lobules) found in
      most mammal fetuses or youngsters. This phenomenon seems to be in line with the
      fetalization theory of Louis Bolk, who considered man as a retarded and
      unspecialized mammal. Moreover, the retention of certain fetal or unspecialized
      traits in the human lung favors a body configuration suited to an upright stance.
      This suggests that the generalized mammalian body plan is that of a bipedal
      being.

PMID- 8350782
TI  - Future impact of molecular biology and biotechnology on bacterial and viral
      diseases.
AB  - The advent of recombinant DNA technology has already made a significant impact on
      various aspects related to the basic understanding of pathogenic mechanisms in
      infectious diseases, as well as practical applications related to diagnostics and
      prevention. The present paper discusses recent technological innovations and
      increased analytical capabilities which promise to have an even more significant
      impact on the control of viral and bacterial diseases.

PMID- 8350784
TI  - A study of primary drug resistance in pulmonary tuberculosis in west Malaysia
      1984-1987.
AB  - Eight hundred and fifty-six strains of Mycobacterium tuberculosis from previously
      untreated patients with pulmonary tuberculosis from various states in West
      Malaysia were studied during the period 1984 to 1987. All the strains were tested
      for in vitro susceptibility to the anti-tuberculosis drugs isoniazid (INH),
      streptomycin (SM), rifampicin (RMP) and ethambutol (ETB). One hundred and twenty
      one of the isolates (14.18%) were resistant to 1 drug while 17 (1.97%) were
      resistant to 2 drugs. No strain was found to be resistant to more than 2 drugs.
      The prevalence of primary resistance to INH was 4.20%, SM was 7.59%, RMP was
      0.95% and ETB was 1.44%. In 1.86% of isolates, resistance was noted to both INH
      and SM, while 0.11% were resistant to both RMP and ETB. There was no significant
      difference in distribution of resistant bacilli between the sexes (p > 0.01).

PMID- 8350783
TI  - Cholesterol reduction therapy: a double-edged knife.
AB  - Cholesterol reduction reduces ischaemic cardiovascular morbidity and mortality in
      the asymptomatic healthy population as well as in those with known coronary
      artery disease. Angiographic studies have also demonstrated regression of
      atherosclerotic plaques as well as retardation of new atheroma formation with
      such therapy. Yet, there is a consistent inability to reduce overall mortality in
      cholesterol-lowering drug trials. An excess of suicide, homicide and violence has
      been attributed to cholesterol reduction interfering with membrane lipids and
      receptors, leading to aggressive behaviour. The risk and benefits of cholesterol
      reduction must thus be weighed in the individual patient; it is more useful in
      those with known coronary artery disease who are at high risk of subsequent
      ischaemic cardiovascular events.

PMID- 8350785
TI  - Risk behaviour associated with HIV infection among drug abusers seen at the
      general Hospital, Kota Bharu, Kelantan.
AB  - Sixty-one serologically positive HIV infected drug abusers admitted to the Drug
      Ward, General Hospital, Kota Bharu, were interviewed for possible risk behaviour
      and AIDS awareness. Fifty-eight subjects were IV abusers while the other 3 were
      non-IV abusers. All the IV abusers had shared injecting equipment with no regard
      for sterility. There was non-usage of condoms among those sexually active. Though
      AIDS awareness was high, there was a lack of risk behaviour change. The drug
      abusers appear to be a problem group in HIV control measures. Educating the drug
      abusers and commitment by them to alter risk behaviour is needed.

PMID- 8350786
TI  - Prevalence of sexually transmitted diseases among female drug abusers in
      Malaysia.
AB  - The prevalence of sexually transmitted diseases (STD) among female drug abusers
      was determined by screening 130 new inmates of a rehabilitation centre. The
      majority of the subjects (77.7%) were self-confessed sex workers. A high
      prevalence of syphilis (50.8%), hepatitis B (52.2%), moniliasis (23.8%) and
      trichomoniasis (19.2%) were noted. Gonorrhoea vaginitis was seen in 8.5%, which
      was low compared to previous studies. Six subjects were seropositive for human
      immunodeficiency virus (HIV), with 5 of them admitting to needle sharing and
      working as prostitutes. More than half of them harboured 2 or more STD. A rich
      reservoir of STD was seen among the drug abusers. With more evidence now
      available concerning the ease of HIV transmission associated with ulcerative STD,
      a stage could be set for greater heterosexual HIV transmission. As part of the
      rehabilitation process, female drug abusers need a thorough screening for STD
      followed by aggressive treatment regimens.

PMID- 8350787
TI  - Pattern of alcoholism in the General Hospital, Kuala Lumpur.
AB  - This study establishes the prevalence rate for alcoholism among the inpatients of
      the General Hospital, Kuala Lumpur, as 11%, but as 25% among the drinking
      population. It also describes the demographic profile of the alcoholic as
      compared to the non-alcoholic drinker and the non-drinker and suggests that
      certain vulnerability factors could contribute to the development of alcoholism.
      A trend noted is also the changing racial trends in the use of alcohol.

PMID- 8350789
TI  - Phenomenological differences of hallucinations between schizophrenic patients in
      Penang & Kelantan.
AB  - Two hundred and seventy patients with schizophrenia (104 patients in Kelantan and
      166 patients in Penang) were interviewed using the Present State Examination to
      elicit the differences in the phenomenology of their hallucinations. The results
      indicate that there are significant differences in the phenomenology of
      hallucinations between the Malays of Penang and Kelantan and also among some
      Chinese patients. These findings indicate that culture does affect the
      phenomenology of schizophrenia, even among people of the same race but of
      different regions.

PMID- 8350788
TI  - Characteristics of psychiatric admissions and aspects of overcrowding at the
      general Hospital, Kuala Lumpur.
AB  - This study examined admissions, final diagnoses and mean duration of stay of
      patients in the Psychiatric Wards at the General Hospital, Kuala Lumpur. The male
      ward was severely overcrowded by 125% over the maximum bed capacity. The majority
      were psychotic, mainly schizophrenic. The female ward had 76% occupancy, also
      mainly psychotic. Neurotics, alcohol dependents and personality disorders formed
      less than 5% of the admissions. There was no difference in the mean duration of
      stay of patients of both UKM and GHKL Units stratified for diagnosis and disposal
      except for newly diagnosed schizophrenics. There is an urgent need for more male
      psychiatric beds/wards.

PMID- 8350790
TI  - The EEG and epilepsy in Kelantan--a hospital/laboratory-based study.
AB  - Five hundred and ninety three cases of clinically diagnosed and suspected
      epilepsy were analysed as regards to the EEG (standard scalp electrode recording)
      features for confirmation and typing. Fifty-five per cent of all clinically
      diagnosed adult epileptics were confirmed by the EEG with the initial record, and
      the EEG confirmatory rate in children was higher at 92%. The frequency of
      generalised epilepsy as confirmed by the EEG was found to be 86% in adults and
      92% in children, reflecting a higher proportion of generalised epilepsy in the
      population than reported elsewhere. Clinical diagnosis of partial epilepsy was
      often subsequently shown to be of generalised type on EEG.

PMID- 8350792
TI  - Lung function in Malay children.
AB  - We conducted a study to measure the peak expiratory flow rate (PEFR), forced
      vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in a group
      of normal Malay primary school children aged 7 to 12 years. PEFR was measured in
      920 children (482 boys and 438 girls) while FVC and FEV1 were measured in 292 of
      them (168 boys and 124 girls). In agreement with previous studies, we found that
      PEFR was correlated with age and height of the subjects but FVC and FEV1 were
      correlated with height only. Prediction equations for all 3 lung function indices
      for Malay boys and girls were formulated. In comparison with the lung function
      values from Western and Chinese subjects, the lung function values in our
      subjects are lower.

PMID- 8350791
TI  - Computed tomography (CT) of orbital pseudotumour.
AB  - Orbital pseudotumour is a non-specific inflammatory disease. Its highly variable
      clinical and radiographic presentation makes specific diagnosis difficult. This
      study on 31 proven cases of pseudotumour shows that unilateral involvement,
      retroorbital fat infiltration and enlargement of multiple extraocular muscles
      with involvement of the tendinous insertions are key computed tomography CT
      features which help to establish the diagnosis of orbital pseudotumour.

PMID- 8350793
TI  - Spirometric studies in Malaysians between 13 and 69 years of age.
AB  - Spirometry was performed on 1,999 subjects (1,385 males and 614 females) ranging
      in age from 13 to 69 years and comprising of all the main races in Malaysia. They
      were divided into 6 age groups. Mean forced vital capacity (FVC) in the males and
      females was 3.49 +/- 0.02 L and 2.51 +/- 0.02 L respectively. Both FVC and FEV1
      correlated negatively with age. Regression analysis on data between the ages of
      20 to 69 years revealed an age-related decline in FVC of about 30 ml per year of
      life in the males and 22 ml per year in the females. Multiple stepwise regression
      of the data for the prediction of an individual's FVC above the age of 20 years
      gave an equation for the males: FVC = 0.0407 (height)-0.0296 (age)-2.343 L and
      for the females: FVC = 0.031 (height)-0.022 (age)-1.64 L. Predicted FVC values
      derived from equations based on other populations were considerably higher than
      the observed mean in this study, re-emphasizing the need to be cautious when
      applying formulae derived from one population to another. Grossly erroneous
      conclusions may be reached unless predicted equations for lung-function tests for
      a given population group are derived from studies based upon the same population
      group.

PMID- 8350794
TI  - A registry of patients with end stage renal disease--the experience at hospital
      Sultanah Aminah, Johor Baru.
AB  - A registry of patients with end stage renal disease was started from 1st January
      1990 at Hospital Sultanah Aminah, Johor Baru. There were 126 patients in 1990 and
      129 in 1991. The peak age was 31 to 60 years old; males outnumbered females
      1.5:1. Forty-three to fifty-six percent presented with small kidneys. Seventeen
      to twenty percent of patients had diabetes mellitus. In 1991, the racial
      distribution of patients was Malay: 50.4%, Chinese: 39.5%, Indian: 7.8% and
      others: 2.3%. The incidence of end stage renal disease in Johor Baru district was
      79 per million per year in 1990 and 86 per million in 1991.

PMID- 8350795
TI  - Occurrence of human rabies in peninsular Malaysia.
AB  - The occurrence of a case of human rabies in Peninsular Malaysia is reported.
      Despite the various control measures taken, sporadic cases of rabies have
      continued to occur in Peninsular Malaysia, especially in the northern states.
      Clinical awareness of the occurrence of rabies is therefore important and
      effective post-exposure prophylaxis should be instituted as soon as possible to
      prevent the possible occurrence of this dreaded disease.

PMID- 8350796
TI  - Fibreoptic intubation--a case series and brief review.
AB  - Fibreoptic intubation has been established as a major advance in the management
      of difficult or failed intubation in the awake patient. If necessary, it may be
      performed under general anaesthesia with either spontaneous or controlled
      ventilation. This should be considered early in the management of failed
      intubation, before multiple attempts with other techniques lead to haemorrhage
      and oedema in the airway. We describe here selected case reports to illustrate
      this in 8 different situations. This is followed by a brief review of the
      technique and indications of fibreoptic intubation.

PMID- 8350797
TI  - Epidural buprenorphine and bupivacaine in major gynaecological operations.
AB  - Eight patients underwent major gynaecological operations. Their post-operative
      analgesia was provided by epidural buprenorphine 0.15 mg and bupivacaine 0.5%.
      The efficacy and side-effects of this combination were assessed. All patients had
      satisfactory analgesia ranging in duration from 10 hours to greater than 36 hours
      after a single dose injection. No significant side-effect was noted.

PMID- 8350798
TI  - Changing patterns in the treatment of early breast cancer: a historical
      perspective and a review of changing local trends.
AB  - Over the past 50 years, a variety of surgical procedures have been advocated for
      the treatment of operable breast cancer, ranging from local excision to
      supraradical mastectomy. Today, the surgical treatment of breast cancer remains
      highly contentious. We review the historical development of breast cancer surgery
      and analyse the available evidence supporting conservative procedures. We also
      express our opinions on the treatment of early breast cancer and illustrate the
      changing patterns of surgery with our experience at National University Hospital.

PMID- 8350799
TI  - Antegrade intraoperative colonic lavage.
AB  - Emergency left-sided colonic resections have traditionally been dealt with by
      employing staged resections due to the dangers of an anastomosis in unprepared
      bowel. A small series of 6 patients with left-sided colonic obstruction is
      presented in which a single stage primary anastomosis was done after an antegrade
      intraoperative colonic lavage. There were no deaths, infective complications or
      anastomotic leaks. Major series in the last decade using intraoperative colonic
      lavage are reviewed as well, to confirm that the method is safe, effective and
      warrants wider usage locally.

PMID- 8350800
TI  - Experience with sublabial transseptal transsphenoidal hypophysectomy at the
      Universiti Kebangsaan Malaysia.
AB  - The transseptal transsphenoidal hypophysectomy has become a relatively frequent
      procedure in recent years. We performed 20 such procedures between January 1984
      and December 1987 for various pituitary disorders. Significant complications such
      as CSF rhinorrhea, meningitis, diabetes insipidus, haemorrhage and septal
      perforation are discussed. The mortality rate for the series was 5%. In analysing
      the data, we feel that this technique of hypophysectomy is a safe procedure.

PMID- 8350801
TI  - Fertility following reversal of female sterilization.
AB  - This retrospective study presents data from 26 women who underwent a reversal of
      female sterilization. The intrauterine pregnancy rate and ectopic pregnancy rate
      were 38.5% and 7.7% respectively. The most successful site of tubal anastomosis
      was isthmic-isthmic anastomosis. The importance of proper patient selection and
      factors that affect the success rate in attempted reversals are emphasised. The
      importance of microsurgical approach is highlighted.

PMID- 8350802
TI  - Actinomycosis of the accessory breast treated with cotrimoxazole.
AB  - Actinomycosis is a chronic suppurative granulomatous disease caused by the
      filamentous bacteria, Actinomyces israelii, which was once thought to be a
      fungus. It is a Gram-positive, aerobic or microaerophillic, non acid-fast hyphal
      organism which fragments into coccoid or bacillary forms and, unlike the fungus,
      does not form conidia. Accessory breast tissue usually occurs along the milk
      lines, frequently in the axilla and rarely in the thighs. Actinomycosis of the
      breast is very uncommon and we report the case of a multiparous woman who had a
      painful lump in the axilla which, on histopathologic examination, showed
      actinomycosis within the accessory breast tissue.

PMID- 8350803
TI  - Human immunodeficiency virus infection in recipients of living unrelated donor
      renal transplants--a report of 4 cases.
AB  - Four cases of Human Immunodeficiency Virus (HIV-1) infection, probably following
      living unrelated donor renal transplantation done in India, are reported. One of
      them subsequently developed Acquired Immunodeficiency Syndrome (AIDS).

PMID- 8350804
TI  - Pain relief with intravenous regional guanethedine in post-traumatic reflex
      sympathetic dystrophy--a case report.
AB  - Intravenous regional guanethedine (IVRG), using the Bier's block technique, was
      given to relieve pain in a 62 year old Indian woman suffering from reflex
      sympathetic dystrophy. The patient obtained complete pain relief with 2
      injections and has remained pain-free for 18 months.

PMID- 8350805
TI  - Haemophagocytosis in typhoid fever.
AB  - This report deals with a young man who developed features of haemophogocytosis
      during the course of typhoid fever. The pertinent clinical and laboratory
      features of typhoid-associated haemophagocytosis are discussed. The need for
      blood component replacement therapy in addition to specific anti-microbials to
      treat haemophagocytosis complicating typhoid fever is stressed.

PMID- 8350806
TI  - Diagnosis and management of blunt pancreatic trauma: a case report with review of
      the literature.
AB  - Details of a young logger who sustained a clean prevertebral transection of the
      pancreas to the left of the superior mesenteric vessels and a crush injury in
      segments 2 and 3 of the liver are presented. CT scan was not done but ultrasound
      scan revealed free intraperitoneal fluid and no comment was made about the
      pancreas. The pancreatic injury was discovered at laparotomy carried out 24 hours
      after admission and treated by resection.

PMID- 8350807
TI  - Septicaemic pulmonary melioidosis with cutaneous pustules.

PMID- 8350808
TI  - Teronac and teratogenecity.

PMID- 8350809
TI  - Handwashing at University Hospital.

PMID- 8350810
TI  - Drug resistant Mycobacterium tuberculosis.

PMID- 8350811
TI  - Substance abuse and the doctor.

PMID- 8350812
TI  - Probability of radiation-induced complications for normal tissues with parallel
      architecture subject to non-uniform irradiation.
AB  - A biologically based model is developed to predict radiation-induced normal
      tissue complication probability (NTCP) in inhomogeneously irradiated organs such
      as the lung or the kidney. The organ is assumed to be composed of independent
      functional subunits (FSUs) organized with a parallel architecture and it is
      assumed that the complication is produced only if a sufficiently large number of
      FSUs (the "functional reserve") are destroyed. A general expression for NTCP is
      derived, as well as simple expressions for the mean and standard deviation of the
      radiation damage to the FSUs. It is demonstrated that these results for
      inhomogeneous irradiation reproduce those of the serial and tumor control models
      when the functional reserve consists of one or all of the FSUs, respectively.
      When the number of FSUs is large, the dose response for organs with identical
      characteristics is very steep. Since clinical dose-response curves may arise from
      populations with varying functional reserves and radiosensitivities, we derive
      expressions for the NTCP for inhomogeneously irradiated organs that incorporate
      such variations.

PMID- 8350813
TI  - Implementation of the ETAR method for 3D inhomogeneity correction using FFT.
AB  - The equivalent tissue-air-ratio (ETAR) method employs three-dimensional (3D) CT
      pixel information to approximate scatter dose contribution for inhomogeneity
      correction. In general, the calculation provides better agreement with
      measurements than the one-dimensional (1D) methods typically used in commercial
      treatment planning systems. In its original implementation, the 3D formulation of
      the ETAR method is modified empirically as a 2D calculation in order to reduce
      computation time. The modification compromises the use of the method in several
      treatment geometries. An examination of the ETAR formulation shows that the
      calculation can be expressed as a convolution and thus can be performed in 3D
      using fast Fourier transform (FFT) techniques. The algorithm has been implemented
      as a 3D FFT convolution. Making use of the symmetric properties of the FFT, the
      new approach shows significant savings in computation time without excessive
      memory requirement. Despite its fundamental limitations when applied to regions
      of electronic disequilibrium, the ETAR method offers a practical solution to
      improving current dose calculation in 3D treatment planning, particularly when
      the more advanced scatter ray-tracing dose calculation algorithms remain
      impractical for clinical use. Recent work to extend the method to approximate
      electron transport is also encouraging.

PMID- 8350814
TI  - Pressure wave generated by the passage of a heavy charged particle in water.
AB  - Energy deposition around the trajectories of ionizing particles with linear
      energy transfer (LET) of 4, 40, and 400 keV/microns in water and subsequent
      diffusion of deposited heat is calculated using computational fluid dynamics.
      Immediately after the deposition of energy by the charged particle, the
      temperature and pressure in the vicinity of the particle track both increase
      dramatically, leading to the formation of a thermal spike and a pressure wave.
      Initially, the region of heat deposition is primarily localized to a region
      called the "thermal core," which has dimensions of 0.3, 1, and 3 nm for particles
      with LETs of 4, 40, and 400 keV/microns, respectively. Instantaneous peak
      temperatures within the thermal core were 800 degrees C-2000 degrees C and peak
      pressures were about 25,000 atm. This sudden deposition of heat in a localized
      region leads to a very strong shock wave around the particle trajectory, which is
      shown to last for a duration of 10(-9)-10(-8) s. Even at distances beyond 10 nm
      away from the particle trajectory, pressures above 100 atm could exist for a
      duration of up to 10(-11) s. This local and transient environment, created by the
      passage of a charged particle in a medium, may lead to new mechanisms of
      radiation action leading to cell damage, as well as to the development of new
      radiation detectors.

PMID- 8350815
TI  - Application of fast simulated annealing to optimization of conformal radiation
      treatments.
AB  - Applications of simulated annealing to the optimization of radiation treatment
      plans, in which a set of beam weights are iteratively adjusted so as to minimize
      a cost function, have been motivated by its potential for finding the global or
      near-global minimum among multiple minima. However, the method has been found to
      be slow, requiring several tens of thousands of iterations to optimize 50 to 100
      variables. A technique to improve the efficiency for finding a solution is
      reported, which is generally applicable to the optimization of continuous
      variables. In previous applications of simulated annealing to treatment planning
      optimization, only one or two weights are varied each iteration. This approach is
      to change all weights simultaneously, using random changes that are initially
      large to coarsely sample the cost function, then are reduced with iteration to
      probe finer structure. The performance of different methods are compared in
      optimizing a plan for treatment of the prostate, in which the search space
      consists of 54 noncoplanar beams and the cost function is based on tumor control
      and normal tissue complication probabilities. The proposed method yields
      solutions with similar values of the cost function in only a fraction of the
      iterations compared either to a fixed single weight adjustment technique, or to a
      method which combines the Nelder and Mead downhill simplex simulated annealing.

PMID- 8350816
TI  - "Coordinate transformation as a primary representation of radiotherapy beam
      geometry" by G. W. Sherouse [Med. Phys. 19(1), 175-179 (1992)].

PMID- 8350817
TI  - Low-energy imaging with high-energy bremsstrahlung beams: analysis and scatter
      reduction.
AB  - The contrast and zero spatial frequency signal-to-noise ratio produced by a
      method for radiation therapy portal imaging known as low-energy imaging with high
      energy bremsstrahlung beams have been mathematically analyzed. The analysis makes
      extensive use of Monte Carlo techniques and incorporates the detector, the
      spectrum, phantom, and geometry. The analysis is validated through comparison
      with measured data including subject contrast measurements and the attenuation of
      the beam with lead. Scatter reduction is found to be potentially the most
      effective method to improve contrast and SNR for a film based system. A large
      fraction of the scatter detected is of a much higher energy than that found in
      diagnostic radiology. Hence, traditional antiscatter grids, such as those used in
      diagnostic radiology, are ineffective. The analysis and theory from the
      literature are applied to design a new grid which is more appropriate for this
      application. The grid produces a modest improvement according to a contrast
      detail study.

PMID- 8350818
TI  - Automatic on-line inspection of patient setup in radiation therapy using digital
      portal images.
AB  - A new method is presented for inspection of patient setup in radiation therapy by
      automatic comparison of the patient position relative to the beam position in
      portal and simulator images. Quantification of patient-setup errors in terms of
      translation, rotation, and magnification is achieved by chamfer matching, a
      robust technique to match drawings and images, which is applied to both anatomy
      outlines and field edges. Applied to field edges, chamfer matching detects and
      visualizes deviations in field shape. Applied to anatomy outlines, the matching
      procedure quantifies and visualizes deviations in patient position relative to
      the radiation field. To test the method and to judge its feasibility, its
      behavior for four hundred different patient-setup deviations, which were
      simulated in four clinical images, was examined. These images show a top view of
      the pelvic region. The performance was measured in terms of accuracy and success
      rate for numerous cost functions and distance codings associated with the chamfer
      matching procedure. An average accuracy of 1.8 mm was found, a success rate of
      90%, and an average overall computation time of 3 s on a 486 microcomputer. The
      whole analysis procedure is fast enough to allow on-line application.

PMID- 8350819
TI  - Uncertainty analysis of field placement error measurements using digital portal
      and simulation image correlations.
AB  - An uncertainty analysis of a field placement error measurement method using
      correlations between digital portal and simulation images has been performed.
      This analysis used the Monte Carlo method to simulate random uncertainties
      arising in image registration and portal field edge detection. The uncertainty
      analysis used data from a field placement error study to predict the dependences
      of the measurement method upon image matchpoint number and spatial distribution,
      image registration, and uncertainties arising in the detection and description of
      the field edge in a portal image. It was shown that the uncertainty in the field
      registration had the most significant effect upon the measurement uncertainty,
      whereas the number of matchpoints had an extremely limited effect (beyond the
      minimum required for the mathematical procedure used in registration). In
      contrast, it was shown that an accurate field placement error measurement
      required that the number of pixels describing a field edge used for comparisons
      should exceed 20, thus automatically setting a minimum field length necessary for
      field placement comparisons. It was also shown that the spatial uniformity of the
      matchpoints in an image pair had a limited effect upon the field placement error
      measurement, provided that the points are distributed over about 15% of the image
      area.

PMID- 8350820
TI  - Verification of radiotherapy treatments: computerized analysis of the size and
      shape of radiation fields.
AB  - An automated technique has been developed for the verification of treatment field
      size and shape in external beam radiation therapy. Portal images from film or
      digital on-line imaging system are analyzed, and basic parameters are derived to
      describe the field size and shape from the contour points on the field boundary.
      The initial set of parameters included length of the perimeter, area, aspect
      ratio, and orientation angle. The parameters found for the actual field in the
      portal image are compared against those calculated for the prescribed field and
      any discrepancies indicated to the operator. The accuracy of the field
      parameterization scheme has been tested on a number of on-line portal images with
      varying fields. The relative error did not exceed a few percent in perimeter and
      area or 2 degrees in the angle, which should be sufficiently low for the
      detection of major errors in field shaping.

PMID- 8350821
TI  - Energy distributions from a racetrack microtron measured with a magnetic
      spectrometer.
AB  - Energy spectra of accelerated electron beams from a racetrack microtron were
      measured using a magnetic spectrometer. The spectrometer utilized a 90 degrees
      dipole magnet. A ray-tracing program was developed to determine the slit
      positions of the spectrometer based on a detailed map of the magnetic field
      measured at field strengths corresponding to about 20 and 50 MeV. The total a
      priori uncertainty (previously often called systematic or class B uncertainty) of
      the measured most probable energy Ep is 0.22% (one approximate standard
      deviation) and the a posteriori uncertainty (previously often called random or
      class A uncertainty) is 0.04% (1 sigma). The estimated energy resolution (delta
      E/E) of the spectrometer is 4 x 10(-4). Spectral energy distributions of the
      electron beam were measured at a Ep = 21.1 and 51.6 MeV, and the obtained full
      width at half-maximum of the energy distributions were 53 and 34 keV,
      respectively. All the measurements were performed in vacuum to minimize the
      influence of electron energy loss and scatter.

PMID- 8350822
TI  - X-ray surface dose measurements using TLD extrapolation.
AB  - Surface dose measurements in therapeutic x-ray beams are of importance in
      determining the dose to the skin of patients undergoing radiotherapy.
      Measurements were performed in the 6-MV beam of a medical linear accelerator with
      LiF thermoluminescence dosimeters (TLD) using a solid water phantom. TLD chips
      (surface area 3.17 x 3.17 cm2) of three different thicknesses (0.230, 0.099, and
      0.038 g/cm2) were used to extrapolate dose readings to an infinitesimally thin
      layer of LiF. This surface dose was measured for field sizes ranging from 1 x 1
      cm2 to 40 x 40 cm2. The surface dose relative to maximum dose was found to be
      10.0% for a field size of 5 x 5 cm2, 16.3% for 10 x 10 cm2, and 26.9% for 20 x 20
      cm2. Using a 6-mm Perspex block tray in the beam increased the surface dose in
      these fields to 10.7%, 17.7%, and 34.2% respectively. Due to the small size of
      the TLD chips, TLD extrapolation is applicable also for intracavity and exit dose
      determinations. The technique used for in vivo dosimetry could provide clinicians
      information about the build up of dose up to 1-mm depth in addition to an
      extrapolated surface dose measurement.

PMID- 8350823
TI  - A technique for the evaluation of a missing tissue compensator system.
AB  - A two dimensional approach to the evaluation of a missing tissue compensator
      system has been developed and implemented. Quantitative descriptors of the dose
      area histograms generated by scanning films irradiated under a variety of
      compensated and uncompensated conditions are proposed. The method has been found
      to be useful during the acceptance testing of a commercial compensator system and
      the results of this exercise are presented.

PMID- 8350825
TI  - On the cause of the variation in tissue-maximum ratio values with source-to
      detector distance.
AB  - While tissue-maximum ratios (TMR) for 60cobalt treatment units have been shown to
      be independent of source-to-axis distance (SAD), high-energy photon beams
      demonstrate variations in their TMR as a function of SAD. Some authors have
      asserted that the distance dependence of the TMR stems from electron
      contamination in the beams, while others have suggested low-energy, scattered
      photons as the cause. Using a magnet to sweep contaminant electrons out of the
      photon treatment beam eliminates any variation in TMR with distance. Thus,
      electron contamination accounts for all of the distance dependence, and any low
      energy, scattered photons behave indistinguishably like the high-energy photons.

PMID- 8350824
TI  - Characteristics of a spoiled 6-MV beam from a dual-energy linear accelerator.
AB  - A beam spoiler for a 6-MV x-ray beam was designed and spoiled beam dosimetry
      performed. The spoiled beam quality was similar to that of the unspoiled beam.
      The percentage depth doses at 5 mm were at least 90% for all field sizes except 4
      x 4 cm, while the surface dose at 0 mm varied from 22.5% for a 4 x 4-cm field to
      85.8% for a 22 x 22-cm field. The spoiled beam showed degraded beam flatness for
      small field size at superficial depths; the beam flatness at 6 mm for a 4 x 4-cm
      field was +/- 9.0%. The beam flatness improved as the field size increased, e.g.,
      at same depth, the beam flatness was +/- 2.5% for a 22 x 22-cm field. The
      penumbra width (90%-10%) of the spoiled beam was greater than that of the
      unspoiled beam for all field sizes and at all depths; e.g., at 0-mm depth, for a
      22 x 22-cm field, the penumbra width was 3.8 cm for the unspoiled beam and 7.2 cm
      for the spoiled beam. Beyond dmax the difference in the penumbra widths between
      the spoiled and unspoiled beam was about 3-4 mm for all field sizes and at all
      depths. The peripheral dose was larger for the spoiled beam.

PMID- 8350826
TI  - Thermoluminescent characteristics of LiF:Mg,Ti from three manufacturers.
AB  - LiF:Mg,Ti thermoluminescent dosimeters (TLD's) were obtained from three
      manufacturers with the specification that they all lie within +/- 5% of the mean.
      All were chips of size 3 mm x 3 mm x 1 mm. The three sample groups were compared
      on the basis of their energy response, linearity of the thermoluminescent (TL)
      response with increasing exposure, sensitivity, and reproducibility of TL
      response. All TLD groups showed similar characteristics in energy response and
      linearity. This is to be expected since the base material and dopants were the
      same. However, the sensitivity varied among the three groups by as much as 40%
      and reproducibility measurements gave standard deviations ranging from 7% to 14%
      among the groups. Annealing procedures were identical in all cases, as were
      irradiation and readout conditions.

PMID- 8350827
TI  - An equivalent-square formula for head-scatter factors.
AB  - A simple formula is evaluated for calculating the equivalent square collimator
      setting that gives the same headscatter factor as a given rectangular field. The
      expression requires that one parameter is determined experimentally. It is found
      that one single value of this parameter can be used for the six x-ray beams
      studied (two accelerators, two energies, with and without wedge).

PMID- 8350828
TI  - Application of a commercial solid-water plane-parallel ionization chamber to the
      AAPM TG-21 protocol.

PMID- 8350829
TI  - Comments on the experimental determination of the replacement correction factor
      for parallel-plate ionization chambers in high-energy electron beams.

PMID- 8350830
TI  - Comments on the experimental determination of the polarity effect of two parallel
      plate ionization chambers in high-energy electron beams.

PMID- 8350832
TI  - Dose-volume histogram computations for small intracranial volumes.
AB  - A sampling formalism is presented to accurately compute the absolute volumes and
      integral dose-volume histograms of small volumes treated in stereotactic
      radiosurgery. The presence of small volumes and sharp dose gradients places
      special constraints on the computational formalism and the accuracy required to
      compute the dose-volume relationships. We use a spatially nonuniform random
      sampling method to allow an efficient and accurate computation of the dose-volume
      histograms for an arbitrary number of volumes. The computation of absolute volume
      vs dose allows intercomparison of dose delivered to target and dose-critical
      volumes and allows a quantitative trade-off analysis often critical to an optimal
      treatment of the lesion.

PMID- 8350831
TI  - Calculation of beta dosimetry in radiation synovectomy using Monte Carlo
      simulation (EGS4).
AB  - Using the EGS4 Monte Carlo code, absorbed dose rate factors were estimated for
      four radionuclides of interest in radiation synovectomy, an intra-articular
      radiation therapy to treat rheumatoid arthritis. The treatment consists of the
      injection of a beta-emitting radionuclide into the joint capsule in order to
      eliminate diseased synovium through irradiation. The radionuclides investigated
      are 32P, 90Y, 165Dy, and 198Au. Calculations reveal the absorbed dose factor (cGy
      cm2/MBq s) as a function of distance (mm) in an EGS4 model of the rheumatic
      joint. The model incorporates bone, articular cartilage, joint capsule, and
      tissue (synovium) components found in all synovial joints, with dimensions in the
      model corresponding to dimensions typically found in larger joints, e.g., the
      knee, shoulder, or hip. Results are compared with previous, analytical approaches
      to beta dosimetry in radiation synovectomy. In addition, radiation backscatter
      due to the presence of bone is investigated and determined to have a negligible
      enhancement effect on absorbed dose to synovium.

PMID- 8350833
TI  - Buildup region of high-energy x-ray beams in radiosurgery.
AB  - The depths of dose maxima of radiosurgical x-ray beams increase with the field
      diameter in the range from 10-30 mm. Furthermore, the degree of the increase is
      proportional to the photon beam energy. This behavior is in contrast to that of
      large radiotherapeutic fields, where the depths of dose maxima decrease with
      increasing field size. The surface doses, depths of dose maxima, and collimator
      scatter factors for radiosurgical beams with energies between 6 and 18 MV are
      presented. It is shown that the change in dmax for radiosurgical beams is a
      result of photon scatter in the phantom rather than in the collimator. Monte
      Carlo simulations of the radiosurgical beams are used to separate the total dose
      into two components: the primary dose and the scattered dose. Calculations
      indicate that buildup region characteristics are governed by the primary dose
      deposition in the medium. The scattered dose has a minimal effect on the total
      dose deposited in media by radiosurgical beams.

PMID- 8350834
TI  - Dosimetry of 125I sources in a low-density material using scaling.
AB  - One may apply O'Connor's scaling theorem to dose measurements with brachytherapy
      sources in order to overcome the difficulties associated with the need for high
      spatial accuracy. This possibility has been evaluated by measuring the dose
      distribution around 125I sources in a low-density styrofoam phantom and comparing
      it with the dose distributions in water and solid water. Some generalization of
      the scaling theorem is proposed to allow for the minor differences in atomic
      composition between styrofoam and water, and the distances are scaled according
      to the ratio of the linear attenuation coefficients, instead of the physical
      densities, of the two media. The validity of this application of the scaling
      theorem has also been tested using Monte Carlo calculations. The results indicate
      that the scaling of the styrofoam measurements to water is a useful approximation
      in brachytherapy dosimetry.

PMID- 8350835
TI  - Tumor localization using fundus view photography for episcleral plaque therapy.
AB  - The accurate localization of ophthalmic tumors on the scleral surface is
      important when calculating radiation dose to the tumor and adjacent structures
      from episcleral I-125 plaques. This is particularly true for tumors close to the
      fovea or optic nerve. A fundus view diagram of the eye is often used by
      ophthalmologists to describe the size and shape of the tumor perimeter as well as
      its geographical location on the retinal surface. There is, however, an inherent
      inaccuracy associated with the use of a hand drawn diagram to obtain physical
      measurements. A computer planning program has been developed which uses CT and a
      digitized photographic montage of the posterior hemisphere to estimate the size
      and location of posteriorly located tumors. A simple phantom was constructed to
      test the software and a direct comparison made between planned versus measured
      tumor size and location in an excised eye.

PMID- 8350836
TI  - Comments on dose measurements for a narrow beam in radiosurgery.

PMID- 8350837
TI  - Superheated drop detector for determination of neutron dose equivalent to
      patients undergoing high-energy x-ray and electron radiotherapy.
AB  - The superheated drop detector (SDD) consists of thousands of superheated drops
      dispersed in a small vial of gel, which vaporize upon exposure to high LET
      radiation, thereby providing a directly observable indication of neutron dose.
      This detector possesses high sensitivity to neutrons and insensitivity to high
      energy photons and electrons, making it suitable for the determination of neutron
      dose equivalent rates around high-energy photon and electron radiotherapy beams.
      In the present work, the SDD was used to measure the neutron dose equivalent in
      and around the radiotherapy beams produced by a 32-MeV linear accelerator. For
      both x-ray and electron beams, the neutron dose profiles were observed to follow
      the photon/electron radiotherapy beam profiles. For 25-MV x rays, the neutron
      dose equivalent per photon dose on the central axis increased by a factor of
      about 3 as field size increased from 5 x 5 to 30 x 30 cm. However, the neutron
      dose equivalent rate at 50 cm off-axis in the patient plane was essentially
      independent of field size. The neutron dose equivalent per electron dose was
      essentially zero for electron beams with energies below 15 MeV, but increased
      rapidly above 15 MeV. For 25-MeV electrons, neutron dose equivalent on the
      central axis was about 1/5 that for 25-MV x rays. Analogous to the data for 25-MV
      x rays, the neutron dose equivalent rate on the central axis of a 25-MeV electron
      beam exhibited a similar field size dependence and outside the beam it was
      essentially independent of field size.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350838
TI  - A survey of fluoroscopic exposure rates: AAPM Task Group No. 11 Report.
AB  - Fluoroscopic procedures, in general, result in much higher exposures to patients
      than do most types of radiographic procedures [National Council on Radiation
      Protection, Report 100, p. 31 (1989)]. In spite of this, fluoroscopic exposure
      rates can vary widely between systems, and often for no apparent reason. The
      charge of AAPM Task Group No. 11 was to evaluate fluoroscopic exposure rates at
      the entrant surface of the x-ray image intensifier, and to disseminate this
      information so that medical physicists could compare their own exposure rate
      measurements with typical values. The measurement protocol was defined for
      various system configurations. Sheets of copper were used to attenuate the x-ray
      beam, and the input exposure rate at the image intensifier (at the input mode
      closest to 23-cm diameter) in the absence of a scattering medium was determined.
      With 2 mm of copper as x-ray beam filtration, the median fluoroscopic exposure
      rate at the image intensifier was found to be 16.5 nC/kg/s (64.0 microR/s), with
      an average kV of 77 and mA of 2.0 (n = 62).

PMID- 8350839
TI  - Measurement of absolute blood iodine concentration during digital subtraction
      ventriculography.
AB  - A system to measure the absolute iodine concentration (mg iodine/milliliter
      blood) in the left ventricle (LV) during digital subtraction ventriculography has
      been developed. The technique uses a catheter to draw blood from the LV through a
      detection cell. This occurs as the iodine bolus passes through the heart. The
      cell determines iodine concentration by measuring x-ray attenuation as the
      iodinated blood passes between a low-power x-ray tube and a diode detector. In
      vitro and in vivo testing of the system was conducted. The system response was
      linear (r = 0.99) with respect to iodine concentration. This response was
      independent of hematocrit. Dispersion of contrast medium in the catheter caused
      distortion of the shape of the time-concentration curve. The impulse response of
      the system was measured and found to be independent of hematocrit. A correction
      algorithm based on Wiener filter deconvolution was developed. In vitro testing
      using simulated time-concentration curves demonstrated that the rms error in the
      iodine measurement after dispersion correction did not exceed 4% over the region
      of the time-concentration curve extending from the peak to the point on the tail
      where the signal fell to 50% of its peak value. Cardiac output was measured from
      the time-concentration curve via the indicator-dilution method in an animal
      model. This cardiac output measurement (COI) agreed closely with cardiac output
      measured simultaneously with an aortic flow probe (CO(P)), namely, COI = 1.02
      CO(P)-0.03 L/min, r = 0.95, SEE = 10%, p < 0.001.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8350840
TI  - Comparison of ROC and AFC methods in a visual detection task.
AB  - The visual observer performance for detecting low-contrast patterns by employing
      both the receiver operating characteristic (ROC) and the 9-alternative forced
      choice (9-AFC) method is investigated. For each observer and each experimental
      technique, the results were reproducible with respect to a repeated observation.
      When the results of different observers for each method are compared, a strong
      variation of values is found. From the ROC data obtained, the expected
      percentages of correct detection in a 9-AFC experiment is calculated and compared
      with the corresponding values of the actual 9-AFC experiment. For some observers,
      the latter values were significantly higher than the computed ones, whereas for
      others the results showed good agreement with predictions from theory.

PMID- 8350841
TI  - Patient dose and image quality in five standard x-ray examinations.
AB  - Patient doses and image quality in five standard x-ray examination projections
      (22-36 measurements per each projection) have been measured, using homogeneous
      phantoms. The means and range of variation for the entrance skin air kerma values
      were: abdomen AP 5.2 mGy (1.1-21 mGy), chest PA 0.27 mGy (0.035-0.84 mGy), lumbar
      spine AP 8.4 mGy (2.9-28 mGy), skull LAT 3.1 mGy (1.1-7.7 mGy), and thoracic
      spine AP 7.9 mGy (1.3-22 mGy). Considerable variation was found in image quality
      parameters: film optical densities, image contrasts, and resolutions as well as
      in exposure values, tube voltages, exposure times, and in half-value thicknesses.
      The study indicated the need to standardize medical x-ray examination techniques
      in different x-ray departments. The measuring method can be used for comparing
      the patient dose and image quality of an individual x-ray unit to the doses and
      image quality in general use. The results can be used as the reference values for
      quality control of x-ray equipment.

PMID- 8350842
TI  - Evaluation of mammographic viewbox luminance, illuminance, and color.
AB  - Twenty-three viewboxes were evaluated in six mammography facilities. Luminance
      and illuminance measurements were made with a recently calibrated photometer.
      Color temperatures were measured with a Minolta color meter. The average
      luminance for the 23 viewboxes was 2920 nit (lumen/Sr/m2), the lowest value was
      1610 nit, and the highest value was 3630 nit. The average illuminance was 40 lux
      (lumen/m2), with 6 lux as the lowest value, and 97 lux as the highest. The
      average color temperature was 8400 K with the lowest value of 4900 K, and the
      highest of 10,900 K.

PMID- 8350843
TI  - The evaluation of a clinical thermometer for measuring developer temperature in
      automatic film processors.
AB  - In medical imaging, the temperature of the developer solution in the film
      processor affects film speed (radiation dose), film contrast, and film base plus
      fog. The National Council on Radiation Protection and Measurement (NCRP) Report
      99 on Quality Assurance, and the American College of Radiology (ACR) Mammography
      Quality Control Manual for Radiologic Technologists, indicate that the developer
      temperature should be within +/- 0.5 degree F (+/- 0.3 degree C) of that
      recommended by the manufacturer for the specific film/developer combination being
      used. The accuracy and repeatability of the thermometer is most important. This
      paper describes the requirements of a thermometer for measuring the temperature
      of the developer solution and suggests an inexpensive but accurate device for
      doing so.

PMID- 8350844
TI  - Adenosine administration for neonatal SVT.
AB  - Adenosine is a purine nucleoside that impairs conduction through the AV node and
      is thus effective in terminating tachycardias involving the AV node. Gaining
      acceptance as the drug of choice for neonatal supraventricular tachycardia (SVT),
      it is given IV as a rapid bolus with an initial dose of 0.05 mg/kg and can be
      increased in increments of 0.05 mg/kg every one to two minutes until termination
      of SVT (to a maximum of 0.25 mg/kg). Because of its half-life of 0.6 to 10
      seconds, adenosine will not prevent reinitiation of SVT, therefore other
      medications should be considered if prophylaxis is required. An advantage of the
      short half-life is the transient nature of adverse effects, which can include
      flushing, nondistressing alterations in respiratory pattern, irritability, sinus
      bradycardia, and varying degrees of AV block. Administration to critically ill
      infants, including those requiring mechanical ventilation, has been reported. The
      infant's blood pressure, electrocardiogram, respiratory status, and capillary
      refill should be monitored before, during, and after adenosine administration.

PMID- 8350845
TI  - The effects of a pressure relief mattress on postnatal head molding in very low
      birth weight infants.
AB  - Very low birth weight (VLBW) infants often develop postnatal head molding (PHM)-
      an elongation of the skull--when a standard, firm mattress is used. This study
      was undertaken to determine if a pressure relief mattress (PRM) might reduce the
      severity of PHM. One hundred twenty-eight infants (birth weight range 567-1,490
      gm, mean 1,084; gestational age range 24-36 weeks, mean 28.5) with no congenital
      or acquired anomalies affecting head growth were randomly assigned to a control
      group (standard, firm mattress) or a study group (PRM). Study infants were placed
      on the PRM within 72 hours of birth. Occipitofrontal circumference (OFC) and
      anterior-posterior (AP) and biparietal (BP) diameters were measured at day four,
      seven, and then at one week intervals of life until the infant reached 2,000 gm
      or was discharged. An electronic digital caliper with an accuracy of 0.025 mm was
      used to obtain the AP and BP measurements. T-tests revealed no significant
      differences in head shape between the two groups. In conclusion, the pressure
      relief mattress did not reduce PHM in VLBW infants.

PMID- 8350846
TI  - Perinatal grief: response to the loss of an infant.
AB  - The grief response of parents following loss of an infant from a multiple
      gestation pregnancy was explored to describe the experience, compare and contrast
      mother's and father's responses, and analyze the properties of the Perinatal
      Grief Scale. Twenty-seven parents participated. Parental responses were complex
      and variable. Most parents disagreed with experiencing difficulty coping and
      despair. Confrontive, self reliant, and supportant coping strategies were used
      most frequently, while supportant, confrontive and optimistic strategies were
      reported the most effective. Anxiety, depression and alterations in activities of
      daily living were reported. The total impact of life events was slightly positive
      for this group. Although the instruments were reliable in this population of
      parents, sensitivity was reduced. A model of grief associated with multiple
      gestation perinatal loss was generated. Selection and effectiveness of coping
      strategies appear to be not only interrelated, but dependent on the time since
      the infants death and the length of the infants life. The length of an infant's
      life and time since death were affirmed as related to both the strength and type
      of relationship between variables associated with the grief response and to use
      and effectiveness of coping strategies. Responses of mothers and fathers appear
      to be similar.

PMID- 8350847
TI  - Comparison of percutaneous venous catheters and teflon catheters for intravenous
      therapy in neonates.
AB  - The purpose of this study was to compare the average duration of catheterization
      of percutaneous venous catheters (PVCs) with Teflon catheters placed in
      peripheral veins of neonates, and to describe the incidence of mechanical or
      infectious complications associated with their use. The sample consisted of
      twelve subjects with a total of 52 catheters--17 PVCs and 35 Teflon catheters.
      The results of the study indicated both a significant increase in the duration of
      catheterization (p = .001) and a significant reduction in the incidence of
      complications (p = .004) when PVCs were used. The mean duration of
      catheterization for PVCs was 178.6 hours and for Teflon catheters 41.9 hours.
      Although 80.8 percent of all the neonates studied suffered some complication
      leading to early catheter removal, such complications were observed most
      frequently with Teflon catheters (91 versus 59 percent of PVCs). However, the one
      subject who experienced the complication of catheter-related sepsis did have a
      PVC in situ for 313.5 hours. For this sample of neonates, the PVC was the most
      efficacious mode of IV therapy.

PMID- 8350848
TI  - Advocacy in action.
AB  - This article uses a paradigm case from clinical practice to isolate an abstract
      nursing concept. After identifying the concept, active advocacy, the article
      first defines it and then analyzes it in depth. The purpose of the article is to
      show how understanding abstract nursing concepts contributes to greater insight
      into the nuances of providing bedside care and contributes to the development of
      expert clinical practice. The article demonstrates how nurses in clinical
      practice can relate their own paradigm cases to other nurses as a way of sharing
      knowledge and information.

PMID- 8350849
TI  - Proctor & Gamble.

PMID- 8350851
TI  - Puzzles as learning tools.

PMID- 8350850
TI  - Kangaroo care.

PMID- 8350852
TI  - Procedural flow chart job aid for the exchange transfusion.

PMID- 8350853
TI  - Hepatitis B vaccine.

PMID- 8350854
TI  - The effect of environmental lighting on the oxygen saturation of preterm infants
      in the NICU.
AB  - The premature infant is more vulnerable to the NICU environment than a full-term
      infant due to neurologic immaturity and physiologic instability. Studies have
      been done on the effects of long-term decreases in environmental light, but none
      have been done on the immediate effects. The purpose of this study was to
      determine the relationship between immediate changes in environmental
      illumination and oxygen saturation in preterm neonates and whether these were
      affected by gestational and postnatal age. The oxygen saturations of 27 sleeping
      infants (2 to 56 days of age) between 26 and 37 weeks gestation were continuously
      recorded for 40 minutes utilizing a Nellcor N200 oximeter. After recording
      baseline saturations for 5 minutes with the room lights at 100 footcandles, the
      illumination level was lowered to 5 footcandles. At the end of 30 minutes, lights
      were increased to the previous level. Oxygen saturations were recorded at one and
      five minutes after illumination decreases and increases. There was a
      statistically significant interaction between repeated measures of saturation at
      baseline and one and five minutes after lights were increased and covariates
      gestational, corrected gestational, and postnatal age (p = .02, p = .008, p =
      .005). Repeated measure analysis of covariance (ANCOVA) revealed no statistically
      significant changes in oxygen saturations after the lights had been lowered for
      babies who were younger in gestational or postnatal age. The results of this
      study suggest that rapidly increasing illumination may be a cause of stress to
      the younger gestationally and postnatally preterm neonate.

PMID- 8350855
TI  - Jin bu huan toxicity in children--Colorado, 1993.
AB  - The consumption of traditional ethnic remedies can have adverse health effects,
      especially among children. Life-threatening bradycardia with rapid onset and
      central nervous system (CNS) and respiratory depression developed in three
      unrelated children in Colorado during 1993 following ingestion of Jin Bu Huan
      tablets, a Chinese herbal medicine used for relieving pain. This report
      summarizes the investigations of these cases.

PMID- 8350856
TI  - Surveillance for cholera--Cochabamba Department, Bolivia, January-June 1992.

PMID- 8350857
TI  - Cigarette smoking-attributable mortality and years of potential life lost--United
      States, 1990.
AB  - Cigarette smoking is the single most preventable cause of premature death in the
      United States. An estimated 390,000 smoking-attributable deaths in the United
      States occurred in 1985, and more than 434,000 deaths occurred in 1988; in 1988,
      an estimated 1,198,887 years of potential life lost (YPLL) before age 65 were
      attributed to smoking. To estimate the national impact of cigarette smoking on
      mortality and YPLL, calculations were performed using the Smoking-Attributable
      Mortality, Morbidity, and Economic Cost (SAMMEC) software. This report summarizes
      the results of this analysis.

PMID- 8350858
TI  - Public health consequences of a flood disaster--Iowa, 1993.
AB  - Unprecedented amounts of rain in the spring and summer of 1993 led to disastrous
      flooding and crop damage in nine Midwestern states. In Iowa (1990 population:
      2,777,000), extensive flood damage occurred in all 99 countries. On July 11,
      1993, the Iowa Department of Public Health (IDPH) requested assistance from CDC
      to assess the adverse public health impact of the flooding and to plan the public
      health response to the disaster. CDC assisted IDPH in performing an initial rapid
      statewide public health assessment and establishing weekly surveillance to
      monitor ongoing or anticipated flood-related health problems. This report
      summarizes the methods of the assessment and surveillance and preliminary
      findings.

PMID- 8350859
TI  - Tuberculosis in Philippine National World War II Veterans immigrating to Hawaii,
      1992-1993.
AB  - The Immigration Act of 1990* allows World War II veterans who are Philippine
      nationals to be naturalized as U.S. citizens and to enter the United States
      without any medical screening or restrictions. Following the diagnosis of
      tuberculosis (TB) in February 1992 in a Philippine national veteran who had
      recently arrived in Hawaii, the Hawaii Department of Health (HDOH) initiated
      efforts to assist veterans who had already arrived in Hawaii to receive TB
      testing and appropriate treatment and monitoring. This report describes the first
      case of TB identified in a veteran who entered Hawaii from the Philippines under
      this act and summarizes efforts by HDOH to detect and treat TB among Philippine
      national veterans.

PMID- 8350860
TI  - State-specific changes in cholesterol screening--behavioral risk factor
      surveillance system, 1988-1991.
AB  - High blood cholesterol (HBC) is an important risk factor for coronary heart
      disease (1)--the leading cause of death in the United States. To reduce the
      prevalence of elevated cholesterol levels in the United States, in 1985 the
      National Heart, Lung, and Blood Institute initiated the National Cholesterol
      Education Program (NCEP). The NCEP recommends that all adults aged > or = 20
      years be screened for HBC at least once every 5 years. One of the national health
      objectives for the year 2000 is to increase to 75% the percentage of adults
      screened for HBC within the preceding 5 years (objective 15.14). To measure
      progress toward this objective, data from CDC's Behavioral Risk Factor
      Surveillance System (BRFSS) were used to examine state-specific trends in
      cholesterol screening from 1988 through 1991. This report summarizes the results
      of this analysis and provides a projected estimate of the 1994 screening rates
      for HBC in each state.

PMID- 8350861
TI  - Control of glycolytic enzyme binding: effect of changing enzyme substrate
      concentrations on in vivo enzyme distributions.
AB  - The effect of changing concentrations of glycolytic intermediates on the binding
      of phosphofructokinase, aldolase and pyruvate kinase to cellular particulate
      matter was investigated. Concentrations of glycolytic intermediates were altered
      by adding 2 mM iodoacetic acid (IAA) to an incubation medium containing tissues
      isolated from the channelled whelk Busycon canaliculatum. Iodoacetic acid
      inhibited glyceraldehyde 3-phosphate dehydrogenase activity causing a 100-400
      fold increase in the concentration of fructose 1,6-bisphosphate as well as 3-20
      fold increases in glucose 6-phosphate, fructose 6-phosphate, and dihydroxyacetone
      phosphate levels depending on the experimental protocol. Cellular pH values were
      not statistically different in the presence of IAA. Measurement of enzyme binding
      to particulate matter showed that the binding of phosphofructokinase, aldolase
      and pyruvate kinase was unaffected by iodoacetic acid under any experimental
      condition. These results show that changes in the tissue concentrations of enzyme
      substrates and products do not regulate enzyme binding to particulate matter in
      the cell.

PMID- 8350862
TI  - Kinetic study of the cytotoxic effect of alpha-sarcin, a ribosome inactivating
      protein from Aspergillus giganteus, on tumour cell lines: protein biosynthesis
      inhibition and cell binding.
AB  - alpha-Sarcin is a ribosome inactivating protein produced by the mould Aspergillus
      giganteus. The effect of this protein on eight different tumour cell lines has
      been studied in the absence of any agent affecting membrane permeability. The
      protein is cytotoxic for all the tumour cell lines considered. alpha-Sarcin
      modifies the cell proliferation pattern by inhibiting the protein biosynthesis of
      the cultured cells. No membrane damage produced by alpha-sarcin has been observed
      by measuring lactic dehydrogenase leakage. Alteration on the cell mitochondrial
      activity has not been detected upon treatment with alpha-sarcin. Differences on
      the extent of the protein binding to the cells have been observed by flow
      cytometric measurements. The kinetic analysis of the protein biosynthesis
      inhibition produced by alpha-sarcin reveals an alpha-sarcin concentration
      dependent lag phase followed by a first order decrease of the protein synthesis
      rate. This parameter is dependent on the external alpha-sarcin concentration. A
      saturable component for the action of alpha-sarcin is also deduced from these
      experiments. Results are discussed in terms of the protein passage across the
      cell membrane as the potential rate-limiting step for the action of alpha-sarcin.

PMID- 8350863
TI  - Effects of saturated fatty acids on n-6 fatty acid metabolism in cultured human
      monocyte-like cells (U937).
AB  - Effects of supplementation of saturated fatty acids (16:0 and 18:0) on metabolism
      of the cytotoxic n-6 fatty acids in cultured human monocyte-like cells (U937)
      have been examined. U937 cells were incubated in 5% delipidated fetal bovine
      serum containing 16:0 and 18:0. Supplementation of either 16:0 or 18:0 has no
      significant effect on the uptake of 18:2n-6 and 18:3n-6. However, addition of
      16:0 to the medium increased whereas 18:0 suppressed the cytotoxic effects of
      18:2n-6 and 18:3n-6. In addition, 16:0 supplementation reduced the incorporation
      of n-6 fatty acids in cellular phospholipid fraction, and enhanced the metabolism
      of n-6 fatty acids, particularly the conversion of 20:3n-6 to 20:4n-6 in U937
      cells. Results with microsomes prepared from U937 cells also showed that 16:0
      supplementation increased the delta 5 desaturase activity. This may be related in
      part to an increase in the availability of 20:3n-6, since results obtained in a
      separate study have shown that 16:0 competed with 20:3n-6 for incorporation into
      the phospholipid molecule at sn-2 position. Increasing the availability and
      formation of long chain n-6 fatty acids, which are cytotoxic, might also be
      responsible for increasing cytotoxicity of 16:0 supplementation.

PMID- 8350864
TI  - Stimulatory effect of beta-alanyl-L-histidinato zinc on cell proliferation is
      dependent on protein synthesis in osteoblastic MC3T3-E1 cells.
AB  - The effect of beta-alanyl-L-histidinato zinc (AHZ) on bone metabolism was
      investigated in osteoblastic MC3T3-E1 cells. Cells were cultured for 3 days at 37
      degrees C in a CO2 incubator in plastic dishes containing alpha-modified minimum
      essential medium supplemented with 10% fetal bovine serum. After the cultures,
      the medium was exchanged for that containing 0.1% bovine serum albumin plus
      various concentrations of AHZ or other reagents, and the cells were cultured
      further for appropriate periods of time. The presence of AHZ (10(-7)-10(-5) M)
      stimulated the proliferation of cells. AHZ (10(-6) and 10(-5) M) increased
      deoxyribonucleic acid (DNA) content in the cells with 48 hr-culture. This
      increase was completely blocked by the presence of cycloheximide (10(-6) M) or
      hydroxyurea (10(-3) M). Also, the presence of cycloheximide (10(-6) M) completely
      inhibited the AHZ (10(-5) M)-induced increase in the proliferation of cells.
      Meanwhile, parathyroid hormone (10(-7) M), estrogen (10(-9) M) and insulin (10(
      8) M) significantly increased cellular DNA content. However, these hormonal
      effects clearly lowered in comparison with that of AHZ (10(-5) M). Dibutyryl
      cyclic AMP (10(-4) M) and zinc sulfate (10(-5) M) did not cause a significant
      increase in cellular DNA content. The present results support the view that AHZ
      has a direct specific proliferative effect on osteoblastic cells in vitro and
      that this effect is dependent on protein synthesis.

PMID- 8350865
TI  - Tissue concentration of calcium-binding protein regucalcin in rats by enzyme
      linked immunoadsorbent assay.
AB  - The concentration of calcium-binding protein regucalcin in the tissues of rats
      was estimated by enzyme-linked immunoadsorbent assay (ELISA) with rabbit-anti
      regucalcin IgG. In male rats (5 weeks old), regucalcin was most pronounced in the
      liver. Liver regulcalcin concentration was about 0.1 microM, when it was
      calculated with regucalcin molecular weight of 28,800. The relatively higher
      level of regucalcin was also found in the kidney as compared with that of the
      skeletal muscle, duodenum, testis, lung, heart, spleen, cerebral cortex and
      hippocampus. Similarly in female rats, regucalcin was remarkable in the liver,
      and appeared only slightly in the kidney. Thus, the tissue distribution of
      regucalcin in rats was specific in the liver. The concentration of regucalcin in
      the liver was altered with increasing age of rats; liver regucalcin level
      linearly increased during 5 weeks old after birth of male rats, and then began to
      decrease gradually. The results coincided with the previous observation of
      Northern blot analyses by using liver regucalcin cDNA as a probe. The present
      finding clearly demonstrates that regucalcin is specifically synthesized in the
      liver of rats.

PMID- 8350866
TI  - Effects of vanadate administration on the high sucrose diet-induced aberrations
      in normal rats.
AB  - Effects of feeding sucrose rich diet supplemented with and without the
      insulinmimetic agent vanadate for a period of six weeks were studied in rats.
      Sucrose diet caused hypertriglyceridemia (140% increase), hyperinsulinemia (120%
      increase) and significant elevations in the levels of glucose (p < 0.001) and
      cholesterol (p < 0.05) in plasma as compared to control starch fed rats.
      Activities of hepatic lipogenic enzymes, ATP-citrate lyase, glucose 6-phosphate
      dehydrogenase and malic enzyme increased by 100-150% as a result of sucrose
      feeding. However, glycogen content and the activities of glycogen synthase and
      phosphorylase in liver remained unaltered in these animals. The plasma levels of
      triacylglycerols and insulin in the rats fed on vanadate supplemented sucrose
      diet were 65% and 85% less, respectively as compared to rats on sucrose diet
      without vanadate. The concentrations of glucose and cholesterol in plasma and the
      activities of lipogenic enzymes in liver did not show any elevation in sucrose
      fed rats when supplemented with vanadate. These data indicate that the sucrose
      diet-induced metabolic aberrations can be prevented by the insulin-mimetic agent,
      vanadate.

PMID- 8350867
TI  - Effects of high sucrose diet on insulin-like effects of vanadate in diabetic
      rats.
AB  - The insulin-like effects of vanadate were compared in streptozotocin-induced
      diabetic rats fed on high starch control and high sucrose diets for a period of
      six weeks. Diabetic rats in both diet groups were characterized by
      hypoinsulinemia, hyperglycemia (6.8-7.0 fold increase) and significant decreases
      (p < 0.001) in the activities of glycogen synthase, phosphorylase and lipogenic
      enzymes, ATP-citrate lyase, glucose 6-phosphate dehydrogenase and malic enzyme in
      liver. There were no diet-dependent differences in these abnormalities. However,
      the insulin-mimetic agent vanadate was more effective in diabetic rats fed
      sucrose diet as compared to animals fed control starch diet. Vanadate
      administration resulted in 30% and 64% decreases in plasma glucose levels in
      diabetic rats fed control and sucrose diets, respectively. The activities of
      glycogen synthase (active) and phosphorylase (active and total) were restored
      significantly by vanadate in control (p < 0.05-0.01) and sucrose (p < 0.001)
      diets fed diabetic rats. This insulin-mimetic agent increased the activities of
      hepatic lipogenic enzymes in control diet fed rats to 38-47% of normal levels
      whereas in sucrose fed group it completely restored the activities. Sucrose diet
      caused a distinct effect on the plasma levels of triacylglycerol (4-fold
      increase) and apolipoprotein B (2.8-fold increase) in diabetic rats and vanadate
      supplementation decreased their levels by 65-75%. These data indicate that
      vanadate exerts insulin-like effects in diabetic rats more effectively in sucrose
      fed group than the animals fed control diet. In addition, vanadate also prevents
      sucrose-induced hypertriglyceridemia.

PMID- 8350868
TI  - Induction of N-acetylglucosaminyltransferase V by elevated expression of
      activated or proto-Ha-ras oncogenes.
AB  - Viral infection of cultured cells with transforming viruses causes an increase in
      cell-surface N-linked beta 1-6 (GlcNAc beta 1-6Man) branching of complex-type
      oligosaccharides. Similar observations have been made after transfection of cells
      with activated oncogenes, which is associated with an induction of tumorigenic
      and metastatic properties. In this study, the effects of transfection of both
      activated and proto-Ha-ras oncogenes into NIH3T3 cells were analyzed. The results
      showed that, in comparison with NIH3T3 cells, both ras transfectants have
      increased sensitivity to the cytotoxic action of L-PHA. An increase in beta 1-6
      branching and an increased level of N-acetylglucosaminyltransferase V (GlcNAc-T
      V), the enzyme which initiates the beta 1-6 branching were also observed. The
      levels of GlcNAc-T I and beta 1-4 Gal-T remained unchanged in activated Ha-ras
      transfected NIH3T3 cells. These data suggest that a specific induction of GlcNAc
      T V occurs after transfection with either the proto- or activated Ha-ras
      oncogenes, which is responsible for the increased beta 1-6 branching previously
      observed.

PMID- 8350869
TI  - Role of protein kinase C in oxidant--mediated activation of phospholipase A2 in
      rabbit pulmonary arterial smooth muscle cells.
AB  - The present study was undertaken to test the hypothesis that activation of cell
      membrane associated protein kinase C (PKC) plays a role in stimulating cell
      membrane associated phospholipase A2 (PLA2) activity, and subsequent liberation
      of arachidonic acid (AA) under exposure of rabbit pulmonary arterial smooth
      muscle cells to the oxidant hydrogen peroxide (H2O2). Exposure of the smooth
      muscle cells to H2O2 dose-dependently stimulates [14C] AA release, and enhances
      the cell membrane associated PLA2 activity. Pretreatment of the cells with
      protein kinase C (PKC) inhibitors H7 and sphingosine prevent the cell membrane
      associated PLA2 activity, and AA release caused by H2O2. Treatment of the smooth
      muscle cells with H2O2 stimulates the cell membrane associated PKC activity.
      Pretreatment of the cells with an antioxidant vitamin E prevents H2O2 caused
      stimulation of the cell membrane associated PKC activity. The cell membrane
      associated PLA2 and PKC activities correlate linearly. These results suggest that
      H2O2 caused stimulation of the smooth muscle cell membrane associated PLA2
      activity, and subsequent liberation of AA can occur through an increase in the
      activity of the cell membrane associated PKC.

PMID- 8350870
TI  - Elicitation of distinct populations of monoclonal antibodies specific for the
      variable domains of monoclonal anti-fluorescein antibody 4-4-20.
AB  - Armenian hamsters were immunized with non-liganded, partially liganded or
      affinity-labeled anti-fluorescein Mab 4-4-20. Seventeen hybridoma producing
      monoclonal anti-4-4-20 antibodies were characterized from chemically-mediated
      fusions of immune hamster lymphocytes with murine Sp2/O-Ag14 myeloma cells.
      Distinct populations of anti-4-4-20 monoclonal antibodies were isolated from
      hamsters receiving immunizations with partially liganded Mab 4-4-20 relative to
      those receiving affinity-labeled 4-4-20. Two of the three monoclonal antibodies
      produced in response to partially liganded 4-4-20 were inhibited in their
      interaction with 4-4-20 by fluorescyl ligand. These two clones, 1F4 and 1B7,
      recognized unique epitopes on the 4-4-20 molecules, as demonstrated by non
      reactivity with members of the 4-4-20 idiotype family. Additionally, 1F4 and 1B7
      demonstrated the ability to delay the association of fluorescein with Mab 4-4-20.
      The 14 characterized non-ligand-inhibitable Mabs elicited to affinity-labeled 4-4
      20 were classified into four separate groups based on various binding properties
      with members of the 4-4-20 idiotype family and binding to resolved H- and L
      chains in a western blot. Members of three of the four groups showed strong
      reactivity with both 04-01 Ig and 04-01 SCA, which utilizes the same L-chain as
      Mab 4-4-20. Six non-ligand-inhibitable Mabs, 4A6, P1E11, 3A5-1, 2C3, 2C4, and
      1A4, delayed the dissociation rate of ligand from Mab 4-4-20 and mutant 4-4-20
      SCA L32phe.

PMID- 8350871
TI  - Defining the structural correlates responsible for loss of arsonate affinity in
      an IDCR antibody isolated from an autoimmune mouse.
AB  - Immunization of the autoimmune mouse strain (M x A) Id/lpr with Ars-KLH, has been
      shown to elicit a prolonged anti-Ars IdCR response similar to that found in A/J
      mice. Cell fusion of splenocytes from a diseased mouse previously immunized with
      Ars-KLH resulted in a monoclonal antibody, 1-52.30, that was found to express the
      strain A major cross-reactive idiotype, but failed to bind Ars. Nucleotide
      sequence analysis demonstrated that 1-52.30: (a) used the "canonical" combination
      of gene segments associated with this idiotype, and (b) exhibited a pattern of
      somatic mutation consistent with selection for high affinity Ars binding. Two
      amino acids, VL 91 and 93, were mutated in 36-65, the germline equivalent of the
      IdCR antibodies, to 1-52.30-like residues (91G-->D, 93T-->M). The results of the
      mutagenesis showed that changing a single light chain residue, VL 91, from
      glycine to aspartic acid, resulted in a dramatic loss of Ars binding activity.

PMID- 8350872
TI  - Recombination activating genes-1 and -2 of the rabbit: cloning and
      characterization of germline and expressed genes.
AB  - The recombination activating genes RAG-1 and RAG-2 appear to be necessary
      components of the machinery needed for the Ig or TCR gene rearrangements that
      occur in developing B and T lymphocytes. In addition RAG-2 has been implicated in
      the process of V-gene diversification by somatic gene conversion in the chicken.
      Because gene conversion may be an important mechanism for V-gene diversification
      in the rabbit, we cloned the rabbit RAG locus and characterized the coding
      regions of the genomic RAG-1 and RAG-2. In addition, we sequenced cDNAs
      encompassing the RAG-2 coding region, part of the RAG-2 5' untranslated region
      and a 967 bp fragment of cDNA from the RAG-1 coding region. Northern analysis
      revealed a RAG-1 mRNA of 6.6 kb which is similar in size to the RAG-1 mRNA
      reported previously for other species, and a major species of RAG-2 mRNA of 4.4
      kb, which is larger than that from the mouse (2.2 kb). Analysis of the genomic
      clones showed that, as in other species, the RAG-1 and RAG-2 genes are oriented
      so as to be convergently transcribed. The DNA sequence analysis showed that the
      rabbit RAG-1 coding region is 91, 85 and 72% identical to human, mouse and
      chicken, respectively. The deduced RAG-1 protein sequence for rabbit is 93, 90
      and 78% identical to human, mouse and chicken. Comparison of the rabbit RAG-2
      coding region revealed 90, 87 and 71% identity to human, mouse and chicken,
      respectively, at the nucleotide level, and 91, 90 and 72% at the protein level.
      Although there is considerable conservation of sequence between species, we
      obtained evidence for allelic forms of the rabbit RAG locus both by Southern
      analyses and by sequencing. A remarkable degree of polymorphism was found in our
      rabbit colonies, particularly in the region 3' of the rabbit RAG-2 coding region.
      A 5' cDNA probe hybridized with one or more additional fragments that are not
      detected with the coding region probes, suggesting that the 5' cDNA sequence
      results from splicing of one or more upstream exons.

PMID- 8350873
TI  - Major involvement of cathepsin B in the intracellular proteolytic processing of
      exogenous IgGs in U937 cells.
AB  - Monoclonal antibodies used for diagnostic and therapeutic purposes behave as
      antigens when injected into patients. They are recognized by T cells in a
      processed form and in a major histocompatibility complex class II restricted
      fashion. Monoclonal murine IgG2a were used as a model to analyse the early phase
      of antigen processing in U937 cells. IgG2a prebound to cell surface Fc receptors
      were rapidly internalized in the cells. During internalization, they were
      proteolysed with a time-dependent intracellular accumulation of 26, 25, 24, 22
      and 14 kDa fragments. Comparison of in vitro IgG2a proteolysis by U937
      subcellular fractions or by purified cathepsin B and their intracellular
      processing indicated that a major cathepsin B like protease is responsible for
      IgG2a intracellular processing in endo-lysosomal compartments of U937 cells.

PMID- 8350874
TI  - Immobilized IL-2 preserves the viability of an IL-2 dependent cell line.
AB  - The mouse T-cell line CTLL-2 is known to be dependent on interleukin-2 (IL-2) for
      both growth and viability. These cells possess high affinity IL-2 receptors and
      have been shown to internalize IL-2 after binding. To determine if
      internalization of IL-2 is required for the mediation of its signal, IL-2 was
      covalently coupled to an insoluble matrix via glutaraldehyde cross-linking and
      CTLL-2 cells were incubated with the immobilized lymphokine matrix. This covalent
      cross-linking prevents the free lateral diffusion and internalization of the
      bound IL-2 receptors (IL-2R) while still permitting specific binding between the
      cells and the immobilized ligands. Although only very limited proliferation was
      observed during the incubation as assessed by 3H-thymidine incorporation, the
      viability of the CTLL-2 cells on the immobilized IL-2 matrix was preserved. Cells
      incubated on the immobilized IL-2 surface could proliferate in response to
      exogenous soluble IL-2 that was added to the cultures after 36 hours whereas
      control cultures incubated with an immobilized BSA matrix had died. This
      indicates that immobilized IL-2 can mediate some of the activity of soluble IL-2
      and that internalization of the IL-2 receptor may not be required for at least
      part of the IL-2 mediated effect.

PMID- 8350875
TI  - Mu switch region deletion is associated with both T cell independent and T cell
      dependent responses.
AB  - Isotype switching is a process by which immunoglobulin variable gene regions
      initially proximal to and expressed with the mu constant region gene (C mu) can
      rearrange downstream to other constant region genes. Thus the same antigen
      binding site can be expressed with each of the other constant region isotypes and
      perform the full panoply of effector functions. Although isotype switching is
      thought to involve highly reiterated 'switch site' sequences located 5' to
      constant region genes, the exact role of these switch sites is unknown. It has
      been reported that prior to switching, the 'donor' switch site 5' of C mu
      occasionally undergoes deletions, but it is not known whether this is an
      adventitious event or one which predisposes to or prevents isotype switching.
      Since T cell independent (TI) immune responses are dominated by IgM while T cell
      dependent (TD) responses are associated with switching to IgG, we have examined
      the state of the mu switch site in 51 IgM-producing hybridomas isolated from a
      variety of TI and TD responses. Although more hybridomas from the TI responses
      studied exhibited S mu deletions, deletion of S mu also occurred in hybridomas
      isolated from TD responses. Analysis of a well-characterized clonally related
      subset of IgM hybridomas also revealed that mu switch region deletion can be
      associated with the productive allele.

PMID- 8350876
TI  - Nucleotide sequences of Abb mRNA in mutant mouse S-27 resisting cancer metastasis
      and affecting responses to tuberculosis.

PMID- 8350877
TI  - [PreS-sequence of the hepatitis B virus envelope: molecular biology and
      immunology].
AB  - Current data on molecular biology and immunology of the proteins of hepatitis B
      viral capsid encoded by the preS-region of HBV genome are reviewed. Main
      attention is paid to study of the immune properties of the capsid proteins, to
      search of immune dominant epitopes encoded in preS-sequences. The medical and
      biological significance of the research is shown as exemplified by search of preS
      antigens and anti-preS-antibodies in serum from patients suffering hepatitis B.
      The use of preS-sequences as components of vaccine preparations is discussed.

PMID- 8350879
TI  - A method for isolation of sequences missing in one of two related genomes.
AB  - We describe a novel technique for isolation of sequences that are present in one
      genome (tracer), but absent in another (driver). Tracer DNA, cleaved with Sau 3A
      and capped with a single stranded PCR adapter, is allowed to hybridize with an
      excess of sheared biotinylated driver; biotinylated DNA and its hybrids with the
      tracer are removed by phenol/chloroform extraction after incubation with
      streptavidin. After several rounds of subtraction the ends of self-annealed
      tracer molecules from the nonextractable fraction are filled-in with Tag
      polymerase and amplified, using the single stranded PCR adapter as a primer. The
      method has been applied to purification of fragments from a 2.9 kb plasmid added
      to E. coli DNA at equimolar quantity. Plasmid derived fragments (250-1000 bp),
      initially comprising 1/1400th part of tracer DNA, were purified to homogeneity
      after two rounds of subtraction followed by PCR.

PMID- 8350878
TI  - [Isolation and properties of BstBSI restriction endonuclease from the
      thermophilic soil bacteria Bacillus stearothermophilus BS].
AB  - A new restriction endonuclease BstBSI was isolated and purified from the
      thermophilic soil bacterium Bacillus stearothermophilus BS by the blue sepharose
      and hydroxyapatite chromatographies. The enzyme is an isoschizomer of SnaI from
      Sphaerotilus natans C. It recognizes the hexanucleotide GTATAC and cleaves DNA in
      the center of the sequence. The maximal catalytic activity of the endonuclease is
      registered in 50 mM tris-HCl (pH 9.0) buffer with the high ionic strength (100 mM
      NaCl) in the presence of 10 mM MgCl2 at 45 degrees C. Glucosylated DNA of the
      phage T4 is not cleaved by the enzyme.

PMID- 8350880
TI  - [HIV lipids--biological role and target for antiviral agents].

PMID- 8350881
TI  - [Induction of synthesis of extracellular DNAase from Proteus mirabilis under the
      effect of compounds, blocking DNA replication].
AB  - The effects of mitomycin C and nalidixic acid on the biosynthesis of
      extracellular endodeoxyribonuclease in Proteus mirabilis have been studied. The
      presence of both antibiotics in the periodic and short-time cultures of washed
      off cells has increased both the activity of the DNAse and protein yield in
      cultural liquid and bacterial cells. PAGE-electrophoresis has shown the effect of
      mitomycin C to increase or induce the synthesis a large number of Proteus
      mirabilis extracellular proteins.

PMID- 8350882
TI  - [Association of DNA with the nuclear skeleton].
AB  - A significant functional role is ascribed to DNA association with the nuclear
      skeleton. Specific proteins tightly bound to DNA have been discovered. According
      to one point of view these proteins perform constant attachment of DNA to the
      nuclear matrix, however, according to other authors this complex exists in
      transcribed genes only. In proliferating cell DNA is anchored by DNA
      topoisomerase II and DNA-polymerase alpha. Except for proteins this function is
      performed by glycoproteins, neutral and phospholipids, RNA. Three types of
      specific DNA sequences have been elucidated: 1. AT-rich enhancers (SAR); 2. GC
      rich origins of replication; 3. centromere and satellite DNA. In places of
      binding to the nuclear matrix DNA bears the numerous defects of secondary
      structure. Based on different criteria several types of DNA complexes with
      nuclear matrix proteins are distinguished: 1. resistant (lamina) and sensitive
      (intramolecular fibrils) to chelating agents; 2. formed by transcriptional
      complexes (transitory) and origins of replication (constant); 3. tight (resistant
      to salt-urea solutions, formed by replicative complex proteins) and weak
      (sensitive).

PMID- 8350883
TI  - A two-year trial of oleic and erucic acids ("Lorenzo's oil") as treatment for
      adrenomyeloneuropathy.
AB  - BACKGROUND: Adrenomyeloneuropathy is an X-linked recessive disorder characterized
      by myelopathy, peripheral neuropathy, and cerebral demyelination, which develop
      in association with the accumulation of very-long-chain fatty acids. The
      administration of oleic and erucic acids inhibits the synthesis of very-long
      chain fatty acids. Recently such dietary treatment has been widely publicized as
      a possible cure for this disease. METHODS: We conducted an open trial in 14 men
      with adrenomyeloneuropathy, 5 symptomatic heterozygous women, and 5 boys (mean
      age, 13 years) with preclinical adrenomyeloneuropathy. The patients ate a low-fat
      diet and received daily doses of glycerol trioleate oil (1.7 g per kilogram of
      body weight) and glycerol trierucate oil (0.3 g per kilogram). Clinical
      manifestations, cerebral and spinal cord magnetic resonance imaging (MRI) scans,
      nerve conduction, and brain-stem auditory and somatosensory evoked potentials
      were studied prospectively over 18 to 48 months. Plasma levels of very-long-chain
      fatty acids and the side effects of erucic acid were monitored monthly. RESULTS:
      By week 10, plasma very-long-chain fatty acid levels declined nearly to normal.
      Nonetheless, over a mean follow-up of 33 months none of the 14 men with
      adrenomyeloneuropathy improved. In nine men there was functional deterioration,
      coincident in four with new cerebral lesions on MRI. In a single patient there
      was a reduction in cerebellar demyelination, but without clinical improvement. In
      one of the five asymptomatic boys signs of myelopathy developed. There were no
      changes in the symptomatic heterozygous women. There was some improvement in
      peroneal-nerve conduction, but no detectable clinical improvement. Conduction to
      the parietal cortex (T12-P37 interpeak latency) worsened in both the symptomatic
      men and the boys with preclinical adrenomyeloneuropathy. There was no change in
      other somatosensory evoked potentials or in brain-stem auditory evoked
      potentials. Asymptomatic thrombocytopenia (< 100,000 cells per cubic millimeter)
      was noted in six patients. CONCLUSIONS: In this open trial we found no evidence
      of a clinically relevant benefit from dietary treatment with oleic and erucic
      acids ("Lorenzo's oil") in patients with adrenomyeloneuropathy.

PMID- 8350885
TI  - A preliminary study of cardiopulmonary resuscitation by circumferential
      compression of the chest with use of a pneumatic vest.
AB  - BACKGROUND: More than 300,000 people die each year of cardiac arrest. Studies
      have shown that raising vascular pressures during cardiopulmonary resuscitation
      (CPR) can improve survival and that vascular pressures can be raised by
      increasing intrathoracic pressure. METHODS: To produce periodic increases in
      intrathoracic pressure, we developed a pneumatically cycled circumferential
      thoracic vest system and compared the results of the use of this system in CPR
      (vest CPR) with those of manual CPR. In phase 1 of the study, aortic and right
      atrial pressures were measured during both vest CPR (60 inflations per minute)
      and manual CPR in 15 patients in whom a mean (+/- SD) of 42 +/- 16 minutes of
      initial manual CPR had been unsuccessful. Vest CPR was also carried out on 14
      other patients in whom pressure measurements were not made. In phase 2 of the
      study, short-term survival was assessed in 34 additional patients randomly
      assigned to undergo vest CPR (17 patients) or continued manual CPR (17 patients)
      after initial manual CPR (duration, 11 +/- 4 minutes) had been unsuccessful.
      RESULTS: In phase 1 of the study, vest CPR increased the peak aortic pressure
      from 78 +/- 26 mm Hg to 138 +/- 28 mm Hg (P < 0.001) and the coronary perfusion
      pressure from 15 +/- 8 mm Hg to 23 +/- 11 mm Hg (P < 0.003). Despite prolonged
      unsuccessful manual CPR, spontaneous circulation returned with vest CPR in 4 of
      the 29 patients. In phase 2 of the study, spontaneous circulation returned in 8
      of the 17 patients who underwent vest CPR as compared with only 3 of the 17
      patients who received continued manual CPR (P = 0.14). More patients in the vest
      CPR group than in the manual-CPR group were alive 6 hours after attempted
      resuscitation (6 of 17 vs. 1 of 17) and 24 hours after attempted resuscitation (3
      of 17 vs. 1 of 17), but none survived to leave the hospital. CONCLUSIONS: In this
      preliminary study, vest CPR, despite its late application, successfully increased
      aortic pressure and coronary perfusion pressure, and there was an insignificant
      trend toward a greater likelihood of the return of spontaneous circulation with
      vest CPR than with continued manual CPR. The effect of vest CPR on survival,
      however, is currently unknown and will require further study.

PMID- 8350884
TI  - A controlled trial of intravaginal estriol in postmenopausal women with recurrent
      urinary tract infections.
AB  - BACKGROUND: Recurrent urinary tract infections are a problem for many
      postmenopausal women. Estrogen replacement restores atrophic mucosa, lowers
      vaginal pH, and may prevent urinary tract infections. METHODS: We enrolled 93
      postmenopausal women with a history of recurrent urinary tract infections in a
      randomized, double-blind, placebo-controlled trial of a topically applied
      intravaginal estriol cream. Midstream urine cultures were obtained at enrollment,
      monthly for eight months, and whenever urinary symptoms occurred. Vaginal
      cultures and pH measurements were obtained at entry and after one and eight
      months. The women were assigned to receive either estriol (n = 50) or placebo (n
      = 43), both administered intravaginally; 36 and 24, respectively, completed the
      eight months of follow-up. RESULTS: The incidence of urinary tract infection in
      the group given estriol was significantly reduced as compared with that in the
      group given placebo (0.5 vs. 5.9 episodes per patient-year, P < 0.001). Survival
      analysis showed that more of the women in the estriol group than in the placebo
      group remained free of urinary tract infection (P < 0.001). Lactobacilli were
      absent in all vaginal cultures before treatment and reappeared after one month in
      22 of 36 estriol-treated women (61 percent) but in none of the 24 placebo
      recipients (P < 0.001). With estriol the mean vaginal pH declined from 5.5 to 3.8
      (P < 0.001), whereas there was no significant change with placebo. The rate of
      vaginal colonization with Enterobacteriaceae fell from 67 percent to 31 percent
      in estriol recipients but was virtually unchanged (from 67 to 63 percent) in the
      placebo recipients (P < 0.005). Side effects were minor, but caused 10 estriol
      recipients (28 percent) and 4 placebo recipients (17 percent) to discontinue
      treatment. CONCLUSIONS: The intravaginal administration of estriol prevents
      recurrent urinary tract infection in postmenopausal women, probably by modifying
      the vaginal flora.

PMID- 8350886
TI  - Effect of dietary fish oil on renal function and rejection in cyclosporine
      treated recipients of renal transplants.
AB  - BACKGROUND: Dietary fish oil exerts effects on renal hemodynamics and the immune
      response that may benefit renal-transplant recipients treated with cyclosporine.
      To evaluate this possibility, we studied the effect of fish oil on renal
      function, blood pressure, and the incidence of acute rejection episodes in
      cyclosporine-treated recipients of renal transplants. METHODS: In a randomized,
      double-blind trial, 33 recipients of first cadaveric kidney transplants who were
      treated with cyclosporine and prednisolone ingested 6 g of fish oil daily during
      the first postoperative year (the fish-oil group), whereas another 33 renal-graft
      recipients treated with cyclosporine and prednisolone ingested 6 g of coconut oil
      daily for three months after which time it was stopped (the control group).
      RESULTS: One year after transplantation, the fish-oil group had higher median
      values than the controls for glomerular filtration rate (53 vs. 40 ml per minute
      per 1.73 m2, P = 0.038) and effective renal plasma flow (214 vs. 178 ml per
      minute per 1.73 m2, P = 0.023) and lower mean arterial pressure (103 vs. 118 mm
      Hg, P = 0.0011). The cyclosporine doses in the two groups were similar. The
      cumulative number of rejection episodes was 20 in the controls, as compared with
      8 in the fish-oil group (P = 0.029). One-year graft survival also tended to be
      better in the fish-oil group, (97 vs. 84 percent, P = 0.097). CONCLUSIONS: The
      daily administration of 6 g of fish oil during the first postoperative year has a
      beneficial effect on renal hemodynamics and blood pressure in renal-transplant
      recipients treated with cyclosporine. Although the fish-oil group had
      significantly fewer rejection episodes than the control group, graft survival at
      one year was not significantly better in the fish-oil group.

PMID- 8350887
TI  - Images in Clinical Medicine: Peutz-Jeghers syndrome.

PMID- 8350888
TI  - Nuclear cardiology (1).

PMID- 8350889
TI  - Treatment of multidrug-resistant tuberculosis.
AB  - The frequency of infections with M. tuberculosis resistant to antituberculous
      drugs is increasing in the United States and globally. This increase is a major
      threat to tuberculosis treatment and control programs. To prevent this situation
      from worsening, initial treatment programs that entail directly observed therapy
      supported by effective inducements or enforcements must be used. Retreatment of
      patients who have multidrug-resistant tuberculosis should be carried out in
      programs with comprehensive microbiologic, pharmacokinetic, psychosocial, and
      nutritional support systems. Regimens of multiple drugs, which generally are
      poorly tolerated and more toxic than traditional regimens, must be administered
      for 18 to 36 months. Resectional surgery may be required for substantial numbers
      of patients. For patients with AIDS who acquire tuberculosis caused by multiply
      resistant strains, the disease may prove lethal before effective therapy can be
      implemented. Ultraviolet irradiation systems should be used to protect health
      care personnel and other patients in high-risk environments. Enhanced federal,
      state, and local programs for prevention and control are urgently needed, and
      research to identify new medications and systems for their delivery is essential.

PMID- 8350890
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 36-1993. A 28-year-old man with AIDS, persistent pancytopenia,
      and lymphoma.

PMID- 8350891
TI  - Resistance to urinary tract infection.

PMID- 8350892
TI  - A declaration of independence for health system reform.

PMID- 8350893
TI  - Reforming our health care system.

PMID- 8350894
TI  - Reforming our health care system.

PMID- 8350895
TI  - Reforming our health care system.

PMID- 8350896
TI  - Reforming our health care system.

PMID- 8350897
TI  - Reforming our health care system.

PMID- 8350898
TI  - Reforming our health care system.

PMID- 8350899
TI  - Reforming our health care system.

PMID- 8350900
TI  - Physician-payment reform.

PMID- 8350901
TI  - Physician-payment reform.

PMID- 8350902
TI  - Physician-payment reform.

PMID- 8350904
TI  - Physician-payment reform.

PMID- 8350903
TI  - Physician-payment reform.

PMID- 8350905
TI  - Vaccine-associated paralytic poliomyelitis.

PMID- 8350906
TI  - Reinfection with multidrug-resistant tuberculosis.

PMID- 8350907
TI  - Reinfection with multidrug-resistant tuberculosis.

PMID- 8350908
TI  - Death in a patient with primary pulmonary hypertension after 20 mg of nifedipine.

PMID- 8350909
TI  - Case 8-1993: cysticercosis.

PMID- 8350910
TI  - Varmus reassuring for NIH.

PMID- 8350911
TI  - Fidia fall-out.

PMID- 8350912
TI  - Prospects for growth hormone turn sour.

PMID- 8350913
TI  - US doctors campaign to support rbGH.

PMID- 8350914
TI  - Varmus nominated to head NIH.

PMID- 8350916
TI  - Neurotransmission and secretion.

PMID- 8350915
TI  - Cortical space race.

PMID- 8350917
TI  - Neurotransmission and secretion.

PMID- 8350918
TI  - Function of vertebrate T gene.

PMID- 8350919
TI  - ALS, SOD and peroxynitrite.

PMID- 8350920
TI  - A possible neuronal basis for representation of acoustic scenes in auditory
      cortex of the big brown bat.
AB  - Behavioural studies and field observations demonstrate that echolocating bats
      simultaneously perceive range, direction and shape of multiple objects in the
      environment as acoustic images derived from echoes. Cortical echo delay-tuned
      neurons contribute to the perception of object range, because focal inactivation
      of these neurons disrupts behavioural discrimination of range. We report here
      that response properties of delay-tuned neurons in the cortical tonotopic area of
      the bat, Eptesicus, transform the sequential arrival times of echoes with
      different delays into a concurrent, accumulating neural representation of
      multiple objects at different ranges. The sharpness of delay tuning
      systematically increases at each best delay in a subpopulation of these neurons
      while responses to echoes at different delays are accumulated. The resulting
      concurrent, multiresolution representation of echo delay corresponds to neural
      implementation of a common representation of images used in computational vision
      and may provide the basis for representing acoustic images of multiple objects as
      acoustic 'scenes'.

PMID- 8350921
TI  - Control of cell fate in C. elegans by a GLP-1 peptide consisting primarily of
      ankyrin repeats.
AB  - The homologous proteins GLP-1 and LIN-12 are required for cell interactions
      during nematode development. glp-1 and lin-12 are members of a gene family that
      includes Drosophila Notch and several vertebrate homologues. The members of this
      family have a single transmembrane domain and a similar arrangement of repeated
      amino-acid motifs (see Fig. 1). The mechanism by which proteins in this family
      function is not understood. One hypothesis is that these proteins are receptors,
      each with an extracellular domain that binds a ligand and an intracellular domain
      that influences the activity of downstream cell fate regulators. Here we report
      that a region of the GLP-1 intracellular domain, consisting primarily of six
      ankyrin repeats, is sufficient to direct cell fate. The cell fate transformations
      seen are similar to transformations caused by gain-of-function mutations in
      either glp-1 or lin-12 and do not rely on endogenous lin-12 or glp-1 activity. We
      propose that the ankyrin repeat region of GLP-1 is responsible for controlling
      downstream regulators of cell fate.

PMID- 8350922
TI  - Ruffles induced by Salmonella and other stimuli direct macropinocytosis of
      bacteria.
AB  - Ruffles are specialized plasma membrane ultrastructures of mammalian cells though
      to be integral to growth, development and locomotion. Induced by growth factors,
      mitogens or oncogene expression, ruffles are sites of filamentous actin
      rearrangement and are temporally associated with enhanced pinocytosis. But the
      function of ruffles, their mechanism of induction and their role in pinocytosis
      are not understood. We have observed formation of structures resembling ruffles
      associated with the site of entry of invasive Salmonella typhimurium. Here we
      report that ruffles elicited by invasive Salmonella directly mediate
      internalization of non-invasive bacteria in a macropinocytotic fashion, a
      phenomenon we term 'passive entry'. Furthermore, ruffles induced in the absence
      of Salmonella also facilitate passive entry. We present evidence that ruffles,
      common to many signalling events, comprise the macropinocytotic machinery
      mediating pinocytosis and are subverted by Salmonella so as to enter mammalian
      cells.

PMID- 8350923
TI  - Positive selection of T lymphocytes on fibroblasts.
AB  - Thymocytes are selected for expression of alpha beta T-cell antigen receptors
      (TCR) which recognize antigen in conjunction with self-major histocompatibility
      complex (MHC) molecules. In the thymus the restriction element is imprinted on
      radioresistant stromal elements and on cells of haematopoietic origin. In mice
      negative for beta 2-microglobulin that are devoid of mature cytotoxic T
      lymphocytes, we find that intrathymic injection of different fibroblasts causes
      the maturation of CD4-CD8+TCRhigh thymocytes with distinct patterns of TCR V beta
      distribution. Here we show that in TCR-transgenic mice, intrathymic injection of
      L cells expressing the selecting H-2Kb molecule (L-Kb cells) reconstitutes the
      maturation of thymocytes bearing the transgenic TCR, and that in normal B10.BR (H
      2k) mice, H-2Kb molecules expressed on L-Kb cells lead to the development of T
      lymphocytes with recognition restricted to H-2Kb. A class I MHC restriction
      element can thus be selected by interaction with fibroblasts, that is, cells of
      other than epithelial or haematopoietic origin.

PMID- 8350924
TI  - A retinoblastoma-binding protein related to a negative regulator of Ras in yeast.
AB  - The growth suppression function of the retinoblastoma protein (Rb) is though to
      be mediated by Rb binding to cellular proteins. p48 is one of the major proteins
      that binds to a putative functional domain at the carboxy terminus of the Rb
      protein. Here we report the isolation of a full-length complementary DNA (RbAp48)
      encoding p48. Complex formation between p48 and Rb occurs in vitro and in vivo,
      and apparently involves direct interaction between the proteins. Like Rb, p48 is
      a ubiquitously expressed nuclear protein. RbAp48 share sequence homology with
      MSI1, a negative regulator of the Ras-cyclic AMP pathway in the yeast
      Saccharomyces cerevisiae. Furthermore, like MSI1, human RbAp48 suppresses the
      heat-shock sensitivity of the yeast ira1 strains and RAS2Val19 strains.
      Interaction with p48 may be one of the mechanisms for suppression of growth
      mediated by Rb.

PMID- 8350925
TI  - Readers respond to "Mammoscam revisited".

PMID- 8350927
TI  - Sensitivity vs. specificity.

PMID- 8350926
TI  - Readers respond to "Mammoscam revisited".

PMID- 8350929
TI  - Abstracting journal articles. A personal experience.

PMID- 8350928
TI  - Cat germs! Pleuropulmonary pasteurella infection in an old man.

PMID- 8350930
TI  - Child abuse.

PMID- 8350931
TI  - Screening for cervical cancer. Pap smears can save lives.

PMID- 8350932
TI  - Durham, City of Medicine, USA. Part 3: The City of Medicine Awards Program and
      the future.

PMID- 8350933
TI  - Doctors, lawyers, and personal injury. Separating myth from fact.

PMID- 8350934
TI  - [Spontaneous lumbar epidural abscess].

PMID- 8350935
TI  - [Increasing psychological morbidity].

PMID- 8350936
TI  - [Paraneoplastic neurological syndromes, current diagnostic possibilities using
      antibody measurements].

PMID- 8350937
TI  - [Taking blood along on travels, sense or nonsense?].

PMID- 8350938
TI  - [Percutaneous endoscopic gastrostomy].

PMID- 8350939
TI  - [Compared to whole body scanning thyroglobulin assay is reliable in the follow-up
      of thyroidectomized patients with thyroid carcinoma].
AB  - OBJECTIVE: To determine whether it is reliable to do thyroglobulin measurements
      during thyroid hormone substitution (Tg ON) alone or whether it is also necessary
      to do 131I total body scanning (TBS) and Tg measurements after withdrawal of
      thyroid hormone substitution (Tg OFF) in the follow-up of patients with
      differentiated thyroid carcinoma. DESIGN: Retrospective. SETTING: University
      Hospital Nijmegen. METHODS: 202 Patients (151 females and 51 males, mean age 50.6
      years) with differentiated thyroid carcinoma were examined in the period 1970-90.
      All patients had undergone total thyroidectomy and if necessary 131I ablation. 27
      Patients with Tg antibodies were excluded (13.4%). In 175 patients Tg OFF levels
      were compared with TBS and clinical and radiological data. In 81 of them Tg ON
      levels were also compared. RESULTS: Specificity of Tg OFF and Tg ON measurement
      was 83 and 88%. Sensitivity of Tg OFF and Tg ON measurement was 100 and 92%. In
      detecting local residual thyroid tissue Tg OFF was superior to Tg ON. In
      detecting metastases Tg OFF and Tg ON were both superior to TBS. CONCLUSION: In
      the follow-up of patients with differentiated thyroid carcinoma it is reliable to
      do Tg measurements during thyroid hormone suppression. When Tg ON is detectable
      (> 3 pmol/l) TBS and Tg OFF measurement and if necessary further investigations
      have to be performed.

PMID- 8350940
TI  - [Microalbuminuria as risk factor for nephropathy in children with insulin
      dependent diabetes mellitus].
AB  - OBJECTIVE: To assess the prevalence of microalbuminuria (> or = 30 mg/24 h) in
      children with insulin dependent diabetes mellitus (IDDM). DESIGN: Retrospective.
      SETTING: Department of Pediatrics, University Hospital, Free University of
      Amsterdam. METHODS: Albumin excretion rate was assessed in 24-hour voiding
      volumes in 71 children, mean age 11.8 yrs (range 3.5-17.9; 27 boys and 43 girls).
      Mean duration of IDDM was 5.4 yrs (1.0-5.0). Patients with albuminuria were
      compared with patients without microalbuminuria. Results of angiotensin
      converting enzyme inhibition (n = 4) are presented. RESULTS: The prevalence of
      microalbuminuria was 16% (n = 11). In 7% (n = 5) the microalbuminuria was
      persistent; in 9% (n = 6) it was intermittent. The mean age of the children with
      microalbuminuria (14.0 years; 8.9-17.4) was significantly higher than the age of
      the children without this disorder (11.7 years; 3.5-17.9). Two prepubertal
      children had developed microalbuminuria. The group with microalbuminuria had a
      significantly higher age at onset of the disease (8.1 years; 1.9-13.0) than the
      group without microalbuminuria (5.8 jaar; 0.9-14.5). The daily dose of insulin in
      the group with microalbuminuria was significantly higher (1.15 U/kg; 0.6-1.56)
      than in the group without microalbuminuria (0.97 U/kg; 0.20-1.87). There was no
      correlation between microalbuminuria and the duration of the disease. CONCLUSION:
      Microalbuminuria may exist as early as the prepuberal period, but is found more
      frequently in children with IDDM who have entered puberty. There is a correlation
      between microalbuminuria and the age which it develops, the age at onset of the
      IDDM and the daily dose of insulin. Secondary prevention of diabetic nephropathy
      with ACE inhibition appears to be possible.

PMID- 8350941
TI  - [Necrotizing fasciitis caused by Group-A beta-hemolytic streptococci].

PMID- 8350942
TI  - [Results of allogeneic bone transplantation in spondylodesis of the spine].

PMID- 8350943
TI  - Characterization of lymphokine-activated killer cells from peripheral blood and
      lymph nodes of non-Hodgkin's lymphoma patients.
AB  - Peripheral blood lymphocytes (PBL) and lymph node lymphocytes (LNL) from non
      Hodgkin's lymphoma patients were tested for LAK cell cytotoxicity using
      appropriate targets in a short-term 51chromium-release assay. The results showed
      a significant depression in LNL-LAK activity suggesting the reduced capacity of
      LNL to generate LAK cells. LNL-LAK cells demonstrated significantly low
      percentages of cells expressing CD16, CD56 and CD25 as compared to PBL-LAK of
      patients and healthy donors. The reduced capacity to generate LAK cells in lymph
      nodes could be due to the presence of low numbers of NK cells which are thought
      to be the main precursors of LAK cells. The IL-2 producing ability of lymph node
      mononuclear cells was found to be significantly higher than that of peripheral
      blood mononuclear cells from both healthy donors and NHL patients.

PMID- 8350945
TI  - Interleukin-2 production by human leukemia cell lines of pre-B cell origin.
AB  - Cells of 7 tested human leukemia cell lines of pre-B cell origin (as
      characterized by immunophenotyping and by the expression of cytoplasmic mu
      chains, but not by surface immunoglobulins) produced after stimulation with
      bacterial lipopolysaccharide (LPS) or phorbol myristate acetate (PMA) a
      lymphokine activity which supported the growth of the interleukin-2 (IL-2)
      dependent CTLL-2 cell line. Three pieces of evidence indicate that the secreted
      lymphokine was functionally and antigenically very similar, if not identical, to
      human IL-2: (1) The lymphokine supported the growth of murine IL-2-dependent CTLL
      2 cells, which did not respond to human lymphokines other than IL-2, but it did
      not stimulate the growth of murine IL-3-dependent FDC-P2 cells, (2) the
      biological activity of the lymphokine was inhibited by monoclonal antibody (mAb)
      anti-human-IL-2, and (3) the proliferation of IL-2-dependent cells in the
      presence of the active material was completely inhibited by the inclusion of the
      anti-mouse-IL-2 receptor (IL-2R) mAb. Since leukemia cells of immature B-cell
      origin also synthesize IL-2R, the human pre-B cell leukemias could represent
      another type of hematological malignancy where the autocrine processes of IL-2
      production and utilization are involved in the expansion of the disease.

PMID- 8350944
TI  - Protective role of vanadium in the survival of hosts during the growth of a
      transplantable murine lymphoma and its profound effects on the rates and patterns
      of biotransformation.
AB  - Vanadium, as ammonium mononium monovanadate, has been found to have
      anticarcinogenic effect in host mice bearing a transplantable ascitic lymphoma.
      The potentiating effect of vanadium was supported by biochemical analysis of
      autopsies relating to markers like microsomal cytochrome P-450, UDP glucuronyl
      transferase (UDPGT) and cytosolic glutathione-S-transferase (GSHT) in the hepatic
      tissue of the hosts, which showed substantial alterations in the extent of tumor
      regression as compared to their lymphoma and normal counterparts, prolonging the
      survival of the hosts.

PMID- 8350946
TI  - Characterization of ferritin from spleens of patients with Hodgkin's disease
      (HD).
AB  - Ferritin, an iron-storing protein, was isolated from disease-involved and 
      uninvolved regions of spleen biopsies obtained from patients with Hodgkin's
      disease (HD). Ferritin from all human spleen biopsies showed a major band of
      polypeptide of M(r) around 20 kDa in 1D-SDS-PAGE analysis. The corresponding
      bands for horse spleen ferritin and apoferritin (Sigma) were at a slightly lower
      M(r) level. In isoelectrofocusing (IEF) studies, the pI values of human spleen
      ferritin from the uninvolved and involved regions were 4.55 and 4.14,
      respectively. These were more acidic than that of horse spleen ferritin (4.79).
      Human spleen ferritin from the involved region also differed from that of the
      uninvolved region in the pattern of CNBr-generated peptide maps in 1D-SDS-PAGE.
      These results suggest that the presence of Hodgkin's disease in human spleen is
      associated with some physiochemical changes in the tissue ferritin.

PMID- 8350948
TI  - Importance of tumor size and repopulation for radiocurability of skin cancer.
AB  - Data on 946 skin cancers treated by radiation were used to estimate the
      importance of repopulation. Six different treatment regimes were used from a
      single dose to 74 Gy given in 47 fractions. High local control of the small skin
      cancers (L 1 cm) was independent of dose fractionation. For large tumors, only 74
      Gy in 47 fractions was the optimal treatment. Time factor analysis showed a steep
      increase in the NTD50 values between day 28 and 65 of treatment. This implies
      that tumor clonogen repopulation starts around 4 weeks of treatment. The present
      results showed a three-component dose response curve instead of the two-component
      curves which were found for head and neck and bladder cancer.

PMID- 8350947
TI  - Teratogenicity of cyclophosphamide in New Zealand white rabbits.
AB  - Pregnant rabbit does received daily oral doses of 6.2 or 18.6 mg/kg
      cyclophosphamide (CP) on days 6-20 of gestation. On day 29, shortly before term,
      the uterine content was removed by Caesarean section. At the dose of 6.2 mg/kg CP
      maternal mortality was 2/9 does and at 18.6 mg/kg CP one abortion was recorded.
      Body weight gain of pregnant females was essentially unaffected by CP treatment.
      Both doses of CP elicited significant dose-dependent decrease of fetal body,
      organ (heart, lung, liver, kidney) as well as placental weight. After treatment
      with 18.6 mg/kg CP, gross examination of fetuses revealed significantly increased
      incidence of exophthalmos, cleft palate/lip, syndactyly, and brachycardia.
      Skeletal anomalies and malformations, significantly increased after the higher CP
      dose, included sternebrae, back-bone and limb defects. Oral administration of CP
      to rabbits in the dose of 18.6 mg/kg during organogenesis resulted in pronounced
      embryotoxic and teratogenic changes.

PMID- 8350949
TI  - Estradiol receptor and prognosis in human breast cancer and its metastases.
AB  - Follow-up of 86 patients for at least 40 months confirmed age dependency of
      receptor binding capacity in primary breast tumors but not in lymph node
      metastases. In most cases receptor binding capacity was higher in lymph node
      metastases than in primary tumors. Prognosis of the disease expressed as
      percentage of patients who survived and had a disease-free interval is related to
      receptor binding capacity of the primary tumors investigated. In our
      investigation, a value of 60 fmol/mg protein seems to be a suitable cut-off value
      to distinguish between breast cancer patients with good and bad prognosis.
      Receptor levels of lymph node metastases showed a similar behaviour as those of
      primary tumors related to percentage of patients who survived, but not to disease
      free interval.

PMID- 8350950
TI  - IgD paraproteinemias.
AB  - In a series of 2038 paraproteinemic sera, 9 IgD paraproteins (0.44%) were found.
      Clinical diagnosis of all the 9 was multiple myeloma. One patient had an IgD
      lambda plasmacytoma which developed into plasmocellular leukemia. Our series of
      IgD paraproteins consisted of 6 females and 3 males with a mean age of 58.5
      years. The mean concentrations of IgD paraproteins were 6.7 +/- 4.26 g/l and the
      mean proteinuria was 5.1 +/- 4.76 g/24 h. Eight IgD paraproteins had light chains
      lambda and one had light chains kappa.

PMID- 8350951
TI  - Geographic variation of secular trends of breast cancer mortality in Spain.
AB  - Breast cancer mortality information contained in the available statistics derived
      from the Spanish death certificates has been reviewed. Mortality from breast
      neoplasms was grouped into three five-year periods: 1903-1907, 1931-1935 and 1975
      1979. Age-adjusted rates were estimated for every province (n = 49) in each
      period, and confidence intervals for the standardized mortality ratios and
      adjusted rates were calculated. Results are presented with maps of Spain that
      illustrate provincial contrasts in each period. Secular breast cancer mortality
      trends in the provinces are discussed in comparison with those of other
      countries. Furthermore, values are compared with the geographical distribution of
      risk factors, the aim being to formulate hypothesis explaining the observed
      contrasts and suggesting some future research lines.

PMID- 8350952
TI  - Modulation of leukosialin (sialophorin, CD43 antigen) on the cell surface of
      human hematopoietic cell lines induced by cytokins, retinoic acid and 1,25(OH)2
      vitamin D3.
AB  - Cell surface expression of leukosialin (sialophorin, CD43 antigen) on human
      neoplastic hematopoietic cell lines K-562, U-937, HL-60 and REH was determined
      with the aid of a new CD43 monoclonal antibody (Bra7G) by the immunochemical
      (radioimmunoprecipitation, immunoblotting) and immunocytofluorometric techniques.
      Interferon-gamma and TNF-alpha were utilized as the "physiological" inducers of
      differentiation-associated markers. The "non-physiological" inducer phorbol ester
      PMA induced down-regulation of leukosialin cell surface expression on immature
      erythroid-myeloid leukemia cell line K-562, but up-regulation of CD43 antigen on
      the promyelocyte leukemia cell line HL-60 and, to a lesser extent on the monocyte
      like U-937 and CALLA+ ALL cell line REH. Retinoic acid down-regulated leukosialin
      on both U-937 monocyte-like cells and the CALLA+ ALL cell line REH. In contrast
      to these data, interferon-gamma, TNF-alpha, retinoic acid and 1,25(OH)2-vitamin
      D3 induced the up-regulation of leukosialin in a promyelocytic leukemia cell line
      HL-60.

PMID- 8350953
TI  - Ceftriaxone versus ceftazidime plus aminoglycoside therapy for infections in
      patients with neutropenia after cytotoxic chemotherapy. Short communication.
AB  - One hundred and one patients undergoing anticancer chemotherapy due to
      hematologic malignancy were retrospectively divided into two groups: 67 patients
      were treated with ceftriaxone plus amikacin, receiving once daily (od) 2-4 g
      ceftriaxone, 1-1.5 g amikacin (those without a peripheral or central venous
      catheter) and 34 patients with central or peripheral venous catheter (CPVC)
      receiving ceftizidime 2 g three times daily (tid) plus amikacin 0.5 g tid i.v.
      Both groups were similar as to their isolated pathogens, localization of
      infection, and basic diagnoses of hematologic malignancies. There was no
      significant difference in efficacy between ceftriaxone plus amikacin versus
      ceftazidime plus amikacin, but the toxicity was lower in once daily ceftriaxone
      plus amikacin group.

PMID- 8350954
TI  - Erythrocyte glutathione peroxidase in patients with colon cancer.
AB  - Erythrocyte activity of glutathione peroxidase (GSH-Px) was measured in 26
      patients with colon cancer and in 26 sex, age, height and weight matched
      controls. The patient group had a lower mean GSH-Px activity than the control
      group (p < 0.001). No correlation was found between glutathione peroxidase
      activity and sex, age, height, or weight, or between glutathione peroxidase
      activity and duration of the disease. The inverse correlation between the
      activity of this enzyme and the extent of the disease may be caused by a
      decreased absorption of selenium from the diseased colon. The significance of
      decreased GSH-Px in patients with this disease is unknown, but the possibility
      exists that this may further increase their risk of developing colonic cancer.

PMID- 8350955
TI  - Blood transfusion and survival after surgery for stage I and II breast cancer.
AB  - The records of 690 Stage I and II breast cancer patients (31% of them with
      transfusions), who underwent mastectomy with axillary dissection were examined
      whether perioperative blood transfusion might be detrimental to survival. The
      overall 5- and 10-year survival rates for 477 patients who had not received
      transfusions were 75% and 63% respectively, compared with 66% and 49% for those
      who had transfusions (p = 0.005). There was no significant difference between the
      groups in any other of the most important prognostic factors. An analysis of the
      subpopulation of patients with favorable prognostic factors yielded similar
      results. A multivariate analysis indicated that blood transfusion was one of the
      four variables significantly related to survival.

PMID- 8350957
TI  - Long-term results in hairy cell leukemia treated by splenectomy.
AB  - Splenectomy as a therapeutic modality has been evaluated in a group of 24
      consecutive patients. Before and after splenectomy only supportive therapy was
      applied with the exception of two patients in whom corticosteroids were
      administered because of vasculitis. Radiation therapy was applied in one patient
      because of massive retroperitoneal lymphadenopathy. One patient received Leukeran
      shortly before the fatal outcome because his response to splenectomy was poor.
      Out of 24 patients 14 patients died. The median survival for the partial
      responders and non-responders was 6 months only. Patients with a complete
      response did not reach median survival yet and 8 of them (33% of the whole group)
      have been alive for more than 9 years, one patient for more than 20 years. Two
      distinct groups of patients with respect to the outcome of splenectomy can be
      distinguished: The first group is characterized by a rapid fatal outcome mostly
      within two years after splenectomy, the second group has a more favorable course
      with a plateau and only occasional deaths after the fourth year.

PMID- 8350956
TI  - Estrogen and progesterone receptor status in breast cancer in Kuwait female
      population.
AB  - The levels cytosol estrogen (ERc) and progesterone (PRc) receptors were
      determined in 315 primary breast cancers of female Arab patients aged 23-80
      years. Most of breast cancers (78%) occurred in women aged 21-50 years, and only
      22% were in women aged 51-80 years. Breast cancers containing ERc and PRc
      concentrations in the range 5-50 fmol/mg of cytosol protein (mg c.p.) were found
      with similar frequency in women aged under or over 50 years (53% for ERc and 43%
      for PRc, respectively). On the other hand, breast cancers with ERc values of > 50
      and > 100 fmol/mg c.p. were twice as frequent in women aged over 50 years as in
      women aged under 50 years. The frequency of breast cancers with PRc level of over
      50 fmol/mg c.p. in women aged over 50 years was only half that in those aged
      under 50 years. In breast cancers of Kuwait Arab women the higher values of ERc
      (> 100 fmol/mg c.p.) and PRc (> 50 fmol/mg c.p.) were less frequent than in other
      populations reported in literature. The low frequency of breast cancer in
      postmenopausal Kuwait women is associated with low proportions of tumors with
      higher ERc and PRc contents. In contrast to this, data from literature indicate
      that in the North Western European and American populations the postmenopausal
      incidence rise of breast cancers is associated with increased proportions of
      tumors with higher ERc and PRc levels.

PMID- 8350958
TI  - Regulatory role of T lymphocytes and NK cells in tumor allograft development.
AB  - In the present study, the respective roles of T cells and their subpopulations as
      well as of NK (natural killer) cells in antitumor immune responses were followed
      using the SaI (H-2a) allograft model. The development of this tumor in B10 (H-2b)
      mice was evaluated after pretreatment of the recipients with xenogeneic
      antithymocyte serum (ATS). Anti-Thy 1.2, anti-Lyt 2.2 and anti-L3T4 monoclonal
      antibodies were used in order to determine T lymphocyte phenotypes and to assess
      the frequency of TC/S and TH subpopulations at various periods of tumor
      development. Rabbit polyclonal anti-asialo GM1 antiserum was used for the
      identification of NK cells. In a previous work it was suggested that the first
      week following transplantation, the cells predominantly involved in the growth
      regulation of SaI belong to the TS subclass. Our results based on the use of anti
      Lyt 2.2 monoclonal antibodies have further supported this finding. The
      application of anti-Thy 1.2 on the 3rd and 5th day has hampered a secondary tumor
      growth while anti-Lyt 2.2 was effective when given on day 5. The depletion of
      Lyt. 2.2+ cells on day 3 resulted in the inhibition of both primary and secondary
      tumor development. On the other hand, when anti-Thy 1.2 was applied on day 7
      after transplantation, the primary and secondary tumor growth was strikingly
      enhanced. It appears that Thy 1.2+ lymphocytes display at this period effector
      functions and contribute, in conjunction with macrophages, to subsequent tumor
      regression. The depletion of L3T4 cells on days 3 and 5 after tumor inoculation
      has resulted in primary tumor growth enhancement. This suggests that cells of the
      L3T4+ phenotype display at this time helper functions contributing to CTL
      proliferation and maturation. A further indication, supporting the possible
      suppressor effect of L3T4+ cells, counts from the finding that anti-L3T4
      treatment results in an inhibition of secondary tumor growth. The anti-asialo GM1
      treatment has not enhanced, at least significantly, primary tumor development but
      has partially or totally inhibited the growth of secondary tumors. It appears
      that cells of the GM1+ (NK cells) phenotype do not participate in any substantial
      way in the early phases of SaI tumor development in ATS treated allogeneic
      recipients.

PMID- 8350959
TI  - Stage dependence of NK cell activity and its modulation by interleukin 2 in
      patients with breast cancer.
AB  - NK cell activity was evaluated in breast cancer patients with different clinical
      stages of disease prior to surgery. In 58 patients with Stages I-III of breast
      cancer the peripheral blood NK cell activity was significantly reduced as
      compared to controls, and NK activity of 11 patients with Stage IV and metastases
      was significantly reduced as compared to both controls and patients with
      locoregional disease. In vitro treatment of peripheral blood lymphocytes (PBL) in
      medium with 10% fetal bovine serum (FBS) alone significantly increased NK cell
      activity in patients with Stages I-III and Stage IV of disease, although the
      level of NK cell activity of patients with Stage IV remained below that for less
      advanced disease. In vitro treatment of PBL of some Stages I-III patients (n =
      41) with interleukin 2 (IL 2) gave a significant, dose-dependent enhancement of
      their NK cell activity so that it was significantly higher than basic NK activity
      of healthy controls. The results showed decrease of NK cell activity in breast
      cancer patients especially in advanced disease and enhancement with IL 2
      indicating the possibility of immunotherapy in this neoplasm.

PMID- 8350960
TI  - Circulating immune complexes in Hodgkin's disease. Reactivity of IgG isolated
      from circulating immune complexes.
AB  - In our earlier report on circulating immune complexes (CIC) from sera of patients
      with Hodgkin's disease (HD), we demonstrated disease-associated increase in the
      intensity of a 40kD (pl 5.6) polypeptide in the CIC. In extension of these
      investigations, we now report that the 40kD moiety exists in CIC as a complex
      with IgG, and that IgG isolated from such CIC samples from sera of patients with
      HD shows preferential reactivity with the typical large binucleate Reed-Sternberg
      (R-S) cells in the sections of disease-involved lymph nodes from HD patients.

PMID- 8350961
TI  - Expression of p43 associated placental isoferritin (PLF) correlates inversely
      with cell growth in breast cancer cell lines MCF-7 and T47-D.
AB  - We have previously demonstrated that the expression of the recently described
      immunosuppressive antigen p43 in breast cancer patients correlates with early
      stages of the disease and a low degree of proliferation of the tumors. Attempts
      were made to evaluate the expression of p43 in two breast cancer cell lines (MCF
      7 and T47-D) stimulated to proliferation by 17-beta estradiol and fetal bovine
      serum (FBS). p43 expression was determined by RIA technique using the new
      monoclonal antibody CM-H-9, the rate of proliferation was assessed by
      [3H]thymidine incorporation during 72 hours of incubation. Induction of
      proliferation by addition of 17-beta estradiol and FBS to serum-free tissue
      culture medium correlated with a decrease of p43 synthesis in both cell lines.
      The level of p43 expression in nonstimulated cells was low in comparison to that
      in cells cultivated routinely (15% FBS, no estrogen). However, the drop of p43
      synthesis was significantly stronger in cell lines with estrogen stimulated
      proliferation. Our in vitro results confirmed previous clinical observations
      describing an inverse correlation between p43 synthesis and degree of
      proliferation and differentiation in breast cancer for the first time. However,
      the pathologic mechanisms leading to this phenomenon need to be elucidated.

PMID- 8350962
TI  - In vitro cytotoxicity and mode of action of 1-alkylpyrrolidine N-oxides.
AB  - A new class of nonaromatic amine oxides was synthesized and tested for cytotoxic
      activity in vitro. The aim of this study was to find if there is any correlation
      between the cytotoxic activity of the investigated 1-alkylpyrrolidine N-oxides
      and their structure (as a structural parameter the number of carbon atoms m in
      the alkyl chain was used). Maximum activity was achieved with 1
      tetradecylpyrrolidine N-oxide (C14) which was chosen for further biochemical
      studies. Further lengthening led to decrease in activity. The drug inhibited the
      incorporation rate of [14C] precursors (adenine, thymidine, uridine, valine) into
      appropriate macromolecules of Ehrlich ascites cells, the extent of inhibition
      being dependent on both time and concentration of the compound in the incubation
      medium.

PMID- 8350963
TI  - Effects of daunomycin and its macromolecular analog daunophilin on the
      proliferation of mammalian cells.
AB  - Effects of daunomycin and daunomycin bound to an HPMA copolymer (daunophilin) on
      the proliferation of mammalian cells cultivated in vitro were compared. One line
      of non-tumor cells (LEP human cells) and two tumor cell lines (human HeLa cells
      and C6 rat cells) were used. It was found that both daunomycin and daunophilin
      had an inhibitory effect on the proliferation of the three cell lines and that
      the effect was irreversible. Daunophilin had to be used in concentrations by two
      orders of magnitude higher (> 1 micrograms/ml) than daunomycin (> 0.01
      micrograms/ml) to produce comparable effect on cell growth.

PMID- 8350964
TI  - Involvement of NOR-bearing chromosome in Rb-fusion: evidence from an in vivo
      murine sarcoma cell line.
AB  - The involvement of NOR-bearing chromosome in the formation of two stable and
      transmissible Robertsonian markers is reported in ascitic form of mouse Sarcoma
      180 (S180) adapted in vivo to outbred strain of Swiss albino mice. The
      chromosomes involved in Robertsonian fusion included t(8;12) and t(16;17).

PMID- 8350965
TI  - Correlation of steroid receptors in synchronous tissues with survival in breast
      cancer patients.
AB  - Estrogen and progesterone receptors (ER and PR) were estimated in 129 synchronous
      (primary and metastatic lymph node) breast cancer tissues, of which 40% were
      premenopausal and 60% were postmenopausal. ER and PR accordance was seen in 68%
      and 70% patients, and ER and PR discordance was seen in 32% and 30%,
      respectively. The mean level of ER in patients having ER accordance was higher in
      responders than in nonresponders. In patients having steroid receptors in
      accordance, there was a trend towards gain of receptors (type II) in responders,
      and loss of receptors (type I) in nonresponders. In ER discordant cases 48% were
      of type I while in PR discordant cases 46% were of type I. In postmenopausal
      patients, survival was lower in patients showing accordance than in those showing
      discordance. In nonresponders showing loss of receptors in lymph node, the
      survival was shorter than in those who showed gain of receptors in lymph node. No
      such trend was seen in premenopausal patients. Our study suggests that in
      postmenopausal patients, survival was better related to ER accordance than ER
      discordance and PR accordance or discordance. However, a larger patient series is
      needed for confirmation.

PMID- 8350966
TI  - ROC analysis of benefit and limitation in radiotherapy for cancer of the oral
      cavity.
AB  - The ROC analysis of optimalization of radiation treatment of cancer of the oral
      cavity was carried out. Material of 210 patients with squamous cell carcinoma
      (SCC) of the oral cavity was included into the study. Based on dose-response
      curves for tumor and late mucosal reactions, iso-utility curves and optimal k
      values were estimated. Optimal k values decreased from 0.792 to 0.584 with
      extension of overall treatment time from 35 to 49 days. It may suggest that the
      planning of additional dose to compensate tumor clonogens repopulation during
      prolonged treatment time does not improve therapeutic gain in radiotherapy for
      cancer of the oral cavity. The ROC is a useful model to estimate optimal
      radiation treatment for a given tumor because it is independent of any arbitrary
      consensus or theoretical assumption.

PMID- 8350967
TI  - Effectiveness of moderate dose combination chemotherapy in Burkitt's lymphoma.
AB  - Twenty-five evaluable pediatric patients with histologically proven Burkitt's
      lymphoma were treated with moderate dose combination chemotherapy consisting of
      cyclophosphamide, vincristine, methotrexate and cytosine arabinoside (COMA
      regime) without central nervous system prophylaxis. Complete remission was
      achieved in 94.1% (16/17) of patients with Stage I, I R, II and III A disease,
      with disease-free survival of more than 3 years. This protocol was attended by
      minimal chemotherapeutic toxicity. This combination chemotherapy was ineffective
      in more advanced disease (Stages III B, IV), major cause of failure being
      progressive disease with central nervous system involvement. This study showed
      the effectiveness of moderate dose chemotherapy without CNS prophylaxis in early
      stage Burkitt's lymphoma including Stage III A and needs for aggressive
      chemotherapy with CNS prophylaxis in more advanced disease.

PMID- 8350968
TI  - Role of sputum cytology in the diagnosis of mediastinal germ cell tumor.
AB  - A rare case of germ cell tumor of the mediastinum infiltrating the lung and
      metastasizing to the supraclavicular lymph node in a 25-year-old male is
      presented. The patient presented with a history of superior vena cava syndrome
      and chest roentgenograms revealed an abnormal mediastinum. Primary positive
      diagnosis was made cytologically on sputum specimens. The peculiar cell type
      found in the Papanicolaou stained sputum smears were correlated with fine needle
      aspiration cytology of lung and lymph node, and confirmed the histologic pattern
      of the tumor metastasizing to the lymph node. To our knowledge, the present case
      is the first report of a primary mediastinal seminoma (germinoma) infiltrating
      the lung and diagnosed by sputum cytology. These results suggest the usefulness
      of sputum examination as an adjunctive diagnostic procedure in the detection of
      patients with possible lung infiltrated germinal neoplasms.

PMID- 8350969
TI  - Cigarette smoke exposure of school children: effect of passive smoking and
      vitamin E supplementation on blood antioxidant status.
AB  - Despite similar vitamin E concentrations, erythrocytes of 25 children of smoking
      parents had an increased tendency (p < 0.01) to peroxidize in vitro as compared
      with those of 28 children of nonsmoking parents. This difference was abolished by
      vitamin E supplementation (100 mg alpha-tocopherol acetate/day for 14 days). The
      increased susceptibility to erythrocyte peroxidation in the smokers may reflect
      lower erythrocyte glucose-6-phosphate dehydrogenase, glutathione peroxidase and
      superoxide dismutase activities (p < 0.001, p < 0.005, and p < 0.02,
      respectively) in children of smoking parents. Children of smoking parents seem to
      be under sustained oxidant stress with increased plasma-conjugated dienes (p <
      0.01) and dehydroascorbate (p < 0.002) concentrations. Total plasma cholesterol
      was similar in children of smoking and nonsmoking parents, and was unaffected by
      vitamin E supplementation. Indices of sustained oxidant stress in children of
      smoking parents were partially ameliorated by vitamin E supplementation.

PMID- 8350970
TI  - [Photoablation using Excimer laser irradiation--a suitable concept for
      microneurosurgery?].
AB  - The suitability of Excimer laser beam for microneurosurgery was investigated in
      an animal experimental study. Cranial bones, cortex and the nervus ischiadicus of
      the rat were irradiated with 193 nm argon fluoride, 248 nm krypton fluoride, 308
      nm xenon chloride and 351 nm xenon fluoride. After survival times of up to 30
      days microscopic and electron optic findings of laser lesions at the tissues
      mentioned above, were studied. By means of the Excimer laser beam high precision
      tissue effects without or with only low thermal damage to the surrounding tissue
      were produced with any desired depth of penetration or extension. In analogy with
      the experiences gathered from animal experiments, a possible use is discussed for
      the removal of bone tissue around cranial nerves or vascular structures, of
      epileptogenic foci, or for cutting off pathways in pain surgery (e.g. the zone of
      entry of the dorsal root of spinal nerves).

PMID- 8350971
TI  - [The prognostic value of AEP and SEP values in subarachnoid hemorrhage. An
      analysis of 64 patients].
AB  - In 64 patients with confirmed subarachnoid haemorrhage the clinical grading
      according to Hunt and Hess was compared to the initial findings of BAEP und SEP
      to elicit possible prognostic statements. Clinical and electrodiagnostic findings
      showed a high correlation. Patients without or with only slight alterations of
      amplitude and/or latency generally showed a favourable course. Recurrent
      haemorrhages or internal complications which can be decisive for outcome cannot
      be predicted by clinical or electrodiagnostic findings. The alterations of BAEP
      and SEP increase parallel to severity of clinical findings. Bilateral loss of
      BAEP or SEP indicates poor prognosis. Prognostic statements can be made with
      certainty only in cases with primary poor clinical condition (Hunt-Hess Grade IV
      V) and marked alterations of evoked potentials.

PMID- 8350973
TI  - [Embolization of cerebral arteriovenous malformations--methods and clinical
      results].
AB  - Interventional treatment by neuroradiological embolisation of cerebral
      arteriovenous angiomas has become an alternative to surgical exstirpation
      especially in problematic localisations and large-size malformations. Clinical
      results showing a marked reduction in attacks and recurrent haemorrhages, evident
      from a three-year report on 17 patients, confirm the value of the method even in
      case of only subtotal occlusion of the malformation.

PMID- 8350972
TI  - [Fiberoptic intubation of neurosurgical patients].
AB  - Patients with cervical spine injury presenting with respiratory distress require
      airway management that does not compromise integrity of the atlanto-occipital
      joint. Endotracheal intubation by means of direct laryngoscopy is not suitable.
      The method of choice is nasotracheal intubation of the awake patient, using a
      flexible fibre bronchoscope. If anatomy or surgical access render the nasal
      approach impossible, fibre optic intubation can be performed orotracheally,
      utilising specific technical aids. Flexible fibrescopes are available in
      different sizes (length and diameter): selection is base on the patient's
      anatomical requirements. Aids to orotracheal intubation are constructed with a
      bore wide enough to accommodate an endotracheal tube, and a face mask equipped
      with an extra intubation port allowing introduction of an endotracheal tube,
      slipped over a fibrescope. Premedication of the patients consists of an orally
      administered benzodiazepine. Topical anaesthesia and vasoconstriction of the
      nasal passages are achieved by cocaine (5-10%), or a local anaesthetic, combined
      with a vasoconstrictor. The selected nostril is prepared by means of introducing
      a nasopharyngeal airway, which--lubricated with xylocaine gel and left in place
      for few minutes--widens the nostril and facilitates passage of the endotracheal
      tube. Through the other nostril, oxygen is administered. Systemic analgo-sedation
      is strictly limited to fentanyl, 0.1 mg i.v. Topical anaesthesia of the larynx
      and cranial trachea is achieved by xylocaine, 2%, administered under direct
      vision through the instrumentation channel of the fibrescope.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8350974
TI  - Three-dimensional videomonitor in microsurgery.
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 a 3-dimensional (3D) converter. The operator can
      observe the 3D images of the operation field on a TV monitor 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 monitoring system for
      microsurgery.

PMID- 8350975
TI  - [Solitary intracranial late metastasis of a granulosa cell tumor of the ovary.
      Case report and review of the literature].
AB  - A 75-year old patient was admitted to hospital in June 1989. She was suffering
      from headache since three months. In the neurological examination a mild
      hemiparesis on the left side, personal changes and apractic disturbances could be
      found. 10 years before a granulosa-cell tumour of the left ovary was extirpated,
      postoperatively the patient received radiation and polychemotherapy. CT-scan and
      MRI of the head showed a tumour parieto-occipital on the right hemisphere with
      multiple cystic and solid areas. The tumour was extirpated in toto. The
      postoperative course was uneventful. Primary tumour of the left ovary and
      intracranial metastasis showed the same histological findings.

PMID- 8350976
TI  - Lumbar radiculopathy caused by a lost silverclip.
AB  - The case of an adult patient with lumbar radiculopathy (L:4) caused by a migrated
      silverclip, which was probably lost during the successful extirpation of a
      cerebellar tumor many years before is presented. The clip was removed surgically
      and the nerve root was submitted to a partial neurolysis. Increased tension in
      the root due to corrosion of the clip and scar formation is the proposed
      pathophysiological mechanism in this case.

PMID- 8350977
TI  - [An unusual case of a blow-out fracture. Entrance of a bone fragment into the
      frontal lobe after a ski accident].
AB  - Due to a ski accident a 16-year old girl suffered from headache, periorbital
      hematoma and ptosis of the right eyelid. No penetrating injury could be seen, but
      in the CT scan a blow-out fracture of the orbital roof and floor was verified.
      Since there was no evident lesion of the eye muscles, an operative indication
      could only be a neurosurgical one. Because of the traumatic connection between
      frontal cerebrum and sinus maxillaris we expected a CSF rhinorrhoea, which could
      not be confirmed.

PMID- 8350978
TI  - Current bibliographies of neuropeptides prepared by The University of Sheffield
      Biomedical Information Service.

PMID- 8350979
TI  - Immunocytochemistry of sequence-related neuropeptides in Drosophila.
AB  - Based on structure, activity, and expression, the Drosophila drosulfakinin I
      peptide (DSK I; FDDY(OSO3H)GHMRFamide) is similar to the vertebrate peptide,
      cholecystokinin. Dromyosuppressin (DMS; TDVDHVFLRFamide) is an abundant peptide
      isolated from adult Drosophila which shares a high degree of sequence homology
      with peptides isolated from chicken, cockroach, fleshfly, and locust. DSK I and
      DMS, encoded by different precursors, have similar expression patterns in larval
      brain tissue; each localizes to cells in the anterior and medial protocerebrum.
      Because of the precedence for coexistence of neural messengers, it was of
      interest to determine the cellular expression patterns relative to one another.
      The question of whether the two peptides were expressed in the same cells was
      resolved using an immunofluorescent double-labeling technique developed for
      sequence-specific antisera raised in separate animals of the same species. Double
      labeling was done using a combination of indirect and direct immunofluorescence.
      DSK I and DMS were shown to localize to different cells in close proximity to one
      another in the larval brain. The non-overlapping expression patterns of these
      peptides illustrate the complete lack of cross-staining with this technique.

PMID- 8350980
TI  - Interleukin-1 beta measured by radioimmunoassay in the rat spleen and thymus is
      increased during chronic inflammatory stress.
AB  - We have developed an extraction method and radioimmunoassay for the measurement
      of interleukin-1 beta (IL-1 beta) in rat tissues, using an antibody specific for
      IL-1 beta, IL-1 beta was detected in the spleen and thymus of control rats.
      Adrenalectomy (ADX) had no effect upon control levels of IL-1 beta. In animals
      with adjuvant-induced arthritis, IL-1 beta content in the spleen and thymus
      increased after 14 days. These increases in tissue IL-1 beta contents were not
      evident in ADX arthritic animals. We conclude that IL-1 beta synthesis is
      stimulated in tissues of the immune system following the development of adjuvant
      induced arthritis. Failure to observe elevated levels of tissue IL-1 beta in ADX
      arthritic rats may be evidence for tissue depletion due to increased IL-1 beta
      release in the absence of circulating corticosteroids.

PMID- 8350981
TI  - Partial reconstruction of the adult Lurcher cerebellar circuitry by neural
      grafting.
AB  - Solid cerebellar grafts, taken from normal mouse embryos (gestational day 12-14),
      were transplanted into the cerebellum of adult Lurcher mice. The degree of
      Purkinje cell replacement was analysed one to three months after transplantation
      by means of immunocytochemistry (antibodies against calbindin, cGMP-dependent
      protein kinase and neurofilament proteins) and electron microscopy. Grafted
      Purkinje cells succeed in moving out of the graft and migrate into the host
      cerebellar cortex. They are present next to the graft in the granule cell and
      molecular layers, and far from the graft remnant, only in the molecular layer,
      indicating that, although both layers subserve Purkinje cell migration, the
      molecular layer is the ultimate target. In the host molecular layer, axons of
      transplanted Purkinje cells form thick bundles running in the frontal plane over
      long distances. Most of them terminate in the upper granule cell layer by
      enlarged bulbs resembling collapsed growth cones. Axons reaching their normal
      targets (the neurons of the deep cerebellar nuclei) are observed only in cases
      where the granule cell layer is disrupted and/or grafted Purkinje cells remain in
      the white matter. The projection is massive only from grafts lying in the close
      vicinity of the target neurons. Electron-microscopic analysis of grafted Purkinje
      cells populating the host cerebellar cortex reveals that their synaptic
      investment is abnormal. In the molecular layer, where the normal inputs are
      reduced, the compartmentation in proximal and distal dendritic segments is
      severely affected, climbing fibre synapses only form on a minority of grafted
      cells and "pinceau" formations are absent. In the granule cell layer, the
      synaptic investment is similar to that of Purkinje cells in agranular cerebellum,
      and even heterelogous synapses with mossy fibres have been observed. These
      results, compared to those previously obtained with grafting experiments in
      Purkinje cell degeneration mutant mouse, allow us to conclude that: (i) the
      Purkinje cell-deficient molecular layer of the host, despite its severe atrophy
      and reactive gliosis, still exerts a positive neurotropism specific for grafted
      Purkinje cells; (ii) the unlesioned host granule cell layer underlying the
      molecular layer containing grafted Purkinje cells, even if almost depleted of
      granule cells, remains an obstacle for the re-establishment of a corticonuclear
      projection; and (iii) the degree of synaptic integration of grafted Purkinje
      cells is directly related to the nearby presence of available host axon
      terminals. Hence, owing to the atrophy of the Lurcher cerebellum, the
      postgrafting restoration of the cerebellar cortical circuit is much less complete
      in this mutant.

PMID- 8350982
TI  - Hippocampal localization of 5'-nucleotidase as revealed by immunocytochemistry.
AB  - The distribution of binding sites for an antibody against ecto-5'-nucleotidase
      was investigated in the mouse hippocampus by light microscopical
      immunocytochemistry. The antibody selectively labels a band corresponding to the
      innervation area of mossy fibre terminals within area CA3. Area CA1 as well as
      the dendate gyrus are negative. In area CA3 only the proximal but not the distal
      parts of the apical dendrites of pyramidal cells are labelled. Labelling is in
      the form of large dots around dendrites of pyramidal cells suggesting that mossy
      fibre terminals are immunopositive. In contrast, an antibody against the
      ubiquitous synaptic vesicle protein SV2 labels the large mossy fibre terminals as
      well as fine and punctate structures in the dendritic and somatic regions
      throughout the hippocampus. Labelled astrocytes can be found in the entire
      hippocampus and are frequent in the stratum radiatum and stratum oriens of the
      CA1 region. Immunopositive astrocytic processes can be found in association with
      capillary walls. Our results suggest that ecto-5'-nucleotidase may play a crucial
      role in the hydrolysis of AMP to adenosine at the mossy fibre synapses. Thus, at
      these synapses, 5'-nucleotidases could function both in completing the
      extracellular hydrolysis of synaptically released ATP as well as in the
      extracellular formation of adenosine.

PMID- 8350983
TI  - Localization of dynamin: widespread distribution in mature neurons and
      association with membranous organelles.
AB  - Tissue distribution and intracellular localization of dynamin by immunoblotting
      and immunocytochemistry is investigated in this study. Dynamin was widely
      expressed in all the neurons we examined, and was especially abundant in the
      central nervous system after maturation, although its expression presented
      regional heterogeneity. Dynamin was present most abundantly in cerebellar
      Purkinje cells and hippocampal pyramidal cells, and to a lesser extent in motor
      neurons and peripheral nerves. However, dynamin was nearly absent in cells such
      as anterior pituitary cells and adrenal medullary cells which secrete mainly
      dense cored vesicles. Dynamin was localized not only in cell bodies, axons, and
      synapses but also in dendrites. Subcellular fractionation indicated that dynamin
      existed in the membrane fraction as well as in the soluble fraction. In ligated
      peripheral nerves, dynamin colocalized with tubulovesicular membranous organelles
      transported mainly anterogradely. By transfection of dynamin cDNA into mouse
      fibroblast L-cells, we showed it colocalized with some membranous organelles but
      not with microtubules. Our results show that dynamin is associated with
      membranous organelles in vivo, although a certain amount of dynamin also exists
      in the soluble fraction and is distributed diffusely throughout mature neurons.
      The data suggest that dynamin's fundamental role involves membrane trafficking in
      neurons in the central nervous system rather than in sliding microtubules as a
      motor protein.

PMID- 8350984
TI  - Ionic mechanisms underlying the depolarizing and hyperpolarizing afterpotentials
      of single spike in guinea-pig cingulate cortical neurons.
AB  - Intracellular recordings and hybrid single-microelectrode voltage-clamp
      techniques were used to study the ionic mechanisms underlying the
      afterdepolarization and the subsequent slow afterhyperpolarization that followed
      a single action potential in layers V/VI neurons of the guinea-pig anterior
      cingulate cortex in in vitro slices. Both the afterdepolarization and
      afterhyperpolarization were markedly suppressed in size by addition of Co2+ or
      Cd2+, reduction in extracellular Ca2+, and intracellular EGTA injection. On the
      other hand, elevation of extracellular Ca2+ concentration augmented the
      amplitudes of the afterpotentials. The afterdepolarization amplitude was
      selectively depressed by the stilbene derivatives, 4-acetamido-4'
      isothiocyanatostilbene-2,2'-disulphonate, disodium 3H2O, and 4,4'
      diisothiocyanatostilbene-2,2'-disulphonic acid, disodium salt. Reduction in
      external Cl- and intracellular Cl- injection enhanced the afterdepolarization
      amplitude without affecting the afterhyperpolarization. The null potentials for
      the afterdepolarizations recorded with K acetate- and Cs acetate-electrodes were 
      68 and -63 mV, respectively. The slope of the null potential obtained with K
      acetate electrodes or Cs acetate electrodes was 49 and 53 mV, respectively, per
      log unit of the external Cl- concentration. Reduction in external K+ markedly
      depressed the afterdepolarization and augmented the afterhyperpolarization in
      size, whereas rise in external K+ markedly augmented the afterdepolarization and
      depressed the afterhyperpolarization. The null potential for the
      afterhyperpolarization recorded with K acetate electrodes was -94 mV. The slope
      of the null potential was 57 mV per log unit of the external K+ concentration.
      Reduction in extracellular Na+ concentration slightly depressed both the
      amplitudes of the afterdepolarization and afterhyperpolarization. A hybrid
      voltage-clamp analysis revealed a slow decaying inward current and a subsequent
      outward current that followed an action potential. Both the amplitudes of the
      inward current corresponding to afterdepolarization and the outward current
      corresponding to afterhyperpolarization were suppressed by addition of Co2+.
      Reduction in extracellular Cl- concentration augmented the inward current
      amplitude without significantly affecting the outward current. These results
      indicate that the afterdepolarization is mainly due to an increase in a Ca(2+)
      activated Cl- conductance, while the afterhyperpolarization is mainly generated
      by an activation of Ca(2+)-mediated K+ conductance.

PMID- 8350985
TI  - Preferential expression of superoxide dismutase messenger RNA in melanized
      neurons in human mesencephalon.
AB  - The copper-zinc-dependent superoxide dismutase messenger RNA expression was
      studied at cellular level by in situ hybridization, using a 35S-labelled
      complementary DNA probe homologous to human copper-zinc-dependent superoxide
      dismutase messenger RNA, in the dopaminergic neuron-containing areas of the human
      mesencephalon (the substantia nigra pars compacta, ventral tegmental area,
      central gray substance and peri- and retrorubral region corresponding to
      catecholaminergic cell group A8). The autoradiographic labelling signal was
      localized in neurons. No detectable hybridization signal could be found in the
      glial cells. Copper-zinc-dependent superoxide dismutase messenger RNA was
      detected in melanin-containing neurons as well as in non-melanized neurons.
      Quantification at cellular level, taking the autoradiographic silver grain
      density as an index of the abundance of copper-zinc-dependent superoxide
      dismutase messenger RNA, indicated that hybridization level was higher in the
      melanized than in the non-melanized neurons within a region. Among melanized
      neurons, cellular copper-zinc-dependent superoxide dismutase messenger RNA
      content was lowest in the neurons of the substantia nigra. No significant
      difference in levels of transcripts was evidenced between the groups of non
      melanized neurons. The data suggest that the abundance of copper-zinc-dependent
      superoxide dismutase messenger RNA is higher in the mesencephalic neurons
      containing neuromelanin compared to other neurons. Thus, the melanized neurons
      have a particular defence system against oxygen toxicity, which may represent a
      basis for their preferential vulnerability to Parkinson's disease.

PMID- 8350987
TI  - Serotonergic innervation of the mature and developing lateral septum of the rat:
      a light and electron microscopic immunocytochemical analysis.
AB  - The serotonergic innervation of the adult and developing lateral septum of the
      rat was studied with immunocytochemical techniques at the light and electron
      microscopic levels. A few, relatively thick serotonergic fibres are found in the
      lateral septum at the time of birth, but they are restricted to its medial part.
      They subsequently extend towards the lateral ventricle, increase in number and
      attain their final distribution pattern by the end of the first postnatal week.
      Thereafter they become finer, with regularly spaced varicosities, show a higher
      density, and generally exhibit features, density, and pattern of innervation
      comparable to the adult at the end of the third postnatal week. In the dorsal
      portion of the lateral septum, serotonergic fibres form characteristic
      pericellular basket-like arrangements around cell somata and their primary
      dendrites. These baskets are first observed at P7, and subsequently increase both
      in number and in terms of the number of serotonergic terminals which they
      comprise. The present findings suggest that the development of serotonergic
      innervation of the lateral septum parallels the neuronal differentiation in this
      area. Ultrastructural analysis has shown that the vast majority (congruent to
      95%) of serotonin varicosities make symmetrical synapses with somata, dendritic
      shafts and spines. These varicosities in new-born animals are in close
      association with neuronal elements, without any intervening neuroglial processes,
      but towards the end of the first postnatal week they exhibit well-defined
      synaptic specializations. The mean diameter of serotonergic varicosities making
      synapses does not change substantially with age. Serotonin-receptive neurons have
      several morphological features in common with the type I cells described in a
      previous Golgi study of the lateral septum [Alonso and Frotscher (1989) J. comp.
      Neurol. 286, 472-487]. Some speculations on the chemical identity of the
      serotonin-receptive cells have been put forward in the present study but double
      labelling studies will certainly shed more light on the organization of the
      serotonergic innervation of the lateral septum.

PMID- 8350986
TI  - Characterization of human brain kynurenine aminotransferases using [3H]kynurenine
      as a substrate.
AB  - The brain metabolite kynurenic acid is an established broad-spectrum antagonist
      at ionotropic excitatory amino acid receptors. In the human brain, two distinct
      enzymes are capable of synthesizing kynurenic acid from its bioprecursor L
      kynurenine. Using [3H]kynurenine as the substrate, the two kynurenine
      aminotransferases (kynurenine aminotransferase I and kynurenine aminotransferase
      II) are now characterized using partially purified enzyme preparations. When
      assayed at its pH optimum of 10.0, kynurenine aminotransferase I showed
      pronounced oxo acid specificity (pyruvate >> 2-oxoglutarate). This co-substrate
      selectivity was lost when assays were performed at pH 7.4. Kynurenine
      aminotransferase I activity was potently inhibited by 2 mM glutamine, tryptophan
      or phenylalanine, but not by 2 mM alpha-aminoadipate or glutamate. In contrast to
      kynurenine aminotransferase I, kynurenine aminotransferase II showed a shallow pH
      curve with an optimum of about 7.4, displayed virtually equal activity with all
      of the nine 2-oxo acids tested and was not susceptible to inhibition by any of 10
      amino acids (2 mM) which are known to serve as substrates for enzymatic
      transamination. Kinetic analyses, performed at pH 7.4 (kynurenine
      aminotransferases I and II) and 10.0 (kynurenine aminotransferase I), and using
      various concentrations of kynurenine, pyruvate or 2-oxoglutarate, respectively,
      substantiated the differences between the two enzymes and further elucidated the
      pH dependence of kynurenine aminotransferase I activity [apparent Km values for
      kynurenine with 1 mM 2-oxoglutarate: 515 microM (pH 7.4) and 22 microM (pH
      10.0)]. Taken together, these data suggest that under physiological conditions,
      human brain kynurenic acid may derive preferentially from kynurenine
      aminotransferase II.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8350988
TI  - Coordinated expression of messenger RNAs for nerve growth factor, brain-derived
      neurotrophic factor and neurotrophin-3 in the rat hippocampus following transient
      forebrain ischemia.
AB  - Changes in nerve growth factor, brain-derived neurotrophic factor and
      neurotrophin-3 messenger RNA expression in the rat hippocampus following 20 min
      of transient forebrain ischemia were evaluated using Northern blot analysis and
      in situ hybridization histochemistry. Twelve hours after the insult, the level of
      nerve growth factor messenger RNA increased markedly in the granular cell layer
      of the dentate gyrus and by day 2 returned to control levels. The level of brain
      derived neurotrophic factor messenger RNA showed a persistent and moderate
      increase. The highest expression of brain-derived neurotrophic factor messenger
      RNA was seen in the dentate granule cells on day 2 after the insult, and then the
      expression returned to the control levels. At 2 days post-ischemia, contents of
      messenger RNAs for nerve growth factor and brain-derived neurotrophic factor were
      reduced in the CA1 region, which may represent delayed loss of vulnerable CA1
      pyramidal neurons. In contrast to brain-derived neurotrophic factor and nerve
      growth factor messenger RNA expression, the level of neurotrophin-3 messenger RNA
      declined in the CA1, the CA2 and the dentate granular layer immediately after
      ischemic insult. In the CA1 region, the reduced expression persisted for at least
      seven days, but in the dentate gyrus, neurotrophin-3 messenger RNA expression
      returned to the control levels after two days of post-ischemic recovery. These
      results suggest that nerve growth factor, brain-derived neurotrophic factor and
      neurotrophin-3 genes are differentially regulated and that each of their gene
      products may play different roles in the central nervous system under
      pathophysiological conditions.

PMID- 8350989
TI  - Autoradiographic localization of 5-hydroxytryptamine1A, 5-hydroxytryptamine1B and
      5-hydroxytryptamine1C/2 binding sites in the rat spinal cord.
AB  - Autoradiographic techniques revealed that 5-hydroxytryptamine1A, 5
      hydroxytryptamine1B and 5-hydroxytryptamine1C/2 binding sites are differentially
      distributed in the spinal cords of adult male rats. In the dorsal horn, 5
      hydroxytryptamine1A sites were dense in all laminae; 5-hydroxytryptamine1B sites
      were more dense in laminae I, III and IV than in lamina II; while 5
      hydroxytryptamine1C/2 sites were very sparse. The dorsal commissure gray matter
      also exhibited very dense 5-hydroxytryptamine1A and 5-hydroxytryptamine1B
      binding. In the intermediate and central gray matter, all three sites were
      moderately dense at autonomic levels, with exceptionally dense1C/2 binding
      restricted to the intermediolateral nucleus at rostral thoracic levels. In the
      ventral horn, 5-hydroxytryptamine1A and 5-hydroxytryptamine1B sites were very
      sparse (except for very dense 5-hydroxytryptamine1A sites located in the
      dorsolateral nucleus of the pudendal nerve), while 5-hydroxytryptamine1C/2 sites
      were relatively dense in motor nuclei. Surprisingly, 5-hydroxytryptamine1B sites
      were moderately dense in the dorsal column corticospinal tract. These studies
      will provide an anatomical perspective for interpretation of the complex role of
      5-hydroxytryptamine in regulating spinal cord function.

PMID- 8350990
TI  - Peptide YY: a neuropeptide in the gut. Immunocytochemical and immunochemical
      evidence.
AB  - Peptide YY immunoreactivity was detected in neuronal elements in the upper
      digestive tract of the rat, cat, ferret and pig by immunocytochemistry and
      radioimmunoassay combined with high-performance liquid chromatography. The two
      peptide YY antisera used do not recognize the related peptides neuropeptide Y and
      pancreatic polypeptide. In the rat peptide YY-immunoreactive nerve fibres were
      virtually restricted to the stomach smooth muscle of the minor curvature where
      they were numerous. Peptide YY-immunoreactive nerve cell bodies occurred in small
      ganglia on the serosal surface of the minor curvature. In the cat and ferret
      peptide YY-immunoreactive nerve fibres occurred in the circular smooth muscle
      layer of both the minor and major curvatures of the stomach and also in the upper
      small intestine; such fibres were numerous also in myenteric ganglia in these
      regions. In the pig, they were few but had roughly the same distribution as in
      the cat and ferret, except that they were quite numerous in thick muscle bundles
      close to the oesophagogastric junction. The presence of peptide YY-immunoreactive
      nerve cell bodies within the myenteric ganglia along the upper digestive tract of
      cat, ferret and pig, and in serosal ganglia of the rat stomach, indicates that at
      least some of the peptide YY-immunoreactive fibres demonstrated originate in or
      close to the gut wall. Double-staining experiments revealed that virtually all
      peptide YY-containing neurons and nerve fibres were distinct from those storing
      neuropeptide Y. Peptide YY-immunoreactive endocrine cells were encountered not
      only in the lower intestines but also in the stomach of the four species studied.
      In the antrum such cells were numerous and constituted a subpopulation of the
      gastrin-containing cells. In the oxyntic mucosa they were few and contained
      somatostatin. Radioimmunoassay revealed peptide YY-like peptides in gastric
      mucosa and smooth muscle from the upper digestive tract of all four species
      examined. The results of high-performance liquid chromatography suggest that the
      peptide YY-like material in the upper digestive tract is distinct from
      neuropeptide Y and pancreatic polypeptide and identical with authentic peptide YY
      except in the antral mucosa where only a small proportion of the peptide YY
      immunoreactive material eluted like authentic peptide YY.

PMID- 8350991
TI  - The role of Muller cells in the formation of the blood-retinal barrier.
AB  - We have compared the ability of Muller cells and astrocytes to induce the
      formation of barrier properties in blood vessels. Muller cells cultured from the
      rabbit retina, and astrocytes and meningeal cells cultured from the rat cerebral
      cortex, were injected into the anterior chamber of the rat eye, where they formed
      aggregates on the iris. We have examined the barrier properties of the vessels in
      those aggregates and, for comparison, the barrier properties of vessels in the
      retina, ciliary processes and iris. Two tracers were perfused intravascularly to
      test barrier properties. The movement of Evans Blue was assessed by light
      microscopy, and the movement of horseradish peroxidase by light and electron
      microscopy. Our results indicate that Muller cells share the ability of
      astrocytes to induce the formation of barrier properties by vascular endothelial
      cells, and we suggest that Muller cells play a major role in the formation of
      barrier properties in retinal vessels.

PMID- 8350992
TI  - Parvalbumin immunoreactivity in the hippocampus of the gerbil after transient
      forebrain ischaemia: a qualitative and quantitative sequential study.
AB  - Parvalbumin immunoreactivity is examined in the hippocampus of the Mongolian
      gerbil (Meriones unguiculatus) in controls and in animals subjected to 20 min of
      forebrain ischaemia produced by bilateral clipping of the carotids. In comparison
      with other species, the hippocampus of the gerbil is characterized by strong
      immunoreactivity of the (presumably excitatory) perforant pathway, and weak
      immunoreactivity (low numbers of neurons and scarce dendritic arbors) in
      nonpyramidal nerve cells (inhibitory neurons) of the CA1 area. These properties
      may play some role in the development and maintenance of seizures in this
      susceptible species. Parvalbumin immunoreactivity is rapidly and ephemerally
      increased in the hippocampus 15 min after reperfusion. Later on, there is a
      transitory decrease of parvalbumin immunoreactivity which is followed by an
      increase 6 h later in the stratum granulare hilus and CA3 area, and not until the
      first and second days in the CA1 area. This increase significantly surpasses the
      number of immunoreactive neurons in control animals in CA1 and CA3 from 48 h
      after reperfusion onwards. The effect is similar using different anaesthetics and
      does not occur in sham-operated animals. In contrast with these findings, the
      number of parvalbumin-immunoreactive neurons in the somatosensory cortex is not
      affected in our model of forebrain ischaemia. On the other hand, GABA
      immunoreactive neurons in CA1 are preserved during the first week after
      reperfusion, although an increase in the number of these cells occurs at the end
      of this period. Delayed neuronal death occurs in the CA1 area 48 h after
      ischaemia, and marked reduction in the number of CA1 neurons is found by the end
      of the first week. Eighty per cent of the remaining cells in CA1 at day 7, and
      83% at day 15, are parvalbumin-immunoreactive nonpyramidal neurons in contrast to
      3% parvalbumin-immunoreactive cells in control animals. These findings indicate
      that GABAergic neurons in CA1 are preserved after forebrain ischaemia, and that
      parvalbumin in CA1 neurons is associated with survival.

PMID- 8350993
TI  - Entorhinal cortex lesion induces differential responses in [125I]insulin-like
      growth factor I, [125I]insulin-like growth factor II and [125I]insulin receptor
      binding sites in the rat hippocampal formation.
AB  - The hippocampus can be induced by deafferentation to selectively reorganize its
      neuronal input. Entorhinal cortex lesion, which causes degeneration of the
      perforant pathway, evokes sprouting of septal afferents as well as glutamatergic
      commissural/associational fibers in the deafferentated zone of the molecular
      layer of the dentate gyrus. Although the process of reactive synaptogenesis that
      follows deafferentation has been extensively studied, at present little is known
      about its molecular basis and the mechanism of initiation. In this study,
      following unilateral lesion of the entorhinal cortex, the time-course of possible
      alterations of insulin-like growth factors I and II, and insulin binding sites
      were evaluated by in vitro quantitative receptor autoradiography. [125I]Insulin
      like growth factor I receptor binding sites did not exhibit any significant
      variation between the contralateral and ipsilateral hippocampal formation at any
      time periods following lesion except in the molecular layer of the dentate gyrus
      (P < 0.05) at day 8. However, when compared with the unlesioned animals, a
      differential time-dependent response of [125I]insulin-like growth factor I
      binding sites was noted in selective layers of the hippocampus. [125I]Insulin
      like growth factor II receptor binding sites showed a significant decrease (P <
      0.05) in the ipsilateral granular cell layer of the dentate gyrus only at day 14
      post lesion. Interestingly, compared to controls, a dramatic bilateral increase
      (P < 0.05) in [125I]insulin-like growth factor II binding was evident between
      days 1 and 8 in most layers of the hippocampal formation. A lesion-induced
      bilateral increase (P < 0.05) in [125I]insulin binding sites was evident in all
      layers of the hippocampus between two to eight days and at 30 days post lesion.
      In selective layers, however, a significant increase (P < 0.05) in [125I]insulin
      binding sites was also observed at days 1 and 14 after lesion. These results,
      which are compatible with the process of degeneration and/or sprouting of the
      terminal fibers, suggest possible involvement of insulin-like growth factors and
      insulin in the sequence of molecular events that occur to facilitate neuronal
      repair and to promote neuronal survival following entorhinal cortex lesion.

PMID- 8350994
TI  - Cholesterol synthesis and lipoprotein reuptake during synaptic remodelling in
      hippocampus in adult rats.
AB  - Apolipoprotein E is synthesized and secreted by astrocytes in the hippocampus
      following lesions of the entorhinal cortex. It was proposed that apolipoprotein
      E, by analogy to its role in cholesterol transport in circulation, could be
      involved in the salvage and reutilization of non-esterified cholesterol released
      during terminal breakdown. The salvaged cholesterol could then be transported to
      neurons by apolipoprotein E-complexes and taken up via the apolipoprotein
      E/apolipoprotein B (low-density lipoprotein) receptor. To test this hypothesis,
      we have examined low-density lipoprotein receptor binding in brain sections of
      rats undergoing hippocampal reinnervation. The number of neuronal cells labelled
      by fluorescent Dil-low-density lipoprotein as well as the density of [125I]low
      density lipoprotein binding sites in the dentate gyrus were found to increase in
      parallel with the extent of cholinergic reinnervation occurring in the
      deafferented hippocampus. In contrast, hippocampal cholesterol synthesis fell by
      more than 60% at eight days post-lesion, but eventually returned to control
      levels at 30 days post-lesion. The transient loss of cholesterol synthesis
      coincided with a peak in hippocampal apolipoprotein E expression. A concomitant
      accumulation of sudanophilic lipids (cholesterol esters and phospholipids) was
      detected in the outer molecular layer of the dentate gyrus and in the hilar
      region. The present findings suggest that non-esterified cholesterol released
      during terminal breakdown is esterified, transported via the apolipoprotein E
      transport system to neurons undergoing reinnervation, and take-up through the low
      density lipoprotein receptor pathway where it is presumably used as a precursor
      molecule for the synthesis of new synapses and terminals.

PMID- 8350995
TI  - Acetylcholinesterase activity and post-lesional plasticity in the hippocampus of
      young and aged rats.
AB  - Applying quantitative microscopic histochemistry, the activity of
      acetylcholinesterase was determined in the various layers of the rat hippocampus
      at three different levels along the rostrocaudal extent. Two age groups of
      animals were examined: young adults (two to three months old) and aged subjects
      (26 months old). Young adults were divided into controls, and animals killed
      eight and 35 days following bilateral ibotenate lesioning of the medial septum
      diagonal band complex. Aged rats were divided into controls and animals 35 days
      post-lesion. Analysis of variance revealed that the mean acetylcholinesterase
      activities of the entire hippocampus of individuals were not significantly
      different between young and aged rats when averaged across controls and 35 days
      post-lesion. There was a significant decrease of acetylcholinesterase activity (
      52%) in young adults eight days post-lesion as compared to controls, but a
      significant increase (+63%) took place until 35 days post-lesion as compared to
      eight days post-lesion. Significantly lower activities existed, however, in young
      (-22%) and aged rats (-18%) 35 days post-lesion as compared to controls. This
      decrease in mean activity was not age dependent. As acetylcholinesterase is
      considered to be a good cholinergic indicator in the hippocampus, the results
      suggest a homotypic collateral sprouting from spared cholinergic afferents
      following ibotenate lesion of the medial septum-diagonal band complex in young
      and aged rats. Based on the data obtained, it is reasonable to assume that there
      was no difference in the post-lesional plasticity of neuronal
      acetylcholinesterase between young adult and aged rats.

PMID- 8350996
TI  - The spectrum of levodopa-related fluctuations in Parkinson's disease.

PMID- 8350997
TI  - Accuracy of diagnosis of persistent vegetative state.
AB  - We reviewed pre-admission diagnosis in all patients referred for inpatient brain
      injury neurorehabilitation over a 5-year period (n = 193). All patients more than
      1 month postinjury with diagnosis of coma or persistent vegetative state were
      selected for review (n = 49). We found that 18 (37%) of these patients were
      diagnosed inaccurately. Inaccurate diagnosis was more likely if the injury was
      more than 3 months before admission and the etiology of injury was trauma (48%).
      Results were statistically significant when traumatic injuries were compared with
      anoxic injuries (p < 0.10). Errors in diagnosis may result from confusion in
      terminology, lack of extended observation of patients, and lack of skill or
      training in the assessment of neurologically devastated patients.

PMID- 8350999
TI  - Status epilepticus: the interaction of epilepsy and acute brain disease.
AB  - We identified 217 patients with status epilepticus (SE), including all seizure
      types from all etiologies, over a 3-year period. There was a significant
      interaction between organic brain disease and a history of epilepsy in the
      development of SE. The majority of patients (59%) had no history of epilepsy.
      These patients were more likely to have acute precipitants associated with SE and
      less likely to have had prior brain disease. They were older, were more likely to
      have generalized convulsive seizures, and had a high proportionate mortality.
      Among the 88 patients with a history of epilepsy, a higher proportion had prior
      brain insults, but fewer had acute precipitants. These patients were younger and
      their mortality was low, but they often had recurrent SE before and after the
      identified episode. Significant acute or prior brain disease is an important
      factor in the development of SE, even in patients with a history of epilepsy.

PMID- 8350998
TI  - Association of apolipoprotein E allele epsilon 4 with late-onset familial and
      sporadic Alzheimer's disease.
AB  - Apolipoprotein E, type epsilon 4 allele (APOE epsilon 4), is associated with late
      onset familial Alzheimer's disease (AD). There is high avidity and specific
      binding of amyloid beta-peptide with the protein ApoE. To test the hypothesis
      that late-onset familial AD may represent the clustering of sporadic AD in
      families large enough to be studied, we extended the analyses of APOE alleles to
      several series of sporadic AD patients. APOE epsilon 4 is significantly
      associated with a series of probable sporadic AD patients (0.36 +/- 0.042, AD,
      versus 0.16 +/- 0.027, controls [allele frequency estimate +/- standard error], p
      = 0.00031). Spouse controls did not differ from CEPH grandparent controls from
      the Centre d'Etude du Polymorphisme Humain (CEPH) or from literature controls. A
      large combined series of autopsy-documented sporadic AD patients also
      demonstrated highly significant association with the APOE epsilon 4 allele (0.40
      +/- 0.026, p < or = 0.00001). These data support the involvement of ApoE epsilon
      4 in the pathogenesis of late-onset familial and sporadic AD. ApoE isoforms may
      play an important role in the metabolism of beta-peptide, and APOE epsilon 4 may
      operate as a susceptibility gene (risk factor) for the clinical expression of AD.

PMID- 8351000
TI  - Progression after chronic manganese exposure.
AB  - We report a longitudinal follow-up study on six patients with chronic manganese
      induced parkinsonism following cessation of manganese exposure. Compared with the
      1987 study, their parkinsonian symptoms showed a slow progression, particularly
      in gait disturbances such as freezing during turning and walking backward with
      retropulsion. The mean disability scores on the King's College Hospital Rating
      Scale were 15.0 +/- 4.2 in 1987 and 28.3 +/- 6.7 in 1991 (p = 0.003, paired t
      test). Review of the video records also confirmed a worsening of parkinsonism,
      especially in difficulty turning. Three of six patients receiving levodopa
      treatment had an initial improvement. The response decreased after 2 to 3 years.
      During the therapy, they did not develop on-off fluctuation or dyskinesia. We
      conclude that patients with manganese-induced parkinsonism may develop increasing
      neurologic dysfunction long after cessation of exposure and that their responses
      to levodopa are different from those of patients with Parkinson's disease.

PMID- 8351001
TI  - HIV-1-associated cognitive/motor complex: absence of neuronal loss in the
      cerebral neocortex.
AB  - We performed a postmortem morphometric study in six AIDS patients and six
      controls to determine if a neocortical neuronal loss occurs in HIV-1-associated
      cognitive/motor complex. Patients were selected during a prospective study
      including psychometric evaluation and neuroimaging, and none had focal lesions.
      Two had HIV-1-associated myelopathy with mild cognitive impairment, and four had
      HIV-1-associated dementia complex. Planimetry did not show any cerebral atrophy.
      Cortical thickness, mean neuronal size, and mean neuronal densities in Brodmann's
      areas 4, 9, and 40 were not statistically different in patients and controls.
      There were no significant changes in neuronal densities of columnar and laminar
      samples, indicating that there was neither global nor selective neuronal loss.
      HIV-1-associated cognitive/motor complex is not necessarily related to
      neocortical neuronal loss, but could be due to subcortical lesions or metabolic
      dysfunction.

PMID- 8351002
TI  - Cool, warm, and heat-pain detection thresholds: testing methods and inferences
      about anatomic distribution of receptors.
AB  - We recently found that vibratory detection threshold is greatly influenced by the
      algorithm of testing. Here, we study the influence of stimulus characteristics
      and algorithm of testing and estimating threshold on cool (CDT), warm (WDT), and
      heat-pain (HPDT) detection thresholds. We show that continuously decreasing (for
      CDT) or increasing (for WDT) thermode temperature to the point at which cooling
      or warming is perceived and signaled by depressing a response key ("appearance"
      threshold) overestimates threshold with rapid rates of thermal change. The mean
      of the appearance and disappearance thresholds also does not perform well for
      insensitive sites and patients. Pyramidal (or flat-topped pyramidal) stimuli
      ranging in magnitude, in 25 steps, from near skin temperature to 9 degrees C for
      10 seconds (for CDT), from near skin temperature to 45 degrees C for 10 seconds
      (for WDT), and from near skin temperature to 49 degrees C for 10 seconds (for
      HPDT) provide ideal stimuli for use in several algorithms of testing and
      estimating threshold. Near threshold, only the initial direction of thermal
      change from skin temperature is perceived, and not its return to baseline. Use of
      steps of stimulus intensity allows the subject or patient to take the needed time
      to decide whether the stimulus was felt or not (in 4, 2, and 1 stepping
      algorithms), or whether it occurred in stimulus interval 1 or 2 (in two
      alternative forced-choice testing). Thermal thresholds were generally
      significantly lower with a large (10 cm2) than with a small (2.7 cm2)
      thermode.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351004
TI  - X-linked adrenoleukodystrophy: adult cerebral variant.
AB  - We report a unique case of a 43-year-old architect with adult-onset
      adrenoleukodystrophy who presented primarily with intellectual decline and no
      evidence of adrenal insufficiency. Serial MRIs taken over a number of months
      demonstrated the evolution of demyelination starting in the frontal white matter
      then shifting to the occipital white matter and finally resolving without any
      therapeutic intervention. Clinically, over this same period of time, the
      patient's symptoms resolved and he was able to return to work. The proband, his
      brother, and his nephew were found to have a color-vision defect. Each of these
      individuals had a red/green gene array that contained a 5' green-red 3' hybrid
      known to be associated with deutan color-vision defects. The proband's brother
      and nephew were otherwise normal. The gene that causes adrenoleukodystrophy
      appears not to be as close to the red/green color vision gene array on the X
      chromosome as previously reported.

PMID- 8351003
TI  - A 4, 2, and 1 stepping algorithm for quick and accurate estimation of cutaneous
      sensation threshold.
AB  - In quantitative sensory testing, certain methods may lead to incorrect estimates
      of vibratory (VDT), cool (CDT), or warm (WDT) detection thresholds. We have shown
      that the specific forced-choice algorithm of testing employed in our Computer
      Assisted Sensory Examination (CASE IV) system, when compared with other tests of
      nerve dysfunction, provides accurate and reproducible estimates of these
      thresholds. Because this forced-choice algorithm is time consuming and
      performance might be made worse by drowsiness or boredom, we explored other
      algorithms that might provide estimates of threshold similar to those obtained
      with the forced-choice algorithm, but more quickly. In a trial of 25 healthy
      subjects and 25 patients with neuropathy, the 4, 2, and 1 stepping algorithm with
      null stimuli, based in part on comparative data from computer simulation and
      insights from patient decision making, provides an accurate estimate of
      threshold. On average, the time needed for forced-choice testing was 12.8 +/- 2.9
      minutes (mean +/- SD). For 4, 2, and 1 stepping testing, it was 2.7 +/- 2.5
      minutes--a large saving of time. Since null stimuli were employed in the 4, 2,
      and 1 stepping algorithm, it was possible to monitor for spurious responses and
      repeat the test if they occurred at an excessive rate. The algorithm appears to
      be sufficiently robust to be recommended for clinical use and for some controlled
      clinical and epidemiologic trials.

PMID- 8351005
TI  - Third-nerve palsy due to penetrating trauma.
AB  - Penetrating trauma is an unusual etiology of third-nerve palsy. Of 815
      hospitalized patients with third-nerve palsies, 20 had such an etiology, with
      gunshot wounds being the usual cause.

PMID- 8351006
TI  - The etiology of posterior circulation infarcts: a prospective study using
      magnetic resonance imaging and magnetic resonance angiography.
AB  - In a prospective study of 70 patients with infarcts in the posterior circulation
      admitted consecutively to a population-based primary-care center, we assessed
      infarct location and etiology using magnetic resonance imaging, three-dimensional
      time-of-flight magnetic resonance angiography, and noninvasive cardiac tests. The
      brainstem (mainly the paramedian pons) was the most commonly infarcted site
      (41/70, 59%), followed by the cerebellum (33/70, 47%). Combined supra- and
      infratentorial multiple vertebrobasilar infarcts occurred in 11 patients (16%).
      Overall, 27 patients (39%) had > or = 50% stenosis or occlusion of the basilar
      artery. There were other large-artery lesions in 19 patients (27%), including
      vertebral (V2-V4) stenosis or occlusion (in seven) and dolichoectatic
      vertebral/basilar arteries (in 12). Fifteen of the 70 patients had a potential
      cardiac source of embolism, which coexisted with large-artery disease in more
      than one-third of the cases. Cerebellar infarct without concomitant brainstem or
      occipital infarct was associated with cardioembolism (67%), while isolated
      paramedian pontine or midbrain infarct was associated with basilar artery
      stenosis (71%), suggesting in situ occlusion of the mouth of the perforators off
      the stenosed basilar artery. After exclusion of other potential causes of stroke,
      presumed small-artery disease associated with chronic hypertension remained the
      likely etiology in only 11 patients (16%), but these infarcts were not associated
      with any of the classical lacunar syndromes. Our findings emphasize the high
      frequency of severe intracranial large-artery disease in posterior circulation
      infarcts.

PMID- 8351007
TI  - Vascular distribution of paradoxical emboli by transcranial Doppler.
AB  - BACKGROUND AND PURPOSE: Paradoxical embolism through a patent foramen ovale is a
      contributory mechanism to stroke and may be diagnosed by contrast
      echocardiography. The intracranial distribution of these emboli has not been
      previously reported. METHODS: We used transcranial Doppler combined with agitated
      saline contrast injection to determine whether there was a preferential
      distribution of the contrast into the anterior or posterior intracranial
      circulation of patients with an acute stroke or transient ischemic attack.
      RESULTS: Forty-nine patients were studied--27 men and 22 women, with a mean age
      of 62.7 +/- 13.3 years (range, 29 to 85 years). Microcavitations were detected in
      the proximal right middle cerebral artery in 12 of 49 patients (24%). A patent
      foramen ovale was confirmed in all cases by simultaneous transesophageal
      echocardiography. Of the 12 patients, microcavitations were also detected in the
      proximal basilar artery in nine (75%). CONCLUSIONS: While paradoxical embolism
      appears to occur more frequently in the anterior circulation, the high rate of
      detection of microcavitations in the basilar artery suggests that paradoxical
      embolism to the posterior intracranial circulation may be more frequent than
      generally believed.

PMID- 8351008
TI  - Memory in patients with cerebellar degeneration.
AB  - Eleven patients with relatively selective cerebellar degeneration and 11 normal
      control subjects underwent a comprehensive neurologic and neuropsychological
      examination. The neuropsychological tests assessed general intellectual ability,
      different aspects of memory (effortful, automatic, and implicit memory
      processes), speed of information processing, and verbal fluency (using both
      category and letter fluency tasks). The results indicated that cerebellar
      patients were significantly impaired only on tasks requiring the use of executive
      functions, such as the initiation/perseveration subtest of the Mattis Dementia
      Rating Scale or the fluency tests, and on memory measures requiring greater
      processing effort. They performed normally on automatic and implicit measures of
      memory. Performance on the effortful memory and executive measures was not
      associated with neurologic variables or mood state. After controlling for the
      initiation/perseveration deficit, the effortful memory scores of the cerebellar
      patients were no longer different from those of controls. The present study
      suggests that memory in patients with relatively pure cerebellar dysfunction is
      only partially compromised and that the impairment is secondary to a deficit in
      executive functions.

PMID- 8351009
TI  - Suppression of dyskinesias in advanced Parkinson's disease. I. Continuous
      intravenous levodopa shifts dose response for production of dyskinesias but not
      for relief of parkinsonism in patients with advanced Parkinson's disease.
AB  - We characterized the clinical dose-response curves for relief of parkinsonism and
      production of dyskinesias as a function of plasma levodopa and 3-O-methyldopa
      levels in six patients with advanced Parkinson's disease (PD) and fluctuating
      responses to oral levodopa/carbidopa. Dose response to ramped intravenous
      levodopa infusion was measured after overnight drug withdrawal on two occasions:
      first after chronic, intermittent oral levodopa/carbidopa, and second after 3 to
      5 days of continuous intravenous levodopa. Continuous intravenous levodopa
      shifted the dyskinesia dose-response curve to the right, reduced maximum
      dyskinesia activity, but did not significantly alter dose response for relief of
      parkinsonism. Improvement in dyskinesia was apparent by the second day of
      continuous levodopa, during which ratios of plasma dopa/3-O-methyldopa remained
      constant. Our results support the hypothesis that relief of parkinsonism and
      production of dyskinesia by levodopa occur by separate mechanisms.

PMID- 8351011
TI  - Repeated exposure to the Mini-Mental State Examination and the Information-Memory
      Concentration Test results in a practice effect in Alzheimer's disease.
AB  - We analyzed short-term variation of Mini-Mental State Examination (MMSE) and
      Information-Memory-Concentration (IMC) Test scores in 39 patients with
      Alzheimer's disease (AD), tested four times over 6 weeks. Although analysis of
      variance had failed to show a significant "learning" effect or other trends, we
      reexamined the data using repeated measures models, with and without a learning
      effect. In the model without a learning effect, mean MMSE scores decreased
      minimally and mean IMC scores decreased by 0.84 points over 6 weeks. In the model
      that allowed a potential learning effect between the first and second test
      sessions, scores increased significantly, by 1.12 +/- 0.47 points for the MMSE
      and 1.04 +/- 0.43 points for the IMC Test. Patients' test scores predicted from
      the models had less variability than did their raw scores. The short-term
      practice effect, although small, should be considered in interpreting changes in
      scores, especially in therapeutic studies in AD.

PMID- 8351010
TI  - Phenotypic expression of X-linked dystonia-parkinsonism (lubag) in two women.
AB  - Lubag (X-linked dystonia-parkinsonism) has been considered a sex-linked recessive
      trait and has been mapped to the pericentromeric region of the X chromosome. We
      studied a 54-year-old man with lubag and two of his female first cousins. Genetic
      typing was carried out using X chromosome markers. Fluorodopa PET was performed
      on the man and one of the women. The man had moderately severe parkinsonism and
      dystonia. A 61-year-old female first cousin had mild left-sided dystonia and her
      54-year-old sister had mild generalized chorea. Genetic typing data revealed that
      all three inherited an X chromosome with marker alleles strongly associated with
      lubag. Cytologic analysis did not reveal evidence of X chromosomal deletion.
      Fluorodopa PET in both the man and one affected cousin revealed reduced striatal
      uptake rate constants consistent with nigrostriatal involvement. These
      observations suggest that lubag may be a codominant disorder and that it is
      possible for women to be affected.

PMID- 8351012
TI  - Comparison of striatal 18F-dopa uptake in adult-onset dystonia-parkinsonism,
      Parkinson's disease, and dopa-responsive dystonia.
AB  - We studied six patients with adult-onset dystonia-parkinsonism (DYS-P) with 18F-6
      fluoro-dopa (18F-dopa) positron emission tomography and compared their influx
      constants (Ki values) with those of six patients with classical childhood-onset
      dopa-responsive dystonia (DRD), 12 age-matched Parkinson's disease (PD) patients
      without dystonia, and 21 normal controls. The DYS-P group had significantly
      reduced mean caudate (67% of normal) and putamen (45% of normal) 18F-dopa uptake.
      These Ki values were similar to mean caudate and putamen Ki values obtained for
      the PD group. In contrast, the DRD group showed minor reductions in mean caudate
      (9%) and putamen (18%) 18F-dopa uptake when compared with normals. The mean
      caudate:putamen Ki ratio was 1.7 in the DYS-P group and 2.1 in the PD group. In
      the DRD and normal groups, the caudate:putamen ratios were close to unity. The
      findings of this study are that adult-onset DYS-P targets the nigrostriatal
      dopaminergic projections in a pattern similar to PD, with the putamen being more
      affected. This provides support for the hypothesis that DYS-P may be a phenotypic
      variant of Lewy body disease. DYS-P seems distinct from childhood-onset DRD, in
      which striatal 18F-dopa uptake is either normal or only mildly reduced.

PMID- 8351013
TI  - Single-photon emission computed tomographic investigation of patients with motor
      neuron disease.
AB  - To investigate the correlation between involvement of the CNS in motor neuron
      disease (MND) and neuroimaging abnormalities, we studied 18 patients with MND by
      single-photon emission computed tomography (SPECT) and MRI. Patients were divided
      into four groups according to the results of SPECT. Group 1 consisted of four
      patients with reduced isotope uptake in the frontal lobe, including the motor
      area, and in the anterior part of the temporal lobe; group 2 consisted of two
      patients with reduced isotope uptake in the motor area spreading to the adjacent
      frontal lobe; group 3 consisted of eight patients with reduced isotope uptake
      confined to the motor area; and group 4 consisted of four patients without
      reduced isotope uptake. We found dementia in group 1, borderline dementia in
      group 2, and no cognitive deficit in group 3 or four. MRI demonstrated enhanced
      T2-weighted signals along the pyramidal tract in eight patients, but this finding
      also existed in some control subjects. SPECT appears useful in identifying the
      location of cortical neuronal degeneration in patients with MND.

PMID- 8351014
TI  - Prevalence of myotonic dystrophy in Guipuzcoa (Basque Country, Spain).
AB  - Prevalence figures for inherited neuromuscular disorders are important both for
      health care planning purposes and for evaluating the need for DNA diagnostic
      services for eugenic approaches. We screened for the prevalence of myotonic
      dystrophy (MyD) through extensive inquiry of neurologic and primary health
      services of Guipuzcoa (Basque Country, northern Spain) between 1989 and 1991.
      Typical adult-onset and neonatal cases and relatives at risk; suffering from a
      partial syndrome, were included. In the latter, molecular typing was performed
      with DNA probes close to the MyD gene to demonstrate the MyD gene carrier status.
      The high prevalence detected (26.5 cases per 100,000 population) could be
      explained by methodological factors, but intrinsic factors, such as a possible
      founder genetic effect or the quick growth of the Guipuzcoa population since the
      last century may contribute to one of the highest MyD prevalence in the world. In
      the future, the methodological basis for epidemiologic surveys of MyD must
      combine molecular technology with more-extensive family inquiries.

PMID- 8351015
TI  - Acute elevation and recovery of intracellular [Mg2+] following human focal
      cerebral ischemia.
AB  - We used 31P magnetic resonance spectroscopy (MRS) to investigate changes in brain
      intracellular [Mg2+] following human focal cerebral ischemia. Mean brain pMg
      (where pMg = -log[Mg2+]) was significantly lower in the ischemic focus of all
      stroke patients (pMg = 3.34 +/- 0.28, n = 45, p < 0.01) when compared with normal
      controls (pMg = 3.50 +/- 0.08, n = 25). Ischemic brain pMg was also significantly
      reduced when the pH of the stroke region was acidotic (pH < 6.90, pMg = 3.07 +/-
      0.44, n = 11, p < 0.01) and when the phosphocreatine index (PCrI = PCr/[PCr+Pi
      (inorganic phosphate)]) was reduced (PCrI < 0.47, pMg = 3.12 +/- 0.42, n = 13, p
      < 0.01). Mean brain pMg was significantly reduced at days 0 to 1 (acute)
      poststroke (pMg = 3.32 +/- 0.28, n = 26, p < 0.01) and at days 2 to 3 (subacute)
      poststroke (pMg = 3.38 +/- 0.28, n = 21, p = 0.03). There was also a significant
      (p < 0.01) correlation between decreased pMg and increased relative signal
      intensity of Pi (normalized by total phosphate signal, Pi/TP) for all stroke
      groups studied. During the temporal evolution of stroke, pH returned to normal
      levels by days 2 to 3, and pMg returned to normal by days 4 to 10 (subacute).
      PCrI and Pi/TP returned toward normal levels after 10 days (chronic), at a time
      when ischemic brain pH had become significantly alkalotic (pH = 7.10 +/- 0.24, n
      = 15, p < 0.01). Elevation of ischemic brain [Mg2+] is temporally linked to the
      acidotic phase of human stroke as well as the breakdown of energy metabolism.
      These acute changes in [Mg2+] may contribute to, or be a marker for, cellular
      injury.

PMID- 8351016
TI  - Titin antibodies in myasthenia gravis: identification of a major immunogenic
      region of titin.
AB  - Approximately 15% of patients with myasthenia gravis (MG) have thymus neoplasia.
      These MG with thymoma (MGT) patients show autoantibodies to striated muscle as
      well as autoantibodies to acetylcholine receptor. To characterize these thymoma
      associated muscle antigens, we cloned a number of immunopositive cDNAs by
      immunoscreening muscle cDNA libraries with sera from MGT patients. Analysis of
      the isolated cDNAs show that all share a common sequence encoding a distinct
      region of the titin gene. We expressed this main immunogenic region (MIR) of
      titin in Escherichia coli, and determined autoantibody serum titers directed
      against the obtained recombinant antigen in a variety of patients. We could
      detect titin MIR autoantibodies in 97% of sera from MGT patients but not in
      control sera from healthy blood donors. Therefore, expressed titin from the MIR
      of the molecule is a sensitive marker antigen for evaluating the presence of
      thymoma in MG.

PMID- 8351017
TI  - Variable distribution of mutant mitochondrial DNAs (tRNA(Leu[3243])) in tissues
      of symptomatic relatives with MELAS: the role of mitotic segregation.
AB  - We studied multiple different postmortem tissue samples from a woman and two of
      her daughters with the MELAS (mitochondrial encephalomyopathy, lactic acidosis,
      and stroke-like episodes) tRNA(Leu(UUR)) mutation at nucleotide 3243 in
      mitochondrial DNA (mtDNA). All tissues examined were heteroplasmic for the
      mutation. The mean proportion of mutant mtDNAs in the mother's tissues (0.30 +/-
      0.10) was significantly lower than that of each of her daughters' (0.76 +/- 0.11,
      p < 0.03, and 0.72 +/- 0.13, p < 0.001); there was no difference in the fraction
      of mutant mtDNAs between the daughters (p < 0.71). This difference in the mean
      proportion of mtDNA mutants between family members correlates with their clinical
      profiles; the mother had the latest onset of disease and lived longest, while the
      two daughters had a strikingly similar clinical course. In individual patients,
      the mean proportion of mutant mtDNAs was not different in tissues deriving from
      ectodermal, mesodermal, and endodermal germ layers. Variance in the mutant:wild
      type mtDNA ratio was normally distributed about the mean, both when all tissues
      were considered together and when different regions of the CNS were considered
      separately. Thus, the proportion of mtDNAs carrying the tRNA(Leu(3243)) mutation
      was not uniform in members of this pedigree and did not undergo rapid mitotic
      segregation along germ-layer divisions. These findings are consistent with the
      hypothesis that the overall proportion of mtDNAs carrying this mutation is
      primarily determined by segregation during oogenesis or early embryologic
      development and that random replicative (mitotic) segregation, subsequent to the
      establishment of primary germ layers, is responsible for the variation between
      tissues.

PMID- 8351018
TI  - Asymmetry of forearm rolling as a sign of unilateral cerebral dysfunction.
AB  - We compared the reliability of asymmetry of forearm rolling (rotation of one
      forearm around the other in front of the torso) as a sign of unilateral cerebral
      dysfunction with that of other standard clinical tests. We studied 62 patients
      with radiologically confirmed unilateral cerebral lesions and 20 control subjects
      with normal imaging. Asymmetric forearm rolling was the most sensitive indicator
      of unilateral hemispheric disease (85%). This simple test is a useful addition to
      the neurologic examination.

PMID- 8351019
TI  - Effect of cranial irradiation on seizure frequency in adults with low-grade
      astrocytoma and medically intractable epilepsy.
AB  - We report the effect of cranial irradiation on seizure frequency in five adults
      with unresected (biopsy-proven) cerebral hemisphere low-grade astrocytoma and
      medically intractable epilepsy. Seizures were refractory to standard
      antiepileptic drugs for 7 months to 27 years. Treatment with 5,400 cGy to 6,120
      cGy focal radiation reduced seizure frequency by more than 90% in three patients
      (one of whom became seizure-free) and by more than 75% (but less than 90%) in one
      patient. One patient had no response. Brain CT or MRI showed a partial tumor
      response to radiation in three of the four patients with reduced seizure
      frequency. In three patients, the reduced seizure frequency continued to the most
      recent follow-up of 1 to 1.5 years. In the patient who became seizure-free,
      seizures recurred at 8.2 years and were associated with tumor progression.
      Irradiation can reduce seizure frequency in some patients with unresected
      cerebral hemisphere low-grade astrocytoma and medically intractable epilepsy.

PMID- 8351020
TI  - Seronegative, non-neoplastic acute cerebellar degeneration.
AB  - Five women are presented with a subacute pure pancerebellar syndrome of ataxia
      and dysarthria to emphasize that this illness may occur without anti-Purkinje
      cell or anti-Yo antibodies, or associated systemic cancer. The syndrome evolved
      over weeks or less and stabilized in four of the patients. Three had had a
      preceding infection and one, a rash, but there was no inflammatory response in
      the spinal fluid. Over the 5-year period during which these patients appeared in
      an individual general neurology practice, there was only one patient with
      paraneoplastic cerebellar degeneration. Despite the association of this syndrome
      with cancer, particularly in women, clinicians will still commonly confront the
      idiopathic variety.

PMID- 8351021
TI  - Anti-Ri-associated paraneoplastic neurologic disorder without opsoclonus in a
      patient with breast cancer.
AB  - A 59-year-old woman with breast cancer and anti-Ri antibodies developed a
      neurologic paraneoplastic disorder characterized by nausea, vomiting, vertigo,
      paresis of upward gaze, and gait ataxia, without opsoclonus. The absence of
      opsoclonus does not rule out the possibility of an anti-Ri-associated
      paraneoplastic neurologic disorder.

PMID- 8351022
TI  - Retinal disease masquerading as spasmus nutans.
AB  - Two children with congenital stationary night blindness were originally diagnosed
      as having spasmus nutans. Both children had the typical features of spasmus
      nutans including asymmetric nystagmus, head shaking, and torticollis. The
      diagnosis of congenital stationary night blindness was established only after
      each child underwent electroretinography. The nystagmus associated with retinal
      disease can mimic many of the features of spasmus nutans. Children suspected of
      having spasmus nutans should undergo complete ophthalmologic examination and
      electroretinography if they are myopic.

PMID- 8351023
TI  - Clinical trial of indomethacin in Alzheimer's disease.
AB  - In a 6-month, double-blind, placebo-controlled study, 100 to 150 mg/d
      indomethacin appeared to protect mild to moderately impaired Alzheimer's disease
      patients from the degree of cognitive decline exhibited by a well-matched,
      placebo-treated group. Over a battery of cognitive tests, indomethacin patients
      improved 1.3% (+/- 1.8%), whereas placebo patients declined 8.4% (+/- 2.3%)--a
      significant difference (p < 0.003). Caveats include adverse reactions to
      indomethacin and the limited scale of the trial.

PMID- 8351024
TI  - Hepatitis B transmission by neurologic pin testing.

PMID- 8351026
TI  - Hysterical hemiparesis accompanying Bell's palsy.

PMID- 8351025
TI  - 'Essential tremor' and CAG repeats in the androgen receptor gene.

PMID- 8351027
TI  - Ciprofloxacin-induced complex partial status epilepticus manifesting as an acute
      confusional state.

PMID- 8351028
TI  - Pentoxifylline-induced musical hallucinations.

PMID- 8351029
TI  - Neurology in family practice.

PMID- 8351030
TI  - Aging and Alzheimer's.

PMID- 8351031
TI  - Serotonin, depression, and PD.

PMID- 8351032
TI  - Centrum ovale infarcts.

PMID- 8351033
TI  - Neurolymphomatosis.

PMID- 8351034
TI  - Neurolymphomatosis.

PMID- 8351035
TI  - Late-onset MS.

PMID- 8351036
TI  - Diagnosis of PD.

PMID- 8351037
TI  - Withholding therapy.

PMID- 8351038
TI  - Withholding therapy.

PMID- 8351039
TI  - Stress and hemorrhages.

PMID- 8351041
TI  - Delayed hemorrhage.

PMID- 8351040
TI  - Delayed hemorrhage.

PMID- 8351042
TI  - A longitudinal study of infections and injuries of Ranger students.
AB  - Causes of medical attrition and their implications for medical support for the
      U.S. Army Ranger course are considered, based on data collected from 190 students
      in a summer class. In the second half of the course, an increase in documented
      infection rates, notably cellulitis of the lower extremities and Streptococcus
      carriage prevalence, coincided with indications of compromised immune function.
      The authors suggest that aggressive treatment in the field, including liberal use
      of antibiotics, and periodic examination of each student by medical personnel are
      critical factors which will minimize medical attrition and ensure safe
      participation of soldiers in this and other stressful and sustained field
      exercises.

PMID- 8351044
TI  - Helping the helpers: family support for social workers mobilized during Desert
      Storm/Shield.
AB  - This study identifies the types of social support available to the families of
      social work officers activated during Operation Desert Storm/Shield and
      determines which social supports were utilized by these families and the degree
      of perceived satisfaction with those social supports. This is a post-event
      assessment on a one-time basis. A Social Support Questionnaire was sent to the
      spouses of all activated Social Work Officers. Findings suggest no correlation
      between amount of social support and perceived effectiveness. Findings also
      suggest a need to assist families of military social work officers with informal
      and formal social support connections.

PMID- 8351045
TI  - Clinical practice guidelines: enhancing quality of care.

PMID- 8351043
TI  - Effect of chewable antiplaque preparation on plaque and gingival index scores in
      military academy cadets during their two-week winter camp.
AB  - Dental emergencies in the military are mostly due to infections of the teeth.
      Practising normal oral hygiene is very difficult during terrain maneuvers, for
      example. Therefore, a chewable antiplaque preparation was developed to inhibit
      the growth of dental plaque. The preparation contains chlorhexidine, fluoride,
      and xylitol and it can be easily added to the soldier's kit. This paper presents
      results on the efficacy of the preparation in maintaining satisfactory oral
      hygiene in military academy cadets during a 2-week winter camp. The preparation
      was found significantly more effective in reducing gingivitis than conventional
      brushing of the teeth (p < 0.001).

PMID- 8351046
TI  - Evolution of America's pioneer bacteriologist: George M. Sternberg's formative
      years.
AB  - George M. Sternberg, 1838-1915, M. D., USA, activated modern American
      bacteriology. He produced the first general bacteriology book in the English
      language in 1880. His first publications on chemical disinfection (1879) preceded
      Koch's Sternberg discovered the pneumococcus (1880) before Pasteur did and
      speculated about phagocytosis (1881) before Metchnikoff. As an experimentalist
      and author, Sternberg stood "at the head of the American school of working
      bacteriologists" by the early 1880s. Our essay on Sternberg's evolution as a
      scientist explains what motivated him and why his early achievements as a
      bacteriologist, praised by contemporaries, have been underestimated more
      recently.

PMID- 8351047
TI  - Cold weather field evaluation of the 18-Man Arctic Tray Pack Ration Module, the
      meal, ready-to-eat, and the Long Life Ration Packet.
AB  - The Army Field Feeding System was evaluated for its ability to provide adequate
      nutrition and hydration during a 10-day cold weather field exercise. Soldiers
      consumed the 18-Man Arctic Tray Pack Ratio Module with either a wet-pack (Meal,
      Ready-to-Eat) or a dehydrated (Long Life Ration Packet) individual ration. Both
      feeding regimens were acceptable, meeting protein and micronutrients
      requirements. However, the soldiers consumed only 70% of their energy
      requirement, thus losing an average of 0.9% of body weight. This weight loss,
      although not excessive, underscores the importance of maintaining an adequate
      food intake during extended cold weather military field operations.

PMID- 8351049
TI  - A one-year look at the impact of cholesterol screening, education, and
      counseling.
AB  - During 1989 and 1990, we offered cholesterol screening in conjunction with
      National Medical Laboratory Week. The proportions of subjects categorized as
      hypercholesterolemic decreased in 1990 in each eligibility category except family
      members. Active duty subjects decreased from 39% to 30%, retired subjects from
      60% to 55%, and civilian subjects from 51% to 43%. These changes were also
      reflected in significant decreases in the mean cholesterol levels for retired and
      civilian subjects. The data suggest a downward trend that we hope will continue
      with active screening, education, and counseling.

PMID- 8351048
TI  - Children's reactions to the Desert Storm deployment: initial findings from a
      survey of Army families.
AB  - Psychological symptom profiles were obtained on 1,601 children of soldiers
      deployed during Operation Desert Storm (ODS). The profiles were obtained from
      reports of the parents who stayed at home with the children. Certain symptoms
      such as sadness were common, but very few parents considered their children's
      problems serious enough to require counseling. The strongest predictor of
      children's receiving counseling during ODS was a previous history of being in
      counseling for emotional problems.

PMID- 8351050
TI  - Indications for internal stenting in intestinal obstruction.
AB  - Internal stenting (sutureless plication) for intestinal adhesions was performed
      operatively in 16 patients. Subsequent recurrent obstruction occurred in four
      patients. Other complications occurred in three patients and included retained
      tube, jejunostomy-site abscess, and intestinal fistulization. Four patients died
      for an in-hospital mortality of 25%. Internal stenting for adhesions should be
      used cautiously. Its use should probably be restricted to the setting of severe
      adhesive small bowel obstruction particularly when numerous enterotomies are
      incurred during the course of adhesiolysis.

PMID- 8351051
TI  - The effects of alcohol and tobacco use on troop readiness.
AB  - Prior studies have documented the ill effects of cigarette smoking on soldier
      athletic performance. We examined the effects, if any, of cigarette smoking and
      alcohol use on troop readiness. A group of 510 soldiers was examined. They
      answered an initial questionnaire and then were followed in sick call for a 2
      month period. The results of the study confirmed that cigarette smoking impacted
      adversely on athletic performance. However, we were unable to quantitate
      increased time off or away from duty as a result of cigarette smoking and alcohol
      use.

PMID- 8351052
TI  - NAMRU-3: forty-six years of infectious disease research.
AB  - The United States Naval Medical Research Unit No. 3 (NAMRU-3), Cairo, Egypt, has
      been in continuous operation studying infectious diseases of military importance
      since its establishment in 1946, even during the lapse in diplomatic relations
      from 1967-1974. Other overseas research laboratories of the Naval Medical
      Research and Development Command include NAMRU-2 in Jakarta, Indonesia, with a
      detachment in Manila, and the Naval Medical Research Institute Detachment Lima,
      Peru. Comparable U.S. Army overseas research laboratories are located in
      Thailand, Brazil, Korea, and Kenya. Department of Defense overseas laboratories
      conduct research on infectious diseases endemic to their respective geographic
      regions which could adversely impact on the health of deployed military forces.
      This article describes the history of one such laboratory, NAMRU-3, and the
      important infectious disease research it conducts to enhance the health of
      military forces deployed to its strategic geographical region of the world.

PMID- 8351053
TI  - Association between an excessive body mass index and coronary heart disease risk
      factors in military personnel.
AB  - The purpose of this study was to document the extent of coronary heart disease
      (CHD) risk factors in military personnel (412 men, 50 women) classified as
      seriously overweight (body mass index [BMI] 27.0-29.9 kg/m2) or obese (BMI > or =
      30 kg/m2) and to evaluate the utility of the BMI to discriminate among
      individuals with an adverse CHD risk profile. Mean body weight and BMI greatly
      exceeded Canadian norms, whereas mean heights were average. There were low but
      significant correlations between BMI and resting and submaximal exercise (stage A
      of the Canadian Aerobic Fitness Test) heart rates and blood pressures, while the
      correlation with predicted VO2max was negative. Except for blood glucose level
      (GLU) in men, there were no significant correlations between BMI and various
      biochemical indices. Compared to "overweight" men, the percentage of "obese" men
      with abnormal values for risk factors were higher, particularly for an adverse
      exercise blood pressure response and low predicted VO2max. In summary, the
      correlations between BMI and the various CHD risk factors, except for GLU and the
      exercise parameters, were minimal or moderate at best. It was concluded that in
      overweight and obese individuals, BMI does not appear to be a particularly
      sensitive indicator of body fat and risk factors.

PMID- 8351054
TI  - Pharmacotherapy for recently evacuated military casualties.
AB  - In late 1990 during the massive Operation Desert Shield/Storm (ODS) deployment of
      United Nations troops, the VA/DoD Joint Contingency Plan was activated. Worst
      case scenarios projected tens of thousands of medical evacuees from the Persian
      Gulf and predicted that U.S. Military Communication Zone and CONUS bed capacity
      would quickly be saturated. As a result, a massive educational program was
      rapidly implemented to prepare 80 VA hospitals to receive ODS personnel within 1
      3 weeks of their evacuation from battalion aid stations or other front-echelon
      medical facilities. This article was written as part of this educational effort.
      Noting that there were no published articles on pharmacotherapy for recently
      evacuated military casualties, the authors wrote the present manuscript for
      inclusion in the ODS Clinical Packet prepared by the VA's National Center for
      PTSD and circulated to VA mental health professionals. Since the published
      literature still lacks an article on this subject and since we believe that our
      comments on pharmacotherapy apply to survivors of most acute traumatic events, we
      present our observations and recommendations with the hope that they may be
      useful to military, VA, and civilian practitioners.

PMID- 8351055
TI  - Antepartum diagnosis of arthrogryposis associated with trisomy 18.
AB  - The discovery of a fetal abnormality during ultrasonography is a widely
      acknowledged indication for genetic amniocentesis. We present a case in which the
      early diagnosis of severe arthrogryposis led to the diagnosis of trisomy 18.

PMID- 8351056
TI  - A persistent left lower lobe infiltrate and chronic cough following chest wounds
      sustained in Vietnam twenty-four years earlier.

PMID- 8351057
TI  - Spine injuries in combat troops--Panama, 1989.
AB  - Operation Just Cause was until recently the largest American combat operation
      since Vietnam, and remains the largest nighttime parachute operation since World
      War II. All 252 casualties were airlifted to San Antonio, Texas, for medical
      treatment. Greater than 80% sustained orthopedic injuries. Sixteen patients were
      admitted for injuries to the back or neck. Three of the four patients with
      significant fractures or fracture-dislocations were paraplegic. Two of the three
      patients with gunshot wounds to the back required extensive reconstruction for
      wound management. In addition to the 252 casualties, there were 23 fatalities,
      among whom 7 suffered major injuries to the spine. Spine injuries represented the
      most significant source of long-term morbidity among those soldiers wounded in
      combat in Panama, and were common among the fatalities. Noteworthy in these cases
      was the high percentage of severe neurologic injuries in patients with
      significant fractures (75%), particularly fractures associated with gunshot
      wounds. Also of interest were the cases of major soft tissue injury associated
      with high-velocity gunshot wounds (66%) and the extensive soft tissue surgery
      needed to treat these injuries.

PMID- 8351058
TI  - Parathyroid carcinoma: case report.
AB  - Parathyroid carcinoma is a rare entity, representing less than 1% to 5% of
      patients with primary hyperparathyroidism. Parathyroid carcinomas are often
      symptomatic, have markedly elevated calcium levels, have palpable masses, are
      equally distributed between the sexes, and present 10 years younger than their
      benign counterparts. Parathyroid carcinoma is often undiagnosed preoperatively,
      suspected intraoperatively, and only confirmed postoperatively. When diagnosed,
      the treatment of choice is an en-bloc resection of the tumor.

PMID- 8351059
TI  - [Hysteroscopic evaluation of female infertility].
AB  - Three-hundred-seventy-one infertile patients underwent hysteroscopic evaluation.
      The test was performed in an outpatient setting without any form of anesthesia. A
      comparison has been made among this technique, the hysterosalpingography and
      ultrasounds: hysteroscopy showed to be more accurate in the evaluation of
      intracavitary pathology, because of its capability to obtain a direct view of the
      uterine cavity. We can evaluate hysteroscopically nature, dimension and
      localization of the lesions. However HSG remains the best technique for the study
      of tubal factors of infertility. We think that hysteroscopy should be used
      besides other diagnostic methods, in order to obtain a better evaluation of the
      infertile patients.

PMID- 8351060
TI  - [Pre-menopausal dysfunctional menometrorrhagia: therapeutic approach].
AB  - Approximately 10% of premenopausal women suffer from dysfunctional
      menometrorrhagia. The correct therapeutic approach to this pathology above all
      requires a precise diagnostic framework. For this purpose the doctor can employ a
      number of laboratory and instrumental tests, both invasive and non-invasive, in
      order to differentiate the dysfunctional forms from those supported by organic
      pathologies or non-gynecological diseases. Once the diagnostic iter has been
      completed, the choice of therapy can be directed towards surgical or medical
      treatment; the latter may be symptomatic or causal. This review focuses on the
      most commonly used treatments for dysfunctional menometrorrhagia in premenopausal
      women and proposes clinical protocols for a correct diagnostic and therapeutic
      approach.

PMID- 8351061
TI  - [Role of the second look in ovarian neoplasia].
AB  - The indications for the execution of a second look in patients affected with
      ovarian cancers and the possible benefits of this procedure, related to the stage
      of the neoplastic disease, are examined. The second look, at first largely used
      in patients in which had been performed adjuvant chemotherapy with drugs
      containing platinum and with no evidence of residual disease, has been later
      strongly criticized and the effective usefulness of this invasive procedure
      discussed. At the moment, we think that the indications for its execution are
      still large because with the second look it is also possible to put into the
      abdomen a catheter which can be used for locoregional chemotherapy and there is
      now the opportunity to perform this procedure also in video-laparoscopy.

PMID- 8351062
TI  - [Minimal celiosurgery in endometriosis].
AB  - After a brief consideration of the recent therapeutic approaches to
      endometriosis, the Authors suggest their laparoscopic method which includes
      drainage by aspiration of the endometrioma using a wide biopsy, followed by
      careful lavage of the cystic cavity and abdomen and partial thermocoagulation of
      the same capsule and any visible residual implants. The patients were admitted
      for infertility in 47% of cases, chorionic pelvic pain in 16% of cases and pelvic
      mass in 10%. By using this procedure symptomatic relief was seen in 72% of cases
      and a pregnancy rate of 81% obtained with encouraging results even in moderate
      and severe endometriosis.

PMID- 8351063
TI  - [Modifications induced on thrombin and plasmin activity by voluntary interruption
      of pregnancy].
AB  - Pregnancy is characterized by plasmatic variations of coagulative factors'
      concentration and by different haemostatic-fibrinolytic balance. At present it is
      possible, with EIA methods, to measure fibrinogen (FgDP) and fibrin (FbDP)
      degradation products with precision and accuracy, as direct indexes of
      fibrinolysis and the thrombin-antithrombin III complex (TAT) as indirect index of
      thrombophilia. We have considered the course of those indexes in 61 pregnant
      women within the tenth week of gestation, before and after voluntary pregnancy
      interruption (VPI) resulted without complications. The results don't show any
      peculiar variation of the examined parameters between the pregnant women before
      VPI and a control group. Comparing the basal data with those obtained three hours
      after VPI, all indexes are increased, particularly FbDP. After 24 hours the
      concentration of FgDP, FbDP and TDP decreased in comparison with the three hours
      control drawing, nevertheless staying higher than the values obtained in the
      basal drawing. The evolution of FDP and of TAT, in our study, points out that, in
      the first weeks of pregnancy, the haemostatic-fibrinolytic balance does not
      differ significantly from the physiological balance. Three hours after VPI
      fibrinolytic mechanisms prevail as regards the fibrinogenolytic ones. TAT
      increases after 3 hours and returns to the rules after 24 hours, proposing itself
      as an indirect index of thrombinic activation and as a direct index of
      antithrombinic activity.

PMID- 8351064
TI  - [Treatment of endometrial hyperplasia with Goserelin depot, an LH-RH analog].
AB  - Nineteen patients with simple endometrial hyperplasia presenting metrorrhagia or
      menometrorrhagia were treated with 4 injections of Goserelin depot, one every 4
      weeks. 12/19 patients were refractory after previous medical therapy. The
      treatment with Goserelin depot resulted in a complete remission of the symptoms,
      occurring within the first month of treatment and still present after a median
      follow-up of 12 months, and in the normalization of the histological profile. No
      patient experienced clinically relevant side effects.

PMID- 8351065
TI  - [Meigs syndrome with bilateral hydrothorax].
AB  - The co-existence of pelvic tumor, hydrothorax and ascites has been known since
      the last century. The features of this disease were described by Meigs and Cass
      in 1937; in the same year Roads named it Meigs syndrome. According to the
      original description this syndrome only included, as pelvic involvement, an
      ovarian neoplasm; at present it is accepted that hydrothorax and the ascites can
      also be associated with a uterine tumor, like a fibroma. The existence of either
      an ovarian or a uterine neoplasm distinguishes the typical Meigs syndrome from a
      pseudo-Meigs syndrome. The most likely pathogenesis of Meigs syndrome ascribes
      the formation of the peritoneal and pleural effusion to the filtration of
      interstitial fluid in the peritoneum through the tumor capsule, and the diffusion
      to the pleural space, generally at the right side, through the diaphragm
      lymphatic vessels and the foramen of Bochdalek. Dockerty reported that at least
      40% of ovarian tumors had a diameter of more than 6 cm when associated with
      hydrothorax and ascites. The entity of pleural and peritoneal effusion can be
      moderate or massive. The effusions generally derive from a transudative process,
      but they can occasionally contain blood cells. The connection between the pelvic
      tumor and the effusion is demonstrated by the regression of the latter when the
      neoplasm is excised. When the pelvic tumor has an ovarian location it derives
      from the connective tissue of the hilus, it appears during fertile age and has a
      slow growth, the clinical signs becoming evident in elder age.

PMID- 8351066
TI  - [Acute pancreatitis in pregnancy].
AB  - This paper describes a case of acute pancreatitis occurring in a patient
      immediately after delivery and in primigravida. The patient had a family case
      history of dyslipidemia (Type IV). The pregnancy had been complicated by
      preeclampsia treated at home with nifedipine tablets (one tablet three times a
      day) with good results on pressure values; lipidic values were high despite
      dietary measures taken. The baby at birth weighed 3830 g after physiologic labour
      and a natural delivery. Acute pancreatitis was diagnosed after observation of
      epigastralgia with irradiation on the left shoulder, vomiting, symptoms of acute
      abdomen such as sweating, increased pulse rate, hypotension, abdominal pain on
      palpation, and absence of peristalsis. An analysis of the blood showed high
      levels of amylase and hyperglycemia, an increase in XDP, and leucocytosis.
      Instrumental tests such as pancreatic echography revealed an increase in
      pancreatic volume, uneven structure of the parenchyma and higher levels of liquid
      in the peritoneum. The patient was moved to intensive-care, a nasal gastric probe
      inserted, hydroelectrolytic treatment was begun, vital functions monitored, pain
      kept under control by medical therapy, and antibiotics administered. Subsequent
      tests showed an improvement in the parameters of pancreatic functions (amylase,
      lipase, calcium hematic) and their gradual return to normal values. The
      computerized tomography of abdomen additionally revealed the presence of
      pancreatic pseudo-cysts and effusion of peritoneal liquid near the right kidney.
      The patient was discharged after two weeks in the surgical ward. There are many
      caused of acute abdomen during and immediately after pregnancy, and one of these
      is acute pancreatitis, though rare (occurring between 1:3800 and 11.467 according
      to Rabkin).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351067
TI  - Nurses in the front lines.

PMID- 8351069
TI  - We've come a long way, maybe. Women's health and the 103rd Congress.

PMID- 8351070
TI  - The term is "health care".

PMID- 8351068
TI  - Nursing & society--the unfinished agenda for the 21st century.

PMID- 8351071
TI  - Nursing education: staying on track.

PMID- 8351072
TI  - An immodest proposal.

PMID- 8351074
TI  - The secret Munchausen epidemic.

PMID- 8351073
TI  - Medical hucksterism is still with us.

PMID- 8351076
TI  - Baccalaureate and master's degree programs in nursing accredited by the NLN 1993
      94.

PMID- 8351075
TI  - President's message: an extraordinary moment in history.

PMID- 8351077
TI  - NMR of proteins.

PMID- 8351078
TI  - The biosynthesis of shikimate metabolites.

PMID- 8351079
TI  - Biological variation of microbial metabolites by precursor-directed biosynthesis.

PMID- 8351080
TI  - Stevioside and related sweet diterpenoid glycosides.

PMID- 8351081
TI  - Direct and indirect care in a multidisciplinary collaborative practice model.

PMID- 8351082
TI  - Women and health care.

PMID- 8351083
TI  - Marie Osborn and the Salmon River Emergency Clinic.

PMID- 8351085
TI  - Combination sulfonylurea and insulin therapy in non-insulin-dependent diabetes
      mellitus.
AB  - Clinicians are frequently faced with treating non-insulin-dependent diabetics
      (NIDDM) who do not exhibit optimal glycemic control on maximal dosages of oral
      sulfonylurea agents or large dosages of insulin. Sustained hyperglycemia is
      implicated in the onset and progression of retinopathy, nephropathy, and
      neuropathy. Recent studies also suggest that hyperinsulinemia contributes to
      hypertension and altered lipid levels. Hence, the maintenance of euglycemia with
      minimal circulating insulin concentrations is the prime goal of therapy. Most
      studies document that the efficacy of combination therapy requires smaller
      insulin doses, enhances glycemic control without adverse effects on body weight
      or lipids, and decreases hypoglycemic episodes compared with insulin monotherapy.
      Therefore, combination therapy may be the optimal therapeutic option in NIDDM
      clients manifesting secondary failure to oral agents or insulin resistance.

PMID- 8351084
TI  - Intensive insulin therapy in insulin dependent diabetes and combination therapy.
AB  - Intensive insulin therapy (IIT) and combination therapy using sulfonylurea and
      insulin are two insulin regimens being used more frequently to improve glycemic
      control. For those patients with insulin-dependent diabetes, IIT or multiple
      daily injection therapy mimics normal pancreatic function by its timing of
      insulin delivery. The improvement in glycemic control carries with it the risk of
      a two- to threefold increase in episodes of hypoglycemia. For those with non
      insulin-dependent diabetes, combination therapy attempts to provide a bridge
      between maximal dose oral hypoglycemic agents and aggressive insulin therapy.
      Although this therapy remains controversial, it has proved useful in select
      patient groups. This article discusses the rationale for IIT, and its
      implementation. Variables that affect IIT are discussed. The combination therapy
      section provides guidelines for patient selection and insulin protocols for
      evening insulin administration. The health care provider is familiarized with
      these alternative therapies and their successful applications.

PMID- 8351086
TI  - Early detection and intervention for hazardous ethanol use.
AB  - Alcohol use is prevalent throughout our culture and produces costly, staggering
      results. Excessive alcohol consumption has extensive implications for the user's
      health, economic well-being, psychological equilibrium, and family and social
      relationships. The resulting consequences add to the spiraling health care costs
      encountered in the United States. Recognition of the pervasiveness of this
      problem is key to primary prevention. This article seeks to encourage clinicians
      to identify high risk alcohol users. Health care providers have potentially a
      great impact on clients and are in a position not only to identify alcohol
      abusers early in the course of their alcohol use, but also to mobilize
      interventions and make referrals. Parameters for recognizing progression of use
      and evaluating the impact of regular consumption are discussed and a protocol for
      rapid, accurate assessment are presented. Low cost interventions will be
      suggested as well as referral guidelines.

PMID- 8351088
TI  - The escalator phenomenon and health care.

PMID- 8351087
TI  - Interpretation of laboratory values in older adults.
AB  - This article describes age-related physiologic changes in the older adult and the
      effect of these changes, if any, on commonly ordered laboratory tests. As
      reported in selected research studies and literature reviews, some laboratory
      parameters change minimally or not at all with age, still remaining within
      recommended reference ranges, while others are altered with age.
      Misinterpretation of an abnormal laboratory value as an aging change can lead to
      underdiagnosis and undertreatment in some instances (such as anemia). Failure to
      appreciate age-related changes can lead to overdiagnosis and overtreatment in
      others (such as hyperglycemia). The results from ongoing national studies are
      needed to establish uniform older adult reference intervals.

PMID- 8351089
TI  - Scleral buckle removal following retinal reattachment surgery: clinical and
      microbiologic aspects.
AB  - Scleral buckle infection following retinal reattachment surgery is infrequent but
      not rare. We identified 45 cases among approximately 3000 scleral buckling
      procedures performed at our institution between July 1, 1985 and July 1, 1991.
      The scleral buckle was exposed in all 45, and the subsequent microbiologic
      culture was positive in 33. The most common causative organism was coagulase
      negative staphylococci (17 of 33 cases with positive cultures). Risk factors for
      an adverse outcome included positive culture, preoperative vision < or = 20/200,
      and preoperative retinal detachment. Broad spectrum antibiotics covered organism
      sensitivity profiles in 16 of the 18 cases tested. Prompt removal of infected
      buckles and treatment with broad-spectrum topical antibiotics are important for
      maintaining vision.

PMID- 8351090
TI  - Combined extracapsular cataract extraction, posterior chamber intraocular lens
      implantation, and pars plana vitrectomy.
AB  - The surgical management of coexisting cataract and vitreoretinal disease has been
      controversial, particularly for eyes with a history of proliferative diabetic
      retinopathy (PDR) or chronic uveitis. We retrospectively studied the results of
      combined extracapsular cataract extraction (ECCE), posterior chamber intraocular
      lens (PC-IOL) implantation, and pars plana vitrectomy in 20 eyes of 16 patients.
      The indications for combined vitrectomy included dense, nonclearing vitreous
      hemorrhage attributed to PDR in 10 eyes, age-related macular degeneration in 2,
      and trauma in 1. The remaining 7 eyes had pars plana vitrectomy to remove
      inflammatory vitreous cell and debris associated with chronic uveitis. Follow up
      ranged from 4 to 32 months (average, 17.4 months). Visual acuity improved in 19
      eyes (95%)--to 20/100 or better in 12 (60%). The improvement ranged from 1 to 13
      Snellen lines (average, 4.9 lines). Postoperative visual acuity improvement
      averaged 7.5 Snellen lines for eyes with chronic uveitis, 7.0 lines for those
      with age-related macular degeneration, and 3.3 lines for those with a history of
      PDR. Postoperative visual acuity was less than 20/100 in 8 eyes (40%). In most
      cases, these latter results were attributed to macular changes associated with
      the underlying ocular disease. Our results confirm previous studies that have
      shown that combined ECCE/PC-IOL implantation and pars plana vitrectomy is a well
      tolerated surgical procedure for diabetics, which can provide clear anterior and
      posterior segment media. In addition, our results suggest that this combined
      procedure can be useful in restoring vision in certain eyes with uveitis in the
      short-term postoperative period.

PMID- 8351091
TI  - Intraocular dexamethasone penetration via subconjunctival or retrobulbar
      injections in rabbits.
AB  - Using high-performance liquid chromatography, we compared tissue levels of
      dexamethasone in the aqueous, vitreous, retina, and choroid of rabbits, 1 and 4
      hours following subconjunctival or retrobulbar injection. One hour following
      injection, dexamethasone levels in all of these tissues were similar in both the
      subconjunctival and retrobulbar groups. Four hours following injection, the
      concentrations in the two groups also were similar, except in the choroid, in
      which the subconjunctival injection yielded significantly lower dexamethasone
      levels than the retrobulbar injection. Tissue steroid levels were comparable
      ipsilateral and contralateral to the injected eyes in both treatment groups after
      4 hours, except in the retina, in which the levels were lower in the
      contralateral eye after subconjunctival injection. These data suggest that
      dexamethasone absorption and delivery is predominantly hematogenous following
      both subconjunctival and retrobulbar injection, especially in highly vascular
      tissues, such as the choroid. Hematogenous delivery of dexamethasone appears to
      peak earlier in the choroid and presumably in other intraocular tissues following
      subconjunctival injections, while retrobulbar injections provide more steady,
      long-term delivery.

PMID- 8351092
TI  - Unilateral lateral rectus recessions in exotropia.
AB  - For the past several years, we have been performing unilateral lateral rectus
      recessions in patients with small- to moderate-angle intermittent or constant
      exotropia. We report a 73% success rate in 45 patients undergoing 6- to 10
      millimeter unilateral lateral rectus recessions in exotropia with a minimum of 6
      months' follow up. The success rate increased to 89% for patients under 4 years
      of age. The advantages of this procedure include operating on only one eye and
      virtual elimination of overcorrections, thereby preventing early postoperative
      consecutive esotropia, which occasionally can result in amblyopia or diminished
      stereopsis in very young children.

PMID- 8351094
TI  - Eye growth after cataract extraction and intraocular lens implantation in
      children.
AB  - We studied the effect of cataract extraction and intraocular lens (IOL)
      implantation (14 unilateral and 2 bilateral cases) on eye growth in 16 children.
      Visual acuity, refractive power, axial length, corneal curvature, and anterior
      chamber depth in both the operated and unoperated eyes were measured before and
      after surgery. The operated eyes tended to become myopic (maximum, -11.00
      diopters). However, though the axial length of two eyes increased significantly
      after surgery, there was no significant difference between the postoperative
      increase in axial length in the operated and in the unoperated eyes. The anterior
      chambers of the unoperated eyes tended to be deeper. We suggest that the tendency
      to become myopic in the operated eyes occurred because, as axial length increases
      with growth, the proportion occupied by the vitreous body, ie, the part posterior
      to the IOL, also increases.

PMID- 8351093
TI  - Reformation of the anterior chamber following trabeculectomy.
AB  - Sixteen eyes requiring surgical reformation of the anterior chamber (AC) in our
      Unit from December 1987 to August 1991 were studied retrospectively to determine
      the incidence of the problem in our hospital and to evaluate the operative
      measures used to restore the AC. The mean preoperative AC depth of these 16 eyes
      was 1.92 mm (range, 1.50 to 2.50 mm). Nine had a history of angle-closure
      glaucoma. Poor surgical technique was a contributing factor in the development of
      a flat AC in 3. Of the remaining 13 eyes, 11 had a trabeculectomy with a fornix
      based, and 2 with a limbus-based, conjunctival flap. Wound leaks occurred in 10
      eyes with fornix-based flaps, but in none of the eyes with limbus-based flaps.
      Factors associated significantly with the development of flat AC following
      trabeculectomy were: a preoperative shallow AC, a history of angle-closure
      glaucoma, and the use of a fornix-based conjunctival flap. Avoiding wound leakage
      when performing trabeculectomy in eyes with a shallow AC or a history of angle
      closure glaucoma by using a limbus-based flap may help prevent postoperative flat
      AC.

PMID- 8351095
TI  - A closed chamber technique for repair of iridodialysis.
AB  - We have developed a surgical technique for repair of traumatic iridodialysis, in
      which a 25-gauge hypodermic needle is used to place a 10-0 polypropylene suture
      in sewing-machine fashion through a closed anterior chamber. The technique also
      can be modified to secure a posterior capsule with a partial zonular dialysis,
      such as may occur during phacoemulsification or cortical clean-up.

PMID- 8351097
TI  - Use of a silicone sheet for delayed adjustable strabismus surgery.
AB  - Adjustable strabismus surgery sometimes fails because of changes in the angle of
      deviation developing a few days after surgery. A thin silicone sheet placed
      between the muscle and sclera prevents postoperative adhesions between these
      tissues, allowing adjustment to be delayed for up to 11 days after surgery. Once
      the final adjustment is made, the silicone sheet is removed.

PMID- 8351096
TI  - A new technique for combined cataract/glaucoma procedures in patients on chronic
      miotics.
AB  - We describe a combined cataract/glaucoma procedure for patients on chronic
      miotics that includes small-incision phacoemulsification to provide increased
      predictability of visual outcome and early visual rehabilitation, and an inferior
      pupilloplasty to facilitate intraoperative visualization. To date, 42 procedures
      have been performed with excellent results. Complications, although minimal, have
      included iridolenticular/iridocapsular adhesions, diplopia, rupture of 10-0
      polypropylene sutures, peripheral anterior synechia, hyphema, and fibrinoid
      aqueous.

PMID- 8351098
TI  - Size of the lens nucleus separated by hydrodissection.
AB  - We measured the extracted central nucleus (diameter and thickness) of 88 eyes
      (average patient age, 72 years) undergoing extracapsular cataract extraction
      (ECCE). The average diameter was 6.51 +/- 0.75 mm; the average thickness, 2.96 +/
      0.33 mm. Since the average lens diameter is approximately 10 mm, a corneoscleral
      incision of 7 to 8 mm in chord length should be sufficient for its removal in
      most ECCE cases. Accumulation of these data and further analysis correlating them
      with age and degree and type of cataract in larger series will be useful in
      determining the smallest possible incision size required for individual patients.

PMID- 8351099
TI  - The lower-lid retractors in congenital entropion and epiblepharon.
AB  - A case of congenital entropion is presented in which the lower-lid crease was
      lost during entropion surgery, yielding a postoperative condition resembling an
      epiblepharon. The case suggests that deficiencies in the lower-lid retractor
      fibers are a key factor in the pathogenesis of both congenital entropion and
      epiblepharon.

PMID- 8351100
TI  - Orbital retractors for posterior segment surgery.
AB  - Successful retinal detachment surgery is greatly aided by proper visualization of
      and access to the intended surgical field. Two retractors, one having a single
      blade and the other a double blade, have been developed to aid retinal detachment
      surgery.

PMID- 8351101
TI  - Eye movement restrictions after Molteno implant surgery.

PMID- 8351102
TI  - Perfluoroperhydrophenanthrene (Vitreon) is radiopaque.

PMID- 8351103
TI  - Adjunctive viscoelastic therapy for postoperative ciliary block glaucoma.

PMID- 8351104
TI  - The use of fibrin glue in mucous membrane grafting of the fornix.

PMID- 8351105
TI  - Let's say what we cut.

PMID- 8351106
TI  - Detector response and exposure control of the RadioVisioGraphy system (RVG 32000
      ZHR).
AB  - The RadioVisioGraphy system (RVG 32000 ZHR) was studied with respect to some
      physical properties including the precision and linearity of the exposure control
      and the detector response to x-rays. The x-ray unit was found to yield repetitive
      exposures that are precisely controlled by the CCX timer. A "preheat" and an
      "after exposure" period were noticed, and their resulting x-ray exposures were
      measured. Two RVG detectors were compared for their responses with x-rays. The
      differences between the detectors were insignificant. However, inhomogeneous
      detector responses were found in both of the detectors; with the same exposure,
      the central parts of the detectors yielded lower pixel values than the peripheral
      parts. A calibration equation was developed to correct for the inhomogeneity.

PMID- 8351107
TI  - Microbiologic contamination during dental radiographic film processing.
AB  - This study investigated microbiologic contamination of an automatic dental
      radiograph processor and daylight loader during a week of simulated clinical use.
      Pure cultures of Candida albicans, Streptococcus pneumoniae, Staphylococcus
      aureus, or Klebsiella pneumoniae were used to contaminate 320 vinyl intraoral
      radiograph packets. Each end of the films was deliberately contaminated during
      opening. These films and 24 uncontaminated control films were processed. Daylight
      loader ports, inlet and outlet rollers, fixer and developer samples, and 12
      processed films were cultured daily. To simulate a weekend, the processor sites
      were cultured during 72 hours of inactivity after the contaminated runs. The
      results showed that contamination of the processor and daylight loader occurred
      and remained even after 48 hours of inactivity. Films remained contaminated after
      processing. In addition, cross-contamination of films occurred in the processor.

PMID- 8351108
TI  - Dense bone island. A review of 107 patients.
AB  - The dense bone island is an asymptomatic radiopacity of unknown origin and is
      known under many synonyms when it occurs in the jaw. This article discusses 113
      dense bone islands in 107 patients with a review of the literature and comparison
      with previous reports. The average age of the patient at discovery was 36 years
      with a women to men ratio of 2:1. The mandible was involved in 109 of the 113
      DBIs, with only 4 in the maxilla. The most common site affected was the
      mandibular first molar region, the premolar region was the second most common
      site affected. Resorption occurred in 11 (9.7%) cases, the first permanent molar
      was the most commonly affected.

PMID- 8351109
TI  - Transposition and microdontia.

PMID- 8351110
TI  - Vertical root fracture.

PMID- 8351111
TI  - Multiple impacted teeth in the maxilla.

PMID- 8351112
TI  - Radiographic artifact mimicking root fracture.

PMID- 8351114
TI  - A new method for drain stabilization.

PMID- 8351113
TI  - Recurrent giant cell reaction to residual Proplast in the temporomandibular
      joint.
AB  - Exuberant foreign-body inflammatory reaction to polytetrafluoroethylene implants
      of the temporomandibular joint, marketed as Proplast-Teflon implants, has been
      widely recognized. Presently, removal of these implants is generally advised.
      Extensive damage of the joint and surrounding structures has been reported,
      including severe bony degeneration, perforation into the middle cranial fossa,
      and cerebrospinal fluid leak. However, recurrent foreign-body giant cell
      reaction, presumably as a result of residual Proplast material, has not been
      reported. We review our experience with Proplast-Teflon implant removal from 112
      joints in 71 patients over a 6-year period, including four joints with recurrent
      giant cell reaction at various times after removal. Emphasis is placed on the
      phenomenon of recurrence and on microsurgical techniques to facilitate implant
      removal.

PMID- 8351115
TI  - More on the contraindications to vasoconstrictors in dentistry.

PMID- 8351116
TI  - Osteomyelitis of the mandible in Tehran, Iran. Analysis of 88 cases.
AB  - This study involved 88 cases of different types of osteomyelitis of the mandible.
      Sixty-nine patients had osteomyelitis after trauma, eight patients after
      radiotherapy, six after dental infection, and six had other causes. Thirty-three
      patients had septicemic infection. Multiple types of aerobic and nonaerobic
      microorganisms were isolated from the infection sites. Types of treatment and
      their results are discussed.

PMID- 8351117
TI  - Epstein's syndrome. Implications for oral surgery.
AB  - Epstein's syndrome is a rare inherited disorder that appears principally as
      nephritis and deafness with thrombocytopathic thrombocytopenia producing a
      bleeding tendency. Management of the disorder for oral surgical procedures is
      discussed and highlighted by a case report.

PMID- 8351118
TI  - Comparative trial of fluconazole and amphotericin in the treatment of denture
      stomatitis.
AB  - The efficacy of fluconazole and amphotericin in the management of denture
      stomatitis was investigated in a comparative trial. Patients were assessed
      clinically, hematologically, and mycologically at the time of entry into the
      study and at 1, 4, and 12 weeks thereafter. A total of 29 patients were selected
      at random to receive 50 mg of fluconazole daily for 14 days; 30 patients were
      selected to receive amphotericin lozenges and cream for 28 days. Clinical
      response rates were similar in both treatment groups throughout the study. The
      best mycologic response was noted after 1 week whereas the best clinical response
      was observed after 4 weeks. Clinical evidence of relapse and recurrence at 12
      weeks was a common finding irrespective of treatment. Side effects were uncommon
      in both groups.

PMID- 8351119
TI  - Old age in health and disease. Lessons from the oral cavity.
AB  - It is not clear if aging distinctions can be made at the level of an organ or
      organism. The purpose of this study was to determine if a general definition of
      systemic aging, primary aging (influence of the passage of time), versus
      secondary aging (influence of extrinsic factors), can be used to discriminate the
      functional status of an individual organ system, the oral cavity. Thirty healthy,
      nonmedicated subjects (that is, those who exhibit primary aging) and 42 persons
      being treated for medical problems and taking prescription medications (that is,
      those who exhibit secondary aging), aged 75 to 96 years, from the oral physiology
      component of the Baltimore Longitudinal Study of Aging were evaluated. A
      standardized examination assessed gingival, periodontal, dental, and oral mucosal
      tissues. There were few substantive differences in oral health and function
      between primary and secondary aging subjects. Thus use of broad definitions of
      aging in an organism did not lead to meaningful predictions of the health or
      function of an individual organ system. Furthermore, the similarity in the oral
      condition between both groups studied here suggests substantial resiliency of the
      oral cavity during aging.

PMID- 8351120
TI  - Assessment of the need for treatment of postendodontic asymptomatic periapical
      radiolucencies in bone marrow transplant recipients.
AB  - Oral screening and treatment of existing oral disease before bone marrow
      transplantation have been reported to decrease the incidence of infectious
      complications during bone marrow transplantation. Information about the adverse
      sequelae of specific preexisting oral diseases during bone marrow transplantation
      is lacking. The presence of postendodontic periapical radiolucencies may suggest
      recurrent or latent infection. The purpose of this study was to compare the
      effect of endodontic treatment with nontreatment of asymptomatic postendodontic
      periapical radiolucencies on the frequency of infectious oral complications
      during bone marrow transplantation. The records of 276 patients undergoing bone
      marrow transplantation examined between July 1988 and June 1991 were reviewed
      retrospectively. Twenty-three postendodontic periapical radiolucencies were
      identified in 8 women and 15 men. The mean age of patients was 41 years (range,
      25 to 58 years). Fourteen of the lesions were untreated, and nine were treated
      before bone marrow transplantation. When outcomes of transplant complications
      were compared, neither increased systemic infection as measured by neutropenic
      days febrile nor local oral infectious complications were significantly
      different. These results suggest that nontreatment of asymptomatic postendodontic
      periapical radiolucencies does not increase the incidence of infectious
      complications during bone marrow transplantation.

PMID- 8351121
TI  - Gingival Kaposi's sarcoma and periodontitis. A case report and suggested
      treatment approach to the combined lesions.
AB  - Kaposi's sarcoma is frequently observed in patients with the acquired
      immunodeficiency syndrome, and the mouth is a common site for these lesions.
      Gingival Kaposi's sarcoma lesions can often be exacerbated by coexisting
      periodontal disease. To obtain the best treatment results, it is important to
      recognize and treat the gingival Kaposi's sarcoma lesion and the associated
      periodontitis concomitantly. In this report we describe a case of oral Kaposi's
      sarcoma in which gingival debridement, root planning and scaling, and monitored
      oral hygiene were used in conjunction with intralesional and systemic
      chemotherapy. These combined therapies significantly reduced the size of the
      lesions and dramatically improved the symptoms.

PMID- 8351122
TI  - Oral T-cell lymphoma associated with celiac sprue. A case report.
AB  - Celiac sprue, also called nontropical sprue, is a malabsorption syndrome with
      symptoms that are triggered mainly by gluten ingestion. Non-Hodgkin's lymphoma of
      the gastrointestinal tract has been reported in patients with a long history of
      celiac sprue. This case report describes the occurrence of primary oral lymphoma
      in such a patient. This case is unusual because lymphomas associated with celiac
      sprue usually develop in the small intestine or in the stomach, and primary
      lymphoma in the mouth is itself uncommon.

PMID- 8351123
TI  - Oral melanotic macules. A review of 353 cases.
AB  - Clinical and histopathologic data were obtained on 353 cases of oral melanotic
      macules. The mean age at the time of diagnosis for all sites was 43.1 years. A
      significant predilection for females (p < 0.001) was noted and the most common
      location was the lower lip (33.0%). The mean size of the lesions was 6.8 mm.
      Brown was the most common color (64.9%), and most (66.0%) of the lesions were
      described as flat. Melanin was evident in both the basal cell layer and lamina
      propria in 93.5% of the cases.

PMID- 8351124
TI  - Rigid fixation of mandibular condyle fractures.
AB  - This article reviews the anatomy and surgical approaches for treating fractures
      of the mandibular condyle with plate and screw fixation. Advantages and
      disadvantages of the preauricular, submandibular, intraoral, retromandibular, and
      rhytidectomy approaches are presented.

PMID- 8351125
TI  - Primary alveolar soft part sarcoma of the tongue of an elderly man. A case report
      and review of the literature.
AB  - A 64-year-old black man had a primary alveolar soft part sarcoma of the tongue.
      It is unusual for this rare tumor to develop in this site in the elderly age
      group. The patient survived nearly 3 years with disease. When the patient
      expired, a complete autopsy was performed. The biopsy material of the primary
      tumor showed characteristic light microscopic appearance, intracellular periodic
      acid-Schiff positive inclusions after diastase reaction, and electron microscopic
      presence of crystals. Immunohistochemistry for neuron-specific enolase was
      positive. The autopsy confirmed widespread visceral and lymphatic metastases. The
      atypical features of this case, including the site of the primary lesion, age of
      the patient at diagnosis, immunohistochemistry of the tumor, and natural history
      of this neoplasm, suggest that alveolar soft part sarcoma may behave differently
      when arising in an extraskeletal site, and could possibly have a different
      histogenesis from the typical alveolar soft part sarcoma found in a younger
      population.

PMID- 8351126
TI  - Diagnosis and treatment of subpontic osseous hyperplasia. Report of a case.
AB  - This report describes a case of subpontic osseous hyperplasia that occurred in
      the posterior mandible of a healthy 67-year-old woman. The two hard masses, which
      were removed from beneath a fixed partial denture that was placed 35 years ago
      and spanned the lower left first premolar and the first and second molars,
      consisted of normal viable dense cortical bone. Only 30 cases of this phenomenon
      defined as a slow-growing, benign osseous proliferation occurring on the crest of
      the alveolar ridge beneath the pontic of a fixed partial denture have been
      described in the literature. Possible causes, including genetic programming,
      functional stimulus, and mild chronic irritation are discussed, as well as
      rationale for treatment of this anomaly.

PMID- 8351127
TI  - Clear cell odontogenic carcinoma with lymph node metastasis.
AB  - Clear cell odontogenic tumors are rare. Review of the literature showed 9 cases
      with a prominent clear cell component. These lesions have exhibited an aggressive
      behavior characterized by an infiltrative local growth pattern, recurrence, or
      metastases. We report a case of an odontogenic tumor that exhibited a biphasic
      pattern and was characterized by lymph node involvement identical histologically
      to the primary tumor. We conclude that the presence of a clear cell component in
      an ameloblastomatous tumor should be viewed as a sign of de-differentiation, and
      that a malignancy with or without metastases should be considered and ruled out
      in such cases.

PMID- 8351128
TI  - In vitro study of the penetration of three bacterial strains into root dentine.
AB  - The purpose of this study was to assess in vitro migration of the following three
      bacterial species into dentinal tubules: Streptococcus sanguis, Actinomyces
      naeslundii and Prevotella intermedia. Twenty-seven bovine incisors were randomly
      divided into three groups. Only the root dentin was used for the experiment.
      Within each group, the nine incisors were sectioned into 36 dentin blocks that
      were incubated with one of the tested bacterial suspensions. Twelve samples were
      taken after 10, 20, and 28 days. Half the samples were observed with scanning
      electron microscopy and the others with light microscopy after standard
      histologic procedures, and the depth of bacterial penetration was measured.
      Analysis of the examinations showed that whatever the technique used, only one
      strain on this experimental model migrated into dentinal tubules. S. sanguis was
      observed at a depth of 792 microns, but no migration was observed for either
      A.naeslundii or P.intermedia. The differences in migration of the bacteria tested
      appear to be related to their morphologic factors and cellular arrangement.

PMID- 8351129
TI  - [Spontaneous abortion and genetic natural selection].
AB  - Author reviews the recent researches related to the genetic causes of spontaneous
      abortions as well as the results of the cytogenetic examinations of gametes,
      early embryos and clinical miscarriages. In the background of more than half of
      first trimester spontaneous pregnancy losses severe chromosomal aberration of the
      fetus can be found. About 60% of abnormal karyotypes is formed by autosomal
      trisomies, the rest is divided among polyploidies, X-monosomy and different
      structural anomalies. The incidence of fetal trisomies correlates with maternal
      age, besides balanced translocations of parents and delayed fertilisation can
      also play a role in the etiology of fetal chromosomal abnormalities. Regarding
      that most of these abnormalities accidentally develop because of meiotic or
      mitotic error there is no great risk of recurrence. Women who have had one
      spontaneous abortion will soon get pregnant again and give birth to a healthy
      child. The abortion of fetuses with abnormal karyotype is the appearance of
      natural genetic selection.

PMID- 8351130
TI  - [Surgical management of liver echinococcosis].
AB  - In the last ten years 62 patients were operated on by the authors because of
      liver echinococcosis. Each of the infections caused by echinococcus granulosus.
      In the course of the examination ultrasonography, abdominal X-ray, Casoni test
      and ELISA were used. Angiography and ERCP were applied only to answer special
      questions. The echinococcus cysts were removed in 15 cases by atypical liver
      resection, in 42 cases by pericystectomy and in 5 cases by partial cystectomy
      using the Pringle's manoeuvre in all of them. Operative mortality was 3.22%.
      Jaundice was observed in three cases, fever in five cases, wound infection in two
      cases. Reoperations had to be performed in two cases. All of the patients were
      treated postoperatively with mebendasol (Vermox). Recurrence of the infection
      could not be observed.

PMID- 8351131
TI  - [First experience with the use of granulocyte-macrophage colony stimulating
      factor in pediatric oncology].
AB  - Authors report their first experiences with the application of granulocyte
      macrophage colony stimulating factor in 12 pediatric cancer patients (14 cases).
      The drug was given in a 5 micrograms/kg single daily dose subcutaneously.
      Patients were divided into three main indication groups: 1. Severe neutropenia
      (white blood cell count < 1.0 G/l) and sepsis (6 patients); 2. Prolonged
      neutropenia (white blood cell count: 1.0-2.0 G/l) and delay in treatment (3
      patients); 3. Dose-escalation of chemotherapy in therapy-resistant cases (4
      patients). Authors report that in all cases a substantial raise in white blood
      cell count could be achieved after 5-6 days of granulocyte-macrophage colony
      stimulating factor treatment. No side effects were detected except of a moderate
      local pain at the site of the injection. Authors suggest that in the above
      described dose and way of administration granulocyte-macrophage colony
      stimulating factor can be an effective agent in the treatment of chemotherapy
      induced neutropenia in paediatric oncology.

PMID- 8351132
TI  - [Dual-chamber rate responsive cardiac pacing].
AB  - The authors describe in this report their first experience with the implantation
      of a rate responsive, dual chamber pacemaker. They emphasize the advantages of
      this type of pacemakers: the maintenance of AV-synchrony and the rate increase in
      response to exercise. Meanwhile they call attention on the complexity of the ECG
      interpretation.

PMID- 8351133
TI  - [Massive colorectal hemorrhage in adult Schonlein-Henoch purpura].
AB  - Schonlein-Henoch purpura is a well known syndrome, rare in adults, and is seldom
      accompanied with extensive colorectal haemorrhage. In abdominal purpura, the
      small bowel is more frequently involved, but cases of oesophageal, gastroduodenal
      and colorectal localisation also have been reported. The cases with colorectal
      bleeding, appearing in adulthood and elderly patients, could cause differential
      diagnostic problems. Described endoscopic features of one patient, who was
      referred to our department, because of colorectal bleeding. The treatment, course
      of disease and endoscopic follow-up is presented. No previous endoscopic
      documentation of this type of localisation has been reported in Hungarian
      literature, so far.

PMID- 8351135
TI  - [Disposal of medical refuse by burning. Procedures and possibilities].

PMID- 8351134
TI  - [Position of the management of the ETT (Scientific Council on Health) on the
      esterin campaign].

PMID- 8351136
TI  - [AUDIT--control of the quality of surgery in Great Britain].

PMID- 8351137
TI  - [Significance of varicella zoster infection in pregnancy and labor].
AB  - The authors observed 25 pregnant or delivering women with varicella and their
      offsprings from 1986 to 1991. The course of varicella of the pregnant and
      delivering mothers was generally benign, only one progressive case was observed
      with pneumonitis after delivery; this woman also recovered upon acyclovir
      treatment. All but one woman delivered on term, in one case the varicella
      developed on the 27th gestational week; this woman gave birth to a premature baby
      of 1180 g who died from a cerebral and lung hemorrhage. No sign of varicella
      zoster virus infection was found at the autopsy. No congenital varicella syndrome
      was observed during the investigation period. Varicella-zoster immunoglobulin was
      given to 21 newborn babies, immediately after birth. Eight of the newborns
      developed varicella, the course of the disease was mild in seven cases. One baby
      who was given no varicella-zoster immunoglobulin and developed progressive
      varicella recovered after acyclovir therapy. During the investigation period the
      authors observed three cases of zoster in infants whose mothers had had varicella
      during pregnancy. The authors discuss the possibilities of prevention of
      varicella-zoster virus infection of newborns and infants.

PMID- 8351138
TI  - [The importance of capnometry and pulse oximetry in laparoscopic
      cholecystectomy].
AB  - Recently the number of surgical and gynaecological operations performed via
      laparoscope has increased. The authors looked for the answer whether the carbon
      dioxide insufflated into the abdominal cavity during laparoscopy could cause
      significant change in the amount of carbon dioxide expired per minute. They
      measured the concentrations of carbon dioxide at the end of expiration, the
      amount of carbon dioxide produced per minute and the oxygen saturation during
      ataranaesthesia, muscle relaxation, intratracheal intubation and controlled
      mechanical ventilation in 20 cases of laparoscopic cholecystectomy. According to
      the results the amount of carbon dioxide exhaled per minute increased 1-3 minutes
      after insufflation and its maximum value was reached within 15-30 minutes (120
      140% of the basic value). The continuous pulsoxymetrical examination showed that
      the constant intraperitoneal pressure equal or higher than 13-15 Hgmm could lead
      to the increase of the intrapulmonal shunt-circulation due to dystelectasis of
      the pulmonary bases. This could be prevented by increasing the respiratory pause
      pressure to the level corresponding to the intraperitoneal pressure. In order to
      decrease the intraoperative anaesthesiological risks associated with the
      procedure the authors propose the use of capnometer and pulsoxymeter for the
      mentioned operation; this will keep level up with the relatively small risks
      associated with the postoperative period of the laparoscopic operations.

PMID- 8351139
TI  - [Leukocyte adhesion defect--a rare form of congenital immune deficiency].
AB  - Leukocyte adhesion defect (LAD) is an inherited defect of phagocytic function.
      This disorder is characterised by delayed separation of the umbilical cord,
      severe recurrent bacterial infections, impaired formation of pus, and high
      leukocyte counts. The granulocytes have severe defect in their chemotactic
      mobility and endocytosis. The disease is attributed to the absence of the
      leukocyte adhesion molecules. (CD11/CD18), which can be verified with monoclonal
      antibodies. The authors describe the disease-process of the first patient
      diagnosed in Hungary. Perinatally the omphalitis, periumbilical abscess and
      periproctal abscess leading to rectovaginal fistula, in the first months the
      otitis, mastoiditis, and expressed leukocytosis referred to the impaired function
      of phagocytic cells, which was verified by laboratory tests as well. The
      decreased inflammation and cicatrization were also striking. This severe form of
      LAD can be cured only by bone marrow transplantation with preliminary sanitation
      of the foci of infection. It took about six months. Unfortunately, the patient
      died of sepsis immediately before transplantation.

PMID- 8351141
TI  - [The activities of Jozsef Lenhossek as museologist and anatomist].

PMID- 8351140
TI  - [Antioxidant effect of vitamin E in experimental hyperlipidemia].
AB  - The effect of Vitamin E treatment was studied in experimental hyperlipidaemia.
      The male Wistar rats got control diet and parallel fat rich diet contained 2%
      cholesterol, 0.5% cholic acid and 20% sunflower oil added into LATI food during 9
      days. The treated hyperlipidemic animals got vitamin E for 9 days in daily 8.56
      mg/b.w.kg dose mixed in food. The effect of antioxidant treatment on changes of
      lipid peroxidation, content of diene conjugates, thiobarbituric acid reactive
      products and natural scavenger capacity of rat liver homogenates and microsome
      fractions were measured by spectrophotometric and luminometric methods. Fatty
      acid composition of lipid fraction of samples was determined by capillary gas
      chromatography. Vitamin E in hyperlipidemia increased the natural scavenger
      capacity of liver and decreased the level of thiobarbituric acid reactive
      products and dien conjugates. There was no change in fatty acid composition of
      samples on effect of vitamin E antioxidant treatment.

PMID- 8351143
TI  - [Licensing rules on private medical practice].

PMID- 8351142
TI  - [Aladar Petz, M. D. (1888-1956), world famous surgeon and inventor from the city
      of Gyor].

PMID- 8351144
TI  - [Halothane hepatitis].
AB  - The greatest disadvantage of the halothane, widely used in the anaesthesiology is
      its ability to cause liver damage. After halothane anaesthesia mild liver enzyme
      elevation in the one fifth of the patients was detected. The incidence of fatal
      halothane hepatitis is rare. It depends on several risk factors: on the genetic
      predisposition, repeated halothane anaesthetics, female sex, age of patient,
      obesity, intrahepatic hypoxia and enzyme induction. In the pathophysiology of
      liver toxicity the metabolism of halothane and immune functions play an important
      role. In this review the last results of researches concerning to the
      hepatotoxicity of halothane are summarised and the authors call the attention on
      the opportunity of its effective prevention.

PMID- 8351145
TI  - [Correlation between tumor regression and survival time after chemotherapy in
      cancer of the oral cavity].
AB  - The examinations were performed on thirty patients with biopsy-confirmed squamous
      cell carcinoma of the oral cavity in clinical stage T2-3No-2M0. The aim of the
      present study was to perform a histological evaluation of the effect of
      preoperative intra-arterial treatment of surgically removed tumours and to
      analyse the correlations with the survival of the patients. The tumour regression
      (R) was evaluated quantitatively on a scale ranging between 1 and 4 points. The
      evaluation yielded a value of R1 in 8/30 cases (residual tumour was not found
      histologically). A tumour of microscopic size (R2) was found in 5/30 cases.
      Partial regression (R3) was established in 12/30 cases, and a slight response
      (R4) in 5/30 patients. The histologic picture was evaluated qualitatively on the
      basis of three arbitrarily chosen parameters. Examinations were made on the
      morphological picture of the residual cancer (C), the inflammatory reaction of
      the stroma (S) and the demarcation tendency of the tumour (D) and the sum of
      these values (A). The higher this point score, the poorer the tumour in question
      responds. Tumours with a score of A3-5 proved to have a very favourable prognosis
      in contrast with those with a score of A8-9. For the borderline scores of A6-7
      the subsequent fate of the patient was decided by the extent of the original
      tumour and by the occurrence or not metastases. It is noteworthy that, with a
      comparatively small number of patients, a significant correlation was
      demonstrated between the survival and the total qualitative point count (A), the
      S value and the D value.

PMID- 8351147
TI  - [Possibilities and limitations of minimally invasive methods in thoracic
      surgery].
AB  - First experiences with minimal invasive thoracic surgery are presented. Between
      November 1991 and September 1992 37 intrathoracic operations--3 lobectomies among
      them--have been performed by their modified method. A special surgical
      thoracoscope was inserted through a 6-7 cm-s incision into the thorax. This
      instrument provides a direct view with excellent distal illumination and it also
      can be applied by video-thoracoscopic system. It is emphasized that their method
      needs further development. It's practical value and result depend on the
      appropriate consideration of possibilities and limits, and on careful selection
      of the patients.

PMID- 8351146
TI  - [Immunohistochemical study of hepatitis B surface and core antigens in HBsAg
      seronegative and seropositive organ and tissue donors].
AB  - Hepatitis B virus antigen screening in the liver of organ and tissue donors was
      performed. The results of a 4-year period are compared with the serological
      findings. The immunohistochemical and serological data altered in two out of 15
      organ donors. HBV antigen could be detected in the liver, however the serological
      examination was negative in these persons. The author emphasize the risk of a
      possible hepatitis B virus transmission through organ and tissue transplantation.
      A detailed examination of the donors is suggested.

PMID- 8351148
TI  - [Genetic counseling and successful pregnancy in patient with Wilson disease].
AB  - The principles of genetic counselling are summarized in a female with Wilson's
      disease. Pregnancy after appropriate treatment during gestation had a successful
      outcome: a healthy boy.

PMID- 8351151
TI  - [Sr. Philomena Schmidt: "I want to be the mouthpiece for basics!". Interview by
      Harald Verworner].

PMID- 8351149
TI  - [He who wants to learn to die, first must learn to live].

PMID- 8351150
TI  - [Care and stay healthy].

PMID- 8351152
TI  - [Reading behavior and leasure time].

PMID- 8351153
TI  - George Washington Crile, anoci-association, and pre-emptive analgesia.

PMID- 8351154
TI  - The tail-flick and formalin tests in rodents: changes in skin temperature as a
      confounding factor.
AB  - In the tail-flick test as well as in the late phase in the formalin test skin
      temperature may in an important way influence the response. A reduced skin
      temperature may be misinterpreted as analgesia, and an increased skin temperature
      as hyperalgesia. These effects and the mechanisms that cause them are discussed.
      It is of particular importance to be aware of these confounding factors when
      using drugs or making lesions that influence blood flow or temperature
      regulation. It is important that all variables influencing the test results are
      kept constant throughout the experiment. This includes not only the ambient
      temperature, but also factors that may influence the vasomotor tone of the
      animals.

PMID- 8351155
TI  - Sex differences in responsiveness to painful and non-painful stimuli are
      dependent upon the stimulation method.
AB  - Sex differences in thermo- and electrocutaneous responsiveness to painful and non
      painful stimuli were investigated in 20 women and 20 men. Heat pain, warmth, and
      cold thresholds were assessed on the hand and foot with a Peltier thermode
      system. In addition, subjects used magnitude estimation to judge the sensation
      intensity evoked by temperatures ranging from 38 degrees C to 48 degrees C
      applied to the forearm. To measure detection, pain, and tolerance thresholds of
      electrocutaneous sensitivity, electrical pulses were administered to the hand.
      Magnitude estimates of sensation intensity were assessed for stimuli ranging from
      0.5 mA to 4.0 mA. There were no sex differences in heat pain, warmth and cold
      thresholds. There were significant sex differences in electrical detection, pain
      and tolerance thresholds, with lower thresholds in women. Correspondingly,
      magnitude estimates were similar in women and men when using thermal stimuli
      while women judged stimuli from 2.5 mA on as more intense than men when using
      electrical stimuli. Despite these discrepancies, the measures for pain
      responsiveness from the two stimulation methods correlated significantly. In
      contrast, no significant correlations between the methods were found when
      considering the responsiveness to non-painful stimuli. The findings help to
      clarify controversies in the pain literature about sex differences. Results
      affirming and denying such differences could be obtained within a single sample,
      with stimulation method as the critical variable.

PMID- 8351156
TI  - A clinical and experimental investigation of the effects of tizanidine in
      trigeminal neuralgia.
AB  - Experiments in cats anesthetized with alpha-chloralose showed that tizanidine
      (TZD: 5-chloro-4-(2-imidazolin-2-yl-amino)-2,1,3-benzothiodiazole) partly
      resembled carbamazepine (CBZ) and baclofen (BCF) in that it depressed excitatory
      transmission and facilitated segmental inhibition of neurons in the spinal
      trigeminal nucleus oralis which responded to tapping but did not affect the
      response of neurons which responded to light stroking of the skin or bending the
      whiskers. In a double-blind crossover study of TZD in refractory trigeminal
      neuralgia, 8 of 10 patients had fewer painful paroxysms while on TZD. However,
      the 6 patients who elected to continue taking TZD experienced a recurrence of
      their attacks of trigeminal neuralgia within 1-3 months. The limited efficacy of
      TZD in the treatment of trigeminal neuralgia may be related to the fact that it
      has no effect on neuronal responses to low-threshold mechanoceptive stimuli,
      suggesting that low-threshold mechanoceptive neurons play an important role in
      the pathogenesis of trigeminal neuralgia.

PMID- 8351157
TI  - Temporal factors in the enhancement of morphine analgesia by desipramine.
AB  - Administration of desipramine, the tricyclic noradrenergic agent, for 7 days pre
      operatively, had been found to potentiate postoperative morphine analgesia. In
      this study we investigated the necessary timing of administration of desipramine
      in its action to potentiate morphine analgesia. We report that the administration
      of desipramine for only 3 days, starting 7 days before surgery, also potentiated
      postoperative morphine analgesia and that the analgesia observed was not
      different from that in patients receiving a full 7 days of desipramine pre
      operatively. The potentiation of morphine analgesia observed was most evident as
      a prolongation of the analgesic response. Patients who also received desipramine
      for only 3 days, but starting 3 days pre-operatively had an analgesic response to
      postoperative morphine that was the same as that in patients receiving placebo.
      The ability of the administration of desipramine early in the pre-operative week
      to interact with postoperative morphine and the lack of response when desipramine
      was given late in the week does not have an explanation at present. However, it
      may reflect the known latency in humans to the onset of the central effects of
      tricyclic antidepressants (TCAs).

PMID- 8351158
TI  - Magnesium sulphate injected subcutaneously suppresses autotomy in peripherally
      deafferented rats.
AB  - In rats, recent evidence suggests that injury discharge caused by peripheral
      nerve section releases excitatory amino acids into the spinal cord which in turn
      influences decisively the development of autotomy, a self-mutilation behaviour
      directed towards the denervated areas. Autotomy has been proposed as a
      behavioural correlate of the neuropathic pain which occurs in humans after
      complete nerve lesions. Mg2+ ions have been shown to offer protection from
      neurological and degenerative disorders in which excitatory amino acids are
      putatively involved. To ascertain the preventive value of Mg2+ administration on
      autotomy, male rats underwent unilateral ligation and transection of the sciatic
      and saphenous nerves 30 min after being injected subcutaneously (s.c.) with 300
      or 600 mg/kg MgSO4 or saline. Thereafter, autotomy was monitored for 8 weeks.
      Serum, lumbosacral (L1-S1) and brain magnesium levels were analyzed 0, 30, 60,
      120, 180, 240, 360 min and 24 h after the s.c. injection of 600 mg/kg MgSO4.
      Serum magnesium levels increased quickly from 1.02 mM (0 time) to 4.52 mM (at 60
      min) and dropped afterwards to reach physiological levels at 6 h. Peak increments
      in L1-S1 and brain Mg2+ levels were smaller (32% and 30%, respectively) although
      maintained for at least 6 h. Magnesium pretreatment in a significant and dose
      dependent manner (1) largely suppressed autotomy, (2) decreased final autotomy
      scores, (3) delayed autotomy onset, and (4) decreased the percentage of animals
      engaged in high autotomy behaviors. The data support a role for excitatory amino
      acids in determining susceptibility to autotomy and suggest a hopeful way to
      prevent neuropathic pain in humans after peripheral deafferentation.

PMID- 8351159
TI  - The roles of spatial recruitment and discharge frequency in spinal cord coding of
      pain: a combined electrophysiological and imaging investigation.
AB  - An investigation was conducted to examine both temporal and spatial factors
      likely to be involved in spinal cord nociceptive coding by wide cord nociceptive
      neurons. Three separate methodologies were employed. First, the impulse frequency
      responses of L4 spinal cord wide-dynamic-range (WDR) neurons to gentle mechanical
      stimulation, vigorous but innocuous brushing, warmth (43 degrees C), and
      nociceptive thermal stimuli (45-49 degrees C) were electrophysiologically
      characterized in unanesthetized, spinal cord-transected rats. Second, the spatial
      distribution of evoked activity in response to the same types of mechanical and
      thermal stimuli was examined utilizing the 14C-2-deoxyglucose (2-DG) metabolic
      mapping method in the same type of animal preparation. Finally, the contributions
      of impulse frequency and numbers of neurons activated to encoding the distinction
      between painful and non-painful sensations were directly evaluated by
      electrically stimulating axons within the spinal cord anterolateral quadrant
      (ALQ) of conscious human subjects. Electrophysiological findings revealed that
      vigorous but innocuous brushing produced intermediate rates of impulse discharge
      significantly greater than those produced by 35 and 43 degrees C stimuli, yet
      indistinguishable from those produced by relatively low nociceptive temperatures
      (45-47 degrees C). Thus, the discharge frequencies of individual dorsal horn WDR
      neurons alone do not provide sufficient information to encode the distinction
      between innocuous and low intensity nociceptive stimuli. Mapping of spinal cord
      activity by the 2-DG method revealed that nociceptive stimuli activated extensive
      rostro-caudal regions extending from L1-L5. In contrast, vigorous but innocuous
      brushing evoked metabolic activity that was confined to a narrow zone within L3.
      Thus, as predicted from previous studies, the distinction between nociceptive and
      non-nociceptive sensory events may be encoded, in part, by differences in the
      spatial distribution, and hence, the relative numbers of spinal cord neurons
      activated by nociceptive and innocuous stimuli. The responses of conscious human
      subjects to varying frequencies and intensities of electrical ALQ stimulation
      clarify the significance of the large numbers of spinal cord neurons activated by
      nociceptive stimuli. With stimulus frequency held constant at 50 Hz, low stimulus
      currents, sufficient to activate only small numbers of ALQ axons, produced
      innocuous sensations. Higher stimulus currents, sufficient to activate larger
      numbers of neurons, consistently produced painful sensations. Increasing ALQ
      stimulus frequency at currents subthreshold for pain or increasing stimulus
      currents at frequencies subthreshold for pain resulted in painful sensations,
      thus indicating that both discharge frequency and numbers of neurons activated
      are both important factors in the encoding of pain.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8351160
TI  - Chronic effects of topical application of capsaicin to the sciatic nerve on
      responses of primate spinothalamic neurons.
AB  - The responses of 144 spinothalamic tract (STT) cells were recorded in 15
      anesthetized macaque monkeys (Macaca fascicularis). Three to 4 weeks prior to the
      acute experiment, the sciatic nerve was surgically exposed on one or both sides
      so that capsaicin or vehicle could be applied. Responses of STT cells recorded in
      3 experimental groups were compared: untreated (21 cells), vehicle-treated (40
      cells), and capsaicin-treated (83 cells). The background activity of cells in the
      vehicle- and capsaicin-treated groups was the same as in the untreated group
      (that is, cells on the side contralateral to surgery). Responses to innocuous
      (BRUSH) and noxious (PINCH) mechanical stimuli were unchanged by vehicle or by
      capsaicin treatment. However, responses to other noxious (PRESSURE and SQUEEZE)
      mechanical stimuli were significantly increased in the vehicle-treated group.
      Compared with a large reference population, all experimental groups showed a
      significant increase in overall responsiveness to mechanical stimuli (as
      determined by cluster analysis), greatest in the vehicle-treated group. Responses
      to noxious heat stimuli were significantly reduced in the capsaicin-treated group
      for 45 degrees C and 47 degrees C stimuli. Volleys in A fibers, probably A delta
      fibers, evoked prolonged responses in many STT cells of all treatment groups.
      Electron microscopic counts of axons in the sciatic nerves of animals treated
      with capsaicin showed a reduced number of C fibers but no appreciable loss of
      myelinated axons. This loss of unmyelinated sensory fibers was presumably
      responsible for the reduction in the responses of the STT cells to noxious heat
      stimuli. Increased responses to some noxious mechanical stimuli and to A fiber
      volleys may have been the consequence of several factors, including surgical
      manipulation, a chemical action of vehicle and a contralateral action of
      capsaicin treatment.

PMID- 8351161
TI  - The sensory response to capsaicin during repeated topical exposures: differential
      effects on sensations of itching and pungency.
AB  - Changes in sensory irritation were measured during repeated topical exposures to
      capsaicin over 2 days. The perceived intensities of itching and pungent
      sensations, predominantly burning and stinging/pricking, were assessed every 60
      sec during 5 applications of capsaicin at inter-stimulus intervals (ISI) of 90
      min (Exp. 1) or 15 min (Exp. 2) and in follow-up tests 24 h later. Psychophysical
      measurements were obtained with a hand-held dynamometer in conjunction with the
      method of magnitude production. When the ISI was 90 min, itching and pungency
      were both significantly reduced (i.e., desensitization occurred) by the fifth
      exposure; however, the reduction occurred more rapidly and dramatically for
      itching. After 24 h, desensitization remained significant only for itching. When
      the ISI was 15 min, the sensations on day 1 first intensified in a manner
      consistent with sensitization, then declined in a manner consistent with
      desensitization; compared to pungency, itch exhibited less sensitization and more
      desensitization. On day 2, overall intensity was less for both categories of
      sensation, primarily because of a reduction in sensitization. Marked individual
      differences were observed in the overall sensitivity to capsaicin, the time
      course of sensation, the susceptibility to capsaicin-induced itch, and the rate
      and duration of sensitization and desensitization. The results are discussed in
      terms of current hypotheses about the sensory mechanisms that underlie chemically
      induced itch and the use of capsaicin as a topical analgesic and antipruritic.

PMID- 8351163
TI  - Enhancement of the epidural morphine-induced analgesia by systemic nifedipine.
AB  - We evaluated postoperative pain relief and incidence of side effects of the
      combination of epidural morphine (0.5 mg) and sublingual nifedipine (10 mg).
      Thirty-six patients were submitted to elective operations and divided into 4
      groups receiving placebo (groups A and B) or morphine (groups C and D) by the
      epidural route, followed by sublingual placebo (groups A and C) or nifedipine
      (groups B and D) administered in a double-blind fashion. The mean (+/- S.E.M.)
      periods of analgesia were 16.6 +/- 1.6 (A), 15 (B) 105 +/- 77.0 (C), and 428.8 +/
      72.0 (D) min. No patient had pruritus, excessive sedation or respiratory
      depression. Episodes of nausea and/or vomiting requiring no specific therapy were
      observed in groups A, B and D. Nifedipine-treated groups also had a significant
      fall in blood pressure which was controlled by rehydration. These results
      indicate that epidural morphine-induced postoperative pain relief may be enhanced
      by systemic administration of nifedipine, with easily controlled side effects.

PMID- 8351162
TI  - Are poor metabolisers of sparteine/debrisoquine less pain tolerant than extensive
      metabolisers?
AB  - It has recently been shown that O-demethylation of the opioid drug codeine to
      morphine depends on the sparteine/debrisoquine oxygenase (CYP2D6) which in man
      exhibits genetic polymorphism. Morphine may be an endogenously formed substance
      in mammalians. Therefore, it may be hypothesized that the final step in an
      endogenous synthesis of morphine from codeine also depends on CYP2D6. CYP2D6,
      which is present in the liver and presumably also in the brain, is not expressed
      in subjects who are poor metabolisers of the sparteine/debrisoquine type. We have
      determined sensitivity to painful stimuli in 94 extensive metabolisers and 82
      poor metabolisers of sparteine in 2 phasic (pain thresholds to heat and pressure)
      and 1 tonic (cold pressor test) experimental pain model. Extensive and poor
      metabolisers did not differ significantly in the 2 phasic pain models neither
      with respect to pain detection nor pain tolerance thresholds. However, for the
      cold pressor test, peak pain ratings and area under the pain rating-time curve
      during 2 min were significantly higher in poor than in extensive metabolisers (P
      = 0.0024 and 0.044). Furthermore, a substantially higher fraction of poor
      metabolisers prematurely withdrew their hand from the ice water during the cold
      pressor test due to intolerable pain (32 vs. 18%, P = 0.0545). We conclude that
      poor metabolisers of sparteine may be less tolerant to tonic pain than extensive
      metabolisers, and we hypothesize that this may be related to an inherited defect
      in endogenous synthesis of morphine via CYP2D6 in the brain.

PMID- 8351164
TI  - Pain assessment with interactive computer animation.
AB  - A method of assessing pain using interactive computer animation is described.
      This method provides quantitative measurements of different qualitative aspects
      of pain experience without reliance on fine verbal distinctions. A clinical
      comparison of this procedure and the Short-Form McGill Pain Questionnaire (SF
      MPQ) is reported. Correlations between paper and animated visual analogue scales
      (VAS) showed that animated measurements can be reliably compared to traditional
      paper-based reporting. Measurements using animations designed to assess different
      qualities of pain experience correlated significantly with SF-MPQ measures,
      providing good concurrent validity. A difference was found between patients who
      chose only one quality-of-pain animation and those who chose more than one,
      possibly indicating a difference in patients' verbal fluency. Patients
      overwhelmingly preferred the interactive animations to the paper-based method.

PMID- 8351165
TI  - Analysis of variance in the study of drug interactions.

PMID- 8351166
TI  - The effect of CPP in neurogenic pain: inhibition of spinal or cortical NMDA
      receptors?

PMID- 8351167
TI  - Is intrathecal octreotide analgesic or what?

PMID- 8351168
TI  - Stress riser fractures of the hip after sliding screw plate fixation.

PMID- 8351169
TI  - Do no harm?

PMID- 8351170
TI  - The basic science of anterior cruciate ligament surgery.
AB  - Surgery for ligamentous injuries of the knee continues to be one of the most
      common procedures performed by orthopaedists. Anterior cruciate ligament (ACL)
      reconstructions are addressed specifically. Basic science and laboratory research
      have had a dramatic effect on our understanding of the underlying pathology of
      the injury, and this information has been used in the development of the clinical
      procedures most commonly used today. The classic stages of ligament healing are
      contrasted with the limited potential of the ACL. Surgical options using
      autografts, allografts, augmentation devices, and primary repair are discussed.
      Present research is examined for possible future directions in the treatment of
      ligament injuries.

PMID- 8351171
TI  - The basic science of meniscus repair.
AB  - The meniscus transmits load and reduces stress and compression of the articular
      cartilage and subchondral bone of the knee during weight bearing. Removal of even
      small portions of the meniscus may increase joint contact forces dramatically and
      lead to early degenerative changes in the knee. The goal of meniscus surgery is
      to preserve as much functional meniscus tissue as possible in the hope of
      decreasing the risk of late degenerative sequelae and still relieve the symptoms
      associated with the tear. The indication for repair of any meniscus tear should
      depend solely on the ability to technically stabilize and coaptate the tear. This
      article reviews the basic treatment principles of meniscal tears.

PMID- 8351173
TI  - Complications associated with the Seidel nail.
AB  - The Seidel nail is an intramedullary locking device available for the treatment
      of humeral shaft fractures that require operative fixation. A retrospective
      review of 13 consecutive patients treated with the Seidel nail was undertaken to
      evaluate results, with attention to complications. No nerve palsies or infections
      occurred. Complications occurred in 46% of the patients and included
      intraoperative comminution associated with lateral placement of the pilot hole,
      instrumentation failure, and underreaming of the canal, resulting in iatrogenic
      fracture.

PMID- 8351172
TI  - Rush rods versus plate osteosyntheses for unstable ankle fractures in the
      elderly.
AB  - Fifty patients with unstable fibular fracture were randomized into two groups.
      Twenty-five were treated with Rush rods and 25 with AO plates. Eighty-eight
      percent of patients treated with intramedullary rods had good or fair functional
      results, compared with 76% of patients undergoing plate and screw fixation. Full
      weight bearing was possible 6 weeks earlier with Rush rods than with AO plates,
      and there was less morbidity in the intramedullary group than in the AO group.
      This study indicates that Rush rods are a useful tool in elderly patients with
      soft bone, who are at risk for complications with plate and screw fixation.

PMID- 8351174
TI  - Preoperative diagnosis of a forearm peripheral schwannoma.
AB  - A 34-year-old man had a right distal forearm mass of unknown etiology for 6
      years. Magnetic resonance imaging showed a tumor in continuity with the median
      nerve. Fine-needle biopsy revealed it to be a schwannoma. Surgical excision was
      performed by separating the nerve fascicles from the tumor. The patient was
      asymptomatic at 12-month follow-up.

PMID- 8351175
TI  - Failure of a well-fixed bone-ingrown titanium hip prosthesis.
AB  - A cementless titanium femoral stem was revised 5 years after implantation because
      of acute pain and progressive osteolysis. Substantial amounts of titanium and
      polyethylene wear debris were found in the surrounding tissues. Multiple sources
      of this debris were found as well as detachment of titanium fiber-mesh pads from
      the body of the femoral stem.

PMID- 8351176
TI  - Disruption of the anterior cruciate ligament in a 4-year-old child.
AB  - Anterior cruciate ligament (ACL) injuries in children are rare. Thus, the natural
      history of ACL injuries in skeletally immature patients is unknown. This case
      represents the longest follow-up (11 years) reported in the literature of an ACL
      injury in a child of less than 5 years old.

PMID- 8351177
TI  - Failure of the polyethylene liner leading to notching of the femoral component in
      bipolar prostheses.
AB  - Polyethylene wear is an increasingly recognized problem in joint replacement
      surgery. Three cases of polyethylene wear in bipolar hip prostheses are
      presented. Owing to failure of the polyethylene liner, impingement of the metal
      shell produced notching of the femoral component.

PMID- 8351178
TI  - A 54-year-old woman with a 15-year history of pain in both legs and back.

PMID- 8351179
TI  - Simple surgical techniques to protect the soft tissues during total knee
      arthroplasty.
AB  - The surgical techniques involved in total knee arthroplasty are often
      overshadowed by implant design, metallurgy, and fixation methods. This is
      especially true when considering the handling of the soft tissues rather than the
      bony cuts. The authors believe that protection of the soft-tissue structures
      around the knee is of paramount importance and describe six surgical techniques
      that they use to accomplish this during total knee arthroplasty.

PMID- 8351180
TI  - Properties of spatial representations: data from sighted and blind subjects.
AB  - Five questions concerning the properties of spatial representations are explored.
      (1) How accurately does a spatial representation correspond to the true scene?
      (2) If inaccurate, how does it differ? (3) Are representations of a familiar
      scene more accurate than those of an unfamiliar one? (4) Do representations of a
      scene currently in view differ from those retained in memory? (5) Do the
      representations of the blind have properties comparable to those of the sighted?
      Seven sighted and 7 highly mobile blind subjects, all familiar with a room, and 6
      sighted subjects unfamiliar with it, were asked to estimate the absolute
      distances between 10 salient objects in the room. The 14 familiar subjects made
      their estimates twice: while they were in the room, and while they were remote
      from it. Regression analyses showed that the estimates of all subjects had strong
      metric properties, being linearly related to true distance, with a true zero
      point; and multidimensional scaling showed that all subjects produced distance
      estimates that could be scaled in two dimensions to closely match the actual
      locations of the objects. Familiarity had no effect. The effect of location of
      testing was the same for both the sighted and the blind: all subjects displayed
      better spatial knowledge when tested in the room; and all subjects underestimated
      true distance substantially when tested out of the room. The results showed no
      qualitative differences as a function of blindness, at least for these highly
      skilled blind travelers.

PMID- 8351181
TI  - Localization of electrocutaneous stimuli on the fingers and forearm: effects of
      electrode configuration and body axis.
AB  - Four experiments were done on the effects of electrode configuration (concentric
      vs. unifocal) and body axis (longitudinal vs. transverse) on localization of
      electrocutaneous pulse stimuli at the fingers and forearm. Subjects pointed to
      the apparent location of current pulses. For the transverse placement of
      electrodes, pulses were localized correctly, whatever the configuration and the
      body site might be. In addition, intrasubject variability at the forearm was
      smaller for the transverse axis than for the longitudinal axis. For the
      longitudinal placement of electrodes, pulses were localized as a function of
      configuration and body site. At the fingers, concentric electrodes provided
      precise localization but unifocal electrodes provided a great mislocalization;
      and intrasubject variability of localization was larger for the unifocal
      electrodes than for the concentric electrodes. At the forearm, whatever the
      configuration might be, the pulses were localized more proximally than the
      stimulus site; and intrasubject variability of localization did not differ
      between the configurations. These results are related to Boring's anchor theory,
      apparent distance between two points, and the localization of other somatosensory
      stimuli.

PMID- 8351182
TI  - When acoustic sequences are not perceptual sequences: the global perception of
      auditory patterns.
AB  - Warren, Bashford, and Gardner (1990) found that when sequences consisting of 10
      40-msec steady-state vowels were presented in recycled format, minimal changes in
      order (interchanging the position of two adjacent phonemes) produced easily
      recognizable differences in verbal organization, even though the vowel durations
      were well below the threshold for identification of order. The present study was
      designed to determine if this ability to discriminate between different
      arrangements of components is limited to speech sounds subject to verbal
      organization, or if it reflects a more general auditory ability. In the first
      experiment, 10 40-msec sinusoidal tones were substituted for the vowels; it was
      found that the easy discrimination of minimal changes in order is not limited to
      speech sounds. A second experiment substituted 10 40-msec frozen noise segments
      for the vowels. The succession of noise segments formed a 400-msec frozen noise
      pattern that cannot be considered as a sequence of individual sounds, as can the
      succession of vowels or tones. Nevertheless, listeners again could discriminate
      between patterns differing only in the order of two adjacent 40-msec segments.
      These results, together with other evidence, indicate that it is not necessary
      for acoustic sequences of brief items (such as phonemes and tones) to be
      processed as perceptual sequences (that is, as a succession of discrete
      identifiable sounds) for different arrangements to be discriminated. Instead,
      component acoustic elements form distinctive "temporal compounds," which permit
      listeners to distinguish between different arrangements of portions of an
      acoustic pattern without the need for segmentation into an ordered series of
      component items.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351183
TI  - Covert effects of alcohol revealed by event-related potentials.
AB  - Contradictory evidence as to the effects of alcohol on early information
      processing stages has been obtained from behavioral and psychophysiological
      investigations. In the present study, choice reaction times, error rates, and
      event-related potentials (ERPs) were recorded in a task in which variations in
      stimulus discriminability and of the (task irrelevant) correspondence between
      stimulus location and response location were orthogonally combined. Both
      discriminability and stimulus-response correspondence affected reaction time and
      electrophysiological chronometric measures as expected. However, no behavioral
      effects of alcohol were observed, possibly because of strategic adjustments.
      Psychophysiological chronometric measures indicated that alcohol leaves the
      initial flow of perceptual evidence to motor stages unimpaired, whereas it
      appears to increase the duration of stimulus evaluation. Interestingly, a number
      of alcohol effects appeared in the ERP amplitudes. Decrements in early ERP
      components indicate alcohol-induced impairments of involuntary visual attention
      and/or the automatic stimulus location-dependent activation of response channels.
      In contrast, a strong enhancement of a late slow-wave component under alcohol may
      reflect the investment of processing resources in order to maintain normal
      performance levels.

PMID- 8351185
TI  - A reexamination of duplex perception evoked by intensity differences.
AB  - Duplex perception is a term used to describe the simultaneous evocation of
      phonetic and nonphonetic percepts, a phenomenon held by some to reveal the
      operation of a specialized module for phonetic perception. In a widely cited
      experiment by Whalen and Liberman (1987), duplex percepts were created by
      replacing the third format transition in a synthetic syllable with a sinusoidal
      tone glide and manipulating the level of the glide relative to the rest of the
      syllable. We discuss this study, and report four experiments. The first two made
      a systematic estimate of the "duplexity threshold"--the tone glide level at which
      a chirp-like sound could be heard as well as the speech-like syllable. In the
      third and fourth experiments, we used the results of the first to repeat and
      extend the experimental procedures in the original Whalen and Liberman study. We
      discuss the differences in outcome, and conclude that our results may be
      explained without the need to invoke a specialized phonetic module.

PMID- 8351184
TI  - The gap between rod and frame influences the rod-and-frame effect with small and
      large inducing displays.
AB  - The role of the spatial separation between the ends of a rod and a frame's inner
      edge (gap) in modulating the rod-and-frame effect (RFE) has been studied here
      with frames subtending either large or small retinal angles. With a large frame,
      rod settings were always in the direction of frame tilt (direct effects) and
      varied inversely with gap size. With a small frame, rod settings were in the
      direction of frame tilt for tilts between 7.5 degrees and 15 degrees; with larger
      frame tilts, rod settings in the direction opposite that of the frame were
      observed (indirect effects). Increasing gap size produced a tendency toward
      negativity (away from frame tilt). Consequently, direct effects were larger for
      small gaps, while the opposite was true for indirect effects. Overall, these
      results point to the importance of gap size in modulating the RFE, for both large
      and small displays.

PMID- 8351186
TI  - Concurrent processes: the affect-cognition relationship within the context of the
      "mere exposure" phenomenon.
AB  - The affect-cognition relationship and Zajonc's (1968) "mere exposure" hypothesis
      were examined in two studies that involved ratings of: (1) preference and
      familiarity for geometric forms previously scaled for complexity and (2)
      preference or height and familiarity for male yearbook pictures previously scaled
      for attractiveness or height. Two exceptions to his hypothesis were noted: simple
      geometric forms and unattractive faces showed satiation, and faces seen once
      before were rated more attractive than both novel faces and faces seen twice
      before. Moreover, mere exposure effects were noted with a nonaffective dimension
      (height). The major finding was that presentation frequency generally manifested
      independent relations to affect and rated familiarity, as well as to height and
      rated familiarity, therefore evoking a concurrent response process (Eriksen,
      1960).

PMID- 8351187
TI  - Tensorial basis to the constancy of perceived object extent over variations of
      dynamic touch.
AB  - Subjects wielded occluded rods, with or without attached masses, and reported the
      distances reachable with their distal tips. Experiments 1-3 compared wielding
      about the wrist, the elbow, and the shoulder. Experiments 4 and 5 compared free
      wielding, using the whole arm, with wielding only about the wrist. The two
      comparisons, respectively, were of spatial and temporal variations in the rod's
      rotational inertia. Perceived extent was found to be constant in both
      comparisons. This constancy was tied to the inertia tensor Iij defined about a
      point that remains a fixed distance from the object during wielding--an invariant
      of the spatially and temporally dependent patterning of mechanical energy
      impressed upon the tissues of the body. Discussion focused on the reciprocal
      action and perception capabilities of multisegmented limbs, the tensorial
      relations in the neurobiology of dynamic touch, and the strategy of understanding
      perceptual constancy through invariants.

PMID- 8351188
TI  - Revisitation of the luminance conditions for the occurrence of the achromatic
      neon color spreading illusion.
AB  - This paper develops the idea (Bressan, 1993) that neon spreading derives from the
      perceptual scissioning of ordinary assimilation color, a process identical to
      that occurring with nonillusory colors in phenomenal transparency. It is commonly
      held that the critical elements in achromatic neon spreading patterns must be of
      luminance intermediate between that of the embedding lines and of the background.
      The interpretation of neon spreading on the basis of color scissioning, however,
      predicts that neon spreading should also be observed for different luminance
      hierarchies, provided that these are compatible with transparency. This
      prediction found experimental support in the present work. The results suggest
      that (1) the widespread notion that chromatic and achromatic neon spreading must
      be mediated by separate mechanisms is unwarranted; (2) the widespread notion that
      color spreading in ordinary assimilation patterns and color spreading in neon
      patterns must be mediated by separate mechanisms is unwarranted; and (3) other
      than pointing to the way in which the overall organization of a scene affects the
      mode of color appearance, the neon spreading effect may not convey any extra
      theoretical relevance.

PMID- 8351189
TI  - Interocular suppression in normal and amblyopic subjects: the effect of
      unilateral attenuation with neutral density filters.
AB  - In normal subjects, binocular rivalry suppression takes time to build up (Wolfe,
      1986a). The time courses of interocular suppression are different and
      heterogeneous in amblyopic subjects (de Belsunce & Sireteanu, 1991). In the
      present study, we found that, in normal observers, progressive reduction of one
      eye's stimulus luminance with neutral density filters produces time courses
      similar to those of amblyopic subjects. Conversely, in amblyopes, attenuation of
      the dominant eye's stimulus produces time courses similar to those of normal
      observers. Under conditions of balancing of the two eyes, amblyopes experience
      alternating suppression, similarly to binocular rivalry of normals.

PMID- 8351190
TI  - Realism of confidence in sensory discrimination: the underconfidence phenomenon.
AB  - This paper documents a very pervasive underconfidence bias in the area of sensory
      discrimination. In order to account for this phenomenon, a subjective distance
      theory of confidence in sensory discrimination is proposed. This theory, based on
      the law of comparative judgment and the assumption of confidence as an increasing
      function of the perceived distance between stimuli, predicts underconfidence-
      that is, that people should perform better than they express in their confidence
      assessments. Due to the fixed sensitivity of the sensory system, this
      underconfidence bias is practically impossible to avoid. The results of
      Experiment 1 confirmed the prediction of underconfidence with the help of present
      day calibration methods and indicated a good quantitative fit of the theory. The
      results of Experiment 2 showed that prolonged experience of outcome feedback (160
      trials) had no effect on underconfidence. It is concluded that the subjective
      distance theory provides a better explanation of the underconfidence phenomenon
      than do previous accounts in terms of subconscious processes.

PMID- 8351191
TI  - The normal distribution in scaling subjective stimulus differences: less "normal"
      than we think?
AB  - The Gaussian, or "normal," distribution is routinely used to model distributions
      of subjective quantities. This practice rests on a trust in the central limit
      theorem, yet this theorem does not cover the case of a mixture of Gaussian
      distributions with different standard deviations, which yields a distribution
      that is heavier tailed than the Gaussian. In psychophysical judgment experiments,
      this may result, for example, from fluctuating or interindividually varying
      attention. Two candidates for describing this commonly encountered type of
      distribution are the logistic distribution and the t distribution with a small
      number of degrees of freedom. In reanalyses of experimental data on three
      category loudness comparisons, as well as in a Monte Carlo simulation, t(4) was
      found to model the underlying mixed inter- and intraindividual distribution of
      subjective loudness differences quite satisfactorily.

PMID- 8351192
TI  - The effects of background visual roll stimulation on postural and manual control
      and self-motion perception.
AB  - The effects of background visual roll stimulation on postural control, manual
      control, and self-motion perception were investigated in this study. In the main
      experiment, 8 subjects were exposed to wide field-of-view background scenes that
      were tilted and static, continuously rotating, or sinusoidally rotating at
      frequencies between 0.03 and 0.50 Hz, as well as a baseline condition. The
      subjects performed either a postural control task (maintain an upright stance) or
      a manual control task (keep an unstable central display horizontally level). Root
      mean square (RMS) error in both the postural and manual control tasks was low in
      the static tilt condition and extremely high in response to continuous rotation.
      Although the phases of the postural and manual responses were highly similar, the
      power and RMS error generated by the sinusoidal visual background stimulation
      peaked at a lower frequency in the postural task. Vection ratings recorded at the
      end of the postural and manual trials somewhat paralleled the frequency tuning
      differences between tasks, which a subsequent experiment showed to be the result
      of the differential motion of the central display rather than the differential
      positioning of the subject. In general, these results show that the dynamic
      characteristics of visual orientation systems vary according to the specific
      motor and/or perceptual system investigated.

PMID- 8351194
TI  - Development and application of a urodilatin (CDD/ANP-95-126)-specific
      radioimmunoassay.
AB  - Urodilatin, a renal natriuretic peptide that is an analogue to circulating atrial
      natriuretic peptide [alpha-ANP(99-126)], is measurable with a highly specific and
      sensitive radioimmunoassay. While most ANP antibodies cannot distinguish between
      urodilatin and other ANP analogues, the polyclonal urodilatin antibody
      specifically measures human urodilatin without any cross-reactivity to other ANP
      analogues. Urodilatin is not detected in blood from healthy volunteers nor from
      cardiac patients. Urinary urodilatin accounts for only a part of total urinary
      ANP immunoreactivity. Urodilatin excretion closely parallels sodium excretion in
      response to an acute volume load while changes in urinary immunoreactive ANP
      excretion do not reflect this renal response. We conclude that specific
      urodilatin assays are required to explore further the physiological role of the
      renal natriuretic peptide.

PMID- 8351193
TI  - Oxygen-dependent expression of the erythropoietin gene in rat hepatocytes in
      vitro.
AB  - Since in juvenile rats the liver is the predominant site of erythropoietin (EPO)
      gene expression, we have used primary cultures of juvenile rat hepatocytes to
      establish and in vitro system for investigation of oxygen-dependent EPO
      formation. When isolated hepatocytes were incubated at reduced oxygen tensions
      for 18-48 h, we found increased secretion of EPO protein and elevated levels of
      EPO mRNA, as determined by RNas protection. This increase was maximal at 3% O2,
      where EPO mRNA levels after 18 h were approximately 15-fold higher than at 20%
      O2. The increase in EPO mRNA at low oxygen tensions was specific insofar as
      [3H]uridine incorporation, as a measure of total RNA synthesis, was reduced by
      approximately 50% at 3% O2, and it appeared to involve gene transcription since
      it was abolished in the presence of actinomycin D (35 microM). Significant
      increases in EPO mRNA were also observed in cells kept at 20% oxygen in the
      presence of cobalt chloride (50 microM) and nickel chloride (400 microM), but EPO
      mRNA levels achieved under these conditions were less than 7% of those in cells
      incubated at 3% oxygen. No increase in EPO mRNA levels was observed in cultures
      incubated at 20% O2 in the presence of cyclic dibutyryl-AMP (10 microM-3 mM),
      cyclic 8-bromoGMP (10 microM-1 mM), cyclohexyladenosine (1 microM), 5'-N
      ethylcarboxamidoadenosine (1 microM) and phorbol 12-myristate 13-acetate (3 nM).
      In the presence of 10% carbon monoxide, used to block haem proteins in their oxy
      conformation, EPO mRNA levels in hepatocytes incubated at low oxygen tensions
      were reduced to 63%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351195
TI  - Hormonal stimulation of Ca2+ and Mg2+ transport in the cortical thick ascending
      limb of Henle's loop of the mouse: evidence for a change in the paracellular
      pathway permeability.
AB  - Recent studies from our laboratory have shown that in the cortical thick
      ascending limb of Henle's loop of the mouse (cTAL) Ca2+ and Mg2+ are reabsorbed
      passively, via the paracellular shunt pathway. In the present study, cellular
      mechanisms responsible for the hormone-stimulated Ca2+ and Mg2+ transport were
      investigated. Transepithelial voltages (PDte) and transepithelial ion net fluxes
      (JNa, JCl, JK, JCa, JMg) were measured in isolated perfused mouse cTAL segments.
      Whether parathyroid hormone (PTH) is able to stimulate Ca2+ and Mg2+ reabsorption
      when active NaCl reabsorption and thus PDte, is abolished by luminal furosemide
      was first tested. With symmetrical lumen and bath Ringer's solutions, no Ca2+ and
      Mg2+ net transport was detectable, either in the absence or in the presence of
      PTH. In the presence of luminal furosemide and a chemically imposed lumen-to-bath
      directed NaCl gradient, which generates a lumen-negative PDte, PTH slightly but
      significantly increased Ca2+ and Mg2+ net secretion. In the presence of luminal
      furosemide and a chemically imposed bath-to-lumen-directed NaCl gradient, which
      generates a lumen-positive PDte, PTH slightly but significantly increased Ca2+
      and Mg2+ net reabsorption. In view of the observed small effect of PTH on passive
      Ca2+ and Mg2+ movement, a possible interference of furosemide with the hormonal
      response was considered. To investigate this possibility, Ca2+ and Mg2+ transport
      was first stimulated with PTH in tubules under control conditions. Then active
      NaCl reabsorption was abolished by furosemide and the effect of PTH on JCa and
      JMg measured. In the absence of PDte and under symmetrical conditions, no Ca2+
      and Mg2+ transport was detectable, either in the presence or absence of PTH. In
      the presence of a bath-to-lumen-directed NaCl gradient, Ca2+ and Mg2+
      reabsorption was significantly higher in the presence than in the absence of PTH.
      Finally, when active NaCl transport was not inhibited by furosemide, but reduced
      by a bath-to-lumen-directed NaCl gradient, PTH strongly increased JCa and JMg,
      whereas only a small increase in PDte was noted. In conclusion, these data
      suggest that PTH exerts a dual action on Ca2+ and Mg2+ transport in the mouse
      cTAL by increasing the transepithelial driving force for Ca2+ and Mg2+
      reabsorption through hormone-mediated PDte alterations and by modifying the
      passive permeability for Ca2+ and Mg2+ of the epithelium, very probably at the
      level of the paracellular shunt pathway.

PMID- 8351196
TI  - Expression of myosin heavy and light chains changes during pregnancy in the rat
      uterus.
AB  - We investigated the in vivo expression of myosin heavy chains (MHC) and myosin
      light chains (MLC) in the rat uterus during pregnancy and post partum (p. p.).
      According to their antigenic reactivity, we observed two smooth-muscle-specific
      MHC (SM-MHC) of 204 kDa and 200 kDa (SM1 and SM2 respectively) and one non-muscle
      specific MHC band of 198 kDa (NM-MHC). Adult virgin female rats expressed SM1 and
      NM-MHC (65/35) but no SM2. During the first pregnancy NM-MHC expression decreased
      in favour of the SM1 form, the SM1/NM-MHC ratio being 82/12 after 20 days of
      pregnancy. SM2 is newly expressed in the first p. p. state, the SM1/SM2/NM-MHC
      ratio being 58/28/14 between 3 and 33 days p. p. During the second pregnancy,
      starting 34 days p. p., both SM2 and NM-MHC expression decreased, the SM1/SM2/NM
      MHC ratio being 85/0/15 after 20 days of pregnancy. Two protein bands of
      approximately 154 kDa and 145 kDa (sodium dodecylsulphate electrophoresis),
      designated SMP1 and SMP2 respectively, with the same immunoreactivity as the SM
      MHC were observed in vivo in the pregnant but not in the non-pregnant uterus. In
      addition, a Ca(2+)-independent protease, which uses MHC as substrate, is
      expressed in the pregnant but not in the non-pregnant rat uterus. Two isoforms of
      the 17-kDa MLC (LC17a and LC17b) exist in the rat uterus. Expression of the LC17a
      isoform increased during the first pregnancy from 46% in virgin rats to 65% in
      uteri of rats 20 days pregnant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351197
TI  - Left ventricular pressure transmission to myocardial lymph vessels is different
      during systole and diastole.
AB  - In six open-thorax-anaesthetized dogs with paced hearts and a retrogradely
      cannulated epicardial lymph vessel, the sensitivity of myocardial lymph pressure
      to left ventricular pressure during systole and during diastole was determined.
      The lymph vessels were cannulated using PE-90 tubing, and lymph pressure was
      measured by connecting the cannula to a microtip pressure transducer. To obtain
      the systolic sensitivity, left ventricular pressure was changed by clamping the
      descending aorta, which caused left ventricular pressure to increase. The
      diastolic sensitivity was obtained from natural variation to left ventricular
      pressure caused by atrial contractions during induced long diastoles. The mean
      ratio of the pulse in lymph pressure to the pulse in left ventricular pressure
      was determined: systole: 0.069 +/- 0.013, n = 213, diastole: 0.76 +/- 0.16, n =
      249 and, if possible, linear regression analysis between lymph and left
      ventricular pressure was performed. The systolic regression coefficients could be
      determined in six dogs and the diastolic coefficients in three dogs. During long
      diastoles lymph pressure variations are on average 76 per cent of those in the
      left ventricle. However, during systole, the sensitivity of lymph pressure to
      left ventricular pressure is more than ten times lower. It is not unlikely that
      the structural embedment of lymph vessels within the myocardium is such that
      volume variations by cardiac contraction are limited.

PMID- 8351198
TI  - Contractile protein gene expression in serum-free cultured adult rat cardiac
      myocytes.
AB  - The effects of two adhesion substrates (serum and laminin) and time in culture on
      the expression of genes encoding myosin heavy chain (MHC) isoforms and alpha
      skeletal actin were analysed in myocytes isolated from adult rat heart and
      maintained in serum-free culture. Relative messenger ribonucleic acid (mRNA)
      abundances were quantitated by dot-blot analysis. Gene expression was not
      influenced by the substrate used. Time in culture induced a decrease in total
      mRNA abundance and an up-regulation of beta-MHC and alpha-skeletal actin genes.
      It is proposed that atrophy of adult myocytes is associated with a pattern of
      gene expression similar to the fetal program.

PMID- 8351199
TI  - Neuropeptide Y potentiates calcium-channel currents in single vascular smooth
      muscle cells.
AB  - The effect of neuropeptide Y (NPY) on Ca(2+)-channel currents in isolated
      vascular smooth muscle cells was studied with the perforated-patch recording
      technique. Using Ba2+ (10 mM) as the charge carrier, inward currents sensitive to
      Cd2+ and nifedipine were potentiated by NPY in a concentration-dependent manner.
      The threshold concentration for the potentiating effect of NPY was 50 nM and
      reached a maximum at 150 nM. NPY shifted the steady-state activation curve to
      less positive membrane potentials by about 6 mV so that the potentiating effect
      was most prominent near the activation threshold of the current. It had no effect
      on steady-state inactivation of the current. These results suggest that NPY may
      potentiate vasoconstriction by promoting calcium entry through L-type voltage
      dependent Ca(2+)-channels.

PMID- 8351200
TI  - Patch-clamp recordings from the soma and dendrites of neurons in brain slices
      using infrared video microscopy.
AB  - A description is given of the implementation of infrared differential
      interference contrast (IR-DIC) video microscopy to an upright compound
      microscope. Using the improved resolution offered by IR-DIC a procedure is
      described for making patch-pipette recordings from visually identified neuronal
      somata and dendrites in brain slices. As an example of the application of this
      technique to electrophysiological recordings from small neuronal processes in
      brain slices we describe whole-cell current-clamp and cell-attached and excised
      patch-clamp recordings from the apical dendrites of layer V pyramidal neurons in
      slices of rat neocortex.

PMID- 8351201
TI  - Agonist-induced intracellular Ca2+ transients in HT29 cells.
AB  - In the present study we have investigated the mechanism of intracellular Ca2+
      activity ([Ca2+]i) changes in HT29 cells induced by adenosine triphosphate (ATP),
      carbachol (CCH), and neurotensin (NT). [Ca2+]i was measured with the fluorescent
      Ca2+ indicator fura-2 at the single-cell level or in small cell plaques with high
      time resolution (1-40Hz). ATP and CCH induced not only a dose-dependent [Ca2+]i
      peak response, but also changes of the plateau phase. The [Ca2+]i plateau was
      inversely dependent on the ATP concentration, whereas the CCH-induced [Ca2+]i
      plateau increased at higher CCH concentrations. NT showed (from 10(-10) to 10(-7)
      mol/l) in most cases only a [Ca2+]i spike lasting 2-3 min. The [Ca2+]i plateau
      induced by ATP (10(-6) mol/l) and CCH (10(-5) mol/l) was abolished by reducing
      the Ca2+ activity in the bath from 10(-3) to 10(-4) mol/l (n = 7). In Ca(2+)-free
      bathing solution the [Ca2+]i peak value for all three agonists was not altered.
      Using fura-2 quenching by Mn2+ as an indicator of Ca2+ influx the [Ca2+]i peak
      was always reached before Mn2+ influx started. Every agonist showed this delayed
      stimulation of the Ca2+ influx with a lag time of 23 +/- 1.5 s (n = 15)
      indicating a similar mechanism in each case. Verapamil (10(-6)-10(-4) mol/l)
      blocked dose dependently both phases (peak and plateau) of the CCH-induced
      [Ca2+]i increase. Short pre-incubation with verapamil augmented the effect on the
      [Ca2+]i peak, whereas no further influence on the plateau was observed. Ni2+ (10(
      3) mol/l) reduced the plateau value by 70%.

PMID- 8351202
TI  - Simultaneous measurement of intracellular pH and contraction in uterine smooth
      muscle.
AB  - Changes in intracellular pH (pHi) are thought to produce large changes in force
      production in the uterus. There have however, been no simultaneous measurements
      of pHi and force in the uterus and therefore no direct information is available
      about the relation between the two. We have used carboxy-SNARF (a pH-sensitive
      fluorophore) in small strips of longitudinal myometrium and obtained simultaneous
      measurements of pHi and force. SNARF did not alter contractile function, and
      continuous measurements of pHi could be made for 2 hours. The mean resting pHi
      (7.16) was similar to that reported previously. Application of weak bases rapidly
      raised pHi, in a concentration-dependent manner, followed by a gradual
      restoration of pHi to resting levels. Alkalinization greatly increased the
      frequency of contractions, often accompanied by a small increase in their
      amplitude. Removal of base produced a rebound acidification which transiently
      abolished contractions. Direct acidification of the cytoplasm, by application of
      weak acid, also abolished contractions. However the alkalinization which
      accompanied removal of acid, produced variable effects on force.

PMID- 8351203
TI  - Effects of divalent cations on the activation of a calcium-dependent potassium
      channel in hippocampal neurons.
AB  - The activation of a calcium-dependent K+ channel K(Ca) in cultured hippocampal
      neurons has been studied after the addition, to the internal solution, of the
      divalent cations magnesium (Mg2+), strontium (Sr2+) or barium (Ba2+). With
      physiological K+ across inside-out patches and Ca2+ present at 0.2 mM in the bath
      solution, a 90-pS channel was activated with an open probability in excess of
      75%. When the internal Ca2+ was reduced to levels near 5 microM, the channel-open
      probability was significantly diminished. However, if 0.2 mM concentrations of
      either Mg2+ or Sr2+ were added to the internal solution, the open probability was
      increased to a value close to original level. In the presence of internal Ca2+ at
      0.1 microM, the K(Ca) channel was not active and was not activated with the
      addition of 0.2 mM Mg2+ or Sr2+ to the internal solution. Thus, Mg2+ or Sr2+ were
      not able to active K(Ca) in the absence of Ca2+; however, both of these divalent
      cations could potentiate the Ca(2+)-induced activation of K(Ca) if internal Ca2+
      was near 5 microM. The results indicate that Mg2+ could have a role as an
      internal modulator of K(Ca) in the Ca(2+)-dependent regulation of excitability in
      nerve membrane. Replacement of Ca2+ with Ba2+, or addition of Ba2+ to Ca
      containing solutions, caused significant decreases in the channel-open
      probability for K(Ca). The action of Ba2+ was primarily mediated by a decrease in
      the frequency of channel opening. At a concentration of 5 microM, Ba2+ diminished
      the channel-open probability by one-half.

PMID- 8351204
TI  - Endogenous MLC2 phosphorylation and Ca(2+)-activated force in mechanically
      skinned skeletal muscle fibres of the rat.
AB  - A method has been developed for measuring the level of phosphorylation of myosin
      regulatory light chains (MLC2) by the endogenous myosin light chain kinase in
      mechanically skinned skeletal muscle fibres. The method was used to characterize
      the endogeous MLC2 phosphorylation capacity of single fast-twitch fibres from the
      rat and to investigate the relationship between the endogenous MLC2
      phosphorylation and the Ca(2+)-activated force. The results show that (1) about
      50% of MLC2 were 32P-phosphorylated after activation of the skinned fibre
      preparation by 30 microM [Ca2+] for longer than 30 s, but that there was
      variability between fibres; (2) most of the endogenous phosphorylating system
      diffused out of the skinned fibre preparation after 5 min exposure to an aqueous
      solution; (3) the MLC2 phosphorylation by the endogenous phosphorylating system
      followed with a delay of the order of 1-2 s after the sudden rise in [Ca2+] from
      below 10 nM to 30 microM; and (4) the sensitivity of the contractile apparatus to
      Ca2+ was markedly increased when the MLC2 were phosphorylated by the endogenous
      phosphorylating system following a rise in [Ca2+]. The Kd for MgATP of the
      endogenous MLC2 phosphorylating system was estimated to be less than 300 microM.
      These results unequivocally demonstrate that prolonged activation of the fast
      twitch muscle fibre leads to increased Ca2+ sensitivity of the contractile
      apparatus and that mechanically skinned fibres can be successfully used to study
      the regulation of the endogenous MLC2 phosphorylation capacity at single muscle
      fibre level.

PMID- 8351205
TI  - Potentiation of sarcoplasmic reticulum Ca2+ release by 2,3-butanedione monoxime
      in crustacean muscle.
AB  - The effect of the chemical phosphatase 2,3-butanedione monoxime (BDM) on various
      aspects of excitation/contraction coupling in crustacean muscle was investigated.
      Despite having a depressant effect on vertebrate skeletal and cardiac muscle, BDM
      was a potentiator of contraction in crustacean muscle. At concentrations of 1-3
      mM BDM caused an increase of potassium contractures in bundles of fibers isolated
      from crayfish muscle. At higher concentrations BDM caused oscillatory
      contractions by itself. In single voltage-clamped cut muscle fibers loaded with
      rhod-2, BDM (0.5-2 mM) potentiated the magnitude and duration of intracellular
      Ca2+ transients elicited by depolarization. At the same time BDM did not affect
      the rate of Ca2+ removal from the myoplasm under conditions where Ca2+ release
      was blocked by tetracaine. Nor did BDM increase Ca2+ entry; in fact it caused a
      decrease in the amplitude of the inward Ca2+ current (ICa). In microsomes
      isolated from lobster muscle, BDM also potentiated Ca2+ release induced by
      caffeine and at higher concentrations (above 3 mM) induced release by itself. At
      the same time it had little effect on Ca2+ uptake. These results indicate that
      BDM potentiates Ca2+ release in crustacean muscle possibly by dephosphorylation
      of the Ca(2+)-release channel.

PMID- 8351206
TI  - Modification of K-ATP channels in pancreatic beta-cells by trypsin.
AB  - The inside-out configuration of the patch-clamp method was used to study the
      effects of trypsin on the activity of ATP-sensitive potassium (K-ATP) channels
      from isolated mouse pancreatic beta-cells. Trypsin (20 micrograms/ml)
      irreversibly enhanced channel activity around twofold by reducing the interburst
      intervals without altering the burst kinetics. No effect on the single channel
      conductance or the inward rectification produced by internal Mg2+ was observed:
      however, the protease did reduce the inhibitory effect of Mg2+ on channel
      activity. Trypsin both prevented rundown of K-ATP channel activity and
      reactivated the channels after complete rundown. These effects of trypsin were
      absent in the presence of trypsin inhibitor. The protease also reduced the
      inhibitory effect of ATP on channel activity, increasing the dissociation
      constant from 7 to 49 microM. Trypsin removed the activating effect of ADP (0.1
      mmol/l) on channel activity and reduced the inhibitory effect of tolbutamide (0.5
      mmol/l). Carboxypeptidase A did not activate K-ATP channels in excised patches,
      although it was able to slightly reactivate channels after complete rundown,
      whereas chymotrypsin increased K-ATP channel activity but it did not produce
      reactivation. The effects of papain were similar to those of trypsin.

PMID- 8351207
TI  - The energetics of shortening amphibian cardiac muscle.
AB  - An isolated amphibian cardiac muscle preparation, toad ventricular strip, was
      used to examine the energetics of shortening. Simultaneous measurements of force
      and length changes and the associated heat production were made. Both the
      isometric heat/stress and the enthalpy (heat+work)/load relationships were
      similar to those previously reported in mammalian cardiac muscle. The activation
      metabolism was higher in this preparation and, like its mammalian counterpart,
      was length dependent. The heat production measured in an isometric contraction
      was approximately 50% higher than that observed at the same stress level in
      rodent mammalian cardiac muscle. This did not affect the maximum isotonic
      mechanical efficiency (work divided by enthalpy) of the preparation which, at an
      afterload of 20% of the maximum stress was 18.1 +/- 1.7% (n = 8). There was no
      evidence for a shortening heat component in this preparation during isotonic
      contractions. It appears therefore that the energetics of shortening amphibian
      cardiac muscle closely resemble the energetics of mammalian cardiac tissue.

PMID- 8351208
TI  - Forces involved in length changes of cochlear outer hair cells.
AB  - Motion or force generation of outer hair cells may contribute to active
      modulation of cochlear mechanics. In order to determine the force involved in
      length changes of outer hair cells, a new in vitro method was used. In the first
      series of experiments, apical and basolateral extracellular spaces of outer hair
      cells of the guinea-pig cochlea were separated. Changes of the voltage between
      the two extracellular spaces induced reversible, proportional changes of the cell
      length of 4.4 nm/mV if the cell had a length of 80 microns. In the second series
      of experiments, cell elongations in response to negative pressure applied to the
      basal end of the cells were measured and corrected for frictional effects. From
      these data, the compliance of the longitudinal axis of the hair cells was
      calculated. It was 220 +/- 130 m/N (n = 25) and 240 +/- 170 m/N (n = 24) for
      cells of the third and fourth cochlear turns, respectively, if the water
      permeability of the cell membrane was neglected. If the water permeability was
      taken into account, the compliance was probably around 500 m/N [corrected]. Thus,
      a mechanism that changes the cell length by 1 microm must generate a static force
      of at least around 2 nN in an outer hair cell of the organ of Corti [corrected].
      Electromotility of outer hair cells, induced by changes of the electrical
      potential difference across the outer hair cell, is a mechanism that generates
      this force.

PMID- 8351210
TI  - A cruel cut.

PMID- 8351209
TI  - Early effects of aldosterone on the basolateral potassium conductance of A6
      cells.
AB  - Aldosterone increases the basolateral conductance in target epithelia. The
      basolateral membrane of tight epithelia contains two different types of K+
      conductances (GK), a "resting" and a volume-activated GK. We have studied the
      early effects (at 4 hours) of 500 nmol/l aldosterone on the basolateral membrane
      GK of A6 cells (a Xenopus laevis kidney cell line), after the permeabilization of
      the apical membrane with amphotericin B. In the presence of a 97 to 3 mmol/l
      apical to basolateral K+ gradient, the "resting", inward rectifying GK was
      similar in control and aldosterone treated cells. In contrast, aldosterone
      induced a 2-fold increase of the volume-activated quinidine sensitive GK.

PMID- 8351212
TI  - Pink's precedent.

PMID- 8351211
TI  - On the move.

PMID- 8351213
TI  - Sweet surrender.

PMID- 8351214
TI  - Whistle while you work?

PMID- 8351216
TI  - Stress: smart delivery.

PMID- 8351215
TI  - Complementary medicine. Acupuncture.

PMID- 8351217
TI  - Learning disabilities: riding high.

PMID- 8351218
TI  - Career development--the hard sell.

PMID- 8351219
TI  - A friend in need.

PMID- 8351220
TI  - Junior doctors--passing the buck.

PMID- 8351221
TI  - Yesterday once more.

PMID- 8351222
TI  - Waiting for Dr Godot.

PMID- 8351223
TI  - Systems of life. The eye and vision. 2.

PMID- 8351224
TI  - Shock of the new. RCM supplement.

PMID- 8351225
TI  - Extend with care. RCM supplement.

PMID- 8351226
TI  - Tired and tested. RCM supplement.

PMID- 8351227
TI  - Seize the day. RCM supplement. Interview by Tricia Reid.

PMID- 8351228
TI  - [Effect of long term treatment with prednisone on remodeling of cancellous and
      cortical bone in dogs].
AB  - The effect of 7 month prednisone administration on cancellous and compact bone
      remodeling in dogs was evaluated by means of histomorphometric and tetracycline
      labeling methods. It was found that treatment with prednisone resulted in
      decrease of bone mass which was caused by increased bone resorption as well as
      considerable diminution of bone formation. In the iliac bone those were
      manifested by increase in resorption of trabecular surface, decrease in osteoid
      surface, and reduction in the osteoid thickness, indicating, with a simultaneous
      decrease in mineralization rate, slowing down of the appositional rate of newly
      formed bone tissue. In the rib cortical bone treatment with prednisone resulted
      in increase of the resorption sites together with decrease of the formation sites
      and tetracycline-labeled osteons. Reduction in the osteoid thickness as well as
      in the mineralization rate was also observed. The changes of bone remodeling
      parameters due to prednisone, although proceeding in the same direction in both
      types of bone tissue, were more marked in the spongy bone than in the compact
      bone.

PMID- 8351229
TI  - [Atrial natriuretic peptide in rheumatic mitral valve disease].
AB  - The aim of the study was to analyze atrial natriuretic peptide (ANP) plasma level
      in patients with rheumatic mitral valve disease in correlation with NYHA
      functional class and selected hemodynamic parameters based on noninvasive
      diagnostic procedures. Echocardiographic (2-D, Doppler) and X-ray chest
      examination were performed to measure left atrium dimension, mitral gradient and
      relative heart volume (RHV). Control group consisted of 10 healthy subjects. ANP
      were measured (radioimmunoassay) in 35 patients before valve replacement. Mean
      values for ANP were significantly elevated in all patients compared to control
      group (p < 0.001). No significant difference between ANP secretion in pts with
      sinus rhythm (mean ANP level 25.3 +/- 6.9 pmol/l) and pts with atrial
      fibrillation (mean ANP level 26.7 +/- 7.6 pmol/l) occurred. Positive correlation
      between left atrium dimension and ANP level were found (r = 0.964) and also
      between RHV and ANP level (r = 0.9) and between NYHA class and ANP level (r =
      0.63). The conclusion is that ANP secretion is elevated in all patients with
      heart failure due to mitral valve disease proportional to its stage.

PMID- 8351230
TI  - [Volume of the functioning gallbladder and its emptying in patients with
      progressive systemic sclerosis].
AB  - The aim of the study was to measure the gallbladder volume (GV) and its emptying
      after meal stimulus in patients with progressive systemic sclerosis (PSS). 18
      women with PSS, aged 49.8 +/- 9.5 yr, participated in the study. Control values
      were obtained from 30 healthy women aged 26.5 +/- 3.5 yr. The duration of PSS
      symptoms ranged from 2 to 25 yr. Subjects with gallstones or cholecystitis as
      well those receiving drugs affecting the gastroduodenal motor function were
      excluded from the study. GV was measured according to Dodds et all (1985) with
      the real-time sonographic apparatus (Sonoline SL Siemens, Germany), after an
      overnight fast and after a test meal. Measurements were repeated in 10 min
      intervals through a 40 min duration of the study. Similar volumes of fasted
      gallbladder were found in the PSS group and in the control group: 25.4 cm3, SEM
      3.0 (PSS), vs. 20.9 cm3, SEM 1.6 (control), p > 0.05. There was not any
      correlation between the fasted GV and duration of the disease symptoms. The test
      meal evoked in both groups a similar trend of the decrease in the GV during 40
      min and the increase in the ejection fraction at this time. Although the changes
      observed were statistically not significant (p > 0.05) there were small
      differences in the gallbladder ejection fraction in two patients, not exceeding
      14% and 18%, and being apparently below of any individual value in the control
      group. CONCLUSION: the gallbladder motor function is very rarely disturbed in
      patients with PSS.

PMID- 8351231
TI  - [Studies of immunoglobulin surface expression in lymphocytes of peripheral blood,
      bone marrow and lymph nodes in patients with B-cell chronic lymphocytic
      leukemia].
AB  - The expression of surface immunoglobulins (SIg) on peripheral blood, bone marrow,
      and lymph node lymphocytes was studied in a group of 10 patients with B cell
      chronic lymphocytic leukaemia. In 4 patients differences in the SIg phenotypes
      were found when cells from blood, bone marrow and lymph nodes were examined.
      Peripheral blood lymphocytes were characterized as a monoclonal B cell population
      whereas in the marrow or lymph node lymphocytes a tendency toward poly-clonality
      was found. We suggest that these differences reflect the origin of the initial
      leukaemic transformation: intra versus extra-medullar. In case of intramedullary
      origin of leukaemia the transformed clone infiltrates subsequently lymph nodes or
      other lymphoid structures. In leukaemia of extra-medullar origin the bone marrow
      is infiltrated later and therefore the tendency toward polyclonal SIg picture of
      the bone marrow lymphocytes contrasts with the monoclonality of the peripheral
      blood cells.

PMID- 8351233
TI  - [Platelet function in patients with diabetes mellitus].

PMID- 8351232
TI  - [Does hypoglycemic treatment with gliclazide and gliquidone affect platelet
      function in type II diabetic patients?].
AB  - The estimation of the influence of gliclazide and gliquidone treatment on
      platelet function in type II diabetic patients was undertaken in the study.
      Aggregation parameters were assessed before and after the change of hypoglycemic
      therapy. Gliclazide was applied in the group I (11 patients, mean age 63.1 +/-
      7.22 years, duration of diabetes 5.63 +/- 2.98 years), group II (19 patients,
      mean age 58.3 +/- 12.4 years, duration of diabetes 7.1 +/- 2.4) received
      gliquidone. The reference group consisted of 10 healthy volunteers (mean age 51.7
      +/- 6.9). Aggregation parameters (threshold ADP concentration, intensity and
      velocity of the aggregation) were measured in examined groups of subjects.
      Metabolic control was estimated basing upon spectrophotometric measurement of
      fructosamine level. Significant increase in threshold ADP concentration (1.89 +/-
      0.47 mumol/l before and 2.36 +/- 0.58 mumol/l after the treatment change p <
      0.05) in group II was found. Threshold ADP concentration did not change
      significantly in group I (2.5 +/- 0.8 mumol/l before v 2.14 +/- 0.68 mumol/l
      after treatment). Significant decrease in the aggregation intensity was found in
      both groups (in group I 8.48 +/- 1.7 before v 6.39 +/- 2.17 after; in group II
      7.35 +/- 1.73 before v 6.05 +/- 1.6 after 1 month treatment--both p < 0.05). The
      aggregation velocity did not change significantly (group I 61. +/- 11 before v
      51.3 +/- 18.7 after, group II 63.2 +/- 14.8 and 62.8 +/- 13.7 respectively).
      Reference group values were ADP 2.7 +/- 0.16, intensity 6.22 +/- 0.53, velocity
      63.2 +/- 2.2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351234
TI  - [Lipid disturbances in kidney transplant patients].

PMID- 8351235
TI  - [Renal biopsy in the aged].
AB  - Pathological findings in urinalysis in the aged persons are usually thought to be
      caused by pathologic processes other than glomerulopathy. Histological evaluation
      of renal tissue in older patients is extremely difficult due to coexistence of
      involuntary changes-hyalinosis, increase in mesangial matrix content, and
      vascular changes. The aim of the study was to evaluate frequency of
      glomerulonephritis, both primary and secondary in persons older than 60. In this
      group, as compared to the younger people the secondary glomerulonephritis was
      more frequent, amyloidosis and vasculitis nodosa being the most frequent. In
      primary glomerulonephritis mesangiocapillary type dominate, quite often some
      tendency to hyalinization could be observed. Renal biopsy is useful as a
      diagnostic tool in both the aged and young. It should be performed regardless the
      patients age.

PMID- 8351236
TI  - [Assessment of outcome in treatment of cardiac shock after myocardial infarction
      with intravenous streptokinase].
AB  - In 1986 a prospective randomized study coordinated by the Institute of Cardiology
      in Warsaw was started in 10 teaching cardiology hospitals in Poland for
      assessment of the results of treatment with intravenous streptokinase infusion in
      acute myocardial infarction. The studied population comprised 927 patients
      admitted to intensive treatment units within 6 hours after the onset of
      infarction pain. For the groups treated with streptokinase or heparin 752
      patients were selected at random. In 175 cases the administration of
      streptokinase was contraindicated. These patients received conventional treatment
      and served as controls. The age of the patients was from 38 to 70 years, mean age
      57.6 +/- 9.3 years. In 105 out of 927 cases cardiac shock was diagnosed. In the
      groups of early shock during hospitalization the death rate was 82%. No
      statistically significant difference was found in the death rates between
      patients with cardiac shock treated with heparin or with streptokinase.

PMID- 8351237
TI  - [Treatment of hypertension in patients with diabetes].

PMID- 8351238
TI  - Pathological features of intestinal microsporidiosis in HIV positive patients. A
      report of 13 new cases.
AB  - Enterocytozoon bieneusi is a microsporidian parasite found only in the
      enterocytes of the small bowel of HIV positive patients, producing chronic
      diarrhea and malabsorption. Since January 1990, we have seen the 13 first
      Mediterranean cases, diagnosed on duodenal pinch biopsy samples. Diarrhea was the
      major symptom in all instances, and E. bieneusi was the sole identified pathogen
      in 6 cases. The diagnosis was made on HES or Giemsa-stained paraffin sections and
      on Giemsa-stained smears (9 cases). In 3 cases, the parasite was also found on
      ileal biopsies, but was never encountered in the colonic mucosa. In all patients,
      transmission electron microscopy of the duodenal mucosa was used, and it
      confirmed the diagnosis of intestinal microsporidiosis. No instance with negative
      optic examination had evidence of an infection by E. bieneusi with electron
      microscopy. Due to the small size of the spores, routine fecal parasitological
      diagnosis is still a difficult procedure, but it is possible that greater
      experience may avoid many of today's invasive investigations. Cytologic and
      histologic routine examination of paraffin sections of the distal duodenal or
      ileal mucosae is a reliable method to diagnose intestinal microsporidiosis in HIV
      positive patients with diarrhea.

PMID- 8351240
TI  - Association of breast cancer and meningioma. Report of 12 new cases and review of
      the literature.
AB  - We report 12 new cases of female breast cancer associated with intracranial
      meningiomas, inclusive of autopsy study. At the time of death the patients' age
      ranged from 52 to 95 years (average 70.6 years). Breast carcinomas were
      documented ante mortem in 11 cases and at autopsy in 1. Meningiomas were
      diagnosed at autopsy (10 cases) or in vivo (2 cases). The diagnosis of meningioma
      antedated that of mammary carcinoma in only one patient. Histologically, the
      cancers were of ductal (11 cases) and lobular infiltrating (1 case) types and
      showed a variable malignancy grade. Widespread extracranial metastases were
      present at autopsy in 7 cases. Brain metastases were seen in 1 case. Neurologic
      signs were referred in 4 subjects. Four breast cancers and one meningioma showed
      immunoreactivity for progesterone receptors, whereas all the cases were negative
      for estrogen receptors. In one case, metastatic breast carcinoma tissue was
      present within a psammomatous meningioma. A brief review of the literature, which
      includes 14 similar observations, is reported. Although the association of breast
      cancer and meningioma is still difficult to explain, its clinical implications
      are important and deserve proper attention. A proper work up in patients with
      suspected intracranial metastases is recommended so that resectable meningiomas
      are not mistaken for metastases.

PMID- 8351239
TI  - Vla-3 distribution in normal and neoplastic non-lymphoid human tissues.
AB  - Using monoclonal antibody (mAb) M-Kid 2 to the alpha 3 beta 1 heterodimer, we
      have evaluated immunohistochemically the in vivo expression of the Vla-3 integrin
      in normal and transformed non-lymphoid human tissues. In normal tissues the alpha
      3 beta 1 complex displays a polarized distribution at the baso-lateral aspect of
      most keratinizing and glandular epithelia. In addition the integrin is detected
      in perineurium, basal lamina of smooth muscular fibers, vascular media, podocytes
      and Bowman's capsule, myoepithelial cells of the parotid and breast, and in
      pulmonary alveoli. Neoplastic transformation is associated with qualitative and
      quantitative changes in expression of this integrin. The loss of polarized
      distribution often occurs in various malignancies. Furthermore, a significant
      decrease in expression occurs in 13% of the colon-rectum carcinomas, 75% of the
      ductal invasive, and 40% of the lobular invasive breast carcinomas. Among the
      lung malignancies tested, the small cell lung carcinomas (SCLC) were found to be
      consistently unreactive with mAb M-Kid 2. Analysis of Vla-3 expression in
      established tumor cell lines demonstrated that the integrin is almost invariably
      expressed by the plastic adherent cell subpopulations.

PMID- 8351242
TI  - Clear cell chondrosarcoma of bone. A report of three cases with
      immunohistochemical and affinity histochemical observations.
AB  - Clear cell chondrosarcoma, a subtype and separate entity from the traditional
      chondrosarcoma, is characterized by its special histologic features, site of
      predilection, slow growth and better prognosis. Three cases are presented with
      elucidation of clinicopathologic correlation and detection by the ABC
      immunohistochemical method using several antibodies. The observation of positive
      reaction to S-100 protein (S-100), vimentin (Vim), alpha 1-antichymotrypsin
      (AACT) and lysozyme (Lyso) by the tumor cells of clear cell chondrosarcoma,
      similar to traditional chondrosarcoma and chondroblastoma, proves that this tumor
      has its origin in the cartilaginous tissue. It was found for the first time that
      the clear cell chondrosarcoma was positive for wheat germ agglutinin (WGA) and
      concanavalin A (Con A). The authors believe that clear cell chondrosarcoma may
      result from the anaplastic changes of chondroblastoma cells into another subtype
      of that tumor. The osteoclast-like multinucleated giant cells (MGC), retaining
      the antigens of phagocytes, are not considered to be neoplastic.

PMID- 8351241
TI  - Flow cytometric DNA analysis as prognostic factor in human breast carcinoma.
AB  - Fresh tumour tissue from 198 primary invasive breast carcinomas was analysed by
      DNA flow cytometry. 108 tumours were non-diploid. A significantly higher
      proportion of non-diploid tumours was found among node-positive patients,
      patients with oestrogen receptor negative tumours and among patients with ductal
      carcinomas. The survival of patients with diploid and non-diploid tumours was not
      significantly different (p = 0.1). Totally, 145 tumours were analyzed with
      respect to S-phase fraction (SPF). The distribution of SPF was different in
      diploid and non-diploid tumours. A low SPF group, defined as the lower SPF
      quartile (< or = 4.6% in diploid and < or = 8.5% in non-diploid tumours), was
      associated with highly differentiated tumours and oestrogen receptor positive
      tumours. Histological grading revealed a highly significant correlation to SPF.
      57% of ductal carcinomas grade I (8 out of 14), 30% of ductal carcinomas grade II
      (20 out of 67) and 5% of ductal carcinomas grade III (2 out of 37) had a low SPF.
      Patients within the low SPF group had a significantly longer survival than had
      patients within the high SPF group (p = 0.006). In a multivariate analysis the
      SPF was found to be an additional prognostic factor next to node status and ER
      status.

PMID- 8351243
TI  - Nucleolar organizer regions related to morphometry, flow cytometry, sex steroid
      receptor content, tumour histology and prognosis in female breast cancer.
AB  - Nuclear organizer regions (Ag-NORs) were visualized and enumerated in biopsy
      specimens from 158 breast carcinomas and the results were correlated with
      clinical, histological, quantitative prognostic factors and survival. The number
      of Ag-NORs was related significantly to histological type (p = 0.003), tubule
      formation (p = 0.013), histological grade (p < 0.001), mean nuclear area (p <
      0.001), SD of nuclear area (p < 0.001), DNA ploidy (p < 0.001), S phase fraction
      (p = 0.001), mitotic index (p < 0.001), estrogen receptor content (p < 0.001) and
      progesterone receptor content (p < 0.001). Ag-NORs were independent of tumour
      size and axillary lymph node status. Neither in the entire cohort (p = 0.16) nor
      in axillary lymph node negative tumours (p = 0.11) was the number of Ag-NORs
      related to survival although a clear trend was observed between lowered survival
      probability and high Ag-NOR count. In multivariate analysis Ag-NORs had no
      independent prognostic value. The results confirm previous results in that Ag
      NORs have no practical prognostic value over already established prognostic
      factors in breast cancer.

PMID- 8351244
TI  - Rhabdomyosarcomas with primary presentation in the skin.
AB  - Five primary and two metastatic rhabdomyosarcomas (RMS) with primary presentation
      in the skin were studied by conventional light microscopy and
      immunohistochemistry. These cases account for only 0.7% of the 682 cases of RMS
      collected at two large institutions with a main interest in soft tissue tumors.
      All but one tumor, which was an embryonal RMS, corresponded to the alveolar
      subtype. The myogenic nature of the tumor cells was supported by the
      immunophenotype including positive reactions for vimentin, desmin, and muscle
      actin. Clinical findings included a male predominance, young age of the patients
      and the location of all primary cutaneous RMS in the face. One of the two
      metastatic RMS presented at birth with a clinical picture highly suggestive of
      congenital metastatic neuroblastoma, notably because of a 100-fold amplification
      of the N-myc copy number. Thus, this case illustrates again that an amplification
      of the N-myc oncogene is not restricted to neuroblastoma, but may also occur in
      other tumor types.

PMID- 8351245
TI  - Extracerebral toxoplasmosis in AIDS. Histological and immunohistological findings
      based on 80 autopsy cases.
AB  - Despite the great amount of literature concerning toxoplasmic encephalitis in
      AIDS patients, little is known about extracerebral toxoplasmosis. Therefore we
      conducted a study of 80 autopsy cases to estimate the frequency of extracerebral
      toxoplasmosis. A control group of 50 cases was completely negative for all
      markers applied. In 35 of the 80 AIDS-cases (43.7%), organisms could be detected.
      In 13 cases (16.2%) there was an extracerebral toxoplasmosis; 4 cases (5%) showed
      only extracerebral involvement and in 9 cases (11.2%), extracerebral
      toxoplasmosis occurred in combination with cerebral manifestations. In 22 cases
      (27.5%), only cerebral toxoplasmosis was found. The following organs were
      involved: cardiac muscle (15%), lungs (6.2%), liver (5%), pancreas (5%),
      gastrointestinal tract (6.2%), adrenal glands (5%), lymph nodes (5%) and testis
      (3.7%). In individual cases further organs, not mentioned above, were involved.
      Pseudocysts could be demonstrated within necroses and inflammatory foci by
      conventional staining, whereas trophozoites became apparent only
      immunohistologically.

PMID- 8351246
TI  - Dissociation of clinical manifestation and histopathology in the course of
      mesangial injury by anti-thymocyte antibody.
AB  - Intravenous administration of heterologous anti-thymocyte antibodies, which react
      with rat mesangial cells, induced minimal mesangiolysis (6 hours to 3 days)
      followed by mesangial hypercellularity. Moreover, autologous immunoglobulins
      appeared in the mesangium within 1 or 2 weeks. At the same time, electron
      microscopy demonstrated mesangial deposits. Accompanying these pathological
      alterations, significant proteinuria developed. To accelerate an acute autologous
      immune reaction, rats were preimmunized with rabbit IgG prior to the injection of
      anti-thymocyte antibodies. They revealed marked mesangiolytic lesions 3 days
      after injection with deposition of autologous immunoglobulins and C 3 in the
      mesangium. In contrast, there was no significant proteinuria. Thus, mild
      pathological alterations in the mesangium induced by heterologous and subsequent
      autologous immune reactions caused proteinuria, and accelerated immune injury to
      the mesangium produced severe mesangiolysis without proteinuria. Based on these
      findings, it is suggested that the time-lapse between heterologous and autologous
      immune reactions to the mesangium influences the pathological alterations and
      clinical manifestations occurring in mesangial injury by anti-thymocyte antibody.

PMID- 8351247
TI  - Light microscopic and immunohistochemical evaluation of vascular and neural
      invasion in colorectal cancer.
AB  - One hundred and sixty consecutive surgically removed colorectal carcinomas were
      investigated on histological sections stained with Hematoxylin and Eosin (H & E).
      Vascular and neural neoplastic invasion was found in 49 (30.6%) and 50 (31.3%)
      patients. In addition, immunohistochemical investigation was performed on step
      sections to those stained with H & E in the first 50 patients, using anti-human
      Factor VIII related antigen, anti-actin and anti-protein S 100 antisera. The
      percentages of positive cases for vascular invasion in this group of 50 patients
      were 20% on H & E sections and 62% on those stained with anti-Factor VIII and
      anti-actin antisera. Neural infiltration was identified in 14% of cases on H & E
      sections and in 70% of cases on anti-protein S 100 treated sections. Since
      vascular and neural infiltration are known to be ominous prognostic factors,
      their identification has great clinical relevance. The use of these simple
      immunohistochemical stains, using readily available antisera on formalin-fixed
      material, is recommended as routine procedure in surgical pathology laboratories.

PMID- 8351248
TI  - Mycoplasma-like organism induced murine cardiac microvasculopathy. A transmission
      electron microscopic study.
AB  - Mycoplasma-Like Organisms [MLO] are intracellular cell wall deficient bacteria
      that cause ocular chronic vasculitis in man and chronic vascular disease in
      plants. Since MLO do not grow in culture, diagnosis of MLO-induced disease
      requires identification of the organisms by electron microscopy.
      Ultrastructurally, MLO appear as pleomorphic tubulo-spherical and filamentous
      organisms. In human ocular disease MLO have been detected in parasitised
      leucocytes and retinal pigment epithelial cells. We have previously reported the
      results of injecting MLO infected human vitreous into mouse eyelids. Two thirds
      of the mice developed chronic disease at the inoculation site, but, more
      importantly, the mice also developed lethal systemic MLO disease. Carditis with
      histologic features similar to those of various types of human carditis occurred
      in 18% of the mice. This report describes the ultrastructural features of the
      cardiac microvascular MLO disease in those 18 mice that died of carditis after
      inoculation with human MLO-infected vitreous. MLO were identified in leucocytes
      and endothelial cells of the murine vascular lesions. The vascular lesions were
      characterized by destruction of vessel walls as well as proliferation of
      endothelial cells. Electron dense deposits were seen in basement membranes and
      pericytial tissues. Similar features have been described in other bacterial
      vascular infections and in human idiopathic carditis. We suggest that MLO could
      be a cause of human cardiovascular disease and should be looked for in such
      cases.

PMID- 8351249
TI  - Departmental audit in histopathology.
AB  - Audit is now part of any laboratory service. Histopathology is no exception, and
      we have set up a system which allows us to review 4% of our specimens. These
      specimens are identified using a random number generator and reviewed by a
      consultant pathologist. Both slides and wet specimens are reviewed and graded
      according to a set scheme. The results from the first year of operation (1990)
      show a high rate of accuracy with no serious diagnostic disagreements between the
      auditor and the reporting pathologist. However, some errors which we would wish
      to prevent were detected and the audit has allowed us to take corrective
      measures. In our opinion, this form of audit is useful and necessary to maintain
      good clinical practice. The cost is considerable--histopathology is by its nature
      labour intensive. Recognition of this fact by health boards is essential if such
      systems are to continue.

PMID- 8351250
TI  - Genetic alterations in a malignant schwannoma from a patient with
      neurofibromatosis (NF1).
AB  - In a patient with neurofibromatosis (von Recklinghausen disease; NF1), normal
      lymphocytes, five cutaneous neurofibromas, and tumour tissue from a recurrence of
      a malignant schwannoma were analysed for genetic alterations. Eleven DNA markers
      located on chromosome 17 and nine randomly chosen markers representing
      chromosomes 1, 2, 3, 4, 5, 6, and 11, were analysed. High resolution Giemsa
      banding of lymphocytes revealed no chromosomal rearrangement. The DNA from the
      neurofibromas were all found to have the same restricted fragment length
      polymorphism pattern as the constitutional DNA from the patient. In the malignant
      schwannoma a complete loss of one allele was found at polymorphic loci on
      chromosome arm 17p. One gene copy of the TP53 gene (17p13.1) and the NF1 gene
      (17q11.2) was lost, as was one copy of the PGA gene (11q13). No mutations were
      detected in the mutational hotspots of the TP53 gene. Partial losses were
      detected at three loci on chromosomes 1, 2 and 6, indicating a clonal variation
      within the tumour since histological evaluation disclosed no normal tissue in the
      analysed specimen. Our data indicate that the NF1 gene may function as a tumour
      suppressor gene, and that, either by effect of dose reduction or complete
      inactivation, both the NF1 gene and the TP53 gene may be critical for the
      progression of a neurofibroma to a malignant schwannoma. The observations made
      are consistent with the concept of stepwise multigenetic changes in tumour
      progression.

PMID- 8351252
TI  - Adenosquamous carcinoma of the duodenum. An immunohistochemical study.
AB  - A rare adenosquamous carcinoma of the duodenum occurred in an 84-year-old woman.
      Histologically the neoplasm showed evidence of glandular and squamous
      differentiation, and both components showed malignant characteristics.
      Intermediate elements sharing squamous and glandular features, were found and
      were immunoreactive for carcinoembryonic antigen, epithelial membrane antigen and
      cytokeratins of both low and high molecular weight. A review of the literature
      and discussion about the histogenesis is included.

PMID- 8351251
TI  - Autoimmune oophoritis. An incidental finding.
AB  - A case of autoimmune oophoritis is reported. A 41-year-old woman had a total
      abdominal hysterectomy and bilateral salpingo-oophorectomy for menorrhagia,
      polymenorrhoea and cystic ovaries. The diagnosis of autoimmune oophoritis was not
      suspected clinically, and was an unexpected histological finding in the ovaries.
      The gross and histological appearances of this rare condition are described, and
      the lymphoid infiltrate characterised by immunocytochemistry. Recognition of this
      condition by pathologists is important, as there is an associated risk of
      developing other autoimmune disease, even some years later, necessitating close
      patient follow-up. In this case serum auto-antibodies to adrenal cortex were
      detected, indicating a subsequent risk of Addison's disease.

PMID- 8351253
TI  - Palpation thyroiditis resembling C cell hyperplasia. Usefulness of
      immunohistochemistry in their differential diagnosis.

PMID- 8351254
TI  - Audit of vitamin B12 therapy.

PMID- 8351255
TI  - Organophosphate pesticides--cause for concern?

PMID- 8351256
TI  - Recurrent pelvic inflammatory disease.

PMID- 8351257
TI  - Recurrent PID in general practice.

PMID- 8351258
TI  - Epilepsy. Establishing the diagnosis.

PMID- 8351259
TI  - Preparing for the CRQ and PEQ.

PMID- 8351260
TI  - Chronic heart failure.

PMID- 8351261
TI  - Preventing fractures.

PMID- 8351262
TI  - Degenerative musculoskeletal disease.

PMID- 8351263
TI  - Prescribing for older patients.

PMID- 8351264
TI  - Thyroid disease.

PMID- 8351265
TI  - Choosing an inhaler device.

PMID- 8351266
TI  - GPs are best placed to help people stop smoking.

PMID- 8351267
TI  - GPs should surrender some of their sovereignty.

PMID- 8351268
TI  - Unexplained fainting and breathlessness.

PMID- 8351269
TI  - Maxillary sinusitis.

PMID- 8351270
TI  - Helicobacter pylori eradication.

PMID- 8351271
TI  - The difficult patient.

PMID- 8351272
TI  - Epilepsy in practice. Management of a new case.

PMID- 8351273
TI  - Passing the MRCGP. The first oral examination.

PMID- 8351274
TI  - Blood disorders.

PMID- 8351275
TI  - Macrocytic anaemias.

PMID- 8351276
TI  - Microcytic anaemias.

PMID- 8351277
TI  - Sickle cell disease and thalassaemia.

PMID- 8351278
TI  - Haemophilia and haemorrhagic disorders.

PMID- 8351279
TI  - Polycythaemias.

PMID- 8351281
TI  - Eurotox '93. Uppsala, Sweden, June 30-July 3, 1993. Abstracts.

PMID- 8351280
TI  - Individualising HRT.

PMID- 8351282
TI  - Regulated expression of the major histocompatibility complex class I genes.
AB  - The major histocompatibility complex (MHC) class I gene products are known to
      play a fundamental role in foreign antigen presentation to the cellular immune
      system. Much attention has been directed to the study of MHC class I gene
      expression as a means to understanding the processes by which MHC class I
      mediated immune responses are regulated. Two areas of considerable interest have
      emerged, including regulation at the levels of transcriptional control and
      antigenic peptide-induced transport of MHC class I molecules. With an emphasis on
      these major areas of research, we review recent developments on the molecular and
      biochemical mediators and events of MHC class I gene regulation.

PMID- 8351283
TI  - Liver membrane composition after short-term parenteral nutrition with and without
      taurine in guinea pigs: the effect to taurine.
AB  - Having recently demonstrated that taurine supplementation prevents total
      parenteral nutrition (TPN)-induced cholestasis, we chose to use this model to
      examine plasma membrane composition in relation to bile formation. Male guinea
      pigs received daily a mixture of glucose and of the amino acid solution Travasol
      with or without added taurine (1.2 mM). After 3 days, bile was collected and
      liver plasma membrane fractions enriched in sinusoidal lateral membrane and bile
      canalicular membrane domains were isolated. In animals receiving TPN alone, bile
      flow and biliary secretory rate of bile acid and bicarbonate decreased
      significantly compared with controls. Although membrane ATPases (Na+K+ and Mg+)
      were unchanged, TPN induced an increase in the lipid to protein ratio and a
      decrease of polyunsaturated fatty acids, in conjunction with a higher content of
      diene conjugates in sinusoidal lateral membrane fractions. Taurine corrected
      these changes and, in addition, reduced significantly the cholesterol to
      phospholipid ratio in both membrane fractions. The data show that changes in
      liver cell membranes occur in TPN-induced cholestasis and suggest that free
      radical injury may play a role. As taurine prevented cholestasis as well as
      membrane changes, it is suggested that taurine should be added to amino acid
      solutions used for parenteral nutrition.

PMID- 8351284
TI  - Effects of cholera and pertussis toxins on prolactin stimulation of lactose
      synthesis and ornithine decarboxylase activity in mouse mammary gland explants.
AB  - Studies indicate that G proteins are likely involved in the signal transduction
      pathway for prolactin's stimulation of mitogenesis in Nb2 cells. In the mammary
      gland, little is known about the possible role of G proteins in the prolactin
      (PRL) stimulation of milk product synthesis. Therefore, the effects of cholera
      and pertussis toxin, enzymes that modify G protein activity, were tested on
      several actions of prolactin on mouse mammary tissue in culture. At concentration
      of 0.1-0.5 micrograms/ml, cholera toxin stimulated ornithine decarboxylase
      activity in a dose-response fashion; when tested in concert, cholera toxin and
      prolactin caused an additive response. Cholera toxin by itself did not affect the
      rate of lactose synthesis, but at concentrations above 0.5 micrograms/ml, it
      attenuated the magnitude of the prolactin stimulation of lactose synthesis.
      Pertussis toxin (0-0.5 micrograms/ml), both by itself and in concert with PRL,
      had no effect on ornithine decarboxylase activity. At concentrations of 25 ng/ml
      and above, pertussis toxin inhibited the PRL stimulation of lactose synthesis,
      whereas at 0.2 and 0.5 micrograms/ml, pertussis toxin abolished the PRL response.
      These observations suggest that a G protein, but not Gs, may be involved in
      prolactin's mechanism of signal transduction in the mouse mammary gland.

PMID- 8351285
TI  - Comparison of glucocorticoid-induced effects in prolactin-dependent and
      autonomous rat Nb2 lymphoma cells.
AB  - Cultured Nb2 node rat lymphoma cells require lactogenic hormone for their
      proliferation. We reported previously that dexamethasone (Dex) inhibits prolactin
      (PRL)-induced mitogenesis and, in the absence of mitogen, induces apoptosis of
      Nb2 cells. Both antiproliferative and cytolytic effects of Dex on Nb2 cells
      appear to involve glucocorticoid (Type II) receptor mediation. In this study, we
      compared Dex effects in PRL-dependent Nb2 cells (Nb2) with SFJCD1 (SF), a clone
      of Nb2 cells that proliferates independently of exogenous PRL. Proliferative
      assays involved a 72-hr incubation in a chemically defined, serum-free medium
      where ovine PRL (1 ng/ml) was added to Nb2 cells but not to SF cells. Both cell
      lines were responsive to the antiproliferative effects of Dex in a dose (6.25-200
      nM)-dependent fashion of comparable sensitivity and magnitude. Co-incubation with
      the glucocorticoid receptor antagonist, RU 486, prevented the antiproliferative
      effect of Dex in both cell lines. In the same medium devoid of PRL, Dex was
      cytolytic to Nb2 cells and fragmented DNA in a fashion reflective of apoptosis,
      but was ineffective in SF cells. A dual chamber incubation system revealed no
      evidence that SF cells produced cytokines that were mitogenic or anticytolytic to
      Nb2 cells. Both Nb2 and SF cells fragmented DNA in a fashion indicative of
      apoptosis in the presence of the Ca2+ ionophore, A23187 (1 microM). These studies
      reveal a basic difference in glucocorticoid responsiveness between the PRL
      dependent Nb2 cell line and its PRL-independent subclone, SF. While both cell
      lines exhibit functional glucocorticoid receptors and the necessary intranuclear
      machinery for apoptosis, the pathway mediating the latter is inhibited or
      dysfunctional in SF cells.

PMID- 8351286
TI  - Maternal dietary zinc influences DNA strand break and 8-hydroxy-2'-deoxyguanosine
      levels in infant rhesus monkey liver.
AB  - Severe zinc deficiency in rodent models has been shown to influence the frequency
      of single-strand breaks in DNA isolated from liver. In the current study, we
      investigated whether DNA isolated from infant monkeys born to mothers fed zinc
      restricted diets would be characterized by higher than normal levels of DNA
      damage. DNA was isolated from 30-day-old infants born to dams fed low zinc (2 or
      4 micrograms Zn/g) or control zinc (50 micrograms Zn/g) diets. The amount of
      single-strand breaks in liver DNA was significantly higher in the low zinc group
      than in controls; consistent with the above, there was a trend for higher steady
      state levels of liver 8-hydroxy-2'-deoxyguanosine in the low zinc group. While
      evidence for DNA damage in the low zinc group was obtained, the activities of
      several antioxidant enzymes were similar between the low zinc and control groups.
      In summary, infants born to monkeys fed low zinc diets are characterized by
      evidence of DNA damage shortly after birth; this damage may be due to an
      increased rate of oxidative damage and/or a reduction in the rate of DNA repair.

PMID- 8351287
TI  - Regulation of the angiotensinogen gene by estrogens in rat liver and different
      brain regions.
AB  - Estrogens regulate the production of angiotensinogen (AOG) in liver and other
      tissues. However, evidence suggests that the effect is tissue specific and that
      it may depend on a variety of factors. We have tested the effects of
      ethynylestradiol (EE) on liver AOG mRNA and plasma AOG in intact male and
      ovariectomized female rats, as well as in hypophysectomized male rats. EE
      stimulated both variables to a comparable extent and in a dose-dependent manner.
      However, its effect on plasma AOG was significantly higher in female than in male
      rats. In addition, there was no response in hypophysectomized male rats; however,
      responsiveness was restored by pretreatment of the animals with prolactin. AOG
      mRNA concentration was also affected by EE in brain, but there were striking time
      and region-specific differences. These results indicate that cell-specific
      factors also modulate the response of the AOG gene to EE in extrahepatic tissues.

PMID- 8351288
TI  - Low zinc status in rats impairs calcium uptake and aggregation of platelets
      stimulated by fluoride.
AB  - Platelets from rats of low zinc status exhibit impaired aggregation in response
      to ADP stimulation. The abnormality has been traced to defective uptake of
      calcium from the external medium. This study was designed to determine the
      location of the molecular defect and whether or not the ADP receptor is involved.
      Washed platelets were collected from rats fed a low zinc diet (< 1 mg/kg) and
      control groups that consumed a zinc-adequate diet (100 mg/kg), ad libitum- and
      pair-fed. Fluoride, a G-protein stimulant, was used to bypass the ADP receptor. F
      stimulated platelet aggregation and calcium uptake; both of these functions were
      impaired by zinc deficiency. At 10 mM F-, the time to half maximal aggregation
      was increased from 1.8 min in platelets from control to 2.8 min in zinc deficient
      rats. At 8 mM F-, the uptake of calcium was decreased from 170 to 85 nM cytosolic
      free calcium. At this concentration of F- there was no release of internal
      calcium. The results show that the molecular defect in the zinc-deficient
      platelet is located in the aggregation pathway beyond the ADP receptor and
      suggest a point between, or including, a G-protein and the plasma membrane
      calcium channel.

PMID- 8351289
TI  - Murine fetal development enhanced by dietary vitamin A, corn oil, and inositol.
AB  - Previous work on the effects of dietary vitamin A on craniofacial anomalies in
      mice revealed that 18-day-old fetuses from dams given 200 IU of vitamin A in corn
      oil daily in their diet weighed approximately 10% more than fetuses from mothers
      fed the unsupplemented standard mouse diet, Purina 5001. In the experiments
      reported here, it has been found that water-soluble vitamin A (200 IU/day) and
      myo-inositol (5 mg/day) added separately to the diets of pregnant mice increased
      the weight of 11-day gestations by approximately 25% and enhanced development of
      the eyes by the equivalent of 0.5-1.0 day without significantly affecting
      development of the liver or hind limbs. Corn oil alone (0.2 ml/day) had a similar
      effect on weight and eye development of 11-day fetuses and, in addition, growth
      of the hind limbs was enhanced modestly. The addition to the diet of vitamin A
      (200 IU/day) dissolved in corn oil (0.2 ml/day) resulted in a 25% increase in the
      weight of the 11-day fetuses and enhanced development of the eyes and hind limbs
      by the equivalent of about 1 day of gestation, suggesting that corn oil contains
      a factor(s) that interacts with vitamin A to accelerate limb development. Corn
      oil contains very small quantities of beta-carotene or retinol (< 1.0 IU vitamin
      A/ml); however, it is a rich source of the essential growth factors linoleic and
      linolenic acids and of inositol esters. The data suggest that the growth
      promoting actions of dietary corn oil are due in part to the inositol esters.

PMID- 8351291
TI  - Personal resourcefulness: positive aspects of functioning in high-risk research.
AB  - This paper discusses theoretical and measurement issues involved in attaining a
      differentiated picture of the distribution of outcomes in subjects selected for
      their elevated risk for psychosis; these outcomes include positive adaptations as
      well as subtle expressions of psychopathology. Many at-risk subjects either do
      not break down or actually "prosper" in the face of risk factors, a problem that
      persists even when risk groups are defined with increasing selectivity. Although
      this phenomenon is often referred to as the problem of "false positives" in risk
      research, its implications are more far-reaching than simply defining a problem
      of low yield in prospective studies.

PMID- 8351290
TI  - Muscarinic signaling pathway in submandibular cells of adult and early postnatal
      rats.
AB  - Elements of the muscarinic signal transduction pathway were compared in
      submandibular acinar cells of 1-day-old, 1-week-old, and adult rats after
      exposure to concentrations of acetylcholine ranging from 0.05 to 10 microM.
      Formation of inositol trisphosphate (IP3) and intracellular Ca2+ were comparable
      in cells from the three age groups after exposure to agonist concentrations < 1
      microM. At higher agonist concentrations, IP3 generation and peak initial changes
      in [Ca2+]i were significantly greater in cells of newborn animals. In cells of 1
      week-old animals, increased peak [Ca2+]i responses were seen even at low agonist
      concentrations, although IP3 production was not increased when compared with
      fully mature cells. Increased initial [Ca2+]i peaks, but comparable subsequent
      plateau [Ca2+]i values, were seen in the immature cells in both Ca(2+)-containing
      and Ca(2+)-free solutions. Permeabilized cells of early postnatal animals took up
      less 45Ca2+ into nonmitochondrial Ca2+ pools in the presence of 1.5 mM ATP and
      also released less tracer in response to intermediate IP3 concentrations than
      adult cells. Developing salivary cells thus show differences in important
      functional linkages of the muscarinic signal transduction pathway, including
      those between receptor activation and phosphoinositide turnover and between IP3
      and release of internally stored Ca2+. Differences in the Ca2+ stores or in their
      sensitivity to IP3 may account for the latter observation. Immature salivary
      cells seem to have adequate mechanisms for Ca2+ entry.

PMID- 8351292
TI  - Adult children of alcoholics: narcissism, shame, and the differential effects of
      paternal and maternal alcoholism.
AB  - Recent clinical and research literature has suggested that having one or both
      parents alcoholic leads to higher levels of character pathology (Baker and
      Williamson 1989; Benson and Heller 1987; Berkowitz and Perkins 1988; Brown 1988;
      Hibbard 1987, 1989; Parker and Harford 1988; Plescia-Pikus et al. 1988; Soyster
      1984; Wood 1987) than is normal for nonclinical adults. Only Berkowitz and
      Perkins (1988) have looked at what difference it may make as to which parent is
      identified as alcoholic.

PMID- 8351293
TI  - The long reach of violence and aggression.
AB  - The immediately preceding issue of psychiatry focused on the effects of violence
      on children. Of particular concern was the immediate impact of violence in the
      community on psychiatric symptoms in young children. Also of concern was the
      relationship of community violence to violence and abuse of children in the home,
      and the short-term impact of violence on many facets of child development. A
      group of five papers in the current issue focuses on the long-term impact of
      violence, aggression, and trauma; its impact on development into late adolescence
      and on severe character pathology in adulthood. Also of concern in this section
      are some of the origins of violence and abusive behavior toward children.

PMID- 8351294
TI  - Toward a model of family and political victimization: implications for treatment
      and recovery.
AB  - Political violence, in any of its ugly guises, has a devastating and long-lasting
      effect on its victims. This effect derives, in my view, from the concurrence of
      two factors: (1) the physical and emotional violence is perpetrated by the very
      agencies of society (such as the police and the armed forces) entrusted with the
      care and protection of individuals, with maintaining order in their world, with
      enforcing stability, and predictability; and (2) a context or a discourse that
      destroys or mystifies meanings so that recognition of that shift from protection
      to violence is blurred.

PMID- 8351295
TI  - A critique of conceptual and treatment approaches to borderline psychopathology
      in light of findings about childhood abuse.
AB  - A series of recent research findings has begung to supply strong evidence of a
      highly significant correlation between borderline psychopathology and experiences
      of repeated childhood trauma including sexual abuse (especially incest), physical
      abuse, and the witnessing of severe domestic violence (Bryer et al. 1987; Herman
      et al. 1989; Western et al. 1990; Zanarini et al. 1989). The replication of these
      results with different research samples is in contrast to the inconsistent
      findings associated with earlier etiological theories, in which the roots of
      borderline pathology were variously linked to schizophrenic or affective
      illnesses (Akiskal 1981; Akiskal et al. 1985; Klein 1977; Perry 1985), to
      derailments in the separation-individuation process (Kernberg 1975, 1976; Mahler
      and Kaplan 1977; Masterson and Rinsley 1975), to actual early losses and
      separations (Bradley 1979; Paris et al. 1988; Soloff and Millward 1983a, 1983b),
      to severe empathic failures during the first years of life (Adler and Buie 1979),
      or to more general family-based pathologies (Frank and Hoffman 1980; Frank and
      Paris 1981; Grinker et al. 1968; Gunderson and Englund 1981; Gunderson et al.
      1980; Links 1990; Walsh 1977; Zinner and Shapiro 1975). Not only do current
      findings regularly identify 50% to 80% of subjects as victims of childhood abuse
      and trauma, but also several studies show that factors such as age of onset,
      severity, and type of abuse reliably discriminate between borderline and other
      diagnostic groups (Herman et al. 1989; Zanarini et al. 1989).

PMID- 8351296
TI  - Sexual abuse and psychopathology.
AB  - With the recognition that sexual exploitation of children is far more common than
      previously thought, a substantial research effort has aimed to describe its acute
      and long-term effects (Kluft 1990). Most studies have been quantitative and have
      pursued one of two strategies: Children identified by referral from child
      protective services as physically victimized are concurrently assessed for
      psychiatric sequelae; alternatively, adults with or without various psychiatric
      syndromes are retrospectively asked to recall the presence or absence of
      traumatic childhood experiences. Descriptive in focus, the results of these
      research efforts have broadened our understanding of the typical constellation of
      symptoms experienced by childhood incest victims and have delineated the adult
      psychiatric diagnostic categories most associated with a history of childhood
      trauma.

PMID- 8351297
TI  - [The prognostic significance of the therapeutic working alliance from the
      perspective of the patient and therapist].
AB  - In general, the prognostic relevance of a working alliance for both the course
      and the outcome of psychotherapy is no longer a matter of dispute. Since a
      working alliance is conceived as an interactional variable, the results must be
      interpreted on the basis of several important dimensions: the perspective of the
      investigator and the time structure during the course of therapy. Using the data
      available from the Berlin Psychotherapy Study (Rudolf 1991), we investigated for
      the 238 patients (inpatients and outpatients who received psychoanalytically
      oriented therapy in the study) the prognostic relevance of diagnostic and therapy
      related working alliance variables for the various outcomes investigated. A
      complex correlation-statistical method (latent-trait-model) was used to consider
      the investigator perspective with regard to the working alliance and the outcome
      as well as the time structure and the diagnostic variables. Our results emphasize
      the relevance of the therapist's perspective beginning with the diagnostic
      indication, the working alliance and finally the outcome. The patient's
      perspective, however, seems to be less relevant. The results are presented and
      discussed in relation to the relevant literature. One result we have found as a
      further important dimension is that the kind of therapy carried out must be taken
      into consideration. This implies that as in our study for all phases of the
      investigation therapy specific instruments must be applied. In this regard our
      results also contribute to the validation of the instrument used to measure the
      working alliance TAB.

PMID- 8351298
TI  - [The significance of the Balint-group work: a review of the literature and an
      empirical study in Unterfranken].
AB  - The group work initiated by Michael Balint aims at a comprehensive understanding
      of the doctor-patient-relationship and a patient-centered medicine. In a review
      of the literature some studies are presented, which focus on results of Balint
      work and changes in the participants of this group method. An empirical study of
      436 physicians in Unterfranken shows that about 9% have participated in Balint
      work. Attitudes and motivations of the participants and setting and results of
      Balint work are studied as well as notions and knowledge of those, who have not
      done Balint work yet. The study demonstrates positive results in most of the
      participants.

PMID- 8351300
TI  - [DKPM basic documentation. A uniform basic documentation for inpatient
      psychosomatic treatment and psychotherapy].
AB  - The Arbeitsgemeinschaft Basisdokumentation presents the DKPM-Basisdokumentation,
      which is conceptualized as a uniform modul of a documentation system for the
      routine-like use in the in-patient psychosomatic and psychotherapy. We outline
      possibilities of use, aspects of the data security and the data access as well as
      some practical presuppositions.

PMID- 8351299
TI  - [Is there a typical conflict in dyspepsia? An epidemiologic psychoanalytic
      contribution to the topic of a specific conflict in psychosomatic medicine].
AB  - The question whether a dependency-independency-conflict is specific for subjects
      with gastric complaints was investigated by means of a representative,
      psychoanalytic-epidemiologic field study (Mannheimer Kohortenprojekt). Out of a
      population of 600 adults probands with dyspepsia were compared with individuals
      with musculoskeletal symptoms and "healthy" subjects. Using interview protocols
      of these individuals two "blinded" raters judged whether the conflict under
      consideration was present in different aspects of life. It could be confirmed
      that subjects with gastric complaints showed the conflict significantly more
      often than either control group. However, the conflict was also found among
      individuals of either control group. It can be concluded that the dependency
      independency-conflict is typical, but not specific for subjects suffering from
      dyspepsia.

PMID- 8351301
TI  - [The status of psychotherapy with handicapped patients].
AB  - Psychotherapy for the handicapped might play an important role in helping these
      multiply stressed persons and their families. It can be put into practice much
      more easily than one may have presumed. It does not require any extreme
      specializations. Therefore, the gap between what is possible and the actual
      reality of a deep lack of efforts in this field calls for explanations, a part of
      which the author tries to outline.

PMID- 8351302
TI  - Robert Kellner, M.D., Ph.D., 1922-1992.

PMID- 8351303
TI  - Psychopharmacologic issues in organ transplantation. Part 2: Psychopharmacologic
      medications.
AB  - This article reviews psychopharmacology in organ transplant patients, with
      particular attention to the changes in the metabolism and elimination of drugs
      during organ insufficiency and drug interactions in the immunosuppressed state.
      The side effects of psychotropic drugs need to be distinguished from those of
      immunosuppressants. Antidepressants, including tricyclics, heterocyclics, MAOIs,
      stimulants, and newer agents, are discussed. Use of neuroleptics for delirium,
      mania, and other organic disorders is described. Lithium may be more difficult to
      use in the immediate postoperative period. Anxiolytics, including benzodiazepines
      and buspirone, are useful depending on the underlying medical problem.

PMID- 8351304
TI  - A literature review of psychotic symptoms associated with the premenstruum.
AB  - The proposed DSM-III-R diagnostic category, Late Luteal Phase Dysphoric Disorder
      (LLPDD), is a severe form of premenstrual disturbance. Core symptoms include mood
      lability and dysphoria with no psychotic features. Yet transient psychotic
      symptoms during the late luteal phase and during menstruation have been noted in
      the literature for decades. Although good prospective data are lacking, patients
      with these disturbances may variably be subsumed under diagnostic categories of
      "atypical psychosis," "periodic psychosis," and "cycloid psychosis." In this
      article, several patients displaying premenstrual psychoses are described. A
      review of the literature on psychoses during the menstrual cycle as it relates to
      the diagnostic criteria for LLPDD follows.

PMID- 8351305
TI  - The sequencing of psychiatric recommendations. Concordance during the process of
      a psychiatric consultation.
AB  - Whether or not medical staff follow through with the recommendations of the
      consultation-liaison (C-L) psychiatrist, a process referred to as concordance, is
      an important factor that influences the outcome of C-L interventions. Previous
      research has demonstrated that process variables have the greatest effect on
      concordance. This study extends earlier research by examining the relationship of
      the timing of various recommendation types and concordance. In this study, the
      authors found that during the first two weeks of a case, psychosocial diagnostic
      recommendations were closely followed (most concordant) when given later in the
      consultation. However, concordance was better when discharge recommendations were
      given earlier. The findings reveal an interaction between the type of
      recommendation and its timing in the consultation in predicting concordance.

PMID- 8351306
TI  - Psychosocial evaluation of organ transplant candidates. A comparative survey of
      process, criteria, and outcomes in heart, liver, and kidney transplantation.
AB  - Psychosocial selection criteria are widely used by transplant programs but have
      not been systematically described or compared within or across transplantation
      type. The authors surveyed all active cardiac, liver, and renal transplant
      programs in the United States about the existence of psychosocial selection
      criteria, how and by whom patients were evaluated, weight given to specific
      criteria, and how often patients were rejected for surgery on psychosocial
      grounds. The results document important differences in the process, criteria, and
      outcomes of pretransplant psychosocial evaluation within and across these
      programs. Cardiac programs are the most stringent, both in criteria and in rate
      of refusals.

PMID- 8351307
TI  - Rapid relief of anxiety in cancer patients with both alprazolam and placebo.
AB  - This study evaluated 36 cancer patients who were enrolled in a randomized, double
      blind, placebo-controlled trial conducted over a 4-week period to evaluate the
      efficacy of alprazolam in the treatment of anxiety associated with cancer.
      Hamilton Anxiety Scale scores declined significantly between baseline and the end
      of the first week of the study in both treatment groups. There was no significant
      difference in response between the patients receiving alprazolam and placebo.
      Similar results were obtained from other instruments. These results suggest that
      nondrug factors or spontaneous improvement may play a more important role than
      pharmacotherapy in the treatment of anxiety associated with cancer.

PMID- 8351308
TI  - Etiology and clinical course of pseudoseizures. Relationship to trauma,
      depression, and dissociation.
AB  - Twenty-seven outpatients with video-EEG-documented pseudoseizures were
      interviewed by a psychiatrist to determine the historical course of seizures and
      diagnose the current presence of these DSM-III-R diagnoses: affective disorders
      (85%), dissociative disorders (85%), and posttraumatic stress disorder (33%).
      Their mean (26.7) and median (26.9) Dissociative Experiences Scale scores were
      elevated. Eighty-eight percent of subjects had sustained significant trauma,
      including sexual abuse/rape (77%) and physical abuse (70%). Four psychodynamic
      pathways to pseudoseizures were noted. Most commonly, pseudoseizures originated
      from dissociated personalities or ego states, were expressions of dissociated
      memories of child abuse, and were triggered by recent stresses or traumas.

PMID- 8351309
TI  - Some advantages of consultation-liaison (medical-surgical) psychiatry becoming an
      added qualification subspecialty.

PMID- 8351310
TI  - Are thymoleptic-responsive "anger attacks" a discrete clinical syndrome?

PMID- 8351311
TI  - Do some chronic pain patients with atypical facial pain overvalue and obsess
      about their pain?

PMID- 8351312
TI  - A case report of Munchausen syndrome with mixed psychological features.

PMID- 8351314
TI  - Aseptic meningitis associated with salicylate overdose.

PMID- 8351313
TI  - Late-onset depression with white matter lesions.

PMID- 8351315
TI  - Breast hypoplasia as an initiating factor in anorexia nervosa.

PMID- 8351316
TI  - Coexistent hypomania and severe hypothyroidism.

PMID- 8351317
TI  - MR imaging of the pancreas.
AB  - Magnetic resonance (MR) imaging sequences that reduce image artifact in upper
      abdominal examinations herald a role for MR in the investigation of pancreatic
      disease. Sequences that have been successful in imaging the pancreas are T1
      weighted breath-hold gradient-echo imaging, which avoids phase artifact caused by
      respiration, and T1-weighted fat-suppressed spin-echo imaging, which reduces
      breathing artifact, removes chemical shift artifact, and improves dynamic range
      of signal intensities. Breath-hold gradient-echo sequences provide useful
      diagnostic information when used prior to and immediately following bolus
      intravenous administration of gadopentetate dimeglumine. This review addresses
      current clinically important roles for MR imaging and emphasizes the detection of
      islet cell tumors, non-organ-deforming pancreatic ductal adenocarcinomas, and the
      distinction between chronic pancreatitis and cancer.

PMID- 8351318
TI  - Imaging of the shoulder.

PMID- 8351319
TI  - Complications of vena cava filters.

PMID- 8351320
TI  - Ligament and tendon tears: secondary signs.

PMID- 8351321
TI  - No fooling around: direct visualization of pulmonary embolism.

PMID- 8351322
TI  - Acute interstitial pneumonia: histopathologic patterns of acute lung injury and
      the Hamman-Rich syndrome revisited.

PMID- 8351323
TI  - It's academic.

PMID- 8351325
TI  - Idiopathic hemochromatosis: MR imaging findings in cirrhotic and precirrhotic
      patients.
AB  - The authors reviewed T2-weighted and T2*-weighted abdominal magnetic resonance
      (MR) images in 19 pathology-proved cases of hepatic iron overload to compare
      patterns of iron distribution among cirrhotic and precirrhotic patients with
      idiopathic hemochromatosis (IH), as well as nontransfusional hepatic siderosis of
      other causes. Fifteen patients had clinical and laboratory evidence of IH. Four
      patients without IH had cirrhosis with moderate siderosis. In the MR images of
      all 19 patients, the liver had low signal intensity. The pancreas of 10 of 11
      cirrhotic patients with IH had low signal intensity. All four precirrhotic
      patients with IH and all four cirrhotic patients without IH had pancreas with
      normal signal intensity at MR. Thus, pancreatic signal intensity was decreased
      only in cirrhotic patients with IH in this limited series. Conversely, pancreatic
      signal intensity is often normal in precirrhotic patients with IH prior to the
      development of cirrhosis, a stage at which definitive diagnosis by means of
      quantitative liver biopsy is important because early phlebotomy may prevent
      morbidity and mortality from IH. In cirrhotic patients with MR evidence of
      increased hepatic iron, the cause of cirrhosis is less likely to be IH if
      pancreatic signal intensity is normal.

PMID- 8351324
TI  - Hepatic CT enhancement: a method to demonstrate reproducibility.
AB  - Optimal techniques for intravenous administration of contrast material in
      computed tomographic (CT) examination of the liver remain controversial mainly
      because of inaccurate methods of data evaluation. This study tested the
      reproducibility of hepatic contrast material enhancement within the same patient
      and the accuracy of two methods of data analysis. Fourteen patients received
      identical CT examinations. Attenuation of liver and vessels was measured before
      and after administration of contrast material, and enhancement was calculated for
      each image. Data were analyzed by averaging enhancement values obtained over 5-
      and 10-second intervals and by using a new computer program that creates an
      enhancement-time curve and measures area under the curve (AUC) for any specific
      time interval. Data were compared between patients' first and second
      examinations. Mean liver enhancement was nearly identical at all time intervals
      with the AUC technique. Analysis of interpatient data showed marked variability
      of all parameters at all measured time intervals, suggesting that results from
      comparative studies within the same patient may be more accurate than those for
      studies of two different treatment groups. The AUC technique is preferable to
      other methods of data analysis for contrast enhancement evaluation.

PMID- 8351326
TI  - Evaluation of portal venous hypertension with cine phase-contrast MR flow
      measurements: high association of hyperdynamic portal flow with variceal
      hemorrhage.
AB  - Thirty-two patients with portal venous hypertension and endoscopically proved
      esophageal varices who were being evaluated for possible liver transplantation
      were studied with cine phase-contrast magnetic resonance (MR) imaging. Flow
      measurements in the main portal vein were obtained and associated with the
      presence of variceal hemorrhage within 2 years before the MR examination. Low
      (hypodynamic) flow was present in 22 patients, while high (hyperdynamic) flow was
      present in 10 patients. The presence of variceal hemorrhage was significantly
      associated with a high portal venous flow rate (P = .001), high variceal grade (P
      = .030), and Child class A or B (P = .003); however, only portal venous flow (P =
      .006) and variceal grade (P = .044) were found to be associated with variceal
      hemorrhage in a multiple logistic regression analysis. The portal venous flow
      rate was significantly higher among patients with Child class A or B disease
      compared with those with class C disease (median, 24.6 vs 8.0 mL/min.kg; P =
      .004).

PMID- 8351327
TI  - Small bowel obstruction: sonographic evaluation.
AB  - Results of 54 sonographic examinations of patients referred for suspected or
      known small intestinal obstruction were retrospectively correlated with surgical
      findings, and the diagnostic value of sonography regarding presence, level, and
      cause of obstruction was compared with that of plain abdominal radiography. The
      diagnosis of obstruction was correct in 89% of cases with sonography and in 71%
      with plain radiography. The level of obstruction was correctly predicted in 76%
      of cases with sonography and in 51% with plain radiography. The cause of
      obstruction was correctly predicted in 20% of cases with sonography and in 2%
      with plain radiography. The authors conclude that use of sonography in evaluating
      patients with bowel obstruction may be helpful in confirmation of the presence of
      obstruction, in determination of the level of obstruction, and in identification
      of the cause of obstruction.

PMID- 8351328
TI  - Posterior tibial tendon tears: utility of secondary signs for MR imaging
      diagnosis.
AB  - To assess the range of appearance of both torn and normal posterior tibial
      tendons (PTTs) and to evaluate secondary signs related to abnormal biomechanics
      as aids in diagnosing PTT tears, 23 patients with complete PTT tears and 34
      control patients were examined with magnetic resonance imaging at 1.5 T.
      Examiners were blinded to diagnosis. The diameter of the PTT was measured at the
      insertion and at the level of the ankle. The torn and control PTTs were bulbous
      distally (respective mean values, 6.2 mm vs 4.6 mm), with overlap in the range of
      tendon size. All PTTs also had overlap in the frequency of intra-tendon signal
      intensity (torn PTTs, 83%, vs control PTTs, 41%; T1-weighted, 61%, vs T2
      weighted, 22%). The presence of a talonavicular abnormality was both a sensitive
      (82%) and specific (100%) sign of a PTT tear. The presence of medial tubercle
      hypertrophy (sensitivity, 89%; specificity, 75%) and an accessory navicular bone
      (sensitivity, 20%; specificity, 100%) were useful secondary signs of a complete
      PTT tear.

PMID- 8351329
TI  - Tears of the anterior cruciate ligament: primary and secondary signs at MR
      imaging.
AB  - To investigate primary and secondary signs of anterior cruciate ligament (ACL)
      tear at magnetic resonance (MR) imaging, the authors retrospectively reviewed 103
      MR imaging examinations obtained in 99 patients, the original interpretations of
      these examinations, clinical records, and arthroscopy reports. Fifty cases of
      arthroscopy-documented complete ACL tear were included. The primary signs of ACL
      tear (ie, abnormal ACL morphologic features or signal intensity) had respective
      sensitivity and specificity values of 96% (48 of 50 examinations) and 94% (50 of
      53) on sagittal images and 92% (46 of 50) and 83% (43 of 52) on coronal images.
      As a secondary sign of ACL tear, bone bruise involving the lateral compartment of
      the knee was found in 40% (20 of 50) of cases of ACL tear and in 4% (2 of 53) of
      cases of normal ACL. The mean curvature of the posterior cruciate ligament was
      increased (0.40 vs 0.27; P < .0001) in cases of ACL tear. An abnormal appearance
      of the ACL on sagittal images remains the single most sensitive and specific sign
      of ACL tear.

PMID- 8351331
TI  - Quadrilateral space syndrome: findings at MR imaging.
AB  - Shoulder pain due to compression of the axillary nerve by fibrous bands in the
      quadrilateral space has been termed the quadrilateral space syndrome. Selective
      atrophy of the teres minor muscle, which is innervated by the axillary nerve, was
      demonstrated at magnetic resonance imaging in three patients with clinical
      findings of the syndrome. This finding, in the appropriate clinical setting, is
      highly suggestive of the quadrilateral space syndrome, which is a potentially
      reversible cause of shoulder pain.

PMID- 8351330
TI  - Waldenstrom macroglobulinemia: MR imaging of the spine and CT of the abdomen and
      pelvis.
AB  - Twenty-three consecutive patients with Waldenstrom macroglobulinemia were studied
      with magnetic resonance (MR) imaging of the spine and computed tomography (CT) of
      the abdomen and pelvis. MR imaging studies included sagittal T1-weighted and
      gradient-recalled-echo sequences performed with and without contrast material
      enhancement. Marrow involvement was identified with MR imaging in 21 of 23 (91%)
      patients. Diffuse involvement was noted in 13 patients (56%), and a variegated
      pattern in eight (35%). CT demonstrated enlarged nodes in 10 of 23 (43%)
      patients. Correlation of MR imaging patterns and presence of adenopathy at CT
      with standard laboratory values for Waldenstrom macroglobulinemia revealed an
      association of the diffuse MR imaging pattern of marrow involvement and the
      presence of enlarged nodes at CT with more advanced disease. MR imaging of the
      spine and CT are reliable means of evaluation of disease status in Waldenstrom
      macroglobulinemia. They may be employed as additional means in the staging of
      Waldenstrom macroglobulinemia and may be helpful in the follow-up of patients
      with this rare hematologic malignancy.

PMID- 8351332
TI  - Direct coronal view of the shoulder with arthrographic CT.
AB  - Direct coronal oblique views of the shoulder were obtained with arthrographic
      computed tomography (CT) in 35 shoulders with surgical correlation. There were 18
      complete cuff tears, four partial ones, two type 3 superior labral, anterior, and
      posterior (SLAP) lesions, and one type 4 SLAP lesion. The coronal sections were
      obtained after double-contrast shoulder arthrography and axial CT sections had
      already been obtained. The patient was seated directly on the slope of the
      gantry, and the shoulder to be studied was positioned in the center of the
      gantry. The maximal time needed for this procedure was 5 minutes. Rotator cuff
      tears were detected with a sensitivity of 95% and a specificity of 100%. The size
      of the tears as determined on the coronal sections was strongly correlated with
      surgical measurement (r = .939). All SLAP lesions were detected. The authors'
      experience shows that obtaining coronal oblique sections is an effective way to
      improve arthrographic CT.

PMID- 8351333
TI  - Rotator cuff: evaluation with fat-suppressed MR arthrography.
AB  - Thirty-seven shoulders with rotator cuff diagnoses proved at arthrography,
      arthroscopy, or open surgery were examined prospectively with magnetic resonance
      (MR) arthrography. T1-weighted MR images were obtained with and without fat
      suppression after intraarticular injection of gadopentetate dimeglumine. Without
      fat suppression, overall accuracy was 84%. False-positive full-thickness tears
      were diagnosed in three patients who were proved to have partial tears. False
      negative normal tendons were diagnosed in two patients who had partial tears. The
      corresponding sensitivity and specificity were 90% and 75%, respectively. With
      the aid of fat-suppressed imaging, full-thickness and partial cuff tears were
      identified with 100% sensitivity and specificity. Fat-suppressed images also
      showed intratendinous contrast material imbibition in three torn cuffs with
      frayed, friable tendon margins. Fat suppression in MR arthrography is valuable in
      the differentiation of partial from full-thickness cuff tears and in the
      detection of small partial tears of the inferior tendon surface.

PMID- 8351334
TI  - Hematopoietic bone marrow within the proximal humeral epiphysis in normal adults:
      investigation with MR imaging.
AB  - The occurrence of hematopoietic bone marrow within the axial skeleton and meta
      diaphyseal regions of long bones is well known. However, it has been generally
      accepted that hematopoietic marrow is not present within the epiphysis of long
      bones in normal adults. This study involved evaluation of marrow patterns in 96
      patients presenting for shoulder magnetic resonance (MR) imaging examinations.
      Residual hematopoietic marrow was present within the proximal humeral metaphysis
      in 99% of patients and extended into the epiphysis in 62%. Epiphyseal
      hematopoietic marrow was more prominent in female subjects (P = .015) and showed
      correlation with prominence of hematopoietic marrow within the proximal humeral
      metaphysis (P = .01). The most characteristic pattern was a curvilinear
      distribution of hematopoietic marrow involving the subcortical region of the
      medial humeral head, though in some patients more centrally located patchy or
      globular regions of hematopoietic marrow were observed. These findings indicate
      that when signal intensity variations are observed within the epiphysis on MR
      images, the possibility of residual or reconverted hematopoietic marrow should be
      considered.

PMID- 8351335
TI  - Facial lymph nodes: normal and abnormal CT appearance.
AB  - Facial lymph node involvement by neoplastic disease is an unusual occurrence. The
      purpose of this study was to determine the normal and abnormal radiologic
      appearance of the facial nodes. Two hundred enhanced computed tomographic (CT)
      studies of patients not at risk for facial node metastasis were studied
      prospectively to establish a normal control group. One hundred consecutive
      patients with extensive recurrent or primary cancer of the epidermal structures
      of the face, the sinonasal region or deep face, or the mucosal surface of the
      oral cavity were examined prospectively to establish a prevalence for metastatic
      facial adenopathy. In addition, all cases of facial node metastases seen on
      imaging studies over an 11-year period (n = 21) were examined retrospectively to
      establish the spectrum of facial lymphadenopathy. Normal nodes could not be
      confidently identified on CT studies. When nodal metastasis occurred, it was
      often in the setting of recurrent disease. The infraorbital nodes tended to be
      the site of origin for lymphomas isolated to the canine fossa.

PMID- 8351336
TI  - Internal architecture of the parotid gland at MR imaging: facial nerve or ductal
      system?
AB  - A radiologic-anatomic study was performed to determine the nature of the low
      signal-intensity curvilinear structures currently seen in the normal parotid
      gland on axial T1-weighted magnetic resonance (MR) images. These structures are
      considered by some to represent the intraparotid facial nerve. After cannulation
      of the Stensen duct, the authors imaged the parotid gland of two cadavers in situ
      before and after intraductal injection of gadolinium
      tetrazacyclododecanetetraacetic acid. Retrograde filling was obtained in one
      gland. The same sections were used throughout a subsequent anatomic study,
      allowing correlation of the MR findings with the macroscopic and histologic
      appearance of the gland. Comparison of MR images and gross and histologic
      sections established that two intraparotid facial nerve segments, although
      identified from the histologic study, were not visible on corresponding MR
      images. Many areas of low signal intensity seen within the gland were found to
      represent the main duct and some afferent ductal branches.

PMID- 8351337
TI  - CT-guided injection of the stellate ganglion: description of technique and
      efficacy of sympathetic blockade.
AB  - Stellate ganglion blockade, typically performed by using palpable osseous
      landmarks, is an accepted method in the diagnosis and treatment of
      sympathetically maintained pain and other conditions. The authors present the
      results of stellate ganglion injection performed with computed tomographic (CT)
      guidance. Thirteen CT-guided procedures were performed in seven patients.
      Lidocaine, bupivacaine, and buprenorphine were used to achieve the blockade.
      Successful blocks were achieved in all 13 cases as evidenced by production of
      Horner syndrome and ipsilateral hand temperature elevations. The average
      ipsilateral and contralateral hand temperature changes following the procedure
      were 7.5 degrees C and 0.5 degrees C. The ipsilateral hand temperature changes
      and the differences between the ipsilateral and contralateral hand temperature
      changes exceeded 1.5 degrees C in every case. Five patients preferred the CT
      guided procedure over the conventional technique, and two patients noted no
      substantial difference between the approaches. With the CT-guided technique, a
      highly effective sympathetic block is achieved with a substantially reduced
      volume of anesthetic compared with the conventional approach.

PMID- 8351338
TI  - Echo-planar perfusion-sensitive MR imaging of acute cerebral ischemia.
AB  - T2*-sensitive echo-planar magnetic resonance imaging was used with first-pass
      magnetic susceptibility contrast enhancement in a cat model of acute regional
      stroke to evaluate the relationship between cerebral hypoperfusion and ischemic
      brain damage. In normal brain, dose-dependent decreases in signal intensity were
      observed after intravenous injection of 0.15-0.50 mmol/kg dysprosium
      diethylenetriaminepentaacetic acid bismethylamide or gadodiamide injection.
      Shortly after unilateral occlusion of the middle cerebral artery, foci of signal
      hyperintensity on diffusion-weighted images were observed in the ipsilateral
      basal ganglia. Sixty minutes after occlusion, perfusion deficits in the
      ipsilateral parietal and temporal cortical gray matter were observed to be
      spatially correlated with areas of hyperintensity on diffusion-weighted images.
      When reflow was attempted after 60 minutes, delayed contrast agent transit
      suggestive of partial ischemic tissue injury was demonstrated. Attempts to
      produce reflow after 2 hours did not restore normal brain perfusion and resulted
      in image hyperintensity and histopathologic brain damage. Six-hour occlusion was
      associated with pronounced perfusion deficits in the ischemic territory.

PMID- 8351339
TI  - Human brain: proton diffusion MR spectroscopy.
AB  - Diffusion of brain metabolites was measured in 10 healthy volunteers by using
      localized proton diffusion magnetic resonance (MR) spectroscopy. Measurements
      were conducted with a clinical MR imager by using a stimulated-echo pulse
      sequence (3,000/60 [repetition time msec/echo time msec], 200-msec mixing time)
      with additional outside-volume suppression. Motion artifacts due to macroscopic
      brain movements were compensated by means of peripheral cardiac gating and
      separate collection of individual spectroscopic acquisitions into a two
      dimensional data matrix. Phase errors due to macroscopic motion were subsequently
      corrected in individual data traces prior to spectral averaging. Mean (+/- 1
      standard deviation) apparent diffusion coefficients of choline-containing
      compounds ([0.13 +/- 0.03] x 10(-3) mm2/sec), creatine and phosphocreatine ([0.15
      +/- 0.03] x 10(-3) mm2/sec), and N-acetyl aspartate ([0.18 +/- 0.02] x 10(-3)
      mm2/sec) were substantially smaller than that of water and were consistent with
      recently published data obtained in anesthetized and paralyzed animals. Adequate
      diffusion sensitivity for metabolites in the human brain can be obtained with
      clinical whole-body imagers despite macroscopic head and brain movements.

PMID- 8351340
TI  - Asymptomatic and neurologically symptomatic HIV-seropositive subjects: results of
      long-term MR imaging and clinical follow-up.
AB  - Cranial magnetic resonance (MR) images were prospectively obtained in 74 human
      immunodeficiency virus (HIV)-seropositive subjects, all of whom had undergone MR
      imaging 24-42 months earlier. The images were interpreted by neuroradiologists
      blinded to the subject's clinical status and were compared with the initial MR
      images and clinical findings. Ten subjects had mild neurologic symptoms, with
      mildly abnormal unchanged images in five (50%). Sixty-four subjects were
      neurologically asymptomatic, with mildly abnormal images in 13 (20%), most of
      which remained unchanged. chi 2 analysis revealed a significant difference (P =
      .042) between the asymptomatic and symptomatic groups with regard to the number
      of subjects with abnormal follow-up images. The number of abnormal images in the
      asymptomatic subjects was significantly less than that in the symptomatic
      subjects. During follow-up of 2-3 1/2 years, most asymptomatic subjects had
      persistently normal MR images. When abnormal, the imaging abnormalities were
      usually static and minor.

PMID- 8351341
TI  - Frameless stereotaxic integration of CT imaging data: accuracy and initial
      applications.
AB  - To evaluate the spatial accuracy of a rapid interactive method of transferring
      computed tomographic (CT) information between its display on a computer screen to
      its source (test object, operating field), a multidimensional computer combined
      with a six-jointed position-sensing mechanical arm was tested with a Plexiglas
      model consisting of 50 rods of varied height and known location, a plastic
      replica of the skull, and, subsequently, three patients. The median error value
      between image and real location was 1-2 mm (P > .95), regardless of the
      registration target sites. The accuracy, however, increased with the selection of
      widespread registration points, and 95% of all errors were below 3.70 mm (P >
      .95). The results compare favorably with the four most commonly used stereotaxic
      framed units. A misregistration error of 0.3-2.2 mm was found during
      intraoperative correlation between anatomy on the CT display and actual anatomic
      location in the operative field.

PMID- 8351342
TI  - Hippocampal sulcus remnant: potential cause of change in signal intensity in the
      hippocampus.
AB  - A small area of changed signal intensity in the hippocampus is often seen on
      magnetic resonance (MR) images of the brain in patients without specific clinical
      signs or symptoms. To ascertain its cause by means of histologic examination,
      this finding was evaluated retrospectively in 109 patients and correlated with
      findings in two human brain specimens. This area of change was typically round or
      curvilinear and 1-2 mm in diameter. Its location was between the hippocampus and
      dentate gyrus. The signal intensity was the same as that of cerebrospinal fluid
      (CSF) with all MR sequences used. The incidence of change in signal intensity was
      greater in elderly patients. Correlation with histologic findings showed that
      this area of change, a dilated perivascular space, was the residual cavity of the
      hippocampal sulcus. Whenever an area of CSF-like signal intensity has this shape
      and topographic features, the possibility of anatomic variation should be
      considered before the change in signal intensity is diagnosed as brain injury.

PMID- 8351343
TI  - Dural invasion by craniofacial and calvarial neoplasms: MR imaging and
      histopathologic evaluation.
AB  - The authors prospectively correlated results of magnetic resonance (MR) imaging
      and histologic examination of the dura in 17 patients with craniofacial and
      calvarial neoplasms and possible intracranial extension. Contrast material
      enhanced MR imaging revealed dural enhancement in 14 patients and no enhancement
      in three. In four cases, the dura deep to the tumor appeared as a continuous band
      of enhancement and there was a thin unbroken hypointense zone between the dura
      and the tumor. Histologic examination in these four patients revealed only dural
      inflammation without neoplastic spread. In 10 patients, there was a break in the
      continuity of the enhancement of the underlying dura or a portion of the dura and
      overlying enhancing tumor could not be separated on MR images. The hypointense
      zone was focally absent in nine of these cases, and in all 10 there was invasion
      of the dura by adjacent tumor. Among the other three patients, in whom dural
      enhancement was not discernible, one had dural invasion by tumor while the other
      two did not.

PMID- 8351345
TI  - Prenatal growth of the human cerebral cortex: brainprint analysis.
AB  - To construct a series of flat maps (brainprints) that document the prenatal
      growth of human cerebral cortex and help identify sulcal landmarks for division
      of cortical regions of interest (ROIs) on mapped surfaces, the authors
      photographed and traced histologic whole-brain slices of 25 normal human fetal
      brains aged 18-42 weeks gestation. Brainprints of both cerebral hemispheres from
      each fetus were constructed with semiautomatic brain-mapping software, and each
      map was divided into five ROIs based on sulcal landmarks: frontal, parietal,
      insular, occipital, and temporal cortices. Surface areas of cerebral hemispheres
      and the five ROIs were estimated. Corrected for histologic shrinkage, brainprint
      estimates of human fetal cortical surface area were approximately twice those of
      previous estimates. Cortical lobe proportions at 18 weeks appeared to be
      unchanged to term. Surface area estimates correlated with fetal age, brain
      weight, and brain volume. This collection of cortical maps may guide future
      quantitative analyses of cerebral hemispheric growth in premature and term
      infants who undergo magnetic resonance imaging, which may, in turn, help predict
      neurobehavioral outcomes of early cortical damage.

PMID- 8351344
TI  - Cerebral sparganosis: MR imaging versus CT features.
AB  - Fourteen magnetic resonance (MR) images of 11 patients with cerebral sparganosis
      were reviewed retrospectively and compared with 13 computed tomographic (CT)
      scans of 10 of the patients. All patients underwent both nonenhanced and contrast
      material-enhanced MR imaging. All white matter degenerations, which were slightly
      hypointense on T1-weighted images and were hyperintense on T2-weighted images,
      were seen as areas of low attenuation on CT scans. Better contrast between normal
      and degenerated brain tissues was seen at MR, and two lesions were seen that were
      missed at CT. The parasitic granuloma was isointense to brain parenchyma on
      images obtained with all pulse sequences. On two follow-up MR images, location or
      shape of the enhancing lesions changed, suggesting migration of the worm. A new
      finding of hyperintensity on T1-weighted images and hypointensity on T2-weighted
      images in subcortical areas probably due to petechial hemorrhages was
      demonstrated in eight patients only at MR. Small calcific foci, which were
      important diagnostic clues of cerebral sparganosis, were detected in four
      patients only at MR, while they were seen in eight patients at CT.

PMID- 8351346
TI  - Thoracic cardiovascular anomalies in children: evaluation with a fast gradient
      recalled-echo sequence with cardiac-triggered segmented acquisition.
AB  - A fast gradient-recalled-echo sequence with cardiac-triggered segmented
      acquisition (fastcard) was compared with a standard T1-weighted spin-echo
      sequence with cardiac gating and respiratory compensation in the evaluation of
      pediatric patients with thoracic cardiovascular anomalies. Twenty patients aged 1
      week to 24 years (median age, 9 months) with various abnormalities underwent
      magnetic resonance (MR) imaging. In 18 patients, MR imaging was performed with
      both gated spin-echo and fastcard. Two observers rated the clinical utility of
      each sequence. Fastcard images were superior to spin-echo images in 10 patients,
      equivalent in seven, and inferior in one. Two additional patients with suspected
      pulmonary vascular lesions were accurately evaluated with the fastcard technique.
      The fastcard technique provides superior demonstration of thoracic cardiovascular
      structures and turbulent flow and enables imaging in multiple phases of the
      cardiac cycle.

PMID- 8351347
TI  - Testicular torsion in infants and children: diagnosis with Doppler sonography.
AB  - The accuracy of Doppler sonography in the evaluation of testicular torsion was
      tested in 65 boys (aged 0-18 years) with acute scrotal pain or swelling. All
      patients underwent pulsed Doppler sonography of both testes, followed by
      scintigraphy (n = 16) and/or surgery (n = 34) and a close clinical follow-up for
      4-8 months (n = 31). Color Doppler sonography was performed in 29 patients. The
      testicular artery was deemed patent if Doppler shifts from branches within the
      parenchyma could be found. Surgery revealed 19 cases of testicular torsion, 17 of
      which were diagnosed with Doppler sonography. There were six technical failures,
      in which no signals could be found on either side. In four boys, no color signals
      were obtained in either testis but subsequent examination with a mechanical
      sector scanner and pulsed Doppler sonography yielded arterial signals. Doppler
      sonography was successful in 59 of 65 boys (91%) and yielded a sensitivity of 89%
      and specificity of 100%. Pulsed Doppler sonography with mechanical sector
      scanners was more sensitive than color Doppler sonography. Intermittent torsion
      was missed both with Doppler sonography and scintigraphy.

PMID- 8351349
TI  - Proton MR and human cervical neoplasia: ex vivo spectroscopy allows distinction
      of invasive carcinoma of the cervix from carcinoma in situ and other preinvasive
      lesions.
AB  - The concept that high-resolution (8.5-T) hydrogen-1 magnetic resonance (MR)
      spectroscopy can be used as an adjunct to conventional histologic diagnosis of
      cervical neoplasia was investigated. Cervical biopsy specimens (n = 159) were
      examined with H-1 MR spectroscopy and the results compared with results of
      histopathologic analysis. A high-resolution lipid MR spectrum was observed in 39
      of 40 invasive carcinomas, whereas the 119 preinvasive samples showed little or
      no lipid spectrum but were characterized by a strong unresolved resonance between
      3.8 and 4.2 ppm. Peak ratios of the methylene/methyl and the unresolved/methylene
      resonances allowed accurate distinction between invasive and preinvasive
      epithelial malignancy (P < .0001). Since MR spectroscopic examination does not
      destroy the specimen, the specimens remained intact for further testing and
      histopathologic analysis. The authors conclude that H-1 MR spectroscopy can
      independently allow distinction between invasive and preinvasive lesions of the
      cervix and has the potential to assist in clinical management of cervical cancer.

PMID- 8351348
TI  - Fluoroscopically guided percutaneous suprapubic cystostomy for long-term bladder
      drainage: an alternative to surgical cystostomy.
AB  - Percutaneous large-bore suprapubic cystostomy catheters were placed under
      fluoroscopic guidance in 60 patients as an alternative to surgical cystostomy.
      Foley catheters (16-20 F) were placed in 57 of the patients in a one-stage
      procedure. Ten-French catheters were initially placed in three patients because
      of difficulty in dilating percutaneous tracks because of obesity (one patient) or
      dense scar tissue (two patients). Three weeks later, 18-F Foley catheters were
      placed in these three patients when mature tracks had developed, making dilation
      easier. Minor complications occurred in three patients, including superficial
      track bleeding in two and urosepsis in one. Fifteen patients were lost to follow
      up. Suprapubic catheters provided excellent long-term drainage (range, 0.5-36
      months; mean, 16 months; median, 18 months) in the remaining 45 patients. The
      authors conclude that percutaneous suprapubic catheter placement is a safe and
      effective procedure that provides excellent long-term bladder drainage.

PMID- 8351350
TI  - Carcinoma of the cervix: value of plain and gadolinium-enhanced MR imaging in
      assessing degree of invasiveness.
AB  - The accuracy of nonenhanced spin-echo (SE) T2-weighted and contrast material
      enhanced SE T1-weighted magnetic resonance (MR) imaging in assessing the degree
      of local tumor invasion was determined prospectively in 53 consecutive patients
      with clinically established early-stage carcinoma of the cervix. With a 0.5-T
      superconducting unit, pulse sequences of 2,000/90 (repetition time msec/echo time
      msec) for T2-weighted images and 500/20 for T1-weighted images were used. In all
      cases, findings of the two MR imaging techniques were compared with results of
      histologic examination of surgical specimens. Tumor infiltration into the
      surrounding structures was classified as partial stromal, complete stromal, or
      parametrial. Tumor-cervical stroma and tumor-parametrium contrast-to-noise ratios
      (C/Ns) were higher (P < .05) at nonenhanced T2-weighted than at enhanced T1
      weighted than at enhanced T1-weighted imaging. In determining the depth of
      invasion, the overall accuracy was 85% for nonenhanced T2-weighted and 57% (P <
      .05) for enhanced T1-weighted imaging. With conventional SE sequences,
      nonenhanced T2-weighted MR imaging is superior to contrast-enhanced T1-weighted
      MR imaging in determining the degree of invasiveness in clinical early-stage
      cervical tumors.

PMID- 8351351
TI  - Mammographic positioning: evaluation from the view box.
AB  - To evaluate the quality of breast positioning for mediolateral oblique (MLO) and
      craniocaudal (CC) views, a prospective study of 1,000 consecutive bilateral
      screening mammographic examinations was performed. Six criteria were tested,
      including depth of tissue seen, inferior extent of the pectoral muscle relative
      to the posterior nipple line, presence of fibroglandular tissue at the posterior
      edge of the film, and whether the nipple was in profile. Pectoral muscle was
      depicted to within 1 cm of the nipple line or below it on 1,612 of the 2,000 MLO
      mammograms (81%); all fibroglandular tissue was depicted on 1,532 MLO mammograms
      (77%). The depth of tissue depicted on the CC mammogram was within 1 cm greater
      or less than the depth on the MLO mammogram on 1,586 CC mammograms (79%); the
      pectoral muscle was seen on 646 CC mammograms (32%). The nipple was in profile in
      1,769 MLO mammograms (88%) and 1,783 CC mammograms (89%) but not in profile in
      either view in 83 cases (4%). Overall improvement was seen in 400 of 587
      examinations (68%) when new mammograms were compared with previous mammograms.
      These criteria can be used to evaluate positioning performance and for quality
      control.

PMID- 8351352
TI  - Acute puerperal breast abscesses: US-guided drainage.
AB  - Breast abscesses typically develop in lactating women. The recommended treatment
      is surgical incision and drainage with the patient under general anesthesia.
      Ultrasonically guided percutaneous drainage with local anesthesia was performed
      in 19 consecutive patients referred for treatment because of clinical signs of
      acute puerperal breast abscess. Eighteen of the 19 patients (95%) were
      successfully treated. Long-term follow-up (median, 12 months) did not show any
      recurrences, and the cosmetic results were excellent. Eight of the 19 patients
      (42%) continued nursing during and after treatment. Ten of the 19 (53%) were
      treated on an outpatient basis. On the basis of these results, the authors
      recommend ultrasonically guided percutaneous treatment for use in patients with
      acute puerperal breast abscesses.

PMID- 8351353
TI  - Quality assurance and cancer detection rates in a provincial screening
      mammography program. Work in progress.
AB  - In 1990, a provincial screening program was inaugurated in Alberta, a Canadian
      province of 2.4 million people. The goal of the program is to decrease the number
      of deaths from breast cancer by 30% in women aged 50-69 years. In the first 18
      months of program operations, efforts were concentrated on high levels of quality
      assurance in all areas of program activities. In particular, the abnormality
      referral rates, cancer detection rates, and size and stage of mammographically
      detected cancers were evaluated. Of the 9,553 women seen, 8,524 were between the
      ages of 50 and 69 years. Reported abnormality rates were initially more than 16%,
      but were brought down steadily to less than 5%. Cancer detection rates increased
      with age, ranging from 1.9 cancers detected per 1,000 women aged 40-49 years to
      14.1 cancers per 1,000 women aged 70 years and older. Forty-one of the 61 cancers
      detected (67%) were less than 1.5 cm in diameter. Forty-three of the 52 cancers
      (83%) in which the nodal status was known were node negative. At the conclusion
      of the first 18 months of operation, interpretation parameters were within the
      target zones expected for a population-based screening program.

PMID- 8351354
TI  - Acute interstitial pneumonia: radiographic and CT findings in nine patients.
AB  - The radiologic findings were reviewed in nine patients with biopsy- or autopsy
      proved acute interstitial pneumonia (AIP). All patients had bilateral air-space
      opacification on radiographs and bilateral, symmetric areas of ground-glass
      attenuation on computed tomographic (CT) scans. The areas of ground-glass
      attenuation had a patchy distribution in six patients (67%) and were diffuse in
      three patients. Air-space consolidation was seen at CT in six patients (67%) and
      involved mainly the lower lung zones in three patients and upper lung zones in
      one patient and was diffuse in two patients. A predominantly subpleural
      distribution of the consolidation was present in two patients. Eight of the nine
      patients died within 3 months of presentation. The authors conclude that the
      radiographic and CT features of AIP are similar to those of adult respiratory
      distress syndrome and represent acute alveolar damage. AIP differs from the more
      chronic forms of interstitial pneumonia in clinical presentation and in
      pathologic and radiologic findings.

PMID- 8351355
TI  - Intracavitary aspergilloma: transthoracic percutaneous injection of amphotericin
      gelatin solution.
AB  - For aspergillomas in patients with fibrocavitary lung disease, surgery is often
      not recommended. Injection or lavage of the cavities with solutions of potassium
      iodide or antifungal agents has had varying success and requires repeated
      sessions because of nonretention of the therapeutic agent within the cavity. In
      three patients with four aspergillomas, the authors used fluoroscopic or computed
      tomographic (CT) guidance to inject amphotericin in gelatin as a liquid that
      solidifies within the cavity at body temperature. The patients were followed up
      with serial chest radiography or CT. The mixture was successfully instilled in
      every case. Three of the four aspergillomas completely resolved within 3 months
      or less, with no evidence of recurrence at follow-up of 6-18 months. The
      remaining aspergilloma decreased in size, but the patient needed pneumonectomy
      because of recurrent hemoptysis within 6 months of amphotericin injection.
      Transthoracic instillation of a liquid mixture of amphotericin and gelatin that
      solidifies rapidly at body temperature may be useful as a one-step treatment for
      aspergillomas.

PMID- 8351356
TI  - Inoperable pulmonary aspergilloma: percutaneous CT-guided injection with glycerin
      and amphotericin B paste in 15 cases.
AB  - Fifteen patients with active inoperable pulmonary aspergilloma underwent
      percutaneous injection of a special therapeutic paste of glycerin and
      amphotericin B. This paste was warmed just prior to injection, and filling of the
      lesional cavity was achieved in one session if it was possible to obtain
      anaerobic conditions for destruction of the aspergilloma. Injection was performed
      with computed tomographic guidance with use of an 18-gauge flexible needle and
      with administration of anti-coughing analgesia. Follow-up was continued for 7
      months on average. Filling of the lesion cavities required three sessions on
      average because of cough or bronchospasm. In 12 cases the aspergilloma regressed
      within 3 months and results at serology became negative. In three cases, there
      was no change in the cavity, but hemoptysis did not recur. Results in this series
      confirm the feasibility and efficacy of this palliative treatment.

PMID- 8351357
TI  - Uncomplicated asthma in adults: comparison of CT appearance of the lungs in
      asthmatic and healthy subjects.
AB  - A study was undertaken to define the computed tomographic (CT) appearance of the
      lungs in subjects with uncomplicated asthma and to compare the prevalence of
      bronchial dilatation at CT in asthmatic and healthy subjects. Clinical features,
      pulmonary physiologic findings, chest radiographs, and high-resolution CT scans
      of 48 asthmatic subjects were reviewed. Forty-one (85%) of the 48 asthmatic
      subjects were undergoing bronchodilator therapy, 28 (58%) were undergoing steroid
      therapy, and 21 (44%) were cigarette smokers. Twenty-seven healthy control
      subjects underwent limited high-resolution CT. At selected CT levels, any
      bronchus with an internal diameter greater than that of the accompanying
      pulmonary artery was considered dilated. In the asthmatic subjects, 153 (36%) of
      429 bronchi evaluated met criteria for bronchial dilatation compared with 37
      (26%) of 142 bronchi in the control group (P < .05). Because bronchial dilatation
      demonstrated at CT did not correlate with clinical data, the authors conclude a
      bronchus larger in diameter than the adjacent vessel is not sufficient evidence
      to diagnose cylindric bronchiectasis.

PMID- 8351358
TI  - Automated in vivo quantification of emphysema.
AB  - A computer program to automatically determine lung volume and percentage of
      emphysema from computed tomographic (CT) chest sections was developed. To test
      it, the authors reviewed scans obtained in 89 patients. Any computer errors in
      identification of normal or emphysematous lungs were corrected manually by
      tracing the boundaries of the lungs or eliminating areas of nonemphysematous lung
      with a roller ball. The corrected values were compared with the uncorrected
      values. In 33 patients from the study group, lung volumes and the percentage of
      emphysema were calculated by using a currently available "voxel highlighting"
      program. Successful computerized analysis of entire lungs was performed in 1
      minute, compared to more than 1 hour for manual analysis. Correlation was high (r
      = .99) between results obtained manually and those obtained with the computer.
      Although the difference between uncorrected and corrected values of the
      percentage of emphysema was statistically significant, this converted to a
      correction of only 0.1%. The computer program allowed quick, accurate, and
      reproducible quantification of emphysema.

PMID- 8351359
TI  - Pulmonary embolism: diagnosis with electron-beam CT.
AB  - Contrast material-enhanced electron-beam computed tomography (CT) (100-msec scan
      time) was performed to image the pulmonary vasculature in 86 patients, each
      suspected of having a pulmonary embolism (PE). Thromboembolic material was
      demonstrated in 39 patients; no emboli were demonstrated in 47. In 25 patients,
      angiographic or pathologic proof was available. There were 19 proved positive CT
      scans, four proved negative scans, one false-negative scan, and one false
      positive scan. In the 21 patients with CT and angiographic correlation, evidence
      of thromboembolic disease was seen in 88 vascular zones. Fifty-three zones were
      positive for PE at both CT and angiography. Eighteen zones were positive for PE
      at angiography alone, and 17 zones were positive at CT alone. Electron-beam CT is
      a potentially effective noninvasive means of diagnosing PE.

PMID- 8351360
TI  - Detection of unsuspected central pulmonary embolism with conventional contrast
      enhanced CT.
AB  - When fast, nondynamic scanning techniques are used in combination with adequate
      intravenous injection of contrast material, good-quality images of the pulmonary
      artery (PA) can be obtained with routine computed tomography (CT). The purpose of
      this study was to evaluate PA filling defects detected on these CT scans. Twenty
      two CT scans from 22 patients with PA filling defects were reviewed. A routine
      scanning technique was used. Thrombus was unilateral in 12 cases and bilateral in
      10. All patients but one had a predisposition for pulmonary embolism (PE).
      However, only five patients underwent CT because there was a strong suspicion for
      PE. In 17 cases, PE was not the first choice of clinical diagnosis; in 13 cases,
      thrombus of the PA was not even considered. Diagnosis was confirmed in 11
      patients with ventilation-perfusion scanning (n = 7), angiography (n = 3), and
      surgery (n = 1). In 11 patients, anticoagulation therapy was started without
      further diagnostic procedures. Diagnosis of thrombus of the PA is possible with
      routine nondynamic, contrast material-enhanced CT. Because PE is often
      unsuspected at clinical examination, every contrast-enhanced CT scan of the chest
      should be evaluated for the presence of filling defects in the PA.

PMID- 8351361
TI  - Percutaneous inferior vena caval filters: follow-up of seven designs in 320
      patients.
AB  - Three hundred twenty-four percutaneous inferior vena caval (IVC) filters of
      different designs were placed in 320 patients from April 1985 through June 1992.
      No acute mortality or substantial morbidity was attributed to filter placement.
      Radiologic or pathologic follow-up data were obtained in 227 (71%) patients (230
      filters); clinical follow-up data only were obtained in 50 (16%) patients (50
      filters). One hundred twenty (43%) patients died; post-filter-placement pulmonary
      emboli (PE) were related to the cause of death in eight. At IVC filter imaging
      studies, 26 of 137 (19%) filters demonstrated caval thrombus; 12 of 132 (9%)
      filters had delayed penetration through the IVC wall of greater than 3 mm; 13 of
      230 (6%) filters migrated more than 1 cm; and five of 230 (2%) filters had
      fracture of a strut or leg. Deep venous thrombosis (DVT) at the insertion
      puncture site or in the lower extremity was noted in 26 of 117 (22%) cases of
      filter placement. Among patients without imaging studies, clinical suspicion of
      complications included PE in four patients, IVC thrombus in 14 patients, and
      lower-extremity DVT in 10 patients. Long-term clinical and radiologic follow-up
      of all IVC filters is indicated due to the relatively high prevalence of some
      complications.

PMID- 8351362
TI  - Vena Tech-LGM filter: long-term results of a prospective study.
AB  - Efficiency and tolerance of the Vena Tech-LGM filter were assessed in 142
      patients prospectively studied during a 2-6-year follow-up period. No patients
      were lost to follow-up, and 137 (91.3%) scheduled control examinations were
      performed. Fifty-three patients died of causes unrelated to thromboembolic
      disease. Pulmonary embolism was suspected in five surviving patients (3.5%).
      Sixteen retractions (18.4%), 16 intracaval migrations (18.4%), and one tilt were
      observed. Filter patency studied at Doppler ultrasonography, with or without
      phlebocavography, gave the following results according to the Kaplan-Meier
      actuarial method: 92% patency after 2 years of follow-up, 80% after 4 years, and
      70% after 6 years. Vena Tech-LGM filter obstruction was related to retraction (P
      < 10(-6)) or distal migration (P < .004). Occurrence of trophic disease in the
      lower limbs during the follow-up period was related to the initial level of deep
      venous thrombosis (P = .03) and had no relation to the patency of the filter. The
      filter was effective in preventing pulmonary embolism, with 70% demonstrating
      long-term patency, and no deleterious effects were imputed to obstructions
      observed during follow-up.

PMID- 8351363
TI  - Intraarterial thrombolysis of lower extremity occlusions: prospective, randomized
      comparison of forced periodic infusion and conventional slow continuous infusion.
AB  - A prospective randomized controlled trial compared forced infusion (FI) of
      urokinase (UK) with conventional slow continuous infusion (CI) in 25 patients
      with 25 acutely ischemic lower limbs. Demographics, ischemia categories, and
      infusion rates and doses were similar for both groups. A preliminary single-pass
      bolus of UK was injected into the thrombus in all patients with a pulsed-spray
      technique, and heparin was administered. UK was then infused with a CI pump (n =
      13) or a prototype pulsed-spray pump (n = 12). The primary end point was patency,
      defined as at least 95% thrombolysis by volume, with brisk antegrade flow
      occurring within 4 hours. Eleven of the 12 patients (92%) who underwent FI and
      nine of the 13 (70%) who underwent CI had patency within 4 hours. However, 10
      patients who underwent FI and nine who underwent CI had residual thrombi
      prolonging infusion. No significant differences between the two groups were
      apparent in speed of lysis, initial success rates, complication rates, or 30-day
      clinical outcome. Lytic therapy, however, was completed within 24 hours in 18 of
      23 (78%) successfully treated patients (P = .01).

PMID- 8351364
TI  - Improved mammography with a reduced radiation dose.
AB  - A 2-cm-high focused air-interspaced grid with a 7:1 ratio and eight lamellae per
      inch was devised. The grid is arc-shaped and pivots on its focal point, the anode
      cathode axis. Milliamperage was 35% less for breast phantom radiographs obtained
      with the new grid versus those obtained with a conventional 5:1 mammographic
      grid. In a comparison study of five mammograms, each evaluated for five
      parameters, the images obtained with the new grid were judged to be of equal or
      better quality than those obtained with a conventional grid in 17 of 20
      comparisons.

PMID- 8351365
TI  - Catheter for percutaneous thrombectomy: first clinical experience.
AB  - The authors evaluated a double-lumen thrombectomy catheter that functions by way
      of the Venturi effect in seven consecutive patients with thrombus in the
      superficial femoral artery. The estimated age of the thrombotic material was
      between 3 days and 9 weeks. Thrombectomy was successful in all patients, and mean
      time required was less than 20 minutes. In five patients, diagnosis,
      thrombectomy, and therapeutic intervention were successfully performed in one
      session.

PMID- 8351366
TI  - Film density calibration for computed radiography systems: is the standard three
      point procedure accurate?
AB  - With computed radiography (CR) systems, laser printer-film processor combinations
      are normally checked daily by using test film three-point density measurements.
      In this study, the authors show that the recommended three-point quality
      assurance procedure can show satisfactory results even though the CR film output
      behaves in an anomalous manner. This problem can be corrected by using a 16-point
      calibration procedure. Regular 16-point calibrations should be performed to
      ensure satisfactory CR system performance.

PMID- 8351367
TI  - Intraorbital wood foreign bodies.

PMID- 8351368
TI  - Contrast and signal-to-noise ratio in radiographic images.

PMID- 8351369
TI  - A step forward in the characterization of adrenal cortical lesions?

PMID- 8351370
TI  - Fluid-fluid level in bronchogenic cysts.

PMID- 8351371
TI  - [Bacterial dysentery in 1991].

PMID- 8351372
TI  - [Distribution of antibodies against Encephalitis ixodica viruses among north-east
      healthy populations of Poland].
AB  - We have undertaken the investigations for the detection of the presence of
      antibodies against Encephalitis ixodica viruses among North-East population of
      Poland. We have found these antibodies in 6.5% among 676 of tested healthy
      persons. The highest % of detected antibodies were noted in forest rangers and in
      physicians acting as hunters. Our data seems to indicate that Encephalitis
      ixodica is still actual disease in this region. Therefore one can suggest the
      necessity vaccination against Encephalitis ixodica.

PMID- 8351373
TI  - [Food poisonings and infections in 1991].

PMID- 8351374
TI  - [Poisoning from chemicals used for plant protection in 1991].

PMID- 8351375
TI  - [Viral hepatitis B in 1991].

PMID- 8351376
TI  - [Non-b viral hepatitis in 1991].

PMID- 8351377
TI  - [Tetanus in 1991].

PMID- 8351379
TI  - [Brucellosis in 1991].

PMID- 8351378
TI  - [Rabies in 1991].

PMID- 8351380
TI  - [Trichinosis in 1991].

PMID- 8351381
TI  - [Aids and HIV infections in 1991].

PMID- 8351382
TI  - [Kazimierz Albin Lachowicz. Doctor of microbiology 1909-1992].

PMID- 8351383
TI  - [Etiologic profile of viral respiratory infections in small children during
      epidemic periods 1990-91 and 1991-92].
AB  - In periods from October 1990 to June 1991 and from September 1991 to June 1992,
      551 hospitalized infants and small children were examined by immunofluorescence
      method for respiratory viruses. In 264 (47.9%) cases viral etiology was
      established. Like in previous seasons the infections of RS and parainfluenza type
      3 viruses dominated. Infections of RS virus were not frequent, and of
      parainfluenza type 3 virus less than in previous seasons. The increase of percent
      of infections due to parainfluenza type 2 and 4 viruses were observed.

PMID- 8351384
TI  - [Neurotropic properties of Listeria monocytogenes and Mycobacterium leprae in
      natural and experimental infections].

PMID- 8351385
TI  - [Infant mortality and perinatal mortality in Poland in the eighties. II. Deaths
      by birthweight].
AB  - The dynamics of the changes in the level of the birthweight-specific infant
      mortality and perinatal mortality rates by age and cause during the eighties is
      presented. The strongest decline in the birthweight-specific infant and perinatal
      mortality rates is observed among the newborns weighing less than 2500 g. The
      level of the low birth weight (7.9% in 1989) and despite the decrease--the infant
      and perinatal mortality rates among the newborns weighing 1001-2500 g (100.5 and
      109.4 respectively in 1989) and among the newborns weighing 601-1000 g (865.3 and
      851.1 respectively in 1989) are high comparing to the developed countries.

PMID- 8351386
TI  - [Actual state of medical supply sterilization in Poland].
AB  - The analysis of condition of sterilization of medical supplies in Poland was
      done. It consider the problem of preparation of medical supplies to
      sterilization, methods of sterilization and control monitoring system in this
      matter. The results of this analysis suggest proposition for improving of
      activities in this field.

PMID- 8351387
TI  - [Certain problems with limits of immunity against measles, mumps and rubella].
AB  - Strategic goals and schemes of immunization against measles, mumps and rubella in
      European countries with special attention for positive and negative sides of
      immunization against rubella and control of congenital rubella were described.
      Vaccines against mumps with strain Urabe AM9 were withdrawn in September 1992 in
      Great Britain. Decision was caused by increasing of complications after
      vaccination to 1 for 4000 doses of vaccine. (Former 1:4,000,000). Only mumps
      vaccine with strain Jeryl Lynn is there accepted. Including of vaccination
      against mumps to the calendar of vaccination in Poland was advised, when vaccine
      MMR with Jeryl Lynn mumps vaccine strain would be available. Monitoring of
      immunization of women against rubella would be necessary after above mentioned
      change in calendar of vaccinations.

PMID- 8351388
TI  - [Infectious diseases in Poland in 1991].

PMID- 8351389
TI  - [Measles in 1991].

PMID- 8351390
TI  - [Whooping cough in 1991].

PMID- 8351391
TI  - [Scarlet fever in 1991].

PMID- 8351392
TI  - [Epidemic parotitis in 1991].

PMID- 8351393
TI  - [Influenza in 1991].

PMID- 8351394
TI  - [Rubella in 1991].

PMID- 8351396
TI  - [Salmonellosis in 1991].

PMID- 8351395
TI  - [Cerebrospinal meningitis and encephalitis in 1991].

PMID- 8351397
TI  - [Psychoanalytic theories of gender identity].

PMID- 8351398
TI  - [Female genital anxieties and conflicts and typical coping mechanisms].

PMID- 8351399
TI  - [Neutrality, bisexuality and androgyny of the psychoanalyst].
AB  - Proceeding from the fact that Western thought is based on Greek philosophy, the
      author pinpoints a feature specific to psychoanalysis. Unlike other sciences,
      which are grounded in the central (and latently homosexual) relation of rhetoric
      and dialogue between teacher and pupil, psychoanalytic dialogue centers around a
      heterosexual (male/female) relationship. Prototypic for this is the confrontation
      of the psychoanalyst with the "complex burden of female love". The fascination of
      philosophy lies in similarity, that of psychoanalysis in difference. The gender
      question, and more specifically the sex of the analyst, has been given little
      attention in connection with the transference/countertransference paradigm. With
      a discussion of the concepts of neutrality (Freud), bisexuality (Freud, Jung) and
      with reference to literary sources on androgyny (V. Woolf, Balzac, Le Guin)
      Molfino undertakes the attempt to take the gender discussion in psychoanalytic
      theory and practice a stage further.

PMID- 8351400
TI  - [A lady vanishes: Sophie Freud and Beyond the Pleasure principle].

PMID- 8351401
TI  - Cosecretion of islet amyloid polypeptide (IAPP) and insulin from isolated rat
      pancreatic islets following stimulation or inhibition of beta-cell function.
AB  - The aim of this work was to simultaneously study the secretion of islet amyloid
      polypeptide (IAPP) and insulin from isolated rat pancreatic islets in vitro. For
      examination of stimulated beta-cells, nutrient secretagogues (16.7 mM glucose, 10
      mM leucine + 2 mM glutamine), phosphodiesterase inhibition (5 mM theophylline), a
      sulphonylurea (0.5 microgram/ml glipizide), a non-nutrient amino acid (10 mM
      arginine), cholinergic stimulation (0.1 mM carbamylcholine) and insulinotropic
      peptides (0.1 microM vasoactive intestinal polypeptide and 0.1 microM glucagon),
      were used. For beta-cell suppression glucose phosphorylation inhibition (10 mM
      mannoheptulose), depletion of extracellular calcium, activation of the ATP
      regulated K(+)-channel (0.5 mM diazoxide), adrenoreceptor stimulation (3 microM
      adrenaline), paracrine modulation (0.1 microM somatostatin), short-term treatment
      with a selective beta-cytotoxin (1.1 and 2.2 mM streptozotocin) and long-term
      treatment with a cytokine (25 U/ml interleukin-1 beta), were studied. The
      compounds with known effects on insulin secretion exerted their expected actions
      and this was paralleled by similar relative changes, with a possible exception
      for glucagon, in the IAPP secretion. The ratio of IAPP/insulin released did not
      change significantly under any of the tested experimental conditions, except for
      a slight increase following carbamylcholine stimulation. On a molar basis approx.
      1% of IAPP was released when compared with insulin. These results are consistent
      with the hypothesis that the regulation of IAPP secretion from beta-cells of
      isolated rat pancreatic islets is essentially regulated by the same mechanisms as
      insulin secretion.

PMID- 8351402
TI  - The effects of intravenous cholecystokinin, secretin and pentagastrin on
      electromyographic activity of the rumen in sheep.
AB  - Several gastroenteropancreatic (GEP) peptides have been reported to alter ruminal
      motility. In the present study, we tested the effects of three of these peptides
      on ruminal myoelectrical activity in the sheep. We measured the effect of 10 min
      IV infusions of pentagastrin, secretin, and cholecystokinin, either alone or in
      combination, on the spike frequency of the rumen in conscious sheep. IV
      administration of 780 pmol/kg pentagastrin significantly decreased spike
      frequency within 10 min with a return towards control levels over the subsequent
      30 min. Secretin decreased ruminal spike activity at doses of 120 and 180
      pmol/kg. Finally, 13, 26 and 35 pmol/kg IV cholecystokinin all resulted in
      significant decreases of spike frequency, with virtual elimination of spiking
      activity at the highest dose. Administration of the lowest dose of secretin, or
      the single dose of pentagastrin, with the lowest dose of CCK resulted in a
      potentiation of their inhibitory effects. We conclude that one mechanism
      underlying the altered motility induced by these GEP peptides is a decrease of
      spike frequency which may contribute to overall contractile activity.

PMID- 8351403
TI  - Primary structure of neuropeptide Y from brains of the American alligator
      (Alligator mississippiensis).
AB  - The purification of NPY from brains of the American alligator (Alligator
      mississippiensis) was achieved using reverse-phase high performance liquid
      chromatography (HPLC). The amino acid sequence was determined using automated
      Edman degradation as Tyr-Pro-Ser-Lys-Pro-Asp-Asn-Pro-Gly-Glu- Asp-Ala-Pro-Ala-Glu
      Asp-Met-Ala-Arg-Tyr-Tyr-Ser-Ala-Leu-Arg-His-Tyr-Ile- Asn-Leu - Ile-Thr-Arg-Gln
      Arg-Tyr. Alligator NPY is the first non-mammalian vertebrate to have 100%
      sequence identity to human NPY. The conservation of alligator NPY suggests that
      serine in position 7 of chicken NPY evolved after the birds and reptiles diverged
      from a common Archosaurian ancestor. Furthermore, the sequence identity between
      alligator and human NPY suggests this sequence is the same as the ancestral
      amniote NPY.

PMID- 8351404
TI  - Neuropeptide Y and neuropeptide Y 3-36: isolation from human pancreatic endocrine
      tumours.
AB  - Using an antiserum raised to the C-terminal region of neuropeptide Y (NPY) which
      does not cross-react with pancreatic polypeptide (PP), immunoreactivity has been
      detected in two different endocrine tumours of the human pancreas in
      concentrations permitting isolation and structural analysis. In a clinically
      typical gastrinoma, resected from the head of pancreas, the concentration of NPY
      immunoreactivity was 3.4 nmol/g. Reverse phase HPLC analysis of extracts of this
      tumour resolved a single immunoreactive peptide coeluting with synthetic human
      NPY. The molecular mass of the isolated peptide, determined by mass spectroscopy,
      was 4270 Da, which was in close agreement with that derived from the deduced
      primary structure of human tumour NPY (4271.7 Da), obtained by gas-phase
      sequencing. A somatostatinoma, resected from the region of the ampulla of Vater,
      contained 3.8 nmol/g of NPY immunoreactivity and isolation of this immunoreactive
      peptide followed by structural analyses, indicated a molecular structure
      consistent with NPY 3-36. These data suggest that NPY immunoreactivity detected
      in human pancreatic endocrine tumours is molecularly heterogenous, a finding
      which may be of relevance in the symptomatology of such tumours as attenuation of
      the N-terminus of this peptide generates receptor selectivity.

PMID- 8351405
TI  - Differences between perinatal angiotensin binding in the brains of SHR and WKY
      rats.
AB  - A growing body of evidence suggests that angiotensin may have a functional role
      in growth and development, in addition to its classical role in the maintenance
      of body water homeostasis. Components of the renin-angiotensin system have been
      identified in the rat fetus. Because of the association between the renin
      angiotensin system and hypertension, we quantified angiotensin receptor binding
      sites in the brains of spontaneously hypertensive rats (SHR) and Wistar Kyoto
      (WKY) rats during perinatal development. Using in vitro receptor autoradiography
      we identified specific 125I-Sar1,Ile8 AII binding in several areas of the brains
      of perinatal rats of both strains and observed significant differences in the
      concentration of binding sites, at different ages in several brain nuclei. With
      the knowledge that components of the renin-angiotensin system appear early in
      development and are known to have an association with cellular growth, it is
      possible that an irregularity in this system occurring during neurogenesis could
      contribute to developmental abnormalities, as well as subsequent hypertension.

PMID- 8351408
TI  - [French Society of Pneumology. List of members (1993)].

PMID- 8351406
TI  - Enteroendocrine peptides in a canine model of orthotopic jejunoileal
      autotransplantation.
AB  - The enteroendocrine cells of the small bowel provide a rich source of regulatory
      peptides involved in the modulation of gastrointestinal function. Recent work
      from our laboratory showed that in situ neural isolation (autotransplantation) of
      the jejunoileum produced marked changes in tissue expression of several
      neuropeptides. In the present study, we examined the influence of extrinsic
      innervation on the tissue expression of endocrine peptides localized to various
      regions of the gastrointestinal tract. Concentrations of immunoreactive gastric
      inhibitory polypeptide (GIP), neurotensin (NT) and peptide tyrosine tyrosine
      (PYY) in fasting plasma and regional tissue biopsies were determined before and
      at varying time points (2, 6, 12 weeks) after a model of canine orthotopic
      jejunoileal autotransplantation. GIP was not altered in plasma or tissue at any
      time point. Plasma concentrations of NT and PYY increased after
      autotransplantation. Following a decrease in tissue concentrations two weeks
      after autotransplantation, NT increased progressively from 2 to 6 to 12 weeks,
      reaching a maximal increase of 895% over baseline in proximal ileum. Tissue
      concentrations of PYY followed much the same pattern as NT, but these trends
      never achieved statistical significance. Chromatographic characterization of
      tissue biopsy extracts revealed molecular heterogeneity of NT-like
      immunoreactivity, while GIP and PYY immunoreactivity coeluted as single species
      with authentic standards. Taken together with our earlier observations, it
      appears that disruption of extrinsic and intrinsic neural continuity to the
      jejunoileum (autotransplantation) does not affect gut endocrine peptides such as
      GIP and PYY to the same extent as enteric neuropeptides. NT has been localized to
      neural as well as endocrine cells and is involved in the temporal adaptive
      response to autotransplantation.

PMID- 8351407
TI  - Helospectin/helodermin-like peptides in guinea pig lung: distribution and
      dilatory effects.
AB  - The lower airways of guinea pigs were analysed for helospectin and helodermin
      using immunocytochemistry. A moderate supply of helospectin/helodermin-like
      immunoreactive nerve fibers and few nerve fibers displaying helodermin
      immunoreactivity was seen in the smooth muscle, around seromucous glands and
      small blood vessels in the trachea and around bronchi and pulmonary blood
      vessels. Helospectin I-, helospectin II- and helodermin-induced suppression of
      smooth muscle responses were analysed using isolated circular segments of trachea
      and pulmonary arteries of guinea pigs. In both airways and arteries the peptides
      caused a concentration-dependent relaxation of precontracted segments. The
      maximal relaxant activity observed was more pronounced in the airways than in the
      arteries. The effects of the helospectins and helodermin were compared to those
      of vasoactive intestinal peptide (VIP), peptide histidine isoleucine (PHI),
      pituitary adenylate cyclase activating peptide (PACAP) and acetylcholine (ACh).
      All peptides, with the exception of PACAP, caused a total or nearly total
      relaxation of the precontracted tracheal segments. In the trachea PACAP was
      significantly more potent than the other five peptides whereas only small potency
      differences were seen in the pulmonary artery. The relaxant responses to
      helospectin I, helospectin II and helodermin in the trachea and the
      intrapulmonary arteries were unaffected by pretreatment with atropine, prazosin,
      yohimbine, propranolol, mepyramine and cimetidine. Conceivably, nerve fibers
      containing helospectin and helodermin may play a role in the regulation of airway
      resistance and in the regulation of local pulmonary blood flow.

PMID- 8351410
TI  - Insulin like effects of lithium and vanadate on the altered antioxidant status of
      diabetic rats.
AB  - Lithium is widely used for treatment of behavioral disorders and has been shown
      to possess insulin-mimetic properties. The present study examines the in vivo
      effects of lithium alone, as well as in combination with vanadate (a potent
      insulin-mimetic agent), on the altered antioxidant status in the liver and kidney
      of diabetic rats. The elevated blood glucose levels in diabetic rats were about
      50% restored by oral administration of lithium (0.3 mg/ml) and were completely
      normalized following vanadate addition (0.05 mg/ml) to lithium. Lithium therapy
      effectively normalized the decreased activities of catalase (CAT) and glutathione
      peroxidase (GSH-PX) but could not restore the lowered superoxide dismutase (SOD)
      in the liver of diabetic rats; while in kidney, the treatment proved to be
      ineffective. Inclusion of vanadate produced synergistic effect and caused partial
      restoration of the altered CAT, GSH-PX and CuZn-SOD levels in diabetic kidney and
      the depressed SOD activity in diabetic liver. These results suggest that lithium
      therapy may prove effective in improving the impaired antioxidant status during
      diabetes and vanadate supplementation at a low dose potentiates the effectiveness
      of lithium action.

PMID- 8351409
TI  - Pathways of formation of 2-, 3- and 4-bromophenol from bromobenzene. Proposed
      mechanism for C-S lyase reactions of cysteine conjugates.
AB  - Bromobenzene is metabolized by the rat and guinea pig to 2-, 3- and 4
      bromophenol. 3-Bromophenol is formed through the sulfur-series pathway to
      phenols. This route involves the enterohepatic circulation; the key intermediate
      is the S-(2-hydroxy-4-bromocyclohexa-3,5-dienyl)-L-cysteine derived from the 4-S
      glutathione conjugate of the 3,4-oxide. A sulfonium ion C-S lyase reaction is
      proposed in order to account for the pyridoxal phosphate-dependent
      cleavage/aromatization step, and a C-S beta-lyase reaction sequence is also
      proposed for the formation of bromodihydrobenzene thiolols. This route of phenol
      formation may prove to be a general one for aromatic hydrocarbons and closely
      related compounds that show arene oxide conjugation with glutathione. 2
      Bromophenol is formed predominately by spontaneous isomerization of the 2,3
      oxide. 4-Bromophenol is formed by the sulfur-series route from the S-(2-hydroxy-5
      bromocyclohexa-3,5-dienyl)-L-cysteine. Additional in vivo routes to 3- and 4
      bromophenol involve dehydration/aromatization of the 3,4-dihydro-3,4-diol,
      possibly by way of conjugates; these routes have transient ketonic intermediates.
      The pathways from bromobenzene to phenols and to sulfur-containing metabolites
      derived from premercapturic acids show species and dosage variation.

PMID- 8351411
TI  - beta-Casomorphin-immunoreactivity in the brain stem of the human infant.
AB  - Using a peptide extraction procedure, reversed phase high performance liquid
      chromatography, and a radioimmunoassay that utilized an antibody raised
      specifically against human beta-casomorphin-8 (BC8), BC-immunoreactivity (BCIR)
      was detected in rostrocaudally increasing levels in nineteen microscopically
      distinct and functionally relevant areas of mesencephalon, pons cerebri, and
      medulla oblongata of eight infants. On the basis of the methodology used, it can
      be concluded, that the BCIR present in their brain stem was due to BC8 and/or to
      some of its congeners. Data in the literature together with those of this study
      indicate that beta-casomorphins could be transported by specific mechanisms from
      the blood into the brain stem and that they could play a role in the central
      regulation of various physiological phenomena.

PMID- 8351412
TI  - Immediate decline in DNA synthesis in neonatal rat lung caused by exposure to
      100% oxygen.
AB  - Oxygen therapy in preterm infants is associated with bronchopulmonary dysplasia,
      but the relative importance of oxygen toxicity as compared to adverse effects of
      intubation and mechanical ventilation, remains uncertain. In freely-breathing
      neonatal rats, exposure to 100% oxygen for as little as 2 hr produced a
      significant reduction in lung DNA synthesis, evaluated by [3H]thymidine
      incorporation, without a concomitant effect on [3H]leucine incorporation into
      protein. These results indicate that hyperoxia has a selective deleterious effect
      on mitosis in developing lung.

PMID- 8351413
TI  - Nature of heme metabolizing enzymes in a mutant rat with hyperbilirubinuria.
AB  - Eisai hyperbilirubinuria rat (EHBR) is a mutant strain which is originated from
      Sprague Dawley rats. The activities of heme metabolizing enzymes in EHBR were
      compared with those of Sprague Dawley rats as the control. The activity of delta
      aminolevulinic acid (delta-ALA) synthetase, the initial and rate-limiting enzyme
      in heme biosynthesis, was significantly higher in the liver of EHBR. However, no
      significant difference in the activity of heme oxygenase, the first and rate
      limiting enzyme in heme degradation, was observed in EHBR as compared to control
      rats. DDC, a porphyrinogenic agent, caused marked and prolonged increase in the
      activity of delta-ALA synthetase in EHBR. However, the contents of microsomal
      total heme and cytochrome P-450 were significantly decreased in EHBR 24 hrs after
      DDC injection. The activity of heme oxygenase by CdCl2, a inducer of heme
      oxygenase, was considerably higher in EHBR than in control rats. These results
      indicate some specific hypersensitivity for heme metabolizing enzymes in EHBR.

PMID- 8351414
TI  - In vitro cell transformation induced by the pesticide fenarimol.
AB  - The pesticide fenarimol is capable of transforming BALB/c 3T3 cells in an in
      vitro model system, and its action resembles a carcinogenic process in vivo. In
      the absence of metabolic activation, transformed foci are already visible in the
      standard experimental procedure. The addition of the S9 fraction as an exogenous
      metabolic system leads to a decrement of cytotoxic effects and the reduction of
      the transformation rate. The transformed phenotype, however, becomes visible when
      confluent cells are replated and allowed further cell replication. Transformation
      effects by fenarimol may be due to both a weak genotoxic activity and/or stronger
      promoting activity.

PMID- 8351415
TI  - Accumulation of malondialdehyde in mouse heart following acute dosing with
      adriamycin is strain specific and unaffected by cardiac catalase status.
AB  - CDF1 and C57BL/6J male mice were acutely dosed with Adriamycin (ADR), and total
      cardiac malondialdehyde (MDA) quantitated following isolation by modification of
      previously developed procedures. Cardiac MDA content in CDF1 mice increased
      significantly 5 days following ADR dosing as reported by others, but was
      unchanged in C57BL/6J mice. ADR-induced mortality and a significant loss in
      cardiac weight 2-3 days after treatment was similar in both strains. Cardiac
      lipid hydroperoxide (LH) content was also unchanged in C57BL/6J mice dosed
      acutely with ADR. However, hepatic LH content increased rapidly following
      treatment with ADR, reaching maximal level 1 day following treatment before
      returning to below untreated levels 24 hours later. Studies with genetically
      acatalasemic C57BL/6J mice showed that neither cardiac nor hepatic lipid
      hydroperoxide content in ADR-dosed animals is affected by tissue catalase levels.
      These results demonstrate that C57BL/6J mouse heart is refractory to ADR-induced
      lipid peroxidation (LP) although overall mortality from the drug is unaffected,
      and do not support the hypothesis that ADR-induced mortality in mice is a
      consequence of cardiac LP.

PMID- 8351416
TI  - J5 prevents endotoxin shock in suckling rats.
AB  - A sublethal dose of endotoxin (lipopolysaccharide: LPS) can induce endotoxin
      tolerance. It is not well known whether LPS feeding causes endotoxemia and
      endotoxin tolerance in the newborn. Since Rc mutant Escherichia coli LPS (J5)
      does not have toxic or lethal effects, J5 is used to induce endotoxin tolerance
      in this study. This study showed that both an intraperitoneal (ip) injection and
      feeding of Rc mutant Escherichia coli LPS (J5) induced endotoxin tolerance in
      suckling rats.

PMID- 8351417
TI  - Sex-related differences of acetohexamide reductase activities in the liver and
      kidney of various mammalian species.
AB  - Sex-related differences of acetohexamide reductase activities in cytosol and
      microsomes from the liver and kidney of the rat, mouse, guinea pig, hamster and
      rabbit were examined. Among animal species tested, the rat, guinea pig and rabbit
      exhibited sex-related differences in the activities. The activities in liver
      cytosol of the rat and rabbit were higher in the females than in the males,
      whereas the activity in kidney cytosol of the rabbit was higher in the male than
      in the female. Furthermore, the activities in liver and kidney microsomes of the
      rat and that in kidney microsomes of the guinea pig were much higher in the males
      than in the females. It is interesting to note that significant sex-related
      differences of acetohexamide reductase activities are found in some animal
      species other than the rat.

PMID- 8351418
TI  - Coronary perfusion pressure, end-tidal CO2 and adrenergic agents in haemodynamic
      stable rats.
AB  - Coronary perfusion pressure (CPP) determines myocardial perfusion during low
      flow. CPP correlates with end-tidal CO2 (PetCO2) during cardiac arrest. Recent
      studies have demonstrated that after adrenaline, increased CPP was associated
      with decreased PetCO2. Intravenous infusions (4 min, N = 10) or bolus (10 s, N =
      6) of methoxamine (60 micrograms/kg), isoproterenol (10 micrograms/kg),
      adrenaline and noradrenaline (3 micrograms/kg) were compared with saline placebo
      (0.2 ml/min) during spontaneous circulation in anaesthetized Sprague-Dawley rats.
      Infusion and bolus of methoxamine, adrenaline and noradrenaline increased CPP
      between 39 and 46% above baseline. Isoproterenol decreased CPP by 67%. PetCO2
      decreased by 27% after bolus and only 10% after infusion of methoxamine but
      increased after infusion (7%) and bolus (10%) of isoproterenol and after infusion
      of adrenaline (11%) and noradrenaline (17%). Equipressor bolus of methoxamine,
      adrenaline and noradrenaline reduced PetCO2 between 10 and 27%. Bolus application
      induced more alpha-effects and drug infusion more beta-effects in the pulmonary
      vasculature. Thus, changes in pulmonary vascular resistance and associated
      increases in dead space were responsible for differences in PetCO2. Alpha-effects
      increased CPP, decreased P(et)CO2 and conversely, beta-effects decreased CPP but
      increased PetCO2 indicating caution when P(et)CO2 is used as non-invasive monitor
      of perfusion, especially after alpha-adrenergic agents.

PMID- 8351419
TI  - Influence on outcome after cardiac arrest of time elapsed between call for help
      and start of bystander basic CPR. The Belgian Cerebral Resuscitation Study Group.
AB  - The exact impact of the 'interval between cardiac arrest (CA) and the start of
      basic cardiopulmonary resuscitation (CPR) performed by bystanders' on outcome is
      not fully established. We retrospectively evaluated data with regard to response
      intervals of 1195 out-of-hospital CA interventions where bystander CPR was
      performed and continued by the eight mobile intensive care units (MICUs)
      participating in the Belgian Cerebral Resuscitation Registry between 1982 and
      1990. Partial correlations between time elapsed from CALL to CPR by lay public
      and outcome were determined when the effect of response times of 1st and 2nd tier
      were removed. The following groups were studied: ventricular fibrillation (VF),
      asystole and electromechanical dissociation (EMD), non-witnessed and witnessed.
      Good outcome was represented by initial restoration of spontaneous circulation
      (ROSC successes) and by prolonged survival (CPR successes) being 22.7 and 9.7%,
      respectively. The mean time +/- S.E.M. between CALL and CPR initiated by lay
      people for the studied population (n = 1195) was 2.5 +/- 0.1 min. The partial
      correlation coefficient between prolonged survival and time passed between CALL
      and bystander CPR was negative for all types of CA, yet significance was reached
      only in the non-witnessed group. Using ROSC as the endpoint significance is
      achieved in all groups except the VF patients, where the intervention times were
      shorter. In our population, prolonged survival was independently and negatively
      influenced by a delay between CALL and any CPR in the non-witnessed CA group (n =
      421).

PMID- 8351421
TI  - The laryngeal mask in cardiopulmonary resuscitation in a district general
      hospital: a preliminary communication.
AB  - For a period of 13 months adult patients sustaining a cardiopulmonary arrest in
      the Royal East Sussex Hospital, Hastings, were attended by nursing staff and
      Operating Department Assistants (ODAs) specially trained in the use of the
      laryngeal mask (LM) as an airway adjunct. The LM was used 41 times in 40
      patients. The LM failed on only two occasions, and was successful in three cases
      where endotracheal intubation proved impossible. No instances of aspiration were
      directly attributable to LM use. LM trained staff adopted its use
      enthusiastically, and skills acquired during training appeared not to fade over
      the period of the study. These results are considered to justify the performance
      of a large-scale trial of use of the LM in cardiac arrest patients.

PMID- 8351420
TI  - Effects of graded doses of epinephrine during asphxia-induced bradycardia in
      newborn lambs.
AB  - To study the hemodynamic effects of graded doses of epinephrine (EPI) in a
      newborn animal model of hemodynamically significant bradycardia, we performed the
      following study. Ten newborn lambs were chronically instrumented with catheters
      and flow transducers so that systemic, pulmonary arterial, left atrial and right
      atrial pressures as well as heart rate, cardiac output and left carotid artery
      flow could be monitored. During each of five asphyxia induced bradycardia
      episodes, with cardiac output depressed to approximately 30% of baseline, lambs
      were given either 0, 1, 10, 50, or 100 micrograms of EPI in a randomized
      sequence. After 30 s, the lambs were resuscitated with room air ventilation while
      hemodynamic parameters were monitored. During asphyxia and prior to EPI
      administration, all hemodynamic parameters were similar. In addition, for the
      first 30 s following EPI administration, hemodynamic parameters continued to
      deteriorate in a manner that was not influenced by the dose of EPI administered.
      During the resuscitation period with resumption of ventilation, systemic blood
      pressure and coronary perfusion pressure rose higher following 50 and 100
      micrograms/kg of EPI than after the smaller doses. Heart rate was highest
      following the 100 micrograms/kg dose. Stroke volume and cardiac output, however,
      appeared to be blunted by the 100 micrograms/kg dose of EPI with no differences
      in carotid flow noted by dose of EPI administered. It appears that doses of EPI
      greater than 10 micrograms/kg, the dose currently recommended by the American
      Heart Association, may be beneficial as an adjunct in treatment of
      hemodynamically significant bradycardia. However, doses as high as 100
      micrograms/kg may blunt cardiac output and stroke volume and should be used with
      caution.

PMID- 8351422
TI  - Tumor necrosis factor and monocytes are released during hemorrhagic shock.
AB  - Tumor necrosis factor (TNF) is a key mediator involved in many physiologic
      processes including immunity, inflammation, and metabolism. A relationship
      between TNF and hemorrhagic shock has not been clearly demonstrated. To help
      understand the role of TNF in hemorrhagic shock we developed a hemorrhagic shock
      model to measure TNF and monocyte levels during hemorrhage and resuscitation.
      Male Sprague-Dawley rats were anesthetized and subjected to a 50% blood loss (30
      ml/kg) over 2 min and left in shock for 58 min. The animals were then
      resuscitated with two times blood loss (60 ml/kg) using lactated Ringers over 1
      h. This model results in 75% mortality within 3 days (LD 75). Blood samples (2
      ml) were obtained at intervals during shock and resuscitation, and assayed for
      TNF concentrations and white blood cell counts. Despite a marked fall in total
      leukocytes (24,600 pre-hemorrhage to 11,300 post-hemorrhage, P < 0.005),
      monocytes increased in percentage and in total count. Blood levels of TNF were
      initially undetectable but rose within 10 min after hemorrhage, peaked at 30 min
      after hemorrhage, and then became undetectable during resuscitation. In this
      model, macrophages and TNF are released into the circulation after hemorrhagic
      shock. TNF may play a role as a mediator in the pathophysiology of hemorrhagic
      shock.

PMID- 8351423
TI  - Corticosteroid supplementation during cardiac arrest in rats.
AB  - HYPOTHESIS: Corticosteroids will improve the rate of resuscitation from cardiac
      arrest. DESIGN: Prospective blinded randomized placebo-controlled trial.
      INTERVENTION: An 8-min cardiac arrest was induced by KCl infusion and chest
      restriction in 36 male Sprague-Dawley rats with continuous EKG and arterial blood
      pressure monitoring. At the start of CPR the rats received one of three study
      drugs: normal saline (placebo); 0.05 mg hydrocortisone (Group A) and 0.25 mg
      hydrocortisone (Group B). Mechanical ventilation, chest compressions and ACLS
      drug administration were provided following a standardized algorithm. RESULTS:
      The resuscitation rate was significantly higher (P < 0.05) in Group B (92%)
      compared to Group A (50%) and placebo (50%). For the rats resuscitated, the
      duration of CPR (placebo = 163 s, Group A = 126 s, Group B = 120 s) and the
      amount of epinephrine used (placebo = 0.007 mg, Group A = 0.005 mg, Group B =
      0.005 mg) did not reach statistical significance (P = 0.15 and P = 0.21).
      CONCLUSION: Hydrocortisone significantly increased the rate of ROSC from cardiac
      arrest. There also appears to be a trend of decreasing duration of CPR and
      epinephrine requirements with hydrocortisone. Further studies evaluating the
      mechanism of action and long term effects of hydrocortisone in cardiac arrest
      need to be conducted.

PMID- 8351425
TI  - CPR and high dose epinephrine.

PMID- 8351424
TI  - Cardiopulmonary-cerebral resuscitation by using cardiopulmonary bypass through
      the femoral vein and artery in dogs.
AB  - Twenty-seven dogs, divided into three groups, were subjected to a normothermic
      ventricular fibrillation (VF) cardiac arrest of 15 min and resuscitated by using
      cardiopulmonary bypass through the femoral veins and artery (F-F bypass). Group I
      (n = 15): Cardiac beating did not return in any dogs during an initial 3-min
      conventional cardiopulmonary resuscitation, but it returned 5.2 +/- 3.8 min (mean
      +/- S.D.) after the successive initiation of the F-F bypass in all dogs, except
      in one with bypass trouble. Intermittent burst waves appeared on the
      electroencephalogram and continuous waves returned, 90.0 +/- 24.7 min and 130.7
      +/- 28.1 min after the start of resuscitation, respectively. Values of blood
      glucose, lactate and potassium 5-15 min after the F-F bypass were significantly
      higher than those before induction of VF, while those of blood pH, base excess,
      hemoglobin, hematocrit, platelet and serum protein decreased significantly. Group
      II (n = 7): Both local cerebral (CBF) and myocardial blood flow (MCBF) returned
      to the pre-arrest level soon after the initiation of the F-F bypass, even though
      spontaneous cardiac beating was not yet restored. Closed or open chest cardiac
      massage could not produce as much blood flow as the F-F bypass did. In the early
      stage of restoration of spontaneous circulation, temporary interruption of the
      bypass led to a decrease in both local CBF and MCBF. Group III (n = 5):
      Spontaneous circulation was restored in all five dogs 5.2 +/- 1.1 min after the
      institution of the F-F bypass, which was continued for 164 +/- 30 min under mild
      hypothermia. After intensive care for a subsequent 6-36 h, the animals barked,
      moved their forelegs and could drink water. The mean neurological deficit score
      (normal: 0, brain death: 500) was 100.6. However, macroscopic examination of the
      brain in two dogs with prominent recovery revealed atrophy of the central gyrus
      and microscopic examination revealed injuries of the vulnerable neurons of the
      brain.

PMID- 8351426
TI  - Coma scales in paediatric resuscitation.

PMID- 8351427
TI  - [Histopathologic observations of restenosis following coronary angioplasty].

PMID- 8351428
TI  - [The respiratory accessory muscles].

PMID- 8351429
TI  - [Ischemic myocardium and remodeling].

PMID- 8351430
TI  - [High altitude medicine and oxymeter].

PMID- 8351431
TI  - [Control of the ventricular rate in atrial fibrillation].

PMID- 8351432
TI  - [Clinical aspects of respiratory muscle fatigue].

PMID- 8351433
TI  - [Selection of pacing mode (3)].

PMID- 8351434
TI  - [Percutaneous cardiopulmonary support system (PCPS)].

PMID- 8351435
TI  - [Effect of pilsicainide hydrochloride on atrial fibrillation threshold].
AB  - To inventigate the electrophysiologic effects of pilsicainide hydrochloride on
      atrial fibrillation, we compared atrial fibrillation threshold (AFT), right
      atrial effective refractory period (RAERP), and inter-atrial conduction time
      (Inter-ACT) before and after the administration of pilsicainide in 12 patients
      with lone paroxysmal atrial fibrillation. The following electrophysiologic study
      was performed before and after the administration of the drug as the paced cycle
      length of 500msec. First, RAERP was measured. Secondly, Inter-ACT from the
      stimulating artifact to the initial deflection in the elecrocardiograms of the
      coronary sinus was measured. Thirdly, high-frequency (50Hz) stimulation was given
      at right atrial appendage continuously for one second just after the eighth basic
      paced beat. The stimulation current was increased by 1mA in a stepwise fashion
      from 2mA until atrial fibrillation ensued. AFT was defined as the lowest
      intensity of the current that induced atrial fibrillation or flutter of more than
      30 seconds. Pilsicanide significantly increased AFT and Inter-ACT, but did not
      change RAERP. In conclusion, it is suggested that pilsicainide might decrease
      atrial vulnerability mainly by its effect on inter-atrial conduction delay and by
      the resulting increase in AFT.

PMID- 8351436
TI  - [A new device: a fenestrated sheath for IABP, which reduces the incidence of
      ischemia in the lower limbs].
AB  - To decrease the incidence of ischemia in the lower limbs, we developed a new
      introducer sheath for IABP, which had 38 side holes (diameter; 1mm). Forty-five
      patients who received IABP counterpulsation support with this fenestrated sheath
      were compared with 108 patients in whom the ordinary nonfenestrated sheath was
      used. There was no significant statistical difference between these two study
      groups regarding age, height, weight and IABP insertion time. The frequency of
      ischemic episode of the lower limbs was 2.2% (one out of 45 patients) in the
      group with the fenestrated sheath, which was significantly lower than those with
      the ordinary sheath (18 out of 108: 16.7%) (p < 0.005). From these data, we
      deduced that this fenestrated sheath allowed more blood flow to the lower limb
      and was thus effective in preventing limb ischemia, particularly in patients with
      small caliber femoral arteries.

PMID- 8351437
TI  - [Early diagnosis and management of acute pulmonary embolism: clinical evaluation
      those of 225 cases].
AB  - To contribute for making early diagnosis and treatment of acute pulmonary
      embolism (APE), we investigated on clinical pictures of 225 patients with APE.
      Common underlying factors were heart disease, prolonged bed rest, post-surgical
      state, thrombophlebitis, malignant tumor and post-catheterization state in this
      order. Dyspnea, chest pain, tachycardia and shock were frequently seen as initial
      symptoms and signs. Blood screening showed leukocytosis, hypoxemia, hypocapnia
      and elevated serum LDH. Electrocardiographic findings highly demonstrated were
      ST.T abnormalities, such as T inversion with ST elevation in V1-3, ST depression
      in V4-6 and sinus tachycardia. Chest X-rays showed diminished pulmonary vascular
      marking and pulmonary artery dilation. Right ventricular dilatation were
      frequently seen on 2-dimensional echocardiograms. Pulmonary artery pressure were
      elevated up to 49/20 (30) mmHg. Twenty-five percent of the patients died, and the
      recurrence was seen in 4%. Thus, as soon as APE is suspected by above clinical
      findings, definitive diagnosis should be obtained by the lung perfusion scan and
      pulmonary arteriography, then oxygen and thrombolytic agents should be given
      immediately to prevent the fatal outcome.

PMID- 8351438
TI  - [Cultured myocardial cell growth and hypertrophy by basic fibroblast growth
      factor].
AB  - Basic fibroblast growth factor (bFGF) is a mitogen that is thought to play a
      important role in myocyte growth. In previous work, we found the increase of
      immunoreactivity of bFGF in cardiac myocyte of young SHR and pressure over loaded
      rat heart, and it suggested that endogenous bFGF which contained high molecular
      form of bFGF contributes to myocardial hypertrophy. To examine this hypothesis,
      rhabdomyosarcoma (A 204 cells) derived bFGF was used as wild type bFGF. Extracted
      bFGF from A 204 cells and nonserum conditioned medium of A 204 cells included
      high molecular form (22, 24 kd), as well as low molecular (18 kd) bFGF by western
      blotting, and showed hypertrophic effect in cultured myocardial cells. The
      hypertrophic effects were indicated in remarkable enlargement of cell size and
      significant increase in phenylalanine incorporation (x 2.2). The maximum
      expression of c-myc mRNA by A 204 conditioned medium was observed 30 min after
      stimulation, and it was also accompanied by an increase of accumulation of alpha
      skeletal actin mRNA by primer extension. After absorption of heparin binding
      growth factor from A 204 conditioned medium, it indicated no hypertrophic
      effects. In conclusion, it is likely that wild type bFGF including high molecular
      weight form plays a important role in cardiac myocyte growth and hypertrophy.

PMID- 8351439
TI  - [A case of sporadic and transient bradyarrhythmias in a patient with a glioma in
      the medulla oblongata].
AB  - In a 20-year-old female patient with a brain stem glioma in the medulla oblongata
      in association with paraplegia and respiratory paralysis, bradyarrhythmias such
      as sinus bradycardia and sinus arrest repeated sporadically and transiently, but
      soon subsided as radiotherapy was being delivered to the glioma in the medulla
      oblongata. The bradyarrhythmias were differentiated from sick sinus syndrome in
      their sporadic and transient character. The patient responded normally to
      atropine, isoproterenol, and phenylephrine. Parasympathetic nerve reflexes
      induced by Aschner's, Czermak's, and Valsalva's maneuvers and sympathetic nerve
      reflex induced by change of body position were within normal limits. Although EKG
      abnormalities associated with diseases of the central nervous system are
      frequently due to intracranial hypertension and/or irritation of the
      hypothalamus, the bradyarrhythmias in this patient were possibly due to vagus
      stimulation caused by the glioma in the medulla.

PMID- 8351440
TI  - [Two adult cases with corrected transposition of the great arteries treated with
      permanent endocardial pacemaker implantation].
AB  - [Case 1] A 32 year-old male had (I, D, D) type corrected transposition of the
      great arteries (cTGA) associated with ventricular septal defect and pulmonary
      stenosis. [Case 2] A 69 year-old male had (S, L, L) type cTGA associated with
      tricuspid regurgitation. Both cases showed advanced atrioventricular (AV) block
      due to HV block. Both patients had endocardial DDD pacemakers implanted, with no
      complication. (I, D, D) type cTGA is rarely accompanied with AV block, while the
      incidence of AV block is high in (S, L, L) type cTGA. We speculate that this
      results from the difference in the position of the AV node between these two
      types.

PMID- 8351441
TI  - [A case of infective endocarditis in which a new vegetation appeared on a
      different site during chemotherapy].
AB  - 42-year-old man, who had been febrile for about a month, was admitted to our
      hospital. Laboratory testing showed leukocytosis and high titer of CRP.
      Streptococcus sanguis II was detected in his blood culture. According to the
      echocardiogram, he had a vegetation on the anterior mitral leaflet, so he was
      diagnosed as having infective endocarditis. Antibiotic susceptibility test using
      the disc method showed (3+) response to penicillin G. After intravenous
      administration of 20 million units of penicillin G for 3 weeks, a new vegetation
      appeared on the posterior mitral leaflet although the one on the anterior mitral
      leaflet had disappeared. Imipenem/cilastatin was administered until the acute
      phase reactants became negative. But the vegetation did not disappear, so he had
      vegetectomy. This is the first case report of infective endocarditis in which a
      new vegetation appeared on a different site despite the disappearance of the
      first lesion during chemotherapy.

PMID- 8351442
TI  - [A case of angiosarcoma presenting as ill-defined opacities on chest
      roentgenogram and hemothorax].
AB  - A 74-year old male was referred to the Tokai University Hospital for evaluation
      of abnormal opacities on a chest roentgenogram. Laboratory tests demonstrated
      leukocytosis, elevated ESR and CRP, elevated LDH, and hypoxemia. The chest
      roentgenogram demonstrated several ill-defined nodular infiltrates on the
      bilateral upper lung fields. In addition, a CT scan revealed bilateral pleural
      effusion which was found bloody on diagnostic thoracocentesis. Administration of
      antibiotics failed to improve lung infiltration or laboratory data. The patient
      died of respiratory failure on the 23rd hospital day. At autopsy, multiple ill
      defined nodules, which were associated with alveolar hemorrhage, were scattered
      in the lungs bilaterally. Both hematoxylin-eosin and silver staining showed
      atypical cells of a vasoformative nature. Factor VIII related-antigen in the
      tumor cells was confirmed by the peroxidase-antiperoxidase method. These findings
      were consistent with angiosarcoma. The tumor foci were demonstrated in the lungs,
      pleura, kidneys, bone marrow, adrenal glands, and the gastrointestinal tract. The
      primary site of angiosarcoma, however, was not identified. Angiosarcoma, either
      primary or metastatic to the lungs, should be included in the differential
      diagnosis of multiple ill-defined nodular opacities associated with hemothorax.

PMID- 8351443
TI  - [A case of chronic hepatitis C complicated by ischemia-like changes seen on the
      electrocardiogram during interferon treatment].
AB  - A 53-year-old woman was admitted to the hospital for chest pain with headache,
      nausea and vomiting, two and a half hours after an intramuscular injection of 6 x
      10(6) units of IFN (interferon) alpha 2a, in the 11th week of IFN treatment for
      chronic hepatitis C. The electrocardiogram (ECG) showed ST depression and T
      inversion in leads II, III, aVF and V3-V6, as commonly seen in myocardial
      ischemia. However, emergency coronary angiography (CAG) did not show stenosis or
      spasms clearly, serum CPK was always within the normal limits, Tc-99m PYP
      scintigraphy and T1-201 scintigraphy did not show any abnormal uptake or defect,
      and the echocardiogram did not show any abnormality. She recovered from chest
      pain and the ischemia-like changes seen on the ECG, after IFN treatment was
      stopped, and she rested for 7 days from this treatment and other treatment using
      nitrites and a calcium-antagonist. After recovery, the ECG during exercise and
      hyperventilation showed changes similar to those seen on admission. From these
      findings, this case was considered to be precipitated by spasms of coronary
      microvessels, which were not noticeable in CAG. The cause was thought to be
      complicated by IFN treatment, because this episode appeared after IFN injection,
      and improved after stopping IFN treatment.

PMID- 8351444
TI  - Surfactant apoprotein A secretion by human tracheobronchial epithelial cells.
AB  - To determine whether surfactant apoproteins are produced locally by the airway
      walls, we used a two-site simultaneous immunoassay with monoclonal antibodies and
      measured the surfactant apoprotein-A (SP-A) content in media cultured with human
      airway explants or cultured epithelial cells. Tracheobronchial explants were
      cultured for 2 successive periods (periods I and II). Significant SP-A
      concentrations were detected in both periods. Methacholine (MCh) or isoproterenol
      (ISP), added to the medium at the beginning of period II, reduced the ratio of SP
      A concentration in period II to that in period I, compared to samples without
      treatment. The SP-A concentration in the medium at the confluent period of
      cultured epithelial cells was significantly higher than at the mid-period,
      indicating that SP-A secretion is dependent on the cell number. The supernatant
      from explants stimulated by MCh was capable of reducing SP-A secretion from
      cultured epithelial cells. Immunohistochemical study of SP-A using monoclonal
      antibody demonstrated positive immunoperoxidase staining in the cytoplasm of
      epithelial cells. Further, Western blots of electrophoresed proteins from
      epithelial cells showed the characteristic properties of SP-A. These findings
      indicate that tracheobronchial epithelium can secrete SP-A.

PMID- 8351445
TI  - Dynamics of the ventilatory response to hypoxia in humans.
AB  - Dynamic responses of the ventilatory system to rapid variations in isocapnic
      hypoxia were studied in five subjects. Sawtooth-shaped inputs were presented at
      constant amplitude with periods of 120, 90, 60, 45 and 30 sec, and square-wave
      inputs at different amplitudes with periods of 120, 60 and 30 sec. A breath-by
      breath model fitting technique was used to assess whether any of a number of
      first order models of hypoxic ventilatory dynamics could fit the data adequately.
      The following was found: 1) An equation for the desaturation of haemoglobin
      provided a better expression for hypoxia in the model than did a hyperbolic
      function of PO2. 2) The gain and/or offset model parameters varied significantly
      between experiments, but the time constant and pure delay terms did not. 3) The
      time constants, and to a lesser extent the pure delays, were found to vary
      significantly between sawtooth experiments of different frequencies. The failure
      of a single set of dynamic parameters to describe all the responses suggests that
      the model is incomplete. 4) There was significant asymmetry in the hypoxic
      response with the on-transient dynamics faster than the off-transient dynamics.
      The results of the model fitting study suggest that a first order model cannot
      fully describe the hypoxic ventilatory dynamics.

PMID- 8351446
TI  - Latency of the ventilatory chemoreflex response to hypoxia in humans.
AB  - Latencies for the ventilatory response to hypoxia have been estimated from data
      from experiments in which square waves of isocapnic hypoxia (periods 30 sec and
      60 sec) were presented to 5 subjects. Distorted steps were excluded from the
      analysis, and the remaining steps were time-aligned relative to the step and then
      averaged. For the 30 sec data, the median latency for the response to the step
      into hypoxia was 1 breath or 5.1 sec (time to mid-point of first significantly
      different breath) and for the step out of hypoxia was 1 breath or 4.7 sec. The
      number of transients analyzed averaged 87 per subject per transition type. For
      the 60 sec data, the median latency for the step into hypoxia was 2 breaths or
      6.8 sec, and for the step out of hypoxia was 2 breaths or 6.0 sec. The number of
      transients analyzed averaged 40 per subject per transition type. These latencies
      are generally shorter than those reported previously and suggest that the
      ventilatory variability may have served to lengthen the measured latency of
      response in previous studies.

PMID- 8351447
TI  - Ventilatory response to exercise after heart and lung denervation in humans.
AB  - This study, aimed at investigating some aspects of breathing control at work, was
      conducted on 8 heart and lung transplant recipients (HLTR) (age 33 +/- 13 years,
      mean +/- SD; 10 +/- 6 months post-transplantation) and on two control groups,
      i.e. 11 heart transplant recipients (HTR) and 11 healthy untrained subjects (C).
      The patients performed a series of 2 to 6 1-min exercise bouts (at 25 or 50 W,
      corresponding to about 50% of their VO2max) on a bicycle ergometer, followed by a
      5 min 25 or 50 W constant load. C exercised both at 50 W (C1) and at 50% of their
      VO2max (C2). Inspiratory (VI) and expiratory (VE) ventilation, tidal volume (VT),
      respiratory frequency (fR), end-tidal O2 and CO2 partial pressures (PETO2 and
      PETCO2 and gas exchange (VO2 and VCO) were measured breath-by-breath. "Phase I"
      ventilatory response (ph I) was determined as the mean changes of VI, VE, VT, fR,
      PETO2 and PETCO2, compared to rest, during the first two respiratory cycles
      following exercise onset. In HLTR ph I did not significantly differ from that of
      C1 and C2, whereas the response was lower in HTR. VE, VO2 and VCO2 responses
      during "phase II" (t 1/2 on-) and "phase III" (steady state exercise) were
      similar in HLTR and in HTR. t 1/2 on- were longer in HLTR and in HTR compared to
      C1. In 3 HLTR the ventilatory pattern during the 5 min constant loads was similar
      to that of HTR and C, whereas 4 HLTR presented higher VT and lower fR values. It
      is concluded that: 1) The ventilatory response to exercise, in all its phases, is
      substantially preserved despite lung denervation. When slight alterations are
      found (i.e. the slower phase II), they are presumably of peripheral origin. 2)
      The normal ph I in HLTR indicates that cardiac and/or pulmonary inputs to the
      respiratory centers are not involved in its regulation, or that their role can be
      subserved by other ventilatory control mechanisms.

PMID- 8351448
TI  - Ventilation is coupled to metabolic demands during progressive hypothermia in
      rodents.
AB  - We examined changes in ventilation and metabolic rate during hypothermia (36-27
      degrees C) induced with exposure to helium-oxygen and cold in halothane
      anesthetized ground squirrels (Spermophilus lateralis) and rats. As a consequence
      of proportionate decreases in VCO2 and breathing frequency, the VE/VCO2 in both
      species remained constant. The changes which occurred in breathing pattern were
      also similar in the two species; an increase in TI and TE along with emergence of
      apneic periods between breaths at body temperatures below 31 degrees C. VT/TI and
      TI/TTOT decreased but VT remained constant with progressive hypothermia. The
      ventilatory responses to hypercapnia and hypoxia decreased to the same extent as
      the ventilatory and metabolic requirements in the ground squirrel but not the
      rat. The changes in VE and VCO2 during hypothermia in the ground squirrel
      predicted well the values observed in deep hibernation. We conclude that
      regulation of ventilation at reduced body temperatures is tightly coupled to
      metabolic demand.

PMID- 8351449
TI  - Frequency of mechanical ventilation and respiratory activity after double lung
      transplantation.
AB  - We investigated the contribution of pulmonary afferent nerve fibers to the
      control of inspiratory activity in awake humans. Eight double lung transplant
      outpatients and eight normal subjects were hyperventilated with a mechanical
      ventilator. Respiratory frequency was increased until no respiratory activity was
      detectable. Then, by either adding CO2 in the inspired gas or decreasing
      respiratory frequency, end-tidal PCO2 (PETCO2) was increased until inspiratory
      activity (i.e. change in inspiratory airway pressure peak and/or time profile)
      was detected. In normal subjects, PETCO2 threshold for inspiratory muscle
      recruitment was significantly lower when frequency was decreased than when CO2
      was added (31.3 +/- 6.8 Torr vs. 38.2 +/- 8.1 Torr respectively, P < 0.005). This
      was not the case in the double lung transplant group (31.5 +/- 6.5 Torr vs. 32.9
      +/- 5.8 Torr). These findings suggest that pulmonary afferent nerves have an
      inhibitory effect on inspiratory activity in humans.

PMID- 8351450
TI  - Limitations to VO2max in humans after blood retransfusion.
AB  - Seven young, healthy male subjects performed maximal exercise on a cycloergometer
      with central venous and arterial catheters, before and after autologous
      retransfusion of red blood cells. Maximal oxygen consumption (VO2max), blood gas
      composition and haemodynamic variables were measured, in order to test the
      hypothesis of monofactorial vs. polyfactorial VO2max limitation. Autologous blood
      retransfusion led to significant increases in haemoglobin concentration and
      consequently arterial oxygen concentration during maximal exercise, while maximal
      cardiac output, heart rate and stroke volume were not significantly changed. The
      relationship between maximal oxygen delivery (cardiac output.arterial oxygen
      concentration; (Q.CaO2)max and maximal oxygen consumption in this study was
      VO2max (L.min-1) = 0.02 + 0.64.(Q.CaO2)max (L.min-1), the slope being
      significantly less than unity. These results suggest that (Q.CaO2)max plays but a
      fractional role in limiting VO2max, in agreement with recent models concerning
      the resistance to oxygen flow in the respiratory system (di Prampero and
      Ferretti, Respir. Physiol. 80: 113-128, 1990). The relative increase in VO2max
      after blood retransfusion matched the relative increase in 'aerobic performance',
      measured as the maximal power output that could be maintained aerobically for 30
      min. Furthermore, the increase in maximal power output (15 +/- 3 watts) could
      account for almost all of the extra oxygen consumption. This match suggests that
      there is an inability to fully utilize muscle oxidative capacity in the
      normocythaemic state.

PMID- 8351451
TI  - Thyroid function in critical illness and burn injury.

PMID- 8351454
TI  - Nutrition in burn patients.

PMID- 8351453
TI  - Metabolic response to burn injury: nutritional implications.

PMID- 8351452
TI  - Pulmonary function in the burn patient.

PMID- 8351455
TI  - White blood cell response to burn injury.
AB  - Multiple sites of decreased immune response have been discovered, but the
      instigation of this diffuse immunosuppression remains a matter of much debate.
      Several investigators have observed immunosuppressive affects of low-molecular
      weight peptides found in the serum of burn and trauma patients. These substances
      have been termed suppressive active peptides (SAP). Current research is also
      focusing on the intricate connection between stress hormones and
      neurotransmitters, in which there exist a complex information channel between the
      immune, endocrine, and central nervous systems. It is becoming clear that immune
      homeostasis may require regulatory influence via immunocompetent cells, along
      with influences from the central nervous system and a balanced endocrine
      environment. In fact, macrophages, lymphocytes, and neutrophils contain receptors
      for many hormones including corticosteroids, insulin, growth hormone,
      catecholamines, acetylcholine, and endorphins. The dramatic alteration in the
      hormonal milieu after injury may play a significant role in immunocompetence.
      Attempts to modulate specific defects in the immune system have been unsuccessful
      to date. Our goal, to decrease the risk of infection in burn patients, therefore,
      is meticulous supportive care. This includes not only reducing the risk of
      invading bacteria, but also increasing the patient's resistance to overall
      infection. The cornerstone of this support is to restore mechanical barrier
      function to as near normal as possible. Immediately after injury, vigorous wound
      management includes several daily debridements combined with wound protection
      using an appropriate topical antimicrobial substance.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8351456
TI  - Bacterial translocation in burn injury.

PMID- 8351457
TI  - [Ovarian cysts. Diagnostic and therapeutic aspects].
AB  - The methods used to carry out exeresis of ovarian cysts by celioscopy are now
      familiar. Today, the main concern is the selection of annexial tumors appropriate
      for celiosurgical treatment in order to limit their use to benign organic cysts
      only. By comparing the results of a sery of 200 cysts which were treated
      surgically with cases in the literature, the authors conclude that the three
      pronged use of clinical, ultrasound and macroscopic data in the diagnosis of
      malignant tumors is reliable. Progress remains to be made however in identifying
      functional cysts which are sometimes mistaken for an organic structure and all
      too often are still dealt with surgically. In order to reduce the incidence of
      such errors, new perspectives are envisaged, knowing that diagnostic error is
      often related to change in their ultrasound structure or their persistence
      despite conventional estro-progestogen treatment.

PMID- 8351459
TI  - [Retroplacental hematoma and uterine Doppler scan].
AB  - The authors studied uterine Doppler findings in four cases of retroplacental
      hematoma at 26, 30.5, 31 and 37 weeks of amenorrhea. In all cases, the diastolic
      index was low, and a diastolic notch was present. In three cases, the hematoma
      was visualised under ultrasound. The literature on the subject confirms that the
      velocity of the uterine circulation is always abnormal in retroplacental
      hematoma. This test is therefore fundamental for the detection of clinically
      incomplete retroplacental hematomas and for determining the pregnancy prognosis
      in women with a history of vascular problems. Two of our patients received
      treatment with acetylsalicylic acid at an early stage of a subsequent pregnancy.
      The uterine Doppler scans carried out during this pregnancy at the same date as
      during the pregnancy with retroplacental hematoma revealed normal bloodflow
      velocity. The infants were born at term with normal weight. Uterine Doppler
      ultrasound is, therefore, an essential prognosis factor for these high-risk
      patients. In addition, routine performance of a uterine Doppler scan at about 22
      weeks of amenorrhea in women in their first pregnancy could be useful, as any
      abnormal finding might be the indication for preventive treatment with
      acetylsalicylic acid.

PMID- 8351458
TI  - [Plea for quality cytological specimens in the screening of cervical cancer].
AB  - In the context of a typical false negative cervical cancer test, the authors
      discuss the value of such screening tests and the various causes of a lack of
      success. A poor sample is the main cause of false negatives, and therefore
      involves everyone taking part in the procedures for this screening test.

PMID- 8351460
TI  - [Diurnal variation of active movements: an indication of fetal hypotrophy?].
AB  - In a prospective study of 36 pregnancies, the authors made use of the mother's
      counting of active movements in order to evaluate the correlation between daytime
      fluctuations in active movements and fetal hypotrophy. With a threshold peak mean
      evening motor activity no more than 20 p. cent greater than in the morning
      throughout the period counted, daytime variations were found to have optimal
      diagnostic capacity for hypotrophy. During the last week preceding delivery, a
      threshold mean peak evening active movements no more than 35 p. cent greater than
      in the morning yielded optimum diagnosis of fetal hypotrophy. Furthermore, there
      was a correlation between daytime fluctuations in active movements and the
      findings of fetal ultrasound biometry and utero-umbilical flow velocimetry.

PMID- 8351461
TI  - [Placenta percreta over a cesarean scar with bladder invasion. General review and
      2 case reports].
AB  - The authors report two new cases of placenta percreta on a caesarian scar with
      invasion of the bladder. On the basis of a review of the literature, they
      demonstrate its seriousness, which is always increased by the unexpected nature
      of the complications. They therefore recall the clinical and paraclinical factors
      which can provide grounds for suspecting this possibility, so that the hemostasis
      hysterectomy required can be carried out on the best possible conditions.

PMID- 8351462
TI  - [Bladder pheochromocytoma and pregnancy. A case report].
AB  - The authors report the case of a 31-year old patient who successfully completed a
      pregnancy despite unsuspected bladder pheochromocytoma. After delivery, the
      patient required care post-partum due to serious hemodynamic problems.
      Hypertension had been attributed to toxemia of pregnancy. The authors recall the
      diagnostic difficulties of tumors of this type, and the means which can be used
      for topographical diagnosis and the precautions to be taken before this tumor can
      be treated surgically.

PMID- 8351463
TI  - [Doctor Pascal Rougon. An imaginary predecessor].
AB  - Through the Rougon-Macquart series and the cases described in the last volume (Le
      Docteur Pascal, 1893), clinical analysis of the 58 characters identifies only
      seven neurotics and six alcoholics (only three of whom were Rougon-Macquart by
      birth). All the other illness described are unrelated to hysteria in the family.
      It remains true, however, that Zola's interpretation of hereditary degeneracy
      follows that of contemporary medical teaching, as witnessed by the genealogics
      published by Charcot in 1893. Through the voice of Dr. Pascal, however, Zola does
      challenge the concepts of heredity advanced by his medical advisors: he envisages
      the concepts of dominance and recessiveness without devising any general scheme
      for the transmission of hereditary characteristics, but eight years before Vries
      he advanced the idea of mutations, which he interprets as accidents occurring at
      the beginning of the ovum's development. When faced by the lack of success of his
      opotherapy of degenerative diseases, Pascal initiates trials versus a placebo and
      puts forward a highly coherent theory of what we would now call the placebo
      effect. It appears, therefore, that contrary to the opinion of most commentators,
      Emile Zola was in fact capable of a remarkable subtleness when he ventured into
      medicine. Through Dr Pascal Rougon, and notwithstanding the mockery of Flaubert,
      Goncourt and France (and of many others), he was a brilliant trail-blazer in the
      fields of genetics and therapeutics. Six years later he was to strike again with
      Dr Boutan, who invented what we now know as the prophylactic care of mothers and
      children (Fecondite, 1898).

PMID- 8351464
TI  - Crystalluria and its possible significance. A patient-control study.
AB  - The significance of crystalluria in the diagnosis and prognosis of urolithiasis
      remains a controversial subject in the current urological literature. In this
      study, in addition to the standard urolithiasis clinical and biochemical work-up,
      routine urine microscopy was performed to study crystals in 1 fresh and 2 stored
      morning urine samples from 140 urinary stone patients and 42 controls.
      Crystalluria was more frequently detected in patients (9.3% of the fresh samples)
      than in controls (2%). Storing the samples for 6 hours did not increase the
      frequency percent of detected crystalluria either in patients or controls.
      However, in the samples stored for 24 hours, the frequency of crystalluria
      increased to 27.1% in patients and only to 12% in controls, though the pH did not
      change from that of the fresh sample. In addition, while calcium oxalate crystals
      in patients formed aggregates whether in fresh or 24 hour samples, those of
      controls did not. This denotes a characteristic change in the physico-chemical
      properties of the urine of stone formers from that of controls. Accordingly, the
      study of crystalluria in patients with urolithiasis seems to help in the proper
      evaluation and, maybe, treatment of the disease.

PMID- 8351466
TI  - Ionic associations within 460 non-infection urinary stones. A quantitative
      chemical analytical study applying a new classification.
AB  - In addition to standard quantitative wet chemical and inductively coupled plasma
      atomic-emission spectrometric stone analytic techniques, elemental analysis for
      the determination of nitrogen, carbon and hydrogen was utilized in this study of
      460 category I (non-infection) urinary stone samples from western Saudi Arabia.
      They were classified according to the percentage composition of detected ions,
      including trace or minimum amounts. The incidence of uric acid stones (24%) is
      higher than that reported from western countries but similar to those reported
      from eastern Europe and other parts of the middle east and most are in the group
      with the highest uric acid content (UrI4). Oxalate stones are the most common
      type (61%) and phosphate stones (15%) the least common. The results confirm the
      reliability of elemental microanalysis and support its use for the quick
      identification of stones especially those that weigh < 1 mg and are too small for
      wet chemical analysis. Within the various stone types, however, the ionic
      associations shown by wet chemical analysis denoted the presence of mutual
      indirect associations between the characterising ion oxalate and both uric acid
      and phosphate ions, but no association between the characterizing ion uric acid
      and phosphate ions. Factors that affect these ionic correlations may influence
      the processes of stone initiation and type of stone formed.

PMID- 8351465
TI  - Stone recurrences in kidneys made stone-free by percutaneous extraction.
AB  - Of 100 renal units which were made stone-free by percutaneous stone extraction in
      1985, 86 (86.0%) were re-examined radiologically up to 5 years after operation.
      The re-examination was performed because of symptoms or as part of a regular
      check-up or after calling the patient. Intrarenal calcifications were diagnosed
      in 27 of 86 (31.4%) of the renal units, but only in 11 (12.8%) were there stones
      requiring treatment.

PMID- 8351467
TI  - Influence of Escherichia coli on urease-induced crystallisation in human urine.
AB  - Urease was added to urines inoculated with Escherichia coli 24 hours earlier and
      to control urines not inoculated with E. coli. The inoculation did not change the
      concentration of the measured urine components. The urease-induced ammonium ion
      production and pH increase was reduced in E. coli-inoculated urines compared to
      control urines. This suggests that E. coli can inhibit urease. The precipitation
      of both phosphate and magnesium on glass rods inserted in the urine was reduced
      with 40-50% in the E. coli-inoculated urines. The results demonstrate that E.
      coli can influence urease-induced crystallisation.

PMID- 8351468
TI  - The distribution of estrogen receptors in the urinary tract of the male rabbit.
      An immunohistochemical and biochemical study.
AB  - The distribution of estrogen receptors (ER) in the urinary system in the male
      rabbit were investigated in 18 mature and healthy rabbits by immunohistochemical
      examination of tissue samples taken from renal pelvis, mid-ureter, bladder-top,
      posterior urethra and the prostate. ER were detected in 17 out of 18 cases in the
      urothelial lining and the subepithelial stromal cells of the posterior urethra;
      and in 15 out of 18 cases in prostatic stromal cells. ER was not found in bladder
      top, mid-ureter or renal pelvis. Receptor determination in the isolated cytosolic
      and nuclear fraction, showed that the mean prostatic receptor density were 151.5
      f mol/mg protein in the nuclear and 51.4 in the cytosolic fraction. The
      corresponding mean values obtained from the posterior urethra were 128.2 and 88.9
      f mol/mg protein. We conclude, that ER can be demonstrated in the urinary system
      of the male rabbit, and these are restricted to the posterior urethra and the
      prostatic stromal tissue.

PMID- 8351469
TI  - Effects of unilateral pelvic ganglionectomy on urinary bladder function in the
      male rat.
AB  - Micturition interval and micturition volume were measured in water loaded male
      rats before and up to 6 weeks after unilateral pelvic ganglionectomy. There was
      no effect on micturition interval until 7 days after the ganglionectomy.
      Micturition interval then remained increased. Maximal micturition volume was
      higher than in the control group from 4 to 14 days after surgery. Cystometrograms
      were recorded 12 days or 6 weeks after surgery. At 12 days the micturition
      pressure was lower in the unilaterally ganglionectomized than in the controls.
      After 6 weeks there was no significant difference in micturition pressure. A
      reduction of micturition pressure by about 50% was observed after i.v. injection
      of atropine, but no residual urine developed. Electron microscope investigation
      showed a considerable decrease in number of nerve terminals on the
      ganglionectomized side 3 days after surgery. Most of them were devoid of synaptic
      vesicles. On the contralateral side the majority of nerve terminals appeared
      normal, but many had a decreased number of vesicles. After 14 days the number of
      terminals was still lower than normal on the ganglionectomized side. They
      generally contained only a small number of vesicles. Also, on the contralateral
      side some nerve endings with the reduced complement of vesicles were found. We
      suggest that the effects of unilateral ganglionectomy on micturition volume and
      interval can be explained by a decreased sensory input from the bladder and that
      the effect on micturition pressure is due to a transient decrease in number and
      function of motor nerve terminals in the detrusor muscle.

PMID- 8351470
TI  - Verrucous carcinoma of the bilharzial bladder. Impact of invasiveness on
      survival.
AB  - Verrucous carcinoma of bilharzial bladder, a rare neoplasm, is regarded as a
      distinct variant of squamous cell carcinoma. We studied 37 cases treated with
      cystectomy in the past 15 years. Despite previous reports of no local invasion
      and no local recurrence or distant metastasis postoperatively, we observed 60% of
      focal tumour transformation into invasive squamous cell carcinoma. Such
      transformation and dedifferentiation to squamous cell carcinoma can be expected
      in a high proportion of these tumours. The survival rate in the invasive cases
      was approximately the same as in squamous cell carcinoma. Non-surgical management
      or adjuvant treatment to surgery are inappropriate in verrucous bladder
      carcinoma. Radical cystectomy is the only standard treatment offering cure.

PMID- 8351471
TI  - Staging of bladder carcinoma by computer tomography-guided transmural core
      biopsy.
AB  - In an attempt to improve staging of bladder cancer, computed tomography-guided
      transmural core biopsy was performed in 17 patients. In the first four patients a
      0.9 mm cutting needle was used. This small needle yielded easily fragmented cores
      and consequently the remaining biopsies were taken with a 1.2 mm needle with an
      improved result. In all but one case sufficient histological material to allow a
      diagnosis was obtained by the core biopsy technique. Transmural tumor
      infiltration, as verified in corresponding cystectomy specimens, could be
      identified more often with the core biopsy than in biopsies obtained by
      transurethral resection. False negative diagnosis occurred when the tumor was not
      clearly visible on the computed tomography scan. No short-term side effects of
      clinical importance were found with the procedure.

PMID- 8351472
TI  - A study of prognosis and clinicopathology of bladder cancer to blood group type
      of host patients in Japan.
AB  - A total of 538 patients with transitional cell carcinoma of the bladder with a
      mean follow up period of 5.8 years (range 1-25) were retrospectively analysed to
      see if there were any associations between blood group and grade, stage, or
      prognosis of the tumour. In contrast to previous findings among European and
      Americans, there were no significant differences among blood groups for stage,
      histological grade, or survival rate.

PMID- 8351473
TI  - Prognostic factors in nodular transitional cell bladder tumours.
AB  - A cohort of 106 nodular transitional cell bladder cancers (TCC) were followed up
      for a mean of 9 years. Clinical stage, WHO grade, six morphometric nuclear
      factors and volume corrected mitotic index (M/V index) were correlated to
      progression and survival during the follow-up period. Nuclear factors were
      related to WHO grade with a borderline significance (p = 0.01-0.3) whereas the
      M/V index showed a highly significant relation to WHO grade. Neither nuclear
      factors nor the M/V index were related significantly to T-, N- or M-categories at
      the time of diagnosis. Progression in N- and M-categories was related
      independently to WHO grade whereas progression in T-category could not be
      predicted significantly by none of the variables included in this analysis.
      Survival was predicted by T-category (p = 0.0028), N-category (p = 0.0001), M
      category (p = 0.0057) and M/V index (p = 0.010). In T1-T2N0M0 tumours survival
      was predicted by the Dmax (p = 0.015) and by the M/V index (p = 0.039). In
      multivariate survival analysis T-category (p < 0.001) had independent prognostic
      value. In T1-T2N0M0 tumours only the M/V index predicted survival independently
      (p = 0.007). The results show that only the proliferation rate in addition to T
      category have prognostic significance in nodular TCC.

PMID- 8351474
TI  - Extraperitoneal pelvioscopy in staging of bladder carcinoma and detection of
      pelvic lymph node metastasis.
AB  - This study was carried out to examine the efficacy of extraperitoneal pelvioscopy
      in detecting pelvic metastasis in patients scheduled to undergo radical
      cystectomy without preoperative chemo- or radiotherapy. The results of
      pelvioscopy were compared with those obtained by laparotomy. 54 consecutive
      patients underwent pelvioscopy without complications. Three were technically
      insufficient. Lymphatic tissue was biopsied in 29 (54%). Pelvioscopy demonstrated
      tumor dissemination in 5 patients (9.3%): 2 had pT4b tumor, 2 pelvic nodal
      metastases and 1 both. The remaining 49 patients with benign pelvioscopy were
      scheduled for laparotomy but 7 patients did not undergo the procedure: 3 had
      extrapelvic metastasis, 1 bronchial carcinoma, 1 aortic aneurysm, 1 refused
      surgery and 1 had pulmonary insufficiency. Accordingly, 42 patients underwent
      open exploration which demonstrated pelvic metastasis in 11: 9 had nodal
      metastasis, 1 a pT4b tumor and 1 both. Consequently the sensitivity of
      pelvioscopy in detecting pelvic metastasis was calculated at only 31%. This
      result indicates that extraperitoneal pelvioscopy should be considered a
      screening procedure rather than an accurate staging procedure for pelvic
      metastasis.

PMID- 8351475
TI  - Laparoscopic lymphadenectomy. Preliminary experience.
AB  - Pelvic lymphadenectomy is a well established method for staging carcinoma of the
      bladder and prostate. Usually it is done by open surgery, but we now report
      preliminary experience with the laparoscopic approach. The technique is described
      in detail, and the results seem to indicate that the procedure is safe, has few
      complications and gives less pain than open surgery, with rapid recovery and
      early postoperative discharge from hospital.

PMID- 8351476
TI  - Radical retropubic prostatectomy for localised prostatic carcinoma: a clinical
      and pathological study of 201 cases.
AB  - To examine the role of radical retropubic prostatectomy in clinically localised
      prostatic cancer we reviewed a series of 201 patients all of whom had undergone
      bilateral pelvic lymphadenectomy. Frozen section showed metastatic pelvic lymph
      nodes in 13 cases and 6 cases were too locally advanced for operation;
      prostatectomy was done for the remaining 182. The pathological staging was based
      on examination of sections of the whole organ. In 109 (60%) the carcinoma was
      confined to the prostate gland or to the specimen, in 46 (25%) there was
      carcinomatous growth in the surgical margin, and in 27 (15%) there was invasion
      of the seminal vesicles. The Gleason score was significantly higher in cases with
      involvement of the surgical margin or seminal vesicles. There was one operative
      death (of pulmonary embolism), and the postoperative cardiovascular morbidity was
      7%. The incidence of wound infection was 6%, and there were two rectal injuries
      and three symptomatic lymphoceles. A total of 135/170 evaluable patients (79%)
      were completely continent postoperatively, and only two developed severe
      incontinence. Erectile potency was preserved in 24 of 126 (19%). We conclude that
      radical retropubic prostatectomy is safe and that the complication rate is
      acceptable. The completeness of the tumour excision seems to be associated with
      the pathological grade of the tumour.

PMID- 8351477
TI  - Age as a prognostic variable in patients undergoing transurethral prostatectomy.
AB  - In a retrospective study the outcome of transurethral prostatectomy (TURP) for
      benign prostatic hyperplasia (BPH) in patients more than 80 years old was
      compared to a control group of patients with a mean age ten years younger. The
      elderly had significantly more tissue resected and presented with a higher rate
      of preoperative urinary tract infection. More urological complications were seen
      among the elderly but these were generally short lived and had no influence on
      the morbidity, mortality and symptomatic outcome. The perioperative mortality was
      3.2% among elderly and 0% in the younger age group. A cardiorespiratory risk
      score could not predict patients at risk. In conclusion the age per se had no
      major influence on the outcome of TURP.

PMID- 8351478
TI  - Urethral stricture repair: results in 179 patients.
AB  - From 1977 till April 1990 169 operative reconstructions of urethral strictures
      were carried out in this clinic. 49 patients with a short stricture (less than 2
      cm) underwent excision and end to end anastomosis. In 18 patients with a long
      stricture (2-6 cm) one stage urethroplasty with a transverse distal penile or
      preputial island of skin flap was used. 102 patients with extensive or otherwise
      problematic strictures were subjected to two-stage mesh skin graft urethroplasty.
      In 10 patients with a short stricture we have recently implanted a new urethral
      stent in the strictured area after visual urethrotomy. During a long-time follow
      up a good anatomical and functional result was achieved in all but 2 patients who
      underwent an excision and end to end anastomosis. In the island flap
      urethroplasty group a restricture occurred in one patient, and mesh graft
      urethroplasty was successful in all but 3 patients. In the urethral stent
      patients the primary results are excellent.

PMID- 8351479
TI  - The "Wallstent": a new stent for the treatment of urethral strictures.
AB  - Ten patients have been reviewed in whom urethral stents were implanted for
      treatment of urethral stricture. Their urethral strictures had been treated with
      a median of 4.2 endoscopic urethrotomies under direct vision without success. The
      patients were first treated with optical urethrotomy, and dilatation to 30 F-
      after which the stents were inserted under direct endoscopic control. A total of
      12 stents were inserted. All patients had a 30 mm stent inserted first, and two
      patients had an additional 20 mm stent inserted because of recurrent stricture at
      the distal or proximal end of the first stent. One patient had a urethrotomy 12
      months after insertion of the stent because of a short recurrent stricture at its
      distal end. The median length of follow up was 24 months. The median preoperative
      maximum flow rate was 6.5 ml/s, and the median postoperative maximum flow rate
      was 20.3 ml/s. Half the patients had postmicturition dribbling postoperatively.
      The stents were covered with epithelium after 6-18 months, most between 12 and 18
      months.

PMID- 8351480
TI  - Balloon dilatation of ureteral strictures.
AB  - Balloon catheter dilatation is now an accepted method for treating strictures of
      the upper urinary tract. A successful result was obtained in 34 (85%) of 40
      patients with symptomatic stricture. The number of dilatations required for
      improved runoff from the kidney was one in 26 cases, two in six cases and three
      in one case. One patient had a permanent stent and six required a conventional
      operation. There were seven recurrences of stricture, all within 4 months after
      the dilatation. One of these patients required nephrectomy because of
      nonfunctioning kidney.

PMID- 8351481
TI  - Adenocarcinoma of the renal pelvis in an elderly woman.
AB  - Adenocarcinoma of the renal pelvis is so rare that many reviews of renal tumours
      fail to include any instance of this lesion. We present a 75-year-old female
      patient with no previous history of urological disease in whom a renal pelvic
      tumour was diagnosed. Histological examination after radical nephroureterectomy
      proved the tumour to be a rare adenocarcinoma. The course of the disease, the
      possible predisposing factors, the treatment of the tumour and the prognosis are
      discussed.

PMID- 8351482
TI  - Restoration of function of a renal allograft by percutaneous transluminal
      angioplasty of an intrarenal vessel.

PMID- 8351483
TI  - Medial fibroplasia: involvement of renal artery and small renal arteries in renal
      vascular hypertension.
AB  - Dysplasia of the renal artery may cause renal vascular hypertension. The most
      common type of dysplasia is the medial fibroplasia. Medial fibroplasia, as well
      as the other types of dysplasia, has only been described in the main and primary
      branches of the renal artery. A case of medial fibroplasia, where arterial
      changes were seen far out in the small renal vessels is reported.

PMID- 8351484
TI  - Hyponatremia, hyperkalemia and hypercalcemia after ileal conduit diversion.
AB  - In all types of urinary diversion interchange of electrolytes between blood and
      the urine in the lumen of the conduit may occur, resulting in electrolyte
      abnormalities. We describe a 67-year-old woman who developed hyponatremia,
      hyperkalemia and hypercalcemia following ureteroileocutaneostomy. The
      hyperkalemia and hypercalcemia were successfully treated with sodium polystyrene
      sulfonate.

PMID- 8351485
TI  - Eosinophilic cystitis simulating invasive bladder carcinoma.
AB  - A case of eosinophilic cystitis simulating an invasive bladder carcinoma is
      reported. The disease had a subacute course and was associated with arthritis of
      the symphysis pubis and both sacroiliacal joints.

PMID- 8351486
TI  - Bladder stone: a complication of intravesical migration of Lippes loop.
AB  - We report on a woman in whom an intrauterine contraceptive device (Lippes loop)
      migrated from the uterus to the bladder with formation of a calculus. Eight years
      elapsed between intrauterine insertion of the device and its retrieval with the
      calculus from the bladder.

PMID- 8351487
TI  - Prostatic abscess. A review of literature and a presentation of 5 cases.
AB  - Abscess of the prostate has become increasingly rare due to modern antibiotics
      and a decreasing incidence of gonococcal infections. It is still difficult to
      diagnose the disorder on clinical grounds. Ultrasound examination is recommended.
      The preferred treatment is nowadays transurethral prostatic resection. We report
      5 cases from a urologic department, during a period of 12 years.

PMID- 8351488
TI  - Y-autosome translocation associated with azoospermia.
AB  - Y-autosome translocation is a rare condition. We report here a case of balanced Y
      autosome translocation associated with azoospermia. Nineteen cases of a balanced
      Y-autosome translocation associated with azoospermia are reviewed, and hormone
      condition and testicular histology are discussed.

PMID- 8351489
TI  - Stimulation of early bone formation by the combination of an osteopromotive
      membrane technique and hyperbaric oxygen.
AB  - Large bone defects often heal incompletely as a result of ingrowth of connective
      tissue. By using a mechanical hindrance, a porous expanded
      polytetrafluoroethylene (e-PTFE) membrane, it is possible to prevent fibroblasts
      and other soft connective tissue cells from entering the defect, thereby allowing
      osteogenesis to occur unhindered. As evidenced in several investigations, this
      osteopromotive membrane technique causes a strongly improved bone regeneration of
      well defined osseous lesions. Hyperbaric oxygen treatment has also been shown to
      accelerate bone healing. In this study the value of combining the two techniques
      was investigated. Through-and-through bone defects, 5 mm in diameter, were
      produced unilaterally in the angular region of the mandibles of adult rats (n =
      60); the defects in half the number of animals were covered lingually and
      buccally with membranes. The animals were then divided into four groups:
      treatment with membrane alone, treatment with hyperbaric oxygen alone, combined
      treatment, and no treatment. Histological examination of the defects after 14
      days showed that the combination of techniques had resulted in significant
      improvement in bone healing, compared with hyperbaric oxygen or the membrane
      technique alone. Synergistic effects can thus be achieved by the use of membranes
      and stimulatory factors for bone regeneration.

PMID- 8351491
TI  - Comparison of quality of speech after Veau-Wardill-Kilner pushback operation and
      the Cronin modification in the primary treatment of cleft palate.
AB  - The quality of speech was compared in 124 young adults with isolated cleft
      palate. Forty-seven subjects were excluded because of the presence of factors
      that might have biased the evaluation of the success rate of the two operations
      studied, leaving 77 subjects who had undergone primary palatoplasty for analysis.
      One stage closure of the soft and hard palate was done for 43 patients by the
      mucoperiosteal palatal V to Y pushback technique (Veau-Wardill-Kilner, group V),
      and 34 underwent the Cronin modification (group C). Their speech was tape
      recorded, analysed by three qualified listeners, and hypernasality assessed by
      four published hypernasality indexes. More subjects in group C achieved normal
      resonance than in group V, who had higher hypernasality index scores than group
      C. The groups managed pressure consonants similarly. Only a few patients had weak
      plosives, audible nasal air emission, or compensatory articulation. Similar
      numbers of secondary operations were done for both groups. However, group V would
      have actually required secondary surgery more frequently than group C.

PMID- 8351490
TI  - The use of preformed HTR polymer implants for chin augmentation. A preliminary
      report.
AB  - Ten patients with microgenia had their chins augmented with HTR polymer implants.
      The implants were inserted intraorally and fixed rigidly with a titanium screw.
      The postoperative course was uneventful except in one patient who had wound
      dehiscence and was resutured. This patient and all the others were clinically and
      radiographically stable at one year follow up.

PMID- 8351492
TI  - Facial growth after pharyngeal flap surgery in cleft palate patients: a five-year
      longitudinal study.
AB  - To assess the influence of a pharyngeal flap on facial morphology in patients
      with cleft lip and palate, we studied prospectively 20 consecutive patients with
      cleft lip and palate aged 4 to 9 years who needed a pharyngeal flap. We also
      studied a control group of 20 subjects matched with regard to age, sex,
      diagnosis, and method of primary treatment. Facial growth was followed for five
      years, beginning one year before operation. Before operation there was no
      significant difference between the operated group and the reference group as far
      as skeletal facial dimensions and angular measurements were concerned. The
      longitudinal comparison within each group showed that there was a change in
      mandibular growth direction backwards and downwards in the operated group. The
      changes in facial growth after pharyngeal flap operation were similar to those
      reported in patients with enlarged adenoids. Four years after operation, the
      change in the direction of mandibular growth did not result in any specific
      facial form that could be identified clinically.

PMID- 8351493
TI  - Latissimus dorsi breast reconstruction. Long term results and return of
      sensibility.
AB  - The long-term results of 44 patients who underwent breast reconstruction after
      mastectomy with latissimus dorsi musculocutaneous flaps with endoprostheses were
      studied. Good symmetry without a brassiere was achieved in 15 patients, slight
      asymmetry in 24 and poor symmetry in five (11%). Symmetry when a brassiere was
      worn was acceptable in all but one of the patients (43/44). A third of the
      patients (n = 13) had developed unacceptable (grade III or IV) capsular
      contraction, but 39 (89%) of the patients studied were satisfied with the long
      term reconstruction. Cutaneous sensibility, measured by von Frey's test, had
      returned to 28 (64%) of the cutaneous skin islands, to their medial parts in
      particular. The flaps in patients who had received concentrated radiation or who
      had large prostheses remained numb. Sensation was normal in the scars of the
      donor areas in all but three patients. Latissimus dorsi breast reconstruction
      with an endoprosthesis is safe and simple. It gives a subjectively satisfactory
      result in nine out of 10 patients and is therefore a valuable method of
      reconstruction after mastectomy.

PMID- 8351494
TI  - Reconstruction of ischial pressure ulcers by skin expansion.
AB  - Ten patients, eight of whom were paraplegic, have had ischial pressure ulcers
      treated by skin expansion. Skin expanders 680 ml in size were inserted
      subcutaneously on the posterior aspect of the thigh. They were filled during a
      short period without complications, the filling being monitored with a cutaneous
      tonometer. At a second operation the ulcers were repaired easily with the
      expanded flaps. After a few weeks the patients were able to undergo a programme
      of rehabilitation that included sitting with the expanded flaps. No ulcers
      recurred during a median follow-up of 12 months (range 8-34).

PMID- 8351496
TI  - Dermatome shaving of psoriasis. Seven years experience in 112 patients.
AB  - Data from the records of 112 patients who were treated by dermatome shaving for
      psoriasis vulgaris were analysed. A psoriatic "area" was defined as all psoriatic
      skin lesions present in a specific region at the first treatment, and 108
      patients with 202 areas were included in the study. In 68 patients the treatment
      was limited to a single area, and 40 patients had from two to nine areas treated,
      mainly on the legs and arms. Complications occurred in nine patients; one had a
      wound infection that required treatment with an antibiotic, in five patients
      healing was prolonged, and three patients developed unsightly scars. Thirty-seven
      patients and 104 areas have not recurred during mean follow-up periods of 1.4
      years and 1.9 years, respectively. In all 108 patients the median recurrence free
      period was eight months (range: 0-5.6 years). The median recurrence free period
      for the 202 areas was 13 months (range: 0-8.2 years). Reshaving of partial
      recurrences in 46 patients led to 40% that did not recur. The best prognostic
      factor available is to do a test shave before initiating more extensive
      treatment.

PMID- 8351495
TI  - Skin expansion. Long term follow up of complications and costs of care.
AB  - To find out our rate of complications after tissue expansion, and the cost of
      treatment in terms of use of hospital resources and length of sick leave, we
      analysed our experience of 181 expansion treatments in 97 patients undertaken
      between 1986 and 1991. There were 60 women and 37 men, with a mean age of 22
      (range 1-74). Twenty patients had more than one period of treatment (range 2-8).
      The most common conditions treated were naevi (n = 75); scars (trauma--n = 33,
      burns--n = 17, and operations--n = 16); and breasts that required reconstruction
      (n = 15). Of the 181 expansions there were 29 failures (16%), and 117 complete
      successes (64%); fifteen of the latter developed minor complications (8%), 35
      were partly successful (20%). There were 77 complications in 71 treatments (38%),
      and 45 expanders (25%) had to be removed prematurely because of complications.
      The most common complications were skin penetration (n = 15), minor infection (n
      = 13), and breakdown of the surgical wound (n = 13). The median (range) inpatient
      hospital stay was 8 days (2-39); number of visits to the outpatient clinic for
      filling 7 days (0-20); and total treatment time/patient 82 (19-286). We conclude
      that skin expansion is a useful technique, but that there is room for improvement
      in reducing the rate of complications and the amount of time that patients spend
      being treated.

PMID- 8351497
TI  - Tissue expansion for the treatment of myelomeningocele. Case report.
AB  - A baby boy who had been born with a large myelomeningocele had a
      ventriculoperitoneal shunt inserted at the age of 6 months. Two months later it
      was revised, after which he developed satisfactorily both mentally and
      physically. He presented at the age of 13 months because the epithelialisation of
      the myelomeningocele was both fragile and incomplete. Enough soft tissue was
      obtained to cover the defect, which was 13 x 10 cm, by the use of two 600 ml
      expanders placed subcutaneously one on either side of the deformity.

PMID- 8351498
TI  - Microsurgical two-stage reconstruction of the thumb. Case report.
AB  - A 40-year-old patient presented with traumatic amputation of the thumb and index
      finger. The second metacarpal bone fragment was transposed to lengthen the first
      metacarpal bone. A free flap from the lateral forearm was used to reconstruct the
      thenar region. Later, the second free toe-to-hand transfer was done from which he
      made a good recovery, achieving active flexion and extension in all joints.

PMID- 8351499
TI  - Fracture of the scaphoid associated with volar displacement of a lower radial
      epiphyseal fracture. Case report.
AB  - A 13-year-old boy fell off his bicycle and landed on his outstretched left hand,
      sustaining a Salter-Harris type II fracture of the lower radial epiphysis with
      volar displacement, and an undisplaced fracture across the waist of the left
      scaphoid. After manipulation, and immobilisation for six weeks, he made a
      complete recovery and has no residual deformity. We hypothesise that the fracture
      was caused by the weight of the body being taken by the relatively stiff and
      immobile hand, and could find no report of a similar case.

PMID- 8351500
TI  - Acute carpal tunnel syndrome caused by peritendinitis calcarea. Case report.
AB  - Two women presented with similar symptoms of acute pain in the hand that was
      diagnosed as acute carpal tunnel syndrome caused by peritendinitis calcarea.
      Radiological examinations in both cases showed calcifications in the carpal
      tunnel. Both patients were operated on immediately and the median nerve was
      decompressed. Both were completely relieved of pain after operation and hand
      function returned to normal.

PMID- 8351501
TI  - Interpreting laser Doppler recordings from free flaps.
AB  - Although the transfer of free flaps is nowadays accomplished with an increasing
      degree of safety, thrombosis of the microvascular anastomoses is still a problem.
      In order to avoid delay in re-operating, various methods for objective blood flow
      monitoring have been tried, among them Laser Doppler Flowmetry (LDF). When one
      reviews the literature, it is apparent that opinions differ about whether or not
      LDF is a reliable technique for this purpose. To focus on the need to interpret
      continuous recordings, this paper reports our findings in six latissimus dorsi
      free flaps chosen from our series of LDF monitoring procedures. One uneventful
      flap, no. 1, had an immediate postoperative LDF value of 4.5 perfusion units
      (PU). LDF values improved during the recovery period and the graphic recording
      showed fluctuations due to normal physiological variations of the blood flow in
      the flap. Another uneventful flap, no. 4, showed the same pattern, though at an
      appreciably lower level, 2 PU, on average. Flap no. 2 had an acceptably high
      value of 3.5 PU despite suffering a venous thrombosis. However, the LDF recording
      showed no fluctuations and the value declined gradually. Another flap, no. 3,
      showed fluctuations and blood flow was normal although the value decreased to 2.5
      PU. In flap no. 5, any value between 2 and 3.5 PU could be obtained merely by
      adjusting the position of the probe in the holder. In no. 6, the LDF value
      suddenly dropped, accompanied by a decrease in the total amount of backscattered
      light, indicating venous obstruction which was confirmed at re
      operation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351502
TI  - Rate of recovery after flexor tendon repair in zone II. A prospective
      longitudinal study of 145 digits.
AB  - A series of 145 digits were treated with three controlled motion programmes after
      flexor tendon repair in zone II. Active interphalangeal joint motion was measured
      four, six and 12 weeks; six months and one year after operation. Although there
      were differences in the final results among the groups, the rate of recovery from
      the end of the controlled motion period (four weeks after operation), was not
      significantly different in the three treatment groups. Overall, a mean of 37% of
      the final distal interphalangeal joint range of motion and 9% of the final
      proximal interphalangeal joint range of motion was recovered between three months
      and one year postoperatively. In only 10 of 27 digits with a poor result
      (combined interphalangeal joint range of motion less than 90 degrees) at three
      months, was the result still poor at one year; 10 regained another 40 degrees or
      more, and eight another 50 degrees or more. The results indicate that it is worth
      waiting six or 12 months before considering tenolysis.

PMID- 8351503
TI  - Neurophysiological diagnosis of the carpal tunnel syndrome: evaluation of
      neurographic techniques.
AB  - Twenty-eight patients with a clinical diagnosis of carpal tunnel syndrome
      underwent extensive neurographic examination. The results were compared with
      those in 86 normal subjects who had no signs or symptoms. The widely used methods
      of measuring distal motor latency from wrist to thenar and the sensory conduction
      velocity from the first and third fingers to the wrist gave highly significant
      differences between the carpal tunnel syndrome group and the control subjects.
      There was, however, a large overlap of values between the two groups and the
      discriminative power of the tests was not sufficient to make a diagnosis. Both
      methods for selectively determining the conduction velocity across the carpal
      tunnel distinguished clearly between hands with carpal tunnel syndrome and the
      control group, with no overlap of values. The results support the diagnostic
      validity of a fractionated study of conduction velocity across the carpal tunnel
      with surface electrodes, a test that can easily be done by a trained nurse or EMG
      technician under the supervision of a clinical neurophysiologist.

PMID- 8351504
TI  - Image freezing or progressive thawing?

PMID- 8351505
TI  - Long-range planning initiative for AASCIN: a Delphi study.

PMID- 8351506
TI  - The prevention and management of urinary tract infections among people with
      spinal cord injuries. National Institute on Disability and Rehabilitation
      Research consensus statement. January 27-29, 1992.
AB  - The Urinary Tract Infection Consensus Conference brought together researchers,
      clinicians, and consumers to arrive at consensus on the best practices for
      preventing and treating urinary tract infections in people with spinal cord
      injuries; the risk factor and diagnostic studies that should be done; indications
      for antibiotic use; appropriate follow-up management; and needed future research.
      Urinary tract infection (UTI) was defined as bacteriuria (102 bacteria/ml of
      urine) with tissue invasion and resultant tissue response with signs and/or
      symptoms. Asymptomatic bacteriuria represents colonization of the urinary tract
      without symptoms or signs. Risk factors include: over-distention of bladder,
      vesicoureteral reflux, high pressure voiding, large post-void residuals, presence
      of stones in urinary tract, and outlet obstruction. Possible
      physiologic/structural, behavioral, and demographic risk factors were identified
      also, Indwelling catheterization, including suprapubic, and urinary diversion and
      the drainage methods most likely to lead to persistent bacteriuria. Infection
      risk is reduced with intermittent catheterization, but more severely disabled
      people who require catheterization by others are at greater risk for UTIs. Clean
      self-intermittent catheterization does not pose a greater risk of infection than
      sterile self-intermittent catheterization and is much more economic. However,
      care must be given to proper cleansing of reusable catheters. Quantitative urine
      culture criteria for the diagnosis of bacteriuria include: catheter specimens
      from individuals on intermittent catheterization > or = 10(2) cfu/ml; clean-void
      specimens from catheter-free males using condom collection devices > or = 10(4)
      cfu/ml; and specimens from indwelling catheters of any detectable concentration.
      Dip stick screening tests may offer promise as an early warning system of UTI
      since they can be self-administered. Symptomatic UTI should be treated with
      antibiotics for 7 to 14 days. Longer courses have not been beneficial. In
      patients with symptomatic UTIs, it is not necessary to wait for the results of
      cultures before starting treatment. Asymptomatic bacteriuria need not be treated
      with antibiotics. There is little evidence presently to support the use of
      antibiotics to prevent infections. Following a recent episode of febrile UTI,
      possible contributing prior events should be reviewed. The upper tracts should be
      evaluated (imaging studies) to identify possible abnormalities. A common concern
      among people with spinal cord injuries is that physicians will alter bladder
      management programs without regard to lifestyle needs. Social/vocational
      flexibility may be more important to them than a state-of-the-art bladder
      management program. Future research should focus on obtaining more representative
      samples and investigate psycho-social-vocational implications as well as
      additional clinical-medical factors.

PMID- 8351508
TI  - Bringing research to the bedside through nursing process.

PMID- 8351507
TI  - Descriptive study of bowel care practices and equipment in spinal cord injury.
AB  - 46% of the 277 SCI veterans responding to the survey used bowel care/shower
      chairs at home. Of those who regularly used these chairs (N = 147), over 66% felt
      their safety was compromised by their use. Caregivers reported similar
      dissatisfaction with existing bowel care/shower chairs. Primary concerns related
      to difficulty in assisting with safe transfers were, lack of hand access to
      perianal area for digital stimulation, lack of ease in rolling and turning the
      chair, difficulty in keeping the chair clean, and lack of durability of chair,
      particularly with brakes and seat. Primary safety risks included patient falls
      and pressure ulcer development. Reports of chair related patient falls (35%) and
      pressure ulcers (24%) were common in the SCI patients surveyed. Less than 54%
      were satisfied with the design and usability of bowel care/shower chairs.

PMID- 8351509
TI  - What are some factors that influence incorporation of urinary management routines
      into a person's daily schedule?

PMID- 8351510
TI  - Who is normal?

PMID- 8351511
TI  - Off to an early start.

PMID- 8351512
TI  - T cell anergy.

PMID- 8351513
TI  - Diet and primate evolution.

PMID- 8351514
TI  - The great radium scandal.

PMID- 8351515
TI  - Antisense oligonucleotides as therapeutic agents--is the bullet really magical?
AB  - Because of the specificity of Watson-Crick base pairing, attempts are now being
      made to use oligodeoxynucleotides (oligos) in the therapy of human disease.
      However, for a successful outcome, the oligo must meet at least six criteria: (i)
      the oligos can be synthesized easily and in bulk; (ii) the oligos must be stable
      in vivo; (iii) the oligos must be able to enter the target cell; (iv) the oligos
      must be retained by the target cell; (v) the oligos must be able to interact with
      their cellular targets; and (vi) the oligos should not interact in a non-sequence
      specific manner with other macromolecules. Phosphorothioate oligos are examples
      of oligos that are being considered for clinical therapeutic trials and meet
      some, but not all, of these criteria. The potential use of phosphorothioate
      oligos as inhibitors of viral replication is highlighted.

PMID- 8351516
TI  - Group II intron RNA catalysis of progressive nucleotide insertion: a model for
      RNA editing.
AB  - The self-splicing bl1 intron lariat from mitochondria of Saccharomyces cerevisiae
      catalyzed the insertion of nucleotidyl monomers derived from the 3' end of a
      donor RNA into an acceptor RNA in a 3' to 5' direction in vitro. In this
      catalyzed reaction, the site specificity provided by intermolecular base pair
      interactions, the formation of chimeric intermediates, the polarity of the
      nucleotidyl insertion, and its reversibility all resemble such properties in
      previously proposed models of RNA editing in kinetoplastid mitochondria. These
      results suggest that RNA editing occurs by way of a concerted, two-step
      transesterification mechanism and that RNA splicing and RNA editing might be
      prebiotically related mechanisms; possibly, both evolved from a primordial demand
      for self-replication.

PMID- 8351517
TI  - Inhibition of an in vivo antigen-specific IgE response by antibodies to CD23.
AB  - Immunoglobulin E (IgE) mediates many allergic responses. CD23 is a 45-kilodalton
      type II transmembrane glycoprotein expressed in many cell types. It is a low
      affinity IgE receptor and interacts specifically with CD21, thereby modulating
      IgE production by B lymphocytes in vitro. In an in vivo model of an allergen
      specific IgE response, administration of a rabbit polyclonal antibody to
      recombinant human truncated CD23 resulted in up to 90 percent inhibition of
      ovalbumin-specific IgE synthesis. Both Fabs and intact IgG inhibited IgE
      production in vitro and in vivo. Thus, CD23 participates in the regulation of IgE
      synthesis in vivo and so could be important in allergic disease.

PMID- 8351518
TI  - Fusion between transcription factor CBF beta/PEBP2 beta and a myosin heavy chain
      in acute myeloid leukemia.
AB  - The pericentric inversion of chromosome 16 [inv(16)(p13q22)] is a characteristic
      karyotypic abnormality associated with acute myeloid leukemia, most commonly of
      the M4Eo subtype. The 16p and 16q breakpoints were pinpointed by yeast artificial
      chromosome and cosmid cloning, and the two genes involved in this inversion were
      identified. On 16q the inversion occurred near the end of the coding region for
      CBF beta, also known as PEBP2 beta, a subunit of a heterodimeric transcription
      factor regulating genes expressed in T cells; on 16p a smooth muscle myosin heavy
      chain (SMMHC) gene (MYH11) was interrupted. In six of six inv(16) patient samples
      tested, an in-frame fusion messenger RNA was demonstrated that connected the
      first 165 amino acids of CBF beta with the tail region of SMMHC. The repeated
      coiled coil of SMMHC may result in dimerization of the CBF beta fusion protein,
      which in turn would lead to alterations in transcriptional regulation and
      contribute to leukemic transformation.

PMID- 8351519
TI  - Amyotrophic lateral sclerosis and structural defects in Cu,Zn superoxide
      dismutase.
AB  - Single-site mutants in the Cu,Zn superoxide dismutase (SOD) gene (SOD1) occur in
      patients with the fatal neurodegenerative disorder familial amyotrophic lateral
      sclerosis (FALS). Complete screening of the SOD1 coding region revealed that the
      mutation Ala4 to Val in exon 1 was the most frequent one; mutations were
      identified in exons 2, 4, and 5 but not in the active site region formed by exon
      3. The 2.4 A crystal structure of human SOD, along with two other SOD structures,
      established that all 12 observed FALS mutant sites alter conserved interactions
      critical to the beta-barrel fold and dimer contact, rather than catalysis. Red
      cells from heterozygotes had less than 50 percent normal SOD activity, consistent
      with a structurally defective SOD dimer. Thus, defective SOD is linked to motor
      neuron death and carries implications for understanding and possible treatment of
      FALS.

PMID- 8351521
TI  - Basic research: the gray zone.

PMID- 8351522
TI  - Physicists take a hard look at vision.

PMID- 8351520
TI  - Dynamics of the hippocampal ensemble code for space.
AB  - Ensemble recordings of 73 to 148 rat hippocampal neurons were used to predict
      accurately the animals' movement through their environment, which confirms that
      the hippocampus transmits an ensemble code for location. In a novel space, the
      ensemble code was initially less robust but improved rapidly with exploration.
      During this period, the activity of many inhibitory cells was suppressed, which
      suggests that new spatial information creates conditions in the hippocampal
      circuitry that are conducive to the synaptic modification presumed to be involved
      in learning. Development of a new population code for a novel environment did not
      substantially alter the code for a familiar one, which suggests that the
      interference between the two spatial representations was very small. The parallel
      recording methods outlined here make possible the study of the dynamics of
      neuronal interactions during unique behavioral events.

PMID- 8351523
TI  - Role of gene defect in hereditary ALS clarified.

PMID- 8351524
TI  - Evolutionists take the long view on sex and violence.

PMID- 8351525
TI  - Thinking about brain cell assemblies.

PMID- 8351527
TI  - A good life.

PMID- 8351526
TI  - Death and dignity.

PMID- 8351528
TI  - State authority, medical dominance, and trends in the regulation of the health
      professions: the Ontario case.
AB  - The relationships amongst the health professions and between them and the state
      are rapidly changing. I argue that analysis of these relationships has to take
      into consideration: the fact that medicine played an intermediary role (through
      medical dominance in health care) between the state and the other health
      occupations; the permeability of the boundaries of the state and the professions;
      and the dual nature of professional organizations (as sites of intra-occupational
      conflict and as possible vehicles of extra-occupational control). In Ontario the
      medical profession partially 'mediated' the relationships between 'non-physician'
      health occupations and the state through medical control over other health care
      occupations. National/provincial health insurance brought the state into the
      health care system as an actor and forced a reconsideration of its relationships
      with medicine and with the other health care occupations. The state came to be
      directly involved in 'rationalizing' health care. This involvement meant curbing
      the power of medicine and modifying the relationships between medicine and the
      para-medical occupations. State influence is partly constructed through a
      particular kind of professional organization, namely, the professional College.
      These changing relationships are illustrated by historical and recent
      developments regarding medicine, nursing and chiropractic in Ontario.

PMID- 8351529
TI  - [Children for the aged. Sibling configuration and support for aged parents in the
      rural south-western area of France].
AB  - The support of the dependent elderly is conditioned by the availability of the
      family, particularly of children, even when assistance services help the elderly
      stay at home. But it is difficult to tell if the elderly will have descendants
      capable of providing for them. A survey carried out in the rural South-Western
      area of France shows the importance of taking into account sibling configuration
      when seeking support for the old and disabled. The analyses presented here result
      from the joint utilization of an epidemiological study based on a questionnaire
      (N = 405) and a sociological survey on family history: 74 elderly people from the
      initial sample as well as several of their relatives and friends were interviewed
      at length on the conditions of support at home. Three main sibling configurations
      have been established: the only child, several children of the same gender,
      several children of different genders. They were related to three types of
      distances between parents and children: co-habitation, vicinity, remoteness. If
      one finds as many children co-habitating with at least one parent in one-child
      families as in the whole sample (33%), it means that family support mostly
      depends on the transfer of property for farmers and tradesmen: in this area, the
      heir must provide for his ageing parents. But there are marked differences
      according to the gender of the children: a boy is only likely to stay with his
      parents if he inherits their professional activity. On a qualitative level, the
      question dealt with in this article is the following: how can one plan for one's
      old age according to the rigidity of the number, the order and the gender of the
      children?

PMID- 8351530
TI  - The utility of health at different stages in life: a quantitative approach.
AB  - Thirty students and thirty-five elderly people compared the quality of life of
      imaginary patients of different ages suffering from end-stage renal disease. By
      manipulating the time the imaginary patients had to be on a transplantation
      waiting list, the utility of health at different periods of life could be
      compared. Except for the very young, respondents found health in the early
      periods of life to be twice as important as in the last decade of life. Health at
      age 35 had an utility somewhere between these two extremes. The responses of the
      elderly people showed remarkable resemblance to the students' responses,
      suggesting that the results reflect a general ethical standard. The values found
      were tested by means of a factorial design and found to fulfill the
      qualifications of an interval scale.

PMID- 8351531
TI  - A longitudinal study of the impact of behavioural change intervention on
      cleanliness, diarrhoeal morbidity and growth of children in rural Bangladesh.
AB  - A community-based intervention was developed through direct participation of the
      target population in assessment and iterative trials to improve hygiene practices
      and to reduce childhood diarrhoea in lowland rural Bangladesh. A total of 185
      (98%) households with children ages 0-18 months in five contiguous villages were
      targeted for the interventions. A comparison site was selected for a detailed
      observational study and for use as a control for the intervention. About 97% of
      all households with children ages 0-18 months were enrolled for study at the
      control site. Children in this age group were targeted because at this
      developmental stage they were most vulnerable to diarrhoeal morbidity and
      malnutrition (related to unhygienic practices). The intervention was implemented
      with the assistance of village leaders through a "Clean Life" campaign by local
      project workers and volunteer mothers who were chosen from the target households.
      The intervention activities started in January 1986 and lasted for 7 months.
      Higher adoption rates of the intervention were associated with better cleanliness
      status, which was related to lower diarrhoea and malnutrition rates in the
      intervention site. The results of between-site longitudinal analyses showed that
      after the intervention, the intervention site had substantially higher
      cleanliness scores, lower diarrhoeal morbidity, and better growth status compared
      to those of the control site, with differences increasing over time. The findings
      suggest that this type of community-based intervention can be very beneficial in
      modifying hygiene behaviours and lowering childhood diarrhoea and malnutrition.

PMID- 8351532
TI  - Cost-effectiveness analysis of prenatal screening and vaccination against
      hepatitis B virus--the case of Belgium.
AB  - The study examines the cost-effectiveness of screening pregnant women in Belgium
      for the presence of hepatitis B virus (HBV) and of vaccinating the newborns if
      necessary. The alternative strategy considered is 'doing nothing'. The rate of
      carriership among a sample of pregnant women in Belgium amounts to 0.67%. If a
      pregnant woman is a carrier of the virus, there is an average probability of 30%
      that she will transmit the virus to her newborn. Later in life, this baby will be
      at risk from serious complications, such as chronic active hepatitis, cirrhosis
      and primary hepatocellular cancer. However, medical costs will be induced by
      screening and vaccination campaigns, lab-tests, vaccine costs, etc. On the other
      hand, resources will be saved by the prevention of severe complications of the
      disease. However, costs dominate savings, the incremental cost-effectiveness
      ratio for the screening and vaccination strategy amounting to 583,581 BEF per
      life-year saved. To check the stability of the cost-effectiveness ratio, a
      sensitivity analysis has been performed on some crucial parameters: the ratio is
      found to be sensitive to the prevalence of HBV among pregnant women, to the costs
      for screening and vaccination and to the discount rate. Increasing the treatment
      costs for a HBV complication hardly changes the cost-effectiveness ratio.

PMID- 8351533
TI  - Determinants of infant mortality in Malawi: a spatial perspective.
AB  - This paper examines the spatial variation of infant mortality in Malawi between
      1977 and 1987. Data from the 1977 and 1987 censuses are used in simple
      correlation and forward stepwise regression analysis to explain and/or predict
      the variation and change of infant mortality is strongly associated with a number
      of demographic and socioeconomic variables. Region in which a district finds
      itself also matters as far as levels of infant mortality are concerned. With a
      rapidly expanding population, the study concludes that the reduction of infant
      mortality throughout the country should be vigorously pursued by the government
      of Malawi. Fertility will continue to be high if infant and childhood mortality
      persist at current levels.

PMID- 8351534
TI  - Determinants of pregnancy outcomes and targeting of maternal health services in
      Jamaica.
AB  - Detailed nationally representative population level data were used to investigate
      the pre-natal care and delivery experiences of pregnant women in Jamaica. The
      results of this study show that: (a) demographic criteria (particularly first
      births) and self-reported clinical pregnancy complications are valid predictors
      of deleterious maternal health outcomes and can be used to stratify mothers into
      risk groups. (b) There appears to be a significant problem of under and
      inappropriate utilization of pre-natal care services by all women and in
      particular by demographically 'high risk' women, i.e. young, first time mothers.
      Significant proportions of the latter group report either no pre-natal care
      visits at all or visits which are later than the first trimester. The problems of
      delayed initiation of pre-natal care are specially exacerbated for poor, teenage
      mothers who happen to be living in the Kingston Metropolitan Area. (c) In terms
      of the content and quality of pre-natal care services the message is somewhat
      mixed. On the positive side the pre-natal care system is doing a moderately
      satisfactory job with regard to diagnostic tests and educational advice. On the
      negative side however, the fact that once women enter the health care system they
      all receive the same moderately adequate care (in terms of diagnostic evaluations
      and educational advice) with no attempt to focus particular attention on high
      risk mothers is troublesome. (d) With regard to appropriate delivery venues for
      pregnant women, pre-natal care visits do not appear to significantly influence
      the choice of delivery venues. Moreover, rich urban women are much more likely to
      deliver in a hospital than their rural peers. In conclusion, the study discusses
      the social and behavioral context of these results, addresses the policy
      implications and makes some recommendations to improve maternal health services.

PMID- 8351535
TI  - Disease and mortality among gold miners of Ghana: colonial government and mining
      company attitudes and policies, 1900-1938.
AB  - This article traces the causes of high mortality rates among African gold miners
      in the former British colonial territories of the Gold Coast and Ashanti, 1900
      1938. No previous studies exist for the early decades owing to the neglect by
      both mining companies and government officials to keep adequate statistics on
      African miner death rates, a flaw which reinforced the lackadaisical response of
      the government to problems of prevention and treatment. A milestone report issued
      in 1924, demonstrating that sanitary precautions, housing conditions and medical
      treatment for most African miners were wretched, forced the colonial state to
      gather regular data on Africans and make long overdue improvements, so that
      mortality rates for underground miners slowly declined by the time of the Second
      World War. But the published statistics concealed from view the far greater
      incidence of general deaths from pulmonary and respiratory tract disease among
      short-term migrant labourers, who lived in the mining towns, but returned to die
      in their home villages.

PMID- 8351536
TI  - Social determinants of child health in Yemen.
AB  - Much of child illness in developing countries can be explained by what have been
      called, 'proximate determinants,' principally infant feeding practices and
      preventive and curative care. During previous field research in a small village
      in Yemen the author observed that despite the uniformly unhealthy environment, a
      minority of the families carried most of the burden of child illness and death.
      This study was carried out to document that observation, and to suggest an
      explanation. The study used quantitative techniques to map child health in the
      community and identify a sub-sample for subsequent in-depth questioning and
      observation. What distinguished women with healthy and unhealthy children was the
      level of resources under their control and the way they managed them; their
      social support or lack of it; and their passive or active attitudes toward life.
      Detailed stories are presented for five of the women. Although biological
      explanations for ill health can lead to useful interventions, the social and
      economic problems of the 'multi-problem family'--well-recognized in
      industrialized countries--must also be addressed to improve child health.

PMID- 8351537
TI  - [Mbombo: therapeutic ritual for high-risk children in rural Zaire].
AB  - The mbombo is a popular ritual practice, with preventive and curative
      implications, of a rural society in central Africa. This rite is used by:
      pregnant women who have lost several children by abortion, at childbirth, or
      during their first year of life; by women who get pregnant after a long spell of
      primary or secondary infertility; by their children until they can walk; and by
      twins and their mother. The principal characteristics of the rite include: the
      separation of mother and child from their family, a long period of marginality
      under the continuous protection of a ritualistic healer, and a progressive
      reinsertion in the therapeutic support group, composed of the family and the
      community of sufferers. When one analyses the meanings and operational functions
      of the global ritual process of this therapy, which incidentally takes into
      account several midwifery techniques, it is not only a fecundity ritual, but also
      a rite of initiation, protection, purification and passage. Thus it is a global
      therapy involving besides child survival, the restoration of a new physiological,
      psychological, religious and social identity of the ritual subjects.

PMID- 8351539
TI  - Vasectomy as a reason for donor insemination.
AB  - Among 200 couples referred for counselling with a view to donor insemination (DI)
      were 21 whose request arose from an earlier vasectomy. This had been judged
      irreversible, apart from one case where the man had been sterilised for genetic
      reasons and therefore had not sought reversal. An overall incidence of 10.5%
      indicates that vasectomy may lead to fertility problems in the event of
      remarriage, which has become more common with an increasing divorce rate. All 21
      husbands but only 3 wives had been previously married; 3 former wives had died,
      otherwise all previous marriages had ended in divorce. Most husbands were
      considerably older than their second wives, especially as compared with the
      majority of men in the larger series who were still in a first marriage. Their
      relative maturity may have helped them to respond more sensitively to their
      wives' maternal needs when they already had children of their own. During a
      follow-up interval of up to 8 years, 2 couples had separated after a brief
      relationship but 9 of the other 12 contacted had become parents by DI. The 3
      remaining couples included a wife who at the latest report was 5 months pregnant,
      and 2 who were still pursuing treatment. Despite the low failure rate in this
      small series we should bear in mind that DI is not an ideal solution to the
      problem of male infertility, nor always even acceptable.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8351538
TI  - An application of Ajzen's theory of planned behaviour to predict mothers'
      intention to use oral rehydration therapy in a rural area of Benin.
AB  - The aim of this study was to identify the psychological factors influencing
      mothers' intentions to use oral rehydration therapy (ORT) for the treatment of
      children's diarrhea in rural areas in South Benin. The subjects were 128
      illiterate and animist mothers, selected at random in the areas of Pahou and
      Avlekete. Mothers were interviewed at home, using a pre-tested instrument
      investigating predictors of motivation as defined in Ajzen's theory of planned
      behaviour. The variables measured were intentions, attitudes, subjective social
      norm, perceived behavioural control and socio-demographic indicators. The
      regression of intention on all variables yielded an adjusted R2 of 0.40 (P <
      0.0001), with perceived consequences of using ORT, perceived barriers to its use,
      and the zone of habitation being the significant predictors. The results suggest
      that the promotion of the use of ORT for treatment of diarrhea, in these areas,
      should be facilitated if the mothers perception of the advantages of using ORT is
      reinforced and if they have easier access to the health care services offered by
      local village health workers.

PMID- 8351540
TI  - The relationship between parenting stress and social support in mothers of
      children with learning disabilities: a Chinese experience.
AB  - This study examined the relationship between parenting stress and social support
      in a random sample of 100 mothers with children at a school for children with
      learning disabilities, and a control group of 75 mothers with similarly aged non
      handicapped children. Mothers of children at Zhi Ling school were found to have
      significantly more stress and significantly less support than those in the
      control group. Parenting stress in the control group was also found to be
      relatively high when compared with what are considered to be normal levels in the
      West. No significant correlation was found between total parenting stress and
      social support. It is suggested that further studies need to differentiate
      between satisfaction with support that is actually received and the perceived
      quality of available support.

PMID- 8351542
TI  - Prevention of bicycle-related injuries in childhood: role of the caregiver.
AB  - To assess perceptions of bicycle-related head injuries, helmet use, and safety
      practices, we had questionnaires distributed to caregivers of 2,500 children in
      the third through sixth grades; 1,006 (40.2%) completed surveys were returned.
      Eight hundred thirty-two caregivers (82.7%) indicated that they had a child
      cyclist in their household; approximately 65% responded that they believed head
      injury was likely if their child was involved in a bicycle mishap. A majority
      (approximately 70%) also said that a bicycle helmet may prevent head injury in
      between 25% and 75% of all occurrences. Yet 758 (91.1%) students did not own or
      have access to a bicycle helmet. Among the caregivers whose child did not have a
      bicycle helmet, 530 (69.9%) stated that they had never thought about purchasing
      one. Caregivers of both helmeted and nonhelmeted youngsters indicated concern for
      bicycle safety (100% versus 94%, respectively). Most caregivers (approximately
      64%) stated that they would encourage their child to attend a bicycle safety
      camp. These findings suggest that caregivers perceive the dangers associated with
      bicycling but are not cognizant of available programs and methods that prevent
      the risk of serious injury to bicyclists.

PMID- 8351541
TI  - Use of tympanic thermometers to screen for fever in patients in a pediatric
      emergency department.
AB  - The use of tympanic thermometers has markedly increased over the past few years.
      While some authors have shown high correlation between rectal and tympanic
      readings, others have found low correlation. After noticing a failure of the
      tympanic thermometer to detect fever in obviously febrile pediatric patients, we
      prospectively evaluated its use in our emergency department. All patients less
      than 6 years of age who were brought in for care over a 2-week period were
      eligible for entry into the study. Nurses were trained in the proper use of the
      instruments before the study began. We used a calibrated tympanic thermometer
      (First Temp 2000A) and an electronic thermometer (IVAC 2080A). In all children
      the tympanic temperature was measured first, immediately followed by measurement
      of the rectal temperature. The 39 children entered into the study ranged in age
      from 2 to 71 months (mean of 27 months). Rectal temperature ranged from 97.8
      degrees to 105.2 degrees F. The correlation between rectal and tympanic was low
      (r = .830) and was worse in patients with fever (r = .612). The mean difference
      was 0.8 degrees F, but was as high as 3.4 degrees F. The tympanic thermometer
      failed to identify five of the 15 febrile patients (T > or = 100.5 degrees F) in
      our study. We therefore conclude that the tympanic thermometer is not sensitive
      enough to be used to screen for fever in pediatric patients.

PMID- 8351543
TI  - Effect of anabolic steroids on HIV-related wasting myopathy.
AB  - Human immunodeficiency virus type 1 (HIV-1) is frequently associated with
      weakness and muscle wasting, referred to as HIV-1 wasting myopathy. This illness,
      often observed in the advanced stages of acquired immunodeficiency syndrome
      (AIDS), responds poorly to therapeutic intervention. We describe the cases of
      three AIDS patients with HIV-1 wasting myopathy who had a favorable response to
      anabolic steroids as evidenced by an improvement in strength, muscle bulk, body
      weight, and sense of well-being.

PMID- 8351544
TI  - Diagnosis of myocardial contusion.
AB  - From July 1988 to July 1990, 159 consecutive cases of major blunt chest injury
      were evaluated prospectively for myocardial contusion with serial
      electrocardiographic monitoring, cardiac isoenzyme studies, and two-dimensional
      echocardiography. One hundred and forty-seven cases in the series were
      assessable; 97 of the patients were male, and 50 were female. They ranged in age
      from 2 to 97 years (average, 38.5 years). There were five deaths, none of cardiac
      origin. Total lactate dehydrogenase (LDH) values were elevated in 115 patients
      (78%); total creatine phosphokinase (CPK) values were elevated in 100 (68%).
      Cardiac isoenzyme patterns were consistent with myocardial contusion in 18
      patients (12%). Seventy-five patients had abnormal electrocardiograms, and 10 of
      these had ectopic rhythms. Two-dimensional echocardiograms were completed in 58
      cases; 12 of these (21%) were abnormal. Nineteen patients (25%) with abnormal
      rhythms had elevated LDH values, and 26 (35%) had elevated CPK values. One
      patient (10%) with ectopy had an abnormal echocardiogram. Two patients (11%) with
      abnormal isoenzyme patterns experienced dysrhythmias. Costs for hospitalization
      and studies amounted to $1,886 per patient. Given the poor predictive value of
      laboratory testing in patients with significant (ie, symptomatic) cardiac
      contusion, observation alone with electrocardiographic monitoring and treatment
      of symptomatic dysrhythmias is an adequate and cost-conscious treatment.

PMID- 8351545
TI  - MacFee incision: a safe approach to the neck.
AB  - We reviewed 37 neck dissections done via the MacFee or double horizontal cervical
      incision to excise neoplasms located in the oral cavity and oropharynx, with
      draining cervical lymph nodes. One half of the patients had immediate
      reconstruction with myocutaneous flaps. Approximately 70% of the patients had
      advanced tumors and many were malnourished at presentation. Three wound
      complications involving the MacFee incision occurred in patients who were
      malnourished and required reconstruction. These wound complications were
      corrected with conservative therapy. Preoperative radiotherapy was a morbid
      cofactor. None of the patients had carotid artery involvement, wound dehiscence,
      or deep cervical infections. The MacFee incision can be used in major head and
      neck resections, with operative morbidity comparable to that of other techniques.

PMID- 8351547
TI  - Retroperitoneal tumors with vena caval extension: a multidisciplinary approach.
AB  - In cases of retroperitoneal tumor with extension to the inferior vena cava (IVC),
      complete resection improves survival, but may require cardiopulmonary bypass
      (CPB) and hypothermic circulatory arrest (HCA). Since 1985, eight patients at our
      institution have had complete resection of retroperitoneal tumors with IVC or
      right atrial involvement. Preoperative evaluation included intravenous
      pyelography, computed tomography of the chest and abdomen, renal arteriography,
      and venography or magnetic resonance imaging of the IVC. Operative technique was
      determined primarily by the extent of IVC or RA involvement and included combined
      median sternotomy and laparotomy, control of the intrapericardial IVC, and
      radical tumor resection. IVC tumor thrombectomy was done using either temporary
      vascular occlusion, CPB, or CPB with HCA. Complete resection for improved
      survival of retroperitoneal tumors with IVC extension is technically feasible
      with acceptable morbidity and mortality rates. A multidisciplinary approach
      allows optimal management of these extensive tumors.

PMID- 8351546
TI  - Use of lumbar run-up technique for cervical myelography.
AB  - Cervical myelography by lumbar run-up produces excellent radiologic studies in
      most cases. Use of this technique avoids the hazards and pitfalls associated with
      a lateral cervical puncture. We discuss 92 cases, with excellent or good results
      in 98% and nondiagnostic studies in only 2%. Both of the poor technical studies
      were followed by computed tomographic myelography to produce diagnostic
      examinations in all cases. There were no serious complications.

PMID- 8351548
TI  - Giant lipomas of the hand and forearm.
AB  - Giant lipomas of the upper extremity are infrequently reported. They can alter
      function by restricting motion or producing compressive neuropathies. This report
      of four cases of giant lipoma in the hand and forearm illustrates these
      functional losses. The role of MRI and CT in preoperative evaluation of these
      lesions is discussed and a report of an anterior interosseous syndrome caused by
      a giant lipoma is presented.

PMID- 8351549
TI  - Safety and efficacy of teicoplanin for bone and joint infections: results of a
      community-based trial.
AB  - To evaluate the efficacy and safety of teicoplanin in the treatment of gram
      positive bone and joint infections, parenteral teicoplanin was used once daily in
      an average dose of 10.1 mg/kg (range 6 to 12 mg/kg) after loading to treat
      patients with acute or chronic osteomyelitis and septic arthritis. From the 66
      patients who met criteria for initial enrollment, 60 gram-positive isolates were
      recovered from bone and joint fluid, and each was sensitive to teicoplanin at <
      or = 2 micrograms/mL (median 0.25 microgram/mL). Teicoplanin was more active in
      vitro against these isolates than either vancomycin or oxacillin. Among the 43
      patients in whom microbiologic efficacy could be assessed, the initial pathogen
      was eradicated in 37 (86%). Clinically, 45 patients infected with staphylococci
      (including oxacillin-susceptible and oxacillin-resistant Staphylococcus aureus
      and coagulase-negative staphylococci) met predetermined criteria for completed
      adequate therapy. Of these, 39 (87%) responded favorably and became free of all
      signs of infection; 6 (13%) failed to respond or suffered relapse. Overall, 36
      patients completed teicoplanin therapy at home. Adverse reactions necessitated
      discontinuance of therapy in 12 patients and included fever, rash, hepatic
      function test abnormalities, and renal insufficiency. We found teicoplanin to be
      effective and generally well tolerated for treatment of bone and joint infections
      by gram-positive organisms in a community setting.

PMID- 8351550
TI  - Surgical clipping of difficult intracranial aneurysms using deep hypothermia and
      total circulatory arrest.
AB  - Intracranial aneurysms often present a challenging problem for the neurosurgeon.
      A variety of techniques have been developed to deal with these lesions. Several
      subspecialists are frequently involved in such treatment. We present our
      experience in a community hospital using a previously described technique of
      hypothermic cardiac arrest and barbiturate cerebral protection.

PMID- 8351551
TI  - Continuing evolution of regionalized perinatal care: community hospital neonatal
      convalescent care.
AB  - We describe the convalescent care of 169 back-transported (to community
      hospitals) and 285 eligible but not back-transported very low birth weight (VLBW)
      infants. Eligible infants who were not back transported to a level I or II
      community hospital were transferred to a level II nursery within the Medical
      University of South Carolina (MUSC) for convalescent care. Study infants were
      admitted to the neonatal intensive care unit (NICU) at MUSC from July 1985
      through June 1989. They were admitted after maternal transport to MUSC for
      imminent delivery (N = 159), out-born community delivery (N = 55), or in-born
      MUSC delivery (N = 240). The mean +/- SD birth weight and gestational age and the
      NICU admission diagnoses for the back-transported and non-back-transported
      neonates were similar. The mean +/- SD weight of neonates at the time they were
      back transported was significantly greater than the weight of neonates at the
      time of intrahospital transfer. In contrast, the discharge weight to home and
      total days hospitalized were significantly less in the back-transported infants.
      Five back-transported neonates (3%) and 12 non-back-transported neonates (4%)
      were readmitted to the NICU. The back-transported infants used more than 3,800
      bed days at community hospitals that would otherwise have been spent in the
      regional center, thus facilitating increased parental and primary physician
      involvement in their care.

PMID- 8351552
TI  - Necrotizing infections of the perineum.
AB  - During a 6-year period, 10 patients were treated for severe necrotizing
      infections of the perineum (Fournier's gangrene) at the Edward Hines Veterans
      Administration Hospital (Hines, Ill). All were male, and their average age was 60
      years. When known, duration of symptoms was 2 to 5 days. Prodromal signs such as
      edema, erythema, and pain frequently developed into rapidly spreading, full
      thickness cutaneous gangrene in less than 24 hours. All patients had significant
      concomitant disease; 60% were diabetic. All patients had expedient and aggressive
      initial debridement, usually within 24 hours of presentation to the surgical
      service. Each patient had a "second-look" debridement within 1 or 2 days.
      Debridement was done an average of 2.6 times per patient. The cause of the
      infection was noted in seven patients--five with perirectal abscess and two with
      urethral trauma. Suprapubic catheters were placed in both patients with urethral
      trauma. Diverting colostomy was done on two patients who had perirectal abscess
      as a nidus; eight patients were treated without colostomy. Polymicrobial
      bacteriologic flora were found in all patients, with a predominance of
      Escherichia coli, Bacteroides sp, and staphylococci. Broad spectrum antibiotics
      and early nutritional supplementation were given. Hospital stay averaged 4 weeks
      (range, 3 to 12 weeks). One patient died (mortality of 10%). Successful
      management of these patients requires expedient diagnosis, aggressive nutritional
      supplementation, and early and repeated debridement as clinically indicated. We
      have not found diverting colostomy to be a necessary part of the management of
      these patients even when the nidus is perirectal.

PMID- 8351553
TI  - Smokeless tobacco use in an outpatient veteran population.
AB  - Smokeless tobacco use is a significant health risk for carcinoma of the
      oropharynx, and has a high prevalence in the southern United States. To evaluate
      the potential demand for a smokeless tobacco cessation program, we surveyed
      patients attending the General Medicine Clinic of a Veterans Affairs Medical
      Center. The prevalence of smokeless tobacco use was 5.8%, which did not justify
      creation of a clinic-based cessation program. Since we observed adults using
      smokeless tobacco as a means to reduce or stop their smoking, smoking cessation
      programs should include counseling against smokeless tobacco use.

PMID- 8351554
TI  - Limited availability of medications for cancer patients.
AB  - We surveyed both chain and independent pharmacies within 10 counties of central
      South Carolina to determine the availability of certain medications that are
      often prescribed for patients during cancer treatment. One hundred twenty (59%)
      of the 202 surveys distributed were returned. Results indicate that many of the
      65 products included in the survey are not stocked on a regular basis by the
      majority of the pharmacies that responded. Limited availability of these
      medications not only may prevent a patient from receiving timely drug therapy,
      but may exacerbate the anxieties and frustrations experienced by patients as they
      deal with their disease as well. This limited accessibility to medications could
      directly influence patient compliance. Therefore, patients need to be informed
      that availability is often limited, and that prescribed medications may require
      special ordering by their pharmacist. Awareness of this potential problem and
      increased communication among physicians, nurses, pharmacists, and patients could
      alleviate delays in drug therapy and improve the continuity of patient care.

PMID- 8351555
TI  - Oxyphil cell neoplasms of the thyroid gland.
AB  - Despite several extensive reviews of the literature within the past decade, the
      treatment of oxyphil cell tumors of the thyroid gland remains controversial. The
      foremost questions today concern the acceptable criteria for diagnosis of oxyphil
      malignancies and the appropriate surgical treatment of these neoplasms. This
      review provides a forum for debate on the treatment of oxyphil neoplasms, with
      emphasis on their unique histopathologic features and unpredictable clinical
      behavior.

PMID- 8351557
TI  - How safe are silicone breast implants?
AB  - The Food and Drug Administration's recent decision to limit the use of silicone
      gel breast implants was surrounded by a great deal of misleading information in
      the popular press. This article outlines the most relevant information available
      in the literature on the most often raised safety issues, including the
      carcinogenicity of silicone, speculation on a possible connection between
      silicone and autoimmune disease, the significance of gel bleed, and the effect of
      implants on mammography. In this attempt to better educate primary care
      physicians, we explain what is known about silicone gel breast implants so
      physicians can more wisely counsel their patients, who may be needlessly
      frightened by inaccuracies they have heard.

PMID- 8351556
TI  - Anorectal manometry: techniques and clinical applications.
AB  - Anorectal manometry has gained wide acceptance as a helpful method to objectively
      assess the apparatus of defecation provided by the anorectal sphincter. The
      standard manometric evaluation enables measurement of resting and squeeze
      pressures, as well as of the length of the functional anal canal (high pressure
      zone [HPZ]). More detailed assessment of radial and longitudinal pressure
      profiles can also be generated from vector volume and vector symmetry index
      assessment. Adjuvant techniques using an intrarectal balloon allow assessment of
      the rectoanal inhibitory reflex (RAIR), rectal sensitivity, capacity, and
      compliance. Although anorectal manometry can be used as a diagnostic test in
      diseases such as Hirschsprung's disease, more often it is used to assess common
      disorders such as chronic idiopathic constipation and fecal incontinence.
      Anorectal manometry has also been considered as a preoperative evaluation in
      patients having abdominal and anorectal procedures during which the state of
      continence can be jeopardized.

PMID- 8351558
TI  - Thomas Hodgkin (1798-1866): physician, Quaker, social activist, and pioneer
      English pathologist.

PMID- 8351559
TI  - Anaphylaxis due to latex.
AB  - The AIDS crisis has mandated the use of universal precautions and has "gloved"
      the health care environs--workers in hospitals, outpatient services, and basic
      city services, including emergency medical personnel, firemen, and police. Thus,
      in the future the number of reported serious latex reactions are expected to
      increase. Since most individuals at risk of sensitization might be identified by
      a simple symptom-related questionnaire, further latex exposure in that group
      could be limited. This could be accomplished by work area reassignment or using
      vinyl gloves if necessary. Autoinjectable epinephrine should be carried by those
      who have had anaphylaxis, and they should become proficient in its use. These
      measures could reduce the likelihood of serious latex-induced morbidity for
      health care workers, paramedical personnel, and patients.

PMID- 8351561
TI  - Concomitant abuse of clonidine and heroin.
AB  - We have reported the case of a 36-year-old woman who abused heroin and clonidine
      concomitantly. To our knowledge, this practice has never been reported in the
      medical literature, although it may be relatively common in certain communities.
      It may place the heroin abuser's health at additional risk and complicate therapy
      for overdose and withdrawal.

PMID- 8351560
TI  - Systemic lupus erythematosus-like illness associated with syndrome of abnormally
      large von Willebrand's factor multimers.

PMID- 8351562
TI  - Spinal epidural abscess due to Aspergillus sp in a patient with acquired
      immunodeficiency syndrome.

PMID- 8351563
TI  - Metastatic adenocarcinoma of the prostate: presentation as a pleural-based mass.
AB  - We have presented an unusual case of metastatic prostate carcinoma simulating a
      primary bone tumor. Although previous reports have described periosteal and
      "pseudosarcomatous" prostate metastases, no report makes reference to rib
      involvement. Furthermore, the large soft tissue component is highly unusual. This
      case illustrates that although such lesions are rare, in the older patient,
      metastases should be included along with primary tumors in the differential
      diagnosis of a spiculated bone lesion with prominent soft tissue involvement.

PMID- 8351564
TI  - Community-acquired Xanthomonas maltophilia pyelonephritis.
AB  - We have described the case of a patient with a community-acquired urinary tract
      infection with what is more typically a nosocomial pathogen. Our patient had not
      been hospitalized recently, and his only established risk factor for X
      maltophilia infection was chronic bladder catheterization. Although paraplegic
      and thus disabled, he was not debilitated. He had had no recent antibiotic
      therapy prior to the onset of symptoms, but he did have a history of multiple
      previous bladder catheter-related infections. We believe that chronic outpatient
      bladder catheterization, with its risk of recurrent infections, may provide
      another niche for emergence of this nosocomial pathogen.

PMID- 8351565
TI  - Torulopsis glabrata in the neonate: an emerging fungal pathogen.
AB  - Fungi are becoming increasingly common nosocomial pathogens in the neonatal
      intensive care patient. The fungus Torulopsis glabrata, a common skin inhabitant,
      is a potential pathogen in the high-risk neonate. In this report we have reviewed
      the cases of two infants in which systemic T glabrata infection was diagnosed.
      One patient survived without apparent sequelae; the other died before diagnosis
      and initiation of therapy. Five other cases of systemic infection by T glabrata
      in neonates have been reported previously, with only one survivor. Early
      recognition and treatment of this nearly uniformly fatal infection is imperative.

PMID- 8351566
TI  - Lithium-induced nephrogenic diabetes insipidus treated with indomethacin.
AB  - NDI occurs in 5% to 20% of patients receiving long-term lithium therapy. The
      associated polyuria usually resolves within 3 weeks of lithium discontinuance but
      can persist beyond a year. For such patients, hydrochlorothiazide and amiloride
      therapy has been hampered by the delayed effect and intrinsic side effects of
      these agents. We have described the case of a 66-year-old man with a history of
      bipolar disorder treated with lithium who was transferred to the intensive care
      unit with coma. Indomethacin therapy, at a dose of 50 mg every 8 hours, was begun
      and improvement of the NDI state was observed within 3 hours of lithium
      administration. There was complete normalization of mental status and laboratory
      studies after 36 hours. A complete 3-week course of indomethacin was required to
      keep the patient free of symptoms of NDI. We have also discussed the role of
      indomethacin in reversing lithium-induced NDI and reviewed pertinent prior
      reports in the literature.

PMID- 8351567
TI  - Combined coronary artery bypass and abdominal aortic aneurysmectomy: appropriate
      management in selected cases.
AB  - Patients with aortic aneurysms frequently have concomitant coronary artery
      disease, which carries the potential for significantly increased perioperative
      morbidity. Most cases of severe surgically correctable coronary artery disease
      can and should be treated by a separate operation before aneurysmectomy to lower
      operative cardiac morbidity and enhance long-term survival. Infrequently, a
      patient can have both unstable coronary disease and a large symptomatic aortic
      aneurysm. In this situation, a single procedure combining coronary artery bypass
      followed by aneurysmectomy, as illustrated by this case report, is a reasonable
      option and should be considered in the cases of carefully selected patients.

PMID- 8351568
TI  - Latex-induced anaphylaxis.

PMID- 8351569
TI  - Significant elevation of CA 19-9 in chronic active hepatitis.

PMID- 8351570
TI  - Splenectomy in the HIV-infected patient.

PMID- 8351571
TI  - [Common errors in small bowel examination--recognition, avoidance and quality
      assurance].

PMID- 8351572
TI  - [Potential clinical applications of the FCR AC-1 in digital luminescence
      radiography].

PMID- 8351574
TI  - [A comparison of magnetic resonance tomography and bone scintigraphy in the
      diagnosis of spinal bone metastases].

PMID- 8351573
TI  - [Magnetic resonance tomographic studies in diseases of the hip joint].

PMID- 8351575
TI  - [Principles and possibilities in the treatment of multiple injuries].
AB  - The authors describe the therapeutic results in 135 patients with multiple
      injuries hospitalized at the Surgical Clinic of the Third Medical Faculty,
      Charles University in 1981-1990. The authors analyze the procedure in the
      treatment of these patients which is provided by the most experienced surgeon in
      collaboration with his assistant. A stage-by-stage procedure and early indication
      of operation is the most important aspect of treatment.

PMID- 8351576
TI  - [Anomalous origin of the right coronary artery from the pulmonary artery].
AB  - The authors report a rare case of the abnormal origin of the right coronary
      artery from the pulmonary artery, presenting with severe angina. Surgical
      correction-reimplantation of anomalous origin into the aorta-was carried out. As
      demonstrated by angiography six months after operation, previously present
      collaterals to the right coronary artery are no longer visualized, right coronary
      is patent with filling from aorta. The patient is only mild symptomatic due to
      diffuse atherosclerotic stenosis of the left coronary artery.

PMID- 8351577
TI  - [Splenosis].
AB  - Four patients where during childhood splenectomy was performed on account of a
      traumatic indication were after 9-12 years subjected to sonographic and
      scintigraphic examination focused on possible evidence of splenosis. In one case
      asymptomatic splenosis was detected by scintigraphy.

PMID- 8351578
TI  - [An unusual case of extensive false aneurysm of the superior gluteal artery].
AB  - The authors describe an uncommon case of a false aneurysm of the superior gluteal
      artery, most probably of post-traumatic aetiology. The condition was resolved by
      exclusion of the aneurysm from the circulation. In the available literature no
      reference to a similar clinical finding and its treatment was found.

PMID- 8351579
TI  - [Endoscopic wedge-shaped lung biopsy--initial experience].
AB  - The authors publish their initial experience with wedge-shaped pulmonary biopsy
      by the endoscopic route. The group is formed by 18 patients who were indicated
      for the operation on account of a disseminated pulmonary process in order to
      assess the micromorphological appearance of the affected lung tissue. Two
      patients developed a complication during operation which therefore was completed
      by minor thoracotomy. In who patients the authors observed after operation slow
      expansion of the pulmonary parenchyma. No death after the operation was recorded.
      The authors assume, based on their initial experience, that this operation will
      soon be included among common diagnostic operations and will help to facilitate
      the diagnosis and selection of treatment in patients with disseminated lung
      disease.

PMID- 8351580
TI  - [Use of the Apache II scoring system for clinical evaluation of the status of
      patients with gastrointestinal hemorrhage].
AB  - The Apache II scoring system has been used to identify a clinical status of 10
      patients, admitted to the intensive therapy unit with bleeding to
      gastrointestinal tract during the period 1. January - 30. Juni 1992. There were 9
      men and 1 woman with mean age of 61.5 years (37-82). Apache II score was
      calculated before beginning of treatment and 4 times during following 3 days
      every 12 or 24 hours. The mean score before beginning of treatment was 9.7 (5
      17). All the patients were treated exclusively by the conservative therapy with
      mean length of hospitalization 8, 1 days (4-12). The score during the therapy has
      had a decreasing tendency and statistically significant decrease came after 72
      hours of treatment. Mortality rate at mentioned values was zero. The use of the
      Apache II scoring system contributes to improvement of clinical judgment of
      patients with gastrointestinal bleeding.

PMID- 8351581
TI  - [Use of cultured epidermal autotransplantation in a severely burned patient].
AB  - In the submitted paper the authors describe in detail the administration of
      cultivated epidermal autotransplants (CEA in a patient with severe burns (80% of
      the body surface). They draw attention to several problems which occurred during
      treatment: a) a relatively small overall increase of CEA and the long time
      required for their cultivation, b) the very difficult preparation of infected
      wound surfaces for transplantation, c) secondary healing of CEA. The solution of
      these problems is according to the authors optimization of the laboratory
      technique of CEA cultivation and substitution of the dermal component of skin.

PMID- 8351582
TI  - [60 years' of the Trauma Hospital in Brno].

PMID- 8351583
TI  - [Report on the activity of regional surgical societies].

PMID- 8351584
TI  - An update on gastrointestinal surgery.

PMID- 8351586
TI  - New advances in the understanding of Barrett esophagus.

PMID- 8351585
TI  - Noncardiac thoracic surgery in children: an overview.

PMID- 8351587
TI  - Limitations and pitfalls of laser angioplasty.
AB  - Overall, the initial and long-term results of LABA have been disappointing. Poor
      initial recanalization rates and high restenosis and hemodynamic failure rates
      have caused investigators to reevaluate the indications for LABA. This
      reevaluation has resulted in an appropriate limitation of the indications for
      LABA. At present, LABA is probably indicated only for the treatment of patients
      with symptomatic, isolated arterial occlusions in whom conventional balloon
      angioplasty cannot be done because mechanical recanalization using a guidewire is
      not possible. Other uses of LABA in patients with peripheral vascular disease are
      discouraged and should be considered experimental. New innovations in technology,
      including improved arterial imaging techniques and better laser delivery systems,
      are required before LABA can become a standard therapy for the treatment of
      patients with peripheral vascular disease. A search for an "ideal" laser
      wavelength for arterial recanalization is futile until these developments occur.
      Once these innovations are in use, laser angioplasty may be an important
      technique in the treatment of peripheral vascular disease. This potentially
      valuable tool for the vascular surgeon should not be abandoned. Rather, it should
      be laid aside until it is better developed.

PMID- 8351588
TI  - Newer aspects of trauma care.

PMID- 8351589
TI  - Sports-related injuries to the shoulder and knee.

PMID- 8351590
TI  - Penile microvascular arterial bypass: indications and surgical considerations.

PMID- 8351592
TI  - Venous access devices: a review.

PMID- 8351591
TI  - Evolving management of biliary tract disease.
AB  - The variety of treatments available for gallstone-related problems require a
      multidisciplinary approach with involvement of the surgeon, endoscopist, and
      radiologist. Many conditions, until recently treatable only by an open operation,
      can now be satisfactorily dealt with by minimally invasive or endoscopic
      techniques. The benefits of such techniques are immediately apparent in terms of
      reduced hospital stay and early patient recovery. The pace of progress,
      particularly in the area of laparoscopic biliary surgery, is rapid and has
      important implications for surgical training and resources. Careful audit and
      prospective trials, when appropriate, are required to determine optimum treatment
      strategies for patients with benign biliary disease. These are exciting times in
      surgery, but our enthusiasm for new techniques should not cloud time-honored
      surgical principles.

PMID- 8351593
TI  - Recent advances in the management of intra-abdominal infections.

PMID- 8351594
TI  - Anal sphincter function: fecal incontinence and its treatment.

PMID- 8351595
TI  - Unsolved problems in endoscopic surgery.

PMID- 8351596
TI  - Proctors, preceptors, and laparoscopic surgery. The role of "proctor" in the
      surgical credentialing process.

PMID- 8351598
TI  - Management of bile leaks following laparoscopic cholecystectomy.
AB  - In a series of 650 consecutive laparoscopic cholecystectomies, nine bile leaks
      were identified (1.4%). Patients with bile leaks presented clinically at a mean
      of 4.9 days (range: 3-8 days) after surgery complaining of diffuse abdominal
      pain, ileus, and nausea. Laboratory values for complete blood counts and liver
      function tests were all mildly elevated. Definitive diagnosis was made on the
      basis of abnormal hepatobiliary scintigraphy. Management strategies included
      laparotomy and drain placement (n = 1), laparoscopy and drain placement (n = 3),
      ERCP and drainage (n = 4), and CT-guided percutaneous drainage (n = 1). When the
      etiology of the leakage was identified, it was most commonly either dysfunction
      of the cystic duct clips (n = 3) or leakage from a disrupted duct of Luschka (n =
      2). The source of the remaining leaks (n = 4) was never determined. We conclude
      that bile leaks are an uncommon cause of morbidity following laparoscopic
      cholecystectomy. Diagnosis can usually be made with nuclear medicine biliary
      tract scans and a variety of managements alternatives are successful in treating
      this complication.

PMID- 8351597
TI  - Current dilemmas in management of common duct stones.

PMID- 8351599
TI  - Laparoscopic cholecystectomy for acute cholecystitis.
AB  - Because laparoscopic cholecystectomy reduces hospitalization time and
      postoperative disability, it is being offered to an increasing number of patients
      with symptomatic gallstones. Nevertheless, acute cholecystitis is still
      considered by many surgeons to be a relative contraindication. Our standard
      approach has been to perform laparoscopy on all patients considered candidates
      for cholecystectomy. From June 1990 to October 1991, the authors personally
      performed laparoscopic cholecystectomy on 110 patients, 29 (26%) of whom had
      pathologically confirmed acute cholecystitis. Of these, nine had evidence of
      gangrene, perforation, or abscess formation. It was necessary to convert to open
      cholecystectomy in four (14%) patients. In each, inflammation or dense adhesions
      precluded the performance of a safe operation. The hepatorenal space was drained
      in 12 (41%) and cystic dust cholangiograms were performed selectively. The mean
      operating time was 108 min. There were no intraoperative complications. One
      patient developed a prolonged postoperative paralytic ileus and two patients were
      noted to have postoperative common duct stones. There were no deaths. The average
      postoperative stay for laparoscopic cholecystectomy was 2.6 days. We conclude
      that the advantages of laparoscopic cholecystectomy can be safely and effectively
      extended to the majority of patients with acute cholecystitis.

PMID- 8351600
TI  - Safe laparoscopic cholecystectomy in a community setting, N = 762.
AB  - Laparoscopic cholecystectomy (LC) can be introduced into a community with
      morbidity and mortality rates equal to that of open cholecystectomy. The entire
      general surgical community of Greensboro, NC, learned the technique of LC on
      animal models prior to offering this innovation to the community. Over the
      ensuing 12 months, they served as surgeons or assistant surgeons to each other on
      762 LCs with morbidity and mortality rates comparable to open cholecystectomy.
      This retrospective study examined the first 1 year of experience beginning
      8/13/90. This work represents all of the LCs performed in Greensboro, and all of
      the surgeons participated in this review. All of the surgeries were done with an
      electrocautery and utilized a 0 degree forward-viewing scope. Cases were
      performed at two hospitals with a surgeon as both operator and assistant, and no
      effort was made to exclude high-risk or elderly patients from this procedure.
      Patients averaged 50 years of age and ranged from 14 to 96 years. Static
      cholangiograms were performed in 27% of patients. Conversion to open
      cholecystectomy was seen in 4.8%. There were two cardiac deaths (0.26%) and
      significant complications were seen in 3.4%. Seven patients required
      reoperations. There were no major common bile duct injuries. This retrospective
      review indicates that this new procedure can be introduced into a community
      setting by novice laparoscopic surgeons acting both as operators and assistant
      with a morbidity and mortality rate comparable to that reported for open
      cholecystectomy.

PMID- 8351601
TI  - Percutaneous endoscopic gastrostomy (PEG) in cancer patients.
AB  - Ninety-nine cancer patients underwent PEG placement attempt at Rosewell Park
      Cancer Institute between January 1, 1985, and December 1, 1987. Ninety-eight of
      these were successful and were retrospectively reviewed to determine if cancer
      patients constitute a high-risk group for PEG placement. Procedure-related
      mortality was 2% and morbidity was 19%. Morbidity of 17% was noted at less than
      30 days and 2% had late complications. Six complications were considered serious
      with peritonitis in 3 and tube loss in 3 patients; an additional 4 patients had a
      failure of adequate GI tract decompression which was the indication for their PEG
      placement. Ascites was a major factor in morbidity with 4 of 5 patients with
      ascites having complications including the 2 deaths. Overall major morbidity was
      not increased in cancer patients without ascites including a group of patients
      with carcinomatosis (18 patients) and 22 patients requiring preoperative
      dilatation and/or tumor ablative procedures. We conclude that morbidity in cancer
      patients is not increased if one excludes those with ascites from the procedure.

PMID- 8351602
TI  - Laparoscopic-guided feeding jejunostomy.
AB  - Access for long-term enteral nutrition has long been the job of the surgeon.
      While percutaneous endoscopic gastrostomy has revolutionized the way we provide
      gastric feedings, jejunal access usually requires laparotomy. We have developed a
      technique for placing a laparoscopic guided jejunostomy. Twenty-three patients
      have undergone this procedure without complication. We believe this technique
      will be a valuable addition to the surgeon's options for obtaining enteral
      access.

PMID- 8351603
TI  - A prospective randomized trial comparing pneumoperitoneum and U-shaped retractor
      elevation for laparoscopic cholecystectomy.
AB  - Between April and August 1991, 83 Japanese patients with symptomatic gallstones
      underwent laparoscopic cholecystectomy in our clinics. A prospective randomized
      trial was carried out to examine the safety, efficacy, and complications of the
      two techniques, pneumoperitoneum vs an elevating method using a U-shaped
      retractor. Forty-two patients were randomly allocated to the pneumoperitoneum (P)
      group and 41 to the U-shaped retractor (U) group. These two groups were well
      matched with respect to age, sex, etiology, and the severity of the chronic
      cholecystitis. Laparoscopic resection was successful for 88.1% (37/42) in the P
      group and 100% (41/41) in the U group. In patients with a severe fibrotic
      gallbladder, the rate of success was significantly higher (P < 0.05) in the U
      group (100%, 6/6) than in the P group (11.8%, 1/6). In the moderately inflamed
      group, the operation time (mean +/- SD) was significantly (P < 0.01) less in the
      U group (58.7 +/- 22.7) than in the P group (87.3 +/- 18.3). With the U-shaped
      retractor the usual surgical instruments can be used, and a rapid and safer
      laparoscopic cholecystectomy can be carried out. We prefer this approach to a
      pneumoperitoneum for patients with an inflamed gallbladder as hospital stay and
      pain are minimal.

PMID- 8351604
TI  - Laparoscopic inguinal hernioplasty. Repair with a conventional vs a new self
      expandable mesh.
AB  - Laparoscopic hernioplasty was performed in a prospective fashion in 100 inguinal
      hernias in 66 patients. When available, a self-expanding prosthesis of Mersilene,
      strengthened with a cross- or star-shaped wire of Nitinol, was used without
      fixation (group B, 43 hernias). When this prosthesis was not available, a
      "classic" Prolene prosthesis was used, placed preperitoneally, and stapled
      according to the technique of Corbitt (group A, 57 hernias). This study compares
      the results of the two techniques. The use of a mesh-expanding Nitinol frame
      significantly shortens the operating time. Since two recurrences appeared in this
      group, we suggest that this modified mesh should also be stapled in place.

PMID- 8351605
TI  - Proximal gastric vagotomy by minimally invasive methods in an acute rat model.
AB  - In this prospective study, minimally invasive methods of proximal gastric
      vagotomy (PGV) were investigated in male Sprague-Dawley rats. Completeness of
      vagotomy by traditional operative therapy, by laser denervation of the gastric
      serosa, and by subserosal or transmucosal injections of chemoneurolytic agents
      was evaluated with postoperative Congo red testing, ulcerogenic stimulation of
      the gastric mucosa, and histochemical labeling of whatever vagal fibers remained
      in the gastric wall. Short-term results demonstrate that successful PGV can be
      performed with minimally invasive methods.

PMID- 8351606
TI  - Laparoscopy-guided intracorporeal ultrasound accurately delineates hepatobiliary
      anatomy.
AB  - The purpose of this study was to develop a technique and assess the ability of a
      laparoscopic ultrasound probe to delineate biliary antomy and to determine the
      presence or absence of duct stones. METHODS: Five pigs had ultrasonography of
      biliary structures and liver at laparoscopy followed by cholangiograms and
      anatomical dissection. Five patients had ultrasonography of the biliary tract at
      laparoscopic cholecystectomy. RESULTS: All animals had adequate visualization of
      important hepatobiliary structure, and an optimal method of accessing these
      structures at laparoscopy was established. Patients had ultrasonography which
      used methods developed in the animal trial. All had adequate visualization of the
      entire common bile duct confirmed by cholangiography. Limitations in
      demonstrating the relationship of the cystic duct to the common duct were
      technical and can be corrected. CONCLUSION: Laparoscopic ultrasonography has
      significant potential for delineation of biliary anatomy and determination of
      presence or absence of duct calculi. Clinical implementation could minimize the
      risk of iatrogenic duct injury and the need for operative cholangiography.

PMID- 8351607
TI  - Thoracoscopic treatment of spontaneous pneumothorax with the ENDO-GIA-Stapler.
AB  - Spontaneous pneumothorax carries a high risk of recurrence after treatment by
      intercostal drainage only. In such cases and in patients with persistent air
      leaks under adequate drainage we avoided correction by open thoracotomy using
      thoracoscopic techniques. On five patients we performed six resections of lung
      areas bearing blebs or bullae. An ENDO-GIA-Stapler was used for transection and
      closure of the lung tissue. In one patient a partial apical pleurectomy was added
      and in four patients an additional pleurodesis with silver nitrate was performed.
      An immediate air-tight suture was achieved in every case. There were no
      complications associated with this method. The postoperative pain and the length
      of hospital stay were markedly reduced compared to open thoracotomy procedures.
      During the follow-up period (3-7 months) no recurrence was noticed.

PMID- 8351608
TI  - Conversions and complications of laparoscopic cholecystectomy. Results of a
      survey conducted by the French Society of Endoscopic Surgery and Interventional
      Radiology.
AB  - During 1991, 41 surgeons of the French Society of Endoscopic Surgery and
      Operative Radiology (SFCERO) performed 3,673 cholecystectome of which 2,955 were
      laparoscopic. Data for those patients in whom a conversion to laparotomy was
      necessary or a complication occurred were collected by a retrospective
      multicenter survey. Conversion was performed in 142 patients (4.8%): in 106 this
      was due to pathology in the subhepatic space; in 36 it was because of a
      complication related to the laparoscopy. There were 101 postoperative
      complications (morbidity 3.4%): 59 biliary and 42 non biliary complications and
      six deaths (mortality 0.2%). There were 18 bile duct injuries, one of which led
      to the death of the patient. Excluding conversions to laparotomy, these figures
      are comparable to those for open cholecystectomy. These results define the limits
      and advantages of laparoscopic cholecystectomy. Conversion to laparotomy remains
      a wise option in cases of technical difficulty or doubtful biliary anatomy.

PMID- 8351609
TI  - Ultrasound in the diagnosis of roundworms in gallbladder and common bile duct.
      Report of four cases.
AB  - Four patients who complained of symptoms and signs compatible with biliary tract
      disease and in whom the diagnosis of gallbladder (three cases) and common bile
      duct ascariasis (one case) was made sonographically are reported. In two patients
      with gallbladder ascariasis, cholecystectomy corroborated the presence of the
      round-worms, and was curative. The third patient was a pregnant woman (32nd
      gestational week) who took piperazine citrate, and a second sonogram performed 29
      days later was completely normal. The fourth patient with common bile duct
      ascariasis underwent choledochotomy with extraction of one ascaris lumbricoides
      from the common duct, and a T tube was left in place for 15 days. All patients
      received antiparasitics and had a favorable outcome. Ultrasonography is an
      important noninvasive diagnostic procedure in the work-up of these patients, who
      usually describe a clinical picture suggesting gallstone disease: this is
      especially true in the presence of pregnancy.

PMID- 8351610
TI  - Splenic injury and abscess complicating endoscopic retrograde
      cholangiopancreatography.
AB  - A subcapsular hematoma of the spleen was incurred during ERCP and papillotomy.
      This was complicated by development of a splenic abscess, which was treated by
      percutaneous drainage.

PMID- 8351611
TI  - Laparoscopic surgery in the rat. Description of a new technique.
AB  - We report a method of laparoscopic surgery in the rat. Our technique is
      illustrated by gastric fundoplication requiring two-handed dissection, suturing,
      and knot tying. This model for laparoscopic surgery is relatively inexpensive,
      can be extended to other operations, and makes use of an extensively studied
      animal. These factors may facilitate investigation of the physiologic effects of
      minimal access surgery.

PMID- 8351612
TI  - Problem-solving in laparoscopic surgery.
AB  - The advent of the laparoscopic revolution and the wider applicability of
      laparoscopic procedures has caused surgeons to re-think the dynamics of
      intraoperative problem-solving. Problems of body habitus, previous surgery,
      exposure, bleeding, and anesthesia, as well as the problem cholangiogram, require
      new and innovative approaches, a practical approach to each of these common
      laparoscopic problems is presented.

PMID- 8351613
TI  - Principles of endoscopic and laparoscopic ultrasound.

PMID- 8351614
TI  - Laparoscopic repair of paraesophageal hiatal hernias.

PMID- 8351615
TI  - The Endo clip applier--a superior extracorporeal knot pusher in disguise?

PMID- 8351616
TI  - Guidelines for diagnostic laparoscopy. Society of American Gastrointestinal
      Endoscopic Surgeons (SAGES).

PMID- 8351618
TI  - Guidelines for office endoscopic services. Society of American Gastrointestinal
      Endoscopic Surgeons (SAGES).

PMID- 8351617
TI  - The role of laparoscopic cholecystectomy (L.C.). Guidelines for clinical
      application. Society of American Gastrointestinal Endoscopic Surgeons (SAGES).

PMID- 8351619
TI  - Guidelines for submission of continuing medical education seeking SAGES
      endorsement for courses in laparoscopic surgery. Society of American
      Gastrointestinal Endoscopic Surgeons (SAGES).

PMID- 8351620
TI  - Neurosurgery in San Diego: a historical vignette.

PMID- 8351621
TI  - Dural carotid cavernous sinus fistula presenting as isolated oculomotor nerve
      palsy.
AB  - We report five patients with dural carotid cavernous sinus fistula presenting
      with isolated oculomotor nerve palsy. All patients were older women with a
      fistula derived from the internal carotid artery, who had early filling of the
      supero-posterior cavernous sinus, followed by drainage posteriorly into the
      inferior petrosal sinus, with low shunt flow. The hypothesized pathogenesis was
      nerve compression by an expanding sinus, or ischemic neuropathy secondary to
      venous congestion or arterial steal. Dural carotid cavernous sinus fistula must
      be considered in patients presenting with isolated oculomotor nerve palsy.

PMID- 8351622
TI  - Unilateral hydrocephalus resulting from occlusion of foramen of Monro: a new
      procedure in the treatment: stereotactic fenestration of the septum pellucidum.
AB  - Obstruction at the foramen of Monro resulting in unilateral hydrocephalus is an
      uncommon entity that may be caused by a wide range of lesions including tumors,
      vascular malformations, and inflammatory conditions. A case of unilateral
      hydrocephalus secondary to congenital atresia of the foramen of Monro treated
      with stereotactic fenestration of the septum pellucidum is presented.

PMID- 8351623
TI  - Sphenoid sinus mucopyocele with marked intracranial extension: a more common
      phenomenon in the Third World?
AB  - Sphenoid sinus mucoceles are rare lesions. Those with intracranial extension were
      thought to be extremely rare in Western literature. We encountered three such
      cases within 1 year. These cases were confirmed on pathological examination to be
      pyoceles of the sphenoid sinus, extending to the sella and suprasellar region.
      Bilateral exophthalmos, papilledema, and severe headache were among the most
      consistent findings encountered. It appears that these lesions might be more
      common in areas of poor socioeconomic status like Third World countries. This
      condition should be considered in the differential diagnosis of lesions of the
      sella extending to the suprasellar region.

PMID- 8351624
TI  - Unilateral pterional approach to bilateral cerebral aneurysms.
AB  - Between 1976 and 1991, we determined that 19 patients harboring bilateral
      supratentorial aneurysms should be approached in a single sitting through a
      unilateral pterional craniotomy. Using microsurgical techniques, the Sylvian
      cistern was opened widely to expose the aneurysms located ipsilateral to the
      craniotomy. These aneurysms were clipped in the usual fashion. Following
      clipping, a tunnel was developed over the contralateral anterior cerebral artery
      and over or under the contralateral optic nerve allowing access to the opposite
      carotid and middle cerebral arteries. The contralateral nonruptured aneurysms
      were clipped in a routine fashion. We were able to clip or wrap with muscle all
      bilateral aneurysms in 15 cases, and we have concluded that this approach can be
      safely employed in selected patients with bilateral supratentorial aneurysms, and
      thus a second craniotomy can be avoided.

PMID- 8351625
TI  - Malignant schwannoma of the cerebellum: case report.
AB  - A case of malignant cerebellar schwannoma is presented in a woman aged 61 years.
      A malignant schwannoma of the cerebellum has not been previously reported in the
      literature. The histological, immunocytological, and ultrastructural properties
      suggested that this lesion was a malignant, partially epithelioid schwannoma.

PMID- 8351627
TI  - Spinal xanthogranuloma in a child: case report.
AB  - A case of a patient with a xanthogranuloma in the thoracic spine is presented.
      Magnetic resonance imaging revealed an intradural extramedullary tumor between T6
      and T9 as a low-intensity mass on both T1- and T2-weighted images. Total removal
      of this tumor was achieved through a laminoplastic laminectomy. Differentiation
      of this disease from other xanthogranulomas in the central nervous system is
      discussed.

PMID- 8351626
TI  - Congenital subclavian steal syndrome with anomaly of the aortic arch.
AB  - A case of congenital subclavian steal syndrome associated with an anomalous right
      sided aorta is reported. A 41-year-old man complaining of vertigo and a loss of
      consciousness was admitted. Physical examination revealed a blood pressure
      differential between the arms that was 20 mm Hg less in the left. Aortography
      showed a right aortic arch from which arose the right subclavian and both common
      carotid arteries. The left subclavian artery did not opacify. Right vertebral
      angiography showed retrograde filling of the left vertebral. A left carotid
      subclavian bypass was performed. Postoperatively, the patient is symptom free
      with equalized blood pressure.

PMID- 8351629
TI  - Resolution of focal CT hypodense lesions in patients with subarachnoid
      hemorrhage.
AB  - Cerebral infarction in the setting of vasospasm due to subarachnoid hemorrhage
      (SAH) is a known complication of aneurysmal rupture. Computed tomography (CT) has
      been instrumental in making this diagnosis; however, focal hypodense lesions on
      CT scan do not always represent infarcted tissue. Two patients are presented here
      who had CT hypodense lesions in regions of cerebral vasospasm following
      subarachnoid hemorrhage.

PMID- 8351628
TI  - Ultrasound-guided brain biopsy: a personal experience with emphasis on its
      indication.
AB  - Between January 1989 and June 1991, 40 ultrasound-guided biopsies of
      supratentorial brain lesions exceeding 15 mm in diameter were performed. The
      apparatus used was Berger's neurobiopsy set, intraoperative 5 = MHz transducer,
      and a B-mode scanner. In 38 cases (95%) the procedure provided a histological
      diagnosis at the first attempt; in two patients, early in the present series,
      biopsy was repeated by computed tomography-guided technique due to insufficient
      samples. Operative mortality was zero and there were no septic complications.
      Clinical symptoms were stationary after the procedure in 34 cases; two cases
      temporarily worsened due to postbiopsy edema and subcortical hemorrhage,
      respectively; and four other cases showed an improvement as a result of
      evacuation of neoplastic cysts. Histologically, there were 24 primary malignant
      tumors, eight low-grade glial tumors, five metastatic tumors, two abscesses, and
      one lymphoma. The ultrasound method for brain lesion biopsy was found to be a
      simple, quick, and low-cost method that gave reliable results. It is indicated
      for supratentorial lesions over 15 mm in diameter that do not demand absolute
      anatomical accuracy.

PMID- 8351630
TI  - Hydrosyringomyelia-Chiari I complex. Prospective evaluation of a modified foramen
      magnum decompression procedure: preliminary results.
AB  - A modified foramen magnum decompression procedure, designed to respect the
      subarachnoid spaces as much as possible, was prospectively evaluated in eight
      consecutive patients with a progressive clinical syndrome related to
      hydrosyringomyelia-Chiari I complex. This evaluation included quantitative
      clinical and magnetic resonance follow-up of at least 1 year in the first six
      patients and 6 months for the last two. Magnetic resonance scans at 6 months or
      more confirmed a persistent reduction of the hydrosyringomyelic cavity in all
      cases, which was associated with obvious subjective improvement. All patients
      have maintained this improvement. The operative technique and methods of clinical
      and radiological follow-up are discussed.

PMID- 8351631
TI  - Mycotic aneurysms of the intracavernous carotid artery.

PMID- 8351632
TI  - Contributions to a seminar on the history of neurosurgery on the West Coast.

PMID- 8351633
TI  - The development of neurosurgery in northern California.

PMID- 8351634
TI  - History of neurosurgery in Oregon.

PMID- 8351635
TI  - Brain tumors always die: a satiric parade. 1937.

PMID- 8351636
TI  - [Sports capacity of patients with scoliosis].
AB  - The burden of sport of patients with scoliosis depends on the age, the expected
      progredience of the deformity and the attained deformation. In children and
      teenagers treated with an orthesis, total prohibition is not appropriate. All
      kinds of sport not involving any risk of injury to the participant or the patient
      wearing an orthesis can be practised. The orthesis may be removed only during
      swimming. For patients with a fused spine the number of the remaining lumbar
      moving segments and the deformity are essential for the exercise load. If there
      are less than three free lumbar segments all kinds of sport with axial and
      rotationary burdens are not to be recommended. If the spinal bending is more than
      50 degrees (Cobb) the limitation of the cardiopulmonary ability is even more
      severe.

PMID- 8351637
TI  - [Current aspects of meniscus transplantation].
AB  - Meniscus transplantation is a common procedure for some orthopaedic surgeons all
      over the world. Deep frozen as well as freeze-dried meniscal allografts were
      transplanted. Reconstruction of the knee ligaments after meniscectomy as well as
      surgical therapy of osteochondral defects of the knee joint after meniscectomy
      are some of the indications for meniscus transplantation. Our own long-term
      results of freeze-dried meniscus, however, showed a degeneration of the
      transplants after two years up to a meniscus regenerate. Deep frozen meniscus
      transplants may be contaminated with virus (e.g. Hepatitis, AIDS). Taking the
      infrapatellar fatty pad for meniscal replacement (as suggested by Lexer) we saw
      only a weak meniscus like tissue after the first year postoperatively. The tendon
      meniscus by means of autologous tendon for meniscus replacement may be an
      alternative procedure. Therefore, meniscus transplantation cannot be recommended
      at present as a standard procedure for reconstruction of the knee joint.

PMID- 8351638
TI  - [Osteochondrosis dissecans of the knee and sports].
AB  - Osteochondritis dissecans (O.d.) of the knee is a common disease, but the
      aetiological factors are still controversial. With a follow-up examination of 97
      surgically treated patients (109 lesions) we looked for the influence of
      preoperative sports activities as a possible aetiological factor. Most of the
      patients complained first symptoms at puberty age between 10 and 15 years, girls
      with a mean age of 12.4 years and boys with a mean age of 15 years. Because of
      that, humoral factors are supposed to have influence on the onset of this lesion.
      Also patients with O.d. of the knee demonstrated a high rate of sports activities
      and/or trauma prior to the onset of symptoms. There was also a good correlation
      between lesions at the medial condyle with varus malalignment. Additionally, in
      most of the patients a high grade of general ligament laxity could be observed at
      the follow-up examination. It seems that biomechanical factors have an important
      aetiological influence on the initiation of O.d. at the knee. At the date of
      follow-up examination all patients reported on a minor sports activity in
      comparison to sports activities prior to the onset of symptoms. The amount of
      postoperative sports activities depends on the level of the resulting Lysholm
      score and on the grade of osteoarthritis.

PMID- 8351639
TI  - [Stress fractures of the navicular bone--biomechanical and densitometry studies].
AB  - One of the most important pathogenetic mechanisms regarding stress fractures of
      the navicular bone lies in the hyperpronation movement of the foot. For recording
      the impacts of the pronation movement on the talonavicular joint, stress and
      pressure experiments are carried out and the radii of curvature as well as the
      bone density are measured. The stress experiments show a rotation movement of the
      talar head in a medioplantar direction of about 20 degrees. The radii of
      curvature of the articulating joint surfaces do not differ to a great extent. A
      possible incongruency in the joint therefore has to be attributed to the rotation
      movement of the talus during pronation of the foot. The pressure experiments show
      a very irregular distribution of pressure in the joint presenting a lateral and
      medial pressure maximum. Fractures preferably occur in the area in between these
      maxima. Areas of high subchondral bone density in the densitometric results are
      found in the central part of the talar head as well as in the medial part of the
      navicular bone. Within the functional adaptation the distribution of bone density
      expresses the rotation movement of the talus during pronation of the foot.

PMID- 8351640
TI  - [Overuse syndrome in ballet: study of the effect of a tape bandage of the upper
      ankle joint with motion analysis].
AB  - In six ballet dancers with overuse syndromes of the foot a study on the effect of
      taping on stabilisation, proprioception and muscular activity was performed. By
      using synchronous surface electromyography and 3-dimensional motion analysis
      three standard ballet positions without and with applied tape were performed.
      Muscular activities of pronator muscles (peroneus longus) and supinator muscles
      (tibialis posterior) were recorded. EMG measurements showed significant
      differences between patients with stable or unstable ankles and painful or pain
      free feet. Applying tape led to significant changes of muscle activities in
      height and antagonist reflex patterns. These changes were highest in dancers with
      unstable ankle joints and metatarsalgia.

PMID- 8351641
TI  - [Traumatic occlusion of the internal carotid artery as an injury sequela of
      soccer].
AB  - The largest number of people engaged in sports in Germany play football. There
      were about 1.5 million sports injuries annually in the previous Federal Republic
      of Germany. Steinbruck (5) reported that the highest number was found in football
      players, in whom the injuries of the legs are most frequent. Head and vascular
      injuries are unusual and seldom in football players. We report on the case of a
      patient who received an elbow blow from his opponent. He developed a stroke with
      hemiparesis because of a traumatic dissection of the A. carotis interna.

PMID- 8351642
TI  - [The special case].

PMID- 8351643
TI  - Josef Warkany 1902-1992.

PMID- 8351645
TI  - Embryonic development of the mammalian caudal neural tube.
AB  - In the literature, some controversy still exists about the embryonic
      developmental processes involved in the formation of the caudal neural tube.
      Therefore, a three-dimensional and histological study concerning the normal
      development of the caudal neural tube was performed on both mouse and human
      embryos. Three developmental processes can be distinguished in caudal neural tube
      development: caudal neuropore closure, secondary neurulation, and degeneration
      and differentiation of the secondary neural tube. Caudal neuropore closure occurs
      at the level of somite 32-34 in both species. Therefore, primary neurulation
      leads to the formation of all spinal cord segments and ganglia. Secondary
      neurulation involves cell deposition from a cluster of neurectodermal cells at
      the caudal end of the closed neural tube, directly around a lumen, the lumen
      always in contact with the lumen of the primary neural tube. This process leads
      only to the formation of the primordia of the filum terminale and ventriculus
      terminalis and, possibly, part of the conus medullaris. Secondary neurulation is
      followed by a period characterized by degeneration and differentiation of the
      secondary neural tube. Its lumen and neural tissue will disappear, whereas part
      of the secondary neurectodermal cells differentiate to a fibrous layer comparable
      and continuous with the marginal layer of the primary neural tube. This fibrous
      layer represents the future filum terminale. The embryological processes
      indicated above can be helpful in the interpretation of congenital anomalies
      affecting the caudal spinal cord and spine.

PMID- 8351644
TI  - Hydantoin syndrome with holoprosencephaly: a possible rare teratogenic effect.
AB  - We report on a newborn girl with lobar holoprosencephaly and clinical signs of
      hydantoin syndrome. During pregnancy the mother was treated with
      diphenylhydantoin and primidon for psychomotor and petit mal seizures. The
      possible relationship between hydantoin syndrome, holoprosencephaly, and maternal
      intake of anticonvulsants during pregnancy is discussed.

PMID- 8351646
TI  - Developmental toxicity evaluation of diethyl and dimethyl phthalate in rats.
AB  - Diethyl phthalate (DEP) and dimethyl phthalate (DMP), phthalic acid ester (PAE)
      plasticizers, were evaluated for developmental toxicity because of reports in the
      literature that some PAE were embryotoxic and teratogenic. A previous study
      (Singh et al., '72) suggested that an increased incidence of skeletal defects in
      rats might result from gestational exposure to DEP (0.6-1.9 g/kg) or DMP (0.4-1.3
      g/kg), ip, on gestational days (gd) 5, 10, and 15. In the current study DEP (0,
      0.25, 2.5, and 5%) or DMP (0, 0.25, 1, and 5%) in feed (approximately 0.2-4.0
      g/kg/day) were supplied to timed-mated rats from gd 6 to 15. Treatment with 5%
      DMP resulted in increased relative maternal liver weight. Also, animals exhibited
      reduced body weight gain during treatment (5% DEP or DMP) and during gestation
      (5% DEP). Weight gain corrected for gravid uterine weight was also reduced in
      animals fed 5% DEP. However, high-dose treatment with either DEP or DMP resulted
      in changes in food and water consumption paralleling the body weight reductions,
      suggesting that apparent toxic effects on maternal body weight may reflect
      PAE/feed unpalatability. Treatment with 2.5% DEP resulted in only transient
      changes in body weight during early treatment. The only maternal effects at 0.25
      or 1% DMP were minor changes in food and/or water consumption, and there were no
      effects at 0.25% DEP. Thus, the NOAELs for maternal toxicity were 1% DMP and
      0.25% DEP. In contrast to the observed maternal toxicity, there was no effect of
      DEP or DMP treatment on any parameter of embryo/fetal development, except an
      increased incidence of supernumerary ribs (a variation) in the 5% DEP group.
      These results do not support the conclusion of other investigators that DEP and
      DMP are potent developmental toxicants. Rather, they suggest that the short-chain
      PAE are less developmentally toxic than PAE with more complex substitution
      groups, e.g., di(2-ethylhexyl) phthalate, mono(2-ethylhexyl) phthalate, and butyl
      benzyl phthalate.

PMID- 8351647
TI  - The effect of tolbutamide on rat embryonic development in vitro.
AB  - Tolbutamide (TOLB) is a sulfonylurea used to treat non-insulin-dependent diabetes
      mellitus and is a suspected teratogen. However, it is not possible to
      discriminate between potential teratogenic effects of TOLB and malformations
      produced by either drug-induced hypoglycemia or the diabetic state itself. We
      examined the direct effect of TOLB on rat embryos cultured in a rodent whole
      embryo culture system. CD strain rat embryos were cultured for 48 h beginning on
      day 9 of gestation (plug day = day 0). Tolbutamide was added at various
      concentrations (90-3,600 microM). At the end of culture, viable embryos were
      examined for morphological score, number of somite pairs, crown-rump and head
      lengths, and DNA and protein content. Tolbutamide produced dose-related decreases
      in all endpoints at concentrations (2,250-3,600 microM) which are two to four
      times the human therapeutic concentration. Sera from TOLB-treated rats were
      adjusted to contain equal concentrations of glucose and insulin and then used for
      embryo culture. Serum from TOLB-treated rats had no observable effect on
      embryonic development. The mechanism for the embryotoxic effect of TOLB is
      unknown; however, the drug was previously demonstrated to alter activity of
      purified yeast glutathione reductase (GR). Because GR may be important for normal
      embryonic development, the effect of TOLB on this enzyme activity in cultured rat
      embryos was evaluated. Tolbutamide (2,700 microM) reduced embryonic GR activity
      by 35-57%. These results indicate that TOLB has a direct embryotoxic effect at
      levels 2 to 4 times the usual therapeutic serum concentrations on developing
      rodent embryos which may be mediated by GR inhibition.

PMID- 8351648
TI  - Potentiation of triamcinolone-induced cleft palate in mice by maternal high
      dietary fat.
AB  - This study investigated whether the current range in dietary fat levels, which
      has arisen partly in response to some major health concerns, would affect
      frequency of congenital anomalies if continued into the period of early
      pregnancy. The effect of 5.6%, or 48% of calories from fat in the maternal diet,
      was tested on pregnant strain CD-1 mice injected with triamcinolone in doses of
      0.01 mg, 0.02 mg, 0.04 mg, or 0.06 mg per day on days 11 through 14 of gestation.
      Frequency of cleft palate increased with increasing doses of triamcinolone, with
      clefts of the palate being rare at the two lower doses. No clefts appeared
      without triamcinolone on either diet. In combination with triamcinolone
      treatment, 226 fetuses exposed to a maternal low fat diet had normal palates and
      86 had cleft palates. With exposure to high fat, 186 fetuses had normal palates
      and 101 had cleft palates, which was a significant increase in clefting (p <
      0.05). Also, the latter group showed a greater degree of retardation in palate
      development (p < 0.05). Thus both a greater frequency and a more severe form of
      clefting support the conclusion that high dietary fat potentiated the cleft
      palate-producing effects of triamcinolone in mice.

PMID- 8351649
TI  - Evaluation of developmental toxicity of coniine to rats and rabbits.
AB  - Conium maculatum (poison hemlock, CM) is teratogenic in several domestic species,
      presumably due to its piperidine alkaloids, including coniine, which has been
      verified to be teratogenic in cattle. Coniine/CM teratogenicity culminates in
      production of arthrogryposis. The purpose of this study was to evaluate coniine
      induced teratogenicity in two laboratory animal species, Sprague-Dawley rats and
      New Zealand white rabbits. Pregnant rats were given coniine (25 mg/kg body
      weight) by oral gavage at 8-hour intervals on gestation days 16-18. Pregnant
      rabbits were given coniine (40 mg/kg body weight) by oral gavage at 8-hour
      intervals on gestation days 20-24. Rats were killed on day 19 and rabbits on day
      29. Fetuses were immediately removed, weighed, and examined for external
      abnormalities. Alternate fetuses were either stained for skeletal examinations
      with alizarin red-S or fixed in Bouin's solution for visceral examination.
      Symptoms of maternal intoxication due to coniine administration were observed in
      both the rat and the rabbit, and higher doses were uniformly lethal. Rabbits
      treated with coniine appeared to lose more weight and eat less than controls, but
      there was no statistically significant difference between groups. Fetal weights
      were significantly lower in coniine-exposed rat and rabbit fetuses indicating
      fetotoxicity. The only statistically significant treatment-related visceral or
      skeletal malformation was a reduction of cranial ossification of rabbit fetuses,
      probably related to maternal toxicity. Coniine-exposed rabbit litters tended to
      be affected by arthrogryposis (no bony deformities noted on skeletal exam) more
      than controls (2/6 vs. 0/9).

PMID- 8351651
TI  - They're outta here ... or are they?

PMID- 8351650
TI  - Glucose causes lengthening of the microvilli of the neural plate of the rat
      embryo and produces a helical pattern on their surface.
AB  - Prominent microvilli have been observed on the surface of neural plates in the
      embryos of many species. Since glucose is the main source of energy for embryos
      before neural tube closure and the onset of vascular circulation, it was of
      interest to study the relationship between these microvilli and glucose
      utilization in the neural plate. By applying microdrops of amniotic fluid to
      chemstrips, which colorimetrically measure glucose by glucose oxidase reaction,
      we determined that day 10 rat amniotic fluid glucose level was 31.6 +/- 1.6
      mg/dl. On day 10 and within about 20 min from removal of the decidual sites, no
      glucose was found in the amniotic fluid. By use of a scanning electron
      microscope, the microvilli of the day 10 neural plate were found to have a 10
      fold increase in length during a 40-min exposure to Hanks' solution at 21-23
      degrees C. Similarly exposed embryos in Hanks' without glucose did not have
      microvillus elongation. However, under whole embryo culture conditions at 38
      degrees C no extension of the microvilli was found. In the closed neural tube of
      the day 10 embryo, the microvilli were stubby and did not elongate with glucose
      exposure. Similarly, day 11 and 14 embryos had short microvilli which did not
      elongate with direct exposure to glucose at 21-23 degrees C. The short microvilli
      on the surface of the closed neural tube on day 11, 14, and 16 were associated
      with low glucose concentrations in the neural tube fluids. By use of a field
      emission scanning electron microscope, the surfaces of the microvilli in the
      extended position were seen to be covered by a right-handed helical array of
      globular objects the size of large molecules. The findings support the hypothesis
      that microvillar length may modulate glucose uptake. Shortening is associated
      with low concentrations of glucose in closed neural tubes, and lengthening occurs
      at glucose exposures of 100 mg/dl.

PMID- 8351652
TI  - Texas short on occupational health care, study shows.

PMID- 8351653
TI  - Costs of on-the-job injuries high in Texas.

PMID- 8351654
TI  - Physicians must report elder abuse.

PMID- 8351655
TI  - Betty Anne Halpern, MD. Disc jockey doctor speaks truth over airwaves.

PMID- 8351656
TI  - Can a consultant help your practice chart a better course?

PMID- 8351657
TI  - Governor signs immunization bill.

PMID- 8351658
TI  - Lawsuit abuse takes toll in Rio Grande Valley.

PMID- 8351659
TI  - HCFA begins inspections of Texas physicians' office laboratories.

PMID- 8351660
TI  - New director, health commissioner talk about Texas Medicaid. Interview by Mark
      Richardson.

PMID- 8351661
TI  - Flawed malpractice study finds unjustified payments are uncommon.

PMID- 8351662
TI  - Coronary artery endarterectomy: a method of myocardial preservation.
AB  - The lack of acceptable coronary arteries for grafting often causes the cardiac
      surgeon considerable problems in treating patients with severe coronary artery
      disease. By combining the standard approach of coronary bypass surgery with
      coronary endarterectomy and with retrograde coronary sinus cardioplegia
      perfusion, we can achieve a longer ischemic period and can flush the debris from
      the coronary arteries in a retrograde fashion. Using this approach, we managed 72
      patients with near inoperable coronary artery disease. One third of these
      patients required endarterectomy of more than one vessel. A higher than expected
      number of patients had diabetes mellitus. The left coronary artery system
      required endarterectomy in almost 60% of patients, much higher than percentages
      reported in other series of patients. The mortality rate in our patients who
      underwent the left system endarterectomy was 5.7%. Endarterectomy must be
      considered an adjunct in the management of high-risk patients with severe
      coronary artery disease.

PMID- 8351663
TI  - Jones' fracture.
AB  - The Jones' fracture is defined as a transverse fracture of the proximal fifth
      metatarsal diaphysis within 1.5 cm of the tuberosity. It is classified
      radiographically as acute, delayed union and nonunion. Some orthopedists also
      have added a classification of stress fractures. The best form of treatment is
      based on the presence or absence of medullary sclerosis adjacent to the fracture
      site. In addition, the prescribed treatment must be adhered to by the patient to
      prevent increased morbidity associated with this fracture.

PMID- 8351664
TI  - Physicians should be able to dispense drugs to patients.

PMID- 8351665
TI  - Extended treatment with diltiazem hydrochloride successful.

PMID- 8351666
TI  - [Inventa nova--mile markers in the history of cardiology].

PMID- 8351667
TI  - [Epidemiologic aspects of heart failure: incidence, causes and follow-up].
AB  - Congestive heart failure can develop as a complication of virtually all forms of
      heart diseases. Depending on diagnostic criteria, the figures for prevalence and
      incidence differ markedly. The frequency of congestive heart failure increases
      with age and doubles in each life decade. In the United States the prevalence of
      1% and for Great Britain 0.4% respectively have been calculated. In the highest
      age groups up to 90 new cases/1000 population per year can be observed. As a
      contribution to decreasing mortality of acute myocardial infarction and better
      treatment of high blood pressure as well as congestive heart failure the number
      of patients in heart failure have increased substantially. In contrast to the
      Framingham Study, nowadays coronary artery disease is the most prevalent etiology
      of congestive heart failure followed by hypertensive heart disease. In younger
      patient groups with advanced heart failure, like heart transplant recipients,
      cardiomyopathies are the main etiologic factor. Heart failure is the leading
      factor for emergency admissions to hospital in adult internal medicine. The main
      reasons for decompensation are acute ischemic syndromes for acute congestive
      heart failure and compliance problems for chronic congestive heart failure. The
      natural history of congestive heart failure is characterized by a marked
      progression, increasing with the severity of heart failure. In parallel,
      mortality increases, too. A variety of clinical, hemodynamic neurohumoral and
      electrophysiologic factors have been described as independent factors predicting
      prognosis. 30 to 50% of heart failure patients die a sudden death as compared
      with progressive pump failure or infectious complications in the others.

PMID- 8351668
TI  - [Pathophysiology of heart failure: peripheral vascular and muscular mechanisms].
AB  - Exercise tolerance in patients with congestive heart failure correlates poorly
      with measures of systolic left-ventricular function and is determined by
      disturbances of the regulation of skeletal muscle perfusion and structural and
      metabolic changes of skeletal muscle itself. The increase in minimal vascular
      resistance in skeletal muscle is due to increased activities of the sympathetic
      nervous system, the renin-angiotensin and vasopressin systems and decreased and
      increased endothelium-mediated vasodilation and vasoconstriction, respectively.
      In addition, skeletal muscle atrophy, decreased oxidative capacity and a relative
      increase of easily fatiguable glycolytic muscle fibres also contribute to the
      reduction of exercise tolerance. The disturbances of skeletal muscle perfusion
      and changes of skeletal muscle are at least in part reversible by vasodilator
      therapy or, in the extreme situation, by cardiac transplantation.

PMID- 8351669
TI  - [Clinical diagnosis of heart failure].

PMID- 8351670
TI  - [Doppler echocardiography diagnosis in heart failure].
AB  - The evaluation of heart failure is one of the most common reasons for
      echocardiography in the adult population. Within this context, Doppler
      echocardiography as a noninvasive diagnostic procedure is able to provide
      immediate and relevant information on functional and structural changes
      underlying the clinical syndrome of heart failure. Analysis comprises global left
      and right-ventricular systolic function, regional wall motion and diastolic
      function. Evidence of normal systolic left-ventricular function has been reported
      in up to 30% of the patients with clinical signs of heart failure, suggesting
      abnormal diastolic function as the origin for the symptoms of heart failure.
      Therefore, noninvasive assessment of heart failure by Doppler echocardiography
      must include analysis of systolic as well as diastolic left-ventricular function.

PMID- 8351671
TI  - [Diagnosis of heart failure with radionuclide ventriculography].
AB  - Radionuclide ventriculography is presented as noninvasive scintigraphic method to
      assess the pump function of the heart. Its role in diagnosis and prognosis of
      congestive heart failure is described. Advantages and limitations of this
      technique as compared to echocardiography are discussed, and the importance of
      left-ventricular ejection fraction in the evaluation of congestive heart failure
      is critically reviewed.

PMID- 8351672
TI  - [Hemodynamics in heart failure: systolic and diastolic dysfunction].
AB  - Cardiac insufficiency is hemodynamically characterised by reduced cardiac output
      and increased diastolic filling pressure at rest and/or during physical activity.
      The increase in diastolic filling pressure compensates cardiac output and is
      either a result of increased initial tension of muscle fibers (Frank-Starling's
      Law) or a sign of decreased myocardial compliance. Increased initial tension of
      muscle fibers is a sign of systolic insufficiency, whereas reduced ventricular
      compliance indicates a disorder of diastolic ventricular function. In systolic
      insufficiency (= systolic dysfunction) a decrease in the ventricular ejection
      fraction is important, as is an increase in filling pressure. In diastolic
      congestive heart failure (= diastolic dysfunction) a reduced ventricular
      compliance with normal stroke function is typical.

PMID- 8351673
TI  - [Arrhythmias and heart failure].
AB  - Numerous factors contribute to the genesis of arrhythmias and sudden cardiac
      death in patients with congestive heart failure. Fibrosis of myocardium,
      ischemia, dilatation of the ventricles and atria, electrolyte imbalance, and
      neurohumoral factors are examples. Various drugs used in the treatment of
      congestive heart failure can also precipitate serious arrhythmias. The role of
      antiarrhythmics, including amiodarone, is still controversial. Judicious
      antiarrhythmic therapy involves weighing potential benefits of such therapy
      against risks, such as worsening heart failure or proarrhythmia. In patients with
      heart failure antiarrhythmic drugs should only be used for symptomatic
      arrhythmias. Low-dose beta-blockade offers a promising measure for the prevention
      of sudden cardiac death even in patients with symptomatic congestive heart
      failure.

PMID- 8351675
TI  - [Indications for heart transplantation, preoperative assessment and treatment].
AB  - Heart transplantation [HTx] is a therapeutic option for an end-stage congestive
      cardiomyopathy. At the present time five and ten years' survival results after
      cardiac transplantation can be compared to those of coronary bypass surgery in
      patients with a three-vessel disease. Ten-year survival after coronary surgery in
      patients with a three-vessel disease and impaired left-ventricular function is
      64%, without decreased left-ventricular function 72%, and after HTx between 60
      and 70%. In spite of good results HTx remains a therapeutic possibility only for
      well-selected candidates with an expected survival of less than twelve months.
      Symptoms and signs for a poor prognosis are: functional NYHA-class III-IV,
      cardiothoracic ratio > 0.55, walking distance of less than 300 m in the 6-minute
      walk test, VO2 max. of < 14 ml/kg, cardiac index < 2.25 l/min/m2, pulmonary
      capillary wedge pressure > 16 mmHg. A syncope of any origin is, in patients with
      functional class III-IV, associated with a 1-year sudden-death incidence of 45%.
      Because of a high daily variability, ventricular ectopy alone is of limited
      prognostic value. Secondary pulmonary hypertension is a common finding in end
      stage congestive heart failure. A mean pulmonary artery pressure above 55 mmHg
      and a transpulmonary gradient of > 12 mmHg are associated with a poor prognosis.
      If pulmonary vascular resistance exceeds 4 Wood units (320 dyn.sec.cm-5),
      reversibility has to be proved, using sodium nitroprussid or prostaglandine E1.
      An irreversible pulmonary vascular resistance above 8-Wood units (640 dyn.sec.cm
      5) is an absolute contraindication for HTx; lung or heart-lung transplantation
      are the only

PMID- 8351676
TI  - [Therapeutic potential of Ro 5-3335. New active benzodiazepine in vitro against
      HIV-1 viruses resistant or non-resistant to AZT].
AB  - Ro 5-3335 is a new benzodiazepine highly active in vitro (IC50 = 0.1-1.0 microM
      [corrected]) against HIV-1 viruses of AIDS resistant or non-resistant to
      zidovudine (AZT). It is also active against HIV-2. Ro 5-3335 is original by its
      mechanism of action, acting on the trans-activation factor of transcription (TAT)
      and non on the reverse transcriptase. Such as, it could prevent proviral DNA to
      express in both evolutive and silent AIDS resistant or non-resistant to AZT or to
      other anti-reverse transcriptase series. In addition, in antagonizing
      extracellular TAT's actions, Ro 5-3335 could alleviate the syndrome commonly
      associated with AIDS as Kaposi's syndrome. In rodent test, Ro 5-3335 has no
      diazepam-like central effects and presents in comparison to AZT a more favorable
      therapeutic index. In dog, the elimination half-life, peak concentration and
      availability are 2 h, 0.8 microM and 85% respectively, after a 1 mg.kg-1 oral
      dose of Ro 5-3335. Theoretically, Ro 5-3335 and now its analogue Ro 24-7429 seem
      to possess all virtues to antagonize evolutive and latent AIDS. Its arrival is
      timely to cope with the ever increasing resistance phenomena, lengthy development
      of AIDS vaccines, exponential contamination of populations worldwide and last but
      not least possibly to impede evolutions of the disease. Ability to manipulate TAT
      mediated activation of HIV-1 genes paves the ways to study conceivable
      corrections of abnormal gene expressions of neurotransmitters, hormones,
      oncogenes and key enzymes.

PMID- 8351677
TI  - [Posology of analgesics in patients with kidney failure].
AB  - Doses and dosing interval of analgesic drugs in renal failure are not always
      available in the data sheet compendium. The aim of the article is to analyse
      literature references and to present main pharmacokinetics modifications for each
      analgesic drug in renal failure. Pharmacokinetics parameters, doses and dosing
      intervals depending on creatinine concentrations are presented for each drug in a
      table.

PMID- 8351674
TI  - [Drug therapy of heart failure].
AB  - The amelioration of symptoms and the improvement of long-term prognosis are the
      main objectives of drug treatment in congestive heart failure [CHF]. Digitalis,
      glycosides and diuretics can reduce dyspnea and increase exercise tolerance,
      while their influence on the course of the cardiac failure remains uncertain.
      Vasodilators, ACE inhibitors in particular, have in contrast not only the
      desirable symptomatic and hemodynamic effects, but they also delay the
      deterioration of LV dysfunction and reduce cardiac mortality. Vasodilators,
      therefore, became first-line drugs in all stages of CHF. In patients with
      moderate to severe heart failure the addition of diuretics and also of digoxin is
      usually required. Pharmacological effects, dosage, side effects and specific
      indications of the various drug groups in CHF are discussed.

PMID- 8351678
TI  - Pharmacokinetics of prazosin administered as gastro-intestinal-therapeutic
      systems to 24 healthy volunteers.
AB  - Pharmacokinetics of prazosin was investigated after single dose administrations
      of four different formulations, according to a randomized trial, to 24 young
      healthy volunteers: immediate release tablets (3 x 1 mg) used as reference
      (Treatment A), two new Gastro-Intestinal-Therapeutic-Systems (GITS) containing
      2.5 mg (Treatment B) and 5 mg (Treatment C) of prazosin, and a traditional
      sustained release formulation (4 mg, treatment D). Relative bioavailability of
      prazosin administered as GITS was only 49.4 +/- 19.5% (B) and 45.5 +/- 18.7 (C)
      versus 73.8 +/- 13.9% (D) (area under the curve normalized at 3 mg dosing); but
      absorption was sustained and plasma concentrations were maintained at a virtually
      constant level for a time period close to 24 h. As a result, mean residence time
      (MRT) of prazosin was considerably increased after GITS administration: 21.6 +/-
      1.0 h (B), 22.5 +/- 1.6 h (C) instead of 5.9 +/- 0.2 h for the reference
      formulation (A) and 10.8 +/- 0.8 h for the traditional sustained release
      formulation (D). Although extrapolation to multiple dosing situations is
      difficult, this study demonstrates the potential suitability of prazosin GITS for
      once daily administrations.

PMID- 8351679
TI  - [Effect of dimethicone on pharmacokinetics and pharmacodynamics of ethyl
      biscoumacetate].
AB  - The influence of dimeticone (Gel de Polysilane Midy) on the pharmacokinetics and
      pharmacodynamics of oral ethyl biscoumacetate was studied in 6 healthy volunteers
      in a randomised single dose, two-way cross-over study. Each volunteer received at
      one week interval a single dose (300 mg) of ethyl biscoumacetate, either alone or
      with dimeticone. Ethyl biscoumacetate levels were measured in plasma for 24
      hours. Pharmacodynamic parameters were measured for 96 hours. Ethyl
      biscoumacetate peak concentration was significantly higher when administered with
      dimeticone (40.3 +/- 25.3 mg/l vs 31.0 +/- 25.7 mg/l; p = 0.031), without
      significant change in the area under curve. Other pharmacokinetic and
      pharmacodynamic parameters did not differ significantly. The slight increase of
      the ethyl biscoumacetate bioavailability with dimeticone in repeated dosing might
      have pharmacodynamic consequence; a clinical trial should address this question.

PMID- 8351680
TI  - [Economic aspects of pharmacovigilance in the pharmaceutical industry].
AB  - The economical aspects of pharmacovigilance in the pharmaceutical industry can be
      assessed by two ways. First the balance between cost of avoiding adverse drug
      reactions (ADR) and cost of ADR should be evaluated during the development. The
      company will have to take into account both efficacy and safety of its compound.
      However if it increases the costs of avoiding ADR it will reduce the costs of
      avoiding ADR occurring after commercialisation. On the other hand the cost of
      side effects of a marketed compound can also be appreciated. This assessment will
      always have to be comparative with an other drug and to take into account the
      benefit of both drugs, if their efficacy is not deemed identical.

PMID- 8351682
TI  - [Drugs involved in toxic epidermal necrolysis (Lyell's syndrome)].
AB  - Drug-induced toxic epidermal necrolysis (Lyell's syndrome) is a rare, potentially
      lethal disease that is characterized by the sudden necrosis of the epidermis and
      frequently associated with mucous and systemic involvement. Even though the
      etiology of the disease is probably multifactorial (including viral infections
      and anomalies of drug metabolism), its iatrogenic origin is the principally
      recognized cause. We have drawn up a substantial list of the culprit drugs
      showing their frequency of involvement in the syndrome.

PMID- 8351681
TI  - [Acute toxicity of zidovudine. Analysis of the literature and number of cases at
      the Paris Poison Control Center].
AB  - 13 cases of zidovudine overdosage have been previously published; 30 have been
      notified to Paris Control Poison Centre up to January 1991. This analysis shows
      that acute toxicity appears infrequent and mild when ingested dose is lower than
      25 gr. However it appears from this series that an haematologic monitoring is
      needed because of the risk of myelosuppression.

PMID- 8351683
TI  - [Evaluation of ten years of pharmacovigilance of antihypertensive drugs in the
      Toulouse University Regional Hospital Center (1981-1990)].
AB  - The eighties were characterized by the introduction of angiotensin converting
      enzyme inhibitors (ACEI) and calcium channel blockers (CCB) in the treatment of
      arterial hypertension. The present study investigates the side effects of
      antihypertensive drugs in the Toulouse University Hospital (France) between 1981
      and 1990. Most of the side effects involved ACEI (45%), CCB (22%) and diuretics
      (18%). Central antihypertensive agents and beta-blocking drugs were involved in 8
      and 9% of side effects respectively. During these 10 years, 197 side effects were
      reported in our hospital (3300 beds). Some of them were found more frequently:
      renal insufficiency (15%) or cough (9%) with ACEI, constipation (3%), gingivitis
      (1%) or lower limb oedema (4.5%) with CCB, hemolytic or autoimmune anemia (2.5%)
      and confusional state (1.5%) with central antihypertensive agents, nightmares
      (1.5%) with propranolol. The most frequently side effects were dermatological
      (20%), hydroelectrolytic (10%) and neuropsychiatric (9.6%) disturbances. In spite
      of the methodological problems of this kind of study (retrospective evaluation,
      under-notification of the side effects and different scores of imputability),
      these data indicate the most frequently observed side effects of antihypertensive
      agents during the eighties. It allows to estimate an approximate frequency of
      these side effects: among the antihypertensive drugs, CCB and diuretics seems the
      less frequently involved in the occurrence of reported side effects.

PMID- 8351684
TI  - Trends in the supply and use of lipid-lowering drugs in Spain, 1983 through 1991.
AB  - Trends in the supply and use of lipid-lowering drugs in Spain were studied
      throughout the period of 1983-1991. Although the supply of such drugs remains
      excessive, a trend towards more rational standards has been apparent: 20
      specialties out of 53 existing in 1983 have been withdrawn (10 fixed-dose
      combinations and 10 obsolete drugs). The overall use of lipid-lowering drugs rose
      from 2.51 DDD/1000 inhab/day in 1983 to 8.47 DDD/1000 inhab/day in 1991. The
      increase was mostly attributable to the subgroup of fibric acid derivatives (1.23
      DDD/1000 inhab/day in 1983 and 6.14 in 1991). The bile acid sequestrants
      accounted for a small fraction of the overall use (0.23 DDD/inhab/day in 1991),
      in spite of its increasing consumption. The use of the two subgroups, nicotinic
      acid derivatives and fixed-dose combinations, has declined. The introduction into
      the market of HMG-CoA reductase inhibitors in 1991 contributed to the increase of
      the overall use in 1.28 DDD/1000 inhab/day but it seems not to have any negative
      influence on the use of other subgroups. Although the prevalence rates of
      hypercholesterolemia are similar, the use of lipid-lowering drugs in 1991 in
      Spain was 3 to 8 times higher than that of the Nordic countries. In conclusion,
      our data suggest that lipid-lowering drugs are highly used in Spain, at least in
      comparison with other western countries, and that the pattern of drug use is not
      in accordance with international recommendations.

PMID- 8351685
TI  - [Measurement of cutaneous blood flow by laser Doppler velocimetry. Importance of
      probe effect and solvent effect after topical application].
AB  - A comparative methodological study of the probe and/or vehicle effects was
      performed in Human volunteers with two laser Doppler velocimeters (L.D.V.):
      Laserflo BPM 403, T.S.I., U.S.A. and Periflux PF2B, Perimed, Sweden. Individual
      variations of skin blood flow are great (up to 1,400%); this could be related to
      spontaneous variations and/or to the occlusive effect of the probe. Skin blood
      flow was significantly increased in 35% of the subjects after the application of
      the probe alone, and in 70 to 90% of the cases after topical application of water
      or ethanol (20 to 50 microliters). Lag times before vasodilatation measured only
      when the probe was applied on the skin were between 7.4 and 27 minutes, they were
      reduced between 5.2 and 8.3 minutes when the vehicles were applied. These data
      suggest that in any protocol for L.D.V. determination an absolute control and a
      vehicle control should be included to evaluate objectively topical vasoactive
      drugs.

PMID- 8351686
TI  - [Commentary: has patch-testing the value of challenge test in dermatology?].

PMID- 8351687
TI  - [Bullous iodides: unusual iatrogenic pathology].

PMID- 8351688
TI  - Fluoxetine-related indifference and akathisia. A case report.

PMID- 8351690
TI  - [Fatal adverse effects. Experience of the Midi-Pyrenees Pharmacovigilance
      Center].

PMID- 8351689
TI  - [Generalized epilepsy induced by trazodone].

PMID- 8351691
TI  - Study of cyclosporin A blood level during the early post-liver-transplantation
      period.
AB  - Correlations between acute rejection rate, cyclosporin A(CsA) blood level and CsA
      dose were studied in a group of 58 patients for 1 month following liver
      transplant. Therapy included prednisolone, azathioprine and CsA administered by
      continuous IV infusion. Blood CsA levels were measured by high performance liquid
      chromatography. No patient required renal dialysis. An acute rejection episode
      was recorded in 24 patients (group 1) between days 4 and 28 (mean 8 days), while
      34 patients (group 2) showed no signs of rejection. A significant difference was
      observed (p < 0.05) between blood CsA levels (mean +/- SEM over the 6 days
      preceding the rejection episode in group 1 patients, and the first 6
      postoperative days in group 2 patients (101 +/- 7 vs 121 +/- 5 ng/ml). The mean
      daily dose of CsA calculated over the same time period was significantly lower (p
      < 0.001) in group 1 patients (46 +/- 2 vs 60 +/- 2 mg/day). In addition, over the
      8 days following surgery, only 54% of patients in group 1 attained a mean blood
      CsA level of a least 100 ng/ml, compared to 94% in group 2.

PMID- 8351692
TI  - [Work loss and depression. Impact of fluoxetine].
AB  - The goal of our study was to explore the impact of various antidepressant drugs
      on the relative risk of work loss in depressed patients. 1,852 depressed patients
      (DSM III-R) were observed using a "cross-sectional" design. Patients were
      included into five groups: patients without antidepressant treatment, patients
      treated with one of the main antidepressant drugs in France (amineptine
      amitriptyline, clomipramine and fluoxetine). Primary variables were the
      depression intensity (Hamilton scores) and job status (work loss). The other
      parameters (clinical, demographic, economic, therapeutic) were used as
      potentially predicting variables. Data have been collected through a network of
      295 physicians (GP, Psychiatrists). The main socio-demographic characteristics of
      treated and untreated depressive patients, either working or absent from work,
      were predominantly female and city dwellers. A significant difference was found
      between working patients and work loss in terms of professional characteristics,
      i.e. type of employment (p < 0.001), type of employer (p < 0.05), level of
      responsibility (p < 0.01) and type of remuneration (p < 0.01). We found a
      positive correlation between depression severity and the risk of work loss (R2 =
      0.86, p < 0.001). This risk was significantly lower with fluoxetine compared to
      other treatments. Pooling these data with data from clinical trials led to a
      saving of 2.4 days (vs clomipramine) to 4.7 days (vs amitriptyline) (p < 0.05,
      respectively) of work loss per patient for a 8-week treatment period.

PMID- 8351693
TI  - [Quality of life and migraine. Validation of the QVM questionnaire in hospital
      consultation and in general medicine].
AB  - The feasibility, the validity and reliability of the questionnaire "Qualite de
      Vie et Migraine" (QVM) were assessed during a study performed on 107 patients
      recruited either in neurological departments in hospitals (N = 58) or by G.P. (N
      = 49). The study was designed as a Test-Retest, the self-questionnaire being
      filled twice at an interval of one week. The filling-in time was an average 7 min
      in hospital and 11 min for G.P.'s patients. The missing values were quite rare,
      between 1% and 2%. The items were assessed "very interesting" or "interesting" by
      94% of the patients, and "easy" or "fairly easy to understand" by 96%. The
      principal component analysis performed on the whole sample allowed the extraction
      of 4 meaningful factors which were in agreement with the pre-defined structure of
      the questionnaire QVM. The 1st axis was a factor of psychological repercussion,
      the 2nd axis was a factor of functional and somatic repercussion, the 3rd axis
      was a factor of social repercussion and the 4th one was a factor of disturbance
      generated by the treatment. The QVM questionnaire allowed the calculation of a
      global index of quality of life and indexes according to the multifactorial
      structure. The global index was significantly higher for the most severe patients
      recruited in hospital, which means that the repercussion of migraine on quality
      of life was greater than for G.P.'s patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351694
TI  - [High dose intravenous immunoglobulins in therapeutic arsenal in autoimmune and
      systemic diseases].
AB  - Immune globulin are extracted from plasma pooled from 1000 or more donors. Each
      lot should contain at least 90% of intact IgG. Intravenous immune globulin are
      recommended unequivocally for some diseases: acute autoimmune thrombocytopenic
      purpura of childhood, autoimmune erythroblastopenia, haemophilia with anti-VIII
      antibodies, Kawasaki's syndrome, and perhaps, Guillain-Barre syndrome.
      Nevertheless, this therapy has been reported to be beneficial for more than 35
      diseases thought to be produced by immunopathology. Large amounts of immune
      globulin, such as 400 to 2000 mg/kg are proposed over a period of two to five
      days. The safety of this treatment, which may be introduced without any special
      structure, is a very interesting quality of the intravenous immune globulin
      therapy. However, comparative efficacy against reference therapy, surveillance
      for long-term positive and adverse effects and cost-effectiveness should be
      carried out.

PMID- 8351695
TI  - Teenage pregnancy and child health in the urban Sahel.
AB  - Longitudinal data for more than 20,000 live births in the cities of Bamako (Mali)
      and Bobo-Dioulasso (Burkina Faso) are used to study the effects of young maternal
      age (less than 18 years and 18-19) on birth weight, child health care and feeding
      behavior, and child mortality, after controlling for other socioeconomic and
      demographic factors. Teenage pregnancies are associated with significantly worse
      prenatal health care and vaccination behavior, lower birth weights, earlier
      weaning, and, especially during the second year of life, higher mortality. A
      proxy for mother's school enrollment at the time of pregnancy is strongly linked
      to worse prenatal health behavior and weakly associated with other poor behaviors
      and health outcomes. Overall, the results highlight the importance of behavioral
      factors relative to strictly biological factors for explaining child health
      differentials.

PMID- 8351696
TI  - Safe abortions in an illegal context: perceptions from service providers in
      Belgium.
AB  - Until April 1990 abortion was illegal in Belgium all circumstances. However, a
      small group of health professionals had long provided high-quality abortion
      services in outpatient facilities and in hospitals. This study is a qualitative
      analysis of perceptions among providers of safe abortion in Belgium before and
      after it was made legal there. The providers' personal, psychological, and
      ethical reactions to abortion are investigated, as well as their opinions on how
      their activities should be organized in order to minimize problems. Standardized
      questionnaires with closed and open questions were used; 143 questionnaires were
      completed. Emotional reactions were reported as being the most difficult aspects
      of practicing abortion. The experience of Belgian practitioners is of value for
      health professionals working in a legally restricted setting who are willing to
      assume some judicial risks to facilitate legal change while demonstrating the
      public health utility of low-cost, safe abortion.

PMID- 8351697
TI  - The influence of spouses over each other's contraceptive attitudes in Ghana.
AB  - To what extent do spouses influence each other's reproductive goals? This
      question was investigated in Ghana with particular reference to family planning
      attitudes. Two mechanisms were identified as plausible explanations for why an
      individual's characteristics may affect a partner's beliefs and behavior.
      Quantitative evidence from the Ghana Demographic and Health Survey and
      qualitative information from focus-group research in Ghana were used in the
      analysis. Results from both data sources show that spousal influence, rather than
      being mutual or reciprocal, is an exclusive right exercised only by the husband.
      The study attributed the limited impact of family planning programs in Ghana and
      most of sub-Saharan Africa to the continued neglect of men as equal targets of
      such programs.

PMID- 8351698
TI  - A community study of gynecological and related morbidities in rural Egypt.
AB  - This study assesses the prevalence of gynecological and related morbidity
      conditions in a rural Egyptian community. A medical examination was conducted on
      a sample of 509 ever-married, nonpregnant women. For gynecological morbidities,
      genital prolapse was diagnosed in 56 percent, reproductive tract infections in 52
      percent, and abnormal cervical cell changes in 11 percent of the women. For
      related morbidities, anemia was present in 63 percent of the women, followed by
      obesity (43 percent), hypertension (18 percent), and urinary tract infection (14
      percent). Regression analysis of risk factors demonstrated the contribution of
      social conditions and medical factors to these diseases. Reproductive tract
      infections were shown to occur more frequently with uterovaginal prolapse, IUD
      use, presence of husband (regular sexual activity), and unhygienic behavior.
      Genital prolapse increased with age and number of deliveries. Age, recent
      pregnancy, education, socioeconomic class, and workload showed significant
      associations with related morbidity conditions. This evidence challenges national
      health programs to go beyond safe motherhood, child survival, and family planning
      in its services to women, and to consider the social context of health as well.

PMID- 8351699
TI  - The simulated client method: evaluating client-provider interactions in family
      planning clinics.
AB  - The "simulated client" method was first detailed in the family planning
      literature in 1985, but it has not been extensively covered since. As used by the
      authors to study client-provider interactions in family planning programs, this
      method essentially consists of sending women to a family planning service
      provider to request information, and interviewing them after the encounter. The
      women do not reveal to service providers they are participating in the study.
      This report describes the method; reviews some of the theoretical, ethical, and
      methodological issues related to it; and underlines its usefulness as a tool for
      examining quality-of-care issues in family planning programs.

PMID- 8351700
TI  - The cost of IUD failure in China.

PMID- 8351701
TI  - Indonesia 1991: results from the Demographic and Health Survey.

PMID- 8351702
TI  - Timeline of immunosuppression.

PMID- 8351703
TI  - 5th Asian Cyclosporine (Sandimmun) Workshop. Proceedings. Taipei, Taiwan,
      Republic of China, April 21-23, 1993.

PMID- 8351704
TI  - Optimization and long-term evaluation of renal function in sandimmune-treated
      renal allograft recipients.

PMID- 8351705
TI  - Effect of cyclosporine on renal function in survivors of liver transplantation
      after 1 year.

PMID- 8351706
TI  - Renal transplantation in the cyclosporine era.

PMID- 8351707
TI  - Long-term safety of cyclosporine in renal transplant recipients: worldwide
      experience.

PMID- 8351708
TI  - Current status of kidney transplantation and immunosuppressive therapy in Japan.

PMID- 8351709
TI  - Immune risk factors: impact on the incidence and diagnosis of rejection.

PMID- 8351710
TI  - Immunologic parameters for the diagnosis of graft rejection.

PMID- 8351711
TI  - Hyperlipidemia and hypertension: impact of steroid withdrawal.

PMID- 8351712
TI  - Simultaneous kidney-pancreas transplantation at the University of Wisconsin.

PMID- 8351713
TI  - Xenotransplantation: state of the art.
AB  - Today, at the beginning of the xenogeneic era of transplantation, only simple and
      single observations about comparative physiology and biochemistry, and even
      anatomy, are known. Very few data exist which in addition inform about mechanisms
      after successful xenotransplantation. Nothing is known about phenomena following
      successfully suppressed hyperacute xenogeneic rejection. Neither the elimination
      of single factors nor the mitigation of whole systems have led to clinically
      relevant survival times. Pig organs transplanted into nonhuman primates survived
      a maximum of 22 days. The hope that transgenic manipulation and modification
      would be useful to prolong survival times of xenogeneic grafts still waits for
      evidence. But, within a short time, xenotransplantation could enable patients to
      receive a life-saving animal organ as an alternative to an allograft.
      Xenotransplantation would, as a new dimension in medicine, shorten if not
      eliminate waiting lists. Therefore, scientists must vigorously develop
      xenografting as a viable alternative for transplantation.

PMID- 8351714
TI  - Ethical aspects in xenotransplantation.
AB  - Ethics aims to achieve optimal human behavior. However, applied ethics depend on
      the cultural environment. In medicine, ethics could allow an amoral operation in
      a fetus or in chronically ill patients because it is new and rich in prospects
      for acquiring knowledge and could improve the quality of life of the patient or
      at least save the life. The operation itself must not be ill natured or unethical
      and the patient must not be misled or given false hope over the outcome. Ethics
      would allow us to offend the dignity of man, such as by xenotransplantation,
      because the wish for well being is often greater than the desire to retain
      dignity. Ethics in xenotransplantation must be based on the interests of the poor
      and unlucky patient and must aim for the good of everyone, but especially meet
      the patient's demands.

PMID- 8351715
TI  - Design of clinical development in transplantation.

PMID- 8351716
TI  - State of the art of liver transplantation in the USA.

PMID- 8351717
TI  - Surgical refinements in liver transplantation.

PMID- 8351718
TI  - Optimization of cyclosporine therapy.
AB  - Cyclosporine is a potent tool in the immunosuppressive armamentarium. It provides
      relatively selective inhibition of T-cell responses without dampening nonspecific
      resistance. However, its use is confounded by a pleiotropic array of side
      effects, the most important of which is renal dysfunction with the not uncommon
      sequelae of hypertension, hyperuricemia, and hyperkalemia. The hepatic injury
      associated with CyA administration, which is characterized by a chronic elevation
      of serum transaminase values, is potentiated by azathioprine or recrudescent or
      de novo viral infections. Finally, the proclivity of the drug to produce
      hyperlipidemia may jeopardize long-term survival; patients not infrequently
      require gemfibrizol and/or pravastatin therapy to control triglyceride and/or
      cholesterol levels, respectively. Two strategies appear to be useful. Our
      concentration-control strategy assesses CyA exposure by analyzing serial
      pharmacokinetic profiles, titering drug doses to achieve initial steady state
      concentrations of 400 ng/mL during continuous i.v. infusion, and to achieve
      average concentrations, namely AUC divided by dosing interval (in hours), of 550
      ng/mL initially with trough levels of 200 ng/mL or above. Pretransplant
      pharmacokinetic profiling permits prediction of the appropriate initial i.v. dose
      in 73% of patients, and in combination with a posttransplant profile of the oral
      dose in about 60% of patients. The target oral concentrations are progressively
      reduced, thereby permitting prospective CyA control and minimizing adverse
      effects. The second synergistic drug strategy uses the median effect mathematical
      model to identify new drug combinations. The combination of CyA with RAPA, a
      macrolide which inhibits lymphokine signal transduction, and with BQR, a difluoro
      quinoline carboxylic acid analog that inhibits pyrimidine biosynthesis, permits
      at least a 20-fold reduction of the CyA dose in rat allograft models as well as
      prevents the activation of some CyA-resistant rejection pathways. Future
      investigations of pharmacologic strategies are undoubtedly likely to re-enforce
      the efficacy and safety of CyA administration for a range of immunologic
      disorders.

PMID- 8351719
TI  - Development of the living-related donor liver transplant program at the Texas
      Medical Center: initial results and surgical complications.

PMID- 8351720
TI  - Extracorporeal liver assist device (ELAD): a preliminary report.

PMID- 8351721
TI  - Prolonged administration of recombinant granulocyte-macrophage colony-stimulating
      factor (GM-CSF) after T-cell-depleted allogeneic bone marrow transplantation.

PMID- 8351722
TI  - Bone marrow transplantation for pediatric patients with severe aplastic anemia in
      Taiwan.

PMID- 8351723
TI  - [Cutaneous manifestations of AIDS].

PMID- 8351724
TI  - [Perimenopausal hemorrhage of uterine origin].

PMID- 8351726
TI  - [Liver tumors manifested as hemorrhages: 9 case reports].

PMID- 8351725
TI  - [Conservative treatment of cancer of the breast in Tunisia].

PMID- 8351727
TI  - [Epidemiology of diabetic retinopathy].

PMID- 8351728
TI  - [Endemic goiter: 39 particular case reports].

PMID- 8351730
TI  - [Cutis marmorata telangiectatica congenita: 2 case reports].

PMID- 8351729
TI  - [An anatomo-clinical and histogenetic study of Kaposi's sarcoma].

PMID- 8351731
TI  - [Hydatidiform mole coexisting with a normal fetus: a rare case report and review
      of the literature].

PMID- 8351732
TI  - [Effect of ethanol on carboxypeptidase H in the rat brain].
AB  - It is established that under a single-dose introduction of ethanol activity of
      carboxypeptidase H increases. During chronic consumption of ethanol changes of
      enzyme activity was less than during a single-dose introduction of ethanol. Most
      considerable changes in carboxypeptidase H activity are observed in the pituitary
      gland, hypothalamus and striatum. Ethanol effect on the activity of membrane
      bound and soluble forms of enzyme was distinguished. It is supposed that
      carboxypeptidase H is involved into the formation of response to ethanol.

PMID- 8351733
TI  - [Effect of an electromagnetic field on subtilisin from Bacillus subtilis 316 m].
AB  - The influence of electromagnetic field on the subtilisin of Bacillus subtilis
      strain 316 M preparation has been studied. It is the increase 30-60% of the
      proteolytic activity during 60-100 min treatment was observed. The effect of
      activation is stable for a month at +4 degrees C. The increase of the proteolytic
      activity is connected with conformational changes of the enzyme molecule, with
      the decrease of pI from 11.4 to 9.2 in particular.

PMID- 8351734
TI  - [Metabolism in experimental chronic ischemic heart disease].
AB  - An increase in frequency of heart contractions, changes in the bioelectrical
      heart activity and decrease of the force-pump heart function are observed in the
      rabbits with model chronic ischemic heart disease lipid metabolism in
      significantly changed the concentration of cholesterol in the right ventricle
      myocardium as well as the concentrations of unsaturated lipid acids in the heart
      tissues increase, while the content of saturated lipid acids and antioxidant
      activity of plasma decrease. Bioenergetic processes change as follows: succinate
      dehydrogenase and alpha-keto-glutarate-dehydrogenase activity decrease, while the
      concentrations of glycogen, lactic and pyruvic acids and lactate dehydrogenase
      activity in the heart tissues increase.

PMID- 8351735
TI  - [Optimal conditions for the functioning of a urease-based biosensor and pH
      sensitive field transistors. Determination of urea in solution].
AB  - The article deals with the optimal conditions of urea determination in solution
      by the enzyme sensor based on pH-sensitive field effect transistor. The
      dependence of response level on temperature, pH, ionic strength, buffer capacity
      were investigated. 10 mM phosphate buffer, pH 7.4 containing 200 mM NaCl is
      optimal for possible measurements of urea in diluted blood. Temperature change in
      the measured samples from 15 degrees to 30 degrees C does not affect the sensor
      signal value. Stability of immobilized ureas was investigated at storage under
      different conditions. In the presence of 1 mM EDTA activity of immobilized enzyme
      does not change during one month storage at 4 degrees C.

PMID- 8351736
TI  - [Effect of fluoroaluminate on the passive transport of calcium in the plasma
      membrane fraction of the pig myometrium].
AB  - Study of the effect of aluminium, fluoride-ions and fluoroaluminium on the
      passive transport of Ca2+ through the plasma membrane of the myometrium cells has
      shown that 10 microM of Al3+, 1 mM of F- and the both ions taken in the mentioned
      concentrations do not affect this process. At the same time 10 mM of F- as well
      as 10 microM of Al3+ together with 10 mM of F- inhibit a passive output of
      calcium from vesicles. The results obtained suppose that inhibitory regulation of
      the passive transport of calcium in the myometrium sarcolemma is executed through
      Gi-protein.

PMID- 8351737
TI  - [Cartilage collagen in health and in pathology].
AB  - The paper deals with the latest data on structure organization of collagen
      proteins--basic and minor components of the extracellular matrix of the animal
      cartilage tissue. Their genetic determination and tissue specificity, differences
      in the initial structure, sizes of spiral and globular domains, availability of -
      SH- and --S--S-bonds are emphasized. Data are presented which confirm that the
      change in the collagen state is one of the determining factors in pathogenesis of
      the cartilage tissue.

PMID- 8351738
TI  - [Expression and function of x-mla genes associated with leukemic transformation
      of cells].
AB  - Expression of genes, associated with leukemic transformation and called x-mla,
      was studied in cells of various types of experimental leukemia and in homologous
      normal cells. Augmentation of x-mla expression in malignant haemopoietic cells
      and lack or very low expression in normal tissues and non-haemopoietic tumors of
      mice and rats has been revealed. The involving of x-mla in proliferation control
      of leukemic but not normal cells has been shown. Product of x-mla--p46 was
      synthesized in cell-free translational system and purified. Its amino acid
      composition was determined and its mitogenic, RNAase activities, and ability to
      phosphorylation have been investigated.

PMID- 8351739
TI  - [Properties of basic (splitting off arginine and lysine residues)
      carboxypeptidases and their role in the functioning of biologically active
      peptides].
AB  - Properties of carboxypeptidases that cleaved arginine and lysine from C-terminus
      of peptides are considered. Their role in processing, modulation and inactivation
      of active peptides are discussed. Mechanisms of regulation of carboxypeptidase H
      activity are considered.

PMID- 8351740
TI  - [Purification and properties of lectins of Polygonatum multiflorum [L.] All. and
      Polygonatum verticillatum [L.] All].
AB  - The lectins from rootstocks of Polygonatum multiflorum [L.]. All. and P.
      verticillatum [L.] All. were purified by affinity chromatography on thyroglobulin
      sepharose. Purified lectins were obtained from fresh raw material of P.
      multiflorum and P. verticillatum, 340 mg/kg and 120 mg/kg, respectively. The both
      lectins do not contain carbohydrates. Amino acid analysis has shown that the both
      lectins had high content of asparaginic acid/the lectin from P. verticillatum
      almost 28%. Ion-exchange chromatography permitted separating the lectin from P.
      multiflorum into 8 isoforms, that did not differ in molecular weight. Purified
      lectins interacted with sialic acid and did not interact with other
      monosaccharides. Purified lectins agglutinated rabbit and rat erythrocytes best
      of all, they less agglutinated mice and horse erythrocytes, but did not
      agglutinate human, cow, sheep and frog erythrocytes at all. Lyophylized lectins
      are amorphous white powders, that are well soluble in distilled water. Scientific
      production co-operative "Lectinotest" began serial production of lectin from
      Polygonatum multiflorum from 1992 year.

PMID- 8351741
TI  - [Effect of the hypothalamo-hypophyseal-adrenocortical system on the functional
      state of Hageman-dependent systems of blood after immobilization stress].
AB  - The reaction of haemostatic system under the condition of sympathetic receptions
      blocking and the suppression of the hypothalamic-hypophyseal-adrenocortical
      system reactivity as the result of immobilisation stress have been studied in the
      experiments on rabbits. It was found that the sympathetic nervous system and HHAS
      took part in the regulation of the blood coagulation, fibrinolysis and
      kininogenesis under stress-syndrome development by the activation of lysosomal
      apparatus of neutrophilic leukocytes of peripheral blood.

PMID- 8351742
TI  - [Isolation, purification and various properties of aspartate kinase from the
      cyanobacterium Plectonema boryanum].
AB  - The enzymic activity of aspartate kinase from filamentous cyanobacteria
      Plectonema boryanum at the logarithmic phase of growth has been studied.
      Aspartate kinase was purified eleven times and extracted in functionally
      homogeneous state from the cell-free extract by the methods of ammonium sulphate
      salting-out, ion-exchange chromatography and isoelectric focusing. Some physical
      and chemical characteristics of the enzyme have been studied: pI-7.2; optimum pH
      9.0; optimum temperature-55 degrees C. The dependence of enzymatic reaction on
      concentration of substrates, co-enzymes, cofactors and protein has been
      established. Regulation of aspartate kinase activity by amino acids of the
      aspartate family has been investigated. L-threonine, L-homoserine and L
      isoleucine (0.01-0.001 M) have a pronounced inhibitory effect. L-lysine and L
      methionine are not immediate inhibitors of aspartate kinase but intensify the
      inhibitory effect of threonine by the cumulative mechanism.

PMID- 8351743
TI  - [Tissue metabolism in ruminants as affected by ionophores].
AB  - Remarkably influencing the VFA formation processes and their ratio in the rumen,
      ionophore action involves the range of free amino acids and individual enzymatic
      reactions of subcellular fractions of the rumen mucosa, heart muscle and
      longissimus muscle, kidneys and liver. The discovered reverse relationship
      between changes of levels of aminoacylation of tRNA and the amount of the
      respective free amino acids possibly is one of the crucial links in the common
      regulatory mechanism aimed at the maintenance of the specific stability of tissue
      and organ metabolism (including protein biosynthesis) in ruminants. It seems to
      be responsible for different effects of the ionophore on the investigated
      processes in different tissues and organs.

PMID- 8351744
TI  - [Sensitivity of chlorpromazine-modified eryhtrocytes to cold stress].
AB  - Development peculiarities of hypertonic cold shock of erythrocytes modified with
      chlorpromazine were studied, maximum protection effect under cooling of cells is
      registered when using chlorpromazine in the concentration 7 x 10(-5) M. Spectrin
      denaturation does not change general pattern of the effect of different
      concentrations of amphipat on sensitivity of erythrocytes to the cold shock but
      it sensitizes cells modified by chlorpromazine (7 x 10(-5) M) to the further
      cooling. Differences between native cells and erythrocytes with denatured
      spectrin are levelled at higher concentrations of amphypat, certain protective
      effect being observed at certain values of the medium tonicity.

PMID- 8351745
TI  - [Effect of ionizing radiation on the structure of erythrocyte membranes].
AB  - Effect of electrons with the energy 5MeV on the erythrocyte ghosts structure has
      been investigated using fluorescent probes 1.8-ANS and DSP-12. The number of ANS
      binding sites was shown to decrease as affected by irradiation. It was found that
      radiation caused reduction of the erythrocyte membrane surface area.

PMID- 8351746
TI  - [Lipid peroxidation in sarcoplasmic reticulum membranes from rock perch and
      rabbit muscles].
AB  - Nonenzymic lipid peroxidation in the membrane of the fragmented sarcoplasmic
      reticulum from white dorsal muscle of teleost fish Scorpaena was studied. It was
      shown that the concentrations of ferrous ions 15 microM and ascorbic acid 0.3 mM
      were sufficient for lipid peroxidation activation. Ethanol inhibited lipid
      peroxidation of the fragmented sarcoplasmic reticulum membranes from white muscle
      of Scorpaena and rabbit.

PMID- 8351747
TI  - [Cu(2+) complexes as inhibitors of free radical oxidation of lipids].
AB  - Cu(2+) complexes of chelate ligands have been studied for their effect on
      oxidation of rat blood plasma lipids, sphingomyelin, lecithin by the method of
      chemoluminescence. The studied Cu(2+) complexes have been shown to possess pro
      oxidant and antioxidant properties depending on their concentration. Antioxidant
      activity of alpha-tocopherol, ionol (2,6-di(tert)-butyl-4-methylphenol) and
      Cu(2+) complexes by the lipid oxidation has been compared.

PMID- 8351748
TI  - [Effect of regulatory light chains of myosin on aggregation of its subfragment
      1].
AB  - Chymotryptic (Ch-Cl) and Mg(2+)-papain subfragments 1 of (Mg-Cl) skeletal myosin
      has been studied. Mg-Cl is known to differ from Ch-Cl by the presence of the
      regulatory light chain (RLC) and elongated heavy chain including C-end hinge
      segment. Experimental data prove the decisive part of coordination bondings with
      bivalent cations in stabilization of RLV on myosin head hinge segment.
      Hydrophobic interactions are also significant that is evidenced by the intensive
      aggregation between subfragment Mg-Cl molecules, after RLC dissociation.

PMID- 8351749
TI  - [Thrombolytic effect of plasmin, miniplasmin and fibrinolysin in simulated
      intraocular hemorrhage].
AB  - The fibrinolytic properties of the preparations of plasmin (Pm), mixture of
      plasminogen and streptokinase (Pg+Sk), miniplasmin (m-Pm) and fibrinolysin have
      been investigated on the models of rabbit's hyphema. The action of preparations
      of Pm and Pg+Sk had approximately equal therapeutic index--the total destruction
      of clots proceeded for 12.0 days, that was 6.6 days less than in the control
      group. The therapeutic effect for m-Pm was 3.6 days. The dose of preparation of m
      Pm, necessary for total destruction of clots, was 15-20% greater than for the
      same dose of Pg+Sk. The preparation of fibrinolysin, used in the same quantities
      of proteolytic activity, as Pg and m-Pg, (16 caseinolytic units per 1 injection)
      had no therapeutic effect.

PMID- 8351751
TI  - Metastasis of renal cell carcinoma to the contralateral renal pelvis.
AB  - Extremely rarely renal cell carcinoma metastasizes to the contralateral renal
      pelvis or ureter. The present report concerns a case where a metastatic tumor
      could be successfully removed from the left renal pelvis 3 years after right
      nephrectomy for the primary tumor. A review of the literature revealed this to be
      only the fourth such case documented.

PMID- 8351750
TI  - [Inactivation of glutathione reductase by quinones and nitrosocarbamides].
AB  - Quinones inactivate oxidized glutathione reductase (EC 1.6.4.2) from yeast with
      rate constants (ki) ranging from 0.03 M-1s-1 (p-benzoquinone) to 10(3) M-1s-1
      (bromanyl). It is glutathione, but not NADP+ that protects the enzyme from
      inactivation, which shows that quinones interact with a glutathione-binding
      centre, cysteine-2, most probably. The mechanism of inactivation by quinones
      differs from that by nitrosoureas which inactivate only the reduced enzyme,
      modifying the reduced catalytic disulphide. 1,3-bis-(2-chloroethyl)-1-nitrosourea
      acts as the most rapid inactivator of the enzyme, possessing ki of 0.77 M-1s-1.

PMID- 8351752
TI  - Two cases of urothelial tumor with high serum level of carcinoembryonic antigen
      and TA-4.
AB  - Two rare cases of urothelial tumor with high serum carcinoembryonic antigen (CEA)
      and TA-4 levels are presented. One is a case of lymph node metastasis due to
      bladder tumor: pathological diagnosis revealed mucoepidermoid carcinoma. The
      other is a case of left renal pelvic tumor: pathological diagnosis revealed
      transitional cell carcinoma with glandular and squamous differentiation. The
      serum CEA and TA-4 levels, high before surgery, decreased after surgery.

PMID- 8351753
TI  - Schwannoma of the penis.
AB  - A schwannoma located in the penile shaft in a 74-year-old patient is described. A
      review of the schwannoma of the penis is presented and the importance of the S
      100 protein stain is stressed.

PMID- 8351755
TI  - Platinum accumulation in the kidney and changes in creatinine clearance following
      chemotherapy with cisplatin in humans.
AB  - To evaluate the effects of repeated administration of cisplatin on kidney
      platinum (Pt) accumulation and renal function, Pt content in the kidney was
      determined in 31 autopsy cases and changes in creatinine clearance (CCr) were
      retrospectively assessed in 26 of 31 autopsy cases. There was no significant
      correlation between the cumulative dose of cisplatin and Pt content in the
      kidney. However, the kidney Pt level was correlated with the dose of cisplatin
      injected within a 7-month period prior to the patient's death. We suggest that
      the dose of cisplatin injected during a relatively short period before a
      patient's death affects Pt content in the kidney. Neither the total dose of
      cisplatin nor the Pt content in the kidney was significantly correlated with the
      decrease in CCr following chemotherapy with cisplatin.

PMID- 8351754
TI  - Continuous evaluation for retroperitoneal hematoma following extracorporeal shock
      wave lithotripsy.
AB  - In this paper we report on a patient with extensive retroperitoneal hematoma due
      to extracorporeal shock wave lithotripsy (ESWL) for a renal stone. The patient
      had a negative history of previous primary renal disease or risk factors for
      retroperitoneal hemorrhage after ESWL. The hematoma was treated conservatively
      and it was completely absorbed 9 months after ESWL as evaluated by computed
      tomography. Gd-DTPA-enhanced dynamic magnetic resonance imaging (dynamic MRI) was
      performed immediately after formation of the hematoma. The decrease in renal
      blood flow in the affected kidney could be observed in this patient by dynamic
      MRI and its time intensity curve.

PMID- 8351756
TI  - Mean nuclear volume of bladder cancer: stereological estimation and its clinical
      value.
AB  - Mean nuclear volumes (MNVs) of bladder cancer cells from the specimens of 100
      patients were estimated by stereological procedure. The value of MNVs of bladder
      cancer were ranged widely, from 114.6 to 1,041.9 microns3. However, strong
      correlation was observed between MNV and histopathological grade and stage.
      Furthermore, the MNV predicts the biological behavior including the malignant
      potential and prognosis of the patient. Patients with MNV below 315 microns3 had
      significantly better prognosis than those with MNV above this value (p < 0.01).
      The 5- and 10-year survival rates for patients with MNV below 315 micron3 were
      both 97%, while those for patients with MNV above 315 microns3 were 65 and 58%,
      respectively. MNVs of the recurrent tumors were significantly increased, compared
      with those of the initial tumors (p < 0.01). MNV of extirpated tumor specimens
      following chemotherapy consisting of cisplatin and Adriamycin through balloon
      occluded arterial infusion (BOAI) was significantly decreased, compared with that
      before BOAI (p < 0.01). We conclude that the MNV is an excellent predictor for
      the prognosis of the patient and the tumor recurrence. Furthermore, the
      stereological estimation of nuclear volume is a simple, quick, inexpensive, and
      reliable method to assess quantitative analysis of the histological and
      biological character of bladder cancer.

PMID- 8351757
TI  - Use of maintenance intravesical bacillus Calmette-Guerin (BCG), with or without
      intradermal BCG, in patients with recurrent superficial bladder cancer. Long-term
      follow-up of a randomized phase 2 study.
AB  - To study maintenance Bacillus Calmette-Guerin (BCG) therapy we treated 49
      patients with recurrent superficial bladder cancer pTa and/or carcinoma in situ,
      failing previous intravesical chemotherapy. They received 20 intravesical
      instillations in 1 year, with or without 6 intradermal inoculations. Side effects
      were frequent, causing treatment stop in 14 patients (29%). Drug-induced cystitis
      was the most frequent side effect, seen in 29 patients (59%). Forty-two patients
      were evaluable for response. During the first 2 years of the study 14 patients
      (33%) had one (n = 8) or more (n = 6) recurrences. A total of 18 patients (43%)
      remained recurrence free with a median follow-up of 47 months. Progression was
      seen in 2 patients from pTa to pT1, another patient died of metastatic bladder
      cancer after 47 months. PPD skin test conversion was of no prognostic value. The
      use of intradermal inoculations caused no significant increase of toxicity and
      had no effect on efficacy, however, both groups were small. It caused no local
      side effects. We conclude that maintenance BCG therapy can be useful for patients
      with recurrent superficial bladder cancer failing previous intravesical
      chemotherapy.

PMID- 8351759
TI  - Post-natal management of antenatally detected, bilateral hydronephrosis.
AB  - 26 children, with antenatally detected, isolated, bilateral hydronephrosis (thus
      consistent with pelvi-ureteric junction obstruction), were investigated for up to
      7 years. The aim was to avoid operation. 34 kidneys were never operated on.
      Despite initially often severe hydronephrosis and poor isotope wash-out on the
      renogram, half of the kidneys improved or even normalized during follow-up. The
      final glomerular filtration rate (GFR) was always normal or almost normal. 18
      kidneys came to surgery, because of poor filtration, symptoms or social reasons.
      At the end of the follow-up, GFR was normal in all but 2 kidneys. In a subgroup
      of the kidneys, with initially severe reduction in filtration, half were operated
      on and half were not; at the end, the GFR was normal in all of the non-operated
      kidneys (and in all but 1 of the operated kidneys). Total GFR was at the end
      normal or almost normal also in the children with persistingly filtration-reduced
      kidneys (always unilaterally), because of compensation by the contralateral,
      although hydronephrotic kidney. Thus, in this study the renographic parameters
      were not very helpful in predicting the prognosis. There was no consistent
      difference between operative and non-operative treatments on final filtration.
      Also hydronephrotic kidneys possessed a substantial capacity for contralateral
      compensation. It is concluded that the initial approach to bilateral, antenatally
      diagnosed hydronephrosis may safely be non-operative. This allows time for the
      clear expression of sustained impairment of renal filtration requiring surgical
      intervention.

PMID- 8351758
TI  - Single-dose versus 3-day prophylaxis with ciprofloxacin in transurethral surgery.
      A clinical trial.
AB  - In 235 patients who underwent transurethral surgery, perioperative oral
      ciprofloxacin prophylaxis was given as a single dose 500 mg versus a 3-day
      regimen. Out of 180 evaluable patients, 84 received a single dose and 96 received
      a 3-day course. In the single dose prophylaxis group there were 5 failures and in
      the 3-day prophylaxis group there were 6 failures. The difference is not
      significant. In 17 patients whose urine culture preoperatively yielded
      microorganisms the 3-day prophylaxis significantly eradicated the bacteriuria in
      83% of the patients.

PMID- 8351760
TI  - Promotion of metastases by tumor necrosis factor in rats bearing Dunning R3327
      MAT-LyLu prostatic cancer.
AB  - We examined the effects of recombinant human tumor necrosis factor (rTNF) on
      highly metastatic rat prostatic cancer, Dunning R3327 MAT-LyLu, in vivo. It
      seemed that the inhibition of tumor growth needed more than 5 x 10(5) units of
      rTNF and this dose was near the lethal dose. Concerning the effect of rTNF on
      metastasis, we found that the metastasis to lung was promoted by 1 x 10(5) units
      of rTNF and the promotion of metastasis was restricted by indomethacin. Although
      MAT-LyLu cells were producing a significant amount of prostaglandin E2, rTNF did
      not enhance the production. We therefore consider that the promotion of
      metastasis was not mediated by prostaglandin E2 from MAT-LyLu cells but was
      mediated by other very complicated conditions. Further studies are necessary to
      resolve the mechanisms.

PMID- 8351761
TI  - Changes of rat urinary bladder during acute phase of spinal cord injury.
AB  - Spinal cord injury (SCI) at Th13 was induced in female Wistar rats, and changes
      in the urinary bladder were examined during the acute phase of SCI. Wet weights
      of the spinal bladders increased twofold over controls by 7 days after SCI.
      Intravesical volumes increased sixfold over control values by day 3, and then
      decreased 7 days after the injury. Maximal pressure within the bladder decreased
      in all spinal rats compared with controls. Smooth muscle cells were isolated from
      the urinary bladder, and their total protein and DNA content were measured by
      multiparametric cytofluorometry. DNA content of isolated smooth muscle cells
      decreased by day 3 and remained 7 days after the spinal injury. Total protein
      content of isolated smooth muscle cells was decreased 1 day after and increased 7
      days after the spinal injury, just when spinal reflex of the bladder recovered.
      These findings suggest that hypertrophy of smooth muscle cells in urinary bladder
      is related to the activity of peripheral autonomic nerve and that smooth muscle
      cells already begin to hypertrophy during the spinal shock period to adjust
      themselves to the new state, that is, the spinal bladder.

PMID- 8351762
TI  - A case of weak mineralocorticoid-producing benign adrenal tumor.
AB  - Tumors producing weak mineralocorticoids are exceedingly rare and most of them
      predominantly produce 11-deoxycorticosterone. We present a case of adrenocortical
      adenoma in which the overproduction of 18-hydroxydeoxycorticosterone exceeded
      that of 11-deoxycorticosterone.

PMID- 8351763
TI  - Renal cell carcinoma insulated in the renal capsule with calcification and
      ossification.
AB  - We describe a case of renal-cell carcinoma insulated and entrapped in the renal
      capsule by a calcified and ossified rim. To our knowledge, this is the first time
      a renal-cell carcinoma of the renal capsule is reported. The fact that the tumor
      cells originated from the distal/medullary tubules was supported by
      immunohistochemical studies. The pertinent literature is reviewed.

PMID- 8351764
TI  - Spinal cord injury. An overview.
AB  - Advancements in the management of urologic complications such as the neurogenic
      bladder have been essential to improving the quality of life and longevity of
      patients with spinal cord injury. These advances are discussed in greater detail
      in the subsequent articles in this issue. Despite the many improvements that have
      been made in post-trauma care, spinal cord injury remains a devastating lesion of
      the nervous system. Current therapies have not proved to be particularly
      effective in preventing or reversing damage to the spinal cord. Still, every
      effort should be made to preserve remaining function and to prevent
      complications. The care of these patients has been significantly improved with
      the development of specialized multidisciplinary centers. The emphasis in current
      treatment focuses on rehabilitation and adaptation to the disability and on
      prevention of secondary disabilities. Research in basic and clinical neuroscience
      will result in better, more useful care and treatment for those with spinal cord
      injury. However, even then, a neurorehabilitation team will be essential to care
      for these patients. Continuing efforts must be made to ensure that people with
      spinal cord injury lead full and productive lives.

PMID- 8351765
TI  - Anatomy and physiology of the lower urinary tract.
AB  - The lower urinary tract has two main functions: storage and periodic elimination
      of urine. These functions are regulated by a complex neural control system
      located in the brain and spinal cord. This control system performs like a simple
      switching circuit to maintain a reciprocal relation between the reservoir
      (bladder) and outlet (urethra and urethral sphincter) components of the urinary
      tract. Spinal cord injury disrupts voluntary control and the normal reflex
      pathways that coordinate bladder and sphincter function. Studies in animals
      indicate that recovery of bladder function after spinal injury is dependent on
      the reorganization of reflex pathways in both the peripheral and the central
      nervous system. Part of this reorganization may be influenced by neural-target
      organ interactions that are mediated by neurotrophic factors released by the
      peripheral organs.

PMID- 8351766
TI  - Acute urologic management of the patient with spinal cord injury. Initial
      hospitalization.
AB  - The early urologic management of the patient with spinal cord injury can be
      straight-forward. Intermittent catheterization is the most acceptable therapy
      until final urologic decisions have been made based on appropriate urodynamic
      studies. The intermittent catheterization should be aggressive and periodic to
      empty the bladder, and the patients should be encouraged to do this independently
      when they are able to. Should any changes occur during this management, such as
      fever, infection, or dysreflexia, urodynamic studies should be done to identify
      high-pressure voiding with a high (40-60 cm H2O) leak-point pressure. Then,
      appropriate therapy should be instituted to lower the bladder pressure,
      including, initially, anticholinergic drugs and, ultimately, maybe another method
      such as a sphincterotomy. We usually reserve aggressive invasive therapy for
      patients whose spinal cord injury has totally evolved and who are rehabilitating,
      usually no less than 6 months after spinal cord injury, except in severe cases.
      There is controversy about the initial and long-term treatment of patients with
      intermittent catheterization, antibiotics, or both. This controversy will
      continue. Upper urinary tract complications associated with spinal cord injury
      have been virtually eliminated with better urologic therapy, and the incidence
      should continue to be negligible if proper therapy is given. Patients who have
      maintained good bladder management and who are doing well physically with good
      nutritional habits and medical care since their spinal cord injury will have a
      much better outcome than those who have more severe urologic and medical
      problems.

PMID- 8351767
TI  - Acute neurologic management of the patient with spinal cord injury.
AB  - Early and effective spinal immobilization, physiological support, precise
      radiographic analysis, and surgical intervention tailored to the specific
      anatomic pathology form the basis for appropriate management of spinal injury.
      Despite improvements in each of these areas, however, the neurologic outcome in
      patients with severe deficits remains problematic. Research into the prevention
      of adverse metabolic changes that occur in the acutely injured spinal cord may
      offer hope for improved outcomes.

PMID- 8351768
TI  - Long-term urologic management of the patient with spinal cord injury.
AB  - The primary goal of bladder management in the patient with a spinal cord injury
      is to achieve adequate bladder drainage, low-pressure urine storage, and low
      pressure voiding. This will help prevent urinary tract infections, bladder wall
      damage, bladder overdistention, vesicoureteral reflux, and stone disease. Bladder
      retraining is indicated in all patients with disorders of the spinal cord and the
      brain. The basic aim is to provide bladder drainage without indwelling catheters
      and, if possible, without leg bags. Bladder retraining is usually begun with
      intermittent catheterization, with the use of alpha blockers to improve drainage
      in patients who are wearing leg bags or with anticholinergic drugs to improve
      continence. However, bladder retraining may be contraindicated in patients with
      vesicoureteral reflux or stone disease and in patients with impending renal
      failure. It is therefore important to evaluate all patients with neurogenic
      bladder using urodynamics, nuclear scanning, renal ultrasound, and voiding
      cystourethrography. In patients with stone disease, intravenous urography may
      also be required. Understanding of the basic neurologic lesion and bladder
      dysfunction is therefore vital to bladder retraining or transurethral surgery to
      provide adequate voiding. The regular periodic follow-up of all patients is vital
      to protect renal function.

PMID- 8351769
TI  - Management of urinary stones in the patient with spinal cord injury.
AB  - The main objective of the urologist treating patients with spinal cord injury is
      to preserve renal function. In order to minimize morbidity, all attempts must be
      made to maintain a low bladder pressure, sterile urine, and a non-obstructed
      drainage system. These patients remain at increased risk of infection and stone
      formation despite all clinical intervention. Diligence in routine follow-up and
      careful evaluations will provide the best possible results. In the face of
      urolithiasis, ESWL, percutaneous nephrolithotomy, and chemolysis are effective
      means of treatment with acceptable morbidity. With future technologic
      advancements and implementation of neurostimulators to improve the urodynamic
      profiles, the incidence of renal insufficiency, urolithiasis, and overall
      morbidity in patients with spinal cord injury is likely to decrease.

PMID- 8351770
TI  - Antimicrobial agents in urinary tract infections in patients with spinal cord
      injury.
AB  - Because of the rapid introduction and active marketing of newer antimicrobial
      agents for urinary tract infections, it is important to evaluate newer
      antibiotics critically. Critical evaluation should be based on published reports,
      spectrum of action, and, very importantly, cost. Newer agents should be compared
      with known effective agents on the basis of hospital antimicrobial sensitivity
      tests. Simple, uncomplicated urinary tract infections caused by community
      acquired multiple drug-sensitive uropathogens can be treated with almost any
      currently available antimicrobial agent. In these situations, a low-morbidity,
      low-cost agent with limited dosage should be chosen. In general, a 3-day course
      of trimethoprim-sulfamethoxazole, nitrofurantoin, a first-generation
      cephalosporin, a penicillin agent, or in some cases a fluoroquinolone will be
      both medically and cost effective. For complicated urinary tract infections, more
      selectivity must be exercised in choosing an appropriate antibacterial agent. In
      these situations, it is necessary to initiate appropriate diagnostic studies to
      identify causes and to treat those complications appropriately. The choice of
      antibiotics must be based on culture results. Initial empiric treatment should be
      carried out with a broad-spectrum agent of low morbidity. In these complicated
      infections, fluoroquinolones may be effective with low expected morbidity.

PMID- 8351771
TI  - Urologic complications of spinal cord injury.
AB  - Spinal cord injuries in the past were associated with a very high mortality,
      predominantly from urologic complications and sepsis. Improvements in the
      urologic and medical management of these patients have significantly decreased
      the morbidity and mortality. Many complications may still develop during the
      urologic management, however. Periodic follow-up is thus essential to recognize
      and treat urologic complications in order to preserve renal function.

PMID- 8351772
TI  - Urinary diversion and reconstruction in the patient with spinal cord injury.
AB  - This article discusses surgical procedures that may be useful in the management
      of patients with spinal cord injury and is intended to be of practical use to
      those in general practice. In addition to a discussion of the pros and cons of
      indwelling Foley and suprapubic catheters, useful reconstructive and diversionary
      procedures are reviewed.

PMID- 8351773
TI  - Urologic management of spinal cord injury in children.
AB  - This overview of the management of children with spinal cord injury has focused
      on a program based on bladder dynamics. The bladder is modulated
      pharmacologically and surgically, if necessary, to create a reservoir that stores
      urine at low pressure, and emptying is achieved by clean intermittent
      catheterization. The parent assumes the responsibility for bladder emptying when
      the child is unable to perform catheterization. Reflex voiding in a balanced
      fashion is not advocated. The program described not only avoids the deleterious
      effects of high voiding pressures, it also obviates the wearing of a urinary
      collection device, which is impractical for most prepubertal boys, and it
      provides for emptying at predictable intervals in order to make the child more
      socially acceptable. This approach seems to improve the child's self-image, and
      it should increase the chances of useful participation in society and a
      fulfilling life.

PMID- 8351774
TI  - Urologic consequences of myelodysplasia and other congenital abnormalities of the
      spinal cord.
AB  - Spina bifida and other congenital abnormalities of the spinal cord are relatively
      common (1 per 1000 births). Early urologic evaluation to determine the extent of
      neurologic involvement of the lower urinary tract is essential. Urodynamic
      studies are important in determining voiding pressure and leak pressure and in
      classifying the type of detrusor and sphincter dysfunction. Therapy is directed
      toward preservation of the upper tracts. Many nonsurgical (clean intermittent
      catheterization and anticholinergic drugs) and surgical procedures allow the
      child to be continent and maintain a normal upper urinary tract. The importance
      of follow-up is stressed because neurourologic changes frequently occur, and
      prompt treatment or change of therapy is essential. Today, children with spina
      bifida are leading healthy, productive lives. A continued multidisciplinary
      approach to their care is important.

PMID- 8351776
TI  - Management of the neurogenic bowel in patients with spinal cord injury.
AB  - Bowel dysfunction in patients with spinal cord injury has a significant impact on
      quality of life as well as causing morbidity and death. This article reviews the
      pathophysiologic features of the neurogenic bowel of patients with spinal cord
      injury. Also discussed are the clinical manifestations, current options for
      management, and newer approaches that address this chronic and debilitating
      problem.

PMID- 8351775
TI  - Electrical stimulation of sacral roots for micturition after spinal cord injury.
AB  - In patients with suprasacral spinal cord injury, electrical stimulation of the
      sacral anterior nerve roots can produce micturition with low residual volumes of
      urine and reduced urinary tract infection. Voiding pressures can be maintained at
      acceptable levels by selective peripheral neurotomy and myotomy or, more
      commonly, by an intermittent pattern of stimulation. Occasionally, external
      sphincterotomy is required. The procedure is usually combined with division of
      the sacral posterior roots, which increases bladder capacity and continence; this
      also increases bladder compliance, which may be protective for the upper urinary
      tracts. A reduction in constipation usually is observed, and some patients are
      able to defecate with the aid of electrical stimulation. Penile erection is
      produced in a substantial proportion of male patients. The procedure has now been
      applied in about 700 patients with spinal cord injury, some of whom have been
      followed for nearly 15 years. The nerves do not appear to be damaged by long-term
      stimulation, and technical faults with the equipment are now uncommon.

PMID- 8351777
TI  - Clinical approach to the sexuality of patients with spinal cord injury.
AB  - This article discusses four complex clinical perspectives on the sexual impact of
      spinal cord injury: the sexual equilibrium between two people, the sexual
      psychology of one individual, the general biology of the organically impaired
      person, and the sexual pathophysiology of the spinal cord deficit. These topics
      affect the re-establishment and maintenance of a sexual life after irreversible
      spinal cord trauma.

PMID- 8351778
TI  - Sexual dysfunction after spinal cord injury.
AB  - Treatment of sexual dysfunction is an integral part of the rehabilitation of the
      patient with spinal cord injury. The degree of sexual dysfunction varies with the
      level and completeness of injury. A multidisciplinary approach is necessary to
      evaluate and treat these patients. Intracorporeal injections of vasoactive
      medications or vacuum devices are effective means of restoring erections in
      selected patients with spinal cord injury. Penile prostheses are rarely indicated
      for this purpose.

PMID- 8351779
TI  - Fertility options and success after spinal cord injury.
AB  - Over the past 9 years, the fertility potential for men with spinal cord injury
      and other neurological impairments has improved. Approximately 80% of men with
      spinal cord injury have semen (collected either by vibration or by
      electroejaculation using rectal probe) of sufficient quality to use in
      intrauterine insemination or in vitro fertilization. Assuming that other factors
      are equal, it would seem that length or level of injury are not dominating
      factors that control the quality of semen from these men.

PMID- 8351780
TI  - Sigma-rectum pouch (Mainz pouch II).
AB  - A substantial modification of the classic technique of ureterosigmoidostomy is
      introduced in this article. To date, this procedure has been used in 47 patients.
      This article reviews the surgical technique of the antemesenterial splitting of
      the intestine at the recto-sigmoid junction which creates a pouch by subsequent
      side-to-side anastomosis.

PMID- 8351781
TI  - Observations on the commercial production of ostrich (Struthio camelus) in the
      United Kingdom: rearing of chicks.
AB  - Two sets of ostrich eggs (60 and 120 eggs) were imported into the United Kingdom
      under class 1 quarantine restrictions. The eggs were incubated and observations
      were made on the growth, survival and sex ratio of the chicks hatched. The chicks
      decreased in weight for five days after hatching before they began a sustained
      period of exponential growth. They reached a liveweight of 4 kg five weeks after
      hatching. Female chicks grew significantly faster than male chicks. The survival
      rates of the chicks to three months of age were 66.7 per cent and 78.3 per cent,
      respectively, for the two sets of eggs, and mortality restricted mainly to the
      first four weeks of rearing. All the birds which died showed poor rates of growth
      before they died. The sex ratio of both groups was skewed 2:1 towards males.

PMID- 8351782
TI  - Morbillivirus antibodies of maternal origin in harbour seal pups. (Phoca
      vitulina).

PMID- 8351783
TI  - Detection of bacterial sinusitis in the Mongolian gerbil (Meriones unguiculatus)
      using magnetic resonance imaging.

PMID- 8351785
TI  - Control of foot-and-mouth disease.

PMID- 8351784
TI  - Ovine ophthalmitis associated with Listeria monocytogenes.

PMID- 8351786
TI  - Disease similar to swine fever.

PMID- 8351787
TI  - Solar haemorrhages in dairy cattle.

PMID- 8351788
TI  - Retina, brain and blood cholinesterase levels in cats treated with oral
      dichlorvos.
AB  - Dichlorvos (DDVP) is used as an antihelmetic, principally in dogs, cats, pigs and
      horses. Retina, whole blood, erythrocyte, plasma and brain cholinesterase (ChE)
      activities were monitored following DDVP exposure in cats to establish their use
      as indicators of exposure to a ChE inhibitor. Following DDVP exposure, whole
      blood ChE activity was 16.8% of preexposure, erythrocyte ChE activity was 33% of
      preexposure, and plasma ChE was 19% of preexposure values. Brain and retinal ChE
      activities were reduced to 45% and 43% of control values. Retinal ChE paralleled
      brain activity.

PMID- 8351789
TI  - Field test of the new fungal identification system in POISINDEX.
AB  - A new program, Fungal Identification System (FIS) was introduced in POISINDEX
      (PI) in 1991. We studied the accuracy of this program compared to the traditional
      method of consulting an expert mycologist and also the utility of FIS for the
      certified specialist in poison information (CSPI) and the emergency department
      personnel. Fifteen samples were obtained from a Chicago area forest preserve and
      immediately identified by a CSPI using FIS from PI of summer-fall 1991. The
      samples were then refrigerated overnight and identified the following morning by
      a PhD mycologist, using standard mycological identification techniques (SMIT).
      Another group of 18 mushrooms were collected in August 1992 from rural
      southwestern Michigan and identified by FIS and SMIT after refrigeration
      overnight. In 4 cases the mycologist used both SMIT and FIS to identify the
      mushrooms. Identification by FIS did not match SMIT in 27 of 31 samples (1 was
      discarded and 1 was identified by FIS but not identified by SMIT). In 2 of 4
      cases where the mycologist used FIS, a different answer was obtained from that
      obtained by the CSPI; however, these were still incorrect identifications. Four
      types of problems using FIS have been identified which can lead to erroneous
      results; these are the use of multipart questions, emphasis on color over less
      variable characteristics, questions which do not account for variability in
      morphology, and problems which arise from the sequence of questions. These points
      need to be addressed before FIS can be used as a safe basis for clinical
      recommendations.

PMID- 8351790
TI  - Isolation, purification, toxicity and some physicochemical properties of
      mycotoxins produced by aspergillus quadrilineatus isolated from acha (Digitaria
      exilis stapf) in Plateau State of Nigeria.
AB  - Some physico-chemical and toxicological studies were carried out on mycotoxins
      elaborated by Aspergillus quadrilineatus isolated from a grain foodstuff, acha
      (Digitaria exilis) in the Plateau State of Nigeria. The mycotoxins produced by A
      quadrilineatus were extractable from rice culture by chloroform. Column
      chromatographic separations of the crude extract in silica gel using different
      elution solvents and biological tests showed that the mycotoxins came off in the
      diethylether, chloroform and mostly in the ethyl acetate fractions. Use of
      different available mycotoxin standards on silica gel G coated chromatoplates
      revealed that 1 of the mycotoxins produced by A quadrilineatus was
      sterigmatocystin. Two other more toxic mycotoxins were isolated and purified from
      the crude chloroform extract; their column, preparative thin-layer
      chromatographic, infrared and UV-spectrophotometric characteristics were
      established. The infrared spectra of the 2 purified mycotoxins suggested that the
      carbonyl group of their structures were similar to that of aflatoxin.

PMID- 8351791
TI  - Determination of the toxicity of molasses in Nubian goats.
AB  - Molasses at 10, 30 or 50% of the diet for 12 w was not toxic to goats and could
      be used as an inexpensive substitute for sorghum grain. No animals showed signs
      or lesions of illness attributable to feeding molasses. There were no differences
      among treatment groups in any of the following parameters: WBC, RBC, PCV, Hb,
      MCV, MCHC, GOT, uric acid, urea, cholesterol, and zinc. Serum creatinine, total
      protein, iron, copper, magnesium and calcium varied between groups but remained
      within the ranges for normal goats. Feedlot performance indicated that
      utilization of molasses energy for body weight gain was a function of intake;
      feeding 50% dietary molasses did not produce economic weight gain.

PMID- 8351792
TI  - Effect of dehydroproline as a collagen synthetic inhibitor in paraquat-induced
      pulmonary fibrosis in beagle dogs.
AB  - To investigate the effect of 3,4-DL-dehydroproline (DHP) on paraquat (PQ)-induced
      pulmonary fibrosis in beagle dogs, 25 beagles without distinction of sex were
      allocated at random into 2 groups; 17 dogs were PQ-dosed and 8 were saline-dosed.
      The 17 dogs were given 1 mg PQ/kg/d sc for 7-11 d; 14 of the 17 had decreased
      body weight on day 11 and were selected, 2 of which were determined at random and
      necropsied. The remaining 12 dogs were randomly divided into 2 groups of 6 dogs
      each (DHP-treated or saline-treated). They received either 25 mg DHP/kg/d sc or
      saline for 14 d and were sacrificed for measurement of lung lipid peroxide and
      lung hydroxyproline (Hyp) concentrations on day 25 or 180 after the PQ
      administrations started. Two of the 17 dogs (11.8%) given 1 mg PQ/kg/d sc died on
      days 9 and 11 of the administration. One dog (5.9%) had no signs of PQ toxicity
      including no decrease in body weight. The remaining 14 dogs (82.4%) had decreased
      body weight until day 11 of the PQ administrations. No significant differences in
      erythrocyte superoxide dismutase, blood catalase and serum-lipid peroxide
      occurred from the PQ dosing; however, lung lipid peroxide increased 4-fold. On
      day 180 the lung lipid peroxide of the PQ + saline treated group was still 4
      times elevated, while the PQ + DHP treated group had about 1/2 that value. Lung
      Hyp concentrations in the PQ dosed dogs were significantly increased.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8351793
TI  - Acute and subchronic oral toxicity of technical quinalphos in rats.
AB  - The organophosphate insecticide quinalphos is extensively used in agriculture.
      Information on the mammalian toxicity of quinalphos is limited. The acute po LD50
      of technical quinalphos was 19.95 mg/kg in males and 13.78 mg/kg in female rats.
      Administration of 0.75, 1.50 or 3.0 mg/kg/d technical quinalphos for 90 d po to
      rats produced poisoning and death. Male rats were more susceptible to quinalphos
      than female rats in the subchronic toxicity studies based on mortality, enzyme
      profiles and cholinesterase inhibition.

PMID- 8351794
TI  - Respiratory exposure of museum personnel to dichlorvos insecticide.
AB  - Dichlorvos (DDVP) is an organophosphate insecticide used to protect museum
      specimens from insect pests. Respiratory exposure of museum personnel to DDVP has
      not been studied previously. Analysis of air samples from museum rooms where DDVP
      was being used when the ventilation system was "on" showed a lower and
      significantly different (p = 0.025) amount of DDVP when compared to air samples
      collected from the same rooms when the ventilation system was "off". The DDVP
      concentrations of all samples collected were below the threshold limit value
      established by the American Conference of Governmental Industrial Hygienists.

PMID- 8351795
TI  - Suspected red maple (Acer rubrum) toxicosis with abortion in two Percheron mares.
AB  - Horses develop severe and often fatal hemolytic anemia after ingesting dried
      leaves from red maple (Acer rubrum) trees. Toxicosis appears related to an
      unknown oxidant present in the dried or wilted leaves. This case report describes
      2 horses that aborted and developed fatal hemolytic anemia after consuming wilted
      leaves from red maple (Acer rubrum). While an absolute diagnosis was not
      confirmed due to lack of proper antemortem and postmortem examinations, red maple
      toxicosis appeared a reasonable diagnosis based on clinical signs and laboratory
      findings. Other differentials include equine infectious anemia, autoimmune
      hemolytic anemia, piroplasmosis, leptospirosis, ehrlichiosis, and other plant or
      chemical sources of oxidants (onion, garlic, kale, phenothiazines).

PMID- 8351796
TI  - Prolonged cardiopulmonary resuscitation during acute disopyramide poisoning.
AB  - A case is reported of sustained electromechanical dissociation due to deliberate
      disopyramide over-dosage in a young healthy girl. Circulatory recovery was
      achieved with standard resuscitative measures, including prolonged cardiac
      massage and isoproterenol infusion plus high dose calcium chloride. Neurological
      recovery was complete.

PMID- 8351797
TI  - Isradipine ingestion in a two-year-old child.
AB  - We reported the first case of accidental or intentional overdose with isradipine.
      A 2 y-old male accidentally ingested 2.5 mg of isradipine. A drop in arterial
      pressure responded to fluids. No other symptoms were noted. The child recovered
      without sequelae.

PMID- 8351798
TI  - Denatonium benzoate as a deterrent to ingestion of toxic substances: toxicity and
      efficacy.
AB  - When ingested at 10 ppm by human beings, denatonium benzoate has an extremely
      bitter, unpleasant taste. The addition of denatonium benzoate to liquid dish
      detergents and orange juice reduces the amount ingested by children. The toxicity
      of denatonium benzoate is low with acute po LD50's in rats of 485-740 mg/kg. The
      use of bittering agents, such as denatonium benzoate, could reduce the ingestion
      of toxic substances by dogs, cats, other animals and children and warrants
      further investigation.

PMID- 8351799
TI  - The effects of nitrate, nitrite, and N-nitroso compounds on animal health.
AB  - The clinical signs of acute nitrate toxicity vary according to species. In
      general, ruminant animals develop methemoglobinemia while monogastric animals
      exhibit severe gastritis. Nitrate ingestion has also been linked to impairment of
      thyroid function, decreased feed consumption, and interference with vitamin A and
      E metabolism. Hematologic changes seen with chronic high nitrate exposure include
      both compensatory increases in red blood cells and anemia, along with increased
      neutrophils and eosinophils. Unlike nitrate, nitrite is capable of inducing
      methemoglobinemia in a wide range of species, ie cattle, sheep, swine, dogs,
      guinea pigs, rats, chickens and turkeys. In rats, chronic nitrite exposure causes
      pathologic changes in a variety of tissues, alterations in motor activity and
      brain electrical activity, and alters gastric mucosal absorption. Nitrite affects
      the metabolism of sulfonamide drugs in animals such as the pig, guinea pig, and
      rat. The N-nitroso compound dimethylnitrosamine causes toxic hepatosis in cattle,
      sheep, mink, and fox. Nitrosamines have been reported in cows milk and been found
      to pass into the milk of goats under experimental conditions.

PMID- 8351800
TI  - Snake venom extractors: a valuable first aid tool.

PMID- 8351801
TI  - A role for Brachiaria decumbens in hepatogenous photosensitization of ruminants?

PMID- 8351802
TI  - Washington's pesticide panel: process and product.

PMID- 8351803
TI  - Lead non-poisoning in the Pacific Northwest.

PMID- 8351804
TI  - Suspected intoxications due to Lathyrus.

PMID- 8351805
TI  - The accuracy of intraoperative diagnoses based on examination of frozen sections.
      A prospective comparison with paraffin-embedded sections.
AB  - The accuracy of diagnoses based on examination of frozen sections was determined
      by comparing the results to those obtained by examination of tissues prepared
      using conventional methods (formalin fixation, paraffin-embedded tissue). One
      hundred ninety-four specimens were examined using the frozen section technique;
      37 were examined to confirm a tentative diagnosis or to document lymph node
      metastasis and the remainder were examined to diagnose an unknown pathologic
      process. Of the 194 specimens examined, an accurate, specific diagnosis was
      obtained in 161 (83%); in 19 (10%), the pathologic process was correctly
      identified, but a specific diagnosis was not obtained; and in 2 (1%) the
      diagnosis was deferred. The remaining 12 (6%) were incorrectly diagnosed by the
      frozen section technique. When the number of specimens in which a specific
      diagnosis was obtained was combined with the number of specimens in which the
      pathologic process was correctly identified, the overall accuracy rate of the
      frozen section technique was 93%. There was no difference in the accuracy of the
      frozen section technique based on the reason for submission of the sample, source
      of tissue submitted, or the type of pathologic process (i.e., inflammatory or
      neoplastic). Of the 12 incorrect diagnoses, 4 (33%) were because of sampling
      errors and 8 (67%) were caused by interpretation errors.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8351806
TI  - Cystourethropexy to correct refractory urinary incontinence due to urethral
      sphincter mechanism incompetence. Preliminary results in ten bitches.
AB  - Cystourethropexy was performed in 10 bitches with refractory urinary incontinence
      due to urethral sphincter mechanism incompetence. All animals had an abnormally
      shaped vesicourethral junction. The bladder neck was located in the pelvic canal
      in nine dogs (pelvic bladder). Surgery alone restored urinary continence in two
      cases and markedly improved incontinence in two cases. Surgery combined with
      medical therapy (phenylpropanolamine, 1.5 mg/kg orally once or twice a day, using
      a sustained-action preparation) restored urinary continence in four cases and
      markedly improved continence in one case. Surgery, with medical therapy, was
      completely ineffective in one case. No major complications were encountered in
      any dogs. In four cases, histopathologic evaluation of the dorsal bladder wall
      and neck revealed the presence of a single, perinuclear, clear vacuole in the
      cytoplasm of smooth muscle fibers. Electron microscopic examination showed that
      the vacuoles represented a dilatation of normal membrane organelles. Such
      abnormalities have the potential to alter the smooth muscle motility. This study
      indicates that cystourethropexy alone restored urinary continence only
      temporarily in the majority of the patients. The significance and frequency of
      the histopathologic findings requires further investigation.

PMID- 8351807
TI  - Clinical and pathologic effects of a modified technique for application of spiral
      prostheses to the cervical trachea of dogs.
AB  - A modified surgical technique for application of extraluminal polypropylene
      spiral prostheses (PSP) to the trachea was developed. A portion of the segmental
      blood supply to the collapsed segment of trachea was maintained by fenestrating
      rather than completely dissecting the right lateral pedicle. Polypropylene spiral
      prostheses were applied to the cervical trachea of 12 dogs (group I) via the
      modified technique and to 12 dogs (group II) with the identical surgical
      dissection but without PSP applied. Clinical abnormalities included mild coughing
      in group I dogs and swelling of the incisions in both groups. Limited necrosis
      and moderate degeneration and inflammation were observed histologically in both
      groups. Pathologic changes were worse in the caudal cervical segment of the
      trachea. Mucosal regeneration was present on day 10 in both groups. Transmural
      tracheal necrosis was not observed. The modified technique for application of PSP
      is recommended by the authors because it provides adequate surgical exposure and
      the blood supply preserved by segmentally dissecting the right lateral pedicle is
      adequate to maintain tracheal viability.

PMID- 8351809
TI  - Use of ultrasound in horses for diagnosis of left dorsal displacement of the
      large colon and monitoring its nonsurgical correction.
AB  - During a 28 month period, 82 horses with clinical signs of abdominal pain were
      examined for left dorsal displacement of the large colon (LDDLC) using
      percutaneous ultrasound. Left dorsal displacement of the large colon was
      diagnosed when a gas echo dorsal to the spleen obliterated the dorsal splenic
      border, or when the colon was observed lateral to the spleen. In 42 horses,
      ultrasound confirmed a diagnosis of LDDLC and 40 horses had no evidence of LDDLC.
      There were five false negative results and no false positives. In four horses
      with LDDLC, the colon was displaced between the spleen and body wall; three of
      these colic episodes resolved with medical therapy and the fourth required a
      celiotomy to relieve a sand impaction. The remaining 38 horses had a renosplenic
      entrapment; surgical correction was elected in 4 horses, 21 horses were corrected
      by a nonsurgical rolling procedure, 12 were corrected at surgery after an
      unsuccessful rolling attempt, and one was corrected by rolling but required
      surgery later because of an additional lesion. Percutaneous abdominal ultrasound
      was a valuable aid in the diagnosis of LDDLC and in confirming correction of the
      displacement after a nonsurgical rolling procedure.

PMID- 8351808
TI  - Quantitative ingrowth analysis of a porous-coated acetabular component in a
      canine model.
AB  - Histomorphometric analysis of bone ingrowth into a porous-coated acetabular
      component was evaluated in a canine model. A total of nine prostheses were
      evaluated, 3 at 6 months, 3 at 12 months, and 3 at 24 months after implantation.
      All implants were grossly stable at the time of retrieval. The mean percentage of
      bone ingrowth was 12% at 6 months, 24% at 12 months, and 24% at 24 months. Narrow
      radiolucent lines noted on microradiographs were more evident at the 6 month time
      period than at the 12 or 24 month time periods. Bone ingrowth into a porous
      coated acetabular component in a weight-bearing model may continue beyond the 6
      month time period, and early evaluation of bone ingrowth may underestimate final
      bone ingrowth.

PMID- 8351810
TI  - Palmar digital neurectomy in horses. 57 cases (1984-1990).
AB  - The medical records of 57 horses that had palmar digital neurectomy performed
      between 1984 and 1990 were reviewed. Neurectomies were performed either by
      transection and electrocoagulation (47 horses) or by the guillotine technique (10
      horses). Middle-aged geldings, Quarter Horses, and Thoroughbreds were
      significantly over-represented when compared with the hospital population. Horses
      used as hunter/jumpers also appeared to be over-represented. Complications
      occurred in 17 (34%) of the 50 horses for which follow-up information was
      obtained. Recurrence of heel pain was the most common complication (14 horses).
      Palpable painful neuromas were detected in three horses. One year after
      neurectomy, 74% of the horses were sound; this decreased to 63% after 2 years.

PMID- 8351811
TI  - In vivo investigation of communication between the distal intertarsal and
      tarsometatarsal joints in horses and ponies.
AB  - The frequency of communication between the tarsometatarsal and distal intertarsal
      joints was investigated in 27 horses and 12 ponies. After the injection of
      diluted latex into the tarsometatarsal joints using the plantarolateral approach,
      the horses and ponies were walked for 200 meters. Latex was found in the distal
      intertarsal joints of 19 of 73 tarsi (26% communication) at necropsy. In 3 tarsi,
      latex was also found in the proximal intertarsal and tarsocrural joints.

PMID- 8351812
TI  - Lateral patellar luxation in miniature horses.
AB  - Bilateral luxation of the patella in four Miniature Horses was corrected by a
      lateral release incision and medial imbrication of the parapatellar fascia to the
      tendon of the sartorius muscle. Before surgery, the four horses had a grade 3 to
      4 lateral patellar luxation bilaterally and had difficulty walking. Trochlear
      ridge hypoplasia was evident on radiographs in each horse. Follow-up information
      varied from 11 months to 4 years after surgery. Three horses had no patellar
      luxation or lameness. The other horse had a normal right stifle, but patellar
      luxation (grade 3) had recurred on the left.

PMID- 8351813
TI  - Correction of patellar luxation by recession sulcoplasty in three foals.
AB  - Lateral luxation of the patella in four femoropatellar joints of three foals was
      repaired by recession sulcoplasty and medial imbrication of the joint. One foal
      was euthanatized because of septic arthritis caused by incisional dehiscence, and
      the other two foals were normal 2 years after surgery. Recession sulcoplasty
      combined with medial imbrication of the joint capsule resulted in a functional
      femoropatellar joint and should be considered in foals affected with lateral
      patellar luxation.

PMID- 8351814
TI  - Hepatic lobe torsion as a cause of colic in a horse.
AB  - A 14-year-old Arabian gelding was examined for colic. An exploratory celiotomy
      was subsequently performed and the left lobe of the liver was found to be
      twisted. The lobe was resected using a TA-90 surgical stapling instrument.
      Histologic examination of the resected liver indicated portal vein and sinusoid
      dilation and congestion with blood. There were focal areas of necrosis and
      bacterial cocci and rods throughout the section. The histologic findings were
      consistent with hepatic lobe torsion. After surgery, the horse was treated with
      broad spectrum antibiotics, anti-inflammatory drugs, heparin, and intravenous
      fluids. The horse recovered without complications, although serum liver enzymes
      remained elevated for more than 1 week after surgery. Seven months after surgery
      the horse showed no adverse affects from the disease.

PMID- 8351815
TI  - Epidural morphine in goats after hindlimb orthopedic surgery.
AB  - Morphine (0.1 mg/kg) diluted with 0.9% saline to a volume of 0.13 mL/kg was
      administered into the epidural space at the lumbosacral junction in 10 halothane
      anesthetized goats immediately before discontinuation of halothane. The same
      volume of 0.9% saline was given to control group of eight anesthetized goats.
      Both groups had undergone an orthopedic procedure that replaced the anterior
      cruciate ligament with a patellar tendon autograft. The appearance and unprovoked
      behavior of goats in the morphine group were significantly different (p < .05)
      from the saline groups. The goats in the morphine group were more sedate and
      struggled less during recovery. Epidural morphine did not produce respiratory
      depression or bloat during a 9 hour observation period. Heart rate, respiratory
      rate, and blood pressure (mean, systolic, and diastolic) of the morphine group
      did not differ from those of the control group.

PMID- 8351816
TI  - Effects of thiopental, ketamine, diazepam, xylazine, and nitrous oxide on EEG
      spike activity and convulsive behavior during enflurane anesthesia in atropinized
      cats. Effect of increasing inhalant concentrations.
AB  - The effects of thiopental, ketamine, diazepam, xylazine, and nitrous oxide, and
      the combinations of thiopental-nitrous oxide and ketamine-nitrous oxide, on both
      enflurane-induced electroencephalographic (EEG) spike activity and convulsive
      behavior were measured quantitatively in atropinized cats receiving enflurane
      with controlled ventilation. Pretreatments with thiopental, ketamine, and
      diazepam reduced both EEG spike frequency and amplitude at 2.5% to 4.5% inspired
      enflurane but did not abolish spike activity. Nitrous oxide (66% of inspired gas)
      did not significantly alter spike frequency or amplitude during 2.5% to 4.5%
      inspired enflurane, but the combination of thiopental-nitrous oxide or ketamine
      nitrous oxide reduced EEG spike activity during 2.5% inspired enflurane.
      Enflurane-induced convulsive score was markedly suppressed by thiopental and
      ketamine and was significantly reduced by diazepam, xylazine and nitrous oxide.
      The combinations of thiopental-nitrous oxide and ketamine-nitrous oxide greatly
      reduced behavioral-convulsive responses induced by 2.5% to 4.5% inspired
      enflurane.

PMID- 8351818
TI  - Different anisotropies for texture and grating stimuli in the visual map of cat
      striate cortex.
AB  - A comparison was made of the directional preferences of cat area 17 cells tested
      with two different stimuli, gratings and random-dot patterns. Depending on the
      stimulus, different distributions of direction preferences (anisotropies) were
      found in the same cells of the central representation of upper layers. With
      gratings most common preferred directions were vertical and horizontal. With
      textures, however, horizontal preferred directions were most common. In contrast,
      lower layer neurons had a bias for vertical preferred directions regardless of
      the type of stimulus used.

PMID- 8351817
TI  - Effects of thiopental, ketamine, diazepam, xylazine, and nitrous oxide on EEG
      spike activity and convulsive behavior during enflurane anesthesia in
      spontaneously breathing atropinized cats. Effect at surgical depth.
AB  - The effects of thiopental, ketamine, diazepam, xylazine and nitrous oxide, and
      combinations of thiopental-nitrous oxide and ketamine-nitrous oxide on
      electroencephalographic (EEG) spike activity and convulsive behaviors in
      atropinized cats at surgical depth of enflurane anesthesia were assessed
      quantitatively for 60 minutes during spontaneous ventilation. Mean inspired
      enflurane concentrations (MIEC) were reduced 16% to 29% by pretreatment with
      thiopental, ketamine, diazepam, and xylazine, and were reduced 19% by 66% nitrous
      oxide. The MIEC of cats anesthetized with thiopental-nitrous oxide-enflurane and
      ketamine-nitrous oxide-enflurane were 35% to 38% lower than that with nitrous
      oxide-enflurane. Pretreatment with thiopental, ketamine, diazepam, and xylazine
      did not reduce the EEG spike frequency during anesthesia but did markedly reduce
      the spike amplitude. The addition of 66% nitrous oxide did not alter the spike
      frequency during anesthesia but tended to reduce the spike amplitude.
      Combinations of thiopental-nitrous oxide and ketamine-nitrous oxide almost
      abolished the spike activity. The addition of 66% nitrous oxide prevented
      convulsive responses elicited by photic and auditory stimulation during enflurane
      anesthesia. Treatment with thiopental, ketamine, diazepam and xylazine, and
      combinations of thiopental-nitrous oxide and ketamine-nitrous oxide, completely
      prevented convulsive responses during enflurane anesthesia.

PMID- 8351819
TI  - Coding for stimulus velocity by temporal patterning of spike discharges in visual
      cells of cat superior colliculus.
AB  - Statistical analyses, performed on extracellularly recorded spike trains
      generated by 69 single motion sensitive visual cells in the intermediate layers
      of superior colliculi of pretrigeminal cat preparations, revealed that--even in
      the unstimulated condition (38/69)--most neuronal spike discharge patterns tended
      to switch between two stochastically distinct states, in the form of rapidly
      alternating "bursting" (high frequency) and "resting" (low frequency) episodes.
      The numbers of consecutive interspike intervals within a given state were, as a
      rule, independent integer-valued random variables with discrete probability
      distributions, in essential agreement with the semi-Markov model proposed by
      Ekholm and Hyvarinen [(1970) Biophysical Journal, 10, 773-796]. The introduction
      of visual stimuli (47/69) moving with velocities of 2-160 deg/sec caused
      systematic and reproducible changes in the ratio of bursting to resting
      activities, decreases in overall discharge variability, and increases in signal
      transinformation flow. Moreover, with one group of stimulated cells (28/47),
      increasing stimulus velocity caused increasingly precise ("stimulus-forced")
      synchronization of bursting episodes with specific phases of stimulus movement;
      while for a smaller group (12/47), stimulus-related alternations between bursting
      and resting states assumed the form of semi-rhythmical burst discharges within
      the characteristic 60-80 Hz "gamma oscillation" range ("stimulus-induced"
      synchronization). For a minority of cells (7/47), switching between bursting and
      resting states--although characteristically modified by stimulus velocity-
      remained largely desynchronized with all phases of stimulus transit. It was
      argued that such temporal patterns of discharge may constitute elements of a
      candidate "distribution" code for movement detection by the cat visual system.

PMID- 8351820
TI  - An illusory transformation of optic flow fields.
AB  - We compared a human observer's ability to locate the focus of expansion (FOE) of
      a radial optic flow field when this flow field was either combined with, or
      overlapped by, planar motion. With combined stimuli, in which the FOE was
      displaced in the direction opposite to the planar motion, subjects accurately
      located the displaced FOE. With overlapping (transparent) stimuli and the FOE
      remaining in the center of the display, we found an illusory transformation of
      the radial pattern: the focus of expansion appeared to be shifted in the
      direction of the planar motion. The speed of both the planar and radial patterns
      of motion influenced the illusion. Presence or absence of visual fixation had
      little effect. We suggest that this illusion might provide a clue as to the way
      the brain processes planar and radial motion which might in turn be relevant to
      the interaction of the planar and radial motion components of optic flow fields.

PMID- 8351821
TI  - Errors in direction-of-motion discrimination with dichoptically viewed stimuli.
AB  - At durations shorter than about 150 msec, a complex grating comprising a static 1
      c/deg grating and a moving 3-c/deg grating is perceived as moving in the
      direction opposite that of the physical direction of motion. Here the phenomenon
      is further examined by measuring the perceived direction of motion of the fused
      images of a 1-c/deg grating presented to one eye and a moving 3-c/deg grating
      presented to the other. The strength of the illusion is almost unaffected by
      dichoptic presentation. This observation is consistent with the hypothesis that
      perceived motion is a consequence of the way the visual system integrates signals
      arising from different detectors tuned to the two component gratings.

PMID- 8351822
TI  - A study of women heterozygous for colour deficiencies.
AB  - We have examined the colour vision of 43 female subjects in the age range 30-59
      yr of whom 31 were obligate carriers of various forms of colour deficiency and
      the rest were women who had no known colour-deficient relatives. In the case of
      all the carriers we established the phenotypes of their colour-deficient sons. As
      a group, carriers made significantly more errors on the Ishihara plates and
      showed enlarged matching ranges on the Nagel anomaloscope, but we could not
      replicate earlier reports of increased error scores on the Farnsworth-Munsell 100
      Hue test or of systematic shifts in Rayleigh match mid-points. We did find that
      the colour matches of carriers of deuteranomaly were significantly displaced from
      those of normals in a ratio-matching task in which a mixture of 546 and 600 nm
      was matched with a mixture of 570 and 690 nm. Owing to X-chromosome inactivation,
      women who are heterozygous for anomalous trichromacy ought to have at least four
      types of cone in their retinae and we ask whether this affords them an extra
      dimension of colour vision, by analogy to New World monkeys where heterozygous
      females gain trichromacy in a basically dichromatic species. Many carriers of
      anomalous trichromacy exhibited no evidence for tetrachromacy, in that they
      accepted large-field Rayleigh matches following a rod bleach and they were unable
      to set unique matches in our ratio-matching task. However, eight carriers of
      anomalous trichromacy--and no other subject--refused large-field Rayleigh
      matches; and we found one carrier of deuteranomaly who was apparently able to
      make unique matches in the ratio-matching task.

PMID- 8351824
TI  - Sensory and attentional components of slowing of manual reaction time to non
      fixated visual targets by ipsilateral primes.
AB  - Reaction time (RT) for detecting extrafoveal targets is lengthened by a non
      informative prime at the same location or in the same hemifield (RT inhibition).
      We assumed that sensory effects at primed locations should be the same for
      unilateral and bilateral primes, whereas systematic covert orienting to a primed
      location should occur only with unilateral primes. We found equal RT inhibition
      for both types of primes at 0.2 sec prime-target intervals (SOA), as contrasted
      with inhibition for unilateral but not bilateral primes at 0.6 sec SOAs. We
      conclude that RT inhibition involves a succession of sensory components and
      orienting-dependent components.

PMID- 8351823
TI  - Assessment of foveal cone photoreceptors in Stargardt's macular dystrophy using a
      small dot detection task.
AB  - We measured frequency-of-seeing curves for tiny (1.125 and 3.375 min arc) stimuli
      flashed briefly at absolute threshold to estimate the density of foveal cones in
      normals and in subjects with Stargardt's macular dystrophy. Foveal absolute
      thresholds for Stargardt's were elevated 1.5 log units over normal. Analysis
      using Poisson counting statistics indicated that the quantal absorption to
      stimulate individual cones was normal for Stargardt's but that effective optical
      density of individual cones was reduced by > 1 log. Numerical density of foveal
      cones was reduced 1 log unit for Stargardt's patients with acuities of 20/30
      20/100.

PMID- 8351825
TI  - An orientation-tuned component in the contrast masking of stereopsis.
AB  - A masking paradigm was used to evaluate the orientation selectivity of the
      mechanisms mediating human stereopsis. Two experienced and eleven naive observers
      viewed stereograms, spatially filtered to contain contrast energy with Gaussian
      passbands in spatial frequency and orientation. Using forced-choice procedures we
      measured contrast thresholds for stereopsis in the presence of oriented masking
      patterns. Our results show that the masking of stereopsis consists of two
      components: one is orientation dependent, the other is non-oriented and has
      greatest magnitude at lower spatial frequencies. Contrary to an earlier study,
      these results imply that stereopsis mechanisms may have similar orientation
      tuning to mechanisms mediating contrast detection.

PMID- 8351826
TI  - Effects of the spatial frequency of test and reference stimuli on stereo
      thresholds.
AB  - The perceived depth of adjacent regions of stereoscopic stimuli may be
      influenced, in part, by differences in the spatial frequency composition of
      adjacent stimuli. Consequently, it would be predicted that, if the test and
      reference stimuli differ in their spatial frequency composition, depth
      discrimination thresholds should be asymmetric about the retinal disparity of the
      reference stimulus. We measured depth discrimination thresholds with test and
      reference stimuli that differed by up to 2 octaves in their spatial frequency
      composition. Stereo-thresholds decreased as a function of spatial frequency to
      about 2-4 c/deg and were then constant. However, in contrast to the predicted
      effects, our results show that, for the range of spatial frequencies used,
      differences of up to 2 octaves in spatial frequency, between test and reference
      stimuli, do not affect depth discrimination thresholds.

PMID- 8351827
TI  - Precision of stereoscopic depth perception from double images.
AB  - The increment depth discrimination function was originally described by Ogle
      [(1953) Journal of the Optical Society of America, 43, 906-913] as a single
      exponential function. In contrast, recent studies have suggested that a two
      component function better describes increment depth discrimination. To determine
      the relative effects of stereoscopic and non-stereoscopic width cues on the form
      of the function, we measured increment depth discrimination under conditions
      where both stereoscopic and dichoptic width cues were available. We found that
      increment depth discrimination data were well described by two-segment functions
      if both stereoscopic and dichoptic width cues were available. However, when
      dichoptic width cues were eliminated, by randomizing the pedestal disparity
      (crossed or uncrossed disparity) between trials, the increment depth
      discrimination function was better described by a single exponential function.
      This result has important implications for models of stereoscopic depth
      processing because it shows that stereoscopic depth discrimination thresholds
      progressively increase as a function of distance from the horopter.

PMID- 8351828
TI  - On the perceptual identity of dynamic stereopsis and kinetic depth.
AB  - This paper presents a set of experiments demonstrating novel interactions between
      kinetic depth (depth-from-motion) and dynamic stereopsis (depth-from-disparity).
      Previous research has shown that adaptation to a moving stereoscopic figure
      influences the subjective percept of a subsequently viewed kinetic depth figure.
      In this paper the interactions between kinetic depth and dynamic stereopsis are
      shown to be very robust and to occur in situations involving perceptual priming.
      It is also found that kinetic depth and dynamic stereo stimuli are
      indistinguishable when the stereoscopic stimulus has small, but perceptually
      salient, disparity. These results are consistent with the hypothesis that stimuli
      for kinetic depth and for dynamic stereopsis engage a common neural network.

PMID- 8351829
TI  - The role of Fourier components in discrimination between two types of plaid
      patterns.
AB  - Do decision processes have separate access to the individual Fourier components
      of a complex pattern? Subjects discriminated between plaid patterns formed by
      multiplying or by summing vertical and horizontal square-wave gratings. Such
      patterns differ in two ways: (1) product plaids contain distinctive off-axis
      Fourier components; (2) adjacent luminances are related by equal ratios in the
      products and by equal differences in the sums. Performance on this task was
      compared with the separately measured unmasked detection thresholds of the off
      axis Fourier components and with performance in control tasks which provided only
      the non-Fourier cues. Performance in the plaid discrimination was worse than
      predicted from the unmasked detection thresholds, but better than predicted from
      the control tasks. The results argue that Fourier components are accessible, but
      that masking reduces their usefulness.

PMID- 8351830
TI  - Active vision and the identification of three-dimensional shape.
AB  - We examined the performance of human observers to identify three-dimensional (3D)
      shape from motion induced by exploratory head movements. Subjects categorized 3D
      quadratic surfaces with randomly chosen shape but with a fixed amount of
      curvature in one of eight shape categories. Human observers had their best
      performance with convex parabolic and concave parabolic shapes, but had more
      difficulties in identifying the hyperbolic shapes. The identification of 3D shape
      was not significantly influenced by the amount of curvature. This means that our
      description of 3D shape closely matches the intuitive notion of shape, and that
      its use in 3D shape perception tasks is justified.

PMID- 8351831
TI  - Another means for measuring the motion aftereffect.
AB  - A new procedure for measuring the motion aftereffect (MAE) is described. The
      procedure involves adaptation to an animation sequence depicting dots moving in a
      given direction followed by presentation of a test sequence depicting dots moving
      in all possible directions. Under adaptation, the test sequence appears to have a
      directional bias opposite the direction experienced during adaptation. This MAE
      can be nullified by viewing an animation sequence in which a percentage of dots
      is constrained to move in a direction opposite the aftereffect. Using a method of
      constant stimuli, this percentage can be varied to find the value yielding
      incoherent motion. This dynamic MAE exhibits the same characteristics as the
      conventional MAE.

PMID- 8351832
TI  - Visual pigments and oil droplets in genetically manipulated and carotenoid
      deprived quail: a microspectrophotometric study.
AB  - The spectral absorbances of visual pigments and retinal oil droplets were studied
      in three groups of Japanese quail (Coturnix coturnix japonica): an unselected
      control population and two artificially selected strains that exhibited different
      early approach preferences between blue and red stimuli. The oil droplets were
      examined with and without prior carotenoid deprivation. Four cone pigments and
      five oil droplet types were identified, resembling those in other avian species.
      Carotenoid deprivation eliminated all pigmentation detectable in oil droplets by
      microspectrophotometry. Placement of chicks on normal diet gradually reintroduced
      normal pigmentation within the span of about a week. No statistically significant
      differences were found between normal and genetically selected birds in either
      visual pigments or oil droplet types, or in their relative proportions. It is
      concluded that differences in the early colour preferences of quail are unlikely
      to be a result of variation in the spectral properties of their photoreceptors.

PMID- 8351833
TI  - Dendritic architecture of ON-OFF direction-selective ganglion cells in the rabbit
      retina.
AB  - ON-OFF direction-selective ganglion cells in rabbit retina have bistratified
      dendritic arbors that are formed by contributions from three or four primary
      dendrites and their dependent branches (dendritic systems). Most dendritic
      systems contribute to both branching planes, but some are confined to a single
      plane. The way in which dendritic systems combine to form the branching planes
      varies from cell to cell, but the dendritic systems always produce a non
      overlapping tiling of the planes having a distinctive mesh-like appearance. This
      mesh-like pattern appears to be produced primarily by a large number of branches
      that terminate close to the cell somata. Despite clear differences in the
      detailed construction of the dendritic arbors, quantitative morphological
      attributes vary primarily with overall size, and the variation is nearly
      isometric. We therefore regard these cells as isomorphic, in the sense that they
      have developed according to the same rather liberal rules for dendritic growth.
      More importantly, however, we have not found any morphological feature that is
      correlated with the cells' preferred response directions. We conclude that the
      distinctive dendritic architecture of these cells is related to general
      requirements for dense, uniform sampling from specific input arrays, and not
      direction-selectivity per se. The most important rules governing the branching
      pattern of the ON-OFF direction-selective cells may be related to territoriality,
      wherein dendrites, dendritic systems, and cells of the same type establish non
      overlapping domains.

PMID- 8351834
TI  - Structural testing of multi-input linear-nonlinear cascade models for cells in
      macaque striate cortex.
AB  - Structural testing methods based on experimental white noise stimulus-response
      data were used to evaluate multi-input linear-nonlinear (LN) cascade models for
      simple and complex cells in macaque striate cortex. An LN structural test index,
      based on white noise stimulation, was developed and found to be suitable for
      classifying cells as simple vs complex. In particular, classification results
      based on the LN structural test index were similar to classification results
      based on a traditional modulation index derived from cell responses to drifting
      sinewave gratings. Judging from their structural test indices, complex cells
      deviated more strongly from LN behavior than did simple cells. Yet, even with
      simple cells, on average, only about 60% of the first- and second-order white
      noise stimulus-response relation was consistent with LN behavior. Just two of
      thirteen simple cells studied had an LN consistency level that exceeded 80%.
      Similar results were found in tests for consistency with an LNL model which
      includes an additional linear post-filter. We conclude that a conventional multi
      input LN network model may be a useful approximation to the response behavior of
      some simple cells. However, even during steady state stimulus conditions,
      subcortical and/or cortical nonlinearities other than a static output
      nonlinearity play a very significant role in shaping the responses of most simple
      cells in the macaque striate cortex.

PMID- 8351835
TI  - The effects of peripheral flicker on foveal spectral sensitivity.
AB  - A flickering surround reduced sensitivity to large, briefly flashed monochromatic
      stimuli superimposed on a steady white background, compared to sensitivity
      measured when the surround was steady. The flickering surround had no effect on
      stimuli that were large and of long duration or small in size. Increasing the
      diameter of the background reduced the magnitude of the effect, but did not
      eliminate it.

PMID- 8351836
TI  - Spatiotemporal properties of motion perception for random-check contrast
      modulations.
AB  - To clarify the mechanism of detecting the motion of contrast modulations, the
      spatiotemporal properties of direction discrimination for contrast motion were
      examined. The stimulus was a microbalanced random stimulus [Chubb and Sperling
      (1988) Journal of the Optical Society of America A 5, 1986-2007], termed random
      window kinematogram (RWK), a shifting random checkerboard pattern in which each
      check was either a patch of random dots (uncorrelated between frames) or a patch
      of uniform gray having the mean luminance of the random dots. The effect of
      exposure duration (ED) on RWK discrimination could be described as stimulus onset
      asynchrony (SOA) dependency when EDs of the first and second frames were the
      same, but the performance was better than predicted from SOA when the first ED
      was short while the second was long. RWK could be seen at longer inter-stimulus
      intervals than random-dot kinematogram (RDK) having similar stimulus parameters
      (e.g. check size, effective contrast). Incoherent motion (e.g. reversed phi)
      could be seen for RWK. Maximum displacement limit (Dmax) for RWK was comparable
      to that of RDK, but it increased in proportion to check size, while Dmax for RDK
      did not. These results suggest that the contrast motion mechanism extracts motion
      locally, and involves a correlation-type motion extraction stage similar to the
      luminance motion mechanism. In addition, the spatial ranges of the contrast
      motion detectors are comparable to those of the luminance motion detectors, but
      their temporal range is larger. The contrast motion mechanism is more scale
      invariant than the luminance motion mechanism.

PMID- 8351837
TI  - Pulse modulation detection in human motion vision.
AB  - We present data on the human sensitivity to temporal pulse modulations of target
      velocity. We measured threshold detection modulation amplitudes for pulse-shaped
      speed modulations, as a function of pulse duration and temporal frequency. At
      short pulse durations (up to 50 msec) and low modulation frequency (1 Hz),
      detection amplitudes are ruled by Bloch's law: the product of pulse duration and
      threshold modulation amplitude is a constant. This constant corresponds to a
      position modulation with an amplitude of 3 arc min in a coordinate frame that
      moves at the average speed (3 deg/sec) of the target. At longer pulse durations
      we find deviations from Bloch's law. Speed modulation thresholds are not
      critically dependent on target luminance contrast. These results are modeled by a
      modulation detection process in two stages. A functional description of the first
      stage is filtering of the true speed modulation signal by a second order low-pass
      filter with a characteristic time constant of 20-25 msec. The second (decision)
      stage is variance detection: modulations are detected when the variance of the
      filtered modulation function exceeds a certain threshold variance. The square
      root threshold variance is estimated 8-10%. This two-parameter model accurately
      predicts the measured dependence of pulse modulation detection thresholds on
      pulse duration and pulse density.

PMID- 8351838
TI  - Motion-based detection by 14-week-old infants.
AB  - Three experiments using standing wave stimuli with 14-week-old human infants are
      reported. Two competing hypotheses regarding the detection of these standing wave
      line stimuli were tested in these studies. Amplitude-based (positional) detection
      was contrasted with speed-based (motion) detection. Temporal oscillation
      frequencies of 0.15, 0.30, 0.60 and 1.20 Hz were used. The detectability of a
      standing wave of fixed amplitude was influenced significantly by the temporal
      frequency of the oscillation. By inference, the results of the three experiments
      supported the motion-based detection hypothesis.

PMID- 8351839
TI  - Spatial-frequency adaptation: evidence for a multiple-channel model of short
      wavelength-sensitive-cone spatial vision.
AB  - The frequency selective effects of spatial adaptation were measured with
      vertically-oriented, cosine stimuli upon an intense long-wavelength (yellow)
      field, which isolated the short-wavelength-sensitive (S) cones. Consistent with
      isolated-S-cone spatial threshold and masking results, the adaptation
      measurements demonstrate S-cones input to multiple, orientation selective,
      spatial frequency mechanisms. Moreover, the adaptation measurements show the
      minimum number of S-cone mechanisms is three. The frequency tuning of each
      mechanism was derived from the S-cone threshold and masking results. Two of the
      tuning curves are bandpass with peak sensitivities in a vicinity of 0.7 and 1.4
      c/deg, respectively. These two closely resemble tuning curves derived from
      results with luminance-modulated stimuli. Confined to the range of frequencies
      examined (0.25-2.83 c/deg), the third tuning curve is lowpass with a high
      frequency cutoff of roughly 2.0 c/deg. However, subsequent measurements of
      orientation selectivity demonstrate the third mechanism to have bandpass
      frequency tuning as well.

PMID- 8351840
TI  - Distortions in two-dimensional visual space perception in strabismic observers.
AB  - Amblyopic subjects were asked to memorize circles of different radii (2, 4 and 6
      degrees), and then to reconstruct them monocularly with each eye, point by point
      (12 points per circle). The resulting two-dimensional maps of visual space showed
      considerable distortions, including expansion, shrinkage and torsion of specific
      regions of the visual field of the amblyopic eye, but not the normal eye. Based
      on the differences between the two eyes, we computed complex two-dimensional
      patterns (gratings, checkerboards, optotypes, written text, natural scenes) as
      "seen" monocularly with the amblyopic eye. These reconstructed patterns were then
      compared with drawings of the same patterns observed through the amblyopic eyes
      of the same subjects. The reconstructed patterns only partially reflected the
      actual perception for the amblyopic eyes. The compensation of complex, globally
      extended scenes in comparison to the distortions obtained by local, punctate
      settings probably reflects cooperative interactions occurring at higher brain
      levels.

PMID- 8351842
TI  - Saccade-contingent displacement of the apparent position of visual stimuli
      flashed on a dimly illuminated structured background.
AB  - Subjects were required to perceptually judge the location of flash targets
      presented at the time of a saccade at various positions scattered two
      dimensionally on a dimly illuminated structured background. The saccade
      contingent mislocalization was shown only in the direction parallel to the
      saccade, and not in the direction perpendicular to the saccade. In addition, the
      mislocalization under the "illuminated background" condition was different in
      several respects from that observed when targets were presented in the dark. It
      was suggested that the mislocalization is successfully explained by assuming
      three physiological and cognitive processes: a sluggish activity of the
      extraretinal eye position signal, visual cues from the visible background, and
      selective inattention to image displacements.

PMID- 8351841
TI  - Binocular eye orientation during fixations: Listing's law extended to include eye
      vergence.
AB  - Any eye position can be reached from a position called the primary position by
      rotation about a single axis. Listing's law states that for targets at optical
      infinity all rotation axes form a plane; the so-called Listing plane. Listing's
      law is not valid for fixation of nearby targets. To document these deviations of
      Listing's law we studied binocular eye positions during fixations of point
      targets in the dark. We tested both symmetric (targets in a sagittal plane) and
      asymmetric vergence conditions. For upward fixation both eyes showed intorsion
      relative to the position that would have been taken if each eye followed
      Listing's law. For downward fixation we found extorsion. The in- or extorsion
      increased approximately linearly with the vergence angle. The direction of the
      Listing axis and the turn angle about this axis can be described by rotation
      vectors. Our observations indicate that for fixation of nearby targets the
      rotation vectors of the two eyes become different and are no longer located in a
      single plane. However, we find that it is possible to decomose the rotation
      vector of each eye into the sum of a symmetric and an anti-symmetric part, each
      with its own properties. (1) The symmetric part is associated with eye version.
      This component of the rotation vector is identical for both eyes and lies in
      Listing's plane. In contrast to the classical form of Listing's law, this part of
      the rotation vector lies in Listing's plane irrespective of the fixation
      distance. (2) The anti-symmetric part of the rotation vector is related to eye
      vergence. This component is of equal magnitude but oppositely directed in each
      eye. The anti-symmetric part lies in the mid-sagittal plane, also irrespective of
      fixation distance. For fixation of targets at optical infinity the anti-symmetric
      part equals zero and the eye positions obey the classical form of Listing's law.
      Thus, the symmetric and anti-symmetric parts of the rotation vectors are
      restricted to two perpendicular planes. Combining these restrictions in a model,
      with the additional restriction that the vertical vergence equals zero during
      fixation of point targets, we arrive at the prediction that the cyclovergence is
      proportional to the product of elevation and horizontal vergence angles. This was
      well born out by the data. The model allows to describe the binocular eye
      position for fixation of any target position in terms of the bipolar coordinates
      of the target only (i.e. using only three degrees of freedom instead of the six
      needed for two eyes).

PMID- 8351843
TI  - Perceptual fading of visual texture borders.
AB  - A light gray square was displayed on a background of dynamic two-dimensional
      noise. After 10 sec of steady eccentric fixation, the square disappeared
      completely and the region corresponding to it was "filled in" by dynamic noise
      from the surround. Furthermore, when the whole display was switched off, a
      persisting patch of dynamic two-dimensional noise was seen in the region
      corresponding to the gray square. This persistent patch could be seen for almost
      10 sec on some trials, suggesting that a dynamic neural representation of the
      surrounding "twinkle" is being created in this region. The fading of the square
      was especially pronounced in peripheral vision. Also, displacing the square by a
      small distance was usually sufficient to restore its visibility but this distance
      increased with eccentricity. This may be a consequence of the progressive
      increase of receptive field size with eccentricity that has been noted in both
      area 17 and MT. The perceptual fading and "filling in" that we report concurs
      with the recent physiological observations of Pettet and Gilbert [(1991) Society
      for Neuroscience Abstracts, 17, 1090] and Gilbert and Wiesel [(1992) Nature, 356,
      150-152] in area 17 of cats and primates.

PMID- 8351844
TI  - Modelling of orientation discrimination across the visual field.
AB  - In many visual tasks thresholds can be made equal across the visual field by
      increasing the size of peripherally presented stimuli by appropriate
      magnification. The parameter E2 represents the eccentricity at which foveal
      stimulus size must double in order to maintain performance equivalent to that at
      the fovea. We measured orientation discrimination for a set of line sizes at
      various eccentricities. Thresholds were successfully scaled by applying a scaling
      function estimated by a technique that requires no prior assumptions regarding
      the size of peripherally presented stimuli. E2 of 1.95 deg was found for
      orientation discrimination. From our results we were able to develop a single
      equation which predicts orientation discrimination thresholds for an average
      observer over a range of different eccentricities and line lengths.

PMID- 8351845
TI  - Application of a simple mechanical model of accommodation to the aging eye.
AB  - A simple model for the mechanics of accommodation in the human eye, previously
      proposed, is applied to the eye at different ages. Data from work by R. F. Fisher
      is used to derive values for the elasticity of lens-plus-zonules and data from
      work by G. W. H. M. van Alphen and W. Graebel is used to derive values for the
      elasticity of the choroid, each at a series of ages. The model is applied in two
      ways: (i) the elasticity of one component is allowed to change with age, while
      the other (and also ciliary muscle force) is held constant and the effect on
      accommodative amplitude is estimated; (ii) both elasticities are allowed to
      change with age, and muscle force is assumed to take on values producing a
      constant change in the radius of the "ciliary ring". It is shown that, in
      principle, age-related changes in choroid could account for a substantial
      component of the observed loss of accommodative amplitude, and it is suggested
      that this may be the case for monkeys, but not for humans. For the case of "all
      components changing", which is probably the case for humans, the ciliary muscle
      is likely to become stronger with age.

PMID- 8351846
TI  - Quantifying color constancy: evidence for nonlinear processing of cone-specific
      contrast.
AB  - Color constancy was studied by the method of comparing color samples under two
      different illuminants using a CRT color monitor. In addition to the classical
      approach in which one of the illuminants is a (standard) white, we performed
      experiments in which the range of differential illumination was extended by using
      pairs of lights that were both colored. The stimulus pattern consisted of an
      array of thirty-five color samples (including five neutral samples) on a white
      background. A trichromatic illuminant-object interaction was simulated analogous
      to that resulting from illumination by three monochromatic lights. The test
      samples, as seen under "test" and "match" illumination, were successively
      presented to the left and right eye (haploscopic matching). The data show
      systematic deviations from predictions on the basis of cone-specific
      normalization procedures like those incorporated in the Retinex algorithm and the
      von Kries transformation. The results can be described by a nonlinear response
      transformation that depends on two factors, receptor-specific sample/background
      contrast and the extent to which the illuminant stimulates the receptor system in
      question. The latter factor explains the deviations. These are mainly caused by
      the short-wave-sensitive system, as a consequence of the fact that this system
      can be more selectively stimulated than the other, spectrally less separated,
      cone systems.

PMID- 8351847
TI  - Psychophysical measures of illusory form perception: further evidence for local
      mechanisms.
AB  - Detection thresholds for a small light spot were measured at various distances
      from configurations (Kanizsa squares and other) consisting of white inducing
      elements on a dark background. Threshold distributions as a function of target
      position, number, size and spacing of contrast inducing elements were
      established. The data show that thresholds are elevated when the target is
      located close to one or more inducing element(s). Furthermore, threshold
      elevations diminish with increasing distance of the target from the
      configurations, increasing spacing and decreasing size of their inducing
      elements. When the target is flashed upon an illusory contour, no threshold
      elevation is observed in any of the conditions tested. Within incomplete illusory
      figures (only half of the square visible), the threshold gradients show the same
      tendencies. The present observations add further empirical support to the idea
      that illusory figures are built up by way of local mechanisms at early stages of
      processing.

PMID- 8351848
TI  - Movement direction analysers: independence and bandwidth.
AB  - Opponent, or ratio, models of movement direction perception propose that pairs of
      analysers, sensitive to opposite directions, are linked in an opponent fashion.
      Alternatively, distribution models posit independence of movement direction
      analysers. To investigate analyser independence, a direction-selective adaptation
      experiment was conducted in which motion coherence thresholds for random-dot
      apparent motion stimuli were measured for upward, downward, leftward and
      rightward motion with and without prior adaptation to rightward motion. Coherence
      thresholds for rightward motion were elevated on average by 0.64 log units after
      adaptation. Thresholds for motion in the other directions remained unchanged.
      Since opponent models predict enhanced sensitivity after adaptation for the
      direction opposite that of adaptation, these results suggest that movement
      direction analysers operate independently. In a second experiment subjects
      adapted to a bidirectional stimulus containing an equal number of leftward and
      rightward moving dots. Leftward and rightward coherence thresholds were elevated
      even though no motion aftereffects were produced. A third experiment in which
      coherence thresholds for test directions within a narrow range were measured with
      and without prior adaptation to motion in the direction of the range's mean
      showed that threshold elevation was maximal when test and adaptation direction
      were matched and fell off as the difference in adaptation and test direction
      increased. The resulting functions indicate that the bandwidth of movement
      direction analysers is between +/- 35 and +/- 40 deg, a value consistent with
      reported mean directional tuning functions of movement sensitive units in the
      middle temporal area but smaller than previously reported psychophysical values.

PMID- 8351849
TI  - Optical flow from eye movement with head immobilized: "ocular occlusion" beyond
      the nose.
AB  - The point of observation translates with eye movement because it is not
      coincident with the center of rotation in the eye. "Ocular occlusion" results.
      The amount of optical structure revealed by eye rotation depends on the distances
      of the occluding and occluded surfaces. The method of adjustment was used in Expt
      1 to investigate the amount of structure detected at distances up to 1 m. In Expt
      2, a forced-choice method was used to confirm predictions based on the assumption
      that the point of observation is in the entrance pupil at 11 mm from the center
      of rotation. (The location of the point of observation in the eye had not been
      measured previously.) Experiment 3 investigated the use of ocular occlusion to
      detect separation of surfaces in depth.

PMID- 8351850
TI  - The effect of transiency on perceived velocity of visual patterns: a case of
      "temporal capture".
AB  - We measured the points of subjective equality of velocity for dynamic
      unidirectionally moving random-dot patterns with different amounts of transiency.
      The transiency was changed by varying the time a dot would move before being
      randomly replotted within the stimulus. The perceived velocity of patterns moving
      at intermediate velocities (4 or 6 deg/sec) was increased by decreasing the point
      lifetime while no speedup was observed at high velocities (12 deg/sec). A speedup
      was also observed when a few stationary points of short lifetime were introduced
      into a stimulus. The non-directional transiency generated by these flickering
      points seems to be captured by the moving pattern and biases the velocity
      estimate. We term this phenomenon "temporal capture". The results are in
      agreement with models that determine velocity by comparing the activity in lower
      and higher temporal frequency channels. Our stimuli would selectively increase
      activity in high temporal frequency channels and thus lead to an increase in
      perceived velocity.

PMID- 8351851
TI  - Detecting and discriminating the direction of motion of luminance and colour
      gratings.
AB  - Human observers were required to discriminate the direction of motion of
      vertically moving, 1 c/deg luminance and colour gratings. The gratings had
      different contrasts and moved at temporal frequencies between 0.5 and 32 Hz.
      Sensitivity [the reciprocal of the contrast at which performance reached 75%
      correct in a temporal two-alternative forced-choice (2 AFC) discrimination task]
      was a band-pass function of temporal frequency for luminance gratings, and a low
      pass function of temporal frequency for colour gratings. Further, when colour
      contrast was expressed in terms of the modulation in cone excitation produced by
      the stimulus, sensitivity to colour gratings was greater than sensitivity to
      luminance gratings at frequencies below 2 Hz. On the other hand, at temporal
      frequencies above 4 Hz, sensitivity to colour gratings was comparable with
      sensitivity to luminance gratings of double the temporal frequency. Detection
      sensitivity was measured for luminance and colour gratings of 1, 4 and 16 Hz.
      With either colour or luminance gratings, detection thresholds were very similar
      to those for direction-of-motion discrimination. This result confirms findings of
      Mullen and Boulton [(1992) Vision Research, 32, 483-488] and Cavanagh and Anstis
      [(1991) Vision Research, 31, 2109-2148], but is different from that reported by
      Lindsey and Teller [(1990) Vision Research, 30, 1751-1761] who used a smaller
      stimulus seen in a parafoveal region and found that motion discrimination
      thresholds were higher than detection threshold for colour gratings. We repeated
      our threshold measurements using parafoveal viewing conditions similar to those
      used by Lindsey and Teller (1990). We found that, although for luminance gratings
      detection thresholds were very close to direction-discrimination thresholds, for
      colour gratings, they were lower. The result is in qualitative agreement with
      Lindsey and Teller (1990). Our results suggest that low-level, or "first-order"
      motion mechanisms are not as sensitive to chromatic gratings as are colour
      detection mechanisms.

PMID- 8351852
TI  - Integration of depth modules: stereopsis and texture.
AB  - Global shape judgements were employed to examine the combination of stereopsis
      and shape-from-texture in the determination of three-dimensional shape. Adding
      textural variations to stereograms increased perceived depth. Thus, texture was
      not simply vetoed by the strong stereo cue. In experiments where the depth
      specified by texture was incongruent with that specified by stereo, the data were
      well described by a weighted linear combination rule. Although only a small
      weight was assigned to texture, this weight was somewhat greater at a farther
      viewing distance. This could be a consequence of the decreased reliability of
      stereopsis at far viewing distances.

PMID- 8351853
TI  - Effects of different texture cues on curved surfaces viewed stereoscopically.
AB  - Stereoscopic shape judgements can be modified by the addition of texture cues.
      This paper examines the properties of texture that are responsible for this
      effect. When a three-dimensional curved surface is projected onto a two
      dimensional image, changes in surface orientation result in gradients of texture
      element size (or area), shape (compression) and density in the image.
      Manipulating each of these gradients independently we found that 97% of the
      variance in the results could be accounted for by the compression gradient. When
      the texture pattern corresponds to a highly anisotropic texture on the object's
      surface, shape-from-texture becomes ineffective. These results suggest that human
      shape-from-texture proceeds under the assumption that textures are statistically
      isotropic, and not that they are homogeneous.

PMID- 8351854
TI  - Saliency effects across dimensions in visual search.
AB  - In previous work it has been shown that search for an orientation target can only
      be done fast, and in parallel, when the target's orientation differs sufficiently
      from that of neighbouring lines. Targets with an increased local orientation
      contrast appear as salient and are immediately detected. In the present study,
      the effect of saliency from other stimulus dimensions was investigated. Five
      subjects were asked to look for vertical lines in texture-like displays, which
      were presented either embedded in the local orientation flow ("non-salient"
      target presentation) or at an increased feature contrast ("salient" target
      presentation). Saliency was obtained from local differences in orientation
      ("within dimension" saliency) or other visual cues ("cross dimensions" saliency),
      such as colour, luminance, motion, and disparity. Targets displaying cross
      dimensional saliency were always non-salient in the orientation domain. The
      results show that subjects were slower in detecting targets from non-salient than
      from salient presentations. The effect of saliency on visual search is not
      feature-specific and, in particular, is not restricted to the stimulus dimension
      in which target features are searched for.

PMID- 8351855
TI  - Magno and parvo visual channels and the subjective Necker cube.

PMID- 8351856
TI  - Dependence of speed and direction perception on cinematogram dot density.
AB  - In the present experiments, we find that with abrupt decreases in dot density of
      random-dot cinematograms, perceived speed decreases, while with abrupt increases
      in dot density, perceived speed increases. Further, in steady-state conditions,
      perceived speed is also affected in the same way, but to a lesser degree, by the
      dot density of cinematograms. Direction discrimination of random-dot
      cinematograms is enhanced when dot density increases abruptly from one stimulus
      to the next, but is degraded when dot density decreases abruptly. Finally, speed
      discrimination remains constant even when density changes abruptly. The perceived
      speed and direction-discrimination data are consistent with the Motion Coherence
      theory which motivated this study, and with models that include a smoothing stage
      similar to this theory. Of the other models that we consider, most predict that
      increasing dot density reduces perceived speed. The speed-discrimination data
      could not distinguish between the different theories.

PMID- 8351858
TI  - [Indications for cornary angiography].
AB  - This is a summary of relative indications for the selection of patients for
      coronary angiography. Coronary angiography is an important part of clinical
      evaluation of patients with ischemic heart disease, valve heart disease,
      cardiomyopathies. Main groups of patients with ischemic heart disease are: angina
      pectoris after low levels of effort despite a good medical treatment, unstable
      angina, variant angina, angina with high risk of acute coronary syndromes from
      noninvasive exercise testing. In addition coronary angiography is indicated in
      patients with unexplained congestive heart failure, in patients with acute
      myocardial infarction with mechanical complication requiring cardiac surgery such
      as hemodynamically important mitral insufficiency, large ventricular septal
      defect or a large aneurysm leading to heart failure. Also in patients with sudden
      death syndrome unrelated to acute myocardial infarction. Patients with silent
      ischemia with known coronary artery disease and with known risk factors should
      undergo coronary angiography. Indication for coronary angiography is also in
      patients with hemodynamically important valvular, subvalvular or supravalvular
      heart disease in whom corrective surgery is contemplated.

PMID- 8351857
TI  - [The position of internal medicine in Europe. Report from a meeting of the
      presidents of European internal medicine societies].

PMID- 8351860
TI  - [Sick sinus syndrome and permanent cardiac pacing].
AB  - The authors submit a retrospective analysis of 140 patients with an affection of
      the sinoatrial node who had a permanent cardiac pacemaker. The analysis comprises
      an 18-month period; the patients were from the eastern Slovakian region. The
      authors emphasize different affections of the sinoatrial node and discuss various
      ways of permanent cardiac pacing and other types of non-pharmacological treatment
      (e.g. electric ablation). Diseases of the sinoatrial node account for as much as
      40% of implantations of a permanent pacemaker on account of bradyarrhythmia. At
      the clinic this implies a quantitative increase of cardiac pacing on account of
      diseases of the sinoatrial node by 18%, as compared with a previous period (e.g.
      the average for 1978-1987). A qualitative change is the introduction of
      physiological permanent cardiac pacing.

PMID- 8351859
TI  - [Inhibition of thrombocyte activity in atherogenesis and thrombogenesis using
      isradipine and other calcium antagonists].
AB  - Increased platelet activity on structurally and functionally impaired endothelium
      leads to a release of serotonin (5HT), thromboxane A2 and growth factors from
      platelets. These vasoactive substances may participate in the development of
      atherosclerosis and thrombovascular events. Platelet aggregatory response to 5HT
      increases with the height of blood pressure, age, smoking and plasma cholesterol
      levels. Lipoprotein fractions exert disparate effects an platelets. LDL
      cholesterol amplifies 5HT-induced platelet activation whereas HDL-cholesterol
      inhibits the amplifying effect of LDL-cholesterol. These results indicate that
      different effects of HDL and LDL-cholesterol on atherosclerotic progression that
      where found in epidemiological and population studies take place at a cellular
      level and may represent one of the underlying cellular mechanisms of
      atherogenesis. This mechanism may be relevant to both atherogenesis and acute
      thrombovascular events and therefore may represent a target of pharmacological
      intervention. Effect of calcium antagonists on serotonin- and LDL-induced
      platelet aggregation were investigated. Isradipin and verapamil (but not
      diltiazem, amlodipin and felodipin) inhibited at therapeutic concentrations
      platelet aggregation induced by 5HT in vitro. Isradipin (but not diltiazem and
      felodipin) also inhibited the amplifing effect of LDL-cholesterol on 5HT-induced
      platelet aggregation in vitro. Effects of isradipin on 5HT-induced platelet
      activity as well as on the amplifying effect of LDL-cholesterol were observed
      also ex vivo. Calcium antagonists differ in their platelet inhibition potency,
      including their effects on platelet response to 5HT and LDL-cholesterol. These
      platelet effects of Calcium antagonists appear to be neither group- nor class
      specific, but rather drug specific. Effect of isradipin may be relevant to
      platelet-mediated coronary vasospasm and to prevention of both atherogenesis and
      thrombogenesis.

PMID- 8351861
TI  - [Captopril in the treatment of congestive heart failure in acute myocardial
      infarct].
AB  - The extent of affection of the heart muscle by infarction with subsequent left
      ventricular dilatation, remodelling and congestive failure is the decisive
      prognostic indicator of mortality. Inhibitors of ACE influence congestive heart
      failure in a favourable way and captopril reduces the morbidity and mortality in
      patients with still asymptomatic left ventricular dysfunction. The authors
      administered to a group of 23 patients with acute myocardial infarction and
      congestive heart failure (grade II according to Killip) small doses of captopril
      (4 x 6.25 mg/day)for a period of 10 days from the 1st-4th day after the onset of
      the disease). From ACE serum levels the effectiveness of these doses was assessed
      in keeping with data in the literature. As compared with a control group of 26
      patients with similar haemodynamic conditions the authors did not find
      significant differences as regards improvement of the decompensation and in the
      mortality (a 3 patients in both groups). As to undesirable effects, arterial
      hypotension was recorded three times, twice minor proteinuria, once asymptomatic
      thrombocytopenia. Decisive for future therapeutic decision making are above all
      the results of the SAVE study which prefers captopril in patients with a yet
      asymptomatic left ventricular dysfunction. The authors are not quite convinced on
      the necessity to administer larger doses of captopril (up to 3 x 50 mg/day) in
      this indication.

PMID- 8351862
TI  - [Comparison of the effects and safety of atenolol and nifedipine in the treatment
      of angina pectoris].
AB  - The effects of atenolol (100 mg/day) and nifedipine (60 mg/day) on angina
      symptoms and exercise tolerance were compared in an open, randomized study.
      Twelve-week treatment period was compared with two weeks of placebo treatment in
      51 patients with chronic stable angina pectoris. Mean frequency of angina attacks
      decreased significantly from 8.3 to 1.6 attacks per week after atenolol treatment
      (p < or = 0.05). Both drugs increased exercise tolerance to development of signs
      of ischemia on electrocardiogram (p < or = 0.05) and increased maximal exercise
      tolerance as well (p < or = 0.05). Mean ST segment depressions at peak exercise
      were significantly decreased after treatment with atenolol and nifedipine (p < or
      = 0.05). Both drugs also increased total exercise capacity in comparison with
      placebo period, stated as 100%:192% after atenolol and to 191% after nifedipine.
      No significant changes of heart rate and blood pressure were noted during
      treatment period. Twelve patients did not finished study, two of them suffered
      myocardial infarction with death in one of them (atenolol group, other one
      nifedipine group). Thus, atenolol in one daily dose is as effective as nifedipine
      in chronic stable angina patients when administered as single therapy.

PMID- 8351863
TI  - [Significance of pulmonary vein flow for the determination of left ventricular
      filling pressure].
AB  - The aim of the submitted study was to evaluate the blood flow in the pulmonary
      veins by transoesophageal Doppler echocardiography which is the ideal method for
      recording the blood flow in the pulmonary veins as the ultrasound probe is
      closely behind the left atrium. In 35 patients with ischaemic heart disease the
      authors evaluated the blood flow in the pulmonary veins to assess whether the
      rate of the blood flow in these vessels can serve a non-invasive estimate of the
      end-diastolic pressure in the left ventricle (LVEDP). It was revealed that venous
      blood flow has in the majority of cases two anterior peaks during ventricular
      systole, one anterior peak during diastole and one negative peak during atrial
      contraction. In patients with normal LVEDP the peak rate and integral time
      velocity of the flow curve is greater during systole, while in patients with a
      higher LVEDP these parameters are higher during diastole. Dopplerian assessment
      of the flow in the pulmonary veins is safe, relatively non-invasive and simple.
      This method makes possible rapid visual estimates of the end-diastolic pressure
      in the left ventricle.

PMID- 8351864
TI  - [Another source of hemorrhage--risks for patients with esophageal varices].
AB  - The authors treated during the past three years 312 patients with oesophageal
      varices after the first haemorrhage. All patients were treated by endoscopic
      sclerotization of oesophageal varices and drugs which reduce the excessive portal
      pressure. After a minimum of two sclerotherapeutic sessions, following control of
      acute haemorrhage, the authors observed a relapse of haemorrhage from the upper
      gastrointestinal tract in 38 patients. In 20 of them the relapse of haemorrhage
      was again from oesophageal varices, but in 18 patients it was of different origin
      and would not be affected by classical treatment with a Sengstaken tube. The
      authors draw attention to the necessity of emergency endoscopy in these patients
      and to the fact that possible postponement of rational treatment, e.g. in
      duodenal ulcers insertion of a tube, may threaten the patient's life.

PMID- 8351865
TI  - [The effect of selective decontamination on malignant hematologic diseases
      treated with aggressive chemotherapy].
AB  - The authors analyzed the course of 100 cycles of chemotherapy administered on
      account of haematological oncological disease: 66 cycles with administration of
      selective decontamination and 34 without its administration. Based on an analysis
      of the gut flora they provided evidence of the necessity of concurrent
      administration of originally separately administered antibiotics and of the
      necessity to replace nystatin by amphotericin B. They found a significant
      reduction of the incidence of infectious complications, the number of days with a
      body temperature above 38 and reduced consumption of antibiotics. The authors
      found a different composition of the agents causing infectious complications--a
      reduction of the ratio of Gram-negative agents and an increase of Gram-positive
      agents and fungi and also in increased percentage of fever of unknown origin. By
      analysis of the sensitivity of the detected microbes to antibiotics the authors
      assessed changes in the resistance caused by administration of selective
      decontamination and assessed the order of assumed effectiveness of the tested
      antibiotics.

PMID- 8351866
TI  - [Endothelial cells in tumors of the rectum and large intestine].
AB  - In 40 controls and 102 patients with tumours of the rectum and large intestine
      the number of circulating anuclear cell residues of endothelial cells was
      investigated. The number of these endothelia in the blood of patients was
      significantly higher (p < 0.001) than in healthy subjects. After successful
      surgery of the tumour and subsequent chemotherapy the number of endothelia in
      venous blood reached normal levels with in 1-2 months. Conversely in patients
      where despite surgery secondaries were detected in other organs, the number of
      endothelia remained elevated.

PMID- 8351867
TI  - [Sjogren's syndrome].
AB  - The authors present an account on Sjogren's syndrome--clinical manifestations,
      diagnosis, pathogenetic aspects and treatment. The diagnosis was based on three
      findings: keratoconjunctivitis sicca, stomatodynia--xerostomia and other
      immunological, diseases. The authors used different immunological examinations,
      bioptic examination of the oral mucosa and parotid glands. As to
      gastroenterological examinations, the gastric secretion is examined according to
      Lambling's method, the gastroduodenum is subjected to radiographic examination,
      endoscopy is performed as well as a bioptic examination of the gastroduedenal
      mucosa.

PMID- 8351868
TI  - [The effect of 2-aminoethylisothiouronium bromide on HLA antigens].
AB  - Lymphocytes treated with a 6% and 4% AET solution after 60 or 120 minutes at 20
      degrees or 37 degrees C display polyreactivity. Polyreactivity does not develop
      after short-term treatment (1-10 mins.). After treatment of lymphocytes with a 3%
      or 2% AET solution for a period of 20 or 30 mins. at 20 degrees or 37 degrees C
      the specific expresivity of HLA--A, B antigens rises; they are manifested,
      contrary to untreated lymphocytes, also by weak HLA sera. Addition of AET to the
      mixture of lymphocytes--HLA serum causes in the first stage of the
      microlymphocytotoxic test negativity of the test due to a block of the haemolytic
      activity of rabbit complement.

PMID- 8351869
TI  - [Therapy of refractory multiple myeloma. II. Therapy using high doses of
      alkylating cytostatic agents and radiotherapy in addition to interferon and bone
      marrow transplantation].
AB  - The author presents part II of his review on the treatment of refractory myeloma.
      Treatment with large doses of melphalane, 140 mg/m2, was associated with a high
      death rate and therefore it is used nowadays only in combination with autologous
      transplantation or treatment with leucocytic growth factors (GM-CSF and G-CSF).
      Medium doses of melphalane (25 mg/m2 to 70 mg/m2) are tolerated better and are
      one of the possible approaches. Another possible therapeutic procedure is whole
      body irradiation. The advantage of extensive irradiation is rapid regression of
      pain. Interferon-alpha achieves a therapeutic response in some 20% of refractory
      patients. Finally the author presents some data on transplantation of bone marrow
      in patients with multiple myeloma.

PMID- 8351870
TI  - [Diabetes mellitus and the digestive tract].
AB  - The author discusses in the submitted paper the important subject of
      manifestations of diabetes in the digestive tract--oesophagus, stomach, small and
      large intestine. Autonomous neuropathy, in particular a reduced tonus of the
      vagus, leads to a number of functional disorders which can produce diabetic
      dysphagia, gastroparesis, diarrhoea and constipation. The reduced tonus of the
      vagus, along with other factors, may lead to atrophy of the gastric mucosa and
      reduced gastric secretion. This explains the higher incidence of atrophic
      gastritis and other complications in diabetic patients. The author discusses also
      basic clinical aspects of these disorders and outlines therapeutic procedures.

PMID- 8351871
TI  - [Intracoronary "stents" in the treatment of ischemic heart disease. Brief
      review].
AB  - The author present a brief review of the contemporary development of stents.
      Stents are used in the therapy of ischaemic heart disease, they are "tubes"
      inserted by methods of intervention cardioangiology into the coronary lumen to
      ensure their patency. At present they are indicated in particular in the
      treatment of acute arterial obliteration after PTCA. Stents used at present do
      not meet the demands required by long-term follow up. Stents used at present in
      clinical work are made from different metals. The authors describe also
      experimental experience with stents made from bioabsorbable materials which
      potentially appear to have much more suitable properties as regards maintenance
      of long-term patency of the affected artery. The properties of an "ideal stent"
      are described.

PMID- 8351872
TI  - [Variability of ECG changes in ambulatory Holter monitoring during treatment of
      hypothyroidism].
AB  - The authors examined by 24-hour Holter monitoring the ECG in 20 patients treated
      on account of primary hypothyroidism with thyroid hormones. The patients were
      divided, with regard to the presence or absence of manifest ischaemic heart
      disease, into two groups which differed significantly as to the mean age of
      patients and the minimal R-R interval. In both groups diffuse ectopia was found
      without persisting activity except for one patient after myocardial infarction
      with relapsing ventricular tachycardia, organic sinoatrial blocks were found in
      two patients, an organic atrioventricular grade II block in one female patient
      and a functional (vagotonic) atrioventricular block of a higher grade in one
      female patient. Significant depressions of the ST segment, mostly of the
      asymptomatic type, were recorded in 55% of the patients, not differing in
      intensity and number of delevelings in positive patients of both groups.
      Comparison of mean circadian heart rates in relation to the type of substitution
      treatment revealed a minor tachycardic effect of one-component preparations
      containing levothyroxine only.

PMID- 8351873
TI  - [Blood component replacement in bone marrow aplasia in patients after aggressive
      chemotherapy for malignant hematologic diseases].
AB  - Aggressive chemotherapy of malignant haematological diseases causes long-term
      aplasia of bone marrow and it is necessary to supplement blood elements
      repeatedly. When procuring blood derivates frequently dramatic situations
      develop. In an attempt to prevent alloimmunization of the patient by careful
      selection of the donor the time interval between indication and administration of
      the transfusion is prolonged. The objective of the present work was to attempt an
      estimate, as regards time and amount, for transfusion of blood derivates. The
      authors analyzed 100 cycles of aggressive chemotherapy with regard to changes of
      the haemogram. The group was divided arbitrarily with regard to the initial value
      of different components of the haemogram and for these portions of the group a
      time schedule of check-up examinations of the haemogram and of the assumed time
      of indication of transfusion of blood derivates was elaborated. In patients with
      an initial values of red blood cells above 3.5 x 10(12)/l the first transfusion
      is usually needed on the 8th day after the beginning of chemotherapy, in patients
      with a values lower than 3.0 x 10(12)/l after the initial supplementation a
      further drop may be expected already on the 4th day. Indication of replacement of
      thrombocytes can be expected in patients with an initial thrombocyte value above
      120 x 10(9)/l cca on the 8th day, in patients with an initial thrombocyte value
      of 30 x 10(9)/l after initial replacement indication of another transfusion can
      be anticipated already on the 4th day after the beginning of chemotherapy.

PMID- 8351874
TI  - [Early empiric antibiotic therapy of infectious complications in patients with
      neutropenia].
AB  - Aggressive chemotherapy used at present for the treatment of malignant
      haematological diseases leads to prolonged aplasia of the bone marrow with the
      possible development of fulminant infectious complications. Treatment of these
      complications must be started immediately when they are detected, i.e. as a rule
      without knowing the bacteriological finding at the time. The objective of the
      present work was to assess by analysis of 376 positive bacteriological findings
      from hospitalized patients with neutropenia and 141 findings of immunocompromised
      patients in their homes a combination of antibiotics for empirical treatment of
      infectious complications which developed during hospitalization or treatment at
      home.

PMID- 8351875
TI  - [Erythropoietin or transfusion?].
AB  - The cause of anaemia in dialyzed patients is multifactorial. In the submitted
      paper the authors give an account of their experience with the treatment of 40
      patients with erythropoietin (Eprex Cilag Co.). The initial Hb values were 78 +/-
      13 g/l and haematocrit 0.24 +/- 0.03. After three months of treatment the
      haematocrit values were 0.30 +/- 0.02 and the Hb values 103 +/- 7 g/l. After one
      year's treatment haematocrit values were 0.31 +/- 0.03, Hb 105 +/- 10 g/l.
      Treatment was started by administration of 150 u/kg/week. Despite considerable
      individual differences the mean maintenance dose after one-year treatment is only
      65 u/kg/week. In two patients treatment was discontinued. Treatment of anaemia in
      dialyzed patients with erythropoietin is effective and as compared with the risks
      of repeated transfusions, also economical.

PMID- 8351876
TI  - [The locomotor system in irreversible renal failure treated with regular
      dialysis].
AB  - Changes of the locomotor apparatus in prolonged uraemia with regular dialyzation
      treatment determine the quality of life with all its consequences for the
      patient. The greatest impact on osteodystrophic disease (the most typical finding
      on the skeleton) is exerted by the length of dialyzation treatment. Of 216
      patients having regular dialyzation treatment in 1979 to 1992 the authors
      observed osteodystrophic disease in 25, i.e. 11.6%. As to other most frequently
      observed changes they recorded osteoporosis in 12.9%, only very rarely
      osteomalacia and even osteopetrosis (1.8%). Carpal tunnel syndrome was recorded
      in 17.4% as a symptom of so-called dialyzation amyloidosis and in one man they
      observed the development of typical rheumatoid arthritis shortly after the onset
      of haemodialyzation. This is a rare observation not described in the literature
      so far. Crystalline arthropathy, incl. typical attacks of gout, were recorded
      only in 11 patients (5%). Changes on the locomotor apparatus in conjunction with
      irreversible renal failure with regular dialyzation treatment were recorded in
      45%. It is important to differentiate findings which are not associated with
      uraemia and haemodialysis. This applies in particular to osteoarthritis deformans
      of the joints and spine. In major uraemic changes participates in particular
      secondary hyperparathyroidism. These changes comprise in particular osteolysis or
      even spontaneous absorption, erosive changes and destructive spondylopathy.
      Contemporary findings on the locomotor apparatus are so varied that they must be
      classified.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351877
TI  - [Aluminum osteopathy--experience with therapy].
AB  - The author discusses the problem of aluminium osteopathy as one of the clinical
      manifestations of aluminium intoxication in dialyzed patients. She describes the
      case-histories of three patients treated on account of aluminium intoxication
      with desferrioxamine. The disease was manifested by pain in the bones and joints
      and muscular weakness, in two patients also with symptoms of encephalopathy. The
      diagnosis was assessed only after a special examination of bone trepanobiopsy
      (staining with aurintricarboxyl acetic acid) and confirmed by assessment of the
      aluminium serum concentration. While treatment of the first patient in 1986 was
      not successful, in another two female patients it proved possible by combined
      treatment (desferrioxamine and haemofiltration treatment) to eliminate the
      aluminium from the organism and to improve the symptoms. At present no longer
      aluminium hydroxide is prescribed as a routine binding agent of phosphates in the
      digestive tract. Therefore cases of aluminium intoxication are rare. Nevertheless
      it is important to pay attention to the problem of aluminium accumulation as its
      early diagnosis facilitates treatment. In the author's opinion the method of
      choice for elimination of aluminium from the organism is one-line haemofiltration
      combined with desferrioxamine.

PMID- 8351878
TI  - [Arthropathy and para-arthropathy in uremic patients on regular hemodialysis].
AB  - Arthropathies and para-arthropathies occur in two thirds of regularly
      haemodialyzed uraemic subjects. The incidence does not depend on age but the
      period of haemodialyzation treatment. After five years of treatment the articular
      apparatus is affected in 100%. In women, as compared with men, the joints of the
      upper extremities, in particular the small joints of the hands are significantly
      more frequently affected.

PMID- 8351879
TI  - [Hyperparathyroidism and parathyroidectomy in dialyzed patients].
AB  - The authors present older and more recent views regarding the pathogenesis of
      hypocalcaemia and secondary hyperparathyroidism in patients with chronic renal
      failure with emphasis on the impact of inorganic phosphate retention and lack of
      1,25-dihydroxyvitamin D3 in body fluids. As regards therapeutic procedures the
      initial problem is to control hyperphosphataemia and to suppress the increased
      parathormone secretion in particular in dialyzed patients. When treating
      hyperphosphataemia it is necessary with regard to the severity of the finding to
      use concurrently several procedures and avoid aluminium phosphate binders. Aimed
      reduction of high parathormone levels in the blood stream can be achieved by
      medicamentous--pharmacological means, using 1,25 (OH)2 D3 or surgery of the
      hypertrophic parathyroid glands. The term parathyroidectomy can comprise also
      percutaneous infiltration of the parathyroid glands with ethanol. From this
      aspect under certain circumstances a combination of different therapeutic
      procedures may prove useful. In the conclusion the authors mention basic data on
      para-thyroidectomies performed in their department: the favourable long-term
      results of operations amounted to 80.4%.

PMID- 8351880
TI  - [The carpal tunnel syndrome, its diagnosis and therapy].
AB  - Secondary amyloidosis is a complication typical for patients on long-term
      haemodialysis (HD). The first clinical signs are usually shoulder joint pain and
      CTS. We have questioned 74 patients who were on regular HD treatment and divided
      them into 3 groups according to the length of HD. Group I--on HD for 1-4 years:
      there were 35 patients in this group, 15 of them (i.e. 43%) had shoulder joint
      pain and/or CTS. None of these patients had such symptoms, which would require
      surgical treatment. Group II--on HD for 5-9 years: there were 22 patients in this
      group, 15 of them (i.e. 68%) had shoulder joint pain and/or CTS. 3 patients from
      this group had severe night pain and were therefore indicated for surgical
      treatment for CTS, each of them on 1 hand only. In 2 cases there was amyloid
      present in the histological examination. Group III--on HD for over 10 years:
      there were 17 patients in this group, 13 of them (i.e. 76%) had shoulder joint
      pain and/or CTS. 5 patients from this group were operated on both hands for
      severe night pain due to carpal tunnel syndrome. Only 1 patient had positive
      amyloid on both hands in the histological examination. All the 8 patients (i.e.
      13 hands) were examined by EMG before the operation, showing reduction of motor
      conduction on n. medianus by 30.7 +/- 15.1%. After the operation the EMG control
      was done in 4 patients (7 hands), showing no improvement in 2 cases and in 5
      cases the conduction on the n. medianus was found to be in the normal
      range.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351881
TI  - [Methods of measuring hyperinsulinism and insulin resistance].
AB  - The author gives an account of methods used for evaluation of hyperinsulinism and
      insulin resistance such as: hyperinsulinaemic, euglycaemic and hyper- and
      hypoglycaemic "clamp", minimal model of glucose and insulin kinetics. They
      evaluate specially indexes used in clinical practice such as: I/G,
      (insulin/glucose--the so-called insulinogenic index), the G/I index, (the so
      called index of insulin resistance) and the index of C-peptide/IRI, basal and
      during the oral glucose tolerance test. In epidemiological studies of the
      prevalence of the X syndrome (5H) he recommends to use the G/I index basal and
      minimal two hours after a glucose load, along with assessment of C-peptide. It is
      thus possible to estimate not only insulin resistance but also hyperinsulinism
      and the ratio of distribution-utilization factors in the development of this
      hyperinsulinism. Hyperinsulinism need not be only hypersecretory but may be also
      associated with a reduced insulin utilization in the liver and peripheral target
      tissues. A hyperinsulinaemic response may be observed in four types of glycaemic
      curves after a glucose load: a in a normal curve, a flat curve, in impaired
      glucose tolerance and in a diabetic curve. According to the author the limiting
      value of the I/G index is 0.4 and the limiting value of the G/I index is 6 when
      the insulinaemia is expressed in mIU/l and the blood sugar level in mg%. The
      limiting level of insulinaemia after two hours is 63 mIU/l. The ratio of C
      peptide: IRI basal is cca 5:1 after a glucose load 2.5:1 when expressed in
      moles.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351882
TI  - [Management of war injuries in Vukovar].
AB  - During 42 days of combat operations the brigade medical station provided surgical
      care for 535 wounded. One third of the wounded (31.8%) were classified in I or II
      grade of emergency. In the units were returned 21.7% of the wounded. Infusion
      therapy was applied in 47%. Laparotomy was performed in 7, drainage of the chest
      cavity in 19 and guillotine amputation of extremities in 11 wounded. The
      mortality was 1.9% at this stage. The way of management was imposed by combat
      operations, manpower and means available.

PMID- 8351883
TI  - [Surgical treatment of facial nerve paralysis in fractures of the temporal bone].
AB  - Of 36 patients with facial nerve palsy caused by the fracture of the temporal
      bone, 28 were treated surgically and 8 conservatively. The way of treatment was
      determined after the detailed radiologic, neurootologic, vestibular and
      functional hearing examinations as well as of the damaged facial nerve. Numerous
      neurootologic disorders have the decisive clinical value in evaluation of the
      site and degree of destruction and selection of adequate way of treatment. The
      authors have shown that early surgical intervention and combined transmastoid and
      translabyrinthine approach provide the most suitable conditions for surgical
      management of the facial nerve and all associated damages in the region of the
      middle and inner ear.

PMID- 8351884
TI  - [Therapy of infected pseudarthroses of the lower leg].
AB  - The retrospective study comprised 23 patients with infected pseudoarthrosis after
      osteosynthesis of of the lower log fracture treated at the Clinic of Orthopedic
      Surgery and Traumatology in Novi Sad. Staphylococcus aureus has been the most
      common causative agent of infection. In all patients debridment of infection foci
      was performed and reosteosynthesis with the external fixator and in 10 patients
      spongioplasty was performed in addition. At the control examination good results
      were achieved in 4, satisfying in 3 and poor in 16 patients. Amputation was
      performed in 5 patients.

PMID- 8351885
TI  - [Infections of the sternum after cardiac surgery].
AB  - Methods of treatment of suppurative mediastinitis in cardiosurgical operations
      applied at the clinic are analysed. These methods are: debridment with closure of
      the sternum with irrigation of the substernal space, debridment with bandage of
      open wound and healing per secundam, debridment with bandage of open wound and
      its closure by myocutaneous layers. It has been concluded that these infections
      are very complex etiopathogenetically because of which it is very important to
      know all relevant risk factors aiming to prevent development of this complication
      in cardiosurgical operations. Its early recognition is necessary.

PMID- 8351886
TI  - [Carbamazepine cardiotoxicity in acute poisoning].
AB  - Manifestations of cardiotoxicity in 9 patients with acute carabamazepine
      poisoning treated at the Clinic of Toxicology and Clinical Pharmacology of the
      M.M.A. in 1989 are reported. In all patients together with symptoms and signs
      characteristic for acute carbamezapine poisoning, there have been also present
      disorders of the cardiovascular system. The most common clinical signs of
      cardiotoxicity have been tachycardia and hypotension, and electrocardiographic,
      ventricular extrasystoles and repolarization disorders. Cardiotoxic
      manifestations in two cases have been the vital threat for the patients. After
      application of nonspecific and symptomatic therapy, clinical and
      electrocardiographic signs of cardiotoxicity were withdrawn, that is, heart
      sequeles were not recorded.

PMID- 8351887
TI  - [Chlamydia trachomatis and Reiter's syndrome].
AB  - Results of the study of incidence of chlamydia trachomatis infection in patients
      with Reiters syndrome are presented. Chlamydia trachomatic was isolated from the
      uretral smear in 12 (34.28%) of 35 patients with Reiter's syndrome. In the group
      of patients with other rheumatologic diseases Chlamydia trachomatis was isolated
      in 2 (5.13%) of 39 patients. In all patients with negative isolation, infection
      was confirmed serologically also and in some patients with negative isolation it
      was also proved.

PMID- 8351888
TI  - [Argyrophilic nucleolar organizers in squamous changes in bronchial epithelium].
AB  - Argyrophil technique for presentation of interphase nucleolar organiser regions
      (AgNOR) is becoming an important method in tumour pathology which is used in
      diagnosis and prognosis. The number of interphase AgNOR is in the strict
      correlation with the degree of cell proliferation. We have used this technique in
      evaluation of degree of differentiation and proliferation of squamous changes of
      the epithelium of the bronchial mucosa. The statistically significant differences
      were found (p < 0.01) in the number of AgNOR by nucleus in cells of benignant
      squamous metaplasia (3.31) and epidermoid bronchial carcinoma (5.34). On the
      basis of numerical values of AgNOR epidermoid bronchial carcinomas could be
      divided into the group with low proliferative capability (AgNOR < 5.34) and in
      the group with high degree of proliferation (AgNOR > 5.34). Prognosis of patients
      with tumours with the high AgNOR value is poorer and they require additional
      systemic chemotherapy regardless of the clinical state of the disease at the
      moment of surgical intervention.

PMID- 8351889
TI  - [Lymphocytoma cutis].
AB  - Three patients with skin lymphocytoma and different histologic and clinical
      appearance of lesions (solitary, grouped, and in the third patient one lesion
      appeared on the forehead and one on the neck) are presented. By the histologic
      analysis and the use of immunohistochemical methods the differentiation of these
      lesions from skin lymphoma and other diseases which could resembe lymphocytoma
      was made. The method of immunoperoxidase has clearly shown formation of
      follicules and polyclonal lymphocytes which is the main histologic feature of
      this pseudolymphoma. By the method of indirect immunofluorescence, antibodies
      against Borrelia burgorferi were not found in the sera of two patients while in
      the third it was not performed.

PMID- 8351890
TI  - [Diagnosis and therapy of lumboischialgia of disk origin].

PMID- 8351891
TI  - [The role of the computer in forensic medicine].

PMID- 8351892
TI  - [The modern approach to ischemic cerebrovascular diseases--with special emphasis
      on algorithms for neuroradiologic management].

PMID- 8351893
TI  - [Diet and gastric cancer].

PMID- 8351894
TI  - [Disorders of olfactory function].

PMID- 8351895
TI  - [Neurosurgical experience at the battlefield in Knin].

PMID- 8351896
TI  - [Pulmonary alveolar proteinosis].

PMID- 8351898
TI  - Sexual misconduct statement of the West Virginia Board of Medicine.

PMID- 8351897
TI  - How the Health Care Surrogate Act of 1993 will simplify medical care in West
      Virginia.
AB  - The West Virginia Health Care Surrogate Act of 1993 became effective July 1,
      1993. This law establishes a process for making health care decisions for adults
      who lack decision-making capacity and who have not completed a medical power of
      attorney that does not require judicial involvement. The law describes how a
      health care surrogate is to be selected by the physician, and it provides
      immunity to the physician and surrogate who make health care decisions according
      to its provisions. This article presents a case in which the application of the
      new law is demonstrated.

PMID- 8351899
TI  - An implication for bone posterity: dietary calcium intake in medical personnel in
      southern West Virginia.
AB  - Osteoporosis in the postmenopausal and elderly years is caused by a multitude of
      factors, which include calcium intake, and is felt largely to be a preventable
      situation. Low dietary calcium intakes (505 mgs. daily) are common in middle-aged
      females in southern West Virginia. Further information about the demographic
      factors in the elderly population from all socioeconomic groups needs to be
      explored to effect changes in dietary lifestyles.

PMID- 8351900
TI  - Papillary intraperitoneal neoplasia resembling ovarian carcinoma after removal of
      benign ovaries.
AB  - Ovarian cancer continues to be a major cause of death in women since there are no
      reliable screening methods and because symptoms usually do not appear until the
      disease has progressed to Stage III or IV, when the chances of cure are very
      poor. Prophylactic oophorectomy is being considered by some physicians for any
      woman undergoing hysterectomy after age 40-45. Even with the removal of benign
      ovaries, intraperitoneal carcinomatosis histologically resembling ovarian cancer
      can occur. This article describes a case of primary papillary intraperitoneal
      neoplasia resembling serous adenocarcinoma of the ovary which presented two years
      after removal of benign ovaries.

PMID- 8351901
TI  - Report of Pseudomonas aeruginosa sinusitis in a patient with AIDS.
AB  - Pseudomonas aeruginosa can cause infections in AIDS patients who frequently do
      not have the usual predisposing conditions such as neutropenia and intravenous
      drug use. The infections due to P. aeruginosa may be difficult to treat in AIDS
      patients. Sinusitis has been increasingly recognized as a complication in
      patients with AIDS. This article describes a case of recurrent P. aeruginosa
      sinusitis which, until recently, was rarely reported in AIDS.

PMID- 8351902
TI  - Expanded definition increases number of reported AIDS cases.

PMID- 8351903
TI  - Carotid endarterectomy for prevention of stroke.
AB  - Carotid endarterectomy, a frequently performed operation, has been used as a
      strategy for preventing stroke in patients with carotid bifurcation disease. The
      safety and efficacy of the operation were recently challenged by a number of
      sources. Three major responses to this challenge were to retrospectively review
      the natural history of carotid bifurcation disease compared with the immediate
      and long-term results of carotid endarterectomy, to initiate 6 prospective
      randomized trials to determine the efficacy of carotid endarterectomy for a
      variety of indications, and to develop appropriateness initiatives and guidelines
      for using this surgical procedure by organizations concerned with health care
      policy. I review the current status of these 3 areas of endeavor. In those areas
      where studies are complete, carotid endarterectomy has been shown to be highly
      effective in reducing stroke risk. Risk reduction has ranged from 66% to 80%
      compared with medical management. Based on these sources and findings, I present
      a list of indications for the operation for surgeons who are able to do the
      operation safely and within the guidelines established by the Stroke Council of
      the American Heart Association.

PMID- 8351904
TI  - Misunderstanding in the classification of diabetes mellitus. What's in a name?
AB  - To assess whether physicians, residents, medical students, hospital diagnosis
      coders, and patients properly use the designations insulin-dependent diabetes
      mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) that were
      established by criteria of the National Diabetes Data Group, we reviewed clinic
      and hospital records and administered questionnaires. Although essentially all
      cases of true IDDM were identified as such and most cases of NIDDM not requiring
      insulin therapy were correctly identified by all groups, patients with NIDDM on
      insulin therapy were misidentified as having IDDM by 38% of residents in internal
      medicine clinics and 68% of primary care and surgical subspecialty residents. On
      a survey, of 22 patients with NIDDM on insulin therapy, 17 (77%) considered
      themselves to have IDDM. Thus, patients who have NIDDM by the established
      criteria who are on insulin therapy are commonly mislabeled as having IDDM. We
      present an approach for dealing with this problem by adapting nomenclature
      focusing on insulin deficiency and resistance. It would probably also be helpful
      to separately identify the subset of patients with "insulin-deficient diabetes"
      who are ketosis-prone. It is important to use immunologic profiling (islet cell
      antibody testing) and insulin sensitivity or deficiency testing (C-peptide
      levels).

PMID- 8351905
TI  - Rehabilitation services for the Pacific.
AB  - The Pacific Basin Rehabilitation Research and Training Center was created to help
      meet the challenges of rehabilitating people in rural remote communities in the
      United States-associated Pacific. We describe the center, the special region it
      serves, some of its many programs, and some of the ways it is helping communities
      in this region provide services that are appropriate and sensitive to the
      culture, the environment, and the disability.

PMID- 8351906
TI  - Neuroplasticity. Key to recovery after central nervous system injury.
AB  - After an injury to the central nervous system, physical and cognitive impairments
      and disabilities often abate. These gains may be partly mediated by mechanisms
      that allow reorganizing of the structure and function within gray and white
      matter. The potential to enhance neurologic recovery by manipulating the brain
      and spinal cord must now be considered in clinical practice. Today's
      rehabilitation routines may not encourage maximum recovery. Indeed, some commonly
      used physical and pharmacologic methods could inhibit the restoration of motor
      activities such as walking. On the other hand, therapies that use our expanding
      knowledge of neuroplasticity could lead to better results for patients.

PMID- 8351907
TI  - Evaluating chest pain in the emergency department.
AB  - Chest pain is one of the most difficult diagnostic problems for physicians
      working in an emergency department. In this setting, more malpractice dollars are
      awarded for missed myocardial infarction than for any other physician error. This
      problem usually occurs when the patient has atypical symptoms, the physician is
      inexperienced, or the diagnosis is not considered. The clinical manifestations of
      myocardial infarction vary greatly, and patients with "atypical" presentations
      have a poorer prognosis than those with classic symptoms. Although no feature of
      a patient's history excludes infarction with certainty, pain that is sharp,
      positional, pleuritic, or reproduced by palpation indicates a lower probability
      of acute ischemic heart disease. New immunochemical methods and serial sampling
      strategies have increased the sensitivity of creatine kinase-MB as an indicator
      for the disorder. Recent investigations have also established the prognostic
      value of the initial electrocardiogram. These methods allow emergency physicians
      to assess the risk of complications and to perform triage when there is a
      shortage of beds in the coronary care unit. Emergency physicians must also
      consider other diseases for which coronary care might be beneficial.

PMID- 8351909
TI  - Treatment of laryngeal dysphonias.

PMID- 8351908
TI  - Magnetic resonance imaging-guided needle biopsy of head and neck lesions.
AB  - The Council on Scientific Affairs of the California Medical Association presents
      the following inventory of items of progress in otolaryngology-head and neck
      surgery. Each item, in the judgment of a panel of knowledgeable physicians, has
      recently become reasonably firmly established, both as to scientific fact and
      important clinical significance. 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 these items of progress in otolaryngology-head and neck
      surgery that have recently achieved a substantial degree of authoritative
      acceptance, whether in their own field of special interest or another. The items
      of progress listed below were selected by the Advisory Panel to the Section on
      Otolaryngology-Head and Neck Surgery of the California Medical Association, and
      the summaries were prepared under its direction.

PMID- 8351910
TI  - Management of the internal carotid artery in skull base operations.

PMID- 8351911
TI  - Olfactory impairment.

PMID- 8351912
TI  - Positron emission tomographic imaging of the head and neck.

PMID- 8351913
TI  - Microvascular free flaps in head and neck reconstruction.

PMID- 8351914
TI  - Spasmodic dysphonia and laryngeal botulinum toxin injection.

PMID- 8351915
TI  - Endoscopic sinus surgery.

PMID- 8351916
TI  - Rat-bite leptospirosis.

PMID- 8351917
TI  - Accidental poisoning by warfarin-contaminated herbal tea.

PMID- 8351918
TI  - Benefits of stopping smoking.
AB  - This article launches a special WESTERN JOURNAL OF MEDICINE effort to help
      prevent disease and disability. Erica Frank, MD, MPH, an Assistant Professor in
      the Department of Community and Preventive Medicine and Department of Medicine,
      Emory University School of Medicine, and Adjunct Professor at the Emory
      University School of Public Health, Atlanta, Georgia, will head the endeavor. The
      goals are to present scientific foundations for prevention and to provide
      practical ways to improve patients' lives. This first article addresses smoking
      cessation. We may think that we know it all, but we may not, and patients do not:
      about 25% of Americans smoke, and more than half of persons who ever smoked began
      their fatal habit before they were 18 years old. Side-stream smoke affects adults
      and children adversely, too, causing inflammation, infection, and cancer. Smokers
      need to stop smoking, and young people need to not start. Dr Frank's review is
      accompanied by a page for patients. It debunks myths and is designed to be
      duplicated so patients can leave their physician's office with a new lease on
      life in hand. Look for future prevention-oriented articles in this series that
      feature science and patient education.

PMID- 8351919
TI  - Health decisions movement.

PMID- 8351920
TI  - Carotid endarterectomy--the big picture.

PMID- 8351921
TI  - A scientific basis for neurologic rehabilitation.

PMID- 8351922
TI  - Earthquakes and myocardial ischemia.

PMID- 8351923
TI  - High tech in a low tech country.

PMID- 8351924
TI  - An offshore pharmacy--a bargain or a danger?

PMID- 8351925
TI  - Testing cardiac function.

PMID- 8351926
TI  - [Renovascular hypertension: invasive percutaneous diagnosis and therapeutic
      possibilities].
AB  - Under the current conditions of improved pharmacological therapy of arterial
      hypertension there is a danger that the physician may overlook considering the
      possibility of underlying renovascular causes for the hypertension. However, the
      diagnosis and treatment of these conditions are simple and easily accessible.
      Digital subtraction angiography is a simple technique which enables the diagnosis
      of renal artery stenosis or stenosis of the aorta to be made as a cause of
      hypertension in more than 90% of cases. Dependent on the type, extent and
      location of obliteration in the renal arteries, percutaneous transluminal-renal
      dilatation with a balloon-catheter is quite frequently the intervention of
      choice. In fibromuscular dysplasia the results are excellent, with a cure rate
      exceeding 90%, the patients being predominantly younger and females dominating.
      In stenosis of atherosclerotic origin, 40-60% show improvement or even
      normalization of blood pressure. A sudden recurrent increase in blood pressure
      during long-term follow-up requires angiography in order to perform either
      dilatation again or surgical reconstruction. In all cases of renovascular
      hypertension, interdisciplinary cooperation between surgeons and interventional
      radiologists is essential and all patients with renal insufficiency require close
      contact to a dialysis centre.

PMID- 8351927
TI  - [Reducing blood pressure and modification of coronary risk factors by therapy
      with doxazosin].
AB  - In an open, non-comparative, multicenter trail performed by general
      practitioners, the efficacy and safety of doxazosin, an inhibitor of postsynaptic
      alpha 1-adrenoceptors, were studied in 924 patients with mild to moderate
      hypertension. Under treatment with doxazosin both systolic and diastolic blood
      pressure decreased significantly from 178.4 +/- 18.2/103.1 +/- 8.6 to 149.1 +/-
      12.0/85.6 +/- 7.3 mm Hg; the mean daily dose at the end of the 12 weeks'
      treatment period was 3.3 +/- 2.6 mg. Heart rate decreased by 5% and body weight
      by 6%. As compared with baseline values, total cholesterol (255.7 +/- 45.4 vs
      232.7 +/- 37.3 mg%), triglycerides (206.3 +/- 97.6 vs 175.2 +/- 70.9 mg%) and
      blood glucose (101.9 +/- 31.0 vs 97.9 +/- 25.5 mg%) decreased significantly,
      whilst HDL-cholesterol (47.7 +/- 13.0 vs 51.5 +/- 12.4 mg%) increased. Overall,
      doxazosin was very well tolerated; only 16% of all patients reported adverse drug
      reactions. The results of this study confirm the effectiveness of doxazosin as
      first-line medication in the treatment of hypertension, especially in patients
      with concomitant metabolic disorders such as hyperlipidemia and diabetes
      mellitus. Moreover, the patients who appear to benefit most from doxazosin
      treatment are those who show the highest metabolism-related coronary risk, as
      calculated according to the Framingham Study equation.

PMID- 8351928
TI  - [Allergic rhinitis, respiratory obstruction and bronchial asthma in the Vienna
      population].
AB  - In the present study the incidence of bronchial asthma, airway complaints, and
      allergic rhinitis was investigated in a randomized population section including
      3000 male and female inhabitants of Vienna (sex ratio 1:1), aged 20-44. Data on
      complaints in the respiratory tract were obtained from a total of 71% of the
      study population. Our results suggest that 14.7% of the entire population was
      suffering from allergic rhinitis (16.4% male versus 13.0% female; p < 0.05).
      Airway complaints such as wheezing, whistling, and feeling of tightness in the
      chest, awakening because of shortness of breath or cough were frequently
      reported, with no major differences between male and female subjects. The overall
      percentage of study subjects stating that they had suffered from airway
      complaints in the year before, i.e., the percentage of those giving affirmative
      answers to one of the questions, was 29%. Bronchial asthma was calculated to be
      present in 5.1% of the entire population (5.9 male versus 4.4 female). Attacks of
      asthma were reported by only 2.2% of the subjects, which gives an indication of
      the discrepancy between identified and unidentified bronchial asthma. Allergic
      rhinitis is correlated to, and constitutes a risk factor for the occurrence of
      complaints in the respiratory tract; public health policy should therefore be
      aimed at the prevention or early treatment of allergic rhinitis, and at reducing
      the proportion of cases suffering from unidentified bronchial asthma.

PMID- 8351929
TI  - [Accuracy of blood glucose self-monitoring in children with type-I diabetes].
AB  - Children with type I diabetes often believe that they are able do gauge their
      blood glucose value without measurement. This study investigated how accurate
      these estimates are and which of the patient characteristics might affect
      accuracy. Nineteen children with type I diabetes (age 7.3-17.3 years, duration of
      diabetes 0.1-12.0 years) estimated their blood glucose immediately before a blood
      glucose measurement by reflectance meter. Ten to 54 estimations and measurements
      were done by each individual during a summer camp. According to the method of Cox
      et al. accuracy of estimates was evaluated by error grid analysis. Five zones
      were defined: accurate estimates (zone A); clinically benign errors (zone B);
      clinically dangerous errors (zone C, D, E). An overall accuracy index was
      calculated by subtracting the summed percentage of estimates in zones C, D, E
      from the percentage in zone A. The mean percentage of estimates in zone A was
      41.5 (10.0-75.0)%, the mean overall accuracy index was 9.8 (-47.4-62.5)%. Except
      for mean blood glucose which was inversely correlated with accuracy index (r = 
      0.53, P = 0.02) none of the other patient characteristics showed an effect on
      accuracy index. CONCLUSIONS: Accuracy of blood glucose estimates is lower in
      children with type I diabetes than in adults and varies substantially between
      individuals. High mean blood glucose values are associated with a lower accuracy
      of estimates.

PMID- 8351931
TI  - [Help for the elderly and rehabilitation of the elderly in inpatient treatment-
      experiences from a nursing home (nursing care facility)].

PMID- 8351930
TI  - [Rehabilitation for the elderly, why?].
AB  - Within human culture the attitude towards the aged has been very different up to
      now, ranking from ritual slaughter to worshipping of the wise old persons.
      Ambivalence persists till now. We have introduced the terminus "rehabilitation of
      the old" to indicate a principal which is adequate in the medical sense as it is
      adequate to humanity. Our slogan runs: nursing alone (meaning isolated care for
      vegetative necessities) is inhuman in old people. Rehabilitative view points and
      activities must come into the care for the aged on all levels there are: from
      readaptation to profession, "over independence and being socially adequate" up to
      the resting last possibility of having fun. Rehabilitation of the old can only
      succeed if there is an integrative set up which means (again as a slogan): We
      want rehabilitation of old to invade all hospitals and all human groupements
      instead of bringing the old out of these groupings and separate them in senior
      ghettos. This must go hand in hand with specialization and scientific
      identification of geriatrics and rehabilitation; specially neuro-rehabilitation
      and rehabilitation of the old, which are in close connex. Quite a number of
      administrative barriers have to be removed, new possibilities must be created.
      There must be a complete new viewing of the matter and new goals in medical
      education, as well pregraduate as postgraduate. A new generation of doctors can
      find here a big good chance. However, it can only be successful in close
      collaboration with a progressive politic administration.

PMID- 8351932
TI  - [Elderly patients in internal medicine departments].

PMID- 8351933
TI  - [Nursing personnel--responsibilities and problems within the scope of
      rehabilitation of the elderly].

PMID- 8351934
TI  - [Rehabilitation--rehabilitation of the elderly: basic concepts and their
      implementation].

PMID- 8351935
TI  - [Discussion and summary of the first inquiry into "rehabilitation of the
      elderly"].
AB  - Financial amelioration is important but not the only important. We need a better
      prestige of rehabilitation of old age in society and in science. We need a better
      motivation. Last but not least permanent accompanying standardization and
      evaluation. Better schooling and post graduate education has to take place within
      all degrees of health professions, mainly in doctors and other leading people,
      eventually "obligatory". We want no "ghettos for aged" which means purely
      geriatric wards. A modern human (as well scientifically as sociologically
      appropriate) way is to have mixed populations in the wards. Modern concept should
      include more phantasy, more individualism instead of standardization. We want new
      trends not only in scientific thinking but as well and even more in political and
      social thinking towards these goals.

PMID- 8351936
TI  - [Psychotropic drugs outside of psychiatry, especially in advanced age].
AB  - The following main rules will optimate use of psychopharmaca: 1) The 3 main
      groups of psychopharmaca have to be ordered according to clear cut target
      symptoms: tranquilizer, neuroleptics, antidepressants. 2) Dosage must be rational
      and individual. Administration has to be long enough (antidepressants) and short
      enough (tranquilizers) according to chemical group, to secure efficacy and to
      avoid addiction. 3) The 2 polar dimensions: more agitating and more tireding,
      have to be used deliberately. 4) Danger of drug addiction and other unfavourable
      side effects must be kept in mind.

PMID- 8351937
TI  - Rehabilitation after cardiovascular diseases, with special emphasis on developing
      countries. Report of a WHO Expert Committee.

PMID- 8351938
TI  - [Importance of echocardiography in general clinical routine practice].
AB  - Echocardiography was carried out in 526 patients on a general internal medical
      ward, 54.8% with a clinical indication and 45.2% in screening. The results were
      compared with the data from the scout view chest x-ray and from the ECG.
      Enlargement of the cardiac cavities detected in echocardiography (UCG) can only
      be found in 43% in the x-rays (left atrium 27%, left ventricle 64%, right
      ventricle 42%). Left ventricular hypertrophy was shown in the UCG in 43% of
      patients with arterial hypertension: of these, 28% had a pathologic ECG. On the
      other hand, only 14% of all hypertensive patients show signs of left ventricular
      hypertrophy on x-ray. The differentiation of systolic (44%) and diastolic (38%)
      dysfunction was only possible by means of UCG in congestive heart failure. A
      chronic pulmonary hypertension detected by x-ray correlated with an enlargement
      of the right ventricle in the UCG. UCG is indicated when there are clinical, ECG,
      chest x-ray signs of heart disease, arterial hypertension or chronic pulmonary
      hypertension. UCG is not a screening method.

PMID- 8351939
TI  - [Quantitative evaluation of aortic valve insufficiency in magnetic resonance
      tomography].
AB  - Flow-encoded magnetic resonance (MR) sequences allow the quantitative evaluation
      of blood flow in any plane of the heart and vessels. For the first time, ejection
      and regurgitation volumes of the left ventricle in the ascending aorta can be
      measured noninvasively. Thus, the regurgitation fraction as a reliable measure of
      aortic valve insufficiency can be determined. The quantitative evaluation of
      aortic valve insufficiency was done by MR in comparison to ultrasound-Doppler
      and, in some cases, in comparison to heart catheterization. A good correlation of
      grading aortic valve insufficiency by the new MR-technique in comparison to
      clinical graduation is shown. The development of a new noninvasive standard for
      quantification of aortic valve insufficiency seems possible.

PMID- 8351940
TI  - [Intra-individual reproducibility of tilt table studies in diagnosis of vasovagal
      syncope].
AB  - Neurally-induced syncope appears to be the underlying pathophysiologic mechanism
      in many patients with unexplained syncope. Diagnosis of vasovagal syncope,
      however, remains difficult and constitutes in many cases an exclusion diagnosis.
      The present study thus aimed to determine the yield of tilt-table testing in the
      work-up of patients with unexplained syncope and most importantly to examine the
      reproducibility of the results of this method. Twenty-four patients with a
      history of syncope and 11 healthy volunteers were examined on 2 days. In 10
      patients, symptoms could be provoked during tilting, in 8 during both tests, in 2
      only on one occasion. Only 1 of 11 volunteers developed presyncope during tilting
      which was not reproducible during the second test. These findings resulted in a
      sensitivity of 42% and a specificity of 91% for the protocol employed in this
      study. Overall reproducibility was 91% which suggests that this tilt-table
      protocol is suitable for evaluation of therapeutic interventions in patients with
      neurally-mediated syncope.

PMID- 8351941
TI  - [Shortening the stimulus T time: indicator for physical activity in patients with
      demand modulated cardiac pacemakers].
AB  - Activity-modulated pacemakers detect body vibrations and increase their pacing
      rate. As the body vibrations are not always related to physical activity, we
      studied in 20 patients with the activity-modulated pacemaker Legend (Medtronic)
      whether a second physiological signal, the paced QT duration, can help to verify
      exercise. At rest, pacing rate was programmed from 60 ppm to 130 ppm in steps of
      10 ppm which shortened the QT duration from 467 +/- 32 ms (60 ppm) to 391 +/- 24
      ms (130 ppm). During treadmill exercise, pacing rate increased from 62 +/- 1 ppm
      to 98 +/- 9 ppm and the QT duration decreased from 450 +/- 25 ms to 372 +/- 27
      ms. Compared to rest, the exercise-induced QT shortening was significantly
      shorter for pacing rates > or = 70 ppm. To simulate artificial sensor activation,
      an electrical razor was put onto the pulse generator. Pacing rate increased to 81
      +/- 7 ppm, but the QT duration shortening was similar to the measurement at rest
      with 80 ppm. In conclusion, the paced QT duration is able to confirm whether body
      vibrations are related to physical exercise.

PMID- 8351942
TI  - [Cardiac characteristics of patients with terminal renal failure after kidney
      transplantation].
AB  - Left ventricular (LV) hypertrophy and dysfunction are risk factors for high
      mortality from cardiovascular causes in patients with end-stage renal disease. To
      determine the frequency of these findings after kidney transplantation, 45
      patients (11 female, 34 male; age: 47.2 +/- 12 years) after transplantation (57
      +/- 37 months) with (n = 21) and without (n = 24) a patent arteriovenous fistula
      were analyzed with echocardiography. A high prevalence of systolic (> 140 mm Hg:
      40%) and diastolic (> 90 mm Hg: 18%) hypertension was observed despite the use of
      1.44 +/- 0.9 (range: 0-3) antihypertensive drugs per patient. Most frequent
      echocardiographic findings were LV hypertrophy (78%; LV mass = 318 +/- 81 g),
      mostly in the asymmetric septal form (47%; mean ratio septal/posterior wall
      thicknesses: 1.38 +/- 0.2), and left atrial dilatation (60%; mean diameter: 44 +/
      6 mm). LV dilatation (33%; mean enddiastolic diameter: 53 +/- 5 mm) and systolic
      dysfunction (20%; mean ejection fraction: 64 +/- 11%) were less common.
      Individual values of LV mass were directly correlated with systolic blood
      pressure (p < 0.05). No relation was found between other echocardiographic (LV
      and left atrial diameters, LV mass, ejection fraction or velocity of
      circumferential fibre shortening) and clinical (transplantation duration, serum
      hemoglobin or creatinine, patency of dialysis access, or choice of
      immunosuppressive therapy) parameters. The presented data suggest that LV
      hypertrophy is frequent after renal transplantation, and that arterial
      hypertension is a key factor for the maintenance of LV hypertrophy in these
      patients, while the patency of the dialysis access, and the durations of
      transplantation or of preceding dialysis therapy are not relevant.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8351943
TI  - [Atrial arrhythmias after modified Fontane operation: effect of preoperative
      hemodynamics and the kind of operation (atriopulmonary vs. total cavopulmonary
      anastomosis)].
AB  - Between October 1986 and March 1992, occurrence of supraventricular tachycardia
      and sinus node dysfunction was investigated pre- and postoperatively by serial
      ECG and Holter monitors in 63 consecutive patients with univentricular
      circulation after modified Fontan operation (total cavopulmonary connection 39
      patients, atriopulmonary connection 24 patients). Mean age at operation was 7.2
      (0.1-20.3) years. Of the 63 patients, 14 (22%) had early (< 14 d)
      supraventricular tachycardia or sinus node dysfunction, which was not related to
      the type of operation. None of nine patients with a preoperative mean right
      atrial pressure < or = 2.5 mm Hg had early supraventricular tachycardia or sinus
      node dysfunction, in contrast to 16/54 patients (30%) with a preoperative mean
      right atrial pressure > or = 2.5 mm Hg. 6/63 patients died during the early (< 14
      d) postoperative period. In only one child death was related to a dysrhythmia
      (junctional ectopic tachycardia). During a mean follow-up of 2.5 years, 12
      patients (21%) had late supraventricular tachycardia or sinus node dysfunction.
      Early supraventricular tachycardia/sinus node dysfunction was a predictor of late
      atrial dysrhythmias, as it occurred in eight of the surviving 14 patients with
      early dysrhythmias, in contrast to four children without early atrial
      dysrhythmias (p < 0.001). After creation of an atriopulmonary connection, 10/22
      patients (45%) had late supraventricular tachycardia/sinus node dysfunction, but
      only 2/35 patients (6%) with a total cavopulmonary connection had late atrial
      dysrhythmias (p < 0.001). CONCLUSIONS: Early atrial dysrhythmias after the Fontan
      operation were related to preoperative hemodynamics. Early supraventricular
      tachycardia/sinus node dysfunction and the atriopulmonary type of Fontan
      connection were significant risk factors for late atrial dysrhythmias.

PMID- 8351944
TI  - [Therapy of postoperative ectopic junctional tachycardia by surface hypothermia].
AB  - Postoperative junctional ectopic tachycardia is associated with a poor prognosis
      in patients after open-heart surgery. This dysrhythmia has been shown to be
      resistant to medical treatment as well as to epicardial pacing and external
      cardioversion. Successful therapy with surface hypothermia in an infant with
      junctional ectopic tachycardia (ventricular rate 210-230 bpm) after repair of
      tetralogy of Fallot is presented. Hypothermia (rectal temperature 32-34 degrees
      C) was effective in decreasing the ventricular rate of the dysrhythmia (< 170
      bpm). After spontaneous cessation of the tachycardia, sinus rhythm resumed,
      resulting in stable hemodynamics.

PMID- 8351945
TI  - [Pulmonary edema as a complication during pericardial puncture in "mixed
      connective tissue disease"].
AB  - A 22-year-old female patient with an 8-year history of mixed connective tissue
      disease (systemic sclerosis overlapping with systemic lupus erythematosus)
      presented with marked respiratory distress, sinus tachycardia (135 bpm), and
      pulsus paradoxus. The chest x-ray showed an enlargement of the cardiac
      silhouette, which was due to a 3-cm-wide, circular pericardial effusion, as
      demonstrated by two-dimensional echocardiography. Pericardiocentesis performed to
      decompress cardiac tamponade did not lead to clinical improvement. The increase
      in dyspnea was caused by a rise in pulmonary wedge pressure from 21 to 40 mm Hg
      following an acute increase of mitral valve regurgitation. In the presence of
      global hypokinesia of the left ventricle, cardiac output decreased from 3.25 to
      2.63 l/min. Intensive care including hemodialysis and plasmapheresis as well as
      high-dose application of cyclophosphamide and steroids led to a stabilization of
      the hemodynamic situation over a period of days. The case report presented here
      supports the general recommendation to perform pericardiocentesis in a stepwise
      manner under hemodynamic monitoring. This holds true primarily for patients with
      mitral valve regurgitation and/or cardiac involvement in connection with an
      underlying disease.

PMID- 8351946
TI  - [Treatment of acute pulmonary hemorrhage in a patient with pulmonary atresia and
      ventricular septal defect by coil embolization of a systemico-pulmonary
      collateral artery].
AB  - Pulmonary hemorrhage due to rupture of pulmonary arteries causes significant
      morbidity and mortality in the natural history of older patients with pulmonary
      atresia and ventricular septal defect. The only therapeutical option for patients
      with persisting pulmonary hemorrhage was surgical resection of the involved
      pulmonary segments. In this case report we describe the successful termination of
      an acute pulmonary hemorrhage in a 9-year-old patient by coil-embolization of a
      systemicopulmonary collateral artery, which provided additional blood supply to
      the left upper-lobe segments. The hemorrhage ceased within 24 h and has not
      recurred during a follow-up period of 7 months. In our opinion, the success of
      the embolization can be attributed to a reduction of the perfusion pressure and a
      normalization of the arterial blood flow in the affected lung segments.

PMID- 8351947
TI  - [Reversible contact lesion in mitral valve endocarditis--follow-up study with
      transesophageal echocardiography].
AB  - This is a case report of a 59-year-old patient with an endocarditis of the mitral
      valve caused by streptococcus viridans. Precordial echocardiography showed a
      highly mobile vegetation of the anterior mitral leaflet prolapsing during systole
      into the left atrium. During diastole contact with the ventricular septum
      caudally to the left ventricular outflow tract was noted. By using
      transesophageal echocardiography (TEE), this zone appeared as a localized
      increased echogenity of the parietal endocardium and underlying myocardium.
      Antibiotic therapy led to a cure of the endocarditis (clinically and according to
      clinical chemistry). The TEE follow-up 2 months later showed persisting mitral
      valve vegetation, whereas neither the endocardial lesion nor the abnormal
      myocardial echo pattern were seen any longer. The likely inflammatory etiology of
      the described lesion is discussed and seems obvious.

PMID- 8351948
TI  - [Psychotropic effects of Sino-Japanese traditional medicines].
AB  - Recently there are a number of clinical reports that Sino-Japanese traditional
      medicines have good effects on patients with anxiety and/or depression. To detect
      the clinical efficacy of those medicines, we have examined those effects on
      various behavioral changes induced by stress in experimental animals. Although it
      appears to be possible to demonstrate a part of the psychotropic effects of the
      medicines, their action mechanisms are far from being understood. An improving
      effect of Shimotsu-to on the spatial cognitive deficits induced by scopolamine in
      eight radial maze might be due to that of paeony root and to its major principle,
      paeoniflorin. However, it appears that pharmacological effects of Shimotsu-to, a
      traditional medicine, cannot be explained by those of an active principle of
      paeony root, paeoniflorin.

PMID- 8351949
TI  - [On the fluctuation of plasma biopterin levels for 24 h in normal controls].
AB  - Tetrahydrobiopterin (BPH4) is the cofactor for the pteridine-dependent
      monooxygenases, which play important roles in the biosynthesis of cateholamines
      and indolamines. These biogenic amines have been thought to be related to
      affective disorders, and the increase of total biopterin (BP) and the lower ratio
      of BPH4 to total BP were observed in plasma of patients with affective disorders.
      For the purpose of giving an explanation of these changes of plasma biopterin
      mentioned above in patients with affective disorders, the fluctuation of plasma
      biopterin levels for 24 h was measured by high-performance liquid chromatography
      with fluorescence detection by the method of Fukushima and Nixon in ten normal
      volunteers. The total BP and BPH4 levels in plasma at 9 am were the highest, and
      those levels at 1 am were the lowest. The range of the fluctuation of total BP
      with the passage of time was narrow compared with the range of the increase of
      total BP observed in the patients with affective disorders. Other factors in
      addition to the fluctuation of plasma BP for 24 h were thought to be related to
      the changes of plarma BP levels in the patients with affective disorders.

PMID- 8351950
TI  - [Impairment of learning and memory and the accessory symptom in aged rats as
      senile dementia model (1)--Emotional behavior].
AB  - It is well known that there is an increase of emotional behavior in senile
      dementia. There are few studies investigating age-related emotional behavior. We
      attempted to investigate emotional behavior of aged rats using various tests.
      Locomotor activity for 24 h decreased in aged rats compared with that in young
      rats. There was no difference in locomotor activity between light and dark
      periods in aged rats. There was no visual abnormality on light/dark
      discrimination test in aged rats. It suggests that locomotor activity during dark
      period may be impaired by aging. Head-dips and social interaction time in hole
      board and social interaction tests, respectively decreased, while start latency,
      defecation and urination in open field test increased in aged rats. Furthermore,
      ambulation and rearing in hole board, social interaction and open field tests
      decreased, and entries into open or closed arms in elevated plus-maze test
      reduced in aged rats compared with those in young rats. These findings suggest
      that anxiety may increase, but spontaneous activity decrease in aged rats. These
      results indicate that aged rats may be useful as an accessory symptom model of
      senile dementia.

PMID- 8351951
TI  - [Impairment of learning and memory and the accessory symptom in aged rats as
      senile dementia model (2)--Learning and memory].
AB  - We attempted to investigate the ability of learning and memory of aged rats.
      Swimming speed of aged rats in Morris's water maze was slower compared with that
      of young rats. Therefore, we used goal distance to indicate ability of learning
      and memory. In training session, distance for both groups decreased with
      training, but in aged rats it was significantly longer than that in young rats.
      In retention test 24 d after the training, distance in aged rats was longer than
      that in young rats, although there was no difference in distance for both groups
      between acquisition and retention tests. The distance in the working memory
      tended to increase with aging. There was no difference in time spent within
      platform phase in probe trial, in percent movement of first trial in habituation
      test, and in step-through latency in passive avoidance, between young and aged
      rats. Drinking latency for aged rats in water finding task was significantly
      longer compared with that in young rats. These findings suggest that learning and
      memory were impaired by aging in spatial and latent learning tasks. Aged rats
      could acquire and maintain memory of simple tasks, but in spatial tasks they
      tended to show decreased ability of retention and working memory.

PMID- 8351952
TI  - [The effect of CRF antagonist on immobilization stress-induced increases in
      noradrenaline release in rat brain regions].
AB  - We investigated the effects of intracerebroventricular (i.c.v.) administration of
      corticotropin-releasing factor (CRF) antagonist, alpha-helical CRF9-41 (ahCRF) on
      stress-induced increases in noradrenaline (NA) release in rat brain regions.
      Pretreatment with ahCRF (50 or 100 micrograms) attenuated significantly the
      stress-induced increases in levels of 3-methoxy-4-hydroxyphenylethyleneglycol
      sulfate (MHPG-SO4), the major metabolite of NA in rat brain, in the locus
      coeruleus region, cerebral cortex, hippocampus, amygdala and hypothalamus. Plasma
      corticosterone levels were not decreased significantly by administration of
      ahCRF. From these results, it is suggested that stress-induced increases in NA
      release in the rat brain regions are attenuated by ahCRF and thus that CRF,
      released during the stress, cause increases in NA release in these regions.

PMID- 8351953
TI  - Human chorionic gonadotropin binding sites in the human endometrium.
AB  - The existence of high-affinity and low-capacity specific binding sites for
      luteinizing hormone (LH)/human chorionic gonadotropin (hCG) has been reported in
      porcine, rabbit and rat uteri. We have identified hCG binding sites in the human
      endometrium collected from 35-42-year-old ovulatory and anovulatory women. The
      binding characteristics of hCG to endometrial tissue preparations from ovulatory
      and anovulatory women showed saturability with high affinity and low capacity.
      Scatchard plot analysis showed the dissociation constant of specific binding
      sites in the ovulatory women to be 3.5 x 10(-10) mol/l and in anovulatory women
      to be 3.1 x 10(-10) mol/l. The maximum binding capacity varied considerably
      between ovulatory (3.85 nmol/kg protein) and anovulatory (6.12 nmol/kg protein)
      endometrium. Among the divalent metal ions tested (Zn2+, Mg2+, Mn2+, Ca(2+)--4
      mol/l), Zn2+ effected a remarkable increase in [125I]hCG binding to the
      endometrium (p < 0.005) whereas Mn2+ showed a marginal increase and other metal
      ions did not have any effect. Data obtained with human endometrium indicate an
      influence of the functional state of the ovary on [125I]hCG binding to
      endometrium.

PMID- 8351954
TI  - Heterologous humoral immune response in patients treated with human growth
      hormone from different sources.
AB  - The existence of homologous anti-human growth hormone (anti-hGH) and heterologous
      anti-bovine growth hormone (anti-bGH) humoral immune responses in hypopituitary
      patients under hGH therapy has been reported previously. In order to study the
      influence of the hormone source, both responses were compared by radiobinding
      assays performed with [125I]hGH or [125I]bGH as tracers. Fifty-seven
      hypopituitary patients treated with extractive hGH, recombinant methionyl hGH or
      authentic recombinant hGH were studied. A very low incidence of heterologous
      antibodies was found in patients under recombinant hGH therapy, contrary to the
      high incidence observed in patients treated with extractive hGH preparations. In
      addition, immunochemical studies performed with a synthetic peptide (hGH 44-128)
      indicated that this peptide exhibited, in the anti-bGH/[125]bGH radioimmunoassay
      system, higher reactivity than the native hGH, suggesting that such a fragment
      resembled an altered conformation of the hormone. The high heterologous response
      elicited only by the extractive hGH along with the behaviour of the hGH 44-128
      fragment supports the fact that the extraction and purification procedures in
      extractive preparations may alter slightly the structure of the hGH molecule and
      trigger a heterologous immune response.

PMID- 8351955
TI  - Microsomal antibodies during gestation in relation to postpartum thyroid
      dysfunction and depression.
AB  - RATIONALE: Microsomal antibodies have been related to postpartum thyroid
      dysfunction and postpartum depression. OBJECTIVES: To detect the value of
      microsomal antibodies during gestation in a random population, as a risk factor
      for thyroid dysfunction and depression during the postpartum period. MAIN
      FINDINGS: The presence of microsomal antibodies was investigated in a random
      population of 293 women at 32 weeks' gestation. At the same time, postpartum
      thyroid function was assessed repeatedly in all women every six weeks up to 34
      weeks' postpartum. Postpartum thyroid dysfunction, defined as the presence of
      abnormal TSH, in combination with abnormal fT4 and/or fT3 values, occurred in 21
      women (7.2%) during the postpartum period. Depression was assessed using the
      Research Diagnostic Criteria without knowing the results of biochemical thyroid
      function tests. At 32 weeks' gestation there were 27 (9.2%) women with elevated
      microsomal antibody titres. Compared with microsomal-antibody negative women at
      32 weeks' gestation, these women had an RR of 20 for developing postpartum
      thyroid dysfunction and an RR of 1.7 for developing postpartum depression.
      CONCLUSIONS: Women with elevated microsomal antibody titres during gestation are
      particularly at risk for postpartum thyroid dysfunction, but only have a slightly
      increased risk for postpartum depression.

PMID- 8351956
TI  - Incidence rate and risk factors for thyroid dysfunction during recombinant
      interleukin-2 therapy in advanced malignancies.
AB  - Immunotherapy using recombinant interleukin 2 (rIL-2) has been shown to induce
      thyroid dysfunction in some cancer patients. The purpose of the present study was
      to evaluate the incidence and risk factors of this adverse autoimmune response.
      Triiodothyronine, thyroxine and thyrotropin levels were measured serially in 146
      consecutive patients treated with rIL-2 for refractory solid tumor (77 patients)
      or malign hemopathy (69 patients); rIL-2 was administered intravenously in 5-day
      cycles (18 x 10(6)-24 x 10(6) IU.m-2.day-1) either alone in 79 cases or in
      combination with autologous bone marrow transplantation in 26 cases, with
      interferon-gamma in 37 cases, with tumor necrosis factor-alpha in 13 and with
      cyclophosphamide in five cases. Some patients underwent more than one therapeutic
      protocol. Peripheral hypothyroidism was present upon entry in nine (6.2%)
      patients. Thyroid dysfunction appeared or worsened during rIL-2 therapy in 24
      (16.4%) patients. Sixteen (10.9%) patients exhibited peripheral hypothyroidism,
      out of which four exhibited biphasic thyroiditis. Another five (3.4%) patients
      developed transient hyperthyroidism. Anomaly could not be classified in three
      patients. Thyroid dysfunction appeared early after one or two cycles. All
      surviving patients recovered. Only gender and presence of antithyroid antibody
      were correlated significantly with rIL-2-induced thyroid abnormalities. No
      correlation was found with any of the other risk factors studied, i.e. type of
      malignancy, rIL-2 treatment procedure, clinical efficacy, evolution of
      circulating lymphocyte subsets or other autoimmune antibodies. Antithyroid
      antibodies were detected in 60.9% of patients with this complication. Thyroid
      stimulating antibodies were never detected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351957
TI  - Normal calcitonin response to pentagastrin stimulation in patients with chronic
      renal failure.
AB  - High calcitonin levels have been reported in chronic renal failure. To study the
      C cell response in patients with chronic renal failure, an intravenous bolus of
      pentagastrin was administered to 11 patients and 11 healthy subjects. Samples
      were obtained at 0, 1, 2, 3, 5 and 10 min for calcitonin assay. In order to
      detect only the active monomeric calcitonin, an immunoradiometric assay method
      was used. The influence of calcium, phosphate, alkaline phosphatase and intact
      parathyroid hormone was also evaluated. Although basal calcitonin levels were
      higher (p < 0.01) in chronic renal failure (mean +/- SEM: 10.1 +/- 2.9 pmol/l)
      versus healthy subjects (1.1 +/- 0.3 pmol/l), the area under the curve showed
      there to be no differences between the two groups. The rising branch of the area
      under the curve, employed as an expression of the C cell response capacity,
      showed no differences either (chronic renal failure vs healthy subjects: 5.6 +/-
      2 vs 2.6 +/- 0.7 pmol l-1 min-1, p = 0.28). In the chronic renal failure group, a
      positive correlation was found (r = 0.625, p < 0.05) between the rising branch of
      the area under the curve and parathyroid hormone. We conclude that monomeric
      calcitonin is increased in chronic renal failure, but C cells of the thyroid
      respond to pentagastrin, as they do in normal subjects. This finding is of great
      clinical importance when a patient with renal impairment is evaluated for
      medullary thyroid carcinoma. The calcitonin response to pentagastrin seems to be
      related directly to the degree of secondary hyperparathyroidism in chronic renal
      failure.

PMID- 8351958
TI  - Effects of chronic heroin abuse on bone and mineral metabolism.
AB  - Though the chronic use of opiates can modify several body functions, only a few
      data are available on the effects of opioid drugs on mineral metabolism. We have
      examined the possible consequences of chronic opiate abuse on bone mass, bone
      turnover and calcium metabolism in 13 male chronic heroin users, examined 1-2
      days after the last administration of the drug (group A), 14 former male heroin
      addicts, examined 4-24 months after drug discontinuation (group B), and 22
      healthy, age- and sex-matched control subjects. In group A, the vertebral bone
      mineral density (measured by Dual-Photon Absorptiometry) was significantly lower
      (p < 0.05) than in the control subjects, despite similar values of total body
      bone mineral, lean body and fat mass. Blood-ionised calcium and urinary calcium
      and hydroxyproline were significantly increased (p < 0.01), whereas parathyroid
      hormone was lower than in controls (p < 0.01). Bone alkaline phosphatase and
      osteocalcin, however, were not significantly different from the control values.
      LH and testosterone levels were low (p < 0.01 vs controls). In contrast, group B
      subjects did not show significant differences from the control group. The chronic
      abuse of opioid drugs may be associated with altered bone metabolism and reduced
      trabecular bone mass, attributable, at least in part, to gonadal deficiency.
      These alterations seem reversible after drug discontinuation.

PMID- 8351959
TI  - Effects of cyclosporin A and verapamil on mouse pancreatic islets.
AB  - Treatment of NMRI mice with cyclosporin A (25 mg/kg body wt) for 11 days caused a
      marked fall in pancreas insulin content, although plasma glucose and plasma
      insulin were unchanged. When islets from untreated mice were exposed to
      cyclosporin A (2 mg/l) in vitro, no effect was seen in the first hour. After 24
      h, cyclosporin A had significantly decreased the islet content of insulin. Post
      culture microperifusion showed that cyclosporin A for 24 or 72 h inhibited the
      insulin secretory responsiveness. Verapamil in vivo (0.4 mg/kg body wt per day)
      or in vitro (37.5 micrograms/l) did not modify these effects. Verapamil at 25
      mg/l suppressed the release of insulin but afforded no obvious protection against
      cyclosporin A during culture. The beneficial action of verapamil on islets
      transplanted to the kidney may reflect renal events rather than a primary
      interaction of drugs in the islets.

PMID- 8351960
TI  - Kinetic changes of melatonin release in rat pineal perifusions at different
      circadian stages. Effects of corticosteroids.
AB  - The kinetic characteristics of melatonin release were documented in perifused
      pineal glands removed from rats sacrificed at six circadian stages (light/dark =
      12:12): three during the light phase, i.e. 3, 7 and 11 hours after light onset
      (HALO), and three during the dark phase, i.e. 15, 19 and 23 HALO. Whatever the
      circadian stage, the melatonin release decreased during the first 3-4 h and then
      remained fairly constant and roughly similar up to 8 h of perifusion. However,
      the kinetics of the release in the first 3 h differed in perifusions of pineal
      glands removed during the light (progressive decline during 3 h) as compared to
      perifusions of pineal glands removed during the dark (sharp decline during the
      first hour and then a progressive decline until reaching a constant level after 3
      h). As the effects of steroid administration on melatonin secretion are a matter
      of controversy, we also studied the direct effects and their circadian stage
      dependence, if any, of corticosterone, deoxycorticosterone and dexamethasone on
      melatonin secretion by pineal glands removed 7 HALO (about the middle of the
      light phase) and 19 HALO (about the middle of the dark phase). High
      concentrations of corticosterone (0.8 x 10(-3) mol/l) and dexamethasone (0.4 x
      10(-3) mol/l) resulted in a significant (p < 0.001) inhibitory effect on
      melatonin production (about a 50% and a 30% decrease, respectively) whatever the
      circadian stage, whereas lower concentrations (10(-4)-10(-5) mol/l) of both
      steroids did not affect melatonin production.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8351961
TI  - Pituitary-gonadal response to gonadotropin-releasing hormone stimulation is
      enhanced in men after strenuous physical exercise.
AB  - The effects of strenuous physical exercise were studied on the pituitary
      testicular response to gonadotropin-releasing hormone (GnRH) stimulation and on
      growth hormone (GH) and cortisol secretion. Eight healthy adult males were
      injected twice intravenously with 0.1 mg of GnRH at intervals of 21 days. At the
      time of the first injection (exercise trial) the subjects had been bicycling for
      4 h on the road, and at the time of the second injection (rest trial) they had
      been resting in a sitting position for 4 h. Blood samples were taken before and
      after the 4-h period and 30, 60 and 120 min after the GnRH injection. Both
      testosterone and luteinizing hormone (LH) decreased during the exercise by 18% (p
      = 0.037) and 29% (p = 0.0028), respectively, but increased after the GnRH
      injection by 1.4- and 12.9-fold (p = 0.0001 for both). The areas under the
      testosterone and LH response curves after GnRH were significantly larger in the
      exercise trial than in the rest trial, threefold (p = 0.013) and 1.3-fold (p =
      0.0007), respectively. Growth hormone and cortisol increased during the exercise
      trial. In the rest trial, the GnRH injection increased serum GH concentrations (p
      = 0.027). In conclusion, the diminished hypothalamic GnRH secretion seems to be
      the major cause of the post-exercise decrease in LH and testosterone, but altered
      sensitivity of the pituitary to GnRH also may be involved. Apparently, the build
      up of pituitary LH stores during exercise explains the enhanced LH and
      testosterone response to GnRH challenge after exercise in comparison to control
      GnRH challenge.

PMID- 8351962
TI  - Fine structural correlates of VIP-like immunoreactivity in the upper spinal
      dorsal horn after peripheral axotomy: possibilities of a neuro-glial
      translocation of a neuropeptide.
AB  - After transection of the peripheral nerve, VIP-like immunoreactivity (VIPLI)
      increases markedly in the ipsilateral upper dorsal horn of the spinal cord.
      Immunoreactivity has been studied by means of light- and electron microscopic
      immunocytochemistry. Under normal conditions, there is little VIPLI present in
      the superficial dorsal horn, confined to small dot-like elements corresponding to
      axonal and glial profiles. At the electron microscopic level, immunostaining was
      found mainly in preterminal and, partly, also in en passant terminal swellings or
      varicosities. The reaction was confined to the axoplasm and, to a lesser extent,
      to large dense core vesicles. VIPLI is also present in several astroglial
      processes. 13, 19, and 25 d after transection of the sciatic nerve, increased
      immunoreactivity was present in the medial 2/3 of the superficial dorsal horn.
      Electron microscopically, VIPLI was seen mainly in preterminal axons and in many
      astroglial processes surrounding axon terminals while VIPLI in the en passant
      axon terminals themselves decreases. 2 months after peripheral axotomy, the
      amount of axonally localized VIPLI decreases considerably and most of the
      immunocytochemically detectable VIPLI is found in expansions and processes of
      astroglial cells. Perikarya of glial cells rarely exhibit VIPLI. VIPLI also
      increased after crushing the related peripheral nerve; however, as soon as the
      nerve fibers regenerate, VIPLI decreases again to normal levels. It appears that
      blockade of the retrograde axoplasmic transport induces a switch in the
      neuropeptide synthesizing machinery of dorsal root ganglion cells which results
      in the expression of VIP instead of substance P, somatostatin and CGRP. It is
      proposed that VIP is released from axon terminals affected by transganglionic
      degenerative atrophy. Subsequently, astroglial cells equipped with receptors for
      VIP, might bind and internalize the released VIP.

PMID- 8351963
TI  - Intermediate filaments and ATPase activity in the vascular wall of vertebrates.
AB  - The vascular wall of aorta and vena cava was examined for adenosine
      triphosphatase (ATPase) activity and cytoskeletal intermediate filaments (IF) in
      different representatives of vertebrates. Enzyme activity was studied by the
      modified method of Padykula and Herman. A streptavididin-biotin
      immunohistochemical method was applied to reveal desmin (D) and vimentin (V) IF.
      Endothelial cells of all vessels were V-positive and D-negative and exhibit high
      ATPase activity. Vascular smooth muscle cells (SMC) in lower vertebrates (pisces
      and amphibia) were also V-positive and D-negative, but showed low ATPase
      activity. SMC were D-positive and V-negative and possessed high enzyme activity
      in aves and mammals, similar to that of the endothelium. In cow vascular wall D
      reactivity and high ATPase activity were mostly expressed in bundles of
      mosaically arranged thick SMC fibres of the outer aortic media as well as in the
      longitudinal fibres in the inferior vena cava. In higher vertebrates SMC of vasa
      vasorum were both V- and D-positive and showed high enzyme activity. The results
      demonstrate that D-immunoreactivity is mostly expressed in SMC of layers of high
      functional activity, which correlates with the intense ATPase reaction in these
      cells.

PMID- 8351964
TI  - Biphasic increase of calcitonin gene-related peptide-like immunoreactivity in rat
      hypoglossal motoneurons after nerve transection.
AB  - In the hypoglossal system the regulation of calcitonin gene-related peptide
      (CGRP) following peripheral nerve transection and prevention of reinnervation was
      studied using immunocytochemistry. In the adult rat axotomy resulted in a
      biphasic increase of CGRP-immunoreactivity (IR) with a first peak after 2 days
      and a second peak after 18 days. In addition to an increase in staining intensity
      the number of CGRP-IR motoneurons was also increased. The lesion-induced
      alterations of CGRP-expression in the hypoglossal nucleus correspond to those
      described in other motor system. A possible contribution of CGRP to
      degeneration/regeneration processes is discussed.

PMID- 8351965
TI  - Effect of fixation conditions on the granule morphology of rat antral gastrin
      cells: an ultrastructural and immunocytochemical study.
AB  - After fixation at pH = 7 or pH = 5 the gastrin (G) cells in the rat pyloric
      antrum were investigated by conventional and immunoelectron microscopy. After
      fixation at pH = 7 G cells contained numerous electron-lucent granules, a few
      electron-dense and intermediate granules while G cells had numerous electron
      dense and intermediate granules, and a few electron-lucent granules after
      fixation at pH = 5. Preembedding immunoelectron microscopy revealed that in G
      cells after fixation at pH = 7, gastrin immunoreactivity was mainly seen in the
      cytoplasm, cores of a few electron-dense and intermediate granules and in the
      periphery but not within the numerous electron-lucent granules; in G cells after
      fixation at pH = 5, gastrin immunoreactivity was mainly visible in the cores of
      numerous intermediate and electron-dense granules, in the periphery of a few
      electron-lucent granules, but weakly in the cytoplasm. Therefore, the variable
      electron density of G cells may reflect differences in the degree of the leakage
      of contents from the gastrum-containing granules into the cytoplasm during
      fixation. This phenomenon may be related to the acidity of the granule substances
      during intragranular maturation.

PMID- 8351966
TI  - Enzyme activities of six different dehydrogenases in Ehrlich ascites cells
      measured by flow cytometry.
AB  - Flow cytometric measurements of the activities of lactate dehydrogenase, glucose
      6-phosphate dehydrogenase, isocitrate dehydrogenase, glycerol-3-phosphate
      dehydrogenase, succinate dehydrogenase and glutamate dehydrogenase in single
      Ehrlich ascites tumour cells are described using a tetrazolium salt/fluorescent
      formazan reaction. Applying cyano-ditolyl-tetrazolium chloride (CTC) as redox dye
      indicating enzyme reaction, and DAPI as a fluorochrome for nuclear DNA staining,
      the bivariate flow cytometric assay of enzyme activity and cell cycle analysis
      was established. Furthermore, adopting the calibration procedure reported
      formerly, consisting of biochemical determination and flow cytometry of the same
      sample performed parallelly, the enzyme activities were expressed in biochemical
      units. The dehydrogenase activities found in Ehrlich ascites cells were 97.5 fmol
      H2 per average positive cell during 5 min for lactate dehydrogenase, 69.0, 10.6,
      25.3, 29.7, and 19.0 fmol H2 per average positive cell during 20 min for glucose
      6-phosphate dehydrogenase, isocitrate dehydrogenase, glycerol-3-phosphate
      dehydrogenase, succinate dehydrogenase and glutamate dehydrogenase, respectively.
      This quantitative procedure can offer an alternative analytic tool for enzyme
      cytology.

PMID- 8351967
TI  - Proteases of polymorphonuclear neutrophils: influence of different salts and
      buffers on pericellular lysis.
AB  - Polymorphonuclear neutrophils (PMN) contain neutral proteases which are
      cytochemically detectable on blood smears. The activity of these proteases can be
      visualized by pericellular lysis, i.e. through a disk like degradation of plasma
      and erythrocytes around centrally located neutrophils. This degradation is
      inhibited by protease inhibitors in a concentration-dependent manner. Striking
      differences in halo formation were found depending on the type of buffer and salt
      used and change of temperature. A halo formation was obtained in Tris-HCl buffer,
      pH 7.5 without salt, at room temperature (22 degrees C), and with short
      incubation periods (30 min). Borate buffer, pH 8.5, showed a comparable halo
      formation only at 37 degrees C, after addition of salts, and after longer
      incubation times (180 min). When different alkali chlorides were used, halo size
      increased with molecular mass. Optimum halo size was achieved at a concentration
      of 250 mM. Addition of MgCl2 and CaCl2 (250 mM) resulted in a small halo
      formation at 22 degrees C, but inhibited halo formation at 37 degrees C. The
      present study shows that the pericellular lysis caused around neutrophils by the
      release of proteases is affected by a complex interaction of salts, temperature,
      buffers and thermodynamic aspects, all of which should be evaluated carefully in
      these kinds of experiments.

PMID- 8351968
TI  - Effects of the fluorescence dye DAPI on microtubule structure in vitro: formation
      of novel types of tubulin assembly products.
AB  - It has been found that the DNA fluorescence dye 4',6-diamidino-2-phenylindole
      (DAPI) is able to stain also microtubules. However, electron microscopy revealed
      that DAPI changed microtubule structure and induced the formation of a broad
      spectrum of polymorphic tubulin assembly products. Upon addition of DAPI to
      microtubules assembled from 10 to 15 mumol tubulin (molar DAPI/tubulin ratios of
      10 to 40) in the presence of microtubule-associated proteins, most of the
      microtubules were decorated with additional protofilaments usually running
      parallel to the protofilaments of the microtubule wall (microtubule-protofilament
      complexes). When DAPI was already present during assembly, curved C- and S-shaped
      protofilament ribbons and microtubule-ribbon complexes with 6-shaped profiles
      were the most prominent products, beside microtubules. Additionally,
      protofilament bundles, some flat sheets, and hoops occurred. Electrophoresis
      revealed that DAPI lowered the amount of associated proteins, especially of tau
      proteins, bound to the assembly products. Nevertheless, DAPI stimulated the
      assembly, enabled pure tubulin to assemble even at concentrations as low as 10
      mumol, and stabilized the assembly products against cold. The microtubule
      protofilament complexes, observed for the first time, are interpreted as the
      result of DAPI-induced protofilament linking as well as of activation of an
      additional tubulin-tubulin binding site which is possibly identical to that
      involved in the formation of microtubule doublets.

PMID- 8351969
TI  - Distribution of carbonic anhydrase isozyme III (CA-III)-positive cells in duct
      segments of the bovine submandibular gland.
AB  - The distribution of carbonic anhydrase III isozyme (CA-III)-positive cells in
      bovine submandibular glands was studied by immunohistochemistry. CA-III showed
      strong immunoreactivity in basal cells and some lining cells of the intercalated
      ducts as well as in striated and interlobular ducts cells. No significant
      immunoreactivity could be found in other portions of the glands. Electron
      microscopically, the immunoreactive basal cells contained scattered tonofibrils
      in their cytoplasm. The distribution of CA-III suggests that the CA-III-positive
      basal cells may play a special physiological role, and that they do not only
      represent undifferentiated lining cells.

PMID- 8351970
TI  - Type IV collagen localization in hamster tracheal epithelial cell cultures.
AB  - Hamster tracheal epithelial (HTE) cell cultures when grown on collagen coated
      Millicell-HA filters for 28 d in vitro have an incomplete basal lamina-like
      structure at the basal plasmalemma/collagen interface. EM evaluation of 42 d HTE
      cell cultures also revealed the presence of hemidesmosome-like structures on the
      basal plasmalemma. In order to better characterize this discontinuous basal
      lamina-like material, HTE cultures at 7, 14, 21, and 28 d were evaluated for the
      presence of type IV collagen, a basal lamina component. Immunocytochemical
      treatment of HTE cultures at these time points resulted in the presence of
      reaction product at the base of the cell layer. When immunocytochemical
      procedures for the localization of type IV collagen were carried out with normal
      mouse trachea, the results were also positive. Immunoblotting evaluation of HTE
      cell supernatants and conditioned media also indicated the presence of type IV
      collagen. Taken altogether, the presence of what appears to be basal lamina,
      hemidesmosome-like structures and immunocytochemical and immunoblot data showing
      the presence of type IV collagen in HTE cultures suggest that HTE cells may be
      producing basal lamina components but cannot organize them into a complete basal
      lamina.

PMID- 8351971
TI  - Immunolocalization of meprobamate-like molecules in rat cerebellar cortex.
AB  - The localization of meprobamate-like (MPB-like) molecules in the cerebellar
      cortex of the rat was investigated with the peroxidase-antiperoxidase (PAP)
      immunocytochemical method using an antiserum raised in rabbits. The positive
      immunoreaction for MPB in several nervous structures and in the wall of blood
      capillaries suggest the presence of endogenous MPB-like molecules.

PMID- 8351972
TI  - Immunohistochemical phenotypes of histioeosinophilic granulomas of thymus and
      reactive eosinophilic pleuritis.
AB  - Immunohistochemical phenotyping of 7 cases of histioeosinophilic granulomas of
      thymus and 4 cases of reactive eosinophilic pleuritis was performed. All 11 cases
      of these 2 entities reacted identically. This supports the view that these 2
      lesions are similar in nature. Both lesions are reactions to the presence of
      insufflated gas and its resorption.

PMID- 8351973
TI  - Chick embryo metanephros: the glycosylation pattern as revealed with lectin
      conjugates.
AB  - Fragments of metanephros were taken from chick embryos and studied from the 7th
      to the 21st d of incubation. A battery of 7 different horseradish peroxidase
      labelled lectins (PNA, ConA, DBA, SBA, LTA, WGA and UEA I) was used to analyse
      the distribution and changes of carbohydrate moieties in glycoconjugates along
      the metanephric nephron from the S-shaped body stage onwards. DBA and SBA reacted
      for a short time at some sites during the considered period of incubation.
      Provided WGA and ConA reacted with most of the nephric components, the almost
      ubiquitous presence of N-acetyl-D-glucosamine and alpha-D-mannose was
      demonstrated. SBA and LTA were found to be good markers of the proximal tubule.
      On the 12th d of incubation, sialic acid was found in the podocytes, capillary
      walls, and the connecting and collecting ducts. On the same day, other
      oligosaccharides were present at the nephric tubular components. The simultaneous
      presence of sialic acid and other sugar residues may be significant for the
      identification of the exact stage of incubation at which metanephric activity
      starts. The possible role of some sugar residues for the regulation of
      metanephric activity is discussed.

PMID- 8351974
TI  - Morphometric analysis of the hypoactivity of FSH-immunoreactive cells in estrogen
      primed male rats.
AB  - In order to evaluate the repercussions of estradiol treatment on the morphology
      and activity of FSH-producing cells, an immunocytochemical and morphometric study
      was carried out in male rats treated chronically with estradiol, relating those
      findings to serum FSH levels at the time of sacrifice. Chronic administration of
      estradiol led to a decrease (p < 0.01) in serum hormone levels that was
      accompanied by a marked decrease in cellular size (p < 0.01) due to a decrease in
      nuclear and cytoplasmic area. Our findings suggest for the adult male rat an
      inhibitory effect on the synthesis and release of FSH following testicular
      atrophy induced by treatment with estradiol.

PMID- 8351975
TI  - Immunological cross-reactivities between proteins secreted by the subcommissural
      organ, and plant lectins.
AB  - The glial subcommissural organ (SCO) discharges a glycoprotein-rich secretory
      product into the third ventricle to form Reissner's fibre (RF). The SCO proteins
      bear N-linked oligosaccharides, such as mediate many cell-cell and cell-matrix
      interactions. In such interactions the corresponding partner molecule recognising
      the sugar chain is often a sugar-specific protein (lectin). We present here
      evidence that the constituents of the SCO secretory product include proteins
      immunologically cross-reactive with certain plant lectins. Polyclonal antisera
      directed against Phaseolus vulgaris agglutinin-L (PHA-L) labelled the apically
      released RF-material of the rat SCO. Indirect ELISA studies shows in addition
      that anti-RF antisera bound to certain plant lectins (PHA-L, Con A). Dot spot
      assays demonstrated binding of anti-PHA-L to RF proteins. In Western blots of RF
      proteins anti-PHA-L, anti-RCA and anti-Con A bound to distinctive subsets of the
      RF protein fractions.

PMID- 8351976
TI  - Enzyme cytochemical expression of aortic smooth muscle cell modulation in primary
      and secondary cultures.
AB  - "Contractile" arterial smooth muscle cells (SMC) return to a less differentiated
      "synthetic" state during adaptative and proliferative processes in vitro and in
      cell cultures. At present, the enzyme expression of the modulation of cultured
      SMC is partially unknown. In order to define metabolic events associated with
      cell modulation in vitro, we studied 16 enzyme activities in primary and
      secondary (P1-P3-P10) SMC cultures in comparison to in situ SMC in fetal and
      adult rat aorta. The "contractile" SMC in aorta of 2 months old rat showed very
      high nucleotide hydrolase activities (5'-nucleotidase, Mg-ATPase, Ca-ATPase), and
      naphthylesterase activities and weak lysosomal acid phosphatase activity; the
      glycolysis-linked dehydrogenases were expressed with higher activities than Krebs
      cycle-linked enzymes. In primary cultures, the SMC near the explant expressed a
      "contractile-like" enzyme behaviour, in opposite to cells in the peripheral part
      of growing area enzymatically similar to sub-cultured SMC. Proliferating SMC in
      secondary cultures were characterized by increased lysosomal activities and by
      the decrease or disappearance of Ca-ATPase, Mg-ATPase, 5'-nucleotidase, and
      butyrylcholinesterase activities like fetal SMC in vivo. These enzyme changes in
      subcultures might be related to a deficiency of nucleotide ester hydrolysis,
      abnormal adenosine and AMP levels, lowered lipolytic capability and increased
      lysosomal reactivity. In conclusion, subcultured "synthetic" SMC expressed enzyme
      cytochemical patterns different from those of "contractile" SMC and similar to
      those of fetal immature SMC. Their enzyme behaviour is unfavourable to
      contractile function and favourable to cell proliferation and lipid accumulation,
      two characteristic features of SMC in atherosclerotic plaques.

PMID- 8351978
TI  - Variations of collateral branching in the motor nerve fibers in the skeletal
      muscle of adult rats.
AB  - Collateral branching (CB) applies to a collateral branch resulting in the
      innervation of two or more muscle fibers by one motor axon. Using a silver
      impregnation with or without cholinesterase (ChE) staining, the morphological
      pattern of innervation was investigated in the motor endplates of the adult rat
      soleus. Two types of variations of CB, type A and B, were noted. In type A
      (elaboration of CB), marked ramification of a single motor axon results in
      double, discrete endings (main and smaller accessory endings) on one muscle fiber
      and collateral formation on the other. The accessory endings were apposed by some
      small, clearly-defined separated units of the postsynaptic ChE site. In type B
      (double endings per endplate), small endings lying close to the main ending were
      either due to ramification of the motor axon innervating the neighboring muscle
      fiber (type B 1) or due to direct contact of non-branched, non-original motor
      axons (type B 2). The incidence of CB and its variations was small and the number
      of subterminal axons innervating more than one muscle fiber (functional terminal
      innervation ratio) was far below the level of partial denervation. In response to
      the local events of muscle, either type A or type B branching could serve as a
      useful tool to remodel the motor endplate for, e.g., its renewal, replacement
      and/or enlargement.

PMID- 8351977
TI  - Analysis of lectin binding sites in the gut of hooded Lister rats with special
      emphasis on recently detected lectins.
AB  - Seven recently isolated lectins were tested for their ability to bind to tissue
      sections of rat gut. Binding sites for N-Acetylgalactosamine specific lectins
      were found in mucins, in the brush border membrane and in goblet cells. Non
      reducing terminal mannose residues were absent from cell surface membranes but
      were detected in the supranuclear region of goblet cells and enterocytes. The
      results of lectin binding obtained in this study were generally similar to lectin
      gut interactions observed in vivo.

PMID- 8351979
TI  - The use of lectins identified with specific antibodies in lectin histochemistry
      of NZB/W F1 mouse kidney.
AB  - The affinity of Helix pomatia, peanut, Pisum sativum, soy bean, and wheat germ
      agglutinins to various nephron parts of NZB/W F1 mice was different and is
      assumed to be age dependent. The affinity of Pisum sativum agglutinin to basal
      membranes of small renal vessels increased with the age of NZB/W F1 mice. The
      wheat germ agglutinin bound to structures with alkaline phosphatase activity.

PMID- 8351980
TI  - Neuronal expression of the RAF protooncogene in the spinal cord of adult guinea
      pigs.
AB  - The cellular raf oncogenes encode cytoplasmic serine/threonine specific protein
      kinases. Since there are some indications that they are involved in neuronal
      plasticity, we investigated the localization of raf protein kinases
      immunohistochemically. The spinal cord of adult guinea pigs was fixed by means of
      transcardial perfusion, transverse sections were cut from each segment and
      stained with monoclonal and polyclonal antibodies, raised against synthetic raf
      peptide and recombinant raf protein, respectively. The motor neurons of the
      ventral horn and the large- and medium sized neurons of laminae I, IV, V, VI, VII
      and VII were stained in every segment of the spinal cord. The widespread
      occurrence of raf kinases in the spinal cord and the literature data indicating
      their participation in growth factor mediated processes, raise the possibility
      that the raf protooncogenes play a fundamental role in the regulation of
      transmembrane signalling of these neurons.

PMID- 8351981
TI  - Definition and classification of childhood injuries.
AB  - Injuries have emerged as the leading cause of child and adolescent morbidity and
      mortality in developed countries. Efforts to control injuries require injury
      surveillance and research, creating the need for standard variable definitions
      and categorizations. Advantages of such standardization include increased
      comparability of data sets, avoidance of spurious conclusions based on
      idiosyncratic definitions and categories and the potential to combine data sets
      (e.g. on injuries and population counts) to yield new information. Pertinent
      standards will differ depending on the purposes for which the data are collected.
      More limited (core) data are appropriate to surveillance and more extensive data
      to research. Existing standards that are likely to be most useful to pediatric
      injury investigators are the International Classification of Diseases External
      Cause (E) codes (which provide mechanism-of-injury diagnoses and are the
      international gold standard for injury data reporting) and the Standard
      Definitions for Childhood Injury Research recently released by the United States
      National Institute for Child Health and Human Development, which include both
      core and complete variable listings. Some key core definitions from the latter
      report are presented.

PMID- 8351982
TI  - Injury surveillance in Australia.
AB  - The development of injury surveillance systems in Australia is described from a
      public health perspective at the national level. Injury surveillance systems have
      undergone significant changes in recent years and further developments are
      planned. Three phases or generations are distinguished, each with distinctive
      features, advantages, and disadvantages. The first generation system was based on
      by-product data from routine mortality and morbidity statistics. The second
      generation system was specifically designed for injury surveillance, mainly using
      data collected for this purpose in hospital accident and emergency departments. A
      third generation of public health surveillance systems for injury control is now
      being developed for Australia. In developing a third generation system, a middle
      course is being charted. The number of data items and the complexity of
      classification for routine surveillance are mid-way between those of the first
      and second generation systems.

PMID- 8351983
TI  - Childhood injuries in Japan.
AB  - Approximately 2000 children aged between 0 and 14 years die annually of accidents
      and their sequelae in Japan. Moreover, accidents and their sequelae are the
      leading cause of death in the 1-4 year, 5-9 year and 10-14 year age groups.
      Accidental drowning and traffic accidents account for 2/3 of all such deaths.
      Measures for preventing injury in these age groups are clearly necessary, since
      the mortality rate due to accidents and their sequelae in children 0 to 4 years
      old is higher in Japan than in European countries. It is considered that the
      lives of 824 infants aged between 0 and 4 years might be saved annually in Japan
      if the mortality rate could be reduced to a level comparable to that in Sweden by
      accident prevention and control. Therefore, a systematic approach for prevention
      of childhood injury is a high priority in Japan.

PMID- 8351985
TI  - Accidental poisoning of children in Japan: a report from the Japan Poison
      Information Center.
AB  - The Japan Poison Information Center (JPIC) was founded only 6 years ago as a
      result of co-operation between the Ministry of Health and Welfare, the Japanese
      Association for Acute Medicine, the Japan Pediatric Society and other related
      medical organizations. The JPIC is the only poison information center admitted by
      the Ministry of Health and Welfare to provide toxicological information to
      medical personnel and the general public, and has two offices on duty in
      alternating 24 h shifts. Every year, JPIC receives about 30,000 inquiries. About
      82% of these inquiries are from the general public and 84% of the patients are
      children 5 years and younger. We contrasted the data in the fiscal year 1991 with
      the data of the American Association of Poison Control Centers (AAPCC). Child
      poison exposure in Japan is characterized by a high exposure rate of children
      under 1 year of age to (mostly) household products. The JPIC also analyzed the
      cause of tobacco ingestion. It is considered that the Japanese lifestyle causes
      differences from those reported by AAPCC. We report the accidental poisoning of
      children in Japan.

PMID- 8351984
TI  - Childhood drownings and near-drownings in Japan.
AB  - In Japan, the leading cause of death for children over 1 year old is injury, and
      for children aged 0-14, drowning is the second leading cause of death. The
      purpose of the present study was to describe the epidemiological factors of
      drownings and near-drowning among Japanese children and to ascertain whether
      there are characteristic patterns for different age groups. Epidemiologic data
      was obtained by questionnaire. A total of 604 cases of submersion injuries were
      reported from 49 hospitals located in 22 Japanese prefectures. In the present
      paper, victims of drowning (n = 134) and near-drowning with permanent severe
      brain damage (n = 51) and those of near-drowning with intact survival or mild
      impairment (n = 419) were investigated. Preschool-aged children, especially
      toddlers, are at the greatest risk of drowning and near-drowning, and for
      children over 2 years of age, boys have three times greater risk than girls. The
      bathtub is the most common place of submersion injuries in Japan, especially for
      children under 4 years of age. The important risk factors for the victims who
      died or were severely impaired were associated with duration of submersion and
      necessity of emergency cardiopulmonary resuscitation on arrival at hospital.

PMID- 8351986
TI  - Injuries of school-aged children in Japan: causes and costs.
AB  - Injuries of school-aged children were presented from several data sources. About
      80,000 schools, from nurseries to upper secondary schools, operate in Japan and
      are attended by 24.3 million students. About 97% of these young people are
      insured by the insurance system of the School Safety Division of the National
      Stadium and School Health Center of Japan. Annual injuries and illnesses total
      1.08 million, 1039 cases being impedimentary and 191 causing death. The average
      incidence of injury and illness is 4.6%, a rate that has been increasing every
      year since 1960. The activity at the time of injury, the impairment incurred, and
      the part of the body injured differ with the type of school and depend mainly on
      the developmental stage of the child. Minor injuries occur at the rate of about
      47 cases in elementary schools and 14 in lower secondary schools versus one
      benefit-applied injury at a school safety center. The cost of injuries under the
      control of schools totaled US$124 million per year in 1990. The average amount of
      benefits per injured student per month was US$63.

PMID- 8351987
TI  - Child traffic accident injuries in Japan.
AB  - This study analyzes the characteristics of traffic accidents involving children.
      It discusses why children with certain attributes and in specific situations are
      exposed to a higher traffic accident risk, in light of their ability to deal with
      traffic and their body characteristics. Finally, based on these results, it
      offers some conclusions and recommendations on ways of improving child safety in
      road traffic.

PMID- 8351989
TI  - Role of a children's hospital safety centre in injury control.
AB  - Over the past 13 years, child safety centres have been established at several
      Australian Children's hospitals. In a short time, they have developed an
      important role in community injury control programmes. These centres provide an
      efficient conduit for transferring up-to-date injury surveillance and prevention
      information to families, industry, health and education professionals, and
      government. The activities of the Child Safety Centre at the Royal Children's
      Hospital in Melbourne are described, together with ways in which a degree of self
      funding can be achieved.

PMID- 8351988
TI  - Preventing accidents in childhood: a European perspective.
AB  - Accidental injury is a principal public health issue with important individual,
      societal and economic consequences. Crude figures show that 2.7 million deaths
      from injury and poisoning are reported worldwide. In developing and
      industrialized countries 10-30% of all hospital admissions are due to accidental
      injuries. In particular, children and adolescents are at risk. In all
      industrialized countries accidental injuries are the major cause of death and
      morbidity among children above the age of one. In the domestic safety area much
      effort has to be invested in improving the safety of the environment and
      products. In the European region, collaboration among authorities in the
      framework of the European Community (EC) has been shown to be productive in the
      area of safety. Although trade interest is predominant in the EC objectives, the
      need to harmonize national regulations and standards towards common European
      standards has appeared to be an important vehicle for establishing standards at
      an optimum level of safety. It has also fostered some collaboration in data
      collection and analysis and in implementing prevention measures. An even stronger
      international collaboration is needed for ensuring that appropriate priorities
      are being set and prevention measures are effectively being implemented.

PMID- 8351990
TI  - Influence of long-term carbamazepine treatment on thyroid function.
AB  - We have studied the effects of carbamazepine on thyroid function in sixteen
      recently diagnosed epileptic children and thirteen epileptic children receiving
      long-term carbamazepine therapy and compared these findings with the thyroid
      function of thirteen healthy control subjects. Thyrotropin (TSH),
      triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3) and free
      thyroxine (FT4) serum levels were determined in both recently diagnosed but as
      yet untreated epileptic children and normal controls. These hormone levels were
      determined again after 2 months of treatment and 12 months of treatment in
      epileptic children. No statistically significant difference was found in the
      endocrine parameters of untreated epileptic children and the normal control
      group. After both 2 months and 12 months of carbamazepine therapy, serum levels
      of T4, FT4 and FT3 were found to be low, but the serum T3 concentration was
      unaffected. Baseline TSH levels were not changed during carbamazepine therapy
      either. Serum TSH levels increased rapidly after thyrotropin-releasing hormone
      stimulation in both the before and 12 months after carbamazepine treatment
      groups, but the response was higher in the 12 months treatment group. The
      findings of the present study suggest that accelerated hormone metabolism is
      responsible for hormonal changes found in patients treated with carbamazepine.
      Carbamazepine also had effects on the function of the hypothalamo-pituitary axis.

PMID- 8351992
TI  - Increased level/dose ratio of amphotericin-B in premature infants with renal
      failure.
AB  - We introduced continuous intravenous infusion of amphotericin-B (AMPH-B) to
      extremely low birthweight (ELBW) infants (< 1000 g) with or without renal failure
      as a single agent for treating definite or probable systemic candidiasis. The
      species of Candida isolated from blood or tracheal aspirate or urine were C.
      albicans in seven infants, C glabrata in two, C. tropicalis in one and C.
      parapsilosis in one. The minimal inhibitory concentrations (MIC) of AMPH-B
      required against these isolates were less than 0.2 micrograms/mL except for that
      against one strain of C. albicans (0.78 microgram/mL). Serum AMPH-B levels were
      0.31-0.78 (0.51 +/- 0.14) micrograms/mL when doses of 0.2-0.55 (0.32 +/- 0.11)
      mg/kg per day were being administered. The serum level was higher than the MIC of
      each isolate in all but one infant who died of disseminated intravascular
      coagulation and Candida pneumonia. Another infant died of congenital heart
      disease. The other nine infants survived. The serum level showed no correlation
      with the daily dose. The ratio of the serum level to the daily dose (L/D ratio)
      showed a significant correlation to serum creatinine (r = 0.787) and the linear
      regression curve followed the equation: L/D ratio = 0.223 x serum creatinine +
      1.11 (P < 0.01). Few adverse effects due to AMPH-B were noted. Our data may give
      a simple reference to serum AMPH-B levels during continuous intravenous infusion
      from the dose and the serum creatinine level.

PMID- 8351991
TI  - Respiratory syncytial virus infection in lower respiratory tract and asthma
      attack in hospitalized children in North Hokkaido, Japan.
AB  - Respiratory syncytial virus (RSV) infection is severe and life-threatening in
      some infants. To investigate the epidemiology of RSV infection in hospitalized
      children in North Hokkaido, Japan, we tried to detect RSV antigen in
      nasopharyngeal aspirates (NPA) from those children with lower respiratory tract
      infection (LRTI) and asthma attack. From April 1991 to March 1992, 317 patients
      were hospitalized in our pediatric ward for the treatment of LRTI and asthma
      attack. The presence of RSV antigen in NPA taken from 283 patients (89.3%) were
      examined by enzyme immunoassay. RSV antigen was detected in 88 patients (31.1%).
      RSV LRTI were noted throughout the year, and the epidemic peak was observed in
      November and December. There was no significant correlation between the RSV
      antigen positive rate and mean temperature. RSV played an important role in LTRI
      in children in North Hokkaido, Japan. RSV LRTI in North Hokkaido was not rare in
      summer, indicating that RSV was transmitted commonly among children throughout
      the year.

PMID- 8351993
TI  - Echocardiographic findings in mild and severe forms of sickle cell anemia.
AB  - M-mode echocardiographic findings were compared between sickle cell anemic and
      healthy children. Patients were composed of two groups; Group 1: mild group with
      no crises, no blood transfusions at the ages of 5.0 to 13.0, total of 12
      children; Group 2: severe group, with frequent crises with requirement of blood
      transfusions at the ages of 3.0 to 13.0 years, total of 18 children. Control
      group was composed of 12 healthy children aged 5.0 to 13.0. When M-mode
      echocardiographic findings were compared, important findings were as follows:
      Mean left atrium dimension was increased both in the mild and severe groups (P <
      0.001) compared with controls. This finding also supports the increase in the
      left ventricle end-diastolic dimension in both the severe and mild groups as
      compared with controls (P < 0.001). The increase in end-diastolic left ventricle
      dimension could be due to anemia present in the patients, but there was no
      difference between the two patient groups. Posterior left ventricle thickness and
      left ventricle mass was increased in both the mild and severe groups compared
      with controls (P < 0.001, P < 0.05), respectively. Left ventricular fractional
      shortening was more or less the same with controls. In spite of left ventricular
      volume load and dilatation, left ventricular contraction was good and systolic
      function was normal, and there was no correlation between the ECHO findings and
      hematological indices.

PMID- 8351994
TI  - A new and rare form of Williams' syndrome.
AB  - A 7 year old girl and her mother have typical phenotypic features of the
      Williams' (elfin facies) syndrome, and both have only mild mitral regurgitation
      with mitral valve prolapse (MVP). Mitral valve prolapse has been reported in only
      three cases but pure mitral insufficiency has not been reported alone. In this
      paper two cases of a new rare form of Williams' syndrome with MVP are presented
      and this rare disorder is discussed.

PMID- 8351995
TI  - Chronic hypomagnesemia and hypokalemia due to renal wasting in siblings.
AB  - A 13 year old girl with carpopedal spasm is presented. Investigation values
      showed hypomagnesemia and hypokalemia. Her younger brother and sister
      demonstrated the same biochemical abnormalities without any symptoms. Their
      urinary excretion of magnesium and potassium were inappropriately high compared
      with their serum levels. Treatment with oral magnesium sulfate failed to correct
      the abnormalities, but serum levels of magnesium and potassium were just below
      the lower limits. This familial disease may represent congenital renal wasting of
      magnesium and potassium.

PMID- 8351997
TI  - A case of urethral prolapse in a young girl.
AB  - Urethral prolapse is rarely reported in the pediatric literature. We report a 4
      year old female with urethral prolapse and discuss the etiology and the
      treatments in children documented in the literature.

PMID- 8351996
TI  - A mild case of nesidioblastosis with diagnostic and therapeutic difficulty.
AB  - A female infant with nesidioblastosis who showed mild clinical symptoms is
      reported. In this patient, insulin levels and insulin to glucose ratios (IRI/G)
      were often normal. Regular milk feedings supplemented with continuous glucose
      infusion (0.7-2 mg/kg per min) or oral glucose feedings (4.5 mg/kg per min)
      prevented hypoglycemia. As leucine-sensitivity was diagnosed at 2 months of age,
      she was started on diazoxide. This was, however, ineffective, and adverse effects
      appeared. Subtotal pancreatectomy (95%) was therefore attempted at 5 months of
      age, and persistent normoglycemia as well as normal growth and development
      followed up to 3 years after the operation. The pancreas showed characteristic
      signs of nesidioblastosis. The above clinical observation suggests that a patient
      with nesidioblastosis whose blood glucose level is easily controllable may
      develop an unexpected episode of hypoglycemia in the presence of a leucine
      sensitivity. In such a patient, diazoxide or, when it is of no avail, surgical
      intervention should promptly be instituted to prevent possible neurologic
      sequelae induced by hypoglycemia.

PMID- 8351998
TI  - Relation of age to effects of phentolamine and phenylephrine on heart.
AB  - In the present study, the responses of neonatal and adult dog hearts to
      phenylephrine (PE) and phentolamine (PA) were investigated in order to determine
      the influence of age factors. PA resulted in the slowing of the heart rate, the
      prolongation of corrected sinus node recovery time, atrial refractory period
      (ARP), ventricular effective refractory period (VERP), and ventricular functional
      refractory period (VFRP), and a significant inhibition of conducting tissues in
      neonatal dogs. In contrast, no such effects were seen in adult dogs. PE had a
      positive chronotropic effect in neonatal dogs but no such effect in adult dogs.
      In conclusion, alpha-adrenoceptors played an important excitatory role in the
      neonatal dog heart.

PMID- 8351999
TI  - Endocardium modulates myocardial contractile performance in isolated guinea pig
      papillary muscles.
AB  - Selective removal of endocardium by 1-s immersion of the muscle into 0.5% Triton
      X-100 resulted in a significant reduction of PT (peak isometric twitch tension)
      at 1.25 mmol.L-1 [Ca2+]o over the stimulation frequency from 0.2 to 2.0 Hz (3.2
      +/- 0.2 vs 4.4 +/- 0.4 mN/mm2 at 1 Hz, P < 0.01), while +dT/dtmax was unaltered.
      Tension-[Ca2+]o relation was shifted in accordance to [Ca2+]o, but with no
      significant change on PT at high [Ca2+]o compared with endocardium-intact
      muscles. TPT (time to peak isometric tension) and RT1/2 (half isometric
      relaxation time) were typically shortened at all [Ca2+]o or various stimulation
      frequencies (TPT: 203 +/- 18 vs 265 +/- 37 ms; RT1/2: 77 +/- 10 vs 108 +/- 26 ms,
      at 1.25 mmol.L-1 and 1 Hz, P < 0.01). Stimulation duration-threshold curve was
      slightly shifted to the left, yet no change in ERP (effective refractory period)
      was found. The data demonstrated that endocardium was an important modulator of
      myocardial contractile performance.

PMID- 8352000
TI  - Effects of rhynchophylline on motor activity of mice and serotonin and dopamine
      in rat brain.
AB  - Rhynchophylline (Rhy) reduced the spontaneous motor activity and enhanced the
      sedative and hypnotic effects of sodium pentobarbital in mice. The effects of Rhy
      on serotonin (5-HT) and dopamine (DA) concentrations in rat brain, and the
      release of 5-HT and DA from the regional brain slices were studied by a
      fluorescence detector. Rhy increased the 5-HT content in the hypothalamus and
      cortex, but reduced the DA concentrations in the cortex, amygdala, and spinal
      cord. Rhy promoted the release of endogenous DA from 4 brain regions. The release
      of 5-HT was increased in 2 brain regions and decreased in hypothalamus slice.
      However, Rhy inhibited the release of both 5-HT and DA evoked by high potassium.

PMID- 8352001
TI  - Effects of argipressin injected into medial amygdaloid body on blood pressure and
      heart rate in rats.
AB  - Graded injections of argipressin (Arg, 150, 300, and 600 ng/1.5 microliters CSF,
      2 min) into the medial amygdaloid body in anesthetized rats produced a dose
      related increase in the mean arterial pressure and heart rate (Maximal delta MAP
      = 2.9 +/- 1.5 kPa, Maximal delta HR = 67 +/- 38 bpm), which lasting > 40 min at
      600 ng dosage. Naloxone (15 micrograms/15 microliters CSF) injected into the
      lateral ventricle blocked the cardiovascular responses to Arg. These results
      suggest that Arg exerts a central action on the cardiovascular system via the
      opioid in the lateral ventricle.

PMID- 8352003
TI  - Selective vasodilatory effect of dipfluzine on vertebral artery in anesthetized
      dogs.
AB  - Dipfluzine (Dip) is a novel calcium antagonist first developed by Department of
      Chemistry, Beijing University. The effects of Dip on hemodynamics and vascular
      resistance in vertebral (VVR), coronary (CVR), and femoral (FVR) arteries were
      compared with those of cinnarizine (Cin) in anesthetized dogs. Dip iv decreased
      dose-dependently VVR at 0.1, 0.3, 1, and 3 mg.kg-1, CVR at 3 mg.kg-1, and FVR at
      1 and 3 mg.kg-1. The fall of VVR by Dip iv was more remarkable than that by Cin
      at the matching doses. The systolic, diastolic, and mean blood pressure and total
      peripheral resistance were temporarily reduced equally by both of them at 1 mg.kg
      1 iv, while Dip and Cin produced no obvious changes in heart rate, cardiac index,
      stroke index, LVP, and dP/dtmax at all doses. These results suggested that Dip
      possessed a high selectivity at different sites of the vasculature and was a more
      potent selective cerebral vasodilator than Cin.

PMID- 8352002
TI  - Effects of 3,6-dimethylamino-dibenzopyriodonium edetate on action potentials in
      guinea pig papillary muscles.
AB  - The effects of 3,6-dimethylamino-dibenzopyriodonium edetate (IHC-72) on action
      potentials (AP) and slow response action potentials of guinea pig papillary
      muscles were studied with intracellular microelectrodes. IHC-72 12.7, 25.4, and
      50.8 mumol.L-1 decreased the maximal upstroke velocity (Vmax), amplitude of
      action potential (APA), over shot (OS), and resting potential (RP) while
      prolonged the action potential duration at 30%, 50%, 90%, and 100% repolarization
      (APD30, APD50, APD90, and APD100). IHC-72 25.4 and 50.8 mumol.L-1 decreased the
      APA, Vmax, and prolonged APD50 and APD90 under high K+ superfusion. IHC-72 25.4
      and 50.8 mumol.L-1 depressed the automaticity, APA, and maximal diastolic
      potential (MDP) of the slow response action potentials induced by BaCl2. The
      results indicated that IHC-72 might nonspecifically inhibit the transmembrane
      movement of Ca2+, Na+, and K+.

PMID- 8352004
TI  - Effects of tetrahydroberberine on ischemic and reperfused myocardium in rats.
AB  - The effects of tetrahydroberberine (THB) on ischemic and reperfused myocardium
      were studied in comparison with verapamil (Ver). In anesthetized rats, THB and
      its analogues, l-THP and l-SPD, reduced the infarct size after 4 h of left
      anterior descending coronary artery (LAD) ligation. In Langendorff hearts, in
      common with Ver, THB 1 and 10 mumol.L-1 markedly decreased the incidences of
      ventricular tachycardia (VT) and ventricular fibrillation (VF) in the reperfusion
      period. The malondialdehyde content and xanthine oxidase activity were also
      decreased in global ischemic-reperfused hearts pretreated with THB (P < 0.01, or
      P < 0.05). It suggested that THB could protect the myocardium from ischemic and
      reperfusion injury.

PMID- 8352005
TI  - Methylflavonolamine protects aorta from atherosclerosis in cholesterol-fed
      rabbits.
AB  - The effect of methylflavonolamine [4'-methyl-7-(2-hydroxy-3-isopropylamino
      propoxy)-flavone hydrochloride, MFA], synthesized recently by the Shanghai
      Institute of Pharmaceutical Industry, on the development of atherosclerosis was
      studied in male New Zealand white rabbits fed cholesterol for 10 wk. MFA, 7 mg.kg
      1 daily ip, did not significantly alter the serum total cholesterol, HDL, and
      triglyceride levels, but significantly lowered the aortic cholesterol and calcium
      contents. Atheromatous lesions covered 53.3 +/- 11.8% of the intimal surface of
      the aorta in the saline group and 11.3 +/- 2.3% in the MFA group (P < 0.01). We
      conclude that MFA suppresses cholesterol-induced atherosclerosis.

PMID- 8352006
TI  - Optimal conditions of chemotherapeutic sensitivity in K562 cell line using
      tetrazolium dye assay.
AB  - Ten antineoplastic agents were used on K562 cell lines with the tetrazolium salts
      (MTT) assay to investigate optimal conditions of the chemotherapeutic
      sensitivity. The doubling time of K562 cell was 20.4 h in 96-well microtitre
      plates. The optical density in MTT assay of the no-drug controls was 0.77 (n =
      45). A 70% reduction (IC70) in absorbance compared with control values using an
      ELISA reader at 570 nm was referred to as drug sensitive and < 70% (IC70) was
      referred to as resistant. The inhibitory effect of the theoretical maximal plasma
      drug concentration (Cmax) in plasma was compared with that of 10% Cmax drug
      concentration. At 10% Cmax after a 2-d drug exposure to daunorubicin and
      homoharringtonine, or after 5 d to epirubicin, 5-fluorouracil, cytarabine
      hydrochloride, and doxorubicin, significant cytotoxicities were shown. There were
      little time-dependent effects after 2-5 d drug exposure for 4 out of the 10
      tested drugs, and mild or marked time- and dose-dependent effect for others.

PMID- 8352007
TI  - Inhibition of spermine on calcium influx during capacitation of guinea pig
      spermatozoa in vitro.
AB  - To investigate the mechanism of action of spermine, we measured the intracellular
      calcium ([Ca]i) of guinea pig spermatozoa using a probe of fluorescence, Quin 2.
      Results showed that spermine (0.25-2.0 mmol.L-1) suppressed the membrane
      permeability to Ca2+ during capacitation, which was similar to that of verapamil
      (a Ca2+ channel blocker). Furthermore, the rapid increase of [Ca]i induced by
      calcimycin (A-23187) was inhibited by spermine and verapamil, whereas
      trifluoperazine (an inhibitor of calmodulin) had no effect on it. The inhibition
      of the acrosome reaction caused by verapamil (5-100 mumol.L-1) or trifluoperazine
      (1-60 mumol.L-1) was reversed by calcimycin and cAMP, respectively. In addition,
      there was no effect on the initiation of the acrosome reaction when verapamil was
      added to capacitated spermatozoa. This result was in agreement with that of
      spermine. When addition of spermine (0.5 mmol.L-1) was combined with
      trifluoperazine (5 mumol.L-1), the acrosome reaction decline almost to zero,
      indicating that spermine might inhibit Ca2+ sensitive channel during sperm
      capacitation.

PMID- 8352008
TI  - Hypoxanthine phosphoribosyl transferase assay of lead mutagenicity on
      keratinocytes.
AB  - An improved hypoxanthine phosphoribosyl transferase (HPRT) assay system was used
      to investigate the genotoxicity in human and rat keratinocytes exposed to Pb2+
      0.1-100 mumol.ml-1 in vitro. Autoradiography was applied to determine the number
      of labeled cells/cm2 of culture with [3H]TdR and liquid scintillation
      spectrometry was used to determine the incorporation of [3H]TdR into DNA counting
      of 6-thioguanine (TG)-resistant cells. The ratio between the number of labeled
      cells in the Pb2+ treated group (T) and in the control group (C) was calculated.
      When the cells exposed to Pb2+ 6 mumol.L-1 for 4 h, the T/C ratios reached 1.75
      (scintillation, S), and 2.07 (autoradiography, A) in human and 1.37 (S), and 1.77
      (A) in rat cells. A positive relation existed between the concentration of Pb2+
      and mutagenicity. Lead should be considered as a weak mutagen in human and rat
      keratinocytes.

PMID- 8352009
TI  - Effects of mebendazole, albendazole, and praziquantel on succinate dehydrogenase,
      fumarate reductase, and malate dehydrogenase in Echinococcus granulosus cysts
      harbored in mice.
AB  - Echinococcus granulosus cyst wall possess high biochemical activities of malate
      dehydrogenase (MD) and fumarate reductase (FR), but low activity of succinate
      dehydrogenase (SD), suggesting that the cyst wall may utilize a partial reverse
      tricarboxylic acid cycle. When infected mice were given intragastrically with
      mebendazole, 25-50 mg.kg-1.d-1, albendazole 300 mg.kg-1.d-1 or praziquantel 500
      mg.kg-1.d-1 for 7-14 d, no apparent effects on SD and FR activities of the cyst
      wall were found, while the MD activity was suppressed by all the 3 drugs, the
      inhibition rates being 34.6-61.6%, 59.8%, and 50.6%, respectively. The results
      suggested that MD may not be an important target for the antihydatidosis drugs.

PMID- 8352010
TI  - [Promoting effect of panaxatriol ginsenoside on gene expression of human
      interleukin-1].
AB  - Effect of panaxatriol ginsenoside (PG) on interleukin-1 (IL-1) gene expression
      was studied by using wheat germ extract (cell-free translation system) and IL-1
      bioassay. The results showed that IL-1 production increased by 40% (487-682 U.ml
      1) at maximum during cell culture (0-84 h) after PG (10 micrograms.ml-1) was
      added to phytohemagglutinin (PHA, 50 micrograms.ml-1) stimulated lymph node
      cells. Meanwhile, IL-1 mRNA from PHA combined with PG stimulated lymph node cells
      translated 39.5% more IL-1 than that of PHA-stimulated cells at maximum (2500
      3489 U/mg RNA).

PMID- 8352011
TI  - [Assay of negative inotropism of bepridil on isolated guinea pig left atrial
      myocardium by simulating constant rate of absorption and elimination].
AB  - The pharmacodynamic characteristic of negative inotropic effect of bepridil on
      isolated guinea pig cardiac atrium was conducted by gradient perfusion with
      constant rate of bepridil ranging from 0-20 mumol.L-1 and inverse, simulating a
      fixed pharmacokinetic parameters of K(a) and K(e), respectively. A counter
      clockwise hysteresis loop of negative inotropism of bepridil was presented.
      Fixing Cp, T, and E by pharmacokinetics/pharmacodynamics (PK/PD) non-parameter
      model, the hysteresis loop was collapsed in figure plotting C(e) against E. The
      estimated K(eo) = 0.03 +/- 0.023 h-1, an apparent T1/2 of pharmacological effect
      was measured, and about 80-fold as long as the pharmacokinetic T1/2. It was
      suggested that the long-lasting effect of bepridil was partly due to the slow
      elimination rate from the effect compartment.

PMID- 8352012
TI  - [Effects of furyl-dihydropyridine on action potential ventricular myocardium of
      rabbit in vivo and isolated guinea pig left atrium in vitro].
AB  - Effects of furyl-dihydropyridine (FDP) on action potential of rabbit ventricular
      myocardium in vivo were observed with floating microelectrode technique. FDP 0.5
      mg.kg-1 i.v. increased APD30 from 104 +/- 7 to 127 +/- 7 ms, APD90 from 146 +/-
      10 to 177 +/- 9 ms (P < 0.01, n = 7), decreased the heart rate from 230 +/- 18 to
      203 +/- 20 bpm (P < 0.05). Nifedipine (Nif) 0.5 mg.kg-1 i.v. reduced APD and
      increased the HR in rabbit. In guinea pig left atrium, FDP and Nif decreased the
      APD, the effects of acetylcholine to shorten the APD was antagonized by FDP 1
      mumol.L-1. In rabbit's sinoatrial nodes, FDP 0.5, 1 mumol.L-1 also suppressed the
      APA and increased the spontaneous sinus cycle length (SCL) and APD50. These
      results indicate that FDP may inhibit the Ca2+ and K+ currents of myocardium.

PMID- 8352013
TI  - [Cardioprotection of 2-[p-(dimethylamino)styryl]pyridine methiodide against
      ischemic damage and myocardial lipid peroxidation].
AB  - Mice were injected ip DSPM 1 or 3 mg.kg-1 3 h prior to a subcutaneous injection
      of isoproterenol (Iso) 20 mg.kg-1 once daily for 2 d. Iso induced reductions of
      Se-glutathione peroxidase (Se-GSH-PX), superoxide dismutase (SOD) activities, and
      an increase of malondialdehyde (MDA) content in myocardium. DSPM 1 or 3 mg.kg-1
      significantly abated reduction of Se-GSH-PX activity and decreased MDA production
      and DSPM 3 mg.kg-1 also abated reduction of SOD activity in the hearts from Iso
      treated mice. The changes of above indices were in accordance with those of
      myocardial ultrastructure and creatine phosphokinase (CPK) concentration in
      serum. The results indicate that DSPM has a protective effect on myocardial
      ischemic injury probably by inhibiting oxygen free radicals and subsequent lipid
      peroxidation.

PMID- 8352014
TI  - [Distribution of 14C labeled at dioxopiperazine or methyl morpholine group of
      probimane by whole body autoradiography].
AB  - Probimane (AT-2153) is a new anticancer compound. It was first developed in this
      Institute. It is effective against mouse tumors S37, S180, Lewis lung carcinoma,
      L1210 and human pulmonary adenocarcinoma heterotransplanted into nude mice. In
      the present work, 14C was labeled at central dioxopiperazine or methyl morpholine
      group of probimane 120 mg.kg-1 was injected iv in mice bearing Lewis lung
      carcinoma by whole body autoradiography. The results showed that probimane was
      broken into at least two parts: a central part and a methyl morpholine group. The
      central part of compound hardly penetrated through the blood-brain barrier, but
      accumulated in the urinary bladder. The methyl morpholine group showed a high
      affinity to tumor tissue and accumulated in spleen, bone and liver.

PMID- 8352015
TI  - [First-pass effect of dauricine].
AB  - The first-pass effect of dauricine (Dau) was compared with that of lidocaine
      (Lid) by measuring the ventricular fibrillation threshold (VFT) and dauricine
      plasma concentration in rats or rabbits. After forelimb or mesenteric vein (imv)
      infusion of Dau at a rate of 1 mg.kg-1 x min-1 in rats, the VFT were 1.64-3.17 or
      1.60-2.11 V, respectively. In the case of Lid at 2.5 mg.kg-1 x min-1, the VFT
      were 1.69-4.79 or 1.67-2.80 V, respectively, after ear vein (iev) or imv infusion
      of Dau at a rate of 0.5 mg.kg-1 x min-1 in rabbits, the VFT were 6.50-12.14 or
      5.81-7.43 V, respectively. Plasma Dau concentration through iev infusion was
      significantly higher than that through imv route. As the dose of imv infusion
      increased, AUC of Dau showed a nonlinear increase. The results suggested that Dau
      showed a considerable first-pass effect, which was dose-dependent.

PMID- 8352016
TI  - [Distribution of harringtonine positively and negatively charged liposome in rat
      tissues].
AB  - Distribution of harringtonine positively and negatively charged liposome (HL(+),
      HL(-)) and harringtonine free drug (FH) in rat tissues were measured by HPLC.
      Their LD50 in mice were compared. The results showed that distribution of HL(+),
      HL(-), In vivo may be changed, that the amount of HL(+), HL(-) was increased in
      the liver, lung, and spleen and in these tissues it was 2-30-fold higher than
      that of HF after iv 2 h. HL(+), HL(-) may aid to permeate through the blood
      brain, blood-testicle barrier, and to reduce acute lethal toxicity. Areas under
      the time curve of HL(+), HL(-) in brain and testis within 2 h were 2-4.5 times as
      much as those of HF. There were significant differences in the fate between
      negatively and positively charged liposomes in vivo.

PMID- 8352017
TI  - [Alpha-adrenoceptor stimulation mediated positive chronotropic effect in isolated
      right heart atria of normotensive and SHRsp rats].
AB  - Concentration-dependent positive chronotropic response to phenylephrine (Phe)
      mediated by alpha 1-adrenoceptor in isolated normotensive and SHRsp rat right
      atria was determined under normal or depressed beat rate by stimulation of
      cholinergic M-receptor. The spontaneous beat rate was increased from 223 +/- 18
      to 271 +/- 16 bpm by Phe 100 mumol.L-1 in the presence of propranolol 1 mumol.L
      1. When the basal rate was lowered by stimulation of cholinergic M-receptor with
      carbachol, PE-induced increment of beat rate was enhanced to 101 +/- 23 bpm,
      accompanied by an increase of the force of contraction from 45 +/- 14% to 125 +/-
      56% (vs control response). However, beta-adrenoceptor mediated positive
      chronotropic effect was attenuated in the presence of carbachol, and no positive
      inotropic effect was detected. PE-induced increase in beat rate in SHRsp (31 +/-
      9 bpm) was lower than that in WKY (41 +/- 10 bpm). After pretreatment with
      carbachol, Phe caused increments in beat rate in SHRsp and WKY were 70 +/- 18 bpm
      and 114 +/- 17 bpm, respectively. It is suggested that in SHRsp, the function of
      cardiac alpha 1-adrenoceptor is lower than that in WKY.

PMID- 8352018
TI  - [Effects of protein kinase C activator and inhibitor on release of tumor necrosis
      factor from mouse peritoneal macrophages].
AB  - The effects of protein kinase C (PKC) activator 1-O-tetradecanoylphorbol-13
      acetate (TPA) and inhibitor 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7)
      and quercetin were studied on release of tumor necrosis factor (TNF) from mouse
      peritoneal macrophages primed with Propionibacterium acnes (PA). The results
      showed that TPA (1-100 ng.ml-1) and lipopolysaccharides (LPS) (1-100 ng.ml-1)
      induced the release of TNF from PA-primed mouse peritoneal macrophages in dose-
      and time-dependent manners in vitro, and the effects of TPA and LPS were
      inhibited by H-7 (12.5-100 mumol.L-1) or quercetin (6.25-25 mumol.L-1) in a dose
      dependent manner. After ip H-7 (50 mg.kg-1), LPS-induced release of TNF in vivo
      decreased significantly. These results suggest that PKC may play a critical role
      in release of TNF from PA-primed macrophages.

PMID- 8352020
TI  - [Blocking effect of anisodamine on acetylcholine receptor channels].
AB  - Anisodamine, an analog of atropine, was isolated first in China. Patch-clamp
      technique was used to study the inhibitory effect of anisodamine (Ani) on
      acetylcholine receptor on the membrane of muscle innervated by neuron. Neural
      tube in embryo of Xenopus laevis were cultured. By whole-cell clamp and outside
      out patch, we found that the inhibitory effect of Ani was obvious on both
      miniature end-plate currents (MEPC) and single channel. This effect was
      reversible and the minimal concentration for complete inhibition was 60 mumol.L
      1, vs 1 and 0.5 mmol.L-1 for atropine and scopolamine, respectively. Our results
      indicate that Ani blocks both M-ACh and N-ACh receptors.

PMID- 8352019
TI  - [Protective effects of nicorandil on action potentials in anoxia and reoxygenated
      ventricular myocardium of guinea pig].
AB  - Standard microelectrode techniques were used to study the effects of nicorandil
      (500 mumol.L-1) on action potentials in anoxia and reoxygenated ventricular
      myocardium of guinea pig. The main results: (a) Nicorandil shortened the action
      potentials duration (APD) and increased the ratio of effective refractory period
      (ERP) to APD90 (ERP/APD90). It did not cause significant changes in resting
      potential (RP), the maximal rate of rise of phase 0 (Vmax) and action potential
      amplitude (APA); (b) Exposure of the preparation to anoxic conditions (hypoxia,
      acidosis, glucose deprivation, and hyperkalemia) for 20 min, resulted in a marked
      depolarization of RP, a shortening of APD, reductions of APA and Vmax, and an
      increase in the ratio of ERP/APD90; (c) Nicorandil did not produce any additional
      effect on these parameters during anoxia except aggravated shortening of APD; (d)
      The changes of action potential parameters during anoxia were all completely
      reversed when the preparation was reoxygenated in the absence of the drug for 20
      min. In the presence of the drug, however, APD was only partially reversed; (e)
      Nicorandil decreased the incidence of abnormal automaticity occurring during
      reoxygenation from 14/16 to 4/16. It is concluded that nicorandil antagonizes the
      cellular mechanisms which underlie the reoxygenation arrhythmias and prevent the
      reoxygenation-induced arrhythmias.

PMID- 8352021
TI  - Combination of HPLC and 252-Cf plasma desorption mass spectrometry for
      identifying composition of ginseng tinctures.
AB  - The 252-Cf plasma desorption mass spectrometry (252-Cf PDMS) determination or
      confirmation of the ginsenoside saponins has been proposed to investigate the
      composition of high performance liquid chromatography (HPLC) peaks of ginseng
      tinctures and galenic preparations. That ionization technique is well suitable
      for the analysis of natural mixtures of these saponins. The 252-Cf PD mass
      spectra of standard ginsenosides Rb1, Rb2, Rc, Re, Rg1, Rd, NG-R2, Z-R1 contain
      the peaks of two types of ions, namely, molecular adduct ions (MAI) and aglycone
      ions. By mass the latter may be referred to either protopanaxadiol or
      protopanaxatriol. The masses of MAI and aglycone ions are determined by the
      carbohydrate chains. The collected HPLC fractions of P ginseng tincture can be
      tested for content of ginsenosides. After studying two MAI peaks from the 252-Cf
      PD mass spectra of the basic ginsenosides, an example of distinction between two
      galenic preparations from different Panax has been shown.

PMID- 8352022
TI  - Dopaminergic influence on the excitability of antidromically activated Renshaw
      cells in the lumbar spinal cord of the rat.
AB  - The interaction between dopaminergic and cholinergic systems in the mammalian
      central nervous system, which is thought to have important implications in the
      pathophysiology of major extrapyramidal disorders, has never been adequately
      demonstrated in vivo. Renshaw cell burst responses to single electrical shocks to
      lumbar ventral roots in spinalized and decerebrated rats were studied. In this
      monosynaptic cholinergic pathway, apomorphine, a dopaminergic receptor agonist,
      inhibited whereas the D2-antagonist sulpiride facilitated the burst responses.
      The mutual antagonism of the two drugs and the depression coupled with the faster
      decay of post-tetanic potentiation of Renshaw cells by apomorphine demonstrate
      the involvement of presynaptic D2-receptors through which dopamine can modulate
      acetylcholine-mediated central synaptic transmission in vivo. The study also
      provides further evidence for the involvement of the spinal cord in
      extrapyramidal disorders.

PMID- 8352023
TI  - Membrane potential oscillations and corticothalamic connectivity in rat
      associational thalamic neurons in vitro.
AB  - Thalamic relay neurons were recorded from the dorsolateral and lateroposterior
      nuclei of the rat thalamus in a superfused explant preparation. The mean membrane
      potential of these cells was -67 +/- 7 mV, input resistance 114 +/- 31 M omega
      and spike amplitude 75 +/- 6 mV. Low-threshold slow membrane potential
      oscillations (1-4 Hz) were present in about 46% of the neurons. They occurred
      either spontaneously or following a membrane potential perturbation. In a
      subpopulation of cells, we also observed a high-threshold membrane oscillation
      when cells were depolarized above -45 mV. This oscillation consisted of bursts of
      low-amplitude spikes interrupted by rhythmic after-hyperpolarizations.
      Stimulation of the corticothalamic pathway elicited prolonged inhibitory
      postsynaptic potentials in associational thalamic neurons. In the presence of
      picrotoxin, corticothalamic input evoked prominent excitatory postsynaptic
      responses that showed marked short-term synaptic plasticity. Our results suggest
      that associational thalamic neurons maintained in vitro have a strong tendency to
      exhibit membrane oscillations. In addition, they receive a direct excitatory
      cortical input that remained functional in explant preparation.

PMID- 8352024
TI  - An indifference point for electrical impedance in humans.
AB  - Regional electrical impedance was used over eight sections of the human body (two
      thoracic; one abdominal; two thigh; two around the knee; and one lower leg) to
      determine the volume indifference point during passive head-up tilt in eight
      subjects. Head-up tilt was performed in 10 degrees increments from 0 degree to 60
      degrees over 6 min. Electrical impedance increased over the thorax in proportion
      to the head-up tilt angle, while abdominal impedance did not change
      significantly, and over the thigh and the lower leg it decreased with increasing
      head-up tilt angle. No change in electrical impedance was noted just above the
      knee, and electrical impedance just below the knee decreased only marginally.
      Results demonstrate minimal fluid accumulation around the knee during head-up
      tilt. Furthermore, in humans the electrical impedance and therefore probably the
      volume indifference point is positioned between the umbilicus and crista iliaca.

PMID- 8352025
TI  - Effect on renin release of inhibiting renal nitric oxide synthesis in
      anaesthetized dogs.
AB  - Nitric oxide plays an important role in the regulation of basal renal blood flow.
      This study was performed to examine whether selective inhibition of renal nitric
      oxide synthesis affects renin release in vivo. Accordingly, in six barbiturate
      anaesthetized dogs renin release was examined before and after intrarenal
      infusion of the selective inhibitor of nitric oxide synthesis, NG-nitro-L
      arginine (NOARG). NOARG was infused into the renal artery to yield a renal
      arterial blood concentration of 0.4 mumol ml-1. NOARG did not change systemic
      arterial blood pressure and glomerular filtration rate, but reduced basal renal
      blood flow by 26 +/- 2%. Urine flow, sodium and potassium excretion were reduced
      after inhibition of renal nitric oxide synthesis. Basal renin release (3 +/- 2
      micrograms AI min-1) was not altered by NOARG infusion (1 +/- 1 micrograms AI min
      1). To stimulate renin release the renal artery was constricted to a renal
      perfusion pressure of 50 mmHg. At this perfusion pressure infusion of NOARG
      reduced renin release significantly from 48 +/- 11 micrograms AI min-1 to 14 +/-
      4 micrograms AI min-1. In conclusion, inhibition of renal nitric oxide synthesis
      reduces basal renal blood flow and reduces renin release stimulated by renal
      arterial constriction. These findings indicate that renal nitric oxide modulates
      both renal blood flow and renin release in vivo.

PMID- 8352026
TI  - Effect of diazepam on endocrine and cardiovascular responses to head-up tilt in
      humans.
AB  - Effects of the GABAergic drug diazepam (0.15 mg kg-1, i.v.) on cardiovascular and
      endocrine responses to 50 degrees head-up tilt were evaluated in seven men.
      During the initial phase of tilt (normotensive phase), increases in heart rate
      (HR) and total peripheral resistance (TPR) and decreases in cardiac output were
      unaffected by diazepam. Also the associated increase in plasma noradrenaline did
      not change, while response in plasma ACTH was diminished and in plasma cortisol
      abolished by diazepam (F(1,10) = 6.45; P < 0.03). After 42 +/- 4 min of sustained
      tilt with saline (control) and 47 +/- 6 min (n.s.) after diazepam, presyncopal
      symptoms appeared (hypotensive phase) associated with decreases in HR, MAP, and
      TPR (P < 0.01). This episode induced a 2-3-fold increase in plasma ACTH, beta
      endorphin, prolactin, cortisol (< 0.01), and a moderate increase in plasma
      adrenaline (P < 0.05). Diazepam did not significantly change cardiovascular and
      endocrine responses to the hypotensive phase of tilt. Results indicate that
      diazepam attenuates the cortisol part of pituitary-adrenal responses to moderate,
      but not to severe, central hypovolaemia in humans with no effect on
      cardiovascular tolerance.

PMID- 8352027
TI  - Rhythmic contractions of isolated small arteries from rat: influence of the
      endothelium.
AB  - Small arteries of the mesenteric arcade from Wistar rats display rhythmic
      oscillations superimposed on the tonic contractile response when exposed to
      submaximal doses of noradrenaline. We have previously shown that mechanical
      removal of the endothelium abolishes these oscillations. In the present study
      different methods to eliminate or modify the influence of the endothelium were
      used in order to further characterize the mechanisms behind rhythmic contractions
      in these vessels. Endothelium was removed either mechanically or chemically by
      perfusing the vessels with 0.3% CHAPS. The absence of functional endothelium
      enhanced noradrenaline sensitivity and simultaneously abolished oscillations in
      tension and membrane potential, but did not affect resting membrane potential.
      The rhythmic activity was also reduced or abolished by exposure to haemoglobin,
      methylene blue, LY83583 or L-NNA. Indomethacin and propranolol were without
      effect. Sodium nitroprusside or the permeant analogue of cyclic GMP, 8-bromo
      cyclic GMP, restored rhythmic activity in precontracted endothelium-denuded
      vessels. The data suggest that release of nitric oxide from the endothelium, and
      subsequent generation of cyclic GMP in the smooth muscle, activates oscillations
      in membrane potential and tension; the oscillator itself appears to be located
      within the smooth muscle cells.

PMID- 8352028
TI  - Vascular effects of endothelin-1 in the cat; modification by indomethacin and L
      NAME.
AB  - Intravenous infusion of endothelin-1 (ET-1) in the cat, 60 pmol x kg body wt-1 x
      min-1 for 5 min, induced an increase in mean arterial blood pressure (MAP) of
      41.3 +/- 4.8 mmHg (n = 6; P < 0.001). Blood flow, as determined with radioactive
      microspheres, was reduced in many tissues. Reductions by 70-80% were observed in
      the choroid plexus, pineal and pituitary glands. Total cerebral blood flow was
      reduced by 18-23%. Pre-treatment with indomethacin or a combination of
      indomethacin and L-NAME caused vasoconstriction in many tissues and modified the
      responses to ET-1 in a variable way, suggesting that normally, ET-1 tends to
      release arachidonic acid metabolites and nitric oxide with great variations
      between different tissues. Intracerebroventricular infusion (i.c.v.) of ET-1, 10
      pmol x kg body wt-1 x min-1, caused an increase in MAP of 79 +/- 11 mmHg (n = 6;
      P < 0.001). Regional blood flow in the medulla oblongata, medulla spinalis,
      choroid plexus, pineal and pituitary glands was reduced by 60-80%. Heart rate,
      cardiac output and coronary blood flow were significantly increased after 30 min
      i.c.v. infusion, indicating an activation of the heart, most probably as part of
      a central ischaemic response. Our results indicate that in many tissues the
      vasoconstrictive effect of ET-1 is influenced by indomethacin- and L-NAME
      sensitive vasodilator mechanisms that are activated by the peptide. In the CNS,
      there may be marked effects on regional blood flow after i.c.v. infusion.

PMID- 8352029
TI  - Effect of catecholamines on the ventricular myocyte action potential in raised
      extracellular potassium.
AB  - We describe the relationship between catecholamines and raised extracellular
      potassium ([K+]o) on action potential parameters and calcium currents in isolated
      ventricular myocytes of the guinea-pig and relate these findings to the problem
      of understanding how the heart is protected from exercise-induced hyperkalaemia
      ([K+]a up to 8.5 mM). Action potential duration (APD90), amplitude and upstroke
      velocity were recorded in stimulated (2Hz) guinea-pig ventricular myocytes using
      whole-cell patch electrode recordings (37 degrees C). Cells were superfused with
      normal K+ Tyrode and with raised K+ Tyrode in the presence of either
      noradrenaline, adrenaline or raised calcium. Inward calcium current was measured
      using voltage clamp. Raised K+ (8, 12, 16 mM K+ Tyrode) caused a significant (P <
      0.01) depolarisation, shortened the APD90 and decreased the action potential
      amplitude and upstroke velocity. In raised K+ Tyrode addition of noradrenaline
      (0.08-0.1 microM) or adrenaline (0.1-0.2 microM) increased action potential
      amplitude (P < 0.01), APD90 (P < 0.01) and upstroke velocity (P < 0.01) (measured
      only in 16 mM K+ Tyrode). In 12 mM K+ Tyrode raised Ca2+ (5-6 mM) increased
      action potential amplitude (P < 0.05) and shortened APD90 (P < 0.05). Addition of
      NA (0.08-0.1 microM) increased the inward Ca2+ current. All effects were fully
      reversible. In raised [K+]o increases in catecholamines and [Ca2+]o cause changes
      in action potential parameters that would be expected to maintain propagation of
      the cardiac action potential in the whole heart. Thus, in the ventricular myocyte
      the increase in conductance to Ca2+ caused by catecholamines may be one factor
      that is important in minimising the potentially adverse effects of exercise
      induced hyperkalaemia.

PMID- 8352030
TI  - Increased technetium uptake is not equivalent to muscle necrosis: scintigraphic,
      morphological and intramuscular pressure analyses of sore muscles after exercise.
AB  - A scintigraphic technique employing technetium pyrophosphate uptake was used to
      identify the area of skeletal muscle damage in the lower leg of four runners 24 h
      after an ultramarathon footrace (160 km). Most of the race had been run downhill
      which incorporated an extensive amount of eccentric work. Soreness was diffuse
      throughout the posterior region of the lower leg. In order to interpret what
      increased technetium uptake reflects and to express extreme endurance related
      damages, a biopsy was taken from the 3-D position of abnormal uptake. In
      addition, intramuscular pressures were determined in the deep posterior
      compartment. Scintigraphs revealed increased technetium pyrophosphate uptake in
      the medial portion of the gastrocnemius muscle. For 3698 fibres analysed, 33
      fibres (1%) were necrotic, while a few other fibres were either atrophic or
      irregular shaped. A cluster of necrotic fibres occurred at the fascicular
      periphery for one subject and fibre type grouping occurred for another.
      Ultrastructural analysis revealed Z-line streaming near many capillaries and
      variously altered subsarcolemmal mitochondria including some with paracrystalline
      inclusions. The majority of the capillaries included thickened and irregular
      shaped endothelial cells. Intramuscular pressures of the deep posterior
      compartment were slightly elevated (12-15 mmHg) for three of the four subjects.
      Increased technetium uptake following extreme endurance running does not just
      reflect muscle necrosis but also subtle fibre abnormalities. Collectively, these
      pathological findings are attributed to relative ischaemia occurring during the
      race and during pre-race training, whereas, intramuscular pressure elevations
      associated with muscle soreness are attributed to mechanical stress caused by
      extensive eccentric work during the race.

PMID- 8352031
TI  - Muscle strength and serum testosterone, cortisol and SHBG concentrations in
      middle-aged and elderly men and women.
AB  - Forty healthy males (M) and females (F) divided into two different age groups
      i.e. M50 years (range 44-57; n = 9), F50 years (range 43-54; n = 9), M70 years
      (range 64-73; n = 11) and F70 years (range 63-73; n = 11) volunteered as subjects
      for examination of muscle cross-sectional area (CSA) and maximal voluntary
      isometric force production characteristics of the leg extensor muscles and serum
      androgen and sex hormone binding globulin (SHBG) concentrations. The CSA in the
      male groups was greatly larger (P < 0.01) than in the female groups and both
      elderly groups demonstrated slightly (n.s.) smaller values in the CSA than the
      two middle-aged groups. Maximal force of 2854 +/- 452 N in M50 was greater (P <
      0.05) than that of 2627 +/- 752 N recorded for F50 as well as the force of 2787
      +/- 843 in M70 was greater (P < 0.001) than that of 1849 +/- 295 recorded for
      F70. The force between F50 and F70 differed significantly (P < 0.05) from each
      other. The maximal rate of force production in M50 was greater (P < 0.01) than in
      F50 as well as in M70 greater (P < 0.01) than in F70. Both middle-aged groups
      demonstrated greater (P < 0.05) values than the respective elderly groups of the
      same sex. The individual values in the CSA correlated with the values in maximal
      force both in the middle-aged subjects (r = 0.66; P < 0.01) and in the elderly
      subjects (r = 0.69; P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352032
TI  - Prodromal contractions and contractility in the feline bladder.
AB  - In the cat there are at least two distinct contractile states of the bladder
      during urine storage, one when prodromal contractions are present and one when
      non-micturating contractions are present. It is proposed that prodromal
      contractions are myogenic. This proposition was examined by comparing prodromal
      contractions before and after hypogastric nerve section as well as comparing
      prodromal contractions with the contractions that remain after sectioning of the
      hypogastric nerves. Key contraction characteristics, such as amplitude, maximum
      gradient and the variance of the intercontraction interval were not significantly
      changed by hypogastric nerve section, providing volume effects were corrected
      for, which suggested that prodromal contractions have a myogenic origin.

PMID- 8352033
TI  - An approach for measurement of tension transient responses of smooth muscles
      during their spontaneous contractions.

PMID- 8352034
TI  - Intracellular carbonic anhydrase activity and its role in GABA-induced acidosis
      in isolated rat hippocampal pyramidal neurones.

PMID- 8352035
TI  - Acute otitis media in adults: a report from the International Primary Care
      Network.
AB  - BACKGROUND: Of 22 million visits annually to United States physicians for acute
      otitis media, almost 4 million are by patients 15 years old or older. Yet the
      clinical spectrum and variables related to recovery have not been reported for
      adults. METHOD: Data originated from 3224 primary care patients with acute otitis
      media, of whom 500 were 15 years old or older, who were enrolled in a prospective
      study in eight countries. At the initial visit, history, symptoms, physical
      findings, and treatment were recorded. At a 2-month follow-up visit, changes in
      treatment and recovery were recorded. RESULTS: Compared with children, adults
      sought care more quickly after symptom onset; were more likely to have had a
      tonsillectomy or adenoidectomy; and were more likely to complain of ear pain,
      decreased hearing, sore throat, and ear discharge. Children were more likely to
      have a history of recent upper respiratory tract infection, serous otitis media,
      and ear tubes; symptoms of fever, diarrhea, and vomiting; and tympanic membrane
      findings of redness, bulging, and ear tubes in place. History of reduced hearing,
      allergy, prophylactic antibiotics, and tympanic membrane findings characterized
      as opaque or dull, fluid, draining pus, perforation, and not visualized were
      equally frequent in both age groups. For adults, neither type nor duration of
      antibiotic affected outcome. Patients receiving antibiotics had lower rates of
      recovery than those who did not. The likelihood of a poor outcome increased with
      an increasing number of past episodes of acute otitis media and with increasing
      age. CONCLUSION: Although history and symptoms differ in adults and children, the
      similarity of tympanic membrane findings is consistent with previous reports of a
      similar bacterial spectrum in both groups. Recovery is related more to individual
      patient characteristics and history than to antibiotic therapy. Adults have an
      increased rate of poor outcome at 2 months compared with children.

PMID- 8352036
TI  - Rate of anabolic-androgenic steroid use among students in junior high school.
AB  - BACKGROUND: Anabolic-androgenic steroid use has become an increasingly large
      problem. Studies document steroid use in high-school students, but not students
      in junior high school. We surveyed 7th-grade students to assess rate of use and
      knowledge about steroids. METHODS: Seventh-grade students completed a 22-question
      survey instrument that addressed previous steroid use, knowledge about the
      effects of steroids, other previous substance abuse, and demographic data. The
      one-sided Z test was used for statistical analyses. RESULTS: There were 4.7
      percent of the male students and 3.2 percent of the female students who admitted
      to using steroids [corrected]. Those more likely to have tried steroids included
      African-Americans (P < 0.05), 15-year-olds (P < 0.05), football players (P <
      0.025), wrestlers (P < 0.005), and past users of alcohol (P < 0.005) or tobacco
      (P < 0.005). There were significant differences between steroid users and
      nonusers in knowledge about the effects of anabolic-androgenic steroids on the
      body: steroid users knew less than nonusers. CONCLUSION: The establishment of
      steroid use in junior high school should cause physicians to seek signs or
      history of steroid use, especially in patients who are members of groups more
      likely to use them. In addition, physicians should initiate dialogue about
      steroids with patients before they are likely to have tried them.

PMID- 8352037
TI  - Seroprevalence of human immunodeficiency virus among family practice outpatients.
AB  - BACKGROUND: Because the human immunodeficiency virus (HIV) is extremely
      heterogeneous in its impact on various subpopulations, it is important to carry
      out HIV seroprevalence studies in different subpopulations using standardized
      techniques. The present study is the first to report seroprevalence rates of HIV
      in family medicine outpatient populations. METHODS: To estimate the prevalence
      and demographic distribution of HIV, 3874 sera samples were collected anonymously
      at six family medicine clinics in San Bernardino County during a 1-year period.
      RESULTS: Fifty-nine (1.52 percent) of the sera samples were confirmed HIV
      positive. Of the 59 HIV-positive patients, 43 were visiting the clinic for HIV
      related reasons. Excluding these 43 cases, and adjusting for age and race using
      the county population as a standard, the overall rate of HIV infection was 0.45
      percent. The 16 HIV-positive patients who visited the clinics for reasons
      unrelated to HIV were between the ages of 20 and 59 years, with the 30- to 39
      year-old age group having the highest prevalence (1.4 percent). Seroprevalence
      was eight times higher for men than women (chi 2 = 14.3, P = 0.0002), and rates
      for African-Americans (0.85 percent) were two to three times higher than for
      Hispanics (0.40 percent) and whites (0.25 percent). CONCLUSIONS: Results of this
      study are consistent with and support findings from previous surveys of more
      general populations in the western United States. There are approximately 7800
      HIV-infected persons residing in San Bernardino County, and an estimated $796
      million will be required to treat these individuals.

PMID- 8352038
TI  - Silver acetate mouth spray as an aid in smoking cessation: results of a double
      blind trial.
AB  - BACKGROUND: We studied the use of an aversive technique to improve the outcome of
      smoking-cessation efforts. We hypothesized that a silver acetate mouth spray,
      which produces a strong aversive taste when cigarettes are smoked, would increase
      the quit rate among smokers. METHODS: Our study was a double-blind, placebo
      controlled trial that was carried out in a private family practice office in an
      urban area. We studied 42 smokers, who were recruited by advertisement and who
      were motivated to quit by self-report. They were randomly assigned active spray
      or placebo spray; all were given a written list of behavioral suggestions. The
      spray was to be used every 2 hours for 3 weeks during which time the subjects
      were to keep diaries of cigarette smoking and spray use. Biochemical measures
      (salivary thiocyanate and cotinine) were recorded at entry, at 3 weeks, and at 3
      months. RESULTS: Thirty smokers completed the study. No differences were found
      between the two groups in quit rate or number of cigarettes smoked. CONCLUSIONS:
      Silver acetate aversive spray did not increase quit rate among motivated smokers.

PMID- 8352039
TI  - Gender of physicians and patients and preventive care for community-based older
      adults.
AB  - BACKGROUND: This study was undertaken to determine whether the gender of patients
      and physicians is a significant factor in deciding which older adults are offered
      preventive care. METHODS: A survey of medical records of ambulatory patients
      older than 60 years was performed in the practices of 210 physicians.
      Documentation of influenza vaccine, rectal examination, fecal occult blood test,
      Papanicolaou smear, pelvic examination, breast examination, mammogram, and
      pneumococcal vaccine was recorded, and rates of compliance were evaluated by sex
      of patient and physician. RESULTS: The medical records of 3327 patients were
      surveyed. Men were given influenza and pneumococcal vaccines more frequently than
      women. Among physicians, women physicians were more likely to give influenza
      vaccine (P = 0.003) and to check for fecal occult blood (P < 0.001). No
      significant difference was found between men and women physicians in the
      frequency of doing Papanicolaou smears, breast examinations, rectal examinations,
      and mammograms. CONCLUSIONS: While a difference in practice patterns was found
      between men and women physicians, most of the variance in compliance with
      preventive care guidelines was unexplained by the gender of physicians and
      patients. Matching of physician and patient by sex did not predict improved
      preventive care, indicating that other factors are involved in the failure to
      provide adequate primary preventive care to the ambulatory elderly.

PMID- 8352040
TI  - Women and HIV.
AB  - BACKGROUND: Infection with the human immunodeficiency virus (HIV) has emerged as
      a major health problem for women in the United States. Family physicians can play
      an important role in the detection and care of HIV-infected women. METHODS: The
      epidemiology and natural history of HIV infection in women were reviewed.
      Articles were selected by a computer MEDLINE search. RESULTS: HIV infection is
      now a leading cause of morbidity and mortality among young women in the United
      States, particularly women of racial and ethnic minorities. Most cases of
      acquired immunodeficiency syndrome (AIDS) in women occur as a result of injection
      drug use or heterosexual transmission. Based on limited information, women and
      men appear to have similar AIDS-defining conditions. Gynecologic problems are
      common in HIV-infected women. Pregnancy does not seem to be affected by early HIV
      infection, but women with advanced disease might be at increased risk for
      obstetric complications. CONCLUSIONS: More women need to be included in natural
      history studies and clinical drug trials. Early awareness of HIV infection and
      better access to health care services are required to improve the treatment and
      survival of HIV-infected women.

PMID- 8352041
TI  - Obstetric care in family practice residencies: a national survey.
AB  - BACKGROUND: Supervision of obstetric care by family practice faculty increases
      the likelihood that family practice residents will choose to practice obstetrics.
      METHODS: A survey instrument was developed to obtain information about practice
      faculty and the educational setting in which residents learn family physician
      obstetric care. Questionnaires were sent to all family medicine residency
      directors and all full-time family physician faculty. RESULTS: Two hundred eighty
      four program directors and 1396 faculty members responded. The mean percentage of
      recent graduates estimated to be practicing obstetrics was 30 percent. Factors
      independently associated with an increased likelihood of resident graduates
      practicing obstetrics included supervision of resident deliveries by family
      physicians, increasing number of family practice center deliveries, regional
      differences, and availability of training to perform Cesarean sections. Sixty
      four percent of the responding family physician faculty were currently
      supervising deliveries, but only 5 percent had Cesarean section privileges. Seven
      percent of the faculty reported denial of obstetric privileges. Eighty-nine
      percent of all respondents supported the mandatory inclusion of obstetrics in
      family medicine residencies. CONCLUSIONS: Residency programs in family practice
      can increase the number of their graduates practicing obstetric care by focusing
      on the family physician supervision model, faculty development that supports this
      model, and clinical privileges of faculty.

PMID- 8352043
TI  - Family practice and the health care system. Implications of health reform for
      family practice.

PMID- 8352042
TI  - Vomiting as a manifestation of borderline personality disorder in primary care.
AB  - BACKGROUND: Patients with borderline personality disorder often are found and
      treated in psychiatric settings following episodes of self-mutilation, such as
      wrist-slashing. Family physicians care for many patients with borderline
      personality disorder, but in primary care settings wrist-slashing or other
      physical mutilation is a less common presenting problem. Frequently these
      patients complain of such symptoms as nausea and vomiting that do not so
      obviously suggest psychopathology. METHODS: Three primary care patients with
      borderline personality disorder in whom episodic vomiting was the chief complaint
      are presented. Hypotheses from the literature about the neurobiology of vomiting
      and self-mutilation are discussed. RESULTS: Vomiting is a primary care analogue
      of self-mutilation in some patients with borderline personality disorder.
      CONCLUSIONS: Family physicians should include careful history taking to
      corroborate other features of borderline personality disorder in evaluating
      patients with persistent, episodic vomiting. Obtaining a history of early sexual
      abuse or chronic interpersonal problems as an adult should not only mitigate the
      compulsion for extensive, costly, and invasive gastrointestinal system
      evaluations in such patients, but also suggest more effective treatment
      strategies.

PMID- 8352044
TI  - Salicylate-induced pulmonary edema: a complication of chronic aspirin therapy.

PMID- 8352045
TI  - Patient awareness of and attitudes toward physician board certification.

PMID- 8352046
TI  - Profile of full-time family practice faculty with private practice experience.

PMID- 8352047
TI  - Family medicine in Korea.

PMID- 8352048
TI  - A good death is hard to find: preliminary reports of a hospice doctor.

PMID- 8352049
TI  - Lessons from the International Primary Care Network.

PMID- 8352050
TI  - Answers in search of questions.

PMID- 8352051
TI  - Physicians' role in health care reform.

PMID- 8352052
TI  - Effectiveness of cough syrups.

PMID- 8352054
TI  - Unsolicited gifts from pharmaceutical companies.

PMID- 8352055
TI  - Techniques of meta-analysis.

PMID- 8352053
TI  - Family physicians and clinical ethics.

PMID- 8352056
TI  - In-hospital cardiopulmonary resuscitation.

PMID- 8352057
TI  - Obscure gastrointestinal bleeding.

PMID- 8352058
TI  - Fracture care.

PMID- 8352059
TI  - AIDS case definition.

PMID- 8352060
TI  - Calcium retention and hormone levels in black and white women on high- and low
      calcium diets.
AB  - Black-white differences in calcium metabolism are sought because they may reveal
      why blacks have higher bone mass than whites. Comparative studies of calcium
      absorption in blacks and whites are not available. In this study, we compare
      fractional calcium retention, an index of calcium absorption, and calcium
      regulating hormone levels in black and white women on a high-calcium diet and
      after adaptation to a low-calcium diet. A total of 30 healthy women (15 black and
      15 white) had measurements of fractional 47Ca retention and calcium regulating
      hormone levels after 8 weeks on a 2000 mg calcium diet and, subsequently, after
      1, 2, 4, and 8 weeks on a 300 mg calcium diet. By 2 weeks after the diet change,
      fractional 47Ca retention, parathyroid hormone (PTH), and 1,25-dihydroxyvitamin D
      [1,25-(OH)2D] had reached a plateau at higher levels, urine calcium at a low
      level, and serum calcium at the same level (repeated-measures ANOVA). Fractional
      47Ca retention, serum calcium, and PTH were similar on both diets in blacks and
      whites. Blacks had higher levels of 1,25-(OH)2D on both diets (e.g., 125.1 +/-
      53.5 SD versus 73.4 +/- 19.0 pmol/liter, P = 0.003 on low-calcium diet) and a
      greater increase in 1,25-(OH)2D after the diet change (33.9 +/- 30.1 SD versus
      11.8 +/- 17.9 pmol/liter, P = 0.021). Serum phosphorus was lower in blacks
      throughout. For hormone levels and fractional calcium retention to stabilize
      after a diet change, 2 weeks was needed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352061
TI  - Alkali absorption and citrate excretion in calcium nephrolithiasis.
AB  - The role of net gastrointestinal (GI) alkali absorption in the development of
      hypocitraturia was investigated. The net GI absorption of alkali was estimated
      from the difference between simple urinary cations (Ca, Mg, Na, and K) and anions
      (Cl and P). In 131 normal subjects, the 24 h urinary citrate was positively
      correlated with the net GI absorption of alkali (r = 0.49, p < 0.001). In 11
      patients with distal renal tubular acidosis (RTA), urinary citrate excretion was
      subnormal relative to net GI alkali absorption, with data from most patients
      residing outside the 95% confidence ellipse described for normal subjects.
      However, the normal relationship between urinary citrate and net absorbed alkali
      was maintained in 11 patients with chronic diarrheal syndrome (CDS) and in 124
      stone-forming patients devoid of RTA or CDS, half of whom had "idiopathic"
      hypocitraturia. The 18 stone-forming patients without RTA or CDS received
      potassium citrate (30-60 mEq/day). Both urinary citrate and net GI alkali
      absorption increased, yielding a significantly positive correlation (r = 0.62, p
      < 0.0001), with the slope indistinguishable from that of normal subjects. Thus,
      urinary citrate was normally dependent on the net GI absorption of alkali. This
      dependence was less marked in RTA, confirming the renal origin of hypocitraturia.
      However, the normal dependence was maintained in CDS and in idiopathic
      hypocitraturia, suggesting that reduced citrate excretion was largely dietary in
      origin as a result of low net alkali absorption (from a probable relative
      deficiency of vegetables and fruits or a relative excess of animal proteins).

PMID- 8352062
TI  - Dual-energy x-ray absorptiometry of the rat: accuracy, precision, and measurement
      of bone loss.
AB  - Dual-energy x-ray absorptiometry (DEXA) is now an established method of measuring
      bone mineral density (BMD) in humans. We have applied the technique to measuring
      BMD in the rat. The short-term precision of the technique was assessed by
      calculating the BMD coefficient of variation at the rat spine (1.20%), total
      femur (0.52%), proximal femur (1.16%), midfemur (1.00%), distal femur (0.96%),
      and proximal tibia (2.2%). The long-term precision of femoral measurements in rat
      cadavers over a 4 week period was 0.72% for the total femur and 1.2% for the
      distal femur. The accuracy of the technique was assessed by comparing DEXA
      measured bone mineral content (BMC) in vitro and in vivo with ashed BMC. Results
      indicated a highly significant positive correlation between in vitro DEXA
      measurements and ash BMC (r = 0.99) and between in vivo DEXA measurements and ash
      BMC (r = 0.89). The ability of the technique to detect bone loss was assessed at
      the femoral site by comparing the BMD of ovariectomized (OVX) and sham-operated
      rats at baseline and at a 1 month follow-up. There was no significant difference
      in BMD between the groups at baseline. However, at 1 month follow-up the OVX
      group showed a significant (p < 0.001) decline in BMD at the distal femur (-8.6%)
      and in the total femur (-4.8%) compared with sham-operated rats. A comparison of
      retired breeder female rats with age-matched nulliparous rats indicated that the
      BMD of retired breeder rats was significantly lower than that of virgin females
      at all femoral sites (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352064
TI  - Prevalence of vertebral fracture in women and the relationship with bone density
      and symptoms: the Chingford Study.
AB  - A population survey was performed to estimate the prevalence of vertebral
      fractures in women aged 45-69 and to determine their relationship to bone density
      and symptoms. Subjects were 1035 women aged 45-69 (mean 55.4 years, response rate
      77%) from the age-sex register of a large 11,000-person general practice in
      Chingford, London. Thoracic and lumbar spine x-rays were read by a semiautomated
      quantitative method. Vertebral fractures were diagnosed using a variety of
      morphometric methods, including a new method we recently developed and the
      published methods of Melton and Eastell. These methods all detect abnormal ratios
      between anterior, central, or posterior vertebral height and between observed
      posterior vertebral height and values predicted from the posterior height of
      adjacent vertebrae. Bone mineral density (BMD) of lumbar spine L1-4 and neck of
      femur was measured by dual-energy x-ray absorptiometry (DXA). Using our method,
      147, 14.2% (95% CI 12.0-16.2%) of the 1035 women, had minor fractures (at least
      two vertebral ratios 2-2.99 SD below the mean) and 20, 1.9% (95% CI 1.2-3.0%) of
      the total, had severe fractures (at least two ratios more than 3 SD below the
      mean). In the 147 women with minor fractures, bone density of the spine was not
      significantly lower than in the other 868 women, and reported back pain or loss
      of height was no more common. Women with multiple minor fractures did have lower
      bone density, by 0.4 SD. In the 20 women with severe fracture, bone density was
      significantly lower, by 0.6 SD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352063
TI  - Bone and mineral metabolism in the androgen-resistant (testicular feminized) male
      rat.
AB  - Androgens have important effects on bone in vivo, possibly by direct activation
      of the androgen receptors in osteoblasts. To test this hypothesis, calcium
      homeostasis, bone mass, and bone turnover were evaluated in mature (4-month-old)
      androgen-resistant (testicular feminized, TFM) male rats. Data were compared with
      data from both female and male littermates of the same age and strain. Compared
      to normal males, TFM had similar serum testosterone, twofold higher estradiol and
      estrone, and sixfold higher androstenedione concentrations. Compared to normal
      females, TFM rats showed lower estradiol but also elevated concentrations of
      androstenedione and estrone. Despite similar free 1,25-(OH)2D3 concentrations,
      both TFM and male rats maintained higher serum calcium and phosphate
      concentrations than their female littermates. Serum IGF-I concentrations in TFM
      rats were decreased compared to male rats (-12%) or female rats (-27%). Serum
      osteocalcin concentrations, however, were twofold higher in TFM rats than in
      females but not significantly different from males. Femoral length, diameter, and
      cortical thickness were intermediate between those of males and females. The
      cancellous bone density of the femur and cancellous bone volume of the proximal
      metaphysis of the tibia, however, were not significantly different between
      groups. The ash weight of the tibia was also not significantly different, and the
      ash weight of the four distal lumbar vertebrae ranged between male and female
      values. Bone mechanical properties as measured by torsional strength and energy
      absorption of the femur were lower in TFM than in females but not different from
      males.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352065
TI  - Effects of transforming growth factor beta 1 and L-ascorbate on synthesis and
      distribution of proteoglycans in murine osteoblast-like cells.
AB  - Proteoglycans synthesized by osteoblasts are incorporated into bone matrix and
      thought to play a role in bone metabolism. Transforming growth factor (TGF) beta
      affects the synthesis of matrix proteins, including proteoglycans, in various
      stromal cells, and proteoglycans, especially decorin, are associated with matrix
      collagen. In the present study, the effects of TGF-beta 1 and L-ascorbate, a
      factor essential for collagen synthesis, on the synthesis and distribution of
      proteoglycans were examined using murine osteoblast-like MC3T3-E1 cells. TGF-beta
      1 stimulated the synthesis of proteoglycans in MC3T3-E1 cells. Among various
      proteoglycans, the synthesis of decorin was preferentially enhanced by TGF-beta
      1, and the effect was more pronounced on secreted decorin compared to that
      associated with the cell/matrix layer. TGF-beta 1 also stimulated the initiation
      and elongation of the dermatan sulfate glycosaminoglycan chain, resulting in a
      larger molecular size of decorin. TGF-beta 1 influenced the synthesis of a
      heparan sulfate proteoglycan only slightly. L-ascorbate had no effect on the
      synthesis of proteoglycans, but increased those associated with the cell/matrix
      layer. Furthermore, when L-ascorbate was added to the culture along with TGF-beta
      1, the percentage of proteoglycans associated with the cell/matrix layer
      increased from 25.8 +/- 1.0 to 41.0 +/- 0.5%. These data demonstrate that TGF
      beta 1 markedly stimulates the synthesis of proteoglycans, especially decorin,
      mainly as a secreting form, that the accumulation of decorin into matrix is
      enhanced by L-ascorbate, and that the effects of TGF-beta 1 and L-ascorbate are
      additive.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352066
TI  - Estrogen does not restore bone lost after ovariectomy in the rat.
AB  - We recently found that 17 beta-estradiol (E2) not only suppresses bone resorption
      but also stimulates bone formation in the cancellous bone of female rats. This
      raises the possibility that E2 treatment might restore the bone lost after
      ovariectomy in the rat. To test this, 13-week-old rats were ovariectomized (ox).
      After a further 13 weeks the animals were injected with E2 (4 mg or 40
      micrograms/kg daily), human calcitonin (hCT) (3 IU/kg daily), (3-amino-1
      hydroxypropylidene)-1-bisphosphonate (AHPrBP) (0.3 mg/kg twice per week), or a
      combination of E2 with hCT or AHPrBP, for 8 weeks. The bone volume at the tibial
      metaphysis of ox animals was approximately 40% of that of sham-operated controls
      at the end of the experiment. Although the bone volume of ox rats treated with E2
      and/or hCT or AHPrBP was slightly higher than that of untreated ox rats, the
      increase was not significant. Neither E2 alone nor a combination of E2 with hCT
      or AHPrBP was associated with a higher bone volume than hCT or AHPrBP alone,
      suggesting no effect of E2 beyond that of inhibition of bone resorption.
      Histodynamic indices of bone formation were increased in untreated ox rats
      compared to controls but suppressed in E2-treated, hCT-treated, and AHPrBP
      treated animals. These results emphasize the similar responses of rat and human
      bone, both of which not only show bone loss with estrogen deficiency, preventable
      by estrogen administration, but also show an inability of estrogen to restore
      bone lost as a result of estrogen deficiency.

PMID- 8352067
TI  - Passive immunization with anti-parathyroid hormone-related protein monoclonal
      antibody markedly prolongs survival time of hypercalcemic nude mice bearing
      transplanted human PTHrP-producing tumors.
AB  - Malignancy-associated hypercalcemia is mainly caused by excessive production of
      parathyroid hormone-related protein (PTHrP) by the tumor. Using anti-PTHrP-(1-34)
      monoclonal murine antibody (anti-PTHrP MoAb), we studied whether repeated
      injection of the homologous antibody would continuously decrease the serum
      calcium concentration in hypercalcemic nude mice bearing transplanted human PTHrP
      producing tumors, leading to prolongation of their survival time. Daily SC
      injections of anti-PTHrP MoAb decreased the serum calcium concentration almost to
      within the normal range in nude mice bearing transplanted human PTHrP-producing
      tumors (T3M-1, EC-GI, PC-3, and FA-6) but not in a nude mouse bearing a
      transplanted parathyroid carcinoma. The antibody did not affect FA-6 tumor growth
      either in vitro or in vivo. Pancreatic carcinoma cells (FA-6), which caused the
      most severe hypercalcemia, were inoculated into 6-week-old nude mice. When severe
      hypercalcemia (approximately 19 mg/dl) had developed, daily SC injection of anti
      PTHrP MoAb was started. Within 18 days of this time point, all untreated tumor
      bearing mice (n = 10) died of hypercalcemia and cachexia, whereas all the treated
      mice (n = 10) showed an increase in body weight and survived for at least 25
      days. Histologic examination of the treated mice revealed a marked decrease in
      osteoclastic bone resorption, without toxicologic findings in the kidney and
      liver. These results suggest that passive immunization against PTHrP can
      continuously ameliorate the hypercalcemia and markedly prolong the survival time
      of severely hypercalcemic, tumor-bearing mice. If a human monoclonal antibody
      against PTHrP-(1-34) could be developed, then passive immunization would be
      potentially one of the most effective therapies for patients with malignancy
      associated hypercalcemia due to excessive production of PTHrP.

PMID- 8352068
TI  - Bone density and body composition on the Pacific rim: a comparison between Japan
      born and U.S.-born Japanese-American women.
AB  - Bone mineral density (BMD) of total body, spine, and proximal femur and the
      percentage of body fat in 151 U.S.-born Japanese-American women and 137 Japan
      born immigrant Japanese-American women living in San Diego, California were
      measured using dual-energy x-ray absorptiometry. These data were compared with
      unpublished data from Japanese women obtained in previous studies in Hamamatsu,
      Japan. The age-adjusted BMD for the spinal level, femoral neck, Ward's triangle,
      trochanter, and total body, respectively, of U.S.-born Japanese-American women
      were 10.2, 9.8, 9.9, 9.2, and 2.7% higher than those of native Japanese women.
      The U.S.-born Japanese-American women had significantly higher body fat than
      immigrant Japanese-American women. Furthermore, the immigrant women had higher
      BMD and higher body fat than their native Japanese counterparts; however, no
      significant total-body BMD differences were found among the three groups after
      age, height, and weight were adjusted. The U.S.-born Japanese-American women had
      BMD values equivalent to those of white normals at the spine and femur.
      Significant life-style differences between U.S.-born and immigrant Japanese
      American women were noted. Weight, exercise, early menarche, and years of
      lifetime estrogen exposure correlated positively with BMD. The significant
      negative correlates of BMD were age, smoking, and percentage of body fat. Our
      study presents data suggesting that immigration to the United States has produced
      a higher BMD in Japanese-American women that is attributable to changes in life
      style and diet.

PMID- 8352069
TI  - Effects of combined prostaglandin and alendronate treatment on the
      histomorphometry and biomechanical properties of bone in ovariectomized rats.
AB  - Prostaglandin E2 (PGE2) has been shown to stimulate both bone resorption and
      formation in experimental animals, leading to augmentation of trabecular and
      cortical bone. The amino bisphosphonate alendronate (ALN) is a potent inhibitor
      of bone resorption. The objectives of this study were to examine if PGE2
      stimulation of bone formation was dependent on bone resorption and if the bone
      accrued as a result of PGE2 treatment contributed to bone strength. The 48 female
      Sprague-Dawley rats were assigned to six groups as follows: five groups (8/group)
      were ovariectomized at the age of 6 months. One group was sacrificed 2 months
      later to establish baseline conditions, and four groups were treated for 25 days
      with (1) vehicle, (2) PGE2 at 3 mg/kg/day, (3) ALN sc at 0.8 micrograms/kg/day,
      and (4) PGE2 + ALN at the respective doses. The sixth group served as
      nonovariectomized untreated controls. Histomorphometric analysis of 6-10 microns
      thick tibial sections after in vivo fluorochrome double labeling showed that
      treatment with PGE2 alone increased endocortical mineral apposition rate and bone
      formation rate, stimulated production of bone trabeculae in the marrow cavity,
      and increased cortical porosity. Combined ALN + PGE2 treatment prevented the
      resorption induced by PGE2 but not the stimulation of bone formation on
      endocortical and periosteal surfaces and resulted in a significant increase in
      cortical thickness. Consistent with these observations, the femoral midshaft
      tested to failure in three-point bending showed a significant increase in
      strength in the PGE2 + ALN group (181 +/- 15 N) compared to time 0 controls (145
      +/- 23 N) or to the ovariectomized vehicle-treated group (141 +/- 28 N).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8352070
TI  - Urinary hydroxypyridinium crosslinks of collagen as markers of bone resorption
      and estrogen efficacy in postmenopausal osteoporosis.
AB  - Estrogen deficiency-induced bone loss has been associated with accelerated bone
      turnover. Levels of some biochemical markers, such as serum osteocalcin (BGP),
      tartrate-resistant acid phosphatase (TRAP), and urinary hydroxyproline (OHP),
      have been shown to be related to the rate of bone turnover. They may therefore be
      useful in identifying the individual at risk for osteoporosis and monitoring the
      efficacy of the treatment. Two recently discovered markers, urinary pyridinoline
      (PYD) and deoxypyridinoline (DPD), are apparently directly related to bone matrix
      degradation and may be more accurate markers of bone resorption than OHP or TRAP.
      To evaluate the effects of menopause, osteoporosis, and estrogen replacement on
      the excretion of these new markers, we measured the levels of PYD and DPD and
      other biochemical markers of bone turnover in four groups of women, premenopausal
      healthy (PRE), postmenopausal healthy (POST), postmenopausal osteoporotic (UTO),
      and postmenopausal osteoporotic with estrogen treatment (ETO). Significant
      increases in PYD, DPD, BGP, TRAP, and OHP were found in POST and UTO groups
      compared with PRE. These increases were blunted by estrogen treatment when the
      levels of each of the markers returned to PRE levels. When comparing POST and UTO
      groups, significant increases were observed in UTO only for PYD, DPD, and urinary
      calcium but not for OHP, BGP, or TRAP. With subgroups matched for age and years
      from menopause, only DPD discriminated between POST and UTO. Indices of bone
      formation covaried with markers of bone resorption in the total
      population.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352072
TI  - 15th annual meeting of the American Society for Bone and Mineral Research. Tampa,
      Florida, September 18-22, 1993. Abstracts.

PMID- 8352071
TI  - Effects of high extracellular calcium and strontium on inositol polyphosphates in
      bovine parathyroid cells.
AB  - The addition of Ca2+ or a variety of divalent cations increases intracellular
      Ca2+ in parathyroid cells and suppresses secretion. Since 1,4,5-inositol
      trisphosphate (IP3) and 1,3,4,5-inositol tetrakisphosphate (IP4) mediate Ca2+
      mobilization in other systems, we examined high Ca(2+)- and Sr(2+)-induced
      accumulation of IP3 and IP4 isomers by anion-exchange HPLC and measured 1,4,5-IP3
      mass in parathyroid cells. Raising extracellular [Ca2+] from 0.5 to 3.0 mM
      increased 3H-1,4,5-IP3 within 5 s, which was confirmed by mass measurements. 3H
      1,3,4-IP3 rose gradually by 10 s and increased for 60 s after the addition of
      Ca2+. Although we detected no change in 3H-1,3,4,5-IP4, the increase in 3H-1,3,4
      IP3 suggests that 3H-1,3,4,5-IP4 was being formed. The addition of 4 mM SrCl2
      produced similar changes in 1,4,5-IP3, which were confirmed by mass assay. 3H
      1,3,4,5-IP4 did not change. However, Sr2+ induced a gradual increase in 3H-1,3,4
      IP3, which remained above control levels for 5 minutes. Isotopic labeling studies
      in this system may underestimate changes in 1,4,5-IP3 mass, but both mass and
      radioisotopic analyses indicate that high extracellular Ca2+ and Sr2+ stimulate
      substantial increases in 1,4,5-IP3 without significant accumulation of 1,3,4,5
      IP4. These studies suggest a role for 1,4,5-IP3 in intracellular Ca2+
      mobilization by divalent cations in parathyroid cells.

PMID- 8352074
TI  - [Present state of myopia studies].

PMID- 8352073
TI  - Spring meeting of the British Geriatrics Society. 15-17 April 1993, Glasgow.
      Abstracts.

PMID- 8352075
TI  - [An electron microscopic histochemical study on the localization of sialic acids
      in human trabecular meshwork].
AB  - The localization of sialic acids in human trabecular meshworks of normal eyes,
      primary open angle glaucoma (POAG) eyes, congenital glaucoma eyes, and juvenile
      glaucoma eyes was investigated using biotinyl lectin (LPA, SSA, MAM) and avidin
      gold electron microscopic histochemistry. Gold particles were detectable in fine
      fibrils underneath Schlemm's canal and collagen fibers of normal, POAG,
      congenital glaucoma, and juvenile glaucoma eyes equally. Many gold particles were
      detected especially in fine fibrils and basal membrane (compact tissue) 3 microns
      underneath Schlemm's canal. The present study indicated that extracellular
      matrices of congenital glaucoma and juvenile glaucoma contained sialic acids and
      that this may be related to the ocular hypertension of these diseases.

PMID- 8352077
TI  - [Participation of procoagulant activity of cultured rabbit lens epithelial cells
      in fibrin formation].
AB  - To clarify the participation of the lens epithelial cells in the postoperative
      fibrin formation in cataract surgery, the generation of procoagulant activity
      (PCA) by cultured rabbit lens epithelial (RLE) cells was investigated. PCA was
      detected in the homogenates of RLE cells cultured for three hours. PCA was
      increased approximately three- to four-fold by lipopolysaccharide (LPS)
      stimulation in a dose dependent manner. Treatment of the RLE cells with
      Concanavalin A resulted in a decrease of PCA. PCA of the RLE cells was not
      observed in Factor VII deficient plasma, as a standard tissue factor (TF).
      Parallelism was recognized between the dose response regression lines for the PCA
      in the RLE cells and standard TF. These results suggest that the PCA in the RLE
      cells is similar to TF, which has glycoprotein as an active site and requires
      coagulation factor VII. Some arachidonic acid metabolic cascade inhibitors which
      show an inhibitory effect for fibrin formation in vivo reduced the generation of
      PCA by the RLE cells in vitro. The activation of arachidonic acid cascade
      followed by the generation of PCA in the RLE cells may participate in
      postoperative fibrin formation.

PMID- 8352076
TI  - [THC-YAG laser sclerostomy ab externo in monkey eyes].
AB  - THC-YAG laser sclerostomy was performed in 7 eyes of 6 monkeys. The 26-gauge
      optic probe, which delivers energy perpendicularly to the long axis of the probe,
      was inserted through a 1-mm conjunctival stab incision, 6-7 mm away from the
      limbus, and the probe tip was positioned at the sclerostomy site. Pulse energy of
      80 mJ or 100 mJ was used with a repetition rate of 5 pulses per second. Total
      energy levels to produce a new outflow pathway ranged from 1.2 to 6.6 J (2.8 +/-
      1.2 J). After the surgery, 5-fluorouracil (0.1 mg daily) was injected
      subconjunctivally for 7 days, and intraocular pressure measurements and
      ophthalmic examination were performed for 4 weeks. Eyes were enucleated just
      after surgery or 1 week or 4 weeks after surgery. Intraocular pressures in
      operated eyes at 1 week and 4 weeks after surgery were reduced to 7-10 (9 +/-
      1.2) mmHg, and 0-11 (3.5 +/- 4.3) mmHg, respectively, in comparison with
      intraocular pressures in nonoperated eyes. Histological examination revealed that
      the sclerostomy hole with a diameter of 150 microns just after surgery had
      narrowed at 1 week, and was closed by subconjunctival proliferative tissues at 4
      weeks after surgery.

PMID- 8352078
TI  - [Retinal ischemic changes in diabetic rats treated with pancreatic islet
      transplantation beneath the renal capsule].
AB  - The effect of pancreatic islet transplantation beneath the renal capsule on
      retinal and choroidal structure was studied using Lewis rats. Rats were divided
      into 3 groups: an untreated diabetic group induced by intravenous injection of
      streptozotocin 65 mg/kg; an islet transplanted group 1 month after induction of
      diabetic state; and an untreated control group. Whole retinochoroidal units were
      examined by light and electron-microscopy. In 6 out of 9 cases in the
      transplanted group, the retina showed marked destructive changes in the outer
      layer including pigment epithelial cells and vacuolization of the inner layer 6
      months after islet transplantation. Occlusion and fibrosis of the
      choriocapillaris adjoining the degenerated retina were also observed. Such
      changes were not observed in the other groups. On electron microscopy, occlusion
      of capillaries and destruction of endothelial cells were frequently found in the
      degenerated retina. These retinal ischemic lesions appear to be caused by
      microvascular obstruction.

PMID- 8352079
TI  - [Cytotoxic T lymphocyte activity after intravitreal inoculation of herpes simplex
      virus type I in mice].
AB  - After inoculating mice with herpes simplex virus (HSV) by a corneal or
      intravitreal route, cytotoxic T lymphocyte (CTL) activity in the cervical lymph
      nodes and spleen was assayed. The spleen and cervical lymph nodes were removed at
      various points till 2 weeks after inoculation, and CTL activity was assayed in a
      groups: (A) mice intravitreally inoculated with HSV, and (B) mice with topical
      application of HSV. The reactivity of delayed type sensitivity was determined by
      the thickness of the mouse ear pinna on the 6th day in both groups. CTL activity
      in the spleen was at the same level in both groups. Up to 10 days after
      inoculation CTL activity in the cervical lymph nodes in group (A) was lower than
      in group (B). The reactivity of delayed type sensitivity in group (A) was lower
      than in group (B). These results indicate that an anterior chamber associated
      immune deviation (ACAID)-like phenomenon occurred after HSV inoculation into the
      vitreous cavity.

PMID- 8352080
TI  - [Volume measurement of the horizontal extraocular muscles using magnetic
      resonance imaging].
AB  - The volume of the horizontal extraocular muscles of 11 normal adults and three
      patients with ophthalmoplegia was measured using magnetic resonance imaging
      (MRI). The MRI examinations were carried out with a Signa Advantage, 1.5 tesla
      superconductive magnetic system manufactured by General Electric. This method
      employs the spin echo technique with a 3.0 mm gapless slice, a 350 ms. repetition
      time, and a 17.0 ms. echo time. The MRI films were projected and magnified on
      Kent paper using an overhead projector. Then the shapes of the horizontal
      extraocular muscles were traced. The volume of the muscles was measured as the
      total weight of Kent papers which were cut out from muscle shapes in all the
      slices. The average volume of the normal medial and lateral rectus muscles was
      690 +/- 87 mm3 and 734 +/- 77 mm3, respectively. Two cases with peripheral nerve
      palsy showed typical atrophy of the paretic muscles. A case with orbital myositis
      showed typical hypertrophy of the inflamed muscles. This measurement may prove
      useful in the analysis and evaluation of extraocular muscles, especially in
      ophthalmoplegia.

PMID- 8352081
TI  - [Plasma intramembrane structure of overaction of the inferior muscle in humans].
AB  - We used the freeze-fracture method to compare the intramembrane structure of the
      plasma membrane in inferior oblique (IO) muscles from six strabismus patients
      with normal IO muscles. Inferior oblique myectomy provided us with small pieces
      of IO muscle from three patients with superior oblique paresis, and from one
      patient each with V-pattern exotropia, V-pattern esotropia, and V-pattern
      intermittent exotropia. Samples of normal IO muscle were obtained from two men,
      aged 33 and 73 years, within 24 hours of their death. The excised muscles were
      separated at their belly part into orbital and global layers, and small bundles
      of muscle fiber were fixed and freeze-fractured. The size of intramembrane
      particles (IMPs) did not differ significantly between normal and strabismus
      affected specimens (mean: 9.5 nm). The density of IMP in the 33-year-old man's
      sample ranged from 800 to 3300/microns2 with a mean of 1823/microns2, in the 73
      year-old man's sample ranged from 100 to 2500/microns2 with a mean of
      670/microns2, while in the affected tissues it ranged from 100 to 1000/microns2
      with a mean 500/microns2. There were no significant differences in caveola size
      and density between normal and strabismus-affected IO muscles.

PMID- 8352082
TI  - [Treatment and prognosis of diplopia].
AB  - The case notes of 341 patients who had consulted the Ocular Motility Clinic of
      Hyogo College of Medicine between 1986 to 1992 with a chief complaint of diplopia
      were studied. The recovery rates of diplopia from major causes were as follows:
      72% of patients recovered from diplopia in oculomotor nerve palsy, 70% in
      trochlear nerve palsy and 71% in abducens nerve palsy. Various treatments were
      effective to eliminate the diplopia in 69% of patients with myasthenia gravis,
      60% in Graves' ophthalmopathy, 78% in blowout fractures and orbital tumors.
      Pharmaceutical therapy was applied in 236 cases. In ocular motor nerve palsy oral
      prednisone gave a higher recovery rate than other medicines. The recovery rate of
      diplopia in medicinal therapy was 60% and it increased to 69% when combined with
      surgical treatment. We concluded that it is better to select the surgical
      treatment if the patient complains of diplopia after more than 6 months of
      conservative therapy.

PMID- 8352083
TI  - [Measurement of ocular position using Purkinje images. Part 1. A new measurement
      system].
AB  - I developed a new system of measuring ocular position using the first and fourth
      Purkinje images. This method used two images which were reflected from the front
      surface of the cornea and the back surface of the lens. I got a cross line from
      the first Purkinje image by putting a cross lens filter in front of the infrared
      camera. When I superimposed the vertical line upon the fourth image, I could get
      the optic axis of the eye. In order to measure the ocular position, I measured
      the angle of the optic axis. The accuracy of this system was +/- 0.1 degrees and
      the maximum error was smaller than +/- 0.5 degrees. Measurements with this system
      were easily obtained from squint patients and correlated well with results from
      the prism cover test (R2: 0.941). This measurement system was more useful than
      the prism cover test because I was able to measure horizontal deviations more
      precisely.

PMID- 8352084
TI  - [Measurement of ocular position using Purkinje images. Part 2. The measurement of
      ocular position in subjects wearing spectacles].
AB  - The first and the fourth Purkinje images are formed by the front surface of the
      cornea and the posterior surface of the lens. This measurement system is based on
      the principle of aligning one image with the other horizontally. It produces a
      precise measurement of the horizontal ocular position. I measured ocular position
      using this system when the subjects wore spectacles. The subjects gazed at a
      target position that was placed horizontally at 5 degrees intervals within a
      range of 25 degrees from the center to both sides. I analyzed the differences
      between the target position and the measurement data obtained by this system. The
      higher the refractive power of the lens the subjects wore, and the further the
      target position was from the center the greater were the differences between
      them. If the fixed target was placed within +/- 10 degrees, the difference was
      less than 0.5 degrees in all the spectacle lenses tested. I concluded that the
      measurements obtained with this system were useful even when the subjects wore
      spectacles.

PMID- 8352085
TI  - [The relationship between the developmental change in visual acuity measurements
      and change of refractive error in young infants].
AB  - 219 normal infants aged 3 to 36 months were tested to investigate the
      relationship between the development of visual acuity and the change of
      refractive error. 17 infants were tested over a period of time. Visual acuity was
      assessed by Teller Acuity Cards (TAC), and refractive error was measured by an
      infrared video refractor (PR1000) without cycloplegics. The results were as
      follows. 1) The success rate of both tests in 3 to 6 month-old infants was higher
      than in infants aged 11 to 14 months and 23 to 36 months. 2) Visual acuity showed
      a rather slow development in infants aged 3 to 12 months. 3) With-the-rule
      astigmatism of 1 diopter (D) or more occurred with a high incidence in the 3 to 8
      month old infants, and decreased with age. 4) The visual acuity in the infants
      with astigmatism was no different than in those without it. 5) The slow
      developmental curve of visual acuity measured in 3 to 12-month old infants was
      probably the result of psychological aversion to the TAC.

PMID- 8352086
TI  - [Corneal curvature of myopia].
AB  - We classified myopia by total refractive error, measured the corneal curvature,
      and analyzed the relationship between the diopter value and corneal curvature in
      growing teen-agers and in adults in their twenties, whose myopic progress is
      presumed to have stopped. We adopted as the harmonic average the central 3.0 mm
      of the cornea. We also examined peripheral corneal curvature in upper side, lower
      side, temporal side and nasal side at about 4.5 mm and 6.5 mm diameter from the
      center. There was very little difference in the harmonic average of corneal
      curvature from -1D to -6D. Similarly, there was very little difference in the
      peripheral corneal curvature. The corneal curvature was larger from central to
      periphery in all directions. The upper side was larger than lower side and the
      nasal side was larger than the temporal side. We concluded that the refractive
      power did not depend on the corneal refractive power in mild to moderate myopic
      patients.

PMID- 8352087
TI  - [The shape of posterior staphyloma in high myopia].
AB  - In 105 eyes of 68 highly myopic patients with focal chorioretinal atrophy in
      posterior staphyloma, the shape of the staphyloma and the process of backward
      elongation were studied. Indirect binocular ophthalmoscopy (and in some cases
      slit-lamp biomicroscopy of the fundus.) was used to observe the staphyloma. The
      results were as follows: 1) In 72.4% of all the eyes, patchy atrophy (part or
      whole) protruded or became dented in the staphyloma. The protrusion and the dent
      did not correlate with age. The refraction of eyes which had protruded patchy
      atrophy was significantly stronger than those which had dented patchy atrophy.
      The axial length of eyes which had protruded patchy atrophy was also
      significantly longer. 2) The protrusion and the dent were localized in patchy
      atrophy with a diameter of over 1.5 PD. 3) In 80.3% of peripapillary
      chorioretinal atrophic cases, atrophy protruded or became dented in the
      staphyloma. 4) In 43.8% the limits of the location of retinal blood vessels
      formed part of the borderlines of the staphyloma. 5) In 28.6%, steps were created
      in the staphyloma by the limits of the location of retinal blood vessels. As the
      staphyloma progresses, patchy atrophy, annular-type myopic crescents, and the
      location of retinal blood vessels influence the shape of the staphyloma.

PMID- 8352088
TI  - [Early change of visual function in high myopia--measured and analyzed by octopus
      automated perimeter].
AB  - To evaluate the early changes of visual function in high myopic eyes, visual
      field examinations were performed using an Octopus 201 automated perimeter to 206
      eyes of 120 patients. Corrected visual acuities were better than 0.8 and there
      were no abnormal findings except tigroid fundus change. 64 eyes of 38 patients
      were selected as a control group, whose refractive degrees were between +1.0D and
      -1.0D, corrected visual acuities were better than 1.0. The correlations of visual
      field changes with age, refractive degrees, axial length and sex were
      investigated. The total loss of high myopia group and the control group was
      compared, and changes in certain members of the high myopia group were followed
      up. The results were as follows: 1) Compared to the control group, the high
      myopia group had remarkably great loss. It revealed that the functional changes
      occurred already in the tigroid fundus stage. 2) Refractive degrees and axial
      length showed a significant positive correlation with total loss. This indicated
      that the refractive degrees and axial length played important roles in
      determining the visual field change of high myopic eyes. 3) Age and sex showed no
      statistically significant correlations with total loss. 4) The mean loss of the
      upper temporal quadrant and 11 degrees-20 degrees annular area were the largest.
      It appeared that the earliest changes in high myopia possibly began from the
      lower temporal region of the disc. 5) In the follow-up study, the loss increased
      persistently in the whole field, especially in the upper temporal and 11 degrees
      20 degrees area.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352089
TI  - [A case of pleomorphic adenocarcinoma of the ciliary body].
AB  - We performed local resection of a ciliary body tumor, which was diagnosed as
      pleomorphic adenocarcinoma arising from nonpigmented epithelium of the ciliary
      body. The patient was a 57-year-old male, and the tumor was found incidentally at
      an ophthalmologic examination. Since the possibility of malignant tumor could not
      be ruled out, local resection of the tumor was performed. The tumor developed
      from the pars plicata and the size was 5.5 x 6.0 x 7.5 mm. Histologically, the
      tumor cells displayed heteromorphism and revealed tubular and glandular
      structures which continued to the ciliary body epithelium. Melanin pigment was
      not observed, except in one small area of the tumor. The interstitium of the
      tumor tissue was stained with alcian blue, and a immunohistochemical study showed
      that tumor cells were positive for epithelial membrane antigen (EMA) and
      vimentin, but negative for S-100 protein and carcinoembryonic antigen (CEA).
      Electron microscopy revealed desmosomes between cells, and microvilli were
      observed at the margin of the glandular cavity structure. In this case, no severe
      complications occurred even after local resection and good visual function was
      maintained.

PMID- 8352090
TI  - Radiologists in the United States: demographic, professional, and practice
      characteristics.
AB  - OBJECTIVE: The purpose of this report is to present a statistical portrait of
      radiologists in the United States based on the 1990 American College of Radiology
      Manpower Survey. Unlike previous surveys, this survey included radiologists who
      were not members of the College and was thus more representative of all
      radiologists. (Approximately three quarters of radiologists are College members.)
      We examined how the demographic, professional, and practice characteristics of
      radiologists vary among major groups within the profession. MATERIALS AND
      METHODS: A stratified random sample of 2804 radiologists and nuclear medicine
      specialists was drawn from the American Medical Association Physician Masterfile,
      which is the most complete and extensive single source of information on
      physicians in the United States. Because the total numbers of female
      radiologists, nuclear medicine specialists, and radiologists less than 35 years
      old are relatively small, these groups were deliberately "oversampled" (hence the
      term stratified random sample) to ensure sufficient numbers of responses in these
      categories for meaningful analysis. A total of 1845 completed questionnaires were
      received, which yields a response rate of 68% if the questionnaires sent to
      invalid addresses are excluded. Responses were weighted to make the data
      representative of all radiologists, despite differences in sampling rates.
      RESULTS: Findings for professionally active radiologists who completed their
      training included the following: 94% were certified by the American Board of
      Radiology, 13% were women, 47% were less than 45 years old, fees for service were
      the primary remuneration for 62%, and 72% are in practices owned by physician
      members of the practice. By major activity in radiology, 69% were diagnostic
      radiology generalists; 11% were radiation oncologists; 18% were diagnostic
      radiology subspecialists; and 2% were nuclear medicine specialists. A breakdown
      by age indicated that the age group of radiologists less than 45 years old
      included more women, diagnostic subspecialists, and persons who had fellowship
      training than other age groups did. Percentages of diagnostic radiology
      generalists and solo practitioners were lower among younger radiologists.
      Radiation oncologists, compared with all others, were the most likely to practice
      solo or in small groups of two to four members. The subfields with the highest
      percentages (60% or more) of diagnostic radiologists reporting expertise or
      proficiency were CT, mammography, and sonography. Among radiologists who were
      retired, half had retired by the time they were 65 years old. However, a majority
      of radiologists 65-69 years old were still working, as were 40% of those 70-74
      years old. CONCLUSION: The profession of radiology is changing, with more women,
      subspecialists, and fellowship-trained radiologists in younger age groups and
      fewer solo practitioners. Only a small percentage of radiologists are not board
      certified. Radiologists typically remain professionally active into their late
      60s or even beyond.

PMID- 8352091
TI  - Plagiarism: what is it, whom does it offend, and how does one deal with it?
AB  - Academic plagiarism is a thorny ethical and practical problem. Perhaps readers
      have never personally encountered or recognized a case of plagiarism so its
      immediate interest and relevance may be obscure. A short case history may provide
      evidence that the issue of plagiarism is germane to the contemporary academic
      endeavor. A young university radiologist recognized his own writing in a
      professional journal under another's authorship, without attribution to himself,
      and had no idea what to do about it. He finally wrote to the author of the
      article who answered something to the effect that it was indeed a "remarkable
      coincidence" and that "great minds think alike." Unsatisfied with the response,
      he considered reporting the matter to the journal editor, but he was a junior
      faculty member while the plagiarist was a revered figure in his subspecialty. He
      chose not to pursue the issue further because he was afraid that the plagiarist
      would harm him professionally [1].

PMID- 8352092
TI  - Imaging of suspected aortic dissection.

PMID- 8352093
TI  - Imaging to distinguish between viable and nonviable myocardium: pathophysiologic
      basis and importance of positron emission tomography.
AB  - One goal of strategies designed to restore nutritive perfusion in patients with
      left ventricular dysfunction attributable to coronary artery disease is salvage
      of reversibly ischemic myocardium in an effort to improve patients' left
      ventricular function, signs and symptoms, and survival. Accurate identification
      of patients likely to benefit from interventions such as coronary
      revascularization requires the differentiation of viable (reversibly
      dysfunctional) myocardium from nonviable (persistently dysfunctional) tissue. To
      date, no consensus has been reached regarding the best approach for achieving
      this differentiation. In this review, the pathophysiologic characteristics of
      viable and nonviable myocardium are summarized, and diagnostic methods that
      exploit these characteristics for the purposes of detecting viable myocardium are
      discussed. Emphasis is placed on approaches that use positron emission tomography
      because of its usefulness in quantifying those specific metabolic processes that
      support both tissue viability and the capacity for functional recovery.

PMID- 8352094
TI  - Clinical and videofluoroscopic evaluation of swallowing disorders.
AB  - Swallowing and feeding problems are common, particularly in elderly persons, and
      will be an increasing cause of disability as the geriatric population expands.
      Consequently, the need for clinical and radiologic examinations of patients who
      have swallowing problems will likely become commonplace. In this review, we
      define the problem confronting these patients, discuss the clinical and
      videofluoroscopic procedures used to examine patients with swallowing difficulty,
      and integrate the results of these examinations and their impact on feeding
      recommendations.

PMID- 8352095
TI  - Idiopathic laryngotracheal stenosis: radiologic findings.
AB  - OBJECTIVE: Acquired nonneoplastic laryngotracheal stenosis can be either focal or
      diffuse. Diffuse tracheal stenosis is caused by sarcoidosis, tuberculosis,
      histoplasmosis, relapsing polychondritis, tracheopathia osteoplastica, and
      Wegener's granulomatosis. Focal tracheal stenosis, on the other hand, usually
      results from placement of an endotracheal or tracheostomy tube or from previous
      neck trauma. At our institution, since 1971, we have seen 49 cases of focal
      laryngotracheal stenosis that could not be attributed clinically or
      histologically to any one of the aforementioned causes. The purpose of this study
      was to study the radiologic features of these idiopathic laryngotracheal
      stenoses. MATERIALS AND METHODS: A retrospective review of records showed that
      radiologic studies were still available in only 15 of the 49 patients with
      idiopathic laryngotracheal stenoses. All 15 patients had radiographs and plain
      tomograms, and one patient had a CT scan of the neck. Three radiologists reviewed
      all the images. RESULTS: The radiologic appearance was variable: the stenoses
      were from 2 to 4 cm long with a lumen between 3 and 5 mm in diameter at the
      narrowest portion. The narrowing was concentric and shaped like an hourglass in
      eight patients (53%) and was eccentric in the other seven (47%). The margins of
      the stenosis were smooth in nine patients (60%) and irregular and lobulated in
      six patients (40%). A dominant mass measuring approximately 1 cm in diameter was
      present in two patients (13%). No evidence of calcification or ossification was
      seen. CONCLUSION: Idiopathic laryngotracheal stenosis produces focal stenosis of
      the cervical part of the trachea, 2 to 4 cm long. The lumen is severely
      compromised, measuring no more than 5 mm in diameter at its narrowest portion.
      The stenosis can be concentric or eccentric and can have either smooth or
      lobulated margins. Special attention should be paid to the airways when chest
      radiographs of patients with a history of prolonged dyspnea and wheezing are
      reviewed. The prevalence of focal stenosis of the larynx and the upper part of
      the trachea due to tracheal intubation has declined since the introduction of low
      pressure, high-volume retention cuffs. Therefore, idiopathic laryngotracheal
      stenosis should be considered in the differential diagnosis in patients with
      focal narrowing of the airway.

PMID- 8352096
TI  - Diagnosis of diseases of the trachea and main bronchi: chest radiography vs CT.
AB  - OBJECTIVE: The purpose of this study was to compare the sensitivities and
      diagnostic accuracies of chest radiography and CT in the assessment of diseases
      of the trachea and main bronchi in regard to detection, evaluation of focal vs
      diffuse disease, separation of benign from malignant disease, and accuracy of
      diagnosis. MATERIALS AND METHODS: The chest radiographs and CT scans of 35
      patients with proved diseases of the trachea and main bronchi and five control
      subjects were randomly assessed by two independent observers in a blind study.
      The diagnoses included 25 malignant and 10 benign conditions. The malignant
      lesions included 24 primary tumors and one metastatic melanoma. The benign
      lesions included two benign tumors, two tracheal stenoses, one focal amyloidosis,
      one tracheomalacia, and four miscellaneous diffuse abnormalities. The observers
      were asked to determine if an abnormality was present, to classify it as focal or
      diffuse and as benign or malignant, and to list the three most likely diagnoses.
      Sensitivities were compared by using the McNemar test. RESULTS: The sensitivity
      of both observers in detecting disease on the chest radiograph was 66%. The
      sensitivity on the CT scan was 97% for the first observer and 91% for the second
      observer (p < .01). Both observers were able to correctly classify the detected
      abnormalities as either focal or diffuse in 91% of cases on the chest radiographs
      and 97% of cases on the CT scans. The abnormalities were correctly classified as
      either benign or malignant in 78% of cases by both observers on the chest
      radiographs and in 85% and 78% of cases on the CT scans by the first observer and
      the second observer, respectively. The correct diagnosis was included in the list
      of the three most likely diagnoses in 61% of cases by both observers after
      reviewing the radiographs and in 56% of cases by one observer and 63% of cases by
      the other observer after reviewing the CT scans. CONCLUSION: CT is superior to
      chest radiography in allowing detection of abnormalities of the major airways.
      Both CT and chest radiography are accurate for differentiating focal from diffuse
      disease, but neither technique is accurate for distinguishing benign from
      malignant disease or for establishing a specific diagnosis.

PMID- 8352097
TI  - CT visualization of the major pulmonary fissures: value of 25 degrees cranially
      tilted axial scans.
AB  - OBJECTIVE: CT visualization of the major (oblique) pulmonary fissures is often
      hampered by partial volume effects of adjacent lung parenchyma. We attempted to
      improve visualization of the fissures by using 25 degrees cranially tilted axial
      scans. An initial in vitro study also was performed. MATERIALS AND METHODS: Both
      conventional and 25 degrees tilted axial CT scans were obtained in 40 adult
      patients. After scans with 2-mm collimation were obtained at 1 cm and 6 cm below
      the carina, the gantry was tilted 25 degrees cranially to be perpendicular to the
      plane of the major fissures, and scans with 2-, 5-, and 10-mm collimation were
      obtained at the same two levels. The appearance of the fissures was classified as
      linear opacity, band-like opacity, or avascular area for each lung at each level.
      RESULTS: On 2-mm conventional axial scans, the major fissures were seen as linear
      opacities in three to 23 patients (8-58%), as band-like opacities in 13-31 (32
      78%), and as avascular areas in one to seven (2-18%). (Ranges indicate lowest and
      highest values when data for the two levels in the two lungs are grouped
      separately.) On 2-mm tilted scans, the ranges were 32-38 patients (80-95%), one
      to eight (2-20%), and zero to one (0-2%), respectively. The 2-mm tilted scans
      were significantly superior to the 2-mm conventional axial scans for showing the
      fissures (p < .01). Direct visualization as linear or band-like opacities was
      possible even on 10-mm tilted scans in 15-32 cases (38-80%). CONCLUSION: Our
      results show that visualization of the major fissure is improved when tilted CT
      scans rather than conventional axial scans are used.

PMID- 8352098
TI  - Lung cysts associated with Pneumocystis carinii pneumonia: radiographic
      characteristics, natural history, and complications.
AB  - OBJECTIVE: The purpose of our study was to characterize the radiographic features
      of thin-walled air-filled structures (cysts) related to Pneumocystis carinii
      pneumonia in a large series of patients, determine the natural history of the
      cysts, and test the hypothesis that the cysts are associated with an increased
      risk of pneumothorax. MATERIALS AND METHODS: Of 100 patients with proved
      pneumocystis pneumonia, 34 (34%) had cysts shown on chest radiographs. The size,
      number, and location of the cysts and their natural history and association with
      pneumothorax were determined. A control group consisting of a random sample of 30
      patients was selected from the 66 patients who had pneumocystis pneumonia but no
      cysts to assess the frequency of pneumothorax in this population. RESULTS: Of 34
      patients with cysts, 32 (94%) had multiple cysts that were 1.0-5.0 cm in
      diameter. Most cysts were in the upper part of the lungs. Most patients had
      complete or partial resolution of the cysts after the acute episode of pneumonia.
      Pneumothoraces occurred in 12 (35%) of the 34 patients with cysts, but in only
      two (7%) of the 30 who did not have cysts (p = .007). CONCLUSION: Cysts related
      to pneumocystis pneumonia are usually multiple, occur most often in the upper
      parts of the lungs, and tend to decrease in size or resolve after the acute stage
      of the infection. In patients with pneumocystis pneumonia, the prevalence of
      pneumothorax is significantly higher in those who have cysts than in those who do
      not. The cysts are similar to pneumatoceles and the high prevalence of
      pneumothorax may be due to the subpleural location of some cysts.

PMID- 8352099
TI  - CT diagnosis of superior vena cava syndrome: importance of collateral vessels.
AB  - OBJECTIVE: The purpose of this study was to evaluate the importance of collateral
      vessels in the CT diagnosis of superior vena cava syndrome. MATERIALS AND
      METHODS: Forty-seven patients with CT evidence of obstruction or compression of
      the superior vena cava or its major tributaries were included in this study.
      Contrast-enhanced CT scans had been obtained with a combined bolus and drip
      infusion technique. We evaluated the CT scans, with particular attention to the
      presence of collateral vessels (and if present, their location), without knowing
      the patients' clinical histories. On reviewing the patients' charts, we found 23
      patients with signs or symptoms of superior vena cava syndrome. We then
      correlated the presence of collateral vessels with the presence of signs and
      symptoms of superior vena cava syndrome. To verify the frequency of visible
      collateral vessels in healthy subjects, we also evaluated CT scans of 50 control
      subjects who did not have mediastinal disease or signs and symptoms of superior
      vena cava syndrome. RESULTS: Collateral vessels were seen on CT scans in 24
      patients. Among the 23 patients who had signs and symptoms of superior vena cava
      syndrome, 22 patients had CT scans that showed collateral vessels. Two cases were
      false-positive and one was false-negative. The presence of collateral vessels,
      regardless of the number and location of the vessels shown on CT scans, was
      highly accurate as a predictor of superior vena cava syndrome, with a sensitivity
      of 96% and a specificity of 92%. Collateral vessels were seen in three (6%) of
      the 50 control subjects. CONCLUSION: We conclude that the presence of collateral
      vessels is a highly sensitive and specific CT sign of superior vena cava
      syndrome.

PMID- 8352100
TI  - Solitary plasma cell tumor of the pleura manifested as massive hemothorax.

PMID- 8352101
TI  - Pulmonary strongyloidiasis: an unusual opportunistic pneumonia in a patient with
      AIDS.

PMID- 8352102
TI  - Arrhythmogenic right ventricular disease: MR imaging vs angiography.
AB  - OBJECTIVE: Arrhythmogenic right ventricular disease (ARVD) is increasingly found
      in young adults with ventricular arrhythmias and is characterized by ventricular
      tachycardia originating within the right ventricle and regional or diffuse
      abnormalities in the contraction of the right ventricle. Until now, the gold
      standard for the detection of global and regional abnormalities of the right
      ventricular wall has been angiography combined with biopsy. The purpose of the
      current study was to compare MR imaging with angiography for assessing the
      location and extent of morphologic and functional abnormalities in patients with
      ARVD. SUBJECTS AND METHODS: Electrocardiographically gated spin-echo and cine
      gradient-echo MR imaging of the heart was performed in 36 consecutive patients
      with biopsy-proved ARVD. Patients were prospectively separated into two groups
      according to the results of invasive electrophysiologic tests (18 with inducible
      ventricular tachycardia during invasive electrophysiologic studies [ARVD 1] and
      18 without inducible ventricular tachycardia [ARVD 2]) and compared with 11
      control subjects. Global and regional morphology and function of the right
      ventricle were assessed with MR imaging, and those findings were compared with
      angiographic findings. RESULTS: Right ventricular ejection fraction was
      significantly lower in patients with ARVD 1 than in patients with ARVD 2 or in
      control subjects. Regional abnormalities of the right ventricular wall also were
      more pronounced in patients with ARVD 1 than in patients with ARVD 2. Signal
      intensity increases corresponding to fatty replacement shown by biopsy were seen
      in 33% of patients with ARVD 1 and in 11% of patients with ARVD 2. Abnormal
      regions of the right ventricular wall seen on MR images corresponded to
      angiographic findings in 86% of patients. Comparison with control subjects showed
      that patients with ARVD 1 had a significant delay in diastolic relaxation of the
      right ventricle. CONCLUSION: Our results show that MR imaging can be used to
      assess morphologic alteration, tissue abnormalities, and global as well as
      regional dysfunction of the right ventricle in patients with ARVD. It may become
      a useful clinical tool for diagnosing and grading ARVD and a worthy substitute
      for angiography and biopsy in the follow-up of patients with ARVD.

PMID- 8352103
TI  - Aortic motion artifact simulating dissection on CT scans: elimination with
      reconstructive segmented images.

PMID- 8352104
TI  - Use of digital mammography in needle localization procedures.
AB  - OBJECTIVE: With digital technology, images can be displayed rapidly and
      manipulated. This study was undertaken to assess the duration and accuracy of
      needle localizations performed with digital vs film-screen technology. These two
      technologies also were compared with respect to radiation doses and ability to
      image a standard phantom. SUBJECTS AND METHODS: A prototype digital mammographic
      system with both a 512 x 512 matrix and a 1024 x 1024 matrix was evaluated by
      using the American College of Radiology mammography accreditation phantom, and
      these results were compared with testing done on commercially available,
      dedicated, analog mammography equipment. Duration, accuracy of needle placement,
      and number of exposures needed to perform localization were recorded for 157
      consecutive needle localizations done with digital technology, and these results
      were compared with data collected from 103 needle localizations done with film
      screen technology. Another 33 localizations attempted with digital imaging were
      aborted because of technical factors. Average glandular doses were calculated for
      those women who had a compressed breast thickness of 4-5 cm. RESULTS: The time to
      complete needle localization was reduced by almost 50%, from 20 to 11 min, when
      digital technology was used. Because of the small (5 x 5 cm) field of view of the
      digital system, an additional mammogram obtained at the onset of the procedure
      was found to be helpful in localization, but otherwise the number of images was
      the same regardless of imaging receptor. Mean glandular dose was reduced by about
      50% with digital imaging from 0.219 to 0.120 cGy. In those 17% (33/190) of needle
      localizations that could not be completed with digital imaging, failure was due
      to a variety of factors. Despite improved detectability of fibrils, specks, and
      masses on digital images, digital systems did not show some fine calcifications
      or soft-tissue masses during needle localizations. Difficulty in imaging lesions
      near the chest wall or in the axilla and the small field of view also caused
      procedures attempted with digital imaging to be aborted and completed with film
      screen systems. CONCLUSION: The time to complete needle localization was reduced
      by 50%, with a similar reduction in patients' radiation dose, when digital
      mammography was used. These findings should be applicable to stereotaxic
      procedures done with digital mammography. Factors limiting the use of digital
      mammography equipment included inability to image some fine calcifications and
      some masses, difficulty in imaging near the chest wall and in the axilla, and a
      small field of view.

PMID- 8352105
TI  - Splenic venous flow exceeding portal venous flow at Doppler sonography:
      relationship to portosystemic varices.
AB  - OBJECTIVE: The purpose of this study was to determine if the Doppler sonographic
      finding of hepatopetal flow in the splenic vein that exceeds hepatopetal flow in
      the portal vein is associated with portosystemic varices. MATERIALS AND METHODS:
      Sixty-four patients with chronic liver disease were studied retrospectively. In
      32 patients, splenic venous flow exceeded portal venous flow (S > P group); in 32
      patients, portal venous flow exceeded splenic venous flow (P > S group). All
      patients were evaluated with Doppler sonography and CT of the upper part of the
      abdomen. Upper endoscopy was performed within 3 months of sonography in 44 of the
      64 patients. RESULTS: In the S > P group, mean splenic volume was significantly
      larger (p = .02) than in the other group. The prevalence of varices as determined
      by CT in the esophageal, coronary, and peripancreatic regions was also higher in
      this group (p < or = .01). When esophageal varices were  present, they were
      judged on the basis of their CT appearance to be massive in 50% of the S > P
      group and in 0% of the P > S group. Upper endoscopy revealed esophageal varices
      in 92% of the S > P group and in 55% of the P > S group (p < .005). Bleeding
      esophageal varices were noted in 75% of the S > P group and in 30% of the P > S
      group (p < .01). CONCLUSION: Patients with chronic liver disease and the Doppler
      sonographic finding of splenic venous flow that exceeds portal venous flow have
      an increased prevalence of portosystemic varices, which tend to be larger and
      more likely to bleed.

PMID- 8352106
TI  - Transdiaphragmatic portosystemic shunt to the pericardiacophrenic vein.

PMID- 8352107
TI  - Segmental anatomy of the liver: utility of a nomenclature accepted worldwide.
AB  - A major use of imaging techniques in the preoperative evaluation of hepatic
      tumors is to help the surgeon determine the feasibility of hepatic resection.
      Although the segmental location of tumors is not the sole criterion for
      determining resectability, such information is crucial for the preoperative
      planning of the type of resection.

PMID- 8352108
TI  - An American's guide to Couinaud's numbering system.

PMID- 8352109
TI  - Hypereosinophilic syndrome: imaging findings in patients with hepatic
      involvement.
AB  - OBJECTIVE: Hypereosinophilic syndrome (eosinophilia without demonstrable cause)
      commonly involves eosinophilic infiltration of the liver and spleen, but few
      reports have described the imaging findings. Accordingly, we reviewed the imaging
      findings in five patients with this syndrome in whom the liver was involved.
      MATERIALS AND METHODS: Five patients who had hypereosinophilic syndrome with
      hepatic involvement were included in the study. The diagnosis of hepatic
      involvement was based on pathologic proof in two patients and on imaging and
      laboratory findings in the other three. Histologic examination of the hepatic
      lesions showed extensive eosinophilic infiltration in two patients and
      centrilobular necrosis in one. All patients had chest radiography, barium studies
      of the gastrointestinal tract, abdominal CT, and sonography. Four patients had
      hepatosplenic scintigraphy. All patients were followed up for 4-24 months.
      RESULTS: All patients had mild to marked hepatomegaly with multiple focal
      lesions. Focal lesions were detected on sonograms in three patients, on CT scans
      in four, and on scintigrams in three. On sonograms, the lesions were usually
      small (less than 2 cm in diameter), sharply or poorly defined nodules with varied
      echogenicity scattered throughout the liver. The lesions were hypodense with
      poorly defined margins on CT scans and appeared as variably sized areas of
      decreased radionuclide uptake on scintigrams. For each patient, the number, size,
      and shape of the lesions varied considerably from one imaging study to another.
      On follow-up studies 2-6 months after treatment, the appearance of the liver was
      normal. Other radiologic findings included transient pulmonary infiltrates (two
      patients), mild cardiomegaly (one patient), and mild lymphadenopathy (three
      patients). CONCLUSION: Hypereosinophilic syndrome is a cause of focal hepatic
      lesions seen on sonograms, CT scans, or scintigrams. The lesions are
      characterized by the varied appearance on the different types of images and the
      disappearance of the lesions with treatment.

PMID- 8352110
TI  - MR findings of multiple biliary hamartomas.

PMID- 8352111
TI  - Histoplasmosis of the colon in patients with AIDS: imaging findings in four
      cases.
AB  - OBJECTIVE: The purpose of this study was to describe and illustrate the
      radiographic findings of colonic histoplasmosis in patients with AIDS. SUBJECTS
      AND METHODS: Four HIV-positive patients were admitted because of fever, abdominal
      pain, tenderness, weight loss, and diarrhea. One patient had known disseminated
      histoplasmosis, one had esophageal moniliasis, and two had no other known
      opportunistic infections or tumors. All four patients had barium enemas, and two
      had abdominal CT examinations. The diagnosis was established via colonoscopic
      biopsy in three patients and with surgery in one patient. RESULTS: Barium enema
      in two patients showed separate, short, apple-core lesions in the transverse and
      descending colon. In one patient, a single lesion in the ascending colon mimicked
      colonic carcinoma. One patient had segmental involvement of the ascending colon,
      compatible with inflammatory bowel disease. CT examination revealed
      circumferential thickening of the wall of the colon with adjacent lymphadenopathy
      of mixed attenuation. Three patients responded to medical therapy, and one
      patient remained symptomatic and was found on a follow-up CT examination to have
      significant recurrence of retroperitoneal lymphadenopathy. CONCLUSION: Colonic
      histoplasmosis in patients with AIDS has protean radiographic features and can
      mimic colonic carcinoma. In these patients, histoplasmosis should be part of the
      differential diagnosis, particularly when several colonic lesions are detected,
      associated regional and retroperitoneal lymphadenopathy is present, and the
      patient is living or has lived in an endemic area.

PMID- 8352112
TI  - Imaging of peritoneal pseudocysts: value of MR imaging compared with sonography
      and CT.
AB  - OBJECTIVE: Peritoneal pseudocysts are created when fluid arising from the ovary
      is trapped by peritoneal adhesions. We studied the value of MR imaging, compared
      with sonography and CT, for detecting these abnormalities. SUBJECTS AND METHODS:
      Nine women, 27 to 49 years old, who had surgically proved peritoneal pseudocysts
      were included in the study. All nine patients were premenopausal, and eight had a
      history of pelvic surgery. All patients were examined with MR imaging and
      sonography, and five were also examined with CT. Imaging findings were analyzed
      and compared with the surgical findings. RESULTS: Sonograms in all nine patients
      showed a thick-walled cyst that contained focal echoes indicating nodules, making
      it difficult to differentiate these lesions from cystic ovarian tumors. In eight
      of the nine patients, the fluid in the pseudocysts had low signal intensity on T1
      weighted MR images and high signal intensity on T2-weighted spin-echo MR images,
      suggesting that the fluid was serous. The pseudocyst had an irregular shape on MR
      images in seven patients and on CT scans in three patients. However, MR provided
      more information than CT did about the nature of the fluid within the pseudocyst.
      CONCLUSION: Our study suggests that MR imaging is more useful than sonography and
      CT for determining the characteristic findings of peritoneal pseudocysts.

PMID- 8352113
TI  - A bad case of medical jargon.

PMID- 8352114
TI  - Assessment of myometrial invasion by endometrial carcinoma: transvaginal
      sonography vs contrast-enhanced MR imaging.
AB  - OBJECTIVE: A prospective study was designed to compare transvaginal sonography
      with contrast-enhanced MR imaging to determine preoperatively the depth of
      myometrial invasion in patients with early-stage endometrial carcinoma. SUBJECTS
      AND METHODS: In 40 patients, findings on transvaginal sonograms, unenhanced T2
      weighted MR images, and contrast-enhanced T1-weighted Mr images were compared
      with histologic findings. The depth of myometrial invasion was classified as
      stage E (tumor limited to endometrium, n = 12), stage S (superficial invasion:
      tumor invades up to 50% of the myometrium, n = 15), or stage D (deep invasion:
      tumor invades more than 50% of the myometrium, n = 13). RESULTS: Findings on
      transvaginal sonograms were accurate in 27 of 40 patients (accuracy, 68%); the
      depth of invasion was overestimated in five patients and underestimated in eight
      patients. The results of unenhanced T2-weighted MR images were accurate in 27
      patients (accuracy, 68%), with four overestimations and nine underestimations.
      The results of contrast-enhanced T1-weighted MR images were accurate in 34
      patients (accuracy, 85%), with five underestimations and one overestimation. In
      the assessment of each stage of myometrial invasion, the sensitivity and
      specificity of contrast-enhanced T1-weighted imaging were higher than those of T2
      weighted MR imaging and transvaginal sonography. The false-positive diagnoses
      based on transvaginal sonograms and T2-weighted images, respectively, involved
      polypoid tumors (n = 4 and 2), distension of the endometrial cavity by pyometra
      (n = 2 and 1), the presence of myoma (n = 2 and 1), atrophy of the myometrium (n
      = 1 and 0), and poor tumor/myometrium contrast (n = 0 and 2). On contrast
      enhanced MR images, accuracy was influenced only in a case of polypoid tumor,
      because tumor, endometrial cavity, and myometrium were clearly distinguished and
      residual myometrium was clearly visualized. With all imaging techniques, false
      negative diagnoses were caused mainly by tumors with superficially spreading
      growth or microscopic invasion. With transvaginal sonography, infiltrative tumor
      also tended to be understaged (n = 3). CONCLUSION: Contrast-enhanced MR imaging
      is significantly superior to transvaginal sonography and unenhanced T2-weighted
      MR imaging for detecting myometrial invasion.

PMID- 8352115
TI  - Multilocular cyst of the kidney.

PMID- 8352116
TI  - Fast spin-echo MR images of the pelvis obtained with a phased-array coil: value
      in localizing and staging prostatic carcinoma.
AB  - OBJECTIVE: The fast spin-echo pulse sequence allows T2-weighted MR images to be
      acquired more rapidly than is possible with conventional spin-echo sequences, and
      phased-array coils can provide a higher signal-to-noise ratio than is possible
      with the body coil. The combination of these methods permits higher resolution
      images to be obtained with more signal averages despite shorter imaging times. In
      this study, initial technical comparisons designed to confirm the advantage of
      combining fast spin-echo pulse sequences with a pelvic phased-array multicoil
      were followed by an assessment of the value of these methods for the localization
      and staging of prostatic carcinoma. SUBJECTS AND METHODS: Seventy-one men with
      known (60) or suspected (11) prostatic carcinoma were imaged with T2-weighted
      fast spin-echo pulse sequences in the axial and coronal planes with a phased
      array of four surface coils (multicoil) for signal reception. Four of these men
      also were imaged with fast spin-echo sequences and the body coil, and six of
      these men also were imaged with T2-weighted conventional spin echo sequences and
      the multicoil; image qualities achieved with these techniques were compared. The
      use of IV glucagon (42 of 71 studies) before fast spin-echo sequences was
      correlated with the subsequent presence or absence of peristaltic artifacts on MR
      images. MR images were analyzed for the presence or absence of prostatic cancer
      in the right and left sides of the gland and for evidence of spread either
      through the capsule, into the seminal vesicles, or to lymph nodes or bone.
      Findings at MR imaging were compared with results of radical prostatectomy (20),
      lymph node dissection without prostatectomy (seven), and biopsy (67). RESULTS:
      Image quality obtained with the combination of the fast spin-echo sequence with
      the multicoil was judged superior to that obtained with either the conventional
      spin-echo sequence with the multicoil or the fast spin-echo sequence with the
      body coil. Significant motion artifacts were noted in 45% of studies (13/29)
      performed without glucagon vs 7% of studies (3/42) performed with glucagon. In
      the 58 patients for whom information concerning the location of tumor in either
      the right or left side of the gland was obtained from biopsy (39) or surgery
      (19), MR images allowed cancer to be detected with 89% sensitivity and 77%
      specificity. Among the 20 patients undergoing prostatectomy and seven others
      undergoing lymph node dissection, MR imaging permitted high accuracies in
      predicting involvement of the seminal vesicles (100%), local transcapsular spread
      (85%), and involvement of pelvic lymph nodes (85%). CONCLUSION: Fast spin-echo
      imaging with a pelvic phased-array multicoil provides high-resolution images of
      the prostate that may obviate an endorectal coil for the detection, localization,
      and staging of prostatic carcinoma.

PMID- 8352117
TI  - MR imaging of the ankle and foot: normal structures and anatomic variants that
      may simulate disease.
AB  - In the past, MR imaging of the ankle and foot has been performed by scanning both
      extremities simultaneously to provide a normal side for comparison. More
      recently, unilateral imaging with small local coils has been favored to maximize
      spatial resolution through use of small fields of view or large matrices. Such
      clarity of detail, however, demands a greater knowledge of normal anatomy and
      anatomic variants. We illustrate the MR appearances of a number of variants
      involving muscle, tendons, ligaments, and osseous structures of the foot and
      ankle. Familiarity with these findings is essential to prevent errors in the
      interpretation of MR images.

PMID- 8352118
TI  - Free vascularized fibular grafts: radiographic evidence of remodeling and
      hypertrophy.
AB  - OBJECTIVE: A study was undertaken to determine the growth potential and
      radiographic appearance of a free vascularized fibular graft as it responds to
      the mechanical and physiologic features of its new environment. MATERIALS AND
      METHODS: In a 10-year period, 30 patients underwent reconstruction of a large
      skeletal defect with a vascularized fibular graft. Radiographic studies were
      adequate for assessing sequential changes in 21 patients. Hypertrophy was
      evaluated by serial measurements of the periosteal and endosteal dimensions and
      was assessed with respect to age, sex, duration and location of the graft, the
      indication for reconstruction, and fixation apparatus. RESULTS: Hypertrophy of
      vascularized bone grafts is not rare. Among 21 vascularized fibular grafts, a
      measurable degree of hypertrophy was found in eight. Hypertrophy was caused by
      periosteal formation of new bone. The amount of hypertrophy could be
      considerable; in some cases it reached 2 cm of new cortical bone, resulting in an
      unusual radiographic appearance of marked cortical thickening. The amount of
      hypertrophy was greatest in young males, but was independent of diagnosis and
      site, and could be seen even in grafts bridged by metallic plates. CONCLUSION:
      Hypertrophy of vascularized bone grafts is a relatively frequent finding and has
      distinctive radiographic features. It is unclear why hypertrophy occurs to a much
      greater extent in some grafts than in others.

PMID- 8352120
TI  - Calcaneus as a site for assessment of bone mineral density: evaluation in
      cadavers and healthy volunteers.
AB  - OBJECTIVE: The value of calcaneal dual-energy X-ray absorptiometry for monitoring
      changes in bone mineral density has not yet been established. Accordingly, the
      focus of this study was to determine the usefulness of the calcaneus as the site
      for bone mineral density measurement with dual-energy X-ray absorptiometry.
      SUBJECTS AND METHODS: Dual-energy X-ray absorptiometry of the calcaneus was
      performed in 19 specimens derived from 11 cadavers and 337 healthy volunteers to
      assess accuracy, in vivo precision, and age-related changes in bone mineral
      density. We also compared calcaneal bone mineral density determined by dual
      energy X-ray absorptiometry with lumbar spine bone mineral density determined by
      dual-energy X-ray absorptiometry (L1-L4) or quantitative CT (L3). RESULTS:
      Studies of specimens showed that dual-energy X-ray absorptiometry had an error
      rate of 6%. In addition, strong correlations were found between bone mineral
      content and ash weight (r = .97, p < .0001) and between bone mineral density and
      ash density (r = .87, p < .0001). In vivo studies showed moderate correlations
      between calcaneal bone mineral density determined by dual-energy X-ray
      absorptiometry and lumbar spine bone mineral density determined by dual-energy X
      ray absorptiometry (men, r = .77, p < .0001; women, r = .76, p < .0001) and
      lumbar spine bone mineral density by quantitative CT (men, r = .68, p < .0001;
      women, r = .68, p < .0001). Calcaneal bone mineral density measured by dual
      energy X-ray absorptiometry and lumbar spine bone mineral density measured by
      quantitative CT continued to decrease throughout the postmenopausal period.
      However, lumbar spine bone mineral density determined by dual-energy X-ray
      absorptiometry did not show further decreases in subjects more than 70 years old.
      CONCLUSION: Taken together, these results suggest that the calcaneus can be used
      as an additional site for determining bone mineral density to assess osteopenia
      in patients when deformities of the spine make quantitative CT or other methods
      of density measurement impossible.

PMID- 8352119
TI  - Motion of the patella during walking: a video digital-fluoroscopic study in
      healthy volunteers.
AB  - OBJECTIVE: The alignment of the quadriceps muscle and patella suggests that the
      patella should deviate laterally out of the patellar groove as the quadriceps
      muscle contracts during walking. The surgical treatment of patellar subluxation
      has been based on this presumption. The purpose of this study was to determine
      the movements of the patella in relation to the other bones of the knee joint
      during normal walking. This is the first study we know of that uses radiographs
      to show these movements. SUBJECTS AND METHODS: Eight healthy adult volunteers
      with no previous complaints referable to the knee walked on a slowly moving
      treadmill while their patellae were imaged fluoroscopically in the
      anteroposterior plane with a Toshiba C-arm. Images were retrieved, transferred to
      radiographic film, and randomized to prevent the observers from knowing the order
      of images. The position of the patella was measured and plotted in relation to
      fixed points of the knee. RESULTS: In each of the subjects at every gait cycle,
      the patella was observed to move vertically first, followed by a sudden shift to
      the medial side before returning to its original position. CONCLUSION: Contrary
      to conventional understanding, our results show that the patella deviates
      medially rather than laterally during walking. This occurs because of
      differential contraction of the components of the quadriceps muscle during
      walking. The management of painful and subluxated patellae must be reevaluated in
      light of this finding.

PMID- 8352121
TI  - Cytologic analysis in fine-needle aspiration biopsy: smears vs cell blocks.
AB  - OBJECTIVE: Imaging-directed fine-needle aspiration biopsy can be performed with
      or without immediate cytologic assessment (smears). We compared the results
      obtained immediately from cytologic smears with the results of cell-block
      analysis. We wished to determine the frequency of false-negative findings on
      cytologic smears in patients subsequently found to have malignant tumors by cell
      block analysis. MATERIALS AND METHODS: We retrospectively reviewed the records
      for 100 consecutive biopsies performed between January 1986 and August 1987. In
      each case, specimens were obtained from both a 22-gauge and a 20-gauge notched
      needle placed in tandem. The study group consisted of 84 patients who had results
      of analyses of both cytologic smears and cell blocks available for review and who
      had clinical or surgical correlation. RESULTS: Sixty-four (76%) of the 84
      biopsies yielded malignant tumor cells, 11 yielded evidence of a benign process,
      and nine were not diagnostic. Malignant tumor cells were seen on the cytologic
      smears in 55 (86%) of the 64 patients who had malignant tumors; in the other nine
      patients, the malignant tumors were indicated by the cell-block analysis only.
      Within the group of benign disorders, in only one case (9%) was the cell block
      diagnostic when the cytologic smear was not. CONCLUSION: Operators performing
      fine-needle aspiration biopsy should be aware of the limitations of immediate
      cytologic evaluation. Cell-block analysis of the aspirate remaining after the
      smears are made can be expected to increase the diagnostic accuracy in up to 14%
      of patients.

PMID- 8352122
TI  - CT-guided celiac ganglion block with alcohol.
AB  - Celiac ganglion block has been performed without radiologic guidance by surgeons
      or anesthetists since it was first described by Kappis [1] in 1914. Radiographic
      guidance for celiac block was first reported in the 1950s [2], and more recently,
      radiologists have used CT to guide needle placement [3-5]. With CT guidance, more
      directed positioning of the needle is possible, allowing alcohol to be deposited
      in the specific ganglion areas. This article reviews our collective experience
      with CT-guided celiac ganglion block.

PMID- 8352123
TI  - Dislodgment of inferior vena caval filters during "blind" insertion of central
      venous catheters.

PMID- 8352124
TI  - High-dose chloral hydrate sedation for children undergoing MR imaging: safety and
      efficacy in relation to age.
AB  - OBJECTIVE: Sedation is frequently essential for successful MR imaging, and
      chloral hydrate is the most commonly used drug for this purpose in infants and
      children. Our experience with these patients suggested that this sedative is less
      effective in older children, even when administered in high doses. However, no
      prospective study comparing the efficacy of chloral hydrate sedation for children
      of different ages undergoing MR imaging has been reported. Accordingly, we
      performed a study to evaluate the effectiveness and safety of chloral hydrate
      sedation in children of various ages. SUBJECTS AND METHODS: The study included
      300 infants and children, 1 month to 11 years old (mean, 3 years), who were given
      oral chloral hydrate, 100 mg/kg, for sedation before MR imaging. The maximum
      total dose administered was 2.5 g, which limited the study to children who
      weighed 25 kg or less. Sedation was considered successful when MR studies were
      completed and at least 95% of the images had little or no motion artifact.
      RESULTS: Sedation was successful in 273 (91%) of 300 children. It was
      unsuccessful in nine of the 203 children who were 48 months old or younger (96%
      success rate) and in 18 of the 97 children who were more than 48 months old (81%
      success rate). A single-tailed t-test showed that the children in whom sedation
      was unsuccessful were significantly older than those in whom it was successful to
      the .0005 level of significance. The failure rate increased steadily for children
      more than 48 months old. Several failures may also have resulted from lengthy
      examination times. Adverse reactions to chloral hydrate sedation included
      hyperactivity (6%), vomiting (4%), and mild respiratory depression (4%). No
      adverse reaction was severe enough to require hospitalization. CONCLUSION: The
      higher failure rate for chloral hydrate sedation in children more than 48 months
      old suggests that the patient's age is an important limitation to the usefulness
      of chloral hydrate sedation for children undergoing MR imaging. However, the low
      rate of adverse reactions makes chloral hydrate a safe drug for sedation of
      children undergoing MR imaging.

PMID- 8352125
TI  - Osteomyelitis in hospitalized children with chickenpox: imaging findings in four
      cases.
AB  - OBJECTIVE: The most common complications of chickenpox are skin and soft-tissue
      infections. Pneumonia and CNS involvement occur less often, and skeletal
      complications are considered rare. The purpose of this study was to evaluate the
      imaging findings of osteomyelitis in children after chickenpox. MATERIALS AND
      METHODS: We retrospectively reviewed the records of children admitted to our
      institution because of chickenpox and analyzed the imaging findings in those who
      had skeletal involvement. Ninety-seven patients were admitted between January
      1991 and January 1993 because of chickenpox or a complication thereof. Four
      previously healthy patients, three boys and one girl, between 1 and 6 years old
      had osteomyelitis. Staphylococcus aureus was isolated from bone in one patient,
      and group A beta-hemolytic streptococcus was isolated from blood cultures in
      another. No organism was grown in the other two; necrotic bone was recovered from
      one lesion and the other healed with periosteal formation of new bone typical of
      osteomyelitis. All patients were treated with IV antibiotics, and their
      recoveries were uncomplicated. RESULTS: Conventional radiographs showed loss of
      fat planes in three patients and destruction of bone in two. Bone scintigraphy
      showed increased uptake of radionuclide in early and late phases in three
      patients. Uptake in one case was extensive, with a central area of relatively
      little uptake corresponding to a subperiosteal fluid collection. CT in two and MR
      imaging in one showed subperiosteal fluid collections surrounding the involved
      bones in association with bone and marrow changes. CONCLUSION: Osteomyelitis was
      the fourth most common complication of chickenpox in our series. The appearances
      on conventional radiographs and scintigrams are indistinguishable from those of
      typical bacterial osteomyelitis. However, CT and MR imaging showed subperiosteal
      fluid collections in three of four patients, an appearance only occasionally seen
      with typical osteomyelitis.

PMID- 8352126
TI  - Aspergilloma complicating cystic fibrosis.

PMID- 8352127
TI  - Thoracic duct cyst in the middle part of the mediastinum.

PMID- 8352128
TI  - Retained surgical sponge after subtotal thyroidectomy.

PMID- 8352129
TI  - Extensive calcification in the inferior vena cava in an adult.

PMID- 8352130
TI  - Asymmetric uterine enlargement: a reliable sign of leiomyomas.

PMID- 8352131
TI  - Fibroepithelial polyp implanted on a ureterocele.

PMID- 8352132
TI  - Double gloving during interventional procedures.

PMID- 8352133
TI  - Bilateral acute thalamic infarcts causing thalamic dementia.

PMID- 8352134
TI  - Tuberous sclerosis with calcification of the cerebellar folia: CT and MR
      findings.

PMID- 8352135
TI  - Routine use of gadopentetate dimeglumine in cranial MR imaging of patients with
      AIDS.

PMID- 8352136
TI  - Tuberculosis of sphenoidal sinus: CT findings.

PMID- 8352137
TI  - Neuroendocrine tumor (paraganglioma) of the cauda equina: MR and pathologic
      findings.
AB  - The MR and pathologic features of a case with neuroendocrine tumor
      (paraganglioma) of the cauda equina are presented. MR showed the tumor to be
      hyperintense on postcontrast examination and also showed serpiginous flow voids
      suggesting vessels capping the tumor. A neuroendocrine tumor should be considered
      in the differential diagnosis of tumors in this location.

PMID- 8352139
TI  - Bilateral nasolacrimal duct mucocele, a rare cause of respiratory distress: CT
      findings in two newborns.
AB  - Two newborns presented with severe respiratory distress caused by nasal
      obstruction. CT showed bilateral soft-tissue masses located under the inferior
      turbinates at the level of the inferior meatuses. Histologic examination showed
      the lesions to be compatible with nasolacrimal mucoceles. The embryology and
      radiographic features of this rare anomaly are discussed.

PMID- 8352138
TI  - Infected congenital mucocele of the nasolacrimal duct.
AB  - The authors report their experience with an infant presenting with an infected
      nasolacrimal duct mucocele, emphasizing correlation of clinical, CT, and surgical
      findings. CT is the imaging modality of choice to demonstrate the triad of 1) a
      cystic medial canthal mass, 2) dilatation of the nasolacrimal duct, and 3) a
      submucosal nasal cavity mass; findings which are diagnostic of this entity. A
      brief review of the relevant embryology is also presented.

PMID- 8352140
TI  - High-dose cytarabine neurotoxicity: MR findings during the acute phase.
AB  - The authors report an acute cerebral and cerebellar syndrome in a patient treated
      with high-dose cytarabine. Diffuse high-intensity lesions in the central white
      matter on T2-weighted MR completely reversed with resolution of the clinical
      syndrome. Although the autopsy revealed cerebellar injury, the cerebral cortex
      was grossly and microscopically normal, consistent with a reversible process.

PMID- 8352141
TI  - Usefulness of brain blood-flow imaging.

PMID- 8352142
TI  - Oversight by authors?

PMID- 8352143
TI  - Specialization's absurd limit.

PMID- 8352144
TI  - Treatment of experimental canine carotid aneurysms with platinum coils.
AB  - PURPOSE: To evaluate and compare the deliverability, positioning, stability, and
      effectiveness of aneurysm occlusion and the incidence of parent-artery thrombosis
      of two different types of platinum coils, using a canine carotid aneurysm model.
      METHODS: 29 experimental canine carotid aneurysms (19 lateral, 6 bifurcation, and
      4 terminal) were constructed and treated with complex-shaped fibered platinum
      coils and simple curved nonfibered platinum Guglielmi detachable coils (GDCs).
      RESULTS: Fibered complex coils were stable, producing 38% complete aneurysm
      occlusion and 61% average reduction in aneurysm lumen size but resulting in 19%
      parent artery occlusions. GDC coils were stable, producing 31% complete aneurysm
      occlusion and 95% average reduction in aneurysm lumen size with no parent-artery
      occlusions. CONCLUSIONS: GDC coils produced an average reduction in aneurysm
      lumen size of 95% without any associated parent-artery occlusions. There were no
      delayed migrations of GDC coils. The ability to remove, reposition, and detach a
      coil was the most significant feature of the GDC coil.

PMID- 8352145
TI  - Platinum coil coatings to increase thrombogenicity: a preliminary study in
      rabbits.
AB  - The authors investigate a modification of the Gugliemi detachable coil. They have
      developed a rabbit model and coating technique to test differences in
      thrombogenicity of platinum coils with a variety of polyurethanes.

PMID- 8352146
TI  - The "current" status of aneurysm treatment?

PMID- 8352147
TI  - Canine model of terminal arterial aneurysm.
AB  - A canine model of terminal aneurysms using a venous pouch surgical technique is
      described. This model mimics the anatomy and hemodynamics of some types of
      carotid and basilar tip aneurysms. This technique produces aneurysms 15 x 21 mm
      in size. The aneurysms have been used to investigate the hemodynamics and
      treatment of terminal aneurysms.

PMID- 8352148
TI  - An endovascular retrieving device for use in small vessels.
AB  - A new retrieval device for use in small vessels was evaluated in a canine model.
      Retrieval was attempted on 25 coils, three silicone balloons, and five catheter
      and guide wire fragments placed in the renal, pulmonary, hepatic,
      brachiocephalic, subclavian, carotid, and maxillary arteries. This was successful
      in 91% (30/33). The snare could also be selectively placed in the vertebral and
      proximal basilar arteries.

PMID- 8352149
TI  - Microcatheter retrieval device for intravascular foreign body removal.
AB  - A microcatheter foreign body retrieval device is described and its first two
      clinical applications are presented. The device functions identically to larger
      loop snare retrievers. It permits access to small vessels and was successful in
      its first clinical applications.

PMID- 8352150
TI  - Spinal epidural arteriovenous fistulas: arterial and venous approaches to
      embolization.
AB  - The authors describe two patients with multiple spinal arteriovenous fistulas and
      exclusive epidural venous drainage. Both presented with a myelopathy caused by
      compression by large epidural veins. Both had arterial embolizations, but one
      required a venous approach to achieve a stable clinical result.

PMID- 8352151
TI  - Carotid sinus syndrome and embolization procedures.
AB  - Two patients developed carotid sinus syndrome following embolization procedures.
      One patient had undergone balloon occlusion of the internal carotid artery; in
      the other patient, embolization of a carotid body tumor had been performed. The
      method of diagnosis as well as the etiology and treatment are discussed.

PMID- 8352152
TI  - Intraarterial papaverine for the treatment of vasospasm.
AB  - The authors describe the use of intraarterial papaverine to treat vasospasm
      following subarachnoid hemorrhage. Two cases are reported: a 40-year-old woman
      with a posterior communicating artery aneurysm and a 67-year-old man with a
      posterior cerebral artery aneurysm. Both patients developed symptomatic,
      angiographically demonstrated vasospasm that responded to papaverine infusion.

PMID- 8352153
TI  - MR imaging of Kallmann syndrome, a genetic disorder of neuronal migration
      affecting the olfactory and genital systems.
AB  - PURPOSE: We report the MR findings in nine patients with clinical and laboratory
      evidence of Kallmann syndrome (KS), a genetic disorder of olfactory and gonadal
      development. In patients with KS, cells that normally express luteinizing hormone
      releasing hormone fail to migrate from the medial olfactory placode along the
      terminalis nerves into the forebrain. In addition, failed neuronal migration from
      the lateral olfactory placode along the olfactory fila to the forebrain results
      in aplasia or hypoplasia of the olfactory bulbs and tracts. Patients with KS,
      therefore, suffer both reproductive and olfactory dysfunction. METHODS: Nine
      patients with KS underwent direct coronal MR of their olfactory regions in order
      to assess the olfactory sulci, bulbs, and tracts. A 10th patient had MR findings
      of KS, although the diagnosis is not yet confirmed by laboratory tests. RESULTS:
      Abnormalities of the olfactory system were identified in all patients. In
      particular, the anterior portions of the olfactory sulci were uniformly
      hypoplastic. The olfactory bulbs and tracts appeared hypoplastic or aplastic in
      all patients in whom the bulb/tract region was satisfactorily imaged. In two
      (possibly three) patients, prominent soft tissue in the region of the bulbs
      suggests radiographic evidence of neurons that have been arrested before
      migration. CONCLUSIONS: Previous investigators of patients with KS used axial MR
      images to demonstrate hypoplasia of the olfactory sulci but offered no assessment
      of the olfactory bulbs. In the present study we used coronal images to show
      hypoplasia of both olfactory sulci and bulbs. In addition, we found what we
      believe to be the radiologic correlate of arrested neuronal migration in KS.

PMID- 8352154
TI  - Kallmann syndrome: MR evaluation of olfactory system.
AB  - PURPOSE: To describe the MR appearance of the olfactory bulbs and tracts and
      temporal lobes in patients with Kallmann syndrome, a disorder characterized by
      hypogonadotropic hypogonadism and anosmia. METHODS: High-resolution MR scans with
      a surface coil placed over the nasion were performed in two patients with
      Kallmann syndrome. Coronal 3-mm thick contiguous sections were obtained through
      the olfactory bulbs and tracts. MR scans included volumetric analysis of the
      bulbs, tracts, temporal lobes, and hippocampi. RESULTS: No olfactory bulbs or
      tracts could be identified in patients with Kallmann syndrome. In comparison, the
      olfactory bulbs and tracts were identifiable in seven healthy volunteers. The
      temporal lobe and hippocampal volumes were comparable between control subjects
      and Kallmann patients. CONCLUSIONS: High-resolution surface-coil MR can identify
      the absence of olfactory bulbs and tracts in patients with Kallmann syndrome.
      Normal olfactory bulbs and tracts are easily discerned with surface-coil imaging.

PMID- 8352155
TI  - Kallmann syndrome: MR findings.
AB  - PURPOSE: To evaluate patients with known hypogonadotropic hypogonadism, some with
      known anosmia, for defective rhinocephalon development that resulted in olfactory
      tract abnormalities, an affliction known as Kallmann syndrome. METHODS: Six
      patients who clinically had hypogonadotropic hypogonadism were examined by MR.
      Thin coronal images of the interior frontal region were used to determine
      presence or absence of olfactory tract and to evaluate the olfactory sulci.
      RESULTS: Olfactory tracts were not seen in three of the six cases; two of which
      had hypoplastic olfactory sulci. CONCLUSIONS: T1-weighted MR examination of the
      inferior frontal region in the coronal plane can help determine whether a patient
      with hypogonadotropic hypogonadism, with or without clinically evident anosmia,
      is afflicted with Kallmann syndrome.

PMID- 8352156
TI  - Bringing Kallmann syndrome into focus.

PMID- 8352157
TI  - CT and MR in infants with pericerebral collections and macrocephaly: benign
      enlargement of the subarachnoid spaces versus subdural collections.
AB  - PURPOSE: To compare CT and MR in the differentiation of benign enlargement of the
      subarachnoid spaces and subdural collections in infants with macrocephaly.
      METHODS: MR was performed in 19 infants with macrocephaly, showing bifrontal
      enlargement of the subarachnoid spaces on CT. RESULTS: In 11 patients, a single
      fluid layer could be distinguished on MR of the pericerebral collections,
      suggesting benign enlargement of the subarachnoid spaces. In eight patients, two
      separate layers were clearly differentiated, an outer layer that was hyperintense
      on all sequences and an inner layer with the same intensity as the cerebrospinal
      fluid. This indicated the presence of subdural collections. These collections
      were mainly frontal in six and extended over the entire hemisphere in two
      patients. On CT, these separate lesions were seen only in three patients and
      missed in three others. In two final patients, CT findings were equivocal with
      evidence of membrane formation within the hypodense collections. In seven
      patients with a subdural collection, subdural-external drainage was performed. In
      three patients, the collection was hemorrhagic. The protein content of the fluid
      showed a mean of 1381.7 +/- 785.6 mg/dL. The MR and surgical findings of a
      subdural collection correlated with the absence of a family history of
      macrocrania, an age under 5 months, and acute clinical signs of vomiting,
      somnolence, and hypotonia. CONCLUSION: MR appears essential in the differential
      diagnosis between benign enlargement of the subarachnoid spaces and subdural
      collections in infants.

PMID- 8352158
TI  - PEHO syndrome (progressive encephalopathy with edema, hypsarrhythmia, and optic
      atrophy): neuroradiologic findings.
AB  - PURPOSE: To investigate the radiologic characteristics of the clinical
      progressive encephalopathy with edema, hypsarrhythmia, and optic atrophy (PEHO)
      symptom complex. This complex is nonspecific, but within this syndrome, a
      subgroup with a defined neuropathologic phenotype and apparently autosomal
      recessive inheritance exists. METHODS: Brain CT or MR studies were performed on
      21 patients with the clinical PEHO syndrome. Their previous neuroradiologic
      studies were re-evaluated. RESULTS: Twelve patients (group A) showed uniform
      changes with early progressive brain atrophy accentuated infratentorially, and
      abnormal myelination. The gyral pattern was normal. Brain atrophy of nine
      patients (group B) differed by being less progressive, supra- rather than
      infratentorial, and often combined with abnormal gyral formation. CONCLUSIONS:
      Postmortem studies permitted correlation of radiographic and morphologic findings
      in three cases. Two autopsied group A patients were compatible with the true PEHO
      syndrome, while one group B patient was incompatible. Group A seems to correspond
      to the core group of the PEHO syndrome. During a patient's life, a suggestive
      diagnosis of the true PEHO syndrome is thus feasible, although neuropathologic
      studies are needed for a conclusive diagnosis.

PMID- 8352159
TI  - An in vitro study of magnetization transfer and relaxation rates of hematoma.
AB  - PURPOSE: To assess, in an in vitro model of acute hematoma, whether hemoglobin
      immobilization by clot and red cell membrane aging can account for the T2
      shortening usually attributed to deoxyhemoglobin. METHODS: Clotted and
      heparinized blood samples were packed (100% hematocrit). The apparent
      magnetization transfer rate (AMTR), T1 and T2 relaxation rates of the samples,
      and images with a volunteer's head were obtained at 1.5 T. RESULTS: The AMTR and
      T1 and T2 relaxation rates were unaffected by the presence of clot. The AMTR was
      unaffected by red cell aging. The diamagnetic packed blood samples, which are
      much denser than brain, were isointense to gray matter on T2-weighted images and
      had about one-fifth the AMTR of white matter. CONCLUSIONS: Hemoglobin
      immobilization by clot structure or red cell contraction with aging is
      insignificant and does not contribute to the T2 shortening of acute hematoma. The
      low AMTR and T2 relaxation rates of diamagnetic blood appear to be caused by the
      mobility of hemoglobin and by the red cell's lack of immobile macromolecular
      structures such as those associated with nucleated brain cells.

PMID- 8352160
TI  - Magnetization transfer effects in MR imaging of in vivo intracranial hemorrhage.
AB  - PURPOSE: Recent papers have hypothesized that diamagnetic effects of clotting and
      conformational changes in aging red blood cells immobilize the hemoglobin protein
      and thus are responsible for the marked hypointensity of acute hematomas on T2
      weighted spin-echo MR images. To test that hypothesis, the authors evaluated 24
      hemorrhagic components of intracranial hemorrhagic lesions using accepted
      criteria based on spin-echo images as the definitions of the stage of the
      hemorrhage. METHODS: As a measure of the effects of macromolecular (hemoglobin
      protein) immobility, magnetization transfer contrast was elicited using a pulsed
      saturation magnetization transfer experiment. The apparent magnetization transfer
      contrast (AMTC) was determined by comparing the signal intensities of saturated
      with unsaturated images and quantified for acute isolated hemorrhages, acute
      nonisolated hemorrhagic lesions, and subacute-to-chronic hemorrhages. RESULTS:
      The AMTC of isolated acute hemorrhage was significantly less than that of normal,
      white matter and gray matter, indicating the lack of significant magnetization
      transfer and therefore the lack of effects of restriction of hemoglobin mobility
      on the signal intensity of acute hemorrhage. Acutely hemorrhagic tissue
      (nonisolated acute hemorrhage) has significantly more AMTC than isolated acute
      hemorrhage, but still not exceeding that of brain parenchyma. CONCLUSION: This in
      vivo data concurs with in vitro data and reinforces the concept that the marked
      hypointensity of acute hematomas is mainly a magnetic susceptibility effect.

PMID- 8352161
TI  - CT in penetrating craniocervical injury by wooden foreign bodies: reminder of a
      pitfall.
AB  - The authors report three cases of penetrating craniocervical injury by wooden
      foreign bodies, which were initially hypodense on CT and thought to be air. When
      these structures were scrutinized with higher window settings, they had a higher
      attenuation and a unique striated internal architecture which the authors propose
      may be specific to wood.

PMID- 8352163
TI  - Interuncal distance measurements in healthy volunteers and in patients with
      Alzheimer disease.
AB  - PURPOSE: To evaluate further the clinical utility of the interuncal distance
      (IUD) measured from axial MR scans as a reflection of hippocampal atrophy.
      METHODS: The IUD measured from the axial MR scans of 17 healthy control subjects
      was correlated with the volume of the amygdala hippocampal complex obtained from
      coronal MR images. The IUD was also measured on axial MR scans in 12 patients
      with possible or probable Alzheimer disease. RESULTS: The correlation between the
      total amygdala hippocampal volume and the IUD was insignificant for control
      subjects (r = -0.38, P = .13). When analysis of covariance was performed with the
      IUD as the dependent variable and age and diagnosis as the independent variables,
      overall R2 was 0.25. Age (F = 5.02, df = 1, P = .034), but not diagnosis (F =
      0.02, df = 2, P = .88), had a significant effect. CONCLUSIONS: The IUD has no
      significant correlation with the amygdala hippocampal volume. The IUD appears to
      be a better measure of overall brain volume, which changes with age. In our
      patient population diagnosed with mild to moderate Alzheimer disease, the IUD
      measurement was not found to be useful in distinguishing their scans from those
      of the volunteers.

PMID- 8352162
TI  - The radiologic prediction of Alzheimer disease: the atrophic hippocampal
      formation.
AB  - PURPOSE: To test the hypothesis that atrophy of the hippocampal formation in
      nondemented elderly individuals would predict subsequent Alzheimer disease.
      METHOD: We studied 86 subjects at two time points, 4 years apart. At baseline all
      study subjects were nondemented and included 54 control subjects and 32 persons
      who had memory complaints and minimal cognitive impairments. All subjects
      received a CT scan using a protocol designed to image the perihippocampal
      cerebrospinal fluid (HCSF) accumulating in the fissures along the axis of the
      hippocampal formation. Blind to the clinical evaluations, we subjectively
      assessed the presence of HCSF at the baseline. Retrospectively, we examined the
      predicted association between baseline HCSF and clinical decline as determined
      across the two evaluations. RESULTS: At follow-up 25 of the 86 subjects had
      deteriorated and received the diagnosis of Alzheimer disease. Of the declining
      subjects, 23 came from the minimally impaired group, and 2 came from the control
      group. In the minimally impaired group the baseline HCSF measure had a
      sensitivity of 91% and a specificity of 89% as a predictor of decline. Both
      control subjects who deteriorated were also correctly identified at baseline. One
      of these two subjects died, and an autopsy confirmed the presence of Alzheimer
      disease. M(r) validation studies demonstrated that HCSF is quantitatively related
      to dilatation of the transverse fissure of Bichat and the choroidal and
      hippocampal fissures. CONCLUSION: Our findings strongly suggest that among
      persons with mild memory impairments, dilatation of the perihippocampal fissures
      is a useful radiologic marker for identifying the early features of Alzheimer
      disease.

PMID- 8352164
TI  - Reflections from the backseat.

PMID- 8352165
TI  - Locating the central sulcus: comparison of MR anatomic and
      magnetoencephalographic functional methods.
AB  - PURPOSE: To compare MR anatomic and magnetoencephalographic (MEG) functional
      methods in locating the central sulcus. METHODS: Eleven healthy subjects and five
      patients with focal cerebral lesions were studied. The central sulcus was located
      anatomically with MR by two independent observers using axial vertex and sagittal
      (midline and lateral) images. Locations via the MEG functional method were based
      on detecting the somatosensory-evoked magnetic fields elicited by painless
      tactile stimuli. RESULTS: The axial method yielded the most consistent interrater
      results, with complete agreement in 76% of sections in both control subjects and
      patients. The intermethod discordance of the sagittal midline and lateral methods
      was 32% in control subjects and 33% in patients. The concordance of MR and MEG
      methods ranged from 55% to 84% in control subjects and 65% to 67% in patients.
      CONCLUSION: MR anatomic techniques can usually identify the central sulcus, but
      in the presence of anatomic distortion, the MEG functional method adds
      significant information.

PMID- 8352166
TI  - The central sulcus and surgical planning.

PMID- 8352167
TI  - Radiologic-pathologic correlation. Diffuse pontine astrocytoma.
AB  - This case demonstrated the classic gross, pathologic, CT, and MR findings of
      pontine astrocytoma. The role of functional brain imaging in identifying regrowth
      of tumor was illustrated and the differential diagnosis of a brain stem lesion
      summarized.

PMID- 8352168
TI  - Predominantly extraaxial astroblastoma: imaging and proton MR spectroscopy
      features.
AB  - The CT, angiographic, MR, and proton MR spectroscopy findings in a case of
      astroblastoma, a rare neoplasm of glial cell origin, are presented. Of particular
      interest is the predominantly extraaxial location of the tumor. CT and MR
      demonstrated a complex mass consisting of a solid nodule and a peripheral
      septated cystic component. The extraaxial nature of the mass was suggested on MR.

PMID- 8352169
TI  - Neuroepithelial (colloid) cyst of the cerebellar vermis containing a
      xanthogranuloma.
AB  - A case of a neuroepithelial cyst of the cerebellar vermis is presented. The cyst
      contained a viscous fluid and a xanthogranulomatous nodule. The fluid showed high
      signal on T1- and low signal on T2-weighted MR images. The xanthogranuloma showed
      mixed intensities with partial contrast enhancement. The correlation of the cyst
      contents and MR signals is discussed.

PMID- 8352170
TI  - Multicenter trial of gadoteridol, a nonionic gadolinium chelate, in patients with
      suspected head and neck pathology.
AB  - PURPOSE: To evaluate the safety and efficacy of gadoteridol as an MR contrast
      agent in patients with suspected head and neck pathology. METHODS: One hundred
      thirty-three adult patients were studied with MR at 12 clinical trial sites
      before and after the intravenous administration of 0.10 mmol/kg gadoteridol.
      After enrollment, patients underwent a complete physical examination. Patient
      monitoring included vital signs, laboratory tests, and recording of the incidence
      and duration of adverse events. To evaluate efficacy, postcontrast T1-weighted
      images were compared with precontrast T1- and T2-weighted images. Investigators
      having clinical information evaluated 129 studies for efficacy; two readers
      blinded to clinical information subsequently evaluated 122 studies using the same
      criteria as the investigators. RESULTS: Eight patients (6.0%) experienced mild
      adverse events possibly or probably related to contrast administration, all of
      which resolved without treatment. Two clinically significant laboratory
      abnormalities considered related or possibly related to the administration of
      gadoteridol were reported in two patients. Enhancement of pathology was seen in
      82.9% of cases evaluated by investigators at the study site and in 78.7% of cases
      subsequently evaluated by the blinded readers. Postcontrast images were judged by
      investigators to provide additional diagnostic information over precontrast
      images in 68.9% of studies. The additional diagnostic information available on
      postcontrast studies most often consisted of improved visualization of pathology
      and better definition of lesion borders. The use of this information might have
      contributed to a change in patient diagnosis in 18.6% of the cases evaluated by
      the investigators and in 16.4% of the cases reviewed by the blinded readers.
      CONCLUSIONS: Preliminary results show gadoteridol to be a safe and efficacious
      contrast agent for enhanced MR study of extracranial and extraspinal head and
      neck pathology.

PMID- 8352171
TI  - Irreversible regional cerebral ischemia: serial MR imaging and proton MR
      spectroscopy in a nonhuman primate model.
AB  - PURPOSE: To delineate the changes in proton MR spectroscopy and imaging that
      occur with acute, irreversible ischemia of the basal ganglia of a baboon.
      MATERIALS AND METHODS: The M1 segments of the middle cerebral arteries of six
      adult male baboons were occluded by endovascular means with microcatheters and N
      butyl cyanoacrylate adhesive. Cerebral blood flow measurements were taken with
      positron emission tomography or radioactive microsphere techniques. Serial
      spatially localized proton MR spectroscopy of the basal ganglia and MR imaging of
      the brain were performed. The distribution of ischemic and infarcted tissue was
      demonstrated by histopathologic techniques or triphenyltetrazolium chloride
      staining. RESULTS: Radioactive microsphere or positron emission tomography
      measurements demonstrated no significant cerebral blood flow within the basal
      ganglia after occlusion of the middle cerebral artery. Proton MR spectroscopy of
      the basal ganglia demonstrated increasing cerebral lactate and decreasing N
      acetyl aspartate within 30 minutes of middle cerebral artery occlusion. Changes
      in the MR imaging signal intensity of the basal ganglia were observed as early as
      3.1 hours on T2-weighted, 3.3 hours on T1-weighted, and 6.1 hours on spin density
      weighted images. The distribution of these changes correlated well with the
      histopathologic features of ischemia and infarction that were seen throughout the
      basal ganglia. CONCLUSION: Changes in MR imaging signal intensity corresponded to
      ischemia and infarction in our baboon model of acute irreversible ischemia of the
      basal ganglia. Increasing cerebral lactate and decreasing N-acetyl aspartate
      preceded changes in MR imaging signal intensity.

PMID- 8352173
TI  - Aneurysms and MR angiography.

PMID- 8352172
TI  - MR angiographic demonstration of an intracranial aneurysm not seen on
      conventional angiography.
AB  - A patient with documented subarachnoid hemorrhage underwent conventional
      angiography, which was negative. MR angiography performed immediately after the
      conventional angiogram demonstrated a 4-mm anterior communicating artery
      aneurysm. This finding was confirmed 1 week later with repeat angiography, and
      the aneurysm was clipped surgically.

PMID- 8352174
TI  - Anatomy of the jaw revisited with a dental CT software program.
AB  - The jaw has traditionally been evaluated by dentists and oral surgeons using
      conventional panoramic and intraoral films. Recently, CT software programs
      specifically developed to evaluate dental implant patients have provided
      radiologists with a new look at the mandible and maxilla. The anatomy seen on
      these reformatted panoramic and cross-sectional images is complex, and our
      objective is to define it. By the use of standard anatomic drawings, mandibular
      and maxillary anatomy was identified on human skulls and then on the axial, cross
      sectional, and panoramic DentaScan images of these skulls. With this anatomic
      description, the DentaScans from several representative patients were then used
      to portray mandibular and maxillary anatomy in a pictorial fashion.

PMID- 8352176
TI  - MR contrast enhancement: an experimental study in postlaminectomy epidural
      fibrosis.
AB  - PURPOSE: To measure the effect of contrast medium dose, time elapsed since
      injection, and maturity of epidural scar tissue on the enhancement of scar tissue
      in MR imaging. METHODS: We imaged 12 beagle dogs with MR at 10 to 60 days after
      lumbar laminectomy, and at necropsy we obtained exactly correlating histologic
      sections. Contrast enhancement of scar tissue at 2, 15, 40, and 60 minutes after
      0.1 and 0.3 mmol of paramagnetic contrast medium per kilogram was measured.
      Contrast enhancement was analyzed with respect to the dose of contrast medium,
      the time of imaging, and the maturity of scar tissue. RESULTS: Epidural scar
      tissue enhanced more intensely at 2 and at 15 minutes than at 40 or at 60
      minutes. Consistently greater enhancement was observed with the dose of 0.3
      mmol/kg than with the dose of 0.1 mmol/kg. Regions of loosely organized scar
      tissue enhanced less intensely and less quickly than did more organized scar
      tissue. CONCLUSION: Contrast enhancement in scar tissue can be heightened by
      increasing the dose of contrast medium from 0.1 to 0.3 mmol/kg and by obtaining
      images within 15 minutes of injection.

PMID- 8352175
TI  - Segmental enhancement of the cochlea on contrast-enhanced MR: correlation with
      the frequency of hearing loss and possible sign of perilymphatic fistula and
      autoimmune labyrinthitis.
AB  - PURPOSE: To relate the finding of selective enhancement of different turns of the
      cochlea to the frequency range of the hearing loss measured by audiogram.
      METHODS: Six patients aged 23 to 53 years, four men and two women, who presented
      with sudden hearing loss and had segmental enhancement of different turns of the
      cochlea on contrast-enhanced MR imaging were included in this retrospective
      study. The patients were imaged on a 1.5 T MR imaging system using pre- and
      postcontrast axial T1-weighted images and postcontrast coronal T1-weighted images
      through the temporal bone. RESULTS: The basal turn of the cochlea enhanced
      selectively in five of the six patients and the apical turn enhanced in the sixth
      patient. All patients had sensorineural hearing loss. Three of the patients with
      basal turn enhancement had predominantly high-frequency hearing loss, whereas the
      patient with apical turn enhancement had predominantly low-frequency hearing
      loss. The two other patients with basal turn enhancement had complete hearing
      loss. Three patients had presumed autoimmune labyrinthitis. The other three
      patients had strong clinical and surgical evidence of a perilymphatic fistula.
      CONCLUSION: Contrast-enhanced MR imaging may demonstrate selective enhancement of
      different turns of the cochlea. In certain patients, the areas of enhancement may
      correlate with specific hearing loss in the frequencies mapped by the enhancing
      segment. Enhancement of the cochlea may represent radiologic evidence of cochlear
      inflammation secondary to a perilymphatic fistula.

PMID- 8352177
TI  - Effect of cigarette smoking on coronary patency after thrombolytic therapy for
      myocardial infarction. TEAM-2 Investigators. Second Multicenter Thrombolytic
      Trials of Eminase in Acute Myocardial Infarction.
AB  - Smokers have been reported to have an improved short-term prognosis after
      myocardial infarction when compared with nonsmokers. This study examines the
      effect of smoking status on infarct-related artery patency, a determinant of
      outcome, following thrombolytic therapy for acute myocardial infarction (AMI). To
      evaluate patency outcome by smoking status, the database of the Second
      Thrombolytic Trial of Eminase in Acute Myocardial Infarction was reviewed, and
      baseline characteristics were compared with infarct-related artery patency early
      (90 to 240 minutes) after thrombolysis in smokers versus nonsmokers. Smokers were
      younger (mean age 53 vs 59 years, p = 0.0001), more likely to be men (86 vs 73%,
      p = 0.008), normotensive (74 vs 58%, p = 0.004), to have an inferior infarction
      (66 vs 51%, p = 0.007), and tended to have higher hematocrits and fibrinogen
      levels than nonsmokers. Smokers had a significantly greater chance of achieving
      complete perfusion (Thrombolysis in Myocardial Infarction trial grade 3) (66 vs
      51% p = 0.007) than nonsmokers, although the combination of grades 2 and 3 did
      not differ. After correcting for imbalances in baseline and angiographic
      variables, multivariate logistic regression identified smoking (odds ratio 1.8, p
      = 0.01) and infarct location (odds ratio 1.7, p = 0.03) as independent predictors
      of achieving grade 3 flow. The independent predictive component of smoking for
      achieving grade 3 patency after thrombolysis suggests the hypothesis that more
      active thrombogenic mechanisms may be operative in smokers, leading to a larger
      thrombus component that is more susceptible to lytic therapy.

PMID- 8352178
TI  - Impact of tissue plasminogen activator and heparin versus heparin alone on
      quantitative coronary angiographic findings in myocardial infarction. The Toronto
      Tissue Plasminogen Activator Trial Study Group.
AB  - The influence of tissue plasminogen activator (t-PA) and heparin versus heparin
      alone on anatomic characteristics of patent infarct-related coronary arteries and
      the development of these angiographic descriptors in coronary arteries that
      remain patent during the hospital course was examined in 108 patients who
      participated in a placebo-controlled trial of recombinant tissue-type plasminogen
      activator in acute myocardial infarction. Coronary angiography was performed 18
      +/- 6 hours after treatment in 47 patients (group A) and at 10 days in 61
      patients (group B). Quantitative coronary angiography of the infarct-related
      lesion was performed, and luminal irregularity was quantitated with an ulceration
      index. Of the 47 patients in group A, 7 (29%) treated with placebo had
      Thrombolysis in Myocardial Infarction grade 2 or 3 perfusion, whereas 18 (78%)
      treated with t-PA had grade 2 or 3 (p < 0.001); there was no difference between
      patients who had grade 2 or 3 perfusion in group B (placebo 59% vs t-PA 75%). In
      group A, at 10 days, the luminal area of the infarct artery had increased from
      0.59 +/- 0.11 to 0.9 +/- 0.24 mm2 and from 0.75 +/- 0.16 to 1.31 +/- 0.39 mm2 for
      placebo- and t-PA-treated patients, respectively (p < 0.04). There was no change
      in the ulcerative index over time in either placebo- or t-PA-treated patients. It
      is concluded that early after infarction, t-PA produces marked and rapid
      improvement in overall patency as compared with heparin, although this difference
      was attenuated at 10 days because of spontaneous recanalization in the placebo
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352179
TI  - Influence of transdermal scopolamine on cardiac sympathovagal interaction after
      acute myocardial infarction.
AB  - In 41 survivors of acute myocardial infarction (AMI) a prospective study was
      performed in 2 sequential phases. In phase 1, the role of baroreflex sensitivity
      and heart rate variability as predictors of inducible and spontaneous sustained
      ventricular tachyarrhythmias was evaluated. In phase 2, the effects of
      transdermal scopolamine on baroreflex sensitivity, spectral and nonspectral
      measures of heart rate variability were investigated. At a mean follow-up of 10
      +/- 3 months after AMI, 5 of 41 patients (12%) developed a late arrhythmic event.
      Of these, all (100%) had inducibility of sustained monomorphic ventricular
      tachycardia at programmed stimulation compared with 3 of 36 patients (8%) without
      events (p < 0.0001). At multivariate analysis, baroreflex sensitivity had the
      strongest relation to both inducibility of sustained monomorphic ventricular
      tachycardia (p < 0.0001) and occurrence of arrhythmic events (p < 0.0001). Of 41
      patients, 28 (68%) consented to undergo phase 2 of the investigation. Baroreflex
      sensitivity significantly (p < 0.00001) increased after transdermal scopolamine
      as well as heart rate variability indexes. Of these, the mean of SDs of normal RR
      intervals for 5-minute segments (p < 0.0001) and the total power (p < 0.0001) had
      the most significant improvement after scopolamine. The present investigation
      confirms that assessment of autonomic function is an essential part of arrhythmic
      risk evaluation after AMI. Transdermal scopolamine, administered to survivors of
      a recent AMI, reverses the autonomic indexes that independently predict
      arrhythmic event occurrence. On the basis of these data, transdermal scopolamine
      could be a potential useful tool in the prophylaxis of life-threatening
      ventricular arrhythmias after AMI.

PMID- 8352180
TI  - Effect of intravenous nitroglycerin on heparin dosage requirements in coronary
      artery disease.
AB  - Patients admitted to the coronary care unit who received both intravenous
      nitroglycerin and heparin were studied to evaluate heparin dosage requirements.
      Physicians ordered all nitroglycerin and heparin doses as well as coagulation
      studies without knowledge of this study. Activated partial thromboplastin time
      (APTT) values obtained during steady-state heparin administration were considered
      therapeutic if the ratio of APTT/APTT-baseline was > or = 1.5. Sixty patients
      with myocardial infarction or unstable angina were included in the study. The
      initial therapeutic heparin dose of 1,014 +/- 151 units/hour produced an APTT
      ratio of 2.0 +/- 0.5. At the time of the initial therapeutic dose, the
      nitroglycerin dose was 110 +/- 108 micrograms/min. There was a significant
      correlation between the initial therapeutic dose and both total (r = 0.56; p =
      0.0001) and lean (r = 0.26; p < 0.05) body weight. Comparison of patients with
      nitroglycerin doses < and > or = 100 micrograms/min revealed a significant
      difference in the initial therapeutic dose (971 +/- 147 vs 1,077 +/- 136 U/hour,
      p < 0.01), but not the initial therapeutic dose standardized to total body weight
      (14.0 +/- 2.5 vs 13.5 +/- 2.7 U/kg/hour). Similarly, analysis of variance
      revealed a significant difference in the initial therapeutic dose (p < 0.05), but
      not the initial therapeutic dose standardized to weight among 5 different
      nitroglycerin dosage ranges (10 to 533 micrograms/min). Neither aspirin use,
      thrombolytic therapy nor decreasing or discontinuing the nitroglycerin dose
      significantly affected heparin requirements. Thus, contrary to prior reports,
      clinically significant heparin resistance induced by nitroglycerin was not found.

PMID- 8352181
TI  - Interrelation between angiographic severity of coronary artery disease and plasma
      levels of insulin, C-peptide and plasminogen activator inhibitor-1.
AB  - Plasma insulin, C-peptide and plasminogen activator inhibitor-1 (PAI-1) levels
      were measured in 64 men with coronary artery disease (CAD) documented by
      angiography. Coronary arteriograms were analyzed, and the severity and diffusion
      of coronary lesions were quantified by score systems. C-peptide and PAI-1 levels
      in patients with CAD were significantly higher than in 30 control subjects.
      Insulin, C-peptide and PAI-1 showed a highly significant correlation with the
      severity scores for coronary lesions (C-peptide more than insulin), but only a
      weak correlation with diffusion scores. Highly significant correlations were
      found between insulin and PAI-1, and even greater ones between C-peptide and PAI
      1. It has been proposed that hyperinsulinemia may be involved in the etiology of
      atherosclerotic cardiovascular disease by dysregulating lipoprotein metabolism
      and blood pressure. These findings support that hypothesis and suggest that
      insulin secretion may be an index of the severity of CAD. Because a direct effect
      of insulin on the cells that synthesize PAI-1 has been shown, the present data
      further indicate that the effect of insulin on fibrinolysis may be another way by
      which hyperinsulinemia accelerates atherogenesis.

PMID- 8352182
TI  - Elevated plasma lipoprotein(a) associated with abnormal stress thallium scans in
      children with familial hypercholesterolemia.
AB  - Plasma lipoprotein(a) (Lp(a)) concentrations are associated with an increased
      risk of coronary artery disease in adults with familial hypercholesterolemia
      (FH). We hypothesized that Lp(a) concentrations in children with FH were higher
      among those with myocardial ischemia on stress thallium scans and among those
      with a family history of premature coronary artery disease. Twenty-nine
      asymptomatic heterozygotes with FH (range 9 to 23 years) and 7 homozygotes (range
      4 to 13 years) were evaluated with clinical assessment, lipoprotein measurement
      and stress thallium scans. Compared with subjects with normal stress thallium
      scans, mean Lp(a) was significantly higher in homozygotes with stress thallium
      abnormalities (79 +/- 18 vs 15 +/- 5.5 mg/dl, p = 0.03), and tended to be higher
      in heterozygotes with stress thallium abnormalities (39 +/- 12 vs 20 +/- 4.2
      mg/dl, p = 0.10). Lp(a) tended to be higher in heterozygotes with a family
      history of premature coronary artery disease (30 +/- 6.4 vs 14 +/- 4.1 mg/dl, p =
      0.12). It is concluded that Lp(a) is higher in hypercholesterolemic children who
      have abnormal stress thallium scans. Lp(a) may be useful in assessing coronary
      artery disease risk in children with FH.

PMID- 8352183
TI  - Cardiac adaptation to increased systemic blood pressure in borderline
      hypertensive men.
AB  - The present study examined cardiac characteristics of borderline hypertensive men
      with a positive parental history of hypertension. Hemodynamics in relation to
      left ventricular function and structure were evaluated in 15 borderline
      hypertensive men with a parental history of hypertension and in 20 normotensive
      control subjects with a negative parental history. Groups were matched in age,
      height, weight and percent body fat. Left ventricular mass and dimensions were
      measured by M-mode echocardiography, and left ventricular function was assessed
      by radionuclide ventriculography. Both groups had similar left ventricular mass,
      dimensions and wall thicknesses. In relation to control subjects, borderline
      hypertensive men had a significantly higher heart rate and blood pressure (BP) (p
      < 0.001), but a similar cardiac index. Borderline hypertensive men had a higher
      peripheral resistance index (p < 0.02), longer time to peak filling rate, and
      reduced cardiac efficiency, whereas they had higher contractility, minute and
      stroke work indexes than did control subjects (all p < 0.05); they also had
      higher diastolic BP (p < 0.03) during exercise, and sustained higher BP during
      recovery than did controls. Although this group of borderline hypertensive men
      did not have an altered cardiac anatomy, they had an increased vascular
      resistance, an altered diastolic function and a reduced cardiac efficiency while
      undergoing a greater work load. These cardiodynamic profiles are consistent with
      functional vascular changes and a parallel compensation by the heart.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8352184
TI  - Clinical and hemodynamic predictors of survival in patients aged < 65 years with
      severe congestive heart failure secondary to ischemic or nonischemic dilated
      cardiomyopathy.
AB  - To identify which clinical or hemodynamic parameters predict survival in patients
      with end-stage heart failure due to dilated cardiomyopathy, 130 consecutive
      patients aged < 65 years (mean 46 +/- 13) assessed for heart transplantation from
      May 1986 to April 1991 were studied. Mean follow-up was 15 +/- 11 months. Left
      ventricular ejection fraction was 22 +/- 7%. Left ventricular end-diastolic
      pressure was 27 +/- 9 mm Hg, and cardiac index was 2.2 +/- 0.6 liter/min/m2.
      Symptom class was IV in 91% of patients and III in 9%. Etiology was ischemic in
      40% of patients and idiopathic in 60%. After intensive medical therapy, heart
      transplantation was considered indicated in 53% of patients, contraindicated in
      20% and not indicated in 27%. Transplantation was performed in 36% of patients
      during follow-up, and 35% died and 29% were alive without transplantation. A
      comparison, excluding patients with transplantation, was performed between those
      who were alive and had survived > or = 6 months after assessment, and those who
      died. On multivariate analysis, the following 3 parameters were independent
      predictors of prognosis: intravenous inotropic requirement (p < 0.001), maximal,
      tolerated captopril dose (p = 0.013) and systolic blood pressure (p = 0.003).
      When patients with transplantation were considered as deaths, stabilization on
      medical therapy also reached statistical significance (p = 0.009). Classic
      prognostic markers including ventricular arrhythmias, left ventricular end
      diastolic pressure, cardiac index, amiodarone therapy and etiology were not
      associated with prognosis in this homogeneous population of severely ill
      patients.

PMID- 8352185
TI  - Effects of orthostatic stress on peripheral capillary filtration in mild
      congestive heart failure after healing of myocardial infarction.
AB  - Patients with heart failure have impaired baroreflex control of the peripheral
      circulation with attenuated vasoconstrictor response during orthostatic stress.
      The aim of this study was to test if this impaired baroreflex control not only
      affects the arterial, but also the capillary bed. Blood flow and capillary
      filtration were measured in the forearm (plethysmography) in 7 normal subjects
      and 7 patients with mild congestive heart failure (New York Heart Association
      functional class II). Measurements were done with the subjects supine and during
      head-up tilt at 45 degrees. While supine, forearm vascular resistance and
      capillary filtration coefficient did not differ significantly between the groups.
      In the control subjects, tilt decreased capillary filtration coefficient by 14 +/
      3% (p < 0.02), and increased forearm vascular resistance by 88 +/- 37% (p <
      0.02); in contrast, patients with heart failure had an increase in capillary
      filtration coefficient of 26 +/- 5% (p < 0.02) and only increased the forearm
      vascular resistance by 10 +/- 1%, (p = NS, p = 0.26). Our data provide evidence
      that patients with mild heart failure, in contrast to normal subjects, increase
      the peripheral capillary filtration during orthostatic stress. The data indicate
      that impaired baroreflex mechanisms might influence the capillary filtration and
      it is suggested that impaired baroreflex control of the peripheral circulation
      can contribute to formation of edema in patients with heart failure.

PMID- 8352186
TI  - Effectiveness of amiodarone and electrical cardioversion for chronic rheumatic
      atrial fibrillation after mitral valve surgery.
AB  - Thirty consecutive patients with chronic rheumatic atrial fibrillation (AF) > or
      = 3 months after successful mitral valve surgery and left atrial diameter < or =
      60 mm were treated with oral amiodarone. Protocol included high loading dosages
      of amiodarone for 4 weeks, and if conversion to sinus rhythm (SR) was not
      achieved then electrical cardioversion was performed. Patients converted to SR
      were maintained on low-dose amiodarone for another 4 weeks when treatment was
      discontinued. Overall, 23 patients (77%) converted to SR after 4 weeks of
      therapy: 12 (40%) taking amiodarone alone and 11 (37%) with the addition of
      electrical cardioversion. The duration of AF > 48 months was an adverse factor in
      the ability to restore SR. Sixteen patients (70%) remained in SR at a mean follow
      up of 17 months. The duration of AF < or = 48 months alone or in combination with
      left atrial diameter < or = 45 mm were the best predictors for long-term
      maintenance of SR. Thus, short-term amiodarone with or without electrical
      cardioversion is effective and safe in the treatment of chronic rheumatic AF
      after mitral valve surgery. The duration of AF and left atrial size can be used
      to identify patients with successful outcome.

PMID- 8352187
TI  - Clinicopathologic features of hypertrophic cardiomyopathy managed by cardiac
      transplantation.
AB  - Clinical records, electrocardiographic, echocardiographic, hemodynamic and
      radionuclide data, and the operatively excised hearts were reviewed in 10
      patients (aged 19 to 46 years, mean 35) who had cardiac transplantation for
      hypertrophic cardiomyopathy. Severe congestive heart failure unassociated with
      outflow obstruction was the indication for transplantation in 9 patients. During
      a pretransplantation period ranging from 45 to 312 months (mean 137) in these 9
      patients, pulmonary artery wedge pressure increased from 19 +/- 9 to 27 +/- 7 mm
      Hg, left ventricular ejection fraction decreased from 51 +/- 11% to 41 +/- 1%,
      left ventricular end-diastolic dimension increased from 42 +/- 6 to 48 +/- 4 mm,
      and total 12-lead QRS voltage decreased from 209 +/- 50 to 156 +/- 41 mm. In
      these 9 patients, the explanted hearts had dilated left ventricular cavities, and
      8 had left ventricular scars without significant narrowing of the epicardial
      coronary arteries. The tenth patient had a nondilated left ventricular cavity and
      had transplantation because of recurrent, refractory syncope. Of the 10 patients,
      3 died within the first month, and another died 8 months after transplantation.
      The remaining 6 patients have survived 20 to 54 months (mean 39) after
      transplantation and are in functional class I or II.

PMID- 8352188
TI  - A new hemostatic puncture closure device for the immediate sealing of arterial
      puncture sites.
AB  - After angiography, 6 to 24 hours of bedrest is indicated to assure that adequate
      hemostasis of the femoral artery has been achieved. Recently, a new hemostatic
      puncture closure device (HPCD) has been developed, which consists of a resorbable
      polymer anchor, a resorbable suture, a small collagen plug and an 8Fr delivery
      device. The device is delivered into the femoral artery through the introducer
      sheath, the anchor is secured against the intraluminal artery wall, and the
      collagen plug is deployed on the arterial wall. The prototype of the HPCD was
      used in 20 patients administered heparin. After insertion of the HPCD, hemostasis
      was achieved in 1.2 +/- 2.1 minutes; in 2 patients a light pressure dressing was
      applied for 4 hours to stop oozing. No late bleeding occurred. In 1 patient the
      positioning suture broke, requiring the application of a pressure bandage.
      Patients were uneventfully mobilized after 6.7 +/- 3.5 hours. In all patients
      serial duplex scanning of the femoral artery was performed before and after 1, 7,
      30 and 90 days after HPCD placement. In 5 patients a small subcutaneous hematoma
      close to the site of introduction could be detected by ultrasound 1 day after
      catheterization. All but 1 patient had normalization of the flow patterns in the
      femoral artery. It is concluded that: (1) the HPCD is an effective device to
      achieve immediate hemostasis after arterial catheterization despite
      antithrombotic therapy, (2) early mobilization was uneventful, (3) duplex
      ultrasound studies demonstrated only transient changes in the punctured femoral
      artery, and (4) further investigations are needed to establish the efficacy and
      safety of the device.

PMID- 8352189
TI  - Evaluation of treatment strategies of malignant ventricular tachyarrhythmias in
      the era of the implantable defibrillator.

PMID- 8352190
TI  - Insulin resistance, glucose intolerance, hyperinsulinemia and dyslipidemia in
      patients with angiographically demonstrated coronary artery disease.

PMID- 8352191
TI  - Angiographic eligibility of community hospital patients with multivessel coronary
      artery disease for percutaneous transluminal coronary angioplasty or coronary
      artery bypass grafting.

PMID- 8352192
TI  - Anti-streptokinase antibodies inhibit fibrinolytic effects of anistreplase in
      acute myocardial infarction.

PMID- 8352193
TI  - Acute myocardial gray level intensity changes detected by transesophageal
      echocardiography during intraoperative ischemia.

PMID- 8352194
TI  - Reproducibility of a positive passive upright tilt test at a seven-day interval
      in patients with syncope.

PMID- 8352196
TI  - Responses to dynamic cardiomyoplasty for idiopathic dilated cardiomyopathy. The
      McGill Cardiomyoplasty Group.

PMID- 8352195
TI  - A characteristic electrocardiographic pattern indicative of manifest left-sided
      posterior septal/paraseptal accessory atrioventricular connections.

PMID- 8352197
TI  - Effects of captopril on renal function before and after surgical correction of
      aortic coarctation.

PMID- 8352198
TI  - Transesophageal echocardiography in congenital submitral aneurysm.

PMID- 8352199
TI  - Absence of adenosine-induced chest pain after total cardiac afferent denervation.

PMID- 8352201
TI  - Systemic but not renal production of prostacyclin is highly reduced in
      cyclosporin-treated heart transplant recipients.

PMID- 8352200
TI  - Effects of acute administration of cyclosporine on levels of cardiovascular
      hormones in heart transplant recipients.

PMID- 8352202
TI  - Survey of selected cardiologists for an operational definition of normal sinus
      heart rate.

PMID- 8352203
TI  - Accuracy of a new nongeometric pulsed Doppler method in cardiac output
      evaluation.

PMID- 8352204
TI  - Proper probe size for pediatric transesophageal echocardiography.

PMID- 8352205
TI  - Blood cyst of the pulmonary valve causing pulmonic valve stenosis.

PMID- 8352206
TI  - Effects of coronary stenosis severity on variability of quantitative angiography.

PMID- 8352207
TI  - In rates we trust.

PMID- 8352208
TI  - US immunization system Rx: install new components.

PMID- 8352209
TI  - Benign neonatal sleep myoclonus.

PMID- 8352210
TI  - On Tiny Tim, Charles Dickens, and pediatrics.

PMID- 8352211
TI  - Bah humbug.

PMID- 8352212
TI  - What was wrong with Tiny Tim?

PMID- 8352213
TI  - Tiny Tim, Dickens, renal disease, and rickets.

PMID- 8352214
TI  - Food-induced bleeding from lymphonodular hyperplasia of the colon.

PMID- 8352215
TI  - Lateral medullary syndrome following varicella infection.

PMID- 8352216
TI  - Injuries to preschool-age children in day-care centers. A retrospective record
      review.
AB  - OBJECTIVES: To increase our understanding of the epidemiologic nature of injuries
      to children in day-care settings by examining injury logs and to determine
      appropriate methods for calculating injury rates. DESIGN: Retrospective, with
      data collected through a review of 1 year's records. SETTING: Four suburban day
      care centers in the upper Midwest. PARTICIPANTS: Five hundred twenty-seven
      preschool-age children, 275 of whom experienced one or more injuries during the
      study period. SELECTION PROCEDURE: Convenience sample. MEASUREMENTS/RESULTS:
      Injury rates were calculated based on the number of hours spent in day care in
      the study year. More than 1000 injuries were reported for 527 children. Injury
      rates ranged from 0.006 to 0.049 per child per standardized 8-hour day in a day
      care center (or six to 49 injuries per 1000 children per 8 hours of exposure).
      However, most injuries were minor, and none resulted in a fatality or hospital
      admission. Using this method, injury rates were examined by gender and month.
      CONCLUSIONS: Future research should determine exposure time based on the actual
      number of hours a child spends in attendance to determine injury rates. Exposure
      time should also be carefully considered in determining product- and location
      specific rates of injury.

PMID- 8352217
TI  - Immunogenicity of Haemophilus influenzae type b polysaccharide-tetanus toxoid
      conjugate vaccine in infants.
AB  - OBJECTIVE: To compare the safety and immunogenicity of three investigational lots
      of Haemophilus influenzae type b polysaccharide-tetanus toxoid (PRP-T) conjugate
      vaccine in infants. DESIGN: A multicenter, randomized immunogenicity trial.
      Infants were vaccinated at 2, 4, and 6 months of age with one of three lots of
      PRP-T. A control group received H influenzae type b oligomers conjugated to
      CRM197 (HbOC). Serum was obtained before each injection and 1 month after the
      third dose, and assayed blindly for antibody in one laboratory. SUBJECTS: Four
      hundred eighty-four infants from private pediatric practices located in five
      geographic areas. MEASUREMENTS AND RESULTS: There were no significant differences
      in the number of adverse events reported for infants receiving PRP-T or HbOC, and
      the rates did not exceed those observed previously in infants given diphtheria
      tetanus-pertussis vaccine alone. Total serum anti-PRP antibody responses were
      analyzed in 336 infants who met strict inclusion criteria. After one, two, or
      three doses, the respective antibody responses to each of the three lots of PRP-T
      and to HbOC vaccine were similar. The only exception was one lot of PRP-T, which
      after one or two injections elicited significantly higher geometric mean antibody
      responses than the other two lots or the HbOC vaccine. After a third injection,
      there were no significant lot differences. Combining the data from the different
      lots, there were no significant differences in the geometric mean antibody
      concentration after three doses of PRP-T or HbOC (8.3 vs 7.7 micrograms/mL), and
      95% and 91%, respectively, of infants had greater than 1.0 microgram/mL of
      antibody. There were no significant differences in the magnitudes of the
      respective IgG1-, IgG2-, and IgM-specific antibody concentrations between infants
      given PRP-T or HbOC. CONCLUSIONS: The three investigational lots of PRP-T tested
      were safe and were as immunogenic as or more so than the licensed HbOC conjugate
      vaccine.

PMID- 8352218
TI  - Hyperinsulinism as a marker in obese children.
AB  - OBJECTIVE: To determine the relationship between insulin and the metabolic
      profile and eventual weight loss in obese children. DESIGN: We first attempted to
      define the metabolic profile for 18 obese children; we then studied weight loss
      in this group longitudinally. SETTING: Department of Pediatrics in a university
      hospital. PARTICIPANTS: Eighteen randomly selected, young, obese male subjects
      from 5 to 16 years of age. INTERVENTIONS: (1) Metabolic screening at the outset,
      including insulinemia and glycemia after the oral glucose tolerance test and
      plasma levels of total cholesterol, high-density lipoprotein cholesterol, and
      triglycerides, and (2) weight loss treatment. RESULTS: We divided the sample into
      "normoinsulinemic" and "hyperinsulinemic" groups, similar for all the variables
      tested except for weight loss and plasma triglyceride levels. A direct
      relationship between weight loss results and duration of treatment was found for
      the entire group. The "hyperinsulinemic" group had a lower percentage reduction
      in excess weight, and the results in this group were not dependent on the
      duration of treatment. CONCLUSIONS: The effort to keep "normoinsulinemic" obese
      children in treatment may be useful; it is advisable to study "hyperinsulinemic"
      children more in depth.

PMID- 8352219
TI  - The immunization status of children with spina bifida.
AB  - OBJECTIVE: To estimate immunization levels among children with spina bifida and
      describe factors that may influence immunization completeness. RESEARCH DESIGN:
      Cross-sectional survey. SETTING: Tertiary care referral center. PATIENTS: One
      hundred twenty children, from 4 months to 18 years of age, seen in the
      myelodysplasia clinic of Children's Hospital, Boston, Mass, from February through
      August 1990. RESULTS: Fifty-eight percent of the children 2 years of age or older
      and 55% of the children 7 years of age or older had completed the immunization
      series recommended by the American Academy of Pediatrics. All but one child had
      an identified primary care provider. Lower immunization levels at 24 months of
      age occurred in older and in poorer children. Most children (80%) received the
      first diphtheria and tetanus toxoids and pertussis and oral poliovirus vaccines
      on time. Immunization delay increased from 20% to 50% through the 18-month
      diphtheria and tetanus toxoids and pertussis and oral poliovirus vaccines and
      declined to 24% at school entry. CONCLUSIONS: Many children with spina bifida are
      underimmunized despite having an identified source of primary care.

PMID- 8352221
TI  - Diagnostic test ordering in the evaluation of febrile children. Physician and
      environmental factors.
AB  - OBJECTIVE: To assess the independent effects of physician and environmental
      factors on test ordering. METHODS: We prospectively studied 6191 consecutive
      visits by nonadmitted febrile (rectal temperature > or = 38.0 degrees C) children
      less than 18 years of age to a children's hospital emergency department from
      March through November 1989. Multiple logistic regression analysis was used to
      control for the mutually confounding effects of patient, physician, and
      environmental factors and to assess attending staff-trainee interactions (effect
      modification). RESULTS: Patients evaluated by hospital-based subspecialists were
      significantly more likely to undergo tests than patients evaluated by community
      based physicians (odds ratio [OR] for undergoing at least one test, 1.13; 95%
      confidence interval [CI], 1.04 to 1.23; OR for complete blood cell count, 1.28;
      95% CI, 1.12 to 1.46). Children seen by physicians with more than 10 years of
      experience were significantly less likely to undergo tests than those seen by
      their more junior colleagues, but this effect was modified substantially by
      trainee presence and level. For example, when children were seen by a physician
      with more than 10 years of experience and no trainee was involved, the OR for
      undergoing at least one test was 0.81 (95% CI, 0.73 to 0.91). If the same
      physician saw the same patient with a junior trainee, the OR for undergoing at
      least one test was 1.08 (95% CI, 0.95 to 1.24). Patients seen between July and
      November were significantly more likely to undergo at least one test than those
      seen between March and June (OR, 1.28; 95% CI, 1.20 to 1.36). CONCLUSIONS:
      Attending staff, trainee, and seasonal effects on test ordering have important
      implications for febrile children and their families, for clinical training and
      supervision, and for health care costs.

PMID- 8352220
TI  - Advice seeking and appropriate use of a pediatric emergency department.
AB  - OBJECTIVES: To determine whether seeking advice prior to an unscheduled visit to
      a pediatric emergency department (PED) influences appropriate use of this setting
      for minor illnesses. DESIGN: Cross-sectional questionnaire survey. SETTING: The
      medical emergency department of the Montreal (Quebec) Children's Hospital, a
      major referral and urban teaching hospital. PARTICIPANTS: Four hundred eighty
      nine of 562 consecutive parents visiting the PED over two periods, one in
      February and the other in July 1989. INTERVENTIONS: None. MEASUREMENTS/MAIN
      RESULTS: Parents of children between 0 and 18 years of age visiting the PED were
      asked whether they had previously sought advice from family, friends, or a
      physician. Other factors possibly related to the decision to seek care were also
      measured. Appropriateness was rated, blind to discharge diagnosis, by two
      pediatricians using a structured series of questions incorporating the child's
      age, time of the visit, clinical state, and problem at presentation. Thirty-four
      percent of visits among respondents were judged appropriate. In bivariate
      analysis, appropriate visits occurred significantly more often when a parent
      spoke to both a physician and a nonphysician (47%) prior to visiting the PED than
      when no advice was sought (29%; P < .05). In multivariate analysis, having a
      regular physician and being one of two children also contributed to
      appropriateness. CONCLUSIONS: Appropriate use of the PED was positively
      influenced by seeking prior advice from both a physician and family member,
      having a regular physician, and having prior child care experience.

PMID- 8352222
TI  - Controlling malignant melanoma. A focus on pediatricians.
AB  - There is evidence that the mortality rate associated with malignant melanoma can
      be decreased by early identification of the risk factors for melanoma and
      precursor lesions and by reducing sun exposure in young patients at higher risk.
      Many of the risk factors for malignant melanoma are seen in the pediatric age
      group. To determine pediatricians' awareness of risk factors for melanoma and
      their ability to recognize the precursors of melanoma, we studied three
      departments of pediatrics--at an urban and a suburban medical center and a
      medical college. Ninety-six members of the audience, which included full-time
      faculty, practicing pediatricians, and pediatrics residents, responded to
      questionnaires before and after a presentation on the risk factors for melanoma.
      Based on the results of the questionnaires, this group of pediatricians believed
      that they were not sufficiently knowledgeable about the risk factors for melanoma
      and did not routinely examine their patients for these risk factors or counsel
      them on proper sunlight protection. These findings indicate a need for making
      pediatricians aware of the risk factors for melanoma and of the critical role
      they play in decreasing the incidence and mortality rate associated with this
      disease.

PMID- 8352223
TI  - The perspectives of current trainees in combined internal medicine-pediatrics.
      Results of a national survey.
AB  - OBJECTIVE: To gather information from combined internal medicine-pediatric
      residents about their application process for residency, their perceptions of the
      stressors during residency, and their future plans. DESIGN: Survey of all
      combined internal medicine-pediatric residents-in-training in the 1989-1990
      academic year. PARTICIPANTS: Fifty-four percent of residents-in-training
      responded to the survey, representing 70% of the programs. RESULTS: Combined
      residents often investigate and rank other generalist residences. However,
      internal medicine is significantly (P < .005) considered more often than
      pediatrics or family medicine. Sixty percent of combined residents do not
      anticipate further training beyond the 4 years and expect to practice both
      specialties. The majority of those interested in a subspecialty expect to
      continue to combine internal medicine and pediatrics in their subspecialty
      practice. Switching services during the residency engenders stress. Factors that
      decrease stress include more frequent switches and increasing seniority.
      Switching from pediatrics to internal medicine is more stressful (P < .0001) than
      switching to pediatrics from internal medicine. The residents considered
      ambulatory training sites and a specific coordinator for the program to be the
      most important features of the residency. CONCLUSIONS: Combined internal medicine
      pediatric programs continue to attract a small cohort of well-qualified US
      medical school graduates, the majority of whom intend to practice as generalists
      in both pediatrics and internal medicine.

PMID- 8352224
TI  - Habitual physical activity and health-related physical fitness in fourth-grade
      children.
AB  - OBJECTIVE: To examine the relationship between habitual physical activity and
      components of health-related physical fitness in children. DESIGN: Cross
      sectional survey with correlational analysis. SETTING: Seven public elementary
      schools in a suburban southern California city. PARTICIPANTS: Five hundred twenty
      eight healthy fourth-grade children (274 boys and 254 girls), 85% of whom were
      non-Hispanic whites. Ninety-eight percent of eligible students participated.
      INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Results of six measures of
      physical activity in children (monitoring by accelerometer, parent report, and
      child self-reports of weekday activity, weekend activity, and summer involvement
      in activity classes and youth sports) were combined in a physical activity index.
      This index of habitual physical activity was examined in relation to measures of
      five components of health-related fitness: the mile run, skin-fold tests, pull
      ups, sit-ups, and the sit-and-reach test. The physical activity index was
      significantly associated with all five fitness components. The canonical
      correlation was .29. CONCLUSION: Active children appear to engage in a sufficient
      variety of activities to enhance multiple components of health-related fitness.

PMID- 8352225
TI  - Radiological cases of the month. Pott's disease in childhood.

PMID- 8352226
TI  - Radiological cases of the month. The migrating BB and the medicine man.

PMID- 8352227
TI  - Picture of the month. Neonatal lupus erythematosus.

PMID- 8352228
TI  - Pathological cases of the month. Myotubular myopathy (centronuclear myopathy).

PMID- 8352229
TI  - Pathological cases of the month. Type 1 spinal muscular atrophy (Werdnig-Hoffman
      disease).

PMID- 8352230
TI  - High Ia (HLA-DR) and low CD11b (Mo1) expression may predict early conversion to
      leukemia in myelodysplastic syndromes.
AB  - The FAB classification of myelodysplastic syndromes (MDS) has been useful in
      predicting prognosis; however, additional methods are required to detect patients
      at high risk for early conversion to acute nonlymphoblastic leukemia (ANLL).
      Using a panel of monoclonal antibodies to myelomonocytic surface antigens (MMSA)
      and flow cytometry, we studied bone marrow cells from 26 patients with MDS of all
      five FAB subtypes. The MMSA studied included Ia (HLA-DR), CD11b (Mo1), CD14 (Mo2,
      My4), CD13 (My7), and CD33 (My9). Marrows were considered "positive" for a given
      MMSA if the percentage of reactive cells exceeded the upper limit of the normal
      range. Twenty-four of twenty-six patients (92.3%) were CD13 (My7)+, suggesting
      that CD13 may serve as a diagnostic marker for MDS. Ten of twelve patients who
      developed ANLL during a median follow-up of 44 weeks were Ia(HLA-DR)+. The Kaplan
      Meier estimated median time to leukemia (TTL) was 16 weeks for Ia+ patients and
      88 weeks for Ia- patients (P = 0.004). All six patients who developed ANLL before
      16 weeks from diagnosis were Ia+, while none of the Ia- patients converted to
      ANLL before 24 weeks. Nine of thirteen patients with low CD11b (Mo1) expression
      (< 53% reactive cells) developed ANLL, compared with only two of 11 patients with
      high CD11b expression (> 53% reactive cells). Kaplan-Meier estimated TTL was 29
      weeks for patients with low CD11b, compared to 160 weeks for patients with high
      CD11b (P < 0.05). Patients who met both criteria, Ia+ and low CD11b, represented
      the poorest prognostic subgroup, with median TTL of 13 weeks compared with 88
      weeks for the others (P = 0.017). Ia and CD11b patterns were not specific for MDS
      subtype, and their expression did not correlate with blast count. These data
      suggest that MDS patients whose bone marrow cells demonstrate high Ia (HLA-DR)
      and low CD11b (Mo1) expression represent a poor prognostic subgroup with short
      TTL. These patients may be candidates for early aggressive or investigational
      treatment.

PMID- 8352231
TI  - Decreased erythropoietin responsiveness to iron deficiency anemia in the elderly.
AB  - The prevalence of anemia in the elderly raises the question of an inappropriate
      secretion of erythropoietin in response to increased demands. Therefore, the
      serum erythropoietin concentration of elderly patients (74-95 years) with iron
      deficiency anemia was measured and compared to that of iron deficiency anemic
      adults (25-60 years). A lowered erythropoietin secretion in response to anemia
      was observed in elderly patients in comparison with adults. However, the serum
      erythropoietin of the anemic elderly was inversely correlated with hemoglobin
      levels as shown for the anemic adults. The progressive reduction of the renal
      function observed with aging could explain the decreased capacity of
      erythropoietin secretion in elderly patients.

PMID- 8352232
TI  - Comparison of the behavior of normal factor IX and the factor IX Bm variant Hilo
      in the prothrombin time test using tissue factors from bovine, human, and rabbit
      sources.
AB  - A subset of hemophilia B patients have a prolonged bovine-brain prothrombin time.
      These CRM+ patients are classified as having hemophilia Bm. The prolongation of
      the prothrombin time has been reported only with bovine brain (referred to as ox
      brain in some literature) as the source of thromboplastin; prothrombin times
      determined with thromboplastin from rabbit brain or human brain are not reported
      to be prolonged. Factor IX from a hemophilia Bm patient (factor IX Hilo) was
      isolated. The activity of factor IX Hilo was compared to that of normal factor IX
      in prothrombin time assays when the thromboplastin source was of bovine, rabbit,
      or human origin. Factor IX, either normal or Hilo, prolonged a prothrombin time
      regardless of the tissue factor source. However, unless thromboplastin was from a
      bovine source, this prolongation required high concentrations of factor IX.
      Further, factor IX normal was as effective as factor IX Hilo in prolonging the
      prothrombin time when rabbit or human thromboplastin was used. With bovine
      thromboplastin, factor IX Hilo was significantly better than factor IX normal at
      prolonging the prothrombin time. The amount of prolongation was dependent on the
      amount of factor IX Hilo added. In addition, the prolongation was dependent on
      the concentration of factor X present in the sample. The prothrombin time changed
      as much as 20 seconds when the factor X concentration was varied from 50% to 150%
      to normal (fixed concentration of factor IX Hilo). These results demonstrate the
      difficulty of classifying the severity of a hemophilia Bm patient based on the
      bovine brain prothrombin time unless both the factor IX and factor X
      concentrations are known.

PMID- 8352233
TI  - Four years' experience with the treatment of all-trans retinoic acid in acute
      promyelocytic leukemia.
AB  - A retrospective analysis was done on 43 patients with acute promyelocytic
      leukemia (APL) at our hospital from June 1987 to August 1992. All-trans retinoic
      acid was used to induce these patients to differentiation. In the early period of
      induction there were risks of severe hemorrhage, which was the main cause of
      early death. Treatments combined with platelets and heparin or aminomethylbenzoic
      (PAMBA) were given to patients with abnormal coagulation. As a result only 4 out
      of 43 patients died of intracranial bleeding at 4-12 days when their white blood
      cell (WBC) counts peaked. The combination of retinoic acid (RA) and HA
      chemotherapy could reduce hyperleukocytosis during the RA induction course. None
      of 7 patients died at early stage with this treatment combination. Our studies
      showed that it could predict the onset of remission at early stage through
      observations on the successive changes of karyotypes and morphology of the bone
      marrow and peripheral blood cells. Our studies also showed that the growth of CFU
      F could be inhibited by RA. We think that it may play a role in the RA-induced
      differentiation. In 4 years of follow-up the overall leukemia-free survival (LFS)
      was 80% with a relapse rate of 45%. Thirty-five patients out of 43 cases were
      still alive in remission, and one was alive in relapse. All 11 out of 43 patients
      relapsed within 3 years, but the relapses occurred later, after 3 years duration
      of remission (P < .01). Retinoic acid failed to induce 5 patients who relapsed
      with the continuation treatment of RA and chemotherapy alternatively. In order to
      overcome the resistance to RA, the continuation treatment of simple chemotherapy
      had been administered following CR. Two cases achieved remission in this way. The
      difference of resistant events to RA reached significance between these 2 groups
      of different continuation treatment.

PMID- 8352234
TI  - Hemostatic study before onset of disseminated intravascular coagulation.
AB  - Early diagnosis is necessary for the treatment of disseminated intravascular
      coagulation (DIC), but criteria for the stage preceding the diagnosis of DIC (pre
      DIC) have not yet been established. To clarify hemostatic abnormalities that
      occur before the onset of DIC, we performed hemostatic studies in 117 patients
      within at least a week before the onset of DIC (pre-DIC), in 237 patients with
      DIC, and in 50 patients without DIC or pre-DIC (non-DIC). Levels of FDP, PT, and
      fibrinogen, and platelet counts were significantly abnormal after the onset of
      DIC, but not before. Thrombin-antithrombin III complex (TAT), plasmin-alpha 2
      plasmin inhibitor complex (PIC), and FDP-D-dimer levels were significantly higher
      before the onset of DIC compared to the non-DIC patients. Hemostatic
      abnormalities were observed within a week before the onset of DIC. Monitoring the
      plasma levels of TAT, PIC, and FDP-D-dimer might be useful for the diagnosis of a
      pre-DIC condition.

PMID- 8352235
TI  - Phase II study of etoposide, ifosfamide, and mitoxantrone for the treatment of
      resistant adult acute lymphoblastic leukemia.
AB  - Although combination chemotherapy induces complete remission in 60-90% of adults
      with acute lymphoblastic leukemia, only 20-45% of patients remain in continued
      remission 5 years from diagnosis. For patients with a short first remission,
      multiple relapses, or patients with disease refractory to initial induction
      chemotherapy, few salvage treatments are successful. To improve the results of
      salvage therapy we studied the efficacy and toxicity of a combination of
      etoposide (100 mg/m2 IV qd x 5), ifosfamide (1.5 g/m2/d x 5), and mitoxantrone (8
      mg/m2/d IV x 3) in 11 adult patients with relapsed or refractory ALL. The median
      follow-up of all patients completing therapy is 208 days (30-484+ days). Eight of
      11 (73%; 95% confidence interval 45-92%) achieved a complete remission, two
      patients failed to enter remission, and one patient died of multiorgan system
      failure shortly after receiving therapy. Median DFS is 96 days and median
      survival from remission is 234 days. Five patients who achieved CR subsequently
      relapsed with a median time to relapse of 80 days (50-151 days). Median time to
      granulocyte > .5 x 10(9)/L was 28 days (21-46 days) and the median time to
      platelet recovery > 20 x 10(9)/L was 24 days (21-39 days). Although
      gastrointestinal toxicity was common, no patient developed severe cardiac,
      hepatic, pulmonary, or neurologic complications. These results demonstrate that
      the combination of etoposide, ifosfamide, and mitoxantrone can be used as an
      effective salvage therapy for patients with resistant ALL.

PMID- 8352236
TI  - Decreased affinity and number of transferrin receptors on erythroblasts in the
      anemia of rheumatoid arthritis.
AB  - In anemia of chronic disease (ACD) in rheumatoid arthritis (RA) a decreased iron
      uptake and transferrin binding by erythroblasts are postulated to play a
      pathophysiological role. To examine whether this is related to changes in
      transferrin receptor expression by erythroblasts, we studied bone marrow from 5
      healthy controls, 5 nonanemic RA patients, and 9 RA patients with ACD. Bone
      marrow mononuclear cells were incubated with increasing concentrations of 125I
      transferrin and specific binding data were analyzed by the method of Scatchard.
      The number of transferrin receptors on erythroblasts from RA patients with ACD
      was significantly lower as compared to nonanemic RA patients (P < .05) and
      controls (P < .02). The affinity of the transferrin receptor tended to be lower
      in ACD. These preliminary data may indicate that transferrin receptor expression
      by erythroblasts is impaired in ACD. Since the rate of erythroid iron uptake is
      mainly determined by the number of transferrin binding sites, this may explain a
      decrease in erythroblast iron availability in ACD in RA.

PMID- 8352237
TI  - Comparison between interphase and metaphase cytogenetics in detecting chromosome
      7 defects in hematological neoplasias.
AB  - Monosomy 7 (-7) is one of the most common chromosomal abnormalities found in the
      leukemic cells of patients with acute myelogenous leukemia (AML) and
      myelodysplastic syndrome (MDS). Because patients with -7 have a poor prognosis,
      their identification is important for treatment planning. Conventionally, -7 is
      detected by the G-banding technique. This study examines the use of fluorescent
      in situ hybridization (FISH) methodology to detect -7 cells in interphase nuclei
      and metaphase chromosomes. Fifteen AML or MDS patients whose leukemic cells were
      found to have -7 by G-banding at disease presentation were studied. In 13 of
      these patients, -7 could be detected in interphase by FISH using a chromosome 7
      specific centromeric DNA probe. The two patients whose leukemic cells were not
      detectable by interphase FISH had -7 and t(1q;7p), which were detectable by FISH
      in metaphase using a chromosome 7-specific painting probe. Metaphase FISH was
      particularly useful in further defining chromosome 7 defects in cells that
      contained aberrant or marker chromosomes. For example, in 6 patients, chromosome
      7 sequences were detectable in aberrant or marker chromosomes by metaphase FISH,
      but not by G-banding. These results suggest that metaphase FISH is an important
      adjunct to conventional cytogenetic methods for defining chromosome 7
      abnormalities in AML and MDS patients. Furthermore, interphase FISH is useful for
      follow-up studies in patients who are found informative for the FISH study at
      presentation.

PMID- 8352238
TI  - 8;21 translocation and multilineage involvement.
AB  - The translocation (8;21)(q22;q22) is commonly associated with acute myeloid
      leukemia (AML) M2 according to the French-American-British (FAB) classification.
      We describe 11 cases of t(8;21) diagnosed by strict FAB criteria. Six cases were
      diagnosed as AML M2, 3 cases as AML M4, 1 case as refractory anemia with excess
      of blasts in transformation, and 1 case as Philadelphia chromosome negative
      chronic myeloid leukemia in acceleration. Translocation (8;21) could thus occur
      in a wider variety of hematological abnormalities. Accordingly, we propose that
      t(8;21) may involve different hemopoietic lineages.

PMID- 8352239
TI  - In vivo antimalarial action of a lipophilic iron (III) chelator: suppression of
      Plasmodium vinckei infection by reversed siderophore.
AB  - We assessed in vivo antimalarial action of a lipophilic iron (III) chelator
      belonging to a new synthetic family of biomimetic siderophores previously termed
      reversed siderophores (RSFs). The family member, RSF ileum2, was chosen for its
      high membrane permeability and fast irreversible inhibition of human malaria
      parasite growth in vitro. [Shanzer A, et al., Proc Natl Acad Sci USA 88:6585,
      1991 and Lytton SD, et al., Blood 81:214, 1993]. The lipophilic drug was
      administered to Swiss mice by subcutaneous route in fractionated coconut oil at a
      dosage of 0.37 g/kg every 8 hr with no adverse reactions observed. After 3-4
      injections demonstrable suppression of Plasmodium vinckei petteri infection was
      observed and an additional 3-4 injections resulted in 2-3-fold lower parasitemia
      with prolonged survival time over sham-injected control mice.

PMID- 8352240
TI  - Cell-mediated immune-pancytopenia complicating primary Sjogren's syndrome.
AB  - A 64-year-old woman with mild bilateral parotid gland swelling and bilateral
      lower extremity purpura was admitted for evaluation of xerostomia and
      pancytopenia. The patient had an increased erythrocyte sedimentation rate,
      pancytopenia, and positive tests for antibodies to nuclear antigen, SS-A, and SS
      B. Impaired cell-mediated immunity was also present. Bone marrow aspiration
      showed a hypoplastic marrow with an increased percentage of lymphocytes. A
      positive Schirmer's test and keratoconjunctivitis were also noted. A diagnosis of
      primary Sjogren's syndrome was made by sialography and histological salivary
      gland findings. Therapy with prednisolone improved the pancytopenia. Addition of
      the patient's peripheral blood mononuclear cells to cultures of bone marrow
      mononuclear cells derived from a healthy volunteer dose dependently inhibited
      colony formation, including mixed hemopoietic colonies. On the other hand,
      addition of the patient's serum failed to inhibit colony formation by normal bone
      marrow mononuclear cells. These results suggested that one of the causes of
      pancytopenia in primary Sjogren's syndrome might be mediated by the inhibition of
      mononuclear cells to the hemopoietic progenitors.

PMID- 8352241
TI  - Measurement of red blood cell-vitamin B12: a study of the correlation between
      intracellular B12 content and concentrations of plasma holotranscobalamin II.
AB  - We have recently reported a new and rapid assay to measure plasma
      holotranscobalamin II (holo TC II) as a means of exploring vitamin B12 status. In
      order to further evaluate the significance of plasma holoTC II in determining
      tissue cobalamin, we have chosen the red blood cell-vitamin B12 (RBC-B12) assay
      as a measure of tissue vitamin B12 content and studied the relationship between
      RBC-B12 and plasma holoTC II levels. Plasma holoTC II and RBC-B12 concentrations
      were concomitantly assayed in 20 hematologically normal controls and cancer
      patients. In our groups of controls, the mean value of RBC-B12 was determined as
      241 +/- 51 pg/ml of packed erythrocytes (PE) with a range varying from 180 to 355
      pg/ml PE. Preliminary results obtained in 32 cancer patients revealed lower
      holoTC II and RBC-B12 levels than the control group and a required threshold
      value of 70 pg/ml of holoTC II in order to maintain a normal RBC-B12 greater than
      180 pg/ml PE.

PMID- 8352242
TI  - Azidothymidine (AZT)-induced siderosis.
AB  - Azidothymidine (AZT) interferes with heme synthesis. This should upregulate the
      synthesis of transferrin receptors and increase the amount of iron taken up by
      the cell. We found a 50% increase in the iron content of liver and a 20% increase
      in the iron content of macrophages in AZT-treated mice.

PMID- 8352243
TI  - Excess iron and catastrophic illness.

PMID- 8352244
TI  - Primary plasmacytoma of generalized lymph nodes: a long survivor.
AB  - Extramedullary plasmacytomas are occasionally seen in the course of multiple
      myeloma; however, primary plasmacytomas are unusual. Most of the primary
      plasmacytomas arise in the upper respiratory system, but a plasmacytoma of the
      lymph nodes is very rare. A case of a 56-year-old female with primary
      plasmacytoma in the lower mandibular, cervical, axillary, and para-aortic lymph
      nodes accompanied by IgA Kappa paraproteinemia is described. After ten courses of
      combination chemotherapy with cyclophosphamide and prednisolone, she obtained
      complete response. However, 6 years later, she had a relapse of plasmacytoma in
      the generalized lymph nodes. She received ten treatments of melphalan
      prednisolone and again obtained complete response. She has remained well without
      chemotherapy or recurrent signs for 9 years. It is considered that conventional
      chemotherapy can be useful for primary plasmacytoma of generalized lymph nodes.

PMID- 8352246
TI  - Relapsing polychondritis and myelodysplastic syndrome.

PMID- 8352245
TI  - Megakaryoblastic transformation of polycythemia vera associated with
      hypercalcemia.
AB  - Leukemic transformation is not uncommon in polycythemia vera, particularly after
      treatment with chemotherapeutic agents. The leukemias that supervene are mostly
      of myeloid type but megakaryoblastic transformation is distinctly uncommon. We
      report a case of polycythemia vera terminating in megakaryoblastic leukemia with
      associated hypercalcemia.

PMID- 8352247
TI  - Cytochrome B5 reductase deficiency and mental retardation.

PMID- 8352248
TI  - Renal malacoplakia reappraised.
AB  - Renal malacoplakia is an unusual form of chronic tubulointerstitial nephritis
      with a predilection for patients with recurrent urinary tract infections and an
      immunocompromised state. Its characteristic feature is the parenchymal
      infiltration by macrophages with ample cytoplasm containing abundant periodic
      acid-Schiff-positive granules, known as von Hansemann cells, and the presence of
      diagnostic extracytoplasmic or intracytoplasmic calcospherites, known as
      Michaelis-Gutmann bodies. Renal malacoplakia is more common in women (female to
      male ratio 3:1), in whom the lesions develop in a younger age group (third to
      fifth decade) than in men (over 50 years). Enlarged kidneys in the presence of
      persistent urinary infection should lead to the consideration of this entity. The
      diagnosis can only be established by pathologic examination of renal tissue.
      Renal biopsy early in the course of the disease is essential since in an
      increasing number of cases medical therapy has resulted in resolution of the
      disease process and preservation of renal function.

PMID- 8352249
TI  - Clinical significance of antineutrophil cytoplasmic autoantibodies with
      specificity for lactoferrin in renal diseases.
AB  - The prevalence and clinical significance of antineutrophil cytoplasmic antibodies
      with specificity for lactoferrin was determined in patients with renal diseases.
      Antilactoferrin antibodies were found in only 12 of 920 patients (1.3%). These
      patients had either "pauci-immune" necrotizing crescentic glomerulonephritis
      (three cases) or lupus nephritis (nine cases). To verify whether antilactoferrin
      antibodies were specific for patients with systemic lupus erythematosus (SLE) and
      renal involvement, we studied 61 additional lupus patients, 40 with active lupus
      nephritis and 21 with active SLE and no renal involvement. Antilactoferrin
      antibodies were found in approximately 15% to 20% of patients with SLE,
      irrespective of the presence of renal involvement. We conclude that
      antineutrophil cytoplasmic antibodies with specificity for lactoferrin are only
      sporadically found in patients with renal diseases; these patients have either
      necrotizing crescentic glomerulonephritis or lupus nephritis. However,
      antilactoferrin antibodies are not a marker for renal involvement in SLE.

PMID- 8352250
TI  - Insurability for asymptomatic hematuria or proteinuria during childhood.
AB  - The objective of this survey was to describe life insurance underwriting
      practices concerning children with asymptomatic hematuria and proteinuria. A
      questionnaire was sent to 200 companies licensed to issue life insurance policies
      in the state of New York. The medical director of each company was asked to
      respond to the insurability of children with asymptomatic hematuria and
      proteinuria. Two case summaries were provided with the questionnaire. Of 97
      companies, 66 would offer insurance to the patient with hematuria, although 38
      (58%) would charge additional premiums. In response to the problem of
      proteinuria, 61 companies would offer life insurance, although 50 (82%) would
      require higher premium charges (P < 0.002 compared with hematuria). We conclude
      that children with asymptomatic hematuria and proteinuria can usually obtain life
      insurance, although often at higher cost. Invasive diagnostic tests are not
      necessary for insurers to offer insurance.

PMID- 8352251
TI  - Plasma exchange in children with hemolytic-uremic syndrome at risk of poor
      outcome.
AB  - A retrospective study on the use of plasma exchange in children with hemolytic
      uremic syndrome was conducted to compare the renal outcome in treated and
      nontreated patients. Only children over 5 years of age were selected because they
      seem to be at major risk of bad renal prognosis. The evolution of renal function
      in the two populations is not significantly different, but chronic renal failure
      (clearance < 60 mL/min/1.73 m2) and end-stage renal failure were present only in
      untreated patients.

PMID- 8352252
TI  - Linear estimates of variable-volume, single-pool Kt/V: an analysis of error.
AB  - Two linear approximations of variable-volume, single-pool Kt/V were compared.
      Each is based on the corrected postserum/preserum urea nitrogen ratio (R), called
      R', where R' = R - 0.03 - UF/W (UF/W being the ratio of the ultrafiltrate volume
      removed to the postdialysis weight). The two formulas were derived by
      construction of tangents to the exponential curve y = -In(R') at approximately
      1.0 and 1.3, namely, y = 2 - 2.7(R') and y = 2.2 - 3.3(R'), respectively. The
      linear formulas were compared with each other and to our previous logarithmic
      formula -In(R - 0.008*t - UF/W). All were compared with the modeled Kt/V using a
      variable-volume, single-pool kinetic model in 500 dialysis sessions, with Kt/V
      ranging from 0.7 to 2.1. Analysis of error uncovered systematic errors in all the
      formulas. However, each of the new linear formulas had very little systematic
      error in the Kt/V range it was designed for, over a span of 0.6 - 0.7 Kt/V units.
      Outside this range the linear formulas underestimate the variable-volume, single
      pool modeled Kt/V, but, barring two-pool or other technical errors, they do not
      markedly overestimate Kt/V in any Kt/V range. The total error with the new linear
      formulas was an acceptable 5%, in the range they were designed for. The results
      suggest that precise estimates of Kt/V can be derived using linear formulas as
      long as a given Kt/V range is targeted.

PMID- 8352253
TI  - Atherogenic lipids and lipoproteins in hemodialysis patients.
AB  - Dyslipidemia may contribute to atherosclerosis in hemodialysis patients. While
      hypertriglyceridemia is relatively common in this population,
      hypercholesterolemia is not. Since abnormalities in various plasma cholesterol
      fractions and lipoproteins have been associated with an increased incidence of
      cardiovascular disease in the nonuremic population, we examined these
      abnormalities to determine whether they occur in patients with chronic renal
      failure. Twenty-four patients on maintenance hemodialysis were studied. We found
      that, despite relatively low plasma total cholesterol levels, a substantial
      number of patients had low high-density lipoprotein cholesterol, low
      apolipoprotein AI, and high apolipoprotein B levels. Furthermore, approximately
      40% and 30%, respectively, of the patients had elevated plasma levels of
      lipoprotein(a) and remnants of chylomicron and very low-density lipoprotein.
      Lipoprotein(a) levels could not be predicted from any of the variables that were
      studied. The abnormal plasma levels of these potentially atherogenic lipids and
      lipoproteins suggest that they may contribute to the high incidence of
      cardiovascular diseases in the hemodialysis population.

PMID- 8352255
TI  - Comparison of first use and reuse of cuprophan membranes on interleukin-1
      receptor antagonist and interleukin-1 beta production by blood mononuclear cells.
AB  - The magnitude of the changes in a variety of blood constituents on exposure to
      the dialysis membrane has been used as an index of "biocompatibility," and
      dialyzer reuse has been postulated to improve biocompatibility by attenuating
      these changes. We studied the hemodialysis-induced changes in the in vitro
      production of interleukin-1 receptor antagonist (IL-1Ra) and interleukin-1 beta
      (IL-1 beta) by peripheral blood mononuclear cells (PBMCs), and compared the
      effect of first use and reuse of cuprophan membranes on these changes. Studies
      were performed during dialysis with first use and third reuse of the same kidney.
      The cell content and production of IL-1Ra and IL-1 beta by unstimulated and
      endotoxin- or IgG-stimulated PBMCs were studied just prior to dialysis, and from
      the afferent and efferent limbs of the blood circuit 15 minutes after the start
      of dialysis. Interleukin-1 receptor antagonist and IL-1 beta were measured by
      specific radioimmunoassay and are expressed as picograms per 2.5 x 10(6) PBMCs.
      Fifteen minutes after the start of dialysis, the number of PBMCs harvested from
      10 mL of blood decreased from 19.8 +/- 4.7 x 10(6) predialysis to 14 +/- 3 x
      10(6) (P = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352254
TI  - Uremic myopathy limits aerobic capacity in hemodialysis patients.
AB  - Eleven end-stage renal disease patients trained by stationary cycling during
      their hemodialysis treatments. After a 6-week control period, 12 weeks of
      training began and was increased to 30 to 60 minutes at > or = 70% of peak heart
      rate. Baseline, pretraining and, posttraining exercise tests were performed.
      Workload (WL), oxygen uptake (VO2peak), cardiac output (Q), heart rate (HR), and
      arterial oxygen content (CaO2) were measured. Stroke volume (SV), arteriovenous
      oxygen difference ((a-v)O2), and mixed-venous oxygen content (CvO2) were
      calculated. Rectus femoris biopsies were obtained pretraining and posttraining.
      At peak exercise, WL increased from 60 +/- 4 to 70 +/- 6 W (P < 0.05), VO2peak
      showed an upward trend from 14.8 +/- 0.9 to 16.8 +/- 1.3 mL/kg/min (P < 0.1), and
      Q, HR, SV, CaO2, CvO2, and (a-v)O2 were unchanged. Ten of the 11 patients
      increased WL, but only six increased VO2peak (five of 11 patients decreased
      VO2peak). The difference between groups (P < 0.02) was attributable to (a-v)O2,
      which increased in those who increased VO2peak (P < 0.02). There was an upward
      trend for succinate dehydrogenase activity (P < 0.06), and phosphofructokinase
      activity increased (P < 0.05). However, the rectus femoris capillary to fiber
      ratio, type I and II fiber areas, and fiber area variability were unchanged, and
      neither histomorphologic nor enzymatic activity changes were related to change in
      VO2peak. We conclude that not all dialysis patients increase VO2peak after
      training, but most can improve exercise capacity. Patients who improved VO2peak
      widened their (a-v)O2 difference, increasing oxygen extraction and showing that
      oxygen delivery is not always the limiting factor. Thus, the limitation of
      VO2peak in dialysis patients is a complex interaction of central and peripheral
      factors. Muscle therapies, such as exercise training, are needed in addition to
      increased oxygen delivery in rehabilitation of dialysis patients.

PMID- 8352256
TI  - Gentamicin clearance during hemodialysis: a comparison of high-efficiency
      cuprammonium rayon and conventional cellulose ester hemodialyzers.
AB  - The advent of high-efficiency hemodialyzers has afforded improved efficiency of
      urea clearance; however, increased clearance of other substances, particularly
      antibiotics, also may occur, necessitating changes in clinical practice.
      Accordingly, we compared the efficiency of gentamicin removal using two different
      hemodialyzers, a conventional saponified cellulose ester (CD 135) and a high
      efficiency cuprammonium rayon dialyzer (TAF 175L), in eight hospitalized patients
      undergoing antibiotic therapy for suspected or proven gram-negative infection.
      The rate of dialysis, estimated as the ratio of dialyzer urea clearance (K) to
      urea distribution volume (V) (K/V urea), and the total elimination rate constant
      (k) of gentamicin were measured during 17 hemodialysis treatments. The K/V urea
      for the two dialyzers, TAF 175L and CD 135, was 0.390 +/- 0.024 hr-1 and 0.413 +/
      0.129 hr-1 (P = NS), respectively. The TAF 175L hemodialyzer was almost twice as
      efficient in removing gentamicin as the CD 135: TAF 175, k = 0.263 +/- 0.024 hr
      1; CD 135, k = 0.132 +/- 0.027 hr-1 (P < 0.001). Moreover, the rate of dialysis
      (K/V urea) was correlated with k of gentamicin for the TAF 175L dialyzer (r2 =
      0.50, P < 0.02) but not for the CD 135 dialyzer. We conclude that dialyzer
      characteristics and the rate of dialysis (K/V urea) should be taken into
      consideration when determining the dosage of gentamicin in patients on
      hemodialysis.

PMID- 8352257
TI  - Maintenance of bone mass in patients receiving dialytic therapy.
AB  - To determine what factors contribute to and change bone mineral density (BMD) in
      dialysis patients, serial lumbar spine dual x-ray absorptiometry studies were
      analyzed by stepwise regression analysis in 67 black dialysis patients. The
      patients were 50.5 +/- 2.0 years of age (mean +/- SE) and 49% were men; the
      patients had received dialytic therapy for 3.7 +/- 0.5 years. The mean initial
      BMD z-score was 0.147 +/- 0.182. By cross-sectional analysis, the BMD increased
      in the male and premenopausal female patients but decreased in the postmenopausal
      female patients by 2.5% g/cm2/decade of life, less than that observed in black
      patients with normal renal function. Univariate analysis and stepwise regression
      analysis demonstrated radiographic evidence of osteopenia (beta-coefficient = 
      0.180 +/- 0.050; P = 0.001) and prior parathyroidectomy (beta-coefficient = 0.133
      +/- 0.070; P = 0.054) as the only variables significantly correlated to the BMD.
      The effects of biochemical variables and different treatments on the delta BMD,
      calculated as the difference between each patient's first and second BMDs divided
      by the interval in years, were evaluated by stepwise regression analysis in 41
      patients. The mean interval between the two BMDs was 18.4 +/- 1.02 months (range,
      5 to 34 months) and the delta BMD was 0.025 +/- 0.018 g/cm2/yr, increasing in 65%
      of the patients. By univariate and stepwise regression analysis, the mean monthly
      serum total alkaline phosphatase concentration was the only variable that
      correlated with the delta BMD (beta-coefficient = 0.0001; P = 0.030).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8352258
TI  - Evidence for increased cancer deaths in chronic dialysis patients.
AB  - We analyzed longitudinal data on the cancer mortality rate in chronic dialysis
      patients and in the general population in Okinawa, Japan. In the general
      population from 1980 to 1990, the mortality rate has been stable at approximately
      1.300 males and 0.897 females per thousand persons year, the male to female ratio
      being 1.45. In the period from 1971 to 1990, we found 91 (4.6%) patients with
      cancer in a group of 1,982 (824 females and 1,158 males) chronic dialysis
      patients; forty-nine of the 91 patient (53.8%) died by April 1, 1991. Using the
      standard mortality rate in the general population, which was obtained for each
      sex and age class (0 to 34 years, 35 to 44 years, 45 to 54 years, 55 to 64 years,
      and > or = 65 years), we calculated the relative risk of death from cancer in
      dialysis patients. The risk ratio in dialysis patients was significantly
      increased, being 2.48 (P < 0.05) for males and 3.99 (P < 0.05) for females. The
      mean (+/- SEM) age at the time of death from cancer in the dialysis group was
      60.1 +/- 2.0 years in the males and 60.1 +/- 2.1 years in the females; the males
      were 6.3 years younger than the general population and the females were 9.3 years
      younger. The proportion of patients with colon cancer (both sexes) and cancer of
      the uterus and breast (females) was higher in the dialysis patients than in the
      general population.

PMID- 8352259
TI  - Extrarenal effect of cyclosporine A on potassium homeostasis in renal transplant
      recipients.
AB  - Cyclosporine A (CyA) is known to cause hyperkalemia by impairing renal potassium
      excretion. However, the observation of transient and severe hyperkalemia
      occurring within 3 to 5 hours of CyA ingestion in several organ transplant
      patients led us to postulate that it might also cause a potassium efflux from the
      intracellular to the extracellular fluid space. We tested this hypothesis by
      studying 22 nondiabetic, renal transplant patients with stable renal function
      (serum creatine < 2.25 mg/dL) who were treated with CyA (CyA group; n = 14) or
      imuran and prednisone (STD group; n = 8). Eight CyA and four STD patients also
      were treated with a beta-blocker (BB). While at rest, fasting plasma potassium
      levels were sampled hourly in all patients from 8:00 am to 1:00 pm. All
      medications (including CyA and BBs) were given after the 8:00 am blood sampling.
      Venous pH, osmolality, insulin, aldosterone, epinephrine, norepinephrine, and CyA
      levels also were determined at 8:00 am, 11:00 am, and 1:00 pm. Urine was
      collected from 11:00 pm to 8:00 am prior to the study (period I) and from 8:00 am
      to 1:00 pm during the study (period II) for measurement of potassium excretion
      (standardized to a 5-hour period). A significant increase in serial plasma
      potassium levels was noted in the CyA + BB group only (P = 0.0006 by repeated
      measures analysis of variance).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352260
TI  - Prevalence and long-term outcome of glomerulonephritis in renal allografts.
AB  - We report long-term results over 10 years in patients developing
      glomerulonephritis after renal transplantation. The prevalence rate of
      glomerulonephritis was 6.2% in 785 renal transplants involving 697 patients with
      end-stage renal disease. This rate was 14% in patients undergoing biopsy of their
      grafts because of malfunction. The rate was 15% in patients diagnosed as having
      glomerulonephritis of any cause prior to transplantation. Membranous, focal
      sclerosing, and IgA glomerulonephritis were the most common histologic diagnoses.
      Documented histologic recurrence occurred in only 1% of patients with poor,
      biopsy-proven glomerulonephritis of their native kidneys. Patients with focal
      sclerosing glomerulonephritis had the greatest risk from recurrence. De novo
      glomerulonephritis was most likely to be membranous in character. The graft
      survival rate of patients with glomerulonephritis was not distinguishable from
      that of patients showing rejection; both were 45% at 60 months and 33% versus
      11%, respectively, at 120 months (P = NS); the graft survival rate in patients
      without rejection was 76% at 120 months. Thus, glomerulonephritis is responsible
      for approximately 14% of renal graft malfunction. Glomerulonephritis has a
      prognosis similar to chronic rejection. Finally, glomerulonephritis as specific
      histologic recurrence is unusual. Patients with glomerulonephritis should not be
      discouraged from undergoing transplantation because of putative risks related to
      recurrence.

PMID- 8352261
TI  - Abrogation of MRL/lpr lupus nephritis by dietary flaxseed.
AB  - A diet supplemented with flaxseed, rich in alpha-linolenic acid and plant lignans
      (the latter, potent platelet-activating factor receptor antagonists), was tested
      in a murine model of lupus nephritis. MRL/lpr female mice (n = 25) were fed 15%
      flaxseed diet for 14 weeks commencing at 10 weeks of age. As controls, 30 MRL/lpr
      mice received a standard rodent diet without flaxseed. Isotope-glomerular
      filtration rate (14C-inulin clearance) was measured at 9, 16, and 24 weeks of
      age. Proteinuria was assessed at 2-week intervals. Spleen lymphocyte
      proliferation, quantitated by DNA analysis, was evaluated using flow cytometry at
      9, 13, 19, and 21 weeks of age. Mortality was recorded throughout the study.
      Glomerular filtration rate at 16 weeks was greater in flaxseed-fed mice (0.15 +/-
      0.03 mL/min) compared with controls (0.06 +/- 0.04 mL/min; P = 0.01). The onset
      of proteinuria (Albustix, Ames Division, Miles Laboratories, Rexdale, Ontario,
      Canada; > or = 2+) was delayed by 4 weeks in the flax-treated mice. The
      percentage of flaxseed-fed mice with proteinuria was lower than the control mice
      up to 21 weeks of age (39% v 58%; P = 0.01). Spleen lymphocyte proliferation
      (percentage of cells in S-phase) at 13 weeks of age was significantly higher in
      the control group (22.9 +/- 5.0, P = 0.01) but not in the flaxseed group (17.2 +/
      4.9) compared with baseline (9 weeks of age) values (13.0 +/- 3.5). Mortality
      was lower in the flaxseed-fed mice versus the control mice (assessed by Mantel
      Haenszel (log-rank) test; P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352262
TI  - Ranitidine-associated interstitial nephritis and Fanconi syndrome.
AB  - Ranitidine is an H2 blocking agent widely used in the treatment of peptic ulcer
      disease. Although acute interstitial nephritis has been described in association
      with a related drug, cimetidine, this complication secondary to ranitidine has
      been reported only once before. We describe a patient who presented with acute
      renal failure and features of Fanconi syndrome in association with the use of
      ranitidine. Renal biopsy showed acute interstitial nephritis. The patient had
      renal tubular acidosis with alkaline urine, aminoaciduria, renal glycosuria,
      uricosuria, and phosphaturia. There was a marked disparity between the degree of
      elevation of urea nitrogen and creatinine concentrations in the serum that was
      attributable to diminished urea generation, since simultaneous measurement of
      inulin, creatinine, and urea clearances showed that they were comparably reduced.
      Urinary nitrogen loss in the form of aminoaciduria contributed significantly to
      decreased urea generation. Both acute renal failure and Fanconi syndrome resolved
      after treatment with prednisone.

PMID- 8352263
TI  - Ranitidine-induced acute interstitial nephritis with epithelial cell foot process
      fusion.
AB  - Although acute interstitial nephritis has been well described with the histamine
      H2-receptor antagonist cimetidine, we found only one previous case report of
      ranitidine-induced interstitial nephritis in the literature. We describe an
      additional patient who developed acute interstitial nephritis after taking
      ranitidine. Electron microscopy showed focal fusion of the epithelial cell foot
      processes that was not described in the previous report of ranitidine-induced
      interstitial nephritis.

PMID- 8352264
TI  - Simultaneous "in series" hemodialysis and hemoperfusion in the management of
      valproic acid overdose.
AB  - There is little published experience with the extracorporeal treatment of
      valproic acid overdose, although the pharmacokinetic properties of valproic acid
      suggest a potential role for hemodialysis and/or hemoperfusion. At therapeutic
      concentrations valproic acid is highly protein bound, but at the higher
      concentrations seen in the overdose setting binding sites become saturated and
      free valproic acid should be subject to removal by hemodialysis. We report the
      case of a patient with serious toxicity secondary to valproic acid overdose who
      was successfully treated with a combination of hemodialysis and hemoperfusion.
      With this treatment the half-life of valproic acid was reduced from a predialysis
      level of 13 hours to 1.7 hours, with rapid lowering of valproic acid levels and
      dramatic clinical improvement. Based on our experience in this patient and a
      review of previously reported cases, hemodialysis should be considered in the
      treatment of valproic acid overdose.

PMID- 8352265
TI  - Acute renal allograft dysfunction in the setting of deep venous thrombosis: a
      case of successful urokinase thrombolysis and a review of the literature.
AB  - Acute renal allograft vein thrombosis is a rare but serious complication of renal
      transplantation. When occurring in the early posttransplant period it is usually
      associated with surgical complications and often results in the loss of the
      graft. At later stages, when graft function has stabilized, its development may
      then be associated with underlying disorders such as glomerulonephritis,
      immunosuppressive therapy, increased hematocrit, acute rejection, or extension of
      lower extremity venous thromboses. We report a case of acute allograft
      dysfunction occurring in the setting of extensive deep vein thrombosis. In our
      patient, thrombosis in the setting of acute graft tenderness and swelling,
      anuria, and an increasing creatinine strongly suggest a diagnosis of acute
      allograft renal vein thrombosis. We describe a successful reversal of acute renal
      failure through urokinase thrombolysis and review the current literature on the
      use of thrombolytic agents for the treatment of acute renal allograft vein
      thrombosis.

PMID- 8352266
TI  - Membranous nephropathy associated with renal cell carcinoma.

PMID- 8352268
TI  - Intravenous versus subcutaneous dosing of epoetin: a review of the literature.
AB  - Recombinant human erythropoietin (epoetin) is approved to be administered by the
      intravenous (i.v.) or subcutaneous (SC) route. Several studies have been
      conducted and published that compare the relative pharmacokinetics and efficacy
      of the IV and SC routes. An analysis of the methodology and results of these
      studies reveals that the data have been somewhat contradictory and highly
      variable. However, most investigations have concluded that the SC route is
      associated with a decreased dose requirement in the correction and/or maintenance
      phase. To justify a switch from the i.v. to the SC route, it is important to
      consider the practical implications, including patient and staff acceptance, as
      well as the financial aspects. Regardless of the route of administration, dose
      titration must be individualized based on the patient's response to epoetin
      therapy, red blood cell turnover rate, and iron status. More studies are needed
      to develop a standardized cost-effective method for epoetin dosing in patients on
      dialysis.

PMID- 8352267
TI  - Optimizing epoetin therapy in end-stage renal disease: the case for subcutaneous
      administration.
AB  - The effectiveness of various recombinant human erythropoietin (epoetin)
      administration routes and dosage schedules in patients on dialysis was studied.
      The mean dose required to achieve and maintain a hematocrit level between 33% and
      40% is 225 U/kg/wk when administered intravenously (i.v.) in three divided doses.
      A once-weekly i.v. schedule requires a dose of 429 U/kg/wk to maintain the same
      target hematocrit. In contrast, the required epoetin dose is reduced by an
      average of 25% to 50% when administered via the subcutaneous (SC) route. Analysis
      of data from 25 dialysis centers shows that SC epoetin administration resulted in
      higher normalized responses than i.v. administration. The hematocrit response in
      patients at these centers was proportional to the weekly dose, with a greater
      slope in those centers using predominantly SC as compared with i.v. dosing. Cost
      analysis indicates that the use of SC dosing two or three times weekly at an
      average total weekly dose of 120 U/kg is effective for the treatment of anemia in
      most patients on dialysis.

PMID- 8352269
TI  - National Cooperative rHu Erythropoietin Study in patients with chronic renal
      failure--an interim report. The National Cooperative rHu Erythropoietin Study
      Group.
AB  - This second interim report of the National Cooperative rHu Erythropoietin Study
      presents data from 324 patients new to recombinant human erythropoietin (Epoetin
      alfa) who completed at least 12 months of study participation. Mean hematocrit
      levels increased to approximately 30% by month 3 in patients on hemodialysis (n =
      293) and stabilized for the remainder of the study whether Epoetin alfa was
      administered by the intravenous (n = 250) or subcutaneous (n = 42) route. The
      intravenous dosage level ranged between 106.9 and 121.6 U/kg/wk; subcutaneous
      dosing ranged between 87.4 and 108.0 U/kg/wk; dosing levels in patients on
      peritoneal dialysis (n = 31) were similar, although there was a trend towards
      slightly higher hematocrit levels. Throughout the 12 months of the study, there
      was no relationship between blood pressure and either hematocrit level or Epoetin
      alfa dose. Approximately two thirds of the patients were receiving iron
      supplementation at any given time, and there was a trend towards the increased
      use of oral iron supplements. The incidence of adverse events in this cohort of
      patients was low throughout the study, and there was no relationship between the
      incidence of adverse events and either hematocrit level or Epoetin alfa dose.
      Based on an analysis of data from baseline to first follow-up, Epoetin alfa
      therapy resulted in improvement in several quality-of-life factors, most notable
      of which was vitality. Improvement occurred in all patient subgroups with some
      variability in the level and intensity of effect. Overall, these data demonstrate
      that Epoetin alfa therapy is safe and effective when used in a broad cross
      section of patients on dialysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352270
TI  - Facility reimbursement: a critical comparison between hemodialysis and peritoneal
      dialysis.
AB  - The population of patients on dialysis in the United States is growing at between
      8% and 9% annually. The increasing patient load places a burden on existing
      dialysis facility capacity and creates a challenge for physicians and
      administrators to meet patient demand in the future. Increasing costs, reductions
      in reimbursement, and volatile regulatory policy have increased the risks
      associated with operating and investing in dialysis facilities. It is important
      that administrators and physicians understand the economics associated with the
      modalities available to treat patients on dialysis and that they incorporate this
      understanding into their planning for the future.

PMID- 8352271
TI  - mtDNA sequences suggest a recent evolutionary divergence for Beringian and
      northern North American populations.
AB  - Conventional descriptions of the pattern and process of human entry into the New
      World from Asia are incomplete and controversial. In order to gain an
      evolutionary insight into this process, we have sequenced the control region of
      mtDNA in samples of contemporary tribal populations of eastern Siberia, Alaska,
      and Greenland and have compared them with those of Amerind speakers of the
      Pacific Northwest and with those of the Altai of central Siberia. Specifically,
      we have analyzed sequence diversity in 33 mitochondrial lineages identified in 90
      individuals belonging to five Circumpolar populations of Beringia, North America,
      and Greenland: Chukchi from Siberia, Inupiaq Eskimos and Athapaskans from Alaska,
      Eskimos from West Greenland, and Haida from Canada. Hereafter, we refer to these
      five populations as "Circumarctic peoples." These data were then compared with
      the sequence diversity in 47 mitochondrial lineages identified in a sample of 145
      individuals from three Amerind-speaking tribes (Bella Coola, Nuu-Chah-Nulth, and
      Yakima) of the Pacific Northwest, plus 16 mitochondrial lineages identified in a
      sample of 17 Altai from central Siberia. Sequence diversity within and among
      Circumarctic populations is considerably less than the sequence diversity
      observed within and among the three Amerind tribes. The similarity of sequences
      found among the geographically dispersed Circumarctic groups, plus the small
      values of mean pairwise sequence differences within Circumarctic populations,
      suggest a recent and rapid evolutionary radiation of these populations. In
      addition, Circumarctic populations lack the 9-bp deletion which has been used to
      trace various migrations out of Asia, while populations of southeastern Siberia
      possess this deletion. On the basis of these observations, while the evolutionary
      affinities of Native Americans extend west to the Circumarctic populations of
      eastern Siberia, they do not include the Altai of central Siberia.

PMID- 8352272
TI  - Chromosome 14 and late-onset familial Alzheimer disease (FAD).
AB  - Familial Alzheimer disease (FAD) is genetically heterogeneous. Two loci
      responsible for early-onset FAD have been identified: the amyloid precursor
      protein gene on chromosome 21 and the as-yet-unidentified locus on chromosome 14.
      The genetics of late-onset FAD is unresolved. Maximum-likelihood, affected
      pedigree-member (APM), and sib-pair analyses were used, in 49 families with a
      mean age at onset > or = 60 years, to determine whether the chromosome 14 locus
      is responsible for late-onset FAD. The markers used were D14S53, D14S43, and
      D14S52. The LOD score method was used to test for linkage of late-onset FAD to
      the chromosome 14 markers, under three different models: age-dependent
      penetrance, an affected-only analysis, and age-dependent penetrance with
      allowance for possible age-dependent sporadic cases. No evidence for linkage was
      obtained under any of these conditions for the late-onset kindreds, and strong
      evidence against linkage (LOD score < or = -2.0) to this region was obtained.
      Heterogeneity tests of the LOD score results for the combined group of families
      (early onset, Volga Germans, and late onset) favored the hypothesis of linkage to
      chromosome 14 with genetic heterogeneity. The positive results are primarily from
      early-onset families. APM analysis gave significant evidence for linkage of
      D14S43 and D14S52 to FAD in early-onset kindreds (P < .02). No evidence for
      linkage was found for the entire late-onset family group. Significant evidence
      for linkage to D14S52, however, was found for a subgroup of families of
      intermediate age at onset (mean age at onset > or = 60 years and < 70 years).
      These results indicate that the chromosome 14 locus is not responsible for
      Alzheimer disease in most late-onset FAD kindreds but could play a role in a
      subset of these kindreds.

PMID- 8352273
TI  - De novo microdeletion on an inherited Robertsonian translocation chromosome: a
      cause for dysmorphism in the apparently balanced translocation carrier.
AB  - Robertsonian translocations are usually ascertained through abnormal children,
      making proposed phenotypic effects of apparently balanced translocations
      difficult to study in an unbiased way. From molecular genetic studies, though,
      some apparently balanced rearrangements are now known to be associated with
      phenotypic abnormalities resulting from uniparental disomy. Molecular
      explanations for other cases in which abnormality is seen in a balanced
      translocation carrier are being sought. In the present paper, an infant is
      described who has retarded growth, developmental delay, gross muscular hypotonia,
      slender habitus, frontal bossing, micrognathia, hooked nose, abundant wispy hair,
      and blue sclerae. Cytogenetically, she appeared to be a carrier of a balanced,
      paternally derived 14;21 Robertsonian translocation. Analysis of DNA
      polymorphisms showed that she had no paternal allele at the D14S13 locus (14q32).
      Study of additional DNA markers within 14q32 revealed that her previously
      undescribed phenotype results from an interstitial microdeletion within 14q32.
      Fluorescent in situ hybridization was used to show that this microdeletion had
      occurred de novo on the Robertsonian translocation chromosome. These observations
      may reactivate old suspicions of a causal association between Robertsonian
      translocations and de novo rearrangements in offspring; a systematic search for
      similar subcytogenetic rearrangements in other families, in which there are
      phenotypically abnormal children with apparently balanced translocations, may be
      fruitful. The clinical and molecular genetic data presented also define a new
      contiguous gene syndrome due to interstitial 14q32 deletion.

PMID- 8352274
TI  - Individual DNA identification from ancient human remains.
AB  - Individual identification of ancient human remains is one of the most fundamental
      requisites for studies of paleo-population genetics, including kinship among
      ancient people, intra- and interpopulation structures in ancient times, and the
      origin of human populations. However, knowledge of these subjects has been based
      mainly on circumstantial archaeological evidence for kinship and intrapopulation
      structure and on genetic studies of modern human populations. Here we describe
      individual identification of ancient humans by using short-nucleotide tandem
      repeats and mtDNAs as genetic markers. The application of this approach to
      kinship analysis shows clearly the presence or absence of kinship among the
      ancient remains examined.

PMID- 8352275
TI  - Linkage analysis of idiopathic generalized epilepsy (IGE) and marker loci on
      chromosome 6p in families of patients with juvenile myoclonic epilepsy: no
      evidence for an epilepsy locus in the HLA region.
AB  - Evidence for a locus (EJM1) in the HLA region of chromosome 6p predisposing to
      idiopathic generalized epilepsy (IGE) in the families of patients with juvenile
      myoclonic epilepsy (JME) has been obtained in two previous studies of separately
      ascertained groups of kindreds. Linkage analysis has been undertaken in a third
      set of 25 families including a patient with JME and at least one first-degree
      relative with IGE. Family members were typed for eight polymorphic loci on
      chromosome 6p: F13A, D6S89, D6S109, D6S105, D6S10, C4B, DQA1/A2, and TCTE1.
      Pairwise and multipoint linkage analysis was carried out assuming autosomal
      dominant and autosomal recessive inheritance and age-dependent high or low
      penetrance. No significant evidence in favor of linkage was obtained at any
      locus. Multipoint linkage analysis generated significant exclusion data (lod
      score < -2.0) at HLA and for a region 10-30 cM telomeric to HLA, the extent of
      which varied with the level of penetrance assumed. These observations indicate
      that genetic heterogeneity exists within this epilepsy phenotype.

PMID- 8352276
TI  - Influence of genotype-dependent effects of covariates on the outcome of
      segregation analysis of the body mass index.
AB  - Several recent studies of the body mass index (BMI) have provided support for a
      recessive major gene influencing heaviness in humans. Segregation analysis of the
      BMI was carried out recently in a series of randomly sampled French-Canadian
      families to determine whether we could replicate the major gene finding by using
      a residual phenotype adjusted for the effects of age and sex. The best model
      included a recessive major effect for high BMI values with residual familial
      resemblance; however, Mendelian transmission could not be confirmed, and the no
      transmission hypothesis (where all the tau's are constrained to be equal) was not
      rejected. Considering that the BMI is a complex phenotype affected by many
      factors and that there are known variations in body composition during growth and
      aging, we undertook a reanalysis of the data, using a model that allowed the
      estimation of genotype-specific age and gender effects. New tests on the
      transmission parameters satisfy the criteria for interfering Mendelian
      segregation. The results suggest that individuals with the "high" recessive
      genotype show the greatest degree of heaviness at birth, with a subsequent trend
      toward lower values throughout life, while individuals with the dominant "normal"
      genotypes show no appreciable trends with age. In addition, the "high" genotype
      appears to confer a greater degree of heaviness in females as compared with
      males. These results, along with other observations from the data, suggest that,
      while a recessive single gene influence may be discernible, the phenotypic
      expression of the BMI is likely to be complicated by genotype x environment
      interactions and, possibly, by the action of other loci. Further, the data also
      are consistent with the hypothesis that modifying factors may include the
      adoption of a more prudent life-style by individuals genetically predisposed to
      heaviness and a secular increase in the incidence, prevalence, and potency of
      environmentally based triggers leading to a higher penetrance of the "heavy"
      genotype in the young.

PMID- 8352277
TI  - Detection of cryptic chromosomal abnormalities in unexplained mental retardation:
      a general strategy using hypervariable subtelomeric DNA polymorphisms.
AB  - Given the availability of DNA from both parents, unusual segregation of
      hypervariable DNA polymorphisms (HVPs) in the offspring may be attributable to
      deletion, unbalanced chromosomal translocation, or uniparental disomy. The
      telomeric regions of chromosomes are rich in both genes and hypervariable
      minisatellite sequences and may also be particularly prone to cryptic breakage
      events. Here I describe and analyze a general approach to the detection of
      subtelomeric abnormalities and uniparental disomy in patients with unexplained
      mental retardation. With 29 available polymorphic systems, approximately 50%-70%
      of these abnormalities could currently be detected. Development of subtelomeric
      HVPs physically localized with respect to their telomeres should provide a
      valuable resource in routine diagnostics.

PMID- 8352278
TI  - Statistical evaluation of multiple-locus linkage data in experimental species and
      its relevance to human studies: application to nonobese diabetic (NOD) mouse and
      human insulin-dependent diabetes mellitus (IDDM).
AB  - Common, familial human disorders generally do not follow Mendelian inheritance
      patterns, presumably because multiple loci are involved in disease
      susceptibility. One approach to mapping genes for such traits in humans is to
      first study an analogous form in an animal model, such as mouse, by using inbred
      strains and backcross experiments. Here we describe methodology for analyzing
      multiple-locus linkage data from such experimental backcrosses, particularly in
      light of multilocus genetic models, including the effects of epistasis. We
      illustrate these methods by using data from backcrosses involving nonobese
      diabetic mouse, which serves as an animal model for human insulin-dependent
      diabetes mellitus. We show that it is likely that a minimum of nine loci
      contribute to susceptibility, with strong epistasis effects among these loci.
      Three of the loci actually confer a protective effect in the homozygote, compared
      with the heterozygote. Further, we discuss the relevance of these studies for
      analogous studies of the human form of the trait. Specifically, we show that the
      magnitude of the gene effect in the experimental backcross is likely to correlate
      only weakly, at best, with the expected magnitude of effect for a human form,
      because in humans the gene effect will depend more heavily on disease allele
      frequencies than on the observed penetrance ratios; such allele frequencies are
      unpredictable. Hence, the major benefit from animal studies may be a better
      understanding of the disease process itself, rather than identification of cells
      through comparison mapping in humans by using regions of homology.

PMID- 8352279
TI  - Nondisjunction of chromosome 15: origin and recombination.
AB  - Thirty-two cases of uniparental disomy (UPD), ascertained from Prader-Willi
      syndrome patients (N = 27) and Angelman syndrome patients (N = 5), are used to
      investigate the pattern of recombination associated with nondisjunction of
      chromosome 15. In addition, the meiotic stage of nondisjunction is inferred by
      using markers mapping near the centromere. Two basic approaches to the analysis
      of recombination are utilized. Standard methods of centromere mapping are
      employed to determine the level of recombination in specific pairwise intervals
      along the chromosome. This method shows a significant reduction in recombination
      for two of five intervals examined. Second, the observed frequency of each
      recombinant class (i.e., zero, one, two, three, or more observable crossovers) is
      compared with expected values. This is useful for testing whether the reduction
      in recombination can be attributed solely to a proportion of cases with no
      recombination at all (because of asynapsis), with the remaining groups showing
      normal recombination (or even excess recombination), or whether recombination is
      uniformly reduced. Analysis of maternal UPD(15) data shows a slight reduction in
      the multiple-recombinant classes, with a corresponding increase in both the zero-
      and one-recombinant classes over expected values. The majority, more than 82%, of
      the extra chromosomes in maternal UPD(15) cases are due to meiotic I
      nondisjunction events. In contrast, most paternal UPD(15) cases so far examined
      appear to have a postzygotic origin of the extra paternal chromosome.

PMID- 8352280
TI  - Functional studies of a germ-line polymorphism at codon 47 within the p53 gene.
AB  - A rare germ-line polymorphism in codon 47 of the p53 gene replaces the wild-type
      proline (CCG) with a serine (TCG). Restriction analysis of 101 human samples
      revealed the frequency of the rare allele to be 0% (n = 69) in Caucasians and
      4.7% (3/64, n = 32) among African-Americans. To investigate the consequence of
      this amino acid substitution, a cDNA construct (p53 mut47ser) containing the
      mutation was introduced into a lung adenocarcinoma cell line (Calu-6) that does
      not express p53. A growth suppression similar to that obtained after introduction
      of a wild-type p53 cDNA construct was observed, in contrast to the result
      obtained by introduction of p53 mut143ala. Furthermore, expression of neither p53
      mut47ser nor wild-type p53 was tolerated by growing cells. In transient
      expression assays, both mut47ser and wild-type p53 activated the expression of a
      reporter gene linked to a p53 binding sequence (PG13-CAT) and inhibited the
      expression of the luciferase gene under the control of the Rous sarcoma virus
      promoter (RSVluc). In the same assay, mut143ala did not activate the expression
      of PG13-CAT and produced only a slight inhibitory effect on RSVluc. These
      findings indicate that the p53 variant with a serine at codon 47 should be
      considered as a rare germ-line polymorphism that does not alter the growth
      suppression activity of p53.

PMID- 8352281
TI  - Further localization of the gene for nevoid basal cell carcinoma syndrome (NBCCS)
      in 15 Australasian families: linkage and loss of heterozygosity.
AB  - Nevoid basal cell carcinoma syndrome (NBCCS; basal cell nevus syndrome or Gorlin
      syndrome) is a cancer-predisposition syndrome characterized by multiple basal
      cell carcinomas (BCCs) and diverse developmental defects. The gene for NBCCS has
      been mapped to 9q23.1-q31 in North American and European families. In addition,
      loss of heterozygosity (LOH) for genetic markers in this region has been detected
      in sporadic BCCs, indicating that the NBCCS gene is probably a tumor-suppressor
      gene. In this study we have determined that the NBCCS gene is also linked to this
      region in Australasian pedigrees and that there is no significant evidence of
      heterogeneity. We have defined the localization of the gene by multipoint and
      haplotype analysis of 15 families, using four microsatellite markers. LOH at
      these loci was detected in 50% of sporadic BCCs, a rate that is significantly
      higher than that in other skin lesions used as controls.

PMID- 8352283
TI  - Better data analysis through data exploration.

PMID- 8352282
TI  - Mutation in the 4a-carbinolamine dehydratase gene leads to mild
      hyperphenylalaninemia with defective cofactor metabolism.
AB  - Hyperphenylalaninemias represent a major class of inherited metabolic disorders.
      They are most often caused by mutations in the phenylalanine hydroxylase gene
      and, less frequently but with usually more serious consequences, in genes
      necessary for the synthesis and regeneration of the cofactor,
      tetrahydrobiopterin. This cofactor is absolutely required for all aromatic amino
      acid hydroxylations, and, recently, nitric oxide production from L-arginine has
      also been found to be dependent on tetrahydrobiopterin. Phenylalanine hydroxylase
      catalyzes a coupled reaction in which phenylalanine is converted to tyrosine and
      in which tetrahydrobiopterin is converted to the unstable carbinolamine, 4a
      hydroxytetrahydrobiopterin. The enzyme, carbinolamine dehydratase, catalyzes the
      dehydration of the carbinolamine to quinonoid dihydropterin. A decreased rate of
      dehydration of this compound has been hypothesized to be responsible for the
      production of 7-biopterin found in certain mildly hyperphenylalaninemic
      individuals. We have now identified nonsense and missense mutations in the 4a
      carbinolamine dehydratase gene in a hyperphenylalaninemic child who excretes
      large amounts of 7-biopterin. This finding is consistent with the role of the
      carbinolamine dehydratase in the phenylalanine hydroxylation reaction. Together
      with previously identified inherited disorders in phenylalanine hydroxylase and
      dihydropteridine reductase, there are now identified mutations in the three
      enzymes involved in the phenylalanine hydroxylation system. In addition, the
      genetics of this system may have broader implications, since the product of the
      dehydratase gene has previously been shown to play an additional role (as
      dimerization cofactor for hepatocyte nuclear factor-1 alpha) in the regulation of
      transcription, through interaction with hepatocyte nuclear factor-1 alpha.

PMID- 8352284
TI  - Tay-Sachs genes in Acadians.

PMID- 8352285
TI  - The designation of mutations.

PMID- 8352286
TI  - Presymptomatic testing for Huntington disease in the United States.

PMID- 8352287
TI  - Fouling one's own nest revisited.
AB  - Transport of hazards from the workplace to the home by workers is a previously
      recognized but poorly addressed public health problem. Particularly disturbing
      are the childhood intoxications which may result from such paraoccupational
      exposure. Work clothes and shoes appear to be a common vehicle for hazard
      transport in recently reported cases as they were in the past, although other
      "markers" for potential paraoccupational exposure may be derived from case
      reviews. These include: poor workplace hygiene, occupational intoxications in
      adult workers, and the "cottage industry" phenomenon. These markers are reviewed
      in the context of recently reported cases and strategies are suggested to
      mitigate these easily preventable exposures.

PMID- 8352288
TI  - Survey of glycol ether use in Taiwan, 1991.
AB  - Glycol ethers (including glycol ether esters) are a group of solvents with medium
      high boiling points and low evaporation rates, possessing solvent characteristics
      of alcohol/ether functions (or ether/ester functions). They have been widely used
      in coatings and other industrial products for more than half a century. Recently,
      E-series glycol ethers have been found to show reproductive and teratogenic
      toxicity, and throughout much of the world they are being replaced by the so
      called P-series glycol ethers. In responding to the impact of the worldwide
      transition from E- to P-series glycol ethers, the current status of glycol ether
      use in Taiwan was studied. This study focuses on the type and quantity of these
      solvents being used, worker and public knowledge about their hazards, and
      possible changes in government regulations being considered. In this study, we
      found that large quantities of E-series glycol ethers were imported and used in
      Taiwan. The best estimates are: 2-ME, 2,500 tons; 2-EE, 1,200 tons; 2-EEA, 5,000
      8,000 tons; 2-BE, 8,000 tons annually in 1991. For P-series glycol ethers, only
      about 2,500 tons are being used. Lack of knowledge about the potential toxic
      effects of the E-series glycol ethers is very common among users, regulatory
      agencies, academic institutes, and the general public. It is hoped that the
      results of this study, along with educational efforts, government regulations,
      and provision of technical services, will help prevent Taiwan from becoming a
      dumping site for these toxic chemicals.

PMID- 8352289
TI  - Evaluation of the national cancer program and proposed reforms.
AB  - A statement by some 68 prominent national experts in industrial medicine,
      carcinogenesis, epidemiology, and public health, released at a February 4, 1992
      press conference in Washington, D.C., charged that the National Cancer Institute
      (NCI) has confused the public by repeated claims of winning the war against
      cancer. In fact, age standardized incidence rates have increased sharply over
      recent decades, while ability to treat and cure most cancers has not materially
      improved. Furthermore, the NCI has minimized evidence for increasing cancer rates
      which are largely attributed to smoking and to diet. In so doing, NCI trivializes
      the importance of occupational carcinogens as non-smoking-attributable causes of
      lung and other cancers, and ignores the tenuous and inconsistent evidence for the
      causal role of diet per se and also the important role of carcinogenic dietary
      contaminants. Reflecting this near exclusionary blame-the-victim theory of cancer
      causation, with support from the American Cancer Society and industry, the NCI
      discounts the role of avoidable involuntary exposures to industrial carcinogens
      in air, water, food, the home, and the workplace. The NCI has also failed to
      provide scientific guidance to Congress and regulatory agencies on fundamental
      principles of carcinogenesis and epidemiology, and on the critical need to reduce
      avoidable exposures to environmental and occupational carcinogens. Contrary to
      NCI, analysis of their $2 billion budget reveals very limited allocations for
      research on primary cancer prevention, and for occupational cancer which receives
      only $19 million annually, 1% of NCI's total budget. Problems of professional
      mindsets in NCI leadership--fixation on diagnosis, treatment, and basic research
      (much of questionable relevance) and the neglect of cancer prevention--are
      exemplified by the composition of the Executive President's Cancer Panel and the
      National Cancer Advisory Board. Contrary to the explicit mandate of the National
      Cancer Act, the Board is virtually devoid of recognized authorities in
      occupational and environmental carcinogenesis. These problems are further
      compounded by institutionalized conflicts of interest reflected in the
      composition of past Cancer Panels, and of the current Board of Overseers of the
      Memorial Sloan Kettering Cancer Center, NCI's prototype comprehensive cancer
      center, with their closely interlocking financial interests with the cancer drug
      and other industries. Comprehensive reforms of NCI policies and priorities are
      overdue. Implementation of such reforms is, however, unlikely in the absence of
      further support from industrial medicine professionals, which is here solicited,
      besides action by Congress and concerned citizen groups.

PMID- 8352290
TI  - Case-control study of congenital defects and parental employment in health care.
AB  - Health care workers may be occupationally exposed to known and suspected
      teratogens including viruses, anesthetic gases, sterilants, mercury, and x
      radiation. To assess the risk of congenital defects among offspring of health
      care workers, we analyzed parental occupational histories for 4,915 case babies
      with congenital defects, registered during the years 1968-1980 by the
      Metropolitan Atlanta Congenital Defects Program (MACDP) registry, and for 3,027
      control babies born without defects during the same period. Offspring of mothers
      employed in a nursing occupation during the periconceptional period had a modest
      excess risk of having at least one congenital defect (relative risk [RR] = 1.42;
      95% confidence interval [CI] 1.06-1.88); the offspring were at statistically
      significant increased risk of having anencephaly or spina bifida (RR = 2.00; 95%
      CI 1.01-4.30), coarctation of the aorta (RR = 2.06; 95% CI 1.10-3.82), genital
      system defects (RR = 1.61; 95% CI 1.03-2.53), and urinary system defects (RR =
      3.43; 95% CI 1.41-8.34). These associations were not confounded by maternal age,
      education, or alcohol consumption. Offspring of mothers employed in
      administrative or clerical jobs in the health care industry also had a modest
      excess risk of defects (RR = 1.35; 95% CI 0.96-1.90), including a statistically
      significant excess risk of limb defects. We also found associations between
      neural tube defects and potential exposure to anesthetic gases and to x
      radiation, but each association was based on only three case babies of
      potentially exposed parents. We found no associations between defects and
      paternal health care employment, except for a few individual defects, and these
      were based on small numbers of exposed subjects. Only one of five previous
      studies reviewed found an increased risk of congenital defects among offspring of
      nurses, but three of the four negative studies had substantially smaller sample
      sizes than the present study. Detection bias may be a possible explanation for
      the apparent excess risk of certain defects among offspring of nurses.

PMID- 8352291
TI  - Health characteristics by longest held occupation and industry of employment:
      United States, 1980.
AB  - Occupational and industrial hazards are unevenly distributed in the workplace.
      National estimates for selected health indices of persons aged 17 years and over
      in the civilian noninstitutionalized population are presented for categories of
      longest held occupation and industry of employment. These estimates were based on
      data collected by the National Center for Health Statistics (NCHS) in the 1980
      National Health Interview Survey (NHIS) and the Occupational Supplement, the
      first survey to collect data on longest held, in addition to current, occupation
      and industry of employment. Data on length of longest held job, limitation of
      activity, disability days, incidence of acute conditions, persons injured,
      hospitalizations, and utilization of medical and dental services are presented.

PMID- 8352292
TI  - Five-year follow-up study of hearing loss at several locations within a large
      automobile company.
AB  - This longitudinal epidemiologic study was designed to investigate hearing loss
      over a 5-year period among noise-exposed employees of a large automobile company
      and to assess effectiveness of hearing conservation programs at locations
      representing the spectrum of operations (assembly, light manufacturing, heavy
      manufacturing and machining, metal fabrication, and founding). Based on
      computerized audiometric test data, the study summarizes methodology developed
      for measuring occupational hearing loss and its application in evaluating
      programs at these locations, which had maximal 8-hr time-weighted average (TWA)
      noise exposures ranging from 104 to 110 dB(A). Methods presented here provide for
      consideration of age and hearing level of study subjects at baseline audiogram
      and clearly demonstrate the extent of hearing loss during the study period. Among
      five study locations, the average hearing loss at 2,000-4,000 Hz in the worst
      loss ear ranged from 3.4 to 6.2 dB over the follow-up period; after adjustment
      for presbycusis, the loss was less than 2 dB at all but one location, which
      showed a loss of nearly 4 dB. In comparison to a control group of nonnoise
      exposed employees, hearing conservation programs at four of the five locations
      were judged to be effective. One location, a metal fabrication plant with a large
      percentage of employees having an 8-hr TWA noise exposure over 90 dB(A), was
      particularly noted for the effectiveness of its program.

PMID- 8352293
TI  - Occupation and lung cancer risk among women in northern China.
AB  - Lifetime occupational histories were obtained in a case-control study of 965
      female lung cancer patients and 959 controls selected from the general population
      in Shenyang and Harbin, People's Republic of China, where most women have worked
      outside the home. After adjusting for smoking, we found a significantly increased
      risk of lung cancer associated with employment involving the manufacture of
      transportation equipment (OR = 1.6, 95% CI = 1.0, 2.6), in particular the
      manufacturing of automobiles (OR = 3.0, 95% CI = 1.4, 6.4). Metal smelting and
      treatment workers were at an increased risk of lung cancer (OR = 1.5, 95% CI =
      1.0, 2.1); the highest risks were observed among metal surfacers (OR = 3.1, 95%
      CI = 1.1, 9.0) and currently employed foundry workers (OR = 13.0, 95% CI = 1.7,
      99.4). On the other hand, about a 50% decreased risk of lung cancer was observed
      among those employed in textile industries or as leaders of state and party
      organizations. Based on self-reports, exposures to coal dust and smoke from
      burning fuel at the workplace were also significant risk factors. The findings
      were similar when the analyses were confined to nonsmokers and were comparable
      across the major cell types of lung cancer.

PMID- 8352294
TI  - A health survey of workers in the pentachlorophenol section of a chemical
      manufacturing plant.
AB  - During 1968 to 1985, 109 workers who had been engaged in the production of
      pentachlorophenol, using non-gamma isomers of hexachloroclohexane (BHC) as the
      raw material, were surveyed. Endemic chloracne among them had been noted since
      1974. The prevalence of chloracne was 73.4% (80/109) in total and 95.2% (20/21)
      in a trichlorobenzene (TCB) tank area where dioxin and dibenzofurans levels were
      thousands of ppm. To our knowledge, PCDDs and PCDFs have not previously been
      reported from thermal decomposition of BHC. Urinary porphyrins were significantly
      higher among exposed workers than among the controls but there was no significant
      difference between the workers with chloracne and those without. The conduction
      velocities of the median motor nerves were much slower among the workers in the
      TCB tank area where the highest PCDDs contamination appeared. The mortality study
      cohort was relatively young. Based on the three deaths observed during the follow
      up, no association could be drawn.

PMID- 8352295
TI  - Occupational risks for primary liver cancer in Shanghai, China.
AB  - Using occupational data for over 3,400 primary liver cancer cases diagnosed
      between 1980 and 1984 reported to the Shanghai Cancer Registry, and employment
      information from the 1982 census for the Shanghai population, standardized
      incidence ratios were computed to generate leads to occupational risks of liver
      cancer. Among men, a statistically significant excess number of cases was
      observed for chemical processors, textile workers, wood workers, blacksmiths and
      machine-tool operators, and material handlers and dock workers. Increased
      incidence of liver cancer also was observed among female transport equipment
      operators. These findings indicate that a number of similar occupations are
      associated with increased risk of primary liver cancer in western countries and
      China. Although causal inferences cannot be drawn from these data, our study adds
      to the limited evidence of the potential role of occupational exposures in liver
      carcinogenesis.

PMID- 8352296
TI  - Resolution of an absolute scotoma and improvement of relative scotomata after
      successful macular hole surgery.
AB  - Visual loss in eyes with full-thickness macular holes is thought to be caused by
      the absence of retinal function in the area of the neurosensory defect as well as
      reduction in retinal function in the surrounding area of neurosensory retinal
      detachment. To improve characterization of the visual function of eyes after
      successful macular hole surgery, we studied six eyes preoperatively and
      postoperatively with macular microperimetry using the scanning laser
      ophthalmoscope. Best-corrected visual acuity was improved postoperatively in all
      eyes. Microperimetry performed preoperatively demonstrated an absolute scotoma
      that corresponded to the neurosensory defect in all eyes, with surrounding
      concentric isopters of relative scotomata. No detectable absolute scotoma was
      found in any eye postoperatively. All eyes showed partial or complete resolution
      of the surrounding relative scotomata. Improvements in visual acuity after
      successful macular hole surgery may be related to disappearance of a detectable
      absolute scotoma as well as improvement in the surrounding retinal function.

PMID- 8352297
TI  - Lipid exudation in age-related macular degeneration.
AB  - We reviewed the relationship between lipid exudation and subretinal neovascular
      membranes associated with age-related macular degeneration. The records of 500
      consecutive patients with subretinal neovascular membranes caused by age-related
      macular degeneration were examined. Seventy-five patients (15%) (85 eyes)
      manifested lipid exudation in conjunction with subretinal neovascularization.
      Twelve patients (2.4%) (13 eyes) had a massive lipid exudative response with
      extensive serous retinal detachment (resembling Coats' disease). Of the 85 eyes
      with subretinal neovascular membranes and lipid exudation, 71 (84%) had a
      subretinal neovascular membrane that was classified as ill defined. Improvement
      of vision with or without treatment was seen in only 14 of these 85 eyes (16.4%).
      After comparing these 85 eyes to 94 eyes from 76 patients with age-related
      macular degeneration and subretinal neovascular membranes but no lipid exudation,
      we found that a subretinal neovascular membrane associated with lipid exudation
      was more likely to be ill defined (71 eyes [84%] vs 35 eyes [37%]; P = .0001),
      was more frequently associated with retinal pigment epithelial detachment (30
      eyes [35%] vs 15 eyes [16%]; P = .0029), and was more likely not to have
      stabilization of visual acuity (14 eyes [16%] vs 31 eyes [33%]; P = .025).

PMID- 8352298
TI  - Pattern-reversal electroretinographic follow-up of laser photocoagulation for
      subfoveal neovascular lesions in age-related macular degeneration.
AB  - Pattern-reversal electroretinograms were used as an objective measure of macular
      integrity in a subset of 42 patients who were randomly assigned at enrollment in
      the Macular Photocoagulation Study to receive laser photocoagulation or no
      treatment for a subfoveal neovascular lesion. Pattern-reversal electroretinograms
      were obtained before randomization, three months and six months after
      randomization, and at six-month intervals randomization, and at six-month
      intervals thereafter. Responses were obtained to phase-alternating checkerboards
      of varying check size. Extrapolation of the best-fit regression line relating log
      check size to amplitude was used to determine retinal acuity. At each follow-up
      period, including three months after laser photocoagulation, treated eyes showed
      less loss in pattern-reversal electroretinographic acuity than untreated eyes.
      The decline in pattern-reversal electroretinographic acuity in untreated eyes
      corresponded to the rapid growth in the area of the subfoveal neovascular lesion.
      The more gradual decline in treated eyes was consistent with an increase in the
      area of the treatment scar caused by spreading atrophy.

PMID- 8352299
TI  - Clinical and immunologic features of human T-cell lymphotropic virus type I
      uveitis.
AB  - The clinical features of idiopathic uveitis were compared by the seropositivity
      for human T-cell lymphotropic virus type I. The statistical analysis of various
      clinical variables disclosed that the uveitis seen in seropositive patients (93
      patients) had a significantly higher incidence of floaters, vitreous opacities,
      retinal vasculitis, and intermediate uveitis than that in seronegative patients
      (222 patients) (P < .05). The odds ratios of the virus infection for these
      clinical manifestations were high and statistically significant, suggesting that
      the virus infection has a role as a risk factor for the development of these
      clinical manifestations. Although visual acuity at the initial examination was
      almost equal between the two groups, after the therapy with topical or systemic
      corticosteroids, or both, visual acuity in seropositive patients was much better
      than that in seronegative patients. The surface phenotype of peripheral
      lymphocytes in the two groups was compared as follows: CD4-positive T lymphocytes
      (P < .05), CD4/8 ratio (P < .01), and CD25-positive T lymphocytes (P < .05) were
      significantly higher in seropositive patients than in seronegative patients.

PMID- 8352300
TI  - Subretinal neovascular membranes in Vogt-Koyanagi-Harada syndrome.
AB  - Subretinal neovascular membranes cause late visual loss and are important
      determinants of final visual acuity in patients with Vogt-Koyanagi-Harada
      syndrome. The purpose of this study was to determine the prevalence and risk
      factors associated with the development of subretinal neovascular membranes in
      Vogt-Koyanagi-Harada syndrome. We reviewed the charts of 58 patients (116 eyes)
      with Vogt-Koyanagi-Harada syndrome. We separated patients into two groups, one
      with and one without subretinal membranes. Demographic characteristics, namely
      age, gender, and race, initial and final visual acuities, duration and method of
      treatment, anterior chamber and vitreous cell, presence of fundus pigmentary
      disturbances, and phase of inflammation, were evaluated for each group. Overall,
      ten eyes (9%) of seven patients developed the subretinal neovascular membranes.
      Demographic characteristics among the two groups of patients were not markedly
      different (P > .10). Visual outcome of patients with subretinal membranes was
      significantly poorer than was that of patients without these membranes (P <
      .001). Eyes with subretinal membranes had a significantly greater degree of
      anterior chamber and vitreous inflammation (P < .02), greater incidence of fundus
      pigmentary disturbances (P < .02), and a greater frequency of chronic recurrent
      phase of inflammation, marked by recurrence of predominantly anterior chamber,
      and occasionally posterior segment, inflammation (P < .02). The membranes were
      located in the peripapillary (four eyes), subfoveal (three eyes), and macular
      extrafoveal (three eyes) regions.

PMID- 8352301
TI  - Choroidal nonperfusion in giant cell arteritis.
AB  - A 68-year-old man had visual loss secondary to isolated choroidal nonperfusion as
      a clinical manifestation of giant cell arteritis. Ophthalmoscopy disclosed
      scattered yellow-white lesions at the level of the retinal pigment epithelium in
      the posterior pole of the right eye. Intravenous fluorescein angiography
      demonstrated marked delay in choroidal filling of the macula in the right eye.
      There was no ophthalmoscopic or angiographic evidence of anterior ischemic optic
      neuropathy or central retinal artery occlusion. After approximately 72 hours of
      intravenous corticosteroid therapy, the patient's visual acuity improved and
      repeat intravenous fluorescein angiography showed normal choroidal circulation.
      Isolated choroidal ischemia is a potential cause of reversible visual loss in
      patients with giant cell arteritis.

PMID- 8352302
TI  - Factors associated with visual loss in patients with advanced glaucomatous
      changes in the optic nerve head.
AB  - We evaluated factors associated with decreased or stable visual function in 72
      patients with primary open-angle glaucoma and complete cupping of the optic disk
      who were followed up five years or more. We found a significantly lower mean
      (15.4 +/- 2.7 mm Hg) and peak (24.5 +/- 6.9 mm Hg) intraocular pressure in those
      patients whose vision remained stable vs those whose vision decreased (21.3 +/-
      3.2 and 39.2 +/- 11.0 mm Hg, respectively) (t-test, P < .001). Additionally, the
      variance of each patient's individual intraocular pressure readings measured
      during the follow-up period was lower in the group with stable vision (4.5 mm Hg)
      than in those in whom vision decreased (9.0 mm Hg) (F test, P < .001). Stepwise
      discriminant analysis disclosed that mean intraocular pressure, variance of an
      individual's intraocular pressure measurements over time, history of argon laser
      trabeculoplasty, and compliance with therapy discriminated 92.9% of patients (52
      of 56) whose vision remained stable and 87.5% of patients (14 of 16) whose vision
      decreased. Reduction of intraocular pressure and compliance with therapy are
      important in patients with complete glaucomatous cupping of the optic disk.

PMID- 8352303
TI  - Lateral geniculate nucleus in glaucoma.
AB  - To assess glaucomatous damage to the lateral geniculate nucleus of the thalamus,
      as well as to its magnocellular and parvocellular layers, we examined the autopsy
      sections of the lateral geniculate nucleus of individuals with and without
      glaucoma. Five patients with a documented history of glaucoma and five controls
      with no ophthalmic or chronic central nervous system disease were included in
      this study. Neurons were counted in autopsy sections of the lateral geniculate
      nucleus. Cells were counted in 40 random microscopic fields of the magnocellular
      and parvocellular layers respectively. The mean magnocellular cell density for
      the glaucoma group of 2.72 +/- 0.13 cells per square millimeter (mean +/- SEM)
      was significantly less than that for the control group of 3.76 +/- 0.13 cells per
      square millimeter (P < .001). There was no statistical difference in the
      parvocellular layer. These data suggest that glaucoma leads to greater loss of
      magnocellular tissue at the level of the lateral geniculate.

PMID- 8352304
TI  - Aqueous tube-shunt implantation and pars plana vitrectomy in eyes with refractory
      glaucoma.
AB  - We reviewed the surgical outcome of 20 eyes of 20 consecutive patients who had
      undergone combined aqueous tube-shunt implantation and vitrectomy for complicated
      glaucoma associated with vitreoretinal disorders. After a mean follow-up of 10.39
      +/- 5.43 months, visual acuity remained stable or improved in 13 patients (65%),
      and intraocular pressure was controlled (< 22 mm Hg) in 15 (75%). The most common
      complications were corneal edema (seven eyes) and choroidal effusion (three
      eyes). Combined tube-shunt implantation and pars plana vitrectomy may
      successfully control intraocular pressure and maintain preoperative visual acuity
      in refractory glaucoma associated with vitreoretinal disorders.

PMID- 8352305
TI  - The use of perfluorophenanthrene in the removal of intravitreal lens fragments.
AB  - We used perfluorophenanthrene as an aid during pars plana vitrectomy in removing
      lens fragments dislocated posteriorly into the vitreous cavity. We reviewed the
      records of all patients (nine patients, nine eyes) referred with dislocated
      lenses who underwent pars plana vitrectomy with perfluorophenanthrene for removal
      of the lens material at Wills Eye Hospital from July 1, 1991, through Nov. 30,
      1991. The lens was dislocated during cataract extraction in eight eyes. One eye
      had a history of nonpenetrating trauma and lens dislocation. In one eye a retinal
      tear was noted intraoperatively and treated. Six eyes had postoperative visual
      acuity of 20/50 or better. In all eyes the lens was removed without further
      complications. Perfluorocarbon liquids such as perfluorophenanthrene may enhance
      current techniques by allowing easier and safer removal of displaced lens
      fragments through the pars plana.

PMID- 8352306
TI  - An adjustable double running suture technique for keratoplasty.
AB  - In a retrospective analysis, we examined 30 consecutive cases of penetrating
      keratoplasty in which a double running 10-0/11-0 nylon suture technique was used
      and the 10-0 suture was adjusted early in the postoperative period to reduce
      astigmatism. When the response to suture adjustment was inadequate, the presence
      of the 11-0 suture allowed for early (ten to 18 weeks) removal of the 10-0
      suture. Rapid visual recovery (12.3 +/- 0.95 weeks; mean +/- standard error) and
      low levels of final astigmatism (2.66 +/- 0.24 diopters) were achieved. Visual
      acuity was 20/20 to 20/40 in 25 of the 28 patients (89%) who were visually
      rehabilitated. In these 28 patients, visual acuity remained stable for the
      remainder of the study. All patients had a minimum of six months' follow-up from
      the time of surgery; mean follow-up was 10.6 +/- 1.70 months.

PMID- 8352307
TI  - Visual improvement as a function of time after lamellar keratoplasty for
      keratoconus.
AB  - Twenty-eight keratoconic patients with either contact-lens intolerance or marked
      corneal scarring over the visual axis underwent lamellar keratoplasty for visual
      rehabilitation. All 28 patients returned for follow-up at six months, 27 (98%)
      had follow-up at one year, and 23 (82%) at two years. The 23 patients with two
      year follow-up showed progressive improvement of visual acuity over time. At six
      months, 11 of 23 patients (48%) had visual acuity of 20/30 or better. At one
      year, 17 of 23 (74%) had 20/30 or better, and at two years, 21 of 23 (91%) had
      20/30 or better. The average postoperative keratometry measurement at two years
      was 43.5 diopters (S.D. = 2.5 diopters), which represented an average reduction
      of 13 diopters from preoperative keratometry. All patients who were less than 32
      years old obtained visual acuity of 20/30 or better after two years and reached
      this level significantly (F = 6.75, P = .02) sooner than those more than 32 years
      old. These results compare favorably with previously reported visual results
      after penetrating keratoplasty.

PMID- 8352308
TI  - Medial canthotomy and cantholysis in eyelid reconstruction.
AB  - Combined medial canthotomy and cantholysis is a quick, technically simple, single
      stage reconstructive technique for use in the reconstruction of the upper or
      lower eyelid. This technique, which transects one lacrimal canaliculus, provides
      up to 20% of the horizontal eyelid dimension for closure. Medial canthotomy and
      cantholysis is most frequently used in combination with other eyelid
      reconstructive techniques for difficult reconstructions, which would otherwise
      require more extensive surgical procedures. The surgical technique is readily
      performed with the patient under general anesthesia and entails the transection
      of one lacrimal canaliculus, lysis of one crus of the medial canthal tendon, and
      lateral advancement of the medial eyelid stump. We used medial canthotomy and
      cantholysis in the reconstruction of 29 eyelid defects (21 upper eyelids and
      eight lower eyelids) over a 12-year period with adequate reconstructive results
      in all cases. Eleven of the patients underwent simultaneous lateral canthotomy
      and cantholysis. Complications of the medial canthotomy and cantholysis technique
      include anterior displacement of the medial portion of the eyelid, epiphora,
      notching of the medial portion of the eyelid, medial ectropion, and
      blepharoptosis. If used with appropriate case selection, this technique allows an
      optimal reconstructive result to be achieved with a minimum of operative time and
      morbidity.

PMID- 8352309
TI  - The effect of anterior transposition of the inferior oblique muscle.
AB  - The effect of anterior transposition of the insertion of the inferior oblique
      muscle was compared with the results from conventional inferior oblique muscle
      recession in 50 patients. Even though both groups of patients had a similar
      degree of overaction preoperatively, postoperative inferior oblique muscle action
      was weaker (P < .01) and upgaze more limited P < .01) in the anterior
      transposition group. These data suggest that anterior transposition serves to
      convert the inferior oblique muscle from an elevator to a depressor on attempted
      elevation. Because anterior transposition is such a powerful weakening operation,
      we suggest that it be reserved for patients with moderate to severe inferior
      oblique muscle overaction. To avoid postoperative hypotropia in upgaze, anterior
      transposition should be performed in both eyes for bilateral inferior oblique
      muscle overaction and not unilaterally.

PMID- 8352311
TI  - Vitrectomy surgery for full-thickness macular holes.

PMID- 8352310
TI  - Congenital cysts of the iris stroma.
AB  - We managed three cases of congenital iris stromal cysts and compared them with 22
      cases in the published reports to delineate the clinical features of this
      condition and determine the best treatment. Our first patient, a 5-month-old
      girl, had injection of a cyst with trichloroacetic acid, but developed a cataract
      and endothelial damage to the cornea and the eye was eventually enucleated. Our
      second patient, a 9-week-old girl, was treated with repeated xenon
      photocoagulation, drainage of the cyst, and cryotherapy, but required enucleation
      of the eye. Our third patient, a 5-month-old girl, had excision of the cyst by
      sector iridectomy with preservation of vision and no recurrence two years later.
      Our results suggest that complete surgical excision is a superior method of
      treatment for congenital cysts of the iris stroma.

PMID- 8352312
TI  - Corneal edema after miochol.

PMID- 8352313
TI  - Specular microscopy and fluorophotometry in the diagnosis of epithelial
      downgrowth after a sutureless cataract operation.

PMID- 8352314
TI  - Blink-associated eye movements with contact-lens wear.

PMID- 8352315
TI  - Corneal ulcer caused by combined intravenous and anesthetic abuse of cocaine.

PMID- 8352316
TI  - Basal cell carcinoma of the conjunctiva.

PMID- 8352317
TI  - Varix of the angular vein manifesting as a medial canthal mass.

PMID- 8352319
TI  - Retinal hemorrhages as an early sign of acute bacterial endophthalmitis.

PMID- 8352318
TI  - Monozygotic twin sisters with adult vitelliform macular dystrophy.

PMID- 8352320
TI  - Ocular coccidioidomycosis.

PMID- 8352321
TI  - Lens clarity after vitrectomy in traumatic lens perforation and vitreous
      penetration.

PMID- 8352322
TI  - 25-gauge intraocular forceps.

PMID- 8352323
TI  - Chiasmal compression from fat packing after transsphenoidal resection of
      intrasellar tumor in two patients.

PMID- 8352324
TI  - The efficacy of optic nerve sheath decompression for anterior ischemic optic
      neuropathy and other optic neuropathies.

PMID- 8352325
TI  - Clinical follow-up of phototherapeutic keratectomy for treatment of corneal
      opacities.

PMID- 8352326
TI  - Therapeutic use of humor in occupational therapy.
AB  - Interviews with five occupational therapists who use humor therapeutically in
      their practice were conducted and analyzed with a phenomenological method so that
      the lived experience of therapeutic humor use in occupational therapy could be
      examined. Sixteen themes were identified through data analysis: The Concept of
      Therapeutic Use of Humor; Spontaneous Versus Deliberate Humor; Humor, the Great
      Equalizer; Humor and Professionalism; Contraindications of Humor; Humor Among Co
      Workers; Humor and Play; Humor and the Environment; Humor Providing Balance; The
      Intrinsic Quality of Humor; The Transformative Power of Humor; The Effects of
      Humor on the Subjects Themselves; Humor as an Evaluation and Treatment Tool;
      Humor as Therapeutic Use of Self; Humor as a Coping Mechanism; and Other Uses of
      Humor With Patients. This study revealed that the use of therapeutic humor in
      occupational therapy is a multifaceted phenomenon, much richer than had been
      previously presented in the literature.

PMID- 8352328
TI  - Combining practice and research.
AB  - Although many authors advocate research involvement for occupational therapists
      involved in clinical practice, no formal studies existed of the personal,
      educational, and workplace environmental factors though to affect therapists'
      ability to integrate clinical research with practice. This exploratory,
      descriptive study surveyed 103 occupational therapists reporting work functions
      of both direct patient care and research. Major findings included: (a) workplace
      learning circumstances focusing on performance and application of clinical
      research were important for adopting a dual practice-research role, (b) research
      activities reflected the evolving character of the role, (c) administrative
      support and a personal commitment to research were critical for success, and (d)
      formal research courses were important, but so were informal discussions
      regarding application and problem solving. The findings have implications for
      university curricula, continuing education, and clinical environments.

PMID- 8352327
TI  - Age differences in functional performance.
AB  - We compared the functional performance of 20 young adult women and 20 older adult
      women on two types of tasks. One type of task was normal instrumental activities
      of daily living (e.g., meal preparation, home maintenance) that were meaningful,
      familiar, and well practiced. The other type was a contrived, relatively
      unfamiliar task of wrapping a package. Although young and old women did not
      differ significantly in their familiarity with the two tasks, results from two
      repeated measures MANOVAs revealed a significant age difference in both
      activities. This finding suggests that older adults show age-related decline with
      tasks even when those tasks are familiar, practiced, and ecologically valid.

PMID- 8352329
TI  - Improvement in upper extremity function and trunk control after selective
      posterior rhizotomy.
AB  - Selective posterior rhizotomy is being increasingly used in the treatment of
      spasticity associated with cerebral palsy. Anecdotal reports in the literature
      note that this procedure results in improved upper extremity function and trunk
      control. We present a systematic analysis of the results of selective posterior
      rhizotomy performed on patients with cerebral palsy at Santa Rosa Children's
      Hospital. Patients were video-taped before surgery and one year postoperatively.
      These videos were reviewed blind by an occupational therapist who graded
      patients' performance on three tasks: assumption of side sitting, maintenance of
      side sitting, and block building. Statistically significant improvements were
      noted in all three categories with p values of .0003, .0001, and .0044
      respectively. These results support the anecdotal reports of improvement in upper
      extremity function and trunk control with selective posterior rhizotomy.

PMID- 8352330
TI  - Attending behavior: a descriptive study of children aged 18 through 23 months.
AB  - The purpose of this study was to provide descriptive data on the attending
      behavior of children aged 18 through 23 months. The method used was designed to
      be clinically feasible for occupational therapy practitioners. Forty-eight
      children between the ages of 18 and 24 months were studied through observation of
      a 15-min session of free play with a standard set of toys. The child's physical
      contact with objects was used as a guideline for timing. Four factors were
      examined: total time attending, total number of activities attended to, average
      attending time per activity, and longest time attending to one activity. The Mann
      Whitney U statistic revealed that there were no significant differences between
      boys and girls on any of the four factors. There were, however, statistically
      significant differences between children aged 18 through 20 months and children
      aged 21 through 23 months for all of the factors except longest time attending to
      one activity. The children in this study changed activities frequently (median of
      10 activities in 15 min) and attended briefly (median attending time per activity
      of 81 sec). They were, however, capable of attending to one activity for much
      longer periods of time (median of 225 sec). With minimal adult intervention, the
      children spent an average of 12.5 min attending to the toys during a 15-min
      session. These results may augment other aspects of occupational therapy
      assessment by offering some insight into whether or not an individual child
      demonstrates age-appropriate attending behavior. Additionally, this standardized
      method of observation may offer occupational therapists a clinically feasible
      means of assessing attending behavior.

PMID- 8352331
TI  - Death in very old age: a personal journey of caregiving.
AB  - This paper describes a personal journey of caregiving for a very old family
      member during dying and death. The phenomenology of caregiving reveals the inner
      struggle experienced by all caregivers, lay and professional, between the needs
      to support both the living and the dying of the terminally ill person. The lived
      experience unfolds in phases of caregiving that support a stage theory of
      development in professionals' work with dying persons. The concept of presencing
      or connecting is a vital component of terminal care and has implications for
      occupational therapy practice. Occupational therapists can use their knowledge
      and understanding of occupation to bring about connecting in the dying
      experience. The contributions of all participants in the dying experience--family
      caregivers, the dying person, and health professionals--are important as sources
      of mutual support in the work of dying.

PMID- 8352332
TI  - An international overview of resource centers on disability.
AB  - Facilities variously known as independent living centers, disabled living
      centers, disability information centers, and resource centers now exist in many
      parts of the world. Although occupational therapists offer valuable perspectives
      on quality of life, knowledge of assistive technology, and a holistic view of
      clients' needs, occupational therapy is not always a part of these centers.
      Occupational therapists themselves may overlook these settings as venues for
      their services. This overview of 38 resource center organizations in 14 countries
      reports on their approaches to supporting persons with disabilities,
      professionals, and other members of the public and explores the presence of
      occupational therapy and other professions in these agencies.

PMID- 8352333
TI  - A comparison of practice issues among occupational therapists in the rural
      Northwest and the Rocky Mountain regions.
AB  - The purpose of this study was to investigate factors that affected occupational
      therapy practice in the rural regions of the Rocky Mountains. It compared data
      from the Rocky Mountain region (Wyoming, Colorado, New Mexico, Utah, and Arizona)
      to a previous study of the Northwest region of Alaska, Idaho, Montana, and
      Washington and expanded on the Northwest study. Results indicated that the two
      areas were similar in their demographics and problems, including need for more
      occupational therapists. The results also have implications regarding specialized
      preservice training for rural-based occupational therapists, other professions'
      availability of continuing education, and other support systems. The authors
      provide recommendations based on the results, other literature, and conjectures,
      for recruitment, training, and ongoing support of rural occupational therapists
      through cooperative consortiums and distance learning.

PMID- 8352334
TI  - Electrical stimulation for restoring independent feeding in a man with
      quadriplegia.

PMID- 8352336
TI  - Partition of occupational science and occupational therapy: sorting out some
      issues.

PMID- 8352335
TI  - Graded activity: legacy of the sanatorium.
AB  - Occupational therapists in all areas of practice grade therapeutic activities to
      help patients progress toward their goals. It is proposed in this paper that the
      concept of graded activity originated in German tuberculosis sanatoria in the
      late 1800s, when patients were required to walk on graded (sloped) land for
      exercise. British physician Marcus Paterson included work, as well as walking, in
      his graduated exercise program for tuberculosis patients and was honored for this
      innovation at the founding meeting of the National Society for the Promotion of
      Occupational Therapy (NSPOT). George Barton, Susan Tracy, and Herbert Hall were
      among the NSPOT members who contributed to the development of graded activity as
      a principle in occupational therapy intervention. The military rehabilitation
      programs established during World War I provided additional impetus, and by the
      mid-1920s, graded activity was recognized as central to the profession.

PMID- 8352337
TI  - Journal articles are inappropriate for special group interests.

PMID- 8352338
TI  - Patient care for the twenty-first century: asserting professional values within
      economic restraints.

PMID- 8352339
TI  - Joseph T. English, M.D., one hundred twenty-first president, 1992-1993.

PMID- 8352340
TI  - A new beginning II.

PMID- 8352341
TI  - Ethics, empathy, and gender in health care.
AB  - The changes that have taken place in medicine over the past few decades have
      challenged our views about the responsibilities and obligations of those
      providing health care and about their relationships with their patients. The
      demands brought by technologic advances and economic concerns have tested our
      ability to practice humane, empathic, and ethical medicine. This paper addresses
      the connection between ethics and empathy in the context of our current health
      care system. The author reviews the concept of empathy and argues that ethical
      medicine is empathic medicine. Since gender differences in health care needs and
      disparities in treatment have been identified, gender serves to focus some of the
      issues and exemplify some concerns about empathic and ethical practice.

PMID- 8352342
TI  - Intergenerational transmission of child abuse: rates, research, and clinical
      implications.
AB  - OBJECTIVE: The author reviews current wisdom concerning the rates and mechanisms
      of intrafamilial components of intergenerational transmission of child abuse and
      illustrates the unreliability of basic data and of assumptions made by reviewers
      and partisan advocates, most of whom underestimate the importance of
      intrafamilial factors in child abuse. METHOD: The information in the report was
      derived from original research plus a recently prepared compilation of 60
      studies, mainly from the United States and the United Kingdom. RESULTS: The crude
      rates of intergenerational transmission of child abuse according to the studies
      reviewed are as follows: one-third of child victims grow up to continue a pattern
      of seriously inept, neglectful, or abusive rearing as parents. One-third do not.
      The other one-third remain vulnerable to the effects of social stress on the
      likelihood of their becoming abusive parents. Intrafamilial factors appear to be
      the cause of personally directed, as opposed to culturally condoned, child abuse.
      Broad social factors, and some medical and psychiatric conditions, lower or raise
      thresholds in which family and personal vulnerabilities and propensities operate.
      CONCLUSIONS: There is no justification for any extremist advocacy in apportioning
      responsibility between the "sins of the parents" and the failings of society. The
      contention that clinical research on abuse is inferior to, and must give way to,
      large-scale or statistically balanced self-report and questionnaire surveys is
      plausible, popular, convincing, and wrong.

PMID- 8352343
TI  - Cortical-striatal-thalamic circuits and brain glucose metabolic activity in 70
      unmedicated male schizophrenic patients.
AB  - OBJECTIVE: The cortical-striatal-thalamic circuit modulates cognitive processing
      and thus may be involved in the cognitive dysfunction in schizophrenia. The
      imaging of metabolic rate in the structures making up this circuit could reveal
      the correlates of schizophrenia and its main symptoms. METHOD: Seventy male
      schizophrenic patients underwent [18F]-fluorodeoxyglucose positron emission
      tomography after a period of at least 4 weeks during which they had not received
      neuroleptic medication and were compared to 30 age-matched male normal comparison
      subjects. RESULTS: Analyses revealed decreased metabolism in medial frontal
      cortex, cingulate gyrus, medial temporal lobe, corpus callosum, and ventral
      caudate and increased metabolism in the left lateral temporal and occipital
      cortices in the schizophrenic cohort. Consistent with previous studies, the
      schizophrenic group had lower hypofrontality scores (ratios of lateral frontal to
      occipital metabolism) than did comparison subjects. The lateral frontal cortical
      metabolism of schizophrenic patients did not differ from that of comparison
      subjects, while occipital cortical metabolism was high, suggesting that lateral
      hypofrontality is due to abnormalities in occipital rather than lateral frontal
      activity. Hypofrontality was more prominent in medial than lateral frontal
      cortex. Brief Psychiatric Rating Scale (BPRS) scores, obtained for each
      schizophrenic patient on the scan day, were correlated with regional brain
      glucose metabolic rate. Medial frontal cortical and thalamic activity correlated
      negatively with total BPRS score and with positive and negative symptom scores.
      Lateral frontal cortical metabolism and hypofrontality scores did not
      significantly correlate with negative symptoms. Analyses of variance demonstrated
      a reduced right greater than left asymmetry in the schizophrenic patients for the
      lateral cortex as a whole, with simple interactions showing this effect
      specifically in temporal and frontal cortical regions. CONCLUSIONS: Low metabolic
      rates were confirmed in medial frontal cortical regions as well as in the basal
      ganglia, consistent with the importance of the cortical-striatal-thalamic
      pathways in schizophrenia. Loss of normal lateralization patterns was also
      observed on an exploratory basis. Correlations with negative symptoms and group
      differences were more prominent in medial than lateral frontal cortex, suggesting
      that medial regions may be more important in schizophrenic pathology.

PMID- 8352344
TI  - Parkinsonism in neuroleptic-naive schizophrenic patients.
AB  - OBJECTIVE: Previous studies in schizophrenia have identified abnormalities
      involving the basal ganglia, but the contribution of neuroleptics to the motor
      system abnormalities in schizophrenia is usually a confounding factor. This study
      addressed the issue of whether parkinsonism, a reflection of dopaminergic
      hypofunction, occurs in schizophrenia per se. METHOD: Clinical ratings and
      quantitative instrumental measures of parkinsonian rigidity, tremor, and
      bradykinesia were obtained in 24 neuroleptic-naive schizophrenic patients and 24
      age- and gender-matched comparison subjects. RESULTS: According to the clinical
      ratings, 21% of the schizophrenic patients had rigidity and 12% had bradykinesia,
      in contrast to none of the normal comparison subjects. With the use of
      instrumental measures, rigidity and tremor were observed in 29% and 37%,
      respectively, of the schizophrenic patients, compared to 4% and none in the
      normal comparison group. The schizophrenic patients also exhibited greater right
      side than left-side parkinsonism. CONCLUSIONS: The findings suggest that
      extrapyramidal motor signs may be part of schizophrenia proper and that some
      patients with schizophrenia have left striatal hypodopaminergia unrelated to
      neuroleptic treatment.

PMID- 8352345
TI  - Establishing the onset of psychotic illness.
AB  - OBJECTIVE: To date, the literature has provided no standardized, replicable
      method for establishing illness onset. The authors describe a method for dating
      the first appearance of prodromal signs of psychotic illness, the emergence of an
      acute episode, and the initiation of treatment seeking. METHOD: Using reports by
      family and friends about a sample of 141 subjects with first-episode psychosis,
      the investigators derived a checklist of behaviors describing the evolution of
      various phases of illness. Supplied with the checklist, clinician pairs
      independently rated the critical phases in the evolution of illness: first
      appearance of noticeable symptoms, first appearance of prominent psychotic
      symptoms, and initiation of treatment seeking. RESULTS: The judges achieved good
      reliability in assigning age at the first appearance of psychotic symptoms and at
      initiation of treatment seeking. Judging the beginning of the prodrome proved
      more difficult. Insidious onset proved as characteristic of affective psychosis
      as of schizophrenia, while treatment lag--the interval between emergence of acute
      psychotic symptoms and initiation of treatment seeking--was longer for
      schizophrenia than for affective psychosis. Onset of schizophrenia occurred
      earlier in women than in men. Depression with psychotic features appeared earlier
      in men than women. CONCLUSIONS: Although dating the onset of illness phases is
      probably feasible, efforts to improve reliability must continue. The study
      results challenge beliefs about gender differences in age at onset.

PMID- 8352346
TI  - Contrasts between patients with affective disorders and patients with
      schizophrenia on a neuropsychological test battery.
AB  - OBJECTIVE: This study was designed to ascertain the degree and specificity of
      cognitive impairments in patients with schizophrenia and patients with affective
      disorders. METHOD: Cognitive function was assessed with a neuropsychological test
      battery in consecutively admitted patients with schizophrenia (N = 57), unipolar
      depression (N = 29), and bipolar disorder (N = 16). RESULTS: The performance of
      the schizophrenic group was significantly below that of the groups with affective
      disorders on measures of attention and psychomotor speed, verbal and visual
      memory, and problem solving and abstraction. IQ was lower in the schizophrenic
      group and appeared to have deteriorated from a normal premorbid level that was
      not different from that of the affective disorder groups, as determined by the
      Wide Range Achievement Test--Revised reading test, a putative measure of
      premorbid intelligence. When IQ was controlled, differences between the groups in
      problem solving and visual memory remained. Psychiatric symptoms had a larger
      impact on test performance in the affective disorder groups than in the
      schizophrenic group. CONCLUSIONS: These results suggest that patients with
      schizophrenia perform systematically worse on cognitive measures than patients
      with affective disorders, which is consistent with their generally poorer
      outcome. The results also indicate that schizophrenia and affective disorders are
      qualitatively distinguishable in neuropsychological terms, given differences in
      apparent intellectual deterioration, profiles of cognitive impairment, and
      associations between cognitive performance and psychopathology.

PMID- 8352347
TI  - A comparative study of paranoid and schizoid personality disorders.
AB  - OBJECTIVE: Family studies have demonstrated a higher rate of schizoid personality
      in the families of probands with schizophrenia and a higher rate of paranoid
      personality in the families of probands with delusional disorder. The authors
      sought to investigate the familial characteristics of probands with schizoid and
      paranoid personality disorders and to delineate the clinical characteristics of
      the two groups. METHOD: Records of 351 inpatients with discharge diagnoses that
      included the term "schizoid personality" or "paranoid personality" were examined
      to identify patients who met DSM-III-R criteria for schizoid personality disorder
      (N = 34) or paranoid personality disorder (N = 19). Comparisons were made between
      the two groups with respect to clinical symptoms, familial characteristics, and
      longitudinal course. RESULTS: The authors found that probands with schizoid
      personality disorder were hospitalized at an earlier age than probands with
      paranoid personality disorder, had more intervention before the index admission,
      and had greater morbidity following the index admission. They also found that
      descriptors of the two syndromes tended to congregate in the respective family
      material, but the differences were not statistically significant. Differences in
      the familial prevalence of schizophrenia were also not statistically significant.
      CONCLUSIONS: These familial data do not support the hypothesis that schizophrenia
      congregates in the families of probands with schizoid personality disorder.
      Possible explanations for this finding are discussed.

PMID- 8352348
TI  - Profiles and predictors of assaultiveness for different psychiatric ward
      populations.
AB  - OBJECTIVE: The authors examined associations between patient-related
      characteristics and assaultiveness on six different psychiatric wards to
      determine 1) the relative contributions of demographic, disorder-related, and
      diagnostic variables to prediction of assaultiveness and 2) how ward composition
      and type of victim affect prediction of assaultiveness. METHOD: Hospital records
      of 1,025 inpatients residing in psychiatric wards within a 6-month time frame
      were reviewed for evidence of assaultiveness. Data on all 260 assaultive patients
      and a sample of 136 of the nonassaultive patients were analyzed with multiple
      regression to predict assaultiveness scores for each ward and each victim
      category. RESULTS: The findings indicated high rates of assaultive patients and
      assaults on fellow patients. Multiple regression results produced different
      predictors of assaultiveness for different wards but not for different categories
      of assault victim within each ward. Overall, age and sex consistently failed to
      predict assaultiveness, whereas greater assaultiveness was significantly
      associated with a greater proportion of time hospitalized since first admission.
      The most powerful unique predictors of assaultiveness scores were diagnostic
      distinctions derived from data on coexistent diagnoses. The most assaults were by
      acute patients whose diagnoses excluded organic mental disorder but included
      either bipolar disorder or personality disorder and longer-stay patients whose
      exclusive diagnosis was organic mental disorder. CONCLUSIONS: This
      identification, albeit modest, of risk factors for assaultiveness on different
      wards nevertheless provides information fundamental to the management policies of
      psychiatric institutions. The findings caution against aggregating different ward
      populations for research on assaultiveness and endorse the usefulness of
      coexistent diagnoses for predicting assaultiveness.

PMID- 8352349
TI  - Short-term clinical prediction of assaultive behavior: artifacts of research
      methods.
AB  - OBJECTIVE: The apparent accuracy of predictions of assaultive behavior in
      psychiatric inpatients varies substantially, depending on the method used to
      study the prediction. The authors explored the effects of different measures and
      sampling strategies on short-term clinical predictions of dangerousness. METHOD:
      The index subjects were patients who were rated by intake clinicians as
      potentially highly assaultive on the ward (N = 32) and patients who were
      involuntarily committed on grounds of danger to others (N = 32). The respective
      comparison groups comprised patients predicted by clinicians not to be assaultive
      (N = 32) and patients committed for reasons other than danger to others (N = 40).
      The text of unit meetings and data from chart reviews were used to determine the
      occurrence and dates of violent acts, seclusions for violent acts or threats, and
      violent threats. RESULTS: There was a significant difference in the rate of
      inpatient violence between the subjects rated at admission as potentially
      assaultive (75.0%) and patients rated as not potentially assaultive (12.5%), but
      the difference in the rates of violence between the patients who were (56.0%) and
      were not (42.0%) involuntarily committed as dangerous to others was not
      significant. Most of the violent acts occurred relatively late in the
      hospitalization, but seclusions occurred almost exclusively in the initial stages
      of hospitalization. CONCLUSIONS: The reported accuracy of clinical predictions of
      assaultive behavior is markedly affected by the choice of sampling strategy,
      comparison group, outcome measures, and follow-up period. Including seclusion and
      violent threats in the outcome variable appears to lead to deceptive findings.

PMID- 8352350
TI  - Seasonality in violent suicide but not in nonviolent suicide or homicide.
AB  - OBJECTIVE: Previous studies have reported seasonal or monthly variation in
      suicide. The present study was conducted in order to determine seasonality and
      other significant rhythms in violent and nonviolent suicide, alone and together,
      and homicide. METHOD: Data on suicide, violent suicide, nonviolent suicide, and
      homicide (categorized according to ICD-9) for all of Belgium for the period 1979
      1987 were analyzed by means of spectral analyses. RESULTS: There was a
      significant seasonality for suicide but not homicide. Seasonality was present in
      violent but not in nonviolent suicide. The number of violent suicides increased
      with age and was more prominent in men. The violent suicide chronograms of
      younger and elderly persons were quite distinct in the occurrence of peaks in
      March-April and August, respectively, and lows in December-January. There was no
      significant relationship between violent suicide and homicide. CONCLUSIONS:
      Seasonality in suicide is determined by significant circannual rhythms in violent
      suicides, which differ between younger and elderly persons.

PMID- 8352352
TI  - Beginning careers in academic psychiatry for women--"Bermuda Triangle"?
AB  - OBJECTIVE: The proportion of women in leadership positions in academic psychiatry
      has not kept pace with the increase in the number of women entering the field.
      This study examines differences in career activities between women and men who
      graduated from the Yale University psychiatric residency training program and
      explores whether these differences can be explained by preresidency expectations,
      residency experiences, or training immediately after residency. METHOD:
      Departmental educational records of the Yale residency program were reviewed to
      determine professional interests expressed before psychiatric residency and
      training focus during residency for 355 residents in the 1970-1983 graduating
      classes. A 1984 follow-up study focused on their postresidency career activities.
      Differences in preresidency interests and experiences, training activities, and
      career paths between all female and male graduates and between women and men who
      chose academic careers were examined. RESULTS: After residency, the female
      graduates' marital status differed from men's--more had never married or were
      divorced. Women's professional activities diverged from men's; their practice
      pattern was different, they spent more hours teaching, and they had fewer
      publications in peer-reviewed journals. This divergence was not accounted for by
      differences in pretraining interests or in training focus during residency. The
      authors present possible explanations. CONCLUSIONS: Further research is indicated
      to determine the underlying causes of career differences between women and men in
      psychiatric practice and academia so that effective strategies for correcting the
      present inequality of women in senior faculty positions can be implemented.

PMID- 8352351
TI  - The abnormality of normal comparison groups: the identification of psychosis
      proneness and substance abuse in putatively normal research subjects.
AB  - OBJECTIVE: Careful assessment of research subjects is important because the
      inclusion of subjects who manifest psychopathology and significant substance
      abuse in normal comparison groups will decrease statistical and experimental
      power. The current study evaluated the usefulness of an MMPI-derived algorithm in
      identifying tendencies toward psychosis and substance abuse in putatively normal
      research volunteers. METHOD: Ninety-eight adults who were recruited as normal
      comparison research subjects completed the MMPI, psychiatric interviews,
      questionnaires, and selected neuropsychological tests. The MMPI classified 81
      presumed normal subjects into four subgroups: 1) not psychosis prone/substance
      abuse not likely, 2) not psychosis prone/substance abuse likely, 3) psychosis
      prone/substance abuse not likely, and 4) psychosis prone/substance abuse likely.
      RESULTS: The MMPI psychosis-prone and substance abuse factors identified
      significantly distressed and dysfunctional individuals with a relatively high
      degree of accuracy. CONCLUSIONS: It is becoming increasingly apparent that the
      cursory self-report screening of normal subjects may result in unacceptable
      levels of psychopathology in comparison groups. The current results also indicate
      that an adequate substance abuse evaluation is extremely important and that brief
      self-report information may be misleading. Empirically derived assessment tools,
      such as the MMPI, may prove useful in allowing researchers to more accurately
      define control parameters and group membership.

PMID- 8352353
TI  - Familial aggregation of emotional and behavioral problems of childhood in the
      general population.
AB  - OBJECTIVE: This study sought to evaluate the existence and implications of
      familial aggregation of emotional and behavioral problems of childhood in a
      general population sample. METHOD: The children included in the study were chosen
      with the use of a sampling technique that identified households in which there
      were two or more children aged 4-16 years living at home at the time of the
      survey. Ratings on checklists of emotional and behavioral problems were obtained
      from parents, teachers of children in elementary school, and the children
      themselves if they were adolescents aged 12-16. Children were classified as
      having problems if their scores on scales of conduct, attention deficit, or
      emotional problems were in the top 10% of the distribution of scores from any
      informant. RESULTS: There was evidence for familial aggregation of these
      problems, particularly conduct and emotional problems. However, this was largely
      derived from the parents' reports of symptoms, not the teachers' or adolescents'
      reports. The degree of familial aggregation varied according to certain sibship
      characteristics and patterns of comorbidity. CONCLUSIONS: Familial aggregation of
      emotional and behavioral problems does exist in a community population and is not
      simply an artifact of clinic attendance.

PMID- 8352354
TI  - Smooth pursuit eye movements and saccadic eye movements in patients with
      delusional disorder.
AB  - OBJECTIVE: This study used eye movement tests to examine whether frontal lobe
      dysfunction is present in delusional disorder. METHOD: Smooth pursuit and
      voluntary saccadic eye movements of 15 delusional patients, 40 schizophrenic
      patients, and 40 normal subjects were recorded and analyzed statistically.
      RESULTS: The schizophrenic patients differed significantly from the normal
      subjects in some smooth pursuit eye movement characteristics, whereas both the
      schizophrenic and the delusional patients showed more saccades than the normal
      subjects during the smooth pursuit test. The delusional patients and normal
      subjects differed significantly in some voluntary saccadic eye movement
      characteristics. CONCLUSIONS: The data support the idea of a biological
      dysfunction in eye tracking in delusional disorder.

PMID- 8352355
TI  - Prediction of response to haloperidol dose reduction by Span of Apprehension
      measures for treatment-refractory schizophrenic patients.
AB  - Thirteen treatment-refractory schizophrenic patients participated in a
      haloperidol reduction study. Two of the subjects were unable to tolerate
      medication reduction. These subjects were comparable to the other patients in
      terms of initial clinical variables but were outliers on baseline accuracy and
      reaction time measures from the Span of Apprehension. The results suggest that
      aspects of basic visual processing and motor response speed may identify patients
      who require higher neuroleptic doses.

PMID- 8352356
TI  - Light therapy of late luteal phase dysphoric disorder: an extended study.
AB  - Nineteen patients with late luteal phase dysphoric disorder (LLPDD) and 11
      healthy comparison subjects underwent a 3-month crossover trial of bright (more
      than 2500 lux) white morning, bright white evening, and placebo dim (less than 10
      lux) red evening light, administered daily for 1 week during the premenstrual
      phase of the menstrual cycle. All light treatments significantly reduced
      depressive ratings from baseline levels.

PMID- 8352357
TI  - Need to clarify DSM-III-R depersonalization disorder.

PMID- 8352358
TI  - Paradoxical sedation with sertraline.

PMID- 8352359
TI  - Ephedrine arousal.

PMID- 8352361
TI  - Captopril-induced mania.

PMID- 8352360
TI  - Unrecognized pregnancy during citalopram treatment.

PMID- 8352362
TI  - Treatment of flashbacks with naltrexone.

PMID- 8352363
TI  - Influence of clozapine on water dysregulation.

PMID- 8352364
TI  - Arnold Bennett, Clayhanger, and Alzheimer's disease.

PMID- 8352365
TI  - Rates of schizophrenia among males and females.

PMID- 8352367
TI  - Cost containment and the profit motive.

PMID- 8352366
TI  - Role of DHEA and DHEA-S in Alzheimer's disease.

PMID- 8352368
TI  - Clozapine, obsessive symptoms, and serotonergic mechanisms.

PMID- 8352369
TI  - Clozapine, obsessive symptoms, and serotonergic mechanisms.

PMID- 8352370
TI  - The file drawer problem in the meta-analysis of the subjective responses to
      alcohol.

PMID- 8352371
TI  - Assessment of onset of panic disorder in relation to onset of agoraphobia.

PMID- 8352372
TI  - Effect of topical 5-aminosalicylic acid (5-ASA) therapy on rectal mucosal biopsy
      morphology in chronic ulcerative colitis.
AB  - Classic teaching emphasizes that chronic ulcerative colitis is characterized
      morphologically by the presence of fixed architectural and cellular mucosal
      changes that categorize the process as chronic. To examine the effect of topical
      5-aminosalicylic acid (5-ASA) enemas on the presence of six histological features
      of chronicity in established chronic ulcerative colitis, 123 mucosal biopsies
      were taken prospectively at 1-month intervals, all from the same anatomic
      location (10 cm), from 14 patients treated with either 5-ASA or placebo enemas.
      The biopsies were evaluated for the presence of mixed inflammation in the lamina
      propria, crypt architectural abnormalities, basally located lymphoid aggregates,
      basal plasmacytosis, villiform surface epithelial configuration, and Paneth cell
      metaplasia. Overall, 29% of biopsies from 64% of patients were histologically
      normal (no chronic features, no active disease). Compared with patients treated
      with placebo enemas, patients treated with 5-ASA enemas showed a significantly
      higher percentage of normal biopsies (36% ASA group vs. 12% placebo group; p =
      0.005) and a lower percentage occurrence of each individual histological feature
      of chronicity. In addition, patients treated with 5-ASA had a higher average
      number of normal biopsies per patient (3.0) than those treated with placebo
      enemas (1.3). Therefore, histologically normal-appearing mucosal biopsies do
      occur in established cases of chronic ulcerative colitis, and this finding is
      enhanced by treatment with 5-ASA enemas. Awareness of these results should
      prevent the presence of normal rectal mucosal biopsy findings in chronic
      ulcerative colitis patients from being misinterpreted as either evidence against
      this diagnosis or as representing focal skip areas characteristic of Crohn's
      disease.

PMID- 8352373
TI  - Adiaspiromycosis: an unusual fungal infection of the lung. Report of 11 cases.
AB  - Adiaspiromycosis (ad"i-ah-spi"ro-mi-kosis) is a worldwide, noninfectious,
      nonarthropod transmitted fungal infection of lower vertebrates, most commonly
      rodents. Humans become an accidental host by inhaling dust-borne spores (conidia)
      of the saprophytic soil fungus, Emmonsia crescens (recently renamed Chrysosporium
      parvum variety crescens). We report 11 cases of this unusual deep mycosis from
      South America, Europe, and the United States. The severity of the disease depends
      on the number of spores inhaled. In limited inoculum, the disease remains
      localized (two cases), whereas in heavy inocula the fungus involves both lungs
      (nine cases) and presents as a diffuse reticulonodular infiltrate. In this
      disseminated form, patients usually complain of cough, dyspnea on exertion, and
      low-grade fever mimicking other systemic fungal infections and tuberculosis. It
      is difficult to unmask the fungus because it is not easily cultured nor is there
      a reliable serologic test. Therefore, a biopsy is required and the pathologist
      must recognize the large (ranging in size from 50 to 500 microns), round, Gomori
      methenamine-silver nitrate and periodic acid-Schiff reagent-positive spherules
      with a trilaminar wall. The spherules can be surrounded by either suppuration,
      epithelioid granulomas with or without necrosis, or concentric, hyalinized
      fibrosis. In the latter chronic stage, the organism may collapse, forming a
      variety of sizes and shapes thereby resembling other fungi, helminths, mineral
      particles, or inhaled pollen grains. Clinically, the infection most commonly
      regresses spontaneously, but may persist, or rarely progress, requiring surgical
      intervention with limited resection to attain cure.

PMID- 8352374
TI  - Immunoperoxidase staining of non-Hodgkin's lymphomas for T-cell lineage
      associated antigens in paraffin sections. Comparison of the performance
      characteristics of four commercially available antibody preparations.
AB  - Paraffin sections of 133 cases of non-Hodgkin's lymphoma (69 B-cell type and 64 T
      cell type) were stained in a labeled streptavidin biotin immunoperoxidase
      technique with a panel of antibodies that recognized T-lymphocyte associated
      antigens. This study was done to determine the sensitivity and specificity of
      these reagents for phenotyping T-cell lymphomas. UCHL-1, polyclonal anti-CD3, Leu
      22, and OPD4 stained 78%, 72%, 91%, and 69% of the cases of T-cell lymphomas,
      respectively. The phenotype of L-26 negative and CD3 or UCHL-1 positive
      accurately predicted T-cell phenotype in 95% (60 of 63) of the T-cell lymphomas
      and was not seen in any of the cases of B-cell lymphoma. Although Leu-22 was the
      most sensitive T-cell-associated marker in this series, its lack of specificity
      for T-lymphocytes limited its usefulness as part of a routine panel designed to
      distinguish between T-cell and B-cell lymphomas. In conjunction with other
      reports, this study supports the use of the T-cell markers CD3 and UCHL-1 in
      combination with the B-cell-associated marker L-26 to phenotype most efficiently
      non-Hodgkin's lymphomas in paraffin sections.

PMID- 8352375
TI  - Sarcomas with combined features of liposarcoma and leiomyosarcoma. Study of two
      cases of an unusual soft-tissue tumor showing dual lineage differentiation.
AB  - Two cases are described of a soft-tissue sarcoma characterized histologically by
      the intimate admixture of areas displaying the features of liposarcoma and
      leiomyosarcoma. Both cases occurred in men, 70 and 77 years of age. The lesions
      were located in the left scrotum and abdominal cavity, respectively.
      Histologically, the lipomatous component in both cases consisted predominantly of
      well-differentiated liposarcoma with myxoid areas. The smooth-muscle component
      was characterized by intersecting fascicles of spindle cells displaying nuclear
      atypicality and scattered mitotic figures; the spindle cells in these areas were
      strongly immunoreactive with actin and desmin antibodies. The above tumors must
      be distinguished from angiomyolipoma, spindle-cell lipoma, myolipoma of soft
      tissue, and more importantly, from "dedifferentiated" liposarcoma. The
      development of dual lineage differentiation within adipose tissue tumors as
      exemplified by these two cases may be more prevalent than has been generally
      recognized, and may require the application of immunohistochemical markers for
      specific identification of the spindle-cell component.

PMID- 8352376
TI  - Necrobiotic palisading suture granulomas simulating rheumatoid nodule.
AB  - Five patients without clinical evidence of rheumatic disease developed
      postoperative periarticular suture reactions featuring necrobiotic granulomas
      histologically similar to rheumatoid nodules. Suture granulomas are to be
      included in the differential diagnosis of palisading granulomas simulating
      rheumatoid nodule.

PMID- 8352377
TI  - Massive chondroid differentiation in fibrous dysplasia of bone
      (fibrocartilaginous dysplasia)
AB  - Eight cases of fibrocartilaginous dysplasia (fibrous dysplasia with massive
      cartilaginous differentiation) of bone are reported. The age of the patients
      ranged from 4 to 26 years, with an average of 17.5 years. The male/female ratio
      was 1:1. In two patients the lesions occurred in a setting of polyostotic fibrous
      dysplasia. The anatomic sites most frequently affected were the femur and tibia.
      The proximal femur was the most common site. Roentgenograms showed well
      demarcated lucent lesions of ground-glass opacity. In addition, stippled or ring
      like calcifications suggesting cartilaginous elements were seen in six cases.
      Histologically, hyaline cartilage islands were found in juxtaposition to a fibro
      osseous lesion characteristic of fibrous dysplasia. Enchondral ossification was
      commonly seen, frequently showing columnar arrangement of cartilage cells
      mimicking a growth plate. The cartilage may show moderate atypism. The important
      thing is to recognize the benign nature of chondroid elements in fibrous
      dysplasia. Even if cartilage dominates the histologic picture, it is important to
      identify the fibro-osseous elements and thereby avoid the misdiagnosis of
      chondrosarcoma.

PMID- 8352378
TI  - Dracunculosis of the broad ligament. A case of a "parasitic leiomyoma".
AB  - This report describes the case of a 29-year-old Nigerian woman with dracunculosis
      presenting as an adnexal mass. The patient had a history of two second-trimester
      spontaneous abortions for which she was being evaluated. During the evaluation,
      she was found to have multiple uterine leiomyomas and a calcified left adnexal
      mass by pelvic ultrasound and radiography. At laparotomy, the calcified mass was
      excised from the left broad ligament, and a myomectomy was performed. Histologic
      examination revealed a calcified, coiled guinea worm embedded in the fibrous
      tissue of the broad ligament. Only one other case of calcified guinea worm in the
      broad ligament has been reported in the literature.

PMID- 8352379
TI  - Carcinosarcoma of the adrenal cortex presenting with mineralocorticoid excess.
AB  - An adrenal carcinosarcoma is reported in a 79-year-old woman presenting with
      clinical signs of hyperaldosteronism. The tumor weighed 199 g and consisted of
      areas typical of adrenal carcinoma and areas of sarcoma. The sarcomatous
      component of the tumor showed osteogenic and chondroid differentiation. Vimentin
      stained both the carcinomatous and sarcomatous regions. Four months after
      resection, the patient developed metastases. This is the third reported case of
      adrenal carcinosarcoma and the only case in which hyperaldosteronism or bony
      differentiation was observed.

PMID- 8352380
TI  - Elastofibromatous lesion.

PMID- 8352381
TI  - Regression of hepatic lesions after treatment of Schistosoma mansoni or
      Schistosoma japonicum infection in mice: a comparative study.
AB  - Experimental infections with Schistosoma mansoni and S. japonicum differ in
      several aspects and post-treatment resorption of fibrosis might be one of them.
      To investigate this point, mice infected with each of these schistosome species
      were treated with praziquantel and the evolution of hepatic lesions was
      sequentially followed for five months. Parasitologic data showing destruction of
      worms and eggs and biochemical findings of progressively decreased collagen
      concentration after cure indicated that the lesions caused by S. mansoni and S.
      japonicum involuted in a similar fashion following chemotherapy. The time
      sequence of the histologic changes indicative of decreasing inflammation and
      progressive matrix degradation and resorption was also similar in both cases.

PMID- 8352382
TI  - Falciparum malaria: differential effects of antimalarial drugs on ex vivo
      parasite viability during the critical early phase of therapy.
AB  - A method of monitoring Plasmodium falciparum viability ex vivo was used to
      compare the ability of different antimalarial drugs to arrest the progression of
      young parasites to mature, potentially damaging stages. Neither pyrimethamine
      sulfadoxine nor quinine, the treatment of choice for severe, life-threatening
      malaria, had a demonstrable effect on circulating parasites during the first 24
      hr of therapy. In contrast, in vivo exposure to halofantrine for as little as six
      hours was sufficient to arrest parasite development. The method of assessing ex
      vivo parasite viability permits a comparison of antimalarial drug action at a
      time that may be critical for the therapy of life-threatening disease. If
      parenteral formulations of halofantrine prove to be safe and effective, they may
      have a role in the therapy of severe malaria.

PMID- 8352383
TI  - A novel pyrrolidonoalkaneamine (WR268954) that modulates chloroquine resistance
      of Plasmodium falciparum in vitro.
AB  - With the recent observations of efflux of chloroquine from Plasmodium falciparum
      and modulation of chloroquine resistance by calcium channel blockers, such as
      verapamil, a great deal of attention has been focused on the development of new
      modulators that can potentiate the efficacy of chloroquine. We report a new
      compound, WR268954, that has weak intrinsic antimalarial activity compared to
      chloroquine. In vitro, it increased the susceptibilities of chloroquine-resistant
      P. falciparum strains to chloroquine and quinine, but did not affect the
      chloroquine-susceptible strains. In the presence of 2,000 nM of WR268954, the 50%
      inhibitory concentration of chloroquine for drug-resistant P. falciparum
      decreased 90-fold in comparison with the control (chloroquine only). The same
      concentration of WR268954 increased the potentiation of chloroquine in resistant
      strains to a level approximately equivalent to that observed for the sensitive
      strain. This compound also potentiates the efficacy of quinine in drug-resistant
      parasites. However, WR268954 did not enhance the efficacy of mefloquine in the
      mefloquine-resistant parasites. In this report, the data show the synergistic
      effect of WR268954 on the antimalarial activity of chloroquine in drug-resistant
      strains of P. falciparum, but only an additive effect on drug-sensitive strains
      of parasites. Compound WR268954 belongs to a pyrrolidino alkane amine class whose
      in vitro chloroquine resistance modulator activity supports the basis for the
      synthesis of this class of compounds.

PMID- 8352384
TI  - PS-15: a potent, orally active antimalarial from a new class of folic acid
      antagonists.
AB  - A new, orally-active inhibitor of dihydrofolic acid reductase (DHFR), PS-15 (N-(3
      (2,4,5-trichlorophenoxy)propyloxy)-N'-(1-methylethyl)- imidocarbonimidic diamide
      hydrochloride), has significant activity against drug-resistant Plasmodium
      falciparum. It is not cross-resistant with other inhibitors of DHFR (e.g.,
      pyrimethamine and cycloguanil). Although it bears similarities to proguanil, PS
      15 represents a new antifolate class of drugs that we have named oxyguanils or
      hydroxylamine-derived biguanides. This compound displays intrinsic antimalarial
      activity and also is metabolized in vivo to WR99210, an extremely active triazine
      inhibitor of DHFR. When tested in vitro against drug-resistant clones of P.
      falciparum, PS-15 was more active than proguanil, and the putative metabolite,
      WR99210, was more active than the proguanil metabolite cycloguanil. The drug is
      also more active as well as less toxic than proguanil when administered orally to
      mice infected with P. berghei. When administered orally to Aotus monkeys infected
      with multidrug-resistant P. falciparum, PS-15 was more active than either
      proguanil or WR99210. In 1973, WR99210 underwent clinical trials for safety and
      tolerance in volunteers. The trials showed gastrointestinal intolerance and
      limited bioavailability; further development of the drug was abandoned. Because
      PS-15 has intrinsic antimalarial activity, is not cross-resistant with other DHFR
      inhibitors, and can be metabolized to WR99210 in vivo, oral administration of
      this new drug should circumvent the shortcomings and retain the advantages found
      with both proguanil and WR99210.

PMID- 8352385
TI  - Plasmodium coatneyi ring-infected erythrocyte surface antigens.
AB  - Plasmodium coatneyi produced ring-infected erythrocyte surface antigen (RESA)
      during infection of the rhesus monkey. This antigen was immunogenic and elicited
      an antibody response that was not persistent but was boosted by repeated
      infections in a manner similar to that seen in P. falciparum infections in
      humans. Preliminary data showed that the appearance and increasing titer of
      antibodies to P. coatneyi RESA-like antigen were associated with prolongation of
      intervals from inoculation to patency and with control of parasitemia. Studies
      using both immunofluorescence assay and Western blot analysis showed that P.
      coatneyi-immune rhesus serum cross-reacted with P. falciparum antigens, but P.
      falciparum immune human serum did not recognize P. coatneyi antigens in either
      assay. These results show that P. coatneyi expresses RESA-like antigen that
      elicits an antibody response similar to that observed for human antibody to P.
      falciparum RESA. However, antibodies to P. coatneyi did not cross-react with P.
      falciparum RESA in erythrocyte membrane immunofluorescence assay and dot
      immunoblot analysis, suggesting that different immunogenic epitopes are present
      on the two molecules. Our observations support the use of this primate model in
      RESA-based vaccine development.

PMID- 8352386
TI  - Elevated antifilarial IgG4 antibody levels in microfilaremic and
      microfilaridermic Gabonese adults and children.
AB  - Immunologic analyses of sera from 47 selected individuals living in a mixed
      filariasis transmission zone in Gabon were carried out. Onchocerca volvulus, Loa
      loa, Mansonella streptocerca, and M. perstans are transmitted in this region.
      Based on parasitologic findings and age, the 47 individuals were stratified into
      four groups: microfilaria negative (Mf-) children (3-15 years old), Mf- adults (>
      15 years old), microfilaria positive (Mf+) children and Mf+ adults. For
      descriptive purposes, the term microfilaria positive refers to individuals with
      skin and blood microfilariae. Antifilarial antibody titers were determined using
      an enzyme-linked immunosorbent assay with Dipetalonema viteae antigens. In
      general, children had higher titers of IgG antibodies than adults. For the IgG1,
      IgG2, and IgG3 subclass responses, both age and microfilarial status appeared to
      be important variables since Mf- children consistently had the highest titers
      whereas Mf- adults had the lowest titers. For the IgG4 antifilarial response,
      only the microfilarial status was an important variable. All Mf+ individuals had
      significantly higher levels of IgG4 antibody than Mf- individuals. Pooled sera of
      Mf- and Mf+ individuals reacted with similar O. volvulus antigens on Western
      blots. Control sera of individuals who did not reside in the study area, but who
      had single infections with L. loa or M. perstans, did not react with any O.
      volvulus antigens.

PMID- 8352387
TI  - Field trial of vaccination against American trypanosomiasis (Chagas' disease) in
      dogs.
AB  - In Santiago del Estero, an area endemic for Chagas' disease in northwestern
      Argentina, household dogs were vaccinated with live-attenuated Trypanosoma cruzi,
      and the prospective incidence of natural infection by this parasite was assessed
      during a two-year followup period. Vaccinated dogs received 10(7) attenuated, TCC
      strain T. cruzi epimastigotes and were given booster vaccinations two and 14
      months later. The number of animals that could be evaluated in vaccinated versus
      control groups was 73 and 75 after one year and 49 and 40 after two years,
      respectively. Parasitologic evaluation by xenodiagnosis indicated that
      vaccination had reduced natural T. cruzi infection from 26.7% to 12.3% after one
      year (P = 0.015). The preventive effect of vaccination after the second year was
      less significant in spite of the booster vaccinations. Inclusion of indirect
      hemagglutination data for the diagnosis of infection slightly increased the
      number of infected dogs without affecting the evidence for protection in the
      first year. Serologic, parasitologic, and isoenzyme studies indicated that
      protection was mediated by an attenuated, self-cured infection. In 15 dogs in
      which the vaccination failed to completely prevent natural infection,
      immunization nevertheless impaired their ability to infect the natural insect
      vectors of the disease in humans.

PMID- 8352388
TI  - Factors affecting exflagellation of in vitro-cultivated Plasmodium falciparum
      gametocytes.
AB  - The environment of Plasmodium falciparum gametocytes changes when they make the
      transition from the vertebrate to the invertebrate host. Gametocytes of this
      species cultivated in vitro were used to evaluate the effect of serum, pH, pCO2
      tension, bicarbonate ion, and temperature on gamete formation. Temperature was
      the only factor responsible for keeping P. falciparum gametocytes in the
      inactivated state. Mature gametocytes held at temperatures above 30 degrees C
      remained quiescent in 10% serum, even at low ambient pCO2 tension, alkaline pH,
      and in the presence of 25 mM bicarbonate ion. When the temperature of the medium
      was allowed to drop below 30 degrees C, gametocytes emerged from the red blood
      cells and microgametocytes consistently exflagellated at pH 7.4, even in the
      absence of bicarbonate ion. With regard to bicarbonate ion, exflagellation in P.
      falciparum is similar to P. berghei and different from P. gallinaceum
      gametocytes, which have an obligate requirement for bicarbonate ion.

PMID- 8352389
TI  - Epidemiologic aspects of a St. Louis encephalitis epidemic in Jefferson County
      Arkansas, 1991.
AB  - In 1991, the first epidemic of St. Louis encephalitis (SLE) ever reported in
      Arkansas resulted in 25 cases in Pine Bluff (attack rate: 44 per 100,000; 95%
      confidence interval [CI] 28-65). To identify risk factors for SLE viral infection
      and risk factors for neuroinvasive illness, we conducted a community-based, cross
      sectional study of noninfected and asymptomatically infected persons and a case
      control study of asymptomatically and symptomatically infected persons. The SLE
      viral infection rate was similar in all age groups and in all studied census
      tracts. Risk factors for asymptomatic infection included: living in a low income
      household (relative risk [RR] = 2.6, 95% CI 1.1-6.0), sitting outside in the
      evening (RR = 2.1, 95% CI 1.0-4.8), and living in homes with porches (RR = 2.9,
      95% CI 0.9-9.3) or near open storm drains (RR = 2.2, 95% CI 1.0-4.9). Compared
      with asymptomatically infected persons, symptomatic persons were older (odds
      ratio [OR] for age > or = 55 years = 13.0, 95% CI 1.2-334) and more likely to
      have a previous history of hypertension (OR = 8.5, 95% CI 1.1-72). Our results
      indicate that advanced age is the most important risk factor for developing
      encephalitis after infection with SLE virus. Hypertension and vascular disease
      may predispose to neuroinvasive disease, but this epidemiologic study has not
      ruled out the confounding effects of age.

PMID- 8352390
TI  - Entomologic investigations of an epidemic of St. Louis encephalitis in Pine
      Bluff, Arkansas, 1991.
AB  - An epidemic of St. Louis encephalitis (SLE) occurred in Jefferson County,
      Arkansas during July-August 1991. At least 26 human cases were involved, with 25
      cases in the town of Pine Bluff. Twelve isolates of SLE virus were obtained from
      mosquitoes collected in Pine Bluff between August 13 and 24: 11 from pools of
      Culex pipiens quinquefasciatus, resulting in a minimum infection rate of 1.6 per
      1,000 (n = 6,768) for this subspecies, and one isolate from a pool of 22
      mosquitoes identified as Cx. (Culex) spp. Three of the SLE-positive pools, two
      from Cx. p. quinquefasciatus and one from Cx. (Cux.) spp., also yielded isolates
      of Flanders virus. Larval surveys resulted in the collection of seven species in
      four genera from 28 larva-positive habitats and the identification of one
      significant site of Cx. p. quinquefasciatus production. Ecologic assessments
      conducted at 12 randomly selected residences resulted in the identification of 17
      larva-positive habitats, for an average mosquito-positive habitat rate of 1.4 per
      residence, and a Cx. p. quinquefasciatus larva-positive habitat rate of 0.6 per
      residence. Aedes albopictus and Cx. p. quinquefasciatus were the species most
      frequently encountered in larval surveys in residential neighborhoods.

PMID- 8352391
TI  - Avian hosts of St. Louis encephalitis virus in Pine Bluff, Arkansas, 1991.
AB  - An investigation of the extent of St. Louis encephalitis (SLE) virus activity in
      the avian population in Pine Bluff, Arkansas was conducted from August 30, 1991
      through September 5, 1991, following an SLE epidemic that resulted in 25 human
      cases. A total of 363 birds of 33 species were captured with ground-level mist
      nets at four sites along the northern edge of the city. No viruses were isolated
      from the serum of these birds, but 91 birds (25%) of 11 species had detectable
      neutralizing antibody against the TBH-28 strain of SLE virus in the constant
      virus, serum-dilution, plaque-reduction neutralization test in Vero cell culture.
      No antibody to eastern equine encephalitis virus was detected. The prevalence of
      antibody to SLE virus varied among the sites from 11% to 44%, but the prevalence
      at each site was influenced by the avian species composition. The two most
      abundant species captured in the city, the American robin (43%) and house sparrow
      (42%), also had the highest prevalence of antibody. Nine other bird species were
      serologically positive but at significantly lower rates than for the abundant
      species. The antibody prevalence was higher in immature birds (27%) than in adult
      birds (15%), but the antibody titers were higher in adult birds than in immature
      ones. The overall SLE antibody prevalence and the prevalence for house sparrows
      were significantly higher than the average prevalence for avian hosts studied
      during previous SLE epidemics. Therefore, house sparrows would be a good choice
      for a local sentinel species.

PMID- 8352392
TI  - Vector and host relationships of California serogroup viruses in western Siberia.
AB  - During 1990 and 1991, adult mosquitoes were collected along the Ob River and its
      tributaries in western Siberia from approximately 51 degrees 18'N to 66 degrees
      4'N. Fifteen virus strains were isolated from 74,196 mosquitoes tested in 1,874
      pools. These included Tahyna virus from Aedes cataphylla-punctor subgroup (one)
      and Ae. excrucians (one), and Inkoo (INK) virus from Ae. communis (one), Ae.
      communis subgroup (one), Ae. hexodontus (two), Ae. punctor subgroup (two), Ae.
      punctor complex (one), and unidentified Aedes species (three). In addition, a
      single Ae. euedes yielded a strain of snowshoe hare (SSH) virus and a strain of
      Getah, an alphavirus. A Bunyamwera serogroup virus was isolated from Ae.
      excrucians. With the exception of the two isolates from a single mosquito,
      minimum infection rates among mosquito taxa ranged from 0.4 to 16.7 per 1,000.
      The INK virus isolates were widely distributed geographically; however, seven of
      the 10 isolates were from two sites north of the Arctic Circle. During 1991, sera
      from two mouse species, five vole species, and four shrew species were collected
      along the upper Ob River for serologic tests. The prevalence of neutralizing
      antibody to SSH virus in these sera was 80%. Prevalence rates in the four most
      abundant species were Apodemus agrarius, 73%; Clethrionomys rutilus, 71%;
      Microtus arvalis, 80%; and Sorex araneus, 91%. This is the first attempt to
      clarify the vector and vertebrate host relationships of California serogroup
      viruses in western Siberia.

PMID- 8352393
TI  - Cryptosporidium infections in a suburban community in Maracaibo, Venezuela.
AB  - A point prevalence survey for Cryptosporidium was conducted in 212 subjects two
      months to 70 years of age in a suburban area with a low socioeconomic status in
      Maracaibo City, Venezuela. Single stool specimens were collected and modified
      Ziehl-Neelsen carbol-fuchsin staining of 10% formalin-preserved stool was used to
      identify Cryptosporidium oocysts. Direct wet mounts, iron-hematoxylin-stained
      smears and formalin-ether concentrates were examined to determine the presence of
      other intestinal parasites. Cryptosporidium infections were identified in 21
      subjects (9.9%), with a high percentage of asymptomatic carriers (15 of 21,
      71.4%). Six children (28.5%) had gastrointestinal symptoms and four of them were
      infants. Cryptosporidium was the single detectable potential pathogenic parasite
      in only five (23.8%) of 21 patients. The infection rate with one or more
      parasites was high (82%) and multiple infections, including pathogenic helminths
      and protozoa, were observed in the majority of patients who passed oocysts. Our
      findings suggest that although Cryptosporidium is an important pathogen, the
      proportion of asymptomatic carriers may be high in areas of low socioeconomic
      status in developing countries.

PMID- 8352394
TI  - Host preferences of the sand fly Lutzomyia longipalpis at an endemic focus of
      American visceral leishmaniasis in Colombia.
AB  - Blood meals from 579 Lutzomyia longipalpis (Diptera:Psychodidae), collected in an
      endemic focus of American visceral leishmaniasis in Colombia, were identified by
      precipitin test. Sand fly collections were made during a 16-month period from the
      inside walls of two houses, a pigpen, and rock crevices in a small community (El
      Callejon) within the endemic area. Feeding patterns of the sand flies varied with
      locality and date of collection. Overall, bovine feedings predominated, but
      feedings were also recorded on pigs, equines, humans, dogs, opossums, birds, and
      reptiles. Calculation of the forage ratios for each host species indicated that
      cows and pigs were the preferred hosts of Lu. longipalpis in El Callejon. Results
      of this study suggest that Lu. longipalpis is an opportunistic feeder and is not
      highly anthropophilic nor strongly attracted to dogs.

PMID- 8352395
TI  - Recent trends in the prevalence and distribution of schistosomiasis in the Nile
      delta region.
AB  - In 1983, a survey of 71 villages in the Nile delta demonstrated that the overall
      prevalence of Schistosoma mansoni and S. haematobium infections was 39% and 5%,
      respectively. Recent increased availability of praziquantel, combined with
      Egyptian Ministry of Health-sponsored media efforts to educate the public about
      schistosomiasis, prompted us to determine the current status of S. mansoni and S.
      haematobium infections in the delta and evaluate any changes that may have
      occurred since the previous survey. The same villages that participated in the
      1983 survey were resampled in 1990. Stool and urine samples were requested from
      all occupants over the age of two years in a 5% sample of houses within each
      village. Stool (Kato) thick smears and urine sediments were read qualitatively at
      the rural health station. Field-prepared Kato smears and a 20% sample of urine
      specimens were forwarded to the Ministry of Health Laboratory, where quantitative
      readings were also performed. Analysis of samples obtained from 17,310 persons
      revealed that S. mansoni prevalence had decreased to 23% and that S. haematobium
      prevalence had decreased to 3% (P < 0.001). The highest levels of schistosome
      infection were found in governates located in the eastern section of the delta.
      The observed changes in the prevalence of S. mansoni and S. haematobium suggest
      that control measures are having a favorable impact on schistosomiasis
      transmission in this region.

PMID- 8352396
TI  - Mycoplasma pneumoniae and Chlamydia trachomatis in acute lower respiratory
      infections in Filipino children.
AB  - The role of Mycoplasma pneumoniae and Chlamydia trachomatis in acute lower
      respiratory infection (ALRI) was studied by serologic analysis of 216 Filipino
      children less than five years old living in periurban slums and middle-class
      neighborhoods. Diagnostic antibody responses to M. pneumoniae and C. trachomatis
      were observed in 18 (8.3%) and five (4.3%), respectively, of the cases with ALRI.
      These bacteria are not susceptible to the antimicrobial treatments currently
      recommended for the treatment of ALRI in developing countries.

PMID- 8352397
TI  - Common diarrhea pathogens and the risk of dehydration in young children with
      acute watery diarrhea: a case-control study.
AB  - The role of common diarrheal pathogens in dehydration was examined in children
      with acute watery diarrhea who attended the treatment center of the International
      Centre for Diarrhoeal Disease Research, Bangladesh, in Dhaka. Two hundred sixty
      nine children with moderate or severe dehydration were matched with 700 children
      with no dehydration. Vibrio cholerae O1 infections were 5.5 times more likely to
      be associated with dehydration than in cases without this agent. No significant
      association could be found between the presence of enterotoxigenic Escherichia
      coli. Campylobacter jejuni, or rotavirus infection and dehydration. These results
      were obtained after simultaneously controlling for age, lack of oral rehydration
      therapy (ORT) at home, protein energy malnutrition, withdrawal of breast-feeding
      during diarrhea at home, poor housing, longer duration of diarrhea at home, and
      delay in reaching the treatment center. The cholera isolation rate was only 4.5%
      and thus explains only a small proportion of the cases of dehydration. In cholera
      endemic areas, a strategy to prevent dehydration in small children is needed to
      ensure correct use of ORT at home, prompt referral, and the use of a suitable
      antibiotic when cholera is clinically suspected.

PMID- 8352398
TI  - Allastair B. Karmody Award. Improved recovery of limb function with ATP/MgCl2 in
      an ischemic canine hind limb.
AB  - The ability of a solution of low-vanadium-content (less than 1 ppm) adenosine
      triphosphate and magnesium chloride (ATP/MgCl2) versus normal saline to improve
      recovery of function and reduce necrosis of skeletal muscle after severe ischemia
      was investigated in an in situ autoperfused canine hind limb model. The study
      consisted of 12 dogs divided into 3 study groups: nonischemic control (NIL) (n =
      7 limbs), ischemic (IL) (n = 7 limbs), and ischemic ATP/MgCl2-treated (IATP) (n =
      7 limbs). In groups IL and IATP, the limb was reperfused for 3 hours following 4
      hours of complete ischemia. In IATP limbs, 200 mumol/kg of ATP/MgCl2 was infused
      upon reperfusion of the limbs, whereas IL limbs received a similar volume of
      normal saline at the time of reperfusion. Function was determined by stimulating
      the deep peroneal nerve and anterior tibial muscle and measuring the resultant
      isometric twitch contractile force of paw dorsiflexion. Muscle necrosis was
      evaluated by photographic analysis of sectioned anterior tibial muscle stained
      with nitroblue tetrazolium dye. ATP/MgCl2 significantly increased functional
      recovery (p < 0.01) and significantly reduced skeletal muscle necrosis (p <
      0.01). This study suggests that ATP/MgCl2 may be useful in reducing the clinical
      sequelae of severe limb ischemia and reperfusion.

PMID- 8352399
TI  - Management of concomitant abdominal aortic aneurysm and gastrointestinal
      malignancy.
AB  - Selecting the most appropriate surgical approach for patients with abdominal
      aortic aneurysm (AAA) and gastrointestinal malignancy remains controversial. In
      an attempt to develop guidelines for the management of patients with these two
      simultaneous lesions, a retrospective review of patients who had concomitant AAA
      and gastrointestinal malignancy was undertaken. During the period from January
      1985 to February 1993, 229 patients with AAA were admitted to our hospital. Among
      these, 19 patients (8%) had a gastrointestinal malignancy together with AAA and
      were divided into 2 groups. Group I was composed of 11 patients who underwent
      either a 1- or a 2-stage operation for both lesions. Group II was composed of
      eight patients who either underwent an operation for one lesion (six patients) or
      did not have any operation (two patients). Among group I, six patients underwent
      the two-stage operation. In four of the six patients, the malignancy was resected
      first. In the remaining two patients, the aneurysmectomy was performed first,
      because, in one patient, the aneurysm was more than 6 cm in diameter, and, in the
      other patient, the aneurysm was a saccular type. Among group I, five patients
      (two patients with gastric cancer, and one patient each with esophageal cancer,
      rectal cancer, and malignant lymphoma of the stomach) underwent a one-stage
      operation. In three of the five patients (two patients with gastric cancer and
      one patient with esophageal cancer), simultaneous resection was carried out by
      using segregated approaches, namely, the retroperitoneal approach for AAA and the
      transperitoneal approach for malignancy. Although the clinical characteristics of
      the patients were different, 8 of the 11 patients (73%) in group I are still
      alive, whereas only 1 of the 8 patients (13%) in group II is still alive. The
      principles of our surgical approaches for concomitant AAA and gastrointestinal
      malignancy are as follows: (1) The lesion that absolutely indicated urgent
      surgery was resected first. (2) If both lesions were asymptomatic, the malignancy
      was resected first. (3) Simultaneous resection using different approaches was
      useful in some patients with concomitant upper early gastrointestinal malignancy.
      (4) Both lesions need to be resected eventually for better long-term survival.

PMID- 8352400
TI  - Comparison of magnetic resonance angiography and contrast arteriography in
      peripheral arterial stenosis.
AB  - Magnetic resonance angiography (MRA) has recently been shown to be more sensitive
      than contrast arteriography in the detection of patent distal runoff vessels.
      This study compares MRA and contrast arteriography in evaluating the severity of
      stenotic lesions in peripheral arteries, which has not been previously
      investigated. Forty-eight arterial stenoses (19 patients) were identified, from
      the distal aorta through the crural vessels. Contrast arteriograms
      (anterioposterior projection) and MRA axial images were used to measure stenoses.
      Interobserver agreement of arteriogram readings was excellent (average weighted k
      = 0.87). Measurements of degree of stenosis as evaluated by MRA and contrast
      arteriography were analyzed by linear regression and Spearman rank correlation,
      which showed a high degree of correlation between the two diagnostic modalities
      (r = 0.83, p < 0.001; rs = 0.84, p < 0.001). These observations suggest that MRA
      is accurate in the evaluation of peripheral arterial stenosis when compared with
      the "gold standard" contrast arteriogram. In addition, MRA cross-sectional images
      provide information beyond that of conventional arteriography, showing details of
      plaque eccentricity and vessel wall characteristics. In the future, MRA may
      supplant diagnostic contrast arteriography for many patients.

PMID- 8352402
TI  - Acute lower extremity ischemia after cardiac surgery.
AB  - A retrospective review during a 5-year period (1987 to 1992) was conducted of all
      patients manifesting leg ischemia after major cardiac surgery. There were 7,620
      procedures performed, and 65 (0.85%) patients (mean age: 65 years) were
      identified with acute ischemia. Diagnosis was made by physical examination,
      during which a cool pulseless extremity without pedal Doppler signals was noted
      in 63 of 65 patients (97%). An intra-aortic balloon pump (IABP) was inserted in
      56 patients (86%). Treatment regimens included medical management (17), IABP
      removal (4), IABP removal and thromboembolectomy (24), thromboembolectomy and
      endarterectomy with patch angioplasty (10), femoral-femoral bypass (17), other
      bypasses (6), fasciotomy (10), and amputation (16). Morbidity was 92% and
      mortality was 46%. Mortality was 11% in those patients developing ischemia
      without an IABP. Acute leg ischemia after cardiac surgery is predictive of high
      morbidity and mortality. This reflects the compromised cardiac status and multi
      system disease. Treatment alternatives are based on the overall clinical status,
      degree of arterial insufficiency, and distribution of pre-existing peripheral
      vascular disease. However, ultimate limb salvage had no influence on overall
      patient survival in our study.

PMID- 8352401
TI  - Very distal bypass for salvage of the severely ischemic extremity.
AB  - Forty-six bypass grafts to tibial arteries distal to the ankle were performed in
      35 patients for salvage of extremities threatened by gangrene or nonhealing
      ulcers (grade III, category 5) or ischemic rest pain (grade II, category 4). Most
      patients (80%) were diabetic, with severely calcified arteries, whom previously
      we would have considered as candidates for primary amputation. All
      reconstructions were performed with autologous saphenous vein. Inflow was from
      the common femoral artery in 5 (11%), the popliteal artery in 25 (54%), or the
      mid-tibial arteries in 16 (35%). Life-table analysis was used to calculate
      primary patency and limb salvage. Results were analyzed according to origin of
      inflow, outflow, or configuration of the conduit (in situ saphenous vein, n = 29
      [63%], reversed saphenous vein, n = 11 [24%], or nonreversed saphenous vein, n =
      6 [13%]). Overall cumulative primary graft patency at 2 years for all grafts was
      72%, and the cumulative limb salvage rate was 89% for the same interval. No
      significant differences were seen in comparing grafts originating from the
      femoral or popliteal level with those arising from the tibial arteries. No
      significant differences were noted in graft patency or limb salvage among grafts
      with a posterior tibial, dorsalis pedis, or plantar artery outflow. No
      significant difference was noted between in situ saphenous vein grafts and
      reversed saphenous vein grafts. A significant decreased primary patency was noted
      for grafts performed with nonreversed, translocated saphenous vein. We conclude
      that bypass grafts to the ankle or foot vessels are beneficial and should be
      considered for limb salvage in extremities with gangrene, ischemic ulceration, or
      ischemic rest pain. In our experience, in situ saphenous vein grafts or reversed
      saphenous vein grafts performed similarly, whereas nonreversed saphenous vein
      grafts have a poorer prognosis. Vessel wall calcification requires a modification
      in technique for performance of these grafts but did not affect long-term
      performance or limb salvage, and thus should not be considered a contraindication
      to vascular reconstruction. The operative microscope was used in 61% (28 of 46)
      of these cases and found useful in creating these delicate anastomoses.
      Additional follow-up is needed to document the long-term results of these very
      distal reconstructions.

PMID- 8352403
TI  - Variations of the arterial anatomy of the foot.
AB  - Reconstruction of the arteries of the foot in patients with severe chronic
      arterial occlusive disease has become a routine and valuable procedure. However,
      it is frequently difficult to select the optimal site for the distal arterial
      anastomosis. In order to determine the most important anatomic variations of foot
      arteries and the relationship of the dorsalis pedis artery to crossing tendons,
      the following study was performed in 30 cadaver limbs of 17 persons (9 men and 8
      women). Their mean age at death was 69.8 years (range: 42 to 93 years). Methods
      to evaluate anatomy included anatomic dissection, arteriography, and preparation
      of corrosion cast models. The latter was performed by injection of liquid plastic
      and catalyst into the tibial arteries followed by chemical debridement of the
      soft tissue of the foot. Photographs of the corrosion cast models were taken at
      various stages of soft tissue dissolution. The dorsalis pedis artery was absent
      in 6.7% of the cases, and the arcuate artery was absent in 33%. The dorsalis
      pedis artery arose from the peroneal artery in 6.7%. The dorsalis pedis artery
      crossed under the extensor hallucis longus tendon at the ankle in 54%, above the
      ankle in 43%, but below the ankle in only 3%. Our study suggests that the optimal
      site for the dorsalis pedis artery anastomosis on the foot is the segment distal
      to the ankle.

PMID- 8352404
TI  - A new look at intraoperative completion arteriography: classification and
      management strategies for intraluminal defects.
AB  - Completion arteriography is widely regarded as an essential component of
      infrainguinal bypasses. However, the significance of various intraluminal filling
      defects is poorly defined, and strategies for managing these defects are unclear.
      Completion arteriography was performed by a standard technique in 78
      infrapopliteal bypasses and were evaluated prospectively for the presence of
      angiographic defects. Thirty-nine arteriograms (50%) had no visible abnormality
      (grade O). Six arteriograms (8%) had minimal (grade I) defects, i.e., round
      lucencies (bubbles) or valve leaflets. Eighteen arteriograms (23%) had moderate
      (grade II) defects, i.e., uniform smooth tapering (up to 90% of luminal diameter)
      of the graft or outflow artery, irregular intraluminal filling defect (less than
      60% of luminal diameter) within the distal graft or its adjacent outflow artery,
      or incomplete or faint graft opacification. Fifteen arteriograms (19%) had severe
      (grade III) defects, i.e., total cutoff of graft or outflow artery opacification
      or irregular intraluminal filling defect (greater than 60%) in the distal graft
      or adjacent outflow artery. Completion arteriograms were further stratified for
      type of bypass and outflow characteristics. All 24 bypasses with grade I or grade
      II defects on completion arteriography had no further surgical treatment.
      However, the 18 bypasses with grade II defects on completion arteriography had
      minimal nonsurgical manipulations consisting of repeat arteriography without or
      with papaverine infusion or urokinase instillation. In all 18, repeat
      arteriography showed improvement in the defect. The 15 bypasses with grade III
      defects had further surgical intervention (graftotomy, thrombectomy, vein
      patching, interposition graft, or graft extension). One-month and 1-year patency
      rates for grafts with grade I and grade II defects (87% and 79%, respectively)
      were not significantly worse than those for the 39 grafts with no arteriographic
      abnormalities (87% and 82%, respectively). In contrast, grafts with grade III
      defects had significantly worse (p < 0.01) 1-month and 1-year patency rates (33%
      and 20%, respectively) despite aggressive surgical correction of the
      arteriographic defects. These results emphasize the value of repeat completion
      arteriography and minimal interventional strategies when grade I or II defects
      are seen on arteriography. The poor outcome with surgical correction of grade III
      defects suggests that completion arteriography may not always define the full
      extent of the problem or that the corrective surgical maneuvers were either
      incomplete or detrimental.

PMID- 8352405
TI  - Is the use of intraoperative post-reconstruction angiography following in situ
      saphenous vein bypass redundant?
AB  - The value of post-reconstruction intraoperative angiography after in situ
      saphenous vein bypass has not been clearly defined. A retrospective review of
      intraoperative completion angiography using a standard proximal bypass injection
      technique without inflow occlusion was performed on 298 in situ saphenous vein
      bypasses constructed over a 72-month interval to treat critically ischemic limbs.
      Abnormal operative angiograms were found on retrospective review in 55 cases
      (18%). Minor abnormalities such as distal arterial or vein conduit spasm (class I
      defects) were found in 26 bypasses (9%) and required no surgical intervention. An
      anastomotic buckle or extrinsic compression due to an adventitial band (class II
      defect) was seen in five bypasses (2%). Defects requiring a major surgical
      revision (class III) were seen in 24 instances (8%). These abnormalities included
      nine cases with intraluminal platelet thrombus and six with a significant
      anastomotic torsional abnormality. In addition, there were five bypasses
      anastomosed to unsuitable diseased segments of distal arteries. Three of 24 (12%)
      of the bypasses with class III angiographic abnormalities required further
      revision within the first month after surgery, after duplex scanning had
      identified hemodynamically significant abnormalities, compared with 14 of 274
      (5%) early revisions of the remaining in situ bypasses. The 30-day primary
      patency rate for bypasses with class III angiographic abnormalities was 88%. This
      compares with a rate of 95% for the remaining bypasses. The difference was not
      statistically significant. The 30-day and 48-month secondary patency rates for
      bypasses undergoing an immediate intraoperative revision for a class III
      abnormality were 100% and 93%, respectively. These rates were equivalent to the
      secondary patency of the in situ bypasses without class III abnormalities.
      Although the incidence of significant (class II and class III) angiographic
      abnormalities was low (10%), these abnormal findings allowed immediate correction
      of a jeopardized bypass, with minimal sequelae.

PMID- 8352406
TI  - Advanced carotid disease in patients requiring aortic reconstruction.
AB  - Perioperative stroke is a devastating complication of abdominal aortic
      operations. Patients requiring aortic reconstruction with advanced carotid
      occlusive disease pose a particularly challenging management problem regarding
      timing of operations. All patients (n = 121) undergoing both carotid artery
      endarterectomy (CEA) and abdominal aortic reconstruction (AAR) within 1 year of
      each other between 1979 and 1989 were reviewed. The sequence of operation was
      analyzed to determine its effect on early and late outcome. CEA was the first
      operation in 99 patients (group I); AAR was performed first in 22 patients (group
      II). Age, gender, number, types of risk factors, and associated medical problems
      were similar in both groups. Indications for CEA were: transient ischemic attacks
      (TIAs), recent ipsilateral stroke, or high-grade asymptomatic carotid artery
      stenosis exceeding 80%. Indications for aortic operation included: abdominal
      aortic aneurysm, aortoiliac occlusive disease, and combined aortic and
      renovascular disease. There were five perioperative strokes, two in group I (2%)
      and three in group II (14%) (p < 0.04). All strokes occurred after AAR. There
      were five perioperative deaths (4%), four in group I (4%) and one in group II
      (5%). Overall survival was significantly greater in group I compared to group II
      (p < 0.04); 5-year survival was 77% and 51%, respectively. Multivariate analysis
      demonstrated age, hypertension, and diabetes to adversely affect survival; CEA as
      the first procedure, however, had a protective effect. Importantly, eight strokes
      occurred in group I in late follow-up, but only one was ipsilateral to the CEA.
      We conclude that CEA in selected patients who require AAR is safe, and, when
      performed prior to abdominal aortic repair, reduces perioperative stroke and may
      improve long-term survival.

PMID- 8352407
TI  - Carotid stump pressure, stump pulse, and retrograde flow.
AB  - In order to obtain a more comprehensive intraoperative hemodynamic profile and to
      predict hypoperfusion during carotid endarterectomy, stump pressure, stump pulse,
      and retrograde internal carotid flow were measured in 261 patients. Our results
      show a significant correlation between stump pressure and retrograde flow (p <
      0.001), stump pressure and the presence of a stump pulse (p < 0.001), and
      retrograde flow and the presence of a stump pulse (p < 0.001). We also
      demonstrated a significant correlation between stump pressure (lower), retrograde
      flow (less), and the absence of a stump pulse in patients with contralateral
      carotid artery occlusion. There was no correlation between the indication for
      carotid endarterectomy and any hemodynamic measurement. The triad of stump pulse,
      stump pressure, and retrograde flow accurately reflects collateral blood flow
      when the carotid is cross-clamped. These determinations can be obtained at low
      cost and are easily and rapidly performed. A protocol for selective shunting in
      patients undergoing carotid endarterectomy with general anesthesia is suggested.

PMID- 8352408
TI  - Is there a conduit of preference for a bypass between the carotid and subclavian
      arteries?
AB  - The conduit of choice for a bypass between the carotid and subclavian arteries
      remains controversial. We retrospectively evaluated 32 patients who underwent
      bypass between the carotid and subclavian arteries. Perioperative mortality was
      limited to a single patient who sustained a myocardial infarction. Long-term
      follow-up (mean: 46 months) revealed an 87% stroke-free survival rate, a 74%
      neurologic symptom-free survival rate, and a 77% primary patency rate at 5 years.
      No overall difference was discerned between a prosthetic or autogenous vein
      conduit. However, in bypasses constructed from the subclavian artery to the level
      of the carotid bifurcation, 100% (nine of nine) of vein bypasses remained
      primarily patent compared with 40% (two of five) of prosthetic grafts (p < 0.05).
      No distinct patency difference was identified between a short vein or a
      prosthetic bypass constructed between the proximal common carotid artery and
      subclavian artery. A vein bypass results in superior patency compared with a
      prosthetic graft for longer bypasses constructed from the subclavian artery to
      the carotid artery bifurcation.

PMID- 8352409
TI  - Extrathoracic bypass procedures for proximal common carotid artery lesions.
AB  - During a 10-year period ending in December 1991, 31 extrathoracic bypass
      procedures were performed in 29 patients for proximal common carotid artery
      atherosclerotic stenosis or occlusion. This included 16 men and 13 women, with a
      mean age of 63 years. Indications for surgery included transient ischemic attacks
      in 23 patients (79%), nonfocal symptoms in 4 patients (14%), and asymptomatic
      proximal common carotid artery stenosis associated with near-total occlusion of
      the internal carotid artery in 2 patients (7%). Severe proximal stenosis or
      complete occlusion of the common carotid artery was demonstrated angiographically
      in all cases. Subclavian-to-carotid bypass was performed in 26 cases and carotid
      to-carotid bypass in 5 cases. Seventy-four percent of the bypass procedures were
      to the common carotid artery and 26% to the external carotid artery.
      Endarterectomy of the common carotid bifurcation was performed in conjunction
      with the bypass procedure in 13 cases and vertebral artery transposition in 2
      other cases. Saphenous vein was used as the bypass conduit in 65% and prosthetic
      grafts in 35% of cases. There were no perioperative strokes or deaths in this
      series, and the mean postoperative hospital stay was 5 days. Follow-up ranged
      from 2 to 118 months (mean: 38.4 months). Graft occlusion occurred in two cases
      during the follow-up period (3-year patency rate: 90%), with recurrence of
      symptoms in one patient, which necessitated revision. Three patients had
      persistence or recurrence of symptoms despite patency of the graft, one other
      patient sustained a posterior circulation infarct, and there was one death
      unrelated to carotid vascular disease during the follow-up period. This
      experience shows that extrathoracic bypass procedures are safe and well tolerated
      for symptomatic proximal common carotid artery stenosis or occlusion. This method
      of reconstruction has excellent long-term patency and protection against further
      anterior circulation neurologic events.

PMID- 8352410
TI  - Carotid endarterectomy with an occluded contralateral carotid artery.
AB  - Five hundred twenty-six patients who underwent carotid endarterectomy were
      separated by reviewing those 81 (15%) patients with an occluded contralateral
      carotid artery and those 445 (85%) with nonocclusion. The population
      characteristics and surgical indications were similar between the occluded and
      nonoccluded groups. Ipsilateral plus contralateral perioperative stroke occurred
      during 11 of 445 operations (2.5%) in which the contralateral carotid was patent,
      and during which no patient was hemorrhagic. Those patients with contralateral
      artery occlusion had ipsilateral plus contralateral stroke in 4 of 81 cases of
      (4.9%) (NS). Intracerebral hemorrhage was responsible for two of four strokes
      after carotid endarterectomy with contralateral occlusion (p = 0.001). Restenosis
      to greater than 50% by duplex scanning was more rapid in the occluded group with
      primary closure (no patch) (p = 0.025) and for men (p = 0.025). Although
      perioperative safety is comparable, patients with contralateral carotid occlusion
      may have a greater risk of intracranial hemorrhage and a more rapid rate of
      restenosis in some subgroups.

PMID- 8352411
TI  - Magnetic resonance angiography in the preoperative evaluation of abdominal aortic
      aneurysms.
AB  - Magnetic resonance angiography (MRA) and magnetic resonance imaging (MRI) are
      noninvasive techniques of visualizing blood vessels without the use of
      intravenous contrast or ionizing radiation. This prospective study assessed
      preoperative MRA and MRI in the evaluation of 28 patients with abdominal aortic
      aneurysm (AAA). MRI and MRA accurately predicted the extent of cephalad AAA, the
      patency of the superior mesenteric artery, and the course of the left renal vein,
      but were less accurate in defining the extent of caudal AAA, flow of the inferior
      mesenteric artery, and multiple renal arteries. This study suggests that MRI and
      MRA are alternatives to the combination of angiography and computed tomographic
      scan in the preoperative evaluation of patients with suspected AAA and no
      evidence of mesenteric or renal ischemia. When combined with preoperative
      segmental Doppler arterial studies, an accurate surgical plan may be formulated.
      Further refinements in image acquisition and postprocessing software analysis
      will advance the use of MRI and MRA for complete evaluation prior to elective AAA
      repair.

PMID- 8352412
TI  - Transesophageal echocardiography for hemodynamic management of thoracoabdominal
      aneurysm repair.
AB  - Maintenance of cardiovascular stability during thoracoabdominal aneurysm repair
      remains a formidable challenge. Transesophageal echocardiography (TEE) has been
      shown to be an excellent method for detecting myocardial ischemia and assessing
      left ventricular volume. We examined the utility of TEE in a group of 17 patients
      from an overall series of 33 patients who underwent thoracoabdominal aneurysm
      resection between 1988 and 1992. The mortality rate was 9%, whereas the
      incidences of myocardial infarction and paraplegia were 13% and 6%, respectively.
      Intraoperative management was significantly altered by TEE data in nine patients.
      Two patients were noted to have mitral valve insufficiency, and one had transient
      ischemia-induced regional wall abnormalities. In six patients, Swan-Ganz-derived
      filling data failed to identify severe hemodynamic alterations that were noted on
      TEE. Five patients were hypovolemic and hyperdynamic, whereas one was in florid
      congestive heart failure. Further investigation is warranted to prospectively
      validate this technique.

PMID- 8352413
TI  - Financial impact of thoracoabdominal aneurysm repair.
AB  - We have reviewed our experience regarding hospital costs and reimbursement for 72
      patients who underwent thoracoabdominal aneurysm repair. Preoperative risk
      factors, postoperative complications, length of stay, and source of reimbursement
      were recorded for all patients. Patients covered by Medicare resulted in a mean
      net institutional loss of $16,472 per patient, whereas a mean net profit of
      $17,847 per patient resulted from patients with commercial insurance. Factors
      associated with institutional financial loss were: age over 75 years,
      preoperative coronary disease, postoperative respiratory failure, and length of
      stay. By multivariate analysis, however, only length of stay was independently
      associated with institutional loss.

PMID- 8352414
TI  - Aortic replacement for abdominal aortic aneurysm in elderly patients.
AB  - Improvements in the operative mortality and morbidity rates in elective aortic
      replacement, which are largely a result of refinements in surgical technique and
      perioperative management, have allowed a more aggressive approach in the
      treatment of abdominal aortic aneurysm (AAA) in elderly patients. To evaluate
      this approach, we reviewed the records of 116 patients 80 years of age and older
      (range: 80 to 93 years) who consecutively underwent aortic replacement for AAA.
      Seventy-seven patients underwent elective aortic replacement with 8 complications
      and a 3% operative mortality rate (2 of 77). Emergent aortic replacement was
      performed in 39 patients (14 with symptomatic nonruptured AAA and 25 with
      ruptured AAA) with 12 complications. In this nonselective subset, there were
      eight deaths, for an operative mortality rate of 20% (symptomatic 14%, ruptured
      24%). In comparison, 780 patients less than 80 years of age underwent aortic
      replacement during the same time period. Within this group, 622 patients who were
      treated on an elective basis had a similar operative mortality (2%) as did
      patients 80 years of age and older. On the basis of these results, we believe
      that elective aortic replacement in elderly patients is justified and can be
      achieved with low operative mortality and morbidity rates. We suggest that the
      chronologic age of the patient should not deter aortic replacement.

PMID- 8352415
TI  - Management of chyloperitoneum after abdominal aortic surgery.
AB  - Chyloperitoneum is a rarely reported complication of abdominal aortic surgery.
      From 1981 to 1992, we treated 5 cases of chylous ascites after operations on the
      abdominal aorta and reviewed 22 previously published cases. There were 22 men and
      5 women, with a mean age of 63.8 years (range: 27 to 93 years). Twenty cases
      (74.7%) occurred after abdominal aortic aneurysm resection, 5 (18.5%) after aorto
      femoral bypass for occlusive disease, and 2 (6.8%) after resection of infected
      aortic grafts, 1 for occlusive disease and the other for infrarenal aortic
      aneurysm. Abdominal distention was the most common presenting symptom, occurring
      in 26 (96.3%) of 27 patients. The mean time from aortic operation to the
      development of symptoms was 18.5 days (range: 7 to 120 days). Diagnosis was
      confirmed by paracentesis, which yielded lipemic, sterile fluid in all patients.
      Therapeutic paracentesis was not successful when used alone, but, when combined
      with a medium-chain triglyceride (MCT) diet or total parenteral nutrition (TPN),
      it resulted in resolution of chyloperitoneum in 8 of 14 patients (57.2%). TPN
      alone or with paracenteses and/or diuretics was successful in 9 of 15 (60%)
      patients. Peritoneovenous shunts resolved chylous ascites in four of five
      patients not responding to diet and/or TPN but resulted in one death due to
      sepsis. Operative ligation of the injured lymphatic channel was successful in all
      five patients treated by laparotomy when nonoperative efforts failed.
      Chyloperitoneum resolved in all but two (7.7%) patients. There were five (18.5%)
      deaths, but only three (11.5%) were directly related to chylous ascites.
      Treatment with TPN resolved chyloperitoneum in all five of our own patients. We
      reached the following conclusions: (1) Chyloperitoneum is a rare complication of
      aortic surgery; (2) This disorder should be considered whenever persistent
      abdominal distention appears after aortic surgery; (3) The diagnosis is easily
      confirmed by paracentesis; and (4) Surgery to close the lymph fistula should be
      reserved for those patients in whom conservative therapy with MCT diets or TPN
      has failed.

PMID- 8352416
TI  - Comparison of operative reconstruction and percutaneous balloon dilatation for
      central venous obstruction.
AB  - To evaluate the efficacy of venous reconstruction versus percutaneous
      transluminal angioplasty for the treatment of obstruction of the superior vena
      cava and its major tributaries, we retrospectively reviewed the clinical course
      of 27 patients, of whom 13 underwent operative reconstruction and 15 had
      angioplasty (1 had both). Three patients had obstruction of the superior vena
      cava, 8 had occlusion of the innominate veins, and 16 had obstruction of the
      subclavian or axillary veins. In both treatment groups, mean age, indications,
      etiology, and location of the lesion were comparable. No major surgical
      complications occurred; one patient who underwent angioplasty experienced stent
      migration to the pulmonary artery without sequelae. Primary symptomatic relief at
      1 year was achieved in 88% in the surgical group versus 36% in the angioplasty
      group (p < 0.05 by Fisher's exact test) and at 2 years in 71% versus 0%,
      respectively (p < 0.01). One- and 2-year success rates with repeated angioplasty,
      however, were 86% and 66% (p > 0.9), respectively. We conclude that the long-term
      success rate of operative reconstruction exceeds that of single percutaneous
      transluminal angioplasty. However, with repeated angioplasty, success rates
      approach those of operative reconstruction.

PMID- 8352417
TI  - Advances in the treatment of phlegmasia cerulea dolens.
AB  - Phlegmasia cerulea dolens (PCD) is an uncommon, severe form of lower extremity
      deep venous thrombosis characterized by extremity swelling, cyanosis, and pain.
      Progression of the thrombotic process may result in extremity gangrene,
      amputation, and death. The relative value of specific therapeutic regimens in the
      treatment of this disease remains uncertain. Twelve patients, 9 females and 3
      males, with PCD were treated during a 10-year period. Eighteen lower extremities
      were involved. Pre-existing conditions included malignancy (eight), postoperative
      state (four), diabetes (three), previous deep venous thrombosis (three), and
      hypercoagulation (two). Venous gangrene was present in four patients. All
      patients were treated initially with bedrest, fluid resuscitation, extremity
      elevation, and systemic high-dose heparin therapy. Five patients had complete
      resolution with this regimen alone. One patient required cessation of heparin
      therapy due to heparin-induced thrombocytopenia and developed gangrenous toes.
      Two patients whose condition failed to respond to heparin therapy underwent
      catheter-based delivery of urokinase with marked clinical improvement. Four
      patients, two with venous gangrene, died, three of whom had disseminated
      malignant disease. A significant percentage of patients with PCD will respond to
      extremity elevation, fluid resuscitation, and aggressive systemic anticoagulation
      therapy. Thrombolytic therapy selectively administered is beneficial in patients
      whose disease fails to respond promptly. Venous thrombectomy should be reserved
      for patients with contraindications to thrombolysis.

PMID- 8352418
TI  - Production of endothelium-derived relaxing factor (EDRF) is compromised after
      ischemia and reperfusion.
AB  - Rabbit hind limbs were subjected to 5 hours of ischemia with or without 1 hour of
      in vivo reperfusion, and the response of femoral artery segments to
      vasocontrictors and vasodilators was studied in vitro. The ability of endothelium
      derived relaxing factor (EDRF)-dependent vasodilators to relax arterial segments
      was not altered after up to 5 hours of ischemia alone but was significantly
      decreased after 4 hours of ischemia if followed by 1 hour of in vivo reperfusion.
      Thus, we concluded that a specific injury occurs to endothelial cells after
      ischemia-reperfusion, which occurs solely during the reperfusion period.

PMID- 8352419
TI  - Pulse-spray pharmacomechanical thrombolysis for treatment of thrombosed dialysis
      access grafts.
AB  - The results of pulse-spray pharmacomechanical thrombolysis (PSPMT) of 209
      thrombosed hemodialysis grafts were reviewed. In PSPMT, concentrated urokinase is
      injected forcefully through catheters with multiple tiny sideholes or sideslits.
      Catheters placed in a crisscross fashion cover the entire clot simultaneously.
      This therapy was successful in treating patients with thrombosed grafts. Of the
      200 grafts with complete therapy, 197 grafts (99%) were patent at the end of the
      procedure. Mean time for pulsed-spray lysis was 40 minutes. Etiologies for graft
      thrombosis were anastomotic venous outflow stenosis, stenosis of the venous
      outflow away from the anastomosis, arterial stenosis, intragraft stenosis,
      pseudoaneurysms, and no identifiable cause in a small percentage. There were 16
      complications, 8 of which required additional therapy or potentially compromised
      the graft. These results suggest that pharmacomechanical thrombolysis and
      angioplasty provide rapid, consistent, and safe recanalization of thrombosed
      hemodialysis grafts and represent an additional therapeutic approach to graft
      management.

PMID- 8352420
TI  - Celiac territory ischemic syndrome in visceral artery occlusion.
AB  - Abdominal angina that is characterized by postprandial pain, and often associated
      with weight loss, is a well-recognized symptom complex of mesenteric artery
      insufficiency (mesenteric territory symptoms). In the past 5 years, we have
      observed six patients with atypical symptoms who had mesenteric artery occlusion
      combined with stenosis or occlusion of the celiac artery. Atypical symptoms
      included severe nausea and vomiting at the sight or smell of food, anorexia,
      weight loss, and right upper quadrant or epigastric discomfort (celiac territory
      symptoms). An extensive work-up to rule out gastric, pancreatic, biliary, or
      colonic pathology was undertaken in these patients. The findings included
      gallbladder dysfunction, diffuse micro-ulceration of gastric mucosa, and colonic
      mucosal ulceration. The diagnosis of visceral artery occlusion was initially
      missed in all six patients. Four patients had cholecystectomy. Visceral
      angiography confirmed occlusion of the celiac, superior, and inferior mesenteric
      arteries. Five patients had dramatic resolution of symptoms after restoration of
      visceral circulation. One patient who developed intestinal infarction before
      revascularization died. Symptoms suggesting upper abdominal visceral pathology
      may be a manifestation of celiac artery stenosis/occlusion coexisting with
      mesenteric artery occlusive disease. Visceral angiography should be part of the
      work-up in these patients for early diagnosis and prompt management.

PMID- 8352421
TI  - Acute mesenteric ischemia after cardiopulmonary bypass.
AB  - Three thousand sixty-six patients underwent cardiopulmonary bypass at the
      Maimonides Medical Center over a 5-year period from January 1, 1987, to January
      1, 1992. Of these patients, 1,890 (62%) were less than 70 years of age, 969 (32%)
      ranged from 70 to 79 years of age, and 207 (7%) were 80 years of age or older.
      The overall 30-day mortality rate was 8%. Eleven patients developed acute
      mesenteric ischemia from 24 hours to 12 days postoperatively. At the time of
      diagnosis, the majority of patients presented with late classical signs and
      symptoms of acute mesenteric ischemia including abdominal distension, respiratory
      distress, hypotension, oliguria, and sepsis. All patients underwent immediate
      laparotomy. Extensive bowel necrosis was found in all, and resection was possible
      in eight patients. All patients died as a result of this complication. Using the
      exact trend test, we found a statistically significant increase in the incidence
      of deaths due to acute mesenteric ischemia after cardiopulmonary bypass in older
      compared with younger patients. This fatal complication after cardiopulmonary
      bypass occurs more often than previously believed and is a relatively common
      cause of death in the elderly.

PMID- 8352422
TI  - Medical reservists in support of humanitarian effort.

PMID- 8352423
TI  - Hume Memorial Lecture. Surgeon's response to battlefield vascular trauma.

PMID- 8352424
TI  - Cell washing versus immediate reinfusion of intraoperatively shed blood during
      abdominal aortic aneurysm repair.
AB  - Significant hematologic changes are known to occur following intraoperative
      autotransfusion of shed blood, but the clinical importance of cell washing prior
      to reinfusion has not been substantiated. To evaluate these changes and their
      relationship to the use of blood bank products and postoperative morbidity, 26
      patients undergoing elective abdominal aortic aneurysm repair were prospectively
      randomized to reinfusion with washed shed blood or to the use of a collection
      system in which filtered, but unwashed, whole blood was reinfused
      intraoperatively. Each patient was evaluated with respect to standard metabolic
      and hematologic laboratory parameters preoperatively, immediately
      postoperatively, and 12 to 18 hours postoperatively. Patient demographic data
      were similar for both groups. Perioperative survival was 100% for both groups.
      Total blood loss and blood volume autotransfused were significantly greater in
      the unwashed cell group compared with the washed cell group (p = 0.00014 and p =
      0.00011, respectively). Hemoglobin, fibrinogen, prothrombin time, and partial
      thromboplastin time levels were not significantly different between the two
      groups at any time perioperatively; fibrin split product and d-dimer levels were
      significantly higher in the unwashed cell group postoperatively (p = 0.016 and p
      < 0.001, respectively). Serum free hemoglobin levels were significantly higher in
      the immediate postoperative period in the unwashed cell group compared with the
      washed cell group (p = 0.0013); by 12 to 18 hours postoperatively, this
      difference was not significant. Haptoglobin levels were significantly lower in
      the unwashed cell group at both postoperative times (123 +/- 86 mg/dL versus 41
      +/- 50 mg/dL, p = 0.0086; 102 +/- 66 mg/dL versus 24 +/- 36 mg/dL, p = 0.0001);
      however, there was no perioperative renal failure in either group. Furthermore,
      homologous blood product use was not significantly different between the two
      groups, with an average of 1.5 +/- 2.5 units of packed red blood cells given to
      patients in the unwashed cell group versus 0.8 +/- 1.7 units in the washed cell
      group (p = 0.419). Overall complications were higher and critical care and total
      hospital stays were longer in the unwashed cell group but did not result from
      autotransfusion of unwashed blood. We conclude that the intraoperative reinfusion
      of unwashed shed blood is safe and effective, causing transient hematologic
      abnormalities that normalize in the early postoperative period, and is not
      associated with increased mortality, or hematologic, cardiopulmonary, or renal
      complications.

PMID- 8352425
TI  - Sperm antigens and reactivity of antisperm monoclonal antibodies in ELISA.
AB  - Several types of sperm antigenic suspensions as well as the whole sperm, either
      methanol-fixed or air-dried, were checked for intensity of binding to monoclonal
      antisperm antibodies with known characteristics of reactivity to sperm. The
      activity of sperm antigen--antibody binding was measured by ELISA (enzyme-linked
      immunosorbent assay) and compared in several variations (parallely run) of the
      assay where different types of sperm antigen preparations were applied. The
      obtained results were then evaluated for statistical significance in Wilcox test.
      It was shown that antibody reactivity was markedly higher in experiments where
      the whole sperm was coated in a solid-phase in comparison to results obtained
      with adhered different sperm antigenic suspensions. However, one exception was
      noted, where the results from ELISA, run with sperm organic extract, were
      (statistically) insignificantly lower than those obtained with the whole sperm.
      Therefore, organic sperm extracts (containing mostly glycolipids) can be a
      valuable alternative to screening for antisperm antibody activity and/or
      infertility background.

PMID- 8352426
TI  - The variability of measuring sperm concentration and motility as determined by
      computer assisted image analysis and visual estimation.
AB  - Systems of computer-assisted image processing (CAIP) offer good reproducibility
      and low intra-assay variability between replicate analyses of the same sample.
      The correlation between these values and those obtained by directly microscopic
      observation can be well demonstrated. The comparability between systems of
      different manufacturers is sufficient and satisfactory. Thus, they are well
      suited for the routine work in the andrologic laboratory. Since sperm parameters
      are used for the prediction of male fertility, it is important to know whether
      computer-assisted analysis improves the predictive power as compared to visual
      estimation. In our study we compared the variation of semen parameters between
      two semen samples of the same individual taken in an interval of at least 3
      months, by using the CAIP and visual methods. Significantly close correlations
      between the two values were obtained by both methods. Values of cell
      concentration showed the highest correlation in both methods (r = 0.75). The
      lowest correlation, but also statistically significant, was observed in the
      values of locally motile cells (r = 0.54 for CAIP and r = 0.30 for visual
      determination). Although apparently higher in CAIP within method correlation
      coefficients did not show statistically meaningful differences between both
      methods. We conclude from our study that if values of sperm concentration and
      motility as measured by CAIP are compared to those obtained by visual
      measurement, the first method is not superior to the latter in terms of retest
      reliability.

PMID- 8352427
TI  - Sperm motility analysis using multi-exposure photography (MEP): validity of the
      method with normal and abnormal patterns.
AB  - Spermatozoon motility is an important semen parameter that can be correlated with
      fertilizing capacity. It can be evaluated by subjective or objective methods such
      as the multiple exposure photography technique (MEP). This technique was: (1)
      validated in terms of accuracy and sensitivity, and (2) used to investigate the
      possibility of differentiating patient subgroups on the basis of sperm motility.
      The method was shown to be accurate. The within and between assay variation
      coefficients were less than 6% and 17% respectively. Maximal sensitivity required
      100 spermatozoa, since coefficients of variation were high when counting smaller
      numbers. A significant difference between fertile, normozoospermic and
      asthenozoospermic groups on the basis of the population pattern was found in a
      retrospective study. Moreover, the asthenozoospermic group could be divided into
      three subgroups, depending on whether one, two, or three motility variables were
      altered.

PMID- 8352428
TI  - Prognostic value of an automated sperm analysis in IVF or insemination therapy.
AB  - During the course of sterility treatment semenograms of 271 IVF and 316
      insemination patients were carried out by two automated semen analysers. The
      parameters of these analyses were correlated to pregnancies resulting from the
      treatment. Semen samples were analysed in the ejaculate and after swim-up
      preparation. In addition, the swim-up suspension of IVF patients was measured
      again 18 h after sperm preparation. Patients were divided into three groups: (1)
      couples who achieved a pregnancy, (2) couples who did not achieve a pregnancy,
      and (3) IVF patients with no fertilization of the oocytes. Because of large
      standard deviations in the quality of ejaculates, the results in the IVF group
      show no significant differences in the semen parameters of husbands of pregnant
      and non-pregnant women. In contrast husbands of women with no fertilization have
      a significantly lower sperm motility. After swim-up preparation these differences
      no longer occur. A further measurement, taken 18 h later, reveals that there are
      no differences in the sperm parameters between the pregnant and non-pregnant
      group. However, the semen quality in the group with no fertilization is
      significantly reduced. The results of the insemination patients are similar to
      those of the IVF group. Thus, the results from automated sperm analysers cannot
      replace either the microscopic or biochemical analysis of an ejaculate and,
      moreover, cannot be used as prognosis for the fertilization capacity of sperms or
      a following pregnancy.

PMID- 8352429
TI  - Electron microscopic immunolocalization of a conserved sperm acrosomal antigen
      recognized by HS-63 monoclonal antibody.
AB  - HS-63 monoclonal antibody was shown to react with a sperm-specific acrosomal
      antigen from spermatozoa of a variety of mammalian species. Indirect
      immunofluorescence showed that HS-63 was associated with acrosome-intact sperm
      after sperm had been fixed with methanol. Electron microscopy (EM) was employed
      to determine the ultrastructural localization of this sperm antigen. When the
      immunogold labelled goat anti-mouse IgG was used as a probe, we demonstrated that
      HS-63 monoclonal antibody did not bind to the freshly prepared human spermatozoa.
      However, gold particles were observed in the intra-acrosomal region, when the
      spermatozoa had been pre-treated with 0.5% Triton X-100 prior to incubation with
      HS-63. We further observed that the immunogold did not stain the inner acrosome
      membrane when the spermatozoa became acrosome-reacted. A good correlation was
      obtained between the percentage of spermatozoa which did not react with HS-63 as
      determined by indirect immunofluorescence assay and that of acrosome-reacted
      spermatozoa as quantitated by electron microscopy. The results of this EM study
      were consistent with those obtained by indirect immunofluorescence assay and both
      indicated that HS-63 reacts only with the capacitated and acrosome-intact
      spermatozoa. Therefore, HS-63 monoclonal antibody is a useful probe for rapid
      evaluation of acrosomal status in human spermatozoa.

PMID- 8352430
TI  - Effect of intratesticular administration of anti-corticotropin-releasing factor
      antiserum (a-CRF) on testicular function in neonatal rats.
AB  - The possible physiological role of testicular corticotropin-releasing factor
      (CRF) in the regulation of testicular functions was studied in neonatal rats. Two
      microlitres of anti-CRF-antiserum (dilution: 1:10 or 1:100) was injected
      intratesticularly to 5 d-old rats with two testes and to hemicastrates. Five days
      after hemicastration and treatment of the remaining testis with the antiserum,
      serum testosterone concentration and basal testosterone secretion in vitro
      decreased significantly. Unilateral testicular injection of a-CRF in rats with
      two testes resulted in a significant drop in serum testosterone level with no
      change in basal testosterone production. Data indicate that in neonatal rats
      testicular CRF might be a local stimulator of steroidogenesis.

PMID- 8352432
TI  - Insulin, insulin resistance, and dyslipidemia.

PMID- 8352431
TI  - Laminin and aminoterminal propeptide of type III procollagen in seminal plasma
      from fertile and vasectomized men.
AB  - The components of the extracellular matrix, laminin and aminoterminal propeptide
      of type III procollagen (PIIINP) were determined in seminal plasma of 50 patients
      with vasectomy and of 50 age-matched fertile patients. The concentration of
      laminin was highly significantly (P < 0.001) elevated in the fertile group as
      compared to the vasectomy group, whereas the concentrations of PIIINP were not
      significantly different between these two groups. Only weak correlations were
      observed between the concentrations of laminin and PIIINP. It is suggested that
      part of the laminin found in seminal plasma is derived from the ductus deferens,
      while the source of PIIINP is probably located at an upper part of the urogenital
      tract.

PMID- 8352433
TI  - Effect of dietary lipid on insulin action. Clinical studies.
AB  - Evidence from the best studies available in the literature suggest that the
      isocaloric substitution of dietary fat for dietary carbohydrate does not cause
      insulin resistance. Although many studies show several differences between the
      diets (for example, changes in dietary fiber or fat subtype), the diets were
      primarily designed to compare the effects of the fat/carbohydrate content, and a
      true important effect of dietary fat on insulin action should have been detected.
      Some studies found other changes in carbohydrate metabolism such as improvements
      in insulin secretion and glucose effectiveness (Sg) that could contribute to the
      conflicting results. For example, glucose uptake as measured by the euglycemic
      clamp includes both insulin-dependent and non-insulin-dependent (SG) factors, so
      that the M value could be affected by changes in SG as well as in insulin action.
      All of these studies have used isocaloric substitution so that body weight is
      maintained. This constraint, while important for determining and direct effect of
      dietary fat, may lead to false conclusions about its overall effects on insulin
      action. One of the most common and potent causes of insulin resistance is
      obesity, and dietary fat is of singular importance in the genesis of obesity.
      Inasmuch as an ad libitum reduced fat diet causes weight loss, the overall effect
      of dietary fat reduction may be an improvement in insulin action because of
      weight loss even in the absence of any direct effects. Long-term studies of the
      effects of fat content within ad libitum diets are needed to place these largely
      negative results from isocaloric studies in context.

PMID- 8352434
TI  - Dietary fish oil and insulin action in humans.

PMID- 8352435
TI  - Dietary fat, carbohydrate balance, and weight maintenance.

PMID- 8352436
TI  - Risk factors for the development of obesity.

PMID- 8352437
TI  - Dietary lipids influence insulin action.
AB  - Insulin binding and insulin responsiveness are altered by dietary fat-induced
      changes in the fatty acid composition of the adipocyte plasma membrane. Feeding a
      high P/S diet increased polyunsaturated fatty acid content of major membrane
      phospholipids of adipocyte plasma membrane in normal and diabetic animals,
      increased membrane linoleic acid content, and prevented a decrease in arachidonic
      acid level in diabetic animals. The high P/S diet increased insulin binding in
      control animals. Animals fed the high P/S diet had significantly higher rates of
      insulin-stimulated glucose transport and lipogenesis than did animals fed the low
      P/S diet. Feeding a high P/S diet significantly increased the amount of glucose
      transported when expressed as a function of the specific amount of insulin bound.
      To determine if dietary fat-induced alterations in the fatty acid composition of
      skeletal muscle lipid alter insulin-dependent and basal muscle metabolism,
      contralateral epitrochlearis and extensor digitorum longus muscles were isolated
      and incubated in vitro. High levels of dietary omega-3 fatty acids reduced PGE2
      and PGF2 alpha synthesis in extensor digitorum longus and epitrochlearis muscle.
      Insulin increased glucose and amino acid transport; the increase in glucose
      transport by insulin was significantly greater after consumption of the high
      omega-3 fatty acid diet. Rats fed high levels of omega-3 fatty acids showed
      reduced net protein degradation in the presence and absence of insulin due to
      decreased rates of protein degradation and synthesis. These experiments indicate
      that high levels of dietary omega-3 fatty acids alter muscle membrane
      composition, glucose transport, and metabolism of muscle protein. To determine if
      dietary fatty acids alter the onset of diabetes and insulin binding to liver
      nuclei in spontaneously diabetic rats, weanling rats were fed chow or
      semipurified diets containing 20% (w/w) fat of either high or low P/S ratio.
      Feeding a high P/S diet increased insulin binding to liver nuclei of control and
      diabetic animals. Although diet did not alter the onset of diabetes, insulin
      binding to liver nuclei is higher in animals at the onset of diabetes than in
      highly diabetic animals. Eight-week-old female C57 B 6J lean and ob/ob mice were
      fed semipurified diets containing 20% (w/w) fat of either high or low P/S ratio
      to investigate the effect of diet on specific binding of insulin to liver nuclei.
      Insulin binding was highest in nuclei from lean mice fed a high P/S diet.
      Specific binding of insulin to nuclei from obese mice was also increased by the
      high P/S diet, but to a lesser extent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352439
TI  - Dietary intake of lipids, insulin secretion, and cellular lipid peroxidation and
      order parameters in humans.

PMID- 8352440
TI  - Effect of dietary fatty acids on LDL binding.

PMID- 8352438
TI  - N-3 fatty acids from fish oil. Effects on plasma lipoproteins and
      hypertriglyceridemic patients.
AB  - In the experimental studies reported in this review, dietary n-3 fatty acids from
      fish and fish oil had profound hypolipidemic effects in normal subjects and in
      hypertriglyceridemic patients with combined hyperlipidemia (type II-b) and types
      IV and V hyperlipidemia. In these carefully controlled metabolic experiments,
      dramatic reductions occurred in plasma triglycerides and to a lesser extent in
      plasma total cholesterol. Reductions in VLDL, chylomicrons, remnants, LDL, apo B,
      and apo E were also noted. HDL changes varied from subject to subject. These
      plasma lipoprotein changes occurred in subjects with non-insulin-dependent
      diabetes mellitus as well, without deterioration of diabetic control. Similar
      results are reported in two other papers in this volume. Fish oil did not cause
      deterioration of diabetic control. Whereas the mechanism of the hypolipidemic
      action of the n-6 rich vegetable oils containing linoleic acid such as corn or
      safflower oil still remains obscure, the mechanism of the hypolipidemic action of
      the n-3 fatty acids in fish oil is well documented. The synthesis of triglyceride
      and VLDL in the liver is greatly reduced by n-3 fatty acids. At the same time,
      the turnover of VLDL in plasma is shortened. In another study, LDL production was
      decreased. Combined with other dietary manipulations, such as a reduction in
      saturated fat and dietary cholesterol, the use of n-3 fatty acids to treat
      hyperlipidemia, especially hypertriglyceridemia, appears to have a well-supported
      rationale. Fish oil combined with a low cholesterol, low saturated fat diet has
      been shown to produce complementary effects. Total plasma cholesterol and LDL
      cholesterol were lowered by the low cholesterol, low saturated fat diet, whereas
      plasma triglyceride and VLDL were decreased by the fish oil. In most situations,
      the use of fish oil supplements should be regarded as pharmacologic therapy,
      particularly effective in severe hypertriglyceridemic states (e.g.,
      chylomicronemia). However, a lifelong diet rich in fish may be protective against
      atherosclerosis as well. Further studies are required to delineate exact doses
      and precise indications for the use of fish oil in different types of
      hyperlipidemias and to differentiate the effects, if any, of the two major n-3
      fatty acids in fish oil, EPA and DHA. The hypolipidemic effects of n-3 fatty
      acids coupled with their known antithrombotic actions (secondary to changes in
      prostaglandin secretion, platelet function, inhibition of growth factors, and
      enhancement of endothelial-derived relaxation factor) appear to have an important
      potential role in the control of coronary heart disease and other atherosclerotic
      disorders. Moreover, fish oil may prevent the "chylomicronemia" syndrome of type
      V hyperlipidemia.

PMID- 8352441
TI  - Dietary monounsaturated fatty acids for patients with diabetes mellitus.

PMID- 8352442
TI  - Effect of intravenous administration of docosahexaenoic acid emulsion on blood
      glucose and insulin concentrations in diabetic rats.

PMID- 8352443
TI  - Effect of dietary fish oil on insulin action in fat cells of control and non
      insulin-dependent rats.

PMID- 8352444
TI  - Effect of high fat feeding on glucose tolerance in neonatally streptozotocin
      treated rats at 3 and 6 months of age.
AB  - In the rat, a high fat intake is believed to be associated with an increased risk
      for the development of glucose intolerance by inducing insulin resistance. The
      aim of this study was to investigate whether reduced insulin production may also
      play a role. Rats were treated with 0, 30, 60, and 90 mg of streptozotocin
      (STZ)/kg of body weight on the day of birth (0, 30, 60, and 90 nSTZ rats). At 3
      or 6 months of age, glucose tolerance was assessed by the intravenous glucose
      tolerance test (IVGTT). STZ dose-dependently decreased first- and second-phase
      insulin responses and correspondingly impaired glucose tolerance. Following a 3
      week high fat diet (HFD: 60% of calories as corn oil), insulin responses were
      higher in control as well as in STZ-treated rats both at 3 and 6 months of age.
      In 3-month-old rats this was accompanied by unchanged or increased glucose levels
      following the glucose load, whereas in 6-month-old 0 and 30 nSTZ rats glucose
      tolerance was slightly improved. After 6 weeks of HFD in 6-month-old rats,
      glucose tolerance was impaired compared to that after 3 weeks of HFD despite
      higher insulin responses. Continuing the HFD for up to 12 weeks further impaired
      glucose tolerance, but insulin responses were decreased compared to those after 6
      weeks of HFD. These results indicate that very low dose neonatal STZ
      administration impairs glucose tolerance through decreased overall insulin
      responses. This may possibly be due to a reduction of B-cell number rather than
      an alteration of B-cell function. No clear evidence exists that a high fat intake
      per se negatively influences glucose-induced insulin responses, but this may
      become apparent after longer periods of high fat feeding.

PMID- 8352445
TI  - Effect of dietary fish oil on 2-deoxy-D-3H glucose uptake in isolated adipocytes
      of rats fed various diets.
AB  - High sucrose diet-induced insulin resistance and mild glucose intolerance are
      associated with decreased insulin binding to isolated adipocytes and reduced
      insulin action in adipose tissue. Enhanced dietary intake of omega-3
      polyunsaturated fatty acids (n-3-FA) counteracts these disorders. To provide more
      information on the possible role of membrane-related glucose transport processes,
      basal and insulin-stimulated 2-deoxy-D-3H glucose uptake was evaluated in
      isolated adipocytes obtained from rats on various dietary regimens. For 2 weeks
      animals were fed three different isocaloric (18 cal% proteins, 19 cal% fat, and
      63 cal% carbohydrate) diets: (1) a standard rat chow (B), (2) a high sucrose diet
      (S, 63 cal% sucrose), or (3) an S diet supplemented with marine fish oil (S + FO,
      Martens, 30 wt% of n-3-FA). High dietary n-3-FA intake resulted in a significant
      decline in both basal (0.05 +/- 0.01 pmol/10(6) fat cells; mean +/- SEM) and
      insulin-stimulated (10(-6) M) (0.20 +/- 0.01) glucose uptake when compared with
      the control (basal: 0.12 +/- 0.02; insulin: 0.35 +/- 0.02) and/or the S group
      (basal: 0.18 +/- 0.03; insulin: 0.43 +/- 0.03), indicating decreases in insulin
      responsiveness and sensitivity (ED50: B: 0.03 +/- 0.01; S: 0.03 +/- 0.01; S + FO:
      0.73 +/- 0.2 nM; p < 0.01 for S + FO vs B and S + FO vs S). Fish oil
      supplementation induced an increase in adipocyte size (B: 69 +/- 1.6; S: 70 +/-
      2.5 and S + FO: 76 +/- 2.2 microns; B: S + FO p < 0.05) and a decrease in plasma
      membrane microviscosity (B: 4.08 +/- 0.3; S: 5.39 +/- 0.5; S + FO: 3.10 +/- 0.3;
      p < 0.05). Rates of basal and insulin-stimulated glucose uptake did not correlate
      with plasma membrane microviscosity; however, a negative relation to fat cell
      size was found (r = -0.484; p < 0.05). On the other hand, a positive correlation
      between both basal (r = 0.504; p < 0.05) and insulin-stimulated (10(-6) M, r =
      0.640; p < 0.02) glucose uptake and blood glucose levels was observed. In
      conclusion, these data (a) suggest a less important role of diet-induced changes
      in plasma membrane microviscosity for glucose uptake in adipose tissue, and (b)
      leave unclear the mechanism of why dietary fish oil decreases the sensitivity of
      glucose uptake to insulin in isolated rat adipocytes.

PMID- 8352446
TI  - Dietary supplementation with N-3 polyunsaturated fatty acids in type 2 diabetes.
      Effects on glucose homeostasis.

PMID- 8352447
TI  - Dietary marine fish oils and insulin action in type 2 diabetes.
AB  - Supplementation of omega-3 fish oils (n-3 FO) usually worsens the glycemic
      control in type 2 diabetic subjects. This may be a dose-related phenomenon and is
      reversed after discontinuation of the n-3 FO supplementation. An increase in the
      daily caloric intake, due to the fat content of n-3 FO supplements, and a
      consequent weight gain may contribute to the increase in hyperglycemia.
      Mechanisms of the increase in hyperglycemia include: (1) n-3 FO may interfere
      with insulin secretion from the pancreas, and this in turn can cause an increase
      in the hepatic glucose output and/or a decrease in the glucose uptake by the
      peripheral tissues; (2) n-3 FO may primarily decrease the sensitivity of liver to
      insulin action and consequently increase gluconeogenesis and/or glycogenolysis
      and/or decrease the glycogenesis; (3) n-3 FO may primarily affect the sensitivity
      of peripheral tissues to insulin, resulting in decreased glucose-uptake; (4) n-3
      FO may increase the availability of gluconeogenic substrates by directly altering
      the partitioning of the metabolic fuels for different pathways in the liver.
      [formula: see text] Direct experimental testing of these possibilities has been
      difficult, because n-3 FO affects the carbohydrate metabolism differently in
      animal models than in humans. The available data suggest that n-3 FO inhibits
      insulin secretion in response to glucose load, mixed meal, and glucagon but not
      at the fasting state. Hepatic glucose output is increased. Sensitivity of the
      peripheral tissues to insulin is not changed. An encouraging observation is that
      the hyperglycemic effect of n-3 FO may decrease with time even when therapy is
      continued. Proper use of this treatment modality requires careful evaluation of
      the risk/benefit ratio for every individual patient.

PMID- 8352448
TI  - Significance of the N-6/N-3 ratio for insulin action in diabetes.
AB  - This report supplies supportive data for the hypothesis that a high n-6/n-3
      dietary fat ratio is a potent, negative variable in NIDDM. Further work is
      necessary to critically evaluate this hypothesis.

PMID- 8352449
TI  - Effects of two fat-modified diets on glucose and lipid metabolism in healthy
      subjects.

PMID- 8352450
TI  - Effect of a low salt diet on blood pressure and vasoactive hormones in the
      hereditary hypertriglyceridemic rat.
AB  - In hereditary HTG rats, basal systolic blood pressure using tail-cuff
      sphygmomanometry was significantly higher (122.1 +/- 2.1 mm Hg; n = 16) than that
      in NTG animals (107.1 +/- 1.52; n = 16). A low salt diet did not influence blood
      pressure in NTG rats during the consecutive 4 weekly periods. However, in the
      second week blood pressure in HTG rats rose significantly in both the control
      rats on a normal salt diet and those on a low salt diet (132.5 +/- 1.89, n = 8,
      and 132.6 +/- 1.93, n = 8). No further changes were registered in the third and
      fourth week in control HTG rats. On the other hand, blood pressure fell
      significantly in HTG rats on a low salt diet in the third week in comparison with
      the second week (119.5 +/- 3.2, n = 8), and it increased again in the fourth week
      (123.0 +/- 2.35, n = 8). Hormones in plasma were determined at the end of the
      experiment. Plasma levels of norepinephrine were not influenced by differences in
      salt intake and were significantly higher by about 45% in HTG than in NTG
      animals. The lowest concentration of corticosterone in plasma was found in
      control HTG rats (1.2 +/- 0.2 vs 4.6 +/- 0.8 micrograms/100 ml in control NTG
      rats). Nevertheless, corticosterone concentration increased in HTG rats on a low
      salt diet at comparable values found in NTG rats on a low salt diet (3.1 +/- 0.8
      vs 4.3 +/- 1.5). Plasma renin activity and plasma aldosterone concentrations were
      not different in the NTG and HTG groups and were uninfluenced by the diets (Table
      1). We conclude that the elevated blood pressure in HTG rats and its variations
      during the experiment may reflect more pronounced sympathetic activity in HTG
      rats rather than blood pressure dependency on different salt intake.

PMID- 8352451
TI  - Insulin resistance and compensatory insulin secretion in middle-aged persons with
      hypertriglyceridemia.
AB  - Insulin secretion and insulin sensitivity were measured in hypertriglyceridemic
      patients using the frequently sampled intravenous glucose tolerance test. Three
      groups of men who were matched for age and body mass index were studied: eight
      healthy control subjects (C), seven patients with mild hypertriglyceridemia and
      normal glucose tolerance (TG), and seven with well-controlled type 2 diabetes
      with hypertriglyceridemia (TG-DM). The first-phase insulin response was increased
      by 116% in the TG group and decreased by 59% in the TG-DM group. The second phase
      of insulin secretion was increased in both TG groups (TG by 310% and TG-DM by
      250%). The mean insulin sensitivity index (SI) was reduced by 50% in the TG group
      and by 60% in the TG-DM group. Glucose effectiveness (SG) was reduced by 30% in
      the TG-DM group compared with the control subjects.

PMID- 8352452
TI  - The phenomenon of a high triglyceride response to an oral lipid load in healthy
      subjects and its link to the metabolic syndrome.
AB  - Excessive postprandial triglyceride (TG) responses despite normal fasting TG
      levels have been described in single cases within small groups of healthy
      subjects and in patients with obesity or precocious atherosclerosis, known to be
      associated with high insulin fasting levels. To clarify this association, fasting
      and postprandial TG and insulin levels were studied in 113 healthy young (25.7 +/
      2.6 years), normal weight (body mass index 20.8 +/- 2.3 kg/m2) male subjects who
      were selected from among 117 subjects on the basis of TG fasting levels < 200
      mg/dl. After a 12-hour fast a standardized liquid lipid load was administered
      containing 58 g mainly saturated fat and 1,017 kcal energy. Both fasting TG
      values and postprandial TG peak values showed bimodal frequency distributions.
      Statistical analysis of fasting TG discriminated two groups: a low fasting TG
      group with normally distributed values < 150 mg/dl (mean +/- SEM: 79.5 +/- 2.7
      mg/dl; n = 104) and a high fasting TG group > 150 mg/dl (194.5 +/- 7.2 mg/dl; n =
      13). Likewise, two groups could be differentiated according to their maximal
      postprandial TG response (TG max) to the lipid load: (1) normal responders with
      TG max < 260 mg/dl (mean +/- SEM: 123 +/- 4.8 mg/dl; n = 96) and (2) high
      responders with TG max > 260 mg/dl (272.5 +/- 20.5 mg/dl; n = 17). Fasting TG and
      TG max were highly correlated (r = 0.745; p < 0.0001). However, 9 of 17 (53%)
      high responders had fasting TG < 150 mg/dl, which means that the prediction of
      high response is only 47.0% based on fasting TG values. Fasting insulin levels
      were significantly higher in high responders than in normal responders, whereas
      they did not differ between the low and high fasting TG group. In conclusion, the
      bimodal frequency distribution of TG max after a lipid load permitted the
      differentiation of two groups, normal responders and high responders, with higher
      fasting insulin levels, which might indicate a link to the metabolic syndrome.

PMID- 8352453
TI  - Prolonged postprandial increment in triglycerides and decreased postprandial
      response of very low density lipoproteins in type 2 diabetics following an oral
      lipid load.

PMID- 8352454
TI  - Role of N-6 and N-3 fatty acids in the dietary treatment of metabolic disorders.
AB  - The impetus to examine the effects on n-3 PUFA was generated from epidemiologic
      studies of a traditional population largely dependent on the marine environment.
      These studies and clinical interventions support a recommendation to increase the
      consumption of n-3 fatty acids, particularly in communities that currently have a
      low n-3 fatty acid intake. If we are to be guided by the diet of other
      traditional hunter-gatherer populations, dependent on both terrestrial and marine
      sources of food, it is clear that we may need to reappraise the importance of
      long chain PUFA of the n-6 series such as arachidonic acid. Recent studies on
      such populations indicate that elevated arachidonic acid levels, when associated
      with elevated n-3 PUFA, are likely not to be harmful to health.

PMID- 8352455
TI  - PUFA supplementation and hypertension in type 1 diabetes.

PMID- 8352457
TI  - Is it time for a clinical trial of dietary fish oil supplementation in
      individuals with NIDDM?

PMID- 8352456
TI  - The hypotriglyceridemic effect of fish oil in adult-onset diabetes without
      adverse glucose control.
AB  - Diabetic control as judged by five criteria did not deteriorate after 6 months of
      fish oil compared to 6 months of olive oil supplementation in 16 patients with
      NIDDM who were eating a low fat, high complex carbohydrate diet. Plasma total and
      VLDL triglyceride and cholesterol decreased significantly after fish oil
      supplementation; plasma total and HDL cholesterol concentrations did not change.
      The LDL cholesterol level was significantly increased with fish oil
      supplementation, suggesting that patients with NIDDM who are given a fish oil
      supplement to decrease the plasma total and VLDL triglyceride levels may also
      need further dietary and/or pharmaceutical therapy to maintain an LDL cholesterol
      level compatible with a low risk of coronary disease. The study emphasizes the
      safe use of fish oil over a 6-month period in diabetic patients.

PMID- 8352458
TI  - Dietary recommendations: what we've learned here.

PMID- 8352459
TI  - Beneficial effects of a fish oil enriched high lard diet on obesity and
      hyperlipemia in Zucker rats.

PMID- 8352461
TI  - Dietary N-3 PUFA-induced changes in heart triglyceride and glucose metabolism of
      hypertriglyceridemic rats and their relation to insulin action.

PMID- 8352460
TI  - Dietary fats, fish, and blood pressure.
AB  - In humans any effects of dietary saturated fats or omega-6 polyunsaturates on
      blood pressure appear to be mediated by changes in caloric intake and long-term
      weight changes. In contrast, omega-3 fatty acids have a mild antihypertensive
      effect which is seen most clearly in untreated subjects with higher blood
      pressures, in older people, and during sodium restriction. The mechanism may be
      due to a combination of effects consequent to incorporation of omega-3 fatty
      acids into vascular phospholipids, leading to reduced formation of endothelial
      contractile substances in larger vessels and impairment of sympathetic
      neuroeffector and other vasoconstrictor mechanisms in resistance vessels.

PMID- 8352462
TI  - Effects of marine fish oil on blood pressure and vascular reactivity in the
      hereditary hypertriglyceridemic rat.

PMID- 8352463
TI  - Accumulation of triglycerides in liver following inhibition of fatty acid
      oxidation by 3-mercaptopropionic acid in perfused liver.

PMID- 8352464
TI  - Dietary regulation of liver malic enzyme activity in relation to the effect of
      triiodothyronine.

PMID- 8352465
TI  - Altered susceptibility to in vitro oxidation of LDL in LDL complexes and LDL
      aggregates.

PMID- 8352466
TI  - Effect of feeding arachidonic acid to streptozotocin diabetic rats.

PMID- 8352467
TI  - Abnormal serum fatty acid composition in non-insulin-dependent diabetes mellitus.

PMID- 8352468
TI  - Action of dietary polyunsaturated fatty acids on the fluidity of erythrocyte and
      platelet membrane in NIDDM.

PMID- 8352469
TI  - Kinetics of free fatty acids in hypertriglyceridemia. Evidence for different
      types of insulin resistance.

PMID- 8352470
TI  - Effect of dietary fish oil on the development and regression of atherosclerosis
      in rabbits.

PMID- 8352471
TI  - Glucose tolerance, insulin secretion, plasma lipid fatty acids, and the
      hypolipidemic effects of fish oil.

PMID- 8352472
TI  - Dietary lipids and glucose tolerance. The San Luis Valley Diabetes Study.

PMID- 8352473
TI  - Triglyceridemia, glucoregulation, and blood pressure in various rat strains.
      Effects of dietary carbohydrates.

PMID- 8352474
TI  - Raised dietary intake of N-3 polyunsaturated fatty acids in high sucrose-induced
      insulin resistance. Animal studies.

PMID- 8352475
TI  - High fat diet-induced insulin resistance. Lessons and implications from animal
      studies.

PMID- 8352476
TI  - Epidemiologic studies on Eskimos and fish intake.
AB  - Chronic diseases such as coronary heart disease and diabetes mellitus are
      uncommon in Eskimos. Total cholesterol levels are generally low, whereas HDL
      cholesterol levels are higher than those in an age- and sex-matched Danish
      population. It is frequently assumed that this is mainly due to their dietary
      pattern, especially with its high content of n-3 polyunsaturated fatty acids,
      derived from fish and other seafoods. Dietary surveys have shown that the intake
      of n-3 polyunsaturated fatty acids in Eskimos is about 14 g/day, whereas it is 3
      g/day in Denmark and about 0.2 g/day in the United States. However, the Eskimo
      diet also differs from the Western diet in other aspects, especially in the
      intake of saturated fatty acids which is low (9 energy-%). The intake of dietary
      cholesterol is rather high because of the large consumption of seafood.
      Individually based studies are better suited to disentangle the health effects of
      different nutrients, inasmuch as confounding factors can be taken into account.
      Several cohort studies have now shown that the consumption of 1-2 fish meals per
      week is associated with a reduction in the risk of coronary heart disease.
      Recently, similar results concerning glucose intolerance and stroke were also
      reported. These combined data suggest that a diet low in saturated fatty acids,
      in combination with a low or moderate level of fish consumption, may be of
      importance in the prevention of diseases such as coronary heart disease, ischemic
      stroke, and diabetes mellitus.

PMID- 8352477
TI  - Insulin resistance in high fat fed rats. Role of glucose transporters, membrane
      lipids, and triglyceride stores.

PMID- 8352478
TI  - Fish oil in a high lard diet prevents obesity, hyperlipemia, and adipocyte
      insulin resistance in rats.

PMID- 8352479
TI  - Thyroplasty: a new approach.
AB  - A new type of thyroplasty implant (prosthesis) has been designed to be used of a
      surgical operation that accomplishes medial displacement of a paralyzed vocal
      cord. The implant is inserted through a rectangular window fashioned in the
      thyroid lamina on the side of the vocal cord paralysis. Instruments for measuring
      the location and outline of the window in the thyroid lamina are presented. A
      thyroplasty saw blade is introduced. By using this blade, a window of precise
      measurement can be constructed without injury to the underlying perichondrium.
      The implant is constructed from a biocompatible, medical-grade polymer. Four
      sizes each are available for the male and female larynges. The proper-size
      implant can be selected with a measuring device. It is not necessary to alter the
      implant at the time of surgery; it snaps into place and suturing is not
      necessary. Once the implant is inserted, its medial or lateral displacement is
      not possible; on the other hand, the implant can be easily removed if vocal cord
      function returns, or if a change to a different-size implant is indicated. The
      design of the implant will close the posterior commissure.

PMID- 8352480
TI  - Measurement of Young's modulus in the in vivo human vocal folds.
AB  - Currently, surgeons have no objective means to evaluate and optimize results of
      phonosurgery intraoperatively. Instead, they usually judge the vocal folds
      subjectively by visual inspection or by listening to the voice. This paper
      describes a new device that measures Young's (elastic) modulus values for the
      human vocal fold intraoperatively. Physiologically, the modulus of the vocal fold
      may be important in determining the nature of vocal fold vibration in normal and
      pathologic states. This study also reports the effect of recurrent laryngeal
      nerve stimulation on Young's modulus of the human vocal folds, measured by means
      of transcutaneous nerve stimulation techniques. Young's modulus increased with
      increases in current stimulation to the recurrent laryngeal nerve. Ultimately,
      Young's modulus values may assist surgeons in optimizing the results of various
      phonosurgeries.

PMID- 8352482
TI  - Experimental endolymphatic hydrops and glycerol. Electrophysiologic study.
AB  - The object of the present study was to evaluate electrophysiologically the
      therapeutic effect of glycerol on the cochlear function of guinea pigs in which
      experimental hydrops had been surgically induced. Fifteen albino guinea pigs were
      used. Each animal was chronically implanted to follow the evolution of hearing.
      The experimental protocol considered 3 groups of guinea pigs (5 animals each).
      Group 1 received no drug treatment, while groups 2 and 3 were given glycerol
      orally at 0.75 and 0.50 g/kg of body weight once a day for 4 months. The
      audiograms of the animals treated with glycerol showed a statistically
      significant hearing improvement compared with the control group. Clinically, our
      results seem to support the view of those who favor the use of glycerol for the
      medical treatment of Meniere's disease at an early stage.

PMID- 8352481
TI  - Carcinoma in situ of the glottis: radiotherapy or excision biopsy?
AB  - Excision biopsy, radiotherapy, and laryngofissure cordectomy have all been used,
      but the best treatment regimen for glottic carcinoma in situ remains
      controversial. A 20-year experience of 37 cases is reported. For the first 10
      years biopsy with radiotherapy was the first-line treatment (n = 20), but for the
      last 10 years surgical or laser excision biopsy alone has been performed (n =
      17). The T stage of the carcinoma in situ does not determine its premalignant
      potential. Malignancy appears to be a recurrence, rather than a new expression of
      carcinogenesis. Excision biopsy alone provides local control results (75%)
      comparable to those of primary radiotherapy (85%). Excision biopsy alone,
      however, retains the option of subsequent radiotherapy with preservation of
      laryngeal function, but very close follow-up, especially in the first year, is
      required.

PMID- 8352483
TI  - Experimental otitis media with effusion induced by platelet activating factor.
AB  - This study tested the hypothesis that platelet activating factor (PAF) in the
      middle ear can induce otitis media with effusion (OME) and that PAF antagonists
      can prevent PAF-induced OME. An initial trial of 16 micrograms of PAF was
      injected into chinchilla bullae, and all ears developed middle ear effusion (MEE)
      within 48 hours. Subsequent trials were performed to test dose dependency.
      Interestingly, 1 or 16 micrograms of PAF caused more MEE and inflammation than
      did 4 or 8 micrograms. A dose of 0.5 micrograms PAF did not cause MEE. Middle ear
      effusion from injected bullae contained the full spectrum of lipoxygenase and
      cyclooxygenase products; additionally, more PAF was detected than was injected.
      Finally, a PAF antagonist (WEB 2170) injected intraperitoneally prevented PAF
      induced OME. This study demonstrates that PAF injected into the middle ear can
      induce OME and that PAF antagonists effectively prevent PAF-induced OME. These
      findings suggest that PAF plays an important role in the pathogenesis of OME.

PMID- 8352484
TI  - Classification of congenital middle ear anomalies. Report on 144 ears.
AB  - The surgical findings in 144 successive ears operated on for congenital
      conductive hearing loss were analyzed, and the results were evaluated in terms of
      hearing gain. All the patients underwent middle ear surgery at the University
      Hospital Nijmegen between 1964 and 1990. A classification system was developed to
      analyze the findings. Class 1 comprises ears with congenital isolated stapes
      ankylosis. Class 2 comprises ears with congenital stapes ankylosis in combination
      with a congenital anomaly of the ossicular chain. Class 3 comprises ears with
      congenital anomalies of the ossicular chain and at least a mobile stapes
      footplate. Class 4 comprises ears with aplasia or severe dysplasia of the oval
      window or round window.

PMID- 8352485
TI  - Australian experience with functional endoscopic sinus surgery and its
      complications.
AB  - There have been reports of severe complications from functional endoscopic sinus
      surgery; however, it is unclear as to how the rate compares with that of the more
      traditional forms of intranasal surgery. To ascertain this, I circulated a
      questionnaire to 100 otolaryngologists in Australia known to have an interest in
      endoscopic nasal surgery and analyzed the results. The results of this survey
      show that complications are very infrequent and that the rates for functional
      endoscopic sinus surgery compare favorably with those of the traditional
      techniques.

PMID- 8352486
TI  - Differential osteoclast activation in endochondral and intramembranous bone.
AB  - Osteoclast activation within the temporal bone leads to hearing loss in a variety
      of pathologic conditions, including otosclerosis, osteogenesis imperfecta,
      Paget's disease of bone, and chronic otitis media. Although endochondral (EC)
      bone is remodeled in these diseases, it is relatively more resistant to
      remodeling when compared to intramembranous (IM) bone. In this study, localized
      bone resorption and remodeling were induced on the inner surface of the middle
      ear by pressurization with air to 10 mm Hg above atmospheric. Osteoclast surface
      increased in IM bone, but not in EC bone. This study supports the concept that
      there may be fundamental differences between EC and IM bone and that EC is more
      resistant to pressure-induced localized resorption than IM bone.

PMID- 8352487
TI  - Congenital ankyloglossia with deviation of the epiglottis and larynx: symptoms
      and respiratory function in adults.
AB  - We operated on 38 adult patients with congenital ankyloglossia with deviation of
      the epiglottis and larynx. The results were as follows. 1) Most patients had
      Angle's class III malocclusion, irregular alignment of the upper teeth, and high
      hard palate. 2) Fifty percent of the patients in our study population had
      obstructive respiratory failure. Their vital capacity increased significantly
      after the operation, but changes of forced expiratory volume in 1 second were not
      prominent. 3) Subjective symptoms of this disease were stiffness of the
      shoulders, a cold feeling in the extremities, an obstructed feeling in the
      throat, insomnia, fatigue, dry skin, irritability and/or anxiety, and
      nervousness. These improved postoperatively. 4) Objective symptoms included
      snoring, muscle cramps, difficulty in playing wind instruments, hoarseness, and
      incorrect articulation. The objective symptoms, except for incorrect
      articulation, improved postoperatively.

PMID- 8352488
TI  - Morphology of the membrana limitans.
AB  - The morphology of the membrana limitans (ML) was studied by light and electron
      microscopy to further understand its functional significance. The ML is a porous
      shield composed of a few to several layers of tightly packed fibrocytes that
      separate the perilymphatic space of the cochlea and saccule from that of the
      utricle and canal system. These fibrocytes are thinner on the side of the
      vestibule. They show many desmosomes and gap junctions and are interspersed with
      fibrils. The 3-dimensional reconstruction from celloidin sections shows that the
      ML, as it is viewed from the anterior side, is rectangular in shape, with various
      surface curvatures and an invagination toward the internal aperture of the
      vestibular aqueduct. Horseradish peroxidase, a tracer substance, placed on either
      side of the ML fails to pass to the opposite side. The ML and trabecular meshwork
      may be a factor contributing to differential sensitivity of cochlear and
      vestibular sensory cells in the presence of noxious substances.

PMID- 8352489
TI  - Sources of variability in posterior rhinomanometry.
AB  - Sources of variability in nasal airway resistance measured by posterior
      rhinomanometry were studied in 5 subjects tested on 5 different days and 56
      subjects tested on 2 different days. On each day, a questionnaire on upper airway
      health and nasal symptoms was completed. The mean individual difference in nasal
      airway resistance between the 2 test days in the group of 56 subjects was 5.3%
      (SD 52.7%). Between-subject variability accounted for 74.9% and 72.5% of the
      total variability in the group of 5 and the group of 56 subjects, respectively.
      For the 5 subjects, by accounting for a change in upper airway symptoms or upper
      respiratory tract infection that occurred over the 5 test days, there was a
      significant decrease in the between-subject variability. The difference in
      sources of variation due to a change in upper airway symptoms was not seen in the
      group of 56 subjects. We conclude that the largest source of variability in nasal
      airway resistance is due to between-subject differences.

PMID- 8352490
TI  - Mucosal fine structure in experimental sinusitis.
AB  - Rabbit maxillary sinuses were inoculated with Streptococcus pneumoniae and
      Bacteroides fragilis, and the histologic response in the sinus mucosa was
      observed over a 12-week period. An increased height of the cylindric cells and
      hyperplasia of the basal cells were frequent findings irrespective of the
      pathogen inoculated. The disease was found to influence the character of the
      secretory product from epithelial secretory cells and to degranulate the
      subepithelial glands. Ciliary loss was a transitional finding. A reduction in the
      number of mitochondria, the occurrence of deformed short microvilli, and
      cytoplasmic blebbing were seen in the cells devoid of normal cilia. It is
      inferred from this study that pneumococcal sinusitis in rabbits is a self
      limiting process, and the mucosal sequelae of the acute infection are persisting
      goblet cells, slight focal fibrosis, and edema. Inoculation with B fragilis
      produces a chronic inflammatory process, with infiltration of mononuclear cells,
      luminal dilatation of the glands exhibiting zymogen granule depletion, and an
      increased thickness of the whole mucosal layer.

PMID- 8352491
TI  - Giant congenital cholesteatoma.

PMID- 8352492
TI  - Papillary neoplasms (Heffner's tumors) of the endolymphatic sac.
AB  - The sources of adenomatous neoplasms in the temporal bones are usually metastases
      or direct extensions from extratemporal lesions, or primary from the middle ear
      cleft. In 1989, Heffner added the endolymphatic sac's epithelium as another
      possible generative origin. In contrast to the adenomatous tumors of the middle
      ear or mastoid, the papillary cystic neoplasms of the endolymphatic sac are large
      and locally aggressive and often involve the middle and posterior cranial fossae
      and bone. These biologically low-grade adenocarcinomas have not been shown to be
      able to metastasize.

PMID- 8352493
TI  - Impact of the acquired immunodeficiency syndrome epidemic on the practice of
      laryngology.
AB  - In only 10 years, the acquired immunodeficiency syndrome epidemic has already had
      an enormous impact on many aspects of the practice of medicine. The practice of
      laryngology typifies the changes that have occurred. Heightened clinical
      vigilance has been required as the laryngologist encounters new and unusual
      manifestations of the disease and must take more extensive histories regarding
      social, behavioral, and sexual practices than were previously necessary. The
      performance of physical examinations and surgical procedures has also changed as
      a result of experience with the lethal human immunodeficiency virus. Numerous
      legal, ethical, and social issues have also been raised by the epidemic and have
      had a major influence on how medicine is practiced and regulated. In this paper
      we review the laryngeal and pharyngeal manifestations of acquired
      immunodeficiency syndrome and discuss illustrative patient examples that
      demonstrate the impact of the disease. We also consider the diverse groups of
      issues that attend this epidemic and that continue to modify practice patterns.

PMID- 8352494
TI  - [Treatment of hyperthyroidism in children with antithyroid drugs].
AB  - Sixteen cases of pediatric hyperthyroidism treated by antithyroid drugs are
      reported. First-line treatment with carbimazole in a mean dose of 19 mg/m2
      initially and 7 mg/m2 after one year ensured control of the disease within 6
      weeks. Mean follow-up was 4 years. Only two children were able to discontinue the
      drug, after 9.1 years and 4.6 years. Two other patients had thyroidectomy, after
      6.7 years and 3.4 years. The main disadvantages of antithyroid drugs are the need
      for prolonged treatment and the risk of recurrence. An attempt at treatment
      discontinuation is warranted in patients with good disease control of 2 to 3
      years duration, goiter size reduction, improved exophthalmos, and decreased anti
      TSH receptor antibodies.

PMID- 8352495
TI  - [Deficiencies of physiological coagulation inhibitors in children with venous
      thromboses of the lower limbs. Prospective study of 6 cases].
AB  - Six patients aged 3 to 14 years with lower limb vein thrombosis were included in
      a prospective study of deficiencies in physiological coagulation inhibitors. The
      laboratory evaluation included standard hemostasis tests, tests for circulating
      anticoagulants, immunological and functional assays of protein C, protein S, and
      antithrombin III, and a study of fibrinolysis. A qualitative protein S deficiency
      with decreased fibrinolysis and protein C deficiency were found. The family study
      detected asymptomatic heterozygotes in both families investigated. No
      antithrombin III deficiency or circulating anticoagulants were found.

PMID- 8352496
TI  - [Clinical experience with totally implantable venous access systems in pediatric
      hematology and oncology].
AB  - Forty-three children with malignant diseases who received 48 totally implanted
      venous accesses (TIVA) were retrospectively analyzed. More than half the patients
      had acute leukemia. Mean age was 6 years 10 months. Mean duration of use of the
      TIVA was 473 +/- 50 days (range 28 to 1,285 da; median 424 days). Removal of the
      TIVA was required because of an adverse event in 33% of cases. Main reasons for
      removal included infection (22.9%), thrombosis (6.25%), and catheter dysfunction
      (4.16%). Catheter-related infections were most often due to staphylococci (90%),
      especially S. epidermidis (63%). Infection rate was 0.48 per 1,000 patient-days.
      Flushing with a vancomycin-heparin solution can be expected to decrease this
      rate. Selection of the implantation site is discussed. In children under 6 years
      of age, the cephalic vein and external jugular vein are often frail or absent and
      are therefore less appropriate than the internal jugular vein or subclavian vein.

PMID- 8352497
TI  - [Value of flexible fiberoptic bronchoscopy under local anesthesia in infants].
AB  - From October 1991 through April 1992, 16 infants aged 5 to 25 months (mean age
      14.3 months) underwent bronchoscopy with a flexible fiberoptic bronchoscope,
      under local anesthesia. The technique is described in detail. Reasons for
      bronchoscopy included recurrent or persistent pneumonia (n = 4), persistent
      atelectasia (n = 4), lymphadenopathy and/or airway compression (n = 2), suspected
      foreign body (n = 2), bronchoalveolar lavage to investigate diffuse interstitial
      lung disease (n = 2), and severe recurrent wheezing (n = 2). The procedure
      established the accurate diagnosis in 14 cases. Adverse events (32%) were minor
      (transient hypoxia, n = 3; moderate fever, n = 1; and laryngospasm, n = 1) and
      resolved completely. Flexible fiberoptic bronchoscopy under local anesthesia is a
      simple procedure which is safe in patients under 30 months of age when performed
      by a experienced operator in an adequate facility. This method is useful for the
      diagnosis and/or treatment of a broad spectrum of conditions.

PMID- 8352498
TI  - [Helicobacter pylori gastritis manifested by acute anemia].
AB  - Helicobacter pylori gastritis usually manifests as recurrent abdominal pain but
      is sometimes discovered upon evaluation for digestive tract bleeding with severe
      anemia. An 11-year-old who was not under medication and had no history of pain
      was admitted for isolated regenerative anemia (5.6 g/dl) due to digestive tract
      bleeding. Laboratory tests showed only low serum iron and ferritin levels.
      Endoscopy disclosed hemorrhagic inflammation of the duodenal cap and antritis
      with a hillocky appearance. The diagnosis of H. pylori infection was established
      on the basis of the finding of curved Gram-negative rods on the smears and of a
      positive urea test. There was moderate interstitial antritis. The patient was
      given an H2 antagonist (ranitidine) and amoxicillin with tinidazole for six
      weeks. Serum IgG antibodies against H. pylori were found in the child's parents
      and siblings, with the exception of a 7 month old infant. A ten year old sister
      had been hospitalized two years earlier for hemorrhagic duodenitis ascribed at
      the time to use of acetylsalicylic acid. H. pylori has been reported in 40% to
      95% of pediatric patients with primary gastritis. Physicians should be familiar
      with this frequent, often familial disease. Management rests on concomitant
      administration of two antimicrobials and an acid secretion inhibitor to the index
      patient and family members. Endoscopy is too invasive to be appropriate for
      monitoring the outcome. In practice, recovery is affirmed on the basis of
      resolution of clinical manifestations and decreased levels of anti-H. pylori
      antibodies.

PMID- 8352499
TI  - [Apple-peel jejunal atresia. Nutritional management].
AB  - Apple-peel jejunal atresia is a rare digestive tract congenital defect often
      accompanied with a short gut. Two cases managed by a three-stage medical and
      surgical approach are reported. A protein hydrolysate-jejunal secretion mixture
      was drip-fed through the distal ileostomy to stimulate trophicity of the distal
      gut.

PMID- 8352500
TI  - [Histiocytic proliferative diseases. Discussion of a case report].
AB  - The case of a ten month old female with initial clinical and histological
      findings suggestive of inappropriate macrophage activation syndrome is reported.
      Subsequently, clinical and pathological changes refuted this diagnosis and
      demonstrated that the patient had Langherans cell histiocytosis. Clinical,
      laboratory and pathological findings characteristic of each type of histiocytosis
      are reviewed. Histological and immunohistochemical studies allow to establish the
      diagnosis of Langherans cell histiocytosis. The finding of erythrophagocytosis in
      our patient suggests that two types of histiocyte proliferation can coexist in
      the same individual.

PMID- 8352501
TI  - [Association of Moebius syndrome and hypopituitarism due to a midline anomaly. A
      case report].
AB  - A 14 year old patient had both Moebius anomalad with arthrogryposis and growth
      hormone deficiency due to a midline defect. This combination suggests an
      abnormality in the organization of the neural crest and homologous neural tube
      segment.

PMID- 8352502
TI  - [Multiple finger geodes in children].
AB  - Three pediatric patients with multiple geodes in the fingers are reported. This
      condition occurs mainly between one and three years and at seven years of age and
      is more common in winter. Affected fingers are swollen. Roentgenograms disclose
      several small lucent defects which are usually located in the middle phalanx.
      Several fingers are usually involved. The erythrocyte sedimentation rate is
      increased in virtually every case. Resolution occurs spontaneously within a few
      weeks or months. There is no tendency towards recurrence. Although the condition
      is inflammatory, exposure to cold is probably a precipitating factor.

PMID- 8352503
TI  - [It doesn't only happen to others: medical expertise].

PMID- 8352504
TI  - [Adjuvant treatments in resectable cancer of the rectum: preoperative
      radiotherapy, postoperative radiation- and chemotherapy or nothing?].
AB  - In addition to curative surgical resection, which remains the treatment of choice
      in rectal cancer, are there any other effective adjuvant treatments capable of
      increasing the life expectancy of patients by decreasing the frequency of local
      recurrences and distant metastases? Analysis of the results and clinical
      arguments in favour of adjuvant treatments demonstrates the efficacy of
      preoperative radiotherapy which decreases the pelvic recurrence rate in patients
      with T2T3T4NxM0 tumours. Postoperative administration of a combination of
      radiotherapy and chemotherapy (5-FU, methyl CCNU) also improved the survival rate
      and disease-free interval in patients operated for rectal cancer. However, the
      adverse effects and toxicity of this adjuvant treatment limit its routine
      administration. Lastly, the efficacy of postoperative radiotherapy and
      postoperative chemotherapy, administered separately, has not been clearly
      demonstrated to date.

PMID- 8352505
TI  - [Treatment of sclerodermic esophagitis: value of duodenal diversion].
AB  - Between 1985 and 1990, six patients were operated on using duodenal diversion for
      reflux esophagitis with scleroderma. Duodenal diversion was performed twice as
      initial procedure and 4 times as treatment of unsuccessful antireflux procedure
      performed ten years previously. Duodenal diversion was associated with truncal
      vagotomy. In cases of reoperation the initial reconstruction procedure was
      removed. An esophageal stricture was resected in one case. One patient with
      previous truncal vagotomy and pyloroplasty underwent supra papillary diversion.
      There was no postoperative death. The mean follow-up was 28 months with one
      patient lost to follow-up. For 4 patients, the postoperative weight gain was 10
      per cent. Abnormalities of lower esophageal motility in scleroderma account for
      the poor results after classical antireflux procedures. In these cases duodenal
      diversion is indicated as primary treatment. In cases of reoperation removal of
      the initial anti-reflux device is required in association with duodenal
      diversion.

PMID- 8352506
TI  - [Cholecystectomy by celioscopy. Apropos of 126 cases].
AB  - One hundred twenty-six cases who underwent laparoscopic cholecystectomy were
      included in the study: 28 males and 98 females with a mean age of 44.2 years.
      Laparoscopic cholecystectomy was performed for uncomplicated cholelithiasis (111
      cases), acute cholecystitis (10 cases), biliary pancreatitis (2 cases) and
      cholangitis (3 cases). The mean operative time was 78 minutes. In 7 cases, a
      transformation into open surgery was necessary (5.5%). There were no deaths and
      one major complication was reported: an iatrogenic injury to the bile duct
      requiring secondary laparotomy. The mean hospital stay was 3.4 days. However,
      despite several advantages, this new technique must be performed by a surgeon
      with experience of biliary tract surgery.

PMID- 8352507
TI  - [Celioscopic gastrostomies and jejunostomies].
AB  - The authors describe a technique of laparoscopic gastrostomy and jejunostomy,
      which has been used in 23 patients between May 1991 and August 1992: 13
      laparoscopic gastrostomies (LG) and 10 laparoscopic jejunostomies (LJ), all
      performed under general anaesthesia. There were no operative deaths, one
      intraoperative complication and 3 postoperative complications. Twelve patients
      had died by the end of the study, 7 patients were still using their feeding tube
      and 4 patients ate normally. The mean duration of use of the feeding tubes was 4
      months for LG and 43 days for LJ. The secondary complications consisted of 3 tube
      obstructions and one case of pyloric obstruction. Laparoscopic gastrostomy and
      jejunostomy, performed according to the method described, constitute an effective
      and reliable alternative to open operations. They can be performed in cases in
      which endoscopic gastrostomy is impossible. Due to its technical simplicity,
      laparoscopic jejunostomy should be preferred to gastrostomy whenever there is a
      risk of inhalation.

PMID- 8352508
TI  - [Right iliac fossa pain in women. Conventional diagnostic approach versus primary
      laparoscopy. A controlled study (65 cases)].
AB  - In a series of 187 patients with acute abdominal pain syndrome, 65 young women
      reported non specific pain in right iliac or pelvic area. A controlled study
      compared 33 patients with immediate laparoscopy and 32 explored with a laboratory
      contrast or imaging approach. In the laparoscopic group, an exact diagnosis was
      made in 97% of the patients, allowing in 2/3 of cases the endoscopic treatment.
      Only 28% in the second group had an exact diagnosis. Hospital stay was shorter in
      the laparoscopic group (4.18 vs 6.16 days; p = 0.01) decreasing the hospital
      cost. The authors suggest that immediate laparoscopy should be performed in young
      women presenting with non-specific abdominal pain.

PMID- 8352509
TI  - [Negative emergency laparotomies 1950-1989].
AB  - In order to list the negative emergency laparotomies, the records of 24,494
      laparotomies performed from 1950 to 1989 were examined. 211 negative laparotomies
      were performed over this 40 years period: 49 for abdominal trauma, 42 for
      supposed intestinal obstruction, 44 for supposed peritonitis or visceral
      infection, 46 for presumed early post-operative abdominal complications and 30
      for gastrointestinal bleeding. Over these 4 decades, the emergency laparotomy
      rate and negative laparotomy rate remained stable despite changes in the
      diagnostic tools, in the age of the patients and the frequency of their diseases.

PMID- 8352510
TI  - [Surgical treatment of supralevator rectocele. Value of transanal excision with
      automatic stapler and linear suture clips].
AB  - A retrospective review of 20 rectoceles performed over a four year period (1988
      1991) was carried out. The major indication for repair was constipation and
      outlet obstruction. All patients were objectively quantified by standardized
      defecography and functional investigations. All patients were repaired via a
      trans-anal approach using a linear stapler. Sixteen patients were improved with a
      mean follow-up of 21.8 months.

PMID- 8352511
TI  - [Is there still a place for surgery in the treatment of communicating pseudocyst
      in chronic pancreatitis?].
AB  - The purpose of this study was to evaluate the results of long term percutaneous
      catheter drainage in the treatment of chronic pancreatic pseudocysts
      communicating with pancreatic ducts. Since 1986, 13 consecutive patients with
      symptomatic pseudocysts were treated prospectively. All pseudocysts were
      associated with chronic pancreatitis. The location was head (n = 8), body (n = 3)
      or tail (n = 2). The procedure included fine needle aspiration under ultrasonic
      control, percutaneous drainage along a guide wire and closed suction aspiration.
      A radiological control was performed weekly and the catheter was left in place
      until total resolution of pseudocyst. Immediate relief of pain and resolution of
      pseudocyst were obtained in all 13 patients. The average length of hospital stay
      was 12.2 +/- 8 days (1 to 23). The average duration of drainage was 36 days.
      There was no mortality of morbidity related to the drainage. There were two
      asymptomatic recurrences, but long-term follow-up (mean 3 years) showed that all
      13 patients were symptom-free. The clinical results of such a long-term catheter
      drainage seem better in our study than in other previous series. It is a simple
      and innocuous procedure, and could be carried out in an outpatient unit. Such
      drainage represents an efficient alternative to endoscopic or surgical treatment
      of chronic pancreatic pseudocyst with ductal communication. In our experience
      surgery is no longer indicated.

PMID- 8352512
TI  - [Intestinal metastases from breast cancer. Apropos of 8 cases].
AB  - Eight patients with intestinal metastases from breast cancer are described. The
      different clinical presentations and pathological types are studied. The
      difficulty in distinguishing such uncommon secondary sites of breast cancer from
      primary intestinal cancer is emphasized. Attention should be paid to intestinal
      symptoms in women with a history of infiltrating lobular breast cancer: in
      agreement with recent literature data the lobular type seems mainly responsible
      for gastrointestinal and peritoneal involvement originating from breast cancer (7
      cases out of 8 in our series). Prolonged survival could be obtained if no
      metastases elsewhere were found with appropriate treatment including ablative
      surgery, chemotherapy and hormonotherapy.

PMID- 8352513
TI  - [Metatarsalgia and modified Helal's operation. Apropos of a series of 40 cases].
AB  - The authors report a series of 40 cases of metatarsalgia operated according to a
      modified Helal technique. The mid-diaphyseal osteotomy was situated obliquely
      inferoanteriorly at an angle of 45 degrees on the metatarsal diaphysis. Twenty
      cases of hallux valgus were operated during the same procedure Surgery allowed a
      reduction in pain and hyperkeratosis in 67.5% of patients. Comparison of the
      results obtained with those reported in the literature confirms that the
      osteotomy must be metaphyseal and that weight bearing must be early and
      effective.

PMID- 8352514
TI  - [Desmoid tumors or intra-abdominal fibromatoses].
AB  - Intraabdominal desmoid tumour or fibromatosis, recurrent but non-metastatic,
      invasive, fibroblastic proliferations, are rare tumours. From 1968 to 1989, 16
      patients were treated at Gustave Roussy Institute. They were associated with
      familial adenomatous polyposis in 10% of cases. These tumours, observed mainly in
      young women (70 to 85% of cases), are aggravated by pregnancy, and spontaneous
      regression can occur at menopause, proving their hormonal dependence. Although
      histologically benign, they are serious lesions due to their invasive character;
      their excision is complete in only 50% of cases. They recur in 30% to 75% of
      cases and cause death of the patient in 30% of cases. Treatment is surgical but
      due to their often very slow course, and their spontaneous stabilisation in some
      cases, a mutilating surgical treatment (extensive small intestine resection) does
      not seem to be justified. Radiotherapy is effective only at doses incompatible
      with the site of these tumours (35 to 60 Gy). Chemotherapy has never been shown
      to be effective.

PMID- 8352515
TI  - [How to choose a camera and a light source for endoscopy?].

PMID- 8352516
TI  - [Nephrocutaneous fistula revealing xanthogranulomatous pyelonephritis].
AB  - A patient presented with a reno-cutaneous fistula revealing a xanthogranulomatous
      pyelonephritis secondary to staghorn calculus. Total nephrectomy was necessary
      because of renal destruction. This treatment allowed closure of the fistula and a
      good clinical result.

PMID- 8352517
TI  - [Efficacy and tolerance of imipenem/cilastatin in the adjuvant treatment of
      surgery for peritonitis in patients over the age of 70 years].
AB  - Eighty eight patients over the age of 70 years, suffering from peritonitis, were
      treated with imipenem/cilastatin single-agent therapy as a complement to surgery.
      The recommended dosage was 30 mg/kg/day and could be increased up to 50
      mg/kg/day, without exceeding four grams per day, administered by four infusions
      per day. Seventy three patients (32 males, 41 females) with a mean, age of eighty
      years and suffering from peritonitis due to perforation, were evaluated. One half
      of patients presented one or several risk factors on inclusion into the study,
      one third received ventilatory assistance and 28.5% presented with shock. The
      perforation was situated in the stomach and duodenum (N = 24), biliary tract (N =
      8), small intestine (N = 3), caecum (N = 10) and colon or sigmoid (N = 28). The
      infection was polymicrobial in 57.4% of cases. Blood cultures were positive in
      seven patients and cultures remained sterile in seven patients. A clinical
      success was obtained in sixty four patients (87%): fifty-six patients were cured
      and eight were improved. Six patients died as a result of infection (mortality:
      8.2%) and three were not improved. No failure was due to development of an
      imipenem-resistant organism. These results confirm the efficacy of
      imipenem/cilastatin single-agent therapy as a complement to surgery for severe
      intra-abdominal infections in this high-risk elderly population.

PMID- 8352518
TI  - Stimulation of iodination and cytokine production by dehydrogenation polymers of
      phenylpropenoids.
AB  - Dehydrogenation polymers of phenylpropenoids (so-called 'synthetic lignins')
      stimulated the iodination (incorporation of radioactive iodine into an acid
      insoluble fraction) of human peripheral blood monocytes and polymorphonuclear
      cells (PMN). The stimulation activity of the polymers strongly depended on the
      amount of hydrogen peroxide used during sample preparation, and on the
      temperature during iodination assay. These polymers also stimulated the
      production of interleukin-1 and tumor necrosis factor by peripheral blood
      mononuclear cells. On the other hand, neither iodination nor cytokine production
      was significantly affected by the phenylpropenoid monomers. Although the polymers
      stimulated the iodination of human leukemic cell lines (HL-60, ML-1), they did
      not induce cytokine production in these cells. The results suggest that
      stimulation of iodination and cytokine production by dehydrogenation polymers of
      phenylpropenoids might be regulated differently.

PMID- 8352519
TI  - Effects of some ruthenium chelates on MCa mammary carcinoma and on TLX5 lymphoma
      in mice.
AB  - A group of four Ruthenium chelates of the mixed hard/soft N-S donor ligands 2
      formylpyridine (4-H/4-phenyl)thiosemicarbazone has been studied in the
      experimental models of MCa mammary carcinoma and TLX5 lymphoma in the CBA mouse.
      Although all the four tested complexes, bis-[2-formylpyridine(4-
      phenyl)thiosemicarbazone]ruthenium(II)chloride]Ru(L1)(L1H)Cl, 1], [2
      formylpyridine(4-phenyl)thiosemicarbazone]ruthenium(II)-mu- trichloro
      chloro(imidazole)ruthenium(III)monomethanolate [Ru2(L1)(imz)Cl4.CH3OH, 9]. [2
      formylpyridine(4-phenyl)thiosemicarbazone]dichloroimidazoler uthenium(II)
      [Ru(L1H)(imz)Cl2,10] and bis[2- formylpyridinethiosemicarbazone]ruthenium(II)
      perchlorate, dihydrate [Ru(L)(LH)ClO4.2H2O, 16], reduced the formation of lung
      metastases at the same extent only compound 1 caused parallel inhibition of the
      growth of the primary tumor. The chemical nature of the tested compounds seems to
      determine the nature of the antitumor effects and the bis-chelates are found to
      be endowed with greater cytotoxic properties towards primary tumor than the
      monochelates. This opens up a very interesting point, whether it is the presence
      of two chelate rings around the Ruthenium(II)/(III) acceptor centre or the
      increase in the number of the soft (S) donor centers that generates greater
      cytotoxic properties in the corresponding ruthenium complexes. As far as the
      reduction of the metastasis formation is concerned, it appears that among the
      four Ruthenium chelates tested, it is possible to identify structures capable of
      controlling the spread of tumor to the lungs in the absence of significant
      cytotoxicity for tumor cells. This finding appears of importance in that it
      indicates the possibility of a specific mechanism of interaction with cells of
      the metastatic tumor. In this context it appears necessary to investigate other
      congeners of this "family" with more sulfur donor sites and particularly those
      with better water solubility.

PMID- 8352520
TI  - Diverse biological activities displayed by phenothiazines, benzo[a]phenothiazines
      and benz[c]acridins (review).
AB  - This review summarizes our experiments which are investigating the relationship
      between the structure and activity of mainly phenothiazines,
      benzo[a]phenothiazines and benz[c]acridines. Phenothiazines had potent
      antiplasmid and antibacterial activities, but induced weak antimicrobial activity
      in vivo. Their antiplasmid activity seemed to be enhanced by Cl- or CF3-
      substitution at the 2C position of phenothiazines and modified by the side-chain
      length and hydrophobicity. Benzo[a]phenothiazines did not show any significant
      antiplasmid or antibacterial activity, but stimulated the differentiation of
      human myelogenous leukemic cell lines and natural killing activity of human
      peripheral blood mononuclear cells in vitro, and induced antimicrobial activity
      in vivo. Circuit current energy (CRE), circuit current (CC), bond current (BC),
      diatropic and paratropic properties of benzo[a]phenothiazines might be correlated
      with their biological activity. Benz[a]acridine showed both in vitro and in vivo
      antimicrobial activities, and carcinogenic activity for skin tumor. The
      carcinogenic benz[c]acridines showed out-of-phase in the L-region and their
      energy was accumulated in the K-region of the molecular orbitals. The results
      suggest the involvement of different molecular orbitals for the expression of
      various biological activities by phenothiazines, benzo[a]phenothiazines and
      benz[c]acridines.

PMID- 8352521
TI  - Polyamine deprivation stimulates natural killer cell activity in cancerous mice.
AB  - It has recently been established that the total blockade of all endogenous and
      exogenous sources of polyamines by a drug containing polyamine deficient chow (DC
      PDC+) could inhibit tumor growth in vivo and increase the antitumoral efficacy of
      chemotherapy drugs. We show here that polyamine deprivation obtained with DC-PDC+
      not only influences tumor development via reduction of polyamine concentrations
      in the tumor itself but, in addition, stimulates cells of the non-specific immune
      system specialized in tumor cell killing. We report that mice grafted with the
      3LL carcinoma present a dramatic decrease in the cytotoxic activity of their
      natural killer (NK) cells. When these animals are treated with DC-PDC+, their NK
      cell activity is completely restored to normal values. Normalization of leucocyte
      number and differential count was observed as well. With respect to the different
      components of the DC-PDC+, it was observed that the endogenous and exogenous
      sources of polyamines have a different degree of impact on tumor development. For
      example, when only polyamines from digestive sources are deprived, a weak but
      significant improvement in NK activity and antitumoral effects were observed,
      without affecting intra-tumoral polyamine concentrations. We conclude that
      polyamines, secreted by the tumor itself as well as absorbed through the
      gastrointestinal tract, could now be considered not only as autocrine growth
      factors but also as natural immunosuppressive factors.

PMID- 8352522
TI  - The interference of geographical changes of cancer risk in tumor etiology in
      Japan.
AB  - An attempt was made to elucidate the relation between various human neoplasias in
      their geneses by comparatively investigating the geographical changes of cancer
      risk either between 2 sexes with one neoplasia or between two neoplasias for each
      sex with the data of multiple local populations of Japan as well as of the world.
      Specific cancer death rates for 11 sites in 46 prefectures of Japan, 1969-1971,
      were used in the domestic study, and age-adjusted cancer incidence rates for the
      corresponding 11 sites in 40 selected cancer registration areas of the world were
      used in the international study. The relation between 2 cancer risks was analyzed
      by calculating a 1st order regression equation using log-transformed data sets.
      Results obtained are as follows: 1) both the domestic and international data sets
      confirmed positive correlations of a high degree between the male and the female
      cancer risks in 6 out of 7 cancer sites tested (esophagus, stomach, colon,
      rectum, liver and bladder). A positive intersex correlation was also observed in
      lung cancer with the international data, but not with the domestic one. It was
      indicated that the male and female populations of Japan as well as of the world
      were under the influence of a common risk modifier in the course of geographical
      changes of cancer risk for each of 6 neoplasias except lung cancer. 2)
      Intercancer correlation was lacking in 11 out of 23 cancer pairs in the domestic
      study, whereas all 22 intercancer correlations but one in the international study
      were found to be statistically significant. Further insight into the correlation
      data of the international study led to the conclusion that the observed
      combination of positive and negative correlation in the 22 cancer pairs were
      explainable in terms of the differential cancer risk changes of Western type and
      Non-Western type cancers due to the transition of life style between the Western
      extreme and the Non-Western extreme in the world. In contrast, a high proportion
      of non-correlations (11 out of 23 cancer pairs) and emergence of opposite or new
      correlations (3 out of 23 pairs) were observed in the domestic study, a finding
      which indicates that the domestic cancer risk modifier, as evidenced in the
      intersex correlation test, is site-specific, and is to be differentiated from the
      Westernization-sensitive cancer risk modifiers of the international
      study.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8352524
TI  - Differentiation of promyelocytic leukemia cells HL-60 induced by daidzein in
      vitro and in vivo.
AB  - We have screened more than one thousand synthetic and natural chemicals to
      explore differentiation inducers and found that daidzein has potent
      differentiation-inducing activity for human leukemia HL-60 cells, both in vitro
      and in vivo. In vitro study showed that daidzein at concentrations exceeding 10
      micrograms/ml caused inhibition of HL-60 cells; and it induced differentiation of
      the cells into granulocytic lineage as judged by NBT reduction activity,
      phagocytic ability and morphological characteristics. Flow cytometry study
      indicated that daidzein arrested HL-60 cells in the G1 phase. The growth of HL-60
      cells in the subrenal capsules of mice and in diffusion chambers implanted into
      the peritoneal cavities of mice was inhibited by 50 mg/kg daidzein. HL-60 cells
      treated with daidzein in vivo also exhibited characteristic morphological changes
      of matured cells. Moreover, the colony forming efficiency of HL-60 cells in
      diffusion chambers in mice was markedly inhibited by the administration of
      daidzein.

PMID- 8352523
TI  - Modulation of c-myc, c-myb, c-fos, c-sis and c-fms proto-oncogene expression and
      of CSF-1 transcripts and protein by phorbol diester in human malignant
      histiocytosis DEL cell line with 5q 35 break point.
AB  - Following exposure to phorbol ester (TPA), DEL cell line, a human malignant
      histiocytosis (MH) cell line, is able to differentiate along a macrophage
      phenotype and thus it provides a suitable model for analyzing the sequential and
      differential gene expression associated with monocyte/macrophage differentiation.
      C-myc, c-myb, c-fos, c-sis and c-fms expression were determined by Northern
      analysis at various times following TPA treatment. The results showed that TPA
      down-modulated the constitutive expression of c-myc, c-myb, and c-fms, mRNA to
      low but still detectable levels. Conversely, TPA-induced differentiation resulted
      in transient appearance of c-fos, whereas no change in the level of c-sis and
      actin transcripts were observed. Thus, the c-fms and c-sis genes appear to be
      regulated in a specific manner in this malignant histiocytosis derived cell line.
      Furthermore, these investigations demonstrated a constitutive CSF-1 gene
      expression which transiently increased at mRNA and also at protein level as
      evaluated by a murine bone marrow CFU bioassay. Through this drug-induced
      modulation, the DEL cell line offers an additional model for studying some of the
      subtle interrelations existing between a growth factor (CSF-1) and its receptor
      (c-fms) in the monocyte/macrophage system.

PMID- 8352525
TI  - A protein inhibitor, extracted from Hela cells, which recognises a cell surface
      protease on preneoplastic cells obtained from cervical smears.
AB  - Hela cells originate from a clone of cervical carcinoma cells. The cytoplasm of
      Hela cells contains a protein which recognises and inhibits a proteolytic enzyme
      (guanidino-benzoatase) on the surface of Hela cells. This same protease is
      present on the surface of abnormal epithelial cells obtained from cervical
      smears, enabling a rhodamine labelled inhibitor extracted from Hela cells to
      locate abnormal cervical cells in monolayer spreads.

PMID- 8352526
TI  - Association and dissociation of a protease and its inhibitor on the surface of
      lung squamous cell carcinoma cells.
AB  - Squamous cell carcinoma cells possess a cell surface protease, referred to as
      guanidinobenzoatase (GB). GB is a plasminogen-activator-like enzyme which can be
      located by the fluorescent probe 9-amino acridine in frozen sections.
      Fluorescence microscopy has been used to study the inhibition of this GB, the
      displacement of inhibitor from GB, the displacement of GB from the cell surface
      receptor and the preparation of both active GB and inhibitor, obtained from these
      frozen sections of tumour tissue.

PMID- 8352527
TI  - The application of double fluorescence to the rapid selection of atypical
      cervical epithelial cells spread in monolayers.
AB  - Monolayer spreads of cervical cells were prepared and reacted in sequence with
      two fluorescent probes. The nuclei were reacted with 4,6-Diamidino-2-phenylindole
      (DAPI), resulting in white fluorescence of all cell nuclei. Those cells
      possessing active guanidinobenzoatase (GB) bound the second probe, rhodamine
      alpha-N-agmatine (Rh-Agm), resulting in orange cell surface fluorescence.
      Atypical epithelial cells possessed both active GB and enlarged nuclei; such
      cells could easily be recognised by their cytological appearance. We illustrate
      our results in the form of colour prints which are representative of our
      observations of cells in both normal and abnormal cervical spreads.

PMID- 8352528
TI  - Regulatory role of mevalonate in the growth of normal and neoplastic human
      mammary epithelial cells.
AB  - Treatment with 25-hydroxycholesterol, an inhibitor of HMG CoA reductase activity,
      efficiently blocked the proliferation of both human normal mammary epithelial
      cells (HMEC) and breast cancer cells (MDA231). Upon release of the block there
      was a rapid increase in the HMG CoA reductase activity, which reached a maximum 4
      h after removal of the inhibitor, in both cell types. In MDA231 this increase in
      enzymatic activity was followed by a rapid initiation of DNA synthesis, whereas
      this process started considerably later in HMEC. Even in HMEC stimulated to DNA
      synthesis by insulin, there was first an increase in HMG CoA reductase activity
      with a maximum 4 h after the addition of the mitogen. If 25-hydroxycholesterol
      was added along with insulin, the subsequent initiation of DNA synthesis was
      prevented. Following a 25-hydroxycholesterol treatment as short as 4 h, the onset
      of DNA synthesis was delayed, indicating that a certain level of HMG CoA
      reductase activity (= mevalonate synthesis) in the early and mid stage of the
      prereplicative phase is required for the transduction of the signal leading to
      initiation of DNA synthesis. In concurrence with these data, it was also
      demonstrated that giving an exogenous supply of mevalonate to the insulin
      stimulated HMEC results in a faster initiation of DNA synthesis.

PMID- 8352529
TI  - IL-2 inhibits the induction of systemic antitumour immunity by IL-4 in the
      peritumoural treatment of experimental melanoma.
AB  - We have examined the relative abilities of interleukin-4 (IL-4) and interleukin-2
      (IL-2) to inhibit the growth of the B.16 melanoma in C57BL/6 mice. Tumours were
      allowed to become established and then treated peritumourally with either IL-4 or
      IL-2, or a combination of IL-4 plus IL-2. Treatment was continued for 7 days and
      then the tumours were removed and weighed. The results showed that IL-4 strongly
      inhibited tumour growth in 83% of individuals, but complete resolution was
      observed in only 18%. In the IL-2 treated groups, the percentage of growth
      inhibited tumours was markedly less (50%), with 14% complete resolutions. In the
      IL-4+IL-2 treated tumours resolution was again different, such that only 57% of
      tumours were smaller than those seen in the controls but there was a high number
      bearing no measurable tumour (25%). In addition, of the three treatments
      described, only peritumoural administration of IL-4 alone could mediate the
      induction of systemic protection from tumour growth. These results suggest that
      IL-4 and IL-2 have different mechanisms of action and that IL-2 may antagonise
      the effect of IL-4 such that the action of the two materials when combined is
      highly unpredictable.

PMID- 8352530
TI  - Differential influence of stromal fibroblasts from different breast tissues on
      human breast tumour cell growth in nude mice.
AB  - The influence of human stromal fibroblasts cultured from normal, non-malignant
      and malignant breast tissues on in vivo growth of human breast tumour cells was
      studied. Earlier appearance and increased incidence were observed when low cell
      inocula of breast MDA-MB 231 tumour cells were coinjected with fibroblasts from
      either normal or non-malignant mammary tissue. However, at higher cell
      inoculations the appearance of MDA-MB tumours was delayed while the incidence was
      reduced. Coinjected fibroblasts derived from breast tumours did not modify MDA-MB
      tumour growth. The tumourigenic MCF-7 and non-tumourigenic NPM14-T4/9 breast cell
      lines were not affected by the presence of normal breast fibroblasts. These
      results indicate that fibroblasts can influence the behavior of tumour cells in
      vivo but the effects depend on the type and the proportions of coinoculated
      cells.

PMID- 8352531
TI  - Expression of C-myc p62 oncoprotein in multiple myeloma: an immunohistochemical
      study of 180 cases.
AB  - The immunohistochemical expression of C-myc p62 oncoprotein was investigated
      using the immunoperoxidase method and the monoclonal antibody (Mab) MYC 1-9E10 in
      bone marrow paraffin sections. 180 cases of multiple myeloma (MM) were studied. C
      myc expression was found to correlate well with the grade of malignancy, type of
      myeloma and tumor cell burden (p < 0.001). A relationship was also observed
      between C-myc p62 and IgA-secreting myelomas. It was found that intermediate
      grade myelomas are heterogeneous as far as C-myc expression is concerned. Our
      findings strongly suggest that C-myc might be involved in myelomutagenesis. The
      evaluation of its expression in MM may be helpful in determining the grade of
      malignancy and possibly the biological behaviour of this tumor.

PMID- 8352532
TI  - Analysis of immunohistochemical results of the ras oncogene product p21 in
      myelodysplastic syndromes.
AB  - Mutation of the ras oncogenes is the most commonly detected molecular abnormality
      in acute myelogenous leukemia and myelodysplastic syndromes (MDS). This molecular
      event may either be acquired by different subclones or by all malignant cells.
      The availability of the ras p21 monoclonal antibody Y13 259 makes possible the
      direct study of the distribution of the ras gene product in human malignant
      cells. The bone marrow smears from 41 patients with MDS were analysed by two
      independent observers after treatment with MoAb Y13 259, biotinylated goat
      antirat IgG, streptavidin, peroxidase and staining with diaminobenzidine. A high
      proportion of strongly positive smears was found among patients with MDS. This
      positivity was found in 25% of refractory anemia, in 80% of the refractory
      anemias with excess of blasts, and in 90% of those in transformation, while all 7
      cases with chronic myelomonocytic leukemia were found positive. The percentage of
      positivity may suggest that activation of ras oncogene in associated with disease
      progression.

PMID- 8352533
TI  - Exclusion from mammographic screening of women genetically predisposed to breast
      cancer will probably eliminate mammographically induced breast cancer.
AB  - In this paper we present our view on the contribution of mammography examinations
      to breast cancer induction in patients with hereditary breast cancer
      predisposition. We contradict the usual reasoning that the benefits of early
      breast cancer detection outweigh the small number of induced breast cancers.
      Though this tenet is justified in the majority of women, yet in a small, readily
      identifiable group of hereditary effected women, radiation even in small doses
      may enhance oncogenesis. If this relatively small group of patients is barred
      from mammography and regularly screened with other means, mammography may even
      become a more safe procedure.

PMID- 8352534
TI  - Oncogenes in cellular immortalisation and differentiation (review).
AB  - Oncogenes have been shown to be able to overcome the limited proliferative
      capacity of normal mammalian cells in culture enforcing them to an immortalised
      phenotype, which in turn may act as a primary step in tumourigenesis. The
      oncogenes which display such immortalisation activity have the common feature of
      nuclear localisation, while the oncogenes which are capable of transforming cells
      are mainly cytoplasmic. Oncogenes from both families have been shown to interfere
      with the differentiation processes of several cell types. There is evidence that
      some of these proto-oncogenes may function as regulators of normal cell
      differentiation, and when immortalisation occurs this is a process of blocking
      the cell from achieving a differentiated state. This article focuses on the
      ability of some oncogenes with different functions, such as myc and ras, to
      override the limited cellular proliferative capacity and their effects on
      differentiation; finally it examines the recent implications that some onco
      suppressor genes are actively participating in cellular differentiation
      processes.

PMID- 8352535
TI  - Head and neck carcinoma with distant metastases: a retrospective analysis of 44
      cases treated with cisplatin-based chemotherapeutic regimens.
AB  - The rarity of medical reports on the chemotherapeutic management of head and neck
      cancer metastatic to distant organs prompted us to review the effect of cisplatin
      based regimens in this clinical setting. Out of 44 eligible patients, 10 patients
      (23%) achieved a CR, 16 patients (36%) has a PR, 7 (16%) no change, and 11 (25%)
      progressed. Patients with rhinopharyngeal carcinoma showed a 69% overall response
      rate, while those with other head and neck carcinomas had a 54% overall response
      rate. No preferential site of response was detected. The difference in mean
      survival of responding patients between the rhinopharyngeal group and the non
      rhinopharyngeal group was statistically significant (P < 0.05). Responding
      patients survived longer than non responders (P < 0.05 in both groups).
      Interestingly, 3 patients in the rhinopharyngeal cancer group survived more than
      2 years from the start of chemotherapy for metastatic disease. These data
      strengthen the observation that rhinopharyngeal carcinoma, even with distant
      metastases, responds to chemotherapy better than other carcinomas arising in the
      head and neck region. Moreover, although survival is still dismal, cisplatin
      based systemic chemotherapy seems an effective palliative treatment for
      metastatic head and neck cancer.

PMID- 8352536
TI  - Inhibition of antitumor effects of flavone acetic acid by cortisone.
AB  - The effect of cortisone (2 mg/mouse) on the effect of the antitumour agent
      flavone acetic acid (NSC 347512) was measured in four different murine tumours,
      growing subcutaneously. Response was measured by histological assessment of
      haemorrhagic necrosis after 24 h, and by assessment of tumour growth delay. In
      C57B1/6 x DBA/2)F1 hosts, cortisone pre-treatment prevented FAA-induced
      haemorrhagic necrosis in Lewis lung (sub-line LLTC) tumours but did not inhibit
      necrosis induction in Colon 38 tumours. Similarly in C3H/HeN mice, cortisone pre
      treatment prevented FAA-induced necrosis of Spon-2 and partially prevented
      necrosis induction in mammary M-16/C tumours. Since corticosteroids are often
      administered, or generated internally, in the course of clinical treatment, this
      result has implications for the clinical use of FAA and other compounds, which
      act on tumour vasculature as part of their antitumour action.

PMID- 8352537
TI  - Hepatic vascular lesions associated with malignant lymphomas.
AB  - Veno-occlusive disease is a serious complication of malignant conditions and
      often follows irradiation or is drug-induced. We report on the liver histology of
      a consecutive series of 32 cases of Hodgkin's and non-Hodgkin's lymphomas. Veno
      occlusive lesions were noted in 27 biopsies prior to treatment. These patients
      had no apparent malignant infiltrate to the liver. The pathogenesis of these
      lesions is unclear.

PMID- 8352539
TI  - Cell cycle related uptake, retention and toxicity of idarubicin, daunorubicin and
      doxorubicin.
AB  - Exponentially growing Molt-4 cells were separated by means of counterflow
      centrifugation into fractions enriched for cells in early G1, late G1, S, or G2+M
      phase of the cell cycle. Subsequently, cells were exposed for 2 h to Idarubicin
      (Ida, 0.02-0.15 microgram/ml). Daunorubicin (Dnr, 0.1-0.75 microgram/ml) or
      Doxorubicin (Dox, 0.1-0.75 microgram/ml). Drug uptake, measured by flow
      cytometry, increased progressively with cell cycle traverse from early G1-to M
      phase. The relative fraction of drug lost following an extensive wash procedure
      was 72% in case of Ida and 23% for Dnr and Dox and was independent of the cell
      cycle phase. Inhibition of DNA synthesis was determined by qualitative flow
      cytometric analysis of 5-iodo-2'-deoxyuridine (IdUrd) incorporation into DNA. The
      three drugs showed a similar gradual increase of inhibition of DNA synthesis from
      G1 to G2+M phase, demonstrating that cell cycle phase dependency of drug toxicity
      applies to all three anthracyclines studied.

PMID- 8352540
TI  - C-myc expression is down-regulated in mafosfamide-treated HL-60 cells undergoing
      apoptosis.
AB  - The expression of the proto-oncogene c-myc has been strongly implicated in the
      regulation of apoptosis. Since we have previously shown apoptosis to occur in HL
      60 leukemic cells exposed to the prodrug Mafosfamide (ASTA Z 7557), the present
      study was undertaken to examine the levels of c-myc mRNA transcripts in such
      cells. Mafosfamide, which is a cyclophosphamide derivative that rapidly generates
      4-Hydroperoxycyclophosphamide after aqueous dissolution, was employed in doses
      ranging from 0.1 to 20 micrograms/ml. No changes in c-myc mRNA levels were
      evident after 1 hour of exposure to Mafosfamide. After 6 and 24 hours of
      Mafosfamide-exposure, however, there was a dose- and time-dependent decrease in c
      myc transcripts. c-myc mRNA expression was reduced to a greater extent than was
      either beta-actin of GAPDH expression. Morphological, biochemical and
      ultrastructural evidence of apoptosis accompanied the Mafosfamide-induced c-myc
      mRNA down-regulation at 24 hours. We conclude that, in the context of Mafosfamide
      treated HL-60 cells, upregulation of c-myc mRNA transcription was not fundamental
      for the activation of the apoptotic cascade.

PMID- 8352538
TI  - Hypercalcemia of cancer: an update.
AB  - Hypercalcemia of cancer is due to secretion of substances with parathyroid
      hormone (PTH)-like activity from tumours of the respiratory, gastrointestinal and
      urogenital tract as well as hematologic malignancies and breast cancer. PTH
      related Protein (PTHrP) is secreted mainly from solid tumours and it has been
      recently recognized as being responsible for hypercalcemia mediated primarily via
      an increased renal reabsorption of calcium and secondly by an increased bone
      resorption. PTHrP-mRNA is expressed in a variety of normal tissues and has
      multiple physiologic and paracrine actions. Bone resorbing factors like the
      cytokines-lymphokines, interleukins, prostaglandins, TNF-alpha/TNF-beta, GM-CSF/G
      CSF, TGF-alpha and TGF-beta are produced by certain solid and hematologic cancers
      and have also been implicated in tumour-induced hypercalcemia. The recently
      introduced PTHrP antagonists are hopeful therapeutic measures for the future.

PMID- 8352541
TI  - The difference between benign and malignant tumours explained with the 4-mutation
      paradigm for carcinogenesis.
AB  - In recent years a 4-mutation paradigm for carcinogenesis was developed for
      mutations in tumour suppressor genes. The major tenet of this paradigm is that
      transformation of a normal cell into a malignant cell is the result of an
      accumulation of a set of 4 specific cancer mutations. In this paper we show that
      this paradigm can explain the characteristic differences between benign and
      malignant tumours. We surmise that benign tumour cells are due to 2 or 3 specific
      cancer mutations, whereas malignant tumour cells contain 4 specific cancer
      mutations and 1-3 tumour progression mutations. The following characteristics,
      essential for differentiating benign and malignant tumours, are explained by our
      paradigm: (a) differentiation--anaplasia, (b) rate of growth, (c) encapsulation-
      invasion, (d) metastasis, and (e) the differences in size of benign epithelial
      and mesenchymal tumours and the relation between tumour size and malignancy.

PMID- 8352542
TI  - Subcutaneous mastectomy with axillary dissection for early breast cancer.
AB  - From 1983 to 1990, subcutaneous mastectomy with axillary dissection was carried
      out for 46 patients with early breast cancer including three bilateral breast
      cancer patients (four breasts). Cancer cells were recognized histopathologically
      in the resection margins of small mammary gland resting under the nipple in four
      cases, and the remaining 42 cases underwent a curative resection. Multicentric
      lesions were found out histopathologically by continuous sections in five cases
      (six breasts). There was no difference in the prognosis using the case-control
      comparison method between 34 patients with ipsilateral invasive carcinoma who
      underwent a subcutaneous mastectomy in this study group and 34 patients who
      underwent a radical or modified radical mastectomy in the control group. Cosmetic
      results of the subcutaneous mastectomy were evaluated in 37 patients, and 9 were
      excellent, 17 were good, 9 were not so good and 2 were poor. Subcutaneous
      mastectomy with axillary dissection was an effective operation for early breast
      cancer including multicentric lesions and some non-invasive ductal carcinomas
      from the prognostic and cosmetic standpoints.

PMID- 8352543
TI  - Prospective malignancy grading, flow cytometry DNA-measurements and adjuvant
      chemotherapy for invasive squamous cell carcinoma of the uterine cervix.
AB  - In a prospective study comprising 310 consecutive patients with carcinoma of the
      cervix, FIGO stages I-IV, the prognostic significance of clinical and flow
      cytometric variable was evaluated in a univariate and multivariate analysis. The
      parameters studied included stage according to FIGO, age, histopathologic grade
      according to Ackerman and MGS scores, DNA ploidy, S-phase fraction as well as
      treatment with radiation only, surgery only or a combination thereof as well as
      adjuvant chemotherapy. Univariate analysis showed that patients in FIGO stages IA
      IIA with MGS up to 14 points survived significantly better than other groups. MGS
      parameter mitosis, vascular invasion and type of invasion predicted survival as
      did clinical stage. Diploid cases with SPF > 15% survived less than remaining
      other cases. Multivariate analysis not including treatment indicated that FIGO
      stage and diploid cases with SPF > 15% predicted survival but not total MGS score
      and age. When treatment for FIGO stages IA-IIA was included, elderly women had a
      worse prognosis. Adjuvant chemotherapy, surgical alone or radiation alone did not
      demonstrate any differences within groups. In Figo stages IIB-IV, cases with
      radiotherapy only survived significantly better than patients with other
      treatment schedules. The frequency of low malignancy patients (< MGS 16) in
      relation to year of initial diagnosis was found to have decreased between years
      1967 and 1988, probably as a result of screening activities.

PMID- 8352544
TI  - Cancer control by family history.
AB  - Family history can be used to identify persons at high cancer risk and to target
      appropriate preventive and therapeutic measures. First-degree female relatives of
      women with breast cancer (n = 600) are at increased risk for breast cancer (RR:
      1.7.95% CI: 1.4-1.9). First-degree relatives of colorectal cancer patients (n =
      184) are at increased risk for colorectal cancer (RR: 1.8.95% CI: 1.4-2.3).
      Families with hereditary cancer syndromes are identified. The family history
      approach can be used in every part of the world, and it should become a part of
      future cancer control activities.

PMID- 8352545
TI  - Antitumor activity of homo-aza-steroidal esters of p-N, N-bis(2
      chloroethyl)aminophenoxyacetic acid.
AB  - The homo-aza-steroidal esters of carboxylic derivatives of N, N-bis (2
      chloroethyl) aniline are reviewed. In particular, we discuss the antitumor
      activity of the esters of homo-aza steroids in which the p-N,N-bis(2
      chloroethyl)aminophenoxyacetic acid is linked to the C-3 or C-17 position, while
      the lactam nucleus is linked to the D or A ring of the modified steroid
      respectively. The current literature indicates clearly that the potential of
      these esters is due to the synergistic activity of both the lactam and the p-N,N
      bis(2-chloroethyl)aminophenoxyacetic acid.

PMID- 8352546
TI  - Growth characteristics of murine B16 melanoma multicellular spheroids: a model
      for invasion and effects of doxorubicin treatments.
AB  - Multicellular spheroids, derived from murine B16 melanoma cells, showed unique
      growth characteristics: when they reached about 500 microns in diameter, their
      morphology changed rapidly and they became amoeba-like irregular-shaped
      aggregates. This morphological characteristic closely resembled that of invasive
      cancer, and may serve as a model for local invasion. To test the possibility that
      the changes mentioned above can be inhibited by a drug, spheroids were treated
      with 0.8 microgram/ml of doxorubicin for one hour and their morphology was
      observed temporally. Although this concentration of the drug decreased the
      survival of the melanoma cells in monolayer to about 10(-3), the growth was not
      delayed nor were the "invasion"-like changes inhibited in the spheroids. We
      believe this system of multicellular spheroids is a useful model to study the
      mechanisms of tumour invasion, although doxorubicin could not inhibit "invasion"
      like changes in this system.

PMID- 8352547
TI  - Different chemo- and endocrino-sensitivity of MCF-7 cells with or without
      estradiol supplement in vitro.
AB  - The sensitivity of MCF-7 cells to tamoxifen (TAM) and mitomycin C (MMC) was
      assessed in rapidly and slowly growing cells with or without estradiol
      supplementation, respectively. The growth of MCF-7 was inhibited by MMC in a
      concentration-dependent manner with or without estradiol (E2) supplementation.
      Preincubation with MMC suppressed subsequent E2 stimulated growth of MCF-7. TAM
      inhibited the growth of MCF-7 supplemented with E2 and preincubation with TAM
      prevented subsequent E2 stimulated growth of MCF-7. However, TAM did not inhibit
      the growth of MCF-7 cells in E2 free medium. These results suggested that MMC may
      be more effective than TAM on breast cancer cells in the dormant or slow-growth
      phase.

PMID- 8352548
TI  - Mechanism for splenocyte-mitogenesis induced in mice by water-extract of
      coniferous slash pine.
AB  - A water extract of wood chips of coniferous slash pine induced appreciable
      splenocyte-mitogenesis in healthy adult, aged, and also tumour-bearing mice.
      Mitogenesis was induced mainly in B-cell subset of splenocytes. The induction was
      not mediated by IL-2 or IFN gamma released from the activated helper T-cell. It
      may be worth noting that this extract could be included in a new type of
      immunomodulator for promotion of the host defense mechanism.

PMID- 8352549
TI  - Prognostic factors affecting response to aminoglutethimide in advanced breast
      cancer.
AB  - An analysis of 122 patients with advanced breast cancer treated with
      aminoglutethimide was carried out. Forty-one patients (34%) achieved a complete
      response or partial response (CR + PR), while 81 patients (66%) remained stable
      or progressed (S + P). A number of variables were analyzed for their prognostic
      importance in terms of response to aminoglutethimide. These variables were
      dominant site of metastases, disease-free survival, estrogen receptor status,
      age, response to prior tamoxifen, response to chemotherapy administered for
      metastatic disease, and dose of aminoglutethimide. The most important factors in
      predicting response were found to be prior response to tamoxifen and a longer
      disease-free survival after diagnosis.

PMID- 8352550
TI  - Inhibition of phospholipase D by agents that inhibit cell growth.
AB  - The phospholipases are an important class of enzymes for growth factor and
      oncogene intracellular signalling. The anti-tumor drug suramin was found to
      inhibit phosphatidylcholine hydrolysis and trans-phosphatidylation by solubilized
      rat brain phospholipase D (PLD) with an IC50 of 15 microM. An azo analogue of
      suramin, which is a considerably more potent inhibitor of phosphatidylinositol
      phospholipase C (PIPLC) than suramin, inhibited PLD with and IC50 of 58 microM. D
      609, a xanthogenate compound with in vitro antitumor activity, inhibited PLD with
      an IC50 of 820 microM. The cytotoxic aminosteroid compound U-73, 122 was a weaker
      inhibitor of PLD with an IC50 of 78 microM. However, U-73, 122 was a more potent
      inhibitor of PLD in fibroblast membranes with an IC50 of 25 microM, while suramin
      was less active with an IC50 of 4.2 mM. The antitumor ether lipid drug ET-18-OCH3
      did not inhibit solubilized or membrane PLD although it is a potent inhibitor of
      PIPLC. The results of the study show that the compounds tested have different
      abilities to inhibit PIPLC and PLD. Access of hydrophilic drugs to membrane PLD
      may be a limiting factor to their inhibitory activity.

PMID- 8352551
TI  - Development, characterization and application of an antibody against 5-fluoro
      2'deoxyuridine-5'monophosphate, the active metabolite of 5-fluorouracil.
AB  - 5-Fluoro-2'-deoxyuridine-5'-monophosphate (FdUMP) is the active metabolite of the
      anticancer agent 5-fluorouracil (5FU). Antibodies against a conjugate of
      thyroglobulin with acetylated FdUMP were raised in 4 rabbits. The maximal titer
      was reached after 3-5 boosters. Subsequently, the antisera were collected and
      partially purified. In a competition assay a 100-fold excess of the natural
      nucleotide dUMP could displace tritiated FdUMP (20 pmol per assay) by about 50%
      in all antisera. However, tritiated dUMP itself did not bind to the antibody. No
      cross-reactivity was observed with the FdUMP precursor 5FU and with the natural
      nucleoside uridine and the nucleotides dTMP, dTTP and UTP. A considerable cross
      reactivity was observed with the monophosphate of bromodeoxyuridine (Br-dUMP).
      Radio-immuno assays for FdUMP and dUMP were developed, for which a 100-fold
      dilution could be used. The FdUMP assay was linear in a range of 0.1 to 5 pmol
      FdUMP in aqueous solutions. Tumour samples contained a non-identified interfering
      factor; a similar interference was observed in an enzyme based assay for FdUMP.
      The dUMP assay was performed by competition of unlabeled dUMP with tritiated
      FdUMP and was linear from 50 to 2000 pmol dUMP per assay. The antibody recognized
      FdUMP bound in a ternary complex synthesized in a cell-free system between FdUMP,
      its target enzyme thymidylate synthase and the folate co-factor.
      Immunohistochemical staining for demonstration of the ternary complex in 5FU
      treated cells and tumours from patients and animals was not yet successful,
      neither with peroxidase nor with immunofluorescence staining. Possibly the amount
      of bound FdUMP is below the detection limit or FdUMP bound to TS is masked. The
      antibody may prove to be useful in studies on modulation of FdUMP and dUMP after
      treatment with thymidylate synthase inhibitors.

PMID- 8352552
TI  - A preliminary pharmacokinetic evaluation of the antimetastatic immunomodulator
      swainsonine: clinical and toxic implications.
AB  - The pharmacokinetics of swainsonine (SW) was investigated in mice after
      intravenous administration of 3 micrograms/ml. The time course of SW blood levels
      followed a three-compartment open pharmacokinetic model which consisted of
      biphasic distribution, and a rapid elimination phase (terminal half-life, 31.6
      min). After completion of the distribution, SW was widely distributed to the
      extravascular space (Vss, 22ml; Vd, 33ml). Free fractions of this substance were
      indistinguishable from unity, indicating little or no protein binding. The rate
      limiting step in the elimination of SW from the body appears to be the slow
      return from the deep compartment into the central one. Accordingly, SW blood
      levels may be low and yet significant amounts of this agent may be present in
      different body organs and tissues. A comparison of SW tissue levels indicates
      that the highest amounts appeared in the bladder, kidney, and thymus, (3.8 0.5,
      and 2.2 nmoles/g wet wt) with the lowest levels consistently appearing in the
      brain (< 0.1 nmoles/g wet wt). Hence, this study suggest that: 1) SW has high
      affinity for the thymus, which is in part consistent with its previously
      published immunomodulatory action; 2) SW should be infused for at least 2 1/2 hrs
      for its concentration to approach a plateau (this is based on the short half-life
      of SW and its time to steady state); and 3) CNS toxicity may be dose-limiting and
      not be present at SW levels preventing metastasis.

PMID- 8352553
TI  - Cytogenetic changes in 67 cranial and spinal meningiomas: relation to
      histopathological and clinical pattern.
AB  - The cytogenetic analysis of 67 meningiomas (58 intracranial and 9 spinal tumors)
      identified chromosomal abnormalities in 63% of cases. When chromosomes involved
      in numerical and structural changes with a frequency of more than one standard
      deviation above the mean were considered, distinct cytogenetic patterns could be
      identified according to sex, anatomical location and histology. The chromosomes
      more frequently affected were 1, 2, 3, 4, 8, 14, 15, 19, 22, Y. No conclusion
      could be drawn regarding the prognostic significance of these karyotypic
      alterations.

PMID- 8352554
TI  - The expression of genes of the steroid-thyroid hormone receptor superfamily in
      central nervous system tumors.
AB  - We studied the expression of ten genes (encoding the receptors for
      glucocorticoid, mineralocorticoid, progesterone, androgen, estrogen, thyroid,
      retinoid acid, vitamin D) belonging to the steroid-thyroid hormone receptor
      superfamily (STRS) in 12 neuroepithelial tumors, 12 meningiomas and 2 human
      glioblastoma cell lines. Our method, based on the polymerase chain reaction,
      allowed the simultaneous amplification of cDNAs of the STRS genes. On average, 7
      STRS genes were simultaneously expressed in each sample. Our study indicates that
      many STRS gene are commonly co-expressed in human CNS tumors. The importance of
      our results for the ongoing and proposed hormonal treatment trials is discussed.

PMID- 8352555
TI  - Pathological features and pyrimidine nucleotide synthesis in human gastric
      carcinomas.
AB  - 5-Fluorouracil, a potent anticancer drug, is clinically known to be more
      effective on a poorly differentiated gastric carcinoma than on a well
      differentiated type. We investigated activities of thymidylate synthetase (TS)
      and thymidine kinase (TK) involved in de novo and salvage pathways, respectively,
      for pyrimidine nucleotide synthesis and histological features in 57 human gastric
      carcinomas. The average activities of TS in 28 poorly differentiated carcinomas
      and TK in 29 well-differentiated type were significantly increased to 128 and
      166%, respectively, of those in normal gastric mucosa. The TK/TS ratio in the
      well-differentiated type was 1.7-fold higher than that in the poorly
      differentiated type. Therefore, the de novo pathway for pyrimidine nucleotide
      synthesis is so predominant in a poorly differentiated carcinoma, but not in a
      well-differentiated type, that the potent TS inhibitor 5-FU or its derivatives
      are suggested to suppress the growth of the poorly-differentiated gastric
      carcinoma.

PMID- 8352556
TI  - Potentiating effect of amphotericin B on five platinum anticancer drugs in human
      cis-diamminedichloroplatinum (II) sensitive and resistant ovarian carcinoma
      cells.
AB  - We have determined an effect of amphotericin B (AMB), an antifungal drug, on the
      cytotoxicity of cis-diamminedichloro-platinum (II) (CDDP) and 4 CDDP analogues in
      a human ovarian carcinoma cell line (NOS2). Intracellular accumulation of CDDP
      was elevated significantly by treatment with AMB, and AMB significantly
      potentiated the cytotoxicity of CDDP by MTT assay. Intracellular accumulation of
      4 CDDP analogues was also elevated by the treatment with AMB and the order of
      increasing accumulation rate of platinum drugs was consistent with that of dose
      modification factor (DMF). AMB also increased the intracellular CDDP accumulation
      in CDDP resistant cells (NOS2CR), derived from NOS2. The intracellular
      accumulations of 4 CDDP analogues were elevated slightly by the treatment with
      AMB in NOS2CR cells. DMFs of 5 platinum drugs in NOS2CR cells, however, were more
      than those in NOS2 cells. These results indicate that AMB sensitizes NOS2 and
      NOS2CR cells to platinum drugs, partially due to the increasing intracellular
      accumulation of these drugs. In addition, CDDP analogues are more effective in
      NOS2CR cells than CDDP, but the cytotoxicity of CDDP was most potentiated by AMB
      among the 5 platinum drugs under study.

PMID- 8352557
TI  - Complex chromosomal changes in a primary squamous carcinoma of the parotid gland.
AB  - The chromosomal observations in a cultured primary epidermoid carcinoma of the
      parotid gland are reported. The tumour had a flat hyper-triploid mode with 7
      recurrent wholly or partially identified marker types and 7-13 additional, mostly
      recurrent, markers, whose origin could not be clarified. There were also many
      recurring numerical deviations in most tumour cells. The picture was consistent
      with a neoplasma in an advanced stage of chromosomal progression. So far, 6q
      markers with varying morphology are the only deviations found in most types of
      malignant salivary tumours and, in particular, in a high percentage of adenoid
      cystic carcinomas. One possible explanation for these observations is the
      occurrence of one or more suppressor genes in 6q which may have relevance for
      malignant neoplasia in salivary gland tissues.

PMID- 8352558
TI  - A metastatic orthotopic-transplant nude-mouse model of human patient breast
      cancer.
AB  - We report here the development of an orthotopic-transplant model of human patient
      breast cancer in nude mice. Histologically-intact patient breast tumor tissue was
      transplanted as intact tissue to the mammary fat pad of nude mice where the tumor
      tissue grew extensively and metastasized to the lung. This is the first
      orthotopic-transplant metastatic model of human breast cancer. The potential
      clinical and basic-science uses of the model are discussed.

PMID- 8352559
TI  - Evaluation of oral aclarubicin treatment for tumors of the gastrointestinal
      track.
AB  - Aclarubicin (ACR), a drug useful for the treatment not only of tumors of the
      hematopoietic system but also of those of the gastrointestinal tract, has been
      administered invariably by the intravenous route. We attempted oral
      administration of ACR to increase its specificity in the treatment of
      gastrointestinal tumors. Oral administration resulted in a much higher intratumor
      concentration but lower peripheral blood cell or bone marrow cell concentration
      of the drug as compared with intravenous administration. The reduced peripheral
      cell inhibition and bone marrow suppression permits the administration of the
      drug in higher doses, and the absence of the drug in the plasma suggests a
      reduced likelihood of myocardial cell injury and hepatocyte impairment. These
      favorable findings are considered to warrant early clinical trial of the
      treatment.

PMID- 8352560
TI  - Induction of NK-like activity in T cells by IL-2/anti-CD3 is linked to expression
      of a new antitumour receptor with specificity for acetylated mannose.
AB  - The generation of MHC-unrestricted cytotoxicity of highly enriched human CD3+ T
      cells (95-99%) by treatment with IL-2 and/or anti-CD3 antibodies was studied. T
      cells obtained by positive immunomagnetic sorting (anti-CD3) developed comparable
      specific cytotoxicities against K562 and Daudi cells when cultured with IL-2 and
      anti-CD3 for 96 h (80% of donors; n = 25). This increase of MHC-unrestricted
      cytotoxicity correlated fairly well with an increased formation of T cell/tumour
      cell conjugates. Moreover, simultaneous expression of a rhamnogalacturonan
      binding receptor on activated T cells could be demonstrated. Rhamnogalacturonan
      was reported to enhance cytotoxicity of CD56+ NK cells by effector cell/target
      cell bridging. Untreated CD3+ cells hardly reacted with rhamnogalacturonan and IL
      2-activated T cells showed only a moderate enhancement of cytotoxicity in the
      presence of rhamnogalacturonan. However, when CD3+ T cells had interacted with
      anti-CD3 antibodies during cell-sorting or during subsequent culturing with IL-2,
      enhancement in cytotoxicity and increased formation of lytic effector cell/tumour
      cell conjugates in the presence of rhamnogalacturonan could be readily
      demonstrated, indicating a bridging effect analogous to CD56+ NK cells. The
      conjugate formation of activated T cells with tumour cells as well as the
      additional rhamnogalacturonan-mediated bridging must be based on the expression
      of receptors with acetyl mannose specificity, since enhancements of MHC
      unrestricted T cell cytotoxicity and conjugate formation were inhibited in a dose
      dependent manner when acetylated mannose was present in the assays.

PMID- 8352561
TI  - Effect of promegestone, tamoxifen, 4-hydroxytamoxifen and ICI 164,384 on the
      oestrone sulphatase activity of human breast cancer cells.
AB  - In the present study, we explored the effects on sulphatase activity by
      Promegestone (R-5020), Tamoxifen (TAM), 4-hydroxytamoxifen (4-OH-TAM) and ICI
      164,384 in the T-47D hormone-dependent and MDA-MB-231 hormone-independent mammary
      cancer cell lines. Using homogenates of these cells it was observed that
      Promegestone has a significant effect on the inhibition of oestrone (E1)
      sulphatase activity. As this effect is competitive, it is suggested that there is
      a direct action of this compound on the enzyme. Tamoxifen has very little or no
      effect, 4-hydroxytamoxifen has an intermediate effect and ICI 164,384 is active
      in the enzyme inhibition, particularly with MDA-MB-231 cells. The present data
      could open new possibilities for human breast cancer treatment, as sulphatase is
      very active in the first step of the conversion of oestrone sulphate (E1S) to
      oestradiol (E2), and oestradiol is one of the principal carcinogenic factors in
      human hormone-dependent breast cancer.

PMID- 8352562
TI  - Mode of action of estra-1,3,5(10)-triene-3, 17 beta-diol, 3-benzoate, 17[4-[4
      [bis(2-chloroethyl)amino]phenyl]-1-oxobutoxy] acetate] (KM2210) on MCF-7 human
      breast tumours transplanted into nude mice.
AB  - KM2210 is a benzoate of an estradiol-chlorambucil conjugate with three active
      metabolites, KM2202, estradiol (E2) and chlorambucil (CBL). The mode of action of
      this compound was assessed using MCF-7 human breast tumours transplanted into
      nude mice. The growth of MCF-7 in nude mice was inhibited by KM2210 and enhanced
      by E2, although the serum levels of E2 in nude mice treated with KM2210 and E2
      were similar. The antitumour activity of CBL was completely blocked by extrinsic
      E2, while KM2210 suppressed the growth of MCF-7 in spite of the presence of E2 in
      the serum of tumour-bearing nude mice. KM2210 and KM2202 suppressed the
      expression of cytosol estrogen receptor (ER) of MCF-7 cells detected by the
      dextran-coated charcoal and fluorescent E2 staining method, although CBL did not
      affect the ER expression of MCF-7 cells. This inhibitory effect of KM2210 on ER
      was also corroborated by the fact that the pretreatment with KM2210 prevented the
      E2-stimulated growth of MCF-7 in nude mice. These results indicated that one of
      the effects induced by KM2210 is the blockage of ER expression in combination
      with the alkylating antitumour activity of CBL. KM2210 is thought to be a
      promising agent with unique modes of action for ER-positive breast carcinomas.

PMID- 8352563
TI  - Lack of influence of c-Ha-ras expression on the drug sensitivity of human bladder
      cancer histocultured in three-dimensions.
AB  - The mechanism of drug resistance in human cancers is complex. In addition to
      overexpression of a series of multiple-drug-resistance genes, there has been the
      suggestion that the Ha-ras gene may participate in conferring resistance. In this
      study, a series of three human-bladder carcinoma cell lines were studied, one
      parental type, one transfected by wild-type Ha-ras and another transfected by
      mutant Ha-ras. The ras gene was overexpressed in the latter two cell lines which
      also were more invasive than the parental when injected as individual cells in
      the nude-mouse bladder. The results described here have indicated that the ras
      gene expression level or mutational status did not affect drug resistance when
      the tumor lines were histocultured as three-dimensional tissue on collagen-sponge
      gels. The drug-response spectrum of the histocultured lines qualitatively
      reflected a clinical experience although all lines were relatively drug
      resistant, possibly reflecting their three-dimensional configuration in culture.

PMID- 8352565
TI  - Metabolism of new anticancer oxysterol derivatives in rats.
AB  - New water soluble derivatives of oxysterols--the phosphodiesters of oxysterols
      and of nucleosides--have been synthesized. In vitro, these compounds share the
      biological properties of their parent oxysterols. Furthermore, they display
      anticancer activity when injected i.p. in mice bearing experimental tumors. The
      pharmacokinetic study described here proved that the water-soluble derivatives of
      oxysterols act as prodrugs releasing free oxysterol in the blood, the liver and
      the kidney after i.p. or i.v. injection in rats. The hydro-solubility of such
      compounds as well as their slow metabolism into the active principle could
      account for their biological activity and make them suitable as new therapeutic
      agents.

PMID- 8352564
TI  - Inhibition of DNA repair in cells treated with a combination of alkylating
      agents.
AB  - Aphidicolin (AP) or hydroxyurea (HU) inhibited DNA repair and enhanced
      cytotoxicity in human ovarian carcinoma cells A2780 treated with L-phenylalanine
      mustard (L-PAM) combined with cisplatin or thioTEPA, and in the cells treated
      with cisplatin combined with thioTEPA. In cultures treated with L-PAM or
      cisplatin alone post-treatment with AP or HU had no effect on DNA repair and
      produced only additive cytotoxicity. Post-treatment with AP + HU inhibited DNA
      repair and enhanced cell killing in cultures treated with L-PAM alone. The
      inhibitor of protein synthesis cycloheximide protected cells from the
      cytotoxicity of AP + HU but had no effect on synergistic cell killing produced by
      DNA repair inhibition. In cisplatin-resistant cells A2780/CP post-treatment with
      AP + HU enhanced the cytotoxicity of L-PAM, but not of cisplatin. However, in
      resistant cells treated with cisplatin combined with L-PAM or thioTEPA DNA repair
      inhibitors decreased IC90 of cisplatin. Treatment of cells with two alkylating
      agents enhanced the sensitivity to DNA repair inhibitors and eliminated low
      sensitivity to inhibitors of repair associated with drug resistance.

PMID- 8352566
TI  - The reversal of multidrug resistance in cancer (review).
AB  - A brief review of the "state of the art" (1992) knowledge concerning various
      strategies and tactics to overcome multidrug resistance is presented. Multidrug
      resistance remains the main obstacle to long-term successful cancer chemotherapy;
      its prevention or elimination is probably one of the most promising avenues in
      cancer research.

PMID- 8352567
TI  - Effects of serine protease inhibitor FOY-305 and heparin on the growth of
      squamous cell carcinoma.
AB  - Effects of serine proteinase inhibitor FOY-305 and heparin on autochthonous skin
      carcinoma were examined using ddY female mice with single tumor induced by
      methylcholanthrene. FOY-305 given intraperitoneally for 9 consecutive weeks
      inhibited the growth of the pre-existing dermal tumors. Heparin alone was equally
      therapeutically effective. However, heparin induced severe mucocutaneous bleeding
      of the gastrointestinal mucosa. In contrast, the combined administration of FOY
      305 and heparin suppressed tumor growth without any visible side effects. There
      was a significant increase in well differentiated cancer cells in mice treated
      with FOY-305 and heparin in combination, suggesting that co-administration of FOY
      305 and heparin may be useful for the treatment of squamous cell carcinoma.

PMID- 8352568
TI  - Difluoromethylornithine and ethylglyoxal bis(guanylhydrazone) as inhibitors of
      human renal carcinoma cell proliferation and polyamine metabolism.
AB  - The significance of the polyamines putrescine, spermidine and spermine for the
      neoplastic proliferation of the human renal carcinoma cell line ACHN was
      investigated. For this purpose cells were cultured in vitro for 4 days with or
      without the addition of pathway inhibitors of polyamine biosynthetic enzymes. It
      was found that treatment of ACHN cells with the specific ornithine decarboxylase
      (ODC) inhibitor difluoromethylornithine (DFMO) resulted in profound decreases of
      ODC activity, polyamine content and cell proliferation rates along with a
      compensatory increase in S-adenosylmethionine decarboxylase (SAMDC) activity.
      Ethylglyoxal bis(guanylhydrazone) (EGBG), a SAMDC inhibitor, evoked a similar
      reduction of cell proliferation and contents of spermidine and spermine. EGBG
      also seemed to stabilize SAMDC, as evidenced by a highly enhanced SAMDC activity
      during enzyme assays in the absence of the inhibitor. Furthermore, EGBG treatment
      caused on activation of ODC and a subsequent build-up of putrescine. The impact
      on polyamine contents and proliferation rates were synergistic when the
      inhibitors were used in combination. None of the inhibitors alone exerted a
      cytocidal activity. It is concluded that polyamines may be implicated in the
      regulation of the neoplastic proliferation of cultured human renal carcinoma
      cells and that polyamine synthesis inhibitors may prove valuable in clinical
      treatment of this disease.

PMID- 8352569
TI  - Effect of duration of exposure to S9788, cyclosporin A or verapamil on
      sensitivity of multidrug resistant cells to vincristine or doxorubicin.
AB  - In order to explain the high potency of S9788, a new multidrug resistance
      modifier currently in clinical development, we investigated its accumulation and
      retention in sensitive and resistant cells. Our results show that S9788 is 13
      fold more accumulated and 23-fold more retained than VRP in the resistant S1/tMDR
      cell line. We also studied the effect of duration of incubation on the ability of
      S9788, verapamil and cyclosporin A to overcome the resistance of S1/tMDR and KB
      A1 cells to a short exposure of doxorubicin or vincristine. Compared to a single
      co-incubation of 4 h, a 24 h post-incubation with 5 microM S9788 markedly
      increased the reversal of S1/tMDR resistance to VCR (fold reversal 4 h = 123;
      fold reversal 24 h = 4739), while it moderately increased S1/tMDR sensitivity to
      DOX (fold reversal 4 h = 1.9; fold reversal 24 h = 2.9). Similar results were
      obtained on KB-A1 resistance to VCR (fold reversal 4 h = 41, fold reversal 24 h =
      21819) and KB-A1 resistance to DOX (fold reversal 4 h = 89; fold reversal 24 h =
      160). This phenomenon also occurred with verapamil and cyclosporin A. These
      results clearly show that the effect of duration of exposure on the modulating
      activity of S9788 and of the 2 other modulators depends on the cytotoxic drug.
      Although the direct transposition of these results to a clinical situation is
      difficult, they suggest that a continuous infusion of S9788, starting
      simultaneously with the administration of the cytotoxic drug and ending 24 h
      later, might be a more effective schedule for clinical administration than a
      bolus administration.

PMID- 8352570
TI  - [Male impotence. An introduction].

PMID- 8352571
TI  - [Flaccidity and erection of the human penis: morphological data].
AB  - Erection of the human penis, a simple and at the same time complex phenomenon,
      requires the involvement of numerous sustaining mechanisms. This paper presents a
      summary of the morphological research work done by the author, mainly concerning
      the mechanisms regulating the blood flow distribution in the arteries and veins,
      the arteriovenous anastomoses, the two corpora cavernosa of the penis with their
      tunica albuginea, the urethral corpus spongiosum, the capsular membrane which
      envelopes the latter, and finally the paraurethral glands. Although it is true
      that the primary mechanism of penile erection is represented by the central and
      peripheral nervous system, it must not be forgotten that the basis for this
      phenomenon consists of the structures of the corpora cavernosa of the penis as
      well as all of the other penile morphological structures.

PMID- 8352572
TI  - [Erection disorders: the value, significance and limits of various examinations].
AB  - Erection, a complex physiological phenomenon, is the result of numerous
      simultaneously interacting mechanisms. A defect of one of these mechanisms can
      induce erectile dysfunction. In this paper, the authors define the various tests
      used to investigate the principal pathways governing erection, taking into
      account their respective value in view of the increasing pressure of budget
      restrictions on health systems.

PMID- 8352573
TI  - [Neurologic and neurophysiologic studies of impotent patients].
AB  - A multispeciality approach of impotent patients are necessary to establish the
      cause of impotence. Neurological history and examination are very important and
      must be completed by neurophysiological investigations. Bulbo-cavernosus reflex,
      conduction velocity of the dorsal nerve of penis and pudendal evoked potentials
      seems the most interesting tests. Urodynamics, perineal EMG, penile vibratory
      sensibility test can help determination of some peripheral neuropathies. Single
      potential analysis of cavernous electric activity may be useful in diagnosis of
      pudendal autonomic dysfunction.

PMID- 8352574
TI  - Single potential analysis of cavernous electrical activity (SPACE). Experiences,
      limitations and perspectives.
AB  - Cavernous electromyography was first introduced by Wagner and Gerstenberg in
      1989. The authors developed a refined method of cavernous electromyography by
      means of single potential analysis in introduced this method into clinical
      Urology as a diagnostic procedure for the evaluation of patients presenting with
      erectile dysfunction. To date, our experience with single potential analysis of
      cavernous electrical activity (SPACE) includes more than 500 patients with
      erectile dysfunction of various etiologies and 92 normal control subjects.
      Several technical modifications and refinements have been adopted during the last
      4 years. In normal control subjects, SPACE shows a regular pattern of activity
      with long phases of electrical silence at the usual amplification interrupted by
      synchronous low frequency, high amplitude potentials. In patients with disruption
      of the peripheral autonomic supply, typical asynchronous potentials with higher
      frequencies and irregular shape are observed. In complete spinal cord lesions,
      abnormal as well as normal electrical activity is found. In patients with a long
      history of insulin-dependent diabetes and presumably cavernous smooth muscle
      degeneration, SPACE recordings show irregular potentials with low amplitudes and
      slow depolarization speed. Synchronization of electrical activity is usually
      absent. Recent studies on patients with venous leakage show that SPACE provides
      independent clinical information about the cavernous smooth musculature. The
      recording of cavernous electrical activity is possible and reproductible. In the
      future, a new software for one-line date processing, storage and interpretation
      of SPACE signals will be available.

PMID- 8352575
TI  - [Revascularization of the penis in cases of male impotence of vascular origin].
AB  - In arteriogenic erectile dysfunction, representing about 80 percent of all
      organic forms of impotence, a purely arteriogenic impotence is distinguished from
      a venous leakage. The former can be treated with promising results by means of
      arterial revascularization. In this respect it is worth mentioning that this form
      of impotence may also occur following pelvic surgery. Furthermore, diabetes
      mellitus at an early stage may be responsible for erectile dysfunction. A venous
      leakage, however, is not a disease of the veins but of the cavernous tissue. In
      most cases ischemic diseases are due to arterial lesions. In our experience have
      found that this disease can be treated with the chance of good results by means
      of our technique of arterial revascularization combined with penile banding.

PMID- 8352576
TI  - [Prostaglandin E1--the pharmacologic prosthesis].
AB  - The treatment of erectile failure has developed rapidly over the last decade with
      the introduction of intracavernosal self injection therapy, first with
      phenoxybenzamine, then with papaverine and paraverine-phentolamine. These drugs
      are now progressively replaced by prostaglandin E1 mainly because of its efficacy
      and fewer side effects. Prostaglandin E1 can induce a rigid erection even in case
      of severe arteriopathy and offers an excellent alternative to a prosthetic
      implant.

PMID- 8352577
TI  - [The value and limits of the use of mechanical erection aids in the treatment of
      erection disorders].
AB  - Mechanical devices for assisting erection are gaining a wider interest and are of
      significant importance in the treatment of erectile dysfunction. The authors have
      assessed their contribution to the treatment of impotence in 36 patients at our
      outpatient Andrology clinic/CHUV. (31 patients with organic impotence, the
      remaining five being of psychogenic origin).

PMID- 8352578
TI  - [The preservation of penile erection during complete prostato-vesiculectomy for
      carcinoma of the prostate].
AB  - At present radical prostatovesiculectomy is the most reliable procedure for
      curing a locally confined prostatic carcinoma with no evidence of metastases. The
      prostatic apex represents the most critical aspect in this operation. A part of
      the symphysis is resected to obtain a better view of the apex. The technique of
      sparing the nerves and arteries which are necessary for erection is described.
      However, nerve sparing radical prostatectomy should only be considered up to a
      clearly confirmed stage T2.

PMID- 8352579
TI  - [Supra-systolic elevation of the intra-cavernous pressure secondary to
      stimulation of the glans penis].
AB  - The role of the perineal muscles in human penile erections is still
      controversial. The authors investigated surface electromyographic activity of the
      ischiocavernous muscles together with intracavernous pressure recordings during
      pressure stimulations of the glans penis. Successive glans stimulations were
      associated with ischiocavernous muscle contractions and increases in
      intracavernous pressure reaching two- to fourfold the systolic blood pressure.
      High correlation coefficients were found between electromyographic and
      intracavernous pressure amplitudes. Voluntary contractions were accompanied by
      intracavernous pressure peaks of similar durations, and areas delineated by
      integrated electromyographic and intracavernous pressure curves showed very high
      correlation coefficients. Anaesthesia of the dorsal nerve resulted in dramatic
      reductions of muscle activity and intracavernous pressures in response to glans
      stimulation. These results suggest that the activity of the muscles in response
      to pressure stimulation of the glans penis is important to augment rigidity
      during vaginal penetration and intercourse due to their ability to increase
      intracavernous pressures.

PMID- 8352580
TI  - [Considerable increase in the perineal arterial flow secondary to stimulation of
      the glans penis].
AB  - The authors investigated the changes in human perineal blood flow by Doppler
      ultrasonography before, during, and after pressure stimulations (30,150 mm Hg)
      applied to the glans penis. We found a local increased blood flow response in 72%
      of 50 patients who consulted our center for erectile dysfunctions. Precise
      measurement analyses of 10 of these subjects allowed us to further characterize
      this response. Its latency ranged from 0.1 to 0.8 sec. and its duration from 4 to
      13 sec. The blood flow increased up to 8 times the prestimulation level. This
      consistent increase in perineal blood flow showed much less variability than
      either the latency or duration of the response. The results of this study suggest
      that intravaginal pressures exerted on the glans penis during vaginal penetration
      and intercourse trigger an augmentation of blood flow into the corpora cavernosa.
      The reflex nature of this response is currently under investigation.

PMID- 8352581
TI  - Intracavernous application of SIN-I in rabbit and man: functional and
      toxicological results.
AB  - The mode of action of the active metabolite SIN-I of the vasodilator prodrug
      molsidomine was studied in vitro and in vivo in corpus cavernosum of rabbit and
      man. SIN-I produces a dose-dependent relaxation of isolated human cavernous
      smooth muscle strips. In the rabbit, the intracavernous application of SIN-I
      increased the intracavernous pressure to a full erection (approximately 100 cm
      H2O). This response was highly reproductible. SIN-I was also injected
      intracavernously 6 times in five rabbits over 2 weeks; no inflammatory or
      fibrotic reactions were found on histology. SIN-I may be a reliable drug for the
      treatment of impotence without side-effects.

PMID- 8352582
TI  - [Flexible penile implants in the restoration of erectile function].
AB  - Flexible penile implants not only allow sexual penetration due to their physical
      properties, but also frequently induce restoration of real erection due to the
      reduction of the venous bed with preservation of the cavernous arteries. The
      author reports a series of 53 penile implant insertions. Restoration of erection
      above the horizontal was observed in 60% of cases with good tumescence of the
      glans.

PMID- 8352583
TI  - [A biomechanical study of flexible penile implants].
AB  - The prostheses used are silicone elastomer flexible penile implants. They are not
      hard, but flexible and capable of being elongated without traction. These
      implants have the advantage of resisting axial pressure which facilitates
      intromission, even in the absence of erection. Their flexibility also allows the
      penis to hang when the patient is standing. For the penis to hang normally, it
      must be sufficiently long (hence the value of cavernopubic release) and the
      intracavernous cavity must be longer than the prosthesis. The prosthesis does not
      alter the cavernous artery, but markedly flattens the venous plexus (lakes and
      efferent veins).

PMID- 8352584
TI  - From bacterial nutrition to enzyme structure: a personal odyssey.

PMID- 8352585
TI  - Protein tyrosine phosphatases.

PMID- 8352586
TI  - The structure and biosynthesis of glycosyl phosphatidylinositol protein anchors.

PMID- 8352587
TI  - Structural and genetic analysis of protein stability.
AB  - One very encouraging development has been the freedom with which amino acid
      replacements can be introduced in a protein of interest. This has made it
      possible to obtain detailed structural and thermodynamic data on a wide variety
      of mutants that modify protein stability. Substitutions of solvent-exposed amino
      acids on the surfaces of proteins are seen to have little if any effect on
      protein stability or structure, leading to the view that it is the rigid parts of
      proteins that are critical for folding and stability. There is every reason to
      expect that it will be possible to rationalize the stabilities of mutant proteins
      from accurate knowledge of their structures. Substantial progress is being made
      in quantitating the interactions that determine and stabilize protein structures.
      Although not specifically the subject of this review, substantial progress is
      also being made in developing methods to engineer proteins of enhanced stability.

PMID- 8352588
TI  - General initiation factors for RNA polymerase II.

PMID- 8352589
TI  - Human gene therapy.

PMID- 8352590
TI  - Nucleocytoplasmic transport in the yeast Saccharomyces cerevisiae.

PMID- 8352591
TI  - hnRNP proteins and the biogenesis of mRNA.

PMID- 8352592
TI  - Eukaryotic DNA replication: anatomy of an origin.

PMID- 8352593
TI  - Membrane partitioning during cell division.

PMID- 8352594
TI  - Cytoplasmic microtubule-associated motors.

PMID- 8352595
TI  - New photolabeling and crosslinking methods.

PMID- 8352596
TI  - Structure-based inhibitors of HIV-1 protease.

PMID- 8352597
TI  - Introns as mobile genetic elements.

PMID- 8352598
TI  - Analysis of glycoprotein-associated oligosaccharides.

PMID- 8352599
TI  - Pathways of protein folding.
AB  - Advances in spectroscopy, protein engineering, and peptide synthesis have had a
      dramatic impact on the understanding of the structures and stabilities of
      transient folding intermediates. The data available from a variety of proteins
      point to the existence of three common stages of folding. 1. Initially, the
      unfolded protein collapses to a presumably more compact form containing
      substantial nonpolar surfaces and secondary structure. This species has little
      thermodynamic stability and encompasses an ensemble of conformations that are in
      dynamic equilibrium and may contain non-native elements of structure. This
      reaction occurs in less than 5 ms and, from a thermodynamic perspective, may be a
      noncooperative transition. The relatively high content of secondary structure
      implies that this manifold of states must be far smaller than the manifold for
      the unfolded protein. 2. The next phase involves the further development of
      secondary and the beginnings of specific tertiary structure throughout the
      protein as well as of measurable stability. Nativelike elements of structure
      appear, possibly in the form of subdomains that are yet to be properly docked. In
      many instances, the packing is not as tight as is ultimately found in the native
      conformation, suggesting that the side chains are in general more mobile. Some
      elements of surface structure, such as loops and the peripheries of sheets and
      helices, are not yet well defined. This stage, which may consist of more than a
      single kinetic step, occurs in the 5-1000 ms time range. The ensemble of
      conformations is much reduced from the first stage; however, it is far from a
      single, highly populated form. 3. The final stage in folding corresponds to the
      concerted formation of many noncovalent interactions throughout the protein. The
      solidlike interior packing is achieved; the final secondary structure forms and
      the surface structures settle into place. The breadth of these conformational
      changes reflects the global cooperativity characteristic of protein folding
      reactions. A pictorial representation of the kinetic and thermodynamic aspects of
      this process is shown in Figure 1. This folding scheme emphasizes the progressive
      development of structure and stability through an ever-slowing set of reactions.
      Because the product of each stage of folding, with the exception of the final
      step, is an ensemble of related but not identical species, it is an
      oversimplification to describe the process as a pathway. Perhaps it is better
      described as a series of transitions between manifolds of structures that are in
      dynamic equilibrium within any given set.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8352600
TI  - Cognition, mechanism, and evolutionary relationships in aminoacyl-tRNA
      synthetases.

PMID- 8352601
TI  - Oxidation of free amino acids and amino acid residues in proteins by radiolysis
      and by metal-catalyzed reactions.
AB  - Basic mechanisms that underlie the oxygen free radical-promoted oxidation of free
      amino acids and amino acid residues of proteins are derived from radiolysis
      studies. Results of these studies indicate that the most common pathway for the
      oxidation of simple aliphatic amino acids involves the hydroxyl radical-mediated
      abstraction of a hydrogen atom to form a carbon-centered radical at the alpha
      position of the amino acid or amino acid residue in the polypeptide chain.
      Addition of O2 to the carbon-centered radicals leads to formation of peroxy
      radical derivatives, which upon decomposition lead to production of NH3 and alpha
      ketoacids, or to production of NH3, CO2, and aldehydes or carboxylic acids
      containing one less carbon atom. As the number of carbon atoms in the amino acid
      is increased, hydrogen abstraction at other positions in the carbon chain becomes
      more important and leads either to the formation of hydroxy derivatives, or to
      amino acid cross-linked products as a consequence of carbon-centered radical
      recombination processes. alpha-Hydrogen abstraction plays a minor role in the
      oxidation of aromatic amino acids by radiolysis. Instead, the aromatic ring is
      the primary site of attack leading to hydroxy derivatives, to ring scission, and
      in the case of tyrosine to the formation of Tyr-Tyr cross-linked dimers. The
      basic pattern for the oxidation of amino acids by metal ion-catalyzed reactions
      (Fenton chemistry) is similar to the alpha-hydrogen abstraction pathway. But
      unlike the case of oxidation by radiolysis, this Fenton pathway is the major
      mechanism for the oxidation of all aliphatic amino acids, regardless of chain
      length, as well as for the oxidation of aromatic amino acids. Curiously, the
      Fe(III)-catalyzed oxidation of free amino acids is almost completely dependent
      upon the presence of bicarbonate ion, and is greatly stimulated by iron chelators
      at chelator/Fe(III) ratios less than 1.0, and is inhibited at chelator/Fe(III)
      ratios greater than 1.0. It is deduced that the most active catalytic complex is
      composed of two equivalents of HCO3-, an amino acid, and at least one equivalent
      of iron; however, two forms of iron, an iron-chelate and another form, must
      somehow be involved. In contrast to the situation with radiolysis, the aromatic
      rings of aromatic amino acids are only minor targets for metal-catalyzed
      reactions. All amino acid residues in proteins are subject to attack by hydroxyl
      radicals generated by ionizing radiation; however, the aromatic amino acids and
      sulfur-containing amino acids are most sensitive to oxidation.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8352602
TI  - The receptors for nerve growth factor and other neurotrophins.

PMID- 8352603
TI  - Function and regulation of ras.

PMID- 8352604
TI  - Control of transcription termination by RNA-binding proteins.

PMID- 8352605
TI  - Cosmetic tattoo ink darkening. A complication of Q-switched and pulsed-laser
      treatment.
AB  - BACKGROUND: High-energy, short-pulse lasers, eg, Q-switched lasers, emitting
      visible and near-infrared light have recently been developed for removing
      tattoos, with little risk of scarring. The mechanisms of action, and possible
      adverse effects other than scarring and hypopigmentation, are not fully
      understood. OBSERVATIONS: We describe five cases of pulsed-laser-induced,
      immediate, irreversible darkening of cosmetic, white, flesh (skin-color), and
      pink-red colored tattoos. Irreversible ink darkening can be an insidious
      complication, because immediate whitening of the skin temporarily obscures the
      subsequently impressive color change. Among these cases, irreversible ink
      darkening occurred with Q-switched ruby (694 nm), Q-switched neodymium (Nd):YAG
      (1064 nm/532 nm), and pulsed green dye (510 nm) lasers. Attempts to remove the
      darkened ink with further laser treatment failed in two cases, and surgical
      excision was necessary. In the other three cases, subsequent laser treatments
      successfully removed the darkened ink. The red cosmetic tattoo ink used in one of
      the cases was placed in agar in vitro and was converted to a black compound
      immediately on Q-switched ruby laser exposure. Ferric oxide, a brown-red
      ingredient commonly used in cosmetic tattoos, was similarly tested and blackened
      in vitro by Q-switched ruby laser exposures. CONCLUSIONS: Although most tattoos
      are not darkened by laser treatment, short-pulsed lasers over a wide spectrum can
      cause immediate darkening of some tattoo inks. Patients should be warned of the
      potential for irreversible cosmetic tattoo darkening, and test-site exposures
      should be performed prior to treatment. In some cases, subsequent laser
      treatments may remove the blackened ink. The mechanism probably involves, at
      least for some tattoos, reduction of ferric oxide (Fe2O3, "rust") to ferrous
      oxide (FeO, jet black), but the chemical reaction that is involved remains
      unknown.

PMID- 8352606
TI  - Disseminated infection with Trichosporon beigelii. Report of a case and review of
      the cutaneous and histologic manifestations.
AB  - BACKGROUND: Trichosporonosis is a potentially life-threatening disseminated
      infection with Trichosporon beigelii, the causative agent of the white piedra.
      Systemic infection by this fungus has been most frequently described in
      immunocompromised hosts with neutropenia, but one case has been reported in the
      acquired immunodeficiency syndrome setting. We report a second case of
      trichosporonosis in a patient with acquired immunodeficiency syndrome and review
      the clinical and histologic characteristics of cutaneous involvement with this
      opportunistic fungal pathogen. OBSERVATIONS: Trichosporonosis occurs most
      commonly in neutropenic patients receiving chemotherapy. We describe the second
      case developing in the acquired immunodeficiency syndrome setting. Cutaneous
      involvement occurred in approximately 30% of patients and most frequently
      presented as purpuric papules and nodules with central necrosis or ulceration.
      Biopsy specimens of these lesions revealed dermal invasion by fungal elements,
      and culture was positive in greater than 90% of the cases. CONCLUSIONS:
      Disseminated infection with T beigelii can occur in immunosuppressed patients,
      including those with acquired immunodeficiency syndrome particularly if
      associated with neutropenia. Cutaneous involvement is common, presenting as
      purpuric papules and nodules. Biopsy and culture of cutaneous findings can help
      establish an accurate diagnosis resulting in rapid and appropriate treatment.

PMID- 8352607
TI  - Lasers in dermatology--1993.

PMID- 8352608
TI  - Ulcerated nodules on the elbows, fingers, and knees. Erythema elevatum diutinum
      (EED).

PMID- 8352610
TI  - Papules and plaques over the joint spaces. Knuckle pads (heloderma).

PMID- 8352609
TI  - Tense bullous lesions on fingers. Orf.

PMID- 8352612
TI  - Dermatology's resident match: it's time for change.

PMID- 8352611
TI  - Irregularly pigmented hyperkeratotic plaque on the thumb. Bowen's disease.

PMID- 8352613
TI  - Expression of toxic epidermal necrolysis in grafted skin is donor-site dominant.

PMID- 8352614
TI  - Incidence of Stevens-Johnson syndrome and toxic epidermal necrolysis in patients
      with the acquired immunodeficiency syndrome in Germany.

PMID- 8352615
TI  - Heterogeneity of polymorphous light eruption: a study of 105 patients.

PMID- 8352616
TI  - Acquired uncombable hair.

PMID- 8352618
TI  - Plantar erythema nodosum: cases in two children.

PMID- 8352617
TI  - Sweet's syndrome and mediastinal lymphadenopathy due to sarcoidosis: three cases
      of a new association.

PMID- 8352619
TI  - Confluent and reticulated papillomatosis. Treatment with etretinate.

PMID- 8352620
TI  - Ominous Tzanck smears in primary herpes simplex virus infection.

PMID- 8352621
TI  - The Q-switched Nd:YAG laser effectively treats tattoos. A controlled, dose
      response study.
AB  - BACKGROUND AND DESIGN: The Q-switched ruby laser was recently shown to remove
      tattoos without scarring. The Q-switched neodymium: yttrium aluminum garnet
      (Nd:YAG) laser, which targets black ink with a longer wavelength that has less
      absorption by melanin, should effectively treat tattoos with fewer pigmentary
      alterations. A prospective, blinded, controlled study was conducted to assess the
      ability of the Q-switched Nd:YAG laser (1064 nm, 10 ns, 5 Hz) to remove tattoos.
      Twenty-five patients with 39 blue-black or multicolored tattoos (14 previously
      untreated, 25 Q-switched ruby laser-resistant) were exposed in randomly derived
      quadrants with 6, 8, 10, or 12 J/cm2 at 3 to 4 week intervals for a total of four
      treatment sessions. RESULTS: An excellent response (> 75% ink removal) was seen
      in 77% of the black tattoos and more than 95% of the black ink cleared in 11
      (28%) of 39 tattoos at 10 to 12 J/cm2 after four treatment sessions. Colored inks
      were not as effectively removed. Response was related to fluence with greatest
      improvement noted in the quadrants treated with 10 and 12 J/cm2. No significant
      side effects, including pigmentary changes or scarring, were noted.
      Histopathologic examination demonstrated persistence of tattoo ink in clinically
      clear areas and confirmed the absence of fibrosis and granulomatous changes.
      CONCLUSION: The Q-switched Nd:YAG laser (1064 nm) effectively treats black
      tattoos with an excellent cosmetic outcome. Bright colors were minimally
      responsive to treatment. Higher doses were more effective and equally well
      tolerated.

PMID- 8352622
TI  - Skin graft take and healing following 193-nm excimer, continuous-wave carbon
      dioxide (CO2), pulsed CO2, or pulsed holmium: YAG laser ablation of the graft
      bed.
AB  - BACKGROUND: Ablative lasers have been used for cutaneous surgery for greater than
      two decades since they can remove skin and skin lesions bloodlessly and
      efficiently. Because full-thickness skin wounds created after thermal laser
      ablation may require skin grafting in order to heal, we have examined the effect
      of the residual laser-induced thermal damage in the wound bed on subsequent skin
      graft take and healing. In a pig model, four different pulsed and continuous-wave
      lasers with varying wavelengths and radiant energy exposures were used to create
      uniform fascial graft bed thermal damage of approximately 25, 160, 470, and 1100
      microns. Meshed split-thickness skin graft take and healing on the thermally
      damaged fascial graft beds were examined on a gross and microscopic level on days
      3 and 7, and then weekly up to 42 days. RESULTS: Laser-induced thermal damage on
      the graft bed measuring greater than 160 +/- 60 microns in depth significantly
      decreased skin graft take. Other deleterious effects included delayed graft
      revascularization, increased inflammatory cell infiltrate at the graft-wound bed
      interface, and accelerated formation of hypertrophied fibrous tissue within the
      graft bed and underlying muscle. CONCLUSIONS: Ablative lasers developed for
      cutaneous surgery should create less than 160 +/- 60 microns of residual thermal
      damage to permit optimal skin graft take and healing. Pulsed carbon dioxide and
      193-nm excimer lasers may be valuable instruments for the removal of full
      thickness skin, skin lesions, and necrotic tissue, since they create wound beds
      with minimal thermal damage permitting graft take comparable to that achieved
      with standard surgical techniques.

PMID- 8352623
TI  - Precise ablation of skin with reduced collateral damage using the femtosecond
      pulsed, terawatt titanium-sapphire laser.
AB  - BACKGROUND AND DESIGN: The precise ablation of skin was studied using an
      ultrashort-pulsed, high-intensity titanium-sapphire (Ti:Al2O3) laser capable of
      peak intensities of tens of terawatts (TW; 1 TW = 10(12) watts [W]) per square
      centimeter. Rat skin was exposed in vitro to femtosecond-pulsed Ti:Al2O3 laser
      radiation at 800 nm, while varying the number of pulses and the intensity up to
      46 TW/cm2. Ablation was evaluated by monitoring the amount of tissue removed per
      pulse as a function of energy, and by light microscopic examination of damage to
      adjacent, nonirradiated tissue. OBSERVATIONS: Ablation depth per pulse was 0.1
      micron at threshold intensity, and it was increased with both the energy per
      pulse and the number of pulses. Minimal damage to adjacent healthy tissue was
      observed, varying 0 to 30 microns. CONCLUSION: The results suggest that ablation
      of skin with femtosecond-pulsed, terawatt Ti:Al2O3 laser may have potential for
      precision cutaneous surgery, and in vivo studies are indicated.

PMID- 8352624
TI  - Pattern of familial aggregation of vitiligo.
AB  - BACKGROUND AND DESIGN: Vitiligo is a disorder whose cause is not well understood.
      This study was undertaken to clarify whether genetic factors are involved in the
      pathogenesis of vitiligo. Data on 160 white kindreds living in the United States
      have been collected. Each family was ascertained through a proband afflicted with
      vitiligo. The nature and extent of familial aggregation and other relevant
      epidemiologic features have been determined. RESULTS: The mean age at onset of
      vitiligo is about 19 years in male and about 24 years in female individuals. The
      percentage of probands reporting one or more first-degree relatives also
      afflicted with vitiligo is 20%. Children of probands are found to be afflicted
      about 1.7 times more commonly than other first-degree relatives. The relative
      risk (RR) for vitiligo is about 7 for parents, about 12 for siblings, and about
      36 for children. For second-degree relatives, the RR varies between 1 and 16.
      Relative risks for all first- and second-degree relatives, except uncles and
      grandsons, are significant at the 5% level. In families in which one or more
      relatives of the proband are afflicted with vitiligo, the intrafamilial
      correlation of ages at onset of vitiligo is moderate (0.6). No statistically
      significant effect (at the 5% level) of parental age at first childbirth was seen
      on the proportion of offspring afflicted with vitiligo. No significant
      association of some commonly related diseases (eg, thyroid disorder or alopecia
      areata) was observed with vitiligo or with a family history of vitiligo.
      CONCLUSIONS: The extent of familial aggregation of vitiligo is statistically
      significant. The pattern of relationship between RR and degree of kinship
      indicates involvement of genetic factors, although it is not consistent with
      single-locus mendelian transmission.

PMID- 8352626
TI  - 1992-1993 national directory of certified nephrology nurses.

PMID- 8352627
TI  - American Nephrology Nurses' Association position statement. HIV and HIV related
      illness.

PMID- 8352625
TI  - A multicenter study on the use of pulsed low-intensity direct current for healing
      chronic stage II and stage III decubitus ulcers.
AB  - BACKGROUND AND DESIGN: Pulsed low-intensity direct current (300 to 600 microA)
      has been used in a double-blind placebo multicenter study in the treatment of
      stage II and stage III chronic decubitus ulcers. RESULTS: Seventy-four ulcers
      were treated in four centers. Forty-three patients were selected for the
      experimental group, and 31 control subjects used the sham instrument (placebo
      group). In the treated group, 25 ulcers (58%) healed in 8 weeks, whereas in the
      placebo group, only one ulcer (3%) healed and most ulcers increased in size.
      Statistical analysis, based on surface area and ulcer depth before and after
      treatment, showed that low-intensity direct current had a significant influence
      on the healing rates for these ulcers (P < .0001). Experiments with guinea pigs
      (n = 10) showed that pulsed low-intensity direct current caused a rapid calcium
      flux in the epidermis. CONCLUSIONS: Pulsed low-intensity direct current
      represents a useful approach for the treatment of stage II and stage III chronic
      decubitus ulcers by increasing the healing rate. The growth of fibroblasts and
      keratinocytes may be enhanced by pulsed low-intensity direct current due to
      changes in calcium homeostasis.

PMID- 8352628
TI  - Hemodialysis of the infant or small child with chronic renal failure.
AB  - Hemodialysis of the infant or small child with chronic renal failure is often
      considered technically difficult or impossible. At Children's Hospital, however,
      chronic hemodialysis has proved to be safe and effective, and a vital component
      in the overall care of these complex patients. Although the ultimate goal is
      renal transplantation, chronic hemodialysis can provide an excellent primary or
      alternative treatment when peritoneal dialysis has failed or is not an option.

PMID- 8352629
TI  - Living with renal failure.
AB  - In this interpretive study, the experience of patients living with chronic renal
      failure was studied. Within the framework of Heideggerian phenomenology, a
      hermeneutic analysis revealed three themes and one constitutive pattern. The
      three themes were: taking on a new understanding of Being, maintaining hope and
      dwelling in dialysis. The constitutive pattern was " CONTROL: The Meaning of
      Technology." The findings provide an understanding of living with renal failure
      that argues against the traditional understanding of noncompliant behaviors. The
      study makes visible the meaning of technology in the lives of renal patients and
      highlights the need for nurses to sustain meaningful human connections with
      patients.

PMID- 8352630
TI  - Home visit effectiveness for peritoneal dialysis patients.
AB  - Medicare regulations require follow-up home visits to home dialysis patients, yet
      routine home visits require a lot of personnel time. The effectiveness of home
      visits was evaluated by a nurse, dietitian and social worker using a
      questionnaire. Thirty-six patients were evaluated during an 18-month period.
      Collectively the team documented an average of 10 pertinent observations per
      visit and made an average of 4 recommendations for change. Staff members gained
      new information about the patient as indicated by the fact that they changed
      their rankings on 5 of 15 parameters following the home visit. The home visit
      policy that recommended an annual home visit was revised to recommend a single
      home visit for each new peritoneal dialysis patient. Further visits are performed
      only if significant problems are identified.

PMID- 8352631
TI  - End stage renal disease secondary to vasculitis.

PMID- 8352632
TI  - Case management of the anemic patient: epoetin alfa--focus on cognitive function.
AB  - Impaired cognitive function associated with end-stage renal disease (ESRD) can
      adversely affect a patient's quality of life and is only partially reversed by
      dialysis. Correction of anemia with Epoetin alfa improves cognitive function and
      other factors that affect quality of life. Thus, nephrology nurses can improve
      their patients' quality of life by ensuring adequate dosing of Epoetin alfa so
      that anemia is corrected and cognitive function benefits are achieved. In
      addition, a knowledge of how cognitive function is evaluated helps nurses analyze
      research studies related to this area.

PMID- 8352633
TI  - ANNA special interest groups.

PMID- 8352634
TI  - When is it teaching and when is it nagging?

PMID- 8352635
TI  - [Revascularization of extracranial cerebral arteries].

PMID- 8352636
TI  - Effect of ethanol on pancreatic lysosomes in rats: a possible mechanism for
      alcoholic pancreatitis.
AB  - Four-hour infusion of ethanol (0.5 g/kg.hr) and additional 2-hour infusion of
      caerulein (0.2 microgram/kg.hr) and secretin (0.2 CU/kg.hr) caused
      hyperamylasemia, pancreatic edema and pancreatic histological changes such as
      interstitial edema and acinar cell vacuolization in the rat. Such a combined
      treatment also induced a redistribution of lysosomal enzyme cathepsin B, from the
      lysosomal fraction to the zymogen fraction in subcellular fractionation. Only
      ethanol infusion caused marginal changes in all these parameters. Moreover, 4
      hour pre-infusion of ethanol caused a significant increase in pancreatic
      cathepsin B output stimulated by caerulein (0.2 microgram/kg.hr) and secretin
      (0.2 CU/kg.hr) compared with the control rats. This pretreatment of ethanol also
      caused a significant increase in cathepsin B/amylase output ratio. These results
      indicate that ethanol administration, if combined with exocrine stimulation,
      causes a colocalization of lysosomal hydrolases with digestive enzymes in the
      same subcellular compartment as well as in the pancreatic ductal space, and also
      suggest one possible mechanism for alcoholic pancreatitis both within and outside
      the acinar cells, since cathepsin B can activate trypsinogen.

PMID- 8352637
TI  - Heat shock response for ischemic kidney preservation and transplantation.
AB  - The heat shock response (HSR) is a form of stress conditioning during which
      reversible changes in cellular metabolism are rapidly induced by brief exposure
      to supra-physiologic levels of heat. The nature of these adaptive adjustments has
      been widely investigated and has received much attention in molecular biology and
      cancer research. Recent evidence indicates that a basic form of this stress
      response exists at the cellular level of virtually every organism. Although the
      physiological phenomenon of HSR is complex, it is well known that it can induce
      specific proteins, known as heat shock proteins (HSP's), which are not normally
      synthesized. HSP's become the major proteins synthesized during the heat shock
      response while normal protein synthesis is suppressed. In addition, the HSR has
      been demonstrated to confer a transient resistance to the organism to subsequent
      episodes of stress. Recently it has been reported that the HSR confers protection
      against cold ischemic injury and extends the cold preservation time of the rat
      kidney to 48 hours. In this study, we have applied the concept of HSR to the
      preservation, and transplantation of warm ischemically injured pig kidneys. Since
      there is a serious shortage of cadaver kidneys available for transplantation
      worldwide, this number would increase if warm ischemic kidneys could be utilized.
      However with present methods of organ recovery and preservation, such kidneys are
      not likely to function after transplantation even if they were removed. We
      hypothesized that the application of a thermal stress to pig kidneys prior to
      organ procurement and preservation will enhance the organs' ability to function
      after warm ischemic injury.

PMID- 8352638
TI  - A new experimental model for gallstone pancreatitis: short-termed pancreatico
      biliary duct obstruction and exocrine stimulation with systemic hypotension in
      rats.
AB  - The effects of short-termed (2 hours) obstruction of pancreatico-biliary duct
      (PBDO) and exocrine stimulation (IDH) by caerulein infusion (0.2 microgram/kg.hr)
      with systemic hypotension (SH) (30% reduction of mean arterial pressure for 30
      min) on the exocrine pancreas were evaluated in the rat. PBDO and IDH with SH
      caused more significant rises in portal serum amylase, cathepsin B and malate
      dehydrogenase levels, and pancreatic water content as well as more significant
      redistribution of cathepsin B activity from the lysosomal fraction to the zymogen
      fraction in the subcellular fractionations than only PBDO, or PBDO with IDH, or
      PBDO with SH group. In addition, more accelerated lysosomal and mitochondrial
      fragility were observed in the PBDO and IDH with SH group. Moreover, PBDO and IDH
      with SH caused an activation of larger amount of trypsinogen in the pancreas
      compared with other groups (PBDO with IDH and PBDO with SH group). These results
      indicate that present model of short-termed PBDO and exocrine stimulation with
      systemic hypotension seems to be pertinent model for gallstone pancreatitis in
      humans, and that redistribution of lysosomal enzymes and subcellular organellar
      fragility seem to play an important role in the pathogenesis of pancreatic
      injuries by PBDO, particularly with exocrine stimulation and pancreatic
      ischaemia, probably via activation of trypsinogen to trypsin by lysosomal enzyme
      such as cathepsin B.

PMID- 8352639
TI  - [Experimental study on reversibility of neuronal function in rats with congenital
      hydrocephalus].
AB  - To evaluate the usefulness of cerebral evoked potential examination in
      determining the severity of hydrocephalus and its prognosis, we measured
      brainstem auditory evoked potential (BAEP), somatosensory evoked potential (SEP),
      and visual evoked potential (VEP) in rats with HTX congenital hydrocephalus. In
      addition, changes in cerebral evoked potentials were measured before and after
      shunt operation, and the reversibility of neuronal function was evaluated. In
      control rats without hydrocephalus, SEP appeared in the latter half of the first
      week after birth, and VEP and BAEP in the former half of the second week. The
      peak latency tended to gradually decrease with growth. Significant differences
      were observed in SEP in the latter half of the second week after birth and in VEP
      in the former half of the third week between the group with hydrocephalus and the
      control group. However, BAEP did not significantly differ between the two groups.
      These results suggest that impairment of cerebral function is more marked than
      that of brainstem function in rats with HTX congenital hydrocephalus, and SEP is
      the most useful for evaluating the progression of this disease. Ventriculo
      peritoneal shunt was performed in the rats with hydrocephalus in the latter half
      of the second week, when the N1 latency of SEP began to be prolonged, or in the
      latter half of the third week. Outcomes markedly differed between the two groups.
      However, the N1 latency of postoperative SEP was shortened in both groups. These
      results strongly suggest that the reversibility of neuronal function in
      hydrocephalus evaluated by SEP examination is well preserved until the terminal
      stage. Cerebral evoked potential examination, especially, SEP examination may be
      useful for evaluating the degree of impairment in neuronal function in
      hydrocephalus.

PMID- 8352640
TI  - [Murder of children by children and adolescents--a rare crime].
AB  - Nine case reports obtained from the autopsy material of three German institutes
      of forensic medicine are presented to illustrate the rare offense "killing of a
      child by a child" and compared with data from the criminal statistics of the
      police. In addition, age-specific peculiarities, including adolescence, are also
      discussed.

PMID- 8352641
TI  - [The effect of luminous and signal munitions on the human body].

PMID- 8352642
TI  - [Abortion in Japan].
AB  - In Japan, the artificial abortion is a penal offence; only in the presence of
      certain conditions it is authorized under the provision of the Eugenic Protection
      Law which was promulgated in 1948. According to the law, the artificial abortion
      is restricted to the period, in which the fetus is not viable outside of the
      uterus. This period is prescribed by notification from the Ministry of Public
      Welfare; up to now it has been shortened twice (1976, 1991). Due to the
      introduction of economic reasons in the list of conditions and the simplification
      of the procedure the artificial abortion in Japan was virtually liberalized.
      Prosecution for illegal abortion is very rare in recent years. The number of
      reported artificial abortions decreases; in the about last 30 years it reduced by
      half. However, the increase in the number of abortions in women younger than 20
      years of age is a problem. The abortion in teenagers is late compared with that
      in other age groups. Although the number of neonaticides does not seem to
      increase, the increase in the number of abortions in teenagers remains a serious
      problem in Japan.

PMID- 8352643
TI  - Function of methylcobalamin: coenzyme M methyltransferase isoenzyme II in
      Methanosarcina barkeri.
AB  - Methanosarcina barkeri was recently shown to contain two cytoplasmic isoenzymes
      of methylcobalamin: coenzyme M methyltransferase (methyltransferase 2). Isoenzyme
      I predominated in methanol-grown cells and isoenzyme II in acetate-grown cells.
      It was therefore suggested that isoenzyme I functions in methanogenesis from
      methanol and isoenzyme II in methanogenesis from acetate. We report here that
      cells of M. barkeri grown on trimethylamine, H2/CO2, or acetate contain mainly
      isoenzyme II. These cells were found to have in common that they can catalyze the
      formation of methane from trimethylamine and H2, whereas only acetate-grown cells
      can mediate the formation of methane from acetate. Methanol-grown cells, which
      contained only low concentrations of isoenzyme II, were unable to mediate the
      formation of methane from both trimethylamine and acetate. These and other
      results suggest that isoenzyme II (i) is employed for methane formation from
      trimethylamine rather than from acetate, (ii) is constitutively expressed rather
      than trimethylamine-induced, and (iii) is repressed by methanol. The constitutive
      expression of isoenzyme II in acetate-grown M. barkeri can explain its presence
      in these cells. The N-terminal amino acid sequences of isoenzyme I and isoenzyme
      II were analyzed and found to be only 55% similar.

PMID- 8352644
TI  - Analysis of a pleiotropic gene region involved in formation of catalytically
      active hydrogenases in Alcaligenes eutrophus H16.
AB  - In Alcaligenes eutrophus H16 a pleiotropic DNA-region is involved in formation of
      catalytically active hydrogenases. This region lies within the hydrogenase gene
      cluster of megaplasmid pHG1. Nucleotide sequence determination revealed five open
      reading frames with significant amino acid homology to the products of the hyp
      operon of Escherichia coli and other hydrogenase-related gene products of diverse
      organisms. Mutants of A. eutrophus H16 carrying Tn5 insertions in two genes (hypB
      and hypD) lacked catalytic activity of both soluble (SH) and membrane-bound (MBH)
      hydrogenase. Immunological analysis showed that the mutants contained SH- and MBH
      specific antigen. Growing the cells in the presence of 63Ni2+ yielded
      significantly lower nickel accumulation rates of the mutant strains compared to
      the wild-type. Analysis of partially purified SH showed only traces of nickel in
      the mutant protein suggesting that the gene products of the pleiotropic region
      are involved in the supply and/or incorporation of nickel into the two
      hydrogenases of A. eutrophus.

PMID- 8352645
TI  - Purification and characterization of phenylacetate-coenzyme A ligase from a
      denitrifying Pseudomonas sp., an enzyme involved in the anaerobic degradation of
      phenylacetate.
AB  - The enzyme catalysing the first step in the anaerobic degradation pathway of
      phenylacetate was purified from a denitrifying Pseudomonas strain KB 740. It
      catalyses the reaction phenylacetate + CoA + ATP-->phenylacetyl-CoA + AMP + PPi
      and requires Mg2+. Phenylacetate-CoA ligase (AMP forming) was found in cells
      grown anaerobically with phenylacetate and nitrate. Maximal specific enzyme
      activity was 0.048 mumol min-1 x mg-1 protein in the mid-exponential growth
      phase. After 640-fold purification with 18% yield, a specific activity of 24.4
      mumol min-1 mg-1 protein was achieved. The enzyme is a single polypeptide with Mr
      of 52 +/- 2 kDa. The purified enzyme shows high specificity towards the aromatic
      inducer substrate phenylacetate and uses ATP preferentially; Mn2+ can substitute
      for Mg2+. The apparent Km values for phenylacetate, CoA, and ATP are 60, 150, and
      290 microM, respectively. The soluble enzyme has an optimum pH of 8.5, is
      insensitive to oxygen, but is rather labile and requires the presence of glycerol
      and/or phenylacetate for stabilization. The N-terminal amino acid sequence showed
      no homology to other reported CoA-ligases. The expression of the enzyme was
      studied by immunodetection. It is present in cells grown anaerobically with
      phenylacetate, but not with mandelate, phenylglyoxylate, benzoate; small amounts
      were detected in cells grown aerobically with phenylacetate.

PMID- 8352646
TI  - Anaerobic oxidation of phenylacetate and 4-hydroxyphenylacetate to benzoyl
      coenzyme A and CO2 in denitrifying Pseudomonas sp. Evidence for an alpha
      oxidation mechanism.
AB  - Anaerobic degradation of (4-hydroxy)phenylacetate in denitrifying Pseudomonas sp.
      was investigated. Evidence is presented for alpha-oxidation of the coenzyme A
      (CoA)-activated carboxymethyl side chain, a reaction which has not been
      described. The C6-C2 compounds are degraded to benzoyl-CoA and furtheron to CO2
      via the following intermediates: Phenylacetyl-CoA, phenylglyoxylate, benzoyl-CoA
      plus CO2; 4-hydroxyphenylacetyl-CoA, 4-hydroxyphenylglyoxylate, 4-hydroxybenzoyl
      CoA plus CO2, benzoyl-CoA. Trace amounts of mandelate possibly derived from
      mandelyl-CoA were detected during phenylacetate degradation in vitro. The
      reactions are catalyzed by (i) phenylacetate-CoA ligase which converts
      phenylacetate to phenylacetyl-CoA and by a second enzyme for 4
      hydroxyphenylacetate; (ii) a (4-hydroxy)-phenylacetyl-CoA dehydrogenase system
      which oxidizes phenylacetyl-CoA to (4-hydroxy)phenylglyoxylate plus CoA; and
      (iii) (4-hydroxy)phenylglyoxylate: acceptor oxidoreductase (CoA acylating) which
      catalyzes the oxidative decarboxylation of (4-hydroxy)phenylglyoxylate to (4
      hydroxy)benzoyl-CoA and CO2. (iv) The degradation of 4-hydroxyphenylacetate in
      addition requires the reductive dehydroxylation of 4-hydroxybenzoyl-CoA to
      benzoyl-CoA, catalyzed by 4-hydroxybenzoyl-CoA reductase (dehydroxylating). The
      whole cell regulation of these enzyme activities supports the proposed pathway.
      An ionic mechanism for anaerobic alpha-oxidation of the CoA-activated
      carboxymethyl side chain is proposed.

PMID- 8352647
TI  - Nitrogen regulation of lignin peroxidase and manganese-dependent peroxidase
      production is independent of carbon and manganese regulation in Phanerochaete
      chrysosporium.
AB  - In this study, a N-deregulated mutant (der8-5) of Phanerochaete chrysosporium was
      used as a tool to investigate the interrelationships between N, C, and Mn(II)
      regulation of LIP and MNP production in this organism. The results showed that
      LIP and MNP production by der8-5 was blocked in excess C medium but not in excess
      N medium. Furthermore, LIP and MNP production in this organism was subject to
      Mn(II) regulation regardless of the fact whether it is grown in low N medium or
      in high N medium. These and other results indicate that N regulation of LIP and
      MNP production in P. chrysosporium is independent of C and Mn(II) regulation.

PMID- 8352649
TI  - Pyranosone dehydratase from the basidiomycete Phanerochaete chrysosporium:
      improved purification, and identification of 6-deoxy-D-glucosone and D-xylosone
      reaction products.
AB  - Pyranose oxidase and pyranosone dehydratase (aldos-2-ulose dehydratase), enzymes
      which convert in coupled reactions D-glucose to beta-pyrone cortalcerone, peaked
      coincidently during idiophasic growth of Phanerochaete chrysosporium under
      agitated conditions. The enzymes were purified from mycelial extracts of the
      fungus and separated from each other by hydrophobic interaction chromatography on
      Phenyl-Sepharose and Phenyl-Superose. Two pyranosone dehydratase activity peaks,
      PD I and PD II, were resolved. The major PD I fraction, consisting about 74% of
      the total dehydratase activity, was further purified by anion exchange
      chromatography on Mono Q to yield apparently pure enzyme as judged by SDS-PAGE
      and gel filtration on Superose 12. Isoelectric focusing indicated
      microheterogeneity of the protein by the presence of at least five protein bands
      with pI 5.1-5.3. PD II had a pI of 5.75. Overall PD I purification was 60.7-fold
      with 50% yield. The enzyme acted on several osones (glycosuloses), with the
      preferred substrate being D-glucosone. D-Xylosone and 6-deoxy-D-glucosone were
      dehydrated at C-3-C-4 to give the corresponding 5-hydroxy-2,3-dioxoalcanals (4
      deoxy-2,3-glycosdiuloses), new enzymatically produced sugar derivatives. The
      latter labile compounds were trapped as diphenylhydrazine or o-phenylenediamine
      derivatives and spectroscopically identified. The analogous D-glucosone
      dehydration product did not accumulate due to its further transformation. pH
      optimum of PD I activity was 6.0 and its pH stability was optimal at pH 7-11. The
      enzyme was sensitive to Me2+ chelating agents and some heavy metal ions (Hg2+,
      Cu2+).

PMID- 8352650
TI  - Expression of hydrogenase in Hupc strains of Bradyrhizobium japonicum.
AB  - Plasmid-borne hup-lacZ transcriptional fusion constructs were introduced into
      three separate mutant strains of Bradyrhizobium japonicum which express
      hydrogenase constitutively (Hupc strains SR470, SR473 and JH101) in both
      autotrophic and heterotrophic environments. The lacZ structural gene linked
      directly to the regulatory region upstream of the hydrogenase structural gene
      encompassing -149 bases expressed beta-gal at a constant, high level, in response
      to various concentrations of Ni (0 microM to 1 microM). beta-Gal activity was
      expressed at a constant level in response to variations in concentration of O2
      (0%-10%) and H2 (0%-10%) as well. The cis-acting region required to express
      hydrogenase constitutively is located between -149 and -98 bases. This is also
      the site of nickel, oxygen and hydrogen-dependent regulatory action in the wild
      type strain. It is postulated that a single mutation in Hupc strains affects the
      trans-acting factor which would normally by responsive to Ni, O2 and H2.

PMID- 8352648
TI  - Copper-containing nitrite reductase from Pseudomonas aureofaciens is functional
      in a mutationally cytochrome cd1-free background (NirS-) of Pseudomonas stutzeri.
AB  - The structural gene, nirK, for the respiratory Cu-containing nitrite reductase
      from denitrifying Pseudomonas aureofaciens was isolated and sequenced. It encodes
      a polypeptide of 363 amino acids including a signal peptide of 24 amino acids for
      protein export. The sequence showed 63.8% positional identity with the amino acid
      sequence of "Achromobacter cycloclastes" nitrite reductase. Ligands for the blue,
      type I Cu-binding site and for a putative type-II site were identified. The nirK
      gene was transferred to the mutant MK202 of P. stutzeri which lacks cytochrome
      cd1 nitrite reductase due to a transposon Tn5 insertion in its structural gene,
      nirS. The heterologous enzyme was active in vitro and in vivo in this background
      and restored the mutationally interrupted denitrification pathway. Transfer of
      nirK to Escherichia coli resulted in an active nitrite reductase in vitro.
      Expression of the nirS gene from P. stutzeri in P. aureofaciens and E. coli led
      to nonfunctional gene products. Nitrite reductase activity of cell extract from
      either bacterium could be reconstituted by addition of heme d1, indicating that
      both heterologous hosts synthesized a cytochrome cd1 without the d1-group.

PMID- 8352651
TI  - Characterization of the glyceraldehyde 3-phosphate dehydrogenase from the
      extremely halophilic archaebacterium Haloarcula vallismortis.
AB  - Glyceraldehyde 3-phosphate dehydrogenase (EC 1.2.1.12) from the extremely
      halophilic archaebacterium Haloarcula vallismortis has been purified in a four
      step procedure to electrophoretic homogeneity. The enzyme is a tetramer with a
      relative molecular mass of 160,000. It is strictly NAD(+)-dependent and exhibits
      its highest activity in 2 mol/l KCl at 45 degrees C. Amino acid analysis and
      isoelectric focusing indicate an excess of acidic amino acids. Two parts of the
      primary sequence are reported. These peptides have been compared with
      glyceraldehyde 3-phosphate dehydrogenases from other archaebacteria, eubacteria
      and eucaryotes. The peptides show a high grade of similarity to glyceraldehyde 3
      phosphate dehydrogenase from eucaryotes.

PMID- 8352652
TI  - Identification of the nifJ gene coding for pyruvate: ferredoxin oxidoreductase in
      dinitrogen-fixing cyanobacteria.
AB  - A 329 bp DNA segment from both Anabaena variabilis and Anabaena PCC 7119 was
      amplified using the polymerase chain reaction (PCR). The sequences from the two
      cyanobacteria showed strong similarities to the corresponding part of the nifJ
      gene from Klebsiella pneumoniae and Enterobacter agglomerans. The present
      findings underline earlier results of enzymatic studies that heterocystous
      cyanobacteria possess a pyruvate:ferredoxin (flavodoxin) oxidoreductase (PFO).
      The nifJ gene segment could not be detected in the non-dinitrogen-fixing,
      unicellular cyanobacterium Anacystis nidulans which is also in accord with
      previous findings from enzyme assays.

PMID- 8352654
TI  - PCR detection of the sheep-associated agent of malignant catarrhal fever.
AB  - From a genomic library previously constructed from a lymphoblastoid cell line
      (LCL) propagated from a bovine case of sheep-associated malignant catarrhal fever
      (SA-MCF), caused by ovine herpesvirus-2 (OHV-2), several OHV-2 clones were
      identified and characterised by hybridisation using probes from the unique region
      of the Alcelaphine herpesvirus-1 (AVH-1) genome. Nucleotide sequence from one
      clone was generated and the predicted amino acid sequence was found to contain
      regions of homology with the 140 and 160 kDa tegument proteins of Epstein-Barr
      virus and herpesvirus saimiri respectively. Oligonucleotide primers were
      constructed and a polymerase chain reaction (PCR) test was developed for the
      detection of OHV-2 viral DNA. Amplified product was identified by restriction
      with RsaI and BmyI. The primers were highly specific for OHV-2 DNA with a limit
      of detection of 6.4 pg of genomic DNA derived from the parent LCL. This was
      estimated to correspond to one diploid bovine cell. The PCR was successfully
      applied to detect OHV-2 DNA in peripheral blood leucocytes (pbl) from clinical
      cases of SA-MCF and normal sheep.

PMID- 8352655
TI  - Nucleotide sequence of the capsid protein cistrons from six potato virus Y (PVY)
      isolates infecting tobacco.
AB  - Complementary DNA libraries representing the capsid protein cistron of the potato
      virus Y (PVY) isolate 'Chilean', 'Hungarian', MsNr, NsNr, O, and 'Potato US' were
      synthesized and used as template for polymerase chain reaction (PCR)
      amplification. An AUG codon for initiating a discrete capsid protein (CP) open
      reading frame was embedded upstream of the first codon of the CP cistrons. PCR
      amplified products of the expected size of 0.8 kilo bases were cloned into the
      transcription vector pBS(+). The fidelity of each PCR-amplified PVY CP cistron
      was tested by transcribing recombinant plasmids in vitro and translating the
      transcripts in two cell free translation systems. Translation analysis of in
      vitro transcribed PVY CP cistrons consistently yielded a polypeptide co-migrating
      with authentic CP that was immunoprecipitated by anti PVY 'Chilean' antibodies.
      The nucleotide sequence of each capsid protein gene was determined by dideoxy
      sequence analysis. Each capsid protein gene was determined to be 801 nucleotides
      in length, encoding a deduced protein of 267 amino acids with calculated M(r)
      ranging from 29,799 to 29,980. The nucleic acid sequence similarity between the
      six isolates ranged between 89 to 97% and the amino acid similarity between 91 to
      99%. The high level of amino acid sequence similarity confirms the classification
      of these viruses as isolates of PVY.

PMID- 8352656
TI  - Complete nucleotide sequence of sugarcane streak Monogeminivirus.
AB  - The complete nucleotide sequence of the genome of the Monogeminivirus sugarcane
      streak virus (SSV) was determined from cloned replicative form DNA. The genome is
      contained in one DNA circle of 2,758 nucleotides, and has four open reading
      frames with the potential to encode proteins of MW > 10 kDa: two in the viral (+)
      sense and two in the complementary (-) sense. Each open reading frame has a
      counterpart among the open reading frames reported for other Monogeminiviruses. A
      potential binding site for a DNA replication primer and potential transcriptional
      control sequences were identified on the (+) strand, and a possible intron on the
      (-) strand. Phylogenetic analysis of coat protein and replication-associated
      protein sequences of SSV and other grass-infecting geminiviruses indicate that
      SSV, although distinct from any other virus, is part of an "African streak virus
      subgroup" of Monogeminiviruses.

PMID- 8352658
TI  - Geminivirus nomenclature: the need to set taxonomic standards.
AB  - The geminiviruses are plant viruses of significant economic impact. Different
      nomenclature has been used in various studies in descriptions of their genomes.
      We propose in this communication a uniform nomenclature to be used in future
      studies.

PMID- 8352657
TI  - Subgroup F adenovirus growth in foetal intestinal organ cultures.
AB  - An in vitro foetal intestinal organ culture system was employed to determine the
      permissiveness of human intestinal cells for subgroup F adenovirus infection.
      Ad40 and Ad41 growth, monitored through group-specific hexon antigen production,
      was poor in comparison to that of Ad2 in these cultures, further demonstrating
      their fastidious nature in most human cells. The low growth capability of these
      viruses in culture, in relation to their association with gastrointestinal
      disease is discussed.

PMID- 8352653
TI  - Role of Langerhans cells and other dendritic cells in viral diseases.
AB  - Langerhans cells are part of a vast system of potent antigen-presenting cells
      known under the name of dendritic cells. During the last decade, much has been
      learned on dendritic cell involvement in the immune response to infectious
      diseases. This review briefly summarizes our current understanding of the role
      played by Langerhans cells and other dendritic cells in the pathogenesis of DNA
      and RNA virus infections. These data may form the basis for the development of
      innovative approaches in the diagnosis, prevention, and treatment of viral
      diseases.

PMID- 8352661
TI  - Coexisting migraine and tension-type headache.

PMID- 8352659
TI  - Resistance of mice vaccinated with rabies virus internal structural proteins to
      lethal infection.
AB  - Mice were vaccinated with recombinant vaccinia virus (rVac) expressing the
      glycoprotein (G), nucleoprotein (N), phosphoprotein (NS) or matrix protein (M) of
      rabies virus and their resistance to peripheral lethal infection with street
      rabies virus was examined. Mice vaccinated with rVac-G or rVac-N developed strong
      antibody responses to the corresponding proteins and essentially all mice
      survived challenge infection. Mice vaccinated with rVac-NS or rVac-M developed
      only a slight antibody response, however, a significant protection (59%) was
      observed in the rVac-NS-vaccinated mice, whereas rVac-M-vaccinated mice were not
      protected. No anti-G antibodies were detected in the sera of mice which has been
      vaccinated with rVac-N or rVac-NS and survived challenge infection. Passive
      transfer of anti-N monoclonal antibodies (MAbs) recognizing an epitope located on
      amino acids 1-224 of the protein prior to challenge resulted in significant
      protection, although the protection was not complete even with a high amount of
      antibodies. In contrast, none of the mice given MAbs recognizing an epitope of
      amino acids 247-415 or F(ab')2 fragments from a protective MAb IgG were
      protected. Administration of anti-CD 8 MAb to rVac-N-vaccinated mice showed no
      significant effect on protection. Our observations suggest that a considerable
      part of the protection achieved by the vaccination with rVac-N can be ascribed to
      the intact anti-N antibodies recognizing an epitope located on amino acids 1-224
      of the protein.

PMID- 8352660
TI  - RNA hybrid mismatch polymorphisms in Australian populations of turnip yellow
      mosaic tymovirus.
AB  - In the Mt. Kosciusko alpine area of Australia there are three well-separated
      populations of Cardamine lilacina, an endemic sward-forming perennial brassica,
      and these are infected with turnip yellow mosaic tymovirus. The genetic variation
      in these viral populations has been assessed by an RNA hybrid mismatch
      polymorphism method. About 100 isolates were examined; the genomic RNA of each
      isolate was prepared from a shoot of a single wild C. lilacina plant. RNA hybrid
      mismatch polymorphisms (RHMPs) were assessed in six regions of the genomes using
      labelled negative-strand probes transcribed from selected portions of a cloned
      TYMV genome. The probed region at the 3' end of the genome showed little
      variation and over 95% of the isolates gave the same pattern. However, other
      parts of the genome, including the 5' non-coding region, were much more variable.
      There was no significant correlation between groupings based on the RHMP
      patterns, and the location from which the isolates were collected, nor with the
      symptom type or severity shown by their host plants. The patterns of variation
      suggested that all three populations of the virus are a single quasi-species; at
      most one tenth of the isolates gave similar RHMP patterns, those of the "master
      copy".

PMID- 8352662
TI  - The origin of pain in 'ischemic-diabetic' third-nerve palsy.

PMID- 8352663
TI  - Unimpaired verbal memory and oculomotor control in asymptomatic adults with the
      genetic marker for Huntington's disease.
AB  - OBJECTIVE: To determine whether asymptomatic individuals at very high genetic
      risk for Huntington's disease (HD) have demonstrable cognitive or oculomotor
      abnormalities. DESIGN: A case-control study was employed. Presence of the
      chromosome-4 DNA marker linked to the HD phenotype was the criterion for HD risk.
      SETTING: The Baltimore Huntington's Disease Project Presymptomatic Testing
      Program at The Johns Hopkins University School of Medicine, Baltimore, Md.
      PARTICIPANTS: Seventy-six asymptomatic adults at risk for HD, voluntarily
      enrolled for genetic testing, and determined by clinical examination to be free
      of major psychiatric disorder or evidence of HD. Twenty were determined to be at
      greater than or equal to 95% risk for HD; 56 were at less than or equal to 5%
      risk [corrected]. MEASURES: The Hopkins Verbal Learning Test was used to assess
      verbal learning and memory. Oculomotor functioning was assessed using Novel
      Stimulus, Mirror-Stimulus, and Predictive-Saccade paradigms. Outcome measures
      included number of correctly recalled words, recognition accuracy, and response
      bias, as well as saccade latency and number of errors on the Mirror-Stimulus
      Test. RESULTS: With one exception, all participants performed within the normal
      range on the Hopkins Verbal Learning Test. In a blind follow-up examination of
      the individual who performed aberrantly on the Hopkins Verbal Learning Test, she
      exhibited neurologic and psychiatric changes sufficient for a clinical diagnosis
      of HD. There were no group differences on the tests of oculomotor functioning.
      CONCLUSIONS: Young, asymptomatic adults at very high genetic risk for HD are
      unimpaired in tests of verbal learning and memory and oculomotor functioning.

PMID- 8352664
TI  - Late-onset Friedreich's ataxia. Molecular genetics, clinical neurophysiology, and
      magnetic resonance imaging.
AB  - OBJECTIVE--To clarify the nosological classification of late-onset Friedreich's
      ataxia (LOFA), ie, patients who have later onset of Friedreich's ataxia (FRDA),
      often after 25 years of age. DESIGN--Comparison of clinical examination data,
      nerve conduction studies, electronystagmographic recording, and magnetic
      resonance imaging of a family with LOFA with a group of patients with FRDA.
      Genetic linkage analysis was performed in the family with LOFA. SETTING--Referral
      center. PATIENTS--Thirteen patients satisfied classic diagnostic criteria of
      FRDA, and three patients from one family satisfied all diagnostic criteria of
      FRDA but with disease onset after 25 years. RESULTS--Results of nerve conduction
      studies, electronystagmographic recording, and magnetic resonance imaging in
      patients with LOFA closely corresponded to observations made in patients with
      FRDA. In addition, genetic linkage analysis using markers tightly linked to the
      FRDA locus on chromosome 9 showed that all affected members of the LOFA family,
      but not their unaffected siblings, had inherited identical paternal and maternal
      genotypes. CONCLUSIONS--Data suggest that LOFA may also result from mutation
      within the FRDA locus.

PMID- 8352665
TI  - Vitamin B12 deficiency and nervous system disease in HIV infection.
AB  - BACKGROUND: Vitamin B12 deficiency may result in a number of neurological and
      neuropsychiatric disorders. Patients with human immunodeficiency virus type 1
      (HIV-1) infection may have a high rate of vitamin B12 deficiency and nervous
      system disease. Vitamin B12 deficiency may contribute to neurological disease in
      HIV-1-infected individuals. OBJECTIVE: To evaluate the possible contribution of
      vitamin B12 deficiency to neurological disease in HIV-1-infected individuals.
      MAIN OUTCOME MEASURES: Comparison of serum vitamin B12 levels with neurological,
      neuropsychological, and mood state abnormalities in 153 HIV-1-positive subjects
      and 57 high-risk seronegative controls. A subgroup of 67 subjects underwent
      additional extensive clinical neurophysiological, cerebrospinal fluid, and
      magnetic resonance imaging evaluations. RESULTS: No statistically significant
      relationships were noted between vitamin B12 levels and abnormalities on any of
      the measures examined. CONCLUSIONS: This study does not indicate an important
      role for vitamin B12 deficiency in the neurological disease of HIV-1 infection.

PMID- 8352666
TI  - Hippocampal neuron loss and memory scores before and after temporal lobe surgery
      for epilepsy.
AB  - OBJECTIVE: To assess the relationship of hippocampal neuron loss to intellectual
      and memory measures before and after temporal lobe surgery. DESIGN: Pyramidal
      cell loss, as determined on the resected tissue, of hippocampal subregion CA1
      correlated highest with other subregional cell loss and thus was used as the
      primary indicator of hippocampal neuron loss. Groups of patients with left and
      right temporal lobe seizures were subdivided according to degree of CA1 neuron
      loss. Behavioral performances of patient groups were compared before and after
      surgery. SETTING: Patient data were obtained from a university program of surgery
      for epilepsy. CASES: Twenty-five patients who had intractable epilepsy. MAIN
      OUTCOME MEASURES: Wechsler Adult Intelligence Scale IQ scores, verbal and
      nonverbal memory measures adapted from the Wechsler Memory Scale, and the Rey
      Osterrieth recall score. RESULTS: Degree of hippocampal cell loss selectively
      related to learning of unrelated word pairs, both preoperatively and
      postoperatively, in patients with left but not right temporal lobe seizures.
      Patients with severe loss of left hippocampal neurons performed worse than those
      with mild-moderate neuron loss both before and after surgery. Immediate recall of
      logical prose did not relate to hippocampal neuron loss, although scores
      decreased following left temporal lobe surgery. CONCLUSION: These findings
      support a role for the left hippocampus in rote verbal memory, ie, learning of
      unrelated word pairs. Semantically complex verbal learning, ie, recall of logical
      prose, is more dependent on extrahippocampal temporal lobe regions. Finally,
      patients with severe as compared with minimal left hippocampal neuron loss may be
      at risk for lower memory functioning postoperatively.

PMID- 8352667
TI  - White matter changes in healthy elderly persons correlate with attention and
      speed of mental processing.
AB  - OBJECTIVE: To evaluate the association between white matter changes
      (leukoaraiosis [LA]) seen on magnetic resonance imaging and cognitive functions.
      DESIGN: Survey of cohorts of neurologically healthy elderly subjects derived
      consecutively from a population-based random sample. SETTING: General community,
      the Helsinki (Finland) Aging Brain Study. SUBJECTS: Cohorts of neurologically
      healthy subjects aged 55, 60, 65, 70, 75, 80, and 85 years (n = 20, 18, 19, 18,
      17, 17 and 11 subjects, respectively; total N = 120). MEASURES: Leukoaraiosis was
      rated in the periventricular areas (0 to 24) and the centrum semiovale (0 to 24);
      also, a total LA score was obtained (0 to 48). The neuropsychological test
      battery covered memory, verbal intellectual and constructional functions,
      language, speed and attention, and speed of mental processing, as well as simple
      psychomotor speed. RESULTS: Low age-related LA scores and deterioration of
      cognitive functions were obtained in the normal subjects. When controlling for
      age, we found that speed and attention, together with the speed of mental
      processing measured by the Trail Making A and the Stroop tests, correlated with
      the total LA score. However, there was wide variation between subjects. Comparing
      groups with and without LA proved the association of LA with Trail Making A time,
      Stroop test result (words/time and difference/time), and the compound score of
      speed and attention. Presence of periventricular LA was especially related to
      speed of mental processing. CONCLUSION: Leukoaraiosis could explain some of the
      intellectual impairment in the elderly, especially that of slowing of distinct
      motor and attentional functions, as well as slowing of mental processing. Mild LA
      in normal aged subjects could also signal brain at risk for further cognitive
      impairment.

PMID- 8352668
TI  - Propranolol and amitriptyline in prophylaxis of migraine. Pharmacokinetic and
      therapeutic effects.
AB  - OBJECTIVES: To determine if the effectiveness of propranolol hydrochloride and
      amitriptyline hydrochloride are correlated with blood levels and/or with
      standardized test of pharmacologic effect and to determine which clinical
      variables are predictors of response to one or the other medication. DESIGN:
      Three-month modules of treatment with each drug and placebo in a randomized
      crossover design. Headache scores from daily diaries were calculated at monthly
      intervals, as were simultaneous blood levels of drug, supine and standing blood
      pressure, pulse rise with exercise, and salivary flow. SETTING: Outpatient
      headache clinic at the University of Kansas Medical Center, Kansas City.
      PATIENTS: Thirty consecutive patients with a history of frequent migraine. MAIN
      OUTCOME MEASUREMENTS: From headache scores, patients were classified as either
      propranolol responders, amitriptyline responders, or nonspecific responders.
      Clinical variables as predictors of response to medications were studied, as were
      effects on frequency, duration, and/or severity of headache. RESULTS AND
      CONCLUSIONS: No significant correlations were found between changes in headache
      score and blood level of drug or change in any of the physiologic measurements.
      Amitriptyline significantly reduced the severity, frequency, and duration of
      headache attacks; propranolol reduced the severity of attacks only. Amitriptyline
      response was correlated with female gender and baseline headaches of shortest
      duration and of highest frequency. Propranolol response was associated with
      attacks of greatest duration at baseline and with low pulse rise with exercise at
      baseline. Nonspecific response was associated with male gender and most frequent
      headaches by history.

PMID- 8352670
TI  - Myasthenic crisis. Response to plasmapheresis following failure of intravenous
      gamma-globulin.
AB  - Myasthenic crisis is a potentially life-threatening complication of myasthenia
      gravis that requires aggressive therapy. We describe four patients in whom
      myasthenic crisis developed and who failed to respond to initial treatment with
      intravenous gamma-globulin. All four patients subsequently responded to intensive
      plasma exchange. Based on our experience, plasmapheresis appears to be superior
      to intravenous gamma-globulin for the treatment of myasthenic crisis in certain
      patients. Prognostic factors that determine the effectiveness of intravenous
      gamma-globulin vs plasmapheresis in these patients merit further investigation.

PMID- 8352669
TI  - Factors that predict antiphospholipid immunoreactivity in young people with
      transient focal neurological events.
AB  - OBJECTIVE: To determine if clinical or radiological features in young people with
      transient focal neurological events may be used to predict the presence of
      antiphospholipid antibodies (aPL). DESIGN: A combined retrospective and
      prospective study of young people with transient focal neurological events.
      Likelihood ratios and confidence intervals were calculated for the proportions;
      logistic regression analysis was performed to determine features predictive of
      aPL immunoreactivity. SETTING: A referral hospital and adjacent outpatient
      clinic. PATIENTS: Sixty-eight patients with one or more transient focal
      neurological events were screened for aPL. Forty-seven patients were obtained
      retrospectively from medical record review of every outpatient personally seen by
      two of us (G.E.T. and S.R.L.) during a 4.5-year period. Twenty-one patients were
      prospectively added prior to retrospective analysis. Patients older than 50 years
      or those with multiple sclerosis or epilepsy were excluded. Five patients
      fulfilling study criteria were excluded because aPL assay results were
      unavailable. MAIN OUTCOME MEASURES: Transient neurological symptoms, stroke risk
      factors, occurrence of cerebral or ocular infarct or death, headache history, and
      serological and radiological studies were systematically obtained. RESULTS: There
      were 29 aPL-positive patients compared with 39 aPL-negative ones. Features that
      distinguished the aPL-positive group included more common monocular visual
      symptoms (38% vs 15%, P = .03), hemisensory symptoms (76% vs 41%, P = .004), and
      systemic lupus erythematosus (14% vs 0%, P = .03) and less common binocular
      visual symptoms (28% vs 51%, P = .05), accompanying headache (66% vs 87%, P =
      .03), and personal (48% vs 74%, P = .03) and family (29% vs 61%, P = .01) history
      of migraine. No differences were noted between the groups for age, gender, stroke
      risk factor profile, and radiological features. In a logistic regression
      analysis, the estimated odds ratio for aPL positivity in patients with monocular
      visual disturbance, hemisensory symptoms, and no family history of migraine were
      5.3, 7.5, and 3.0, respectively, when controlling for the other variables.
      CONCLUSIONS: Several clinical features of transient focal neurological events in
      aPL-positive patients distinguish these individuals from their aPL-negative
      cohort. Amaurosis fugax, unilateral paresthesias, and no family history of
      migraine may predict aPL positivity in young persons with transient focal
      neurological deficits.

PMID- 8352671
TI  - Brain magnetic resonance imaging in acute optic neuritis. Experience of the Optic
      Neuritis Study Group.
AB  - OBJECTIVE: Changes in the brain on magnetic resonance images are common in
      patients with optic neuritis even when there is no other clinical evidence of
      multiple sclerosis. The current study was designed to determine systematically
      the prevalence of brain abnormalities on magnetic resonance images in the
      patients entered into the Optic Neuritis Treatment Trial. DESIGN: Prospective
      multicenter clinical trial. SETTING: Referral centers. PATIENTS AND METHODS:
      Brain magnetic resonance images from 418 patients with acute optic neuritis (77%
      women; mean age, 32.0 years) were evaluated at a central reading center with the
      use of a standardized classification system (ranging from 0 for normal to IV for
      most extensive changes). RESULTS: Of the scans, 40.9% were classified as grade 0,
      10.8% as grade I, 9.1% as grade II, 6.7% as grade III, and 32.5% as grade IV. For
      patients with isolated (monosymptomatic) optic neuritis, 26.7% had two or more
      lesions. CONCLUSIONS: We found a lower prevalence of brain magnetic resonance
      imaging abnormalities in isolated optic neuritis than previous studies have
      reported. This likely is due to our study having a higher degree of
      standardization of patient inclusion criteria, which limited patient selection
      bias.

PMID- 8352672
TI  - Anatomic-radiologic basis of Lhermitte's sign in multiple sclerosis.
AB  - OBJECTIVE: To test the presumption that Lhermitte's sign in multiple sclerosis is
      the result of a lesion in the cervical spinal cord. DESIGN: The radiologic files
      of 887 patients with multiple sclerosis were reviewed. A detailed questionnaire
      regarding Lhermitte's sign was sent to 75 patients who had undergone magnetic
      resonance imaging of the brain and cervical spinal cord. Of the 64 patients who
      responded, 55 patients who had complete magnetic resonance imaging files were
      studied. The cases of two illustrative patients are presented. RESULTS: A strong
      association between Lhermitte's sign and abnormalities of the cervical spinal
      cord seen on magnetic resonance imaging was noted. Most of the abnormalities were
      in the posterior part of the cervical spinal cord. CONCLUSIONS: The findings
      confirm the presumption that a lesion in the posterior columns of the cervical
      spinal cord is the cause of Lhermitte's sign in multiple sclerosis.

PMID- 8352673
TI  - Should hypertension be treated after acute stroke? A randomized controlled trial
      using single photon emission computed tomography.
AB  - OBJECTIVE: To determine if previously hypertensive patients with acute ischemic
      stroke should be treated with antihypertensive medication in the immediate
      poststroke period. DESIGN: Randomized double-blind, placebo-controlled trial.
      SETTING: Sixteen consecutive hypertensive patients (four men and 12 women; mean
      age, 66 years [age range, 46 to 83 years]) with middle cerebral artery infarction
      within 72 hours of onset and blood pressure between 170 and 220 mm Hg(systolic)
      and 95 and 120 mm Hg (diastolic). INTERVENTION: Placebo (n = 6), nicardipine
      hydrochloride (20 mg [n = 5]), captopril (12.5 mg [n = 3]), or clonidine
      hydrochloride (0.1 mg [n = 2]) given every 8 hours for 3 days. MAIN OUTCOME
      MEASURES: Decline in blood pressure, change in cerebral blood flow as measured by
      single photon emission computed tomography, and clinical change as determined by
      the National Institutes of Health Stroke Scale. RESULTS: Blood pressure fell
      significantly in both the drug-treated group as a whole and in those patients
      receiving placebo (P < .001). There was no difference in blood pressure levels
      between these two groups throughout the study period. Patients receiving
      nicardipine had a consistently lower pressure than the other groups. A
      significant negative relationship was noted between the maximum blood pressure
      fall and improvement in cerebral blood flow. There were four patients whose blood
      pressure dropped by more than 16% of the baseline value on any 24 hours in the
      first 3 days. All either failed to increase or actually decreased their cerebral
      blood flow to the affected area. Three of these patients were treated with
      nicardipine. There was no significant difference in clinical course between the
      placebo-and drug-treated groups as a whole. CONCLUSIONS: Hypertensive ischemic
      stroke patients with a moderate elevation of blood pressure in the first few days
      may not require antihypertensive therapy. Nicardipine and possibly other calcium
      channel blockers may cause an excessive fall in blood pressure and impair
      cerebral blood flow in these patients and should therefore be used with caution.

PMID- 8352674
TI  - Neurologist's role in understanding violence.

PMID- 8352675
TI  - The neurological defense of violent crime. 'Insanity defense' retooled.

PMID- 8352676
TI  - Frontal-subcortical circuits and human behavior.
AB  - OBJECTIVE: This synthetic review was performed to demonstrate the utility of
      frontal-subcortical circuits in the explanation of a wide range of human
      behavioral disorders. DATA SOURCES: Reports of patients with degenerative
      disorders or focal lesions involving frontal lobe or linked subcortical
      structures were chosen from the English literature. Individual case reports and
      group investigations from peer-reviewed journals were evaluated. STUDY SELECTION:
      Studies were included if they described patient behavior in detail or reported
      pertinent neuropsy-chological findings and had compelling evidence of a disorder
      affecting frontal-subcortical circuits. DATA EXTRACTION: Information was used if
      the report from which it was taken met study selection criteria. DATA SYNTHESIS:
      Five parallel segregated circuits link the frontal lobe and subcortical
      structures. Clinical syndromes observed with frontal lobe injury are
      recapitulated with lesions of subcortical member structures of the circuits. Each
      prefrontal circuit has a signature behavioral syndrome: executive function
      deficits occur with lesions of the dorsolateral prefrontal circuit, disinhibition
      with lesions of the orbitofrontal circuit, and apathy with injury to the anterior
      cingulate circuit. Depression, mania, and obsessive-compulsive disorder may also
      be mediated by frontal-subcotical circuits. Movement disorders identify
      involvement of the basal ganglia component of frontal-subcortical circuits.
      CONCLUSIONS: Frontal-subcortical circuits mediate many aspects of human behavior.

PMID- 8352677
TI  - Topical diclofenac reduces pain following photorefractive keratectomy.

PMID- 8352678
TI  - Zinc and macular degeneration.

PMID- 8352680
TI  - Suprachoroidal hemorrhage following a Valsalva maneuver.

PMID- 8352679
TI  - Magnetic resonance images of eyelid anatomy.

PMID- 8352681
TI  - Intravenous epinephrine and acute macular neuroretinopathy.

PMID- 8352683
TI  - Ocular protrusion with contralateral jaw movement.

PMID- 8352682
TI  - Proptosis and periorbital edema due to diltiazem treatment.

PMID- 8352684
TI  - Preparing for managed competition. Utilization of ambulatory eye care visits to
      ophthalmologists.

PMID- 8352685
TI  - The Alcon Research Institute. A model for interaction between the pharmaceutical
      industry and academic medicine.

PMID- 8352686
TI  - The content and cost of cataract surgery.
AB  - Although more than 1 million cataract surgeries are performed annually in the
      United States, little is known about the frequency of use or cost of various
      services provided in connection with this procedure. To assess the frequency with
      which various ophthalmic, optometric, anesthesia, and medical services are
      provided in conjunction with cataract surgery and to estimate the cost to
      Medicare associated with those services, we analyzed 1985 through 1988 Medicare
      claims records of a nationally representative 5% sample of Medicare
      beneficiaries. The experience of 57,103 Medicare beneficiaries who underwent
      extracapsular cataract surgery in 1986 or 1987 that was not combined with another
      ophthalmologic procedure formed the basis of our analysis. Projections for
      current costs were performed using 1991 charges allowed by Medicare for physician
      services. We estimate that the median charge allowed by Medicare for a "typical"
      episode of cataract surgery in 1991 was approximately $2500. In addition to the
      $3.4 billion that Medicare spent in 1991 on such "typical" episodes, Medicare
      spent more than $39 million on miscellaneous "atypical" preoperative
      ophthalmologic tests, such as specular microscopy (14% of cases) and potential
      acuity testing (8% of cases), more than $7 million on postoperative
      ophthalmologic diagnostic tests, such as fluorescein angiography (3% of cases),
      and more than $18 million on perioperative medical services (most commonly
      electrocardiography and chest roentgenography). The major determinants of the
      cost to Medicare associated with cataract surgery are the rate of performance of
      cataract surgery and neodymium-YAG laser capsulotomy and the charges allowed for
      these procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352687
TI  - Prediction of visual function in eyes with mild to moderate posterior pole
      residua of retinopathy of prematurity. Cryotherapy for Retinopathy of Prematurity
      Cooperative Group.
AB  - OBJECTIVE: The Multicenter Trial of Cryotherapy for Retinopathy of Prematurity
      (CRYO-ROP) assigned eyes with macular heterotopia to the "favorable" outcome
      category and eyes with retinal fold involving the macula to the "unfavorable"
      outcome category. This binary assignment did not agree well with measured visual
      acuity outcome. We tested the hypothesis that rating structural outcome on a
      continuum from less to more severe would improve prediction of visual acuity in
      eyes with macular heterotopia or retinal fold. DESIGN: Fundus photographs of the
      69 eyes in the CRYO-ROP trial that had macular heterotopia (n = 55) or retinal
      fold (n = 14) at the 1-year follow-up were analyzed for severity of macular
      heterotopia, macular elevation, and pigmentary disturbances. Each physician
      author estimated each eye's predicted Snellen acuity, based on the photographic
      findings and clinical expertise. These results were compared with the grating
      acuity obtained at ages 1 and 3 1/2 years with the Teller Acuity Card procedure
      and with letter acuity obtained at age 3 1/2 years with the crowded HOTV test.
      PATIENTS: The 69 eyes were from 59 patients in the randomized portion of the CRYO
      ROP trial. RESULTS: Although eyes with retinal fold tended to have greater visual
      impairment than eyes with macular heterotopia, there was a wide variation in
      acuity in both groups, and physicians were unable to predict visual acuity from
      retinal appearance. CONCLUSION: The physician cannot reliably predict either
      grating acuity or letter acuity in eyes with macular heterotopia or macular fold
      due to retinopathy of prematurity. There is no substitute for periodic visual
      acuity testing in these eyes.

PMID- 8352688
TI  - Anterior stromal puncture. Immunohistochemical studies in human corneas.
AB  - OBJECTIVE: To investigate the mechanism of action of corneal anterior stromal
      puncture (ASP) in humans. DESIGN: Immunocytochemical techniques were used to
      localize fibronectin, type IV collagen, and laminin in human corneas with bullous
      keratopathy, some of which had undergone ASP. Corneal specimens were obtained
      from transplant procedures performed in a related clinical study. SETTING:
      Outpatients in private practice settings. PATIENTS: Nine patients with recurrent
      erosion secondary to bullous keratopathy who were judged to be poor candidates
      for keratoplasty. INTERVENTIONS: Anterior stromal puncture was performed on each
      patient using a standardized needle, and corneal transplants were performed on
      patients whose erosions did not resolve after ASP. PRIMARY OUTCOME MEASURES:
      Subjective comfort and slit-lamp verification of resolution of rupture of bullae
      and erosions in patients who underwent ASP; Nomarski differential interference
      contrast photography, immunohistochemical staining, and light microscopy were
      applied to the corneal specimens. RESULTS: All three matrix glycoproteins were
      observed in the epithelial basement membrane of normal corneas. In patients with
      bullous keratopathy who did not undergo ASP, the epithelial basement membrane of
      the cornea did not stain with antibodies against human fibronectin, type IV
      collagen, or laminin. In patients with bullous keratopathy who underwent ASP, all
      three major proteins were present at the puncture sites and in the reactive
      subepithelial pannus adjacent to the puncture site. Epithelial basement membrane
      of untreated regions showed little or no staining. CONCLUSIONS: The results
      suggest that the absence of these extracellular matrix proteins in the epithelial
      basement membrane of patients with bullous keratopathy may be an important factor
      in the development of poor epithelial adhesion and secondary erosions. Anterior
      stromal puncture may promote epithelial reattachment, at least in bullous
      keratopathy, by stimulating the production of extracellular matrix proteins that
      are important in the attachment of epithelial cells to the underlying connective
      tissue. Epithelial-stromal reactions and the development of subepithelial
      fibrosis may also play a role in reestablishing epithelial attachment.

PMID- 8352689
TI  - Comparison of diabetic retinopathy detection by clinical examinations and
      photograph gradings. Barbados (West Indies) Eye Study Group.
AB  - OBJECTIVE: To compare the use of clinical examination and fundus photograph
      gradings in detecting diabetic retinopathy in a population that includes persons
      with and without diabetes. DESIGN: Population-based epidemiologic study. SETTING:
      Sir Winston Scott Polyclinic, Bridgetown, Barbados, West Indies. PARTICIPANTS:
      Subset of a random sample of the country's population aged 40 to 86 years.
      RESULTS: Among 1168 black persons with fundus photograph evaluations,
      ophthalmologic examinations, diabetes history, and glycated hemoglobin data, 21%
      reported a history of diabetes; 9.5% had definite diabetes (glycated hemoglobin >
      11.5%); and 13.3% had a diabetes history and glycated hemoglobin value less than
      or equal to 11.5%. The frequency of diabetic retinopathy in this group was 7.7%
      (90/1168) by clinical examination, 8.7% (102/1168) by photograph gradings, and
      6.7% (78/1168) by both methods. CONCLUSIONS: These results suggest that in
      certain populations that include diabetics and nondiabetics, a clinical
      examination by an ophthalmologist will detect most cases of diabetic retinopathy
      identified by disc and macula photographs read by skilled graders. However, it
      will lead to an underestimate of prevalence. Staff availability and cost, issues
      not examined in this study, should determine which approach is selected.

PMID- 8352690
TI  - Improvement in visual function after displacement of the retinal elevations
      emanating from optic pits.
AB  - OBJECTIVE: To define the functional deficit that correlates with the inner layer
      separation and the outer layer detachment that have been observed in optic pit
      maculopathy and to determine the effect of a gas tamponade that compresses or
      displaces the two layers. DESIGN: The central visual field before and after a gas
      tamponade on the posterior pole were charted on a 1-m tangent screen and compared
      with the changes in the retina observed biomicroscopically and with
      stereophotography. SETTING: The gas operations were done at four hospitals in the
      New York, NY, area and one in Cleveland, Ohio. The retinal examinations, visual
      field testing, and stereoscopic photography for eight patients were done at The
      New York Hospital. The patient who lived in Cleveland was examined and
      photographed in Cleveland. PARTICIPANTS: Nine patients between the ages of 18 and
      46 years with optic pit maculopathy. INTERVENTION: The patients were operated on
      by five retinal surgeons with a variety of procedures. Four patients had a
      vitrectomy and intraocular gas injected. Five patients had gas injected after
      external compression. Two patients had laser applied in conjunction with the
      intraocular injection. The gas tamponade was the unifying factor. RESULTS: The
      dense central scotoma in optic pit maculopathy relates to the outer layer
      detachment and displacement of it from the posterior pole yields an improvement
      in visual acuity. The inner layer separation persists centrally after a gas
      tamponade and continues to provide access for the flow of fluid from the pit. The
      scotoma that relates to the inner layer separation is mild and consistent with
      relatively good visual acuity.

PMID- 8352691
TI  - Surgical management of complications associated with X-linked retinoschisis.
AB  - OBJECTIVE: To evaluate the role of surgical intervention in cases with severe,
      vision-threatening complications of X-linked retinoschisis. DESIGN: A
      retrospective survey of consecutive patients with X-linked retinoschisis who
      underwent surgery at our institution during a 16-year period. SETTING: A tertiary
      care eye hospital. PATIENTS: Six eyes of four patients were identified. The mean
      age of the patients at the time of the first surgical procedure was 4.9 years
      (range, 18 months to 9 years). INTERVENTION: Scleral buckling procedure or pars
      plana vitrectomy. MAIN OUTCOME MEASURE: Surgical indications and long-term
      anatomic and visual outcome. RESULTS: Patients were initially operated on for
      rhegmatogenous retinal detachment (three eyes), exudative retinal detachment (one
      eye), and vitreous hemorrhage (two eyes). The surgical approach was scleral
      buckling for retinal detachment and vitrectomy for vitreous hemorrhage or
      proliferative vitreoretinopathy. Anatomic success and ambulatory vision (20/400
      or better) was achieved in five of the six eyes with a mean follow-up of 3.8
      years (range, 1 to 6 1/2 years). An average of 1.8 procedures per eye were
      performed. Two of the four eyes approached by primary scleral buckling eventually
      required vitrectomy. Proliferative vitreoretinopathy with retinal detachment was
      the major reason for reoperation. CONCLUSIONS: Surgery for X-linked retinoschisis
      associated retinal detachment and vitreous hemorrhage can yield favorable
      anatomic and functional results. Multiple operations and the use of advanced
      vitreoretinal techniques to manage proliferative vitreoretinopathy-related
      complications, however, were necessary for ultimate success in certain cases.

PMID- 8352692
TI  - Strabismus following implantation of Baerveldt drainage devices.
AB  - OBJECTIVE: To describe the clinical features of strabismus following implantation
      of a Baerveldt glaucoma seton. DESIGN: Case series of four patients with a
      minimum follow-up of 6 months. SETTING: Specialized glaucoma referral center at
      Bascom Palmer Eye Institute/Ann Bates Leach Eye Hospital, Miami, Fla. PATIENTS:
      Consecutive sample of four patients with persistent binocular diplopia following
      implantation of a 350-mm2 Baerveldt glaucoma seton in the superotemporal
      quadrant. RESULTS: Each patient presented with a characteristic pattern of either
      exotropia or hypertropia, or both. The deviation increased with gaze opposite the
      ipsilateral superior and lateral muscles and decreased in the field of action of
      the involved muscles. All patients demonstrated a convergence insufficiency type
      of exotropia. CONCLUSION: These patients presented with a similar type of
      restrictive strabismus. Proposed mechanisms include an increase in the length
      tension curve of the muscle induced by the underlying bleb and a posterior
      fixation effect as a result of scarring behind the implant.

PMID- 8352693
TI  - Subepithelial mucinous corneal dystrophy. Clinical and pathological correlations.
AB  - We describe a family with an unusual autosomal dominant anterior corneal
      dystrophy. The onset was characterized by frequent, recurrent corneal erosions in
      the first decade. This subsided during adolescence and was followed by
      progressive decreased vision. Slit-lamp examination revealed bilateral
      subepithelial opacities and haze, involving the entire cornea, but most dense
      centrally. Histopathological study revealed a subepithelial band of eosinophilic,
      periodic acid-Schiff-positive, alcian blue-positive, hyaluronidase-sensitive
      material anterior to Bowman's layer. Electron microscopy demonstrated
      subepithelial deposition of fine fibrillar material consistent with
      glycosaminoglycan. Immunohistochemical analysis indicated that the accumulated
      material contained a combination of chondroitin 4-sulfate and dermatan sulfate.
      This unique condition clinically resembled Grayson-Wilbrandt dystrophy, but
      differed histochemically. To our knowledge, this anterior corneal dystrophy has
      not previously been reported, and it is best described by the name "subepithelial
      mucinous corneal dystrophy."

PMID- 8352694
TI  - Tissue plasminogen activator and Staphylococcus epidermidis endophthalmitis.
AB  - OBJECTIVE: To determine whether intraocular administration of tissue plasminogen
      activator (tPA) speeds clearance of inflammatory debris or prevents
      fibroproliferative complications in an animal model of endophthalmitis. METHODS:
      Aphakic rabbits were given an intraocular dose of Staphylococcus epidermidis
      organisms known to cause moderate inflammation and to self-sterilize. They were
      then randomized to receive either tPA or saline injections 2 and 3 days after
      inoculation. All eyes were graded by one masked clinician seven times, 1 to 28
      days after infection. Vitreous samples from selected eyes were cultured. RESULTS:
      Treated and control eyes were found to have no significant difference in
      inflammatory scores. Although the eyes treated with tPA had more retinal
      detachments and more positive cultures than control eyes, these numbers were not
      statistically significant (P = .44 to .71). CONCLUSION: Fibrinolysis with
      intraocular tPA does not accelerate clearance of inflammation nor decrease
      fibroproliferative complications in this animal model of endophthalmitis.

PMID- 8352695
TI  - Corneal surface morphology following excimer laser ablation with humidified
      gases.
AB  - OBJECTIVE: To compare the effects of blowing dry (nitrogen or helium) and
      humidified gases over the corneal surface during photorefractive keratectomy.
      METHODS: Excimer laser myopic ablations were performed on porcine eyes (10 per
      group) using humidified and dry nitrogen and helium gas under ambient conditions.
      Surface smoothness was quantified with light and electron microscopy. RESULTS:
      Corneas that were ablated using humidified gas were smooth and equivalent to
      those ablated under ambient conditions. Dry nitrogen and helium blowing resulted
      in increased surface irregularity evident on light and electron microscopy (P <
      .001). The pseudomembranes in the humidified gas and ambient air groups had fewer
      surface discontinuities than did those in the nonhumdified gas groups and
      appeared to have a thinner electron-dense surface layer. CONCLUSIONS: The blowing
      of humidified gas during excimer laser corneal ablation produces a smoother
      surface than does the blowing of dry gas and is comparable to that produced under
      ambient (no blowing) conditions. Maintaining corneal moisture is important in
      photorefractive keratectomy. If blowing gas is necessary to remove debris from
      the surface, the gas should be humidified.

PMID- 8352696
TI  - Adrenochrome deposit.

PMID- 8352698
TI  - Here's to your health?

PMID- 8352697
TI  - Transconjunctival entropion repair.
AB  - Involutional lower-eyelid entropion has three underlying correctable causes:
      eyelid laxity, overriding of the orbicularis oculi muscle, and attenuation of the
      lower-eyelid retractors. We describe a new technique for correcting this problem.
      A transconjunctival approach is used to advance or fortify the lower-eyelid
      retractors. The orbicularis oculi muscle can also be addressed through this
      approach. Combining this technique with lateral canthal resuspension anatomically
      corrects the entropion by addressing all three correctable causes.
      Transconjunctival blepharoplasty can also be performed in conjunction with this
      technique. Twenty-three eyelids of 18 patients successfully underwent this
      procedure. Six patients underwent simultaneous transconjunctival blepharoplasty.
      Follow-up ranged between 9 and 18 months. There were no postoperative
      recurrences, overcorrections, or lower-eyelid retraction. This approach yields a
      stable and definitive repair of involutional entropion with excellent
      postoperative cosmesis.

PMID- 8352699
TI  - Effect of lovastatin on serum lipid profile in the treatment of
      dyslipoproteinaemia in uraemic patients on continuous ambulatory peritoneal
      dialysis.
AB  - BACKGROUND: Dyslipoproteinaemia is an important risk factor for cardiovascular
      disease in uraemic patients on continuous ambulatory peritoneal dialysis (CAPD).
      Lovastatin is an HMG Coenzyme A reductase inhibitor which is useful in treating
      non-uraemic patients with hypercholesterolaemia. AIMS: We conducted a single
      blind cross-over study versus placebo in 10 CAPD patients to examine the effect
      of lovastatin (20-40 mg) on the serum lipid profile and its safety in uraemic
      patients. METHODS: Treatment phases were of eight weeks' duration. Each four
      weeks' measurements were made of serum total cholesterol (TC), triglyceride (TG),
      HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), VLDL-cholesterol (VLDL-C),
      Apolipoprotein A1 & B (Apo A1 & Apo B) and Lipoprotein (a). After eight weeks,
      lovastatin significantly reduced TC by 29% from 6.7 +/- 0.3 (mean +/- S.E.M.) to
      4.8 +/- 0.1 mmol/L, LDL-C by 41% from 4.6 +/- 0.3 to 2.7 +/- 0.1 mmol/L and Apo B
      by 32% from 116 +/- 7 to 78 +/- 3 mg/dl (p < 0.01). HDL-C increased by 8% from
      1.2 +/- 0.1 to 1.3 +/- 0.2 mmol/L after eight weeks' therapy (p < 0.05). TG
      decreased by 18% from 1.9 +/- 0.4 to 1.6 +/- 0.3 mmol/L (p < 0.05). There was no
      significant difference in changes of other lipid profiles between placebo and
      drug. No adverse effects of the drug were noted during treatment and the liver
      function and muscle enzymes were not significantly altered by either drug therapy
      or placebo. RESULTS: Lovastatin appears to be a safe and useful drug in
      effectively treating dyslipoproteinaemia in CAPD patients.

PMID- 8352700
TI  - Decreased uptake of L-cystine by duodenal brush border membrane vesicles from
      patients with cystinuria.
AB  - BACKGROUND: The pathophysiology of cystinuria remains unclear. Decreased
      absorption of L-cystine across brush border membranes of small intestinal and
      renal proximal tubular epithelial cells is likely but has not been directly
      demonstrated. AIMS: To compare the rates of L-cystine transport by isolated
      duodenal brush border membranes of normal individuals and patients with
      cystinuria. METHODS: Distal duodenal biopsies were taken from normal individuals
      and patients with cystinuria. Brush border membrane vesicles (BBMV) were prepared
      using magnesium aggregation and differential centrifugation and the rates of L
      cystine transport into the vesicles measured using a rapid filtration technique.
      RESULTS: Rates of L-cystine transport by BBMV from patients with cystinuria were
      reduced at 5 minute (p = 0.003) and 30 minute (p = 0.053). Time points,
      indicating that L-cystine absorption across brush border membranes is abnormal in
      cystinuria.

PMID- 8352701
TI  - Aconitine poisoning following the ingestion of Chinese herbal medicines: a report
      of eight cases.
AB  - BACKGROUND: Traditional Chinese medicines often contain 'chuanwu' and 'caowu',
      the roots of certain Aconitum species which are thought to have an anti
      inflammatory effect in many conditions. Excessive amounts of these materials,
      which contain diterpene alkaloids particularly aconitine, can produce toxic
      effects and occasional fatalities. AIMS: This study was conducted to document the
      adverse effects related to these herbal medicines which resulted in hospital
      admission and to determine the outcome in these patients. METHODS: A
      retrospective survey was conducted of patients admitted to the Prince of Wales
      Hospital, Hong Kong with suspected adverse effects from Chinese herbal medicines
      containing chuanwu or caowu over a two year period from 1989 to 1991. RESULTS:
      Eight patients were identified with features of mild to moderate intoxication
      including nausea and vomiting, paraesthesiae or numbness in the mouth and
      extremities, hypotension and ventricular extrasystoles. The management of
      aconitine poisoning is essentially supportive and in-hospital observation with
      ECG monitoring should be continued for at least 24 hours because of the risk of
      cardiovascular collapse and ventricular arrhythmias. The medical profession and
      general public should be alerted to the potential toxicity of these herbs and
      their usage should be controlled by legislation in Hong Kong as it is in some
      other countries.

PMID- 8352702
TI  - Yttrium synovectomy: a meta-analysis of the literature.
AB  - BACKGROUND: Yttrium synovectomy for chronic synovitis of the knee enjoys
      widespread usage in Australia with approximately 400 patients receiving yttrium
      90 in 1991. Despite abundant anecdotal evidence of its efficacy there is a
      paucity of controlled trials and those that have been done have produced
      conflicting results and have been of insufficient sample size. AIMS: To
      critically and quantitatively evaluate the published English literature on
      comparative trials of yttrium-90 therapy for chronic synovitis of the knee.
      METHODS: The technique of meta-analysis was utilised. The literature search was
      carried out using the MeSH terms of synovectomy and knee; and yttrium. This was
      augmented by referring to reviews, current textbooks and back-references. Outcome
      measures varied between trials but could be grouped as treatment success. The
      Peto modification of Mantel and Haenszl was used for statistical pooling of data
      yielding a pooled odds ratio (OR). RESULTS: The literature search revealed ten
      controlled trials of which two were excluded from further analysis. Yttrium was
      superior to placebo (OR 2.42, 95% CI 1.02-5.73) but this result should be
      interpreted with caution due to possible publication bias. Yttrium was not
      superior to triamcinolone (OR 1.89, 95% CI 0.81-10.55) or other active modalities
      (OR 1.04, 95% CI 0.72-1.52). Further research comparing yttrium with other
      modalities is necessary to properly determine its place in rheumatological
      practice.

PMID- 8352703
TI  - Duplicate reporting of AIDS cases between two neighbouring countries.
AB  - AIMS: To measure the extent and characteristics of cases of duplicate
      notification of diagnoses of Acquired Immunodeficiency Syndrome (AIDS) between
      Australia and New Zealand. METHODS: Cases of AIDS notified to the national AIDS
      registries in both Australia and New Zealand were identified, using date of birth
      and a name code. Cases determined to have been notified to both registries were
      analysed with respect to exposure category, country of birth and country of
      death. RESULTS: Twenty-six cases of AIDS were determined to be common to both
      registries, representing 1.1% of cases notified to the Australian registry and
      11.1% of cases notified to the New Zealand registry. Exposure to HIV was
      attributed to male homosexual contact for all cases, and a history of injecting
      drug use was reported more frequently to the Australian registry for the cases in
      common. For the majority of cases notified to both registries, country of birth
      was recorded as New Zealand. Deaths following AIDS were reported as occurring in
      both countries with equal frequency.

PMID- 8352704
TI  - Repair of the anterior mitral leaflet.
AB  - BACKGROUND: Repair rather than replacement of the diseased mitral valve has been
      the goal of the cardiac surgeon. Although well accepted for posterior leaflet
      pathology, a diseased anterior leaflet was believed by some to be irreparable.
      AIMS: To assess the result of reconstructive mitral valve surgery involving the
      anterior mitral leaflet in a selected group of patients. METHODS: Twenty
      consecutive patients with degenerative (19), ischaemic (one) and
      congenital/calcific mitral regurgitation were evaluated. There were five females
      and 15 males with a mean age of 62 +/- 12 years (41-75 years). The technique used
      to repair these valves included chordal transposition, leaflet plication
      commissuroplasty and a new technique we call leaflet repositioning. RESULT: There
      were no deaths, follow-up is complete with mean follow-up of 31 +/- five months
      (two-102) months. All patients have had 2DE and 13 TOE as well. There have been
      no reoperations due to failure of the repair, 95% of patients are in NYHA Class I
      II post operative, while 15% have significant residual regurgitation.

PMID- 8352705
TI  - Pneumococcal vaccine: current status.

PMID- 8352706
TI  - Clinical implications of laboratory testing for the thrombophilic disorders.

PMID- 8352707
TI  - Alcohol and the J-curve survival.

PMID- 8352708
TI  - Prolonged exacerbation of the neurological sequelae of stroke by post-stroke
      partial epileptic seizures.

PMID- 8352709
TI  - Stem cell mobilisation with cyclophosphamide--what dose?

PMID- 8352710
TI  - Fatal transfusion-associated graft-vs-host disease.

PMID- 8352711
TI  - Anabolic steroid hepatotoxicity: lessons to be learnt?

PMID- 8352712
TI  - Spontaneous involution of an atrial myxoma complicated by bacterial endocarditis.

PMID- 8352713
TI  - Delays preceding admission to hospital and treatment with thrombolytic agents of
      patients with possible heart attack.

PMID- 8352714
TI  - Radiofrequency catheter ablation for paroxysmal supraventricular tachycardia: a
      report of 135 procedures.
AB  - BACKGROUND: Paroxysmal Supraventricular Tachycardia (PSVT) is a common condition
      which until recently has been treated with anti-arrhythmic drugs or surgery.
      Radiofrequency (RF) catheter ablation is a new mode of treatment which provides a
      cure of this condition. AIMS: To present our early experience of RF catheter
      ablation for PSVT. METHODS: One hundred and thirty-five procedures were performed
      in 117 patients. The diagnostic study and therapeutic catheter ablation were
      performed as a combined electrophysiological procedure in 74 patients (63%). In
      58 patients (50%), PSVT was due to Atrio-ventricular junctional (nodal) re
      entrant tachycardia (AVJRT). Twenty-five of the 58 patients underwent a fast
      pathway ablation while 33 had ablation of their slow pathway. The mean number of
      radiofrequency pulses delivered was ten for a mean duration of 25 seconds.
      Radiofrequency ablation of accessory pathways was attempted in 58 patients;
      pathways were left-sided in 29 patients, postero-septal in 21, midseptal in five,
      Mahaim connection in two, antero-septal in one and right free wall in one
      patient. One patient with incessant automatic atrial tachycardia also underwent a
      successful RF ablation. RESULTS: Using RF ablation cure of PSVT was achieved in
      90% of patients. Cure of AVJRT was achieved in 95% (55/58) of patients using
      either fast or slow pathway ablation. Only one patient required permanent
      pacemaker implantation for Mobitz type I AV block following fast pathway
      ablation. The overall success rate for ablation of accessory pathways was 85%.
      There is an operator learning curve for this procedure suggested by the fact that
      the success rate for accessory pathway ablation at first attempt was 63% in the
      first 29 patients and 93% in the remaining 29. There was no significant morbidity
      or mortality during or after the procedure. In a mean follow-up of nine months in
      the patients with successful ablation only two patients with AVJRT had a
      recurrence of documented PSVT. Both these patients had successful repeat RF
      ablation. Catheter ablation using radiofrequency energy is an effective and safe
      therapeutic option for patients with symptomatic PSVT.

PMID- 8352715
TI  - Australian Geriatrics Society. Annual scientific meeting. Sydney, 29 April - 1
      May, 1993. Abstracts.

PMID- 8352716
TI  - Evolutionary adaptation and stress: energy budgets and habitats preferred.
AB  - Natural populations are normally exposed to substantial environmental stress. The
      consequences of stress include elevated metabolic costs and additive genetic
      variability. From the former, preferred habitats should be located in
      environments corresponding to minimum total energy expenditure. This tendency
      occurs in the field for behavioral adaptation of Drosophila to variable
      temperature (and humidity) conditions. Laboratory studies of resource preference
      in Drosophila suggest a low genetic variability. However, under more stressful
      field conditions, genetic variability should be higher. Habitat preference
      studies under stressful conditions therefore need to be emphasized in modeling
      situations in nature.

PMID- 8352717
TI  - Selection for high and low pupation height in Drosophila ananassae.
AB  - Selection for high and low pupation height in Drosophila ananassae was carried
      out for 10 generations. Response to selection resulted in rapid divergence in
      pupation height in replicates of both high and low lines. There was a significant
      difference in mean pupation height among high, low, and control lines. Regression
      coefficients for both high and low lines were significantly different from zero.
      The realized heritability over 10 generations was 45-49 for the high lines and 26
      29 for the low lines. The F1 hybrids produced by making reciprocal crosses
      between high and low lines showed intermediate pupation height. These findings
      suggest that pupation height in D. ananassae is under polygenic control, with a
      substantial amount of additive genetic variation.

PMID- 8352718
TI  - Comparisons of subcolonies of selectively bred long-sleep and short-sleep mice.
AB  - The Albany subcolony of the selectively bred Long- and Short-Sleep mice was
      directly compared to the original Colorado colony. As expected from the
      additional selection applied to the Colorado colony, small differences in the
      selection phenotype, loss of the righting reflex duration following ethanol
      treatment, were observed in the Short-Sleep line. However, no colony differences
      existed in three other indices of ethanol effects. Clear line differences in the
      shape of the locomotor activity dose-response curve, thermoregulatory effects of
      ethanol, and ethanol elimination rate replicated earlier findings, but these
      differences were similar in the two colonies. These data argue for stability of
      the polygenic control system and provide a picture of remarkable similarity of
      the two sublines, which were separated by more than 30 generations.

PMID- 8352719
TI  - Olfactory discrimination of urinary odortypes from congenic strains (DBA/1Bg and
      DBA1.C57BL10-YBg) of mice differing in their Y chromosomes.
AB  - Differential effects of one or more genes in the nonpseudoautosomal region of the
      DBA1 and C57BL10 Y chromosomes on offensive attack may be mediated, at least in
      part, by differential effects of this Y chromosomal gene(s) on the sending and
      receiving of discriminable urinary odortypes. This hypothesis is based, in part,
      on the report that urine from a pair of Y chromosomal congenic strains
      (C57BL6.AKR-Y and C57BL6) of mice can be discriminated in a Y maze test. The AKR
      and C57BL6 Y chromosomes come from two distinct species of mouse (Mus domesticus
      and Mus musculus, respectively). Thus, this Y chromosomal variant exists between
      mouse species. The DBA1 and C57BL10 Y chromosomes come from a single species, Mus
      musculus. Here we show that in the Y maze system previously used, urine from mice
      with the DBA1 and with the C57BL10 Y chromosomes can also be discriminated. Thus,
      there are discriminable urinary odortypes for this pair of Y chromosomes from the
      same species, Mus musculus.

PMID- 8352720
TI  - A comparison of the contribution of the major histocompatibility complex (MHC)
      and Y chromosomes to the discriminability of individual urine odors of mice by
      Long-Evans rats.
AB  - A go/no-go operant task was used to assess the ability of male Long-Evans rats to
      discriminate between the urine odors from pairs of intact MHC congenic mice
      (C57BL/6-H-2Kb/J and C57BL/6-H-2Kbm1/ByJ), intact Y congenic mice (DBA1 and
      DBA1.C57BL10-Y), and castrated Y congenic mice of these two strains. The MHC
      congenic strains differ in alleles of the H-2 K locus, while the Y congenic
      strains differ in the nonrecombining part of the Y chromosome. Analysis of the
      number of correct responses to a criterion of 85% correct on each block of 20
      trials revealed that the ability of the subjects to discriminate between urine
      odors did not differ whether samples were from pairs of intact MHC congenic mice,
      intact Y congenic mice, or castrated Y congenic mice. These findings are
      consistent with the hypothesis that individually unique urine odors may be
      influenced both by genes in the nonrecombining part of the Y chromosome and by
      genes in the major histocompatibility complex of chromosome 17. These odors are
      not androgen dependent. Such urinary chemical signals may be involved in
      pregnancy block (the Bruce effect), aggression, and other mouse social behaviors.

PMID- 8352721
TI  - Neonatal vestibular stimulation and mating in cerebellar mutants.
AB  - Two cerebellar mutants, staggerer and reeler, and their congenic nonmutants were
      used in this experiment. Experimental animals were subjected to intense
      rotational stimulation on a tilted plane during the first 3 weeks of life, while
      controls were left nonstimulated. The capacity for mating, as evidenced by
      vaginal plugs or the occurrence of pregnancy, was assayed during two periods:
      between 36 and 89 days of age (Experiment A) and between 90 and 120 days of age
      (Experiment B). During Experiment A the mutants as well as the normals were caged
      inter se with partners of the opposite sex. During Experiment B the animals were
      caged with intact, sexually experienced partners. The animals were examined daily
      for evidence of mating. During Experiment A, only 3 of the 89 couples
      participating in this study showed evidence of mating. During Experiment B, the
      number of males of both strains which had mated increased significantly. The
      staggerer females showed a relatively high level of mating activity, whether
      stimulated or not. The reeler females, in contrast, rarely mated, although early
      stimulation significantly increased the level of sexual efficiency. The majority
      of the normal males and females mated, whether stimulated or not. It was
      concluded that massive motor-sensory stimulation in infancy, improving gait and
      body balance in staggerer and reeler mice, may also improve mating efficiency.

PMID- 8352722
TI  - Estimating and controlling for the effects of volunteer bias with pairs of
      relatives.
AB  - If pairs of relatives correlate in their liability to participate in a research
      project, it is possible to test for the effects of volunteering on the criterion
      variable of interest. Much of the information for this test comes from a
      difference in criterion variable mean between individuals with and those without
      a cooperative relative. Also, if data are available from more than one class of
      relative, it may be possible to discriminate between (i) volunteering that occurs
      as a consequence of the criterion variable and (ii) volunteering as a cause of
      the criterion. Likelihood formulae are presented that permit quantification and
      significance testing of volunteer bias. If data are collected from a genetically
      informative design such as a twin study, it is possible to estimate genetic and
      environmental parameters independent of the contaminating effects of such bias.
      We describe some methods of reducing the computational burden of multidimensional
      integration to allow extension to multivariate data. Implications for research
      design and management are discussed.

PMID- 8352723
TI  - Familial transmission of cognitive abilities in offspring tested in adolescence
      and adulthood: a longitudinal study.
AB  - As part of a follow-up study of now-adult offspring who originally participated
      in the Hawaii Family Study of Cognition (HFSC) from 1972 to 1976, 49 females and
      46 males from 73 families of Caucasian ancestry and 63 females and 55 males from
      92 families of Japanese ancestry were retested (average test-retest interval, 13
      years) on the battery of cognitive abilities tests they took as adolescents. Age
      corrected scale scores for verbal ability, spatial ability, perceptual speed,
      visual memory, and unrotated first principal component were calculated for the
      offspring's fathers and mothers, for their original HFSC testing, and for the
      retesting. Model-fitting procedures for a univariate model of familial
      transmission indicated significant differences in the parameters between the two
      racial/ethnic groups for all five cognitive abilities scales. These procedures
      also demonstrated no significant differences in familialities for offspring
      abilities in adolescence vs. mature adulthood across all five abilities scales
      and both racial/ethnic groups.

PMID- 8352724
TI  - Nature, nurture, and conservatism in the Australian Twin Study.
AB  - Church attendance, educational level, and six conservatism scales were the
      subject of a multivariate behavior-genetic analysis by Truett et al. (Behav.
      Genet. 22, 43-62, 1992), based on responses from a large sample of adult
      Australian twins. These data are here analyzed in a different way to elicit
      general conservatism factors in the genetic, shared environmental, and unshared
      environmental covariation. The general genetic factor appears mainly to reflect
      intellectual sophistication; the general environmental factors, religious
      affiliation. These factors are similar, although not identical, for men and
      women.

PMID- 8352725
TI  - Segregation analysis of speech and language disorders.
AB  - Complex segregation analysis was performed on pedigrees ascertained through 45
      probands (26 males, 19 females) with a history of preschool speech and language
      disorders. Hypotheses concerning mode of inheritance were tested using the
      POINTER segregation analysis program. Although there is strong evidence for
      familial transmission of this trait, we were unable to distinguish between a
      major gene and multifactorial transmission model using likelihood-ratio chi
      square tests. Future studies with quantitative measures of speech and language
      disorders are needed to resolve the issue of mode of inheritance for this trait.

PMID- 8352726
TI  - Radical-induced chain oxidation of proteins and its inhibition by chain-breaking
      antioxidants.
AB  - Exposure of proteins to oxygen-centred radicals results in dramatic changes in
      their structure, stability and function; properties that have been studied in
      many laboratories from a qualitative viewpoint. To allow a quantitative
      evaluation, we subjected aerated solutions of BSA to hydroxyl and superoxide
      anion radicals generated radiolytically under conditions where all radicals
      formed reacted with the protein (as judged by maximum damage to BSA). We observed
      that for each radical generated approx. 15 amino acids were consumed initially.
      Similar results were found with lysozyme and melittin. Such a massive consumption
      of BSA's amino acids was not observed when irradiations were carried out under
      anaerobic conditions. When bilirubin or Trolox (a water-soluble analogue of
      vitamin E) was added at a 2-fold molar excess over BSA, initial consumption of
      all measured amino acids, except tryptophan, decreased 4-fold. The total mass of
      amino acids initially protected (from consumption) exceeded the mass of
      antioxidants consumed by more than a factor of 20. Such protection of amino acids
      was not observed when the antioxidant-inactive acetyl Trolox was used. These
      results suggest that radical-mediated oxidation of proteins can proceed via a
      previously unrecognized chain reaction that may be inhibited by chain-breaking
      antioxidants.

PMID- 8352727
TI  - Interactions between active-site-serine beta-lactamases and compounds bearing a
      methoxy side chain on the alpha-face of the beta-lactam ring: kinetic and
      molecular modelling studies.
AB  - The interactions between three class A beta-lactamases and compounds bearing a
      methoxy side chain on the alpha-face of the beta-lactam ring (cefoxitin,
      moxalactam and temocillin) have been studied. When compared with the situation
      prevailing with good substrates, both acylation and deacylation steps appeared to
      be severely impaired. Molecular modelling studies of the structures of the Henri
      Michaelis complexes and of the acyl-enzymes indicate a major displacement of the
      crystallographically observed water molecule which connects the glutamate-166 and
      serine-70 side chains and underline the role of this water molecule in both
      reaction steps.

PMID- 8352728
TI  - Biotin binders selected from a random peptide library expressed on phage.
AB  - Recombinant biotin-binding phages were affinity-selected from a random peptide
      library expressed on the surface of filamentous phage. Phage binding to
      biotinylated proteins was half-maximally inhibited by micromolar concentrations
      of a monobiotinylated molecule. Sequencing of the peptide inserts of selected
      phages led to the identification of a previously unknown biotin-binding motif,
      CXWXPPF(K or R)XXC. A synthetic peptide containing this sequence motif inhibited
      streptavidin binding to biotinylated BSA with an IC50 of 50 microM. This compound
      represents the shortest non-avidin biotin-binding peptide identified to date. Our
      results illustrate that phage display technology can be used to identify novel
      ligands for a small non-proteinaceous molecule.

PMID- 8352729
TI  - DNA substrate specificity of pea DNA methylase.
AB  - DNA methylase, present in low-salt extracts of nuclei prepared from Pisum sativum
      shoot tips, methylates model DNA substrates containing CNG trinucleotides or CI
      dinucleotides only. The binding to the hemimethylated trinucleotide substrates is
      very much stronger and more persistent than the binding to the unmethylated
      substrates or to the hemimethylated dinucleotide substrate. When the DNA
      concentration is limiting, the rate of methyl-group transfer with the
      hemimethylated CNG substrate is much greater than that with the unmethylated CNG.
      However, the Vmax. is similar for the two CNG substrates. On fractionation using
      Q-Sepharose, two peaks of activity are seen with different relative activities
      using the di- and trinucleotide substrates. The relative activity with these
      substrates changes during purification, during plant growth and on heating at 35
      degrees C as well, indicating that more than one enzyme or more than one form of
      the enzyme may be present.

PMID- 8352730
TI  - The role of the 5'-flanking region in the cell-specific transcription of the
      human von Willebrand factor gene.
AB  - Transcriptional regulation of the human von Willebrand factor (vWF) gene was
      investigated in calf pulmonary artery endothelial (CPAE), HeLa, COS 7 and Hep G2
      cells. Various lengths of flanking sequences extending up to 2123 bp 5' of the
      transcription initiation site and containing 19 bp of the first exon, were linked
      to the bacterial chloramphenicol acetyltransferase (CAT) gene and these
      constructs were assayed in transient transfection assays. Sequences up to 89 bp
      upstream of the cap site showed transcriptional activity in all cell types.
      Sequences between -147 and -419 bp markedly reduced CAT activity in CPAE cells
      and abolished it in other cell lines. A domain from -592 to -810 bp generated low
      levels of expression only in CPAE cells. This transcriptional activity was
      repressed with constructs containing 1041 to 1240 bp upstream of the cap site.
      Endothelial cell-specific transcription was restored by a construct that
      contained 1286 bp upstream of the cap site. The additional 46 bp upstream of the
      negative regulatory domain were within the 5' end of an inverse human Alu-family
      DNA repeat. RNAase-protection assays confirmed the correct transcriptional
      initiation. The sequence between -89 and -420 contained at least one negative
      regulatory element able to repress the CAT gene expression controlled by the
      heterologous thymidine kinase promoter in all cell types. A construct that
      included the sequence from -89 to -1286 bp increased the transcriptional activity
      directed by the thymidine kinase promoter only in CPAE cells. These results
      indicate that negative and positive elements in the 5'-flanking region interact
      to regulate vWF gene expression.

PMID- 8352732
TI  - A mobile element on a virus particle surface identified by nuclear magnetic
      resonance spectroscopy.
AB  - The presence of a mobile element in the coat protein of pepper ringspot
      tobravirus (PRV) has been established by 1H n.m.r. spectroscopy; two-dimensional
      correlation spectroscopy (COSY) measurements show that this element consists of
      alanine, asparagine, glycine, proline, serine and threonine only. By reference to
      the amino acid sequence of the coat protein, it is concluded that the mobile
      element is associated with the C-terminal region and consists of between 11 and
      38 residues.

PMID- 8352731
TI  - Correlation between secretion and phospholipase D activation in differentiated
      HL60 cells.
AB  - Receptor-directed agonists including N-formylmethionyl-leucyl-phenylalanine
      (fMetLeuPhe), C5a, ATP and UTP all activate phospholipase D (PLD), which is
      accompanied by secretion in differentiated HL60 cells. Interference in the
      production of phosphatidase (PA) by the PLD pathway by diverting it towards the
      production of phosphatidylethanol (PEt) in the presence of ethanol leads to near
      total inhibition of the secretion evoked by ATP and UTP and a partial inhibition
      of that evoked by fMetLeuPhe and C5a. In streptolysin-O-permeabilized cells,
      fMetLeuPhe is able to activate PLD, and this is dependent on the presence of a
      low concentration of guanosine 5'-[gamma-thio]-triphosphate (GTP[S]). Ca2+ (10
      microM) and GTP[S] individually or in combination are also able to activate PLD
      and secretion. The stimulation of secretion in permeabilized cells stimulated by
      Ca2+ alone or fMetLeuPhe or GTP[S] is also abrogated when the production of PA is
      diverted to PEt by the presence of ethanol. Activation of PLD by GTP[S] or
      fMetLeuPhe is decreased if the cells are permeabilized first and GTP[S] or
      fMetLeuPhe is added subsequently. This corresponds well with the loss of the
      secretory response. We conclude that the ability of GTP[S] or fMetLeuPhe to
      stimulate secretion from permeabilized cells is dependent on a prior activation
      of the PLD signalling pathway. PA, generated as a consequence of PLD activation,
      acts as second messenger that can provide an initiating signal for secretion and
      is not required for exocytosis itself.

PMID- 8352733
TI  - Non-enzymic glycation of collagen inhibits binding of oxidized low-density
      lipoprotein.
AB  - We have examined the effect of non-enzymic glycation of native soluble collagen,
      in solution or in gels, on binding of oxidized low-density lipoprotein (LDL). We
      found the following. (1) Glycation markedly inhibited binding of LDL. This is
      contrary to results previously reported; the difference may be attributable to
      the use of detergent- and heat-denatured collagen, covalently bound to agarose
      beads, in the earlier study. (2) With increased duration of glycation, collagen
      solution would not gel, and preformed gels dissolved. (3) [14C]Glucose bound to
      collagen gels dissociated slowly, even at pH 5, suggesting that it was not
      present as a Schiff's base; in addition, ketoamines, pentosidine and fluorescent
      advanced glycation products were not detectable in glycated collagen gels,
      although they accumulated in tendon collagen glycated under the same conditions.
      It is hypothesized that the difference in glycation effects between gel and
      tendon may be due to the strength of cross-linking before glycation: the increase
      in intermolecular distance in collagen fibrils which results from glycation
      disrupts the fibrils in gels, preventing binding of LDL and formation of
      glycation-dependent cross-links, whereas the extensive cross-linking in tendon
      maintains the intermolecular distances within a range which permits formation of
      glycation cross-links.

PMID- 8352734
TI  - Biosynthesis of 3,4-didehydroretinol from retinol by human skin keratinocytes in
      culture.
AB  - The uptake and metabolism of radiolabelled retinol was studied in cultivated
      human skin cells. Normal epidermal keratinocytes in primary culture were able to
      incorporate unbound [11,12-3H]all-trans-retinol from the growth medium and
      transform it into 3,4-didehydroretinol (dehydroretinol) in a dose- and time
      dependent manner. A total of 23% of the radioactive label became cell-associated
      during a 48-h incubation period when added at 7 nM to differentiated
      keratinocytes submerged in serum-containing, high-calcium (1.56 mM) culture
      medium. At that time point, 25-30% of cell-bound radioactive retinol had been
      converted into dehydroretinol, with no labelled retinal, dehydroretinal, retinoic
      acid or dehydroretinoic acid being detected in cells or medium. Thus
      dehydroretinol, which occurs physiologically in mammalian skin tissue in vivo,
      was identified as the predominant neutral retinol metabolite in cultured
      keratinocytes using h.p.l.c. and anhydro-derivatization procedures. At least 94%
      of the product, along with its precursor, was present in the cells in esterified
      form, with no traces of the compound being secreted into the cell environment.
      The rate of formation of dehydroretinol from its precursor was significantly
      lower in keratinocytes grown in serum-free, low-calcium (0.09 mM) culture medium,
      and in medium pre-incubated with excess unlabelled substrate. Furthermore, the
      application of 13-cis-retinoic acid (isotretinoin), a therapeutic retinoid drug
      known to markedly reduce dehydroretinol levels in human skin, blocked the
      biosynthesis of this metabolite in cultured keratinocytes. The 3,4
      dehydrogenation pathway observed in this study could not be shown to operate to
      any significant extent in cultures of human epidermal melanocytes or dermal
      fibroblasts, supporting the hypothesis that keratinocytes represent the principal
      cell type involved in dehydroretinol formation from retinol in human skin.

PMID- 8352735
TI  - A glycosulphatase that removes sulphate from mucus glycoprotein.
AB  - A novel glycosulphatase has been purified from a mucus glycopeptide-degrading
      Prevotella from the colon. The purified enzyme removed inorganic [35S]sulphate
      from 35S-labelled native rat gastric mucus glycoprotein. Desulphation of mucus
      glycoprotein was initially rapid (19% complete after 10 min) but then plateaued,
      reaching only 33% after 3 h. Crude periplasmic extracts could remove 79% of the
      radioactivity as inorganic sulphate. These results suggest that steric hindrance
      may limit the access of the purified glycosulphatase to the mucus glycoprotein
      oligosaccharide chains in the absence of glycosidases, and/or that the enzyme may
      have the wrong specificity for some of the remaining sulphated sugars in the
      chains. The apparent molecular mass of the enzyme was 111 kDa as judged from gel
      exclusion chromatography, and it appeared to be composed of two identical
      subunits. The enzyme was localized in the periplasm of the bacterium, and using
      pig gastric mucus glycopeptide as a growth substrate markedly increased enzyme
      levels. Enzymic activity increased at the end of the growth phase. The substrate
      specificity of the enzyme was tested against low-molecular-mass sulphated
      molecules. The monosaccharides glucose 6-sulphate and N-acetylglucosamine 6
      sulphate were rapidly desulphated, the latter being the major sulphated sugar in
      some mucus glycoproteins. Lactose 6-sulphate, galactose 6-sulphate, sulphated
      steroids and unsaturated disaccharide sulphate breakdown products from
      chondroitin sulphate were not desulphated. Glycosulphatases which can remove
      sulphate from mucus glycoproteins may play an important role in the degradation
      of highly sulphated mucus glycoproteins in the digestive tract, and could modify
      the effectiveness of mucus glycoproteins in mucosal protection.

PMID- 8352736
TI  - Properties of the pyridoxaldimine form of glutamate semialdehyde aminotransferase
      (glutamate-1-semialdehyde 2,1-aminomutase) and analysis of its role as an
      intermediate in the formation of aminolaevulinate.
AB  - Glutamate semialdehyde aminotransferase (glutamate-1-semialdehyde 2,1
      aminomutase; EC 5.4.3.8) was converted into its pyridoxaldimine form by
      exhaustive replacement of endogenous pyridoxamine phosphate with pyridoxal
      phosphate. The isomerization of glutamate 1-semialdehyde to 5-aminolaevulinate by
      this form of the enzyme followed an accelerating time course which indicated that
      the enzyme initially had no activity but was converted into the active
      pyridoxamine phosphate form in an exponential process characterized by a rate
      constant (k) of 0.027 s-1. The pyridoxaldimine form of the enzyme was converted
      rapidly into the pyridoxamine form by (S)-4-aminohex-5-enoate and much more
      slowly by 4-aminobutyrate. The steady-state velocity of the enzyme increased in a
      markedly non-linear fashion with increasing enzyme concentration, indicating that
      the extent of dissociation of an intermediate in the reaction to free
      diaminovalerate and the pyridoxaldimine form of the enzyme depends upon the
      concentration of the enzyme.

PMID- 8352739
TI  - Cloning of the gene for glutamate decarboxylase and its expression during
      conidiation in Neurospora crassa.
AB  - Neurospora crassa glutamate decarboxylase (GAD) is produced during conidiation
      and stored in dormant conidia. Polyclonal antibody was generated to GAD that had
      been purified to homogeneity. The anti-GAD antibody was specific for N. crassa
      GAD and inhibited GAD activity. The level of GAD protein decreased during
      conidial germination, indicating that GAD was degraded during this phase of
      development. The anti-GAD antibody was used to isolate a cDNA clone of GAD from a
      lambda ZAP cDNA expression library. Escherichia coli containing a plasmid with
      the cDNA insert produced GAD activity. The cDNA clone contained a 2.6 kbp insert
      and hybridized to a 2.6 kb mRNA species from conidiating cultures of N. crassa.
      GAD mRNA was not present in vegetative hyphae. In conidiating cultures, GAD mRNA
      was first detected when conidia began to appear. The level of GAD mRNA increased
      as conidiation progressed. This is the first example of the cloning of an enzyme
      that is regulated at the level of mRNA during the asexual developmental cycle of
      N. crassa.

PMID- 8352737
TI  - Purification and properties of the uroporphyrinogen decarboxylase from
      Rhodobacter sphaeroides.
AB  - Uroporphyrinogen decarboxylase (EC 4.1.1.37) was purified 600-fold from
      Rhodobacter sphaeroides grown anaerobically in the light. The enzyme, under both
      denaturing and non-denaturing conditions, is a monomer of M(r) 41,000. The Km
      values are 1.8 microM and 6.0 microM for the conversion of uroporphyrinogen I and
      III to coproporphyrinogen I and III respectively. The enzyme is susceptible to
      inhibition by both uroporphyrinogen and uroporphyrin. The pH optimum is 6.8 and
      the isoelectric point is 4.4. The importance of cysteine and arginine residues is
      implicated from studies with inhibitors. The sequence of the first 29 amino acids
      of the N-terminus shows a high degree of similarity to the primary structures of
      other uroporphyrinogen decarboxylases. Studies on the order of decarboxylation of
      the four acetic acid side chains of uroporphyrinogen III suggest that at high
      substrate levels a random route is preferred.

PMID- 8352738
TI  - Plasma activities of lecithin:cholesterol acyltransferase, lipid transfer
      proteins and post-heparin lipases in inbred strains of rabbits hypo- or hyper
      responsive to dietary cholesterol.
AB  - Plasma lipoproteins, plasma activities of lecithin:cholesterol acyltransferase
      (LCAT), phospholipid transfer protein (PLTP), cholesteryl ester transfer protein
      (CETP) and post-heparin lipases were measured before and after cholesterol
      challenge in two inbred strains of rabbits with either a high (hyper-responders)
      or a low (hyporesponders) response of plasma cholesterol to dietary cholesterol.
      The purpose of this study was to provide clues about the mechanisms underlying
      the effect of dietary cholesterol on lipoprotein levels and composition, and
      particularly those underlying the strain difference of this effect. Cholesterol
      feeding (0.15 g of cholesterol/100 g of diet) caused increased plasma total
      cholesterol concentrations and an increased ratio of cholesteryl
      esters:triacylglycerol in all lipoprotein particles in both strains; these
      effects were significantly greater in hyper- than hypo-responsive rabbits.
      Feeding on the high-cholesterol diet lowered plasma triacylglycerols in hyper
      responders, but caused increased plasma triacylglycerol levels in hyporesponders.
      This was accompanied by significantly greater increases in the activities of
      hepatic triacylglycerol lipase and lipoprotein lipase in hyper- than in hypo
      responders. Both strains showed a dietary-cholesterol-induced rise in plasma CETP
      as well as in PLTP activity. The increase in PLTP activity was greater in the
      hyper-responders, but that of CETP was less. There was no effect of dietary
      cholesterol on LCAT activity. It is hypothesized that the lipases are involved in
      the removal of cholesterol-rich lipoproteins.

PMID- 8352740
TI  - Phorbol myristate acetate stimulates [3H]choline incorporation into
      phosphatidylcholine independently of the 'de novo' pathway in Krebs-II ascitic
      cells: a unique effect of phorbol ester on choline uptake.
AB  - The effect of phorbol 12-myristate 13-acetate (PMA) on [3H]choline incorporation
      into phosphatidylcholine (PtdCho) and on the 'de novo' pathway of PtdCho
      synthesis has been investigated, compared with that of oleic acid, in ascitic
      strain Krebs-II cells. Both compounds stimulated [3H]choline incorporation into
      PtdCho, but the PMA-induced incorporation was saturable at concentrations of the
      agonist around 100 nM, whereas no saturation was noticed with oleic acid up to 1
      mM. Chase experiments showed no effect of PMA on the conversion of phosphocholine
      into CDP-choline. The phorbol ester did not stimulate any of the enzyme
      activities of the 'de novo' pathway, whereas oleic acid increased specifically by
      2.5-fold the CTP:phosphocholine cytidylyltransferase (CT, EC 2.7.7.15) activity.
      In addition, no change in the subcellular distribution of CT was observed upon
      incubation with PMA, in contrast with oleic acid treatment. Cells challenged with
      oleic acid showed a 25-fold increase in diradylglycerol (DG) content, which was
      not modified upon incubation with 200 nM PMA, the most effective concentration of
      phorbol ester promoting choline incorporation. Subcellular fractionation of Krebs
      II cells on Percoll gradients revealed that [3H]PMA and 1-radyl-2-[3H]oleoyl
      glycerol, derived from exogenously supplied [3H]oleic acid, both exhibited the
      same enrichment in the endoplasmic reticulum. We have previously shown that the
      labelled fatty acid also accumulated in the endoplasmic reticulum [Terce, Record,
      Tronchere, Ribbes and Chap (1992) Biochem. J. 282, 333-338]. However, PMA induced
      a stimulation of choline uptake, which was not provoked by PMA 4-O-methyl ether,
      which interacts poorly with protein kinase C. Our data provide evidence that the
      enhancement of [3H]choline incorporation into PtdCho triggered by PMA and oleic
      acid proceeds via completely distinct mechanism(s).

PMID- 8352741
TI  - Hepatic lipase function and the accumulation of beta-very-low-density
      lipoproteins in the plasma of cholesterol-fed rabbits.
AB  - The accumulation of cholesterol-rich beta-very-low-density lipoproteins (beta
      VLDL) in the plasma of rabbits fed on a high-fat high-cholesterol diet is due to
      a defect in the clearance of these lipoprotein remnants from circulation by the
      liver. In view of the evidence that hepatic lipase participates in the process of
      rapid removal of remnants from circulation, and considering that rabbits are
      naturally deficient in hepatic lipase, we examined whether this defect in the
      clearance of beta-VLDL could be reversed by exogenous hepatic lipase. We report
      that treatment in vitro of [3H]cholesterol-labelled beta-VLDL, or rat
      chylomicrons, with hepatic lipase resulted in the formation of particles that
      were rapidly cleared from circulation by the liver when injected intravenously
      into hypercholesterolaemic rabbits. These results are consistent with the notion
      that, in addition to the well-established requirement for lipoprotein lipase
      activity, the generation of remnants capable of being efficiently taken up by the
      liver also requires the action of hepatic lipase. Lipoprotein lipase acts on
      triacylglycerol-rich lipoproteins to transform them into particles (remnants)
      which bind to the surface of liver cells, where they become accessible to hepatic
      lipase. Hepatocyte endocytosis of these remnants occurs only after further
      modification by hepatic lipase. According to this scheme, the results presented
      suggest that the accumulation of beta-VLDL in the circulation of rabbits fed on a
      high-fat high-cholesterol diet is the result of the saturation of the available
      hepatic lipase by abnormally high levels of lipoprotein-lipase-generated
      chylomicron remnants.

PMID- 8352742
TI  - Processing of chimeric mammalian cytochrome b5 precursors in Escherichia coli:
      reaction specificity of signal peptidase and identification of an aminopeptidase
      in post-translocational processing.
AB  - A chimeric precursor interlinked by an arginine residue between the full-length
      signal sequence of alkaline phosphatase and the eukaryotic cytoplasmic cytochrome
      b5 was constructed. Expression of the chimeric precursor protein in Escherichia
      coli resulted in efficient export of spectrally authentic cytochrome b5 into the
      periplasm [Karim, Harding, Evans, Kaderbhai and Kaderbhai (1993) Bio/Technology
      11, 612-618]. On sequencing, the apparent absence of arginine at the N-terminus
      of the secreted cytochrome b5 implied that the chimera was either miscleaved by
      signal peptidase or further processed following signal excision by an
      uncharacterized peptidase. The influence of the N-terminal region of cytochrome
      b5 on the unusual processing of the chimeric precursor was investigated by
      engineering a number of variant forms in which the region between Arg+1 and the
      mature portion of cytochrome b5 was extended and varied. Observations of the in
      vivo processed patterns of these variant cytochrome b5 forms exported into the
      periplasm revealed that the absence of arginine was due to neither miscleavage of
      the translocated precursor by the signal peptidase nor the nature of the early
      region of cytochrome b5. In fact, the selective excision of the arginine residue
      occurred subsequent to signal sequence deletion by an aminopeptidase which was
      sensitive to the metal chelator o-phenanthroline. We show that this
      aminopeptidase also participates in the trimming of the N-terminal arginine
      residue of the bacterial alkaline phosphatase to generate the three isoenzymes in
      the periplasm.

PMID- 8352743
TI  - Adenosine 5'-[alpha beta-methylene]triphosphate potentiates the oscillatory
      cytosolic Ca2+ responses of hepatocytes to ATP, but not to ADP.
AB  - Single rat hepatocytes microinjected with aequorin generate oscillations in
      cytosolic free Ca2+ concentration ([Ca2+]i) when stimulated with agonists acting
      through the phosphoinositide signalling pathway. The duration of these transients
      has been shown to be characteristic of the stimulating agonist, so that
      transients of very different duration can be induced in the same individual
      hepatocyte by different agonists. In a previous study we have shown that ADP and
      ATP, which are believed to act through a single P2y-purinoceptor species, elicit
      very different [Ca2+]i responses in most of the hepatocytes. We have interpreted
      this as evidence for two Ca(2+)-mobilizing purinoceptors. The methylated
      derivative of ATP, adenosine 5'-[alpha beta-methylene]-triphosphate (pp[CH2]pA),
      is only a weak P2y-purinoceptor agonist. When 100 microM pp[CH2]pA was supplied
      to aequorin-injected hepatocytes, there was no effect on [Ca2+]i. However, 25
      microM pp[CH2]pA co-supplied with ATP causes a potentiation of the [Ca2+]i
      response in most of the hepatocytes. The effect was specific for ATP-induced
      transients; [Ca2+]i transients induced by other agonists, and importantly by ADP,
      were not affected by addition of pp[CH2]pA. This further illustrates differences
      in the actions of ADP and ATP, strengthening the argument for separate receptors
      for these nucleotides.

PMID- 8352744
TI  - Nuclear import of the human androgen receptor.
AB  - Nuclear import of the human androgen receptor was investigated by
      immunocytochemical analysis of androgen receptor deletion and substitution
      mutants, which were transiently expressed in COS-1 cells. The signal responsible
      for nuclear import is encoded by amino-acid residues 608-625 and is functionally
      similar to the bipartite nucleoplasmin nuclear-localization signal. Although the
      subcellular distribution of androgen receptors mutated in the DNA-binding domain
      was unchanged compared with the wild-type androgen receptor, in the presence of
      ligand these mutations resulted in part of the receptor population forming
      clusters. Depending on the presence or absence of the bipartite nuclear
      localization signal, clusters were formed in the nucleus or in the cytoplasm,
      respectively. Expression of the wild-type androgen receptor in different cell
      lines revealed a cell-line-specific subcellular distribution of the unliganded
      receptor. The androgen receptor was predominantly nuclear when expressed in HeLa
      cells, whereas mainly cytoplasmic staining was observed when it was expressed in
      COS-1 cells. In the presence of hormone, the androgen receptor was located in the
      nucleus, independent of the cell line that was expressing the receptor. Anti
      androgens and various steroid hormones induced the nuclear localization of the
      wild-type androgen receptor in a dose-dependent way, without activating
      transcription of an androgen-regulated reporter gene. This indicates that the
      inability of the tested compounds to activate transcription is not due to
      inhibited nuclear import.

PMID- 8352745
TI  - Reduced sulphydryl groups are required for DNA binding of Ku protein.
AB  - The Ku protein, a DNA-binding complex that is composed of two subunits of 70 kDa
      and of 86 kDa, has been suggested to play a role in gene transcription. The
      dependence of the in vitro DNA-binding activity of affinity-purified Ku protein
      on reduced cysteine residues has been studied using sulphydryl-modifying agents.
      Inhibition of the DNA-binding activity was caused by alkylation with N
      ethylmaleimide and by crosslinking with azadicarboxylic acid bis(dimethylamide).
      Treatment of the protein with a large excess of N-ethylmaleimide after it had
      bound to DNA did not completely dissociate the complex from the DNA, suggesting
      that some cysteines may be in direct contact with DNA. Pre-incubation of the
      protein at 37 degrees C or above caused rapid inactivation of DNA binding. The
      elevated temperature azadicarboxylic acid bis(dimethylamide) treatments resulted
      in the formation of a crosslinked product, which was detected by Western
      blotting. The effects of azadicarboxylic acid bis(dimethylmaleimide) and heat
      were completely reversible by treatment with a reducing agent, such as
      dithiothreitol. These results demonstrate that in vitro DNA-binding activity of
      the Ku protein requires reduced sulphydryl groups. Interestingly, the DNA-binding
      activity of Ku protein was protected from heat inactivation by the presence of a
      HeLa cell nuclear extract, suggesting that a nuclear factor or factors may be
      responsible for the maintenance of the reduced cysteines of the Ku protein in
      vivo. Thus, the biochemical function of the Ku protein may be regulated through
      oxidation-reduction of its cysteine residues.

PMID- 8352746
TI  - DNA precursors are channelled to nuclear matrix DNA replication sites.
AB  - Studies of replicative DNA synthesis using DNA precursors have shown that the DNA
      that was replicated most recently is that associated with the nuclear matrix.
      Consequently, precursors arising via the salvage and the de novo metabolic
      pathways are first incorporated into a small percentage of the total nuclear DNA
      that is termed nuclear matrix-associated DNA. These results have been
      substantiated in cell culture, as well as in intact mammalian systems.
      Furthermore, when DNA precursors were injected intravenously into regenerating
      rat liver, a significant lag in the incorporation of orotic acid-derived
      nucleotides (de novo pathway precursors) into nuclear DNA was observed, when
      compared with deoxythymidine-derived nucleotides (salvage pathway precursors).
      This lag in incorporation kinetics was also evident at the nuclear matrix level,
      although, once incorporated into nuclear matrix-associated DNA, the distribution
      patterns of both precursors into extra-matrix nuclear DNA fractions were
      identical. To determine the basis for this kinetic lag, we compared the
      incorporation kinetics of orotic acid and of deoxythymidine into dTTP and into
      nuclear matrix-associated DNA, respectively. Orotic acid-derived nucleotides
      entered the cytosolic dTTP pool before being incorporated into nuclear matrix
      associated DNA, that is, traversing the classical metabolic route of DNA
      precursors. Conversely, deoxythymidine-derived nucleotides by-passed the soluble
      dTTP cellular pool and engaged directly in DNA synthesis at the nuclear matrix.
      Not only is this the first evidence for nucleotide channelling in an intact
      mammalian system, but it also forms direct evidence that salvage pathway DNA
      precursors are channelled to nuclear matrix-associated sites of DNA replication.

PMID- 8352748
TI  - Developmental changes in the isoelectric variants of rat hepatic hydroxysteroid
      sulphotransferase.
AB  - Major isoenzymes of androsterone-sulphating sulphotransferase (AD-ST) were
      isolated from liver cytosols of weanling and young adult female rats and their
      isoelectric properties were compared. On chromatofocusing the enzyme activity of
      young adults was eluted over a wider range of pH than was that of weanling rats.
      The activity at pH 7.8-7.2 (fraction I) is obvious at both ages, whereas the
      activity eluted over the pH 6.6-5.5 range (fraction II) is much lower in
      weanlings than in young adults. The AD-ST activities eluted in fractions I and II
      were separately purified by 3'-phosphoadenosine 5'-phosphate-agarose affinity
      chromatography at both ages. Two-dimensional gel electrophoresis of the isolated
      enzyme revealed several subunits with distinct pI values, but with the same
      molecular mass, namely 30 kDa. The relative levels of the pI 6.7 and pI 7.2
      subunits are high and the relative level of the pI 6.1 is low in fraction I. In
      fraction II, the levels of pI 6.1 and pI 6.7 subunits are high and the level of
      the pI 7.2 subunit is low. There is no significant difference in the relative
      levels of the pI variants in each fraction between weanlings and young adults.
      The N-terminal amino acid sequences of the pI variants are identical within the
      area determined, irrespective of animal age or pI values. These results
      demonstrate that the pI variants of AD-ST are derived from the same precursor by
      post-translational modification or that they are products of closely related, but
      distinct, genes. The pI 6.1 and 6.7 subunits presumably increased during the
      development from the weanling stage to adulthood, resulting in the increase in
      acidic form(s) of AD-ST (fraction II) in adult females.

PMID- 8352747
TI  - New families in the classification of glycosyl hydrolases based on amino acid
      sequence similarities.
AB  - 301 glycosyl hydrolases and related enzymes corresponding to 39 EC entries of the
      I.U.B. classification system have been classified into 35 families on the basis
      of amino-acid-sequence similarities [Henrissat (1991) Biochem. J. 280, 309-316].
      Approximately half of the families were found to be monospecific (containing only
      one EC number), whereas the other half were found to be polyspecific (containing
      at least two EC numbers). A > 60% increase in sequence data for glycosyl
      hydrolases (181 additional enzymes or enzyme domains sequences have since become
      available) allowed us to update the classification not only by the addition of
      more members to already identified families, but also by the finding of ten new
      families. On the basis of a comparison of 482 sequences corresponding to 52 EC
      entries, 45 families, out of which 22 are polyspecific, can now be defined. This
      classification has been implemented in the SWISS-PROT protein sequence data bank.

PMID- 8352749
TI  - Phenylalaninylargininylarginine: a novel tripeptide exerting Zn(2+)-dependent,
      insulin-mimetic inhibitory action on myocardial proteolysis.
AB  - A novel tripeptide, Phe-Arg-Arg, was found to exert a potent, insulin-mimetic
      inhibitory action on lysosomal proteolysis in the Langendorff-perfused rat heart.
      This tripeptide was synthesized based upon its partial structural analogy to the
      biguanide anti-hyperglycaemic agent, phenformin (phenylethylbiguanide), which has
      previously been found to exert a Zn(2+)-dependent inhibitory action on lysosomal
      proteolysis. Hearts were biosynthetically labelled with [3H]leucine in vitro. The
      percentage change in subsequent release of [3H]leucine (2 mM non-radioactive
      leucine) was determined in non-recirculating perfusate. The background Zn2+
      content of the perfusate was determined to be 20 nM. Major endogenous Zn2+
      buffers were present in molar excess of Zn2+: 0.1 mM citrate, 0.2% BSA, and
      complete physiological amino acids. Infusion of maximally effective levels of
      chloroquine (30 microM) or insulin (5 nM) caused a 38% inhibition of total
      proteolysis, which corresponds to the lysosomal subcomponent. In the presence of
      background levels of perfusate Zn2+ the infusion of Phe-Arg-Arg (10 microM),
      insulin (5 nM), or phenformin (2 microM) maximally caused a 39% inhibition of
      [3H]leucine release. Combined infusion of maximally effective levels of insulin
      and Phe-Arg-Arg, or maximal levels of chloroquine and Phe-Arg-Arg did not cause
      additive inhibition of [3H]leucine release greater than the 39% inhibition caused
      by either agent alone, regardless of the order of infusion. Addition of
      physiological concentrations of Zn2+ (1 microM) to the background perfusate Zn2+
      accelerated the insulin-mimetic action of submaximally effective levels of Phe
      Arg-Arg, and increased its potency. Prior chelation of background Zn2+ by a 3 h
      perfusion with CaNa2 EDTA (2 microM) reversibly delayed the time course of Phe
      Arg-Arg action and decreased its potency at submaximal concentrations.

PMID- 8352750
TI  - L-alanine uptake by rat liver parenchymal and haematopoietic cells during the
      perinatal period.
AB  - Alanine disposal by liver parenchymal and haematopoietic cells from 21-day
      fetuses, newborns and adult rats was studied. Preparations selectively enriched
      in either haematopoietic cells or hepatocytes were obtained by direct perfusion
      of fetal- and neonatal-rat livers. L-Alanine transport into liver parenchymal
      cells was best fitted to two Na(+)-dependent saturable systems. The high-affinity
      system showed a much higher activity (Vmax.) in hepatocytes from fetuses and
      newborns than in those from adult rats (2.4, 4.3 and 0.3 nmol/8 min per 10(6)
      cells for fetuses, newborns and adults respectively). Vmax. for the low-affinity
      component was slightly lower during the perinatal period than in the adult (about
      30 nmol/8 min per 10(6) cells for hepatocytes from fetuses and newborns, versus
      48 nmol/8 min per 10(6) cells for adult rat parenchymal cells). Haematopoietic
      cells from fetal-rat livers showed significant Na(+)-dependent L-alanine uptake
      which was completely abolished after birth. These results show that the transport
      systems involved in L-alanine uptake by liver parenchymal cells are fully
      developed before birth. This probably contributes to fulfilling the high
      requirement for neutral amino acids for protein synthesis during development.
      Haematopoietic cells may play an important role in liver amino acid metabolism
      during fetal life.

PMID- 8352751
TI  - Kinetics and mechanism of DNA repair: an automated programmable apparatus for
      fast time-resolved studies of the repair of mammalian DNA after u.v. irradiation.
AB  - An automated apparatus, designed and constructed for use in fast time-resolved
      studies of mammalian DNA repair after u.v. irradiation, is described. The
      methodology makes use of caged DNA-break-trapping reagents, e.g. [alpha
      32P]dideoxyadenosine triphosphate [see Meldrum, Shall, Trentham and Wharton
      (1990) Biochem J. 266, 885-890] and the apparatus incorporates excimer lasers
      both for the delivery of u.v. damage and for the photoactivation of the caged
      reagents. The design is based on a sample-changing turntable which permits the
      sequential irradiation and quenching of samples. A maximum of eight samples can
      be processed in a single experiment, the sequence of events being programmed on a
      microcomputer, which permits a very generalized experimental sequence. Pipettes
      for addition of cells, nucleotides and quenching agent are driven pneumatically.
      A pair of pneumatically operated platinum electrodes allows electroporation of
      cells for loading of negatively charged reagents prior to irradiation. The time
      resolution of the apparatus is dependent upon the experimental scheme used and
      can be very short (e.g. 1 ms) when caged reagents are used; a more usual period
      is 1 s for the shortest incubation.

PMID- 8352752
TI  - N.m.r. and molecular-modelling studies of the solution conformation of heparin.
AB  - The solution conformations of heparin and de-N-sulphated, re-N-acetylated heparin
      have been determined by a combination of n.m.r. spectroscopic and molecular
      modelling techniques. The 1H- and 13C-n.m.r. spectra of these polysaccharides
      have been assigned. Observed 1H-1H nuclear Overhauser enhancements (n.O.e.s) have
      been simulated using the program NOEMOL [Forster, Jones and Mulloy (1989) J. Mol.
      Graph. 7, 196-201] for molecular models derived from conformational-energy
      calculations; correlation times for the simulations were chosen to fit
      experimentally determined 13C spin-lattice relaxation times. In order to achieve
      good agreement between calculated and observed 1H-1H n.O.e.s it was necessary to
      assume that the reorientational motion of the polysaccharide molecules was not
      isotropic, but was that of a symmetric top. The resulting model of heparin in
      solution is similar to that determined in the fibrous state by X-ray-diffraction
      techniques [Nieduszynski, Gardner and Atkins (1977) Am. Chem. Soc. Symp. Ser. 48,
      73-80].

PMID- 8352753
TI  - Oxygen Michaelis constants for tyrosinase.
AB  - The Michaelis constant of tyrosinase for oxygen in the presence of monophenols
      and o-diphenols, which generate a cyclizable o-quinone, has been studied. This
      constant depends on the nature of the monophenol and o-diphenol and is always
      lower in the presence of the former than of the latter. From the mechanism
      proposed for tyrosinase and from its kinetic analysis [Rodriguez-Lopez, J. N.,
      Tudela, J., Varon, R., Garcia-Carmona, F. and Garcia-Canovas, F. (1992) J. Biol.
      Chem. 267, 3801-3810] a quantitative ratio has been established between the
      Michaelis constants for oxygen in the presence of monophenols and their o
      diphenols. This ratio is used for the determination of the Michaelis constant for
      oxygen with monophenols when its value cannot be calculated experimentally.

PMID- 8352754
TI  - Characterization of quail intestinal mucin as a ligand for endogenous quail
      lectin.
AB  - The S-type lectins have been shown to be components of mucosal scrapings, and in
      avian systems these lectins have been localized immunohistochemically to the
      mucosal surface and goblet cells of the intestine. The interaction of lectin
      specifically with purified mucin has not, however, been established. Quail
      intestinal mucin was purified by two subsequent isopycnic density-gradient
      centrifugations in CsCl and chromatography on Sepharose Cl-2B. Purified mucin,
      obtained from the void volume of the Sepharose column, was characterized by
      SDS/PAGE, amino acid and carbohydrate analyses, sensitivity to thiol reduction,
      and cross-reactivity with antibody preparations to rat and human intestinal
      mucins on Western blots. Antibody raised against purified quail mucin partially
      cross-reacts with purified rat, rabbit and human intestinal mucins, and
      specifically labels the mucosal surface and goblet cells of quail intestine by
      the immunoperoxidase technique. Protein eluted by lactose from an affinity matrix
      composed of quail intestinal mucin possessed the same molecular mass on SDS/PAGE
      as intestinal lectin and reacted on Western blots with a lectin-specific
      antibody. The data clearly demonstrate the co-localization of lectin and mucin in
      the quail intestine and also the ability of the lectin to specifically interact
      with the purified mucin, raising the question of the role of endogenous lectins
      in secretions.

PMID- 8352757
TI  - Crystallisation and preliminary crystallographic analysis of recombinant Xenopus
      laevis Cu,Zn superoxide dismutase b.
AB  - The recombinant Cu,Zn superoxide dismutase from the South African frog Xenopus
      laevis, expressed in E. coli, has been crystallized in a form suitable for high
      resolution crystallographic investigations. The crystals grow from polyethylene
      glycol solutions, at pH 6.0, 28 degrees C, and belong to the orthorhombic space
      group P2(1)2(1)2(1) with unit cell edges a = 73.33, b = 68.86, c = 59.73 A, one
      protein dimer (32,000 M(r)) per asymmetric unit. Diffraction data have been
      collected to 3.0 A resolution, and a molecular replacement solution found for
      Xenopus laevis superoxide dismutase using the bovine enzyme as search model. The
      crystallographic R-factor corresponding to this solution is 0.412, in the 15.0
      3.0 A resolution range.

PMID- 8352756
TI  - Involvement of acceptor side components of PSII in the regulatory mechanism of
      Plectonema boryanum grown photoautotrophically under diazotrophic condition.
AB  - Alternating peaks of photosynthetic activity (P-phase) and nitrogen fixing
      activity (N-phase) were shown in Plectonema boryanum grown under diazotrophic
      condition in continuous light. In N-phase photosystem I activity increased by 35
      45% and oxygen evolution decreased by 70-80% which was partially restored to 45
      55% in the presence of 2,6-dichloro-p-benzoquinone. Thermoluminescence glow curve
      in P-phase consists of a major band at 25 degrees C which was shifted to 10
      degrees C in N-phase. Both these bands are sensitive to DCMU and
      tetranitromethane. Flash excitation studies with major thermoluminescence band in
      P and N-phase showed oscillations with same periodicity of four having maxima at
      2nd and 6th flashes. On the basis of these observations it is suggested that
      photosynthetic electron transport under diazotrophic growth condition is
      regulated by the redox levels of the secondary quinone acceptor QB.

PMID- 8352755
TI  - Studies on the carbohydrate-binding characteristics of human pulmonary surfactant
      associated protein A and comparison with two other collectins: mannan-binding
      protein and conglutinin.
AB  - The surfactant-associated protein A (SP-A) belongs to the collectin family, a
      group of C-type lectins encompassing also surfactant-associated protein D, mannan
      binding protein (MBP) and conglutinin. These proteins all have carbohydrate
      recognition domains joined to collagen stalks. It seems likely that SP-A, like
      MBP and conglutinin, may mediate anti-microbial activity through binding to
      carbohydrates on the microorganisms and collectin receptors on phagocytic cells.
      We have studied the influence of carbohydrates on the binding of SP-A, MBP and
      conglutinin to mannan in an enzyme-linked lectin-binding assay. All sugars were
      of D-configuration, except fucose of which both L- and D-configurations were
      tested. The order of inhibiting potency on the binding of SP-A was: N
      acetylmannosamine > L-fucose, maltose > glucose > mannose. The following sugars
      were non-inhibitory: galactose, D-fucose, glucosamine, mannosamine,
      galactosamine, N-acetylglucosamine, and N-acetylgalactosamine. The best inhibitor
      of MBP was N-acetylglucosamine. Otherwise MBP showed a selectivity similar to
      that of SP-A. Conglutinin binding was inhibited by all the sugars examined except
      N-acetylgalactosamine. For conglutinin, as for MBP, the best inhibitor was N
      acetylglucosamine. Normal human SP-A, alveolar-proteinosis SP-A purified by ion
      exchange chromatography, and alveolar-proteinosis SP-A purified by n-butanol
      extraction showed no difference in sugar selectivity. The influence of pH and of
      the calcium concentration was also examined. Organic solvent-extracted SP-A from
      patients suffering from alveolar proteinosis and normal SP-A showed different
      sensitivity profiles.

PMID- 8352758
TI  - Expression and localization of dystrophin in cultured neonatal rat cardiac
      myocytes.
AB  - We examined the expression and localization of dystrophin in cultured neonatal
      rat cardiac myocytes by Western blot analysis and immunohistochemistry using an
      antidystrophin antibody. Western blot analysis showed a single band with a
      molecular weight of about 400 kd. Immunohistochemical staining also detected
      dystrophin in cultured cardiac myocytes, and it was found primarily around the
      nucleus on day 2 of culture, the area and degree of staining increased on days 4
      and 7, and most cells were stained almost entirely on day 14. We conclude that
      dystrophin also is expressed in cultured neonatal rat cardiac myocytes, and that
      it increases with time, and extends from the perinuclear area to the whole cell.

PMID- 8352759
TI  - Primary structure of the factor VIII binding domain of human, porcine and rabbit
      von Willebrand factor.
AB  - von Willebrand factor (vWF) binds to Factor VIII (FVIII) and the FVIII binding
      domain has been localized to the amino-terminal of the vWF subunit. The DNA
      sequence coding for part of the vWF precursor (provWF) including the FVIII
      binding domain has been compared in man, pig and rabbit. The sequenced fragment
      corresponds to nucleotides 2416 to 2886 of the human vWF cDNA and encodes for the
      last 41 amino acids of the propolypeptide, the cleavage site and the first 116
      amino acids of the mature vWF subunit. The homology of the three deduced amino
      acids sequences is remarkable: 88% between porcine and human and 87% between
      rabbit and human sequences. Four contiguous amino acids are lacking in the rabbit
      propolypeptide (-10 to -7) when compared to the human and porcine sequences. The
      cleavage site of the propolypeptide is conserved in the three species as well as
      amino acids where mutations in the human gene lead to a binding defect of vWF to
      FVIII. The Asn-94 N-glycosylation site is present in the human and rabbit
      sequences but absent in the pig sequence.

PMID- 8352760
TI  - The mouse iduronate sulfatase gene: identification of a novel transcript.
AB  - Complementary DNAs, cDNAs, coding for iduronate sulfatase (IDS, E.C.3.1.6.13)
      have been isolated and characterized in man and mouse. The murine cDNA (MTA16)
      was highly homologous to the human counterpart. By screening the same mouse
      thymus cDNA library another cDNA (MTA13) was isolated: it is 1831 bp long and is
      identical to a part of the MTA16 cDNA in its 5' region, but it is completely
      divergent in the 3' region. Characterization of the MTA13 mRNA as well as its
      genomic organization are presented. The results herein reported support the
      hypothesis that MTA13 and MTA16 mRNAs are encoded by the same gene.

PMID- 8352761
TI  - Sequence and functional characterization of feline interleukin 2.
AB  - Since the discovery of its involvement in the pathogenesis of feline
      immunodeficiency virus infection ("cat AIDS") and feline leukemia virus
      infection, the role of feline interleukin 2 (IL-2) has been a focus of particular
      interest. The purpose of this study was to clone feline IL-2 cDNA, as well as
      synthesize bioactive recombinant feline IL-2. The isolation of cDNA encoding
      feline IL-2 was carried out using a PCR-based strategy and screening of a feline
      leukocyte cDNA library. Feline IL-2 consists of 154 amino acids including a
      putative signal sequence and has 81%, 69%, 60% and 64% identity to human, bovine,
      murine and rat IL-2, respectively. Feline IL-2 cDNA was expressed in COS-7 cells.
      The secreted protein has CTLL-4 murine cytotoxic T cell proliferative activity
      characteristic of authentic IL-2. These data confirm the synthesis of bioactive
      recombinant feline IL-2.

PMID- 8352762
TI  - Stimulation of lipid peroxidation or 4-hydroxynonenal treatment increases
      procollagen alpha 1 (I) gene expression in human liver fat-storing cells.
AB  - Hepatic fat-storing cells (FSC) play a key role in the development of fibrosis as
      a major source of collagen and other extracellular matrix (ECM) proteins in the
      injured liver. Both experimental and clinical studies have shown that lipid
      peroxidation is often associated with the development of liver fibrosis. Here we
      report that exposure of cultured human liver FSC to the pro-oxidant system
      ascorbate/iron results in an early induction of lipid peroxidation, as monitored
      in terms of MDA and fluorescent aldehyde/protein adducts production, and in a
      significant increase of the constitutive expression of procollagen type I mRNA
      paralleled by the accumulation of the protein in cell culture media. This
      fibrogenic effect is almost completely abolished by pretreatment of FSC cultures
      with the antioxidants alpha-tocopherol (Vitamin E) or diphenylphenylendiamine
      (DPPD). Moreover, treatment of FSC with 1.0 microM 4-hydroxynonenal (HNE), a
      highly reactive aldehydic end-product of lipid peroxidation, results in a
      significant stimulation of procollagen type I gene expression and synthesis,
      suggesting that this aldehyde also exerts profibrogenic activity. These findings
      indicate that oxidative reactions can directly influence procollagen I gene
      expression and synthesis in FSC, thus contributing to the development of liver
      fibrosis.

PMID- 8352763
TI  - Kinetic study of the thermal denaturation of G actin using differential scanning
      calorimetry and intrinsic fluorescence spectroscopy.
AB  - Previous studies of the thermal denaturation of G actin have yielded conflicting
      results which have led to contradictory interpretations of the denaturation
      process. In their interpretations, these authors postulated that the thermal
      denaturation of G actin can be described by thermodynamical equilibrium laws
      despite the fact that this transition is irreversible. Using differential
      scanning calorimetry and fluorescence spectroscopy, we now show that thermal
      denaturation of G actin does not obey to equilibrium thermodynamics, but rather,
      is a two-step irreversible phenomenon under kinetic control. It can therefore be
      analyzed using the recently developed Sanchez-Ruiz equations.

PMID- 8352764
TI  - A basic transthyretin variant (Glu61-->Lys) causes familial amyloidotic
      polyneuropathy: protein and DNA sequencing and PCR-induced mutation restriction
      analysis.
AB  - A new mutation of transthyretin (TTR) has been identified in a patient with late
      onset familial amyloidotic polyneuropathy (FAP) of Japanese origin. Peptide
      mapping by reverse-phase high performance liquid chromatography to compare the
      patient's TTR with normal TTR showed the presence of an abnormal peptide. Amino
      acid sequence analysis of the peptide (residues 49-61) showed a lysine-for
      glutamic acid substitution at position 61. This substitution, verified by direct
      DNA sequencing, was the result of a guanine to adenine change on exon 3 of the
      TTR gene. A polymerase chain reaction-induced mutation restriction analysis (PCR
      IMRA) system was established to rapidly detect the missense mutation. TTR-Lys61
      is the first variant TTR with a replacement of the acidic with basic amino acid
      to be found in the amyloid precursor proteins of FAP.

PMID- 8352765
TI  - Effect of erythroid differentiation factor on maintenance of human hematopoietic
      cells in co-cultures with allogenic stromal cells.
AB  - The effect of erythroid differentiation factor (EDF) on the maintenance of human
      hematopoietic progenitors in a microenvironment was examined by co-culture of
      adherent- and E rosette-depleted mononuclear cells from the bone marrow (BM) or
      peripheral blood (PB) with allogenic stromal cells. EDF had no effect on colony
      formation of erythroid burst-forming units (BFU-E) from the BM cultured without a
      stromal layer. The number of BFU-E cultured with the stromal layer was decreased
      less in the presence of EDF than in its absence. This activity of EDF was also
      observed when the mononuclear cells were separated from the stromal layer by a
      filter membrane. These data suggest that EDF facilitates maintenance of the
      number of BFU-E through a humoral factor(s) secreted by the stromal layer. The
      number of BM erythroid colony-forming units (CFU-E) was decreased on addition of
      EDF, which promotes differentiation of CFU-E. The number of PB CFU-E was
      increased irrespective of the presence or absence of EDF over 2 weeks, suggesting
      that BFU-E, which are more abundant in PB than in BM, differentiate to supply CFU
      E. However, the addition of EDF resulted in less increase of PB CFU-E, indicating
      that it inhibited the proliferation of CFU-E progenitors to suppress colony
      formation. On the other hand, CFU-GM was consistently decreased by addition of
      EDF to this culture system. These data indicate that EDF acts as a commitment
      factor and/or a promoter of erythroid progenitors in a hematopoietic
      microenvironment.

PMID- 8352766
TI  - The PKC-inhibitor Ro 31-8220 selectively suppresses PMA- and diacylglycerol
      induced fluid pinocytosis and actin polymerization in PMNs.
AB  - The PKC-inhibitor Ro 31-8220 inhibits stimulated fluid pinocytosis of human PMNs
      induced by the PKC-activators phorbol myristate acetate (PMA, IC50 = 1.35 x 10(
      6) M) or diacylglycerols (OAG, diC8) by 95%, whereas Ro 31-8220 has no effect on
      D2O- or fNLPNTL-induced pinocytosis and enhances cytochalasin D- induced
      pinocytosis. Also formation of F-actin induced by PMA or diacylglycerols is
      selectively inhibited. The results indicate that a Ro 31-8220 -sensitive PKC is
      involved in signal transduction for enhanced pinocytosis and F-actin formation in
      response to one class of stimuli (classical activators of PKC) but not to others.

PMID- 8352767
TI  - A computational model of the HBK2 potassium channel ion pore.
AB  - A computational model of the putative ion pore region of the HBK2 potassium
      channel was developed. Utilizing experimentally derived constraints,
      conformations corresponding to both the open and closed states of the ion pore
      were determined. Also, a conformational basis for the different sensitivites of
      the internal and external tetraethylammonium binding sites has been proposed. The
      model presented here suggests a role for other regions of the HBK2 protein in
      determining the ion pore conformation.

PMID- 8352768
TI  - Identification of peptide:N-glycanase activity in mammalian-derived cultured
      cells.
AB  - The recent finding of peptide:N-glycanase (PNGase) in medaka embryos (Seko, A.,
      Kitajima, K., Inoue, Y., & Inoue, S., J.Biol. Chem. 266, 22110 (1991)) raised the
      question of how widespread is the occurrence of this type of de-N-glycosylating
      enzyme. In experiments designed to identify PNGase in the mammalian system, we
      searched for its activity in some cultured cell lines. Incubation of a 14C
      labeled N-glycopeptide with extracts prepared from cultured cells resulted in
      producing the free glycan and the peptide. Detailed characterizations of the
      products, formed upon incubation of a 14C-labeled N-glycopeptide substrate with
      the enzyme preparation from C3H mouse loose connective tissue-derived L-929
      cells, by HPLC, amino acid and carbohydrate composition analyses, and peptide
      sequence analysis unequivocally established the reaction products to be the free
      glycan having di-N-acetylchitobiosyl sequence at its reducing end and free
      peptide in which the originally glycan-linked Asn residue was converted to the
      Asp residue. This represents the first demonstration of PNGase in mammalian cells
      and thus PNGase appears to be a very common enzyme expressed in not only plants
      and bacteria but also a wide range of animals although its functional
      significance remains to be clarified.

PMID- 8352769
TI  - A common nuclear factor that binds to the transcriptional control regions of
      ribosomal protein L5 and 5S rRNA genes.
AB  - We have examined the binding of chicken nuclear protein to the promoter regions
      of chicken ribosomal protein L5 and 5S rRNA genes. A nuclear protein was shown to
      bind to similar sequences in both promoter regions of the L5 gene (-36 to -21)
      and the internal control region of 5S rRNA gene (56 to 71). Its molecular mass
      was estimated to be 34 kDa. Competition gel mobility assay showed that the
      protein is different from the TATA-box binding protein (TBP). The protein may
      play a role in a transcriptional coordination of the two genes transcribed by
      different polymerases, RNA polymerase II and III.

PMID- 8352770
TI  - Position of cyclization in cyclic ADP-ribose.
AB  - Cyclic adenosine diphosphoribose (cADPR) is a putative second messenger of
      calcium homeostasis synthesized from NAD by cleavage of the nicotinamide-ribose
      bond and cyclization of the ribose to the adenine ring. In this study, the
      ultraviolet absorption spectra of cADPR have been studied as a function of pH and
      compared to other compounds containing an adenine ring with substitutions at
      known positions. The results support a structure for cADPR in which cyclization
      is to position 1 of the adenine ring, rather than to N6, as has been previously
      proposed.

PMID- 8352772
TI  - Antibodies specific for human albumin function as blocking antibodies when
      attached to erythrocyte-bound albumin.
AB  - Albumin is shown to be firmly bound to human red blood cells using the techniques
      of flow cytometry, immunoblotting, and complement fixation. The interactions
      between antibodies attached to the cell bound albumin and the complement system
      are examined. Antibodies specific for human serum albumin bind to albumin on
      erythrocytes and activate both homologous and heterologous complement in the
      absence of hemolysis. Moreover, treatment of erythrocytes with anti-albumin
      antibodies renders the cells resistant to classical pathway mediated lysis
      initiated by a passive lysis system. Thus, erythrocyte-bound anti-albumin
      antibodies appear to function in a manner similar to "blocking" antibodies
      described in some bactericidal systems.

PMID- 8352771
TI  - Cyclic AMP-induced transcriptional repression of the insulin-responsive glucose
      transporter (GLUT4) gene: identification of a promoter region required for down
      regulation of transcription.
AB  - The mechanism(s) by which cyclic AMP represses transcription of the GLUT4 gene
      was investigated. 3T3-L1 preadipocytes were stably transfected with a series of
      5' deletion mutants of the mouse GLUT4 gene promoter fused to the bacterial CAT
      gene and then were induced to differentiate into adipocytes. A method based on
      reverse transcription/polymerase chain reaction (PCR) amplification was developed
      and optimized to quantitate expression of CAT mRNA transcripts. Treatment with 8
      bromo-cAMP down-regulated the level of CAT mRNA in adipocytes transfected with
      the -7000/CAT, -785/CAT and -469/CAT constructs, but not the -78/CAT construct.
      Thus, the regulatory element(s) which mediates transcriptional repression by cAMP
      resides in the proximal promoter of the GLUT4 gene between positions -469 and 
      78. Since down-regulation of GLUT4 mRNA is unaffected by inhibitors of protein
      synthesis, cAMP (and insulin) may activate phosphorylation or dephosphorylation
      of an existing transcription factor that interacts with the GLUT4 proximal
      promoter.

PMID- 8352773
TI  - Glycoprotein 2 of zymogen granule membranes shares immunological cross-reactivity
      and sequence similarity with phospholipase A2.
AB  - Glycoprotein 2 (GP2), the major protein of rat pancreatic zymogen granule
      membranes (ZGMs), cross-reacted with an antiserum against porcine secretory
      phospholipase A2 (sPLA2). Amino acid sequence comparison showed 45% similarity
      and 23% identity between porcine PLA2 and the C-terminal portion of GP2. An
      antiserum to intestinal brush border Ca(2+)-independent PLA2 (bbPLA2) also
      recognized GP2. The antigenic and sequence similarities between GP2, sPLA2, and
      bbPLA2 imply that the role of GP2 in cellular function is associated with
      phospholipid binding and/or hydrolysis.

PMID- 8352774
TI  - Molecular cloning and sequencing of sulfated glycoprotein-2 cDNA from testis of
      mouse: implications of two different mRNAs of SGP-2.
AB  - We cloned a mouse homolog of sulfated glycoprotein-2 (SGP-2) cDNA by screening a
      mouse testicular cDNA library and its nucleotide sequence was determined. The
      predicted amino acid sequence of the cDNA shares 93% identity with that of rat
      SGP-2. The nucleotide sequences of both cDNAs show extensive homology throughout
      the open reading frames and 3' untranslated regions. The 5' untranslated regions,
      however, share homology only up to 28 bp upstream from the start codons; the rest
      of sequences are quite different. DNA sequence homology search to mouse SGP-2
      cDNA through the EMBL/GenBank database and a recent study on the genomic
      organization of rat TRPM-2 gene suggest a possibility that there are at least two
      different SGP-2 mRNAs as a result of alternative splicing and/or different
      promoter usage in mouse.

PMID- 8352775
TI  - Complement component C3-derived neutrophil chemotactic factors purified from
      exudate of rat carrageenin-induced inflammation.
AB  - Two neutrophil chemotactic factors have been purified from the exudate of chronic
      phase of rat carrageenin-induced inflammation. Both the factors were derived from
      the third component of complement (C3); one was an NH2-terminal fragment (C3a) of
      alpha chain of C3 and another chemoattractant was a COOH-terminal fragment of
      beta chain, which was referred to as C3 beta c, on the basis of their molecular
      masses and NH2-terminal amino acid sequences. C3a exhibits potent chemotactic
      activity for rat neutrophils, and C3 beta c is a novel basic neutrophil
      chemoattractant with molecular mass of about 11 kDa, suggesting that both
      chemoattractants play a role in the neutrophil infiltration into inflammatory
      site of carrageenin-induced inflammation in rats.

PMID- 8352776
TI  - The nucleotide exchange rates of rho and rac small GTP-binding proteins are
      enhanced to different extents by their regulatory protein Smg GDS.
AB  - Rho p21 and rac p21 small GTP-binding proteins are regulated by the same
      inhibitory and stimulatory GDP/GTP exchange proteins termed rho GDI and smg GDS,
      respectively. RhoA p21 and rac1 p21 bind with similar affinities to rho GDI and
      both proteins also bind with similar affinities to smg GDS. RhoA p21 and rac1 p21
      have similar GDP/GTP exchange rates in the absence of rho GDI and smg GDS. The
      velocity of the GDP/GTP exchange reaction for rhoA p21 was enhanced much more by
      smg GDS than was the velocity of nucleotide exchange for rac1 p21. In the
      presence and absence of smg GDS, rho GDI reduced the velocities of these
      nucleotide exchange reactions of rhoA p21 and rac1 p21 to similar extents. These
      results suggest that rhoA p21 is activated first followed by rac1 p21 activation
      in response to extracellular signals.

PMID- 8352777
TI  - Relationship between aging and susceptibility to protein oxidative damage.
AB  - The objective of this study was to determine if the susceptibility of tissues to
      experimental oxidative damage is altered during the aging process. Adult
      houseflies were X-irradiated at different dosages, when they had reached 0.25 and
      0.70 of their average life expectancy. Protein carbonyl content and activity of
      glucose-6-phosphate dehydrogenase were used as indices of oxidative damage. Fly
      homogenates as well as the live flies were more susceptible to oxidative damage
      at the older than at the younger age.

PMID- 8352778
TI  - beta-Amyloid protein amplifies calcium signalling in central neurons from the
      adult mouse.
AB  - The role of beta-amyloid in Alzheimer's disease and its cellular mechanism of
      action are still unclear. Based on observations that beta-amyloid influences
      neuronal calcium homeostasis we investigated the effect of the peptide on K(+)
      induced enhancement of free intracellular calcium in dissociated neurons from
      adult mice. Preincubation with beta-amyloid fragment 25-35 at concentrations > or
      = 0.05 mumol/l resulted in marked amplification of the K(+)-induced Ca2+
      response. This effect was also observed with fragment 1-40, whereas fragment 1-28
      or 12-28 did not affect the Ca2+ response. This preparation therefore presents a
      valuable model to investigate the action of beta-amyloid ex vivo in individual
      animals. Our findings suggest a small but consisting destabilizating effect of
      beta-amyloid on neuronal Ca2+ homeostasis resulting in chronically increased
      neuronal vulnerability.

PMID- 8352779
TI  - Identification of three forms of the gamma subunit of G proteins isolated from
      bovine spleen.
AB  - We reported previously that G proteins from bovine spleen contain at least five
      forms of the gamma subunit (designated S1 through S5), among which S1 and S5 have
      been identified as novel gamma and gamma 2 subunits, respectively. In this study,
      we identified the other three forms of the gamma subunit, namely, S2, S3 and S4.
      Amino acid sequences of proteolytic fragments obtained from S2, S3 and S4
      coincided exactly with internal sequences of gamma 7, gamma 5 and gamma 2,
      respectively. However, sequence analysis of undigested S4 revealed that S4 was an
      N-terminally truncated form of gamma 2, while analysis of the C-terminal fragment
      by fast atom bombardment mass spectrometry revealed that the C-terminus of S4
      seemed to be geranylgeranylated and carboxymethylated as is that of intact gamma
      2. Thus, the three types of gamma subunit obtained from bovine spleen were
      identified as gamma 7, gamma 5, and an N-terminally truncated gamma 2.

PMID- 8352780
TI  - Ovariectomy decreases the mRNA levels of transforming growth factor-beta 1 and
      increases the mRNA levels of osteocalcin in rat bone in vivo.
AB  - Estrogen depletion causes postmenopausal osteoporosis. Here we report that steady
      state mRNA levels of transforming growth factor-beta 1 (TGF-beta 1) and
      osteocalcin in bone persistently decreased and increased, respectively, in vivo
      in estrogen-depleted rats after ovariectomy (OVX). 21 female Wistar rats (7-month
      old) were randomized and underwent OVX or sham-operation, total RNA was extracted
      from tibiae and assessed by Northern blot analysis. OVX induced 70-80% decrease
      in TGF-beta 1 mRNA levels and 2- to 3-fold increase in mRNA levels of osteocalcin
      compared with controls three weeks after surgery. These changes persisted up to
      twelve weeks post-operation. OVX caused 15% reduction in femoral bone mineral
      density and 2-fold elevation in serum osteocalcin levels as early as two weeks
      post-operation. Moreover, estrogen depletion resulted in marked decrease and
      increase, respectively, in steady state mRNA levels of TGF-beta 1 and osteocalcin
      in vitro in osteoblastic rat osteosarcoma cells, ROS 17/2.8. Our results provide
      the first in vivo evidence that expression of TGF-beta and osteocalcin in bone is
      reciprocally regulated at the transcriptional level in estrogen deficient OVX
      rats and suggests that TGF-beta 1 may play a role in estrogen-dependent
      maintenance of normal bone density.

PMID- 8352781
TI  - Detection of Zn-binding in domain E of the porcine estradiol receptor.
AB  - A 32 kDa fragment of the porcine estradiol receptor, which contains the entire
      hormone-binding domain E and parts of the adjacent domains D and F, binds 65Zn
      with high affinity. Nonradioactive Zn and Cu are equally potent competitors, Co
      and Ni are less effective. The capacity for Zn-binding is pH-dependent, it is
      abolished by the ethoxycarboxylation of imidazole, but remains unimpaired after
      the modification of sulfhydryls by vinylpyridine. The presence of a HDXXH motif
      in domain E of the receptor and the significance of its similarity with the HEXXH
      zinc-binding motif of metallo-proteases are discussed.

PMID- 8352782
TI  - Identification of a protein product of the myotonic dystrophy gene using peptide
      specific antibodies.
AB  - In order to identify the protein product of the recently characterised myotonic
      dystrophy gene, we have raised an antibody (DMAP1) to a peptide sequence of the
      predicted gene product. This antibody identifies a novel 52 kDa protein in a
      range of mouse tissues, and in addition a related 42 kDa protein in brain and
      heart. A second antibody raised to a different peptide from the same predicted
      sequence, also identifies the 52 kDa protein, which strongly implies that this 52
      kDa protein is a major translation product of the myotonic dystrophy gene.

PMID- 8352783
TI  - Effect of spermine on mitochondrial matrix calcium in relation to its enhancement
      of mitochondrial calcium uptake.
AB  - The mechanism of spermine-induced enhancement of mitochondrial Ca2+ uptake was
      explored using the fluorescent Ca2+ indicator Fluo-3/AM to measure the free
      matrix Ca2+ concentration. Simultaneously, the extramitochondrial Ca2+
      concentration was registered by a Ca(2+)-ion selective electrode. Spermine
      lowered the extramitochondrial steady state Ca2+ concentration and at the same
      time induced a decrease of the intramitochondrial Ca2+ concentration. However,
      there is a concentration-dependent reversal of the stimulatory action of
      spermine, which may be explained by the existence of a second, low-affinity
      binding site for spermine which mediates an inhibition of uptake in spite of the
      existence of an inwardly directed Ca2+ gradient.

PMID- 8352784
TI  - Nicotinic acetylcholine receptor mRNAs in myasthenic thymuses: association with
      intrathymic pathogenesis of myasthenia gravis.
AB  - Reverse transcription and the polymerase chain reaction showed that the alpha-,
      beta- and gamma-subunit genes of nicotinic acetylcholine receptor (AChR) in human
      skeletal muscle were expressed in myasthenia gravis (MG) thymuses (3 thymomas and
      7 hyperplastic thymuses). A study of the expression of these subunit mRNAs in a
      variety of human tissues showed that alpha-subunit mRNA was expressed in human
      thymus and cerebral cortex, and that all three subunits were expressed only in
      human child thymus. Our results suggest that a complete AChR similar to
      extrajunctional (embryonic) muscle AChR is expressed in MG thymuses and that
      intrathymic AChR might be the primary antigen which induces autoimmune responses
      to muscle AChR.

PMID- 8352785
TI  - Effect of spermine on mitochondrial glutathione release.
AB  - Spermine prevents glutathione release induced in rat liver mitochondria by the
      combined addition of Ca2+ and phosphate. Spermine also inhibits mitochondrial
      swelling, membrane potential decrease, oxygen uptake and [14C] sucrose entry
      stimulated by the above reported agent. Mitochondrial swelling is completely
      prevented by 25 microM spermine while higher concentrations (100 microM) are
      required for the full inhibition of glutathione release. Therefore, polyamines
      decrease the mitochondrial inner membrane permeability and, by preventing
      mitochondrial glutathione loss, also act as protective agents against oxidative
      stress.

PMID- 8352786
TI  - Up-regulation of ETB receptor subtype mRNA by angiotensin II in rat
      cardiomyocytes.
AB  - The effect of angiotensin (ANG) II on the expression of endothelin (ET) receptor
      subtype (ETA, ETB) mRNA in cultured neonatal rat cardiomyocytes was studied. ANG
      II (10(-7) M) increased steady-state mRNA levels of ETB receptor, but not ETA
      receptor, during 6-12 hr incubation, whose effect was dose-dependent (10(-9)-10(
      7) M). ANG II receptor type-1 (AT1) antagonist (CV-11974) completely inhibited
      the ANG II-induced up-regulation of ETB receptor, whereas the inhibitory effect
      by ANG II receptor type-2 (AT2) antagonist (PD 123319) was incomplete. These
      results suggest that ANG II up-regulates cardiac ETB receptor, predominantly via
      AT1 receptor.

PMID- 8352787
TI  - A novel domain sequence of connectin localized at the I band of skeletal muscle
      sarcomeres: homology to neurofilament subunits.
AB  - A cDNA of 4.0 kb was cloned from a chicken embryo skeletal muscle cDNA library,
      using an antibody to muscle elastic protein connectin (titin), the molecular mass
      of which is estimated to be 3,000 kDa. Immunoelectron microscopy revealed that
      the antiserum raised against the product of the cDNA expressed in E. coli bound
      to the epitopes of the connectin filament near the N2 line of chicken breast
      muscle sarcomeres. The predicted amino acid sequence contains eight
      immunoglobulin C2 motifs and regions highly homologous with the high and medium
      molecular weight subunits of neurofilament. In addition, there are regions
      homologous with desmoplakin, calsequestrin, and calpastatin.

PMID- 8352788
TI  - Cloning and sequence analysis of the 5'-flanking region of the estrogen
      sulfotransferase gene: steroid response elements and cell-specific nuclear DNA
      binding proteins.
AB  - A 2954 bp region of the guinea pig estrogen sulfotransferase gene was cloned and
      sequenced including 2888 nt upstream of the cap site. This represents the first
      cloning of the promoter region of a steroid sulfotransferase gene. The 5'
      flanking region was found to contain a conventional TATA box variant and
      sequences homologous to estrogen and glucocorticoid response elements. Gel
      mobility shift assays detected the presence of nuclear proteins in adrenocortical
      SW-13 and Y-1 cells that bind specifically to 30 mer DNA sequences containing
      either estrogen or glucocorticoid response elements. In contrast, gel shift
      experiments using 3T3 fibroblast cells failed to demonstrate similarly upshifted
      bands. Block deletion studies indicated that regulation of basal estrogen
      sulfotransferase promoter activity was located within the first 1000 bp upstream
      of the transcription initiation site.

PMID- 8352789
TI  - Stable expression of human endothelin receptors ETA and ETB by transfected baby
      hamster kidney cells.
AB  - The cDNAs for human endothelin receptors ETA and ETB were subcloned into the
      eukaryotic expression vector pMPSV/CMV and transfected, in parallel with plasmids
      carrying resistances for hygromycin B and puromycin, into baby hamster kidney
      (BHK) cells. Cell clones constitutively expressing high levels of either receptor
      were obtained through the combined selective pressure of both antibiotics. This
      was further confirmed by Northern blot analysis using ETA- or ETB-specific
      oligonucleotide probes. The calculated KD for endothelin (ET)-1 binding to ETA
      and ETB were 2.2 x 10(-10) M and 5.3 x 10(-10) M, respectively. Competitive
      binding experiments using the different ET forms showed the expected isopeptide
      selective and non-isopeptide-selective profiles for ETA and ETB, respectively. BQ
      123, a specific ETA antagonist, competed with ET-1 for binding to ETA but not to
      ETB.

PMID- 8352790
TI  - Cloning and sequence analysis of a cDNA encoding tetrameric carbonyl reductase of
      pig lung.
AB  - A cDNA for tetrameric carbonyl reductase was cloned from a pig lung cDNA library.
      The cDNA had an open reading frame encoding a protein of 244 amino acid residues
      with a predicted monomer molecular weight of 25,985. The authenticity of the cDNA
      was confirmed by a perfect match of 80 amino acids determined from sequencing of
      amino-terminus, carboxy-terminus and internal fragments of the purified enzyme.
      The deduced sequence of the carbonyl reductase shows a similarity to those of the
      short-chain alcohol dehydrogenase superfamily proteins; notably it had an
      extensive homology (85% identical residues) with a putative gene product of
      murine adipocyte.

PMID- 8352791
TI  - Characterization of histogranin receptors in human peripheral blood lymphocytes.
AB  - Histogranin (HN), a peptide recently isolated from bovine adrenal medulla, is
      also present in the spleen. In present studies, specific high affinity binding
      sites for HN were characterized on membrane preparations of human lymphocytes by
      radioligand binding. [125I]-[Ser1]HN binding was found to be dependent on time
      and protein concentration and to be sensitive to trypsin treatment. The binding
      displayed high affinity (Kd = 1.1 +/- 0.3 nM) and saturability (Bmax = 40.2 +/-
      5.0 fmol/mg protein), and it was reversed upon addition of unlabelled [Ser1]HN
      and closely related peptides. The relative potency of various fragments in
      displacing [125I][Ser1]HN binding indicated that the active core of the molecule
      resides inside the C-terminal fragment, HN-(6-15). Interestingly, depressed
      patients displayed a marked decrease in the binding activity (from 15.4 to 8.55
      fmol/mg protein at 0.5 nM of [125I][Ser1]HN). The presence of high affinity HN
      binding sites on lymphocytes provides evidence for a modulatory role for HN in
      the regulation of lymphocyte functions.

PMID- 8352792
TI  - Isolation and identification of a novel peptide from the accessory sex gland of
      the female house fly, Musca domestica.
AB  - A peptide of novel structure was isolated from accessory glands of the female
      house fly, Musca domestica by molecular-weight limit centrifugal ultrafiltration
      and reversed-phase HPLC. After amino acid and protein sequence analyses, the
      structure of this peptide was confirmed by chemical synthesis and plasma
      desorption mass spectral analysis to be Leu-Leu-Asn-Ala-Leu-Pro-Leu-Asp-Ala-Leu
      Ser-Ser-Leu-Thr-Gly-NH2. The accessory gland peptide stimulated contraction of
      the house fly oviduct at concentrations of 10(-7) M and above.

PMID- 8352793
TI  - Basal high blood pressure cosegregates with the loci on chromosome 1 in the F2
      generation from crosses between normotensive Wistar Kyoto rats and stroke-prone
      spontaneously hypertensive rats.
AB  - We investigated the linkage between high blood pressure (BP) and microsatellite
      genotypes in the independently produced F2 progenies between Wistar Kyoto rats
      (WKY) and stroke-prone spontaneously hypertensive rats (SHRSP) at the age of 2.5,
      3 and 5 months before salt loading and after 2 month salt loading. In 2.5, 3 and
      5 month-old male and female F2 progenies, blood pressure was significantly higher
      in homozygotes of the SHRSP allele at the two loci on rat chromosome 1,
      leukosianine (LSN) and myosin light chain (MYL2), than those of heterozygotes or
      WKY homozygotes. However, this strong cosegregation was attenuated after salt
      loading for 2 months. Basal (non salt-loaded) blood pressure strongly
      cosegregates with the loci on rat chromosome 1 and, therefore, putative gene(s)
      in this region contribute to the development of basal high blood pressure in
      SHRSP.

PMID- 8352794
TI  - Osteogenic protein-1 stimulates proliferation and differentiation of human bone
      cells in vitro.
AB  - The effect of recombinant human osteogenic protein-1 (OP-1) on proliferation and
      alkaline phosphatase (ALP) activity was studied using human bone cells in
      culture. TE85, osteosarcoma cells with osteoblastic characteristics and normal
      bone cells derived from mandible (HBM) were used. OP-1 stimulated 3H-thymidine
      incorporation in a dose dependent manner in TE85 (5-fold over vehicle control at
      3-10 ng/ml) and HBM cells (1.8-fold at 100 ng/ml). In TE85 cells, OP-1 also
      increased cell number (2.4-fold over vehicle control at 3 ng/ml). OP-1 stimulated
      ALP activity in TE85 cells (4-fold over vehicle control at 30 ng/ml), but
      moderately inhibited ALP activity in HBM cells (to 67% of vehicle control at 100
      ng/ml). Because 1,25(OH)2D3 has been shown to increase ALP activity in many cell
      types, we also studied if 1,25(OH)2D3 modulates the effects of OP-1 on ALP
      activity. In the presence of 10(-8) M 1,25(OH)2D3, a biphasic response occurred
      in TE85 and HBM cells with stimulation of ALP activity at low dose of OP-1 and
      inhibition at high dose. Thus, the effect of OP-1 on ALP activity appeared to be
      modulated by 1,25(OH)2D3. Our results suggest that OP-1 could be an important
      regulator of osteoblast proliferation and differentiation.

PMID- 8352795
TI  - Cloning and expression in Escherichia coli of Thermotoga neapolitana genes coding
      for enzymes of carbohydrate substrate degradation.
AB  - A genomic library of thermophilic anaerobic eubacterium Thermatoga neapolitana
      was constructed in E. coli using the pTZ19R plasmid vector. Some groups of
      recombinant clones with different cellulase activities were revealed: clones
      carrying genes for an 1,4-beta-glucanases, 1,3-beta-glucanases, beta-xylanases,
      beta-glucosidases and beta-xylosidases. One clone possessing avicelase activity
      was obtained. Some clones were selected with amylolytic activities toward
      amylose, amylopectin and pullulan.

PMID- 8352796
TI  - The elastolytic properties of subtilisin GX from alkalophilic Bacillus sp. strain
      6644 provides a means of differentiation from other subtilisins.
AB  - A serine protease exhibiting high activity in alkaline media was purified from
      alkalophilic Bacillus strain GX6644. The enzyme, subtilisin GX, has a molecular
      weight of 25,000 and a pI greater than 9.5. The protease exhibited high
      elastolytic activity, but unlike most elastin hydrolyzing enzymes, elastin
      hydrolysis and binding were not inhibited by 0.1 M NaCl. The elastolytic
      properties of subtilisin GX together with its specificity toward amino acid
      phenyl esters functionally distinguishes this protease from other subtilisins.
      However, comparisons of the available amino-terminal sequence of subtilisin GX
      with subtilisins from alkalophilic and neutrophilic Bacillus species revealed
      extensive homology.

PMID- 8352797
TI  - Hela cells proteasome interacts with leucine-rich polypeptides and contains a
      phosphorylated subunit.
AB  - The proteasome is a multicatalytic proteinase complex composed of several non
      identical protein subunits with molecular weights ranging from 20 to 35 kDa. To
      approach the mechanisms modulating the activity of this protease, we have
      investigated the possible interaction of this particle with specific polypeptides
      as well as the phosphorylation status of its subunits. A specific antiserum was
      used to immunoprecipitate this particle under native conditions. Three major
      polypeptides, characterized by molecular masses of 53, 59 and 77 kDa co
      immunoprecipitated specifically with the proteasome. Labelling experiments
      indicated that these proteins are leucine-rich and contain very few methionine
      residues. None of them were phosphorylated in vivo in normal cell growth
      conditions, in contrast to one of the proteasome subunit (30 kDa). These results
      indicate that, in vivo, the proteasome is probably associated with leucine-rich
      polypeptides and that this protease is a kinase substrate.

PMID- 8352798
TI  - Apoptosis induction in 32D cells by IL-3 withdrawal is preceded by a drop in the
      intracellular calcium level.
AB  - The 32D murine myeloid cell line is dependent on interleukin-3 (IL-3) for growth
      in vitro. We show here that IL-3 induces a slow increase in endocellular calcium,
      which is sizeable two hours after the addition. Withdrawal of the cytokine
      induces apoptosis, whose classic late events are evident after 16/18 hours, and
      are preceded by a calcium drop during the first 2/3 hours after IL-3 subtraction.
      Calcium drop is here proposed as a trigger of the apoptotic process, in agreement
      with other recently reported findings.

PMID- 8352799
TI  - Molecular cloning of polymorphic markers on RLGS gel using the spot target
      cloning method.
AB  - A new method for target cloning of DNA fragments corresponding to spots on the
      two-dimensional restriction landmark genomic scanning (RLGS) profile has been
      developed (targeted spot cloning). We used a Not I restriction trapper to select
      target DNA fragments from Not I, Eco RV double digests of genomic DNA. The use of
      the restriction trapper substantially reduces the background clones that are
      established from the direct recovery of RLGS spot DNA from the two-dimensional
      gels. Genomic DNA clones were isolated in this study as mouse genome markers for
      58 spot loci that were previously characterized using RLGS spot mapping. This
      method provides a powerful tool for isolating DNA clones after their
      identification by RLGS system.

PMID- 8352800
TI  - Inhibitory effect of arachidonic acid on GTPase activating protein is antagonized
      by 1-stearoyl, 2-arachidonoyl glycerol.
AB  - The intrinsic GTPase activity of cellular protein p21ras is strongly increased by
      cytosolic GTPase activating protein (GAP). The activity of this enzyme has been
      shown to be inhibited by arachidonic acid. We report here that this inhibition is
      antagonized by the presence of 1-stearoyl, 2-arachidonoyl glycerol. This effect
      is structure specific and dose dependent, being maximum at 200 micrograms/ml of
      diacylglycerol (DG). These results suggest that production of DG in response to
      hormones or growth factors stimulation could indirectly modulate the interaction
      between p21ras and GAP.

PMID- 8352801
TI  - The precursor molecule of a V lambda II-immunoglobulin light chain-derived
      amyloid fibril protein circulates precleaved.
AB  - The putative precursor molecule of a human AL type amyloid fibril protein was
      isolated from an ultrafiltrate after hemofiltration. Subsequent separation of
      this protein was achieved by high performance liquid chromatography (HPLC) after
      reduction and carboxymethylation of the disulfide bonds. The protein was
      separated into several fractions which were further analyzed by automatic amino
      acid sequence determination. It was deduced from the sequence data that the
      precursor molecule is an immunoglobulin L-chain of the lambda-type. The V-region
      of this protein is most closely related to the proteins of subgroup II. Internal
      splits occurred in the molecule after lysine residues in positions 110, 129 and
      179. The predominant fragment commences with either serine or alanine in position
      9 and extends to a serine in position 65 of the V-region. Tryptic peptides
      generated from the fragments cover nearly the entire V- and C-region of the L
      chain, with the exception of positions 1-8, from which no peptide has been
      isolated.

PMID- 8352802
TI  - The determinants of the dimeric structure of seminal ribonuclease are located in
      its N-terminal region.
AB  - A chimeric cDNA was constructed, coding for the N-terminal region of BS-RNase
      (residues 1-49) and the C-terminal region of RNase A (residues 50-124). The
      resulting chimeric DNA was expressed in Escherichia coli and found to code for
      RNase chains that spontaneously assembled into a covalently dimeric ribonuclease.

PMID- 8352803
TI  - c-MYC repression of promoter activity through core promoter elements.
AB  - c-MYC was found to repress expression of the c-myc promoter in a transient assay
      system. Deletion constructs showed the cis-acting element(s) were common to both
      the P1 and P2 promoters. Further analysis involving replacement of the P2 TATA
      box and initiator elements with the SV40 late promoter initiator localized the
      cis-acting elements to the core promoter.

PMID- 8352804
TI  - Cloning a novel form of rat PDGF A-chain with a unique 5'-UT: regulation during
      development and in glomerulonephritis.
AB  - An unique form of rat platelet-derived growth factor A-chain (PDGF A-chain), with
      a novel 5' UT region, was cloned from a rat macrophage cDNA library and
      expressed. In the 5' UT, the homology of the 79 bp sequence adjacent to the ATG
      codon between rat and human was 92%; however, the homology of the remainder in
      the 5' UT was less than 30%. RNase mapping indicated this form was differentially
      expressed during development and immune glomerular injury, and that it probably
      arose from alternative splicing. We propose that the variant mRNAs reflect
      different levels of the control of PDGF A-chain expression.

PMID- 8352805
TI  - Identification of ionizable groups essential for the enzyme catalysis on
      glutathione S-transferase P.
AB  - The pH-Vmax/KmGSH plot of glutathione S-transferase P (GST-P) showed a bell
      shaped profile, indicating bifunctional catalysis for glutathione (GSH)
      conjugation. The ionization constant (Ke) and the heat of ionization (delta He)
      of the essential ionizable group in the GSH binding site were measured and the
      value of pKe1 was 5.9 and that of pKe2, 8.4, while the delta He1 and delta He2
      were -0.2 and 7.9 kcal/mole, respectively. In a solvent containing 25% ethanol,
      pKe1 and pKe2 shifted to the alkaline side by 0.47 and 0.2, respectively. These
      kinetic results indicated that carboxyl and phenolic groups were ionizable groups
      essential for the GSH conjugation. Chemical modifications using aminomethane
      sulfonic acid and N-acetylimidazole supported the results of the kinetic studies.

PMID- 8352806
TI  - Sp1 interacts with the consensus sequence for Egr-1 gene product with a cellular
      factor(s) and activates the transcription through this element.
AB  - We report that Sp1 from nuclear extracts of BRL-3A cells interacts with the
      consensus DNA sequence for the Egr-1 gene product in an overlapping manner.
      Purified Sp1 failed to bind to this sequence and with the addition of sub
      saturating level of nuclear extracts, the binding activity appeared. In
      Drosophila cells (SL2), exogenously expressed Sp1 activated the transcription
      through the Egr-1 site. These findings suggest that Sp1 can be targeted to a non
      Sp1 (Egr-1) site with a cellular factor(s) and can activate the transcription
      through this element.

PMID- 8352807
TI  - Mechanism-based inhibitors of serine proteinases based on the Gabriel-Colman
      rearrangement.
AB  - Neutrophil-derived mediators such as, for example, the serine proteinase
      elastase, cathepsin G and proteinase 3, play a critical role in inflammatory lung
      disease. This report describes the design, synthesis and in vitro inhibitory
      activity of some novel mechanism-based inhibitors of human leukocyte elastase and
      cathepsin G. The design of the inhibitors is based on the Gabriel-Colman
      rearrangement. The behavior of the synthesized compounds toward elastase and
      cathepsin G with respect to inhibitory prowess, mode of interaction, specificity,
      etc., has been found to be dependent on the recognition and reactivity elements
      present in each inhibitor.

PMID- 8352808
TI  - Monoclonal antibodies against human neurotrophin-3.
AB  - Hybridomas producing monoclonal antibodies (MoAbs) against human neurotrophin-3
      (hNT-3) were established using recombinant hNT-3 produced in CHO cells and E.
      coli as immunogens. Of the five MoAbs obtained, MoAb 3w3 showed the highest
      antibody titer and also best neutralized NT-3 activity as measured by the
      survival of chick embryonic day-8 dorsal root ganglia neurons. A sandwich enzyme
      immunoassay (EIA) for NT-3 was established with solid phase MoAb 3W3 and the Fab'
      fragment of MoAb 3W3 conjugated to horseradish peroxidase. The detection limit
      was 2.7 pg/well of NT-3 and no cross-reactivity with nerve growth factor up to
      100 ng/well was observed. Using this EIA system we have screened a variety of
      cell lines for NT-3 production. Among these tested, only human Burkitt's lymphoma
      Namalwa cells were found to be producing NT-3.

PMID- 8352809
TI  - Alteration of DNA binding specificity by nickel (II) substitution in three zinc
      (II) fingers of transcription factor Sp1.
AB  - Transcription factor Sp1, which has a DNA binding domain composed of three zinc
      fingers, binds to GC box (consensus sequence, G/T-GGGCGG-G/A-G/A-C/T) and
      activates the transcription by RNA polymerase II. Metal substitution of
      nickel(II) for zinc(II) in Sp1 causes no differences in the mode of protein-DNA
      interaction. However, sequence preference of Ni(II)Sp1 changes from 5'-GGGGCGGGGC
      to 5'-GGGGCGTGGC, and is distinct from that of Zn(II)Sp1. The result indicates an
      important effect of metal-induced folding on sequence-specific recognition of DNA
      by zinc-finger proteins.

PMID- 8352810
TI  - pH dependent conformational changes modulate functional activity of the
      mitochondrial ATPase inhibitor protein.
AB  - A 12kDa, heat stable protein (IF1) inhibiting hydrolytic activity of
      submitochondrial particles was purified to electrophoretic homogeneity from
      buffalo heart mitochondria. Specific activity of the purified fraction was > 5000
      units/mg. Maximal inhibition was observed at pH 6.0 and was Mg++ and ATP
      dependent. Circular dichroism studies showed that the inhibitor peptide undergoes
      a dramatic, reversible conformational change in response to pH which correlates
      well with its ability to inhibit ATP hydrolysis catalyzed by inhibitor depleted
      submitochondrial particles. It is shown for the first time that IF1 with a
      predominantly beta-sheet component is more efficient at suppressing ATPase
      activity.

PMID- 8352811
TI  - Oxygenated cholesterols as ligands for cytosolic-nuclear tumor promoter binding
      protein: yakkasteroids.
AB  - Several oxygenated cholesterols and their derivatives (yakkasteroids) were
      prepared as candidate ligands for cytosolic-nuclear tumor promoter binding
      protein (CN-TPBP). Among the compounds, a possible natural substance, 3 beta,5
      alpha-dihydroxycholestan-6-one (yakkasterone), showed the highest binding
      affinity to CN-TPBP. It also showed high specificity for binding to CN-TPBP: it
      does not bind to protein kinase C. Investigation of the structure-activity
      relationships of yakkasteroids revealed that the structure of the side chain at
      the 20-position is important for the binding activity to CN-TPBP.

PMID- 8352812
TI  - Prolactin-independent induction of alpha-lactalbumin gene expression in mammary
      gland explants from pregnant Balb/c mice.
AB  - A four-fold increment of alpha-lactalbumin mRNA was induced in mammary gland
      explants from mid-pregnant Balb/c mice cultured for 24h in media containing
      insulin, cortisol and T3, and this response was enhanced by 40% with the addition
      of prolactin. In contrast, elevated beta-casein gene expression was evident only
      in explants cultured in media with insulin, cortisol, T3 and prolactin. These
      results suggest that the induction of the alpha-lactalbumin gene was prolactin
      independent and did not result from retention of endogenous prolactin, or its
      effects, by the mammary explants.

PMID- 8352813
TI  - Purification of a 57kDa nuclear matrix protein associated with thiol:protein
      disulfide oxidoreductase and phospholipase C activities.
AB  - Proteins of the internal nuclear matrix from chicken liver were fractionated, by
      chromatographic procedures, in non denaturing conditions. At least two fractions
      were present with phosphatidylinositol-specific phospholipase C and three with
      thiol:protein-disulfide oxidoreductase activity. A 57kDa protein was isolated
      which copurified with both these activities. Partial amino acid sequences showed
      a high degree of homology with a cytosolic protein previously identified as a
      phospholipase C and with a microsomal protein identified as a thiol:protein
      disulfide oxidoreductase. Our finding leaves the question still unanswered of the
      real function of this protein, which for the first time has been isolated from
      the nuclear matrix.

PMID- 8352814
TI  - [New central analgesic-acting triaminopyridines].
AB  - New Triaminopyridines with a Central Analgesic Activity 2-Amino-3-((prop-1-en-3
      yl)oxycarbonylamino)-6-(4-fluorobenzyla mino) pyridine hydrochloride (D-19050) is
      a centrally and peripherally acting analgesic with rapid onset, long duration of
      action and a good therapeutic range. D-19050 can be obtained in a 5-step
      synthesis starting from 2,6-dichloropyridine.

PMID- 8352815
TI  - Thiazolidinone congeners as central nervous system active agents.
AB  - 3-(Benzylidene amino)-2-imino-4-thiazolidinones (IIa-c) synthesized by
      cyclization of substituted thiosemicarbazones (Ia-c) were converted into 2-amino
      3-(substituted benzylamino)-4-thiazolidinones (IIIa-c), 2-imino-3-(alpha-aryl azo
      benzylidene) amino-4-thiazolidinones (IVa-f) and 2-(2-amino-4-oxo-3
      thiazolidinyl)-3-aryl-4-isothiazolidinones (VIa-c), IVa-f were finally converted
      into 5-(arylamino methyl)-2-imino-3-(alpha-aryl azobenzylidene)-amino-4
      thiazolidinones (Va-l). These compounds III, V and VI were evaluated for their
      monoamine oxidase (MAO) inhibitory activity in vitro and various CNS activities
      in vivo. Some of the compounds exhibited promising CNS activity.

PMID- 8352816
TI  - Characterisation of the central nervous depressant activity of a commercially
      available valerian root extract.
AB  - The evaluation of a commercially available valerian root extract (Valdispert)
      revealed pronounced sedative properties in the mouse with respect to a reduction
      in motility and an increase in the thiopental sleeping-time. A direct comparison
      with diazepam and chlorpromazine revealed a moderate sedative activity for the
      tested extract. The extract showed only weak anticonvulsive properties.

PMID- 8352817
TI  - [The bioequivalence of two nifedipine sustained-release formulations after single
      administration in steady state].
AB  - Investigations into the Bioequivalence of Two Nifedipine Controlled-release
      Formulations after Single Application and in Steady State. The bioequivalence of
      nifedipine (CAS 21829-25-4) in controlled-release formulation (Corinfar retard
      dragees) was tested versus a reference preparation in 22 subjects in a cross-over
      design after the first dose and in steady state. Compared to the reference, the
      preparations tested were found to have a relative bioavailability of 0.86 and
      0.95, respectively. The bioavailability parameters of the preparations tested did
      not differ from each other. In particular, the fluctuation indices were noted to
      be highly similar. In view of the marked prolonged-action effect, a twice-per-day
      application is possible for the majority of the patients.

PMID- 8352818
TI  - Kinetics and pharmacodynamic effects of a novel prodrug of N-methyldopamine at
      single dose in healthy volunteers.
AB  - Kinetics and cardiovascular effects of SIM2055 (CAS 103878-96-2), the 4-O
      phosphate of N-methyldopamine (epinine), at single dose by the oral route were
      studied in 9 healthy adult volunteers (6 women and 3 men) ranging in age from 22
      to 39 years. SIM2055 was administered at increasing doses (from 100 to 300 mg).
      Plasma concentrations of free epinine were not detectable after the 100 mg dose,
      but were measurable after the 200 mg and 300 mg doses. Pharmacokinetic data
      suggest that in man SIM2055 is promptly absorbed, quickly hydrolysed to epinine,
      metabolized to homovanillic acid and 3,4-dihydroxy-phenylacetic acid, conjugated
      with sulphuric acid and excreted in large amounts into urine. The 24-h urinary
      recovery of the 3 metabolites considered together, expressed as a percentage of
      the dose of SIM2055 administered, was 78 +/- 6 with the 100 mg dose, 66 +/- 11
      with the 200 mg dose and 55 +/- 6 with the 300 mg dose (mean +/- S. D.). SIM2055
      was well tolerated by all subjects. After its administration, the heart rate and
      the systolic and diastolic blood pressure presented no systemic or clinically
      significant variations. No substantial changes were observed with the ECG
      parameters. No subject reported gastric or systemic effects during the period of
      observation.

PMID- 8352819
TI  - Competition between deferiprone, desferrioxamine and other chelators for iron and
      the effect of other metals.
AB  - Competition for iron between the leading oral iron chelator deferiprone (L1, 1,2
      dimethyl-3-hydroxypyrid-4-one) and desferrioxamine (DF), and the effect of other
      metals has been studied. Visible spectroscopy was used to estimate the
      displacement of iron from DF-iron(III) and L1-iron(III) complexes, respectively,
      by varying quantities of up to 100 molar equivalent of a competing metal ion M+
      (Mg2+, Al3+, Ca2+, Mn2+, Co2+, Cu2+, Zn2+ and Pb2+) at physiological pH. Copper
      and aluminium showed the greatest competition against iron, while magnesium,
      calcium and manganese had little or no effect and the other metals an
      intermediate effect. DF showed greater selectivity for iron than L1 under these
      conditions. An analogous series of experiments carried out using a competing
      chelator of up to 50 molar equivalent in a place of a competing metal ion showed
      that 8-hydroxyquinoline, diethylenetriamine-pentaacetic acid (DTPA) and tropolone
      were more effective at displacing iron from DF-Fe and (L1)3Fe complexes than
      maltol or omadine. Desferrioxamine was the most efficient competitor against L1.
      Stoichiometric studies of the L1 complexes of aluminium and copper at pH 7.4
      using Job Plots, suggested the formation of (L1)3Al and (L1)2Cu complexes,
      respectively.

PMID- 8352820
TI  - Erythema formation in magnesium-deficient albino rats. A non-invasive model for
      the screening of anti-inflammatory agents and oral mineral supplements.
AB  - The enteral bioavailability of magnesium firmly bound to a fire-proof, inert SiO2
      Al2O3 matrix (ground magnesia boats) was studied in magnesium-deficient albino
      Sprague-Dawley rats, with and without blocking gastric hydrochloric acid
      secretion with omeprazole. Magnesium was absorbed, although to a small degree,
      also at anacidity. Pronounced erythema, developing after only some days in
      hypomagnesemic hypercalcemic rats, are proposed as a non-invasive model for the
      screening of antiinflammatory substances. Using this model significant protective
      effects were proven for cromoglycate, polyenthylene glycol 400, and omeprazole;
      the latter, however, seems more likely to act via a magnesium-sparing mechanism.

PMID- 8352821
TI  - Pharmacokinetics and pharmacodynamics of naproxen in acute experimental
      hepatitis.
AB  - The pharmacokinetics of intravenous naproxen (CAS 22204-53-1) 6 mg kg-1, were
      studied in Wistar rats under control conditions and 1, 3 and 10 days after the
      induction of acute hepatitis by a single intraperitoneal injection of
      galactosamine 375 mg kg-1. In non-intoxicated rats t1/2 was 5.31 +/- 0.90 h, Vd
      was 0.21 +/- 0.01 l.kg-1, Cl was 17 +/- 5 ml.h-1.kg-1, AUC was 354.4 +/- 8.8
      micrograms.h.ml-1 and 99.18 +/- 0.09% of naproxen was bound to plasma proteins.
      One day after intoxication the liver was considerably damaged; cytochrome P450,
      the main enzymatic system for naproxen metabolism, was decreased in 90%. Naproxen
      t1/2 was increased to 11.9 +/- 1.2 h but Vd did not change significantly,
      therefore clearance was reduced to 37%. Binding to plasma proteins was decreased
      to 83.21 +/- 0.27%. At day 3 liver function and naproxen pharmacokinetics
      exhibited a partial recovery, t1/2 was 6.59 +/- 0.92 h and clearance was 12.2 +/-
      5 ml.h-1.kg-1 being not significantly different from controls; notwithstanding
      AUC was still significantly different from that of non-intoxicated rats. 10 days
      after galactosamine injection all pharmacokinetic parameters, as well as those of
      liver function, returned to basal levels. The results indicate that acute
      hepatitis produces an important reduction in naproxen elimination. Changes in
      naproxen disposition, which exhibit a time course similar to that of liver
      damage, are mainly determined by a decrease in intrinsic hepatic clearance and in
      the binding to plasma proteins.

PMID- 8352822
TI  - High-performance liquid chromatographic analysis of piroxicam and tenoxicam in
      plasma, blood and buffer solution. Application to pharmacokinetic studies in
      small laboratory animals.
AB  - A rapid and sensitive high-performance liquid chromatographic procedure is
      described for the simultaneous determination of piroxicam (CAS 36322-90-4) and
      tenoxicam (CAS 59804-37-4) in blood, plasma and buffer solutions used in the
      equilibrium dialysis studies. The method can be used to measure either piroxicam
      and tenoxicam in these three fluids using the other as internal standard. A
      Nucleosil C18 and a mobile phase consisting of an acetonitrile-distilled water
      acetic acid (58 : 38 : 4) mixture were used. The flow rate was 1 ml/min and the
      effluent was monitored at 365 nm with 0.02 AUFS (absorbance units full scale).
      The sensitivities of this method were 0.2 microgram/ml levels of piroxicam and
      tenoxicam in the plasma, blood and buffer solutions samples.

PMID- 8352823
TI  - Preparation of a gelatin-binding conjugate containing gold thiomalate.
AB  - Plasma fibronectin has a range of binding sites, for ligands, including
      denaturated collagen (gelatin). It has been proposed that this activity may be
      used for nonimmune drug targeting to sites in the extra-cellular matrix such as
      the targeting of gold thiomalate to rheumatoid joints. In the present study, a
      novel conjugate has been developed, consisting of the gold thiomalate bound at
      high density to the gelatin-binding domain of fibronectin, through a polylysine
      carrier. Isolation and cross-linking of suitable fragments of fibronectin
      (relative molecular weights 65 and 52 kDa) to polylysine is followed by
      conjugation to gold thiomalate on a solid phase, gelatin-agarose affinity
      absorbent. Although gold thiomalate has the ability to inactivate, the protein
      gold conjugate produced by this technique retained its gelatin-binding activity.

PMID- 8352824
TI  - Potentiation of human polymorphonuclear leukocytes respiratory burst and
      phagocytosis by a standardized liver and spleen fraction of peptides.
AB  - The effect of Factor AF2 (AF2), a xenogeneic fraction of peptides with a
      molecular weight of < 10,000 Dalton obtained from livers and spleens of newborn
      lambs, on the oxygen consumption and the phagocytic activity of human
      polymorphonuclear leukocytes (PMN) was studied. AF2 increased the oxygen uptake
      of PMN exposed both to serum-treated zymosan (STZ), a phagocytosable stimulus,
      and phorbol-myristate-acetate (PMA), a soluble stimulus. The potentiating effect
      of the drug was dose-dependent and more pronounced when suboptimal amounts of
      either stimulus were used. The phagocytic activity of PMN, as measured by the
      rate of mineral oil particles ingestion, was also increased by AF2 in a dose
      dependent manner. These results suggest that the drug may influence PMN behaviour
      in at least two ways: 1. by increasing the rate of phagocytosis, and 2. by
      potentiating the respiratory burst induced by soluble and particulate stimuli.
      The results are discussed in relation to the beneficial effects of AF2 in cancer
      patients under chemotherapy or radiation treatment.

PMID- 8352825
TI  - Synthesis and potential anthelmintic activity of methyl-5-(4-salicyloyl-piperazin
      1-yl)-benzimidazole-2-carbamates.
AB  - A series of methyl-5-(4-salicyloyl-piperazin-1-yl)-benzimidazole-2-carba mates
      (IX) has been prepared. 5-(4-Salicyloyl-piperazin-1-yl)-2-nitro anilines (VII)
      have been synthesized starting from 5-piperazino-2-nitro anilines and salicyloyl
      chlorides. Catalytic reduction of VII with Pd/C, followed by treatment with 1,3
      dicarbomethoxy-S-methyl isothiourea, yielded the corresponding carbamates (IX),
      the anthelmintic activity of which was studied. Compound IXa significantly
      reduced the numbers of preadults, adults and encysted T. spiralis larvae in
      experimental mice.

PMID- 8352826
TI  - [Development of methods for measuring the emptying time of solid and liquid test
      meals in rat stomachs].
AB  - Different methods for experimental measuring the gastric emptying time in the rat
      have been developed. For the invasive method of measuring the stomach emptying
      time of a solid test meal containing Amberlite pellets too many animals are
      necessary. On the other hand, for the non-invasive examination of the emptying of
      a radioactively marked liquid test meal by scintigraphy the resolution of the
      gamma-camera is too low. However we were able to develop a non-invasive
      fluoroscopic method for the simultaneous measurement of the gastric emptying of a
      solid (10 radiodense markers) and a liquid (0.5 ml diluted contrast medium) test
      meal. Using this method it was possible to examine the influence of stomach
      motility stimulating drugs, such as the parasympathomimeticum carbachol and the
      dopamine antagonist metoclopramide.

PMID- 8352827
TI  - Studies on the reliability of a novel absorption-lipophilicity approach to
      interpret the effects of the synthetic surfactants on drug and xenobiotic
      absorption.
AB  - Some theoretical principles of the absorption/lipophilicity approach, which
      attempts to explain the effects of the synthetic surfactants on xenobiotic and
      drug intestinal absorption, are reviewed and experimentally checked by examining
      the correlations obtained between "in situ" absorption constants, ka, found in
      rat colon, and "in vitro" lipophilicity indexes, K', for two compound series
      (secondary aliphatic amines and phenylalkylamines) in the absence and in the
      presence of the nonionic surfactant Polysorbate 80, in the intestinal perfusion
      fluid. Evidence is given for the following actions of the synthetic surfactant:
      at its critical micelle concentration (CMC), it increases the polarity of the
      absorbing membrane and, at the same time, it disrupts the aqueous stagnant
      diffusion layer adjacent to the mucosal barrier. When a supramicellar
      concentration (SMC) is used, the above actions are almost totally masked by the
      micellar solubilization of the tested amines, which decreases their absorption
      constants relative to those found at CMC, as markedly as solute lipophilicity
      increases. As a consequence of these actions, the correlations between ka and K',
      which are clearly hyperbolic in free solution, become potential in the presence
      of the surfactant at its CMC, whereas at SMC a bilinear correlation is obtained.
      Absorption via lipophilic ionized species seems to take place for both compound
      series. Mathematical and physicochemical interpretations of this behaviour are
      outlined, and biopharmaceutical implications of these phenomena are discussed.

PMID- 8352828
TI  - Techniques of mitosis counting.

PMID- 8352829
TI  - Residency leave.

PMID- 8352830
TI  - Genetic counseling for families with inherited susceptibility to breast and
      ovarian cancer.
AB  - Efforts are under way to isolate a gene (BRCA1) on chromosome 17q12-21. Mutations
      in this gene predispose women to breast and ovarian cancer. Women with germline
      mutations in BRCA1 are estimated to have an 85% lifetime risk of developing
      breast cancer and an increased but as yet undetermined risk of ovarian cancer. It
      is estimated that one in 200 to 400 American women may be carriers of BRCA1
      mutations. We have identified several families that show linkage between breast
      and/or ovarian cancer and genetic markers that flank BRCA1. It is now possible,
      within these linked families, to prospectively identify family members likely to
      be carrying BRCA1 mutations. Because of profound and immediate clinical
      ramifications, we offered to provide this information to one such extended
      family. To provide information to this family, we developed a protocol to address
      the many issues that arise in the delivery of these services. Although testing
      for BRCA1 mutation carriers is currently limited to very rare families being
      analyzed for research purposes, this experience presages the complexities of the
      much larger scale availability of population screening for BRCA1 mutations, which
      is likely to become a reality in the next few years.

PMID- 8352831
TI  - Long-term observations of human immunodeficiency virus-infected chimpanzees.
AB  - Twenty-seven chimpanzees inoculated with material presumed to contain human
      immunodeficiency virus (HIV) between June 1983 and February 1985 were studied.
      The animals were examined on four to six occasions between 1989 and 1992 for
      serologic, virologic, hematologic, immunophenotypic, as well as clinical signs of
      HIV infection and compared to five uninfected control animals. The 19 animals
      that had seroconverted within 244 days of inoculation remained antibody positive,
      whereas those that did not seroconvert within 244 days of inoculation remained
      antibody negative 6 to 8 years later. HIV antigen was demonstrated at least once
      in lymphocyte cultures from 12 of the 19 antibody positive chimpanzees during
      this period. Nested polymerase chain reaction amplified proviral DNA in
      lymphocytes from 14 of the 19 animals. No proviral DNA was detected in antibody
      negative animals. Antibody titers were generally higher in animals from which
      virus was recovered in lymphocyte cultures [granulocyte-macrophage (GM) titer,
      1:8427] compared to virus-negative animals (GM titer, 1:3608). Mean total white
      blood cell and lymphocyte subtype counts were similar in the HIV-infected animals
      and uninfected controls. The high antibody levels and Western blot profiles, over
      periods as long as 9 years in these chimpanzees, suggest continuous stimulation
      of the immune system by HIV antigen although virus was detected only sporadically
      in the peripheral blood. No illness suggestive of immunodeficiency was seen.

PMID- 8352832
TI  - Expert evidence in cases of child abuse.

PMID- 8352833
TI  - Gene therapy begins.

PMID- 8352834
TI  - Recovery from neurological deficits following biotin treatment in a biotinidase
      Km variant.
AB  - A 15-year-old boy suffered from progressive bilateral optic neuropathy of acute
      onset at the age of 10 years. Subsequently he developed spastic paraparesis and a
      predominantly motor type neuro-axonal neuropathy in all limbs. The basic error
      has been elucidated to be due to an unusual biotinidase Km variant with biphasic
      enzyme kinetics causing systemic biotin depletion and consequent multiple biotin
      dependent carboxylase deficiency. After daily oral substitution with 10 mg biotin
      metabolic derangements subsided rapidly. Follow-up studies over one year after
      substitution with biotin demonstrated remarkable recovery from part of the
      previously present neuro-ophthalmological, motor and cognitive deficits. The
      previously extinguished flash-evoked visual potentials now showed clear responses
      after six months of substitution with biotin. In contrast with reports in
      literature, these findings indicated that neurological damage associated with
      biotinidase deficiency, rather than being permanent, is to some extent
      reversible.

PMID- 8352835
TI  - Philosophy of care. A pilot study comparing certified nurse-midwives and
      physicians.
AB  - Certified nurse-midwives (CNMs) and physicians (MDs) are thought to differ in
      philosophy of pregnancy care and childbirth. However, these differences have not
      been documented quantitatively. This article describes and compares the beliefs
      and care philosophies of CNMs and MDs toward aspects of antepartum and
      intrapartum care of low-risk women. The sample included seven CNMs and 10
      obstetricians at a large tertiary-care hospital. Using stringent statistical
      criteria for testing differences between the two groups, significantly more
      teaching was done by the CNMs than by the MDs. Other differences were all in
      expected directions.

PMID- 8352836
TI  - Colour blindness and natural selection: studies in four nomadic tribal groups
      from Andhra Pradesh, India.
AB  - 438 males and 369 females from four endogamous nomadic groups of the Yerukala
      viz. Suvvi, Badda, Uppu and Kunchapuri of Andhra Pradesh (India) were examined
      for red-green colour blindness using the 15th edition of Isihara's colour
      blindness chart. The absence of defective colour vision in the Badda Yerukala and
      very low frequencies among the other groups agree not only with the hypotheses of
      Post (1962) and Pickford (1963) concerning the operation of natural selection,
      but corroborates, too, the opinion of Malhotra (1978) that nomads by virtue of
      their life-style demand good colour vision.

PMID- 8352837
TI  - Management of alcohol problems: the role of the general practitioner.
AB  - Some 23% of men and 8% of women in the United Kingdom are consuming alcohol at
      levels that are of risk to their health, or are experiencing some problems
      related to their alcohol use. Traditionally, general practitioner efforts have
      focused on diagnosing and treating patients with a substantial history of
      dependence, and relatively little attention has been given to early intervention,
      with at-risk drinkers identified in general practice through screening or case
      finding programmes. Evidence indicates that early interventions by general
      practitioners are effective in reducing alcohol consumption among at-risk
      patients. Further work is still needed on the most effective ways of supporting
      general practitioners in this task.

PMID- 8352838
TI  - Evaluation of lithium treatment in alcoholism.
AB  - In psychiatric practice, lithium prevents manic depressives recidivism. Lithium
      could also be useful in non-manic-depressive conditions with a reduction of
      aggression and impulsivity. From the observation that alcoholics often present
      mood swings and impulsivity, several authors studied the effects of maintenance
      doses of lithium on alcohol intake and the depressive symptoms of alcoholics.
      This article reviews all the published controlled and uncontrolled studies on the
      effects of lithium in chronic alcoholics. Wren, Kline and colleagues firs
      demonstrated that lithium treatment could significantly decrease the number of
      disabling alcoholic episodes and that its effect was independent of an effect on
      the depressive symptoms. These initial optimistic conclusions were not confirmed
      by later controlled studies involving a larger number of patients. Most of the
      recent studies failed to demonstrate a significant effect of lithium on the
      depressive symptoms of alcoholics. Thus, it is now established that lithium is
      not an effective treatment of affective disorders in alcoholics. The latest
      published studies also suggest that lithium treatment does not decrease alcohol
      intake or craving for alcohol in either depressed or non-depressed alcoholics.

PMID- 8352839
TI  - Anxiogenic responses of rats on withdrawal from chronic ethanol treatment:
      effects of tianeptine.
AB  - Rats were fed a liquid diet with concentrations of ethanol increasing over 2
      weeks and then maintained for 4 weeks to give a mean ethanol intake of 11.6
      g/kg/day. They were withdrawn from ethanol for 12 hr and tested in two tests of
      anxiety, the social interaction and elevated plus-maze tests, and in the
      holeboard, which provides measures of exploration and motor activity. Compared
      with control animals that had received the liquid diet without ethanol, the rats
      withdrawn from ethanol showed significant reductions in social interaction, in
      the percentage of entries onto, and time spent on, the open arms of the plus
      maze, and in measures of general activity in all three tests. Tianeptine, a
      tricyclic antidepressant which increases 5-HT uptake, reversed the anxiogenic
      responses and the hypoactivity detected in the social interaction test, but was
      without significant effect in the other tests.

PMID- 8352840
TI  - Excretion of malondialdehyde, formaldehyde, acetaldehyde and acetone in the urine
      of rats following acute and chronic administration of ethanol.
AB  - Recent studies have shown that xenobiotics which induce oxidative stress result
      in an increased production and excretion of acetaldehyde (ACT), formaldehyde
      (FA), acetone (ACON) and malondialdehyde (MDA) in the urine of rats. We have
      therefore examined the effect of acute and chronic ethanol administration on the
      excretion of these four lipid metabolites in female Sprague-Dawley rats. Urine
      samples were collected over dry ice for 6 hr time periods. Aliquots of urine were
      derivatized with 2,4-dinitrophenylhydrazine HCl, and extracted with n-pentane.
      High pressure lipid chromatogrpahy (HPLC) was used to quantitate and the
      hydrazones of the four lipid metabolite products. Following a single, oral, acute
      dose of 5 g ethanol/kg, urinary excretion of ACT increased approximately 5.8-fold
      from 6 to 12 hr posttreatment, and decreased thereafter. FA excretion decreased
      by approximately 50% from 0 to 12 hr, returned to control values in the 18-24 hr
      urine samples, and was 1.3-fold greater than control values at 42-48 hr. ACON
      increased 3.1-fold over control values from 0 to 30 hr and remained elevated
      throughout the remaining 18 hr of the study. The excretion of MDA increased
      approximately 1.5-fold from 18 to 36 hr, then remained constant through the 48 hr
      time point. In a separate series of experiments, a chronic oral dose of 0.5 g
      ethanol/kg was administered to rats for 10 consecutive days and the urinary
      excretion of the lipid metabolites MDA, FA, ACT and ACON was examined for 11
      days, beginning with the first day of ethanol administration.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8352841
TI  - Rates of protein synthesis in different regions of the normotensive and
      hypertrophied heart in response to acute alcohol toxicity.
AB  - The objective of study was (a) to investigate whether protein synthesis in
      different regions of the heart (i.e. left and right atria, left and right
      ventricles) expressed equal sensitivity to acute ethanol dosage, and (b) to
      ascertain whether concomitant cardiac abnormalities (i.e. experimental
      hypertrophic heart disease) exacerbated these responses. Acute ethanol dosage (75
      mmol/kg body weight, i.p.) to mature male Wistar rats reduced the fractional rate
      of protein synthesis (ks, %/day) in all regions (atria and ventricles) of the
      normal and overloaded (30 days aortic constricted) hearts. The responses in ks
      were variable. In normal heart, the atrial tissues showed a slightly greater
      decrease in ks (approx. -30%) when compared to the ventricular regions (approx 
      20%). The most pronounced effects occurred in the hypertrophied left ventricular
      tissues where the depressive effects of ethanol on the rate of protein synthesis
      were potentiated in the presence of hypertrophy (ks reduced by approx 40%). Other
      regions of the overloaded heart did not show additional sensitivity to the
      effects of ethanol on protein synthesis in the presence of chronic hypertension.
      In conclusion, the deleterious effects of ethanol on the left ventricle are
      additive in the presence of chronic hypertrophy. These results may have important
      implications for other cardiac abnormalities where there is also concomitant
      ethanol exposure.

PMID- 8352842
TI  - Relative and combined roles of ethanol and protein malnutrition on muscle zinc,
      potassium, copper, iron, and magnesium.
AB  - The aim of the present study is to analyse the relative and combined effects of
      ethanol and protein malnutrition on muscle zinc, copper, iron, potassium, and
      magnesium in ethanol-fed rats. The study was performed in 32 animals divided into
      four groups, fed with the Lieber-DeCarli control, 36% ethanol, 2% protein, and
      36% ethanol 2% protein containing diets, respectively. Right gastrocnemius muscle
      was removed 2 months later, and was studied both chemically and histochemical
      morphometrically. Both muscle zinc and potassium, but not copper nor iron nor
      magnesium, were significantly decreased in the protein-deprived, ethanol-fed
      animals, the main effect of these variations being attributable to ethanol rather
      than to protein deprivation. However, coexisting protein deprivation aggravated
      the decrease in both muscle zinc and potassium. Both muscle zinc and potassium
      were significantly related to serum albumin, weight loss, and type IIb fibre
      atrophy; and muscle zinc, in addition, to the decrease in type IIb fibre
      proportion. Therefore, a decrease in muscle content of both elements is related
      to histochemical-morphometrical changes observed in alcoholic myopathy. In
      addition, both ethanol and protein deficiency exerted independent, highly
      significant effects both on type IIb fibre atrophy and proportion.

PMID- 8352843
TI  - Tumour necrosis factor, interleukin-1 and interleukin-6 in alcoholic cirrhosis.
AB  - The existence of a cellular immune deficit in alcoholic cirrhosis, and the
      alterations described in cytokine synthesis in this disease, led us to compare
      serum concentrations of tumour necrosis factor-alpha, interleukin-1 beta and
      interleukin-6 in a group of 33 patients with alcoholic cirrhosis (classified
      according to the Child-Pugh grade of severity of liver disease) and 43 healthy
      volunteers. Serum concentrations of tumour necrosis factor-alpha, interleukin-1
      beta and interleukin-6 were significantly raised in alcoholic cirrhosis patients,
      with no significant differences between patients with liver disease of different
      grades of severity. The results suggest that cirrhosis involves the activation of
      the monocyte-macrophage system, which may contribute to the progression of the
      disease and its clinical manifestations.

PMID- 8352844
TI  - Litonit: evaluation of clinical effectiveness.
AB  - Clinical data are presented on a new anti-alcoholic drug, litonit. A substantial
      reduction in the pathological addiction to alcohol takes place under the effect
      of litonit, and a stable aversive reaction to alcohol develops. The new drug is
      distinguished by its low toxicity, good tolerance, and its failure to cause
      disorders of the liver and kidneys even after chronic administration.

PMID- 8352845
TI  - A feature of alcoholic Wernicke's encephalopathy favourable to the maintenance of
      memory function: vomiting.
AB  - Outcome in terms of progression of Korsakoff's psychosis is known to be unlikely
      when the preceding thiamin deficiency syndrome, Wernicke's encephalopathy, does
      not follow heavy alcohol use. There is evidence that alcohol potentiates thiamin
      related brain damage. It is argued here that in heavy drinkers, if vomiting
      precedes the onset of the encephalopathy, then the latter might develop at a time
      when tissue alcohol levels are close to zero. Any progression to Korsakoff's
      psychosis could then be associated with less or even no impairment. This outcome
      would not be expected if ingestion of alcohol continued during the vomiting
      stage. In a follow-up study of 61 cases of alcoholic Wernicke's encephalopathy,
      these concepts are given some support by the results obtained.

PMID- 8352846
TI  - Severity of alcohol dependence; rating by patient records.
AB  - A method to assess the severity of alcohol dependence by rating patient records
      was developed using the items of the 'alcohol abuse' subscale of the Swedish
      version of the Alcohol Use Inventory (AVI). The records of 37 alcoholics were
      rated and the scores were compared with the patients' self-report scores of the
      AVI and clinical assessments based on the structured clinical interview for DSM
      III-R (SCID). The inter-rater reliability was rs = 0.88. The correlations between
      the record ratings and the alcoholics' self-ratings were rs = 0.77 for both
      raters and 0.55-0.57 between the record ratings and the total SCID-scores. The
      correlations between the self-ratings and SCID-scores were rs = 0.90. It is
      suggested that this method may facilitate record-based follow-up studies of
      alcoholics.

PMID- 8352847
TI  - End of life care in Duchenne muscular dystrophy.
AB  - End of life care for patients with Duchenne muscular dystrophy (DMD) has become
      increasingly complex because of new technologies, changes in medical personnel
      over periods of time, emergence of home health care systems, and increasing
      patient and family autonomy in decision-making. In this review, we discuss the
      medical problems, particularly respiratory and cardiac failure, faced by DMD
      patients. Current concepts concerning the evaluation and options for treatment of
      these problems are presented as well as the ethical issues involved in the care
      of the DMD patient. These issues include the medical indications for treatment,
      patient preferences, quality-of-life issues, and contextual features related to
      legal, institutional, religious, geographic, cultural, social, and financial
      factors. We also present our experience at Loma Linda University Medical Center
      over the past 10 years in the development of a home mechanical ventilation
      program for DMD patients and an algorithm for the evaluation of these patients.
      Many patients with DMD do well on long-term ventilation, but some find that their
      quality of life is less than desirable and choose to discontinue this method of
      life-prolongation. Many of these new options are very expensive, making the
      decision to use them a difficult one. Ultimately, these are societal issues that
      require clear reflection on matters of resource allocation that should be
      performed by health care professionals, citizens, and health planners.

PMID- 8352848
TI  - Influence of gestational age, birth weight, and asphyxia on neonatal
      neurobehavioral performance.
AB  - The objectives of this study were to determine the influence of birth weight,
      gestational age, and asphyxia on neurobehavioral performance at 40 weeks
      conceptional age, and to demonstrate that this performance may differ in preterm
      high-risk infants when using low-risk preterm rather than healthy term infant
      norms. A cross-sectional comparative design was used to compare neurologic
      behavior in healthy and high-risk newborns at 40 weeks conceptional age using the
      Einstein Neonatal Neurobehavioral Assessment Scale. Seventy-four high-risk
      newborns were selected from a consecutive sample of asphyxiated, very-low-birth
      weight, and small-for-gestational-age neonates. Controls did not fulfill any of
      the high-risk criteria and had no pre- or perinatal complications. There were 37
      healthy term and 17 low-risk preterm controls. Statistically significant
      differences occurred between high-risk newborns and term controls for the total
      score (P < .001) as well as for most individual items (P < .05). Analysis of high
      risk subgroups revealed that small-for-gestational-age and term asphyxiated
      newborns had the most abnormal responses. When comparing test performance between
      preterm high-risk and term controls, the majority of test items achieved
      significance (P < .05); however, when compared to low-risk preterm controls,
      fewer items were abnormal, and the probability level on abnormal items was less
      significant than expected. This disparity in interpretation of neurobehavioral
      status in preterm high-risk neonates using a preterm versus term reference sample
      warrants further investigation. Appropriate normative standards for preterm
      infants require definition because it may increase the utility of the neonatal
      neurologic examination and its prognostic value.

PMID- 8352849
TI  - Prospective study of spinal muscular atrophy before age 6 years. DCN/SMA Group.
AB  - Spinal muscular atrophy (SMA) is a common neuromuscular disorder of childhood,
      associated with a high mortality rate during the first 2 years of life. Most
      practitioners expect patients with SMA to follow a progressive course with loss
      of muscle strength and function over 2-10 years. Counselling sessions with
      parents frequently emphasize the high mortality rate and risk for respiratory
      failure. The progressive nature of SMA has been attributed to the loss of motor
      neurons. Fifty-eight children, ages 6 years and younger, were examined between
      January, 1987, and April, 1992, as part of a large, multicenter collaborative
      study of SMA. Muscle function was evaluated at regular intervals using a
      standardized protocol that was demonstrated to be reliable. We determined a
      prevalence of 56% for tongue fasciculations, a prevalence of 22% for facial
      weakness, and persistent deep tendon reflexes in one patient. Improved motor
      function and acquired milestones during the study were documented. This work
      should contribute toward a better understanding of the natural history of SMA.

PMID- 8352850
TI  - MRI assessment of myelination patterns in high-risk infants.
AB  - Magnetic resonance imaging (MRI) was used in high-risk infants to assess the
      myelination process and its relationship with neurologic outcome. The time period
      when delayed myelination is best detected by MRI was also studied. MRI was
      performed in 39 high-risk infants (i.e., preterm infants, infants with
      respiratory distress syndrome, or with neonatal convulsions and asphyxia). In 10
      of 11 infants with normal development, MRI revealed a normal myelination pattern
      before 2 months of age, and in 11 of 13 infants after 2 months of age.
      Conversely, in infants with poor outcomes, MRI demonstrated delayed myelination
      patterns in only 1 of 4 infants before 2 months of age but in 9 of 11 infants
      after 2 months of age. In patients with poor outcomes, delayed myelination was
      found more frequently after rather than before 2 months of age. These findings
      demonstrate that delayed myelination detected by MRI is useful in predicting the
      neurologic outcome of high-risk infants, especially after 2 months of age.

PMID- 8352851
TI  - Congenital adrenal hyperplasia and cerebral lateralizations.
AB  - Handedness, immunologic disorders, language lateralization, reading fluency, and
      visual-motor achievements were assessed in 25 patients with congenital adrenal
      hyperplasia and age-matched right- and left-handed normal controls. An increased
      rate of left-handedness in the congenital adrenal hyperplasia group was evident.
      The prevalence of immunologic disorders, dichotic listening patterns, and visual
      motor/reading achievement ratio were more similar to left-handed and
      significantly different from right-handed controls. Females appeared to be more
      affected than males in some of the functions. These results partly support the
      hypothesis of intrauterine androgenic effects on hemispheric function, but not to
      the extent of a complete lateralization shift.

PMID- 8352852
TI  - Abnormal cortical excitability in Rett syndrome.
AB  - Visual and somatosensory evoked potentials (VEPs and SEPs) were studied in 9
      patients with Rett syndrome and compared with those in 6 patients with
      photosensitive progressive myoclonus epilepsy (PPME). In Rett syndrome, a giant
      III-IV amplitude of VEPs was present in 8 patients, although none exhibited giant
      II-III amplitudes. Four of 6 patients with Rett syndrome who demonstrated giant
      SEPs did not have a C reflex. Conversely, the patients with PPME demonstrated
      giant II-III and III-IV amplitudes in VEPs, and giant SEPs with concurrent
      positive C reflexes. It is concluded that the mechanism of altered cortical
      excitability in Rett syndrome is different from that in PPME.

PMID- 8352853
TI  - Asymptomatic Becker muscular dystrophy: expression of dystrophin and dystrophin
      related protein.
AB  - The expression of dystrophin and a dystrophin-related protein in muscle from 3
      asymptomatic Becker muscular dystrophy patients is reported. Histology
      demonstrated moderate variation in fiber size with clustered basophilic
      regenerating fibers. Immunostaining for dystrophin revealed a patchy appearance
      on most fibers, but never on clustered regenerating fibers. Those regenerating
      fibers did, however, have positive immunoreactivity to a dystrophin-related
      protein. It is speculated that overexpression of the dystrophin-related protein
      in regenerating muscle fibers may contribute to the slow progression of muscle
      weakness or atrophy.

PMID- 8352854
TI  - Late fetal pontine destruction.
AB  - A child with an absent pons is described who died 8 weeks after birth. At
      postmortem examination, the defect was consistent with a vascular event in the
      last trimester.

PMID- 8352855
TI  - Pyruvate dehydrogenase deficiency: clinical and biochemical diagnosis.
AB  - A female neonate with pyruvate dehydrogenase (PDH) deficiency is presented with
      clinical, radiologic, biochemical, neuropathologic, and molecular genetic data.
      She was dysmorphic, with a high forehead, lowset ears, thin upper lip, upturned
      nose, and rhizomelic limbs. Cranial MRI revealed severe cortical atrophy,
      ventricular dilatation, and corpus callosum agenesis. Pyruvate and lactate levels
      were increased in CSF and blood. Urinary organic acid profile was compatible with
      PDH deficiency. PDH activity was normal in fibroblasts, lymphocytes, and muscle.
      The PDH E1-alpha gene was sequenced and a single base mutation was found within
      the regulatory phosphorylation site in exon 10. It is postulated that this
      mutation causes a cerebral form of PDH deficiency. Tissue-specific expression of
      the disease could be explained by differential X chromosome inactivation because
      the PDH E1-alpha gene is located on this chromosome. Dysmorphism with severe
      cerebral malformations in female patients merits a metabolic evaluation,
      including determination of lactate and pyruvate levels in CSF.

PMID- 8352856
TI  - Dermoid of cavernous sinus resulting in isolated oculomotor nerve palsy.
AB  - Intracranial dermoid cysts and acquired oculomotor nerve palsies are individually
      rare in childhood. This report describes a 4-year-old boy with acute oculomotor
      nerve palsy and pupillary sparing secondary to a dermoid within the lateral wall
      of the cavernous sinus. The clinical signs resolved after complete surgical
      excision of the tumor with no evidence of recurrence on computed tomography 1
      year later. This is the first case report in childhood of a dermoid within the
      cavernous sinus and of an isolated oculomotor nerve palsy due to a dermoid cyst.

PMID- 8352857
TI  - Cerebral edema in acute hepatic failure: clinicopathologic correlation.
AB  - A child developed acute fulminant viral hepatitis and cerebral edema confirmed on
      postmortem examination. Clinical evidence of herniation, effacement of cortical
      sulci on computed tomography, and elevated cerebrospinal fluid pressure preceded
      complicating terminal events, demonstrated that cerebral edema was associated
      with acute hepatic failure, rather than complicating factors, and led to the
      patient's death. The mechanism is unknown.

PMID- 8352858
TI  - Cerebral malformations in Carpenter syndrome.
AB  - The inherited forms of craniosynostosis can be divided into 4 groups: isolated
      craniosynostosis, craniosynostosis with syndactyly, craniosynostosis with
      polydactyly and syndactyly, and craniosynostosis with other somatic
      abnormalities. Acrocephalopolysyndactyly or Carpenter syndrome consists of
      craniosynostosis, short fingers, soft tissue syndactyly, preaxial polydactyly,
      congenital heart disease, hypogenitalism, obesity, and umbilical hernia. As many
      as three-fourths of the patients have some degree of intellectual impairment. The
      etiology of mental retardation in this syndrome has not been explored. A patient
      is reported with the features of Carpenter syndrome who has profound
      developmental delay and cerebral malformations demonstrated by magnetic resonance
      imaging and computed tomography. Because mental retardation is not an invariable
      feature of this syndrome or other craniosynostosis syndromes, neuroradiologic
      examination may help in predicting the intellectual outcome in these patients.

PMID- 8352859
TI  - MRI in neonatal dural sinus thrombosis.
AB  - Dural sinus thrombosis in the newborn period is a rare but underrecognized
      condition which may cause seizures, macrocephaly, lethargy, and respiratory
      depression. A 10-day-old term infant with no pre- or perinatal risk factors for
      thrombosis presented with seizures and was found to have dural sinus thrombosis
      on computed tomography and magnetic resonance imaging (MRI). One week later, MRI
      revealed partial resolution and 3 weeks later disclosed a complete resolution of
      the thrombosis. Clinicians should consider the diagnosis of neonatal dural sinus
      thrombosis in infants presenting with seizures and/or increased intracranial
      pressure even in the absence of risk factors or when the cranial computed
      tomography is normal. MRI is the most sensitive diagnostic tool to establish the
      diagnosis and permit a noninvasive follow-up, contributing to our understanding
      of the natural history, associated pathology, and prognosis of this condition.

PMID- 8352860
TI  - Myopathy with abnormal distribution of dystrophin, growth retardation, mental
      retardation, and hypospadia.
AB  - A 9-year-old boy with severe growth retardation, mild mental retardation, and
      hypospadia had a high serum CK level without muscle weakness and atrophy. Muscle
      biopsy revealed a moderate variation in fiber size with a few necrotic and
      scattered regenerating fibers. Although muscle membranes were clearly stained by
      immunostaining with antibody to dystrophin, N-terminal region (2-5E2), fibers in
      groups revealed striking, intense staining with the other antibody, C-terminal
      region (4C5), suggesting some aberration of the dystrophin gene near the C
      terminal area. His unique clinical features, as well as myopathy, are reported,
      although further study is necessary to clarify the relationship between the
      anomalous conditions and dystrophin abnormalities.

PMID- 8352861
TI  - Mevalonic aciduria in 3 siblings: a new recognizable metabolic encephalopathy.
AB  - Mevalonic aciduria, due to mevalonate kinase deficiency, is the first recognized
      defect in the biosynthesis of cholesterol and isoprenoids. Very few patients with
      this disorder have been reported. Three siblings born from consanguineous parents
      are reported. Several clinical signs were present in all 3 children, including
      failure-to-thrive, susceptibility to infections, hepatosplenomegaly, cataract,
      and psychomotor retardation. Dysmorphic features were more apparent in the two
      older siblings. Urinary organic acid analysis by gas chromatography/mass
      spectrometry invariably revealed a high urinary excretion rate of mevalonic acid.
      Mevalonate kinase activity assayed in fibroblasts was very low. Diagnosis of this
      very rare disease may be suspected simply on clinical evidence; it is confirmed
      by abnormal excretion of mevalonic acid.

PMID- 8352862
TI  - Autosomal recessive cerebellar hypoplasia.

PMID- 8352863
TI  - The health of the Inuit of North America. A bibliography from the earliest times
      through 1990.

PMID- 8352864
TI  - Tensions within the academic health center.
AB  - A variety of forces are converging to unbalance the internal environment of the
      academic health center, and the dean of the medical school sits uneasily in the
      resulting vortex of conflicting needs and demands. For example, the introduction
      of Medicare in 1965 profoundly changed the size and complexity of medical school
      departments and greatly stimulated the growth of hospitals. More stresses have
      come from rising health care expectations of the public; the replacement of free
      for-service indemnity health care by managed care and vertically integrated
      health care systems; the proliferation of academic specialties and
      subspecialties; and the recent growth in the academic medical center, which is
      seen as a threat to the academic integrity of the university. Within the medical
      school there are tensions between basic and clinical research, between education
      and research, between education and clinical practice, and between the dean and
      department chairs over allocation of resources. Perhaps the most complex tensions
      exist between the medical school dean and the academic hospital director. The
      overarching tension in the academic health center results from striving to
      balance the need to fulfill academic goals with the need to fill hospital beds to
      maintain financial solvency. This tension will not lessen so long as there is no
      common vision for the academic health center as a whole, and will probably
      increase with the forthcoming changes in health care reform. The dean and the
      hospital director must forge a strong alliance, and the hospital must realize
      that for its continuing success, it must support the academic program.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8352865
TI  - Three views on faculty tenure in medical schools.
AB  - Three distinguished academicians share their thoughts on tenure and its future in
      academic medicine. Paul J. Friedman, from the University of California, San
      Diego, School of Medicine, explains and defends tenure as practiced in medical
      schools. He examines the question of giving tenure to clinical faculty, explains
      posttenure academic review, reports that the impending end of mandatory
      retirement will not have a significant effect on faculty turnover, and suggests
      that medical schools make the status of emeritus faculty more attractive. Next,
      Gail H. Cassell, from the University of Alabama School of Medicine, examines
      various beliefs about tenure and tenured faculty in the light of available
      studies, and concludes that many of the negative "myths" about the effect of
      tenure (e.g., promoting mediocrity and discouraging productivity) are not borne
      out by research findings. While she supports tenure, she maintains that better
      criteria are needed for awarding it; that the evaluation of faculty members'
      teaching needs much improvement; and that more research on tenure is needed.
      Finally, Richard A. Cooper, from the Medical College of Wisconsin, states that
      tenure should not continue, because the purposes of tenure (e.g., ensuring
      freedom of expression; providing long-term financial security and stability)
      should be and can be accomplished in other ways for all faculty, not just tenured
      faculty. A different system is needed, one that respects the value of all
      faculty, that responds to their diverse objectives, is fiscally responsible, and
      fosters the continuing culture and vitality of medical schools.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8352866
TI  - Community partnerships: educational linkages to increase the number of primary
      care practitioners.
AB  - The Community Partnerships initiative is focused on the creation of academic, non
      hospital community health centers shaped by people and institutions at the local
      level. In our view, public policy-makers need such positive ideas and programs to
      support--things to be for rather than against. Incessant lamenting about the
      problems of the health care system will change the system less than will positive
      programs shaped and supported by the people whose needs they serve. All of us in
      medical education recognize the need for change in medical education. The
      Community Partnerships program represents one strategy for change that brings
      communities directly into the sphere of influence and enables them to enhance the
      relevance of the educational experience for health professions students.

PMID- 8352867
TI  - A national consensus on the essential international-health curriculum for medical
      schools. International Health Medical Education Consortium.

PMID- 8352868
TI  - Biomedical research training must remain a priority.

PMID- 8352869
TI  - Omitting the obvious.

PMID- 8352870
TI  - How one school obtained the benefits of problem-based learning without
      revolution.

PMID- 8352871
TI  - Providing clinical experience to first-year students.

PMID- 8352872
TI  - Take students' course evaluations with a grain of salt!

PMID- 8352873
TI  - Residents' desire for more clinical ethics education.

PMID- 8352874
TI  - Performances on the NBME I, II, and III by medical students in the problem-based
      learning and conventional tracks at the University of New Mexico.
AB  - BACKGROUND: Problem-based learning curricula are growing in popularity, and
      questions have been raised about the appropriateness of standardized
      examinations, such as the National Board of Medical Examiners (NBME) Parts I, II,
      and III examinations, for assessing students in these new curricula. METHOD: Data
      on students' performances on the NBME I were analyzed for 508 graduates of the
      conventional track and 167 graduates of the problem-based Primary Care Curriculum
      (PCC) track at the University of New Mexico School of Medicine from the classes
      of 1983-1992; on NBME II, for 447 and 144 graduates, respectively (classes of
      1983-1991); and on NBME III, for 313 and 100 graduates, respectively (classes of
      1983-1989). The analyses also included data on the students' total Medical
      College Admission Test (MCAT) scores, undergraduate science grade-point averages
      (SGPAs), and admission subgroups within tracks. The statistical methods included
      analysis of covariance, Student's t-test, and the Fisher exact test. RESULTS: The
      students who had requested the PCC track but had been randomized into the
      conventional track had the highest mean scores on all the study variables (for 34
      students, 521 on the NBME I, and for 19 students, 551 on the NMBE III). The high
      risk students who had requested but had not been accepted into the PCC track
      seemed to benefit from the highly structured conventional track with regard to
      their NMBE I performances (467 for 18 students). The PCC students--both those who
      had been randomized into the PCC and those who had been selected into the PCC-
      had significantly lower mean scores on the NBME I (455 for 85 students and 463
      for 82 students compared with 505 for the 439 students who chose the conventional
      track), but significantly higher mean scores on the NBME III (521 for 38 students
      and 522 for 62 students compared with 483 for the seven high-risk students and
      487 for the 276 students who chose the conventional track). For both tracks,
      strong relationships were found among the scores on the three NBME examinations.
      For the PCC students, significantly weaker relationships were found between mean
      SGPAs and mean scores on the NBME I, II, and III. For both tracks, MCAT scores,
      especially in the lowest and highest ranges, were most predictive of performances
      on the NBME I and II. CONCLUSION: In the short run, the more teacher-centered and
      structured conventional curriculum better prepared the students for the NBME I,
      while in the long run, the more student-centered problem-based curriculum better
      prepared the students for the NBME III:

PMID- 8352875
TI  - Physicians' knowledge of genetics and genetic tests.
AB  - PURPOSE: To assess primary care physicians' and psychiatrists' knowledge of
      genetics and genetic tests and the factors associated with differences in these
      physicians' knowledge. METHOD: Questionnaires were mailed in 1991 to 1,795
      primary care physicians (family physicians, internists, pediatricians,
      obstetrician-gynecologists) and psychiatrists who had graduated from medical
      school between 1950 and 1985 (67.6% of the sample had graduated after 1970) and
      who were members of professional societies. The questions elicited demographic
      and practice characteristics as well as knowledge of genetics concepts and facts
      and awareness of the availability of genetic tests. To validate the
      questionnaire, 360 medical geneticists and genetic counselors received
      questionnaires. Statistical analysis involved arc-sine function transformation, t
      tests, analyses of variance, F-tests, Tukey's HSD, and stepwise multiple
      regression. RESULTS: A total of 1,140 (64.8%) of the non-geneticist physicians
      responded. They correctly answered an average of 73.9%, SD, 13.9%, of the
      knowledge items, compared with 94.6%, SD, 4.2%, for the genetics professionals (p
      < .001). The most significant predictors of knowledge were recency of graduation
      from medical school and practicing in primary care specialties in which exposure
      to genetics problems is likely. Other significant predictors (from most to least
      important) were graduation from a U.S. medical school, willingness to adopt a new
      predictive test before it becomes standard practice, not using pharmaceutical
      companies as a source of information about new medical practices, and taking a
      required genetics course in medical school. CONCLUSIONS: The results suggest that
      knowledge of genetics and genetic tests is increasing among physicians,
      particularly among more recent graduates and physicians who are exposed to
      genetics problems in their practices, but deficiencies remain. Although a medical
      school course in genetics may improve knowledge, it is not sufficient. Greater
      emphasis is needed at all levels of medical education to reduce the chance of
      physician error as more genetic tests become available.

PMID- 8352876
TI  - Correlations between graduates' performances as first-year residents and their
      performances as medical students.
AB  - PURPOSE: To correlate graduates' performances as first-year residents with their
      performances as medical students, particularly their performances as seniors on a
      clinical skills examination using standardized patients. METHOD: Residency
      directors were asked to rate the first-year performances of the 232 graduates
      from the classes of 1989-1991 of the Brown University School of Medicine. Pearson
      correlation coefficients were calculated for the relationships between these
      ratings and the two scores (for data collection and interpersonal skills) that
      the graduates had received in their senior year on a clinical skills examination
      using standardized patients. Correlations were also calculated between the
      residency ratings and the graduates' preclinical and clinical course grades and
      scores on Parts I and II of the National Board of Medical Examiners (NBME)
      examination. RESULTS: Ratings were returned and complete data were available for
      203 (87.5%) of the graduates. Among all the parameters of medical school
      performance, the data-collection score on the clinical skills examination
      correlated best (.273) with performance as a first-year resident. The
      correlations between the residency ratings and scores on the NBME I and II were
      practically zero. CONCLUSION: This comparatively strong correlation between the
      graduates' data-collection scores and their performance ratings as first-year
      residents suggests that performance-based assessments using standardized patients
      may be at least as good as--perhaps even better than--traditional methods of
      evaluating medical students in predicting their performances as first-year
      residents.

PMID- 8352877
TI  - Students' psychosocial characteristics as predictors of academic performance in
      medical school.
AB  - PURPOSE: To investigate the incremental effects of selected psychosocial measures
      -beyond the effects of conventional admission measures--in predicting students'
      academic performances in medical school. METHODS: In 1989-90, 210 second-year
      students at Jefferson Medical College were each asked to complete 11 psychosocial
      questionnaires that were then used as predictors of performance measures in
      medical school. The students' scores on three subtests of the Medical College
      Admission Test (MCAT) were also used as predictors. Three composite measures of
      performance were used as the criterion measures: basic science examination
      grades, clinical examination grades, and ratings of clinical competence. A
      multiple regression algorithm (general linear model) was used for statistical
      analysis. RESULTS: The response rate was 83% (175 students). When the
      psychosocial measures were added to the statistical models in which the common
      variances of the MCAT scores were already determined, significant increments in
      the common variances were observed for two of the three performance measures:
      basic science grades and clinical examination grades. Whereas only 4% of the
      common variance in the ratings of clinical competence could be accounted for by
      the MCAT scores, 14% could be accounted for by the psychosocial measures.
      CONCLUSION: The "noncognitive," or psychosocial, measures increased the magnitude
      of the relationships between the predictive and criterion measures of the
      students' academic performances, beyond the magnitude attained when only the
      conventional admission measures were used. Therefore, psychosocial measures
      should be considered as significant and unique predictors of performance in
      medical school.

PMID- 8352878
TI  - Senior students' evaluations of the usefulness of the Glaxo Pathway Evaluation
      Program.
AB  - PURPOSE: To examine the influence of the Glaxo Pathway Evaluation Program on
      fourth-year medical students' specialty-choice decisions. METHOD: In February
      1992, 274 seniors at three medical schools were asked to complete a 19-item
      questionnaire regarding their evaluations of the usefulness of the Pathway
      program in helping them to make their specialty-choice decisions. RESULTS: A
      total of 237 seniors responded to the survey (though not all responded to all 19
      items), indicating that they found the program to be moderately useful. More than
      half of the students (107 of 207, 51.7%) reported that they had followed the
      program's decision-making model and found it moderately useful. The students'
      responses indicated that those components intended to facilitate self-assessment
      and provide information about the various specialty options were fairly well
      utilized, i.e., 59.9% of the students had reevaluated the Critical Factors, and
      73.6% had compared their individual profiles with the Specialty Profiles, finding
      both exercises moderately useful. Other follow-up activities had been used
      variably. CONCLUSION: The students evaluated the program as being moderately
      useful. The authors conclude that the program is a useful, comprehensive, and
      reasonably objective tool. Whether students using the program achieve long-term
      commitment to and satisfaction in their chosen specialties remains to be
      determined.

PMID- 8352879
TI  - Internal medicine residents' perceptions of the balance between service and
      education in their night-call activities.
AB  - PURPOSE: To quantify the workload of residents on night call and to determine the
      residents' perceptions of the balance between service and education in their
      night-call activities. METHOD: Twenty-two internal medicine residents--nine first
      year residents and 13 senior residents (i.e., in their second, third, or fourth
      year)--kept logs of their night-call activities for two periods of 16 days each
      in 1991-92, at a 772-bed teaching hospital affiliated with Wright State
      University School of Medicine. The residents used the following five-point scale
      to rate each activity: 1, strictly service; 3, even balance; 5, strictly
      education. They also recorded the total times spent on various activities. Data
      were analyzed by using the independent and paired t-tests. RESULTS: Ninety-eight
      percent of the logs were returned. The first-year and senior residents did not
      differ significantly in times spent on logged events. Both the first-year and the
      senior residents perceived many night-call activities to be weighted toward
      education, especially those involving evaluation of acutely ill patients being
      considered for hospital admission (overall mean rating of 3.3). There was no
      striking difference between the first-year and senior residents' perceptions of
      the balance between service and education in their activities. CONCLUSION: The
      residents' perceptions of the relationship between service and education indicate
      that there was an even balance between the two. The educational aspects of night
      call duties can and should remain an integral part of residents' training.

PMID- 8352880
TI  - Is colony-stimulating factor-1 a key mediator of breast cancer invasion and
      metastasis?

PMID- 8352881
TI  - Novel variants of CD44 arising from alternative splicing: changes in the CD44
      alternative splicing pattern of MCF-7 breast carcinoma cells treated with
      hyaluronidase.
AB  - CD44 is a cell-surface glycoprotein postulated to play a role in a variety of
      biological processes, including lymphocyte homing and tumor-cell metastasis.
      Several isoforms of CD44 have been identified in human cells, and the genesis of
      some of these isoforms has been attributed to alternative splicing. In the study
      presented here we amplified three novel transcript variants of CD44 from human
      cell lines using a reverse transcriptase-polymerase chain reaction strategy. Two
      of the novel isoforms differed from previously described CD44 isoforms as a
      result of alternative splicing that occurred at previously reported splice
      junctions. The third novel CD44 isoform was generated from a previously
      unreported alternative splice junction near the 5' end of the open reading frame.
      Southern blot analysis of genomic DNA revealed that these novel isoforms and all
      of the previously described CD44 isoforms arose from alternative splicing. The
      capability of cells to modify their CD44 alternative splicing pattern was
      demonstrated in MCF-7 cells, which altered their CD44-isoform expression pattern
      in response to treatment with hyaluronidase. A better understanding of mechanisms
      regulating CD44 alternative splicing may provide insights into diverse processes,
      including tumor-cell metastasis and lymphocyte homing.

PMID- 8352882
TI  - Association of protein kinase C activation with induction of ornithine
      decarboxylase in murine but not human keratinocyte cultures.
AB  - The goal of this study was to compare the response of mouse epidermal
      keratinocytes (MEKs) and human epidermal keratinocytes (HEKs) to 12-O
      tetradecanoylphorbol-13-acetate (TPA) with respect to the activation and
      downregulation of protein kinase C (PKC), the expression of c-jun and c-fos, and
      the expression and induction of ornithine decarboxylase (ODC) activity.
      Keratinocytes from adult CD-1 mice and from discarded adult human skin were grown
      in primary culture in a high-calcium serum-free medium that supported
      proliferation and differentiation. Immunoblotting of freshly isolated and
      cultured MEKs and HEKs for isozymes of protein kinase C revealed that fresh HEKs
      contained PKC alpha, PKC beta, and PKC delta; no PKC gamma, PKC epsilon, or PKC
      zeta were detected. In fresh MEKs, PKC alpha, PKC beta, PKC delta, and PKC zeta
      were observed, but not PKC gamma or PKC epsilon. After 2 wk in culture, the
      isozyme profiles of MEKs and HEKs were similar except that PKC gamma was
      noticeably present in HEK cultures. Activation of partially purified total PKC by
      TPA was similar in freshly isolated and cultured MEKs and HEKs, indicating that
      the two species were similar in this regard and that 2 wk of culture did not
      alter this characteristic. When MEK and HEK cultures were treated with TPA for 3
      h, less than 30% of the control level of PKC activity was detected, indicating
      that TPA-induced downregulation of PKC was similar in MEKs and HEKs. After
      treatment with TPA, MEK cultures produced a large induction of both c-jun and c
      fos mRNA by 60 min, as determined by northern blot analysis, and a large
      induction of ODC mRNA and enzyme activity by 6 h. TPA treatment of cultured HEKs,
      however, did not induce ODC activity; in fact, less activity, compared with that
      of control cultures, was observed. Northern blot analysis also revealed no
      increase in c-jun, c-fos, and ODC mRNA in HEKs. However, c-jun and c-fos mRNA and
      both ODC mRNA and enzyme activity were induced in HEKs fed growth factors after
      several days of deprivation. This suggests that the lack of ODC induction by TPA
      in HEKs is probably due to species differences in downstream steps in PKC signal
      transduction.

PMID- 8352883
TI  - Interleukin-1 alpha gene expression and localization of interleukin-1 alpha
      protein during tumor promotion.
AB  - Treatment of the dorsal epidermis of SENCAR mice with 12-O-tetradecanoylphorbol
      13-acetate (TPA) induced a time- and dose-dependent stimulation of interleukin-1
      alpha (IL-1 alpha) gene expression. Levels of IL-1 alpha mRNA were elevated as
      early as 15 min and peaked at 3-4 h after a single application of TPA (2
      micrograms or 10 micrograms). IL-1 alpha gene expression increased in epidermal
      tissue isolated from SENCAR mice at 1, 3, 6, 10, 16, and 22 wk after a single
      treatment with 10 nmol 7,12-dimethylbenz[a]anthracene (DMBA) and subsequent twice
      weekly application of 2 micrograms TPA. IL-1 alpha-immunoreactive protein was
      specifically localized within suprabasal keratinocytes in cutaneous tissue
      isolated from mice treated with DMBA-TPA for 1-22 wk and in nonproliferating
      cells located within papilloma tissue isolated from SENCAR mice at 22 wk after
      initiation and promotion. Basal cells within hyperplastic epidermis did not
      produce IL-1 alpha-immunoreactive protein. DMBA treatment alone did not induce IL
      1 alpha gene expression. Injection of IL-1 alpha-specific antibodies (50
      micrograms) into SENCAR mice via the tail vein 2 h before treatment with TPA (2
      micrograms or 10 micrograms) significantly (P < 0.05) inhibited the skin
      thickening usually observed 24 h after treatment with TPA. Autoradiography
      studies showed that injection of anti-IL-1 alpha antibodies inhibited
      incorporation of [methyl-3H]thymidine by keratinocytes within the epidermis and
      by cells within hair follicles. It also inhibited neutrophil infiltration into
      the dermis, which usually results from topical application of TPA. These data
      suggest that IL-1 alpha is a pivotal cytokine produced by specific subpopulations
      of epidermal keratinocytes and that IL-1 alpha primarily regulates the epidermal
      proliferative response of a distinctly separate population of keratinocytes after
      topical exposure of murine epidermis to TPA and secondarily modulates neutrophil
      migration into the dermis. Consequently, manipulation of IL-1 alpha may be a way
      to attenuate or abrogate the cutaneous response to TPA by altering keratinocyte
      proliferation, the resultant hyperplasia, and a portion of the inflammatory
      response characterized by dermal infiltration of neutrophils.

PMID- 8352884
TI  - Detection of p53 gene mutations in rat hepatocellular carcinoma cell lines by
      denaturing gradient gel electrophoresis.
AB  - Structural alterations of the p53 gene were investigated in chemically induced
      rat hepatocellular carcinomas (HCCs), hyperplastic hepatic nodules (HPNs), and
      cell lines derived from rat neoplastic and normal liver cells. The mutations were
      detected by GC-clamped denaturing gradient gel electrophoresis using DNA that had
      been amplified from p53 mRNA by the reverse transcriptase-polymerase chain
      reaction. This method enabled us to find single-base changes within the p53 gene
      without using radioisotopes. The presence of mutations was subsequently confirmed
      by DNA sequencing. No mutations were detected in six primary HCCs and 12 HPNs
      induced by the Solt and Farber regimen (Nature 236: 701-703, 1976), suggesting
      that p53 gene mutations do not play a major role in rat hepatic carcinogenesis.
      However, five of seven HCC cell lines and one of two cell lines derived from
      normal liver cells had the mutated p53 gene and had lost the normal p53 gene.
      Five cell lines had a G-->T transversion at various codons, whereas one line had
      a 21-base deletion in exon 5. Therefore, we conclude that p53 gene mutations may
      occur in vitro during establishment of the cell lines or may be derived from very
      small populations within the primary tumors.

PMID- 8352885
TI  - High variability of nitrosamine metabolism among individuals: role of cytochromes
      P450 2A6 and 2E1 in the dealkylation of N-nitrosodimethylamine and N
      nitrosodiethylamine in mice and humans.
AB  - We undertook this study to answer several questions regarding nitrosamine
      metabolism. Kinetics of nitrosamine metabolism showed the involvement of at least
      two enzymes in the dealkylation of N-nitrosodiethylamine (NDEA) and N
      nitrosodimethylamine (NDMA) in mouse liver microsomes. Coumarin inhibited both
      reactions competitively. On the other hand, microsomal coumarin 7-hydroxylase was
      inhibited by NDMA (Ki 2.7 mM) and NDEA (Ki 0.013 mM). The big difference in the
      Ki values suggests a higher affinity of NDEA than NDMA to Cyp2a-5 (mouse
      cytochrome P450coh). A specific antibody against Cyp2a-5 inhibited more of the
      microsomal NDEA (up to 90%) than NDMA (up to 40%) dealkylation. The converse was
      true with anti-Cyp2e-1 antibody. These results suggest that the primary substrate
      for Cyp2a-5 is NDEA and for Cyp2e-1, NDMA. Western blot analysis of human liver
      microsomes showed a great interindividual variation in the amounts of CYP2A6
      (human cytochrome P450coh) and CYP2E1. Also, coumarin 7-hydroxylation and
      nitrosamine dealkylation varied greatly among individuals. A high correlation (r
      = 0.93, P < 0.001) was found between NDEA and coumarin metabolism. Both
      activities were associated with CYP2A6. On the other hand, little or no
      correlation was found between microsomal CYP2A6 and CYP2E1 or between CYP2E1 and
      NDEA dealkylation. Immunoinhibition of human microsomal NDEA metabolism by CYP2a
      5 antibody varied greatly among individuals (10-90%), suggesting, as in the case
      of mice, that NDEA is metabolized primarily by CYP2A6, at least in some
      individuals. Taken together the data suggest that (1) the metabolic activation of
      nitrosamines in humans varies greatly among individuals; (2) different
      nitrosamines may partially be metabolized by different cytochrome P450 isozymes;
      and (3) because of similarities between nitrosamine metabolism in mice and
      humans, inbred strains of mice would be relevant experimental models for studying
      nitrosamine activation.

PMID- 8352886
TI  - High expression of cytochrome P450 2a-5 (coumarin 7-hydroxylase) in mouse
      hepatomas.
AB  - A high level of Cyp2a-5 was found in spontaneous and transplanted mouse hepatomas
      compared with normal liver. Increased expression of Cyp2a-5 was associated with
      an increase in coumarin 7-hydroxylation, a marker activity of Cyp2a-5, and the
      corresponding mRNA, suggesting that regulation of Cyp2a-5 in hepatomas is
      pretranslational. In contrast, the total P450 content and arylhydrocarbon
      hydroxylase and amidopyrene demethylase activities decreased. Pyrazole, a strong
      inducer of Cyp2a-5 in normal mouse livers, also increases this isozyme in
      hepatomas. A parallel increase in the corresponding mRNA suggests that pyrazole,
      like the formation of hepatomas, affects the regulation of Cyp2a-5
      pretranslationally.

PMID- 8352887
TI  - Activation of immediate-early gene expression by peroxisome proliferators in
      vitro.
AB  - The hepatocarcinogenicity of peroxisome proliferators (PPs) in rodents has been
      attributed both to oxidative DNA damage resulting from excessive leakage of
      peroxisomal H2O2 and to increased hepatocellular replication that may be
      independent of peroxisome proliferation. Because of the growing association
      between tumor promotion and alterations in growth-regulatory signal transduction
      pathways, we investigated whether PPs can modulate these pathways in a mouse
      liver epithelial cell line, BNL-CL.2. We tested two PPs that differ markedly in
      rodent tumorigenicity for their ability to activate immediate-early proto
      oncogene expression. 4-Chloro-6-(2,3-xylidino)-2-pyrimidinylthioacetic acid (Wy
      14643), a highly tumorigenic PP, was an exceptionally strong inducer of c-fos
      expression. Wy-14643 was also stronger than DEHP in stimulating c-jun expression,
      whereas both PPs were fairly strong inducers of jun-B and jun-D. The induction of
      fos and jun expression by Wy-14643 was specifically inhibited by the protein
      kinase C inhibitor 1-(5-isoquinolinesulfonyl)-2-methylpiperizine dihydrochloride
      (H-7). DEHP-induced gene expression was strongly inhibited by H-7, but was also
      partially inhibited by an inhibitor of protein kinase A. The activation of fos
      and jun gene expression by PPs was independent of peroxisome proliferation since
      it was an immediately-early response not requiring protein synthesis and since
      the cell lines used in this study do not undergo peroxisome proliferation. Our r
      results raise the possibility that the carcinogenicity of PPs may be due, in
      part, to epigenetic modulation of growth-regulatory signal transduction pathways.

PMID- 8352888
TI  - Timing of replication of differentially transcribed genes in Syrian hamster
      embryo fibroblasts.
AB  - Syrian hamster embryo cell lines have been used as models of neoplastic
      progression in vitro. Changes in phenotype and biological properties have been
      observed in these cell lines in association with modulation of gene
      transcription. We explored this natural evolution of cells in culture to
      investigate the reported relationship between transcriptional activity and
      replication in early S phase. In this study we used two nontumorigenic cell lines
      that had either retained (supB+) or lost (supB-) the ability to suppress
      tumorigenicity of malignantly transformed hamster fibroblasts (BP6T). In
      association with the loss of suppressor gene function, supB- cells have
      downregulated the expression of the H19 and tropomyosin-I (TM-I) genes, which are
      actively transcribed in supB+ cells. Synchronous populations of supB+ and supB-
      cells were pulse-labeled with [3H]thymidine and bromodeoxyuridine at 1-h
      intervals during S phase; the replicating DNA was isolated by centrifugation in
      cesium chloride gradients and hybridized to 32P-labeled gene probes. No
      correlation was found between the timing of gene replication and the status of
      expression of these two genes. TM-I replicated during the first hour and H19
      replicated between the second and third hours of the S phase in the expressing
      and nonexpressing cell lines. Immunoglobulin gene sequences, known to be late
      replicating in fibroblasts, replicated at the end of the S phase. These results
      suggest that downregulation of transcription is not always accompanied by a
      concomitant change in time of gene replication from early to late S phase.

PMID- 8352889
TI  - Heritable colorectal cancer and cancer genes: systemic expressions.
AB  - Epidemiological studies of heritable cancer have demonstrated that cancer
      predisposition is a dominant trait; these studies have also predicted the
      recessive outcome of the neoplastic process. Biochemical studies of dominantly
      heritable cancer have demonstrated the relevance of systemic effects. The
      systemic effects are presumably due to a dominant mutation at the "initiator
      locus." Collectively they define cancer initiation at the cellular level (as
      described in this review). Molecular biological studies have demonstrated that
      cancer progression and the appearance of clinical cancer occur through an
      accumulation of recessive mutations at critical loci. We must continue to try to
      define not only the inherited and acquired gene defects that initiate the
      neoplastic state but also the subsequent genetic alterations and biomarkers
      involved in tumor progression. These genetic defects are already proving useful
      in diagnosis and prognostication. The hope is that these biomarkers may be useful
      for designing specific differentiation therapy.

PMID- 8352890
TI  - Rare frequency of activation of the Ki-ras gene in rat colon tumors induced by
      heterocyclic amines: possible alternative mechanisms of human colon
      carcinogenesis.
AB  - Heterocyclic amines present in cooked foods are known to produce colon tumors in
      F344 rats at a high incidence, indicating the possibility of involvement of ras
      gene activation in colon carcinogenesis in rats as in humans. We examined
      mutations at codons 12, 13, and 61 of the Ki-ras, Ha-ras, and N-ras genes by
      polymerase chain reaction--direct sequencing in seven colon tumors in F344 rats
      induced by 2-amino-6-methyldipyrido-[1,2-a:3',2'-d]imidazole (Glu-P-1), 11
      induced by 2-amino-3-methylimidazo[4,5-f]quinoline, and nine induced by 2-amino-1
      methyl-6-phenylimidazo[4,5-b]pyridine. A Ki-ras gene mutation (G-->T at the
      second position in codon 12) was found in one Glu-P-1-induced colon
      adenocarcinoma. None of the other 26 tumors had mutations in any of these three
      ras family genes. These results indicate that in rats, colon carcinogenesis
      induced by heterocyclic amines may be induced by alterations of other oncogenes
      or tumor suppressor genes. We think this experimental system using carcinogens to
      which humans are exposed is a good model for studying alterations of other genes
      in human colon tumors in which no Ki-ras alterations are observed.

PMID- 8352891
TI  - No point mutation of Ha-ras or p53 genes expressed in preneoplastic-to-neoplastic
      progression as modeled in mouse JB6 cell variants.
AB  - Alterations of the p53 gene have been found in many human and animal tumors, and
      ras mutations have been seen somewhat less frequently. Loss of p53 tumor
      suppressor activity has been implicated in multistage tumor promotion/progression
      after initiation by Ha-ras or Ki-ras activation. Whether p53 or ras alterations
      occur during promotion of neoplastic transformation in JB6 cells has not been
      reported. Using a series of mouse JB6 variants representing different stages of
      progression toward the tumor-cell phenotype, we investigated whether mutational
      activation of Ha-ras and mutational inactivation and altered expression of the
      p53 gene occurred during progression. We report here that neither point mutations
      of the Ha-ras or p53 genes nor p53 structural alterations were involved in this
      process. Although there was no significant difference in steady-state levels of
      p53 mRNA, an elevated level of immunoprecipitable p53 protein was observed in a
      subset of transformed cells. We also report the detection of a second 2.2-kb p53
      hybridizing transcript. This transcript was not translated into p53 protein and
      may be a nuclear precursor of the mature message. Both p53-hybridizing
      transcripts were downregulated by prolonged 12-O-tetradecanoylphorbol-13-acetate
      (TPA) treatment (24 h) regardless of the stage of progression. We conclude from
      this study that in JB6 variants (1) mutational activation of Ha-ras and
      inactivation of p53 are unlikely to be involved in preneoplastic progression; (2)
      increased amounts of p53 protein may be involved in a subset of transformed
      cells, possibly reflecting a longer half-life, as demonstrated in other systems;
      and (3) late downregulation of p53 mRNA but not protein expression may be a
      secondary response in the TPA-mediated signal transduction pathway.

PMID- 8352892
TI  - Protein synthesis-dependent cytoplasmic translocation of p53 protein after serum
      stimulation of growth-arrested MCF-7 cells.
AB  - p53 protein was localized in the cytoplasm of growing and in the nucleus of
      growth-arrested MCF-7 cells. While the absolute amount and rate of synthesis of
      p53 in growing and arrested cells were nearly the same, the protein in growing
      cells was phosphorylated to a greater extent than in arrested cells. The
      abilities of the cytoplasmic and nuclear p53 proteins to bind to DNA sequences
      specific for p53 protein binding did not differ remarkably despite their
      differential phosphorylation levels. Serum-induced translocation of the p53
      protein from the nucleus to the cytoplasm, as well as DNA and protein synthesis,
      were inhibited by cycloheximide. These results suggest that the DNA synthesis
      associated cytoplasmic translocation of p53 protein in response to serum
      stimulation depends on de novo protein synthesis and not on alteration of the
      protein's ability to bind to specific DNA sequences.

PMID- 8352894
TI  - [Review of the original texts on wujia (Cortex Acanthopanacis)].

PMID- 8352893
TI  - Nucleotide sequence analysis of c-raf-1 cDNA and promoter from a radiation
      resistant human squamous carcinoma cell line: deletion within exon 17.
AB  - The c-raf-1 proto-oncogene is the cellular homologue of v-raf, the oncogene of
      the acutely transforming retrovirus 3611-MSV. The product of c-raf-1 (raf-1) is a
      74-kDa cytoplasmic serine/threonine protein kinase. We previously reported that
      antisense human c-raf-1 cDNA transfection results in reduction of the endogenous
      c-raf-1 transcript, decreased tumor growth rate, and enhanced radiation
      sensitivity of SQ-20B tumor cells established from a radiation-resistant
      laryngeal squamous cell carcinoma. In the study reported here, we used cDNA
      linked polymerase chain reaction amplification and nucleotide sequencing to
      examine the structure of the 3233-bp SQ-20B c-raf-1 cDNA. The 812-bp c-raf-1
      promoter region was analyzed by genomic DNA amplification followed by cloning and
      sequencing. Sequence comparison with a previously published c-raf-1 sequence
      indicated no structural changes within the coding region of SQ-20B c-raf-1.
      However, a 4-bp deletion was observed in the 3' untranslated region within exon
      17. This deletion was also present in a c-raf-1 cDNA clone isolated from a SQ-20B
      cDNA library. While the possibility of a 3' transcriptional control mechanism
      cannot be ruled out, it appears that the raf-1 protein kinase may regulate the
      development of radioresistant malignancies via interaction with other molecules
      in the damage and repair-related signal transduction pathways.

PMID- 8352895
TI  - [Preliminary studies on medicinal plants of Corydalis in Sichuan].
AB  - This paper reports the species, distribution and medical uses of Corydalis in
      Sichuan Province, of which 3 species e.g., Corydalis linstowiana and C.
      moupinensis, are found in China for the first time, 5 species C. balansae, C.
      trifoliolata e. g. are found in Sichuan for the first time. Medica effects of 10
      species are described.

PMID- 8352896
TI  - [Identification of 7 snake-drugs by protein viscosity].

PMID- 8352897
TI  - [Effect of reproductive materials on the yield of Pinellia ternata (Thunb.)
      Breit].

PMID- 8352898
TI  - [Effect of different preparations of ginger on blood coagulation time in mice].
AB  - The experiments indicate that the decoction, ether extraction and suspension
      liquid of roasted ginger and charcoal of ginger all can markedly shorten the
      blood coagulation time in mice, while the decoction, ether extraction of fresh
      ginger and dry ginger cannot. The decoction of ginger charcoal has stronger
      effect than roasted ginger in shortening the blood coagulation time in mice. The
      effect of decoction of ginger charcoal on blood coagulation time tends to
      increase when the dosage is increased.

PMID- 8352899
TI  - [Influence of processing methods on the solubility of calcium from the Mongolian
      medicine zhuangxi].
AB  - In search of scientific basis for rationalizing the processing method of the
      Mongolian medicine Zhuangxi comparative tests were effected on the contents of
      calcium in crude and processed calcium and gypsum rubrum, and on the solubility
      of calcium in 0.1 mol/L HC1 from the two minerals.

PMID- 8352900
TI  - [Studies on longevity tea].
AB  - This paper reports the preparation, physical and chemical identification and
      content determination of Longevity Tea. The preparation process is advanced, the
      content determination is simple and accurate and thus can be taken as standards
      for the quality control of Longevity Tea.

PMID- 8352901
TI  - [Effect of different preparation crafts on the content of baicalin in
      shuanghuanglian (SHL) injection].
AB  - The content of baicalin is stable when baicalin is added quantitatively in
      preparation. The time of extraction of the effective components of SHL with
      alcohol and the concentration of alcohol have little effect on the content of
      baicalin. The components can be extracted once, and the content of alcohol is
      preferably 85%. The pH level has greater influence on the content of baicalin,
      and should be controlled between 7.0 to 8.0. 0.2% activated carbon is suitable in
      preparation.

PMID- 8352902
TI  - [Chemical constituents of Acanthopanax giraldii Harms var. hispidus Hoo].

PMID- 8352903
TI  - [Chemical constituents of ragweed (Ambrosia artemisiifolia L.)].
AB  - Three sesquiterpene lactones isolated from the aerial parts of Ambrosia
      artemisiifolia were identified as psilostachyin, psilostachyin B and
      psilostachyin C. All of them have some molluscicidal activity against Oncomelania
      hupensis.

PMID- 8352904
TI  - [Quantitative determination of liensinine in the embryo Nelumbinis (Nelumbo
      nucifera Gaertn.) by TLC-scanning].
AB  - The content of liensinine in the green seed embryo of Nelumbo nucifera was
      determined by dual-wavelength TLC-scanning. The crude drug was extracted with two
      different method of impregnating and refluxing. The content of liensinine was
      determined to be 0.853% and 0.939% and the average recovery was 97.9% and 100.9%
      respectively.

PMID- 8352905
TI  - [Experimental studies on the symptom-complex mechanism of pi man zao shi of
      dachengqi decoction].
AB  - Experiments have shown that Dachengqi Decoction can inhibit the activity of G
      germs which commonly grow in the intestinal tract, inactivate the endotoxin
      directly in vitro, reduce the amplitude of fever caused by endotoxin injected
      intravenously, promote the gastric secretion and gastric retaining in rats, and
      increase the level of glycogen in liver. It also has some other effects. All
      these actions contribute to the explanation on the efficacy of Dachengqi
      Decoction to purge off the internal heat.

PMID- 8352906
TI  - [Comparison between actions of shiquandabu pills and shiquandabu liquor on
      immunological parameters in mice].
AB  - The comparison shows that both Shiquandabu pills and Shiquandabu liquor are
      efficacious in strengthening the immunological functions of mice. No significant
      difference has been found between the two forms of preparation. There exists a
      good dose-efficacy relationship for the pills in immunological functions.

PMID- 8352907
TI  - [Clinical application and research of modified wendan tang decoction].

PMID- 8352908
TI  - Stromal cells in long-term cultures: keys to the elucidation of hematopoietic
      development?
AB  - Long-term bone marrow cultures mirror many aspects of in vivo mammalian
      hematopoiesis. Thus, these cultures have been used widely to analyze the complex
      interactions that regulate hematopoietic differentiation. Hematopoiesis in vivo
      and in vitro is dependent on stromal cells, a mixture of support cells. In the
      past years numerous clonal stromal cell lines derived from murine and human
      tissues have been isolated and characterized. The stromal cell lines have proved
      to be invaluable tools for the elucidation of the molecular and cellular signals
      that govern differentiation and self-renewal of hematopoietic cells. This review
      describes the salient features of arrow cultures with a focus on the isolation
      and characterization of stromal cell lines. We summarize how stromal cell lines
      have been crucial tools for the detection, isolation, and maintenance of rare
      pluripotent stem cells and B lineage cells. Intriguing questions about the nature
      of stromal cells, their requirements for growth and differentiation, and their
      histogenic origin remain areas for further investigation.

PMID- 8352909
TI  - Immunoregulation by cytokines.
AB  - The study of cytokine biology relevant to the in vivo (patho)physiology of the
      immune response is complicated by a series of features inherent to the cytokine
      system. The present survey focuses on the mechanisms governing the function of
      cytokines that may give rise to methodological and conceptual problems concerning
      in vivo manipulations of immunologically relevant cytokines. Special emphasis is
      laid on the complex interrelation between individual cytokines (cascades,
      synergy, anergy, pleiotropism, and redundancy), as well as on the mechanisms that
      guarantee a compartmentalization of cytokines, i.e., a chronological, spatial,
      cell-type differentiation stage, and activation-dependent restriction of their
      function. The in vivo effects of cytokines can be studied either by augmenting
      their concentration or reducing their bioavailability. The advantages of local
      and systemic cytokine injections, usage of transgenes, or expression as gene
      products encoded by recombinant viruses are discussed and contrasted with
      different manipulations provoking cytokine deficiencies, namely the application
      of cytokine antagonists, neutralizing antibodies and receptor derivates, receptor
      targeted cytotoxic drugs, and germ line disruption of cytokine genes. Both types
      of intervention are afflicted with major problems. Whereas providing an excess of
      cytokines in vivo, especially at the systemic level, constitutes an essentially
      non-physiological intervention, the induction of cytokine deficiencies will only
      unravel essential effects, but is incapable of elucidating the many pleiotropic
      cytokine effects that, by virtue of the redundancy of the system, compensate for
      each other.

PMID- 8352910
TI  - Evolution of immune reactions.
AB  - The history and evolutionary pathways of defense reactions among various forms of
      life are reconstructed. The vertebrates evolved step-by-step from their
      invertebrate ancestors living in the distant past. The ancestry of vertebrate
      defense mechanisms must be traceable to them because these functions cannot be
      considered separately from the common evolutionary schema. The first part of this
      survey is therefore devoted to the description of major defense reactions and
      achievements in invertebrates. Particular emphasis is given to the taxa of
      present-day invertebrates most likely to exhibit some relationship to the
      chordates and thus to show real traces of vertebrate immune patterns. The second
      part involves three key assemblages of deuterostomate animals--the echinoderms,
      the nonvertebrate chordates, and the first vertebrates because these animals are
      believed to have created the prerequisites for transition from the invertebrate
      type of defense to the vertebrate type of adaptive immunity.

PMID- 8352911
TI  - Diagnosis and treatment of depression in general practice.

PMID- 8352912
TI  - Side-effects of antidepressants.

PMID- 8352913
TI  - Comparisons of clinical efficacy.

PMID- 8352914
TI  - Suicide in depressed patients: medico-legal issues.

PMID- 8352915
TI  - Debits and credits in the management of depression.
AB  - Concern over the cost of health care is playing an increasing role in Great
      Britain, but evaluation of benefit is generally inadequate. This is particularly
      true in the case of depression, for which the cost of drugs is 1.9% of the
      National Health Service pharmaceutical budget. Since differences in effectiveness
      between antidepressant drugs are difficult to demonstrate, quality-of-life
      studies may help to identify outcome differences. At present, the worst outcome
      of depressive illness--suicide--absolves carers from further costs. An assessment
      is needed which takes into account both the direct and indirect costs of
      depression; this should include the costs of investment into improving diagnosis.
      Even without financial analyses, it is clear that some cases of suicide can be
      prevented by prescribing less toxic drugs, but research is needed to investigate
      whether use of these drugs also reduces the costs of overdose.

PMID- 8352916
TI  - The economic evaluation of antidepressant drug therapy.

PMID- 8352917
TI  - Cost management: the economist's viewpoint.

PMID- 8352918
TI  - Epilepsy and mental retardation: an overview.

PMID- 8352919
TI  - Epilepsy in institutionalized patients with encephalopathy: clinical aspects and
      nosological considerations.
AB  - This study was designed to correlate the prevalence of epilepsy with the severity
      and type of encephalopathy of 1,023 institutionalized patients and tentatively
      classify each according to the Proposals of the Commission on Classification and
      Terminology of the International League Against Epilepsy. Of this sample, 326
      individuals were diagnosed with epilepsy. Sex distribution and mean age in the
      epilepsy and no epilepsy groups were similar, but degree of handicap was higher
      for those with epilepsy. Of these individuals 32.5% had a partial form. Of the
      204 patients with generalized epilepsy (62.5%), 64 had a form with
      electroclinical characteristics of the idiopathic type; 57, a syndromic form (53
      cases with a Lennox-Gastaut syndrome); and 83, a nonsyndromic form. Degree of
      handicap and frequency of seizures were lower in subjects with partial epilepsy
      and with those having electroclinical characteristics of the idiopathic type.

PMID- 8352920
TI  - Changes in antiepileptic drug prescribing patterns in large institutions:
      preliminary results of a five-year experience.
AB  - Routine antiepileptic prescriptions were analyzed for stable cohorts from two
      large, state-run, Accreditation Council-certified ICFs/MR for the time period
      October 1, 1987, to April 1, 1992. Results indicated marked decrease in numbers
      of individuals receiving (a) more than two antiepileptic drugs concurrently and
      (b) barbiturates. Retrospective analyses revealed that (a) over 90% of a group
      undergoing barbiturate taper maintained the same or improved seizure control and
      (b) some adults undergoing barbiturate tapers improved in target behaviors.
      Findings indicate the feasibility of changing antiepileptic regimens utilizing
      individual case evaluation and treatment and suggest the importance of
      considering possible psychological and behavioral disturbances associated with
      barbiturate therapy for adults and children.

PMID- 8352921
TI  - Antiepileptic drug status in adult outpatients with mental retardation.
AB  - Charts of 100 patients with mental retardation and epilepsy from the community
      were reviewed to survey use of antiepileptic drugs and examine the relation of
      mental retardation and seizure type to antiepileptic drug status. Sixty patients
      were on monotherapy and 40, on two or three antiepileptic drugs. Most subjects
      had generalized tonic-clonic seizures (68%), but there was a trend for those with
      profound retardation to have relatively more mixed seizures. Subjects on more
      than one antiepileptic drug were less likely to have fully controlled seizures
      (50%). Individuals with mixed seizures were comparatively more likely to be on
      more than one antiepileptic drug and have uncontrolled seizures. Implications for
      clinical management of epilepsy in adults with mental retardation were discussed.

PMID- 8352922
TI  - Control of epilepsy in a mentally retarded population: lack of correlation with
      IQ, neurological status, and electroencephalogram.
AB  - An investigation of 90 children with mental retardation and epilepsy who were
      seen at a developmental evaluation clinic was conducted to determine whether
      control of their epilepsy was related to their level of mental retardation. Their
      level of retardation, neurological findings, and EEGs were classified and
      compared with the quality of seizure control. No correlation was found between
      quality of control and any of these parameters. Results suggest that there is no
      firm relation between the level of mental retardation and control of epilepsy. It
      also appears that the neurological status and EEG do not affect quality of
      seizure control for this group.

PMID- 8352923
TI  - Movement of individuals with complex epilepsy from an institution into the
      community: seizure control and functional outcomes.
AB  - The successful community placement of 15 medically fragile individuals with
      profound mental retardation and complex epilepsy was examined. We found that
      simplification of anticonvulsants, early intervention for seizures, and improved
      staff education resulted in (a) fewer seizures, (b) decreases in emergency room
      visits for status seizures and drug-related side effects, and (c) increased
      levels of functioning as measured by activities of daily living. This program
      allowed for a medically fragile epileptic population to be transferred from the
      institution to the community.

PMID- 8352924
TI  - Mental retardation, mental illness, and seizure diagnosis.
AB  - The coexistence of epilepsy in individuals with mental retardation and mental
      illness is common. Little is known about whether individuals with all three
      conditions do significantly worse on inpatient units compared to persons with
      mental retardation and psychiatric disorder but without a seizure diagnosis.
      During 62 consecutive months, 247 individuals with mental retardation and
      psychiatric disorders were discharged from a university hospital. A review of
      discharge summaries yielded 39 individuals with a seizure diagnosis. The only
      difference between the groups with and without seizures was level of mental
      retardation. No differences existed with regard to length of stay, transfer to
      state hospital, psychiatric co-morbidity, or medical illness. Although it is
      sometimes difficult for many individuals with mental retardation to be admitted
      to a psychiatric hospital during exacerbations of mental illness, they should not
      be further stigmatized by presence of a seizure diagnosis.

PMID- 8352925
TI  - Temporal expression of tissue inhibitors of metalloproteinases in mouse
      reproductive tissues during gestation.
AB  - Tissue inhibitors of metalloproteinases (TIMPs) appear to play an important
      regulatory role in tissue remodelling and invasion by malignant cells. Since
      pregnancy involves morphological changes in existing maternal tissues, as well as
      a strictly controlled invasion by fetal trophoblasts, we have examined the
      temporal expression of TIMP-1, TIMP-2, and specific metalloproteinases in the
      mouse uterus, decidua, placenta, amnion, and ovaries throughout gestation by
      examining mRNA levels on northern and slot blots. Maximal levels of TIMP-1 mRNA
      were observed from day 6 to day 10 in the uterus, decidua, and placenta. In clear
      contrast to the early burst of TIMP-1 mRNA accumulation, the level of TIMP-2 mRNA
      increased steadily throughout gestation in the uterus, decidua, and amnion, while
      in the placenta it showed a sevenfold increase after day 14. In amnion, TIMP-1
      was induced specifically on day 18. Interestingly, the normally high level of
      TIMP-1 mRNA seen in the ovaries of virgin mice was low during gestation, until
      day 18 and postpartum, when a sixfold increase over the levels in virgin ovary
      was observed. In contrast, ovarian TIMP-2 mRNA showed a marginal increase during
      gestation. The temporal pattern of 72 kDa gelatinase type A followed that of TIMP
      2 in the decidua and ovary. Stromelysin-2 mRNA was detected at term only in ovary
      and decidua. Our data show that the temporal accumulation of TIMP-1 and TIMP-2
      mRNA is precisely coordinated in each of the tissue compartments and is
      independently regulated during the in vivo remodeling of reproductive tissues in
      gestation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352926
TI  - Glucose, pyruvate, and lactate concentrations in the blastocoel cavity of rat and
      mouse embryos.
AB  - The concentrations of glucose, pyruvate, and lactate have been measured in the
      blastocoel fluid of single rat and mouse blastocysts, using the technique of
      micropuncture combined with an ultramicrofluorescence assay. When cultured in the
      presence of 5.55 mM glucose, 11.5-12.5 mM L-lactate and 0.25-0.33 mM pyruvate,
      concentrations in the blastocoel fluid of mouse and rat were 2.30 and 2.75 mM
      glucose, 14.6 and 19.6 mM L-lactate, and 0.13 and 0.50 mM pyruvate, respectively.
      When cultured in the presence of 1.0 mM glucose and 1.0 mM L-lactate,
      concentrations in the blastocoel fluid were 0.50 and 0.59 mM glucose and 2.22 and
      3.70 mM L-lactate, respectively. These results suggest that (1) the blastocyst is
      capable of maintaining considerable concentration gradients of substrates across
      the trophectoderm, (2) the microenvironment of the blastocoel is adequately
      supplied with energy substrates for the development of the inner cell mass, and
      (3) the inner cell mass is capable of developing in both high and low glucose and
      lactate concentrations.

PMID- 8352927
TI  - Transcriptional activity and nuclear ultrastructure of 8-cell bovine embryos
      developed by in vitro maturation and fertilization of oocytes from different
      growth categories of antral follicles.
AB  - The normalcy of nuclear differentiation in 8-cell bovine embryos derived by in
      vitro procedures from oocytes isolated from antral follicles of three different
      size categories was studied using autoradiographic localization of RNA synthesis
      and fine-structure nuclear morphology. In the few embryos derived from the
      oocytes from the small category of follicles (1-2 mm) the unlabeled nuclei
      prevailed. In contrast, the oocytes isolated from the more progressed follicles
      (medium and large size: 2-8 mm) yielded embryos with only slight, if at all
      detectable, differences to the picture expected in in vivo developed normal
      embryos. The diverging features probably concerned a slower onset of gene
      transcription, its consecutive pattern of localization as well as less pronounced
      progress of chromatin condensation and nucleolar differentiation. The assessment
      of these morphological changes and characteristics for individual embryos was
      obscured by marked differences in the status of the nuclei of particular
      blastomeres forming an embryo. Here the differences were seen in the
      fragmentation of nuclei, in the degree of chromatin condensation and in the
      absence of the nucleolus-associated chromatin in some of the blastomeres. It is
      suggested that most of the embryos from medium and large follicles have a
      comparable differentiation pattern of nuclear function development as embryos
      developing normally in vivo.

PMID- 8352928
TI  - Binding characteristics and immunolocalization of porcine seminal protein, PSP-I.
AB  - PSP-I, a 13 kDa protein purified from boar seminal plasma, was found to have
      about 50% amino acid sequence homology with a family of zona pellucida-binding
      proteins known as spermadhesins. These proteins are produced by the accessory
      gland(s) of the male reproductive tract and coat the spermatozoa during
      ejaculation. In this study, we have investigated the possible biological
      functions of PSP-I using a solid-phase protein binding assay and its site of
      synthesis using both Western blot and immunocytochemical analyses. PSP-I was
      found to bind a number of proteins including endo-beta-galactosidase digested
      ZP3, soybean trypsin inhibitor, IgA, IgG and alpha-casein, indicating that it may
      have multiple functions. The protein or carbohydrate structures were not critical
      in the binding, since polyvinyl sulfate could effectively inhibit the binding of
      PSP-I to these proteins. Western blot analysis using specific antiserum to PSP-I
      showed that the protein was present in the seminal vesicle but not in the testes,
      epididymis or prostate. The protein was revealed by immunocytochemical analysis
      in the epithelium of seminal vesicles but not in the testes or the epididymis. It
      is concluded that PSP-I is synthesized by the epithelium of the seminal vesicles,
      secreted into the semen during ejaculation, and may be involved in various
      reproductive functions, such as preventing premature acrosome reaction and
      immunosuppression.

PMID- 8352929
TI  - ZNC(C)PR affects developmental changes of P46 phosphorylation in rat hippocampus.
AB  - Protein phosphorylation has been suggested to be correlated with brain
      development and with the molecular mechanism of behavioral effects of
      neuropeptides. The present study reports in vitro endogenous phosphorylation of
      P46, a membrane-associated protein that is changed during development of the rat
      hippocampus. This study indicated that the degree of endogenous phosphorylation
      may be correlated with the establishment of synaptic connections. Interestingly,
      P46 was proved to be identical to a well-known growth-associated protein B-50/GAP
      43 in its identical apparent molecular weight, isoelectric point, phosphorylation
      dependence, and the cross immunoreaction of monoclonal anti-B-50/GAP-43 antibody
      and P46. Moreover, neonatal administration of neuropeptide ZNC(C)PR could
      facilitate the developmental progress of P46 endogenous phosphorylation. It is
      suggested that the changes in P46 phosphorylation could be involved in the
      cellular mechanism of ZNC(C)PR behavioral effects on learning.

PMID- 8352930
TI  - Changes in ovarian follicles and in vitro sex hormone release in the lizard
      Podarcis sicula sicula.
AB  - An in vitro superfusion method was used to test sex hormone release from
      different kinds of ovarian follicle (growing follicles, postovulatory follicles,
      and atretic follicles) in the lizard Podarcis sicula sicula. Sex hormone output
      changes with the stage of follicle evolution and sexual cycle. Previtellogenetic
      follicles prevail in early-spring quiescent ovaries and secrete mainly
      progesterone, which is probably utilized at that phase to delay ovarian
      resumption. In the acute ovary, progesterone output from previtellogenetic
      follicles decreases, whereas vitellogenetic follicles produce a significant
      amount of 17 beta-estradiol, which is necessary for sustaining vitellogenin
      synthesis by the liver and oviduct growth. As follicles become ripe, progesterone
      production is resumed, and it increases in young postovulatory follicles. This is
      in line with the functions assigned to the hormone at that phase of the sexual
      cycle, i.e., the induction of oocyte maturation and the regulation of egg
      retention in the oviduct. Postovulatory follicles can also synthetize 17 beta
      estradiol. After oviposition, this hormone, which is secreted by the old
      postovulatory follicles, can reinitiate vitellogenin synthesis, allowing the
      development of a new oocyte set. Our data confirm that active, although
      ephemeral, corpora lutea are also formed in oviparous species. A limited
      contribution to ovarian sex steroid production derives also from atretic
      follicles, at least at the early stages of the breeding cycle.

PMID- 8352931
TI  - Immunoelectron microscope localization of snRNP, hnRNP, and ribosomal proteins in
      mouse spermatogenesis.
AB  - We have studied the ultrastructural distribution of heterogeneous nuclear
      ribonucleoproteins (hnRNPs), small nuclear ribonucleoproteins (snRNPs), and
      ribosomal proteins during mouse spermatogenesis and spermiogenesis by means of
      specific antibodies and immunocytochemistry. All the above components were
      detectable from primary spermatocytes until the spermatid elongation phase, when
      the RNA synthetic activity is known to cease. Ribosomal protein (P1/P2 and L7)
      labeling disappeared as early as during the acrosome phase, and nucleoli were no
      longer labeled even during the cap phase. The nucleoplasmic structures labeled
      with the different anti-nucleoplasmic RNP immunoprobes corresponded, until the
      acrosome phase, to those previously observed as targets of the same antibodies in
      the nucleoplasm of somatic cell nuclei. Clusters of interchromatin granules of
      spermatocyte and early spermatid nuclei exhibit some labeling for hnRNP when
      compared with nuclei of Sertoli cells or previously analyzed liver or tissue
      culture cells, where these structural constituents usually remain weakly labeled
      or unlabeled. In spermatids in step 10, another type of nuclear granule,
      resembling perichromatin granules, but occurring in aggregates, can be observed.
      These structural constituents were labeled with antibodies recognizing
      nucleoplasmic snRNP antigens and therefore suggesting a non-nucleolar origin of
      these granules. Finally, we have observed nucleoplasmic areas of fibrogranular
      material, occurring only in primary spermatocytes. These components were labeled
      with anti-ribosomal protein antibodies but did not contain either hnRNPs or
      snRNPs.

PMID- 8352932
TI  - Spermatid nucleus of Megaselia scalaris Loew (Insecta, Diptera, Phoridae): a
      study using anti-histone antibodies, scanning electron microscopy, and a
      centromere-specific oligonucleotide.
AB  - The structure of elongated spermatid nuclei was examined in the fly Megaselia
      scalaris using indirect immunofluorescence with anti-histone antibodies, scanning
      electron microscopy, and in situ hybridization with a centromere-specific
      oligonucleotide. The immunofluorescence experiments showed that, in keeping with
      the situation in most animals, histones are hyperacetylated prior to their
      displacement from the nucleus in the course of spermiogenesis. Scanning electron
      microscopy revealed that grooves run parallel to the long axis of the spermatid
      nuclei. The chromatin is segmented into blocks lateral to the grooves. This
      finding most probably indicates that the chromatin is not yet maximally condensed
      at this stage. The retarded chromatin condensation may be correlated with the
      export of somatic histones from the nucleus. The location of the centromeres
      could not be identified using scanning electron microscopy, but in situ
      hybridization showed that a centromere-specific oligonucleotide mapped to the
      central or close to the central areas within the spermatid nucleus. Possibly, the
      chromosomes are extended and arranged parallel to the long axis of the spermatid
      nucleus.

PMID- 8352933
TI  - Lysophosphatidylcholine disrupts the acrosome of tammar wallaby (Macropus
      eugenii) spermatozoa.
AB  - The acrosomal status of wallaby spermatozoa was evaluated by light and electron
      microscopy after incubation in 1-100 microM lysophosphatidylcholine (LPC) for up
      to 120 min. Treatment with 1 and 10 microM LPC for 120 min did not lead to
      acrosomal loss, or detectable alteration to the acrosome, as detected by Bryan's
      staining and light microscopy. Incubation with 25 microM LPC had little effect on
      acrosomal loss, however statistically significant changes (P < 0.05) in the
      acrosomal matrix (altered) were detected after 10-min incubation by light
      microscopy. Around 50% of acrosomes were altered after 20-min incubation in 50
      microM LPC (P < 0.001), and 40% of spermatozoa had lost their acrosome after 60
      min incubation (P < 0.001). Treatment with 75 and 100 microM LPC led to rapid
      acrosomal loss from around 50% of spermatozoa within 10 min (P < 0.001), and by
      60 min acrosomal loss was 70-80%. LPC, like the diacylglycerol DiC8 (1,2
      dioctanoyl-sn-glycerol), is thus an effective agent to induce loss of the
      relatively stable wallaby sperm acrosome, and it also induces changes within the
      acrosomal matrix. Ultrastructure of the LPC-treated spermatozoa revealed that the
      plasma membrane and the acrosomal membranes were disrupted in a manner similar to
      that seen after detergent treatment (Triton X-100). There was no evidence of
      point fusion between the plasma membrane overlying the acrosome and the outer
      acrosomal membrane. The plasma membrane was the first structure to disappear from
      the spermatozoa. The acrosomal membranes and matrix showed increasing disruption
      with time and LPC concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352934
TI  - Biotinylation of proteins on the surface of zona-free mouse oocytes.
AB  - In this study, we have labelled proteins on the surface of unfertilized, zona
      free mouse oocytes using a nonisotopic biotinylation procedure. The zona
      pellucida was weakened by brief incubation in chymotrypsin and removed by
      mechanical pipetting through a narrow-bore glass pipette. Surface proteins were
      labelled using sulfo-NHS-biotin (sulfosuccinimidobiotin), a water-soluble,
      membrane-impermeable biotinylation reagent. The distribution of biotinylated
      proteins on the oocyte surface was assessed by fluorescence microscopy using
      streptavidin-FITC. Bright fluorescence was noted on the surface of the oocyte,
      except in a circular region overlying the meiotic spindle where the fluorescence
      was weak or absent. The intensity of fluorescence was markedly reduced by
      incubation of biotinylated oocytes in trypsin (1 mg/ml) or chymotrypsin (2
      mg/ml), and in vitro fertilization experiments showed that biotinylation did not
      compromise the fertilizability of the oocytes. The biotinylated proteins were
      separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE)
      and analyzed by Western blotting using streptavidin-HRP and enhanced
      chemiluminescence (ECL) detection. The most prominent biotinylated proteins were
      of M(r) 82 and 69 kD, but other major proteins of M(r) 93, 78, 61, 52, 49, 40,
      28, and 22 kD were detected, as well as 14 minor proteins of M(r) 18-100 kD. The
      major bands could be detected in fewer than 50 oocytes. This biotinylation
      procedure is fast, versatile and sensitive, and it is therefore an excellent tool
      for studying proteins exposed on the surface of mammalian oocytes and embryos.

PMID- 8352935
TI  - Biochemical characterization and epididymal localization of the maturation
      dependent ram sperm surface antigen ESA152.
AB  - We examine here the biochemical properties and epididymal localization of a
      maturation dependent ram sperm surface antigen. A monoclonal antibody, ESA152,
      identifies an antigen that is present on the surface of ejaculated sperm, but is
      absent from testicular sperm. Crosslinking of the ESA152 antigen with bivalent
      antibodies induces the acrosome reaction, redistributing the antigen into the
      anterior region of the sperm head where it associates with the fusion product of
      the plasma membrane and the outer acrosomal membrane. The ESA152 antigen appears
      as a polypeptide of 18 kDa on immunoblots of SDS-polyacrylamide gels. The ESA152
      epitope includes the sialic acid termini of N-linked oligosaccharides, as shown
      by its sensitivity to neuraminidase and endoglycosidase F. The ESA152 antigen is
      a highly hydrophobic integral membrane protein that resists aqueous extraction,
      partitions into the detergent phase of Triton-X-114, and solubilizes in
      chloroform-methanol mixtures. The anchoring of ESA152 is unaffected by
      phosphtidylinositol specific phospholipase C. The antigen is absent from extracts
      of caput and corpus epididymidis but appears abruptly in the first segment of the
      cauda. Immunofluorescence reveals that the ESA152 epitope first appears in
      clusters of cells in the luminal epithelium of the proximal cauda, prior to or
      concurrent with its appearance on sperm.

PMID- 8352936
TI  - Analysis of lipid peroxidation mechanisms in human spermatozoa.
AB  - The mechanisms by which ferrous ion promoters induce malondialdehyde generation
      by human spermatozoa have been investigated in order to provide a rational basis
      for the quantification and interpretation of lipid peroxidation assays.
      Incubation of human spermatozoa with a ferrous ion promoter in the presence of
      thiobarbituric acid (TBA) led to the generation of the bone fide malondialdehyde
      TBA adduct. The importance of iron in the stimulation of lipid peroxidation was
      emphasized by the ability of Desferal and EDTA to suppress malondialdehyde
      generation. Paradoxically, when the concentration of EDTA relative to iron was
      equimolar or greater, the suppression of malondialdehyde formation was
      accompanied by the generation of hydroxyl radicals. These results suggested that
      the addition of promoter did not effect the first-chain initiation of lipid
      peroxidation but favored an alternative mechanism involving the catalytic
      decomposition of pre-existing lipid peroxides. This conclusion was reinforced by
      the inability of reagents that would limit the formation (superoxide dismutase
      and/or catalase) or availability (mannitol, formate) of hydroxyl radicals, to
      influence malondialdehyde generation. While hydroxyl radicals were not directly
      involved in Fe(2+)-promoted malondialdehyde generation, the existence of
      significant correlations between reactive oxygen species production and the
      outcome of the TBA assay, suggested that Fenton chemistry might be important in
      the initiation of peroxidative damage. It is proposed that the impeded
      propagation of peroxidation initiated by Fenton or Haber Weiss reactions would
      lead to the accumulation of lipid peroxides in the spermatozoa and it is these
      peroxides that are induced to decompose during the Fe(2+)-promoted TBA assay,
      stimulating a lipoperoxidative chain reaction and malondialdehyde formation.

PMID- 8352937
TI  - Multiple effects of seminal plasma on the acrosome reaction of human sperm.
AB  - Mammalian sperm do not respond to inducers of the acrosome reaction immediately
      after ejaculation. They become responsive after they are removed from seminal
      plasma and incubated in an appropriate medium. We tested the effects of seminal
      plasma on the development of acrosomal responsiveness. Washed human sperm
      incubated 24 hr in vitro with 10% (v/v) seminal plasma did not complete an
      acrosome reaction when exposed to human follicular fluid, progesterone, or
      ionomycin. Seminal plasma did not reduce sperm viability or motility. Electron
      microscopy of sperm incubated 24 hr with 5% seminal plasma and then treated with
      progesterone revealed no sign of membrane fusion or other changes that are
      associated with the acrosome reaction. During a 12-hr incubation, seminal plasma
      was 50% effective at inhibiting the acrosomal response to progesterone when
      diluted 821 +/- 112 fold (mean +/- SD, n = 3). Sperm that were incubated with
      seminal plasma for 24 hr and then washed free of the seminal plasma became
      acrosomally responsive over the following 24 hr, at a rate similar to that of
      sperm not incubated with seminal plasma in vitro. When sperm were incubated 6 hr
      without seminal plasma and then seminal plasma was added, the sperm population
      transiently became more responsive to progesterone, and then became unresponsive.
      During incubation in vitro, the ability of sperm to have an augmented response to
      a mixture of seminal plasma plus progesterone developed slightly earlier and more
      rapidly than ability to respond to progesterone alone. When sperm were incubated
      24 hr without seminal plasma, a few acrosome reacted in response to the addition
      of seminal plasma alone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352938
TI  - Sperm:egg ratios and putative molecular signals to modulate gamete interactions
      in polytocous mammals.
AB  - Reasoning from the premises that 1) the sperm:egg ratio at the time of activation
      of the secondary oocyte in mammals is close to unity under conditions of
      spontaneous mating, 2) a majority of eggs within the cumulus oophorus of a
      polytocous species is fertilized in a reasonably short interval of time, and 3)
      spermatozoa would find it difficult to reverse their approach to the zona
      pellucida, it is proposed that molecular gradients exist to divert spermatozoa
      penetrating the cumulus mass away from eggs already activated and towards eggs as
      yet unfertilized. Possible sources of such molecular cues are considered, as is
      the event that triggers their release.

PMID- 8352939
TI  - Tumor suppressor genes.

PMID- 8352940
TI  - Preferential expression in mushroom bodies of the catalytic subunit of protein
      kinase A and its role in learning and memory.
AB  - Involvement of the cAMP cascade in Drosophila learning and memory is suggested by
      the aberrant behavioral phenotypes of the mutants dunce (cAMP phosphodiesterase)
      and rutabaga (adenylyl cyclase). Line DCO581, isolated via an enhancer detector
      screen for genes preferentially expressed in the mushroom bodies, contains a
      transposon in the first exon of the catalytic subunit gene (DCO) of protein
      kinase A (PKA). RNA in situ hybridization and immunohistochemistry show that DCO
      is preferentially expressed in the mushroom bodies. The DCO581 insertion and an
      independently isolated hypomorphic allele (DCOB10) each produce homozygous
      lethality and a 40% decrease in PKA activity in heterozygotes. This decrease has
      mild effects on learning but no effect on memory. However, the 80% reduction in
      activity obtained by constructing heteroallelic yet viable DCO581/DCOB10 animals
      results in a dramatic learning and memory deficit. These results suggest that PKA
      plays a crucial role in the cAMP cascade in mushroom bodies to mediate learning
      and memory processes.

PMID- 8352941
TI  - Navigational errors made by growth cones without filopodia in the embryonic
      Xenopus brain.
AB  - We have developed an exposed brain preparation for observing growth cone
      pathfinding behavior while performing in vivo pharmacological manipulations, and
      we used it to test whether Xenopus retinal growth cones need filopodia to
      navigate. Time-lapse video observation showed that cytochalasin B acted quickly
      and reversibly when applied; cytochalasin B-treated growth cones lacked
      filopodia, but had active lamellipodia and continued to advance slowly. Whereas
      normal retinotectal axons visualized with horseradish peroxidase turn caudally in
      the mid-diencephalon to reach the tectum, cytochalasin B-treated axons grew past
      the normal turning point and, instead, continued straight within the
      diencephalon. In dose-response experiments, pathfinding became abnormal in the
      same concentration range in which filopodia disappeared. These results suggest
      that filopodia are necessary for retinal growth cones to respond to guidance
      signals in the diencephalon.

PMID- 8352942
TI  - S4 mutations alter the single-channel gating kinetics of Shaker K+ channels.
AB  - The S4 sequence comprises at least part of the voltage sensor in Shaker K+
      channels. Two site-directed mutations in the Shaker S4 sequence, R368Q and R377K,
      which decrease the voltage dependence of the whole-cell current, alter voltage
      dependent gating at the single-channel level. Compared with the wild-type
      channel, they increase the latency to first opening, destabilize the open state,
      and alter the equilibria of voltage-dependent transitions, so that some of the
      charge movement occurs after the first opening. Whether these changes reflect a
      new mechanism of activation is a key question. Although the mutations alter the
      kinetics of many steps in the gating process, we conclude that the mutant
      channels are likely to activate using the same fundamental mechanism as wild-type
      channels.

PMID- 8352943
TI  - Gating currents from a nonconducting mutant reveal open-closed conformations in
      Shaker K+ channels.
AB  - In voltage-dependent ion channels, a voltage sensor region is responsible for
      channel activation and an aqueous pore is responsible for ion conduction. These
      two processes have been traditionally considered to be independent. We describe
      here a mutation in the putative pore region (W434F) that completely abolishes ion
      conduction without affecting the gating charge of the channel. Gating currents in
      the nonconductive mutant were found to be identical in their kinetic and steady
      state properties to those in conductive channels. Gating current measurements
      could be performed without subtracting pulses and in the presence of normal
      physiological solutions. Application of internal tetraethylammonium (an open
      channel blocker) induced Off charge immobilization for large depolarizations,
      suggesting that the internal tetraethylammonium-binding site becomes available
      upon depolarization. We concluded that for this mutant, although the conduction
      pathway is not functional, the channel can still undergo the closed-open
      conformation in response to voltage changes.

PMID- 8352944
TI  - Dexamethasone rapidly induces Kv1.5 K+ channel gene transcription and expression
      in clonal pituitary cells.
AB  - Glucocorticoids specifically increase Kv1.5 K+ channel mRNA in normal and clonal
      (GH3) rat pituitary cells. Here, we demonstrate that dexamethasone, a
      glucocorticoid agonist, rapidly induces Kv1.5 gene transcription, but does not
      affect Kv1.5 mRNA turnover (t1/2 approximately 0.5 hr) in GH3 cells. Immunoblots
      indicate that the steroid also increases the expression of the 76 kd Kv1.5
      protein approximately 3-fold within 12 hr without altering its half-life (t1/2
      approximately 4 hr). In contrast, Kv1.4 protein expression is unaffected.
      Finally, we find that the induction of Kv1.5 protein is associated with an
      increase in a noninactivating component of the voltage-gated K+ current. Our
      results indicate that hormones and neurotransmitters may act within hours to
      regulate excitability by controlling K+ channel gene expression.

PMID- 8352945
TI  - Expression of a mitogen-inducible cyclooxygenase in brain neurons: regulation by
      synaptic activity and glucocorticoids.
AB  - Prostaglandins play important and diverse roles in the CNS. The first step in
      prostaglandin synthesis involves enzymatic oxidation of arachidonic acid, which
      is catalyzed by prostaglandin H(PGH) synthase, also referred to as
      cyclooxygenase. We have cloned an inducible form of this enzyme from rat brain
      that is nearly identical to a murine, mitogen-inducible cyclooxygenase identified
      from fibroblasts. Our studies indicate that this gene, here termed COX-2, is
      expressed throughout the forebrain in discrete populations of neurons and is
      enriched in the cortex and hippocampus. Neuronal expression is rapidly and
      transiently induced by seizures or NMDA-dependent synaptic activity. No
      expression is detected in glia or vascular endothelial cells. Basal expression of
      COX-2 appears to be regulated by natural synaptic activity in the developing and
      adult brain. Both basal and induced expression of COX-2 are inhibited by
      glucocorticoids, consistent with COX-2 regulation in peripheral tissues. Our
      studies indicate that COX-2 expression may be important in regulating
      prostaglandin signaling in brain. The marked inducibility in neurons by synaptic
      stimuli suggests a role in activity-dependent plasticity.

PMID- 8352946
TI  - A novel receptor-type protein tyrosine phosphatase is expressed during
      neurogenesis in the olfactory neuroepithelium.
AB  - Tyrosine phosphorylation plays a central role in the control of neuronal cell
      development and function. Yet, few neuronal protein tyrosine phosphatases (PTPs)
      have been identified. We examined rat olfactory neuroepithelium for expression of
      novel PTPs potentially important in neuronal development and regeneration. Using
      the polymerase chain reaction with degenerate DNA oligomers directed to the
      conserved tyrosine phosphatase domain, we identified 6 novel tyrosine
      phosphatases. One of these, PTP NE-3, is a receptor-type PTP expressed
      selectively in both rat brain and olfactory neuroepithelium. In the olfactory
      neuroepithelium, PTP NE-3 expression is restricted to neurons and describes a
      novel pattern of expression with a high level in the immature neurons and a lower
      level in mature olfactory sensory neurons.

PMID- 8352947
TI  - In vivo recovery of repeatedly strained rat skin after systemic treatment with
      desmotropic drugs.
AB  - The mechanical behavior of rat skin during repeated strain in vivo and the
      restoration process thereafter were studied following 10 days' treatment with
      desmotropic drugs (300 mg/kg p.o. D-penicillamine or 10 mg/kg s.c. prednisolone
      acetate). Repeated (30 times) elongations of up to 40% were performed under
      anesthesia both longitudinally and perpendicularly to the body axis. Evaluation
      of this first run of 30 cycles showed stress values as well as the moduli of
      elasticity to be decreased after D-penicillamine, whereas they were greatly
      increased after prednisolone acetate treatment. The decay of stress values during
      repeated strain revealed similar effects of treatment. In the second part of the
      experiment, the restoration process was evaluated by a second run of 30 cycles
      after 1, 6 and 16 h. In the late phases of recovery, an even better restitution
      ad integrum was found in treated animals. Overall, in contrast to other
      biomechanical parameters, the restoration process is barely influenced by
      treatment with desmotropic compounds.

PMID- 8352948
TI  - How does sodium lauryl sulfate alter the skin barrier function in man? A
      multiparametric approach.
AB  - The effects of topically applied sodium lauryl sulfate were studied in vivo, in
      man, through noninvasive methods and compared with those obtained in vitro, using
      human stratum corneum as a model. The results show that the very marked increase
      of transepidermal water loss obtained in vivo cannot be related to any removal of
      epidermal lipids. The most likely explanation of our findings lies in the
      hyperhydration of stratum corneum consecutive to the inflammation process and a
      possible disorganization of the lipid bilayers.

PMID- 8352949
TI  - Penetration of Sandimmune (cyclosporin A) in rat skin in vitro. Effects of
      penetration enhancers and solvents.
AB  - The effect of various fatty acids or alcohols on the penetration rates and skin
      concentrations of cyclosporin A (Sandimmune; CyA) was evaluated in an in vitro
      model using skin of hairless rats. The influence of chain length, number and
      position of double bonds and branching of the carbon chain of the enhancer were
      investigated. In addition the penetration dependency of CyA on the concentration
      of both enhancer and CyA was studied. CyA was quantitated by high-performance
      liquid chromatography. The penetration rates of CyA through rat skin decreased
      with increasing number of double bonds of the enhancer and decreasing CyA
      concentrations in the donor solution, and increased with increasing chain length
      of the enhancer. Enhancers increase penetration rates by a factor of up to 20-90
      in alcoholic vs. maximally 5-fold in oily compositions. Enhancers increase skin
      concentrations of CyA by a factor of up to 10-25 in alcoholic and about 4-20 in
      oily compositions.

PMID- 8352950
TI  - Glucocorticoid effect on hair growth initiation: a reconsideration.
AB  - It has been demonstrated by various workers in the past that glucocorticosteroids
      block hair growth. Using the mouse model for studying hair growth induction we
      reexamined the effect of topically applied steroids on hair growth to establish
      at what stage the steroid block acts. In accord with studies by others, we found
      that these steroids block hair growth at the point of anagen initiation, but that
      once the steroid applications are stopped, hair growth starts. Since steroid
      withdrawal alone did not induce hair growth, it is clear that these steroids do
      not block, either spontaneous or manipulated, hair growth induction, but they do
      block, the apparent next step, i.e., hair formation. Moreover, since hair growth
      could be induced even while the animals were being treated with the steroid, the
      induction step appears independent of the steroid block. These studies and those
      of others lead us to conclude that these steroids block the expression of hair
      forming genes, but do not interfere with the signal(s) that initiates those
      genes. This system appears to be ideal for identifying the signals (perhaps,
      genes) responsible for initiating hair growth.

PMID- 8352951
TI  - Computerized microassay of keratinocyte cell-plastic attachment and proliferation
      for assessing net stimulatory, inhibitory and toxic effects of compounds on
      nonimmortalized cell lines.
AB  - Testing of pharmacological agents that affect growth of epidermal keratinocytes
      (EK) requires a standardized assay. We have developed an assay measuring net
      effects of stimulatory (e.g. growth factors), inhibitory (e.g. methotrexate) or
      toxic (e.g. Triton X-100) compounds. The amount of crystal violet staining viable
      EK attached to the wells of standard 96-well microplates is measured in situ
      using an ELISA plate reader. Optical density readings are directly converted into
      cell counts by computer software. Counts obtained by this method strongly
      correlate with the results obtained using the [3H]thymidine uptake assay and
      direct cell counts. The assay standardizes measurements of nonimmortalized EK
      lines with different innate proliferative properties and allows accurate
      quantitation of EK numbers in the range of 2,500-500,000 EK/well.

PMID- 8352952
TI  - In vivo evaluation of the penetration of topically applied drugs into human skin
      by spectroscopic methods.
AB  - Spectroscopic techniques are reported on which allow to study in vivo the
      penetration behaviour of topically applied light-absorbing drugs into human skin.
      Remittance spectroscopy, a purely optical method, provides a good tool in both,
      skin adaptation by use of a remote viewing head coupled to the spectrometer via
      optical fibres, and adequate sensitivity for the detection of small amounts of
      the applied drugs. The measuring depth in the skin is determined by the
      wavelength-dependent optical penetration depth, which itself depends on light
      absorption and light scattering. In the UV-spectral region the optical
      penetration depth is of the order of the thickness of the stratum corneum (UV-A)
      or of only a superficial part of it (UV-B, UV-C). Fluorescence spectroscopy,
      another optical method, offers two kinds of drug detection, a direct one in case
      of self-fluorescent drugs or an indirect one being based on the light absorption
      of the drug, which may give rise to a screening of the self-fluorescence of the
      skin itself or of an applied marker. The measuring depth is comparable to that
      achieved with remittance spectroscopy. A third method is photothermal
      spectroscopy which is determined by thermal properties of the skin in addition to
      optical properties. Photothermal spectroscopy is unique in that it allows depth
      profiles of drug concentration to be measured non-invasively, as the photothermal
      measuring depth can be changed by varying the modulation frequency of the
      intensity-modulated incident light. Results of measurements demonstrating the
      potentials of these spectroscopic methods are presented.

PMID- 8352953
TI  - Assessment of topical corticosteroid activity on experimentally induced contact
      dermatitis: echographic evaluation with binary transformation and image analysis.
AB  - A new echographic evaluation method employing a B scanner and a dedicated
      software (Dermavision 2D, Cortex Technology, Hadsund, Denmark) was used in
      assessing the potency of three different corticosteroids. Experimental lesions
      were induced by patch tests with nickel sulfate 5% in petrolatum in 10 sensitized
      subjects and treated with two medications of different steroids (clobetasol
      propionate, fluocinolone acetonide or clobetasone butyrate) performed 16 and 40 h
      after the application of the nickel patch tests. Clinical and echographic
      evaluations were carried out at the beginning of the experiment and 64 h after
      the induction of the reactions. After obtaining echographic images, these were
      processed by software, enabling the selection of amplitudes of interest, the
      highlighting of parts of images and their assessment by a value corresponding to
      the number of pixels (picture elements). For evaluations a low reflecting band
      was chosen, marking edema and inflammatory infiltration. At positive patch test
      sites we observed a progressive increase in the number of low reflecting pixels,
      in accordance with the intensity of the reaction. Therapeutic response was
      assessed as the difference between values of treated and untreated test sites.
      The rank order of the efficacy of test substances as determined echographically
      was identical to the rank order generally accepted for these steroids. This
      evaluation method of topical corticosteroid activity could be usefully employed
      besides traditional evaluation methods.

PMID- 8352954
TI  - Strength and viscoelastic properties of anisotropic rat skin after treatment with
      desmotropic drugs.
AB  - Male Sprague-Dawley rats were treated 10 times either with 2 or 10 mg/kg s.c.
      prednisolone acetate or with 300 or 1,000 mg/kg p.o. D-penicillamine or with 100
      or 300 mg/kg p.o. aminoacetonitrile bisulfate. Samples of dorsal skin were tested
      either longitudinally or perpendicularly to the body axis. Relaxation and
      hysteresis experiments were performed at different degrees of elongation.
      Finally, ultimate values were measured. In all groups, ultimate strain was much
      higher perpendicularly than longitudinally to the body axis. A dose-dependent
      increase of all parameters indicating strength or elasticity was found after
      prednisolone acetate treatment, whereas the indicators of viscosity showed a
      decrease. D-Penicillamine treatment decreased all parameters of strength and
      elasticity and increased viscosity and plasticity. Aminoacetonitrile bisulfate
      induced biphasic changes: after high-dose treatments strength and elasticity were
      increased and viscosity decreased. The results are discussed in view of changes
      of biochemical composition and cross-linking of collagen.

PMID- 8352955
TI  - Nuclear membrane dynamics.
AB  - Our understanding of nuclear membrane trafficking and protein targeting has
      increased significantly, due to newly developed assays and tools. We present a
      conceptual framework for thinking about protein targeting to the inner nuclear
      membrane, and discuss nuclear envelope assembly in terms of vesicle binding to
      chromatin, vesicle fusion, structural attachments to the inner membrane, and the
      mitotic regulation of these attachments.

PMID- 8352956
TI  - Lamin dynamics.
AB  - Nuclear lamins form a highly insoluble structure, the nuclear lamina, which is
      associated with the nuclear envelope. Recent results suggest, however, that the
      lamins are more dynamic than originally thought. They accumulate in nucleoplasmic
      foci in the G1 stage of the cell cycle and later appear mainly in the peripheral
      lamina. Some of the lamin foci are closely associated with heterochromatin.
      Furthermore, the various lamin types assemble into the lamina polymer
      independently of each other. Both the assembly and disassembly of the lamins, as
      well as the interaction of the lamins with other nuclear structures such as the
      nuclear membrane, may be mediated by phosphorylation and dephosphorylation.

PMID- 8352957
TI  - Chromosome structure inside the nucleus.
AB  - Recent in situ three-dimensional structural studies have provided a new model for
      the 30 nm chromatin fiber. In addition, research during the past year has
      revealed some of the molecular complexity of non-histone chromosomal proteins.
      Still to come is the unification of molecular insights with chromosomal
      architecture.

PMID- 8352958
TI  - Role of chromatin structure in the regulation of transcription by RNA polymerase
      II.
AB  - Recent studies on chromatin have concentrated on the relationship between its
      structure and gene activity. This topic, which addresses the fundamental
      mechanisms by which genes are expressed, has become a controversial issue, and
      the present data support the hypothesis that the structure of chromatin is an
      important component of transcriptional regulation. Notwithstanding, the
      complexity of this problem suggests that the current models are probably only a
      rough approximation of the truth.

PMID- 8352959
TI  - DNA repair.
AB  - Multiple DNA repair processes are required to maintain the integrity of the
      cellular genome. Recent advances, including elucidation of three-dimensional
      structures of DNA repair enzymes, and the cloning and characterization of DNA
      repair genes implicated in human inherited disease, have given new insights into
      the surprising complexity of cellular responses to DNA damage.

PMID- 8352960
TI  - Origins of DNA replication that function in eukaryotic cells.
AB  - This past year has seen a significant increase in our understanding of eukaryotic
      origins of replication, of the proteins that identify these origins, of DNA
      sequences that promote their unwinding, and of transcription factors that
      stimulate origin activity. DNA replication begins at specific sites in both
      simple and complex genomes, but origins in complex genomes may include nuclear
      structure as well as DNA sequence.

PMID- 8352961
TI  - Nuclear organization of pre-mRNA processing.
AB  - Recent studies have suggested that small nuclear ribonucleoprotein particles
      (snRNPs), non-snRNP splicing factors, and several heterogeneous nuclear RNP
      proteins change their organization within the cell in response to transcriptional
      activity. Several of the RNA substrates with which these factors interact have
      been shown to localize in tracks that are associated with regions in which
      splicing factors are concentrated (nuclear speckles). It is now thought that pre
      mRNA splicing may occur within these tracks.

PMID- 8352962
TI  - The role of small nuclear RNAs in RNA splicing.
AB  - Recent genetic and biochemical experiments have revealed an intimate and dynamic
      role for small nuclear RNAs (snRNAs) in multiple steps of RNA-splicing reactions.
      Both snRNA-substrate and snRNA-snRNA interactions are involved. These
      interactions concern not only splice site and branch point definition, but also
      the catalytic reactions of the first and second steps of splicing. Studies reveal
      a striking conservation between snRNA interactions and interactions found in RNAs
      encoded by genes with group II self-splicing introns.

PMID- 8352963
TI  - Regulation of gene expression by light.
AB  - The past year has seen significant advances in the biochemical, genetic and
      molecular dissection of the light signal transduction and developmental pathways
      that lead to photoregulated gene expression in higher plants. A major part of
      recent research has focused on the assignment of biological functions to the
      various photoreceptors, the genetic dissection of the photoreceptor action
      pathways, and the identification of the cis-acting sequences and trans-acting
      factors that regulate the downstream light-regulated genes.

PMID- 8352964
TI  - Tat and the HIV-1 promoter.
AB  - The HIV-1 Tat protein enhances the formation of productive RNA polymerase II
      elongation complexes, potentially acting through a positive-acting, DRB-sensitive
      elongation factor. Tat is usually recruited to the HIV-1 promoter through the Tat
      trans-activation response element RNA stem-loop structure; however, recent data
      suggest that in certain cell types it can be directed instead through upstream
      enhancer elements. New studies also reveal that the response element overlaps a
      novel motif that promotes the assembly of abortive elongation complexes in the
      absence of Tat.

PMID- 8352965
TI  - Regulation of RNA polymerase II transcription.
AB  - Transcription initiation plays a central role in the regulation of gene
      expression. Exciting developments in the last year have furthered our
      understanding of the interactions between general transcription factors and how
      these factors respond to modulators of transcription.

PMID- 8352966
TI  - Regulation of the NF-kappa B/rel transcription factor and I kappa B inhibitor
      system.
AB  - The interplay between proteins of the NF-kappa B/rel and I kappa B families is a
      tightly regulated process that ensures appropriate responses to specific
      environmental and developmental signals. Various mechanisms are utilized in
      regulating NF-kappa B/rel and I kappa B activities, some unique to this
      transcription factor system. All of these regulatory strategies converge towards
      one purpose, namely the controlled nuclear translocation of activated NF-kappa
      B/rel protein complexes. The variety of rel-related and ankyrin repeat containing
      subunits makes regulation of this system both rich and complicated.

PMID- 8352967
TI  - POU-domain proteins: structure and function of developmental regulators.
AB  - POU-domain proteins are a group of developmental regulators found in organisms as
      distant as worm and man. The sequence conservation of the POU-domain has allowed
      the characterization of increasing numbers of proteins containing the domain,
      many of which act to control the generation and maintenance of differentiated
      cell phenotypes in organs as diverse as skin and brain. Analysis of the means by
      which POU-domain proteins regulate transcription has led to a further
      understanding of how this group initiates specific developmental programs.

PMID- 8352968
TI  - Steroid and related receptors.
AB  - Steroid hormone receptors stimulate gene transcription by binding to DNA as
      homodimers, whereas many other members of the nuclear receptor family appear to
      function as heterodimers or as monomers. This is important for target gene
      recognition and, given that many of the receptors are expressed in multiple
      forms, generates many combinations of ligand-dependent transcription factors that
      regulate the expression of different genes in diverse pathways.

PMID- 8352969
TI  - Transcriptional cascades in Drosophila.
AB  - Genetics and molecular analyses have combined to yield insights into a functional
      cascade of transcription factors necessary to establish the molecular blueprint
      of the Drosophila body pattern in response to positional information in the egg.
      Recent progress in this field raises exciting questions regarding the molecular
      mechanisms involved, and their conservation in biological pattern-forming
      processes.

PMID- 8352970
TI  - Yeast transcription factors.
AB  - Studies of yeast transcription factors have contributed greatly to understanding
      basic molecular mechanisms of eukaryotic gene regulation, largely due to powerful
      genetic approaches that are unavailable in other organisms. The broad outlines of
      these mechanisms are fairly well understood, and there is an increasing number of
      examples where detailed information is available.

PMID- 8352971
TI  - Nucleus and gene expression.

PMID- 8352972
TI  - [The evaluation of cognitive deterioration in transient ischemic attacks].
AB  - We compared the degree of dementia in a group of 41 patients who, four years
      previously, had presented a first TIA with that of 31 healthy controls of similar
      age. For pathogenic diagnosis the Hachinski and Gustafson-Nilsson scales were
      applied, while mental state was evaluated by the Folstein, Blessed, GDS and CDR
      tests. We performed in all cases cerebral CT and several MR. The findings
      associated with dementia were the presence of multi-infarctions, leucoaraiosis or
      lacunes in the cerebral CT and the presentation of new ischemic episodes,
      sphincterian or gait disturbances and focal deficits. There were no differences
      with the control group in the cases only presenting one TIA. Polyglobulia was the
      only factor significantly associated with vascular dementia in these patients.

PMID- 8352973
TI  - [The application of evoked potentials to the evolutive control of continuous
      spike/wave epilepsy during slow wave sleep].
AB  - We studied 4 patients (14-21 years old) with continuous spike/wave epilepsy
      during slow wave sleep with visual evoked potentials (VEP) and somatosensory
      evoked potentials (SEP). All the patients presented the same focality and
      received the same medication (primidone plus sodium valproate). No case had
      another pathology not related with epilepsy which could alter the evoked
      potential findings. The results obtained in the initial evoked potentials were
      compared with those achieved after 5 years of treatment. In the initial study
      interhemispheric asymmetry in the latency of the early component (L.N1) of the
      SEP was observed with a mean of 10%. Five years later normal SEP were obtained
      with the asymmetry having disappeared thus leading to the deduction that the
      physiopathologic improvement found in these patients was due to the treatment of
      sodium valproate together with primidone.

PMID- 8352974
TI  - [Basic norms for the utilization of phenytoin by intravenous injection].

PMID- 8352975
TI  - [Hemiplegia in posterior cerebral artery infarctions: analysis of various
      responsible mechanisms].
AB  - When cerebral infarction determines hemiplegia or hemiparesia which accompany a
      hemilateral sensitive deficit and hemianopsia and even neuropsychologic symptoms
      (aphasic alterations in the case of injury to the left hemisphere, heminegligence
      and anosognosy in the case of injury to the right hemisphere) the involvement of
      a sylvian artery syndrome is usually considered. Nonetheless, recent
      contributions have reported that such symptoms may appear in infarctions of the
      territory of the posterior cerebral artery. Two clinical-radiologic observations
      in this line are presented. Nuclear magnetic resonance demonstrated injury to the
      posterior arm of the internal capsule in one case and in the other the lesion
      developed over three times, in the latter of which injury to the cerebral
      peduncle was produced causing hemiparesia. The authors emphasize that hemiplegia
      or hemiparesia in some infarctions of the posterior cerebral artery may be due to
      1) mesencephalic infarction in the posterior plane of the retromamillar Foix and
      Hillemand pediculum (or G. Lazorthes interpedunculum), 2) infarction or "ischemic
      penumbra" in the internal capsule by involvement of any of the perforating
      branches of the posterior cerebrum irrigating the thalamus, except for the medial
      posterior choroid artery or even of the Foix and Hillemand thalamus-tuberian
      pediculum (or Lazorthes inferior and anterior) which principally initiates at the
      posterior communicating branch with a fragment of the posterior branch of the
      internal capsule perhaps not always being under its control. In this case, the
      thrombus occupying the posterior cerebrum may extend to the cited communicating
      branch or a hemodynamic deficit may be produced in the territory of the
      same.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8352976
TI  - [The conduction of nerve impulses through MRIT2 hyperintense areas of patients
      with multiple sclerosis].
AB  - Normal nerve impulse conduction through pathological areas has been documented
      but is believed to be rare in Multiple Sclerosis (MS). We present two patients
      with clinically definite Multiple Sclerosis, Poser's type 1a, in whom evoked
      potentials (EP) and magnetic resonance imaging (MRI) were performed for
      diagnostic purposes. The first patient had normal brainstem auditory evoked
      potentials (BAER) and normal somatosensory evoked potentials (SEP) despite a
      large unilateral midbrain lesion on MRI. The second patient had normal SEP and an
      extensive lesion in the cervical spinal cord. These findings demonstrate that
      normal transmission can occur through hyperintense areas, and the rise the
      problem of nature of the lesions in Multiple Sclerosis.

PMID- 8352977
TI  - [Disseminated encephalomyelitis. A study of 5 cases].
AB  - Five cases of acute disseminated encephalomyelitis (ADE) with a follow-up longer
      than 5 years are presented. The clinical picture, CT images, MR and laboratory
      tests, specially LCR and evoked potentials presented in a variable form. In two
      cases the symptoms were preceded by viral infection. The course was acute in one
      case while the other four evolved in a subacute form during weeks. In two
      patients a pseudotumoral pattern was observed in the CT and MR images leading to
      difficulties in the diagnosis. Clinical improvement was accompanied by a partial
      resolution of the lesions. Steroid treatment improved symptomatology in all the
      cases. Knowledge of this process may avoid the unnecessary practice of other,
      more aggressive tests.

PMID- 8352978
TI  - [Pseudotumors as neurologic manifestation of Behcet disease].

PMID- 8352979
TI  - [Myoclonic encephalopathy caused by lead intoxication].

PMID- 8352980
TI  - Comparative analysis of anti-arrhythmic effect of propranolol and metoprolol in
      patients with supraventricular tachyarrhythmias.
AB  - Eighty-seven patients with paroxysmal tachydysrhythmias were submitted to
      clinical and laboratory evaluation and electrophysiologic studies were performed
      during the 3rd, 6th and 12th months of the therapy with propranolol or
      metoprolol. Metoprolol did not induce any significant change in sinoatrial
      correct time, in sinoatrial recovery time or in corrected sinoatrial recovery
      time. It decreases significantly the effective and functional AV refractory
      periods as well as increases the effective refractory period of the additional
      pathway. The mechanism of tachycardia preventing an involvement of the additional
      pathway in retrograde direction consists in the appearance of a block in the
      indicated additional pathway. The results of the humoral aspects are the
      following: propranolol inhibits the functions of the thyroid and sexual glands
      both in acute tests and in tests performed during the 3rd, 6th and 12th month of
      therapy; metoprolol has no significant effect on the functions of the thyroid and
      sexual glands; apparently, it influences the cardiac conduction system and
      myocardium directly.

PMID- 8352981
TI  - [Coronary thrombosis in patients who have died of acute myocardial infarct. A
      clinico-anatomical study of 167 successive cases].
AB  - AIM: To determine the incidence of recent coronary thrombus in a population died
      of acute myocardial infarction (AMI) and to evaluate the relation between its
      presence and some clinical parameters (age, gender, time interval between the
      onset of symptoms and death and cause of death). POPULATION AND METHODS: 167
      hearts of consecutive patients died of AMI and without thrombolytic therapy.
      Hearts were fixed in formaldehyde 10% for two weeks and then the epicardial
      coronary arteries were divided in 5 mm segments, which were examined by visual
      inspection to identify recent thrombi. Cuts for microscopical observation were
      obtained in cause of doubt. In each patients a clinical protocol with 64
      parameters is performed. In statistical treatment Pearson's dispersion test and
      Student's t test were used. RESULTS: We found coronary thrombus in the infarction
      related artery in 74%. The thrombus distribution in the epicardiac coronary
      arteries was the following: 47% in the anterior descendent artery, 27% in the
      right coronary artery, 21% in the left circumflex and 5% in the left main. The
      comparison between the groups with and without coronary thrombus showed no
      differences in age and gender, but the time interval between AMI and death was
      shorter in the group with thrombus. Concerning the different causes of death
      (cardiac failure, cardiac rupture and others) the coronary thrombus prevailed in
      the group with left ventricule free wall rupture. There was no influence of the
      time interval between AMI and death on the larger prevalence of coronary thrombus
      found in cardiac rupture. CONCLUSIONS: The frequency of recent coronary thrombus
      in the infarction related artery was of 74% in this group of patients died of AMI
      without thrombolytic therapy. The presence of coronary thrombus was not related
      with patients age or gender. The frequency of coronary thrombus was inversely
      proportional to the time interval between AMI and death, and larger in the group
      with left ventricule free wall rupture.

PMID- 8352982
TI  - [The indices of pressure variability by noninvasive ambulatory monitoring of the
      arterial pressure. A study in 2 normotensive and hypertensive populations].
AB  - OBJECTIVE: Analysis of different indices of blood pressure (BP) variability using
      the ambulatory blood pressure monitoring (ABPM) method in two populations of
      hypertensive patients (HTA Group) and normotensive volunteers (NOR Group).
      SETTING: Noninvasive prospective ambulatory study to assess the alterations of
      the circadian blood pressure profile through ABPM indices of blood pressure
      variability. PATIENTS: Patients with the diagnosis of essential arterial
      hypertension referred for clinical investigation to the Cardiology Department of
      Egas Moniz Hospital in Lisbon. MATERIAL AND METHODS: 40 hypertensive patients
      (HTA Group) and 30 normal subjects (NOR Group) were included in this study. We
      calculated the short and long term variability indices. The short term
      variability indices were the casual and mean immediate BP deviation, percentage
      of BP peaks and BP peak relative deviation and maximal range variation. Some
      clinical and general factors considered were namely age, gender, height, weight,
      body area and index, mean and casual systolic-diastolic blood pressure. RESULTS:
      Concerning systolic blood pressure in hypertension Vs normal groups respectively,
      the casual BP deviation was 15 +/- 4 mmHg and 7 +/- 4 mmHg (p 0.003), the mean
      immediate BP deviation was 18.5 +/- 4 mmHg and 7.5 +/- 3 mmHg (p 0.002), the
      percentage of BP peaks was 27 +/- 6% (p < 0.001), the percentage of BP peak area
      was 29 +/- 7% and 6 +/- 3% (p 0.001) and the percentage of relative deviation was
      14 +/- 4% and 8 +/- 3% (p 0.03). For diastolic blood pressure all differences
      were not statistically significant between the two groups and the same happened
      for systolic blood pressure in relation to standard deviation and maximal range
      variation. Among these parameters and general and clinical characteristics, the
      systolic mean and casual blood pressure level showed an acceptable correlation
      with mean immediate deviation (R = 0.54/0.49), percentage of BP peaks (R =
      0.56/0.49) and percentage of BP peak area (R = 0.60/0.53). CONCLUSIONS: Blood
      pressure variability can be adequately evaluated through the method of ambulatory
      blood pressure monitoring. Some variability indices can be extracted from the 24
      hour curves of ambulatory blood pressure monitoring. Long-term variability
      indices are not related to the level of blood pressure. In the hypertension group
      we found a greater variability concerning short term indices, namely immediate
      deviation, percentage and are of peak curve.

PMID- 8352983
TI  - [A transesophageal color-coded pulsed Doppler echocardiographic study of the
      spatial distribution of mitral regurgitation jets].
AB  - OBJECTIVE: Transesophageal echocardiographic analysis of color Doppler
      characteristics of mitral valvular regurgitation jets. DESIGN: Transesophageal
      echocardiographic prospective study. SETTING: Ambulatory patients referred to
      Echocardiographic Laboratory of Gregorio Maranon General Hospital, Madrid, Spain.
      MATERIAL AND METHODS: We studied a group of 100 consecutive patients with mitral
      regurgitation diagnosis. In each patient we calculated the degree of severity,
      percentage of wall intersection, maximal traced area, axis direction, atrial
      depth, maximal transversal diameter, perimeter and angle of the mitral
      regurgitation jet. We divided the entire population in three different groups
      according to the jet direction in central (CJ), eccentric (EJ) and wall jets
      (WJ). MAIN RESULTS: The direction of the mitral regurgitation jet was central in
      49%, eccentric in 33% and impinging the left atrial wall in 18%. The mitral
      regurgitation jet angle was in the CJ 80 +/- 11 degrees, EJ 33 +/- 10 degrees and
      WJ 6 +/- 7 degrees. Maximal mitral regurgitant traced area in CJ was 732 +/- 104
      mm2, EJ was 593 +/- 110 mm2 and WJ was 267 +/- 80 mm2. Maximal regurgitant jet
      depth in CJ was 36 +/- 17 mm, EJ 30 +/- 15 mm and WJ 49 +/- 14 mm. The perimeter
      of the mitral regurgitation jet in the CJ was 87 +/- 22 mm, EJ was 68 +/- 22 mm
      and WJ was 92 +/- 30 mm. CONCLUSIONS: Color Doppler quantification criteria are
      not useful in all patients with mitral regurgitation jets. The presence of atrial
      walls close to the mitral regurgitation jet area is an important factor in the
      mitral regurgitation color Doppler evaluation.

PMID- 8352984
TI  - [Pheochromocytoma--apropos a clinical case].
AB  - A case of a 43-year-old woman with severe sustained hypertension resistant to
      many antihypertensive drugs, frequent hypertensive crisis and symptoms suggestive
      of pheochromocytoma (symptomatic triad) is presented. Three of the four
      determinations of the urinary catecholamines metabolites have been normal as it
      was the only determination of plasmatic catecholamines. Abdominal sonography and
      CT scan detected a left adrenal mass, that have been histologically confirmed,
      after surgery, to be a pheochromocytoma. After adrenalectomy, the patient
      symptoms disappeared but she maintained mild hypertension easily controlled with
      drugs. The finding of normal plasmatic and urinary catecholamines values in a
      patient with sustained hypertension may suggest that we are handling with a case
      of essential hypertension and a superimposed pheochromocytoma with paroxysmal
      secretion. Some considerations are made essentially about specificity and
      sensitivity of diagnostic tests.

PMID- 8352985
TI  - [Hemolytic anemia in the malfunction of a mitral bioprosthesis].
AB  - Valvular cardiac prosthesis have dramatically altered the prognosis of patients
      with valvular cardiac disease; however, they are not free of complications.
      Prosthesis disfunction and problems related to anticoagulation are the more
      common, but hemolytic anemia should also be considered. In this case, hemolytic
      anemia appears as the major complication of a mitral bioprosthesis; the decision
      concerning the presentation of this case report rests upon its rarity and
      peculiar circumstances of appearance. A brief revision of the diagnostic work-up
      is also made.

PMID- 8352986
TI  - [Ketanserin as antioxidant].
AB  - Free radicals have been related to the pathogenesis of some cardiovascular
      diseases. Several drugs used to treat these diseases were shown to have
      antioxidant properties. Our purpose was to evaluate if ketanserin, a selective S2
      receptor antagonist with proven antihypertensive efficacy and which beneficially
      affects hemorheology, also is able to inhibit lipid peroxidation. Lipid
      peroxidation was induced in different biological systems in vitro and evaluated
      by the formation of thiobarbituric acid-reactive products. Ketanserin 50 microM
      inhibited copper-dependent lipid peroxidation in human red-cell suspensions by
      40.8% and the subsequent hemolysis by 57,3%. It was less efficient in inhibiting
      hydrogen peroxide-dependent lipid peroxidation and hemolysis in the same system.
      Ketanserin 100 microM inhibited lipid peroxidation induced by a mixture of
      copper(II) and hydrogen peroxide in hepatic microsomal suspensions and in brain
      total homogenates by 86.2% and 56.7%, respectively. These results proved an
      antioxidant effect for ketanserin which was unknown, although its therapeutic
      relevance remains undetermined.

PMID- 8352987
TI  - [A double ambulatory product (blood pressure and heart rate), mild arterial
      hypertension and left ventricular hypertrophy].
AB  - OBJECTIVE: Analysis of the different ambulatory blood pressure monitoring derived
      parameters in terms of cardiac structural repercussion, in patients with isolated
      systolic and mild systolic-diastolic hypertension. SETTING: Prospective study
      involving simultaneously the two-dimensional echocardiographic technique and the
      ambulatory blood pressure monitoring method. PATIENTS: Out patients regularly
      observed in the Cardiology Department of Egas Moniz Hospital in Lisbon, were
      included in our study. MATERIAL AND METHODS: We studied 50 hypertensive patients
      who fulfilled the inclusion criteria of our study (Group H) and 20 subjects who
      were the normal aged matched population (Group N). through ambulatory blood
      pressure monitoring, in each individual of these two groups, we considered the
      mean values of daily systolic blood and diastolic blood pressure, heart rate and
      ambulatory heart rate blood pressure product. Through two-dimensional
      echocardiography we calculated the left ventricular mass and the correspondent
      index corrected for the body surface. RESULTS: In the H group an comparing to the
      N group, the mean value of the daily systolic blood pressure was 112 +/- 6 mmHg
      and 159 +/- 8 mmHg (p < 0.001) respectively, diastolic blood pressure was 60 +/-
      5 mmHg and 75 +/- 7 mmHg respectively (p < 0.001), heart rate blood pressure
      product was 6720 +/- 580 and 12561 +/- 678 (p < 0.0001) and of the left
      ventricular mass index was 109 +/- 10 gm2 and 145 +/- 7 g/m2 (p < 0.001). The
      correlation coefficient between the left ventricular mass index and mean
      systolic, diastolic blood pressures and ambulatory heart rate blood pressure
      product was 0.60 (p < 0.01), 0.45 (p = NS) and 0.73 (p < 0.001) respectively.
      CONCLUSIONS: In the evaluation of the increase in left ventricular mass,
      ambulatory heart rate blood pressure product is a more accurate parameter
      compared to the mean daily blood pressure values. Ambulatory blood pressure
      monitoring is a method with a great potential and clinical application, when
      studying patients with hypertension diagnosis.

PMID- 8352988
TI  - [Myocardial fibrosis--the theoretical bases, clinical aspects and therapeutic
      implications].
AB  - A review on the present knowledges of the myocardial structure, with particular
      emphasis on the collagen network and its degradation/synthesis process was
      performed. Myocardial fibrosis and cardiac remodeling concepts are analysed,
      explaining them in the context of ventricular hypertrophy, arterial hypertension,
      myocardial remodeling in ischemic heart disease and cardiac remodeling in the
      aged. We also review the role of the renin-angiotensin-aldosterone system in
      myocardial fibrosis, as well as the results of preventing action of angiotensin
      converting enzyme inhibitors and aldosterone antagonists in myocardial fibrosis
      and consequent cardiac remodeling in the animal experimentation. Clinical and
      therapeutic implications of this knowledge are discussed as well as therapeutic
      implication in man, in view of recent studies.

PMID- 8352989
TI  - [In memoriam Dr. A. Chorao de Aguiar].

PMID- 8352990
TI  - [Cochlear pathology following chronic electrical stimulation in cats].
AB  - This study is to follow the faults during safe research of chronic electrical
      stimulation of auditory nerve. They were surgical trauma; electrode excursion
      from scala tympani in different periods after insertion, direct current trauma to
      the cochleas during chronic electrical stimulation due to the stimulator fault.
      Extensive histopathological changes were observed, including widespread hair cell
      and spiral ganglion loss and new bone growth. These results have important
      implications both in the use and design of cochlear prostheses.

PMID- 8352991
TI  - [Kanamycin ototoxicity and melanin in the inner ear].
AB  - In order to clarify the relationship between ototoxicity of aminoglucoside and
      inner ear melanin, we have undergone observations on the cochleas of albino and
      pigmented guinea pigs with surface preparation, paraffin section. SEM and ECochG
      following chronic administration of kanamycin. The damage in the pigmented animal
      was more serious than that of the albino ones. It seems that the cochlea of the
      pigmented animal is more susceptible to kanamycin than that of the albino ones.
      It suggests that melanin may be implicated in the ototoxicity of aminoglucoside
      antibiotics that might be due to its capacity to take and accumulate the drug.

PMID- 8352992
TI  - [Reinnervation of posterior cricoarytenoid muscle: a comparison of nerve
      implantation and neuromuscular pedicle transfer in an animal model].
AB  - Recently, methods of reinnervating posterior cricoarytenoid muscle (PCA) have
      been reported by many authors. This study was undertaken to compare direct
      implantation (NI) of a branch of the ansa cervicalis supplying the sternothyroid
      muscle with the transfer of a neuro-muscular pedicle of the ansa cervicalis
      innervating the sternothyroid muscle (NMP) in a denervated PCA dog model. Both
      were carried out immediately after denervation. The results showed that
      reinnervation with return of physiological function of PCA were got by both
      methods of nerve transfer. The NMP was apparently superior to the NI. The reason
      was that the NMP implanted more motor end-plates into the denervated PCA. So the
      NMP should be chosen first when possible. The NI is consistently effective when
      NMP is not available.

PMID- 8352993
TI  - [Evoked otoacoustic emission behavior in clinical sensorineural hearing loss].
AB  - The present study revealed a significantly higher EOAE incidence in subjects with
      sensorineural hearing loss of unknown causes (81.82%) than in those with tumor of
      the cerebellopontine angle (42.86%), sudden deafness (41.38%) and equilibrium
      disorders (50%). EOAEs had been detected in some ears with mean pure-tone hearing
      threshold across 0.5, 1 and 2 kHz above 40 dB HL. For subjects with sensorineural
      hearing loss of unknown causes, the correlation coefficient between the mean
      hearing threshold and EOAE detection threshold amounted to only 0.40. It seems
      that EOAEs are related primarily to the nature of hearing loss rather than simply
      to pure-tone audiometric behavior.

PMID- 8352994
TI  - [Relation between pure tone audiometry and speech audiometry in various hearing
      impaired listeners].
AB  - Pure tone audiometry and speech audiometry were performed in 30 normal-hearing
      listeners and 75 listeners suffering from conductive, sensorineural hearing loss
      or presbyacusia. The results were as follows: (1) For listeners with conductive
      or mild sensorineural hearing loss, or with mild presbyacusia, the difference
      between speech reception thresholds (SRT) and pure tone averages (PTA) was not
      significant (P > 0.05). (2) For listeners with profound sensorineural hearing
      loss or presbyacusia, the SRT were about 10 dB greater than the PTA. (3) The
      maximum discrimination score (PBXax) measurements should be made at a comfortable
      intensity for each listener, some 30 dB above the SRT in general. We conclude
      that the PTA can replace the SRT directly for the listeners described in (1) or
      that the PTA, by adding 10 dB, can also be used as a replacement of the SRT for
      the listeners described in (2).

PMID- 8352995
TI  - [Transcranial resection of tumors involving nose, paranasal sinuses and anterior
      skull base].
AB  - Two cases of low-grade malignancies involving extensively the nose, paranasal
      sinuses, and anterior skull base were treated with transcranial resection and
      simultaneous repair of the dura as well as reconstruction of the skull base. The
      results appeared satisfactory. The advantages include: (1) much better cosmetic
      effect than the combined craniofacial resection. (2) almost equally full surgical
      exposure. (3) reliable repair and reconstruction of the anterior skull base with
      elimination of severe intracranial complications.

PMID- 8352996
TI  - [Study on lipid peroxides contents and superoxide dismutase activity in blood
      serum of elderly patients with head and neck carcinomas].
AB  - The LPO contents and SOD activity were measured in blood serum of 110 elderly
      patients with head and neck carcinomas. The results showed that the LPO contents
      and SOD activity between the patients and control group (P < 0.01, P < 0.05) and
      the LPO contents between the metastatic group and non-metastatic group (P < 0.01)
      were significantly different. The LPO contents ascended (P < 0.01) by the 5th day
      and descended (P < 0.01) by the 14th day after operation. The relation between
      the occurrence and metastasis of the carcinoma and the LPO contents and SOD
      activity in blood serum was discussed.

PMID- 8352997
TI  - [Pharyngo-gastric anastomosis].
AB  - Thirteen cases of laryngo-pharyngo-cervical oesophagus carcinoma were treated by
      pharyngo-gastric anastomosis and total laryngectomy. All patients after operation
      could swallow. The five-year survival rate was 1/4, three-year survival rate was
      3/7 and one-year survival rate 9/13. We suggest that resection of pharyngo
      laryngo-esophageal, carcinoma with removal of all the pathological lesions and
      pharyngo-gastric anastomosis is the best way for the prophylaxis of recurrence
      when the carcinoma involves the cervical esophagus. Furthermore, due to the high
      tendency of metastasis to neck lymph nodes in the early stage of the carcinoma,
      neck dissection should be performed during operation. The advantages of pharyngo
      gastric anastomosis are wide indication and good blood supply.

PMID- 8352998
TI  - [The manifestation and significance of vimentin-9 in the otosclerotic stapes].
AB  - Vimentin-9 is a special marker for identification of fibroblast. By the avidin
      biotin-peroxidase complex staining method, monoclonal anti-vimentin-9 was used to
      observe the role of fibroblasts in the development of otosclerosis. The results
      showed that fibroblasts were involved in the ossification process of the
      otosclerrotic lesions. Hence, the monoclonal anti-vimentin-9 might be an
      objective marker to identify the type and the developmental tendency of the
      otosclerotic process.

PMID- 8352999
TI  - [Changes of cochlear electrical activities in early experimental hydrolabyrinth].
AB  - Changes of endocochlear potential (EP), cochlear microphonic potential (CM) and
      summating potential (SP) were studied in guinea pig cochlea after four weeks
      blockade of the endolymphatic sac and duct. The EP, CM and SP were measured with
      a microelectrode through the spiral ligament of the first turn. EP was decreased
      by 15%. The minimum CM output produced by tone burst of six frequencies (0.5, 1,
      2, 4, 5 and 8 KHz) had reduced by 83.1%, 82.4%, 84.5%, 84.2%, 47.2% and 54.2%
      respectively, and the maximum CM output had declined by 54.3%, 41%, 43.2%, 21.1%,
      26% and 24% separately. The minimum SP output caused by 4, 5 KHz tone burst had
      declined by 62.4% and 70.5%, and the maximum SP output had decreased by 41.5%,
      45.2% in the early experiments. These results indicate that EP, CM and SP all
      underwent decreases. The extent of CM declination at low frequencies was larger
      than that at the high frequencies in the early experiments. The mechanisms of
      influence on EP, CM and SP in early experimental endolymphatic hydrops are
      discussed.

PMID- 8353000
TI  - NHS Efficiency Index: acute sector primacy yet again.

PMID- 8353001
TI  - The health care experience and health behaviour of the Chinese: a survey based in
      Hull.
AB  - Lack of knowledge about the health care experience and health behaviour of an
      important ethnic minority group prompted a study to inform the provision of
      health care and promote local action in Hull. Thirty Chinese 'takeaway' shops
      were randomly selected from the Yellow Pages of the Hull telephone directory, and
      all Chinese people working in them asked to complete a questionnaire. It
      contained questions on their knowledge, use and experience of primary health care
      and health promotion, together with aspects of their health behaviour. The same
      questionnaire in English was delivered to all workers in 30 fish and chip shops,
      to provide a White comparison group. Eighty (71 per cent) of the Chinese returned
      their questionnaire, and 73 (67 per cent) were returned from the chip-shop
      workers. The results indicate that the Chinese in Hull are not making optimal use
      of health services; they use some services inappropriately, whereas others, such
      as preventive health programmes, are under-used. One of the main reasons is
      identified as the language/communication difficulties faced by many Chinese.
      Other reasons are also highlighted and their implications discussed. The findings
      of this survey are in keeping with the mainly unpublished work undertaken
      elsewhere on this comparatively little researched ethnic minority group.

PMID- 8353002
TI  - Small area analysis: abortion statistics.
AB  - Small area analysis has developed over the last two or three decades as a useful
      tool in health services research, as it allows the identification of areas within
      health or local authority districts with high rates of morbidity and mortality,
      and thus provides a useful base for planning the delivery of health services. A
      profile was compiled for Liverpool Family Health Services Authority on planned
      parenthood in the Liverpool District, with the aim of identifying where resources
      are needed most - which parts of the City, and which groups of women, are most in
      need. The profile included an analysis of various outcome measures, including
      abortion statistics, which can be used as a guide to the apparent effectiveness
      of services. Using a combination of statistics on NHS abortions for electoral
      wards, and private abortions by postal district, it became apparent that, on the
      whole, areas of high NHS induced abortion rates also have high private (British
      Pregnancy Advisory Service; BPAS) induced abortion rates, and vice versa. The
      maps for NHS and BPAS abortion rates suggest that total abortion rates are high
      in City centre wards, and low in areas south of the City. This would suggest that
      there are differences in social factors, family planning provision, and other
      factors which are influencing abortion rates. Although available indicators would
      suggest that City centre wards are in greatest need of improved family planning
      provision, these are the wards which are relatively well provided with health
      authority family planning clinics.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353003
TI  - What price public aviaries?

PMID- 8353004
TI  - Social and behavioural predictors of women's cancer screening practices in
      Northern Ireland.
AB  - The aim of this study was to describe the extent of cancer screening practices
      among women resident in Northern Ireland and to identify the social and
      behavioural characteristics associated with these practices. The study involved a
      survey of adults resident in the community in Northern Ireland. Contact was made
      with a sample of 1162 residents who were asked to complete a questionnaire about
      preventive health practices and attitudes. This produced a response rate of 65.1
      per cent. Of these, 391 were women who were asked questions about breast self
      examination (BSE), attendance for cervical screening, and certain social and
      behavioural factors. Approximately 28 per cent of the women performed BSE
      regularly, a further 28 per cent performed it occasionally, and the remainder
      rarely or not at all. Almost 20 per cent of the women had had a smear test once,
      48 per cent several times, and the rest never. Performance of BSE and attendance
      for smear tests and BSE was more common among those women aged 35-54 years, who
      were married, worked outside the home, and whose religion was Church of Ireland
      (Anglican). The most frequent reason given for not performing BSE was fear of
      finding a lump and ignorance of the procedure. The most frequent reason given for
      non-attendance for a smear test was that it was not thought necessary at their
      age. Public health strategies designed to promote cancer screening need to
      consider the value of directing their campaigns at those who are most reluctant
      to perform these practices.

PMID- 8353005
TI  - Population screening for abdominal aortic aneurysm: do the benefits outweigh the
      costs?
AB  - To prevent the high mortality rate associated with ruptured abdominal aortic
      aneurysm (AAA), population screening at or soon after retirement age has been
      advocated, with elective operations being performed on patients with the
      appropriate indications. There is considerable pressure on some health
      authorities to fund such programmes even though there is substantial uncertainty
      about the consequent benefits. The ultrasound screening test is acceptable and
      accurate. Also, other health problems may be detected in the same screen.
      However, screening would lead to a questionable increase in surgery, as most
      patients with AAA die from other causes and not from a ruptured aneurysm. In
      addition, there is an elective operative mortality of around 5 per cent.
      Furthermore, as many of those who have a positive result on screening would never
      have known that they harbour an aneurysm, there is the possibility of unnecessary
      anxiety arising from the test. An economic analysis has been conducted for two
      identical, hypothetical cohorts of men using the best available data. One cohort
      was assumed to undergo screening and a number of men were indicated for immediate
      elective aneurysm repair or for follow-up, and surgery if their aneurysms become
      large. The other cohort was assumed not to be screened and would thereby face the
      possibility of rupture with its adverse outcome. The survival prospects of the
      two cohorts were calculated as life expectancies and in terms of life-years: the
      incremental life-years gained were compared with the incremental costs of the
      programme. Although there are considerable uncertainties in the analysis
      parameters, the base-line result and sensitivity analysis indicate that, on the
      basis of current knowledge, population screening should not be introduced.

PMID- 8353006
TI  - Are deprivation indicators a proxy for morbidity? A comparison of the prevalence
      of arthritis, depression, dyspepsia, obesity and respiratory symptoms with
      unemployment rates and Jarman scores.
AB  - The aim of the study was to examine the relationship between specific areas of
      morbidity measured using validated survey questions and deprivation indicators to
      see if the latter could act as a proxy in health needs assessment, health service
      planning and resource allocation in a typical health authority. A postal
      questionnaire was used to provide information about arthritis, depression,
      dyspepsia, obesity and respiratory symptoms in a simple random sample from the
      study population. The questions were from survey instruments that have been
      widely used to derive information about these conditions. The relationships
      between the prevalence of these specific areas of morbidity and both unemployment
      and the Jarman Underprivileged Areas Score were explored. Spearman's rank
      correlation coefficients were calculated and compared for each combination of
      measures. The study population was a random sample of the residents of each of
      the 22 electoral wards in Rotherham Health Authority. Responses were obtained
      from 82 per cent of the 5000 sampled. Although all morbidity measures showed
      positive correlations with both Jarman score and unemployment, some, notably
      those relating to respiratory disease and depression, were much more strongly
      correlated than others, such as obesity. There was no difference between
      unemployment and Jarman score in respect of the magnitude of the correlation
      coefficients. In conclusion, for some, but not all, conditions socio-economic
      measures are a good proxy for morbidity. Unemployment is just as useful a proxy
      as the Jarman score.

PMID- 8353007
TI  - Accidental injury attendances as predictors of future admission.
AB  - A case-control study was carried out in Nottingham Health District, to establish
      whether children under five years of age admitted to hospital after a accidental
      injury were more likely to have previously attended the accident and emergency (A
      & E) department than community controls. The subjects were 342 case-control pairs
      matched on sex and date of birth, consisting of children under five years
      resident in the Health District, and the main exposure measures were attendance
      at the A & E department before the case's first admission, type of injury and
      number of earlier attendances. It was found that, after adjusting for social
      deprivation score and proximity to hospital, children who had been admitted after
      an accidental injury were twice as likely to have attended the A & E department
      than community controls, and were more likely to have had more than one earlier
      attendance. Odds ratios were significantly raised for soft-tissue injuries and
      lacerations. It is concluded that accidental injuries in pre-school children that
      require attendance at the A & E department predict accidental injuries requiring
      admission. Making attendances at A & E departments notifiable to health visitors
      would facilitate the undertaking of accident prevention work.

PMID- 8353008
TI  - The process of evaluation of a new technology: genetic services and the
      introduction of DNA probes.
AB  - This paper gives a summary of the main results and recommendations, contained in
      reports for the Department of Health, of an evaluation of the introduction of DNA
      probes in the service activity of clinical genetics. The reports analysed cost
      and benefits of this technology, the potential demand for its use, the
      characteristics of the families referred to the service in terms of social and
      geographical distribution, the relative impact of DNA probes on the work-load of
      services in comparison with other activities, and the communication skills
      required by geneticists in relation to patients and other colleagues. However,
      the major element of this paper is the discussion of issues related to the
      process of evaluation. There has recently been discussion about ways to improve
      dissemination of results of health services research. We discuss here the major
      barriers that public health physicians and health service researchers need to
      address when playing the role of independent evaluators of services or new
      technologies. During the course of the evaluation of DNA testing, major changes
      occurred in the NHS. The evaluator will have to consider not only the costs and
      effectiveness of the new technology, but also how the findings are interpreted by
      the providers within the constraints of the new organizational structure.

PMID- 8353009
TI  - Death certification by house officers and general practitioners--practice and
      performance.
AB  - The objective of this study was to assess the knowledge, attitudes and behaviour
      of House Officers and General Practitioners (GPs) in relation to death
      certification, to determine the scope for future intervention. A postal
      questionnaire was used to survey all House Officers (174) and a 10 per cent
      random sample of GPs (131) in Mersey Region. The main outcome measures were:
      death certification experience; knowledge, attitudes and behaviour in relation to
      data uses and coding; and acceptability of Cause of Death statements. Response
      rates were comparable-119/174 House Officers (68.4 per cent) and 95/131 GPs (72.5
      per cent). Most House Officers (78.8 per cent) and GPs (85.3 per cent) reported
      that they made the best possible Cause of Death statement but, respectively, 62.4
      per cent and 59.3 per cent of these might modify a statement in some
      circumstances. Significantly more House Officers (70.3 per cent) than GPs (44.2
      per cent) acknowledge room for improvement and were amenable to more training
      (86.6 per cent versus 52.5 per cent), but significantly fewer felt sufficiently
      instructed (23.7 per cent versus 52.6 per cent). Most respondents (> 90 per cent)
      considered accurate death certification important, but 46.2 per cent of House
      Officers had not read the death certificate book instructions. Knowledge was
      variable, especially concerning Underlying Cause of Death. Written Cause of Death
      statements were broadly similar in style and standard between groups. Experience
      did not appear to improve death certification practice. Better and co-ordinated
      undergraduate and early post-graduate education (which should be continuing and
      audited), and practical accessible guidance on death certificate completion,
      might improve standards of practice and performance within the existing
      framework. Alternative methods of presenting guidance on death certificate
      completion should be explored.

PMID- 8353010
TI  - Quarterly communicable disease review October to December 1992. From the PHLS
      Communicable Disease Surveillance Centre.

PMID- 8353011
TI  - PL(92)CO/4-neuro and ophthalmic surgery procedures on patients with or suspected
      to have, or at risk of developing, Creutzfeldt-Jakob disease (CJD), or Gerstmann
      Straussler-Scheinker syndrome (GSS)

PMID- 8353012
TI  - Neuro and ophthalmic surgery procedures on patients with or suspected to have, or
      at risk of developing, Creutzfeldt-Jakob disease (CJD), or Gerstmann-Straussler
      Scheinker syndrome (GSS)

PMID- 8353013
TI  - Colorectal cancer screening.

PMID- 8353014
TI  - The new Part I MFPHM examination.

PMID- 8353015
TI  - General practitioners, skin lesions and the new contract.

PMID- 8353016
TI  - Urban-rural health differences.

PMID- 8353017
TI  - [Immunogenetic factors in the onset of experimental tumors].
AB  - The influence of immunological and genetic factors on the appearance of
      experimental tumors has been studied in mice by means of bidirectional selection.
      We found that the incidence of lymphomas, solid tumors and chronic nephritis is
      greater in mice selected for low antibody response than in mice selected for high
      antibody response. These findings suggest that the genes that control the
      antibody response also regulate life-span and resistance to neoplastic and
      inflammatory diseases. Similarly, we are carrying out bidirectional selective
      breeding to obtain two lines of mice, one sensitive and one resistant to the
      induction of cutaneous papillomas by chemical carcinogens. The two lines differ
      notably in terms of both percent of incidence and tumor multiplicity. The results
      of this study demonstrate clearly that resistance and susceptibility to
      carcinogenesis are subject to polygenic control.

PMID- 8353018
TI  - [The pharmacological therapy of glomerulonephritis].
AB  - Clinical and experimental studies have markedly expanded our understanding of the
      causes of renal disease. Although they have not resulted in comparable
      therapeutic advances, new lines of treatment have emerged which cannot be
      underestimated. The prognosis of lipoid nephrosis has been substantially
      modified. The treatment of membranous glomerulonephropathy with steroids and
      immunosuppressive drugs may modify the course of the disease, at least in a
      subset of patients with decreased and deteriorating renal function. Encouraging
      results have been reported after the use of inhibitors of platelet aggregation in
      mesangiocapillary glomerulonephritis. We have demonstrated that a receptor
      antagonist of thromboxane can significantly influence the renal functional
      parameters in patients with lupus nephritis. ACE-inhibitors, cyclosporine and
      NSAID's have proved useful in reducing nephrotic proteinuria. Lipid lowering
      agents are able to ameliorate the glomerular lesions in experimental models of
      renal injuries. Since systemic hypertension may initiate the development of renal
      disease or accelerate loss of function in the kidney in which parenchymal disease
      is already established, controlling hypertension by any effective means helps to
      slow the progression of renal failure. Preliminary reports have suggested that
      there may be advantages to using ACE-inhibitors and/or calcium entry blockers.

PMID- 8353019
TI  - [Arterial hypertension in the black race].
AB  - Hypertension represents a major health problem for black populations living in
      Western countries. In particular, blacks living in the United States have a three
      to fivefold greater mortality from hypertensive disease than do whites. Better
      knowledge of the pathophysiology of hypertension in blacks can aid in the
      treatment of recently urbanized black people coming to Italy from African
      countries. Hypertension occurs more frequently in blacks than in whites, due to
      increased volemia; this characteristic seems to be related to a genetically
      determined increase in sodium sensitivity. Environmental factors seem to play a
      relevant role. Several studies performed on blacks migrating from rural to urban
      areas both in Africa and the USA, have shown that urbanization is closely related
      to increased blood pressure. The occurrence of cardiac and cerebrovascular
      complications of hypertension also seems to be closely related to socioeconomic
      factors. In fact, recently immigrated black people often lack health care
      facilities and consequently have poor control of hypertension. The environmental
      factors could be overcome by implementing systems to improve health care
      facilities, in particular blood pressure control, for recently urbanized blacks.

PMID- 8353020
TI  - [Osteoporosis and fractures: a review of current therapies].
AB  - The authors examine the effects of different drugs used in osteoporosis therapy
      for the primary and secondary prevention of fractures. They base their review on
      prospective randomized studies; retrospective studies are included only if a
      consistent number of subjects has been examined. Their methodological
      characteristics are illustrated, and results with significant levels and 95%
      confidence intervals are reported. Only hormone replacement therapy and salmon
      calcitonin have been demonstrated as able to prevent vertebral and non-vertebral
      fractures. Vitamin D and its analogues seem to be effective only in elderly
      patients, although conclusive data are lacking. With regard to bisphosphonates,
      only data on vertebral fractures are presently available. Results from fluoride
      studies are still very inconclusive, and, in fact, lead to the hypothesis of a
      fracture-promoting effect. At present, no data on ipriflavone are available.
      Considerably more research is necessary to define the efficacy of different
      treatment protocols for fracture prevention. Each therapeutic proposal for
      osteoporosis should be supported by data on its efficacy in reducing the
      incidence of fractures. Not always, in fact, is an absolute increase of bone mass
      followed by the effective prevention of fractures. At this time, only estrogens
      and calcitonin have been demonstrated as able to reduce fracture incidence.

PMID- 8353021
TI  - [Hypothyroid myopathy in a young adult].
AB  - We describe here the case of a young man admitted to our department for asthenia
      and diffuse myalgia. Because of persistently increasing aminotransferase levels
      over the preceding 2 years, he had undergone a number of diagnostic procedures to
      evaluate liver function. On admission to our department, the patient suffered
      from asthenia, myalgia, notable hair loss and sinus bradycardia. Laboratory
      examinations confirmed severe primary hypothyroidism with high serum levels of
      aminotransferase, aldolase and creatine-phosphokinase attributable to thyroprivic
      myopathy. The thyroid deficit was caused by autoimmune atrophic thyroiditis.
      Treated with levothyroxine, the patient recovered fully from his illness, his
      normal metabolic state was restored, and his serum aminotransferase level
      returned to normal.

PMID- 8353022
TI  - Dialysis and transplant patients in the long term.
AB  - The history of renal replacement therapy is traced from the early days of
      dialysis and kidney transplantation through the era of miraculous technology and
      the alleged certainties of anti-rejection therapy. Attention is focused on the
      newly found or anomalous biotypes that are common to both dialysis and
      transplantation. In dialysis not only the patient but also uremia is maintained
      and either hyper- or hyporeactivity in different biological systems may occur
      with or without clinical symptoms. In transplantation, while the balance between
      immunomodulation and immunotolerance is far from ideal, extrarenal complications
      may occur with an atypical mode of presentation, serious immunological renal
      lesions may develop asymptomatically and clinical signs of rejection may appear
      without noticeable laboratory alterations.

PMID- 8353023
TI  - [The autocrine-paracrine modulation of natural killer activity in man by peptides
      of the corticostatin-defensin family].
AB  - Corticostatins (CS)-defensins are a family of peptides recently isolated from
      neutrophils and cells of myeloid lineage. They have been termed CS in that
      members of the family inhibit ACTH-induced steroidogenesis, and defensins in that
      they are highly effective as enhancers of intracellular killing of pathogens.
      Natural killer (NK) cells are an immunocyte subset whose cytotoxic activity is
      modulated by lymphokines and hormones. Recent evidence suggests a myeloid origin
      for these cells. We evaluated whether two human CS-defensins, HP-1 and HP-4, are
      able to modulate in vitro spontaneous NK cell activity of human peripheral blood
      mononuclear (PBM) cells and in vitro susceptibility to the stimulatory effect by
      immune interferon (IFN-gamma) or interleukin 2 (IL-2) and to the inhibitory
      effect of cortisol. PBM cells were incubated for 20 h with HP-1 or HP-4 and IFN
      gamma or IL-2 or cortisol. NK cell activity was measured in a 4-h direct
      cytotoxicity assay (K562 cells as a target). We also searched for CS-defensins in
      NK-enriched cell preparations by means of HPLC separation of the supernatant
      obtained from sonicated cells. HP-1 and HP-4 significantly inhibited both
      spontaneous and lymphokine-inducible NK cell activity, and potentiated cortisol
      dependent inhibition. Radioimmunoassay on HPLC purified fractions demonstrated
      the presence of HP-1 in NK-enriched cell preparations. Our data indicate that HP
      1 and HP-4 are negative modulators of NK cell cytotoxicity and that
      autocrine/paracrine mechanisms are conceivably involved. HP-1 production by NK
      cells may be viewed as additional support for the thesis of the myeloid origin of
      these immune effectors.

PMID- 8353024
TI  - [The gastric anatomico-functional aspects (parietal cell mass, stimulated acid
      secretion and gastrinemia) in pernicious anemia].
AB  - We present here a study of parietal cell mass, stimulated acid secretion and
      basal gastrinemia both in the course of isolated chronic atrophic gastritis of
      the body-fundus and in chronic atrophic gastritis of the body-fundus associated
      with pernicious anemia. Analysis of our results evidences an overlapping cyto
      secretory profile characterized by hypoparietalism with hypo-achlorhydria. The
      higher basal gastrinemia levels in pernicious anemia depend on the histological
      status of the antral mucosa--which was always normal in the patients with
      pernicious anemia--rather than any substantial morpho-functional differences of
      the body-fundus. We thus conclude that the term "atrophic gastritis" should be
      abolished, and that the term "chronic atrophic gastritis" be used to describe
      both conditions.

PMID- 8353025
TI  - [Sodium-modulating hormones and the pressor response to sodium chloride in
      essential arterial hypertension].
AB  - Some predictive markers for NaCl sensitivity, related to the red blood cell
      membrane or to circulating proteins, have already been described in human
      essential hypertension. The present study was planned to investigate whether or
      not some hormones produced by the kidney or acting at the kidney level could be
      used as new markers for NaCl sensitivity. The study was conducted in 28 not
      previously treated outpatients affected by uncomplicated mild to moderate
      essential hypertension. After 15 days on a normal NaCl diet, plasma renin
      activity (PRA), plasma atrial natriuretic peptide (ANP), and the urinary
      excretion of active kallikrein were evaluated. The sensitivity of blood pressure
      to changes in NaCl intake was then assessed in all patients, according to a
      randomized double blind cross-over design. Each patient was assigned to a high
      (240 mmol of NaCl/day for 15 days) or low (40 mmol of NaCl/day for 15 days) NaCl
      intake. During the assessment of NaCl sensitivity, the double blindness was
      achieved by the use of capsules containing either NaCl or placebo. Fifteen
      patients (11 males and 4 females) resulted as NaCl-sensitive, while 13 patients
      (8 males and 5 females) were classified as NaCl-resistant. Our results indicate
      that PRA levels were significantly lower in the NaCl-sensitive group than in the
      NaCl-resistant one (0.108 +/- 0.05 ng/L/s vs 0.247 +/- 0.16 ng/L/s, p < 0.007),
      in the presence of raised levels of plasma ANP in NaCl-sensitive hypertensives
      (18.08 +/- 4.61 fmol/mL vs 12.45 +/- 3.77 fmol/mL, p < 0.006).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8353026
TI  - [Current advances in various aspects of chronic obstructive bronchopneumopathy
      and in the pathogenesis of bronchial asthma].
AB  - The continuing interest of researchers in chronic obstructive pulmonary disease
      (COPD) is due not only to its increasing socio-economic impact, but also to the
      rapid advances made in the comprehension of various mechanisms of this disease,
      advances made feasible chiefly by a broader interdisciplinary approach to the
      subject. The most significant progress has been made through the study of
      bronchial asthma: researchers have confirmed that a particular inflammation of
      the bronchial mucosa is the common feature of all asthmatic syndromes. IgE
      antibodies specific for allergens as well as Th2 type T cells seem to play a
      central role in allergic bronchial asthma. Other types of T cells producing
      different combinations of cytokines, chiefly IL-5, may be involved in the
      pathogenesis of intrinsic and professional asthma. It is hoped that this recently
      gained knowledge will enable improvement in the prevention and therapy of asthma
      and other COPD syndromes.

PMID- 8353027
TI  - Expanded programme on immunization (EPI). Reassessment of the neonatal tetanus
      problem.

PMID- 8353028
TI  - Potential years of life lost before age 65, 1990 and 1991.

PMID- 8353029
TI  - Update: International Task Force for Disease Eradication. 1992.

PMID- 8353030
TI  - Expanded programme on immunization (EPI). Poliomyelitis eradication activities in
      Shandong Province.

PMID- 8353031
TI  - Mass vaccination campaigns to control the 1991-1992 poliomyelitis outbreak.

PMID- 8353032
TI  - Helix pomatia and prognosis of breast cancer.

PMID- 8353033
TI  - Current statistical issues in clinical cancer research.

PMID- 8353034
TI  - Surrogate endpoints.

PMID- 8353035
TI  - Involvement of RET oncogene in human tumours: specificity of RET activation to
      thyroid tumours.
AB  - Non-thyroid neoplasia were analysed by Southern blot of genomic DNA and DNA
      prepared by reverse transcription and amplification by polymerase chain reaction
      (RT/PCR) for the activation of the RET oncogene. It is known that the
      rearrangement of RET occurs in about 10%-20% of human thyroid papillary
      carcinomas. None of 528 non-thyroid tumours showed rearrangement of the RET proto
      oncogene, whereas three out of 30 thyroid papillary carcinomas were positive for
      RET activation. Therefore the activation of RET seems to be a somatic cell
      mutation specific to human thyroid carcinomas.

PMID- 8353036
TI  - Interleukin-1 beta and interleukin-6 release by peripheral blood monocytes in
      head and neck cancer.
AB  - In patients with advanced head and neck squamous cell carcinoma (HNSC), evidence
      of cell-mediated immunity and monocyte functional abnormalities has been
      reported. We studied the production of interleukin 1 beta (IL-1 beta) and
      interleukin 6 (IL-6) by peripheral blood monocytes from 22 patients with HNSC (12
      larynx and ten oral cavity cancers) in comparison with monocyte cytokine
      production of age-matched healthy subjects. Pure monocytes were incubated with
      and without lipopolysaccharides (LPS) (10 micrograms ml-1) for 4 h at 37 degrees
      C and IL-1 beta and IL-6 concentrations were determined in supernatants by
      specific ELISA. There was no significant difference in IL-1 beta levels in
      monocyte supernatants from cancer in comparison to control subjects; conversely,
      a higher IL-6 production by unstimulated and LPS-activated cells from HNSC
      patients than from controls was found. No relationship was observed between
      cytokine production and cancer stage. The regression analysis evidenced a
      significant correlation between IL-1 beta and IL-6 monocyte-release in HNSC
      patients and in controls, so suggesting a possible autocrine control of IL-6
      production by other cytokines.

PMID- 8353037
TI  - Haematological toxicity of carboplatin and cisplatin combined with whole body
      hyperthermia in rats.
AB  - Acute haematological toxicity induced by cis-diammine-1,1-cyclobutane
      dicarboxylate platinum (II) (carboplatin) and cis-diamminedichloroplatinum (II)
      (cisplatin) in combination with whole body hyperthermia (WBH) (2 h at 41.5
      degrees C) was examined using a F344 rat model. The thermal enhancement ratios
      (TERs) of drug-mediated thrombocytopenia, anaemia and leukopenia were determined
      from the dose-response curves of the nadir values of the peripheral platelet, RBC
      and WBC counts. Carboplatin produced profound depression of platelet counts which
      was over three-fold greater than cisplatin (14% vs 51% of the control), while the
      decrease in WBC and RBC counts induced by carboplatin did not differ
      significantly from those observed with cisplatin. These carboplatin or cisplatin
      mediated haematological toxicities were significantly enhanced by WBH. The depth
      of decrease in platelet, RBC and WBC counts induced by the maximum tolerated dose
      (MTD) of carboplatin (30 mg kg-1) combined with WBH was identical to that induced
      by the MTD of carboplatin (70 mg kg-1) alone. The TERs of carboplatin-mediated
      thrombocytopenia, anaemia and leukopenia were 2.0, 2.8 and 1.9, respectively. The
      thermal enhancement of cisplatin mediated haematological toxicity was similar to
      that of carboplatin, with TERs of 1.8 for thrombocytopenia, 2.4 for anaemia and
      1.9 for leukopenia. These data, demonstrating thermal enhancement of cisplatin or
      carboplatin-mediated haematological toxicity, must be taken into account in the
      clinical application of the combination therapy of platinum and WBH.

PMID- 8353038
TI  - Growth of cultured human glioma tumour cells can be regulated with histamine and
      histamine antagonists.
AB  - The 50% survival time for low grade astrocytomas is 50 months and for high grade
      astrocytomas it is 13 months, underlining the need for new therapies. Several
      reports show that in vivo histamine antagonists cause retardation of tumour
      growth in some animal models and prolonged survival in cancer patients. Therefore
      we have tested the growth modulating effects of histamine and histamine
      antagonists on human glioma cultures. Twelve freshly excised human gliomas were
      cultured and tested for their in vitro sensitivity to histamine and histamine
      antagonists. Four continuous glioma cell lines were used to confirm the glioma
      specificity of the effects observed in the primary cell lines. In low serum
      concentration (0 or 1%) the growth of 5/9 primary glioma-derived cultures could
      be stimulated with 0.2 mM histamine, and in 4/5 cases with 0.2 microM histamine.
      One mM of the histamine H2-receptor antagonist cimetidine could inhibit the
      growth of 4/5 primary glioma cultures when tested in 1% human AB serum, and of
      6/13 cases when tested in 1% FCS. Lower concentrations (down to 1 microM) were
      less effective. The histamine H1-receptor antagonist pyrilamine gave variable
      results. The specificity of the effects is indicated by the absence of a
      generalised toxic effect, by the observation that the antagonist-induced
      inhibition could be reversed with histamine, and by the correlation of the
      obtained cimetidine-induced growth inhibition with the maximal growth rate of the
      primary cell lines in 10% FCS. The observed cimetidine-induced inhibition of the
      in vitro proliferation of gliomas suggests that cimetidine is a relevant
      candidate for the in vivo growth inhibition of these tumours.

PMID- 8353039
TI  - pH in human tumour xenografts: effect of intravenous administration of glucose.
AB  - pH frequency distributions of tumours grown s.c. from 30 human tumour xenograft
      lines in rnu/rnu rats were analysed with the use of H+ ion-sensitive semi
      microelectrodes prior to and following stimulation of tumour cell glycolysis by
      i.v. infusion of glucose. At normoglycemia, the average pH of the tumours
      investigated was 6.83 (range, 6.72-7.01; n = 268). Without exception, all
      xenografts responded to the temporary increase in plasma glucose concentration
      (PGC) from 6 +/- 1 to 30 +/- 3 mM by an accumulation of acidic metabolites, as
      indicated by a pH reduction to an average value of 6.43 (range, 6.12-6.78; n =
      292). This pH value corresponds to a ten-fold increase in H+ ion activity in
      tumour tissue as compared to arterial blood. Tumour pH approached minimum values
      at 2-4 h after the onset of glucose administration and could be maintained at
      acidic levels for 24 h by controlled glucose infusion. Irrespective of pH
      variations between tumours grown from individual xenograft lines, there was no
      major difference in pH response to glucose between the four main
      histopathological tumour entities investigated, i.e. breast, lung and
      gastrointestinal carcinomas, and sarcomas. In tumours from several xenograft
      lines, an increase in blood glucose to only 2.5-times the normal value (14 mM)
      was sufficient to reduce the mean pH to 6.4. Glucose-induced acidosis was tumour
      specific. The pH frequency distributions in liver, kidney and skeletal muscle of
      tumour-bearing rnu/rnu rats were only marginally sensitive to hyperglycemia
      (average pH, 6.97 vs normal value of 7.14). Tumour-selective activation of pH
      sensitive anti-cancer agents, e.g. alkylating drugs, acid-labile prodrugs or pH
      sensitive immunoconjugates may thus be feasible in a wide variety of human
      cancers.

PMID- 8353040
TI  - Intra-tumoral heterogeneity of tumour potential doubling times (Tpot) in
      colorectal cancer.
AB  - Intra-tumoural heterogeneity of proliferation has been assessed by taking
      multiple biopsies from 30 colorectal cancers. Following in vivo IUDR labelling,
      dual parameter flow cytometry was used to measure tumour DNA index (DI) and
      labelling index (LI) and to derive DNA synthesis time (Ts) and potential doubling
      time (Tpot). Heterogeneity was seen for all parameters under investigation.
      Overall coefficients of variation (CV) and logarithmic transformation of Ts and
      Tpot (due to their non-gaussian distributions) indicate that LI (CV 25%) was the
      most variable parameter. Intra-tumoral heterogeneity in Tpot (lnTpot CV = 22%)
      was less than inter-individual variation (CV = 63%), suggesting that this
      variation should not be a limitation to the possible usefulness of this technique
      as an independent prognostic indicator. Correlations of Tpot values were examined
      between the shortest, the median and the value for a pooled homogenate sample
      from a single tumour. Using an homogenate, it was possible to accurately predict
      classification of tumour Tpot values as being below the median ('fast tumours')
      in 15 of 19 cases (79%). The data suggest that assaying an homogenate may allow a
      more rapid analysis of a multiply sampled tumour.

PMID- 8353041
TI  - Loss of cell-cell and cell-matrix adhesion molecules in colorectal cancer.
AB  - Adhesion molecules are thought to play a vital role in the induction and
      maintenance of tissue differentiation and their loss or down-regulation has been
      implicated in the neoplastic process. Recent studies have shown that the
      morphoregulatory activities are a consequence of interactive processes between
      several cell adhesion molecules rather than the function of a single molecule.
      Therefore, we have investigated a panel of adhesion molecules including members
      of the integrin, cadherin and immunoglobin superfamily in colorectal cancer.
      Twenty-eight consecutive colorectal adenocarcinomas were stained using an avidin
      biotin indirect immunoperoxidase technique. Our results showed a consistent loss
      of the alpha 2 and beta 1 integrin subunits (21/28 = 75% and 22/28 = 78.6%
      respectively) and a decrease in expression of E-cadherin in 5/5 poorly
      differentiated adenocarcinomas. Carcinoembryonic antigen expression was preserved
      but with basolateral accentuation seen in tumours. There was no statistical
      correlation with Dukes' stage. These results provide further evidence that in
      colorectal cancer there is a widespread deregulated expression of cell-cell and
      cell-matrix adhesion molecules. Changes in the expression and function of
      adhesion molecules which regulate growth and differentiation may play a role in
      the behaviour of colorectal cancer.

PMID- 8353042
TI  - Enhancement by thyroxine of gastric carcinogenesis induced by N-methyl-N'-nitro-N
      nitrosoguanidine in Wistar rats.
AB  - The affects of L-thyroxine (T4) on the incidence and histology of gastric cancers
      induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), and on the labelling
      index of gastric mucosal epithelial cells were investigated in Wistar rats. After
      oral treatment with MNNG for 25 weeks, the rats received s.c. injections of T4
      (0.2 microgram kg-1) in depot form every other day until the end of the
      experiment in Week 52. This long-term treatment with T4 significantly increased
      the incidence of gastric cancers in Week 52. However, it did not influence the
      histological type of the gastric cancers. It also caused significant increases in
      the labelling indices of the fundic and antral epithelial cells. These findings
      indicate that T4 enhances the development of gastric cancers, and that its effect
      may be related to its effect in increasing proliferation of gastric epithelial
      cells.

PMID- 8353043
TI  - Retinoic acid receptors in retinoid responsive ovarian cancer cell lines detected
      by polymerase chain reaction following reverse transcription.
AB  - The growth inhibitory effects of all-trans and 13-cis retinoic acid (RA) and of
      the synthetic retinoids TTNPB, TTNPB-ethylester and TTNN were studied on seven
      human epithelial ovarian cancer cell lines and one ovarian teratocarcinoma cell
      line. Six of seven ovarian adenocarcinoma cell lines were inhibited in their
      growth by RA and by synthetic retinoids in a dose dependent manner. No response
      to these substances was observed for the ovarian teratocarcinoma cell line. The
      knowledge that RA and retinoids exert their action on the cells via nuclear
      receptors led us to examine the expression of RAR-alpha, -beta and -gamma mRNA by
      these cell lines by polymerase chain reaction following reverse transcription.
      All cell lines expressed RAR-alpha and -gamma mRNA and six of the eight cell
      lines were found to express additionally RAR-beta mRNA, among them the ovarian
      teratocarcinoma cell line. Our data indicate that there was no direct association
      between the presence of RAR subtype transcripts and the response to retinoids in
      ovarian cancer cell lines.

PMID- 8353044
TI  - Bioavailability and feasibility of subcutaneous 5-fluorouracil.
AB  - Continuous intravenous (i.v.) infusion of 5-fluorouracil (5-FU) has been shown to
      be superior to bolus regimens in terms of response rates and toxicity. However, a
      continuous infusion is more expensive and prone to complications such as
      thromboembolism and infections. A way to circumvent these problems would be to
      administer 5-FU subcutaneously (s.c.). To assess feasibility and bioavailability
      of s.c. 5-FU, eight patients with advanced cancer received 250 mg 5-FU as an
      infusion over 90 min either intravenously (i.v.) or s.c. into the abdominal wall.
      The mean +/- s.d. bioavailability of s.c. 5-FU was 0.89 +/- 0.23. The
      interpatient variability for the area under the plasma concentration-time curve
      was 48% for the s.c. and 36% for the i.v. infusion. No local side effects were
      observed. To test the local tolerance of a more prolonged administration three
      patients received 930-1,000 mg m-2 5-FU by 24-h continuous s.c. infusion. The
      steady-state plasma levels were comparable to i.v. infusion. One patient
      developed a painless skin pigmentation at the s.c. infusion site. However, the
      same reaction was observed at the forearm after i.v. infusion. We conclude that
      at the dose studied s.c. 5-FU has an almost complete bioavailability and is well
      tolerated. Further work will show, whether prolonged s.c. infusion can be used as
      a safe and economical alternative to i.v. infusion.

PMID- 8353045
TI  - Scintigraphic evaluation of functional hepatic mass in patients with advanced
      breast cancer.
AB  - Recent studies suggest a high specificity of 99mTc-galactosyl neoglycoalbumin
      (99mTc-NGA) receptor scanning in vivo by providing both morphological and
      functional diagnosis of liver disease. In 22 patients with advanced breast cancer
      99mTc-NGA (150 MBq; 50 nmol) was exclusively trapped by the liver, the images
      showing 'cold spots' in areas of liver metastases formation. A two-tailed
      analysis was performed: the time activity curves recorded for the liver and
      precordial area were subjected to a kinetic receptor-calculating model allowing
      an estimation of the NGA-receptor concentration of the liver (i.e. hepatic
      binding protein, HBP) as well as calculation of the residual functional liver
      volume (RFLV) via the S.P.E.C.T.-study. In breast cancer patients with liver
      metastases a significantly (P < 0.01) lower HBP-concentration was estimated (0.65
      +/- 0.16 vs 0.82 +/- 0.17 mumol l-1) as evidenced by a lower 99mTc-NGA
      accumulation in the liver resulting also in a significantly (P < 0.001) lower
      RFLV (739 +/- 348 vs 1336 +/- 184 ml). In four amonafide-treated patients (800 mg
      m-2 intravenous infusion over 3 h) approximately one week after one chemotherapy
      cycle a significant (P < 0.05) increase in HBP-concentration (0.56 +/- 0.10 vs
      0.72 +/- 0.06 mumol l-1) of the liver was found corresponding with an increase in
      RVLF (546 +/- 297 vs 670 +/- 265 ml). These regulatory mechanisms at the HBP
      level measured in vivo provide further evidence that 99mTc-NGA should have
      promise as a clinically useful receptor radiopharmaceutical for both
      quantification of liver function and assessment of liver morphology.

PMID- 8353046
TI  - A phase I study of prolonged continuous infusion of low dose recombinant
      interleukin-2 in melanoma and renal cell cancer. Part II: Immunological aspects.
AB  - Previously we described the clinical aspects of a phase I study of prolonged
      continuous infusion of low-dose recombinant interleukin-2 (rIL-2). In the present
      paper we report several immunological effects in 13 patients with melanoma and
      renal cell cancer treated on an out-patient basis with rIL-2 for uninterrupted
      periods ranging from 5 to 18 weeks. Groups of three patients were treated at
      following dose levels 0.18, 0.6, 1.8 or 6 x 10(6) IU m-2 24 h-1 and one patient
      was treated with 3 x 10(6) IU m-2 24 h-1. Prolonged rIL-2 treatment resulted in a
      dose-dependent and sustained increase in the percentage and absolute number of
      (CD56+, CD8dim) natural killer cells. Within this population a preferential
      increase in the CD56bright cells with low expression of CD16 was observed. The
      CD27 antigen was also upregulated in the CD56bright CD16dim population. This
      increase of NK cells was accompanied by an enhancement of the cytotoxic capacity
      of the peripheral lymphocytes. No consistent signs of T cell activation or
      expansion were noted.

PMID- 8353047
TI  - Oral contraceptives and breast cancer in northern Italy. Final report from a case
      control study.
AB  - To assess the relation between oral contraceptive (OC) use and breast cancer, we
      analysed data from a case-control study conducted in Northern Italy between 1983
      and 1991 on 2,309 cases below age 60 and 1,928 controls admitted to hospital for
      acute diseases unrelated to OC use and to any of the known or potential risk
      factors for breast cancer. OC use was reported by 16% of cases and 14% of
      controls. The multivariate relative risk (RR) for ever vs never use of
      combination OC was 1.2 (95% confidence interval (CI) 1.0-1.4). However, there was
      no trend in risk with duration. The RR was elevated for very short use, but
      declined to 0.8 (95% CI = 0.5-1.0) for five or more years' use. No noteworthy
      relationship was found for other major measures of OC use, although RR estimates
      were above unity for women who had stopped use less than 5 years before (RR =
      1.5, 95% CI = 1.1-2.0), started use less than 10 years before (RR = 1.3, 95% CI =
      1.0-1.9), started when 25 or more years old (RR = 1.4, 95% CI = 1.1-1.7), or
      after first birth (RR = 1.2, 95% CI = 1.0-1.5). No interaction was observed
      between OC use and family history of breast cancer, parity and age at first
      birth. A separate analysis of 373 cases and 456 control below age 40 showed no
      association with ever use (RR = 0.9, 95% CI = 0.6-1.2).

PMID- 8353048
TI  - Past and present physical activity and endometrial cancer risk.
AB  - We examined the relation between physical activity and endometrial cancer using
      data from a multicentre case-control study involving 405 endometrial cancer cases
      and 297 population controls. Estimates of recreational (i.e. active sport, walks
      and hikes) and nonrecreational activity (i.e. house cleaning, climbing stairs and
      walking or standing on the job) were obtained using interview information. After
      adjustment for age, study area, education, parity, years of use of oral
      contraceptives, years of use of menopausal oestrogens and cigarette smoking,
      recent recreational inactivity was associated with increased risk (RR = 1.9 for
      lowest vs highest tertile). Similarly, recent nonrecreational inactivity was
      associated with increased risk (RR = 2.2 for lowest vs highest tertile). Further
      adjustment for body mass and nonrecreational activity attenuated the association
      between risk and recent recreational inactivity (RR = 1.2; 95% CL = 0.7-2.0) but
      adjustment for body mass and recreational activity did not alter the association
      between risk and recent nonrecreational inactivity (RR = 2.0; 95% CL = 1.2-3.1).
      To evaluate the relation between risk and sustained inactivity, we simultaneously
      examined activity levels at three periods (RR i.e. age 20-29, age 30-39 and
      recently) in women age 50 and older. After adjustment for potential confounders
      and body mass, risk was elevated among women who were always recreationally
      inactive (RR = 1.5 for always active vs always inactive) and among women who were
      always nonrecreationally inactive (RR = 1.6 for always active vs always
      inactive). This study suggests that physically inactive women may be at increased
      risk of endometrial cancer because they are more likely to be overweight or
      obese. Our data also suggest that inactivity per se may be associated with an
      increased risk of endometrial cancer. However, we cannot rule out the possibility
      that our results, particularly those for nonrecreational activity, reflect
      unmeasured confounding factors. Future studies should attempt to obtain more
      detailed assessments of physical activity, including the intensity with which an
      individual engaged in an activity and the actual time involved in exertion.

PMID- 8353049
TI  - Depletion of circulating cyst(e)ine by oral and intravenous mesna.
AB  - The sulfhydryl status of normal and tumour cells is critically important in
      determining their susceptibility to various cytostatic agents. As a sulfhydryl
      compound, mesna (sodium 2-mercaptoethane-sulfonate) which is used in large doses
      to prevent haemorrhagic cystitis associated with certain chemotherapeutic
      regimens might derange cellular thiol homeostasis. In order to investigate the
      effects of mesna on the concentrations of thiols in plasma, cysteine, glutathione
      and their disulfides were measured by HPLC following the oral and intravenous
      administration of mesna to healthy volunteers. After 7.3 mmol mesna i.v. free
      cysteine rose from 8.2 (95% CI 7.0-9.4) nmol ml-1 to 53.6 (47.4-59.8) nmol ml-1
      at 5 min, most likely due to reduction of circulating cystine by the sulfhydryl
      drug. This initial rise was followed by a marked decrease of total cyst(e)ine in
      plasma from 276 (215-337) nmol ml-1 to a nadir of 102 (89-115) nmol ml-1 between
      30-120 min after infusion, most likely due to an increased uptake of cysteine
      into cells and an increased urinary excretion of cyst(e)ine. Qualitatively
      similar changes were seen after oral mesna. The present data indicate that mesna
      depletes circulating cyst(e)ine and may thereby markedly alter the sulfhydryl
      status of cells in vivo although the drug itself is not taken up by most cells.

PMID- 8353050
TI  - EPIC: an effective low toxicity regimen for relapsing lymphoma.
AB  - We have treated 40 patients was relapsed or resistant lymphoma with the
      combination of Etoposide, Prednisolone, Ifosfamide and Cisplatin (EPIC). Complete
      response was obtained in 11 patients (28%) with an overall response of 58%. The
      presence of bulky disease (P < 0.005), elevated LDH serum levels (P < 0.005),
      response to prior chemotherapy (P < 0.01) and B symptoms (P < 0.005) were
      significantly associated with response. However on multivariate analysis only the
      presence of bulky disease and of B symptoms were independent adverse factors for
      response and for survival. The regimen was well tolerated with myelosuppression
      being the most common toxicity. Leucopenia < or 1,000 microliters-1 and
      thrombocytopenia < or = 25,000 microliters-1 developed in 27% and 4% of cycles
      respectively. There were no treatment related deaths. The EPIC regimen has
      equivalent activity to other reported cisplatin based regimens used in the
      treatment of recurrent lymphoma, but is associated with lower treatment related
      morbidity and mortality.

PMID- 8353051
TI  - Primary carcinoma of the fallopian tube--a retrospective analysis of 115
      patients. Austrian Cooperative Study Group for Fallopian Tube Carcinoma.
AB  - Incidence and prognostic factors of primary carcinoma of the Fallopian tube were
      studied in a retrospective multi-centre analysis of 115 women during the period
      1980 to 1990. Data of 28 departments (university as well as general hospitals)
      were included in the present study which was designed to evaluate the current
      diagnosis and treatment of carcinoma of the Fallopian tube in Austria, and to
      compare the results with those from the literature. Stages were classified
      according to the modified FIGO-system for ovarian cancer; grading followed the
      criteria of Hu et al. (1950). The mean age of the patients was 62.5 years. Forty
      seven (40.9%) tumours were found to be in stage I, 20 (17.4%) in stage II, 34
      (29.6%) in stage III, and 14 (12.1%) in stage IV. In 82 patients, the tumour
      could be completely removed. The surgical method applied in 95 cases was removal
      of the uterus, the adnexa, and/or the omentum, or lymph nodes. Postoperatively
      patients underwent adjuvant therapy which was either irradiation (n = 40; 34.8%),
      or chemotherapy (n = 49; 42.6%); 26 women (22.6%) had no therapy after operation.
      The 5-year survival rate for all stages was 36.5%. In stages I and II the 5-year
      survival was 50.8% compared to 13.6% in stages III and IV. FIGO-stage I and II
      and a residual tumour less than 2 cm in advanced disease had a prognostically
      favourable impact, which was proven in univariate as well as multivariate
      analysis.

PMID- 8353052
TI  - The absence of Harvey ras mutations during development and progression of
      squamous cell carcinomas of the head and neck.
AB  - We have examined the incidence of Harvey ras mutations in human squamous cell
      carcinomas (SCC) of the upper aerodigestive tract using the polymerase chain
      reaction (PCR) followed by direct sequencing. No mutations were detected at
      codons 12, 13, 59 or 61 of this gene in any of six papillomas, five
      erythroplakias, 56 squamous cell carcinomas, and 16 SCC cell lines. Some of the
      SCC were lymph node metastases (three) or tumours which had recurred following
      radiotherapy (seven). We conclude that Harvey ras mutations are not a common
      event in the pathogenesis or recurrence of SCCs from Caucasian subjects, in
      contrast to the situation with Indian populations (Saranath et al., 1991).

PMID- 8353053
TI  - A meta-analysis of studies of dietary fat and breast cancer risk.
AB  - There is strong evidence that breast cancer risk is influenced by environmental
      factors, and animal experiments and human ecological data suggest that increased
      dietary fat intake increases the incidence of the disease. Epidemiological
      evidence on the relationship of dietary fat to breast cancer from cohort and case
      control studies has however been inconsistent. To examine the available evidence
      we have carried out a meta-analysis to summarise quantitatively the large
      published literature on dietary fat in the aetiology of breast cancer. After
      assembling all of the published case control and cohort studies, we extracted the
      relative risk in each study that compared the highest to the lowest level of
      intake. We then calculated a summary relative risk for all studies. The summary
      relative risk for the 23 studies that examined fat as a nutrient was 1.12 (95% CI
      1.04-1.21). Cohort studies had a summary relative risk of 1.01 (95% CI 0.90-1.13)
      and case control studies a relative risk of 1.21 (95% CI 1.10-1.34). Summary
      estimates of risk for specific types of fat excluded unity for only saturated
      fat. For the 19 studies that examined food intake, the summary relative risks
      were 1.18 (95% CI 1.06-1.32) for meat, 1.17 (95% CI 1.04-1.31) for milk, and 1.17
      (95% CI 1.02-1.36) for cheese. Summary relative risks for total fat intake were
      examined for several potential modifying factors. Regression analysis showed that
      European studies were more likely than studies done in other countries to show an
      increased relative risk associated with dietary fat and breast cancer, after
      taking into account potential modifying factors that included study design and
      quality.

PMID- 8353054
TI  - Expression of pepsinogen C in human breast tumours and correlation with
      clinicopathologic parameters.
AB  - We have examined by immunohistochemistry the ability of breast carcinomas to
      produce pepsinogen C, an aspartyl proteinase usually involved in the digestion of
      proteins in the stomach. A total of 113 out of 245 breast tumours (46%) were
      positive for pepsinogen C immunostaining. There was a significant association
      between pepsinogen C and oestrogen receptors with proteinase levels higher
      (HSCORE) in oestrogen receptor positive tumours than in oestrogen receptor
      negative. There was also a significant association between pepsinogen C and
      histological grade, pepsinogen C levels being higher in well and moderately
      differentiated breast carcinomas than in poorly differentiated tumours. On the
      basis of these results, we suggest that pepsinogen C may be useful as a marker of
      good prognosis in breast cancer.

PMID- 8353055
TI  - A phase II and pharmacokinetic study with oral piritrexim for metastatic breast
      cancer.
AB  - Piritrexim is a lipid-soluble antifolate which, like methotrexate, has a potent
      capacity to inhibit dihydrofolate reductase. We performed a multicentre phase II
      study with piritrexim in patients with locally advanced or metastatic breast
      cancer. Twenty-four patients of which sixteen had received prior chemotherapy,
      were initially treated with 25 mg piritrexim orally administered trice daily for
      four days, repeated weekly, with provision for dose escalation or reduction
      according to observed toxicity. Of twenty-one patients evaluable for tumour
      response, one patient achieved a partial response which lasted for 24 weeks.
      Three patients had stable disease during 12 weeks of treatment, seventeen had
      progressive disease. Pirtrexim was generally well tolerated, in eighteen patients
      the dose could be escalated. Myelotoxicity was the most frequent observed
      toxicity of this piritrexim regimen. Leucopenia and thrombocytopenia grade 3/4
      occurred in 38% of the patients sometime during treatment. Pharmacokinetic
      analysis of piritrexim in three patients during the first treatment cycle,
      revealed peak levels 1 to 2 h after an oral dose, with a trend towards a higher
      peak plasma levels and AUCs on the fourth dosing day compared with the first
      dosing day. In conclusion, orally administered piritrexim appears to be a regimen
      with little activity in patients with locally advanced or metastatic breast
      carcinoma.

PMID- 8353056
TI  - The relationship between students' behaviour at home and attention and
      achievement in elementary school.
AB  - In this study a model is proposed in which attention in the classroom is supposed
      to mediate the relationship between home background factors and achievement in
      school. Home background factors in the study were the socioeconomic status of the
      parents (SES) and the amount of problem behaviour of the child at home. The
      latter was supposed to be an indicator of the adequacy of parental discipline
      practices. For attention a distinction is made between a behavioural component
      termed attentional behaviour, and a cognitive component termed attention
      regulation. The effects of attention were studied for two domains of achievement,
      namely reading comprehension and arithmetic. The model was tested by means of
      structural equations modelling in a sample (N = 376) of 9-year-old children
      attending grade 6 of regular elementary schools in the Netherlands. The results
      showed that attention can be considered as an important mediator between home
      problem behaviour and achievement in school. The absence of problem behaviour at
      home had a substantial positive relationship with attention, the latter having
      moderate effects on arithmetic achievement and reading comprehension. No effects
      of SES on attention were found. Distinguishing between attentional behaviour and
      attention regulation, it appeared that the latter is equally related to both
      types of achievement. Interestingly, however, classroom attentional behaviour was
      more closely related to arithmetic achievement than to reading comprehension.
      Finally, SES appeared not to be related to arithmetic achievement but exerted a
      small direct effect on reading comprehension.

PMID- 8353057
TI  - Proximate causes of aggressive fighting in middle school children.
AB  - In study 1, 8- and 11-year-old girls and boys (N = 110) were interviewed
      individually and asked about why children in general, and themselves in
      particular, fight with fellow pupils in the playground. A substantial proportion
      of children (51 per cent) reported having had at least one aggressive fight
      during the previous year. The most common reasons for children resorting to
      fighting were retaliations to teasing, retaliations to unprovoked assaults,
      disagreements over aspects of the game that was being played, because another
      child was disliked, and to settle dominance disputes. In study 2, a direct
      observational methodology was employed to examine how often children of these
      ages engage in aggressive fighting, how long fights last, and their proximate
      causes. Among the younger pupils, a large proportion of fights (43.3 per cent)
      had no obvious immediate cause to an adult observer, but others were caused when
      a playful assault received an aggressive retaliation (15.4 per cent), and by
      disputes over space in the playground (13.5 per cent). Among the 11-year-old
      pupils, a smaller percentage of fights (14.8 per cent) had no obvious immediate
      cause. The two most common causes of fighting at this age were aggressive
      retaliations to teasing (25.9 per cent) and aggressive retaliations to accidental
      injury/hurt (18.5 per cent). In study 3, in situ interviews were combined with
      direct playground observations in order to reveal participants' views (or
      onlookers' views if participants were not available to be interviewed) about the
      causes of fights. Again, the most common causes of fighting were disputes over
      some aspect of the game being played (33.3 per cent), aggressive retaliations to
      teasing (25.0 per cent), disagreements over possession of toys/equipment (14.6
      per cent), and aggressive retaliations to accidental injury/hurt (14.6 per cent).
      Age and sex differences are reported in some measures across all three studies.
      The results are discussed in terms of their implications for interventions aimed
      at improving children's experiences of life on the school playground.

PMID- 8353058
TI  - Using the child behaviour checklist in ordinary primary schools.
AB  - The study considers the application of the Child Behaviour Checklist (Achenbach &
      Edelbrock, 1986) to the identification of children with emotional and behavioural
      difficulties in ordinary primary schools. Teachers provided checklist data on a
      sample of 320 boys and 118 girls previously referred to the schools psychological
      services and a further 183 boys and 39 girls who had not been referred. There was
      a high level of agreement between referred and non-referred student status and
      subsequent classification using the CBCL criteria for psychiatric disturbance. An
      analysis of variance was carried out to determine how far teacher expectations
      may contribute to CBCL scores. The results indicated that teacher differences
      within schools are more important than the differences which exist between
      teachers working in different schools. The results support the validity of the
      CBCL. The future application of the CBCL in ordinary schools is discussed.

PMID- 8353059
TI  - Stress levels, gender and personality factors in teachers.
AB  - The study reports an investigation of stress levels, gender and personality
      dimensions in a sample of school teachers. The Professional Life Stress Scale
      (PLSS) was used to assess teachers' stress levels and the Eysenck Personality
      Questionnaire (EPQ) was used to define their personality dimensions (Extroversion
      Introversion, Neuroticism-High Psychoticism-Low Psychoticism). The study sample
      consisted of 95 teachers, 51 females and 44 males. Results revealed that the
      majority of teachers sampled, 72.6 per cent, were experiencing moderate levels of
      stress, and 23.2 per cent serious levels. T-test results showed no significant
      difference between male and female teachers in stress levels. Correlation
      analysis between stress level and personality dimensions revealed significant
      positive correlation between stress and psychoticism. A significant negative
      correlation emerged between stress and extroversion, and a significant positive
      correlation between stress and neuroticism. A multiple regression analysis
      revealed that extroversion and neuroticism were the best predictors of stress
      levels. Overall, the results therefore indicated that personality dimensions
      appear to contribute more to stress levels than do the variables of either age or
      gender.

PMID- 8353060
TI  - Teacher stress and cognitive style.
AB  - The aim of the study was to investigate the relationship between the teacher's
      cognitive style and occupational stress. A sample of 212 teachers in Maltese
      secondary schools completed a questionnaire surveying both the level of overall
      stress and the severity of four major areas of job stress. They were also given
      the Cognitive Styles Analysis which assesses two fundamental dimensions of
      cognitive style, wholist-analytic and verbal-imagery. For the top and bottom 25
      per cent of the sample with extreme style characteristics, self-reported teacher
      stress was not related to style in a simple manner. However, style interacted
      significantly with teacher age. With regard to the four major areas of
      occupational stress, significant variations in the levels of stress were observed
      with style: whereas Analytics reported greater stress than Wholists for 'pupil
      misbehaviour' and 'poor working conditions', the converse was true for 'poor
      staff relations' and 'time pressures'.

PMID- 8353061
TI  - A developmental study of specific spelling disability.
AB  - Previous studies have identified a group of individuals with specific problems in
      spelling, and compared them to a group with problems in reading and spelling.
      Those who are poor at reading and spelling are thought to have more severe
      underlying language problems. This study compared the cognitive abilities of
      three groups of children: one specifically spelling disabled, one spelling and
      reading disabled, and one control group without reading or spelling problems. The
      groups were identified at age 14. A five-year retrospective analysis of their
      performance revealed that both of the disabled groups had been significantly
      poorer than the controls, not only in spelling but also in reading. Both the
      disabled groups showed other signs often associated with dyslexia such as poor
      WISC-R Coding and Digit Span. Analyses of their spelling errors did not reveal
      the superior phonetic abilities which some other studies have found to
      differentiate specifically spelling disabled from reading + spelling disabled
      groups. The specific spelling disabled group did show some evidence of
      superiority in Verbal IQ subtests. These results are consistent with the idea
      that specific spelling disability is a residual problem of individuals who,
      possibly by means of underlying verbal strengths, have managed to compensate for
      earlier reading difficulties.

PMID- 8353062
TI  - The effect of cognitive style and mode of presentation on learning performance.
AB  - The effect of text-plus-text versus text-plus-picture computer presentation
      conditions, and the students' cognitive styles, on learning performance was
      investigated. In the text-plus-text condition, the learning material content
      described the working of car braking systems. The text-plus-picture condition
      consisted of text with additional pictorial information. Fifty-nine 15-16-year
      old students in a secondary school were randomly assigned, within sexes, to one
      of the conditions. Having worked through the computer presented material, they
      were given a post-test overall learning performance. Immediately following this,
      they did the Cognitive Styles Analysis (CSA) (Riding, 1991) which measures an
      individual's position on two cognitive style dimensions; Verbal-Imagery and
      Wholist-Analytic. It was found that the Verbal-Imagery cognitive style and
      presentation condition interacted in their effect on overall learning performance
      (p < .05). In the text-plus-picture condition Imagers were superior to
      Verbalisers, while the text-plus-text condition Verbalisers did better than
      Imagers. It was also observed that Imagers used more diagrams to illustrate their
      answers than Verbalisers. The results are discussed in terms of their
      implications for instruction.

PMID- 8353063
TI  - Affective factors and learning behaviour in secondary school mathematics and
      English lessons for average and low attainers.
AB  - This study had two broad aims; firstly, to investigate the predictive
      relationships between i) overall subject affective factors (attitude and
      subjective norm), ii) specific lesson factors (behaviour intention, perceived
      preventive factors and self efficacy) and iii) learning behaviour during lessons;
      and secondly, to investigate the consistency of these affective factors across
      English and maths, and whether there were differences between average and low
      attaining pupils in these affective factors. Twenty-eight boys and girls, aged 11
      14 years, in an inner city comprehensive school were assessed for these factors
      in two subjects over two occasions. It was found that neither attitude nor
      subjective norm were consistently predictive of intentions. The lesson specific
      factors (behaviour intention, preventive factors and self efficacy), which were
      inter-related, were moderately predicted by past learning behaviour, and were
      each predictive of subsequent learning behaviour. Pupils were also consistent in
      their affective perspectives to learning maths and English, though few
      differences were found between average and low attaining pupils. The significance
      of the findings is discussed in terms of the theoretical links between self
      efficacy and reasoned action approaches, the context of assessment and the nature
      of behaviour intention.

PMID- 8353064
TI  - Breast cancer: more clarity or more confusion?

PMID- 8353065
TI  - Euthanasia: more confusion than ever in The Netherlands.

PMID- 8353066
TI  - Battle over PCR fees.

PMID- 8353067
TI  - Immunosuppression with purine analogues--the flip side of the gold coin.

PMID- 8353068
TI  - The challenge of dose-intensity in ovarian cancer.

PMID- 8353069
TI  - Dose effect relationship in breast cancer.

PMID- 8353070
TI  - Drugs ten years later: epirubicin.

PMID- 8353071
TI  - Immunosuppressive effects and clinical response of fludarabine in refractory
      chronic lymphocytic leukemia.
AB  - BACKGROUND: Fludarabine monophosphate is a new adenine nucleoside analogue with a
      promising efficacy in B-cell chronic lymphocytic leukemia (B-CLL) with response
      rates, including hematological complete remissions, of 50%-60% in previously
      treated and 75%-80% in previously untreated patients. PATIENTS AND METHODS: Here,
      the clinical experience with and side effects of fludarabine are reported in 19
      patients with refractory CLL (17 B-CLL, 2 T-CLL). All patients were pretreated
      with one to four different regimens and had progressive disease. Fludarabine was
      administered at a dosage of 25 mg/m2 daily for 5 days as a 30-minute intravenous
      infusion. This course was repeated every fifth week. Dosage and time course were
      adapted to toxicity. RESULTS: 12/18 (67%) evaluable patients achieved partial
      remissions (PR), 1/18 (6%) had stable disease (SD) and 5/18 (28%) were
      progressive. The median duration of partial remission until relapse or death was
      6 months. Most responses to fludarabine occurred within two treatment courses.
      Major toxic effects included infections in 11 patients and nausea in 8 (mainly
      grade 1). Meanwhile, three patients died of progressive disease and 8 of
      pneumonias or other infections. Two patients had pneumocystis carinii pneumonias
      and one an aspergillus pneumonia. The high infection rate may be due not only to
      hypogammaglobulinaemia or fludarabine-induced granulocytopenia but also to a
      remarkable decrease of CD4(+)-cells during fludarabine therapy. In one case a
      tumor lysis syndrome was observed. No CNS toxicity was noted. CONCLUSION: It is
      concluded that fludarabine is effective even in patients with advanced chronic
      lymphocytic leukemia refractory to multiple chemotherapy regimens. However,
      fludarabine has a remarkable suppressive effect on T-lymphocytes, predominantly
      CD4(+)-lymphocytes. Long-term antibiotic prophylaxis is recommended.

PMID- 8353072
TI  - A randomised dose intensity study in ovarian carcinoma comparing chemotherapy
      given at four week intervals for six cycles with half dose chemotherapy given for
      twelve cycles.
AB  - BACKGROUND: The importance of dose intensity has not been clearly defined in
      ovarian cancer and we present a prospectively randomised trial of dose intensity
      in patients with ovarian cancer. PATIENTS AND METHODS: Ninety-nine patients with
      FIGO stage Ic, II, III and IV epithelial ovarian cancer were randomised to
      receive cycles of standard dose cyclophosphamide (600 mg/m2) and carboplatin (300
      mg/m2) alternating with adriamycin (50 mg/m2) and ifosfamide (5 G/m2) for 6
      cycles at monthly intervals (49 patients) or cycles of half dose cyclophosphamide
      (300 mg/m2) and carboplatin (150 mg/m2) alternating with adriamycin (25 mg/m2)
      and ifosfamide (2.5 G/m2) for 12 cycles at monthly intervals (50 patients).
      Patients in each arm were well balanced for major prognostic factors. RESULTS:
      The combined clinical response rate (complete response and partial response) on
      the 6 month arm was 76% compared with 48% on the low dose intensity arm (p =
      0.009). With a median follow up of 25.7 months the median survival on the low
      dose intensity arm is 20.9 months. The median survival point on the 6 month arm
      has not yet been reached. The median progression free interval on the 12 month
      arm was 19.8 months, the median value has not yet been reached on the standard
      arm. The amount of residual tumour following initial laparotomy was the only
      significant independent variable affecting survival (p = 0.0001). The mean
      received dose intensity of each drug was greater than 80% of the planned dose
      intensity. More patients had clinical disease progression during treatment on the
      low dose intensity arm (42%) when compared to the standard dose intensity arm
      (8%) (p = 0.0003). Fifteen patients on the standard dose arm experienced a total
      of 18 delays and 5 patients on the low dose arm experienced 17 delays. Nausea,
      vomiting and diarrhoea were similar for both standard and low dose cycles of
      chemotherapy with a consequent benefit for patients receiving fewer cycles even
      though these were of higher dose. CONCLUSIONS: The combination studied was more
      effective when given at the higher dose intensity and the improved response and
      survival was not accompanied by a significant increase in toxicity.

PMID- 8353073
TI  - Patterns of survival in patients with Hodgkin's disease: long follow up in a
      single centre.
AB  - BACKGROUND: Prolonged remission can now be induced in the majority of patients
      with Hodgkin's disease with chemotherapy and/or irradiation. However, there is a
      significant proportion of patients in whom this approach fails, either at
      presentation or subsequently. Survival is the definitive endpoint to assess
      treatment efficacy. In this study, the survival patterns of a large group of
      consecutive patients treated in a single institution are presented. RESULTS: The
      overall median survival was 18.3 years. Clinical remission (complete remission
      plus good partial remission) was induced in 443 (85%); the median survival of
      patients in remission has not been reached. Fifty-eight patients achieved
      responses less than clinical remission with initial therapy (partial response) or
      had progressive disease, the median survival of this group being 1.4 years. With
      further therapy, remission was subsequently induced in 10; 5 are still alive, 5
      have died between 1.9 years and 14.3 years. Twenty patients died before
      completion of therapy. Recurrence has been documented in 147 of the patients in
      remission (following initial therapy) over a median follow up period of 13 years
      (minimum 5 years). One hundred forty-three of these patients were retreated
      following recurrence (105 chemotherapy, 28 radiotherapy, 6 combined modality
      treatment and 4 surgery). Second remission was induced in 109/143 (76%). There
      was a trend towards better second remission induction in patients whose first
      remission was longer than 1 year (p = 0.06). The median duration of second
      remission was inferior to first remission duration (p < 0.001). There was no
      correlation between duration of first remission and survival following recurrence
      (p = 0.8) or with duration of second remission (p = 0.54). There was no
      significant difference in duration of second remission between patients who were
      initially treated with radiotherapy or chemotherapy (p = 0.3). The median
      survival following second remission was 12.0 years, being the same for patients
      with initially localized disease (stages I and II) treated with radiation alone
      and for patients with advanced Hodgkin's disease (stages III and IV) treated with
      chemotherapy. Survival after recurrence is significantly better for patients
      under 50 years at the time of recurrence (p < 0.001). Second recurrence was
      documented in 46 patients, third remission being reinduced in 22, the median
      survival of the latter being 5.1 years. CONCLUSION: These results illustrate the
      importance of prolonged follow up in defining the clinical course of patients
      with HD and are vital for planning experimental chemotherapy at the time of
      treatment failure or recurrence.

PMID- 8353074
TI  - Blood lymphocyte clonal excess in advanced non-Hodgkin's lymphoma. Relation to
      clinical data and prognosis.
AB  - BACKGROUND: Increasingly sensitive methods, based on the monoclonal nature of
      NHL, are used to detect tumour spread and remaining disease. Since the lymphomas
      are thought to arise due to successive genetic changes, clonal cells in different
      compartments do not necessarily represent the same disease despite a common
      clonal origin. PATIENTS AND METHODS: In 179 patients with advanced NHL, clonal
      cells in peripheral blood were identified by light chain restriction analysed in
      flow cytometry, i.e. clonal excess (CE) analysis. RESULTS: CE was more common in
      low grade NHL (52%) than in high grade NHL (21%). In patients with a normal
      lymphocyte count CE was found in 23%. CE was significantly correlated to small
      cell histology and bone marrow involvement. In high grade NHL CE in peripheral
      blood was more common in those with discordant small or mixed cell involvement of
      the bone marrow. CE was significantly related to failure to achieve remission in
      both histologic subgroups. Survival was not influenced by CE in low grade NHL but
      in high grade NHL. In multivariate analyses however, CE did not emerge as an
      independent risk factor but age, B-symptoms and LDH were the major factors.
      CONCLUSIONS: The utility of blood CE analyses in clinical praxis has still to be
      settled and the prognostic value of CE per se seem limited in the current
      perspective. The existence of CE in high grade NHL might be a clue of different
      biology as compared to de novo high grade NHL.

PMID- 8353075
TI  - Escalated M-VAC chemotherapy and recombinant human granulocyte-macrophage colony
      stimulating factor (rhGM-CSF) in patients with advanced urothelial tract tumors.
AB  - BACKGROUND: The M-VAC regimen (methotrexate, vinblastine, adriamycin, and
      cisplatin) has significant antitumor activity in patients with advanced
      urothelial tract cancer. Growth factors may provide the possibility of treating
      patients with higher doses of chemotherapy, for longer periods, with less
      morbidity, and improved results. A trial of an escalated dosage of M-VAC with
      recombinant GM-CSF (rhGM-CSF) was initiated. PATIENTS AND METHODS: 23 patients
      were treated with an escalated dose of M-VAC every 2 weeks plus rhGM-CSF 250
      micrograms/m2 s.c. days 4-10. Dose level I (n = 13) was 1.65 times the dose of
      standard M-VAC. Adriamycin and cisplatin were given at 2.5 times the dose of
      standard M-VAC. Dose level II (n = 10) was a relative dose intensity of 1.95.
      Adriamycin and cisplatin were both given at 2.9 times the dose. CONCLUSIONS: The
      response rate was 70% (95% CI 60%-80%). Seven patients (30%) had CR, and 9 (39%)
      had a PR. Five (22%) patients had stable disease and 2 (9%) had progression. Of
      the CR patients, 3 had the CR confirmed pathologically (CRp). Response occurred
      in 11 patients treated at dose level I and 5 at dose level II. Toxicity was
      primarily hematologic. Dose level II was too toxic due to thrombocytopenia. Non
      hematologic toxicity was minimal. The value of this schedule (dose level I)
      compared to standard M-VAC will be further evaluated in a randomized trial to be
      initiated by the Genitourinary Group of the EORTC.

PMID- 8353076
TI  - Phase II study of an oral combination of doxifluridine, prednimustine and
      idarubicin (FUPRIDA) for first line treatment of advanced breast cancer.
AB  - BACKGROUND: An oral combination chemotherapy for breast cancer may be of
      advantage for many patients, if its activity is equivalent to that of i.v.
      treatments. The bioavailability of oral idarubicin and of oral doxifluridine
      allows for their use in an oral 3 drug regimen. PATIENTS AND METHODS: Idarubicin
      29 mg/m2 was given on day 1, doxifluridine 1500 mg and prednimustine 60 mg were
      given daily for 10-14 days (7 days/m2) in 17 patients with advanced breast
      cancer. Cycles (1 to 18) were repeated every 4 weeks or delayed if required by
      toxic effects. RESULTS: Nine responses were observed with durations ranging from
      2 to 16 months. Responding lesions were the primary tumor, or skin, liver and
      bone metastases. WHO grade 3-4 toxic effects included leukopenia (7 patients),
      diarrhea and emesis (2 and 1 patient). There were no toxic deaths. CONCLUSIONS:
      If our results are confirmed, this oral 3-drug-combination is a safe and
      effective treatment that may improve the quality of lives of breast cancer
      patients with poor venous access.

PMID- 8353077
TI  - Phase II study of sequential high-dose methotrexate (MTX) and 5-fluorouracil (F)
      alternated with epirubicin (E) and cisplatin (P) [FEMTX-P] in advanced gastric
      cancer.
AB  - BACKGROUND: FAMTX (5-fluorouracil, adriamycin, methotrexate) is one of the most
      effective drug combinations in gastric cancer. Therefore, modifications of FAMTX
      appear of interest and the FEMTX-P regiment was conceived. PATIENTS AND METHODS:
      Fifty patients with unresectable locally advanced and/or metastatic gastric
      carcinoma were treated with methotrexate 1500 mg/m2 i.v. and 5-fluorouracil 1500
      mg/m2 i.v. on day 1; leucovorin rescue 15 mg/m2 orally every 6 hours for 8 doses
      on days 2 and 3; epirubicin 60 mg/m2 i.v. and cisplatin 50 mg/m2 i.v. on day 15,
      q 4 weeks. RESULTS: Of forty-seven patients evaluable for response, five (11%)
      achieved complete responses and seventeen (36%) partial responses (total response
      rate 47%). The median duration of response was 8+ months (range: 5-25+ months).
      Four of 14 patients with locally advanced disease were successfully downstaged
      and subsequently resected. The median duration of survival of all patients was 10
      months (range: 1-25+ months). Leukopenia grade 4 occurred in 18% of patients and
      thrombocytopenia grade 4 and mucositis grade 4 in 4% and 2%, respectively.
      Treatment postponement for hematologic toxicity was necessary in 54% of patients.
      CONCLUSIONS: The FEMTX-P regimen is an active regimen in advanced gastric
      carcinoma, with acceptable toxicity.

PMID- 8353078
TI  - Neoadjuvant chemotherapy with adriamycin, cisplatin, vincristine and
      cyclophosphamide (ADOC) in invasive thymomas: results in six patients.
AB  - BACKGROUND: Locally advanced malignant thymomas are usually radically resectable
      in about 60% of stage III but hardly ever in stage IVA. Neoadjuvant chemotherapy
      followed by surgery could improve both resection rate and curability. Cisplatin
      containing regimens have repeatedly been found to be highly active in advanced
      disease, with overall response rates ranging from 80%-90%. PATIENTS AND METHODS:
      3 patients with stage III and 3 with stage IVA invasive thymomas, according to
      Masaoka staging, entered the study. Histology was: lymphoepithelial 4 cases,
      epithelial 2 cases. 4 cycles of the ADOC scheme--Adriamycin (40 mg/sqm),
      cisplatin (50 mg/sqm) on day 1, vincristine (0.6 mg/sqm) on day 2, and
      cyclophosphamide (700 mg/sqm) on day 3, every 21 days--were administered to 5
      patients, while 1 patient received 5 cycles. RESULTS: 5/6 patients (83.3%)
      attained partial responses and underwent radical surgery followed by two further
      ADOC cycles. The disease-free intervals were 5+, 6+, 15+, 16+, 26+ months. One
      patient showing stable disease at the end of the fifth cycle was referred to
      radiotherapy. Toxicity was tolerable: grade III (WHO) nausea/vomiting and
      leukopenia grade III occurred in 2 patients each. CONCLUSIONS: These results
      suggest that the ADOC scheme is active as a neoadjuvant approach in invasive
      thymoma stages III and IVA, rendering possible radical resectability in 83% of
      patients.

PMID- 8353079
TI  - Myocardial infarction after chemotherapy for testicular teratoma.

PMID- 8353080
TI  - Severe hypocalcaemia after treatment with oral clodronate and aminoglycoside.

PMID- 8353082
TI  - San Salvatore Prize coupled with Kaplan Lecture goes to Gianni Bonadonna.

PMID- 8353081
TI  - Should we be using 5-HT3 antagonists as first line antiemetic therapy in
      cisplatin-based chemotherapy?

PMID- 8353083
TI  - Antiemetic therapy--where do we go from here?

PMID- 8353084
TI  - Euthanasia in The Netherlands: facts and moral arguments.
AB  - Some facts about euthanasia practices in The Netherlands are given. It is shown
      that there are several possible courses of action at the end of life, of which
      active euthanasia is the most problematic. Euthanasia is related to respect for
      the patient and the patient's right to refuse medical treatment. Some moral
      arguments against and in favour of euthanasia are discussed.

PMID- 8353085
TI  - The relevance of pharmacology in clinical oncology practice. Pharmacology is
      relevant.

PMID- 8353086
TI  - The relevance of pharmacology in clinical oncology practice. Pharmacology is (as
      yet) no relevant....

PMID- 8353087
TI  - The relevance of pharmacology in clinical oncology practice. The moderator thinks
      that....

PMID- 8353088
TI  - Hematopoietic growth factors and chemoprotectants: should we move toward a two
      step process for phase I clinical trials in oncology?

PMID- 8353089
TI  - Oral ondansetron in the prophylaxis of nausea and vomiting induced by
      cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in women with breast
      cancer. Results of a prospective, randomized, double-blind, placebo-controlled
      study.
AB  - BACKGROUND: The combination of cyclophosphamide, methotrexate and 5-fluorouracil
      (CMF) is a widely used chemotherapy regimen in breast cancer patients. However,
      the control of nausea and vomiting induced by oral CMF is a rarely examined
      problem. Therefore we felt a randomized, placebo controlled study justified in
      order to improve currently available antiemetic therapy. SUBJECTS AND METHODS: In
      a randomised double-blind trial ondansetron given orally, 8 mg three times a day
      for 15 days, was compared with placebo in 82 breast cancer patients receiving
      chemotherapy with CMF (cyclophosphamide 100 mg/m2 orally days 1-14, methotrexate
      40 mg/m2 i.v. days 1 and 8 and 5-fluorouracil 600 mg/m2 i.v. days 1 and 8). The
      patients recorded nausea and the number of vomits and retches daily on diary
      cards. Forty-two patients received ondansetron and 40 received placebo. RESULTS:
      Significantly more patients who received ondansetron experienced neither vomiting
      nor retching (emesis) compared to those receiving placebo over a 15 day treatment
      period (60% vs. 35%, p = 0.027). The difference, with 95% confidence limits, was
      estimated at 25 (4.45%). Furthermore, there was a trend in favour of ondansetron
      in the control of nausea. Ondansetron was well tolerated, with 25 patients (59%)
      reporting at least 1 adverse event compared to 18 patients (45%) receiving
      placebo (p = 0.191). CONCLUSION: The results indicate that ondansetron given
      orally for 15 days is safe and effective in the control of emesis induced by CMF.
      It is however too early to recommend ondansetron as standard antiemetic therapy
      for oral CMF, as the treatment of nausea and vomiting in this setting has not
      been studied thoroughly enough.

PMID- 8353090
TI  - Early clinical trial of MDL 73.147 EF: a new 5-HT3-receptors antagonist for the
      prevention of chemotherapy-induced nausea and vomiting.
AB  - BACKGROUND: Like MDL 72.222, one of the first selective 5-hydroxytryptamine3 (5
      HT3) receptors antagonist discovered, MDL 73.147 EF has been shown to possess
      antiemetic properties in the ferret model. We conducted a phase I study with MDL
      73.147 EF in 31 patients, treated with emetogenic drugs over one to five days
      (cisplatin, cyclophosphamide, doxorubicin, dacarbazine). PATIENTS AND METHODS: 5
      groups of at least 5 patients received rising unit doses of MDL 73.147 EF (10 to
      50 mg) intravenously before chemotherapy, with two more doses per day if needed.
      Nausea was assessed by a patient-completed visual analogue scale and episodes of
      vomiting recorded by an independent observer. RESULTS: 51.6% of the patients were
      complete responders on day one and 40% on days two to five. One patient was given
      other rescue antiemetic therapy. Adverse events included constipation (25.8%),
      mildly elevated blood pressure (12.9%) and other minor events. No extrapyramidal
      effects have been reported. There was no suggestion of dose-dependent efficacy at
      the dose levels studied in this limited set of patients. CONCLUSIONS: We conclude
      that MDL 73.147 EF is a well tolerated and possibly effective antiemetic.

PMID- 8353091
TI  - A phase II study of ifosfamide, carboplatin and cisplatin in advanced and
      recurrent squamous cell carcinoma of the uterine cervix.
AB  - BACKGROUND: Discouraging response duration and long-time survivals have so far
      been the result of cisplatin-containing combination chemotherapy against advanced
      or recurrent squamous cell carcinoma of the uterine cervix. In order to increase
      the platinum-based effect upon this tumor without an increase in the specific
      toxicity of cisplatin, we combined it with carboplatin, added ifosfamide, which
      has been shown to possess a comparable degree of single-agent activity. PATIENTS
      AND METHODS: Thirty-six patients with advanced or recurrent squamous cell
      carcinoma of the uterine cervix not curable by radiation or surgery were treated
      with a combination of ifosfamide 1.5 gr/m2 i.v. days 1-3, carboplatin 200 mg/m2
      i.v. day 1, and cisplatin 50 mg/m2. Thirty-one patients were evaluable for
      response and 34 patients for toxicity. RESULTS: Twenty-three patients responded
      (64%), 11 (31%) of them completely, and 12 (33%) partially. Median response
      duration was 23 weeks (range 8-107 weeks), reaching 27 weeks and 21 weeks for
      patients with and without disease in previously irradiated areas, respectively.
      Median survival is 40 weeks (range 1-114 weeks). Toxicity consisted mainly of
      moderate to severe myelosuppression, resulting in 2 toxic deaths. CONCLUSION: The
      response rate, also for earlier irradiated areas, compares favorably with other
      known cisplatin-containing regimens. The combination deserves investigation in a
      randomized setting.

PMID- 8353092
TI  - Fats used in seasoning and breast cancer risk: a case-control study in Moscow,
      Russia.
AB  - BACKGROUND: As part of a case-control study of breast cancer conducted in Moscow
      the relationship between consumption of fat in seasoning and risk of breast
      cancer was assessed. DESIGN: The study comprised 92 cases and 110 controls. Cases
      were newly diagnosed consecutive cases seen at the breast clinic of the Cancer
      Research Centre of the Russian Academy of Medical Sciences during the year 1990.
      None of the patients had been previously treated for breast or other cancers and
      none had distant metastases. Patient were interviewed in the Clinic within two
      days of admission. Controls were recruited from women visiting their friends and
      relatives treated in the same Cancer Centre. RESULTS: Four levels of frequency of
      use of butter and vegetable oils, and four levels for combined sources were
      created to evaluate the association between use of fat in seasoning and breast
      cancer risk. Compared to low use, a non-significant increase in risk was observed
      for the highest intake of butter (Odds Ratio (OR) = 1.5, 95% Confidence Interval
      (CI) (0.8, 3.0)). High frequency of use of vegetable oil in seasoning decreased
      the risk of breast cancer. For the highest category of use, the adjusted OR was
      0.2 (95% CI (0.1, 0.5)). Frequent use of mayonnaise also appeared to be
      associated with a decrease in the risk of breast cancer (OR = 0.1; 95% CI (0.01,
      0.4)). For total fat seasoning consumption (vegetable oil+mayonnaise), the
      adjusted OR for highest category of intake was 0.1 (95% CI (0.03, 0.3)).
      CONCLUSIONS: The results of the study suggest a negative association between
      consumption of fat used for seasoning (except butter) and breast cancer risk.
      This may be a direct effect or due to increased consumption of salad-type
      vegetables by high consumers of these sources of fats. The topic should be
      addressed in other studies in different populations.

PMID- 8353093
TI  - High grade soft tissue sarcoma.
AB  - The management of our patient was similar to that of many patients with soft
      tissue sarcomas. His primary care was in a General Hospital where the surgeon had
      no specialist experience of these tumours and did not anticipate such a
      diagnosis. As a result the diagnostic procedure was inappropriate and compromised
      the chances of success of further more radical conservative surgery. Radiotherapy
      was unable to prevent local recurrence and amputation became necessary. Pulmonary
      metastases developed and were resected but within a short space of time extensive
      inoperable metastases recurred. Although these responded to chemotherapy, the
      response duration was short and the patient died soon afterwards. The major
      lessons to be learned are the need to have a high index of suspicion about a
      possible neoplastic cause of increasing soft tissue swellings and to refer
      patients for biopsy to a specialist centre where there is experience of all
      aspects of the management of these rare but potentially curable malignancies.

PMID- 8353094
TI  - Pharmacokinetics of 5-fluorouracil in colorectal cancer patients receiving
      interferon.
AB  - BACKGROUND: The outlook for patients with advanced colorectal cancer remains
      poor. Recent reports of the combination of 5-fluorouracil (5-FU) and alpha
      interferon in colorectal cancer have suggested better response rates. One
      possible explanation for interaction between 5-FU and interferon is that
      interferon alters the pharmacokinetics of 5-FU, increasing plasma 5-FU levels.
      PATIENTS AND METHODS: To investigate the possibility of interaction between the
      two agents, steady state 5-FU pharmacokinetics was evaluated in patients with
      colorectal cancer who received 5-FU by continuous i.v. infusion with and without
      concurrent administration of subcutaneous alpha-interferon. 5-FU levels were
      measured by reverse-phase high-performance liquid chromatography. RESULTS: Twenty
      six patients were evaluated. There were 4 partial responses (15%). There was no
      significant difference in steady state 5-FU levels whether or not alpha
      interferon was administered concurrently. CONCLUSION: Any synergistic activity
      that may exist between this combination of 5-FU and alpha-interferon is not
      simply due to altered 5-FU pharmacokinetics.

PMID- 8353095
TI  - Low-dose oral etoposide in epithelial cancer of the ovary.
AB  - AIMS: To evaluate antitumour activity, toxicity, pharmacokinetics, and the
      pharmacodynamic relationship with neutropenia of low-dose oral etoposide (E) in
      patients (pts) with epithelial cancer of the ovary previously treated with
      cisplatin. PATIENTS AND METHODS: Eighteen pts receiving 50 mg daily of oral E for
      21 days every 4 weeks. CBC with differential repeated every week. E plasma levels
      determined by HPLC method (sensitivity limit: 0.1 microgram/ml) with evaluation
      during the first cycle of bioavailability and weekly 24-hour drug concentrations.
      RESULTS: Among 17 evaluable pts, 1 partial remission of 9 months. Dose-limiting
      neutropenia of high inter-patient variability. Mean bioavailability value of 75%,
      ranging from 44% to 100%. No correlation between mean 24-hour E plasma levels and
      ANC nadir or relative decrease of ANC during the first cycle. CONCLUSIONS: Low
      dose oral E is ineffective as salvage treatment in epithelial cancer of the
      ovary. The large variability of neutropenia requires a careful hematological
      monitoring to avoid severe myelosuppression.

PMID- 8353096
TI  - Assessing quality of life in clinical trials.

PMID- 8353097
TI  - Secondary cancer following Hodgkin's disease.

PMID- 8353098
TI  - Renal cancer after busulphan treatment for chronic myeloid leukemia: therapeutic
      implications.

PMID- 8353099
TI  - Pharmacokinetics and in vitro studies of l-leucovorin. Comparison with the d and
      d,l-leucovorin.
AB  - BACKGROUND: The active isomer of leucovorin (LV), LV-6S was compared with the
      racemic form, LV-6R,S and the inactive form, LV-6R. MATERIALS AND METHODS:
      Pharmacokinetic studies of LV-6S and 6R,S were performed on normal volunteers and
      patients. Growth of Pediococcus Cerevisiae (PC), a LV-dependent strain, was
      measured with the 3 forms of LV. CCRF-CEM, a leukemic human cell line, was used
      to compare the effect of LV-6S, 6R,S and 6R on the rescue of methotrexate (MTX)
      and on the cytotoxicity of 5-fluorouracil (5-FU). RESULTS: LV-6S exhibits
      pharmacokinetic patterns similar to those obtained with LV-6R,S whatever the
      route used, oral or intravenous. The growth of PC was similar with the active
      isomer and the racemic form while the unnatural isomer, LV-6R did not promote any
      growth. Cells exposed to MTX (10(-7) to 10(-5) M) were rescued from MTX
      cytotoxicity with LV-6S and LV-6R,S at concentrations 100 and 200 fold higher,
      whereas LV-6R did not reverse toxic effects of MTX. An enhancement of the
      cytotoxicity induced by 5-FU (10(-4) M) was obtained after preexposure of cells
      to LV-6S or LV-6R,S while LV-6R did not exhibit any synergistic effect.
      CONCLUSION: LV-6S has similar effects to LV-6R,S in vitro and in vivo but at half
      doses; its clinical use prevents the possible interference of the inactive
      isomer, especially in patients receiving high doses of LV.

PMID- 8353100
TI  - What can we learn from a meta-analysis of trials testing the modulation of 5-FU
      by leucovorin? Advanced Colorectal Meta-analysis Project.
AB  - BACKGROUND AND DESIGN: We previously reported a meta-analysis of all randomized
      clinical trials comparing 5-FU to 5-FU plus intravenous d.l. leucovorin (LV) in
      patients with advanced colorectal cancer. RESULTS: The meta-analysis confirmed
      the advantage of 5-FU/LV over 5-FU alone in terms of response rate: overall, the
      response rate was 11% with 5-FU alone vs 23% with 5-FU/LV (p < 10(-7)). At the
      same time, it was showed that tumor regression can not be considered a surrogate
      end point for survival in patients with advanced colorectal cancer: no
      significant survival advantage was observed for patients allocated to 5-FU/LV.
      The present paper focuses on the interest of meta-analysis to study the role of
      the biomodulation of 5-FU by LV. This approach is compared with the analysis of
      individual clinical trials in terms of power, bias and credibility. It is argued
      that for the meta-analysis to be reliable, individual patient data from all
      available studies must be used, rather than summary data extracted from published
      papers. CONCLUSION: It is concluded that meta-analysis is very useful as a tool
      to explore and summarize available data on a given clinical problem, though its
      purpose is not to recommend any treatment modality. This meta-analysis has
      confirmed both the benefit of biomodulation of 5-FU by LV, and the limitations of
      the current modalities to impact significantly on overall patient survival.
      Further laboratory and clinical research is warranted on the biomodulation of 5
      FU by LV.

PMID- 8353101
TI  - Large scale trial for adjuvant treatment in high risk resected colorectal
      cancers. Rationale to test the combination of loco-regional and systemic
      chemotherapy and to compare l-leucovorin + 5-FU to levamisole + 5-FU.
AB  - BACKGROUND: Failure rate of colorectal cancer after surgical resection remains
      around 50% and adjuvant treatments are clearly required. PATIENTS AND METHODS:
      All patients with serosal involvement and/or lymph node metastases are at risk of
      recurrence (Dukes-Astler Coller B2, C1, C2). For thirty years many randomized
      trials testing chemotherapy and radiation therapy (rectum) have been conducted
      and some have demonstrated some kind of significant activity. We have analysed
      these trials and proposed with the EORTC GI tract cooperative group a new
      prospective randomized trial (40911). RESULTS: In colon cancer, five trials have
      tested single agent systemic chemotherapy and failed to demonstrated a
      significant increase in survival. Four trials have tested systemic chemotherapy
      with 5-FU + MeCCNU +/- oncovin and only one (NSABP COI ant ROI) has demonstrated
      some significant benefit in term of survival. The combination of 5-FU +
      levamisole has been tested in 4 trials; in two there was a trend in favor of the
      treated group and in the intergroup trial there was a very significant increase
      in survival for Duke C patients. Six trials have tested the efficacy of post
      operative local chemotherapy (intraportal); 3 demonstrated a significant
      increased survival and 2 a decrease in hepatic recurrence rate. Among the ongoing
      trials the EORTC 40911 aims to evaluate the interest of combining systemic
      chemotherapy (5-FU + levamisole or 5-FU + 1 folinic acid) to postoperative local
      chemotherapy (intraportal or intraperitoneal). In rectal cancer, preoperative
      radiation therapy significantly decreases the local recurrence rate, more than
      post-operative radiation therapy. The combination of post-operative radiation
      therapy with chemotherapy increases significantly survival rate. Presently
      patients with mobile rectal tumor located at the middle or the upper part of the
      rectum should be when possible randomized in trials such as the EORTC 40911.
      Concerning patients with large tumor located at the inferior part of the rectum
      new trials combining preoperative radiotherapy chemotherapy will be initiated.
      CONCLUSIONS: Some randomized trials using polychemotherapy have resulted in
      increasing survival rate in adjuvant setting regarding patients with colorectal
      cancer. New trials have been initiated to further improve these encouraging
      results.

PMID- 8353102
TI  - 5-Fluorouracil combined with the [6S]-stereoisomer of folinic acid in high doses
      for treatment of patients with advanced colorectal carcinoma. A phase I-II study
      of two consecutive regimens.
AB  - BACKGROUND: Potentiation of the antitumor activity of 5-fluorouracil (5-FU) by
      folinic acid has been demonstrated in patients with colorectal adenocarcinoma.
      Modulation is due to the interaction of thymidylate synthase (TS),
      fluorodeoxyuridylate (FdUMP), and methylene tetrahydrofolate (5,10-CH2-FH4),
      which leads to the formation of a stable ternary complex with concomitant enzyme
      inactivation. Folinic acid consists of a mixture of equal parts of two
      stereoisomers differing in chirality at the C6 carbon of the pteridine ring. Only
      the levorotatory [6S]-folinic acid is transformed into active folate cofactors.
      However, the [6R]-stereoisomer is not inert; it was shown to interfere with the
      [6S] form at the cellular level. The possibility of a deleterious effect of the
      unnatural stereoisomer on the modulation of 5-FU led us to carry out 2
      consecutive phase I-II studies of 5-FU combined with the [6S]-stereoisomer of
      folinic acid given in high doses for treatment of patients with advanced
      colorectal carcinoma. PATIENTS AND METHODS: Treatment comprised 5-FU by i.v.
      infusion for 2 hours (the initial dose was 350 mg/m2/d; it was incremented by 25
      mg/m2/d until a maximal dose of 550 mg/m2/d) and [6S]-folinic acid (100 mg/m2/d
      by rapid i.v. injection in Regimen 1, and 100 mg/m2 by rapid i.v. injection
      followed by a 2-hour infusion of 250 mg/m2 in Regimen 2) for 5 days, every 21
      days. Twenty-five pts and 27 pts were assessed in Regimen 1 and in Regimen 2,
      respectively. They had had no prior chemotherapy. The median follow-up time was 9
      months and 15.5 months for patients treated with Regimen 1 and Regimen 2,
      respectively. For pts treated with Regimen 1, the response rate was 52% (CR, 12%;
      PR, 40%). The median time to disease progression was 9.2 months. The probability
      of survival at 12 months was 73%. For pts treated with Regimen 2, the response
      rate was 37% (CR, 7%; PR, 30%). The median time to disease progression was 8.9
      months. The probability of survival at 12 months was 67%. Improvement in quality
      of life was achieved in most patients who had symptoms due to the tumor before
      the start of treatment. The dose-limiting toxic effects (WHO grades > or = 3)
      were diarrhea, dermatitis, and mucositis. One single episode of grade 4 diarrhea
      occurred. After injection according to the schema in Regimen 1, [6S]-folinic acid
      was rapidly cleared from plasma (mean t 1/2 alpha and t 1/2 beta of 7.2 and 126
      minutes, respectively). The mean concentration of the [6S]-stereoisomer two hours
      after injection was 5.8 mmol/L. After a rapid i.v. injection of 100 mg/m2
      followed by a 2-hour infusion of 250 mg/m2, the mean concentration of [6S]
      folinic acid two hours after the injection was 57.5 mmol/L. Pharmacokinetic data
      suggests saturation of the metabolic conversion of [6S]-folinic acid when large
      doses are administered. CONCLUSION: The [6S]-form of folinic acid potentiates the
      antitumor effect of 5-FU given concomitantly. However, increase of the daily dose
      of the folate did not result in a therapeutic improvement. The present results
      justify a more complete exploration of the pure active stereoisomer as a
      modulator of the fluoropyrimidines.

PMID- 8353103
TI  - L-folinic acid and 5-fluorouracil in the treatment of advanced breast cancer: a
      phase II study.
AB  - BACKGROUND: The combination of 5-fluorouracil (5-FU) and folinic acid (FA) is an
      active combination for the treatment of advanced breast cancer (ABC).
      Theoretically, the biologically active isomer of FA, 1-FA, should be more
      effective than racemic FA in modulating 5-FU activity. PATIENTS AND METHODS:
      Thirty-three patients (pts) with ABC, all previously treated with an
      anthracycline-based combination for advanced disease were treated with 1-FA: 100
      mg/m2 i.v. and 5-FU: 370 mg/m2 i.v. for 5 consecutive days every 4 weeks.
      RESULTS: Three complete remission (CR) and 11 partial remission (PR) were
      obtained for an overall response rate of 42% (95% CI = 25-59). Median duration of
      response was 10 months, median survival was 15 months for responders, 11 months
      for NC and 3 for PD. Eleven pts experienced a WHO grade III-IV oral mucositis
      (33%), 6 pts had grade III and one grade IV diarrhea, two pts had grade IV
      neutropenia resulting in one toxic death. CONCLUSIONS: In this heavily pretreated
      population of pts with ABC, this regimen showed an interesting activity with
      substantial toxicity. Both the response rate and the pattern of side-effects seem
      similar to those experienced with the racemic mixture of d,1-FA. Modulated 5-FU
      warrants an increasing consideration in the treatment of breast cancer.

PMID- 8353104
TI  - Stereoisomers in clinical oncology: why it is important to know what the right
      and left hands are doing.
AB  - BACKGROUND: In the past few years it has become clear that the individual
      stereoisomers, especially the enantiomers, of a biologically active chiral
      molecule may differ in potency, pharmacological action, metabolism, toxicity,
      plasma disposition and urine excretion kinetics. The situation exists in all
      classes of therapeutically active agents including chiral agents used in clinical
      oncology. Chiral anticancer agents which exist as a pair of enantiomers are
      commonly administered as racemic (50:50) mixtures of the two isomers. The
      possibility exists that only one of the enantiomers possesses the desired
      pharmacological activity while the other is responsible for part or all of the
      observed toxicity. The toxicity due to the non-efficacious isomer may be the
      difference between a clinically useful anticancer drug and one which is too toxic
      to use. RESULTS: The chiral compounds used in standard and experimental cancer
      chemotherapy include leucovorin, ifosfamide and verapamil. Only one stereoisomer
      of leucovorin, (6S)-leucovorin is active and data suggests that the
      administration of just the single isomer may enhance the activity of the agent as
      well as improve therapeutic monitoring. Both enantiomers of verapamil, (R)
      verapamil and (S)-verapamil, are active in reversing adriamycin resistance in
      some tumor lines. The standard clinical formulation of verapamil is a mixture of
      the two isomers and cannot be used in clinical treatment of resistant disease due
      to the cardiotoxicity of the (S)-isomer. (S)-verapamil is the active calcium
      channel blocking agent while (R)-verapamil has no effect in this area. Thus, an
      effective anticancer drug would be (R)-verapamil. Data also exists which suggests
      that the use of a single isomer of ifosfamide may reduce dose limiting CNS
      toxicity. CONCLUSION: The existence of stereoisomeric forms of a chemical has
      been a recognized fact for almost 150 years. However, the clinical consequences
      of symmetry and asymmetry are only just beginning to be considered. Within the
      three-dimensional structures of the human body lie tremendous potentials for
      differential drug actions and, perhaps, new keys to the treatment of cancer and
      other diseases. The next few years should see the end to the two-dimensional
      clinical pharmacology we are accustomed to and the growth of stereochemical
      clinical pharmacology; where we always know what the right and left hands are
      doing.

PMID- 8353105
TI  - The patient as sufferer.
AB  - The use of the term sufferer to replace patient has become increasingly common.
      This paper examines the varied meanings implicit in the word sufferer from the
      Judaeo-Christian perspective. This includes the biblical themes of suffering as
      human nature, as punishment, as a test, as atonement and as liberation and
      deliverance. The consequences of these themes for the sufferer's role are
      examined, particularly the sufferer as accepting and the sufferer as victim. It
      is argued that replacing the medical model, implied by 'patient' with a
      theological model, implied by 'sufferer' does not free the person from the
      constraints of a damaging label.

PMID- 8353107
TI  - Cognitive therapy for depression with individuals with intellectual disabilities.
AB  - The increase in research into psychopathology in people with intellectual
      disability has recently spread to include depression. Several reports have
      appeared on the assessment of depression in the client group and there is a
      pressing need for research into treatment of depression in people with
      intellectual disability. The present paper reviews cognitive behaviour therapy
      for depression and reports on its adaptation for people with intellectual
      disability. Two case studies of individuals with mild intellectual disability
      illustrate the clinical applications. All the elements of cognitive behaviour
      therapy for depression were maintained and simplified. Both subjects were able to
      monitor their feelings of depression and subject 2 monitored the frequency of
      suicidal thoughts. Improvements were seen in both cases on the Zung Depression
      Inventory and daily monitoring of depressive feelings.

PMID- 8353106
TI  - Measuring medical students' empathy skills.
AB  - Empathy is an important skill for the medical practitioner or medical students to
      develop when interviewing patients. It helps the interviewer establish effective
      communication, which is important for accurate diagnosis and patient management.
      Two facets of medical education limit students' development of accurate empathy:
      the traditional format of interviewing training and the social ethos of medical
      training and medical practice, which stress clinical detachment. A number of
      researchers and educators have developed consulting skills training programmes,
      designed to enhance students' empathic skills and ability. One difficulty for
      researchers has been the conceptual complexity of the term 'empathy' and greater
      difficulty in measuring the dimension. This paper reviews the range of approaches
      to the measurement of empathy and reports on a research study designed to
      evaluate a two-stage measurement technique, involving a pencil-and-paper test of
      empathy and independent observer ratings of medical students' actual interview
      behaviours. Results lead to the conclusion that pencil-and-paper tests of empathy
      cannot incorporate the range of complex cognitive, emotional and behavioural
      components of the empathy construct. On the other hand, trained observers have
      been able to use items on a specially developed History-taking Rating Scale to
      discriminate between the empathic behaviours of a group of students trained in
      consulting skills with those of a group of control students who each carried out
      videotaped history-taking interviews with hospitalized patients.

PMID- 8353108
TI  - Coping strategies in major depressed, agoraphobic and comorbid in-patients: a
      longitudinal study.
AB  - The first aim of this study was to explore the diagnostic specificity of coping
      styles by comparing ways of coping in non-anxious major depressed, non-depressed
      agoraphobic, and both major depressed and agoraphobic (comorbid) in-patients. The
      second aim was to investigate whether a vulnerability model, a state model, or a
      combined vulnerability-state model of coping accounted best for the data. On
      admission and when discharged, 95 patients completed the Way of Coping Checklist
      and were evaluated on several symptom scales. Self-report symptom scales were
      completed at one-year follow-up as well. The 'purely' agoraphobic and the
      comorbid patients showed less seeking of social support and more wishful thinking
      than the major depressed patients. For the wishful thinking scale, these
      differences were related to differences in level of global psychopathology.
      Overall, the results for the seeking social support scale were consistent with a
      combined vulnerability-state model. The problem-focused coping and wishful
      thinking scores behaved mostly as state phenomena. The avoidance scores provided
      ambiguous evidence. In a subsample of 30 agoraphobic patients who received a
      combination of exposure and psychodynamic treatment, higher pre-treatment levels
      of seeking social support and lower pre-treatment levels of avoidance as coping
      both predicted a more favourable course of symptoms pertaining to fear of fear in
      the one-year follow-up period.

PMID- 8353109
TI  - The California Psychotherapy Alliance Scales: a pilot study of dimensions and
      elements.
AB  - The reliability and clinical utility of the rater form of the California
      Psychotherapy Alliance Scales (CALPAS-R) was investigated on a sample of 12 one
      hour audiotapes representing differing therapeutic dyads and sampled from
      sessions two to six of a relationship-oriented (exploratory) therapy within pilot
      cases of a large outcome study. Both global dimensions and element-based ratings
      were used to test the feasibility of employing the elements as a way of obtaining
      a finer-grained analysis of the therapeutic alliance. Results are reported in
      terms of the interrater reliability of the dimensions and elements, and show
      element ratings to yield dimensional measures similar or superior to global
      ratings in reliability. In addition, CALPAS-R ratings were analysed in
      conjunction with client ratings of session depth and smoothness as well as
      helpfulness.

PMID- 8353110
TI  - The assessment of antenatal emotional attachment: development of a questionnaire
      instrument.
AB  - The nature of the relationship which female and male expectant parents develop
      during pregnancy with their unborn baby has both theoretical and clinical
      significance. It potentially provides a framework for improved understanding of
      many aspects of psychosomatic obstetrics, including reactions to foetal loss.
      Existing instruments designed to assess this relationship inadequately
      differentiate between attitude to the foetus per se versus attitude to the
      pregnancy state or motherhood role. The present paper presents a theoretical
      model of the subjective experiences of human attachment. This is utilized to
      develop a questionnaire to assess the antenatal attachment construct. Item
      analysis results in a 19-item maternal and 16-item paternal questionnaire with
      high levels of internal consistency. Each takes approximately five minutes to
      complete. Finally, the factor structures of the resultant questionnaires are
      explored.

PMID- 8353111
TI  - Increased substance use in survivors of the Herald of Free Enterprise disaster.
AB  - Cross-sectional data are reported on 73 survivors of the Herald of Free
      Enterprise disaster. Many reported an increase in their consumption of alcohol,
      cigarettes, sleeping tablets, antidepressants and tranquillizers at six and 30
      months. The level of increased use was, however, lower at 30 months than at six
      months, although this was less evident for alcohol and cigarettes than the other
      substances. In addition, self-reports of increased substance use are associated
      with higher levels of psychological distress as measured by the General Health
      Questionnaire and the Impact of Events Scale. It is suggested that substance use
      might help to maintain subsequent psychological distress.

PMID- 8353112
TI  - Peripheral victims of the Herald of Free Enterprise disaster.
AB  - We report on an unexpected phenomenon following the Herald of Free Enterprise
      disaster. A series of cross-channel ferry workers referred by their GPs to the
      Folkestone Mental Health Team, during the three years after the disaster,
      presented with post-traumatic stress disorder, despite having no direct contact
      with the disaster as survivors, bereaved relatives or helpers. A retrospective
      case study is described of 14 ferry crew members presenting with PTSD. Thirteen
      completed the GHQ60. Evidence is presented of severe functional impairment in
      this group. It is argued that these subjects are indirect victims of the Herald
      of Free Enterprise disaster. Ways in which the 'ripples outward' of a major
      marine accident might extend to such peripheral victims are discussed.

PMID- 8353113
TI  - High-frequency ventilation in newborn lambs after intra-uterine creation of
      diaphragmatic hernia.
AB  - Infants with congenital diaphragmatic hernia (CDH) die, because their lungs are
      hypoplastic and their pulmonary vascular resistance remains elevated after birth.
      In human newborns, it is difficult to appreciate the benefit of new therapeutic
      approaches, because the pathological findings are not uniform, the disease is
      rare and the clinical criteria for poor prognosis with conventional therapy are
      uncertain. To study the benefit of high-frequency ventilation (HFV) the use of
      Tolazoline in CDH, we created a diaphragmatic defect in sheep fetuses at 0.6
      gestation and studied full-term newborns after a caesarian section. A sternotomy
      was performed to place catheters and flow probes on the aorta and pulmonary
      artery and to clamp the ductus arteriosus and the left pulmonary artery. Twins
      were used as control, and the CDH lambs were either ventilated with conventional
      ventilation (CV) or HFV. 23 ewes were operated upon with a 22% abortion rate and
      31 newborn lambs (10 controls and 21 CDH) were studied. A complete gasometric and
      hemodynamic study was performed in 23 lambs (7 controls, 8 CDH with CV and 8 CDH
      with HFV). Clinical and pathological findings of the lambs with CDH were very
      similar to severe CDH in humans with bilateral lung hypoplasia, severe
      respiratory distress, high pulmonary vascular resistance and severe hypoxemia.
      HFV dramatically improved CO2 elimination, allowed less aggressive ventilation,
      and was associated with higher flows and lower systemic and pulmonary vascular
      resistance. However, HFV did not improve oxygenation leaving the newborn with
      severe hypoxemia associated with massive intrapulmonary foramen ovale shunting
      from right to left.

PMID- 8353114
TI  - Necrotizing enterocolitis (NEC)--mortality and long-term results.
AB  - From 1974-88 73 patients were treated for necrotizing enterocolitis (NEC) in the
      surgical department at the Children's Hospital of Cologne. 70% of these had other
      complaints and 77% were premature babies, of which 30% were small-for-dates. A
      greater than expected proportion of deaths occurred in babies not of low birth
      weight: Of those above 2500 g 35% died and of those under 1500 g 20%. Initial
      signs and symptoms became apparent in 80% within the first two weeks. The most
      frequent signs were distended abdomen (81%), diffuse tenderness (46%), bloody
      stools (39%) and absent peristalsis (39%). Radiology showed edema of the bowel
      wall in 49%, free air in the abdomen in 38% and intestinal pneumatosis in 34%. It
      remains questionable whether peritoneal lavage could lead to earlier diagnosis
      and referral of the sick children to the hospital. The course of the disease was
      less severe when babies had received breast milk. Colon and distal ileum were
      involved most frequently. Laparotomy showed perforations of the bowel in 39
      patients (64%), inflammatory alterations in 18 and necroses in 12. The survival
      rates improved within the period of 1974-88 from 64 to 79%. Thirty-two of the 51
      survivors were available for follow-up: 9 patients (28%) had more than 4
      stools/day, 8 (25%) were underweight, 8 (25%) suffered from food intolerance, 5
      (16%) from diarrhoea, 4 (13%) from limited exercise tolerance. Physical
      retardation could only be seen in 3 children under the age of 2.

PMID- 8353115
TI  - Early and semi-early surgery for scoliosis caused by hemivertebrae--indications
      and results.
AB  - We report a series of 50 congenital scolioses due to hemivertebrae. This
      malformation was responsible for progressive deformity, largely predominant on
      the frontal plane. The average follow-up was 5 years and 3 months. Seven patients
      had mature bones. The series comprised 31 girls and 19 boys. Three types of
      operations were performed: (a) hemivertebrae resection (5 cases); (b) early, most
      posterior convexity fusion carried out before the age of 6 years (26 cases), and
      (c) semi-early convexity fusion performed between the ages of 6 and 12 years (19
      cases). The results obtained in children with a more than 2 years' follow-up
      were: (a) early convexity fusion (18 cases): 7 epiphyseodesis effects, 6 graft
      effects and 4 failures; (b) semi-early convexity fusion (16 cases): 6
      epiphyseodesis effects, 8 graft effects and 2 failures; (c) hemivertebrae
      resection (5 cases): moderate gain that remained stable in 4/5 cases.

PMID- 8353116
TI  - Clinical course and treatment of pheochromocytomas in children. Analysis of five
      cases.
AB  - Between 1965 and 1990 five children with pheochromocytomas were treated. Clinical
      course, methods of diagnosis, treatment and results established by follow-up from
      6 months to 20 years are presented. Hypertension and headaches occurred in all
      patients. One child with a malignant form of pheochromocytoma manifested central
      nervous symptoms imitating epilepsy and additionally diffuse pulmonary metastases
      were found. One patient had a family history of pheochromocytomas and presented
      with hypermetabolic state and neurovegetative symptoms. One child had multifocal
      tumors: two in the posterior mediastinum and one in the retroperitoneal space.
      All patients were treated by either enucleation of the tumor, tumor excision or
      adrenalectomy. One child died 12 years after surgery from the rapid progression
      of pulmonary metastases of pheochromoblastoma present at the time of diagnosis.

PMID- 8353117
TI  - Creation of experimental urethral obstruction in utero: evaluation of fetal renal
      function.
AB  - Management of obstructive uropathy diagnosed in utero would be markedly enhanced
      by the availability of a simple, safe and quantitative fetal renal function test
      to predict postnatal renal function. In order to allow experimental evaluation of
      such a parameter, we adjusted a model of complete urethral obstruction with
      urachal ligation in 30 fetal lambs at 79 or 99 days of gestation. The method
      described allows obstruction in male and female fetuses as early as 79 days of
      gestation, with an overall high survival rate (control: 12/14; obstructed:
      23/29), although lower (6/12) when obstruction is performed early (79 days)
      during gestation. Consequences of obstruction were examined on the 121st day of
      gestation. Severe hydronephrosis, ureteral and calyceal dilatation, with or
      without ascites and pulmonary hypoplasia were observed in all fetuses; creatinine
      clearance determined in utero was decreased in both groups with obstruction
      (early and late) vs control group: 1.15 +/- 0.5, NS, and 0.58 +/- 0.4, p < 0.01
      vs 1.61 +/- 0.8 ml/min/kg respectively. In both obstructed groups, fetuses with
      ascites displayed lower plasma creatinine concentration and higher creatinine
      clearance values when compared to fetuses without ascites. In conclusion, the
      experimental model of obstructive uropathy described appears efficient and easily
      reproducible, allowing therefore the evaluation of a predictive parameter of
      postnatal renal function. Our preliminary results suggest that renal fetal
      function is more dependent on the degree of obstruction than on the term of its
      creation.

PMID- 8353118
TI  - Use of Ethibloc in the treatment of cystic and venous angiomas in children. 19
      cases.
AB  - The authors report the use of Ethibloc in the treatment of cystic lymphangiomas
      and venous angiomas in 19 children. This embolizing product is injected by
      puncture in situ. Ten cystic lymphangiomas were treated, including 7 of the
      cervico-facial region. Of these ten, 8 were embolized initially using Ethibloc,
      and 2 after surgery. The diagnosis was always confirmed by echography and in some
      cases also by scanner. Six were completely cured and 2 had partial but
      satisfactory results requiring further injections. The final 2 cases when
      Ethibloc was administered after surgery, gave very disappointing results as the
      residual lesion was microcystic and thus difficult to access for the Ethibloc
      injection. The 9 venous angiomas involved various regions, including 5 facial
      lesions. These angiomas required a more extensive blood-clotting and radiologic
      assessment: standard radiography to detect the clot, Doppler echography and
      M.R.I. precisely clarifying the exact extension in depth. For 6 patients the cure
      was complete, for 2 others the results were good. Finally, in 1 case Ethibloc
      embolization was carried out prior to surgery, allowing definitive cure. In all,
      this technique resulted in a complete cure in 2/3 of the cases and its simplicity
      makes it a seemingly interesting alternative to surgery.

PMID- 8353119
TI  - The Rapunzel syndrome: a case report and review of the literature.
AB  - The Rapunzel syndrome, found characteristically in girls with varying
      gastrointestinal symptoms, is a rare form of gastric trichobezoar extending
      throughout the bowel. The previously reported cases have different clinical and
      pathological features affecting the mortality. We describe a new case
      preoperatively diagnosed with none of the complications previously reported.

PMID- 8353120
TI  - Splenoptosis (wandering spleen).
AB  - Splenoptosis which is a congenital fusion anomaly of dorsal mesogastrium in
      children is a very rare entity. In the literature cases are usually diagnosed at
      operation and it is noted that in former years splenectomy had a special place
      among various methods of treatment. In this report, a 7-year-old case of
      splenoptosis diagnosed on ultrasonography and isotope scintigraphic methods
      preoperatively and treated by splenopexy is presented. In cases with splenoptosis
      the clinical and radiologic diagnostic criteria are given and the importance of
      splenopexy in treatment is emphasized.

PMID- 8353121
TI  - The abdominoscrotal hydrocele.
AB  - While hydrocele is among the commonest inguinal anomalies in children, less than
      20 cases have been reported of its extreme form, the abdominoscrotal hydrocele
      (ASH). This anomaly consists of a large inguinoscrotal hydrocele which
      communicates in an hour-glass fashion with a large "intra-abdominal" component.
      The latter lies deep to the narrow internal inguinal ring, but superficial to the
      peritoneal cavity proper, which is displaced superiorly and medially. The
      abdominal component of the ASH thus lies latero- and retroperitoneally, sometimes
      reaching the lower pole of the kidney. We report five ASH in four children under
      one year old. All four underwent complete resection of the ASH. If the abdominal
      portion of the hydrocele can not be delivered through a standard approach, we
      advocate a properitoneal approach as described for recurrent adult hernias. The
      external oblique, internal oblique and transversalis muscles are divided
      horizontally above the level of the internal inguinal ring. The peritoneal cavity
      is retracted superiorly, separating it from the ASH. By decompressing the scrotal
      component of the ASH, its abdominal part can be emptied through the narrow
      communication at the internal ring. In this fashion, the processus vaginalis can
      be identified and ligated deep to internal ring, and the floor of the inguinal
      canal is left intact. The pathophysiology of ASH is not clear. A one-way valve
      effect of the patent processus vaginalis may be one cause of the massive
      accumulation of peritoneal fluid in the ASH. Complete resection is curative, and
      the properitoneal approach should be considered.

PMID- 8353122
TI  - Infantile myofibromatosis: an unusual presentation and a review of the
      literature.
AB  - An infant with an unusual presentation of Infantile Myofibromatosis (IM) is
      presented. Massive involvement of the pelvic region complicated the delivery and
      precluded meaningful therapy. The literature is reviewed.

PMID- 8353123
TI  - Tailgut remnant--or teratoma?
AB  - The tailgut is the distalmost portion of the embryonic gut, located caudal to the
      cloacal membrane. Up to the sixth week of development, it is in close proximity
      to the distal end of the notochord and the neural tube. It completely regresses
      by the seventh week, but some caudal duplication-like cysts have been attributed
      to its remnants. We report a full-term male born with a large heterogeneous
      sacral mass. Severe bony abnormalities of the coccyx, sacrum and lower lumbar
      vertebrae were present, but the infant was neurologically intact. At surgery, the
      upper cystic structures within the mass were found to communicate with the dura,
      while the solid component, whose surface resembled intestinal mucosal folds, was
      closely related to the perirectal tissues. The mass was completely resected and
      the dura oversewn. Since this complex mass contained all three cell lines in an
      aberrant location, it satisfies the definition of a sacrococcygeal teratoma.
      However, its unique architecture suggests a malformative, rather than tumoral
      origin. The macroscopic appearance of this lesion reflects the embryonic
      relationship between the tailgut, the neural tube and the notochord.

PMID- 8353124
TI  - Cone epiphysis of the knee and scurvy.
AB  - A rare case of metaphyseal cupping of the distal femur resulting from infantile
      scury in a child is reported. The radiological and surgical aspects of this case
      are of particular interest. MRI demonstrated central epiphysiodesis of the right
      knee, surgery achieved rupture of the epiphyseal plate and resulted in femoral
      lengthening. The child's limp disappeared as a result.

PMID- 8353125
TI  - Does fibrin glue cause foreign body reactions?

PMID- 8353126
TI  - Improved purification and biochemical characterization of phospholipase D from
      cabbage.
AB  - Phospholipase D (phosphatidylcholine phosphatidohydrolase, EC 3.1.4.4) was
      purified from cabbage leaves. The two step purification procedure involved
      hydrophobic chromatography on Octyl-Sepharose followed by a Mono-Q/FPLC-column
      with a total yield of 23% and a purification factor of 1000. A zymographic assay
      was used to detection of PL D activities at various stages of purification under
      non denaturing PAGE. The molecular mass was determined to be 90 kDa using the
      SDS/PAGE method, and 90,200 Da as calculated from the amino acid analysis. The
      isoelectric point of the enzyme is acidic (pI = 4.7). The amino-acid composition
      and 29 residues of the NH2-terminal amino-acid sequence were determined.

PMID- 8353127
TI  - Two open reading frames adjacent to the Escherichia coli K-12 transketolase (tkt)
      gene show high similarity to the mannitol phosphotransferase system enzymes from
      Escherichia coli and various gram-positive bacteria.
AB  - I have subcloned and sequenced the genes cmtB and cmtA of Escherichia coli K-12
      which lie adjacent to the tkt gene on the chromosome. The genes cmtB and cmtA
      could encode a cytoplasmic protein (EIIA) and an integral-membrane protein
      (EIIBC), respectively, of the bacterial phospho enol pyruvate-dependent
      carbohydrate phosphotransferase system. High similarity to the Enzymes IIMtl of
      Escherichia coli K-12 (gene mtlA) and of Staphylococcus carnosus was detected,
      but the two genes did not complement mannitol-negative E. coli mutants without
      the use of a heterologous promoter.

PMID- 8353128
TI  - Kinetic studies on the reduction of acetohexamide catalyzed by carbonyl reductase
      from rabbit kidney.
AB  - The kinetic mechanism for the reduction of acetohexamide catalyzed by carbonyl
      reductase from rabbit kidney was investigated. The initial velocity and product
      inhibition studies indicated that the enzymatic reaction follows an ordered Bi Bi
      mechanism, in which NADPH binds to the enzyme first and NADP leaves last. This
      kinetic mechanism was confirmed on the basis of the dead-end inhibition by
      Cibacron Blue and the binding of NADPH and NADP to the free enzyme. However,
      whether or not coenzyme-induced isomerization is involved in the enzymatic
      reaction remains to be clarified. In kinetic studies of inhibition of the enzyme
      by therapeutically active drugs, indomethacin and befunolol were found to be
      noncompetitive and competitive inhibitors, respectively, with respect to
      acetohexamide.

PMID- 8353129
TI  - Purification and partial characterization of a mitogenic lectin from the latex of
      Euphorbia marginata.
AB  - A lectin was purified from the latex of Euphorbia marginata by affinity
      chromatography on acid-treated Sepharose 6B and elution with lactose. The lectin
      is a glycoprotein composed of two identical subunits with M(r) 30,000, approx.
      The haemagglutinating activity of the lectin is not specific for any human blood
      group, and is inhibited by galactose and galactose-containing sugars and by
      gentiobiose. The lectin is strongly mitogenic for human T-lymphocytes and induces
      the release of interleukin-1 beta and tumor necrosis factor-alpha from cultured
      mononuclear cells.

PMID- 8353130
TI  - Higher-order dielectrophoretic effects: levitation at a field null.
AB  - Experiments with certain new micro-electrode structures used to achieve passive
      dielectrophoretic levitation of small particles and biological cells reveal a
      pronounced size-dependent effect not anticipated by the conventional dipole-based
      model. The conventional theory fails to predict this size effect because it
      neglects higher-order moments such as the quadrupole, hexapole, and octupole.
      These higher-order moments are in fact responsible for the levitation force
      achieved by azimuthally periodic electrode structures because, in such
      geometries, the electric field is zero along the axis so that the induced dipole
      moment must be zero. For example, the planar quadrupole levitates particles
      passively along the central axis through the interaction of its field with the
      induced quadrupolar moment of the particle. The size effect reported with this
      structure is readily explained in terms of this quadrupolar component of the
      ponderomotive force exerted on the particle.

PMID- 8353131
TI  - The absence of glyoxylate cycle enzymes in rodent and embryonic chick liver.
AB  - There have been several reports over the past decade of the presence of the
      glyoxylate cycle enzymes, isocitrate lyase and malate synthase, in animal
      tissues. Reaction products in these assays have been measured principally by
      chromatographic separation of isotopes or by colorimetric procedures. In this
      report more sensitive and accurate HPLC and HPCE analyses were used to detect
      enzymatic activity. Reversed phase HPLC revealed the absence of detectable
      isocitrate lyase activity in guinea pig, rat and chick embryonic liver. The
      formation of several other alpha-keto acids was detected and this may account for
      the previously reported activities. Using HPCE to monitor malate formation malate
      synthase activity was not detected in these tissues. These results indicate that
      when assaying enzyme activities in crude tissue homogenates specific methods for
      the identification of end products are required.

PMID- 8353132
TI  - Mithramycin: a very strong metal chelating agent.
AB  - The interaction of mithramycin (MTR) with Ca2+, Cd2+, Tb3+, Gd3+, Li+, Na+ and K+
      ions has been studied by circular dichroism and absorption spectroscopy.
      Mithramycin binds strongly to Ca2+, Cd2+, Tb3+ and Gd3+ forming a 1:4 Ca2+: MTR
      entities with a left-handed screw conformation. The concentration of Ca2+ present
      in water currently used being about 10 microM, this leads to the conclusion that,
      in most of the experiments reported in the literature, about 40 microM
      mithramycin were actually bound to Ca2+. Mithramycin also binds to Na+, forming
      entities with left-handed screw conformation, but not to K+ and Li+. None of
      these cations were able to promote the mithramycin-DNA interaction.

PMID- 8353133
TI  - Hemoglobin multiple emulsion as an oxygen delivery system.
AB  - Multiple emulsion technology provides a mechanism for the encapsulation and in
      vivo delivery of drugs, proteins, and other materials which would otherwise be
      degraded, cleared rapidly, or toxic to the host. These feasibility studies were
      performed to evaluate a prototype Hb multiple emulsion as a stable oxygen
      delivery system. A concentrated solution of hemoglobin (Hb) was encapsulated in
      the form of a Hb-in-oil-in-water (Hb/O/W) multiple emulsion. Studies using
      mineral oil demonstrated that Hb multiple emulsions have several important
      characteristics that are compatible with utility as a blood substitute. These
      include: satisfactory rheological properties and good hydrodynamic stability
      compared to whole blood, high encapsulation concentration of Hb and high
      encapsulation efficiency with little met-hemoglobin generation, and satisfactory
      oxygen affinity and cooperativity compared to whole blood. Isovolemic exchange
      transfusions of Hb/O/W multiple emulsion can support life in rats whose
      hematocrit has been reduced to levels (5% or lower) that are incompatible with
      survival, and induces no acute toxicity. These results are consistent with the
      utility of Hb/O/W as an oxygen-carrying red blood cell substitute or organ
      perfusion media.

PMID- 8353134
TI  - A pulse radiolysis study of the reactions of 3-hydroxykynurenine and kynurenine
      with oxidizing and reducing radicals.
AB  - Pulse radiolysis has been used to study the reactions of 3-hydroxykynurenine and
      kynurenine with solvated electrons, superoxide radicals, hydroxyl radicals and
      azide radicals. Both 3-hydroxykynurenine and kynurenine react with solvated
      electrons with diffusion controlled rate constants (k = 2.5 x 10(10) M-1 s-1 and
      2.3 x 10(10) M-1s-1, respectively). Neither compound was observed to react with
      superoxide radicals under our experimental conditions, an upper limit of 1.2 x
      10(5) M-1s-1 for the rate constant of this reaction was estimated for both
      compounds. However, we do observe that a stable product of autooxidation of 3
      hydroxy-kynurenine reacts with superoxide radicals and we calculate a lower limit
      for the rate of this reaction of 5.8 x 10(6) M-1s-1. Reactions of 3
      hydroxykynurenine and kynurenine with hydroxyl radicals proceed with diffusion
      controlled rate constants (1.2 x 10(10) M-1 s-1 and 1.3 x 10(10) M-1 s-1,
      respectively). The measured values for the rate constants for reaction of 3
      hydroxykynurenine and kynurenine with azide radicals are 2.1 x 10(10) M-1s-1 and
      4.8 x 10(9) M-1 s-1, respectively. The differences in these rate constants are
      attributed to differences in the measured oxidation potentials for 3
      hydroxykynurenine (+1.0 V vs. NHE) and kynurenine (+1.15 V vs. NHE).

PMID- 8353135
TI  - Effect of insulin and glucose load on bile lactate secretion by the isolated rat
      liver. Role of hepatic parenchyma heterogeneity.
AB  - Parenchymal heterogeneity in lactate disposal by perivenous and periportal
      hepatocytes is believed to be an important factor affecting the overall lactate
      metabolism by the liver. The aim of this work was to investigate the possibility
      of the existence of a different role of both acinar zones 1 and 3 in lactate
      secretion into bile. The effect of insulin and glucose load was also studied
      using isolated in situ rat liver preparations. Perfusions with erythrocyte-free
      Krebs-Henseleit solutions were carried out in intact livers and after restricted
      damage of zone 1 or zone 3 by digitonin administration as a bolus through the
      portal or the hepatic vein, respectively. In intact livers lactate concentrations
      in bile were similar to those found in the perfusate. In both compartments
      lactate concentrations were observed to increase over 90 min of perfusion. During
      this time, bile lactate output increased from 5 to 8 nmol/min per g liver with no
      significant effect on bile flow. Replacement of perfusate by a fresh lactate-free
      one at 60 min failed to induce any reduction in lactate concentration in bile
      samples collected during the following 30 min which suggests the absence of easy
      equilibration of biliary lactate with the sinusoidal compartment. Insulin
      administration (bolus: 100 mU/100 g body weight, plus portal infusion: 5 mU/min
      per 100 g body weight) was found to markedly enhance bile lactate concentrations
      (+110%) and output (+139%). On the contrary, glucose load was found to have no
      effect on lactate output into bile. No significant difference in the increase in
      bile lactate output was observed during 90 min perfusion with either 0, 5, 10,
      15, 25 or 35 mM initial glucose concentrations. After restricted damage of acinar
      zone 1 or 3, insulin-induced bile lactate secretion was significantly reduced.
      This effect was not different regardless the damaged acinar zone. In summary
      these results suggest that insulin plays an important role in the control of the
      output of lactate into bile and that the existence of acinar heterogeneity in
      this function seems unlikely. Moreover the quantitative contribution of bile
      lactate to overall lactate handling by the liver and to bile formation seems very
      low.

PMID- 8353136
TI  - Regulation of hyaluronate production by interleukin 1 in cultured human chorionic
      cells.
AB  - Human chorionic cells in culture synthesized and secreted a large amount of
      hyaluronate as well as tissue collagenase. When these cells were treated with
      human recombinant interleukin 1 alpha (hrIL-1), the biosynthesis and secretion of
      hyaluronate were predominantly accelerated, but those of sulfated
      glycosaminoglycans were not modulated. This promotive effect of hrIL-1 was not
      due to the increase in endogenous prostaglandins including prostaglandin E2 since
      cyclooxygenase inhibitors, indomethacin and diclofenac did not modulate the IL-1
      mediated production of hyaluronate. On the other hand, the cotreatment of
      chorionic cells with hrIL-1 and cycloheximide suppressed the IL-1-mediated
      hyaluronate production, suggesting that protein, de novo, synthesis required for
      the enhancement of hyaluronate synthesis. Upon treatment with hrIL-1, the
      membrane bound-hyaluronate synthase activity was increased up to 5-fold in a time
      dependent manner. On the other hand, when chorionic cells were treated with hrIL
      1 and/or protein kinase C inhibitor, 1-(5-isoquinolinesulfonyl)-2-methyl
      pyperadine hydrochloride (H7), the IL-1-mediated production of hyaluronate was
      effectively suppressed. Similarly, H7 effectively suppressed the protein kinase
      activator, 12-O-tetradecanoyl-phorbol-13-acetate-enhanced production of
      glycosaminoglycans with a similar extent. These results indicate that IL-1
      induced acceleration of hyaluronate production was reflected on the increase in
      hyaluronate synthase activity, and that protein kinase C participates positively
      in the IL-1-signal transduction for the increased synthesis of hyaluronate in
      human chorionic cells.

PMID- 8353137
TI  - The induction of intracellular calcium activity in cultured human myometrial
      smooth muscle cells.
AB  - Cells maintained in serum free medium for 24 hours were found to have a higher
      incidence of both spontaneous increases in intracellular calcium ([Ca2+]i) (Ca2+
      spikes) and small random changes in [Ca2+]i (Ca2+ 'noise'). The spontaneous
      transient increases in [Ca2+]i and the Ca2+ 'noise' disappear in solutions
      containing nominally zero Ca2+.

PMID- 8353138
TI  - Estrogen regulation of proto-oncogenes coding for nuclear proteins.
AB  - Estrogen hormones are known to exert a complex influence on development and
      function of the female reproductive organs of vertebrates by regulating cell
      growth and differentiation, as well as to be implicated in oncogenesis and
      maintenance of tumor growth. Estrogen acts on cells via interaction with an
      intracellular receptor, which, like all receptors for steroid hormones, is a
      trans-acting transcription enhancer factor activated by the cognate ligand and
      capable of binding to specific, cis-acting enhancer elements usually located
      within the 5'-flanking regions of target genes. Additionally, estrogen regulates
      gene expression by influencing mRNA stability or via interaction of the estrogen
      receptor with transcription regulatory factors. This article reviews data
      indicating that estrogen directly activates (primary activation) expression of
      proto-oncogenes codifying for nuclear proteins that, in turn, are responsible for
      indirect (secondary) activation of other genes. This cascade mechanism of gene
      activation is likely to progress for several more steps and allows us to envisage
      how estrogen can direct a complex task such as cell reproduction. Among proto
      oncogenes codifying for nuclear proteins, we focus on fos, jun, myc, and related
      genes. The mechanisms of regulation of these genes by estrogen, including
      regulation of transcription, messenger RNA stabilization, and protein-protein
      interaction, are reviewed.

PMID- 8353139
TI  - Role of GTPases and GTPase regulatory proteins in oncogenesis.
AB  - The GTPases comprise a superfamily of GTP-binding proteins with intrinsic GTPase
      activity. Some members of this family representing either heterotrimeric or small
      G-proteins are involved in the transmission of mitogenic signals. Mutations that
      lead to constitutively activated G-proteins have been shown to contribute to
      malignant transformation. These genes represent, therefore, putative oncogenes.
      Examples are the gsp and gip2 oncogenes, encoding GTPase deficient alpha-subnits
      of Gs or Gi-2 proteins. Representatives from the family of small G-proteins are
      the products of the Harvey-, Kirsten- or N-ras oncogenes. These oncogenes, which
      are frequently expressed in human malignancies, code for proteins (p21ras) that
      are locked in the activated GTP-bound state because their GTPase is refractory to
      the ras-specific GTPase activating protein (GAP). In other cases p21ras-GTP
      levels have been found to be elevated as a result of an increase in GDP/GTP
      exchange rate. In neurofibromatosis v. Recklinghausen, a mutated gene (NF1) is
      detectable. The protein encoded by NF1 contains a GAP homology region, binds
      p21ras-GTP, and stimulates the hydrolysis of p21ras-bound GTP. Both ras-GAP (p120
      GAP) and NF1-GAP are inhibited by acidic lipids. Elevated levels of these lipids
      may exert growth-stimulatory or perhaps tumor-promoting activity by increasing
      p21ras GTP. The function of transforming p21ras is under control of tumor
      suppressor genes. Putative suppressor genes isolated from revertants from ras
      transformed cells include rsp-1 and the ras recision gene (rrg). Experimentally,
      an overexpression of Rap 1A/Krev-1 is able to antagonize transformation by
      p21ras. This mechanism also may be relevant under normal conditions. p53 also is
      capable of inhibiting transforming p21ras. It is postulated that p105-RB exerts a
      similar anti-ras effect. The mechanism by which retinoic acid suppresses
      transformation by ras is discussed. Current strategies for a pharmacological
      interference of p21ras function are described.

PMID- 8353140
TI  - A critical approach to the malignant transformation of human breast epithelial
      cells with chemical carcinogens.
AB  - This work was undertaken with the purpose of clarifying the factors that modulate
      the transformation of human breast epithelial cells. For accomplishing this goal,
      it was necessary to establish the adequate culture conditions for maintaining
      primary cultures of breast tissue for their treatment with genotoxic agents. It
      also was determined whether primary cultures generated from these tissues
      maintained the basic biological properties of the host. In this work we have been
      able to show that the in vivo developmental stage of the gland is important in
      the expression of an early transformation phenotype after treatment with chemical
      carcinogens in vitro; furthermore, that the culture conditions, mainly the
      calcium concentration in the medium, are important in the selection of that
      specific phenotype. Four carcinogens, 7,12-dimethylbenz(a)anthracene (DMBA),
      benzo(a)pyrene (BP), methyl-N-nitro-nitrosoguanidine (MNNG), and N-methyl-N
      nitrosourea (NMU) were used for treating primary human breast epithelial cell
      (HBEC) cultures. Ten out of 20 samples tested expressed survival efficiency in
      agar methocel. The immortalized human breast epithelial cell line MCF-10 was
      treated with the same chemical carcinogens, which induced point mutations in
      codons 12 and 61 and the expression of malignant phenotypes in treated cells. MCF
      10 cells transfected with the mutated c-Ha-ras gene exhibited the same malignant
      phenotypes shown by carcinogen-treated cells, mainly tumorigenesis in SCID mice.
      It was concluded that both chemical carcinogens and mutated ras gene induce
      malignant transformation of immortalized HBEC, which suggests that the critical
      point in the transformation pathway is the immortalization of the cell.

PMID- 8353141
TI  - Detection of cancer by tumor markers in the blood: a view to the future.
AB  - Markers for cancers in the blood include secreted glycoproteins of solid tissue
      tumors as well as cell surface markers, and chromosomal rearrangements or mutated
      genes in circulating blood cells. The most successful markers for the diagnosis
      of solid tissue cancers have been alphafetoprotein and prostate specific antigen.
      Other markers, such as CEA and a number of carbohydrate epitopes, e.g., CA 15.3,
      CA 19.9, CA 50, CA 242, and mucin epitopes, such as MCA, CA 125, and DU-PAN-2 are
      now being used to determine prognosis and to monitor the response to therapy of a
      variety of cancers. Cytologic markers in the blood include clusters of
      differentiation (CD) epitopes on blood cells and chromosomal changes, primarily
      translocations found in many human lymphomas. In the future more specific
      mutations in specific oncogenes or alterations in expression of oncogenes or
      suppressor genes, such as p53, may provide clinically useful markers.

PMID- 8353142
TI  - The c-myc oncogene in tumor progression.
AB  - Tumor progression is a complex process involving many alternative molecular
      pathways that are often tissue and/or species specific. The c-myc oncogene has
      been implicated in malignant progression in a variety of human tumors. In many
      instances, amplification and/or elevated expression of the c-myc gene have been
      associated with poor prognosis or decreased survival; in other cases,
      correlations have been demonstrated between c-myc activation and specific
      parameters of advanced neoplastic stage such as hormone independence,
      transplantability, invasiveness, etc. The tumor types exhibiting c-myc as a
      "progressor" gene include breast, colon, small cell lung carcinoma, as well as
      ovarian cancer, lymphomas, and squamous cell carcinomas. The c-myc oncogene has
      been implicated in a number of experimental animal tumor models, especially rat
      liver. Several studies have found that c-myc often functions in rodent tumor
      progression. For example, rat skin carcinomas induced by ionizing radiation show
      c-myc amplification to be related directly to tumor size and age.

PMID- 8353143
TI  - Phosphotyrosyl protein phosphatases: potential regulators of cell proliferation
      and differentiation.
AB  - Tyrosyl phosphorylated proteins have been associated with the regulation of
      cellular activities, including proliferation, differentiation, and
      transformation. The overall cellular levels of tyrosyl phosphorylated proteins
      are regulated by the balance of the activities of both tyrosyl protein kinases
      and phosphotyrosyl protein phosphatases. Until recently, it was generally assumed
      that the kinase reaction was the key regulatory process for determining the level
      of tyrosyl phosphorylated proteins and that the dephosphorylation reaction was an
      unregulated event. However, recent evidence strongly suggest a regulatory role
      for phosphotyrosyl protein phosphatases for determination of the overall level of
      tyrosyl phosphorylated proteins. This review focuses on the discussion of the
      properties, the regulation, and the primary structure of phosphotyrosyl protein
      phosphatases. Evidence that supports an important role for phosphotyrosyl protein
      phosphatases on cell proliferation and differentiation also is presented.

PMID- 8353144
TI  - Targeting lung cancer genes: a novel approach to cancer prevention and therapy.

PMID- 8353145
TI  - The thoracic surgeon's role in smoking cessation and prevention.

PMID- 8353146
TI  - Chemoprevention of lung cancer.

PMID- 8353147
TI  - Lasers for the early detection of lung cancer.

PMID- 8353148
TI  - Monoclonal antibodies for early cytologic detection of lung cancer.

PMID- 8353149
TI  - Significance of lymph node metastases in lung cancer.

PMID- 8353150
TI  - The role of thoracoscopy in the management of intrathoracic neoplastic processes.

PMID- 8353151
TI  - Sleeve resections for lung cancer.

PMID- 8353152
TI  - Surgery for stage N2 lung cancer.

PMID- 8353153
TI  - Chemotherapy and radiation therapy for lung cancer.

PMID- 8353154
TI  - Placental transfer of free fatty acids: importance of fetal albumin concentration
      and acid-base status.
AB  - Free fatty acids (FFA) are the main class of naturally occurring lipids
      transferred across the placenta, irrespective of species. In order to study the
      importance of fetal plasma albumin concentration and pH on placental transfer of
      FFA, in situ perfusion of the rabbit placenta in late gestation was used as an
      experimental model. Increasing albumin concentration on the fetal side of the
      placenta from 1 to 6% significantly increased transfer of FFA across the
      placenta. However, alteration of the umbilical perfusate pH in the range 7.0-7.5
      had no significant effect.

PMID- 8353155
TI  - Soluble interleukin-2 receptor and interleukin-2 in human amniotic fluid of
      normal and abnormal pregnancies.
AB  - In the present study, 63 specimens of human amniotic fluid were tested for the
      presence of free soluble interleukin-2 receptor (IL-2R). Thirty-two of these were
      also tested for the presence of IL-2. Significant reduction in free soluble IL-2R
      (IU/ml) or free IL-2R (IU/mg albumin) levels were found in the amniotic fluid
      obtained from pregnant women with Down's syndrome fetuses as compared with normal
      pregnancies. In addition normal amniotic fluid was found to contain low levels of
      IL-2, while no IL-2 was found in amniotic fluid from pregnant women with Down's
      syndrome fetuses when tested by two different tests.

PMID- 8353156
TI  - Cobalt-mesoporphyrin inhibits heme oxygenase activity but it does not induce
      lipid peroxidation in rat brain membranes during photoirradiation.
AB  - We examined the effects of cobalt-mesoporphyrin (CoMP) in vitro. The porphyrin
      inhibited the activity of rat splenic heme oxygenase but scarcely stimulated
      peroxidation of lipids in a membrane fraction from rat brain during
      photoirradiation. The apparent inhibition constant for CoMP was 344 nM. It is
      suggested that CoMP may be a promising candidate for a chemopreventive of
      neonatal hyperbilirubinemia that is not associated with phototoxicity.

PMID- 8353157
TI  - Acute effects of cocaine on ornithine decarboxylase activity in fetal and
      neonatal rat heart: evidence for cardiotoxicity.
AB  - Fetal exposure to cocaine is associated with increased perinatal cardiac risk. In
      the current study, we examined the effects of acute cocaine administration on
      ornithine decarboxylase (ODC) activity in fetal and neonatal rat heart. ODC is a
      key regulatory enzyme in the control of cell differentiation and growth, and
      rapid changes in ODC are associated with the response to cell injury.
      Administration of 30 mg/kg s.c. of cocaine to pregnant rats on the 20th day of
      gestation caused acute elevation of fetal cardiac ODC that persisted throughout
      the ensuing 24 h. In contrast, the same dose given directly to neonatal rats the
      day after birth evoked only a short-term (1-h) stimulation of ODC that was
      reversed by 4 h after treatment. By 4 days of age and subsequently, cocaine was
      unable to elicit acute stimulation of heart ODC and only evoked inhibition of
      enzyme activity. Elevated progesterone levels during pregnancy have been shown to
      sensitize the maternal myocardium to cocaine-induced catecholaminergic effects;
      the greater sensitivity of fetal heart ODC to cocaine, as compared to neonatal
      heart, supports the hypothesis that similar enhancement of fetal cardiac
      irritability can contribute to cocaine-induced cell damage.

PMID- 8353158
TI  - Lipoxygenase activity in rat embryos and its potential for xenobiotic oxidation.
AB  - This paper reports dioxygenase activity in rat embryos and demonstrates for the
      first time the ability of rat embryo lipoxygenase (LO) to oxidize xenobiotics in
      vitro. Significant dioxygenase activity towards linoleic acid was found in
      cytosol isolated from rat embryos in different developmental stages on day 9 and
      10 of gestation. All four xenobiotics tested were oxidized at significant rate by
      the LO in the presence of linoleic acid. Both dioxygenase activity and benzidine
      oxidation were inhibited by the known inhibitors of LO, i.e. nordihydroguaiaretic
      acid and eicosatriynoic acid. These findings suggest that LO may be an important
      pathway for xenobiotic metabolism in the rat embryo.

PMID- 8353159
TI  - Effects of epidermal growth factor on ornithine decarboxylase activity and DNA
      synthesis in rats during the perinatal period.
AB  - The effects of epidermal growth factor (EGF) on ornithine decarboxylase (ODC)
      activity and DNA synthesis were studied during the perinatal period in rats. EGF
      administration to neonatal rats increased ODC activity and DNA synthesis in
      neonatal rat liver, but not in brain. EGF administration to maternal rats
      increased ODC activity in maternal rat liver, but not in rat placenta and fetal
      rat liver. These data suggest that EGF has mitogenic effects on neonatal and
      maternal rat liver and play some important roles in fetal and neonatal growth.

PMID- 8353160
TI  - Stimulatory effects of insulin on DNA synthesis in suckling mouse colon.
AB  - The influence of insulin on the postnatal development of DNA synthesis and
      epithelial and muscular cell proliferation has been studied in suckling mice.
      Daily administration of insulin (12.5 mU/g body weight) during 3 days to 8-day
      old mice induced a significant increase of the incorporation of [3H]-thymidine
      into DNA in the small intestine and the proximal and distal halves of the colon.
      The esophagus and the glandular portion of the stomach did not respond. A
      detailed analysis of the proximal and distal colon between 4 and 30 days revealed
      a decrease of [3H]-thymidine incorporation into total DNA during this period.
      However, the establishment of the labeling indices in specific compartments such
      as the epithelium and the muscularis externa revealed that the epithelial
      cellular proliferation increased around weaning period in both segments while a
      drastic reduction of cellular proliferation occurred in the muscle layer. A
      premature rise of the circulating insulin level induced a significant increase of
      the epithelial labeling indices in both colonic segments but remained without
      effects on the muscular layer. These results suggest an important role of insulin
      in the modulation of the ontogenic changes in epithelial cell proliferation of
      the mouse colon.

PMID- 8353161
TI  - Falling intracranial pressure: an important element in the genesis of
      intracranial hemorrhage in the beagle puppy.
AB  - To study the role of extravascular intracranial pressure (ICP) in the genesis of
      intracranial hemorrhage in the beagle puppy, we measured ICP in animals on the
      day of birth, untreated 3-day-old controls, and 3-day-old animals treated from
      birth with prolactin. Baseline ICP varied substantially in all 3 groups. Only 8%
      of this variability was attributable to variability in mean arterial pressure and
      central venous pressure. ICP was lower in the 3-day-old controls, animals at high
      risk for intracranial hemorrhage after a hypovolemic/hypotensive insult followed
      by rapid volume expansion, than in the other groups which are at lower risk.
      Administration of a hyperosmolar insult, intraperitoneal glycerol, to animals
      whose ICP was relatively high promptly lowered ICP. After this treatment, the
      risk of intracranial hemorrhage was markedly increased in these previously low
      risk groups. We conclude that the normal neonatal decrease in brain water content
      and the consequent fall in ICP substantially increase the risk of intracranial
      hemorrhage in the beagle puppy, a model which appears similar in pathophysiology
      to hemorrhage in the preterm human infant.

PMID- 8353162
TI  - Breast feeding and formula feeding affect differently plasma thyroid hormone
      concentrations in infant baboons.
AB  - We tested the hypothesis that plasma thyroid hormone levels in infant baboons are
      differentially affected by breast-feeding and nursery rearing. Infant baboons
      were breast-fed (n = 17), or fed formulas with a high polyunsaturated to
      saturated fat ratio (P/S) (n = 13), or a low P/S formula (n = 14). Plasma total
      triiodothyronine (T3) and free T3 (fT3) concentrations increased from 4 to 14
      weeks of age in infants fed either formula, but decreased in breast-fed infants.
      At 9 and 14 weeks of age, infants fed the formulas averaged 31% higher T3 and 53%
      higher fT3 concentrations compared with breast-fed infants. Although T3
      concentrations of the high P/S formula group compared with the low P/S formula
      group were not different at any single age, from 4 to 14 weeks the T3 averaged
      19% higher in the high P/S formula group. Plasma total thyroxine (T4) or free T4
      (fT4) concentrations were not significantly different among the diet groups
      during the preweaning period. In summary, formula-fed infants maintained higher
      plasma T3 and fT3 levels compared with breast-fed infants in the late preweaning
      period.

PMID- 8353163
TI  - Reduced levels of alpha-1-antitrypsin in children exposed to high levels of air
      pollution.
AB  - Health risks associated with environmental pollution, particularly in Eastern
      Europe, are a cause for concern. In order to gain some insight into the effects
      of exposure to high levels of air pollution particularly by heavy metals, we
      measured the concentration of nine plasma proteins in plasma samples from newborn
      babies and 5- to 6-year old children living in heavily polluted areas of Poland,
      as well as from some newborns and adults from unpolluted areas of Poland and
      control samples within the local Southampton population. The concentrations of
      all proteins measured were in or close to their expected range, with the
      exception of alpha 1-antitrypsin (alpha 1AT). The concentration of this protein
      was lower in both groups of Polish children from the polluted areas, particularly
      in the 5- to 6-year old group. These children were shown to be phenotypically
      normal. Since adult levels of alpha 1AT are usually reached within 2 weeks
      postpartum, these findings raise the possibility that continued exposure to high
      levels of pollution may lead to reduced levels of alpha 1AT in plasma; this may
      compound the impairment of lung function in children living in highly polluted
      areas.

PMID- 8353164
TI  - Depression in stroke rehabilitation.
AB  - Despite recent advances in understanding the pathophysiology of poststroke
      depression, major questions remain. They include the relative importance of
      lesion location and size and the confounding effects of time since stroke, age,
      prior history of depression, and cerebral atrophy. To evaluate these issues, we
      systematically assessed depressive features, functional status, and brain
      structure with computer tomography scans in 91 men undergoing stroke
      rehabilitation. Forty percent met DSM-III criteria for major depressive disorder.
      Mood disturbance was more severe for patients with right than with left
      hemisphere lesions, correlated with functional disability and lesion size, and
      was associated with previous history of depression. Age, time since stroke, and
      atrophy did not correlate with mood. Depression is common in delayed stroke
      recovery, regardless of lesion location. Because there are no demographic or
      anatomic features that predict the absence of depression, depression screening
      should be part of the assessment of all patients undergoing stroke
      rehabilitation.

PMID- 8353165
TI  - Amphetamine-produced attenuation of latent inhibition is modulated by stimulus
      preexposure duration: implications for schizophrenia.
AB  - The relationship between amphetamine-produced dopamine overreactivity and
      attention to irrelevant stimuli is reflected in an attenuated latent inhibition
      (LI) effect. This occurs in both animal and human subjects. The present study
      examines the manner in which this effect in rats is modulated by the duration of
      stimulus preexposure. A factorial design was used with three levels of stimulus
      preexposure duration and either amphetamine or saline administration. In
      addition, there were corresponding groups that did not receive stimulus
      preexposure. It was found that although amphetamine did indeed abolish LI at
      short exposure intervals (30 sec), the LI effect was normal for long stimulus
      preexposure durations (150 sec). The data were discussed in terms of the affects
      of amphetamine on the processing of irrelevant stimuli and the relationship of
      such a dysfunctional attentional process to schizophrenia.

PMID- 8353166
TI  - Indole-pyruvic acid, a tryptophan ketoanalogue, antagonizes the endocrine but not
      the behavioral effects of repeated stress in a model of depression.
AB  - Increased glucocorticoid secretion is frequent in mood disorders and is
      normalized by long-term antidepressant therapy. Many antidepressants act by
      increasing central serotonin transmission. We investigated the effects of a
      serotonin precursor, indole-pyruvic acid (IPA), in an animal model of depression
      based on repeated exposure to unpredictable stress. Rats were divided in groups,
      and IPA (20 mg/kg), the tricyclic antidepressant imipramine (IMI) (5 mg/kg), or
      vehicle was administered daily during 3 weeks of repeated exposure to various
      stressors according to the procedure described by Katz et al [Katz RJ, Roth KA,
      Carroll BJ (1981): Neurosci Biobehav Rev 5:247-251]. After treatment, rats were
      evaluated for stress-induced exploratory behavior and killed 24 hr later. Serum
      corticosterone levels and glucocorticoid receptor (GR) immunoreactivity (IR) in
      the nuclei of neurons located in the hippocampal subregion CA1 were also
      measured. Rats exposed to repeated stress showed a lower exploratory behavior
      score (p < 0.01), higher basal corticosterone levels (p < 0.01), and stronger GR
      IR in the hippocampus (p < 0.05) than control rats. All of these effects were
      antagonized by IMI treatment. IPA administration did not affect the behavioral
      response induced by repeated stress (p < 0.01) but normalized serum
      corticosterone levels. In addition, IPA treatment produced a decrease in GR IR (p
      < 0.05 versus control group) that was not modified by exposure to repeated
      stress.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353167
TI  - N200 component of event-related potentials in depression.
AB  - Event-related potentials (ERPs) recorded during a two-tone discrimination
      (oddball) task were examined in 36 drug-free depressed patients and 36 control
      subjects. At remission, the ERPs of 12 of the depressed patients were reexamined.
      In the depressed patients, although a group difference was not detected in the
      peak latency and amplitude of N200 to rare stimuli, the mean amplitude for the
      N200 latency range in the difference waves was smaller than in the control
      subjects. Mismatch negativity (N2a), which was elicited by rare stimuli, was
      reduced in amplitude; but N2b may have been evoked to frequent stimuli more in
      the patients than in the control subjects. Depressed subjects may have a deviance
      in the fully automatic cerebral mismatch process that is assumed to be related to
      mismatch negativity and provoke the controlled mismatch detection process
      (presumed to be associated with N2b) even to nontarget frequent stimuli. These
      findings were observed during remission; however, there was a tendency for the
      N2b amplitude to decrease and recover toward the level of the control subjects.

PMID- 8353168
TI  - 3H-spiroperidol binding to peripheral mononuclear cells in schizophrenic and
      healthy subjects.
AB  - 3H-spiroperidol binding to peripheral blood mononuclear cells was measured in 28
      patients, who fulfilled DSM-III-R-criteria for schizophrenia and 17 healthy
      subjects. There were no significant differences in characteristic binding
      parameters (Kd, Bmax) between schizophrenic and healthy subjects. Moreover, there
      was no relation of binding parameters to any of the subtypes of schizophrenia or
      to the course of illness according to DSM-III-R-criteria. However, some patients
      exhibited higher Bmax values without having a unique clinical symptomatology
      according to known diagnostic criteria. Neuroleptic treatment had no consistent
      effect on binding parameters intraindividually. Kd and Bmax values were not
      related to age or gender. In conclusion, despite our previously reported improved
      methodology, we were not able to corroborate the clinical importance of this
      "peripheral marker" as a tool for diagnosing schizophrenia or for predicting the
      response to neuroleptic treatment in our sample of schizophrenic patients.

PMID- 8353169
TI  - Glial fibrillary acidic protein in the cerebrospinal fluid of children with
      autism and other neuropsychiatric disorders.
AB  - The cerebrospinal fluid (CSF) of 47 children and adolescents with autism was
      analyzed for the contents of two astroglial proteins, the glial fibrillary acidic
      protein (GFA) and S 100. The results were contrasted with those obtained in
      similarly aged cases with other neuropsychiatric disorders (n = 25) and in normal
      children (n = 10). S-100 did not discriminate the groups from each other.
      However, GFA in autism and autistic-like conditions was at a level almost three
      times that in the normal group. The results could implicate gliosis and
      unspecific brain damage in autism. An alternative model would be increased
      synapse turnover regardless of underlying cause.

PMID- 8353170
TI  - A pilot study of biological predictors of treatment outcome in obsessive
      compulsive disorder.

PMID- 8353171
TI  - Auditory-evoked responses in chronic alcohol and drug abusers.

PMID- 8353172
TI  - THA does not affect sleep or EEG spectral power in Alzheimer's disease.

PMID- 8353173
TI  - The noncompliance factor in the dexamethasone suppression test.

PMID- 8353174
TI  - Dopamine and depression: circuitous logic?

PMID- 8353175
TI  - Mouse preimplantation embryos exhibit receptor-mediated binding and transcytosis
      of maternal insulin-like growth factor I.
AB  - High-resolution microscopy in conjunction with colloidal gold-labeled insulin
      like growth factor I (IGF-I) has been used to provide evidence that the IGF-I
      receptor is first detected in 8-cell-stage mouse embryos, confirming the results
      of previous reverse transcriptase polymerase chain reaction (RT-PCR) studies.
      Specificity for the IGF-I receptor was demonstrated by displacement with
      unlabeled IGF-I and dual-labeling experiments with colloidal gold-labeled or
      unlabeled insulin. Labeled IGF-I ligand is internalized by means of receptor
      mediated endocytosis following its concentration in coated pits, and it can be
      visualized within cytoplasmic organelles. Immunocytochemical analyses at the
      blastocyst stage, using gold-labeled antibodies to the receptor, confirmed the
      expression of IGF-I receptors on all cells of the embryo. Similar studies with
      antibodies directed against the ligand demonstrated that IGF-I internalized by
      the embryo in vivo is maternally derived. Approximately 40% of blastocysts showed
      apical plasma membrane binding of gold-labeled ligand ("responders"), while
      approximately 60% did not demonstrate binding ("nonresponders"); however, both
      classes of embryo expressed receptors on basolateral membranes of trophectoderm
      cells and on the surface of inner masses. Functional studies show that incubating
      embryos in physiological levels of IGF-I (40 ng/ml) results in increased numbers
      of cells in the inner cell mass (p < 0.05), but not the trophectoderm, as
      compared to controls.

PMID- 8353176
TI  - Hyperosmotic tolerance of human spermatozoa: separate effects of glycerol, sodium
      chloride, and sucrose on spermolysis.
AB  - Hyperosmotic stress, which cells experience during the freezing process, and its
      release during the warming process are both related to cryoinjury. To define
      optimal cooling or warming rates and prevent osmotic injury to human sperm,
      information is required regarding the osmotic tolerance of the cells as a
      function of 1) time, 2) temperature, 3) type of solute, and 4) solute
      concentration. Human sperm samples were divided into three aliquots. The aliquots
      were equilibrated at 0, 8, and 22 degrees C, respectively. Different hyperosmotic
      solutions were prepared by addition of either a permeating cryoprotective agent
      (glycerol) or nonpermeating solutes (sucrose, non-ionic; or NaCl, ionic) to
      isotonic Mann's Ringer solution. Aliquots of the prepared solutions were
      equilibrated at 0, 8, and 22 degrees C, respectively. A small volume (2.5
      microliters) of each sperm aliquot was quickly mixed with 50 microliters of each
      hyperosmotic solution at the corresponding temperature. After times ranging from
      5 s to 5 min, 10 microliters of each hyperosmotic cell suspension was abruptly
      returned to an isosmotic environment by mixing with 500 microliters of Mann's
      Ringer solution at the corresponding temperature. The plasma membrane integrity
      of cells after exposure to hyperosmotic stress and after return to isosmotic
      conditions was measured by a dual staining (carboxyfluoroscein diacetate and
      propidium iodide) technique and flow cytometry. The morphology of the treated
      cells was observed by scanning electron microscopy of freeze-substituted sperm.
      The results indicate that human spermatozoa exhibited a significant
      posthypertonic lysis/injury, i.e., loss of membrane integrity, when returned to
      isosmotic conditions after exposure to hyperosmotic solutions of NaCl or sucrose.
      The higher the hyperosmolality, the more serious the cell injury. The majority of
      the cells (> 50%) lost membrane integrity when the osmolality was > or = 2000
      mOsm. In contrast, if the sperm were not returned to isosmotic conditions, the
      majority of the sperm in the hyperosmotic solutions appeared to maintain membrane
      integrity. For a given higher hyperosmolality (> 1000 mOsm), posthypertonic
      spermolysis was reduced with a decrease of temperature. Cell survival was also
      affected by time of cell exposure to hyperosmotic environments before cells were
      returned to the isotonic condition. The shorter the time, the higher the cell
      survival. When exposed to hyperosmotic glycerol solutions that were isotonic with
      respect to electrolytes, few cells lost their membrane integrity if the
      osmolality of glycerol was < 3000 mOsm. For a fixed high osmolality (> 3000
      mOsm), the lower the temperature, the higher the percentage spermolysis.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8353177
TI  - Effects of growth factors and growth factor-extracellular matrix interactions on
      mouse trophoblast outgrowth in vitro.
AB  - A variety of cell types at the blastocyst implantation site produce growth
      factors that could play important role(s) in the implantation process. Recent
      evidence indicates that decidual cells and/or embryos produce transforming growth
      factor-alpha (TGF-alpha), epidermal growth factor (EGF), platelet-derived growth
      factor (PDGF), fibroblast growth factor (FGF), and colony-stimulating factor (CSF
      1). Furthermore, receptors for EGF, PDGF, and CSF-1 have been detected on
      embryonic and trophoblastic cells. The purpose of this study was to investigate
      the effects of these growth factors and possibly growth factor-extracellular
      matrix interactions on mouse blastocyst attachment and trophoblast outgrowth in
      vitro. Various dilutions of the growth factors TGF-alpha, EGF, PDGF, FGF, and CSF
      1 were added to cultures of 5-day-old hatched blastocysts in fibronectin-coated
      plastic wells. Blastocysts were scored for attachment, trophoblast outgrowth, and
      surface area at 24, 48, and 72 h. Each of these growth factors significantly
      enhanced trophoblast outgrowth, and a cocktail containing all of the growth
      factors had a significantly stronger effect. PDGF and FGF, but no other growth
      factors, also enhanced trophoblast outgrowth following pulsatile incubation with
      the fibronectin matrix coating of the culture wells, indicating that interactions
      between these growth factors and extracellular matrix elements could influence
      implantation. This study suggests that various growth factors may play an
      important role in the implantation process, that synergistic effects may be
      obtained by combinations of growth factors, and that interactions between certain
      growth factors and extracellular matrix elements may be significant.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8353178
TI  - Mullerian inhibiting substance production associated with loss of oocytes and
      testicular differentiation in the transplanted mouse XX gonadal primordium.
AB  - The mouse XX gonadal primordium develops seminiferous-like tubules after
      transplantation into the renal subcapsular site of the adult male or female
      mouse. We examined the ontogeny of Sertoli cell differentiation in XX gonadal
      grafts by immunocytochemical staining and organ culture bioassay for Mullerian
      Inhibiting Substance (MIS). During normal in situ development of the XY gonad,
      MIS staining was first detected in fetal Sertoli cells at 12 days of gestation
      (d.g.) and remained intense until 4 days postpartum (d.pp.), after which it
      gradually diminished with progressive testicular development. In the normal in
      situ XX gonad, MIS was detected in granulosa cells of growing follicles at 7
      d.pp. and thereafter. When the XX gonad at 12 d.g. was grafted beneath the renal
      capsule, a few testicular cords composed of MIS-positive cells appeared on Day 7
      post-transplantation (equivalent to 19 d.g.), much earlier than the normal
      appearance of MIS production in the intact XX ovary. The ovarian region
      containing germ cells at the meiotic prophase was unstained for MIS in the same
      sections. The incidence of XX gonadal grafts containing MIS-positive testicular
      cords and the number of such cords per gonadal graft steadily increased from Day
      7 to Day 14 post-transplantation. Germ cells were absent or scarce inside the MIS
      positive testicular cords. The MIS bioactivity in both control gonads and gonadal
      grafts coincided with the immunocytochemical staining for MIS. These results
      support the hypothesis that XX cells differentiate into Sertoli cells as a
      consequence of oocyte loss in the gonadal graft.

PMID- 8353179
TI  - Zona pellucida filtration of structurally abnormal spermatozoa and reduced
      fertilization in teratospermic cats.
AB  - Zona pellucida (ZP) penetration, in vitro fertilization, embryo development, and
      the morphology of fertilizing sperm were examined through use of normospermic (>
      60% structurally normal sperm/ejaculate) versus teratospermic (< 40% structurally
      normal sperm/ejaculate) ejaculates from domestic cats. In addition, the effect of
      swim-up processing on sperm-oocyte interaction was compared with that of simple
      sperm washing. Normospermic and teratospermic ejaculates were evaluated for sperm
      motility and morphology. Sperm were preincubated for 1 h, then coincubated with
      in vivo-matured follicular cat oocytes (n = 401) for 20 h and with ZP-intact,
      salt-stored oocytes (n = 202) for 6 h. In vivo-matured oocytes were assessed for
      percent cleavage and stage of embryo development over time. Salt-stored oocytes
      were assessed for percent ZP penetration (proportion of oocytes containing sperm
      within or through the inner ZP), mean (+/- SEM) number of inner ZP-penetrated
      sperm, and the morphology of all bound and penetrated sperm. The incidence of
      pleiomorphic sperm in raw ejaculates averaged 29% in normospermic versus 67% in
      teratospermic males, but all ejaculates contained high sperm motility ratings (>
      60%). Swim-up processing increased (p < 0.05) the number of normal sperm
      recovered/teratospermic inseminate (66.5 +/- 2.3%) compared to recovery after
      simple washing (28.6 +/- 2.2%). Percent sperm motility also increased (p < 0.05)
      in teratospermic males after swim-up (90.0 +/- 1.3%) as compared to sperm washing
      (64.2 +/- 3.7%). Cleavage rate in vitro was higher (p < 0.05) using sperm from
      normospermic (86.3%) compared to teratospermic (50.3%) males, but rates of embryo
      development to the morula/blastocyst stage were similar (p > 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8353180
TI  - Serotonergic 5HT2 receptors mediate the inhibitory action of serotonin on
      luteinizing hormone secretion in ovariectomized, estradiol-treated ewes that are
      refractory to short days.
AB  - Previous studies with high doses of cyproheptadine suggested that serotonergic
      (5HT) neural mechanisms participate in the photoperiodic inhibition of secretion
      of LH in ovariectomized estradiol-treated ewes. In the present study, we tested
      this hypothesis further with lower doses of more specific 5HT2 receptor
      antagonists, including the highly specific ketanserin. Eight ovariectomized
      estradiol-treated ewes were subjected to 90 long days (16L:8D) followed by 207
      short days (8L:16D) in order to induce photorefractoriness. Plasma LH
      concentrations were measured in blood sampled twice weekly. Changes in LH pulse
      frequency were measured after intrajugular injections of cyproheptadine or
      ketanserin (0.1, 0.25, 0.6, and 1.5 mg/kg) before the increase in LH secretion
      induced by the short days (SD ewes). After the ewes became refractory to short
      days (RSD ewes), they were again treated with the three lowest doses of
      cyproheptadine and ketanserin and, in addition, methysergide at the same doses.
      In the period following the transition from long to short photoperiod, LH
      secretion increased above basal levels after 42.0 +/- 0.0 days (mean +/- SEM) and
      then decreased after 137.0 +/- 7.4 days. In SD ewes, cyproheptadine significantly
      increased the number of LH pulses at the lowest dose tested (0.13 vs. 1.13
      pulses/3 h at 0.1 mg/kg). Similar responses were observed at 0.25 mg/kg (0.13 vs.
      0.88 pulses/3 h), at 0.6 mg/kg (0.13 vs. 0.75 pulses/3 h) and at 1.5 mg/kg (0.13
      vs. 0.88 pulses/3 h). Ketanserin induced a dose-dependent increase in the number
      of LH pulses at 0.6 mg/kg (0 vs. 0.63 pulses/3 h) and at 1.5 mg/kg (0 vs. 0.75
      pulses/3 h).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353181
TI  - Effects of corticotropin-releasing hormone on luteinizing hormone, testosterone,
      and cortisol secretion in intact male rhesus macaques.
AB  - We previously have shown that 6 h of restraint stress in intact male rhesus
      macaques (Macaca mulatta) suppresses plasma levels of both LH and testosterone
      and that this effect lasts beyond the period of restraint. Since corticotropin
      releasing hormone (CRH) inhibits both the GnRH pulse generator and LH release in
      ovariectomized macaques and is generally thought to be the central mediator of
      stress-induced inhibition of gonadotropin release, we investigated the influence
      of CRH administration on LH and testosterone in unrestrained intact male rhesus
      macaques. Blood samples were collected from 5 intact male macaques at 15-min
      intervals for 15 h from a remote site. During this time, each animal received a 4
      h infusion of CRH (100-micrograms bolus followed by 100 micrograms/h for 4 h)
      through an indwelling jugular catheter. Blood samples were collected for an
      additional 8 h after cessation of the CRH infusion. ACTH and cortisol levels were
      significantly elevated during and after the CRH infusion and were comparable to
      levels observed during restraint. Although LH levels appeared lower in animals
      given CRH, they were not different from those in untreated control males. In some
      animals, CRH appeared to stimulate or prolong LH release. Testosterone levels in
      CRH-treated animals were significantly lower than in controls both during and
      after CRH administration. In some instances, increases in plasma LH were not
      accompanied by a rise in testosterone. This would suggest that as was observed in
      restrained animals, stress exerts either a direct or an indirect inhibition of
      testicular testosterone secretion. The present data indicate that this effect may
      be mediated by CRH.

PMID- 8353183
TI  - Identification and partial characterization of an immunoglobulin A protease
      associated with human sperm.
AB  - The ability of human sperm to evade local humoral immune response at the female
      genital tract has received little attention. As some microorganisms inactivate
      secretory immunoglobulin A (S-IgA) by enzymatic degradation as a part of their
      pathogenic mechanism, we decided to test the hypothesis that there is an IgA
      protease in human semen that helps sperm to progress through the cervix uteri.
      Incubation of different semen fractions in the presence of S-IgA revealed IgA
      protease activity associated with raw semen or sperm but not with seminal plasma;
      raw semen and sperm produced two split products of 66 kDa and 45 kDa,
      respectively, in SDS-PAGE. The enzymatic activity was blocked with EDTA. IgG and
      IgM were not digested under the same experimental conditions. Degradation of S
      IgA by an IgA protease on the sperm surface may be among the mechanisms present
      in semen that enable sperm to evade an immune response in the female genital
      tract.

PMID- 8353182
TI  - Purification and partial characterization of relaxin and relaxin precursors from
      the hamster placenta.
AB  - Previous immunological studies have indicated that the molecular structure of
      hamster relaxin is quite different from that of porcine relaxin. In the present
      study, hamster relaxin was purified from placentas and characterized in order to
      investigate its biochemical properties. Placentas from Days 14 and 15 of
      gestation were homogenized in 0.26 N HCl-62.5% acetone containing protease
      inhibitors. After centrifugation, soluble proteins were acetone precipitated.
      Soluble proteins were applied to a carboxymethyl cellulose ion-exchange column
      and bound proteins were eluted with 0.1 and 0.3 M NaCl. Western blot analysis
      detected 16.5-, 18.7-, and 36.0-kDa relaxin-immunoreactive (IR) proteins within
      the 0.1 M NaCl eluant and detected a 5.6-kDa relaxin-IR protein within the 0.3 M
      NaCl eluant. The 5.6-kDa protein was purified to homogeneity by gel filtration
      (Sephadex G-50), ion-exchange HPLC, and C18-HPLC. Reduction of the 5.6-kDa
      protein prior to electrophoresis resulted in a single band of lower molecular
      mass, suggesting that hamster relaxin consists of two chains of approximately
      equal molecular mass. Isoelectric point of the 5.6-kDa protein was 7.78. The 16.5
      and 18.7-kDa IR proteins were copurified by gel filtration and ion-exchange
      HPLC. At least five isoelectric point variants were observed for the 16.5- and
      18.7-kDa proteins. The N-terminal amino acid for the 5.6 and 18.7 relaxin-IR
      proteins was arginine, and subsequent cycles indicated an identical partial
      sequence that was consistent with that for relaxins from other species.

PMID- 8353184
TI  - Nuclear status of human sperm cells by transmission electron microscopy and image
      cytometry: changes in nuclear shape and chromatin texture during spermiogenesis
      and epididymal transit.
AB  - Computer-assisted transmission electron microscopy (TEM) image cytometry was used
      to investigate changes in nuclear shape and chromatin texture of human sperm
      during normal spermiogenesis and epididymal transit. Analysis was performed on a
      large series of micrographs of longitudinal sections of nuclei from spermatids
      and epididymal caput and cauda sperm. Thirteen parameters characterizing nuclear
      shape and chromatin texture were measured. Quantitative data showed that from
      early spermiogenesis to the end of epididymal transit, a decrease in nuclear area
      and width occurred concomitantly with not only an increase in chromatin
      condensation but also an increase in heterogeneity of the degree of condensation.
      The oriented spatial arrangement of chromatin along the major nuclear axis as
      measured by gradient parameters indicated that in humans, condensation of
      chromatin begins in the posterior pole and proceeds apically; this is an
      important difference between humans and other mammalian species. Most parameters
      did not differ substantially in sperm from testis and caput epididymis, but did
      change as the cells moved from the caput to the cauda epididymis, indicating
      completion of nuclear maturation. Discriminant functions of basic parameters, as
      followed by canonical transformation and cluster representation, automatically
      classified the nuclei in a sequence that was found to concur with the biological
      maturation sequence during normal spermiogenesis and epididymal transit.

PMID- 8353185
TI  - Involvement of the central noradrenergic system in opioid modulation of
      luteinizing hormone and prolactin secretion in the pig.
AB  - The role of norepinephrine (NE) in the progesterone (P)-dependent endogenous
      opioid peptide (EOP) suppression of LH and prolactin (PRL) secretion in the pig
      was studied. Fifteen ovariectomized gilts treated with P (0.85 mg/kg b.w. i.m.)
      twice daily for 10 days were assigned, 5 gilts each, to the following treatment
      groups: 1) control, 2) AIMAX (N-methyl-N1[1-methyl-2-propenyl]1,2
      hydrazinedicarbothioamide), and 3) anti-GnRH serum. On day 4 of P treatment,
      AIMAX (125 mg per 1.8 kg feed/day), previously shown to be an NE synthesis
      inhibitor, was fed daily for 7 days to group 2. On the last day of P treatment,
      group 3 gilts received an i.v. injection of anti-GnRH serum at 0800 h while Group
      1 animals received an i.v. injection of serum collected from hypophysectomized
      gilts. Jugular blood samples were collected every 15 min for 9 h starting at 1000
      h. All gilts received two injections of naloxone (NAL; 1 mg/kg b.w., i.v.) at
      1400 h and 1600 h and an injection of a GnRH analogue (D-[Ala6-desGly-NH10]
      ethylamide; 5 micrograms/pig, i.v.) at 1800 h. Pretreatment serum LH
      concentrations were lower (p < 0.05) in AIMAX-treated gilts (0.19 +/- 0.09 ng/ml)
      than in controls (0.53 +/- 0.09 ng/ml), but were similar to those in GnRH
      antiserum-treated gilts (0.32 +/- 0.09 ng/ml). NAL increased (p < 0.001) serum LH
      concentrations in control animals and averaged 1.6 +/- 0.2 ng/ml the first h.
      AIMAX and anti-GnRH serum blocked the NAL-induced LH secretion. Serum PRL
      concentrations averaged 6.0 +/- 0.1 ng/ml for all groups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8353186
TI  - Repeated administration of prostaglandin F2 alpha during the early luteal phase
      causes premature luteolysis in the pig.
AB  - Previous investigators considered pig corpora lutea refractory to the luteolytic
      effects of prostaglandin (PG) F2 alpha before Day 12 of the estrous cycle. This
      study was designed to determine whether multiple injections of PGF2 alpha would
      result in a sustained reduction of serum progesterone and luteolysis, leading to
      significant shortening of the estrous cycle and interestrous interval. On Days 5
      10 of an estrous cycle, gilts (n = 4) received injections of 12.5 mg PGF2 alpha
      (dinoprost tromethamine) i.m. every 12 h, or vehicle (PBS; n = 4) according to
      the same schedule. Mean interestrous interval in PGF2 alpha-treated gilts was
      reduced (p < 0.001) to 13.3 +/- 0.5 days compared with 19.8 +/- 0.6 days for
      control gilts. Serum progesterone declined below 1 ng/ml by Day 10.5 in PGF2
      alpha-treated gilts compared to Day 17.5 in control animals. Serum concentrations
      of estradiol-17 beta (E2) reached maximal levels in PGF2 alpha-treated gilts
      earlier (Day 12.5) in the cycle than in control gilts (Day 19.5). Peak E2 and LH
      concentrations coincided with the periestrous period, suggesting that PGF2 alpha
      induced estrus is accompanied by normal follicular development and ovulation.
      These results demonstrate that the pig is susceptible to the luteolytic effects
      of PGF2 alpha before Day 12 if repeated injections are given from Day 5 through
      Day 10.

PMID- 8353187
TI  - Progesterone regulation of endometrial estrogen receptor and cell proliferation
      during the late proliferative and secretory phase in artificial menstrual cycles
      in the rhesus monkey.
AB  - Progesterone (P) down-regulation of uterine estradiol (E) receptor (ER) appears
      to be a general mechanism by which P modulates E action in the uterus. Our
      present studies focus on the regulation of ER by P during the changeover from E
      to P dominance during artificial menstrual cycles in the rhesus monkey. Because
      of differential cell-type response and the cellular zonation of the primate
      uterus, we used immunohistochemical analysis in addition to biochemical assays to
      study the regulation of ER by P. Ki-67 immunoreactivity was used as an index of
      endometrial proliferation. We performed our analyses on Days 13 (peak of E), 14
      (declining E and rising P), 17 (basal E and rising P), and 21 (basal E and peak
      P). ER immunoreactivity was present throughout the endometrium in luminal and
      glandular epithelia and stromal fibroblasts on Day 13. As E was withdrawn and P
      rose on Day 14 there were few distinct changes in ER staining in stromal and
      epithelial cells. On Day 17, immunoreactive staining showed a distinct reduction
      for stromal cells in all zones. Although luminal epithelial cells showed a
      decrease in immunoreactivity on Day 17, zones II, III, and IV retained positive
      staining for ER in glandular epithelia. ER staining in stromal cells on Day 21
      was similar to the pattern observed on Day 17, whereas epithelial cells in zones
      I, II, and III showed a reduction in staining. Glandular epithelia in zone IV
      maintained strong positive staining for ER on Day 21.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8353188
TI  - Development of rabbit zygotes cultured in protein-free medium with catalase,
      taurine, or superoxide dismutase.
AB  - The present study was designed to examine the influence of several potential
      antioxidants in a synthetic medium completely devoid of macromolecules.
      Antioxidants may be beneficial as additives to a synthetic medium because they
      could serve as scavengers of toxic free radicals in media lacking serum, serum
      albumin, or other macromolecules that may serve as scavengers in more complex
      media. Rabbit zygotes were cultured for 72 h at 39 degrees C in media containing
      varying concentrations of the anti-oxidants in a gas phase consisting of 5%
      CO2:95% humidified air. At 72 h embryo development was recorded, and embryos were
      fixed and stained with Hoechst 33342 DNA stain to facilitate counting of cells.
      In experiment 1, concentrations of catalase ranging from 250 to 1000 IU did not
      affect the proportion of zygotes developing into blastocysts or the cell number
      (p > 0.05). In experiment 2, 2.5-10 mM taurine increased the proportion of
      zygotes developing into expanding blastocysts (70-78% vs. 40% for controls) and
      increased cell number from 100 to 154-159 (p < 0.05). In experiments 3 and 4,
      superoxide dismutase was tested over a range of 100-2400 IU/ml. The response
      reached a plateau at 600 IU/ml, with positive responses in rate of embryo
      development and growth similar to that found with taurine in experiment 2. These
      studies indicate that culture of zygotes into blastocysts in a macromolecule-free
      medium with 5% CO2:95% air is substantially improved when agents that could serve
      as antioxidants are included. Other mechanisms of action are not excluded by
      these studies.

PMID- 8353189
TI  - Chorioallantoic placenta formation in the rat. III. Granulated cells invade the
      uterine luminal epithelium at the time of epithelial cell death.
AB  - Rat gestation sites were microscopically examined on Days 7, 8, and 9 of
      pregnancy to determine the fate of epithelial cells lining the uterine lumen
      mesometrial to the implantation chamber. This region of the uterine lumen and the
      mesometrial region of the implantation chamber comprise the site of
      chorioallantoic placenta formation. The fate of the uterine luminal epithelium
      was closely associated with a subepithelial accumulation and epithelial invasion
      of granulated cells (granulated metrial gland cells). On Day 7, mature granulated
      cells were not detected in the subepithelial stroma, and epithelial cells
      appeared healthy. On Day 8, when granulated cells began populating the
      subepithelial stroma and a few crossed the basal lamina, some epithelial cells
      degenerated in situ. On Day 9, when large numbers of granulated cells invaded the
      epithelium, large numbers of epithelial cells were displaced from their basal
      lamina and were degenerating. Degenerating cells were of two morphological types.
      One type conformed to the standard description of apoptosis; that is, cells
      rounded up, detached from their neighbors, and their nuclei fragmented, although
      other organelles remained intact. The other type of cell degeneration resembled
      apoptosis in some respects, but the cells were very electron-dense, adjacent
      cells often remained attached, membranous organelles including mitochondria were
      swollen, and nuclei did not fragment. Granulated cells are related to natural
      killer cells, cells that induce target cell apoptosis, and we suggest that
      granulated cells may be involved in uterine luminal epithelial cell death. The
      conceptus remained in an antimesometrial region of the implantation chamber
      during the times studied and did not come into direct contact with these
      epithelial cells.

PMID- 8353190
TI  - Removal of the olfactory bulbs modifies the gonadal responses to photoperiod in
      the lesser mouse lemur (Microcebus murinus).
AB  - The sexual activity of the lesser mouse lemur, unlike that of most living
      primates, is clearly dependent on photoperiod. Males responded to long daylengths
      (> 12 h light/day) by rapid testicular development and an increase in
      testosterone levels reaching 65.8 +/- 1.5 ng/ml (n = 12) after 3 wk of inductive
      photoperiod. Levels were maintained unchanged until 14 wk of exposure to long
      photoperiod, when spontaneous gonadal regression was observed. Under short
      daylengths, intact males exhibited regressed gonadal function with low plasma
      concentrations of testosterone: 5.4 +/- 1 ng/ml. To investigate the effect of
      olfactory bulb deprivation on gonadal responses to photoperiod, 12 males were
      bulbectomized (BX) during exposure to either long (n = 8, BX1) or short (n = 4,
      BX2) daylengths. In both groups of BX males, responses to long or short
      daylengths were maintained. However, the timing and the amplitude of gonadal
      responses to photoperiod were modified; BX males underwent a significant delay in
      testis development and also had reduced testosterone levels (53.3 +/- 2.3 ng/ml
      and 37.3 +/- 0.9 ng/ml for BX1 and BX2 groups, respectively). Moreover, BX males
      did not exhibit spontaneous gonadal regression after 14 wk of exposure to long
      daylengths, indicating that the photorefractory state did not appear, at least
      under our experimental conditions. In this primate, olfactory bulbs exert an
      important effect on the neuroendocrinological control of reproductive
      responsiveness to photoperiod.

PMID- 8353191
TI  - Immunosuppressive levels of glucocorticoid block extrauterine luteolysins in the
      rat.
AB  - Leukocytes, normal constituents of the corpus luteum, release prostaglandins
      (PGs), superoxide, and hydrogen peroxide (H2O2) upon activation. These products
      appear to mediate luteolysis, and it has been postulated that activated
      leukocytes serve a role in corpus luteum regression. Glucocorticoids prevent
      leukocyte infiltration and activation by inhibiting cytokine production,
      secretion, and action, and also inhibit eicosanoid synthesis. The objective of
      the present studies was therefore to assess whether glucocorticoid would
      influence luteal regression in the rat. Ovulation and pseudopregnancy were
      synchronized in prepubertal rats by gonadotropin treatment. In uterine-intact
      rats, functional luteal regression, assessed from serum progesterone levels,
      began on Day 10 and was complete by Day 14. Dexamethasone blocked luteal
      regression in uterine-intact animals when administered daily from early in
      pseudopregnancy for as long as treatment was continued (up to Day 17).
      Immunosuppressive effects of dexamethasone were evident in the inhibition of
      estrogen-induced infiltration of eosinophils, as shown by abrogation of estrogen
      induced uterine peroxidase activity, and high continuous levels of dexamethasone
      were necessary to block luteolysis. Hysterectomy extended luteal function by
      several days, with maintenance of maximal serum progesterone levels up to Day 12;
      but serum progesterone levels were reduced about 50% by Day 16 and completely
      depressed by Day 19. Dexamethasone treatment of hysterectomized rats from Day 12
      until Day 15 or 18 blocked the decline in serum progesterone levels.
      Dexamethasone treatment did not block the decrease in serum progesterone levels
      induced within 24 h by PGF2 alpha in uterine-intact animals on Day 9 or in
      hysterectomized animals on Day 19.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353192
TI  - Effect of bovine serum albumin concentration and source on sperm capacitation in
      the golden hamster.
AB  - Since virtually all experiments on sperm capacitation routinely include serum
      albumin in the culture media, the relative effect of BSA concentration on sperm
      capacitation was investigated. The fertile life of hamster sperm, as measured by
      the ability to penetrate the zona pellucida, decreased from 5 to 3 h as the
      concentration of BSA was increased from 3 to 18 mg/ml. To determine the extent of
      sperm capacitation in sperm populations that resulted in 100% penetration, the
      rate and timing of sperm penetration through the zona pellucida was determined.
      For each insemination, the rate of sperm penetration (%/min), the time when 50%
      of the eggs were zona-penetrated (T50), and the sperm capacitation index
      (T50/rate) were calculated. The extent of sperm capacitation as measured by all
      three parameters increased as the duration of preincubation or the BSA
      concentration was increased. The data on the duration of preincubation and the
      BSA concentration matrix indicated two properties of the effect of BSA on sperm
      capacitation: 1) the extent of sperm capacitation after the first hour of
      preincubation was independent of BSA concentration; and 2) when sperm were
      preincubated for two or more hours, the capacitating effectiveness of BSA was
      saturable; the saturating concentration of BSA decreased as the duration of
      preincubation increased. To determine whether the first hour of preincubation is
      independent of BSA, sperm were preincubated for 1 h without BSA and then 2 h with
      BSA. The extent of sperm capacitation of these sperm was equal to that of the 3-h
      control sperm; thus the first hour of capacitation is independent of
      BSA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353193
TI  - Effect of cumulus maturity on sperm penetration in the golden hamster.
AB  - The influence of the cumulus on gamete interaction was investigated in naturally
      and precociously ovulated eggs from superstimulated (eCG) hamsters. Inseminations
      were performed in which the absolute gamete ratio (sperm/egg) was held constant,
      but the relative gamete ratio (sperm x egg-1 x ml-1) was varied 10-fold. Sperm
      penetration to the perivitelline space was significantly higher at the higher
      relative gamete ratio, indicating that there is no chemoattractant in the cumulus
      and that gamete interaction in cumulus-intact eggs is a function of collision
      frequency, which varies according to the relative gamete ratio. The level of
      successful gamete interaction as a function of the relative gamete ratio was
      determined for naturally and precociously ovulated eggs. The level of sperm
      penetration reached saturation at a relative gamete ratio of 10(3.3) for
      naturally ovulated eggs and 10(4.0) sperm x egg-1 x ml-1 for precociously
      ovulated eggs. At suboptimal relative gamete ratios, there was no difference in
      the level of penetration between partially and fully capacitated sperm. These
      results indicate that the larger, more mature cumulus of naturally ovulated eggs
      is successfully penetrated at lower collision frequencies than the denser, less
      mature cumulus of precociously ovulated eggs. To determine whether the maturity
      of the cumulus affects the timing of sperm penetration, cumulus-free and cumulus
      intact eggs were inseminated at their optimal relative gamete ratios. The rate of
      sperm penetration of partially capacitated sperm was not different between
      cumulus-free and cumulus-intact eggs, regardless of ovulation method. However,
      the period of time between insemination and when half the eggs were penetrated
      (T50) was longer in cumulus-intact eggs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353194
TI  - Glutathione concentration during maturation and after fertilization in pig
      oocytes: relevance to the ability of oocytes to form male pronucleus.
AB  - The present study examined the kinetics of glutathione (GSH) concentration during
      maturation and after fertilization in pig oocytes and its relevance to the
      ability of pig oocytes to form a male pronucleus after in vitro fertilization.
      The GSH concentration was significantly higher in pig oocytes matured in Waymouth
      medium than in pig oocytes matured in either modified (m) TCM-199 or mTLP media.
      The addition of 0.04-0.57 mM cysteine (CySH) to mTLP significantly increased both
      the GSH concentrations in oocytes matured in vitro and the rate of male
      pronucleus formation as compared to those in oocytes cultured in mTLP alone. When
      pig oocytes were cultured 12, 24, or 36 h in mTLP plus 0.14 mM CySH, their GSH
      concentrations were significantly higher than in uncultured oocytes. After
      fertilization, the GSH concentration in pig oocytes declined significantly. GSH
      concentrations in oocytes matured in vivo did not differ from those in oocytes
      matured in mTLP plus 0.14 or 0.57 mM CySH. The results indicate that 1) the
      composition of maturation medium affects the GSH concentration in pig oocytes; 2)
      the addition of CySH to maturation medium permits GSH synthesis by the pig
      oocytes; 3) GSH levels in pig oocytes change during maturation and after
      fertilization; and 4) GSH synthesis during oocyte maturation is an important
      factor for promoting their ability to form a male pronucleus after fertilization.

PMID- 8353195
TI  - [New opioids for anesthesia--do we need them?].

PMID- 8353196
TI  - [Cardiac pacemakers and implantable cardioverter-defibrillators in the
      perioperative phase].
AB  - Recent developments have changed the techniques and indications for different
      methods of temporary cardiac pacing. Temporary transvenous pacing involves
      endocardial right ventricular stimulation by a bipolar electrode, introduced
      directly via a vein, or through a "paceport" pulmonary artery catheter. A
      "multipurpose" pulmonary artery catheter permits both atrial and ventricular
      sensing and pacing. Noninvasive transcutaneous cardiac pacing is safe, fast, and
      easily applicable. However, pain and discomfort from cutaneous nerve or muscle
      stimulation may be intolerable for unsedated patients. Transoesophageal cardiac
      pacing is usually successful only for atrial stimulation, e.g., in sinus node
      bradycardia, but is not indicated in patients with impaired AV-conduction. In
      patients with implanted pacemakers, temporary cardiac pacing can both impair or
      improve the haemodynamic situation. Implanted pacemakers should always be checked
      following surgery involving electrocautery. Preoperatively, rate-responsive
      pacemakers should be re-programmed so as to avoid activation of the rate
      responsive function. Automatic implantable cardioverter-defibrillators should be
      deactivated to avoid delivery of inappropriate shocks. In patients with implanted
      epicardial patch electrodes, transthoracic defibrillation can be difficult with
      routine defibrillation protocols and may require positioning of the paddles on
      the lateral chest wall. However, emergency noninvasive transcutaneous cardiac
      pacing is possible in such patients with normal thresholds.

PMID- 8353197
TI  - [Quantifying pathological disorders of consciousness. Reliability criteria, aims,
      feasibility].
AB  - Within a survey of coma scales we distinguish scales of clinical findings
      (Glasgow Coma Scale [GCS], Glasgow Liege Scale [GLS], Innsbruck Coma Scale [ICS],
      Comprehensive Level of Consciousness Scale [CLOCS]), grading tests (Vigilance
      Scale [VS], Funktionspsychose-Skala-B [FPBS-B]) and level-scales (Reaction-Level
      Scale [RLS-85], Munich Coma Scale [MCS]). With regard to the purpose we
      differentiate a classification of depth, the prediction of prognosis and the
      monitoring of changes. For the purpose of classification of depth, the RLS-85
      because of its superior objectivity is preferable, but the GCS is of comparable
      validity and more widely used. The GLS differentiates the deeper states of coma
      better than either of these because brainstem-reflexes in cranio-caudal order are
      added. Within the prediction of prognosis all coma-scales have only limited
      validity and for the purpose of resource economy require additional criteria in
      the individual case. For the purpose of monitoring changes the level-scales
      primarily do not fit, the GCS is not sensitive enough. The Glasgow-Cologne-List
      is better suited; it is more than one-dimensional, but can be expressed through
      the GCS numbers for comparative purposes. The ICS is not widely used and the
      prognostic validity has not been proven to the same extent. The Glasgow-Cologne
      List could be amplified for the less severe disturbances of consciousness
      according to Price (32,33), and for the lower levels according to the GLS
      (2,3,4). In both cases the expense is slightly higher.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8353198
TI  - [Score systems in emergency medicine].
AB  - Trauma scores are used in emergency medicine to classify the severity of
      injuries. Score systems are applied in science and epidemiological investigations
      in emergency and intensive care. Moreover, trauma scores are intended to support
      the decisions in triage and predict the prognosis of mortality. Scores are based
      on anatomicmorphological or physiological parameters by which the intensity of
      injury is graded and valued. Commonly used scores are the Injury Severity Score
      (ISS) and the Revised Trauma Score (RTS). The Glasgow Coma Scale (GCS) is a
      system that is used worldwide to classify neurologic deficiencies after injury of
      the brain. Trauma scores have a good prognostic potential by comparing large data
      bases of different patient groups. Individual prognosis of mortality by trauma
      scores in the routine of emergency medicine are rapid classification of the
      injury after trauma and early identification of critically ill patients. Score
      systems can support decisions and the training of emergency staff. Future studies
      should go into the grade of rehabilitation and the quality of life after trauma
      as a -possibly score-aided-prognostic parameter.

PMID- 8353199
TI  - [Regulation of energy metabolism by the type and amount of carbohydrate
      administration].

PMID- 8353200
TI  - [New possibilities of parenteral nutrition by various administration forms of
      amino acids].

PMID- 8353201
TI  - [Importance of fats as energy supply, membrane building blocks and
      immunomodulators in parenteral nutrition].

PMID- 8353202
TI  - [Trace elements and electrolytes as binding element of intermediary metabolism].

PMID- 8353203
TI  - [Early extubation after heart surgery interventions: pro].

PMID- 8353204
TI  - [Early extubation after heart surgery interventions: contra].

PMID- 8353205
TI  - [Quality control 100 years ago. "Narcosis statistics" by Gurlt from 1893].
AB  - Even 100 years ago the problem of quality assurance in anaesthesia was
      investigated. In 1890 the German Society of Surgery decided to start "Multicenter
      Statistics on Surgical Anaesthesia." The project was headed by Ernst Gurlt,
      surgeon in Berlin. In 1893 he reported on the basis of 62 questionnaires on
      approximately 50,000 anaesthetic procedures, mostly performed with chloroform. 9
      fatal chloroform cases led to a mortality rate of 1:4,275. On the other hand
      among 6,213 cases with ether anaesthesia there was no death. Gurlt strictly
      recommended the administration of ether, seconded by contemporaries such as
      Garre, Trendelenburg, Roux and Juillard. Gurlt's report includes as appendix
      detailed information on the administered anaesthetics, application techniques,
      premedication, fatal and non-fatal complications extracted from 18 of the
      analysed questionnaires. Gurlt's publication is an early document of quality
      assurance in Germany.

PMID- 8353206
TI  - [Septic shock with acute abdomen in idiopathic hemochromatosis].
AB  - The case of a patient with abdominal crisis and shock without any discernible
      origin who died 36 hours after hospital admission despite maximal therapy is
      described. Gram-negative sepsis, peritonitis and haemochromatosis with hepatic
      siderosis was the post-mortem diagnosis. We consider spontaneous peritonitis
      arising from translocation of normal intestinal flora (E. coli) through the
      intact wall of the gut combined with the impaired ability of the reticulo
      endothelial system to remove endotoxin to be the causative factors. It is unknown
      whether the adrenal insufficiency due to siderophilic adrenal hypophysis and
      adrenal glands contributed to the fulminant course of the disease. Undiagnosed
      liver cirrhosis and especially haemochromatosis should therefore be included in
      the differential diagnostic considerations in patients presenting with these
      symptoms, and in whom no obvious cause for a septic focus can be found.

PMID- 8353207
TI  - Portrait of inequality.
AB  - America's children are stalked by race- and income-based inequities that demand
      our attention. Health care reform efforts that respect the needs of the entire
      child can diminish these inequities. Six prescriptions will help: universal early
      childhood education; comprehensive health and family life education; parental
      support; reinforcement of male responsibility; comprehensive school-based
      clinics; and opportunities for higher education.

PMID- 8353208
TI  - National health insurance: is this the answer for the poor and underserved?

PMID- 8353209
TI  - Health care reform: what it might mean to urban public hospitals.
AB  - Health care reform proposals may affect public hospitals in a number of ways. To
      insure that such proposals benefit the underserved communities within which
      public hospitals operate, reform initiatives should be evaluated against 10
      criteria that emphasize prevention and primary care, community health education,
      cost control, tort reform, and community values.

PMID- 8353210
TI  - Health care for Nebraska's medically indigent.
AB  - In this study, several alternatives for the provision of health care to the
      medically indigent of Nebraska were analyzed quantitatively and qualitatively.
      These alternatives were: expansion of county medical assistance programs, state
      purchased health insurance policies, Medicaid expansion, revenue pool to
      redistribute charity-care losses, all-payer rate system, mandated employer
      purchased health insurance, and charity-care districts. Under four future
      scenarios, alternatives were ranked on the basis of program costs, a sensitivity
      analysis, and qualitative criteria. This analysis found that state-purchased
      health policies would result in lower program costs than either an increase in
      county assistance programs or employer-mandated health insurance. Medicaid
      expansion would reach fewer than one-third of the state's medically indigent. A
      revenue pool and all-payer rate system are the least costly alternatives but
      depend on the continuing good will of providers.

PMID- 8353211
TI  - Hawaii's near-universal health insurance--lessons learned.
AB  - To date, Hawaii is the only state to have implemented near-universal health
      insurance. The cornerstone of this program is the country's only requirement that
      employers provide health insurance for all employees who work at least 20 hours
      per week. Combined with low unemployment, voluntary modified community rating by
      health insurers, and expanded Medicaid and Medicare, this employer mandate has
      been part of a patchwork mechanism that insures upwards to 95 percent of the
      state's population. Indeed, by adding a state-sponsored gap group-insurance
      program, Hawaii may now insure in excess of 95 percent of its population. The
      program has generated good health outcomes, good consumer satisfaction, and
      relatively modest overall health care expenditures. But for all that near
      universal insurance provides, there is still a great need for community-based
      preventive and primary care programs with outreach and family support services.
      In addition, traditionally underserved populations continue to be at increased
      risk. Both funding reform and continued infrastructure development must occur to
      achieve universal access to care.

PMID- 8353212
TI  - The Oregon Health Plan: a rational approach to care for the underserved.
AB  - The Oregon Health Plan addresses the needs of 450,000 Oregonians presently
      without health insurance, among them 120,000 living in poverty who are not now
      Medicaid-eligible. This is accomplished by expanding eligibility for Medicaid to
      individuals and families with incomes at 100 percent of the federal poverty
      level. T0 help expand access within the limitations of the state budget, certain
      services, determined to be of limited value or effectiveness, are not covered for
      payment. This concept of rationing health care reimbursement stands in contrast
      to existing mechanisms of rationing employed by every state and the nation. The
      Oregon Health Plan introduces a rational plan for expanding services to the
      entire population of the state, while acknowledging the limitations of funding
      resources.

PMID- 8353213
TI  - Managed health care for Medicaid enrollees: the Philadelphia model.
AB  - HealthPASS, a program of capitated managed care for 82,000 Medicaid enrollees in
      a defined geographic area of Philadelphia, Pennsylvania, is administered by
      Healthcare Management Alternatives, Inc. (HMA), a minority-owned corporation,
      under a multiyear contract with the Commonwealth of Pennsylvania. HMA has striven
      to improve care to this low-income community by mounting innovative campaigns to
      encourage early access to health care, ongoing health education, and aggressive
      outreach and follow-up, in addition to specific projects designed to reduce
      infant mortality, expand Head Start, and bolster pediatric care. The program has
      been judged independently to provide high-quality service cost-effectively.

PMID- 8353214
TI  - Can a poor state afford not to expand Medicaid?
AB  - Some advocates of the uninsured support expansion of Medicaid programs, while
      others say that expansions are simply unaffordable, especially in poor states.
      State-level analyses of the costs and consequences of these expansion programs
      are infrequent. This study evaluates three programs to expand eligibility for
      Alabama's Medicaid program. The first two programs would raise the Aid to
      Families with Dependent Children (AFDC) eligibility threshold to 50 and 100
      percent, respectively, of the federal poverty level. The third program, currently
      not available to the states without a federal waiver, would drop all categorical
      eligibility requirements and base eligibility solely on whether income is below
      the federal poverty level. Only 10.7 and 18.3 percent, respectively, of Alabama's
      uninsured would gain health care coverage under the first two programs. The third
      program would increase the proportion of Alabamians with health coverage to
      nearly 50 percent. For all of these programs, front-end state costs would be
      largely countered by federal funding and offsets, such as reductions in
      uncompensated hospital care and savings realized by former uninsureds from
      reductions in out-of-pocket expenditures for health services.

PMID- 8353215
TI  - How Tennessee finances Medicaid.
AB  - Tennessee is fortunate to have a comprehensive Medicaid program involving some 22
      optional services, all financed through a combination of state revenues. These
      range from general state revenues to provider-donated funds, provider-specific
      taxes, and recently, a privilege tax. The state pays approximately $920 million
      to participate in Medicaid; the state's share generates $1.9 billion in federal
      dollars. The current system for financing the state's Medicaid program is
      unsustainable. Because Tennessee is relatively poor, legislators cannot afford to
      continue to increase its share of Medicaid expenditures at a rate 10 times
      greater than the general revenue increase from the entire state. To continue a
      comprehensive Medicaid program, Tennessee must move forward with alternative
      strategies to control Medicaid expenditures and manage resources.

PMID- 8353216
TI  - Principles of health care reform: an African-American perspective.
AB  - To protect the interests of underserved Americans, fair and rational health care
      reform must embrace 10 principles. These include universal and comprehensive
      coverage; mandatory cost containment; equity; freedom to change jobs or to
      relocate; high quality; reduced paperwork; primary care; help for the
      underserved; consumer-oriented care; and fair financing.

PMID- 8353217
TI  - Local advocacy for the medically indigent: strategies and accomplishments in one
      county.
AB  - Because no national health program assures entitlement to basic services,
      advocates must cope with barriers to access on the local level. The authors
      report several strategies that a community-based coalition has used to improve
      indigent care in one county. Research strategies have involved short-term
      investigations of barriers to needed services. Political strategies have
      attempted to improve the county government's administrative procedures and
      financial support of services for the poor. Legal strategies have involved the
      participation of attorneys who represent clients unable to receive care. Although
      such advocacy efforts do not guarantee access, they can substantially improve the
      availability of local services.

PMID- 8353218
TI  - National health care reform and community and migrant health centers.
AB  - Community and migrant health centers (CHCs) have been shown to increase access to
      health care, improve health status, and reduce health care costs in communities
      that they serve. Thus CHCs can play an important role in providing for
      underserved communities under any program of national health care reform whose
      aim is universal, affordable access. To benefit the poor, such a plan should be
      federally administered and progressively financed, with comprehensible enrollment
      procedures, easy paperwork, and clearly delineated limits and benefits.

PMID- 8353219
TI  - A proposal to provide care to the uninsured through a network of community health
      centers.
AB  - While a national health insurance plan is needed, this alone will not provide
      access for approximately 30 million persons who face geographic, cultural,
      language, or health care system barriers, or who live in areas with provider
      shortages. These barriers often coexist with lack of insurance coverage, but they
      also affect millions who have public, or even private, coverage. Moreover, large
      segments of this population suffer from health problems not adequately addressed
      by the traditional medical model: teenage pregnancy, AIDS, injury, substance
      abuse, and the like. To provide appropriate care for these underserved persons,
      we propose to expand the existing network of community health centers over the
      next 10 years to a total of approximately 3,000. Such an expansion would provide
      a cost-effective approach to improving provider distribution, increasing consumer
      input, combining personal health services with health promotion, and removing
      both financial and nonfinancial barriers to care. This model can be implemented
      either independent of or in conjunction with other health care system reform
      efforts.

PMID- 8353220
TI  - Targeting needs of the underserved: current programs in Tennessee.
AB  - Health care needs of indigents are a major force driving the need for health care
      reform in the U.S. Governor McWherter of Tennessee and his Administration have
      highlighted the need for available, affordable, and accessible health care
      services for all Tennesseans and especially for the medically indigent. This
      paper describes programs developed and implemented during the McWherter
      administration. These programs include community health agencies, placement of
      health care providers in underserved areas, increasing the number of citizens
      served by the Medicaid program, coordination of high-risk prenatal and child care
      to year one, and special demonstration projects in various African-American
      communities. Major reform is needed at the national level. In the meantime, the
      McWherter Administration will continue to develop new and innovative ways to
      increase the availability, accessibility, and affordability of health services in
      Tennessee.

PMID- 8353221
TI  - Improving access to the underserved through Medicaid managed care.
AB  - New York City's Harlem community faces extraordinary health care needs that a
      failing economy has made more urgent. In an attempt to open lines of access to
      health care, the New York City Health and Hospitals Corporation has implemented a
      managed care program for Medicaid participants. The program is a team approach to
      link each Medicaid patient with a primary care physician responsible for
      coordinating medical services for the patient. We hope the managed care program
      will help us conserve our dwindling resources while better managing patients'
      services and improving access to care.

PMID- 8353222
TI  - Children can't wait for health care reform.
AB  - There is widespread agreement that the American health care system needs
      comprehensive reform. This kind of reform will take time, however, and millions
      of Americans have urgent health care needs that must be met now. This is
      especially true for the nation's poor children, for whom the health care "safety
      net" has greatly eroded in the past decade. New Jersey's health care reform
      initiatives will ultimately provide for accessible preventive and primary
      pediatric care, with a community-based "medical home" serving as a child's
      gateway to the health care system. In the meantime, New Jersey has established
      programs dealing with such urgent problems as infectious childhood diseases, lead
      poisoning, AIDS, and infant mortality. While in the spirit of the state's long
      range planning effort, these programs are up and running now, their impact
      maximized in this period of budgetary constraints through coalition- and network
      building.

PMID- 8353223
TI  - Health care today: pragmatic reform or Utopia?

PMID- 8353224
TI  - What safety net for children?
AB  - As our nation attempts to address the multiple health and social needs of
      children, it is obvious that the so-called safety net of services for children
      and families is currently not meeting their needs. Within the current dialogue
      over health care reform, the special needs of children and pregnant women must
      not be lost. This paper discusses basic components which should be included in
      any discussion of health care reform. Individualized personal involvement in the
      solution to the health and social problems of today's underserved children and
      families is crucial.

PMID- 8353225
TI  - Health care reform for the elderly. Satellite teleconference.

PMID- 8353226
TI  - Principles for forging a national health plan.
AB  - One point which has emerged with a resounding voice during this conference is the
      need to clearly assemble and carefully communicate data and information as a
      means of empowerment. We hope that the recommendations from this conference will
      contribute to this end. We urge all to become actively involved in seeking
      change, and ensuring that the future health of Americans and of our nation will
      not reflect our inequitable, costly present.

PMID- 8353227
TI  - Diskitis in children.

PMID- 8353228
TI  - Role of infection due to Campylobacter jejuni in the initiation of Guillain-Barre
      syndrome.
AB  - Recent reports suggest that infection with Campylobacter jejuni, a common enteric
      pathogen, may cause Guillain-Barre syndrome (GBS) by triggering demyelination of
      peripheral nerves. GBS is preceded by an acute infectious illness (due to a
      variety of agents) in 50%-75% of cases; the onset of neurological symptoms is
      preceded by diarrhea in 10%-30% of cases. In the last decade, more than 20
      published anecdotal reports and case series have described patients with C.
      jejuni infection documented 1-3 weeks before onset of GBS. Cultures of fecal
      samples obtained at the onset of neurological symptoms from patients with GBS
      have yielded C. jejuni in more than 25% of cases. A relatively rare serotype,
      Penner type O19, is overrepresented among isolates of C. jejuni from Japanese
      patients with GBS. Serological studies suggest that 20%-40% of patients with GBS
      have evidence of recent C. jejuni infection. In summary, infection with C. jejuni
      is a common antecedent to GBS and probably plays a role in initiating
      demyelination; although several pathogenic mechanisms are possible, none has been
      proven.

PMID- 8353229
TI  - Clostridium difficile infection associated with antineoplastic chemotherapy: a
      review.
AB  - Colitis and infection due to Clostridium difficile have been reported in patients
      receiving antineoplastic chemotherapy for cancer without prior antibiotic
      treatment. Chemotherapeutic agents can alter the normal bowel flora and cause
      extensive intestinal inflammatory changes, potentiating both the growth of C.
      difficile and its production of toxin. This review includes all 23 known reported
      cases of C. difficile infection associated with antineoplastic chemotherapy and
      examines the pathogenesis, clinical features, and management of this condition.
      Chemotherapy-associated C. difficile colitis has been documented in association
      with a variety of neoplasms. Various classes of antineoplastic agents have been
      incriminated, methotrexate most commonly. A spectrum of illness ranging from mild
      to fulminant has been reported. Symptoms, management, and outcome have appeared
      to be no different than for antibiotic-associated cases, but the available data
      are limited. Chemotherapy-associated infection with C. difficile may be
      underreported because it is not suspected and/or because frequent concomitant use
      of antibiotics masks its true incidence. C. difficile infection should be kept in
      mind whenever a patient undergoing antineoplastic chemotherapy develops diarrhea.
      Prompt, appropriate diagnostic testing and early treatment may avert morbidity
      and death.

PMID- 8353230
TI  - Mixed cutaneous phaeohyphomycosis in a cocaine user.
AB  - The dematiaceous fungi rarely cause serious disease in humans. We report a case
      of mixed cutaneous phaeohyphomycosis caused by two dematiaceous fungi,
      Exserohilum rostratum and Curvularia species, and review the microbiological
      characteristics and clinical significance of these organisms.

PMID- 8353231
TI  - Emergence of resistance to imipenem in Enterobacter isolates masquerading as
      Klebsiella pneumoniae during therapy with imipenem/cilastatin.
AB  - Clinical isolates identified as Klebsiella pneumoniae by the Vitek, Enterotube
      II, and API 20E systems were recovered from a patient undergoing therapy with
      imipenem/cilastatin. These isolates were resistant to multiple beta-lactam
      agents, and some were even resistant to imipenem. Analysis revealed a Bush group
      1 beta-lactamase, and imipenem resistance corresponded to the loss of outer
      membrane proteins in strains expressing high levels of this beta-lactamase.
      Further characterization efforts yielded abnormal but positive results of tests
      for ornithine decarboxylase production and motility, and chromosomal homology to
      an Enterobacter cloacae ampR, ampC probe was detected. These results suggested
      that the organisms were actually of an Enterobacter species, perhaps Enterobacter
      aerogenes. Cefoxitin resistance may be a useful marker for preventing this
      misidentification in the future; misidentification of such organisms poses a
      hazard, as it may lead to inappropriate beta-lactam therapy for infections caused
      by organisms that have the potential for resistance due to inducible group 1
      cephalosporinases.

PMID- 8353232
TI  - Forty years of meningococcal disease in Israel: 1951-1990.
AB  - Meningococcal disease accounts for approximately 20% of cases of bacterial
      meningitis in Israel. During the period 1951-1990, the annual incidence of
      meningococcal disease rarely exceeded two cases per 100,000 persons and was
      generally higher among non-Jews (largely the Arab population) than among Jews;
      there were some notable peaks of disease activity during 1963-1967, 1975, and
      1987-1988. The highest incidence was among infants and young children, with a
      slight male predominance. The main period of disease activity was from January to
      April, but an unusual secondary peak in July coincided with the onset of peak
      summer temperatures. Monthly disease frequencies were significantly correlated
      with relative humidity. Incidence rates varied between regions and were lower in
      cities than in smaller settlements. Overall case-fatality rates decreased to
      approximately 11% for the period 1981-1990. Outbreaks were infrequent and tended
      to be small. Meningococci of serogroup B have dominated since the mid-1970s.
      Group A meningococci were isolated significantly more commonly from Arabs
      (26.26%) than from Jews (1.03%; P < .000001). The frequency with which group A
      organisms occurred among clinical isolates appeared to follow a more or less
      cyclical pattern.

PMID- 8353233
TI  - Cholecystitis caused by Campylobacter jejuni.

PMID- 8353234
TI  - A case of pelvic inflammatory disease associated with Neisseria meningitidis
      bacteremia.

PMID- 8353235
TI  - Multiple-drug-resistant Salmonella typhi.

PMID- 8353236
TI  - Invasive disease caused by multiple clones of Corynebacterium diphtheriae.

PMID- 8353237
TI  - Successful antepartum treatment of listeriosis with vancomycin plus netilmicin.

PMID- 8353238
TI  - St. Louis encephalitis in patients with human immunodeficiency virus infection.

PMID- 8353239
TI  - Potential interference of cycloserine in assay for cyclosporine.

PMID- 8353240
TI  - Fulminant sepsis due to group B beta-hemolytic streptococci following
      transcervical chorionic villi sampling.

PMID- 8353241
TI  - Clinical presentation and outcome in cases of listeriosis.

PMID- 8353242
TI  - Corynebacterium striatum: a diphtheroid with pathogenic potential.
AB  - Although nondiphtherial corynebacteria are ubiquitous in nature and commonly
      colonize the skin and mucous membranes of humans, they rarely account for
      clinical infection. Corynebacterium striatum has rarely been reported to be a
      pathogen, causing pleuropulmonary infections and bacteremia in only
      immunocompromised or anatomically altered patients. We noted C. striatum to be
      the infecting pathogen or copathogen in six patients. To our knowledge, this
      report describes the first cases of C. striatum causing infection of exist sites
      of central venous catheters, thrombophlebitis associated with central venous
      catheters, conjunctivitis, and chorioamnionitis as well as a possible pathogen
      contributing to peritonitis and pyogenic granuloma. Unlike Corynebacterium
      jeikeium, which is highly resistant to beta-lactam agents, aminoglycosides, and
      quinolones, all strains of C. striatum isolated from the patients described in
      this report were susceptible to vancomycin and aminoglycosides, and all strains
      except one were susceptible to penicillin G, imipenem, and ciprofloxacin. C.
      striatum should be recognized as a potential pathogen in both immunocompromised
      and normal hosts in the appropriate circumstances, and appropriate antimicrobial
      therapy can quickly lead to resolution of infection.

PMID- 8353243
TI  - Group B streptococcal toxic shock-like syndrome: report of a case and
      purification of an associated pyrogenic toxin.
AB  - A patient with streptococcal toxic shock-like syndrome (TSLS) caused by
      Streptococcus agalactiae (group B Streptococcus) is described. The patient had
      all of the defining criteria for toxic shock syndrome (TSS), including fever,
      hypotension, erythematous rash, desquamation, and involvement of multiple organs.
      Neither Staphylococcus aureus nor group A streptococci were recovered, but
      vaginal and urine cultures yielded group B streptococci. The group B
      streptococcal isolate gave negative results in antibody tests for the production
      of TSS toxin 1, staphylococcal enterotoxins, and streptococcal scarlet fever
      toxins. However, the strain produced a novel pyrogenic toxin. This toxin,
      purified from culture fluids by ethanol precipitation, isoelectric focusing, and
      reverse-phase high-pressure liquid chromatography, had a molecular weight of
      12,000 and an isoelectric point of approximately 7.0. The purified toxin was
      pyrogenic in rabbits, enhanced the susceptibility of the animals to lethal
      endotoxin shock, and caused the proliferation of rabbit splenocytes; these
      properties define pyrogenic toxins. When given to three rabbits via a
      subcutaneous miniosmotic pump, the toxin caused TSS-like symptoms ending in
      death. Three additional group B streptococcal strains from patients with TSLS
      were tested and were found to produce a toxin with similar properties.

PMID- 8353244
TI  - Toxic shock syndrome complicating influenza A in a child: case report and review.
AB  - Despite extensive literature on toxic shock syndrome, reports of its
      manifestations in children remain relatively uncommon. Similarly, toxic shock
      syndrome in association with influenza B or influenza-like illness has been
      reported in 12 patients, but it has been reported to occur following influenza A
      in only two patients to date. We report a third case of toxic shock syndrome in a
      child with influenza A and review the association between epidemic influenza and
      toxic shock syndrome ("the Thucydides syndrome").

PMID- 8353245
TI  - Sustained bacteremia in 26 patients with a permanent endocardial pacemaker:
      assessment of wire removal.
AB  - We reviewed the data on 26 patients with permanent endocardial pacemakers who had
      28 episodes of bacteremia to determine whether removal of the wire is required.
      Patients recovered completely from the first episode in seven of 20 cases of
      staphylococcal bacteremia and in six of six cases of nonstaphylococcal bacteremia
      (P = .015). Definitive cure was not achieved during the first episode in seven
      cases of staphylococcal bacteremia related to the pacing system when the wire was
      not withdrawn; however, cure was achieved in five of six cases when the whole
      pacemaker was removed (P < .01). The duration of treatment was longer for the
      patients from whom the wire was not removed during the first episode (P < .01).
      Whether cases of staphylococcal bacteremia were related to the pacing system or
      not, the rate of recovery of the responsible microorganism from the wires was
      similar for both groups of patients (six [82%] of seven and three [75%] of four,
      respectively). Nonstaphylococcal bacteremia was unrelated to the pacing system in
      five of six cases; these patients were all cured without removal of the wire.

PMID- 8353246
TI  - Visceral leishmaniasis in patients with AIDS: report of three cases treated with
      pentavalent antimony and interferon-gamma.
AB  - The optimal therapy for visceral leishmaniasis in patients with AIDS is unknown.
      We describe herein three patients with advanced AIDS and disseminated
      leishmaniasis who were treated with meglumine antimoniate plus interferon-gamma.
      The conditions of the three patients rapidly improved, and the therapeutic
      combination drastically reduced the parasite burden; after administration of
      antiprotozoal therapy for 4 weeks, cultures of bone marrow were negative for two
      of the three patients. Interferon-gamma was well tolerated. Because the patients
      died of other AIDS-related diseases in the months following therapy, the efficacy
      of the combination of meglumine antimoniate and interferon-gamma for preventing
      relapses remains unknown.

PMID- 8353247
TI  - Symptomatic primary infection due to human immunodeficiency virus type 1: review
      of 31 cases.
AB  - In this series of 31 patients with acute infection due to human immunodeficiency
      virus (HIV) type 1, the male-to-female ratio was 3.4:1 and the mean age was 31.3
      years. Sexual transmission accounted for 83.9% of cases; 45.2% of the patients
      were homosexual and 38.7% were heterosexual. The mean duration of symptoms and
      signs was 21 days (range, 5-60 days). Fever (87.1%) and skin rash (67.7%) were
      most commonly reported. Physical examination findings were abnormal for 96% of
      the patients; the oral cavity (76.7%) and the skin (73.3%) were the most
      frequently involved sites. Thirteen of 25 patients with sexually acquired
      infection had genital or oral ulcers, whereas five intravenous drug users had
      none (P = .052). Thrombocytopenia was the most common hematologic abnormality and
      was detected in 17 of 23 patients tested. P24 antigenemia, an initially negative
      screening test for HIV antibody, and a low CD4+ lymphocyte count were noted in 23
      of 29, 23 of 30, and 14 of 21 tested patients, respectively.

PMID- 8353248
TI  - Antibody to capsular polysaccharides of Streptococcus pneumoniae: prevalence,
      persistence, and response to revaccination.
AB  - The prevalence of immunity to Streptococcus pneumoniae in the adult population of
      the United States is unknown. In the study described herein, military recruits
      had anticapsular IgG antibody to only 15% of common pneumococcal serotypes,
      whereas working men and elderly men had IgG antibody to 33% and 34% of the common
      serotypes, respectively (P < .001). Among eight elderly subjects, the prevalence
      of IgG antibody to capsular polysaccharides increased from 30% to 78% after
      pneumococcal vaccination; 6 years thereafter, the rate of positive reactions had
      declined to 58% and IgG levels had declined substantially. With revaccination,
      IgG levels returned to within (+/-) 40% of the original postvaccination levels.
      IgM and IgG antibody appeared or began to increase in titer 6 days after
      vaccination; the rate and degree of response were the same after the first and
      second exposures. Since most individuals rapidly develop IgG antibody after
      colonization by S. pneumoniae and since IgG confers immunity, these data suggest
      that pneumonia is infrequent among healthy adults not because preexisting
      immunity is widespread but because--with colonization--an immune response
      develops rapidly, preceding specific events that might lead to infection. Our
      findings support recommended vaccination procedures and suggest that wider
      application in subsets of healthy younger adults should be considered.

PMID- 8353249
TI  - Mycobacterium avium complex infection and AIDS: advances in theory and practice.
AB  - The role of disseminated infection with the Mycobacterium avium complex (MAC) in
      the natural history of AIDS has been controversial. It is now clear that this
      complication of immunosuppression induced by human immunodeficiency virus type 1
      (HIV-1) has a major impact upon the quality of life and duration of survival of
      patients with advanced HIV-1 infection. Progress has been made in our
      understanding of the bacteriology, pathogenesis, prevention, and treatment of MAC
      infection. Drs. Constance Benson and Jerrold Ellner (of Rush Medical College in
      Chicago and Case Western Reserve University in Cleveland, respectively) have led
      the effort by the AIDS Clinical Trials Group to develop new methods of managing
      this serious complication of advanced HIV-1 infection. In this AIDS commentary
      they review our current knowledge of MAC organisms and the clinical problems
      resulting from infection with these mycobacteria.

PMID- 8353250
TI  - Comparison of patients with enterococcal bacteremia due to strains with and
      without high-level resistance to gentamicin.
AB  - Patients with enterococcal bacteremia due to strains with and without high-level
      gentamicin resistance (HLGR; MIC, > 2,000 mg/L) were compared. Between 1986 and
      1991, there were 178 episodes of enterococcal bacteremia: 47 and 131 episodes,
      respectively, due to enterococcal strains with and without HLGR. Sixty-two, 57,
      and 59 episodes, respectively, were in patients with transient bacteremia (a
      single positive blood culture), bacteremia (two or more positive blood cultures),
      and polymicrobial bacteremia. Nosocomial bacteremia accounted for 61.7% and 51.1%
      of episodes due to strains with and without HLGR, respectively. All isolates were
      strains of Enterococcus faecalis except for 13 strains of Enterococcus faecium, 4
      of Enterococcus avium, and 3 of Enterococcus durans. Although the mortality was
      slightly higher among patients infected with strains with HLGR than among those
      infected with strains without HLGR (38.3% vs. 30.5%, respectively), there was no
      statistical difference. The mortality rate was adversely affected by old age (P <
      .01) and rapidly and ultimately fatal underlying conditions (P < .001). The
      addition of gentamicin to the treatment regimens had no effect on mortality.

PMID- 8353251
TI  - Intrapartum transmission of group A streptococcus.
AB  - Intrapartum transmission of group A streptococcus has not been well documented.
      As the incidence of severe infections due to this organism has recently
      increased, it is important to assess if such transmission occurs. We observed two
      cases of severe neonatal infections due to group A streptococcus, one of which
      was fatal, that appeared to have been transmitted from the mother during birth.
      Perinatal prophylaxis, which has been recommended for infections due to group B
      streptococcus, should be evaluated for infections due to group A streptococcus.

PMID- 8353252
TI  - Clinical algorithms for the screening of women for gonococcal and chlamydial
      infection: evaluation of pregnant women and prostitutes in Zaire.
AB  - A substantial proportion of women with gonococcal and/or chlamydial infection are
      asymptomatic. Thus active case detection is problematical, particularly in
      developing countries, where facilities and materials for laboratory testing are
      limited. We assessed the diagnostic validity of the hierarchical clinical
      algorithms recommended by the World Health Organization as well as that of a
      nonhierarchical scoring system, using data for 1,160 pregnant women (a low
      prevalence group) and 1,222 prostitutes (a high-prevalence group) in Kinshasa,
      Zaire. Neisseria gonorrhoeae and/or Chlamydia trachomatis was detected in 6.5%
      and 31.0% of pregnant women and prostitutes, respectively. No single variable
      that was both sensitive (> 60%) and specific (> 60%) was associated with
      infection. A simple hierarchical algorithm based only on reported symptoms had a
      sensitivity of 48.0% and 54.9% and a specificity of 75.2% and 52.2% for the
      screening of pregnant women and prostitutes, respectively. A second algorithm
      that included a speculum examination had a sensitivity of only 29.3% but a
      specificity of 85.3% in pregnant women. When a nonhierarchical scoring system was
      used, the sensitivity was 72.0% and 71.0% and the specificity was 73.5% and 55.8%
      for pregnant women and prostitutes, respectively. Scoring systems that
      incorporate risk markers as well as symptoms and signs may represent affordable
      alternative methods of screening for gonococcal and/or chlamydial infections
      among women in resource-poor settings.

PMID- 8353253
TI  - Efficacy of antimicrobial prophylaxis in placement of cerebrospinal fluid shunts:
      meta-analysis.
AB  - The objective of this study was to determine if perioperative antimicrobial
      prophylaxis decreases the incidence of subsequent shunt infection in patients who
      require placement of internal CSF shunts. Data sources included a computerized
      search of two biomedical data bases, contact with colleagues, and a review of
      abstracts of meetings and of references of identified trials and reviews. Studies
      were chosen for detailed review if they involved human subjects who underwent CSF
      shunt placement, with random allocation of patients to groups receiving
      perioperative systemic antimicrobial agents or to a control group and an outcome
      measure of subsequent shunt infection. Twelve (32%) of 37 studies met selection
      criteria and were included. Features of trial design were extracted and trial
      quality was evaluated with use of a predetermined protocol by three independent
      investigators who were blinded to titles, authors, and institutions.
      Individually, only one of 12 trials achieved statistical significance favoring
      prophylaxis; in the aggregate, the use of prophylactic antibiotics was associated
      with a significant reduction in subsequent CSF shunt infection (Mantel-Haenszel
      weighted risk ratio: 0.52; 95% confidence interval: 0.37, 0.73; P = .0002;
      approximate risk reduction: 50%). This systematic overview of 12 trials of 1,359
      randomized patients demonstrates that perioperative use of antimicrobial agents
      in CSF shunt placement significantly reduces the risk of subsequent infection.

PMID- 8353254
TI  - [Magnetic resonance tomography (MRT) of the knee joint: meniscus, cruciate
      ligaments and hyaline cartilage].
AB  - The use of MRT for diagnosing injury to the meniscus, the cruciate ligaments and
      hyaline cartilage was evaluated retrospectively in 82 knee joints without any
      knowledge of operative findings. In 49 cases the results were verified by
      arthroscopy and in 33 cases by arthrotomy. Sensitivity, specificity and
      diagnostic accuracy of MRT for meniscus lesions was 73.9%, 96.9%, and 94.6%.
      Corresponding values for lesions of the anterior cruciate ligament were 88.9%,
      96.6%, and 94.7%, and for lesions of the hyaline cartilage 62.6%, 96.1%, and
      87.9%, respectively. In addition to its high specificity, MRT proved accurate in
      excluding lesions of the meniscus (97.1%) of the anterior cruciate ligament
      (96.6%) and of hyaline cartilage (88.8%). A negative finding on MRT therefore
      makes the presence of a lesion of the meniscus, cruciate ligaments of cartilage
      unlikely. In such cases one is justified in delaying the use of arthroscopy or
      arthrotomy.

PMID- 8353255
TI  - [MRT in clinically unclear posttraumatic knee joint lesions].
AB  - An MRI examination was performed on 31 patients with clinically questionable
      posttraumatic knee joint lesions. A broad range of intra- und extraarticular
      pathological changes was found. The correlation of MRI with arthroscopy and
      surgery showed a correct MRI diagnosis in 78% of the meniscal lesions (n = 18)
      and in 89% of the anterior cruciate ligament ruptures (n = 9). An analysis of
      false positive and false negative MRI diagnoses was made. MRI offers the
      opportunity for noninvasive complex assessment of knee joint structures and is of
      particular value in the diagnosis of posttraumatic knee joint lesions.

PMID- 8353256
TI  - [Bone marrow edema--an early form of femur head necrosis].
AB  - We examined 15 patients (16 hips) with painful hips whose radiographs were either
      normal (n = 9) or showed a minimal decrease in radiodensity (n = 7). The
      available bone scintigrams of 9 cases were positive. T1-weighted images
      visualised a diffuse signal loss of the bone marrow in all hips, with various
      extensions in the head, neck, and intertrochanteric area. These regions were
      hyperintensive on T2-weighted images. Focal anomalies were not seen in any of the
      cases. All patients underwent core decompression treatment. Histology of 13 hips
      confirmed not only the presence of bone marrow oedema but of bone changes
      corresponding to those of avascular necrosis. Follow-up examinations with MR
      after core decompression showed normal signal intensity in all cases. Magnetic
      resonance represents a viable diagnostic tool for identifying bone marrow oedema.
      Due to our histological results bone marrow oedema should be included in the
      differential diagnosis as an early stage of necrosis of the hip.

PMID- 8353257
TI  - [Femur head necrosis and bone marrow edema syndrome in pregnancy].
AB  - MR examinations were performed in 9 patients suffering from severe pain of the
      hip during the third trimenon without any relief after birth. Pathologic signal
      changes could be observed in 11 hips (oedema in the region of the femoral head
      and neck (n = 8); avascular necrosis of the femoral head surrounded by bone
      marrow oedema (n = 3)). In 7 hips a relatively rapid decrease of the oedema
      following core decompression was demonstrated. Focal necrosis, however, did not
      show any changes. In two patients, treated conservatively, markedly delayed
      healing was evident. MR imaging is the modality of choice for early diagnosis as
      well as follow-up of therapy of the bone marrow oedema syndrome or avascular
      necrosis and can be performed already during pregnancy.

PMID- 8353258
TI  - [The acetabular prosthesis: detection of a migration using ruler and pencil?
      Measurements on a pelvic phantom in comparison with a 3D computer simulation].
AB  - Conventional X-ray films were made with varying degrees of tilt of a pelvic
      phantom containing an acetabular prosthesis. The position of the prosthesis was
      then reconstructed graphically. The measurement errors were calculated and an
      estimate was made for the tilt. There is a linear correlation between the
      measurement error and the tilt of the prosthesis. Therefore a tilt dependent
      maximum error can be calculated. This error is very small for small degrees of
      tilt, so that acetabular migration can in this instance be evaluated with greater
      confidence than with other graphical methods. The error also correlates with the
      determination of the selected region of the acetabulum, but not with the position
      of the central focus spot or image magnification.

PMID- 8353259
TI  - [The role of sonography and MR tomography in the diagnosis and therapeutic
      control of the carpal tunnel syndrome].
AB  - 120 wrists of 105 patients with carpal tunnel syndrome were studied
      preoperatively by high-resolution sonography. Follow-up examinations after carpal
      tunnel release were performed in 72 wrists. In addition, 40 wrists were examined
      preoperatively, and 20 wrists were examined postoperatively by MR imaging. Based
      on quantitative analysis of the cross-sectional area and shape of the median
      nerve and of the palmar bowing of the flexor retinaculum, sonography established
      the diagnosis in 95% of cases. MR was superior in the evaluation of mild degrees
      of median nerve compression, and in the detection of possible causes of the
      carpal tunnel syndrome, such as synovitis of the flexor tendon sheaths or
      ganglionic cysts. In postoperative follow-up, sonographic demonstration of a
      normally flattened median nerve was an excellent indicator of the successful
      carpal tunnel release. In 10 patients with persistent or recurrent symptoms after
      carpal tunnel release, the underlying pathology could be exactly demonstrated by
      MR.

PMID- 8353260
TI  - [Diabetic osteoarthropathy (DO) of the forefoot].
AB  - In patients suffering from diabetic osteoarthropathy, a total of 97 forefeet were
      evaluated concerning their bone tissue and soft tissue transformations. The most
      prevalent forms of demineralisation were circumscribed osteoporosis (21%) and
      diffuse osteoporosis (20%). Subluxations (6.2%), dislocations (2.1%), erosions
      (8.3%), marginal usures (11.3%) or cysts of the bone (11.3%) were seen only
      rarely. Extensions of the articular space (10.3%) were more prevalent than
      disappearances of the articular space (4.1%). The MTP (26.8%) and PIP joints
      (10.3%) were confirmed to be preferred localisations. A sudden loss of articular
      surface (25%) and a fast transition to mutilation (23.5%) show the increasing
      tendency of the fast transition to advanced stages of destruction by omitting the
      earlier stages.

PMID- 8353261
TI  - [99mTc-MAG3-kidney function scintigraphy without and with captopril in the
      diagnosis of renovascular hypertension].
AB  - In this study, the diagnostic value of renal function scintigraphy performed both
      without and with ACE inhibition has been evaluated using the new
      radiopharmaceutical 99mTc-MAG3. In cases of decompensated renal artery stenoses,
      the typical scan finding with this tubular excreted agent was shown to be a
      distinct parenchymal nuclide retention in combination with a delayed appearance
      of the radiotracer in the pelvic system. Using this criterion in 43 patients with
      suspected renovascular hypertension, sensitivity and specificity were 89 and 88%,
      respectively. Bilateral positive findings were non-specific; excluding them from
      the study, specificity increased to 100%. In renal insufficiency, captopril scans
      seem to be of reduced diagnostic value. Summarising our experiences, renal
      function scintigraphy using 99mTc-MAG3 without and with captopril was proved to
      be a reliable non-invasive method to detect or exclude haemodynamically relevant
      renal artery stenosis.

PMID- 8353262
TI  - [The effectiveness of Braun's anastomosis in Billroth II surgery. The role of
      hepatobiliary sequence scintigraphy (HBSS) in the diagnosis of bile flow
      following stomach resection].
AB  - After resection of the stomach the alkaline reflux of the duodenal contents into
      the residual stomach is a major factor to be taken into consideration when
      assessing the causes leading to irregularities of the mucosal barrier. Illnesses
      that may arise subsequent to gastric surgery are gastritis of the resected
      stomach, inflammation of the anastomosis, anastomotic ulcers and--with
      reservations--anastomotic carcinoma. In view of these clinical pictures, a
      protective function for the biliary system is ascribed to Braun's entero
      anastomosis. With the aid of hepatobiliary sequence scintigraphy (HBSS) a
      functional analysis was obtained from 30 patients, subsequent to gastric surgery-
      after Billroth II with entero-anastomosis--which showed a surprisingly high rate
      of reflux into the residual stomach, in 16 out of these 30 patients. The high
      grade HBSS data with regard to the biliary reflux proportions after gastric
      surgery and the low-grade effectiveness of Braun's entero-anastomosis are clearly
      evidenced.

PMID- 8353263
TI  - [Three-dimensional imaging of the pelvic veins using magnetic resonance
      angiography].
AB  - The veins in the pelvis and lower limbs have been demonstrated by means of
      magnetic resonance angiography (MRA) in 11 normals and in 20 patients, using a
      "time-of-flight" technique (TOF). Using normals, changes in the measurement
      parameters were used in order to optimise the examination protocol; consequently,
      the internal and external iliac veins and the superior and inferior gluteal veins
      could be identified in all cases and the internal pudendal veins in 6 out of 11
      cases. This examination protocol was then used in patients with clinical
      suspicion of lower limb or pelvic vein thrombosis. Comparison of the MRA findings
      with those of phlebography (7 cases), duplex sonography (6 cases) and colour
      Doppler examinations (11 cases) showed that MRA was better for diagnosing
      thrombosis of the internal iliac veins (10 cases) than the other methods. In two
      patients thromboses of the common iliac veins and the inferior vena cava were
      demonstrated which were missed by colour Doppler examination. On the basis of our
      present experiences, MRA, using a two-dimensional TOF technique, appears to be a
      reliable non-invasive technique for demonstrating the veins of the pelvis and
      thigh.

PMID- 8353264
TI  - [Magnetic resonance arteriography, duplex sonography and conventional
      arteriography for the evaluation of peripheral arterial occlusive disease].
AB  - A prospective controlled study of 41 peripheral arterial occlusions was carried
      out, comparing duplex sonography, magnetic resonance arteriography and contrast
      arteriography. 87.8% of duplex sonography findings and 80.5% of magnetic
      resonance arteriographies agreed with the appearances of contrast arteriography
      (gold standard). Duplex sonography tended to overestimate the length of an
      occluded segment by an average of 2 cm (0.5-5 cm), whereas magnetic resonance
      arteriography showed less deviation from contrast arteriography (+/- 2 cm). The
      advantage of duplex sonography lies in its ability to provide morphological and
      functional information concerning the obliterated segment. Its disadvantage is
      that it can only demonstrate one segment and that the examination must be carried
      out in individual segments. Magnetic resonance arteriography provides vascular
      demonstration in several planes similar to angiography but signal-voids due to
      limited resolution and flow changes may limit diagnosis of occlusions. Additional
      phase contrast techniques may provide quantitative information on flow velocities
      and flow rates. Both duplex sonography and magnetic resonance arteriography are
      suitable methods for the non-invasive investigation of peripheral arterial
      occlusive disease.

PMID- 8353265
TI  - [Ambulant transbrachial 4-French arteriography with particular reference to the
      aortofemoral vascular system].
AB  - Arteriograms were carried out on 176 patients using 4-F catheters through a
      transbrachial approach. Criteria for exclusion from the series were injuries to
      the upper limb, hemiparesis or poor pulses in the presence of a normal femoral
      pulse. There were no local vascular complications requiring treatment. On two
      occasions the brachial artery could not be punctured. Acute posterior cerebral
      infarction was the only serious complication (0.5%). 67% of the patients were
      examined on an outpatient basis and this did not appear to increase the risk of
      complication. We regard this as a suitable method for demonstrating the pelvic
      and lower limb arteries on ambulant patients.

PMID- 8353266
TI  - [Initial results of in vivo 31P-NMR spectroscopy of the spleen in patients with
      splenomegaly].
AB  - In-vivo 31P-NMR spectroscopy of the spleen was carried out in 15 patients with
      splenomegaly from various causes (Hodgkin's disease, non-Hodgkin lymphoma,
      polycythaemia vera, chronic lymphatic leukaemia, chronic myeloid leukaemia).
      Volume selection was with the ISIS technique, voxel size was between 3 x 5 x 5
      and 8 x 6 x 7 cm3. There was a markedly elevated (PM+Pi)/beta-NTP quotient (mean
      3.41 with a standard deviation of 0.37) (p < 0.001) and raised PDE/beta/NTP
      quotient as compared with 8 normals, who showed an (PME+Pi)/beta-NTP quotient of
      2.32 and a PDE/beta/NTP quotient of 1.11. These raised quotients were interpreted
      as indicating increased membrane phospholipid metabolism due to increased cell
      turnover. The data suggest there may be some clinical value in performing 31P-NMR
      spectroscopy for defining splenic involvement in myeloproliferative diseases but
      further confirmatory studies will be necessary.

PMID- 8353267
TI  - [Determinants of observer variability in early diagnostic mammography--a ROC
      analysis].
AB  - As part of the German mammographic study, the participating doctors were given
      test films of 30 histologically confirmed cases. Regarding the indications for
      biopsy there was good sensitivity (the median amongst 25 doctors was 0.87).
      Specificity (median 0.86) could be improved. Comparison of individual results
      with the majority showed considerable variability within the group of doctors
      performing mammography. ROC analysis indicated that there was considerable
      observer variability which was independent from the specialty or praxis
      characteristics of the participants. The inclusion of mammography in an early
      diagnostic programme requires continuing education of the participants in this
      technique. This should be supported by further methods of quality assurance.

PMID- 8353268
TI  - [Percutaneous removal of an intraperitoneal foreign body].

PMID- 8353269
TI  - [A functional disorder of the temporomandibular joint in a newborn infant-
      preoperative CT-3D diagnosis and postoperative documentation].

PMID- 8353270
TI  - [Lymphoepithelial cyst of the tail of the pancreas--a case report].

PMID- 8353271
TI  - Intramedullary spinal cord germinoma. Case report and review of the literature.

PMID- 8353272
TI  - A natural history for pediatric acute leukemia.

PMID- 8353273
TI  - Dynamics of GATA transcription factor expression during erythroid
      differentiation.
AB  - Although the formation of terminally differentiated erythroid cells has been
      shown to require the presence of a functional GATA-1 gene in vivo, the role of
      this transcription factor and other members of the GATA family at earlier stages
      of erythroid differentiation is unclear. In this report, the expression of GATA
      1, GATA-2, and GATA-3 has been examined in enriched peripheral blood progenitors
      before and after culture in a well-characterized liquid culture system. In
      addition primary leukemic cells as well as several erythroleukemic and
      nonerythroid cell lines were analyzed for GATA factor expression. The results
      show that the profile of GATA factor expression in erythroid cells is distinct
      from that of myeloid or lymphoid lineages. Erythroleukemic cell lines express
      little or no GATA-3, but high levels of GATA-1 and GATA-2. When they are induced
      to display the terminal erythroid phenotype, little change in the level of GATA-1
      is detected but a significant decline in the levels of GATA-2 is observed
      commensurate with the degree of maturation achieved by the cells. Enrichment of
      erythroid progenitors from peripheral blood leads to selection of cells that
      express both GATA-1 and GATA-2. As the enriched populations are cultured in
      suspension in the presence of multiple cytokines, the levels of both GATA-1 and
      GATA-2 initially increase. However, in cultures containing only erythropoietin,
      which show exclusive erythroid differentiation, the levels of GATA-1 continue to
      increase, whereas GATA-2 expression declines as erythroid maturation progresses.
      In contrast, cultures lacking Epo (ie, with interleukin-3 and kit ligand) display
      limited progression towards both the myeloid and erythroid pathways, and high
      levels of expression of both GATA-1 and GATA-2 are maintained. Despite the
      initial upregulation of GATA-1 expression in the latter cultures, terminal
      erythroid differentiation does not occur in the absence of erythropoietin. These
      results indicate that GATA-1 upregulation is associated with both the initiation
      and the maintenance of the erythroid program, but that these two processes appear
      to be under separate regulatory control. Thus, the dynamic changes in the levels
      of different GATA factors that occur during primary erythroid differentiation
      suggest that the levels of these factors may influence the progression to
      specific hematopoietic pathways.

PMID- 8353274
TI  - The chromosome 4q21 gene (AF-4/FEL) is widely expressed in normal tissues and
      shows breakpoint diversity in t(4;11)(q21;q23) acute leukemia.
AB  - The chromosomal translocation, t(4;11)(q21;q23), is the most common type of 11q23
      chromosomal abnormality, being highly prevalent in infant acute leukemias and
      associated with a poor prognosis. The t(4;11) results in the fusion of an 11q23
      gene (MLL, HRX, Htrx-1, or ALL-1) and a 4q21 gene (AF-4 or FEL). To further
      evaluate the 4q21 gene and its role in t(4;11) acute leukemia, we have cloned a
      38-kb genomic region and mapped exons of the AF-4 gene. The 4q21 breakpoints in
      19 cases of t(4;11) acute leukemia were analyzed by Southern analysis and pulsed
      field gels. Seventeen of the 19 cases had breakpoints on chromosome 4q21 that
      were scattered in this 38 kb region. Expression of the AF-4 gene was studied in a
      total of 28 various nonhematopoietic, hematopoietic, and t(4;11) leukemic cell
      lines. The AF-4 gene was expressed in all cell lines as a major and a minor
      transcript. In addition to the normal transcripts, two fusion transcripts from
      the derivative 11 and derivative 4 chromosomes were identified in all t(4;11)
      cell lines except B1, which had only the der(11) transcript. These findings
      suggest that the breakpoints on 4q21 cluster over a broader area than do the
      breakpoints in the 11q23 gene, and that der(11) encodes the fusion RNA found
      consistently in leukemia cells.

PMID- 8353275
TI  - Predictability of the t(1;19)(q23;p13) from surface antigen phenotype:
      implications for screening cases of childhood acute lymphoblastic leukemia for
      molecular analysis: a Pediatric Oncology Group study.
AB  - The t(1;19)(q23;p13) translocation occurs in approximately 5% of B-precursor
      acute lymphoblastic leukemias (ALLs) occurring in children. Its presence has been
      associated with a poor prognosis, which may be overcome with more intensive
      therapy. Although leukemic cells from cases of t(1;19)-ALL frequently express
      cytoplasmic mu heavy chains, their complete antigenic profile remains undefined.
      Among 697 consecutive cases of B-precursor ALL with complete phenotypic studies
      using a panel of monoclonal antibodies, 22 cases were found to carry the t(1;19).
      Twenty of 22 cases had an identical, complex phenotype characterized by
      homogeneous expression of CD19, CD10, and CD9; complete absence of CD34; and at
      least partial absence of CD20. Overall, this phenotype was seen in only 8.0% (56
      of 697) of childhood B-precursor ALL. One of the two remaining t(1;19)-carrying
      cases conformed to this phenotype, but was lacking data for CD9. The other case
      differed by virtue of expression of CD34 and was also hyperdiploid with 55
      chromosomes. Molecular studies showed E2A-PBX1 abnormalities in all examined
      cases (12 of 12) with the t(1;19), including the case lacking CD9 data. In
      contrast, no E2A-PBX1 abnormalities were detected in the sole t(1;19)-ALL with
      CD34 expression. Seventeen cases with the characteristic phenotype and
      uninformative cytogenetics were also molecularly analyzed and 5 of 17 (including
      4 of 8 with unsatisfactory cytogenetics and 1 of 9 with a normal karyotype)
      contained E2A gene rearrangements and E2A-PBX1 fusion mRNAs. Our results show
      that all cases of t(1;19)-ALL with concomitant E2A-PBX1 fusion invariably express
      a characteristic but uncommon profile of surface antigens. These observations
      suggest that selective molecular analysis of a small subset of patients (those
      with uninformative cytogenetics and the characteristic phenotype) can identify a
      significant number of additional cases of ALL with E2A-PBX1 fusion that might
      benefit from more intensive therapy.

PMID- 8353276
TI  - Hematopoietic cells from mice deficient in wild-type p53 are more resistant to
      induction of apoptosis by some agents.
AB  - Wild-type p53 is a tumor-suppressor gene that can induce cell death by apoptosis
      when expressed in myeloid leukemic and some other types of tumor cells. However,
      the question remained as to what extent wild-type p53 is a mediator of apoptosis
      in normal cells. We have used mice deficient in wild-type p53 to determine
      whether induction of apoptosis in hematopoietic cells from these p53 deficient
      mice is defective. We show here that bone marrow myeloid progenitor cells from
      p53-deficient mice are more resistant to induction of apoptosis when there was
      only a low concentration of the viability factors granulocyte-macrophage colony
      stimulating factor; interleukins-1 alpha, -3, and -6; or stem cell factor; or
      when apoptosis was induced in these cells by irradiation or heat shock. The loss
      of one allele of wild-type p53 was sufficient for increased resistance. The
      higher resistance to apoptosis in p53-deficient mice was also found in irradiated
      thymocytes, but not in thymocytes treated with dexamethasone or in mature
      peritoneal granulocytes. The degree of resistance in irradiated myeloid
      progenitors and thymocytes showed a dosage effect of the number of wild-type p53
      genes. The results show that wild-type p53 is involved in the induction of
      apoptosis by some agents in normal hematopoietic cells. Loss of wild-type p53
      can, therefore, contribute to tumor development by decreasing cell death at low
      concentrations of viability factors and after exposure to a DNA-damaging agent.
      The results also show that there are wild-type p53-dependent and -independent
      pathways of normal cell apoptosis.

PMID- 8353277
TI  - Home treatment with intravenous enzyme replacement therapy for Gaucher disease:
      an international collaborative study of 33 patients.
AB  - Intravenous enzyme replacement therapy (Alglucerase; Ceredase; Genzyme Corp,
      Boston, MA) is an effective and safe treatment for patients with type 1 Gaucher
      disease. In an attempt to reduce its high cost, a "low-dose high-frequency"
      protocol (30 U/kg/mo, 3 times a week) was introduced and found to be as effective
      as the original high-dose protocol (60 U/kg every 2 weeks). Because receiving
      frequent infusions creates a burden for many patients, we have implemented a
      program of home treatment for our patients. We now report the safety and
      feasibility of low-dose/high-frequency home intravenous enzyme-replacement
      therapy in 33 patients with Gaucher disease. The chronic nature of the treatment,
      its safety, lack of adverse effects, the stable condition of most patients, and
      the need to reduce the high cost make enzyme replacement for Gaucher disease a
      good candidate for intravenous home therapy.

PMID- 8353278
TI  - Soluble forms of the interleukin-6 signal-transducing receptor component gp130 in
      human serum possessing a potential to inhibit signals through membrane-anchored
      gp130.
AB  - The interleukin-6 (IL-6) signal is transduced through membrane-anchored gp130,
      which is associated with IL-6 receptor (IL-6R) in the presence of IL-6. Soluble
      forms of gp130 (sgp130) with molecular weights of 90 and 110 Kd were found in
      human serum. In the presence of recombinant IL-6 (rIL-6), serum sgp130 were
      capable of associating with serum sIL-6R. By the sandwich enzyme-linked
      immunosorbent assay, healthy human sera was shown to contain 390 +/- 72 ng/mL of
      sgp130. A mouse pro-B-cell line-derived transfectant, BAF-130, expressing human
      gp130 was used to examine the function of serum sgp130. When supplemented with
      rIL-6, human serum induced DNA synthesis in BAF-130 cells, whereas the serum
      deprived of sIL-6R did not. In contrast, the DNA synthesis induced in BAF-130
      cells by rIL-6-supplemented serum was increased when the serum was deprived of
      sgp130. These results indicated that serum sgp130 could negatively regulate the
      IL-6 signal. Recently, gp130 has been shown to be involved in the signaling
      processes of oncostatin M, leukemia inhibitory factor, and ciliary neurotropic
      factor, in addition to those of IL-6. Recombinant sgp130 showed inhibitory effect
      on the biologic function of such cytokines. This work implies physiologic roles
      of naturally produced serum sgp130 in modulating signals through gp130.

PMID- 8353279
TI  - Prothymosin alpha gene expression correlates with proliferation, not
      differentiation, of HL-60 cells.
AB  - Accumulating evidence suggests that prothymosin alpha has an as yet undefined
      intracellular, perhaps intranuclear, function related to cell proliferation.
      Prothymosin alpha mRNA and/or peptide levels increase when cells are stimulated
      to proliferate. Because proliferation and differentiation events are often
      inversely correlated, we examined prothymosin alpha gene expression during
      proliferation and differentiation of HL-60 myeloid leukemia cells. Steady-state
      levels of prothymosin alpha mRNA, which are high in exponentially growing HL-60,
      decrease within hours after induction of HL-60 to differentiate along the
      neutrophil pathway with dimethylsulfoxide (DMSO) or along the macrophage lineage
      with either tetradecanoylphorbol acetate (TPA) or bryostatin 1. The decline in
      prothymosin alpha mRNA in response to these differentiation signals parallels
      that of c-myc mRNA under the same conditions. We then determined whether the
      downregulation of prothymosin alpha and c-myc mRNA were due to differentiation or
      cessation or proliferation. Recombinant human gamma-interferon induces monocytic
      differentiation of HL-60, but permits continued proliferation, and, under these
      conditions, expression of prothymosin alpha, as well as of c-myc, mRNA remains
      elevated. We conclude that prothymosin alpha and c-myc expression are coregulated
      in differentiating HL-60 and that their expression correlates with the
      proliferative state of HL-60 cells, rather than with the differentiated state.

PMID- 8353280
TI  - Enhancement of the biologic effects of interleukin-3 in vivo by anti-interleukin
      3 antibodies.
AB  - Interleukin-3 (IL-3) has been shown to be a promising agent in the stimulation of
      bone marrow regeneration following myeloablative therapy. The biologic half-life
      of this agent is very short (5 to 15 minutes), which limits the effectiveness of
      low-dose therapy. Here we show that the biologic effects of low-dose IL-3 in mice
      may be enhanced by concurrent use of polyclonal anti-IL-3 antibodies. The
      biologic effects of IL-3 in vivo were enhanced dramatically by the combination of
      the cytokine and polyclonal rabbit anti-IL-3 antibodies, which recognized a
      peptide comprising the first 29 amino acids of the IL-3 molecule. Enhancing
      effects were not apparent in vitro, where weak neutralizing properties were
      observed for these antibodies. The mechanism of this enhancement by the antibody
      appears to be via a ninefold reduction in the total-body clearance of the
      cytokine in vivo. The apparent volumes of distribution for IL-3 and for the IL
      3/antibody complex were surprisingly similar and exceeded the expected
      intravascular volume. The prolonged biologic half-life of IL-3 was reproducibly
      associated with a threefold to fivefold increase in splenic mast-cell precursors
      over levels observed in mice treated with IL-3 alone; increases in the numbers of
      mature mucosal-type mast cells in the spleen, but not in the jejunum or lung;
      increases in IL-3-dependent colony-forming unit-cell in the spleen; and an
      apparent redistribution of mast cells away from the bone marrow. These
      experiments demonstrate that antibodies to a cytokine can enhance the biologic
      activity of that cytokine in vivo.

PMID- 8353281
TI  - Regulation of manganese superoxide dismutase and other antioxidant genes in
      normal and leukemic hematopoietic cells and their relationship to cytotoxicity by
      tumor necrosis factor.
AB  - Myeloid cells are a major source of superoxide and other oxygen metabolites. As a
      protective mechanism, cells express antioxidant enzymes including manganese
      superoxide dismutase (Mn-SOD), copper-zinc SOD (Cu/Zn-SOD), and glutathione
      peroxidase (GSX-PX). Even though hematopoietic cells are a major source of
      oxidants, little is known of their expression of antioxidants. We found that
      seven myeloid leukemic cell lines blocked at different stages of differentiation
      constitutively expressed Mn-SOD, Cu/Zn-SOD, and GSX-PX RNAs. Level of Mn-SOD
      activities paralleled levels of Mn-SOD RNA. Terminal differentiation of native HL
      60 cells to either granulocytes or macrophages did not alter levels of Mn-SOD RNA
      but markedly decreased cell division. Myeloid leukemic lines sensitive to
      cytotoxic effects of tumor necrosis factor (TNF) as well as normal peripheral
      blood lymphocytes and monocytes, dramatically increased their levels of Mn-SOD
      RNA in the presence of TNF. In contrast, Cu/Zn-SOD and GSX-PX RNA levels did not
      increase in these same cells. TNF-resistant leukemic lines had higher
      constitutive levels of Mn-SOD RNA and activity; and these levels did not change
      in the presence of TNF. Antisense but not random oligonucleotides to Mn-SOD
      markedly increased the sensitivity to the inhibitory effects of TNF for both the
      native HL-60 (TNF-sensitive) and K562 (TNF-resistant) cell lines. Further studies
      showed that the antisense oligonucleotides entered the cells and resulted in
      decreased levels of Mn-SOD RNA. The data suggest that Mn-SOD may provide
      protection against cytotoxicity of TNF in hematopoietic cells.

PMID- 8353282
TI  - Normalization of markers of coagulation activation with a purified protein C
      concentrate in adults with homozygous protein C deficiency.
AB  - Homozygous or double heterozygous protein-C deficiency can present at birth with
      purpura fulminans or later in life with venous thrombosis. Two homozygous
      patients who had previously sustained thrombotic episodes were investigated at a
      time when they were asymptomatic and not receiving antithrombotic therapy. The
      plasma levels of protein-C antigen and activity in both individuals were
      approximately 20% of normal. We administered a highly purified plasma-derived
      protein C concentrate to these individuals and monitored levels of several
      markers of in vivo coagulation activation. Assays for protein-C activation
      (activated protein C and protein C activation peptide) showed a sustained
      increase from reduced baseline levels, whereas thrombin generation (as measured
      by prothrombin fragment F1 + 2) gradually decreased over about 24 hours into the
      normal range. These investigations provide direct evidence that protein C is
      converted to activated protein C in vivo, and that the protein-C anticoagulant
      pathway is a tonically active mechanism in the regulation of hemostatic system
      activation in humans.

PMID- 8353283
TI  - CD63 is a component of Weibel-Palade bodies of human endothelial cells.
AB  - Weibel-Palade bodies are secretory granules of vascular endothelial cells
      specialized in the storage of von Willebrand factor (vWF) and P-selectin, two
      adhesion proteins that can be rapidly mobilized to the cell surface by exocytosis
      in response to thrombin or other agonists. In this study, we attempted to
      identify additional components of Weibel-Palade bodies by raising monoclonal
      antibodies to these granules, purified by cell fractionation. One antibody, 2C6,
      was found to be specific for CD63, a membrane glycoprotein previously described
      in the lysosomes of platelets and other cell types. The immunopurified 2C6
      antigen was recognized by an anti-CD63 reference antibody, 2.28, by Western
      blotting. Also, the biosynthetic profile of the 2C6 antigen in endothelial cells
      showed a nascent molecular mass and a glycosylation pattern identical to that of
      CD63. Immunofluorescence staining with 2C6 showed the lysosomes, and also
      elongated structures identified as Weibel-Palade bodies by their shape,
      distribution, and positive staining with anti-vWF antibodies, CD63 was also found
      by Western blotting of subcellular fractions highly enriched in Weibel-Palade
      bodies. Our results indicate that CD63 colocalizes with vWF and P-selectin in the
      Weibel-Palade bodies of endothelial cells, and together with these adhesion
      proteins it could be rapidly expressed on the cell surface in areas of vascular
      injury and inflammation.

PMID- 8353284
TI  - Tumor-infiltrating lymphocytes derived from select B-cell lymphomas secrete
      granulocyte-macrophage colony-stimulating factor and tumor necrosis factor-alpha
      in response to autologous tumor stimulation.
AB  - Tumor infiltrating lymphocytes (TIL) were cultured from 17 B-cell lymphoma
      specimens derived from patients with predominantly low-grade malignancies.
      Specimens included 15 lymph-node biopsies, 1 malignant pleural effusion, and PBL
      from 1 patient with circulating lymphoma cells. The phenotypic and proliferative
      characteristics of TIL cultured in interleukin-2 (IL-2) were studied, as well as
      cytolysis and cytokine secretion in response to autologous tumor. Flow cytometry
      of fresh tumor suspensions showed that 50% of cells (median) were malignant B
      cells and 36% were infiltrating T lymphocytes. After culture for approximately 1
      month, TIL were 75% +/- 8% CD3+ (mean +/- SEM), 47% +/- 8% CD4+ and 35% +/- 7%
      CD8+. TIL proliferation was modest in most cases: the median maximum expansion
      was 32-fold in 25 days. Lysis of autologous tumor in 4-hour 51Cr release assays
      was mediated by 2 of 12 TIL studied, but was nonspecific. However, these same two
      TIL, when cocultured with various tumor stimulators, preferentially secreted
      tumor necrosis factor-alpha and granulocyte-macrophage colony-stimulating factor
      after autologous tumor stimulation; unstimulated TIL secreted undetectable or
      barely detectable levels of these cytokines. In one TIL culture, cytokines were
      secreted by purified CD4+ TIL but not by CD8+ cells, and secretion was completely
      abrogated by the anti-major histocompatibility complex (MHC) class II antibody
      IVA12. Thus, although specific cytokine secretion by lymphoma TIL in response to
      autologous tumor was observed, it occurred in fewer than 20% of patients studied.

PMID- 8353285
TI  - Reactive oxygen intermediates activate NF-kappa B in a tyrosine kinase-dependent
      mechanism and in combination with vanadate activate the p56lck and p59fyn
      tyrosine kinases in human lymphocytes.
AB  - We have previously observed that ionizing radiation induces tyrosine
      phosphorylation in human B-lymphocyte precursors by stimulation of unidentified
      tyrosine kinases and this phosphorylation is substantially augmented by vanadate.
      Ionizing radiation generates reactive oxygen intermediates (ROI). Because H2O2 is
      a potent ROI generator that readily crosses the plasma membrane, we used H2O2 to
      examine the effects of ROI on signal transduction. We now provide evidence that
      the tyrosine kinase inhibitor herbimycin A and the free radical scavenger N
      acetyl-cysteine inhibit both radiation-induced and H2O2-induced activation of NF
      kappa B, indicating that activation triggered by ROI is dependent on tyrosine
      kinase activity. H2O2 was found to stimulate Ins-1,4,5-P3 production in a
      tyrosine kinase-dependent manner and to induce calcium signals that were greatly
      augmented by vanadate. The synergistic induction of tyrosine phosphorylation by
      H2O2 plus vanadate included physiologically relevant proteins such as PLC gamma
      1. Although treatment of cells with H2O2 alone did not affect the activity of src
      family kinases, treatment with H2O2 plus vanadate led to activation of the p56lck
      and p59fyn tyrosine kinases. The combined inhibition of phosphatases and
      activation of kinases provides a potent mechanism for the synergistic effects of
      H2O2 plus vanadate. Induction of tyrosine phosphorylation by ROI may thus lead to
      many of the pleiotropic effects of ROI in lymphoid cells, including downstream
      activation of PLC gamma 1 and NF-kappa B.

PMID- 8353286
TI  - Human endothelial cells express proteinase 3, the target antigen of
      anticytoplasmic antibodies in Wegener's granulomatosis.
AB  - Autoantibodies directed against cytoplasmic antigens of neutrophils (ANCA),
      especially proteinase 3 (PR-3), have proved to be a useful clinical tool
      confirming the diagnosis or monitoring disease activity of Wegener's
      granulomatosis (WG). Although several concepts concerning the pathophysiologic
      potentials of ANCA have been discussed, only sparse data about ANCA-endothelium
      interactions have been available. In this study, we have investigated the
      expression of PR-3 in cytokine-treated human endothelial cells using purified
      anti-PR-3 antibodies of patients with WG, murine and human monoclonal anti-PR-3
      antibodies as probes. We were able to show that tumor necrosis factor-alpha,
      interleukin-1 alpha/beta, and interferon-gamma led to an increased PR-3
      expression in the cytoplasm of endothelial cells by performing polymerase chain
      reaction analysis, Western blot, cyto-enzyme-linked immunosorbent assays, and
      confocal laser scanning microscopy. Moreover, PR-3 was also translocated into the
      cell membrane, becoming accessible to ANCA. Our data suggest a possible direct
      pathogenic effect of anti-PR-3 antibodies in WG and other vasculitides. Anti-PR-3
      antibodies represent an important missing link in ANCA-endothelial interactions.

PMID- 8353287
TI  - Hodgkin's lymphoma-derived tissue serially transplanted into severe combined
      immunodeficient mice.
AB  - Hodgkin (H) and Reed-Sternberg (RS) cells are considered to be the malignant cell
      population in Hodgkin's disease (HD). To date, their analysis has been hampered
      by their scarcity in primary tumors, poor growth in vitro, and lack of an animal
      model. To establish an in vivo system for the characterization of the malignant
      cells in HD, tumor biopsy samples from 13 HD patients were transplanted beneath
      the renal capsule or into the liver of severe combined immunodeficient (SCID)
      mice. HD-derived tissue from three patients gave rise to human tumors in SCID
      mice. Three different histologic patterns were observed: (1) lymphoproliferative
      disease (LPD), (2) anaplastic large cell lymphoma (ALCL), (3) Hodgkin-like
      lesions (HDLL). Immunohistochemical analysis showed that the tumors consisted of
      activated B cells (CD30+, CD20+). Epstein-Barr virus (EBV)-encoded transcripts
      were found in 80% to 100% of the tumor cells, although H and RS cells in the
      primary tumors of two patients were EBV-. All tumors examined (3 of 3) and the
      majority (6 of 10) of cell lines recultured in vitro had an abnormal karyotype.
      Southern blot analysis of the human Ig heavy chain gene showed that monoclonal or
      oligoclonal tumors of different B-cell origin grew in the SCID mice from the same
      germ line-configurated primary biopsy specimen. Our data suggest that the human
      cells in the SCID mice have either been derived from EBV superinfected H and RS
      cells or from EBV-infected bystander cells. If the latter is true, then these
      bystander cells must be genetically abnormal. The genetic defect would be either
      aneuploidy or instable euploidy. In either case, the cells might proliferate into
      malignant aneuploid HDLL or ALCL under the influence of EBV and the special
      environment encountered in the SCID mice.

PMID- 8353288
TI  - Tyrosine phosphorylation of P160 BCR by P210 BCR-ABL.
AB  - It is well established that the chimeric BCR-ABL gene formed by joining parts of
      the BCR and ABL genes plays a key role in the pathogenesis of Philadelphia (Ph)
      chromosome-positive leukemias. We report that simultaneous expression of P210 BCR
      ABL and P160 BCR in simian COS-1 cells yielded stable complexes of these two
      proteins, and induced phosphorylation of P160 BCR on tyrosine residues in vivo.
      Tyrosine phosphorylation of a deletion mutant encoding 553 amino acids of BCR N
      terminal sequences was also detected when it was coexpressed with P210 BCR-ABL.
      We propose that tyrosine phosphorylation of P160 BCR by P210 BCR-ABL and their
      stable physical interaction may perturb normal BCR functions and that these
      alterations are directly involved in the pathologic processes found in Ph
      chromosome-associated leukemias.

PMID- 8353289
TI  - Junctions of the AML1/MTG8(ETO) fusion are constant in t(8;21) acute myeloid
      leukemia detected by reverse transcription polymerase chain reaction.
AB  - The chromosomal translocation, t(8;21), is found frequently in acute myeloid
      leukemia (AML) with maturation (FAB-M2). We have previously mapped the
      translocation breakpoints of t(8;21) in a specific intron of the AML1 gene on
      chromosome 21. In this study, we cloned cDNAs synthesized from a cell line
      carrying t(8;21) by reverse transcription polymerase chain reaction (RT-PCR)
      using an AML1-specific primer. The analysis of the cDNAs structure has led to the
      identification of the fusion of AML1 with a gene named MTG8 on chromosome 8,
      which seems to be identical to ETO. Northern analysis using MTG8 (ETO) probes
      detected 7.8-kb and 6.2-kb RNAs and several minor RNAs in the cell line with
      t(8;21), but failed to detect any transcripts in a cell line without t(8;21). A
      set of primers were designed to detect the AML1/MTG8(ETO) fusion by PCR. The PCR
      amplified identical products in all 6 patients and one cell line with t(8;21),
      suggesting that the AML1/MTG8(ETO) fusion is a constant feature associated with
      t(8;21) and the junctions of the AML1/MTG8(ETO) fusion are restricted in a unique
      site. Because the PCR detection of the AML1/MTG8(ETO) fusion at the RNA level is
      highly sensitive, it can be used as a sensitive method for diagnosis and
      detection of minimal residual disease in t(8;21) leukemia.

PMID- 8353290
TI  - Evidence that red blood cell protein p55 may participate in the skeleton-membrane
      linkage that involves protein 4.1 and glycophorin C.
AB  - Human erythrocyte p55 is a peripheral membrane protein that contains three
      distinct domains in its primary structure: an N-terminal domain, an SH3 motif,
      and a C-terminal guanylate kinase domain. We used naturally mutated red blood
      cells (RBCs) with primary genetic defects resulting in the absence of protein 4.1
      (4.1[-] hereditary elliptocytosis) or glycophorin C (Leach elliptocytosis). The
      absence of either protein was associated with the absence of p55. On a
      stoichiometric basis, the reduction in glycophorin C (about 80%) was concomitant
      to the lack of p55 in RBCs devoid of protein 4.1. Similarly, the reduction of
      protein 4.1 (about 20%) was equivalent to the absence of p55 in RBCs devoid of
      glycophorin C. These correlations suggest that p55 is associated, in precise
      proportions, with the protein 4.1-glycophorin-C complex, linking the skeleton and
      the membrane. The protein 4.1-glycophorin-C cross-bridge is known to be
      critically important for the stability and mechanical properties of human RBC
      plasma membrane. Because isoforms of protein 4.1, glycophorin C, and p55 exist in
      many tissues, these results provide evidence of a linkage between the skeleton
      and the membrane that may have implications in many nonerythroid cells.

PMID- 8353291
TI  - Orientation of erythrocytes in a strong static magnetic field.
AB  - The frequency of exposure to strong magnetic fields has increased as the magnetic
      resonance image-diagnostic technique (MRI) and passenger transport systems based
      on the principle of magnetic levitation have come into wider use. Accordingly, it
      has become necessary to more systematically assess their influence on the body
      and set strict guidelines on acceptable limits of magnetism exposure. Therefore,
      we have assessed the influence of an uniform static magnetic field (8 T in
      maximum) on normal erythrocytes. The erythrocytes were oriented with their disk
      plane parallel to the magnetic field direction. These erythrocytes were
      influenced even by 1 T and almost 100% of them were oriented when exposed to 4 T.
      Furthermore, the degree of orientation was not influenced by the state of
      hemoglobin (oxy: diamagnetic, deoxy and met: paramagnetic). The dependence of the
      measured degree of orientation on the intensity of the magnetic field was in good
      agreement with the theoretical equation for the magnetic orientation of
      diamagnetic substances. As a result of a numerical analysis based on the
      equation, the anisotropic diamagnetic susceptibility of erythrocytes was found to
      be delta chi = 8 x 10(-22) electromagnetic units/erythrocyte. It was almost in
      agreement with the calculated value delta chi = 6 x 10(-22) emu/erythrocyte
      estimated from the diamagnetism of the membrane constituents of erythrocyte.

PMID- 8353292
TI  - In vitro transcription from the human A gamma-globin gene promoter.
AB  - We report enhanced transcription from the human A gamma-globin gene promoter in
      nuclear extracts (NE) of erythroleukemia (K562) cells compared with that in HeLa
      NE. We do not observe differences in transcription levels in the two extracts
      with nonglobin promoter templates. Our findings, indicating preferential
      recognition of the globin gene promoter by nuclear factors in K562 cells, are
      consistent with results of studies previously reported by ourselves and others. A
      novel finding described here is that the addition of a double-stranded octamer
      motif oligonucleotide to K562 NE increases the level of transcription from the A
      gamma-globin gene promoter, suggesting a potential role for an octamer motif
      binding factor in the repression of A gamma-globin gene transcription. A cosmid
      construct containing extensive human gamma- and beta-globin gene promoter and
      structural sequences as well as upstream control sequences also exhibits higher
      levels of globin gene transcription in K562 NE than in HeLa NE. Our demonstration
      of the feasibility of efficient, globin promoter-specific in vitro transcription
      of this complex template offers a novel approach for the systematic analysis of
      the effects of putative regulatory factors on globin gene expression in vitro in
      the context of a genetic environment approximating that found in vivo.

PMID- 8353293
TI  - Effect on lymphocyte subsets of clotting factor therapy in human immunodeficiency
      virus-1-negative congenital clotting disorders. The Transfusion Safety Study
      Group.
AB  - Patients with hemophilia A without human immunodeficiency virus type 1 (HIV-1)
      infection have lower CD4+ counts and CD4+/CD8+ ratios than controls. This is
      usually interpreted as a therapy-induced immunodeficiency. Our data re-examine
      the effect of therapy on peripheral blood mononuclear cell immunophenotypic
      subpopulations in all congenital clotting disorders. Since late 1985 we have
      prospectively observed HIV-1 uninfected persons with all types and severity of
      disorder. Controls were household members without clotting disorders or HIV-1
      infection. Analyses of immunophenotype and treatment included a longitudinal
      random effects model. Compared with controls, age-adjusted CD4+ counts were
      significantly lower in treated patients (P < .0001) and in patients with all
      types of clotting disorders who were seldom or never treated (P = .0005).
      Significantly lower values among both treated and untreated clotting disorder
      subjects (P < .05) were likewise found for total lymphocytes, several other T
      cell subsets, and the CD4+/CD8+ ratio. For most indexes, including the CD4+ count
      and CD4+/CD8+ ratio, the type of clotting deficiency was not a significant
      variable. Comparing persons who had no or minimal therapy with those having the
      most showed increases in CD8+ (P = .0017) and CD20+ CD21- counts (P = .0255), and
      a lower CD20+ CD21+/CD20+ ratio (P = .0106) in the latter. Controls and persons
      with clotting disorders differ in CD4+ count. Among those with clotting factor
      disorders, there is no difference attributable to type of clotting disorder or
      factor therapy. Large amounts of treatment increased CD8+ and CD20+ CD21- counts,
      but were not associated with a change in CD4+ count.

PMID- 8353294
TI  - Disappearance of lysosomal storage in spleen and liver of mucopolysaccharidosis
      VII mice after transplantation of genetically modified bone marrow cells.
AB  - Mice homozygous for the gusmps allele lack beta-glucuronidase activity and
      provide a useful model for human Mucopolysaccharidosis type VII (MPS VII), also
      known as Sly syndrome. Bone marrow (BM) transplantation was shown to correct the
      metabolic defect and to increase the life span of diseased animals. We have used
      this murine model in a preclinical study aimed at evaluating whether the
      techniques currently available for gene transfer into large mammalian and human
      BM cells will provide efficient enzyme replacement therapy in MPS patients.
      Autologous BM was transplanted into deficient mice after retrovirus-mediated
      transfer of the human beta-glucuronidase cDNA. Conditioning of recipients was
      performed by a single sublethal irradiation of 4.5 Gy, giving rise to low donor
      engraftment. In recipient mice analyzed until 145 days after gene transfer, the
      percentage of genetically modified hematopoietic cells was less than 5%.
      Nevertheless, beta-glucuronidase enzyme activity was detectable in various
      organs, including the brain, and disappearance of lysosomal storage was obvious
      in the liver and spleen. These results show that the autologous transplantation
      of genetically engineered BM cells could be beneficial in MPS patients.

PMID- 8353295
TI  - Functional iron deficiency.

PMID- 8353296
TI  - Platelet function and thromboxane synthesis in myeloproliferative disorders.

PMID- 8353297
TI  - Remission after erythropoietin administration for erythroleukemia--a case study.

PMID- 8353298
TI  - Piezoelectric extracorporeal shock wave lithotripsy in 93 patients with
      gallstones.
AB  - Ninety-three patients with gallstones were selected for extracorporeal shock wave
      lithotripsy (ESWL) with a piezoelectric device (EDAP LT-OI) to verify the
      efficacy and safety of this technique. Neuroleptoanalgesia with intravenous
      diazepam and phentanyl was performed in almost all patients. The treatment was
      combined with adjuvant litholytic therapy using oral ursodeoxycholic acid. Follow
      up period was nine months. Piezoelectric ESWL was able to disintegrate
      radiolucent gallstones in 97.9% of cases. By the ninth month 68 patients (73.1%)
      were stone-free. Best results were obtained with single stones smaller than 20
      mm. After ESWL, surgical cholecystectomy was necessary in 2.1% of cases. This
      study confirms the efficacy and safety of piezoelectric extracorporeal shock wave
      lithotripsy combined with ursodeoxycholic acid adjuvant therapy for selected
      cases of gallstone disease.

PMID- 8353299
TI  - The impact of ultrasonography on the prognosis of pancreatic cancer.
AB  - The authors review 207 consecutive patients admitted for pancreatic cancer from
      1960 to 1989 to the 1st Department of Surgery of the University of Rome "La
      Sapienza", in order to ascertain whether ultrasonography contributes to achieving
      the ideal goal of early diagnoses. The results achieved show a higher number of
      early diagnoses (< 1 month from first symptoms) performed by means of US, and a
      concurrent increase of cases amenable to radical surgery during the period 1975
      1989, and basically from 1985 to 1989. Diagnostic imaging, namely US, is
      therefore deemed to provide earlier diagnoses and higher rates of pancreatic
      resectability.

PMID- 8353300
TI  - Combined granular cell tumour of the oesophagus and stomach: a case report and
      review of the literature.
AB  - The case of a 56-year-old man with contemporary benign granular cell tumour of
      the oesophagus and stomach is reported. Surgical resection of the oesophagus and
      stomach was performed after the diagnosis of squamous cell carcinoma on a
      superficial oesophageal biopsy which showed a pseudo-epitheliomatous hyperplasia
      of the stratified squamous epithelium covering the oesophageal Granular Cell
      Tumour (GCT). Hyperplasia was also found in the overlying gastric mucosa. Eight
      GCTs of the oesophagus, observed between 1980 and 1985, were reevaluated to
      compare the neoplastic characteristics and the occurrence of overlying epithelial
      hyperplasia. Only one patient was female; three had multiple oesophageal tumours
      and four showed pseudo-epitheliomatous hyperplasia. A review of the literature is
      included with emphasis on the rare cases of multiple GCTs. The association of
      chronic alcoholism with GCT of the gastro-intestinal tract is also stressed.

PMID- 8353301
TI  - Organ transplantation and branched chain amino acid metabolism in humans:
      methodological problems and possible pitfalls.

PMID- 8353302
TI  - Macronutrient oxidation in liver disease.

PMID- 8353303
TI  - Ultrastructural evidence for the axonal localization of caudodorsal cell hormone
      mRNA in the central nervous system of the mollusc Lymnaea stagnalis.
AB  - The technique of in situ hybridization has been used to evaluate the expression
      of an ovulation hormone mRNA (caudodorsal cell hormone; CDCH) in the central
      nervous system (CNS) of the mollusc Lymnaea stagnalis. Hybridization with
      radioactive as well as with nonradioactive labeled oligonucleotide and plasmid
      probes revealed a specific labeling on cell bodies of caudodorsal cells (CDCs),
      which are known to produce CDCH, on the light microscopical level. In addition,
      specific labeling was observed outside the cell bodies, as far as the cerebral
      commissure, where CDCH is released in the haemolymph. To investigate whether
      these signals represent an axonal localization of the CDCH mRNA, we performed in
      situ hybridization at the electron microscopical (EM) level. The results showed
      an intraaxonal localization of CDCH mRNA with digoxigenin labeled oligonucleotide
      and plasmid probes. Gold labeling was observed in secretion granules, and double
      labeling experiments showed that these granules also contain CDCH. This specific
      intragranular localization suggest that CDCH mRNA is transported through the axon
      and released by exocytosis in the haemolymph.

PMID- 8353304
TI  - mRNA structure, in situ, as assessed by microscopic techniques.
AB  - The secondary and tertiary structure of RNA, in situ, is thought to be involved
      in distinct functions such as directing association of the RNA with the
      cytoskeleton, enzymatic activity of some RNAs, and the control of translation. In
      situ transcription (IST), a procedure by which cDNA is synthesized in situ, has
      been used to assess mRNA structure in situ using fixed cells or tissues. Distinct
      banding patterns were noted for mouse and rat POMC. Unique IST banding patterns
      were observed when an oligonucleotide complementary to a putative POMC stem-loop
      structure was used to prime IST. Indeed local changes in banding patterns could
      be elicited by pharmacological agents which modulate POMC translation. Inhibition
      of POMC synthesis with NaF or dexamethasone decreased the number of POMC mRNAs in
      the polysome fractions and increased the intensity of high molecular weight IST
      derived bands. Forskolin, a stimulator of POMC synthesis, had the opposite
      effect. One mechanism by which translational control is thought to occur is by
      regulation of ribosome movement down the mRNA by specific binding of cytosolic
      proteins to RNA structure. Cytosolic protein fractions from AtT20 pituitary cells
      have been shown to specifically bind to the IST-predicted RNA structure. These
      findings suggest that 1) mRNA structure can be assessed in situ, 2) translation
      may be altered by the secondary and tertiary structure of mRNAs, and 3) a
      predicted stem-loop structure exists in situ in the 5'-end of POMC mRNA.

PMID- 8353305
TI  - Protocol of electron microscope in situ nucleic acid hybridization for the
      exclusive detection of double-stranded DNA sequences in cells containing large
      amounts of homologous single-stranded DNA and RNA sequences: application to
      adenovirus type 5 infected HeLa cells.
AB  - In order to gain a further insight into the relationships of the complex process
      of replication of adenovirus genomes to the substructures which occur in the
      nuclei of adenovirus type 5 (Ad5) infected HeLa cells, we have visualized
      directly, at the electron microscopic level, viral double-stranded DNA (dsDNA) in
      late infected nuclei by the use of a post-embedding in situ hybridization
      technique with a biotinylated specific DNA probe. The procedure is based on the
      removal of single-stranded (ss) nucleic acids by S1 nuclease. The highest levels
      of signal density for viral dsDNA were detected over the fibrils of the large,
      centrally located viral genome storage site and over the viral nucleoids of both
      clustered and isolated viruses. Lower but significant signals were observed over
      the fibrillo-granular network of the peripheral replicative zones, where both
      transcription and replication of viral DNA occur. On the other hand, the labeling
      of the enclosed viral ssDNA accumulation sites, also involved in viral
      replication but not transcription, was negligible, which suggests that, in the
      latter, the newly synthesized viral dsDNA immediately extends into the adjacent
      peripheral replicative zone to be transcribed and/or replicated.

PMID- 8353306
TI  - The use of in situ hybridization to study erythropoietin gene expression in
      murine kidney and liver.
AB  - In situ hybridization has been used to localize erythropoietin (EPO)-producing
      cells in murine kidney and liver. Peritubular interstitial cells were the only
      cell type that produced EPO in the kidney. The EPO-producing cells were primarily
      concentrated in the inner cortex but were also seen in the outer medulla and
      outer cortex. EPO-producing cells represented less than 10% of the total
      interstitial cell population. The number of EPO-producing cells per square
      centimeter of cortex directly correlated with the amount of renal EPO mRNA and
      varied in an inverse exponential manner with hematocrit. These results suggest
      that EPO is expressed in an all-or-none fashion in peritubular interstitial cells
      and that the oxygen carrying capacity of blood is the major regulator of renal
      EPO production. Peritubular interstitial cells were also identified as the renal
      source of human EPO in transgenic mice that expressed human EPO mRNA is a
      regulated fashion in the kidney. Transgenic mice exhibiting inducible supranormal
      liver expression of human EPO were used to identify EPO-producing cells in the
      liver. Hepatocytes surrounding central veins produced human EPO in these mice.
      Individual hepatocytes were able to modulate their production of human EPO
      depending upon the severity of anemia to which they were subjected. Two types of
      widely scattered cells produced EPO in severely anemic nontransgenic mice. Eighty
      percent of EPO-producing cells were hepatocytes and 20% were classified as being
      nonepithelial based on their nuclear morphology and location in venous sinusoids.

PMID- 8353307
TI  - Characterization of the suprachiasmatic nucleus in organotypic slice explant
      cultures.
AB  - Suprachiasmatic nuclei (SCN) from hypothalami of postnatal rats were maintained
      for 18-39 days in vitro as organotypic slice explants. Neuronal subtypes
      containing vasopressin (VP), vasoactive intestinal polypeptide (VIP), gastrin
      releasing hormone (GRP), and GABA were immunocytochemically identifiable in these
      cultures. In situ hybridization histochemistry was compatible with these SCN
      slice explant cultures, and mRNA encoding for VP was detected bilaterally within
      these nuclei. After 18 days in vitro, both VP mRNA and VP immunoreactivity
      increased from levels present on postnatal days 4 (the earliest age from which
      the explanted tissue was derived) to levels typical of adult SCNs. In contrast,
      the GRP expression remained low, characteristic of early postnatal animals and
      far lower than adult levels. This suggests that the developmental cues or
      programs necessary for enhanced VP expression are maintained in these cultures,
      while those affecting GRP expression are absent or inhibited. VIP-containing
      neurons were numerous in the cultures. Culture slices appeared healthy, and
      similar numbers and distributions of identifiable neurons within the SCN were
      observed, whether or not the slices were grown in the presence of serum. EM
      analysis revealed that the SCN in vitro is composed of tightly packed neurons,
      processes, and abundant synapses containing both clear and dense core vesicles,
      closely resembling the SCN in vivo. Vasopressinergic neuronal somata contained
      extensive Golgi systems and labeled secretory granules, the latter organelle
      being present also within processes and synaptic terminals. GABA-immunopositive
      processes and synaptic profiles were abundant, with labeling occurring
      particularly over secretory vesicles and mitochondria. This slice culture system
      effectively maintained much of the intrinsic organization and cellular components
      of the SCN for long periods in vitro and should be an excellent model system for
      studying the intrinsic molecular mechanisms and extrinsic cues which regulate
      neuronal phenotype in this circadian pacemaker.

PMID- 8353308
TI  - An assessment of the efficacy of in situ hybridization as a quantitative method
      by variance components estimation.
AB  - One serviceable feature of in situ hybridization is its potential for assessing
      relative levels of mRNA in specific regions of tissues and organs. To determine
      its efficacy as a quantitative technique, we applied a nested factorial design to
      a multifactorial experiment. Estimates of the magnitude of variance components
      then allowed an assessment of variation over samples of sections from the same
      tissue source, variation in label over 2 anatomical sites within the same section
      of tissue, as well as experiment-to-experiment variation. We found approximately
      51% of the total variance arose from experiment-to-experiment variation, while
      approximately 21% of the total variance was due to variation in autoradiography
      grain density over neurons in the same brain region. Rat-to-rat variation
      accounted for approximately 11%. About 10% of the variance was due to variation
      between sections of tissue that were derived from the same tissue source and were
      hybridized in the same hybridization experiment. Variation between 2 homologous,
      bilaterally located brain regions located on the same tissue section (the right
      and left supraoptic nucleus), accounted for approximately 5% of the total
      variance. The remaining unaccounted error variance was approximately 2% of the
      total variance. Since an expected change in cellular content of a particular mRNA
      was observed as a function of experimental treatment, results suggest in situ
      hybridization is a useful quantitative method.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353310
TI  - In situ hybridization in HIV research.
AB  - In situ hybridization (ISH) for HIV is an arduous, demanding means of detecting
      viral genetic material in cells and tissues. Good ISH requires broad technical
      skills and devotion to controls for every step of the process as well as a
      critical eye when interpreting results. ISH may be used to detect HIV in three
      ways: by hybridizing to viral RNA, by hybridizing to proviral mRNA being produced
      for virion packaging, and by hybridizing to proviral DNA in the cytoplasm or
      integrated in the nucleus of an infected cell. Here we discuss the technical
      considerations involved and the problems encountered in using ISH to study the
      pathobiology of HIV infection.

PMID- 8353309
TI  - Differences of size and shape of active and inactive X-chromosome domains in
      human amniotic fluid cell nuclei.
AB  - It is a widely held belief that the inactive X-chromosome (Xi) in female cell
      nuclei is strongly condensed as compared to the largely decondensed active X
      chromosome (Xa). We have reconsidered this problem and painted X-chromosome
      domains in nuclei of subconfluent, female and male human amniotic fluid cell
      cultures (46,XX and 46,XY) by chromosomal in situ suppression (CISS)
      hybridization with biotinylated human X-chromosome specific library DNA. FITC
      conjugated avidin was used for probe detection and nuclei were counterstained
      with propidium iodide (PI). The shape of these nuclei resembling flat ellipsoids
      or elliptical cylinders makes them suitable for both two-dimensional (2D) and
      three-dimensional (3D) analyses. 2D analyses of Xi- and Xa-domains were performed
      in 34 female cell nuclei by outlining of the painted domains using a camera
      lucida. Identification of the sex chromatin body in DAPI-stained nuclei prior to
      CISS-hybridization was confirmed by its colocalization with one of the two
      painted X-domains. In 31 of the 34 nuclei the area AXi for the inactive X-domain
      was smaller than the area AXa for the active domain (mean ratio AXa/AXi = 1.9 +/-
      0.8 SD, range 1.0-4.3). The signed rank test showed a highly significant (P <
      .0001) difference both between AXa and AXi and between the ratios r(Xa) and
      r(Xi), calculated by dividing the maximum length L of each X-domain by its
      maximum width W. In most nuclei (26/34) we found r(Xa) > r(Xi) demonstrating a
      generally more elongated structure of Xa. For 3D analysis a confocal scanning
      laser fluorescence microscope (CSLFM) was used. Ten to 20 light optical sections
      (PI-image, FITC-image) were registered with equal spacings (approx. 0.4 microns).
      A thresholding procedure was applied to determine the PI-labeled nuclear and FITC
      labeled X-domain areas in each section. Estimated slice volumes were used to
      compute total nuclear and X-domain volumes. In a series of 35 female nuclei most
      domains extended from the top to the bottom nuclear sections. The larger of the
      two X-chromosome domains comprised (3.7 +/- 1.7 S.D.)% of the nuclear volume. A
      mean ratio of 1.2 +/- 0.2 SD (range 1.1-2.3) was found for the volumes of the
      larger and the smaller X-domains in these female nuclei. In a series of 27 male
      amniotic fluid cell nuclei the relative X-chromosome domain volume comprised (4.0
      +/- 2.6 S.D.)%.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8353311
TI  - Morphological modulation of intercalated cells in human fetal kidney.

PMID- 8353312
TI  - alpha-Thalassaemia.
AB  - The large number of naturally occurring mutants of this well-characterized locus
      provides an excellent opportunity for elucidating the relationship between its
      structure and function. Comparisons of what has been learned about the alpha
      globin locus with complementary observations on the beta-globin locus, provide a
      strategy for understanding the co-ordinate regulation of eukaryotic gene
      expression. From a practical point of view it is important to remember that
      millions of individuals throughout the world are carriers of alpha-thalassaemia
      and every year many thousands of pregnancies are at risk of producing children
      with the severe alpha-thalassaemia syndromes. The data summarized here provide
      the basis for accurately predicting the genotype in such cases and thus enabling
      appropriate prenatal testing. However, because this is a genetic disease that
      predominantly affects individuals from countries with limited health resources,
      simpler and cheaper methods of screening and diagnosis will have to be developed
      before this information has a significant impact on the attendant morbidity and
      mortality (see Chapter 9, this volume).

PMID- 8353313
TI  - beta-Thalassaemia.

PMID- 8353314
TI  - The population genetics of the haemoglobinopathies.
AB  - The haemoglobinopathies are the commonest single gene disorders known, and are so
      common in some regions of the world that the majority of the population carries
      at least one genetic abnormality affecting the structure or synthesis of the
      haemoglobin molecule. The prevalence of the common haemoglobinopathies (the alpha
      and beta-thalassaemias, HbS, HbC and HbE) is almost certainly a result of the
      protection they provide against malaria, as the epidemiological evidence reviewed
      in this chapter shows. World-wide, the distributions of malaria and the common
      haemoglobinopathies largely overlap, and micro-epidemiological surveys have
      confirmed the close relationship between the disorders. However, there are
      complications to this picture which appear to undermine the malaria hypothesis.
      First, in some areas, malaria and haemoglobinopathies are not coincident. Second,
      the malaria hypothesis does not easily explain why no two regions of the world
      have the same haemoglobinopathy or combination of haemoglobinopathies. The
      majority of mutations have arisen only once and are regionally specific. By using
      molecular characterization of mutations and the analysis of haplotypes on
      haemoglobinopathy-bearing chromosomes it is possible to show how a combination of
      selection by malaria, genetic drift and population movements can explain the
      first complication. In order to explain the second, we have argued that malaria
      selection has operated relatively recently on human populations (within the last
      5000 years). The present distribution is then seen as the result of selection
      elevating sporadic mutations in local populations. In the absence of sufficient
      gene flow to spread all mutations to all populations, the consequence is a
      patchwork distribution of haemoglobinopathies. Given time, we would expect the
      mutations that protect and do not compromise the health of their carriers to
      become widely disseminated, but it is likely that human intervention will alter
      this process of natural selection.

PMID- 8353315
TI  - Management of Cooley's anaemia.
AB  - The current management of Cooley's anaemia has succeeded in prolonging the
      patient's life to at least the fourth decade, in allowing a number of the
      patients to procreate children, and in allowing most of them to lead a nearly
      unrestricted normal life. The price to be paid for this is the cumbersome and
      expensive adherence to a rigorous regimen of chronic transfusion and compliance
      with chelation therapy. Economical and psychological factors make it difficult
      for many patients to benefit from these advances, but those who can may be
      reasonably assured of a long and fruitful existence. It must be realized that the
      only defect in Cooley's anaemia is one of haemoglobin synthesis, and well-managed
      patients are in any other aspect capable of leading a normal life. In certain
      areas of the world, such as Cyprus (Loukopoulos et al, 1990) and Sardinia (Cao et
      al, 1990), extensive and intensive programmes of prenatal screening have reduced
      to nearly negligible levels the birth of children with Cooley's anaemia (see
      Chapter 9 this volume). Yet, in many countries a complete management of Cooley's
      anaemia is today not feasible for economic or cultural reasons, and this disease
      remains a serious public health problem. The future of the management of Cooley's
      anaemia appears at the moment full of hopes and frustrations (Gale, 1989; Bank,
      1990). However, it is important to understand that if the current group of
      patients with Cooley's anaemia have to be the beneficiaries of future
      developments (be it genetic engineering and/or advances in histocompatibility
      matching), it is necessary that these patients be maintained in excellent
      clinical shape. It would be very sad when a cure for Cooley's anaemia became
      available, if most patients could not avail themselves of it because of pre
      existing irreversible body damage.

PMID- 8353316
TI  - Bone marrow transplant for the haemoglobinopathies: past, present and future.
AB  - Bone marrow transplantation (BMT) is the only treatment currently available which
      can cure thalassaemia and sickle cell anaemia. However, it is not without risk
      and the complications of graft failure, GVHD, veno-occlusive disease,
      interstitial pneumonitis and infections, together with the toxicity of the
      conditioning therapy result in a transplant-related mortality in children of 10
      20%. For the survivors, long-term sequelae include chronic GVHD, endocrinopathies
      and an increased incidence of secondary malignancies. The decision to offer BMT
      to a patient with a haemoglobinopathy must be based on a knowledge of the
      relative risks of transplant and conventional therapy. However, in sickle cell
      anaemia, a subset of patients with particularly severe disease can be identified
      at an early age when the risks associated with BMT are at their lowest. In
      thalassaemia, chelation therapy can delay the onset of organ damage due to
      hypertransfusion but is unlikely to prevent it entirely. The results of BMT in
      children without organ impairment are excellent and BMT must now be considered a
      real alternative to conventional treatment. Gene therapy is an exciting prospect
      for the future but recent progress in retroviral gene transfer has been hindered
      by poor infection efficiencies and expression levels in the target cells. The
      identification of the positive regulatory elements of both the alpha- and beta
      globin genes may resolve some of these problems. Finally, alternative gene
      delivery systems are being investigated, but the introduction of gene therapy for
      the haemoglobinopathies into clinical practice may need to await successful gene
      targeting and replacement.

PMID- 8353317
TI  - The regulation of human globin gene expression.
AB  - The haemopoietic system provides a well-characterized and accessible system for
      studying the mechanisms of developmental regulation and differentiation in higher
      eukaryotes. Our current understanding of the steps involved in the early stages
      of differentiation are poorly understood but a great deal is now known about the
      mechanisms by which globin expression is regulated in cells committed to the
      erythroid lineage. Many of the critical cis-acting sequences and some of the
      important trans-acting factors involved have been identified and current work is
      focusing on how these interact to produce high levels of tissue-specific and
      developmentally regulated expression of the human globin genes.

PMID- 8353318
TI  - Sickle cell disease pathophysiology.
AB  - The primary pathophysiological event in the erythrocytes of individuals with the
      various sickle syndromes is the intracellular aggregation or polymerization of
      sickle haemoglobin (HbS). The extent of polymerization is determined by the
      intracellular haemoglobin composition (% HbS and % HbS A, A2 and F),
      concentration (MCHC and % of dense cells) and oxygen saturation, as well as minor
      factors such as intracellular pH and DPG concentration. Intracellular HbS
      polymerization leads to a marked decrease in the flexibility or rheological
      properties of the sickle erythrocytes and obstruction in various microcirculatory
      beds, as well as chronic anaemia. Other abnormalities in the properties of the
      sickle erythrocytes, including membrane abnormalities, changes in ion fluxes and
      volume and endothelial adhesion, result from acute and chronic oxygen-linked
      polymerization events and may, in turn, modify polymerization. However, within a
      good approximation, many aspects of sickle cell disease pathophysiology--for
      example variations in anaemia among the different sickle syndromes--can be
      explained in terms of differences in polymerization tendency. Thus, the effects
      of alpha-thalassaemia can be explained with reference to changes in MCHC and
      syndromes with high HbF are understandable in terms of the sparing effect of HbF
      on polymerization. Recent therapeutic approaches to sickle cell disease focus on
      attempts to reduce intracellular HbS polymerization by altering the haemoglobin
      molecules, erythrocyte properties, or the distribution of intracellular
      haemoglobin species. The last, through pharmacological elevation of HbF, has
      become the central focus of much laboratory and clinical research in recent
      years. Agents such as hydroxyurea (with or without recombinant erythropoietin)
      and butyrate compounds elevate HbF (and reduce HbS) in a majority of sickle
      erythrocytes, thus decreasing intracellular polymerization. Current prospective
      protocols are designed to see if these changes cause clinical improvement at
      acceptable doses. Other treatment strategies, including bone marrow
      transplantation and possible gene replacement therapies, are also under active
      clinical or laboratory investigation.

PMID- 8353319
TI  - The clinical features of sickle cell disease.
AB  - Evidence from structural studies of DNA suggest that the sickle cell mutation has
      arisen on at least three separate occasions in Africa and as a fourth independent
      mutation in the Eastern Province of Saudi Arabia or India. The pathophysiology of
      sickle cell disease is essentially similar in these different areas although the
      frequency and severity of complications may vary between areas. Generally, the
      chronic haemolysis and resulting anaemia is well tolerated, although serious
      morbidity and occasionally mortality may be associated with the aplastic crisis
      or cholelithiasis. Exacerbation of anaemia below steady state levels occurs with
      chronic glomerular damage and renal failure, especially in older patients. Most
      of the morbidity of the disease arises from bone marrow necrosis in the painful
      crisis or from vaso-occlusive manifestations. Changes in the splenic circulation
      result in life-threatening episodes of acute splenic sequestration, the chronic
      morbidity of hypersplenism, and splenic dysfunction renders children prone to
      pneumococcal septicaemia. Chronic organ damage contributes to chronic leg
      ulceration in adolescence and progressive renal, pulmonary, and occasionally
      cardiovascular impairment in later life. The clinical spectrum of homozygous
      sickle cell disease varies widely between patients. Factors contributing to this
      variability include alpha-thalassaemia, persistence of high HbF levels,
      haematology, social circumstances, and geographical and climatic variation. Many
      of the causes of mortality may be prevented or more effectively treated, leading
      to increased survival and an increased quality of life in affected subjects.

PMID- 8353320
TI  - Dynamics of the bacterial genome: deletions and integrations as mechanisms of
      bacterial virulence modulation.
AB  - Bacterial virulence is a multifactorial phenomenon, arising from the coordinate
      action of special abilities of the infectious agents, termed as virulence
      factors, which is crucial for the infectious process. The genetic determinants
      encoding those factors are termed virulence associated genes, which can be
      located on the bacterial chromosome or on extrachromosomal elements (plasmids).
      Various examples have repeatedly demonstrated that bacterial genome dynamics
      contributes to virulence modulation. Strikingly, a reduced in vivo virulence of
      the pathogens was shown to be due to the spontaneous loss of virulence associated
      genes. The deletion events can involve chromosomal as well as plasmid regions.
      Also integration of plasmids into the chromosome are considered as dynamic
      events. The new genetic location of the formerly plasmid encoded virulence
      associated genes can result in an alteration of virulence expression.

PMID- 8353321
TI  - Chromosomal rearrangement and serovar conversion in Leptospira biflexa strains.
AB  - A bacterial population change involving chromosomal rearrangement and phenotypic
      changes in antigens, proteins and lipopolysaccharides is described for strains of
      Leptospira biflexa that were previously grown in media containing homologous
      oligoclonal antibodies. The chromosomal rearrangement phenomenon showed that the
      variants differed from the parent strains, yet they were similar to
      phenotypically related serovars already occurring in nature. Accordingly, in
      vitro serovar conversion mediated by chromosomal rearrangement, due to as yet
      unknown genetic mechanisms, had occurred.

PMID- 8353322
TI  - Pseudomonas fluorescens var. aluphilia--the influence of Al3+ on the growth rate
      and formation of phenazines.
AB  - The thin-layer chromatographic characterization of phenazine derivatives formed
      by a subspecies of Pseudomonas fluorescens under iron deficiency conditions in
      the presence of Al3+ showed that regarding type and quantity they were relatively
      different from phenazines generated on the basis of Be(2+)-containing culture
      media or containing neither Be2+ ions nor Al3+ ions. A comparison has shown that
      bacterial synthesis of phenazine derivatives is stimulated more by Be2+ ions than
      by Al3+ ions.

PMID- 8353323
TI  - Optimal selection of biochemical tests to identify microbial species.
AB  - Microbial species are mainly identified by biochemical tests. A numerical
      procedure is described, serving as an aid to decide which biochemical tests
      should be used and to check if these tests are sufficient to discriminate the
      species under consideration.

PMID- 8353324
TI  - Effect of growth of Bacteroides fragilis at different redox levels on potential
      pathogenicity in a HeLa cell system: demonstration by confocal laser scanning
      microscopy.
AB  - During trauma, the intestinal anaerobe, Bacteroides fragilis, may enter into a
      pathogenic state. The process coincides with changing environmental conditions
      particularly the redox level in situ. To gain insight into this phenomenon B.
      fragilis was grown at different redox levels, and the invasive potential was
      examined using an in vitro model consisting of HeLa cell monolayers. The clinical
      strain AIP 5-86 was taken from a small collection of B. fragilis strains able to
      penetrate into tissue cell monolayers when selected by an acridine orange-crystal
      violet fluorescent staining technique. Following preliminary investigation by
      confocal laser scanning microscopy (CLSM), this particular strain was regarded as
      representative for examining the invasive potential. After growth in a defined
      medium under oxidizing, reducing or intermediate Eh7 conditions, the washed mid
      log phase bacteria were allowed to interact with HeLa cell monolayers for 45 min
      at 37 degrees C. The results were extensively monitored by CLSM to follow the
      reactions in a stereoscopic dimension. In addition, the bacteria were examined by
      transmission and scanning electron microscopy before interaction to distinguish
      characteristics in surface configuration. The growth of the bacteria at
      particular redox levels seemed to influence their potential for pathogenicity.
      After growth at relatively high Eh, the bacteria easily penetrated into the HeLa
      cells, but not at low Eh, as determined by the laser scanning studies.
      Examination of the bacteria alone by transmission and scanning electron
      microscopy revealed small vesicles and a tendency to aggregate after growth at
      the low redox level while there were rather few vesicles and an implied
      dispersion at the high redox level. This leaves it open whether the invasiveness
      was based on the alterations found during growth of the bacteria. Different redox
      levels as well as the respective changes of the bacterial surface may help to
      discern the commensal from the pathogenic state of B. fragilis.

PMID- 8353325
TI  - Characterization of the murine macrophage receptor for group B streptococci.
AB  - The macrophage has been shown to bind potentially pathogenic bacteria in the
      absence of serum components or opsonins but the mechanism is poorly understood.
      The rich array of sugars on the surface of group B streptococci plus the presence
      of membrane-associated lectin receptors on the macrophage suggests that this is a
      likely means for bacterial recognition by these host defense cells. Inhibition
      studies with free sugars and neoglycoconjugates of bovine serum albumin, however,
      failed to confirm this hypothesis. Furthermore, neuraminidase-treatment to expose
      galactose residues and the use of isogenic bacterial strains having no capsule or
      no capsular sialic acid yielded no confirmation of lectin-mediated recognition.
      The trypsin-sensitive receptor exhibited temperature dependence and a requirement
      for divalent cations distinct from that reported for the lectin-like galactose
      receptor. The activity of this streptococcal binding receptor was inhibited by 2
      deoxy-D-glucose but not by neutrophil elastase. Pre-exposure of macrophages to
      bound fibronectin and treatment with phorbol ester each enhanced bacterial
      binding. These data fail to support a role for the galactose lectin and provide
      preliminary evidence for involvement of the leukocyte integrins in macrophage
      recognition of group B streptococci.

PMID- 8353326
TI  - Fungal pathogens in etiology of septic shock in neutropenic patients with cancer
      (short communication).
AB  - During the 3 years from 1989 to 1991, we evaluated the etiology of septic shock
      cases and infection-associated mortality. A total number of 38 patients was
      included in the study, according to the criteria for septic shock (SS),
      (Intensive Care Medicine Society, 1989). In 1989, P. aeruginosa and
      Enterobacteriaceae among the pathogens prevailed. In 1990 and 1991, S. aureus,
      enterococci and fungi were most frequent. From 8 patients with SS in 1990, the
      shock was due to Candida albicans in 1 and to mucoraceae in 3 patients. In 10
      patients examined in 1991, 8 cases of SS were due to Candida albicans,
      Aspergillus niger, Fusarium solani and Acremonium strictum. The decrease of the
      incidence of shocks and increase of fungal etiology were found to be associated
      with the use of quinolones in prophylaxis and cephalosporines, aminoglycosides
      and vancomycine in empiric therapy in febrile neutropenic patients.

PMID- 8353327
TI  - Critical examination of an enzyme immunoassay for detection of positive IgM
      antibodies against toxoplasma in newborns.
AB  - The Toxonostika IgM test, which has been examined in this study, is a modified
      antibody capture test (7). Evaluation with sera from newborns revealed that, like
      in the ELISA tested in 1988, doubtful or false positive results were obtained in
      10% of the cases (6). Therefore, a positive toxoplasmosis IgM result in newborn
      sera should always be retested with another test system.

PMID- 8353328
TI  - Intranuclear development of asexual and sexual generations of Eimeria hermani
      Farr, 1953, the coccidian parasite of geese.
AB  - Both merogonic and gamogonic stages of Eimeria hermani occurred within the
      nucleus of epithelial cells of the intestine of experimentally infected goslings
      (Anser anser domesticus L.). They were located within a parasitophorous vacuole.
      Several developing meronts were often observed in one host nucleus and each of
      them had its own parasitophorous vacuole. We suppose that two generations of
      meronts were formed by ectomerogony from 2 to 4 days post infection (DPI). During
      the gamogony (4-6 DPI), we observed invagination of the host cell nucleoplasm
      into the parasites and we suppose that this may be connected with the process of
      the parasite's feeding.

PMID- 8353329
TI  - First clinical use of the Possis synthetic coronary graft.
AB  - The Possis polytetrafluoroethylene Permaflow coronary graft incorporates a
      Venturi resistor within the graft. Insertion is constructed by creating an
      anastomosis to the superior vena cava with subsequent anastomoses in sequence to
      coronary arteries requiring grafting. Finally, the graft is sewn to the aorta.
      The Venturi resistor controls flow through the aortocaval fistula, maintaining
      systemic pressure proximal, permitting systolic and diastolic flow to the grafted
      coronary arteries while maintaining constant flow through the graft. Animal
      studies demonstrated long-term patency. This graft was implanted in a patient
      with unstable angina pectoris and inadequate native conduit. Catheterization 6
      weeks postoperative revealed patency of all anastomoses.

PMID- 8353330
TI  - Present status of reconstructive surgery for aortic valve disease.
AB  - Most surgical techniques for reconstruction of the aortic valve, although
      described a long time ago, are now feasible with satisfactory results. The
      general surgical principles for successful reconstruction, and the operative
      techniques of annuloplasty, commissurotomy, free edge resuspension, unrolling and
      thinning, and cusp extension are described. Methods for intraoperative evaluation
      of the repaired valve are also described. Between August 1988 and April 1992, 166
      patients underwent aortic valve reconstruction with a 3.2% hospital and 1.2% late
      mortality. There were no thromboembolic events in the patients with isolated
      aortic valve repair. The reoperation rate was 6.5%. Echocardiographic study at
      last follow-up showed stable results at 4 years maximum follow-up.

PMID- 8353331
TI  - Application of fresh and cryopreserved homografts harvested from transplant
      patients for correction of complex congenital heart disease.
AB  - In recent years, the use of homograft tissue in cardiac surgery has increased so
      that supply is limited. Since October 1990, aortic and/or pulmonary valves were
      collected from 17 transplant recipients at the Department of Cardiovascular
      Surgery of the University of Padova Medical School (11 male, 6 female, mean age
      43.4 years, range 11 months to 61 years). The indications for transplant were
      dilated cardiomyopathy in 7, and end-stage ischemic heart disease in the
      remaining 10 patients. Twelve such valves have been subsequently reimplanted
      either as fresh or as cryopreserved valved homografts in the repair of different
      forms of congenital heart disease, by means of different tailoring techniques (7
      male, 5 female; mean age 4.8 years [range 1 day to 18 years]; transposition of
      the great arteries = 5 cases; tetralogy of Fallot = 3 cases; hypoplastic left
      heart syndrome = 2 cases; double outlet right ventricle = 1 case; truncus
      arteriosus = 1 case). Overall, early mortality was 25%. None of these deaths
      could be related to the use of homografts. There have been no instances of valve
      related complications among nine patients surviving surgery at a mean follow-up
      of 11 months. All patients having heart explanted should be regarded as potential
      sources for aortic and pulmonary homografts.

PMID- 8353332
TI  - Aortic valve replacement using a continuous suture technique.
AB  - The continuous suture technique has been proposed as an alternate method for
      aortic valve replacement (AVR). Advantages include a decreased ischemic and
      bypass time. Despite reports of a low incidence of perivalvular leak, wide use of
      the continuous suture technique has not been adopted. This report reviews our
      experience with the continuous suture technique. From January 1984 through
      November 1991, 181 consecutive patients underwent AVR using the continuous suture
      technique. The mean age was 61 years (range 6 to 88 years). Diagnoses included
      pure aortic stenosis (AS) in 41%, aortic insufficiency (AI) in 31%, and a
      combination of AS and AI in 28%. Fifty-six patients underwent isolated AVR and
      125 underwent AVR combined with other procedures. The overall early mortality was
      5.5%. Early mortality for isolated AVR was 0% (0/56) and was 8.0% (10/125) for
      those undergoing concomitant procedures. Late mortality was 4.7% in a mean follow
      up of 30 months (range 1 to 86 months). The incidence of perivalvular leak was
      2.3% (4/171 operative survivors). Perivalvular leak was mild in two, and moderate
      in two; none required reoperation. Perivalvular leak developed only in patients
      whose suture line was not reinforced with glutaraldehyde treated pericardium. The
      continuous suture technique is a quick and effective method for AVR and results
      in a low incidence of perivalvular leak.

PMID- 8353333
TI  - Implantation of the unstented bioprosthetic aortic root: an improved method.
AB  - The problem of early onset aortic insufficiency as seen with the scalloped,
      subcoronary homograft aortic valve replacement is reduced with the use of a total
      root replacement. In addition, the naturally competent aortic root is more
      durable. From September 1985 to April 1991, 26 consecutive patients underwent
      aortic root replacement with 10 autografts, 14 homografts, and 2 xenografts using
      a modified implantation method. Twenty-five patients were discharged from the
      hospital. This partial inclusion root technique for implanting unstented valves
      in the aortic position decreases the probability of early failure secondary to
      technical malalignment at the time of implantation. In contrast to total root
      replacement, it avoids the need to destroy the recipient aortic root. A
      longitudinal aortotomy is performed to the aortic annulus in the mid-portion of
      the noncoronary sinus. The proximal suture line is interrupted with the valve
      oriented in the anatomical position. Circumferential running monofilament side-to
      side anastomoses approximate the donor coronary ostia to the recipient. A running
      medial and lateral posterior suture line to the lateral superior portions of the
      aortotomy completes the integrity of the anterior wall of the implantation. One
      autograft attempt failed and one homograft patient died postoperatively. Follow
      up ranges from 1 to 6 years in 24 patients. Postoperative aortic insufficiency
      was significant in one case due to inappropriate sizing of the proximal aortic
      suture line. There has been no evidence of progressive aortic insufficiency
      detected by the early onset of diastolic murmurs or echocardiograms as was our
      previous experience with the scalloped subcoronary method.

PMID- 8353334
TI  - Mitral and aortic annular enlargement for insertion of adequate size prosthetic
      valves.
AB  - Mitral and aortic valve rings were radically enlarged in a 70-year-old white
      female presenting with unusually tiny and severely stenotic rheumatic mitral and
      aortic valve disease. A common aorto-left atrial incision created by cutting
      across the two valves made it possible to implant adequate size St. Jude valves.
      The resulting defect in the roof of the left atrium and the aortic root were
      closed with a generous patch of polytetrafluoroethylene (PTFE). The center of the
      patch and the unattached segments of the two prostheses were incorporated with
      interrupted horizontal mattress sutures.

PMID- 8353335
TI  - A modified reconstruction technique after extended anterior descending artery
      endarterectomy.
AB  - An increasing number of patients with advanced coronary artery disease and
      diffusely complex atherosclerotic lesions are referred for coronary artery bypass
      surgery (CABG). Under these circumstances, complete myocardial revascularization
      with an adequate distal runoff can only be achieved by extensive manual
      endarterectomy and a reconstructive procedure prior to conduit placement. Because
      of the numerous septal and diagonal branches of the left anterior descending
      artery (LAD), an extended and meticulous endarterectomy is warranted. Placement
      of the internal mammary artery (IMA) on such a widely opened vessel requires
      reconstruction with a vein patch and the IMA. A modified technique of extended
      manual endarterectomy, distal vein patch, and proximal IMA reconstruction and
      revascularization is described. This technique was used in six patients between
      October 1990 and December 1992 with 100% early survival. This technique is less
      time consuming and more importantly allows for a direct artery-to-artery
      anastomosis with the potential for a better long-term patency.

PMID- 8353336
TI  - Intraoperative coronary angioscopy--technique and results: a study of 38
      patients.
AB  - Over a period of 11 months, 38 patients submitted to coronary artery
      revascularization underwent intraoperative angioscopy of the coronary arteries
      and internal thoracic arteries. Fifty-nine lesions were observed, but only 31
      stenoses responsible for coronary insufficiency were observed (33%). Forty-four
      distal anastomoses were explored (47%) but ten of these explorations were
      incomplete. None revealed technical failure of the anastomosis. Thirteen
      harvested left internal mammary arteries were explored. One of the explorations
      led to rejection of the graft due to an intimal fracture. Some tiny intimal flaps
      were observed in our experience, as in others. Although the iatrogenic origin of
      these lesions in relation to the introduction of the angioscope is obvious, it
      does not seem to influence the outcome of the operation. In our opinion, two main
      fields appear to be developing in coronary angioscopy: preoperative assessment of
      the quality of internal thoracic artery grafts, and control of distal graft
      anastomoses. The flexibility of the angioscopes and of the leading catheters must
      be improved to minimize the risk of arterial wall traumatic lesions.

PMID- 8353337
TI  - Use of a Dacron mesh coated pericardium for aortic augmentation.
AB  - A technique is described for aortic augmentation with Dacron mesh coated
      pericardial patch. This method avoids the use of synthetic graft material with
      the potential for weak adherence of pseudointima and microembolization.
      Hemostasis is improved and fibrous tissue ingrowth into the mesh prevents late
      aneurysm formation. The incorporation of the pericardial patch into the aortic
      wall and the normal endothelialization of the patch is documented after a 5-year
      follow-up.

PMID- 8353338
TI  - Future cardioprotective considerations.
AB  - Remarkable strides have been made in perioperative myocardial protection for
      heart operations. Recent advances in understanding the physiology of myocardial
      ischemia and its protective responses suggest that there is a possibility for
      further improvement. Some of these strategies are discussed in this article,
      which updates current thinking in regard to operative developments contributing
      to myocardial protection, preconditioning, inhibition of adenosine triphosphate
      catabolism, the critical role of adenosine, management of myocardial edema,
      antioxidant therapy, endothelial cell injury, and the interaction between
      activated leukocytes and the endothelium. Some potential new directions for
      cardioprotection are identified.

PMID- 8353340
TI  - Modified elephant trunk procedure.

PMID- 8353339
TI  - Current management of the Wolff-Parkinson-White syndrome.
AB  - In this review, we discuss the pathophysiology of the Wolff-Parkinson-White (WPW)
      syndrome and describe medical, surgical, and catheter based principles. WPW
      syndrome results from the congenital presence of impulse-conducting fascicles,
      known as accessory pathways (APs) or bypass tracts, which connect atria and
      ventricles across the annulus fibrosis and are capable of preexciting portions of
      the ventricular myocardium. Once triggered, atrioventricular reciprocating
      tachycardias (AVRTs) generally result from depolarization wavefronts moving
      anterograde through the AV node to the ventricles and returning retrograde to the
      atria along the AP. Rapid AVRT decreases ventricular filling time and cardiac
      output, resulting in symptoms. Medications that prolong AP refractory periods
      (flecainide, propafenone, and amiodarone) prevent rapid AP anterograde conduction
      (from atria to ventricles) in atrial tachycardias such as atrial fibrillation or
      flutter. In emergencies, adenosine can be used to terminate the AVRT of WPW
      syndrome. Otherwise, Class IA or IC antiarrhythmic agents are used to slow AP
      conduction either with or without AV nodal blocking agents. Open chest surgical
      ablation of a bypass tract in a symptomatic patient was first reported in 1968.
      The original endocardial surgical techniques for localizing and dividing APs were
      refined and an alternative epicardial approach has been developed. Reported
      mortality rates in experienced hands were 0% to 1.5% in large series for patients
      without additional cardiac abnormalities. Catheter delivered radiofrequency (RF)
      energy is now applied intravascularly to ablate APs. Since the first large series
      of patients undergoing RF ablation was reported in 1989, the procedure had proved
      safe, cost effective, and well tolerated. RF ablation has become the initial
      nonpharmacological treatment of choice for WPW syndrome; surgical ablation has
      become relegated to those cases where symptoms are intolerable and RF ablation is
      not feasible.

PMID- 8353341
TI  - Percutaneous femoropopliteal graft placement.
AB  - PURPOSE: Femoropopliteal bypass surgery is now recommended for the treatment of
      long-segment or diffuse superficial femoral artery disease. The authors describe
      a technique for percutaneous placement of a prosthetic femoropopliteal graft.
      PATIENTS AND METHODS: The technique has been accomplished with conventional
      polytetrafluoroethylene graft material and a variety of implantation techniques
      in eight patients. RESULTS: Technical success was achieved in all patients who
      underwent graft placement. Grafts up to 28 cm in length were placed, and graft
      patency was demonstrated up to 10 months after implantation. Six of the eight
      patients were asymptomatic during the follow-up period; one patient who had
      symptoms during this time underwent thrombolysis and redilation of the distal
      stent, and the symptoms resolved. In the other patient with symptoms, the
      procedure failed clinically because of poor runoff. CONCLUSION: This study
      demonstrates the feasibility of percutaneous graft placement in the femoral
      artery, but durability must be established in relation to traditional bypass
      surgery before it can be recommended on a wider scale.

PMID- 8353342
TI  - Percutaneous peripheral atherectomy.

PMID- 8353343
TI  - Transcatheter therapy of severe acute lower extremity ischemia.
AB  - PURPOSE: Transcatheter methods of revascularization were performed in 11 patients
      with severe acute lower extremity ischemia and extensive vascular occlusions in
      whom surgical revascularization was not possible (10 patients) or was not
      preferred (one patient). PATIENTS AND METHODS: The acute ischemia was considered
      category 2 in nine patients and category 3 in two. Vascular occlusions were
      located in the superficial femoral artery in four patients, popliteal artery in
      10, all three crural arteries in 10, and two crural arteries in one.
      Transcatheter methods included accelerated thrombolysis with 325,000 to 1.75
      million U of urokinase, adjunct angioplasty, use of intraarterial vasodilators,
      and creation of pedal arterial flow loops. RESULTS: Initial success was 100% in
      the nine patients with category 2 ischemia. Eight limbs were saved; one occlusion
      at 10 days necessitated below-knee amputation. For the two patients with category
      3 ischemia, one procedure failed and the other reduced the level of amputation.
      CONCLUSION: In patients with severe acute ischemia, transcatheter
      revascularization is a viable treatment option when strategies for reperfusion
      establish both inflow and microcirculatory outflow.

PMID- 8353344
TI  - Emergent renal artery revascularization for acute anuria.

PMID- 8353345
TI  - Extensive aortic and renal artery dissection following percutaneous transluminal
      angioplasty.

PMID- 8353346
TI  - Endovascular grafting in elastase-induced experimental aortic aneurysms in dogs:
      feasibility and preliminary results.
AB  - PURPOSE: A new model of aortic aneurysm was developed in 12 beagles to study the
      feasibility of endoluminal exclusion of aortic aneurysms. MATERIALS AND METHODS:
      After preliminary experiments in four dogs, aneurysms were induced by infusing
      elastase into an isolated segment of the abdominal aorta in eight dogs. To create
      aortic endoprostheses, a Palmaz stent was sutured onto each end of an ultrathin
      Dacron tube. Endoprosthesis placement was performed under fluoroscopic and
      intravascular ultrasonographic (US) guidance. The endoprostheses were introduced
      via a femoral arteriotomy, through a 12-F sheath positioned in the aorta, and
      then were expanded on an angioplasty catheter. RESULTS: Intravascular US and
      aortography showed aneurysms in the elastase-perfused area in the eight animals
      and demonstrated the exclusion of the aneurysm by the endoprostheses in six
      cases. Intravascular US was more accurate than aortography in demonstrating two
      cases of endoprosthesis dysfunction. Aneurysm formation was proportional to the
      loss of elastic tissue observed at histologic examination of the elastase-infused
      area. Macro- and microscopic examinations confirmed thrombosis of the excluded
      part of the aneurysm and patency of all grafts. CONCLUSION: This model and
      intravascular US appear helpful in exploring the feasibility of endovascular
      treatment of abdominal aortic aneurysm.

PMID- 8353347
TI  - Effectiveness of a prolapsed bird's nest filter.
AB  - PURPOSE: The authors evaluated the variable deployment of the Bird's Nest filter,
      including frequency and extent of prolapse in clinical use, and analyzed the
      effects of this variability on clot-trapping efficiency with an in vitro model.
      MATERIALS AND METHODS: In the clinical placement of 20 filters, the average
      length of cephalic filter wires from the center of the filter was measured from
      radiographs obtained immediately after placement. To analyze the effects of
      prolapse, a variable-rate pump was used to mimic the effects of respiration on
      IVC flow. Four clot sizes (5 x 20, 5 x 40, 10 x 20, and 10 x 40 mm) were
      evaluated with four filter configurations with wires stretched to different
      lengths in a cephalic direction from the center of the filter: 2 cm (normal
      tight), 5 cm (normal-loose), 8 cm (moderate prolapse), and to a maximum of 12 cm
      (maximum prolapse). Ten passes for each clot size were performed with each filter
      configuration in both the horizontal and vertical positions. The smallest clots
      were also tested with a slower constant-rate pump. RESULTS: In clinical use, the
      average length of the filter wire was 5.4 cm (range, 1.2-9.0 cm). With the
      variable flow pump, the in vitro degree of prolapse did not significantly
      decrease the trapping efficiency for any but the smallest (5 x 20-mm) clots, for
      the maximum prolapse configuration in the horizontal position (P = .01). In
      addition, for these clot sizes, the filter was more efficient with the slower
      constant rate compared with the faster variable rate; this difference was only
      statistically significant in the horizontal position for the maximum prolapse
      configuration (P = .007). CONCLUSION: The results suggest that in clinical
      practice, a prolapsed Bird's Nest Filter remains effective for all but small
      clots.

PMID- 8353348
TI  - Acute clot-trapping efficiency in dogs with compacted versus elongated wires in
      bird's nest filters.
AB  - PURPOSE: The clot-trapping efficiency of the Bird's Nest filter was studied in
      dogs with the stainless steel wires in a compacted versus fully elongated
      configuration. MATERIALS AND METHODS: Bird's Nest filters were placed
      infrarenally with the wires compacted in 10 dogs and with the wires elongated in
      an additional 10 dogs. The dogs were separated into two groups, five dogs with
      each wire configuration in each group. In group 1, 10 unlabeled 6 x 30-mm blood
      clots were injected into the inferior vena cava. In group 2, six 6 x 10-mm, four
      6 x 15-mm, and four 6 x 30-mm labeled clots were introduced. RESULTS: In group 1,
      clot-trapping efficiencies were 82% for the compacted versus 86% for the
      elongated configuration, as seen on serial cavograms and pulmonary angiograms. In
      group 2, clot-trapping efficiencies were 90% for the compacted versus 97% for the
      elongated configuration, as seen at fluoroscopy. Clot size did not affect
      trapping efficiency. CONCLUSION: Acute clot-trapping efficiency of Bird's Nest
      filters did not differ when the wires were in a compacted versus elongated
      configuration. This study suggests that placement of a Bird's Nest filter in the
      elongated configuration may be satisfactory and may not indicate placement of a
      second filter.

PMID- 8353349
TI  - 1993 SCVIR annual meeting notes.

PMID- 8353350
TI  - Closure of a duodenal fistula with fibrin sealant.

PMID- 8353351
TI  - Percutaneous cholecystostomy for suspected acute cholecystitis in the
      hospitalized patient.
AB  - PURPOSE: The authors evaluated the outcome of 49 hospitalized patients with
      sepsis and possible acute cholecystitis in whom emergency percutaneous
      cholecystostomy was attempted on 50 occasions. PATIENTS AND METHODS: All
      cholecystostomy procedures were performed with ultrasound (US) guidance by using
      either the trocar (n = 35) or the Seldinger (n = 15) technique. Forty of the 50
      cholecystostomies (80%) were attempted at the patients' bedside, and 49 of the 50
      catheters (98%) were placed successfully. RESULTS: Twenty-five of these patients
      eventually died of other causes (51%), but there was clinical improvement in 31
      of the 49 patients (63%) based on a 72-hour decrease of temperature to less than
      37.3 degrees C, normalization of white blood cell count, and/or resolution of
      abdominal pain. US findings were correlated with clinical response. Clinical
      improvement occurred most frequently after cholecystostomy in patients with
      either a distended gallbladder (74%), pericholecystic fluid (80%), or gallstones
      (92%). Forty-three of the 49 patients underwent cholecystostomy alone (88%), and
      six required further procedures (12%). There were six complications (12%)
      including catheter dislodgment (n = 3), hematoma (n = 1), and severe pain (n =
      2). No deaths were directly attributed to percutaneous cholecystostomy.
      CONCLUSION: Percutaneous cholecystostomy performed in septic hospitalized
      patients is a low-risk procedure that may be helpful in the treatment of some
      patients with suspected acute cholecystitis.

PMID- 8353352
TI  - Randomized double-blind clinical trial of celiac plexus block for percutaneous
      biliary drainage.
AB  - PURPOSE: This study was undertaken to determine the efficacy of celiac plexus
      block (CPB) as a method of providing analgesia for percutaneous biliary drainage
      (PBD). PATIENTS AND METHODS: Thirty-two patients scheduled to undergo PBD were
      prospectively assigned randomly into placebo (30 mL of normal saline) and
      treatment (30 mL of 0.25% bupivacaine) CPB groups. Each patient received .03
      mg/kg of midazolam for premedication before PBD and had access to a patient
      controlled analgesia pump during the procedure. The pump was set to deliver 0.2
      mg of midazolam and 25 micrograms of fentanyl per dose with a 3-minute lockout
      time. Vital signs, including heart rate and blood pressure, were continuously
      monitored during the procedure and recorded for comparison with baseline values.
      Patients completed a 10-point visual analogue pain scale following completion of
      their procedure. RESULTS: Patients in the placebo and treatment groups self
      administered a mean of 2.0 and 1.85 mg of midazolam, respectively (P = .40), and
      a mean of 247 and 231 micrograms of fentanyl, respectively (P = .40). On a 10
      point pain scale, the mean postprocedure versus preprocedure elevation in pain
      was 2.1 points in the placebo group versus 1.6 points in the treatment group (P =
      .60). Overall, the degree of satisfaction with the analgesia was equal in both
      groups. CONCLUSION: This study indicates that CPB is not an effective means of
      providing additional visceral pain relief over and above that which can be
      accomplished with self-administered intravenous medication for patients who
      undergo PBD.

PMID- 8353353
TI  - Arterial complications of pancreatitis: diagnostic and therapeutic aspects in 104
      cases.
AB  - PURPOSE: A retrospective study of 104 cases of arterial lesions related to
      pancreatitis was undertaken to examine the diagnostic and therapeutic benefits of
      arteriography compared with ultrasonography (US) and computed tomography (CT).
      PATIENTS AND METHODS: Data were acquired from responses to a questionnaire.
      Eighty-seven patients were men, 17 were women (age range, 21-80 years; mean, 48
      years). These lesions were usually revealed by hemorrhage (70 cases), pain (69
      cases), or both (46 cases). RESULTS: Arteriography was immediately positive in 90
      of 93 patients in whom it was performed, but US and CT may also permit incidental
      discovery of silent lesions (17 cases). These lesions are often single (90%) and
      related to an arterial rupture in a pseudocyst (60%) or a pseudoaneurysm (48%).
      They involved the splenic (42%), the gastroduodenal (22%), and the small
      pancreatic arteries (25%). Of 32 cases in which embolization was performed,
      immediate success was achieved in all cases but bleeding recurred in 12 cases
      (37%). Treatment in 25 patients was a definitive success (78%), and five patients
      died of hemorrhage (16%). CONCLUSION: Arteriography remains essential for
      diagnosis of arterial lesions, and embolization may be indicated as a stabilizing
      preoperative procedure and also for immediately stopping hemorrhage.

PMID- 8353354
TI  - Percutaneous removal of an embolized Wallstent during a transjugular intrahepatic
      portosystemic shunt procedure.

PMID- 8353355
TI  - Delayed Wallstent migration after a transjugular intrahepatic portosystemic shunt
      procedure: relocation with a loop snare.

PMID- 8353356
TI  - Percutaneous transfemoral retrieval of a free-floating titanium Greenfield filter
      with an Amplatz goose neck snare.

PMID- 8353357
TI  - Increased presaturation pulse gaps in two-dimensional time-of-flight MR
      angiography: a pitfall in diseased lower extremities.

PMID- 8353358
TI  - Radiologic diagnosis of superior vena cava laceration.

PMID- 8353359
TI  - Occlusion of an aberrant right subclavian artery arising from a Kommerel
      diverticulum.

PMID- 8353360
TI  - Advances in dietetics and impact on the development of specialty practice areas.

PMID- 8353361
TI  - Fish-oil-containing diet and platelet aggregation.
AB  - Current research suggests that a diet high in fish oil may be useful for
      immunomodulation in hospitalized patients. However, one of the side effects of
      fish oil is a prolongation of the bleeding time, specifically by reducing
      platelet aggregability. Although this effect might be beneficial for patients
      with cardiovascular disease, it would be a potential concern in certain
      critically ill patients. To address this concern, we conducted a prospective
      study of platelet aggregation in 16 surgical patients who were randomly assigned
      to receive either a diet containing 16.5 g of fish oil in 1500 ml (Impact) or
      usual care (standard enteral formulas devoid of fish oil). Feeding was
      successfully accomplished in the patient group receiving a diet that provided
      approximately 14.2 g of fish oil/day for 1 wk without significantly affecting
      platelet aggregability. Thus, it appears that, over the short term, this dose of
      fish oil does not alter platelet function in hospitalized surgical patients.

PMID- 8353362
TI  - Zinc deficiency in elderly patients.
AB  - Zinc is needed for growth and development, DNA synthesis, neurosensory functions,
      and cell-mediated immunity. Although zinc intake is reduced in elderly people,
      its deficiency and effects on cell-mediated immunity of the elderly have not been
      established. Subjects enrolled in "A Model Health Promotion and Intervention
      Program for Urban Middle Aged and Elderly Americans" were assessed for nutrition
      and zinc status. One hundred eighty healthy subjects were randomly selected for
      the study. Their mean dietary zinc intake was 9.06 mg/day, whereas the
      recommended dietary allowance is 15 mg/day. Plasma zinc was normal, but zinc in
      granulocytes and lymphocytes were decreased compared with younger control
      subjects. Of 118 elderly subjects in whom zinc levels in both granulocytes and
      lymphocytes were available, 36 had deficient levels. Plasma copper was increased,
      and interleukin 1 (IL-1) production was significantly decreased. Reduced response
      to the skin-test antigen panel and decreased taste acuity were observed. Thirteen
      elderly zinc-deficient subjects were supplemented with zinc, and various
      variables were assessed before and after zinc supplementation. Zinc
      supplementation corrected zinc deficiency and normalized plasma copper levels.
      Serum thymulin activity, IL-1 production, and lymphocyte ecto-5'-nucleotidase
      increased significantly after supplementation. Improvement in response to skin
      test antigens and taste acuity was observed after zinc supplementation. A mild
      zinc deficiency appears to be a significant clinical problem in free-living
      elderly people.

PMID- 8353363
TI  - Polydextrose and activities of brush-border membrane enzymes of small intestine
      in rats and glucose absorption in humans.
AB  - We investigated the effect of polydextrose, one of the water-soluble non
      digestible polysaccharides, on the activities of brush-border membrane enzymes of
      small intestine in rats and on glucose absorption with relation to the thickness
      of the unstirred water layer in humans. Rats were fed a 5% polydextrose
      supplemented elemental diet for 2 or 4 wk. The mucosal alkaline phosphatase,
      maltase, and sucrase activities were measured in the upper, middle, and lower
      intestine. There was no significant difference between control and polydextrose
      groups. The potentiometric tube was inserted orally in the jejunum. Glucose
      absorption was measured by perfusion with the solutions with or without 5%
      polydextrose. There was no significant difference in the glucose absorption rate
      or the thickness of the unstirred water layer between control and polydextrose
      solutions. The increase in viscosity of the polydextrose solution was negligible.
      This study indicated that polydextrose had no effect on the thickness of the
      unstirred water layer and did not inhibit glucose absorption in humans.

PMID- 8353364
TI  - Symptomatic hyperlipasemia after cardiopulmonary bypass: implications for enteral
      nutritional support.
AB  - The incidence of pancreatitis after cardiopulmonary bypass is reported as < 0.1%.
      We report a milder form of pancreatitis characterized by hyperlipasemia and early
      intolerance to enteral nutrition without overt signs of clinical pancreatitis. A
      retrospective study was conducted in 72 patients who had received tube feeding. A
      statistically (p = 0.01) greater incidence of symptomatic hyperlipasemia was
      noted in post-cardiopulmonary bypass (PCPB) patients (42%, 5 of 12) than in non
      PCPB patients (0%, 0 of 60). Four of the 5 PCPB patients who developed
      symptomatic hyperlipasemia received tube feeding into the stomach or duodenum
      before onset of their symptoms. The overall incidence of PCPB symptomatic
      hyperlipasemia during the study period was 1.3% (5 of 375). A prospective study
      was then carried out in 54 PCPB patients. Five patients became critically ill,
      and 4 of these developed symptomatic hyperlipasemia. Three of the 4 patients had
      received tube feeding into the stomach or duodenum before the onset of symptoms.
      In all cases, the symptoms of tube-feeding intolerance were mild and resolved
      with termination of feeding. This study suggests that critically ill
      cardiopulmonary bypass patients may be more susceptible to developing symptomatic
      hyperlipasemia, which is characterized by early intolerance to enteral
      nutritional support.

PMID- 8353365
TI  - Nutrition and metabolic management of AIDS during acute illness.
AB  - Diarrhea, sepsis, and malnutrition in the AIDS population are common. Some
      authors have predicted length of survival based on malnutrition biomarkers alone
      (degree of weight loss at presentation and serum albumin). Similarly, the
      hypothesis that malnutrition creates a vicious cycle that potentiates
      susceptibility to opportunistic infections may be valid. Consideration should be
      given to combining aggressive enteral and parenteral support with metabolic
      support in the acute phase of illness and between bouts of infections to
      facilitate patient care and to restore lean tissue. A skilled nutritional support
      service can deliver needed metabolic support along with nutritional support to
      these patients. In this case, we focused on the challenges of treating a new
      patient with significant malnutrition associated with AIDS of unknown duration;
      untreated gastrointestinal pathogens associated with substantial acid-base,
      electrolyte, and micronutrient deficiency; and systemic sepsis.

PMID- 8353366
TI  - Carnitine metabolism and human carnitine deficiency.
AB  - Carnitine in the human body is derived from the intake of preformed dietary
      carnitine and biosynthesized carnitine, stemming from the metabolism of lysine
      and methionine. Carnitine is synthesized in liver and kidney, stored in skeletal
      muscle, and excreted mainly in urine. Carnitine has two main functions, i.e.,
      transporting long-chain fatty acids into the mitochondrial matrix for beta
      oxidation to provide cellular energy and modulating the rise in
      intramitochondrial acyl-CoA/CoA ratio, which relieves the inhibition of many
      intramitochondrial enzymes involving glucose and amino acid catabolism. Thus, the
      main consequence of carnitine deficiency is impaired energy metabolism. Human
      carnitine deficiency can be either hereditary or acquired. Hereditary carnitine
      deficiency can be grouped into three clinical entities: myopathic carnitine
      deficiency, systemic carnitine deficiency, and organic acidurias. Acquired
      carnitine deficiency is due to inadequate intake, increased requirement, and
      increased loss of carnitine. The definite diagnosis of carnitine deficiency is
      based on the determination of free- and acylcarnitine levels in serum, urine,
      and/or tissues. The estimated safe and adequate daily carnitine intake for adults
      is 150-500 mumol/day whereas pharmacological doses of carnitine are required for
      the treatment of hereditary carnitine deficiency.

PMID- 8353367
TI  - Carbohydrate metabolism and requirements for nutritional support: Part III.

PMID- 8353368
TI  - Risk versus benefit of fish oil for hospitalized patients.

PMID- 8353369
TI  - The elusive enigma of post-cardiopulmonary bypass pancreatitis and the role of
      early enteral feeding.

PMID- 8353370
TI  - Glucose/fatty acid cycle: regulatory system.

PMID- 8353371
TI  - Clinical problem of hospital malnutrition.

PMID- 8353372
TI  - Clinical evaluation of serum ferritin as index of iron stores.

PMID- 8353373
TI  - Beneficial effect of L-arginine in collagen vascular diseases: a role for nitric
      oxide.

PMID- 8353374
TI  - Errors in hypothesis testing and power.

PMID- 8353375
TI  - "An apple a day keeps the doctor away" and other health claims.

PMID- 8353376
TI  - Interactions of nutrition and ventilation.

PMID- 8353377
TI  - Metabolism in fever. 1928.

PMID- 8353378
TI  - The 1992 John M. Kinney International Award for Nutrition and Metabolism. Dietary
      L-lysine and calcium metabolism in humans: background.

PMID- 8353379
TI  - Analysis for atrazine in fortified cornmeal and corns using a commercially
      available enzyme immunoassay microtiter plate.

PMID- 8353380
TI  - Aldrin contamination at a school in South Australia.

PMID- 8353381
TI  - Malathion leakage from fruit fly male-annihilation traps on Kauai, Hawaii.

PMID- 8353382
TI  - Trace element analysis of the traditional medicine, Jamu.

PMID- 8353383
TI  - Occupational exposures to PAHs measured with UV derivative spectroscopy corrected
      for advective and gaseous losses.

PMID- 8353384
TI  - Bile duct hyperplasia and transient liver parenchymal cell alteration by
      methylisocyanate.

PMID- 8353386
TI  - Bacterial enumeration and mercury volatilization in deep subsurface sediment
      samples.

PMID- 8353385
TI  - Comparison of phytooestrogen-coumestrol and oestrone effects on the liver
      membranes insulin receptors in ovariectomized female rats.

PMID- 8353387
TI  - Influence of some growth regulators and cations on inhibition of chlorophyll
      biosynthesis by lead in maize.

PMID- 8353388
TI  - Elemental and morphological analyses of atmospheric particles from southwestern
      part of Mexico City.

PMID- 8353389
TI  - Transplanted aquatic mosses for monitoring trace metal mobilization in acidified
      streams of the Vosges Mountains, France.

PMID- 8353390
TI  - Validation of a paramagnetic particle-based ELISA for the quantitative
      determination of carbaryl in water.

PMID- 8353391
TI  - Pesticide residues in cropland soils and shallow groundwater in Punjab Pakistan.

PMID- 8353392
TI  - Hematological values of rainbow trout, Oncorhynchus mykiss W., exposed to
      premetallized dyes.

PMID- 8353393
TI  - Pollution of the River Niger and its main tributaries.

PMID- 8353394
TI  - Chronic toxicity of Pydraul 50E to lake trout.

PMID- 8353395
TI  - Cadmium and lead uptake by red swamp crayfish (Procambarus clarkii) of Louisiana.

PMID- 8353396
TI  - Toxicity of cadmium and lead to juvenile red swamp crayfish, Procambarus clarkii,
      and effects on fecundity of adults.

PMID- 8353397
TI  - Histopathological effects of sublethal exposure to phenol on two variously pre
      stressed populations of bullhead (Cottus gobio L.).

PMID- 8353398
TI  - Metal leaching from experimental coal fly-ash oyster cultch.

PMID- 8353399
TI  - Acyclovir for varicella in immunocompetent patients.

PMID- 8353400
TI  - Solitary versus multiple cholesterol gallbladder stones. Mechanisms of formation
      and growth.
AB  - The development and growth pattern of solitary and multiple cholesterol
      gallbladder stones was defined using cholecystography in a prospective study of
      48 patients whose initial cholecystograms indicated a stone-free gallbladder and
      who developed gallstones within the subsequent 5 years. Radiological observations
      performed over 365 patient-years were complemented by macroscopic examination,
      radiograms, scanning electron microscopy, and chemical analysis of gallstones
      from these and other patients obtained at cholecystectomy. Solitary gallstones
      were found to develop after a precursor phase of over 2 years during which free
      floating crystal laminae of cholesterol formed. These laminae subsequently
      aggregated loosely and underwent external compaction and internal remodeling by
      movement of cholesterol molecules to form compact spheroids. A single lamina was
      observed to function as a nucleus for the development of a solitary stone shaped
      as an ellipsoid. About 10% of solitary stones were found to have a solitary
      pigment stone in their center. In contrast, multiple cholesterol gallstones
      formed without a precursor phase. Innumerable, very thin cholesterol crystals
      appeared which very abruptly aggregated to form spheres of up to 1 mm in
      diameter. Within 3 months a second aggregation took place in which these spheres
      colaesced to form mulberry stones. Mulberry stones in turn were transformed
      either to faceted stones (if many were present in the gallbladder) or to barrel
      stones (if few were present) over a period of 3 years. It is proposed that
      temporary occlusion of the cystic duct leads to supersaturation of bile with
      calcium bilirubinate and/or calcium carbonate which in turn promotes deposition
      of either or both of these calcium salts on the surface of single or multiple
      gallstones. For multiple gallstones, this process or the deposition of additional
      cholesterol crystals seals the gallstone surface and is followed by metamorphosis
      of the stone center.

PMID- 8353401
TI  - Treatment of acute postoperative renal failure after liver and heart
      transplantation by urodilatin.

PMID- 8353402
TI  - Tumor-associated antigens in effusions of malignant and benign origin.
AB  - We determined the concentration and effusion/serum ratio of mucin-like carcinoma
      associated antigen (MCA) in comparison to carcinoembryonic antigen, carbohydrate
      antigen 19-9, cancer antigen 125, and cancer antigen 15-3 in 80 sera and 99
      effusions from 64 patients with histologically confirmed malignancies (4 patients
      out of this group showed various effusions simultaneously, which were analyzed
      separately) and 31 patients with various nonneoplastic diseases. Tumor cells were
      detected by cytological examination in 41 effusions (60.3%) from patients with
      neoplastic diseases, while in another 27 cases this method failed to demonstrate
      the malignant origin of the effusion. Of the cytological "positive" malignant
      effusions 90% were also correctly identified by an elevated MCA concentration at
      a cutoff level of 10 U/ml, whereas only one effusion of benign origin (3%) showed
      a slightly elevated MCA concentration of 10.5 U/ml. In 33% of cytologically
      "negative" effusions of patients with neoplastic diseases, the MCA concentration
      was also elevated, with a maximum of 453 U/ml. Increased MCA levels in
      cytologically confirmed malignant effusions were not restricted to metastatic
      breast cancer. All 17 cytologically "positive" "non-breast cancer" effusions were
      correctly identified by their MCA concentrations. None of the other tumor markers
      reached this high sensitivity at the same level of specificity. The ratio of
      effusion/serum concentration of all tumor markers as well as the concentration of
      cancer antigen 125 in effusions was of little diagnostic value. Our results
      indicate that the MCA concentration in an effusion correlates very closely with
      its malignant origin and is superior to all the other antigens tested.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8353403
TI  - Repertoires of autoantibodies against homologous eye muscle in ocular and
      generalized myasthenia gravis differ.
AB  - If weakness of the eye muscles remains the only symptom of myasthenia gravis (MG)
      for more than 2 years, the condition is operationally defined as ocular MG (OMG).
      A number of clinical, genetic, and immunological differences between this variant
      and generalized MG (GMG) have been described. We analyzed repertoires of
      autoantibodies against proteins of skeletal and extraocular muscle in sex- and
      age-matched groups of patients with either GMG or OMG (n = 10 in each group). All
      GMG sera detected a group of three proteins larger than 200 kDa which were not
      detected by any of the OMG sera. Two components with apparent molecular weights
      of 50 and 60 kDa were stained by seven of the ten OMG sera but by none of the GMG
      group. These antigens are probably soluble, cytoplasmatic proteins of the eye
      muscle. OMG sera, furthermore, detected a protein of about 45 kDa in the pellet
      fraction of eye muscle but failed to do so after adsorption with skeletal muscle
      fractions. We conclude that OMG and GMG sera contain autoantibodies of different
      specificities. Our findings further support immunological heterogeneity in MG.

PMID- 8353404
TI  - Ultrastructural study on human lung in alveolitis versus pulmonary fibrosis.
AB  - Lung specimens of 21 patients with diffuse interstitial lung disease were
      examined. The present ultrastructural study outlines the topography and
      distribution of inflammatory changes in the interstitium, endothelium, and in
      pneumocytes and phagocytes. Alveolitis is characterized by marked regenerative
      activity of type II pneumocytes (cuboid metaplasia), intraluminal macrophage
      accumulation, endothelial swelling, multilamination of the endothelial basement
      membrane, pericapillary edema, and primarily by cellular infiltrates in the
      interstitial space. The most prominent feature of the interstitium in pulmonary
      fibrosis is the lack of immunoinflammatory cells. In some areas there is a marked
      absence of alveolar lumen while only a small number of macrophages are present in
      the remaining alveolar lumen. Most of the capillaries in the fibrous septum have
      been destroyed. Ultrastructural studies of lung biopsies in patients with diffuse
      interstitial lung disease allow the differentiation between alveolitis and
      pulmonary fibrosis and thus contribute to a therapeutic decision.

PMID- 8353405
TI  - Ergometer exercise in myoadenylate deaminase deficient patients.
AB  - Three patients with primary myoadenylate deaminase deficiency were subjected to
      exercise on a bicycle ergometer at 125 W for 30 minutes. Blood samples prior to,
      during, and at the end of exercise were analyzed for lactate, ammonia, and
      hypoxanthine. In addition, urinary hypoxanthine excretion was measured. In these
      patients the serum lactate level increased to concentrations between 7.9 and 9.0
      mmol/l at the end of exercise whereas the mean lactate level in nine control
      subjects at the end of exercise was 3.3 mmol/l (range 1.1-8.1 mmol/l). There was
      no difference to control subjects in the exercise-induced increase in plasma
      levels of ammonia and hypoxanthine or in the increase in urinary hypoxanthine
      excretion. The findings support the hypothesis of a reduced substrate supply to
      the citric acid cycle in myoadenylate deaminase deficiency. The normal formation
      of ammonia and hypoxanthine excludes a marked loss of adenine nucleotides in
      working muscles in these patients.

PMID- 8353406
TI  - Hypoxia of diabetic feet with abnormal arterial blood flow.
AB  - Necrotic ulcers of the feet are a dangerous complication of the diabetic foot
      syndrome. Besides peripheral vascular disease (PVD) peripheral neuropathy is an
      important factor in the pathogenesis of necroses. We examined whether the reserve
      of circulation during reactive hyperemia at the feet of patients with type I
      diabetes mellitus with abnormal blood flow (n = 17) is decreased compared with
      diabetic (n = 14) and nondiabetic (n = 20) controls. Further we analyzed whether
      there is a correlation with the oxygen supply of the foot. PVD was excluded by
      clinical check-up, oscillography, and Doppler ultrasound. The reserve of
      circulation of the foot was measured during reactive hyperemia and oxygen supply
      of the foot by oximetry. Abnormal blood flow of the foot was diagnosed by the
      pulsation index. On examination it was found that the reserve of circulation of
      diabetic feet with abnormal blood flow is about 52% less than in diabetic and
      about 50% less than in nondiabetic controls (P < or = 0.005). The decreased
      reserve of circulation correlates with the oxygen supply of the feet; this is
      about 21% less compared to diabetic feet with normal blood flow and about 16%
      less in comparison to nondiabetic feet. The present study shows that diabetic
      feet suffer from disturbed circulation although there is no evidence of PVD. This
      disturbed circulation is correlated with a decreased oxygen supply of the feet.
      Hypoxia during strain could be of great importance in the pathogenesis and
      treatment of necrotic ulcers of diabetic feet.

PMID- 8353407
TI  - PHLECO: a multicenter study of the fate of 1647 hospital patients treated
      conservatively without fibrinolysis and surgery.
AB  - The PHLECO Study (phlebothrombosis conservative therapy) is a multicenter
      investigation of patients with deep vein thrombosis receiving conservative
      nonfibrinolytic hospital treatment. A second study (part II: PHLEFI,
      phlebothrombosis fibrinolytic treatment) to be published later deals with the
      outcome of fibrinolytic therapy. In both studies the incidence of life
      threatening sequelae, such as pulmonary embolism, is of major interest. The 49
      medical departments participating in the study mailed the relevant data to the
      Duisburg Coordination Center for further data analysis and the following
      information was gained: (a) In descending order of frequency, the clinical
      conditions of thrombosis were: immobility, postoperative status, malignancy,
      hormone treatment, posttraumatic conditions, and pregnancy. (b) In descending
      order of frequency, the sites of thrombosis were: femoral vein, calf vein, iliac
      vein, popliteal vein, and subclavian vein. Left-sided thrombosis predominated in
      the iliac and subclavian vein groups. (c) In descending order of frequency, the
      treatment regimens employed were: intravenous heparin+oral anticoagulants,
      intravenous heparin+subcutaneous heparin, intravenous heparin alone, subcutaneous
      heparin alone, intravenous heparin+subcutaneous heparin+oral anticoagulants,
      subcutaneous heparin+oral anticoagulants, intravenous heparin+platelet
      aggregation inhibitors. (d) The average hospital stay was 23.7 +/- 15.6 days. No
      correlation existed between duration of hospital stay and particular types of
      therapy. (e) The incidence of nonfatal pulmonary embolism was 16.1% while that of
      fatal pulmonary embolism was 2.33%. (f) Women outnumbered men in the group with
      fatal pulmonary embolism, and the death rate among older patients was higher than
      that among younger patients. (g) Patients with fatal pulmonary embolism had a
      shorter history of thrombosis than patients in the unselected cohort (patients
      with and without pulmonary embolism).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353408
TI  - Clinical pharmacology in the 1990s: a personal perspective.

PMID- 8353409
TI  - Compliance and adverse drug reactions: a prospective study with ethinylestradiol
      using continuous compliance monitoring.
AB  - This study examined the relationship between adverse reactions and patient
      compliance with ethinylestradiol at 40 micrograms twice daily versus 20
      micrograms four times daily. In a randomized study 61 female patients with
      primary infertility were prescribed the drug twice daily (n = 31) or four times
      daily (n = 30). Ethinylestradiol was administered for 7 days before the sperm
      cervical mucus penetration-test was performed for hormonal standardization of the
      cervical mucus quality. Drug compliance was measured by continuous monitoring
      using the Medication Event Monitoring System. Two parameters were evaluated:
      percentage of prescribed doses taken (administration compliance) and adherence to
      the prescribed dose schedule (regimen compliance, number of days with two or four
      dosing events recorded). Adverse drug reactions were assessed using a
      standardized questionnaire. Fourty-four women experienced side effects, of which
      81% were rated by patients as being mild. Patient compliance was higher with the
      twice daily than with the four times daily regimen: 85% versus 65% prescribed
      doses taken (P < 0.05). There was no significant difference in compliance
      comparing patients with and without adverse reactions (82% versus 72%,
      respectively), but compliance was lower and more irregular with at least 3 versus
      one or two adverse reactions reported: 54% versus 84% in administration
      compliance and 31% versus 58% in regimen compliance (P < 0.05). Compliance was
      also lower in patients with nausea and vomiting than in those without these
      symptoms, 59% versus 91% and 34% versus 66% (P < 0.005), respectively, and lower
      with moderate or severe compared to mild side effects; 48% versus 85% and 25%
      versus 59% (P < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353411
TI  - Mammalian chromosome structure.
AB  - The DNA sequences that are necessary for the formation of a functional mammalian
      chromosome are thought to be the origins of replication, the telomeres and the
      centromere. Telomere structure is now well understood, with the functional
      element characterized as the motif (TTAGGG)n. The structures of the DNA regions
      that contain origins of replication and a centromere are known, but the
      functionally important elements within these regions are still only poorly
      defined.

PMID- 8353412
TI  - Trisomy in humans: incidence, origin and etiology.
AB  - Molecular studies conducted over the past year have demonstrated the importance
      of aberrant genetic recombination in the etiology of several human trisomies, and
      have begun to shed light on the basis of the association between advancing
      maternal age and trisomy. Preliminary studies of gametes using fluorescence in
      situ hybridization indicate that this will be a useful approach in the analysis
      of human non-disjunction.

PMID- 8353413
TI  - Trinucleotide repeats and genome variation.
AB  - The recent cloning of several disease genes has identified the instability of
      trinucleotide repeats as a fundamental mechanism for variation within the human
      genome. This mutation mechanism explains the unique inheritance characteristics
      of the diseases it causes, and there is a significant potential that this
      mechanism is involved in the pathogenesis of other, as yet uncharacterized,
      genetic diseases.

PMID- 8353410
TI  - Genetics of cancer predisposition and progression.
AB  - The development of human cancer is a multistep process that entails a
      progressively more malignant phenotype through the evolution of cellular subsets
      with increasing numbers of genetic alterations. Here we review the molecular
      genetics of human cancer predisposition and progression and describe paradigmatic
      cancer types and cancer syndromes. We also briefly consider the future impact of
      molecular biology on cancer diagnosis and treatment.

PMID- 8353414
TI  - Wilms' tumour gene and function.
AB  - The Wilms' tumour gene, WT1, encodes a protein with four zinc fingers that is
      probably a transcription factor. In humans, WT1 mutations can lead to childhood
      kidney tumours and to developmental defects of the kidney and gonad. The WT1 gene
      may have a role in the mesenchyme to epithelial switch in a range of mesodermally
      derived tissues. Furthermore, growth-factor genes may be targets for repression
      by the WT1 protein during development. WT1 is the first example of a tumour
      suppressor gene with a specific developmental role.

PMID- 8353415
TI  - Microsatellite polymorphisms and the genetic linkage map of the human genome.
AB  - The use of simple sequence repeats as polymorphic genetic markers has
      significantly facilitated the construction of reference maps of the human
      chromosomes and the mapping of mendelian genetic diseases. These markers display
      major advantages over other systems, including restriction fragment length
      polymorphisms and satellites, but also have some limitations.

PMID- 8353416
TI  - Integrating maps of human chromosome 11.
AB  - The past year has seen major advances in our understanding of chromosome
      structure, driven by technology that allows the rapid construction of physical
      and genetic maps. Information on the structure and organization of human
      chromosome 11 is rapidly being accumulated as a result of these developments.

PMID- 8353417
TI  - Integrating maps of chromosome 16.
AB  - The recently published, detailed cytogenetic-based physical map of chromosome 16
      has the highest resolution of any autosomal cytogenetic map thus far constructed.
      The genetic map has been integrated with the cytogenetic map to facilitate the
      regional localization of disease genes by linkage. Disease genes for tuberous
      sclerosis, familial Mediterranean fever, Rubinstein-Taybi syndrome and Morquio A
      syndrome have now been assigned to chromosome 16. The search for the adult
      polycystic kidney disease gene has recently been narrowed to the analysis of
      candidate loci on chromosome 16, and localization of the gene determining
      juvenile Batten disease has been further refined by disequilibrium mapping.

PMID- 8353418
TI  - Deletions of human chromosome 22 and associated birth defects.
AB  - Investigations into the genetic basis of DiGeorge syndrome have shown that in the
      majority of cases there are DNA deletions from the long arm of chromosome 22, at
      22q11. Similar deletions are now known to be present in a wide range of
      conditions with overlapping clinical features, and are an important cause of
      familial congenital heart defect. Deletions within 22q11 have also been
      identified in individuals with no clinical complications.

PMID- 8353419
TI  - Charcot-Marie-Tooth disease type 1A: mutational mechanisms and candidate gene.
AB  - Charcot-Marie-Tooth disease type 1A, the most common inherited peripheral
      neuropathy, is associated with a submicroscopic DNA duplication of 1.5 Mb that
      can arise de novo, and which is flanked by a > 17 kb mosaic repeat. The PMP22
      gene, encoding a peripheral myelin protein, maps within the duplication. In a
      subset of Charcot-Marie-Tooth patients, point mutations can occur within the
      gene. Thus, the alternative mechanisms of overexpression of PMP22 and structural
      alterations in the protein encoded can cause the disease phenotype.

PMID- 8353420
TI  - Genomic imprinting and candidate genes in the Prader-Willi and Angelman
      syndromes.
AB  - The Prader-Willi and Angelman syndromes are now well established as the paradigm
      of genomic imprinting in human disease. Over the past year, much has been learnt
      about the mechanisms by which these syndromes arise and molecular diagnostics for
      the majority of patients are now available. Mouse models for aspects of the
      syndromes have been established, and the first association between a gene,
      located in chromosome 15, at 15q11-q13, and a phenotype (albinism) has been
      proven. Large parts of the critical regions have been cloned and at least six
      genes identified. Three genes or DNA sequences may be imprinted: two of these
      demonstrate DNA-methylation imprints and one is functionally imprinted in mouse.
      While the molecular mechanism of imprinting is not yet understood, it is
      beginning to yield its secrets to DNA methylation, replication, and chromatin
      structure studies of the phenomenon.

PMID- 8353421
TI  - Mitochondrial disorders.
AB  - Several different types of mitochondrial DNA mutations have now been identified
      in a wide spectrum of human disorders. There is some correlation between certain
      of these mutations and the patient's clinical phenotype, although this
      relationship is not absolute. The mechanisms by which these mutations produce
      respiratory chain deficiency and the dysfunction of different tissues are
      unknown. It is becoming increasingly likely that the nuclear genome plays an
      important role in the expression of the mitochondrial DNA mutation and the
      pathogenesis of these diseases.

PMID- 8353422
TI  - Polygenic disease.
AB  - Considerable success is now being achieved in defining genetic susceptibility
      loci in polygenic disease. In particular, new susceptibility loci have been
      identified in hypertension, type I and type II diabetes, asthma and malaria
      infection. The approaches and tools for mapping such susceptibility determinants
      are becoming more clearly defined and the identification of further
      susceptibility genes is likely to be in demand in the near future.

PMID- 8353423
TI  - Mammalian DNA-repair genes.
AB  - The sequence and functional homology of certain genes between mammalian and non
      mammalian eukaryotes has facilitated significant advances in our understanding of
      mammalian DNA repair. Several novel DNA damage and repair genes have been
      identified by using a variety of approaches. Study of these genes will lead to an
      increased understanding of the biological consequences of aberrant DNA
      maintenance in humans and other species.

PMID- 8353424
TI  - Biochemical genetics: examples of life after cloning.
AB  - The blend of biochemistry and molecular biology required to understand the
      pathogenesis of genetic disease is assuming an increasing role in research. We
      review three example of this inevitable post-cloning trend: first, the surprising
      relationship between mice with albino deletions and human hereditary tyrosinemia
      type I; second, the discovery that choroideremia is due to defect in prenylation;
      and third, fibrillin mutations in the Marfan syndrome.

PMID- 8353425
TI  - Dystrophin and related proteins.
AB  - During the past year significant progress has been made in understanding how
      dystrophin deficiency leads to muscle cell necrosis in Duchenne muscular
      dystrophy and Becker muscular dystrophy. Dystrophin interacts with a glycoprotein
      complex spanning the muscle sarcolemma, effectively linking the actin
      cytoskeleton to the extracellular matrix. The carboxyl terminus of dystrophin is
      required for glycoprotein binding. Interestingly, at least three mRNAs
      transcribed from the distal end of the DMD gene in tissues other than muscle have
      been shown to encode this domain. Deficiency of a second component of the
      dystrophin-associated glycoprotein complex has been shown to occur in another
      muscle-wasting disorder, severe childhood autosomal recessive muscular dystrophy.
      Sequence analysis of the entire cDNA for the autosomal dystrophin-related protein
      utrophin has shown that dystrophin and utrophin are closely related. Furthermore,
      both of these proteins have been shown to bind to the same or a similar
      glycoprotein complex in muscle.

PMID- 8353426
TI  - Genetic control of gastrulation in the mouse.
AB  - In the past, understanding of the process of gastrulation in the mouse has
      primarily been based on morphological analyses. Recently, a number of molecules
      have been implicated in mesoderm induction and axis formation in Xenopus, and
      several of these exhibit unique patterns of expression during mouse gastrulation.
      These gene-expression data, together with fate mapping, ectopic expression
      experiments and mutational analysis, will now facilitate studies on the
      functional aspects of gastrulation in the mouse.

PMID- 8353427
TI  - Gene therapy: adenovirus vectors.
AB  - The past year has seen a proliferation in the use of recombinant, replication
      defective adenoviruses for experimental models of gene therapy. The fact that
      adenovirus infects most cell types with no requirement for cell division,
      combined with the high titers and high efficiency of gene transfer obtainable
      with recombinant adenovirus, make it a promising system for in vivo human gene
      therapy.

PMID- 8353428
TI  - Mammalian genetics.

PMID- 8353429
TI  - Noonan's syndrome with keratoconus and optic disc coloboma.
AB  - We report the case of a 14-year-old girl with multiple findings characteristic of
      Noonan's syndrome, including short stature, mild mental retardation, facial,
      skeletal and renal abnormalities. In addition, ophthalmic examination revealed a
      keratoconus in the left eye and a right optic disc coloboma. To date, only two
      cases of Noonan's syndrome with keratoconus have been reported, and this is the
      second case of this syndrome with optic disc coloboma. To our knowledge, this is
      the first report of Noonan's syndrome associated with unilateral keratoconus and
      contralateral optic disc coloboma. In view of the large number of patients with
      Noonan's syndrome reported to date and the rarity of these ocular abnormalities,
      it is most likely that this association is fortuitous. Ocular findings reported
      in patients with Noonan's syndrome are reviewed.

PMID- 8353430
TI  - An anatomic index for the severity of ocular injuries.
AB  - Ocular injuries are a frequent cause of monocular blindness and cause
      disfigurement and discomfort. We developed a measure of severity for eye injuries
      using a multi-attribute utility (MAU) model. The severity index scoring was
      applied to eye injuries that presented at hospitals in Wisconsin, U.S.A. The
      resulting distribution of severities was compatible with that seen by general eye
      care physicians. A severity scale provides a means of comparing the severity of
      injuries from a wide variety of traumatic sources (e.g. automobile crashes,
      combat injuries, occupational accidents, etc.) and is useful in evaluating
      preventive and public health measurements.

PMID- 8353431
TI  - Intraocular levels of cefuroxime in inflamed rabbit eyes.
AB  - The pharmacokinetics of cefuroxime was studied in the inflamed rabbit eye
      employing subconjunctival, intravitreal and combined intravitreal-intravenous
      routes of administration to study the intraocular levels and the duration of
      minimum inhibitory concentrations (MIC) of the antibiotic in the vitreous and in
      the aqueous. A standard inoculum of viable S. aureus was injected into the
      vitreous of 36 pigmented rabbits to establish experimental endophthalmitis. A
      biological method was used for the antibiotic assay. Penetration of systemically
      and subconjunctivally administered-cefuroxime into the inflamed vitreous was
      poor. Intraocular inflammation increased the clearance of the intravitreally
      injected cefuroxime. A dose of 75 mg subconjunctivally produced levels in the
      aqueous far exceeding MIC for over six hours. Penetration of intravitreally
      injected cefuroxime into the aqueous was poor, inconsistent and short lasting.
      Following a single intravitreal injection of 1000 micrograms cefuroxime, levels
      exceeding the MIC for common ocular pathogens persisted in the vitreous for at
      least 24 hours but supplementation with intravenous cefuroxime neither increased
      the intraocular levels nor delayed the clearance of the intravitreally injected
      antibiotic.

PMID- 8353432
TI  - Corneal sensitivity after penetrating keratoplasty.
AB  - In order to determine corneal sensitivity after penetrating keratoplasty, 71
      corneal transplants and their recipient beds were tested using the Cochet-Bonnet
      esthesiometer. The periods from surgery to examination were two weeks to 15
      years. When the test results were divided into six groups according to the
      postoperative period, correlation analysis revealed a progressive improvement of
      sensitivity in the central and peripheral graft as well as in the recipient
      cornea. Only one graft had normal central sensitivity at 24 months; 36 grafts
      were completely anesthetic while 35 grafts had some level of sensitivity at the
      time of last clinical testing. Age, preoperative diagnosis or graft size were not
      correlated with the recovery of sensitivity. The extent and time of reinnervation
      in corneal grafts varied in individual patients.

PMID- 8353433
TI  - Silicone intubation as an alternative to dacryocystorhinostomy for nasolacrimal
      drainage obstruction in adults.
AB  - Silicone tubing was used to repair the patency of the nasolacrimal drainage
      system in 115 patients (four bilaterally) with chronic nasolacrimal duct
      obstruction. The patients were over 20 years old and 16 were men and 99 women;
      46% presented an uncomplicated obstruction with epiphora and 54% presented
      additional signs of chronic dacryocystitis. We used the technique of Quickert and
      Dryden with modifications. The silicone tube remained for a mean of 5.5 months
      (+/- 2.5 SD). After removal of the tube the follow-up ranged from 6 to 42 months
      (mean +/- SD: 16 +/- 9). Patency was maintained in 89% of cases with
      uncomplicated obstruction and in 69% of those with chronic dacryocystitis (total
      success rate 78%). We can therefore recommend silicone intubation of the lacrimal
      drainage system as an alternative to dacryocystorhinostomy (DCR), in adults with
      obstruction of the nasolacrimal duct. In addition, unlike DCR this technique is
      bloodless and the operation takes less time.

PMID- 8353434
TI  - Evaluation of efficacy and safety of ciprofloxacin ophthalmic solution versus
      chloramphenicol.
AB  - The results of this clinical study demonstrate that ciprofloxacin ophthalmic
      solution 0.3% is as safe and as effective as 0.5% chloramphenicol ophthalmic
      solution in the treatment of conjunctivitis and blepharitis of bacterial
      aetiology. Both agents achieved microbiological improvement rates in excess of
      90% after 1 week's treatment. On ciprofloxacin 93.5% of patients were judged
      clinically cured or improved versus 84.6% on chloramphenicol after 1 week. There
      were no serious adverse affects. One patient in each group suffered drug-related
      side-effects (chemosis, erythema) which resolved on discontinuation or changing
      of therapy. Cirpofloxacin is not associated with the rare, but serious, side
      effect of aplastic anaemia which is associated with chloramphenicol use. On the
      evidence of this study ciprofloxacin would appear to be an appropriate agent for
      general use as a topical ophthalmic formulation.

PMID- 8353435
TI  - Dopamine and its metabolites in human tears.
AB  - Dopamine is known to stimulate ion transport in the corneal epithelium. Since
      epithelium is in contact with tears, we searched for dopamine and its metabolites
      in tears. Twenty normal subjects participated in this study. Twenty microliters
      of tears were collected in capillary tubes after trigeminal stimulation and
      immediately analyzed using high-performance liquid chromatography with
      electrochemical detection. Dopamine and two of its metabolites, 3,4
      dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), were identified
      and measured. The mean concentration of dopamine was 8.9 +/- 5.1 ng/ml; DOPAC,
      2.2 +/- 1.6 ng/ml; and HVA, 0.55 +/- 0.4 ng/ml. These results permit us to
      suggest that dopamine is deaminated by monoamine oxidase, then methylated by
      catechol-O-methyltransferase and that catabolism occurs in the lacrimal gland and
      perhaps in corneal epithelium. Finally, part of the dopamine involved in ion
      transport may come from tears.

PMID- 8353436
TI  - Hyperbaric oxygenation combined with nifedipine treatment for recent-onset
      retinal artery occlusion.
AB  - We describe the results of early hyperbaric oxygenation combined with nifedipine
      treatment for central retinal artery occlusion, and explain the results
      pathophysiologically. We report four cases in which hyperbaric oxygenation
      therapy was applied in combination with nifedipine, eyeball massage, and glycerol
      for the treatment of central retinal artery occlusion. In two of the cases in
      which therapy was started less than 100 minutes after the acute onset of visual
      loss and one case in which therapy was started during the course of central
      arterial occlusion, considerable improvement in visual acuity was observed, while
      in the fourth case in which therapy was started six hours after the acute onset
      of visual loss, no improvement appeared. We conclude from these results that
      hyperbaric oxygenation therapy has a beneficial effect on the final visual
      outcome of central retinal artery occlusion, provided it is applied early enough.
      Further investigation is needed to fully define the nature and terms of this
      beneficial effect.

PMID- 8353437
TI  - Fibrin reaction after extracapsular cataract extraction: a statistical
      evaluation.
AB  - As part of a retrospective study, 1056 eyes of 940 patients who had undergone
      extracapsular cataract surgery and posterior chamber IOL implantation were
      studied using statistical methods (chi-squared test). We studied the presence of
      fibrin reaction in three subgroups: diabetics without retinopathy (102 eyes),
      previously operated for primary open angle glaucoma "POAG" (78 eyes) and
      exfoliation syndrome without glaucoma (43 eyes). The results were compared for
      these three groups and for a group of normal individuals. The incidence of fibrin
      reaction was 13.7% in the diabetics, 44.8% in the group of previously operated
      POAG and 27.9% in the group of exfoliation syndrome without glaucoma. All the
      groups studied had this complication much more often than the controls (p <
      0.0001). The incidence among previously operated eyes for POAG was higher than in
      diabetic eyes without retinopathy (p < 0.0005) and in exfoliation syndrome
      without glaucoma eyes (0.05 < p < 0.1). Fibrin reaction was more common in
      exfoliation syndrome without glaucoma than in diabetic eyes without retinopathy
      (p < 0.05).

PMID- 8353438
TI  - Spontaneous hyphaema arising from a strand of persistent pupillary membrane.
AB  - A case is reported of spontaneous hyphaema arising from a persistent strand of
      vascularised pupillary membrane. This strand, and an aneurysmal dilatation from
      which haemorrhage occurred, were illustrated by fluorescein angiography. The
      embryogenesis of pupillary membranes is discussed and the literature is reviewed
      with reference to spontaneous hyphaema.

PMID- 8353439
TI  - History of brain stem surgery.
AB  - The earliest surgical procedures on the brain stem parenchyma were directed at
      sectioning specific fiber pathways to alleviate pain. Subsequently, some tumors,
      abscesses, and vascular lesions that displace rather than invade the parenchyma
      have been successfully removed. Future advances depend on the ability to preserve
      and restore neural function in operated tissue.

PMID- 8353440
TI  - Surgical anatomy of the brain stem.
AB  - Successful surgery within the brain stem parenchyma demands precise knowledge of
      the surface anatomy, relationship between surface and deep structures,
      microscopic anatomy, and functional anatomy of the brain stem. Emphasis on
      correlative knowledge of these aspects of brain stem anatomy will improve the
      success of brain stem surgery.

PMID- 8353441
TI  - Experimental brain stem surgery.
AB  - Few models of experimental brain stem surgery exist in the literature. Often,
      experiments were devised in the animal laboratory after a similar surgical
      procedure already had been attempted on human subjects. Many of the experiments
      referenced in this article were performed with the goal of delineating
      neuroanatomic or neurophysiologic pathways, and then this information was used to
      develop new techniques in the clinical arena, such as BAERs. A new model for
      brain stem hemorrhage is presented in this article as well as a comparison of the
      outcomes of open surgical evacuation, stereotactic aspiration, and control
      animals with pontine hemorrhages.

PMID- 8353442
TI  - Assessing brain stem function.
AB  - Intraoperative neurophysiologic monitoring provides objective measures of nervous
      system function that are of value when operating in proximity to the brain stem.
      Real-time measurements of function can be correlated to operative manipulations
      in order to reduce the risk of damage in critically important regions. Techniques
      for evaluating brain stem function clinically and electrophysiologically are
      presented along with their applications during surgery of the brain stem.

PMID- 8353443
TI  - Diagnostic imaging of the brain stem.
AB  - The small size of the brain stem, its location between the petrous pyramids, and
      the density of neuroanatomic structures in its substance make imaging of the
      brain stem one of the most challenging aspects of diagnostic neuroradiology. The
      relative value of CT, MRI, and angiography in the diagnosis of various brain stem
      lesions is reviewed. The contributions that can be made by more advanced
      diagnostic and functional imaging techniques are presented.

PMID- 8353444
TI  - Surgical approaches to the brain stem.
AB  - During the last decade there has been a remarkable increase in the interest of
      neurosurgeons in surgical approaches along the base of the skull. A plethora of
      different approaches, most of which involve a slight variation of a previously
      described approach, have been reported in the recent literature, frequently with
      proprietary claims of originality. This increased confidence of the neurosurgeon
      in approaching lesions along the base is due to our renewed interest in the
      anatomy of the skull base and our willingness to collaborate with some of our
      colleagues in otorhinolaryngology who have concentrated their surgical anatomic
      studies in this area for years. It is clear that the neurosurgeon who currently
      undertakes surgery of complex lesions involving the base of the skull, the brain
      stem and the associated cranial nerves and arteries must have a thorough
      understanding of this anatomy and frequently must engage the help of an ear-nose
      and-throat colleague to enhance his or her own expertise with these complex
      cases. The emerging principle is that whenever possible, exposure should be
      obtained through carefully planned bone removal along the base rather than
      through brain retraction. It needs to be emphasized, however, that most of the
      complex approaches alluded to in the preceding sections are necessary only when
      the surgeon is dealing with extrinsic lesions, neoplastic or vascular, that only
      secondarily affect the brain stem itself. Almost all intrinsic lesions of the
      brain stem can be accessed through one of the more traditional approaches with
      which all neurosurgeons should be fully familiarized. When the lesion involves or
      points toward the floor of the fourth ventricle, a standard suboccipital approach
      through the vermis suffices. Lesions presenting in the cerebellopontine angle or
      the lateral pons may be safely approached through a standard retromastoid
      craniectomy. A more direct (perpendicular) access can be obtained by a standard
      subtemporal-transtentorial approach when the lesion is high and lateral, by a
      combined subtemporal-suboccipital approach when the lesion extends more
      inferiorly, and by a combined subtemporal-presigmoid approach for the more
      anteriorly located lesions. Anterior or anterolateral lesions of the highest
      aspect of the pons or of the mesencephalon can be readily accessed by the
      pterional-anterior temporal approach or by a standard subtemporal approach.
      Dorsal mesencephalic lesions require a supracerebellar/infratentorial approach
      or, when they extend more inferiorly, an occipital transtentorial approach. When
      the ventral aspect of the lower brain stem is involved, the lateral suboccipital
      approach works well.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8353445
TI  - Intraparenchymal brain stem radiosurgery.
AB  - Stereotactic radiosurgery using the gamma unit has been used to manage patients
      with brain stem tumors or vascular malformations as an alternative to
      microsurgical resection. Whether associated with the pial or ependymal brain stem
      surface or within the brain stem parenchyma proper, radiosurgery provides
      relatively safe and effective management. Radiosurgery is a valuable alternative
      for many patients with pathologic lesions of the brain stem and may represent the
      only surgical option for some patients.

PMID- 8353446
TI  - Primary pontine hemorrhagic events. Hemorrhage or hematoma? Surgical or
      conservative management?
AB  - The pathophysiology of primary pontine hemorrhagic events is unclear, but the
      traditional classification of hemorrhage or hematoma does not have either
      pathologic or clinical support. Reported cases of brain stem hemorrhage suggest
      that patients who suffer progressive deterioration from hemorrhagic pontine
      lesions may benefit from surgery even if they eventually become comatose, whereas
      those who suddenly lose consciousness and have profound neurologic deficit
      probably will not survive.

PMID- 8353447
TI  - Arteriovenous malformations of the brain stem.
AB  - Arteriovenous malformations (AVMs) of the brain stem are, fortunately, rare
      clinical entities. Prompt diagnosis and anatomic evaluation of patients with
      brain stem hemorrhages resulting from AVMs have been greatly facilitated by high
      resolution CT scanning and particularly MR image scanning. The goal of any
      treatment is complete occlusion of the malformation with minimal risk to the
      patient, primarily to prevent rebleeding and further neurologic injury from the
      AVM.

PMID- 8353448
TI  - Cavernous angiomas of the brain stem.
AB  - Cavernous angiomas in contact with the pial or ependymal surfaces of the brain
      stem can be totally and safely resected. Such an approach is recommended for
      symptomatic patients. For asymptomatic patients whose lesions are deeply embedded
      in the parenchyma, close observation without surgical intervention is
      recommended.

PMID- 8353449
TI  - Tumors of the medulla.
AB  - Intrinsic tumors of the medulla are amenable to gross total or radical subtotal
      resection in 30% to 50% of cases. Many of these lesions are histologically
      benign, and, with careful selection, aggressive surgical treatment has a role.

PMID- 8353450
TI  - Tumors of the pons.
AB  - Advances in imaging have made possible confident diagnosis of infiltrative
      pontine gliomas without biopsy. When the diagnosis is in doubt, stereotactic
      biopsy is the procedure of choice. Surgical intervention is restricted to tumors
      with a dorsally exophytic component and other rare circumstances.

PMID- 8353451
TI  - Tumors of the midbrain.
AB  - Focal midbrain tumors in childhood are usually low-grade astrocytomas amenable to
      surgical resection. Small lesions presenting only with hydrocephalus are best
      treated by cerebrospinal fluid diversion without biopsy or surgical resection.

PMID- 8353452
TI  - Infectious lesions of the brain stem.
AB  - Infectious lesions of the brain stem are rare and include primarily abscess and
      encephalitis. The most common etiologic agents for abscess formation are
      Streptococcus sp., Staphylococcus sp., and M. tuberculosis. Encephalitis is
      associated most often with L. monocytogenes and herpes simplex virus infection.
      Classical brain stem syndromes are uncommon with brain stem infections, and CSF
      obstruction can be seen with neurocysticercosis. The diagnosis of these lesions
      has been greatly aided by CT and MR imaging. Microsurgery and stereotaxis are
      both appropriate techniques for the treatment of brain stem abscess that
      establish a diagnosis, identify the causative agent, and relieve mass effect on
      important neural structures. Symptoms of hydrocephalus should be treated with
      temporary or permanent CSF diversion. Viral involvement of the brain stem is
      usually self-limited, and improved antimicrobial therapy has contributed to a
      decrease in the morbidity and mortality of bacterial and parasitic infections.
      Although once believed to be uniformly fatal, infections of the brain stem have
      now been successfully treated for more than a decade.

PMID- 8353453
TI  - Surgical treatment of syringobulbia.
AB  - The treatment of syringobulbia requires a precise diagnosis of the etiology. This
      allows a surgical procedure directed at treating the underlying etiology or
      decompressing the hindbrain. In most cases, symptoms can be greatly improved.

PMID- 8353454
TI  - Rehabilitation of the lower cranial nerves.
AB  - Brain stem lesions frequently cause dysfunction of the lower cranial nerves. Even
      with successful treatment, dysfunction may remain. Various methods for
      rehabilitating the patient with persistent lower cranial nerve dysfunction are
      presented.

PMID- 8353455
TI  - Management of ophthalmic complications in surgery of the brain stem.
AB  - This article reviews assessment and rehabilitation of abnormalities of the
      afferent and efferent visual system that may follow surgery of the brain stem.
      Attention is drawn to newer techniques of assessment (contrast sensitivities and
      binocular visual fields) and of management (low vision aids, Fresnel prisms,
      botulinum toxin injections, and adjustable suture strabismus surgery).

PMID- 8353456
TI  - Control of the circulation by endothelial mediators. Inaugural G.B. West Memorial
      Lecture.

PMID- 8353457
TI  - Diagnostic approaches to allergy.

PMID- 8353458
TI  - Identification of cockroach aeroallergens from living cultures of German or
      American cockroaches.
AB  - The Air Sentinel and polytetrafluoroethylene (PTFE) membranes were used to
      capture airborne particles over living colonies of German or American
      cockroaches. Silver-stained SDS-PAGE gels revealed protein bands at 80, 55, 36,
      and several bands below the 33-kD marker. SDS-PAGE/immunoblots of PTFE eluates
      from German cockroach colonies incubated with serum from cockroach-sensitive
      individuals revealed IgE-binding bands with apparent molecular weights of 36 and
      80 kD. Only the 36-kD allergen and allergens below the 33-kD marker were evident
      in the American PTFE eluate. ELISA analysis with a monoclonal antibody assay
      identified the presence of both Bla g I and Bla g II in the German PTFE eluate.
      No Bla g I or Bla g II could be identified in the American PTFE eluate. These
      studies demonstrate that in addition to Bla g I and Bla g II, several other
      aerosolized allergens become airborne over cockroach colonies and may be
      important in the environment where cockroaches are abundant.

PMID- 8353459
TI  - Sequence polymorphisms of cDNA clones encoding the mite allergen Der p I.
AB  - Sequence information has been obtained from 5 cDNA clones encoding the major
      house dust mite allergen Der p I, including one which codes for the full length
      preproenzyme form of the molecule. All translated sequences were unique with 1-3
      differences between each clone. 4/5 of the substitutions found were to residues
      found in Der f I and two positions had a substitution in more than one clone. The
      polymorphisms included residues already described to be in T cell epitopes, so as
      well as being necessary to consider them in the construction of synthetic
      allergens, the substitutions will be important for the interpretation of
      experimental and genetic studies.

PMID- 8353460
TI  - Isolation and preparation of antisera to ovine IgE.
AB  - Elevated levels of ovine reaginic antibody were induced by immunization with
      Ascaris suum antigens. The PCA activity of this antibody persisted in the skin of
      sheep for 20 days and was abolished by heating to 56 degrees C, suggesting that
      it was immunoglobulin E. Attempts to isolate IgE from this hyperimmune serum by
      gel filtration, ion exchange and affinity chromatography resulted in the
      preparation of a PCA-positive fraction containing proteins with molecular weights
      of 70, 56 and 22 kD on SDS-PAGE. This preparation was used to raise an antiserum
      in a rabbit to IgE which was rendered specific by absorption. An antiserum to the
      heavy chain of ovine IgE was also raised in a rabbit by immunization with a
      fraction prepared from the 68- to 80-kD region of SDS-PAGE by excision and
      electroelution. Both antisera were positive in reverse cutaneous anaphylaxis
      tests and recognized a single protein with a molecular weight of 70-72 kD on SDS
      PAGE immunoblotting. The presence of this protein in reaginic sheep serum, the
      molecular weight of its heavy chain, its heat lability and long-term skin
      sensitizing ability are characteristic of IgE.

PMID- 8353461
TI  - Augmented passive transfer of contact sensitivity in severe combined
      immunodeficiency mice and its dependence of V beta 8+ cells in the picryl system.
AB  - The passive transfer of contact sensitivity using picryl chloride immune cells
      from H-2 syngenic BALB/c donors was analyzed in severe combined immunodeficiency
      (SCID) mice which lack functional T and B lymphocytes. H-2-restricted and antigen
      specific contact sensitivity was transferred to SCID mice, and comparison between
      the level of contact sensitivity and the number of transferred cells showed a
      significantly more efficient transfer to SCID than to BALB/c mice. The cells
      passively transferring contact sensitivity were shown to carry the V beta 8
      phenotype. Moreover, chromium-labeled cells from BALB/c PC1-primed donors
      localize normally in peripheral lymphoid organs and an increased percentage of
      cell arrival in the ears is clearly observed in SCID after challenge with picryl
      chloride.

PMID- 8353462
TI  - Relationship of interleukin-4 to isotypic distribution of anti-double-stranded
      DNA antibodies in systemic lupus erythematosus.
AB  - IgG subclasses of anti-double-stranded DNA antibodies were determined in 182
      patients with systemic lupus erythematosus. All isotypes were detected, but IgG1
      and IgG3 were predominant (62 and 51% of the cases, respectively). An average of
      64 +/- 27% was IgG1, 16 +/- 22% IgG2, 16 +/- 19% IgG3 and 4 +/- 10% IgG4. The
      rank order or frequency was IgG1, IgG3, IgG2 and IgG4 in patients with
      musculoskeletal involvement; IgG1, IgG2, IgG3 and IgG4 in those with renal
      complications; IgG3, IgG1, IgG2 and IgG4 in those with cutaneous involvement; and
      IgG1, IgG3, IgG2 and IgG4 in those with hematological manifestations. Interleukin
      4 (IL-4) was detectable in 17 of 36 selected patients, as opposed to 1 of 40
      normal controls. The percentage of the total autoantibody contributed by IgG1 was
      significantly higher (p < 0.03) in these patients than in the remainder with
      undetectable levels of IL-4.

PMID- 8353463
TI  - In vitro interleukin-5 production of peripheral blood mononuclear cells is
      increased in patients with asthma.
AB  - To determine whether the capacity of interleukin-5 (IL-5) production is increased
      in patients with asthma, we studied in vitro IL-5 production from peripheral
      blood mononuclear cells (PBMC) in 27 asthmatics (16 allergic asthmatics and 11
      nonallergic asthmatics) and 10 normal subjects. IL-5 production of
      phytohemagglutinin (PHA)-stimulated PBMC was significantly greater in asthmatics
      than in normal subjects (p < 0.02). IL-5 production of PBMC by IL-2 stimulation
      was also significantly increased in asthmatics compared with that of normal
      subjects (p < 0.05). In contrast, IL-2 production of PHA-stimulated PBMC did not
      significantly differ between asthmatics and normal subjects. In addition, the
      number of CD4+ and CD8+ T cells in PBMC or CD4+/CD8+ ratio did not significantly
      differ between asthmatics and normal subjects, whereas CD25+ T cells were
      significantly increased in asthmatics compared with those of normal subjects (p <
      0.02). Finally, there was no significant correlation between the in vitro IL-5
      production of PBMC and blood eosinophil counts in asthmatics and normal subjects.
      Our results indicate that the capacity of IL-5 production, but not of IL-2
      production, is increased in asthmatics. The increased capacity of IL-5 production
      might be involved in the migration and activation of eosinophils in the airways
      of asthmatics.

PMID- 8353464
TI  - Alteration in T cell subset phenotypes as cell markers for rejection or long-term
      allograft acceptance in allografted rats treated with antithymocyte globulin.
AB  - The alterations in the absolute levels of lymphocyte phenotype subsets were
      measured in a rat model for heart allograft acceptance induced by antithymocyte
      globulin (ATG). In untreated, allografted rats all T lymphocytes decreased with
      50% within 3 days after transplantation and recovered within 1 week. ATG alone
      induced a depletion of 75% of the T lymphocytes, which did not normalise until 60
      days after treatment. During the first 10 days, ATG-treated rats with an accepted
      allograft had higher levels of T lymphocytes than those with rejections while the
      T lymphocytes recovered faster after day 10 in the later rats. The study
      demonstrates different alterations in T lymphocytes phenotype subsets between
      rejecting rats and rats with long-term accepted allograft. It also shows that the
      operation trauma with rejection as well as the ATG treatment strongly influence
      the T cell subsets.

PMID- 8353465
TI  - Heterogeneity in the IgE binding to a peptide derived from the house dust mite
      allergen Der p II indicates that the IgE response is highly polyclonal.
AB  - The fine specificity of IgE antibody binding to peptide 65-78 of the house dust
      mite major allergen Der p II was examined by comparison with binding to two
      peptides in which the cysteines corresponding to cys73 and cys78 in Der p II were
      substituted by serines and methionines. Differences in binding behavior indicated
      that at least three different subpopulations of IgE antibodies bound to peptide
      65-78. Even at the level of such a small fragment the IgE response in individual
      donors proved to be polyclonal.

PMID- 8353466
TI  - [Cutaneous parasitism by Leishmania (Leishmania) chagasi during South American
      visceral leishmaniasis].
AB  - Eighteen patients from the northeastern Brazilian State of Ceara with proven kala
      azar were studied for evidence of skin parasitism: two had ulcerative or papular
      skin lesions and 16 had clinically normal skin. Punch biopsies (3 mm) of intact
      paraspinal subscapular skin were performed on all patients; in those with papular
      or ulcerative lesions biopsies also were taken from an active site. One of each
      of the subscapsular biopsies and half of each biopsy from an active lesion were
      studied; the other specimens were seeded on NNN Difco Blood Agar Base Medium for
      parasite culture. The biopsies revealed a discrete to intense mononuclear
      inflammatory infiltrate, predominantly perivascular in nature. No amastigotes
      were observed in any tissue sections but 7 of the 18 patients yielded
      promastigotes on skin culture identified by monoclonal antibodies and by enzyme
      electrophoresis as Leishmania (Leishmania) chagasi [L. (L.) chagasi]. The
      isolation of Leishmania (Leishmania) chagasi, the recognized aetiologic agent of
      visceral leishmaniasis in the New World, from the skin of nearly 40% of 18 AVL
      patients proves dermatotropism of L. (L.) chagasi occurs and may be frequent in
      neotropical human visceral leishmaniasis (AVL.). Infected persons with skin
      parasites could act as a reservoir of infection and allow human to human
      transmission.

PMID- 8353467
TI  - [Epidemiological, clinical and biological features of mucocutaneous leishmaniasis
      in Bolivia after a 221 patient sample].
AB  - The authors present a clinical, biological and epidemiological study of 221 cases
      of mucocutaneous leishmaniasis observed in Bolivia between January 1990 and April
      1991. The patients exhibited cutaneous lesions in 136 cases and mucous
      involvement in 85 cases. It is stressed on the severity of the disease in
      Bolivia.

PMID- 8353468
TI  - [Parasitological efficacy of repeated treatments with ivermectin in an
      onchocerciasis focus in north Cameroon].
AB  - 321 adults living in an hyperendemic onchocerciasis focus in North-Cameroon who
      received a first dose of ivermectin (150 micrograms/kg) in 1987 and a total of
      three, four or five doses from 1987 to 1991 were parasitologically examined in
      1992. The prevalence of skin microfilariae (PMf) and the geometric mean
      microfilarial load (GMMf) were respectively reduced by 33 and 97% from the
      initial values in the group of subjects who received five treatments. In 1992,
      the PMf and the GMMf were not significantly different in the groups which
      received three, four or five doses of ivermectin. It is not necessary to achieve
      an important drug coverage to maintain a tolerable level of infestation in the
      community.

PMID- 8353469
TI  - [Autochthonous anguilluliasis in France].

PMID- 8353470
TI  - [A case of polyradiculoneuritis associated with dengue in a patient native to
      French Guiana].
AB  - An acute polyradiculoneuritis in a woman native of French Guiana has been
      observed with serologic conversion against flaviviruses by inhibition of
      hemagglutination test. Dengue's diagnostic was been kept in spite of lack of
      causal virus isolation and non-typical clinical symptoms. Association dengue
      polyradiculoneuritis appears quite uncommon and is worthy of note, in view of
      frequency of infection by Flaviviruses.

PMID- 8353471
TI  - [Tropical endemic limbal conjunctivitis in Cameroon patients. Apropos of 819
      cases in Yaounde].
AB  - The authors report the epidemiological and clinical aspects of tropical endemic
      limbo-conjunctivitis in 819 cameroonian patients followed up from June 1989 to
      June 1990: Tropical endemic limbo-conjunctivitis constitutes about 4% of causes
      of consultation in our services. The population concerned with LCT is composed of
      46.28% of girls and 53.72% of boys; 85% of patients presenting with tropical
      endemic limbo conjunctivitis are aged between 7 months and 15 years; Allergy and
      past family history of tropical endemic limbo conjunctivitis are rare and
      filariasis is an aggravating factor of the disease; The pure globus form is the
      most frequent (80%) and we did observe especially stages I and II of the disease;
      The disease does not seem to cause blindness in our area. Synonym: Vernal kerato
      conjunctivitis.

PMID- 8353472
TI  - [Introduction of onchocerciasis in Central America: the role of the French
      expeditionary corps to Mexico (1861-1867)].
AB  - Close relationships between American and African strains (from savanna) of
      onchocerciasis have been confirmed by biochemical analysis. It is admitted that
      the parasite could have been introduced by slave trade. But in Mexico, Torroela
      supported the hypothesis that onchocerciasis was introduced by Nubian soldiers of
      the French troops between 1861 and 1867. Some of the 600 soldiers of the Egyptian
      bataillon, included in the French expeditionnary corps, could have been
      onchocerciasis carriers. But these troops caserned in Vera Cruz remained in the
      littoral plain and have not been in contact with the Oxoaca focus of
      onchocerciasis. It is very unlikely that they can have been at the origin of the
      disease focus.

PMID- 8353473
TI  - [Seroprevalence of the human immunodeficiency virus (HIV) in pregnant women
      coming for maternity consultation to the hospital center of Libreville (Gabon) in
      June 1990].
AB  - The pregnant women as a control group was chosen in 1990 in order to estimate the
      HIV Seroprevalence in Libreville. As a result of that survey it appears that the
      prevalence of that retrovirus seems to remain under 2% and that those women are
      HIV-1-infected.

PMID- 8353474
TI  - [Surveillance of HIV seroprevalence in Mauritania].
AB  - The results of our study in four years, blood donors and tuberculosis patients
      HIV seroprevalence using ELISA for detection HIV1/HIV2 antibodies and Western
      blot for confirmation, indicate that seroprevalence in blood donors is 0.28%
      without a significant increase tendency. Our data show that 88 HIV seropositive
      confirmed, 70% were HIV1, 25% HIV2 and 5% double reactivity HIV1/HIV2.

PMID- 8353475
TI  - [Bacteriological aspects of purulent meningitis in Bamako district. Apropos of
      1,541 bacterial strains collected from 1979 to 1991].
AB  - This study is about bacteriological aspects of purulent meningitis in Bamako area
      upon 1,541 strains collected from 1979 to 1991. It showed that N. meningitidis,
      S. pneumoniae and H. influenzae b are responsible. In general, N. meningitidis is
      the most frequent, but this depends on years and months. Since 1988, N.
      meningitidis serogroup C has supplanted serogroup A. N. meningitidis is
      predominant between 7 to 30 years. S. pneumoniae between 1-28 days and 31 to 68
      years, H. influenzae between 1 month to 6 years. The frequency of these species
      is the same in male and female. The 3 species are quite sensitive to antibiotics
      tested except sulphonamides and cotrimoxazole. Meanwhile, the appearance of
      strains of S. pneumoniae to penicillin and H. influenzae to ampicillin must be
      followed with interest to check any time the importance of the phenomenon.

PMID- 8353476
TI  - [Clinical, epidemiological and therapeutic aspects of purulent meningitis in the
      adult. Apropos of 74 cases treated at CHU of Brazzaville (Congo)].
AB  - During 2 years and 9 months, 74 patients were hospitalized to purulent meningitis
      at the Hospital of Brazzaville and 33 were bacteriologically confirmed. The
      pneumococcus was responsible in 24 cases (33.4%). The analysis of 74 files showed
      that 34 patients died, 40 were completely cured without any after effect. The
      factors for these bad prognosis are: the presence of signs of cerebral pains; a
      CSF cytology inferior to 500 cells/mm3; total CSF proteins inferior to 2 g/l and
      the time before hospitalisation superior to 5 days.

PMID- 8353477
TI  - [Initial resistance to streptomycin, isoniazid, rifampicin and ethambutol in
      bacillus-laden tuberculosis patients at the National Center of Pneumo-physiology
      at Cotonou (Benin)].
AB  - The authors are reporting results from a study about BK sensitivity among
      principal antituberculosis drugs in Benin Republic: 81.5% of them are susceptible
      for all specific antibiotics, 8.5% are offering resistance to INH and
      Streptomycin together. In this preliminary study no primitive resistance for RMP
      has been found.

PMID- 8353478
TI  - [Purulent pleurisy in a specialized hospital environment in Bamako].
AB  - We report the results of a retrospective study of 108 cases of pleural empyema
      collected in the Pneumo-Phthisiology Department of the National Hospital of
      "Point G" from September 1984 to August 1990. The sex-ratio is 3/1 in favour of
      males with a mean age of 35.5 years. The pleural empyema represent 2.2% of all
      patients admitted in the Hospital and 20.2% of liquid effusions of the Pleura
      observed during the study period. The causal common germ has been placed in a
      proeminent position in 18 cases (16.7%) including 14 cases of gram-positive
      germs. Tuberculous aetiology has been proven in 16 cases (27.6%) against 67 cases
      of bacterial pleuresies (62%). The initial treatment has consisted in an
      empirical antibiotherapy of a large spectrum associated with repeated washing
      punctions. A short-term antituberculous chemotherapy (8 months, 2RHZS(6TH)) has
      been administrated each time the tuberculous aetiology has been proven or
      strongly presumed. The therapeutic results have been favourable in 85 cases
      (78.7%) and unfavourable in 23 cases (21%) including 10 deaths (9.2%).

PMID- 8353479
TI  - [Coprological evaluation of refugees in Strasbourg between January 1986 and
      December 1990].
AB  - 1,000 refugees living in Strasbourg have had a stoll parasitologic exam between
      1986 and 1990. We have not retained results of South America and other areas of
      Asia subjects because of their scarce total number. Proportionally, the most
      numerous are the South East Asia Nationals (51.7%); followed by those from Middle
      East and Africa (20 and 15.5%) and more recently by those from East of Europe
      (5.2%). Their parasitic infestation's rate remains important (60.9%) but variable
      depending on their origin. Thus, people coming from Middle East and Africa are
      parasited mainly by protozoan, although those from South East Asia are parasited
      by helminths. It's interesant to notify that the prevalence of D. fragilis is ten
      times higher among East European people than in the common people.

PMID- 8353480
TI  - [Herpes Zoster, predictive element of human immunodeficiency virus infection
      (HIV). Epidemio-clinical study in Cotonou (Benin)].
AB  - An epidemio-clinical study of Herpes Zoster in 39 healthy patients of Benin has
      permitted to the authors to evaluate the positive predictive value of Herpes
      Zoster for HIV infection on West Africa; and to compare it with results of
      central Africa. The mean age of patients is 34.74 years. The positive predictive
      value of Herpes Zoster for HIV infection is 41.02%. It is increased by the
      cranial site of Herpes Zoster.

PMID- 8353481
TI  - A simple non-radioactive method for diagnosis of Huntington's disease.

PMID- 8353482
TI  - A PCR method for accurate assessment of trinucleotide repeat expansion in
      Huntington disease.

PMID- 8353483
TI  - Improved PCR conditions for the stretch of (CAG)n repeats causing Huntington's
      disease.

PMID- 8353484
TI  - Denaturing gradient gel electrophoresis (DGGE) assay for K-ras and N-ras genes:
      detection of K-ras point mutations in human lung tumour DNA.
AB  - Point mutations in the ras oncogenes are very common in lung cancers as well as
      in many of the other solid tumours. To effectively examine the occurrence of
      these mutations in a large number of tumour samples, we have applied denaturing
      gradient gel electrophoresis (DGGE) for the analysis of point mutations of the K
      ras and N-ras genes, using GC-clamped, PCR-amplified DNA fragments. Among the 68
      tumour DNA samples, we detected 14 mutations in the K-ras gene. This was 78% of
      the mutations identified by oligonucleotide hybridization. Altogether, eight of
      the nine different kinds of base substitutions found in the tumour samples were
      detected by the DGGE assay, representing substitutions at codons 12, 13, and 61
      of the K-ras gene. Six of the detected mutations were guanine to thymine
      transversions at codon 12; this was the most common type of alteration. On the
      basis of our experience, the present non-radioactive DGGE analysis seems to be
      readily applicable for detection of the mutations in the K-ras and N-ras genes.
      Types of ras gene mutations frequent in adenocarcinomas of the lung are also
      discussed.

PMID- 8353485
TI  - Mouse neurofibromatosis type 1 cDNA sequence reveals high degree of conservation
      of both coding and non-coding mRNA segments.
AB  - To identify evolutionary conserved domains and facilitate the recognition of
      potentially significant mutations in NF1 patients or tumors, we have determined
      the complete approximately 12 kb sequence of mouse neurofibromatosis type 1 mRNA.
      The sequence predicts a 2841 amino acid protein that is more than 98% identical
      to human neurofibromin. All but 9 of the 45 amino acid differences between mouse
      and human neurofibromin occur in the N-terminal half of the protein, with 16
      changes clustered just upstream of the IRA-related segment. Given the high degree
      of sequence identity, virtually any sequence alteration in NF1 patients or tumors
      is potentially significant. We have also found that the 3' untranslated segment
      of NF1 mRNA is highly conserved, suggesting that this region may also be a target
      for mutations in NF1 patients.

PMID- 8353486
TI  - Fine mapping of the human SCIDX1 locus at Xq12-13.1.
AB  - Previous linkage analysis of families with X-linked severe combined
      immunodeficiency (SCIDX1) mapped this locus to a large region encompassing about
      10 to 20 cM at Xq12-21. We have analyzed in SCIDX1 families the segregation of 7
      highly polymorphic microsatellites repeats localized to this region, including a
      new polymorphic microsatellite at the DXS135 locus described in this study, to
      refine the mapping of this disease locus. The observations of genetic
      recombinants within the previously defined SCIDX1-region allow us to establish
      new flanking markers at the DXS135 and DXS227 loci, which significantly reduce
      the region harboring the SCIDX1 locus to a distance estimated between 3 to 5 cM.
      The existence of multiple, highly polymorphic markers in the refined SCIDX1
      region will greatly improve the accuracy of carrier detection and prenatal
      diagnosis for SCIDX1.

PMID- 8353487
TI  - Evolutionary conservation of possible functional domains of the human and murine
      XIST genes.
AB  - The human XIST gene, a candidate for a role in X chromosome inactivation, has
      recently been cloned and sequenced, yielding a 17 kb cDNA with no apparent
      significant, conserved open reading frame. In addition, the XIST transcript has
      been localized within the nucleus to the Barr body by RNA in situ hybridization.
      This subnuclear localization and lack of any significant protein-coding potential
      suggest that XIST may act as a functional RNA within the nucleus. In the absence
      of a conserved open reading frame, we have turned to evolutionary studies as a
      first step toward elucidating a function for XIST in the process of X
      inactivation. While probes for XIST detect homologues in numerous eutherians,
      sequence comparisons require significant gapping and reveal identity levels
      intermediate between those seen for coding and non-coding regions in other genes.
      Further, sequence comparison of the most likely candidate open reading frame
      among several primate species reveals sequence changes not normally associated
      with protein-coding regions. Other features of XIST are conserved in different
      species, however, including the position of a major transcription start site and
      active X chromosome-specific DNA methylation patterns at the gene's 5' end.
      Finally, a possible molecular basis for differing propensity toward X
      inactivation between Xce alleles in mouse is investigated by comparing the
      sequence of the Xist conserved 5' repeats in mouse strains carrying different Xce
      alleles.

PMID- 8353488
TI  - A gene from chromosome 4p16.3 with similarity to a superfamily of transporter
      proteins.
AB  - We have previously used exon amplification to identify the ADD1 gene in cosmid
      Y24 from the Huntington's disease (HD) region of 4p16.3. The same technique has
      now yielded a second gene from this cosmid. This gene appears to encode a novel
      member of a superfamily of transporter proteins that includes active and passive
      transporters in a number of species. The predicted protein of 455 amino acids
      displays sequence similarity with the E. coli tetracycline resistance efflux
      protein encoded by cloning vector pBR322, and with a number of related
      transporters. This gene should open a route to isolating additional mammalian
      members of this growing superfamily.

PMID- 8353489
TI  - Intergenerational stability of the myotonic dystrophy protomutation.
AB  - The amplification of the CTG trinucleotide repeat in myotonic dystrophy (DM)
      correlates with increasingly severe phenotypes. We designate its minimal
      amplification the 'protomutation' since it is the mutation itself at an early
      stage of intergenerational evolution and is associated with very mild clinical
      signs. From the study of 536 DM mutation carriers (from 158 affected families), a
      total of 60 DM-parent/DM-offspring pairings were identified in which the parent
      had the protomutation. We found a strong correlation between the protomutation
      length and the amplification observed in the next generation. We also observed
      the stable transmission of the protomutation through successive generations. This
      stability may explain the maintenance in the population of this autosomal
      dominant disease despite the low reproductive fitness of severe DM phenotypes.

PMID- 8353490
TI  - Molecular diagnosis of homozygous myotonic dystrophy in two asymptomatic sisters.
AB  - The genetic defect underlying myotonic dystrophy (DM) has been identified as the
      expansion of an unstable trinucleotide repeat sequence, and this discovery has
      led to new approaches to diagnosis and genetic counselling in families with the
      disorder. We report the genetic analysis of a consanguineous DM family in which
      two asymptomatic sisters had been shown to be homozygous for the 'at risk'
      haplotype. PCR analysis of the region spanning the trinucleotide expansion
      demonstrated that both sisters possessed two alleles with repeat sizes normally
      seen in minimally affected patients. Extensive clinical examination failed to
      demonstrate any of the symptoms of DM in these women. The implications of this
      finding, both for understanding the disease mechanism, and for genetic
      counselling in such situations are discussed.

PMID- 8353491
TI  - Direct retroviral-mediated transfer of a dystrophin minigene into mdx mouse
      muscle in vivo.
AB  - At the cellular level, the primary pathology in Duchenne muscular dystrophy (DMD)
      is caused by deficiency of the sarcolemmal-associated protein, dystrophin, in the
      striated musculature. Here we describe the somatic transfer and long-term
      expression of a human dystrophin minigene corresponding to a mild Becker muscular
      dystrophy (BMD) phenotype in skeletal muscle tissues of the dystrophin-deficient
      mdx mouse by direct retroviral transduction. Following a single intramuscular
      injection of recombinant retrovirus, sarcolemmal expression of dystrophin was
      observed in an average of approximately 6% of myofibres in treated tibialis
      anterior muscles and was associated with activated reappearance of at least one
      component (43kD) of the dystrophin-glycoprotein membrane complex (DGC).
      Furthermore, expression of recombinant dystrophin was observed in muscle tissues
      up to 9 months after treatment and a significant enhancement of retrovirus
      mediated myofibre transduction was obtained in mdx muscle undergoing
      experimentally-induced regeneration. The results clearly demonstrate that
      retroviral transduction of activated satellite cells in regenerating skeletal
      muscle is a feasible route for direct and stable dystrophin gene transfer into
      muscle tissues in vivo.

PMID- 8353492
TI  - Novel alleles, hemizygosity and deletions at an Alu-repeat within the
      neurofibromatosis type 1 (NF1) gene.
AB  - Neurofibromatosis type 1 (NF1) (von Recklinghausen) is a common autosomal
      dominant disorder, characterised by the presence of peripheral neurofibromas,
      cafe-au-lait spots and Lisch nodules of the iris. Due to the high mutation rate
      at the NF1 locus, most patients are expected to have different mutations,
      limiting molecular analysis and genetic counseling to the identification of the
      mutation in each patient or family, or to the use of DNA polymorphisms. We have
      analysed an Alu-repeat polymorphic sequence (AAAT), located in intron 27 of the
      NF1 gene, in 70 NF1 and 40 CEPH families and we have detected several genetic and
      molecular abnormalities. In two families the NF1 individuals were hemizygous at
      the AAAT-repeat and/or at the CA-repeat of intron 27 of NF1, due to interstitial
      deletions, which include intron 27 to exon 37 of the NF1 gene. A 71-bp deletion
      at the Alu sequence was detected in non-NF1 chromosomes of members of three NF1
      families. New alleles at the AAAT-repeat were found in one NF1 family and in
      three CEPH families giving a mutation rate for this AAAT-repeat of 0.36% per
      allele, which is one of the highest detected for a microsatellite locus.

PMID- 8353493
TI  - Characterization of translational frame exception patients in Duchenne/Becker
      muscular dystrophy.
AB  - The clinical progression of Duchenne muscular dystrophy (DMD) patients with
      deletions can be predicted in 93% of cases by whether the deletion maintains or
      disrupts the translational reading frame (frameshift hypothesis). We have
      identified and studied a number of patients who have deletions that do not
      conform to the translational frame hypothesis. The most common exception to the
      frameshift hypothesis is the deletion of exons 3 to 7 which disrupts the
      translational reading frame. We identified a Becker muscular dystrophy (BMD)
      patient, an intermediate, and a DMD patient with this deletion. In all three
      cases, dystrophin was detected and localized to the membrane. One DMD patient
      with an inframe deletion of exons 4-18 produced no dystrophin. One patient with a
      mild intermediate phenotype and a deletion of exon 45, which shifts the reading
      frame, produced no dystrophin. Two patients with large inframe deletions had
      discordant phenotypes (exons 3-41, DMD; exons 13-48, BMD), but both produced
      dystrophin that localized to the sarcolemma. The DMD patient, 113, indicates that
      dystrophin with an intact carboxy terminus can be produced in Duchenne patients
      at levels equivalent to some Beckers. The dystrophin analysis from these
      patients, together with patients reported in the literature, indicate that more
      than one domain can localize dystrophin to the sarcolemma. Lastly, the data shows
      that although most patients show correlation of clinical severity to molecular
      data, there are rare patients which do not conform.

PMID- 8353494
TI  - Refined localization and yeast artificial chromosome (YAC) contig--mapping of
      genes and DNA segments in the 7q21-q32 region.
AB  - The chromosome localizations for 159 gene and DNA segments have been refined to
      one of five intervals in the 7q21-132 region through hybridization analysis with
      a panel of somatic cell hybrid lines. Seventy-two of these chromosome 7 markers
      are also mapped on common or overlapping yeast artificial chromosome (YAC)
      clones. In addition, the breakpoints of chromosome rearrangement contained in
      five of the somatic cell hybrid lines have been defined by flanking probes within
      YAC contigs. To provide a framework for further mapping of the 7q21-q32 region,
      we have established the physical order of a set of reference markers: cen-(COL1A2
      D7S15-CYP3A4-PON)-D7S456-(brea kpoint contained in cell hybrid 1EF2/3/K017)-GUSB
      D7S186-ASL-(PGY1-PGY3 -GNB2-EPO-ACHE)-D7S238-(proximal breakpoint in GM1059-Rag5)
      D7S240-(CUTL1-PLANH1)-(breakp oints in 1CF2/5/K016 and 2068Rag22-2)-(PRKAR2B
      D7S13)-LAMB1-(breakpoint in JSR-17S)-DLD-D7S16-MET-WNT2-CFTR-D7S8-tel.

PMID- 8353495
TI  - A hypervariable segment in the human dopamine receptor D4 (DRD4) gene.
AB  - The human dopamine D4 receptor contains a novel polymorphism within the putative
      third cytoplasmic loop of the protein. The polymorphism is characterized by a
      varying number of direct imperfect 48-bp repeats in the gene. Pharmacological
      characterization has suggested that this receptor is the site through which the
      atypical neuroleptic clozapine exerts its antipsychotic action and that some
      polymorphic variants display different pharmacological properties. Further
      analysis of the repeat region using innovative technologies indicates that the
      alleles vary not only in the number of repeats (2-8 or 10 repeat units) but also
      in the sequence of the repeats and the order in which they appear. In 178
      unrelated chromosomes we have identified 19 different repeats in 25 different
      haplotypes coding for 18 different predicted amino acid sequences, making this
      one of the most variable functional proteins currently described.

PMID- 8353496
TI  - Analysis of the SRY gene in 22 sex-reversed XY females identifies four new point
      mutations in the conserved DNA binding domain.
AB  - The open reading frame of the SRY gene has been examined in a series of 22 XY
      females with clinically defined pure gonadal dysgenesis by direct sequencing of
      biotinylated PCR product bound to streptavidin coated beads. Amongst the 22 XY
      females examined, five (two of whom are sisters) were found to have single base
      changes all within the highly conserved DNA binding (or HMG box) domain. In the
      remaining 17 cases, the SRY gene sequence was indistinguishable from that found
      in normal males. In three of the XY females with point mutations, the altered
      amino acids occur in highly conserved positions leading to non-conservative
      changes (Arg to Gly at position 5, Met to Thr at position 21 and Arg to Trp at
      position 76). Examination of the SRY gene from the father's Y chromosome has
      shown that the mutations at position 5 in patient SHM60 and position 21 in
      patient HN31 have arisen de novo. In the case of the two sibs, both have
      identical mutations where a C to T transition in codon 17 has created a TAG
      termination signal, thus suggesting that the deceased father is likely to be a
      gonadal mosaic for the mutation. In the case of the mutations at positions 17 and
      76, the fathers are not available for investigation and so it has not been
      possible to determine whether the changes are de novo. These data indicate that
      the majority of XY females with pure gonadal dysgenesis owe their sex-reversed
      phenotype to mutations in as yet uncharacterised segments of the SRY gene, or, at
      other loci acting early in the sex-determining pathway.

PMID- 8353497
TI  - YAC-assisted cloning of transcribed sequences from the human chromosome 3p21
      region.
AB  - The region surrounding the ZNF35 zinc finger protein gene on 3p21 is of
      particular interest, as this region of chromosome 3 is frequently involved in
      rearrangements and/or deletions associated with various human tumors including
      lung and renal carcinoma. We have analyzed yeast artificial chromosomes (YACs),
      identified by PCR screening, using oligonucleotides derived from the ZNF35 gene.
      PFGE and Southern blot/hybridization analysis revealed that the clones cover 750
      kb including the ZNF35 gene. The use of specific somatic cell hybrids have
      allowed us to locate the YAC contig telomeric to the D3F15S2 locus, in a region
      which is frequently deleted in lung carcinomas. In addition, we have developed a
      novel cDNA hybridization protocol allowing the isolation of transcribed sequences
      present in the overlapping YAC clones. Using the cDNA hybridization selection, we
      have isolated and characterized one transcribed sequence (D3S1362E) from the 3p21
      YAC contig and the corresponding cDNA has been isolated. DNA sequencing analysis
      indicated that the D3S1363E cDNA codes for a putative transcription factor.
      Northern blot analysis indicated that the D3S1362E sequence hybridized to
      multiple transcripts in skeletal muscle, and weakly hybridizing transcripts of
      similar sizes were detected in other tissues.

PMID- 8353498
TI  - Exon skipping in the E-cadherin gene transcript in metastatic human gastric
      carcinomas.

PMID- 8353499
TI  - Pyruvate dehydrogenase deficiency caused by a 5 base pair duplication in the E1
      alpha subunit.

PMID- 8353500
TI  - Autosomal dominant 'sector' retinitis pigmentosa due to a point mutation
      predicting an Asn-15-Ser substitution of rhodopsin.

PMID- 8353501
TI  - Molecular defect in a patient with pyridoxine-responsive homocystinuria.

PMID- 8353502
TI  - Six dinucleotide microsatellite polymorphisms on human chromosome 3.

PMID- 8353503
TI  - Three tetrameric repeat polymorphisms on human chromosome 3: D3S1349; D3S1350;
      D3S1351.

PMID- 8353504
TI  - Unusual length polymorphism in human steroid 5 alpha-reductase type 2 gene
      (SRD5A2).

PMID- 8353505
TI  - Dinucleotide repeat polymorphism near the RP3 locus in Xp21 (DXS1110).

PMID- 8353506
TI  - A dinucleotide repeat polymorphism (D9S202) in the Friedreich's ataxia region on
      chromosome 9q13-q21.1.

PMID- 8353507
TI  - Dinucleotide repeat polymorphism at the human olfactory marker protein (OMP)
      locus on chromosome 11q13.5 near tyrosinase (TYR).

PMID- 8353508
TI  - Dinucleotide repeat polymorphism at the D9S126 locus (9p21).

PMID- 8353509
TI  - Simple sequence repeat polymorphism in the cartilage matrix protein (CRTM) gene
      at 1p35.

PMID- 8353510
TI  - D11S971 CATT polymorphism (RC27) located near the MEN1 locus at 11q13.

PMID- 8353511
TI  - Dinucleotide repeat polymorphism at the locus for human ferrochelatase (FECH).

PMID- 8353512
TI  - Dinucleotide repeat polymorphism at the human pituitary adenylate cyclase
      activating polypeptide (PACAP) gene.

PMID- 8353513
TI  - A polymorphic dinucleotide repeat at the D8S339 locus.

PMID- 8353514
TI  - Dinucleotide repeat polymorphism proximal to the spinal muscular atrophy region
      at the D5S524 locus.

PMID- 8353515
TI  - Trinucleotide repeat polymorphism at the D5S373 locus.

PMID- 8353516
TI  - New human DNA polymorphisms submitted to the genome data base.

PMID- 8353517
TI  - Aldehyde dehydrogenase (ALDH) activity in Drosophila melanogaster adults:
      evidence for cytosolic localization.
AB  - The subcellular localization of the aldehyde dehydrogenase activity from the ALDH
      (EC 1.2.1.3) enzyme has been studied in nutritionally manipulated Drosophila
      melanogaster adults from a wild (LRC) and an ADH-null (bAdhn4) strain. ALDH
      activities from ALDH or ADH (EC 1.1.1.1) enzymes were selectively inhibited by
      prefeeding respectively the flies sucrose solutions supplemented with either
      cyanamide or acetone respectively. ALDH, ADH (as a cytosolic marker) and
      succinate dehydrogenase (EC 1.3.9.1) (as a mitochondrial marker) activities were
      assayed in both the mitochondrial and cytosolic fractions isolated from flies
      subjected to each treatment. Total ALDH activity in the cytosolic fraction was
      found to be between five (ADH strain) and ten (ADH strain) times higher than that
      in the mitochondrial fraction. Prefeeding cyanamide resulted in a 64% (ADH
      strain) and a 90% (ADH strain) reduction of the cytosolic ALDH activity, whereas
      prefeeding acetone resulted in a 38% (ADH strain) reduction of this activity.
      Prefeeding both cyanamide and acetone resulted in a total inhibition of ALDH
      activity, which was also observed after an extended cyanamide treatment. In
      conclusion, our results support that, contrary to what occurs in larvae, in
      adults the ALDH activity from ALDH enzyme is mainly localized in the cytosolic
      fraction: about 85% in ADH+ and 90% in ADH- strains. Although larvae and adults
      use different ALDH activities to detoxify acetaldehyde (from ADH and ALDH
      enzymes, respectively) both of them are cytosolic. Reasons for these different
      uses are discussed in relation to the subcellular localization of ALDH activity.

PMID- 8353518
TI  - Drosophila suzukii contains a peptide homologous to the Drosophila melanogaster
      sex-peptide and functional in both species.
AB  - A peptide homologous to the Drosophila melanogaster sex-peptide (SP) was isolated
      from Drosophila suzukii accessory glands and its amino acid sequence determined.
      The D. suzukii peptide contains 41 amino acids and has a calculated molecular
      weight of 5100 Da. Comparison of the sequences reveals strong homologies in the N
      terminal and C-terminal parts of the peptides. In the D. suzukii sex-peptide,
      however, five additional amino acids are inserted after amino acid 7. Based on
      the sequence of the peptide, a cDNA coding for the D. suzukii peptide was
      isolated by PCR. Sequence analysis of the cDNA confirmed the SP amino acid
      sequence determined by peptide sequencing. Furthermore, based on the cDNA
      sequence, we isolated the D. suzukii sex-peptide gene by inverse PCR. The D.
      suzukii sex-peptide gene contains an intron and codes for a 60 amino acid
      precursor. The D. melanogaster and the D. suzuki sex-peptides elicit rejection
      behaviour in the presence of males and an increased egg laying in virgin females
      of both species.

PMID- 8353519
TI  - Purification and primary structure of ceratotoxin A and B, two antibacterial
      peptides from the female reproductive accessory glands of the medfly Ceratitis
      capitata (Insecta:Diptera).
AB  - In the present article we report the purification and the amino acid sequence of
      two antibacterial peptides present in the secretion of the female reproductive
      accessory glands of the dipteran insect Ceratitis capitata. Both peptides consist
      of 29 amino acid residues, are heat stable, strongly basic and differ from each
      other for the substitution of two amino acids. Their primary sequence and
      predicted secondary structure are related to other families of peptides known to
      have lytic and/or antibacterial activity. We propose the name ceratotoxins (from
      Ceratitis) for these antibacterial peptides.

PMID- 8353520
TI  - Purification and properties of the soluble midgut trehalase from the gypsy moth,
      Lymantria dispar.
AB  - The midgut trehalase (THA) from fifth instar Lymantria dispar (gypsy moth) larvae
      was purified to homogeneity by two separate methods: gel filtration followed by
      Rotofor preparative IEF, and affinity chromatography on trehalose coupled to
      Sepharose 6B followed by preparative polyacrylamide gel electrophoresis. Midgut
      THA from the last stadium L. dispar larvae existed mainly in soluble form and
      displayed a single band of activity in nondenaturing polyacrylamide gels when
      stained by a THA-specific staining procedure. Analytical IEF of purified midgut
      THA revealed a single protein band with an apparent pI of 4.6. SDS-PAGE and gel
      permeation studies indicated that the smallest active form of THA in the late
      fifth instar larval midgut was a monomeric protein with an approximate size of 60
      kDa. A specific activity of 67 units/mg of protein at 30 degrees C and at pH 6.4
      was determined for the enzyme purified by affinity chromatography and preparative
      gel electrophoresis. The midgut enzyme exhibited a very high substrate
      specificity with a Km of 0.4 mM for trehalose. The enzyme was maximally active at
      pH 5.4-6.0 and was thermally stable at temperatures up to 65 degrees C. The
      midgut THA was insensitive to inhibition by a high concentration of Tris,
      sucrose, p-nitrophenyl-beta-D-glucoside or phloridzin. Divalent cations metal
      ions, hypertrehalosaemic hormone and octopamine had no significant effect on the
      activity of the purified enzyme in vitro. The purified enzyme was inactivated by
      modification with DEP and was competitively inhibited by castanospermine with an
      apparent Ki of 0.8 x 10(-6)M at pH 6.4.

PMID- 8353521
TI  - A cuticle-degrading proteinase from the moulting fluid of the tobacco hornworm,
      Manduca sexta.
AB  - Moulting fluid of pharate adult tobacco hornworm moths, Manduca sexta, contains a
      novel cuticle-degrading proteinase, designated as MFP-1. The enzyme has been
      purified using heparin affinity chromatography and partially characterized.
      Before purification MFP-1 is associated with a large complex having an apparent
      native molecular mass > 669 kDa. After purification MFP-1 has a molecular mass of
      41 kDa. The pI of the enzyme is 5.54. MFP-1 can be classified as generally
      trypsin-like on the basis of its substrate specificity and inhibition by soybean
      trypsin inhibitor. The enzyme's preferred substrate, Tos-Gly-Pro-Arg-pNA, its
      inhibition by hirudin, and its affinity for heparin, all indicate that MFP-1 has
      some characteristics in common with the vertebrate blood-clotting enzyme
      thrombin. MFP-1 is probably a serine protease, since it is inhibited by both DFP
      and PMSF (specific inhibitors of serine proteinases). However, the enzyme was
      also inhibited by a number of agents that affect cysteine proteinases. Purified
      MFP-1 degrades Manduca cuticle in vitro. We suggest that the enzyme may act as
      the first step in the degradation of the cuticle during the moulting process.

PMID- 8353522
TI  - Effects of parasitism by the braconid wasp Cotesia congregata on host hemolymph
      proteins of the tobacco hornworm, Manduca sexta.
AB  - Parasitism by the braconid wasp Cotesia congregata causes major alterations in
      the hemolymph proteins of host tobacco hornworm larvae. Earlier studies showed
      that the total amount of hemolymph protein is reduced during parasitism,
      beginning almost immediately after the host is parasitized. Simultaneously,
      parasitism induces synthesis of large amounts of novel proteins that appear in
      the blood as early as 1-2 h post-parasitization. The present report confirms
      earlier studies describing the presence of novel proteins in last instar hosts,
      and also characterizes the effects of parasitism in altering the titers of
      several endogenous host hemolymph proteins normally produced by the fat body and
      other tissues. Analysis of hemolymph plasma using SDS-PAGE and densitometry, as
      well as immunodiffusion assays, showed that in terminal stage fifth instar host
      larvae, the titers of serpins and arylphorin were dramatically reduced relative
      to the levels of these proteins detected in nonparasitized gate II fifth instar
      larvae of the same age. The relative differences between parasitized and
      nonparasitized larvae increased with time following ecdysis to the fifth instar,
      so that the day 4 nonparasitized larvae had arylphorin titers of c. 30 mg/ml,
      whereas parasitized day 4 larvae with newly emerged wasps had only one sixth that
      amount of storage protein circulating in the hemolymph. Similarly, in
      nonparasitized larvae the hemolymph serpin concentration increased from c. 200
      micrograms/ml (on day 0) to > 600 micrograms/ml (on day 4) in prewandering gate
      II larvae, but in parasitized larvae the hemolymph serpin concentration was
      maintained in the range of 100-200 micrograms per ml hemolymph until the pharate
      third instar parasites emerged from the host larva on day 4. In contrast, the
      level of hemolymph lipophorin was unaffected by parasitism, and lipophorin
      increased from c. 1.3 to > 3 mg/ml during the time interval between days 0 and 4
      in both nonparasitized and parasitized larvae. Hemolymph titers of insecticyanin
      also were not significantly different in parasitized vs nonparasitized larvae,
      and in both types of larvae the concentration of this pigment decreased by c. 50%
      during the same time interval when lipophorin was increased significantly.
      Instead of causing a generalized inhibition of host hemolymph protein synthesis,
      parasitism causes a complex array of changes in the hemolymph protein profile of
      Manduca sexta, possibly via the mediation of hormonal modulators of host protein
      synthesis, or transcriptional or translational regulation of host gene expression
      by factors associated with the polydnavirus or molecules secreted by the
      parasites.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8353523
TI  - Purification and characterization of a trypsin-like digestive enzyme from spruce
      budworm (Choristoneura fumiferana) responsible for the activation of delta
      endotoxin from Bacillus thuringiensis.
AB  - A trypsin-like enzyme purified from spruce budworm (Choristoneura fumiferana) gut
      juice has a molecular mass of 25 kDa and its pH activity profile indicates a pKa
      of 8. Sequence homology with bovine trypsin of the N-terminus and active site,
      and the ionization dependence for catalysis, reflect the typical trypsin-like
      activities measured. The action of this enzyme (designated CFT-1) is compared to
      the neat gut juice with regard to the proteolytic activation of the delta
      endotoxin from Bacillus thuringiensis.

PMID- 8353524
TI  - Sequence of a 17 kDa vacuolar H(+)-ATPase proteolipid subunit from insect midgut
      and Malpighian tubules.
AB  - A 0.4 kb polymerase chain reaction (PCR) product obtained from cDNA made from the
      midgut and Malpighian tubules of fifth instar larvae of Heliothis virescens was
      used to screen a larval midgut and Malpighian tubules cDNA library. Four clones
      were obtained, one of 1.9 kb and others of 1.4 kb. The 1.9 kb clone encodes a
      17.2 kDa protein which is highly homologous to other vacuolar ATPases
      proteolipids. Putative N-glycosylation and DCCD binding sites were observed at
      amino acid residues 83 and 139, respectively.

PMID- 8353525
TI  - Sequence of a cDNA and expression of the gene encoding epidermal and gut
      chitinases of Manduca sexta.
AB  - Insects use chitinolytic enzymes to digest chitin in the exoskeleton during the
      molting process. We have isolated and sequenced a chitinase-encoding cDNA from
      the tobacco hornworm, Manduca sexta, compared its sequence with genes encoding
      chitinolytic enzymes from other sources, and studied chitinase gene expression
      and hormonal regulation during the larval-pupal transformation. The insert DNA in
      this clone is 2452 nucleotides long with an open reading frame of 1662
      nucleotides that encodes a protein of 554 amino acids with a molecular weight of
      62 kDa. Several regions of the amino acid sequence in this protein are similar to
      sequences in yeast, cucumber and bacterial endo-beta-N-acetylglucosaminidases.
      Hybrid-selection of mRNA and in vitro translation yielded an immunoreactive
      protein with an apparent molecular mass of 75 kDa, which is similar to the size
      of a chitinase present in pharate pupal molting fluid. Southern blot analysis
      indicated that one or two genes related to the cDNA clone are encoding chitinases
      in the Manduca genome. The major tissues expressing chitinase genes were the
      epidermis and gut with mRNA levels highest on c. days 5-7 during the fifth larval
      instar. Injection of 20-hydroxyecdysone into ligated fifth instar abdomens caused
      about a 10-fold increase in mRNA levels in both epidermis and gut, and topical
      application of the juvenile hormone mimic, fenoxycarb, suppressed the ecdysteroid
      induced accumulation of chitinase RNA.

PMID- 8353526
TI  - Mass spectrometry and characterization of Aedes aegypti trypsin modulating
      oostatic factor (TMOF) and its analogs.
AB  - Trypsin modulating oostatic factor (TMOF), a decapeptide that directly inhibits
      the biosynthesis of trypsin- and chymotrypsin-like enzymes in epithelial cells of
      mosquito midgut and indirectly inhibits vitellogenesis in anautogenous females,
      has been sequenced by Fourier transform mass spectrometry analysis. The peptide
      has a primary amino acid sequence of NH2-Tyr-Asp-Pro-Ala-(Pro)6-COOH and probably
      exhibits left-handed helical conformation as was shown by computer stereoview
      simulation. The factor is metabolized very rapidly (half-life of 1.6 h) in intact
      mosquitoes when injected after the blood meal. Inhibition of trypsin biosynthesis
      was followed in ligated abdomens, which synthesize trypsin but do not metabolise
      TMOF. At concentrations of 3 x 10(-9) M and 6.8 x 10(-6) M, TMOF inhibited 50 and
      90% of trypsin-like enzyme biosynthesis, respectively. Several analogs of varying
      chain lengths were synthesized and evaluated for biological activity using dose
      response curves. Switching the positions of Tyr and Asp at the N-terminus reduced
      the activity of the hormone, indicating that the N-terminus is important for
      biological activity. Removal of two to five prolines at the C-terminus also
      reduced activity, indicating that both the N- and C-termini are important.
      Synthesis of trypsin-like isozyme was followed in several insect species using
      [1,3-3H]diisopropyl-fluorophosphate (DFP) in the presence of tosylamide-2
      phenylethyl chloromethyl ketone. Marked reduction of [1,3-3H]diisopropyl
      phosphoryl-trypsin-like derivatives was noted after TMOF treatment, as assessed
      by polyacrylamide gel electrophoresis. These results indicate that the
      biosynthesis of trypsin-like enzyme in mosquitoes and other insects may be
      regulated by sequence-related TMOFs.

PMID- 8353527
TI  - Identification and quantification of juvenile hormone biosynthesized by larval
      and adult Australian sheep blowfly Lucilia cuprina (Diptera: Calliphoridae).
AB  - Recent evidence indicates that higher dipterans biosynthesize predominantly the
      novel juvenile hormone (JH) bisepoxide, methyl (2E,6trans)-6,7,10,11-bisepoxy
      3,7,11-trimethyl-2-dodecen oate (JHB3), together with a small proportion of
      methyl (2E,6E)-10,11-epoxy-3,7,11-trimethyl-2,6-dodecadienoate (JHIII) and
      possibly its 6,7-epoxy isomer. A strategy of gas chromatography-mass spectrometry
      (GC-MS) involving cool on-column GC and negative-ion chemical ionization MS has
      enabled the selective analysis of underivatized JH-like products released in
      vitro by ring glands and corpora allata of Lucilia cuprina. JHB3 is released to
      the exclusion of mono-epoxidized and unepoxidized esters. The rate of JHB3
      release in adult females increases dramatically after protein feeding from 0.2 to
      5.2 pmol/h/gland. Values agree well with the rate of JH biosynthesis determined
      by radiochemical assay. As revealed by thin-layer chromatography, the radiolabel
      is predominantly incorporated into JHB3, of which only 2% is retained in the
      corpus allatum indicating almost immediate release from the gland. Approximately
      5% of radioactive material retained in the glands co-migrates with JHIII and may
      be an intermediate in JHB3 synthesis. We conclude that JHB3 is the only juvenile
      hormone biosynthesized in vitro by L. cuprina. The data suggest that JHB3 may be
      the exclusive JH synthesized by higher dipterans.

PMID- 8353528
TI  - Tissue distribution of microsomal cytochrome P-450 monooxygenases and their
      inducibility by phenobarbital in the insecticide resistant LPR strain of house
      fly, Musca domestica L.
AB  - Cytochrome P-450s, cytochrome b5, P-450 reductase, and four P-450 monooxygenase
      activities were abundant in proximal intestine (PI), Malpighian tubules (MT), and
      fat bodies (FB) in the insecticide resistant (LPR) strain of house fly.
      Insecticide resistance in LPR flies was associated with increases in P-450
      monooxygenase activities in nearly all of these tissues relative to an
      insecticide susceptible strain. Cytochrome P-450lpr was present in all tissues
      and at higher levels in LPR than in susceptible flies suggesting that the role of
      P-450lpr in monooxygenase-mediated insecticide resistance is not due to its
      higher levels in a single tissue. However, it appears that fat bodies may have a
      major role in resistance due to their relatively large size and the abundance of
      P-450lpr in this tissue. Total cytochrome P-450s, cytochrome P-450lpr and P-450
      monooxygenase activities were generally refractory to phenobarbital (PB)
      induction in LPR. This contrasts with a previous report in susceptible house
      flies showing that P-450 monooxygenases were induced by PB. It appears that total
      P-450s, cytochrome P-450lpr and monooxygenase activities were expressed at
      constitutive high levels in several tissues of LPR house flies.

PMID- 8353529
TI  - Dietary ethanol stimulates the activity of phosphatidylcholine-specific
      phospholipase D and the formation of phosphatidylethanol in Drosophila
      melanogaster larvae.
AB  - When administered in the diet to third instar Drosophila melanogaster larvae,
      short chain primary alcohols reduce phosphatidylcholine (PC) levels. The ethanol
      induced reductions in larval PC may be in part due to an increase in the activity
      of PC-specific phospholipase D (PC-specific PLD, EC 3.1.4.4). PC-specific PLD not
      only hydrolyzes PC, but it also apparently catalyzes the formation of
      phosphatidylethanol. PC-specific PLD activity was also stimulated by 200 mM
      ethanol, methanol, isopropanol, n-butanol, and n-propanol. In vitro studies
      indicated that Drosophila PC-specific PLD activities were enhanced by
      submicromolar concentrations of Ca2+ and by GTP-gamma S. In vivo studies
      utilizing [14C]lyso-palmitoyl phosphatidylcholine indicated that dietary ethanol
      promoted the flux of label into triacylglycerol, 1,2 diacylglycerol, and fatty
      acid ethyl esters, while the label in PC decreased.

PMID- 8353530
TI  - [Proceedings of the 88th annual meeting of the American Urological Association
      (AUA). San Antonio, 15-20 May 1993].

PMID- 8353531
TI  - Transgenesis in chickens.
AB  - The application of transgenic technology to domestic poultry offers an
      alternative means to conventional practice for improvement of this highly
      productive agricultural species. The hen's reproductive system has unique
      characteristics which have imposed limitations on the use of established methods
      for artificial gene transfer. In this article, we review the various strategies
      that have been adopted to overcome the problem. Target sites for gene insertion
      include the fertilized ovum, the blastodermal embryo in the unincubated egg, and
      the primordial germ cells. Notable success in obtaining somatic and germline
      transformation has been achieved with the use of retroviral vectors to infect the
      blastodermal embryo. Current attempts to introduce DNA directly into the genome,
      without resort to pathogen-derived vectors, are discussed.

PMID- 8353532
TI  - Sexing and detection of gene construct in microinjected bovine blastocysts using
      the polymerase chain reaction.
AB  - We present a polymerase chain reaction (PCR)-based procedure for rapid bovine
      embryo sexing and classifying embryos for the presence of exogenous DNA. Fourteen
      bovine blastocysts microinjected with gene construct DNA at the pronuclear stage
      were divided into quarters and subjected to amplification with construct-specific
      and sex gene-specific (ZFY/ZFX) primers in the same initial PCR reaction.
      Blastocysts carrying microinjected construct DNA could be identified by the
      presence of construct-specific PCR product in approximately 4 h. Approximately
      half of the microinjected and two of 16 non-microinjected blastocysts typed PCR
      positive for the construct DNA. Owing to erroneous amplifications in the two non
      microinjected control blastocysts, and the inability of the system to distinguish
      integrated from non-integrated copies of the microinjected construct, the number
      of construct-positive blastocysts determined in our assay most likely
      overestimates the number of true transgenic embryos. Nevertheless, using this
      assay, we were able to determine that approximately half of the microinjected
      embryos were negative for the transgene construct and thus could be eliminated
      from transfer to a recipient cow. Embryo sexing was achieved in less than 6 h by
      restriction fragment length polymorphism analysis of nested ZFY/ZFX PCR products
      reamplified from initial PCR reactions. In 11/14 microinjected blastocysts all
      sections assayed unambiguously as the same sex. In one embryo, only one section
      was analysed, while two other blastocysts showed some discrepancies of sexing
      results between the sections analysed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353533
TI  - The endosperm-specific expression of a rice prolamin chimaeric gene in transgenic
      tobacco plants.
AB  - The 5' upstream region (-680 to +40), containing the potential promoter and
      complete signal peptide coding sequence of the rice seed storage prolamin gene
      was amplified in vitro using the polymerase chain reaction from the genome of
      Chinese rice cultivar Zhonghua 8. The physical map and DNA sequence analysis show
      strong homology with the 5' flanking region of the rice prolamin gene published
      by Kim and Okita (1988a). No change in the signal peptide coding sequence and a
      long leader sequence with several small open reading frames were found. The
      chimaeric gene containing the 5' flanking region of the prolamin gene (-680 to 
      18) was transcriptionally fused with the beta-glucuronidase (GUS) reporter gene
      and the fusion junction was confirmed by both physical mapping and DNA sequence
      analysis. The resultant chimaeric gene was used to transform tobacco explants,
      using the Ti binary system of Agrobacterium tumefaciens LBA4404. Three transgenic
      tobacco plants with as many as 20 copies of the chimaeric GUS gene (confirmed by
      dot and Southern hybridization) were analysed further. Histochemical analysis
      revealed GUS activity in the endosperm tissue of tobacco seed at the
      developmental stage about 20 days after flowering (DAF). No GUS activity was
      found in leaves, stems, roots and flowers of the transgenic tobacco plants.
      Therefore, we conclude that the 5' upstream region from -680 to -18 was
      sufficient to confer the endosperm-specific expression of the rice prolamin gene.

PMID- 8353535
TI  - Insect-resistant chrysanthemum calluses by introduction of a Bacillus
      thuringiensis crystal protein gene.
AB  - A 3'-end truncated crystal protein gene, derived from Bacillus thuringiensis (Bt)
      subsp. aizawai 7.21, encoding the toxic fragment of the insecticidal protein
      cryIA(b), was constructed. The gene was inserted into a transformation vector,
      also carrying the neomycin phosphotransferase II (nptII) gene and the beta
      glucuronidase (gus) gene, and introduced in the oncogenic Agrobacterium
      tumefaciens strain A281, harbouring the Ti-plasmid pTiBO542. The recombinant
      Agrobacterium strain was used to transform leaf explants of chrysanthemum
      (Dendranthema grandiflora) cultivar Parliament. The resulting tumours were
      kanamycin-resistant, exhibited beta-glucuronidase activity and produced agropine
      and mannopine. In most tumours, all simultaneously transferred genes were
      expressed, owing to selection for the presence of both T-DNAs, but no correlation
      was found between the level of expression of the various genes. A bioassay was
      developed, in which larvae were fed with tumorous chrysanthemum tissue, in order
      to detect the effect of the transferred toxin gene on larval development. Using
      this bioassay with second instar larvae of Heliothis virescens (tobacco budworm),
      17 tumour lines were tested. Several of these lines proved to be strongly
      inhibitory to larval growth. These results indicate that Bt-based insect
      resistance might be used as a tool in reducing the amount of pesticides used in
      chrysanthemum culture.

PMID- 8353534
TI  - Regulation of expression of transgenes in developing fish.
AB  - The transcriptional regulatory elements of the beta-actin gene of carp (Cyprinus
      carpio) have been examined in zebrafish and goldfish harbouring transgenes. The
      high sequence conservation of the putative regulatory elements in the beta-actin
      genes of animals suggested that their function would be conserved, so that
      transgenic constructs with the same transcriptional control elements would
      promote similar levels of transgene expression in different species of transgenic
      animals. To test this assumption, we analysed the temporal expression of a
      reporter gene under the control of transcriptional control sequences from the
      carp beta-actin gene in zebrafish (Brachydanio rerio) and goldfish (Carrasius
      auratus). Our results indicated that, contrary to expectations, combinations of
      different transcriptional control elements affected the level, duration, and
      onset of gene expression differently in developing zebrafish and goldfish. The
      major differences in expression of beta-actin/CAT (chloramphenicol
      acetyltransferase) constructs in zebrafish and goldfish were: (1) overall
      expression was almost 100-fold higher in goldfish than in zebrafish embryos, (2)
      the first intron had an enhancing effect on gene expression in zebrafish but not
      in goldfish, and (3) the serum-responsive/CArG-containing regulatory element in
      the proximal promoter was not always required for maximal CAT activity in
      goldfish, but was required in zebrafish. These results suggest that in the
      zebrafish, but not in the goldfish, there may be interactions between motifs in
      the proximal promoter and the first intron which appear to be required for
      maximal enhancement of transcription.

PMID- 8353536
TI  - [Echographic aspects of gynecomastia].
AB  - Gynecomastia is a size increase of man's breast, due to non neoplastic ductal and
      glandular stroma proliferation. Prevalent ductal proliferation defines the
      "florid" type, while prevalent stroma increase defines the "quiescent" type.
      Pseudo-gynecomastia is a non glandular volume increase. Sonography is able to
      recognize the different parts of normal male breast and to diagnose gynecomastia.
      Moreover by sonography we can distinguish three echo-patterns linked to the
      anatomopathologic pattern which can lead therapy.

PMID- 8353537
TI  - [The role of echography in the diagnosis of adrenal masses].
AB  - Ultrasound investigations, which are non-invasive and have a relatively low cost,
      are of primary importance nowadays in the diagnosis of a number of abdominal
      diseases. Nevertheless, their use to study adrenal masses still gives rise to
      different interpretations, as the small dimensions, deep position within the
      retroperitoneum and fatty envelopment of the normal adrenal gland make it
      difficult to identify using this method. However, the introduction of new
      equipment and probes with a higher image resolution, combined with increasing
      experience on the part of the operators, is greatly improving the situation. The
      percentage of visualization of the normal adrenal gland, which in the past was
      only 78% on the left and 44% on the right, according to Yeh, now oscillates
      between 90 and 95% on the left and 70 and 90% on the right. The overall
      sensitivity of ultrasound investigations found by the A.A. on a total of 44
      expanding processes successively subjected to surgery, was 86.3% (96% on the
      right, 68.4% on the left, with a sensitivity of 100% for all masses greater than
      3 cm. These results confirm the role of ultrasound in the diagnosis of adrenal
      masses.

PMID- 8353538
TI  - [Cystic renal pathology].
AB  - Ultrasonography has a great interest in diagnosis of cystic kidney disorders for
      typical eco-pattern of this pathology. In this work we show the eco-pattern of
      the most common cystic kidney disorders. Particularly we examine simple cysts
      (typical, atypical, complicated), multicystic kidney dysplasia, autosomal
      recessive polycystic kidney disease (infantile) autosomal dominant polycystic
      kidney disease (adult age). The so-called neoplastic cysts (multiloculated cysts,
      multiloculated cysts nephroma, cystic nephroblastoma), medullar cysts (medullary
      sponge kidney, medullary cystic disease), parapyelic cysts, acquired cystic
      kidney disease in renal failure patients, parasitic cysts, epidermoid cysts.
      About this disorders we present the more typical and expressive ultrasonographic
      appearance and we define the role and the opportunity of diagnostic setting by
      echography, moreover ultrasonography allows us to make a differential diagnosis
      between cystic kidney disorders and other kidney disease.

PMID- 8353539
TI  - [Uronephrologic echography: state of the art].
AB  - We report the ultrasound usefulness and capacity of them to be explain several
      disease that find field of uronephrology. We value the improvement make to the
      system. At the time, in fact, it is the early diagnostic technique to be
      performed. The AA emphasize the absence of invasiveness, the simplicity and the
      good compliance. Ultrasonography limit the application of more invasive and
      complicate procedure as TAC and RM.

PMID- 8353540
TI  - [Echo-guided puncture of intraprostatic cysts].
AB  - The occurrence of an obstruction of the ejaculatory ducts, in spite of its
      rarity, must be considered by the Urologists in the screening of the etiologic
      causes of obstructive azoospermia. Nowadays, the diagnostic approach, which
      includes the biochemical study of seminal plasma and prostatic ultrasound, often
      leads to the preoperative recognition of the site of obstruction. Various
      surgical and endoscopic techniques have been adopted for the treatment of
      ejaculatory duct obstructions in different historical periods. Herein we describe
      our experience that starts from 1979. 17 infertile patients with intraprostatic
      cysts and 2 with a stenosis of the veru montanum were treated by us following
      these criteria: 9 azoospermic patients underwent scrototomy and endoscopy; 10
      patients with a severe oligozoospermia underwent echo-guided puncture of an
      intraprostatic cyst. The patients were placed in the lithotomy position, a 16 G
      needle was adopted and by means ultrasound was possible to follow the needle
      entering the cyst. When no spermatozoa was detected in the cystic liquid,
      sclerosing agents (Sodium-tetradecyl-sulphate 30 mg in 1 l.) was introduced. This
      easy procedure was carried out on outpatients in local anaesthesia. One out of
      ten oligozoospermic patients had to repeat the echo-guided puncture of
      intraprostatic cyst as the first attempt had been followed by recurrence. Eight
      out of ten subfertile patients who had undergone percutaneous echo-guided
      treatment had longer than 1 year follow-up: in seven cases an increase in sperms
      number and motility was obtained; in one case sperm count remained unmodified. In
      three cases the partners became pregnant.

PMID- 8353541
TI  - [Echo-flowmetric control 6 years after percutaneous treatment of varicocele].
AB  - Several Authors have discussed the long term efficacy of sclerotherapy; somebody
      supposes that percutaneous angiographic treatment of spermatic vein is not sure
      at all because the occlusion due to the sclerosing agents is not retained as long
      lasting. Studies have been done by other Authors about comparison of recurrent
      varicocele anatomy following surgery and percutaneous balloon occlusion: it is
      concluded that venous collaterals are identified easily by renal venography, and
      knowledge of these collaterals is helpful in planning further radiological
      treatment. Since 1980 we have always treated left varicocele by means of
      percutaneous sclerotherapy of the spermatic veins following renal phlebography:
      the treatment is done on an outpatient basis, in local anaesthesia. Sclerosing
      agents we usually adopt are: sodium-tetradecyl sulphate and alcohol. At our
      knowledge long-term results of this treatment have never been published; this is
      the reason for which long-term follow-up of 27 patients that 6 years ago
      underwent percutaneous sclerotherapy was done. Only 16 of them have accepted to
      repeat: a) physical examination; b) Doppler flowmetry; c) scrotal ultrasound. The
      presence of a varicocele was demonstrated in 2 out of 16 patients (12.5% of the
      case). These data confirms that percutaneous treatment performed following the
      procedures we adopted in 1986 has a long term efficacy in 87.5% of the
      cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353542
TI  - [Echo-guided transperineal and transrectal prostatic biopsy: complications of the
      2 methods].
AB  - We evaluated the complications of transrectal and transperineal ultrasound-guided
      prostatic biopsy in 280 patients. All patients underwent antibiotic prophylaxis
      with a different scheme according to the approach for the biopsy. Urine culture
      and, in some patients, blood culture have been collected after biopsy. We have
      reported the same rate of complications for the two modalities except for a lower
      rate of positive urine culture and blood culture in the group of patients
      submitted to transperineal biopsy; this type of approach, then, should be
      considered of first choice in some patients with a higher risk of infections.

PMID- 8353543
TI  - [A case of congenital renal malformation with arteriovenous fistula].
AB  - Renal arteriovenous fistulas caused by vascular malformation are relatively rare,
      with a reported prevalence of less than 0.04%. The authors discuss about a
      clinical case studied by Echo-color-doppler, C.T. scan and Digital angiography.
      Nevertheless there is a good correlation between the results from these different
      Imaging Techniques, Duplex-Doppler seems to be poorly specific to define by
      itself a diagnosis of a tumoral renal mass.

PMID- 8353544
TI  - [Color Doppler echography of the cavernous bodies after F.I.C. in the study of
      erectile impotence of vascular origin].
AB  - Study with the Doppler method has been associated with "cavernometrics" and
      "cavernography" in erection pathologies for some time. But this enquiry is
      burdened not only be technical inaccuracies such as the lack of knowledge of the
      angle of incidence of the doppler wave and the diameter of the explored vessel
      etc, but also by intrinsic difficulty method itself. Therefore, the authors have
      used a color Doppler to individuate and study the cavernous arteries, and present
      the results obtained from a group of 21 patients, all affected by erectile
      deficits, who were selected on the basis of anamnestica and clinical criteria.
      They individualized 21 patients in whom the vasculogenic nature of their
      affection appeared probable, out of the 125 who were under their observation for
      their sexual inadequacy. In three patients the clinical suspicion of a venous
      incompetency was confirmed by dynamic "cavernometrics with cavernography". The
      study of the four phases of erection (flaccidity, tumescence, erection,
      detumescence) was carried out after an intracavernous injection of 20 micrograms
      of PGE/1. The parameters considered were: systolic velocity of the hematic wave,
      diastolic speed, the index of resistance and range. In cases of vasculogenic
      impotence with an arterial base the systolic wave in the 2nd and 3rd phases
      presented a speed inferior to the norm of standard values, the resistance index
      altered by the lacking of physiological increment due in the erectile beyond the
      closing of venous "polsters", also to the rigidity of the albuginea.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8353545
TI  - [Transrectal echography in the diagnosis of cervico-urethral obstruction in the
      young].
AB  - The authors present a case of severe cervico-urethral obstruction by Von Brunn
      cysts. These cysts are often found even in macroscopically healthy bladders, but
      only rarely reach such a size as to be revealed by ultrasound. They can be
      asymptomatic or cause obstruction if large. They are no longer considered
      preneoplastic lesions and are therefore treated according to symptoms. When these
      cysts cause dysuria they are removed, preferably by transurethral resection, as
      it is the only method (unlike needle aspiration) which prevents recurrence.

PMID- 8353546
TI  - [Echographic evaluation of kidney transplant "en bloc"].
AB  - Kidney transplants from infant donors are associated in the literature with poor
      results as regards both functionality and the survival of the transplant. Hence
      the increasing frequency, for kidneys obtained from donors under 5 years of age,
      of a surgical technique defined as "en bloc", involving the transplant of both
      kidneys into a single receiver and using the donor aorta and vena cava for
      vascular anastomosis. This technique seems to provide results comparable with
      those obtained using adult organs. Ultrasound and Doppler investigations are
      routinely performed in patients undergoing such a transplant. This study presents
      ultrasound and Doppler images of "en bloc" transplants, with particular reference
      to one case of pseudoaneurysm of the donor aorta and one of stenosis of the renal
      artery, revealed by Echo-Color-Doppler. The importance of ultrasound in this kind
      of transplant is emphasized, as it enables post-operative monitoring of the
      physiological growth in volume of the two transplanted infant kidneys.

PMID- 8353547
TI  - [Transrectal echography in the evaluation of the effects of endocavitary laser
      therapy in patients with bacterial prostatitis].
AB  - 104 patients with acute bacterial prostatitis were randomized to an antibiotic
      therapy group (group I) and an antibiotic plus laser therapy group (group II).
      Laser therapy was applied ever other day through a trans-rectally inserted
      fiberoptic probe. Resolution of the symptoms occurred in 87% of the patients in
      group I and 92% in group II (p < 0.001). Transrectal ultrasound resulted in
      resolution of the peri-prostatic venous plexus congestion in 43.7% of the
      patients in group I and 89.7% in group II. In conclusion, the combination of
      laser therapy and antibiotics in bacterial prostatitis provides both a better
      resolution of the symptoms and a reduction or disappearance of the peri-prostatic
      venous congestion.

PMID- 8353548
TI  - [Echography in the follow-up of patients receiving an endoscopic injection of
      teflon for vesico-renal reflux].
AB  - The surgical treatment of vesicorenal reflux implies open surgery and
      consequently an hospitalization. The sub-ureteric injection of poly-tetra-fluoro
      ethylene (Teflon) for correction of vesicorenal reflux was first utilized in 1981
      by Matouschek. We have reviewed our personal experience with endoscopic
      correction of vesicorenal reflux from 1985 to 1990 and evaluated the importance
      of ultrasonography especially in the follow up.

PMID- 8353549
TI  - [Echo-guided puncture of intraprostatic cysts: our experience].
AB  - Prostatic cysts are a pathological condition which is rare and still poorly
      known. In the past a precise diagnosis was difficult and was made with radiologic
      examination and/or cystoscopy and/or surgery. Up to date echotomography is the
      most important technique not only for the diagnosis but also for the treatment of
      prostatic cysts. The Authors relate upon their experience about diagnosis and
      treatment of prostatic cysts.

PMID- 8353550
TI  - [Echographic localization and monitoring of bladder calculi treated with ESWL].
AB  - The standard treatments for bladder stones consist either of an open operation or
      endoscopic transurethral disintegration and extraction. These treatment require
      anesthesia and hospitalization. We report our experience of ESWL monotherapy in
      the treatment of 10 patients affected by bladder stones. Our early datas show
      that ESWL for bladder stones is a safe an effective therapy which can be
      performed without the use of anesthesia in an outpatient basis.

PMID- 8353551
TI  - [Echo-Doppler evaluation of the renal arterial flow in hepatic cirrhosis].
AB  - In liver cirrhosis the sodium retention depends on a decreased renal perfusion by
      arteriolar vasoconstriction. To evaluate the usefulness of echo-Doppler in
      detecting such hemodynamic impairment, we studied 16 cirrhotic patients and 16
      healthy subjects as control group. We measured Pulsatility Index (P.I.) and
      Resistivity Index (R.I.). Both parameters resulted to be statistically higher in
      cirrhotic patients than in controls; moreover they resulted to be higher in
      cirrhotics with ascites than in those without. Therefore echo-Doppler can detect
      intraparenchymal renal vasoconstriction in cirrhosis, this impaired perfusion is
      already evident before ascites formation.

PMID- 8353552
TI  - [The role of echography in the evaluation of stenosis of the male urethra].
AB  - Twenty male patients with known urethral stricture disease were evaluated using
      Ultrasonic urethrography, retrograde and anterograde urethrography and Cystoscopy
      for comparative analysis of the three techniques. The Ultrasonic urethrography
      provides the most accurate information regarding anatomic side, stricture length,
      number, the degree of scarring spongiofibrosis. Therefore the Authors suggest a
      larger use of this technique.

PMID- 8353553
TI  - [The role of echography in cancer of the penis].
AB  - The Authors, observing two cases of penile cancer, lay stress on the role of
      Ultrasonography in this disease. Its easy and quick execution, its low cost, the
      possibility to repeat it, its diagnostic sensibility in evaluating the extent of
      the penile cancer, permit us to consider it a screening technique of primary
      importance.

PMID- 8353554
TI  - [Intracavitary echography with a 12.5 MHz microprobe: a new study method in the
      pathology of the urinary tract].
AB  - Endoluminal sonography performed with 12.5 MHz miniature transducer-containing
      catheters with diameter of 6 or 9 Fr., is a new technique for the study of
      urinary tract. We studied: U.S. scan of 10 corpes and 10 operatory specimens
      (bladders and kidneys) with anatomic measurement in vitro. U.S. scan of 20
      patients "in vivo" with pathologies involving bladder and upper urinary tract. We
      studied the normal anatomy of bladder and ureter by U.S. and we detected the
      structures beyond the ureteral lumen as: vessels, lymph nodes, muscle. Our
      indications for the utility of this new U.S. technique are: Detection and staging
      of superficial T.C.C. of the bladder. Detection of dangerous vessels near the
      U.P.F before endopielotomy. Excretory tract minus (endoluminal ultrasound is
      helpful in differentiating such pelvic filling defects as blood clots, no opaque
      stones and transitional cell carcinoma).

PMID- 8353555
TI  - [Echo-guided percutaneous drainage of renal cysts].
AB  - Treatment of renal cysts in the ultrasound guided percutaneous drainage,
      associated with intra-cavital sclerosis-inducing agents to avoid recurrence, is
      often proposed. This report describes the technique and the most suitable
      sclerosis inducing agents. The best results are obtained with alcohol. No
      increase in complications or discomfort was observed.

PMID- 8353556
TI  - [Echography during drug-induced erections in the study of penile plastic
      induration].
AB  - Clinical investigation is still fundamental in the diagnosis of La Peyronie's
      disease. In this study 36 patients underwent clinical investigation and
      ultrasound in basal conditions and during drug-induced erection, and the results
      were compared. In basal condition US does not provide much useful supplementary
      informations. During drug-induced erection US accurately visualizes plaque site
      and dimensions and anatomical abnormalities about corpora cavernosa, albuginea,
      septum and dorsal vessels.

PMID- 8353557
TI  - [Vesico-intestinal fistula in Crohn disease: the role of echography in its
      diagnosis].
AB  - Ultrasound is in widespread use in the study of gastrointestinal pathologies. In
      Crohn disease it is helpful in diagnosing complications such as thickening of the
      bowel loop walls, abscesses, lymph node enlargement and vesical-enteric fistulas.
      This report presents two cases in which vesical-enteric fistulas were visualized
      by US; confirming a diagnosis of Crohn's disease in one case, and diagnosing the
      fistula during the follow-up in the second patient in whom Crohn's disease had
      previously been diagnosed.

PMID- 8353558
TI  - [Traumatic injuries of the urethra: an echographic study].
AB  - US in the lower urinary tract usually explores the bladder and the prostatic
      urethra. In this study we used US instead of x-rays to visualize the remaining
      urethra in 42 patients. US was useful in the presence of urethral trauma. The
      site and extent of injury, particularly peri-urethral lesions (hematomas, urinary
      collection and abscesses in relation to the urethra) were observed. Ultrasound's
      efficacy and reproducibility were also useful in post-operative follow-ups.

PMID- 8353559
TI  - Should government further regulate physician supply? Yes.

PMID- 8353560
TI  - Should the government further regulate physician supply? No.

PMID- 8353561
TI  - Dynamic pay initiatives.
AB  - In the battle to manage change and deal successfully with health care reform,
      hospitals are looking to innovative methods to optimize compensation for their
      executives. Results of the 1993 Hay Hospital Compensation Survey indicate clearly
      that the pressures of managed care and the uncertainty--but inevitability--of
      reform are forcing organizations to use new tools and strategies for achieving
      productivity and quality goals. Another interesting survey finding: Two positions
      critical to the success of integrated health care systems--the head of medical
      affairs and the head of managed care--show significant compensation growth during
      the past two years.

PMID- 8353562
TI  - A call for consultants.
AB  - There is a consensus that reform will create a boon for consultants. Many
      organizations have already brought in consultants to help formulate new
      strategies; but how do you find the right one?

PMID- 8353563
TI  - Biotech on the brink.

PMID- 8353564
TI  - Managing costs and care. Medicare bundled pricing CABG demo is catching on fast.
AB  - After two years of experimenting, hospitals and physicians participating in the
      Medicare bundled-payment CABG project are enthusiastic. Their effort may offer a
      model for future collaboration.

PMID- 8353565
TI  - Seniors speak up. Advocates for the elderly prepare for congressional reform
      debate.
AB  - Senior citizen advocacy groups are preparing for the release of the Clinton
      administration's reform plan. And policymakers are expected to listen when they
      speak up.

PMID- 8353566
TI  - Sizing up Pennsylvania. Geisinger aims to reshape its delivery system.

PMID- 8353567
TI  - Joseph A. Califano Jr. A former HEW secretary looks at health care reform.
      Interview by Terese Hudson.
AB  - Joseph A. Califano Jr. was secretary of Health, Education and Welfare in the
      Carter administration and is now president of the Center on Addiction and
      Substance Abuse at Columbia University, an independent not-for-profit research
      center. He also serves as an adjunct professor of public health at Columbia
      University. Califano has written eight books, including America's Health Care
      Revolution: Who Lives? Who Dies? Who Pays?, published in 1986. He will speak at
      the American Society for Healthcare Marketing and Public Relations 15th annual
      meeting, Sept. 11-14 in San Francisco. He spoke recently with Senior Editor
      Terese Hudson about the possibilities and problems in the current move to reform
      health care.

PMID- 8353568
TI  - Mind/body medicine makes an impression on San Diego.

PMID- 8353569
TI  - Telecommunicators making their way into the health care market.

PMID- 8353570
TI  - Data watch. Americans speak out on health care reform.

PMID- 8353571
TI  - Breaking down assumptions, managing change.

PMID- 8353572
TI  - Creating change in the ICU: the battle with tradition, tenure and tenacity.

PMID- 8353573
TI  - Cardiopulmonary support in the intensive care unit.

PMID- 8353574
TI  - Myocardial contusion: new concepts in diagnosis and management.
AB  - Myocardial contusion is diagnosed with one or a combination of four diagnostic
      procedures: electrocardiography, echocardiography, creatine kinase MB fractions
      and/or radionuclide procedures. This article presents a critical review of 18
      recent studies addressing the utility, sensitivity and specificity of these
      tests. Careful review suggests that clinically significant myocardial contusions
      as a result of blunt trauma are rare and may be detected simply and inexpensively
      using electrocardiography and careful physical examination. Serum myocardial
      enzymes and radionuclide studies are nonspecific and are not predictive of
      cardiac complications. Echocardiography is useful in the management of myocardial
      decompensation but not as a primary screening tool in blunt cardiac injury. Cost
      comparisons, resource allocation and implications for critical care practice are
      discussed.

PMID- 8353575
TI  - Evaluation of the effects of heparinized and nonheparinized flush solutions on
      the patency of arterial pressure monitoring lines: the AACN Thunder Project. By
      the American Association of Critical-Care Nurses.
AB  - OBJECTIVE: To evaluate the effects of heparinized and nonheparinized flush
      solutions on the patency of arterial pressure monitoring lines. SAMPLE: A total
      of 5139 patients from 198 participating sites comprised the sample for this large
      scale, randomized clinical trial. METHODS: Patients were randomly assigned to
      heparinized and nonheparinized flush solution treatment groups. Data were
      collected at 4-hour intervals for up to 72 hours on presence of acceptable square
      waveform and arterial backflow. RESULTS: Arterial pressure monitoring lines
      maintained with heparinized flush solutions had a significantly greater
      probability of remaining patent over time than lines maintained with
      nonheparinized flush solutions. In addition to heparin, four other variables
      significantly influenced the probability of lines remaining patent: receiving
      other anticoagulants or thrombolytics, having a catheter longer than 2 inches,
      femoral insertion site and male gender. CONCLUSIONS: Chances for patency are
      greatest in men with long femoral lines who receive other anticoagulants or
      thrombolytics and heparinized flush solutions. Risks of nonpatency are greatest
      in women with short nonfemoral lines who do not receive other anticoagulants or
      thrombolytics and have nonheparinized flush solutions.

PMID- 8353576
TI  - Is stress at hospital discharge after acute myocardial infarction greater in
      women than in men?
AB  - BACKGROUND: Stress surrounding hospital discharge after acute myocardial
      infarction increases the likelihood that the condition will recur. Although
      increased age, a more severe illness and a higher incidence of persistent cardiac
      symptoms suggest that women would experience more stress at discharge, data
      comparing stress experienced by women and men have not been reported. PURPOSE: To
      compare the level of stress experienced by women and men at hospital discharge
      after acute myocardial infarction. SAMPLE: Data from 54 women and 182 men from a
      government hospital, two private community hospitals and a teaching/community
      hospital. RESULTS: Stress scores of women were not found to be different from
      those of men, nor were five of the six most stressful concerns identified in the
      study. No difference was found in severity of illness or age. CONCLUSIONS: Women
      and men experience similar levels of stress at hospital discharge after acute
      myocardial infarction. Furthermore, both genders can benefit equally from
      interventions designed to reduce stress.

PMID- 8353577
TI  - Clinical management of supraventricular tachycardia with adenosine.
AB  - Adenosine is a reliable agent to convert supraventricular tachycardia to regular
      sinus rhythm with few complications. Also, adenosine may be useful in the
      diagnosis of narrow and wide QRS complex tachycardias. Original research articles
      published predominantly in the last 10 years were reviewed. These articles
      examined the therapeutic and electrophysiologic effects of adenosine compounds
      and compared their actions to other antiarrhythmics.

PMID- 8353578
TI  - Unstable angina associated with critical proximal left anterior descending
      coronary artery stenosis.
AB  - A critical proximal left anterior descending coronary artery stenosis associated
      with unstable angina places a patient at extreme risk for extensive anterolateral
      myocardial damage with potentially irreversible hemodynamic demise.
      Characteristics of this pathology are a clinical profile of new-onset unstable
      angina, normal or minimally elevated cardiac enzymes, and 12-lead
      electrocardiographic indicators specific for anterolateral ischemia usually seen
      in periods when the patient is pain-free. Knowledge of this profile,
      administration and evaluation of pharmacologic therapies and a unique bedside
      monitoring strategy with hourly surveillance of the precordial leads are key
      measures necessary to stabilize and preserve the integrity of myocardial tissue
      until aggressive, invasive revascularization therapies are instituted.

PMID- 8353579
TI  - A protocol for initiation of nasal positive pressure ventilation.
AB  - BACKGROUND: Respiratory failure related to neuromuscular weakness has commonly
      been managed with long-term ventilation by tracheostomy. Currently, nasal
      positive pressure ventilation is being used with success in this patient
      population. It has been suggested that initiation of nasal positive pressure
      ventilation is best done in an intensive care setting. METHOD: Nine patients were
      placed on nasal ventilation during a brief admission to a medical floor staffed
      by nurses trained in respiratory care. This process was facilitated by use of a
      standardized protocol for nursing staff that identified treatment objectives.
      RESULTS: Following the initiation of nasal positive pressure ventilation, this
      group of patients experienced near normalization of daytime measurements of
      partial pressure of arterial carbon dioxide, reported increases in daytime energy
      levels, and relief of nighttime signs and symptoms. These objectives were
      accomplished with no significant complications. Use of this protocol may also
      decrease length and cost of hospitalization and improve patient acceptance of
      noninvasive ventilatory assistance.

PMID- 8353580
TI  - Morphine sulfate, transdermal fentanyl citrate and ketorolac tromethamine:
      effects on postoperative pulmonary function.
AB  - The physiological effects of morphine sulfate and fentanyl citrate on
      postoperative pulmonary function demonstrate varying degrees of respiratory
      depression related to dose, route of administration and pre-existing pathologies.
      Current postoperative analgesic therapies that include concomitant use of
      narcotic agonists and nonsteroidal anti-inflammatory drugs require adjustment of
      drug dosages to provide adequate pain relief while avoiding drug-induced
      complications. Specific nursing considerations include understanding therapeutic
      and adverse effects of these agents on pain and ventilation, continuous pain
      assessment and early recognition and treatment of respiratory depression.

PMID- 8353581
TI  - Adult respiratory distress syndrome: a consideration with rapid respiratory
      decompensation in association with preeclampsia.
AB  - Adult respiratory distress syndrome, presenting as rapid respiratory
      decompensation in the setting of preeclampsia at 36 weeks of gestation, was
      managed by early hemodynamic monitoring with pulmonary artery catheterization.
      With confirmation of the diagnosis of preeclampsia the patient was delivered
      promptly; improvement of her respiratory failure was observed within 48 hours.
      Consideration of adult respiratory distress syndrome in the setting of
      preeclampsia is discussed, with emphasis on early confirmation of the diagnosis
      and determination of the precise mechanisms of pulmonary edema.

PMID- 8353582
TI  - Effects of neck position on intracranial pressure.
AB  - OBJECTIVE: To investigate the effects of four nonneutral neck positions on
      intracranial pressure. DESIGN: An alternating treatment design was used to
      investigate the effect on intracranial pressure of rotation of the head to the
      left and right, neck flexion and neck extension. Each experimental position was
      separated by a neutral recovery period. SETTING: Neurological intensive care
      units in two tertiary care centers in the southwestern United States. SUBJECTS:
      Ten patients whose intracranial pressure was being therapeutically monitored but
      who were not experiencing prolonged periods of elevated intracranial pressure.
      PROCEDURE: Each neck position was maintained manually by the research staff for 5
      minutes. Intracranial pressure was recorded at 1-minute intervals throughout the
      45-minute data collection period. RESULTS: Rotating the head to the right and
      left and placing the neck in flexion resulted in significantly higher
      intracranial pressure readings than the baseline neutral neck position or
      positioning the neck in extension. The highest individual intracranial pressures
      always occurred with the head and neck rotated or in flexion. CONCLUSIONS: These
      data support previous studies that indicated that a patient at risk for
      pathological increase in intracranial pressure should not be positioned with the
      neck in flexion or the head turned to either side.

PMID- 8353583
TI  - Echocardiographic determination of valid zero reference levels in supine and
      lateral positions.
AB  - BACKGROUND: The phlebostatic axis--the junction of the fourth intercostal space
      and the midpoint of the anterior-posterior diameter--has been accepted as a
      reliable external reference point for the mid-right and mid-left atrium.
      Acceptance of this reference point is based upon research conducted in 1945 that
      measured venous pressures in the hands of subjects positioned with the head of
      the bed raised to different levels. The validity of this reference point for
      intracardiac pressure measurements in supine or laterally positioned patients has
      not been established. PURPOSE: To determine the validity of the phlebostatic axis
      in the supine and lateral positions. METHODS: To determine validity in the supine
      position, we compared the distance from the phlebostatic axis to a fixed external
      point (the bed surface) and the distance from the right and left atria in the
      supine position to this same fixed external point. The distances from the right
      and left atria to the bed surface were determined with echocardiography and were
      used as the standard for the proper position of external reference points. To
      determine the validity of the phlebostatic axis in lateral positions, we compared
      the distances from the right atrium and left atrium to the bed surface in the
      supine position with those distances in different lateral positions. RESULTS: We
      analyzed the data of 25 normal, healthy subjects. The study findings show that
      the phlebostatic axis is a valid reference point for the right atrium, and the
      phlebostatic axis and midanterior-posterior diameter are valid reference points
      for the left atrium in the supine position. However, neither is a valid external
      reference point in the lateral positions. Pressure measurements obtained when
      patients are in the lateral positions are not accurate. There remains a need to
      develop valid methods of accurate pressure measurements in various body
      positions.

PMID- 8353584
TI  - Clinical safety and cost of heparin titration using bedside activated clotting
      time.
AB  - OBJECTIVE: To evaluate the clinical safety of heparin titration and the
      procedural cost of anticoagulation measurement using bedside low-range activated
      clotting time. DESIGN: Quasi-experimental study using data gathered through
      retrospective record review. SETTING: Coronary care, medical intensive care and
      telemetry units of a community hospital. SUBJECTS: Sample of 102 patients
      undergoing elective percutaneous transluminal coronary angioplasty. INTERVENTION:
      Intravenous heparin therapy was titrated using low-range activated clotting time
      in 51 percutaneous transluminal coronary angioplasty patients. Data from this
      group were compared to a matched sample of 51 angioplasty patients whose
      intravenous heparin therapy was titrated using activated partial thromboplastin
      time. RESULTS: No differences in procedural, early or late complications were
      found between the groups. The cost of managing heparin therapy with low-range
      activated clotting time was less than with activated partial thromboplastin time.
      CONCLUSION: These results suggest that titrating heparin therapy based on bedside
      low-range activated clotting time for the angioplasty patients in this sample was
      as safe as with activated partial thromboplastin time. Use of bedside low-range
      activated clotting time saved money for the hospital.

PMID- 8353585
TI  - Accuracy of drawing coagulation samples from heparinized arterial lines.
AB  - OBJECTIVE: To determine the accuracy of activated partial thromboplastin time and
      prothrombin time studies when samples are drawn through heparinized arterial
      lines. METHODS: A total sample of 90 grouped blood samples (from 30 subjects) was
      used. Patients were all male, with a mean age of 65 and were studied within 24
      hours of percutaneous transluminal coronary angioplasty. Each patient had three
      venous control and arterial line sample sets (a total of 90 blood samples) drawn
      when routinely ordered for monitoring therapy. For the arterial line sample, a
      discard volume of the deadspace, deadspace + 2 mL, or deadspace + 4 mL was
      randomly assigned for each sample. The venous control volumes were the same for
      all three sample sets. RESULTS: A 2 x 3 repeated measures analysis of variance
      was used to analyze the results. The independent variables were the source of the
      sample (venous vs arterial) and the discard volume of arterial blood (deadspace,
      deadspace + 2 mL, deadspace + 4 mL). The dependent variables were the activated
      partial thromboplastin time and prothrombin time values. Mean arterial activated
      partial thromboplastin time values were significantly higher than the
      corresponding venous values. Mean activated partial thromboplastin time values
      were not significantly different among the discard volumes of blood drawn.
      However, there was a significant source by volume interaction. Tukey post-hoc
      comparisons of venous-arterial activated partial thromboplastin time differences
      among the three volumes showed significant differences between deadspace volume
      and deadspace + 2 mL, and deadspace volume and deadspace + 4 mL. There was no
      significant difference between deadspace + 2 mL and deadspace + 4 mL volumes.
      CONCLUSION: Results indicated that the minimal amount of discard volume for
      accurate activated partial thromboplastin time values in this population of
      percutaneous transluminal coronary angioplasty patients was the catheter
      deadspace volume plus 2 mL (total 3.6 mL).

PMID- 8353586
TI  - Pacemaker update. Part II: Atrioventricular synchronous and rate-modulated
      pacemakers.

PMID- 8353587
TI  - An open door policy in ICU.

PMID- 8353588
TI  - An open door policy in ICU.

PMID- 8353589
TI  - Cytosolic calcium oscillators: critical discussion and stochastic modelling.
AB  - In the last few years, an immense amount of experimental data on agonist-induced
      cytosolic Ca2+ oscillations has emphasized the necessity of theoretical models
      accounting for these phenomena. In the first part of the paper, a critical
      analysis of different minimal Ca2+ oscillator models is presented, which reveals
      that not all of the so far proposed mechanisms are capable to reproduce
      experimental data adequately. The second part of the paper is devoted to a
      computational method using a stochastic simulation algorithm which describes the
      time evolution of Ca2+ oscillations at the molecular level. In contrast to the
      deterministic formulation of the models presented so far, the stochastic
      treatment takes account of the inherent fluctuations of cytosolic Ca2+ in
      cellular subcompartments. In the macroscopic limit, the stochastic models display
      dynamics analogous to the deterministic ones.

PMID- 8353590
TI  - Opposite effect of superoxide dismutase, L-arginine analogues, methylene blue and
      desferal: suppression of histamine-induced and stimulation of serotonin-induced
      paw edema in mice.
AB  - Endogenous nitric oxide (NO, endothelium-derived relaxing factor) was stimulatory
      for histamine- and suppressive for serotonin-induced paw edema of mice. This
      action was mediated by guanosine 3',5'-cyclic monophosphate production. Local
      injection of superoxide dismutase (SOD), catalase, NG-monomethyl-L-arginine (L
      NMMA), methylene blue and Desferal (iron chelator) mixed with mediator suppressed
      histamine-induced edema at doses between 0.1 and 100 micrograms/kg and showed no
      or little stimulatory effect at higher doses. L-arginine reversed the effect of L
      NMMA. Serotonin edema was enhanced by a high dose of these drugs. Their effect
      became suppressive as the histamine ratio was increased in edema induced by a
      histamine-serotonin mixture. This suggested that serotonin-induced vascular
      permeability decreased with a greater production of either O2- or NO. Cimetidine
      (H2-antagonist) was not effective in histamine edema of normal mice, but became
      suppressive (ED50 = 70 micrograms/kg) when 10 mg/kg L-NMMA was coinjected. SOD
      and methylene blue also rendered this edema sensitive to cimetidine. A
      simultaneous decrease in sensitivity to mepyramine (H1-antagonist) indicated that
      NO and oxyradicals kept H1-receptors activated. L-NMMA had no effect on
      bradykinin edema, but suppressed thrombin-, acetylcholine-, platelet-activating
      factor-, substance P- and FeCl3-induced paw edemata. Nitroprusside (NO donator)
      suppressed serotonin edema. N-Acetylcysteine and cytochrome c, but not ascorbate
      and hydroxyl radical scavengers suppressed histamine edema.

PMID- 8353591
TI  - Simultaneous, continuous, on-line and real-time spectral analysis of multiple
      physiologic signals by a personal-computer-based algorithm.
AB  - We presented in this communication a computer algorithm that offers the advantage
      of simultaneous analysis of the power spectrum of multiple physiologic signals,
      including systemic arterial pressure, single-neuronal and electroencephalographic
      signals, on a continuous, on-line and real-time basis. It provided sensitive
      definition, discrimination and quantification (graphic and digital) of the
      various frequency components in the spectrum. There was also great flexibility in
      selecting the physiologic signal(s) to be analyzed, the choice of results of
      analysis to be displayed for each physiologic parameter and the alteration of
      sensitivity and baseline of each event channel. Furthermore, it included window
      options to improve the frequency or temporal resolution and discrimination of the
      spectral changes. Most importantly, all these desirable features can be
      accomplished economically with a general purpose personal computer.

PMID- 8353592
TI  - In vitro transformation of epithelial cells by ras oncogenes.
AB  - Genes of the ras family of dominant transforming genes are frequently activated
      by specific point mutations in common human epithelial malignancies and also in
      many experimental tumour models. Testing of the hypothesis that ras activation is
      a critical event in tumorigenesis involves reconstruction of genetic events in
      vitro using appropriate epithelial models. This article reviews experimental
      transformation of human and rodent epithelial cells by ras oncogenes in vitro,
      alone and in combination with cooperating oncogenic events.

PMID- 8353593
TI  - Basal cell adhesion to a culture substratum controls the polarized spatial
      organization of human epidermal keratinocytes into proliferating basal and
      terminally differentiating suprabasal populations.
AB  - The contribution of adhesion to an extracellular matrix in the polarized spatial
      organization of keratinocytes was studied in dispase-detached cultures stored as
      floating sheets. Proliferating and terminally differentiating cell populations
      were, therefore, localized on tissue sections by their DNA-synthesizing ability
      and involucrin immunostaining, respectively. A progressive reorganization was
      induced from superposed proliferating and differentiating layers into clusters
      exhibiting differentiating cells on the outside. Measurements of proliferation
      and terminal differentiation in detached cultures revealed the progressive
      disappearance of proliferating cells, followed by an increase in involucrin
      positive cells. Attempts to block the spatial reorganization by the addition of
      components of the extracellular matrix remained unsuccessful. These results
      suggest that basal anchorage is responsible for the superposition of
      proliferating and differentiating cells in keratinocyte cultures. They afford new
      arguments for the induction of terminal differentiation in non-adhesive
      keratinocytes which exhibit a concomitant modification of cell shape.

PMID- 8353594
TI  - A defined collagen substrate and nutrient diffusion gradient culture system
      allows human colon cancer cells to assume a more differentiated phenotype.
AB  - A culture system is presented in which a biologically more relevant substrate in
      the form of a collagen membrane and a biologically more relevant diffusion
      gradient system for nutrient delivery to the cells are provided. Five established
      human colon cancer cell lines (Caco-2, DLD-1, Widr, HCT 116 and HCT 8) were
      cultured in this system and three of them showed increased differentiation
      compared with the same cells cultured on the usual cell culture substrates of
      plastic and glass and with cells grown in an anchorage-independent manner. Caco-2
      cells grow on plastic as a monolayer of large pleomorphic cells with scant mucin
      production. When cultured in a gradient diffusion system in a sandwich of type
      I/IV collagen the Caco-2 cells showed the highest degree of morphological and
      biochemical differentiation as evidenced by cellular alignment, glandular
      formation and mucin production. Similarly DLD-1 cells exhibited the greatest
      degree of morphological and biochemical differentiation in a gradient system in a
      type I/IV collagen sandwich. HCT 116 and HCT 8 cells, however, showed little
      change in differentiation phenotype under any of the 11 culture conditions
      tested. Widr cells grew in a type I/IV collagen sandwich in a gradient diffusion
      system as multilayered sheets of cells with intercellular spaces, suggestive of a
      moderate increase in differentiation phenotype. As judged by morphology and mucin
      production a range of differentiation capacities is exhibited by the five cell
      lines tested under the optimal differentiating culture conditions, with the order
      from most able to differentiate to least able to differentiate being Caco-2 > or
      = DLD-1 > or = Widr > HCT 116 > or = HCT 8.

PMID- 8353595
TI  - Permissive and instructive induction of adult rodent prostatic epithelium by
      heterotypic urogenital sinus mesenchyme.
AB  - Adult rodent (rat and mouse) prostatic ducts (PR) were recombined
      heterospecifically with fetal urogenital sinus mesenchyme (UGM) (mouse UGM plus
      rat PR or rat UGM plus mouse PR), and the resultant tissue recombinants were
      grafted under the renal capsule of male athymic mice. For recombination with
      mouse UGM the ductal tips of each of the 4 rat prostatic lobes [ventral (VP),
      lateral type 1 (L1), lateral type 2 (L2), and dorsal prostate (DP)] were used.
      For recombination with rat UGM the ductal tips of each of the 2 mouse prostatic
      lobes [ventral (VP) and dorso-lateral prostate (DLP)] were used. After 1 month of
      growth in vivo, the DNA content of UGM+PR recombinants increased substantially
      (6.1- to 76.8-fold increase) over the combined DNA content of the isolated UGM
      and PR prior to grafting. Immunocytochemical, polyacrylamide gel electrophoretic
      and Western blot analyses demonstrated that irrespective of the initial source of
      the adult prostatic duct, the epithelium of UGM + PR recombinants continued to
      express its normal lobe-specific secretory proteins as well as secretory proteins
      specific to other prostatic lobes. For example, rat ventral and lateral type 2
      prostate do not normally express DP-1, a rat dorsal-prostatic-specific protein,
      but after recombination with mouse UGM the induced prostatic epithelium expressed
      DP-1 as well as C3, a rat ventral-prostatic-specific protein. Sensitive reverse
      transcriptase-polymerase chain reaction techniques (RT-PCR) verified the
      expression of mRNA for C3 and DP-1 in such tissue recombinants. Analogous results
      were obtained for UGM + PR tissue recombinants constructed with prostatic ductal
      tips from rat L1, L2 and DP and mouse VP and DLP. These findings demonstrate that
      adult rodent prostatic epithelium retains a responsiveness to its connective
      tissue environment, and that fetal UGM can permissively induce prostatic ductal
      growth and morphogenesis while instructively inducing the expression of a new
      spectrum of prostatic secretory proteins.

PMID- 8353596
TI  - The influence of tissue microenvironment (stroma and extracellular matrix) on the
      development and function of mammary epithelium.
AB  - The morphogenesis and functional differentiation of mammary epithelium depends on
      signalling from systemic hormones and on cues from the local tissue
      microenvironment. With regard to the latter, regulatory cues are mainly provided
      by two subcompartments of the mesenchyme/stroma [fibroblastic and adipocyte] and
      the subjacent basement membrane. During embryogenesis, fibroblastic mesenchyme
      determines the sexual phenotype of the gland while adipocyte mesenchyme controls
      mammary-specific ductal morphogenesis. In the juvenile animal, adipocyte stroma
      continues to support ductal expansion while fibroblasts negatively regulate
      ductal outgrowth via interactions with the epithelium possibly involving TGF-beta
      mediated deposition of collagen I and chondroitin sulphate. In the adult,
      evidence from culture studies show that the signals required for the induction of
      tissue-specific differentiation during pregnancy and maintenance of function
      during lactation arise primarily from basement membrane. Beta-casein synthesis is
      induced in single mammary epithelial cells embedded within a basement membrane
      matrix via an integrin-dependent pathway. Further support for a critical role for
      basement membrane in the functional differentiation of the gland comes from
      studies in involution where degradative loss of basement membranes correlates
      with loss of functional activity in the epithelium. Thus the extracellular matrix
      in conjunction with certain cytokines plays a central role in coordinating
      mammary epithelial development. The findings discussed give further credence to a
      modal where mammary epithelium, together with certain elements of the subjacent
      microenvironment, form a dynamic and reciprocally interactive functional unit
      that regulates tissue specific gene expression in the mammary gland.

PMID- 8353597
TI  - Hippocampal circuitry complicates analysis of long-term potentiation in mossy
      fiber synapses.
AB  - Much of the current interest in the hippocampus concerns a rapid and persistent
      form of synaptic plasticity, called long-term potentiation (LTP), that is a
      candidate substrate for some of the mnemonic functions of this structure. There
      are at least two kinds of LTP in the hippocampus. One form is found at the
      synapse between the mossy fibers of the granule cells and the pyramidal neurons
      of the CA3 region. Attempts to examine the mechanism underlying this form of LTP
      have yielded contradictory conclusions. The authors show how the complex
      circuitry of the dentate gyrus and adjacent hippocampus may have caused the
      contradictions. To overcome problems introduced by the circuitry, a specific set
      of procedures and criteria for evoking and identifying mossy fiber responses is
      proposed. Use of these or similar procedures and criteria will improve the design
      and interpretation of experiments on mossy fiber LTP and allow more informative
      comparisons among species and brain regions and across laboratories.

PMID- 8353598
TI  - Spatial learning and the saturation of long-term potentiation.

PMID- 8353599
TI  - Hippocampal synaptic enhancement and spatial learning in the Morris swim task.
AB  - The authors attempted to replicate the study of Castro, Silbert, McNaughton, and
      Barnes (1989) in which it was concluded that bilateral saturation of hippocampal
      synaptic enhancement produced a deficit in acquisition of a spatial navigation
      problem in the Morris swim task. The original protocol was followed as closely as
      possible, but no effect of long-term enhancement (LTE) saturation on spatial
      performance in this task was found. This negative result suggests either that the
      previous finding using the swim task reflected statistical error or that some as
      yet undetermined variable is of critical importance in this phenomenon. The
      present negative finding also raises a question concerning the reproducibility of
      the earlier results of McNaughton, Barnes, Rao, Baldwin, and Rasmussen (1986) in
      which LTE saturation apparently led to a prolonged deficit on a different spatial
      task. Although negative results in such experiments do not constitute grounds for
      rejecting the underlying hypothesis, the present lack of a positive effect
      renders uncertain, for the time being, one of the lines of experimental support
      for the theory that LTE at hippocampal synapses reflects a mechanism for the
      associative, distributed storage of new spatial information.

PMID- 8353600
TI  - Cumulative long-term potentiation in the rat dentate gyrus correlates with, but
      does not modify, performance in the water maze.
AB  - The electrically induced increase in hippocampal synaptic strength known as long
      term potentiation (LTP) is thought to involve some of the same mechanisms as
      those mediating information storage during spatial learning. Physiological
      saturation of synaptic weights might therefore be expected to occlude spatial
      learning. In support of this, Castro et al. (Castro CA, Silbert LH, McNaughton
      BL, Barnes CA, 1989, Nature 342:545-548) reported that repeated induction of LTP
      to asymptotic levels, over a 14-day period, blocked the ability of rats to learn
      the position of a hidden platform in a water maze shortly afterwards. The authors
      have attempted to replicate this finding in two experiments. In Experiment 1,
      rats were given either 400 Hz stimulation as 50 trains/day over a 5-day period,
      to induce LTP, or were given the same number of stimulus pulses at 1 Hz. Two
      hours after the last stimulation session they underwent eight spatial learning
      trials, occurring at 2-hour intervals. In Experiment 2, the procedure of Castro
      et al. was followed exactly, with LTP induced by 10 trains of 400 Hz stimulation
      daily for 14 days. Spatial learning trials began 10 minutes after the last
      stimulation session and consisted of 12 trials with alternating 30-second and 2
      minute intervals. In neither experiment was a significant impairment of spatial
      learning observed. However, there was a strong positive correlation, in both
      experiments, between the final level of LTP and subsequent performance in the
      water maze.

PMID- 8353601
TI  - Induction of long-term potentiation at perforant path dentate synapses does not
      affect place learning or memory.
AB  - In two experiments the authors failed to detect an effect of inducing bilateral,
      long-lasting synaptic potentiation at perforant path dentate synapses on spatial
      learning by rats in the Morris place navigation task. Daily sessions of high
      frequency stimulation of perforant path axons produced large increases to an
      asymptotic level in population spike and field excitatory postsynaptic potential
      recorded in ipsilateral dentate gyrus. Place learning proceeded normally 24 hours
      after the last of 14 high-frequency stimulation sessions in rats that had
      previously mastered the procedural aspects of place navigation (Experiment 1) and
      in rats that were naive (Experiment 2).

PMID- 8353602
TI  - Differential effects of kindling and kindled seizures on place learning in the
      Morris water maze.
AB  - There is some controversy about the role of long-term potentiation (LTP) in
      spatial learning. The authors have found that triggering generalized kindled
      seizures with stimulation of the perforant path disrupts spatial learning in the
      Morris water maze but that kindling per se does not affect spatial learning. It
      is suggested that abnormal electrical activity induced by high-frequency
      stimulation of the perforant path may have been responsible for the disruption of
      spatial learning previously attributed to LTP saturation.

PMID- 8353603
TI  - An examination of the relations between hippocampal long-term potentiation,
      kindling, afterdischarge, and place learning in the water maze.
AB  - Two approaches were used to study the relations between the acquisition of place
      learning in the Morris water maze and long-term potentiation (LTP), kindling, and
      afterdischarge (AD). In the first, the possibility of behavioral LTP in the
      dentate gyrus field potential evoked by stimulation of the perforant path was
      evaluated in rats that showed robust place learning in the water maze. There was
      no effect of place learning on the field potential, and field potential measures
      did not correlate with place learning acquisition measures. In the second
      approach, the effect of bilateral saturation of LTP on subsequent place learning
      in the water maze task, begun within 5 minutes of the last LTP session, was
      evaluated. The effect of kindled seizures evoked bilaterally from the perforant
      path, or of a single unilateral AD, on acquisition of the water maze task (begun
      within 10 minutes) were also evaluated. Bilateral LTP saturation did not affect
      place learning, and the bilateral LTP group learned as readily as controls. In
      contrast, the kindled and AD groups were severely impaired in their performance
      of the place learning task. A second day of training in the water maze without
      any further electrical stimulation indicated that these groups had acquired
      considerable information on the first day of maze training and were not
      distinguishable from controls on the second day of training. This indicated that
      the deficit in these groups on the first day of training was temporary and likely
      resulted from a temporary perturbation of normal brain function due to the
      seizures. The results indicate that bilateral saturation of LTP in the dentate
      gyrus does not affect place learning in the water maze. They also indicate that
      recent hippocampal seizures, but not kindling, disrupt place learning in this
      task.

PMID- 8353604
TI  - Spatial selectivity of unit activity in the hippocampal granular layer.
AB  - Single neuron activity was recorded in the granular layer of the fascia dentata
      in freely moving rats, while the animals performed a spatial "working" memory
      task on an eight-arm maze. Using recording methods that facilitate detection of
      units with low discharge rates, it was found that the majority (88%) of cells in
      this layer have mean rates below 0.5 Hz, with a minimum of 0.01 Hz or less. The
      remaining recorded cells exhibited characteristics typical of the theta
      interneurons found throughout the hippocampus. Based on several criteria
      including relative proportion and the relation of their evoked discharges to the
      population spike elicited by perforant path stimulation, it was concluded that
      the low-rate cells correspond to granule cells. Granule cells exhibited clear
      spatially and directionally selective discharge that was at least as selective as
      that of a sample of CA3 pyramidal cells recorded under the same conditions.
      Granule cells had significantly smaller place fields than pyramidal cells, and
      tended to have more discontiguous subfields. There was no spatial correlation
      among simultaneously recorded adjacent granule cells. Granule cells also
      exhibited burst discharges reminiscent of complex spikes from pyramidal cells
      while the animals sat quietly; however, the spike duration of granule cells was
      significantly shorter than CA3 pyramidal cell spike durations. Under conditions
      of environmental stability, granule cell place fields were stable for at least
      several days. Following occasional maze rotations relative to the (somewhat
      impoverished) visual stimuli of the recording room, granule cell place fields
      were maintained relative to the distal spatial cues; however, frequent rotations
      of the maze sometimes resulted in a shift in the reference frame to the maze
      itself. These observations indicate that granule cells of the fascia dentata
      provide their CA3 targets with a high degree of spatial information, in the form
      of a sparsely coded, distributed representation.

PMID- 8353605
TI  - Effects of glucocorticoids on hippocampal long-term potentiation.
AB  - The effects of chronic and acute corticosterone (CORT) administration were
      investigated on hippocampal long-term potentiation (LTP) in the dentate gyrus
      granule cell layer of the rat. Electrophysiological experiments were performed in
      vivo under urethane anesthesia. Chronic CORT treatment (40 mg/kg/day) over 21
      days decreased LTP compared to vehicle controls, even when LTP was measured 48
      hours after cessation of CORT treatment, when serum CORT levels had returned to
      baseline. A single injection of CORT also decreased LTP compared to vehicle
      controls, but only when CORT levels were high, since at 48 hours after a single
      acute CORT injection LTP was not depressed. The decrements in LTP were seen both
      for the slope of the excitatory postsynaptic potential and for the population
      spike. Yet CORT had no effects on posttetanic potentiation or neuronal
      excitability. These findings are consistent with previous reports showing a
      reduction in LTP in the CA1 field of animals exposed to stress or acute CORT
      administration.

PMID- 8353606
TI  - GABA induces a unique rise of [Ca]i in cultured rat hippocampal neurons.
AB  - GABA evoked a reversible rise of free intracellular calcium concentration ([Ca]i)
      in cultured rat hippocampal neurons, detected with Fluo-3 fluorescence in a
      confocal laser scanning microscope. The GABA-evoked change of [Ca]i was mimicked
      by muscimol and not by baclofen, but was only minimally affected by picrotoxin or
      bicuculline, indicating that this effect of GABA is not likely to be mediated by
      activation of GABAB receptor or by a conventional chloride-linked GABAA receptor.
      GABA-evoked rise of [Ca]i expressed a marked desensitization; only 10-20 minutes
      after a previous exposure to GABA was the response to a subsequent application
      fully expressed. This desensitization was not seen in electrophysiological
      responses to GABA or in [Ca]i changes evoked by NMDA in the same neurons. The
      GABA response appeared to be developmentally regulated and was seen in 1-7-day
      old more than in 21-28-day-old cells. It is suggested that GABA evokes a unique
      change of [Ca]i in young hippocampal neurons.

PMID- 8353607
TI  - Perineuronal satellitosis in the human hippocampal formation.
AB  - A previously unreported example of perineuronal satellitosis in the medial CA1
      and adjacent subiculum in the human hippocampal formation is described. This
      phenomenon is characterized by a clustering of glial cells in relation to the
      perikarya of a subpopulation of neurons in the deep pyramidal layer and around
      most neurons scattered in the stratum oriens and subcortical white matter. Most
      of the perineuronal satellite glia were identified as oligodendrocytes based on
      their nuclear chromatin patterns and antigenic properties. Satellite
      oligodendrocytes were mostly of the medium dense variety. A type of satellite
      glia with nuclear features of the dark oligodendrocyte could not be identified
      unequivocally using the antigenic criteria employed in this study.

PMID- 8353608
TI  - Hippocampal function in the rat: cognitive mapping or vicarious trial and error?
AB  - The most prominent hypothesis of hippocampal function likens the hippocampus to a
      "cognitive map," a term used by a famous learning theorist, E. C. Tolman, to
      explain maze learning. The usual application of this concept of cognitive map, as
      it applies to the hippocampus, is to what is called spatial learning, mainly in
      the radial-arm maze of Olton and the Morris water maze. In a recent Hippocampus
      Forum, evidence for the cognitive map hypothesis was reviewed in a lead article
      by Nadel, followed by a series of commentaries by leading investigators of
      hippocampal function. This speculative commentary offers an alternative not
      represented in the forum--that the function of the hippocampus in spatial
      learning is not as a cognitive map, but that it subserves another function
      proposed by Tolman in his work on simple discrimination learning, vicarious trial
      and error, based on incipient, conflicting dispositions to approach and avoid.

PMID- 8353609
TI  - Epilepsy induced collateral sprouting of hippocampal mossy fibers: does it induce
      the development of ectopic synapses with granule cell dendrites?
AB  - In the present study, using Golgi and electron microscopy techniques,
      experimentally induced epilepsy (kindling and kainate treatment) elicited
      collateral sprouting of mossy fibers in rat hippocampus. Collateral branches
      invade the hilus, cross the granule cell layer, and distribute throughout the
      inner third of the molecular layer. These newly developed collaterals may acquire
      the typical features of mossy fibers including giant fiber varicosities
      (mousses), although the mean surface of these mousses was thinner in these
      collaterals than in terminal branches. Granule cell dendrites may develop giant
      thorny excrescences, suggesting that the targets of these collaterals are granule
      cells. Giant synaptic boutons appear in the inner third of molecular layer of
      epileptic rats. These boutons acquire the morphological features of mossy fiber
      boutons and made multiple synaptic contacts with dendritic spines. The analysis
      of the profile types suggests that some of the newly developed collateral mossy
      fibers made hypotrophic synaptic contacts.

PMID- 8353610
TI  - Neurochemical development of the hippocampal region in the fetal rhesus monkey.
      I. Early appearance of peptides, calcium-binding proteins, DARPP-32, and
      monoamine innervation in the entorhinal cortex during the first half of gestation
      (E47 to E90).
AB  - Although the entorhinal cortex is a key structure connecting the hippocampal
      formation with the rest of the cerebral cortex, little is known about its early
      chemoanatomical development in primates. In the present study, a
      cytoarchitectonic analysis and immunocytochemical detection of somatostatin,
      neurotensin, parvalbumin, calbindin-D 28K, DARPP-32, as well as tyrosine
      hydroxylase, dopamine-beta-hydroxylase, and serotonin, were carried out on serial
      sections of the entorhinal cortex of six rhesus monkey fetuses aged E47 to E90
      (gestation period 165 days). At E56 the cortical plate of the entorhinal cortex
      already exhibited a sublamination; at E64 the lamina dissecans was partly formed,
      allowing the emergence of the lamina principalis externa and interna, and at E83
      most of the regional and laminar subdivisions characteristic of the adult cortex
      could be identified, except for the rhinal sulcus restricted to a small dimple.
      The neurochemical development paralleled the early cytoarchitectonic
      differentiation, both largely preceding that of the neighboring cortical areas.
      The somatostatin-like immunoreactive innervation, first detected at E56, was very
      dense as early as E64 and displayed by E83 a laminar distribution similar to that
      found in the adult. Labeled neurons indicated an intrinsic origin for this
      innervation but an extrinsic connection might be present as labeled fibers in the
      subplate of the entorhinal cortex were in continuity with positive fibers in the
      intermediate zone of the hippocampal formation. A faint neurotensin-like
      immunoreactivity first detected at E64 became prominent at E83 in the entorhinal
      cortex but stopped abruptly at the anlage of the rhinal sulcus. The lack of
      neurotensin-labeled neurons contrasted with their presence in other parts of the
      hippocampal region and suggested a precocious extrinsic connection. Only rare
      parvalbumin-LIR neurons were detected at midgestation, whereas calbindin-D 28K
      was expressed from E47 on in Cajal-Retzius cells and from E56 on in various types
      of neurons in the cortical plate and subplate. Most characteristic was a category
      of medium-sized, deeply stained calbindin-LIR neurons, present only in the lamina
      principalis externa and possibly corresponding to the population of large neurons
      described by Kostovic et al. (1990, Soc Neurosci Abstr 16:846) in early
      developing entorhinal cortex of human fetuses. These and probably other neurons
      were also DARPP-32-positive, suggesting the possibility of an early dopaminergic
      regulation. Indeed, the monoaminergic innervation of the entorhinal cortex was
      detected from E56 on and gradually increased in density, displaying areal and
      laminar differences in the distribution of the dopaminergic, noradrenergic, and
      serotoninergic afferents.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8353611
TI  - Phase relationship between hippocampal place units and the EEG theta rhythm.
AB  - Many complex spike cells in the hippocampus of the freely moving rat have as
      their primary correlate the animal's location in an environment (place cells). In
      contrast, the hippocampal electroencephalograph theta pattern of rhythmical waves
      (7-12 Hz) is better correlated with a class of movements that change the rat's
      location in an environment. During movement through the place field, the complex
      spike cells often fire in a bursting pattern with an interburst frequency in the
      same range as the concurrent electroencephalograph theta. The present study
      examined the phase of the theta wave at which the place cells fired. It was found
      that firing consistently began at a particular phase as the rat entered the field
      but then shifted in a systematic way during traversal of the field, moving
      progressively forward on each theta cycle. This precession of the phase ranged
      from 100 degrees to 355 degrees in different cells. The effect appeared to be due
      to the fact that individual cells had a higher interburst rate than the theta
      frequency. The phase was highly correlated with spatial location and less well
      correlated with temporal aspects of behavior, such as the time after place field
      entry. These results have implications for several aspects of hippocampal
      function. First, by using the phase relationship as well as the firing rate,
      place cells can improve the accuracy of place coding. Second, the characteristics
      of the phase shift constrain the models that define the construction of place
      fields. Third, the results restrict the temporal and spatial circumstances under
      which synapses in the hippocampus could be modified.

PMID- 8353612
TI  - Learning and memory after adrenalectomy-induced hippocampal dentate granule cell
      degeneration in the rat.
AB  - Adrenalectomy (ADX) of normal adult rats causes selective hippocampal dentate
      granule cell degeneration that is prevented by corticosterone. The ability to
      destroy this one hippocampal cell type noninvasively made it possible to address
      the role of the dentate granule cells in learning and memory. Four months after
      ADX, 31 of 45 rats failed to show obvious granule cell loss and displayed
      behavior in the Morris water maze that was similar to 16 sham-operated control
      rats and 16 ADX rats maintained on corticosterone throughout the study.
      Conversely, 14 of the 45 ADX rats experienced a loss of granule cells that varied
      from minimal to extensive. Although there were no obvious differences between
      groups in motoric and motivational characteristics or search strategies, ADX rats
      with moderate to extensive granule cell loss acquired place learning slightly
      slower than controls or ADX rats with minimal or no obvious cell loss.
      Furthermore, the ADX rats with moderate to extensive cell loss were temporarily
      impaired following alteration of either intramaze or extramaze cues compared to
      controls. In contrast, the rats with granule cell loss remembered an old place
      and learned a new place as quickly as controls. These results suggest that a
      normal complement of dentate granule cell may not be necessary for the
      acquisition or retention of spatial information in the Morris water maze.

PMID- 8353613
TI  - Activation, travel distance, and environmental change influence food carrying in
      rats with hippocampal, medial thalamic and septal lesions: implications for
      studies on hoarding and theories of hippocampal function.
AB  - Rats transport food from exposed areas to covered areas where they eat it or
      leave it. Although there is evidence that limbic structures play a role in food
      transport, their role is controversial. Here it was found that although many rats
      with large hippocampal, septal/diagonal band of Broca or dorsomedial thalamic
      lesions did not carry food but ate it where they found it, a few presentations of
      an auditory stimulus could restore food carrying. Once restored, most features of
      food carrying in hippocampal rats were normal in relation to food presentation
      schedules, deprivation levels, ambient illumination, circadian cycles, food size,
      and eating times. Nevertheless, food carrying impairments re-emerged when the
      testing environment was changed. Hippocampal rats were also excessively
      responsive to increases in travel distance and stopped carrying food at distances
      over which control rats would still carry large food pellets. Auditory
      stimulation did not restore food carrying over long travel distances. The
      findings that sensory stimulation, environmental change, and travel distance
      influence food carrying probabilities in rats with limbic system lesions is
      discussed in relation to research on limbic control of food hoarding and theories
      of limbic system function.

PMID- 8353614
TI  - Maps, routes, and the hippocampus: a neural network approach.
AB  - This study describes hippocampal participation in maze navigation in terms of a
      real-time, biologically plausible neural network. The system is composed of (1) a
      goal-seeking mechanism, (2) a cognitive map system, and (3) a route system. The
      goal-seeking mechanism displays exploratory behavior until either the goal is
      found or a sufficiently strong prediction of the goal is generated. The cognitive
      map is a topological map that stores associations between places and views of
      accessible places, and between places and reward. The route system establishes
      associations between cues and reward. Both systems compete with each other to
      establish associations with the reward, with the cognitive system generally
      overshadowing the route system. In agreement with previous models, it is assumed
      that the hippocampus modulates the storage of cognitive maps in cortical areas
      and mediates the competition between cognitive maps and route systems. After
      hippocampal lesions, animals navigate through mazes making use of the route
      system. Computer simulations show that the network effectively describes latent
      learning, detour behavior, and place learning in normal and hippocampal- and
      cortical-lesioned animals.

PMID- 8353615
TI  - Sources of variation in phonetograms.
AB  - Despite the growing popularity of the phonetogram or F0-SPL Profile in the United
      States and its continuing use in Europe, it is generally acknowledge that a wide
      range of results are obtained by different investigators using the technique.
      Nonuniformity of results calls into question the basic validity of the method as
      a descriptor of vocal function limits. This article reviews some of the more
      common diversities in methods among investigators and suggests that variation of
      results in voice profiles may be as much an indication of nonstandardization of
      technique as in the inherent variability of subjects.

PMID- 8353616
TI  - Phonatory control in male singing: a study of the effects of subglottal pressure,
      fundamental frequency, and mode of phonation on the voice source.
AB  - This article describes experiments carried out in order to gain a deeper
      understanding of the mechanisms underlying variation of vocal loudness in
      singers. Ten singers, two of whom are famous professional opera tenor soloists,
      phonated at different pitches and different loudnesses. Their voice source
      characteristics were analyzed by inverse filtering the oral airflow signal. It
      was found that the main physiological variable underlying loudness variation is
      subglottal pressure (Ps). The voice source property determining most of the
      loudness variation is the amplitude of the negative peak of the differentiated
      flow signal, as predicted by previous research. Increases in this amplitude are
      achieved by (a) increasing the pulse amplitude of the flow waveform; (b) moving
      the moment of vocal fold contact earlier in time, closer to the center of the
      pulse; and (c) skewing the pulses. The last mentioned alternative seems dependent
      on both Ps and the ratio between the fundamental frequency and the first formant.
      On the average, the singers doubled Ps when they increased fundamental frequency
      by one octave, and a doubling of the excess Ps over threshold caused the sound
      pressure level (SPL) to increase by 8-9 dB for neutral phonation, less if mode of
      phonation was changed to pressed. A shift of mode of phonation from flow over
      neutral to pressed was associated with a reduction of the peak glottal
      permittance i.e., the ratio between peak transglottal airflow to Ps. Flow
      phonation had the most favorable relationship between Ps and SPL.

PMID- 8353617
TI  - Superimposition of speaking voice characteristics and phonetograms in untrained
      and trained vocal groups.
AB  - This study details a comparison of the speaking F0 and intensity values of young
      male and female adults with and without vocal training, as well as the
      superimposition of the speaking F0 and intensity data upon phonetograms. Results
      indicated that (a) trained vocalists have similar mean speaking F0's than do
      untrained vocalists, but exhibit significantly greater speaking F0 ranges than do
      untrained vocalists; (b) trained vocalists are significantly greater mean
      intensity levels in speech, as well as significantly greater speaking intensity
      ranges than do untrained vocalists; (c) the mean speaking F0 for both trained and
      untrained vocalists was found in the vicinity of the 5-7% frequency level of the
      entire phonational F0 range (in Hz), equivalent to 12-16% of the phonational F0
      range in semitones; (d) the overall speech area (mean speaking F0 and minimum and
      maximum speaking F0 peaks) was found in the lower 23-31% of the entire
      phonational F0 range (in semitones), with the untrained subjects utilizing the
      lower 25% of the phonational range (in semitones) and the trained subjects
      extending this area to the lower 28-31%; and (e) significant correlations were
      observed between the total intensity range and intensity range used in speech in
      trained female vocalists and between total F0 range and speaking F0 range in the
      combined trained male and female group. These results have important implications
      for the use of the phonetogram, as well as the clinical applicability of vocal
      training exercises in various speech and voice therapy cases.

PMID- 8353618
TI  - Airflow measurements: theory and utility of findings.
AB  - The biomechanical movements of vocal structures are shown to control flow of
      expiratory air for the production of speech sounds. Laminar and turbulent air
      flow are discussed as they relate to sound generation. Theoretic and therapeutic
      utility of air flow profiles in differentiating linguistic contrasts and vocal
      characteristics are discussed along with considerations of relative utility and
      accuracy for various flow-measuring devices and strategies.

PMID- 8353619
TI  - Inverse-filtered air flow and EGG measures for sustained vowels and syllables.
AB  - The purpose of this investigation was to compare the effects of two speaking
      tasks on laryngeal measures obtained from inverse-filtered air flow and
      electroglottograph (EGG) waveforms. Flow amplitude, air flow duty cycle, EGG duty
      cycle, and fundamental frequency were measured for normal young and aged adults
      during vowel prolongation and syllable repetition. There were significant between
      task differences for flow amplitude and fundamental frequency. Variability
      appeared no greater for syllable repetition than vowel prolongations. Syllable
      repetition was slightly better than vowel prolongation for differentiating the
      vocal behaviors of aged and young speakers. Between-task relationships were
      strong for fundamental frequency and more moderate for the other laryngeal
      measures. It was concluded that syllable repetition would be preferable to vowel
      prolongation for measurement of aerodynamic and EGG parameters and that findings
      could be generalized across speaking tasks for fundamental frequency but not air
      flow and duty cycle measures.

PMID- 8353620
TI  - Laryngeal and respiratory activity during vocalization in macaque monkeys.
AB  - The present study describes the laryngeal and respiratory muscle activity
      associated with vocalizations in macaque monkeys. During the bark vocalization, a
      short, aperiodic call, the cricothyroid, thyroarytenoid, rectus abdominis, and
      intercostals were active while the posterior cricoarytenoid and diaphragm were
      quiet. During the coo vocalization, a longer, clear call, the cricothyroid,
      thyroarytenoid, intercostals, rectus abdominis, and diaphragm were active. In one
      monkey, the posterior cricoarytenoid was also active during the call, while in
      another monkey it was not. Laryngeal muscle activity was correlated with the
      amplitude and duration of the coo call. Results suggest that the amplitude and
      duration differences between calls are determined primarily by laryngeal
      modification of the airflow, and that the differences in posterior cricoarytenoid
      activity may be due to differences in voice intensity.

PMID- 8353621
TI  - Vocal attrition in voice students: survey findings.
AB  - A questionnaire designed in part to survey symptoms of vocal attrition and
      possible factors contributing to it was administered to 79 university female
      voice students. Of the 74 students (94%) completing the questionnaire, 10 (13%)
      were free of symptoms, 19 (26%) had few (one or two), and 45 (61%) had multiple
      (three or more) symptoms. Thirty-five students (47%) had sought medical help for
      voice problems since they began their singing career. Students with multiple
      symptoms were significantly more likely to (a) be bothered, frustrated, worried,
      depressed, or anxious about their voice; (b) quit performance, forgo audition,
      limit their repertoire, or quit singing altogether; (c) speak in a voice that is
      too low in pitch; and (d) have a general tendency to worry, be depressed or
      anxious, or have mood swings. The clinical implications of these and other
      findings are discussed.

PMID- 8353622
TI  - A critical view of the yawn-sigh as a voice therapy technique.
AB  - The purpose of this study was to take a critical look at a voice therapy
      technique known as the yawn-sigh. The voiced sigh as an approach in voice therapy
      has had increased use in recent years, particularly with problems of vocal
      hyperfunction. In this study, the physiology of the yawn-sigh was studied with
      video nasoendoscopy in eight normal subjects; their taped voices were also
      studied acoustically for possible fundamental frequency and format changes in
      producing selected vowels under normal and sigh conditions. Although each subject
      was given a model by the examiner of a yawn-sigh, one of the eight subjects could
      not produce a true yawn-sigh. Endoscopic findings for seven of the eight subjects
      performing the yawn-sigh demonstrated retracted elevation of the tongue, a lower
      positioning of the larynx, and a widened pharynx. Acoustic analyses for the seven
      subjects producing the sigh found a marked lowering of the second and third
      formants. Implications for using the yawn-sigh in voice therapy are given, such
      as using a modified "silent" yawn-sigh, as an easy method for producing greater
      vocal tract relaxation.

PMID- 8353623
TI  - Sarcoidosis of the larynx: preserving and restoring airway and professional
      voice.
AB  - Professional voice users may present with disastrous dysponia and life
      threatening upper airway disturbances due to a rare condition. Two teachers
      demonstrated extrathoracic obstructive laryngeal lesions by videolaryngoscopy and
      pulmonary function flow-volume loops. A characteristic "honking" voice and
      edematous, pink, diffuse turban-like enlargement of the supraglottic structures
      are considered pathognomonic of laryngeal sarcoidosis. Diagnosis was confirmed by
      biopsies, and clinical and radiologic findings. Sarcoidosis is a variable,
      disseminated disease involving many body organs, self-limited or progressive,
      with frequent exacerbations and remissions, affecting the larynx in 0.5-1.4% of
      patients. Spinal cord involvement demonstrated by new magnetic resonance imaging
      techniques can be heralded by voice changes detected in professional voice users.
      Systemic corticosteroid therapy combined with intralesional steroid injections
      and microendoscopic surgery, with or without tracheostomy, preserved and restored
      both professional voice and airway.

PMID- 8353624
TI  - Overtone singing: productive mechanisms and acoustic data.
AB  - Overtone singing is where one person sings in two voices, the first voice
      represented by the fundamental and the second by an enhanced harmonic. Overtone
      singing is performed in chest register. Tuning of the first or second formant and
      a reduction of the formant bandwidth down to 20 Hz make harmonics prominent.
      Narrowing the pharynx, velar constriction, variation of the small mouth opening,
      and a tension of the walls of the mouth cavity are used. Changing prominent
      harmonics has the effect of creating an overtone melody with sustained tones,
      tone steps, and trillos.

PMID- 8353625
TI  - Laryngeal biomechanics: an overview of mucosal wave mechanics.
AB  - The biomechanics of wave propagation in viscoelastic materials can be useful in
      understanding the nature of normal and pathologic vocal fold vibration. Mucosal
      wave movement is the primary means by which the larynx transforms the egressive
      pulmonary air flow into sound. This short tutorial describes a number of concepts
      fundamental to the understanding of the vocal fold traveling wave. The
      displacement velocity of the vocal folds is shown to be proportional to the wave
      speed, which in turn is proportional to the elastic modulus or stiffness of the
      vocal folds. Finally, a few cases of unilateral paralysis are used to demonstrate
      how vocal fold stiffness, entrainment, and degree of vocal fold closure interact
      to create the complex vibratory patterns that occur in disordered laryngeal
      states. It is emphasized that surgical voice restoration must consider these
      properties of the mucosal wave to improve phonatory function.

PMID- 8353626
TI  - Perceptual evaluations of voice scatter in unison choir sounds.
AB  - The preferences of experiences listerners for pitch and formant frequency
      dispersion in unison choir sounds were explored using synthesized stimuli. Two
      types of dispersion were investigated: (a) pitch scatter, which arises when
      voices in an ensemble exhibit small differences in mean fundamental frequency,
      and (b) spectral smear, defined as such dispersion of formants 3 to 5 as arises
      from differences in vocal tract length. Each stimulus represented a choir section
      of five bass, tenor, alto, or soprano voices, producing the vowel [u], [a], or
      [ae]. Subjects chose one dispersion level out of six available, selecting the
      "maximum tolerable" in a first run and the "preferred" in a second run. The
      listeners were very different in their tolerance for dispersion. Typical scatter
      choices were 14 cent standard deviation for "tolerable" and 0 or 5 cent for
      "preferred." The smear choices were less consistent; the standard deviations were
      12 and 7%, respectively. In all modes of assessment, the largest dispersion was
      chosen for the vowel [u] on a bass tone. There was a vowel effect on the smear
      choices. The effects of voice category were not significant.

PMID- 8353627
TI  - Quantitative evaluation of phonetograms in the case of functional dysphonia.
AB  - According to the laryngeal clinical findings, figures making up a scale were
      assigned to vocally trained and vocally untrained persons suffering from
      different types of functional dysphonia. The different types of dysphonia--from
      the manifested hypofunctional to the extreme hyperfunctional dysphonia--were
      classified by means of this scale. Besides, the subjects' phonetograms were
      measured and approximated by three ellipses, what rendered possible the
      definition of phonetogram parameters. The combining of selected phonetogram
      parameters to linear combinations served the purpose of a phonetographic
      evaluation. The linear combinations were to bring phonetographic and clinical
      evaluations into correspondence as accurately as possible. It was necessary to
      use different kinds of linear combinations for male and female singers and
      nonsingers. As a result of the reclassification of 71 and the new classification
      of 89 patients, it was possible to graduate the types of functional dysphonia by
      means of computer-aided phonetogram evaluation with a clinically acceptable error
      rate. This method proved to be an important supplement to the conventional
      diagnostics of functional dysphonia.

PMID- 8353628
TI  - Belting and pop, nonclassical approaches to the female middle voice: some
      preliminary considerations.
AB  - There is a commonly perceived difference in the sound produced in the approximate
      range D4-D5 by female singers in the western opera and concert tradition, on the
      one hand, and certain other styles, including rock, pop, folk, and some Broadway
      musicals, on the other. The term "belting" is sometimes used to refer to at least
      one approach to such "nonclassical" singing. In this study, based on
      spectrographic, electroglottographic, and sub- and supraglottal pressure
      measurements on representative voices of the "operatic" and "nonclassical"
      tradition, acoustic and laryngeal differences between the two traditions are
      described, and an objective, specific definition of "belting" is offered.

PMID- 8353629
TI  - Vocal matching of frequency modulation in synthesized vowels.
AB  - Nine male singers attempted to match rates and extents of synthesized vocal
      vibrato at low, middle, and high pitch levels. The results showed that on
      average, the singers were able to match rates of 3, 5, and 7 Hz within 13%. It
      was difficult for the singers, however, to match extents of 0.5, 1.0, and 1.5
      semitones. Thus, the results indicated singers' reasonably good ability to match
      rates but, contrary to prevalent opinions, not extents of vocal vibrato.

PMID- 8353630
TI  - Intervention with young voice users: a clinical perspective.
AB  - This diverse group is described in relation to life stage, short- and long-range
      performance objectives, and lifestyle factors pertinent to vocal health.
      Physical, behavioral, cognitive, and psychosocial issues relevant to assessment
      and intervention will be addressed. The possible dissonance between a clinician's
      developmental perspective and a client's immediate pragmatic concerns is
      discussed. In addition, the specific challenges of dealing with adolescents
      (e.g., the influence of the peer group, the emergence of autonomy, the
      redefinition of relationships with significant adults, and the vulnerability of
      the mechanism) are related to clinical problem solving.

PMID- 8353631
TI  - Perceptual-acoustic relationships in spasmodic dysphonia.
AB  - Perceptual ratings were obtained from voice samples of 19 patients with adductor
      spasmodic dysphonia before and 1 week after unilateral treatment with Botulinum
      toxin. Five experienced listeners judged samples of sustained phonation using a
      seven-point equal-interval scale. The perceptual parameters assessed were overall
      severity, strain-strangled voice quality, and breathiness. Perceptual results
      were related to the standard deviation of fundamental frequency and the voice
      break factor, two acoustic parameters previously shown to be significantly
      improved following Botulinum toxin injection. Results indicate that in general
      the spasmodic dysphonia voice is perceived as less severe, less strain-strangled,
      and more breathy 1 week after treatment. Interrelations among perceptual
      parameters and relationships with acoustic analyses are discussed.

PMID- 8353632
TI  - Long-term results of recurrent laryngeal nerve resection for adductor spasmodic
      dysphonia.
AB  - From a total of 43 adductor spasmodic patients over a 10-year period, 11
      underwent resection of a portion of the recurrent laryngeal nerve on one side.
      The initial results were excellent but a varying degree of recurrence took place
      in 8 patients. In 4, a reoperation was done. At the final follow-up, 2-8 years
      after the primary operation, 4 patients were no longer suffering from spasmodic
      dysphonia, another 5 were better off than before surgery, and 1 remained
      unchanged. Only 1 was worse off. Electromyographic findings indicated that the
      recurrence of symptoms was due to regeneration of the nerve fibers.

PMID- 8353633
TI  - Tracking change in dysphonia: a case study.
AB  - This longitudinal case study of a woman with nodules examines the relationship
      between clinical and acoustic measures of change. Relative changes in voice
      quality, vocal fold condition, and patient symptoms were compared to measures of
      mean fundamental frequency (MFF), jitter, and fundamental frequency range (FFR).
      Seven assessments were performed over a 2-year period. The findings indicated
      that voice quality judgments tended to relate to changes in degree of vocal fold
      pathology and patient report of vocal function. However, acoustic measures of
      MFF, FFR, and jitter did not relate to measures of clinical change. The
      discussion focuses on explanations for the acoustic findings, the need for using
      connected speech samples for perceptual and acoustic analysis, and a suggestion
      for future study.

PMID- 8353634
TI  - Vocal fold exposure in phonosurgery.
AB  - A difficult laryngeal exposure is made easier by placement of the patient's head
      and neck into the Boyce-Jackson "sniffing position" and then flexing them further
      if necessary, by selection of a laryngoscope appropriate to the patient and to
      the triangular glottic shape, by placement of the laryngoscope along the path of
      least resistance, by use of a true suspension device in order to apply the force
      for laryngoscopy towards the larynx and away from the teeth and gums, and by
      allowing time for the force to work. With these techniques, an easy exposure is
      made almost perfect. The true vocal folds are exposed from vocal process to
      anterior commissure without the need for external pressure, the endotracheal tube
      remains out of sight between the arytenoids, and there is no risk to the teeth,
      gums, and cervical spine.

PMID- 8353635
TI  - Vocal tract acoustics.
AB  - This paper considers the topic of vocal tract acoustics from the three
      perspectives: (a) the acoustic theory of speech production; (b) contemporary
      laboratory methods for acoustic analysis, and (c) measurement of the acoustic
      signal of speech. Linear source-filter theory is the standard acoustic theory of
      speech production and is the foundation for remarkable advances in the analysis
      and synthesis of speech. Digital signal processing, the dominant laboratory
      method for speech analysis, enables the acquisition and recording of the acoustic
      speech signal but also implements quantitative algorithms largely based on linear
      source-filter theory. Measurements of the acoustic signal reflect the acoustic
      theory of speech production, laboratory methods for signal analysis, and
      principles of experimental phonetics. Basic issues in the three domains of
      theory, laboratory methods, and measurement are summarized as they pertain to the
      interests of the voice scientist, voice clinician, and voice teacher.

PMID- 8353636
TI  - That golden voice--talent or training?
AB  - This article is an updating and expansion of a lecture presented at the
      Thirteenth Symposium on the Care of the Professional Voice, New York, June 1984;
      a somewhat limited version of the manuscript was published in the Transcripts of
      that symposium. Basically, an attempt will be made by an observer from another
      field to lay the groundwork for the better understanding of the "voice teacher."
      Accordingly, some of the dialogue to follow may be a little informal; it
      certainly is interpretive. The latter portion of the discussion will involve
      suggestions/illustrations that may be useful in further enhancing this somewhat
      underrated field and bonding it to others. While the comments found below reflect
      only the opinions of the author, it is fair to state that most of them have been
      articulated by others.

PMID- 8353637
TI  - Physical definition of the "flageolet register".
AB  - The highest "register" of the female singing voice, often called the "flageolet
      register" (also called "flute register," "bell register," etc., as well as the
      misleading term "whistle register"), is broadly recognized by voice pedagogues,
      but not generally defined in terms that are adequate for objective description.
      This article presents a description of characteristic patterns of vocal fold
      movement and of vocal tract formants that are specific for the register.
      Measurements are made by electroglottograph, pharyngeally placed wide-band
      pressure transducers, and an external microphone in professional soprano subjects
      who are adept in using this register.

PMID- 8353638
TI  - Supralaryngeal muscle activity during sustained vibrato in four sopranos: surface
      EMG findings.
AB  - Four classically trained sopranos, aged 22-41 years, sustained a vibrato at a
      comfortable loudness level, and at different vowels (/u/, /i/, or /a/) and pitch
      levels (220, 277, 349, 440, 554, 698, or 880 Hz). Pairs of surface electrodes
      were placed on each singer's right side over the submandibular region, the
      thyroid cartilage, mandibular ramus, and upper lip to record electromyographic
      (EMG) activity from the anterior suprahyoid (ASH), extralaryngeal (ELAR),
      massetter (MAS), and perioral (PER) muscles, respectively. A headset-mounted
      miniature microphone transduced the voice, and a Kay Visi-Pitch extracted the
      voice fundamental frequency (F0). The output of the Visi-Pitch, a voltage analog
      of the F0 (VF0), and the EMG signals were digitized, the EMG signals rectified
      and smoothed, and the VF0 and smoothed EMG signals were subjected to Fast Fourier
      Transform (FFT) analysis. Spectral peaks in the FFT records indicated vibrato
      related activity in the ASH and ELAR muscles, with occasional vibrato-related
      activity in the MAS and PER muscles. The role of supralaryngeal muscles in
      vibrato is discussed.

PMID- 8353639
TI  - Phonational profiles of female professional singers and nonsingers.
AB  - Measures of the SFF, vocal intensity, phonational range, and habitual pitch level
      are reported for 39 professional singer and 39 nonsinger females, who were
      divided into three age groups (young, middle, and old age), with the
      professionals further divided into sopranos and altos. Each read the "Rainbow
      Passage" and spoke extemporaneously, from which measures of the SFF and vocal
      intensity were calculated; phonational range and habitual pitch levels were also
      determined. No significant differences were noted between the reading and
      speaking tasks. The SFF and intensity levels were significantly higher for the
      professionals in comparison to the nonsingers, but only for certain age groups.
      Moreover, whereas the nonsinger SFF levels varied significantly as a function of
      age, those for the professional singers did not. Although trends occurred, no
      significant differences were found for the mean phonational range or habitual
      pitch levels when the professionals and nonsingers were compared.

PMID- 8353640
TI  - Short-term variation of subglottal pressure for expressive purposes in singing
      and stage speech: a preliminary investigation.
AB  - According to previous investigations, subglottal pressure in singing is adapted
      not only to loudness but also to fundamental frequency. Here the significance of
      musical expression to subglottal pressure is analyzed in terms of alternations
      between stressed and unstressed bar positions. Esophageal pressure was recorded
      together with the audio signal in a male and a female professional singer using a
      paranasally introduced pressure transducer while the subjects performed vocal
      exercises. Also, the subjects gave examples of actors' speech by reading poetry
      aloud. The results show that subglottal pressure can be used for stressing the
      first beat in bars and also for increasing the sound level in voiced consonants
      in actor's speech.

PMID- 8353641
TI  - Interactive effects of local smoothing window size and fundamental frequency on
      shimmer calculation.
AB  - Slow amplitude modulation of human voice was approximated by a sinusoidal wave.
      The theoretical effects of smoothing window size, F0, and modulation frequency on
      window amplitude average as well as calculated shimmer were mathematically
      derived. Subsequently, the theoretical predictions were tested using idealized
      and real voice signals from normal speakers. The theoretical and experimental
      results suggest that shimmer (when calculated using a smoothing window) is a
      function of window duration and modulation frequency. Window duration when
      defined as a constant number of pitch periods varies from speaker to speaker
      depending on their F0. It may not be desirable to use local smoothing windows
      with a constant number of cycles for shimmer computation, especially if voices
      with known low-frequency amplitude modulations but notably different fundamental
      frequencies are compared.

PMID- 8353642
TI  - Effects of the manual laryngeal musculoskeletal tension reduction technique as a
      treatment for functional voice disorders: perceptual and acoustic measures.
AB  - During a 2-year period, 17 patients with "functional dysphonia" were assessed and
      managed in a hospital setting. A single treatment approach, known as manual
      laryngeal musculoskeletal tension reduction, was employed. The effects of the
      therapy regimen were analyzed using perceptual and acoustical measures of vocal
      function. The results indicated a significant change in the direction of "normal"
      vocal function in the majority of patients within one treatment session.
      Perceptual measures of severity were consistently more likely to be rated as
      normal following treatment. Acoustic measures of voice confirmed significant
      improvements in jitter, shimmer, and signal-to-noise ratio (SNR). Results are
      discussed in terms of the clinical utility and effectiveness of this treatment
      approach for functional dysphonia.

PMID- 8353643
TI  - Pushing exercise program to correct glottal incompetence.
AB  - A voice therapy program using pushing exercises to correct glottal incompetence
      is described. The program utilizes various types of instrumentation to determine
      whether or not a given patient is likely to benefit from the treatment. The
      program also provides feedback of target voices. Three cases with incomplete
      glottal closure and subsequent vocal dysphonia characterized by an asthenic
      breathy quality are used to illustrate the program. Details of the program,
      termination criteria, and problems and precautions learned from treating 29
      patients over a 3-year period are presented.

PMID- 8353644
TI  - Voice: a historical perspective. L. V. Shcherba and the concept of linguistic
      experimental phonetics.

PMID- 8353645
TI  - Russian vowels in qualitative and quantitative respects.

PMID- 8353646
TI  - Safety of a new, ultrafiltrated whey hydrolysate formula in children with cow
      milk allergy: a clinical investigation.
AB  - The purpose of this study was to determine whether a new ultrafiltrated whey
      hydrolysate infant formula, Profylac, could be administered safely to children
      with cow milk protein allergy/intolerance. Profylac has a stated molecular weight
      of < 8 kD and at least 30,000 times reduced antigenicity which is controlled by a
      combination of ELISA-techniques and immunochemical methods. The study comprised
      66 children with cow milk protein allergy/intolerance diagnosed by controlled
      elimination/challenge procedures. The children were aged 1 month-14.5 years,
      median 1 11/12 years and 15 were below 1 year. Thirty-five of these children had
      proven IgE-mediated reactions (cow milk protein allergy). Sixty-one of the
      children had at least two different symptoms and 31 had concomitant allergies to
      other foods and/or inhalants. All 66 children underwent and tolerated open,
      controlled challenges with Profylac. A total of 64 children continued having
      Profylac daily for at least 3 months and 58 for at least 6 months after
      challenge. Nine of the children older than 1 year did not like the taste and only
      had Profylac in minor amounts. No side effects were registered. Fifteen of the
      infants were below 1 year of age, and this group was compared with an age matched
      group of 16 infants challenged with and fed an extensively hydrolysed casein
      hydrolysate, Nutramigen. All the infants in these two groups accepted and
      tolerated Profylac and Nutramigen, respectively, and no side effects were
      registered. Among the 35 patients with IgE-mediated reactions 6% (2/35) had
      positive skin prick tests and 11% (3/28) had specific IgE class 2 against
      Profylac, 2 of the latter before intake of Profylac.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8353647
TI  - Interferon-gamma production by cord-blood mononuclear cells is reduced in
      newborns with a family history of atopic disease and is independent from cord
      blood IgE-levels.
AB  - For newborn children both elevated serum IgE levels in the cord blood and a
      positive family history of atopic disease have been shown to be risk factors for
      the manifestation of atopic diseases. In adult patients with atopic dermatitis,
      in vitro interferon-gamma (IFN-gamma) production is reduced and a negative
      correlation with serum IgE levels has been shown. We have now raised the question
      if newborn infants at risk for the development of atopic disease have similar
      abnormalities of cytokine production at birth. In vitro production of interleukin
      2, interleukin 6 and interferon-gamma by peripheral blood mononuclear cells was
      measured in 53 newborns: 21 had cord blood IgE levels above 0.9 kU/l, 21 had a
      positive family history, 7 had both elevated IgE and a positive family history;
      18 newborns with no identifiable risk for atopic disease served as controls.
      Umbilical cord blood mononuclear cells were stimulated with PHA or monoclonal
      antibody OKT3. In vitro production of interleukin 2 and 6 was comparable in all
      groups. Compared to controls IFN-gamma production of peripheral mononuclear cells
      (PBMC) from newborns with elevated cord blood IgE was not different, but PMBC
      from newborns with a familial risk showed a significant decrease in PHA induced
      IFN-gamma production (p < 0.005, U-test). No correlation between umbilical cord
      blood IgE and diminished IFN-gamma production was found in newborns with or
      without a positive family history. We conclude that immunoregulatory
      abnormalities in newborns of atopic families are detectable already at birth and
      are unrelated to cord blood IgE.

PMID- 8353648
TI  - Wiskott Aldrich syndrome: an immunodeficiency syndrome not rare in Western
      Australia.
AB  - Wiskott Aldrich syndrome, a combined cellular and humoral X-linked
      immunodeficiency, is generally considered to be rare. The aim of this study was
      to ascertain the true prevalence in the paediatric population in Western
      Australia, describe the clinical features, and summarise the current literature
      on this unusual condition. All cases of Wiskott Aldrich syndrome presenting to
      Princess Margaret Hospital in Perth during the period from January 1960 to
      January 1990 were identified by a retrospective review of case records and by
      interviewing hospital immunology, haematology and general clinical staff. Nine
      cases of Wiskott Aldrich syndrome are described, demonstrating that the
      prevalence of Wiskott Aldrich syndrome in Western Australia is nine times that
      expected from previous reports. Death occurred in a number of patients before the
      correct diagnosis was recognised. The clinical features in this group are quite
      variable. Low isohaemagglutinins, elevated IgE, blunted DTH skin multitest, and
      very low CD8 numbers are however consistent features. Wiskott Aldrich syndrome
      may be more prevalent than previously recognised, and should be considered in
      males with thrombocytopenia and infection.

PMID- 8353649
TI  - Budesonide: safety and efficacy aspects of its long-term use in children.
AB  - Fifty-two asthmatic children aged 4 to 13 years (mean 9.6) were enrolled in this
      open 12-month study of budesonide, 200 mcg bid, administered by tube-spacer
      inhaler (INHALET, ASTRA DRACO). The aim of the study was to assess long-term
      safety, as well as efficacy, of budesonide in children whose asthma was not
      adequately controlled by their current therapy. Children attended the clinic
      every three months for assessment of lung function and height. In addition, an
      adrenal function test and routine clinical chemistry and haematology were
      performed. Parents completed diary cards once each week, recording the child's
      PEF, asthma symptoms, beta 2-agonist consumption and other medication (no
      prophylactic drugs or other inhaled steroids were allowed and oral steroids were
      used for emergency treatment only). There were significant increases in all
      clinic lung function tests (baseline to last visit) and in diary card PEF (first
      3 months vs last 3 months). These were accompanied by decreases in asthma
      symptoms and use of beta 2-agonists or other medication. There was no indication
      that growth was affected by study treatment and basal adrenal function (basal
      cortisol) did not change significantly throughout the study. The adrenal response
      to Synacthen had actually increased significantly by the end of the study. No
      serious adverse events were associated with budesonide treatment. In conclusion,
      regular budesonide therapy was associated with a significant improvement in lung
      function and symptoms over one year. Budesonide was well-tolerated by the
      children and appeared to have no adverse influence on either growth or adrenal
      function.

PMID- 8353650
TI  - Effect of disodiumcromoglycate on intestinal permeability changes and clinical
      response during cow's milk challenge.
AB  - Oral disodiumcromoglycate (DSCG) has been used for many years in the prevention
      of food allergic reactions. The reported effectiveness varies widely and little
      is known about the mode of action. The aim of this study was to evaluate the
      effect of DSCG pretreatment (2 x 100 mg) on intestinal permeability (IP), as
      measured with a sugar absorption test (SAT), in relation to the clinical response
      during food challenge in 30 children suspected of cow's milk allergy. In the SAT
      the urinary Lactulose/Mannitol (L/M) ratio was measured after oral administration
      of these compounds. DSCG pretreatment did not alter the number of clinically
      positive challenges. Children with clinically positive challenges showed a
      significant increase in the L/M ratio with placebo pretreatment as compared to
      children with clinically negative challenges (p = 0.0008). This difference was
      reduced to nonsignificant levels after DSCG pretreatment (p = 0.07). We conclude
      that DSCG in this dosage probably reduces the local intestinal response but does
      not prevent the extraintestinal reactions.

PMID- 8353651
TI  - Usefulness of neonatal eosinophil counts as a marker of atopy?
AB  - Eosinophil count (EC) were obtained from 312 newborns with and 172 without family
      history of atopy (FHA). The EC were higher in infants with than without FHA.
      Elevated EC were recorded in babies of parietaria sensitive mothers born in the
      spring, as compared to other seasons. The predictive value of EC with regard to
      development of atopic diseases up to 18 months of age was prospectively studied
      in 103 newborns with FHA. Using 5 x 10(8) cells/l as cut-off level the predictive
      allergy value was 41%. Elevated EC appears to be a marker of atopy in newborns.

PMID- 8353652
TI  - Are hypodense eosinophils in children activated or immature?
AB  - In patients with allergic asthma and rhinitis high numbers of hypodense
      eosinophils (HE) have been demonstrated. In a previous study we reported that
      asthmatic and healthy children had more HE than their adult counterparts. We
      assumed that this might, in part, be due to the presence of immature eosinophils
      in children. To distinguish between immature and activated eosinophils,
      determination of eosinophil cationic protein (ECP) might be interesting as it is
      known that high serum levels of ECP are associated with increased activation of
      eosinophils. In this study we determined the levels of ECP in serum in asthmatic
      and healthy children and adults trying to distinguish activated from immature
      eosinophils. We found that ECP levels were not increased in children (healthy and
      asthmatic) compared to adults (healthy and asthmatic). This supports the
      hypothesis that increased numbers of HE in childhood are, at least in part,
      immature eosinophils. Nevertheless, we could confirm that inflammation was
      present in children because soluble interleukin-2-receptor (sIL-2R), a marker of
      lymphocyte activation, was higher in asthmatic children as compared to healthy
      children. IL-6, a marker of macrophage/monocyte activation, was not different in
      the different patient groups. We conclude that although signs of inflammation are
      present in childhood asthma, the increased numbers of HE in children are in part
      due to the presence of immature eosinophils.

PMID- 8353653
TI  - Why do asthmatic children need referral to an emergency room?
AB  - Asthmatic attacks continue to be a major cause of referral to the emergency room
      (ER), despite currently available effective treatments. We have prospectively
      evaluated 100 consecutive children who were referred to the ER with acute asthma
      and were followed by their primary physicians. Only 46% were able to recognize
      acute attacks, and 26% had the knowledge and skills for self-management. The
      prophylactic therapy recommended was usually appropriate, but the compliance was
      poor and mean serum theophylline levels (STL) was 6.8 micrograms/ml, with
      subtherapeutic values (< 10 micrograms/ml) in 44 (88%). We studied an additional
      group of 50 consecutive children who were on a routine follow-up in the hospital
      asthma clinic. All were examined periodically and were instructed on the disease.
      The compliance of these children was much better and STL were within the
      therapeutic range in 73%, significantly higher than in the ER patients (p <
      0.001). Their need for ER treatment or hospitalization was much lower than the
      former group. Poor compliance is a major factor causing referral of asthmatic
      children to ER, and careful education can improve patient compliance with reduced
      referral and subsequent hospitalization.

PMID- 8353654
TI  - Modulation of human eosinophil chemotaxis and adhesion by anti-allergic drugs in
      vitro.

PMID- 8353655
TI  - The eosinophil granulocyte in allergic inflammation.

PMID- 8353656
TI  - The therapeutic index of antihistamines.

PMID- 8353657
TI  - The role of food allergy and eosinophils in atopic dermatitis.

PMID- 8353658
TI  - Is there a place for antihistamines in the treatment of perennial asthma?

PMID- 8353659
TI  - Cetirizine in allergic rhinitis.

PMID- 8353660
TI  - A placebo-controlled trial of cetirizine in seasonal allergic rhino
      conjunctivitis in children aged 6 to 12 years.
AB  - A total of 124 children of both sexes aged between 6 and 12 years with pollen
      associated rhino-conjunctivitis were included in a multicentre double-blind study
      of parallel group design to compare the effects of cetirizine 10 mg daily, given
      as 5 mg morning and evening for 2 weeks, with those of placebo of identical
      appearance. Rhinorrhea, sneezing, nasal obstruction and nasal and ocular pruritus
      were evaluated using symptom scores by patients on daily self-evaluation cards
      and by investigators who, in addition, made a global evaluation at the end of
      treatment. Appropriate wash-out periods for previous medicines were observed.
      Unchanged treatment of asthma was allowed and inhaled corticosteroids were
      continued in 3 placebo patients. Compliance was checked and found to be less than
      80% of the prescribed dosage in 2 cetirizine patients. The mean percentage of
      study days when symptoms were absent or at the most mild (i.e. present but not
      disturbing), as reported daily by the patients, was significantly greater with
      cetirizine (56.2%) than placebo (29.7%). This 26.5% difference was considered
      clinically significant. The value of this method of expressing treatment effects
      in allergic rhinitis is discussed. Improvement in maximum symptom scores
      (severest symptoms) assessed by investigators was better for cetirizine than
      placebo after treatment for 1 week and 2 weeks. Improvement in individual daily
      symptoms was greater for cetirizine than placebo after a few days.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8353661
TI  - Allergic inflammation.
AB  - A greater understanding of the basic mechanisms of allergic inflammation is
      pertinent to the development of new treatments. Previous studies have focused on
      the role of mediators of hypersensitivity and effector cells, including mast
      cells and eosinophils. Recent evidence suggests that IgE-dependent activation and
      tissue eosinophilia are under the local regulation of distinct cytokines.
      Originally described as products from T lymphocytes, these peptide messengers are
      produced by alternative cells, including mast cells, eosinophils and the
      respiratory epithelium. In vitro studies in murine models and using cloned human
      T lymphocytes indicate the preferential production of "Th2-type" cytokines,
      including interleukin-4 (IL-4) and IL-5. This review considers the evidence from
      in vivo studies in humans that "Th2-type" cytokines have a primary role in
      orchestrating both IgE-dependent events and local tissue eosinophilia. Novel
      therapeutic approaches might include a broad strategy directed against T
      lymphocytes, including the use of immunosuppressive agents or anti CD4 antibodies
      or more precise targeting of IL-4 and/or IL-5.

PMID- 8353662
TI  - Sternal fractures.
AB  - Sternal fractures have become more common since the introduction of seat belt
      legislation. However, the injury often heals well with minimal or no sternal
      deformity. Morbidity and mortality in patients with fractures of the sternum are
      usually due to other organ injuries.

PMID- 8353663
TI  - Management of pain in thoracic surgery.
AB  - Severe pain after thoracotomy is the most important factor responsible for
      ineffective ventilation, ineffective cough, and impaired ability to sigh and to
      breathe deeply. Effective analgesia minimizes and may even reverse the expected
      decline in pulmonary function and also prevents postoperative pulmonary
      complications.

PMID- 8353664
TI  - Connective tissue diseases: advances in diagnosis and management.
AB  - Connective tissue diseases encompass a group of multisystem inflammatory
      syndromes whose pathogenesis is thought to be autoimmune. They are all associated
      with the production of autoantibodies that bind to predominantly intracellular
      antigens. We will describe recent advances that have led to improved
      classification and more accurate prognosis.

PMID- 8353665
TI  - Management of uterine fibroids.
AB  - Until recently the management of uterine fibroids has been exclusively surgical
      in the form of either hysterectomy or myomectomy. The development of minimally
      invasive techniques and the introduction of LHRH agonists has allowed more
      conservative management to maintain or restore fertility.

PMID- 8353666
TI  - Late problems faced by childhood cancer survivors.
AB  - One in 650 children will develop cancer by the age of 15 years, of whom 50-60%
      will be cured. Early recognition and appropriate management of the long-term
      sequelae of their treatment is essential if we are to provide these children and
      young adults with as normal a life as possible.

PMID- 8353667
TI  - Acute tracheal obstruction.

PMID- 8353668
TI  - Appropriateness of cardiac surgery in the elderly.

PMID- 8353669
TI  - Occupational health and safety for doctors.

PMID- 8353670
TI  - Cardiac surgery in older people--the Papworth experience.

PMID- 8353671
TI  - Role of the respiratory nurse specialist.

PMID- 8353672
TI  - Writers' cramp.
AB  - At least 4000 people suffer from writers' cramp in the UK. While diagnosis is
      straightforward, treatment is difficult and many therapies are unsatisfactory.
      This article reviews the various manifestations of writers' cramp, the
      physiological evidence indicating that it is a neurological disease and the
      therapeutic techniques available.

PMID- 8353673
TI  - Computed tomography scanning of the thorax.
AB  - Although the chest radiograph remains the initial imaging study in patients with
      intrathoracic pathology, computed tomography has become useful in the early
      detection and evaluation of all aspects of lung, mediastinal, pleural and chest
      wall disease. High resolution computed tomography has particular advantages in
      the characterization of parenchymal lung disease.

PMID- 8353674
TI  - 'Pick's disease'--101 years on still there, but in need of reform.

PMID- 8353675
TI  - Fluoxetine in phantom limb pain.
AB  - Complete recovery of phantom limb pain of five years' duration occurred in a 71
      year-old man following treatment with fluoxetine. There was no coexisting
      affective disorder. Further research is indicated in view of the postulated role
      of lowered central 5-hydroxytryptamine activity in the genesis and maintenance of
      chronic pain.

PMID- 8353676
TI  - Familial cosegregation of affective disorder and Hailey-Hailey disease.
AB  - We report on a family with co-occurrence of affective disorder and Hailey-Hailey
      disease in two brothers and the mother. The putative chromosomal locus of Hailey
      Hailey disease, which is a rare dominantly inherited dermatosis, may be a
      promising candidate region for genetic studies in affective disorder.

PMID- 8353677
TI  - Secondary prevention of non-fatal deliberate self-harm. The green card study.
AB  - In an attempt to address the low compliance with offers of treatment shown by
      patients after episodes of non-fatal deliberate self-harm (DSH), patients who had
      harmed themselves for the first time were offered rapid, easy access to on-call
      trainee psychiatrists in the event of further difficulties, and they were
      encouraged to seek help at an early stage should such problems arise. The follow
      up data obtained after one year showed a significant reduction of actual or
      seriously threatened DSH in the experimental group, who also made considerably
      less demands on medical and psychiatric services, when compared with controls.

PMID- 8353678
TI  - Thalamo-frontal psychosis.
AB  - A 43-year-old man presented with an 18-month history of acute-onset cyclical
      behavioural change affecting mood, appetite, sleep, and energy levels. This had
      followed an initial episode of transient drowsiness which lasted 24 hours. On
      examination, there was some evidence of visual memory and frontal lobe deficits.
      A brain CT scan showed bilateral thalamic infarcts and a brain SPECT scan showed
      bilateral hypoperfusion of the frontal lobes. To our knowledge, this is the first
      reported case of thalamic infarction associated with acute-onset cyclical
      affective psychosis with clinical and neurophysiological features of frontal lobe
      syndrome. The case also highlights the possible role of thalamo-frontal circuits
      in the pathogenesis of the Kleine-Levin syndrome.

PMID- 8353679
TI  - Tourette's syndrome and right hemisphere dysfunction.
AB  - Poor performances of patients with Tourette's syndrome (TS) on tests requiring
      visual-perceptual abilities had led previous authors to the suggestion of right
      hemisphere involvement. We have compared the results of neuropsychological
      examination of 16 children with TS, with those of 16 children with a lesion of
      the right hemisphere. No evidence was found of a dysfunction of the right
      hemisphere in TS.

PMID- 8353680
TI  - Oedipus at Delphi.

PMID- 8353681
TI  - Clozapine and negative symptoms.

PMID- 8353682
TI  - Salivary testosterone levels and major depressive illness in men.

PMID- 8353683
TI  - Attitudes to mental illness.

PMID- 8353684
TI  - An Eysenck for the 1990s?

PMID- 8353685
TI  - Integration of psychodynamics in Scandinavian psychiatry.

PMID- 8353686
TI  - Child psychiatric syndromes with a somatic presentation.

PMID- 8353687
TI  - Parental bonding.

PMID- 8353688
TI  - Tattooed female psychiatric patients.

PMID- 8353689
TI  - Postage stamp test for sexual disorders.

PMID- 8353690
TI  - Gastric emptying and bloating in anorexia nervosa.

PMID- 8353691
TI  - Blood-letting in bulimia nervosa.

PMID- 8353692
TI  - Abuse of the nasogastric tube in patients with eating disorders.

PMID- 8353693
TI  - Psychological treatment of generalised anxiety disorder. A review of the clinical
      significance of results in outcome studies since 1980.
AB  - Comparative outcome studies of generalised anxiety disorder suggest that
      psychological therapy is a potentially valuable alternative to anxiolytic
      medication. However, on average psychological therapy results in modest
      improvements in symptoms, with about 50% of patients achieving normal
      functioning. Limited follow-up data indicate that these changes are maintained
      over six months. Cognitive therapy appears to be most effective, although
      comparisons with other therapies are limited and non-specific factors are clearly
      important. There is also evidence of considerable variability in outcome between
      studies, with the best results obtained with patients who are free of anxiolytic
      medication and recruited directly from primary care or other non-psychiatric
      settings. The effects on outcome of patient characteristics known to be
      associated with more severe illness and complexity of clinical presentation have
      yet to be explored. A balanced appraisal of the value of psychological therapy
      with this common condition requires a fuller description of sample
      characteristics and more systematic investigation of the clinical significance of
      treatment effects over the long term.

PMID- 8353694
TI  - Alzheimer's disease and chromosome 14. Different gene, same process?

PMID- 8353695
TI  - A controlled study of the onset, duration and prevalence of postnatal depression.
AB  - In a two-stage screening procedure using the Edinburgh Postnatal Depression Scale
      and Goldberg's Standardised Psychiatric Interview, 232 women six months after
      delivery were compared with control women individually matched for age, marital
      status and number of children, obtained from general practitioner lists, who were
      not pregnant nor had had a baby in the previous 12 months. No significant
      difference in the point prevalence of depression at six months was found between
      the postnatal (9.1%) and control women (8.2%) nor in the six-month period
      prevalence (13.8% postnatal, 13.4% controls), but a threefold higher rate of
      onset of depression was found within five weeks of childbirth. The possible
      explanations relate to the long duration of depression in women with young
      children, and the stressful effect of childbirth and its psychosocial sequelae.

PMID- 8353696
TI  - A pilot study of schizophrenia-like psychosis in epilepsy using single-photon
      emission computerised tomography.
AB  - In a pilot study, SPECT was used to explore differences in rCBF between a group
      of patients with schizophrenia-like psychoses of epilepsy (SLPE) and a matched
      group of epileptic controls. Five patients in each group were investigated and
      those with SLPE showed significant reductions in the index of rCBF in the left
      medial temporal region. These differences are being investigated further.

PMID- 8353697
TI  - The relationship between social dysfunctioning and psychopathology among primary
      care attenders.
AB  - The extent of social dysfunctioning and its relationship to psychological
      disorders among Dutch primary care patients was examined. Social dysfunctioning
      in these patients was rather limited, but was more pronounced in patients with a
      psychological disorder than in those without. Disabilities were largely
      restricted to the occupational and social roles, with family role functioning and
      self-care relatively intact. Social dysfunctioning was moderately related to
      psychopathology, with higher levels of dysfunctioning in more severe and
      depressed cases. The extent of social dysfunctioning among patients with both
      anxiety and depression was similar to that of patients with a single diagnosis of
      depression. Depressed patients had a similar level of dysfunctioning to non
      psychotic psychiatric out-patients. Analyses regarding the effects of diagnosis
      and severity on social dysfunctioning revealed considerable overlap between these
      two aspects of psychopathology. This study supports the need for a simultaneous
      but separate assessment of psychopathology and social dysfunctioning. However,
      future research should incorporate additional predictors of social dysfunctioning
      (e.g. personality, life events, long-term difficulties, physical disorders), and
      prospective studies should be conducted to clarify the temporal sequences of
      symptom severity, diagnosis, and comorbidity on the one hand, and social
      dysfunctioning on the other.

PMID- 8353698
TI  - Suicide notes.
AB  - Detailed case reports of incidents of suicide and attempted suicide on the London
      Underground railway system between 1985 and 1989 were examined for the presence
      of suicide notes. The incidence of note-leaving was 15%. Notes provided little
      insight into the causes of suicide as subjectively perceived, or strategies for
      suicide prevention.

PMID- 8353699
TI  - A controlled trial of home-based acute psychiatric services. I: Clinical and
      social outcome.
AB  - While research has shown community-based psychiatric care to be as good as, or
      better than, hospital-based care, generalisation to clinical practice has been
      difficult. This prospective, randomised controlled study examined a community
      based approach feasible within NHS conditions. Ninety-four patients were randomly
      allocated to experimental and 78 to control treatments and followed for one year.
      The groups were well matched apart from an excess of psychotic control patients.
      No differences in clinical or social functioning outcome were found. Both groups
      improved substantially on clinical measures in the first six weeks, with some
      slow consolidation thereafter. There were three suicides in the control group and
      one in the experimental group. Access to care was better in the experimental
      group (93% attended assessment) than in the control group (75% attended
      assessment).

PMID- 8353700
TI  - A controlled trial of home-based acute psychiatric services. II: Treatment
      patterns and costs.
AB  - Treatment records of 94 patients treated in an experimental home-based
      psychiatric service and 78 control patients in standard care were collected over
      one year. There was a substantial reduction in in-patient care in the
      experimental group, both in terms of proportion admitted and duration of
      admissions, despite similar out-patient and general practice care. The total
      treatment costs were significantly larger (> 50%) for standard care when
      controlled for by diagnostic grouping. Costs were further examined by including
      all specialist psychiatric care, and by excluding patients with primary diagnoses
      of brain damage or alcoholism. Sensitivity analysis explored the effects of
      increasing the cost of home visits. The relative cost effectiveness of the
      experimental service persisted. Clinical and social outcome was similar in
      control and experimental groups.

PMID- 8353701
TI  - Befriending young mothers.
AB  - The context of voluntary befriending schemes to help mothers of young children is
      outlined. There is evidence that two main UK voluntary befriending schemes to
      help mothers of young children engage families where there is significant
      psychosocial morbidity. It is concluded that well conducted befriending schemes
      can make a significant contribution to the mental health of mothers and children.
      Whether they do so will depend on their experience and training and the elements
      they incorporate.

PMID- 8353702
TI  - The importance of the role of the patient in the outcome of schizophrenia.
AB  - The Family Interpersonal Perception Test (FIPT) was used to explore the
      relationships between schizophrenic patients and their parents, and how these
      related both to relapse in the year after discharge and to improvement in social
      functioning. Forty schizophrenic patients and their parents were tested during
      their first ever admission to hospital and again two years later. Parents' and
      patient's views of each other were more negative in those with worse outcome, but
      what most significantly distinguished groups with different outcomes was how
      patients expected their parents to see them. The FIPT, therefore, reveals
      patterns of interaction in which the patient's role in outcome is at least as
      important as that of the parents, and can aid the identification of specific
      features with which to work in therapy.

PMID- 8353703
TI  - Acting on delusions. I: Prevalence.
AB  - Associations between delusions and abnormal behaviour were retrospectively
      assessed in a sample of 83 consecutively admitted deluded subjects. All were
      interviewed about events in the previous month using a new measure of delusional
      phenomenology and action. For 59 subjects this information was supplemented by
      informant interviews. Clinical consensus was reached concerning the probability
      that actions reported by informants were linked to delusions. Half of the sample
      reported that they had acted at least once in accordance with their delusions.
      Violent behaviour in response to delusions was uncommon. Information provided by
      informants suggested that some aspect of the actions of half of the sample was
      either probably or definitely congruent with the content of their delusions.
      However, there was no link between self-reports and informants' reports of such
      action. A latent class analysis of self-reported delusional action suggested
      three classes of action, namely aggressive to self or other, defensive action,
      and either none or single action. Self-reported action was associated with
      delusions of catastrophe. Informant data suggested that persecutory delusions
      were the most likely to be acted upon, but in contrast delusions of guilt or
      catastrophe appeared to decrease the chance of delusional behaviour. Actions
      associated with abnormal beliefs are more common than has been suggested.

PMID- 8353704
TI  - Acting on delusions. II: The phenomenological correlates of acting on delusions.
AB  - The aim of the study was to identify the phenomenological characteristics of
      those delusions which are associated with action. The sample consisted of 79
      patients admitted to a general psychiatric ward, each of whom described at least
      one delusional belief. The variables studied included the phenomenology of the
      delusions, and behaviour. Two behavioural ratings were used, one derived from the
      subjects' own description of their behaviour and the other from information
      provided by informants. There was no association between delusional phenomenology
      and acting on a delusion when the subjects' behaviour was described by
      informants. When action was described by the subjects themselves, acting was
      associated with: being aware of evidence which supported the belief and with
      having actively sought out such evidence; a tendency to reduce the conviction
      with which a belief was held when that belief was challenged; and with feeling
      sad, frightened or anxious as a consequence of the delusion.

PMID- 8353705
TI  - Depression in old age. A reconsideration of cerebral disease in relation to
      outcome.
AB  - In a prospective study, 32 patients with depressed mood and cerebral pathology
      were compared over one year with 66 depressed patients who were cerebrally
      intact. The hypothesis that the former would have a poorer outcome for depression
      was not confirmed, although the group with cerebral pathology had a significantly
      higher than expected death rate. Prognostic factors were identified only for the
      cerebrally intact group. Those who had major depression were more likely than
      those with minor depression to be given physical treatments, irrespective of
      which group they belonged to.

PMID- 8353706
TI  - Psychiatric morbidity and compulsory admission among UK-born Europeans, Afro
      Caribbeans and Asians in central Manchester.
AB  - Psychiatric admissions in Central Manchester of Europeans, Afro-Caribbeans, and
      Asians (within three age-bands) were studied over four years. Among the Afro
      Caribbean group there were more single or unemployed persons than in either the
      Asian or European groups, which suggested greater socio-economic disadvantage.
      Rates for first admissions and readmissions among Afro-Caribbeans were greater;
      among Asians they were similar except for the 16-29-year age-group, who tended to
      have lower rates than Europeans. A higher proportion of Afro-Caribbeans and
      Asians were psychotic. In the Afro-Caribbean group, the raised rates of admission
      were largely attributable to increased rates of schizophrenia. The highest rate
      occurred in second-generation (UK-born) Afro-Caribbeans and was nine times that
      among Europeans. The police were more frequently involved in the admissions of
      Afro-Caribbeans compared with Europeans or Asians. Higher proportions of Afro
      Caribbeans and Asians who were readmitted were detained under the Mental Health
      Act 1983, when compared with Europeans.

PMID- 8353707
TI  - Mirth, laughter and gelastic seizures.
AB  - Little is known about what pathways subserve mirth and its expression laughter.
      We present three patients with gelastic seizures and laughter elicited by
      electrical stimulation of the cortex who provide some insight into the mechanisms
      of laughter and its emotional concomitants. The first patient had seizures
      manifested by laughter without a subjective feeling of mirth. Magnetic resonance
      imaging showed a cavernous haemangioma in the left superior mesial frontal
      region. Ictal subdural electrode recording showed the seizure onset to be in the
      left anterior cingulate gyrus. Removal of the lesion and of the seizure focus
      rendered the patient virtually seizure free over 16 months of follow-up. The
      other two patients had complex partial seizures of temporal lobe origin.
      Electrical stimulation of the fusiform gyrus and parahippocampal gyrus produced
      bursts of laughter accompanied by a feeling of mirth. These cases reveal a high
      likelihood of cingulate and basal temporal cortex contribution to laughter and
      mirth in humans, and suggest the possibility that the anterior cingulate region
      is involved in the motor act of laughter, while the basal temporal cortex is
      involved in processing of laughter's emotional content in man.

PMID- 8353708
TI  - Reliability of histological diagnosis including grading in gliomas biopsied by
      image-guided stereotactic technique.
AB  - We report clinical and pathological data of 419 image-guided stereotactic
      biopsies. In the present series the diagnostic yield, estimated by comparing the
      original histological diagnoses with follow-up data, was found to be
      approximately 94% in gliomas. As it has been suggested that malignancy of
      astrocytic gliomas may be considerably underestimated in the small tissue samples
      obtained by stereotactic biopsy, we have reviewed 160 adult, diffuse
      supratentorial astrocytic tumours, correlating the original Kernohan tumour
      grades with survival. In this grading system, although there was generally a good
      correlation between histological grade and survival probability (P < 0.0001), no
      distinction could be made between the grade 3 (anaplastic astrocytoma) and grade
      4 (glioblastoma) groups. Tumour grades obtained by applying the criteria of the
      more recent Daumas-Duport grading system were also determined and correlated with
      survival. These latter tumour grades not only correlated well with survival (P <
      0.0001), but also enabled us to identify a group of patients with intermediate
      grade malignancy (grade 3, anaplastic astrocytoma), surviving longer than those
      with grade 4 tumours. Image-guided stereotactic biopsy is a useful means of
      providing tissue samples for histological diagnosis of brain neoplasms, including
      gliomas. Histological grading of adult, diffuse supratentorial astrocytic gliomas
      diagnosed by this technique is possible and should be carried out using an
      appropriate grading system.

PMID- 8353709
TI  - Decreased number of oxytocin neurons in the paraventricular nucleus of the human
      hypothalamus in AIDS.
AB  - The number of immunocytochemically identified vasopressin (AVP) and oxytocin
      (OXT) neurons was determined morphometrically in the paraventricular nucleus of
      the hypothalamus of 20 acquired immunodeficiency syndrome (AIDS) patients and 10
      controls. The AIDS group consisted of 14 homosexual males (age range 25-62
      years), four of whom had a probable HIV-1 associated dementia complex, and six
      non-demented heterosexuals (four males and two females, age range 21-73 years).
      Ten males without a primary neurological or psychiatric disease served as a
      control group. The number of OXT-expressing neurons in the paraventricular
      nucleus of both groups of AIDS patients was approximately 40% lower than that of
      the controls. In contrast, the three groups showed no significant differences in
      the number of AVP-expressing neurons in the paraventricular nucleus. Since there
      were no significant differences in the number of AVP and OXT cells between the
      homosexual and heterosexual subjects with AIDS, the morphological difference in
      the paraventricular nucleus seems to be related to AIDS and not to sexual
      orientation. No inflammatory changes were found in the paraventricular nucleus
      area. The selective changes in the OXT neurons of the paraventricular nucleus may
      be the basis for part of the neuroendocrine, autonomic dysfunction or vegetative
      symptoms in AIDS.

PMID- 8353710
TI  - Brain MRI changes in phenylketonuria. Associations with dietary status.
AB  - Following the introduction 30 years ago of neonatal screening and early dietary
      treatment for phenylketonuria there has been a dramatic decrease in the severity
      of neurological dysfunction associated with this disorder. However, there is
      evidence that subtle neurological impairment remains common in early treated
      subjects and in the last 3 years there have been a number of reports of overt
      neurological impairment with white matter abnormalities on MRI. The frequency of
      white matter changes in phenylketonuria, and the relation of these changes to
      dietary management, have remained unclear. The present study examines MRI
      findings in 34 subjects aged 8-33 years. Twenty-five subjects had been detected
      by routine neonatal screening and nine had been missed in the screening
      programme. At the time of the investigation 16 of the early treated and two of
      the late treated subjects were still receiving a diet low in phenylalanine. All
      but two of the 34 subjects showed abnormalities on MRI. In the early diagnosed
      group it could be shown that the severity of MRI changes (graded 1-5) was
      significantly and independently associated with phenylalanine concentrations at
      the time of investigation and the time since dietary treatment had been
      withdrawn. These data are consistent with studies in animals showing that
      hyperphenylalaninaemia increases myelin turnover in a dose dependent manner. It
      is suggested that the effects of phenylalanine on myelin pose a lifelong hazard
      to the nervous system.

PMID- 8353711
TI  - The causalgia-dystonia syndrome.
AB  - We report 18 patients (16 women and two men) with causalgia and dystonia,
      triggered by peripheral injuries in 15 cases and occurring spontaneously in
      three. The injury was often trivial, and did not cause overt peripheral nerve
      lesions. The mean age at presentation was 28.5 years. None had a family history
      of dystonia. The leg was affected initially in 12 patients, the arm in the
      remaining six cases. All had burning pain, allodynia and hyperpathia, along with
      vasomotor, sudomotor and trophic changes. All developed dystonic muscle spasms in
      the affected part. Dystonia always appeared at the same time or after the
      causalgia. The spasms were typically sustained, producing a 'fixed' dystonic
      posture, in contrast to the mobile spasms characteristics of idiopathic torsion
      dystonia. There was spread of the causalgia and of the dystonia from its initial
      site both in the affected limb and to other extremities, the latter in
      hemiplegic, transverse and triplegic distribution. All investigations were
      normal. All modes of conventional treatment failed to relieve either the pain or
      the dystonia, but two patients recovered spontaneously. At present it is
      impossible to decide whether this distressing syndrome is a true functional
      disorder of the central nervous system, or is of psychogenic origin.

PMID- 8353712
TI  - Asymmetrical pre-synaptic and post-synpatic changes in the striatal dopamine
      projection in dopa naive parkinsonism. Diagnostic implications of the D2 receptor
      status.
AB  - Nine L-dopa na ve patients with clinically diagnosed parkinsonism were studied
      using positron emission tomography with 6-L-[18F]fluorodopa ([18F]dopa, a pre
      synaptic tracer) and [11C]raclopride (which binds to D2 receptors). Putamen
      [18F]dopa uptake was reduced in all patients, confirming a loss of function
      affecting the nigrostriatal projection. In eight patients the putamen with the
      lowest [18F]dopa uptake (always contralateral to the clinically most affected
      side) had the highest [11C]raclopride binding, suggesting upregulation of the
      post-synaptic D2 receptors. In the ninth patient [11C]raclopride binding was
      lower in the putamen with the lowest [18F]dopa uptake, indicating an additional
      post-synaptic deficit. All nine patients were shown to be L-dopa responsive. The
      subsequent clinical course of the former eight patients has been typical of
      idiopathic Parkinson's disease, whilst the ninth patient has developed postural
      hypotension, urinary incontinence and respiratory stridor typical of multiple
      system atrophy. Reduced [11C]raclopride binding in L-dopa naive parkinsonian
      patients might serve as a useful early marker of this condition.

PMID- 8353713
TI  - Response choice in Parkinson's disease. The effects of uncertainty and stimulus
      response compatibility.
AB  - Reaction time paradigms provide a set of methods for assessing aspects of the
      planning and execution of voluntary movements in Parkinson's disease. Attention
      has focused mainly on the issue of programming of responses, employing a
      combination of simple reaction time (SRT) and choice reaction time (CRT)
      paradigms. The first part of the present study replicated an earlier finding in
      which patients showed a disproportionate slowing in CRT compared with SRT. The
      main aim of the study was to investigate the possible role of response choice, a
      key stage prior to motor programming in this CRT deficit. Two factors were
      manipulated: (i) response uncertainty and (ii) stimulus-response compatibility.
      The patients showed a normal increase in reaction time with increasing
      uncertainty in the compatible conditions, and a normal response to stimulus
      response compatibility in the two-choice task. However, the two groups showed
      qualitatively different patterns of interaction between the two experimental
      factors, with only the patients showing a disproportionate slowing with
      incompatible stimulus-response relationships in the four-choice task. The data
      were interpreted in terms of Hasbroucq et al.'s (1990) list-rule model of
      stimulus-response compatibility effects, which suggested that the patients and
      controls were using different strategies for dealing with incompatible stimulus
      response relationships. The use of different strategies makes it impossible to
      determine whether or not the processing of the patients is impaired in
      Parkinson's disease, although further research is suggested to clarify the
      question. However, the present data suggest that any impairment in response
      choice is unlikely to contribute to the slowing in CRT in Parkinson's disease
      under conditions of high stimulus-response compatibility.

PMID- 8353714
TI  - Alternating fluency in Parkinson's disease. An evaluation of the attentional
      control theory of cognitive impairment.
AB  - One theory for the pattern of cognitive impairment associated with Parkinson's
      disease is that deficits are apparent only on tasks which rely on the internal
      control of attention, which in turn is assumed to place heavy demands on limited
      attentional resources. This theory is evaluated in the present study by examining
      the performance of Parkinson's disease subjects and matched healthy control
      subjects on a series of fluency tasks. In one condition, subjects were required
      to generate exemplars under standard verbal fluency instructions, i.e. either to
      a single letter or a single semantic category. In a related condition, subjects
      had to generate exemplars alternately using two fluency probes, which could
      either be from the same domain, i.e. letter-letter or category-category, or from
      different domains, i.e. category-letter. The requirement to alternate between
      fluency probes presumably places greater demands on internal attentional control
      mechanisms, and in a yoked condition, subjects were given external cue cards to
      minimize these extra demands. Overall, there was no evidence that Parkinson's
      disease subjects had a basic fluency deficit, nor were they impaired when
      required to alternate between probes of the same domain. A specific deficit did
      emerge, however, for the mixed alternating condition (i.e. category-letter), in
      which Parkinson's disease subjects produced significantly more perseverative
      errors and had a significantly lower output. The former of these was reversible
      by the provision of external cue cards, but the overall output was unchanged.
      These data do not support the theory of internal attentional control, at least as
      a general theory of cognitive impairment in Parkinson's disease. To explain the
      observed pattern, we propose that Parkinson's disease is associated with: (i) a
      deficit in inhibitory attentional processes, and (ii) an impairment in the
      maintenance of those internal representations which control action.

PMID- 8353715
TI  - Evidence of multiple memory systems in the human brain. A [18F]FDG PET metabolic
      study.
AB  - Patients with global amnesia of different aetiologies (n = 11), and patients with
      probable Alzheimer's disease of recent onset and mild to moderate severity (n =
      18) underwent extensive neuropsychological examination, which included the
      evaluation of multiple components of memory, and a measurement of regional
      cerebral glucose metabolism with [18F]fluoro-deoxyglucose ([18F]FDG) and PET. In
      the neuropsychological tests, both global amnesia and Alzheimer's disease
      patients had impaired episodic long-term memory, while deficits of short-term,
      semantic and implicit memory were present only in Alzheimer's disease. When local
      metabolic rates for glucose were compared with values from age- and education
      matched normal controls, a common pattern of bilateral hypometabolism was present
      in the hippocampus, cingulate and frontal basal cortex of both global amnesia and
      Alzheimer's disease patients. On the other hand, significant hypometabolism was
      found in the thalamus in only global amnesia, and in the frontal, parietal and
      temporal associative cortex in only Alzheimer's disease. The results of a
      multivariate regression analysis of test scores with metabolic data indicated
      that different clusters of cerebral areas were associated with each of the main
      components of memory function. These data are in agreement with 'neural network'
      models of the neural basis of cognition, according to which complex functions are
      subserved by multiple interconnected cortical and subcortical structures.

PMID- 8353716
TI  - Autobiographical amnesia resulting from bilateral paramedian thalamic infarction.
      A case study in cognitive neurobiology.
AB  - A patient with a chronic amnesic state resulting from bilateral paramedian
      thalamic infarction showed a pattern of retrograde amnesia not previously
      reported. Personally relevant autobiographical memory was profoundly impaired,
      whereas knowledge of famous people and public events was relatively spared.
      Furthermore, knowledge of famous people, including the ability to make accurate
      temporal judgements, was less affected than knowledge of public events. In
      addition, we have documented a severe and systematic distortion of personal
      memory. These findings are not compatible with current accounts of retrograde
      amnesia based either upon the type of information stored (e.g. episodic versus
      semantic memory), or upon simple storage versus access models. We propose an
      explanation based upon an interactive cognitive model in which the patient shows
      a disorder at the 'thematic retrieval framework' level of memory organization due
      to a disconnection of frontal and medial temporal memory systems.

PMID- 8353717
TI  - Face perception after brain injury. Selective impairments affecting identity and
      expression.
AB  - Current theoretical models of face perception postulate separate routes for
      processing information needed in the recognition of a familiar face, for matching
      photographs of unfamiliar faces and for the analysis of facial expressions. The
      present study investigated this claim in a group of ex-servicemen who had
      sustained unilateral brain injuries affecting posterior areas of the left or
      right cerebral hemisphere. Care was taken to confirm the nature of impairment by
      using two different tasks to assess each of the three theoretically defined
      abilities (leading to a total of six tasks). We adopted a stringent application
      of the double dissociation methodology to investigate the pattern of performance
      across tasks of individual ex-servicemen. A selective impairment was defined as a
      significantly impoverished performance on both tests of a specific ability, while
      all other tasks were performed within normal limits. In addition, we used both
      accuracy and response latency measures to substantiate evidence for spared or
      defective abilities. The results showed selective impairments of all three
      abilities on accuracy scores. Response latency data confirmed the finding of a
      selective deficit in the processing of facial expressions, but produced evidence
      suggesting that impairments affecting familiar face recognition and unfamiliar
      face matching were not completely independent from each other in this group of ex
      servicemen.

PMID- 8353718
TI  - Deficit in classical conditioning in patients with cerebellar degeneration.
AB  - There is evidence from animal experiments that the cerebellum and its associated
      brainstem circuitry are involved in the acquisition of the conditioned response.
      In order to obtain evidence for their involvement in humans, we studied classical
      delay conditioning, using the eye-blink conditioned response, in five patients
      with pure cerebellar cortical atrophy and seven patients with
      olivopontocerebellar atrophy. The results were compared with those obtained in a
      group of neurologically healthy volunteers matched with the patients for age and
      sex. The two groups of patients had similar abnormalities in the acquisition of
      the conditioned response and produced fewer conditioned responses than in the
      control subjects in any given block of trials. Many of the patients' conditioned
      responses were inappropriately timed with respect to the conditioned stimulus.
      These results support the role of the cerebellum in the expression and timing of
      the conditioned response.

PMID- 8353719
TI  - Stretch-induced electromyographic activity and torque in spastic elbow muscles.
      Differential modulation of reflex activity in passive and active motor tasks.
AB  - Stretch-evoked electromyographic (EMG) activity and torque signals have been
      studied in elbow joint muscles of both sides of patients with spastic hemiparesis
      and healthy subjects. In order to reveal differences in the generation of muscle
      tone between clinical assessment and functional movement, stretches of different
      velocities and amplitudes were applied during passive and quasi-functional active
      motor tasks. In spastic patients the strength and duration of the EMG responses
      following stretching of flexor and extensor muscles during both passive and
      active tasks were dependent on the stretch velocity and duration, respectively.
      This effect was seen on both the spastic and unaffected side. Under passive
      conditions EMG activity after stretching was negligible in the limb muscles of
      healthy subjects, of small amplitude in unaffected limbs of the patients, but was
      strong in affected muscles. Under active conditions, the amplitude of the early
      (M1) component of the EMG signal was larger, while the later components (M2 and
      M3) were smaller. These differences were due more to a change in reflex gain than
      to a change in reflex threshold when the stretch velocity signal was the basis
      for calculation. It is suggested that in spastic paresis, modulation of stretch
      induced EMG activity in the spastic limb becomes restricted to a smaller range
      with a poor ability to switch off under passive conditions. Furthermore, the
      reflex EMG activity suffers a reduced facilitation under active conditions. In
      comparison with unaffected limbs the stretch-evoked torque on the affected side
      was increased under passive conditions (due to the extra EMG activity) and
      decreased under active conditions (due to a reduced EMG activity). An increased
      torque to EMG ratio was found in spastic flexor and extensor muscles during
      active tasks. This is thought to be due to changes in mechanical muscle fibre
      properties suffered as a consequence of defective muscle activation following
      cerebral lesions. The consequences for clinical assessment of muscle tone and
      therapy of spastic movement disorder are discussed.

PMID- 8353720
TI  - Colour vision in New World monkeys and the single-locus X-chromosome theory.
AB  - The single-locus X-chromosome theory was proposed to explain the unique intra-
      and inter-species variation in the colour vision found in New World monkeys. The
      colour vision of only five species of these monkeys has been studied in any
      detail, and although this data does show some minor deviations from the theory,
      it is generally consistent with the theory. It has been suggested that the colour
      vision of New World monkeys may represent an intermediate stage in between the
      dichromatic colour vision of non-primate mammals and the uniform trichromacy of
      Old World primates. Alternatively, the colour vision system of New World monkeys
      may represent a method of obtaining the maximum variation in the colour vision of
      closely related family groups.

PMID- 8353721
TI  - Topographic organization of the corticonuclear projections from the paraflocculus
      in the albino rat: an autoradiographic orthograde tracing study.
AB  - The topographic organization of corticonuclear projections from the paraflocculus
      was studied in rats by an autoradiographic orthograde tracing method. The
      corticonuclear fibers from the paraflocculus terminated primarily in the
      caudoventral part of the lateral cerebellar nucleus and in the lateral part of
      the posterior interpositus nucleus. The rostrolateral part of the ventral
      paraflocculus projected only to the lateral nucleus, and the caudomedial part
      projected only to the posterior interpositus nucleus. Although differential
      projections from the dorsal and ventral paraflocculi were not clearly observed,
      the dorsal paraflocculus appeared to project to slightly more dorsal parts of the
      lateral and posterior interpositus nuclei than did the ventral paraflocculus. The
      lateral, medial, rostral, and caudal parts of each sublobule tended to project to
      the ventral, dorsal, rostral, and caudal regions within the caudoventral part of
      the lateral nucleus, respectively, despite massive overlap in the individual
      terminal fields. The corticonuclear projection from the dorsal and ventral
      paraflocculi to the posterior interpositus nucleus were organized in different
      directions; those from the dorsal paraflocculus were organized rostrocaudally,
      while those from the ventral paraflocculus were organized mediolaterally. These
      results suggest that in rats the corticonuclear projections from the
      paraflocculus are topographically organized in the mediolateral and rostrocaudal
      directions as well as in the dorsoventral direction.

PMID- 8353722
TI  - Reversed phase HPLC analysis of proenkephalin-related and prodynorphin-related
      end-products in the brain of a urodele amphibian, Ambystoma tigrinum.
AB  - Acid extracts of the brain of a urodele amphibian, Ambystoma tigrinum, were
      screened with radioimmunoassays specific for enkephalin-related products and
      dynorphin-related products. Following Sephadex G-50 column chromatography a peak
      of enkephalin-sized immunoreactive material was detected near the total volume of
      the column. The enkephalin-sized immunoreactivity was further analyzed by
      reversed phase HPLC. This analysis detected peaks of authentic Met-enkephalin and
      Leu-enkephalin. However, the molar ratio of Met-enkephalin to Leu-enkephalin in
      the brain of this amphibian was approximately 80:1. These observations would
      suggest that the Leu-enkephalin detected in the brain of Ambystoma may be derived
      from a source other than the Proenkephalin precursor. Neither Met-enkephalin-RGL
      or Met-enkephalin-RF were detected by radioimmunoassay in brain extracts from
      this urodele. However, following digestion with trypsin and carboxypeptidase B, a
      novel peak of C-terminally extended Met-enkephalin was detected. Two peaks of
      Prodynorphin-related products were also detected following gel filtration
      chromatography. These immunoreactive forms were detected using antisera specific
      for alpha-neo-endorphin and dynorphin B(1-13). No immunoreactive forms with
      antigenic determinants similar to mammalian dynorphin A(1-17) or dynorphin A(1-8)
      were detected in this species. Reversed phase HPLC analysis indicated that the
      major form of urodele alpha-neo-endorphin eluted with the same retention time as
      synthetic mammalian alpha-neo-endorphin. Urodele dynorphin B(1-13)-related
      immunoreactivity eluted as a single peak, however, this form did not elute with
      the same retention time as synthetic mammalian dynorphin B(1-13).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8353723
TI  - The visual system of the Florida garfish, Lepisosteus platyrhincus (Ginglymodi).
      I. Retina.
AB  - The retina and choriocapillaris of the Florida garfish, Lepisosteus platyrhincus
      (Ginglymodi), was examined at the light and electron microscopic levels. The
      inner limiting membrane is covered by an extensive system of vitreal blood
      vessels emanating from the hyaloid artery, which enters the eye ventrally at the
      proximal end of the elongated optic nerve head. Two size classes of ganglion cell
      soma are segregated by optic axon fascicles and Muller cell endfeet, all of which
      lie at the level of the ganglion cell layer. A third class of 'displaced'
      ganglion cells lies at the border of the inner plexiform and inner nuclear layers
      amidst tightly packed amacrine, bipolar and Muller cell soma. Two layers of
      horizontal cells lie vitread of a synaptic zone consisting of a complex
      arrangement of horizontal and bipolar dendrites invaginating rod spherules and
      cone pedicles to form single and multiple (three to six) synaptic ribbon
      connections, respectively. Immediately vitread of the photoreceptor nuclei lie a
      population of 'displaced' bipolars. Three types of photoreceptors are
      characterised: unequal double cones, single cones (large and small) and rods.
      These show retinomotor movements where the rods elongate in the light and are
      masked by the pigment epithelium and contract in the dark as the pigment migrates
      sclerad. Ultrastructurally, 4 types of dark-staining (osmophilic) granules are
      described: (1) Small glycogen granules (0.033 microns) aggregated at the bases of
      the photoreceptor nuclei and larger similar granules (0.078 microns and termed
      paraboloids) vitread to the ellipsoid; (2) tapetal granules (0.32 microns)
      distributed throughout the dorsal four-fifths of the retinal pigment epithelium
      (RPE); (3) pigment granules (0.5-2.0 microns) in the RPE, concentrated in ventral
      retina; (4) granules or melanosomes (0.813 microns) of the choriocapillaris. The
      second class of granules constitute a tapetum lucidum eliciting a yellow eyeshine
      when viewed in the dark. Two other tapeta also exist, a guanine tapetum
      (irregular guanine crystals) and a tapetum fibrosum (stacks of collagen fibrils).
      Functional correlations are made, and the putative ancestral (primitive)
      condition of particular visual characters is established for the ray-finned
      fishes by out-group comparisons.

PMID- 8353724
TI  - The visual system of the Florida garfish, Lepisosteus platyrhincus (Ginglymodi).
      II. Cornea and lens.
AB  - The cornea of the Florida gar, Lepisosteus platyrhincus (Ginglymodi) was examined
      at the scanning and transmission electron microscopic levels. In addition, the
      schematic eye of the garfish was revealed by frozen sectioning of the whole orbit
      in the horizontal and transverse planes. The lens is spherical, obeys
      Matthiessen's ratio, and is supported by a dorsal suspensory ligament and a
      ventral retractor lentis muscle. The cornea, devoid of a spectacle, is comprised
      anteriorly of an epithelium (eight to ten cells thick) and covered by a layer of
      flattened cells up to 26 microns in diameter. On the scanning electron
      microscope, these cells appear to be covered in microplicae and microvilli.
      Beneath the epithelium lies a granular basement membrane abutting a true Bowman's
      layer, composed of a random arrangement of collagen fibrils with no keratocytes.
      The corneal stroma constitutes 54% of the total thickness and contains 55-65
      collagen fibril lamellae, oriented perpendicular to neighbouring lamellae.
      Scattered keratocytes, containing large amounts of mitochondria, lipid droplets
      and glycogen granules lie in between the perpendicularly oriented lamellae.
      Posterior to the stroma is a thin and partially broken basement membrane (no true
      Descemet's membrane exists), adjacent to a monolayered endothelium covered in
      microvilli. In the periphery, an autochthonous layer is found between the stroma
      and the endothelium. Stromal pigment granules, enveloped in large nucleated
      cells, act as a non-occlusible yellow filter in the dorsal cornea. Functional
      correlations are made and the presence and/or thickness of corneal structures
      discussed in relation to the evolution of the vertebrate cornea.

PMID- 8353725
TI  - Anticipatory tonal coarticulation in Thai noun compounds after unilateral brain
      damage.
AB  - The time course and extent of anticipatory coarticulation between tones was
      investigated in normal and brain-damaged Thai-speaking subjects. Subjects were
      classified into five groups including 11 young normal, 9 old normal, 12 right
      hemisphere, 9 left hemisphere fluent, and 6 left hemisphere nonfluent. Stimuli
      consisted of five bisyllabic noun compounds with a falling tone on the initial
      syllable and each of the five Thai tones (mid, low, falling, high, rising) on the
      final syllable. Height and slope of F0 was measured at 10% intervals throughout
      the duration of the initial syllable. Results indicated anticipatory effects on
      both height and slope of the falling tone. Height effects extended throughout
      from the beginning. The falling tone was generally higher when occurring before
      the low/rising tones than when occurring before the mid/falling/high tones. Slope
      effects were restricted to the terminal portion. The falling tone before
      low/rising tones exhibited a steeper slope than before falling/high tones. In
      magnitude of effect, patients with left and right hemisphere lesions were
      statistically indistinguishable from those of normal subjects. No differences
      were noted in coarticulatory patterns as a function of aphasia type. All brain
      damaged speakers were more variable in F0 production than normals. Findings are
      interpreted to highlight properties of nonfluent aphasic speech and neurological
      bases of speech production.

PMID- 8353726
TI  - Broca on cerebral control for speech in right-handers and left-handers: a note on
      translation and some further comments.
AB  - In my analysis (Harris, 1991) of Broca's views (1865) on the relationship of
      handedness to speech representation, a passage from one of Broca's later articles
      was mistranslated. This has implications for one part of the analysis, which this
      note explains. New details and comments are also added to the story.

PMID- 8353727
TI  - Levy-Reid hypothesis.
AB  - The inconsistencies in the research findings looking to test for the Levy-Reid
      hypothesis on the relationship between hand posture and laterality have been
      accounted for in various ways. Some authors (Cohen, 1991; Weber and Bradshaw,
      1981) have suggested that existing methodologies for experimentally establishing
      laterality of language functioning are unreliable. To overcome this constraint,
      we have taken Halsey, Blauenstein, Wilson, and Wills' (1980) suggestion of using
      cerebrovascular accident (CVA) patients in which laterality of expressive speech
      has been established incontrovertibly. We examined 74 CVA subjects assessing hand
      posture, handedness, and side of stroke. Our findings lend support for Levy-Reid,
      nevertheless further examination of the hypothesis using a cross-cultural sample
      underscores the impact education and culture have on hand posture.

PMID- 8353728
TI  - Locative prepositional phrases in severe aphasia.
AB  - Six severely aphasic patients were trained on C-VIC, a computerized alternative
      communication system. Patients with both global and Broca's aphasia were able to
      produce and comprehend locative prepositions using C-VIC. The Broca's aphasic
      patients were able to produce and interpret symbol order correctly in C-VIC
      locative prepositional phrases, despite their difficulties in performing the same
      tasks using English. One patient's verbal production of locative prepositional
      phrases improved markedly after C-VIC training. These results suggest that the
      "mapping" impairment suffered by some Broca's aphasics may be ameliorated by use
      of alternative communication system, such as C-VIC.

PMID- 8353729
TI  - Dysprosody following acquired neurogenic impairment.
AB  - Dysprosody is typically associated with the dysarthrias following acquired
      neurogenic disturbance but it has also been associated with impairment to the
      cortex of the right cerebral hemisphere (Behrens, 1985). Currently there is
      little agreement in the clinical literature as to the locus or nature of
      processes involved in production and reception of prosody. This paper
      investigates the usefulness of two psycholinguistic models of prosody--involving
      "abstract" and "concrete" processes (Ladd & Cutler, 1983)--in accounting for
      dysprosody following motor pathway as well as cortical lesions. Four groups of 10
      adult patients each participated in the study; the first group had sustained a
      right cerebral hemisphere cortical stroke, the second group had hypokinetic
      dysarthria, the third group had ataxic dysarthria, and the fourth group was
      normal controls. Acoustic analysis using the Kay VisiPitch/PC was conducted on
      pairs of matched noun phrase and noun compounds (e.g., greenhouse, green house),
      interrogative and declarative versions of sentences, and sentences spoken in each
      of four different emotional tones. Right cerebral hemisphere damaged subjects
      produced shorter durations than the other groups for each stimulus class.
      However, all of the subjects were able to use duration to signal temporal
      information for the lexical distinction between noun compounds and noun phrases.
      The results are consistent with a model of prosodic control which involves both
      cortical as well as physiological control processes. Current treatment for
      dysprosody is discussed in light of this new emphasis on cognitive control
      processes.

PMID- 8353730
TI  - The Gogi (word-meaning) syndrome with impaired kanji processing: alexia with
      agraphia.
AB  - Two cases, one with probable Pick's disease and one with herpes simplex
      encephalitis, are presented, focusing on Gogi (word-meaning) aphasia-like
      syndrome as their salient clinical feature. Their aphasic symptoms were
      characterized by impaired kanji processing and preserved kana processing in
      writing and oral reading known as a defining feature of Gogi aphasia, but little
      evidence of so-called "phonetic use of kanji in writing" and "confusion between
      on- and kun-readings of kanji in oral reading" often observed in Gogi aphasia.
      Systematic neuropsychological test batteries administered to them showed that the
      selective impairment of kanji processing did not always arise from a disturbance
      of a specific ability known to be essential to Gogi aphasia (i.e., failure in
      comprehending the semantic content of spoken and written language), but rather
      from an amnestic disruption in the ability to access the correct orthographic and
      phonological forms of kanji words. This selective impairment of kanji processing
      may be compatible with "alexia with agraphia of kanji," recently known to be
      attributable to left posterotemporal lesions. These results suggest that Gogi
      aphasia (or similar syndromes) is not necessarily a real syndrome but a polytypic
      constellation of symptoms.

PMID- 8353731
TI  - Language and task effects on lateralized word recognition.
AB  - Behavioral laterality effects in naming and lexical decision in Farsi and English
      were used to evaluate three theories of cross-linguistic differences. First, the
      Scanning hypothesis predicts a smaller right visual hemifield advantage (RVFA) in
      Farsi in both tasks. Second, the Cerebral Dominance hypothesis predicts a
      consistent RVFA in both languages. Third, the Right Hemisphere hypothesis
      predicts a selective decrease in RVFA in Farsi for those components of the task
      that involve lexical semantic access. Results supported the Right Hemisphere
      hypothesis, showing greater right hemisphere contribution to orthographic
      addressing in Farsi than in English.

PMID- 8353732
TI  - The noun-verb problem and Chinese aphasia: comments on Bates et al. (1991).

PMID- 8353733
TI  - Where is the boundary between compounds and phrases in Chinese? A reply to Zhou
      et al.

PMID- 8353734
TI  - [Biochemical parameters in the blood in patients during open-heart surgery. II.
      Malondialdehyde, superoxide dismutase and catalase as indicators of formation and
      elimination of free oxygen radicals].
AB  - Investigation of cardiosurgical patients have provided evidence for the
      generation of free oxygen radicals during open heart surgery. The finding of
      increased plasma malondialdehyde concentrations, considered to be an indicator of
      lipid peroxidation in cell membranes, is suggestive of this process.
      Simultaneously, the antiradical capacity of tissue was found to exhibit a
      decreasing trend, as established by the levels of superoxide dismutase and
      catalase in erythrocytes of peripheral blood which tended to diminish. The
      funding that no changes in the studied parameters were observed in the blood from
      the coronary sinus taken before and after interruption of coronary blood flow
      demonstrates that the commonly applied protection of the myocardium by
      hypothermic cardioplegic solution and topical cooling of the heart is effective
      in suppressing radical formation. (Fig. 5, Ref. 36.)

PMID- 8353735
TI  - [The effect of middle-molecular ninhydrin-positive substances isolated from the
      rat myocardium on rat serum arylamidase activity after administration of
      ethanol].
AB  - Protein-free extract from the myocardium of control rats and the majority of its
      fractions were found to stimulate arylamidase activity. Ethanol administration to
      rats for 1, 3 or 7 weeks increased the amount of fractions which displayed an
      inhibitory effect. The observed changes were probably due to enhanced protein
      degradation and/or to decreased amino acid incorporation into proteins following
      ethanol administration. (Tab. 4, Fig. 2, Ref. 19.).

PMID- 8353736
TI  - [Treatment of ulcerative colitis].
AB  - The authors' 10-year experience with the treatment of 134 patients suffering from
      ulcerative colitis is presented. The standard with sulfasalazine proved
      successful in mild forms of the disease, yet preparations containing only 5
      aminosalicylic acid had to be administered to patients with intermediate and
      serious forms of the disease. The authors recommend to individualize treatment
      with corticoids and antibiotics and to reserve this approach for severe
      conditions. The use of supplementary therapeutic procedures, particularly
      administration of drugs affecting the immune system, is still a rather
      controversial issue. (Tab. 3, Ref. 24).

PMID- 8353737
TI  - [Celiprolol increases the microcirculation in subcutaneous tissue and calf
      muscles in essential hypertension].
AB  - The microcirculation of the subcutaneous tissue and muscles of the extremities is
      changed already in the early stage of essential hypertension. Insight into the
      effect of celiprolol, a beta blocker of the third generation, on tissue
      microcirculation is of both pathogenetic and therapeutic value. On using the
      method of Na131I tissue clearance, the effect of celiprolol on the
      microcirculation of subcutaneous tissue and muscles of the extremities was
      studied in 21 patients with essential hypertension. Celiprolol was administered
      orally in the daily dose of 300 mg. After one-week administration celiprolol
      significantly reduced mean arterial pressure and significantly increased the
      microcirculation in the subcutaneous tissue of the hand and crus as well as in
      the calf muscle. Celiprolol was thus found to increase the microcirculation in
      those tissues of the extremities in which its decrease was recorded before onset
      of the treatment. The obtained results may be of therapeutic value particularly
      in patients suffering from ischemia of the lower extremities. (Fig. 2, Ref. 19.).

PMID- 8353738
TI  - [Electron microscopy immunolocalization of ribosomal ribonucleoproteins using
      autoantibodies from patients with systemic lupus erythematosus].
AB  - Serum of patients against rRNP was tested by Western blot method. Four
      ribonucleoproteins (15, 16, 36 and 38 kDa) specifically reacted with the
      antiserum used. The autoantibodies were used for immunolocalization of antigenic
      structures by immunogold method on ultrathin cryosections of hepatocytes, cumulus
      cells of antral follicle and spermatocytes. Mice and hamsters were used. The
      cytoplasm appeared to be labelled most intensively. Gold particles were loosely
      arranged in the cytoplasm (cumulus cells) or they were associated with
      endoplasmatic reticulum (hepatocytes). Nucleoli were labelled by a lower
      incidence of the marker. Gold particles were found over the dense fibrillar
      component bordering on the granular component. In the cytoplasm individual gold
      particles were observed. (Fig. 7, Ref. 31.).

PMID- 8353739
TI  - [Catecholamines and changes in blood pressure during stress tests in type 1
      diabetics].
AB  - The influence of metabolic control on catecholamine secretion and blood pressure
      during upright posture, mental stress and physical exercise was studied in 34
      normotensive normoalbuminuric type 1 (insulin-dependent) diabetic patients
      without autonomic neuropathy. A poor metabolic control did not induce different
      changes in blood pressure and plasma catecholamines as compared to a good
      metabolic control, except for an exaggerated rise in plasma adrenaline in
      patients with asymptomatic hypoglycemia. The lack of correlation between plasma
      catecholamines and blood pressure suggest that some other factors are also
      involved in the hemodynamic reaction to mental stress and physical exercise in
      diabetic patients. (Fig. 2, Tab. 3, Ref. 25.).

PMID- 8353740
TI  - [Immunotherapeutic principles in the treatment of tumors].
AB  - Numerous clinical and experimental immunological studies have shown that the
      activity of the immune system plays a decisive role in the course of tumor-macro
      organism interaction. The aim of the present paper was to characterize the basic
      principles which should be taken into consideration in the complex strategy of
      cancer management. The best therapeutic effect can be achieved when the immune
      system is changed from the state of tumor-protective activity into tumor
      destructive activity. This can be achieved by the combined effect of three
      synergistic procedures: (1) elimination of the suppressive influence of tumor
      cells on the immune system; (2) elimination of the suppressive activity of the
      immune system; (3) stimulation of anti-tumor effector cell populations of the
      immune system. (Ref. 53.)

PMID- 8353741
TI  - [Time delay in acute myocardial infarct].
AB  - The authors present their experience concerning the time-delay in 357 patients
      with acute myocardial infarction admitted to the coronary unit over the years
      1988-1991. This time indicator was evaluated by using two approaches, i.e. the
      global time-delay (the time between the onset of the patient's complaints and
      his/her admission to the coronary unit) and patient's time-delay (the time
      between the onset of the patient's complaints and his/her decision to notify the
      health care service). Arbitrary criteria were set up: 10 hours for the former and
      5 hours for the latter parameter. The established criteria were met by 40% of the
      patients. Only 24% of the patients presented at the coronary unit within 6 hours,
      and these could receive thrombolytic treatment. The decision time (patient's time
      delay) amounted that the education level of our population has to be enhanced so
      as to increase the number of patients with acute myocardial infarction presenting
      at the coronary unit at an early stage. (Tab. 1, Ref. 9.)

PMID- 8353742
TI  - [Incidence of malignant tumors in Slovakia. I. Levels and trends 1968-1989].
AB  - In the period from 1968-1989 an increase in the overall incidence of malignant
      tumors was recorded in men. Of the individual localizations a particularly marked
      increase was recorded in tumors of the lung, followed by tumors of the oral
      cavity, pharynx, esophagus, pancreas, urinary bladder, kidney (related to
      smoking), as well as of the testis and prostate gland. In women the values of
      overall incidence were lower and the trends were relatively stabilized. This is
      due to the relatively slow increase in the incidence in cancer of the breast and
      female reproductive organs and to the slight increase in cancer of the lung.
      Cancer of the kidney, urinary bladder and pancreas exhibited increased incidence.
      Low values, stabilized and even decreasing trends were recorded in the incidence
      of cancer of the oral cavity, pharynx, esophagus, and larynx, as compared to
      values found in men. In both sexes the incidence of cancer of the stomach showed
      a pronounced decrease, while the incidence of cancer of the colon and rectum was
      increasing. A smaller or greater rise was found also in the incidence of tumors
      of the hematopoietic and lymphatic tissues (except Hodgkins's disease). The
      trends observed in the incidence of malignant tumors in Slovakia are suggestive
      of their uncontrolled course, not affected by preventive measures. Yet the
      findings provide important information for directing the measures so as to aim at
      localizations of priority. (Tab. 2, Fig. 7, Ref. 20.)

PMID- 8353743
TI  - [Transesophageal atrial pacing in bradyarrhythmia disorders of heart rhythm
      (preliminary report)].
AB  - The aim of the paper was to assess the contribution of transesophageal atrial
      stimulation in bradyarrhythmic derangements of the heart rhythm. The main purpose
      was to make the diagnostic simpler and safer. Since the series of patients
      involved is small, our results are to be considered as a preliminary report. (1)
      When only dysfunction of the sinoatrial node is involved, the method yields
      results comparable to those obtained by invasive electrophysiological
      examination. Compared to the latter, invasive approach, the great advantage of
      the presented method is its repeatability and simplicity. (2) Greater caution is
      required on evaluating the conductivity, as it can not be reliably determined in
      the His-Purkinje system. (Tab. 2, Fig. 5, Ref. 12.)

PMID- 8353744
TI  - [The importance of terminology in education, professional activities and in
      research].

PMID- 8353745
TI  - [Molecular medicine].
AB  - The introduction of new methods into medicine, such as recombinant DNA,
      production of monoclonal antibodies, and particularly polymerase chain reactions,
      yielded much knowledge and information in fields like preventive medicine
      (prenatal screening), reproduction strategies (preimplantation diagnosis of
      genetic defects), molecular diagnosis (oncological and infectious diseases), gene
      therapy, etc. In many areas the practical use of these sophisticated approaches
      has become technically feasible yet due to the high cost involved it is still
      limited. The introduction of some screening programs will be associated with
      ethical problems of serious impact. To date we can already establish
      presymptomatic diagnosis of some progressive diseases for which however no
      therapy is available. Potential abuse of confidential genetic information as well
      as the possibilities of using gene therapy for "corrective eugenics" are loaded
      with serious ethical problems. Prospective doctors have to be prepared for this
      situation in the course of undergraduate studies of medicine. (Ref. 11.)

PMID- 8353746
TI  - [Antioxidative properties of cardioactive agents].
AB  - Calcium entry blockers reduce the ischemia-reperfusion induced damage to the
      myocardium. Free oxygen radicals play a role in the pathogenesis of this injury.
      The mechanism of the protective action of calcium entry blockers is unknown in
      these conditions and appears to be independent of the blockade of slow calcium
      channels. As demonstrated in this paper, the calcium entry blockers nifedipine,
      verapamil and diltiazem are effective scavengers of free oxygen radicals and this
      characteristic may be importantly involved in their protective effect against
      myocardial damage induced by ischemia and reperfusion. The pro-oxidative capacity
      of the antineoplastic drug cisplatin is assumed to play a role in the mechanism
      of its renal toxicity action. The presented study showed that the new
      antioxidative substance with antiarrhythmic and antihypoxic properties-stobadine
      succeeded in inhibiting the pro-oxidative effect of cisplatin. Our findings
      suggest that administration of cisplatin along with antioxidants may result in a
      protective effect against the renal toxicity of cisplatin. (Fig. 5, Ref. 38.)

PMID- 8353747
TI  - [Diagnosis of echinococcosis in the population of Slovakia].
AB  - Serologically diagnosed cases of echinococcosis in man occurring over the years
      1970-1990 are reported. In the given period 292 serum samples were examined
      obtained from patients clinically suspected of echinococcosis, either with or
      without indication of localization in different organs. Of the total of 22
      serologically positive patients echinococcal cysts were found in the liver in 17
      patients (77.27%), in the lungs in three (13.63%) and in two patients the
      localization was not established. The patients with positive serological finding
      were within the age range of 33 to 68 years, with the exception of one 11-year
      old boy. The value of serological examination of echinococcosis in the subjects
      involved in our study is highlighted by the findings in those patients who
      underwent surgery. Both the positive and the negative serological results were
      confirmed by the surgical findings of the presence or absence of echinococcus.
      (Tab. 3, Ref. 22.)

PMID- 8353748
TI  - [The effect of ethanol on the occurrence of peptides with antibacterial effects
      in the rat myocardium]].
AB  - The effect of 7% ethanol on the peptide content in the myocardium was studied
      during prolonged exposition. The protein-free extract from the myocardium of
      controls as well as experimental groups following 1-8 weeks ethanol
      administration contained peptides with antibacterial activity. Long-term ethanol
      administration resulted in changes in physico-chemical properties of peptides
      both compared with controls and also among the experimental groups mutually. The
      changes were manifested by differences in the elution profiles following gel
      chromatography and RF values after electrophoresis or by different amino acid
      composition. The results are compared with the influence of peptides on the
      growth of bacterial cultures S. aureus. Ethanol administration induced diminution
      of the diameter of the inhibitory zones. This effect was most marked in the group
      fed with ethanol for 3 and 8 weeks. (Fig. 5, Ref. 17.)

PMID- 8353749
TI  - [Does short-term high-frequency jet ventilation damage the tracheobronchial
      mucosa?].
AB  - In anesthetized rabbits, the occurrence of histopathological changes was studied
      above below and the level of the endotracheal tube opening after one-hour high
      frequency jet ventilation (f = 150.min-1,Pin = 70-90 kPa, Ti = 0.5) with
      nonhumidified air and oxygen mixture (FiO2 = 0.6). The findings were compared
      with those obtained in intact rabbits and in rabbits which were inhaling
      nonhumidified air from the environment spontaneously via the endotracheal tube.
      Mechanical obstruction of the airways by mucus or necrosis of the mucous membrane
      was not observed. The major histopathological changes characteristic of
      inflammation and mechanical damage of the mucosa were recorded above the opening
      of the endotracheal tube. Towards the main bronchi the degree of the injury was
      decreasing. (Tab. 2, Fig. 2, Ref. 11.)

PMID- 8353750
TI  - [Serodiagnosis of larval toxocariasis in Slovakia].
AB  - The results of serological examinations performed over the years 1986 to 1990 in
      patients suspected of larval toxocariasis, coming from different Institutes of
      National Health in Slovakia, are reported. Seropositivity was within the range
      from 9.38 to 23.56%. The five-year average was 17.72%, with a predominance of
      seropositivity in the country. Age-related analysis of the series of patients did
      not show any significant difference of seropositivity in children and adults
      (18.00 and 17.21% respectively). Higher seropositivity rates were found in boys
      (20.73%) compared to girls (14.69%). This was found to be reversed in adults,
      where women had higher seropositivity rates than men (20.61 and 12.08%
      respectively). The ocular for of larval toxocariasis showed a higher prevalence
      in adults. (Tab. 4, Fig. 1, Ref. 18.)

PMID- 8353751
TI  - [Changes in hemostasis in ischemic heart disease].
AB  - The relationship between changes in blood coagulation, the occurrence and
      severity of risk factors of ischemic heart disease and the clinical condition of
      the patient was investigated. The at risk group of patients 42.2% had more than 3
      pathological parameters. Intravascular blood coagulation was not activated in any
      of the patients. In patients with acute myocardial infarction (MI), 62.2% had
      more than 3 pathological parameters on the first day of MI development.
      Demonstrable activation of intravascular blood coagulation was found in 28.2% of
      these patients. On day 5 of MI, activation of intravascular blood coagulation was
      recorded in 57.7% of the patients treated by classical approach and in 15.4-30.8%
      of the patients on thrombolytic treatment. In the at risk group, primary
      hemostasis and the fibrinolytic system were more affected, in patients with MI
      the whole hemostatic mechanism was involved. On day 5 of MI, in patients with
      classical therapy pathological laboratory findings still persisted or were even
      more deteriorated, particularly increases in fibrinogen level. At that time, in
      patients on thrombolytic therapy no substantial changes of initial values were
      recorded. No correlation was found to exist between changes in hemostasis and the
      risk profile or between changes in hemostasis and the clinical severity of MI.
      The obtained results justify the administration of antithrombotic substances,
      especially in patients with unstable angina pectoris. On observing time
      constraints, administration of thrombolytics is justified in MI. (Fig. 9, Ref.
      25.)

PMID- 8353752
TI  - [Long-term results of revascularization surgery in oblitertive arteriosclerosis
      of the lower extremities].
AB  - The authors evaluated their 15-year experience with revascularization operations
      for atherosclerosis obliterans (ASO) of the lower extremities. Over the period
      from 1975 to 1990, 1112 patients with ASO were admitted to their department and
      in 674 (60.6%) of them revascularization operation was performed. Direct
      revascularization surgery (bypass, desobliteration, angioplasty) was performed in
      318 (47.2%) patients and indirect revascularization, sympathectomy in 326 (52.8%)
      patients. On evaluating the long-term results of aortobifemoral (AF2),
      femoropopliteal (FP) and femorocrural (FC) bypasses the following long-term
      patency was established: AF2 bypass--patency up to 2 years 92%, up to 5 years
      90%, up to 10 years 76%, up to 15 years 75%; FP bypass--patency up to 2 years
      90%, up to 5 years 84%, up to 10 years 62%, up to 15 years 46%; FC bypass-
      patency up to 2 years 63%, up to 5 years 50%, up to 10 years 25%. Complications
      developed in 10%, the mortality rate was 2.5% and 8% in FP and AF2, respectively.
      The obtained results are comparable with the data published in the literature.
      The authors achieved the best results in the suprainguinal region with AF2
      bypasses on using mostly dacron prostheses and in the infrainguinal region FP
      bypasses on using the autologous great saphenous vein. (Tab. 3, Fig. 4, Ref. 17.)

PMID- 8353753
TI  - [Quantitative changes in the ultrastructure of myocardial cells in Japanese quail
      during hypergravity, hypodynamia and space flight].
AB  - The experimental work aimed at the quantitative ultrastructure of the myocardial
      cells of the Japanese quail Coturnix coturnix japonica during hypergravitation,
      hypodynamism and space flight in a Soviet satellite. For the determination of
      quantitative changes of the myocardial ultrastructure a morphometrical method was
      used with parameters like the number of mitochondria, average mitochondrial size,
      relative mitochondrial volume, deficiency of cristae and relative volume of
      myofibrils. The quails were observed in 3 groups. The absolute control consisted
      of quails living in normal Earth conditions, in the laboratory group the quails
      were exposed to conditions of hypergravitation and hypodynamism in a specially
      constructed centrifuge, and in the flying group the quails were exposed to space
      flight in a Soviet orbital station MIR. In the group of absolute controls no
      pathological changes of the myocardial ultrastructure were found. In the flying
      group there were no significant changes, with the exception of decreased relative
      volume of myofibrils, which however agrees with the findings on symptoms
      corresponding to human and animal heart weakness during space flights. In the
      laboratory group, pathological changes were observed in each of the fractions.
      The most significant pathological findings were found in the group controls in
      the center and in hypergravitation combined with hypodynamism. It can be
      concluded that the laboratories can simulate conditions induced by the start and
      flight of space ships. (Fig. 2, Ref, 8.)

PMID- 8353754
TI  - [Evaluation of hepatic damage in personnel in the anesthesiology- resuscitation
      department in relation to halothane exposure].
AB  - In a simple uncontrolled toxicological study 27 workers of an anesthesiology
      resuscitation department of a hospital type III were examined. Besides detailed
      clinical examination, determination of basic hematological and biochemical
      parameters as well as ultrasonography, also selected parameters of
      proteosynthetic function of the liver, some so-called proteins of the acute phase
      and the biological half-life of antipyrine were established in the workers under
      study. The occurrence of pathological findings in the picture of the examinations
      performed was related to long-term professional exposure to halothane over the
      period of one year before the examination. With regard to the possibility of
      chronic hepatotoxic damage, appropriate attention should be paid to workers of
      anesthesiology-resuscitation departments, concerning particularly entrance
      medical examinations and regular screening and follow-up of their health
      condition, including check-ups hepatic parameters. (Tab. 4, Ref. 23.)

PMID- 8353755
TI  - [Morphologic findings in models of acute experimental pancreatitis].
AB  - Morphological changes found in two models of acute experimental pancreatitis are
      presented. Acute pancreatitis was induced in rats by the method of ligation of
      the lateral pancreatic ducts and by the method of the blind duodenal loop. After
      four hours the animals were sacrificed and processed for light and electron
      microscopic examination. Changes indicative of edematous and necrotizing
      pancreatitis were recorded. In the electron microscopic picture the predominant
      findings were disintegration of organelles of acinar cells and the appearance of
      numerous vacuoles and autophagosomes. The presented models of pancreatitis are
      considered to be suitable for further research into the pathogenesis and
      therapeutic intervention of acute pancreatitis in rats. (Fig. 15, Ref. 8.)

PMID- 8353756
TI  - [Personal experience with endoscopic therapy of chronic pancreatitis].
AB  - Endoscopic drainage is a modern and effective therapy in patients with chronic
      obstructive pancreatitis. The authors demonstrate their experience with this
      therapy in 20 patients. It resulted in pain disappearance in 60% of the patients
      and in body weight increase within 1 year after therapy in 55% of the patients.
      Steatorrhea was not significantly influenced by the therapy. The main
      complication of endoscopic therapy were frequent restenoses (30%). (Tab. 4, Fig.
      2, Ref. 12.)

PMID- 8353757
TI  - [Biochemical indicators in the blood and liver in rats after administration of
      beta-escin].
AB  - The effect of beta-escin on selected parameters of carbohydrate and lipid
      metabolism was studied in blood and liver tissue. The aim was to established
      whether its administration would result in steatosis of the liver. Rats were
      given sodium salt of beta-escin in water solution orally by gavage in the dose of
      10 mg/kg or 70 mg/kg. Analysis of blood samples and liver tissue showed that
      administration of beta-escin to healthy rats did not induce any substantial
      changes in the metabolic parameters studied. The rats did not develop steatosis.
      The biological half-life of antipyrine was only sightly prolonged. (Tab. 3, Fig.
      1, Ref. 10.)

PMID- 8353758
TI  - [What are the costs of septic complications in surgery?].
AB  - Infectious complications have remained the most frequent cause of morbidity in
      surgical patients, and that despite the constantly broadening range of up-to-date
      antimicrobial drugs administered prophylactically and therapeutically, the
      improved methods of cultivating microorganisms and of establishing sensitivity to
      antibiotics. Infections in surgical patients lead to prolonged hospitalization,
      prolonged working disability, and to increased cost of treatment. Considerable
      economic consequences of infections in surgical patients are demonstrated on the
      basis of the authors' clinical material and possibilities of preventing
      infections and of their treatment are also discussed. (Fig. 1, Tab. 2, Ref. 21.)

PMID- 8353759
TI  - [Antibiotic therapy in the intensive care unit].
AB  - The results of antibiotic treatment administered to 78 patients within one year
      are reported. Due to the nosocomial nature of the infections, the serious overall
      condition of the patients and the associated diseases, the prognosis remained
      unfavourable despite adequate antibiotic treatment. In the group of patients on
      dialysis ofloxacin and ciprofloxacin proved effective. Patients with exacerbation
      of chronic bronchitis responded well to doxycycline. In the treatment of
      infections of the urinary tract, the known favourable effect of cotrimoxazol was
      confirmed. Of the group of 78 patients with transitory or permanent
      cardiostimulation, 18 received antibiotic treatment. In 6 of them with transitory
      cardiostimulation antibiotics were given as a prophylactic measure, 4 patients
      developed febrile conditions after implantation of the cardiostimulator and 8
      patients received antibiotics due to infections of the respiratory and urinary
      tract. After implantation of the cardiostimulator 60 patients (77%) did not
      require antibacterial treatment. (Ref. 5.)

PMID- 8353760
TI  - [Care of the aged population].
AB  - Topical problems in the care of geriatric patients are presented. Qualified
      estimations suggest that subjects above 60 years of age represent more than one
      half of the daily clientele of a district physician. The basic characteristics of
      elderly people are their fragility, readily attained decompensation and
      diminished adaptability. Their hospitalization is thus demanding and involves
      risks. Geriatric patients require comprehensive care. Treatment without removing
      their social fears and psychic anxiety does not yield adequate effect. Active
      involvement of relatives into the program of care may prove a beneficial
      contribution. The main aim is to provide comprehensive health and social care
      primarily at the patient's home. (Ref. 10.)

PMID- 8353761
TI  - [The relation of speech to the right and left cerebral hemispheres].
AB  - Verbal speech functions are localized in right-handed subjects nearly exclusively
      and in left-handed ones mostly in the left hemisphere. Much information on these
      functions has been obtained by studying patients affected with spontaneous
      damages, as well as after hemispherectomy, after severing the corpus callosum,
      and during electric stimulation of the brain in neurosurgical procedures. In the
      presylvian region of the hemisphere dominant for speech, a region for the
      production and identification of speech was found, surrounded by an area for
      shortterm verbal memory. The predominance of the right ear in recognizing verbal
      stimuli, established by the dichotic test, applies to the population rather than
      to the individual. The substance of verbal dominance of the left hemisphere lies
      in the prevalence of its capacity to distinguish rapid acoustic sequences and to
      produce them. Observations made on deaf-mute patients with sign language have
      demonstrated that humans possess a genetically determined ability to develop
      speech, regardless the modality. Speech functions of the right hemisphere concern
      mostly nonverbal prosodic components of speech.

PMID- 8353762
TI  - [Genetic disorders in the pediatric population in Orava].
AB  - The study is focused on genetic characterization of the child population of the
      Orava region, where genetic isolates persisted as long as the middle of this
      century. Active screening for genetic pathology over a period of 5 years involved
      examination of 1058 children aged 0-14 years. Genetically determined pathological
      conditions were diagnosed in 757 children, which represents 1.67% of the child
      population of this region. Chromosomal aberrations were established in 55
      children (0.12%), monogenic diseases in 193 children (0.43%), of these autosomal
      recessive conditions in 88 children (0.19%), and multifactorially determined
      conditions in 478 children (1.06%). Focal occurrence of an inherited disease was
      not recorded. Genetic load of the population studied was found to be comparable
      to that in panmictic populations. The occurrence of diseases inherited as
      autosomal recessive traits suggests that the influence of genetic isolates does
      no longer persist in Orava.

PMID- 8353763
TI  - [Enzymes in tumors of the breast. Histochemical study of the stroma in breast
      carcinomas].
AB  - The results obtained in histochemical examination of the stroma of mammary gland
      carcinomas allow to draws the following conclusions. The reaction for alkaline
      phosphatase proved suitable for detecting proliferation zones in the stroma of
      mammary gland carcinoma. Proliferation of fibroblasts, myofibroblasts,
      endothelial cells, and possibly also of other cells is involved. At present,
      myofibroblasts can not be cytoenzymatically differentiated from fibroblasts. The
      reactions for acid phosphatase and nonspecific esterase provide a quick and
      reliable picture on the amount of macrophages. The combined reaction for alkaline
      phosphatase and dipeptidylpeptidase IV in the same section indicates that
      individual segments of the newly formed capillary bed in the stroma of the tumor,
      i.e. the arterial, intermediary and venous segment, are differentially equipped
      by these enzymes. The activity of several enzymes in carcinomal stroma with
      typical stripe- and wave-like architecture can most probably be assigned to
      fibroblasts and myofibroblasts. Between the enzymatic activity in the stroma and
      the type or differentiation of the carcinoma no relationship was established.

PMID- 8353764
TI  - [Use of the CA 19-9 tumor marker in the diagnosis of pancreatic carcinoma].
AB  - The contribution of the tumor marker CA 19-9 to differential diagnosis between
      malignant and nonmalignant diseases of the pancreas was assessed in a group of
      120 patients. On using border values of CA 19-9 80 U/ml, its sensitivity was
      found to be 84.4% and its specificity 84.8% for carcinomas of the pancreas.
      Correlation of CA 19-9 values with results of computer tomography and endogenous
      retrograde cholangiopancreatography in the patients studied yielded an over 80%
      accordance. In the light of the obtained results, the authors consider
      determination of CA 19-9 levels to be a suitable method supplementing the imaging
      examination methods in suspect carcinoma of the pancreas.

PMID- 8353765
TI  - [Use of high-frequency modulated continuous positive airway pressure in
      experimental respiratory distress syndrome and pulmonary edema].
AB  - The effect of high frequency (f = 300.min-1) modulated continuous positive airway
      pressure (CPAP) (0.49 kPa) was compared with that of CPAP without modulation
      (0.49 kPa) in 24 anesthetized rabbits in experimental respiratory distress
      syndrome (RDS) and pulmonary edema. RDS was induced by single excessive lavage of
      the lung on using the impulse and expulse effect of high frequency jet
      ventilation. Pulmonary edema was elicited by i.v. administration of a mixture of
      fatty acids. Decreased dynamic compliance of the lung and increased respiration
      work and rate were recorded both in experimental RDS and pulmonary edema. In RDS
      paO2 was reduced and paCO2 increased. In pulmonary edema, despite diminished
      respiration volume, ventilation was enhanced by the higher respiration rate and
      both paO2 and paCO2 were reduced. Application of CPAP resulted in normalization
      of blood gases. Modulated CPAP, compared to CPAP without modulation, further
      decreased paCO2 and increased paO2. The results obtained in experimental models
      of RDS and pulmonary edema in rabbits show the beneficial effect of high
      frequency modulated CPAP by pressure oscillation on values of blood gas tension.

PMID- 8353766
TI  - [Relation between blood glucose and insulin in hemodialysis].
AB  - In 25 patients with chronic renal failure, the levels of glycemia and
      immunoreactive insulin (IRI) were determined in one-hour intervals over the
      period of eight-hour hemodialysis. The study was performed in hemodialysis with
      and without 200 mg% glucose in the dialysis solution. The mutual behavior of the
      two substances was evaluated. In patients on a chronic hemodialysis program the
      level of IRI was found to depend on elimination, secretion, and endogenous
      control of IRI. The internal processes may be involved to a more important extent
      in achieving the definitive levels of IRI (middle-molecular substance) than its
      elimination by hemodialysis. The actual regulator-glucose (low-molecular
      substance) need not change its level significantly in this process.

PMID- 8353767
TI  - [The effect of rotating magnetic fields on the growth of Deal's guinea pig
      sarcoma transplanted subcutaneously in guinea pigs].
AB  - The effect of rotating magnetic field (RMF) was studied on the growth of Deals'
      guinea pig sarcoma (DGPS) transplanted subcutaneously into the inguen of guinea
      pigs. The 0.2 ml of transplanted suspension contained 1.5-2.0 x 10(6) of vital
      DGPS cells. Over a period of 24 days the animals were daily two times exposed to
      RMF for 3 hours. The animals were sacrificed in chloroform anesthesia, the
      inguinal tumors, lungs and hearts were removed and weighed. The following
      findings were recorded: 1. RMF inhibited the growth of DGPS cells in experimental
      guinea pigs compared to control animals (p < 0.001); 2. In the experimental
      animals DGPS cells did not metastasize into the lung parenchyma; 3. The
      pathological characteristics of the tumors in the experimental and control group
      of guinea pigs tended to be different. (Tab. 3, Ref. 14.)

PMID- 8353768
TI  - [The clinical picture of imported malaria and its relation to P. falciparum
      parasitemia].
AB  - The paper summarizes the results of clinical examinations of imported malaria in
      48 patients, semi-immune foreigners infected with P. falciparum and P. vivax/P.
      ovale. Of the objective manifestations, hepatosplenomegaly was predominant in P.
      falciparum infections (34%), whereas in P. vivax infections its occurrence rate
      was 19%. Body temperature over 38 degrees C with shivering had a higher frequency
      in P. vivax (81%) compared to P. falciparum (41%) infections. Pathologically
      altered hematologic values, particularly mild to medium increase in sedimentation
      rate, were found in all patients with P. vivax/P. ovale, while in patients
      infected with P. falciparum only in those whose parasitemia exceeded 10,000
      trophozoites in 1 microliter blood. Reduced values of hemoglobin, hematocrit, and
      mean erythrocyte volume are indicative of microcytic anemia of mild degree.
      Biochemical examinations yielded slightly increased values of the thymol
      turbidity test and mild reduction of serum proteins at simultaneous increase of
      albumins (8% of the patients examined). Of the parameters of humoral immunity,
      there was a rise in immunoglobulin values concerning particularly IgG and IgM,
      and that in all types of malarial infection studied. Increased values of
      circulating immunocomplexes had a high frequency rate with all plasmodial
      species, in P. falciparum infections independently of the degree of parasitemia.
      (Tab. 7, Ref. 13.)

PMID- 8353769
TI  - [von Hippel-Lindau disease].
AB  - The available diagnostic and therapeutic possibilities allow to treat
      successfully all manifestations of von Hippel-Lindau disease. Adenocarcinomas of
      the kidneys, however, still present a serious therapeutic problem due to their
      mostly bilateral and multifocal occurrence. Evidence that patients after
      bilateral nephrectomy with subsequent dialysis or transplantation would have a
      longer survival time than patients whose kidneys had not been removed has not
      been provided as yet. Partial resection or enucleation of tumors may postpone the
      development of metastases but does not prevent tumor formation in the remaining
      parts of the kidneys. Considering the late appearance of metastases, though
      evidence only in one of our patients, we preferred not to remove the kidney and
      to introduce dialysis. The availability of sonography has put the kidney into the
      focus od attention in this disease. Not only does sonography allow to monitor
      regularly members of the affected families but also to screen for the disease at
      routine sonographic examination of the abdomen. (Fig. 7, Ref. 15.)

PMID- 8353770
TI  - [The 100th anniversary of Szondi].

PMID- 8353771
TI  - [Congenital malformations: care or predict?].
AB  - Spectacular scientific and technological advances made in the last decade have
      had such a profound impact on biological and medical science that they have
      dramatically modified the citizen's behaviour concerning life events, especially
      congenital malformation. Prenatal diagnosis (PND) leads to do the diagnosis of
      almost all fetal internal and external malformations. The matter is, not only to
      care, but, first to know. The positive efficiency of PND is sometimes preparing
      the best cares and, of course, to recognize many severe anomalies postnatally
      diagnosed before PND time, and carrying wellknown 50% rate mortality by neo-natal
      surgery. Congenital diaphragmatic hernia is pointed out as a good example of it,
      and of hopes and disappointing in utero foetal surgery. New protocol of
      assessment of fetal renal function is an appreciated method to do prognosis of
      some fetal uropathies before late in utero drainage, for a short time waiting for
      necessary maturation of lungs allowing premature delivery. The possibility to do
      PND of small and benign malformation leads to ask for the question of utility of
      to know. In spite of the respect of quality of life, can we really allow this
      type of human selection to be made? The next knowledges of the human genoma map
      bring us into the predictive medicine. Using "compulsory" PND is a real risk to
      practice dangerously, a soft eugenism. PND must be, and remain an outstanding
      advance to provide better treatment.

PMID- 8353772
TI  - [Synergism and antagonism between estrogens and progestins: an update].
AB  - Our purpose is to provide a review of studies performed since forty five years,
      concerning interactions of natural or synthetic estrogens and progestins. In this
      paper, the terms synergism and antagonism have to be considered in a broader
      sense than usually done. In addition to the classical concepts of succession and
      of simultaneity synergism between estradiol and progesterone, notions of "saving"
      and of "necessity" synergism came from decidualization studies in the rabbit
      (1949). The necessity synergism put definitively and end to the idea that
      estradiol was only a female hormone and progesterone a mother one. Our research
      in the field of ovum implantation showed also that estrogens might be secreted by
      mammalian ova (1949), which is now well established. The participation of
      estrogens to the process of decidualization in the rat suggested even (1958,
      1959) their role in the starting implantation. From 1960, synthetic estrogens and
      progestins were tested, in a first step especially ethynylestradiol and
      chlormadinone acetate. In the rabbit and in the rat, these new tools permitted us
      to dissociate the hormonal needs of embryonic growth and of morphogenesis (1965).
      The studies related to the effects of these analogs upon the adrenal gland, as
      upon the hypophysis (1963), led to their clinical use in the treatment of
      advanced breast cancers, and the studies concerning their effects in the
      ovulation to the discovery of the antiovulatory synergism of synthetic estrogens
      and progestins (1966, 1982). These observations are in agreement with the
      Courrier rules with regard to the relationships between the relative, but also
      absolute, quantities of estradiol and of progesterone administered, and the
      obtained biological effects. Nevertheless, progestins exist with incomplete or,
      on the contrary, superfluous pharmacological activities. In the extreme, the
      estrogenic properties of norethisterone take precedence over its progestogenic
      properties when administered doses are growing (1977). These phenomena have now
      to be understood at a molecular level. Though explanations are presently
      available for some processes, many of them remain to day unexplained, and
      inversely other explanations are coming into sight.

PMID- 8353773
TI  - [Molecular genetics of hemochromatosis].
AB  - Haemochromatosis is an inherited disorder of iron metabolism characterized by a
      general iron over loading. Without diagnosis and early treatment, it is a serious
      and potentially fatal disease by cardiac failure or hepatocellular carcinoma in
      particular. Gene prevalence was estimated at 0.06 in Brittany, so that
      haemochromatosis may be the most common genetic disease in this area. The
      biochemical defect of the disease is unknown; only one fact is well established:
      the iron absorption through duodenal mucosa is excessive. However we don't know
      if it is a primary event. The gene is also unknown but in 1975 it was located on
      the short arm of chromosome 6, closely linked to the HLA class I region, less
      than 1 cM from HLA-A. None of the genes coding for the known iron proteins could
      be the haemochromatosis gene because of their chromosomal localization. In order
      to locate this gene with precision, we have used a reverse genetic approach now
      called positional cloning. Characterization of new polymorphic markers and
      linkage disequilibrium analysis, have led us to locate the gene within a 350 kb
      region around HLA-A. We have then searched for all the structural genes in this
      region. Seven new genes have been so identified and located with precision. A
      structural analysis of these genes was undertaken to find an eventual abnormality
      in patients.

PMID- 8353774
TI  - [Occupational arm ailments in musicians].
AB  - We began our specific interest in this subject in 1975 and to date have seen and
      treated over 600 musicians with functional problems of the upper limb. These are
      common problems affecting over one third of instrumental musicians. Every
      instrument may have its own specific repercussions. However certain factors may
      influence their onset: intensive practice; a technique requiring non
      physiological positioning; a change in technique, instrument or habits; pre
      existing trauma; psychological predisposition; inappropriate physique. The
      presentations are varied and the limits imprecise. Muscles, tendons, joints and
      nerves may be involved. The commonest, and easiest to cure are due to pain
      resulting from overuse syndromes cover a multitude of sins resulting from marked
      physical effort in excess of the normal physiological capacity of the body. Joint
      instability and degenerative disease pose their own specific problems. Peripheral
      nerve lesions can be related to overuse syndromes or to the adoption of non
      physiological or harmful positions. The most difficult problems to deal with are
      those related to a loss of motor control when performing the same repetitive
      movement--functional dystonia. Their origin remains obscure with the major
      discussion revolving around either a neurological or organic aetiology. Our
      intensive experience of instrumentalists with these problems secondary to bad
      positioning or posture, has led us to propose a therapeutic regime based on
      structured re-education and relaxation. The great majority of sufferers overuse
      syndromes or functional dystonias have been able to resume their professional
      activities. It is clear that functional dystonias are curable if treatment is
      instituted early and that the lesions are not too long standing.

PMID- 8353775
TI  - [Celioscopic cholecystectomy].
AB  - Laparoscopic digestive surgery is right now like a revolution. The author after a
      short historic homage to Raoul Palmer who in 1940 realized the first laparoscopy
      and also to Philippe Mouret and Francois Dubois who performed the first
      laparoscopic cholecystectomy in the world in 1987, is doing some comments. The
      comments are based in the experience of the author who performed in his surgical
      department about 400 cholecystectomies and another study realized with B.
      Delaitre on 6512 cases showing a decrease of morbidity however a dramatic
      increase of biliary complications from 1.0/00 to 1% this leads the author to two
      type of reflexions. One based on technical problem especially in high frequency
      surgery the other in training of this new surgical technic and also on rapid
      extension, sometime anarchistic of the indications of this new digestive
      laparoscopic surgery. In conclusion, we have to performed clinical research
      before doing next applications of laparoscopic surgery and keep in mind the
      necessity for a new technic to be better for patients.

PMID- 8353776
TI  - [Prevalence of gastrocnemius vein insufficiency using color-coded Doppler
      ultrasound (modifications of the therapeutic strategy)].
AB  - The importance of morphologic and dynamic lesions of the gastrocnemius vein is
      underestimated. Color-coded Duplex scanning was performed in 483 patients with
      varicosities and 869 legs with some venous abnormalities were discovered. Two
      types of lesion on gastrocnemius veins were founded: incompetence and dilatation
      usually located on the medial gastrocnemius vein. In 29.34% of the limbs, a
      medial gastrocnemius vein incompetence was present and a dilatation in 15.42%.
      Medial gastrocnemius vein incompetence was associated with a mid calf
      gastrocnemius communicating vein incompetence in 25%. Physiopathological
      hypothesis could be drawn of our observations. Gastrocnemius veins when
      incompetent should be ligated flush to the popliteal vein. The high prevalence of
      gastrocnemius vein should be considered in the management of varicose veins and
      color-coded Duplex scanning routinely performed before surgery.

PMID- 8353777
TI  - [The Hellp syndrome: a frequent (?) obstetric emergency].
AB  - Preeclampsia is a multisystem disorder of pregnancy whose clinical presentation
      is related to the importance and the extent of maternal microvasculature damage.
      16 patients with preeclampsia, thrombocytopenia (< 100,000/mm3), elevated liver
      enzymes and hemolysis are described. Weinstein in 1982 assigned the acronym of
      Hellp syndrome for this clinical presentation of preeclampsia. This syndrome was
      seldom recognized during the first years of the study but was diagnosed later on,
      in 1 pregnancy out of 600 parturitions and in 5% of preeclampsia in 1991. Two out
      of the patients developed eclamptic seizures. The mode of delivery was as
      follows: 9 out of 16 had an emergency Caesarean section; the 7 other patients had
      vaginal delivery after induction of labor. Delivery occurred before 32 weeks of
      gestation for 6 out of 17 newborns. Outcome was good for 14 of the 17 newborns
      (one twin pregnancy). Two fetuses died: one in utero and one during interruption
      of the pregnancy at 24 weeks of gestation. A small for gestational age preterm of
      32 weeks died on his second day of life. Early diagnosis of Hellp Syndrome,
      especially when abdominal pains are present, allows a prompt management of these
      patients, including delivery, which appeared in our experience, the only way to
      avoid fetomaternal complications. The thrombotic microangiopathics and acute
      fatty liver of pregnancy are potential imitations of Hellp syndrome and they must
      be considered for differential diagnosis. The frequency of Hellp Syndrome varies
      from one study to another. It can be increased up to 6 fold if referred to the
      number of pregnancies and up to 3 fold if referred to the number of
      preeclampsias. These differences can be real but may be due to bias related to
      differences in practice between centers and also differences in definitions of
      Hellp Syndrome and preeclampsia.

PMID- 8353778
TI  - [A new entity of sperm pathology: peri-axonemal flagellar dyskinesia].
AB  - The study of 17 infertile men has led to define a new entity of sperm pathology
      as part of the more general field of flagellar dyskinesias. Sperm parameters of
      the studied patients and a control series have been first estimated by routine
      analysis (concentration, motility, morphology). To precise their characteristics,
      kinetic and ultrastructural investigations, as the zona-free hamster oocyte
      penetration test, have been performed. Sperm parameters of the studied cases, as
      revealed by routine analysis, were close to the control group. However, a major
      kinetic anomaly was found which was characterized by an important decrease of the
      amplitude of lateral head displacement (1.6 microns vs 5.3 microns, p < 0.001),
      although the progressive velocity was only slightly impaired (20.3 microns vs
      24.9 microns, p < 0.05). Electron microscopy revealed anomalies limited to the
      peri-axonemal structures such as the outer dense fibers and the fibrous sheath.
      Rates of sperm-oocyte attachment were normal but rates of oocyte penetration were
      low (27.7% of decondensed sperm heads vs 85.6%, p < 0.001). Attempts to assisted
      fertilization with the studied patients (51 cycles of insemination, 8 cycles of
      in vitro fertilization) were unsuccessful. All these data suggest that the
      infertility can be attributed to the movement disturbances which should impair
      sperm propulsion throughout the cervical mucus and the zona pellucida.

PMID- 8353779
TI  - The critical care unit. In search of management.
AB  - Given the impending crisis in health care economics, all segments of the health
      care industry must maintain quality while becoming more efficient and cost
      effective, particularly the critical care units that are disproportionately large
      consumers of the health care dollar. This article reviews the managerial and
      administrative issues, responsibilities, challenges, and demands that confront
      unit directors now and in the future. Also, this article provides a context and
      framework for all following articles in this volume.

PMID- 8353780
TI  - Intensive care units in the triage mode. An organizational perspective.
AB  - Decisions to admit and discharge patients to and from the intensive care unit
      (ICU) when resources are scarce should be made according to the triage principle-
      that is, resources should be allocated based on the patient's ability to benefit
      from critical care. The ICU organizational structure and the constraints on
      decision-making processes are discussed in this article along with strategies for
      improvement in both areas.

PMID- 8353781
TI  - Management as the art of politics.
AB  - This discussion has furnished a personal view of some of the features involved in
      managing a busy surgical ICU. Experience has provided the reference frame rather
      than an extensive literature search and associated bibliography. Physician
      involvement in ICU management depends on the character of the institution and the
      ability of the director to influence physician, nursing, and ancillary staff
      behavior by force of personality rather than by relying on universally accepted
      behavioral covenants. The issues raised are controversial and should provoke more
      discussion than acceptance. It is to be hoped, however, that some of the points
      will be recognized as common problems requiring solution in all similar
      environments. "Management as the art of politics" summarizes the 1980s' approach
      to ICU governance, and it is fitting to question its acceptability in an era of
      cost containment, resource restriction, and increased awareness of the rights of
      a patient and his or her family to control the extent of medical care rendered.
      Laissez faire management is unacceptable today, and future governance will
      reflect increased responsibility for unit managers and the realization that the
      ICU is an institutional and societal resource that cannot respond to the
      prerogative of individual users. The Magna Carta of ICU governance remains to be
      written. It is inappropriate for ICU managers to assume responsibilities that
      preclude the prerogative of the admitting physician and appropriate medical
      consultants. It is equally important, however, that the medical community
      recognizes the importance of adjudicating access to and care within ICUs. Scarce
      medical resources used in these areas represent as much as 20% of all medical
      expenditures, the bulk of which is spent in unsuccessful ventures. Management of
      this resource cannot be relegated to inexperienced, naive, or self-serving
      clinicians. The tools for managing the ICU in the '90s have been introduced, and
      they will begin to define the new concept of a successful outcome following
      admission. Clinicians traditionally have focused on individual patients, and this
      approach has led to many improvements in care. The next challenge facing the ICU
      management team will be to organize the process of patient care that will ensure
      the best possible individual outcome while promoting general efficiency of the
      available resources to function for all. Physician and nurse managers will be co
      responsible for adjudicating a complex, costly, and vital hospital resource; the
      price of failure is unacceptable.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8353782
TI  - Establishing an administrative core curriculum for critical care physicians.
AB  - Summary recommendations for a core curriculum in intensive care unit
      administration and management are presented for inclusion in critical care
      medicine fellowship training programs. Attention is focused on program content
      and teaching formats that may be adapted to various educational priorities.

PMID- 8353783
TI  - Critical care management in the 1990s. Making collaborative practice work.
AB  - The creation of a partnership, the hallmark of true collaborative practice, is an
      ongoing, dynamic process. It demands commitment, energy, and creativity. It is
      learned and therefore must be role modeled. One must remember that it takes time
      to develop collaborative relationships. One must begin slowly, walk not run, and
      have realistic expectations. It is a joy to work in an environment that has
      developed and is in the process of continually developing true collaborative
      practice. Hope for the future of health care lies in our ability to deliver
      coordinated and collaborative care. Nursing, medicine, and administration
      together can and must provide the solutions to our health care delivery problems
      before those solutions are legislated. We must set policies and priorities to
      appropriately allocate scarce resources. We must address personnel needs,
      credentialing, and compensation to ensure adequate numbers of qualified staff to
      meet the growing needs of our patients. We must evaluate technology and our
      physical environments to determine the types of services that we will offer. We
      must continue to broaden our collaborative efforts to extend from the patient
      care arena into the realms of education, research, and administration. It is up
      to each of us and each of our colleagues to work every day toward a more
      collaborative practice environment. By empowering each other, we can put into
      place a collaboration which "works jointly with others in intellectual endeavors"
      rather than one which merely "cooperates with an enemy force."

PMID- 8353784
TI  - Total quality management in the critical care environment. A primer.
AB  - Quality management has become issue No. 1 in organizations throughout the
      country. Hospitals have joined this crusade and are embarking on their own
      programs to maintain their competitive edge. TQM or CQI has been identified as
      showing great success in achieving quality. As TQM systems begin developing in
      hospitals, CCUs will be called on to join in these efforts. By understanding what
      TQM is, how it is used, and how it can be applied, CCU staffs will be able to
      incorporate TQM in their own practices. By choosing projects carefully, using
      scientific measurement in clinical and nonclinical areas, and developing a team
      based approach, the CCU staff can achieve improved clinical outcomes as well as
      improved procedures that result in better staff and patient satisfaction.

PMID- 8353785
TI  - Current and emerging legal issues in critical care.
AB  - Antitrust, access to care, and accountability are but three areas of law directly
      affecting the provision of critical care services. As the country continues to
      wrestle with increased health care costs, the expanding needs posed by an aging
      population and problems such as the AIDS epidemic, and whether or not to adopt
      some form of national health insurance, the legal system will continue to
      interact with the health care delivery system. Providers of critical care
      services are in the forefront of advances in medicine and are in the middle of
      the political, economic, and policy debates about the shaping of the health care
      system. They must not allow themselves to be caught at the end of rapid changes
      in the legal system. Critical care providers must take a leadership role in
      helping shape the forces that will be the major legal issues in years to come. If
      providers do not like lawyers and bureaucrats telling them how to provide patient
      care, they must seize the initiative in shaping defined standards of care. If
      providers do not like to be forced into providing "useless" or "unnecessary"
      care, they must be more honest in discussing care options with patients,
      families, and the media. If they do not like being told for how long to
      hospitalize a patient, they must be more responsible in making decisions to
      admit, transfer, or discharge a patient. Lawyers have been quite happy to step
      into what has long been perceived as a vacuum of leadership among medical care
      providers, and will continue to do so as long as there is uncertainty and lack of
      consensus about what constitutes appropriate medical care.

PMID- 8353786
TI  - ABCs of quality assurance.
AB  - The following six points offer a summary of principles to the manager who must
      develop a QA program: Institutional commitment to the QA process is essential for
      success. This must be embodied in the table of organization for QA and the
      commitment of resources to the task. The QA plan should address mechanisms for
      data collection, data review, and outcome reporting. Lines of responsibility
      should be stated clearly. The manner in which the outcomes of the QA process are
      implemented and communicated back to the front-line workers must be clearly
      stated and continually fed back to them. Clinical evaluations work best in the
      presence of politically neutral practice guidelines. Vociferous complainers
      frequently can be made part of the process, harnessing their energy to good
      effect. Self survey should precede an accreditation site visit by at least 6
      months. The best sources of JCAHO thinking on QA methods are the many JCAHO
      publications, several of which focus on the critical care arena.

PMID- 8353787
TI  - Technology and equipment: essentials of the art of evaluation, negotiation, and
      acquisition.
AB  - The competition for scarce finances for equipment/technology purchases can be won
      with careful preparation and documentation. Planning and implementing effective
      negotiation strategies can lower the cost of new technology acquisitions.

PMID- 8353788
TI  - Clinical engineering support for the critical care unit.
AB  - A tremendous selection of choices, both for goods and services, is available in
      the health care industry. Unfortunately, even marginal increases in expenses are
      hard to rationalize in today's market. To squeeze every bit from every dollar
      requires very active and dynamic leadership. Regulatory requirements, with the
      requisite documentation, must be met efficiently to free the organization to
      concentrate resources on providing primary health care. Capital dollars can be
      spent only on the best value to meet corporate objectives. The processes of
      health care delivery, risk assessment and management, and technology acquisition
      must be integrated on a corporation-wide scope to optimize the final product. To
      this end, the clinical engineering department brings essential skills to this
      participatory, dynamic management of modern health care facilities. This process
      of technology management has been implemented in various hospitals since 1985.
      Taking lessons from industry, hospital administrators are focusing management
      resources to address specific concerns. Clinical engineering, with its technical
      expertise, practical knowledge in the delivery of health care, and accrued
      database, is an essential part of this process. This technology management
      process involves an integration of experts to find specific solutions, and the
      supporting policies and procedures to ensure universal use of technology
      management.

PMID- 8353789
TI  - Organization and management of critical care systems in unconventional
      situations.
AB  - Critical care medicine is a field of medicine using the highest concentration of
      expensive diagnostic and life-support technology for the benefit of a single
      individual. Conventional use of this resource and specialty is clearly
      understood, despite the fact that it is not necessarily comparable among
      different institutions. Some of the major issues in using critical care as a
      medical tool during extraordinary stress on the hospital, and the potential for
      using it in unconventional environments outside an established institution, have
      been reviewed. It is clear that the expertise and multidisciplinary approach can
      be of great use in disaster response, and a national effort toward integrating
      critical care into overall medical response is in progress.

PMID- 8353790
TI  - Using severity measures to describe high performance intensive care units.
AB  - This article describes the use of various scores and probabilities to clinically
      categorize patients in the adult intensive care unit. Some of the limitations of
      these severity measures are reviewed including variable definitions, timing of
      measurements, and whether models can be used for individual patients. Also, this
      article discusses how probability models may be used to compare similar types of
      intensive care units using standardized clinical and cost performance indices.

PMID- 8353791
TI  - Admission, discharge, and triage in critical care. Principles and practice.
AB  - This article reviews the practices of admission, discharge, and triage to or from
      a special care unit and how they differ based on unit type and patient load. The
      need to solve the excess patient/insufficient resources dilemma is also
      addressed.

PMID- 8353792
TI  - The ethics of medical futility.
AB  - This article traces the evolution of the debate between the futility of
      cardiopulmonary resuscitation and the patient's right to consent, analyzing its
      origins in the 1970s and examining new policies recommended by the American
      Medical Association in 1991.

PMID- 8353793
TI  - Rationing health care. Impact on critical care.
AB  - Critical care practitioners are faced with ethical dilemmas every day. The
      increasing costs of health care coupled with the scarcity of resources, including
      critical care nurses, have created yet another ethical dilemma--rationing of
      health care. Rationing of critical care is occurring today and current conditions
      indicate that these decisions will become an increasing issue in the delivery of
      critical care services. This article identifies some of the ethical issues
      associated with the rationing of critical care and examines the foundations of
      ethical thought upon which such decisions can be based. Understanding the overall
      cost containment movement as well as the potential problems associated with
      medical gatekeeping will allow critical care practitioners to better deal with
      the ethical dilemmas of today as well as help them anticipate those that will
      arise in the near future.

PMID- 8353794
TI  - Regionalization and categorization of critical care services.
AB  - Regionalized systems of care match the medical needs of individual patients to
      available resources. Hospitals are categorized based on their personnel and
      technologic resources. Triage guidelines, based on severity of disease, are
      developed to link patient types to hospital categorization levels.
      Regionalization requires major planning, publicity, and educational efforts to
      implement an ongoing coordination and continuous quality improvement to function.

PMID- 8353795
TI  - Death in America: a clinician's perspective.
AB  - In America today, the practices of medicine and law have so interfered with the
      dying process that death has become a perversion of the natural process. In order
      to better understand death in American society, this article addresses the moral
      ethical issues, individual rights, state regulatory laws, and other medico-legal
      concerns.

PMID- 8353796
TI  - Immunosuppressive therapy following cardiac transplantation.

PMID- 8353797
TI  - Combining vasoactive infusions for maximal cardiac performance in the
      postoperative period.

PMID- 8353798
TI  - Angiotensin converting enzyme inhibition: pharmacologic management to minimize
      postinfarction heart failure.

PMID- 8353799
TI  - Hypertensive crisis in the 1990s.

PMID- 8353800
TI  - Comparisons and controversies in clot buster drugs.

PMID- 8353801
TI  - Role-modeled visiting compared with restricted visiting on surgical cardiac
      patients and family members.

PMID- 8353802
TI  - Annoyance to ICU noise: a model of patient discomfort.

PMID- 8353803
TI  - Remission of Philadelphia positive chronic myelogenous leukemia associated with
      t(3;21) after bone marrow transplantation.
AB  - We here report a male patient with an additional t(3;21)(q26;q22) in Philadelphia
      positive chronic myelogenous leukemia (Ph + CML). In spite of the presence of
      this progression of disease marker and probably related to alpha-interferon
      therapy, this case entered into remission as a second chronic phase. At that
      time, he underwent allogeneic bone marrow transplantation. One year after BMT he
      showed a disappearance of leukemic clones at the cytogenetic and molecular
      levels. At present the patient has 21 months of clinical and hematologic
      remission. It is of interest to note that the association of alpha-interferon
      hydroxyurea and bone marrow transplantation might produce a negative selection
      pressure against the leukemic clone in this patient.

PMID- 8353804
TI  - Blastic phase chronic myeloid leukemia with a four-break rearrangement:
      t(11;9)(9;22)(q23;p22q34;q11).
AB  - Chromosome analysis of bone marrow (BM) aspirate from a 36-year-old man with
      chronic myeloid leukemia (CML) in blastic phase (BP) showed a four-break
      rearrangement t(11;9)(9;22)(q23; p22q34;q11), which can be considered a
      t(9;22)(q34;q11) and a secondary t(9;11)(p22;q23). It is not surprising that
      additional chromosome abnormalities occur in patients with Ph-positive CML in BP,
      but it is of interest that t(9;11)(p22;q23), characteristic of acute myeloid
      leukemia French-American-British (FAB) type M5 (ANLL-M5) was observed. The
      possible meaning of this additional change in BP of CML is discussed.

PMID- 8353805
TI  - Myeloid leukemias and myelodysplastic syndromes: chemical exposure, histologic
      subtype and cytogenetics in a case-control study.
AB  - We conducted a case control study of 50 acute myeloid leukemias (AML), 17 chronic
      myeloid leukemias (CML), 19 myelodysplastic syndromes (MDS), and 246 controls.
      The cases were classified according to the French-American-British (FAB)
      classification, and chromosome aberrations were recorded according to the
      International System for Human Cytogenetic Nomenclature. Exposure to suspected
      leukemogenic agents was assessed blindly by an industrial hygienist. Increased
      risks were noted for mechanics, welders, electricians, and drivers among men and
      among farmers and textile workers among women. Increased SMRs for leukemias in a
      census-based cohort study conducted in the same area (Torino) were previously
      reported for electricians and drivers among men and for textile workers among
      women. We detected nonstatistically significant increased relative risks for
      exposure to benzene (odds ratio, OR = 1.7), petrol refining products (1.9),
      polycyclic aromatic hydrocarbons (1.7), and electromagnetic fields (1.6) in men;
      in women, a statistically significant association with exposure to pesticides was
      detected [OR = 4.4; 95% confidence interval (CI) 1.7-11.5]. Although exposure to
      pesticides was confined to AML, MDS cases included a high proportion of subjects
      exposed to benzene and electromagnetic fields. No particular histologic subtype
      of AML was associated with chemical exposures except for that of pesticides with
      the M4 category. Chromosome aberrations were not associated with chemical
      exposures (OR = 1.0), but a nonstatistically significant excess was noted in
      association with electromagnetic fields (OR = 2.1).

PMID- 8353806
TI  - Two additional cases of acute myeloid leukemia with t(7;11)(p15;p15) having low
      neutrophil alkaline phosphatase scores.
AB  - We report two additional patients with acute myeloid leukemia (AML) and a
      translocation between chromosomes 7 and 11: t(7;11)(p15;p15). One patient was
      diagnosed as having AML-M2 and the other as AML with myelofibrosis. Both patients
      had low-level neutrophil alkaline phosphatase (NAP) scores. In the literature,
      only 15 AML patients with t(7;11)(p15;p15) have been reported; nine of them had
      an AML-M2 morphology, and all had a decreased NAP score. Moreover, mean survival
      of the reported AML patients with t(7;11)(p15;p15) was 15 months, although 85% of
      them obtained complete remission, indicating that this type of leukemia
      frequently tends to relapse. These findings indicate a strong association between
      the chromosome abnormality and hematologic manifestations of this disease.

PMID- 8353807
TI  - Trisomy 4 and de novo acute myelomonocytic leukemia in a Kuwaiti patient.
AB  - Trisomy 4 is a rare but specific karyotypic abnormality associated with primary
      and secondary acute myeloblastic leukemia (AML). We report such an occurrence in
      a Kuwaiti patient with de novo acute myelomonocytic leukemia and its
      disappearance on achievement of complete remission.

PMID- 8353808
TI  - Cytogenetic abnormalities detected by direct analysis in a case of
      choriocarcinoma.
AB  - Malignant trophoblastic cells from a case of choriocarcinoma were cytogenetically
      investigated by direct analysis of fresh tissue from the tumor. To our knowledge,
      previous cytogenetic studies have been performed only on established cell lines.
      In this study, 54 metaphases were observed, of which 41 were fully karyotyped.
      Three chromosomally abnormal lines were identified. In all of them, trisomy 3 and
      10, a supernumerary isochromosome 1q,i(1)(q10), an i(8)(q10) replacing one
      chromosome 8, and a marker chromosome were observed. In addition, involvement of
      chromosome 12 was observed in two of the three lines, trisomic in one and an
      i(12)(q10) in the other.

PMID- 8353809
TI  - Cytogenetic and fluorescence in situ hybridization investigation of ring
      chromosomes characterizing a specific pathologic subgroup of adipose tissue
      tumors.
AB  - Cytogenetic analysis of 184 adipose tissue tumors, 175 lipomas, and nine
      liposarcomas (LPS) showed the presence of a ring chromosome and/or a long marker
      chromosome in 10 cases with common histologic features such as atypical stromal
      cells with or without lipoblasts. In five of the cases, this appeared to be the
      sole cytogenetic abnormality. Fluorescence in situ hybridization (FISH) analysis
      with a microclone library specific for chromosome region 12q13-q15 showed
      extensive staining of the ring and long marker chromosomes, indicating that
      genetic sequences of this particular region of chromosome 12 are present in these
      marker chromosomes, most likely in an amplified form.

PMID- 8353810
TI  - Rationalization of in situ hybridization: testing up to 16 different probes on a
      single slide.
AB  - Although particularly interested in tumor research, investigators in many tumor
      cytogenetics laboratories cannot afford extensive molecular/interphase
      cytogenetics studies in addition to routine cytogenetics analyses, primarily
      because many slides must be stained to examine a few cases using a panel of
      centromeric probes. Moreover, fluorescence in situ hybridization (FISH)
      techniques mostly require freshly prepared reagents, such as hybridization
      mixtures or antibody solutions. These technical requirements are very time
      consuming, thus limiting their use in routine screening. We report a
      significantly economical method for rapid performance of interphase cytogenetics
      in great numbers of cases. The major advantage if its superior efficiency: up to
      16 different probes may be used on one single slide. Moreover, the method is
      significantly cheaper than other techniques owing to minimal probe consumption.
      The technique is also best suited if great numbers of new probes, e.g.,
      polymerase chain reaction (PCR)-generated YAC-probes, must be tested for their
      applicability in FISH.

PMID- 8353811
TI  - Eosinophilia in myelodysplastic syndrome with a (12;21)(q23;q22) translocation.
AB  - Cytogenetic analysis of bone marrow (BM) cells from a patient with
      myelodysplastic syndrome (MDS) associated with eosinophilia showed a
      45,XY,t(12;21)(q23;q22), -17 karyotype. We performed clonal and suspension
      cultures using the patient's BM mononuclear cells to clarify the mechanism of
      eosinophilia. Eosinophil colonies formed in the presence of interleukin-5 (IL-5)
      and granulocyte-macrophage colony-stimulating factor (GM-CSF), but not in the
      presence of IL-3. When BM cells were cultured in suspension in the presence of IL
      5, they differentiated to mature eosinophils, and chromosome analysis identified
      the 45,XY,t(12;21)(q23;q22), -17 karyotype in all metaphases. The patient's serum
      did not stimulate eosinophil proliferation or differentiation in comparison with
      normal serum, however, these data suggest that the abnormal clone with
      45,XY,t(12;21)(q23;q22), -17 karyotype may have an increased responsiveness to IL
      5 and GM-CSF, resulting in eosinophilia.

PMID- 8353812
TI  - Toxicity of bile acids to colon cancer cell lines.
AB  - Quantitative aspects of bile acid cytotoxicity to colon cancer cell lines were
      investigated because of the etiological role in colon carcinogenesis attributed
      to the toxic effects of bile acids on colon mucosal cells. The cytotoxicity of
      major colonic bile acids differed. Lithocholate was the most toxic, followed by
      chenodeoxycholate and deoxycholate, with cholate being non-toxic over the
      concentration range studied. Cytotoxicity increased with time of exposure. Values
      for IC50 for some of the acids were determined to be in the physiological range,
      as estimated from their concentrations in fecal water. The results suggest
      dietary factors that contribute to bile acid mucosal damage. They also identify
      factors of possible importance in the association of high concentrations of bile
      acids in fecal water with risk for colon cancer.

PMID- 8353813
TI  - The correlation of response with plasma pharmacokinetics and polyamine
      concentrations in patients with acute myelogenous leukemia receiving amonafide.
AB  - We have investigated the correlation of clinical responses (decreases of white
      blood cells and peripheral blasts) with pharmacokinetic and pharmacodynamic
      parameters in patients with acute myelogenous leukemia who are receiving
      amonafide. The increase of plasma polyamine concentrations was used as a measure
      of tumor sensitivity (pharmacodynamic effect). The correlations between
      pharmacokinetic parameters (biological half life, area under the concentration
      time curve (AUC), total plasma clearance), decreases of total white blood cells
      and peripheral leukemic blasts were weak (maximum r = 0.47). Correlations of
      response with polyamines were better than those with pharmacokinetic parameters,
      but not exceptional; of these, the best correlations were with the increase of
      putrescine. On the other hand, correlations of combinations of AUC and increases
      of plasma polyamine concentrations with decreases of total white blood cell
      counts approached unity. Unexpectedly, decreases of peripheral leukemic blasts
      were correlated just as well with putrescine increase alone (r = 0.91, P = 0.003)
      or with a combination of polyamine increases and AUC (r = 0.92, P = 0.036).

PMID- 8353814
TI  - Impairment of fibrinolysis during the growth of two murine mammary
      adenocarcinomas.
AB  - The fibrinolytic activity present in the euglobulin (EU) fraction of BALB/c mice
      before and during the growth of M3 and MM3 murine mammary adenocarcinomas was
      characterized. The main plasminogen activator (PA) form contained in EUs from
      control mice was defined as murine urokinase-type PA (uPA). Overall fibrinolytic
      activity decreased significantly during tumor development. Zymographies showed
      that this fall was associated with a reduction in the free uPA band (47 kDa) and
      to the detection of a tissue-type PA (tPA) complexed band (117 kDa). Western
      blotting showed free tPA protein (68 kDa) in control mice, that disappeared in M3
      tumor-bearing mice. In this model, high subcutaneous tumor burden induces a
      severe impairment in the circulating fibrinolytic system.

PMID- 8353815
TI  - [Preliminary investigation on the epidemiology of migraine in China].
AB  - The prevalence of migraine was investigated in all provinces, municipalities and
      autonomous regions (except Taiwan) of the People's Republic of China. Random
      sampling from provincial capitals and from rural areas according to demonstration
      were used. Among a total screened population of 3,837,597 persons, there were
      37,808 cases of migraine. The morbidity and the annual incidence rate were
      985.2/100,000 and 79.7/100,000, respectively. The male/female ratio was 1:4.
      Inland plateaus were higher morbidity areas (more than 1,500/100,000) and coastal
      provinces and cities were lower morbidity areas (less than 400/100,000). The
      incidence rate was higher in spring in the south, while it was higher in summer
      in the north. The incidence rate was higher in hot and damp climate. The
      morbidity under 14 years old in China was significantly lower than those in
      overseas reports.

PMID- 8353816
TI  - [A comparative analysis of current conditions of oral health between residents
      living in towns and those in countryside in Guangdong Province].
AB  - A sampling population of 23,665 in Guangdong Province including 4 towns and 4
      countryside had been surveyed for the current situation of oral health. A
      comparative analysis of residents between towns and countryside had been
      conducted and the results indicated that the rural residents had a higher
      prevalence rate of dental caries (65.30%) than those who lived in towns (59.96%).
      The Decayed Missing Filling (DMF) of the population (4.62) and of the patients
      (7.08) in countryside were both significantly higher than those (2.86 and 4.78,
      respectively) of citizens (P < 0.001). Females had a higher rate of dental caries
      than males both in towns and in countryside. Citizens had a higher prevalence
      rate of periodontosis than rural residents. This paper also presents a comparison
      of jaw deformity and personal health behaviour, an age distribution of dental
      caries and a multiple regression analysis.

PMID- 8353817
TI  - [A preliminary report on the preparation of antisera against Haemophilus
      influenzae].
AB  - The antigenicity of 5 strains of serotype b Haemophilus influenzae was compared.
      Strain 58534 showed a higher titer than the rest four. Three lots of antisera
      were made by immunizing rabbits with 6 strains of Haemophilus influenzae. The
      results indicated that the antibody titer against strain 58534 also showed a
      higher level, and the titer only dropped by one dilution after stored in cool
      place for half a year. We considered that Haemophilus influenzae serotype b
      strain 58534 is a good strain for the preparation of antiserum against
      Haemophilus influenzae.

PMID- 8353818
TI  - [A study on transmission of dengue virus by Culex fatigans].
AB  - Patients with acute dengue fever within 2 days of onset were simultaneously
      bitten by Culex fatigans, Aedes aegypti and Aedes albopictus, which were fed and
      incubated in the laboratory. Isolation and quantitative assay of dengue virus and
      transmission experiment were conducted on specimens collected from 3 kinds of
      mosquitoes at different time. The result showed a positive rate of 5.13% (2/39)
      and an average viral titer of 2.41 logTCID50, for Culex fatigans, which indicates
      that Culex fatigans might be naturally infected with dengue virus and might
      transmit dengue virus after infection. But the positive rate and infection rate
      of Culex fatigans were significantly lower than those of Aedes aegypti and Aedes
      albopitus, which indicates that Culex fatigans might play a less important role
      in the transmission of dengue virus.

PMID- 8353819
TI  - [An epidemiological investigation on lung cancer and other tumours among coal
      workers with pneumoconiosis].
AB  - A retrospective cohort study was made on lung cancer and all tumours among coal
      workers with pneumoconiosis in the Haibowan Mining Bureau. Results indicated that
      the mortality of lung cancer among workers with pneumoconiosis was distinctly
      higher than that among the local population (P < 0.005, RR = 56.1, AR = 225.2,
      SMR = 8.07, P < 0.01). The mortality of all tumours among staffs and workers in
      the Haibowan Mining Bureau was 599.4 per one hundred thousand, but only 62.5
      among the local population (P < 0.005). It is suggested that lung cancer in
      workers exposed to coal dust for more than 18 years should be regarded as
      occupational cancer.

PMID- 8353820
TI  - [A study on the relationship between Helicobacter pylori and chronic gastritis
      and peptic ulcer by the case-control method and sequential analysis].
AB  - The association between Helicobacter pylori and the chronic gastritis and peptic
      ulcer was investigated by the case-control method, 1:1 matched study and
      sequential analysis. The results of three methods showed that the degree of
      association between Helicobacter pylori and the chronic gastritis and peptic
      ulcer was significant (chi 2 = 22.70, P < 0.001, OR = 15.63, 95% CI of OR was
      5.05, 48.43), especially that between Helicobacter pylori and active chronic
      gastritis (OR = 20.92). The results indicate that Helicobacter pylori might be an
      etiological factor for patients with chronic gastritis and peptic ulcer.

PMID- 8353821
TI  - [A report on investigation of an outbreak of Legionnaires' disease in a hotel in
      Beijing].
AB  - During the period from February to March, 1992, an outbreak of upper respiratory
      infection (influenza-like syndrome) took place in a hotel in Beijing. An
      epidemiological investigation and bacteriological examination were carried out in
      this hotel. The results showed that it was an outbreak of Legionnaires' disease
      caused by Legionella pneumophila serogroup 10 (Lp10): The incidence was 13.51%
      (5/37). This is the first report on LP10 infection in China.

PMID- 8353822
TI  - [Ureaplasma urealyticum and intrauterine infection of fetus].
AB  - Ureaplasma urealyticum (Uu) infection in pregnancy can lead to a poor outcome. To
      confirm the relation between Uu and intrauterine infection, 65 placentas were
      taken for isolation and identification of Uu from pregnant women with positive
      antibody to Uu. Uu was isolated from 13 (20%) of the 65 placentas. The pathologic
      examination of 6 placentas showed that there were acute or chronic inflammatory
      cell infiltration. Cord blood IgM antibody was examined by ELISA from 5 cases in
      which Uu was isolated from placentas and 3 of them was positive to Uu. The 5 cord
      blood specimens were assayed by the metabolic inhibition test for serotypes of
      Uu, and one of them was serotype 8. Since the isolation of Uu from some pregnant
      women, the pathologic changes of placentas, and the detection of specific IgM
      from cord blood showed a good consistency, we conclude that the Uu infection may
      occur in utero.

PMID- 8353823
TI  - [A study on a local epidemic of dengue fever in Shaxi district of Zhongshan city,
      1991].
AB  - An epidemic of dengue fever occurred in Shengshi Village of Shaxi District in the
      last ten-day period of August, 1991. A wrong diagnosis was made on account of
      atypical clinical symptoms and careless investigation during early days.
      Effective measures had not been taken in time, so that the disease spread to
      neighbouring three villages and the town. The epidemic lasted for 64 days and 112
      cases were found. It had been proven by etiologic studies that type 1 dengue
      virus caused this epidemic.

PMID- 8353824
TI  - [An investigation on smoking situation among middle school students in Japan and
      in Jiangxi, China].
AB  - The past smoking rate among middle school students in Jiangxi was 30.5%, which
      was higher than that in Japan (25.4%). However, the present smoking rate and the
      frequent smoking rate among middle school students in Jiangxi are 5.8% and 1.1%,
      respectively, which are far lower than those in Japan (8.7% and 5.3%). The past
      smoking rate among boy students at each academic year in Jiangxi was higher than
      that in Japan, but the statistical indices of the present smoking rate and of the
      frequent smoking rate among boy students and among girl students at each academic
      year are lower than those in Japan. In Japan, the smoking rate among middle
      school students in cities was higher than that in the countryside, but vice versa
      in Jiangxi. The average number of cigarettes consumed per day in Japan was higher
      than that in Jiangxi. This investigation indicates that the smoking rate among
      middle school students was much influenced by their friends and relatives, health
      education in schools, self-feelings about school life and attitude towards
      smoking, etc.

PMID- 8353825
TI  - [A matched case-control study on 87 cases of congenital malformations].
AB  - In order to investigate the risk factors of congenital malformations, a case
      control study on congenital malformations with 87 matched pairs was carried out
      in hospitals of Yinchuan area. The results showed that the risk factors of the
      congenital malformations in this area were mainly nocuous mental stimulation
      during early pregnancy, hyperemesis gravidarum, parturient personality (high
      scores of psychoticism and neuroticism), degree to parturient education and
      exposure to other detrimental factors in early pregnancy, smoking habit of
      neonate's father, and so on.

PMID- 8353826
TI  - [The first report of 2 imported AIDS cases in Guangzhou].
AB  - In March and May 1991, two imported AIDS cases were reported for the first time
      in Guangzhou. We investigated the cases and found that they have been
      misdiagnosed, because the doctors were not well familiar with this disease. The
      investigation showed that clinicians must improve their diagnostic ability. And
      the surveillance on AIDS must be carried out.

PMID- 8353827
TI  - Dynamics of the effects of levoprotiline and maprotiline on EEG in patients with
      major depressive episodes (DSM-III-R).
AB  - The presented study compares the effect of the well-tested antidepressant
      maprotiline and a new antidepressant with an atypical pharmacological profile,
      levoprotiline, on EEG during repeated assessment after single dose
      administration. From the original number of 34 patients fulfilling the criteria
      of a major depressive episode (DSM-III-R) on account of a low-voltage record or
      pathological findings 11 were eliminated. To 12 of the remaining patients
      levoprotiline was administered and to 11 maprotiline, after a one-week placebo
      period, in doses of 150 mg. The EEG was recorded after an accommodation session
      immediately before, 1.5, 3, 4.5, 6 and 24 hours after a single dose
      administration. The record was taken on a 16-channel average reference montage at
      rest with closed eyes. Two-minute intervals were divided into 30 four-second
      periods at a sampling frequency of 128 Hz. From the signal by means of FFT the
      spectra were estimated and the mean spectrum for the entire recording was
      calculated. This was then divided into 10 frequency bands. The new method of
      frequency analysis of alpha-entropy was also used which is a global measure of
      the difference between two spectra. Three hours after administration of a single
      dose levoprotiline had an EEG profile corresponding to the profile of tricyclic
      antidepressants, i.e. it increased the values of the power spectra density in the
      region of 5-8.5 Hz and in the entire beta band; the decline of power in the alpha
      band was, however, absent. As regards maprotiline, 3 hours after administration a
      profile typical for antidepressants was not found; obviously because of the great
      variance of values of power spectra density as a result of great interindividual
      differences in the ingestion phase. Changes of the EEG spectrum expressed as
      values of alpha-entropy during different periods of apparently assessment are not
      incidental. After the initial rise of values a decline occurs.

PMID- 8353828
TI  - [Detection of cerebropathy in neurologic and psychiatric diseases].
AB  - The authors made a comprehensive examination of 16 patients--epileptics,
      alcoholics, psychotic subjects and patients after cerebral contusion. The
      patients were subjected to a neurological, psychiatric, psychological examination
      as well as to a morphological examination (X-ray, CT, NMR), physiological
      examination (EEG, polysomnography, evoked potentials), immunological examination
      and SPECT. The majority of patients had positive CT and SPECT findings suggesting
      focal brain damage. These results could be explained only in exceptional cases by
      injury, the majority was of unknown aetiology. With this corresponded focal EEG
      abnormalities and in particular sleep disorders, sometimes subjective but always
      detectable by objective methods. There was always a shortage of REM, sometimes
      also NONREM sleep. Half the patients were subjected to an immunological
      examination which was always positive and comprised elevated acute stage proteins
      and proteins associated with the stress reaction. Numerous data in the literature
      and the authors' experience indicate that the mentioned pathological findings are
      not incidental and form, independently on the aetiology, an integrated unit for
      which the term cerebropathy can be used. A primary role is played by the
      epileptic focus and its quality, i.e. above all the rate of discharge and site
      and humoroergic systems of the brain stem, in particular their efficiency and
      mutual balance. The events have a programmed sequence. At the beginning an
      epileptic focus develops which influences the surrounding area, secondary and
      tertiary foci are formed and the thalamo-cortical system is affected. Soon this
      is followed by an apparent influence of the epileptic activity on structures of
      the brain-stem. The consequence are changes affecting sleep, mood, mental
      performance, immunity, endosecretion and paroxysms. Subsequently individual
      symptoms are already prepared but have a different latency of manifestation and
      the latter depends also on external provoking influences. The thalamo-cortical
      reaction is characterized by the manifestation of epileptic paroxysms and sets in
      after a different interindividual incubation following injury. The same applies
      to the hippocampal reaction manifested by the organic psychosyndrome. Some
      symptoms such as changes of immunity, sleep or endosecretory function are not
      necessarily manifested if the influence of the focus on structures of the brain
      stem is not sufficiently intense. Conversely if the effect on the brain-stem and
      limbic structures is greater and the effect on the thalamo-cortical system
      smaller, psychotiform behaviour develops. Then there are marked changes of
      phoria, dynamogeny, rate, affectivity, sleep and hormonal secretion and its
      equilibrium.

PMID- 8353829
TI  - [Ethical problems in modern sexology].
AB  - The paper is focused on problems of sexual minorities. The authors discuss their
      position in society, terminological problems and in particular questions
      associated with ethical problems of treatment of paraphilics. The authors
      differentiate between essential, possible and not indicated therapeutic
      provisions. They also focus attention on ethical aspects of different types of
      treatment of sexual delinquents (surgical, pharmacological and psychotherapeutic
      methods), whereby they emphasize in particular the necessity to obtain the
      patient's informed consent. According to the authors skilled therapy gives a
      chance to reintegrate the paraphilic patient into society and to protect victims
      delinquent sexual behaviour.

PMID- 8353830
TI  - [Summary of results of a study of heredity of intelligence in a sample of the
      Czech population. III. Longitudinal and genealogic study of twins and their
      families].
AB  - The author presents further results of the longitudinal study of inheritance of
      intelligence, its components and structure in twins. Summarized results are
      presented for the age period from 0-15 years as well as detailed results of
      individual components and the global IQ in the age group of 8-15 years. The paper
      follows after two previous ones published in 1988 where the applied methods and
      statistical evaluation were described. Evidence was provided that heredity of
      intelligence is involved in children from a very early age, i.e. 0-3 years. After
      the age of 4 heredity predominates markedly over environmental influences up to
      the age of 15 years investigated so far by the author. (A slight decline occurs
      during the prepubertal period-age 13 and 14 years.) The author found that in
      particular the following components of intellect are inborn: abstract thinking,
      logic, talent for mathematics, concentration, inquisitiveness. Very detailed
      tables are presented for possible comparison with data in the literature and data
      from adults. The author found that the development of intelligence from childhood
      to adult age is very irregular. This uneven character is also mostly inborn.
      Statistical evaluation revealed several basic types of developmental curves and
      extreme variants. This will, however, be discussed in another paper. The
      theoretical results can be used also in practice in school education, counselling
      psychologic and psychiatric out-patient departments.

PMID- 8353831
TI  - [Indications for antidepressive agents in relation to diseases of the
      cardiovascular system].
AB  - Antidepressants, in particular tricyclic ones (TCA), and inhibitors of
      monoaminooxidase (IMAO) exert a number of undesirable cardiovascular effects. TCA
      and IMAO frequently cause postural hypotension (PH). IMAO administration is
      associated with the risk of hypertensive crisis. TCA raises the heart rate and
      can cause abnormalities in the conduction of the cardiac excitation. TCA are
      contraindicated after myocardial infarction and are the cause of death after
      overdosage. When PH is undesirable, in hypertension and cardiac insufficiency the
      following safe antidepressants are recommended: nortriptyline, mianserine,
      trazodone and viloxazine. In abnormalities of conduction of the cardiac
      excitation and after myocardial infarction only mianserine, trazodione and
      viloxazine are recommended. With regard to cardiovascular toxicity,
      antidepressants from the series of selective inhibitors of serotonin reabsorption
      are very promising: fluvoxamine, fluoxetine, citalopram, paroxetine and
      sertraline. The same applies also to the reversible IMAO type A moclobemide.

PMID- 8353832
TI  - [Effects of group psychotherapy].
AB  - Using questionnaires SCL 90 and PFI, the author investigated in 1989-1990 the
      effect of group psychotherapy provided at the psychotherapeutic department of the
      psychiatric sanatorium in Kromeriz. The group comprised 40 men and 60 women with
      neurotic complaints. The control group was formed by 45 men and 193 women without
      neurotic complaints. The questionnaire SCL90 recorded positive changes after
      group psychotherapy in the therapeutic community, in particular in female
      patients. A catamnestic examination made after one year, using the same
      questionnaire, suggests that the therapeutic results have a permanent character.
      Conversely the PFI questionnaire recorded few significant changes. The problem of
      assessment of the effect of psychotherapy is discussed also on a more general
      level.

PMID- 8353833
TI  - [Memories of psychiatric practice in a North American prison].

PMID- 8353834
TI  - Inhibitory effect of aspirin on azoxymethane-induced colon carcinogenesis in F344
      rats.
AB  - Epidemiologic studies suggest that sustained use of aspirin may reduce the risk
      of development of and mortality due to colon cancer. Previous preclinical studies
      have shown that several non-steroidal anti-inflammatory drugs act as potential
      chemopreventive agents in experimentally induced colon cancer models. The present
      study was designed to investigate the chemopreventive effect of 40 and 80%
      maximum tolerated dose (MTD) levels of aspirin administered in the diet on
      azoxymethane (AOM)-induced colon carcinogenesis in male F344 rats. The MTD of
      aspirin as determined in male F344 rats was 500 p.p.m. Beginning at 5 weeks of
      age, all animals were randomly divided into various experimental groups (48
      rats/group) and fed one of the semipurified diets containing 0, 200 p.p.m. (40%
      MTD), or 400 ppm (80% MTD) of aspirin. Two weeks later, all animals (36
      rats/group) except the vehicle-treated groups (12 rats/group) were administered
      s.c. injections of AOM at a dose level of 15 mg/kg body wt, once weekly for 2
      weeks. All animals were continued on their respective dietary regimen for
      additional 52 weeks and necropsied. Histopathologic evaluation of colon tumors
      was performed by routine procedures. Basal levels and ex vivo production of
      colonic mucosal and tumor prostaglandin E2 (PGE2) were measured in all groups.
      The results indicate that daily oral administration of 200 and 400 p.p.m. aspirin
      significantly inhibited the incidence (% animals with tumors) and multiplicity
      (tumors/animal) of invasive adenocarcinomas of the colon as well as the size of
      adenocarcinomas. Colonic mucosal and tumor PGE2 levels (basal and ex vivo
      production) were significantly reduced in animals administered 200 and 400 p.p.m.
      aspirin. The results of this study support the epidemiologic evidence that
      ingestion of aspirin inhibits colon carcinogenesis. Although the precise
      mechanisms of aspirin-induced colon tumor inhibition remain to be determined, it
      is likely that the effect may be mediated through the modulation of prostaglandin
      synthesis.

PMID- 8353835
TI  - Depression of catalase gene expression after immortalization and transformation
      of mouse liver cells.
AB  - To understand the molecular basis of the remarkable decrease of catalase activity
      after immortalization and malignant transformation of mouse liver cells,
      expression of the catalase gene was studied in in vivo mouse liver cells and
      nontransformed normal mouse liver cell line as well as liver cell lines
      transformed by N-methyl-N-nitro-N-nitrosoguanidine, SV40 virus or by conventional
      subcultivation. In vivo liver cells had much greater levels of catalase mRNA and
      immunoreactive protein than in vitro cell lines, which correlates with elevated
      enzyme activity. Among the cell lines, normal cells had in general higher mRNA
      levels and more catalase protein than that of the transformed cell lines, also
      correlating with enzyme activity. The down regulation of catalase gene expression
      seen in transformed lines may occur transcriptionally rather than
      posttranscriptionally as demonstrated by cycloheximide and/or actinomycin D
      treatment. The striking difference in catalase gene expression seen between liver
      tissue and liver cell lines was unlikely due to gross structural alterations in
      the catalase gene, but might be explained by a remarkable difference in
      methylation status of the catalase gene, as demonstrated by Southern blot
      analysis following HpaII digestion. Our results suggested that during cellular
      immortalization and malignant transformation, a change in the oxidant stress
      ultimately led to a cellular response that, in turn, led to down regulation of
      the catalase gene.

PMID- 8353836
TI  - Iterative chromosome mutation and selection as a mechanism of complete
      transformation of human diploid fibroblasts by SV40 T antigen.
AB  - The acquisition of an extended lifespan and of neoplastic properties, including
      anchorage independence, ability to grow in low serum-containing media,
      morphological transformation, immortalization and tumorigenicity in nude mice
      were studied in 31 human fibroblast lineages transfected with plasmids containing
      the SV40 early genes. Plasmids were used that contained sequences for large T
      alone, or large T plus small t or large T plus small t plus the SV40 origin.
      Cells expressing large T antigen gradually acquired the ability to form colonies
      in low serum or to form anchorage-independent colonies. Large T antigen was
      sufficient to cause complete transformation to tumorigenicity if multi-step
      lineage evolution was obtained by prolonged serial passage and if in vivo
      progression was assisted by means of a gelatin sponge implantation technique.
      Cells derived from progressive tumors initiated in sponges showed enhanced
      tumorigenicity as measured by ability to obtain tumors without using sponges and
      with reduced latent period, higher incidence and with fewer cells inoculated.
      Multiple lineages of human fibroblasts have been converted to tumorigenicity
      without additional treatments such as transfection with activated oncogenes or
      exposure to carcinogens. These data, taken in conjunction with earlier studies
      showing that T antigen causes chromosome mutation preceding and accompanying the
      accumulation of the neoplastic phenotype, suggests that the T protein drives the
      transformation process by acting as a mutagen and cells with growth advantages
      were selected for in vitro and in vivo. With the possible exception of
      morphological transformation, the presence or absence of genes for small t and
      the SV40 origin were not critical for the process.

PMID- 8353837
TI  - A new in vivo model for studying invasion and metastasis of rat and human bladder
      carcinomas.
AB  - The biological potential of tumor cells is best evaluated at the organ site
      orthotopic to the tumor cells. Recent studies have documented site-specific
      differences in the potential of tumor cell growth. However, orthotopic
      implantation of bladder cancer cells into bladders of nude mice only resulted in
      a low tumor yield. We have developed a new model that consists of a rat bladder
      transplanted into the retroperitoneal space and connected to a reservoir s.c.
      placed in a nude mouse. Rat malignant bladder cancer cells (MYU3L and LMC19)
      transfected with the human growth hormone (hGH) gene as a biomarker were
      introduced into the transplanted bladder by percutaneous puncture of the attached
      reservoir. Successful uptake was indicated by a progressive rise in the hGH level
      in the bladder aspirate. When examined at 6-16 weeks post transplantation, all
      mice that had received MYU3L (n = 6) or LMC19 (n = 6) cells were found to have
      invasive carcinomas. MYU3L was highly invasive, forming multiple peritoneal
      implants, but was not metastatic. LMC19 was deeply invasive and metastasized to
      the retroperitoneal and subclavian lymph nodes and the lungs (4/6). Of two human
      bladder cancer cell lines (RT4 and T24) tested, RT4 formed multiple minute
      papillary tumors in five of six bladders, two of which were minimally invasive to
      the muscle layer. T24 cells formed only one to two small tumors in three of six
      bladders, and these were confined to the lamina propria. This system appears
      promising for studies of the mechanism of tumor invasion and metastasis and for
      evaluation of antineoplastic agents.

PMID- 8353838
TI  - Brain and liver targeted overexpression of O6-methylguanine DNA methyltransferase
      in transgenic mice.
AB  - O6-Methylguanine DNA methyltransferase (MGMT; EC 2.1.1.63) is an unusual DNA
      repair protein in that it directly and specifically repairs a premutagenic DNA
      lesion without involving other proteins. MGMT removes the alkyl group from O6
      alkylguanine in DNA in a unique stoichiometric reaction by accepting the alkyl
      group on a cysteine residue. The intracellular level of MGMT varies among tissues
      and appears to be inversely correlated to tissue-specific tumorigenesis induced
      by monofunctional alkylating agents. Because MGMT acts in solo, genetic
      manipulation of its expression may provide valuable insight into its contribution
      to cellular resistance to alkylation toxicity and to tumor induction. The human
      MGMT full length cDNA has been fused with a portion of the human transferrin (TF)
      5'-flanking region (TF/MGMT). Transgenic founder mice were produced carrying the
      TF/MGMT transgene and then bred to establish stable transgenic lines. Human MGMT
      transcripts were specifically expressed in abundance in transgenic brain and
      liver tissues. In vitro MGMT assays revealed approximately 150-fold and
      approximately 25-fold increases in MGMT activity in transgenic brain and liver
      extracts respectively. Western blot analysis confirmed that human MGMT protein is
      specifically synthesized in transgenic brain and liver tissues.

PMID- 8353839
TI  - Comparison of transplacental and neonatal initiation of mouse lung and liver
      tumors by N-nitrosodimethylamine (NDMA) and 4-(methylnitrosamino)-1-(3-pyridyl)-1
      butanone (NNK) and promotability by a polychlorinated biphenyls mixture (Aroclor
      1254).
AB  - We have previously shown a positive tumor-promoting effect of a single dose of
      Aroclor 1254 on lung and liver tumors initiated neonatally in the mouse by N
      nitrosodimethylamine (NDMA). In this study, we have confirmed and extended this
      observation with NDMA and the tobacco-specific nitrosamine, 4-(methylnitrosamino)
      1-(3-pyridyl)-1-butanone (NNK) given either transplacentally or postnatally,
      followed by a single dose of Aroclor 1254 on day 56. This polychlorinated
      biphenyl (PCB) mixture was an effective promoter of both lung and liver tumors;
      however, there were specific initiator and sex-related differences in this
      response. Aroclor administration significantly increased the incidence of lung
      tumors initiated transplacentally by NDMA or NNK in male mice. Neither
      nitrosamine initiated tumors transplacentally in females, but lung tumors
      initiated with NNK and liver tumors caused by NDMA in neonatal females were
      promoted by PCBs. Both liver and lung tumors initiated neonatally by NDMA in male
      animals, but not NNK-initiated tumors, were promoted by PCBs. These data confirm
      that PCBs are able to promote both NDMA- and NNK-initiated tumors, but with
      chemical-, sex- and age-dependent difference; this suggests influences of both
      quantitative and qualitative factors in susceptibility to tumor promotion.

PMID- 8353840
TI  - Effects of green tea catechins in a rat multi-organ carcinogenesis model.
AB  - The effects of dietary administration of green tea catechins (GTC) were examined
      using a multi-organ carcinogenesis model. Groups of 15 F344 male rats were
      initially treated with a single i.p. administration of 100 mg/kg body wt N
      diethyl-nitrosamine, 4 i.p. administrations of 20 mg/kg body wt N
      methylnitrosourea, 4 s.c. doses of 40 mg/kg body wt 1,2-dimethylhydrazine,
      together with 0.05% N-butyl-N-(4-hydroxybutyl)nitrosamine for 2 weeks and then
      0.1% 2,2'-dihydroxy-di-n-propylnitrosamine for 2 weeks, both in the drinking
      water, for a total initiation period of 4 weeks. GTC in the diet, at doses of 1.0
      or 0.1%, was administered from 1 day before and during carcinogen exposure, after
      carcinogen exposure or both during and after carcinogen exposure. Further groups
      of animals were treated with carcinogen, 1% GTC or basal diet alone as controls.
      All animals were killed at the end of week 36, and all major organs examined
      histopathologically. The numbers of small intestinal tumors (adenomas and
      carcinomas) per rat were significantly reduced in the groups treated with 1% GTC
      during (0.13 +/- 0.35) and after carcinogen exposure (0.31 +/- 0.48) and in those
      receiving 1% and 0.1% GTC both during and after carcinogen exposure (0.14 +/-
      0.36, 0.46 +/- 0.97 respectively) as compared with the carcinogen alone group
      (1.07 +/- 1.21). On the other hand, numbers of glutathione S-transferase
      placental form positive liver foci per cm2 were slightly but significantly
      increased in the groups treated with 1 and 0.1% GTC during carcinogen exposure,
      1% GTC after carcinogen exposure and 1% GTC both during and after carcinogen
      exposure. The results indicated that while GTC inhibits small intestinal
      carcinogenesis it slightly enhances hepatocarcinogenesis in a dose dependent
      manner when applied both during and after carcinogen exposure.

PMID- 8353841
TI  - N-methyl-N'-nitro-N-nitrosoguanidine-induced carcinogenesis: differential pattern
      of upper gastrointestinal tract tumours in Wistar rats after single or chronic
      oral doses.
AB  - Male Wistar rats were treated with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)
      either as a single dose of 50, 125 or 250 mg/kg given by gavage or via drinking
      water for 28 weeks at a concentration of 40, 80 or 160 micrograms/ml, in the case
      of the higher concentration reverting to 80 micrograms/ml after the first 8
      weeks. The single dose regimen had no effect on water intake or body weight, but
      the chronic exposure led to a dose-dependent reduction in water intake that was
      paralleled by a slower weight gain, with the final body weights at approximately
      90, 84 and 79% of the control weight values. The combined yield of benign and
      malignant tumours (79-100% of the animals treated) occurred in the forestomach in
      the case of the single doses, whereas the chronic exposure resulted in a maximum
      yield of tumours located in the pyloric region of the glandular stomach (64-100%
      of animals treated). The principal histological types of tumours induced were
      squamous cell papilloma and carcinoma in the forestomach and adenocarcinoma in
      the pylorus. There was a persistent, but low yield (25-30% of animals treated) of
      tumours in the jejunum, mainly adenocarcinoma, after administration via drinking
      water, whereas after single doses, multiple solitary cysts and cholangioma (30%
      and 25-70% respectively of the animals treated) were found in the liver. This
      report differs from earlier reports in that marked effects were noted on water
      consumption and body weight gain and that tumour induction can be achieved after
      much shorter periods of exposure than previously reported in the literature.
      These data confirm the tissue specificity of MNNG when given either as a single
      or chronic dose regimen and provide a suitable model for the investigation of the
      target cell specificity of tumour induction.

PMID- 8353842
TI  - Cyclosporine stimulates hepatocyte proliferation and accelerates development of
      hepatocellular carcinomas in rats.
AB  - A recent study from our laboratory demonstrated that cyclosporine (CsA), a
      prototype immunosuppressant, enhanced the growth of carcinogen-induced enzyme
      altered foci in rat liver, suggesting that CsA may stimulate development of
      hepatocellular carcinomas. In the present study, we examined (i) whether CsA
      accelerates development of hepatocellular carcinomas in experimental animals,
      (ii) whether CsA stimulates the proliferation of resting hepatocyte in vivo and
      (iii) whether CsA modulates the production of growth factors implicated in liver
      cell growth, hepatocyte growth factor (HGF), transforming growth factor alpha
      (TGF alpha) and transforming growth factor beta 1 (TGF beta 1). Foci of
      hepatocytes, positive for glutathione S-transferase placental form were induced
      in male F344 rats by a single dose of diethylnitrosamine followed by 7 weeks
      promotion by a choline-deficient diet. The animals were then divided in two
      groups, and subsequent development of hepatocellular carcinomas was compared in
      rats fed a basal diet or a basal diet containing 0.015% CsA. Development of
      hepatocellular carcinoma was accelerated in the rats maintained on a CsA diet.
      Feeding a CsA diet as the sole treatment, for 2, 4 and 10 weeks induced
      significant increases in liver weight, and resulted also in an enhanced
      incorporation by hepatocytes of 5-bromo-2-deoxy-uridine. Serum levels of
      glutamate-oxaloacetate transferase, glutamate-pyruvate transferase and lactic
      dehydrogenase were not altered by feeding a CsA diet. Northern Blot analyses of
      the expression of HGF, TGF alpha and TGF beta 1 mRNAs in the liver showed similar
      patterns of expression between rats fed a basal diet and a CsA diet. The levels
      of HGF mRNA were not altered in the lungs and kidneys of rats fed a CsA diet.
      These results indicate that CsA stimulates rat liver cell proliferation in vivo
      without inducing liver cell necrosis, and that this effect may contribute to
      accelerated development of hepatocellular carcinomas in rats fed a CsA diet. As
      previously observed with BR 931, a hypolipidemic peroxisome proliferator,
      stimulation of liver cell growth by CsA did not entail changes in the production
      of HGF, TGF alpha or TGF beta 1.

PMID- 8353843
TI  - Repair of ribosomal RNA genes in hamster cells after UV irradiation, or treatment
      with cisplatin or alkylating agents.
AB  - We have measured the DNA damage formation and repair in the ribosomal and the
      dihydrofolate reductase (DHFR) genes after treatment of hamster cells with
      different types of DNA damaging agents. In mammalian cells, the ribosomal DNA
      (rDNA) is transcribed by RNA polymerase I, whereas the DHFR is transcribed by RNA
      polymerase II, whereas the DHFR is transcribed by RNA polymerase II. Cells were
      treated with agents that induce different types of lesions, and that are known to
      be repaired via different pathways. We used UV (254 nm) irradiation, treatment
      with cisplatin and treatment with the alkylating agents nitrogen mustard (HN2)
      and methyl methanesulphonate (MMS). UV induced pyrimidine dimers were detected
      with the enzyme T4 endonuclease V, which creates nicks at the dimer sites; the
      breaks are then resolved and identified by denaturing electrophoresis and
      Southern blot. Intrastrand adducts formed by the alkylating agents HN2 and MMS
      were quantitated by generating strand breaks at abasic sites after neutral
      depurination. Interstrand crosslinks (ICL) formed by HN2 and cisplatin were
      detected by a denaturation-reannealing reaction before neutral agarose gel
      electrophoresis. We find that the repair of the pyrimidine dimers is
      significantly less efficient in the RNA polymerase I transcribed rDNA genes than
      in RNA polymerase II transcribed DHFR gene at 8 and 24 h after irradiation. ICL
      and intrastrand adducts induced by HN2 are also removed more slowly from the rDNA
      than from the DHFR gene. In contrast, MMS induced intrastrand adducts and
      cisplatin induced ICL are repaired equally efficiently in the RNA polymerase I
      and RNA polymerase II transcribed genes. We conclude that for some types of DNA
      damage, there is less repair in the ribosomal genes than in the DHFR; but for
      other DNA lesions there is no difference. The difference in repair efficiency
      between the rDNA and the DHFR genes may reflect the different RNA polymerase
      involved in their transcription. It may, however, alternatively, reflect the
      different nuclear localization of these genes.

PMID- 8353844
TI  - Dose-dependent ras mutation spectra in N-nitrosodiethylamine induced mouse liver
      tumors and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone induced mouse lung
      tumors.
AB  - In a previous study, the spectrum of H-ras mutations detected in B6C3F1 mouse
      liver tumors induced by 5, 50 or 150 mumol/kg body wt of N-nitrosodiethylamine
      (NDEA) was similar to that in spontaneous B6C3F1 mouse liver tumors, suggesting
      that activation of the H-ras gene in NDEA-induced mouse liver tumors may not be
      the direct result of the chemical interaction with the H-ras gene. In the present
      study, mutations in the H-ras oncogene from B6C3F1 mouse liver tumors induced by
      5 or 50 mumol/kg body wt of NDEA were characterized by DNA amplification with
      polymerase chain reaction (PCR), single-strand conformation of polymorphism
      (SSCP) and direct sequence analysis. Twenty-one of 66 NDEA-induced B6C3F1 mouse
      liver tumors contained activated H-ras gene with 2 of 21 having a CG to AT
      transversion at the first base of codon 61, 17 of 21 having AT to GC transition
      and 2 of 21 having an AT to TA transversion at the second base of codon 61 in the
      H-ras gene. The predominant mutation, AT to GC transition (17/21, 81%) is
      consistent with the formation of O4-ethylthymine adduct, and is distinct from the
      predominant CG to AT transversion (50%) at the first base of codon 61 detected in
      H-ras gene from NDEA-induced B6C3F1 mouse liver tumors in a previous study by
      Stowers et al. Mutations in the K-ras oncogene from 59 A/J mouse lung tumors
      induced by 0.53 mmol/kg body wt of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone
      (NNK) were also characterized by using the above mentioned methods. Forty-six of
      59 NNK-induced A/J mouse lung tumors contained activated K-ras genes. All 46
      (100%) of the activated K-ras gene had GC to AT transitions at the second base of
      codon 12. The same mutation was observed in 70% (7/10) of the K-ras oncogene from
      A/J lung tumors induced by 4.8 mmol/kg body wt (given in 21 doses) of NNK. These
      data suggest that other factors in addition to genotoxic effect might be involved
      in the induction of rodent tumors by some carcinogens when given at higher doses.
      Therefore, further studies to compare the dose-dependent differences in the
      profile of ras mutations induced by chemical carcinogens may help to assess human
      cancer risk. Mutation(s) in exons 5-8 of the p53 gene was not found in these NDEA
      induced mouse liver tumors and NNK-induced mouse lung tumors.

PMID- 8353845
TI  - High mutagenic activity of N-nitrosobis(2-oxopropyl)amine and N-nitrosobis(2
      hydroxypropyl)amine in the host-mediated assay in hamsters: evidence for
      premutagenic methyl and hydroxylpropyl adducts.
AB  - The carcinogenic nitrosamines N-nitrosobis(2-oxopropyl)-amine (BOP) and N
      nitrosobis(2-hydroxypropyl)amine (BHP) were tested in excision-repair-deficient
      strains of hisG46 Salmonella mutants in the intrasanguinous host-mediated
      mutagenesis assay (HMA) in male Syrian hamsters. The major adducts produced by
      BOP in the hamster are methylguanines, while BHP leads to hydroxypropylguanines
      as well as methylguanines. Both nitrosamines were potent mutagens in bacteria
      recovered from the liver. On a comparison of administered dose, BOP was more
      potent, but when compared at doses producing similar levels of O6-methylguanine
      (O6-MeG) in host liver DNA, or at equitoxic doses in the hamster, BHP was more
      potent. BHP was approximately 10 times less mutagenic in an excision-repair
      proficient strain of Salmonella, but the mutagenicity of BOP was not reduced. The
      effects of excision repair on in vitro mutagenesis induced by the direct-acting
      analogs N-(2-oxopropyl)-N-nitrosourea (OPNU), a methylating agent, and N-(2
      hydroxypropyl)-N-nitrosourea (HPNU), a hydroxypropylating agent, were also
      examined. Mutagenesis by HPNU, but not OPNU was very sensitive to excision
      repair. Thus BOP appears to lead to mutagenesis via methylation, while
      mutagenesis by BHP apparently proceeds via hydroxypropylation. BOP, BHP, OPNU and
      HPNU were several times less mutagenic in hisG428 than hisG46 strains. In
      contrast to hisG46 strains, which are reverted mainly by base-pair substitutions
      at G:C base pairs, hisG428 strains are generally more sensitive to mutagenesis at
      A:T base pairs. Taken together the above results and observations that > 90% of
      the adducts from BOP and BHP were alkylguanines, suggest that the major
      premutagenic adducts produced from BOP and BHP are alkylguanines as opposed to
      other alkylated bases. BOP and BHP were weak mutagens in the Salmonella/S-9
      mutagenesis assay using hamster liver S-9 fraction. When compared with results in
      the HMA, BOP and BHP were orders of magnitude less mutagenic in vitro. This
      observation suggests: (i) the pathways or enzymes involved in the activation of
      these carcinogens (although uncertain) may be different in vivo and in vitro; or
      (ii) the pathways for the in vitro and in vivo metabolism may be similar, but the
      conditions used for the in vitro activation of these nitrosamines are inadequate
      to generate significant levels of nitrosamine metabolites.

PMID- 8353846
TI  - Impact of various sources of garlic and their constituents on 7,12
      dimethylbenz[a]anthracene binding to mammary cell DNA.
AB  - The present studies assessed the impact of various sources of garlic and their
      constituents (water- and ethanol-extracts and S-allylcysteine) on the in vivo
      binding of the carcinogen 7,12-dimethylbenz[a]anthracene (DMBA) to rat mammary
      cell DNA. The provision of dietary raw garlic powder (2%) or its water-extract
      (1.5%) reduced DMBA-DNA binding by 33 and 46% respectively. Dietary
      supplementation with a commercially available deodorized garlic powder (powder A)
      at 2 or 4% depressed the occurrence of adducts by 50 and 78% respectively, while
      providing a commercially available high sulfur garlic preparation (powder B) at
      2% reduced binding by 56%. A pair-feeding study revealed that the depression in
      carcinogen binding was independent of food intake or weight gain. Although 1% raw
      garlic powder did not significantly influence the occurrence of DMBA-DNA adducts,
      an equivalent as the water-extract (0.75%), the ethanol-extract (0.015%) or
      commercially available powders (A and B) reduced DMBA adducts in mammary tissue
      by 44, 25, 71 and 65% respectively. Dietary fortification with S-allylcysteine
      (SAC), a water-soluble constituent of processed garlic, caused a progressive
      decrease in the binding of DMBA to DNA. Studies with SAC suggest the primary
      effect of garlic and its constituents is on the bioactivation and binding of the
      carcinogen rather than DNA repair. These data reveal that several forms of garlic
      are effective, although variable, in altering carcinogen bioactivation and
      presumably chemically induced carcinogenesis.

PMID- 8353847
TI  - Metabolic activation and deactivation of arylamine carcinogens by recombinant
      human NAT1 and polymorphic NAT2 acetyltransferases.
AB  - A genetic polymorphism at the NAT2 gene locus, encoding for polymorphic N
      acetyltransferase (NAT2), segregates individuals into rapid, intermediate or slow
      acetylator phenotypes. Both rapid and slow acetylator phenotypes have been
      associated with increased incidence of cancer in certain target organs related to
      arylamine exposure, suggesting a role for acetylation in both the activation and
      deactivation of arylamine carcinogens. A second gene (NAT1) encodes for a
      different acetyltransferase isozyme (NAT1) that is not subject to the classical
      acetylation polymorphism. In order to assess the relative ability of NAT1 and
      NAT2 to activate and deactivate arylamine carcinogens, we tested the capacity of
      recombinant human NAT1 and NAT2, expressed in Escherichia coli XA90 strains
      DMG100 and DMG200 respectively, to catalyze the N-acetylation (deactivation) and
      O-acetylation (activation) of a variety of carbocyclic and heterocyclic arylamine
      carcinogens. Both NAT1 and NAT2 catalyzed the N-acetylation of each of the 17
      arylamines tested. Rates of N-acetylation by NAT1 and NAT2 were considerably
      lower for heterocyclic arylamines such as 2-amino-3-methyl-imidazo[4,5
      f]quinoline (IQ), particularly those (e.g. IQ) with steric hindrance to the
      exocyclic amino group. For carbocyclic arylamines such as 4-aminobiphenyl and
      beta-naphthylamine, the apparent affinity was significantly (P < 0.05) higher for
      NAT2 than NAT1. NAT1/NAT2 activity ratios and clearance calculations suggest a
      significant role for the polymorphic NAT2 in the N-acetylation of carbocyclic
      arylamine carcinogens. Both NAT1 and NAT2 catalyzed acetyl coenzyme A-dependent O
      acetylation of N-hydroxy-2-aminofluorene and N-hydroxy-4-aminobiphenyl to yield
      DNA adducts. NAT1 catalyzed paraoxon-resistant, intramolecular N,O
      acetyltransferase-mediated activation of N-hydroxy-2-acetylaminofluorene and N
      hydroxy-4-acetylaminobiphenyl at low rates; catalysis by NAT2 was not readily
      detectable in the presence of paraoxon. In summary these studies strongly suggest
      that the human acetylation polymorphism influences both the metabolic activation
      (O-acetylation) and deactivation (N-acetylation) of arylamine carcinogens via
      polymorphic expression of NAT2. These findings lend mechanistic support for human
      epidemiological studies suggesting associations between both rapid and slow
      acetylator phenotype and cancers related to arylamine exposure.

PMID- 8353848
TI  - Metabolism of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in human
      kidney epithelial cells transfected with rat CYP2B1 cDNA.
AB  - In all species where it has been tested, the tobacco-specific nitrosamine 4
      (methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) has been shown to be a potent
      carcinogen, and NNK and other nitrosamines may play a role in human tobacco
      related carcinogenesis. Purified rat CYP2B1 has been shown to metabolize NNK, and
      the CYP2B1 gene is expressed constitutively in rat lung. The objectives of this
      study were to test the capacity of CYP2B1, synthesized from a rat hepatic cDNA in
      Ad293 cells, to metabolize NNK, and to define the type and the proportions of the
      final metabolites produced. Ad293 cells were transfected with a CYP2B1 expression
      vector (pMT2-2B1), or with a control vector and incubated in culture medium
      containing [3H]NNK, after which alpha-carbon hydroxylation and pyridine N
      oxidation metabolites were identified by HPLC analysis and quantitated by
      scintillation counting. pMT2-2B1-transfected cells were capable of catalyzing
      alpha-carbon hydroxylation and pyridine N-oxidation of NNK, although the
      reduction product 4-(methylnitrosamino)-1-(3-pyridyl)-1-butan-1-ol(NNAL) was the
      major metabolite formed in cells regardless of transfection treatment. The total
      amount of alpha-carbon hydroxylation metabolites produced by pMT2-2B1-transfected
      cells was greater than that of pyridine N-oxidation metabolites. However, pMT2
      2B1 transfected cells produced approximately ten-fold more pyridine N-oxidation
      metabolites and only two-fold more alpha-carbon hydroxylation metabolites than
      control cells. Furthermore, the amount of NNAL-N-oxide was much lower than that
      of NNK-N-oxide in the medium of pMT2-2B1-transfected cells, even though the
      amount of available NNAL, resulting from carbonyl reduction of NNK, was very
      high; this suggests that NNAL is poorly N-oxidized by CYP2B1 compared to NNK.
      These results show that within living cells NNK was metabolized by CYP2B1 via
      both the pyridine N-oxidation and alpha-carbon hydroxylation pathways. However,
      CYP2B1 preferentially catalyzed pyridine N-oxidation, which is considered to be a
      deactivation reaction.

PMID- 8353849
TI  - Expression of human cytochrome P450 1A1 in DNA repair deficient and proficient
      human fibroblasts stably transformed with an inducible expression vector.
AB  - Cytochromes P450 catalyze the bioactivation of many carcinogens. In particular,
      cytochrome P450 1A1 (CYP1A1) catalyzes the conversion of polycyclic aromatic
      hydrocarbons, such as benzo[a]pyrene, into potent mutagenic agents. Human skin
      fibroblasts, both DNA repair deficient (xeroderma pigmentosum group A: XPA) and
      DNA repair normal have been co-transformed with a chimeric gene construct
      containing human CYP1A1 coding sequences controlled by the cadmium (Cd) ion
      inducible mouse metallothionein-I promoter and pRSV-NEO, a dominant selectable
      marker for G418 resistance. Individual G418 resistant colonies were cloned and
      analyzed for Cd inducible CYP1A1 activity. Six clones of DNA repair deficient
      cells and five clones of DNA repair proficient cells have been isolated which
      express Cd inducible CYP1A1. Benzo[a]pyrene-trans-7,8-diol (BPD) is cytotoxic in
      Cd induced CYP1A1 expressing cells. The cytotoxicity can be inhibited by 10
      microM alpha-napthoflavone. Differential cytotoxicity between the DNA repair
      deficient and proficient CYP1A1 expressing transformants is observed. BPD is
      cytotoxic to Cd induced CYP1A1 expressing XPA cells at > 10-fold lower doses than
      it is to Cd induced CYP1A1 expressing DNA repair normal cells. These data
      indicate that BPD is metabolized to a DNA damaging agent by induced CYP1A1. In
      contrast, benzo[a]pyrene-trans-7,8-diol-9,10-epoxide added to the media is only
      slightly more cytotoxic to DNA repair deficient than to proficient cells
      regardless of CYP1A1 expression. These studies demonstrate the usefulness of the
      CYP1A1 transformed fibroblasts in examining the cytotoxic effects of
      benzo[a]pyrene metabolites and suggest the future usefulness in examining the
      toxic effects of polycyclic aromatic hydrocarbons and other xenobiotics
      bioactivated by CYP1A1.

PMID- 8353850
TI  - Bioactivation of N-hydroxy-2-acetylaminofluorenes by N,O-acyltransferase:
      substituent effects on covalent binding to DNA.
AB  - N-Acetoxyarylamines are reactive metabolites that lead to arylamine adduct
      formation with biological macromolecules. A series of 7-substituted-N-hydroxy-2
      acetylaminofluorenes were converted to reactive N-acetoxyarylamines by enzymatic
      N,O-acyltransfer in the presence of DNA. The N-arylhydroxamic acid substrates
      that contained electronegative 7-substituents formed greater amounts of DNA
      adducts than either the unsubstituted compound (N-OH-AAF) or those analogs that
      contained electron-donating groups in the 7-position. Glutathione did not
      decrease the rates of DNA adduct formation, but other nucleophiles, such as
      potassium O-ethylxanthate, thiourea and N-acetylmethionine, inhibited adduct
      formation by the 7-Br-substituted compound (7-Br-N-OH-AAF) and the unsubstituted
      parent compound (N-OH-AAF). Nucleophiles, reducing agents (e.g. ascorbic acid)
      and spin-trapping agents had minimal effect on DNA adduct formation by the
      bioactivated form of 7-acetyl-2-(N-hydroxy-acetylamino)fluorene (7-Ac-N-OH-AAF).
      Triethylphosphite, an agent that reacts with aryl nitrenes, caused a
      concentration-dependent reduction in the amount of DNA adduct formed subsequent
      to bioactivation of 7-Ac-N-OH-AAF, but did not influence adduct formation when N
      OH-AAF and 7-Br-N-OH-AAF were the substrates. The results indicate that a change
      in the reaction mechanism(s) responsible for DNA adduct formation occurred when
      the strongly electronegative acetyl group was incorporated into the 7-position of
      N-OH-AAF. It is proposed that a nitrene intermediate is involved in the formation
      of covalent adducts with DNA when 7-Ac-N-OH-AAF is activated by N,O-acyltransfer.

PMID- 8353851
TI  - Demonstration of a 65 kDa tumor-specific phosphoprotein in urine and serum of
      rats with N-methyl-N-nitrosourea-induced mammary adenocarcinomas.
AB  - Polyclonal antibodies against a 65 kDa tumor-associated phosphoprotein (p65) were
      used to develop an ELISA to analyze the presence of p65 in urine and serum of
      rats bearing N-methyl-N-nitrosourea-induced mammary gland adenocarcinomas. Highly
      purified rat p65 was added to normal urine and serum to establish a quantitative
      standard curve with the average correlation coefficient being 0.98 and 0.99
      respectively. All samples of urine and serum obtained from different carcinoma
      bearing rats showed p65 concentrations above the normal levels found in the
      control urine and sera. The correlation coefficient between tumor burden and p65
      concentration in urine and serum was 0.65 and 0.77 respectively. The average
      levels of p65 in normal urine and normal serum were 37.0 +/- 32.0 and 48.0 +/-
      38.0 ng/ml respectively. In the case of urine obtained from rats bearing mammary
      adenocarcinomas, the mean p65 level was 119.0 +/- 35.9 ng/ml and their serum
      level was 225.4 +/- 67.5 ng/ml. Sensitivity, specificity and predictive value for
      serum and urine marker elevation were 78.5, 70.0 and 78.5% respectively.
      Following in vitro phosphorylation of concentrated urinary proteins,
      isoelectrofocusing, SDS-PAGE and autoradiography, a phosphorylated form of the 65
      kDa protein with a pI of 5.8 was identified in the urine of tumor-bearing rats.
      This phosphoprotein bound to an antiphosphotyrosine monoclonal antibody and an
      anti-p65 polyclonal as determined by Western blot analysis. Using the anti-p65
      antibodies in an immunoprecipitation procedure, the main radio- and immunoactive
      band of 65 kDa and two lower mol. wt bands of 50 and 41 kDa, apparently
      representing degradation products of p65, were identified after in vitro and in
      vivo phosphorylation of urinary proteins obtained from mammary carcinoma-bearing
      rats.

PMID- 8353852
TI  - Transgenic Drosophila carrying mammalian cytochrome P-4501A1: an application to
      toxicology testing.
AB  - Transgenic Drosophila which carry a canine cytochrome P-450 were established and
      evaluated for its value on toxicology testing. Dah1, a cDNA clone for the canine
      hepatic P-4501A1, was ligated between the promoter of Drosophila heat-shock
      protein gene and the terminator of actin 5C gene, and then microinjected into
      Drosophila embryos with a transposon P element. The injected DNA was stably
      integrated into chromosomal DNA in germ line cells. After heat-shock treatments,
      transgenic larvae produced mRNA and a detectable amount of protein that cross
      reacted with antibodies against rat P-4501A1. The ability of transgenic flies to
      activate procarcinogens was monitored in the DNA repair test with the endpoint
      being preadult mortality of repair-defective mei-9a mei-41D5/Y males. Heat-shock
      treatments of larvae showed that the repair-defective males carrying the P-4501A1
      transgene were killed by lower concentrations of 7,12-dimethylbenz[a]anthracene
      than their non-transgenic or non heat-shocked counterparts. Coadministration of
      alpha-naphthoflavone, one of the inhibitors of P-4501A subfamily, cancelled the
      enhanced mortality of transgenic males, supporting that 7,12
      dimethylbenz[a]anthracene was metabolized to its genotoxic form by the expressed
      P-4501A1 enzyme. This study indicates a potential utility of transgenic
      Drosophila for screening mammalian promutagens and procarcinogens.

PMID- 8353853
TI  - The effects of patterned calorie-restricted diets on mammary tumor incidence and
      plasma endothelin levels in DMBA-treated rats.
AB  - Chronic caloric restriction has been shown to inhibit mammary tumor promotion in
      the 7,12-dimethyl-benz[a]anthracene (DMBA) rat mammary tumor model. The
      objectives of this study were to determine (i) the effects of chronic caloric
      cycling (yo-yo dieting) on mammary tumor promotion by high fat diets and (ii) the
      effect of three dietary regimens +/- superimposed mammary tumor burden on plasma
      endothelin-1,2 (ET) levels. Female Sprague-Dawley rats were treated with DMBA (5
      mg/rat) and divided into three dietary groups: ad libitum (AL) (containing 15%
      corn oil); 40% calorie restricted (CR) (containing 20% corn oil so consumption of
      fat was equivalent between AL and CR); a calorie cycled (CC) group fed
      alternatively AL and CR diets each 48 h period. After 10 weeks, tumor incidences
      were: AL, 63%; CR, 27%; CC, 57% (AL versus CR, P < 0.05; CC versus CR, P < 0.05;
      AL versus CC, NSD). ET levels (pg/ml plasma) were: AL, 16.0 +/- 6.54; CR, 32.31
      +/- 0.34; CC, 23.44 +/- 5.04 (AL versus CR, P < 0.01; CC versus CR, P < 0.01; AL
      versus CC, P < 0.05). Plasma ET levels were independent of tumor incidence and
      tumor burden, but plasma ET levels were significantly increased in rats with a
      prior history of calorie restriction. As expected, maintained caloric restriction
      reduced mammary tumor incidence but intermittent caloric restriction (caloric
      cycling or yo-yo dieting) was without similar benefit.

PMID- 8353854
TI  - The in vitro metabolic activation of the 11-trifluoromethyl analogue of the
      potent carcinogen 15,16-dihydro-11-methyl-cyclopenta[a]-phenanthren-17-one to
      mutagens.
AB  - A strongly electronegative, bay-region analogue of the potent carcinogen 15,16
      dihydro-11-methylcyclopenta[a]phenanthren-17-one, namely 15,16-dihydro-11
      trifluoromethylcyclopenta[a]phenanthren-17-one, is mutagenic to Salmonella
      typhimurium TA100. Also it is metabolized at the 1,2- and 3,4-positions in the A
      ring as well as C-15 in the D-ring to give 3,4-dihydroxy-3,4,15,16-tetrahydro-11
      trifluoromethyl- cyclopenta[a]phenanthren-17-one as the only mutagenic
      metabolite. In these respects its behaviour is closely similar to that of the 11
      methyl compound, suggesting that the electronic nature of the bay-region
      substituent is rather less critical than its spatial configuration in influencing
      metabolism to genotoxic intermediates. It remains to be seen, however, whether
      the trifluoromethyl compound is also a carcinogen.

PMID- 8353855
TI  - Increasing the interval between initiation and the onset of exposure to orotic
      acid decreases its promoting effect on rat liver carcinogenesis.
AB  - The present study was designed to determine whether a delay in the start of the
      promoting regimen after the administration of a carcinogen would influence the
      promoting efficacy of orotic acid on the development of hepatocellular carcinoma
      in rats. Male Fischer 344 rats weighing 130-150 g were injected with a single
      dose of diethylnitrosamine (200 mg/kg body wt i.p.) then divided into 3 groups:
      groups 1 and 2 were given semi-synthetic basal diet or the same diet containing
      1% orotic acid (OA) respectively starting 1 week after the carcinogen; group 3
      received the OA diet starting 5 weeks after the administration of
      diethylnitrosamine. Animals from these 3 groups were sacrificed after 25, 32, 42
      and 60 weeks of being fed their respective diets. The results indicated that
      delaying the start of the OA diet after the carcinogen resulted in about a 50%
      decrease in the incidence of hepatic nodules and/or hepatocellular carcinomas at
      various time points during the experiment. This decrease in promoting efficacy of
      OA was not apparently explainable by lack of metabolic effects of OA, at least in
      terms of induction of nucleotide pool imbalance, a condition that appears to be
      important for OA to exert its tumor promoting effects.

PMID- 8353856
TI  - Metabolism and activation of pancreas specific nitrosamines by pancreatic ductal
      cells in culture.
AB  - Metabolism of 14C labeled N-nitrosobis(2-oxopropyl)amine (BOP), N-nitroso(2
      hydroxypropyl)(2-oxopropyl)amine (HPOP) and N-nitrosobis(2-hydroxypropyl)amine
      (BHP) by pancreatic duct cells in culture involves the following two pathways:
      reduction or oxidation reactions at the beta-carbon which result in the inter
      conversion of these nitrosamines and activation reactions which result in the
      decomposition of the nitrosamine, the evolution of 14CO2 and the labeling of
      macromolecules. Reduction of BOP to HPOP seems to contribute significantly to the
      metabolism of the former nitrosamine by pancreatic duct cells, however, redox
      reactions at the beta-carbon of HPOP or BHP are not extensive. In terms of DNA
      damage, all three nitrosamines yield methyl and hydroxypropyl adducts. As
      expected, HPOP and BHP yield higher levels of O6-hydroxypropylguanine than BOP,
      while the latter yields higher levels of O6-methylguanine. There is no
      correlation between the ability of these nitrosamines to alkylate duct cell DNA
      in vitro and their carcinogenic potency in vivo. Concentrations of DNA adducts
      induced by pancreas specific nitrosamines (PSNs) in cultured duct cells at
      concentrations comparable to those found in the pancreatic juice of animals
      treated with BOP, are almost an order of magnitude lower than those induced in
      the pancreas of such animals. Discrepancies between in vitro and in vivo
      formation of active metabolites and DNA adducts may be attributed to the decline
      of the cells' ability to activate PSNs during culturing. In the same vein, the
      ductal cell may not be the main source of active metabolites targeting its DNA in
      the animal model.

PMID- 8353857
TI  - Inhibition of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone mouse lung
      tumorigenesis by arylalkynes, mechanism-based inactivators of cytochrome P450.
AB  - Arylalkynes such as 4-phenyl-1-butyne (PBY), 5-phenyl-1-pentyne (PPY) and 2
      ethynylnaphthalene (2-EN) are suicide inhibitors of cytochrome P450 enzymes.
      Arylalkyl isothiocyanates such as 6-phenylhexyl isothiocyanate (PHITC) are
      structurally related to arylalkynes and are known to inhibit the cytochrome P450
      mediated metabolic activation and tumorigenicity of a tobacco-specific lung
      carcinogen, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). In this study,
      we compared the ability of PBY, PPY, 2-EN and PHITC to inhibit A/J mouse lung
      tumorigenesis by NNK. Groups of 20 female mice were gavaged with 5 mumol of
      arylalkyne or PHITC in corn oil. Two hours later they were given a single i.p.
      injection of 10 mumol NNK. The mice were killed 16 weeks later. PPY and PHITC
      were both potent inhibitors of tumorigenesis by NNK, reducing lung tumor
      multiplicity from 8.35 tumors per mouse to 0.40 and 0.35 respectively. PBY and 2
      EN also significantly inhibited tumor multiplicity. The results of this study
      demonstrate that arylalkynes and PHITC are potent inhibitors of NNK induced lung
      tumorigenesis in A/J mice, consistent with the hypothesis that inhibition of
      specific cytochrome P450 enzymes is involved in inhibition of tumorigenesis.

PMID- 8353858
TI  - Complementary tumor induction in neural grafts exposed to N-ethyl-N-nitrosourea
      and an activated myc gene.
AB  - Using a combination of transplacental carcinogen exposure and retrovirus-mediated
      oncogene transfer into fetal brain transplants, we have studied complementary
      transformation by N-ethyl-N-nitrosourea (NEU) and the v-myc oncogene in the
      nervous system. Previous experiments had demonstrated that both agents will not
      induce tumors independently whereas simultaneous expression of v-H-ras and v
      gag/myc exerted a powerful transforming potential in neural grafts. In order to
      identify other genetic alterations that co-operate with an activated myc gene,
      the neurotropic carcinogen NEU was used to generate mutations of cellular genes.
      On embryonic day 14 (ED14), pregnant donor animals (F344 rats) received a single
      i.v. dose of NEU (50 mg/kg). Twenty-four hours later (ED15), the fetal brains
      were removed, triturated and incubated with a retroviral vector carrying the v
      gag/myc oncogene. Subsequently, these primary cell suspensions were transplanted
      stereotactically into the caudate-putamen of syngenic adult recipients. After
      latency periods of 3-6 months, 5 of 10 recipients harboring ED15 fetal brain
      transplants developed malignant, poorly differentiated neuroectodermal tumors in
      the grafts. No tumor development was observed in seven recipients harboring ED16
      neural grafts. Cell lines were established from three tumors and the 110 kd
      gag/myc fusion protein encoded by the retroviral construct was identified in the
      tumors by Western blotting. Several candidate genes for mutational activation by
      NEU including the H-ras, K-ras and neu oncogenes were analyzed for specific point
      mutations by polymerase chain reaction (PCR) and direct DNA sequencing of the PCR
      products. However, no mutations were found in any of these genes. These findings
      lend further support to the multistep hypothesis of neoplastic transformation in
      the brain. The tumors induced in this model provide an interesting tool for the
      identification of genes that co-operate with an activated myc gene in
      neurocarcinogenesis.

PMID- 8353859
TI  - The synthetic colon peptide pyroGlu-His-GlyOH inhibits growth of human colon
      carcinoma cells (HT-29) transplanted subcutaneously into athymic mice.
AB  - Growth inhibitory tripeptide, pyroGlu-His-GlyOH colon mitosis inhibitor (CMI),
      was recently isolated from water extracts of mouse intestine. In the present
      study, it was demonstrated in two different experiments that i.p. injections of
      CMI, daily or 3 times a week, could inhibit the long-term s.c. growth of HT-29
      cells in athymic mice. The growth inhibitory effect was most pronounced initially
      with approximately 50-90% growth inhibition, and declined terminally with
      approximately 40-60% growth inhibition. A bell-shaped dose-response curve with
      maximal effect at 1 pmol/animal/injection was seen.

PMID- 8353860
TI  - Lack of initiating capacity of the genotoxic air pollutant 2-nitrofluorene in the
      mouse skin two-stage carcinogenesis system.
AB  - 2-Nitrofluorene (NF) is a potent genotoxic substance found in environments where
      incomplete combustion takes place. NF is a mutagen and a carcinogen in animal
      models. NF or 7,12-dimethylbenz[a]anthracene (DMBA) was administered once
      topically to female SENCAR mice followed by promotion by 12-O
      tetradecanoylphorbol-13-acetate (TPA) in two different studies. TPA (2-5
      micrograms) was administered twice a week for 13 or 19 weeks after initiation of
      DMBA (5-10 micrograms) or NF (50-1500 micrograms). DMBA administration (positive
      control) resulted in the formation of many papillomas, which were seen from week
      8-9 after initiation. The negative controls administered acetone only were free
      of tumours. NF administration did not result in papilloma formation, even at high
      initiating doses of NF combined with a dose of TPA causing a systemic toxic
      effect in terms of a significant reduced body weight. The mechanism behind the
      absence of papilloma formation after administration of genotoxic and carcinogenic
      NF remains to be investigated.

PMID- 8353861
TI  - Natriuretic peptide system in human heart failure.
AB  - BACKGROUND: Atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP),
      and C-type natriuretic peptide (CNP) are a family of structurally related
      peptides that participate in the integrated control of renal and cardiovascular
      function. Previous studies suggest a functional role for these hormonal peptides
      in cardiorenal regulation in congestive heart failure (CHF). METHODS AND RESULTS:
      The present studies were performed in normal subjects (n = 6) and in patients
      with mild (New York Heart Association [NYHA] class I to II, n = 20) and severe
      (NYHA class III to IV, n = 20) CHF by use of radioimmunoassay and
      immunohistochemical staining (IHCS). Plasma ANP was significantly increased in
      both mild and severe CHF compared with normal subjects. In contrast, plasma BNP
      was only moderately increased in the severe CHF group, and plasma CNP
      concentration was unchanged in CHF compared with normal subjects. Atrial tissue
      concentrations of the natriuretic peptides did not parallel circulating
      concentrations. ANP predominated in normal atrial tissue, but BNP predominated in
      CHF. In ventricular tissue, IHCS staining was present for all three peptides in
      normal ventricular myocardium and was markedly enhanced in CHF. CONCLUSIONS:
      These studies support a differential regulation of ANP, BNP, and CNP circulating
      concentrations and tissue activity in human CHF.

PMID- 8353862
TI  - Right ventricular-vascular interaction in congestive heart failure. Importance of
      low-frequency impedance.
AB  - BACKGROUND: Vasodilator agents are widely used in congestive heart failure. These
      agents may have important effects on the pulsatile aspects of right ventricular
      hydraulic load. METHODS AND RESULTS: Fifteen patients with severe congestive
      heart failure were studied during cardiac catheterization by use of high-fidelity
      pressure transducers and a catheter-mounted flow velocity probe. Three graded
      doses of nitroprusside were infused as pulmonary artery (PA) pressure and flow
      were continuously recorded. From Fourier transforms of signal-averaged waves, PA
      impedance, hydraulic power, and wave reflection indices were derived. At the
      highest dose of nitroprusside (66 +/- 41 micrograms/min), cardiac output was
      significantly improved, whereas PA mean and wedge pressure, resistance, impedance
      at the first harmonic, characteristic impedance, and wave reflection amplitude
      were all reduced. At the dose (32 +/- 20 micrograms/min) at which cardiac output
      first showed improvement, only PA mean pressure and first-harmonic impedance were
      significantly reduced. Hydraulic power cost per unit of forward flow was also
      lowered at this dose, despite lack of significant change in pulmonary vascular
      resistance. At the lowest dose of nitroprusside (11 +/- 4 micrograms/min), six
      patients experienced a decrease in stroke volume, whereas the other nine were
      either unchanged (n = 1) or showed an increase (n = 8). Multiple regression
      revealed that only the change in first-harmonic impedance correlated with this
      effect, increasing when stroke volume decreased and decreasing when stroke volume
      increased (P = .02). The change in first-harmonic impedance at this dose appeared
      to be caused by alterations in the amplitude of PA wave reflections. At higher
      doses, changes in mean PA pressure (but not in pulmonary vascular resistance)
      correlated with changes in stroke volume. CONCLUSIONS: Nitroprusside vasodilation
      at low doses alters PA hemodynamics in congestive heart failure primarily through
      changes in low-frequency impedance. In some patients, this effect is associated
      with decreased stroke output. At higher doses, favorable alterations in
      resistance, low- and high-frequency impedance, and wave reflections all
      contribute to increased forward flow and decreased power requirement per unit
      forward flow. These findings show that ventricular-vascular interaction is
      importantly affected by pulmonary vasodilation and that appreciation of pulsatile
      properties is required to understand the effects of pulmonary vasodilation on
      cardiac output.

PMID- 8353863
TI  - Circulating beta-atrial natriuretic factor in congestive heart failure in humans.
AB  - BACKGROUND: beta-Atrial natriuretic factor (beta-ANF) is an antiparallel dimer of
      alpha-ANF (alpha-ANF) with diminished cyclic GMP generation in vitro. To date,
      the presence of beta-ANF in the circulation of humans with severe congestive
      heart failure (CHF) remains controversial. The current study was designed to
      determine the presence and magnitude of circulating beta-ANF in severe CHF, to
      correlate plasma beta-ANF with the degree of ventricular dysfunction, and to
      investigate the role of human plasma and atrial tissue in the degradation of beta
      ANF. METHODS AND RESULTS: Venous plasma samples were obtained from patients (n =
      12) with severe CHF and normal volunteers (n = 8). Total plasma ANF was measured
      by radioimmunoassay. alpha-ANF and beta-ANF in nonextracted plasma were separated
      by gel filtration chromatography using a P-6 column. Right atrial tissue samples
      (n = 5) were collected from a different group of patients at the time of open
      heart surgery. 125I beta-ANF and I125 ANF were incubated with atrial tissue or
      plasma. The corresponding peak areas of beta-ANF were determined by Tamaya
      Digital Planimeter. beta-ANF represented 61% of total plasma ANF in CHF patients
      and was not detected in normal human plasma. The elevation of beta-ANF correlated
      with the severity of ventricular dysfunction. Thirty percent of beta-ANF and 100%
      alpha-ANF were converted to smaller peptide fragments in atrial tissue no
      conversion in plasma. CONCLUSIONS: beta-ANF is the principal form of circulating
      ANF in patients with severe CHF and correlates with the degree of left
      ventricular dysfunction. beta-ANF is not generated from alpha-ANF and may be
      degraded rapidly in atrial tissue to smaller peptide fragments that do not occur
      in plasma. As beta-ANF is reported to have reduced biological action, the current
      studies may support the conclusion that the ANF system in CHF has reduced
      functional activity despite increases in circulation concentrations.

PMID- 8353864
TI  - Unfavorable outcome in patients with primary electrical disease who survived an
      episode of ventricular fibrillation.
AB  - BACKGROUND: Prognosis in patients with ventricular tachyarrhythmia without
      structural heart disease (primary electrical disease) has been described as
      excellent. However, prognosis may be less favourable in the subgroup surviving an
      episode of ventricular fibrillation. METHODS AND RESULTS: We prospectively
      followed 19 consecutive patients (age, 13 to 66 years; mean age, 33 years) who
      had survived an episode of documented ventricular fibrillation. Structural heart
      disease, preexcitation, and long QT syndromes were excluded by thorough
      cardiologic evaluation. All patients underwent 24-hour Holter monitoring,
      exercise testing, and programmed electrical stimulation according to a
      standardized protocol. Holter monitoring revealed episodes of ventricular
      tachyarrhythmia in 5 patients. Exercise testing reproducibly provoked ventricular
      tachycardia in 2 patients. Baseline programmed electrical stimulation yielded
      inducibility of rapid ventricular tachyarrhythmia in 10 patients (53%) and
      noninducibility in 9 (47%). Nine patients were discharged on antiarrhythmic drug
      therapy. A defibrillator was implanted in 10 patients. During 43-month follow-up
      (range, 5 to 85 months; median, 41 months), major arrhythmic events recurred in 7
      patients (37%). Four of these patients had noninducibility at baseline programmed
      electrical stimulation. Two patients on antiarrhythmic drugs had recurrent
      cardiac arrest: one died suddenly and the other was successfully resuscitated
      from ventricular fibrillation and subsequently underwent defibrillator
      implantation. In the other 5 patients, termination of (pre)syncopal episodes was
      associated with defibrillator shocks. Termination of ventricular fibrillation was
      documented by Holter recording in one of these patients. Specific markers
      predictive of a recurrent event could not be identified, although 6 of 7 patients
      with recurrent events had experienced at least one episode of cardiac arrest or
      (pre)syncope before the index episode. CONCLUSIONS: Patients with primary
      electrical disease presenting with ventricular fibrillation are at high risk of
      recurrence of major arrhythmic events during long-term follow-up. Noninducibility
      at baseline study does not predict an uneventful course. Also, early
      defibrillator implantation should be considered in these patients.

PMID- 8353865
TI  - Comparative mechanisms of antiarrhythmic drug action in experimental atrial
      fibrillation. Importance of use-dependent effects on refractoriness.
AB  - BACKGROUND: Antiarrhythmic drugs are considered to terminate atrial fibrillation
      by prolonging refractoriness, but direct experimental evaluation of this concept
      has been limited. The atria are activated rapidly during atrial fibrillation, and
      antiarrhythmic drugs are known to have important rate-dependent actions. The
      potential role of such properties in determining drug effects during atrial
      fibrillation has not been evaluated. METHODS AND RESULTS: We evaluated the
      effects of representative class Ia (procainamide), Ic (propafenone), and III
      (sotalol) antiarrhythmic drugs on sustained cholinergic atrial fibrillation and
      atrial electrophysiological properties in anesthetized, open-chest dogs. Loading
      and maintenance doses were used to produce stable plasma concentrations, and
      computer-based 112-electrode epicardial mapping was used to study atrial
      conduction and activation during atrial fibrillation. Clinically used doses of
      procainamide and propafenone terminated atrial fibrillation in 13 of 13 (100%)
      and 7 of 10 (70%) dogs, respectively, but a dose of sotalol (2 mg/kg IV) in the
      clinical range terminated atrial fibrillation in only 2 of 8 (25%) dogs (P =
      .0005 vs procainamide, P = .08 vs propafenone). Procainamide and propafenone
      prevented atrial fibrillation induction in 13 of 13 (100%) and 7 of 10 (70%)
      dogs, respectively, compared with none of 8 dogs for 2 mg/kg sotalol (P < .0001
      vs procainamide, P = .004 vs propafenone). A larger dose of sotalol (cumulative
      dose, 8 mg/kg) was uniformly effective in terminating atrial fibrillation and
      preventing its induction. All drugs significantly increased atrial refractory
      period, with effects that were use dependent for propafenone but reverse use
      dependent for sotalol. Effective doses of all drugs significantly increased the
      wavelength for reentry at rapid atrial rates in the presence of vagal stimulation
      into the range observed under drug-free conditions in the absence of vagal input.
      The inefficacy of clinical doses of sotalol was explained by the reverse use
      dependence of its effects on refractoriness, which resulted in reduced effects on
      wavelength at rapid rates. The effects of propafenone on refractoriness were
      significantly increased at rapid rates, contributing to its ability to increase
      wavelength and terminate atrial fibrillation. Activation mapping showed that
      drugs terminated atrial fibrillation by reducing the number and increasing the
      size of reentry circuits, leading to termination by mechanisms related to block
      in the remaining circuit(s). CONCLUSIONS: We conclude that antiarrhythmic drugs
      terminate experimental atrial fibrillation by increasing the wavelength for
      reentry at rapid rates, leading to a reduction in the number of functional
      reentry circuits and, eventually, failure of reentrant excitation. Use-dependent
      effects on refractoriness can limit (in the case of the reverse use dependence of
      sotalol) or contribute (in the case of propafenone) to antiarrhythmic drug
      efficacy against atrial fibrillation by determining drug-induced changes in
      wavelength at rapid atrial rates.

PMID- 8353866
TI  - Chronic atrial fibrillation and stroke in paced patients with sick sinus
      syndrome. Relevance of clinical characteristics and pacing modalities.
AB  - BACKGROUND: The goal of the report was to study the long-term incidence and the
      independent predictors for chronic atrial fibrillation and stroke in 507 paced
      patients with sick sinus syndrome, adjusting for differences in baseline clinical
      variables with multivariate analysis. METHODS AND RESULTS: From 1980 to 1989, we
      implanted 376 dual-chamber, 19 atrial, and 112 ventricular pacemakers to treat
      patients with sick sinus syndrome. After a maximum follow-up of 134 months (mean:
      59 +/- 38 months for chronic atrial fibrillation, 65 +/- 37 months for stroke),
      actuarial incidence of chronic atrial fibrillation was 7% at 1 year, 16% at 5
      years, and 28% at 10 years. Independent predictors for this event, from Cox's
      proportional hazards model, were history of paroxysmal atrial fibrillation (P <
      .001; hazard ratio [HR] = 16.84), use of antiarrhythmic drugs before pacemaker
      implant (P < .001; HR = 2.25), ventricular pacing mode (P = .003; HR = 1.98), age
      (P = .005; HR = 1.03), and valvular heart disease (P = .008; HR = 2.05). For
      patients with preimplant history of paroxysmal atrial fibrillation, independent
      predictors were prolonged episodes of paroxysmal atrial fibrillation (P < .001;
      HR = 2.56), long history of paroxysmal atrial fibrillation (P = .004; HR = 2.05),
      ventricular pacing mode (P = .025; HR = 1.69), use of antiarrhythmic drugs before
      pacemaker implant (P = .024; HR = 1.71), and age (P = .04; HR = 1.02). Actuarial
      incidence of stroke was 3% at 1 year, 5% at 5 years, and 13% at 10 years.
      Independent predictors for stroke were history of cerebrovascular disease (P <
      .001; HR = 5.22), ventricular pacing mode (P = .008; HR = 2.61), and history of
      paroxysmal atrial fibrillation (P = .037; HR = 2.81). CONCLUSIONS: Development of
      chronic atrial fibrillation and stroke in paced patients with sick sinus syndrome
      are strongly determined by clinical variables and secondarily by the pacing
      modality. Ventricular pacing mode predicts chronic atrial fibrillation in
      patients with preimplant paroxysmal atrial fibrillation but not in those without
      it.

PMID- 8353867
TI  - Electrocardiographic correlates of spontaneous termination of ventricular
      tachycardia in patients with coronary artery disease.
AB  - BACKGROUND: In vitro studies have reported that beat-to-beat variance in
      tachycardia cycle length and in conduction and repolarization properties can
      result in spontaneous termination of reentrant arrhythmias. The purpose of this
      study was to define the ECG patterns associated with spontaneous termination of
      ventricular tachycardia in humans late after myocardial infarction. METHODS AND
      RESULTS: The QRS durations, QT intervals, and cycle lengths were measured on a
      beat-to-beat basis during episodes of sustained and spontaneously terminating
      ventricular tachycardias (VT) induced at antiarrhythmic drug-free and drug
      assessment electrophysiological studies. Twenty-six patients were studied. Four
      categories of inducible ventricular tachycardia were studied: inducible sustained
      ventricular tachycardia in an antiarrhythmic drug-free state, spontaneously
      terminating ventricular tachycardia in an antiarrhythmic drug-free state,
      sustained ventricular tachycardia on antiarrhythmic therapy, and spontaneously
      terminating ventricular tachycardia on antiarrhythmic therapy. The ECG patterns
      that were statistically related to spontaneous termination of ventricular
      tachycardia included impingement of the QTP interval on the tachycardia cycle
      length (P < .001) both in the presence and absence of drugs, transient shortening
      of QRS just before termination, and paradoxical prolongation of QTP after abrupt
      shortening of ventricular tachycardia cycle length. In addition, greater beat-to
      beat variances in tachycardia cycle lengths, QT intervals, and QRS durations were
      statistically associated with spontaneously terminating ventricular tachycardia.
      These ECG patterns did not occur during sustained episodes of ventricular
      tachycardia during the antiarrhythmic drug-free state or during ineffective
      antiarrhythmic drug therapy. CONCLUSIONS: A dynamic interplay between QRS
      duration, QT interval, and cycle length of tachycardia and their variances are
      associated with spontaneous termination of ventricular tachycardia in humans late
      after infarction. This study of ECG changes associated with spontaneous
      termination of ventricular tachycardia provides insight into potential mechanisms
      of antiarrhythmic drug efficacy.

PMID- 8353868
TI  - Frequency-dependent electrophysiologic effects of amiodarone in humans.
AB  - BACKGROUND: In general, antiarrhythmic agents that prolong the action potential
      duration (APD) have attenuated effects on repolarization at short cycle lengths
      (reverse frequency dependence), and this may limit their efficacy for controlling
      ventricular arrhythmias. The frequency-dependent effects of amiodarone on
      repolarization may differ from those of other antiarrhythmic agents and have not
      been determined in humans. METHODS AND RESULTS: The frequency-dependent effects
      of amiodarone on repolarization and conduction were determined during
      electrophysiologic study in 19 patients at drug-free baseline and after 11 days
      of amiodarone loading (1621 +/- 162 mg/d, group A) and in 15 additional patients
      after > or = 1 year of chronic amiodarone therapy (380 +/- 56 mg/d, group B). The
      two groups were similar in all clinical characteristics. The ventricular APD at
      90% repolarization (APD90), right ventricular effective refractory period (VERP),
      and QRS duration were determined at paced cycle lengths of 300 to 600
      milliseconds. In group A, amiodarone significantly (10% to 13%, P < .001)
      increased the APD90 at all paced cycle lengths by approximately 30 milliseconds
      compared with baseline. Similarly, there were no frequency-dependent effects on
      the percent increase in VERP. However, there was greater amiodarone-induced
      prolongation of the VERP magnitude at longer paced cycle lengths than at shorter
      cycle lengths (P = .04), although the VERP remained significantly prolonged at
      the shortest paced cycle length (300 milliseconds) by 33 +/- 22 milliseconds
      (16.9% increase from baseline, P < .001). Amiodarone significantly (P < .01)
      increased the QRS duration at paced cycle lengths < or = 500 milliseconds by a
      maximum of 28% compared with baseline measurements. The increase in ventricular
      conduction time was frequency dependent (P < .01), consistent with significant
      sodium channel blockade. The VERP/APD90 ratio (determined at twice diastolic
      threshold) was significantly prolonged by amiodarone (as compared with baseline)
      at cycle lengths > or = 400 milliseconds, indicative of both time- and voltage
      dependent effects on refractoriness. The increase in induced sustained
      ventricular tachycardia cycle length in group A patients after amiodarone loading
      was significantly correlated with the increase in VERP (r = .68, P = .044) but
      not with increases in QRS duration or APD90. In addition, there were no
      significant differences in frequency-dependent effects of amiodarone between
      groups A and B. CONCLUSIONS: The frequency-dependent response of the
      electrophysiologic effects of amiodarone are similar after 11 days of loading or
      > or = 1 year of chronic therapy. Amiodarone does not exert frequency-dependent
      effects on ventricular repolarization; it prolongs refractoriness by both time-
      and voltage-dependent mechanisms and exerts frequency-dependent effects on
      ventricular conduction. The absence of amiodarone-induced reverse frequency
      dependent effects on repolarization, together with its time-dependent effects on
      refractoriness may account in part for the high efficacy of the drug and its low
      propensity to cause torsade de pointes.

PMID- 8353869
TI  - Antiarrhythmic effects of selective prolongation of refractoriness.
      Electrophysiologic actions of sematilide HCl in humans.
AB  - BACKGROUND: Recent data have suggested that antiarrhythmic agents that act
      largely by delaying conduction may not be as effective in controlling ventricular
      arrhythmias as those that prolong repolarization. Recently, numerous "pure" class
      III agents have been developed. METHODS AND RESULTS: The antiarrhythmic and
      electrophysiologic profiles of sematilide, a "pure" class III agent, were
      determined in 27 patients with clinical ventricular arrhythmias and inducible
      sustained ventricular tachycardia during electrophysiologic study. After
      treatment with oral sematilide (mean dose, 133 +/- 29 mg every 8 hours), the
      patients underwent repeat 24-hour ambulatory ECG monitoring and
      electrophysiologic study. The baseline sinus cycle length and QT, QTc, JT, and
      JTc intervals were significantly increased 8 to 17% by sematilide (P = .001 to
      .029). There were no changes in the PR or QRS intervals. Sematilide (at a paced
      cycle length of 600 ms) significantly increased the atrial effective refractory
      period (238 +/- 32 to 264 +/- 32 ms; 11 +/- 16% increase from baseline; P =
      .013), atrioventricular nodal effective refractory period (296 +/- 74 to 354 +/-
      71 ms; 20 +/- 19%; P = .029), and right ventricular effective refractory period
      (252 +/- 25 to 281 +/- 30 ms; 12 +/- 8%; P < .001) but did not significantly
      change the PA or HV intervals, the corrected sinus node recovery time, or the
      Wenckebach cycle length. Determination of the frequency-dependent effects of
      sematilide (n = 10) on the right ventricular monophasic action potential duration
      (APD90) during ventricular pacing at cycle lengths of 600 to 300 ms revealed that
      the APD90 was significantly prolonged by sematilide during ventricular pacing at
      600 to 350 ms (APD90 increase of 40 +/- 17, 27 +/- 21, 18 +/- 18, and 14 +/- 15
      ms, respectively) but not at 300 ms (APD increase of 13 +/- 19 ms). Sematilide
      significantly prolonged the APD90 to a greater degree at longer than at shorter
      cycle lengths (P = .02). The ventricular effective refractory period had a
      similar reverse frequency-dependent relation as the APD90. Sematilide had no
      effect on the ventricular effective refractory period-to-APD90 ratio or on
      ventricular conduction. Sematilide suppressed the induction of sustained
      ventricular tachycardia in 41% of all patients exposed to sematilide.
      Prolongation of ventricular refractoriness was correlated with ventricular
      tachycardia suppression. The right ventricular effective refractory period (at
      600 ms) increased by 38 +/- 14 ms in patients whose sustained ventricular
      tachycardia was suppressed by sematilide and by 19 +/- 18 ms in patients not
      suppressed (P = .015). One patient developed short runs of pause-dependent
      nonsustained ventricular tachycardia. Eight patients were placed on long-term
      sematilide therapy, and during a mean follow-up period of 7.0 +/- 7.5 months, two
      patients developed sudden cardiac death, and one additional patient had recurrent
      sustained ventricular tachycardia. CONCLUSIONS: The electrophysiologic profile of
      sematilide is consistent with selective block of outward potassium currents and
      associated isolated lengthening of the ventricular effective refractory period
      and APD; sematilide demonstrates a significant degree of reverse frequency
      dependence of the ventricular APD and effective refractory period; and
      suppression of ventricular tachycardia inducibility by sematilide appears to be
      correlated with increases in the right ventricular effective refractory period.

PMID- 8353870
TI  - Influence of implantable cardioverter-defibrillators on the long-term prognosis
      of survivors of out-of-hospital cardiac arrest.
AB  - BACKGROUND: Survivors of out-of-hospital cardiac arrest not associated with acute
      myocardial infarction are at high risk for recurrent cardiac arrest and sudden
      cardiac death. The impact of the implantable cardioverter-defibrillator on long
      term prognosis in these patients is uncertain. METHODS AND RESULTS: Three hundred
      thirty-one survivors of out-of-hospital cardiac arrest (age, 56 +/- 13.7 years)
      underwent electrophysiologically guided therapy. Implantable defibrillators were
      placed in 150 patients (45.3%), and 181 patients (54.7%) received pharmacological
      and/or surgical therapy alone. Left ventricular ejection fraction was 35.2 +/-
      16.6% in defibrillator recipients and 45.3 +/- 18.2% in nondefibrillator
      patients. Median patient follow-up was 24 months in the defibrillator group and
      46 months in the nondefibrillator group. In a proportional hazards model, the
      independent predictors of total cardiac mortality were left ventricular ejection
      fraction of less than 0.40 (relative risk, 4.55; 95% confidence interval, 2.44 to
      8.33; P = .0001), absence of an implantable defibrillator (relative risk, 2.70;
      confidence interval, 1.41 to 5.00; P = .017), and persistence of inducible
      sustained ventricular tachycardia (relative risk, 1.84; 95% confidence interval,
      0.97 to 3.49; P = .045). The 1- and 5-year probabilities of survival free of
      cardiac mortality in patients with left ventricular ejection fraction of less
      than 0.40 were 94.3% and 69.6% with a defibrillator and 82.1% and 45.3% without a
      defibrillator, respectively. For patients with left ventricular ejection fraction
      of 0.40 or more, the 1- and 5-year probabilities of survival free of cardiac
      mortality were 97.7% and 94.6% with a defibrillator and 95.4% and 86.9% without a
      defibrillator, respectively. CONCLUSIONS: In survivors of out-of-hospital cardiac
      arrest, the implantable defibrillator is associated with a reduction in cardiac
      mortality, particularly in patients with impaired left ventricular function.

PMID- 8353871
TI  - Functional significance of intimal thickening as detected by intravascular
      ultrasound early and late after cardiac transplantation.
AB  - BACKGROUND: Detection of transplant coronary disease remains difficult. Both
      intravascular ultrasound (IVUS) imaging and functional coronary vasomotion
      studies have been used to evaluate this process. However, the time course of
      intimal thickening as assessed by IVUS and the relation between structure and
      function have not been explored. METHODS AND RESULTS: In 40 patients 1 to 8 years
      after transplantation, 108 coronary artery segments were analyzed by IVUS.
      Intimal index [% intimal area (lumen+intimal area)] and maximal thickness were
      used to quantify intimal thickening. Abnormal IVUS was present in 53 of 108
      segments (49%) (mean intimal index of diseased segments, 23 +/- 2%; maximal
      thickness, 530 +/- 47 microns). For those patients with intimal thickening in all
      segments of the analyzed artery, more time had elapsed since transplantation (4.3
      +/- 0.6 years) than for those whose arteries contained some normal (2.6 +/- 0.3
      years) or all normal segments (2.2 +/- 0.6 years, P < .05). Both the proportion
      of segments with intimal thickening and the degree of thickening increased as a
      function of time after transplantation (P < .5). By multivariate analysis, the
      independent predictors of intimal thickening were increasing time after
      transplantation and pretransplantation hypercholesterolemia (P = .02). Within the
      cohort of 40 patients, endothelium-dependent vasomotor function was evaluated in
      26 matched segments from 11 patients studied 1 year after transplantation and in
      15 matched segments from 8 patients studied > or = 5 years after transplantation
      by serial infusions of acetylcholine (10(-8) to 10(-6) mol/L). Of the 26 segments
      assessed for structure/function correlation at 1 year after transplantation, 22
      had no intimal thickening by IVUS. However, endothelial dysfunction was present
      in 13 of these normal segments (mean diameter constriction, 18.8 +/- 2.3%). Of
      the 15 segments studied > or = 5 years after transplantation, 11 had intimal
      thickening. Nine of these 11 segments had preserved endothelial function (mean
      diameter dilation, 8.6 +/- 2.9%). There was no relation between the degree of
      intimal thickening and the magnitude of the endothelium-dependent response to
      acetylcholine. CONCLUSIONS: This study has shown that intimal thickening after
      transplantation begins as a heterogeneous process and increases in extent and
      magnitude over time. Also, endothelial dysfunction occurs early before the
      intimal thickening; yet in those patients surviving > or = 5 years, endothelial
      function may recover even in the presence of moderate intimal pathology. The
      variable relation between intimal pathology and endothelial function is probably
      a result of the episodic nature of immune injury.

PMID- 8353872
TI  - Functional and neurochemical evidence for partial cardiac sympathetic
      reinnervation after cardiac transplantation in humans.
AB  - BACKGROUND: The presence of cardiac reinnervation in humans after cardiac
      transplantation has been widely debated, based on the application of differing
      methods for the assessment of neuronal function. Some of these techniques have
      been rather indirect; consequently, the time course and extent of cardiac
      reinnervation remains uncertain. METHODS AND RESULTS: To test for the presence of
      cardiac reinnervation after transplantation, we examined neurochemical
      (radiolabeled norepinephrine [NE] kinetics) and functional markers (power
      spectral analysis, heart rate response to exercise) of cardiac sympathetic nerve
      integrity in 15 cardiac transplantation recipients and 25 healthy control
      subjects of similar age. Cardiac transplantation subjects were studied 9 weeks to
      8 years after cardiac transplantation (10 "early" patients < 18 months and 5
      "late" patients > 2 years after cardiac transplantation). At rest, cardiac NE
      spillover was markedly attenuated early after transplantation (11.2 +/- 18.3
      pmol/min) compared with subjects late after transplantation (105 +/- 11 pmol/min,
      P < .01) or in healthy control subjects (103 +/- 15 pmol/min, P < .01). Heart
      rate variability (measured by total spectral power) was significantly reduced in
      cardiac transplantation recipients compared with control subjects (59.4 +/- 30 vs
      1673 +/- 516 milliseconds squared; P < .05), with evidence of a trend toward
      increasing spectral power late after transplantation. During exercise, the
      cardiac NE spillover was significantly lower in early cardiac transplantation
      recipients when compared with control subjects (163 +/- 50 vs 1876 +/- 418
      pmol/min, P < .01). Late cardiac transplantation subjects showed a response
      intermediate (1080 +/- 254 pmol/min) between that of the early cardiac
      transplantation and control groups. However, measurements of the neuronal
      reuptake process for NE (assessed by the fractional extraction of plasma labeled
      NE across the heart and tritiated dihydroxyphenylglycol release) were
      significantly depressed in both early and late cardiac transplantation subjects.
      CONCLUSIONS: The present study demonstrates a partial restoration of cardiac
      sympathetic nerve function in humans up to 8 years after heart transplantation.

PMID- 8353873
TI  - Transcatheter occlusion of patent ductus arteriosus with adjustable buttoned
      device. Initial clinical experience.
AB  - BACKGROUND: Several devices are available for transcatheter occlusion of patent
      ductus arteriosus. Most of these devices either require complicated intracardiac
      maneuvering, have not been tried in humans, or need a large-sized sheath for
      implantation of the device. METHODS AND RESULTS: During a 26-month period ending
      November 1992, 14 patients underwent transcatheter closure of patent ductus
      arteriosus with an adjustable buttoned device delivered via a 7F sheath under an
      institutional review board-approved custom-made device protocol. The children
      were 15 months to 8 years of age with weight range of 7.2 to 19 kg. The patent
      ductus arteriosus measured from 2 to 7.5 mm (median, 3 mm) at the narrowest
      diameter and was conical, short, or tubular. They were occluded with devices
      measuring 15 to 20 mm. The ratio of pulmonary to systemic flow decreased (P <
      .01) from 1.9 +/- 0.6 (mean +/- SD; range, 1.3 to 3.2) to 1.05 +/- 0.1 (1 to
      1.3). Continuous murmur of patent ductus arteriosus disappeared in all except 1
      patient. Small residual shunts were detected by color Doppler studies in 4 of 14
      patients (29%). All patients were followed for 1 to 24 months (mean, 6 +/- 7
      months). The device was intact in all patients, and no breakage of the wires was
      noted. No shunts were seen in 12 of 14 patients (86%), and minute residual shunts
      were seen in 2 children. No major complications were encountered. CONCLUSIONS: It
      is concluded that transcatheter closure of patent ductus arteriosus with the
      adjustable buttoned device is feasible and effective and can be accomplished via
      small 7F sheaths; a 7F sheath is adequate for all ductal sizes; and the
      adjustable length of the loop accommodated all types of patent ductus arteriosus.
      Clinical trials on a larger number of patients are warranted.

PMID- 8353874
TI  - Left ventricular diastolic Doppler characteristics in beta-thalassemia major.
AB  - BACKGROUND: Diastolic left ventricular function expressed by diastolic Doppler
      characteristics of the left ventricle has never been properly investigated.
      METHODS AND RESULTS: Left ventricular inflow and pulmonary vein flow patterns
      were assessed by Doppler echocardiography in 88 beta-thalassemia major patients
      with normal left ventricular systolic function; 34 were young (age, 15.1 +/- 3.2
      years) and 54 were adults (age, 25.1 +/- 3.6 years). The findings were compared
      with those obtained from 22 young (age, 13.8 +/- 2.4 years) and 24 adult (age,
      25.3 +/- 4.1 years) normal individuals. In both groups of patients, peak flow
      velocities in early (E) and late (A) diastole were higher than in the control
      subjects (young E: P < .01; adult E: P < .001; young A: P < .05; adult A: P <
      .05), whereas no difference was found in the E/A ratio, deceleration time, or
      isovolumic relaxation time. Pulmonary vein systolic (S) and diastolic (D)
      velocities were also higher in beta-thalassemia major patients compared with the
      control subjects (young S: P < .05; adult S: P < .05; young D: P < .05; adult D:
      P < .05). Restrictive left ventricular abnormalities were only found in 7
      patients who were among the oldest beta-thalassemia major population of the adult
      group (P < .01) with highly elevated mean serum ferritin. In comparison to the
      remaining adult patients, interventricular septum and left ventricular posterior
      wall thickness were increased (P < .01 and P < .01, respectively). The left
      atrium and right ventricle were dilated (P < .05 and P < .01, respectively).
      CONCLUSIONS: Doppler diastolic indexes in beta-thalassemia major patients with
      normal left ventricular systolic function are similar to those seen in conditions
      with an increased preload, probably because of chronic anemia. Only severe iron
      loading and deposition in the myocardium leads to the restrictive abnormalities
      of left ventricular filling.

PMID- 8353875
TI  - Diagnosis of intramural coronary artery in transposition of the great arteries
      using two-dimensional echocardiography.
AB  - BACKGROUND: An intramural coronary is an uncommon but potentially significant
      risk factor for transfer of the coronary arteries as part of the arterial switch
      operation for transposition of the great arteries. Preoperative diagnosis is
      advantageous because it helps prevent accidental injury to the intramural
      coronary artery during transection of the aortic root and excision of the
      coronary artery ostium from the aorta. Therefore, we investigated the reliability
      of two-dimensional echocardiography for detecting an intramural coronary artery
      in infants with d-transposition of the great arteries. METHODS AND RESULTS: All
      infants with d-transposition of the great arteries who underwent echocardiography
      and primary surgical repair at this institution between January 1987 and June
      1992 were identified by search of the cardiology data base. From this group, all
      patients diagnosed with an intramural coronary artery were identified by review
      of the echocardiographic, surgical, and autopsy reports. Among 435 infants with
      transposition, 29 infants were diagnosed as having an intramural coronary artery.
      In 27 cases, the diagnosis was confirmed at surgery or autopsy, and there were
      two false-positive echocardiographic diagnoses (specificity, 99.5%). Twenty of
      the 27 patients with an intramural coronary artery were correctly diagnosed
      prospectively by echocardiography (sensitivity, 75%), including 17 of 23 patients
      with an intramural left coronary artery or left anterior descending coronary
      artery and 3 of 4 patients with an intramural right coronary artery. Two primary
      diagnostic criteria were identified: a major coronary artery arising from the
      contralateral septal sinus, near the usually intercoronary commissure, and a
      course for this vessel within the posterior aortic wall between the great
      arteries, creating a "double-border" appearance. Retrospective review using these
      criteria identified 26 of the 27 intramural arteries with no false-positive
      diagnoses. CONCLUSIONS: We conclude that coronary echocardiography is a very
      promising technique for detecting an intramural coronary artery in transposition
      of the great arteries. Careful prospective application of the identified
      diagnostic criteria should greatly improve the diagnostic accuracy.

PMID- 8353876
TI  - On-line assessment of left atrial area and function by echocardiographic
      automatic boundary detection.
AB  - BACKGROUND: Direct assessment of left atrial (LA) function has not been
      previously performed by noninvasive techniques; rather, LA function has been
      evaluated only indirectly via the analysis of transmitral flow velocity by
      Doppler. The recent development of real-time two-dimensional echocardiographic
      automatic boundary detection suggests that LA dimensions can be measured
      instantaneously to provide on-line assessment of its systolic and diastolic
      functions. METHODS AND RESULTS: We performed echocardiographic assessment of LA
      dimensions and function with automatic boundary detection in 45 patients by using
      the apical four-chamber view. Thirty-seven patients had structural or functional
      cardiac abnormalities, 35 patients were in sinus rhythm, and 10 patients had
      atrial fibrillation. Moderate to severe mitral regurgitation (MR) was noted in 16
      patients. We also studied 10 control subjects to assess normal values of LA
      cavity area and indexes of function. From the instantaneously derived LA area, we
      derived indexes of systolic atrial expansion and diastolic atrial emptying. There
      were excellent correlations between the on-line-derived LA areas and those
      measured off line from videotaped images of conventional echocardiography (r =
      .91 for end-diastolic and .93 for end-systolic areas; SEE, 4.0 and 3.8 cm2,
      respectively). Patients in atrial fibrillation had depressed diastolic emptying
      index (0.17 +/- 0.05) compared with those in sinus rhythm (0.28 +/- 0.12; P <
      .02). Furthermore, patients with chronic MR exhibited larger LA cavity areas and
      depressed systolic and diastolic LA function as compared with those without MR.
      In addition, the Doppler-determined mitral E/A ratio was related to the ratio of
      early diastolic-to-late diastolic change in LA cavity area (r = .79; SEE 0.6; n =
      35). CONCLUSIONS: Instantaneous LA cavity area measurement by echocardiographic
      automatic boundary detection is accurate and feasible in patients with diverse
      cardiac disorders. Patients with atrial fibrillation had a depressed diastolic
      emptying index and those with significant mitral regurgitation had depressed
      systolic expansion index as well. LA functional indexes in both systole and
      diastole can be derived providing an approach for quantitative evaluations of
      left atrial-left ventricular interactions based on geometric assessment
      noninvasively.

PMID- 8353877
TI  - Application of color Doppler flow mapping to calculate effective regurgitant
      orifice area. An in vitro study and initial clinical observations.
AB  - BACKGROUND: Analogous to stenotic valve area in the assessment of valvular
      stenosis, regurgitant orifice area (ROA) represents a fundamental parameter to
      assess valvular insufficiency. However, this parameter has not been routinely
      available up to now. In this study, we introduce the concept and provide the
      methodology to calculate regurgitant orifice area noninvasively, based on the
      analysis of the proximal flow convergence zone. METHODS AND RESULTS: In an in
      vitro study, we showed the feasibility and the accuracy of calculating effective
      ROA by the proximal flow convergence method throughout a range of driving
      pressures. The calculated and true ROA showed an excellent correlation with r =
      .992, delta ROA = -1.4 +/- 2.9 mm2. We then applied this concept clinically in 77
      patients with mitral regurgitation and showed a very good correlation between
      effective ROA calculated by the proximal flow convergence method and calculated
      by the Doppler echocardiographic method: r = .95, delta ROA = -0.2 +/- 3.9 mm2.
      The ROA also correlated very well with Doppler echocardiographic-derived
      regurgitant stroke volume (r = .93) and regurgitant fraction (r = .82). In a
      subgroup of 20 patients who underwent invasive evaluation, the calculated
      effective ROA also correlated well with the angiographic grade of mitral
      regurgitation (rho = .81). CONCLUSIONS: We conclude that effective ROA represents
      unique information on the severity of a regurgitant lesion and can easily be
      calculated by the proximal flow convergence method. This new parameter should
      enhance our understanding and improve the serial assessment of valvular
      regurgitation.

PMID- 8353878
TI  - Validation of the proximal flow convergence method. Calculation of orifice area
      in patients with mitral stenosis.
AB  - BACKGROUND: It has been proposed recently that measuring the flow convergence
      region proximal to an orifice by Doppler flow mapping can provide a means of
      calculating regurgitant flow rate. Although verified in experimental models, this
      approach is difficult to validate clinically because there is no ideal gold
      standard for regurgitant flows in patients. However, this method also can be used
      to derive cardiac output or flow rate proximal to stenotic orifices and therefore
      to calculate their areas by the continuity equation (area = flow rate/velocity).
      Applying this method in mitral stenosis would provide a unique way of validating
      the underlying concept because the predicted areas could be compared with those
      measured directly by planimetry. METHODS AND RESULTS: We studied 40 patients with
      mitral stenosis using imaging and Doppler echocardiography. Doppler color flow
      recordings of mitral inflow were obtained from the apex, and the radius of the
      proximal flow convergence region was measured at its peak diastolic value from
      the orifice to the first color alias along the axis of flow. Flow rate was
      calculated assuming uniform radial flow convergence toward the orifice, modified
      by a factor that accounted for the inflow funnel angle formed by the mitral
      leaflets. Mitral valve area was then calculated as peak flow rate divided by peak
      velocity by continuous-wave Doppler. The calculated areas agreed well with those
      from three comparative techniques over a range of 0.5 to 2.2 cm2: 1) cross
      sectional area by planimetry (y = 1.08x-0.13, r = .91, SEE = 0.21 cm2); 2) area
      derived from the Doppler pressure half-time (y = 1.02x-0.14, r = .89, SEE = 0.24
      cm2); and 3) area calculated by the Gorlin equation in the 26 patients who
      underwent catheterization (y = 0.89x + 0.08, r = .86, SEE = 0.24 cm2). Agreement
      with planimetry was similar for 22 patients with mitral regurgitation and 18
      without it (P > .6), as well as for 6 in atrial fibrillation (P > .2).
      CONCLUSIONS: These results validate the proximal flow convergence concept in the
      clinical setting and also demonstrate that it can be extended to orifice area
      calculation using the continuity equation.

PMID- 8353879
TI  - Endothelin antiserum decreases volume-stimulated and basal plasma concentration
      of atrial natriuretic peptide.
AB  - BACKGROUND: Endothelin-1 (ET-1) is the most powerful factor known to release
      atrial natriuretic peptide (ANP) in vivo and in cultured cardiac myocytes or
      preparations of atrium. We tested the role of endogenous ET-1 in the regulation
      of ANP release by passive immunization in anesthetized rats. METHODS AND RESULTS:
      Intravenous injection of antiserum against ET-1 was shown to decrease basal and
      volume-stimulated plasma concentrations of ANP, whereas control serum was without
      effect. Antiserum generated in rabbits cross-reacted 100% with endothelin-2 and 
      3. In pentobarbital-anesthetized Wistar rats treated with ET-1 antiserum, plasma
      ANP concentration measured by radioimmunoassay was reduced by 37% from starting
      level after 10 minutes and by 30% after 60 minutes. Control rat serum had no
      effect on plasma ANP. Rapid intravenous infusion of 8 mL of 0.9% NaCl caused a
      sixfold increase of plasma ANP concentration in control rats but only twofold in
      rats pretreated with ET-1 antiserum (P < .01). This effect of ET-1 antiserum was
      dose dependent. ET-1 antiserum changed neither blood pressure nor heart rate
      significantly in anesthetized rats. Pretreatment with ET-1 antiserum did not
      affect the initial hypotensive response to intravenous ET-1 0.5 nmol/kg but
      significantly attenuated the subsequent hypertensive response to endothelin.
      CONCLUSIONS: Endothelin may be a physiological modulator of both basal and
      stimulated ANP release.

PMID- 8353880
TI  - Downregulation of c-myc expression by antisense oligonucleotides inhibits
      proliferation of human smooth muscle cells.
AB  - BACKGROUND: Proliferation of smooth muscle cells (SMCs) plays an important role
      in vascular pathobiology, being involved in the development of coronary
      restenosis and atherosclerosis. The activation of nuclear proto-oncogenes appears
      to be a final common pathway onto which various mitogenic signals coverage.
      Accordingly, we attempted to determine whether the activation of the c-myc
      nuclear proto-oncogene is essential for human SMC proliferation and explored the
      possibility of inhibiting their growth using antisense oligonucleotides directed
      against c-myc messenger RNA (mRNA). METHODS AND RESULTS: Proliferation of human
      SMCs was associated with an increase in c-myc mRNA expression after growth
      stimulation. Using 15-mer phosphorothioate oligonucleotides (oligomers), we
      tested their growth-inhibitory effect in SMCs in vitro. Antisense oligomers
      directed against the translation initiation region of the human c-myc gene
      exhibited a significant antiproliferative effect, whereas sense and mismatched
      oligomers did not inhibit the growth. The growth-inhibitory effect of c-myc
      antisense oligomers was dose dependent and preventable by an excess of sense
      oligomers. Furthermore, growth inhibition of SMCs treated with c-myc antisense
      oligomers was associated with a marked decrease in the c-myc mRNA level.
      Phosphorothioate oligomers remained stable in medium containing 20% serum and
      were detectable in SMCs as early as 1 hour after cell exposure. Intact oligomers
      rapidly accumulated intracellularly and persisted within human SMCs for at least
      16 hours. CONCLUSIONS: c-myc antisense oligomers reduced c-myc expression and
      produced a significant growth inhibition of human SMCs, indicating an important
      role of c-myc gene activation in the process of SMC proliferation. Furthermore,
      extracellular stability and rapid cellular uptake provide the basis for future
      studies assessing the therapeutic role of the c-myc antisense approach in
      reducing SMC proliferation in the process of vascular restenosis.

PMID- 8353881
TI  - Both increased and decreased platelet adhesion to thermally injured
      subendothelium is caused by denaturation of von Willebrand factor.
AB  - BACKGROUND: Thermal angioplasty methods heat the arterial wall. We related
      platelet adhesion to the temperature to which subendothelium and purified
      adhesive proteins had been exposed. METHODS AND RESULTS: Cultured subendothelium,
      purified von Willebrand factor, collagen types I and III, or fibronectin was
      applied to glass coverslips. Coverslips were mounted on a heating device that
      applied a temperature gradient from 30 to 100 degrees C. De-endothelialized
      umbilical arteries were heated by immersion in phosphate-buffered saline. After
      cooling to room temperature, the surfaces were perfused with blood at 37 degrees
      C (shear rate, 1600 sec-1). Compared with 37 degrees C, platelet adhesion to
      endothelial cell matrix was significantly reduced by 25%, 50% or 75% after
      heating to 69 +/- 1 degree C (mean +/- SEM, P < .05), 72 +/- 1 degree C, or 75 +/
      1 degree C, respectively. Platelet coverage to umbilical artery subendothelium
      was in the same way significantly reduced after heating to 71 +/- 1 degree C, or
      77 +/- 1 degree C, respectively. In contrast to endothelial cell matrix, however,
      heating to about 55 degrees C increased platelet coverage from 30 +/- 5% to 54 +/
      6% (P < .05). Both platelet adhesion to von Willebrand factor and monoclonal
      antibody binding against the GpIb binding site of von Willebrand factor showed a
      comparable temperature dependence as platelet adhesion to subendothelium,
      provided the proper von Willebrand factor concentration was used. Platelet
      adhesion to heated collagen types I and III was increased and maximal at 57 +/- 2
      degrees C and 62 +/- 2 degrees C, respectively. Preincubation of collagen III
      with proteins resulted in decreased platelet adhesion with increasing
      temperatures. Heating did not affect the reactivity of fibronectin. CONCLUSIONS:
      In vitro platelet adhesion to human subendothelium is reduced by more than 50%
      after heating it briefly to more than 74 degrees C. Temperatures in excess of 80
      degrees C reduce platelet adhesion by at least 85%. Thermal denaturation of von
      Willebrand factor is responsible not only for the decreased thrombogenicity above
      71 degrees C but also for the increased thrombogenicity near 55 degrees C,
      provided that the von Willebrand factor concentration is low.

PMID- 8353882
TI  - Short-term and long-term role of platelet activating factor as a mediator of in
      vivo platelet aggregation.
AB  - BACKGROUND: Platelet activating factor (PAF) is a phospholipid released upon
      stimulation by a variety of cells and has been implicated in several
      pathophysiological events such as asthma and inflammatory diseases. However,
      although the ability to aggregate platelets in vitro was the first biological
      activity ascribed to PAF, its role in contributing to the in vivo formation of
      arterial thrombi has not been thoroughly clarified. METHODS AND RESULTS:
      Intravascular platelet aggregation was initiated in two different animal models
      of arterial stenosis and endothelial injury. An external constrictor was
      positioned around rabbit carotid arteries and canine coronary arteries. After
      placement of the constrictor, a typical pattern of flow developed in the stenotic
      vessels. This pattern of flow, characterized by progressive reductions of carotid
      or coronary blood flow followed by spontaneous or induced restorations of flow
      (cyclic flow variations, CFVs), is related to recurrent platelet aggregation at
      the site of the stenosis followed by dislodgment of the thrombus. After observing
      CFVs for 30 minutes, BN52021 (up to 1.2 mg/kg), a potent and selective PAF
      antagonist, was given intravenously to rabbits (n = 12) and dogs (n = 10).
      BN52021 completely inhibited CFVs in 10 of 12 rabbits, whereas it was relatively
      ineffective in abolishing CFVs in dogs (only 2 of 10 animals inhibited). This
      different effect of BN52021 was not explained by too small a dose of the drug to
      achieve a complete blockade of PAF receptors in dogs, since ex vivo platelet
      aggregation was completely inhibited in both rabbits and dogs in response to
      exogenous PAF at concentrations up to 10(-5) mol/L. In a second group of 10 dogs,
      the hypothesis that PAF may become an important mediator of CFVs in dogs only
      several hours after endothelial injury was tested. After 30 minutes of baseline
      CFVs, these animals received a bolus of BN52021 up to 1.2 mg/kg. After this
      treatment, CFVs were completely abolished in 2 of 10 animals. The remaining 8
      dogs were followed for an additional 8-hour period, at the end of which a second
      bolus of BN52021 was given. At this time, BN52021 was effective, as CFVs were
      abolished in 6 of 8 animals. These effects of BN52021 at 8 hours were not the
      consequence of a cumulative dose of the compound, since ex vivo platelet
      aggregation in response to PAF returned to baseline values immediately before
      administering the second dose. To identify possible sources of PAF other than
      aggregating platelets at the site of arterial stenosis, dogs in a third group
      were killed after 30 minutes (n = 7) and after 8 hours (n = 8) of CFVs.
      Histological sections of the stenotic coronary artery showed a marked leukocyte
      infiltration in these arterial segments after 8 hours of CFVs, whereas sections
      from dogs killed after 30 minutes showed only moderate or no infiltration.
      CONCLUSIONS: These data demonstrate that PAF plays an important role as a
      mediator of platelet aggregation in vivo in rabbits and dogs. In the canine
      model, PAF appears to become more important after leukocyte infiltration of the
      arterial wall, as it may contribute to initiating enough platelet activation to
      lead to cyclic flow variations at sites of arterial stenosis and endothelial
      injury. Data from the present study suggest that PAF antagonists may be used as
      antiplatelet agents.

PMID- 8353883
TI  - Inhibition of experimental neointimal hyperplasia and thrombosis depends on the
      type of vascular injury and the site of drug administration.
AB  - BACKGROUND: Heparin inhibits vascular smooth muscle cell proliferation in tissue
      culture and limits neointimal hyperplasia after experimental arterial injury but
      has been ineffective in reducing clinical restenosis. We examined how this
      discrepancy might reflect suboptimal drug-tissue interactions and/or differences
      in the vascular response to injury. METHODS AND RESULTS: Intravenous infusion was
      compared with local administration of heparin to injured rabbit iliac arteries
      either from drug-impregnated polymeric controlled release matrices in the
      perivascular space or from drug-releasing endovascular stents. Occlusive
      thrombosis, seen in 42% of control stent-bearing arteries, and partial thrombosis
      were virtually eliminated by heparin delivery from any route. Intimal area 14
      days after balloon withdrawal denudation alone was reduced to an equal extent by
      continuous systemic heparin or by perivascular heparin for the first 3 days. In
      contrast, endovascular stents produced more exuberant neointimal hyperplasia, the
      inhibition of which required continuous rather than only early heparin
      administration. Neither perivascular delivery limited to the first 3 days nor
      stent-based delivery reduced neointimal hyperplasia as effectively. CONCLUSIONS:
      The antiproliferative and antithrombotic effects of heparin differ markedly,
      depending on the type of arterial injury and the mode of drug administration.
      Different forms of injury may require different therapies, and complications of
      arterial intervention such as excessive neointimal hyperplasia and thrombosis may
      demand alternate therapeutic regimens. Duration, dose, and site of delivery
      rather than frank resistance to therapy may explain why experimentally effective
      antiproliferative and antithrombotic agents fail clinically.

PMID- 8353884
TI  - Influence of the status of the renin-angiotensin system on the effect of
      cilazapril on neointima formation after vascular injury in rats.
AB  - BACKGROUND: Angiotensin converting enzyme (ACE) inhibition has been shown to
      prevent neointima formation after vascular injury in rats. However, clinical
      results evaluating restenosis after angioplasty have been negative. The goal of
      the present study was to evaluate the influence of the renin-angiotensin system
      (RAS) status on the effect of ACE inhibition on neointima formation. METHODS AND
      RESULTS: Arterial injury was produced by ballooning the left carotid artery of
      rats, and neointima formation was evaluated by morphometry 2 weeks after
      ballooning. The effects of cilazapril were assessed in four experimental groups:
      normotensive rats, spontaneously hypertensive rats, hypertensive rats with a
      renal artery stenosis induced by clipping (two-kidney, one-clip rats), and
      hypertensive rats with uninephrectomy, high salt intake, and administration of
      deoxycorticosterone (DOCA). In parallel groups of rats, measurement of plasma
      renin activity was made in order to characterize (at least at the plasma level)
      the status of the RAS. As expected, renal artery stenosis markedly increased
      plasma renin activity, and DOCA decreased it to undetectable levels. Cilazapril
      had a marked preventive effect on neointima formation in normotensive rats,
      spontaneously hypertensive rats, and two-kidney, one-clip rats but was
      ineffective in DOCA rats. CONCLUSIONS: We conclude that the status of the RAS has
      a major influence on the effect of cilazapril on neointima formation after
      vascular injury.

PMID- 8353885
TI  - Tone-dependent coronary arterial-venous pressure differences at the cessation of
      venous outflow during long diastoles.
AB  - BACKGROUND: The origin and magnitude of the back pressure opposing diastolic
      coronary inflow remain controversial. The arterial pressure at which coronary
      inflow stops during a prolonged diastole, ie, "zero-flow pressure," is higher
      than coronary venous pressure. However, because of capacitive discharge as
      distending pressure falls, flow at the microcirculatory level exceeds inflow, and
      coronary outflow ceases later than inflow. If coronary arterial pressure
      continues to exceed venous pressure at the point of venous flow cessation, zero
      flow pressure cannot be an artifact of capacitive discharge. METHODS AND RESULTS:
      Coronary inflow and outflow, arterial pressure, and right atrial pressure have
      been measured during long diastoles in closed-chest dogs chronically instrumented
      with volumetric flow probes on the great cardiac vein or coronary sinus as well
      as the circumflex artery. Although venous outflow continued for 1 to 4 seconds
      after arterial inflow ceased, coronary artery pressure at the point of venous
      flow cessation (Pfv = 0) always exceeded right atrial pressure (13 +/- 1.3 mm Hg
      [SEM] vs 6 +/- 0.7 mm Hg, P < .001). When vasomotor tone was augmented using
      vasopressin, the diastolic pressure-flow relation shifted to the right, with Pfv
      = 0 increasing to 21 +/- 2.4 mm Hg despite an unchanged right atrial pressure (6
      +/- 0.5 mm Hg). CONCLUSIONS: Transcoronary pressure differences persist when
      venous outflow stops and are larger when vasomotor tone is augmented.
      Measurements of zero-flow pressure that exceed venous pressure cannot be
      considered an artifact of continuing capacitive discharge after the cessation of
      arterial inflow. Diastolic coronary back pressure exceeds right atrial pressure
      and is tone dependent.

PMID- 8353886
TI  - Role of K+ATP channels in coronary vasodilation during exercise.
AB  - BACKGROUND: The mechanism of metabolic regulation of coronary vascular tone is
      still unclear. Therefore, we examined the role of vascular smooth muscle K+ATP
      channels in regulating coronary blood flow under resting conditions, during
      increments in myocardial metabolic demand produced by treadmill exercise, and in
      response to a brief ischemic stimulus. METHODS AND RESULTS: Ten chronically
      instrumented dogs were studied at rest and during a four-stage exercise protocol
      under control conditions and during intracoronary infusion of the K+ATP channel
      blocker glibenclamide at rates of 10 and 50 micrograms.kg-1 x min-1.
      Glibenclamide (50 micrograms.kg-1 x min-1) decreased coronary blood flow at rest
      from 51 +/- 4 to 42 +/- 6 mL/min (P < .05), decreased myocardial oxygen
      consumption from 5.70 +/- 0.31 to 4.11 +/- 0.56 mL O2/min (P < .05), and
      decreased systolic wall thickening from 21 +/- 3% to 12 +/- 3% (P < .05). The
      depression of systolic wall thickening produced by glibenclamide was reversed
      when coronary blood flow was restored to the control level with intracoronary
      nitroprusside, indicating a primary effect of glibenclamide on coronary flow
      during resting conditions. However, glibenclamide did not impair the increases of
      coronary blood flow, myocardial oxygen consumption, and systolic wall thickening
      that occurred during exercise. In eight resting awake dogs, 50 micrograms.kg-1 x
      min-1 glibenclamide decreased the peak reactive hyperemia blood flow rate
      following a 20-second coronary occlusion from 149 +/- 14 mL/min during control
      conditions to 111 +/- 15 mL/min (P < .05), decreased the duration of reactive
      hyperemia from 49 +/- 6 to 33 +/- 3 seconds (P < .05), and decreased reactive
      hyperemia excess flow from 33 +/- 5 to 20 +/- 4 mL (P < .05). CONCLUSIONS: These
      data demonstrate that K+ATP channels modulate coronary vasomotor tone under
      resting conditions and contribute to coronary vasodilation during ischemia.
      However, the coronary vasculature retains the capacity to dilate in response to
      increases in oxygen demand produced by exercise when K+ATP channels are blocked.

PMID- 8353887
TI  - Effects of active compression-decompression resuscitation on myocardial and
      cerebral blood flow in pigs.
AB  - BACKGROUND: This study was designed to assess the effects of a modified
      cardiopulmonary resuscitation (CPR) technique that consists of both active
      compression and active decompression of the chest (ACD CPR) versus standard CPR
      (STD CPR) on myocardial and cerebral blood flow during ventricular fibrillation
      both before and after epinephrine administration. METHODS AND RESULTS: During a
      30-second period of ventricular fibrillation cardiac arrest, 14 pigs were
      randomized to receive either STD CPR (n = 7) or ACD CPR (n = 7). Both STD and ACD
      CPR were performed using an automated pneumatic piston device applied midsternum,
      designed to provide either active chest compression (1.5 to 2.0 in.) and
      decompression or only active compression of the chest at 80 compressions per
      minute and 50% duty cycle. Using radiolabeled microspheres, median total
      myocardial blood flow after 5 minutes of ventricular fibrillation was 14 (7 to
      30, minimum to maximum) STD CPR versus 30 (9 to 46) mL.min-1 x 100 g-1 with ACD
      CPR (P < .05). Median cerebral blood flow was 15 (10 to 26) mL.min-1 x 100 g-1
      with STD CPR and 30 (21 to 39) with ACD CPR (P < .01). When comparing STD with
      ACD CPR, aortic systolic (62 mm Hg [48 to 70] vs 80 [59 to 86]) and diastolic (22
      [18 to 28] vs 28 [21 to 36]) pressures, calculated coronary systolic (30 [22 to
      36] vs 49 [37 to 56]) and diastolic (18 [16 to 23] vs 26 [21 to 31]) perfusion
      pressures, end-tidal CO2 (1.4% [0.8 to 1.8] vs 2.1 (1.8 to 2.4]), cerebral O2
      delivery (3.1 mL.min-1 x 100 g-1 [1.5 to 4.5] vs 5.3 [3.8 to 7.5]), and cerebral
      perfusion pressure (14 mm Hg [4 to 22] vs 26 [6 to 34]) were all significantly
      higher with ACD CPR: To compare these parameters before and after vasopressor
      therapy, a bolus of high-dose epinephrine (0.2 mg/kg) was given to all animals
      after 5 minutes of ventricular fibrillation. Organ blood flow and calculated
      perfusion pressures increased significantly in both the STD and ACD groups after
      epinephrine. The differences observed between STD and ACD CPR before epinephrine
      were diminished 90 seconds after epinephrine but were again statistically
      significant when assessed 5 minutes later, once the acute effects of epinephrine
      had decreased. No difference in short-term resuscitation success was found
      between the two groups. CONCLUSIONS: We conclude that ACD CPR significantly
      increases myocardial and cerebral blood flow during cardiac arrest in the absence
      of vasopressor therapy compared with STD CPR:

PMID- 8353888
TI  - Cardiac stress protein elevation 24 hours after brief ischemia or heat stress is
      associated with resistance to myocardial infarction.
AB  - BACKGROUND: To test the hypothesis that the heat shock response is associated
      with myocardial salvage, the heat stress protein (HSP) content of cardiac tissue
      was increased by either ischemic or thermal stress. METHODS AND RESULTS: Rabbits
      were divided into four groups. Ischemic pretreatment (n = 15) comprised four 5
      minute episodes of coronary ligation separated by 10 minutes of reperfusion. The
      corresponding control group (n = 21) underwent surgical preparation without
      coronary ligation. Thermal pretreatment (n = 16) involved whole-body temperature
      elevation to 42 degrees C for 15 minutes; corresponding controls (n = 15) were
      treated with anesthetic alone. Twenty-four hours later, hearts were removed for
      HSP estimation or infarct size assessment after a 30-minute coronary ligation.
      Myocardial HSP72 content assessed by Western blotting was elevated by both
      ischemic and thermal pretreatments (2.5 +/- 0.2 units, n = 4, and 2.8 +/- 0.3
      units, n = 4, mean +/- SEM; P = NS, respectively) compared with the corresponding
      control groups (1.0 +/- 0.3, n = 4, P < or = .01 and 0.3 +/- 0.1, n = 4, P < or =
      .01, respectively). HSP60 was preferentially elevated by ischemic pretreatment.
      After a 30-minute coronary occlusion and 120 minutes of reperfusion, ischemic and
      thermal pretreatments limited infarct size as a percentage of the volume at risk
      by 28.8 +/- 5.2% vs 52.0 +/- 5.2%, P < or = .01 and 32.8 +/- 3.8% vs 56.9 +/-
      6.5%, P < or = .01, respectively. CONCLUSIONS: Myocardial stress protein induced
      by either sublethal thermal or ischemic injury is associated with myocardial
      salvage. Our findings suggest that stress protein elevation, rather than the
      nonspecific effects of thermal or ischemic stress, may be responsible for the
      myocardial protection seen in this model. Our observations may have important
      implications regarding myocardial adaptation to brief periods of ischemia.

PMID- 8353889
TI  - Streptozotocin-induced non-insulin-dependent diabetes protects the heart from
      infarction.
AB  - BACKGROUND: The vulnerability of the myocardium of a diabetic animal to an
      ischemic insult is controversial. To address this issue, streptozotocin-induced
      non-insulin-dependent diabetes (NIDD) was induced in rats, and the effects of
      regional myocardial ischemia were assessed by measuring infarct size. METHODS AND
      RESULTS: Open-chest rats with NIDD and age-matched control rats underwent 30 or
      45 minutes of regional ischemia and 2-hour reperfusion. Infarct size was measured
      by tetrazolium. Control rats had 32.0 +/- 3.3% infarction of the risk zone after
      a 30-minute coronary occlusion, whereas NIDD rats had significantly smaller
      infarcts (11.5 +/- 3.1% of the risk area, P < .005). When ischemic time was
      extended to 45 minutes, infarct size in control animals averaged 57.9 +/- 6.2%,
      whereas only 37.3 +/- 5.6% of ischemic myocardium was infarcted in NIDD rats (P <
      .05). In a subset NIDD group, rats experienced a period of ischemic
      preconditioning (three cycles of 5-minute ischemia/5-minute reperfusion) before
      45-minute ischemia. Infarct size in these rats averaged only 6.9 +/- 3.0% (P <
      .01 vs nonpreconditioned NIDD rats with 45-minute coronary occlusions).
      Collateral flow was measured in NIDD rat hearts with radioactive microspheres.
      Collateral flow was < 1% of normal myocardial blood flow. CONCLUSIONS: We
      conclude that NIDD protects the heart from infarction and that this protection is
      not related to the development of coronary collaterals. Furthermore,
      preconditioning can further protect the NIDD heart.

PMID- 8353890
TI  - Regional differences in function within noninfarcted myocardium during left
      ventricular remodeling.
AB  - BACKGROUND: The mechanisms of ventricular enlargement and dysfunction during
      postinfarct remodeling remain largely unknown. Although global left ventricular
      architectural changes after myocardial infarction are well documented,
      differences in function between adjacent and remote noninfarcted myocardium
      during left ventricular remodeling have not been investigated. These functional
      differences may relate to regional differences in wall stress during contraction
      and may contribute to chamber enlargement and global dysfunction after
      infarction. METHODS AND RESULTS: Anteroapical infarcts were produced in seven
      sheep by ligation of the mid left anterior descending coronary artery and second
      diagonal branch at thoracotomy. Magnetic resonance short-axis and long-axis
      images tagged by spatial modulation of magnetization were obtained before and 1
      week, 8 weeks, and 6 months after infarction. Left ventricular volumes, mass,
      ejection fraction, and lengths of infarcted and noninfarcted segments were
      measured. Circumferential and longitudinal shortening in the subendocardium and
      subepicardium, wall thickness, and histopathology were assessed in infarcted
      segments and regions adjacent to and remote from the infarct border. We found
      that a difference in circumferential and longitudinal segmental shortening
      between adjacent and remote noninfarcted myocardium present at 1 week persisted
      up to 6 months after myocardial infarction. However, partial improvement of
      function in adjacent regions occurred during infarct healing between 1 and 8
      weeks after infarction. Left ventricular volume increased up to 6 months after
      infarction, out of proportion to the concomitant eccentric hypertrophy, whereas
      the ejection fraction fell. Left ventricular dilatation late in the remodeling
      process was secondary to lengthening of noninfarcted segments, which were free of
      significant fibrosis. CONCLUSIONS: Left ventricular dilatation and eccentric
      hypertrophy during remodeling are associated with persistent differences in
      segmental function between adjacent and remote noninfarcted regions. These
      functional differences may reflect increased wall stress in adjacent noninfarcted
      regions and contribute to the global dilatation and dysfunction characteristic of
      left ventricular remodeling after infarction.

PMID- 8353891
TI  - Combination treatment with captopril and the thyroid hormone analogue 3,5
      diiodothyropropionic acid. A new approach to improving left ventricular
      performance in heart failure.
AB  - BACKGROUND: An agent that improves left ventricular (LV) performance by non-cAMP
      mediated mechanisms would be valuable in the treatment of chronic heart failure.
      We have shown earlier that the thyroid hormone analogue 3,5-diiodothyropropionic
      acid (DITPA) binds to nuclear receptors, alters transcription of T3-responsive
      genes, and increases +dP/dtmax in hypothyroid rats with substantially less effect
      on heart rate and metabolism than thyroid hormone, which makes it a selective
      cardiotonic agent. METHODS AND RESULTS: To determine whether DITPA might be
      useful in treating heart failure, we compared chronic treatment with normal
      saline, captopril (2 g/L), or the combination of DITPA (375 micrograms/100 g) and
      captopril (2 g/L) in Sprague-Dawley rats beginning 3 weeks after coronary artery
      ligation. Both DITPA/captopril and captopril treatment decreased LV end-diastolic
      pressure compared with controls (21 +/- 2 and 26 +/- 2 mm Hg, respectively, vs 34
      +/- 3 mm Hg, P < .05 for each). The addition of DITPA to captopril produced a 36%
      increase in resting cardiac index (P < .05) and shifted the cardiac function
      curve upward and to the left, indicative of enhanced myocardial performance.
      Also, DITPA/captopril compared with captopril treatment or control produced an
      increase in the rate of LV relaxation, as manifested by a decrease in tau, the
      time constant of LV pressure decline (17.5 +/- 1.0 vs 22.2 +/- 1.7 milliseconds,
      P < .05) and a larger absolute value for -dP/dtmax (-4561 +/- 361 vs -3346 +/-
      232 mm Hg/s, P < .05). These changes occurred without changes in heart rate, LV
      mass, LV systolic pressure, or peripheral resistance relative to captopril
      treatment (P > .05). CONCLUSIONS: The combination of DITPA and captopril improved
      cardiac output, increased -dP/dtmax, and increased the rate of LV relaxation to a
      greater extent than captopril treatment in the rat postinfarction model of heart
      failure. Use of a cardiotonic analogue of thyroid hormone represents a new
      approach to improving LV performance and may be a useful adjunct to afterload
      reduction for the treatment of heart failure.

PMID- 8353892
TI  - Defining coronary restenosis. Newer clinical and angiographic paradigms.

PMID- 8353893
TI  - Disordered eicosanoid formation in pregnancy-induced hypertension.

PMID- 8353894
TI  - Congestive heart failure in a 70-year-old man.

PMID- 8353895
TI  - Impact of implantable cardioverter-defibrillators on prognosis of cardiac arrest
      survivors. A continuing controversy.

PMID- 8353896
TI  - Do antisense approaches to the problem of restenosis make sense?

PMID- 8353897
TI  - Ischemic preconditioning and adenosine release.

PMID- 8353898
TI  - Progressive left ventricular dysfunction and remodeling after myocardial
      infarction.

PMID- 8353899
TI  - Is implantable defibrillator therapy the therapy of choice for all patients with
      malignant ventricular tachyarrhythmias?

PMID- 8353900
TI  - Coronary spasm and the development of coronary atherosclerosis.

PMID- 8353901
TI  - Coronary atherosclerosis on angiography--progress or regress, and why?

PMID- 8353903
TI  - Behavior change and compliance: keys to improving cardiovascular health. How
      health behavior relates to risk factors.

PMID- 8353902
TI  - Illusion of reperfusion. Does anyone achieve optimal reperfusion during acute
      myocardial infarction?
AB  - Thrombolytic therapy significantly improves the natural history of acute
      myocardial infarction, but recent data suggest that current reperfusion
      strategies have yet to realize the maximum potential for reduction of mortality
      and salvage of ventricular function. Coronary patency rates as high as 85%
      assessed by angiography 90 minutes after initiation of treatment greatly
      overestimate the efficacy of thrombolytic regimens, as this conventional
      angiographic "snapshot" view does not satisfactorily reflect the dynamic
      processes of coronary artery recanalization and reocclusion or the adequacy of
      myocardial perfusion. In fact, only the unusual patient appears to achieve
      optimal reperfusion for acute myocardial infarction, with a substantial
      deterioration of benefit in many patients due to insufficiently early or rapid
      recanalization, incomplete patency with TIMI grade 2 flow or critical residual
      coronary stenoses, absence of myocardial tissue reflow despite epicardial artery
      patency, intermittent coronary patency, subsequent reocclusion, or reperfusion
      injury. Recently developed techniques to critically assess the quality of
      reperfusion, coupled with the introduction of novel pharmacological agents and an
      improved understanding of the roles and mechanisms of existing thrombolytic and
      adjunctive drugs, have provided the opportunity to overcome many of the present
      limitations of reperfusion therapy. Emerging strategies to achieve optimal
      reperfusion are directed at enhancement of the velocity and quality of
      thrombolysis, amelioration of the adverse effects of reperfusion, and use of
      alternative pathways to myocardial salvage.

PMID- 8353904
TI  - Setting the policy, education, and research agenda to reduce tobacco use.
      Workshop I. AHA Prevention Conference III. Behavior change and compliance: keys
      to improving cardiovascular health.

PMID- 8353905
TI  - Behavior changes and the prevention of high blood pressure. Workshop II. AHA
      Prevention Conference III. Behavior change and compliance: keys to improving
      cardiovascular health.

PMID- 8353906
TI  - Obesity. Workshop III. AHA Prevention Conference III. Behavior change and
      compliance: keys to improving cardiovascular health.
AB  - The workshop provided the opportunity to discuss issues and develop and integrate
      ideas. The following recommendations for public policies, education programs, and
      high-priority research initiatives were developed: Recommendations for Public
      Policies: Focus on prevention by requiring school programs to emphasize
      appropriate diet, physical activity, and general health guidance to promote
      cardiovascular health and prevent disease through federal funding. Provide better
      access to exercise (city planning, work-site interventions). Influence food
      availability and accessibility. Influence reimbursement policies for effective
      early intervention and prevention strategies for obesity. Reevaluate policies for
      use of drugs in the treatment of obesity. Recommendations for Education Programs:
      Sponsor scientific workshop to: Define the most appropriate weight standards for
      prevention and treatment. Identify who should lose weight and why, when, and how.
      Promote the fact that obesity is an important health risk factor, even at
      moderate levels, and that excess visceral fat is particularly hazardous. Target
      health care professionals, consumers, and the media for education about: Nature
      of obesity as a heterogeneous syndrome. Recommendations for diet, exercise,
      behavioral interventions, drugs, and surgery. Recognition of special needs of
      populations of different ethnicity, gender, age, etc. State-of-the-art treatment
      and treatment programs. High-Priority Research Initiatives: Build better bridges
      between basic research and treatment/prevention practices. Acknowledge that
      obesity is a heterogeneous syndrome that may best be characterized as different
      obesities. Research on defining subtypes. Implications for etiology and
      treatment. Better characterization of genotypes and phenotypes. Study the effects
      of weight loss, weight gain,and weight cycling on medical and psychosocial
      outcomes and mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8353907
TI  - Lipids. Workshop IV. AHA Prevention Conference III. Behavior change and
      compliance: keys to improving cardiovascular health.

PMID- 8353908
TI  - Physical inactivity. Workshop V. AHA Prevention Conference III. Behavior change
      and compliance: keys to improving cardiovascular health.

PMID- 8353909
TI  - Behavior change and compliance: keys to improving cardiovascular health. Workshop
      VI. AHA Prevention Conference III.

PMID- 8353910
TI  - AHA out front in fight to save animal research laboratories.

PMID- 8353911
TI  - The National Heart, Lung, and Blood Institute value function: measure for
      measure.

PMID- 8353912
TI  - Calcium antagonists differently inhibit proliferation of human coronary smooth
      muscle cells in response to pulsatile stretch and platelet-derived growth factor.
AB  - BACKGROUND: Vascular smooth muscle cell proliferation is the key event of
      coronary artery disease. Mechanical forces, in particular, pulsatile stretch and
      platelet-derived growth factor, may play an important role. METHODS AND RESULTS:
      Vascular smooth muscle cells were cultured from the media of human left
      descending coronary arteries obtained from organ donors using the explant method.
      To study effects of pulsatile stretch on vascular smooth muscle cell
      proliferation, a computer-controlled in vitro pulsatile stretch device was used.
      Cells were seeded onto Flex I culture plates with deformable membranes and
      exposed to pulsatile stretch (60 cycles per minute) and/or growth factors.
      Proliferation of smooth muscle cells was determined by 3H-thymidine
      incorporation. Pulsatile stretch markedly stimulated 3H-thymidine incorporation
      of coronary smooth muscle cells (180 +/- 15 to 432 +/- 27 cpm/10(5) cells; P <
      .05) after 24 hours and increased cell number after 6 days (10.3 +/- 0.7 x
      10(4)/mL; P < .05). Platelet-derived growth factor-AB (0.01 to 10 ng/mL)
      concentration-dependently stimulated 3H-thymidine incorporation in coronary
      smooth muscle cells (EC50, 0.1 ng/mL) and had additive effects with pulsatile
      stretch. The Ca2+ antagonist verapamil (10(-7) to 10(-5) M) concentration
      dependently inhibited proliferation stimulated by platelet-derived growth factor
      back to control levels (P < .05 to .01) but not that induced by pulsatile
      stretch. CONCLUSIONS: Pulsatile stretch and platelet-derived growth factor are
      potent stimuli for proliferation of coronary smooth muscle cells. The selective
      inhibitory effect of a Ca2+ antagonist on smooth muscle cell proliferation
      stimulated by platelet-derived growth factor but not by pulsatile stretch may
      explain why the drugs have only modest antiatherogenic effects in patients with
      coronary artery disease.

PMID- 8353913
TI  - Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health
      Study. Cardiovascular Heart Study (CHS) Collaborative Research Group.
AB  - BACKGROUND: Peripheral arterial disease measured noninvasively by the ankle-arm
      index (AAI) is common in older adults, largely asymptomatic, and associated with
      clinically manifest cardiovascular disease (CVD). The criteria for an abnormal
      AAI have varied in previous studies. To determine whether there is an inverse
      dose-response relation between the AAI and clinical CVD, subclinical disease, and
      risk factors, we examined the relation of the AAI to cardiovascular risk factors,
      other noninvasive measures of subclinical atherosclerosis using carotid
      ultrasound, echocardiography and electrocardiography, and clinical CVD. METHODS
      AND RESULTS: The AAI was measured in 5084 participants > or = 65 years old at the
      baseline examination of the Cardiovascular Health Study. All subjects had
      detailed assessment of prevalent CVD, measures of cardiovascular risk factors,
      and noninvasive measures of disease. Participants were stratified by baseline
      clinical CVD status and AAI (< 0.8, > or = 0.8 to < 0.9, > or = 0.9 to < 1.0, >
      or = 1.0 to < 1.5). Analyses tested for a dose-response relation of the AAI with
      clinical CVD, risk factors, and subclinical disease. The cumulative frequency of
      a low AAI was 7.4% of participants < 0.8, 12.4% < 0.9, and 23.6% < 1.0.
      participants with an AAI < 0.8 were more than twice as likely as those with an
      AAI of 1.0 to 1.5 to have a history of myocardial infarction, angina, congestive
      heart failure, stroke, or transient ischemic attack (all P < .01). In
      participants free of clinical CVD at baseline, the AAI was inversely related to
      history of hypertension, history of diabetes, and smoking, as well as systolic
      blood pressure, serum creatinine, fasting glucose, fasting insulin, measures of
      pulmonary function, and fibrinogen level (all P < .01). Risk factor associations
      with the AAI were similar in men and women free of CVD except for serum total and
      low-density lipoprotein cholesterol, which were inversely associated with AAI
      level only in women. Risk factors associated with an AAI of < 1.0 in multivariate
      analysis included smoking (odds ratio [OR], 2.55), history of diabetes (OR,
      3.84), increasing age (OR, 1.54), and nonwhite race (OR, 2.36). In the 3372
      participants free of clinical CVD, other noninvasive measures of subclinical CVD,
      including carotid stenosis by duplex scanning, segmental wall motion
      abnormalities by echocardiogram, and major ECG abnormalities were inversely
      related to the AAI (all P < .01). CONCLUSIONS: There was an inverse dose-response
      relation of the AAI with CVD risk factors and subclinical and clinical CVD among
      older adults. The lower the AAI, the greater the increase in CVD risk; however,
      even those with modest, asymptomatic reductions in the AAI (0.8 to 1.0) appear to
      be at increased risk of CVD.

PMID- 8353914
TI  - Increased risk of coronary heart disease death in men with low total and low
      density lipoprotein cholesterol in the Russian Lipid Research Clinics Prevalence
      Follow-up Study.
AB  - BACKGROUND: A continuously increasing risk of coronary heart disease with
      increasing levels of cholesterol has been reported by many observational and
      experimental studies. However, this type of association has not been observed in
      studies in the Russian Lipid Research Clinics. METHODS AND RESULTS: Twelve-year
      coronary heart disease mortality among 40- to 59-year-old men was analyzed in the
      Moscow and St Petersburg examines in the Russian Lipid Research Clinics Program.
      The baseline survey examined 6431 men fasting and free of prevalent coronary
      heart disease. Lipids and lipoproteins, blood pressure, body mass, education
      level, alcohol intake, and smoking history were obtained. Mortality follow-up was
      based on contacts with participants or their relatives or neighbors. Coronary
      heart disease mortality was analyzed based on risk factor levels and was further
      divided into rapid and nonrapid deaths. A J-shaped cholesterol-coronary heart
      disease risk function was present for both total and low-density lipoprotein
      cholesterol. Further examination showed hypocholesterolemic men to have lower low
      density and higher high-density lipoprotein cholesterol, higher alcohol
      consumption, leaner body mass, and less education than men with normal or high
      cholesterol levels. When education level was considered, the J-shaped risk
      function was present only among men with less than a high school education. When
      deaths were classified into rapid (less than 24 hours after onset of symptoms)
      and nonrapid, the J-shaped risk function was restricted to rapid deaths.
      CONCLUSIONS: The results of disclose a sizeable subset of hypocholesterolemics in
      this population at increased risk of cardiac death associated with lifestyle
      characteristics.

PMID- 8353915
TI  - Regional blood flow, oxidative metabolism, and glucose utilization in patients
      with recent myocardial infarction.
AB  - BACKGROUND: Metabolic imaging with positron emission tomography (PET) can detect
      tissue viability in clinical infarct regions. With appropriate tracer kinetic
      models and serial PET imaging, regional myocardial blood flow and rates of
      metabolism can now be quantified in patients with recent myocardial infarctions.
      METHODS AND RESULTS: Serial PET imaging with [13N]ammonia, [11C]acetate, and 18F
      deoxyglucose was performed in 22 patients with recent infarctions to measure
      regional blood flow (in milliliters per gram per minute), glucose metabolism (in
      micromoles per gram per minute), and oxidative metabolism (in clearance rate per
      minute). Hypoperfused clinical infarct regions were classified as "PET mismatch"
      if 18F was increased relative to 13N activity or "PET match" if 13N and 18F
      activities were reduced concordantly. Blood flows differed significantly between
      normal, mismatch, and match segments (0.83 +/- 0.20, 0.57 +/- 0.20, and 0.32 +/-
      0.12 mL.g-1.min-1, respectively). The relation between oxidative metabolism and
      blood flow was piecewise linear and differed significantly between PET mismatch
      and PET match. Oxidative metabolism was less severely reduced than blood flow in
      mismatch regions but but reduced in proportion to blood flow in match regions.
      There was considerable overlap of blood flows between both types of PET segments.
      CONCLUSIONS: Quantification of regional blood flow and substrate metabolism in
      postinfarction patients revealed alterations in the relation between substrate
      delivery and consumption demonstrated previously only in invasive animal
      experiments. The preserved oxidative metabolism in myocardium with PET mismatches
      may be ascribed to a regional increase in oxygen extraction. Such increase
      together with preserved glucose utilization may be the prerequisite for survival
      of ischemically injured myocardium.

PMID- 8353916
TI  - Electrocardiographic diagnosis of postinfarction regional pericarditis. Ancillary
      observations regarding the effect of reperfusion on the rapidity and amplitude of
      T wave inversion after acute myocardial infarction.
AB  - BACKGROUND: The ECG recognition of diffuse pericarditis following acute
      myocardial infarction has been based on changes of the ST segment and, to a
      lesser extent, alterations of the PQ segment. No ECG criteria exist for the
      diagnosis of postinfarction regional pericarditis. Recently, it was observed that
      the T wave evolution follows an atypical pattern before fatal free wall rupture
      and that this pattern is due to the associated pericarditis. Therefore, this
      study was conducted on 200 patients with acute myocardial infarction to further
      elucidate the sensitivity and specificity of the atypical T wave changes in
      patients with regional postinfarction pericarditis without rupture and to assess
      the affect of lytic treatment on the rapidity and amplitude of postinfarction T
      wave evolution. METHODS AND RESULTS: An analysis of the clinical courses and
      serial ECGs of 200 consecutive patients with acute myocardial infarction was
      performed. Among 43 patients with postinfarction pericarditis, the pattern of T
      wave evolution consistently differed from the customary postinfarction pattern of
      T wave evolution. This unusual evolutionary course was expressed as either
      persistently positive T waves 48 or more hours after infarction (67%) or
      premature, gradual reversal of inverted T waves to positive deflections (33%).
      The sensitivity and specificity of these T wave alterations were 100% and 77%,
      respectively. The only other processes identified that caused this type of
      postinfarction T wave evolution were cardiopulmonary resuscitation, reinfarction,
      and very small infarcts. Both reperfusion, as judged by the creatine kinase-MB
      curve, and patency, as assessed by the angiogram, were correlated with the
      rapidity and depth of T wave inversion. Ninety percent of patients with
      reperfusion attained a maximum T wave negativity of 3 mm or more within 48 hours
      after the onset of chest pain in the lead that initially displayed the greatest
      ST segment elevation. Seventy-six percent of patients without reperfusion
      attained a maximum negativity of 2 mm or less within 72 hours. Thus, like the ST
      segment, accelerated evolution and deepening of the T wave may be noninvasive
      markers of reperfusion. CONCLUSIONS: First, premature reconcordancy of the ST
      segment and T wave after acute myocardial infarction is a sensitive, reasonably
      specific, and easily recognizable ECG manifestation of postinfarction regional
      pericarditis. Second, reperfusion is associated with accelerated evolution and
      deepening of the T waves following acute myocardial infarction.

PMID- 8353917
TI  - Late potentials and ventricular enlargement after myocardial infarction. A new
      role for high-resolution electrocardiography?
AB  - BACKGROUND: Arrhythmias are common in patients who have developed ventricular
      enlargement after myocardial infarction. METHODS AND RESULTS: A prospective study
      was undertaken to assess the relation between ventricular dilatation and the
      development of late potentials after myocardial infarction. Echocardiograms and
      signal-averaged ECGs were recorded on days 1,3,7, and 42 in 52 patients with a
      first anterior myocardial infarction. Twenty-nine percent of patients were late
      potential-positive on their initial signal-averaged ECG recorded on the day of
      admission. The incidence of late potentials rose during the next week to a peak
      of 42% at day 7, declining to 13% by day 42. The presence of late potentials on
      the day of admission was associated with an increase in end-diastolic volume
      index of 16.1 +/- 6.0 mL/m2 (mean +/- SEM), compared with a decreased of 4.7 +/-
      2.7 mL/m2 among late potential-negative patients (P < .006). Qualitatively
      similar results were evident for late potentials on day 3 and day 7. By contrast,
      there was no association between late potentials on day 42 and ventricular
      dilatation. Marked dynamic changes in late potentials were evident during the
      first week. Patients with persistent late potentials (n = 9) on all three
      recordings in the first week showed a marked increase in end-diastolic volume
      index of 21.3 +/- 8.1 mL/m2 (P < .005 in comparison with patients who were
      persistently negative [n = 20]). Patients demonstrating dynamic positivity (n =
      15) not present on all three recordings in the first week showed no significant
      increase in end-diastolic volume index. CONCLUSION: It is concluded that late
      potentials during the first week after infarction are associated with subsequent
      ventricular dilatation. These early-phase late potentials may be a manifestation
      of cell slippage. They arise before gross topographical enlargement and may serve
      as a predictor of ventricular dilatation.

PMID- 8353918
TI  - Slow conduction in the infarcted human heart. 'Zigzag' course of activation.
AB  - BACKGROUND: Ventricular tachycardias occurring in the chronic phase of myocardial
      infarction are caused by reentry. Areas of slow conduction, facilitating reentry,
      are often found in the infarcted zone. The purpose of this study was to elucidate
      the mechanism of slow conduction in the chronic infarcted human heart. METHODS
      AND RESULTS: Spread of activation was studied in infarcted papillary muscles from
      hearts of patients who underwent heart transplantation because of infarction.
      Recordings were carried out on 10 papillary muscles that were superfused in a
      tissue bath. High-resolution mapping was performed in areas revealing slow
      conduction. Activation delay between sites perpendicular to the fiber direction
      and 1.4 mm apart could be as long as 45 milliseconds. Analysis of activation
      times revealed that activation spread in tracts parallel to the fiber direction.
      Conduction velocity in the tracts was between 0.6 and 1 m/s. Although tracts were
      separated from each other over distances up to 8 mm, they often connected with
      each other at one or more sites, forming a complex network of connected tracts.
      In this network, wave fronts could travel perpendicular to the fiber direction.
      Separation of tracts was due to collagenous septa. At sites where tracts were
      interconnected, the collagenous barriers were interrupted. CONCLUSIONS: Slow
      conduction perpendicular to the fiber direction in infarcted myocardial tissue is
      caused by a "zigzag" course of activation at high speed. Activation proceeds
      along pathways lengthened by branching and merging bundles of surviving myocytes
      ensheathed by collagenous septa.

PMID- 8353919
TI  - The ability of several short-term measures of RR variability to predict mortality
      after myocardial infarction.
AB  - BACKGROUND: We studied 715 patients 2 weeks after myocardial infarction to test
      the hypothesis that short-term power spectral measures of RR variability
      (calculated from 2 to 15 minutes of normal RR interval data) will predict all
      cause mortality or arrhythmic death. METHODS AND RESULTS: We performed power
      spectral analyses on the entire 24-hour RR interval time series. To compare with
      the 24-hour analyses, we selected short segments of ECG recordings from two time
      periods for analysis: 8 AM to 4 PM and midnight to 5 AM. The former corresponds
      to the time interval during which short-term measures of RR variability would
      most likely be obtained. The latter, during sleep, represent a period of
      increased vagal tone, which may simulate the conditions that exist when patients
      have a signal-averaged ECG recorded, ie, lying quietly in the laboratory. Four
      frequency domain measures were calculated from spectral analysis of heart period
      data over a 24-hour interval. We computed the 24-hour power spectral density and
      calculated the power within three frequency bands: (1) 0.0033 to < 0.04 Hz, very
      low frequency power, (2) 0.04 to < 0.15 Hz, low frequency power, and (3) 0.15 to
      0.40 Hz, high frequency power. In addition, we calculated the ratio of low to
      high frequency power. These measures were calculated for 15-, 10-, 5-, and 2
      minute segments during the day and at night. Mean power spectral values from
      short periods during the day and night were similar to 24-hour values, and the
      correlations between short segment values and 24-hour values were strong (many
      correlations were > or = 0.75). Using the optimal cutpoints determined previously
      for the 24-hour power spectral values, we compared the survival experience of
      patients with low values for RR variability in short segments of ECG recordings
      to those with high values. We found that power spectral measures of RR
      variability were excellent predictors of all-cause, cardiac, and arrhythmic
      mortality and sudden death. Patients with low values were 2 to 4 times as likely
      to die over an average follow-up of 31 months as were patients with high values.
      The power spectral measures of RR variability did not predict arrhythmic or
      sudden deaths substantially better than all-cause mortality. CONCLUSIONS: Power
      spectral measures of RR variability calculated from short (2 to 15 minutes) ECG
      recordings are remarkably similar to those calculated over 24 hours. The power
      spectral measures of RR variability are excellent predictors of all-cause
      mortality and sudden cardiac death.

PMID- 8353920
TI  - Relation of plasma lipoprotein(a) to infarct artery patency in survivors of
      myocardial infarction.
AB  - BACKGROUND: In the minutes to days after myocardial infarction, endogenous lysis
      of an occlusive coronary arterial thrombus occurs in most subjects. Compared with
      those in whom thrombolysis does not occur, those with antegrade flow in the
      infarct artery have improved left ventricular performance, less left ventricular
      dilatation, and improved survival. This study was performed to assess intrinsic
      hemostasis and fibrinolysis in survivors of myocardial infarction with or without
      antegrade perfusion of the infarct artery. METHODS AND RESULTS: In 105 survivors
      of infarction (75 men, 30 women; age, 30 to 80 years) not given thrombolytic
      therapy, coronary angiography revealed a patent (group 1, n = 52) or occluded
      (group 2, n = 53) infarct artery. Plasma concentrations of plasminogen,
      fibrinogen, tissue plasminogen activator activity, infarct artery. Plasma
      concentrations of plasminogen, fibrinogen, tissue plasminogen activator activity,
      plasminogen activator inhibitor activity, cholesterol, triglycerides, and
      lipoproteins, including lipoprotein(a) (Lp[a]), were measured in blood procured
      23 +/- 13 (mean +/- SD) months after infarction. Groups 1 and 2 were similar in
      age, sex, race, cardioactive medications, infarct artery, extent of coronary
      artery disease, and left ventricular performance. Of the plasma constituents
      assayed, the groups were similar except that Lp(a) averaged 18.5 +/- 21.7 mg/dL
      in group 1 and 49.1 +/- 44.8 mg/dL in group 2 (P < .001). This difference was
      evident in both Caucasian (n = 65) (P = .009) and African American (n = 40) (P =
      .01) subjects. CONCLUSIONS: Survivors of myocardial infarction who failed to
      recanalize the infarct artery have higher plasma Lp(a) concentrations than those
      with a patent infarct artery. Lp(a) may inhibit intrinsic fibrinolysis.

PMID- 8353921
TI  - Concordance and discordance between stress-redistribution-reinjection and rest
      redistribution thallium imaging for assessing viable myocardium. Comparison with
      metabolic activity by positron emission tomography.
AB  - BACKGROUND: Stress thallium scintigraphy provides important diagnostic and
      prognostic information in patients with coronary artery disease by demonstrating
      regional myocardial ischemia. However, if the clinical question being addressed
      is whether a region is viable and not whether there is inducible ischemia, then
      it may be more reasonable to perform rest-redistribution imaging rather than
      stress-redistribution imaging followed by either reinjection or late
      redistribution. Therefore, we determined whether stress-redistribution
      reinjection and rest-redistribution imaging provide the same information
      regarding myocardial viability. METHODS AND RESULTS: Both stress-redistribution
      reinjection and rest-redistribution thallium single photon emission computed
      tomographic imaging was performed in 41 patients with chronic stable coronary
      artery disease, with quantitative analysis of regional thallium activity.
      Thallium reinjection was performed immediately after the 3- to 4-hour
      redistribution images were completed. Of the 155 myocardial regions with
      perfusion defects on the stress images, 91 (59%) were irreversible on
      conventional 3- to 4-hour redistribution images. When the outcomes of these
      irreversible regions were assessed after reinjection and compared with rest
      redistribution images, there was concordance of data regarding myocardial
      viability (normal/reversible or irreversible) in 72 of the 91 (79%) irreversible
      defects. Twenty of the 41 patients also underwent positron emission tomography at
      rest with [18F]fluorodeoxyglucose and [15O]water. In these patients, stress
      redistribution-reinjection and rest-redistribution imaging provided concordant
      information regarding myocardial viability in 427 (72%) of 594 myocardial regions
      and discordance in 167 regions. However, when irreversible thallium defects were
      further analyzed according to the severity of the thallium defect in these
      discordant regions, 149 of 167 (89%) demonstrated only mild-to-moderate reduction
      in thallium activity (51% to 85% of normal activity), and positron emission
      tomography verified 98% of these regions to be metabolically active and viable.
      Thus, when the severity of thallium activity was considered within irreversible
      thallium defects, the concordance between stress-redistribution-reinjection and
      rest-redistribution imaging regarding myocardial viability increased to 94%.
      CONCLUSIONS: These data indicate that one of two imaging modalities, either
      stress-redistribution-reinjection or rest-redistribution imaging, may be used for
      identifying viable myocardium. However, if there are no contraindications to
      stress testing, stress-redistribution-reinjection imaging provides a more
      comprehensive assessment of the extent and severity of coronary artery disease by
      demonstrating regional myocardial ischemia without jeopardizing information on
      myocardial viability.

PMID- 8353922
TI  - Relation of phasic coronary flow velocity profile to clinical and hemodynamic
      characteristics of patients with aortic valve disease.
AB  - BACKGROUND: Our objective was to assess phasic coronary blood flow and velocity
      characteristics of the proximal portion of the left anterior descending artery
      and to evaluate their relation to the clinical and hemodynamic manifestations in
      patients with aortic valve disease. METHODS AND RESULTS: We examined 26 patients
      with chronic aortic regurgitation (AR), 12 patients with predominant aortic
      stenosis (AS), and 11 control subjects using an intravascular Doppler catheter
      with spectral analysis. Angiographic assessment of AR identified 10 patients with
      mild regurgitation and 16 with severe regurgitation. The resting systolic
      coronary flow velocity-time integral (VTI) was significantly higher and the
      diastolic VTI was slightly but significantly higher in patients with severe
      regurgitation than in those with mild regurgitation (11.8 +/- 4.2 vs 4.1 +/- 1.1
      cm, P < .001; 18.5 +/- 5.8 vs 13.2 +/- 3.2 cm, P < .05) and control subjects (4.0
      +/- 1.0 cm, P < .001 and 13.3 +/- 3.6 cm, P < .05), respectively. Patients with
      AS had a slightly lower resting systolic VTI (3.8 +/- 1.4 cm) and a higher
      diastolic VTI (14.6 +/- 3.7 cm) than control subjects. Resting coronary blood
      flow was greater in patients with aortic valve disease than in control subjects.
      There was a significant correlation between the ratio of the resting systolic to
      diastolic VTI (S/D ratio) and the ratio of the aortic systolic to diastolic
      pressure (r = .75, P < .001) in patients with AR. The S/D ratio was inversely
      correlated with left ventricular systolic pressure (r = -.92, P < .001) and
      positively correlated with the ratio of the aortic systolic to diastolic pressure
      (r = .68, P < .05) in patients with AS. CONCLUSIONS: Our results indicate that
      hemodynamic changes related to aortic valve disease contribute to alterations in
      the resting phasic coronary blood flow and velocity profiles observed in these
      patients.

PMID- 8353923
TI  - Detailed angiographic analysis of high-speed mechanical rotational atherectomy in
      human coronary arteries.
AB  - BACKGROUND: Several types of atherectomy devices have been developed recently for
      treatment of patients with ischemic heart disease. METHODS AND RESULTS:
      Mechanical rotational atherectomy (MRA) using a high-speed rotational burr
      (Rotablator) was performed on 116 lesions in 104 patients. MRA alone was
      performed in 27 lesions (23%), and conventional balloon angioplasty (PTCA) was
      performed after MRA in 89 lesions (77%). Diameter stenosis decreased from 70 +/-
      13% before MRA to 54 +/- 23% after MRA, and the final diameter stenosis (after
      MRA alone or with adjunctive PTCA) was 30 +/- 20% (P < .001). Minimal lumen
      diameter increased from 1.0 +/- 0.5 mm before MRA to 1.4 +/- 0.7 mm after MRA,
      and the final minimal lumen diameter was 2.3 +/- 0.7 mm (P < .001). MRA resulted
      in a decrease in diameter stenosis of 20% or more in 44% of lesions, and the
      final diameter stenosis (after MRA alone or after PTCA) was less than 50% in 75%
      of lesions. Considering the small diameter of available burrs, the magnitude of
      lumen enlargement was equal to 91% of the burr diameter, and only 9% of the burr
      diameter was "lost" due to elastic recoil or spasm. These angiographic results
      were obtained despite the presence of complex lesion morphology, including the
      presence of calcification in 17% of lesions and ostial location in 26% of
      lesions. Significant angiographic complications included abrupt closure (13
      lesions, 11.2%), no reflow (8 lesions, 7%), severe coronary vasospasm (16
      lesions, 13.8%), and guide wire fracture (3 lesions, 2.7%). There were no
      coronary artery perforations. Adjunctive therapy, including salvage PTCA,
      thrombolytic agents, and vasodilators, was successful in treating angiographic
      complications in 42 of 49 lesions (86%). Clinical complications included Q-wave
      myocardial infarction (5 patients, 4.8%), non-Q-wave myocardial infarction (3
      patients, 2.9%), femoral vascular injury requiring surgery (3 patients, 2.9%) or
      blood transfusion (8 patients, 7.7%), abrupt closure requiring emergency bypass
      graft surgery (2 patients, 1.9%), and in-hospital death (1 patient, 1.0%).
      Angiographic follow-up (mean follow-up interval, 5.0 +/- 2.0 months) was
      available in 84% of successfully treated patients and revealed a restenosis rate
      of 51%, defined as a residual diameter stenosis of more than 50%. There was no
      significant difference in restenosis rates between de novo lesions (50%) and
      restenosis (54%) lesions. CONCLUSIONS: These data suggest that for the treatment
      of most coronary stenoses, PTCA is required after MRA to achieve satisfactory
      lumen enlargement or to salvage complications. Angiographic complications appear
      to be more common after MRA, and salvage PTCA often is required to manage these
      device-induced complications. The combination of MRA and PTCA does not prevent
      restenosis.

PMID- 8353924
TI  - Restenosis rate after multiple percutaneous transluminal coronary angioplasty
      procedures at the same site. A quantitative angiographic study in consecutive
      patients undergoing a third angioplasty procedure for a second restenosis.
AB  - BACKGROUND: Several studies suggest that repeated percutaneous transluminal
      coronary angioplasty procedures at the same site are associated with a
      progressively increasing risk of further restenosis and that short time intervals
      between successive procedures are predictive of future restenosis. METHODS AND
      RESULTS: We assessed by quantitative coronary angiography the angiographic
      probability of restenosis when repeat percutaneous transluminal coronary
      angioplasty was performed at a site where restenosis had occurred after two
      previous angioplasty procedures. Of 99 consecutive patients who underwent a third
      angioplasty procedure, 96 had successful procedures. Uncomplicated failure
      (residual stenosis > or = 50%) occurred in 3 patients. No major complications
      occurred. Follow-up angiography was routinely advised; it was performed in 83
      patients (86%) with successful procedures. Restenosis (recurrence of > or = 50%
      stenosis determined by quantitative coronary angiography) occurred in 32 patients
      (39%). An interval of < 3 months between the second and third angioplasty was
      strongly associated (P < .005) with the occurrence of further restenosis after a
      third procedure. CONCLUSIONS: The angiographic probability of further restenosis
      after three successive angioplasty procedures at the same site is similar to that
      reported after a first angioplasty procedure in studies that used a similar
      definition of restenosis. Patients who undergo a third angioplasty procedure
      within 3 months of a previous procedure at the same site have a much higher risk
      of subsequent restenosis. This easily identified subgroup may benefit from an
      alternative therapeutic approach.

PMID- 8353925
TI  - Luminal narrowing after percutaneous transluminal coronary angioplasty. A study
      of clinical, procedural, and lesional factors related to long-term angiographic
      outcome. Coronary Artery Restenosis Prevention on Repeated Thromboxane Antagonism
      (CARPORT) Study Group.
AB  - BACKGROUND: The renarrowing process after successful percutaneous transluminal
      coronary angioplasty (PTCA) is now believed to be caused by a response-to-injury
      vessel wall reaction. The magnitude of this process can be assessed by the change
      in minimal lumen diameter (MLD) at follow-up angiography. The aim of the present
      study was to find independent patient-related, lesion-related, and procedure
      related risk factors for this luminal narrowing process. A model that accurately
      predicts the amount of luminal narrowing could be an aid in patient or lesion
      selection for the procedure, and it could improve assessment of medium-term (6
      months) prognosis. Modification or control of the identified risk factors could
      reduce overall restenosis rates, and it could assist in the selection of patients
      at risk for a large loss in lumen diameter. This population could then constitute
      the target population for pharmacological intervention studies. METHODS AND
      RESULTS: Quantitative angiography was performed on 666 successfully dilated
      lesions at angioplasty and at 6-month follow-up. Multivariate linear regression
      analysis was performed to obtain variables with an independent contribution to
      the prediction of the absolute change in minimal lumen diameter. Diabetes
      mellitus, duration of angina < 2.3 months, gain in MLD at angioplasty, pre-PTCA
      MLD, lesion length > or = 6.8 mm, and thrombus after PTCA were independently
      predictive of change in MLD. Overall prediction of the model was poor, however,
      percentage-correct classification for a predicted change between -0.1 to -0.4 mm
      was approximately 10%. Lesions showing no change or regression (change > -0.1 mm)
      and lesions showing large progression (< or = -0.4 mm) were more predictable
      (correct classification, 59.5% and 49.7%, respectively). CONCLUSIONS: Renarrowing
      after successful PTCA as determined with contrast angiography is a process that
      cannot be accurately predicted by simple clinical, morphological, and lesion
      characteristics.

PMID- 8353926
TI  - Blunted nocturnal fall in blood pressure in hypertensive women with future
      cardiovascular morbid events.
AB  - BACKGROUND: In essential hypertension, a blunted or absent nocturnal fall in
      blood pressure (BP) may be associated with increased target organ damage. In this
      case-control study, we tested the hypothesis that an association exists between a
      blunted or absent nocturnal fall in BP and future cardiovascular morbid events in
      patients with essential hypertension. METHODS AND RESULTS: Case subjects were 32
      hypertensive patients with a first fatal or nonfatal major cardiovascular event
      who had off-therapy ambulatory BP monitoring 1 to 5 years earlier in the context
      of a registry of morbidity and mortality in hypertensive patients. Control
      subjects were 49 hypertensive patients free from cardiovascular events. The
      groups were matched with regard to date of baseline ambulatory BP monitoring,
      age, sex, clinic systolic and diastolic BP, and daytime ambulatory systolic and
      diastolic BP. At their baseline evaluation, cases and controls did not differ, in
      either sex, with respect to clinic BP (men, 164/100 vs 162/99 mmHg; women, 178/96
      vs 180/93 mmHg), mean daytime ambulatory BP (men, 151/94 vs 147/95 mm Hg; women,
      156/90 vs 158/89 mm Hg), age (men, 55 vs 56 years; women, 69 vs 68 years), sex,
      body weight, serum cholesterol, known duration and family history of
      hypertension, smoking habits, renal function, or prevalence of diabetes.
      Echocardiographic left ventricular mass, determined in a subset of patients, was
      greater in cases than in controls in men (145 vs 115 g/m2, P = .038) and women
      (137 vs 102 g/m2, P = .032). The time interval between baseline ambulatory BP
      monitoring and subsequent cardiovascular event (cases: mean, 2.1 years) or last
      contact with our center (controls: mean, 2.5 years) did not differ between the
      groups. In the baseline ambulatory BP profile, the nocturnal reductions of
      systolic and diastolic BP in men were 9% and 11%, respectively, in cases vs 9%
      and 12% in controls (all P = NS), whereas in women they were 3% and 8% in cases
      vs 11% and 16% in controls (P = .002/.004). CONCLUSIONS: This retrospective case
      control study suggests an association between the reduction or absence of the
      usual nocturnal fall in BP and future cardiovascular morbid events in white women
      with essential hypertension.

PMID- 8353928
TI  - Changes in dendritic morphology of rat spinal motoneurons during development and
      after unilateral target deletion.
AB  - During normal development, motoneuron dendrites in the spinal nucleus of the
      bulbocavernosus (SNB) grow exuberantly to almost twice their adult length and
      then retract. In this study, we retrogradely labeled SNB motoneurons with cholera
      toxin B-conjugated horseradish peroxidase (BHRP) to examine the maturation of SNB
      dendritic arbors in more detail, particularly with regard to its spatial
      distribution and reorganization. The number and orientation of SNB motoneuron
      primary processes did not change over the first ten weeks of life. In contrast,
      total dendritic length, radial extent and arbor area increased significantly
      through the first four postnatal weeks and declined thereafter. The declines in
      length and extent were restricted to particular portions of the arbor,
      specifically the dorsal, ipsi- and contralateral projections. Estimates of the
      degree of overlap between the dendritic arbors from both sides of the SNB
      reflected these changes, with overlap initially increasing and then decreasing as
      the SNB established its adult dendritic morphology. To determine if dendritic
      interactions facilitated by this arbor overlap might be involved in regulating
      the normal retraction of SNB dendrites, we reduced SNB motoneuron numbers
      unilaterally by target muscle removal on the day of birth. Somal size, number and
      orientation of primary processes developed normally in unilateral muscle
      extirpated animals. The dendritic morphology of surviving SNB motoneurons in
      unilateral muscle extirpated males was altered, with significant increases in
      dendritic length, extent and arbor area relative to those of normal males. These
      results indicate that substantial changes in dendritic organization of SNB
      motoneurons occur in normal development and may be influenced by interactions
      between dendrites from the two halves of the SNB.

PMID- 8353927
TI  - Structural and functional alterations of the intramyocardial coronary arterioles
      in patients with arterial hypertension.
AB  - BACKGROUND: In hypertensive patients with angina pectoris, the coronary
      vasodilator reserve is frequently impaired despite a normal coronary angiogram.
      Experimental data indicate that structural alterations of the intramyocardial
      coronary vasculature contribute to an increased minimal coronary resistance and a
      diminished coronary flow reserve. METHODS AND RESULTS: In 14 patients (10 men and
      4 women) with arterial hypertension and 8 normotensive subjects, minimal coronary
      resistance and vasodilator reserve (dipyridamole: 0.5 mg/kg body wt, gas
      chromatographic argon method) were determined after the angiographic exclusion of
      relevant coronary artery disease. Coronary reserve was depressed in hypertensive
      patients (2.7 +/- 2.3 vs 4.6 +/- 1.3, P < or = .05) due to increased minimal
      coronary resistance (0.64 +/- 30 vs 0.24 +/- 0.055 mm Hg.min.100 g.mL-1, p < or =
      0.002). In right septal biopsies, mean external arteriolar diameter (21.6 +/- 2.3
      vs 17.2 +/- 2.5 microns, P < or = .001), mean arteriolar wall area (271 +/- 61 vs
      172 +/- 62 microns 2, P < or = .01), percent medial wall area (69.9 +/- 4.0 vs
      66.0 +/- 3.2%W, P < or = .05), mean periarteriolar fibrosis area (216 +/- 122 vs
      104 +/- 68 microns 2, P < or = .05), and volume density of total interstitial
      fibrosis (3.6 +/- 1.8 vs 1.9 +/- 0.5Vv% fibrosis, P < or = .05) were increased in
      hypertensive patients compared with normotensive subjects. Minimal coronary
      resistance correlated with %W (r = .6, P < or = .003) and Vv% fibrosis (r = .62,
      P < or = .002). Left ventricular mass index (111 +/- 21 vs 97 +/- 17 g/m2, P =
      NS) and left ventricular end-diastolic pressure (12 +/- 6 vs 8 +/- 3 mm Hg, P =
      NS) did not correlate significantly with minimal coronary resistance. In
      multivariate analysis, both %W and Vv% fibrosis explained half of the variability
      of minimal coronary resistance (r2 = .5, P < or = .002). CONCLUSIONS: Structural
      remodeling of the intramyocardial coronary arterioles and the accumulation of
      fibrillar collagen are decisive factors for a reduced coronary dilatory capacity
      in patients with arterial hypertension and angina pectoris in the absence of
      relevant coronary artery stenoses.

PMID- 8353929
TI  - The effect of nerve growth factor on cholinergic cells in primary fetal striatal
      cultures: characterization by in situ hybridization.
AB  - In situ hybridization using 35S-labeled antisense oligonucleotide probes for
      choline acetyltransferase (ChAT), and m1 and m2 muscarinic receptors was employed
      to monitor the effect of nerve growth factor (NGF) on cholinergic cells in mixed
      neuronal-glial striatal brain cultures prepared from E16/E17 rat embryos. In
      cultures treated with NGF, cells reactive to the ChAT oligonucleotide probe were
      significantly larger than cells in untreated cultures. In addition, there was a
      significant increase in the number of silver grains over reactive cells in
      cultures exposed for 9-10 days to exogeneous NGF. Similar results were obtained
      with an oligonucleotide probe specific for m2 muscarinic receptors: in NGF
      treated cultures, cells reactive to the m2 receptor probe were significantly
      larger and had more silver grains than cells from non-treated cultures. On the
      other hand, no significant effect of NGF on cell size or on the number of grains
      was observed for cells reactive to an m1 muscarinic receptor probe. These results
      demonstrate that NGF specifically increases the transcription of genes (ChAT and
      m2 muscarinic receptor) the expression of which is associated with cholinergic
      neurons, promoting the growth of this particular type of neuron.

PMID- 8353930
TI  - Differential timing and sexual dimorphism in the expression of the vasopressin
      gene in the developing rat brain.
AB  - The ontogeny of vasopressin (VP) gene expression in extrahypothalamic neurons of
      the bed nucleus of the stria terminalis (BNST) and medial amygdala (MA) was
      investigated using in situ hybridization. In both the BNST and MA, VP mRNA
      positive cell profiles were only detected a few days after birth. In males, VP
      mRNA-expressing cell profiles appear in the BNST on day 3 and in the MA on day 5.
      In contrast, hybridization signals could not be detected in the female brain
      until day 14 in the BNST and day 35 in the MA. Adult VP mRNA levels are attained
      by day 35 in the BNST and day 60 in the MA for both sexes. From this data, it is
      apparent that development of the VP system is delayed in females compared to the
      males. Therefore, these data suggest that the sexual dimorphic pattern in the
      expression of VP mRNA in these nuclei of the adult brain is evident early in the
      development process.

PMID- 8353931
TI  - Excitatory amino acid regulation of the enkephalin phenotype in mouse embryonic
      spinal cord cultures.
AB  - Expression of the preproenkephalin gene in developing spinal cord-dorsal root
      ganglia (SC-DRG) cultures was determined by Northern analysis following
      treatments with different agonists and antagonists of the glutamate receptor.
      Cultures (10-12 days old) were treated with various concentrations (10(-7)-10(-3)
      M) of N-methyl-D-aspartate (NMDA), quisqualate, kainic acid (KA), 2-amino-5
      phosphonovaleric acid (APV) and 5-methyl-10,11-dihydro-5H-dibenzo[a,
      d]cyclohepten-5,10-imine maleate (MK801) either with or without blocking
      spontaneous electrical activity with 1 microM tetrodotoxin (TTX). In electrically
      active cultures, treatments with NMDA and KA increased preproenkephalin
      transcripts (mRNAppENK), showing maximum effects at 1 microM (4-fold and 2-fold,
      respectively), while treatments with quisqualate and MK801 caused concentration
      dependent down-regulation in mRNAppENK. The most effective concentrations of NMDA
      (1 microM) and quisqualate (10 microM) altered mRNAppENK levels within 4 h of
      treatment and peaked after 24 h for NMDA and 48 h for quisqualate treatment. Co
      treatment with APV completely blocked the NMDA-induced rise of mRNAppENK. During
      electrical blockade, none of the concentrations of NMDA tested showed any effect
      on enkephalin expression, neither could NMDA pre-treatment prevent the TTX
      induced down-regulation of mRNAppENK. Our results indicate that the activity
      dependent establishment of the enkephalin phenotype is modulated through the
      selective activation of the NMDA-glutamate receptor.

PMID- 8353932
TI  - Age- and dose-related NMDA induction of Fos-like immunoreactivity and c-fos mRNA
      in the arcuate nucleus of immature female rats.
AB  - Glutamate and the N-methyl-D-aspartate (NMDA) receptor are important regulatory
      components of the hypothalamic control of luteinizing hormone (LH) secretion.
      Peripheral injection of prepubertal rats with NMDA induces maximal secretion of
      LH within 8 min as well as the expression of the proto-oncogene, c-fos, within
      the mediobasal hypothalamus (MBH). Because the induction of the c-fos gene is
      recognized as a sensitive marker of neuronal activity, the detection and
      characterization of c-fos mRNA and Fos protein may be particularly useful in the
      analysis of the GnRH (gonadotropin releasing hormone) neuronal system. This study
      has examined the effect of different doses of NMDA on c-fos mRNA and Fos-like
      immunoreactivity (Fos-lir); the time-course of induction of c-fos mRNA and the
      appearance of Fos-lir expression and the ontogeny of NMDA-induced Fos-lir. Our
      results indicate that NMDA-induced c-fos mRNA and protein are maximal by 60 and
      120 min, respectively. Both c-fos mRNA and protein attain peak levels using NMDA
      doses between 20 and 40 mg/kg. Ontological studies demonstrated that Fos-lir
      could be detected at 5 days after birth, but declined after sexual maturation.
      The data presented here indicate that the immunohistochemical localization of c
      fos gene expression, in conjunction with in situ hybridization, is a useful
      technique for mapping NMDA-sensitive pathways and may provide anatomical and
      physiological evidence that better defines the glutamatergic control of sexual
      maturation.

PMID- 8353933
TI  - Developmental regulation of neuronal expression for the eta subtype of the 14-3-3
      protein, a putative regulatory protein for protein kinase C.
AB  - An in situ hybridization technique was applied to rat nervous tissues, to analyse
      the developmental changes in expression for the eta subtype mRNA of 14-3-3
      protein, a putative regulatory protein for protein kinase C. Although signal
      levels of the eta subtype mRNA were low in mitotic cells in the ventricular zone,
      most neurons displayed a marked increase at their definitive location in the
      mantle zone. In general, neurons in the spinal ventral horn and peripheral
      ganglia showed this increase at E13-E15, those in the telencephalon,
      diencephalon, midbrain, pons and medulla oblongata at E18-P1, and the cerebellar
      Purkinje cells at P7-P14. It is at these developmental stages when neuronal
      differentiation including axonal and dendritic growth and ramification occurs
      actively. Subsequently high levels of the eta subtype mRNA were maintained until
      the adult stage in projection type neurons possessing larger cell bodies and
      highly developed dendritic fields, such as the olfactory mitral cells,
      hippocampal pyramidal cells, cerebellar Purkinje cells, and motor neurons in the
      brainstem and spinal cord. However, the signal levels decreased until the adult
      stage in smaller projection type neurons. On the other hand, the signal levels in
      local circuit type neurons were consistently low throughout development. These
      findings suggest that gene expression for the eta subtype mRNA of the 14-3-3
      protein is regulated in close relation to both neuron types and their
      cytodifferentiation.

PMID- 8353934
TI  - S-adenosylmethionine decarboxylase in human brain. Regional distribution and
      influence of aging.
AB  - Recent experimental animal studies have implicated brain polyamines as having
      roles in both brain development and human brain neurodegenerative conditions. In
      order to provide baseline information, in normal human brain, on one of the key
      polyamine synthesising enzymes, S-adenosylmethionine decarboxylase (SAMDC), we
      examined the sensitivity of this enzyme to various cofactors/inhibitors, its
      regional distribution, and influence of aging in neurologically normal autopsied
      human brain. SAMDC in normal human brain is similar to that reported in other
      mammalian cells with regard to substrate affinity (Km = 39 microM), marked
      sensitivity to putrescine activation (+600%), inhibition
      (methylglyoxalbisguanidine and MDL 73811), and pH optimum (7.2). There was an
      uneven distribution of enzyme activity in human brain, and of the 12 brain
      regions examined, the highest activity was observed in occipital, parietal,
      frontal and temporal cortices (36-58 pmol/h/mg protein); intermediate activity in
      cerebellar and insular cortex, pulvinar thalamus, caudate and putamen (12-27
      pmol/h/mg protein); and lowest activity in medial-dorsal thalamus, lateral globus
      pallidus and white matter (< 11 pmol/h/mg protein). The influence of aging (1 day
      to 103 years) on SAMDC activity in occipital cortex, the region showing the
      highest activity in human brain (n = 59) was also determined. Enzyme activity
      increased by approximately 600% from age 6 months to near maximal levels at age
      10 years, then remained generally unchanged up to 103 years. Since SAMDC is a key
      regulatory enzyme in the synthesis of spermidine and spermine, the marked
      increase in SAMDC activity in the neonate and the sustained high enzyme levels
      throughout adulthood, imply a role for these polyamines in both development and
      mature brain function.

PMID- 8353935
TI  - Effects of a specific glucocorticoid receptor antagonist on corticotropin
      releasing hormone gene expression in the paraventricular nucleus of the neonatal
      rat.
AB  - Mechanisms controlling the synthesis of corticotropin releasing hormone (CRH) in
      neonatal rats, and the ontogeny of glucocorticoid (GC) feedback control of
      hypothalamic CRH remain unknown. Specific issues are whether stress induces up
      regulation of CRH gene expression during the first postnatal week, and the role
      of GC feedback, at the hypothalamic level, in the stress-hyporesponsive period.
      We studied the ontogeny of the negative feedback regulation of CRH gene
      expression by GC in the paraventricular nucleus (PVN). We implanted chronic
      cannulae containing a GC-receptor antagonist, RU 38486, in rats on postnatal days
      3 to 13. Three days later, animals were sacrificed, and brains were analyzed for
      CRH-messenger RNA (CRH-mRNA), using semi-quantitative in situ hybridization.
      Animals implanted with cholesterol-containing cannulae served to evaluate the
      stressful effect of implantation on CRH-mRNA abundance. The presence of GC
      receptor messenger RNA (GR-mRNA) in the PVN of neonatal rats was also determined.
      RU 38486 did not increase CRH-mRNA abundance during the first postnatal week,
      despite the presence of GR-mRNA in the PVN. Chronic-implantation stress also
      failed to increase CRH synthesis. CRH gene expression in the PVN was enhanced in
      infant rats implanted with RU-38486 on postnatal day 9 or later. Cholesterol
      implantation on days 9, 10 (but not later), resulted in increased PVN-CRH-mRNA.
      Thus, CRH-mRNA is up-regulated by chronic blockade of GC receptors only
      subsequent to the eighth postnatal day. Furthermore, such blockade does not
      affect the response of CRH-mRNA to chronic stress in the neonatal rat.

PMID- 8353936
TI  - Large chondroitin sulfate proteoglycans of developing chick CNS are expressed in
      cerebral hemisphere neuronal cultures.
AB  - Chondroitin sulfate proteoglycans (CSPG) of the extracellular matrix may play
      regulatory roles in central nervous system (CNS) development. We have examined
      the expression of two large CSPGs of the embryonic chick brain, which can be
      differentiated using the monoclonal antibodies HNK-1 and S103L, in cultures of
      embryonic day 6 chick cerebral hemisphere neurons. Western blot analysis
      following immunoprecipitation and endoglycosidase treatment revealed that these
      cultures produce S103L- and HNK-1-reactive proteoglycans which are biochemically
      indistinguishable from the CSPGs (previously) identified in homogenized chick
      embryo brain extracts. The HNK-1-reactive CSPG accumulated in the medium
      throughout the course of cultures. In contrast, the S103L-reactive CSPG was found
      in a neuron-associated form during the period of aggregate establishment in
      culture, as well as in a soluble form secreted into the medium.
      Immunocytochemical staining of cultures with the S103L antibody localized
      reactivity to most neurons during the period of aggregate formation, while
      neuronal processes and the few flat cells present (presumably neuroblasts and
      early glia) were negative. Cell selection experiments confirmed that
      neurofilament-positive cells were the source of the S103L-reactive CSPG. The use
      of differential fixation techniques suggested that the cell-associated S103L
      reactivity may be intracellular. Because of this pattern of expression and
      localization, we propose that the developmentally regulated S103L-reactive CSPG
      may play a role in neuronal migration arrest and organization of neurons into
      functional aggregates.

PMID- 8353937
TI  - Ontogeny of Leu-enkephalin and beta-endorphin innervation of the preoptic area in
      male and female rats.
AB  - The distribution of endogenous opioid peptide-containing fibers in the medial
      preoptic area of developing male and female rats was examined using
      immunohistochemical methods. In particular, the ontogeny of leucine-enkephalin
      (leu-enk) and beta-endorphin (beta-endo) innervation was studied using antisera
      directed against these compounds. The distribution of Leu-enk and beta-endo
      differed at each age examined from birth to postnatal day 12 (P12). Furthermore,
      the patterns of fiber innervation differed across development. Leu-enk-like
      immunoreactivity was initially densest in the lateral preoptic region of both
      sexes, ultimately expanding into the medial preoptic region to become densest in
      the lateral portion of the medial preoptic nucleus by P12. This latter pattern
      was observed only in males, however, as females continued to exhibit diffuse
      medial preoptic Leu-enk-like immunoreactivity at P12. In contrast, the
      distribution and developmental pattern of beta-endo-like immunoreactivity was
      similar in both sexes; diffuse staining was observed in the medial preoptic
      region at birth, later becoming dense only in the periventricular and parastrial
      nuclei. The time course of development of Leu-enk and beta-endo innervation of
      the medial preoptic area suggests that the sexually dimorphic expression of
      opioid immunoreactivity occurs after preoptic neurons appear in their sexually
      dimorphic configuration. Therefore, although the development of opioid-containing
      pathways could be influenced by the perinatal gonadal steroid hormone
      environment, medial preoptic Leu-enk and beta-endo innervation might not
      contribute directly to the sexually dimorphic neuronal organization of the
      preoptic area.

PMID- 8353938
TI  - Cocaine depresses cerebral glucose utilization in fetal sheep.
AB  - To assess if cocaine alters cerebral glucose metabolism in the fetus, we infused
      cocaine 0.6 mg/min intravenously to 6 of 13 fetal sheep for the 55 min prior to
      measurement of glucose utilization by an autoradiographic method. Overall, local
      cerebral glucose utilization (LCGU) was lower in cocaine-exposed fetuses than in
      7 controls (P = 0.058). In the cocaine-exposed fetuses, 33 of 34 structures had
      lower mean LCGU than in the comparable structures of control fetuses. In
      addition, the autoradiographs in 4 of 6 cocaine-exposed fetuses revealed thin,
      dark lines of increased glucose utilization within the central white matter of
      some frontal gyri which were not seen in any of the 7 control fetuses. These
      lines were distributed similarly to ones seen earlier in severely hypoxic newborn
      lambs. In fetal lambs, cocaine resulted in a generalized decrease in LCGU and a
      specific increase in glucose utilization in parts of cortical white matter of the
      frontal gyri, possibly secondary to local ischemia.

PMID- 8353939
TI  - Rapid plastic response following early retinal lesions in rats.
AB  - Following an early retinal lesion, aberrant uncrossed projections from the
      opposite, undamaged, retina form in the target visual nuclei. The present study
      has examined the development of such aberrant projections by making retinal
      lesions in newborn rat pups, and then examining the nature of the uncrossed
      retinocollicular projection at different ages following the lesion. Intravitreal
      injections of horseradish peroxidase were made into the intact eye, and the
      uncrossed projection was subsequently revealed histochemically. A mature aberrant
      projection forms as early as postnatal day 9. On postnatal days 5 and 2, aberrant
      projections are discernable amongst the exuberant uncrossed terminals of normal
      developing rats, although the former have not matured to form the dense terminal
      fields characteristic of older projections. Aberrant projections were also
      detectable as early as 12 h following the lesion, revealed as a relative increase
      in the density of uncrossed label. These results indicate that lesion-induced
      plastic responses by intact retinal arbors are initiated shortly after the
      insult, and they caution the use of retinal lesions in studies of normal
      retinotopic connectivity during development.

PMID- 8353940
TI  - More rapid biochemical diagnosis of myocardial infarction: necessary? Prudent?
      Cost effective?

PMID- 8353941
TI  - Spectrophotometry of hemoglobin: various perspectives.

PMID- 8353942
TI  - Homocysteine and other thiols determined in plasma by HPLC and thiol-specific
      postcolumn derivatization.
AB  - We describe a versatile high-performance liquid-chromatographic method for
      determining homocysteine and other plasma sulfhydryls. Using three different
      procedures for preparation of plasma, we determined total, free (non-protein
      bound), and reduced forms of homocysteine, cysteine, glutathione,
      cysteinylglycine, and gamma-glutamylcysteine in human plasma. Sample preparation
      involves disulfide reduction with dithiothreitol and protein precipitation with
      sulfosalicylic acid. The assay utilizes isocratic reversed-phase ion-pair liquid
      chromatography at pH 2.4, postcolumn derivatization with 4,4'-dithiodipyridine,
      and colorimetric detection at 324 nm. The intra-assay precision (CV) of the
      method for total homocysteine is 1.5%; the interassay precision over 2.5 months
      is 2.5%. The detection limit for homocysteine is < 50 nmol/L plasma.

PMID- 8353943
TI  - Recombinant creatine kinase proteins and proposed standards for creatine kinase
      isoenzyme and subform assays.
AB  - We developed standards for creatine kinase (CK; EC 2.7.3.2) assays by expressing
      human CK cDNAs in COS cells. Cells were transiently transfected with full-length
      cDNAs for CK subunits M and B, individually and in combination; and subsequently,
      high concentrations of CK activity were present in the cell lysate (1.2 U/mg
      protein). These proteins exhibited the characteristic isoenzyme-specific
      electrophoretic mobilities for CK MM and BB isoenzymes. We also produced subforms
      of CK MM and MB, identical to the modified CK variants produced in plasma after
      muscle or myocardial injury, by mutating the cDNA for the CK M subunit to delete
      the carboxy-terminal lysine residue. When this construct was cotransfected with
      the normal cDNAs for CK M and B, five electrophoretically distinct CK isoenzymes
      were detected by nondenaturing electrophoresis: MM3, MM2, MM1, MB2, and MB1.
      These proteins retained 100% of their activity after storage of the cell lysates 
      20 or 4 degrees C for 3 months.

PMID- 8353944
TI  - Serum cholesterol determined by liquid chromatography with 6-chlorostigmasterol
      as internal standard.
AB  - We describe an accurate and precise method for determining serum cholesterol by
      high-performance liquid chromatography (HPLC). After addition of 6
      chlorostigmasterol as internal standard, serum is treated with alcoholic
      potassium hydroxide. Subsequently the cholesterol and internal standard are
      extracted from the mixture into n-hexane and then derivatized to phenylurethanes
      for measurement by HPLC with ultraviolet detection. The effective chromatographic
      separation and the use of an appropriate internal standard make this procedure
      free from interferences by other serum sterols and precise. The mean cholesterol
      concentration in Standard Reference Material (SRM) 909 (human serum) assayed by
      this procedure (4.346 mmol.g-1 x L-1) agreed well with the value assigned by the
      National Institute of Standards and Technology (4.359 mmol.g-1 x L-1). Within-run
      and total CVs were 0.56% and 0.78%, respectively. Therefore the performance of
      this procedure is sufficiently good to allow its use as a candidate reference
      method for serum cholesterol determination.

PMID- 8353945
TI  - Calcium determination in serum with stable alkaline Arsenazo III and triglyceride
      clearing.
AB  - We describe an analytical procedure for determining serum calcium, using the
      ligand Arsenazo III in an aqueous alkaline medium. The choice of pH for the
      proposed technique differs from current procedures, which are for the most part
      carried out in a slightly acidic medium. An acidic medium avoids interference
      from magnesium, but is spectrophotometrically suboptimal for this pH-dependent
      reaction: the molar absorptivity of the Arsenazo III complex with calcium at acid
      pH is 13,787 L mol-1 cm-1, about one-half of that at a more optimal alkaline pH
      (26,574 L mol-1 cm-1). We have included a clearing technique in the reagent to
      avoid spectral aberrations from hypertriglyceridemic samples. alpha-Cyclodextrin
      absorbs the nonesterified fatty acids liberated from triglycerides by a microbial
      lipase. This modification may also be helpful for binding nonesterified fatty
      acids, which are known to interfere with calcium procedures by forming calcium
      soaps and thus preventing the reaction with intended ligands. The use of 8
      hydroxyquinoline sulfonate as the magnesium-masking agent facilitates the use of
      alkaline pH. The less-water-soluble alternative, 8-hydroxyquinoline, commonly
      used as a precipitating agent for several methods, is difficult to solubilize in
      the alkaline reagent and tends to precipitate when complexed to magnesium.
      Finally, the use of alkaline pH results in a prolonged (> or = 6 weeks) shelf
      life for the reagent.

PMID- 8353946
TI  - Creatine measurement in serum and urine with an automated enzymatic method.
AB  - I describe an automated enzymatic procedure to quantitate creatine in both serum
      and urine. In this assay, which requires no pretreatment of the sample, creatine
      kinase (CK; EC 2.7.3.2) and pyruvate kinase (EC 2.1.7.40) are used as auxiliary
      enzymes and lactate dehydrogenase (EC 1.1.1.27) is used in the indicator
      reaction. CK is also used as the starting reagent. Data obtained with the present
      method for creatine measurement in serum were compared with those from the Jaffe
      method and an enzymatic method: y = 1.13x - 7.58, SE = 4.48, and r = 0.925
      (Jaffe); and y = 1.17x + 2.73, SE = 5.06, and r = 0.962 (enzymatic); for creatine
      measurement in urine: y = 0.63x + 39.74, SE = 296.7 and r = 0.719 (Jaffe). The
      present method provides improved precision: the total CVs for serum, determined
      by the present and comparative methods, respectively, were 3.5-8.9%, 8.2-43.0%,
      and 5.3-16%; for urine, the CVs were 3.3-5.1% and 9.6-21.2% for the present and
      comparative method, respectively. I established the normal reference interval as
      13-74 and 13-89 mumol/L for creatine in serum, and as 175-700 and 150-1200
      mumol/24 h for creatine in urine for men and women, respectively.

PMID- 8353947
TI  - Time-resolved immunofluorometric assay of human growth hormone.
AB  - We describe a time-resolved immunofluorometric assay (trIFMA) for human growth
      hormone (hGH), in which monoclonal antibody (mAb)-coated microtiter strip wells
      and a europium (Eu) chelate-labeled mAb are used. We compare the new trIFMA, in
      which two mAbs are used, with an immunoradiometric assay (IRMA) in which
      polyclonal antibodies are used. Serum samples (n = 185) from 36 children with
      various diagnoses were analyzed. In addition, 24-h profile samples (72 per child)
      from 39 children were analyzed. The trIFMA was more sensitive (detection limit,
      0.03 mIU/L) than existing IRMAs. Both the intra- and interassay CVs were < or =
      10.6% for hGH concentrations between 1 and 100 mIU/L. The trIFMA is technically
      simple and rapid, requires no centrifugation or separation reagent, and has a
      counting time of only 1 s per sample. In addition, the Eu label is nontoxic,
      presents no waste-disposal problems, and has a long shelf-life. Finally, the
      assay requires only small volumes of serum (25 muL), which is of considerable
      importance in pediatric use. The mAbs used for the trIFMA selectively bind the 22
      kDa form of hGH, with the result that the assay detects about 80% of the amount
      detected by the polyclonal IRMA.

PMID- 8353948
TI  - Europium-labeled oligonucleotides to detect point mutations: application to PIZ
      alpha 1-antitrypsin deficiency.
AB  - We describe a novel assay for detection of point mutations. The method combines
      the specificity and sensitivity of the polymerase chain reaction (PCR) and allele
      specific oligonucleotides (ASO) with highly sensitive time-resolved fluorometry.
      ASO probes differing by a single base substitution and labeled with europium (Eu)
      chelates were hybridized in solution simultaneously with a biotinylated oligomer
      to a PCR-amplified nucleic acid fragment. The hybrids formed were then collected
      onto streptavidin-coated microtitration wells. Subsequently, the hybrids were
      washed under stringent conditions and the remaining ASO probe was measured in a
      time-resolved fluorometer. We discuss the strategy underlying the design of the
      Eu-labeled ASO probes for the solution hybridization assay. The method was
      applied to the detection of the Z-mutation in the alpha 1-antitrypsin gene.
      Evaluation of whole-blood samples spotted on Guthrie cards demonstrated
      successful accuracy of the method.

PMID- 8353949
TI  - Profiles of very-long-chain fatty acids in plasma, fibroblasts, and blood cells
      in Zellweger syndrome, X-linked adrenoleukodystrophy, and rhizomelic
      chondrodysplasia punctata.
AB  - Profiles of saturated very-long-chain (> C22) fatty acids were studied in plasma,
      fibroblasts, erythrocytes, platelets, and leukocytes of patients affected by
      peroxisomal disorders such as Zellweger syndrome, X-linked adrenoleukodystrophy
      (X-ALD), and classic rhizomelic chondrodysplasia punctata (RCDP) and in controls.
      In Zellweger patients, the concentration of hexacosanoic acid (C26:0) and the
      C26:0/C22:0 ratio are greatly increased in plasma and fibroblasts. However, the
      plasma concentration of docosanoic acid (C22:0) is greatly decreased. Also in
      platelets, leukocytes, and to a lesser extent erythrocytes, the C26:0
      concentrations and both the C26:0/C22:0 and C24:0/C22:0 ratios are greatly
      increased. The C24:0/C22:0 ratio is significantly increased in plasma, platelets,
      and leukocytes, but not in erythrocytes. In X-ALD, the C26:0 concentration and
      the C26:0/C22:0 and C24:0/C22:0 ratios are significantly increased in plasma,
      fibroblasts, platelets, and leukocytes, but the erythrocytes show substantial
      overlap in the 5-90% ranges between controls and patients. In RCDP, slightly
      increased C26:0 and C26:0/C22:0 ratios are found in erythrocytes, platelets, and
      leukocytes, but not in plasma and fibroblasts. We conclude that plasma and
      fibroblasts are the specimens of choice for biochemical diagnosis of Zellweger
      syndrome and X-ALD, respectively. The slight increase in C26:0 in blood cells of
      RCDP patients suggests a decreased flux of very-long-chain fatty acids through
      the peroxisomal beta-oxidation pathway in liver in this genetic disorder.

PMID- 8353950
TI  - Comparison of quality-control rules used in clinical chemistry laboratories.
AB  - Numerous papers have been written to show which combinations of Shewhart-type
      quality-control charts are optimal for detecting systematic shifts in the mean
      response of a process, increases in the random error of a process, and linear
      drift effects in the mean response across the assay batch. One paper by Westgard
      et al. (Clin Chem 1977;23:1857-67) especially seems to have attracted the
      attention of users. Here we derive detailed results that enable the
      characteristics of the various Shewhart-type control schemes, including the
      multirule scheme (Clin Chem 1981;27:493-501), to be calculated and show that a
      fundamental formula proposed by Westgard et al. in the earlier paper is in error,
      although their derived results are not seriously wrong. We also show that, from a
      practical point of view, a suitably chosen Cusum scheme is near optimal for all
      the types and combinations of errors discussed, thereby removing the selection
      problem for the user.

PMID- 8353951
TI  - Trace elements determined along single strands of hair by inductively coupled
      plasma mass spectrometry.
AB  - Flow injection-inductively coupled plasma mass spectrometry has been evaluated
      for determining the distribution profile of trace elements along a single strand
      of hair. Hair was cut into several mm long sections from follicle to the distal
      end. Each section was solubilized in a capped 1.5-mL polypropylene tube with
      small volume of nitric acid (typically 50 microL) at room temperature. After
      dilution an aliquot (50 microL) was introduced into the mass spectrometer by flow
      injection. The limit of determination was typically 5-50 pg with 5-10% precision
      (CV), depending on the element examined; this corresponds to sub-microgram/g
      concentrations of these elements in hair segments. Recent exposure and intake
      history of individuals to thallium or mercury could be reconstructed by this
      system.

PMID- 8353952
TI  - Determination of clozapine, norclozapine, and clozapine-N-oxide in serum by
      liquid chromatography.
AB  - We report a new assay to measure the serum concentrations of the atypical
      antipsychotic drug clozapine and two major metabolites, norclozapine and
      clozapine-N-oxide. The analytes and an internal standard (triprolidine) were
      extracted from alkalinized samples into ethyl acetate and back-extracted into 0.1
      mol/L HCl. The acid extracts were chromatographed on a reversed-phase liquid
      chromatographic column with photodiode array detection (210-340 nm). With the 254
      nm signal, between-run imprecision (CV) was < 2% for clozapine and norclozapine
      at 400 micrograms/L, and 4.1% for clozapine-N-oxide at 100 micrograms/L. Absolute
      recovery exceeded 65%, and the detection limit was approximately 3-4
      micrograms/L. In 25 patients at steady state at a mean daily clozapine dosage of
      269 mg (3.09 mg/kg), clozapine averaged 231 +/- 144 micrograms/L (mean +/- SD);
      norclozapine and clozapine-N-oxide concentrations averaged 84% and 23% that of
      clozapine. Analyte concentrations were significantly correlated with daily dose.
      The method's ability to quantify clozapine and two major metabolites
      simultaneously with precision and sensitivity makes it useful in pharmacokinetic
      studies and therapeutic monitoring.

PMID- 8353953
TI  - Free thyroxine assessed with three assays in sera of patients with nonthyroidal
      illness and of subjects with abnormal concentrations of thyroxine-binding
      proteins.
AB  - Three methods for estimating free thyroxine (FT4) in serum were studied:
      equilibrium dialysis, the SPAC-ET FT4 radioimmunoassay kit, and the Amerlite MAB
      FT4 luminometric assay. Serum samples from 10 subjects with above-normal
      thyroxine-binding globulin (TBG), 6 with low TBG, 30 with familial dysalbuminemic
      hyperthyroxinemia (FDH), 13 with nonesterified fatty acids (NEFA) concentrations
      in serum > 1.0 mmol/L, and 178 patients with various degrees of nonthyroidal
      illness (NTI) were measured and compared with samples from 42 euthyroid blood
      donors. The Amerlite MAB FT4 assay compared well with equilibrium dialysis,
      whereas the SPAC-ET assay averaged 40% lower. All three assays were not
      influenced by changes in TBG and showed no or only little changes in the presence
      of NEFA. Mean FT4 values in the FDH samples were somewhat higher than in controls
      when measured with the SPAC-ET assay, about equal with equilibrium dialysis, and
      somewhat below the mean control value with the Amerlite MAB FT4 assay, although
      individual results were within the control reference range. In NTI patients, no
      FT4 values were below the control reference range by the Amerlite MAB FT4 assay,
      4 of 178 were below this range by equilibrium dialysis, and 1 of 178 was below
      this range by the SPAC-ET assay. In all assays a large proportion of the NTI
      samples showed FT4 values above the control reference range, a result that will
      interfere with the efficacy of these assays for assessing thyroid function in NTI
      patients.

PMID- 8353954
TI  - Platelet-poor plasma serotonin in normal and preeclamptic pregnancy.
AB  - We determined serotonin concentrations in platelet-poor plasma (PPP) from 11
      preeclamptic pregnant women and 11 normal pregnant women by HPLC with
      electrochemical detection after a concentration step. Serotonin concentrations in
      PPP are very low in comparison with those in platelets, so it is very important
      to avoid in vitro release of serotonin from platelets. We therefore investigated
      three types of anticoagulants, the method of blood sampling, and the influence of
      whether the first or second 10 mL of blood is assayed. The type of anticoagulant
      proved to be important, K3-EDTA giving the best results. The serotonin
      concentrations in PPP from the preeclamptic pregnant women were significantly
      higher (P = 0.0001) than in the normal pregnant women: mean values +/- SD were
      27.0 +/- 13.5 and 2.8 +/- 1.4 nmol/L, respectively. We suggest that the
      measurement of serotonin in PPP might be helpful in study of the role of
      serotonin in the development of preeclampsia.

PMID- 8353955
TI  - Estimation of plasma and urinary hemoglobin by a rate spectrophotometric method.
AB  - A method is described for estimating plasma and urinary hemoglobin concentrations
      as low as 3 mg/L. The assay measures at 528 nm the rate of peroxidation of
      chlorpromazine by hemoglobin and is not affected by ascorbate and bilirubin
      concentrations up to 500 mumol/L. Results by this method (mean +/- SD: 54.4 +/-
      41.6 mg/L; n = 19) correlated well with those by a scanning spectrophotometric
      method (52.5 +/- 41.6 mg/L; r = 0.96) and a Coulter Instrument method (r = 0.99;
      Coulter method: 125 +/- 15 g/L; rate method: 122 +/- 15 g/L; n = 10, r = 0.99).
      The correlation for assays of 20 plasma samples by our method and a
      tetramethylbenzidine method was also good (r = 0.95) though the latter gave lower
      results (31.1 +/- 31.6 mg/L) than the chlorpromazine method (50.9 +/- 41.1 mg/L).
      The chlorpromazine rate method gave an intra- and interday CV of 7.9% and 9.7%,
      respectively, at a hemoglobin concentration of 31 mg/L.

PMID- 8353956
TI  - Fast, manual, nonradioactive method for DNA sequencing.
AB  - We describe a protocol that allows nonradioactive detection of sequencing
      products after manual, direct, solid-phase sequencing of polymerase chain
      reaction-amplified DNA. The amplified DNA fragment to be studied is biotinylated
      at the 5' end of one of the two oligonucleotide primers used for amplification,
      allowing coupling to streptavidin-coated magnetic beads. The immobilized double
      stranded DNA is then separated into single strands by alkaline treatment. A 5'
      biotinylated sequencing primer is used after saturating with a biotin solution
      any possible remaining affinity sites on the streptavidin-coated magnetic beads.
      Sequencing is performed by using T7 DNA polymerase, and the sequencing products
      are electrophoresed in denaturing polyacrylamide sequencing gel. After transfer
      of the products to a nylon membrane, the sequencing pattern is revealed by
      chemiluminescence. Biotinylated alkaline phosphatase is bound to the 5' end of
      the sequencing primer via a streptavidin bridge and catalyzes the reaction by
      cleaving a phosphate group from a chemiluminescent substrate. The emitted photons
      are detected by exposing the membrane to x-ray film. This method is simple,
      rapid, and consistently successful and reproducible.

PMID- 8353957
TI  - Rapid multicomponent analysis of hemoglobin derivatives for controlled antidotal
      use of methemoglobin-forming agents in cyanide poisoning.
AB  - When cyanide poisoning is treated with a methemoglobin-forming agent, oxidative
      metabolism is protected at the expense of the oxygen capacity of the blood. The
      affinity of methemoglobin for CN- is high enough to compete with cytochrome
      oxidase, which protects the latter from becoming blocked, but all hemoglobin used
      for this purpose is lost for the transport of oxygen. Therefore, the fractions of
      the various hemoglobin derivatives present in the blood should be carefully
      monitored during this kind of treatment. After we had developed a multiwavelength
      spectrophotometric method for this purpose, we studied the feasibility of using a
      modified commercial six-wavelength hemoglobin photometer (Radiometer OSM3) for
      easy and rapid analysis of methemoglobin and methemoglobin cyanide in small
      samples of blood. All conditions appeared to be fulfilled for the construction of
      a practical multiwavelength photometer for reliably monitoring methemoglobin
      therapy in patients with cyanide poisoning, even in the presence of
      carboxyhemoglobin, as often occurs in fire victims.

PMID- 8353958
TI  - A method to quantify deviations from assay linearity.
AB  - We present a statistical method to quantify deviations from linearity for assays
      that veer from linear assay responses. Our procedure handles the common case of
      unequally spaced analyte levels and nonconstant variance and provides a least
      squares estimate with a confidence interval for the amount of deviation from
      assay linearity at a specified analyte concentration. This estimate of assay bias
      due to nonlinearity goes beyond the NCCLS EP6 lack-of-fit test, which tests for
      only the presence of nonlinearity. Knowing that nonlinearity is present is
      insufficient; users need to know the magnitude of the bias caused by
      nonlinearity. Our method can also be used with multifactor designs that estimate
      other systematic assay effects such as drift and carryover, thus obviating the
      need for a separate protocol to assess linearity. The procedure is carried out by
      adding extra columns to the design matrix corresponding to the concentration
      level(s) of interest. The extra columns, which replace the quadratic column, are
      orthogonal to all other columns. We describe a general method of constructing the
      new columns, and illustrate the procedure with a manual ammonia assay example
      dataset from EP6.

PMID- 8353959
TI  - Measurement of carboxyhemoglobin and total hemoglobin by five specialized
      spectrophotometers (CO-oximeters) in comparison with reference methods.
AB  - We measured total hemoglobin (CtHb) and carboxyhemoglobin (COHb) in 100 patients'
      blood samples by using five specialized spectrophotometers (CO-oximeters)--IL 482
      CO-Oximeter, Corning 2500 CO-oximeter, Radiometer OSM 3 Hemoximeter, Corning 270
      CO-oximeter, and the AVL 912 CO-Oxylite--and compared the results with those
      obtained with the manual cyanmethemoglobin method and a gas-chromatographic (GC)
      method, respectively. For the CtHb measurements, the differences between the
      cyanmethemoglobin method and the CO-oximeters were not clinically important for
      any model. For the blood COHb measurements, the direction of the bias relative to
      GC was dependent on COHb concentration. In general, the CO-oximeters
      underestimated COHb concentration for COHb > 2.5% of total hemoglobin but
      overestimated COHb concentration for COHb < or = 2.5%. We conclude that all five
      CO-oximeters compared favorably with the reference methods for CtHb and for high
      concentrations of COHb. However, the inaccuracy of CO-oximeters for low
      concentration (< or = 2.5%) COHb measurements may make these instruments
      unsuitable for some applications.

PMID- 8353960
TI  - Latex agglutination test for detecting antibodies to Treponema pallidum.
AB  - We have developed an automated latex agglutination test for Treponema pallidum
      (TPLA) for measurement of the concentration of treponemal antibodies in
      syphilitic sera. The assay needs neither a complicated pretreatment of the sera
      nor special techniques. Intra- and interassay precision studies showed high
      reproducibility. Potentially interfering substances, such as bilirubin,
      hemoglobin, triglycerides, and rheumatoid factor, did not affect the results. The
      results obtained with the TPLA test showed a strong correlation with those from
      conventional methods. This test for antibodies to T. pallidum may be useful for
      the mass screening of syphilitic infections.

PMID- 8353961
TI  - Evaluation of evacuated blood-collection tubes: effects of three types of
      polymeric separators on therapeutic drug-monitoring specimens.
AB  - The potential of three types of separator materials found in conventional blood
      collection tubes for interference in therapeutic drug measurements was assessed.
      None of the separators (based on acrylic, silicone, or polyester polymers) had
      any significant effect on the concentrations of seven drugs (theophylline,
      digoxin, phenytoin, phenobarbital, gentamicin, ethanol, and cyclosporine) in
      blood specimens that were processed and analyzed promptly. Storage of specimens
      for 24 h resulted in an average 2.4% increase in theophylline values in specimens
      collected in tubes with the acrylic separator (P = 0.024); an average 8.1%
      decrease in phenytoin in specimens collected in tubes with the polyester-based
      separator (P < 0.001); and an average 4.2% decrease in phenobarbital in specimens
      collected in tubes with the polyester-based separator (P = 0.02). All other drug
      concentrations were not significantly affected. A small decrease in phenytoin
      (7.9%; P < 0.01) was seen when the specimen volume in 7-mL tubes containing
      polyester-based separator was reduced to 1.0 mL; all other drug concentrations
      were unaffected by partial filling of tubes. Paired blood specimens from
      pediatric patients, when collected in plain tubes and tubes containing acrylic
      separator, yielded no significant differences for theophylline, digoxin,
      tobramycin, phenytoin, or phenobarbital concentrations. The three commercially
      available separators had only small effects on therapeutic drug concentrations,
      and a newly developed separator based on an acrylic resin was suitably inert.

PMID- 8353962
TI  - Within- and between-subject biological variations of follitropin, lutropin,
      testosterone, and sex-hormone-binding globulin in men.
AB  - The within-subject and between-subject biological variation of the serum
      concentrations of follitropin, lutropin, sex-hormone-binding globulin, and
      testosterone; the ratio between the serum concentrations of testosterone and sex
      hormone-binding globulin; and the concentration of testosterone in saliva have
      been studied in a group of 20 men during 12 months. The between-subject
      coefficients of variation (CVs) were 36.0% for follitropin, 37.0% for lutropin,
      42.7% for sex-hormone-binding globulin, 21.3% for testosterone in serum, 28.8%
      for testosterone in saliva, and 51.6% for the ratio between serum concentrations
      of testosterone and sex-hormone-binding globulin. The medians of the within
      subject CVs for the respective analyses and ratio were 17.3%, 24.0%, 12.1%,
      10.9%, 17.3%, and 9.4%. These data were used to calculate the desirable
      imprecision, the critical difference for significant change detection, and the
      index of individuality.

PMID- 8353963
TI  - Early diagnosis of acute myocardial infarction with use of a rapid immunochemical
      assay of creatine kinase MB isoenzyme.
AB  - In 195 patients presenting with chest pain and referred acutely for cardiological
      assessment, blood was taken immediately for assay of creatine kinase (CK; EC
      2.7.3.2) MB isoenzyme by an immunochemical method and results [mass units of
      enzyme per liter of plasma (microgram/L)] were obtained within 30 min of
      sampling. Diagnosis of acute myocardial infarction in the patients was made
      independently, based on electrocardiograms and conventional cardiac enzyme
      profiles. The administration of any thrombolytic therapy in response to the CK-MB
      concentration result was also noted, allowing assessment of the assay's potential
      influence on patient management in addition to the diagnostic efficiency
      evaluation. The study demonstrated that, when blood samples were collected on
      admission to hospital and the decision level suggested by the manufacturers was
      utilized, the assay had an immediate sensitivity of 52% and a specificity of 97%.
      Of the 81 patients who were shown by conventional means to have had acute
      myocardial infarction, 8 (10%) had equivocal electrocardiograms but positive CK
      MB concentration results. In four of these patients (5%), thrombolytic therapy
      was given on the basis of the clinical features and a positive CK-MB
      concentration result alone.

PMID- 8353964
TI  - Primary aldosteronism in a patient with an aldosterone-producing adenoma.
AB  - We describe an unusual patient presenting with a history of refractory
      hypertension and hypokalemia. Initial screening tests for adrenal hypertension
      were consistent with primary aldosteronism and an abdominal computed tomography
      scan showed an 8-mm left adrenal mass. However, adrenal venous sampling revealed
      markedly suppressed plasma aldosterone in the left adrenal vein but increased
      plasma aldosterone in the right adrenal vein. Therefore, on the basis of the
      clinical, radiographic, and laboratory findings, we concluded that the patient
      had a nonfunctioning adrenocortical adenoma on the left and an aldosterone
      producing adrenocortical adenoma on the right, with the aldosteronoma resulting
      in hypertension and hypokalemia. Right adrenalectomy decreased the hypertension
      and corrected the hypokalemia. The right adrenal contained a 7-mm nodule
      microscopically consistent with the diagnosis of a cortical adenoma. The case
      highlights key steps and potential pitfalls in the evaluation of adrenal
      hypertension.

PMID- 8353965
TI  - Interference of polyclonal free light chains with identification of Bence Jones
      proteins.
AB  - We present a case in which kappa free light chains caused difficulty in
      interpreting classical urinary immunoelectrophoresis, but immunofixation
      electrophoresis (IFE) demonstrated the presence of a lambda-Bence Jones protein.
      Analysis of the urine by Ouchterlony double diffusion and IFE after gel
      filtration chromatography showed that the difficulty was caused by the presence
      of large amounts of polyclonal free light chains. The workup also demonstrated
      that although IFE is the more sensitive and specific technique, IFE performed on
      concentrated urinary samples is especially subject to misinterpretation unless
      densely staining patterns are diluted and reassayed. This process of sample
      dilution provides a means for titrating antigen and antibody concentrations such
      that condition-specific patterns become visible on the gel. This workup also
      shows that, at some dilutions, polyclonal free light chains may migrate in the
      same manner as an oligoclonal band in a so-called ladder configuration. These
      bands were observed from both monomeric and dimeric fractions isolated by gel
      chromatography, consistent with reports that this pattern is largely linked to
      the isoelectric points of the molecules. We speculate that, in rare instances,
      the distinction between polyclonal and monoclonal kappa free light chains
      migrating as a ladder-banding pattern may be equivocal.

PMID- 8353966
TI  - Factitious hyperthyroxinemia due to a monoclonal IgA in a case of multiple
      myeloma.
AB  - A clinically euthyroid 53-year-old woman with an IgA-lambda-secreting multiple
      myeloma presented with increased serum concentrations of thyroid hormones.
      Laboratory studies revealed increased total thyroxine (T4) and triiodothyronine
      (T3) concentrations, a high-normal free T4 concentration, and a normal basal
      thyrotropin (TSH) concentration with a normal response to thyroliberin (TRH). Her
      serum concentration of IgA was 11,040 mg/L (normal range 900-4500 mg/L) and
      immunoelectrophoresis revealed it to be monoclonal. This monoclonal IgA bound
      both T4 and T3, as determined by serum immunoelectrophoresis and direct binding
      studies. Immunoelectrophoresis in the presence of [125I]T4 or [125I]T3 localized
      the radiolabeled iodothyronines to a band corresponding exactly to the precipitin
      arc of the monoclonal IgA. We performed direct binding studies with IgA purified
      by affinity chromatography with the lectin jacalin. Purified IgA (50 micrograms)
      bound both [125I]T4 (12.3%) and [125I]T3 (2.7%) specifically and in a dose
      dependent manner. Scatchard analysis of competitive-binding data utilizing
      [125I]T4 and unlabeled T4 revealed a Kd of 2.2 x 10(-7) mol/L. The binding
      capacity for T4 was approximately 7 mumol/L. Thus, in this case of IgA-secreting
      myeloma, the monoclonal IgA acts as an additional thyroid hormone-binding protein
      in serum that interferes in the T4 and T3 RIAs. This is the first report of a
      monoclonal IgA producing an apparent euthyroid hyperthyroxinemia.

PMID- 8353967
TI  - Stability of vitamin A circulating complex in spots of dried serum samples
      absorbed onto filter paper.

PMID- 8353968
TI  - Radioimmunoassay for a new bone resorption marker and results for pediatric
      subjects.

PMID- 8353969
TI  - Low-density lipoprotein particle size in familial hypercholesterolemia.

PMID- 8353970
TI  - Improved correlation of sweat chloride quantification by the CF Indicator System
      and the Gibson-Cooke Sweat Test.

PMID- 8353971
TI  - Free thyroxine measured by the Ciba Corning ACS-180 on samples from patients with
      familial dysalbuminemic hyperthyroxinemia.

PMID- 8353972
TI  - Fluoxetine, an antidepressant, and norfluoxetine, its metabolite, determined by
      HPLC with a C8 column and ultraviolet detection.

PMID- 8353973
TI  - Immunobilization of barley oxalate oxidase onto alkylamine glass for determining
      urinary oxalate.

PMID- 8353974
TI  - Cysteine proteinase activity in synovial fluids measured with a centrifugal
      analyzer.

PMID- 8353975
TI  - Xylose, anti-gliadin, and anti-endomysium antibodies in adult celiac disease.

PMID- 8353976
TI  - Ethylene glycol, glycolic acid, and metabolic acidosis of unknown origin.

PMID- 8353977
TI  - Choice of anticoagulant affects measurement of plasma fibrinogen.

PMID- 8353978
TI  - Lipid factors as predictors of coronary disease.

PMID- 8353979
TI  - Lack of immunosuppressive effect of low-dose oral methotrexate on lymphocytes in
      rheumatoid arthritis.
AB  - Whether methotrexate (MTX) is effective in rheumatoid arthritis (RA) because of
      immunosuppressive and/or anti-inflammatory mechanisms of action is controversial.
      Many lines of investigation point to the latter. We evaluated DNA synthesis in
      peripheral blood lymphocytes (PBL) from 33 RA patients on oral MTX (7.5-15 mg/wk)
      and in 30 healthy controls by flow cytometric cell cycle analysis (CCA). DNA
      synthesis was also evaluated with a thymidilate synthetase activity assay (TSA)
      (3H-deoxyuridine incorporation) in 12 patients and 21 controls (12 on MTX and
      NSAID, and 9 healthy subjects). The patients had taken MTX for at least 3 months
      and were in different stages of clinical activity. There were no significant
      differences in TSA or in the cell cycle phase distributions (especially the S
      phase) between treated RA patients and controls. These data suggest that low-dose
      oral MTX does not inhibit DNA synthesis and therefore does not have an
      immunosuppressive effect on lymphocytes from patients with RA.

PMID- 8353980
TI  - Selective suppression of resting B cell function in patients with systemic lupus
      erythematosus treated with cyclophosphamide.
AB  - The immunological function of patients with inactive systemic lupus erythematosus
      (SLE) receiving chronically administered, low-dose cyclophosphamide (CY) together
      with prednisolone (PSL) was compared with that of inactive patients receiving PSL
      alone. A striking selective suppression of "genuine" resting, but not "partially"
      or "fully" activated, B cell function was noted in the patients receiving PSL +
      CY as measured by Staphylococcus aureus Cowan I (SAC)-induced proliferative
      responses by Percoll-separated small resting B cells of high density; the small
      resting B cells sedimenting in a high density fraction were more responsive to
      SAC in patients treated with PSL alone than those in normal controls. However,
      the spontaneous proliferation and spontaneous secretion of immunoglobulins by
      peripheral blood B cells were elevated in both the patient groups. The
      proliferative responses to phytohaemagglutinin and concanavalin A by T cells were
      not significantly different between both patient groups. The data indicate that
      the genuine resting B cells may be the major target for the CY effect in SLE, and
      thus such selective suppression may help explain the efficacy of CY and PSL
      together in treating SLE.

PMID- 8353981
TI  - Copper and zinc status in rheumatoid arthritis: studies of plasma, erythrocytes,
      and urine, and their relationship to disease activity markers and pharmacological
      treatment.
AB  - We studied the status of copper and zinc in rheumatoid arthritis (RA). The aims
      of the work were to ascertain whether or not RA is associated with copper and/or
      zinc deficiency, to establish the relationship between these trace metals and the
      main biohumoral and clinical indices of the disease, and to examine the effect on
      copper and zinc of the drugs normally used by RA patients. Metal levels were
      measured by atomic absorption spectroscopy in the plasma, whole blood cells and
      24 hr urine of 120 RA patients; 70 patients suffering from primary osteoarthritis
      were used as the control group. In the plasma of RA patients copper and
      ceruloplasmin levels were found to be significantly increased whereas zinc levels
      were significantly decreased. No major variations were observed in the blood cell
      and 24 hr urine copper and zinc levels. Plasma copper was significantly
      correlated with some of the biohumoral markers of RA, but did not correlate with
      any of the clinical indices of the disease. Plasma zinc was significantly
      correlated with numerous of the biohumoral as well as clinical markers of RA.
      With the exception of an increased urinary excretion of copper in D-penicillamine
      treated RA patients, drug therapy did not influence the copper status in RA.
      Conversely, plasma zinc was found to be lower in RA patients taking NSAIDs and/or
      steroids. These results suggest the following conclusions: i) RA patients do not
      seem to be deficient in either copper or zinc; ii) plasma copper appears to be a
      poor index of RA severity; iii) plasma zinc could have some practical value in
      defining the overall severity of the disease.

PMID- 8353982
TI  - Intravenous and oral cyclophosphamide pulse therapy in rheumatic diseases: side
      effects and complications.
AB  - Twenty five patients (12 with systemic lupus erythematosus, 6 with Wegener's
      granulomatosis, and 7 with miscellaneous rheumatic diseases) who had been on
      intravenous or oral cyclophosphamide pulse therapy for more than 3 months were
      evaluated for safety of treatment. Side effects were reported by 20 patients
      (80%), mainly nausea (17 patients, 68%). Complications were observed in 13
      patients (52%), of whom 6 had severe infections (24%). Oral cyclophosphamide
      given in repeated low dose pulses (5 mg/kg for 3 consecutive days) is better
      tolerated with regard to nausea than intravenous administration. The use of
      cyclophosphamide therapy is recommended in patients with disease that does not
      respond to conventional regimens, although the attending physician should be
      aware that infections may appear at any time during treatment, and effective
      prophylaxis against nausea is required.

PMID- 8353983
TI  - Multicenter study of the safety/efficacy of misoprostol in the prevention and
      treatment of NSAID-induced gastroduodenal lesions.
AB  - Gastrointestinal symptoms and lesions are often associated with the clinical use
      of non-steroidal antiinflammatory drugs (NSAIDs). An open-label, single arm
      multicenter Italian study evaluated if misoprostol, a prostaglandin E1 analogue
      with gastroduodenal mucosal protective activity, was effective in the prevention
      and treatment of NSAID-induced gastroduodenal lesions. Patients affected by
      rheumatoid arthritis (RA) or osteoarthritis (OA), in treatment with NSAIDs and
      suffering from gastric symptoms or gastroduodenal lesions related to NSAID use,
      were admitted to the study. Gastrointestinal and arthritic symptoms were assessed
      before and after 4 weeks co-administration of an NSAID (the most frequent was
      diclofenac, used in 35% of the RA and in 22% of the OA patients, followed by
      piroxicam and tenoxicam respectively) + misoprostol (200 mcg two times daily in
      58% of the cases, 200 mcg three times daily in 39%, 200 mcg four times daily in
      3%). On admission and after 4 weeks of therapy a gastrointestinal endoscopy was
      performed to evaluate the condition of the gastroduodenal mucosa. Final results
      showed that: (i) NSAID-related gastric lesions were more frequent than duodenal
      lesions; (ii) when patients were given misoprostol and NSAIDs, 96% of them did
      not develop gastric lesions and 97% did not develop duodenal lesions; (iii) even
      when NSAID therapy was continued, gastric or duodenal lesions induced by NSAIDs
      healed or in any case did not worsen in 92% and 91% respectively of the cases;
      (iv) during the period of coadministration of NSAIDs+misoprostol, NSAID-related
      UGI symptoms disappeared or improved in 77% of the cases.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8353984
TI  - Functional characterization of T cells bearing the gamma/delta T-cell receptor in
      patients with primary Sjogren's syndrome.
AB  - High percentages of gamma/delta+ T cells in the peripheral blood of a subgroup of
      patients with primary Sjogren's syndrome (SS) were found. This allowed us to
      purify and analyze them without their being previously expanded in vitro, and to
      investigate, therefore, the role of these cells in the pathological immune
      response which characterizes such systemic autoimmune disorders. The results
      showed poor proliferation of patient gamma/delta+ T cells in response to anti
      CD3, due not to macrophage-dependent suppression but to defective interleukin 2
      (IL-2) synthesis. Despite the defective proliferation patient gamma/delta+ cells,
      unlike those of the normal controls, provided a helper effect in inducing B cells
      to secrete immunoglobulins (Ig), particularly when they were preincubated with IL
      2. The relative increase in a gamma/delta+ T cell subset which, although it
      secretes low levels of IL-2, is able to provide help for B-cell Ig synthesis,
      suggests that this T-cell subpopulation may be functional in vivo and may be
      involved in the pathological immune response encountered in pSS.

PMID- 8353985
TI  - Effect of antimicrobial treatment on chronic reactive arthritis.
AB  - In a double-blind study comprising 36 patients the effect of a three-month course
      of ciprofloxacin on chronic reactive arthritis was evaluated. At the end of the
      follow-up period 6 months after stopping the therapy, arthralgia, pain at
      movement and morning stiffness had decreased significantly compared to the values
      before the treatment in the ciprofloxacin group, whereas the Ritchie index and
      ESR showed a significant decrease in the control group. We conclude that further
      studies are necessary before the value of prolonged ciprofloxacin treatment of
      chronic reactive arthritis can be established.

PMID- 8353986
TI  - Increased prevalence of antibodies to adenovirus and respiratory syncytial virus
      in polymyalgia rheumatica.
AB  - Serum antibodies to a panel of 13 viruses and to Mycoplasma pneumoniae and
      Chlamydia psittaci were tested in 17 patients with polymyalgia rheumatica (PMR)
      and in 17 age- and sex-matched controls with osteoarthritis seen in the same
      rheumatological clinic. Antibodies to adenovirus (ADV) and respiratory syncytial
      virus (RSV) were significantly more prevalent in PMR. These antibodies were
      titred in 26 patients with PMR, including those evaluated in the pilot study (17
      women, 9 men, mean age 72.5 years), and in 26 controls. 25/26 PMR patients tested
      positive for antibodies to ADV vs. 12/26 controls (p = 0.0002) and the
      concentration was higher in patients than in controls (p < 0.01). Antibodies to
      RSV were present in all PMR patients and in 12/26 controls (p = 0.00005) and
      their concentration was higher in patients than in controls (p < 0.01). Serial
      determinations performed in 18 PMR patients showed that the antibody titer did
      not change significantly. These data suggest that a trivial infection may trigger
      PMR in elderly people, with ADV and RSV among the possible microorganisms
      involved.

PMID- 8353987
TI  - Geographic distribution of calcium pyrophosphate (CPPD) deposition disease in pre
      Columbian North America: independent validation of CPPD criteria.
AB  - Calcium pyrophosphate deposition disease (CPPD), a form of crystalline arthritis,
      has a unique distribution in the Early to Middle Archaic Periods (3000 to 8000
      years before the present) of North America, contrasting with the generalized
      geographic distribution of osteoarthritis. Incursion of CPPD into specific
      regions suggests possible migration patterns. The disparate geographic
      distribution of CPPD and osteoarthritis provide independent verification of the
      validity of diagnostic criteria utilized for the identification of CPPD.

PMID- 8353988
TI  - Nerve growth factor and mast cell distribution in the skin of patients with
      systemic sclerosis.
AB  - Nerve growth factor (NGF), a well-characterized neurotrophic factor, induces an
      increase in the number of mast cells (MCs) in the peripheral tissues of
      developing rats, as well as histamine release in fully differentiated MCs. Since
      MCs increase in the dermis of patients with early systemic sclerosis (SSc), we
      examined the distribution of NGF in the skin of patients affected by SSc.
      Immunohistochemical studies showed that NGF distribution was more intense in the
      dermis of patients with SSc than in the skin of controls. A possible correlation
      between MCs and NGF in disease activity is hypothesized.

PMID- 8353989
TI  - Lupus psychosis: differentiation from the steroid-induced state.
AB  - Steroid induced psychosis in SLE is rare but clinically important, and often
      difficult to distinguish from lupus cerebritis. We report a patient with SLE who
      became depressed following an increase in her steroid dosage. Based on her
      clinical presentation and high levels of antibodies to P ribosomal proteins (both
      in CSF and serum) a diagnosis of lupus cerebritis was made. Steroid dosage, time
      intervals, and the duration of mental changes may help in differentiating steroid
      psychosis from lupus cerebritis. No single laboratory test sufficient to
      establish a definitive diagnosis of lupus cerebritis is available at the present
      time. However, elevated levels of antibodies to P ribosomal proteins may assist
      in confirming the diagnosis of this condition.

PMID- 8353990
TI  - Expansion of gut associated immunoglobulin A secreting lymphocytes in rheumatoid
      arthritis correlates with high levels of serum IgA.
AB  - We report the emergence of polyclonal expansion of gut lymphocyte associated
      tissues producing IgA in a patient with rheumatoid arthritis associated with a
      high serum IgA concentration. The role of IgA in rheumatoid arthritis is
      reviewed.

PMID- 8353991
TI  - Normal levels of soluble CD4 in sera from patients with juvenile chronic
      arthritis.
AB  - Sera from a group of patients with juvenile chronic arthritis (JCA) were tested
      for soluble CD4 (sCD4). In most cases normal levels of the molecule were detected
      independent of disease activity. Similar results were obtained when sera from a
      population of adult rheumatoid arthritis (RA) patients were analyzed.
      Immunophenotypic studies of circulating mononuclear cells from seven JCA patients
      with active disease showed that T cells did not express activation markers.
      Finally, preliminary experiments showed that sCD4 levels were high in the
      synovial fluids from 3 RA patients as compared with paired serum determinations.

PMID- 8353992
TI  - Coexistence of human immunodeficiency virus type 2 (HIV2) and rheumatoid
      arthritis.

PMID- 8353993
TI  - Methotrexate in juvenile chronic arthritis.

PMID- 8353994
TI  - Red blood cell and platelet autoantibodies in scleroderma.

PMID- 8353995
TI  - Comparison of a fluorometric test with the standard ELISA assay for the detection
      of anticardiolipin antibodies.

PMID- 8353996
TI  - Cryoglobulinemia related to hepatitis C virus infection in patients with human
      immunodeficiency virus infection.

PMID- 8353997
TI  - Raised IgA kappa/lambda ratio in juvenile chronic arthritis.

PMID- 8353998
TI  - Erythrocyte binding of antiphospholipid antibodies.

PMID- 8353999
TI  - T cell-targeted immunotherapy in murine collagen-induced arthritis.
AB  - Counteracting the effect of autoimmunity can be achieved by elimination or
      inactivation of autoreactive T cells. We have focused on two approaches targeting
      on autoaggressive T cells in the model of collagen-induced arthritis (CIA) in
      mice. First, type II collagen (CII) primed DBA/1 mice were treated with various
      monoclonal antibodies (mAb) specific for the beta chains of the T cell receptor
      (TCR) using a protocol resulting in a long-term elimination of the target T
      cells. Indeed, CIA could be suppressed by injection of anti-V beta 8.1, 2 mAb and
      down-regulated by that of anti-V beta 2 and/or anti-V beta 5, presumably by
      deleting pathogenic T cell clones. In contrast, treatment with either anti-V beta
      6 or anti-V beta 11 mAb did not alter CIA. Second, we generated CII-specific T
      cell hybrid clones that recognize the antigenic peptides in association with Kq
      and IA(q) molecules respectively for CD8+ and CD4+ cells. Vaccination with the
      irradiated hybrid clones, 3 weeks prior to immunization, was effective in
      preventing the development of arthritis. Furthermore, this suppression was
      antigen and disease specific. Most importantly, one CD8+ clone could reverse the
      ongoing disease. These new therapeutic approaches derived from animal models may
      offer a hope of more selective interventions for the treatment of human
      autoimmune diseases.

PMID- 8354000
TI  - Systemic vasculitis.
AB  - The systemic vasculitides are comparatively rare but important disorders of
      childhood. Apart from Henoch-Schonlein purpura, which is the commonest example in
      paediatric practice, Kawasaki disease is most often encountered. Polyarteritis
      and Wagener's granulomatosis have a lower incidence but are associated with a
      high morbidity and mortality. Newer investigative procedures and therapeutic
      approaches have led to more accurate diagnoses and improved outcome but further
      advances await a better understanding of the vasculitides: polyarteritis;
      Kawasaki disease; Wagener's granulomatosis; and ANCA in childhood.

PMID- 8354001
TI  - Leukocyte adhesion.
AB  - Adhesion of leukocytes is a major event in the induction and effector phases of
      the immune response, as well as in inflammatory reactions. T-cell activation
      requires interaction with antigen-presenting cells (APC), B-cell activation needs
      cognate interaction with T-cells, while cytotoxic T cells strongly bind target
      cells. Migration of leukocytes into inflammatory areas is mediated by a crucial
      step of leukocyte binding to endothelial cells followed by trans-endothelial
      migration. Adhesion molecules mediating these various cell to cell interactions
      belong to three families, i.e. the immunoglobulin superfamily, integrins and
      selectins.

PMID- 8354002
TI  - Heat-shock proteins and juvenile chronic arthritis.
AB  - Heat-shock proteins are a category of proteins that are synthesized under
      stressful conditions (such as increased temperatures) both by prokaryotic and
      eukaryotic cells. Heat-shock proteins are a major target of the immune response
      and thus can be considered dominant antigens. Under physiological circumstances
      the response to heat-shock proteins is considered to play a role in the overall
      defence against bacterial infections. An aberrant immune response against heat
      shock proteins may lead to autoimmunity, as illustrated by adjuvant arthritis in
      Lewis rats. Current evidence also points towards a role of T cell immunity
      against heat-shock proteins in the development of human autoimmune diseases such
      as juvenile chronic arthritis.

PMID- 8354003
TI  - Signal transduction by inflammatory cytokines.
AB  - The mechanisms by which the inflammatory cytokines interleukin-1 and interleukin
      6, and tumour necrosis factor alpha activate cellular genes are reviewed. Common
      usage of some receptors and transcription factors are beginning to emerge, and
      many offer insights into newer therapeutic options.

PMID- 8354004
TI  - Can we prevent long term cardiac damage in Kawasaki disease? Lessons from
      Lactobacillus casei cell wall-induced arteritis in mice.
AB  - A single intraperitoneal injection of sonicated cell walls from group B
      Lactobacillus casei (LC) produces an acute inflammatory coronary arteritis in
      mice that closely resembles the coronary arteritis found in children with
      Kawasaki Disease (KD). The coronary arteritis is accompanied in its early stages
      by pancarditis and valvulitis, and in its later stages by coronary artery
      aneurysms, stenoses, and myocardial infarctions. The importance of this model is
      two-fold. First, it provides the opportunity to study the natural history of
      coronary artery disease over a relatively short life span. Second, it provides a
      model system in which the effects of immunological and pharmacological
      interventions may be tested without putting human life at risk. Studies to date
      indicate that inflammatory coronary arteritis such as occurs in this model and in
      children with KD is associated with the accelerated development of coronary
      artery insufficiency and premature death from cardiovascular disease. The use of
      immunomodulators or other agents early in the disease course to reduce the
      frequency and severity of the coronary arteritis appears to reduce the incidence
      of premature death in this mouse model and may reduce the consequences of KD as
      well.

PMID- 8354005
TI  - Intravenous immunoglobulin (IVIg) in the treatment of autoimmune and inflammatory
      diseases.
AB  - The beneficial effect of intravenous immunoglobulin (IVIg) in certain autoimmune
      disorders has led to the development of clinical trials in a large number of
      autoimmune and systemic inflammatory diseases. Experimental studies are being
      carried out to understand better the mechanisms of action of IVIg. In this
      review, we discuss the clinical use of IVIg in autoimmune disorders and outline
      the possible mechanisms by which IVIg may be exerting an immunoregulatory effect
      in various autoimmune and systemic inflammatory diseases. A clear understanding
      of the mechanisms of action of IVIg in autoimmune diseases will facilitate the
      optimization of their use as a therapeutic alternative to conventional
      immunosuppression.

PMID- 8354006
TI  - Immunogenetic aspects of juvenile chronic arthritis.
AB  - The HLA associations of Juvenile Chronic Arthritis are reviewed in the light of
      the newest results. The most convincing data are available about the early onset
      pauciarticular Juvenile Chronic Arthritis (EOPA-JCA), where there are highly
      significant associations with 3 different regions of the HLA system: the HLA-A
      locus (HLA-A2), the HLA-DR/DQ region (HLA-DR5 and DR8 haplotypes) and the DP
      region (DPB1*0201). All these associations are independent of each other and not
      brought about by linkage disequilibrium. There are significant interactions
      between the associated alleles DPB1*0201 and DR5 haplotypes, DPB1*0201 and DR8
      haplotypes as well as between A2 and DR5 and DR8 haplotypes, and between A2 and
      DPB1*0201. The association with the DR/DQ haplotypes reveal that most likely the
      DQA1 gene locus is primarily associated with JCA. There is a common motif which
      is present on all susceptible DQA1 alleles (0401, 0501, 0601) and not present on
      all the others (12). Taking all these information together, the following
      hypothesis is proposed: the observed HLA associations are a reflection of the
      direct involvement of the HLA genes in pathogenesis. The normal function of HLA
      molecules, namely the presentation of peptides of the T-cell receptor, is assumed
      to be a key mechanism in pathogenesis where an arthritogenic peptide is
      specifically bound by the DQ molecules, with binding specificity determined by
      the common motive on the DQA chain. It is possible that some of the arthritogenic
      peptides may be derived from self-histocompatibility antigens such as HLA-A2
      and/or DPB1*0201.

PMID- 8354007
TI  - T cell receptor variable region gene usage in juvenile chronic arthritis.
AB  - Up to now the data regarding T cell receptor V-gene usage by juvenile chronic
      arthritis synovial T lymphocytes has been conflicting. Thus, some studies claim
      that locally in the diseased joint there is an oligoclonal expansion of T cells
      with restricted T cell receptor variable region gene usage while others have
      found V-gene usage in the joint compatible with a polyclonal expansion of the T
      cells.

PMID- 8354008
TI  - Total hip replacement for juvenile chronic arthritis.

PMID- 8354009
TI  - Imaging in pediatric rheumatology.

PMID- 8354010
TI  - Ocular involvement during chronic inflammatory diseases in children.

PMID- 8354011
TI  - Relevance of the pharmacokinetics of non-steroidal anti-inflammatory drugs
      (NSAIDs) in children.
AB  - The pharmacokinetics of the NSAIDs is relevant to therapy in different ways:
      absorption, protein binding and distribution, metabolism and elimination. The
      pharmacokinetics of a drug is most relevant to therapy when plasma concentrations
      of the drug are related to efficacy and/or to side effects. The kinetic
      parameters then allow one to calculate the optimal dose regimen, i.e. the one
      maintaining plasma concentrations within the therapeutic range. The
      pharmacokinetic characteristics of the different NSAIDs relevant to therapy in
      children are reviewed.

PMID- 8354012
TI  - Pain in juvenile chronic arthritis: consequences for the musculo-skeletal system.
AB  - Pain in juvenile chronic arthritis is underestimated. Children often don't
      verbalize their pain adequately. On a pain scale they usually grade pain lower
      than adults. Pain perception always depends on subjective factors, especially the
      child's stage of development. The younger the child the more nonverbal pain
      expressions dominate. Malpositioning of involved joints or abnormal patterns of
      movement are often the only signs of pain. This is demonstrated in an inquiry
      directed to the parents of 111 small children with different subgroups of
      juvenile chronic arthritis. In a reflex reaction children bring their inflamed
      joints into a pain relieving position. This triggers a vicious circle which may
      result in joint deformity and permanent handicap. Arthritis interferes with the
      child's activities. Behavioural changes and finally developmental disturbances
      can follow.

PMID- 8354013
TI  - Is there a useful model for the study of childhood uveitis and arthritis?

PMID- 8354014
TI  - Naturally occurring arthritis in experimental animals.

PMID- 8354015
TI  - Dose response evaluation. Use of plasma concentration confidence intervals as a
      tool to predict optimal drug dose ratio.

PMID- 8354018
TI  - Nonparametric meta-analysis of published data on kidney-function dependence of
      pharmacokinetic parameters for the aminoglycoside netilmicin.
AB  - The distribution and elimination of various drugs depend on kidney function. This
      dependence is published either as a linear regression equation or as the discrete
      extreme values for normal kidney function and anuria. A meta-analysis of the
      published pharmacokinetic data is required to build up a knowledge-based computer
      system for dosage adjustment in renal failure. A sample comparison of 4
      statistical methods for meta-analysis was performed by applying them to 13
      publications about the aminoglycoside netilmicin. Parametric meta-analytical
      methods I and II are based on regression equations alone (Z-transformation,
      maximum likelihood) and yield unreliable data, especially with regard to extreme
      values for anuria. The parametric meta-analytical method III is based on means of
      extreme values (standard 2-stage approach) and does not permit a decision as to
      whether linear interpolation of a parameter (e.g. volume of distribution) can be
      used for all degrees of renal insufficiency. In contrast, the nonparametric
      median (meta-analytical method IV) is based on the extreme values calculated from
      regression equations and empirical extreme values combined into 1 group of data
      on normal kidney function and another on anuria. For netilmicin, the meta
      analytical median with the 95% confidence interval (95% CI) yields a significant
      increase in the dominant elimination half-life from 2h (95% CI 1.9h, 2.6h) in
      patients with normal kidney function to 45h (95% CI 41h, 301h) in those with
      anuria (p = 0.001). For a normal bodyweight of 65kg, the volume of distribution
      also increases significantly from 13L (95% CI 9L, 15L) to 20L (95% CI 14L, 21L)
      in patients with anuria (p = 0.04). Thus, drug dosage adjustment according to
      therapeutic peak and trough concentrations requires knowledge of the distribution
      and elimination parameters, since they can both be independently altered in renal
      failure. We conclude that the most robust meta-analysis of these alterations is
      achieved with the nonparametric median of extreme values.

PMID- 8354017
TI  - Pharmacokinetic optimisation of general anaesthesia in pregnancy.
AB  - A significant proportion of women require general anaesthesia during pregnancy or
      for delivery. There are many practical difficulties in studying anaesthetic drugs
      and techniques to determine what may be best for both the mother and fetus.
      Physiological changes of pregnancy may alter the pharmacokinetics and
      pharmacodynamics of anaesthetics and the fetal disposition of drugs is largely
      unknown. With the limited pharmacokinetic data available, conclusions on the
      suitability of drugs are reached in conjunction with sophisticated neonatal
      neurobehavioural testing. The normal fetus appears able to withstand a variety of
      anaesthetic techniques but there is little information regarding the compromised
      fetus or premature neonate. Provided that adequate maternal anaesthesia is
      achieved, it is prudent to choose an anaesthetic technique which minimises fetal
      exposure to drugs and use agents which can be eliminated quickly by the neonate.
      Currently available drugs with rapid maternal and neonatal elimination include
      propofol, suxamethonium, atracurium, nitrous oxide and isoflurane.

PMID- 8354019
TI  - Effect of continuous arteriovenous haemofiltration on pharmacokinetics of
      amrinone.
AB  - This case report details the pharmacokinetic adjustments of an amrinone infusion
      in a paediatric patient who developed multiorgan system failure with anuric renal
      failure and was prescribed continuous arteriovenous haemofiltration. A
      significant proportion of clearance of amrinone is nonrenal. Near normal amrinone
      clearance can occur in patients with hepatic and renal dysfunction if continuous
      arteriovenous haemofiltration is used. Hepatic dysfunction with renal failure may
      require a reduction in the continuous amrinone infusion rate as previously
      reported for neonates.

PMID- 8354020
TI  - Clinical pharmacologists and health care reform: contributing to the debate.

PMID- 8354016
TI  - Pharmacokinetic drug interactions with ACE inhibitors.
AB  - Angiotensin converting enzyme (ACE) inhibitors which have active moieties
      excreted mainly in urine require adjustment of either the dose or the interval
      between doses in patients with moderate to severe renal dysfunction or severe
      congestive heart failure. Those agents such as temocapril (CS 622) and
      fosinopril, excreted both in urine and bile, may not require such adjustment.
      Renal clearance of ACE inhibitors may be reduced and some accumulation may occur
      in elderly patients with mild renal dysfunction or congestive heart failure. The
      bioavailability of ACE inhibitors is reduced by concomitant food or antacids
      which may slow gastric emptying and raise gastric pH. Pharmacokinetic
      interactions with ACE inhibitors are unlikely in patients receiving thiazide or
      loop diuretics. When ACE inhibitors are given hyperkalaemia may occur in patients
      with renal insufficiency, those taking potassium supplements or potassium-sparing
      diuretics, and in diabetic patients with mild renal impairment. While no
      pharmacokinetic interaction precludes use of this combination, the
      pharmacokinetics of some ACE inhibitors are subject to greater variability when
      patients also receive beta-blockers. Calcium antagonists and ACE inhibitors have
      additive anti-hypertensive effects and pharmacokinetic interactions between these
      agents are unlikely. One report exists of a significant effect of coadministered
      hydralazine on the pharmacokinetics and urinary excretion of lisinopril. Data on
      interactions between ACE inhibitors and digitalis are contradictory. There is no
      evidence that the concomitant use of ACE inhibitors and digoxin is associated
      with an increased risk of digitalis toxicity. ACE inhibitors are mainly excreted
      by glomerular filtration and renal tubular secretion. Possible interactions
      between ACE inhibitors and probenecid have been noted, with renal and total body
      clearance of ACE inhibitors being potentially reduced in the presence of
      probenecid. Probenecid pretreatment may enhance the pharmacodynamic response of
      ACE inhibitors. Few but contradictory data exist on the effects of H2-blockers on
      ACE inhibitor pharmacokinetics and little information is available on
      interactions between ACE inhibitors and hypoglycaemic drugs. Some case reports
      link ACE inhibitors with the induction of lithium toxicity. Coadministration of
      lithium should be undertaken with caution, and frequent monitoring of lithium
      concentrations is recommended with all ACE inhibitors. Nonsteroidal anti
      inflammatory drugs (NSAIDs) may attenuate the haemodynamic actions of ACE
      inhibitors. NSAIDs reduce renal excretion of ACE inhibitors, with a corresponding
      increase in circulating drug concentrations. There is little information
      available on the pharmacokinetic interaction with ACE inhibitors and cyclosporin,
      but caution should be employed when they are used together.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8354021
TI  - A systematic integrated approach to improvement of drug prescribing in an acute
      care hospital: a potential model for applied hospital pharmacoepidemiology.

PMID- 8354022
TI  - A population and family study of N-acetyltransferase using caffeine urinary
      metabolites.
AB  - Population and family studies were undertaken to validate caffeine as a probe
      drug to establish the genetic status of rapid acetylators and slow acetylators.
      The acetylator status was established from the urinary metabolic ratio of 5
      acetylamino-6-formylamino-3-methyluracil to 1-methylxanthine (AFMU/1X) after oral
      administration of caffeine. We confirmed a bimodal distribution (chi 2(1) =
      229.48; p << 10(-9)) of the AFMU/1X ratio in 245 unrelated subjects. A third
      distribution did not significantly improve the fit to the data (chi 2(1) = 0.04;
      p = 0.84). Complex segregation analysis of 76 nuclear families confirmed the
      monogenic inheritance of N-acetyltransferase, with incomplete dominance of the
      rapid allele over the slow one. We observed a slight shift between the mean
      activities of heterozygous and homozygous rapid acetylators (t = 2.89; p < 0.01).
      However, the 30 obligate heterozygotes belonging to the 76 families were evenly
      distributed among the rapid acetylators and never located in a hypothetic
      intermediary group between slow acetylators and rapid acetylators.

PMID- 8354023
TI  - Inhibition and induction of cytochrome P4502E1-catalyzed oxidation by isoniazid
      in humans.
AB  - We studied the effect of isoniazid administration on the cytochrome P4502E1
      catalyzed elimination of chlorzoxazone and acetaminophen. Isoniazid, 300 mg
      daily, was administered for 7 days to a group of 10 volunteer slow acetylators.
      Acetaminophen, 500 mg, and chlorzoxazone, 750 mg, were administered on separate
      occasions before isoniazid, during the period of isoniazid administration, and
      after the discontinuation of isoniazid. Isoniazid inhibited the clearance of
      chlorzoxazone by 58%, as assessed from plasma data, and inhibited the formation
      of acetaminophen thioether metabolites (a measure of the formation of the
      hepatotoxin N-acetyl-p-benzoquinone imine and catechol oxidative metabolites of
      acetaminophen, as determined from their recovery in urine, by 63% and 49%,
      respectively. Two days after the discontinuation of isoniazid, the clearance of
      chlorzoxazone was increased over the value before isoniazid by 56%. Acetaminophen
      thioether but not catechol metabolites were increased by 56% 1 day after the
      discontinuation of isoniazid and had returned to the pre-isoniazid value 3 days
      after the discontinuation of isoniazid. We conclude that the time course of the
      interaction with regard to chlorzoxazone elimination and formation is compatible
      with an inhibition-induction effect of isoniazid on cytochrome P4502E1. The
      mechanism of this biphasic effect is probably induction by protein stabilization,
      which results in inhibition of catalytic activity while isoniazid is present.

PMID- 8354024
TI  - Reproducibility of antipyrine half-lives in elderly subjects.
AB  - Antipyrine half-life determined on three to five separate occasions over a period
      ranging from 3 weeks to 1 year was highly reproducible in each of 20 elderly
      subjects (12 women and 8 men; mean age, 83 years). The mean within-subject
      coefficient of variation for antipyrine half-life was 9.6%, whereas the between
      subject coefficient of variation was 33.3%. These findings indicate high
      reproducibility of individual rates of drug metabolism in medically stable
      elderly subjects.

PMID- 8354025
TI  - The pharmacokinetics of morphine and morphine glucuronides in kidney failure.
AB  - The pharmacokinetics of morphine and its glucuronide metabolites were
      investigated in three groups of patients with kidney failure (nondialyzed,
      receiving dialysis, and transplantation) and compared with a group of normal
      healthy volunteers. Patients in all three renal groups were undergoing surgical
      procedures (nondialyzed group undergoing arteriovenous fistula formation,
      dialysis group undergoing placement of a peritoneal dialysis catheter, and the
      transplant group undergoing live donor kidney transplant). A sensitive, specific
      high-performance liquid chromatographic assay was used to quantitate morphine,
      morphine-3-glucuronide, and morphine-6-glucuronide. Patients with kidney failure
      had a significantly increased morphine area under the curve (AUC) compared with
      control subjects. There was also an increase in the metabolites morphine-3
      glucuronide and morphine-6-glucuronide that was severalfold greater than the
      increase in morphine AUC. This metabolite accumulation was reversed by kidney
      transplantation, providing an elegant confirmation on the role of the kidney in
      morphine pharmacology.

PMID- 8354026
TI  - Reduction of 3'-azido-3'-deoxythymidine to 3'-amino-3'-deoxythymidine in human
      liver microsomes and its relationship to cytochrome P450.
AB  - The formation of 3'-amino-3'-deoxythymidine (AMT) in patients receiving 3'-azido
      3'-deoxythymidine (zidovudine) and the potential role of this metabolite in
      zidovudine-induced toxicity was recently demonstrated by our laboratory. This
      study evaluated the formation of AMT versus cytochrome P450 (P450) content,
      cytochrome B5 (B5) content and the reduced form of nicotinamide adenine
      dinucleotide phosphate (NADPH)-cytochrome P450 reductase activity in human liver
      microsomes obtained from 24 different donors. Significant interindividual
      differences in total P450 content and P450 reductase activity were observed,
      whereas no variation was observed in B5 content. Of particular importance,
      metabolism of zidovudine to AMT varied widely and correlated with P450 content
      but not with B5 content or P450 reductase activity. The apparent values for the
      Michaelis-Menten constant and the maximum rate of metabolism of the reaction were
      46.1 mmol/L and 3.5 nmol/min/mg microsomal protein. These large variations of AMT
      levels as a function of P450 suggest that major interindividual differences may
      be observed in the pharmacokinetics and formation of this metabolite that may
      affect the pharmacodynamic properties of zidovudine. Potential drug-drug
      interactions may occur with therapeutic agents that interact with or induce P450
      (zidovudine).

PMID- 8354027
TI  - The cardiovascular interaction between caffeine and nicotine in humans.
AB  - In a placebo-controlled, double-blind randomized design, we investigated the
      cardiovascular interaction between caffeine (250 mg intravenously) and nicotine
      (4 mg chewing gum) in 10 healthy volunteers, both under baseline conditions and
      during physical and mental stress (standing up and mental arithmetic). Caffeine
      alone induced a significant increase in blood pressure associated with a decrease
      in heart rate, whereas nicotine alone increased both blood pressure and heart
      rate. The combination of caffeine and nicotine increased systolic and diastolic
      blood pressure by 10.8 +/- 2.0 and 12.4 +/- 1.9 mm Hg, respectively. This pressor
      response did not differ significantly from the calculated additive effects of
      caffeine and nicotine on blood pressure, measuring 12.9 +/- 2.0 and 14.2 +/- 2.1
      mm Hg, respectively. Heart rate and forearm blood flow also showed a similar
      response when the combination of caffeine and nicotine was compared with the
      calculated sum. During physical stress (standing up), blood pressure, heart rate,
      and plasma catecholamines increased in the placebo test. The pressor response to
      standing up was less pronounced after the combination of caffeine and nicotine
      compared with the sum of the separate effects (combination versus sum: delta
      diastolic blood pressure, 24.7 +/- 1.9 versus 35.2 +/- 2.6 mm Hg [p < 0.01];
      delta mean arterial pressure, 22.1 +/- 2.0 mm Hg versus 28.6 +/- 1.6 mm Hg [p <
      0.05]). The plasma catecholamine response did not differ between the combination
      and the sum of both drugs. During mental arithmetic, blood pressure, heart rate,
      and forearm blood flow increased in the placebo test. The forearm vasodilator
      response to mental stress was attenuated by the combination of caffeine and
      nicotine compared with the sum of both drugs (combination versus sum: delta
      forearm blood flow, -0.1 +/- 0.3 versus 1.4 +/- 0.5 ml/100 ml/min [p < 0.05]). We
      conclude that the combined administration of caffeine and nicotine shows additive
      effects on cardiovascular parameters during baseline conditions but less than
      additive effects during sympathoadrenal stimulation.

PMID- 8354028
TI  - Influence of cyclosporine pharmacokinetics, trough concentrations, and AUC
      monitoring on outcome after kidney transplantation.
AB  - To assess the importance of cyclosporine pharmacokinetics on graft outcome and
      acute rejection episodes, pretransplant and a total of 1868 posttransplant whole
      blood cyclosporine pharmacokinetic profiles were performed in 160 consecutive
      kidney transplant recipients. The following posttransplant pharmacokinetic risk
      factors were associated with a poorer graft survival and a higher incidence of
      acute rejection: F, < 25%; clearance, > 325 ml/min; steady-state cyclosporine
      concentrations, < 350 ng/ml during intravenous infusion; or average cyclosporine
      concentrations, < 400 ng/ml during the first oral study. Although the
      discrimination between rejecting and nonrejecting patients was greatest for
      cyclosporine concentrations obtained at 24 hours after drug administration,
      measurements at 6 and 14 hours, as well as average concentrations, were all
      highly predictive. Because of the strong association between the cyclosporine
      concentrations and outcome, an equation is described to provide initial oral dose
      prediction. Furthermore, this association suggests that improved cyclosporine
      pharmacokinetic monitoring may aid in improving outcome after kidney
      transplantation.

PMID- 8354029
TI  - Tricyclic antidepressants in red cells and plasma: correlation with impaired
      intraventricular conduction in acute overdose.
AB  - OBJECTIVE: Tricyclic antidepressant levels in red blood cells and plasma in acute
      overdose and their association with cardiotoxicity were studied. METHODS: This
      was a prospective study in 15 patients with acute tricyclic antidepressant
      overdose. Tricyclic antidepressant parent compounds and metabolites were measured
      in red blood cells and plasma, and tricyclic antidepressant levels were
      correlated with ECG indexes of toxicity. RESULTS: Plasma levels of the parent
      compounds were higher than their red blood cell levels on admission (mean +/- SD,
      691 +/- 409 and 337 +/- 220 ng/ml, respectively). Admission metabolite levels
      were higher in red blood cells than in plasma (264 +/- 180 and 190 +/- 164 ng/ml,
      respectively). QRS duration and the red blood cell levels of the metabolites were
      significantly correlated at the time of admission (r = 0.77, p < 0.01), as well
      as at 6 to 10 hours (r = 0.74, p < 0.01). CONCLUSIONS: In acute overdose, a shift
      of tricyclic antidepressants from plasma to red blood cells and increased levels
      of red blood cell metabolites reflect tissue redistribution of the drug.
      Tricyclic antidepressant red blood cell metabolites are the best markers for
      impaired intraventricular conduction.

PMID- 8354030
TI  - Serotonin syndrome and drug interactions.

PMID- 8354031
TI  - Oral tyramine challenge tests.

PMID- 8354032
TI  - Nonsedating antihistamine approved by FDA.

PMID- 8354033
TI  - Increasing breast milk supply.

PMID- 8354034
TI  - Vancomycin pharmacokinetics in elderly patients.

PMID- 8354035
TI  - Effect of flumazenil on benzodiazepine-induced respiratory depression.
AB  - The ability of flumazenil to reverse benzodiazepine-induced respiratory
      depression is discussed through a review of the relevant literature. Flumazenil
      has been shown to be effective in reversing benzodiazepine-induced sedation, but
      its ability to reverse benzodiazepine-induced respiratory depression is
      controversial. Part of this controversy stems from the lack of consistent data on
      the incidence and nature of depressed respiratory function after benzodiazepine
      administration. In addition, a variety of tests are used to assess respiratory
      function, but because breathing is both automatic and under voluntary control,
      the results of some of these tests can be affected by patient effort. In such
      cases, improvement can result from an increased level of consciousness even
      though the central respiratory drive remains depressed. Thus, studies using these
      tests to determine flumazenil's effect on respiratory depression are
      inconclusive, as they do not accurately measure reversal of the central
      respiratory depression induced by benzodiazepines. However, studies using methods
      that do accurately assess central respiratory drive have involved small numbers
      of subjects and demonstrated a variable incidence of respiratory depression
      associated with benzodiazepine use. When benzodiazepine-induced respiratory
      depression was evident, the ability of flumazenil to reverse it was inconsistent
      and short-lived. Flumazenil may be able to improve breathing through improved
      consciousness, but its effects on central respiratory depression are
      inconsistent. Therefore, unless additional information becomes available
      supporting flumazenil's ability to reverse benzodiazepine-induced respiratory
      depression, it should not be used for this indication.

PMID- 8354036
TI  - Human gene therapy.
AB  - Current concepts in gene transfer and its application to the treatment of human
      genetic disorders, cancer, and other diseases are discussed. Gene therapy is a
      technique in which a functioning gene is inserted into a human cell to correct a
      genetic error or to introduce a new function to the cell. Many methods, including
      retroviral vectors, have been developed for ex vivo and in vivo gene insertion
      into cells. Some pharmacists have likened gene therapy to a sophisticated form of
      drug delivery and have envisioned an active role for the pharmacy profession.
      There are several safety and ethical issues related to manipulating the human
      genome that need to be understood. Current gene therapy efforts focus on gene
      insertion into somatic (nongerminal) cells only. Gene therapy has the potential
      to revolutionize the treatment of genetic disorders, diseases associated with a
      genetic component (e.g., cystic fibrosis), cancer, AIDS, and many other diseases.
      Gene transfer may also be used to better understand the biology of disease
      processes, such as the source of relapse in bone marrow transplant patients. The
      human genome project will undoubtedly lead to the identification,
      characterization, and understanding of genes that are responsible for many human
      diseases, and gene therapy trials are sure to expand accordingly. To date, over
      40 clinical trials have been approved and more than 110 patients have been
      entered in gene therapy studies. There are still many technical obstacles to
      overcome before gene therapy can have widespread application. Injectable vectors
      need to be developed to simplify foreign gene administration. Perhaps the biggest
      problem to overcome will be engineering the target cells to be able to regulate
      gene expression according to physiologic needs. Pharmacists should become
      knowledgeable about gene transfer techniques and possible clinical applications
      of gene therapy to keep abreast of the newest trends in medicine.

PMID- 8354037
TI  - Vitamin A as an immunomodulating agent.
AB  - Findings on the benefits and mechanism of action of vitamin A in measles and
      other infectious diseases and immunocompromised states are discussed. Vitamin A
      deficiency is one of the world's major malnutrition problems and is most commonly
      found in children under the age of five years. An association between vitamin A
      status and immune function has been suggested by community studies and animal
      experiments. Mortality and susceptibility to infection and diarrhea are higher in
      children with vitamin A deficiency. The association between increased mortality
      and morbidity and vitamin A deficiency is strongest in children with measles.
      Vitamin A supplementation reduces mortality and complications resulting from
      measles. Measles may increase the body's utilization of vitamin A, possibly
      because of the rapid destruction of epithelial surfaces. Vitamin A may boost
      immune responses in the elderly, persons with high exposure to ultraviolet light,
      patients who have undergone surgery, and persons with parasitic infection, but
      more studies are needed. The immune defect caused by vitamin A deficiency may be
      due to alterations in the glycoproteins of the lymphocyte membrane, an adverse
      effect on helper T-cell function, the effect on epithelial tissue, or some other
      mechanism. Vitamin A therapy is relatively safe, and its effectiveness in
      children with measles and possibly other groups appears to justify public health
      campaigns to eliminate vitamin A deficiency. Vitamin A apparently has important
      immunomodulating properties, notably in patients with measles.

PMID- 8354038
TI  - Vancomycin pharmacokinetics and dosage requirements in hematologic malignancies.

PMID- 8354039
TI  - Adverse effects of molgramostim in marrow transplant recipients.

PMID- 8354040
TI  - Lidocaine therapy: time for re-evaluation.

PMID- 8354041
TI  - MEDWatch: the new FDA medical products reporting program.

PMID- 8354042
TI  - Criteria for use of flumazenil in adult inpatients and outpatients.

PMID- 8354043
TI  - [Treatment of pulmonary embolism. Current status and future prospects].
AB  - Although still severe, the prognosis of pulmonary embolism has recently improved
      due to considerable progress in the therapeutic field. This paper concerns the
      various therapeutic tools, both pharmacologic and surgical, which are already
      available or under evaluation. Despite the introduction of thrombolytic drugs,
      heparin remains an indispensable drug. The rationale for its use comes from the
      need of preventing further clot formation, while endogenous fibrinolysis or
      thrombolytic drugs are dissolving the already existing clots. Thrombolytic drugs,
      such as streptokinase, urokinase or rt-PA, have changed the therapeutic strategy
      of pulmonary embolism, due to their ability to accelerate the normal fibrinolytic
      mechanisms and to facilitate pulmonary reperfusion. This often allows an early
      disappearance of symptoms and a reduced incidence of invalidating complications
      involving the respiratory function. rt-PA seems to be most effective and fast in
      inducing reperfusion (angiographic signs of clot dissolution are obtained in 82%
      of the patients within 2 hours). The administration of rt-PA by intravenous bolus
      has recently been proposed, which would induce an even faster thrombolysis and
      fewer hemorrhagic complications. The role of surgical therapy has declined after
      the diffusion of thrombolytic drugs, being reserved only for the most serious
      cases. When anticoagulation is counter-indicated or not effective, the prevention
      of embolic relapses can be achieved by percutaneous insertion of caval filters of
      different types. Some new catheters provided with rotating metallic tips, which
      allow the mechanical fragmentation of the emboli, are presently under evaluation.
      Although some improvements are needed, this technique is expected to become soon
      of general use, especially in cases in which thrombolytic therapy is counter
      indicated.

PMID- 8354044
TI  - Chronic obstructive pulmonary disease. A possible correlation between platelet
      aggregation tests and respiratory indexes. ECOB Group.
AB  - It has been suggested that thrombotic events occurring in patients with chronic
      obstructive pulmonary disease could be partially due to abnormalities in blood
      coagulation and fibrinolysis, as well as to changes in platelet function. In the
      present study in vitro platelet aggregation, in addition to clotting activity,
      has been studied in 20 patients with chronic obstructive pulmonary disease and
      different degrees of alteration of blood gas analysis. The results obtained
      suggest that the presence of a condition of platelet hypoaggregability
      characterizes patients with marked hypercapnia and/or hypoxemia, whereas the
      improvement of respiratory indexes is followed by a trend to normalization, or,
      more often, to an increase of platelet activity.

PMID- 8354045
TI  - [Efficacy and tolerability of cisapride in a new formula of 10 mg effervescent
      capsules for the treatment of functional dyspepsia].
AB  - The efficacy and tolerability of Cisapride effervescent granules and a
      metoclopramide-dimethicone combination were compared double-blind in two
      comparable groups of 15 patients each with dyspepsia. All patients received three
      sachets daily of either drug for 6 consecutive weeks. As for efficacy, Cisapride
      effervescent granules was found to reduce 85% (11/13) of symptoms to a
      statistically significant extent, as against 42% (5/12) in the reference group.
      Statistical analysis showed Cisapride effervescent granules to be more effective
      than the reference drug for 6 out of 11 evaluable symptoms. Mean global
      improvement was 86% for Cisapride effervescent granules vs 41% for the reference
      combination. Final judgment by the physician was more favorable for Cisapride
      effervescent granules than for the reference drug (p < 0.0001). Treatment
      withdrawal was never necessary and no significant changes of laboratory values
      were observed. No statistically significant difference between the two treatments
      as to tolerability was observed. In conclusion, Cisapride effervescent granules
      was found to have a better risk/benefit ratio than the reference combination.

PMID- 8354046
TI  - [Effectiveness of loratadine vs. placebo in the treatment of urticaria-angioedema
      syndrome in patients with food allergy].
AB  - Loratadine is a new, highly selective, non sedating, H 1-receptor antagonist,
      without central nervous system activity. In a randomized double-blind, crossover
      study, we evaluated the effects of loratadine and placebo administered once daily
      in 184 food intolerant patients affected by urticaria-angioedema. The difference
      between loratadine and placebo treatment was significant in relieving symptoms.
      Adverse reactions reported in the treatment were mild, in fact somnolence was
      reported by 3.4%, dry mouth by 2.2% of patients.

PMID- 8354047
TI  - [Efficacy and tolerability of ketoprofene administered through iontophoresis in
      rheumatoid arthritis. Results from a multicentric study].
AB  - Three-hundred and twelve patients with osteoarthritic diseases were admitted to a
      multicenter clinical trial. The patients were given 100 mg Ketoprofen twice-a-day
      by iontophoresis for 10 consecutive days. Pain relief was almost complete in
      94.6% of the patients, improvement of active motility in 83.6%, disappearance of
      swelling in more than half of the patients and functional improvement in about
      all the cases. Two allergic skin reactions of a mild degree (0.6%) were
      registered. Therefore, Ketoprofen administered by iontophoresis showed to be
      efficacious and safe in the treatment of acute osteoarthritic diseases also in
      high risk patients.

PMID- 8354048
TI  - [Aortic dissection: the role of diagnostic imaging, with special reference to
      magnetic resonance imaging and its implications in the pathogenesis].
AB  - The aim of this work was to evaluate the usefulness of angiography, CT scan and
      MR imaging in the diagnosis of aortic dissection, on the basis of the authors'
      experience and literature review. Angiographic study is still considered the
      first choice technique in the diagnosis of aortic dissection, although it is
      considered not completely safe. CT scan allows to note the early thickening of
      the vessel walls (due to intraparietal bleeding) and the presence of
      calcifications in the thrombosed portion of the lesion. MR study allows
      multiplanar study of the lesions without contrast medium, and best visualization
      of subendothelial bleeding in dissections without intimal lesion.

PMID- 8354049
TI  - [The CADIZ program].

PMID- 8354050
TI  - Inversion and configuration of faces.
AB  - If the mouth and eyes of a face are inverted, the altered construction appears
      grotesque when upright, but not when upside-down. Three studies of this "Thatcher
      illusion" employed faces that were grotesque when upright because: (a) their eyes
      and mouths had been inverted ("Thatcherized" faces), (b) their eyes and mouths
      had been moved (spatially distorted faces), or (c) they had grotesque posed
      expressions. Inversion reduced the apparent grotesqueness of both Thatcherized
      and spatially distorted faces, but not grotesque-expression faces. Moreover,
      Thatcherized and distorted faces, although not grotesque-expression faces, were
      judged as more similar to normal, smiling faces when face-pairs were inverted
      than when they were upright. Similarity ratings to inverted face-pairs were
      correlated with latencies of response to these pairs in a task that encouraged
      attention to components (e.g., mouths, eyes) rather than wholistic properties.
      Similarity ratings to upright face-pairs showed no such correlation, and this and
      other findings suggested that although similarity ratings to upright faces are
      based on wholistic information, similarity ratings to inverted faces are based
      largely on components. The Thatcher illusion reflects a disruption of encoding of
      wholistic information when faces are inverted.

PMID- 8354051
TI  - Mental rotation, mental representation, and flat slopes.
AB  - The "mental rotation" literature has studied how subjects determine whether two
      stimuli that differ in orientation have the same handedness. This literature
      implies that subjects perform the task by imagining the rotation of one of the
      stimuli to the orientation of the other. This literature has spawned several
      theories of mental representation. These theories imply that mental
      representations cannot be both orientation-free and handedness-specific. We
      present four experiments that demonstrate the contrary: mental representations
      can be both orientation-free and handedness-specific. In Experiment 1 we
      serendipitously discovered a version of R. N. Shepard and J. Metzler's (1971)
      "mental rotation" task in which subjects accurately discover the handedness of a
      stimulus without using "mental rotation," i.e., in which reaction time to compare
      the handedness of two forms is not a function of the angular disparity between
      the two forms. In Experiment 2 we generalize this finding to different
      experimental procedures. In Experiment 3 we replicate this finding with a much
      larger group of subjects. In Experiment 4 we show that when we preclude the
      formation of an orientation-free representation by never repeating a polygon,
      subjects carry out the handedness comparison task by performing "mental
      rotation."

PMID- 8354052
TI  - Adequacy of treatment of uremia in the nineties.

PMID- 8354053
TI  - Adequacy of hemoperfusion for blood purification in uremia.

PMID- 8354054
TI  - Quality of membrane. High flux membrane and its future.

PMID- 8354055
TI  - Advantages of meltspun membrane technology compared to solution spinning.

PMID- 8354056
TI  - Computerized monitoring of dialysis.

PMID- 8354057
TI  - Hemodynamic criteria for adequacy of volume regulation and prevention of
      myocardial impairment in chronic hemodialysis patients.

PMID- 8354058
TI  - Hybrid bioartificial kidney: pitfalls and present state of the art.

PMID- 8354059
TI  - Supplemented dialysis: amino acid-based solutions in peritoneal dialysis.
AB  - Peritoneal dialysis is associated with several metabolic and nutritional
      abnormalities, some of which are related to the use of glucose-based solutions.
      Furthermore, the catabolic effects of uremia per se, protein and amino acid
      losses into the dialysate, peritonitis and poor appetite contribute to amino acid
      abnormalities, negative nitrogen balance and a high prevalence of malnutrition in
      peritoneal dialysis patients. To overcome these problems the use of amino acid
      instead of glucose as an osmotic agent has been proposed. Short-term studies have
      shown that amino acid-based solutions in peritoneal dialysis may supplement in
      excess the daily losses of amino acids during dialysis with glucose-based
      solutions. The amino acid solutions produce similar ultrafiltration and solute
      transport as the standard glucose solutions although the period of effective
      ultrafiltration is rather short. However, it should be noted that some studies
      have reported that the transport of small and large solutes may increase in
      patients using amino acid solutions. During the early 1980s several investigators
      have developed and tested different amino acid solutions for peritoneal dialysis.
      The initial clinical experience from Toronto with amino acid solutions containing
      large amounts of non-essential amino acids and inadequate amount of buffer were
      in general discouraging. The patients, who were not always malnourished and
      tended to have a low energy intake, developed increased BUN levels, acidosis, no
      improvement in nutritional status or amino acid abnormalities and, in some cases,
      anorexia. In 1985 a new 1% amino acid solution, containing an increased buffer
      amount and amino acids (mainly essential) in proportions which take the amino
      acid abnormalities in uremic patients into account, became available. The use of
      this solution resulted in some improvement in amino acid pattern and nutritional
      parameters, but acidosis and increased BUN levels remained problems. The
      experiences from these and previous studies showed that: (1) the improvement of
      the composition of amino acid solutions was beneficial; (2) a further increase of
      the buffer amount was needed; (3) patients included should have signs of protein
      malnutrition combined with low dietary protein intake to benefit from
      intraperitoneal amino acid supply, and (4) energy intake should be sufficient to
      prevent amino acids to end up as energy source. For this purpose a new improved
      1.1% amino acid solution has been developed containing a further increase of some
      essential amino acids and an increased amount of lactate (40 mmol/l). This
      solution has been tested in malnourished patients eating 0.8 g protein/kg/day and
      25-30 kcal/kg/day.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8354060
TI  - The new bionic era in renal replacement therapy.

PMID- 8354061
TI  - What is adequate CAPD?

PMID- 8354062
TI  - Biocompatibility: methodology and evaluation.

PMID- 8354063
TI  - Biocompatibility of dialysis membranes.

PMID- 8354064
TI  - Approach to dialysis biocompatibility: evaluation through in vivo investigation
      of lymphocyte biology. A technical note.

PMID- 8354065
TI  - Dialysate biocompatibility: evaluation and expectations.

PMID- 8354066
TI  - High-flux dialysis, dialysate quality and backtransport.

PMID- 8354067
TI  - Quality of life and adequacy of dialysis.

PMID- 8354068
TI  - Studying the culture and effectiveness of biomedicine.

PMID- 8354069
TI  - Perspectives on the health and health care of Canada's first peoples.

PMID- 8354070
TI  - Micro-anatomo politics: mapping the Human Genome Project.

PMID- 8354071
TI  - An introduction to cultural and social studies of sciences and technologies.

PMID- 8354073
TI  - Galton's regret and DNA typing.

PMID- 8354072
TI  - The development of property rights in biotechnology.
AB  - The translation of biological theory into engineering (biotechnology) has
      resulted in the development of novel products and processes. Some of these
      products are living organisms, usually containing unique genetic arrangements not
      found in nature. The extension of legal protection to products and processes was
      required in order for biotechnology to become an unexceptional way in which to do
      business. The American experience with biotechnology, repeated elsewhere, is
      demonstrated to have proceeded first through the negotiation of obstacles in
      administrative law and second through challenges to property law. This outcome
      for the regulatory management of biotechnology and the legal protection of its
      products may be interpreted as a function of a cultural bias for scientific
      authority and progress ideology.

PMID- 8354074
TI  - Histories of immune systems.

PMID- 8354075
TI  - Psychoneuroimmunology: the problem of the situatedness of illness and the
      conceptualization of healing.
AB  - Psychoneuroimmunology claims to go beyond narrow biological perspectives of
      illness to consider behavioral components as an integral part of health and
      disease. The conceptualization of the embodiment of behavioral dimensions and how
      they may be represented in terms of interaction between the central nervous
      system and the immune system are therefore central theoretical issues.
      Psychoneuroimmunology is thus an arena in which questions about the body and
      person in context should come to the fore. There are multiple approaches in the
      psychoneuroimmunological literature, including those which attempt to address in
      some fashion the issue of the situatedness of illness. It is argued here that the
      problem of the representation of situatedness is the primary axis of tension in
      current research and writing in psychoneuroimmunology. Diverse attempts to
      represent extremely complex (and non-linear) relationships between behavioral and
      biological dimensions of 'immune system' functioning drive a number of
      researchers, though they operate under disciplinary, institutional, and funding
      constraints in the U.S. which tend to work against the development of competing
      or radical models within psychoneuroimmunology itself.

PMID- 8354076
TI  - A cultural analysis of human behavioral breakdowns: an approach to the ontology
      and epistemology of psychiatric phenomena.
AB  - This paper explores the usefulness of a concept of "human behavioral breakdowns"
      for studying psychiatric phenomena from a cross-cultural standpoint. The kinds of
      conceptualizations that are available in the English literature about human
      behavioral breakdowns across societies are reviewed. The way these breakdowns
      have been handled in the Western European Tradition of medicine is given special
      emphasis. Attention is focused on schizophrenia as one of the modern "disease"
      concepts of psychiatry that is a variant of human behavioral breakdowns. The
      essay then looks at "schizophrenia" using contemporary ideas about cultural
      relativism as these apply to the study of psychiatric phenomena in relation to
      society. Perspectives about the variable as versus the invariant in schizophrenia
      are reviewed.

PMID- 8354077
TI  - Group A streptococcal infections--1993.

PMID- 8354078
TI  - Pediatric immunizations.
AB  - The record of disease prevention in children is an impressive testament to our
      universal immunization program. However, these successes are being threatened by
      rates of vaccination in some areas of the country that are substantially less
      than those seen in the developing world. Unless the pediatric immunization rates
      are improved, epidemics of other vaccine-preventable diseases will recur, as
      evidenced by the measles outbreaks. Although the tools needed for disease
      prevention are available, the means for their delivery are lacking. It is the
      obligation of us all to immunize the nation's children.

PMID- 8354079
TI  - Vascular disorders of the upper torso.

PMID- 8354080
TI  - Neutralization of animal viruses.

PMID- 8354081
TI  - Neonatal and infantile acne vulgaris.

PMID- 8354082
TI  - Black dermographism: mechanism for formation of black color.

PMID- 8354083
TI  - A dermatologic diary. Portrait of a practice.

PMID- 8354084
TI  - Psoriasis associated with human immunodeficiency virus/acquired immunodeficiency
      syndrome.
AB  - Since the prevalence of psoriasis is between 1.5 to 2 percent, it would be
      expected to occur by chance in a person infected with HIV who is genetically
      predisposed to psoriasis. Several studies in the literature on HIV/AIDS
      associated psoriasis have reported such percentages of frequency. Although
      psoriasis is a low priority for a patient with HIV/AIDS who is coping with many
      other cutaneous conditions and cancers, when treating the HIV/AIDS-infected
      psoriatic patient, immunosuppressive drugs are contraindicated because of their
      serious impact on an already immunodeficient person.

PMID- 8354085
TI  - Metastatic umbilical carcinoma: the Sister Joseph's nodule.
AB  - Metastatic umbilical carcinoma has been referred to by generations of physicians
      as Sister Joseph's nodule. Though not common, this characteristic lesion is
      important to recognize and properly evaluate. We present a case of an eighty-two
      year-old woman with a Sister Joseph's nodule due to an unknown primary carcinoma,
      and we review the diagnostic and prognostic features of umbilical metastases.

PMID- 8354086
TI  - Aggressive sebaceous carcinoma of the eyelid: an elusive diagnosis.
AB  - Sebaceous carcinoma of the eyelid, an extremely rare neoplasm, can resemble
      blepharitis, conjunctivitis, or chalazion, as in the case presented here. A
      biopsy specimen should be examined if these conditions fail to respond to
      therapy, especially if the lesion is unilateral. The tumor can be multifocal, and
      pagetoid proliferation is common. Therefore, recurrences are common after
      conservative surgery, even if frozen sections are obtained from the margins.
      Orbital exenteration may be necessary to prevent metastasis.

PMID- 8354087
TI  - Unusual erythema of the proximal nail fold and onychodermal band.

PMID- 8354088
TI  - Epidermodysplasia verruciformis: report of a case with palmar pits.
AB  - A case of epidermodysplasia verruciformis is reported. This rare disease is
      characterized by a generalized eruption of flat warts and lesions resembling
      pityriasis versicolor. Epidermodysplasia verruciformis is considered to represent
      a distinctive pattern of abnormal reactivity to the human papillomavirus. Our
      patient, in addition to showing the classic skin lesions, exhibited pitlike
      lesions of the palms.

PMID- 8354090
TI  - [Oral glucose tolerance test in late pregnancy women].
AB  - A total of 514 pregnant women had oral glucose tolerance test (OGTT) with 75g
      glucose load performed between 24 and 37 weeks of gestation. They were divided
      into 2 groups. Group I (n = 350) was normal pregnant controls. Group II (n = 164)
      was at high risk of DM group. With pooled data the results of OGTT from group I,
      a statistically derived criterion (based on 97.5 percentile approximated to the
      nearest 5) was devised. This criterion defines the lower limits of abnormal
      values for venous plasma glucose in Chinese pregnant women during an OGTT with a
      75g glucose load as follows: fasting 5.5 mmol/L, 1 hour 10.2 mmol/L, 2 hours 8.2
      mmol/L, 3 hours 6.6 mmol/L. These values are lower than those recommended for
      pregnant women by NDDG and WHO. It is a question whether the criterion derived
      from data in caucasian population are fit for the population in developing
      countries. Serum insulin release test were performed in 81 of 350 pregnant women
      in group I. The results showed that serum insulin release levels after a glucose
      load in late pregnancy were more active than those in the non-pregnant state.
      OGTT in women of group II with high risk of GDM showed to be more intolerant
      compared with those women in group I.

PMID- 8354089
TI  - [Changes in plasma and urinary digoxin-immunoreactive like substance in normal
      pregnancy and pregnancy-induced hypertensive women].
AB  - Plasma and urinary digoxin-immunoreactive like substance (DILS) were measured in
      normal non-pregnant (NNP), normal pregnant (NP) and pregnancy-induced
      hypertensive women (PIH). The plasma DILS level of PIH, compared with NNP, was no
      significantly decreased (P > 0.05); but that of NP was significantly decreased (P
      < 0.01). While the urinary DILS levels of PIH and NNP were significantly higher
      than that in NNP (P < 0.01). In 24-72 hours after delivery the plasma and urinary
      DILS levels were all significantly lower than that in NNP (P < 0.05). These
      results indicate that DILS may play a role in homeostasis regulation in NP or
      PIH.

PMID- 8354091
TI  - [Clinical analysis of perinatal outcome in gestational diabetes].
AB  - This retrospective study was carried out on 78 women with gestational diabetes
      during Nov. 1982-Oct. 1991. The study indicates that treatment of gestational
      diabetes can reduce the occurrence of macrosomia. Macrosomia occurred in 19.35%
      of the insulin-treated group, 21.05% of the diet-treated group, and 50% of the
      untreated group. Neonatal morbidity was decreased in good diabetic control group.
      A routine prenatal "50g glucose screen" in pregnant women with high-risk factor
      should be carried out in order to make early diagnosis of gestational diabetes.
      Delivery time should be choosen during 38-40 weeks of gestation.

PMID- 8354092
TI  - [Immunologic diagnosis and treatment in the cases of unexplained habitual
      abortion].
AB  - One hundred and fourty-eight cases of habitual abortion were screened for
      etiologies. We found 40.5% (60/148) were unexplained. Among them, 34 cases were
      volunteers for receiving repeated active immunolization with low-dose of
      lymphocyte from their husbands or other donors, and 12 cases were taken as
      control. The successful pregnant rate was 86.4% (19/22) in treatment group which
      is higher significantly than in control (P < 0.05). meanwhile, used by
      microlymphocytotoxic antibody test and one-way mixed lymphocyte reaction and its
      inhibition test, the observations on immunologic state before and after
      vaccination were made in 19 cases. We found both the positive rate of
      microlymphocytotoxic antibody test and the relative suppressive rate of
      lymphocyte response were increased significantly post-vaccination than pre
      vaccination. These results not only confirmed that active immunization was
      effective, but also suggested that habitual abortion may be associated with the
      lack of protective antibody and/or block antibody.

PMID- 8354093
TI  - [Menstrual status as risk factors of endometriosis: a case-control study].
AB  - A case-control study, involving 203 cases of pelvic endometriosis and 406
      randomly selected and age-matched community controls, was conducted. The results
      showed that women characterized by earlier menarche (< or = 12 years) and longer
      period (> 7 days) were associated with an elevated risk. Longer cycle (> 35 days)
      seemed to have a protective effect. There are a tendency to increasing risk for
      endometriosis associated with primary dysmenorrhea and energetic physical
      activities during menstruation. The results indicate that intensive treatment of
      primary dysmenorrhea and avoidance of strenuous exercise during menstruation may
      prevent pelvic endometriosis.

PMID- 8354094
TI  - [Prognostic factors of endometrial carcinoma: a study of 98 cases].
AB  - Ninety-eight cases of endometrial carcinoma treated in our hospital during 1965
      1988 were reviewed. The 5-year survival rate was 64.3%. Many factors were found
      to be related to 5-year survival: clinical stage, histological type, histological
      grade, depth of myometrial invasion and the amount of lymphocytic infiltration
      around islands of tumour cells. Earlier clinical stage, higher histological grade
      and less myometrial invasion had more favorable prognosis. Adenocarcinoma and
      adenoacanthoma had more favorable prognosis when compared with adenosquamous
      carcinoma and papillary adenocarcinoma. The more the amount of lymphocytic
      infiltration, the better prognosis. No correlation was found between the 5-year
      survival rate and the uterine size, the therapeutic modality, the age, parity,
      menstrual state of patient.

PMID- 8354095
TI  - [Cytotoxicity of recombinant human tumor necrosis factor (rHTNF) alone and in
      combination with chemotherapeutic agents on human ovarian cancer cells].
AB  - The cytotoxic activities of recombinant human tumor necrosis factor (rHTNF) and
      five chemotherapeutic agents, CTX, 5-FU, VCR, DDP, KSM, against two human ovarian
      cancer cell lines, OVCAR3 and CAOV3, using the MTT assay were studied. The result
      showed that cytotoxicities of rHTNF at 5 x 10(4)-5 x 10(7) U/L against CAOV3 cell
      line for 24h exposure were from 14.2% +/- 6.8% to 67.2% +/- 3.0%, and that
      against CAOV3 cell line were from 8.2% +/- 4.3% to 60.9% +/- 1.3%. The cytotoxic
      effects of all five chemotherapeutic agents against the two cell lines were much
      lower than that of rHTNF. Various degrees of synergistic enhancement
      cytotoxicities of DDP or KSM in combination with rHTNF were assessed. Especially,
      distinct synergistic effects of a low dose, 50kU/L, or rHTNF with nearly all
      concentration (10(-4)-10(-1) mg/L) of KSM were obtained on the two cell lines.

PMID- 8354096
TI  - [Pregnancy induced hypertension and calcium deficiency].

PMID- 8354097
TI  - [Radioimmunoscintigraphy in the diagnosis of early and recurrent ovarian
      cancers].

PMID- 8354098
TI  - The feedsideward of cephalo-adrenal immune interactions.
AB  - The feedsideward phenomenon is the interaction of three or more rhythmic
      physiological entities by a diversified spectrum of rhythms that constitute a
      rhythmic network. These rhythmic units are: a) the modulator, b) the actor, c)
      the reactor and d) the integrative unity. Rhythmic interactions are characterized
      by an alternating sequence of algorithmically predictable effects of attenuation,
      no effect, and stimulation occurring in different frequencies. The basis of this
      phenomenon was determined from experimental evidence derived from cephalo-adrenal
      ex vivo studies. Internal phase-shift studies allow the demonstration ex vivo of
      a collateral hierarchy of rhythmic neuro-endocrine interactions as alpha, beta,
      gamma and delta rhythms. Linear least squares analyses describe and quantify
      circadian (alpha, beta and gamma) and infradian (delta) rhythms in the original
      series and the differences in responses [beta-alpha] and [gamma-delta]. These
      spontaneous and response rhythms reveal a collateral neuro-endocrine hierarchy
      and validate a pineal feedsideward phenomenon. Circadian-infradian murine
      rhythmic intermodulations are demonstrated in the epithelial corneal mitosis;
      brain neurosteroids and pineal melatonin content. A circadian rhythm in pineal
      melatonin content in female B6D2F1 mice and the chronomodulating action of
      melatonin + ACTH upon adrenal corticosterone production are confirmed. A
      chronopilot ex vivo study "suggests" that melatonin chronomodulates mouse
      aldosterone production. In a second chronopilot study, HrIL-2 chronomodulates rat
      corticosterone production ex vivo. Feedsidewards in vivo were seen in the
      chronomodulation of tumor-host balance occurring after melatonin, IL-2,
      cefodizime, and cyclosporine treatments that enhanced or delayed tumor growth and
      survival time of tumor-bearing mice.

PMID- 8354099
TI  - Beyond circadian chronorisk.

PMID- 8354100
TI  - More on chronomes: circaseptans and circasemiseptans in Marburg, Germany, and 47
      other locations.

PMID- 8354101
TI  - Relationship between activity levels and circadian blood pressure variations.
AB  - In 17 healthy Japanese students (14 males and 3 females) an ambulatory activity
      level monitoring instrument (Actigraph) was attached to the wrist for 48-hour
      measurement of wrist movement (with 0.01G or higher acceleration). At the same
      time, an ambulatory blood pressure monitoring apparatus was attached to these
      subjects to monitor blood pressure (BP) and heart rate (HR) every 30 minutes.
      Sleeping hours were calculated from the activity levels. The sleeping hours
      obtained by the Actigraph correlated with those judged from the diary. The
      correlation was better for the go-to-sleep time than for the awakening time.
      Activity level, HR and BP showed a similar circadian variation. Activity level
      differed significantly between the active daytime (4500 counts/hour) and during
      sleep at night (720 counts/hour). The acrophase of activity level, obtained by
      the cosinor method, was 235 degrees which did not significantly differ from that
      of BP and HR. Hourly activity levels correlated with HR and BP at corresponding
      hours. These results suggest that BP is affected by activity levels even if this
      rhythm continues to recur in bedrest.

PMID- 8354102
TI  - Circadian stage-dependence of acetyl-L-carnitine effects on blood pressure and
      heart rate of clinically healthy subjects.

PMID- 8354103
TI  - Repeated alcohol intake changes circadian rhythm of ambulatory blood pressure.
AB  - The blood pressure of 7 clinically healthy volunteering social drinkers was
      studied while they consumed, with a crossover design for 5 days, either 40 g of
      alcohol by day or fruit juice, with the two spans on alcohol and juice being
      separated by a one-week washout. Whereas the rhythm-adjusted mean was not
      changed, a clear statistically significant increase in the circadian double
      amplitude was found. The study provides a model for a rapidly achieved circadian
      amplitude hypertension which may precede an elevation of the overall blood
      pressure mean in the natural course of the disease.

PMID- 8354104
TI  - Beyond circadian chronorisk: worldwide circaseptan-circasemiseptan patterns of
      myocardial infarctions, other vascular events, and emergencies.

PMID- 8354105
TI  - [Structural basis of mutagenicity of heterocyclic amines].
AB  - The CASE (computer-automated structure evaluation) was used to gain an
      understanding of the basis of mutagenicity of heterocyclic amines. It was found
      that the activity of these molecules was dependent upon the amino connected with
      the carbon in the benzene cycle, and the position of nitrogens in the heterocycle
      was also important. Both the sensitivity and specificity of the CASE system
      established in my laboratory approached 1.00.

PMID- 8354106
TI  - [The causes for hyporeactiveness of vaccination against hepatitis B and the
      strategies to resolve the situations].

PMID- 8354107
TI  - [The use of decision making analysis for evaluating hepatitis B inoculation
      strategy].
AB  - Using quality adjusted life year (QALY) as an evaluation measure of cost
      effectiveness for assessing hepatitis B inoculation strategy in China, through
      the decision tree model. The result showed that for hepatitis B inoculation,
      priority should be given to neonates and infants aged 0-3 years; and the age of
      vaccination subjects be extended to, adults older than 25 yrs. The result also
      indicated: that the net cost for each QALY gained due to vaccination was very
      high, so that the ultimate control of hepatitis B epidemic not only depended on
      the development of highly effective and inexpensive vaccine, but also on the
      improvement of economic level and sanitary status.

PMID- 8354108
TI  - [Immune-efficacy of recombinant vaccinia HB vaccine on middle school students of
      Uigur nationality].
AB  - Immunization efficacy of HB vaccine which is gene engineering vaccine of vaccinia
      virus recombinant was studied. A total of 206 middle school students of Uygur
      nationality in Hami, Xinjiang was vaccinated. A varying dosage of 10 micrograms,
      5 micrograms, and 2.5 micrograms and 0, 1, 2 months schedule was carried out. The
      results showed that a seroconversion rate of 100%, 92.4% and 83.5%, in respect to
      10 micrograms, 5 micrograms and 2.5 micrograms dosages were found while the
      mIU/ml values were 129.25, 132.27 and 121.18 respectively. The difference between
      seroconversion rates of 10 micrograms and 2.5 micrograms was significant (P <
      0.05), whereas, that between conversion rate due to 10 micrograms and 5
      micrograms was not (P > 0.05). Results in a year after primary immunization
      showed seroconversion rates of the three groups being 97.10%, 89.80% and 76.00%
      (P < 0.05); mIU/ml value were 151.0, 95.2 and 71.6 (P < 0.01), showing that the
      10 micrograms group gave superior results to the 5 micrograms and 2.5 micrograms
      groups.

PMID- 8354109
TI  - [Effects of cereals from Kaschin-Beck's disease endemic area on fibrillogenesis
      in vitro of cartilage type II collagen in rats].
AB  - In this feeding trial, rats were fed with diets of (a) cereals from Kaschin
      Beck's Disease (KBD) endemic area, (b) Sesupplemented cereals from the area as
      above, (c) cereals from non-KBD endemic area. The purpose of this experiment was
      to study the effects of cereals from KBD endemic area and Se on the kinetics of
      formation of cartilage type II collagen fibril, the stability and ultrastructure
      of fibrils formed in vitro. The results indicated that feeding of low-selenium
      cereals from KBD endemic area may cause decelaration of rats cartilage type II
      collagen fibrillogenesis, reduction of stability of fibril, diminishing of fibril
      diameters, and increase or decrease of fibril banding periods. Sesupplemented
      cereals from KBD endemic area partially rectified the pathologic changes
      mentioned above. These observations are important for further study on the
      etiology and pathology of KBD.

PMID- 8354110
TI  - [Health effects on workers exposed to low concentration carbon monoxide at high
      altitude].
AB  - Workers exposed to carbon monoxide (CO) at a concentration of 26.8mg/m3 at an
      altitude of 2,300 metres above sea level were compared with a control group of
      local inhabitants. There were significant differences in symptoms of headache,
      vertige fatigue and weakness memory impairment, insomnia, palpitation and
      neurobehavioral functions. CO concentration in respiratory air and HbCO in blood
      was higher but partial pressure of oxygen (PO2) and saturation of oxygen (SaO2)
      in blood was lower in the exposed group than the control group. Self-comparison
      of CO in respiratory air and HbCO in blood was higher after work than before
      work. Neurasthenia rate was significantly higher but PO2 and SaO2 significantly
      lower at high altitude than in the plain. The results indicated that under same
      CO concentrations the hazards to workers at high altitude were greater than to
      those working in the plain. The author recommends that at high altitude the CO
      permissible level should be appropriately lowered.

PMID- 8354111
TI  - [Multidimensional assessment study on the health and functional status of elderly
      in Xicheng district of Beijing City].
AB  - This paper evaluates the health and functional status of the elderly in four
      dimensions, i.e. social support, mental health, physical health, activities of
      daily living (ADL). The results indicated: a) the ability to live independently
      was the most important health problem of the elderly in urban area; b) In the
      elderly, the mental health, physical health and ADL were closely interrelated,
      social support had various positive effects on the three other dimensions
      mentioned above; c) income, sex, age and employment history were four important
      demographic and socioeconomic factors influencing the health and functional
      status of the elderly. The results also indicated that mean Ridit and the
      cumulative impairment score are two useful indices for evaluating health and
      function.

PMID- 8354112
TI  - [Study on determinationing the bone mineral content as diagnostic value for
      occupational fluorosis].
AB  - The results of determination of the bone density of 194 workers exposed to
      fluorine by SPA-III type osteodensimeter were compared with people unexposed to
      fluorine, and with the results of diagnosing the luorosis by X-ray. (1) The
      abnormal bone cortex thickness and density rate in the people exposed to fluorine
      was significantly higher than the ordinary people (P < 0.05). (2) In the people
      exposed to fluorine, the correspondency rate of determining fluorosis of bone by
      X-ray and by osteodensimeter were 84.6%, and results of the two methods had no
      significant difference (P > 0.05). (3) In another group of 155 cases, whose
      values of hair fluorine and urinary fluorine were higher than the ordinary people
      (66.5%), the abnormal density of bone of 103 cases had been determined by
      osteodensimeter, but not by X-ray. This showed that the diagnosis of early
      changes of osteofluorosis by osteodensimeter was more sensitive than by X-ray.
      (4) There was close association between the unusual rate of osteodensity and the
      superstandard rate of hair fluorine and urinary fluorine. The above findings
      indicated the determination of bone density can be used as a diagnostic index for
      occupational fluorosis.

PMID- 8354113
TI  - [Study of total lead exposure on a hazard to the health of children].
AB  - This study of total lead exposure on 128 children from four kindergartens in
      Beijing and 194 children from two townships in the suburb of Beijing, all aged
      between 5 and 6.5 years, showed that the urban children had higher blood lead
      levels (0.375 mumol/L, 7.77 micrograms/dl) than their teachers' (0.223 mumol/L,
      4.63 micrograms/dl) by 67.4%. While suburban children had higher blood lead
      levels (0.594 mumol/L, 12.3 micrograms/dl) than their mothers' (0.299 mumol/L,
      6.19 micrograms/dl) by 98.7%. There was approximately 72.5%-74.7% of suburban
      children whose blood lead levels were well over 0.483 mumol/L (10 micrograms/dl)
      and 23%-25% were above 0.724 mumol/L (15 micrograms/dl). Suburban children had
      higher FEP levels and an abnormal rate of FEP than urban children. The lead
      levels taken in through diet by suburban children were higher (43.7-85.9
      micrograms/day per child) than urban children (29.3 micrograms/day per child). As
      the main source of lead came from foodstuff and air, 90%-98% of lead was taken in
      with food, of which 89% came from intake of cereals and vegetables. There was a
      significant correlation between the blood lead levels, the practical intelligence
      quotient (IQ), and the visomotor integration based upon the survey of the two
      groups of children. The results showed that the lead exposure poses a significant
      hazard to the health of children in Beijing.

PMID- 8354114
TI  - [Study on cadmium load and calcium deficit].
AB  - The effects of cadmium given by intraperitoneal injection on calcium absorption
      and calcium balance in rats were investigated. The results showed that intestinal
      calcium absorption rate decreased steadily with increasing cadmium load. When the
      cadmium load exceeded 9.0 mg, the average calcium absorption fell into negative
      value and thus led most of the rats to calcium deficit. It suggested that the
      negative calcium balance in rats was caused mainly by way of fecal excretion
      rather than the urinary route, since the calcium loss via the intestinal tract
      surpassed that via the urinary tract. The excess of urinary calcium
      (hypercalciurea), which appeared concurrently with that of feacl one's has,
      however, the same significance of indicating the calcium loss, so it can be
      referred to an indicator of calcium deficit. Our results gave no support to the
      view that calcium deficit and skeletal lesion were resulted from the calcium loss
      by urinary way. In the study, we found that there was negative correlation
      between cadmium burden and calcium balance, and there was remarkable dose
      response relationship between cadmium burden and the rate of calcium deficit.

PMID- 8354115
TI  - [Effects of water hardness and salt intake on the formation and disappearance of
      experimental atherosclerosis].
AB  - The present study examined the effects of water-hardness and salt-intake, both of
      which were higher in north China than in the south, on experimental
      atherosclerosis in quail. At the end of the experiment atherosclerotic lesions in
      the high-salt groups were found to be more marked than those in the low-salt
      groups. No significant difference in total cholesterol value was found between
      the two groups. There was a significant positive correlation between the degree
      of atherosclerosis and serum-sodium value (r = 0.501, P < 0.01). There was no
      difference in all values between hard-water or soft-water groups. Our study
      suggested that high salt-intake stimulated and enhanced the formation of
      atherosclerosis while it delayed and impeded its disappearance, but water
      hardness did not.

PMID- 8354116
TI  - DNA cytometry consensus conference.

PMID- 8354117
TI  - Guidelines for implementation of clinical DNA cytometry. International Society
      for Analytical Cytology.

PMID- 8354118
TI  - Consensus review of the clinical utility of DNA cytometry in bladder cancer.
      Report of the DNA Cytometry Consensus Conference.

PMID- 8354119
TI  - Consensus review of the clinical utility of DNA cytometry in carcinoma of the
      breast. Report of the DNA Cytometry Consensus Conference.

PMID- 8354120
TI  - Consensus review of the clinical utility of DNA flow cytometry in colorectal
      cancer.

PMID- 8354121
TI  - Consensus review of the clinical utility of DNA flow cytometry in neoplastic
      hematopathology.

PMID- 8354122
TI  - Consensus review of the clinical utility of DNA content cytometry in prostate
      cancer.

PMID- 8354123
TI  - The homing cursor: a tool for three-dimensional chromosome analysis.
AB  - When studying the three-dimensional shape of prophase chromosomes (or any other
      tubular structure), it is useful to represent these structures as a string of
      three-dimensional Cartesian coordinates along the medial axis. This procedure was
      automated in order to limit the number of human interactions and to improve
      reproducibility. In this paper the design, implementation, and validation of the
      automated method is presented. From the data presented it can be concluded that
      the cursor algorithm provides an objective and therefore reproducible method to
      trace the medial axes of prophase chromosomes automatically. This method could
      allow a more extensive understanding of the (changes in) chromosome organisation
      throughout the cell cycle, its relation to cell function, and the complex process
      of chromosome condensation.

PMID- 8354124
TI  - Derivative domain fitting: a new method for resolving a mixture of normal
      distributions in the presence of a contaminating background.
AB  - Derivative domain least squares analysis is a new method for resolving multiple
      peaks superimposed on a slowly varying continuum into separate normal (Gaussian)
      distributions without developing a functional approximation for the continuum.
      The method is based on fitting the first derivative of the data with the first
      derivative of the sum of a series of normal distributions. A functional
      approximation for the continuum is not necessary as long as the first derivative
      of the continuum is approximately zero (i.e., the continuum varies slowly
      compared to the normal distributions).

PMID- 8354125
TI  - Detection of rare cells at a frequency of one per million by flow cytometry.
AB  - In a model study we seeded the pre-B-cell line REH into 250 million peripheral
      blood mononuclear cells (PBMC) at frequencies of 10(-4), 10(-5), and 10(-6). By
      flow cytometry we could detect the REH cells and found a background of about one
      event per 100 million PBMC. This sensitivity was achieved by removing four
      sources of false positive events, including nonspecific immunofluorescence,
      autofluorescence, background particles from previous experiments, and bursts of
      events during acquisition. To overcome limits to rare event detection imposed by
      nonspecific staining and autofluorescence, we used positive and negative
      selection for the REH cells. Another fluorochrome was added to stain the
      background cells and particles. In order to remove particles and background from
      previous experiments, a cleaning technique was developed and event bursts were
      removed from the analysis by developing an algorithm that screens the list-mode
      data for events that were not Poisson distributed.

PMID- 8354126
TI  - Determining Tpot in heterogeneous systems: a new approach illustrated with
      multicell spheroids.
AB  - Like many tumors, multicell spheroids from Chinese hamster V79-171b fibroblasts
      display karyotypic heterogeneity as they enlarge. This creates significant
      problems for analysis of univariate DNA content histograms of cells from
      spheroids, and even for bivariate bromodeoxyuridine (BrdUrd)/DNA flow histograms.
      While attempting to routinely measure spheroid cell kinetics with the latter
      approach, a simple alternative that overcomes many of the inherent problems
      emerged. The exit rate of BrdUrd-labelled cells from the S-phase compartment(s),
      determined using standard DNA analysis software, is used to define the duration
      of S-phase and ultimately the potential doubling time of the clonogenic cell
      population. This approach appears to offer several advantages over the
      conventional "relative movement" technique for heterogeneous samples,
      particularly since the subjective distinction between labelled/divided tetraploid
      G1 cells vs. labelled/undivided diploid G2 is no longer required. Further, the
      technique avoids some potential artifacts that might be expected for
      heterogeneous tumors where cell subpopulations proliferate with quite different
      cell kinetics.

PMID- 8354127
TI  - Comparison of pepsin and trypsin digestion on paraffin-embedded tissue
      preparation for DNA flow cytometry.
AB  - Preparation with enzymes plays an important part in obtaining good results in
      cellular DNA content measurements from paraffin-embedded tissue using flow
      cytometry. Therefore, we have compared two groups of DNA histograms obtained with
      pepsin (Hedley method) and trypsin digestion (Schutte method). Samples of five
      tumor types were compared: eight lung, seven breast, five thyroid, seven stomach,
      and six colon cancer cases. All samples were stained with propidium iodide (PI).
      The incidence of DNA aneuploidy determined by the Schutte method indicated a
      higher ratio in four tumor types than that determined by the Hedley method.
      Concerning the coefficient of variation (CV) used to estimate the quality of the
      DNA histogram, the diploid G1 peak determined by the Schutte method produced a
      smaller CV in five tumor types than did the Hedley method. This Schutte method
      had especially good results in lung and thyroid cancer. Furthermore, the amount
      of debris (background) determined by the Schutte method indicated a decrease in
      four tumor types compared with the Hedley method. In cell-cycle analysis of ten
      DNA diploid cases, DNA histograms by the Hedley method showed an increased S
      phase fraction due to an overlapping of debris and aggregated cells. These
      results indicate that preparation by trypsin digestion is a method superior to
      pepsin digestion when the sample from paraffin-embedded tissue is stained with PI
      for the purpose of DNA content measurement.

PMID- 8354128
TI  - Variations in DNA aneuploid cell content during tumor dissociation in human colon
      and head and neck cancers analyzed by flow cytometry.
AB  - Experimental research involving human solid tumors often requires single cell
      suspensions of high yield that are representative of the tissue of origin and in
      which the cellular property of interest is preserved. This is particularly
      necessary for the determination of DNA ploidy by flow cytometry. Mechanical
      dissaggregation and proteolytic enzyme digestion are the most commonly employed
      dissociation techniques for solid tumors. Comparative testing of techniques is
      often not performed. Mechanical and proteolytic enzyme dissociation techniques
      were comparatively tested in 77 human squamous cell cancers of the head and neck
      (SCCHN) and 25 human colon cancers for cellular yield, dye exclusion viability,
      quality, and morphology of DNA histograms, and the presence and proportion of DNA
      aneuploid subpopulations. Significant and consistent DNA aneuploid subpopulation
      losses were noted in mechanical preparations of SCCHN and enzymatic preparations
      of colon cancers. The frequency of SCCHN specimens with DNA aneuploid
      subpopulations was underestimated by 52% in mechanical cell suspensions, and the
      proportion of DNA aneuploid cells was diminished in an additional 30% of the
      specimens. Conversely, the frequency of specimens with DNA aneuploid
      subpopulations was underestimated by 38% in cell suspensions from enzymatically
      dissociated human colon cancer and their proportion diminished in an additional
      50% of the specimens. Incubations of human colon cancers with three commonly
      employed proteolytic enzymes demonstrated a progressive loss of DNA aneuploid
      subpopulations as a function of enzyme concentration and incubation time. This is
      a serious potential source of error in the flow cytometric determination of DNA
      ploidy in human solid tumors, and may contribute to the diversity of results
      obtained and occasional contradictory conclusions reached in such studies.

PMID- 8354129
TI  - DNA ploidy status and DNA content instability within single tumors in renal cell
      carcinoma.
AB  - In order to investigate the relationship between genetic instability and DNA
      aneuploidy of malignant cells in human solid tumors, we studied the variations of
      DNA index within a single tumor. Multiple sampling (mean of 6.4 samples per
      tumor) was performed in 24 renal cell carcinomas (RCC). Based on the variations
      in DNA indices within a single tumor, RCC were divided into three groups: 1)
      tumors with stable DNA indices (variation within the range of the measurement
      error), including all DNA diploid tumors (n = 8), all hyperdiploid tumors (n =
      3), a hypodiploid tumor (n = 1), and only 2 of 11 tetraploid and hypotetraploid
      tumors; 2) tumors with moderate variations in DNA indices, which were all close
      to tetraploidy (n = 5); and 3) tumors with large variations of DNA indices. In
      this last group, subclones present within a tumor varied widely in their DNA
      indices from the tetraploid to the triploid region, reflecting the DNA content
      instability within the tumor cell population. These results suggest that DNA
      aneuploidy can arise by two different mechanisms: 1) loss or gain of chromosomes
      leading to hypodiploid or hyperdiploid tumors with no apparent increase in DNA
      content instability, and 2) doubling of the chromosome set followed by random
      loss of chromosomes as suggested by the DNA indices ranging from tetraploid to
      triploid region found in three tumors. Differences in DNA indices within one
      tumor characterize subclones which may arise by chromosome loss or gain.

PMID- 8354130
TI  - Recognition and reduction of artifacts from autolysis in paraffin-embedded tissue
      using DNA/nuclear protein flow cytometry.
AB  - Artifacts from autolysis can be a problem in retrospective flow-cytometric
      analyses of DNA content in paraffin-embedded tissues. Autolyzed tissue from rat
      liver, human liver, and rat spleen were stained for DNA and nuclear protein to
      determine if this technique would be useful in identifying partially degraded
      cells. After the tissue was deparaffinized and rehydrated, the nuclei were
      isolated using 0.5% pepsin. Propidium iodide (PI) and fluorescein isothiocyanate
      (FITC) were used to stain DNA and nuclear protein. When unfixed rat liver tissue
      was allowed to undergo autolysis at 4 degrees C for 24-48 h before fixation,
      there was a progressive broadening of the G1 and G2M DNA peaks and a slight
      increase in the average DNA contents of these peaks. Nuclei that stained more
      intensely with PI also stained more intensely with FITC. Similar results were
      obtained using human liver and rat spleen. Sometimes the increased PI staining
      resulted in a false aneuploid peak. The distinctive skewing of the DNA/nuclear
      protein histograms from autolysis was reduced by increasing the incubation of the
      tissue in 0.5% pepsin from 0.5 h to 1.5 h during the nuclei-isolation step. The
      DNA/nuclear protein method provides a means for identifying artifacts from
      autolysis, whereas the extended pepsin treatment provides a means for reducing
      these artifacts.

PMID- 8354131
TI  - An improved assay for the detection of Toxoplasma gondii antibodies in human
      serum by flow cytometry.
AB  - The diagnosis of toxoplasmosis relies primarily on the demonstration of specific
      antibodies to Toxoplasma gondii. We describe a flow cytometry method for the
      determination of antibodies to whole fixed tachyzoites by indirect
      immunofluorescence. Fixed tachyzoites in suspension have characteristic light
      scattering properties. The amount of IgM, IgG, and IgA antibodies from patients'
      sera bound to the tachyzoites can be estimated from the mean fluorescence
      intensities observed using class-specific conjugates for different Ig heavy
      chains. Appropriate serum dilutions for the estimation of specific IgG titres and
      for the discrimination between sera positive and negative for IgA and IgM
      antibodies were established using 40 random sera from pregnant women. The method
      proved to be quantitative and highly sensitive as compared with currently used
      assays. Coefficients of variation between series ranged from 6.4% to 12.2% and
      could be controlled by the inclusion of positive and negative standard sera in
      the test series. The method might represent a major improvement in cost
      effectiveness as compared with routine immunofluorescence assay by fluorescent
      microscopy when the volume of testing is sufficient. It can be fully automated,
      and its large scale application is currently under investigation.

PMID- 8354133
TI  - Fluorescence instability of propidium iodide-labelled microspheres in
      (para)formaldehyde.
AB  - An instability of the fluorescence of propidium iodide (PI)-labelled microspheres
      was observed when the beads were used as an internal fluorescence standard in
      cell samples suspended in paraformaldehyde (pFA) for flow cytometric phenotyping.
      Flow cytometry of fluorochrome-labelled microspheres as well as
      spectrofluorometry of PI-fluorochrome solutions in PBS-buffered 1% pFA or
      formalin (FA) revealed strong increases of PI fluorescence starting immediately
      after the addition to the fixatives. We propose a chemical reaction which leads
      to two additional conjugated double bonds in the modified fluorochrome causing
      the increased fluorescence emission. Therefore, PI-labelled microspheres should
      not be applied as internal fluorescence references in aldehyde-containing cell
      suspensions for flow cytometric analysis, except when the time interval between
      the addition of beads and the measurement can be kept constant or if it lasts
      longer than 1 h.

PMID- 8354132
TI  - Quality control study of the Italian group of cytometry on flow cytometry
      cellular DNA content measurements.
AB  - A quality control study on DNA flow cytometry, extended to 43 national
      laboratories, has been carried out by the Italian Group of Cytometry, using
      defined fixed suspensions of cultured human leukemia K562 cells and human blood
      lymphocytes. The participating laboratories were allowed to follow their own
      staining and measurement protocols. Aliquots of cellular suspension had to be
      measured three times on the same day and two other times on different days. A
      large heterogeneity of procedures emerged among participants. The average of mean
      DNA index laboratory values, from 36 laboratories who sent evaluable data, was
      1.68, with a range from 1.49 to 1.97. The coefficients of variation ranged from
      2.35 to 9.39% and from 2.79 to 8.5% for diploid and aneuploid peaks,
      respectively. Statistical analysis of the results showed quite good
      intralaboratory reproducibility, but statistically significant differences were
      observed among laboratories, for both DNA indices and coefficients of variation.
      These differences appear to be consistent. For standardization, it is essential
      that efforts should be made to identify the main sources of variation and to
      control them.

PMID- 8354134
TI  - Medicines cheaper over the counter.

PMID- 8354135
TI  - [The prevalence of neurodermatitis among school children in the Hannover
      administrative district].
AB  - A special questionnaire was developed to obtain up-to-date data on the prevalence
      of atopic dermatitis among children. It was validated by specialist diagnosis in
      320 children, providing a diagnostic sensitivity and specificity of 97%. This
      questionnaire was used for all school entrants in 1990 in the Hanover District. A
      total of 4,916 children were examined and the questionnaire satisfactorily
      completed by a relative or guardian (usually the mother) of 4,651. The prevalence
      of atopic dermatitis was 11.8%, ranging from 8.4% to 17.3% among the 20
      constituent communities. The regional differences were smaller than the scatter
      of diagnostic classifications by the school doctors and the reports of a positive
      history by the parents. The results demonstrate the validity of a systematic
      enquiry employing relevant diagnostic and anamnestic items.

PMID- 8354136
TI  - [A comparison of the gastroduodenal tolerance of ticlopidine and acetylsalicylic
      acid].
AB  - Changes in the gastroduodenal mucosa caused by 250 mg ticlopidine twice daily
      (group 1; n = 12) or 300 mg aspirin daily (group 2; n = 12) were compared in a
      randomized double-blind trial of 24 healthy men, aged 20 to 35 years. An
      oesophago-gastroduodenoscopy was performed before and after either drug had been
      taken for 7 days. Results were tabulated according to a uniform scoring system
      (normal mucosa, erythema, petechiae, erosions, ulcer, and blood in the lumen).
      Both groups had identical scores at the start of the trial (group 1: 0.9 +/- 0.1;
      group 2: 0.8 +/- 0.1). After the seven days, the score in group 2 had risen to
      9.7 +/- 1.5 (median 9.0), while it had hardly changed in group 1 (1.7 +/- 0.5;
      median 1.0), a statistically significant difference (P < 0.05). The data indicate
      that ticlopidine is better tolerated by the gastroduodenal mucosa than low dosage
      aspirin.

PMID- 8354137
TI  - [Thoracic actinomycosis masquerading as a central bronchial carcinoma].
AB  - A 41-year-old cachectic woman (weight 42.7 kg, height 1.65 m) was admitted to
      hospital because a chest radiogram had suggested a left central bronchial
      carcinoma. Four days previously she had noted for the first time a firm elastic
      swelling parasternally in the fourth intercostal space. This swelling was
      directly aspirated by needle after bronchoscopic results had been nonspecific.
      Surprisingly, pus containing actinomyces filaments was aspirated. Computed
      tomography confirmed a paramediastinal abscess, 8 x 5 x 6 cm, which had
      infiltrated into the left thoracic wall. The abscess was incised and drained.
      After treatment for two weeks, initially with three times daily 10 mega
      penicillin G intravenously, followed by erythromycin, 500 mg twice daily for 12
      weeks, the thoracic actinomycosis was no longer demonstrable radiologically and
      by ultrasound. It is suggested that in any unclear pulmonary infiltrate without
      evidence of tuberculosis or carcinoma actinomycosis should be included in the
      differential diagnosis.

PMID- 8354138
TI  - [Biliary complications following laparoscopic cholecystectomy. Endoscopic
      retrograde cholangiopancreatography in the diagnosis and therapy].

PMID- 8354139
TI  - [Cushing syndrome. III: Cortisol or glucocorticoid excess].

PMID- 8354140
TI  - [Stepwise diagnosis in oropharyngeal dysphagia and functional disorders of the
      pharyngoesophageal segment].

PMID- 8354141
TI  - [Helicobacter pylori infection and ulcer disease].

PMID- 8354142
TI  - [Oxyuriasis].

PMID- 8354143
TI  - [Oral hygiene in the critically ill].

PMID- 8354144
TI  - [An accelerated appearance of a multifocal leukoencephalopathy caused by
      fluorouracil and ranitidine].

PMID- 8354145
TI  - [Obstructive jaundice caused by a metal clip in the common bile duct following
      laparoscopic cholecystectomy].

PMID- 8354147
TI  - [Blood pressure development in children and youth. Observation of its course in
      children over 10 years].
AB  - 115 children (79 boys, 36 girls; mean age 11 4/12 [10 1/2-15 4/12] years) with
      primary borderline blood pressure or mild hypertension (90th to 97th percentile
      according to the German League for the Fight Against High Blood Pressure) and 115
      healthy children of corresponding age (52 boys and 63 girls) with innocent
      cardiac murmurs were followed in a paediatric cardiologic outpatient department,
      initially for 5 years. Blood pressure was measured at rest and on exercise
      (bicycle ergometry). After 5 years 51 of the children with primary hypertension
      (44%) still had borderline pressures, in 11 moderately severe hypertension had
      developed, while in the remaining 53 children (46%) the blood pressure was
      normal. Among the control group borderline pressures were recorded in only two
      children. After 10 years, 92 children in the test group and 79 in the control
      group were re-examined. 26 children (28%) among the test group were normotensive,
      35 (38%) had borderline pressures, and 31 (34%) had moderately severe
      hypertension. Among the control group, borderline hypertension had developed in 3
      children, moderate hypertension in one. Among children with persisting
      hypertension those with hypertension on exercise and/or over-weight significantly
      predominated (85% and 66%, respectively).

PMID- 8354146
TI  - [Acute effect of metoclopramide on esophagus motility in diabetes mellitus].
AB  - The acute effect of metoclopramide on oesophageal motility was investigated
      prospectively in 33 consecutive patients (20 men and 13 women; mean age 60.5 +/-
      12.6 years) with type I (n = 8) or type II (n = 25) diabetes. 15 patients had a
      peripheral sensory-motor polyneuropathy only and three just an autonomic cardial
      neuropathy. Both lesions were present in ten, none in five. No patient had
      oesophago-gastroduodenal lesions. Sphincter pressure, relaxation time,
      contraction amplitude and propulsion velocity of bolus-induced oesophageal
      peristalsis were measured manometrically after intravenous administration of 10
      mg metoclopramide. Resting pressure in the lower oesophageal sphincter rose
      significantly by 26.7%, contraction amplitude in the tubular portion of the
      oesophagus by more than 30%, and propulsion velocity by more than 20% (P for each
      < 0.05). At the same time the amount of segmental and aperistaltic oesophageal
      contractions regressed significantly. The effect of metoclopramide was
      demonstrated regardless of the type of diabetes, duration of diabetes and any
      manifestation of autonomic cardial or peripheral sensory-motor neuropathy.

PMID- 8354148
TI  - [Glucocorticoid monotherapy for Cogan syndrome?].
AB  - A 27-year-old woman suddenly developed persistent rotatory dizziness with
      unsteadiness on standing and walking, associated with symptoms relating to the
      autonomic nervous system, all signs and symptoms disappearing without treatment
      in 3 days. Ten days before this episode she had noticed progressive bilateral
      impairment of hearing accompanied by tinnitus. Caloric and audiometric tests
      confirmed bilateral impairment of the audiovestibular organ. A week later she
      also developed bilateral iritis and papillitis. The constellation of ocular and
      audiovestibular signs suggested Cogan's syndrome. Under high-dosage
      glucocorticoid treatment (initially 1,000 mg/d prednisolone intravenously for 3
      days, then 100 mg/d orally in decreasing doses down to 10 mg daily) the ocular
      signs improved, but the bilateral hearing impairment persisted. A recurrence
      occurred after 5 months, while on a prednisolone dosage of 10 mg daily, together
      for the first time with arthralgias, suggesting systemic involvement. Although
      the symptoms quickly subsided when dosage was increased to 100 mg daily, repeated
      attempts at dose reduction brought about renewed exacerbation at 70 mg daily. As
      the necessary high steroid dosage led to severe side effects, an
      immunosuppressive drug was added (100 mg cyclophosphamide and 20 mg prednisolone,
      both daily; later 5 mg methotrexate weekly and 4 mg prednisolone every other
      day). The symptoms had not recurred when re-examined 7 months later.

PMID- 8354149
TI  - [Atrial septum aneurysm as the cause of a thromboembolic infarction of the brain
      stem and cerebellum?].
AB  - A 32-year-old woman with migraine for several years again had a migraine attack
      with headache, nausea, vomiting and eye-muscle disorder, 14 days after an
      uncomplicated delivery. Within 24 hours a left-dominant hemiparesis developed,
      followed 12 hours later by tonic-clonic seizure and deep unconsciousness (Glasgow
      score: 3); the patient could not be aroused. Cranial computed tomography revealed
      extensive infarction of the brainstem and cerebellum. Angiography demonstrated
      occlusion of the basilar artery but not other abnormalities of other vessels.
      There was no evidence for vascular anomalies and the clotting tests were normal.
      Transoesophageal echocardiography demonstrated an atrial septal aneurysm. But any
      interatrial shunt (e.g. through a patent foramen ovale) was excluded by colour
      Doppler sonography, making it highly unlikely that a paradoxical embolus was the
      cause of the infarction. The brainstem infarction resulting from the basilar
      artery occlusion did not respond to treatment and the patient died 10 days after
      the initial seizure.

PMID- 8354150
TI  - [Therapeutic possibilities for shoulder arthroscopy].

PMID- 8354151
TI  - [Cardioembolic stroke].

PMID- 8354152
TI  - [Are results from animal experiments applicable to humans?].

PMID- 8354153
TI  - [Sudden visual and speech disorder].

PMID- 8354154
TI  - [Resistance to diuretics in congestive heart insufficiency].

PMID- 8354155
TI  - The electro-auditory physiology frontier.

PMID- 8354156
TI  - Clinical correlates of sudden auditory-vestibular loss in a cochlear implant
      patient.
AB  - The precise electrophysiologic mechanism for sudden sensorineural auditory
      vestibular loss has yet to be defined. No human models exist for this idiopathic
      phenomenon. A 67-year-old cochlear implant (CI) patient experienced what could be
      termed a "typical" acute sudden auditory-vestibular loss. Vestibular and CI
      electrical psychophysical changes were monitored over a 22-month period. Once the
      acute vestibular problems diminished, CI electrical parameters returned to near
      pre-episode levels. Some improvement occurred in rotational chair phase lag and
      asymmetry. While improving, platform posturography continued to show difficulty
      performing sensory organization tests V and VI. These clinical findings may imply
      that ganglion cell and neuronal population are responsible for the auditory
      findings in sudden auditory-vestibular loss. Secondly, a CI patient may serve as
      an ideal human model for further study of this phenomenon, should it occur.

PMID- 8354157
TI  - Aggressive fibromatosis (fibrosarcoma) of the facial nerve.
AB  - Aggressive fibromatosis of the facial nerve is a very rare tumor. Three cases
      have been previously reported. The tumor is locally recurrent and often has a
      fatal outcome. This report is of a ten-year-old boy whose tumor originally
      developed in the parotid area with subsequent spread to the base of the skull,
      the neck and the cerebellopontine angle. Treatment was by wide surgical excision,
      radiation therapy and chemotherapy. Despite treatment, the patient died. The
      clinical features of this case will be described. Only wide surgical excision
      early in the course of the disease may offer a chance for cure.

PMID- 8354158
TI  - Aneurysms of the temporal bone.
AB  - Aneurysms of the internal carotid artery in the temporal bone are rare lesions
      which can present clinically as a growth in the middle ear cleft. Hemorrhage,
      occurring spontaneously or iatrogenically, is a primary concern. This study
      describes morphological and embryological characteristics of the internal carotid
      artery in relationship to the protympanum and temporal bone. Concepts of
      pathogenesis and pathology are discussed, with reference to the neurosurgical and
      otolaryngologic literature. Clinical characteristics, including methods of
      surgical repair, are presented using three illustrative case reports. Methods of
      surgical repair include: 1) reinforcement; 2) ligation; and 3) primary excision
      and reanastomosis.

PMID- 8354160
TI  - Viral otitis media.

PMID- 8354159
TI  - Is fine needle aspiration biopsy of salivary gland masses really necessary?
AB  - The use of fine needle aspirate biopsies (FNAB's) in the outpatient setting has
      progressively escalated, particularly in the area of head and neck pathology. An
      increasing percentage of these are for salivary gland masses. We present our
      experience with salivary gland FNAB's at our institution for four years, from
      1988-1992. One thousand and twenty-two (1,022) FNAB's of superficial masses were
      performed by two pathologists. One hundred sixty-three (15.9%) were salivary
      gland biopsies. Of these 163 cases, 21 (12.9%) were normal tissue, 77 (47.2%)
      were inflammatory processes, 50 (30.7%) were benign tumors, and 15 (9.2%) were
      malignant tumors. None of the aspirates were unsatisfactory. Tissue correlation
      was possible in 47 (28.8%) cases. Two false negative cases (4.3%) were
      identified; these were a Warthin's tumor diagnosed as chronic sialoadenitis by
      FNAB; and a poorly differentiated squamous cell carcinoma diagnosed as
      adenocarcinoma by FNAB. There were no false positive cases. Overall sensitivity
      was 95.7% and specificity was 100%. Our experience indicates that FNAB of
      salivary glands is an effective screening procedure in evaluating salivary gland
      masses. The cytologic diagnosis may assist the clinician in allaying patients'
      anxieties, as well as in further collateral workup prior to definitive therapy.

PMID- 8354161
TI  - Endoscopic view of ostium of nasolacrimal duct.

PMID- 8354162
TI  - Hemorrhagic polyp.

PMID- 8354163
TI  - Twenty years of environmental health research. A dedication to David P. Rall.

PMID- 8354164
TI  - Twenty years of environmental health research. A dedication to David P. Rall.
      Introduction.

PMID- 8354165
TI  - Advances in mechanisms of activation and deactivation of environmental chemicals.
AB  - Environmental chemicals are both activated and detoxified by phase I and phase II
      enzymes. The principal enzymes involved in phase I reactions are the cytochrome P
      450s. The phase II enzymes include hydrolase and the conjugative enzymes such as
      glucuronyltransferases, glutathione transferases, N-acetyltransferase, and
      sulfotransferase. Although other phase I and phase II enzymes exist, the present
      review is limited to these enzymes. Once thought to be a single enzyme, multiple
      cytochrome P-450 enzymes have been purified and characterized from many different
      species across the evolutionary tree. The application of molecular biology
      techniques to this field has identified more than 150 cytochrome P-450 genes to
      date. At least 20-30 cytochrome P-450 enzymes appear to exist in each mammalian
      species, and many polymorphisms in these enzymes are being identified. The
      cytochrome P-450 enzymes can now be expressed in recombinant form using cDNA
      expression systems. The phase II conjugative enzymes add a hydrophilic moiety
      such as sulfate, glucuronide, or acetate to compounds, which increases their
      water solubility and facilitates their excretion. However, conjugates of a number
      of compounds also result in more reactive electrophilic species, which appear to
      be the ultimate carcinogens. Many of these phase II enzymes also represent
      families of enzymes, and polymorphisms can affect the ability of these enzymes to
      metabolize chemicals. Whenever possible, we have reviewed knowledge of the human
      enzymes involved in particular pathways.

PMID- 8354166
TI  - Lead toxicity: current concerns.
AB  - Over the 20-year period since the first issue of Environmental Health
      Perspectives was published, there has been considerable progress in the
      understanding of the potential toxicity of exposure to lead. Many of these
      advances have been reviewed in published symposia, conferences, and review papers
      in EHP. This brief review identifies major advances as well as a number of
      current concerns that present opportunities for prevention and intervention
      strategies. The major scientific advance has been the demonstration that blood
      lead (PbB) levels of 10-15 micrograms/dL in newborn and very young infants result
      in cognitive and behavioral deficits. Further support for this observation is
      being obtained by prospective or longitudinal studies presently in progress. The
      mechanism(s) for the central nervous system effects of lead is unclear but
      involve lead interactions within calcium-mediated intracellular messenger systems
      and neurotransmission. Effects of low-level lead exposure on blood pressure,
      particularly in adult men, may be related to the effect of lead on calcium
      mediated control of vascular smooth muscle contraction and on the renin
      angiotensin system. Reproductive effects of lead have long been suspected, but
      low-level effects have not been well studied. Whether lead is a carcinogen or its
      association with renal adenocarcinoma is a consequence of cystic nephropathy is
      uncertain. Major risk factors for lead toxicity in children in the United States
      include nutrition, particularly deficiencies of essential metals, calcium, iron,
      and zinc, and housing and socioeconomic status. A goal for the year 2000 is to
      reduce prevalence of blood lead levels exceeding 15 micrograms/dL.

PMID- 8354167
TI  - Chemicals and cancer in humans: first evidence in experimental animals.
AB  - Certain human diseases have been traced to exposure to environmental and
      occupational chemicals. In many instances the first evidence of potential adverse
      effects came from experimental studies and were subsequently discovered in
      humans. Associations of human cancers, as a diverse group of diseases, and
      chemicals have been made since the middle 1700s. Since then, nearly 100
      chemicals, mixtures of chemicals, or exposure circumstances are now recognized as
      being or strongly implicated as being carcinogenic to humans. Of the less than
      1000 agents evaluated adequately for carcinogenicity in laboratory animals, a
      varying spectrum of data from studies on humans are available for only about 20
      25%. So far, more than 60 agents are linked unequivocally as causing cancer in
      humans, and another 50 or so are strongly suspected of being carcinogenic to
      humans. Not all of these have been or can be evaluated in animals because some
      are industrial processes or "occupations," some are environmental and cultural
      risk factors, and some are mixtures of agents. For those that can be studied
      experimentally, the qualitative concordance between humans and animals approaches
      unity, and in every case there is at least one common organ site of cancer in
      both species. The evidence of carcinogenicity in experimental animals preceded
      that observed in humans for nearly 30 agents and is the subject of this paper.

PMID- 8354168
TI  - Asbestos-induced lung disease.
AB  - This review attempts to deal with two major questions concerning asbestos-induced
      lung disease: How does inhaled asbestos cause cell proliferation and fibrosis?
      and Will there continue to be risk from exposure to asbestos in schools and
      public buildings? The first is a scientific question that has spawned many
      interesting new experiments over the past 10 years, and there appear to be two
      hypothetical schemes which could explain, at least in part, the
      fibroproliferative effects of asbestos fibers. One supports the view that toxic
      oxygen radicals generated on fiber surfaces and/or intracellularly are the
      central mediators of disease. The second hypothesis is not mutually exclusive of
      the first, but, in my opinion, may be integral to it, i.e., the cellular injury
      induced by oxygen radicals stimulates the elaboration of multiple varieties of
      growth factors and cytokines that mediate the pathogenesis of asbestosis. There
      is increasing evidence that molecules such as platelet-derived growth factor and
      transforming growth factor beta, both synthesized and secreted by activated lung
      macrophages, are responsible, respectively, for the increased interstitial cell
      populations and extracellular matrix proteins that are the hallmarks of asbestos
      induced fibrosis. The challenge today is to establish which combinations of the
      many factors released actually are playing a role in disease pathogenesis. The
      issue of continued risk currently is more a question of policy and perception
      than science because a sufficient database has not yet been established to allow
      full knowledge of the circumstances under which asbestos in buildings constitutes
      an ongoing health hazard. The litigious nature of this question does not help its
      resolution. In as much as public policy statements and risk assessment are not
      within my purview, I have focused on the state-of-the-art of asbestos as a
      complete carcinogen. It appears to be generally nongenotoxic, but all asbestos
      fiber types can induce chromosomal mutations and aneuploidy, perhaps through
      their ability to disrupt normal chromosome segregation.

PMID- 8354169
TI  - Complex mixtures of air pollutants: characterizing the cancer risk of polycyclic
      organic matter.
AB  - Complex mixtures of polycyclic organic matter (POM) are used to illustrate the
      scientific problems and issues associated with characterizing the comparative
      risk of related complex mixtures. The complexity of mixtures in which the active
      components are not well characterized present special challenges, which include
      identifying the critical components of mixtures, their sources, and the
      appropriate biomarker(s) of exposure and dose; developing the appropriate
      experimental models for dose-response assessment; species extrapolation; and
      developing a scientific basis for predicting from one mixture to another.
      Strategies for addressing these issues include bioassay-directed chemical
      characterization of bioactive components of complex mixtures, apportionment
      methods to determine the source of biological activity and risk, DNA adduct
      methods to determine tissue exposure and target dose of mixtures, and comparative
      approaches to determining the relative similarity, potency, and risk of complex
      mixtures. Epidemiological data are available for humans exposed to POM from coke
      ovens, coal roofing tar, coal smoke, aluminum smelters, and cigarette smoke.
      These emissions are characterized and compared to POM from automotive emissions
      (diesel and gasoline), woodstove emissions, residential oil furnace emissions,
      and ambient air particles. The tumor potency and estimated cancer risks for these
      POM mixtures ranges over nearly three orders of magnitude.

PMID- 8354170
TI  - Chemical agents and the immune response.
AB  - Our desire to understand the potential adverse human health effects of
      environmental chemical exposure has coincided with an increased understanding of
      the immune system and an appreciation of its complex regulatory network. This has
      spawned a broad interest in the area of immunotoxicology within the scientific
      community as well as certain concerns in the public sector regarding chemical
      induced hypersensitivity and immunosuppression. The incidence of alleged human
      sensitization to chemicals has increased, in part, due to the fact that chemical
      companies are moving to larger and/or different markets. It has been estimated
      that 35 million Americans suffer from allergic disease, of which 2-5% are from
      occupational exposure. Although there is not yet a clear understanding of dose
      response relationships or disease predisposition, there are many well-defined
      examples (isocyanates, anhydrides) of chemical sensitizers in humans and
      experimental animals. Evidence that chemicals suppress immune responses in humans
      is considerably less well established, although there is a public perception that
      chemicals generally cause immunosuppression. This perception has been fueled by
      highly publicized legal cases and scientific controversies within the academic
      and industrial communities. As a consequence of these public and scientific
      concerns, many of the regulatory agencies are developing immunotoxicity testing
      guidelines. At the present, however, there are limitations on adequate human
      methodology and data that allow the extrapolation of animal data to assess human
      risk. The potential for human immunosuppression remains of concern, however,
      because of a large database generated from animal studies that demonstrates
      immunosuppression as well as reports of immunosuppression in humans inadvertently
      (e.g., halogenated aromatic hydrocarbons) or occupationally (asbestos, benzene)
      exposed to xenobiotics.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354171
TI  - Carcinogenicity of 1,3-butadiene.
AB  - 1,3-Butadiene, a high-production volume chemical used largely in the manufacture
      of synthetic rubber, is a multiple organ carcinogen in rats and mice. In
      inhalation studies conducted in mice by the National Toxicology Program, high
      rates of early lethal lymphomas occurring at exposure levels of 625 ppm or higher
      reduced the development and expression of later developing tumors at other sites.
      Use of survival-adjusted tumor rates to account for competing risk factors
      provided a clearer indication of the dose responses for 1,3-butadiene-induced
      neoplasms. An increase in lung tumors in female mice was observed at exposure
      concentrations as low as 6.25 ppm, the lowest concentration ever used in a long
      term carcinogenicity study of this gas. Human exposures to 1,3-butadiene by
      workers employed at facilities that produce this chemical and at facilities that
      produce styrene-butadiene rubber have been measured at levels higher than those
      that cause cancer in animals. Furthermore, epidemiology studies have consistently
      revealed associations between occupational exposure to 1,3-butadiene and excess
      mortality due to lymphatic and hematopoietic cancers. In response to the
      carcinogenicity findings for 1,3-butadiene in animals and in humans, the
      Occupational Safety and Health Administration has proposed lowering the
      occupational exposure standard for this chemical from 1000 ppm to 2 ppm. Future
      work is needed to understand the mechanisms of tumor induction by 1,3-butadiene;
      however, the pursuit of this research should not delay the reduction of human
      exposure to this chemical.

PMID- 8354172
TI  - Contamination and restoration of groundwater aquifers.
AB  - Humans are exposed to chemicals in contaminated groundwaters that are used as
      sources of drinking water. Chemicals contaminate groundwater resources as a
      result of waste disposal methods for toxic chemicals, overuse of agricultural
      chemicals, and leakage of chemicals into the subsurface from buried tanks used to
      hold fluid chemicals and fuels. In the process, both the solid portions of the
      subsurface and the groundwaters that flow through these porous structures have
      become contaminated. Restoring these aquifers and minimizing human exposure to
      the parent chemicals and their degradation products will require the
      identification of suitable biomarkers of human exposure; better understandings of
      how exposure can be related to disease outcome; better understandings of
      mechanisms of transport of pollutants in the heterogeneous structures of the
      subsurface; and field testing and evaluation of methods proposed to restore and
      cleanup contaminated aquifers. In this review, progress in these many different
      but related activities is presented.

PMID- 8354173
TI  - Aquatic toxicology: past, present, and prospects.
AB  - Aquatic organisms have played important roles as early warning and monitoring
      systems for pollutant burdens in our environment. However, they have significant
      potential to do even more, just as they have in basic biology where preparations
      like the squid axon have been essential tools in establishing physiological and
      biochemical mechanisms. This review provides a brief summary of the history of
      aquatic toxicology, focusing on the nature of aquatic contaminants, the levels of
      contamination in our waters, and the origins of these agents. It considers the
      features of the aquatic environment that determine the availability of
      xenobiotics to aquatic life and the fate of foreign chemicals within the
      organism. Finally, toxic effects are considered with primary emphasis on the
      potential of aquatic models to facilitate identification of the underlying
      mechanisms of toxicity.

PMID- 8354175
TI  - Developmental toxicology: status of the field and contribution of the National
      Toxicology Program.
AB  - The NTP has conducted developmental toxicity studies on more than 50 chemicals,
      often in multiple species. Several chemicals caused developmental toxicity in the
      absence of any toxicity to the mother. Although hazard to humans is determined by
      the level of exposure to the chemical and its inherent toxicity, those agents
      that selectively disturb the development of the conceptus are of particular
      concern because other manifestations of toxicity would not warn the mother of
      overexposure. Whether the LOAEL (lowest-observed adverse effect level) for
      maternal toxicity was high or low did not correlate with the potential of
      chemicals to cause developmental toxicity. The form of developmental toxicity
      that determined the LOAEL most frequently was decreased body weight in mice and
      rats, but not rabbits, where the LOAEL was determined more often by an increase
      in resorptions. Several in vitro and short-term tests appear promising as screens
      to predict the outcome of developmental toxicity studies in mammals. However, the
      only screens that have undergone formal validation studies are those evaluated by
      the NTP. Improvements in our ability to predict risk to humans have been limited
      by our knowledge of the mechanisms by which agents cause developmental toxicity.
      Thus, future growth is dependent on a better understanding of the biological
      processes that regulate normal development, therein providing the necessary
      framework for understanding mechanisms of abnormal development.

PMID- 8354174
TI  - Toxicology, structure-function relationship, and human and environmental health
      impacts of polychlorinated biphenyls: progress and problems.
AB  - Polychlorinated biphenyls (PCBs) are industrial compounds that have been detected
      as contaminants in almost every component of the global ecosystem including the
      air, water, sediments, fish, and wildlife and human adipose tissue, milk, and
      serum. PCBs in commercial products and environmental extracts are complex
      mixtures of isomers and congeners that can now be analyzed on a congener-specific
      basis using high-resolution gas chromatographic analysis. PCBs are metabolized
      primarily via mixed-function oxidases into a broad spectrum of metabolites. The
      results indicate that metabolic activation is not required for PCB toxicity, and
      the parent hydrocarbons are responsible for most of the biochemical and toxic
      responses elicited by these compounds. Some of these responses include
      developmental and reproductive toxicity, dermal toxicity, endocrine effects,
      hepatotoxicity, carcinogenesis, and the induction of diverse phase I and phase II
      drug-metabolizing enzymes. Many of the effects observed for the commercial PCBs
      are similar to those reported for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and
      related compounds. Structure-function relationships for PCB congeners have
      identified two major structural classes of PCBs that elicit "TCDD-like"
      responses, namely, the coplanar PCBs (e.g., 3,3',4,4'-tetraCB, 3,3'4,4',5-pentaCB
      and 3,3',4,4',5,5'-hexaCB) and their mono-ortho coplanar derivatives. These
      compounds competitively bind to the TCDD or aryl hydrocarbon (Ah) receptor and
      exhibit Ah receptor agonist activity. In addition, other structural classes of
      PCBs elicit biochemical and toxic responses that are not mediated through the Ah
      receptor. The shor-term effects of PCBs on occupationally exposed humans appear
      to be reversible, and no consistent changes in overall mortality and cancer
      mortality have been reported. Recent studies have demonstrated that some
      developmental deficits in infants and children correlated with in utero exposure
      to PCBs; however, the etiologic agent(s) or structural class of PCBs responsible
      for these effects have not been delineated. In contrast, based on a toxic
      equivalency factor approach, the reproductive and developmental problems in
      certain wildlife populations appear to be related to the TCDD-like PCB congeners.

PMID- 8354176
TI  - Fertility, reproduction, and genetic disease: studies on the mutagenic effects of
      environmental agents on mammalian germ cells.
AB  - Because genetically based diseases have a major impact on human health, the
      National Institute of Environmental Health Sciences (NIEHS) has conducted a
      research and testing program for more than a decade to address chemical induction
      of heritable genetic damage in the germ cells of mammals. Although most genetic
      disease results from preexisting mutations, a portion is due to the occurrence of
      new mutations. The supposition that exposure to mutagenic chemicals contributes
      to the occurrence of new mutations in the human population is strongly supported
      by the results from animal models. Such studies clearly demonstrate the potential
      of environmental chemicals to induce mutations in both somatic and reproductive
      cells of mammals. This NIEHS program has become a leader in the identification of
      genetic hazards in the environment and in the acquisition of animal model data
      used by regulatory agencies in assessing genetic risks to human health.

PMID- 8354178
TI  - Genetic toxicology: current status of methods of carcinogen identification.
AB  - A critical aspect of the efforts to relate the results of short-term genetic
      toxicity tests with those from long-term rodent tests for carcinogens is the
      quality and consistency of the studies conducted by the National Toxicology
      Program. Analysis of the results in relationship to chemical structure has shown
      that mutagenic potential is a primary risk factor for carcinogen identification.
      Chemicals positive in the Salmonella assay-generally possess "structural alerts"
      for electrophilic interactions, are predominantly represented among chemicals
      producing trans-species carcinogenic effects in rodents, and among those
      identified as carcinogenic to humans. Current efforts are aimed at defining
      toxicological, structural, and mechanistic properties of nonmutagens that are
      carcinogenic in rodents.

PMID- 8354177
TI  - The toxicology of benzene.
AB  - Benzene is metabolized, primarily in the liver, to a series of phenolic and ring
      opened products and their conjugates. The mechanism of benzene-induced aplastic
      anemia appears to involve the concerted action of several metabolites acting
      together on early stem and progenitor cells, as well as on early blast cells,
      such as pronormoblasts and normoblasts to inhibit maturation and amplification.
      Benzene metabolites also inhibit the function of microenvironmental stromal cells
      necessary to support the growth of differentiating and maturing marrow cells. The
      mechanism of benzene-induced leukemogenesis is less well understood. Benzene and
      its metabolites do not function well as mutagens but are highly clastogenic,
      producing chromosome aberrations, sister chromatid exchange, and micronuclei.
      Benzene has been shown to be a multi-organ carcinogen in animals. Epidemiological
      studies demonstrate that benzene is a human leukemogen. There is need to better
      define the lower end of the dose-response curve for benzene as a human
      leukemogen. The application of emerging methods in biologically based risk
      assessment employing pharmacokinetic and mechanistic data may help to clarify the
      uncertainties in low-dose risk assessment.

PMID- 8354179
TI  - Mercury: major issues in environmental health.
AB  - In the past, methylmercury compounds were manufactured as fungicides or appeared
      as unwanted byproducts of the chemical industry, but today the methylation of
      inorganic mercury in aquatic sediments and soils is the predominant if not the
      sole source of methylmercury. This form of mercury is bioaccumulated to a high
      degree in aquatic food chains to attain its highest concentrations in edible
      tissues in long-lived predatory fish living in both fresh and ocean waters. It is
      well absorbed from the diet and distributes within a few days to all tissues in
      the body. It crosses without hindrance the blood-brain and placental barriers to
      reach its principal target tissue, the brain. It is eliminated chiefly in the
      feces after conversion to inorganic mercury. The biological half-time of
      methylmercury in human tissues is about 50 days, but there is wide individual
      variation. Adult poisoning is characterized by focal damage to discrete
      anatomical areas of the brain such as the visual cortex and granule layer of the
      cerebellum. A latent period of weeks or months may ensue before the appearance of
      signs and symptoms of poisoning. The latter manifest themselves as paresthesia,
      ataxia, constriction of the visual fields, and hearing loss. The prenatal period
      is the most sensitive stage of the life cycle to methylmercury. Prenatally
      poisoned infants exhibit a range of effects from severe cerebral palsy to subtle
      developmental delays. Methylmercury is believed to inhibit those processes in the
      brain specially involved in development and growth such as neuronal cell division
      and migration.

PMID- 8354180
TI  - Agricultural exposures and cancer trends in developed countries.
AB  - Recent increases have been reported in industrial countries for several sites of
      cancer. The causes of these increases remain unknown. Efforts should proceed to
      identify those occupational groups with increases in the same sites, as these may
      indicate relevant exposures. Two analyses were undertaken: trends in cancer
      mortality in industrial countries were reviewed to identify recently increasing
      sites and summaries were compiled of studies on farmers which have shown
      increased risks for these same sites of cancer. Using data provided by the World
      Health Organization, age-specific rates were developed for a number of sites of
      cancer from 1968 to 1986. Trends in the ratio of male to female cancer mortality
      were also assessed for several of these countries. Based on a literature review
      by the National Cancer Institute, patterns of cancer in farmers reported in 20
      studies from 8 countries are summarized, weighting each study by its size to
      create combined relative risks. In industrial countries, rates of cancer
      mortality increased for a number of sites, including melanoma, prostate, non
      Hodgkin's lymphoma, multiple myeloma, breast, brain, and kidney cancer. The ratio
      of male to female cancer mortality (for all sites of cancer excluding lung) has
      generally increased in several countries during this same time period. Many of
      the same sites that have increased in the general population have also been found
      to be increasing in farmers. Significant excesses occurred for Hodgkin's disease,
      multiple myeloma, leukemia, skin melanomas, and cancers of the lip, stomach, and
      prostate. Nonsignificant increases in risk were also noted for non-Hodgkin's
      lymphoma and cancers of connective tissue and brain in many surveys.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8354182
TI  - Mechanisms of kidney cell injury from metals.
AB  - The most environmentally abundant toxic metals/metalloids (arsenic, cadmium,
      lead, and mercury) are each known to produce cell injury in the kidney but the
      molecular mechanisms underlying these events are now being elucidated. It is
      clear that the nephrotoxicity of these agents is due, in part, to the fact that
      urinary elimination is a major route of excretion from the body. The role(s) of
      molecular factors such as metal-binding proteins, inclusion bodies, and cell
      specific receptorlike proteins that appear to influence renal tubule cell
      expression, have attracted increased interest as determinants that modulate cell
      populations as special risk for toxicity and renal cancer. The future of
      mechanistic toxicology studies with regard to how and why only certain renal cell
      populations become targets for toxicity from these metals/metalloids and other
      less common inorganic nephrotoxicants must focus on the molecular handling of
      these agents by target cell populations.

PMID- 8354181
TI  - Human health effects of air pollution.
AB  - Over the past three or four decades, there have been important advances in the
      understanding of the actions, exposure-response characteristics, and mechanisms
      of action of many common air pollutants. A multidisciplinary approach using
      epidemiology, animal toxicology, and controlled human exposure studies has
      contributed to the database. This review will emphasize studies of humans but
      will also draw on findings from the other disciplines. Air pollutants have been
      shown to cause responses ranging from reversible changes in respiratory symptoms
      and lung function, changes in airway reactivity and inflammation, structural
      remodeling of pulmonary airways, and impairment of pulmonary host defenses, to
      increased respiratory morbidity and mortality. Quantitative and qualitative
      understanding of the effects of a small group of air pollutants has advanced
      considerably, but the understanding is by no means complete, and the breadth of
      effects of all air pollutants is only partially understood.

PMID- 8354183
TI  - The fifth plot of the Carcinogenic Potency Database: results of animal bioassays
      published in the general literature through 1988 and by the National Toxicology
      Program through 1989.
AB  - This paper is the fifth plot of the Carcinogenic Potency Database (CPDB) that
      first appeared in this journal in 1984 (1-5). We report here results of
      carcinogenesis bioassays published in the general literature between January 1987
      and December 1988, and in technical reports of the National Toxicology Program
      between July 1987 and December 1989. This supplement includes results of 412 long
      term, chronic experiments of 147 test compounds and reports the same information
      about each experiment in the same plot format as the earlier papers: the species
      and strain of test animal, the route and duration of compound administration,
      dose level and other aspects of experimental protocol, histopathology and tumor
      incidence, TD50 (carcinogenic potency) and its statistical significance, dose
      response, author's opinion about carcinogenicity, and literature citation. We
      refer the reader to the 1984 publications (1,5,6) for a guide to the plot of the
      database, a complete description of the numerical index of carcinogenic potency,
      and a discussion of the sources of data, the rationale for the inclusion of
      particular experiments and particular target sites, and the conventions adopted
      in summarizing the literature. The five plots of the database are to be used
      together, as results of individual experiments that were published earlier are
      not repeated. In all, the five plots include results of 4487 experiments on 1136
      chemicals. Several analyses based on the CPDB that were published earlier are
      described briefly, and updated results based on all five plots are given for the
      following earlier analyses: the most potent TD50 value by species,
      reproducibility of bioassay results, positivity rates, and prediction between
      species.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354185
TI  - Risk assessment: the perspective and experience of U.S. environmentalists.
AB  - Risk assessment is a set of decision rules widely used in the United States for
      identifying and quantifying the risks of chemicals and other events for adverse
      effects to human health, usually cancer. Scientific criticism has been directed
      toward the default assumptions and test methods used in risk assessment by
      regulatory agencies. This paper evaluates the contribution of risk assessment as
      an instrument of public policy toward the timely and efficient resolution of
      controversial issues in environmental and occupational health. Experience with
      risk assessment during the past decade does not support its utility in this
      regard. Alternatives to risk assessment in its current formulation are discussed.

PMID- 8354186
TI  - A second look at methanol.

PMID- 8354184
TI  - Mechanisms of multistep carcinogenesis and carcinogen risk assessment.
AB  - Many different types of chemical exposures can increase the incidence of tumors
      in animals and humans, but usually a long period of time is required before the
      carcinogenic risk of an exposure is manifested. Both of these observations can be
      explained by a multistep/multigene model of carcinogenesis. In this model, a
      normal cell evolves into a cancer cell as the result of heritable changes in
      multiple, independent genes. The two-stage model of initiation and promotion for
      chemical carcinogenesis has provided a paradigm by which chemicals can act by
      qualitatively different mechanisms, but the process of carcinogenesis is now
      recognized as more complex than simply initiation and promotion. Even a three
      stage model of initiation, promotion, and progression, which can be operationally
      defined, is not adequate to describe the carcinogenic process. The number of
      genes altered in a cancer cell compared to a normal cell is not known; recent
      evidence suggests that 3-10 genetic events are involved in common adult
      malignancies in humans. Two distinct classes of genes, protooncogenes and tumor
      suppressor genes, are involved in the cancer process. Multiple oncogenes may be
      activated in a tumor, while multiple tumor-suppressor genes may be inactivated.
      Identification of the genes involved in carcinogenesis and elucidation of the
      mechanisms of their activation or inactivation allows a better understanding of
      how chemical carcinogens influence the process of neoplastic evolution. The
      findings of multiple genetic changes (including point mutations, chromosomal
      translocations, deletions, gene amplification, and numerical chromosome changes)
      in activated protooncogenes and inactivated tumor-suppressor genes provide
      experimental support for Boveri's somatic mutation theory of carcinogenesis. In
      addition to mutagenic mechanisms, chemicals may heritably alter cells by
      epigenetic mechanisms and enhance the clonal expansion of altered cells. Most
      chemical carcinogens operate via a combination of mechanisms, and even their
      primary mechanism of action may vary depending on the target tissues. The
      classification of chemicals by mechanism of action or by nongenotoxic or
      genotoxic activity has certain inherent difficulties because no classification of
      chemicals is exhaustive or definitive.

PMID- 8354187
TI  - Banking on future research.

PMID- 8354188
TI  - Cleaner air may mean worse health.

PMID- 8354189
TI  - Women's health research at NIEHS.

PMID- 8354190
TI  - Environmentally related cancer in women.

PMID- 8354191
TI  - Diethylstilbestrol as a model for environmental estrogens.

PMID- 8354193
TI  - NIEHS to play unique role in women's health research effort.

PMID- 8354192
TI  - Role of the environment in osteoporosis.

PMID- 8354194
TI  - Minority health research.

PMID- 8354195
TI  - A holistic approach to breast cancer research.

PMID- 8354196
TI  - What's good for the gander may not be good for the goose.

PMID- 8354197
TI  - Monitoring nitrite, N-nitrosodiethanolamine, and mutagenicity in cutting fluids
      used in the metal industry.
AB  - We carried out an integrated environmental/biological monitoring program to
      evaluate cancer hazards among metal industry workers exposed to cutting fluids.
      Several cutting fluids were sampled according to response to a semiquantitative
      nitrite rapid test in metal factories in central Italy. The nitrite-positive
      samples were analyzed for nitrite and nitrosodiethanolamine (NDELA) content and
      mutagenic activity. The nitrite-negative samples were analyzed only for
      mutagenicity. Of the total samples, 20.6% were nitrite positive, and all
      contained NDELA. However, nitrite content was not quantitatively predictive of
      the NDELA content, which varied enormously among samples (0.3-1900 mg/kg).
      Nitrite-negative samples were always nonmutagenic. Mutagenicity was found in half
      the NDELA-containing samples but was not related to nitrite or NDELA content.
      Nitrite screening of cutting fluids in the field is an interesting method for
      identifying samples that potentially contain NDELA and other unknown mutagens
      and, when performed with short-term mutagenicity tests, nitrite screening seems
      to be a valid tool by which industrial managers and health officers could
      minimize the health hazards associated with occupational exposure to cutting
      fluids.

PMID- 8354198
TI  - Characterization of acute 4,4'-methylene dianiline hepatotoxicity in the rat.
AB  - Methylene dianiline (DDM) is a chemical intermediate in the production of
      isocyanates and other industrial chemicals, and it is hepatotoxic in humans. The
      acute hepatotoxicity of orally administered DDM was characterized in rats. Rats
      receiving DDM (25-225 mg/kg, per os) demonstrated a dose-dependent elevation in
      serum alanine aminotransferase activity, g-glutamyltransferase activity, and
      serum bilirubin concentration. DDM also caused a decrease in bile flow and an
      elevation in liver weight. Significant changes in these markers of liver injury
      occurred between 8 and 12 hr after a single, oral administration of DDM.
      Histologically, DDM caused multifocal, necrotizing hepatitis with neutrophil
      infiltration. Changes in the portal regions consisted of bile ductular necrosis,
      portal edema, neutrophil infiltration, mild fibrin exudation, and segmental
      necrotizing vasculitis. The role of cytochrome P450 monooxygenase (MO)-mediated
      metabolism in DDM hepatotoxicity was evaluated using the MO inhibitors,
      aminobenzotriazole and SKF-525A and the MO inducers phenobarbital and beta
      naphthoflavone. Aminobenzotriazole provided protection from DDM-induced
      hepatotoxicity, whereas SKF-525A had no effect. The effect of phenobarbital
      pretreatment depended on the dose of DDM administered. At a dose of DDM that
      produced a maximal hepatotoxic response, phenobarbital did not influence
      hepatotoxicity. However, phenobarbital pretreatment provided protection against
      the hepatotoxic effects of a lower dose of DDM. beta-naphthoflavone pretreatment
      had a more modest effect on DDM-induced hepatic insult. These results demonstrate
      that DDM causes acute hepatotoxicity in the rat that is dose and time dependent.
      Results using inducers and inhibitors of MO suggest that DDM requires
      bioactivation to exert toxicity; however, the relationship between metabolism and
      toxicity may be complex.

PMID- 8354199
TI  - Evaluation of the biological effects of police radar RAMER 7F.
AB  - This paper presents results of experiments on the effects of electromagnetic
      radiation in the millimeter range (frequency 34.0 +/- 0.1 GHz, power density 20
      muW/cm2) emitted by a police radar device. Considering the physical properties of
      the radiation in millimeter range (skin effects), the experiments were carried
      out on hairless mice. The main physiological parameters tested were body mass,
      body temperature, peripheral blood, and mass and cellularity of several important
      organs. Critical organs, the skin, and cornea were examined by electron
      microscopy. Differentiation ability of hematopoietic cells, progenitors of
      granulocytes and macrophages, and DNA synthesis in the cornea were compared in
      irradiated and nonirradiated animals. None of the parameters tested was affected
      to an extent that would indicate the start of a pathological process or the risk
      of damage to genetic material.

PMID- 8354200
TI  - Nasal cytology in southwest metropolitan Mexico City inhabitants: a pilot
      intervention study.
AB  - Southwest metropolitan Mexico City (SWMMC) inhabitants have been exposed several
      hours per day for the last 6 years to photochemical smog, ozone being the most
      important oxidant pollutant. Subjects exposed to the SWMMC atmosphere develop
      several histopathological changes in their nasal mucosa: dysplasia is the most
      significant, affecting 78.72% of adult individuals within 60 or more days of
      residence in SWMMC. This study was originally designed to explore whether
      chemical intervention could modify nasal dysplasia, as determined by nasal
      cytology, in a defined adult population. In a placebo-controlled, randomized,
      double-blind trial, 177 healthy male subjects were divided into 5 groups to whom
      5000 IU of vitamin A, 100 IU of vitamin E, a combination of vitamins A and E
      (5000 IU + 100 IU), 16 mg of beta-carotene, or placebo were administered daily
      for 4 months. Sixteen clinical and cytological variables were monitored. No
      effect on dysplasia was seen at the end of the 4-month trial; however, an
      apparent reversibility as well as progression of the dysplastic nasal lesions and
      high correlation coefficients between dysplasia and nasal cytology of
      polymorphonuclear leukocytes (PMNs; 0.85), squamous metaplasia (SM; 0.50), and
      nasal mucosa atrophy (NMA; 0.41) were found. A mathematical theoretical nasal
      dysplasia (tD) predictor equation for SWMMC adult male inhabitants is proposed
      (tD = 0.85 delta PMNs + 0.50 delta SM + 0.41 delta NMA + 0.98), in which PMNs are
      the best single dysplasia predictor, and all variables are independent.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8354201
TI  - Bacterial and human cell mutagenicity study of some C18H10 cyclopenta-fused
      polycyclic aromatic hydrocarbons associated with fossil fuels combustion.
AB  - A number of isomeric C18H10 polycyclic aromatic hydrocarbons (PAHs), thought to
      be primarily cyclopenta-fused PAHs, are produced during the combustion and
      pyrolysis of fossil fuels. To determine the importance of their contributions to
      the total mutagenic activity of combustion and pyrolysis samples in which they
      are found, we characterized reference quantities of four C18H10 CP-PAHs:
      benzo[ghi]fluoranthene (BF), cyclopenta[cd]pyrene (CPP),
      cyclopent[hi]acephenanthrylene (CPAP), and cyclopent[hi]aceanthrylene (CPAA).
      Synthesis of CPAA and CPAP is described. The availability of reference samples of
      these isomers also proved to be an essential aid in the identification of the
      C18H10 species often found in combustion and pyrolysis samples. Chemical analysis
      of selected combustion and pyrolysis samples showed that CPP was generally the
      most abundant C18H10 isomer, followed by CPAP and BF. CPAA was detected only in
      pyrolysis products from pure PAHs. We tested the four C18H10 PAHs for
      mutagenicity in a forward mutation assay using S. typhimurium. CPP, BF, and CPAA
      were roughly twice as mutagenic as benzo[a]pyrene (BaP), whereas CPAP was only
      slightly active. These PAHs were also tested for mutagenic activity in human
      cells. In this assay, CPP and CPAA were strongly mutagenic but less active than
      BaP, whereas CPAP and BF were inactive at the dose levels tested. Also, the
      bacterial and human cell mutagenicity of CPAA and CPAP were compared with the
      mutagenicity of their monocyclopenta-fused analogs, aceanthrylene and
      acephenanthyrlene. Although the mutagenicities of CPAP and acephenanthrylene are
      similar, the mutagenic activity of CPAA is an order of magnitude greater than
      that of aceanthyrlene.

PMID- 8354202
TI  - Chemical nature and immunotoxicological properties of arachidonic acid
      degradation products formed by exposure to ozone.
AB  - Ozone (O3) exposure in vivo has been reported to degrade arachidonic acid (AA) in
      the lungs of rodents. The O3-degraded AA products may play a role in the
      responses to this toxicant. To study the chemical nature and biological activity
      of O3-exposed AA, we exposed AA in a cell-free, aqueous environment to air, 0.1
      ppm O3, or 1.0 ppm O3 for 30-120 min. AA exposed to air was not degraded. All O3
      exposures degraded > 98% of the AA to more polar products, which were
      predominantly aldehydic substances (as determined by reactivity with 2,4
      dinitrophenylhydrazine and subsequent separation by HPLC) and hydrogen peroxide.
      The type and amount of aldehydic substances formed depended on the O3
      concentration and exposure duration. A human bronchial epithelial cell line (BEAS
      2B, S6 subclone) exposed in vitro to either 0.1 ppm or 1.0 ppm O3 for 1 hr
      produced AA-derived aldehydic substances, some of which eluted with similar
      retention times as the aldehydic substances derived from O3 degradation of AA in
      the cell-free system. In vitro, O3-degraded AA induced an increase in human
      peripheral blood polymorphonuclear leukocyte (PMN) polarization, decreased human
      peripheral blood T-lymphocyte proliferation in response to mitogens, and
      decreased human peripheral blood natural killer cell lysis of K562 target cells.
      The aldehydic substances, but not hydrogen peroxide, appeared to be the principal
      active agents responsible for the observed effects. O3-degraded AA may play a
      role in the PMN influx into lungs and in decreased T-lymphocyte mitogenesis and
      natural killer cell activity observed in humans and rodents exposed to O3.

PMID- 8354203
TI  - Lung cancer in the lower lobe is associated with pulmonary asbestos fiber count
      and fiber size.
AB  - We studied exposure to asbestos, pulmonary fibrosis, fiber count, and fiber size
      in relation to the lobar origin of lung cancer in 90 consecutive patients. Among
      the 32 patients with a history of occupational exposure to asbestos, 22 were
      construction workers. The proportion of lower-lobe tumors increased with the
      duration of exposure from 45% in those working less than 15 years to 82% in those
      working 15 years or more in the construction trade, as compared with 25% in
      patients who were probably not exposed. The location of the tumor in the lower
      lobe was explained by the high number of total fibers [odds ratio (OR) = 9.0, CI
      = 2.3-34.6), of fibers 3 microns and longer (OR = 22.1, CI = 3.9-125), and fibers
      of anthophyllite (OR = 14.6, CI = 2.4-83.4) and crocidolite (OR = 7.0, CI = 1.2
      41.2) when the effect of smoking and fibrosis was adjusted in the logistic
      regression analysis. The location of the tumor did not correlate with fibrosis,
      pack-years smoked, or the number of short (< 3 microns) fibers. Our findings
      suggest that asbestos causes an excess of lower-lobe tumors at a relatively low
      exposure level, independently of pulmonary fibrosis.

PMID- 8354204
TI  - Studies with 1,2-dithiole-3-thione as a chemoprotector of hydroquinone-induced
      toxicity to DBA/2-derived bone marrow stromal cells.
AB  - Stromal cells from DBA/2 mouse bone marrow have been shown to be susceptible to
      cytotoxicity induced by several redox-active metabolites of benzene, including
      hydroquinone (HQ). Treatment with HQ also alters the composition of stromal cell
      populations by preferentially killing stromal macrophages compared to stromal
      fibroblasts. This cytotoxicity can be prevented by 1,2-dithiole-3-thione (DTT) as
      a result of the induction of quinone reductase (QR), a quinone-processing enzyme,
      and glutathione. The inductive activities of DTT protected stromal cells against
      HQ-induced cytotoxicity and against HQ-induced impairment of stromal cell ability
      to support myelopoiesis. In vivo feeding of DTT to DBA/2 mice increased QR
      activity within the bone marrow compartment and protected bone marrow stromal
      cells isolated from the DTT-fed animals from ex vivo HQ challenge. Thus, the
      inducibility of cellular defense mechanisms and xenobiotic-processing enzymes by
      chemoprotective agents such as DTT may be a useful strategy for protecting
      against chemically induced bone marrow toxicities.

PMID- 8354205
TI  - Mercury-induced renal autoimmunity: changes in RT6+ T-lymphocytes of susceptible
      and resistant rats.
AB  - The repeated administration of mercury to rats of the Brown Norway (BN) inbred
      strain results in a self-limiting production of autoantibodies to renal antigens
      (e.g., laminin) and autoimmune glomerulonephritis. In contrast, rats of the Lewis
      (LEW) strain do not develop renal autoimmunity after mercury treatment.
      Suppressor T-cells and/or the idiotype-anti-idiotype network have been implicated
      in the control of autoimmunity in susceptible (BN) rats as well as the
      "resistant" state of nonsusceptible (LEW) animals. In our investigations of the
      immune regulation of mercury-induced autoimmune glomerulonephritis, we have
      performed a phenotypic analysis of lymphocyte subpopulation in the spleens and
      lymph nodes of mercury-treated and control LEW, BN, and (BN x LEW) F1 hybrid
      rats. Of particular interest were RT6+ T-cells, a subpopulation of lymphocytes
      that may have immunoregulatory properties and show a relative decrease in mercury
      treated BN rats concomitantly with the development of autoimmune responses to
      renal autoantigens. LEW rats did not develop renal autoimmunity after mercury
      treatment and had no significant change in the ratio of RT6+ to RT6- T
      lymphocytes. Interestingly, the administration of mercury to (BN x LEW) F1 hybrid
      rats caused effects similar to those observed in the BN strain. Auto-immune
      responses to antigens of the kidney coincided with a change in the balance within
      the RT6 cell population, which was altered in favor of T-lymphocytes that do not
      express the RT6 phenotype.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354206
TI  - Chronic obstructive pulmonary disease (heaves) as an inflammatory condition.

PMID- 8354207
TI  - Intra-operative cardiac arrest: routes to recovery.

PMID- 8354208
TI  - Responses of horses affected with chronic obstructive pulmonary disease to
      inhalation challenges with mould antigens.
AB  - Eight control and 8 asymptomatic COPD-affected horses were given, on separate
      occasions, inhalation challenges with extracts of Micropolyspora faeni,
      Aspergillus fumigatus and Thermoactinomyces vulgaris. All horses were also given
      nebulised phosphate-buffered saline (PBS) challenges and 'natural challenges'
      (NCs), i.e. exposure to hay and straw, as control challenges. Responses were
      assessed by clinical, pulmonary mechanics, arterial blood gas tensions, arterial
      blood pH and bronchoalveolar lavage fluid cytological examinations. PBS
      challenges had no effect on control or COPD-affected horses, while NC induced
      COPD only in the COPD-affected horses. Pulmonary disease, similar to naturally
      occurring COPD, was induced, only in the COPD-affected horses, by M. faeni and A.
      fumigatus challenges, thus implicating these organisms in the aetiology of equine
      COPD. The role of T. vulgaris in the aetiology of equine COPD could not, however,
      be determined because the T. vulgaris challenges, in addition to inducing
      pulmonary disease in 4 COPD-affected horses, induced pulmonary disease in 2
      control horses which had been unaffected by NC. The absence of pulmonary disease
      in control horses after M. faeni, A. fumigatus and NC challenges suggests that
      equine COPD is a pulmonary hypersensitivity, rather than a non-specific toxic
      response.

PMID- 8354209
TI  - Evaluation of local endobronchial antigen challenges in the investigation of
      equine chronic obstructive pulmonary disease.
AB  - Local transendoscopic endobronchial antigen challenge, which has proved to be a
      valuable clinical and research technique in the study of human pulmonary
      hypersensitivity, was evaluated in control and asymptomatic COPD--affected
      horses. Transendoscopic endobronchial challenges with phosphate-buffered saline
      (PBS), Micropolyspora faeni extract at 60 and 600 micrograms/ml and mouldy hay
      extract elicited neutrophilic airway inflammatory responses in control (N = 5-7)
      and asymptomatic COPD-affected (N = 5-7) horses, as determined by cytological
      examinations of bronchoalveolar lavage fluid (BALF) harvested from the challenged
      lung segments. Endobronchial challenges with 600 micrograms M. faeni extract/ml
      induced a significant BALF neutrophilia only in horses with asymptomatic COPD,
      when compared with PBS challenges. However, as the BALF neutrophil ratios of COPD
      affected horses after this M. faeni challenge did not differ significantly from
      those of control horses, this finding has little clinical diagnostic value. The
      BALF neutrophilia induced in control and asymptomatic COPD-affected horses by 60
      micrograms M. faeni extract/ml and mouldy hay extract challenges was not
      significantly different from that induced by PBS challenge. Endoscopically
      visible bronchial changes were observed in some of the control and COPD-affected
      horses within 5 mins and at 5 h after PBS, M. faeni and mouldy hay extract
      challenges. We conclude that this technique is of no value in the investigation
      of equine COPD.

PMID- 8354210
TI  - Evaluation of intradermal mould antigen testing in the diagnosis of equine
      chronic obstructive pulmonary disease.
AB  - Intradermal end-point titres for commercial aqueous extracts of Micropolyspora
      faeni, Thermoactinomyces vulgaris and Aspergillus fumigatus were determined in
      control and chronic obstructive pulmonary disease (COPD) affected horses. The
      intradermal end-point titres of control and COPD-affected horses were not
      significantly different and values for individual horses for M. faeni, A.
      fumigatus and T. vulgaris were not correlated with the pulmonary dysfunction or
      with the bronchoalveolar lavage fluid neutrophilia which had been induced by
      previous inhalation challenges with these antigens and by 'natural (hay and
      straw) challenges'. These findings suggest divergence of the dermal and pulmonary
      reactivities to M. faeni, A. fumigatus and T. vulgaris in the horse and indicate
      that intradermal mould antigen testing is of limited value in the investigation
      of equine COPD.

PMID- 8354211
TI  - Clinical pharmacokinetics of amikacin in hypoxic premature foals.
AB  - The pharmacokinetics of amikacin, administered iv at 7 mg/kg, every 8 h, were
      evaluated over the first 48 h of hospitalisation in 7 critically ill hypoxic
      premature foals and compared with those in 8 full-term nonhypoxic critically ill
      neonatal foals. The pharmacokinetic data were used to calculate dosage schedules
      that would maintain the plasma amikacin concentrations in individual foals within
      a target range of > or = 15 micrograms/ml but < 30 micrograms/ml for peak values
      and < or = 3 micrograms/ml for trough values. The results indicated a
      statistically significant increase in the amikacin serum half-life (5.39 +/- 3.46
      h) and smaller elimination rate constant (0.17 +/- 0.09 h-1) in premature foals.
      The pharmacokinetic derangements required increasing the dose to 8.5-10.5 mg/kg
      bwt in 6 of 7 premature foals and an increase in the dosage interval to 12-24 h
      in all 7 foals. Overall, the total dosage of amikacin was decreased in the
      hypoxic, premature foals so that target peaks and troughs could be maintained.
      Our findings suggest that prematurity and hypoxia are variables related to a
      prolonged serum half-life of amikacin in hypoxic, premature foals. Although there
      was no evidence of amikacin-induced nephrotoxicity in any of these foals, daily
      monitoring and tailoring of the dose schedule to the individual foal are strongly
      advised.

PMID- 8354212
TI  - Cardiovascular effects of thoracic compression in horses subjected to euthanasia.
AB  - Six horses scheduled for euthanasia were instrumented for the measurement of
      blood flow by thermodilution, pulmonary arterial, right atrial and arterial blood
      pressures and collection of arterial blood for pH and blood gas analysis. The
      horses were anaesthetised with intravenous (iv) thiamylal sodium (10 mg/kg) and
      placed in right lateral recumbency. After euthanasia with an overdose of
      pentobarbitone sodium (100 mg/kg, iv) and loss of the electrocardiogram and
      arterial pulse pressure, thoracic compression at rates of 40, 60 and 80
      compressions/min was instituted. Thoracic compression was accomplished by an
      investigator who delivered a blow to the chest wall with his knee while dropping
      from a standing or crouching position. Compression rates of 40, 60 and 80/min
      produced blood flows of 5.65 +/- 0.5, 6.33 +/- 1.11 and 8.28 +/- 2.16 litres/min,
      respectively. Compression rates of 80/min produced significantly (P < 0.05)
      greater blood flows and mean arterial blood pressures than did slower rates. The
      blood flows produced by 80 thoracic compressions/min were approximately 50% of
      those reported for deeply anaesthetised horses and while not sufficient to
      sustain life might be used to prolong life in order to facilitate distribution of
      resuscitative drugs to vital tissues.

PMID- 8354213
TI  - Characterisation of osseous bodies of the distal phalanx of foals.
AB  - The distal phalanx and metacarpal physis of both forelimbs of 32 Thoroughbred
      foals 3-32 weeks of age were radiographed to identify those limbs with osseous
      bodies at a palmar process (PP) of the distal phalanx. Osseous bodies (ossicles)
      were identified radiographically in 19% of the foals. Sixteen of the 32 foals
      were selected for microradiographic and histological evaluation: 6 foals with
      radiographic evidence of ossicles and 10 foals without. Fourteen ossicles of the
      PP were observed radiographically. Ossicles were either a triangular bone
      fragment at the palmar aspect of the distal angle of the PP, or an oblong bone
      fragment separated from P3 by a radiolucent line extending 1-3 cm from the
      incisure of the PP to the solar margin. One foal had radiographic evidence of
      bilateral distal metacarpal physitis. Seventeen of 35 PPs examined
      microradiographically were considered normal, in that the dorsal and solar
      cortices were thin with trabecular bone orientated parallel to the cortical
      surfaces, and there was a depression in the dorsal cortical surface (i.e.
      parietal sulcus). Abnormal microradiographic findings in the other 18 PPs
      included a fracture line extending from the dorsal cortical surfaces and
      trabecular bridging of the fracture gap. The fracture line was often continuous
      with the parietal sulcus. Microradiographic evidence of a fracture was found in
      75% of foals evaluated. Normal histological findings in 16 PPs included thin
      dorsal and solar cortices with trabeculae orientated parallel to the cortical
      surfaces, parallel-fibred dense connective tissue attachments of the deep digital
      flexor tendon to the solar cortical surfaces, and a neurovascular bundle
      associated with the parietal sulcus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354214
TI  - Radiographic and microscopic correlation of diffuse interstitial and
      bronchointerstitial pulmonary patterns in the caudodorsal lung of adult
      thoroughbred horses in race training.
AB  - Complete thoracic radiographic examinations were performed on 7 horses ranging in
      age from 24 to 60 months, followed by in-situ lung fixation. Radiographs were
      examined by 3 radiologists for the presence, degree and distribution of
      generalised pulmonary patterns within a region of interest in the caudodorsal
      lung. Pulmonary tissue was obtained from 12 sites within a designated volume of
      interest in the caudodorsal lung, corresponding to the area of interest evaluated
      radiographically, and examined for the presence, character and severity of
      microscopic lesions. Radiographic findings within the volume of interest
      consisted of mild to moderate bronchial, bronchointerstitial, or interstitial
      pulmonary patterns. Interstitial and bronchointerstitial radiographic findings
      were related to severity of peribronchiolar mononuclear cell infiltrates, the
      degree of bronchiolar mucosal plication, and alveolar capillary and peribronchial
      blood vessel erythrocyte content. The severity of the interstitial radiographic
      pattern was inversely associated with the perceived diagnostic quality of the
      radiographic examinations. There was no evidence of spatial variation in the
      severity of the microscopic changes examined in this limited pulmonary region.
      Inter-rater reliability between radiologists was good in the assessment of
      diagnostic quality of the radiographic examinations but poor in assessing
      severity of the primary generalised pulmonary patterns within the radiographic
      region of interest.

PMID- 8354215
TI  - The airway response of horses with recurrent airway obstruction (heaves) to
      aerosol administration of ipratropium bromide.
AB  - The airway response to aerosol administration of the anticholinergic agent
      ipratropium bromide was determined in 8 horses with recurrent airway obstruction
      (heaves). The reversibility of airway obstruction was confirmed by measuring lung
      function before and during stabling; and by determining the response to atropine
      administration (0.02 mg/kg bwt intravenously). The dose-response to ipratropium
      bromide was determined using a Williams square design experiment in which 25, 50
      or 75 micrograms ipratropium bromide/ml (4 ml/100 kg bwt) or the same volume of
      vehicle was administered to each horse by nebulisation. Lung function was
      measured before and 1 and 4 h after nebulisation. Vehicle had no effect on lung
      function. Ipratropium decreased the maximal change in pleural pressure during
      tidal breathing (delta Pplmax) and pulmonary resistance (RL) and increased
      dynamic compliance (Cdyn). At the 1 h measurement period, the effect on RL and
      Cdyn was dose-dependent. A separate experiment demonstrated that the duration of
      action of ipratropium was between 4 and 6 h.

PMID- 8354216
TI  - Paravertebral thoracolumbar anaesthesia in 10 horses.
AB  - The caudal border of the last rib was used as a reliable point of orientation
      while performing paravertebral thoracolumbar anaesthesia (PTLA) on 10 horses
      undergoing standing flank laparotomy. The local anaesthetic in all horses was 2%
      lidocaine. The PTLA procedure was completed in 9.8 +/- 1.8 mins (mean +/- sd).
      Sedation was provided by a combination of intravenous morphine with xylazine or
      detomidine. Overall analgesia, provided by the combination of PTLA and sedation,
      was rated as excellent in 2 horses and good in 6 horses. In the remaining 2
      horses, overall analgesia was rated as fair because of incomplete analgesia at
      the ventral portion of the incision. Total time, from start of PTLA to end of
      surgery was 143.5 +/- 24.2 mins. Five horses responded mildly to suturing of the
      ventral portion of the incision. Apart from 1 horse which developed transient,
      unilateral hindlimb weakness intraoperatively, no other complications were
      noticed. We conclude that PTLA can easily be performed in the horse and, combined
      with systemic sedation, is an effective and safe method of providing analgesia
      for standing flank laparotomy.

PMID- 8354217
TI  - In-vitro susceptibility to antimicrobial drugs of bacterial isolates from horses
      in The Netherlands.
AB  - Minimum inhibitory concentrations (MICs) of 30 antimicrobial agents (including
      the hitherto unreported antimicrobial agents doxycycline, minocycline, vanomycin,
      3 quinolones and 3 combinations of antimicrobial agents) for isolates of
      Salmonella spp. (20), Escherichia coli (17), Klebsiella spp. (8), Proteus spp.
      (7), Pseudomonas aeruginosa (7), Actinobacillus equuli (5), Rhodococcus equi (4),
      Streptococcus zooepidemicus (23), Streptococcus equisimilis (6), Streptococcus
      equi (4), coagulase-positive Staphylococcus spp. (20) and Taylorella
      equigenitalis (19) were determined using the agar dilution method. All isolates
      were of equine origin. MICs were compared with recommended MIC breakpoints. The
      results indicate that, for some of the pathogenic bacteria evaluated,
      susceptibility testing of isolates from the individual patient is essential to
      determine an appropriate antimicrobial treatment.

PMID- 8354218
TI  - Streptococci and Pasteurella spp. associated with disease of the equine lower
      respiratory tract.
AB  - The likelihood of finding evidence of inflammation in 551 tracheal washes
      collected endoscopically from 278 Thoroughbred racehorses increased with the
      number of bacterial colony forming units (cfu) per ml of wash (P < 0.001). The
      aerobic bacteria Streptococcus zooepidemicus, Pasteurella/Actinobacillus-like
      species and Streptococcus pneumoniae were significantly associated with lower
      airway inflammation whereas coagulase-negative Staphylococcus spp., alpha
      haemolytic Streptococcus spp., Acinetobacter spp., Bacillus spp., Escherichia
      coli, Pseudomonas aeruginosa, non-haemolytic Streptococcus spp. and
      Enterobacteriaceae were not; Bordetella bronchiseptica was not isolated. Lower
      airway inflammation was particularly associated with bacteria in horses < or = 3
      years of age. S. zooepidemicus, S. pneumoniae and Pasteurella/Actinobacillus-like
      species were isolated from 167 of 551 washes, either alone or in combination.

PMID- 8354220
TI  - More theories than facts: equine rhabdomyolysis.

PMID- 8354219
TI  - Predictable ovulation in mares treated with an implant of the GnRH analogue
      deslorelin.

PMID- 8354221
TI  - Dorsal displacement of the soft palate in neonatal foals.

PMID- 8354222
TI  - Clinical, cytogenetic and endocrine evaluation of a horse with a 65,XXY
      karyotype.

PMID- 8354223
TI  - Partial re-establishment of villous placentation after reduction of an equine co
      twin by foetal cardiac puncture.

PMID- 8354224
TI  - High-performance capillary electrophoresis of glycoconjugates.
AB  - Capillary electrophoresis (CE) has recently emerged as a highly promising
      technique for the analysis and structural study of glycoconjugates. This article
      reviews the current status of CE and its potential in glycobiology. The
      separation media suitable for the analysis of monosaccharides, oligosaccharides
      and very large carbohydrate-based biomolecules are discussed. The detection
      aspects emphasize chemical derivatization approaches to tagging the
      glycoconjugates of interest for enhanced response in absorption and fluorescence
      spectroscopy.

PMID- 8354225
TI  - Studies in capillary zone electrophoresis with a post-column multiple capillary
      device for fraction collection and stepwise increase in electroosmotic flow
      during analysis.
AB  - A new approach involving the stepwise increase in electroosmotic flow during
      analysis in capillary zone electrophoresis is introduced and evaluated in the
      rapid separations of proteins and peptides. The stepwise increase in
      electroosmotic flow is based on the principle of coupled capillaries in series
      having different flow characteristics, a concept that was introduced recently by
      our laboratory. To produce stepwise changes in electroosmotic flow during
      analysis, a post-column multiple capillary device, which allowed the switching
      between several coupled capillary systems, was designed and constructed in-house.
      The utility of the multiple capillary device was also demonstrated and extended
      to fraction collection of separated analytes in short capillary segments. The
      fraction collection in capillaries facilitated the quantitative transfer of the
      collected fractions to high performance liquid chromatography (HPLC) for further
      analysis or to mass spectrometry (MS) for structural determination. The off-line
      combination of capillary zone electrophoresis with HPLC or MS utilized commercial
      instruments without the need of expensive interfacing designs.

PMID- 8354226
TI  - Screening and characterization of biopharmaceuticals by high-performance
      capillary electrophoresis with laser-induced native fluorescence detection.
AB  - High-performance capillary electrophoresis (HPCE) with laser-induced native
      fluorescence (LIF) detection is used to address significant problems in the
      quality control of biopharmaceuticals. All of the biopharmaceuticals studied can
      be detected at subnanomolar levels with linear dynamic ranges of at least 3
      orders of magnitude. HPCE/LIF can determine impurities in "purified"
      biopharmaceuticals present in amounts less than 0.01% (i.e., at 4 x 10(-11) M)
      that of the major component. With HPCE/LIF, detection sensitivity is thus no
      longer a concern in the assaying of active ingredients in biopharmaceutical
      dosage formulations. The peptide mapping of biopharmaceuticals present at 1 x 10(
      7) M (or an injected limit of detection of 60 amol) is presented. Also, kinetic
      information on the reaction of a recombinant enzyme-drug with its substrate
      present at the micromolar level has been extracted from electropherograms
      acquired in real-time.

PMID- 8354227
TI  - Two-dimensional separations of peptides and proteins by comprehensive liquid
      chromatography-capillary electrophoresis.
AB  - Analysis of biological samples is problematic because of their complex
      composition. Reversed phase liquid chromatography (RPLC), size exclusion
      chromatography (SEC), and, more recently, capillary zone electrophoresis (CZE)
      are routinely used for the analysis of these samples, but are eventually limited
      because they are one-dimensional (1-D) methods. As sample complexity increases,
      the separation efficiency necessary to resolve a large number of sample
      components in one dimension becomes prohibitively high. A solution to this
      problem has been to use a two-dimensional (2-D) approach. Each dimension in a 2-D
      separation relies on a different separating mechanism. By expanding the
      separation into two dimensions, sample components unresolved in the first
      dimension can often be separated in the second. This circumvents the requirement
      for extremely high efficiencies in either dimension. Two-dimensional slab gel
      electrophoresis has been used successfully in this area, but a more instrumental
      approach is desired. In this paper we describe three coupled-column approaches to
      2-D separations. First, microcolumn SEC-CZE is explored as a means of 2-D protein
      analysis. Next, RPLC-CZE is investigated for analysis of peptides in tryptic
      maps. Finally, RPLC is coupled with fast CZE (FCZE), a unique form of CZE
      analysis, for fast 2-D analysis of peptides. Details of the instrumentation used
      in these 2-D systems will be presented along with the results of some typical 2-D
      analyses.

PMID- 8354228
TI  - Use of small-diameter capillaries for increasing peptide and protein detection
      sensitivity in capillary electrophoresis-mass spectrometry.
AB  - The use of small ID capillaries is shown to provide a substantial increase in
      sensitivity for capillary electrophoresis-electrospray ionization/mass
      spectrometry (CE-ESI/MS). In a comparison using capillaries ranging from either
      100 to 10 microns or 50 to 5 microns ID and chemically modified with
      aminopropylsilane, a 25- to 50-fold increase in sensitivity was observed for both
      peptide and protein mixtures. This enhanced solute sensitivity allowed the
      detection of approximately 150 attomoles of melittin (2845 Da) with selected ion
      monitoring and 600 attomoles of carbonic anhydrase (29,157 Da) while scanning for
      CE-MS with a quadrupole mass spectrometer. For the protein mixture, mass spectra
      of sufficient quality for precise molecular weight determination (< or = 0.05%)
      were obtained for 600 attomole injections using a 5 microns ID capillary. The
      increase in sensitivity with small capillary diameters can be primarily
      attributed to a reduced mass flow rate of buffer and other background
      constituents into the electrospray source, which allows for greater sample
      ionization efficiency. A model that qualitatively accounts for the results is
      presented, but quantitative agreement is precluded due to difficulties in
      accounting for contributions due to a liquid sheath flow used with the
      electrospray source. The model accounts for the observation that the ESI/MS
      appears to function as a concentration-sensitive detector under many conditions
      using large-diameter capillaries. A transition occurs, however, to a regime where
      the ESI/MS functions as a mass flow-sensitive detector for small-diameter
      capillaries, where the ESI current is limited by the rate of delivery to the ESI
      source of charge carrying species in solution. These results suggest peptide and
      protein analysis at low attomole and subattomole levels should be obtainable with
      alternative types of mass spectrometers.

PMID- 8354229
TI  - The characterization of snake venoms using capillary electrophoresis in
      conjunction with electrospray mass spectrometry: Black Mambas.
AB  - Capillary electrophoresis has been used in conjunction with electrospray mass
      spectrometry using both full-scan and selected ion monitoring modes to supply as
      much information as possible about the venom of Dendroaspis polylepis polylepis
      (Black Mamba). As an example of the application of capillary
      electrophoresis/electrospray mass spectrometry (CE/ESI/MS) to the analysis of a
      complex mixture of small proteins, we have analyzed the venom of Dendroaspis
      polylepis polylepis using the combined techniques. Both full-scan and selected
      ion monitoring modes were employed. CE/ESI/MS provides a rapid and extremely
      sensitive method for molecular weight determination, particularly when selected
      ion monitoring is employed. It has been utilized to provide sequence confirmation
      for those toxins which have already been described in the literature. Our
      methodology indicates the presence of at least 70 peptides in the molecular
      weight range 6000-9000.

PMID- 8354230
TI  - Fast analysis of proteins by isoelectric focusing performed in capillary array
      detected with concentration gradient imaging system.
AB  - Isoelectric focusing of several protein samples is performed simultaneously in an
      array of 2-4 short capillaries (4-10 cm long). The separated proteins are
      detected by either an on-line concentration gradient imaging detection system, or
      a single point concentration gradient detector which requires a mobilization step
      following the focusing process. The application of the capillary array increases
      the throughput of the capillary isoelectric focusing (CIEF) technique, and makes
      the technique comparable in sample throughput to the gel slab isoelectric
      focusing technique, but with much faster speed of separation and quantitation.
      The analysis is completed in 2-3 min with the imaging detection system, which is
      about 100 times faster than the conventional gel slab isoelectric focusing and 10
      times faster compared to conventional CIEF. The resolution of the separation is
      0.02 pH units or better. All separated proteins in the capillary array are
      detected by the universal concentration gradient detector, which eliminates the
      need for sample derivatization. The concentration limit of detection for the
      inexpensive instrument described in this work is about 30 micrograms/mL and can
      be reduced by using higher quality components in the system, such as a more
      stable laser, higher optical quality capillaries and a faster computer A/D board.
      The sample consumption is 400 nL for the 4 cm long, 100 microns ID square
      capillary. The isoelectric point (pI) values of the samples can be directly
      determined without internal pI markers from their positions inside the capillary
      after focusing when the imaging detection system is used.

PMID- 8354231
TI  - Determination of the isoelectric points of low and high molecular mass ampholytes
      by capillary electrophoresis.
AB  - A methodology for a reliable and absolute determination of isoelectric points of
      amphoteric species by capillary zone electrophoresis is proposed. The principle
      of this absolute method consists in the application of an additional
      electroosmotic and/or hydrodynamic flow of a background electrolyte. This allows
      the measurement of electrophoretic mobilities of substances close to their
      isoelectric points where the net electric charge is very low and electrophoretic
      mobility tends to zero. The mobilities are measured at various pH values of the
      electrolyte so as to find the pH at which the substance moves through the
      separation column at zero mobility under the action of the additional flow only.
      The number of required measurements is lowered to the minimum with the help of
      the iterative procedure based on the Regula Falsi algorithm. The precision of the
      proposed method is predicted theoretically. The feasibility is demonstrated on
      real samples. The isoelectric points of histidine, myoglobine and ribonuclease
      are found from their titration curves.

PMID- 8354232
TI  - Application of high-performance capillary electrophoresis to the analysis of H1
      histones.
AB  - High-performance capillary electrophoresis for the separation of rat testis H1
      histone variants and their phosphorylated modifications is described. The
      influence of buffer pH, hydroxypropylmethyl cellulose, and buffer concentration
      has been investigated. Under optimized conditions (500 mM phosphate buffer, pH 2,
      0.03% hydroxypropylmethyl cellulose) using an uncoated capillary, eight H1
      histone subfractions, including two H1(0) histones and H1t and their
      phosphorylated modifications, are resolved. Application of capillary
      electrophoresis to the separation of H1 histones provides an important new
      alternative to high-performance liquid chromatography (HPLC) and traditional gel
      electrophoresis.

PMID- 8354233
TI  - Using capillary electrophoresis in the optimization of a carboxypeptidase Y
      catalyzed transpeptidation reaction.
AB  - A peptide amide, R-Arg-NH2, was produced by carboxypeptidase Y (CPDY)-catalyzed
      transpeptidation of a peptide, R-Ala-OH in presence of a large excess of Arg-NH2.
      Baseline separation of R-Ala-OH and R-Arg-NH2 was achieved by free solution
      capillary electrophoresis (CE) analysis. With CE the reactions could be closely
      followed with an analysis frequency of 3-6 h-1. Due to a low consumption of
      sample per CE analysis (1-5 nL introduced, 5-6 microL in the sample vial), the
      reactions were performed in 100 and 250 microL volumes. Consequently, the
      optimization experiments consumed limited amounts of enzyme and substrate only.
      At optimized experimental conditions approximately 90% conversion of the starting
      peptide, R-Ala-OH, to R-Arg-NH2 was achieved.

PMID- 8354234
TI  - A model for the mobility of single-stranded DNA in capillary gel electrophoresis.
AB  - The electrophoretic mobility of single-stranded DNA in denaturing polyacrylamide
      gel-filled capillaries is analyzed as a function of the applied electric field.
      The resultant mobility plots are complex functions of the fragment size and
      electric field. Traditionally, these plots are separated into three mobility
      regimens corresponding to Ogston sieving, reptation without stretching and
      reptation with stretching theories. However, none of these theories accurately
      models the variations in mobility that we observe with electric field strength.
      As a result, we propose a modification of the Ogston sieving theory which
      accounts for the stretching of migrating DNA molecules in the direction of the
      electric field. This theory assumes that the applied electric field in
      conjunction with the gel matrix distorts the DNA, altering the effective size of
      the migrating molecule. The stretched DNA offers a smaller cross-section to the
      gel pore and thus sieves as though it were a smaller molecule. In this modified
      Ogston theory, the electrophoretic mobility depends only on the applied electric
      field, the size of the fragment, and constants which are independent of size and
      field strength. The modified Ogston equation accurately predicts the mobilities
      of DNA fragments in all three mobility regimes, providing a single, simple model
      to account for all of the observed behavior.

PMID- 8354235
TI  - Contribution of secondary structure to DNA mobility in capillary gels.
AB  - Intramolecular base pairing at the 3' end of single-stranded DNA molecules can
      cause increased electrophoretic mobility. In DNA sequencing separations this can
      result in compressions, where multiple oligomers differing in length by one base
      comigrate, which complicate sequence analysis. Using a novel approach to the
      application of capillary electrophoresis to DNA sequencing, incorporation of
      formamide into capillary gels, different separation field strengths, and external
      heating of the capillary are examined for their ability to resolve compressions.
      The identity of the 3' terminal nucleotide has also been observed to influence
      oligomer mobility in cross-linked acrylamide slab gels. We utilize automated data
      collection from DNA sequencing separations to show that a similar effect is also
      present in linear acrylamide capillary gels run at high field strengths. We also
      demonstrate the ability of capillary electrophoresis to separate synthetic oligos
      of the same length but differing in composition by one base, or of the same base
      composition but different sequence.

PMID- 8354236
TI  - Ultrasensitive plasmid mapping by high performance capillary electrophoresis.
AB  - This paper compares high performance capillary electrophoresis (HPCE) and
      conventional slab electrophoresis in mapping of four closely related plasmids
      with three different restriction enzymes. The plasmids express full length and
      truncated forms of a growth factor receptor oncogene product and were digested
      with HpaII, HaeIII and RsaI. The resulting oligonucleotide fragments were under
      2000 base pairs in length, a size well suited to separation by HPCE with linear
      polyacrylamide as a sieving matrix. Plasmid mapping is an essential tool in
      biotechnology both for the design of an expression system and for monitoring the
      stability of the expression system during fermentation. HPCE can yield much
      higher resolution of oligonucleotides than attainable in conventional agarose gel
      electrophoretic procedures for plasmid mapping. In the examples described here,
      the HpaII digests provided the surest identification of individual plasmids in
      the HPCE analysis and could discriminate among all four plasmids. In conventional
      slab electrophoresis, however, the RsaI digests provided the best discrimination,
      although two of the plasmids in this system yielded essentially identical
      electrophoretic patterns. Hence the optimal restriction enzyme for plasmid
      mapping applications with HPCE may differ from that selected on the basis of
      conventional slab gel analysis, and the former technique can provide higher
      discrimination among related plasmids. The advantages of the HPCE format with
      respect to speed, low sample consumption and resolution are described.

PMID- 8354237
TI  - Capillary electrophoresis of DNA restriction fragments with solutions of
      entangled polymers.
AB  - Separation of DNA restriction fragments in dilute buffer solutions of network
      forming polymers such as linear polyacrylamide (PAA), hydroxyethyl cellulose
      (HEC) and polyvinylalcohol (PVA) in phosphate buffer were investigated. PVA in
      buffers already became inhomogeneous after a few separations with resultant
      deterioration of resolution. Hydroxylic polymers, capable of forming suitable
      networks in buffers, are strongly adsorbed to fused silica surfaces suppressing
      the electroosmotic flow. These polymers could be applied as surface modifiers in
      capillaries, filled with buffer media containing other polymers such as PAA.
      Suppression of the electroosmotic flow by adsorbed HEC at pH 7 was slightly more
      effective than with PVA but the former coating was less stable due to weaker
      binding to the fused silica surface. Good separations of restriction fragments
      could be achieved with solutions of PAA or HEC as separation media after surface
      pretreatment of fused silica capillaries by either PVA rinsing or coating
      according to Hjerten.

PMID- 8354238
TI  - Capillary zone electrophoresis of large DNA.
AB  - Capillary zone electrophoresis (CZE) of DNA 23.1 to 48.5 kb in length in
      polyacrylamide solutions of several concentrations provides evidence for polymer
      concentration and DNA length-dependent stretching and orientation of these
      species and suggests an effective separation at a polymer concentration of about
      0.6%. Applying a 0.1% polyacrylamide concentration to the lambda-phage DNA
      ladder, at least 5 components are separated; separation improves with lowering of
      the field strength to 2 V/cm and, correspondingly, extended duration of CZE.
      Saccharomyces pombe chromosomal DNA separates into 3 major components on CZE at
      high field strength (270 V/cm) in 0.9% polyacrylamide solution, confirming a
      previous finding made on electrophoresis in a 1.1 mm ID tube at low field
      strength. However, the finding is limited to one source of the DNA plug, and the
      chromosomal identity of the components remains unknown. Methodological problems
      in the CZE of large DNA relate to the need for extended duration of pressure
      injection if absorbance detection is applied, the need to define the starting
      zone after extended pressure injection, the need to melt and digest agarose plugs
      prior to loading, and related needs for thermostating of the sample chamber and
      for software compatible with low voltage operation.

PMID- 8354239
TI  - Capillary electrophoresis/mass spectrometry determination of inorganic ions using
      an ion spray-sheath flow interface.
AB  - The determination of inorganic cations and anions by capillary
      electrophoresis/mass spectrometry (CE/MS) is reported using an ion spray-sheath
      flow interface coupling. A twelve-component synthetic mixture of cations which
      included the positive ions of K, Ba, Ca, Mn, Cd, Co, Pb, Cr, Ni, Zn, Ag, and Cu
      was loaded into the capillary column at levels ranging from 30 to 300 pg,
      separated by CE, and detected by indirect UV and in the full-scan (m/z 35-450)
      positive ion CE/MS mode using an aqueous buffer containing 30 mM creatinine and 8
      mM alpha-hydroxyisobutyric acid, pH 4.8. Creatinine forms adducts with the
      cations which are observed in the gas phase and requires rather high (120
      electron volts) declustering energy to dissociate. This produces a reduction in
      charge state to form the free, singly charged, inorganic cations which are
      observed in the mass spectra. CE/MS analysis of an aqueous acidic extract of used
      aircraft engine oil revealed high levels of lead as well as lower levels of
      chromium and nickel. CE-indirect UV analysis of a synthetic mixture containing
      300 pg each of 11 inorganic ions, which included the anions of Br, Cl, NO2, NO3,
      S2O3, N3, SCN, SO4, SeO4, oxalate, and MoO4, is shown. The running buffer which
      affected this separation contained 5 mM ammonium dichromate, 10 mM ammonium
      acetate, and 20 mM diethylenetriamine at pH 9.3. Although indirect UV detection
      revealed good separation of these anions, CE/MS analysis of this mixture was
      complicated by interfering ion current signals from the cluster ions formed by
      the interaction between the additives and the analytes.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8354240
TI  - Application of a diode-array detector in capillary electrophoresis.
AB  - In the last decade diode-array detection has proved to be extremely useful in
      high performance liquid chromatography in recording UV-visible spectra directly
      and on-line in the column effluent. In capillary electrophoresis (CE) only fast
      scanning detectors with long scan times (up to 2 s) are commercially available. A
      home-made CE instrument with a diode-array detector (DAD) was built and compared
      with a commercial fast-scanning detector. It is shown that the fast-scanning
      detector is advantageous when less than eight wavelengths are monitored. Due to
      the high data collection rate the DAD is superior if high resolution UV-visible
      spectra are acquired or if several spectra of a narrow peak (usual peak width in
      CE below 5 s) are needed for peak purity control. It is shown that DAD detection
      can help to develop separation methods, to identify peaks according to their UV
      visible spectra, and to check peak purity.

PMID- 8354241
TI  - Acetylator phenotyping via analysis of four caffeine metabolites in human urine
      by micellar electrokinetic capillary chromatography with multiwavelength
      detection.
AB  - The simultaneous analysis of 5-acetylamino-6-formylamino-3-methyluracil (AFMU), 5
      acetylamino-6-amino-3-methyluracil (AAMU), 1-methylxanthine (1X) and 1-methyluric
      acid (1U), the four urinary metabolites of caffeine employed for acetylator
      phenotyping in man, by micellar electrokinetic capillary chromatography (MECC) is
      reported. Using on-column fast scanning multiwavelength detection is shown to
      permit unambiguous identification of AAMU, AFMU, 1X and 1U in the three
      dimensional electropherograms obtained with both direct urine injection or
      application of extracted urine. The phenotype status of a number of healthy
      volunteers, some with known acetylator status, were determined using peak height
      ratios of AFMU/1X, (AFMU + AAMU)/1X and compared to those obtained by high
      performance liquid chromatography (HPLC) employing the AFMU/1X peak height ratio.
      Another set of MECC data was obtained after deliberate conversion of AFMU to
      AAMU, the results being expressed by AAMU/1X,AAMU/(1U + 1X) or AAMU/(AAMU + 1U +
      1X) ratios. The data suggest that most reliable data are obtained when
      phenotyping is conducted under conditions of complete conversion of AFMU to AAMU.
      Phenotyping employing caffeine and analysis of its urinary metabolites by MECC is
      shown to be simple and, with automated instruments, potentially suitable for
      routine use and large-scale population analysis. The agreement of MECC data
      obtained from three different instruments demonstrates the high level of maturity
      of this emerging technology.

PMID- 8354242
TI  - On the pH dependence of polymerization efficiency, as investigated by capillary
      zone electrophoresis.
AB  - The conversion efficiency of 5 different catalyst systems for polyacrylamide gel
      polymerization has been assessed as a function of pH of the gelling solution, in
      the pH 4.0-10.0 range. The system of persulfate-N,N,N',N'-tetramethylethylene
      diamine (TEMED) gives optimal incorporation of monomers only in the pH 7.0-10.0
      range; at progressively acidic pH values, the conversion drops markedly until, at
      pH 4.0, no gelation occurs. In the system of riboflavin-TEMED, the opposite
      behavior is observed: good conversions in the pH 4.0-7.0 interval (with a peak at
      pH 6.2), followed by progressive worsening at alkaline pH values until, at pH
      10.0, no gelation occurs. An excellent catalyst system appears to be the complex
      comprising methylene blue, toluene-4-sulfinic acid and diphenyliodonium chloride,
      which is able to guarantee > 95% conversion in the pH 4.0-8.0 range. Lower
      efficiencies are obtained at pH 9.0 and 10.0 (down to 81% conversion) but
      gelation still occurs in the entire pH range. Two other systems (ascorbic acid,
      ferrous sulfate and hydrogen peroxide in one case, and persulfate, TEMED and
      hydrosulfite, in another case) have been investigated. The former has some
      efficiency only at pH 4 (81% conversion), with a rapid drop as pH increases (only
      48% incorporation at pH 6). The latter exhibits the opposite behavior: 70%
      efficiency at pH 4.0, increasing to 92% conversion at pH 6.0.

PMID- 8354243
TI  - Acetylsalicylic acid has no effects on various isolated immune cells in vitro.
AB  - In addition to the well known biological effects of acetylsalicylic acid (ASA),
      its stimulating effect on the immune system has recently been described. In the
      present study, therefore, the influence of ASA on isolated leucocytes was
      investigated in vitro. Various concentrations of ASA, representing therapeutic
      concentrations, had neither an inhibitory nor a stimulating influence on the
      cytotoxicity of CD16-positive cells. The phytohaemagglutinin-induced
      proliferation of lymphocytes and the phagocytosis activity of monocytes and
      neutrophilic granulocytes was similarly unaffected. These results would indicate
      that the immunostimulating effects already described for ASA cannot be examined
      in isolated leucocytes in vitro and should be attributed to an interaction of
      various effector cells in vivo.

PMID- 8354244
TI  - Continuous percutaneous measurement by laser-Doppler flowmetry of skeletal muscle
      microcirculation at varying levels of contraction force determined
      electromyographically.
AB  - Laser-Doppler flowmetry (LDF) and electromyography (EMG) were used simultaneously
      for measuring skeletal muscle blood perfusion in relation to static load and
      fatigue. Percutaneous single-fibre LDF and bipolar surface EMG of the trapezius
      muscle were performed continuously during a 10-min series of alternating periods
      of static contractions and rest, each of 1-min duration. The muscle was exposed
      to static load expressed as shoulder torque, by keeping the arms straight and
      elevated at 30, 60, 90 and 135 degrees. On-line computer processing of the LDF
      and EMG signals made possible the interpretation of the relationship between the
      perfusion and the activity of the muscle. The LDF and root mean square (rms)-EMG
      were normalized by using the average value of the serial examinations of each
      individual as a reference value. Spectrum analyses of EMG showed the lowest
      variability for median frequency (MDF) in the frequency range 10-1000 Hz and mean
      power frequency (MPF) at 2-1000 Hz. The LDF power spectrum density during low
      (muscle rest) and high (high-force muscle contraction) perfusion indicated that
      disturbances were small when measurements were performed during sustained static
      contraction with as little movement as possible. Vasomotion, i.e. rhythmic
      variations in the blood flow, were present and showed a frequency of 5-6
      cycles.min-1. Application of a tourniquet to the upper arm caused an arrest of
      the microcirculation in the distally situated brachioradial muscle which was
      followed by a postischaemic hyperaemia upon removal of the torniquet.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8354245
TI  - Microcirculation in the upper trapezius muscle during varying levels of static
      contraction, fatigue and recovery in healthy women--a study using percutaneous
      laser-Doppler flowmetry and surface electromyography.
AB  - Microcirculation in the upper portion of the trapezius muscle was measured
      percutaneously by continuous laser-Doppler flowmetry (LDF) during two 10-min
      series of alternating 1-min periods of static contraction and rest determined
      electromyographically (EMG). Stepwise increased contraction was induced by
      keeping the arms straight and elevated at 30, 60, 90 and 135 degrees, which was
      repeated with a 1-kg load carried in each hand. Thereafter, fatigue and recovery
      were recorded while the subject kept her arms straight and elevated at 45 degrees
      carrying the 1-kg hand load as long as possible, followed by rest with arms
      hanging and no load. A group of 16 healthy women of different ages was studied.
      Signal processing was done on line using a 386 SX computer. The LDF- and root
      mean-square (rms) EMG signals were normalized. Spectrum analyses of EMG mean
      power frequency (MPF) and median spectrum frequency were performed. The rms-EMG
      increased significantly with an increase in the calculated shoulder torque (r =
      0.75). Accumulated local fatigue was indicated by a decrease in MPF with
      increased shoulder angle and added load (r = -0.54). Blood flow increased with
      increased shoulder angle (r = 0.82, with hand load r = 0.62) and with increased
      shoulder torque (r = 0.72), and also showed a significant increase with increased
      EMG activity (r = 0.74). The LDF showed a negative correlation to MPF (r = 
      0.67), with increased values when MPF was lowered. During the endurance test, a
      moderate increase of LDF occurred which reached its maximum during the 1st min of
      recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354246
TI  - Effect of hand paddle aids on oxygen uptake during arm-stroke-only swimming.
AB  - Cardiorespiratory responses during arm-stroke-only swimming with and without the
      aid of paddle were compared in seven trained swimmers. Water flow rate was
      started at 0.80 m.s-1 and was increased by 0.05 m.s-1 every 2 min up. to 1.00 m.s
      1. Subsequently, the flow rate was increased by 0.05 m.s-1 every minute until
      exhaustion. At given submaximal water flow rates, oxygen uptake, heart rate (fc),
      pulmonary ventilation (VE) and respiratory frequency (fR) during swimming using
      hands alone (H) were significantly higher than when aided by paddles (P). There
      were no significant differences in tidal volume (VT) between H and P. The
      subjects were able to swim significantly faster using paddles (P < 0.05);
      however, no significant differences between H and P were found in peak oxygen
      uptake (VO2peak, Fc, VE, FR, VT and the blood lactate concentration at which
      VO2peak was obtained (P > 0.05). These results would suggest that the ability to
      swim faster with paddles does not depend on higher energy production but may be
      attributed to higher propelling efficiency.

PMID- 8354247
TI  - 31P-nuclear magnetic resonance spectroscopy study of the time course of energy
      metabolism during exercise and recovery.
AB  - This study evaluated the time courses of intracellular pH and the metabolism of
      phosphocreatine (PCr) and inorganic phosphate (Pi) at the onset of four exercise
      intensities and recoveries. Non-invasive evaluation of continuous changes in
      phosphorus metabolites has become possible using 31P-nuclear magnetic resonance
      spectroscopy (31P-MRS). After measurements at rest, six healthy male subjects
      performed 4 min of femoral flexion exercise at intensities of 0 ("loadless"), 10,
      20 and 30 kg.m.min-1 in a 2.1 T superconducting magnet with a 67-cm bore.
      Measurements were continuously made during 5 min of recovery. During a series of
      rest-exercise-recovery procedures, 31P-MRS were accumulated using 32 scans
      spectrum-1 requiring 12.8 s each. At the onset of exercise, PCr decreased
      exponentially with a time constant of 27-32 s regardless of the exercise
      intensity. The time constant PCr resynthesis during recovery was about 27-40 s.
      The PCr kinetics were independent of exercise intensity. There were similar Pi
      kinetics at the onset of all types of exercise, while those of Pi recovery became
      significantly longer at the higher exercise intensities (P < 0.05). Furthermore,
      the intracellular pH indicated temporary alkalosis just at the onset of exercise,
      probably due to absorption of hydrogen ions by PCr hydrolysis, and then decrease
      at a point about 40%-50% of the pre-exercise PCr. The pH recovery time was longer
      than that for the Pi or PCr kinetics. By using a more efficient resolution system
      it was possible to obtain the phosphorus kinetics during exercise and to follow
      PCr resynthesis within the first few minutes of recovery.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8354248
TI  - Kinetics of heart rate and catecholamines during exercise in humans. The effect
      of heart denervation.
AB  - To elucidate the role of factors other than the nervous system in heart rate (fc)
      control during exercise, the kinetics of fc and plasma catecholamine
      concentrations were studied in ten heart transplant recipients during and after
      10-min cycle ergometer exercise at 50 W. The fc did not increase at the beginning
      of the exercise for about 60 s. Then in the eight subjects who completed the
      exercise it increased following an exponential kinetic with a mean time constant
      of 210 (SEM 22) s. The two other subjects were exhausted after 5 and 8 min of
      exercise during which fc increased linearly. At the cessation of the exercise, fc
      remained unchanged for about 50 s and then decreased exponentially with a time
      constant which was unchanged from that at the beginning of exercise. In the group
      of eight subjects plasma noradrenaline concentration ([NA]) increased after 30 s
      to a mean value above resting of 547 (SEM 124) pg.ml-1, showing a tendency to a
      plateau, while adrenaline concentration ([A]) did not increase significantly. In
      the two subjects who became exhausted an almost linear increase in [NA] occurred
      up to about 1,300 pg.ml-1 coupled with a significant increase in [A]. During
      recovery an immediate decrease in [NA] was observed towards resting values. The
      values of the fc increase above resting levels determined at the time of blood
      collection were linearly related with [NA] increments both at the beginning and
      end of exercise with a similar slope, i.e. about 2.5 beats.min-1 per 100 pg.ml-1
      of [NA] change.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354249
TI  - Cardiorespiratory response at the onset of passive leg movements during sleep in
      humans.
AB  - To examine the ventilatory response at the onset of passive leg movements during
      sleep in man and the concomitant changes in cardiac output (Qc), five healthy
      male subjects had their knee joints extended and flexed alternately at a
      frequency of about 60.min-1 for about 8 s. Minute ventilation (VI), respiratory
      frequency, tidal volume, end-tidal partial pressure of carbon dioxide and of
      oxygen, stroke volume (SV), heart rate (fc) and Qc were measured before, during
      and after passive leg movement during sleep stage III or IV (SLEEP). These values
      were compared with those of the awake condition (AWAKE). The VI increased
      significantly (P < 0.05) compared with the mean of five breaths preceding the
      movement (pre-movement) within one or two breaths at the onset of passive leg
      movements in both conditions. The difference between the mean of the first and
      second breaths after the onset of leg movement and pre-movement was 5.2 (SEM 1.9)
      l.min-1 for SLEEP and 2.7 (SEM 1.1) l.min-1 for AWAKE, respectively. Four of the
      five subjects showed a larger increase in ventilation during SLEEP compared with
      AWAKE. The fc increased significantly (P < 0.05) at the beginning of the passive
      movement in all cases, while SV showed an increase or decrease so that Qc showed
      no significant change in either condition. These results would suggest that
      afferent drive from moving limbs could produce an increase in ventilation without
      any change in Qc.

PMID- 8354250
TI  - Muscle strength and history of heavy manual work among elderly trained women and
      randomly chosen sample population.
AB  - The association between a history of heavy work and muscle strength was studied
      among 51 physically active women aged 66-85 years trained in sports and 41 women
      aged 70-81 years selected randomly from the population register. Maximal
      isometric muscle strength of hand grip, arm flexion, leg extension and trunk
      flexion and extension were measured using specially constructed dynamometers. The
      capacity of the abdominal muscles was evaluated by means of a sit-up test. The
      study included an interview dealing with the subjects' histories of heavy manual
      employment. The mean histories of heavy work for the trained and untrained women
      were 24 and 36 years, respectively. The trained women showed significantly
      greater maximal isometric muscle strength and abdominal muscle capacity than the
      untrained women. Among the trained women there was no correlation between the
      amount of heavy work and muscle performance. Among the untrained women the amount
      of heavy work correlated positively with maximal isometric trunk extension
      strength. The results would suggest that among elderly women, whether physically
      active or not, a history of heavy work has no systematic association with muscle
      strength.

PMID- 8354251
TI  - The temperature within the circle of Willis versus tympanic temperature in
      resting normothermic humans.
AB  - We measured the temperature of arterial blood within the circle of Willis
      (T(Willis)) in seven normothermic patients undergoing carotid arteriography. We
      found this temperature to be lower by 0.13 to 0.30 degrees C than tympanic
      temperature and by 0.30 to 0.55 degrees C lower than rectal temperature. By
      imposing this data on calculated cerebral heat balance it can be suggested that
      the average cerebral temperature of a resting subject is somewhat higher than
      tympanic temperature. These findings would also support indirectly the thesis
      that temperature gradients may exist within the brain.

PMID- 8354252
TI  - Acute and delayed effects of prolonged exercise on serum lipoproteins. I.
      Composition and distribution of high density lipoprotein subfractions.
AB  - To investigate the effects of a single period of prolonged exercise on
      lipoprotein concentration and composition, the serum of 13 healthy, endurance
      trained men was examined before and after (1 h, 20 h) a field test [running time,
      130 (SD 7.4) min]. We found changes in composition of all of the lipoprotein
      fractions isolated. In detail, all very low density lipoprotein particle
      components were reduced after exercise; the most pronounced changes found were in
      the concentrations of phospholipids (PL) and triglycerides (TG) (PL, before vs 20
      h after, P < 0.01; TG, before vs 20 h after, P < 0.01). The serum high density
      lipoprotein (HDL)-cholesterol mass was unchanged after exercise, but both HDL
      subfractions showed changes in composition. In HDL3 the relative amounts of
      cholesterol increased (unesterified free cholesterol; FC) before vs 20 h after, P
      < 0.05; cholesterylester (CE), before vs 20 h after, P < 0.01) and TG and PL
      decreased (TG and PL, before vs 20 h after, P < 0.05). The HDL2 particles became
      enriched in the relative amount of CE (before vs 20 h after, P < 0.01) and lost
      TG after exercise (before vs 20 h after, P < 0.01). The observation that all the
      changes in lipoprotein concentration and composition reached their maximal
      differences compared to the pre-exercise values 20 h afterwards would support the
      assumption that circulating lipoproteins play an important role in the
      regeneration period, refilling the intramuscular triglyceride stores.

PMID- 8354253
TI  - Acute and delayed effects of prolonged exercise on serum lipoproteins. II.
      Concentration and composition of low-density lipoprotein subfractions and very
      low-density lipoproteins.
AB  - To investigate the effects of a single period of prolonged exercise on
      lipoprotein concentration and composition, 13 healthy endurance-trained men were
      examined before and after (1 h, 20 h) a cross-country run [30 km, time: 130 (SD
      7.4) min]. The data show that following acute exercise, serum triglyceride (TG)
      concentration were reduced (36%) as a consequence of a reduced number (31%) of
      very low density lipoprotein (VLDL) particles. Changes in composition of VLDL
      were present but less evident. In contrast to this, acute exercise did not induce
      significant changes in the average concentration of individual low-density
      lipoprotein (LDL) subfractions. However, changes in dense LDL [density (d) >
      1.044 g.ml-1] concentration were significantly correlated to changes in serum TG:
      a reduction of dense LDL occurred in subjects with large reductions in serum TG.
      In addition, LDL composition changed significantly. Immediately (1 h) after
      exercise the TG content of all LDL subfractions was reduced. These reductions
      were significant in large (d = 1.006-1.037 g.ml-1) and small LDL (1.044-1.063
      g.ml-1). It can be concluded therefore from our study that acute exercise
      primarily altered the composition of LDL subfractions while their concentration
      remained stable.

PMID- 8354254
TI  - Cardiac output in paraplegic subjects at high exercise intensities.
AB  - The purpose of this investigation was to compare cardiac output (Qc) in
      paraplegic subjects (P) with wheelchair-confined control subjects (C) at high
      intensities of arm exercise. At low and moderate exercise intensity Qc was the
      same at a given oxygen uptake (VO2) in P and C. A group of 11 athletic male P
      with complete spinal-cord lesions between T6 and T12 and a group of 5 well
      matched athletic male C performed maximal arm-cranking exercise and submaximal
      exercise at 50%, 70% and 80% of each individual's maximal power output (Wmax).
      Maximal VO2 (VO2max) was significantly lower, VO2max per kilogram body mass was
      equal and maximal heart rate (fc) was significantly higher in P compared to C. At
      VO2 of 1.3, 1.5 and 1.7 l.min-1, and for P 65%-90% of the VO2max, Qc was not
      significantly different between the groups, although, Qc in P was achieved with a
      significantly lower stroke volume (SV) and a significantly higher fc. Although
      the SV was lower in P, it followed the same pattern as SV in C during incremental
      exercise, i.e. an increase in SV until about 45% Wmax and thereafter a stable SV.
      The similar Qc at a given VO2 in both groups indicated that, even at high
      exercise intensities, circulation in P can be considered isokinetic with a
      complete compensation by fc for a lower SV.

PMID- 8354255
TI  - Regulation of local sweating in sleep-deprived exercising humans.
AB  - Thermoregulatory sweating [total body (msw,b), chest (msw,c) and thigh (msw,t)
      sweating], body temperatures [oesophageal (T(oes)) and mean skin temperature
      (Tsk)] and heart rate were investigated in five sleep-deprived subjects (kept
      awake for 27 h) while exercising on a cycle (45 min at approximately 50% maximal
      oxygen consumption) in moderate heat (T(air) and T(wall) at 35 degrees C). The
      msw,c and msw,t were measured under local thermal clamp (Tsk,l), set at 35.5
      degrees C. After sleep deprivation, neither the levels of body temperatures
      (T(oes), Tsk) nor the levels of msw,b, msw,c or msw,t differed from control at
      rest or during exercise steady state. During the transient phase of exercise
      (when Tsk and Tsk,l were unvarying), the msw,c and msw,t changes were positively
      correlated with those of T(oes). The slopes of the msw,c versus T(oes) or msw,t
      versus T(oes) relationships remained unchanged between control and sleep-loss
      experiments. Thus the slopes of the local sweating versus T(oes) relationships
      (msw,c and msw,t sweating data pooled which reached 1.05 (SEM 0.14) mg.cm-2.min
      1.degree C-1 and 1.14 (SEM 0.18) mg.cm-2.min-1.degree C-1 before and after sleep
      deprivation) respectively did not differ. However, in our experiment, sleep
      deprivation significantly increased the T(oes) threshold for the onset of both
      msw,c and msw,t (+0.3 degrees C, P < 0.001). From our investigations it would
      seem that the delayed core temperature for sweating onset in sleep-deprived
      humans, while exercising moderately in the heat, is likely to have been due to
      alterations occurring at the central level.

PMID- 8354256
TI  - A modified, local sweat collector for warm and humid conditions.
AB  - The purpose of this study was to modify a previously described local sweat
      collector to facilitate the investigation of sweat rate and composition in a warm
      (30 degrees C) and humid (relative humidity 80%) environment. The adherence of
      the collector to the skin was improved and a pouch was appended at the lower end
      of the collector. The limitations of the closed collector were examined by
      comparing the local sweat rate and the quantity of electrolyte excreted in sweat
      with those obtained using a second collector with a wide opening (to permit free
      evaporation) and by changes in the body mass. Eight subjects performed exercise
      on a cycle ergometer consisting of four equal periods of 15 min each, at 60%
      maximal oxygen consumption, with a rest of 5 min between each period. The sweat
      produced on a local skin area (85 cm2, upper posterior thorax region) was
      collected at the end of each period, before measuring the body mass on a
      sensitive (+/- 1 g) platform balance. The mean local sweat rate [2.61 (SEM 0.19)
      mg.cm-2.min-1] was 2.4 times greater than the pro-rated whole body mass loss but
      the two were strongly correlated (r = 0.82, P < 0.01). Compared to the open
      collector, the greater quantity of electrolyte excreted into the closed collector
      would suggest that the conditions which prevailed in the closed collector, such
      as a higher local skin temperature, may have affected the function of the sweat
      gland.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354257
TI  - Does maximal neural activation of muscle increase after resistance training?

PMID- 8354258
TI  - The peripheral cholecystokinin receptors.

PMID- 8354259
TI  - Stereospecificity of the interaction of porcine pancreatic phospholipase A2 with
      micellar and monomeric inhibitors. A time-resolved fluorescence study of the
      tryptophan residue.
AB  - The binding effect of enantiomeric substrate analogs under micellar form on the
      local conformation and dynamics of the N-terminal region of porcine pancreas
      phospholipase A2 was examined by time-resolved fluorescence measurements of its
      single tryptophan residue (Trp3). The complexity of the fluorescence intensity
      decay of the unliganded protein (four excited-state lifetime populations)
      suggests a conformational heterogeneity of the N-terminal region of the protein.
      A considerable simplification of the excited-state lifetime profile was
      specifically observed in the complex with one of the stereoisomers [(R)-2
      tetradecanoylamino)-hexanol-phosphocholine] at low inhibitor/protein molar ratio
      of approximately 9. This indicates the existence of a definite conformation of
      the N-terminal region of the protein in the complex. No effect was detected for
      the S-enantiomer. In parallel, the rotational mobility of the Trp residue in the
      complex with the R-enantiomer was reduced. At a higher inhibitor/protein molar
      ratio of approximately 130, the stereospecificity of the interaction was lost and
      complexes were formed with both stereoisomers. These complexes were, however, not
      similar to the specific one either in terms of the local Trp3 environment or of
      the volume of the rotating unit. The local effects of low amounts of monomeric
      inhibitors added to a preformed protein/micelle complex of a phospholipase A2
      double mutant in which a Trp residue was genetically inserted near the active
      site at position 31 while the natural Trp3 was replaced by Phe [Kuipers, O.,
      Vincent, M., Brochon, J. C., Verheij, H. M., de Haas, G. H. & Gallay, J. (1991)
      Biochemistry 30, 8771-8785], were also monitored by time-resolved fluorescence of
      this single Trp residue. A stereospecific dependence of the local perturbations
      was again observed. These results support the idea that the active conformation
      of the protein is reached in solution only after formation of a ternary complex:
      protein-interface-inhibitor.

PMID- 8354260
TI  - The glucagon-insulin antagonism in the regulation of cytosolic protein binding to
      the 3' end of phosphoenolpyruvate carboxykinase mRNA in cultured rat hepatocytes.
      Possible involvement in the stabilization of the mRNA.
AB  - Since protein binding to the 3' end of mRNA is believed to be involved in the
      control of mRNA stability, the time course of alterations in glucagon-induced
      phosphoenolpyruvate-carboxykinase-mRNA (PCK) levels, in the absence and presence
      of insulin, was correlated with the time course of changes in the binding of
      cytosolic protein from 24-h cultured rat hepatocytes to the 3' end of PCK mRNA.
      PCK-mRNA levels were monitored by Northern blot analysis and protein binding was
      analyzed by an electrophoretic mobility-shift assay. In 24-h cultured rat
      hepatocytes, binding of cytosolic protein to the PCK-mRNA 3' end and PCK-mRNA
      levels were increased to a transient maximum at 2 h and 2-4 h, respectively, by a
      1-nM glucagon treatment, added with a change of medium. 100 nM insulin, added
      simultaneously with glucagon, reduced the glucagon-induced maximum of protein
      binding by 80% and the increase of PCK mRNA by about 30%. In controls without
      hormonal treatment protein binding at 1 h was also increased; this increase was
      prevented by insulin. 100 nM insulin, added 1 h after glucagon, reversed protein
      binding to the 3' end of PCK mRNA to nearly initial levels within 1 h and
      impaired the glucagon-induced increase in PCK-mRNA levels by 30%. The
      transcriptional inhibitor cordycepin, added 1 h after glucagon, did not prevent
      the further increase in glucagon-enhanced protein binding nor its reversal by
      insulin. It did, however, prevent a further significant increase in PCK mRNA.
      Hormonally regulated protein binding could be localized to the 256 distal bases
      of the PCK-mRNA 3' end. The proximal 466 bases of the PCK-mRNA 3' end as well as
      the 1050 bases of the histone-H1(0)-mRNA 3' end and the 1200 bases of the
      arylsulfatase-A-mRNA 3' end also bound cytosolic protein(s), but this protein
      binding was not altered by treatment with glucagon or insulin. The 3' end of PCK,
      arylsulfatase A and H1(0) mRNA exhibited strong binding of cytosolic protein(s)
      from diverse rat tissues such as heart, liver and lung as well as Fao rat
      hepatoma cells. Cytosolic protein(s) from spleen showed weak binding and proteins
      from HeLa and U937 tumor cells did not bind. Protein binding was most prominent
      with the 3' end of PCK mRNA and cytosolic extracts from liver.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8354262
TI  - Isoforms of fatty-acid-binding protein in bovine heart are coded by distinct
      mRNA.
AB  - In the course of our studies on structure/function relationships of fatty-acid
      binding proteins, we reported earlier that the two isoforms of the 15-kDa cardiac
      fatty-acid-binding protein (cFABP) from bovine heart only differ in one position;
      Asn98 in pI 5.1-cFABP; Asp98 in pI 4.9-cFABP [Unterberg, C., Borchers, T.,
      Hojrup, P., Knudsen, J. and Spener, F. (1990) J. Biol. Chem. 265, 16,255-16,261].
      In the present study, we elucidate the origin for this heterogeneity. Isoelectric
      focusing analysis of immunoprecipitated in vitro translation products from total
      mRNA and positive-hybrid-selected cFABP/mRNA revealed two L-[35S]methionine
      labeled proteins corresponding to pI 5.1-cFABP and pI 4.9-cFABP. In a control
      experiment, recombinant mRNA derived from cDNA encoding pI 5.1-cFABP was
      translated and produced only pI 5.1-cFABP as shown by isoelectric focusing of the
      translation products. We could observe co-translational acetylation but not post
      translational deamidation of the cFABP isoforms. Taken together, our results
      demonstrate that the isoforms of cardiac fatty-acid-binding protein found in
      bovine heart are coded by distinct mRNA species.

PMID- 8354261
TI  - Tissue-dependent variation in the expression of elongation factor-1 alpha
      isoforms: isolation and characterisation of a cDNA encoding a novel variant of
      human elongation-factor 1 alpha.
AB  - A novel isoform of human elongation factor-1 alpha (EF-1 alpha 2) has been
      characterised. It shows a high similarity to other EF-1 alpha proteins,
      especially to a rat EF-1 alpha variant and it has all the characteristics of a
      functional EF-1 alpha protein. The pattern of expression of both EF-1 alpha 2 and
      EF-1 alpha was analysed in different human tissues. This showed that the two
      proteins were differentially expressed, EF-1 alpha 2 was expressed in brain,
      heart, skeletal muscle and in the transformed cell lines AMA and K14, but was
      undetectable in other tissues and in both primary and transformed human
      fibroblasts. EF-1 alpha was expressed in brain, placenta, lung, liver, kidney,
      pancreas and in all the cell lines that we have analysed but barely detectable in
      heart and skeletal muscle.

PMID- 8354263
TI  - Site specificity of glycation of horse liver alcohol dehydrogenase in vitro.
AB  - The site specificity of in vitro glycation of horse liver alcohol dehydrogenase
      (ADH) was examined and the results interpreted in terms of structural features of
      the enzyme molecule. In a phosphate buffer solution, glycation occurred at Lys231
      (the main site of glycation in vivo), at Lys228 (which is not glycated in vivo),
      and at several unidentified positions. Buffer anions or NAD+ did not affect
      glycation of Lys231; this supported our hypothesis that the base catalyst which
      removes a proton from carbon 2 of a Lys231-attached aldimine is part of the ADH
      molecule [Shilton, B.H. & Walton, D.J. (1991) J. Biol. Chem. 266, 5587-5592]. Use
      of a molecular modelling programme indicated that this catalyst was likely to be
      the imidazole group of His348, exerting its effect through the hydroxyl of
      Thr347. Glycation of Lys228 occurred only in the presence of phosphate; in this
      case molecular modelling showed that the base catalyst could be a phosphate ion,
      bound to ADH at a positive region of the coenzyme binding site. NAD+ inhibited
      glycation of Lys228 by binding to the enzyme and restricting access to glucose.

PMID- 8354264
TI  - 1H- and 15N-NMR assignment and solution structure of the chemotactic Escherichia
      coli Che Y protein.
AB  - Che Y is a 129-residue parallel alpha/beta protein involved in bacterial
      chemotaxis. We have used this protein as a model to study the folding reaction of
      parallel alpha/beta proteins. As a first step we carried out the complete
      assignment of the 1H and 15N spectra from Escherichia coli Che Y protein on the
      basis of two-dimensional 1H homonuclear and 1H-15N heteronuclear experiments by
      using sequence-specific methods. Our assignments differ from the preliminary
      assignments made by Kar et al. [Kar, L., Matsumura, P. & Johnson, M.E. (1992)
      Biochem. J. 287, 521-531] of aromatic residues obtained by comparison of NOEs
      with short proton-proton distances in the crystal structure of Che Y. The
      analysis of the extension of the secondary elements, as well as a preliminary
      calculation of the three-dimensional structure, indicate that the solution
      structure is closely coincident with the single crystal structure determined by X
      ray diffraction.

PMID- 8354265
TI  - In vitro formation of a photoreversible adduct of phycocyanobilin and tobacco
      apophytochrome B.
AB  - The light-stable tobacco phytochrome apoprotein (PHYB) expressed in yeast can be
      assembled with phycocyanobilin to give a photoreversible adduct. The spectral
      properties of the reconstituted PHYB-phycocyanobilin species were determined by
      absorbacen and difference absorbance spectroscopies. The holoprotein exhibits
      absorbance maxima at 408 nm and 712 nm for the far-red-light-absorbing (Pfr) form
      and 356 nm and 658 nm for the red-light-absorbing (Pr) form. The ligation of the
      chromophores to the dimeric PHYB apoprotein resulted in a PHYB-phycocyanobilin
      adduct with the spectral properties of the Pr form. Kinetic analyses of the in
      vitro reconstitution for PHYB apoprotein under saturating concentrations of
      phycocyanobilin revealed a pseudo first-order rate constant of 2.8 x 10(-2)s.-1.
      The similarity with the reported rate constant for the reconstitution of light
      labile phytochrome (PHYA) from oat [Li, L. & Lagarias, J.C. (1992) Phytochrome
      assembly, J. Biol. Chem. 267, 19,204-19,210] suggests that the mechanisms of
      chromophore attachment are probably very similar for PHYA and PHYB.

PMID- 8354266
TI  - Involvement of the ADP/ATP carrier in permeabilization processes of the inner
      mitochondrial membrane.
AB  - The effect of different agents on inner-mitochondrial-membrane permeabilization
      and lipoperoxidation induced by Ca2+ and the pyridine-nucleotide oxidant t
      butylhydroperoxide or inorganic phosphate was investigated. Comparing the
      protection conferred by ADP, a substrate of the ADP/ATP carrier, dithiothreitol,
      a disulfide reductant and butylhydroxytoluene, a radical scavenger, it was found
      that ADP was always the most effective against mitochondrial damage, when present
      in the incubation medium from the beginning. Moreover, carboxyatractyloside, a
      specific inhibitor of the ADP/ATP carrier, abolished completely the protective
      effect of ADP on both the lipoperoxidation and mitochondrial swelling processes.
      Experiments where deenergized mitochondria were previously incubated with Ca2+
      showed a decrease in the content of active ADP/ATP carrier, indicating a direct
      involvement of this protein in the formation of a non-specific Ca(2+)-dependent
      pore. Our results also eliminate the possibility of an attack of oxygen radicals
      on lipids or proteins of the mitochondrial membrane as the primary event
      triggering the permeability transition of the inner mitochondrial membrane.

PMID- 8354267
TI  - Abundance and subcellular distribution of GTP-binding proteins in 3T3-L1 cells
      before and after differentiation to the insulin-sensitive phenotype.
AB  - The abundance and the subcellular distribution of GTP-binding proteins was
      studied in membrane fractions (plasma membranes and low-density microsomes) from
      3T3-L1 cells before and after differentiation to the insulin-sensitive phenotype.
      After differentiation, the abundance of alpha i (alpha subunit of GTP-binding
      protein Gi), alpha o (alpha subunit of GTP-binding protein G(o)), and of a 47-kDa
      alpha s (alpha subunit of GTP-binding protein Gs) as detected by immunoblotting
      with specific antisera was reduced by 10-50% when normalized per membrane
      protein. In contrast, a 43-kDa alpha s was increased about threefold after
      differentiation. Furthermore, cholera-toxin-catalyzed ADP-ribosylation of both 43
      kDa and 47-kDa alpha s was disproportionately increased ninefold and threefold,
      respectively, possibly reflecting the increased production of an ADP-ribosylation
      factor in the differentiated cells. The small GTP-binding protein Ha-ras was
      reduced by 50%, whereas rab1 and other small GTP-binding proteins tentatively
      identified as rab-isoforms (ras-homologous gene products from brain) were
      increased by 100% and 70%, respectively. Since the total protein content of 3T3
      L1 cells was increased threefold after differentiation, the observed increase of
      the 43-kDa alpha s, rab1 and of the other rab isoforms was eightfold, sixfold and
      fivefold, respectively, when normalized/cell count. With the exception of the rab
      isoforms, all GTP-binding proteins were predominantly, if not exclusively,
      located in the plasma membrane; comparable amounts of the rab isoforms were found
      in plasma membranes and low-density microsomes. Insulin induced the
      characteristic redistribution of glucose transporters GLUT4 from low-density
      microsomes to the plasma membranes, but failed to alter the subcellular
      distribution of any of the GTP-binding proteins investigated. These data suggest
      that the increase in the abundance of the 43-kDa alpha s subunit and of several
      rab isoforms might be related to specific functions of the adipocyte-like
      phenotype, but that none of the investigated guanine-nucleotide-binding
      regulatory (G)-proteins appears to be tightly associated with the GLUT4.

PMID- 8354268
TI  - Retrobiosynthetic analysis of carbon fixation in the phototrophic eubacterium
      Chloroflexus aurantiacus.
AB  - The phototrophic bacterium Chloroflexus aurantiacus does not use any of the known
      autotrophic CO2 fixation pathways. There is evidence for a new cyclic autotrophic
      pathway in which acetyl-CoA is converted to 3-hydroxypropionate and further to
      succinate and malate. This hypothesis was tested by feeding growing cultures
      during several generations with 3-hydroxy[1-13C]propionate, [1-13C]acetate, or [2
      13C]acetate, in addition to unlabeled CO2. The relative 13C content of individual
      carbon atoms in biosynthetic amino acids and nucleosides was determined by 1H-
      and 13C-NMR spectroscopy. 13C coupling patterns were analyzed by two-dimensional
      13C-TOCSY experiments which were optimized for the analysis of multiply 13C
      labeled biosynthetic samples. From the 13C enrichments of amino acids and
      nucleosides, the labeling patterns of central metabolic intermediates were
      evaluated by a retrobiosynthetic approach. Both 3-hydroxypropionate and acetate
      were incorporated into all central metabolic pools. The 13C labeling and coupling
      patterns suggest a novel carbon fixation pathway via 3-hydroxypropionate.
      Specifically, we propose that acetyl-CoA is carboxylated to malonyl-CoA which is
      reduced under formation of 3-hydroxypropionyl-CoA. Dehydration and reduction
      yield propionyl-CoA which is converted to succinate by a second carboxylation
      reaction. The net product of autotrophic carbon fixation appears to be
      glyoxylate. However, it is not yet known how glyoxylate is channeled into
      anabolic metabolism. Assimilation of acetate can proceed via the CO2 fixation
      pathway, but also via the glyoxylate pathway.

PMID- 8354269
TI  - Enzymes of a novel autotrophic CO2 fixation pathway in the phototrophic bacterium
      Chloroflexus aurantiacus, the 3-hydroxypropionate cycle.
AB  - The phototrophic bacterium Chloroflexus aurantiacus can grow autotrophically but
      seems not to assimilate CO2 via any of the known autotrophic pathways. Holo
      [Holo, H. (1989) Arch. Microbiol. 151, 252-256] proposed a new pathway in which 3
      hydroxypropionate is formed from acetyl-CoA. Previous studies excluded the
      operation of known CO2 fixation pathways and provided indirect evidence for the
      suggested pathway based on 13C-labelling experiments. Here all enzyme activities
      of the postulated cyclic CO2 fixation mechanism are demonstrated in vitro. In
      essence, acetyl-CoA is carboxylated and reductively converted via 3
      hydroxypropionate to propionyl-CoA. Propionyl-CoA is carboxylated and converted
      via succinyl-CoA and CoA transfer to malyl-CoA. Malyl-CoA is cleaved to acetyl
      CoA and glyoxylate. Thereby, the first CO2 acceptor molecule acetyl-CoA is
      regenerated, completing the cycle and the net CO2 fixation product glyoxylate is
      released. This cycle represents the fourth autotrophic pathway in nature and is
      designated the 3-hydroxypropionate cycle.

PMID- 8354270
TI  - Molecular characterization of HES-2, a mammalian helix-loop-helix factor
      structurally related to Drosophila hairy and Enhancer of split.
AB  - Drosophila hairy (h) plays a crucial role in early development as a pair-rule
      segmentation gene. h and its structurally related gene Enhancer of split [E(spl)]
      are also required for normal sensory neurogenesis in late development. To analyze
      the molecular mechanisms of mammalian development, we recently characterized
      three rat helix-loop-helix (HLH) factors that show structural homology to the
      Drosophila h and E(spl) gene products, and found that rat factors exhibit
      distinct spatiotemporal expression patterns and act as a negative regulator.
      Here, we report the molecular characterization of another member of this family,
      designated HES-2. Rat HES-2 protein has a basic HLH domain homologous to h and
      E(spl) as well as the carboxy-terminal Trp-Arg-Pro-Trp sequence conserved among
      this family. The HES-2 mRNA is present as early as embryonic day 9.5 and is
      detected in a variety of tissues of both embryos and adults. DNase-I-footprinting
      analyses indicate that HES-2 binds to all E box sequences (CANNTG) we tested as
      well as to the N-box sequences (CACNAG). Further studies of gel-mobility-shift
      assays show that HES-2 has a higher affinity for the E box than for the N box.
      Transient transfection analyses suggest that HES-2 decreases the transcription
      originating from the promoters containing either the E box or the N box. These
      results indicate that HES-2 acts as a negative regulator through interaction with
      both E-box and N-box sequences.

PMID- 8354271
TI  - Folding and assembly of phage P22 tailspike endorhamnosidase lacking the N
      terminal, head-binding domain.
AB  - Tryptic digestion of a thermal unfolding intermediate of the phage P22 tailspike
      endorhamnosidase produces an N-terminally shortened protein fragment comprising
      amino-acid residues 108-666 [Chen, B.-L. & King, J. (1991) Biochemistry 30, 6260
      6269]. In the present work, the 60-kDa C-terminal fragment was purified to
      homogeneity from the tryptic digest by gel-fitration chromatography. As in the
      case for the whole tailspike protein (72 kDa), the purified fragment was found to
      remain stably folded as a highly soluble, SDS-resistant, enzymatically active
      trimer. However, its unfolding in the presence of guanidinium chloride was
      accelerated at least 10-fold compared to the complete, native tailspike protein.
      Shortened tailspike trimers reconstituted spontaneously and with high yield after
      diluting a solution containing acid-urea-unfolded fragment polypeptides with
      neutral buffer. Upon recombinant expression of the 60-kDa polypeptide in
      Escherichia coli, it also assembled efficiently and formed SDS-resistant trimers.
      The refolding and assembly pathway of the N-terminally shortened tailspike
      paralleled that of the complete protein with slightly, but significantly,
      accelerated folding reactions, at both the subunit and the trimer levels. As
      found for the complete tailspike protein, yields of refolding and assembly of the
      60-kDa fragments into SDS-resistant trimers decreased with increasing
      temperature. The refolding yield of fragments derived from a temperature
      sensitive mutant (Gly244-->Arg) tailspike protein was affected in similar fashion
      as shown for the whole protein. We conclude that the N-terminal domain (residues
      1-107) is dispensable for folding and assembly of the P22 tailspike
      endorhamnosidase both in vitro and in vivo.

PMID- 8354272
TI  - Electrostatic evidence for the activation of the glutathione thiol by Tyr7 in pi
      class glutathione transferases.
AB  - A number of spectrophotometric studies [Graminski, G.F., Kubo, Y. & Armstrong,
      R.N. (1989) Biochemistry 28, 3562-3568; Liu, S., Zhang, P., Ji, X., Johnson,
      W.W., Gilliland, G.L. & Armstrong, R.N. (1992) J. Biol. Chem. 267, 4296-4299]
      have recently shown that the glutathione (GSH) thiol is deprotonated when it is
      in complex with glutathione S-transferase. Different models have been proposed
      for the activation of the glutathione S gamma, all pointing out the key role of
      active-site residue Tyr7. It remains unclear, however, how Tyr7 is actually
      involved in this process. In this paper we present an analysis of the
      electrostatic potential in the region of the active site of a pi-class GSH
      transferase. This analysis provides evidence that the titration behaviour of the
      absorption band of the E.GSH complex with a pK between 6 and 7 [Liu, S., Zhang,
      P., Ji, X., Johnson, W.W., Gilliland, G.L. & Armstrong, R.N. (1992) J. Biol.
      Chem. 267, 4296-4299] should rather be explained by the protonation/deprotonation
      equilibrium of Tyr7 than by the protonation/deprotonation equilibrium of the GSH
      thiol group itself. On the basis of this conclusion, a mechanism for activation
      of GSH is proposed: the Tyr7 OH group is deprotonated by the influence of the
      protein charge constellation and the peptide dipoles. Thus it acts as a general
      base, promotes proton abstraction from the GSH thiol and creates a thiolate anion
      with high nucleophilic reactivity.

PMID- 8354273
TI  - Estrogen-inducible pS2 protein is not the key regulatory component in the
      proliferation of human breast cancer cells (MCF-7).
AB  - Exposure of human breast cancer cells (MCF-7) to tumor promoters such as 12-O
      tetradecanoyl phorbol 13-acetate (TPA) for 24 h at concentrations of 1-100 nM
      resulted in marked inhibition of DNA synthesis but a 3-5-fold increase in the
      amount of pS2 protein in the medium. These results support our previous
      suggestion that pS2 protein is not involved in the mechanism controlling
      proliferation of MCF-7 cells. During treatment with TPA, the intracellular
      content of pS2 protein was constant, suggesting that TPA did not induce secretion
      of pS2 protein but rather de novo synthesis of the protein. The increase in the
      pS2 protein content of the medium by TPA was inhibited by simultaneous addition
      of cycloheximide, but not by that of actinomycin D. Northern-blot hybridization
      analysis showed that the amount of pS2 mRNA was unchanged by treatment of the
      cells with TPA. These results indicate that TPA does not induce transcription of
      the pS2 gene, and suggest that the main effect of TPA results from the induction
      of translation of pS2 mRNA.

PMID- 8354274
TI  - cDNA nucleotide sequence and primary structure of mouse uterine peptidylarginine
      deiminase. Detection of a 3'-untranslated nucleotide sequence common to the mRNA
      of transiently expressed genes and rapid turnover of this enzyme's mRNA in the
      estrous cycle.
AB  - Peptidylarginine deiminase is a protein-modulating enzyme which converts the
      arginine residues in proteins to citrulline residues. This study describes the
      complete primary structure of mouse peptidylarginine deiminase, which was deduced
      from nucleotide sequence analysis of cDNA clones plus proteochemical analysis of
      the purified enzyme. The composite cDNA sequence contained a 5' untranslated
      region of 7 bases, an open reading frame of 2019 bases that encoded 673 amino
      acids, a 3' untranslated region of 2662 bases, and part of a poly(A) tail. The N
      terminal and C-terminal sequences of the enzyme matched the sequences deduced
      from nucleotide analysis. Furthermore, we determined that the N-terminal sequence
      was N alpha-acetyl-Met-Gln-, a sequence which has never previously been reported
      among N alpha-acetyl-Met proteins. The Arg 352 of the enzyme was converted to a
      citrulline residue and the potential Asn-linked glycosylation site (Asn542-Glu543
      Ser544) had no carbohydrate moiety. Thus, mouse peptidylarginine deiminase
      consists of 673 amino acids with a molecular mass of 76,260. Mouse
      peptidylarginine deiminase mRNA has two AU-rich structures in the 3' untranslated
      region which exhibit a high degree of similarity to those in lymphokine, cytokine
      and proto-oncogene mRNA species. Since the rat enzyme (previously reported) does
      not possess these characteristic structures, we compared the levels of enzyme
      activity and mRNA in the mouse and rat uterus at four defined phases of the
      estrous cycle. The degradation of peptidylarginine deiminase and its mRNA
      proceeded significantly faster in the mouse than in the rat. We speculate that
      the unusual structure of the mouse enzyme and its mRNA be involved in this
      species-specific rapid degradation.

PMID- 8354275
TI  - Purification and characterization of N-glycolyneuraminic-acid-specific lectin
      from Scylla serrata.
AB  - A sialic-acid-binding lectin with specificity for N-glycolylneuraminic acid
      (NeuGc) was purified from the hemolymph of the marine crab Scylla serrata by
      affinity chromatography using thyroglobulin-coupled agarose. The binding
      specificity of Scylla lectin distinguishes it from other known sialic-acid
      specific lectins found in Limulus polyphemus and Limax flavus, which show a
      broader range of specificity for sialic acids. The molecular mass of the purified
      lectin is about 55 kDa. Under reducing conditions (SDS/PAGE), it resolved into
      two subunits of 30 kDa and 25 kDa. NeuGc inhibited hemagglutination activity of
      the purified lectin at a concentration as low as 0.6 mM, whereas N
      acetylneuraminic acid (NeuAc) even at a concentration of 100 mM, failed to
      inhibit hemagglutination. This finding was supported by potent inhibition of
      hemagglutination by bovine and porcine thyroglobulins, which contain a NeuGc
      alpha 2-6Gal as terminal component of oligosaccharide residues. Neither
      glycoproteins (glycophorin NN; porcine submaxillary mucin), which contain NeuAc
      alpha 2-3Gal/GalNAc and NeuAc alpha 2-6GalNAc, nor human acid glycoprotein, which
      contains NeuAc alpha 2-3/alpha 2-6 Gal, or colominic acid, a sialopolymer with
      NeuAc alpha 2-8NeuAc, inhibited the lectin activity. The specificity of the
      lectin for NeuGc appears to account for the fact that it agglutinates rabbit and
      mice erythrocytes, but not human A, O, AB, rat or chicken erythrocytes, which
      contain NeuAc. The inability of the lectin to agglutinate erythrocytes (horse)
      that prominently express NeuGc could be due to O-acetylation of NeuGc. In support
      of this, bovine submaxillary mucin, which contains O-acetylated NeuGc inhibited
      the hemagglutination of the lectin better after removal of O-acetyl groups by
      base treatment. The unique specificity of Scylla lectin is of diagnostic
      potential for human cancer tissues expressing NeuGc, since NeuGc is not found in
      normal human tissues.

PMID- 8354276
TI  - Cholesterol 7 alpha-hydroxylase is up-regulated by the competitive inhibitor 7
      oxocholesterol in rat liver.
AB  - Rats of the Sprague-Dawley strain were infused intravenously with a fat emulsion
      (Intralipid, trademark of Kabi Pharmacia, Uppsala, Sweden) containing 7
      oxocholesterol. This resulted in an increased cholesterol 7 alpha-hydroxylase
      activity in liver microsomes as compared to controls and was accompanied by
      increased levels of cholesterol 7 alpha-hydroxylase mRNA and microsomal
      cholesterol 7 alpha-hydroxylase protein. Rats were also fed a cholestyramine
      supplemented diet and infused with 7-oxocholesterol. These animals excreted about
      half as much bile acids in faeces as cholestyramine-fed controls. Addition of 7
      oxocholesterol to liver microsomes from normal rats in amounts corresponding to
      those present in microsomes from 7-oxocholesterol-treated rats inhibited the
      cholesterol 7 alpha-hydroxylase activity by about 75%. Cholesterol induced a type
      I binding spectrum when added to a purified bacterial-expressed cholesterol 7
      alpha-hydroxylase (P-450c7 delta 2-24). 7-Oxocholesterol competitively inhibited
      the cholesterol binding spectrum, while 7 beta-hydroxycholesterol did not
      interfere with binding of cholesterol to the enzyme. It is concluded that
      treatment with the competitive inhibitor 7-oxocholesterol leads to a reduced bile
      acid biosynthesis and, as a consequence of reduced bile acid inhibition, a
      compensatory increase in cholesterol 7 alpha-hydroxylase synthesis. The high
      enzyme activity measured in microsomal preparations from 7-oxocholesterol-treated
      rats may be due to a continuous conversion of 7-oxocholesterol into less
      inhibitory metabolites, e.g. 7 beta-hydroxycholesterol. The latter compound was
      found in high concentrations in liver microsomes from rats treated with 7
      oxocholesterol. The physiological importance of these results is discussed in
      relation to the previous findings that 7-oxocholesterol is accumulated in liver
      after cholesterol feeding and that 7-oxocholesterol is formed from cholesterol
      during lipid peroxidation.

PMID- 8354277
TI  - Transduction of reducing power across the plasma membrane by reduced glutathione.
      A 1H-NMR spin-echo study of intact human erythrocytes.
AB  - The NMR signal of reduced glutathione (GSH) was monitored in intact human
      erythrocytes by the 1H spin-echo Carr-Purcell-Meiboom-Gill pulse sequence.
      Addition of GSH, which was unable to cross the erythrocyte membrane, produced an
      approximate twofold increase of the GSH signal in glucose-depleted cells.
      Addition of oxidised glutathione (GSSG), did not affect the signal, and addition
      of GSH to hemolysates gave a much smaller increase. Reduction of internal GSSG by
      NADPH-dependent enzymes was excluded by experiments with glucose-supplied or
      glucose-6-phosphate dehydrogenase deficient cells. Involvement of external thiol
      groups of the erythrocyte membrane was shown by the lack of effect in cells
      treated with an impermeable thiol-blocking compound. Involvement of spectrin was
      indicated by the proportional loss of the effect in erythrocytes with variable
      genetic deficiency of spectrin. Protein-glutathione mixed disulfides appeared to
      be the source of the NMR response since an increase of their content, by diamide
      treatment or aging procedures, produced a higher GSH signal, while their
      reduction by permeable reductants gave the opposite effect. It is concluded that
      GSH can transduce its reducing power by a thiol/disulfide exchange mechanism that
      sequentially involves sulfur-rich proteins spanning across the erythrocyte
      membrane.

PMID- 8354278
TI  - Human alpha and beta parvalbumins. Structure and tissue-specific expression.
AB  - alpha and beta parvalbumins are Ca(2+)-binding proteins of the EF-hand type. We
      determined the protein sequence of human brain alpha parvalbumin by mass
      spectrometry and cloned human beta parvalbumin (or oncomodulin) from genomic DNA
      and preterm placental cDNA. beta parvalbumin differs in 54 positions from alpha
      parvalbumin and lacks the C-terminal amino acid 109. From MS analyses of alpha
      and beta parvalbumins we conclude that parvalbumins generally lack
      posttranslational modifications. alpha and beta parvalbumins were differently
      expressed in human tissues when analyzed by immunoblotting and polymerase-chain
      reaction techniques. Whereas alpha parvalbumin was found in a number of adult
      human tissues, beta parvalbumin was restricted to preterm placenta. The pattern
      of alpha parvalbumin expression also differs in man compared to other
      vertebrates. For example, in rat, alpha parvalbumin was found in extrafusal and
      intrafusal skeletal-muscle fibres whereas, in man, alpha parvalbumin was
      restricted to the muscle spindles. Different functions for alpha and beta
      parvalbumins are discussed.

PMID- 8354279
TI  - Subunit composition, crystallization and preliminary crystallographic studies of
      the Desulfovibrio gigas aldehyde oxidoreductase containing molybdenum and [2Fe
      2S] centers.
AB  - The Desulfovibrio gigas aldehyde oxidoreductase contains molybdenum bound to a
      pterin cofactor and [2Fe-2S] centers. The enzyme was characterized by SDS/PAGE,
      gel-filtration and analytical ultracentrifugation experiments. It was
      crystallized at 4 degrees C, pH 7.2, using isopropanol and MgCl2 as precipitants.
      The crystals diffract beyond 0.3-nm (3.0-A) resolution and belong to space group
      P6(1)22 or its enantiomorph, with cell dimensions a = b = 14.45 nm and c = 16.32
      nm. There is one subunit/asymmetric unit which gives a packing density of 2.5 x
      10(-3) nm3/Da (2.5 A3/Da), consistent with the experimental crystal density, rho
      = 1.14 g/cm3. One dimer (approximately 2 x 100 kDa) is located on a
      crystallographic twofold axis.

PMID- 8354280
TI  - Sequence of extracellular mouse protein BM-90/fibulin and its calcium-dependent
      binding to other basement-membrane ligands.
AB  - Partial sequence comparisons have recently indicated that two extracellular
      components, fibulin from human placenta and BM-90 from a basement-membrane
      producing mouse tumor, are either identical or closely related proteins. In this
      study, a complete sequence analysis of mouse BM-90 cDNA showed a 539-residue N
      terminal core structure (domains I and II), which was 85% identical with the same
      core structure of human fibulin. A 137-residue C-terminal sequence (domain III)
      was unique for BM-90 and could also be identified by Edman degradation. This
      suggested a novel splice product, variant D, which is characteristic for the
      mouse tumor. A second 117-residue C-terminal sequence (domain III) was identified
      in additional mouse cDNA clones and showed 91% identity with the region specific
      for variant C of fibulin. Northern blots using mouse cells demonstrated two mRNA
      species, 2.7 kb and 2.3 kb, which encoded the variants D and C, respectively. The
      sequence of BM-90/fibulin indicates the presence of nine epidermal-growth-factor
      like repeats in the core domain-II structure, eight of which contain consensus
      motifs for calcium binding. This binding is apparently important for the
      interaction of BM-90 with laminin and nidogen and for some weaker interactions
      with collagen IV. Further binding of BM-90 was demonstrated to fibronectin and BM
      90 itself, but did not depend on calcium. Major binding sites for BM-90 were
      identified at a C-terminal segment of laminin A chain and at the N-terminus of
      nidogen. The broad interaction repertoire of BM-90 is comparable to that of
      nidogen and both proteins may have similar roles as connecting elements in the
      extracellular matrix.

PMID- 8354281
TI  - Multiphasic denaturation of glutathione transferase B1-1 by guanidinium chloride.
      Role of the dimeric structure on the flexibility of the active site.
AB  - The unfolding and refolding mechanisms of dimeric glutathione transferase GSTB1-1
      from Proteus mirabilis, using guanidinium chloride as a denaturant, have been
      investigated. The protein transitions were monitored by enzyme activity,
      intrinsic fluorescence, far ultraviolet circular dichroism and gel-filtration
      chromatography. The non coincidence of denaturation curves at equilibrium
      indicates that the unfolding of GSTB1-1 is a multistep process, i. e.
      inactivation of the structured dimer, dissociation into partially structured
      monomers followed by complete unfolding. In the 50% inactivated enzyme the Km for
      glutathione increases threefold, while the kcat appears almost the same,
      indicating that the initial phase of the denaturation involves the binding site
      of glutathione. The rapid recovery of the folded dimer precedes the complete
      enzyme reactivation. This indicates that the reconstitution of the native
      structure of GSTB1-1 is the result of folding and association of compact monomers
      followed by subtle rearrangements of assembled monomers that build up the active
      site.

PMID- 8354282
TI  - Purification and characterisation of D-glucose oxidase from white-rot fungus
      Pleurotus ostreatus.
AB  - D-Glucose oxidase was purified 27.5-fold to apparent homogeneity with an overall
      yield of 23.8%, from Pleurotus ostreatus, through a purification procedure of
      ammonium sulphate precipitation, gel-permeation, anion-exchange and hydrophobic
      interaction chromatography. The molecular mass determined by gel filtration was
      found to be 290 kDa. SDS/PAGE revealed that the enzyme consists of four subunits
      with a molecular mass of 70 kDa. The absorption spectra of the enzyme exhibit
      maxima at 280, 360 and 460 nm. The enzyme shows a fluorescence spectrum with an
      excitation maximum at 470 nm and an emission maximum at 530 nm. These results
      indicate that the prosthetic group of the enzyme is flavin and that the enzyme
      contains 4 mol flavin/mol enzyme. The enzyme is optimally active at 50 degrees C
      and at pH 5.5-6.0. It exhibits broad affinity for various sugars and specificity
      for D-glucose with Km value of 1.34 mM. 2,6-Dichloroindophenol, Wurster's blue,
      and 4-benzoquinone can function as electron acceptors but phenazine methosulphate
      cannot function as an electron acceptor. The enzyme is inhibited completely by
      mercuric chloride and partially by silver sulphate, sodium azide 8
      hydroxyquinoline.

PMID- 8354283
TI  - Feedback regulation of mammalian ornithine decarboxylase. Studies using a
      transient expression system.
AB  - Ornithine decarboxylase catalyzes the first step in the biosynthesis of
      polyamines in mammalian cells. The enzyme is subject to various control
      mechanisms to maintain adequate intracellular levels of polyamines. Polyamines
      exert a strong feedback control on ornithine decarboxylase. In a recent study
      [van Daalen Wetters, T., Macrae, M., Brabant, M., Sittler, A. & Coffino, P.
      (1989) Mol. Cell. Biol. 9, 5484-5490], it was concluded that feedback control of
      ornithine decarboxylase is mainly, if not exclusively, a posttranslational
      phenomenon. The existence of a fast-acting polyamine-stimulated component of
      ornithine decarboxylase degradation that acts on newly synthesized monomeric
      forms of the enzyme was postulated. In the present study we have used a transient
      expression system to test this hypothesis. The expression of ornithine
      decarboxylase in mock-transfected COS cells varied depending on the cellular
      supply of polyamines as has been found in other mammalian cells. Thus,
      supplementing the cells with exogenous spermidine resulted in a marked decrease
      in ornithine decarboxylase activity, whereas depletion of intracellular
      polyamines, using an ornithine decarboxylase inhibitor, gave a large increase in
      the cellular content of the enzyme. COS cells expressing an ornithine
      decarboxylase mRNA devoid of its 5' non-translated region did not exhibit any
      feedback control of the enzyme, neither in the presence of exogenous spermidine
      nor when the intracellular polyamine levels were depleted to the same extent as
      in the mock-transfected COS cells. The results strongly suggest that the feedback
      control of ornithine decarboxylase is not merely a posttranslational phenomenon.

PMID- 8354284
TI  - Reaction of imidazole-citrate-deformed glycogen phosphorylase with amino acids.
AB  - Incubation of phosphorylase with L-valine in the presence of 0.4 M imidazole
      citrate results in a time-dependent decrease in the absorption of the enzyme
      bound cofactor pyridoxal 5'-phosphate at 333 nm and the generation of a new
      absorption maximum at 415 nm which appears to be due to an enzyme-bound coenzyme
      amino-acid aldimine adduct. Consequently, the enzyme is inactivated to less than
      10% of its initial activity. The formation of the adduct of phosphorylase b with
      L-valine (0.1 M) proceeds with t1/2 approximately 8 min at pH 6.8 and 25 degrees
      C and is slightly inhibited by AMP. Phosphorylase a reacts five times more slowly
      than phosphorylase b. The decrease in enzymic activity is linked to the formation
      of the coenzyme-amino-acid adduct and is not due to resolution of the enzyme.
      Both the original absorption spectrum and phosphorylase activity are restored by
      gel filtration in the absence of L-valine and imidazole citrate. Similar
      reactions occur with other L-amino acids, an exception being L-cysteine which
      leads to resolution of the enzyme [Shaltiel, S., Hedrick, J. L. & Fischer, E. H.
      (1966) Biochemistry 5, 2108-2116]. No reaction is observed with D-amino acids or
      in the absence of imidazole citrate. Pyridoxal-reconstituted phosphorylase
      rapidly produces with amino acids not only the aldimine adduct but also a species
      absorbing at 318 nm. Enzyme-bound pyridoxal 5'-phosphate and pyridoxal exhibit a
      positive CD signal in the region of 333 nm; in contrast, the absorption bands of
      the coenzyme-amino-acid adducts at 415 nm and 318 nm are optically inactive.
      Neither pyridoxal-5'-phosphate-reconstituted nor pyridoxal-reconstituted
      phosphorylase in imidazole citrate catalyses any of the common pyridoxal-5'
      phosphate-mediated reactions of amino acids, e.g. transamination, decarboxylation
      or racemization, thus testifying to the high degree of reaction specificity of
      phosphorylase.

PMID- 8354285
TI  - Identification and analysis of a matrix-attachment region 5' of the rat glutamate
      dehydrogenase-encoding gene.
AB  - Eukaryotic chromatin is thought to be organized into independently regulated loop
      domains by interaction of matrix-attachment regions (MAR) of the DNA to the
      nuclear matrix. To define the borders of the chromatin loop containing the
      glutamate dehydrogenase (GDH) gene, we screened the GDH gene and flanking regions
      for the presence of MAR sequences. We here report identification, mapping and
      sequencing of an (A + T)-rich MAR located 2010-1397 bp upstream of the
      transcription initiation site of GDH, that mediates strong binding to the nuclear
      matrix. Smaller regions can also confer binding capacity, although at a lower
      affinity. This (A + T)-rich MAR contained 11 bp and 12 bp (A + T)-rich direct
      repeats, but not any of the sequences previously described to be associated with
      MAR activity. We here show that the presence of (A + T)-rich domains of DNA is
      not sufficient to confer binding capacity, since (A + T)-rich sequences located
      downstream of the identified MAR did not bind to the nuclear matrix. Moreover, a
      consensus topoisomerase-II-binding site located downstream of the MAR was found
      to be insufficient to mediate substantial binding. The number of binding sites in
      the nuclear matrix for MAR-containing fragments was shown to be approximately
      15,000/nucleus. Since organization of the entire rat genome in loops with an
      average loop size of 100 kbp would require 60,000 binding sites, this suggests
      that only part of the genome is organized in loops. Alternatively, we might have
      underestimated the number of binding sites. The GDH MAR, and MAR-containing
      fragments derived from other species, were found to bind to the same binding
      sites in the nuclear matrix, although the affinity varied.

PMID- 8354286
TI  - Structural similarity between lung surfactant protein D and conglutinin. Two
      distinct, C-type lectins containing collagen-like sequences.
AB  - Preparations of bovine lung surfactant D (SP-D) and conglutinin were examined by
      electron microscopy, gel-filtration and SDS/PAGE. SP-D is composed of non
      covalently linked subunits, of 160 kDa, which each contain three, disulphide
      linked, 44-kDa polypeptide chains. In the electron microscope a single 160-kDa
      subunit of SP-D appears as a 45.8 +/- 3-nm-long rod connected to a small globular
      'head'. Particles were also seen which correspond to non-covalently linked
      dimers, trimers and tetramers of the 160-kDa monomer subunit of SP-D. The
      tetramer structure contains 12 polypeptide chains and is very similar to the
      electron microscopy images and model reported by Strang et al. [Strang, C. J.,
      Slayter, US., Lachmann, P. J. and Davis, A. E. (1986) Biochem. J. 236, 3811-389]
      for bovine conglutinin in which four 160-kDa subunits are disulphide-linked to
      give a molecule of expected molecular mass of 528 kDa. This study confirmed the
      findings by Strang et al. in the above paper for intact conglutinin and also
      emphasised that the rod-like structures, of length 37.6 +/- 3.7 nm, seen in the
      conglutinin subunits were significantly shorter than those in SP-D despite the
      close similarity in amino acid sequence (79% identify) and chain length between
      the two proteins. In addition, a truncated form of conglutinin was found in the
      conglutinin preparations, due to limited proteolysis of the Arg-Ala bond at
      position 54 in the 44-kDa chains. These truncated conglutinin chains yield a
      subunit composed of three shortened, non-disulphide-linked, chains and this
      subunit appears as a monomer with a rod length of 34.2 +/- 2.8 nm in the electron
      microscope. On gel-filtration, a proportion of the SP-D preparation behaved, as
      expected, as a molecule with an apparent molecular mass of 600 kDa. The remainder
      of the SP-D preparation behaved as aggregated material with a molecular mass
      greater than 900 kDa which yielded no distinct structures in the electron
      microscope. Intact conglutinin was eluted at a position greater than 900 kDa but
      yet provided clear electron microscopy images of the tetramer structure described
      above.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8354287
TI  - Pigments induce folding of light-harvesting chlorophyll a/b-binding protein.
AB  - The conformational behaviour of the light-harvesting chlorophyll a/b-binding
      protein (LHCP), the apoprotein of the major light-harvesting complex (LHCII) of
      photosystem II in plants, has been studied. According to the circular dichroism
      in the ultraviolet range measured with isolated LHCII, the protein in the complex
      adopts a folded structure with a high content of alpha helix (about 60%), whereas
      the non-pigmented, solubilized protein has a less ordered structure (about 20%
      alpha helix). LHCP-pigment complexes that have been reconstituted from the
      overexpressed protein and isolated pigments in the presence of detergents display
      a protein CD signal similar to that of authentic LHCII, indicating that LHCP
      folds into the native structure during the reconstitution procedure. Renaturation
      of LHCP in these experiments is dependent on the presence of pigments and the
      formation of stable LHCP-pigment complexes. Pigment-induced engagement of LHCP in
      a compact structure has also been shown by two additional experimental
      approaches. (a) Upon complex formation, LHCP or its precursor (pLHCP) becomes
      resistant to trypsin digestion with the exception of an N-terminal segment of the
      protein; the same protection of LHCP is known to occur in intact thylakoids. (b)
      Pigment binding renders a cysteine residue within the N-proximal hydrophobic
      domain of the protein as well as a newly introduced cysteine four amino acid
      positions from the C terminus inaccessible to modification with a sulfhydryl
      specific label whereas the N terminus stays susceptible to specific labelling.
      These observations support the notion that only the N terminus protrudes from a
      compact protein-pigment structure in LHCII. The fact that the major part of LHCP
      is trypsin-resistant in pigmented complexes reconstituted in the absence of a
      membrane or even lipids justifies caution in using protection against trypsin as
      a criterion for the integration of LHCP into the thylakoid membrane.

PMID- 8354288
TI  - Inactivation of interleukin-6 in vitro by monoblastic U937 cell plasma membranes
      involves both protease and peptidyl-transferase activities.
AB  - Human promonocytic U937 cells have previously been shown to possess at their cell
      surface specific transmembrane serine proteases and N-terminal amino acid
      proteases as well as associated enzymes including elastase and cathepsin G. In
      this study, purified plasma membranes from U937 cells are reported to degrade the
      recombinant 21-kDa 125I-interleukin-6 (125I-IL-6) into 8-kDa products with loss
      of biological activity, as monitored by polyacrylamide gel electrophoresis and a
      cell-proliferation bioassay. Degradation of 125I-IL-6 by plasma membranes was
      completely prevented by the serine-protease inhibitor diisopropyl
      fluorophosphate, but was only partially impaired by alpha 1-protease inhibitor
      and antibody against cathepsin G. A similar incubation of 125I-IL-6 with
      cathepsin G purified from U937 cells caused hydrolysis of the cytokine into
      similar inactive 8-kDa fragments, whereas incubation with purified U937 cell
      elastase failed to degrade the peptide. These findings indicate that U937 cells
      hydrolyze IL-6 using cell-associated serine-protease activity and that cathepsin
      G partially participates in this degradation. Prolonged incubation of 8-kDa 125I
      IL-6 fragments with purified U937 plasma membranes, led to a complete loss of IL
      6 activity related to the transformation of the 8-kDa forms into a higher
      molecular-mass complex (16 kDa). This complex was stable in SDS and 2
      mercaptoethanol at 100 degrees C and was not dissociated by hydroxylamine
      treatment, indicating the formation of a covalent non-ester bond between the 8
      kDa 125I-IL-6-derived peptide and an undetermined acceptor. An initial oxidative
      treatment of 125I-IL-6 partially prevented complex formation, suggesting the
      presence of one or more oxidizable methionine residues at the binding site of 8
      kDa 125I-IL-6 peptide. The kinetics of complex formation (time dependence and
      plasma-membrane-concentration dependence), as well as its inhibition by a
      specific inhibitor of N-amino-peptidase activity, bestatin, suggest the
      participation of peptidyl-transferase activity in complex formation. Finally, a
      plasma-membrane fraction, corresponding to a molecular mass > or = 30 kDa, was
      able to convert the 8-kDa 125I-IL-6 forms into the 125I-labeled 16-kDa complex,
      suggesting that a > or = 30-kDa peptidyl-transferase enzyme catalyzes the
      reaction and provides the 125I-labeled 16-kDa peptide by dimerization of 8-kDa
      125I-IL-6-derived intermediates. Further identification of the plasma-membrane
      associated peptidyl transferase as a regulator of IL-6 proteolysis may be of
      physiological relevance for the control of IL-6 biological activity.

PMID- 8354289
TI  - Protein O-mannosylation in Candida albicans. Determination of the amino acid
      sequences of peptide acceptors for protein O-mannosyltransferase.
AB  - A protein-O-D-mannosyltransferase (PMT) assay was optimised using a microsomal
      membrane preparation from Candida albicans and a peptide acceptor, YNPTSV.
      [14C]Mannose was transferred from dolichyl phosphate [14C]mannose to the
      threonine or serine residues of the peptide. During the assay, the peptide was
      highly susceptible to proteolysis. A blocked peptide Ac-YNPTSV-NH2 was resistant
      to proteolysis and was apparently a better acceptor for O-mannosylation. This
      peptide had a Km value of 4.3 mM in the assay. A number of other peptides were
      tested with altered sequences. Maximum incorporation of [14C]mannose was obtained
      with a pentapeptide YATAV (Km 2.2 mM) which was further improved by blocking both
      ends: Ac-YATAV-NH2 (Km 0.25 mM). Finally, and unexpectedly, an improvement was
      noted if the acetyl group on the N terminus was replaced by a biotin residue.
      Biotin-YATAV-NH2 had a Km of 0.075 mM. The biotin residue may be important in
      increasing the lipophilicity of the peptide and thus aid its adhesion to the
      Candida membranes. The simplest peptide that could act as an efficient mannose
      acceptor was Ac-ATA-NH2, whilst no incorporation was observed with Ac-GTG-NH2.

PMID- 8354290
TI  - Teichoic acid and lipoteichoic acid of Streptococcus pneumoniae possess identical
      chain structures. A reinvestigation of teichoid acid (C polysaccharide).
AB  - Teichoic acid (C polysaccharide) was extracted and purified from Streptococcus
      pneumoniae R6 with standard procedures except that lipoteichoic acid was
      extracted first. The dephosphorylated repeating unit was isolated after
      hydrolysis with 48% (by mass) HF, the bis(phosphocholine)-containing repeating
      unit was isolated by alkali hydrolysis, anion-exchange chromatography and
      phosphomonoester cleavage. On the basis of compositional analysis, fast-atom
      bombardment mass spectrometry and NMR spectroscopy the following structure is
      proposed: [formula: see text] where AATGal is 2-acetamido-4-amino-2,4,6-trideoxy
      D-galactose. The repeating units are linked to each other by phosphodiester bonds
      between O5 of the ribitol and O6 of the glucopyranosyl residue of adjacent units.
      This chain structure is identical with that previously established for
      pneumococcal lipoteichoic acid [Behr, T., Fischer, W., Peter-Katalinic, J. &
      Egge, H. (1992) Eur. J. Biochem. 207, 1063-1075]. This represents a unique
      situation because in other Gram-positive bacteria teichoic and lipoteichoic acids
      are structurally unrelated.

PMID- 8354291
TI  - Structures of the glycopeptidolipid antigens of two animal pathogens:
      Mycobacterium senegalense and Mycobacterium porcinum.
AB  - The structures of the major glycolipid antigens of two animal pathogens
      Mycobacterium senegalense and Mycobacterium porcinum were elucidated by a
      combination of fast-atom bombardment mass spectrometry, nuclear magnetic
      resonance spectroscopy, chemical analyses and radiolabeling experiments. Five
      glycoconjugates belonging to the class of C-mycoside glycopeptidolipids were
      characterized in each species. They shared with those recently described in M.
      peregrinum the same unusual distribution of the disaccharides on the alaninol end
      of the molecules. Both species showed the presence of the novel sulfated
      glycopeptidolipid. In addition, some acetylated forms of the glycolipids were
      also present in the species examined. Identical seroreactivities were observed
      between the glycolipid antigens extracted from M. senegalense, M. porcinum and M.
      peregrinum and an antiserum raised against the whole lipid antigens of M.
      peregrinum. These data reinforce the close taxonomic relationships between the
      three mycobacterial species and demonstrate the antigenicity of the new variants
      of mycobacterial glycopeptidolipids.

PMID- 8354292
TI  - Effect of cell attachment and growth on the synthesis and fate of dolichol-linked
      oligosaccharides in Chinese hamster ovary cells.
AB  - The inhibition of cellular processes in suspended anchorage-dependent Chinese
      hamster ovary (CHO) cell lines and their restoration upon attachment to a solid
      substrate has been used as a model to study the relationship between
      oligosaccharide-diphospho-dolichols and their metabolic products (glycoprotein
      and soluble oligosaccharide material, i.e. oligosaccharide phosphates and neutral
      oligosaccharides). Using metabolic labelling we demonstrated that suspended cells
      have a low incorporation rate into lipid intermediates and into glycoproteins.
      The oligosaccharide-lipid populations are mainly glucosylated and the neutral
      oligosaccharides have exclusively a chitobiosyl residue at their reducing end. In
      contrast, monolayer cells exhibit a high incorporation rate into lipid
      intermediates with a pattern dominated by two species containing either two or
      five mannose residues, and into glycoproteins with a pattern similar to the one
      observed for suspended cells (i.e. glucosylated species). In monolayer cells the
      neutral oligosaccharides possess either one or two GlcNAc residues at their
      reducing end. The variations in the nature and in the quantity of soluble
      oligosaccharide material as a function of the cell density reflects regulatory
      points in the synthesis of N-glycosyl proteins. The first regulatory point could
      be the control of the quantity of non-glucosylated oligosaccharide-lipids to be
      channelled toward the glucosylated lipid-donor pool. The level of this donor pool
      being constant, the oligosaccharide-transferase could utilize oligosaccharide
      lipid donors at a constant rate by two different reactions: either transfer onto
      protein when acceptors are available, or transfer onto water generating neutral
      oligosaccharides possessing two GlcNAc residues at the reducing end. Another
      regulatory point would be the degradation of a part of neoglycoproteins leading
      to the release of neutral oligosaccharides possessing one GlcNAc residue at the
      reducing end.

PMID- 8354293
TI  - Glucose administration induces the premature expression of liver glucokinase gene
      in newborn rats. Relation with DNase-I-hypersensitive sites.
AB  - Glucokinase first appears in the liver of the rat 2 weeks after birth and its
      activity rapidly increases after weaning on to a high-carbohydrate diet. The
      appearance of glucokinase is principally due to the increase of plasma insulin
      and to the decrease of plasma glucagon concentrations. Oral glucose
      administration to 1- or 10-day-old suckling rats induced an increase in plasma
      insulin and a fall in plasma glucagon and allowed a rapid accumulation of liver
      glucokinase mRNA, secondarily to a stimulation of gene transcription. When
      unrestrained late pregnant rats were infused with glucose during 36 h to induce
      an increase in fetal plasma insulin and a decrease in fetal plasma glucagon
      concentrations, glucokinase mRNA was detectable in fetal liver but the level was
      100-fold lower than that observed in 1- or 10-day-old suckling rats. It is
      suggested that the hormonal environment did not allow glucokinase gene expression
      to be induced in fetal liver and that the absence of expression of glucokinase in
      suckling rat liver is due to the presence of low plasma insulin and high plasma
      glucagon levels. The chromatin structure of the glucokinase gene was examined
      during development by identification of DNase-I-hypersensitive sites from the
      region comprised between -8 kb upstream and +4 kb downstream of the cap site.
      Five hypersensitive sites were found: four liver-specific sites upstream of the
      cap site and one non-specific site in the first intron. These sites are already
      present in term fetus but the intensity of the two proximal sites located
      upstream of the cap site increase markedly after birth. This suggests that these
      sites could be implicated in the regulation of glucokinase gene expression by
      insulin and glucagon. Full DNase-I-hypersensitivity of these two proximal sites
      seems necessary for the mature response of glucokinase gene in response to
      changes in pancreatic hormones concentrations.

PMID- 8354294
TI  - Properties of some nuclear nucleases of rat thymocytes and their changes in
      radiation-induced apoptosis.
AB  - Three nuclease activities have been found and characterized in rat thymocyte
      nuclear extracts. A Mn(2+)-dependent nuclease is loosely bound to nuclear
      components and can be extracted with 0.35 M NaCl. The enzyme is activated by Mn2+
      but not by Mg2+, Ca2+, or both. Its molecular mass is 36-40 kDa when measured by
      gel filtration and 37 kDa by SDS/PAGE. An acidic nuclease is independent of
      divalent ions, produces DNA strand breaks with 5'-OH ends, its molecular mass is
      about 37 kDa. Two fractions of Ca2+/Mn(2+)-dependent nuclease, differing in
      binding to CM-Sepharose but identical in other respects, are active in the
      presence of Mn2+ but can be additionally activated by Ca2+. They are inactive in
      the presence of Mg2+ or Ca2+ but cleave DNA in Ca2+/Mg(2+)-containing medium. The
      molecular mass of the enzyme is 22 kDa as determined by both gel filtration and
      electrophoresis. The dependence of nuclease activities on pH, ions, and
      sulfhydryl reagents is described. Cycloheximide injection to both control and
      irradiated animals strongly inhibits the activities of Ca2+/Mn(2+)-dependent
      nuclease from thymocyte nuclei separated by chromatography on CM-Sepharose and
      does not change the activities of Mn(2+)-dependent and acidic nucleases. Nuclease
      activity in thymocyte nuclei from irradiated rats is increased in Ca2+/Mg(2+)
      containing and Ca2+/Mn(2+)-containing media whereas there is no change in the
      activity of acidic nuclease. Ca2+/Mn(2+)-dependent nuclease is extracted from
      thymocyte nuclei of irradiated rats with 0.35 M NaCl but from control nuclei only
      with 0.5 M NaCl. Possible reasons of labilization of Ca2+/Mn(2+)-dependent
      nuclease binding to the nuclear structures in dying thymocytes are discussed.

PMID- 8354295
TI  - Ciprofibrate, a carcinogenic peroxisome proliferator, increases the
      phosphorylation of epidermal-growth-factor receptor in isolated rat hepatocytes.
AB  - Ciprofibrate, a hypolipidaemic drug with carcinogenic and peroxisome
      proliferation effects in rat liver, was found to increase the phosphorylation of
      epidermal-growth-factor receptor in 32P-labeled isolated rat hepatocytes. This
      effect was suppressed by protein-kinase-C inhibitors, and was accompanied by an
      almost complete inhibition of the receptor autophosphorylation normally induced
      by its ligand. However, in vitro experiments showed that protein-kinase-C
      phosphorylation of purified epidermal-growth-factor receptor was activated by
      ciprofibroyl-CoA, the acyl-CoA derivative of the drug, but not by the unmodified
      drug. Neither compound affected the ligand induction of epidermal-growth-factor
      receptor autophosphorylation in isolated liver membranes. These results suggest
      that metabolically produced ciprofibroyl-CoA in liver cells would activate
      protein-kinase-C and produce changes in epidermal-growth-factor-receptor
      function.

PMID- 8354296
TI  - Evaluation of amoxicillin clavulanate twice daily versus thrice daily in the
      treatment of otitis media in children. Danish-Swedish Study Group.
AB  - A total of 311 children who had recurrent otitis media or who had experienced
      failure of initial treatment of acute otitis media with phenoxymethylpenicillin,
      amoxicillin, ampicillin esters or cefaclor were entered into a single-blind study
      in two parallel groups in order to compare the clinical efficacy and safety of
      amoxicillin/clavulanate suspension given b.i.d. or t.i.d. for seven days. The
      patients were examined prior to the start of treatment, at an early follow-up
      visit 9 to 12 days after the start of treatment and at a late follow-up visit
      about three weeks later. Specimens for bacteriological culture were taken from
      the nasopharynx at entry, at the early follow-up visit, and at the late follow-up
      visit if there were symptoms of otitis. Both treatment groups showed a similar
      response, 90% or more of the patients being cured or showing improvement at the
      time of the early follow-up visit. The initial nasopharyngeal cultures showed
      growth of Haemophilus influenzae in 53% of the patients, Moraxella catarrhalis in
      43% and Streptococcus pneumoniae in 39%. After treatment, cultures showed
      elimination of the initial pathogens in 30% of patients in both groups and
      recolonization in 23% in both groups. Haemophilus influenzae was the bacteria
      most frequently found in the nasopharynx at the first follow-up visit. Adverse
      effects, which consisted mostly of gastrointestinal and dermatological reactions,
      tended to be more common in the b.i.d. group but the difference was not
      statistically significant.

PMID- 8354297
TI  - Efficacy of pyrimethamine/sulfadoxine in the prevention of toxoplasmic
      encephalitis relapses and Pneumocystis carinii pneumonia in HIV-infected
      patients.
AB  - The efficacy and safety of 25 mg pyrimethamine plus 500 mg sulfadoxine given
      twice a week in preventing relapses of AIDS-related toxoplasmic encephalitis was
      evaluated in an open study. The 56 HIV-infected patients evaluated had responded
      to intensive treatment with pyrimethamine/clindamycin prior to starting the
      present prophylactic regimen. Four patients (7 %) experienced relapse while on
      pyrimethamine/sulfadoxine. The probability of freedom from relapse was > 90% for
      12 months and > 80% for 24 months. Side effects comprised mild or moderate
      allergic reactions which occurred in 23 patients (41 %), leading to
      discontinuation in four patients (7%). Forty-nine of the 56 patients did not have
      a history of Pneumocystis carinii pneumonia and did not receive antiparasitic
      prophylaxis other than pyrimethamine/sulfadoxine; two of them (4 %) developed
      pneumocystosis. The probability of freedom from pneumocystosis was about 90 % for
      24 months. Pyrimethamine/sulfadoxine twice a week appears to be a promising
      regimen for prevention of toxoplasmic encephalitis, and also appears to provide
      protection against Pneumocystis carinii pneumonia. Although allergic reactions
      are usually mild and disappear on continuation, they may limit the value of this
      regimen.

PMID- 8354298
TI  - Determination of serum arabinitol levels by mass spectrometry in patients with
      postoperative candidiasis.
AB  - A combined gas chromatography-mass spectrometry (GC-MS) technique was used for
      serial determination of serum arabinitol levels in patients with postoperative
      candidiasis. Forty subjects were investigated, 18 patients with candidiasis, 7
      patients with superficial Candida colonization and 15 postoperative control
      patients. The arabinitol levels were highly elevated, slightly elevated and
      normal in 13, 1 and 4 patients respectively with candidiasis; in 2, 2 and 3
      colonized patients and in 1, 1 and 13 control patients (p < 0.001, chi 2, between
      all the groups). The sensitivity of a single arabinitol determination for
      detection of postoperative candidiasis was 27.6 % and the specificity 89.2 %. Use
      of multiple samples improved sensitivity up to 72.2% per patient (123 samples)
      with a specificity of 86.4 %. Highly elevated arabinitol concentrations were
      detected in only one patient before the onset of therapy. Determination of
      arabinitol levels by GC-MS is a specific test for diagnosing candidiasis, but
      multiple samples are required for adequate sensitivity, and the initiation of
      therapy must still be on an empirical basis.

PMID- 8354299
TI  - Evaluation of five commercial antifungal susceptibility testing systems.
AB  - Five commercial antifungal susceptibility testing systems were studied for
      repeatability and reproducibility as well as concordance of results with the MICs
      for ten reference strains belonging to six different species. Repeatability was
      determined by testing each strain in triplicate on the same day, and
      reproducibility by repeating this triple determination on three different days.
      On the basis of 630 yeast-antifungal agent results for Mycototal and
      Mycostandard, 540 for Candifast, and 450 for ATB Fungus and Diff Test,
      repeatability was consistently equal to or greater than 95%. Reproducibility was
      80.07% for Candifast and greater than 95% for the other systems. The concordance
      with the reference MICs was 51.65% for Candifast, 75.33% for ATB Fungus, 80.89%
      for Diff Test, 90.16% for Mycostandard and 90.32% for Mycototal. Although the
      performance of Diff Test and ATB Fungus was satisfactory, Mycototal and
      Mycostandard gave notably better results with imidazoles. Mycostandard, which is
      easier to use and includes tests for fluconazole and itraconazole, would seem to
      be potentially the most useful antifungal susceptibility test available at
      present.

PMID- 8354300
TI  - Detection of antibodies to Candida albicans germ tube as a possible aid in
      diagnosing systemic candidiasis in bone marrow transplant patients.
AB  - Indirect immunofluorescence assays to detect antibodies to Candida albicans
      blastospore and germ tube were performed in sera of 29 bone marrow transplant
      patients. Antibodies to germ tube were present in the sera of six patients, in
      four of whom a Candida albicans infection was highly probable, while in the other
      two patients it was not possible to determine the previous course. No healthy
      blood donors had these antibodies. On the other hand, detection of antibodies to
      Candida albicans blastospore showed low specificity in the diagnosis of systemic
      candidiasis. These preliminary findings suggest that the detection of antibodies
      to Candida albicans germ tube may be an important aid in the diagnosis of
      systemic candidiasis in bone marrow transplant patients.

PMID- 8354301
TI  - Ten-year survey of quinolone resistance in Escherichia coli causing urinary tract
      infections.
AB  - In a ten-year survey (1983-1992) of quinolone resistance in Escherichia coli
      causing urinary tract infections in a general practice patient population, 9,934
      strains were tested. Resistance increased remarkably from 1989 onwards. The rate
      of resistance to pipemidic acid was < or = 6% before 1989 and 18% in 1992; the
      rate of resistance to ciprofloxacin (MIC > or = 4 mg/l) was 0.8% in 1989 and 7.1%
      in 1992. Although the consumption of older quinolones decreased the total
      consumption of quinolones increased yearly.

PMID- 8354302
TI  - Interpretive criteria and quality control parameters for determining bacterial
      susceptibility to fosfomycin tromethamine.
AB  - Studies with fosfomycin tromethamine disks containing 200 micrograms of
      fosfomycin and 50 micrograms of glucose-6-phosphate confirmed the following zone
      diameter criteria for the NCCLS method: < or = 12 mm for resistant (MIC > or =
      256 micrograms/ml), 13-15 mm for intermediate (MIC 128 micrograms/ml) and > or =
      16 mm for susceptible (MIC < or = 64 micrograms/ml). Additional studies defined
      acceptable MIC and zone diameter ranges for the following quality control
      strains: Escherichia coli ATCC 25922, MIC 0.5 to 4.0 micrograms/ml, zone diameter
      23 to 29 mm; Staphylococcus aureus ATCC 25923, zone diameter 26 to 32 mm;
      Pseudomonas aeruginosa ATCC 27813, MIC 2.0 to 8.0 micrograms/ml; and Enterococcus
      faecalis, ATCC 29212, MIC 16 to 64 micrograms/ml.

PMID- 8354303
TI  - Comparison of fixed concentration and fixed ratio options for dilution
      susceptibility testing of gram-negative bacilli to ampicillin and
      ampicillin/sulbactam.
AB  - Ampicillin combined with sulbactam was tested at both fixed ratio (2:1 and 1:1)
      and fixed sulbactam concentrations (4 micrograms/ml, 8 micrograms/ml and 16
      micrograms/ml) against 2440 consecutively isolated gram-negative bacilli.
      Sulbactam significantly enhanced the spectrum of ampicillin activity. Overall, at
      8 micrograms/ml ampicillin inhibited 50% of the Enterobacteriaceae isolates,
      whereas 69% to 84% of the isolates were inhibited by the various sulbactam
      combinations. The widest spectrum of activity for ampicillin/sulbactam was
      achieved by testing at a fixed sulbactam concentration of 16 micrograms/ml,
      followed by the 1:1 ratio and the fixed 8 micrograms/ml (84%, 76% and 74%
      inhibited, respectively). The amount of sulbactam at the susceptible breakpoint
      concentrations of ampicillin markedly affected the percentage of susceptible
      strains. Combinations that include 8 micrograms/ml of sulbactam are suggested for
      consideration.

PMID- 8354304
TI  - Frequency and antimicrobial susceptibility of clinical isolates of enterococci.
AB  - A study was performed to determine the frequency and antimicrobial susceptibility
      of Enterococcus species in clinical specimens. Of 943 aesculin-positive isolates,
      873 (92%) were identified as enterococci (737 Enterococcus faecalis, 129
      Enterococcus faecium and 7 other Enterococcus species). High-level resistance to
      gentamicin was found in 15.2% of Enterococcus faecalis, but not in Enterococcus
      faecium; 58% of Enterococcus faecium were resistant to gentamicin at a
      concentration of 64 mg/l. None of the isolates were shown to possess vancomycin
      resistance.

PMID- 8354305
TI  - Detection of Helicobacter pylori in gastric biopsy tissue by polymerase chain
      reaction.
AB  - To evaluate the sensitivity of a polymerase chain reaction (PCR) assay using
      nested primers in detecting Helicobacter pylori, gastric tissue biopsy specimens
      were collected on endoscopy from 17 patients with a duodenal ulcer. DNA was
      extracted by phenol/chloroform treatment or boiling in water, and then subjected
      to a nested PCR using two primer pairs from the urease gene of Helicobacter
      pylori. Fourteen of the 17 patients were positive for Helicobacter pylori using
      DNA samples extracted by either method. The PCR results correlated well with the
      results of an enzyme immunoassay to detect IgG antibody. However, there were two
      culture negative patients. The three PCR negative patients were both culture
      negative and serologically negative. DNA from 9 of the 14 patients was randomly
      selected and subjected to semiquantification by serial dilutions, and then PCR.
      The results showed that phenol/chloroform extraction yielded 10-1000 times more
      DNA than the boiling method. It is concluded that the PCR assay is a rapid and
      sensitive method for detecting Helicobacter pylori, and that phenol/chloroform
      extraction is superior to simple boiling in obtaining DNA samples for PCR.

PMID- 8354306
TI  - Comparative in vitro activity of biapenem, a new carbapenem antibiotic.
AB  - Biapenem is a new carbapenem antibiotic with high stability to human renal
      dehydropeptidase I. Its in vitro activity was compared with that of imipenem,
      meropenem, ceftazidime, ceftriaxone, piperacillin and gentamicin against a total
      of 650 recent clinical isolates. MICs were determined by a standard agar dilution
      procedure and all isolates were tested at two inocula (10(4) and 10(6) cfu).
      Biapenem inhibited 90% of isolates of Escherichia coli, Klebsiella spp., Proteus
      mirabilis, Proteus vulgaris, Morganella morganii, Providencia stuartii,
      Enterobacter spp., Citrobacter freundii, Serratia marcescens, Salmonella typhi,
      Shigella sonnei and Yersinia enterocolitica at < or = 2 mg/l and was as active as
      or two- to four-fold more active than imipenem against all these species, with
      the exception of Serratia marcescens, against which imipenem was two-fold more
      active. Biapenem was two-fold more active than imipenem against Pseudomonas
      aeruginosa (MIC90 4 mg/l) and had activity similar to that of imipenem against
      the Bacteroides fragilis group (MIC90 0.5 mg/l) but was two-fold less active than
      imipenem against methicillin-susceptible Staphylococcus aureus (MIC90 0.06 mg/l)
      and was, like imipenem, inactive against methicillin-resistant Staphylococcus
      aureus.

PMID- 8354308
TI  - Epidemiology of invasive aspergillosis in European cancer centres. EORTC Invasive
      Fungal Infections Cooperative Group.

PMID- 8354307
TI  - Antimicrobial activity of the new carbapenem biapenem compared to imipenem,
      meropenem and other broad-spectrum beta-lactam drugs.
AB  - The in vitro activity of biapenem was compared to that of imipenem, meropenem and
      other broad-spectrum beta-lactams. A total of 716 isolates from recent cases of
      clinical septicemia and an additional 137 stock strains possessing known beta
      lactamases or other well-characterized resistance mechanisms were tested. The
      minimal concentrations inhibiting 90% of strains (MIC90) of Enterobacteriaceae
      species were for biapenem 0.03 to 1 mg/l and for imipenem 0.25 to 2 mg/l. No
      member of the Enterobacteriaceae was found to be resistant to biapenem. Biapenem
      and meropenem were the most active drugs against Pseudomonas aeruginosa, with an
      MIC90 of 1 mg/l. Biapenem was more active than ceftazidime against most gram
      negative and gram-positive bacteria tested. Biapenem was as potent as imipenem
      against anaerobic bacteria (including Bacteroides fragilis), with an MIC90 of
      0.25 mg/l. High MICs of biapenem were demonstrated for Xanthomonas maltophilia,
      oxacillin-resistant Staphylococcus spp. and Enterococcus spp. These species have
      demonstrated resistance to other carbapenems and to most of the newer
      cephalosporins. The results of this study, coupled with previously documented
      favorable qualities of biapenem, endorse further investigation of this broad
      spectrum antibacterial agent for clinical use.

PMID- 8354309
TI  - Testing susceptibility of fungi to fluconazole.

PMID- 8354310
TI  - Screening for Chlamydia trachomatis and Neisseria gonorrhoeae in pregnant Turkish
      women.

PMID- 8354311
TI  - Determination of a new cut-off value for the diagnosis of congenital
      toxoplasmosis by detection of specific IgM in an enzyme immunoassay.

PMID- 8354312
TI  - Twenty-four hour blood pressure monitoring in healthy children.
AB  - Blood pressure and heart rate were measured every 20 min during the day and every
      30 min during the night in 105 children (51 girls and 54 boys, aged 6-10 years)
      with a portable automated blood pressure monitor using an oscillometric principle
      of measurement. The monitor was well accepted by most of the children and the
      rate of invalid measurements was only 13%. Mean systolic and diastolic blood
      pressure was 114 +/- 7/72 +/- 5 by day and 99 +/- 7/56 +/- 6 by night. The
      corresponding heart rates were 93 +/- 8 and 72 +/- 9 beats/min. No significant
      differences were found between boys and girls. At night, systolic blood pressure
      dropped by 13% +/- 4%, the diastolic value by 22% +/- 7% and heart rate fell by
      22% +/- 6%. Mean systolic and diastolic blood pressure measurements correlated
      positively with the subject's height, whereas no correlation was found with age.

PMID- 8354313
TI  - Physiological pulmonary branch stenosis in newborns: 2D-echocardiographic and
      Doppler characteristics and follow up.
AB  - Transient systolic murmurs in neonates and premature infants due to mild left
      (LPA) and right (RPA) pulmonary branch stenosis is recognized but follow up
      studies are lacking. We studied echocardiographically 21 neonates with murmur and
      10 controls. Diameters of the main pulmonary artery (MPA), LPA and RPA were
      smaller in patients with murmur. Colour-coded Doppler showed turbulent flow in
      LPA and RPA in 20/21 (95%) patients and flow velocities of both pulmonary
      branches were significantly higher than in controls. The follow up study at 3
      months in 14/21 (67%) patients showed absent or decreased murmur in 9 (64%).
      Echographically, absolute and relative diameters of LPA and RPA increased whereas
      the ratio of MPA/aorta did not change suggesting accelerated growth or dilatation
      of the pulmonary branches. Flow velocities decreased significantly in the
      branches. Thus, transient systolic murmurs in neonates are associated with
      temporary relative hypoplasia of the pulmonary branches which showed increased
      growth leading to disappearance of the murmur in most cases within 3 months of
      life.

PMID- 8354314
TI  - Apolipoprotein E phenotypes and plasma lipids in diabetic children and
      adolescents.
AB  - Apolipoprotein E (apoE) polymorphism is a genetic determinant of serum
      lipoprotein levels and coronary heart disease risk. ApoE appears in three major
      isoforms E2, E3 and E4, coded by corresponding alleles epsilon 2, epsilon 3 and
      epsilon 4. These give six different phenotypes. Patients with insulin dependent
      diabetes (IDDM) have been reported to have increased incidence of E2/2
      homozygosity. We studied the frequencies of apoE phenotypes and their association
      with plasma lipids in 201 diabetic children, aged 2-17 years, and in 216 healthy
      controls with the same age range. Phenotyping was performed directly from plasma
      by iso-electric focusing and immunoblotting. Plasma total and high density
      lipoprotein (HDL) cholesterol (C) and triglycerides were determined by routine
      laboratory methods. Apolipoprotein A1 (apoA1) and B (apoB) were measured by
      turbidometry. There were no differences in apoE phenotype or allele distributions
      between the diabetic and control subjects. The frequencies of epsilon 2, epsilon
      3, and epsilon 4 in the diabetic and control children were 0.08 versus 0.07, 0.73
      versus 0.72 and 0.19 versus 0.21. The difference in apoE2/2 frequencies (2.0 in
      diabetic and 0.5% in normal children) was not statistically significant. In the
      diabetic children, there was a distinct relation between apoE phenotype and
      plasma lipids; presence of apoE2 was associated with the lowest and that of apoE4
      with the highest concentrations of total and low density lipoprotein (LDL) C, and
      apoB. Ratios of HDL-C/LDL-C and apoA1/apoB showed on opposite trend. The
      influence of apoE polymorphism on plasma lipids was less clear in the
      controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354316
TI  - Silent carrier beta-thalassaemia due to a severe beta-globin mutation interacting
      with other genetic elements.
AB  - Beta-thalassaemia is caused by the presence of two mutated beta-globin genes, one
      inherited from each parent. We describe two families in which the diagnosis of
      beta-thalassaemia intermedia was delayed because one of the parents, an
      obligatory heterozygote, had normal haematological parameters (silent carrier
      beta-thalassaemia). DNA analysis revealed that these silent carriers were
      heterozygous for a point mutation in the polyadenylation signal (AATAAA-AATAAG).
      This defect is known to cause a moderately severe beta-thalassaemia phenotype. In
      one case, concurrent deletional alpha-thalassaemia was found in the silent
      carrier, which may have contributed to the mild phenotype. The increasing
      availability of DNA analysis should allow prompt diagnosis of such cases. Silent
      carrier beta-thalassaemia presents a diagnostic challenge to the clinician who
      evaluates children with anaemia.

PMID- 8354315
TI  - Interleukin-3, interleukin-6, granulocyte-macrophage colony-stimulating factor
      and erythropoietin cord blood levels of preterm and term neonates.
AB  - The cascade of known haematopoietic growth factors controlling granulomonopoiesis
      and erythropoiesis includes interleukin-3 (IL-3), interleukin-6 (IL-6),
      granulocyte-macrophage colony-stimulating factor (GM-CSF), and erythropoietin
      (EPO). Elevated endogenous IL-3 and IL-6 cord blood levels in infection-free
      premature and mature neonates may reflect their possible role for expansion of
      haematopoietic progenitor cells, granulocytes and monocytes. Within the erythroid
      lineage a synergistic action of IL-3, IL-6 and EPO can be assumed. To identify
      the regulatory role in fetal haematopoietic expansion cord blood plasma levels of
      these haematopoietic growth factors were assessed in 19 premature and 20 mature
      infants using commercial enzyme-linked immunosorbent assay and enzyme-amplified
      sensitivity immuno assay test kits. Peripheral blood IL-3, GM-CSF and EPO were
      studied in 5 and 10 premature infants respectively. Compared with cord blood
      levels we found a decline in EPO levels but no decrease of IL-3 and GM-CSF during
      the 1st month of life. We conclude that postnatal decrease in plasma burst
      promoting activity levels in preterm infants is mainly explained by low postnatal
      EPO levels.

PMID- 8354317
TI  - Acute osteomyelitis and septic arthritis in the neonate, risk factors and
      outcome.
AB  - Twenty-two neonates with acute osteomyelitis (AO) or septic arthritis (SA) were
      included in a study based on a review of medical reports and a long-term clinical
      and radiological follow up. Clinical symptoms, bacteriology, risk factors, and
      outcome are discussed. The diagnoses were difficult, the clinical symptoms vague,
      fever rare and white cell count normal. Detection by plain radiological films was
      more efficient than by radionuclide bone scan. Staphylococcus aureus was the
      predominant causative organism and a shift towards group B Streptococcus in
      recent years was not identified. Risk factors for AO and SA were prematurity
      (13/22), respiratory distress syndrome (15/22) and perhaps most important:
      umbilical artery catheterisation (15/22). Severe sequelae were found in only 1
      patient, while 3 patients had slight asymptomatic changes. The relatively
      favourable long-term outcome is unexplained, but may be related to early and
      appropriate, long lasting antibiotic treatment.

PMID- 8354318
TI  - Low level virus replication in infants with vertically transmitted fulminant
      hepatitis and their anti-HBe positive mothers.
AB  - Perinatal transmission of hepatitis B virus (HBV) occurs in about 10%-20% of anti
      HBe seropositive mothers. The babies are at risk of developing fulminant
      hepatitis. In most cases no viral DNA has been detected in the sera of mothers
      and children by conventional hybridisation techniques. Thus, the aim of our
      investigation was to demonstrate HBV DNA in three children with liver failure and
      their anti-HBe positive mothers by more sensitive molecular hybridisation
      techniques. The babies were healthy at birth and did not receive vaccination. At
      3 months of age they developed acute liver failure and died from liver
      insufficiency. Only in one child serum HBV DNA was detected by dot blot
      hybridisation, but polymerase chain reaction (PCR)-detectable HBV DNA was present
      in all sera. The liver specimen was negative for HBV DNA by Southern blot
      hybridisation, but showed a focal distribution of viral sequences as determined
      by in situ hybridisation. This finding was confirmed by PCR. Our results prove
      that chronic anti-HBe positive HBsAg carrier mothers and their babies show a low
      level virus replication. Fulminant hepatitis is due to vertical transmission of
      very small amounts of viral DNA, only detectable by most sensitive techniques
      like PCR and in situ hybridisation. Our findings underline the necessity to
      vaccinate all babies of HBsAg positive mothers regardless of HBeAg/anti-HBe
      status.

PMID- 8354319
TI  - Oral cornstarch therapy: is persorption harmless?
AB  - Sediments prepared from freshly voided urine of four patients with glycogenosis
      Ia, or leucine-sensitive hypoglycaemia, on oral cornstarch therapy contained
      starch granules, evidence for persorption i.e. the incorporation of undissolved
      starch particles. In these patients, amyluria was more marked than in untreated
      controls. While cornstarch therapy is successful and causes few side-effects, the
      possibility of late adverse reactions to persorbed starch should not be
      disregarded.

PMID- 8354320
TI  - Continuous negative extrathoracic pressure and cardiac output--a pilot study.
AB  - Continuous negative extrathoracic pressure (CNEP) has been recently reintroduced
      as therapy for respiratory failure. To determine its effects on cardiac output a
      pilot study was performed in ten patients aged 2 months-3 years (median 4
      months). All had chronic respiratory failure (seven with bronchopulmonary
      dysplasia). Five were breathing spontaneously and five were intubated and
      undergoing intermittent positive pressure ventilation. Transcutaneous oxygen
      saturation and PCO2, together with ECG were continuously monitored. Pulmonary
      artery blood flow velocity was measured non-invasively using pulsed wave Doppler.
      The 95% confidence intervals for the changes with and without CNEP in
      spontaneously breathing and ventilated patients showed no statistically
      significant changes in heart rate, O2 saturation, transcutaneous PCO2 or cardiac
      output. This study shows that the use of CNEP, administered in a tank respirator,
      does not lead to large changes in cardiac output.

PMID- 8354321
TI  - Ureaplasma urealyticum infection in newborns: three case reports.
AB  - We report three newborns with different manifestations of Ureaplasma urealyticum
      infection; a term newborn with acute neonatal pneumonia and two very low birth
      weight infants with bronchopulmonary dysplasia and osteomyelitis of the femur,
      respectively. The association of U. urealyticum with acute and chronic
      respiratory disease in term and preterm newborns has recently been reported. Our
      two cases are similar to other case reports from the literature, but we were
      unable to find any previous reports of osteomyelitis due to U. urealyticum in the
      premature babies. Isolation of U. urealyticum in pure culture from the blood was
      considered to be related to local infection in all three patients. All patients
      were cured by erythromycin.

PMID- 8354322
TI  - Efficacy of phototherapy in neonatal hyperbilirubinaemia associated with glucose
      6-phosphate dehydrogenase deficient status.
AB  - The efficacy of phototherapy in a group of 427 infants with hyperbilirubinaemia
      associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency and a
      comparable group of 3924 G6PD normal infants with non-haemolytic
      hyperbilirubinaemia was evaluated. Phototherapy was highly effective in reducing
      bilirubin levels in both groups of infants, being significantly more effective in
      the group with normal G6PD status. Failure rate was very low (2.03/1000) in the
      group with normal G6PD status and nil in the G6PD deficient group. Bilirubin
      rebound after phototherapy was unremarkable with very few infants requiring a
      second exposure--4.68/1000 in the G6PD deficient group and 6.37/1000 in the G6PD
      normal group. All the babies tolerated phototherapy well. Phototherapy would
      therefore seem to be a simple and effective method for the management of severe
      jaundice associated with G6PD deficiency.

PMID- 8354323
TI  - Carbamazepine-induced skin rash in children with epilepsy.
AB  - The clinical and epidemiological findings in children with epilepsy who
      experienced skin rashes induced by carbamazepine (CBZ) were prospectively
      evaluated. Thirty-three (9.9%) of 335 patients who received CBZ therapy
      experienced a skin rash. Seven had diffuse erythema, 13 miliary exanthema, 11
      maculopapular or speckled reddish rash, 3 petechiae, and 2 mucocutaneous
      syndrome. A skin rash was more frequent in older children (over 6 years old). The
      skin rashes appeared soon after initiation of the therapy, i.e., from the 8th to
      60th day (mean: 14.3 +/- 9.6 days) after the start of CBZ therapy and disappeared
      within a few days after discontinuation of the therapy. Haematological
      abnormalities (30.3%), such as leucocytopenia and thrombocytopenia, and hepatic
      dysfunction (27.3%) sometimes appeared concomitantly with the skin rash. CBZ is
      an effective and safe antiepileptic drug, but careful management is necessary on
      initiation of the therapy.

PMID- 8354324
TI  - Guillain-Barre syndrome following immunisation with Haemophilus influenzae type b
      conjugate vaccine.
AB  - The Guillain-Barre syndrome (GBS) is an immune-mediated disease often associated
      with viral or bacterial infections and with immunisation. IgM antibodies have
      been implicated as the main trigger event in GBS. So far, only four cases of GBS
      have been observed following immunisation with a conjugate vaccine against
      Haemophilus influenzae type b. We report another patient with GBS after this
      vaccination. We measured immunoglobulins against the H. influenzae type b
      polysaccharide (PRP) component of the vaccine. Surprisingly the anti-PRP IgM
      antibody level was markedly elevated (100 micrograms/ml) in the plasma of this
      patient. We speculate that an excessive anti-PRP IgM antibody response to the
      vaccine might be the cause of GBS.

PMID- 8354326
TI  - Hepatorenal failure after carbamazepine therapy.

PMID- 8354325
TI  - The effect of sodium cromoglycate on upper and lower respiratory symptoms in
      children born prematurely.
AB  - The aims of this study were to assess whether sodium cromoglycate (SCG) was an
      effective prophylaxis against both upper and lower respiratory tract signs and to
      determine factors which affected the site and magnitude of the response to SCG.
      Sixteen children born prematurely were entered into a randomised placebo
      controlled trial at 15 months of age (range 4-31 months). The patients received,
      in random order, either 3 weeks' treatment with SCG (5 mg) or placebo, both given
      four times a day by inhalation via a spacer device. Parents were asked to record
      the occurrence and severity of their child's upper respiratory tract signs;
      sneezing and runny nose and lower respiratory tract signs; day and night time
      cough and wheeze. During the active compared to the placebo period there was an
      overall reduction of 47% and 53% in upper and lower respiratory tract signs,
      respectively. The magnitude of response to SCG as assessed by either the change
      in upper or lower respiratory tract signs was not significantly related to the
      patient's gestational or postnatal age, the occurrence of neonatal chronic lung
      disease, family history of atopy or the order in which the therapy was
      administered. We conclude that inhaled SCG may be a useful prophylaxis for both
      upper and lower respiratory tract signs for children born prematurely and less
      than 3 years of age.

PMID- 8354327
TI  - Discrete membranous subaortic stenosis in siblings.

PMID- 8354328
TI  - Ventilatory requirements for respiratory distress syndrome in small for
      gestational age infants.

PMID- 8354329
TI  - Complications of parenteral nutrition via an umbilical vein catheter.

PMID- 8354330
TI  - How to remove ingested batteries?

PMID- 8354331
TI  - Mechanisms of tubulo-interstitial injury in progressive renal diseases.
AB  - A vast amount of evidence, based upon human renal biopsy material, indicates that
      the presence of tubular atrophy and interstitial fibrosis is a better indicator
      of outcome of renal function than is the extent of glomerular sclerosis. The
      pathophysiological basis for this surprising fact has not been adequately
      addressed. In this review we point out that the systemic hypertension which
      accompanies most forms of chronic renal disease could impact adversely upon the
      vasodilated interstitial vascular compartment which, together with a component of
      primary capillary injury related to the disease process, could cause progressive
      obliteration of particular capillaries. This would initiate a process of chronic
      tubular ischaemia ultimately leading to tubular atrophy. Since tubular cells have
      been shown to produce an array of cytokines and growth factors which modulate
      fibroblast proliferation, extracellular matrix production and chemo-attracts for
      infiltrating cells, it is further proposed that it is the tubular injury which
      initiates the deleterious cascade of events. Tubular injury may be aggravated by
      the filtration of potentially 'noxious' molecules through the diseased glomerulus
      and by infiltrating cells. As the vascular bed into which glomerular blood flow
      empties is progressively obliterated, glomerular function declines and renal
      failure advances in relation to the degree of tubulo-interstitial fibrosis.

PMID- 8354332
TI  - Glucose-induced water movement from the intracellular to the extracellular space
      and its influence on calculations of glucose metabolism.
AB  - The osmotic effect of intravenous glucose was investigated in eight healthy
      volunteers. Increases in plasma glucose can induce water movement from the
      intracellular to the extracellular space. Serum choline esterase was used as an
      endogenous marker of serum dilution. Intravenous tests with 5, 15, 30 and 35 g of
      glucose showed that the water shift was proportional to the amount infused. The
      respective dilutions of choline esterase were 1.3 +/- 0.7%, 3.3 +/- 0.9%, 6.3 +/-
      0.8% and 7.8 +/- 0.5%. The effect on extracellular water was maintained when
      plasma glucose remained elevated (inhibition of insulin secretion with a
      somatostatin analogue). In comparison to glucose, infusion of 10 g of a mixture
      of amino acids produced a less pronounced effect than expected. The acute water
      shift after intravenous glucose dilutes serum components including glucose (8% of
      total extracellular glucose at 35 g). This can be misinterpreted as glucose
      clearance when calculating metabolic rates. For estimated amounts a proportional
      correction should be made (3.5% per 5 mmol l-1 increase). A measured plasma
      glucose of 22.2 mmol l-1 should be corrected to 24.8 mmol l-1, while a plasma
      glucose value of 5.0 mmol l-1 needs no correction.

PMID- 8354333
TI  - Investigations into the haemorheological significance of postprandial and fasting
      hypertriglyceridaemia.
AB  - Two study designs were conceived to evaluate the rheological significance of
      hypertriglyceridaemia. We first investigated the course of serum- (SV) and plasma
      viscosity (PV) and erythrocyte aggregation in serum (SEA) and plasma (PEA) of
      healthy normolipidaemic individuals over 4 h after a fatty rich meal, in native
      material and after removal of triglyceride rich lipoproteins by centrifugation.
      Secondly, blood from patients with untreated hypertriglyceridaemia was
      investigated under fasting conditions. PEA and SEA increased in parallel with
      postprandial triglycerides (+135 mg dl-1), but the effect on PEA was more
      pronounced (+0.8 abs% increase; 2 h after the meal) as compared to SEA (+0.4 abs%
      increase). PV and SV increased in parallel to the same extent (+0.05 mPas). In
      the triglyceride poor infranatant no significant changes occurred. In fasting
      plasma PEA and PV were significantly lower (1.1 abs% and PV 0.04 mPas
      respectively) in infranatant than in native plasma, while only small differences
      in triglyceride (mostly VLDL) were observed. This phenomenon was barely
      detectable in serum samples. We conclude that triglyceride rich lipoproteins have
      a profound influence on haemorheological parameters, and that fibrinogen in
      particular, potentiates the effect of large fasting VLDL on plasma viscosity and
      erythrocyte aggregation.

PMID- 8354334
TI  - Bile concentration promotes nucleation of cholesterol monohydrate crystals by
      increasing the cholesterol concentration in the vesicles.
AB  - Cholesterol in bile is solubilized in mixed micelles and cholesterol-phospholipid
      vesicles. Biliary cholesterol supersaturation and increased concentration of bile
      in the gallbladder promotes nucleation of cholesterol monohydrate crystals and
      gallstone formation, possibly by creating unstable vesicles with a high
      cholesterol/phospholipid ratio. In the present study super-saturated and
      unsaturated biles (cholesterol saturation index (CSI) 1.4 and 0.8 respectively)
      were prepared with concentrations typical of gallbladder and more dilute hepatic
      bile (total lipid concentration (TLCo) 10 and 2.5 g dl-1 respectively). The
      distribution of cholesterol between vesicles and micelles, and vesicular
      cholesterol/phospholipid ratio were studied using ultracentrifugation and gel
      permeation chromatography. The nucleation time of cholesterol crystals was
      determined in whole model bile, and in the vesicular and micellar peak fractions.
      Increased CSI and bile dilution led to an increased proportion of cholesterol
      solubilized in vesicles. The concentration of bile did not influence vesicular
      cholesterol/phospholipid ratio. The vesicular cholesterol/phospholipid ratio
      found in gel-permeation chromatography experiments was similar at high and low
      CSI, whereas the ratio was significantly higher in supersaturated than in
      unsaturated biles in ultracentrifugation studies. Nucleation of cholesterol
      crystals from whole model bile was more rapid at the higher bile concentration
      and higher cholesterol saturation. Nucleation time in whole model bile correlated
      significantly with nucleation time in the corresponding vesicular peak fraction
      obtained by gel-permeation chromatography (r = 0.58: P < 0.01) and with the
      cholesterol concentration in this vesicular peak (r = -0.77; P < 0.002) but not
      with vesicular peak cholesterol/phospholipid ratio.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8354335
TI  - Decreased in vitro oxidizability of low-density lipoprotein in
      hypercholesterolaemic patients treated with 3-hydroxy-3-methylglutaryl-CoA
      reductase inhibitors.
AB  - We studied the effects of the 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase
      inhibitors simvastatin and pravastatin on the in vitro susceptibility of low
      density lipoprotein (LDL) to oxidation. Twenty-three hypercholesterolaemic
      patients (mean serum cholesterol 9.7 mmol l-1) were treated with increasing doses
      of either simvastatin or pravastatin for 18 weeks. No significant differences in
      effect on lipid levels between the two drugs were found. Treatment resulted in
      lowering of total cholesterol and LDL-cholesterol by maximally 30% and 34%,
      respectively. Chemical composition analysis showed that LDL particles contained
      relatively more protein and less free cholesterol and cholesteryl-ester after
      treatment. The LDL cholesterol/protein ratio decreased from 1.24 +/- 0.21 to 0.97
      +/- 0.23 (n = 20). By continuous monitoring of in vitro oxidation it appeared
      that LDL was less susceptible to oxidation after drug treatment. Maximal rate of
      diene production was significantly decreased from 19.7 +/- 3.1 to 18.5 +/- 3.3
      nmol min-1 mg-1 LDL; total diene production decreased significantly from 420.3 +/
      67.6 to 380.5 +/- 49.1 nmol mg-1 LDL; the lag time was unchanged throughout the
      study. These studies show that HMG-CoA reductase inhibitors reduce the
      oxidizability of LDL by altering its composition.

PMID- 8354336
TI  - Long-term treatment with octreotide in patients with the Zollinger-Ellison
      syndrome.
AB  - This study reports the effects of 4 and 5-year treatment with octreotide (200
      micrograms sc bid) in the Zollinger-Ellison syndrome (ZES). No symptoms related
      to acid hypersecretion were observed in the four patients throughout the study,
      and upper GI endoscopy was normal. Basal acid output (BAO) measured 12 h after
      injection, was below 10 mmol h-1 in three to four patients and previous
      ranitidine treatment was discontinued. In the fourth case (pretreatment BAO
      value: 115 mmol h-1), BAO progressively decreased to 42 mmol h-1 after 5 years of
      octreotide treatment. At the end of the study, serum gastrin levels were 58.5%
      (30-68) of the pretreatment values and two patients had normal gastrin levels.
      Peak acid output (PAO) decreased markedly after 2, 4 and 5 years, by 68% (35-89)
      suggesting that octreotide had exerted an antitrophic effect on parietal cell
      mass. Diffuse hyperplasia of fundic argyrophil cells present in two patients
      before octreotide, decreased during the treatment. Mean argyrophil cell density
      for all patients was not significantly modified. Antral gastrin-cell density was
      in the normal range. No long-term side effect of octreotide treatment was
      observed. Although octreotide may not be considered as a substitute for
      benzimidazoles in the treatment of ZES, its specific properties may be of
      therapeutic benefit in some ZES patients.

PMID- 8354337
TI  - Postabsorptive retinyl palmitate removal is retarded in lecithin-cholesterol
      acyltransferase deficiency.
AB  - Postabsorption fat clearance of intestinal lipoproteins indicated by retinyl
      palmitate was studied in two siblings with the classical lecithin-cholesterol
      acyltransferase (LCAT) deficiency and in a control group of 21 healthy subjects
      with similar apoprotein E 3/3 phenotype. Relatively high pre- and postabsorptive
      cholesterol esterification percentage of chylomicrons suggested that acyl
      coenzyme A:cholesterol acyltransferase activity was not inhibited. Postabsorptive
      levels of plasma lipids increased and decreased roughly similarly in the cases
      and controls with the postabsorptive peak values at about 4 h. Plasma total and
      chylomicron levels of retinyl palmitate were not affected by LCAT deficiency,
      while the removal of the vitamin from very low and intermediate density
      lipoproteins was clearly reduced so that the peak concentrations, values under
      the response curves and the time of the peak concentrations were markedly higher
      than in the controls. The long-lasting circulation of chylomicron remnants of
      density < 1.006-1.019 g ml-1 may have some clinical significance because
      postabsorptive lipoproteins are suspected to have atherogenic potentiality.

PMID- 8354338
TI  - On the relationships between mineral metabolism, obesity and fat distribution.
AB  - Alterations in calcium metabolism have been associated with cardiovascular risk
      factors. An altered binding of calcium to plasma proteins and raised levels of
      parathyroid hormone (PTH) have been described in morbid obesity. In the present
      study, indices of mineral metabolism were related to obesity (body mass index,
      BMI) and fat distribution (waist to hip ratio, w/h) in 194 subjects with a wide
      range of BMI and w/h. The ratio of total serum calcium to plasma ionized calcium
      (Ca2+) was found to be significantly correlated to both BMI (r = 0.20, P < 0.02)
      and w/h (r = 0.22, P < 0.005). Serum phosphate was also correlated to both of the
      indices of obesity in an inverse way (r = -0.24, P < 0.0008 for BMI and r = 
      0.33, P < 0.0001 for w/h). These relationships were still significant when the
      influences of age, sex and serum creatinine were included in the multiple
      regression analysis. This kind of analysis also disclosed that w/h was superior
      to BMI as a determinant of serum phosphate and the total calcium/Ca2+ ratio in
      serum. PTH was not significantly correlated to any of the indices of obesity. In
      conclusion, fat distribution rather than obesity per se was found to be
      associated with an altered mineral metabolism.

PMID- 8354339
TI  - Pancreatic beta-cell function and interleukin-1 beta in plasma during the acute
      phase response in patients with major burn injuries.
AB  - Animal experiments demonstrate that interleukin-1 beta (IL-1 beta) is beta-cell
      cytotoxic in vitro and inhibits insulin secretion in vivo. However, it is unknown
      if IL-1 beta affects beta-cell function in man. Since IL-1 beta and other
      cytokines are main mediators of the acute phase response, the objectives of the
      present study were to examine beta-cell function in patients with major burn
      injuries, and to test if changes in beta-cell function correlated to systemic
      levels of IL-1 beta and tumour necrosis factor alpha (TNF alpha). We established
      and validated an IL-1 beta assay measuring free and protein bound IL-1 beta;
      protein bound IL-1 beta was detached from the IL-1 beta specific binding protein
      by acidification, rendering it accessible for the employed antibody. The IL-1
      beta specific binding protein (43-60 kDa) was found in serum and plasma from all
      tested patients and normal subjects. Survivors of burn injuries had a stimulated
      beta-cell function, whereas non-survivors had an impaired beta-cell function as
      indicated by an increased plasma concentration of proinsulin, and an increased
      proinsulin/insulin ratio. In addition, non-survivors had significantly increased
      plasma levels of IL-1 beta. However, we could not demonstrate any correlation
      between C-peptide, proinsulin, insulin or proinsulin/insulin ratio and plasma
      concentration of IL-1 beta. In conclusion, beta-cell function abnormalities are
      evident in patients with major burn injuries, and a high plasma level of IL-1
      beta correlates with a fatal outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354341
TI  - The endothelin ETA receptor-specific effect of 50-235, a nonpeptide endothelin
      antagonist.
AB  - We characterized the endothelin receptor antagonist 27-O-caffeoyl myricerone (50
      235), isolated from the bayberry Myrica cerifera, using rat aortic smooth muscle
      A7r5 cells that express ETA receptors and human Girardi heart cells that express
      ETB receptors. 50-235 concentration-dependently inhibited 125I-ET-1 binding to
      A7r5 cells with Ki of 51 +/- 12 nM, while it had no effect on 125I-ET-1 and 125I
      ET-3 bindings to Girardi heart cells. Also in affinity cross-linking studies with
      125I-ET-1, 50-235 inhibited labeling of a protein of M(r) = 67,000 in A7r5 cells,
      but did not inhibit labeling of two proteins with M(r) values of 70,000 and
      46,000 in Girardi heart cells. Functionally, 50-235 inhibited the ET-1-induced
      increase in cytosolic free Ca2+ concentration ([Ca2+]i) in a dose-dependent
      manner (IC50 = 11 +/- 2 nM) in A7r5 cells. On the other hand, this compound had
      no effect on the basal level of [Ca2+]i and the high K(+)- and bombesin-induced
      increases in [Ca2+]i in A7r5 cells, nor on the ET-1-induced increase in [Ca2+]i
      in Girardi heart cells. Also, 50-235 inhibited ET-1-promoted mitogenesis of A7r5
      cells. Thus, we conclude that 50-235 is a specific endothelin A receptor
      antagonist that could be very useful for elucidating the physiological and
      pathophysiological significance of ET.

PMID- 8354340
TI  - Binding of the muscarine receptor antagonist heptane-1,7-bis(dimethyl-3'
      phthalimidopropyl)ammonium bromide at cholinoceptor sites.
AB  - The binding of the bisquaternary muscarine receptor antagonist heptane-1,7
      bis(dimethyl-3'-phthalimidopropyl)-ammonium bromide (C7/3-phth) was investigated
      at a number of cholinergic binding sites using (-)-[3H]nicotine, [3H]pirenzepine
      and (-)-[3H]quinuclidinyl benzilate ([3H]QNB) in both central and peripheral
      tissues. C7/3-phth displayed an affinity for muscarine M2 receptors in rat atria
      (70.1 nM) which was 1.6-fold greater than for putative M4 receptors in rabbit
      lung, and 4- to 5-fold greater than for M1 receptors in rat cerebral cortex. Its
      affinity for nicotine receptors in the cortex was low, being 808-fold lower than
      its affinity for the M2 receptor. Although the displacement of (-)-[3H]nicotine
      and [3H]pirenzepine binding in rat cortex by C7/3-phth was best described in
      terms of one-site modelling, low Hill coefficients were observed with C7/3-phth
      in displacement studies using [3H]QNB in this tissue. The possibility of
      allosteric interactions or multiple receptor subtype interactions is discussed.

PMID- 8354342
TI  - Polyclonal anti-idazoxan antibodies: characterization and purification.
AB  - Amino-idazoxan coupled to hemocyanine was used to raise anti-idazoxan antibodies
      in the rabbit. The antibodies were affinity purified with an amino-idazoxan
      affinity column. Binding studies with [3H]idazoxan showed a dissociation constant
      of 2.2 +/- 1.4 nM. The specificity spectrum of these antibodies indicates that
      the imidazoline part of idazoxan is more important for recognition than the
      benzodioxan ring as imidazoline substances (clonidine, cirazoline) are powerful
      competitors of [3H]idazoxan binding on the antibodies. Catecholamines or
      imidazoles were unable to displace [3H]idazoxan from the antibodies. These anti
      idazoxan antibodies present specificity similarities with the imidazoline
      receptor as did our previously obtained anti-clonidine antibodies. Affinity
      purified antibodies represent useful tools for studying the imidazoline receptors
      particularly with an anti-idiotypic approach.

PMID- 8354343
TI  - Metformin and brown adipose tissue thermogenetic activity in genetically obese
      Zucker rats.
AB  - The effect of chronic metformin treatment on brown adipose tissue thermogenetic
      activity was investigated in young genetically obese Zucker rats. The binding of
      [3H]GDP to brown adipose tissue mitochondria, expression of uncoupling protein
      mRNA in brown adipose tissue, weight gains and cumulative food intakes were
      measured in metformin (320 mg/kg orally for 12 days)-treated obese Zucker rats as
      well as in pair-fed--and in ad libitum--fed control obese rats. The weight gains
      were identically reduced in the metformin- and pair-fed control group compared to
      the ad libitum--fed rats. Metformin also significantly reduced cumulative food
      intake. The binding of [3H]GDP to brown adipose tissue mitochondria and the
      expression of uncoupling protein mRNA in brown adipose tissue were not modified
      by metformin. It is concluded that the weight gain reducing effect of metformin
      in obese Zucker rats is mainly due to reduced food intake and does not involve an
      effect of metformin on brown adipose tissue thermogenetic activity.

PMID- 8354344
TI  - Up-regulation of 5-HT2 receptors in the rat brain by repeated administration of
      SR 46349B, a selective 5-HT2 receptor antagonist.
AB  - Chronic administration (twice a day for three days and on the morning of the
      fourth day) of SR 46349B (trans-4-[(3Z)3-(2-dimethylaminoethyl)oxyimino-3-(2
      fluoroph enyl)propen-1- yl]phenol hemifumarate) (10 mg/kg, orally), a selective 5
      HT2 receptor antagonist, caused 24 h later a marked increase (+42%) of the
      maximum binding capacity of [3H]ketanserin in rat brain cortical membranes
      without change in its affinity constant. Further, administration of the 5-HT2
      receptor agonist, (+/-)-DOI((+/-)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane)
      (1 mg/kg, i.p.), produced in chronic SR 46349B treated rats a significant
      increase in the amount of [3H]-inositol phosphate compared to corresponding
      controls. In addition, subacute administration of SR 46349B caused a 2-fold
      increase in the head-twitch response to (+/-)-DOI (0.5 mg/kg, i.p.). This
      enhanced response was blocked by an acute administration of ritanserin (6-(2-[4
      [bis(4-fluorophenyl)methylene]-1-piperidinyl]ethyl]-7- methyl-5H-thiazolo[3,2
      a]pyrimidin-5-one) (10 mg/kg). Finally, a significant enhancement (+29%) of 5-HT2
      receptor mRNA levels was observed in the cortex. Taken together, these data
      showed that an up-regulation of 5-HT2 receptors occurred in rats following
      repeated treatment with a selective 5-HT2 receptor antagonist. The effects of SR
      46349B on 5-HT2 receptors might implicate pre-translational regulation.

PMID- 8354345
TI  - Evidence that protein kinase C alpha has reduced affinity towards 1,2-dioctanoyl
      sn-glycerol: the effects of lipid activators on phorbol ester binding and kinase
      activity.
AB  - The effect of 1,2-diacylglycerols on specific binding of [3H]phorbol 12,13
      dibutyrate to cytosolic protein kinase C (PKC) was investigated in tissues
      reported to contain different proportions of PKC isoforms. In lung, frontal
      cerebral cortex and cerebellum cytosols (enriched in PKC alpha, beta and gamma,
      respectively) displacement of specific binding by phorbol 12,13-dibutyrate or
      diacylglycerols containing unsaturated acyl chains was of similar potency for
      each tissue. A range of 1,2-diacylglycerols containing saturated acyl chains
      exhibited varying affinities for [3H]phorbol 12,13-dibutyrate binding sites in
      each tissue; defining an optimal acyl chain length of around 14 carbons in each
      case. However, the affinities of saturated diglycerides were consistently lower
      in lung cytosol than in frontal cerebral cortex and cerebellum cytosols, with the
      greatest differences occurring at lower acyl chain lengths, especially with 1,2
      dioctanoyl-sn-glycerol. Furthermore, a mixed micelle assay of PKC activity showed
      that 1,2-dioctanoyl-sn-glycerol displayed reduced potency at PKC alpha partially
      purified from COS 7 cell cytosol compared to the mixture of PKC isoforms present
      in rat midbrain cytosol. Both low potency of 1,2-dioctanoyl-sn-glycerol as a
      displacer of [3H]phorbol 12,13 dibutyrate binding and the ability of arachidonic
      acid to act as an allosteric enhancer of binding, correlated with the
      proportional PKC alpha content of a range of tissues reported in the literature.
      In PKC enzyme activity assays, 1,2-dioctanoyl-sn-glycerol, but not phorbol 12,13
      dibutyrate, was correspondingly a much poorer activator of PKC alpha from COS 7
      cells than of the broad consensus of isoforms in rat midbrain. When alpha and
      beta isoforms were extensively-purified on DEAE-cellulose then hydroxyapatite,
      both the low affinity of 1,2-dioctanoyl-sn-glycerol for [3H]phorbol 12,13
      dibutyrate binding sites and their allosteric regulation by arachidonic acid were
      confirmed to be characteristic of the alpha rather than the beta isoforms.

PMID- 8354346
TI  - [Biological function models with wild-derived genes. Why do we have to use mice,
      in particular wild derived mice, for the biomedical research?].

PMID- 8354347
TI  - [Gene therapy of a lethal mutation associated with adrenal hyperplasia in mice].

PMID- 8354348
TI  - [Development of animal models for carcinogenesis by transgenesis. Transgenic
      mouse models for cancer research].

PMID- 8354349
TI  - [Usefulness of transgenic mice in carcinogenicity tests].

PMID- 8354350
TI  - [What mouse contributed the first representation of the adrenal cortex X zone?].
AB  - The X zone, innermost cortex of the mouse adrenal, was first represented by
      Kiyoshi Masui and Yasushige Tamura in the Japanese in 1924 and in the English in
      1926. All the mice used by them were reared by themselves at the Laboratory of
      Veterinary Anatomy, Faculty of Agriculture, Imperial University of Tokyo. They
      were the first scientists in Japan that attempted to breed mice in their own
      laboratory and used them for scientific researches in the literature. The
      importance of the breeding of laboratory animals by users was first pointed out
      by Sahachiro Hata in 1914, who found Salvarsan as a specific medicine against
      Spirochaeta pallida in cooperation with Paul Ehrlich in 1910. Hata's idea on the
      breeding of laboratory animals by researchers themselves might inspire Masui.
      Hata himself tried to breed laboratory mice in the Kitasato Institute. They were
      called "French mice", because they were believed at that time to be introduced
      from Europe before 1910. Masui and Seitaro Adachi (1926) also used French mice in
      their basic studies. They compared the body size between French and Nanking mice
      with special attention to the genetic factors controlling the body size for the
      purpose of improving of army horses. They noticed that French mice were larger in
      body size and more active in reproduction. Hata noticed a difference in reaction
      to Salvarsan between two mice. Our survey of the literature revealed that the X
      zone in the mice used by Masui and Tamura had many distinctive characteristics.
      The major two found in 90-day-old virgins were the extremely thick X zone and its
      division into two sublayers, one being composed of vacuolated cells only and the
      other of non-vacuolated cells only. It seems most reasonable to postulate that
      the first representation of the X zone was made in French mice bred by Masui and
      Tamura themselves. These characteristics of the X zone in the mice used by Hata
      or Masui and Tamura were very similar to those observed in inbred strains of
      mice, KK and NC, which Kyoji Kondo established from Japanese fancy mice, Kasukabe
      and Nishikinezumi groups, respectively. The same characteristics were also found
      in 4 of 28 recombinant inbred (RI) strains between A/J and SM/J established by
      Masahiko Nishimura. Since both A/J and SM/J have not such characteristics, the
      thick X zone consisting of 2 sublayers with and without vacuolation seems to
      appear on a certain specific genetic background.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8354351
TI  - Cryopreservation of mouse spermatozoa from inbred and F1 hybrid strains.
AB  - Mouse epididymal spermatozoa from inbred(BALB/c, C3H/He, C57BL/6N, CBA/JN and
      DBA/2N) and F1 hybrid (B6C3F1, BDF1 and CDF1) strains suspended in
      cryopreservation solution (18% raffinose and 3% skim milk in distilled water)
      were frozen and stored at -196 degrees C. After thawing at room temperature,
      sperm motility and fertilizing ability were examined. Spermatozoa from all of the
      strains were successfully frozen, although the motility and the fertilization
      rates of frozen-thawed spermatozoa (the proportions of the fresh oocytes from
      Jcl:ICR strain which developed to pronuclear oocytes and 2-cell embryos after
      insemination by frozen-thawed spermatozoa) varied among strains (motility: 23%
      for C57BL/6N to 62% for DBA/2N; fertilization rates: 26% for C57BL/6N to 89% for
      DBA/2N). Nearly all 2-cell embryos fertilized by frozen-thawed spermatozoa were
      transferred to the oviducts of pseudopregnant recipients and 35-62% of 2-cell
      embryos developed into normal young.

PMID- 8354352
TI  - [Possibility of detecting visual functional disturbance in rats by the open-field
      test].
AB  - In order to determine whether visual disturbance in small rodents is detectable
      by means of the open-field test, the ambulation scores of enucleated and intact
      rats in an open-field were measured. In a 30-min test of Slc:Wistar/ST rats,
      there were significant differences in ambulation scores between enucleated and
      intact rats in the first 10-min. In addition, the effects of observation times
      (09:00-11:00, 13:00-15:00 and 17:00-19:00 hr) and strains on the open-field test
      were studied using a 10-min test. Regardless of observation times, ambulation
      scores of enucleated rats of the Slc:Wistar/ST and F344/N Slc strains were
      significantly elevated as compared with those of intact rats from both strains.
      When tested during the 13:00-15:00 hr period, there were significant differences
      in the Slc:SD rats. These findings indicate that the changes in ambulation are
      due to visual disturbance. However, significant ambulatory changes in F344/N Slc
      rats were documented at the three different observation times. Based on these
      results, Slc:Wistar/ST rats appear to be suitable for detecting visual
      disturbance by the open-field test.

PMID- 8354353
TI  - [Morphometric studies on the effects of dehydration on the renin-immunopositive
      cells in the kidney of the Mongolian gerbil (Meriones unguiculatus)].
AB  - Effects of dehydration on the total area of the kidney occupied by renin
      immunopositive cells were morphometrically studied on parasagittal sections by an
      image-analyzing system in the Mongolian gerbils. Changes in the body weight and
      plasma osmolarity were simultaneously measured to compare with morphometric data.
      The body weight decreased rapidly at the beginning, and gradually after 10 days
      of dehydration. On the other hand, the plasma osmolarity showed no significant
      change at 2 days, increased gradually after 5 days, and reached a plateau after
      15 days. Similarly, the total area of renin-positive cells showed no significant
      changes at 2 days, increased remarkably after 5 days, and reached a plateau after
      15 days. These findings suggest that the plasma osmolarity and total area of
      renin-positive cells showed no significant changes at the beginning of
      dehydration because the increase in the plasma osmolarity was compensated by the
      expenditure of inter-and intra-cellular fluid, and the total area of renin
      positive cells was increased in response to the acceleration of renin synthesis
      stimulated by the increase in the plasma osmolarity after a certain period of
      dehydration. The total area seemed to be maintained on a certain level because
      the further increase in the plasma osmolarity was suppressed by the excretion of
      electrolytes from the body in proportion to the water loss after a long period of
      dehydration.

PMID- 8354354
TI  - [Application of DNA fingerprinting to investigation of genetic relationships
      between laboratory rabbit strains].
AB  - It is well known that laboratory rabbits are not controlled genetically like
      laboratory mice and rats. In order to test the usefulness of DNA fingerprinting
      in investigation of genetic uniformity of the laboratory rabbits strains and
      their relationships, we applied DNA fingerprinting using bacteriophage M13 probe
      to five strains (2 inbreds (JWY-NIBS and DuY-NIBS) and 3 outbreds (JW-NIBS,
      Icl:JW and WHHL)). DNA fingerprints of 2 inbred strains showed the same banding
      patterns within each strain but the strain-specific patterns. Although there were
      no rabbits showing the same banding patterns in 3 outbred strains, average
      percent differences (APD) were 13.7 to 18.6. A dendrogram based on APD of DNA
      fingerprints was constructed by 2 large clusters, JW group and DuY. The
      dendrogram was essentially similar to that based on rabbit mandible measurements.
      These results suggest that DNA fingerprinting is available not only for the
      genetic monitoring of the laboratory rabbit strains but also for the
      investigation of their genetic relationships.

PMID- 8354355
TI  - Establishment of inbred strain of long-haired golden hamster.
AB  - Features of a long-haired mutant and inheritance of mutation were investigated in
      the golden hamster (Mesocricetus auratus). The hair of adult long-haired hamsters
      was longest at the rump and flanks (approximately 70 mm) and was also unusually
      long at the neck (45 to 50mm). The hair length of males was more striking than
      that of females. Mating experiments indicated that an autosomal recessive gene is
      responsible for the inheritance of long hair. An albino long-haired hamster
      strain was established by continuous full-sib mating from F2 hybrids, descendants
      of (acromelanic albino x agouti long-haired) F1 progeny, and genetic homogeneity
      was confirmed by DNA fingerprinting. The long-haired strain was characterised by
      the fact that males grew larger than females, in contrast to the other strains of
      hamsters.

PMID- 8354356
TI  - [Age-related changes in bone weights and their components in rats].
AB  - Age-related changes in the wet, dry and ash weights and components such as water,
      organic substance, ash, calcium and phosphorus of femur, tibia and first lumbar
      vertebra and serum biochemical constituents related to bone metabolism were
      examined in Wistar rats. A total of 60 males and 60 females were used, and every
      five rats of both sexes were examined at 1 and 2 months of age and then at
      intervals of 3 months between 3 and 30 months of age. Each bone weight increased
      rapidly up to 3 months of age and then gradually up to 12 months of age in
      females and 9 months of age in males, but thereafter decreased at 27 and 30
      months of age in males. Between 1 and 6 or 9 months of age in both sexes, a
      decrease in water content, increases in ash, calcium and phosphorus, and almost
      no change in organic substance in each bone were observed. After 15 months of age
      in males, an increase in water content, decreases in ash content, calcium and
      phosphorus, and almost no changes in organic substance were observed in males.
      The value of serum calcium decreased up to 12 months of age but then increased
      after 18 months of age in both sexes. Serum phosphorus and alkaline phosphatase
      activity decreased up to 9 months of age in both sexes. The data obtained in this
      study supported the results in our previous study that the peak bone strength of
      the femur and peak bone volume of trabecular bone of the proximal metaphysis of
      the tibia were at 12 months of age in both sexes in Wistar rats.

PMID- 8354357
TI  - [Visual evoked potential from dura in rats].
AB  - Visual evoked potentials (VEPs) were recorded from 8 different points (from
      points A and B near the bregma to points G and H near the occipital bone) of the
      dura under parietal bone in rats. The study was performed with 68 adult male Slc:
      Wistar/ST rats weighing 259.9-298.0g. VEPs recorded from the dura had a large
      negative component with a peak around 45 msec (N1), a large positive component
      with a peak around 75 msec and a large negative component with a peak around 120
      msec (N2). Points A and B were not suitable for recording of the VEPs because
      some rats showed no N2 peak. The amplitude of peaks N1 to P at point E, upper the
      left optic layer of the superior colliculus, was higher than those from other
      points. Point E was the best position for recording of the VEP from dura in Slc:
      Wistar/ST rats.

PMID- 8354358
TI  - Characterization of mycoplasma strains isolated from house musk shrews (Suncus
      murinus) and their infectivity in mice and rats.
AB  - Five mycoplasma strains isolated from house musk shrews (Suncus murinus) in the
      Central Institute for Experimental Animals were characterized and compared with
      three murine mycoplasma strains, Mycoplasma pulmonis m 53, M. arthritidis PG6,
      and M. neurolyticum Type A, and with reference strain G3-5 previously isolated
      from a house musk shrew. These isolates fermented glucose, but did not hydrolyze
      urea and arginine, passed through membrane filters of 450 nm pore size, were
      sensitive to digitonin, and formed minute (115 to 231 microns in diameter)
      colonies on agar medium. All the five unclassified house musk shrew mycoplasma
      strains and strain G3-5 used as a reference constituted a homogeneous group based
      on (i) their antigenic properties (determined using the metabolism inhibition
      test), (ii) their polypeptide profiles (determined using sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and the Western blotting assay), and (iii)
      their genomic properties (determined using DNA cleavage pattern analysis), but
      were quite distinct from the established murine mycoplasmas on the basis of these
      findings. In a survey of 56 house musk shrews aged 2 to 45 weeks in our colonies,
      mycoplasmas were isolated from the oral cavities of all animals examined. No
      gross or microscopic lesions were observed in the five animals from which the
      mycoplasma strains were isolated. In experimental infection, the mycoplasma was
      not infective for mice and rats. The results suggest that this group of
      mycoplasmas is a common inhabitant of house musk shrews.

PMID- 8354359
TI  - Serological evidence of pneumonia virus of mouse (PVM) infection in laboratory
      rats.
AB  - PVM specific antibody was determined using 3 serological tests (Parker's original
      hemagglutination-inhibition [HI] test, modified HI test, and indirect fluorescent
      antibody [IFA] test). IFA test was found to be the most sensitive method, so that
      IFA test was considered to be the method of choice for a small scale
      microbiological monitoring in animal facilities. A total of 1,280 sera including
      rats, mice, hamsters and rabbits were tested for PVM antibody. The prevalence of
      PVM antibody was 17.2% (116/674) in conventional rats and 30.0% (160/200) in SPF
      rats obtained from commercial breeders and research facilities. Furthermore, two
      samples of 144 conventional rabbits (1.4%) were showed specific antibody positive
      to the virus. However, hamsters and mice showed no evidence of PVM infection.
      These results suggest that PVM infection is prevalent, especially in laboratory
      rats in Japan.

PMID- 8354360
TI  - Postnatal development of the auditory brainstem response (ABR) in beagles.
AB  - Postnatal development of the auditory brainstem response (ABR) in beagles was
      studied by repeated ABR recordings from birth to 16 weeks of age. In ABR
      recording, waves I, II and III appeared at the same time 13 to 17 days of age,
      while wave IV during 13 to 20 days of age and wave V during 20 to 35 days of age,
      respectively. The latencies of waves II, III and IV became close to the control
      level at 6 weeks of age, whereas wave I had a similar latency to the control at 3
      weeks of age. The latency of wave V became close to the control level at 8 weeks
      of age. I-III interpeak latency stabilized at 4 weeks of age, however, I-V and
      III-V interpeak latencies stabilized during 8 to 10 weeks of age. There was a
      marked individual difference in amplitude of ABR components in beagles. Wave I
      amplitude reached the plateau level at 3 weeks of age, and wave II, III and IV at
      6 weeks of age. No further development in ABR was observed on and after 10 weeks
      of age. It may be concluded, from electrophysiological point of view, that the
      peripheral auditory pathway matures at 3 weeks of age and the auditory rely
      system in brainstem at 10 weeks of age in beagles.

PMID- 8354361
TI  - Historical control data of organ weight and gross findings in F344/DuCrj rats and
      B6C3F1 mice.
AB  - Organ weight and gross postmortem findings of control Fischer 344/DuCrj rats and
      B6C3F1 mice are presented from subchronic, chronic toxicity and carcinogenicity
      studies that were conducted over a 9 year period at our center (An-Pyo Center).
      The mean organ weight of the liver, kidney, spleen and the lung were increased
      associated with age in both species. The most common findings observed at 109
      weeks in both species were thymic atrophy, enlargement of the spleen, dilation of
      the lumen of the uterus and ovarian cysts. Male and female Fischer 344/DuCrj rats
      commonly exhibited a granular surface of the kidneys, hypertrophy of and/or
      nodular pituitary glands and subcutaneous tissue masses. Multiple white patches
      and hypertrophy or atrophy of the testes, atrophy of the seminal vesicles and
      prostate and nodules in the pancreas were seen frequently in male rats.
      Malformative nodule in the liver was a common finding in female rats. The most
      common lesions seen in both male and female B6C3F1 mice were nodules in the liver
      and lungs and enlargement of the lymph nodes. Nodules on the preputial gland were
      commonly seen in the males. Sex differences were evident in the incidence of some
      of the above findings. These historical data will contribute to analyze the organ
      weight and gross findings at necropsy in long-term toxicity and carcinogenicity
      studies.

PMID- 8354362
TI  - Mortality, body weight, food and water consumption, and clinical signs in Slc:
      B6C3F1 (C57BL/6 x C3H) mice utilized in chronic toxicity and carcinogenicity
      studies.
AB  - In vivo historical control data for Slc: B6C3F1 mice, including mortality, body
      weight, food and water consumption, and clinical signs and which were obtained
      from long-term toxicity and carcinogenicity studies (11 male and 12 female
      studies) conducted at the Biosafety Research Center, Foods, Drugs and Pesticides,
      (An-Pyo Center) during the last five years are presented. Mean survival at 83 and
      109 weeks of age was 96.4% (min: 94.0%, max: 100%) and 79.0% (min: 74.0%, max:
      86.0%) in males and 98.7% (min: 96.0%, max: 100%) and 81.7% (min: 70.0%, max:
      90.0%) in females, respectively. The maximum mean body weight of males and
      females was 45.1 +/- 3.1 g (mean +/- S.D.) and 39.2 +/- 4.1 g, respectively. Male
      mice attained their maximum body weight at 72.7 +/- 4.3 weeks of age and females
      at 76.2 +/- 5.9 weeks of age. Clinical symptoms increased with age, particularly
      after week 84, and included: wasting, piloerection and palpable abdominal masses.
      Hypothermia and auricular pallor were common findings in moribund animals from
      week 79 to 104 of the studies. The use of in-house, historical control data can
      prove invaluable in the evaluation and interpretation of experimental results,
      especially in long-term and life-time studies.

PMID- 8354363
TI  - Comparison of electron irradiation diets and gamma irradiation diets for
      reproductive effects on rats.
AB  - Rats were maintained on 50 kGy electron irradiation diets. Effects of the diets
      on reproductive performance of parents and developmental performance of fetuses
      (F1 and F2) were studied by comparison with data in rats maintained on gamma
      irradiation diets, as control animals, and the background data of our facility.
      As the result, no specific changes were observed in the group maintained on
      electron irradiation diets. Electron irradiation diets sterilized under the
      condition of 50 kGy irradiation in the present study, as well as the existing
      gamma irradiation diets, were found to be useful for breeding and nursing rats.

PMID- 8354364
TI  - [Fine structure of the vomeronasal organ in the house musk shrew (Suncus
      murinus)].
AB  - Fine structure of the vomeronasal organ (VNO) was examined in an insectivore,
      house musk shrew (Suncus murinus), from a viewpoint of comparative anatomy. The
      VNO was a pair of tubular structure, about 6mm in length, and situated at the
      base of the nasal septum. The medial wall of the lumen of the VNO was lined with
      the sensory epithelium (SE) consisting of sensory, supporting and basal cells,
      while the respiratory epithelium (RE) lining the lateral wall was
      pseudostratified and covered with microvilli. Jacobson's glands were distributed
      on the dorsolateral to ventrolateral side of the VNO and opened to the lumen in
      the transitional region from the RE to the SE. Their secretion was PAS-positive
      bu talcian blue-negative. Ultrastructurally, sensory cells of the SE were bipolar
      neurons and covered on their free surface with conspicuously long microvilli. The
      other ultrastructural features in sensory, supporting and basal cells were
      similar to those in previously reported species. The ultrastructural features of
      the RE were also similar to those in previous reports except that the free
      surface was covered with microvilli instead of cilia. In addition, a few kinds of
      migrating cells were often observed in both the SE and the RE. Acinar cells of
      Jacobson's glands possessed a round to elliptical nucleus and many large
      secretory granules, about 1,000 nm in diameter. Rough endoplasmic reticulum and
      Golgi apparatus were well developed in their cytoplasm.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8354365
TI  - [Learning dysfunction model in ddY mouse and IgG].
AB  - Mice of the ddy strain having once received an electric shock in the dark chamber
      of a passive avoidance response unit were divided into two groups according to
      their behavior pattern. It is suggested that learning function of the mice which
      did not avoid the dark chamber (negative-avoidance mice: N-mice) was disturbed.
      After an injection of IgG obtained from the positive-avoidance mice (P-mice) into
      the N-mice, these prior N-mice displayed the behavior pattern similar to that of
      P-mice following an application of electric shock. It was found that the sugar
      chain structure of N-mouse IgG was different from that of P-mouse IgG. This
      result indicates that the sugar chain structure is related to the learning
      ability of ddy mice.

PMID- 8354366
TI  - [Lectin histochemical studies on the musk gland in the house musk shrew (Suncus
      murinus)].
AB  - The musk gland of the adult house musk shrews (Suncus murinus) of both sexes was
      studied lectin histochemically. The musk gland was a kind of scent gland,
      consisted of congregation of branched or unbranched simple tubuloalveolar gland
      holocrine in nature and was attached by an apocrine gland-like structure (sweat
      gland) in the deeper layer of its periphery. Acinar cells of the musk gland were
      distinguishable into three type from basal to luminal parts of the acinus;
      immature cells, mature cells and degenerating cells. There was no histological
      difference between both sexes. Lectin-binding pattern of the musk gland was
      examined in comparison with that of the sweat gland and ordinary sebaceous gland
      by histochemical staining techniques using seven lectins: ConA, RCA I, PNA, SBA,
      UEA-I, DBA, WGA, WGA and PNA labelled the duct of the musk gland more intense
      than the acinus. Several lectins showed a tendency to label the cells situated
      near the luminal surface more intense than those near the basement membrane in
      both the acinus and duct of the musk gland. In the sweat gland and ordinary
      sebaceous gland, the lectin-binding pattern was different with each other and
      from that in the musk gland. These findings suggest that the musk gland, sweat
      gland, and ordinary sebaceous gland are different to each other in nature of
      cells and the secretion.

PMID- 8354367
TI  - [Relative growth of physiques in laboratory-bred cynomolgus monkeys: a
      longitudinal study during the first 6 years of life].
AB  - Physical growth was studied longitudinally in laboratory-bred cynomolgus monkeys
      (Macaca fascicularis) aged from birth to 6.0 years in females and to 6.5 years in
      males. An allometric formula was applied to morphometrical growth data and the
      relative growth of each morphological site to anterior trunk length was analyzed.
      The growth patterns of all of the measurement sites in females and most of the
      sites in males showed monophasic allometry; while those of head length, head
      breadth and morphological upper face length in males were judged to show diphasic
      allometry. The growth patterns of morphological total face length, upper arm
      length and lower arm length in some males showed diphasic allometry.
      Morphological measurements with negative allometry were head length, head
      breadth, morphological total face length, total head height, biacrominal breadth
      hand length and foot length, while the other morphological measurements revealed
      isometry in both sexes. However, the values of the relative growth coefficient to
      anterior trunk length were larger in males than in females, except for in the
      case of biiliac breadth. These differences in growth patterns may cause the
      morphological differences between genders after sexual maturation in this primate
      species.

PMID- 8354368
TI  - Effects of soft X-ray irradiation on ocular development in Sprague-Dawley rats.
AB  - Pregnant rats were irradiated with soft x-rays at a dose of 1.6, 3.2, 6.3 or 12.6
      Gy on Day 9 of gestation, and the eyes of F1 offspring were examined using
      indirect ophthalmoscopy and biomicroscopy during Postnatal Week 5.
      Ophthalmoscopic examination revealed iris and choroidal coloboma, microphthalmia
      and anophthalmia in the 3.2, 6.3 and 12.6 Gy groups. In addition to those
      anomalies, lens luxation and associated anterior displacement of the vitreous
      face, and retinal vascular anomalies were observed in the 12.6 Gy group.
      Histological examination revealed agenesis of retinal vessels. Ophthalmoscopic
      examination using biomicroscopy and indirect ophthalmoscopy detected choroidal
      coloboma, lens and vitreous luxation and defect in retinal vessels which could
      not be detected by external observation, demonstrating the usefulness of this
      technique in the postnatal stage of teratology studies.

PMID- 8354369
TI  - [Comparison of sexual behavior patterns in small laboratory animals].
AB  - It is known that in the reproductive systems, aged-related changes are prominent.
      Similarly, in normal nonhuman primates and other mammals such as rats, various
      sexual activities of male and female decline with aging. The purpose of the
      present study was to clarify the pattern of sexual behavior in matured mice,
      voles, Syrian hamsters, rats, guinea pigs, rabbits and house musk shrews of both
      sexes, and to select the appropriate animals for studies of aged-related changes
      in sexual behavior. There were species differences among laboratory animals in
      the pattern of sexual behavior. In summary, hamsters and rats ejaculated about
      three times during 30 min, while mice did once during 10 hrs. The former animals
      showed the intromission and ejaculation within a few min and 10 min,
      respectively, the latter did the ejaculation a few hrs after introduction of a
      heat female. In female animals, rats displayed receptive and proceptive
      behaviors, while hamsters and guinea pigs did only receptive behavior. From the
      above results, rats of both sexes may be recommended for studies of aged-related
      changes in sexual behavior.

PMID- 8354370
TI  - Production of transgenic rats using pregnant and pseudopregnant rats prepared at
      a breeding farm.
AB  - We used pregnant and pseudopregnant Wistar-Imamichi rats, prepared at a breeding
      farm, for production of transgenic rats. The donor and recipient rats were
      transported to our facility for ova manipulation and embryo implantation,
      respectively. As a foreign gene, 1.9 kb of a hybrid gene was constructed with the
      rat renin promoter and chloramphenicol acetyltransferase-coding gene. Fertilized
      oocytes were collected from the donor and the foreign DNA was microinjected into
      the pronuclei of 539 oocytes by the method of Hochi. The manipulated oocytes were
      cultured to the 2-cell stage. One hundred seventeen 2-cell embryos were implanted
      in the recipient rats. Of 67 newborns, 55 rats grew up to be 3-week-old
      weanlings. Genomic DNA was extracted from the tail of these weanlings and
      examined by polymerase chain reaction analysis. Six transgenic rats were found to
      have been generated by the present method. In this way, transgenic rats were
      produced by an efficient combination of breeding farm utilization and laboratory
      research.

PMID- 8354371
TI  - [Cryopreservation of transgenic mouse embryos by ultrarapid freezing].
AB  - Two transgenic mice lines were produced by introducing the rat GH antisense
      transgene and the chicken beta-actin promoter/firefly luciferase hybrid gene in
      our laboratory. We cryopreserved the transgenic embryos, obtained by
      fertilization in vitro with the sperm of hemizygous males for the transgene, by
      the ultrarapid freezing. The survival rates of cryopreserved 2-cell embryos were
      high (> 70%) at thawing in both lines and 53% and 16% of cryopreserved 2-cell
      embryos, respectively, developed to live young after transferring to oviducts of
      recipients. Each transgene was detected at about 40% of the live young from two
      transgenic lines. These results indicated that the cryopreservation of embryos by
      ultrarapid freezing was valuable for sustaining transgenic mouse lines without
      genetic contaminations.

PMID- 8354372
TI  - [Comparison of glutathione peroxidase activity in erythrocytes and certain
      tissues between voles and mice].
AB  - Glutathione peroxidase (GSH-Px) activities in erythrocytes and certain tissues
      were investigated in herbivorous voles and C57BL/6J mice. In both voles and mice,
      GSH-Px activities in liver, kidney and erythrocyte were higher than those of the
      other tissues, such as adipose tissue, pancreas and skeletal muscle. Voles showed
      lower GSH-Px activities in liver, kidney, erythrocyte and brain compared with
      mice.

PMID- 8354373
TI  - Contraceptive efficacy of the diaphragm, the sponge and the cervical cap.
AB  - A reanalysis of data from two clinical studies--in which 1,439 women were
      randomly assigned to use either the contraceptive sponge or the diaphragm and
      1,394 women were randomly assigned to use either the cervical cap or the
      diaphragm--found first-year probabilities of failure during typical use of 17%
      for the sponge, 18% for the cervical cap and 13-17% for the diaphragm. The first
      year probabilities of failure during perfect use are 11-12% for the sponge, 10
      13% for the cervical cap and 4-8% for the diaphragm. The probability of failure
      during perfect use is significantly higher among women who have given birth than
      among those who have not for users of the sponge (19-21% vs. 9-10%) and users of
      the cervical cap (26-27% vs. 8-10%), but not for users of the diaphragm.

PMID- 8354374
TI  - Changes in adolescent males' use of and attitudes toward condoms, 1988-1991.
AB  - Data from more than 1,000 sexually active young males interviewed in 1988 for the
      National Survey of Adolescent Males at ages 15-19 and reinterviewed in 1990-1991
      at ages 17-22 show that as the respondents grew older, their condom use declined.
      Although respondents' attitudes about the effects of condoms on pregnancy risk,
      partner appreciation, sexual pleasure and embarrassment became more favorable
      toward condom use over time, their degree of worry about AIDS and their perceived
      likelihood of getting AIDS declined. When data on males aged 17.5-19 in each time
      period were contrasted, the level of condom use was found to be essentially
      constant. Several condom-related attitudes among this age-group had become more
      favorable, although their perceived risk of acquiring AIDS had diminished.
      Multivariate analyses revealed that decreased worry about AIDS and increased
      denial of the seriousness of AIDS were modestly associated with a decline in
      condom use. Change in condom use was also affected by change in perceived
      reduction in sexual pleasure and by female partner's appreciation of condom use.

PMID- 8354375
TI  - Exploring norms and beliefs related to AIDS prevention among California Hispanic
      men.
AB  - A focus-group study gathered qualitative information from Hispanic males in
      California regarding ethnic factors that might enhance or interfere with AIDS
      prevention efforts. A predominantly working-class convenience sample of 75 men
      aged 18-40 participated in seven groups of 10-12 participants each. Three groups
      were composed of single men, three of married men and one was composed of
      homosexual and bisexual men. Four groups included only participants born outside
      the United States; and Spanish was the preferred language in five of the groups.
      Evaluation of the discussions indicates that while AIDS awareness is high among
      this population, condom use is sporadic. Few participants knew that someone
      infected with the human immunodeficiency virus could appear healthy; most
      believed they could easily determine if a woman is risky by her appearance or
      social standing. Although many participants thought HIV could be transmitted
      through casual contact, the homosexual and bisexual men were more likely to
      acknowledge that they were at some risk of infection; most of the heterosexual
      men did not perceive themselves as being at risk, even those who engaged in sex
      with prostitutes or women they met at bars. The participants had ambivalent
      attitudes toward women who suggested condom use and were often reluctant to
      initiate condom use themselves. Religion did not seem to play a major role in the
      men's attitudes about AIDS, sexuality and condom use.

PMID- 8354376
TI  - Measuring public attitudes on abortion: methodological and substantive
      considerations.
AB  - Data from a 1989 CBS News/New York Times survey are used to examine the effect
      that the framing of questions on abortion has on estimates of what proportions of
      the population support various legal positions. The nationwide data and results
      from six state polls show that general questions with only two or three options
      overestimate the proportions of respondents who either favor a ban on all
      abortion or who would allow abortion under all circumstances. Questions that pose
      specific circumstances result in movement of respondents out of extreme
      categories and into more moderate ones. Even respondents who indicate they would
      favor abortion in all specific circumstances and those who favor abortion in none
      are likely to moderate their views when asked if they support restrictions that
      have been proposed in a number of states.

PMID- 8354377
TI  - Teenage abortion, birth and pregnancy statistics by state, 1988.

PMID- 8354378
TI  - Questions of balance: issues emerging from the introduction of the hormonal
      implant.

PMID- 8354379
TI  - Vasectomy and prostate cancer: more questions than answers.

PMID- 8354380
TI  - Do school-based clinics reduce birthrates?

PMID- 8354381
TI  - Do school-based clinics reduce birthrates?

PMID- 8354382
TI  - In vitro biosynthesis of lactase in suckling and adult rabbits. Regulatory
      mechanisms involved in the decline of the lactase activity.
AB  - Steady state forms, levels and the in vitro biosynthesis of lactase-phlorizin
      hydrolase (LPH) proteins have been studied in proximal and middle intestine of
      suckling and adult rabbits. In most adult tissues the lactase activity and the
      LPH protein content were low and the synthesis rate of the 200 kDa lactase
      precursor was reduced in comparison to suckling tissues. In a few tissues with
      low enzymatic activity the LPH protein content was relatively high, and high
      lactase synthesis occurred. In addition, the ratio (labeled lactase)/(lactase
      protein) was lower in the middle jejunum of the adult rabbit than in the proximal
      region. Both decreased synthesis of LPH precursor and increased turnover or
      inactivation of the enzyme may cause the decline of the lactase activity.

PMID- 8354383
TI  - Ruptured erythrocytes inhibit the oxidation of membranes by 15-hydroperoxy
      eicosatetraenoic acid.
AB  - In this study, the pro-oxidant effects of the hydroperoxide, 15-hydroperoxy
      eicosatetraenoic acid (15-HPETE), on erythrocyte membranes and the modulation of
      the oxidation by haem proteins released from ruptured erythrocytes have been
      assessed. The results indicate that ruptured erythrocytes may act as an
      antioxidant in protecting membranes against oxidative stress induced by
      hydroperoxides and that it is the oxyhaemoglobin that is the active constituent
      of the protective mechanism. An important feature of the mechanism is the
      peroxidatic action of oxyhaemoglobin and its rate of reaction with 15-HPETE.

PMID- 8354384
TI  - The complete amino acid sequence of a thrombin-like enzyme/gyroxin analogue from
      venom of the bushmaster snake (Lachesis muta muta).
AB  - The complete amino acid sequence of a thrombin-like enzyme with gyroxin activity
      isolated from the venom of the bushmaster snake Lachesis muta muta was determined
      by automated and DABITC/PITC microsequencing of the intact protein; fragments
      derived from it by separate cleavages with cyanogen bromide, iodosobenzoic acid
      and hydroxylamine; and peptides resulting from enzymatic digestions with trypsin,
      pepsin, chymotrypsin, and elastase. The protein, which is composed of 228
      residues, contains four putative sites of N-linked glycosylation and exhibits
      significant sequence similarities with other serine proteases reported from snake
      venoms.

PMID- 8354386
TI  - Altered substrate selectivity of PKC-eta pseudosubstrate site mutants.
AB  - Three protein kinase C (PKC)-eta mutants were constructed in which the whole or
      part of the pseudosubstrate site was replaced with corresponding parts of the PKC
      alpha pseudosubstrate site. The resulting chimaeric kinases were compared with
      wild-type PKC-eta in their ability to phosphorylate a PKC-eta peptide substrate
      or histone. Changes in the pseudosubstrate site of PKC-eta are accompanied by
      changes in substrate selectivity, indicating that the substrate selectivity
      observed for PKC-eta is at least in part due to its pseudosubstrate site.

PMID- 8354385
TI  - A synthetic peptide of the N-terminus of ADP-ribosylation factor (ARF) inhibits
      regulated exocytosis in adrenal chromaffin cells.
AB  - We have investigated the role of ADP-ribosylation factor (ARF) in regulated
      exocytosis in digitonin-permeabilized adrenal chromaffin cells by the use of a
      synthetic peptide, hARF1(2-17), based on the N-terminus of the protein. hARF1(2
      17) inhibited Ca(2+)-dependent but not basal exocytosis, whereas equimolar levels
      of other synthetic peptides were ineffective. The inhibitory effect of hARF1(2
      17) was dose-dependent and half-maximal at 12 microM. GTP gamma S-induced
      secretion in the presence of non-stimulatory CA2+ concentrations was also
      inhibited by hARF1(2-17). These results point to a hitherto unsuspected role for
      ARF in regulated exocytosis, and the potency of the hARF1(2-17) peptide suggests
      that ARF is essential for exocytosis in bovine adrenal chromaffin cells.

PMID- 8354387
TI  - Determination of renal clearance of neopterin by a pharmacokinetic approach.
AB  - Pharmacokinetic modelling was used to determine the glomerular filtration rate
      and tubular secretion of neopterin, a marker for cellular immune activation. The
      method involves parameter identification employing the transient venous plasma
      concentration profiles of marker substances. By combined i.v. injection of
      neopterin and inulin which is excreted exclusively via glomerular filtration,
      neopterin was shown to be excreted in addition to glomerular filtration, by
      tubular secretion: clearance of inulin, 112 (S.D. 2.2) ml/liter; clearance of
      neopterin, 499 (S.D. 79.7) ml/min. A pilot experiment using in addition p-amino
      hippuric acid suggests that neopterin and p-amino hippuric acid may employ the
      same carrier system for tubular secretion.

PMID- 8354388
TI  - Human insulin gene enhancer-binding proteins in pancreatic alpha and beta cell
      lines.
AB  - Electrophoretic mobility shift assays were performed using oligonucleotides
      corresponding to known protein binding sites within the human insulin gene
      enhancer and nuclear extracts from mouse pancreatic alpha and beta cell lines.
      The results demonstrate that a previously described factor, IUF-1, binds to three
      sites at -82 (the CT1 box), -215 (the CT2 box), and -319 (the CT3 box) in the
      human insulin gene enhancer. IUF-1 was present only in beta but not in alpha
      cells, while all other DNA-binding proteins were present in both cell lines. IUF
      1 may therefore be an important determinant of insulin gene beta cell-specific
      expression.

PMID- 8354389
TI  - Pseudo-symmetrical difluoroketones. Highly potent and specific inhibitors of HIV
      1 protease.
AB  - A series of novel, pseudo-symmetrical difluoroketones which are highly potent
      inhibitors of the HIV-1 protease (IC50 = 1.55-0.02 nM) were synthesized. These
      compounds also possess good antiviral activity by inhibition of the cytopathic
      effect of HIV-13B in MT-4 cells in vitro.

PMID- 8354390
TI  - Cloning of a human liver UDP-glucose pyrophosphorylase cDNA by complementation of
      the bacterial galU mutation.
AB  - A human liver cDNA clone which encodes the UDP-glucose pyrophosphorylase was
      isolated by complementation of a bacterial galU mutant. The deduced amino acid
      sequence of the human enzyme comprised 508 amino acids with a calculated
      molecular mass of 56,950. The human enzyme significantly resembles those of
      potato tuber and slime mold with a homology of 46.6% and 43.2%, respectively, in
      amino acid sequence. No homology was found between the eukaryotic and the
      prokaryotic enzymes. Northern blotting analysis revealed that the gene was
      expressed at the highest level in skeletal muscle, followed by liver, heart and
      kidney.

PMID- 8354391
TI  - Mutations in beta-actin: influence on polymer formation and on interactions with
      myosin and profilin.
AB  - Two beta-actin mutants, one with proline 38 replaced with alanine (P38A) and the
      other with cysteine-374 replaced with serine (C374S), as well as the wild-type
      beta-actin, were expressed in the yeast, S. cerevisiae, purified to homogeneity,
      and analyzed in vitro for polymerizability and interaction with DNase I, myosin,
      and profilin. Both mutations interfered with the polymerization of the actin, and
      with its interaction with myosin. The C374S mutation had the most pronounced
      effect; it reduced the polymerizability of the actin, abolished its binding to
      profilin, and filaments containing this mutation moved at reduced rates in the in
      vitro 'motility assay'. The ATPase activity measured in solutions containing
      myosin subfragment 1 was similar for both the mutant and wild-type actins.

PMID- 8354392
TI  - Skin L-tryptophan-2,3-dioxygenase and rat hair growth.
AB  - We have identified a new enzyme, skin L-tryptophan-2,3-dioxygenase (skin TDO),
      that catalyzes the degradation of L-tryptophan into formylkynurenine in rats. The
      rate of this degradation peaks in all rats at 5 to 6 weeks after birth, and also,
      among rats depilated at 8 weeks old, at 10 to 11 weeks after birth. We have also
      observed that the properties of this enzyme are closer to those of hepatic L
      tryptophan-2,3-dioxygenase (hepatic TDO) than to indoleamine 2,3-dioxygenase.
      Although an intraperitoneal injection of L-tryptophan increased the activity of
      skin TDO to approximately 2.2 times greater than control values, an
      intraperitoneal injection of hydrocortisone and alpha-methyl-DL-tryptophan, both
      compounds known to affect hepatic TDO activity, had no effect on skin TDO
      activity. The molecular weight of skin TDO was estimated to be 16.0 kDa, which is
      close to the molecular weight of hepatic TDO, yet a much larger molecule than
      indoleamine-2,3-dioxygenase. Increased hair growth rates paralleled increased
      levels of skin TDO activity in 5- to 6-week-old rats, and marked increases in the
      activity of skin TDO occurred 2 or 3 weeks after depilation. Enzyme activity was
      also greatest 2 days before the time of maximum hair root length. Therefore, skin
      TDO may play an important role in the initiation or suppression of rat hair
      growth.

PMID- 8354393
TI  - Elongation in a Dictyostelium in vitro translation system is affected by
      calmodulin antagonists.
AB  - We have previously shown that the Dictyostelium discoideum ribosomal protein L19
      specifically binds Ca2+/calmodulin [Sonneman et al. (1991) J. Biol. Chem. 266,
      23091-23096]. To investigate the role of calmodulin in the regulation of protein
      synthesis, we have now established an in vitro protein synthesizing system from
      Dictyostelium cells which can elongate polypeptide chains with high efficiency.
      Various calmodulin antagonists affected translation in this system. The
      inhibitory effects of the antagonists could be partially reversed by addition of
      calmodulin. A monoclonal antibody against D. discoideum calmodulin also
      specifically inhibited protein synthesis. Similar effects of calmodulin
      antagonists were found in a standard wheat germ in vitro translation system.

PMID- 8354394
TI  - Up-regulation of system A activity in the regenerating rat liver.
AB  - System A activity for neutral amino acid transport, measured as the MeAIB
      sensitive Na(+)-dependent L-alanine uptake, is induced 6 h after partial
      hepatectomy in plasma membrane vesicles from rat livers. Other Na(+)-dependent
      transporters, like system ASC (MeAIB-insensitive Na(+)-dependent L-alanine
      transport) and the nucleoside carrier show similar inductions. Up-regulation of
      system A is not explained by changes in the dissipation rate of the Na+
      transmembrane gradient, as deduced from uptake measurements performed in the
      presence of monensin. To determine whether induced system A shared any similarity
      with the activity found in hepatoma cell lines, we analyzed the N-ethylmaleimide
      (NEM) sensitivity of system A in both regenerating and control rat liver plasma
      membrane vesicles. NEM treatment was equally effective in inhibiting system A in
      both experimental groups. Thus, during the prereplicative phase of liver growth,
      a transport activity similar to basal system A is up-regulated in liver
      parenchymal cells, by a stable mechanism that does not involve changes in the Na+
      transmembrane gradient.

PMID- 8354395
TI  - Evidence for a distinct H7-resistant form of protein kinase C in rat anterior
      pituitary gland.
AB  - Inhibition of phorbol 12,13-dibutyrate-induced protein kinase C (PKC) activity
      from rat midbrain, anterior pituitary and a number of other tissues, as well as
      COS 7 cells, was studied in vitro. In anterior pituitary, Ca(2+)-independent
      activity was notably resistant to H7 but sensitive to staurosporine and Ro 31
      8220. All Ca(2+)-dependent activity was sensitive to these three inhibitors.
      Mezerein and 1,2-dioctanoyl-sn-glycerol also activated this H7-insensitive PKC
      from anterior pituitary. The distribution of this activity, prominently expressed
      in pituitary and perhaps also lung, and its characteristic resistance to H7 but
      not other inhibitors, does not obviously correlate with that of any of the well
      characterised PKCs, and may reflect either a novel or a modified isoform.

PMID- 8354396
TI  - Kinetics of glucose oxidase catalyzed electron transfer mediated by sulfur and
      selenium compounds.
AB  - Unusually high electron transfer rates in Aspergillus niger glucose oxidase
      catalyzed oxidation of glucose using 5,6:11,12-Bis(dithio)tetracene (TTT), 1,2
      dimethyltetraselenafulvalene (DMTSF) and tetrathiafulvalene (TTF) were observed.
      At pH 7.0 oxidation rate constants (TN/Km) in the range from 1.0.10(7) to
      8.7.10(7) M.s-1 were deduced from experimental data. One of the investigated
      mediators, DMTSF, has been used for electrocatalytical glucose oxidation on
      graphite at a potential of 0.3 V vs. a standard calomel electrode (SCE). The
      prepared bioelectrodes have a sensitivity of 1.3 microA/(cm2.mM), a pH optimum at
      6.5-7.0, and a linear range which covers the relevant range for monitoring
      physiological levels of glucose. The bioelectrodes are stable for more than one
      month.

PMID- 8354397
TI  - Ionic bases of the membrane potential and intracellular pH changes induced by
      speract in swollen sea urchin sperm.
AB  - Signal transduction initiated by the egg peptide, speract, in sea urchin sperm is
      not fully understood. Hypotonically swollen sperm are a suitable model to study
      peptide signal transduction. Ion substitution experiments now indicate (i) that
      the permeability to Na+, Ca2+, and Mg2+ contributes to the sperm resting membrane
      potential; (ii) the repolarization induced by nM concentrations of speract is Na+
      dependent and mediated by an as yet unidentified channel; (iii) the
      depolarization triggered by nM concentrations of speract involves Ca2+ channels
      since it is Ca(2+)-dependent and blocked by Co2+ and Ni2+, two Ca2+ channel
      blockers; (iv) hyperpolarizing swollen sperm with valinomycin increases
      intracellular pH (pHi) in the same way as speract, thus the speract-induced
      hyperpolarization may be responsible for the pHi increase.

PMID- 8354398
TI  - High molecular weight aspartic endopeptidase generates a coronaro-constrictory
      peptide from the beta-chain of hemoglobin.
AB  - Studying the influence of brain cathepsin D (EC 3.4.23.5) and high molecular
      weight (HMW) aspartic endopeptidase (EC 3.4.23.-) on the processing of
      hypothalamic calmodulin-binding coronaro-constrictory peptide factors from the
      beta-chain of globin it was found that only HMW aspartic endopeptidase generates
      the fragment 31-40 of the beta-chain of bovine hemoglobin (Hb) by cleavage of the
      Leu30-Leu31 and Phe40-Phe41 bonds. Digestion of the beta-chain of globin was
      performed at 37 degrees C at an enzyme/substrate ratio of 1:80 at pH 3.5 using
      different times of incubation (from 4 h to 10 h). The resulting peptides were
      separated by reversed-phase high-performance liquid chromatography (HPLC) and
      then identified by amino acid analysis and Edman degradation. The differences in
      specificity and activity of these two brain aspartic proteinases could be
      explained by their different structural features. Our finding provides evidence
      for a different biological function of these two enzymes. Data obtained give us
      reason to suppose that HMW aspartic proteinase probably can participate in the
      processing of the coronaro-constrictory peptide in vivo by limited proteolysis of
      Hb or Hb-like protein.

PMID- 8354399
TI  - The C-terminal region of the S component of staphylococcal leukocidin is
      essential for the biological activity of the toxin.
AB  - The Staphylococcal toxin leukocidin consists of two protein components, F and S.
      From a culture medium of Staphylococcus aureus RIMD 310925, we isolated a
      truncated form of S (LS2), of which the C-terminal 17-residue segment is missing.
      Unlike intact S, LS2, showed neither leukocytolytic activity in the presence of F
      nor affinity for monosialoganglioside GM1 (GM1). When excited at 280 nm, both S
      and LS2 exhibited intrinsic tryptophan fluorescence with an emission maximum at
      318 nm. Upon binding to GM1, the emission maximum of S underwent a blue shift to
      310 nm, whereas no change in fluorescence took place on mixing GM1 with LS2. We
      conclude that the C-terminal region of S is essential for its biological activity
      as well as for its binding to GM1 and that this binding is accompanied by a
      conformational change of the S protein.

PMID- 8354400
TI  - Receptor phage. Display of functional domains of the human high affinity IgE
      receptor on the M13 phage surface.
AB  - In this paper we demonstrate that phage display technology is a suitable system
      for studying the interaction between the high-affinity receptor for IgE (Fc
      epsilon RI) and IgE. The alpha subunit extracellular domains of the human
      receptor were expressed on the surface of filamentous phage M13 fused to the
      carboxyl-terminal part of the gene III protein (pIII). Two constructs were made,
      the first with both the Ig-like domains of the receptor alpha chain and the
      second with only the C-terminal domain. The fusion genes were cloned in a
      phagemid vector to display monovalently the receptor on the phage surface. Our
      results indicate that the alpha receptor expressed on the phage is able to
      interact with IgE as demonstrated by an ELISA assay. In addition, by using the
      same system, we show that a single domain of the alpha receptor is sufficient for
      the interaction with IgE although with a binding affinity lower than that of the
      two-domain receptor.

PMID- 8354401
TI  - A rapid and efficient purification method for recombinant annexin V for
      biophysical studies.
AB  - Annexin V binds in a calcium-dependent manner to acidic phospholipids and
      exhibits ion channel activity in vitro. We are investigating mutants of annexin V
      by single channel measurements, X-ray crystallography and electron microscopy in
      order to understand the structure-function relationships of the ion channel
      activity. We describe here a method to obtain very pure recombinant annexin V
      required for such studies. The initial step is the mild opening of the bacterial
      cells by an osmotic shock. In the purification procedure, use is made of the
      reversible calcium-mediated binding of annexin V to liposomes. In the last
      purification step the protein is subjected to ion-exchange chromatography and
      elutes as a single peak free of any detectable contaminants.

PMID- 8354402
TI  - Structure of three acidic O-linked carbohydrate chains of porcine zona pellucida
      glycoproteins.
AB  - Structural analysis by 1D and 2D 1H NMR spectroscopy of three acidic O-linked
      oligosaccharide alditols, released from porcine zona pellucida glycoproteins by
      alkaline borohydride treatment, afforded the following structures: Gal beta 1
      4(6SO4)GlcNAc beta 1-3Gal beta 1-4GlcNAc beta 1-3Gal beta 1-3GalNAc- ol Neu5Gc
      alpha 2-3Gal beta 1-4(6SO4-)GlcNAc beta 1-3Gal beta 1- 4GlcNAc beta 1-3Gal beta 1
      3GalNAc-ol Neu5Ac alpha 2-3Gal beta 1-4(6SO4-)GlcNAc beta 1-3Gal beta 1-4GlcNAc
      beta 1- 3Gal beta 1-3GalNAc-ol These oligosaccharides are the smallest compounds
      that contain the structural elements which are present in the acidic, high
      molecular mass O-linked carbohydrate chains of porcine zona pellucida
      glycoproteins.

PMID- 8354403
TI  - Two-step epoxidation of hyoscyamine to scopolamine is catalyzed by bifunctional
      hyoscyamine 6 beta-hydroxylase.
AB  - In several solanaceous plants, hyoscyamine is first hydroxylated at the 6 beta
      position, and then epoxidized to scopolamine. We expressed hyoscyamine 6 beta
      hydroxylase (H6H) in Escherichia coli as a fusion protein with maltose-binding
      protein. The crude cell extract from the bacterium that expressed the soluble
      fusion protein showed a strong hydroxylase activity and a weak epoxidase
      activity. When 100 microM of hyoscyamine was fed to the recombinant bacterium,
      the alkaloid was first converted to 6 beta-hydroxy hyoscyamine, and then to
      scopolamine, which was almost the only alkaloid found in the culture after one
      week. Therefore, H6H catalyzes two consecutive reactions that oxidize hyoscyamine
      to scopolamine.

PMID- 8354404
TI  - Peptide synthesis by chymotrypsin in frozen solutions. Free amino acids as
      nucleophiles.
AB  - Nucleophilic efficiency of the free amino acids in chymotrypsin-catalyzed acyl
      transfer in ice at -18 degrees C using ethyl esters of N-maleyl-L-tyrosine and L
      tyrosine as the acyl group donors has been studied. Although the amino acids did
      not act as acyl acceptors in liquid water, the high yields of peptides were
      obtained in frozen solutions at pH 10.5 (before freezing). The efficiency of
      amino acids in the formation of the corresponding dipeptides depended on the
      substrate used, and decreased in the order Ser,Thr,Gln > Lys > Cit > Ala > Ala >
      Gly > Asn > Arg > Glu > Val > Orn > Asp with no peptide formed with His, Leu, Ile
      and Pro) for N-maleyl-L-tyrosine ethyl ester and Ser > Lys > Orn > Arg,Cit > Gln
      > Thr > Asn > Ala > Gly (with no peptide formed with Glu, Val, Asp, His, Leu, Ile
      and Pro) for L-tyrosine ethyl ester.

PMID- 8354405
TI  - Metribuzin resistance in photoautotrophic Chenopodium rubrum cell cultures.
      Characterization of double and triple mutations in the psbA gene.
AB  - Sequence analysis of eight metribuzin-resistant mutants of photoautotrophic
      Chenopodium rubrum cell cultures revealed new mutations in the psbA gene coding
      for the 32 kDa herbicide binding protein. Mutants were found to possess either
      two or three changes in the amino acid sequence of the D1-protein between
      positions 219 and 272.

PMID- 8354406
TI  - Yeast mitochondrial ATP-dependent protease: purification and comparison with the
      homologous rat enzyme and the bacterial ATP-dependent protease La.
AB  - Homogenous ATP-dependent protease has been isolated for the first time from
      mitochondria of yeast Saccharomyces cerevisiae. The enzyme molecule consists of
      six 120 kDa subunits. It is a serine protease with an absolute ATP requirement
      for its activity. Basic enzymatic characteristics of the yeast protease are
      similar to those of the corresponding rat mitochondrial enzyme and of the E. coli
      protease La. The yeast enzyme immunochemically cross-reacts with the bacterial
      protease La.

PMID- 8354407
TI  - High-resolution XANES studies on vanadium-containing haloperoxidase: pH
      dependence and substrate binding.
AB  - High-resolution X-ray absorption vanadium K-edge spectra were recorded for
      samples of vanadium-containing bromoperoxidase from the brown alga, Ascophyllum
      nodosum, at pH 9, 7, 5 and 4, as well as for enzyme samples containing the
      substrates, hydrogen peroxide and bromide. The well-resolved features of the
      XANES spectra are discussed. The pH-dependence of the structure of the active
      site has been studied revealing no significant change of the absorption features.
      We were able to detect an interaction of H2O2 with the vanadium site of the
      bromoperoxidase using XAS spectroscopy, whereas addition of bromide causes no
      energy shift of the XANES spectrum. The possible role of vanadium during the
      enzymatic reaction is discussed on the basis of our results.

PMID- 8354408
TI  - Trehalose-6-phosphate, a new regulator of yeast glycolysis that inhibits
      hexokinases.
AB  - Trehalose-6-phosphate (P) competitively inhibited the hexokinases from
      Saccharomyces cerevisiae. The strongest inhibition was observed upon hexokinase
      II, with a Ki of 40 microM, while in the case of hexokinase I the Ki was 200
      microM. Glucokinase was not inhibited by trehalose-6-P up to 5 mM. This
      inhibition appears to have physiological significance, since the intracellular
      levels of trehalose-6-P were about 0.2 mM. Hexokinases from other organisms were
      also inhibited, while glucokinases were unaffected. The hexokinase from the
      yeast, Yarrowia lipolytica, was particularly sensitive to the inhibition by
      trehalose-6-P: when assayed with 2 mM fructose an apparent Ki of 5 microM was
      calculated. Two S. cerevisiae mutants with abnormal levels of trehalose-6-P
      exhibited defects in glucose metabolism. It is concluded that trehalose-6-P plays
      an important role in the regulation of the first steps of yeast glycolysis,
      mainly through the inhibition of hexokinase II.

PMID- 8354409
TI  - A role for iron in transcriptional activation by FNR.
AB  - FNR is a transcriptional regulator which controls the expression of target genes
      in response to anoxia in Escherichia coli. The mechanism by which FNR senses and
      responds to anaerobiosis is unknown but indirect evidence suggests that an iron
      cofactor is involved. Using KMnO4 as a probe for DNA melting at active promoters,
      footprinting studies have now shown that the ferrous iron chelator, ferrozine,
      inhibits open complex formation in vivo, and that FNR with a high iron-content is
      essential for open complex formation in vitro. Since open complex formation is an
      essential pre-requisite for transcription, it is concluded that transcriptional
      activation by FNR is mediated by a ferrous iron cofactor.

PMID- 8354410
TI  - Molecular mechanism of inhibition of mammalian protein synthesis by some four
      chain agglutinins. Proposal of an extended classification of plant ribosome
      inactivating proteins (rRNA N-glycosidases).
AB  - The four chain agglutinins from Abrus precatorius, Viscum album and Ricinus
      communis promote depurination of the 28 S rRNA from rabbit reticulocyte ribosomes
      characteristic of the common ribosome-inactivating proteins (RIPs). These
      agglutinins inhibited mammalian protein synthesis at nanomolar concentrations but
      they do not affect plant protein synthesis under the same conditions. Therefore,
      they should also be considered as true RIPs but of a new class, the four-chain
      RIPs. An extended classification of RIPs is presented based on the former one
      from Stirpe et al. [Bio/technology 10 (1992) 405-412].

PMID- 8354411
TI  - Arachidonic acid abolishes the mitogen-induced increase in cytosolic free Ca2+
      and intracellular pHi in rat thymocytes.
AB  - The effects of arachidonic acid (AA) and the lectin mitogens, concanavalin A (Con
      A) and phytohemagglutinin (PHA), on [Ca2+]i and pHi in rat thymocytes have been
      studied by using the intracellular fluorescent probes, Fura-2 and BCECF. It was
      revealed that exogenous AA (3 microM), in addition to the well-known changes in
      basal [Ca2+]i and pHi, also caused a complete blockade of [Ca2+]i and pHi signals
      induced by Con A (10 micrograms/ml) and PHA (10 micrograms/ml). In contrast,
      exposure of thymocytes to mitogens did not prevent the AA-induced increase in
      [Ca2+]i and decrease in pHi. In experiments with sodium propionate, the
      similarity between AA action and EIPA (ethylisopropylamiloride), an inhibitor of
      Na+/H+ exchangers, was revealed. It is proposed that the inhibitory effect of AA
      on mitogen-induced lymphocyte proliferation is due primarily to the blockade of
      transmembrane [Ca2+]i and pHi signals, associated with a sustained cytosolic
      acidification.

PMID- 8354412
TI  - Identification of a novel high-affinity binding site for N
      acetylchitooligosaccharide elicitor in the membrane fraction from suspension
      cultured rice cells.
AB  - Binding experiments using a 125I-labeled tyramine conjugate of N
      acetylchitooctaose, a highly potent elicitor for the induction of phytoalexin
      production in rice cells, and a microsomal membrane preparation from suspension
      cultured rice cells showed the presence of a novel high-affinity binding site for
      this oligosaccharide. The binding of the ligand was saturable and the Scatchard
      plot analysis of the results indicated the presence of a single class of binding
      site with a Kd of 5.4 nM which is comparable with that reported for the binding
      of the hepta-beta-glucoside elicitor in soybean membrane. The ligand binding was
      inhibited by unlabeled N-acetylchitoheptaose but not by its deacetylated form.
      These characteristics of this binding site coincide well with the specificity and
      sensitivity for the elicitor in several assay systems, suggesting the possible
      involvement of this binding site in the recognition of the elicitor in vivo.

PMID- 8354413
TI  - Association of annexin V with mitochondria.
AB  - Annexin V is an intracellular protein recently shown to be localized to nucleoli
      and cytosol. In this study we show that cytosolic annexin V is associated with
      mitochondria. To assess the nature of the annexin V-mitochondrial interaction, an
      annexin V binding activity was partially purified from placental cytosol by
      annexin V-affinity chromatography. Five polypeptides in the eluate appeared to be
      associated with annexin V, with a predominant species of 27 kDa. Antibodies to
      the 27 kDa polypeptide recognised mitochondria but not nucleoli. We conclude that
      annexin V interacts with a 27 kDa mitochondrial polypeptide that is possibly part
      of a larger complex.

PMID- 8354414
TI  - Use of bimanyl actin derivative (TMB-actin) for studying complexation of beta
      thymosins. Inhibition of actin polymerization by thymosin beta 9.
AB  - By reacting trimethylammoniobromobimane bromide (TMB bromide) with rabbit muscle
      actin, a fluorescent reporter group was linked to cysteine at position 374.
      Fluorescence of TMB-actin decreased significantly on addition of thymosin beta 4
      (T beta 4), a peptide of 43 amino acid residues reported to bind to monomeric
      actin and to prevent filament formation. Based on this effect, we determined the
      KD value of the thymosin beta 4 complex as 0.8 microM, a value that is in
      agreement with previous determinations. In addition to the main compound thymosin
      beta 4, bovine tissue contains a related peptide, thymosin beta 9 (T beta 9),
      which has 41 amino acid residues and ca. 75% sequence homology. In the present
      study we show for the first time that T beta 9, similar to T beta 4, forms a 1:1
      complex with monomeric actin, and hereby inhibits actin polymerization. With a KD
      value of 1.1 microM the affinity of T beta 9 is in the same range as that of T
      beta 4, suggesting that T beta 9, like T beta 4, contributes to maintaining the
      pool of monomeric actin in bovine non-muscle cells. Further proof of the
      interaction of T beta 9 with actin was provided by native PAGE, where the complex
      showed the reported higher mobility, as well as by crosslinking experiments.
      Using different crosslinking reagents, like water-soluble carbodiimide (EDC), m
      maleimidobenzoyl-N-hydroxysuccinimidate (MBS), and disuccinimidylsuberate (DSS),
      we were able to produce conjugates of 47 kDa. In one of these (from MBS) both
      actin and T beta 9 could be identified by immunoblotting. When, in the MBS
      crosslinking experiments, native actin was replaced with (374-NEM)-actin, the 47
      kDa band was not seen, indicating that Cys-374 takes part in the thiol-specific
      crosslinking reaction. This suggests that part of the binding site of T beta 9
      must be located close to the carboxy-terminus.

PMID- 8354415
TI  - Cell-specific expression of Gq/11 protein and mRNA in rat seminiferous tubules.
AB  - As part of a study to elucidate the involvement of G proteins in signal
      transduction in testicular cells, we have examined the cellular localization of
      Gq/11 within the seminiferous tubules. The somatic cells (Sertoli cells,
      peritubular cells) contain high amounts of both Gq/11 alpha mRNA and
      immunoreactive protein. In contrast, very low levels of these G proteins and the
      corresponding mRNAs are present in the germ cells (pachytene spermatocytes, round
      spermatids). Thus, in the germ cells, receptor-regulated inositol phospholipid
      hydrolysis is not likely to be regulated via Gq/11, but rather through the Go
      protein, which has been previously shown to be abundant in rat germ cells. Since
      the somatic cells are nearly devoid of Go, the Gpp(NH)p-stimulated phospholipase
      C in these cells is probably regulated by Gq and/or G11.

PMID- 8354416
TI  - Nephrotic syndrome associated with Schistosoma mansoni infection.
AB  - A case of nephrotic syndrome in which Schistosoma mansoni infection associated
      with membranoproliferative glomerulonephritis type 1 is reported. In endemic
      areas glomerulopathy secondary to Schistosoma mansoni has been described.
      Although not commonly seen in mainland United States, Schistosoma mansoni
      infection should be considered in the differential diagnosis of proteinuria in
      persons who have visited or are from endemic regions.

PMID- 8354417
TI  - Fatal injury surveillance report, Delaware, 1990. Head and spinal cord injuries.
AB  - The Delaware Disabilities Prevention Program is funded through a five-year
      Centers for Disease Control and Prevention (CDC) grant to prevent primary and
      secondary disabilities associated with mental retardation and low socioeconomic
      status; head and spinal cord injuries; and sickle cell disease. This report
      focuses on fatal head and spinal cord injuries. Death certificates and autopsy
      reports from 1990 were the data sources used for this study. In 1990, 122 fatal
      head injuries and 20 fatal spinal cord injuries occurred among Delaware
      residents. Eight of these individuals experienced both head and spinal cord
      injuries. Motor vehicle crashes caused the majority of both head and spinal cord
      deaths. Suicides, homicides, and falls were the other major causes of fatal head
      injuries. Deaths are only the tip of the injury iceberg. Head and spinal cord
      injuries can cause lifelong disabilities affecting family, friends, and the
      entire community.

PMID- 8354418
TI  - Sexual misconduct in the physician-patient relationship.

PMID- 8354419
TI  - Computers in medicine.

PMID- 8354420
TI  - Through the looking glass.

PMID- 8354421
TI  - Clarification of access to patient records.

PMID- 8354422
TI  - Teachers should follow school no smoking rule.

PMID- 8354423
TI  - Paramedic standing orders.

PMID- 8354424
TI  - Intrauterine position effects on sexually dimorphic asymmetries of Mongolian
      gerbils: testosterone, eye opening, and paw preference.
AB  - A series of experiments was undertaken to both discover and explore the causes of
      sexually dimorphic phenotypic asymmetries in infant and adult Mongolian gerbils.
      We found that (1) the order in which the eyes of individual gerbil pups opened
      varied with their gender; right eyes of female pups opened before left eyes,
      while left eyes of male pups opened before right eyes, and (2) the paw that adult
      gerbils held in the air while maintaining a species-typical tripedal stance
      varied with gender; female gerbils held their right paws in the air significantly
      more often than did male gerbils. Both order of eye opening and laterality of paw
      use while in a tripedal stance varied significantly as a function of the
      intrauterine position which subjects had occupied as fetuses. These data
      implicate exposure to testosterone as a mediator of the development of
      asymmetries exhibited by Mongolian gerbils.

PMID- 8354425
TI  - Body scale and infant grip configurations.
AB  - This study examined whether hand/object size ratios define common boundaries to
      the grip configuration patterns of infants and adults. A group of 5- to 8-month
      old infants and a group of adults engaged in a displacement grasping task with
      inverted cups that varied in size. The findings showed that infant and adult grip
      configurations varied systematically with object size: More digits were brought
      into the contact grip configurations with increasing object size. Furthermore,
      when object size was scaled to hand size, common dimensionless ratios defined the
      grasping patterns and transitions between grasping patterns in a similar manner
      for both adults and infants. Consistent with a dynamical view of the development
      of coordination, the strong role of body scale on the developmental prehensile
      coordination pattern was observed for a given set of task constraints.

PMID- 8354426
TI  - Individual differences in the visual attention of human infants: further evidence
      for separate sensitization and habituation processes.
AB  - How many and what kinds of processes mediate infant visual attention? Are they
      influenced by stimulus "complexity?" Analyses were performed on visual fixation
      data from ninety 4-month-old infants; the time each infant spent looking at a
      black and white checkerboard pattern containing either 4 x 4, 12 x 12, or 20 x 20
      checks per picture was measured for eight 10-s trials, with 10-s interstimulus
      intervals (Kaplan & Werner, 1986). Correlational and factor analyses revealed one
      significant source of individual variability (or factor) in the 4 x 4 data, and
      two significant sources in the 12 x 12 and 20 x 20 data. One factor gained
      strength over progressive trials and accounted for decreases in looking time. A
      second factor gained strength over the first few trials, then lost strength over
      the remaining trials, and accounted for initial increments in looking time. The
      two factors are consistent with a dual-process model of infant response dynamics;
      the first may represent habituation, a decremental process, and the second may
      represent sensitization, an incremental process that is activated by "complex"
      stimuli.

PMID- 8354427
TI  - Hemispheric specialization in infant chimpanzees (Pan troglodytes): evidence for
      a relation with gender and arousal.
AB  - The current study extends previous documentation of behavioral asymmetries in
      hand-to-mouth, self-consoling behaviors of infant chimpanzees. The underlying
      source of lateralized hand-to-mouth, self-calming behavior was investigated by
      comparing individual differences in neonatal arousal levels, regulatory ability,
      and motor performance with individual differences in the degree of laterality at
      3 months. Asymmetrical hand-to-mouth, self-calming behaviors at 3 months of age
      were significantly related to general arousal at 2 days of age (i.e., the Range
      of State cluster scores measured by the Brazelton Neonatal Behavioral Assessment
      Scale). Simply stated, chimpanzees with a right-hand bias in hand-to-mouth
      behavior exhibited lower arousal at 2 days of age compared with nonright-handed
      individuals. The only item of the Range of State cluster to distinguish subjects
      was irritability: Right-handed subjects were less irritable. Previously, a trend
      was reported with respect to sex differences in the laterality of hand-to-mouth
      behavior. With the greater number of subjects in the present study, we found that
      females exhibited a significantly greater right-hand bias for hand-to-mouth
      behaviors (12 of 13) than did males (9 of 15). We conclude that neonatal
      arousability, and not regulatory capacity or motor performance, predicts the
      degree of laterality found in hand-to-mouth, self-calming behaviors in 3-month
      old chimpanzees. These data are discussed from the standpoint of early pari
      parturitional or intrauterine factors affecting lateralized development.

PMID- 8354428
TI  - Acquired disabilities: new directions.

PMID- 8354429
TI  - The stability of binocular fixation during reading in adults and children.
AB  - The authors recorded the binocular eye-movements of children and adults while
      they read single words appropriate for their reading ability. Normal data were
      obtained from nine- to 11-year-old primary-school children and adults, because
      very little is known about changes in binocular vergence during reading. These
      normal data were compared with those from poor readers of the same age who had
      passed or failed the Dunlop Test. On average, normal children made larger
      vergence errors while they fixated words than did adults. There were no
      differences between the groups of children, therefore the authors conclude that
      poor vergence control during reading fixations is not the immediate cause of the
      non-word error effect found among children who fail the Dunlop Test.

PMID- 8354430
TI  - Handedness and progressive hydrocephalus in spina bifida patients.
AB  - Hand preference and functional hand-dominance of 45 spina bifida patients (aged
      13 to 25 years) were assessed by means of self-reports on an ordinal scale and a
      tapping task. Non-right-handedness was more frequent among patients with
      accompanying progressive hydrocephalus. Left-hand preference was significantly
      more frequent in this group than in patients without shunts. Non-right-handedness
      in hydrocephalic patients correlated positively with the estimated degree of pre
      operative progress of the hydrocephalus. The apparent failure to establish right
      handedness in these patients seemed to reflect a developmental disorder of
      lateralization, related to a more advanced degree of progressive hydrocephalus at
      an early age. It is suggested that the disorder may be attributable to
      dysfunction of the corpus callosum, caused by delay in the development of
      callosal white matter when the hydrocephalus is in a progressive state.

PMID- 8354431
TI  - Visual evoked potentials and visual processing in stimulant drug-exposed infants.
AB  - Prenatal exposure to cocaine and amphetamines has been associated with many
      adverse effects in infants, including neurological abnormalities. Recent evidence
      shows that the visual system may be useful in infancy to evaluate neurological
      functioning. Visual evoked potentials (VEPs) and visual recognition memory
      testing were carried out on eight infants with prenatal drug-exposure and eight
      controls, matched for ethnicity and socio-economic status. The drug-exposed
      infants performed significantly worse on the visual recognition test. However,
      there were no differences between groups on VEP testing and no correlations
      between tests. The results suggest that the difficulties found in visual
      recognition memory of drug-exposed infants are not related to neurological
      maturity, as measured by VEPs.

PMID- 8354432
TI  - Reliability of an index of child characteristics.
AB  - The ABILITIES index provides a means to describe nine areas of functional
      abilities and disabilities. In this study, the authors examined the agreement
      between ratings made by 130 parents and teachers, 130 parents and specialists,
      and 125 teachers and specialists. Stability of ratings was assessed by asking 40
      teachers to complete the index a second time, an average of 34 days after the
      first rating. The results suggest that raters who vary considerably in expertise,
      discipline and relationship to the child generally agree as to the child's
      presenting characteristics.

PMID- 8354433
TI  - Autism and hypomelanosis of Ito in twins.
AB  - A pair of monozygotic and a pair of dizygotic twins with autism and hypomelanosis
      of Ito skin-abnormalities are described. These observations are further evidence
      of the frequent association between these two conditions, already demonstrated in
      the literature, and suggest a possibly higher incidence of single gene
      associations among cases of autism with known genetic basis.

PMID- 8354434
TI  - [Change in central hemodynamics during antiorthostatic influences in humans with
      varying types of blood circulation and physical preparedness].

PMID- 8354435
TI  - [Electromyographic patterns of thermoregulatory activity of motor units in the
      process of body cooling].

PMID- 8354436
TI  - [The training effect of high-frequency electric stimulation on the fast tibial
      anterior muscle in man. II. Effect on speed-force properties and working
      capacity].

PMID- 8354437
TI  - [Combination of differently directed physical stresses in amateur runners:
      skeletal muscle adaptation and hormonal profile].

PMID- 8354438
TI  - [Effect of local thermostimulation of the skin on reflex excitability of wrist
      flexor motor neurons].

PMID- 8354439
TI  - [Differentiated secretory response of the stomach, duodenum and pancreas to test
      breakfasts of various composition].

PMID- 8354440
TI  - [Zinc metabolism in healthy people as affected by physical exertion].

PMID- 8354441
TI  - [Geometry of adaptive in biosystems].

PMID- 8354442
TI  - [Status of the erythron in cadets with varyious degrees of adaptability to study
      in a military school].

PMID- 8354443
TI  - [Emotions and their role in cognitive processes at various ontogenetic stages].

PMID- 8354444
TI  - [The helium-neon laser in apex cardiography].

PMID- 8354445
TI  - [Human recognition of odors as a function of previous experience].

PMID- 8354446
TI  - [Hypotensive effect of biomechanical stimulation of leg muscles in man].

PMID- 8354447
TI  - [Physiologic changes in aminazine syndrome, traumatic shock and alimentary
      dystrophy].

PMID- 8354448
TI  - [Cerebral organization of emotions at various levels CNS activation].

PMID- 8354449
TI  - [Regularities of the effect of acupuncture on EEG and hemodynamic parameters as a
      function of the initial type of circulation in hypertensive patients].

PMID- 8354450
TI  - [Features of visual contrastometry in patients with basal ganglia dysfunction].

PMID- 8354451
TI  - [Cognitive hypothesis of hemispheric asymmetry of human emotional functions].

PMID- 8354452
TI  - [Functional state of the human nervous system at various stages of burn injury
      (according to recorded super-slow biopotentials].

PMID- 8354453
TI  - [Non-specific factors of Pa/Nb complex formation in mid-latent auditory evoked
      potentials].

PMID- 8354454
TI  - [Human EEG-correlates in multisided peripheral exposure to alternating magnetic
      field].

PMID- 8354455
TI  - [Mathematical analysis of cardiac rhythm].

PMID- 8354456
TI  - [Use of automated programs for comprehensive prognostic evaluation of individual
      adaptive potential].

PMID- 8354457
TI  - [Evaluation of the adaptive potential of adolescents at various stages of puberty
      according to autonomic, morphometric and hormonal parameters].

PMID- 8354458
TI  - Identification and sequence analysis of the replication region of the phage
      resistance plasmid pCI528 from Lactococcus lactis subsp. cremoris UC503.
AB  - The replication region of the phage resistance plasmid pCI528 from Lactococcus
      lactis subsp. cremoris UC503 was localised to within a 10-kb HindIII restriction
      fragment. A 6.3-kb BglII-HindIII subclone of this fragment, cloned into a
      replication probe vector, allowed replication in Lactococcus but not in Bacillus
      or Lactobacillus. Sequence analysis revealed an ORF of 1152 bp preceded by a
      putative ori region containing a 22-bp sequence tandemly repeated three and three
      quarter times, a second smaller direct repeat and two inverted repeats. Extensive
      homology was observed with the well characterised replication region of the small
      cryptic plasmid pCI305 (Hayes, F., Vos, P., Fitzgerald, G.F., deVos, W. and Daly,
      C. Plasmid 25, 16-26).

PMID- 8354459
TI  - Hydrogen-ubiquinone oxidoreductase activity by the Bradyrhizobium japonicum
      membrane-bound hydrogenase.
AB  - The Bradyrhizobium japonicum heterodimeric nickel-iron hydrogenase efficiently
      catalyzed H2-ubiquinone-1 oxidoreductase activity at rates up to 47% of the
      maximal rates obtained using the artificial electron acceptor methylene blue. Gel
      filtration chromatography and SDS-polyacrylamide gel electrophoresis experiments
      demonstrated that the purified enzyme was a heterodimer containing only the 65
      kDa and 33 kDa subunits. Reduced minus oxidized absorption difference spectra
      demonstrated the absence of detectable cytochromes. The H2-ubiquinone-1
      oxidoreductase activity of both the purified heterodimeric hydrogenase and
      membranes was significantly inhibited by 2-n-heptyl-4-hydroxyquinoline-N-oxide
      and antimycin A, inhibitors known to act in the quinone region of electron
      transport chains. Our results are the first report of H2-ubiquinone
      oxidoreductase activity by a purified hydrogenase.

PMID- 8354460
TI  - Mouse pathogenicity studies of Nocardia asteroides complex species and clinical
      correlation with human isolates.
AB  - Nocardia asteroides complex organisms derived from human specimens between 1979
      and 1992 were identified to the species level. Of 117 N. asteroides complex
      organisms, 34 (29%) were N. farcinica, 28 (24%) were N. nova, and 55 (47%) were
      N. asteroides sensu stricto. An analysis of the specimen sites from which the
      organisms were derived showed that isolates derived from blood, brain, or bone
      marrow were more likely to be N. farcinica than the other two species. A study of
      the virulence of ten strains of each species was undertaken, using a mouse model
      with intravenous inoculation. The 50% lethal doses (LD50) for N. farcinica were
      significantly lower than those of the other two species. LD50 values for N. nova
      and N. asteroides were not significantly different. The above data confirming the
      greater virulence of N. farcinica support the identification of species within
      the N. asteroides complex.

PMID- 8354461
TI  - Trifluoperazine inhibits the incorporation of labelled precursors into lipids,
      proteins and DNA of Mycobacterium tuberculosis H37Rv.
AB  - We have recently demonstrated that the calmodulin antagonist trifluoperazine has
      antitubercular activity in vitro against Mycobacterium tuberculosis H37Rv
      susceptible and resistant to isoniazid. It is now shown that trifluoperazine at a
      concentration of 50 micrograms ml-1 when added to the cells along with the
      labelled precursors inhibited the incorporation of [14C]acetate into lipids (63%)
      and uptake of [14C]glycine (74%) and [3H]thymidine (52%) by whole cells of M.
      tuberculosis H37Rv by 6 h of exposure. After 48 h, the inhibition was 87%, 97%
      and 74%, respectively. However, when the drug was added to cells taking up and
      metabolizing the labelled precursors at a later point (3 h for [14C]acetate and
      [3H]thymidine and 12 h for [14C]glycine) it inhibited completely the uptake of
      all the precursors, at least up to 24 h. The onset of inhibitory action was very
      rapid, i.e. 3 h. It is suggested that trifluoperazine has multiple sites of
      action and acts probably by affecting the synthesis of lipids, proteins and DNA.

PMID- 8354462
TI  - Purification and characterization of an 'actomyosin' complex from Escherichia
      coli W3110.
AB  - An 'actomyosin' complex was purified from Escherichia coli W3110 using selective
      precipitation. The complex contains three major components of 19.5, 18.5 and 17
      kDa. The 19.5- and 17-kDa proteins were purified by electroelution, peptide
      mapped and N-terminally sequenced. The structural gene for the 17-kDa protein was
      found to have been previously identified in an operon containing several other
      genes including the essential lpxA, lpxB and dnaE. The possible function of the
      17-kDa protein and the other 'actomyosin' components is discussed.

PMID- 8354463
TI  - Inhibition of adhesion of enteroinvasive pathogens to human intestinal Caco-2
      cells by Lactobacillus acidophilus strain LB decreases bacterial invasion.
AB  - Salmonella typhimurium and enteropathogenic Escherichia coli (EPEC) were found to
      adhere to the brush border of differentiated human intestinal epithelial Caco-2
      cells in culture, whereas Yersinia pseudotuberculosis and Listeria monocytogenes
      adhered to the periphery of undifferentiated Caco-2 cells. All these
      enterovirulent strains invaded the Caco-2 cells. Using a heat-killed human
      Lactobacillus acidophilus (strain LB) which strongly adheres both to
      undifferentiated and differentiated Caco-2 cells, we have studied inhibition of
      cell association with and invasion within Caco-2 cells by enterovirulent
      bacteria. Living and heat-killed Lactobacillus acidophilus strain LB inhibited
      both cell association and invasion of Caco-2 cells by enterovirulent bacteria in
      a concentration-dependent manner. The mechanism of inhibition of both adhesion
      and invasion appears to be due to steric hindrance of human enterocytic pathogen
      receptors by whole-cell lactobacilli rather than to a specific blockade of
      receptors.

PMID- 8354464
TI  - Comparative analysis of three sensitins used in cutaneous testing for
      tuberculosis and paratuberculosis in cattle.
AB  - Correspondence between components of sensitins (avian, bovine, and johnin-PPD
      tuberculins) and the proteins of the corresponding microorganisms (Mycobacterium
      avium, Mycobacterium bovis and Mycobacterium paratuberculosis) was established.
      Most of these identified proteins are present in the three organisms, but the
      38.3- and 48.8-kDa proteins of M. avium and the 54.0- and 58.7-kDa proteins of M.
      bovis are endowed with species-specific epitope(s).

PMID- 8354465
TI  - The in vitro antibacterial activity of ceftriaxone against Streptococcus pyogenes
      is unrelated to penicillin-binding protein 4.
AB  - The in vitro activities of penicillin and ceftriaxone were compared against 29
      strains of Streptococcus pyogenes with the result that ceftriaxone showed greater
      activity than penicillin. The morphological changes induced by 1/2 and 1x MIC
      concentrations of penicillin and ceftriaxone, respectively, were very similar
      using scanning electron microscopy. Competitive binding studies using 'cold'
      penicillin or ceftriaxone as inhibitors of radiolabeled penicillin binding
      demonstrated that ceftriaxone had a very low affinity for penicillin binding
      protein (PBP) 4 compared to that of penicillin. Since ceftriaxone had greater
      antibacterial activity, this suggests that PBP 4 may not be important to the in
      vitro activity of ceftriaxone. In contrast, the IC50 for ceftriaxone was much
      lower (> 200 fold) for PBPs 2 and 3 compared to PBP 4, suggesting greater avidity
      of these high molecular mass PBPs for ceftriaxone. These data may at least in
      part explain the superior in vitro activity of ceftriaxone compared to penicillin
      against S. pyogenes. These data, together with the observation that PBP 1 was
      saturated at a lower concentration of penicillin than any of the other PBPs,
      suggest that the inhibition of PBPs 1, 2, and 3 mediates the bactericidal
      activity of beta-lactam antibiotics against group A streptococci.

PMID- 8354466
TI  - Differentiation of Naegleria fowleri and other Naegleriae by polymerase chain
      reaction and hybridization methods.
AB  - In order to detect and identify Naegleria fowleri strains an assay based on the
      Polymerase Chain Reaction (PCR) was evaluated. The amplified DNA fragments were
      detected by gel electrophoresis and ethidium bromide staining, followed by
      Southern blot hybridization with an internal digoxigenin-labeled probe. A set of
      primers (B1B2) which flank a 678-bp region within a virulence-associated gene,
      allowed for the highly specific identification of N. fowleri, since Naegleriae
      (N. lovaniensis, N. australiensis, N. gruberi, N. andersoni and N. jadini) and
      other Protozoa did not react. These primers did not detect amplification products
      from various organisms: Gram-positive bacteria, Gram-negative bacteria, algae,
      yeasts and human DNA. Whereas a second set of primers (A1A2), which flank a
      different sequence, detected various Naegleriae and Acanthamoebae strains. After
      40 amplification cycles, the limit of detection was a single cell (cyst or
      trophozoite). Thus, the PCR appears to be a rapid and powerful tool for
      identification and detection of N. fowleri.

PMID- 8354467
TI  - Horizontal spread of an altered penicillin-binding protein 2B gene between
      Streptococcus pneumoniae and Streptococcus oralis.
AB  - The region encoding the transpeptidase domain of the penicillin-binding protein
      2B (PBP 2B) gene of two penicillin-resistant clinical isolates of Streptococcus
      oralis was > 99.6% identical in nucleotide sequence to that of a penicillin
      resistant serotype 6 isolate of Streptococcus pneumoniae. The downstream 849 base
      pairs of these genes were identical. Analysis of the data indicates that the PBP
      gene has probably been transferred from S. pneumoniae into S. oralis, rather than
      vice versa, and shows that one region of this resistance gene has been
      distributed horizontally both within S. pneumoniae and into two different
      viridans group streptococci.

PMID- 8354468
TI  - [The xrs2 gene controls recombination repair in yeast].
AB  - The XRS2 mutants of Saccharomyces cerevisiae are sensitive to ionizing and UV
      irradiation, have altered rates of spontaneous and induced mitotic recombination
      and are defective in meiosis. Haploid xrs2 cells bearing a mutation in RAD51 or
      RAD52 genes are more sensitive to gamma-rays than respective single mutants. On
      the other hand, double mutants xrs2-6 and rad50-1 (cdc40-1, radH) have the same
      radiosensitivity as the single mutants. At the same time, diploid double mutants
      xrs2-6rad51 (rad52) have no stronger sensitivity than single rad51 or rad52,
      whilst xrs2-6cdc40-1 mutant is more sensitive than each of the single mutants.
      These data confirm our previous assumption that XRS2 gene belong to the RAD52
      epistatic group. During vegetative growth of xrs2-6 cells the frequency of
      plasmid-plasmid recombination as well as plasmid and chromosome copies of ADE2
      gene are higher than in wt cells, while the efficiency of recombination during
      transformation is higher in wt cells but not in xrs2-6 cells.

PMID- 8354469
TI  - [Fundamental and applied aspects of research on the virus-like plasmids of the
      yeast Saccharomyces].
AB  - Six types of the antagonistic activity (AA) in Saccharomyces were distinguished
      and characterized. The K1, K2, K3 and K6 activities were associated with the
      presence of the two kinds of cytoplasmic killer virus-like particles (VLP)-
      cytoplasmic double-stranded RNAs (dsRNAs) consisting of the main (L) and minor
      (M) species. All four antagonistic groups contained the L dsRNAs of the same
      size. The size of the M dsRNAs are dependent on the origin of the host strain.
      The cytoplasmic inheritance of the K4 activity was observed among the strains
      which contained no dsRNAs. The AA of this type was not connected with the
      integrity of mitochondria, also. The K5 activity was under chromosomal control.
      The optimum and the limits of pH for detection of the AA were dependent on the
      type of activity. The natural route of extracellular infection by the killer VLPs
      was the penetration of the VLP into the early protoplast-like spore sprouts. The
      variability of the K2 activity was studied through mutagenesis of the marked
      genetic stocks. Twenty six chromosomal genes were involved in the control of this
      activity. Most of these genetic determinants differed from the chromosomal
      determinants of the K1 activity in their phenotypes or localization. Four
      phenotypically different mutational defects of the M-2 plasmid affected the
      manifestation of the K2 character. Epistatic and cumulative interactions between
      mutant chromosomal genes controlling the reproduction of the K2 plasmids were
      observed. Having compared the peculiarities of genetic control of the mutant
      phenotypes of the K1 and the K2 killers, we acquired the ability to propose a
      functional model of regulation of the killer virus-like plasmids reproduction.
      This model defines the interactions between hypothetical gene products and killer
      dsRNAs or their intermediates. The perspectives of selection of dsRNAs producers
      were studied. The methods for construction and maintaining the productive strains
      from the diploids homozygous for a chromosomal mutation increasing the copy
      number of both K2 killer plasmids were developed. These methods assisted in
      obtaining the producers suitable for large-scale cultivation.

PMID- 8354470
TI  - [Role of heat-shock proteins in the recovery of mitotic chromosome damage induced
      by high temperature in Drosophila melanogaster].
AB  - The synthesis of the heat-shock proteins (HSP) and the frequency of the mitotic
      chromosome damages (pulverizations, chromosome, chromatid stickiness, etc.) was
      studied in the cells of larva nervous ganglion in the process of recovery after
      heat shock (37 degrees C, 30 min). Analysis was performed in two strains of
      Drosophila melanogaster (Canton S-the wild type and the mutant l(1)ts403 with the
      defect in the HSP system). Correlation between the dynamics of HSP synthesis and
      the alteration of the chromosome pulverization and stickiness frequency was shown
      for both Drosophila strains under study. These results, in accord with the data
      on HSPs' binding to chromosomes following heat shock and their role as molecular
      chaperones, allowed to suggest that HSPs took part in chromosome condensation and
      in the recovery of heat shock induced damages leading to chromosome and chromatid
      stickiness.

PMID- 8354471
TI  - [An unusual heteromorphic bivalent in the common vole (Microtus arvalis) from
      Byelarus].
AB  - Electron microscopic analysis was carried out on the synaptonemal complexes of
      ten male common voles (Microtus arvalis) caught of 1990 in Byelorussia. In the
      early pachytene stage of spermatocytes of four males heteromorphic bivalent has
      been found in one of five large autosomes. In the central region of the bivalent
      one of the lateral elements is in the form of a D-loop, characteristic of
      insertion/deletion heterozygotes. However, high-resolution G-band staining of
      mitotic chromosomes from fibroblasts showed no significant differences in the G
      band patterns between homologues.

PMID- 8354472
TI  - [Immunogenetic similarity and the distance between Swiss brown cattle and 86
      other bovine populations].
AB  - By using the frequencies of 43-46 antigens of 9-11 genetic blood group systems in
      108145 animals the immunogenetic similarity (r +/- m(r)) and the distance (d)
      between a Swiss brown cattle and other 86 representatives of the Bovinae
      subfamily were calculated. The position of Swiss brown cattle on a linear model
      of the Bovinae family was determined. The position has following indexes: r =
      0.7816 +/- 0.0197; d = 0.2181. Phylogenesis of 16 cattle breeds reared with
      participation of the Swiss brown breed was studied. On the dendrogram these
      breeds formed two clusters and three branches. The clusters at the bottom of the
      dendrogram (Swiss brown x brown carpathian) and in the middle (ala-tau x
      caucasian brown) included breeds reared in the foothills and highlands, and the
      top of the dendrogram is formed by the lebedin, kostroma breeds and the Tajik
      type of Swiss brown zebu cattle reared in the flat country.

PMID- 8354473
TI  - [Further analysis of location of the gene for inborn dominant Nochurli cataract].
AB  - The study of location of the gene for inborn dominant nokhur kataracta is going
      on. No linkage of this gene with the locus of alpha-globin gene (16p13.3) and the
      locus (7q36-qter) was revealed. Additional evidence was obtained for a possible
      location of the gene for inborn dominant nokhur kataracta on the 14 chromosome.
      The maximal lod value equaled to 1.089 at theta = 0.20 in the analysis of
      kataracta genes and alpha-1-antitrypsin (14q32.1), and 0.846 at theta = 0.30 for
      the kataracta gene and D14S13 (14q32.1-q32.32). For the alpha-1-antitrypsin gene
      the maximal lod value was 2.24 at theta = 0.05.

PMID- 8354474
TI  - [Features of the distribution of alleles of the HLA-DRB1 04 and HLA-DQB1 03 genes
      among healthy people of European origin in Western Siberia].
AB  - The allelic HLA-DRB1 04 and HLA-DQB1 03 polymorphism in caucasians living among
      the West Siberia Mongoloid aborigenes was studied. As a result of our studies, it
      was shown that the HLA-DRB1 0403/07 predominates and HLA-DRB1 0404/08 is absent
      in the Russian population of West Siberia, in contrast to those among Caucasians
      living in West Europe and North America. The frequencies of HLA-DQB1 03 alleles
      are similar to those observed among the all Caucasians. Gametic association HLA
      DR4 - HLA-DQw was found for the first time in Caucasians of West Siberia.

PMID- 8354475
TI  - [Role of individual genes in expression of phenotypic properties of the cold
      adapted strain A/Leningrad/134/47/57 (H2N2)-a donor of attenuation of live
      influenza vaccine].
AB  - The influenza A/Leningrad/134/47/57 (H2N2) (A/Len/47) cold-adapted virus
      expresses the ability to reproduce at 25 degrees C (the ca phenotype) and
      inability to reproduce at 40 degrees C (the ts phenotype). It was attenuated for
      mice. Reassortants of this donor virus with the genes coding for the surface
      glycoproteins from the epidemic viruses, i.e. hemagglutinin (HA) and
      neuraminidase (NA), have been shown to be attenuated, immunogenic and genetically
      stable. We made attempts to reveal the influence of individual genes from the
      A/Len/47 ca virus on the expression of some phenotypic properties. Different
      "single-gene" reassortants were created and investigated using the influenza
      A/PR/8/34 (H1N1) virus as another parent with the opposite phenotypic properties,
      i.e. lack of ca+ and ts+ phenotypes and high virulence for mice. We managed to
      obtain "single-gene" reassortants with PB1, NA and NS genes at this stage of the
      work. None of them (probably including the M gene as well) could determine the ca
      or ts phenotypes, nor could the presence of the NA and NS genes from the strain
      A/Len/47 influence these properties. However, our findings show that the combined
      influence (synergism) of the PB1 and NS genes from the ca donors results in the
      ts phenotype of the reassortants. Significant role of the NS gene for attenuation
      of influenza viruses in mice has been revealed.

PMID- 8354476
TI  - [A simple and effective method for isolation of DNA from fossil bones for
      subsequent amplification using the polymerase chain reaction].
AB  - A method for DNA extraction from fossil bones based on DNA water elution from the
      bone powder is proposed. The method allows extraction of paleo-DNA from the great
      number of bone specimens simultaneously within one day and in quantities
      sufficient for DNA amplification by the polymerase chain reaction.

PMID- 8354477
TI  - [Comparative analysis of the level of heterozygosity for glucose phosphate
      isomerase (GPI) locus in silver foxes (Vulpes vulpes) of domesticated and control
      populations].
AB  - This communication is the first step of the studies on the correlation between
      protein polymorphism and the level of phenotypic diversity. The level of
      heterozygosity for glucose phosphate isomerase (GPI) locus was analysed in two
      populations of silver foxes. One of them has been selected for domestic behaviour
      during many years. This selection vector gave rise to many phenotypic novelties;
      46% of the foxes analyzed has aberrant phenotypes. Another population was control
      bred under the same conditions of experimental farm of Siberian Dept. Russian
      Sci. with a commercial purpose. All the foxes analyzed from this population,
      except one, had a standard phenotype. Among 96 domestic foxes under analysis,
      only one heterozygotes for the GPI locus was detected. Among 112 control foxes,
      six were heterozygotes. In other words the data obtained indicate no correlation
      between the level of morphological diversity and the state of heterozygosity of
      the GPI locus.

PMID- 8354478
TI  - [Effect of immobilization of amidopyrine in polyvinyl alcohol on mutagenicity of
      yeast].
AB  - Frequency of gene mutations was studied on the yeast Saccharomyces cerevisiae
      after treatment with amidopyrine (AP) and polyvinyl alcohol (PVA). PVA was found
      to have no mutagenic activity, whereas AP increased mutation frequency in
      dependence of drug concentrations (15 and 30 mg/ml) and the duration of cell
      treatment (4 and 24 hours). Immobilization of AP in PVA led to decrease in drug
      mutagenicity.

PMID- 8354479
TI  - Prevention of atopic diseases in high risk babies (long-term follow-up).
AB  - Several studies have demonstrated that dietary and environmental manipulations in
      the first months of life have a protective effect on the development of allergic
      diseases in babies "at risk" of atopy. We have prospectively followed up 174
      "high risk" infants who underwent dietary and environmental manipulations, such
      as exclusive breast-feeding for the first 6 months of life, supplemented if
      necessary with soy-protein formula (Isomil, Abbott), delayed weaning beyond the
      6th month of life, and rigorous environmental manipulations for the elimination
      of house-dust mite and passive smoking. The low prevalence of atopic disease
      (10%) and the trivial course of the allergic manifestations in this "at risk"
      population confirm the effectiveness of this preventive program. Moreover, this
      study demonstrates that the incidence of atopic dermatitis peaks at 6 months, and
      decreases until it disappears. Food allergy appears only at 6 months and may
      disappear later. The incidence of asthma peaks at 6 and 36 months and decreases
      at low levels in the intervals. Allergic rhinitis develops not sooner than 36
      months.

PMID- 8354480
TI  - Murine monoclonal antibodies to glycoprotein antigens of Aspergillus fumigatus
      show cross-reactivity with other fungi.
AB  - Six monoclonal antibodies produced against Aspergillus fumigatus were studied for
      their cross-reactivity against other fungal antigens from related and unrelated
      organisms. Five of the monoclonal antibodies reacted with glycoprotein antigens
      as evidenced by their binding to concanavalin A, although one did not react with
      concanavalin A. The reactivities of the monoclonal antibodies with various
      antigens were studied by biotin-avidin linked immunosorbent assay and Western
      blots. The results indicate that two monoclonal antibodies (Asp D1 and Asp C9)
      react with antigens from aspergilli as well as other fungi including Penicillium
      notatum and Candida albicans, whereas three of six antibodies (Asp H10, Asp ILB8,
      and Asp C2B1) react with A. fumigatus antigen only. Hence, these monoclonal
      antibodies can be used to obtain group specific and species specific antigens for
      various immunodiagnostic assays.

PMID- 8354481
TI  - Polymerization and fractionation of house dust mite allergen.
AB  - Glutaraldehyde polymerization and appropriate fractionation of allergens result
      in significantly decreased allergenicity with retained immunogenicity. In a
      manner similar to that employed with other allergens, we have prepared monomer
      dust mite (MDM) and polymerized dust mite (PDM). As with other polymerized
      allergens such as polymerized ragweed, PDM is more than 2 logs less allergenic
      than MDM as determined by cutaneous end point titration in sensitive patients.
      Moreover, PDM and MDM are similarly immunogenic in rabbits. As determined by
      inhibition studies (with rabbit antisera) PDM is antigenically complete and
      contains no new epitopes against which antibody was produced. In summary, we have
      prepared PDM which has the desired characteristics of reduced allergenicity,
      retained immunogenicity, antigenic completeness, and absence of new antigenic
      determinants.

PMID- 8354482
TI  - Standardization of allergenic extracts: a manufacturer's perspective.
AB  - The current procedure for standardizing allergenic extracts utilizes quantitative
      skin testing techniques and in vitro techniques. A reference preparation is
      selected and tested using a sensitive intradermal skin test technique to
      determine allergy units. Subsequent batches of standardized extracts are compared
      to the reference preparation using in vitro techniques. The standardization
      program has accelerated over the past few years and all indications are that it
      will continue to do so in the future.

PMID- 8354483
TI  - Portugal's contribution to navigation and discovery of the New World.
AB  - Even before the birth of Prince Henry the Navigator (1394) Portugal had displayed
      a maritime calling due to its 500-mile shore line and numerous natural bays.
      Inspired by the riches of India he saw during the Portuguese exploration along
      the coast of West Africa, Prince Henry set out methodically to collect
      information by bringing together Jews and Moors with geographical knowledge to
      found his School of Navigation. From 1415 until his death in 1460 he attracted to
      his school the foremost contemporary scholars in mathematics, astronomy, and
      cartography along with experts in knowledge of the compass, astrolabe, water
      currents, and the winds. This concentration of talent yielded the invention of
      the caravel, the most important navigational advancement of the time, crucial for
      long voyages across the high seas. Although the rest of Europe busied itself in
      political and religious wars, for 70 years (1415-1492) Portugal alone pursued the
      discovery of the Atlantic. "No nation in the 15th century exhibited so great a
      spirit of maritime enterprise as the Portuguese."

PMID- 8354484
TI  - Art and artifice in the science of histology. 1933.
AB  - Introduction to the original article. Dr Pio del Rio-Hortega has been working
      'temporarily' in a little laboratory in La Residencia for the past 15 years. With
      exemplary perseverance and goodwill, he has carried out, in this little corner, a
      labour that has been greatly appreciated by researchers throughout the world, but
      is perhaps not sufficiently recognized among ourselves. Through the use of
      original methods he has been able to make visible the most delicate details of
      the structure of cells. His research on the histology of the nervous system led
      him to discover a new species of cells, which the scientific world has baptized,
      in his honour, with the name of 'Hortega cells'. His uninterrupted line of
      investigation continues with research on tumours of the nervous system, on which
      he was confirmed as the leading authority at the last International Conference on
      Cancer. Dr Rio-Hortega is a devotee of the visual arts, and a fruit of the
      marriage between his enthusiasm for art and his scientific activities is the
      article that follows.

PMID- 8354485
TI  - Chromogranin A, secretogranin II and vasoactive intestinal peptide in
      phaeochromocytomas and ganglioneuromas.
AB  - By means of immunohistochemistry we analysed the distribution of chromogranin A,
      secretogranin II and vasoactive intestinal peptide (VIP) in 16
      phaeochromocytomas, two cases of combined phaeochromocytoma-ganglioneuroma and
      four adrenal ganglioneuromas. Chromogranin A was found in the majority of
      phaeochromocytes and in mixed phaeochromocytomas-ganglioneuromas. Secretogranin
      II was present to a lesser degree in phaeochromocytes, but strong immunostaining
      was found in most ganglion cells of phaeochromocytomas, in the ganglioneuroma
      component of combined tumours and in adrenal ganglioneuromas. Vasoactive
      intestinal peptide was present in some ganglion cells of phaeochromocytomas, in
      the ganglioneuroma component of mixed tumours and in three of four adrenal
      ganglioneuromas. On semi-adjacent sections a co-localization of VIP and
      secretogranin II was demonstrated. These results indicate that neuronal
      differentiation is accompanied by an increased immunohistochemical expression of
      secretogranin II. Therefore, secretogranin II may be a useful marker for ganglion
      cell differentiation.

PMID- 8354487
TI  - The value of histomorphological features of chorionic villi in early spontaneous
      abortion for the prediction of karyotype.
AB  - This study was conducted to evaluate the value of histomorphological features of
      chorionic villi, such as size, shape, vascularity, trophoblast proliferation and
      trophoblastic pseudo-inclusions, for the prediction of chromosomal abnormality.
      Slides of 83 early spontaneous abortions were assessed by three observers.
      Assessments and karyotype were compared and likelihood ratios computed.
      Likelihood ratios of < or = 0.40 or > or = 2.50 were not obtained by all three
      observers for any of the features. One or two observers obtained likelihood
      ratios of > or = 2.50 for lacunar stromal hydrops, presence of trophoblastic
      hyperplasia, moderate to abundant trophoblastic hyperplasia, presence of
      trophoblastic lacunae, few intervillous fibrin deposits and few intervillous
      trophoblastic buds. Likelihood ratios of < or = 0.40 were found for small
      chorionic villi and presence of basophilic staining. Lacunar stromal hydrops and
      trophoblastic lacunae were predictive of triploid karyotype, but not specific for
      any other type of chromosomal abnormality. After application of data previously
      obtained on Cohen kappas, lacunar stromal hydrops, moderate to abundant
      trophoblastic hyperplasia and presence of trophoblastic lacunae remained as
      possibly useful features, again mainly for identifying triploidy. Most of the
      items claimed to be related to abnormal karyotype, however, were not predictive
      at all.

PMID- 8354486
TI  - Immunohistochemical characteristics of Hodgkin and Reed-Sternberg cells in
      relation to age and clinical outcome.
AB  - One hundred and fifty-four cases of Hodgkin's disease diagnosed between 1985 and
      1988 from an unselected population were stained with a panel of six monoclonal
      antibodies; LN1, MB2, L26 (CD20), all B-cell antibodies, UCHL1 (CD45 RO), mainly
      T-cell antibody, Leu M1 (CD15), Ber H2 (CD30) and the polyclonal CD3, T-cell
      antibody. The results were related to age, histopathological subgroup and
      prognosis. There was no significant difference in staining patterns in the 90
      patients below the age of 60 compared with the 54 patients above that age. In the
      entire group, significantly fewer mixed cellularity cases were positive with Ber
      H2 and Leu M1 compared to nodular sclerosis. Disease-free survival tended to be
      better for cases stained with T-cell related antibodies. This study thus
      indicated differences in behaviour between T-cell positive and negative Hodgkin's
      disease and that there are antigenic differences between nodular sclerosis and
      mixed cellularity subgroups. We could not, however, show any phenotypic
      differences between the tumour cells in young and old patients.

PMID- 8354488
TI  - Pustular drug eruptions: a histopathological spectrum.
AB  - We have reviewed the histopathological features of 11 patients with pustular drug
      eruptions. Two main histological patterns were seen. Eight cases revealed
      features of toxic pustuloderma with the presence of spongiform intraepidermal
      pustules in association with papillary oedema and a mixed inflammatory cell
      infiltrate around upper dermal blood vessels. Pustules were present at different
      levels within the epidermis. The other three cases exhibited leucocytoclastic
      vasculitis with neutrophil collections both below and within the epidermis. One
      case showed continuity between the subepidermal and intra-epidermal pustules.
      These findings suggest a dynamic process in which neutrophils collect around
      upper dermal blood vessels and are then eliminated via the overyling epidermis.
      The presence of extravasated red blood cells within the intra-epidermal pustules
      indicates that this process is passive rather than the result of specific
      chemotaxis or cell migration.

PMID- 8354489
TI  - Benign trichogenic tumours: a report of two cases supporting a simplified
      nomenclature.
AB  - We report two cases of a rare benign tumour of hair germ. Clinically, both were
      solitary, well-circumscribed, subcutaneous nodules located in the extremities.
      Histologically, the tumours were characterized by nests and thin cords of
      basaloid epithelial cells intimately associated with a cellular stroma. The
      basaloid cells exhibited peripheral palisading, keratinization in the form of
      keratotic cysts and squamoid transformation, and pilar differentiation. An
      unusual, but distinctive, cribriform pattern of growth was observed. There was no
      communication with the overlying epidermis. Abundant primitive hair germinal buds
      and rare more advanced abortive hair follicles were identified. These
      histological appearances encompass features of both trichoblastic fibroma and
      trichogenic trichoblastoma, thus distinguishing these neoplasms from other skin
      tumours and reinforcing the hypothesis that these tumours are closely related
      from a histogenetic point of view. The presence of overlapping histological
      features can be problematic for practising histopathologists who rarely encounter
      these conditions. With this in mind, the term benign trichogenic tumour may be
      more appropriate to encompass these two tumours and related neoplasms that appear
      to lie within the spectrum of hair follicle development.

PMID- 8354490
TI  - The value and significance of nucleolar organizer region (AgNOR) proteins in
      ulcerative colitis and adenocarcinomas of the large bowel.

PMID- 8354491
TI  - Rectal biopsy as a diagnostic procedure of chronic visceral leishmaniasis.

PMID- 8354493
TI  - Partial nodular transformation of liver in a child.

PMID- 8354492
TI  - Pigmented ganglioneuroblastoma: a tumour cell 'storage disease'?

PMID- 8354494
TI  - Histological classification of tissue from spontaneous abortions: a valueless
      exercise?

PMID- 8354495
TI  - Leiomyoid mesotheliomas.

PMID- 8354496
TI  - Hepatic angiomyolipomas.

PMID- 8354497
TI  - Hispanic, Latino, or Raza? Coming to terms with diversity.

PMID- 8354498
TI  - Civil liability of mentally ill persons.

PMID- 8354499
TI  - Using field trials to evaluate proposed changes in DSM diagnostic criteria.

PMID- 8354500
TI  - Developmental psychoacoustics: what infants and children hear.

PMID- 8354501
TI  - The agitated patient, Part II: Pharmacologic treatment.

PMID- 8354502
TI  - Chronic depression.
AB  - OBJECTIVE: Chronic depression has not been appreciated or studied as well as
      episodic mood disorders or other chronic psychiatric disorders. This review
      provides an overview of the clinical features, biology, and treatment of chronic
      depression and suggests additional areas for research. METHODS: The English
      language literature was searched using MEDLINE. Additional references were
      selected from the bibliographies of recent publications. Studies of chronic
      nonbipolar depressed patients were selected; chronicity was defined as the
      persistence of depressive symptoms for at least two years or as a diagnosis of
      DSM-III or DSM-III-R dysthymia, "double depression," or chronic major depression.
      RESULTS AND CONCLUSIONS: Reported prevalence rates of chronic depression range
      from 3 to 5 percent in community samples and from 9 to 31 percent in clinical
      samples. Compared with patients with major depression, those with chronic
      depression have increased neurotic personality traits, adverse life events,
      health care utilization, and comorbid psychiatric and medical conditions,
      especially thyroid dysfunction. Biological and family studies support the
      relationship of chronic depression to the major mood disorders. Chronicity is
      also associated with inadequate treatment with anti-depressant drugs.
      Serotonergic or monoamine oxidase inhibitors may be more effective in treating
      chronic depression than tricyclic antidepressants. Psychosocial therapies need
      further study but may be especially useful in combination with drug treatment.
      Future research should investigate the clinical and biological correlates of
      subtypes of chronic depression, the response of the subtypes to different
      antidepressants, and the relative efficacy of combined antidepressant
      psychosocial treatment.

PMID- 8354503
TI  - Outcomes for the mentally ill in a program for older homeless persons.
AB  - OBJECTIVE: The study evaluated the success of a generic service program for older
      homeless persons in improving the well-being of mentally ill clients. It
      attempted to identify factors that predicted the number of service encounters and
      outcome in seven areas, including housing, entitlements, physical and mental
      health, and sobriety. METHODS: All persons newly admitted to the program during a
      two-and-a-half-year period were asked to participate in structured interviews
      assessing their physical and mental health and their support networks. Two-thirds
      of those eligible, or 130, participated in the intake interviews. At three-year
      follow-up or last contact, outcome was compared for 41 psychiatric clients with
      psychotic symptoms or self-reported history of psychiatric hospitalizations and
      89 clients with no psychiatric symptoms or previous hospitalizations. RESULTS:
      Persons with mental illness averaged 2.5 favorable outcomes, and a majority
      obtained temporary or permanent housing, improved their physical health, and
      secured entitlements. However, mentally ill clients had significantly fewer
      service encounters and favorable outcomes than clients who were not mentally ill.
      Types of presenting problems at intake were the only significant predictors of
      outcome for mentally ill clients. CONCLUSIONS: A generic service program for
      older homeless persons can successfully improve the well-being of mentally ill
      clients, although outcomes are less favorable for such clients than for clients
      who are not mentally ill.

PMID- 8354504
TI  - Characteristics of children whose parents have been incarcerated.
AB  - OBJECTIVE: The study sought to determine the relationship between parental
      incarceration and behavioral and family characteristics among children in a day
      hospital. METHODS: Chi square analysis and t tests were used to compare
      preadmission characteristics and teachers' behavioral ratings of a group of 16
      children in a day hospital setting who had experienced the incarceration of one
      or both parents and a group of 21 children in that setting who had no history of
      parental incarceration. RESULTS: Children in the parental incarceration group
      were significantly more likely to have experienced parental substance abuse than
      those whose parents had not been incarcerated. A history of child abuse or
      maltreatment appeared to be more likely among the parental incarceration group.
      Boys whose fathers had been incarcerated received higher teacher ratings of
      delinquent and aggressive behavior. Paternal incarceration among girls was
      associated with a significant increase in attention problems. CONCLUSIONS: A
      history of parental incarceration may be quite common in some mental health
      samples of children. It appears to be associated with severe family dysfunction
      and behavioral disorders.

PMID- 8354505
TI  - The boundaries of psychiatric rehabilitation.
AB  - The authors describe the development of modern psychiatric rehabilitation, from
      its early association with occupational therapy to its present state as a
      discipline with an armamentarium of treatment strategies. Psychiatric
      rehabilitation addresses difficulties in three domains of patients' lives:
      clinical status, functional status, and quality of life. The authors suggest that
      the acceptance of rehabilitation as a separate discipline has been slow due to
      boundary conflicts between these domains and between the disciplines that
      traditionally represent them. The authors call for a more central role for
      rehabilitation, which integrates treatment in the three domains and uses group
      methods to formulate plans and enhance client involvement.

PMID- 8354507
TI  - Development and evaluation of drop-in centers operated by mental health
      consumers.
AB  - As part of a statewide initiative begun in 1989 to promote consumer involvement,
      the Pennsylvania Office of Mental Health initially funded the development of nine
      consumer-operated drop-in centers. This paper describes some of the programs and
      services developed by the centers and presents results of a survey of consumers'
      use of and satisfaction with services. During the six-month survey period, a
      total of 478 consumers used services; average daily attendance at each center was
      28. Most centers had one paid position supplemented by heavy use of volunteers.
      Most projects had collaborative relationships with a few providers who maintained
      a low profile in daily operations. Although consumers were highly satisfied with
      the drop-in centers, they desired improvements in the number of paid staff, hours
      of operation, management, and transportation.

PMID- 8354506
TI  - Respecting the autonomy of chronic mentally ill women in decisions about
      contraception.
AB  - Treatment of women patients with chronic mental illness who are at risk of
      unwanted pregnancies presents ethical challenges to the clinician who wishes to
      respect the patient's autonomy while also helping her avert the potential adverse
      consequences of unwanted pregnancy. The clinician who simply allows the patient
      to continue at risk or coerces her into using contraception may not have
      adequately considered the variable nature of the patient's autonomy. The authors
      suggest that the clinician should assess and treat conditions underlying the
      patient's variable impairment of autonomy to maximize her ability to participate
      in family planning decisions. Case examples are used to illustrate assessment of
      patients' decision-making capacity, development of family planning approaches
      that respect patients' autonomy, and use of a newly available contraceptive
      implant.

PMID- 8354509
TI  - What employers want in managed care programs.

PMID- 8354508
TI  - Psychoeducation in Spain.

PMID- 8354510
TI  - Pay as an incentive in work participation by patients with severe mental illness.

PMID- 8354511
TI  - Esophageal atony and dilatation as a side effect of thiothixene and benztropine.

PMID- 8354512
TI  - Race and therapeutic alliance.

PMID- 8354513
TI  - Medicaid in state hospitals.

PMID- 8354514
TI  - Drug-induced mania.

PMID- 8354515
TI  - Drug use by day patients.

PMID- 8354516
TI  - Hospitalphilia.

PMID- 8354517
TI  - Ternary complex formation with 5-fluoro-2'-deoxyuridylate and the kinetic
      properties of thymidylate synthase from Lactobacillus leichmannii.
AB  - Lactobacillus leichmannii thymidylate synthase (5,10-CH2-H4PteGlu:dUMP C
      methyltransferase, EC 2.1.1.45) forms a tight and stable covalently bonded
      ternary complex with the inhibitor 5-FdUMP in the presence of the cofactor 5,10
      CH2-H4-PteGlu. 'Filter assay' employing the radioactive nucleotide ligand showed
      that 2 moles of FdUMP are bound per mole enzyme during the ternary complex
      formation with the L. leichmannii dTMP synthase. This is in line with our earlier
      observation on the Streptococcus faecium thymidylate synthase [Narasimha Rao, K &
      Kisliuk R L (1983), Proc Natl Acad Sci USA, 80, 916-920]. The enzyme has Km
      values of 6.3 x 10(-6) M, 8.2 x 10(-5) M and 1.0 x 10(-4) M for dUMP, (dl)-L
      H4PteGlu and Mg2+ respectively; Vmax for dUMP, (dl)-L-H4PteGlu and Mg2+ are;
      0.55, 0.5 and 1.1 respectively. It has K(i) values of 6.7 x 10(-6) M, 2.2 x 10(
      6) M, 5.0 x 10(-5) M and 2.0 x 10(-4) M for FdUMP, dTMP, MTX and Ca2+
      respectively. The type of enzyme inhibition with FdUMP, dTMP, MTX and Ca2+ was
      competitive. dTMP Studies clearly show the 'end product' inhibition of the
      enzyme.

PMID- 8354518
TI  - Sugar-specific interaction of bovine brain beta-galactoside-binding lectin with
      endogenous gangliosides.
AB  - Sugar-specific binding of the 14 kDa beta-galactoside-binding lectin from bovine
      brain grey matter to mixed endogenous gangliosides was demonstrated by affinity
      electrophoresis and hemagglutination inhibition. Gangliosides prepared by Folch
      extraction, base treatment and silica gel chromatography, when incorporated in
      native or desialated form in polyacrylamide gel above their critical micellar
      concentration, arrested the mobility of the lectin during electrophoresis at pH
      8.2. This effect was sugar-specific since it was reversed if lactose, but not
      sucrose, was present in the gel. Also, retention of the brain lectin by
      ganglioside and its reversal by lactose were concentration-dependent. In presence
      of bovine serum albumin, at pH 7.4 native and desialylated gangliosides equally
      inhibited agglutination of trypsinized rabbit red cells by bovine brain lectin,
      but not that by the alpha-galactoside-specific antibody from human serum. Results
      suggested the possibility of endogenous gangliosides acting as cell surface
      receptors in mediation of brain lectin function.

PMID- 8354519
TI  - Biochemical activities of denatured covalently closed circular duplex DNA.
AB  - Covalently closed circular duplex DNA when exposed to high alkaline pH followed
      by neutralization yields a collapsed state structure (form I(d)) that can undergo
      transition to form I and was susceptible to S1 nuclease. Form I(d), in spite of
      its compact structure, admits specific cleavage by restriction enzymes over its
      entire genome. When used in a semi-in vitro replication complex, form I(d) gave
      significantly better template activity, and undergoes better primer extension in
      in vitro using Klenow. Thus form I(d) having a compact shape can behave as a
      better substrate in a few key enzymatic reactions.

PMID- 8354520
TI  - Effect of propranolol hydrochloride on blood cell lipids in relation to partition
      coefficient and biological activity.
AB  - Considering the high lipophilicity of propranolol (log P = 3.56), its
      interactions with the cell membrane lipids of goat blood have been investigated.
      It is observed that lipid loss after incubation of blood cells with propranolol
      hydrochloride in salt glucose medium for varying periods of time was accompanied
      with significant increases in PUFAs. Amongst the PUFAs studied the omega 3 and
      omega 6 fatty acids, the two important precursors of eicosenoids, have shown
      increase in varying amounts. This phenomenon is presumably responsible for the
      significant cardiovascular activity of this drug.

PMID- 8354521
TI  - Telomere structure and function.

PMID- 8354522
TI  - Effect of substrate and phosphate ions on the quaternary structure symmetry of
      glyceraldehyde-3-phosphate dehydrogenases of mung beans and rabbit muscle.
AB  - Effects of glyceraldehyde-3-phosphate (G-3-P) and phosphate ions on thermal
      inactivation of glyceraldehyde-3-phosphate dehydrogenases (GPDHs) of mung beans
      and rabbit muscle have been studied at different pH. In the absence of any
      ligand, the two enzymes show a striking similarity in the pH-dependence of the
      kinetics of thermal inactivation. At lower pH values both the enzymes biphasic
      kinetics with each phase accounting for about half of the starting activity (a C2
      symmetry of the homotetrameric enzyme molecule). The kinetics change to a single
      exponential decay at higher pH values, a D2 symmetry [Malhotra & Srinivasan
      (1985) Arch. Biochem. Biphys. 236, 775-781; Malhotra & Tikoo (1991) Indian, J.
      Biochem. Biophys. 28, 16-21]. With each enzyme, phosphate ions are found to have
      no effect on the kinetic pattern at lower pH, but G-3-P brings about a change
      from biphasic to a single exponential decay. At higher pH values, G-3-P has no
      effect on the single exponential decay kinetic pattern, but phosphate ions change
      the same to a biphasic loss of activity with each phase accounting for about half
      of the starting activity. It has been concluded that with both the enzymes, G-3-P
      and phosphate ions have higher affinity and stabilise the D2- and C2-symmetry
      conformation, respectively. Binding isotherms of the two substrates for these
      enzymes have been described based on the ligand concentration-dependence of the
      changes in the rate constants and kinetic pattern of thermal
      inactivation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354523
TI  - Studies on cinnamic acid-4-hydroxylase from wounded potato tissue: isolation and
      characterization of cinnamic acid-4-hydroxylase activation factor.
AB  - Cinnamic acid-4-hydroxylase activation factor has been found to be located in the
      supernatant fraction of wounded potato tissue homogenate in phosphate buffer. The
      factor has been purified to homogeneity as judged by SDS polyacrylamide gel
      electrophoresis, by heat treatment on boiling water-bath for 7.5 min followed by
      dialysis with cut off limit of 8 kDa and final separation by gel filtration on
      Sephadex G-50 column. Gel filtration resolved this into three active fractions of
      molecular mass 12500, 10000 and 8500 Da conjugated to a fluorescent compound and
      subsequently identified as a folate derivative. The amino acid analysis of
      polypeptide chains of these fractions revealed that the polypeptides were rich in
      glutamic and aspartic acids. The fluorescent moiety of the complex released from
      polypeptide chain of molecular weight 10000 by mild acid hydrolysis was able to
      support the growth of Lactobacillus casei ATCC 7469 which requires folic acid for
      its growth. On storage, this compound degraded into a number of fluorescent
      products identified as p-amino benzoic acid, p-amino benzoyl glutamic acid,
      pteroic acid and 6-methyl pterin indicating that the activation factor is a folic
      acid derivative conjugated with the polypeptide chain.

PMID- 8354524
TI  - Ca(2+)-induced alterations in the activity of membrane (Ca(2+)-Mg2+)-ATPase of
      human and rat erythrocytes.
AB  - Effect of intraerythrocyte Ca2+ elevation on human and rat erythrocyte membrane
      (Ca(2+)-Mg2+)-ATPase along with that of incubation of the erythrocyte ghosts in
      their own hemolysates enriched with Ca2+ has been studied. While the membrane
      (Ca(2+)-Mg2+)-ATPase levels of Ca(2+)-loaded human erythrocytes showed an initial
      increase and subsequent decline, membranes incubated in their own hemolysate
      showed a consistent decrease in the enzyme activity. Calmodulin sensitivity was
      retained by the preparations in contrast to the earlier observations made with
      washed erythrocyte membranes. Similar changes in (Ca(2+)-Mg2+)-ATPase activity
      but of greater magnitude were observed in response to Ca2+ in the calpain-rich
      rat erythrocytes. Considerable crosslinking and proteolysis was observed in case
      of human and rat erythrocytes exposed to high Ca2+ concentrations. The Ca(2+)
      activable transglutaminase, however, did not play any role in the activation of
      the (Ca(2+)-Mg2+)-ATPase.

PMID- 8354525
TI  - Halothane-induced fulminant hepatic failure.
AB  - Fulminant hepatic failure developed in the early post-operative period in a
      patient after third exposure to halothane. Exclusion of other causes of post
      operative jaundice and temporal relationship of jaundice to anesthesia suggested
      halothane as the etiologic agent for the submassive necrosis, which was
      documented at postmortem liver biopsy.

PMID- 8354526
TI  - Volvulus of stomach in childhood.
AB  - Six children, aged upto one year, with volvulus of the stomach are reported.
      Vomiting and regurgitation of feeds were the main presenting symptoms.
      Eventration of the left hemidiaphragm was present in four cases. Barium meal
      confirmed the diagnosis. Five cases were operated on through an abdominal
      approach. Plication of the diaphragm (3 cases), colonic displacement (2) and
      gastrostomy (3) were resorted to. One child needed reoperation for a missed
      Ladd's band. There was no operative mortality.

PMID- 8354527
TI  - Splenic hemangiomatosis with osseous involvement.
AB  - A rare case of splenic hemangiomatosis with bone involvement in the upper
      extremity is presented. The findings on ultrasonography and CT scan abdomen were
      suggestive of splenic hemangiomatosis. X-ray of left forearm showed findings
      characteristic of osseous hemangiomatosis, which was subsequently confirmed on
      histology.

PMID- 8354528
TI  - The case of a sticky stomach.

PMID- 8354529
TI  - Percutaneous endoscopic gastrostomy in patients with head injury.

PMID- 8354530
TI  - Newer stool based diagnostic tests in infectious diseases: possibilities and
      pitfalls.

PMID- 8354531
TI  - Perforated duodenal ulcer: is definitive surgery warranted?

PMID- 8354532
TI  - Detection of Entamoeba histolytica antigens in stool in amebiasis.
AB  - BACKGROUND: Stool microscopy, the conventional method of diagnosing intestinal
      amebiasis, fails to detect Entamoeba histolytica in more than 30-40% of
      clinically suspected cases. Demonstration of parasite products in clinical
      specimens has been suggested as an alternative. However, the usefulness of
      demonstrating amebic antigen in the stools of clinical cases needs to be
      assessed. METHODS: A double-antibody sandwich enzyme linked immunosorbent assay
      (ELISA) using anti-trophozoite antibodies to capture E histolytica specific
      coproantigen(s) was carried out on stools obtained from 31 patients with
      microscopically confirmed non-dysenteric amebic colitis, 18 patients with
      intestinal parasites other than E histolytica and 41 apparently healthy subjects.
      RESULTS: The assay detected E histolytica specific coproantigen(s) in stools of
      23 (74.2%) of 31 subjects with non-dysenteric amebic colitis, none of 18 with
      other parasitic infections and 1 (2.4%) of 41 apparently healthy subjects.
      CONCLUSION: Our results provide evidence for the presence of E histolytica
      specific coproantigen(s) in stool eluates from patients with amebic infection;
      this finding can be exploited for confirming ongoing amebic infection. However,
      the sensitivity of the assay needs to be improved by the use of relevant
      monospecific/monoclonal antibodies.

PMID- 8354533
TI  - Is ulcer recurrence after simple closure of perforated duodenal ulcer
      predictable?
AB  - OBJECTIVE: To study whether factors such as age, duration of pre-perforation
      symptoms, size of perforation and operative evidence of chronicity could predict
      recurrence of ulcer after simple closure of perforated duodenal ulcers, thus
      enabling patients at high risk of recurrence to be subjected to definitive
      surgery instead of simple closure of perforation. DESIGN: Retrospective. One
      hundred and fifty-two patients who had undergone simple closure of duodenal ulcer
      perforation in the last 10 years were included in the study. SETTING: A
      postgraduate research and teaching institution. PATIENTS AND MEASUREMENTS:
      Patients were subjected to a personal interview and Visick grading of symptoms 1
      10 years after simple closure of duodenal ulcer perforation. Ninety of them
      underwent esophagogastroduodenoscopic evaluation. RESULTS: Symptomatic ulcer
      recurrence rate was 23.1% by Visick grading and 42.2% on endoscopy. Ulcer symptom
      recurrence rate had no correlation with patient's age, duration of pre
      perforation symptoms, or size of perforation, but correlated significantly with
      operative evidence of chronicity (p < 0.001). However, 7 of 35 symptomatic
      recurrences would have been missed by the use of this criterion alone. Endoscopic
      evidence of recurrence also correlated only with operative evidence of
      chronicity. False positives and false negatives with Visick grading showed that
      this symptomatic evaluation was unsatisfactory even for selecting patients for
      further endoscopic workup. CONCLUSION: Though not infallible, evidence of
      chronicity of ulcer at laparotomy may be a useful predictor of recurrence of
      ulcer after simple closure of perforated duodenal ulcer.

PMID- 8354535
TI  - Role of anxiety and personality in non-ulcer dyspepsia: a comparative study with
      duodenal ulcer.
AB  - BACKGROUND: Though emotional factors are known to influence gut functions,
      studies evaluating the role of anxiety and personality in non-ulcer dyspepsia
      (NUD) are few and have not yielded consistent results. AIMS: To find out whether
      anxiety and abnormal personality pattern are specifically associated with NUD.
      METHODS: 33 patients with NUD and 30 patients with duodenal ulcer, who were
      randomly selected from among those attending a gastroenterology out-patient
      clinic, were administered a) the Eyesenck Personality Inventory, to measure
      neuroticism and extroversion; and b) a short self-rating scale for anxiety, to
      measure state and trait anxiety. RESULTS: There were no significant differences
      between the two groups in state anxiety, neuroticism and extroversion. Trait
      anxiety, however, was significantly higher in the NUD group (p = 0.05).
      CONCLUSIONS: Though the difference in trait anxiety score between the two groups
      attained significance, this finding needs further support to indicate a causal
      role for anxiety in NUD. There is need for further studies about the role of
      anxiety in various subgroups of NUD.

PMID- 8354534
TI  - End point for sclerosis of esophageal varices.
AB  - BACKGROUND: Small esophageal varices are difficult to inject intravariceally and
      complete eradication of varices may not be therapeutically necessary. METHODS: A
      prospective study designed to compare the use of different end points of
      sclerotherapy ie (i) total eradication (grade 0) (ii) grade I varices or (iii)
      grade II white (IIw) varices, by stopping variceal injection when one of these
      was reached. The patients were followed endoscopically and clinically at 3-4 mo
      intervals. OUTCOME MEASURES: Variceal recurrence and rebleeding rates. RESULTS:
      Of 266 patients with portal hypertension (147 cirrhosis, 51 non-cirrhotic portal
      fibrosis, 68 extra-hepatic portal venous obstruction), 232 (87.2%) reached one of
      the three end points--six to grade 0, 96 to grade I and 130 to grade IIw. Among
      212 patients followed up for a mean post-sclerotherapy period of 12.2 mo (range 3
      48 mo), variceal recurrence rates, time intervals to recurrence and rebleed rates
      were comparable in patients with endpoints of grade I and grade II (white)
      varices (28.5% vs 38.9%, 10.8 mo vs 9.2 mo, and 7.7% vs 7.8%, respectively; all p
      = ns). Overall, 51 patients had interval bleed before reaching the end point--50
      (98%) of them bled from grade III and IV varices while only one patient (2%) bled
      with grade IIw varices. CONCLUSION: Grade I or grade IIw varices should be
      acceptable as the end points for endoscopic sclerotherapy of esophageal varices.

PMID- 8354536
TI  - Combination of anticholinergic agent and H2 receptor antagonist in duodenal ulcer
      treatment--a randomized, double blind multicenter study.
AB  - BACKGROUND: The acid suppressive abilities of H2 receptor antagonists and
      anticholinergics have been claimed to be additive. METHODS: A multicenter, double
      blind, randomized trial comparing ranitidine (150 mg) plus propantheline bromide
      15 mg at bedtime to ranitidine 300 mg alone at bedtime was conducted in 161
      patients with endoscopically confirmed uncomplicated duodenal ulcer. RESULTS:
      After six weeks of therapy, ulcer healing rates in the two groups were comparable
      ie 80% in the combination group (ranitidine + propantheline) and 79.4% in the
      ranitidine group. Pain relief after one, two and four weeks of treatment was also
      comparable in the two groups. Side effects to drugs were minor and comparable in
      both the groups. CONCLUSION: A combination of 150 mg ranitidine and 15 mg
      propantheline bromide is as efficacious as 300 mg ranitidine in inducing healing
      of uncomplicated duodenal ulcers, with similar side-effects but at greatly
      reduced cost.

PMID- 8354537
TI  - Involvement of prostaglandins in chilli-induced early gastric vascular damage in
      adult Wistar rat.
AB  - OBJECTIVE: To explore the role of prostaglandins in protecting against chilli
      induced early gastric vascular damage. METHODS: Early gastric vascular damage was
      induced in rats by oral administration of 8 mg/Kg chilli extract. The damage was
      assessed by estimating spectrophotometrically the amount of Evan's blue leaking
      into gastric tissue and luminal contents 10 min after exposure to chilli. Further
      groups of rats were pretreated with misoprostol (10, 25 or 50 micrograms/Kg) or
      dazmegrel (1, 5 or 25 mg) to evaluate their protective effects. RESULTS: Both
      misoprostol and dazmegrel were able to reduce gastric vascular damage induced by
      chilli in a dose-dependent fashion. CONCLUSION: Prostaglandins may play a role in
      protecting against chilli-induced early gastric vascular damage.

PMID- 8354538
TI  - Retraction of publication.

PMID- 8354539
TI  - Endoscopic variceal ligation: an effective method of variceal obliteration.
AB  - Endoscopic variceal ligation was performed in 20 patients with portal
      hypertension of varied etiology. Variceal obliteration was achieved in 18
      patients (90%) while recurrence of bleeding occurred in two patients (10%). The
      average number of bands required was four per patient and average number of
      sessions required for variceal obliteration was two. We found the procedure to be
      cheap, safe and effective in achieving early variceal obliteration.

PMID- 8354540
TI  - Emergency endoscopic nasobiliary drainage without the aid of fluoroscopy.
AB  - Endoscopic nasobiliary drainage without the aid of fluoroscopy, as an emergency
      procedure, was performed successfully in four patients with severe calculous
      cholangitis. There were no complications. All the patients improved and three
      were taken for definitive surgery later.

PMID- 8354541
TI  - Hyperbilirubinemia following hepatitis A in a patient with G6pD deficiency.
AB  - A case of viral hepatitis A with G6PD deficiency is described. The condition
      should be suspected in the presence of indirect hyperbilirubinemia, and anemia in
      a patient with viral hepatitis; repeat G6PD testing 8 weeks later is recommended
      for diagnosis.

PMID- 8354542
TI  - Modifications in the seminal protein pattern and concentration among infertile
      men.
AB  - Lower concentrations of protein observed in semen of infertile men were mostly
      due to absence of vesicular proteins with higher isoelectric pH above pH 8.3. Two
      to four proteins with lower isoelectric pH showing electrophoretic mobility and
      originating both from seminal vesicle and prostate were absent in infertile semen
      samples. Concentrations of such proteins among oligozoospermic and azoospermic
      samples with complete maturation arrest and Sertoli cell only syndrome decreased
      mainly towards cathode, whereas, in vasectomized azoospermia the number of
      protein bands decreased both towards cathode and anode, though the concentration
      decreased mainly in the anodic proteins.

PMID- 8354543
TI  - Environmental conditions, anthropometric parameters and arterial blood pressure.
AB  - The influence of environmental conditions and anthropometric parameters on
      arterial blood pressure level was studied in 280 healthy Kashmiri subjects, aged
      18-50 years (140 males, 140 females) Men in the age group of 18-20 years had
      higher blood pressure than women and their systolic blood pressure showed
      significant correlation with height, weight and skinfold thickness. Females (18
      20 years) showed association of diastolic blood pressure with weight, skinfold
      thickness. Females (18-20) years) showed association of diastolic blood pressure
      with weight, skinfold thickness and mid-arm circumference. After the age of 20
      years females had higher blood pressure than males. Height and weight decreased
      with age in both the sexes. Skinfold thickness and midarm circumference increased
      with age in females. A comparison between the present study and those reported
      from Haryana and Delhi revealed a higher diastolic pressure in Kashmiris.

PMID- 8354544
TI  - Purulent pericarditis caused by Salmonella typhimurium--a case report.

PMID- 8354545
TI  - Immunological tests for diagnosis of tuberculosis.

PMID- 8354546
TI  - Evaluation of lactic dehydrogenase in cases of meningitis.
AB  - Lactic dehydrogenase (LDH) was measured serially in cerebrospinal fluid (CSF) and
      serum in 23 cases of meningitis (15 pyogenic and 8 tuberculous) and equal number
      of age and sex matched healthy controls to find out its diagnostic and prognostic
      significance in cases of meningitis. The LDH activity was significantly elevated
      in the CSF and serum (p < 0.001) in cases of pyogenic (PM) as well as tuberculous
      meningitis (TBM). The maximum elevation was seen on the 1st day and the activity
      declined thereafter. However, in 3 cases of PM and 5 cases of TBM, the LDH
      activity on subsequent estimations increased serially and all these cases died.
      Further, the basal LDH activity in the 3 cases of PM who died was significantly
      higher (p < 0.01) than those who survived. The rise in enzymatic activity in the
      CSF was significantly higher (p < 0.001) than in the serum in all the cases of
      meningitis. The LDH activity was significantly higher in PM as compared to TBM (p
      < 0.001) both in the CSF as well as the serum.

PMID- 8354547
TI  - Incidence of salmonella meningitis in Ludhiana (Punjab).
AB  - A retrospective study was carried out at Dayanand Medical College & Hospital,
      Ludhiana (Pb.) during the period from January 1985 to December 1990 to know the
      incidence of Salmonella meningitis. Salmonella etiology was established in 8
      (3.43%) cases out of 233 cases of bacterial meningitis. Out of 8 cases, 7 were
      children under the age of 2 years. 4 Patients yielded S. typhimurium, 3, S. typhi
      and 1 S. senftenberg from cerebrospinal fluid samples. No Salmonella organism was
      isolated from blood cultures except one in which S. typhi was isolated. S.
      typhimurium was the predominant isolate showing multi drug resistance to commonly
      used drugs such as ampicillin, chloramphenicol, streptomycin, tetracycline and
      kanamycin. S. senftenberg also showed similar drug resistance pattern. S. typhi,
      on the other hand was sensitive to above antibiotics.

PMID- 8354548
TI  - Multiple drug resistance and genetic characterization of Salmonella typhimurium
      isolated at Chandigarh.
AB  - A total of 1072 strains of S. typhimurium were isolated in Chandigarh during 1985
      1988. Genetic characterization of 'R' plasmids was attempted in 21 multiple drug
      resistant strains (ACKSSu TT p-19, ACKSSu, TP-I, AKSSu Tp-1). All the 21 strains
      were sensitive to gentamicin, furoxone and nalidixic acid. Level of resistance to
      different antimicrobial drugs varied from 200 to 1000 mg/L. Majority of the
      strains were untypable by the present set of 31 typing phages (Ut-17, Phage type
      21-2, Phase type 99-2). All the plasmids belonged to class I transfer system. All
      the plasmids restricted some or all the typing phages of S. typhimurium and 39
      also restricted phage phi 2. These plasmids belonged to F1me or I1
      incompatibility groups and did not inhibit the function of fertility factor (fi
      ).

PMID- 8354549
TI  - The changing facets of Salmonellosis.

PMID- 8354550
TI  - Significance of serum immunoglobulin levels in conglomeration with trans-sternal
      phlebography in the phlebography management of breast cancer.
AB  - The study was conducted on 63 patients with breast lump and twenty normal healthy
      females. In benign breast disease, a significant (P < 0.001) rise in serum IgA,
      significant (P < 0.001) decrease in IgG and no change in IgM levels was seen
      before operation. A significant decrease (P < 0.001) in serum IgA and significant
      increase in IgG and IgM was observed post operatively. In carcinoma breast, a
      significant (P < 0.001) elevation in IgA, IgG and IgM levels was found pre
      operatively with a concomitant decrease in serum IgA and IgG and increase in
      serum IgM levels, post operatively. Trans-sternal phlebography (TSP) carried out
      with 95.23% success has revealed significant (P < 0.001) change in the staging of
      carcinoma breast. The increased levels of serum immunoglobulins associated with
      the patients of carcinoma breast with metastasis has led to conclude that these
      levels, if punctuated with TSP findings can lead to better assessment of the
      staging of carcinoma breast and thereby its management.

PMID- 8354551
TI  - Isolation of Capnocytophaga species from non-vital anterior teeth.
AB  - Root-canal infection is very common in India. Both aerobic and anaerobic
      organisms have been claimed for its aetiology. However, isolation of
      Capnocytophaga species from non-vital anterior teeth is sparse. In this study a
      solitary case of Capnocytophagal root canal infection is reported.

PMID- 8354552
TI  - Effect of levamisole as an immunomodulating agent in trophoblastic lesions.
AB  - Both cell mediated immunity and humoral immunity was assessed in 16 patients of
      hydatidiform mole and 6 patients of choriocarcinoma. Fifty percent patients of
      choriocarcinoma and 11 patients of vesicular mole were given levamisole (LVM)
      trial and were followed for 2 months. Absolute lymphocyte count (ALC) was
      significantly increased in vesicular mole after levamisole treatment but in
      choriocarcinoma no effect was obtained. Marked improvement of T cell rosette
      count was also seen in LVM treated patient of both vesicular mole (p < 0.001) and
      choriocarcinoma. Cutaneous DTH response to 2:4 DNCB in vesicular mole was also
      increased after LVM. Before treatment only 31.25% patients had strong cutaneous
      response but after treatment 53.35% patients had strong response, while cases of
      choriocarcinoma were unaffected. LVM also raised all the serum immunoglobulins
      (IgG, IgM, IgA) in both vesicular mole and choriocarcinoma. Hence, levamisole
      therapy was found to have a beneficial effect on both cellular and humoral
      immunity in the lesions of trophoblasts.

PMID- 8354553
TI  - Primary lymphoma of the brain.
AB  - In this study, clinical and histopathological features of primary lymphomas of
      the brain have been described in eight patients. The primary nature of lymphoma
      in these patients was confirmed by extensive clinical as well as radiological
      investigations and supported by a detailed histopathological examination.
      Computerised tomography (CT) scan showed multiple intra-cerebral lesion in two
      patients and in six patients the lesion was solitary. Although primary lymphoma
      of the brain carries poor prognosis, it is essential that these tumours should be
      accurately diagnosed as well as should be distinguished from secondary tumours.

PMID- 8354554
TI  - Sclerema neonatorum--histopathologic study.
AB  - Histopathological study of 10 cases sclerema neonatorum showed subcutaneous
      fibrosis with lobulation in all the cases. 8 (80 percent) cases showed non
      specific chronic inflammation of dermis and thinning of epidermis with atrophy of
      rete pegs and hypercollgenisation of dermis was evident in 70 percent cases. Fat
      necrosis with crystallisation of fat content was not a conspicuous feature.

PMID- 8354555
TI  - Morphological identification of Candida species on glucose agar, rice extract
      agar and corn meal agar with and without Tween-80.
AB  - A comparative study for the identification of 32 known strains of Candida species
      on the basis of morphology on glucose agar, rice extract agar and corn meal agar
      with and without Tween 80 revealed that when Tween 80 is incorporated in the
      media identification is possible for 96.8% of the species within 48 hours on rice
      extract agar and for 96.8% of the species within 48 hours on rice extract agar
      and for 90.6% of the species on glucose agar. The germ tubes and chlamydospores
      were also produced more on rice extract agar than on 0.1% glucose agar. Rice
      extract agar with Tween 80 can be used as single medium for morphologic
      identification of Candida species. The inoculated medium is first incubated at 37
      degrees C for 3 hours and examined for germ tube formation and then incubated at
      25 degrees C for 24 to 72 hours and examined for appearance of chlamydospores and
      mycelial morphology.

PMID- 8354556
TI  - Multi drug resistant Salmonella typhi in Ludhiana (Punjab).
AB  - 280 Salmonella typhi strains isolated from suspected cases of enteric fever
      during the year 1990 were studied for susceptibility to the antimicrobial agents
      chloramphenicol, ampicillin, cotrimoxazole, gentamycin, kanamycin, amikacin,
      ciprofloxacin by Kirby Baur disc diffusion method. All were blood culture
      positive cases. 63 strains (21.9%) were found resistant to chloramphenicol,
      ampicillin, cotrimoxazole, but sensitive to the amino glycosides and
      ciprofloxacin. Present study shows the prevalence of multi drug resistant
      Salmonella typhi in this region of Punjab.

PMID- 8354557
TI  - Prevalence of Nocardia species in the soil of Patiala area.
AB  - Five hundred soil samples were examined for Nocardia species in Patiala area by
      using paraffin bait technique. Forty (8 per cent) yielded Nocardia species. All
      the forty isolates identified as Nocardia asteroides were pathogenic to white
      mice.

PMID- 8354558
TI  - Acute renal failure in lymphoma of the kidney.
AB  - Involvement of kidney by lymphomatous process occurs in 30-40% of cases of
      lymphoma, if the disease is left untreated. Incidence of renal involvement at
      initial presentation is 2.7%-6%. Mostly it is in the form of insidious renal
      failure. Acute renal failure as initial manifestation of the disease is very
      rare. A case of lymphomatous involvement of the kidney, with initial presenting
      manifestation of ARF is discussed, and the mechanisms responsible for rarity of
      this is analysed.

PMID- 8354559
TI  - Rhinoentomophthoromycosis: a report of three cases.
AB  - Three cases of rhinoentomophthoromycosis involving the nasal region are presented
      diagnosis in the first two cases was made on surgical biopsy and in the third
      case by fine needle aspiration biopsy. A granulomatous inflammatory reaction was
      seen in tissue around hollow broad hyphae of the fungus. The hyphal strands were
      surrounded by eosinophilic deposits Splendore--Hoeppli phenomenon.

PMID- 8354560
TI  - Vasitis nodosa--a case report.

PMID- 8354561
TI  - Primary endodermal sinus tumour of the vagina: a case report.

PMID- 8354562
TI  - Digital and clavicular bone metastasis from transitional cell carcinoma of
      urinary bladder: a case report.

PMID- 8354563
TI  - Leiomyosarcoma of gallbladder: a case report.
AB  - A case of leiomyosarcoma of gallbladder, a rare tumor in hepatobiliary region, is
      reported. The present case differs from previously reported cases in its
      presentation with empyema of gallbladder and multiple intrahepatic cholangiolytic
      abscesses. Curative surgery could not be undertaken on account of poor condition
      of patient, and invasion of tumor into liver and adjacent organs.

PMID- 8354564
TI  - Multi drug resistant Salmonella typhi in Bombay.
AB  - An outbreak called 'Dombivali fever' started in March 1990 and spread rapidly all
      over Bombay and adjoining area. A concomitant and steady increase in multidrug
      resistant Salmonella typhi isolation was observed. Later this outbreak called
      'Dombivali fever' was proved to be resistant typhoid fever only. The present
      paper deals with comparison of this outbreak with previous two years laboratory
      data from Sir J.J. Hospital, Bombay. A very high isolation rate of S. typhi (215
      isolates) in 1990 as compared to 62 isolates in the last two years (1988-89), was
      observed in this laboratory. The incidence of multidrug resistance in cases of
      enteric fever (EF) was also very high (67.6%) in 1990, as compared to 6.2% in
      1988 and 23.3% in 1989. All the strains tested in 1990 were sensitive to
      ciprofloxacin.

PMID- 8354565
TI  - Transferable drug resistance in Salmonella senftenberg.
AB  - Six Salmonella senftenberg strains were isolated from blood samples of patients
      clinically diagnosed to be suffering from enteric fever during the recent
      outbreak of enteric fever in and around Calcutta. All of them were multidrug
      resistant including chloramphenicol. The minimum inhibitory concentration (MIC)
      of the drugs in which they were resistant, were well above the normal level. All
      these strains were sensitive to cephalexin, gentamicin, furazolidone and
      ciprofloxacin. The transferable drug resistance test suggested that the strains
      were carrying transferable drug resistant gene containing ACSTK resistant factor.

PMID- 8354566
TI  - Atypical salmonellosis: two cases of sacroiliitis.
AB  - Two young adult males presented with fever, severe pain, redness, swelling over
      the left sacroiliac joint and inability to walk and squat. A differential
      diagnosis of tuberculous sacroiliitis was considered. On blood culture isolation
      of S. Typhi in both of them was suggestive of sacroiliitis of salmonella
      etiology. They recovered completely following specific antibiotic therapy,
      aspirin and bed rest. At recovery both showed extremely high Widal titres.

PMID- 8354567
TI  - Diagnostic utility of immunohistochemical techniques in intramedullary Schwann
      cell tumours.
AB  - Histopathologic features in two intramedullary schwann-cell tumours, closely
      resembled with those of fibrillary astrocytoma and could not be differentiated
      from each other by the conventional histochemical stains. However application of
      tumour markers-Glial fibrillary acidic protein (GFAP) and S-100 protein were
      found to be useful in differentiating these two tumours and thus helped in making
      an accurate histopathological diagnosis in these two patients.

PMID- 8354568
TI  - Assessment of past occupational exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin
      using blood lipid analyses.
AB  - Current 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) concentrations were determined
      in blood samples for 138 persons who had been involved in assessment, clean-up
      and demolition activities after the 1953 BASF trichlorophenol reactor accident.
      From these data and detailed descriptions of the circumstances and duration of
      individual exposure, a regression model was developed for describing the
      relationships between various exposure situations and TCDD concentration. The
      model explained 65% of the variability in log (TCDD) concentration. Using half
      life assumptions and the regression model parameters we estimated cumulative TCDD
      concentrations back-calculated to the time of exposure for all 254 members of the
      accident cohort. The geometric mean cumulative TCDD concentration for all cohort
      members averaged 137.7 ppt. Estimated cumulative TCDD concentrations correlated
      well with chloracne severity. The mean TCDD concentrations were 38.4 ppt for the
      no chloracne subgroup (n = 139), 420.8 ppt for the moderate chloracne subgroup (n
      = 59) and 1008 ppt for the severe chloracne subgroup (n = 56). The estimation
      procedure should be helpful in assessing the relationships between various health
      outcomes and TCDD exposure in this cohort.

PMID- 8354569
TI  - Maternal occupation and congenital heart defects: a case-control study.
AB  - This paper reports a Swedish analysis of the possible effect of maternal
      occupation on the occurrence of congenital heart defects. The analysis included
      3324 infants (1108 cases and 2216 controls) born during the period 1982-1986.
      Information on maternal occupation was retrieved using two sources: the 1985
      census and the Medical Birth Registry. A comparison between these two sources
      using the information on mothers of 756 infants born in 1986 showed a good
      concordance although 11% of the women were reported with a different employment
      status. No association appeared between the type of maternal occupation and the
      occurrence of infant congenital heart defects although some odds ratios were
      slightly above 1.

PMID- 8354570
TI  - Urinary N-acetyl-beta-D-glucosaminidase and beta-aminoisobutyric acid in workers
      occupationally exposed to metals such as chromium, nickel, and iron.
AB  - To examine the relationships between the urinary excretion of N-acetyl-beta-D
      glucosaminidase (NAG) and beta-aminoisobutyric acid (AIBA) as a metabolite of
      thymine, and exposure to chromium, nickel, and iron, we determined these
      parameters in 58 workers engaged in the cutting and grinding of stainless steel
      or iron-steel plates. A significant increase in urinary NAG activity or urinary
      AIBA excretion was found in some of these workers. However, we could not find a
      significant positive correlation between the urinary excretion of NAG or AIBA and
      the urinary concentration of chromium, nickel, or iron as an indicator of
      internal dose.

PMID- 8354571
TI  - Work noise annoyance and blood pressure: combined effects with stressful working
      conditions.
AB  - In a community-based cross-sectional study (n = 174, 68% participation), we
      examined the effect on blood pressure of occupational noise annoyance and its
      combined effect with social support at work, nightshift work, and work
      satisfaction. In a multivariate analysis the effect of noise annoyance alone
      (mean difference, 95% CI) was 2.1 (-3.0, 7.3) mmHg for systolic and 3.5 (0.3,
      7.4) mmHg for diastolic blood pressure (n = 44). The combined effect with low
      work satisfaction was 7.5 (0.0, 15.0) mmHg systolic and 6.3 (0.6, 12.4) mmHg
      diastolic (n = 18). With nightshift work the effect was 5.0 (-2.4, 12.4) mmHg on
      systolic and 8.1 (2.5, 13.7) mmHg on diastolic blood pressure (n = 15). The
      findings for social support were inconsistent. The results suggest that analysis
      of main effects only may underestimate the true public health impact and
      underline the necessity of searching for combined effects of environmental
      stressors.

PMID- 8354572
TI  - The effectiveness of respirators measured during styrene exposure in a plastic
      boat factory.
AB  - In a plastic boat company we studied workers' attitudes toward wearing
      respiratory protective equipment and differences in styrene exposure received
      with and without respirators. The workers studied used either half-facepiece air
      purifying or full-face air-supplied respirators as much as possible during the
      first day of the study. On the second day respirators were used only for short
      periods or not at all. Individual styrene exposures were measured by personal air
      sampling in the breathing zone. When using respirators the exposure was measured
      both inside and outside the respirators. The styrene metabolites mandelic and
      phenylglyoxylic acids were determined in urine samples collected during the
      workday. The eleven workers studied used the respirators 52% of the time on the
      first day and 7% of the time on the second. The reasons for not wearing
      respirators were that they delayed work, were too tight and uncomfortable, made
      it difficult to breath, and/or became too warm. The use of respirators during
      work operations such as spraying, laminating, and painting reduced the styrene
      exposure by 56%-92%. The excretion rate of mandelic and phenylglyoxylic acids in
      urine collected at the end of the working day was 30%-99% lower when respirators
      were worn than when they were not.

PMID- 8354573
TI  - Occupational exposure and lung cancer risk in a coastal area of northeastern
      Italy.
AB  - A case-control study of lung cancer and occupational exposure was conducted in a
      coastal area of Northeastern Italy where metallurgical and mechanical industries,
      docks and shipyards are located. Cases comprised 756 men who died of primary lung
      cancer in a 5-year period. Controls comprised 756 male subjects dying from other
      causes during the same period. Occupational exposures to lung carcinogens were
      assessed according to a job title-based approach, using two separate lists of
      industries/occupations recognized as being causally associated (list A) or
      suspected of being causally associated (list B) with lung cancer in humans.
      Exposure to asbestos was classified as absent, possible, or definite. After
      adjustment for cigarette smoking and place of residence, a significant
      association was found between lung cancer and occupations in both list A
      [relative risk (RR) = 2.25, 95% confidence interval (CI) = 1.68-3.03] and list B
      (RR = 1.33, 95% CI = 1.03-1.71). A significant excess risk was found for workers
      with definite exposure to asbestos as compared to those with no exposure to lung
      carcinogens (RR = 1.98, 95% CI = 1.42-2.75). Among occupations with recognized
      exposure to lung carcinogens other than asbestos, a significant excess risk for
      lung cancer was observed in iron and metalware workers. In occupational groups
      with definite exposure to asbestos, elevated risk estimates were found for
      shipyard workers, dockworkers, carpenters, and electricians. The combined effect
      of smoking and asbestos was found to be compatible with that expected under a
      multiplicative model. The overall population-attributable risk (ARp) for
      cigarette smoking was found to be 87.5%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354574
TI  - Occupational exposure to hexahydrophthalic anhydride: air analysis, percutaneous
      absorption, and biological monitoring.
AB  - Urinary hexahydrophthalic acid (HHP acid) levels were determined in 20 workers
      occupationally exposed to hexahydrophthalic anhydride (HHPA) air levels of 11-220
      micrograms/m3. The levels of HHP acid in urine increased rapidly during exposure
      and the decreases were also rapid after the end of exposure. The elimination half
      time of HHP acid was 5 h, which was significantly longer than in experimentally
      exposed volunteers, possibly indicating distribution to more than one
      compartment. There was a close correlation between time-weighted average levels
      of HHPA in air and creatinine-adjusted levels of HHP acid in urine collected
      during the last 4 h of exposure (r = 0.90), indicating that determination of
      urinary HHP acid levels is suitable as a method for biological monitoring of HHPA
      exposure. An air level of 100 micrograms/m3 corresponded to a postshift urinary
      HHP acid level of ca. 900 nmol/mmol creatinine in subjects performing light work
      for 8 h. Percutaneous absorption of HHPA was studied by application of HHPA in
      petrolatum to the back skin of three volunteers. The excreted amounts of HHP acid
      in urine, as a fraction of the totally applied amount of HHPA, were within
      intervals of 1.4%-4.5%, 0.2%-1.3%, and 0%-0.4% respectively, indicating that the
      contribution from percutaneous absorption is of minor importance in a method for
      biological monitoring.

PMID- 8354575
TI  - Biochemical and physiological aspects of 2,5-hexanedione: endogenous or exogenous
      product?
AB  - This article reports results regarding two different physiological aspects of 2,5
      hexanedione (2,5-HD). The first is the relationship between "free" 2,5-HD (the
      fraction of "real" 2,5-HD) and "total" 2,5-HD (2,5-HD obtained from acid
      hydrolysis) in urine and blood of workers exposed to n-hexane. The second part of
      the study is an attempt to clarify "physiological" excretion of 2,5-HD in
      subjects not occupationally exposed to n-hexane. The concentration of free 2,5-HD
      in urine of workers exposed to n-hexane is about 8% of total urinary 2,5-HD. In
      blood, free 2,5-HD is about 50% of the total. The serum concentration range of
      total and free 2,5-HD in workers from whom blood was taken was 33-418
      micrograms/l and 14-283 micrograms/l respectively. In subjects not exposed to n
      hexane, urinary concentration of 2,5-HD ranged between 0.17 and 0.98 mg/l, the
      urinary excretion rate between 0.23 and 0.57 microgram/min, and renal clearance
      between 14 and 66 ml/min. The blood concentration of 2,5-HD in nonexposed
      subjects was 6-30 micrograms/l. Fluctuations typical of a circadian rhythm were
      not observed for 2,5-HD in blood or urine. We think that 2,5-HD is mainly a
      product of intermediate metabolism in the human body. Only a minimal part could
      derive from n-hexane as a ubiquitous micropollutant.

PMID- 8354576
TI  - Cadmium, zinc, copper, and metallothionein levels in the kidney and liver of
      inhabitants of upper Silesia (Poland).
AB  - The levels of Cd, Zn, Cu and metallothionein (MT) were determined in renal cortex
      and liver of 75 subjects decreased in the period 1986-1989 in the area of Upper
      Silesia (Katowice). The mean age of the population studied was 53.6 +/- 14.6
      years. The determined levels (mean +/- SD) were: 43.1 +/- 23.5 micrograms Cd/g;
      52.5 +/- 17.4 micrograms Zn/g; 2.2 +/- 0.7 microgram Cu/g; 0.80 +/- 0.36 mumol
      Hg/g in renal cortex and 3.5 +/- 2.5 micrograms Cd/g; 82.8 +/- 34.3 micrograms
      Zn/g; 4.5 +/- 2.6 micrograms Cu/g; 0.69 +/- 0.44 mumol Hg/g in the liver. The
      level of Cd in renal cortex was 40% higher in smokers compared to nonsmokers and
      was independent of the gender. Whole-body retention of Cd was 34.1 +/- 18.5 mg;
      smoking elevated the value from 27.1 to 38.2 mg. Compared with a similar study
      made in central Poland (Lodz), a significant difference was found only regarding
      the level of Zn and MT in the liver, pointing to the possibility that exposure to
      this element in the region of Upper Silesia may be higher.

PMID- 8354577
TI  - Prevalence of objective eye manifestations in people working in office buildings
      with different prevalences of the sick building syndrome compared with the
      general population.
AB  - A cross-sectional clinical epidemiological study was carried out among 169 office
      workers in four Copenhagen town halls with different prevalences of the sick
      building syndrome. The results were compared with those in 112 subjects randomly
      selected from the general population. Biomicroscopic eye manifestations, such as
      premature break-up of the precorneal tear film, absence of foam at the inner eye
      canthus and epithelial damage of the bulbar conjunctiva, were investigated
      together with self-reported eye complaints. Although intercorrelated, the
      objective eye manifestations independently were statistically associated with
      self-reported eye complaints in office workers. The prevalence of the objective
      eye manifestations was significantly elevated in office workers compared with the
      general population and most pronounced for the buildings with a high prevalence
      of the sick building syndrome (P < 0.001). In the general population, subjects
      with a non-industrial occupation, including office workers, had a significantly
      higher prevalence of objective eye manifestations than those with an industrial
      occupation (P = 0.03), but the prevalence was still significantly lower than that
      among the office workers in buildings with a high prevalence of the sick building
      syndrome (P < 0.001). Since possible confounders were found not to explain the
      difference in prevalence of objective eye manifestations and complaints among the
      two populations, it is concluded that the office environment (buildings and/or
      type of office work) promotes these objective changes accompanied by self
      reported complaints.

PMID- 8354578
TI  - Biological monitoring of occupational exposure to n-hexane by measurement of
      urinary 2,5-hexanedione.
AB  - Occupational exposure to n-hexane in shoe factory workers was monitored by
      measuring urinary 2,5-hexanedione, the major metabolite of this solvent and the
      probable cause of peripheral neuropathy in exposed workers. Solvent pollution was
      monitored in the work environments of 189 employees, of whom 123 (65%) worked in
      Alicante, Spain, and 66 (35%) in Veneto, Italy. 2,5-Hexanedione was measured in
      spot urine samples collected from workers at the end of the shift. Information on
      working conditions was obtained from a previous study. A significant linear
      correlation was found between mean environmental concentration of n-hexane and
      urinary concentration of 2,5-hexanedione. The variability in the correlation may
      have been due to the variable use of protective clothing (gloves), and to
      variations in exposure during the working week. In numerous workers, percutaneous
      absorption of n-hexane represented as much as 50% of the total absorbed dose.
      Urinary concentrations of 2,5-hexanedione tended to increase during the working
      week. Simultaneous exposure to n-hexane and toluene tended to reduce urinary
      excretion of 2,5-hexanedione, whereas exposure to n-hexane and methyl ethyl
      ketone tended to increase excretion of the metabolite.

PMID- 8354579
TI  - Elbow joint disorders in relation to vibration exposure and age in stone quarry
      workers.
AB  - Elbow joint disorders were studied in relation to vibration exposure and age in
      74 male stone quarry workers who operated mainly chipping hammers and sometimes
      rock drills. They were examined for range of active motion in elbow extension and
      flexion, and by means of radiographs of the elbow joint. Effects of age and
      vibratory tool operation on the elbow joint were statistically estimated using
      multiple regression analysis. In the analysis of all subjects, including those
      aged over 60 years, age was significantly related to the range of motion in
      extension and to radiographic changes in both elbows, and the duration of
      vibratory tool operation was associated with the range of right elbow flexion.
      Among subjects under the age of 60 years, duration of vibratory tool operation
      showed a significant dose-effect relationship to the range of flexion and
      radiographic changes in the right elbow, but there was no significant
      relationship with age. The present results suggest that the operation of chipping
      hammers and rock drills contributes to elbow joint disorders or osteoarthrosis,
      even when the effect of age is taken into account. Besides vibration exposure, it
      may be necessary to consider various loads on the elbow joint such as firmly
      grasping and pressing the tool against stones with the arm bent at about 90
      degrees, and carrying stones.

PMID- 8354580
TI  - The development of mechanical circulatory systems: "the labors of Hercules".

PMID- 8354581
TI  - Must we treat uremic dyslipidemia?

PMID- 8354582
TI  - Detection of low molecular size lipopolysaccharide contaminated in dialysates
      used for hemodialysis therapy with polyacrylamide gel electrophoresis in the
      presence of sodium deoxycholate.
AB  - Dialysis membranes are generally considered to be impermeable for bacterial
      endotoxin (lipopolysaccharide, LPS) contaminated in dialysates used for
      hemodialysis therapy, since LPS molecular size in aqueous media has been reported
      to be more than 10(6). However, there are few reports concerning its size in
      dialysates. We have already presented a newly developed polyacrylamide gel
      electrophoresis with sodium deoxycholate (DOC-PAGE) which proves the LPS size.
      Using this method, therefore, we attempted to clarify the size of LPS in
      dialysates. We demonstrated that LPS in dialysates had roughly two different
      molecular sizes with DOC-PAGE and that compared to migration profiles of
      Salmonella LPS as controls on DOC-PAGE, one molecular size of LPS was
      approximately 4,000 and the other in tens of thousands. This investigation
      indicates the possibility of LPS transfer across dialysis membranes.

PMID- 8354583
TI  - Ticlopidine improves dialysis clearance of solutes in uremic patients by reducing
      blood clotting in dialyser fibers.
AB  - Ticlopidine, a platelet aggregation inhibitor was tested, in a double blind
      comparative cross-over study versus placebo, in 51 dialysed uremic patients who
      had increased dialyser blood clotting (> 25 fibers clotted/dialyser). At the end
      of a 7-day treatment period with 250 mg daily, the clearance of urea, creatinine
      and phosphate was determined at 30 and 210 minutes of dialysis, as well as the
      number of fibers clotted at the end of dialysis. Ticlopidine improved dialyser
      clearances for urea, creatinine and phosphate from 165 +/- 41 to 182 +/- 35 (p <
      0.01), 135 +/- 37 to 143 +/- 35 (p < 0.05), and 120 +/- 36 to 130 +/- 35 (p <
      0.05) ml/min, respectively, at 30 min of HD and a similar effect was seen after
      210 min of dialysis. The number of dialyser fibers clotted after dialysis was
      reduced by ticlopidine therapy from 110 +/- 48 to 15 +/- 8 (p < 0.01).
      Ticlopidine reduced the initial dialysis-induced drop in leucocyte count by 20%
      (p < 0.05); no change in platelet or erythrocyte count was observed. Two out of
      51 patients experienced an adverse reaction from ticlopidine (cutaneous haematoma
      and minor gingival bleeding). We conclude that ticlopidine is an efficient and
      safe drug for dialysed uremic patients since it can reduce blood clotting and
      thereby increase dialysis efficiency.

PMID- 8354584
TI  - Catheter-implanted prosthetic heart valves. Transluminal catheter implantation of
      a new expandable artificial heart valve in the descending thoracic aorta in
      isolated vessels and closed chest pigs.
AB  - A new expandable artificial heart valve was developed for implantation by a
      transluminal catheter technique without using thoracotomy or extracorporeal
      circulation. The aim of this study was to implant the valve in isolated vessels
      of the descending thoracic aorta as well as in closed chest pigs, and furthermore
      to study the prosthesis' mechanical stability and the valve function. The
      artificial valve was made by mounting a porcine aortic valve on an expandable
      stent. Before implantation, the stent-valve was compressed on a deflated balloon
      catheter and mounted inside an introducer sheath. After intravascular
      introduction to the descending thoracic aorta the stent-valve was discharged from
      the sheath. Implantation was performed by balloon inflation which expanded the
      stent-valve to a diameter exceeding the internal vessel's diameter. After balloon
      deflation the stent-valve maintained an expanded configuration ensuring a stable
      fixation against the vessel wall. In vitro implantations were performed in 36
      isolated descending thoracic aorta specimens obtained from 80 kg pigs. Mechanical
      stability was evaluated by applying a downing load to the prosthesis. No
      displacement occurred at loads < or = 1 kg when a large balloon (31 mm) was used
      for implantation. Transvalvular pressure differences between 11-47 mmHg (median)
      were obtained at antegrade flowrates between 5-8 l/min. Furthermore, only
      moderate leakage flows were measured during retrograde perfusion. In vivo
      implantations were performed in six 80 kg pigs. Implantation was safe and easy,
      and angiograph and haemodynamic evaluations revealed essentially no stenosis or
      regurgitation. No complications in migration, perforation, hemorrhage or
      thrombosis were observed. This study indicates a good mechanical stability and
      valve function of the new expandable artificial valves.

PMID- 8354585
TI  - Heparinization of biological vascular graft reduces fibrin deposition.
AB  - An alternative graft is needed for coronary bypass operations in patients lacking
      suitable autologous vessels. We therefore studied Denaflex, a biologic graft, in
      a dog ex-vivo shunt model to determine whether heparin treatment makes this graft
      less thrombogenic. Comparison was also made to Bioflow, a nonheparinized biologic
      graft. Fibrinogen deposition during high flow (593 +/- 202 ml/min) decreased from
      672 +/- 467 ng/mm2 in nonheparinized Denaflex grafts to 448 +/- 298 ng/mm2 (p <
      0.05) in heparinized Denaflex grafts. At low flow (117 +/- 13 ml/min),
      heparinization of Denaflex grafts similarly decreased fibrinogen deposition from
      1102 +/- 601 ng/mm2 to 703 +/- 405 ng/mm2 (p < 0.05). At both flow rates
      fibrinogen deposition in Bioflow grafts was less than in nonheparinized Denaflex,
      but was similar to heparinized Denaflex grafts. Platelet deposition was not
      influenced by heparinization of Denaflex grafts and was similar among Denaflex
      and Bioflow preparations. Whether Denaflex performs acceptably in vivo as a
      xenograft requires extensive study.

PMID- 8354586
TI  - Use of the microdialysis technique in the monitoring of subcutaneous tissue
      glucose concentration.
AB  - For some time the subcutaneous (s.c.) tissue has been the target for continuous
      glucose measurement. The microdialysis technique permits an extracellular region
      approach, which has been used for about two decades for measuring various
      metabolites in dialysates obtained from different body regions. By connecting a
      s.c. implanted microdialysis probe to a flow chamber of an amperometric glucose
      sensor, the procedure of glucose sensing was transferred to ex vivo. Using this
      device it was possible to obtain, for up to 24 hours, s.c. tissue glucose
      profiles of healthy and diabetic people. The microdialysis theory, the
      calibration process and other microdialysis technique applications are discussed
      in this paper. Although the combination of the microdialysis technique and
      amperometric glucose sensing requires certain technical equipment, the
      combination of microdialysis and glucose sensor seems to be a promising approach
      to a continuously functioning glucose sensing system.

PMID- 8354588
TI  - Parathyroidectomy: whom, when, how?

PMID- 8354587
TI  - Morphological response of the peritoneum and spleen to intraperitoneal
      biomaterials.
AB  - The present study was performed to evaluate the morphological response of the
      peritoneum and spleen to biomaterials. Silicone elastomer, knitted dacron or
      rubber was implanted, respectively, into a rat's peritoneal cavity and the
      morphology of the peritoneum and spleen was studied at 4 hours and on the 1st,
      4th, 7th and 21st day after surgery. The morphological changes were identical
      among groups with different implanted materials. After intraperitoneal
      implantation of biomaterials from 4 hours and on, an infiltration of inflammatory
      cells was found in the slackened edematous superficial part of the peritoneum.
      Also noted in the spleen were stasis, vessel dilatation and fibrin deposition.
      With the help of scanning electron microscopy, a marked denudation and separation
      of the mesothelial cells, with infiltration of inflammatory cells, were observed.
      Peripheral leucocytes significantly increased in number one day after
      intraperitoneal implantation. Three weeks after intraperitoneal implantation, the
      materials were completely encapsulated and the morphological aberration of the
      peritoneum and spleen disappeared. The findings reveal the consequence and the
      resolution of the host-biomaterial interaction, which could contribute to the
      explanation of various pathophysiological alterations, including the
      translocation of enteric bacteria and the development of infectious complications
      after intraperitoneal biomaterial implantation.

PMID- 8354589
TI  - Use of gentamicin physiologically-based model for individual dosing.
AB  - A new approach to fixing initial doses of gentamicin (GM) for i.m. administration
      (that is most commonly used anyway) is discussed. This approach is based on a
      physiologically-based model allowing to reproduce individual patterns of GM
      concentration change in the patient's blood. This approach was used to reproduce
      the individual pattern of GM concentration change after the initial i.m.
      administration of 80 mg to 19 male patients (age-range 21 to 73 years, weight
      range 50-94 kg, creatinine concentration in the blood 0.4-1.6 mg/d). The GM
      concentration levels, obtained with the help of this model, were afterwards
      compared to the results of FPIA measurement of GM concentrations in the blood of
      the patients 0.5, 1, 2, 3, 5 and 7 h after administration. It proved that the
      average deviation of the predicted values from the actual was equal to 20 per
      cent for all the measuring time-points. For comparison we used individual
      patterns of GM distribution in blood calculated according to the one-compartment
      model from the same values of Vd, Cl and dose. In this case the error of
      pharmacokinetic prediction exceeded the 20 per cent and amounted to 43 per cent
      by 0.5 and 7 hours. Thus, the new approach with the physiologically-based model
      provides better accuracy for stable pharmacokinetic prediction for longer
      stretches of time upon administration, which is especially important for the
      correct establishment of dosing intervals.

PMID- 8354590
TI  - Lack of activities of amikacin and sulphamethoxazole against Mycobacterium avium
      intracellulare.
AB  - Twenty clinical isolates of Mycobacterium avium-intracellulare were tested with
      amikacin and sulphamethoxazole for in-vitro susceptibilities. The MICs and MBCs
      of the former drug ranged from 8 to > 64 mg/L (median MIC: 64 mg/L, median MBC: >
      64 mg/L). The MICs and MBCs of the latter drug were found to be > 256 mg/L. Each
      of eight patients with invasive pulmonary disease due to these organisms was
      treated with amikacin for six months and with cotrimoxazole (sulphamethoxazole
      trimethoprim) for one year. Only one patient had sustained bacteriological
      conversion. Three patients showed a transient reduction of bacillary load during
      the period of amikacin administration. The rest all failed to show response. Thus
      sulphamethoxazole was found to have no activity against Mycobacterium avium
      intracellulare, and amikacin has doubtful activity when used alone in treatment
      of M. avium-intracellulare infection.

PMID- 8354591
TI  - Effects of some cephalosporins and teicoplanin on platelet aggregation.
AB  - Antibiotics may interfere with platelet (PLT) function, and beta-lactam
      antibiotics may interact with PLT aggregation, by inhibiting the binding of
      agonists of this aggregation (such as ADP and collagen) to specific receptor
      sites. In this study we have evaluated the relative in-vitro antiplatelet effects
      of some old and new cephalosporins (cefonicid, ceftazidime, ceftriaxone,
      cefotaxime, cefuroxime and flomoxef) and of teicoplanin, a new glycopeptide
      antibiotic. All the cephalosporins tested, and also teicoplanin, were found to
      have the potential to adversely affect human platelet aggregation only at high
      concentrations which are not achieved in vivo.

PMID- 8354592
TI  - Oral ciprofloxacin for treatment of chronic osteomyelitis.
AB  - Seventeen adult patients with chronic osteomyelitis were treated with oral
      ciprofloxacin, 750 mg twice daily. Treatment ranged from 28 to 254 days. Efficacy
      was considered to be good, based upon clinical resolution observed in 13 patients
      (76%). Clinical and microbiological failure was observed in 3 patients (18%), and
      there was one case of reinfection. Tolerance was very satisfactory, since the
      adverse reactions were mild and transitory; these occurred in 7 patients (41%),
      being cutaneous rash in 4 patients and diarrhoea in 3 patients. No patient had to
      discontinue treatment. Thus, oral ciprofloxacin may be useful option for the
      prolonged treatment of chronic osteomyelitis, provided that it is always
      associated with surgical debridement. Due to the probable development of
      ciprofloxacin resistance in the S. aureus multiresistant strain, already observed
      in two patients in the present investigation, it is suggested that for the
      treatment of such infections another drug with antistaphylococcal activity should
      be associated with the ciprofloxacin.

PMID- 8354594
TI  - L-carnitine in cardiogenic shock therapy: pharmacodynamic aspects and clinical
      data.
AB  - Following our previous work on biochemical and clinical aspects of cardiogenic
      shock, we carried out an open study on 27 patients hospitalized in shock
      condition and investigated for the entire period of permanence in intensive care
      units (ICU). The subjects were treated with high doses of L-carnitine following
      previous results on the use of this molecule in conditions of oxidative damage
      due to acute cellular hypoxia. When compared with the data reported in the
      literature, the results obtained in this study show a surprisingly positive trend
      for the carnitine-treated patients in terms of survival rate to the cardiogenic
      shock. This finding and statistical analysis of the clinical parameters confirm
      the suggestion that L-carnitine could be credited with a new and interesting role
      in the therapy of cardiogenic shock.

PMID- 8354593
TI  - Oral ciprofloxacin for treatment of severe infections.
AB  - Twenty adult patients with severe infections were treated with oral
      ciprofloxacin, 500 or 750 mg twice daily. Treatment ranged from 8 to 25 days.
      Efficacy was good: 14 patients (70%) were cured, four (20%) improved and there
      were only two (10%) failures. Tolerance was very satisfactory, the most common
      side-effects being mild gastrointestinal symptoms (three patients). Only one
      adverse laboratory result was observed: a transient rise in blood urea nitrogen
      and creatinine levels. None of the adverse effects led to discontinuation of
      treatment. Thus, ciprofloxacin presents as a promising drug for treatment of
      severe infections caused by susceptible organisms when ambulatorial therapy, at
      least during a large part of the treatment, is possible and desirable.

PMID- 8354595
TI  - Pharmacokinetic study of the relative bioavailability and bioequivalence after
      oral intensive or repeated short term treatment with two polyamino acid
      formulations.
AB  - The authors studied the relative bioequivalence and bioavailability of two oral
      polyamino-acid formulations (packet and flacon), based on 4 amino acids (L
      glutamine, L-phosphoserine, L-phosphothreonine and L-arginine) in association
      with vitamin B12 (Bio-logos, Sigma Tau Pharma S.A). Open-trial testing was
      carried out after intensive treatment and on the attainment of sustained levels.
      50 healthy volunteers (27 males, 23 females), ranging in age from 23 to 32 years,
      were included in the study. The pharmacokinetic behaviour of the various active
      ingredients was examined at a haematic level. Possible undesirable side-effects,
      resulting from treatment, were also examined during the study. The mean
      pharmacokinetic constants considered (Ke1, Cmax and t1/2) generated an almost
      overlapping AUC (area under the curves) for all homologous components contained
      in both pharmaceutical forms. This indicates almost complete bioequivalence. The
      mean index for the rate of relative bioavailability was, in fact, estimated to be
      106.3 +/- 12.4%. Repeated treatment did not appear to disturb the absorption
      mechanisms of the active ingredients contained in either of the two formulations
      examined, maintaining the relative bioavailability relationship within a
      negligible range, with a statistically non-significant difference (Student's t
      test for coupled data). A few episodes, characterized by slight increases in
      excitability, were reported for both preparations in two patients (4%).

PMID- 8354596
TI  - Interactions of Ostertagia species with their bovine and ovine hosts.
AB  - Ostertagia spp. affect their hosts in several complex interactions involving
      structural, biochemical, hormonal, nutritional and immunological mechanisms.
      Following infection with Ostertagia spp. the specialised secretory function and
      junctional integrity of gastric epithelial cells is lost. The pH of the abomasal
      contents is elevated and pepsinogen concentration in the plasma increases. There
      is a concurrent elevation in the concentration of blood gastrin. The effects may
      be a response to the physical interaction of parasite with epithelial cells, may
      be mediated through parasite excretory/secretory products, or by neural
      mechanisms. There may also be interactions between the responses since elevated
      abomasal pH stimulates secretion of gastrin. Hormonal changes may also have a
      role in the increased susceptibility of host to parasite during the
      periparturient period. Prolactin was considered the most likely hormone candidate
      although there is now a body of evidence to suggest that elevated prolactin
      concentrations are not solely responsible. Infection with Ostertagia spp. causes
      a marked inappetance, negative nitrogen balance and reduction in apparent gross
      energy digestion. The level of nutrition may also affect the response of the host
      to the parasites and establishment of O. circumcincta is lower in animals on a
      low plane of nutrition than those on a high plane. Immunity of Ostertagia spp.
      develops slowly and once established is manifest following challenge by an
      initial hypersensitivity response, followed by a cell mediated response and then
      an antibody response. Parasites may fail to establish or may be expelled from
      immune animals and if they do establish may be stunted with small vulval flaps
      and lower biotic potential and may become inhibited at the early fourth stage of
      development.

PMID- 8354597
TI  - Influence of sex and reproductive status on susceptibility of ruminants to
      nematode parasitism.
AB  - Bulls and rams are notorious among stockmen and stud breeders for their
      apparently greater susceptibility than cows, ewes, steers or wethers to diseases
      caused by excessive infection with parasitic nematodes. Extension advice given to
      farmers generally includes a recommendation to treat entire male animals as
      though they were weaners. In contrast, the scientific literature contains little
      documentation of this fact, although the phenomenon has been well-described in
      laboratory animals. Scientific interest in the susceptibility of lactating cows
      and especially ewes to nematode parasitism has been more extensive, but
      unproductive in terms of elucidating responsible mechanisms. Where ewes have
      acquired immunity to nematode infection, they tend to lose it around the time of
      parturition and during lactation, with important epidemiological and productivity
      consequences. In strains of sheep selected for resistance to nematode infection,
      principally through a more rapidly acquired immune response, resistant ewes still
      undergo a periparturient loss of immunity but retain their relative superiority
      over unselected or susceptible ewes. The mechanisms involve effects of hormones
      associated with lactation on the immune system, but an unequivocal role for
      prolactin or any other hormone has not yet been identified. Collaboration between
      immunologists, endocrinologists and parasitologists is required.

PMID- 8354598
TI  - The effect of age and dietary protein on immunity and resistance in lambs
      vaccinated with Trichostrongylus colubriformis.
AB  - Development of immunity and resistance to Trichostrongylus colubriformis was
      measured in sheep, 8-26 or 33-51 weeks of age, that were offered two levels of
      dietary protein (11 and 20%). Resistance to challenge infection was ascertained
      by measuring worm burden, faecal egg count and eggs in utero in the nematode.
      Development of immunity was measured by an in vitro lymphocyte blastogenesis test
      to T and B cell mitogens and to somatic antigen from infective (L3) larvae. Young
      lambs offered the low protein diet showed a significantly lower resistance to
      parasites than older animals. The young animals on the high protein diet
      developed better resistance. Age and dietary protein influenced in vitro T
      lymphocyte responses to parasite antigen and mitogens, which were particularly
      well developed in vaccinated lambs on the high protein diet. Lymphocyte
      responsiveness to L3 larval antigen was negatively correlated with parasite
      status in vaccinated older lambs, and may be important in the development of
      acquired resistance to T. colubriformis.

PMID- 8354599
TI  - The effect of feed intake on the rate of flow of digesta and the disposition and
      activity of oxfendazole in sheep.
AB  - Within 3 h of intra-ruminal (IR) administration oxfendazole (OFZ) was extensively
      associated with digesta particulate material. This association appeared to be a
      passive adsorption/desorption since sheep given dose equivalent OFZ which was
      contained solely in rumen particulate digesta (obtained from OFZ treated donor
      sheep) exhibited similar OFZ disposition to the IR treated animals. The
      association of OFZ with rumen particulate digesta is a major determinant of the
      pharmacokinetic behaviour of OFZ. The kinetic disposition of OFZ was compared in
      sheep fed 400 g and 800 g day-1 of 50:50 lucerne/wheaten chaff. The flow rate of
      rumen and abomasal fluid and particulate digesta increased with feed intake
      whilst the availability of OFZ and its metabolites in the digestive tract and
      bloodstream decreased. Compared to untreated sheep fed 800 g day-1, OFZ did not
      affect benzimidazole (BZ) resistant Trichostrongylus colubriformis, but reduced
      the numbers of BZ-resistant Haemonchus contortus by 61%. When sheep were fed 400
      g day-1 36 h before and after OFZ administration, 60% of T. colubriformis and 94%
      of H. contortus were removed. Elevated anthelmintic efficacy in sheep can
      therefore be obtained when gastric flow has been slowed by temporarily reducing
      feed intake.

PMID- 8354600
TI  - Host genes, parasites and parasitic infections.
AB  - Resistance to infection of mammalian hosts by parasites is under genetic control
      at many different levels: between species, between races, breeds and lines of
      single species and between individuals. These genetic effects have been described
      in many host-parasite systems. Here we review the interaction between three
      elements: host genes, parasites and the environment in which parasitic infections
      develop. Already livestock industries exploit genetic variation between breeds,
      particularly for the control of trypanosomiasis and tick infestation in cattle.
      In most populations, and to many diseases, resistance is heritable and selective
      breeding for resistance in commercial livestock species has been successful
      experimentally. Attempts at utilizing genetic variation are placed in the broad
      context of the coevolution of host and parasite, the limited knowledge we have of
      the mode of action of resistance genes and our ability to use genetic information
      to predict resistance to parasites.

PMID- 8354601
TI  - Calibrating the bootstrap test of monophyly.
AB  - It has been suggested that the bootstrap test of monophyly is too conservative,
      i.e. the test rejects the hypothesis of monophyly when it is true far too often.
      Here, a method called the iterated bootstrap is described which estimates by
      randomization the probabilities associated with rejecting the hypothesis of
      monophyly when it is true and accepting the hypothesis of monophyly when it is
      false. Using this method, the bootstrap test can be calibrated by taking account
      of the errors associated with the hypothesis test. This method is applied to the
      high-level phylogeny of the Platyhelminthes using 18S rRNA sequences. The
      analysis suggests that the data cannot unequivocally resolve the placement of the
      Platyhelminthes with respect to the Annelida and Insecta.

PMID- 8354602
TI  - Affinities of the Gyliauchenidae: utility of the 18S rRNA gene for phylogenetic
      inference in the Digenea (Platyhelminthes).
AB  - 18S rRNA sequences were analysed using parsimony and distance matrix methods to
      infer relationships among 8 species of trematodes. In particular, the disputed
      relationships of the digenean family Gyliauchenidae were examined. This family is
      regarded by some to be close to the Lepocreadiidae, and by others to be close to
      the Paramphistomidae. The data gave very strong support for placing the
      Gyliauchenidae close to the Lepocreadiidae, and almost no support for the
      alternative hypothesis. This support was found, regardless of the method of
      analysis, using data from different regions of the molecule as well as from the
      entire molecule. Morphological features are re-interpreted in the light of this
      conclusion.

PMID- 8354604
TI  - The role of nematophagous fungi in the biological control of nematode parasites
      of livestock.
AB  - The control of nematode parasites of livestock is presently based entirely on
      anthelmintic treatment and grazing management. On their own, these methods are
      not sustainable because parasites invariably develop resistance to anthelmintics
      and because of increasing public concern about chemical residues in livestock
      products and the environment. Although alternative, non-chemotherapeutic control
      strategies, such as vaccines and genetic selection for resistance are the focus
      of considerable research activity worldwide, biological control of nematode
      parasites has been virtually ignored. The little work that has been done is
      restricted largely to western Europe and involves virtually just one fungal
      species, namely Arthrobotrys oligospora. More recent studies indicate other known
      nematophagous fungal species are more efficient predators of infective larvae in
      sheep faeces than A. oligospora, and others have a greater capacity to survive
      passage through the gastrointestinal tract of ruminants. These findings plus the
      relatively sparse numbers of microbial competitors in the fresh faecal
      environment, compared with the plant rhizosphere where biological control of
      plant parasites is proving a particularly intractable problem, engenders optimism
      that the biological control of animal parasitic nematodes may become a practical
      reality. Such control will never be a substitute for chemotherapy, where the
      primary purpose is worm removal from the host, but should be incorporated
      together with other options into integrated pest management systems to provide
      sustainable nematode control of livestock into the twenty-first century.

PMID- 8354603
TI  - Phylogenetic position of Heronimus mollis (Digenea): evidence from 18S ribosomal
      RNA.
AB  - Most (1918bp) of the nucleotide sequence of the 18S ribosomal RNA gene of
      Heronimus mollis was determined. We aligned this sequence with 18S rRNA sequences
      from 7 other digeneans and an aspidobothrean. Using these data we explored the
      phylogenetic position of H. mollis. No support was found for the hypothesis that
      H. mollis is the sister taxon of the remaining digeneans examined here;
      similarly, no support was found for the hypothesis that H. mollis is closely
      related to the paramphistomes. These analysis together with the skewness of the
      frequency distribution of the lengths of 100,000 trees sampled randomly from the
      set of all possible trees (generated from these data) indicate that 18S rRNA
      sequences are valuable for phylogenetic inference in the Digenea.

PMID- 8354605
TI  - Modified Nissen fundoplication in the treatment of gastroesophageal reflux
      disease.
AB  - Twenty-five consecutive patients underwent a primary modified Nissen
      fundoplication for gastroesophageal reflux disease. According to this procedure,
      an increase of the diameter of the gastric wrap to a comfortable passage of the
      surgeon's index finger between oesophagus and gastric wrap was obtained, while
      the length of the gastric wrap was 1.0 cm. The fixation of the wrap on the
      anterior wall of the oesophagus was done at the level of the mucosal cardia 1.0
      cm above the gastroesophageal junction strengthened by four mesh pledgets. Two
      more stitches between the seromuscular layer of the gastric fundus and the
      oesophageal musculature were placed to prevent reduction of created
      oesophagogastric intussusception. The results of this modified Nissen procedure
      are excellent during the early postoperative follow-up period, ranging from 10 to
      45 months and averaging 26 months.

PMID- 8354606
TI  - Auxiliary liver transplantation in the pig without portal blood: a study of a new
      technique for application to the heterotopic hepatic xenotransplant.
AB  - An auxiliary liver transplantation surgical technique in the pig, in which the
      graft only receives blood flow via the hepatic artery since an end-to-side
      portacaval shunt is performed in the donor animal prior to the transplantation,
      is described. The functional impairment of the receptor liver was done by a
      ligature of the choledoch, provoking death by sepsis in six of the transplanted
      animals at 8.16 +/- 6.61 days post transplantation. The auxiliary liver never
      suffered atrophy and prevented jaundice. It can be concluded that this simple
      surgical technique could be applied to the heterotopic xenotransplantation when
      the complications inherent in the immunological aggression are eliminated.

PMID- 8354607
TI  - Living-related liver transplantation in Africa.
AB  - Liver transplantation is an effective therapy for end stage liver disease.
      Nevertheless in many areas of the world organ availability remains a major
      problem. We report here the success of the first living-related liver
      transplantation in Africa. The left lateral lobe of the mother was transplanted
      orthotopically to her 6 year old child suffering from liver cirrhosis
      complicating glycogen storage disease. The social and medical problems
      encountered are discussed. Living-related liver transplantation is a viable
      option in countries where cadaveric organ donation is either illegal or socially
      unacceptable.

PMID- 8354608
TI  - Definitive surgical treatment of cholelithiasis in selective patients with liver
      cirrhosis.
AB  - A review of 132 cirrhotic patients with cholelithiasis was carried out. Of the 87
      patients who underwent definitive surgical procedures for gallstones, patients of
      Child's A grade had less operative blood loss, blood transfusion and shorter
      hospital stay than those of B and C grades. No mortality in cirrhotic patients
      with Child's A and B grade was found in both emergency and elective surgery.
      Emergency operation in patients with Child's C grade resulted in more operative
      blood loss and requirement than elective surgery. Patients in this grade had also
      a higher morbidity rate and four deaths ensued. Of the 83 survivals after
      definitive procedures, 78 patients (93.9%) were still alive in the following 62.8
      months without any biliary tract symptoms. Of patients who survived after
      cholecystolithotomy, 6 patients (33.3%) had recurrent stones in the same follow
      up period. Therefore, we recommend that definitive biliary surgery be selectively
      carried out in cirrhotic patients in Child's A and B grade. However, a
      conservative approach is more suitable in Child's C patients in emergency
      conditions and definitive procedures should be considered when their liver
      function improves.

PMID- 8354609
TI  - A comparison of laser and cold knife conization.
AB  - Currently, there are two methods of cervical conization, the laser and the cold
      knife. This retrospective review examined 217 laser cases and 205 cold knife
      cases to see which method was superior. The cold knife was shown to have a
      shorter operative time and a lower overall cost to the patient; however, it was
      associated with more intraoperative blood loss and more overnight admissions for
      observation. There were no differences in post operative bleeding complications
      requiring a visit to the emergency room or to the operating room. It is concluded
      that overall, there is no clearly superior method of conization for the treatment
      of cervical intra-epithelial neoplasia.

PMID- 8354610
TI  - Is cervical cancer in Ethiopian women the result of a sexually transmitted
      disease?
AB  - Cervical cancer is the most prevalent cancer of women in Ethiopia and sexually
      transmitted diseases are highly prevalent in the country. In order to establish a
      possible cause and effect relationship between sexually transmitted diseases and
      cervical cancer, likely etiological socio-economic factors for these two
      conditions have been analysed. While residence, income, age at first coitus, age,
      number of sexual partners, marital status/profession and duration of sexual life
      affect both conditions, there is a significant difference between the most
      important factors in the etiology of the separate conditions. Serological testing
      shows a high prevalence of gonorrhea, which was used as a marker of STD. Women
      with gonococcal antibodies had evidence of increased exposure to other STD; there
      was no such correlation for cervical cancer. Our results indicate that STD per se
      is unlikely to be a primary cause of CC in Ethiopia. It appears probable that the
      etiology of CC in Ethiopia is multifactorial. Early exposure of the immature
      cervical epithelium to STD, the trauma of repeated childbirth, and multiple
      sexual partners in women whose defence factors are impaired by chronic
      malnutrition, add up to a major medico-socio-economic factor. The evidence
      presented here suggests that CC in Ethiopia is not so much the result of a
      sexually transmitted disease, but a sociosexual disease.

PMID- 8354611
TI  - Curative local excision for mucosal esophageal carcinoma.
AB  - We performed a curative local excision for mucosal esophageal carcinoma through a
      thoracotomy with the help of intraoperative endoscopy and Lugol's staining. The
      mucosa and submucosa containing the lesion is completely resected, with neither
      narrowing nor shortening of the esophagus left remaining.

PMID- 8354612
TI  - A new incision for pyloromyotomy.
AB  - Over the past two years forty infants with hypertrophic pyloric stenosis have
      been operated on using a supraumbilical transverse midline skin incision with
      retraction of the two rectus muscles apart. This incision has given us good
      exposure, has improved the delivery of the pylorus, produced a strong closure,
      and given a good cosmetic result. We propose this incision as an alternative to
      be used in the operative approach to the pylorus in the treatment of hypertrophic
      pyloric stenosis.

PMID- 8354613
TI  - Colostomy isolation during abdominal surgery.
AB  - Isolation of a colostomy during other abdominal operations could become
      burdensome or lead to contamination of operative site with feces. I present an
      effective, rapid, and safe technique that involves the placement of a purse
      string suture and colostomy packing in addition to external dressing.

PMID- 8354614
TI  - Spontaneous and time-related degeneration of Carpentier-Edwards bioprosthesis in
      mitral position.
AB  - To assess the spontaneous and time-related degeneration of the Carpentier-Edwards
      (C-E) bioprosthesis at 13 years after implantation, the cases of 48 patients who
      had undergone mitral valve replacement with C-E bioprosthesis are examined. The
      time-related clinical findings were started from a new rumbling murmur at an
      average of 5.9 years. The time-related change of transmitral flow was assessed by
      pressure half time and peak pressure gradient on pulsed Doppler cardiography, and
      pressure gradient and effective mitral valve area on cardiac catheterization.
      These values were expressed as an identical linearized curve: pressure half time
      Y = 13.3 X +41.9, peak pressure gradient Y = 1.47 X +1.25, pressure gradient Y =
      1.90 X -3.79, mitral valve area Y = -0.87 X +1.39. From the combined evidence
      presented by these results, the initial structural deterioration of C-E
      bioprosthesis is stenotic change of the cusp, not tear or laceration, and
      correlates well in length of implantation, as evidenced by a linear curve. We are
      encouraged that the lack of catastrophic prosthetic valve failure, as has been
      associated with the pericardial valve, affords the opportunity for an elective
      safe reoperation.

PMID- 8354615
TI  - Ligation of hernial sac. A needless step in adult hernioplasty.
AB  - High ligation of indirect hernia sacs in adults is still commonly practiced.
      Animal and clinical studies have shown that this is unnecessary. To previous
      studies we add our own experience of over 6,321 adult hernia repairs in which the
      sacs were rarely excised and never ligated. The questionable logic leading to
      high ligation is outlined. Experience reveals that non-ligation of indirect sacs
      is harmless and may decrease post-operative pain.

PMID- 8354616
TI  - Retroperitoneal lymph node dissection for testicular tumors using the
      thoracoabdominal approach.
AB  - During the past 4 years, 16 patients with testicular tumor underwent
      retroperitoneal lymph node dissection using the thoracoabdominal extraperitoneal
      approach described by Scardino. In 4 of them, the lymph node dissection was
      performed without pleurotomy using our modified technique. No uncontrollable
      intra- or post-complications or operative deaths occurred in our series. From our
      experience, it was concluded that the thoracoabdominal approach was suitable for
      maximum exposure of the retroperitoneal area and was associated with lower
      mobility. Furthermore, our modified extrapleural extraperitoneal technique also
      provided an excellent operative field comparable to the thoracoabdominal
      approach.

PMID- 8354617
TI  - Polytetrafluoroethylene injection for the treatment of partial fecal
      incontinence.
AB  - Perianal injection of polytetrafluoroethylene (Teflon or Polytef) paste was used
      in the treatment of 11 patients with partial fecal incontinence which followed
      internal sphincterotomy in 7 patients and was idiopathic in 4. All patients had
      been incontinent for more than 4 years, and had failed to respond to conservative
      measures. 5 ml of Polytef paste were injected, without anesthesia, in the rectal
      neck submucosa, above the pectinate line at each of the 3 and 9 o'clock
      positions. Patients were followed for 18 to 24 months. They were categorized into
      3 scores: 1, cured; 2, improved, and 3, no change. Long-term cure (score 1)
      occurred in 45.4% after the 1st injection and in 63.6% after the 2nd injection.
      36.4% showed partial improvement (score 2). No failures occurred. Improvement is
      believed to be due to the increase in rectal neck pressure produced by the
      cushion-effect of the polytef submucosal injection. The technique is simple, easy
      and without complications. It is performed on an outpatient basis.

PMID- 8354618
TI  - Is the preferential use of polytetrafluoroethylene grafts for below-knee
      femoropopliteal bypass justified?
AB  - The usefulness of polytetrafluoroethylene graft (PTFE) for primary below-knee
      femoropopliteal bypass was examined. Forty-five primary femoropopliteal bypasses
      with PTFE were performed in 35 patients during a 7-year period. Patients were
      divided into two groups: above-knee (A-K group, n = 20) and below-knee (B-K
      group, n = 25) bypass. Differences in intergroup patient demographics were not
      significant. The primary patency rate in the A-K group at 3 and 5 years was 83.6%
      and 50.2%, respectively, and was 76.2% at both 3 and 5 years in the B-K group.
      These differences were not significant. Cause of graft failure, 3 grafts in the A
      K group and 5 grafts in the B-K group, was kinking or thrombus formation
      associated with intimal hyperplasia at the distal anastomosis. All grafts in the
      A-K group with more than 10% stenosis in the early postoperative period had more
      than 50% stenosis in the late postoperative period. On the other hand, the one
      graft in the B-K group with 25% stenosis in the early postoperative period had
      50% stenosis in the late postoperative period. We concluded that the use of PTFE
      for primary below-knee femoropopliteal artery is reasonable when atherosclerosis
      in the proximal popliteal artery is slight. However, close follow-up is necessary
      to detect and treat graft stenosis early.

PMID- 8354619
TI  - The diagnosis of internal mammary node metastases of breast cancer.
AB  - It is important to know the status of internal mammary lymph node (IMN) in
      estimating the prognosis in patients with breast cancer and/or planning the
      treatment. In the first series of this study, the diagnostic value of internal
      mammary lymphoscintigraphy (IMLS) and that of parasternal sonography (PS) were
      evaluated in 57 patients. The overall diagnostic accuracy of IMLS was 72% and
      that of PS, 84%, compared with IMN metastases confirmed on a biopsy. In the
      second series, 23 patients who underwent extended radical mastectomy and were
      found to have IMN metastases, were examined for the sizes and locations of
      metastatic IMN. Minute metastatic lymph nodes not detectable by IMLS or PS were
      found in 9 (39%) of the patients. However, the incidence of metastases to the
      first and/or second intercostal spaces was 97% for the patients. We concluded
      that a biopsy of the first and second intercostal spaces is useful in providing
      the information of IMN status.

PMID- 8354620
TI  - The role of tamoxifen in the prevention and treatment of benign and malignant
      breast lesions: a chemopreventive.
AB  - Tamoxifen (Nolvadex) has been in use for over 20 years and currently is probably
      the most prescribed anti-cancer medication in the world. It is an orally
      effective, synthetic, non-steroidal, estrogen antagonist and agonist agent. In
      studies and trials it has been shown to have only limited side effects. It has
      produced regressions in women with fibrocystic changes, including precancerous
      ones, and in those with metastatic breast cancer, where its benefits were first
      observed. It has increased disease free survival (DFS) and overall survival (OS)
      rates when given as an adjuvant systemic type of therapy in women with early
      breast cancers, and it has reduced the incidence of contralateral breast cancers.
      In addition there are reports indicating its long term use, especially in
      postmenopausal women, may produce overall health benefits. Over the years an
      increasing body of data has emerged allowing for viable hypotheses about the
      possible use of tamoxifen in the prophylaxis of breast cancer, namely that when
      administered in long-term therapy it may reduce the incidence of breast cancer in
      women so treated, that it may provide overall health benefits, particularly in
      postmenopausal women, and that its benefits should far outweigh any risks from
      its relatively limited side effects. However, carefully designed and conducted
      clinical trials are needed to test the safety of tamoxifen and its ability to
      prevent breast cancer before it is advocated for the prophylactic treatment of
      healthy women to prevent breast cancer, even realizing the increasing magnitude
      of the breast cancer problem.

PMID- 8354621
TI  - Risk factors associated with postoperative mortality in patients with esophageal
      cancer.
AB  - We examined how impaired host defense mechanisms contribute to fatal
      complications following transthoracic esophagectomy for malignancy, and compared
      them with other risk factors. Risks associated with operative mortality were
      categorized into 5 groups. Twelve of 80 patients had postoperative fatal
      complications. Five variables in the category of impaired defense mechanisms
      predicted fatal complications with an accuracy of 86.3%. The accuracy of
      prediction by preoperative vital organ dysfunction, other preoperative risks,
      intraoperative risks, and perioperative risks was 87.3%, 90.0%, 87.5%, and 85.0%,
      respectively. When the 5 groups of risk variables were considered together, the
      accuracy increased to 93.8%. We conclude that impaired defense mechanisms are one
      of the important risk factors that contribute to postoperative fatal
      complications and should be considered with other risk factors when predicting
      mortality of transthoracic esophagetcomy.

PMID- 8354622
TI  - Postoperative complications in the treatment of chagasic megaesophagus.
AB  - The postoperative complications of Chagasic megaesophagus were studied in 250
      Chagasic patients referred to the Gastroenterology Clinic of Hospital das
      Clinicas, Federal University of Minas Gerais, Belo Horizonte, Brazil. The
      treatment was balloon dilatation in 45 (18.0%), myotomy and cardioplasty in 63
      (25.2%), Merendino's surgery in 139 (55.6%), esophagogastroplasty in 2 (0.8%) and
      esophagocoloplasty in 1 (0.4%). There were 125 (50%) early and 30 (12%) late
      postoperative complications, and in 65 patients (26%) recurrent dysphagia was
      noted: nineteen (7.6%) after myotomy and cardioplasty, 9 (3.6%) after Merendino's
      operation and 37 (14.8%) after balloon dilatation. Eighty-five patients (34%)
      needed reoperations either to correct recurrent dysphagia (56 patients, 22.4%) or
      to treat other complications (29 patients, 11.6%). The reoperations to correct
      the 19 recurrences after myotomy and cardioplasty were Merendino's operation (12
      patients, 4.8%), forceful dilatation (1 patient, 0.4%), forceful dilatation
      followed by Merendino's (2 patients, 0.8%), another myotomy (2 patients, 0.8%),
      myotomy followed by Merendino and balloon dilatation (1 patient, 0.4%) or
      esophagogastroplasty (1 patient, 0.4%). The recurrences after dilatation were
      treated by myotomy (15 cases, 6%), Merendino's operation (12 cases, 4.8%) and
      myotomy followed by Merendino's (3 cases, 1.2%). After Merendino seven
      reoperations (2.8%) were done: reduction of interposed loop (6 cases, 2.4%) and
      esophagocoloplasty (1 case, 0.4%). The time elapsed between the first operation
      and reoperation or dilatation varied from a few weeks to 18 years.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8354623
TI  - Anencephaly--organ transplantation?

PMID- 8354624
TI  - The brain stem in brain death: a critical review.

PMID- 8354625
TI  - When is medical treatment "futile"?

PMID- 8354626
TI  - The impact of assisted suicide on persons with disabilities--is it a right
      without freedom?

PMID- 8354627
TI  - In re T.A.C.P.

PMID- 8354628
TI  - In re Ray.

PMID- 8354629
TI  - Paternalism, disability, and the right to die.

PMID- 8354630
TI  - Carlton Johnson, et al., v. Webb Thompson, M.D., et al. Petition for a Writ of
      Certiorari to the United States Court of Appeals for the Tenth Circuit.

PMID- 8354631
TI  - Effects of frontal lesions on a selective attention task.
AB  - We set out to test the hypothesis that patients with frontal damage are
      specifically disabled in carrying out tasks requiring a high level of controlled
      attention. A group of patients with frontal lesions and another group of patients
      with retrorolandic lesions were tested for selective attention on a computerized
      task designed to produce a conflict situation between automatic and controlled
      processes. Frontal patients proved to be significantly more prone to errors of
      commission (false alarms) than retrorolandic patients.

PMID- 8354632
TI  - Botulinum toxin treatment in patients with focal dystonia and hemifacial spasm. A
      multicenter study of the Italian Movement Disorder Group.
AB  - In six Centers belonging to the Italian Movement Disorder Study Group, the
      efficacy of botulinum toxin treatment was evaluated in an open collaborative
      study in 251 patients with focal dystonia and hemifacial spasm. The percentage of
      functional improvement ranged from 66% to 81% in patients with blepharospasm,
      from 40% to 51% in patients with spasmodic torticollis and from 73% to 81% in
      those with hemifacial spasm. Good results were also obtained in patients with
      oromandibular dystonia, laryngeal dystonia and writer's cramp. Side effects were
      mild and transient. Local botulinum toxin injection is the first choice
      symptomatic treatment in focal dystonia and hemifacial spasm.

PMID- 8354634
TI  - Chromosome 22 monosomy in a radiation-induced meningioma.
AB  - We report for the first time on the cytogenetics of a radiation-induced
      meningioma, in a patient without neurofibromatosis. Chromosome 22 monosomy was
      found in more than 50% of the cells examined. These findings seem to suggest that
      the same kind of chromosomal aberrations are found in both "idiopathic" and
      radiation-induced meningiomas and that a common etiopathogenetic mechanism might
      be at work in meningiomas of whatever origin.

PMID- 8354633
TI  - Myopathy in long-term AZT therapy: clinical, electrophysiological and biopsy
      study in 67 HIV+ subjects.
AB  - The occurrence of muscular pathologies in AZT treated subjects has been evaluated
      in 67 HIV seropositive outpatients (56 AZT-treated and 11 untreated controls) in
      a neurological clinical and paraclinical follow-up study. Standard
      electromyographic and electrodiagnostic examinations, together with muscle enzyme
      determination, were performed in every subject, and periodically repeated at
      fixed intervals; in 11 patients a muscle biopsy sample was also obtained. An AZT
      related myopathy was diagnosed in 8 biopsied cases; 9 more patients were
      considered to have AZT myopathy on clinical, EMG and ex juvantibus criteria.
      Statistical analysis showed that treatment duration was more relevant to the
      development of the myopathy than AZT dosage, though an individual predisposition
      could not be excluded, at least in a small number of cases. The risk of
      developing a toxic myopathy will therefore have to be considered when evaluating
      long-term effects of AZT therapy.

PMID- 8354635
TI  - Focal inhibitory seizures as the presenting sign of ischemic cerebrovascular
      disease.
AB  - Recurrent episodes of transient neurological dysfunction occurring in a patient
      with evidence of recent multiple lacunar infarctions were at first diagnosed as
      transient ischemic attacks (TIAs), but later proved to be due to focal inhibitory
      seizures. The differential diagnosis between TIAs and partial epileptic seizures
      in patients with ischemic cerebrovascular disease may sometimes be difficult in
      the presence of uncommon clinical manifestations.

PMID- 8354637
TI  - Tarsal tunnel syndrome in skiers. Case report.
AB  - We describe a case of tarsal tunnel syndrome recently observed in a skier. It is
      the second case to be reported. Our aim is to stress the relevance of this
      syndrome to foot pain in these athletes.

PMID- 8354636
TI  - Unusual seizures with a benign course in a case of acute lymphoblastic leukemia
      of childhood.
AB  - We report the unusual seizures in a patient with acute lymphoblastic leukemia.
      The convulsive disorder began acutely as partial somatomotor status epilepticus
      and with diffuse EEG slowing. The seizures then became myoclonic-atonic (drop
      attacks) and an EEG focus appeared on the left paramedian centro-parietal areas,
      activated by proprioceptive stimuli. Despite the severity of the clinical picture
      at onset, the seizures showed a benign course, and disappeared on carbamazepine
      therapy. We think that this epileptic syndrome may have been caused by diffuse
      iatrogenic encephalopathy, probably related to intrathecal methotrexate therapy.

PMID- 8354638
TI  - Interferon-gamma reduces tumor-induced Ia- macrophage-mediated suppression: role
      of prostaglandin E2, Ia, and tumor necrosis factor-alpha.
AB  - Tumor growth enhances macrophage (M phi) suppressor activity by causing M phi to
      increase synthesis of inhibitory molecules such as prostaglandin E2 (PGE2) or
      decreasing their expression of up-regulatory molecules such as the class II MHC
      protein Ia. Although these tumor-induced changes are correlated, it is unknown
      whether tumor-bearing host (TBH) Ia- M phi become more suppressive by increasing
      their PGE2 synthesis. To assess the role of PGE2 in tumor-induced Ia- M phi
      mediated suppression of CD4+ T-cell alloreactivity, unseparated (Ia(+)-enriched)
      or Ia(+)-depleted (Ia-) populations of murine normal host (NH) or TBH splenic M
      phi were added to mixed lymphocyte reaction (MLR) cultures. NH or TBH Ia- M phi
      were significantly more suppressive than their respective unseparated
      populations, and TBH Ia- M phi were more suppressive than their NH counterparts.
      When PGE2 production was blocked with indomethacin, TBH Ia- M phi-mediated
      suppression was reduced more than suppression mediated by all other M phi
      populations. A PGE2-specific ELISA showed more PGE2 in Ia- M phi-containing
      cultures than in those with whole M phi and more in cultures containing TBH Ia- M
      phi than in their NH counterparts. Because interferon-gamma (IFN-gamma) is a
      potent M phi activation molecule that regulates both Ia expression and PGE2
      production, the effects of IFN-gamma on tumor-induced Ia- M phi-mediated
      suppression were investigated. Exogenous IFN-gamma reduced suppression mediated
      by all M phi populations except NH unseparated M phi. IFN-gamma suppressed
      alloreactivity without M phi or with NH unseparated M phi. Suppression mediated
      by NH or TBH Ia-, and TBH unseparated M phi was also reduced when M phi were pre
      incubated with IFN-gamma before their addition to MLR cultures. IFN-gamma
      addition did not block Ia- M phi-mediated suppression by decreasing M phi PGE2
      production. In fact, IFN-gamma addition increased PGE2 production two-fold in MLR
      cultures. However, IFN-gamma partly reduced suppression mediated by exogenous
      PGE2 added to M phi-depleted cultures. Cytofluorometric analysis showed that IFN
      gamma increased the percentage of Ia+ M phi in NH and TBH Ia- M phi populations.
      Blocking TNF-alpha activity with anti-TNF-alpha antibodies caused IFN-gamma to
      suppress alloreactivity in all M phi-added cultures. Collectively, these data
      show that tumor-induced suppression mediated by Ia- M phi is caused by increased
      PGE2 synthesis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8354639
TI  - Pancreas-specific venular labeling by monastral blue B in the BB rat: modulation
      by prostaglandins and their inhibitors.
AB  - Leaky blood vessels in the microcirculation can be detected in vivo by injecting
      an animal with colloidal pigments like Monastral blue B (MbB). We have previously
      used this labeling method in the BB rat, an animal model of spontaneous
      autoimmune diabetes, and detected increased vascular permeability restricted to
      the venules of the pancreas. The earlier data suggested that pancreata of animals
      susceptible to labeling contain trapped intravascular monocytes that are
      activated to release vasoactive mediators after phagocytosis of MbB. To explore
      these observations further, we investigated the effects of prostaglandins on this
      system. Prostaglandins are known to be important mediators of inflammatory
      responses and to modulate the expression of disease in other animal models of
      autoimmunity. We now report that MbB-induced pancreatic labeling is modulated by
      misoprostol (an analogue of prostaglandin E1), prostaglandins of the E series,
      and inhibitors of prostaglandin synthesis. The nonsteroidal anti-inflammatory
      drugs ibuprofen and ketorolac both reduced the intensity of labeling in
      susceptible BB rats in a dose dependent manner. In contrast, both misoprostol and
      prostaglandin E2 given at low doses induced pancreatic permeability in the
      labeling-resistant Wistar Furth rat. To extend this finding, we also tested much
      higher drug doses, since at high concentrations, E series prostanoids exert anti
      inflammatory effects. We observed that large doses of prostaglandin E1,
      prostaglandin E2, and misoprostol all suppressed labeling in the BB rat. We
      conclude that presence of MbB in the pancreatic circulation of the rat induces
      organ specific venular leakage by an inflammatory process involving
      prostaglandins.

PMID- 8354640
TI  - The effect of ebselen on polymorphonuclear leukocyte and lymphocyte migration to
      inflammatory reactions in rats.
AB  - Ebselen, a selinyl organic compound with anti-inflammatory properties was found
      by us previously to inhibit in vitro human polymorphonuclear leukocyte (PMNL)
      adhesion to and migration through umbilical vein endothelium monolayers. Here we
      investigated in rats the effect of ebselen on PMNL and spleen T lymphocyte (SPLT)
      migration to inflamed joints induced by intra-articular (i.a) injection of
      recombinant murine tumor necrosis factor alpha (mTNF alpha) and to dermal
      inflammatory reactions. Inflammation was induced in the carpal and talar joints
      of rats by intra-articular (i.a.) injection (100 ng) of mTNF alpha once daily for
      2 days. Corresponding joints in the opposite limb received diluent.
      Simultaneously, the rats were treated p.o. with either ebselen (100 mg/kg/day) or
      indomethacin (2 mg/kg/day) or vehicle for 2 days. Dermal inflammation was induced
      by intradermal injection (0.05 ml) of inflammatory stimuli. Accumulation of 51Cr
      labelled rat blood PMNL, 111In-labeled SPLT, and extravasation of 125I-labelled
      human serum albumin (HSA) in the joints and in skin sites were measured.
      Treatment of rats with ebselen inhibited by 33-65% PMNL migration to the mTNF
      alpha inflamed joints, and to dermal inflammation induced by zymosan activated
      serum (ZAS; containing C5adesArg), endotoxin (LPS), mIL-1 beta and mTNF alpha.
      Migration of SPLT to dermal inflammation induced by interferon gamma (IFN gamma),
      poly-inosine-cytosine (poly I:C) and LPS was also significantly inhibited (22
      33%), but SPLT migration into the inflamed joints was not effected by ebselen.
      Indomethacin treatment of rats also inhibited PMNL migration into the inflamed
      joints, but unlike ebselen, indomethacin inhibited only ZAS induced dermal PMNL
      accumulation. In contrast to ebselen, indomethacin inhibited SPLT migration into
      the inflamed joints as well as to the dermal inflammation induced by poly I:C and
      a delayed-type hypersensitivity reaction (DTH). In addition, treatment of rats
      with indomethacin significantly inhibited plasma protein (125I-HSA) extravasation
      in the inflamed joints and the dermal inflammatory reaction induced by ZAS, but
      ebselen had no such effect. In conclusion, ebselen appears to have a distinct
      antiinflammatory mechanism of action from indomethacin and the PMNL findings are
      consistent with a direct inhibitory action on PMNL activation and PMNL
      transendothelial migration as observed previously in vitro.

PMID- 8354641
TI  - Inhibition of ornithine decarboxylase activity decreases polyamines and
      suppresses DNA synthesis in human colonic lamina propria lymphocytes.
AB  - Ornithine decarboxylase (ODC) and the polyamines are essential for cell
      proliferation in a variety of cells including lymphocytes. In this study, we
      investigated the potential role of ODC and polyamines in human colonic lamina
      propria lymphocytes (LPL) compared to peripheral blood lymphocytes (PBL). Our
      results show that con A stimulation of LPL and PBL was associated with marked
      increases in ODC and polyamines. The specific inhibitor of ODC, alpha
      difluoromethylornithine (DFMO), resulted in a complete inhibition of ODC activity
      and depletion of putrescine, spermidine and spermine levels. DFMO also suppressed
      DNA synthesis of LPL and PBL by up to 48% and 62% respectively. This
      antiproliferative effect was reversed by adding back the polyamines putrescine (1
      mM), spermidine (10 microM) or spermine (10 microM) to the culture medium. We
      conclude that ODC and the polyamines are important for human LPL proliferation,
      and hence may play a role in human mucosal immune function.

PMID- 8354642
TI  - In vivo immunopharmacological properties of tuftsin and four analogs.
AB  - Four analogs of the natural macrophage-activator peptide tuftsin (T-K-P-R) were
      synthesized with the aim of obtaining compounds more effective in the stimulation
      of the immune system than tuftsin. Modifications to the parent tuftsin molecule
      were (i) substitution of the proline (P) residue, and/or (ii) replacement of the
      N-terminal residue threonine (T). The study presented here shows that the
      integrity of the NH2 terminus is not mandatory for a full biological tuftsin-like
      activity. Our data also suggest that the analogue F-(psi)-K-ABO-R, where ABO is a
      non-natural amino acid, is a promising agent for immunotherapy of infectious and
      neoplasic diseases for which tuftsin has already demonstrated some efficacy.

PMID- 8354643
TI  - Glucocorticoids modulate soluble interleukin-2 receptor levels in vivo depending
      on the state of immune activation and the duration of glucocorticoid exposure.
AB  - We have studied the modulation of circulating soluble interleukin-2 receptor (sIL
      2R) levels by glucocorticoids in subjects with different states of immune
      activation. In contrast to normal subjects, 40 mg methylprednisolone
      administration over 6 days resulted in a significant fall of elevated circulating
      sIL-2R levels (p < 0.05) in patients with active atopic dermatitis, most
      pronounced in those patients showing the highest pre-treatment levels of sIL-2R
      and scores of disease activity. Following administration of 1 mg dexamethasone,
      sIL-2R levels remained unchanged both in normal subjects and patients with atopic
      dermatitis. Circulating sIL-2R levels were significantly decreased in patients
      with long-term hypercortisolism due to Cushing's disease (p < 0.05) and
      significantly elevated (p < 0.05) in hypocortisolemic patients. Blockade of
      adrenal cortisol secretion by 1.5 g metyrapone did not change sIL-2R levels in
      normal subjects and sIL-2R levels were not affected in depressive patients,
      either before or after clinical remission or following 1.5 g metyrapone
      administration. These data suggest that the effect of glucocorticoid
      administration on circulating sIL-2R levels depends on the state of immune
      activation and the duration of glucocorticoid exposure. The circulating sIL-2R
      levels show significant changes in patients with chronic alterations of
      endogenous glucocorticoid secretion and in response to prolonged glucocorticoid
      therapy in disorders with immune activation.

PMID- 8354644
TI  - Community health development: an anthology of the works of Guy W. Steuart.

PMID- 8354645
TI  - Social and behavioral change strategies. 1985.

PMID- 8354646
TI  - Guy W. Steuart: the person and his works.

PMID- 8354647
TI  - The importance of programme planning. 1959.

PMID- 8354648
TI  - Community health education. 1962.

PMID- 8354649
TI  - Community health development: an overview of the works of Guy W. Steuart.

PMID- 8354650
TI  - Health, behavior, and planned change: an approach to the professional preparation
      of the health education specialist. 1965.

PMID- 8354651
TI  - Planning and evaluation in health education. 1969.

PMID- 8354652
TI  - Scientist and professional: the relations between research and action. 1969.

PMID- 8354653
TI  - The world is not round: innovation and the medical wheel. 1977.

PMID- 8354654
TI  - Social and cultural perspectives: community intervention and mental health. 1978.

PMID- 8354655
TI  - Changing patterns of infections in the immunocompromised patient with cancer.
AB  - Infectious complications have become frequent causes of morbidity and mortality
      in cancer patients, often replacing the primary disease as the leading cause of
      death. Intensive chemotherapy regimens, widespread prophylactic and therapeutic
      administration of antibiotics, and reliance on intravascular catheters have
      altered the epidemiology of infections in these patients. The authors review how
      gram-positive bacteremias have replaced gram-negative bacteremias as the leading
      causes of infections in many patients with cancer, and how fungal infections have
      become a leading cause of morbidity and mortality as bacterial infections are
      better controlled. Multiresistant organisms that have developed during the past
      decade and future trends in infectious complications of cancer patients are also
      discussed.

PMID- 8354656
TI  - Evolving risk factors for infectious complications of cancer therapy.
AB  - Advances in the supportive care of cancer patients have led to improved long-term
      outcomes. Infection, however, remains the most significant complication of cancer
      therapy. The author reviews the impact of new cancer therapies on the risk
      factors for infectious complications and the impact of therapy on the alterations
      in host defense. The relative importance of therapy-induced changes are
      contrasted with immunologic abnormalities associated with specific cancers. In
      addition, the author contrasts these changes with the infectious complications of
      human immunodeficiency virus infection, highlighting common themes in
      immunocompromised patients.

PMID- 8354657
TI  - Understanding and diagnosing infectious complications in the immunocompromised
      host. Current issues and trends.
AB  - The number of patients who are at an increased risk of life-threatening infection
      has expanded greatly during the past decade. This expansion is because of two
      events, one terrible in its consequences, the other very positive. The first is
      the unprecedented epidemic of opportunistic infection that follows infection with
      the human immunodeficiency virus or the acquired immunodeficiency syndrome. The
      second is a direct consequence of the successes of the transplant surgeon, the
      cancer chemotherapist, the hematologist, and the rheumatologist. The authors
      review the current issues and trends in understanding and diagnosing infectious
      complications in the immunocompromised host.

PMID- 8354658
TI  - Infectious complications in the immunocompromised host. The antimicrobial
      armamentarium.
AB  - The treatment of infectious complications in the cancer patient has evolved as a
      consequence of the developments in cancer chemotherapy, which significantly
      impair immune function. Broad-spectrum, single-agent antibiotics have replaced
      more cumbersome multidrug regimens for empiric coverage of fever and neutropenia
      in many institutions. The use of new, potent oral antibiotics may be a next step
      toward further simplifications. Several new antivirals have come into clinical
      use in the past decade, and reports of viral resistance to the standard agent,
      acyclovir, have come forth. Increasing experience with new (and older) antifungal
      and antiparasitic agents has given a better understanding of the use of these
      drugs for both prophylaxis and treatment. This overview includes a critical
      appraisal of the attributes and limitations of current antibiotics, antivirals,
      antifungals, and antiparasitic agents for the immunocompromised host.

PMID- 8354659
TI  - Approach to management of fever and infection in patients with primary bone
      marrow failure and hemoglobinopathies.
AB  - The characteristic spectrum of infections in patients with aplastic anemia,
      chronic neutropenic diseases, sickle cell disease, thalassemia, and other
      hemoglobinopathies are described. The major risk factor for infection in patients
      with bone marrow failure is the degree of neutropenia and monocytopenia. In
      patients with aplastic anemia, invasive fungal infections emerge as the major
      causes of mortality. Life-threatening infections are rare in patients with
      chronic neutropenic diseases; however, necrotizing enterocolitis due to
      Clostridium species may be an exception. Bacterial infections, predominantly with
      encapsulated bacteria, are the most common cause of death in patients with sickle
      cell disease, especially those who are younger than 5 years of age. Patients with
      thalassemia and other hemoglobinopathies are particularly susceptible to life
      threatening infections with Yersinia enterocolitica as a result of iron overload
      or of the chelating therapy with desferrioxamine.

PMID- 8354660
TI  - Approach to the immunocompromised host with pulmonary symptoms.
AB  - Respiratory disease is common in patients who are immunocompromised, which may be
      because of opportunistic infection, non-infectious processes related to the
      underlying disease, or therapy instituted for treatment. Approaching pulmonary
      symptoms in an immunocompromised host is a complex challenge because the symptoms
      represent a diverse spectrum of disease. In addition to the routine clinical
      evaluation, this article reviews four diagnostic procedures to characterize
      pulmonary disease. Current concepts regarding the prevention of infection are
      also addressed.

PMID- 8354661
TI  - Growth of mycoplasma transformed tTN129 cells depends on IGF-I.

PMID- 8354662
TI  - Staurosporine induces multinucleation following chromosome decondensation in
      Colcemid-arrested cells.

PMID- 8354663
TI  - A better defined medium for human prostate cancer cells.

PMID- 8354664
TI  - A simplified in vitro model of oxidant injury using vascular endothelial cells.
AB  - Oxidant injury of the vascular endothelium is considered an early event in the
      pathogenesis of atherosclerosis. The model of oxidant injury is crucial to the
      investigation of antioxidants. In the present study, a convenient in vitro model
      of oxidant injury induced by hydrogen peroxide (H2O2) was developed using bovine
      pulmonary artery endothelial cells (PAEC). Viability of PAEC grown in 96-well
      culture plates was determined with methylthiazol tetrazolium (MTT) colorimetric
      assay. Cell membrane integrity was measured by lactate dehydrogenase (LDH)
      release from PAEC grown in 24-well plates. Malondialdehyde (MDA, a product of
      lipid peroxidation) in PAEC grown in 6-well plates was detected by a
      thiobarbituric acid fluorometric assay. Incubation of H2O2 with PAEC caused a
      dose-dependent decrease of cell viability, an increase of LDH release, and an
      elevation of MDA production. MTT assay was convenient, quantitative, non
      radioactive, and suitable for testing a large number of samples. The fluorometric
      assay for measuring MDA production in endothelial cells used 6-well plates
      instead of 80-cm2 flasks employed by previous investigators. The use of multiwell
      culture plates in these assays made it possible for more samples to be tested in
      any single experiment. The three assays are reproducible with low intraplate and
      interplate coefficients of variation. This in vitro model is suitable for
      screening antioxidants and for studying pharmacodynamics at the cellular level.

PMID- 8354665
TI  - Culturing the epiblast cells of the pig blastocyst.
AB  - Pig epiblast cells that had been separated from other early embryonic cells were
      cultured in vitro. A three-step dissection protocol was used to isolate the
      epiblast from trophectoderm and primitive endoderm before culturing. Blastocysts
      collected at 7 to 8 days postestrus were immunodissected to obtain the inner cell
      mass (ICM) and destroy trophectodermal cells. The ICM was cultured for 2 to 3
      days on STO feeder cells. The epiblast was then physically dissected free of
      associated primitive endoderm. Epiblast-derived cells, grown on STO feeders,
      produced colonies of small cells resembling mouse embryonic stem cells. This
      primary cell morphology changed as the colonies grew and evolved into three
      distinct colony types (endodermlike, neural rosette, or complex). Cell cultures
      derived from these three colony types spontaneously differentiated into numerous
      specialized cell types in STO co-culture. These included fibroblasts,
      endodermlike cells, neuronlike cells, pigmented cells, adipogenic cells,
      contracting muscle cells, dome-forming epithelium, ciliated epithelium, tubule
      forming epithelium, and a round amoeboid cell type resembling a plasmacyte after
      Wright staining. The neuronlike cells, contracting muscle cells, and tubule
      forming epithelium had normal karyotypes and displayed finite or undefined life
      spans upon long-term STO co-culture. The dome-forming epithelium had an
      indefinite life span in STO co-culture and also retained a normal karyotype.
      These results demonstrate the in vitro pluripotency of pig epiblast cells and
      indicate the epiblast can be a source for deriving various specialized cell
      cultures or cell lines.

PMID- 8354666
TI  - Morphogenesis of "duct-like" structures in three-dimensional cultures of human
      cancerous pancreatic duct cells (Capan-1).
AB  - Pancreatic duct cells secrete water and ions, bicarbonate in particular. The
      study of these secretion processes is hindered by the unavailability of human
      pancreatic tissue. In this study, pancreatic human cells of the Capan-1 cell line
      were employed to investigate secretion in vitro. These cells are of ductal origin
      because in standard culture they polarize spontaneously forming domes in the
      culture dishes, indicating the existence of transepithelial exchange of water and
      electrolytes. In culture in suspension, Capan-1 cells form hollow spheroids
      bounded by a cell monolayer in a radial organization. These three-dimensional
      structures could be maintained in culture for more than 140 days. In young
      cultures, the cells of these spheroids grew rapidly (mitotic index = 9.2% on Day
      2). Their cytologic features were analyzed by immunocytochemical, cytoenzymatic
      methods, and by electron microscopy. We showed that they are: a) polarized with
      an apical pole facing the culture medium; b) organized in a monolayer; c) bound
      by tight junctions and desmosomes; d) characterized by a particular distribution
      of enzyme systems known to play a role in ion exchanges, with placental-type
      alkaline phosphatases and carbonic anhydrases IV on their apical membranes and
      Ca(2+)-ATPases on their basolateral membranes. Crystalline structures were
      detected histochemically in the closed cavities and in the intercellular spaces
      of the spheroids. X-ray emission spectroscopy and electron diffraction showed
      that they consisted of calcium phosphate in an apatite structure. They were
      assumed to derive from a raised concentration of Ca2+ and phosphate ions under
      the impermeable monolayer of the spheroids. In addition, numerous cells secreted
      M1 gastric-type mucins, and acquired the ability to produce colonic-type M3
      mucins. These hollow spheroids swelled during the culture period. Taken together
      these results suggest that the Capan-1 cells organized in these hollow spheroids
      exchange ions. Their three-dimensional structure resembles that of human
      pancreatic ducts, and they may therefore represent a useful model system for
      investigation of Cl- and HCO3- ion exchange processes in the human pancreas.

PMID- 8354667
TI  - Role of thrombospondin in the adhesion of human endothelial cells in primary
      culture.
AB  - The role of thrombospondin on the adhesion of endothelial cells in primary
      culture was studied using a serum-free defined medium or thrombospondin-depleted
      fetal bovine serum. Under these conditions, only 6% of the cells adhered to
      gelatin-coated dishes, whereas cells adhering to gelatin in the presence of
      normal fetal bovine serum were considered as 100% adhesion. The percentage of
      cells attached to fibronectin or thrombospondin-coated dishes in thrombospondin
      depleted serum was 66 and 32%, respectively. The addition of purified platelet
      thrombospondin to thrombospondin-depleted serum increased the adhesion of
      endothelial cells to gelatin and to thrombospondin, up to 32 and 59%,
      respectively, and restored the attachment to fibronectin to the same extent as
      that observed in the presence of normal serum. In contrast to the attachment, the
      spreading of the adhering cells was not further influenced by the addition of
      soluble thrombospondin. Subcultured cells did not require any protein for
      adhering to gelatin substrata. These observations indicate that thrombospondin
      plays a major role in the adhesion of endothelial cells in primary culture.

PMID- 8354668
TI  - Development of primary culture of ovine fetal hepatocytes for studies of amino
      acid metabolism and insulinlike growth factors.
AB  - We report the development and characterization of a system of primary culture of
      ovine fetal hepatocytes to aid in the understanding of the cellular regulation of
      fetal growth and metabolism with emphasis on amino acid metabolism and
      insulinlike growth factor gene expression and to allow comparison to in vivo
      studies. Hepatocytes were isolated from late gestation fetal lambs by in situ
      perfusion and collagenase digestion utilizing occlusion of the ductus venosus to
      limit intrahepatic shunting. Hepatocytes were cultured in media modified to mimic
      fetal concentrations of glucose, lactate, and amino acids. Ovine fetal
      hepatocytes in primary culture maintain the pattern of fetal amino acid
      production and utilization seen across the fetal liver in vivo. Specifically,
      there is a net production of serine and a net utilization of glycine. Cultured
      ovine fetal hepatocytes specifically increase tritiated thymidine incorporation
      in response to insulin and insulinlike growth factor II (IGF-II). IGF-II mRNA
      abundance is high and IGF-I mRNA is low in cultured ovine fetal hepatocytes as in
      the fetal sheep liver in vivo. These data demonstrate the successful isolation of
      ovine fetal hepatocytes that retain some of the characteristics of the ovine
      fetal liver while maintained in short-term culture.

PMID- 8354669
TI  - Notice of retraction.

PMID- 8354670
TI  - Intertrochanteric osteotomy and autogenous bone-grafting for avascular necrosis
      of the femoral head.
AB  - A prospective study was done of forty-five hips in forty-three patients who had
      Ficat stage-III avascular necrosis of the anterosuperior part of the femoral
      head. The patients had been followed for an average of sixty-five months (range,
      thirty-six to 126 months) after an operation that included a valgus-flexion
      intertrochanteric osteotomy, curettage of necrotic bone, and grafting of
      autogenous bone to the avascular segment. The patients were 32 +/- 8 years old
      (mean and standard deviation). Patients who were more than forty-five years old,
      had an underlying systemic disease, had been treated with steroids, had more
      extensive involvement of the femoral head, or were poorly motivated were excluded
      from the study. The mean preoperative Harris hip score was 34 +/- 10 points, and
      the mean score at the most recent assessment was 90 +/- 7 points. Six hips (13
      per cent) failed; failure was defined as a Harris hip score of less than 70
      points or the performance of a subsequent replacement arthroplasty. Survivorship
      analysis demonstrated cumulative survival without such failure to be 87 per cent
      at five years; the ten-year cumulative survival was essentially unchanged. The
      results of this study suggest that the role of intertrochanteric osteotomy and
      bone-grafting of the femoral head should be considered anew for the treatment of
      avascular necrosis of the hip in younger patients who have not received steroids.
      The results of this procedure should be compared again with those of arthroplasty
      in the treatment of this condition.

PMID- 8354671
TI  - Acute slipped capital femoral epiphysis: the importance of physeal stability.
AB  - To test the traditional classification system of slipped capital femoral
      epiphysis, we evaluated the presenting symptoms and radiographs of fifty-four
      patients and reclassified the slipped epiphyses as unstable or stable, rather
      than acute, chronic, or acute-on-chronic. Slips were considered to be unstable
      when the patient had such severe pain that weight-bearing was not possible even
      with crutches. Slips were considered to be stable when the patient could bear
      weight, with or without crutches. We reviewed the records on fifty-five hips in
      which the slip would have been classified as acute because the duration of
      symptoms was less than three weeks; thirty of these were unstable and twenty-five
      were stable. All slips were treated with internal fixation. A reduction occurred
      in twenty-six of the unstable hips and in two of the stable hips. Fourteen (47
      per cent) of the thirty unstable hips and twenty-four (96 per cent) of the twenty
      five stable hips had a satisfactory result. Avascular necrosis developed in
      fourteen (47 per cent) of the unstable hips and in none of the stable hips. We
      were not able to demonstrate an association between early reduction and the
      development of avascular necrosis.

PMID- 8354672
TI  - The epidemiology of bilateral slipped capital femoral epiphysis. A study of
      children in Michigan.
AB  - The records of 224 children who had a slipped capital femoral epiphysis and who
      had no underlying metabolic or endocrine disorder were studied retrospectively to
      investigate the epidemiology of bilateral slipped capital femoral epiphysis.
      Eighty-two (37 per cent) of the 224 children (fifty-one boys and thirty-one
      girls) had a bilateral slip. Sixty-four of these children were black and eighteen
      were white. The age at the time of the diagnosis of the first slip was 13 +/- 1.7
      years (mean and standard deviation), the duration of the symptoms was 5 +/- 5.0
      months, and the angle of the slip was 26 +/- 16 degrees. Obese children were
      younger at the time of the diagnosis of the first slip (12 +/- 1.6 compared with
      13 +/- 1.6 years for the children who were not obese, p = 0.001). The diagnosis
      of a slipped capital femoral epiphysis was made simultaneously in both hips in
      forty-one children and sequentially in forty-one children. Compared with the
      children in whom both hips were diagnosed simultaneously, the children in whom
      the hips were diagnosed sequentially had had a shorter duration of the symptoms
      before the diagnosis of the first slip (3 +/- 2.4 compared with 7 +/- 5.9 months,
      p = 0.0003), were younger at the time of the diagnosis of the first slip (12 +/-
      1.9 compared with 13 +/- 1.2 years, p = 0.001), and tended to be more obese (p =
      0.025). In 88 per cent of the patients who had sequential slips, the second slip
      was diagnosed within eighteen months after the diagnosis of the first
      slip.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354673
TI  - Complications of use of the Ilizarov technique in the correction of limb
      deformities in children.
AB  - We reviewed the records of the first forty patients who had been managed at our
      institution with the Ilizarov technique for the correction of limb deformities,
      including limb-length inequality, to delineate the complications of this method
      of treatment. The duration of follow-up ranged from two and one-half to four
      years. A complication was defined as any untoward occurrence to a patient either
      during the course of treatment or after removal of the fixator. A major
      complication was considered one that necessitated an additional operative
      procedure; caused lasting sequelae, such as malunion, deformation of new bone,
      joint contracture or stiffness, or nerve palsy; or prolonged the treatment. A
      minor complication was regarded as one that responded to non-operative treatment
      and did not cause lasting sequelae, such as transient decreased motion of the
      joint, paresthesia, or pin-track infection. There were eighty-eight complications
      -thirty-eight, major, and the remaining fifty, minor--in the sixty-one segments
      of the limb that were treated; this represented an average of almost one and one
      half complications for each segment. Twenty-nine unplanned operative procedures
      were performed either during treatment with the Ilizarov technique or after
      removal of the fixator. As anticipated, the prevalence of major complications was
      highest in the patients who had had more complex and prolonged treatment. Such
      complications were encountered less often as the surgeons gained experience with
      the procedure, but the rate of minor complications remained relatively constant,
      despite the increased experience.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354674
TI  - Injury of the sciatic nerve associated with acetabular fracture.
AB  - In order to document functional outcome, we followed fourteen patients who had an
      injury of the sciatic nerve associated with a displaced acetabular fracture for a
      mean of twenty-seven months. In three of the patients, the injury was iatrogenic.
      Electromyography was useful in the localization and determination of the severity
      of the injury. According to the functional scale that was used, all but one
      patient had a satisfactory (fair or better) functional outcome, but eleven
      patients had residual neurological sequelae that ranged from minor paresthesia to
      footdrop. Seven patients who had an injury of both the tibial and peroneal
      divisions of the sciatic nerve had complete or nearly complete motor and sensory
      recovery of the tibial component. The patients who had isolated, mild involvement
      of the peroneal nerve had a favorable prognosis, but those who had a severe
      injury of the peroneal component, whether it was isolated or associated with an
      injury of the tibial component, did not recover good function.

PMID- 8354675
TI  - Arthroscopically assisted arthrodesis for osteoarthrotic ankles.
AB  - Arthroscopically assisted arthrodesis of the ankle was performed in nineteen
      patients who were selected because they had osteoarthrosis with minimum or no
      deformity of the ankle. After arthroscopic resection of the synovial membrane,
      the subchondral bone, and cartilage from the tibial, fibular, and talar articular
      surfaces, three percutaneous, cannulated, cancellous screws were used for
      internal fixation. Of these nineteen patients, ten had radiographic evidence of
      union by the second postoperative month; five, by the third; one, by the fifth;
      and one, by the sixth. Two patients had a non-union, but a successful open
      arthrodesis was subsequently performed on one of these patients. At two years,
      the scoring system of Mazur et al. indicated a poor result in one patient (after
      a non-union), a fair result in two, a good result in four, and an excellent
      result in twelve patients. Arthroscopically assisted arthrodesis of the ankle
      produces good results in patients who have osteoarthrosis of the ankle with
      minimum or no deformity, and the immediate postoperative morbidity is of very
      short duration.

PMID- 8354676
TI  - Hypoplasia of the glenoid. A review of sixteen patients.
AB  - We reviewed the records of sixteen patients, fifteen to sixty-two years old, who
      had glenoid hypoplasia with or without an associated deformity of the humeral
      head. The patients were divided into three groups: those who had bilateral
      glenoid hypoplasia without instability of the shoulder (Group I), those who had
      bilateral glenoid hypoplasia with instability of the shoulder (Group II), and
      those who had unilateral glenoid hypoplasia with deformity of the humeral head
      (Group III). When first seen by us, thirteen of the sixteen patients had pain in
      the shoulder, which they had noted after an increase in their previous level of
      activity. All were managed with a specific rehabilitation program for the
      shoulder. The patients were followed for an average of five years, and most were
      able to return to their previous level of activity with the resolution of the
      symptoms.

PMID- 8354677
TI  - Loss of external rotation following anterior capsulorrhaphy of the shoulder.
AB  - A retrospective study was performed on twenty shoulders in nineteen patients who
      had been managed for severe loss of external rotation of the glenohumeral joint
      after a previous anterior capsulorrhaphy for recurrent instability. All patients
      had noted a restricted range of motion, and seventeen shoulders had been painful.
      In seven shoulders, the humeral head had been subluxated or dislocated
      posteriorly, and sixteen shoulders had been affected by mild to severe
      glenohumeral osteoarthrosis. All twenty shoulders were treated with a
      reoperation, which consisted of a release of the anterior soft tissue. In
      addition, eight shoulders had a total arthroplasty and one had a
      hemiarthroplasty. At an average duration of follow-up of forty-eight months, all
      shoulders had an improvement in the ratings for pain and range of motion. The
      average increase in external rotation was 45 degrees (range, 25 to 65 degrees).
      Patients who have a major loss of external rotation following anterior
      capsulorrhaphy of the shoulder may be at risk for the development of posterior
      subluxation and glenohumeral osteoarthrosis. The performance of an anterior
      release should be considered for these patients.

PMID- 8354678
TI  - Age-related changes in the tensile properties of cortical bone. The relative
      importance of changes in porosity, mineralization, and microstructure.
AB  - Tensile testing to failure was done on 235 cortical specimens that had been
      machined from forty-seven femora from human cadavera. The donors had ranged in
      age from twenty to 102 years at the time of death. After mechanical testing, the
      porosity, mineralization, and microstructure were determined. Linear regression
      analysis showed that the mechanical properties deteriorated markedly with age.
      Ultimate stress, ultimate strain, and energy absorption decreased by 5, 9, and 12
      per cent per decade, respectively. The porosity of bone increased significantly
      with age, while the mineral content was not affected. Microstructural analysis
      demonstrated that the amount of haversian bone increased with age. Both bivariate
      and multivariate analyses demonstrated the importance of age-related changes in
      porosity to the decline in mechanical properties. Changes in porosity accounted
      for 76 per cent of the reduction in strength. Microstructural changes were highly
      correlated with porosity and therefore had little independent effect. Mineral
      content did not play a major role. Thus, the quantitative changes in aging bone
      tissue, rather than the qualitative changes, influence the mechanical competence
      of the bone.

PMID- 8354679
TI  - Load-bearing capacity of corticocancellous bone grafts in the spine.
AB  - We investigated the relationship between the densities and areas of commonly used
      autogenous tricortical bone grafts from the iliac crest and the fibula and their
      mechanical load-bearing abilities. Intact corticocancellous grafts, seven
      millimeters thick, were obtained during elective spinal arthrodeses from fifty
      six patients: from the anterior part of the pelvis in twenty-four patients, the
      posterior part of the pelvis in twenty-nine patients, and the fibula in three
      patients. The apparent densities and cross-sectional areas of the cortical and
      cancellous bone were measured with use of a specific computed-tomographic
      technique before the specimens were mechanically tested to failure in uniaxial
      compression. Specimens from the anterior superior iliac spine were able to bear
      significantly higher axial loads (average, 3230 newtons; range, 430 to 8112
      newtons) than were those from the posterior superior iliac spine (average, 1458
      newtons; range, 350 to 4639 newtons) (p < 0.001). The cancellous density was the
      most significant single factor in the prediction of the load to failure of the
      grafts from the iliac crest (adjusted r2 = 0.58; p < 0.0001). When all of the
      physical variables (the cancellous and cortical densities and areas) were entered
      into a multiple-regression model, the combination of the cortical and cancellous
      densities and the cortical area was a good predictor (adjusted r2 = 0.68; p <
      0.001) of the load to failure. The fibular grafts were stronger than those from
      the other two sites, but they had the least over-all cross-sectional area and
      cancellous bone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354680
TI  - Genetic transmission of fibrodysplasia ossificans progressiva. Report of a
      family.
AB  - Fibrodysplasia ossificans progressiva is a rare connective-tissue disorder
      characterized by congenital malformation of the great toes and by progressive
      heterotopic ossification of the tendons, ligaments, fasciae, and skeletal
      muscles. We document the genetic transmission of fibrodysplasia ossificans
      progressiva from a sporadically affected father to each of his three children:
      two daughters and a son. Previous consideration of a genetic etiology was based
      on the fact that the disease has been reported in several sets of monozygotic
      twins, that an increased paternal age has been associated with sporadic
      occurrences of the disorder, and that there have been several reports of genetic
      transmission in the remote past. Although an autosomal-dominant genetic
      transmission has long been suspected, the findings in the family reported on here
      provide confirmation for such inheritance and a basis for the diagnosis and
      counseling of patients who have this disease.

PMID- 8354681
TI  - Deep peroneal-nerve injury as a result of arthroscopic meniscectomy. A case
      report and review of the literature.

PMID- 8354682
TI  - Aneurysmal bone cyst arising after tibial fracture. A case report.

PMID- 8354683
TI  - Persistent synchondrosis of the second cervical vertebra simulating a hangman's
      fracture in a child. Report of a case.

PMID- 8354684
TI  - Blindness as a complication of intraoperative positioning. A case report.

PMID- 8354685
TI  - Arthroscopy of the ankle and foot.

PMID- 8354686
TI  - Magnetic resonance-imaging studies of the shoulder. Diagnosis of lesions of the
      rotator cuff.

PMID- 8354687
TI  - Isokinetic and isometric measurement of strength of external rotation and
      abduction of the shoulder.

PMID- 8354688
TI  - Arthroplasty of the metatarsophalangeal joint with a double-stem silicone
      implant.

PMID- 8354689
TI  - Fixation with a single screw for slipped capital femoral epiphysis.

PMID- 8354690
TI  - MAS6 encodes an essential inner membrane component of the yeast mitochondrial
      protein import pathway.
AB  - To identify new components that mediate mitochondrial protein import, we analyzed
      mas6, an import mutant in the yeast Saccharomyces cerevisiae. mas6 mutants are
      temperature sensitive for viability, and accumulate mitochondrial precursor
      proteins at the restrictive temperature. We show that mas6 does not correspond to
      any of the presently identified import mutants, and we find that mitochondria
      isolated from mas6 mutants are defective at an early stage of the mitochondrial
      protein import pathway. MAS6 encodes a 23-kD protein that contains several
      potential membrane spanning domains, and yeast strains disrupted for MAS6 are
      inviable at all temperatures and on all carbon sources. The Mas6 protein is
      located in the mitochondrial inner membrane and cannot be extracted from the
      membrane by alkali treatment. Antibodies to the Mas6 protein inhibit import into
      isolated mitochondria, but only when the outer membrane has been disrupted by
      osmotic shock. Mas6p therefore represents an essential import component located
      in the mitochondrial inner membrane.

PMID- 8354691
TI  - Localization of Drosophila retinal degeneration B, a membrane-associated
      phosphatidylinositol transfer protein.
AB  - The Drosophila retinal degeneration B (rdgB) mutation causes abnormal
      photoreceptor response and light-enhanced retinal degeneration. Immunoblots using
      polyclonal anti-rdgB serum showed that rdgB is a 160-kD membrane protein. The
      antiserum localized the rdgB protein in photoreceptors, antennae, and regions of
      the Drosophila brain, indicating that the rdgB protein functions in many sensory
      and neuronal cells. In photoreceptors, the protein localized adjacent to the
      rhabdomeres, in the vicinity of the subrhabdomeric cisternae. The rdgB protein's
      amino-terminal 281 residues are > 40% identical to the rat brain
      phosphatidylinositol transfer protein (PI-TP). A truncated rdgB protein, which
      contains only this amino-terminal domain, possesses a phosphatidylinositol
      transfer activity in vitro. The remaining 773 carboxyl terminal amino acids have
      additional functional domains. Nitrocellulose overlay experiments reveal that an
      acidic amino acid domain, adjacent to the PI transfer domain, binds 45Ca+2. Six
      hydrophobic segments are found in the middle of the putative translation product
      and likely function as membrane spanning domains. These results suggest that the
      rdgB protein, unlike the small soluble PI-TPs, is a membrane-associated PI-TP,
      which may be directly regulated by light-induced changes in intracellular
      calcium.

PMID- 8354692
TI  - Molecular characterization of mammalian cylicin, a basic protein of the sperm
      head cytoskeleton.
AB  - The cytoskeletal calyx structure surrounding part of the nucleus of the mammalian
      sperm head contains two major kinds of basic proteins, i.e., the approximately 60
      kD calicin and a group of very basic (IEP > pH 10) polypeptides ranging in size
      from approximately 58 to approximately 100 kD ("multiple band proteins," MBPs).
      We have produced MBP-specific mAbs and have isolated a bovine and a human cDNA
      clone encoding one of these proteins, termed "cylicin" (from the Greek word c eta
      kv lambda l zeta for cup or beaker). Bovine cylicin I of a calculated molecular
      weight of 74,788 contains a high proportion (29%) of positively charged amino
      acids, resulting in an IEP of 10.55, numerous KKD tripeptides, and is
      characterized by an organization of the central part of the molecule in nine
      repeating units of maximally 41 amino acids each of which according to prediction
      analysis should tend to form an alpha helix. The identity of the polypeptide has
      been proven by direct amino acid sequencing of > 14 different fragments and by
      experiments using antibodies raised against a partial cDNA-derived protein
      segment produced in E. coli. By Northern blot analysis we have identified the 2.4
      kb cylicin I mRNA only in testis. The unusual cytoskeletal protein cylicin is
      compared with other proteins and its possible architectural role during
      spermiogenesis is discussed.

PMID- 8354693
TI  - Neurotrophins and their receptors in rat peripheral trigeminal system during
      maxillary nerve growth.
AB  - We examined the expression of the neurotrophins (NTFs) and their receptor mRNAs
      in the rat trigeminal ganglion and the first branchial arch before and at the
      time of maxillary nerve growth. The maxillary nerve appears first at embryonic
      day (E)10 and reaches the epithelium of the first branchial arch at E12, as
      revealed by anti-L1 immunohistochemistry. In situ hybridization demonstrates,
      that at E10-E11, neurotrophin-3 (NT-3) mRNA is expressed mainly in the
      mesenchyme, but neurotrophin-4 (NT-4) mRNA in the epithelium of the first
      branchial arch. NGF and brain-derived neurotrophic factor (BDNF) mRNAs start to
      be expressed in the distal part of the first brachial arch shortly before its
      innervation by the maxillary nerve. Trigeminal ganglia strongly express the mRNA
      of trkA at E10 and thereafter. The expression of mRNAs for low-affinity
      neurotrophin receptor (LANR), trkB, and trkC in trigeminal ganglia is weak at
      E10, but increases by E11-E12. NT-3, NT-4, and more prominently BDNF, induce
      neurite outgrowth from explant cultures of the E10 trigeminal ganglia but no
      neurites are induced by NGF, despite the expression of trkA. By E12, the
      neuritogenic potency of NGF also appears. The expression of NT-3 and NT-4 and
      their receptors in the trigeminal system prior to target field innervation
      suggests that these NTFs have also other functions than being the target-derived
      trophic factors.

PMID- 8354694
TI  - Activated mouse astrocytes and T cells express similar CD44 variants. Role of
      CD44 in astrocyte/T cell binding.
AB  - The CD44 adhesion molecule is expressed by astrocytes, glial-type cells which
      exhibit features of accessory cells for immune responses in the central nervous
      system. In primary cultures of mouse astrocytes, we have observed that surface
      expression and mRNA levels of CD44 are induced following stimulation with either
      PMA, or tumor necrosis factor alpha plus gamma interferon. Comparison of CD44
      splice variants expressed by astrocytes and a T cell hybridoma shows that upon
      activation, both cell types express a similar pattern of CD44 transcripts. Thus,
      in both cell types, CD44 transcripts are produced which contain additional exons,
      including the exon v6 (known to be expressed by in vivo activated lymphocytes and
      by metastatic variants of tumor cells) as well as variants of larger size. In the
      autoimmune disease multiple sclerosis, activated T cells cross the blood-brain
      barrier and lead to inflammation in the central nervous system. Analysis of mice
      with experimental allergic encephalomyelitis, frequently used as an animal model
      of multiple sclerosis, shows that CD44 is induced in vivo on glial cells
      surrounding inflammatory lesions. Using an in vitro model for adhesion between T
      cells and astrocytes, we have found a correlation between the activation state of
      these cells and their adhesion potential. Dose-dependent inhibition of adhesion
      by hyaluronate and by anti-CD44 monoclonal antibody KM81 shows that CD44 is
      involved in the adhesive interactions between T cells and astrocytes.

PMID- 8354695
TI  - Murine clusterin: molecular cloning and mRNA localization of a gene associated
      with epithelial differentiation processes during embryogenesis.
AB  - Clusterin is a broadly distributed glycoprotein constitutively expressed by
      various tissues and cell types, that has been shown to be involved in cell-cell
      adhesion and expressed during cellular differentiation in vitro. To assess the
      suggested participation of clusterin in these processes in vivo, we have cloned
      the cDNA encoding murine clusterin and studied the cellular distribution of
      clusterin mRNA during murine embryogenesis. Sequence analysis of the cDNA
      encoding murine clusterin revealed 92 and 75% sequence identity with the rat and
      human cDNAs, respectively, and conservation of the predicted structural features
      which include alpha-helical regions and heparin-binding domains. From 12.5 d of
      development onwards, the clusterin gene is widely expressed in developing
      epithelia, and selectively localized within the differentiating cell layers of
      tissues such as the developing skin, tooth, and duodenum where proliferating and
      differentiating compartments are readily distinguished. In addition, transient
      and localized clusterin gene expression was detected in certain morphogenetically
      active epithelia. In the lung, abundant gene transcripts were detected in
      cuboidal epithelial cells of the terminal lung buds during branching
      morphogenesis, and in the kidney, clusterin gene expression in the epithelial
      cells of comma and S-shaped bodies coincided with the process of polarization.
      Our results demonstrate the in vivo expression of the clusterin gene by
      differentiating epithelial cells during murine embryogenesis, and provide novel
      evidence suggesting that clusterin may be involved in the differentiation and
      morphogenesis of certain epithelia.

PMID- 8354697
TI  - The nuclear pore complex.

PMID- 8354696
TI  - Integrin-mediated neurite outgrowth in neuroblastoma cells depends on the
      activation of potassium channels.
AB  - Electrical signals elicited by integrin interaction with ECM components and their
      role in neurite outgrowth were studied in two clones (N1 and N7) isolated from
      41A3 murine neuroblastoma cell line. Although the two clones similarly adhered to
      fibronectin (FN) and vitronectin (VN), this adhesion induced neurite outgrowth in
      N1 but not in N7 cells. Patch clamp recordings in whole cell configuration showed
      that, upon adhesion to FN or VN but not to platelet factor 4 (PF4), N1 cells
      undergo a marked (approximately equal to 20 mV) hyperpolarization of the resting
      potential (Vrest) that occurred within the first 20 min after cell contact with
      ECM, and persisted for approximately 1 h before reverting to the time zero
      values. This hyperpolarization was totally absent in N7 cells. A detailed
      analysis of the molecular mechanisms involved in N1 and N7 cell adhesion to ECM
      substrata was performed by using antibodies raised against the FN receptor and
      synthetic peptides variously competing with the FN or VN binding to integrin
      receptor (GRGDSP and GRGESP). Antibodies, as well as GRGDSP, abolished adhesion
      of N1 and N7 clones to FN and VN, revealing a similar implication of integrins in
      the adhesion of these clones to the ECM proteins. However, these anti-adhesive
      treatments, while ineffective on Vrest of N7 cells, abolished in N1 cells the FN-
      or VN-induced hyperpolarization and neurite outgrowth, that appeared therefore
      strictly associated and integrin-mediated phenomena. The nature of this
      association was deepened through a comparative analysis of the integrin profiles
      and the ion channels of N1 and N7 cells. The integrin immunoprecipitation profile
      resulted very similarly in the two clones, with only minor differences concerning
      the alpha V containing complexes. Both clones possessed Ca2+ and K+ delayed
      rectifier (KDR) channels, while only N1 cells were endowed with inward rectifier
      K+ (KIR) channels. The latter governed the Vrest, and, unlike KDR channels, were
      blocked by Ba2+ and Cs+. By moving patched cells in contact with FN-coated beads,
      it was shown that KIR channel activation was responsible for the FN-mediated
      hyperpolarization of Vrest. Treatment with Pertuxis toxin (PTX) abolished this
      hyperpolarization and neurite outgrowth, indicating that a G protein is
      interposed between integrins and KIR channels and that the activation of these
      channels is required for neuritogenesis. In fact, the block of KIR channels by
      Cs+ abolished both hyperpolarization and neurite outgrowth, provided that the
      cation was supplied during the first two hours after N1 cell contact with
      FN.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8354698
TI  - Reversible effects of nuclear membrane permeabilization on DNA replication:
      evidence for a positive licensing factor.
AB  - We have investigated the mechanism which prevents reinitiation of DNA replication
      within a single cell cycle by exploiting the observation that intact G2 HeLa
      nuclei do not replicate in Xenopus egg extract, unless their nuclear membranes
      are first permeabilized (Leno et al., 1992). We have asked if nuclear membrane
      permeabilization allows escape of a negative inhibitor from the replicated
      nucleus or entry of a positive activator as proposed in the licensing factor
      hypothesis of Blow and Laskey (1988). We have distinguished these possibilities
      by repairing permeabilized nuclear membranes after allowing soluble factors to
      escape. Membrane repair of G2 nuclei reverses the effects of permeabilization
      arguing that escape of diffusible inhibitors is not sufficient to allow
      replication, but that entry of diffusible activators is required. Membrane repair
      has no significant effect on G1 nuclei. Pre-incubation of permeable G2 nuclei in
      the soluble fraction of egg extract before membrane repair allows
      semiconservative DNA replication of these nuclei when incubated in complete
      extract. Addition of the same fraction after membrane repair has no effect. Our
      results provide direct evidence for a positively acting "licensing" activity
      which is excluded form the interphase nucleus by the nuclear membrane. Nuclear
      membrane permeabilization and repair can be used as an assay for licensing
      activity which could lead to its purification and subsequent analysis of its
      action within the nucleus.

PMID- 8354700
TI  - Learning, forgetting, and retrieval of everyday material across the adult life
      span.
AB  - Levels and rates of acquisition and amounts of forgetting of name-face
      associations and grocery list items were assessed in a sample of 1,921 normal
      participants that was divided into five age groups (i.e., 17-39, 40-49, 50-59, 60
      69, and 70+). Retrieval was assessed via the consistent long-term retrieval score
      (CLTR) from the Grocery List Selective Reminding Test (GLSRT). Substantial linear
      age-associated declines in level of acquisition were noted for both name-face
      associations and grocery list items. There was a significant age-related drop in
      rate of acquisition of name-face associations. Remarkably, very little forgetting
      occurred over a 40-min delay at any age on either measure. There was a
      significant linear age-related decline in retrieval efficiency for grocery list
      items, when variance due to both level of acquisition and retention was removed.
      The nature of age-associated memory decline and its possible neuroanatomic
      correlates is discussed.

PMID- 8354699
TI  - Preventing re-replication of DNA in a single cell cycle: evidence for a
      replication licensing factor.
AB  - Xenopus egg extracts treated with the protein kinase inhibitor 6
      dimethylaminopurine (6-DMAP) are unable to support the initiation of DNA
      replication. Nuclei assembled in 6-DMAP extracts behave as though they are in G2,
      and will not undergo another round of DNA replication until passage through
      mitosis. 6-DMAP extracts are functionally devoid of a replication factor that
      modifies chromatin in early G1 before nuclear envelope assembly, but which is
      itself incapable of crossing the nuclear envelope. This chromatin modification is
      capable of supporting only a single round of semiconservative replication. The
      behavior of this replication factor is sufficient to explain why eukaryotic DNA
      is replicated once and only once in each cell cycle, and conforms to the previous
      model of a Replication Licensing Factor. Cell cycle analysis shows that this
      putative Licensing Factor is inactive during metaphase, but becomes rapidly
      activated on exit from metaphase when it can modify chromatin before nuclear
      envelope assembly is complete.

PMID- 8354701
TI  - Differential aspects of conceptual processing in the Category Test and Wisconsin
      Card Sorting Test.
AB  - Ninety-six veterans from neuropsychiatric wards were administered the Category
      Test (CT), Wisconsin Card Sorting Test (WCST), and a series of concept formation
      tests assessing attribute identification and rule learning. The CT and WCST
      shared only 30% common variance, and related to different facets of concept
      formation. The WCST was associated with attribute identification, which entails
      discrimination of relevant features, while the CT was more related to rule
      learning, which assesses the deduction of classification rules. The CT and WCST
      should not be regarded as similar measures of one construct such as
      "abstraction." Use of discrete scores from each test can help assess different
      aspects of concept formation.

PMID- 8354702
TI  - Adapting the Rivermead Behavioural Memory Test for use with children aged 5 to 10
      years.
AB  - We describe modifications made to the Rivermead Behavioural Memory Test (RBMT) to
      make it appropriate for use with children. Results of a sample of 335 children
      aged 5 to 10 years, attending mainstream schools, are reported. Each child was
      given two of the four versions of the modified test for children together with a
      number of tests of memory and achievement from the Wechsler Intelligence Test for
      Children (Revised WISC-R), and the British Ability Scales (BAS). The children's
      version of the behavioural memory test (RBMTC) has good interrater and parallel
      from reliability. The validity of the RBMTC was established in two ways. First,
      with other tests of memory from the WISC and BAS. Second, a small (n = 36) group
      of children with severe epilepsy and memory difficulties, attending a residential
      school, were tested. The houseparents of these children were asked to complete
      rating scales on everyday memory performance. There was significant agreement
      between houseparents' observations and scores on the RBMTC (Spearman rank
      correlation = .71, p < .001), indicating that the test is indeed assessing
      everyday memory.

PMID- 8354703
TI  - Assessment of hand preference in two language-trained chimpanzees (Pan
      troglodytes): a multimethod analysis.
AB  - The nonhuman primate literature concludes that monkeys and apes do not exhibit
      handedness preferences at the population level. This discrepancy between human
      and nonhuman primate findings may be due to differences in the methods of
      assessment of handedness, lack of reliability between various measures of
      handedness, and a paucity of studies involving great apes. This paper presents
      the results of extensive hand preference studies with two language-trained
      chimpanzees (Pan troglodytes). Both naturalistic and experimental paradigms are
      described. In particular, various methodologic factors involved in handedness
      assessment, including the use of a hand preference measure previously used with
      human subjects were examined. Both chimpanzees exhibited a right-hand preference
      for fine motor tasks requiring manual dexterity.

PMID- 8354704
TI  - Course of insight disorder and emotional dysfunction following closed head
      injury: a controlled cross-sectional follow-up study.
AB  - Closed-head injury (CHI) patients at either 6 months (n = 24), 1 year (n = 19),
      or 2 to 3 years (n = 23) postinjury, were compared with a group of orthopedic
      control (OC) patients (n = 27). CHI patients assessed at 6 months postinjury
      experienced a Post-Traumatic Insight Disorder, in which they underreported the
      severity of their behavioural impairments. CHI patients in the 1 year and 2 to 3
      year follow-up groups evidenced both greater insight about their level of
      behavioural impairment, and higher levels of emotional dysfunction. These
      findings suggested that the return of insight is associated with increased risk
      for emotional dysfunction. Implications of these findings for assessment and
      treatment of closed-head injury patients are discussed.

PMID- 8354705
TI  - Lexical decision performances in P-type dyslexic, L-type dyslexic, and normal
      reading boys.
AB  - Lexical decision performances in P-type dyslexic, L-type dyslexic, and normal
      reading boys were investigated using three-letter and four-letter words (familiar
      words) and nonwords presented in the central visual field. For words, P-type
      dyslexics displayed significantly longer latencies for four-letter than for three
      letter word decisions, whereas L-type dyslexics and normal readers did not. For
      nonwords, all subject groups showed significantly larger mean latencies for four
      letter than for three-letter nonword decisions. In general, the error data
      corresponded to the latency data. L-type dyslexics, however, made more errors
      during four-letter words than during three-letter words, although they had
      similar latencies in both conditions. The results are discussed with reference to
      the hypothesis that P-type dyslexics would use a sequential processing mode for
      reading familiar words, whereas L-type dyslexics would employ a parallel
      processing mode for reading familiar words.

PMID- 8354706
TI  - Proactive interference in patients with amnesia resulting from anterior
      communicating artery aneurysm.
AB  - Diencephalic and temporal amnesics display an excessive sensitivity to proactive
      interference (PI) in memory tasks of the AB/AC kind. There exists considerable
      controversy about the nature of this sensitivity to PI. Moreover, it is an open
      question whether such sensitivity to PI is an obligatory feature of amnesia, or
      rather an incidental result of frontal damage often reported in amnesics. This
      question was reexamined by enrolling patients with an operated aneurysm of the
      anterior communicating artery (ACoA) and matched controls for an AB/AC learning
      task of two lists of 12 paired-associate words. It appeared that ACoA patients,
      like diencephalic and temporal amnesics, did indeed display a marked sensitivity
      to PI when compared to normals (Exp. I), even when performance of both groups in
      the learning of the first list was equated (Exp. II). The distribution of errors
      made in learning the second list, as well as the correlations between performance
      in learning the second list and a Stroop test, suggest that sensitivity to PI in
      ACoA amnesics could be the consequence of an inability to suppress irrelevant
      information at retrieval due to defective inhibitory attentional mechanisms.
      Complementary data collected in a small sample of Korsakoff's amnesic subjects
      are also described.

PMID- 8354707
TI  - Digit Memory Test: unequivocal cerebral dysfunction and suspected malingering.
AB  - The Digit Memory Test (DMT) (Hiscock & Hiscock, 1989), a forced-choice test for
      detecting malingering, was administered to 27 patients with unequivocal cerebral
      dysfunction, 5 patients with postconcussional syndrome, 6 suspected malingerers
      and 10 normal controls. Results indicate that, even in patients with severe, but
      static cerebral dysfunction and unequivocal memory disorder, DMT performance is
      between 95% to 100% correct. By contrast, the 6 patients in whom malingering was
      seriously considered performed at a level much below the other three groups (74%
      correct) but not significantly below chance. The DMT may be helpful in evaluating
      patients suspected of malingering even when they do not score significantly below
      chance.

PMID- 8354708
TI  - Generative naming in Parkinson disease patients.
AB  - The generative naming ability (verbal fluency) of 88 idiopathic Parkinson disease
      (PD) patients was evaluated and compared to that of 21 Alzheimer disease (AD)
      patients and 43 normal age- and education-matched normal control subjects. The PD
      patients were classified according to whether they scored within the normal range
      on the Mini-Mental State Examination (MMSE), a score of 27 or higher, or in the
      abnormal range, a score of 26 or lower. Semantic and letter generative naming
      tasks were administered to assess verbal fluency. Results of the study provide
      evidence that letter category naming is inherently more difficult than semantic
      category naming; that age significantly affects generative naming; that PD
      patients with normal MMSE scores were significantly inferior to normal control
      subjects in generative naming even after the effects of age and mental status are
      controlled; that PD patients with non-normal MMSE scores performed like AD
      patients after controlling for the effects of age and mental status; and, that
      ideational perseveration is the most common type of error response for all
      subject groups.

PMID- 8354709
TI  - Models of cognitive deficit and statistical hypotheses: multiple sclerosis, an
      example.
AB  - The purpose of the current study was to describe four models of cognitive deficit
      and to outline the statistical hypotheses underlying each model. The four models
      of cognitive deficit were (a) specific deficit; (b) subgroup deficit; (c) a
      syndrome dissociation model; and (d) a global function dissociation model.
      Neuropsychological data are analyzed to examine each of these four models in a
      sample of mild Multiple Sclerosis (MS) patients. The results suggest that for
      these subjects and tests, the specific deficit model best fits the data. The
      results are reviewed initially in the context of MS. There follows a
      consideration of statistical caveats and finally, general applications of the
      proposed procedures.

PMID- 8354710
TI  - Malingering and other validity considerations in the neuropsychological
      evaluation of mild head injury.
AB  - Eight malingerers (MPs) were identified via significantly below-chance symptom
      validity testing (SVT) within a sample of 106 consecutive admissions for
      neuropsychological evaluation. The resulting incidence of 7.5% is seen as a
      minimal estimate of malingering within the sample. Eight individuals who "passed"
      SVT but produced neuropsychological data of questionable validity were also
      identified (QVs). MPs and QVs were compared with matched controls on 14 measures
      that have been previously suggested as indicators of invalid neuropsychological
      data. MPs and QVs differed from controls on General Neuropsychological Deficit
      Scale, Fingertip Number Writing, and Digit Span. CVLT Recognition, Finger
      Agnosia, and Speech Perception differed for one of the target groups versus
      controls and had trends toward significance in the other group. However, many of
      the previously suggested invalidity signs were rare or absent. Reliance on these
      measures could result in overconfidence in the validity of neuropsychological
      data.

PMID- 8354711
TI  - A meta-analysis of the relative sensitivity of neuropsychological screening
      tests.
AB  - The National Institute of Mental Health recently formed a committee of experts
      which published a proposal for a lengthy neuropsychological test battery judged
      most apt to detect diffuse brain damage while covering a wide range of cognitive
      abilities. The purposes of the present study were (1) to assemble empirical
      evidence of the existence of statistically significantly sensitive screening
      tests across an equivalently wide range of functional domains, and (2) to present
      this evidence systematically, in such a manner as to help clinicians select
      subsets of screening tests manifesting greatest sensitivity to diffuse brain
      damage. It was found that in certain functional domains (speed of processing,
      problem solving, executive functions), marked differences in sensitivity
      occurred. Brief tests just as sensitive as time-consuming tests were also
      identified. The reader is cautioned about possible extraneous sources of the
      differences obtained (test and group selection bias, test reliability, test
      difficulty, procedural effects, Type I error). Nevertheless, it was concluded
      that a brief highly sensitive and functionally wide-ranging neuropsychological
      test battery for screening cases of putative diffuse brain dysfunction can be
      assembled.

PMID- 8354712
TI  - Lateralization of verbal memory and unilateral hippocampal sclerosis: evidence of
      task-specific effects.
AB  - This study retrospectively investigated the effect of left (LHS) versus right
      (RHS) hippocampal sclerosis on verbal memory, measured by means of the Paired
      Associate Learning and Logical Memory subtests of the Wechsler Memory Scale (WMS)
      administered as part of a routine preoperative assessment. Patients were selected
      for the presence of unilateral hippocampal sclerosis by means of preoperative
      magnetic resonance imaging (MRI) and postoperative neuropathology. The LHS
      patients (n = 20) were significantly worse on paired associate learning than RHS
      patients (n = 18), the performance of RHS patients being consistent with
      normative standards. In contrast, no laterality effect was seen on the immediate
      and delayed recall of passages; the evidence suggests that both groups performed
      at a mildly impaired level. It was suggested that the laterality of verbal memory
      is conditional upon specific task demands in patients with damage to mesial
      temporal structures.

PMID- 8354713
TI  - Implications of statistical tests of variance and means.
AB  - The primary purpose of this paper is to illustrate that tests for the homogeneity
      of variance in the statistical analysis of clinical neuropsychological data may
      provide unique information. Specifically, tests of variance homogeneity are more
      sensitive to outliers than the more commonly used tests of group means. Moreover,
      when both a test of means and of variance are done and the results compared, the
      nature of the deficit within the sample can be interpreted with greater
      confidence.

PMID- 8354714
TI  - Brain injury: a personal view.

PMID- 8354715
TI  - Reverse passive hemagglutination tests for rapid diagnosis of snake envenomation.
AB  - Reverse passive hemagglutination (RPHA) tests for the detection of six major
      poisonous snake venoms of Thailand were studied. Three different species of red
      blood cells i.e., sheep (SRBC), human (HRBC) and chicken (CRBC) were sensitized
      with protein A-affinity purified rabbit antivenom IgG using chromic chloride as a
      coupling reagent. The properties of these sensitized erythrocytes with regard to
      sensitivity, specificity, stability to venom enzymes and storage etc., were
      studied and compared. The sensitivities of the RPHA tests in venom detection were
      2 to 635 ng/ml. Cross-reactions were observed with heterologous venoms at
      concentrations at least 62 times higher than those observed with homologous
      venoms. After treatment with glutaraldehyde, the coupled red blood cells showed
      reduced sensitivity but were stable at 4 degrees C from 1 to 12 months depending
      upon the antibody and the species of erythrocytes. The entire test required 60 to
      120 min. The RPHA using fresh SRBC correctly identified various venoms in 48 of
      59 (81.3%) serum samples and 16 of 26 (61.5%) wound swabs. Venom mis
      identifications were made in 2 sera (3.4%). In a comparison of 24 paired serum
      and wound swab samples, more positive identifications were made with serum than
      with swab samples but the difference was not statistically significant (p >
      0.05).

PMID- 8354716
TI  - A simple, sensitive, dual mAb based ELISA for murine gamma interferon
      determination: comparison with two common bioassays.
AB  - Three assays of murine IFN gamma are compared in terms of sensitivity, intra- and
      inter-assay variability, specificity and simplicity. The widely used viral
      inhibition assay requires 48 hours, necessitates continuous maintenance and
      optimization of fibroblast growth, and exhibits the lowest sensitivity.
      Inhibition of WEHI-279 B cell [3H]thymidine incorporation requires 48-60 hours to
      quantitate IFN gamma production, can be subject to non-specific inhibition, and
      is also labor intensive. In both bioassays, specificity must be determined by the
      analysis of duplicate samples in the presence of neutralizing, IFN gamma-specific
      mAb. In contrast, a 24 hour, dual mAb ELISA, in which IFN gamma is captured by
      immobilized, purified rat IgG1 XMG 1.2 mAb and identified with biotinylated mAb
      R4-6A2 and streptavidin-alkaline phosphatase detects IFN gamma production > 0.05
      U/ml. The quantitative range in this assay is typically from 1-100 U/ml. In
      addition to providing the greatest specificity and shortest duration, this ELISA
      exhibits the lowest coefficient of variation of the three assays compared.
      Collectively, assay characteristics such as sensitivity, absence of interference
      by other proteins, reproducibility, speed and simplicity support the conclusion
      that this dual mAb based sandwich ELISA represents a substantial improvement over
      inhibition of viral cytopathic effect or inhibition of WEHI-279 bioassays for
      characterization of antigen- or mitogen-driven IFN gamma production.

PMID- 8354717
TI  - Quantitative analysis of immunoglobulin G subclasses in the rat.
AB  - Quantitative ELISAs have been developed for the four immunoglobulin G (IgG)
      subclasses (IgG1, IgG2a, IgG2b and IgG2c) of the rat. These assays were shown to
      have excellent sensitivity, reproducibility and adequate specificity for studies
      of natural IgG and antigen-elicited IgG responses. The sensitivity (working range
      for each isotype assay) was: IgG1, 1.6 to 200 ng/ml; IgG2a, 8 to 200 ng/ml;
      IgG2b, 1.6 to 200 ng/ml; and IgG2c, 1.6 to 1000 ng/ml. The isotype sum and the
      direct assay of total plasma IgG agreed closely. The utility of these assays was
      demonstrated in a study of the development of total IgG and of the specific IgG
      response following immunization with tetanus toxoid (TT). For total IgG, the
      predominant isotype was IgG2b (64% of total IgG) followed by IgG2a (29%), IgG1
      (4%) and IgG2c (3%). In contrast, the anti-TT response was mainly of the IgG1
      subclass (57% of total anti-TT). These quantitative assays should prove useful
      for investigating the response to experimental vaccines and the influence of
      cytokines on class switching in vivo.

PMID- 8354718
TI  - Radioimmunoassay for rat B-type natriuretic peptide (BNP-45).
AB  - Rat BNP-45 is the main circulating form of BNP in rat plasma. To understand the
      role of BNP in physiological and pathophysiological conditions, a specific
      radioimmunoassay (RIA) for the quantitative determination of the peptide in
      plasma and tissues is necessary. An assay using rBNP-45 as the standard in
      conjunction with antisera directed against this peptide has not been described in
      the literature, though some investigators have reported values ranging from 0.73
      2.0 pmol/L using either BNP-26 or BNP-32 as the standard peptide. Unfortunately,
      these forms of BNP do not exist in rat plasma. In our studies, we have developed
      a specific RIA for rBNP-45 using rBNP-45 as the standard peptide and Tyro-rBNP-45
      as the radioligand. We have used two specific antisera for assay purposes; one
      against rBNP-45, and the second to a peptide composed of the first 20 amino acids
      of rBNP-45 (rBNP[1-20]). The recovery of various amounts of rBNP-45 added to
      control plasma was 50-80% depending on the method of extraction and purification.
      The interassay and intraassay coefficients of variation were 12% and 6%
      respectively. Values obtained were similar for blood sampled by either cardiac
      puncture, decapitation, or aortic puncture. The method was used to measure rBNP
      45 in the plasma of normal (WKY) and Spontaneously Hypertensive (SHR) rats. The
      values obtained were 5.46 +/- 0.43 and 19.6 +/- 2.36 pmol/L respectively. The rat
      atrial natriuretic peptide (ANP[99-126]) values in the same extracts were 23.2 +/
      0.45 and 51.6 +/- 3.16 pmol/L.

PMID- 8354719
TI  - Radioimmunoassay of ganirelix in plasma or serum.
AB  - A procedure for the radioimmunoassay (RIA) of ganirelix in plasma or serum at
      concentrations as low as 0.050 ng/ml is described. Antiserum was produced by
      coupling the N-terminus glycyl analog of ganirelix to BSA by a carbodiimide
      reaction and immunizing rabbits with this conjugate. The antiserum did not
      crossreact with LHRH or with various ganirelix peptide fragments. For RIA, 125I
      labeled ganirelix was used as the tracer and a double antibody procedure was used
      to separate the free and bound fractions. No purification of the analyte was
      required prior to RIA. Accuracy of the method was assessed by adding known
      quantities of ganirelix to ganirelix-free plasma and determining the ratio of
      measured to added analyte. Linear regression analysis for the concentration range
      0.050-50.0 ng/ml yielded a regression equation of y = 0.97x + 0.18, r = 0.999,
      where x is the amount added and y is the amount measured. Additional validation
      was obtained from an in vivo study in which [3H]-ganirelix was administered to
      monkeys and plasma clearance profiles were determined by RIA and an HPLC
      radiochemical method. The results were in agreement within experimental error of
      the two methods. Linear regression analysis of the comparative data gave the
      equation y = 0.92x + 33.7, r = 0.980, where x is the amount measured by RIA and y
      is the amount measured by HPLC-radiochemical analysis.

PMID- 8354720
TI  - Aging and microcirculatory dynamics in human gingiva.
AB  - There have been no published reports characterizing gingival vascular function in
      humans of different ages. In this study, we compared gingival vascular dynamics
      in 60 healthy male humans ranging in age from 18-75 years (young, 18-25 years
      (Y); middle, 35-45 years (M); old, 65-75 years (O), 20 subjects/group). Both
      videomicroscopy of individual microvessels and laser doppler flowmetry were
      employed to assess marginal gingival circulation. Systemic cardiopulmonary
      parameters were monitored as controls. The number of gingival vessels visible in
      a microscopic field was higher and the number of microvessels exhibiting active
      flow was lower in M and O compared to Y. There were no differences among age
      groups in laser doppler flow values (tissue blood flow) or in red blood cell
      velocity in individual vessels. Although not statistically significant with age
      there was a trend towards decreasing blood flow velocity in both the laser
      doppler and videomicroscopic measurements. Blood pressure increased slightly with
      age. Peripheral oxygen saturation was lower in O compared to Y and M. No
      differences were seen in heart rate, respiratory rate or end-tidal carbon dioxide
      concentration. The changes in blood pressure and oxygen saturation were expected.
      The differences in numbers of visible vessels and the number of vessels with
      active blood flow may reflect the way the gingival microcirculation adapts with
      age to changing nutritional needs or to microbial and/or mechanical challenge.

PMID- 8354721
TI  - A comparative study of electric toothbrushes for the effectiveness of plaque
      removal in relation to toothbrushing duration. Timerstudy.
AB  - The purpose of the present study was to test the plaque-removing efficacy of 4
      different toothbrushes in relation to duration of toothbrushing. The brushes
      studied were a manual toothbrush (M), a conventional electric toothbrush--the
      Blend-a-Dent (BL), the Interplak (IP) and the Braun Plak Control (BPC). For this
      study, 20 subjects were selected. The study was divided into 5 experiments which
      differed only in respect to the brushing time. The available time in experiment 1
      through 5 was 7.5, 15, 30, 45, 90 s per quadrant respectively. Prior to each
      experiment, all subjects were asked to abstain from oral hygiene procedures for
      at least 24 h. The efficacy of toothbrushing in each experiment was studied while
      one investigator (MAL) brushed the teeth of the subjects. In each subject, all 4
      brushes were tested. Each brush was assigned to a quadrant in a random order. No
      toothpaste was used throughout this study. The amount of dental plaque was
      evaluated before and after brushing by means of the Silness & Loe plaque index at
      6 sites around each tooth investigated. The results show an increase in efficacy
      for all brushes varying from 7.5 s per quadrant to 90 s per quadrant (mean plaque
      reduction in terms of percentage 7.5 s-90 s: M = 40%-75%, BL = 45%-82%, BPC = 51%
      94%, IP = 64%-92%). The IP removed significantly more plaque than the other 3
      after 7.5 s of brushing. From 15 s through 90 s, the IP and BPC were equally
      effective.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354722
TI  - Oral hygiene, periodontal conditions and carious lesions in patients treated with
      dental bridges. A 15-year clinical and radiographic follow-up study.
AB  - A longitudinal study, extending over a period of 15 years, was carried out in a
      group of 102 patients who received 108 bridges made by the senior students at the
      Dental Faculty, University of Oslo, in 1967/68. The study included 343 abutment
      teeth, and the remaining teeth in the same jaw which received the restoration,
      525 in all, served as control. The oral hygiene, gingival condition, pocket
      depth, caries on crowned teeth, location of crown margins and changes of alveolar
      bone level were recorded during the study. During the first 10 years, the
      patients received oral hygiene prophylaxis every 6 months. The mean age of the
      patients at the beginning of the study was 48 years. Of the original group of 102
      patients, 88 attended the clinical examination after 5 years, 71 after 10 years,
      and 55 after 15 years. The amount of plaque did not differ between the crowned
      teeth and the control teeth during the observation period, while GI score 2 and 3
      was more frequent in crowned teeth than in the control teeth during this period.
      This was mainly observed when the crown margins were located sub-gingivally. A
      slight increase in mean pocket depth was recorded in the crowned teeth while the
      mean pocket depth for the control teeth remained at the same level during the 15
      years. Caries lesions were recorded in 3.3% of the abutment tooth surfaces at the
      5th year, in 10.0% at the 10th year and in 12.0% at the 15th year examination. No
      statistical differences in bone loss could be detected between the control teeth
      and the crowned teeth.

PMID- 8354723
TI  - Evaluating the efficacy of a new flossing aid.
AB  - The purpose of this clinical trial was to compare the efficacy of a new flossing
      aid (Flosser) with finger flossing on preventing plaque and gingival
      inflammation. 35 adults who did not use dental floss routinely were assigned
      randomly to one of 2 treatment groups (Flosser or finger flossing) in a 2-period,
      single-blind crossover study. After prophylaxis, subjects were instructed to use
      the flossing aid or finger floss 1 x per day and to continue brushing for 30
      days. Gingival inflammation (GI & BPI) and plaque (PI) were assessed prior to the
      prophylaxis and at 30 days. After a 30 day "washout" period, subjects were again
      reassessed for gingival inflammation and plaque, given a prophylaxis, assigned
      the opposite treatment (2nd treatment period) that they received the first
      treatment period, and assessed (GI, BPI & PI) after 30 days. Comparing the mean
      difference of the 30-day buccal interproximal scores between the treatment groups
      (flossing aid scores minus finger flossing scores) showed that the mean
      differences with 95% CI were: -0.013 +/- 0.067 [GI], -0.017 +/- 0.044 [BP] and
      0.019 +/- 0.014 [PI]. No statistically significant differences from zero (0.05
      alpha) were observed using the t-test. There was a high level of compliance (90%)
      with the prescribed regiment, and subjects preferred (56%) the flossing aid
      slightly over finger flossing. Even though there were no statistically or
      clinically significant differences in gingivitis and plaque scores between the 2
      flossing groups, the positive inclination for the flossing aid makes it a
      desirable addition to the armamentarium of preventive dentistry.

PMID- 8354724
TI  - Failure of adjunctive minocycline-HCl to eliminate oral Actinobacillus
      actinomycetemcomitans.
AB  - Considerable problems have been reported in the eradication of Actinobacillus
      actinomycetemcomitans from periodontal sites. The present communication describes
      the 2-year results of a comprehensive combined mechanical/surgical and adjunctive
      minocycline (200 mg/day for 3 and another 2 weeks) treatment regimen in 28
      patients with A. actinomycetemcomitans-associated periodontitis. Elimination of
      A. actinomycetemcomitans at periodontal sites was a prerequisite for gain of
      clinical attachment of > or = 2 mm or decrease of probing depth to < or = 4 mm
      after subgingival scaling plus minocycline (p < 0.01). Whereas 2 years after
      active treatment A. actinomycetemcomitans could not be detected at monitored
      sites in 23 patients, the organism was found on buccal mucosa and in saliva in 17
      and 12 cases, respectively. One or 2 years after periodontal surgery, there was a
      significant association between log10-numbers of A. actinomycetemcomitans in
      buccal samples and numbers of residual pockets of > or = 7 mm as well as gingival
      sites with overt gingivitis (R2 = 0.687, p < 0.001). Present results indicate
      failure of an even prolonged administration of adjunctive minocycline to
      eliminate oral A. actinomycetemcomitans in most cases of A. actinomycetemcomitans
      associated periodontitis.

PMID- 8354725
TI  - Secnidazole concentrations in plasma and crevicular fluid after a single oral
      dose.
AB  - Metronidazole and related nitroimidazole derivatives, including ornidazole and
      tinidazole, have been used successfully in the treatment of periodontal diseases.
      The purpose of this study was to measure secnidazole (another nitroimidazole
      derivative) concentrations in plasma and gingival crevicular fluid (GCF) after
      intake of a single oral dose. Secnidazole concentrations were estimated in 11
      human healthy volunteers after a single dose of 2 g taken orally. Samples of
      blood and GCF were collected before intake and during the following 72 h. A high
      performance liquid chromatography (HPLC) method has been developed for the
      determination of secnidazole in microsamples (1 to 3 microliters) of GCF. The
      mean peak blood and GCF levels were equal to 40.5 +/- 9.4 micrograms ml-1 at 2 h
      in blood and 26.4 +/- 7.0 micrograms ml-1 at 1 h in GCF, respectively. Apparent
      elimination half-life was 28.8 h (blood) and 30.4 h (GCF), respectively. These
      results show that the rate and extent-absorption of secnidazole are slightly
      higher in blood than in GCF, but the elimination of the drug is similar in the
      two body fluids.

PMID- 8354726
TI  - Pilot clinical study of a fluoride resin and conditioning paste for desensitising
      dentine.
AB  - The clinical trial was carried out on 34 'hypersensitive' teeth in 10 subjects.
      Dentine sensitivity was measured as the pain perception thresholds to controlled
      air and probe stimuli. In each subject, pairs of teeth of comparable initial
      sensitivity were randomly assigned to a test (T) or control (C) treatment. All
      teeth were cleaned and a conditioning paste applied. Group T was treated with a
      topically-applied light-cured resin; Group C received a placebo, sham light
      cured. Air sensitivity was remeasured after treatment, and the procedures were
      repeated after 1, 2, and 3 weeks. When comparing air thresholds before and after
      treatment at each visit, the test agent caused significantly greater reduction in
      sensitivity than the control. The median increase in air threshold in the test
      group was 2.5 s at visit no. 1, 1.3 s at visit no. 2 and 0.8 s at visit no. 3.
      Comparisons of the initial thresholds at each visit showed no significant long
      term changes in sensitivity in either group.

PMID- 8354727
TI  - IL-1 in gingival crevicular fluid following closed root planing and papillary
      flap debridement.
AB  - Interleukin (IL)-1 alpha and beta are cytokines which can mediate inflammatory,
      bone resorbing, and reparative effects in the periodontium, but few longitudinal
      data exist exploring their role following periodontal therapy. This study
      examined gingival crevicular fluid (GCF) concentrations of IL-1 alpha and IL-1
      beta at sites with shallow sulci (SS) or inflamed moderate/advanced pockets
      (M/AP) before and 6 months after treatment with closed scaling/root planing
      (SC/RP) or papillary flap debridement (PFD), all in the same subject (n = 14
      patients). No significant differences were noted in IL-1 alpha or beta
      concentrations (determined with two-site enzyme-linked immunosorbent assays)
      between SS and M/AP sites at baseline. While both therapies improved clinical
      parameters of periodontal disease, IL-1 alpha concentration increased
      significantly (p < 0.05) in M/AP-PFD sites 6 months after treatment, but were
      unchanged in other groups. IL-1 beta concentrations were numerically lower after
      therapy, except for a significant increase (p < 0.05) in M/AP-PFD sites. These
      data suggest that surgical wound healing in an inflamed, plaque-infected site
      (M/AP-PFD) results in prolonged production of IL-1, which may be a reflection of
      the extent of tissue trauma and delayed wound healing. In spite of increased IL-1
      levels, these sites demonstrated significant short-term improvement in clinical
      attachment level (+ 1.8 mm, p < or = 0.001) postoperatively.

PMID- 8354728
TI  - Healing in periodontal defects treated by decalcified freeze-dried bone
      allografts in combination with ePTFE membranes. Assessment by computerized
      densitometric analysis.
AB  - This study quantitatively assessed radiographic changes in alveolar bone density
      by computer-assisted densitometric image analysis (CADIA) in periodontal defects
      that were treated with decalcified freeze dried bone allograft (DFDBA) alone or
      in combination with interproximal expanded polytetrafluroethylene membranes
      (ePTFE). The radiographic changes where then analyzed for correlation with the
      clinically assessed changes. The radiographic changes were evaluated on
      standardized radiographs of treated sites treated prior to, 1 week after surgery,
      and 6 months post-operatively. 15 patients with one pair of bilateral
      interproximal periodontal defects of similar morphology and > or = 6 mm in pocket
      depth participated. Analysis of the changes 6 months after treatment showed that
      the increases in density in the defect areas that received the graft were
      significantly greater than the adjacent areas (p < 0.001). These adjacent areas,
      in contrast, demonstrated significantly larger loss in radiographic density than
      the defect area (p < 0.001). The placement of DFDBA into the defects produced in
      itself significant increases in radiographic density, as illustrated by the
      results of one week which remained at six months. Utilization of ePTFE addition
      to DFDBA did not lead to additional radiographic gains in the defect area. While
      at one week the analysis suggested increased resorption by the combined treatment
      over grafting alone, such differences did not persist at 6 months post-surgery.
      Analysis comparing CADIA derived values for change with those of the clinical
      assessment revealed some associations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354729
TI  - Healing in periodontal defects treated by decalcified freeze-dried bone
      allografts in combination with ePTFE membranes (I). Clinical and scanning
      electron microscope analysis.
AB  - This study clinically evaluates the use of decalcified freeze-dried bone
      allograft (DFDBA) in conjunction with an expanded polytetrafluoroethylene (ePTFE)
      membrane specifically designed for the treatment of interproximal intraosseous
      defects. It also examines by SEM, plaque contaminated membranes retrieved from
      patients. 15 advanced periodontitis patients with two bilateral interproximal
      probing depths of > or = 6 mm participated. After hygiene phase, measurements
      were made to determined soft tissue recession, pocket depth, clinical attachment
      levels and amount of keratinized tissue. Defects from each pair were randomly
      treated with ePTFE plus DFDBA (experimental) or DFDBA alone (control).
      Measurements were made during the surgery to determine crestal resorption, defect
      resolution and defect fill. Membranes were removed at 4 to 6 weeks and analyzed
      by SEM. Each site was surgically reentered and measurements repeated at six
      months. Both groups showed clinical and statistically significant changes when
      compared to baseline (P < 0.01), but no difference between groups. The
      experimental group showed increased soft tissue recession vs control group, 0.9
      versus 0.4 mm, and loss of keratinized tissue 1.6 versus 0.1 mm (P < 0.0001).
      Control sites showed a 58% bone fill while experimental sites had 70% bone fill.
      There were no clear patterns of microbial colonization or cell adherences in
      either side of the membrane. It was concluded that the presence of plaque on the
      membranes did not compromise the initial clinical healing during the first 4-6
      weeks. Results suggest a beneficial effect with the use of either technique for
      the treatment of intraosseous defects.

PMID- 8354730
TI  - Platelet-derived growth factor and dexamethasone combined with a collagen matrix
      induce regeneration of the periodontium in monkeys.
AB  - Platelet-derived growth factor (PDGF) and the glucocorticoid dexamethasone
      combined with a collagen carrier matrix (CM) induced regeneration of the
      periodontium in monkeys. Regeneration was stringently defined as: (1) new
      cementum, (2) new supra-crestal bone extending coronally from the residual
      alveolar interdental septum and (3) functionally-oriented periodontal ligament
      fibers attaching new cementum to new bone. A single application of
      PDGF/dexamethasone/CM or CM was placed in debrided lesions of experimental
      periodontitis displaying 3-5 mm of attachment loss associated with horizontal and
      angular bony defects. Regeneration, judged histologically by these criteria and
      quantified by computer assisted histomorphometry after 4 weeks, was present only
      in PDGF/dexamethasone/CM treated lesions and not in those treated with CM or
      debridement alone. PDGF/dexamethasone/CM induced 5-fold more new cementum and
      ligament, and 7-fold more supra-crestal bone than control treatments. The
      presence of substantial amounts of regenerated periodontium including increased
      height of the alveolar bone; fill of vertically resorbed interdental alveolar
      septa in PDGF/dexamethasone/CM treated lesions suggests that this combination may
      provide a new therapeutic agent for the regeneration of lesions of periodontitis
      associated with horizontal as well as angular bony defects.

PMID- 8354731
TI  - Autotransplantation of a tooth using guided tissue regeneration.
AB  - Autotransplantation is an alternative treatment to replace missing or
      periodontally-involved hopeless teeth. A prerequisite for performing this
      procedure is having a recipient site with sufficient bone volume to support the
      transplant. Often, however, crestal bone resorption following tooth extraction or
      periodontitis results in a reduced alveolar ridge with inadequate dimensions to
      properly house the transplant. In these cases, the procedure is contraindicated.
      A case is presented in which the biologic principle of guided tissue regeneration
      was used to gain periodontal support around an autotransplanted 3rd molar. The
      results suggest the potential use of guided tissue regeneration in conjunction
      with autotransplantation. This may represent a new area in reconstructive
      dentistry.

PMID- 8354732
TI  - Unrelated agranulocytosis in a patient taking clozapine.

PMID- 8354733
TI  - Effects of fluvoxamine, alone and in combination with ethanol, on psychomotor and
      cognitive performance and on autonomic nervous system reactivity in healthy
      volunteers.
AB  - The effects of fluvoxamine (50 or 100 mg), alone and in combination with ethanol
      (0.8 g/kg), on psychomotor and cognitive performance and on autonomic nervous
      system reactivity were studied in healthy male volunteers. Fluvoxamine produced
      neither serious psychomotor or cognitive impairment nor alterations in autonomic
      nervous system functioning at these doses. There was no evidence that fluvoxamine
      exacerbated, or improved, ethanol-induced impairments of memory or any other
      measures evaluated. Fluvoxamine tended to improve recognition, but not free
      recall, of words.

PMID- 8354734
TI  - Interindividual variations of desmethylation and hydroxylation of clomipramine in
      an Oriental psychiatric population.
AB  - We measured the concentrations of clomipramine and its metabolites, N
      desmethylclomipramine, 8-hydroxy-N-desmethylclomipramine, and 8
      hydroxyclomipramine in plasma in 92 Japanese psychiatric patients receiving
      clomipramine hydrochloride (Anafranil, Ciba-Geigy Japan Limited, Takarazuka,
      Japan) by high-performance liquid chromatography. Although there were large
      interindividual variations of total drug concentrations and concentrations of
      parent or intermediate metabolic compounds in plasma, significant positive
      correlations were observed between these drug concentrations and daily doses of
      clomipramine hydrochloride (milligrams per kilogram of body weight). The
      metabolic ratios for both desmethylation and hydroxylation varied substantially
      with 30- to 90-fold interindividual variations. Frequency distribution histograms
      and probit analyses of these parameters identified only one possible poor
      hydroxylator but no poor desmethylator of clomipramine. These results suggest
      that there are large interindividual variations of capacities for hydroxylation
      and desmethylation of clomipramine in the Oriental population and that
      therapeutic drug monitoring is essential in clinical practice to reduce the
      adverse effects of clomipramine and to prevent poor response to clomipramine.

PMID- 8354735
TI  - Pretreatment systolic orthostatic blood pressure and treatment response in
      geriatric depression: a revisit.
AB  - Three previous studies have found significant positive correlations between
      pretreatment systolic orthostatic blood pressure (PSOP) and tricyclic
      antidepressant (TCA) response in geriatric depression (i.e., the greater the
      pretreatment orthostatic drop, the greater the treatment response). The purposes
      of this study were to revisit the question of whether PSOP predicts TCA response
      and also to examine whether large systolic orthostatic pressure (SOP) is a state
      or trait variable in late-life depression. We retrospectively examined PSOP data
      collected from 48 elderly patients with recurrent unipolar depression treated
      with nortriptyline (mean level in plasma, 85.3) in the open, acute-treatment
      phase of an ongoing double-blind, placebo-controlled study of maintenance
      therapies in late-life depression. PSOP was not significantly correlated with
      treatment response as measured by the Hamilton Rating Scale for Depression at
      weeks 7 to 9 (r = -0.12, not significant). Likewise, a 10-mm PSOP cutoff did not
      significantly differentiate patients by responder status. We did find that all
      five of our placebo-randomized, maintenance therapy patients with PSOPs greater
      than 10 mm had marked decreases in their SOPs in the nortriptyline-free, well
      state. Thus, our findings fail to replicate earlier reports of PSOP predicting
      TCA response in geriatric depression. However, our results do preliminary suggest
      that large SOP may be state dependent. We discuss plans to study prospectively
      whether large SOP is state dependent and whether SOP is a clinically useful
      predictor of recurrence in late-life depression.

PMID- 8354736
TI  - Clozapine response and adverse effects in nine brain-injured patients.
AB  - Clozapine was used to treat nine brain-injured patients with psychotic symptoms
      or outbursts of rage and aggression refractory to other medications. Verbal and
      physical aggression decreased markedly in two patients, and one additional
      patient had a dramatic decrease in bizarre behaviors. Mild improvement occurred
      in three patients with a decrease in agitation and frequency of auditory
      hallucinations. Response was indeterminate in three patients because of
      inadequate length of treatment. The incidence of side effects appeared to be
      higher than expected, with seizures occurring in two of nine patients. These case
      reports illustrate that clozapine may be useful in the treatment of psychosis and
      aggressive behavior after brain injury, despite the occurrence of adverse
      effects.

PMID- 8354737
TI  - A predictive study of obsessive-compulsive disorder response to clomipramine.
AB  - Studies on predictive factors of the obsessive-compulsive disorder response to
      pharmacologic treatment, specifically clomipramine, are relatively scarce. Forty
      five patients treated for a mean period of 18.6 months were classified as having
      poor response, intermediate response and excellent response, defined by change
      scores on the Yale-Brown Obsessive-Compulsive Scale. Poor and intermediate
      response patients were grouped together and compared with the excellent response
      subgroup. Univariate analysis showed length of illness, family history
      (siblings), initial compulsiveness score, and cleaning rituals as significant
      predictors. Two multiple regression analyses with these as independent or
      predictive variables showed higher initial scores on the Yale-Brown Obsessive
      Compulsive Scale associated with poorer response to treatment but, most
      importantly, cleaning rituals as a predictor of poor or modest response to
      clomipramine. It may be important for the clinician to assess cleaning habits
      separately from the more frequently mentioned obsessive-compulsive symptom, hand
      washing. This distinction may have important clinical, therapeutic, and
      prognostic implications.

PMID- 8354738
TI  - Unrelated agranulocytosis in a patient taking clozapine.

PMID- 8354739
TI  - Sertraline-induced akathisia.

PMID- 8354740
TI  - Dystonic reaction associated with fluvoxamine.

PMID- 8354741
TI  - Assessment of treatment-resistant major depression--The Michigan Adequacy of
      Treatment Scale.

PMID- 8354742
TI  - Paradoxical mood shifts to euthymia or hypomania upon withdrawal of
      antidepressant agents.

PMID- 8354743
TI  - Two-year clinical evaluation of two dentine-adhesive systems in cervical lesions.
AB  - Two commercially available dentine-adhesive systems, Tenure and Tripton, were
      tested in two different cavity designs by placing 132 Class V composite
      restorations in cervical lesions of 35 patients. In Group A, the cervical
      restorations were placed totally in dentine without any intentional enamel
      involvement. In Group B, they were placed in dentine with adjacent enamel margins
      bevelled and acid etched. The retention rate, the evidence of clinical
      microleakage, and the marginal integrity were monitored over a 2-year period. The
      results of this clinical investigation indicate a high failure rate when only
      dentinal bonding was involved. A loss rate of 30% for Tenure and 55% for Tripton
      was noted in Group A after 2 years of clinical service. However, both adhesive
      systems used in combination with micromechanical retention on the enamel border
      (Group B) performed extremely well with only one restoration each having debonded
      over the 2-year period. Identically, marginal integrity and evidence of clinical
      microleakage more severely deteriorated with time for the Group A restorations in
      comparison with their Group B counterparts. In summary, the overall results were
      more positive for Tenure than for Tripton. It is concluded that micromechanical
      retention by acid etching of the enamel margin is still indispensable for the
      clinical success of cervical Class V composite restorations, primarily for
      retention and clinical microleakage and also, but to a lesser degree, for
      marginal adaptation.

PMID- 8354744
TI  - A 3-year follow-up study on single implant treatment.
AB  - The purpose of this study was to investigate restorative and postinsertion
      problems in patients provided with single implant supported restorations. Fifty
      consecutive single implant patients were reviewed over a period of 3 years
      following placement of artificial crowns. One (1.4%) of the 70 inserted implants
      was lost during the follow-up period, which gives a cumulative success rate of
      98.5%. The most frequent complication was loosening of the single tooth abutment
      screw. This problem was associated with fistulas during the first year of
      clinical service. A more severe complication was that three adjacent teeth had to
      be endodontically treated due to accidental devitalization from surgical trauma
      during implant insertion. The mean marginal bone level adjacent to the implants
      was reduced 0.5 mm from crown insertion to the third annual review.

PMID- 8354745
TI  - A prospective study of the survival of chemically activated anterior resin
      composite restorations in general dental practice: 5-year results.
AB  - The principals of 26 general dental practices agreed to use six chemically
      activated resin composite restorative materials to restore Class III and Class V
      lesions and record information concerning their performance over a period of 5
      years. The information collected was analysed by actuarial methods to assess the
      clinical longevity and reasons for replacement as perceived by the dentists
      operating in the General Dental Service in England. At the end of 5 years, 14
      dentists provided sufficient returns for their data to be considered suitable for
      analysis. The database consisted of 2399 Class III and 1093 Class V restorations.
      The overall probability of survival at 5 years of Class III and Class V
      restorations was 62.9% and 71.8% respectively. The difference in performance
      between the six restorative materials was small, with the probability of survival
      varying from 70.4 +/- 2.9% to 56.3 +/- 2.9% for the Class III restorations and
      78.6 +/- 3.7% to 67.7 +/- 4.2% for the Class V restorations. The main reasons for
      replacement were general surface discoloration, secondary caries and fracture.
      The chemically activated composite restorative materials available at the time of
      initiating this study produced comparable performances in general dental practice
      when used without enamel and dentine bonding techniques. This suggests that more
      general practice-based clinical studies are needed to determine whether or not
      improvements in materials and techniques are effectively transferred to the
      general practice situation.

PMID- 8354746
TI  - A simple method for monitoring mutans streptococci in margins of restorations.
AB  - Plaque material collected from margins of restorations using a sharp toothpick
      was streaked across one and the same plastic strip from a commercially available
      test kit and inoculated in a liquid medium containing bacitracin. The
      reproducibility of the method was good. The method is simple, inexpensive and
      suitable for the chairside demonstration of the colonization of mutans
      streptococci in localized areas of the mouth, such as margins of restorations.

PMID- 8354747
TI  - Inhibition of serum albumin flux across exposed dentine following conditioning
      with GLUMA primer, glutaraldehyde or potassium oxalates.
AB  - A variety of medicaments used on dentine in various treatment procedures may
      cause a reduction in dentine permeability. By observing the flow of endogenous
      serum albumin across exposed dentine, agents known to promote dentine bonding of
      restorative resins or retard dentine sensitivity were assessed regarding their
      capacity to arrest dentinal fluid flow. Experiments were conducted in young adult
      macaque monkeys employing Class V cavity preparations in incisors and canines. A
      diffusion-in-gel-enzyme-linked-immunosorbent-assay (DIG-ELISA) was used to
      quantitate serum albumin in effluents from these cavities at various time periods
      following either no treatment or topical application with GLUMA primer,
      glutaraldehyde or potassium oxalates. While in untreated cavities serum albumin
      continued to flow even after a period of 1 week, a substantial reduction or
      complete cessation of serum albumin flux was seen following topical application
      of the agents tested, suggesting a durable effect on dentinal fluid flow. No
      difference between agents was observed. Further cutting of the cavity bottom a
      few tenths of a millimetre resulted in renewed flow of serum albumin. Data
      suggest that the solutions tested are capable of reducing dentinal fluid flow
      onto exposed dentine surfaces.

PMID- 8354748
TI  - Air humidity: a detrimental factor in dentine adhesion.
AB  - Successful dentine adhesion may be negatively influenced by intrinsic and
      extrinsic dentine wetness. Testing the influence of high humidity levels during
      the application of bonding systems is therefore relevant. It was the aim of this
      study to investigate in vitro the sensitivity to air humidity of the dentine bond
      strength for some commercially available bonding systems. Four bonding systems
      were tested in vitro on human molars at temperature/humidity levels of 25 degrees
      C and 40% relative humidity (RH) as well as 35 degrees C and 95% RH. Four
      operators each made two samples of the respective treatment combinations. After
      shear bond testing a three-way ANOVA was carried out. Only the factors
      'material', 'humidity' as well as their interaction were statistically
      significant. The factor 'operator' did not exert a significant influence on the
      shear bond strength. For the 'clinically dry' group statistically significant
      differences were found between all materials (P < 0.001). In the 'high humidity'
      setting too, significant differences were found between materials (P < 0.001).
      The shear bond strength values ('high humidity') were very low (< 3 MPa) for
      Gluma 2000, Denthesive and Syntac, while the mean values for Scotchbond Multi
      Purpose were significantly higher (12 MPa; P < 0.001). It was concluded that in
      general bonding systems are highly sensitive to extrinsic dentine wetness,
      resulting in very low adhesion values at high humidity.

PMID- 8354749
TI  - CO2 laser and the diagnosis of occlusal caries: in vitro study.
AB  - The diagnosis of small lesions in pit and fissure sites is becoming increasingly
      problematical. This study was designed to evaluate, in vitro, the potential use
      of a carbon dioxide (CO2) laser technique as an aid to the diagnosis of incipient
      pit and fissure caries. Vaporization of the organic material in the 'early'
      carious lesion should lead to its carbonization and thus make it more
      conspicuous. Pilot studies were carried out to identify lasing parameters which
      produced no visible effect on sound enamel but which caused charring
      (carbonization) of white spot fissure lesions. Fifty extracted human molars and
      premolars were air-polished on the occlusal surfaces and independently scored
      clinically for caries, both before and after lasing. The teeth were subsequently
      sectioned and examined histologically. Of the 37 sites histologically scored as
      sound or exhibiting precavitation lesions, eight were correctly scored as sound
      both prelasing and postlasing. Of the 29 precavitation lesions detected
      histologically, five were detected clinically prelasing and 11 were detected
      postlasing. This 21% difference in the sensitivity of caries diagnosis between
      the prelasing and postlasing examinations was statistically significant (at the
      95% level). There were no false-positive caries diagnoses. Further research, in
      particular the refining of lasing parameters employed, is indicated.

PMID- 8354750
TI  - Flow injection analysis of formaldehyde leached from denture-base acrylic resins.
AB  - Formaldehyde is responsible for allergic inflammation in acrylic denture wearers
      and the quantitation of formaldehyde is necessary to study its leaching from
      denture-base materials. Flow injection analysis was developed to quantify the
      formaldehyde leached from acrylic resins. Different resins were immersed in
      aqueous solvents at 37 degrees C and the immersion solutions were directly
      injected into the flow system, in which formaldehyde was converted on-line to a
      fluorescent derivative and its fluorescence was detected. Under the optimized
      conditions, the leached formaldehyde could be quantified in a short time (within
      4 min) with high sensitivity (pmol levels per injection) and high specificity (no
      fluorescent response to the other leachables). In leaching experiments,
      significant amounts of formaldehyde were leached from autopolymerized resins, but
      not from heat- and microwave-polymerized resins.

PMID- 8354751
TI  - Age changes in the viscoelasticity of a temporary soft lining material.
AB  - The viscoelastic properties of a widely used temporary soft lining material have
      been monitored in vivo and in vitro using a force distance probe. Over a period
      of 8 weeks' clinical use, Coe Soft demonstrated a significant and continued
      reduction in compliance with time, the reduction being particularly rapid over
      the first week. These changes were not associated with a reduction in measured
      lining thickness for which significant changes were not found. In vitro immersion
      in water, saline or artificial saliva was characterized by a rapid and
      significant reduction in compliance values over the first week. Further continued
      reductions in compliance values were only observed in artificial saliva over 8
      weeks, and on prolonged immersion in distilled water over 96 weeks. All
      reductions in compliance were significantly less than those seen clinically.

PMID- 8354752
TI  - Optimal estimation of hearing-aid compression parameters.
AB  - A new procedure for measuring the attack and release time constants of a hearing
      aid compression circuit is presented in this paper. The procedure is based on a
      mathematical model of the response of a compression system to sudden increments
      or decrements in the amplitude of a sinusoidal excitation. The parameters of the
      model, which include the attack and release time constants, are fitted to the
      measured hearing-aid test-signal response using a minimum mean-squared error
      criterion. A computer simulation of a compression hearing aid is used to
      illustrate the behavior of the compression amplifier and to assess the accuracy
      of the estimated attack and release time constants.

PMID- 8354753
TI  - Localization using nonindividualized head-related transfer functions.
AB  - A recent development in human-computer interfaces is the virtual acoustic
      display, a device that synthesizes three-dimensional, spatial auditory
      information over headphones using digital filters constructed from head-related
      transfer functions (HRTFs). The utility of such a display depends on the accuracy
      with which listeners can localize virtual sound sources. A previous study [F. L.
      Wightman and D. J. Kistler, J. Acoust. Soc. Am. 85, 868-878 (1989)] observed
      accurate localization by listeners for free-field sources and for virtual sources
      generated from the subjects' own HRTFs. In practice, measurement of the HRTFs of
      each potential user of a spatial auditory display may not be feasible. Thus, a
      critical research question is whether listeners can obtain adequate localization
      cues from stimuli based on nonindividualized transforms. Here, inexperienced
      listeners judged the apparent direction (azimuth and elevation) of wideband
      noisebursts presented in the free-field or over headphones; headphone stimuli
      were synthesized using HRTFs from a representative subject of Wightman and
      Kistler. When confusions were resolved, localization of virtual sources was quite
      accurate and comparable to the free-field sources for 12 of the 16 subjects. Of
      the remaining subjects, 2 showed poor elevation accuracy in both stimulus
      conditions, and 2 showed degraded elevation accuracy with virtual sources. Many
      of the listeners also showed high rates of front-back and up-down confusions that
      increased significantly for virtual sources compared to the free-field stimuli.
      These data suggest that while the interaural cues to horizontal location are
      robust, the spectral cues considered important for resolving location along a
      particular cone-of-confusion are distorted by a synthesis process that uses
      nonindividualized HRTFs.

PMID- 8354754
TI  - The perception of temporal modulations by cochlear implant patients.
AB  - The perception of temporal modulations of pulsatile electric stimuli was measured
      in seven cochlear implant patients using the Cochlear Pty. Limited prosthesis.
      Four patients were postlingually deafened adults and three patients were young
      adults who were deafened very early in life. The first study measured detection
      thresholds for modulated pulse duration for a series of modulation frequencies
      and pulse rates. The shape of the detection thresholds as a function of
      modulation frequency, the temporal modulation transfer function, often resembled
      a low-pass filter with a 50-100-Hz cut-off frequency. Thresholds did not markedly
      vary across the different pulse rates for most patients. Thresholds were less
      than 10%-20% of the range of usable hearing for most patients. The second study
      compared detection thresholds for modulated pulse durations around different
      reference pulse durations: 50, 100, and 300 microseconds. Detection thresholds
      were generally proportional to the different reference pulse durations. The third
      study measured difference limens for the discrimination of modulation depth. The
      difference limens were similar to the detection thresholds for the same reference
      pulse duration and pulse rate. The three patients deafened very early in life
      showed more within-group variation in performance, and their overall levels of
      performance were poorer than those of the postlingually deafened adults.

PMID- 8354756
TI  - High rate otoacoustic emissions.
AB  - One of the practical problems of testing young children using evoked otoacoustic
      emissions (EOAEs) is that there is a need for the child to be quiet for a period
      of a minute or so. To achieve this can mean test periods of 10 min or longer. A
      new application of maximum length sequences (MLSs) to EOAEs is described that
      enables the test to be performed in a few seconds or less. Data from adults and
      neonates obtained at stimulation rates up to 840 clicks/s are presented and
      compared with conventionally derived emissions and the implications and
      applications of this new method are assessed.

PMID- 8354755
TI  - Acoustic impedance of the maternal abdomen.
AB  - Contact sensors to monitor fetal heart, breathing, and movement sounds with
      increased sensitivity and bandwidth are under development. To understand the
      inherent acoustical properties of the maternal abdomen and its interaction with
      these sensors, the driving-point impedance Z(j omega) was measured in nine women
      during their last trimester of pregnancy. An electromechanical shaker with a
      contact area of 2.85 cm2 produced abdominal vibrations between 10 and 500 Hz, and
      the resulting force and acceleration were measured. After digitally integrating
      the acceleration signal to obtain the velocity and removing the massive effects
      of the coupling between the shaker and the abdomen, Z(j omega) was estimated
      using spectral techniques. The imaginary part of Z(j omega) depicted a dominant
      compliance effect at low frequencies, a resonance at a frequency of 28 +/- 16 Hz
      (mean +/- s.d.), and a dominant mass effect at higher frequencies. The real part
      of Z(j omega) increased steadily with frequency. A series resistance-mass
      compliance (R-M-C) circuit modeled these characteristics of Z(j omega) well when
      R was allowed to exactly mimic the frequency dependence of the real part of Z(j
      omega). Estimated element values of 6.6 +/- 2.2 x 10(-3) kg for M, 2.1 +/- 1.4 x
      10(-3) m/N for C, and roughly 10 Ns/m for R (at resonance) were similar to those
      estimated for other body tissues such as the thigh but quite different from that
      of the often-studied chest wall.

PMID- 8354757
TI  - A model of cochlear mechanics with outer hair cell motility.
AB  - The outer hair cell (OHC) is known to have the ability to change its length in
      response to voltage changes across its membrane. The apparent function of this
      OHC motility is to enhance the tuning of the basilar membrane. The model
      presented in this paper represents the displacement-to-voltage and voltage-to
      displacement transducers of the OHC explicitly, each as low-pass filter
      functions. The model results show that this OHC representation is sufficient to
      provide a model of cochlear mechanics with mechanical tuning at the inner hair
      cell which is comparable to the threshold tuning curves observed in single
      auditory nerve fibers. The enhancement of tuning provided by OHC motility can be
      interpreted as the combined action of a cochlear amplifier and a second filter.
      This model demonstrates that realistic cochlear tuning does not require intrinsic
      resonance in any cochlear structure other than the basilar membrane.

PMID- 8354758
TI  - Propagation of shock waves in elastic solids caused by cavitation microjet
      impact. I: Theoretical formulation.
AB  - To understand the physical process of the impingement of cavitation microjet and
      the resultant shock wave propagation in an elastic solid, a theoretical model
      using geometrical acoustics was developed. Shock waves induced in both the jet
      head (water) and the solid were analyzed during a tri-supersonic impact
      configuration when the contact edge between the jet head and the elastic boundary
      expands faster than the longitudinal wave speed in the solid. Impact pressure at
      the boundary was solved using continuity conditions along the boundary normal.
      Reflection and refraction of shock waves from a solid-water interface were also
      included in the model. With this model, the impact pressure at the solid boundary
      and the stress, strain as well as velocity discontinuities at the propagating
      shock fronts were calculated. A comparison with results from previous studies
      shows that this model provides a more complete and general solution for the jet
      impact problem.

PMID- 8354759
TI  - Propagation of shock waves in elastic solids caused by cavitation microjet
      impact. II: Application in extracorporeal shock wave lithotripsy.
AB  - To better understand the mechanism of stone fragmentation during extracorporeal
      shock wave lithotripsy (ESWL), the model developed in Part I [P. Zhong and C.J.
      Chuong, J. Acoust. Soc. Am. 94, 19-28 (1993)] is applied to study cavitation
      microjet impingement and its resultant shock wave propagation in renal calculi.
      Impact pressure at the stone boundary and stress, strain at the propagating shock
      fronts in the stone were calculated for typical ESWL loading conditions. At the
      anterior surface of the stone, the jet induced compressive stress can vary from
      0.82 approximately 4 times that of the water hammer pressure depending on the
      contact angles; whereas the jet-induced shear stress can achieve its maximum,
      with a magnitude of 30% approximately 54% of the water hammer pressure, near the
      detachment of the longitudinal (or P) wave in the solid. Comparison of model
      predictions with material failure strengths of renal calculi suggests that jet
      impact can lead to stone surface erosion by combined compressive and shear
      loadings at the jet impacting surface, and spalling failure by tensile forces at
      the distal surface of the stone. Comparing responses from four different stone
      types suggests that cystine is the most difficult stone to fragment in ESWL, as
      observed from clinical experience.

PMID- 8354760
TI  - Air pressure regulation during speech production.
AB  - Vocal tract pressures during speech tend to be maintained in the face of airway
      leaks that might be encountered by individuals with repaired palatal clefts. This
      study tested the hypothesis that such constant pressures can be explained as a
      consequence of constant pressure source characteristics of the respiratory system
      during speech production. This conceptualization differs from pressure regulation
      theories [e.g., D. Warren, Cleft Palate J. 23, 251-260 (1986)] which posit that
      active reflexive compensatory responses occur to regulate air pressure during
      speech. Four experiments were conducted to (a) confirm the distinction between
      constant flow versus constant pressure sources using a plastic vocal tract model,
      (b) compare air pressure and flow patterns associated with airway leaks in normal
      speakers to model data, (c) study the effects of gas density in the vocal tract
      model on air pressure and air flow patterns predicted by a nonreflexive constant
      pressure source hypothesis, and (d) compare air pressure and air flow patterns
      associated with airway leaks obtained from normal speakers using different gas
      densities to model data. Overall, observed flow and pressure patterns suggest the
      possible influence of constant pressure source characteristics of the respiratory
      system during speech on maintenance of intraoral air pressure.

PMID- 8354761
TI  - Response latency, latency-based receiver-operating characteristics, and
      uncertainty about interaural phase in the detection of in-phase and out-of-phase
      tones presented in noise.
AB  - Subjects were given the task of detecting tonal signals presented in a continuous
      background of white noise which was always in phase at the ears (No). The signals
      were either in phase (So), or phase-reversed (S pi) at the ears. The analysis of
      response latencies (for similar levels of performance) indicated that there were
      consistent differences in the processing of the two types of signals. Latencies
      were longer, and somewhat more variable, for S pi than for So signals. It was
      also found that the theory of signal detectability can contribute to an
      understanding of what and how decisions are made. Latencies were treated as
      confidence ratings in order to determine latency-based receiver operating
      characteristics (LROCs) for the detection task. It was observed that the LROCs
      for the interaural condition No-So tend to leave the origin at a steeper angle
      than do those for the interaural condition No-S pi, presumably reflecting the
      different sensory and decision processes employed in the two conditions. When the
      two interaural conditions were intermixed within blocks of trials, performance
      was slightly impaired in comparison to the situation in which the interaural
      condition remained constant throughout blocks of trials.

PMID- 8354762
TI  - Adaptation of suppression as an explanation of enhancement effects.
AB  - Delaying the onset of a signal relative to the onset of a simultaneous notched
      masker often improves the ability of subjects to "hear out" the signal at both
      threshold and suprathreshold levels. Viemeister and Bacon [J. Acoust. Soc. Am.
      71, 1502-1507 (1982)] suggested that such signal-enhancement effects might be
      attributable to adaptation of the suppression directed from the masker to the
      signal, thereby releasing the signal from suppression. In support of their
      hypothesis, Viemeister and Bacon reported that a masker, preceded by an enhancer
      having no component at the signal frequency, produced more forward masking than
      did the masker by itself. Here the masker enhancement described by Viemeister and
      Bacon, signal enhancement, and two-tone suppression were measured in the same six
      subjects. Parametric manipulations of the masker-enhancement stimulus produced
      results similar to those previously reported for parallel investigations of
      signal enhancement, indicating that the two types of enhancement are closely
      related effects. Although the present data reveal an inverse relationship between
      the amounts of suppression and enhancement, suggesting that the two processes may
      be interrelated, no support was obtained for the hypothesis that adaptation of
      suppression can account for enhancement.

PMID- 8354763
TI  - Psychoacoustics of normal adult chickens: thresholds and temporal integration.
AB  - Three adult female chickens were trained to detect pure tones using a positive
      reinforcement paradigm. A modified perometer estimation-through sequential
      testing (PEST) threshold determination procedure was used to measure the
      audiogram between 250 and 5500 Hz, at 0.1-octave steps over most of the range.
      For the mean audiogram, threshold increased rapidly below 400 Hz and above 4000
      Hz. Between these extremes was a broad low threshold area where thresholds varied
      between 11 and 23 dB, with the lowest thresholds between 1000 and 2000 Hz.
      Audiograms were similar for all three subjects over the middle of the frequency
      range, but there was more variability across subjects at the extreme high and low
      frequencies. After determination of the audiogram, thresholds for 12 frequencies
      were measured as a function of stimulus duration (ranging from 16 to 750 ms) to
      determine a threshold-duration function. Average time constants varied from 148
      to 348 ms, increasing with increasing stimulus frequency. Average slopes varied
      from 2.18 dB per doubling of duration to 2.61 dB per doubling of duration,
      increasing with increasing stimulus frequency. The increases in slope and time
      constant with stimulus frequency, while consistent, were small compared to the
      variability of these parameters across subjects.

PMID- 8354764
TI  - Temporal and spectral basis of the features perceived in repeated noise.
AB  - When a half-second segment of a noise is played repeatedly, it initially creates
      a "whooshing" perception. With longer listening, however, individual features
      like "clanks" and "rasping" emerge. It is easy to tap the period of the perceived
      structure. This offers a possibility to investigate the mechanisms underlying the
      perception of these distinct features. The present study addresses the subject of
      the temporal and spectral extent of the physical correlates of these percepts.
      Five subjects participated in this study, and their tapping is in notable,
      although not perfect correlation. The physical correlate of the features can be
      confined in time to intervals as small as 100 ms. This segment of the stimulus is
      processed largely independently from the rest of the noise sample. Spectral
      processing is, in general, local. Some features, however, are spread over more
      than one octave. In 3 cases out of 25, across-channel processing is apparent.

PMID- 8354765
TI  - Combined evaluation of interaural time and intensity differences: psychoacoustic
      results and computer modeling.
AB  - The physical and the psychophysical relationships between interaural time and
      intensity differences were studied for 24 frequency bands of critical bandwidth
      covering the full audio range. For the physical investigations a catalogue of
      outer ear impulse responses for 122 directions of the upper hemisphere was
      analyzed according to the combinations of interaural time and level differences
      found in each critical band. From these data curves of "natural combinations" of
      the interaural parameter differences were determined by the minimum square error
      method. In a psychoacoustical study it is shown that signals containing "natural"
      parameter combinations produce response patterns that differ from those produced
      when signals with contradictory interaural properties have been used. Finally an
      extension to the powerful binaural model of Lindemann [J. Acoust. Soc. Am. 80,
      1608-1622 (1986)] is introduced, taking into account the results of the previous
      investigations.

PMID- 8354766
TI  - Moclobemide: a reversible MAO-A-inhibitor showing weaker antidepressant effect
      than clomipramine in a controlled multicenter study. Danish University
      Antidepressant Group.
AB  - Antidepressant and unwanted effects of moclobemide (400 mg/day) and clomipramine
      (150 mg/day) were compared in a double-blind, randomised, in-patient, fixed-dose
      study with weekly ratings and drug level measurements. After 1 week of single
      blind placebo treatment, 115 patients with major depression fulfilled the
      criterion of a Hamilton Depression Scale (17-item, HDS) score of > or = 18 and
      were started on active treatment for 6 weeks. Drop-outs on moclobemide (n = 20)
      were in particular due to worsening and suicidality (n = 9) whereas drop-outs on
      clomipramine (n = 12) in particular were due to side effects/adverse events (n =
      6) and no drop-outs due to worsening. End-point analysis on the basis of
      different depression ratings showed consistently a significantly weaker effect of
      moclobemide (final median HDS: 15) compared with clomipramine (final median HDS:
      11). The difference involved both sleep and depression symptoms. These results
      are generally at variance with the main body of literature on moclobemide,
      although a higher frequency of drop-out due to worsening in moclobemide-treated
      patients compared to tricyclic antidepressant-treated patients has been reported
      in several studies.

PMID- 8354767
TI  - The sources of convergence between measures of apathy and depression.
AB  - Apathy and depression are discriminable but related dimensions of behavior. The
      purpose of this study was to evaluate the source of the overlap between measures
      of apathy and depression. We evaluated the intercorrelations between the Apathy
      Evaluation Scale (AES) and the Hamilton Rating Scale for Depression (HamD) in 107
      subjects, aged 53-85, who met research criteria for normal aging, left or right
      cerebral hemisphere stroke, probable Alzheimer's disease, or major depression. We
      determined the correlation between the individual items on the HamD and the total
      scores on the AES and the HamD. The HamD items having the strongest correlations
      with AES total score were diminished work/interest, psychomotor retardation,
      anergy, and lack of insight. The correlation between AES and HamD total scores
      was nonsignificant when major depression subjects and these variables most
      closely related to apathy were excluded from consideration. These findings
      indicate that the convergence between HamD and AES is attributable to (i) a
      subset of HamD items which are consistent with the syndrome of apathy and (ii)
      the fact that major depression is associated with both apathy and depression.
      Clinical and research applications of these results are discussed.

PMID- 8354768
TI  - Response of psychotic depression subtypes to pharmacotherapy.
AB  - Patients with psychotic depression respond well when treated with a combination
      of an antidepressant and antipsychotic medication. We previously reported that
      they will respond in a similar fashion when treated with amoxapine monotherapy.
      There are few prospective studies on the pharmacologic treatment response of
      psychotic depression subtypes. We treated 37 inpatients, 21 with mood congruent
      (MC) psychotic depression and 16 with mood incongruent (MI) psychotic depression,
      in a randomized double-blind fashion with either the combination of amitriptyline
      and perphenazine or with amoxapine for 4 weeks. Depression and psychosis ratings
      improved in a similar manner in both the MC or MI patients irrespective of
      medication treatment group. Global response rates were similar in the MI patients
      and MC patients. The data suggest that classifying psychotic depression into MC
      versus MI subtypes may have limited acute prognostic value in pharmacotherapy
      response rates.

PMID- 8354769
TI  - 48-hour rapid cycling: results of psychopathometric, polysomnographic, PET
      imaging and neuro-endocrine longitudinal investigations in a single case.
AB  - We report a 64-year-old patient suffering from rapid cycling bipolar disorder who
      was studied by means of polysomnography, neuroendocrine tests and PET (positron
      emission tomography) imaging. In a manner only partly compatible with the
      cholinergic-aminergic imbalance model of mania and depression, a linkage of REM
      sleep disinhibition and depressive mood was observed, but no decisive REM sleep
      delay was seen on manic days. Growth hormone secretion after clonidine
      stimulation was blunted on depressive and hypomanic days. A series of total sleep
      deprivations led to a positive effect on psychopathology for about two weeks.
      Carbamazepine treatment normalized REM sleep variables, damped the amplitude of
      mood cycling of the patient, increased TSH and decreased FT4.

PMID- 8354770
TI  - A new sampling strategy for linkage studies in psychoses.
AB  - Linkage between stuttering and manic-depression has been postulated to account
      for the reported association between these conditions, in three large pedigrees.
      This finding permits a novel and potentially more productive sampling strategy to
      be used in future linkage studies.

PMID- 8354771
TI  - A study comparing paroxetine placebo and imipramine in depressed patients.
AB  - These data provide evidence for the antidepressant efficacy of paroxetine.
      Paroxetine- and imipramine-treated patients were significantly different from
      placebo-treated patients, but little different to each other, on all depressive
      outcome measures. However, paroxetine appeared to have a possibly greater and
      earlier beneficial effect on anxiety symptoms associated with depression, when
      compared with imipramine. Both active therapies were effective in treating
      patients with severe depression. Side effects for paroxetine were typical of
      other serotonin (5-HT) uptake inhibitors but different from those of imipramine.
      In particular, anticholinergic and cardiovascular symptoms were reduced, and
      premature withdrawal less likely.

PMID- 8354772
TI  - Specificity of mixed affective states: clinical comparison of dysphoric mania and
      agitated depression.
AB  - To investigate the clinical specificity of mixed affective states, we compared
      clinical characteristics of mixed (dysphoric) manics to those of agitated
      depressed patients. The subjects were inpatients studied in the NIMH Clinical
      Research Branch Collaborative Study on the Psychobiology of Depression,
      Biological Studies. Behavior and symptom ratings for depressive and manic
      symptoms were obtained during a 15-day placebo washout period. Patients with
      agitated depression were compared to those in acute manic episodes with and
      without prominent depressive symptoms. Mania ratings clearly distinguished
      agitated depressed from mixed manic patients. Concerning depression and general
      psychopathology, mixed manics had more severe agitation, hostility and cognitive
      impairment than did agitated depressed patients. Depressed mood and anxiety did
      not differ significantly between the two groups. Nurse ratings for depression and
      anxiety, based on ward behavior, were similar for mixed manics and agitated
      depressed patients, while physician-interview rated depression and anxiety were
      higher in agitated depressed patients. These data support the existence of
      superimposed depressive and manic syndromes in mixed manics.

PMID- 8354774
TI  - One house of dentistry.

PMID- 8354773
TI  - Brain electrical activity in depression described by equivalent dipoles.
AB  - The majority of neurophysiological investigations of waking EEG in depression
      have been relatively disappointing. Since the topographic distribution of brain
      electrical activity over the scalp in the frequency domain (FFT-power) varies
      considerably when choosing another site for the reference, it is not surprising
      that various investigators reported contradictory results. The aim of the present
      study was to investigate differences in brain electrical activity in a sample of
      depressed patients as compared to healthy subjects using a newly developed method
      called FFT approximation. As the major finding healthy subjects and depressed
      patients demonstrated significantly divergent patterns of localization between
      frequency bands in the anterior-posterior direction. The investigation suggests
      that a non-invasive neurophysiological methods gives results which are comparable
      to those obtained by other functional and structural imaging methods in
      depressive illness.

PMID- 8354775
TI  - Bonding amalgams.

PMID- 8354776
TI  - A noteworthy study.

PMID- 8354777
TI  - Implants revisited.

PMID- 8354778
TI  - Checking anti-retraction valves.

PMID- 8354779
TI  - A flawed study on TM?

PMID- 8354781
TI  - AIDS cited as no. 1 health concern.

PMID- 8354782
TI  - Tufts' study aims to save cancer patients' salivary glands.

PMID- 8354780
TI  - What the experts know.

PMID- 8354783
TI  - Managing medical emergencies.
AB  - A simple dental procedure can quickly escalate into a medical emergency.
      Management of six common emergencies is described.

PMID- 8354784
TI  - Dental office emergencies: do you know your legal obligations?

PMID- 8354785
TI  - Dental office compliance evaluation for the OSHA Bloodborne pathogens Standard
      and Hazard Communication Program.

PMID- 8354786
TI  - Prevalence of upper extremity neuropathy in a clinical dentist population.
AB  - When asked about altered sensation in hands or arms, forearms, cervical area or
      neck, 29 percent of Nebraska dentists surveyed said they felt pain, followed by
      numbness and tingling. The prevalence suggests the possibility of an occupational
      concern.

PMID- 8354787
TI  - Managing obstructive sleep apnea.
AB  - Obstructive sleep apnea, cessation of breathing during sleep, is potentially life
      threatening and requires prompt intervention. A prosthesis can reposition the
      mandible during sleep and minimize or prevent the tongue from collapsing against
      the pharynx. Two case reports discuss the effectiveness of prosthetic devices.

PMID- 8354789
TI  - Educating patients: a new necessity.

PMID- 8354788
TI  - HIV-related neuropsychiatric changes: concerns for dental professionals.
AB  - HIV infection can cause a variety of neuropsychiatric changes. These changes and
      their effects on dental care delivery are discussed. A case report illustrates
      the behavioral changes of one patient.

PMID- 8354790
TI  - Medicare: trends in reimbursing hospital dental practices.
AB  - A survey of dentists working in hospitals found that dental procedures covered
      under Medicare are not equally reimbursed. Lack of uniform guidelines,
      appropriate interpretation and universal claim forms lead to problems. Most
      respondents favor medically adjunctive dental care in the national health care
      reform.

PMID- 8354791
TI  - The patient's health history form: how healthy is it?
AB  - An aging population, a more medically complex patient base and concerns about
      infectious diseases have complicated dentistry in the past decade--making a
      thorough health history more important than ever. A survey comparing dental
      university health history forms with those used by some general practitioners is
      presented.

PMID- 8354792
TI  - Acute effect of cigarette smoking on the coronary circulation: constriction of
      epicardial and resistance vessels.
AB  - OBJECTIVES: This study was performed to determine the acute effect of cigarette
      smoking on proximal and distal epicardial conduit and coronary resistance
      vessels. BACKGROUND: Cigarette smoking causes constriction of epicardial arteries
      and a decrease in coronary blood flow in patients with coronary artery disease,
      despite an increase in myocardial oxygen demand. The role of changes in
      resistance vessel tone in the acute coronary hemodynamic effect of smoking has
      not been examined. METHODS: Twenty-four long-term smokers were studied during
      cardiac catheterization after vasoactive medications had been discontinued. The
      effect of smoking one cigarette 10 to 15 mm long on proximal and distal conduit
      vessel segments was assessed before and immediately after smoking and at 5, 15
      and 30 min after smoking (n = 8). To determine the effect of smoking on
      resistance vessels, coronary flow velocity was measured in a nonobstructed artery
      with a 3F intracoronary Doppler catheter before and for 5 min after smoking (n =
      8). Eight patients were studied without smoking to control for spontaneous
      changes in conduit arterial diameter (n = 5) and resistance vessel tone (n = 3).
      RESULTS: The average diameter of proximal coronary artery segments decreased from
      2.56 +/- 0.12 mm (mean +/- SEM) before smoking to 2.41 +/- 0.09 mm 5 min after
      smoking (-5 +/- 2%, p < 0.05). Distal coronary diameter decreased from 1.51 +/-
      0.07 to 1.39 +/- 0.06 mm (-8 +/- 2%, p < 0.01). Marked focal vasoconstriction
      after smoking was observed in two patients. Coronary diameter returned to
      baseline by 30 min after smoking. There was no change in vessel diameter in
      control patients. Despite a significant increase in the heart rate-mean arterial
      pressure product, coronary flow velocity decreased by 7 +/- 4% (p < 0.05) and
      coronary vascular resistance increased by 21 +/- 4% (p < 0.01) 5 min after
      smoking. There was no change in these variables in the control subjects.
      CONCLUSIONS: Smoking causes immediate constriction of proximal and distal
      epicardial coronary arteries and an increase in coronary resistance vessel tone,
      despite an increase in myocardial oxygen demand. These acute coronary hemodynamic
      effects may contribute to the adverse cardiovascular consequences of cigarette
      smoking.

PMID- 8354793
TI  - Smoking-induced coronary vasoconstriction: implications for therapeutic use of
      nicotine.

PMID- 8354794
TI  - Altered coronary vasodilator reserve and metabolism in myocardium subtended by
      normal arteries in patients with coronary artery disease.
AB  - OBJECTIVES: The aim of this study was to investigate coronary vasodilator reserve
      and metabolism in myocardium subtended by angiographically normal arteries remote
      from ischemia. BACKGROUND: After infarction, structural and functional changes
      occur in remote myocardium often subtended by normal arteries. Whether changes
      occur in regions remote from ischemic but noninfarcted myocardium is unknown.
      METHODS: Coronary vasodilator reserve was measured with positron emission
      tomography in 12 patients with single-vessel disease using intravenous
      dipyridamole (0.56 mg/kg for 4 min). In another 10 patients, simultaneous
      arterial/great cardiac vein catheterization was performed during atrial pacing to
      measure myocardial metabolism in regions subtended by diseased or normal
      arteries. RESULTS: Basal myocardial blood flow in stenosis-related regions was
      comparable to that in remote regions but was lower after dipyridamole
      administration (1.73 +/- 0.91 vs. 2.89 +/- 0.93 ml/min per g, p < 0.01), giving
      coronary vasodilator reserve values of 1.80 +/- 0.82 and 2.73 +/- 0.89 (p <
      0.01). In normal control subjects, basal myocardial blood flow was 0.92 +/- 0.13
      and 3.67 +/- 0.94 ml/min per g in the basal state and after dipyridamole (both p
      < 0.05 vs. values in remote regions), and coronary vasodilator reserve was 4.07
      +/- 0.98 (p < 0.01) vs. values in remote regions). During pacing there was net
      lactate release in diseased regions (-18 +/- 27%, p < 0.05 vs. values in remote
      regions and control subjects) and extraction in remote regions (38 +/- 17%) and
      in normal control subjects (26 +/- 11%). Glucose and alanine extraction were
      increased in diseased (8 +/- 6% and 6 +/- 6%) and remote regions (6 +/- 3% and 4
      +/- 3%), compared with values in normal control subjects (2 +/- 3% and -1 +/- 3%,
      both p < 0.05 vs. diseased and remote regions). CONCLUSIONS: Coronary vasodilator
      reserve is reduced and glucose and alanine metabolism is abnormal in regions
      subtended by normal arteries remote from ischemic but noninfarcted myocardium.

PMID- 8354795
TI  - Abnormal systolic blood pressure response during exercise recovery in patients
      with angina pectoris.
AB  - OBJECTIVES: This study was conducted to clarify the mechanisms of the abnormal
      systolic blood pressure response after exercise in patients with angina pectoris.
      BACKGROUND: An abnormal systolic blood pressure response in patients with angina
      pectoris has been observed not only during exercise but also during the recovery
      period after exercise. However, the mechanisms of this abnormal response during
      recovery have not been elucidated. METHODS: Thirty-five patients with angina
      pectoris and 17 control subjects underwent bicycle ergometric studies after
      insertion of a Swan-Ganz catheter. RESULTS: In control subjects, all hemodynamic
      variables decreased rapidly after exercise. In 7 of the 35 patients, systolic
      blood pressure increased after exercise. The patients with angina were classified
      into two groups. In group I (17 patients), changes in systolic blood pressure
      during recovery were smaller than those in control subjects. In group II (18
      patients) recovery of systolic blood pressure was normal. Changes in stroke index
      from rest to peak exercise were smaller in group I than in group II. Stroke index
      in both patient groups increased paradoxically during recovery. The increase in
      systemic vascular resistance index during recovery and the ratio of plasma
      norepinephrine concentration to cumulative work load were greater in group I than
      in group II. CONCLUSIONS: An abnormal systolic blood pressure response after
      physical exercise in patients with angina pectoris is indicative of severe
      myocardial ischemia during exercise and may be caused by an increase in stroke
      volume due to recovery from myocardial ischemia and increased systemic vascular
      resistance secondary to exaggerated sympathetic nervous activity.

PMID- 8354796
TI  - Independent and incremental prognostic value of exercise single-photon emission
      computed tomographic (SPECT) thallium imaging in coronary artery disease.
AB  - OBJECTIVES: The objective of this study was to examine the independent and
      incremental prognostic value of exercise single-photon emission computed
      tomographic (SPECT) thallium imaging in patients with angiographically defined
      coronary artery disease. BACKGROUND: Previous studies showed the importance of
      exercise thallium-201 in risk stratification. However, most of these studies used
      planar imaging techniques. METHODS: Follow-up data were obtained in 316 medically
      treated patients with coronary artery disease. Cox proportional hazards
      regression models were used to examine the independent and incremental prognostic
      values of clinical, exercise, thallium and cardiac catheterization data. RESULTS:
      There were 35 events (cardiac death or nonfatal myocardial infarction) at a mean
      follow-up time of 28 months. Univariate analysis showed that gender (chi-square =
      5.1), exercise work load (chi-square = 3.1), extent of coronary artery disease
      and left ventricular ejection fraction (chi-square = 14.8) and thallium variables
      (chi-square = 22.7) were prognostically important. The thallium data provided
      incremental prognostic value to catheterization data (chi-square = 33.7, p <
      0.01). The extent of the perfusion abnormality was the single best predictor of
      prognosis (chi-square = 14). Patients with a large perfusion abnormality had a
      worse prognosis than that of patients with a mild or no abnormality (Mantel-Cox
      statistics = 10.6, p < 0.001). CONCLUSIONS: In medically treated patients with
      coronary artery disease, exercise SPECT thallium imaging provides independent and
      incremental prognostic information even when catheterization data are available.
      The extent of the perfusion abnormality is the single most important prognostic
      predictor.

PMID- 8354797
TI  - Ischemic threshold during two exercise testing protocols and during ambulatory
      electrocardiographic monitoring.
AB  - OBJECTIVES: The aim of this study was to examine the dependence of the ischemic
      threshold during exercise testing on the exercise protocol employed and to
      determine the relation between the ischemic thresholds observed during exercise
      and during daily activity. BACKGROUND: The ischemic threshold (heart rate at 1-mm
      ST segment depression) during daily activity has been reported to be lower than
      that observed during exercise testing. Recent reports have hypothesized that this
      difference is probably dependent on the exercise protocol employed. METHODS:
      Twenty-two patients with known coronary artery disease, not receiving antianginal
      medications, were evaluated by repeated exercise testing according to the Bruce
      and the modified Davidson protocols and by 48-h ambulatory electrocardiographic
      monitoring. RESULTS: Although the heart rate at 1-mm ST segment depression was
      somewhat lower with the Davidson than with the Bruce protocol (112 +/- 14 vs. 115
      +/- 14 beats/min), the rate-pressure product at 1-mm ST segment depression was
      similar during the two protocols (16,900 +/- 4,000 vs. 17,700 +/- 3,600). The
      mean heart rate (100 + 12 beats/min) at 1-mm ST segment depression during
      ambulatory ischemic episodes (n = 137) was significantly lower than that observed
      during both exercise protocols (p < 0.001 for both comparisons). CONCLUSIONS:
      Exercise-induced ischemia occurs at a relatively fixed threshold that is mainly
      dependent on myocardial oxygen demand and is independent of the exercise protocol
      employed. Ischemia on ambulatory monitoring, however, occurs at a much more
      variable threshold that is commonly lower than that observed during exercise and
      is therefore dependent on other factors in addition to increased demand.

PMID- 8354799
TI  - Verapamil and aspirin modulate platelet-mediated vasomotion in arterial segments
      with intact or disrupted endothelium.
AB  - OBJECTIVES: This study was designed to examine the effects of verapamil and
      aspirin, which decrease thromboxane A2 and serotonin release, on the modulation
      of vascular tone by platelets. BACKGROUND: Aggregating platelets cause
      constriction of de-endothelialized arterial segments through thromboxane A2 and
      serotonin release. These cells cause relaxation of arterial segments with intact
      endothelium through release of the endothelium-derived relaxing factor. METHODS:
      Healthy subjects were given either no drug, verapamil or aspirin for > or = 5
      days before their platelets were obtained. The effects of platelets obtained from
      subjects before and after treatment with aspirin or verapamil on the tone of rat
      aortic rings were determined. RESULTS: As expected, control platelets (before
      verapamil or aspirin treatment) induced concentration-dependent relaxation of rat
      aortic rings with intact endothelium and a concentration-dependent contraction of
      de-endothelialized rings. Verapamil treatment enhanced (p < 0.02) the platelet
      mediated relaxation in rings with intact endothelium and abolished platelet
      mediated constriction (p < 0.01) in the de-endothelialized rings. Aspirin
      treatment also abolished (p < 0.05) platelet-mediated constriction of the de
      endothelialized rings. The de-endothelialized rings contracted normally in
      response to the synthetic thromboxane A2 analogue U46,619, as well as to
      serotonin, indicating that the vascular smooth muscle response to thromboxane A2
      and serotonin was intact. CONCLUSIONS: This study provides evidence for the
      modulation of platelet-mediated vasoconstriction of de-endothelialized arterial
      segments by prior treatment of subjects with verapamil or aspirin. In clinical
      syndromes characterized by endothelial dysfunction or disruption, treatment with
      verapamil or aspirin may modify platelet-vessel wall interactions.

PMID- 8354798
TI  - Benefits of cardiac rehabilitation and exercise training in secondary coronary
      prevention in the elderly.
AB  - OBJECTIVES: The aim of this study was to determine the effects of cardiac
      rehabilitation and exercise training on plasma lipids, indexes of obesity and
      exercise capacity in the elderly and to compare the benefits in elderly patients
      with coronary heart disease with benefits in a younger cohort. BACKGROUND:
      Despite the well proved benefits of cardiac rehabilitation and exercise training,
      elderly patients with coronary heart disease are frequently not referred or
      vigorously encouraged to pursue this therapy. In addition, only limited data are
      available for these elderly patients on the benefits of cardiac rehabilitation on
      plasma lipids, indexes of obesity and exercise capacity. METHODS: At two large
      multispecialty teaching institutions, baseline and post-rehabilitation data
      including plasma lipids, indexes of obesity and exercise capacity were compared
      in 92 elderly patients (> or = 65 years, mean age 70.1 +/- 4.1 years) and 182
      younger patients (< 65 years, mean 53.9 +/- 7.4 years) enrolled in phase II
      cardiac rehabilitation and exercise programs after a major cardiac event.
      RESULTS: At baseline, body mass index (26.0 +/- 3.9 vs. 27.8 +/- 4.2 kg/m2, p <
      0.001), triglycerides (141 +/- 55 vs. 178 +/- 105 mg/dl, p < 0.01) and estimated
      metabolic equivalents (METs) (5.6 +/- 1.6 vs. 7.7 +/- 3.0, p < 0.0001) were lower
      and high density lipoprotein cholesterol was greater (40.4 +/- 12.1 vs. 37.5 +/-
      10.4 mg/dl, p < 0.05) in the elderly than in younger patients. After
      rehabilitation, the elderly demonstrated significant improvements in METs (5.6 +/
      1.6 vs. 7.5 +/- 2.3, p < 0.0001), body mass index (26.0 +/- 3.9 vs. 25.6 +/- 3.8
      kg/m2, p < 0.01), percent body fat (24.4 +/- 7.0 vs. 22.9 +/- 7.2%, p < 0.0001),
      high density lipoprotein cholesterol (40.4 +/- 12.1 vs. 43.0 +/- 11.4 mg/dl, p <
      0.001) and the ratio of low density to high density lipoprotein cholesterol (3.6
      +/- 1.3 vs. 3.3 +/- 1.0, p < 0.01) and a decrease in triglycerides that
      approached statistical significance (141 +/- 55 vs. 130 +/- 76 mg/dl, p = 0.14)
      but not in total cholesterol or low density lipoprotein cholesterol. Improvements
      in functional capacity, percent body fat and body mass index, as well as lipids,
      were statistically similar in the older and younger patients. CONCLUSIONS:
      Despite baseline differences, improvements in exercise capacity, obesity indexes
      and lipids were very similar in older and younger patients enrolled in cardiac
      rehabilitation and exercise training. These data emphasize that elderly patients
      should not be categorically denied the psychosocial, physical and risk factor
      benefits of secondary coronary prevention including formal cardiac rehabilitation
      and supervised exercise training.

PMID- 8354800
TI  - Failed direct coronary angioplasty for acute myocardial infarction: in-hospital
      outcome and predictors of death.
AB  - OBJECTIVES: The purpose of this study was to compare the mechanisms, predictors
      and outcome of patients with failed direct coronary angioplasty of the infarct
      related artery with those in patients with successful direct angioplasty.
      BACKGROUND: Direct coronary angioplasty of the infarct-related artery, without
      antecedent thrombolytic therapy, is an effective treatment for patients with
      acute myocardial infarction. Concern has been expressed over high mortality rates
      in patients with failed direct infarct angioplasty. METHODS: All patients treated
      by angioplasty were prospectively entered into a computer data base. The
      characteristics and outcome of all patients with failed direct angioplasty were
      reviewed and compared with those of patients with successful direct angioplasty.
      RESULTS: Direct angioplasty was successful in 705 (94%) of 750 patients and
      unsuccessful in 45 (6%). Patients in the failure group were more likely to be in
      cardiogenic shock (22% vs. 7%, p < 0.003), to have had a previous myocardial
      infarction (44% vs. 28%, p < 0.03) and to have three-vessel coronary artery
      disease (44% vs. 23%, p < 0.003). Age, gender, ejection fraction, previous bypass
      surgery and diabetes mellitus were similar in both groups. Only the presence of
      multivessel coronary artery disease (p < 0.004) and cardiogenic shock (p < 0.025)
      were independent predictors of failed direct angioplasty. In-hospital death (31%
      vs. 4.8%, p < 0.001) and the need for emergency coronary artery bypass surgery
      (27% vs. 0.5%, p < 0.0001) were more frequent in patients with unsuccessful than
      in patients with successful direct angioplasty. Patients with failed direct
      angioplasty and in-hospital death usually had multiple high risk characteristics,
      including cardiogenic shock (50%), previous myocardial infarction (43%) and
      multivessel coronary artery disease (93%). CONCLUSIONS: Direct coronary
      angioplasty is an effective method for establishing reperfusion in acute
      myocardial infarction. Procedural failure is infrequent, usually occurring in
      patients with high risk baseline characteristics.

PMID- 8354801
TI  - Influence of infarct-related artery patency on the indexes of parasympathetic
      activity and prevalence of late potentials in survivors of acute myocardial
      infarction.
AB  - OBJECTIVES: The purpose of this study was to determine whether infarct-related
      coronary artery patency influences myocardial electrical stability as measured by
      the prevalence of late potentials or heart rate variability. BACKGROUND: Several
      studies have suggested that loss of vagal activity is associated with an
      increased incidence of arrhythmic death after myocardial infarction. METHODS: A
      short-duration, high resolution electrocardiogram (ECG) was performed before
      hospital discharge in 175 patients with a first myocardial infarction. Seventy
      three patients received thrombolytic therapy. All patients underwent coronary
      angiography. Coronary occlusion was defined as minimal or no anterograde flow.
      Eighty-eight patients (50.3%) had an occluded infarct-related artery. Sixty-two
      healthy subjects served as control subjects to determine the normal range of
      heart rate variability. RESULTS: Comparison between the control group and
      patients without patency of the infarct-related artery in the time domain and
      spectral analyses revealed in the latter patients a reduced heart rate
      variability (p < 0.0001) and a lower power spectrum density in both the 0.05- to
      0.15-Hz band (p < 0.0001) and the 0.15- to 0.35-Hz band (p < 0.0001). The heart
      rate variability in patients with late potentials was lower than in those with a
      normal signal-averaged ECG. Those patients with spontaneous or thrombolysis
      induced reperfusion have less occurrence of late potentials and higher
      parasympathetic activity than do patients with a closed artery. CONCLUSIONS: This
      study suggests that the patency of the infarct-related artery determines both the
      absence of late potentials and the preservation of vagal tone and may explain the
      reduction in mortality induced by thrombolytic therapy in myocardial infarction.

PMID- 8354802
TI  - Significance of diabetes mellitus in patients with acute myocardial infarction
      receiving thrombolytic therapy. Investigators of the International Tissue
      Plasminogen Activator/Streptokinase Mortality Trial.
AB  - OBJECTIVES: The purpose of this study was to evaluate the risks and benefits
      associated with thrombolytic therapy in patients with diabetes presenting with
      acute myocardial infarction. BACKGROUND: Diabetes mellitus is associated with
      adverse risk factors and a hypercoagulable state that may adversely affect the
      outcome of thrombolytic therapy. METHODS: Data were analyzed from 8,055 of the
      8,239 patients with acute myocardial infarction who received thrombolytic therapy
      in the International Tissue Plasminogen Activator/Streptokinase Mortality trial
      (diabetes history was missing for 184 patients). RESULTS: There were 883 patients
      with and 8,272 patients without diabetes. Among the diabetic patients, 160 were
      receiving insulin therapy. Baseline risk factors were significantly worse in
      diabetic patients, who were older and had a higher rate of previous infarction
      and antecedent angina and a higher Killip grade at admission. Bleeding and
      hemorrhagic and ischemic stroke rates were similar among diabetic and nondiabetic
      patients. Hospital and 6-month mortality rates were highest among diabetic
      patients receiving insulin therapy (16.9% and 23.1%, respectively), followed by
      diabetic patients not receiving insulin therapy (11.8% and 17.8%), and lowest in
      nondiabetic patients (7.5% and 10.7%, p < 0.0001). Whereas diabetes of 5 years'
      duration was associated with a mortality rate similar to that of nondiabetic
      patients, a > 5-year duration was associated with a relative mortality risk of
      1.38 (95% confidence interval [CI] 0.88 to 2.15) and a > 10-year duration with a
      relative mortality risk of 1.99 (95% CI 1.40 to 2.81). The independent relative
      risk for incremental mortality from discharge to 6 months was 1.74 (95% CI 1.21
      to 2.50). Mortality rate among diabetic patients was lowest in patients who
      received both streptokinase and heparin (9.8% vs. 16.1% in patients who received
      streptokinase but no heparin, p < 0.05). CONCLUSIONS: The relative mortality of
      diabetic versus nondiabetic patients was similar to that observed in previous
      studies of patients with myocardial infarction not receiving thrombolytic
      therapy, indicating that mortality in diabetic patients receiving thrombolytic
      therapy is reduced to the same extent as in nondiabetic patients. In addition,
      risk of bleeding and stroke was not increased, indicating that diabetic patients
      can safely receive thrombolytic therapy for the same indications as nondiabetic
      patients.

PMID- 8354803
TI  - Effect of thrombolysis on acute mitral regurgitation during evolving myocardial
      infarction. Experience from the Thrombolysis in Myocardial Infarction (TIMI)
      Trial.
AB  - OBJECTIVES: This study was undertaken to determine whether early successful
      thrombolysis can reverse infarct-associated mitral valve dysfunction. BACKGROUND:
      Mitral regurgitation is a common complication of acute myocardial infarction and
      has been shown to adversely affect both short- and long-term prognosis. Although
      anecdotal reports have suggested that reperfusion of the infarct-related artery
      may restore normal function to the mitral valve, this theory has not been
      subjected to formal investigation. METHODS: Patients with total or partial
      obstruction of the infarct-related artery received intravenous thrombolytic
      therapy with either streptokinase or recombinant tissue-type plasminogen
      activator within 7 h of symptom onset (mean 4.8 h) as part of the Thrombolysis in
      Myocardial Infarction (TIMI) Phase I trial. Repeat coronary angiography assessed
      arterial patency at 90 min and 10 days after attempted reperfusion. The presence
      and severity of mitral regurgitation were determined by contrast ventriculography
      both before thrombolysis and before hospital discharge. RESULTS: Overall, 21
      (16%) of the 132 study patients exhibited mitral regurgitation on either their
      initial or their predischarge ventriculogram. The proportion of infarct-related
      arteries found to be patent (TIMI flow grade 2 or 3) was statistically similar in
      patients with and without mitral regurgitation during each angiographic
      evaluation period (initial, 90 min and 10 days). Although coronary artery
      perfusion increased overall during sequential measurement (mean TIMI grade was
      0.4 +/- 0.6 initially, 1.5 +/- 1.3 at 90 min and 2.2 +/- 1.0 at 10 days), the
      pattern of reperfusion observed could not predict an increase or decrease in
      regurgitant severity (p = NS). Early mitral regurgitation resolved in 57% of
      patients by 10 days, but this resolution appeared independent of the presence or
      absence of improved coronary perfusion (60% vs. 50%). The development of new
      regurgitation during the recovery period (6%) was also unrelated to improved
      perfusion (7% vs. 4%). CONCLUSIONS: Acute mitral regurgitation developing during
      myocardial infarction shows frequent changes in its presence or severity during
      the 1st 10 days, appears independent of coronary artery patency both early and
      late after thrombolysis and cannot be reliably treated by improving arterial
      perfusion with thrombolytic agents.

PMID- 8354804
TI  - Cardiac rupture, a clinically predictable complication of acute myocardial
      infarction: report of 70 cases with clinicopathologic correlations.
AB  - OBJECTIVE: To test the hypothesis that certain clinical events may precede free
      wall myocardial rupture and allow its prediction, we conducted a retrospective
      and prospective study of 70 patients with rupture. BACKGROUND: Rupture of the
      left ventricular free wall develops in approximately 10% of patients with fatal
      acute transmural myocardial infarction. Clinically, its occurrence has been
      considered precipitous and unexpected. Pathologically, however, rupture appears
      to be a stuttering, progressive process characterized in many instances by an
      infiltrating intramural hemorrhage and a thrombus within the tear of > or = 1
      day's duration. METHODS: The clinical course and evolutionary
      electrocardiographic (ECG) changes in 70 consecutive patients with rupture and
      100 comparison patients with acute myocardial infarction but without rupture were
      reviewed to ascertain whether certain clinical symptoms, signs and ECG
      alterations occur in patients prone to develop rupture, allowing its
      anticipation. In addition, a correlation was established between the site of
      infarction indicated by the ECG and the site of rupture determined at autopsy or
      surgery. RESULTS: Patients with rupture had a significantly greater incidence of
      pericarditis, repetitive emesis and restlessness and agitation than did patients
      without rupture. More than 80% of patients with rupture had two or more symptoms
      compared with 3% of patients without rupture (p < 0.002). A deviation from the
      expected evolutionary T wave pattern occurred in 94% of patients with rupture and
      34% of control patients (p < or = 0.02). An abrupt transient episode of
      hypotension and bradycardia, probably due to the initial tearing of the
      epicardium with a resultant small hemopericardium, was observed in 21% of
      patients with rupture. Rupture of the midlateral wall was most common (32%) and
      usually occurred in the setting of an inferoposterolateral infarction related to
      an acute left circumflex artery occlusion. On the basis of these clinical and ECG
      changes, rupture was confirmed by echocardiography and pericardiocentesis in the
      two most recent patients, and the defect was successfully repaired. CONCLUSIONS:
      Rupture is often preceded by particular symptoms, signs--namely, one or more
      episodes of abrupt, transient hypotension and bradycardia and unexpected
      alterations of the T waves, especially directional changes of the latter.
      Patients displaying these symptoms, signs and ECG changes require a bedside
      echocardiogram and echocardiographically guided pericardiocentesis if fluid is
      visualized. If the pericardiocentesis identifies the fluid as blood, immediate
      surgery is indicated.

PMID- 8354805
TI  - Percutaneous angioplasty of stenosed gastroepiploic artery grafts.
AB  - OBJECTIVES: This report describes our early experience and results with
      percutaneous transluminal coronary angioplasty of gastroepiploic artery grafts in
      12 patients. BACKGROUND: Angioplasty has been successfully performed in saphenous
      vein and internal thoracic artery grafts; however, experience with angioplasty in
      gastroepiploic artery/coronary artery bypass grafts is limited. METHODS: Balloon
      angioplasty was performed in 12 patients (11 men, 1 woman; mean age 58 +/- 8
      years) with either total occlusion (6 patients) or severe stenosis (6 patients)
      of a gastroepiploic artery/coronary artery anastomosis. In seven patients, a
      guide wire/balloon catheter system was used through a 7F sheath inserted into the
      celiac trunk. In seven patients, including two who had unsuccessful wire/balloon
      angioplasty, an over the wire system was used through a 6.5F Cobra or 7F JR4
      guide catheter, selectively inserted into the gastroduodenal artery. RESULTS:
      Angioplasty was successful in five (83%) of six patients with stenosis and in one
      of six patients with total occlusion (p = 0.08, 1 - beta = 0.68). The guide wire
      could not be advanced through the lesion in five patients, and the balloon
      catheter did not cross the lesion in one patient whose gastroepiploic artery was
      tortuous. Catheters exhibited better trackability and pushability when the over
      the wire system was used, and five of the six successes were achieved using this
      approach. Follow-up arteriography was performed in five patients, and all of the
      gastroepiploic artery grafts were patent without stenosis. CONCLUSIONS:
      Angioplasty can be safely performed in stenosed gastroepiploic artery grafts. An
      over the wire system that uses a thin balloon catheter inserted through a guide
      catheter in the gastroduodenal artery seems optimal.

PMID- 8354806
TI  - Therapeutic end points for the treatment of atrioventricular node reentrant
      tachycardia by catheter-guided radiofrequency current.
AB  - OBJECTIVES: The purpose of this prospective study was to test the hypothesis that
      the elimination of inducible repetitive atrioventricular (AV) node reentry
      despite the persistence of slow AV pathway conduction is a valid end point for
      radiofrequency catheter ablation procedures in patients with supraventricular
      tachycardia due to AV node reentry. BACKGROUND: Although modification of AV node
      physiology by radiofrequency current can eliminate AV node reentrant tachycardia,
      therapeutic end points that are definitive of a satisfactory result in patients
      undergoing modification of the slow AV pathway have not been established.
      Applications of radiofrequency current at selected sites may eliminate all
      evidence of slow pathway conduction or sufficiently modify the refractory
      properties of the slow pathway to preclude sustained arrhythmias. Accordingly,
      total abolition of dual AV node physiology may not be necessary to prevent
      arrhythmia recurrence. METHODS: Radiofrequency catheter ablation of the slow AV
      pathway was attempted in 59 patients with typical AV node reentry. Tissue
      ablation was performed with a continuous wave of 500-kHz radiofrequency current.
      Twenty-five to 35 W was applied for 60 s at the site selected for tissue
      destruction. RESULTS: Dual AV node physiology was eliminated completely in 35
      patients (59%), persisted without inducible AV node reentry in 13 patients (22%)
      and persisted with inducible single AV reentrant beats in 11 patients (19%). In
      patients with persistent dual AV node physiology, the maximal difference between
      the effective refractory period of the fast and slow pathways was reduced from
      104 +/- 62 ms before the procedure to 37 +/- 37 ms after AV conduction had been
      modified (p < 0.001). During a mean follow-up interval of 15 months (range 4 to
      28), only one patient (2%) had a recurrence of the tachycardia. CONCLUSIONS:
      Results demonstrate that when complete elimination of dual AV node physiology is
      difficult, modification of slow pathway conduction to the extent that repetitive
      AV node reentry cannot be induced is a definitive end point that portends a good
      prognosis.

PMID- 8354807
TI  - Safety and efficacy of central intravenous bolus administration of adenosine for
      termination of supraventricular tachycardia.
AB  - OBJECTIVES: This study was done to quantify the dosing differences between
      central and peripheral adenosine administration for treatment of supraventricular
      tachycardia. BACKGROUND: Earlier studies that evaluated the safety and efficacy
      of adenosine primarily utilized a peripheral site of administration. Although it
      has been recommended that lower doses should be given centrally, dosing
      recommendations have not been provided. METHODS: Thirty adults with
      supraventricular tachycardia underwent invasive electrophysiologic study and were
      treated with central and peripheral intravenous administration of adenosine.
      Peripheral injections were administered through a venous catheter in an upper
      extremity and central infusions were accomplished by means of a catheter
      positioned in or near the right atrium. The site of administration was randomized
      and each subject received adenosine by both routes. Adenosine was administered
      every minute in increasing increments of 3, 6, 9 and 12 mg until the tachycardia
      terminated. Peripheral responses were compared with those obtained centrally.
      RESULTS: The minimal effective peripheral dose was distributed among the four
      doses: Tachycardia was terminated in 11 patients with 3 mg (37%), in 10 (33%)
      with 6 mg, in 4 (13%) with 9 mg and in 5 (17%) with 12 mg. In contrast, after
      central administration, 23 episodes of tachycardia (77%) were terminated with 3
      mg, 6 (20%) with 6 mg and 1 (3%) with 9 mg; none required 12 mg. Lower doses of
      adenosine were more effective after central than after peripheral administration,
      with 63% of the subjects requiring a lesser dose. There was no difference between
      the two routes of drug administration in the incidence of side effects or
      transient arrhythmias at the time of tachycardia termination. CONCLUSIONS:
      Adenosine can be safely given centrally for termination of supraventricular
      tachycardia. The initial dose should be 3 mg.

PMID- 8354808
TI  - Effect of rate and coupling interval on endocardial R wave amplitude variability
      in permanent ventricular sensing lead systems.
AB  - OBJECTIVES: We have observed sensing errors in third generation implantable
      cardioverter-defibrillators that appear to be caused by variation in the R wave
      amplitude during sinus rhythm, particularly after premature beats. The purpose of
      this study was to quantify spontaneous R wave variability during sinus rhythm and
      to determine whether abrupt changes in cycle length further augment R wave
      amplitude variability. BACKGROUND: Pacemaker sensing algorithms presume a
      relatively constant R wave signal to establish a sensing threshold. The concept
      of a fixed sensing threshold is not as applicable in third-generation
      cardioverter-defibrillators, which depend on automatic gain amplifiers to rapidly
      detect ventricular fibrillation. These devices may be susceptible to undersensing
      during sinus rhythm if significant variability in R wave signal characteristics
      occurs. METHODS: Twelve patients with combination bradycardia pacing cardioverter
      defibrillators were studied. The device used (Cadence, Ventritex) allowed
      recording of real time, telemetered electrograms from the sensing lead system.
      Measurements were made of the maximal range of the R wave amplitude during sinus
      rhythm and in response to abrupt changes in heart rate produced by premature
      atrial and ventricular stimuli. RESULTS: The maximal range in R wave amplitude
      during sinus rhythm was 1.7 +/- 1.3 mV, or 23.7 +/- 19.2% of the mean R wave
      amplitude. The R wave amplitude variability increased with abrupt changes in
      cycle length, with a range of 2.8 +/- 1.5 mV, or 38.8 +/- 18.3% of the mean R
      wave amplitude (p < 0.05 compared with sinus rhythm). In most patients, R wave
      amplitude and coupling interval demonstrated an inverse proportional relation.
      CONCLUSIONS: There is substantial variability in the R wave amplitude during
      sinus rhythm measured by permanent ventricular sensing lead systems, and this
      variability is further augmented by abrupt changes in cycle length. This
      phenomenon may explain the occurrence of undersensing of sinus rhythm in
      implantable cardioverter-defibrillators with automatic gain sense amplifiers.

PMID- 8354809
TI  - Relation between left ventricular shape and exercise capacity in patients with
      left ventricular dysfunction.
AB  - OBJECTIVES: The aim of this study was to identify dynamic predictors of exercise
      duration in patients with systolic left ventricular dysfunction and to test the
      hypothesis that left ventricular shape is an independent determinant of exercise
      duration in these patients. BACKGROUND: Measurements of left ventricular volumes
      and ejection fraction at rest do not predict exercise capacity in patients with
      systolic left ventricular dysfunction. Left ventricular shape at rest has been
      reported to be an independent determinant of exercise duration in these patients.
      The significance of alterations in left ventricular shape that occur during
      dynamic exercise has not been investigated. METHODS: Twenty-one patients with a
      documented ejection fraction < 40% performed symptom-limited graded upright
      bicycle exercise with simultaneous quantitative two-dimensional echocardiography.
      End-diastolic volume, end-systolic volume, stroke volume, ejection fraction and
      sphericity index were measured at rest and peak exercise. RESULTS: Eleven
      patients exercised beyond stage II (6 min, 50 W), averaging 8.9 +/- 1.9 min; 10
      patients were unable to complete stage II, averaging 4.9 +/- 0.9 min. No patient
      developed clinical evidence of ischemia during the exercise period. Of the
      echocardiographic variables considered, only end-systolic and end-diastolic
      sphericity indexes at peak exercise (r = 0.809 and 0.711, respectively) and the
      change in end-systolic sphericity index during exercise (r = 0.697) were strongly
      correlated with exercise duration. CONCLUSIONS: Conventional descriptors of left
      ventricular function are poor predictors of exercise capacity. Dynamic changes in
      heart shape correlate strongly with exercise duration and may be important
      determinants of exercise capacity in patients with systolic left ventricular
      dysfunction.

PMID- 8354810
TI  - Long-term follow-up (12 to 35 weeks) after dynamic cardiomyoplasty.
AB  - OBJECTIVES: To obtain information on the long-term effects of dynamic
      cardiomyoplasty on hemodynamics and muscle histology, this surgical method was
      evaluated in goats. BACKGROUND: Dynamic cardiomyoplasty has been introduced as a
      new method to treat patients with severe cardiac failure. METHODS: In 24 goats,
      the left latissimus dorsi muscle was wrapped around the heart. The muscle was
      then subjected to progressive electrical stimulation. In 16 goats, invasive
      transesophageal Doppler echocardiographic measurements and histologic evaluation
      of the latissimus dorsi muscle were performed at > or = 12 weeks after the
      wrapping. RESULTS: Only two goats showed an increase in aortic and left and right
      ventricular pressures concomitant with increased aortic flow during latissimus
      dorsi muscle stimulation both before and after induction of cardiac failure using
      imipramine. This was accompanied by a preserved latissimus dorsi muscle structure
      and nearly complete transformation to type I muscle fibers. The remaining 14
      goats showed extensive lipomatosis in the latissimus dorsi muscle, with severe
      intimal hyperplasia and proliferation of smooth muscle cells in the walls of the
      thoracodorsal artery and its branches. An increase in endoneural and endomysial
      connective tissue was observed, with some goats showing destroyed nerve branches
      near the electrodes. These findings differed from those observed after long-term
      electrical stimulation of goat latissimus dorsi muscle in situ. CONCLUSIONS:
      Dynamic cardiomyoplasty is of use in the treatment of severe heart failure if the
      histologic structure of the wrapped latissimus dorsi muscle remains intact. Long
      term results in goats suggest that the current approach used in dynamic
      cardiomyoplasty may lead to deterioration of the wrapped muscle.

PMID- 8354811
TI  - Exercise-induced hypoxemia in heart transplant recipients.
AB  - OBJECTIVES: The purpose of this study was to determine whether heart
      transplantation has an adverse effect on pulmonary diffusion and to investigate
      the potentially deleterious effects of impaired pulmonary diffusion on arterial
      blood gas dynamics during exercise in heart transplant recipients. BACKGROUND:
      Abnormal pulmonary diffusing capacity is reported in patients after orthotopic
      heart transplantation. Abnormal diffusion may be caused by cyclosporine or by the
      persistence of preexisting conditions known to adversely affect diffusion, such
      as congestive heart failure and chronic obstructive pulmonary disease. METHODS:
      Eleven patients (mean age 50 +/- 14 years) performed pulmonary function tests 3
      +/- 1 months before and 18 +/- 12 (mean +/- SD) months after heart
      transplantation. Transplant patients were assigned to groups with diffusion > 70%
      (n = 5) or diffusion < 70% of predicted values (n = 5). The control group and
      both subsets of patients performed 10 min of cycle exercise at 40% and 70% of
      peak power output. Arterial blood gases were drawn every 30 s during the 1st 5
      min and at 6, 8 and 10 min. RESULTS: Significant improvements in forced vital
      capacity (17.4%), forced expiratory volume in 1 s (11.7%) and diffusion capacity
      (6.6%) occurred in the patients; however, posttransplantation vital capacity,
      forced expiratory volume and diffusion were lower (p < or = 0.05) compared with
      values in 11 matched control subjects. Changes in blood gases were similar among
      groups at 40% of peak power output. At 70% of peak power output, arterial blood
      gases and pH were significantly (p < or = 0.05) lower in transplant patients with
      low diffusion (arterial oxygen pressure 15 to 38 mm Hg below baseline) than in
      patients with normal diffusion and control subjects. Cardiac index did not differ
      (p > or = 0.05) between transplant patients with normal and low diffusion at rest
      or during exercise. Posttransplantation mean pulmonary artery pressure was
      significantly related to exercise-induced hypoxemia (r = 0.71; p = 0.03).
      CONCLUSIONS: Abnormal pulmonary diffusion observed in patients before heart
      transplantation persists after transplantation with or without restrictive or
      obstructive ventilatory defects. Heart transplant recipients experience exercise
      induced hypoxemia when diffusion at rest is < 70% of predicted. Our data also
      suggest that abnormal pulmonary gas exchange possibly contributes to diminished
      peak oxygen consumption in some heart transplant recipients; however, direct
      testing of this hypothesis was beyond the scope of the present study. This
      possibility needs to be investigated further.

PMID- 8354812
TI  - Effect of exercise on valvular resistance in patients with mitral stenosis.
AB  - OBJECTIVES: This exercise study assessed the relation between valvular resistance
      and flow in patients with mitral stenosis. BACKGROUND: Valvular resistance has
      been proposed as an alternative measure of stenotic valvular lesions, which is
      speculated to remain stable under changing hemodynamic conditions. METHODS: In 35
      of 40 patients with pure or predominant mitral stenosis, continuous wave Doppler
      measurements of the mitral stenotic jet were possible at rest and during supine
      bicycle ergometry. Simultaneously, transvalvular flow was assessed by
      thermodilution technique. For calculation of valvular resistance, the mean mitral
      valve pressure gradient was determined according to the simplified Bernoulli
      equation and divided by transvalvular flow. Additionally, effective mitral valve
      area was calculated according to the continuity equation method, dividing flow by
      the mean diastolic flow velocity. RESULTS: Valvular resistance was 65 +/- 32
      dynes.s.cm-5 at rest and increased to 82 +/- 43 dynes.s.cm-5 at 25 W (p < 0.001).
      The most prominent increase in valvular resistance (rest to 25 W 63 +/- 28 to 95
      +/- 48 dynes.s.cm-5, p < 0.001) was found in those patients who had no or only a
      moderate (< 20%) change in effective mitral valve area. In contrast, valvular
      resistance remained constant (67 +/- 36 vs. 70 +/- 32 dynes.s.cm-5) in patients
      with a significant (> or = 20%) increase in mitral valve area with exercise.
      CONCLUSIONS: In patients with mitral stenosis, the exercise-induced changes in
      valvular resistance are heterogeneous. This is the result of the variable
      response of mitral valve area to an increase in flow. In the individual patient,
      mitral valve area can significantly increase, a factor that has to be taken into
      account when interpreting the hemodynamic relevance of the obstruction.
      Calculated valvular resistance is flow dependent and has no advantage over valve
      area calculations for quantifying mitral stenosis.

PMID- 8354813
TI  - Mechanisms and outcome of severe mitral regurgitation after Inoue balloon
      valvuloplasty. North American Inoue Balloon Investigators.
AB  - OBJECTIVES: The purpose of this study was to assess the incidence, mechanism and
      outcome of severe mitral regurgitation after treatment of mitral stenosis with
      percutaneous mitral valvuloplasty using the Inoue balloon. BACKGROUND: Severe
      mitral regurgitation occurs in up to 15% of percutaneous balloon valvuloplasty
      procedures for acquired mitral stenosis. The incidence and mechanism of
      production of mitral regurgitation with the recently introduced single-balloon
      Inoue technique have not been characterized. METHODS: We examined the incidence,
      mechanism, predictors and outcome of severe mitral regurgitation after Inoue
      balloon valvuloplasty in 280 patients in the North American multicenter registry.
      Twenty-one patients who developed either clinically significant or
      angiographically severe regurgitation were identified, and their echocardiograms
      were reviewed to determine the mechanism of regurgitation. These patients were
      then compared with the remaining patients without severe regurgitation to
      identify predictors of this outcome. RESULTS: The incidence of severe
      regurgitation in this study was 7.5%, and the mean grade of angiographic
      regurgitation in these patients increased from 0.9 +/- 1.0 to 2.8 +/- 0.7 (p <
      0.05). The most common cause of regurgitation (43%) was rupture of chordae
      tendineae to the anterior or posterior mitral leaflet. Tearing of a leaflet
      (usually the posterior one) occurred in 30% of patients; and no recognizable
      structural abnormality, with wide splitting of the commissures and a central
      regurgitant jet, was present in five patients (26%). All patients with definite
      posterior leaflet tears had heavily calcified leaflets. Patients who developed
      severe regurgitation had fewer balloon inflations and a higher grade of
      preexisting mitral regurgitation but were otherwise similar to the remaining
      patients without severe regurgitation. During 6-month follow-up, 71% of the
      patients with severe regurgitation were treated surgically; the grade of
      regurgitation decreased in four patients (19%), and five patients (24%) have not
      required mitral valve replacement during 18 +/- 5 months of follow-up.
      CONCLUSIONS: Severe mitral regurgitation is a relatively infrequent complication
      of Inoue balloon valvuloplasty and results from disruption of the valve
      integrity, including chordal rupture and leaflet tearing. Careful balloon
      positioning may help avoid chordal rupture, and heavily calcified posterior
      leaflets may be at greater risk of tearing. Most patients who develop severe
      regurgitation will require nonemergency mitral valve replacement.

PMID- 8354814
TI  - Role of left ventricular regional nonuniformity in hypertensive diastolic
      dysfunction.
AB  - OBJECTIVES: This study investigated 1) the role of left ventricular diastolic
      nonuniformity in hypertensive left ventricular diastolic dysfunction, and 2) the
      effects of a calcium channel antagonist on diastolic nonuniformity in
      hypertensive and normotensive subjects. BACKGROUND: Augmented left ventricular
      diastolic nonuniformity contributes to diastolic dysfunction in hypertrophic
      cardiomyopathy. Impaired left ventricular diastolic function with preserved
      systolic function has been recognized in hypertension. Therefore, abnormal
      ventricular regional nonuniformity might also be involved in hypertensive
      diastolic dysfunction in a milder form of hypertrophy. METHODS: Thirteen patients
      with established hypertension underwent radionuclide ventriculography before and
      after nifedipine administration. Indexes of left ventricular function were
      derived by computer analysis of the time-activity curve. After a computer
      subdivided the left ventricle into four regions, a time-activity curve of each
      region was constructed to determine an index of left ventricular diastolic
      nonuniformity. This index was calculated as the sum of the absolute values of
      time difference between global and regional peak filling in the septal, the
      apical and the lateral region. Ten normotensive subjects were studied for
      comparison. Echocardiography was performed in both groups. RESULTS: The two
      groups were matched for age, gender, heart rate, echocardiographic dimensions and
      systolic function. In the hypertensive group, left ventricular diastolic filling
      indexes were impaired, with a negative correlation between peak filling rate and
      the diastolic nonuniformity index. Although the change in ejection fraction after
      nifedipine administration was similar in the two groups, the increase in peak
      filling rate was larger in the hypertensive patients. The diastolic nonuniformity
      index decreased after nifedipine in the hypertensive but not in the control
      group. This decrease correlated with improved peak filling rate in the
      hypertensive group. CONCLUSIONS: In hypertensive patients with preserved systolic
      function, left ventricular diastolic nonuniformity increases, causing early
      diastolic dysfunction. Decreased diastolic nonuniformity after pharmacologic
      intervention contributes to lessened ventricular filling dysfunction, regardless
      of changes in loading conditions in hypertension. Thus, diastolic nonuniformity
      is an important determinant of left ventricular filling abnormality and might be
      a target of pharmacologic intervention in hypertensive patients.

PMID- 8354815
TI  - Hypertrophic cardiomyopathy in the young: another form of ischemic
      cardiomyopathy?

PMID- 8354816
TI  - Restrictive left ventricular filling pattern in dilated cardiomyopathy assessed
      by Doppler echocardiography: clinical, echocardiographic and hemodynamic
      correlations and prognostic implications. Heart Muscle Disease Study Group.
AB  - OBJECTIVES: This study was undertaken to evaluate the frequency of restrictive
      left ventricular filling pattern in dilated cardiomyopathy, as well as its
      clinical and hemodynamic correlations and prognostic implications. BACKGROUND: In
      dilated cardiomyopathy, as in other heart diseases, different left ventricular
      filling patterns were observed on Doppler echocardiography. Some patients showed
      a "restrictive filling pattern," similar to that associated with restrictive
      cardiomyopathy, characterized by predominant E waves and a shortened E
      deceleration time. METHODS: Pulsed Doppler transmitral curves were analyzed in 79
      consecutive patients with dilated cardiomyopathy assigned to two study groups
      according to E deceleration time: group 1 (n = 36) had a restrictive left
      ventricular filling pattern (E deceleration time < 115 ms); group 2 (n = 43) had
      an E deceleration time > or = 115 ms. RESULTS: Patients in group 1 were
      significantly younger, in a higher New York Heart Association functional class,
      more frequently had a third heart sound and had a higher left ventricular filling
      pressure at catheterization. In addition, they showed more severe left and right
      ventricular dysfunction and dilation, a larger left atrium and more severe mitral
      regurgitation. A restrictive filling pattern was associated at Doppler study with
      a higher E wave velocity, lower A wave velocity and higher E/A ratio. During a
      follow-up interval of 22 +/- 14 months, all 14 patients who subsequently died or
      required heart transplantation showed a restrictive left ventricular filling
      pattern. At multivariate analysis, E deceleration time was the most powerful
      independent prognostic indicator of poor outcome or transplantation. CONCLUSIONS:
      Restrictive left ventricular filling pattern is frequent in dilated
      cardiomyopathy, is associated with more severe disease and is a powerful
      indicator of increased mortality risk and need for heart transplantation.

PMID- 8354817
TI  - An echocardiographic study of the fluid mechanics of obstruction in hypertrophic
      cardiomyopathy.
AB  - OBJECTIVES: The goal of this study was to investigate the hydrodynamic cause of
      mitral-septal contact and obstruction in patients with hypertrophic
      cardiomyopathy. BACKGROUND: Mitral-septal apposition has been shown to be the
      cause of obstruction in patients with hypertrophic cardiomyopathy. With
      obstruction, characteristic continuous wave Doppler tracings show an increasing
      acceleration of flow. (Tracing is concave to the left.) METHODS: We studied 24
      consecutive patients who had a Doppler echocardiographic pressure gradient > or =
      36 mm Hg. We pursued two lines of inquiry. 1) Before the onset of obstruction, we
      systematically measured the angle between the direction of left ventricular
      Doppler color flow and the protruding mitral leaflet in early systole. 2) After
      the onset of obstruction, we qualitatively analyzed the concave contour of the
      continuous wave Doppler tracings in our patients and developed a hydrodynamic
      theory of the obstruction phase to explain the characteristic tracings. We
      present a mathematic model to support this concept. RESULTS: We measured 129
      angles. Just before mitral-septal contact, the protruding mitral leaflet projects
      at a mean 40 degrees and 45 degrees relative to flow in the apical long-axis and
      apical five-chamber views, respectively. At mitral-septal contact, the
      obstructing leaflet projects at a mean 52 degrees and 58 degrees relative to flow
      in the same respective views. Even very early in systole, at leaflet coaptation,
      11 of 23 patients had angles > 15 degrees relative to flow. After mitral-septal
      apposition, obstruction across a cowl-shaped orifice begins. During this stage,
      the obstructing leaflet projects at a mean 55 degrees and 63 degrees relative to
      flow. In 22 patients, the continuous wave Doppler tracing of the left ventricular
      outflow jet showed an increasing acceleration of flow. CONCLUSIONS: Just before
      mitral-septal contact, the protruding leaflets project at high angles relative to
      flow. At these high angles, flow drag, the pushing force of flow, is the dominant
      hydrodynamic force on the protruding leaflet and appears to be the immediate
      cause of obstruction. The high angle between flow direction and the protruding
      leaflet precludes significant Venturi effects. Even earlier in systole, at
      leaflet coaptation, flow drag is dominant in half of the patients, with angles
      relative to flow > 15 degrees. After obstruction is triggered, it appears from
      our data and model that the leaflet is forced against the septum by the pressure
      difference across the orifice. The increasing acceleration of Doppler flow is
      explained by a time-dependent amplifying feedback loop in which the rising
      pressure difference across the orifice leads to a smaller orifice and a higher
      pressure difference.

PMID- 8354819
TI  - Congestive heart failure in rheumatic carditis: valvular or myocardial origin?

PMID- 8354818
TI  - Evidence against a myocardial factor as the cause of left ventricular dilation in
      active rheumatic carditis.
AB  - OBJECTIVES: The aim of this study was to determine whether left ventricular
      dilation and congestive heart failure in patients with acute rheumatic fever with
      carditis are accompanied by left ventricular contractile dysfunction. BACKGROUND:
      Acute rheumatic fever with carditis involves both the myocardium and endocardium,
      with consequent valvular regurgitation. The relative contribution of volume
      overload induced by valvular regurgitation and myocardial dysfunction due to
      rheumatic myocarditis to the overall degree of left ventricular dilation and
      congestive heart failure in these patients is unknown. METHODS: To investigate
      this, we evaluated 32 patients (15 male, 17 female, mean age 14 +/- 3 years) with
      documented active carditis and congestive heart failure. All 32 patients were
      found to have significant isolated mitral regurgitation or combined mitral and
      aortic regurgitation. Echocardiographic analysis of left ventricular dimensions
      and systolic performance was performed before and after isolated mitral or
      combined mitral and aortic valve replacement and the results were compared with
      those in 19 control subjects matched for age, gender and body surface area.
      RESULTS: Both preoperative left ventricular end-diastolic diameter and percent
      fractional shortening were significantly increased in patients compared with
      control subjects (57 +/- 7 vs. 43 +/- 3 mm, p < 0.001, and 38 +/- 6% vs. 33 +/-
      1%, p < 0.001, respectively). After valve replacement, left ventricular end
      diastolic diameter decreased significantly (57 +/- 7 to 47 +/- 6 mm, p < 0.001).
      Although percent fractional shortening decreased significantly postoperatively
      (38 +/- 6% to 32 +/- 6%, p < 0.001), the postoperative percent fractional
      shortening did not differ from that in control subjects (32 +/- 6% vs. 33 +/- 1%,
      p = NS). CONCLUSIONS: The results of this study indicate that left ventricular
      dilation and heart failure in patients with acute rheumatic carditis rarely occur
      in the absence of hemodynamically significant regurgitant valve lesions.
      Furthermore, rapid reduction in left ventricular dimensions and preservation of
      fractional shortening after isolated mitral or combined mitral and aortic valve
      replacement suggest that rheumatic carditis is not accompanied by any significant
      degree of myocardial contractile dysfunction.

PMID- 8354820
TI  - Accurate preoperative diagnosis of pericardial constriction using cine computed
      tomography.
AB  - OBJECTIVES: The purpose of this study was to determine the accuracy of cine
      computed tomography in the diagnosis of constrictive pericarditis. BACKGROUND:
      Constrictive pericarditis is characterized by abnormalities of both cardiac
      structure and function. Accurate diagnosis requires detection of both a thickened
      pericardium and abnormal ventricular diastolic filling. At present, no one
      diagnostic technique has demonstrated sufficient accuracy in this setting. Cine
      computed tomography is a relatively new cardiac imaging mode with very high time
      and spatial resolution that has the potential to accurately diagnose constrictive
      pericarditis. METHODS: Twelve consecutive patients were retrospectively
      identified who had catheterization findings suggestive of constrictive
      physiology, had undergone a cine computed tomographic examination and had
      pathologic data that delineated the status of the pericardium. Group 1 (with
      constrictive pericarditis; n = 5) had surgical confirmation of thickened
      pericardium and improved clinically after pericardiectomy. Group 2 (no
      constrictive pericarditis; n = 7) had cardiomyopathy with normal pericardium.
      Seven normal volunteers (Group 3) were also studied. Cine computed tomograms were
      obtained for the entire heart (8-mm slices, 17 frames/s, nonionic contrast
      medium). Pericardial thickness was measured at 10 degrees intervals at three
      ventricular levels in each subject. The rapidity of diastolic filling was
      assessed by calculating the percent filling fraction in early diastole. RESULTS:
      Pericardial thickness was 10 +/- 2 mm (mean +/- SD) in Group 1, 2 +/- 1 mm in
      Group 2 and 1 +/- 1 mm in Group 3 (p < 0.05, constrictive pericarditis vs. no
      constrictive pericarditis). Left ventricular filling fraction was 83 +/- 6% in
      Group 1, 62 +/- 9% in Group 2 and 44 +/- 5% in Group 3. Right ventricular filling
      fraction was 93 +/- 5% in Group 1, 62 +/- 14% in Group 2 and 35 +/- 6% in Group 3
      (p < 0.05, Group 1 vs. Groups 2 and 3). Both indexes provided a clear-cut
      distinction between patients with and without constriction. CONCLUSIONS: Cine
      computed tomography simultaneously provides both anatomic and physiologic data
      that allow accurate preoperative diagnosis of pericardial constriction.

PMID- 8354821
TI  - Ultrasonic backscatter system for automated on-line endocardial boundary
      detection: evaluation by ultrafast computed tomography.
AB  - OBJECTIVES: The purpose of this study was to evaluate the accuracy of the
      recently developed echocardiographic on-line endocardial border detection system
      using ultrafast computed tomography, an independent and proved tomographic
      imaging modality. BACKGROUND: The automated system for on-line endocardial border
      detection identifies the blood-tissue interface by acoustic quantification of the
      ultrasonic backscatter signal. METHODS: Eighteen subjects were screened by
      conventional echocardiography and acoustic quantification. Ten of these, with
      high quality echocardiographic images, were also examined by ultrafast computed
      tomography. Comparable image planes at the midpapillary level were analyzed.
      Measurements of left ventricular cavity area were compared at end-diastole and
      end-systole and time course analyses of cavity area during the cardiac cycle were
      performed. RESULTS: There was good correlation between values for left
      ventricular end-diastolic area (r = 0.99), end-systolic area (r = 0.93) and
      fractional area change (r = 0.91) using the two methods. The on-line backscatter
      system underestimated end-diastolic area (p < 0.001), but the negative bias was
      small (-1.6 cm2) and the 95% confidence intervals were narrow (-3.6 cm2 to +0.4
      cm2). In contrast, the backscatter system overestimated end-systolic area (p <
      0.02); the positive bias for this variable was also small (+2.6 cm2) but the
      confidence intervals were relatively wide (+7.9 to -2.8 cm2). The negative bias
      of backscatter values for cavity area was fairly constant during diastole and
      early systole (range -5% to -10%), but during the second half of systole,
      backscatter values increased progressively relative to computed tomographic
      values. Real time values for fractional area change measured by the backscatter
      system were 13% smaller than those determined by ultrafast computed tomography (p
      < 0.001), with wide confidence intervals (+3% to -30%). Absolute peak rates of
      area change during systole and diastole were lower by 39% (p < 0.001) and 41% (p
      < 0.01), respectively, using the on-line ultrasonic backscatter system. Time
      course analyses revealed the errors to be consistent with cardiac cycle-dependent
      alterations in gain sensitivity of the ultrasonic backscatter system.
      CONCLUSIONS: The ultrasonic backscatter system is associated with cyclic cavity
      area measurement errors that need to be addressed if its early promise for on
      line assessment of ventricular function is to be fulfilled. Incorporation of an
      electrocardiographically triggered time-varying gain control may improve accuracy
      for on-line analysis of ventricular performance.

PMID- 8354822
TI  - The search for intelligent quantitation in echocardiography: "eyeball,"
      "trackball" and beyond.

PMID- 8354823
TI  - Predictive factors for spontaneous closure of atrial septal defects diagnosed in
      the first 3 months of life.
AB  - OBJECTIVES: To establish the rate of spontaneous closure of atrial septal defects
      diagnosed before age 3 months, 101 infants (mean age 26 days) with an interatrial
      shunt confirmed by Doppler echocardiography were followed up for an average of
      265 +/- 190 days. BACKGROUND: Even if interatrial shunts in the newborn are
      frequently encountered, little is known about their natural history. METHODS:
      Defect diameter on two-dimensional echocardiography and width of color flow jet
      were measured in the subcostal view. Right and left ventricular diameters and
      atrial septal curvature were also studied. Kaplan-Meier curves were obtained to
      predict age of spontaneous closure in relation to initial defect diameter.
      RESULTS: There was no significant correlation between the diameter of the atrial
      septal defect and right ventricular/left ventricular ratio or type of septal
      curvature (vertical or concave toward the left atrium). The classic predominance
      of girls over boys was observed only for defects > 5 mm. An overall rate of
      spontaneous closure of 87% was observed. Frequency and timing of closure were
      inversely correlated to atrial septal defect diameter: closure occurred in 100%
      (32 of 32) of defects in group 1 (diameter < 3 mm), 87% of defects (39 of 45) in
      group 2 (diameter 3 to 5 mm), 80% of defects (16 of 20) in group 3 (diameter 5 to
      8 mm). Spontaneous closure did not occur in four patients of group 4 (defect > or
      = 8 mm) during an average follow-up interval of 417 days (range 294 to 597 days).
      CONCLUSIONS: These results suggest that infants with an atrial septal defect < 3
      mm need not be followed up as 100% of these defects will be closed by age 18
      months; those with a defect 3 to 5 or 5 to 8 mm should be evaluated by the end of
      the 12th and the 15th month, respectively, when > 80% of these defects will be
      closed. An atrial septal defect with a diameter > or = 8 mm may have little
      chance of closing spontaneously and the possibility of surgical correction should
      be considered. Defects < 3 mm probably do not constitute a cardiac malformation
      in light of their natural evolution and gender distribution.

PMID- 8354824
TI  - Impaired endothelial function occurs in the systemic arteries of children with
      homozygous homocystinuria but not in their heterozygous parents.
AB  - OBJECTIVES: Because endothelial dysfunction is an early event in atherogenesis,
      we aimed to determine whether endothelial function is normal or impaired in the
      systemic arteries of children with homozygous homocystinuria or in those of
      heterozygous adults, or both. BACKGROUND: Homocystinuria is strongly associated
      with premature vascular disease in homozygotes, and even heterozygotes have been
      shown to be at increased risk from early atherosclerosis associated with
      hyperhomocystinemia. METHODS: We conducted noninvasive studies on the superficial
      femoral or brachial arteries of 9 children aged 4 to 17 years (mean 11) with
      homozygous homocystinuria and on the brachial arteries of 14 obligate
      heterozygous parents age 33 to 49 years (mean 41). Each subject was matched with
      two control subjects. Using high resolution ultrasound, we measured vessel
      diameter at rest, during reactive hyperemia (with flow increase causing
      endothelium-dependent dilation) and after sublingual administration of
      nitroglycerin (an endothelium-independent vasodilator). RESULTS: Flow-mediated
      dilation was observed in the control children (9 +/- 0.6%, range 6% to 14%) but
      was impaired in the children with homocystinuria (2.8 +/- 0.7%, range 0% to 7%, p
      < 0.0001). In contrast, nitroglycerin-mediated dilation was similar in both
      groups (15.7 +/- 1.6% vs. 13.1 +/- 1.2%, p = 0.27), indicating that the impaired
      flow-mediated dilation is secondary to endothelial dysfunction. In the
      heterozygous parents, both flow-mediated dilation and nitroglycerin responses
      (6.3 +/- 0.9%, 17 +/- 1.4%, respectively) were similar to control values (6.8 +/-
      0.7%, 20.7 +/- 1.7%, p > 0.10). CONCLUSIONS: Children with homozygous
      homocystinuria had impaired endothelial function in the systemic arteries as
      early as 4 years of age, representing an early event in their premature vascular
      disease. However, endothelial function was preserved in the heterozygous adults.

PMID- 8354825
TI  - Balloon angioplasty for postoperative pulmonary artery stenosis in transposition
      of the great arteries.
AB  - OBJECTIVES: This study was designed to assess the success rate and determinants
      of success or failure of balloon angioplasty for postoperative pulmonary stenosis
      in patients with transposition of the great arteries. BACKGROUND: Previous
      reports have suggested that pulmonary stenosis that develops after the arterial
      switch operation is not likely to be dilated. METHODS: Twenty-eight patients with
      transposition of the great arteries underwent 39 balloon angioplasty procedures
      after the arterial switch operation. The mean age at dilation was 4.5 +/- 2.2
      years (range 0.7 to 9.8), and the interval between operation and balloon dilation
      was 3.6 +/- 1.8 years. The criterion of successful dilation was a > or = 50%
      increase in predilation diameter or a > or = 50% decrease in predilation pressure
      gradient. If the right ventricular/aortic pressure ratio decreased by > or = 0.2,
      so that the ratio became < 0.68, reoperation was thought to be not indicated.
      RESULTS: The success rate of balloon angioplasty for pulmonary artery stenosis
      was 51% (20 of 39 dilations). The mean age at dilation in the group with
      successful dilation (3.6 years) was significantly younger than that in the group
      with unsuccessful dilation (5.4 years). The interval between operation and
      dilation in the successful dilation group (2.4 years) was significantly less than
      that in the unsuccessful dilation group (4.6 years). In 13 patients who underwent
      balloon angioplasty < 3.5 years after operation, balloon dilation was successful
      in 92%. The balloon/artery ratio was significantly greater in the successful than
      in the unsuccessful dilation group. A right ventricular/aortic pressure ratio >
      or = 0.68 was observed in 20 patients, and reoperation was not indicated in 10
      patients (50%). There was no death, but one pulmonary artery rupture that did not
      require surgical intervention occurred. Aneurysmal dilation of the pulmonary
      artery was observed in three patients. CONCLUSIONS: These data indicate that
      although the success rate of balloon angioplasty for pulmonary artery stenosis
      after the arterial switch operation is low (approximately 50%), balloon
      angioplasty can be the first therapeutic choice owing to the low complication
      rate and the potential benefit of the procedure. The success rate can be high if
      angioplasty is performed < 3.5 years after operation and a balloon of adequate
      size is used.

PMID- 8354826
TI  - High pressure balloon angioplasty for branch pulmonary artery stenosis: early
      experience.
AB  - OBJECTIVES: The aim of this study was to evaluate the efficacy and safety of high
      pressure balloons (17 to 20 atm, Blue Max, Meditech) to dilate branch pulmonary
      artery stenosis. BACKGROUND: The low success rate (50% to 60%) for angioplasty of
      branch pulmonary artery stenosis using low pressure balloons is due primarily to
      the inability to eliminate the balloon waist. Hence, higher inflation pressures
      may improve results. METHODS: Hemodynamic and angiographic data from 52 patients
      (0.3 to 34.8 years old) who underwent high pressure balloon dilation of branch
      pulmonary artery stenosis between October 1990 and February 1992 were reviewed
      retrospectively, as were data from previous low pressure dilations in these
      patients. Common diagnoses included tetralogy of Fallot (n = 9), tetralogy of
      Fallot with pulmonary atresia (n = 23), single ventricle (n = 8) and isolated
      congenital pulmonary stenosis (n = 7). The 52 patients had 72 vessels dilated.
      Criteria for success were a > or = 50% increase in vessel diameter or a > 20%
      decrease in right ventricular to aortic pressure ratio. RESULTS: Of 36 vessels
      with previously unsuccessful low pressure balloon dilation, 23 (63%) were
      successfully dilated with high pressure balloons. Of the 36 remaining vessels, 29
      (81%) were successfully dilated with high pressure balloons. Factors associated
      with success were stenosis at a surgical anastomosis and disappearance of the
      balloon waist with dilation. Aneurysms developed in three vessels. Complications
      occurred in seven patients (13%); in two patients the distal pulmonary artery was
      perforated by a stiff guide wire, causing death in one. CONCLUSIONS: Dilation of
      stenotic peripheral pulmonary arteries with high pressure balloons improves the
      success rate of angioplasty both in patients who have had unsuccessful dilation
      with a low pressure balloon and in those without previous attempted dilation.

PMID- 8354827
TI  - Scimitar syndrome in infancy.
AB  - OBJECTIVES: The objectives of this study were to determine the anatomic and
      physiological factors most responsible for the severe symptoms and poor prognosis
      of infants with scimitar syndrome. BACKGROUND: Whereas the diagnosis of scimitar
      syndrome is often made incidentally in older children and adults who undergo
      chest radiography for diverse reasons, infants in whom the diagnosis is made
      typically present with severe symptoms and have a poor prognosis. METHODS: The
      clinical, catheterization and imaging data of 13 consecutive infants with
      scimitar syndrome who underwent cardiac catheterization in the 1st 6 months of
      life were reviewed, with emphasis on the pulmonary artery pressure, pulmonary and
      cardiovascular anatomy, therapeutic interventions and outcome. RESULTS: Twelve of
      the 13 infants had pulmonary hypertension at the time of diagnosis. Six patients
      died despite specific treatment. Eleven of 13 infants had associated cardiac
      malformations and 9 had large systemic arterial collateral channels to the right
      lung. Seven patients had anomalies involving the left side of the heart,
      especially varying degrees of hypoplasia of the left heart or aorta, and six of
      these patients died. Ten patients underwent surgical or transcatheter therapy in
      the 1st year of life. Systemic arteries to the right lung were ligated in three
      patients and occluded by transcatheter embolization in four. Balloon angioplasty
      was carried out in two patients, one with stenosis of the left-sided pulmonary
      veins and one with stenosis of the anomalous right pulmonary vein. The latter had
      placement of a balloon-expandable stent. In both patients, pulmonary vein
      stenosis progressed. Six patients had surgical repair of associated
      cardiovascular anomalies, and two required repair of extracardiac congenital
      anomalies. Occlusion of the anomalous systemic arteries was generally associated
      with clinical improvement, but congestive heart failure and pulmonary
      hypertension recurred in those patients with associated cardiovascular anomalies,
      whose condition subsequently responded after correction of the shunt lesions.
      CONCLUSIONS: The severe symptoms and pulmonary hypertension found in infants with
      scimitar syndrome have many causes. Anomalous systemic arterial supply, pulmonary
      vein stenosis and associated cardiovascular anomalies play a significant role,
      and the ultimate outcome of individual infants depends on the feasibility of
      treating these anomalies in early infancy.

PMID- 8354828
TI  - Radiofrequency catheter ablation of supraventricular arrhythmias in patients with
      congenital heart disease: results and technical considerations.
AB  - OBJECTIVES: The aim of this study was to report the results and techniques of
      radiofrequency ablation for treatment of supraventricular arrhythmias in patients
      with congenital structural heart disease. BACKGROUND: The management of patients
      with congenital and other structural heart disease may be complicated by serious
      arrhythmias due to Wolff-Parkinson-White syndrome or by atrial arrhythmias after
      cardiac surgery. Ablation techniques using radiofrequency current are
      revolutionizing the management of arrhythmias, but reports have included few with
      structural heart disease. METHODS: Fifteen patients with significant heart
      disease underwent radiofrequency ablation: 11 with Wolff-Parkinson-White syndrome
      and 4 with intraatrial reentrant tachycardia after atrial surgery. Seven had
      Ebstein's anomaly, complex in two, and the rest had other defects. Coexistence of
      structural defects introduced significant technical difficulties to
      radiofrequency ablation in patients with the Wolff-Parkinson-White syndrome and
      was accomplished by adaptation of current techniques. Ablation of intraatrial
      reentrant tachycardia was performed by finding early atrial activation sites with
      electrogram fractionation for radio-frequency application. RESULTS:
      Radiofrequency ablation was initially successful in 14 of 15 patients, with cure
      in 10 and clinical improvement in 14. Two patients subsequently underwent cardiac
      surgery without perioperative arrhythmias. CONCLUSIONS: Radiofrequency ablation
      in patients with congenital heart disease and arrhythmias in both safe and
      effective and may be the preferred approach to treatment in some patients. In
      patients who are to undergo surgical correction or palliation, preoperative
      radiofrequency ablation of the tachycardia substrate is effective and may be
      preferred to operative accessory pathway division. The ablation of intraatrial
      reentrant tachycardia shows promise in the management of patients who have
      undergone extensive atrial surgery, and it may eventually become the preferred
      approach, particularly when there are contraindications to the use of
      antiarrhythmic agents.

PMID- 8354829
TI  - Dual natriuretic peptide system in experimental heart failure.
AB  - OBJECTIVES: The objectives of this study were 1) to define in an experimental
      model of heart failure the time course of changes in plasma brain natriuretic
      peptide concentrations during the development of and recovery from heart failure,
      and 2) to relate the changes to changes in atrial natriuretic peptide
      concentration and hemodynamic status. BACKGROUND: Brain natriuretic peptide is a
      circulating peptide with homology to atrial natriuretic peptide. However, unlike
      the latter, its changes during heart failure and its relation to cardiac filling
      pressures have not been studied. METHODS: Eight male mongrel dogs underwent right
      ventricular pacing at 250 beats/min for 3 weeks until heart failure occurred and
      were followed up during recovery for 4 weeks after cessation of pacing. RESULTS:
      Heart failure was characterized by an increase in both left ventricular and end
      diastolic pressure (6.6 +/- 4.1 mm Hg at the control measurements to 35.1 +/- 5.9
      mm Hg at 3 weeks, p < 0.01) and right atrial pressure (6.7 +/- 1.1 to 11.4 +/-
      2.1 mm Hg, p < 0.01). Recovery was accompanied by a return of cardiac filling
      pressures to control level. The time course of change of arterial plasma brain
      natriuretic peptide concentration was similar to that of atrial natriuretic
      peptide. Plasma concentrations of both peptides increased after 1 week of pacing
      (16 +/- 4 pg/ml at the control measurement to 59 +/- 20 pg/ml at 1 week, p <
      0.001 for brain natriuretic peptide and 84 +/- 55 to 856 +/- 295 pg/ml, p < 0.001
      for atrial natriuretic peptide). The level of both peptides then stayed level
      with no further increase at 3 weeks and returned to the control value by 4 weeks
      of recovery. There was an excellent correlation between plasma concentrations of
      the two peptides (r = 0.86, p < 0.001) and between the two peptides and cardiac
      filling pressures. However, compared with atrial natriuretic peptide, plasma
      brain natriuretic peptide concentration had a smaller percent increase during
      evolving heart failure and a slower rate of decline at recovery. CONCLUSIONS:
      Brain and atrial natriuretic peptide constitute a dual natriuretic system and are
      both responsive to changes in cardiac filling pressures in heart failure.
      However, brain natriuretic peptide appears to be less responsive than atrial
      natriuretic peptide.

PMID- 8354830
TI  - Graded myocardial ischemia is associated with a decrease in diastolic
      distensibility of the remote nonischemic myocardium in the anesthetized dog.
AB  - OBJECTIVES: This study was designed to investigate the changes in regional
      distensibility of the ischemic segment and of a remote nonischemic segment
      brought about by graded myocardial ischemia. BACKGROUND: Ventricular
      distensibility is a major determinant of left ventricular end-diastolic pressure.
      The effects of graded myocardial ischemia on the regional distensibility of the
      ischemic area have not been studied. Moreover, there are few data on the effects
      of myocardial ischemia on the regional distensibility of the nonischemic
      myocardium. METHODS: Nine anesthetized open chest mongrel dogs were fitted with
      instruments to measure left ventricular pressure and circumferential length
      (sonomicrometry) in the ischemic segment and in a nonischemic segment. The
      pressure-length relation was modified by stepwise infusion and withdrawal of 200
      ml of each dog's own blood over 30 min in five consecutive stages of regional
      ischemia. Unstressed dimensions were obtained by repeated inferior vena cava
      occlusions. In both segments, regional distensibility was assessed at end
      diastole by means of the constants of the pressure-length (chamber stiffness),
      the pressure-strain and the force-strain (myocardial stiffness) relations.
      RESULTS: In the ischemic segment, partial and complete coronary occlusions were
      associated with a twofold increase in the chamber stiffness constant, the
      pressure-strain constant and the myocardial stiffness constant, whereas in the
      nonischemic segment the chamber stiffness constant, the pressure-strain constant
      and the myocardial stiffness constant increased by 50%. CONCLUSIONS: Regional
      myocardial ischemia is associated with a decrease in distensibility of both the
      ischemic and the remote nonischemic myocardium.

PMID- 8354831
TI  - Left ventricular diastolic collapse in regional left heart cardiac tamponade. An
      experimental echocardiographic and hemodynamic study.
AB  - OBJECTIVES: This study was designed to describe the hemodynamic abnormalities
      associated with the appearance of left ventricular diastolic collapse in the
      setting of regional left heart cardiac tamponade. BACKGROUND: Cardiac tamponade
      after heart surgery is frequently associated with localized pericardial effusion.
      Although right ventricular diastolic collapse and right atrial collapse are
      reliable echocardiographic findings in patients with circumferential pericardial
      effusion and tamponade, they are often not present in postoperative patients with
      localized pericardial effusion and regional left heart tamponade. Left
      ventricular diastolic collapse has been described in such patients, but the
      degree of hemodynamic alteration that exists with this finding is not known.
      METHODS: Acute regional left heart tamponade was produced 14 times in seven
      spontaneously breathing anesthetized dogs by infusing fluid into an isolated
      compartment created in the pericardial space adjacent to the left ventricular
      free wall. Continuous echocardiographic imaging and hemodynamic monitoring of
      left ventricular, systemic arterial, right atrial, pulmonary capillary wedge and
      pericardial pressures were performed. Measurements at baseline were compared with
      those made at the onset of left ventricular diastolic collapse and at
      decompensated tamponade. RESULTS: Left ventricular diastolic collapse was noted
      in all 14 episodes of regional tamponade. It occurred when pressure in the left
      pericardial compartment exceeded left ventricular diastolic pressure by 3.0 +/-
      1.9 mm Hg. At the onset of left ventricular diastolic collapse, cardiac output
      and mean arterial pressure were significantly reduced from the control value (p <
      0.05). Systolic hypotension was noted only twice at this stage, respiratory
      variation in systolic pressure > 10 mm Hg only once. The appearance of this sign
      was also associated with elevated left heart filling pressures. CONCLUSIONS: Left
      ventricular diastolic collapse is a reliable sign of regional left ventricular
      tamponade and is associated with a reduction in cardiac output. This
      echocardiographic finding usually occurs before the development of arterial
      hypotension and pulsus paradoxus. Thus, left ventricular diastolic collapse is
      potentially more reliable than hypotension or pulsus paradoxus in the diagnosis
      of regional left ventricular tamponade.

PMID- 8354832
TI  - Influence of heparin and systemic lysis on coronary blood flow after reperfusion
      induced by the novel recombinant plasminogen activator BM 06.022 in a canine
      model of coronary thrombosis.
AB  - OBJECTIVES: We sought to evaluate whether anticoagulation by an intravenous
      heparin infusion prevents deterioration of coronary blood flow restored by the
      novel recombinant plasminogen activator BM 06.022, and to compare the effects of
      profound fibrinogenolysis with those of an intravenous bolus injection of
      heparin. BACKGROUND: Recent clinical studies indicate that heparin appears to be
      effective in reducing reocclusion when combined with recombinant tissue-type
      plasminogen activator (rt-PA), but that heparin is associated with an increased
      bleeding incidence. Therefore, the need for heparin has to be critically
      evaluated in the development of BM 06.022. METHODS: BM 06.022 is an
      unglycosylated variant of human tissue-type plasminogen activator. Thrombus
      formation in anesthetized open chest dogs was induced by electrical injury. Left
      circumflex coronary artery blood flow was monitored for 4 h using an
      electromagnetic flow probe. Twenty dogs were randomized to receive intravenous
      heparin (100 IU/kg bolus plus 100 IU/kg per h) in group B or saline solution in
      group A before an intravenous bolus injection of 200 kU/kg (= 0.34 mg/kg) BM
      06.022 1 h after thrombus formation. Another 14 dogs were randomized to receive a
      single intravenous bolus injection of 200 IU/kg heparin plus 200 kU/kg BM 06.022
      in group D or saline solution plus 1,000 kU/kg BM 06.022 in group C. RESULTS: In
      the absence of a systemic lytic state, heparin infusion prolonged (p < 0.05) the
      cumulative patency time (sum of time intervals during which the coronary artery
      was patent) to 204.3 +/- 7.4 min (group B) compared with 34.6 +/- 10.8 min with
      saline solution (group A), and increased (p < 0.05) the area under the curve for
      coronary blood flow versus time (AUCFlow) to 34.0 +/- 3.4 ml.h.min-1 compared
      with 7.7 +/- 4.6 ml.h.min-1. Profound fibrinogenolysis after administration of
      1,000 kU/kg BM 06.022 (group C) and a single intravenous heparin injection (group
      D) did not differ in their effects on the cumulative patency time (182 +/- 30.3
      vs. 177.5 +/- 25.4 min) and AUCFlow (36.0 +/- 10.3 vs. 30.5 +/- 4.8 ml.h.min-1),
      but these values were improved (p < 0.05) compared with those obtained after
      administration of saline solution plus 200 kU/kg BM 06.022 (group A).
      CONCLUSIONS: In the absence of a systemic lytic state, intravenous heparin is
      required as an adjunct to BM 06.022 to maintain coronary blood flow in dogs.

PMID- 8354833
TI  - Physics and engineering of transcatheter cardiac tissue ablation.
AB  - Ablation of arrhythmogenic cardiac tissues has emerged as one of the most
      important advances in cardiac electrophysiology. With the introduction of
      transcatheter ablation, the treatment of ventricular tachycardia, Wolff-Parkinson
      White syndrome and other cardiac arrhythmias has progressed from an expensive and
      painful surgical therapy accompanied by a long recovery period to the less
      expensive, less traumatic transcatheter approach. The feasibility of cardiac
      ablation, along with the increasing number of physicians using the technique,
      requires understanding of the anatomic and electrophysiologic bases of
      transcatheter ablation as well as the different technologies, their limitations
      and complications. This report provides an overview of the physical, scientific
      and technical aspects of cardiac ablation performed with the methods currently
      available and a summary of the limitations of each method and expected future
      technologic developments in this growing field. Emphasis is placed on
      radiofrequency and direct current energies, the primary methods now used. Methods
      such as cryoablation and laser, and microwave and chemical ablation are discussed
      with less detail because the method of delivering energy for these ablative
      procedures has not been fully developed.

PMID- 8354834
TI  - The editorial process.

PMID- 8354835
TI  - Remembering Keats in Rome.

PMID- 8354836
TI  - Same-day surgical admission. American College of Cardiology Cardiovascular
      Surgery Committee.

PMID- 8354837
TI  - Heart rate variability for risk stratification of life-threatening arrhythmias.
      American College of Cardiology Cardiovascular Technology Assessment Committee.

PMID- 8354838
TI  - Heart rate variability: disagreement on the markers of sympathetic and
      parasympathetic activities.

PMID- 8354839
TI  - Diastolic function of the nonfilling human heart.

PMID- 8354840
TI  - An inquiry into the fate of the transference in psychoanalysis.
AB  - Despite universal agreement about the importance of transference, there is no
      single, comprehensive, generally accepted explanation for the place transference
      occupies in clinical psychoanalytic theory. In this presentation, I trace the
      origins of some major trends prominent in theoretical controversy to their
      antecedents. Some seminal contributions which introduced important issues into
      the evolving theory of transference are highlighted; this is followed by a brief
      outline of the ideas of a representative sample of current theorists. This
      comparison of the appearance of fundamental evolutionary modifications of
      transference theory with present-day differences in theoretical emphasis leads to
      the identification of four persistent themes: (1) the nature of the influence of
      the patient's relationship with the analyst in the analytic experience, (2) how
      to account for the analyst's subjectivity and its role in the analytic process,
      (3) what weight to assign to the interpersonal dimension of the transference, and
      (4) differences among theoretical perspectives as reflected in the precise
      content of transference interpretations. Difficulties in the path of comparative
      evaluation of differences in theoretical accounts of the transference and its
      handling are noted. A few reasons for my adherence to the theory I prefer are
      mentioned solely for the purpose of underlining areas of controversy that require
      serious attention and further clarification.

PMID- 8354841
TI  - The couple's constructive and destructive superego functions.
AB  - Just as the couple becomes the repository of both partners' conscious and
      unconscious sexual fantasies and desires, and of their consciously and
      unconsciously activated internalized object relations, so does the couple
      activate both partners' conscious and unconscious superego functions. The
      interaction of the partners' superego over time results in the forging of a new
      system, which I am calling the couple's superego. The functions of the couple's
      joint superego structure is described, as are the symptoms of superego pathology
      in the couple's love life. The vicissitudes of gratitude and guilt, of
      stereotyping and conventionality, of deceptiveness and long-range destructive and
      self-destructive scenarios, are explored in the context of a spectrum reflecting
      the severity of joint superego pathology. A clinical case vignette illustrates
      some of these developments in a couple's life.

PMID- 8354842
TI  - Cathexes and their objects in the thought of Sigmund Freud.
AB  - This paper reexamines Freud's theory of "cathexis" (a quantity of motivational
      intensity invested in an object) in the light of recent developments in
      philosophy and cognitive psychology. Contrary to what is often thought, the
      quantitative element is defensible as a purely psychological idea. The notion of
      a cathexis is closely similar to the philosophical idea of an "intentional"
      state, which derives from Franz Brentano, Freud's teacher and mentor. Freud
      initially held the object of a cathexis always to be intrapsychic, a position
      which is untenable and which he largely abandoned after 1915, when he began
      (correctly) to take cathected objects generally to be persons or events, not
      their representations. His idea of a cathexis as "entering into" its object
      contains a valuable and neglected insight, which undermines the centrality of the
      distinction between the "outer" and "inner" realms of experience. This
      distinction should not be confused with the key distinction between "fantasy" and
      "actuality" with respect to cathectic objects. So-called "inner" (fantasy)
      objects are generally "inside" the mind in a metaphorical sense only.

PMID- 8354843
TI  - Recovering a repressed memory, and representational shift in an adolescent.
AB  - This case report focuses on the disappearance of a fixed pictorial iconic
      representation and transformation to symbolic (word) representation following the
      recovery of a repressed memory in a twelve-and-a-half-year-old after the first
      eleven months of psychoanalysis. There is a substantial body of psychoanalytic
      literature on the importance of language, naming or articulation of experiences
      associated with transformation of psychic structure (Fenichel, 1941; Glover,
      1955; Kris, 1956a, 1956b; Werner and Kaplan, 1963; Schafer, 1976, 1978a, 1978b,
      1980; Shapiro, 1979; Spence, 1982; Stern, 1989) and a relatively autonomous
      literature on the communicative representational power of children's play or
      visual portrayals (Piaget, 1962; A. Freud, 1947; Klein, 1964; Axeline, 1947;
      Esman, 1983; Neubauer et al., 1987; Krall, 1989). To our knowledge, there is no
      report of the structural effect of the recovery of a repressed traumatic
      experience, in this case, with subsequent parental confirmation of the traumatic
      event.

PMID- 8354844
TI  - Gender identity disorder in boys. Panel report.

PMID- 8354845
TI  - Learning from our unsuccessful cases. Panel report.

PMID- 8354846
TI  - The significance of religious themes and fantasies during psychoanalysis. Panel
      report.

PMID- 8354847
TI  - The difference between termination in psychotherapy and psychoanalysis. Panel
      report.

PMID- 8354848
TI  - Modulation by protein kinase C of arachidonic acid release from permeabilised
      myometrial cells of guinea pig uterus.
AB  - The effects of protein kinase C activation on phospholipase A2 and phospholipase
      C activity in permeabilised cultured myometrial cells from guinea pig uterus have
      been studied. Phospholipase A2 activity was followed by measurement of
      [3H]arachidonic acid release from [3H]arachidonic acid-prelabelled membrane
      lipids. [3H]Arachidonic acid release was stimulated by Ca2+ at 1-10 microM and by
      GTP gamma S at 1 microM to 1 mM in the presence of 10 microM Ca2+. The activation
      by calcium was enhanced 89.5 +/- 12.7% (P < 0.01) in the presence of 1 microM
      phorbol 12-myristate 13-acetate (PMA) and that by 1 microM GTP gamma S by 65.4 +/
      4.4% (P < 0.001). The PMA enhancement of arachidonic acid release was completely
      blocked by 3 microM staurosporine. Phospholipase C activation was followed by
      measurement of [3H]inositol polyphosphate production from [3H]inositol
      prelabelled membrane lipids. This was stimulated by Ca2+ at 0.1 and 10 microM and
      by 1 and 50 microM GTP gamma S. PMA at 1 microM caused a consistent reduction in
      the extent of Ca2+ and GTP gamma S-stimulated inositol polyphosphate production
      and 3 microM reversed the inhibitory action of PMA. The data are consistent with
      arachidonic acid release in permeabilised myometrial cells from guinea pigs
      reflecting in large part phospholipase A2 activation and with that pathway being
      stimulated by protein kinase C activation. They are also consistent with protein
      kinase C activation causing reduction in phospholipase C pathways in uterine
      myocytes, at least as measured by inositol polyphosphate release.

PMID- 8354850
TI  - A new technique for studying potential changes in nephrons of chick embryo
      kidneys in vivo.
AB  - To make the chick embryo accessible to electrophysiological measurements in its
      mesonephric kidney during the period between embryonic days (e.d.) 5 and 10, a
      special "chick-embryo-incubation bath" was constructed. It consists of an aerated
      chamber covering the egg and maintaining the gas exchange across the shell, and
      of a warmed reservoir of the incubation medium, into which the embryo is pulled
      out of the egg through a window in the shell. The two compartments are separated
      with a rubber membrane tightly fitting to the edges of the shell-window. The
      incubation medium contains a modified Krebs-Henseleit-Ringer solution and
      anesthetic Tricaine (Sigma). Access to the mesonephric nephrons is achieved by
      surgical excision of the body wall on the right side performed at e.d. 5. On
      average only about 35 percent of the operated embryos survive till the third day
      after surgery but during the next two days a mortality rate recedes to zero. The
      tolerance of short-term survival of embryos placed in the incubation bath was
      tested for up to 4 1/2 h. It was very good in embryos of age 5 to 7 e.d. as
      assessed by a steady heart rate and the presence of arterio-venous differences. A
      modified differential amplifier containing circuits for frequency compensation of
      the two channels was used for high-fidelity registration of voltage changes in
      the embryonic nephron with a single double-barrel microelectrode.

PMID- 8354849
TI  - A placental extract inhibits breathing induced by umbilical cord occlusion in
      fetal sheep.
AB  - Umbilical cord occlusion in the presence of adequate oxygenation induces
      continuous breathing and arousal in the chronic unanesthetized fetal sheep
      preparation. The mechanism responsible for this is unknown. We hypothesized that
      if a placental factor is responsible for the inhibition of breathing in the
      fetus, the administration of a placental extract while the fetus is breathing
      continuously after cord occlusion should reverse these changes. Thus, at about 10
      min after the induction of continuous breathing by cord occlusion, we
      administered a placental extract and three subfractions separated by
      ultrafiltration to 14 chronically instrumented fetal sheep at 133 +/- 1 day
      gestation. The Krebs solution in which the placental extract was prepared was
      used as control. Within two minutes of the infusion of the whole placental
      extract in the carotid artery of the fetus, breathing output (integral of EMGdi x
      f) diminished in all experiments and was completely abolished in 15/17 (88%).
      Krebs solution had no effect on breathing. The infusion of subfractions of
      different molecular weight showed that the inhibition was primarily related to
      the subfraction between 3.5 and 10 kD. There were no significant changes in blood
      gas tensions, pH, blood pressure, and heart rate associated with the infusions of
      the extracts. The ECoG switched from low to high voltage in the majority of the
      experiments using whole extract and the subfraction 3.5 to 10 kD. These findings
      suggest that a placental factor, probably a peptide with a molecular weight
      between 3.5 and 10 kD, inhibits breathing in fetal life.

PMID- 8354851
TI  - Effect of the prenatal maternal environment on the control of breathing during
      non-rapid-eye-movement sleep in the developing lamb.
AB  - This study examines the effects of altering the prenatal maternal metabolic and
      hormonal environment via chronic cold exposure of under-fed ewes on developmental
      changes in breathing control of developing lambs. Breathing frequency and timing
      were measured during non rapid-eye-movement (non-REM) sleep in lambs born from
      either shorn or unshorn ewes after being maintained for at least one hour at warm
      (28-19 degrees C) and cool (14-5 degrees C) ambient temperatures at 1, 4, 14 and
      30 days of age. Breathing frequency and oxygen consumption were significantly
      higher in 1 day old lambs born from shorn ewes compared with those lambs born
      from unshorn ewes, at both warm and cool ambient temperatures. In the shorn group
      breathing frequency decreased between 1 and 4 days of age and continued
      decreasing upto 30 days of age, during which period inspiratory and to a greater
      extent expiratory time, lengthened. Laryngeal "braking" of expiratory airflow was
      observed in more than 50% of lambs born from shorn ewes during non-REM sleep in
      the warm at 4, 14 and 30 days of age, and in the cold at 14 and 30 days of age.
      In contrast, lambs born from unshorn ewes showed no change in breathing frequency
      between 1 and 4 days of age, but a decrease was observed between 4 and 14 days of
      age, whilst laryngeal "braking" of expiratory airflow was rarely observed at any
      age.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354852
TI  - Postnatal development of nonshivering thermogenesis in rats: effects of rearing
      temperature.
AB  - A comparative chronological study (from 1 to 33 days post partum) was performed
      to establish the capacity for nonshivering thermogenesis (NST) in rats born and
      reared at 28 degrees C and at 16 degrees C. The resting metabolism measured at 33
      degrees C was higher in the 16 degrees C rats than in the 28 degrees C rats from
      the 3rd day. When expressed per weight or per surface area units it was higher in
      16 degrees C pups than in 28 degrees C pups until the end of the 3rd week. In
      fact the resting metabolism was significantly proportional to different powers of
      weight (W0.67 at 16 degrees C and W0.75 at 28 degrees C) during the suckling
      period. At birth, respiratory quotient (RQ) was the same in both groups (0.70);
      it increased slowly to the end of the 3rd week (about 0.80). During the 3rd week
      RQ was lower in 16 degrees C rats than in 28 degrees C animals. This indicates
      that 16 degrees C rats are more dependent on the milk supplied by their mother.
      After weaning there were no differences in RQ values (0.90). Rectal temperature
      was low in both groups on day 1 (about 32 degrees C). It increased until weaning
      when it stabilized at 37 degrees C. From day 1 to day 18, it was significantly
      lower in cold reared rats. The capacity for NST was measured by investigating the
      effect of an injection of norepinephrine (NE) on the metabolic rate at 33 degrees
      C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354853
TI  - Imported Opisthorchis viverrini and parasite infections from Thai labourers in
      Taiwan.
AB  - In order to determine the prevalence of intestinal parasites among labourers from
      Thailand in Taiwan, the stool samples from 1364 Thai labourers were examined by
      the formalin-ether concentration method and 18.0% were found to be infected with
      one or more parasites. The infection rates of hookworm, Opisthorchis viverrini,
      Strongyloides stercoralis, Enterobius vermicularis, Ascaris lumbricoides,
      Hymenolepis nana, Capillaria philippinensis, Schistosoma japonicum, Echinostoma
      sp., Entamoeba coli, Giardia lamblia, and Entamoeba histolytica, were 7.6%, 7.0%,
      3.2%, 0.5%, 0.3%, 0.1%, 0.1%, 0.1%, 0.1%, 0.4%, 0.2%, and 0.1% respectively. The
      prevalence was highest among the 21-25 age group (24.8%). Among the 245 infected
      persons, 91% were infected with one parasite, 8% with two parasites and 1% with
      three parasites. The finding that parasitic infections are prevalent among Thai
      labourers demonstrates the need for control measures in foreign labourers in
      Taiwan and further studies to determine the susceptibility of O. viverrini to the
      snail hosts of Clonorchis sinensis.

PMID- 8354854
TI  - A first instance of human philophthalmosis in Israel.
AB  - Conjunctivitis due to the trematode Philophthalmus in a 13-year-old Israeli girl
      is described. A single worm, probably a mature Philophthalmus palpebrarum, was
      detected on the palpebral conjunctiva of the upper eyelid of the right eye.
      Removal of the worm resulted in rapid abatement of the ocular symptoms. This is
      the first documentation of human philophthalmosis in Israel.

PMID- 8354855
TI  - Distribution of some elements in hydatid cysts of Echinococcus granulosus from
      buffalo (Bubalus bubalis).
AB  - Distribution of some elements during development of endogenous daughter (hydatid)
      cysts of Echinococcus granulosus of buffalo origin was determined by atomic
      absorption spectrophotometry. These analyses showed that the distribution of
      copper and cobalt was highest in the smallest cysts. These elements gradually
      decreased in the cysts as they enlarged. The distribution of zinc, iron and
      manganese was very high in the smallest cysts in comparison to copper and cobalt,
      but these three elements decreased greatly in larger cysts. Iron and manganese
      were the only two elements found in very high concentrations in "thin-walled"
      cysts. Like all other elements both calcium and magnesium decreased as the cysts
      increased in size. In the thin-walled cysts magnesium increased by four times
      initially and this was followed by a two-fold "influx" of calcium in the "white
      spots" in the above cysts. The significance of these findings is discussed in
      relation to earlier works.

PMID- 8354856
TI  - The prevalence and intensity of infection with helminth parasites in Mus spretus
      from the Setubal Peninsula of Portugal.
AB  - The results of a 5 year study of helminth parasites of Mus spretus, are reported.
      Six nematode and 5 cestode species were identified but no helminth showed 100%
      prevalence in M. spretus, the most commonly encountered nematode and cestode
      species being Syphacia obvelata (46.6%) and Taenia taeniaeformis (22.4%). Among
      the more unusual helminth species identified was Eucoleus bacillatus, a
      capillariid nematode inhabiting the stomach musculature. This species was
      identified in 3 of the 5 years of the study. The results are discussed in the
      broader context of previous studies and the epidemiology of rodent helminth
      infections in general.

PMID- 8354857
TI  - Onchocerciasis in British cattle: a study of the transmission of Onchocerca sp.
      in north Wales.
AB  - The transmission of bovine Onchocerca spp. in Britain was investigated by
      studying the Ceratopogonidae and Simuliidae which attacked bait cattle between
      April and October at two sites in North Wales, where either Onchocerca lienalis
      and O. gutturosa (Cynwyd), or O. lienalis alone (Pentrefoelas) occurred. Based on
      the relative abundance of each species, their seasonal variation in abundance and
      preferential feeding sites on cattle, the presence of Onchocerca sp. infective
      larvae and the development of patent infections in bait cattle, vectors were
      identified as Simulium ornatum s.1. at Pentrefoelas and S. reptans at Cynwyd
      (0.5% and 1.5% of parous flies infective, respectively). There was no significant
      difference between the lengths of the infective larvae from vectors at either
      site (Pentrefoelas: mean = 543.5 microns, SD = 29.45; Cynwyd: mean = 550.86
      microns, SD = 35.26; p > 0.1), which were consistent with descriptions of O.
      lienalis. The identity of a vector for O. gutturosa was not determined and the
      role of certain candidates is discussed. In this respect, the absence of
      Culicoides nubeculosus was notable. Transmission of Onchocerca sp. was limited to
      a short period of about 8 weeks, by a combination of vector abundance and
      parasite uptake from dermal skin layers, and a mean daily temperature requirement
      of 15 degrees C or more for complete parasite development in the vector. The
      effect of this temperature restriction in relation to the geographical
      distribution of the two species is discussed.

PMID- 8354858
TI  - Antagonistic effect of predacious Arthrobotrys fungi on infective Haemonchus
      placei larvae.
AB  - Laboratory experiments were performed to investigate the ability of isolates from
      the predacious fungus species Arthrobotrys conoides (one isolate) and Al. robusta
      (four isolates) to trap and kill infective Haemonchus placei larvae. Three groups
      for each isolate were formed: group 1, fungi and infective larvae; group 2,
      fungi; group 3, infective larvae. There were statistically significant
      differences (P < 0.05) between the antagonistic effects of three isolates of A.
      robusta, but there was no such difference between the isolate of A. conoides and
      isolates of A. robusta. This result indicates that there can be a variation in
      the predatory capacity of different isolates within a single fungus species.
      After 20 days of assay, there was greater recuperation of infective H. placei
      larvae in group 3 compared to group 1.

PMID- 8354859
TI  - Histopathology of the small intestinal mucosa in Nematodirus spathiger infection
      in rabbits.
AB  - Rabbits were experimentally infected with two levels (5000 and 17,000) infective
      larvae of Nematodirus spathiger. Histological (villus length, mucosa to serosa
      ratio, crypt surface) and biochemical (protein content, alkaline phosphatase and
      leucine aminopeptidase activities) measurements relating to the small intestinal
      mucosa were examined along the entire length of the organ. In the proximal
      intestine, the presence of worms was associated with villus abrasion, increased
      crypt surface and decreased alkaline phosphatase and leucine aminopeptidase
      activities. Conversely, beyond the main site of infection in the distal small
      intestine, some signs of hypertrophied villi and crypts were noted without any
      changes in enzyme activities. These distal variations were similar to those
      previously described in experimental Trichostrongylus colubriformis infections of
      rabbits. These results tend to confirm the use of the rabbit as an experimental
      model to study Nematodirus infection. They also suggest that the distal adaptive
      process in the nematode-parasitized small intestine could occur independently of
      the worm species.

PMID- 8354860
TI  - Changing chemosusceptibility in the second-stage larvae of Toxocara canis by long
      term incubation.
AB  - Second-stage larvae of Toxocara canis were maintained in vitro for one year.
      Susceptibility of the larvae to drugs was evaluated by means of minimal
      larvicidal concentration (MLC) and larval bursting percentage. MLCs of citral and
      decanoic acid were almost constant throughout all stages of incubation. However,
      bursting percentage markedly varied within the first 20 weeks of incubation.
      Therefore, while larvae are available for use in the MLC assay at any stage of
      incubation, those beyond the first 20 weeks after incubation should be used for
      the bursting assay to obtain reproducible results.

PMID- 8354861
TI  - Density-dependent effects on establishment of Necator americanus and Ancylostoma
      ceylanicum.
AB  - The relationships between the number of infective larvae (L3s) to which animals
      were exposed and the establishment of A. ceylanicum and N. americanus in hamsters
      were examined. There was no evidence of density-dependent constraints on the
      establishment of A. ceylanicum in the range 10-1000 larvae, but an experiment in
      which the range was extended to 1500 L3s gave a significant negative correlation
      between the magnitude of the infecting dose and percentage establishment. Even so
      the percentage reduction was relatively small, approximating to 0.89% per 100
      larvae administered, and in practice density-dependent constrains on
      establishment are unlikely to affect experiments with this species in which much
      lower doses (< 250 L3) are generally employed. The range of doses for N.
      americanus L3s was smaller (10-400). Of the four experiments reported, two gave a
      significant reduction of establishment with increasing dose and two did not. When
      the data was split into low doses (< 100 L3s) and high doses (> 100 L3s), falling
      establishment with increasing dose was only detected in the lower dose range.
      There was no difference in the establishment when doses of 100 L3s were compared
      with 250 or 400 L3s. On balance, it was concluded that density-dependent
      constraints on establishment of N. americanus in hamsters were not marked and
      would have little significant effect on experiments utilizing fewer than 200 L3s
      (approximately 7.6% reduction between 10 and 200 L3s). These results are
      discussed in relation to host regulation of hookworm burdens.

PMID- 8354862
TI  - Infectivity, growth and distribution of preovigerous adults of Echinostoma
      caproni in ICR mice.
AB  - All 23 6-8-week old outbred female ICR mice, each fed 100 metacercarial cysts of
      Echinostoma caproni, were infected on days 2, 4, 6, and 8 postinfection (PI) with
      a mean of 45 worms/host. To examine worm distribution in the mouse, the small
      intestine was divided into five equal sections (segments 1-5 beginning with the
      pylorus). Worms were found mainly in segments 3 and 4 and were never found in
      segment 1. Mean body area of worms fixed in 10% neutral buffered formalin (NBF),
      hot alcohol-formalin-acetic acid (AFA) and aceto-carmine increased slowly until
      day 4 and then rapidly until day 8 PI. There was a significant difference in the
      mean body area of worms fixed in hot AFA, NBF, and aceto-carmine on all days
      except 4 and 6. Distinction of the ovary and ootype was apparent by day 6 and
      uterine cooling was observed by day 8 PI. Only 2 of 50 worms showed eggs in the
      uterus on day 8 PI.

PMID- 8354863
TI  - Strongyloides ratti: dissociation of immunological memory of the protection
      against tissue migrating larvae and intestinal adult worms in mice.
AB  - Immunological memory generated by infection with S. ratti was studied separately
      in the migratory and intestinal phases in mice. Protection against reinfection in
      the migratory phase was 96-98% at 2 weeks but significantly decreased to 60% at
      12 weeks after the primary infection. However, protection in the intestinal phase
      was 96% even 12 weeks after the primary infection. Recall of immunity against the
      intestinal phase persists for longer than that against the migratory phase in
      mice.

PMID- 8354864
TI  - Vaccination with hatched but non-activated, non-viable oncospheres of Taenia
      taeniaeformis in rats.
AB  - The usefulness of hatched but non-activated oncospheres as a candidate vaccine
      was evaluated using a Taenia taeniaeformis/rat system, since preparation of these
      oncospheres in vitro is known to be very simple. The findings were: (1) rats
      vaccinated with non-viable oncospheres became completely resistant to challenge
      infection; (2) intra-venous injection was the most effective to induce complete
      resistance; (3) a single oncosphere was sufficient to induce complete resistance
      in infected rats, whereas approximately 50 and 500 non-viable oncospheres were
      required to evoke strong and complete resistance, respectively, in vaccinated
      rats. The usefulness of non-viable oncospheres without adjuvant is discussed.

PMID- 8354865
TI  - Aspergillus terreus during hospital renovation.

PMID- 8354866
TI  - Environmental contamination with Staphylococcus aureus and outbreaks: the cause
      or the effect?

PMID- 8354867
TI  - An outbreak of mupirocin-resistant Staphylococcus aureus on a dermatology ward
      associated with an environmental reservoir.
AB  - OBJECTIVE: To investigate a cluster of mupirocin-resistant Staphylococcus aureus
      on a dermatology ward. DESIGN: An outbreak of mupirocin-resistant S aureus was
      noted on the dermatology ward during a prospective epidemiologic study of
      methicillin-resistant S aureus (MRSA) and borderline methicillin-susceptible S
      aureus (BMSSA). Pulsed-field gel electrophoresis (PFGE) of whole-cell DNA
      digested with Sma I was used as a marker of strain identity. SETTING AND
      PATIENTS: An 850-bed university hospital with a 12-bed inpatient dermatology
      ward. Most patients have severe, exfoliating dermatologic disorders. RESULTS:
      MRSA or BMSSA were isolated from 13 patients on the dermatology ward over a 14
      month period. Eleven of these isolates (84.6%) were mupirocin-resistant. Nine
      isolates were present on admission (81.8%); 8 of these patients had been
      hospitalized on the same ward within the last two months. Nasal and hand cultures
      from 36 personnel were negative for mupirocin-resistant MRSA or BMSSA. Extensive
      environmental culturing revealed that a blood pressure cuff and the patients'
      communal shower were positive for mupirocin-resistant BMSSA. PFGE of all
      mupirocin-resistant isolates demonstrated that the nine patients and both
      environmental sources had identical DNA typing patterns. INTERVENTIONS: Changing
      of blood pressure cuffs between patients and more stringent cleaning of communal
      areas was initiated. Repeat environmental cultures were negative. CONCLUSIONS: S
      aureus is not usually associated with an environmental reservoir; however, these
      patients all had severe desquamation, which may have prolonged environmental
      contamination.

PMID- 8354868
TI  - Trends in antimicrobial utilization at a tertiary teaching hospital during a 15
      year period (1978-1992).
AB  - BACKGROUND: Antimicrobials are a major part of hospital pharmacy budgets and must
      be considered in resource planning and spending projections. Logically, trends in
      antimicrobial usage should be linked to trends in resistant pathogens. OBJECTIVE:
      To examine long-term trends in antimicrobial use over a 15-year period (1978 to
      1992) and contrast them with changes in pathogens causing nosocomial bacteremia.
      SETTING: A 900-bed, tertiary care teaching hospital. METHODS: Pharmacy records
      were reviewed to identify parenteral antimicrobial agents administered to adult
      inpatients. Results were expressed in average daily adult doses per 1,000 patient
      days. RESULTS: Chloramphenicol use decreased, while use of penicillin G,
      antistaphylococcal penicillins, first-generation cephalosporins, and
      aminoglycosides remained relatively stable. In contrast, there was a sharp
      increase in the use of second- and third-generation cephalosporins (7-fold and
      6.5-fold increase, respectively), vancomycin (161-fold increase), metronidazole
      (32-fold increase) and amphotericin B (35-fold increase). The proportion of
      nosocomial bacteremias due to methicillin-resistant gram-positive bacteria rose,
      but gentamicin resistance in gram-negatives remained at low levels. During the
      past 14 years, the percentage of patients receiving at least one parenteral
      antimicrobial rose from 23% to 44%. Among patients receiving antimicrobials, the
      average number of different agents used per patient increased from 1.8 to 2.1.
      CONCLUSIONS: If newer agents were available, use of older agents usually
      declined. If newer alternatives were not available, use of older agents rose
      sharply. The increased use of antimicrobials in adults was related to the
      expanded proportion of patients receiving these agents.

PMID- 8354869
TI  - A prospective randomized trial comparing manual and automated endoscope
      disinfection methods.
AB  - OBJECTIVE: To compare the efficacy of endoscope disinfection using automated and
      manual systems. DESIGN: Prospective randomized trial. SETTING: A 1,000-bed
      tertiary care referral center. METHODS: All endoscopes underwent a three-stage
      decontamination process including brushing and cleaning with water and detergent,
      manual or automated disinfection with 2% glutaraldehyde, and 70% alcohol rinse
      with forced air drying. Cultures were obtained from endoscopes from both groups
      before and after alcohol rinse and then after overnight storage. RESULTS:
      Cultures from 8/30 (27%) automated and 11/30 (37%) manually disinfected (P =
      0.58) endoscopes grew gram-negative bacteria and/or nontuberculous mycobacteria
      before the alcohol rinse. After alcohol rinse, 3 (10%) of 30 automated and 8
      (27%) of 30 manually disinfected endoscopes remained contaminated (P = 0.28).
      Manually disinfected endoscopes were contaminated more frequently with coliform
      bacteria, whereas endoscopes undergoing automated disinfection were more
      frequently contaminated with nontuberculous mycobacteria, but the differences
      were not statistically significant. After alcohol rinse and forced air drying,
      there was no difference in contamination rates between freshly disinfected
      endoscopes and those stored overnight (7/30 (23%) versus 4/30 (13%), P = 0.50).
      Colonoscopes and duodenoscopes were contaminated more often than gastroscopes (P
      = 0.00001). CONCLUSION: The persistent endoscope contamination after manual and
      automated disinfection indicates the importance of developing more reliable and
      effective disinfection methods.

PMID- 8354870
TI  - Evaluation of a rapid readout biological indicator for flash sterilization with
      three biological indicators and three chemical indicators.
AB  - OBJECTIVE: Flash sterilization is most commonly used for emergency sterilization
      of unwrapped items in a gravity displacement sterilizer for three minutes.
      Sterilization quality assurance is monitored by biological indicators that
      require a 24-hour incubation prior to reading. In this study, we compared a new
      biological indicator that provides results within 60 minutes with three
      conventional, 24-hour biological indicators for monitoring flash sterilization
      and three chemical indicators. DESIGN: Conventional biological indicators tested
      included the conventional Attest 1261, Proof Flash and Assert, while the rapid
      readout indicator tested was Attest 1291. Attest Rapid Readout detects the
      presence of a Bacillus stearothermophilus enzyme by reading a fluorescent product
      that is produced by the enzymatic break-down of a nonfluorescent substrate.
      Chemical indicators tested included Comply, Incheque, and Thermalog S. Survival
      at 132 degrees C in a gravity displacement sterilizer was measured by media color
      change after incubation for 24 hours at 56 degrees C for the three conventional
      biological indicators, fluorescence at 60 minutes for the Attest Rapid Readout
      biological indicator, and color change for the chemical indicators. Each exposure
      time was replicated four times with 10 of each biological and chemical indicator
      per run. RESULTS: The conventional biological indicators (Attest, Proof Flash,
      and Assert) had 90%, 48%, and 40% spore survival at two minutes exposure; 23%,
      3%, and 0% at three minutes exposure; and 3%, 0%, and 0% at four minutes exposure
      respectively. The Attest Rapid Readout biological indicator had 88%, 33%, and 0%
      enzyme activity detectable at 2, 3, and 4 minutes exposure. The chemical
      indicators Comply, Incheque, and Thermalog S revealed sterilization failure rates
      of 100%, 100%, and 100% at 0 minutes exposure; 100%, 100%, and 45% at one minute;
      0%, 0%, and 28% at two minutes exposure; 0%, 0%, and 18% at three minutes
      exposure; and 0%, 0%, and 0% at four minutes exposure, respectively. CONCLUSION:
      The sensitivity of the Attest Rapid Readout parallels the conventional biological
      indicators. These data suggest that a 60-minute rapid readout biological
      indicator is equivalent to the 24-hour biological indicators. If further studies
      demonstrate that a four-minute flash sterilization cycle provides a needed safety
      margin to ensure sterilization, then consideration should be given to requiring a
      four-minute flash sterilization cycle. Chemical indicators were too sensitive to
      the processing conditions (eg, steam) and are inadequate to ensure adequate
      sterilization.

PMID- 8354871
TI  - Diarrhea among residents of long-term care facilities.
AB  - Diarrhea is a common problem among residents of long-term care facilities.
      Although the etiology of many cases of diarrhea will be noninfectious, the
      approach to managing all patients with diarrhea must include assuring the
      adequacy of hydration and controlling the spread of infection. The latter issue
      is especially critical in nursing homes where a large proportion of patients can
      became ill over a several-day period during an outbreak. Although most outbreaks
      of diarrhea are viral in origin, bacterial outbreaks can lead to hospitalization
      and even death. Increasing awareness among physicians and infection control
      practitioners of the correct approaches to investigating and managing cases of
      diarrhea among nursing home patients is necessary because the magnitude of this
      problem will grow as the number of individuals being cared for in long-term care
      facilities increases.

PMID- 8354872
TI  - Managing occupational exposures to HIV-1 in the healthcare workplace.

PMID- 8354873
TI  - In vitro autoradiographic visualization of occupied estrogen receptors in the rat
      brain with an iodinated estrogen ligand.
AB  - Methods have been developed for the selective measurement of occupied estrogen
      receptors (ER) in brain tissue sections. Cryostat sections of unfixed tissue were
      incubated with radiolabeled estrogen at physiological temperatures, displacing
      endogenous receptor-bound estrogen by radioligand and thereby allowing the
      receptor complexes to be visualized autoradiographically after washing to remove
      nonspecifically bound steroid. The resultant autoradiographs were analyzed by
      computer-assisted densitometry. Synthetic 11 beta-methoxy-substituted
      radiolabeled estrogens gave the best autoradiographic images, as a result of
      reduced nonspecific labeling, although [3H]-estradiol was also used successfully.
      With the synthetic ER ligand 11 beta-methoxy 16 alpha-[125I]-iodo-estradiol,
      exposure times of less than 24 hr generated acceptable autoradiographs; with 3H
      labeled estrogens, exposures of 3 months or more may be required. The method is
      sufficiently sensitive to detect physiological changes in ER occupation and to
      allow determination of receptor affinities and saturation binding capacities in
      discrete cell groups identified in sections from individual animals.

PMID- 8354874
TI  - Developmental expression of SP-A and SP-A mRNA in the proximal and distal
      respiratory epithelium in the human fetus and newborn.
AB  - We used immunolocalization and in situ hybridization to determine the
      distribution of SP-A and SP-A mRNA in lungs of human fetuses and normal newborn
      infants. Early in the second fetal trimester a few immunostained cells were
      observed in tracheal epithelium, often in mucosal folds near the origin of
      submucosal gland ducts. Non-mucous tracheal gland cells were immunostained for SP
      A as they became differentiated. Expression of SP-A mRNA was similar to that of
      immunolocalization in the second trimester. Immunostained cells and SP-A mRNA
      also appeared about the same time in gestation in isolated cells of bronchial
      epithelium and glands. SP-A mRNA was seen in bronchiolar cells and pre-Type II
      cells lining terminal airways of fetuses at 19-20 weeks of gestation. Only in
      liveborn infants did cells of bronchioloalveolar portals and mature Type II cells
      contain SP-A mRNA or immunostain for SP-A. In postnatal infants, luminal material
      was also stained for SP-A. Although some alveolar macrophages contained
      immunoreactive material, SP-A mRNA was never detected. The abundance of SP-A in
      tracheal and bronchial glands and epithelium of conducting airways supports the
      importance of non-surfactant-associated functions for SP-A and may be related to
      a role in host defense.

PMID- 8354875
TI  - Validation of immunohistochemical quantification in confocal scanning laser
      microscopy: a comparative assessment of gap junction size with confocal and
      ultrastructural techniques.
AB  - Confocal scanning laser microscopy (CSLM) is increasingly being used to image
      antibody-labeled structures visualized with a fluorescent secondary antibody.
      Such digital images are routinely stored on computer and are well suited to
      quantitative analysis. Although theoretical aspects of CSLM imaging and
      resolution are well defined, information is lacking on the relationship observed
      between measurements of fluorescent antibody-labeled structures and the size of
      the same structures as determined by electron microscopy (EM). In the present
      study we examined this relationship for the cardiac gap junction. Data on the
      size of immunofluorescent-labeled gap junctions were acquired by two methods of
      analysis from CSLM images and compared statistically with measurements of gap
      junction size obtained by freeze-fracture EM. The freeze-fracture data were
      compared before and after exclusion of small junctions, corresponding to those
      that theoretically would not have been detected in CSLM analysis. The data
      obtained by the different methods were similar but not identical, reflecting the
      advantages and limitations of each technique. However, the comparison did
      indicate that with appropriate sample preparation and orientation, accurate and
      rapid analysis can be achieved by CSLM, particularly when digital semi-automated
      techniques are employed.

PMID- 8354876
TI  - Glycoproteins of mouse vaginal epithelium: differential expression related to
      estrous cyclicity.
AB  - We used lectin overlay blotting and SDS-PAGE to analyze the estrous cycle
      specific expression of mouse vaginal epithelial glycoproteins. Seven lectins
      chosen for their differential carbohydrate-binding specificity revealed 15
      glycoproteins that showed cycle-related expression. Each lectin had a unique
      binding pattern different from the patterns revealed by other lectins. However,
      several estrous cycle phase-specific glycoproteins reacted with more than one
      lectin. The most prominent of these glycoproteins (M(r) 92-95 KD) was weakly
      expressed in late diestrus and fully expressed only in proestrus, coincident with
      the transformation of two superficial layers of vaginal squamous epithelium into
      mucinous cuboidal cells. Electron microscopic lectin histochemistry revealed the
      glycoproteins in the mucinous granules of surface cuboidal cells and in the lumen
      of the vagina. Our results illustrate the complexity of glycoconjugate synthesis
      in mouse vagina and reveal the distinct cycle-specific patterns of individual
      glycoprotein expression. These cyclic glycoproteins could serve as vaginal
      biochemical markers for the specific phases of the estrous cycle.

PMID- 8354877
TI  - Secretion of chondroitin sulfate from embryonic epidermal cells in Xenopus
      laevis.
AB  - We examined proteoglycans (PGs) in amphibian epidermal cells by
      immunofluorescence microscopy. Immunoelectron microscopy with pre- and post
      embedding methods, combined with HRP- or gold-conjugated secondary antibody,
      revealed ultrastructural localization of glycosaminoglycans (GAGs). Embryonic
      epidermis secretion granules in Xenopus laevis contained chondroitin 6-sulfate
      and unsulfated chondroitin. Immature secretion granules were also labeled with
      anti-chondroitin 6-sulfate and anti-chondroitin. A step-wise digestion experiment
      on chondroitinase ABC revealed that fine filaments in the secretion granules were
      chondroitin sulfate chains. Inhibition experiments with brefeldin A revealed that
      the life of a secretion granule was 5-10 hr, suggesting that GAG secretion from
      embryonic epidermis is routed through a regulated pathway.

PMID- 8354878
TI  - Expression of decorin mRNA in the nervous system of rat.
AB  - A rat cDNA clone (pCD67) isolated from a cDNA library of regenerating sciatic
      nerve by differential hybridization screening revealed 75% homology on the
      nucleic acid level and 81% homology (including conservative amino acid changes)
      to the deduced amino acid sequence of the core protein of human
      dermatan/chondroitin sulfate proteoglycan decorin (PGII, PG40, PG-S2). Two
      transcripts of 1.3 and 1.75 KB very similar in size to the two decorin mRNA
      species previously identified in connective tissue were detected by Northern
      blotting in both normal and injured sciatic nerve and in the mature and embryonic
      rat brain. The steady-state level of the decorin 1.3 KB mRNA was very much higher
      in peripheral nerve than in the central nervous system or in other non-neural
      tissues (skeletal muscle, heart, colon, kidney). In situ hybridization
      experiments indicated that decorin mRNA is expressed by Schwann cells and
      vascular cells in peripheral nerve. In the spinal cord the ventral horn motor
      neurons and other neurons in gray matter showed specific hybridization signals.
      Furthermore, in situ hybridization indicated decorin expression in Purkinje
      neurons and cells of the molecular layer in cerebellum, and in neurons of the
      primary olfactory cortex and brainstem (pons). Our data clearly demonstrate
      decorin mRNA expression in distinct neural cell populations, suggesting yet
      unknown functions of this proteoglycan in the peripheral and central nervous
      system.

PMID- 8354879
TI  - Silver-enhanced diaminobenzidine-sulfide (SEDS): a technique for high-resolution
      immunoelectron microscopy demonstrated with monoamine immunoreactivity in monkey
      cerebral cortex and caudate.
AB  - A common frustration of immunoelectron microscopy (IEM) is the density of the
      3,3'-diaminobenzidine (DAB) label, which obscures intracellular details of
      labeled structures. To overcome this problem, a silver enhancement protocol was
      developed which leaves silver deposits on very low levels of DAB. The resulting
      label is composed of easily visualized punctate silver deposits, localized in
      processes with little or no detectable DAB. This technique incorporates several
      modifications into previously described methods for silver enhancement of DAB.
      The principal innovation is to pretreat the DAB label with sodium sulfide before
      silver enhancement, which substantially increases the sensitivity of the silver
      enhancement. In addition, cysteine was used in place of thioglycolic acid to
      suppress tissue argyrophilia, allowing use of both glutaraldehyde- and
      paraformaldehyde-fixed tissue without degradation of ultrastructure. We
      demonstrate this technique with dopamine, norepinephrine (NE), and serotonin
      (5HT) immunoreactivity in monkey prefrontal cerebral cortex and with dopamine
      immunoreactivity in the anterior caudate. The punctate label allows essentially
      unobscured visualization of the intracellular details and cell membranes of these
      monoamine axons. Whereas 5HT axons formed small asymmetric synapses, dopamine and
      NE axons typically formed small symmetric synapses with notably subtle membrane
      specializations. It is likely that these are often obscured by conventional DAB
      labeling. The use of several preparations indicates that this technique will be
      useful with a variety of antibodies. It might also provide an attractive
      alternative to colloidal gold, especially with glutaraldehyde-fixed tissue which
      is not easily penetrated by gold particles.

PMID- 8354880
TI  - Histamine-storing cells in the oxyntic mucosa of the rat stomach: a transmission
      electron microscopic study employing fixation with carbodiimide.
AB  - We studied the distribution of histamine (HA) immunoreactivity in endocrine cells
      of the acid-producing mucosa in rat stomach with pre-embedding immunoelectron
      microscopy (IEM) using an antiserum against HA. Four fixation modifications were
      compared to optimize the ultrastructural morphology and staining pattern with the
      antisera produced against carbodiimide-conjugated HA. Fixation with 4% 1-ethyl
      3(3-dimethyl-aminopropyl) carbodiimide (EDCDI) combined with both 4%
      paraformaldehyde and 0.1% glutaraldehyde gave superior results compared with
      EDCDI alone. Enterochromaffin-like (ECL) cells were easily distinguished from
      other endocrine cells in optimally fixed samples. The peroxidase end-product was
      distributed within the cytoplasm surrounding the vesicles of the ECL cells. ECL
      cells comprised about 75% of all endocrine cells, and about 90% of them were HA
      immunoreactive (HA-IR). No other HA-IR cell types were identified by EM in the
      basal half of the oxyntic region of rat gastric mucosa. The results suggest that
      a combination of EDCDI and aldehydes is suitable for IM demonstration of HA in
      cells. ECL cells from a predominant portion of endocrine cells in the oxyntic
      glands and may constitute the only significant non-mast cell store of HA in rat
      gastric mucosa.

PMID- 8354881
TI  - In situ fluorescent visualization of nucleolar organizer region-associated
      proteins with a thiol reagent.
AB  - Nucleolar organizer regions (NORs) are nucleolus-forming rDNA loops associated
      with argyrophil proteins, the amount of which varies according to the
      proliferative state of the cell. It has been presumed that the nucleolar protein
      related thiol groups may have a role in selective silver staining. We
      investigated the nuclear thiol distribution with a fluorescent thiol reagent,
      coumarinyl-phenyl-maleimide (CPM) in human K-562 myeloblast cultures and found
      that SH group-related fluorescence was brightest in the area of nucleoli, which
      became highly selective after RNAse digestion. A remarkable co-localization of
      AgNOR silver reaction and CPM fluorescence was observed, although occupation of
      the SH groups by CPM did not prevent the silver staining. We applied the stain to
      dual-parameter flow cytometry in combination with DNA content measurements, which
      provide further information on nucleolar function and changes in experimental and
      pathological specimens.

PMID- 8354883
TI  - Measurement of DNA content and of tritiated thymidine and bromodeoxyuridine
      incorporation by the same cells.
AB  - We tested a method of measuring DNA content (Feulgen) and tritiated thymidine
      ([3H]-T) and bromodeoxyuridine (BrdU) incorporation by the same cell. Initial
      experiments showed that Feulgen hydrolysis denatured the DNA of fixed cells
      sufficiently to allow detection of incorporated BrdU with monoclonal antibodies.
      MCa-11 cells were then double-labeled with [3H]-T and BrdU, placed on slides, and
      Feulgen stained. Next, absorption cytometry was performed to measure the DNA
      content of randomly selected cells. Feulgen staining and the development and
      removal of either the [3H]-T or the BrdU grains after DNA measurements did not
      interfere with subsequent detection of the grains from the other label, and BrdU
      and [3H]-T can be used reliably in combination for identification of S-phase
      cells. This method may eventually allow the use of microscope-based image
      analysis to selectively measure the DNA contents and the BrdU/[3H]-T labeling of
      non-transformed stromal and cancer cells in solid tumors, thereby providing new
      insights into the growth kinetics of these heterogeneous cell populations.

PMID- 8354882
TI  - A novel hinge system and incubation chamber for emulsion-coated coverslip
      autoradiography.
AB  - We describe an emulsion-coated coverslip autoradiographic technique for large (50
      x 50 mm) sections of monkey or human brain. The technique uses adhesive-backed,
      teflon-reinforced aluminum foil as a flexible hinge that allows the coverslip to
      swing away from the slide so that the emulsion and tissue can be processed
      independently. We also describe a plexiglas incubation chamber that allows two
      slides with coverslips folded away to be processed back-to-back in 5 ml of
      reagent solution. In general use, the chamber minimizes the volume of solution
      needed to cover large slide-mounted sections and is ideal for radioligand or
      immunohistochemical reactions that use expensive reagents. For autoradiography,
      the chamber greatly facilitates independent processing of the emulsion and tissue
      section. Together, the foil-hinge method and incubation chamber virtually
      eliminate the major technical pitfalls of previous emulsion-coated coverslip
      methods. Moreover, they facilitate combination of histochemical or
      immunocytochemical staining with autoradiographic localization of
      neurotransmitter receptors in the same tissue section. This is demonstrated by
      thioflavin S staining of neuritic plaques and tangles and autoradiographic
      localization of serotonin 1A receptors in sections of Alzheimer disease brain.

PMID- 8354885
TI  - Enhancement of immunoassay sensitivity by molecular modification of competitors.
AB  - The potential of weak competitors to enhance the sensitivity of competitive
      immunoassays is described. Several triazine derivatives have been analyzed for
      their use as competitors. Their binding properties were determined using an
      enzyme-linked immunosorbent assay (ELISA) with a monoclonal antibody specific to
      triazines. Selected derivatives were immobilized onto the surface of a fibre
      optic sensor and atrazine was determined in a competitive manner using a
      fluorescein-labelled antibody. Using the weak binding competitor 11-(4-ethylamino
      6-methylthio-s-triazine-2-yl)undecanoic acid (TE11S) the detection limit for
      atrazine could be lowered 100-fold in comparison to 2-aminohexylamino-4
      ethylamino-6-isopropylamino-s-triazine (AHA), the previously used competitor.

PMID- 8354884
TI  - Chicken egg antibodies for immunohistochemical labeling of growth hormone and
      prolactin in bovine pituitary gland.
AB  - We describe the production of polyclonal chicken antibodies specific for bovine
      growth hormone (bGH) and prolactin (PRL). Antibodies were generated by
      immunization of laying hens with recombinant bGH (rbGH), pituitary derived bGH
      (pbGH), and ovine PRL (oPRL). After the lipoprotein fraction was removed by
      dextran sulfate precipitation the antibodies were isolated from the egg yolks by
      ammonium sulfate precipitation. Immunization with rbGH and oPRL generated large
      amounts of specific antibodies, as revealed by ELISA and Western blot analysis.
      Antibodies against pbGH showed pronounced crossreactions with oPRL. The
      antibodies against rbGH and oPRL were well suited for sensitive and specific
      labeling of the GH- and PRL-synthesizing cells in bovine pituitary glands by
      immunohistochemistry. In addition, a quick and sensitive procedure for
      demonstration of both bGH- and PRL-synthesizing cells in a single paraffin
      section by double immunohistochemistry is presented. The chicken anti-bGH
      antibodies showed excellent results in combination with rabbit anti-PRL
      antibodies. The main advantage of avian antibodies in double immunostaining
      methods is the lack of crossreactions between avian antibodies and mammalian
      immunoglobulins and receptors which bind to the crystalline fragment of mammalian
      immunoglobulins (Fc receptors).

PMID- 8354886
TI  - Two-site ELISA for quantification of the terminal C5b-9 complement complex in
      plasma. Use of monoclonal and polyclonal antibodies against a neoantigen of the
      complex.
AB  - A quantitative ELISA procedure using monoclonal and polyclonal antibodies against
      neoantigens of the terminal C5b-9 complement complex has been developed. The
      ELISA was demonstrated to be both sensitive and reproducible. The normal range
      for C5b-9 determinations, defined as 2.5-97.5% interval of the values obtained in
      76 healthy blood donors, was 3.12-10.3 AU/ml. The presence of rheumatoid factor
      did not affect the determination of C5b-9 as demonstrated by immunoabsorption
      studies.

PMID- 8354887
TI  - A fluorometric assay for the quantitation of cell adherence to endothelial cells.
AB  - A rapid quantitative fluorometric assay was developed for analysis of leukocyte
      adherence to endothelial cells. In this method adherent monocyte and T cell lines
      are labeled with the fluorescent dye Calcein AM without affecting cell function.
      Following coincubation with endothelial cells and gentle washing to remove
      nonadhering cells, the relative fluorescence intensity of the adhering cells is
      determined with a fluorescence microtiter plate reader. Relative fluorescence
      intensity increases linearly with cell number over a wide range of
      concentrations. By comparison of fluorescence levels of adhering cells to a
      dilution series of labeled cells alone, the number of adhering cells can be
      determined. We compared this adherence assay with the 51Cr-labeling assay and
      found comparable adherence. However, we found the fluorescence assay to be more
      rapid as the use and special handling of radioactive material is eliminated. To
      monitor the reliability and reproducibility of this method, we followed the
      adherence of Calcein AM-labeled THP-1 cells, a human monocytic cell line, to
      human endothelial cells treated with interleukin-1.

PMID- 8354888
TI  - Immunoassay reagents for psychoactive drugs. II. The method for the development
      of antibodies specific to imipramine and desipramine.
AB  - Imipramine and desipramine were structurally modified by the attachment of spacer
      arms to the aromatic ring which were subsequently attached to bovine serum
      albumin. This approach utilized novel spacer arms and conjugation methods. This
      method yielded antisera with excellent selectivity and good titers. Rabbits were
      used to raise the antisera and the antibodies produced were characterized with
      respect to their cross-reactivity with imipramine, desipramine and hydroxy
      metabolites as well as selected structurally related compounds.

PMID- 8354890
TI  - A europium fluoroimmunoassay for measuring binding of antigen to class II MHC
      glycoproteins.
AB  - A dissociation-enhanced lanthanide fluoroimmunoassay employing europium
      streptavidin and time-resolved fluorimetry was developed to measure binding of
      biotin-labeled peptides to class II MHC proteins. Binding of biotin-peptides as
      measured by this assay was saturable and inhibited in the presence of unlabeled
      peptide. Background fluorescence was minimal and there was a direct relationship
      between signal and biotin-peptide/class II complex concentration from 1.3 pmol to
      less than 1 fmol total class II. The sensitivity of the assay and the ability to
      selectively capture specific class II proteins from detergent lysates of cells
      with solid phase mAb made it possible to measure formation peptide/class II
      complexes in live APC cultured with biotin-labeled insulin. This assay is
      expected to be useful for routine measurement of peptide/class II binding and
      biochemical analysis of Ag processing events.

PMID- 8354891
TI  - The optimisation of a novel iodide microassay and its application in an
      immunoassay for human antibody levels in serum.
AB  - Radioactive iodine has been used as an antibody label in many immunoassays. The
      feasibility of using non-radioactive iodine as a label was investigated. A
      microassay for iodide based on the Sandell-Kolthoff reaction was optimised. It
      was used to detect iodine-labelled antibody and successfully applied to the
      detection of human IgG in serum samples. The performance of this assay system
      compared with enzyme-linked immunosorbent assay using HRP was evaluated.

PMID- 8354889
TI  - Human IgG in immune complexes bound to human erythrocyte CR1 is recognized
      differently than human IgG bound to an erythrocyte surface antigen.
AB  - We have developed several methods, including a new use of magnetic cell
      separation techniques, to examine how human IgG bound to human erythrocytes can
      be recognized. We find that human IgG in complement-opsonized immune complexes
      bound to erythrocyte CR1 is less accessible to several probes than human IgG
      bound to the rhesus antigen on erythrocytes. These findings suggest that the
      mechanism by which immune complexes are removed and cleared from erythrocyte CR1
      in the circulation is different from the mechanisms which lead to splenic
      clearance of IgG sensitized erythrocytes.

PMID- 8354892
TI  - Production of monoclonal and polyclonal antibodies against human osteocalcin
      sequences and development of a two-site ELISA for intact human osteocalcin.
AB  - In this study we have raised polyclonal and monoclonal antibodies against human
      osteocalcin sequences coupled to bovine serum albumin (BSA). The antibodies were
      used for the development of a novel two-site ELISA on microtiter plates for
      intact human osteocalcin. The epitope, recognized by the monoclonal hybridoma
      product Os 31/2 that was used as the capture antibody, was located on the amino
      terminal sequence 1-29. The antibodies used for detection recognized the sequence
      1-49. This method failed to detect any tryptic peptides derived from human
      osteocalcin sequence 1-49 nor did it detect peptide 1-29, thus demonstrating high
      specificity for the intact osteocalcin 1-49 only. This is a novel technique for
      the determination of intact osteocalcin. We have also validated the assay
      parameters for routine use. This direct and relatively simple procedure promises
      to be a powerful diagnostic and investigative tool.

PMID- 8354893
TI  - Use of density perturbation to isolate immunologically distinct populations of
      cells.
AB  - Experiments have been carried out to demonstrate that, using antibody coated
      Dynabeads as a model system for density labelling MOLT-4 T cells, the overall
      density of cells can be increased such that the cells that bind particles can be
      separated on isopycnic isotonic density gradients from cells that bind fewer
      particles. The increase in density is dependent on the cell volume and the number
      of particles bound. After centrifugation, cells with bound particles were found
      at positions in the gradient that reflected their increased density. Observed
      density ranges for cells with particular numbers of particles bound coincided
      closely with calculated expected density ranges. These results indicate the
      potential for separation of different subpopulations of cells on the basis of the
      immunological identity of the surface of cells using density perturbation methods
      involving antibody coated-density particles.

PMID- 8354894
TI  - A method for the detection of erythrocyte-bound interleukin-8 in humans during
      interleukin-1 immunotherapy.
AB  - Interleukin-8 (IL-8) has been recently shown to bind to human erythrocytes with
      high affinity and is therefore potentially difficult to detect in serum or
      plasma. IL-8 is transiently elevated in the serum of baboons after the
      administration of interleukin-1 alpha (IL-1 alpha). The objective of this study
      was to investigate whether IL-8 can be detected in the plasma or in detergent
      lysed erythrocytes from cancer patients undergoing treatment with IL-1 alpha.
      Using a specific radioimmunoassay (RIA), plasma IL-8 was detected within 1-2 h
      after the first IL-1 alpha infusion. Thereafter, the levels declined rapidly and
      after 4-8 h were undetectable. Erythrocyte-bound IL-8 was detectable 1-2 h after
      the increase in plasma levels. The erythrocyte-bound IL-8 levels were higher than
      those measured in plasma and remained elevated long after the plasma levels had
      become undetectable. Erythrocyte membranes accounted for all of the erythrocyte
      associated IL-8, as IL-8 was undetectable in the cytosol after erythrocyte lysis.
      The assay used in these studies detects IL-8 in erythrocyte lysates when it
      cannot be measured in plasma and may therefore be useful in monitoring IL-8
      production in vivo.

PMID- 8354895
TI  - Novel method for the measurement of cytokine production by a one-stage procedure.
AB  - A new one-step culture-immunoassay procedure is described for testing cytokine
      production by immunocompetent cells in whole blood (WB) without the need for an
      isolation step. Briefly, WB samples or distilled water were added to RPMI medium
      containing specific anti-cytokine peroxidase-labelled monoclonal antibodies and
      incubated in micro-well plates coated with specific capture monoclonal
      antibodies, directed against distinct epitopes of the cytokine, and containing
      dried polyclonal activators (5.625 micrograms LPS + 1.125 micrograms PHA) or
      dried standards respectively. The optimalisation of the assay is described for an
      extended measurement range. The best compromise between sensitivity and linearity
      was obtained with the addition of 50 ng/well for TNF-alpha and IL-6 or 100
      ng/well for IFN-gamma of unconjugate antibodies to the corresponding conjugate.
      The kinetics of individual production of each cytokine in WB of normal healthy
      donors showed values entering the standard range following incubation times of
      between 2 and 8 h for TNF-alpha, 2 and 4 h for IL-6, and 4 and 24 h for IFN
      gamma. The sensitivity, the precision (intra-assay CVs) and the reproducibility
      (interassay CVs) of the assays were as follows: 70 pg/ml, < or = 14% and < or =
      11% for TNF-alpha; 25 pg/ml, < or = 11% and < or = 16% for IL-6; 25 pg/ml, < or =
      19% and < or = 20% for IFN-gamma. The accuracy (% of recovery) of the assays was
      in the order of 100% and between 40 and 60% in the absence or presence of
      polyclonal activators, reflecting the occurrence of an active
      production/consumption mechanism during the activation.

PMID- 8354896
TI  - Evaluation of the methodology of polymorphonuclear leukocyte chemotaxis.

PMID- 8354897
TI  - Background noise in ELISA procedures. Influence of the pH of the coating buffer
      and correlations with serum IgM concentration.

PMID- 8354898
TI  - Tuberculosis symposium: emerging problems and promise.
AB  - Between 1985 and 1991, 39,000 cases of tuberculosis occurred in excess of those
      expected based on previous trends. Immigration from high-prevalence countries,
      coinfection with human immunodeficiency virus (HIV), and outbreaks in
      congregative facilities are most responsible for the increase. Coincident with
      the increase in tuberculosis, outbreaks of multidrug resistant (MDR) tuberculosis
      have occurred. Clinical and epidemiologic data support nosocomial transmission.
      MDR tuberculosis occurred late in the course of HIV infection and was refractory
      to treatment. Compounding the problems of rising incidence and increasing
      resistance was the sudden recognition of shortages of antituberculous drugs. The
      problems currently posed by tuberculosis require new approaches to diagnosis and
      rapid sensitivity testing as well as assuring an adequate supply of licensed
      drugs and development of new drugs. A number of steps have been taken by
      governmental agencies to assure that the challenge is met.

PMID- 8354899
TI  - Generation of neutralizing anti-B19 parvovirus human monoclonal antibodies from
      patients infected with human immunodeficiency virus.
AB  - The prevalence of IgG antibodies to human B19 parvovirus (anti-B19) is elevated
      in individuals infected with human immunodeficiency virus (HIV), especially
      during the later stages of HIV infection. In subjects with high titers of IgG
      anti-B19, 86% (19 of 22) had circulating B cells producing anti-B19.
      Immortalization of these cells with Epstein-Barr virus and generation of
      heterohybridomas by fusion with a mouse X human heteromyeloma resulted in the
      production of two cell lines producing IgG1 kappa monoclonal antibodies (MAbs).
      Both of these MAbs were specific for conformational epitopes on the VP2 capsid
      protein of B19 parvovirus and both were capable of neutralizing 50% of the viral
      infectivity in a human erythroid colony-forming unit assay at < or = 1 micrograms
      of MAb/mL. These human MAbs are potentially useful in the treatment of acute B19
      parvovirus infection.

PMID- 8354900
TI  - Evidence for mother-to-child transmission of human T lymphotropic virus type II.
AB  - Serologic analysis of the children of 2 married human T lymphotropic virus type
      II (HTLV-II)-infected prostitutes demonstrated antibodies to HTLV-II in an 8-year
      old boy whose only recognizable risk for HTLV-II infection was breast-feeding
      during his first 4 years of life. Limited sequence analysis of isolates infecting
      the mother and child demonstrated 100% identical sequences in the long terminal
      repeat (LTR65-297; 236 bp), pol4762-4919 (157 bp), and env5523-6003 (480 bp)
      regions (both isolates were subtype a), suggesting mother-to-child transmission.
      In contrast, isolates obtained from 2 other prostitutes from the same geographic
      region had sequences different from those of the first woman and her child, and
      the second and third women were infected with HTLV-II subtype b. Although
      vertical transmission of HTLV-II in this 8-year-old child cannot be conclusively
      ascertained, the probability is overwhelming that infection occurred through
      breast-feeding for an extended period of time.

PMID- 8354901
TI  - Experimental hepatitis E: pathogenesis in cynomolgus macaques (Macaca
      fascicularis).
AB  - The pathogenesis of experimental hepatitis E has not been thoroughly
      investigated. The purpose of this study was to more accurately document the
      events in this disease. Cynomolgus macaques were inoculated intravenously with
      bile or feces containing hepatitis E virus (HEV). Serum, bile, and liver
      specimens were evaluated with light microscopy, immune electron microscopy,
      immunofluorescence microscopy, EIA, and polymerase chain reaction. In the third
      week, there were histopathologic changes and HEV antigen (HEVAg) in liver, HEV in
      bile, and alanine aminotransferase (ALT) elevations. Widespread pathologic
      changes were detected during the fourth week and antibody to HEV (anti-HEV) and
      peak ALT values in the fifth or sixth week. By the sixth week, HEVAg had
      disappeared but pathologic changes persisted. This study supports the concept
      that experimental hepatitis E has an initial phase in which hepatic HEV
      replication is accompanied by the onset of hepatitis and a later phase in which
      the appearance of anti-HEV is accompanied by progression of the hepatitis.

PMID- 8354902
TI  - Middle ear abnormalities during natural rhinovirus colds in adults.
AB  - To determine middle ear pressure (MEP) changes during natural rhinovirus colds,
      adults with illness for < or = 3 days were tested by digital tympanometer daily
      for 5 days (study 1) or every other day for 7 days (study 2). Abnormal MEPs (< 
      50 or > +20 mm H2O) were found in 72% of 36 patients in study 1 (P < .001, vs.
      baseline of 11%) and 76% of 55 patients in study 2 (P < .001, vs. 15% of 103
      healthy controls). Major abnormalities (> or = +100 or < or = -100 mm H2O) were
      found in 61% of patients in study 1 (P < .001, vs. baseline of 0) and 47% in
      study 2 (P < .001, vs. control of 5%). MEP abnormalities usually resolved by day
      14. Only 1 subject developed clinically apparent otitis media. Earache or
      respiratory symptom scores did not correlate with MEP abnormalities. These
      results indicate that natural rhinovirus colds in adults are frequently
      associated with marked but transient MEP abnormalities.

PMID- 8354903
TI  - Mucosal immunity and protection after intranasal immunization with recombinant
      adenovirus expressing herpes simplex virus glycoprotein B.
AB  - A recombinant adenovirus (Ad) expressing glycoprotein B (gB) of herpes simplex
      virus (HSV) type 1 (AdgB8) was evaluated as a mucosal vaccine candidate. When
      administered intranasally (inl) to C57B1/6 mice, AdgB8 induced levels of serum
      anti-HSV gB IgG antibodies similar to those of mice immunized intraperitoneally
      (ip), which neutralized both HSV-1 and -2. Mice immunized inl with AdgB8 produced
      secretory IgA specific for HSV gB, but mice immunized ip did not. Splenic anti
      HSV cytotoxic T lymphocytes (CTL) were observed after inl and ip immunization;
      however, there was a time-dependent decrease in the anti-HSV CTL activity from
      spleens of inl immunized mice. Anti-HSV CTL were also present in the mediastinal
      lymph nodes after inl but not ip AdgB8 immunization. Furthermore, mice immunized
      inl with AdgB8 were protected against heterologous inl challenge with HSV-2, and
      this protection lasted longer than in ip-immunized mice. These results indicate
      that mucosal immunization with a recombinant adenovirus can induce mucosal and
      systemic immune responses and provide long-term protection from mucosally or
      sexually transmitted viruses.

PMID- 8354904
TI  - Human peripheral blood xenografts in the SCID mouse: characterization of
      immunologic reconstitution.
AB  - Immune reconstitutions (hu-PBL-SCID mice) resulting from adoptive transfer of
      human peripheral blood mononuclear cells into 1800 C.B-17 scid-/scid-mice were
      characterized. Over 90% of reconstitutions were successful as evidenced by human
      immunoglobulin production. Variability was noted with donor, cell number, and
      cell type. Human cells (T lymphocytes, few B cells) could be recovered by 5 days
      after engraftment. High levels of soluble CD8 and interleukin-2 receptors were
      detected in sera of hu-PBL-SCID mice. Cells recovered from 17 mice proliferated
      in response to antigens to which the donor had been primed; responses to
      nonboosted antigen also increased in some animals. After reconstitution,
      lymphocytes were found in the spleen and lymph nodes without full restoration of
      normal architecture. The hu-PBL-SCID mouse shows promise as a model system for a
      variety of immunologic studies. The inherent variation in the system must be
      minimized for appropriate use of the model.

PMID- 8354905
TI  - Comparative inhibitory effects of various nucleoside and nonnucleoside analogues
      on replication of influenza virus types A and B in vitro and in ovo.
AB  - Six nucleoside analogues, two sulfated polysaccharides, and four protease
      inhibitors were evaluated in vitro as inhibitors of influenza virus replication.
      Four guanosine analogues (mizoribine, ribavirin, pyrazofurin, and 5-ethynyl-1
      beta-D-ribofuranosylimidazole-4-carboxamide), the sulfated polysaccharide dextran
      sulfate (molecular weight 500,000), and two protease inhibitors (camostat
      mesilate and nafamostat mesilate) were inhibitory to the replication of strains
      of influenza virus types A and B at concentrations down to 0.3 micrograms/mL. Of
      these seven compounds, ribavirin, camostat mesilate, and nafamostat mesilate were
      efficacious in both reducing the virus titer and increasing the survival rate of
      influenza virus-infected chick embryos. For camostat mesilate, the ED50 (required
      to improve the survival rate of influenza virus-infected chick embryos by 50%)
      was 0.80 micrograms/g, and its selectivity index, based on the ratio of the 50%
      toxic dose (required to reduce the viability of chick embryos by 50%) to ED50,
      was 280. Camostat mesilate deserves further exploration for its potential in the
      treatment of influenza virus infection.

PMID- 8354906
TI  - Maternal immunization with influenza or tetanus toxoid vaccine for passive
      antibody protection in young infants.
AB  - Women in the last trimester of pregnancy were given trivalent inactivated
      influenza virus vaccine (TIV; A/Sichuan/H3N2, A/Taiwan/H1N1, B/Victoria) or
      tetanus toxoid (TT). Maternal blood was drawn before immunization and at delivery
      (median, 5 weeks later); infant blood was obtained within 5 days of birth and 2
      months later. Antibody responses to TIV and TT were determined by
      microneutralization assay and ELISA. T cell response was determined by lymphocyte
      proliferation. Maternal seroconversion to vaccine antigens was found to one or
      more influenza antigen in all TIV recipients and to TT in 9 of 13 TT recipients.
      Significantly higher IgG antibodies to maternal vaccine antigens were present in
      cord and infant serum. Significant blastogenic responses were seen to influenza A
      and B in maternal cells of TIV-immunized women but not in cord or infant
      lymphocytes. Maternal immunization resulted in higher infant levels of vaccine
      specific IgG antibody but not in the transfer of specific T lymphocyte
      response(s) or production of neonatal IgM antibody.

PMID- 8354907
TI  - Comparison of endotoxin release by different antimicrobial agents and the effect
      on inflammation in experimental Escherichia coli meningitis.
AB  - In a rabbit Escherichia coli meningitis model, endotoxin liberation and
      concentrations of leukocytes, tumor necrosis factor (TNF), and lactate were
      compared after a single intravenous dose of cefotaxime, cefpirome, meropenem,
      chloramphenicol, or gentamicin. These antibiotics caused a 2- to 10-fold increase
      in cerebrospinal fluid concentrations of free (filterable) endotoxin within 2 h
      of starting treatment. By contrast, free endotoxin concentrations increased
      almost 100-fold in untreated animals 4 h later as bacteria continued to multiply.
      An initial enhancement of inflammation in the central nervous system occurred in
      all treatment groups compared with untreated controls. No significant differences
      were observed between treatment groups except for lower TNF concentrations in
      chloramphenicol-treated animals. Antibiotic therapy in E. coli meningitis,
      irrespective of the agent used, may result in an increase in free endotoxin and
      enhancement of inflammation, but the amount of endotoxin liberated is
      considerably smaller than that shed by untreated bacteria.

PMID- 8354908
TI  - Induction of immunologic memory in infants primed with Haemophilus influenzae
      type b conjugate vaccines.
AB  - The ability of different Haemophilus influenzae type b conjugate vaccines to
      induce immunologic memory was compared in 381 infants who were vaccinated with
      one of three conjugate vaccines beginning at 2 months of age. All infants were
      vaccinated with unconjugated type b capsular polysaccharide, polyribosylribitol
      phosphate (PRP), at 12 months. In each group, high antibody responses were
      detected by 6-9 days after vaccination. One month after receiving PRP, infants
      primed with PRP conjugated to the outer membrane protein of Neisseria
      meningitidis or PRP oligomers conjugated to the cross-reactive mutant diphtheria
      protein, CRM197, had twofold higher total anti-PRP antibody concentrations than
      did infants primed with PRP conjugated to tetanus toxoid (P < .005). After the
      conjugate and the PRP boost, notable differences were present among vaccine
      groups with respect to the magnitude of the IgG anti-PRP antibody concentrations
      and light chain variable region usage as determined by idiotypic analysis. Thus,
      each of the conjugate vaccines primed infants for the ability to evoke memory
      antibody responses to PRP, but qualitative and quantitative differences in
      priming induced by different vaccines may affect their ability to confer
      protection against disease.

PMID- 8354909
TI  - Triple combination penicillin-vancomycin-gentamicin for experimental endocarditis
      caused by a highly penicillin-and glycopeptide-resistant isolate of Enterococcus
      faecium.
AB  - A combination of low-dose penicillin (75,000 IU/kg twice daily [b.i.d.])
      vancomycin (30 mg/kg b.i.d.) and gentamicin (6 mg/kg b.i.d.) has been shown to be
      as effective as a combination of high-dose penicillin (500,000 IU/kg b.i.d.) and
      gentamicin (6 mg/kg b.i.d.) in the treatment of rabbit endocarditis caused by an
      Enterococcus faecium strain moderately resistant to beta-lactams and highly
      resistant to glycopeptides. The same regimens were evaluated against an E.
      faecium strain highly resistant to both penicillin (MIC, 128 micrograms/mL) and
      vancomycin (MIC, 512 micrograms/mL). High doses of penicillin-gentamicin and
      vancomycin-gentamicin had no effect in in vitro killing-curve studies or in
      rabbits after treatment for 5 days. High doses of penicillin-vancomycin were only
      bacteriostatic in killing curves and provided a small reduction in the bacterial
      titers of the vegetations. In contrast, high-dose penicillin-vancomycin
      gentamicin was bactericidal in vitro and highly effective in treating rabbits.
      However, the emergence of a bacterial subpopulation resistant to the synergistic
      effect of penicillin and vancomycin could reduce the clinical utility of this
      combination.

PMID- 8354910
TI  - Norway rats as reservoir hosts for Lyme disease spirochetes on Monhegan Island,
      Maine.
AB  - To determine whether the agent of Lyme disease, Borrelia burgdorferi, may be
      maintained in the absence of its usual white-footed mouse reservoir host, Ixodes
      dammini ticks from an island where mice are absent were examined. Prevalence of
      spirochetal infection was described for ticks removed from mammals, birds, and
      vegetation on Monhegan Island, Maine. Forty percent of adult I. dammini removed
      from vegetation were infected. Norway rats were heavily infested with ticks, and
      > 60% of such ticks contained spirochetes. Other hosts were less frequently
      infested by ticks, and few such ticks were infected by spirochetes. The
      prevalence of antibody to B. burgdorferi was 23% in dogs and cats; 4% of island
      residents had Lyme disease. Thus, rats maintain Lyme disease spirochetes on
      Monhegan Island, and there may be transmission of this agent by I. dammini to
      island residents and their pets.

PMID- 8354911
TI  - Combination therapy in experimental invasive aspergillosis.
AB  - Combination antifungal therapy was assessed in an immunosuppressed rabbit model
      of invasive aspergillosis. Treatment with fluconazole, amphotericin B, or a
      combination of both significantly prolonged survival of animals lethally
      challenged with Aspergillus fumigatus. High-dose amphotericin B was the most
      effective therapy for invasive aspergillosis. Although no antagonism was seen
      when fluconazole was given prophylactically or therapeutically in combination
      with amphotericin B, combination therapy did not augment the antifungal activity
      of amphotericin B. Animals given a sublethal challenge of A. fumigatus had lower
      mortality rates when given amphotericin B, fluconazole as treatment or
      prophylaxis, or various combination therapies. Only animals treated with
      flucytosine had mortality rates comparable to those of controls. No antagonism
      was observed with combinations of fluconazole and amphotericin B, flucytosine and
      amphotericin B, or fluconazole and flucytosine. These observations provide
      evidence that fluconazole, flucytosine, and amphotericin B used in various
      combinations are not antagonistic and may provide some insight into the treatment
      of invasive aspergillosis in humans.

PMID- 8354912
TI  - Epidemiology of cutaneous leishmaniasis in Colombia: a longitudinal study of the
      natural history, prevalence, and incidence of infection and clinical
      manifestations.
AB  - This prospective study measured the incidence of Leishmania infection, by
      Leishmanin skin test (LST) conversion, and leishmaniasis, by new acquisition of
      lesions, in a Leishmania braziliensis endemic area of Colombia, during 7243
      person-years. The incidence rate of infection and leishmaniasis varied greatly by
      village, ranging from 2.8 to 23.0/100 person-years and 0.0 to 20.4/1000 person
      years, respectively. Adult males experienced greater rates of both infection and
      leishmaniasis. Most primary infections (91%) were subclinical initially. Typical
      scars were predictive of subsequent leishmaniases both for persons initially LST
      reactive (risk ratio = 11.3, P = .003) and for those initially nonreactive (risk
      ratio = 3.2, P = .02). Only one-third of the diagnosed leishmaniasis cases
      (24/77) were due to newly acquired infections in naive hosts. The relative
      contribution of existing lesions, recurrences, and new infections to the burden
      of disease should be considered in the planning of leishmaniasis control
      programs.

PMID- 8354913
TI  - Epidemiology of cutaneous leishmaniasis in Colombia: environmental and behavioral
      risk factors for infection, clinical manifestations, and pathogenicity.
AB  - Through a longitudinal, active surveillance for Leishmania (Viannia) braziliensis
      and Leishmania (Viannia) panamensis infection and lesions on the Pacific Coast of
      Colombia, risk factors for infection (leishmanin skin test conversion),
      leishmanial lesions, and pathogenicity were examined. Risk factor information was
      obtained prior to and independently of case ascertainment. Similar factors were
      associated with acquisition of infection and of leishmaniasis, including male
      sex, age > 10 years, and farming occupation. The behaviors of entering the forest
      after sunset, hunting, and lumbering were most strongly associated with
      Leishmania infection independently of age, sex, and farming occupation.
      Environmental conditions associated with infection, including tall trees near the
      home, home located > 15 m from the nearest neighbor, and floor and roof made of
      open material, were less strong predictors of risk. Pathogenicity, the risk of
      lesion given a new infection, was reduced in those > 30 years of age and those
      entering the forest frequently.

PMID- 8354914
TI  - Direct detection of infectious human immunodeficiency virus type 1 (HIV-1) immune
      complexes in the sera of HIV-1-infected persons.
AB  - The sera of human immunodeficiency virus type 1 (HIV-1)-infected subjects were
      examined for the presence of infectious HIV-1-antibody complexes by their ability
      to infect Fc gamma receptor (Fc gamma R)-bearing cells. Infection of Fc gamma R
      bearing cells by a serum in which half of the p24 antigen was present in a form
      of immune complexes was inhibited by aggregated human immunoglobulin. Then in
      studies on 22 sera, 9 sera produced p24 antigen during 14 days of culture in U937
      cells. HIV-1 p24 production was inhibited or delayed by the pretreatment of cells
      with aggregated human immunoglobulin in 6 of the 9 sera that were infectious.
      These results may reflect interactions between virus-antibody complexes and Fc
      gamma R-bearing cells in vivo because serum itself was used as the source of
      virus and virus-antibody complexes. The results indicate that infectious HIV-1
      immune complexes are present in the circulation of HIV-1-infected patients.

PMID- 8354915
TI  - Endemic human T cell leukemia virus type II infection in southwestern US Indians
      involves two prototype variants of virus.
AB  - Human T cell leukemia virus (HTLV) type II is endemic in certain American
      Indians, and high rates of infection occur in intravenous drug users (IVDUs).
      North American IVDUs are infected with two distinct variants, HTLV-IIa and -IIb.
      If IVDUs became infected as a result of interaction with members of an American
      Indian population, both viral forms should be demonstrable in such populations.
      Nucleotide sequence analysis of 630 bases of the env gene encoding the gp21
      protein was done on DNA from 12 New Mexico Indians (8 Pueblo, 4 Navajo). All
      samples were typical subtype a or b viruses. Seven of the 8 Pueblo and 2 of 4
      Navajo had subtype b; the rest had subtype a. The results are compatible with an
      indigenous New World origin for both subtypes of HTLV-II.

PMID- 8354916
TI  - Campylobacter immunity and quantitative excretion rates in Thai children.
AB  - Campylobacter species were isolated from 61 (15%) of 416 Thai children < 5 years
      old with diarrhea. Although the baseline levels of Campylobacter-specific
      antibody increased with age, 80.3% of Campylobacter-infected children
      seroconverted compared with 12.9% of 45 Shigella-infected patients used as
      controls. The response to acute infection was greatest in the 6- to 12-month-old
      group. Nonseroconverters had higher initial IgG levels than did seroconverters (P
      = .001). Quantitative cultures showed a range of 1-8 log10 Campylobacter cfu/g of
      stool (median, 6.0 log10), and the seroconversion rate was highest in those with
      the highest Campylobacter excretion. Fecal Campylobacter excretion was inversely
      related to age (chi 2 for trend, P = .03). These studies indicate that endemic
      Campylobacter exposure frequently induces seroconversion in young children,
      whether Campylobacter is isolated as a single pathogen or one of multiple
      pathogens, and that fecal excretion of the organism is inversely related to the
      age-related immune response to infection.

PMID- 8354917
TI  - Capsular types of Vibrio vulnificus: an analysis of strains from clinical and
      environmental sources.
AB  - Vibrio vulnificus produces a capsular polysaccharide (CPS) that is essential for
      virulence. CPS from V. vulnificus clinical strain MO6-24 has been purified and
      the structure determined. In preliminary screening with antisera raised to MO6-24
      CPS, 4 (19%) of 21 clinical isolates (including MO6-24), but none of 67
      environmental V. vulnificus isolates, agglutinated with anti-MO6-24 antisera (P =
      .003). CPS was isolated from a subset of 12 clinical and 7 environmental isolates
      and analyzed by high-performance anion-exchange chromatography and one
      dimensional nuclear magnetic resonance. MO6-24 and 1 other serologically positive
      strain had identical CPS structures; the other 2 serologically positive strains
      had substitutions in two of four sugar residues. Thirteen other capsular types
      were identified among the remaining 15 strains from which CPS was extracted.

PMID- 8354918
TI  - Kinetics of specific IgG antibodies for monitoring the effect of anti
      Helicobacter pylori chemotherapy.
AB  - A total of 104 patients with recurrent duodenal ulcer were treated with either
      ranitidine plus amoxicillin plus metronidazole or ranitidine plus placebo. To
      study the effect of the eradication of Helicobacter pylori on the systemic immune
      response in an IgG ELISA, sera were drawn from all patients before the onset of
      therapy and at 6, 16 +/- 2, 32 +/- 2, and 60 +/- 2 weeks after therapy. In
      patients with eradication of the organism, a significant (P < .001) reduction of
      the specific IgG titer occurred. This was not observed in patients without
      bacterial eradication. If a titer reduction of > 50% was taken as an indicator
      for eradication of H. pylori, the sensitivity of the serologic test was 97.6%
      99.7%. Its specificity increased with the interval to the onset of chemotherapy
      from 56.3% to 97.6%. Serologic tests are simple to perform and cause very little
      discomfort to the patient.

PMID- 8354919
TI  - Salicylate potentiates amikacin therapy in rodent models of Klebsiella pneumoniae
      infection.
AB  - In vitro effects of salicylate on Klebsiella pneumoniae include capsule
      repression and enhanced aminoglycoside activity. The effects of high-dose
      salicylate on amikacin therapy were assessed in animal models. In a mouse
      lethality model, amikacin protective doses were reduced up to 12-fold by
      salicylate doses of 277 mg/kg. Salicylate alone increased the LD50 for K.
      pneumoniae in mice by nearly 1 log unit. In a lobar pneumonia model, rats
      received salicylate-amikacin intravenously 3 days after challenge, and bacteria
      were quantified from lung tissue on day 7. Rats receiving one-fourth the minimum
      effective amikacin dose had 1 x 10(6) cfu/g of lung, while no bacteria were
      detected in those also receiving salicylate (173 mg/kg). At one-eighth the
      minimum effective dose of amikacin, salicylate prevented the development of
      pneumonia. Salicylate potentiation of antimicrobial therapy far surpassed that
      observed in vitro, yet the potentiation was abolished in neutropenic animals.
      Thus, salicylate may enhance phagocytosis rather than antibiotic action in
      therapy.

PMID- 8354920
TI  - Use of polymerase chain reaction in an epidemiologic investigation of Pontiac
      fever.
AB  - In June 1992, 13 (38%) of 34 resort guests experienced illness that met a symptom
      based case definition of Pontiac fever. Each ill guest reported using an indoor
      hot tub compared with 6 (29%) of 21 nonill guests (P < .001). Water samples from
      the indoor hot tub were culture-negative for legionellae using standard
      techniques, coculture with amebae, and intraperitoneal inoculation of guinea
      pigs. However, polymerase chain reaction (PCR) testing of the water samples
      indicated the presence of Legionella pneumophila. Direct fluorescent antibody
      testing identified the organism as serogroup 6. Seroconversion to L. pneumophila
      serogroup 6 occurred in 7 (64%) of 11 ill guests and none of 5 nonill guests (P =
      .03). These results suggest that in certain circumstances, culture of
      environmental samples should be supplemented with additional tests such as PCR.
      These results are also consistent with the concept that Pontiac fever can be
      caused by nonviable legionellae.

PMID- 8354921
TI  - Prospective evaluation of red man syndrome in patients receiving vancomycin.
AB  - The incidence of red man syndrome (RMS) and its relationship to histamine were
      investigated in patients receiving vancomycin or an aminoglycoside (control).
      During the 60-min infusions, patients were observed for signs or symptoms
      consistent with RMS, including pruritus, erythema, angioedema, and cardiovascular
      depression. Four blood samples were obtained at 30-min intervals for
      determination of histamine concentrations. One (3.4%) of 29 vancomycin- and none
      of 8 aminoglycoside-treated patients had documented RMS. The mean maximum changes
      in blood pressure and heart rate were not significant and were similar between
      groups. Increases in histamine concentrations to > 1 ng/mL occurred only in 25%
      (2/8) of the aminoglycoside patients. Vancomycin induced minimal changes in
      histamine concentrations despite the occurrence of RMS. From these observations,
      it appears that RMS is not closely associated with histamine release, and
      elevated histamine concentrations do not predict RMS. Further investigation is
      needed to elucidate other mediators of RMS.

PMID- 8354922
TI  - Isolation of Mycobacterium avium complex from bone marrow aspirates of AIDS
      patients in Brazil.
AB  - Mycobacterium avium complex (MAC) infection has not been reported as a major
      opportunistic infection among patients with AIDS in Latin America or Africa. In
      this study, 125 AIDS patients who had persistent fever, anemia, and leukopenia
      were examined among 2628 AIDS patients admitted to Instituto de Infectologia
      Emilio Ribas between May 1990 and April 1992. From the bone marrow aspirates of
      the 125 patients, MAC was isolated from 23 (18.4%) and Mycobacterium tuberculosis
      was isolated from 9 (7.2%). Between 1985 and 1990, only 11 MAC isolations among
      60,000 cultures obtained from human immunodeficiency virus-seronegative patients
      were documented in Sao Paulo. Hence, the minimal estimated rate of MAC infection
      in AIDS patients in this city was 23/2628, or 0.88%. These findings suggest that
      MAC infection is an important opportunistic infection, especially among a subset
      of patients with AIDS in Brazil who have clinical characteristics and risk
      activities similar to those associated with MAC infections in North America and
      Europe.

PMID- 8354923
TI  - Polymerase chain reaction for the diagnosis of candidemia.
AB  - A PCR assay was developed for the diagnosis of candidemia. Primers were selected
      to amplify a 158-bp segment from the Candida actin gene that was detected by
      hybridization with a 32P-labeled oligomer probe. The lower limit of detection was
      DNA extracted from 10 Candida yeasts/sample, or 25 fg of purified Candida
      albicans DNA. This PCR was specific for medically important Candida species.
      Circulating Candida DNA was detected by this PCR from plasma of mice with induced
      candidemia and from sera in 11 (79%) of 14 patients with blood cultures positive
      for Candida species. This PCR may offer a sensitive method for diagnosis of
      candidemia.

PMID- 8354924
TI  - Serum IgG reactivity with 41-, 31-, and 28-kDa larval proteins of Strongyloides
      stercoralis in individuals with strongyloidiasis.
AB  - Proteins from a deoxycholate-soluble extract of Strongyloides stercoralis
      infective larvae were separated by SDS-PAGE, blotted onto nitrocellulose paper,
      and reacted with sera from individuals with confirmed S. stercoralis infections
      (n = 100), suspected S. stercoralis infections in whom no larvae could be
      detected (n = 27), and other nematode infections (40 with Wuchereria bancrofti,
      20 with Onchocerca volvulus, 20 with Necator americanus, and 20 with mixed
      Ascaris lumbricoides and Trichuris trichiura infections). Immunodominant proteins
      of approximately 41, 31, and 28 kDa were recognized by IgG in 91%, 88%, and 90%,
      respectively, of sera from those with confirmed strongyloidiasis; in 100%, 100%,
      and 93% of sera from those with suspected strongyloidiasis; and in 9%, 12%, and
      14% of sera from those infected with other nematodes. IgG reactivity to each of
      these proteins was a more specific means of immunodiagnosis than the currently
      used indirect ELISA; the methods were equally sensitive.

PMID- 8354925
TI  - Treponemal infection and outcome of pregnancy.

PMID- 8354926
TI  - Interferon-alpha therapy for patients with chronic fatigue syndrome.

PMID- 8354927
TI  - Evidence of direct transmission of Escherichia coli O157:H7 infection between
      calves and a human.

PMID- 8354928
TI  - Liposome-encapsulated ciprofloxacin is effective in the protection and treatment
      of BALB/c mice against Francisella tularensis.

PMID- 8354929
TI  - The value of the second blood culture.

PMID- 8354930
TI  - Tampon-collected genital cells in the detection of Chlamydia trachomatis by
      polymerase chain reaction.

PMID- 8354931
TI  - Rapid detection of acute cholera in airline passengers by coagglutination assay.

PMID- 8354932
TI  - Determination of Mycobacterium leprae viability by polymerase chain reaction
      amplification of 71-kDa heat-shock protein mRNA.

PMID- 8354933
TI  - Soluble interleukin-2 receptor is involved during systemic mycosis.

PMID- 8354934
TI  - [Structure and functions of vacuolar-type H(+)-ATPase from animal cells].

PMID- 8354936
TI  - [Catenins: the proteins associated with the cytoplasmic domain of cadherins].

PMID- 8354935
TI  - [Biosynthesis, processing and activity control of cathepsin E].

PMID- 8354937
TI  - [Phosphorylation in tau protein].

PMID- 8354938
TI  - [Fractionation of capillary HPLC peaks for protein sequencing].

PMID- 8354939
TI  - Pursuing an elusive goal: molding strategic teachers and learners.

PMID- 8354940
TI  - Integrative strategy instruction: a potential model for teaching content area
      subjects to adolescents with learning disabilities.
AB  - In part because learning strategies are often taught in isolated resource
      settings outside of the contexts in which students with learning disabilities are
      expected to apply this knowledge, generalization has been a significant challenge
      to educators. To address this problem, an instructional model is proposed for
      integrating cognitive strategy instruction and content area instruction when
      teaching students in content area classes. Teacher-directed instructional
      procedures, cooperative learning, and direct explanation and dialectical strategy
      instruction are integrated into four key instructional processes: orienting,
      framing, applying, and extending. In this model, teacher-mediated instructional
      devices and routines used to teach content area subjects serve as a basis for
      teaching students to self-mediate parallel cognitive strategies and processes.
      The model is discussed in terms of its theoretical and philosophical orientations
      as manifested in its knowledge and instructional bases. A scenario is provided
      that depicts a social studies teacher implementing many of the principles and
      methods associated with the model.

PMID- 8354941
TI  - Devices and desires: integrative strategy instruction from a motivational
      perspective.

PMID- 8354942
TI  - Special education for the twenty-first century: integrating learning strategies
      and thinking skills.

PMID- 8354943
TI  - Ellis's "potential" integrative strategy instruction model: an appealing
      extension of previous efforts.

PMID- 8354944
TI  - A four-year longitudinal investigation of the social skills and behavior problems
      of students with learning disabilities.
AB  - This longitudinal, prospective study investigated the social skills and behavior
      problems of three groups of students (10 students per group) from kindergarten
      through third grade: learning disabilities (LD), low achievement (LA), and
      average/high achievement (A/HA). Social skills and behavior problem rating scales
      were completed by teachers on all students during kindergarten through third
      grade. Students in the LD and LA group exhibited significantly lower social
      skills and higher levels of behavior problems than their A/HA peers, but no
      significant differences for either measure were found between the LD and LA
      groups. Scores on the cooperating/responding factor of the social skills rating
      scale increased over time, but scores on the outgoing/initiating factor of the
      social skills rating scale did not change significantly over time. Discussion
      focused on the finding that students in the LD and LA groups did not differ
      significantly on social skills or behavior problems over time, though both groups
      demonstrated more behavior problems and lower social skills than the A/HA
      students.

PMID- 8354945
TI  - Referral-to-placement ratio: a finding in need of reassessment?
AB  - Previous research has reported that the number of evaluated children placed in
      special education is as high as three out of four. The purpose of the present
      study is to reassess, extend, and update referral-to-placement research. Subjects
      consisted of 236 predominantly white children referred for special education
      evaluation from 12 suburban and rural school districts. Of the 236 pupils
      referred, 128 were diagnosed as learning disabled (LD) by a multidisciplinary
      team (MDT). The 128 students identified as eligible for services for students
      with LD had a mean IQ of 96.43 and a mean age of 10.2. The majority of the
      subjects were male (70%). The results suggest that the number of students
      referred who are actually placed is lower (approximately one out of two) than
      previously reported. It is concluded that further research is needed to verify
      the current referral-to-placement ratio and to explore the factors influencing
      this ratio.

PMID- 8354946
TI  - The relationship between learning disabilities and persisting delinquency.
AB  - Recidivism of delinquency in juveniles with learning disabilities (LD), the focus
      of the present study, has been virtually unexplored in previous research. Data
      from a longitudinal study initiated in 1978 are examined. Sixty-five subjects
      with LD (47 males and 18 females) who had been diagnosed and assessed between the
      ages of 8 and 12 years were located and, during a personal structured interview
      at the median age of 18 years, reported police contact. This population was
      subdivided into two groups on the basis of whether police contact had continued
      or discontinued, as reported in a second personal interview at the age of 25
      years. Discriminant analysis on parent and subject variables correctly classified
      75% of the subjects and revealed that certain personality characteristics, such
      as impulsivity and poor judgment, discriminate between persisting and
      nonpersisting delinquency in youth with learning disabilities.

PMID- 8354947
TI  - Effect of aging on cholesterol 7 alpha-hydroxylation in humans.
AB  - In order to investigate the alterations of bile acid synthesis in aging, we
      studied the rates of cholesterol 7 alpha-hydroxylation, the rate-limiting step,
      in 28 patients of different ages (34-83 years old, 14 below and 14 above the age
      of 65) of both sexes. Hydroxylation rates were determined by tritium release
      assay after an intravenous bolus of [7 alpha-3H]cholesterol. Cholesterol 7 alpha
      hydroxylation was significantly decreased in the older age group, compared to
      middle-aged subjects, both in males and females; moreover, a significant inverse
      correlation between hydroxylation rates and age was found in the whole sample (r
      = -0.56; P < 0.01) and in females, but not in males. The percent concentration of
      deoxycholic acid in plasma (determined by gas-liquid chromatography) was
      increased in older subjects. Plasma cholesterol and triglyceride levels were not
      related with age even though triglyceride concentrations tended to be lower in
      the older age group. Triglyceride, but not cholesterol levels, were directly
      correlated with hydroxylation rates (r = 0.45, P < 0.05). After cholestyramine
      treatment (8-12 g/day for 4 weeks) a sharp increase in 7 alpha-hydroxylation
      rates was observed in three elderly patients, accompanied by reduced levels of
      dihydroxylated bile acids. Our data are consistent with a reduced rate of
      conversion of cholesterol to bile acids with aging, particularly in females, and
      suggest a coordinate reduction of triglyceride production. Alterations of the
      quantitative and/or qualitative pattern of the bile acid pool recirculating to
      the liver may be responsible, at least in part, for the changes observed.

PMID- 8354948
TI  - Analysis of plasma lipids by NMR spectroscopy: application to modifications
      induced by malignant tumors.
AB  - Lipid extracts of plasma were studied by 31P and 1H NMR spectroscopy at 9.4 T.
      Signals recorded on lipid mixtures were assigned to different lipid classes using
      a data base built with two-dimensional 1H COSY spectra of seven standard lipids.
      Signals unique to glycerophospholipids, sphingolipids, and triacylglycerols were
      identified. 31P and 1H NMR spectroscopy was used to study qualitative and
      quantitative modifications induced in plasma by malignant tumors. The results
      show a significant increase in triglyceride/phospholipid ratio and a concomitant
      decrease of total phospholipids in patients with cancer. In order to check for
      the possible presence of particular lipids such as glycolipids in these patients,
      1H COSY spectra were recorded on the intact plasma and on extracts of plasma
      lipids in patients with cancer and in healthy subjects. Only in one case of
      ovarian cancer, a cross-peak at 1.35 and 4.15 ppm, corresponding to fucose
      residue in glycolipids, was detected.

PMID- 8354949
TI  - Analysis of techniques to obtain plasma for measurement of levels of free fatty
      acids.
AB  - Accuracy in measurement of plasma free fatty acids (FFA), and therefore
      prevention of the in vitro lipolysis, is a crucial step to understand the
      physiologic role of plasma FFA and their relationships in the pathogenesis of
      important metabolic disorders such as central obesity, insulin resistance, and
      diabetes mellitus. As lipoprotein triglyceride-fatty acids are elevated in these
      states, in vitro lipolysis of triglycerides may artifactually increase FFA.
      Plasma FFA were measured in subjects before and after heparin administration,
      under different experimental conditions affecting the in vitro activity of
      lipoprotein lipase (LPL) and hepatic lipase (HL). Paraoxon, a cholinesterase
      inhibitor neurotoxin known to block plasma lipolytic activity, and preextraction
      timing and temperature of collection were tested. Paraoxon was required to
      prevent triglyceride hydrolysis in: a) preheparin plasma allowed to stand at room
      temperature (21 degrees C) for 2 h, before being frozen at -20 degrees C (FFA =
      1817 +/- 291 vs. 698 +/- 66 microEq/l, P < 0.005, mean +/- SEM, without and with
      paraoxon, respectively); and b) in postheparin plasma immediately stored at -20
      degrees C (FFA = 2682 +/- 357 vs. 1299 +/- 150 microEq/l, P < 0.005, without and
      with paraoxon, respectively). No difference in the FFA level was found in
      preheparin plasma collected either with or without paraoxon when: a) the samples
      were placed in ice and immediately assayed; b) the specimens were immediately
      frozen at -70 degrees C and assayed 60 days later.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8354950
TI  - Quantitation of plasma lipids by gas-liquid chromatography on high temperature
      polarizable capillary columns.
AB  - We have previously demonstrated the potential usefulness of capillary columns
      coated with a high temperature polarizable phenylmethylsilicone liquid phase in
      plasma lipid profiling (Kuksis, A., J.J. Myher, and P. Sandra. 1990. J.
      Chromatogr. 500: 427-441). The present study reports improved operating
      conditions along with a practical application to the analysis of a series of
      human plasma samples in comparison to capillary gas-liquid chromatography on
      nonpolar columns. For this purpose the plasma lipids were dephosphorylated with
      phospholipase C and converted to the trimethylsilyl ethers. The molecular species
      of the plasma lipids were identified by comparing the relative retention times to
      reference standards. The species were quantitated using tridecanoylglycerol as
      internal standard. The recoveries of the lipid classes were determined by summing
      the molecular species within each carbon number and comparing the proportion of
      the carbon numbers obtained on polar and nonpolar columns. The relative
      recoveries varied with the lipid class and sample load and averaged as follows:
      FA C16, 78%; FA C18, 78%; FC, 99%; tridecanoylglycerol (TD), 100% (by
      definition); CER 34:1, 92%; DG C34, 103%; DG C36, 98%; CE C16, 73%; CE C18, 61%;
      TG C50, 93%; TG C52, 60%; TGC54, 32%. We conclude that high temperature
      polarizable capillary columns are suitable for qualitative and quantitative
      assessment of plasma lipids and provide more information per man-hour, instrument
      time, and unit cost than any other analytical method known.

PMID- 8354951
TI  - Evaluation of deuterated cholesterol and deuterated sitostanol for measurement of
      cholesterol absorption in humans.
AB  - The continuous isotope feeding method of Crouse and Grundy (1978. J. Lipid Res.
      19: 967-971) for measurement of dietary cholesterol absorption has been modified
      by using markers labeled with stable isotopes ([2,2,4,4,6-2H5]cholesterol or
      [25,26,26,26,27,27,27-2H4]cholesterol or [26,26,26,27,27,27-2H6] cholesterol and
      [5,6,22,23-2H4]sitostanol) quantified by gas-liquid chromatography-selected ion
      monitoring. Tracing of the isotope distribution of the authentic markers and
      after their intestinal passage, including the microbiological products
      (coprostanol and coprostanone) revealed stability of the labels. The new method
      was evaluated in six monkeys on two occasions by comparison with the original
      method using radioactively labeled cholesterol and sitosterol. The results
      obtained by the two different methods were in excellent agreement, and absorption
      ranged from 49% to 73% (mean 60%) for the stable isotope method and from 51% to
      69% (mean 62%) for the radioactive method. The coefficient of variation of
      cholesterol absorption in animals ranged from 3.9% to 15.1% (mean 7.1%) for
      stable isotopes and 1.9% to 13.6% (mean 5.7%) for radioactive isotopes. In twelve
      subjects cholesterol absorption was measured by the new method from total fecal
      samples frozen immediately and compared to results obtained from small fecal
      aliquots (approximately 1 g) sent by ordinary mail to the laboratory. A
      significant correlation of cholesterol absorption between the two different
      sample handlings was obtained (r = 0.981, P < 0.001). In addition, measurement of
      cholesterol absorption twice in seven volunteers 2 weeks apart revealed identical
      results. Thus, the new method is extremely safe and reproducible without
      radioactive exposure to the subjects and labortory staff and can be used on women
      of child-bearing age.

PMID- 8354952
TI  - Assessment of percent cholesterol absorption in humans with stable isotopes.
AB  - Dietary cholesterol restriction is a general recommendation for the medical
      community and emphasizes the importance of intestinal cholesterol absorption and
      metabolism in humans. However, several methods that may accurately quantify
      cholesterol absorption utilize radioactive isotopes that are undesirable for
      younger individuals, women, children, and normal subjects. To eliminate this
      hazard, we have developed a procedure for measurement of percent cholesterol
      absorption, based on that of Zilversmit (1972. Proc. Soc. Exp. Med. Biol. 140:
      862-865), using stable nonradioactive isotopic tracers of cholesterol.
      [26,26,26,27,27,27-2H]cholesterol (30 mg) was administered orally and
      [23,24,25,26,27-13C]cholesterol (15 mg) was administered intravenously on day 0
      and percent cholesterol absorption was calculated as the plasma ratio of
      oral/intravenous isotopic tracer on day 3 as determined by gas chromatography
      mass spectrometry with selected ion monitoring. Tracer cholesterol given orally
      peaked in plasma on day 2 and then slowly declined in parallel with the
      intravenous tracer. Cholesterol absorption in 16 healthy subjects (on no
      medication and not ingesting alcohol) consuming a Step One Diet was 53.5% +/- 8.5
      SD%. Five subjects underwent repeat testing after 4-6 weeks with excellent
      replication (SD of difference between tests = 2.8%). No differences in the
      metabolism of [13C5]cholesterol, [2H6]cholesterol, and [14C]cholesterol were
      observed. The use of stable isotopes for the study of percent cholesterol
      absorption is precise and safe, allowing repeated measurements in normal
      individuals and thus facilitating clinical investigation of this key component of
      human cholesterol metabolism.

PMID- 8354953
TI  - Hypertriglyceridemia in nephrotic rats is due to a clearance defect of plasma
      triglyceride: overproduction of triglyceride-rich lipoprotein is not an
      obligatory factor.
AB  - This study was conducted to determine whether overproduction of triglyceride-rich
      lipoprotein is an obligatory factor for experimental hypertriglyceridemia in
      nephrotic rats. Nephrosis was induced in male Wistar rats by administration of
      150 mg/kg puromycin aminonucleoside. Nephrotic rats had slightly increased
      triglyceride secretion rate (TGSR) estimated using Triton WR1339 (0.53 +/- 0.05
      vs. 0.45 +/- 0.04 mg/min, P < 0.05 vs. control rats) and marked
      hypertriglyceridemia (330.4 +/- 78.6 mg/dl). Rats made diabetic by 40 mg/kg
      streptozotocin were normotriglyceridemic (66.3 +/- 12.1 mg/dl) but had suppressed
      TGSR (0.33 +/- 0.09 mg/min). Experimental nephrosis was induced in diabetic rats.
      Their TGSR remained suppressed (0.35 +/- 0.06 mg/min) but they had marked
      hypertriglyceridemia (296.6 +/- 72.4 mg/dl) suggesting further impairment of
      triglyceride removal from the circulation in diabetic rats caused by nephrosis.
      Endogenously radiolabeled very low density lipoprotein (VLDL)-triglyceride from
      donor rats was reinjected into normal recipient rats. [3H]VLDL from the
      experimental groups (the rats with nephrosis, diabetes with nephrosis, and
      diabetes alone) were more slowly cleared by normal rats than VLDL from normal
      rats. These results suggest that circulating insulin is essential for increased
      triglyceride secretion in experimental nephrosis and that nephrotic
      hypertriglyceridemia can be induced only by a triglyceride removal defect.
      Therefore, hypersecretion of triglyceride-rich lipoprotein is not an obligatory
      factor for nephrotic hypertriglyceridemia.

PMID- 8354955
TI  - Genetic variation in mouse apolipoprotein A-IV expression is determined pre- and
      post-transcriptionally.
AB  - Among inbred mouse strains there is a striking genetic variation in the levels of
      apolipoprotein A-IV (apoA-IV) mRNA in the liver, although intestinal mRNA levels
      vary only twofold in these strains. In the present study we have characterized
      the apoA-IV expression phenotypes in strains C57BL/6J and 129/J, and investigated
      the molecular basis for the genetic variation. We report that the two strains
      differ eight- to tenfold both in the levels of apoA-IV mRNA and in the rate of
      apoA-IV protein synthesis in liver. Presumably due to the increased synthetic
      rate, strain 129 exhibits a threefold higher concentration of apoA-IV protein in
      the circulation. mRNA synthesis and turnover studies indicate that both
      transcriptional and post-transcriptional events contribute to the genetic
      variation in steady state apoA-IV mRNA levels. An analysis of the levels of apoA
      IV mRNA derived from 129 and C57BL/6 alleles in F1 mice indicates that the
      genetic control of apoA-IV mRNA levels involves both cis-acting elements linked
      to the apoA-IV gene, and genetically distinct trans-acting factors.

PMID- 8354956
TI  - Effect of membrane lipids on the lactosylceramide molecular species specificity
      of CMP-N-acetylneuraminate:lactosylceramide sialyltransferase.
AB  - It has previously been shown that when the molecular species specificity of rat
      liver Golgi CMP-N-acetylneuraminate:lactosylceramide alpha 2,3-sialyltransferase
      was determined, using as the substrate lactosylceramide (LacCer) incorporated
      into liposomes prepared with rat liver Golgi lipids, the enzyme showed a
      pronounced variation in activity towards the various molecular species of LacCer
      (J. Lipid Res. 1989. 30: 1789-1797). In this paper, -the LacCer molecular species
      specificity of sialyltransferase from neuroblastoma NB2a cells was examined using
      five naturally occurring and three synthetic molecular species of LacCer. The
      enzyme activity was determined by following the formation of [14C]GM3 from CMP
      [14C]neuraminic acid and individual molecular species of LacCer incorporated into
      liposomes. Nonspecific lipid transfer protein was included in the enzyme assay to
      facilitate the transfer of LacCer and other lipids between the liposomes and the
      membrane where sialyltransferase is located. In these enzyme assays the liposomes
      contained approximately 10 times more lipid phosphorus than either the microsomal
      fraction of NB2a cells or the Golgi fraction of rat liver. Thus, in the presence
      of nonspecific lipid transfer protein, the lipid composition of the membrane
      where sialyltransferase is located was modified to resemble the lipid composition
      of the liposomes. When the molecular species specificity of NB2a cell
      sialyltransferase was determined with LacCer incorporated into liposomes prepared
      with NB2a cell lipids, the enzyme showed no specificity towards the various
      molecular species of LacCer. However, when the molecular species specificity of
      NB2a cell sialyltransferase was determined with LacCer incorporated into
      liposomes prepared with rat liver Golgi lipids, the enzyme showed a variation in
      activity towards the various LacCer molecular species similar to that observed
      with the liver Golgi enzyme using liposomes prepared with liver Golgi lipids.
      Likewise, when the molecular species specificity of rat liver Golgi
      sialyltransferase was determined with LacCer incorporated into liposomes prepared
      with NB2a cell lipids, the liver enzyme then showed no specificity towards the
      various molecular species of LacCer. These results indicate that the lipid
      environment of the membrane can alter the molecular species specificity of
      sialyltransferase towards its lipid substrate, LacCer.

PMID- 8354954
TI  - Cholesterol 7 alpha-hydroxylase: evidence for transcriptional regulation by
      cholesterol or metabolic products of cholesterol in the rat.
AB  - Cholesterol 7 alpha-hydroxylase, the rate-determining enzyme in the bile acid
      biosynthesis pathway, is regulated in a negative feedback manner by hydrophobic
      bile salts returning to the liver via the portal circulation. The role of
      cholesterol in the regulation of cholesterol 7 alpha-hydroxylase and the
      interrelationship between the cholesterol and bile acid biosynthesis pathways
      remain controversial. The objective of the present study was to define the role
      of cholesterol in the regulation of cholesterol 7 alpha-hydroxylase and determine
      the molecular level of its control. In order to avoid intestinal or intravenous
      administration of cholesterol, we manipulated the flow of cholesterol within the
      hepatocytes by decreasing cholesterol synthesis with lovastatin in bile fistula
      rats (bile acid synthesis is up-regulated), or by increasing cholesterol supply
      by administering mevalonate, a precursor of cholesterol, to rats with intact
      enterohepatic circulation (bile acid synthesis is normal). In the first series of
      studies, lovastatin was administered as a single intravenous bolus (10 mg/kg) to
      rats with chronic bile fistula and to rats with intact enterohepatic circulation
      (cholesterol and bile acid synthesis is normal). Three hours after lovastatin
      administration, cholesterol 7 alpha-hydroxylase specific activity, enzyme mass,
      mRNA, and gene transcriptional activity were decreased by 35%, 32%, 56%, and 34%,
      respectively, in rats with chronic bile fistula. In rats with intact
      enterohepatic circulation, lovastatin administration resulted in a similar
      decrease (34%) of cholesterol 7 alpha-hydroxylase specific activity.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8354957
TI  - Metabolism and choleretic activity of homochenodeoxycholic acid in the hamster.
AB  - The hepatic metabolism and the choleretic effect of homochenodeoxycholic acid,
      the C25 homologue of chenodeoxycholic acid, were investigated in the hamster.
      After intravenous administration of 3H-labeled homochenodeoxycholic acid into
      biliary fistula hamsters, more than 80% of the radioactivity was recovered in
      bile in 4 h. A relatively small proportion of homochenodeoxycholic acid was
      present in bile as the taurine (22%) or glycine (4%) conjugate. However, more
      than 70% of the administered compound was biotransformed into C23 bile acids. The
      major C23 metabolites in bile were norchenodeoxycholic acid (17%),
      tauronorchenodeoxycholic acid (33%), and a trihydroxy norbile acid (identified as
      3 alpha, 5 beta, 7 alpha-trihydroxy-24-nor-5 beta-cholan-23-oic acid, 19%). Small
      amounts (< 5%) of sulfate(s) and glucuronide(s) were also detected.
      Homochenodeoxycholic acid, when infused intravenously into the hamster, produced
      a striking choleresis. The increase in bile flow after infusion of this compound
      was 6- to 7-times that induced by chenodeoxycholic acid. The apparent choleretic
      activity of homochenodeoxycholic acid, 181 microliters/mumol, was much greater
      than that of chenodeoxycholic acid, 11 microliters/mumol. In conclusion,
      homochenodeoxycholic acid induced a hypercholeresis of the same order of
      magnitude as norchenodeoxycholic acid, presumably because considerable
      proportions of this compound were degraded to the hypercholeretic
      norchenodeoxycholic acid via beta-oxidation in the liver.

PMID- 8354958
TI  - Effect of dietary cholesterol and taurocholate on cholesterol 7 alpha-hydroxylase
      and hepatic LDL receptors in inbred mice.
AB  - Compared to BALB/c mice, inbred C57BL/6 mice are more susceptible to developing
      fatty streak atherosclerotic lesions when fed a cholesterol-rich diet containing
      taurocholate. We examined the metabolic basis for the taurocholate requirement.
      In contrast to widely accepted assumptions, taurocholate did not increase
      cholesterol absorption in either strain of mouse. However, in susceptible C57BL/6
      mice, taurocholate was required to increase plasma concentrations of apoB. In
      both strains, the cholesterol-rich diet increased both the activity and mRNA for
      7 alpha-hydroxylase, a compensatory response to maintain cholesterol homeostasis.
      In both strains, adding taurocholate to the diet suppressed both the activity and
      mRNA for 7 alpha-hydroxylase, thus blocking this important compensatory response.
      The cholesterol-rich diet (without taurocholate) significantly increased hepatic
      cholesterol content in both strains of mice, but repressed low density
      lipoprotein (LDL) receptor mRNA only in BALB/c mice (not in C57BL/6 mice).
      However, adding taurocholate to the cholesterol-rich diet did decrease LDL
      receptor mRNA in C57BL/6 mice. In C57BL/6, but not in BALB/c mice, there was a
      linear parallel relationship between 7 alpha-hydroxylase mRNA and LDL receptor
      mRNA. These data show the existence of strain-specific differences in the effects
      of dietary cholesterol and taurocholate on 7 alpha-hydroxylase and LDL receptor
      expression. The combined data suggest that genetic factors determine how the
      expression of hepatic LDL receptors responds to dietary cholesterol and
      taurocholate.

PMID- 8354959
TI  - Dietary cholesterol stimulates hepatic biosynthesis of triglyceride and reduces
      oxidation of fatty acids in the rat.
AB  - Experiments were conducted in the intact rat and in the isolated, perfused rat
      liver to investigate the possibility that the increase in the concentration of
      hepatic triglyceride and increase in the secretion of the very low density
      lipoprotein (VLDL)-triglyceride (TG) resulting from addition of cholesterol to
      the diet are due to stimulation of synthesis of triglyceride, reduced fatty acid
      oxidation, or both. Male rats were fed for 7 days with either a cholesterol-free
      diet to which 5% (w/w) corn oil was added, or with the same diet supplemented
      with 0.5% cholesterol. Fed animals received [1-14C]oleic acid via the tail vein,
      as a complex with rat serum, and were killed 2 h later. Feeding cholesterol for 7
      days increased hepatic triglyceride and cholesteryl ester (CE) concentrations,
      moderately elevated free cholesterol, but did not affect phospholipid (PL)
      levels, as we had previously observed after a feeding period of 3 weeks.
      Incorporation of [1-14C]oleic acid into hepatic and plasma triglyceride increased
      significantly (60 and 48%, respectively) with cholesterol feeding. Incorporation
      of [1-14C]oleic acid into hepatic and plasma cholesteryl esters increased by 63
      and 79%, respectively, while incorporation into phospholipid was unaffected.
      Increasing the fat (corn oil) content of the diet to 20% (w/w) did not change
      these effects of dietary cholesterol. Studies using isolated, perfused rat livers
      were carried out in vitro after rats were fed the 5% corn oil diet for 3 weeks.
      [Perfusions lasted 4 h. The perfusion medium contained 3% bovine serum albumin
      and 30% washed bovine erythrocytes in Krebs-Henseleit-HCO3 buffer.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8354960
TI  - Plasma lipoproteins in the golden Syrian hamster (Mesocricetus auratus):
      heterogeneity of apoB- and apoA-I-containing particles.
AB  - We present the quantitative and qualitative characteristics of the apolipoprotein
      (apo) B- and apoA-I-containing lipoprotein subspecies in the plasma of male
      Golden Syrian hamsters. The spectrum of hamster lipoproteins of d < 1.172 g/ml
      was subfractionated by isopycnic density gradient ultracentrifugation. ApoB
      containing subspecies were distributed up to a density of 1.074 g/ml. Hamster
      very low density lipoproteins (VLDL, d < 1.018 g/ml; approximately 120 mg/dl
      plasma) were triglyceride (TG)-rich, deficient in cholesteryl ester (CE), and
      highly heterogeneous in size, containing chylomicron-like particles. ApoVLDL
      contained proteins analogous to human apoB-100, apoB-48, and apoE. ApoB
      containing subspecies with physicochemical properties typical of low density
      lipoproteins (LDL) were identified as a single, major size species in the density
      interval from 1.019 to 1.074 g/ml, particle diameter decreasing progressively
      with increase in density. Hamster LDL-like subspecies were distinguished from
      their human counterparts by a relative deficiency in core CE (< 30% by wt) and by
      enrichment in triglyceride. The high M(r) form of apoB was the major
      apolipoprotein of all LDL-like subfractions, in which apoE was detected as a
      minor component. Total plasma levels of LDL (d 1.019-1.074 g/ml) amounted to
      approximately 140 mg/dl (approximately 25% of d < 1.172 g/ml lipoproteins). The
      distribution of dense apoB-containing subspecies overlapped that of apoA-I
      containing, high density lipoprotein-1 (HDL1)-like particles in the density
      interval approximately 1.039-1.074 g/ml. ApoA-I-containing subspecies with the
      physical and chemical characteristics of HDL were exclusively present over the
      density interval 1.074-1.172 g/ml. Quantitatively, these subspecies predominated
      in hamster plasma (approximately 270 mg/dl). Light, HDL2-like particles of d
      1.065-1.103 g/ml (HDLL) were preponderant, (approximately 66% of total HDL).
      Marked size heterogeneity was evident, and was associated with distinct particle
      contents of minor apolipoproteins. Both HDLL and heavy HDL (HDLH, d 1.103-1.172
      g/ml) were enriched in CE as evidenced by elevated weight ratios of CE:FC (7-9:1)
      and of CE:TG (up to approximately 50:1). Considered together, the core lipid
      contents of apoB- and apoA-I-containing lipoproteins are consistent with the
      hypothesis that the hamster is partially deficient in neutral lipid (CE, TG)
      transfer activity.

PMID- 8354961
TI  - Regulation of hepatic triglyceride lipase by thyroid hormone in HepG2 cells.
AB  - Hypothyroidism has been reported to be associated with reduced hepatic
      triglyceride lipase (HTGL) activity. In order to understand the molecular
      mechanism by which thyroid hormone regulates HTGL activity, effects of
      triiodothyronine (T3) on HTGL activity, mRNA level, transcription run-on
      activity, and protein synthetic rate were studied in HepG2 cells. HepG2 cells
      treated with 1 nM T3 showed an increase in HTGL activity that was first detected
      at 24 h; HTGL activity continued to increase at 36 h and stayed at the elevated
      level at 48 and 60 h. At maximal stimulation (48 h), T3-treated cells had the
      following HTGL activities: 155% in spontaneously released (SR) and 224% in
      heparin-releasable (HR) HTGL activities (mean levels compared to control).
      Stimulation of HTGL activity by T3 was dose-dependent and saturable. There was,
      however, no change in HTGL mRNA level throughout the course of T3 treatment. The
      effects of T3 were reduced when transcription was blocked by actinomycin D (mean
      level compared to actinomycin D treatment in the absence of T3: 109% in SR and
      127% in HR activities) or translation was blocked by cycloheximide (127% in SR
      and 122% in HR activities), but HTGL activities were still significantly higher
      than control. Nuclear run-on assays indicate that T3 did not change the rate of
      transcription of the HTGL gene. We further determined the rate of HTGL synthesis
      by measuring the amount of [35S]methionine incorporated into newly synthesized
      HTGL immunoprecipitated by a monospecific anti-human HTGL antibody. We found that
      the T3-stimulated increase in HTGL activity was not accompanied by any change in
      the rate of HTGL biosynthesis. Our experimental data indicate that the T3
      stimulation of HTGL activity in HepG2 cells is mediated at posttranscriptional
      and posttranslational levels. The partial but significant inhibition of the T3
      stimulation of HTGL activity by actinomycin D and cycloheximide suggests that the
      effects of T3 may be mediated by other cellular processes that are more directly
      regulated by the hormone. This study represents the initial report on the
      mechanism of HTGL activation by physiological concentrations of thyroid hormone.

PMID- 8354962
TI  - Apolipoprotein B-52 mutation associated with hypobetalipoproteinemia is
      compatible with a misaligned pairing deletion mechanism.
AB  - We have identified a new truncation of apoB in a large kindred with
      hypobetalipoproteinemia that arose by an ambiguous deletion of one of four
      different groups of base-pairs. Eleven affected members of the kindred had total
      cholesterols (C) of 114 +/- 28, LDL-Cs of 46 +/- 21, and apoBs of 47 +/- 25 (all
      in mg/dl, mean +/- SD). These levels were lower (P < 0.0001) than in 15
      unaffected relatives. On Western blotting, apoB-100 and a second major band
      corresponding to apoB-52 were seen in the affected individuals. The majority of
      the plasma apoB-52 was associated with a smaller than normal low density
      lipoprotein (LDL) particle. The molecular basis for this apoB-52 truncation is a
      5-bp deletion, converting the sequence between cDNA nucleotide 7276 and 7283 from
      5'-AAGTTAAG-3' into the mutant sequence 5'-AAG-3'. This results in a frameshift
      starting at amino acid residue 2357 and a termination codon at amino acid residue
      2362. Deletion of one of four different groups of five consecutive bases, i.e.,
      AAGTT, AGTTA, GTTAA, and TTAAG, all result in the same mutant sequence. Thus, the
      precise deletion is ambiguous. We propose that a misaligned pairing mechanism
      involving repeat sequences is compatible with this deletion mutation. We have
      noted similar ambiguous deletions associated with apoB-37, apoB-40, and a number
      of single base deletions and some may also be explained by a misaligned pairing
      mechanism. Small ambiguous deletions appear to constitute a major proportion of
      the apoB gene mutation spectrum suggesting that it may be a suitable model for
      studying the mechanisms of such mutations.

PMID- 8354963
TI  - Behavior systems and reinforcement: an integrative approach.
AB  - Most traditional conceptions of reinforcement are based on a simple causal model
      in which responding is strengthened by the presentation of a reinforcer. I argue
      that reinforcement is better viewed as the outcome of constraint of a functioning
      causal system comprised of multiple interrelated causal sequences, complex
      linkages between causes and effects, and a set of initial conditions. Using a
      simplified system conception of the reinforcement situation, I review the
      similarities and drawbacks of traditional reinforcement models and analyze the
      recent contributions of cognitive, regulatory, and ecological approaches.
      Finally, I show how the concept of behavior systems can begin to incorporate both
      traditional and recent conceptions of reinforcement in an integrative approach.

PMID- 8354964
TI  - Delay reduction: current status.
AB  - Delay-reduction theory states that the effectiveness of a stimulus as a
      conditioned reinforcer may be predicted most accurately by the reduction in time
      to primary reinforcement correlated with its onset. We review support for the
      theory and then discuss two new types of experiments that assess it. One compares
      models of choice in situations wherein the less preferred outcome is made more
      accessible; the other investigates whether frequency of conditioned reinforcement
      affects choice beyond the effect exerted by frequency of primary reinforcement.

PMID- 8354965
TI  - A selectionist approach to reinforcement.
AB  - We describe a principle of reinforcement that draws upon experimental analyses of
      both behavior and the neurosciences. Some of the implications of this principle
      for the interpretation of behavior are explored using computer simulations of
      adaptive neural networks. The simulations indicate that a single reinforcement
      principle, implemented in a biologically plausible neural network, is competent
      to produce as its cumulative product networks that can mediate a substantial
      number of the phenomena generated by respondent and operant contingencies. These
      include acquisition, extinction, reacquisition, conditioned reinforcement, and
      stimulus-control phenomena such as blocking and stimulus discrimination. The
      characteristics of the environment-behavior relations selected by the action of
      reinforcement on the connectivity of the network are consistent with behavior
      analytic formulations: Operants are not elicited but, instead, the network
      permits them to be guided by the environment. Moreover, the guidance of behavior
      is context dependent, with the pathways activated by a stimulus determined in
      part by what other stimuli are acting on the network at that moment. In keeping
      with a selectionist approach to complexity, the cumulative effects of relatively
      simple reinforcement processes give promise of simulating the complex behavior of
      living organisms when acting upon adaptive neural networks.

PMID- 8354966
TI  - Response acquisition under targeted percentile schedules: a continuing quandary
      for molar models of operant behavior.
AB  - The number of responses rats made in a "run" of consecutive left-lever presses,
      prior to a trial-ending right-lever press, was differentiated using a targeted
      percentile procedure. Under the nondifferential baseline, reinforcement was
      provided with a probability of .33 at the end of a trial, irrespective of the run
      on that trial. Most of the 30 subjects made short runs under these conditions,
      with the mean for the group around three. A targeted percentile schedule was next
      used to differentiate run length around the target value of 12. The current run
      was reinforced if it was nearer the target than 67% of those runs in the last 24
      trials that were on the same side of the target as the current run. Programming
      reinforcement in this way held overall reinforcement probability per trial
      constant at .33 while providing reinforcement differentially with respect to runs
      more closely approximating the target of 12. The mean run for the group under
      this procedure increased to approximately 10. Runs approaching the target length
      were acquired even though differentiated responding produced the same probability
      of reinforcement per trial, decreased the probability of reinforcement per
      response, did not increase overall reinforcement rate, and generally
      substantially reduced it (i.e., in only a few instances did response rate
      increase sufficiently to compensate for the increase in the number of responses
      per trial). Models of behavior predicated solely on molar reinforcement
      contingencies all predict that runs should remain short throughout this
      experiment, because such runs promote both the most frequent reinforcement and
      the greatest reinforcement per press. To the contrary, 29 of 30 subjects emitted
      runs in the vicinity of the target, driving down reinforcement rate while greatly
      increasing the number of presses per pellet. These results illustrate the
      powerful effects of local reinforcement contingencies in changing behavior, and
      in doing so underscore a need for more dynamic quantitative formulations of
      operant behavior to supplement or supplant the currently prevalent static ones.

PMID- 8354967
TI  - Scaling pigeons' choice of feeds: bigger is better.
AB  - Preferences of hungry pigeons among 10 grains and pellets were analyzed using a
      Thurstone scaling procedure. The recovered scales were positively correlated with
      size of the feed. The correlations improved when the Thurstonian assumption of
      equal-sized discriminal dispersions (Case V) was replaced with the assumption of
      proportional-sized dispersions (Case VI), as entailed by Weber's law. The
      correlations weakened when the experiments were conducted with the pigeons close
      to their free-feeding weights, where the probability of sampling alternative
      grains increased. In the final experiment, exposure to a large pellet shifted the
      preferences between two smaller pellets.

PMID- 8354968
TI  - Techniques for establishing schedules with wheel running as reinforcement in
      rats.
AB  - In three experiments, access to wheel running was contingent on lever pressing.
      In each experiment, the duration of access to running was reduced gradually to 4,
      5, or 6 s, and the schedule parameters were expanded gradually. The sessions
      lasted 2 hr. In Experiment 1, a fixed-ratio 20 schedule controlled a typical
      break-and-run pattern of lever pressing that was maintained throughout the
      session for 3 rats. In Experiment 2, a fixed-interval schedule of 6 min
      maintained lever pressing throughout the session for 3 rats, and for 1 rat, the
      rate of lever pressing was positively accelerated between reinforcements. In
      Experiment 3, a variable-ratio schedule of 20 or 35 was in effect and maintained
      lever pressing at a very stable pace throughout the session for 2 of 3 rats; for
      1 rat, lever pressing was maintained at an irregular rate. When the session
      duration was extended to successive 24-hr periods, with food and water accessible
      in Experiment 3, lever pressing settled into a periodic pattern occurring at a
      high rate at approximately the same time each day. In each experiment, the rats
      that developed the highest local rates of running during wheel access also
      maintained the most stable and highest rates of lever pressing.

PMID- 8354969
TI  - A cellular analogue of operant conditioning.
AB  - Using the hippocampal-slice preparation, we attempted to model operant
      conditioning in vitro by reinforcing pyramidal cell bursting responses with local
      micropressure applications of transmitters and drugs. The same injections were
      administered independently of bursting to provide a "noncontingent" control for
      direct pharmacological stimulation or facilitation of firing. The results
      suggested that the bursting responses of individual CA1 pyramidal neurons may be
      reinforced in a dose-related manner by response-contingent (but not
      noncontingent) injections of dopamine and the selective dopamine D2 agonist, N
      0923. N-0924, a stereoisomer of N-0923 that is largely devoid of D2-agonist
      activity, failed to reinforce CA1 bursting. Burst-contingent injections of the
      excitatory neurotransmitter glutamate also failed to reinforce CA1 bursting;
      indeed, the glutamate applications (whether contingent or random) reduced the
      likelihood of bursts while increasing the frequency of solitary spikes.
      Reinforcement delays exceeding 200 ms largely eliminated the reinforcing efficacy
      of the D2 agonist N-0437 in CA1 operant conditioning. The results are consistent
      with the suggestion that the behaviorally reinforcing effects of dopaminergic
      agents can be modeled in vitro in the hippocampal-slice preparation.

PMID- 8354971
TI  - Reversibility of single-incentive selective associations.
AB  - Rats were trained to press a lever in the presence of a tone-light compound
      stimulus and not to press in its absence. In each of two experiments, schedules
      were designed to make the compound a conditioned punisher for one group and a
      conditioned reinforcer for the other. In Experiment 1, one group's responding
      produced food in the presence of the compound but not in its absence. The other
      group's responding terminated the compound stimulus, and food was presented only
      in its absence. When tone and light were later presented separately, light
      controlled more responding than did tone in the former group, but tone gained
      substantial control in the latter. The same effects were also observed within
      subjects when the training schedules were switched over groups. In Experiment 2,
      two groups avoided shock in the presence of the compound stimulus. In the absence
      of the compound, one group was not shocked, and the other received both response
      independent and response-produced shock. When tone and light were presented
      separately, the former group's responding was mainly controlled by tone, but the
      latter group's responding was almost exclusively controlled by light. These
      effects were also observed within subjects when the training schedules were
      switched over groups. Thus, these single-incentive selective association effects
      (appetitive in Experiment 1 and aversive in Experiment 2) were completely
      reversible. The schedules in which the compound should have been a conditioned
      reinforcer consistently produced visual control, and auditory control increased
      when the compound should have become a conditioned punisher. Currently accepted
      accounts of selective associations based on affinities between shock and auditory
      stimuli and between food and visual stimuli (i.e., stimulus-reinforcer
      interactions) do not adequately address these results. The contingencies of
      reinforcement most recently associated with the compound and with its absence,
      rather than the nature of the reinforcer, determined whether auditory or visual
      stimulus control developed.

PMID- 8354970
TI  - The nature of sexual reinforcement.
AB  - Sexual reinforcers are not part of a regulatory system involved in the
      maintenance of critical metabolic processes, they differ for males and females,
      they differ as a function of species and mating system, and they show ontogenetic
      and seasonal changes related to endocrine conditions. Exposure to a member of the
      opposite sex without copulation can be sufficient for sexual reinforcement.
      However, copulatory access is a stronger reinforcer, and copulatory opportunity
      can serve to enhance the reinforcing efficacy of stimulus features of a sexual
      partner. Conversely, under certain conditions, noncopulatory exposure serves to
      decrease reinforcer efficacy. Many common learning phenomena such as acquisition,
      extinction, discrimination learning, second-order conditioning, and latent
      inhibition have been demonstrated in sexual conditioning. These observations
      extend the generality of findings obtained with more conventional reinforcers,
      but the mechanisms of these effects and their gender and species specificity
      remain to be explored.

PMID- 8354972
TI  - Fort Knox and the open scientific landscape.

PMID- 8354973
TI  - Glucocorticoid-induced osteoporosis: pathogenesis, prevention and treatment, with
      special regard to the rheumatic diseases.
AB  - OBJECTIVES: To review factors associated with development of osteoporosis in
      patients with rheumatic diseases, as well as the preventive and therapeutic
      measures. DESIGN: A MEDLINE literature search. RESULTS: 1 Pathogenesis.
      Rheumatoid arthritis in itself causes reduction of bone mass; this process can be
      aggravated by glucocorticoid treatment. With glucocorticoid treatment, bone
      mineral density decrease is most pronounced during the first months of treatment.
      There is no agreement on the effects of daily dose, cumulative dose, and duration
      of glucocorticoid treatment on the rate of bone loss. However, with treatment by
      low doses (< 10 mg of prednisone equivalent per day), bone loss appears to be
      minimal or even undetectable compared to controls. Alternate day treatment, or
      treatment with steroid 'pulses' have not been shown to protect from bone loss. 2
      Prevention and treatment. Prophylactic and therapeutic measures for
      glucocorticoid-induced osteoporosis include calcium supplementation, vitamin D in
      physiological doses and oestrogen in perimenopausal female patients. Efficacy has
      not always been shown in this particular indication but is extrapolated from
      other forms of osteoporosis. Limited data exist on treatment with anabolic
      steroids, calcitonin (with an additional analgesic effect) and biphosphonates and
      reduction of fracture rates has not yet been investigated. At present, there is
      insufficient evidence to show that altered steroid molecules can dissociate
      adverse effects on bone from clinically desirable effects. CONCLUSION: In view of
      the paucity of study data, prophylaxis and therapy of glucocorticoid-induced
      osteoporosis should receive more attention in future clinical studies.

PMID- 8354974
TI  - Effects of weight loss on pulmonary function in obese men with obstructive sleep
      apnoea syndrome.
AB  - The effects of long-term behaviour modification of obesity on pulmonary function
      was studied in eight men with obstructive sleep apnoea syndrome (initial mean
      body mass index [BMI] 41.8 kg m-2) before and after a mean weight loss of 20 +/-
      7 (SD) kg. Mean arterial PCO2 fell from 6.3 +/- 1.2 to 5.5 +/- 0.6 kPa (P < 0.05)
      and concomitant significant improvements were found in vital capacity, total lung
      capacity, functional residual capacity and forced expired volume (FEV 1.0). The
      study suggests that weight loss per se, rather than the method of choice to
      achieve weight loss, results in clinically significant improvement of pulmonary
      function in obese men.

PMID- 8354975
TI  - Progressive renal failure in patients with lupus nephritis.
AB  - OBJECTIVE: To investigate the mode of progression to renal failure in patients
      with lupus nephritis in relation to disease activity and responsiveness to
      corticosteroid therapy. DESIGN: Retrospective clinical study. SETTING: University
      hospital. SUBJECTS: Twenty-eight patients with progressive lupus nephritis (Cr >
      or = 1.4 mg dl-1). INTERVENTIONS: Rapidity of progression was defined as the
      slope of the reciprocal of serum creatinine values. Lupus activity was scored
      using the systemic lupus erythematosus disease activity index system. MAIN
      OUTCOME MEASURES: Improvement of serum creatinine values after 6 months of
      therapy. RESULTS: Rapidity of progression, which was calculated during the
      deterioration in kidney function, reflected systemic and serological disease
      activity, and moreover closely correlated with response to corticosteroid
      therapy.

PMID- 8354976
TI  - High serum insulin, insulin resistance and their associations with cardiovascular
      risk factors. The northern Sweden MONICA population study.
AB  - OBJECTIVES: To estimate the prevalence of insulin resistance and high serum
      insulin levels and to investigate their relationship to other cardiovascular risk
      factors. DESIGN: Cross-sectional cardiovascular risk factor survey. SETTING:
      Northern Sweden. SUBJECTS: A subsample of the population-based Northern Sweden
      MONICA Study. This subsample underwent an oral glucose tolerance test after an
      overnight fast, and consisted of 354 men and 404 women in the 25-64-year age
      range. MAIN OUTCOME MEASURES: Delineation of low insulin sensitivity and high
      serum insulin by the diagnostic test technique, prevalence of these variables and
      their associations with cardiovascular risk factors. RESULTS: The participants
      were classified into four subgroups by an insulin sensitivity index and fasting
      serum insulin. The combination of low insulin sensitivity and high serum insulin
      was present in 17% of the male and in 18% of the female 25-64-year-old
      population. In both sexes this combination was closely associated (P < 0.001)
      with body mass index, waist-hip ratio, blood pressure and serum triglycerides,
      and correlated inversely with serum HDL cholesterol (P < 0.001). When high serum
      insulin was present as an isolated entity it was as closely associated with other
      cardiovascular risk factors such as isolated low insulin sensitivity, except that
      impaired glucose tolerance occurred exclusively in the group with isolated low
      insulin sensitivity. CONCLUSIONS: The combination of insulin resistance and high
      insulin levels is associated with a marked clustering of cardiovascular risk
      factors and is present in one-sixth of the middle-aged population in the north of
      Sweden.

PMID- 8354977
TI  - The influence of antihypertensive therapy on the structural arteriolar changes in
      essential hypertension: different effects of enalapril and hydrochlorothiazide.
AB  - OBJECTIVES: To assess the peripheral and central haemodynamics, in particular the
      effect on minimal resistance in the hand, with an ACE inhibitor in comparison
      with a diuretic. DESIGN: Double-blind randomized parallel group study. SUBJECTS:
      Twenty-eight previously untreated men with essential hypertension (supine
      diastolic blood pressure > 95 mmHg repeatedly on placebo). METHODS/INTERVENTION:
      Causal and intra-arterial blood pressure, dye-dilution technique, water
      plethysmography at rest and at ischaemia, enalapril (n = 14), hydrochlorothiazide
      (n = 14). RESULTS: After 6 months the mean arterial pressure was reduced from
      112.7 to 96.9 mmHg (change -15.9 mmHg; 95% confidence interval (CI) -21.9, -9.8)
      on enalapril and from 110.1 to 101.5 mmHg (change -8.6 mmHg; CI -14.4, -2.8).
      Heart rate did not change on any of the therapies. Enalapril reduced blood
      pressure mainly through a reduction in total peripheral resistance (delta -3.0
      PRU100; CI -5.6, -0.4) while hydrochlorothiazide reduced blood pressure mainly
      through a reduction in cardiac output (delta -0.8 l/min-1; CI -1.5, -0.07).
      Minimal vascular resistance (mean of right and left hand) displayed a significant
      time x treatment interaction indicating a different trend with enalapril than
      hydrochlorothiazide with a change of -0.12 PRU100 (CI -0.33, 0.05) on enalapril
      and a change of 0.14 (CI -0.29, 0.56) on hydrochlorothiazide. The resistance
      level after 6 months was significantly higher on hydrochlorothiazide than on
      enalapril (P = 0.0105). CONCLUSION: Enalapril reduced blood pressure through
      vasodilatation and hydrochlorothiazide through decreased cardiac output. The two
      therapies also affected minimal vascular resistance (an indirect measure of
      vascular wall thickness) differently; with enalapril showing a favourable
      response in contrast to hydrochlorothiazide.

PMID- 8354978
TI  - Determination of urinary N-acetyl-beta-glucosaminidase in patients with
      hypertension and renal artery stenosis.
AB  - The purpose of the study was to measure the urinary excretion of N-acetyl-beta
      glucosaminidase (U-NAG) in patients suspected of having renovascular hypertension
      and to compare the enzyme excretion before and after active intervention with
      operation or percutaneous transluminal renal angioplasty (PTRA). Eighty-one
      patients with severe, therapy-resistant hypertension were examined with regard to
      renal artery stenosis (RAS). At least one significant renal artery stenosis was
      found in 61 patients, whilst the remaining 20 patients were classified as having
      essential hypertension. Enzyme levels were found to be significantly higher in
      RAS patients as compared with patients with severe hypertension lacking
      significant renal artery stenosis, 0.66 (0.41-0.91, median value, 1st and 3rd
      quartiles) versus 0.35 (0.27-0.54); P < 0.01. Both groups of patients had
      significantly higher U-NAG values than a healthy reference population (0.2, 0.13
      0.27; P < 0.01). Forty of the RAS patients were randomized to surgery or PTRA and
      followed prospectively for 2 years. After either renal vascular surgery or PTRA a
      significant rise in U-NAG excretion was observed 7-10 days after treatment.
      Urinary NAG excretion remained elevated during long-term follow-up. It is
      suggested that U-NAG should be determined in patients with therapy-resistant
      hypertension with suspicion of renal artery stenosis.

PMID- 8354980
TI  - Very early risk stratification by electrocardiogram at rest in men with suspected
      unstable coronary heart disease. The RISC Study Group.
AB  - OBJECTIVES: To determine the possibility of very early prognostic stratification
      based on electrocardiograms (ECGs) at rest and/or cardiac enzyme levels after an
      episode of suspected unstable coronary heart disease. DESIGN AND SETTING: Men
      with suspected unstable angina or non-Q-wave myocardial infarction were studied
      in the coronary care units of eight hospitals. The ECGs at rest and creatinine
      kinase were followed. SUBJECTS: In total 911 men were followed for 12 months. Of
      8136 consecutively admitted, 3365 fulfilled the inclusion criteria. Excluded were
      2454 patients, mainly because of a larger myocardial damage, signs of myocardial
      dysfunction, other serious cardiac or non-cardiac disease or an ECG not possible
      to interpret regarding ST-T-segment changes in the precordial leads. MAIN OUTCOME
      MEASURES: End-points at follow-up were cardiac death, myocardial infarction and
      severe (class III or IV) angina. RESULTS: Compared to patients with normal a ECG
      who had an 8% 1-year risk of myocardial infarction or death, the risk with
      isolated negative T waves was 14% (P < 0.05), ST elevation 16% (P < 0.05), ST
      depression 18% (P < 0.01) and the combination of ST elevation and ST depression
      26% (P < 0.001). The only finding related to future severe angina was ST
      depression. The risk of cardiac events was comparably elevated in patients with
      anterior or inferior site of ECG changes. Cardiac enzyme levels had no predictive
      value regarding future events. CONCLUSIONS: Electrocardiograms at rest obtained
      during the initial days of hospitalization provide very early and valuable
      prognostic information in men admitted with suspected unstable coronary heart
      disease.

PMID- 8354979
TI  - Liver damage from low-dose oral contraceptives.
AB  - OBJECTIVE: To study whether the decrease in the content of oestrogen and gestagen
      in modern low-dose oral contraceptives (OC) has yielded a lower incidence of
      adverse liver reactions, and to describe the biochemical pattern of the adverse
      liver reactions from low-dose OC. DESIGN: We surveyed all liver reactions from OC
      reported to SADRAC (Swedish Adverse Drug Reactions Advisory Committee) from 1966
      to 1989. MAIN OUTCOME MEASURE: Incidence of reported adverse liver reactions
      (number of reported adverse reactions/OC sales in defined daily dose [DDD]).
      RESULTS: There was a sharp decline in the number of reports during the studied
      period, suggesting changes in reporting habits. However, there was also a
      significantly lower incidence of reports for medium-compared to high-oestrogen
      dose OC, and a further decrease, albeit non-significant, in incidence with low
      oestrogen dose OC. Furthermore, in three comparisons of pairs of OC that differed
      only in the gestagen dose, there was a strong trend towards a higher reporting
      rate with higher gestagen dose. Cholestatic and hepatocellular liver enzyme
      patterns were equally frequent in patients with adverse reactions from low-dose
      oestrogen OC. There was no report of liver tumours related to use of low
      oestrogen dose OC. CONCLUSION: There seems to be a decrease in the incidence of
      adverse liver reactions related to lower contents of both oestrogen and gestagens
      in OC of the combined-preparation type.

PMID- 8354981
TI  - Low-dose warfarin decreases coagulability without affecting prothrombin complex
      activity.
AB  - OBJECTIVES: To assess the efficacy of a fixed, low dose of warfarin in lowering
      factor VII coagulant activity (FVII:C) and to investigate the effects on the
      plasma coagulation cascade. DESIGN: An open pilot study with two dose levels of
      warfarin: 1.25 and 2.5 mg day-1 during two consecutive 4-week periods. All
      subjects received aspirin 75 mg day-1. Prothrombin fragment 1 + 2 (F(1 + 2)),
      protein C, protein S, FVII:C, factor X and P-prothrombin complex activity (P-PT)
      were measured at baseline, at 2-week intervals and 4 weeks after end of
      treatment. Coagulation activation peptide F(1 + 2) was used as a marker of
      thrombin formation. SUBJECTS: Twelve male patients with a history of myocardial
      infarction. Inclusion was made through a written questionnaire. RESULTS: Warfarin
      1.25 mg day-1 lowered FVII:C from 113 U dl-1 to 107 U dl-1 (P = 0.025) and F(1 +
      2) from 1.60 nmol l-1 to 1.27 nmol l-1 (P = 0.013) but had no effect on protein C
      or P-PT. A dose of 2.5 mg day-1 induced further lowering of FVII:C (91 U dl-1, P
      = 0.0042), and also of protein C from 116% to 99% (P = 0.034) and P-PT from 107%
      to 81% (P = 0.0096) mean values. CONCLUSION: Warfarin 1.25 mg day-1 seems to
      exert an anticoagulant effect without reduction in PT or the natural
      anticoagulant protein C and is suggested, in combination with aspirin, to be a
      safe and simple therapy against arterial thrombotic disease, making regular PT
      controls unnecessary.

PMID- 8354982
TI  - Tracking of cardiovascular disease risk factors including maximal oxygen uptake
      and physical activity from late teenage to adulthood. An 8-year follow-up study.
AB  - OBJECTIVES: The aim of the study was to analyse changes in coronary heart disease
      (CHD) risk factors from adolescence to young adulthood, and how changes in risk
      factors relate to changes in lifestyle. DESIGN: A randomized sample of school
      children was tested in 1983 and followed-up 8 years later. In 1983 a dropout of
      0.7% was found and the sample was representative of 16-19-year-old Danes.
      SUBJECTS: Subjects followed-up 8 years later (two-thirds of the original sample)
      were 88 male and 115 female 15-19-year-old school children attending 18 high
      schools, nine vocational and nine trade schools, throughout Denmark. MAIN OUTCOME
      MEASURES: Height, body weight, body fat, occupation and coronary heart disease
      risk factors including physical activity (PA), fitness, blood pressure (BP),
      serum cholesterol, HDL cholesterol, triglyceride (TG) and smoking habits were
      assessed. RESULTS: In males all risk factors increased: the increases in total
      cholesterol level and systolic and diastolic BP were large, 0.85 mmol l-1 and 11
      mmHg, respectively. In females, the risk for some factors increased (total
      cholesterol and BP), others decreased (higher HDL cholesterol), and triglyceride
      did not change. Significant tracking was found in both sexes, with the highest
      correlation coefficients in men. A total risk score was calculated by
      categorizing risk factors into six groups--1 to 6--and then adding the scores.
      Pearson correlation between the total risk scores in 1983 and 1991 in men was r =
      0.67 (P < 0.001). Only a weak association was found for the total risk score in
      women. Nearly 50% of the boys, who were initially in the upper quintile of risk,
      were still in the upper quintile 8 years later for most risk factors. In men, the
      changes in risk factors were related to social factors. Blue-collar workers and
      the unemployed had the highest increase in risk factors, and the largest decrease
      in VO2max (ml min-1 kg-1) when analysed together. In both sexes the best
      relationship between 1983 and 1991 values was found in body mass index (BMI).
      Leisure time physical activity (PA) and triglyceride (TG) had a low correlation
      between 1983 and 1991 values. Physical activity had a non-significant correlation
      over time for women, indicating that PA in 1983 did not predict PA in 1991 at
      all. CONCLUSION: Coronary heart disease risk factors tracked in both males and
      females, but only in males was a strong relationship found for total risk from
      adolescence to young adulthood, indicating the influence of a poor lifestyle in
      high-risk men. Lower social status related to higher risk.

PMID- 8354983
TI  - The cost-effectiveness of treating hypertension in elderly people--an analysis of
      the Swedish Trial in Old Patients with Hypertension (STOP Hypertension).
AB  - OBJECTIVES: The aim of this study was to estimate the cost-effectiveness of
      antihypertensive treatment in elderly people based on the results of the Swedish
      Trial in Old Patients with Hypertension (STOP Hypertension). DESIGN: The STOP
      Hypertension study was a randomized trial comparing active antihypertensive
      treatment with a placebo. The risk of stroke, cardiovascular disease and total
      mortality was significantly reduced in the actively treated group compared to
      placebo. SETTING: One hundred and sixteen primary health care centres in Sweden.
      SUBJECTS: A total of 1627 hypertensive patients aged 70-84. No patient was lost
      to follow-up. INTERVENTIONS: Antihypertensive treatment with beta blockers and
      diuretics for a mean follow-up of 25 months. MAIN OUTCOME MEASURE: The cost
      effectiveness ratio estimated as the net cost (the treatment cost minus saved
      costs of reduced cardiovascular morbidity) divided by the number of life-years
      gained (the increase in life expectancy from treatment). RESULTS: The cost per
      life-year gained was estimated as SEK 5000 for men and SEK 15,000 for women ($1 =
      SEK 6; 1 pound = SEK 10). The cost per life-year gained did not exceed SEK
      100,000 in any of the sensitivity analyses. CONCLUSIONS: It is concluded that
      treatment of elderly hypertensive patients with beta blockers and/or diuretics is
      cost-effective according to the results of the STOP Hypertension study.

PMID- 8354984
TI  - Non-paroxysmal arterioventricular junctional tachycardia during postprandial
      hypoglycaemia in an obese non-diabetic patient.
AB  - We have observed the simultaneous occurrence of postprandial hypoglycaemia and a
      rare cardiac arrhythmia: non-paroxysmal arteriovenous junctional tachycardia
      (NPJT) in a patient with suspected coronary heart disease (CHD) submitted to oral
      glucose tolerance testing (OGTT). To our knowledge the association between
      hypoglycaemia and NPJT has not been previously described. The pathogenesis of
      NPJT might involve a myocellular Ca2+ overloading determined by a hypoglycaemia
      induced catecholamine discharge in a transiently ischaemic myocardium.

PMID- 8354985
TI  - Spontaneous resolution of acquired factor X deficiency in amyloidosis.
AB  - We describe the case of a 51-year-old man with systemic amyloidosis in whom
      factor X activity was initially 6% of the normal. Amyloidosis was responsible for
      congestive heart failure and a nephrotic syndrome but there was no bleeding
      diathesis. A 12-month trial of melphalan and prednisone failed to improve cardiac
      and renal dysfunction; factor X levels remained low. Eighteen months after this
      treatment was stopped, factor X spontaneously normalized although renal
      insufficiency persisted. We suggest that the possibility of a spontaneous factor
      X recovery must be considered when evaluating efficacy of therapeutic agents in
      amyloidosis.

PMID- 8354986
TI  - Essential cryofibrinogenaemia, leukocytoclastic vasculitis and chronic purpura.
AB  - Cryofibrinogenaemia refers to the presence of cold-precipitable proteins in
      plasma but not in serum. It is usually associated with malignancy, thromboembolic
      diseases or various inflammatory processes; rarely it may be essential. The most
      common clinical presentations of cryofibrinogenaemia are cold-intolerance,
      purpura, skin necrosis and ulcers. We describe a middle-aged woman with essential
      cryofibrinogenaemia, leukocytoclastic vasculitis, and chronic purpura for over 25
      years with several exacerbations. In patients with otherwise unexplained purpura
      or skin necrosis, determination of plasma cryofibrinogen should be considered.

PMID- 8354987
TI  - Survival analysis of 118 patients with systemic sclerosis.
AB  - Life-table analysis based on the survival statistics of 118 Hungarian patients
      with systemic sclerosis suggests that the presence of skin hypo- and/or
      hyperpigmentation indicates a poor prognosis. Furthermore, truncal skin
      involvement, lung, cardiac, and renal manifestations, older age at the onset of
      disease, anaemia, hand deformity, and elevated erythrocyte sedimentation rate
      values, predict an unfavourable prognosis, whilst patients with exposure to
      chemicals shows a relatively favourable disease outcome.

PMID- 8354988
TI  - Angiotensin-converting enzyme inhibition and physical training in heart failure.

PMID- 8354989
TI  - Lack of evidence of exon 13 mutations in the beta cardiac myosin heavy chain gene
      with familial hypertrophic cardiomyopathy in Japan.

PMID- 8354990
TI  - Physiological response of Zebu and taurine oxen to draught work.
AB  - Four Zebu and four Simmental oxen were submitted to continuous and to graded
      draught work. Venous blood samples were taken before, during, and after exercise
      at intervals of 2-5 min. Anaerobic threshold was reached at a draught power of
      1.6 +/- 0.06 kW for Zebu and 0.7 +/- 0.07 kW for Simmental. Corresponding plasma
      lactate concentrations were 1.7 +/- 0.2 mmol/liter and 1.6 +/- 0.3 mmol/liter,
      respectively. Partial pressure of oxygen (pvO2), carbon dioxide (pvCO2), and
      plasma free fatty acids (FFA) during and after work differed between breeds (P
      approximately .001) and individuals (P approximately .05). After work, an up to 8
      fold increase in FFA was found. Highest plasma lactate concentrations during
      continuous maximal draught were 3.75 +/- 1.76 (Zebu) and 6.01 +/- 0.88 mmol/liter
      (Simmental). Acid-base-state during and after exhaustive work remained stable.
      Heart rate in both breeds did not exceed 190 min-1. It is concluded that 1) even
      during heavy draught work, anaerobic energy formation plays a minor role for
      cattle, 2) fatigue in working oxen may be related to cardiovascular limitations,
      and 3) the physical fitness of European beef-breed oxen is lower compared to
      multipurpose African Zebu oxen.

PMID- 8354991
TI  - Two GnRHs fluctuate in correlation with androgen levels in the male frog Rana
      esculenta.
AB  - ChickenII-(cII-) and salmon (s-) GnRH levels have been measured in the male frog
      Rana esculenta during the annual cycle. The presence of pituitary binding
      activity for both peptides and plasma androgen levels has been investigated in
      order to give insight into the significance of the dual control exerted by the
      GnRH forms present in the R. esculenta brain. ChickenII- and s-GnRHs showed high
      values during the spring-summer period. Conversely, while cII-GnRH peaked in
      February, s-GnRH declined slowly from February until May. Plasma androgen levels
      increased as the peptides decreased during the autumn-winter period. Still high
      androgen levels (but significantly lower as compared with winter concentrations)
      were found during spring. Using iodinated cII-GnRH, GnRH binding sites were
      detected in pituitary preparations when the corresponding peptide concentration
      decreased in the brain. On the contrary, no binding sites were found using
      labeled s-GnRH. Our results indicate that cII-GnRH has a hypophysiotropic
      activity, while the role of s-GnRH needs to be further investigated.

PMID- 8354992
TI  - Effects of prolactin, growth hormone, and triiodothyronine on prolactin receptors
      in larval and adult tiger salamanders (Ambystoma tigrinum).
AB  - The effects of porcine growth hormone (pGH) or ovine prolactin (oPRL) alone and
      in combination with triiodothyronine (T3) on renal PRL receptors were determined
      in both pre- and post-metamorphic tiger salamanders (Ambystoma tigrinum). The
      protein hormones were given at a dose of 1.0 micrograms/gm body weight/day and
      the T3 was given at 10.0 ng/gm body weight/day. The duration of treatment was 7
      days. Effects on growth, and plasma thyroid hormone levels were also determined.
      Ovine PRL increased growth in both larvae and adults and reversed metamorphic
      changes. Administration of T3 increased the plasma T3 concentration, as measured
      by radioimmunoassay, and when given alone caused weight loss at both stages. The
      GH decreased plasma T4 and increased plasma T3 concentrations, indicating that it
      caused an increase in T4 deiodination. In adults the renal PRL receptor affinity
      of 2.9 +/- 0.7 x 10(10) L/mol and capacity of 160 +/- 22 fmol/mg protein were
      higher than the corresponding values of 1.8 +/- 0.3 x 10(10) L/mol and 29.2 +/-
      3.8 fmol/mg in larvae. In adults only, there is an additional low-affinity, high
      capacity PRL binding site. The oPRL treatment decreased the binding capacity of
      33.2 +/- 1.2 and 5.9 +/- 4.9 fmol/mg in adults and larvae, respectively. By
      contrast, pGH increased the capacities to 249 +/- 18 and 62.1 +/- 6.8 fmol/mg in
      adults and larvae, respectively. Treatment with T3 alone doubled the oPRL binding
      capacity to 58.3 +/- 4.7 fmol/mg in larvae, but there was no effect in adults. In
      both developmental stages the effects of oPRL and pGH on the receptors were not
      changed by the simultaneous T3 treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8354993
TI  - Detection of insulin receptors in newt liver and forelimb regenerates and the
      effects of local insulin deprivation on epimorphic regeneration.
AB  - Previous in vivo and in vitro studies indicate that insulin is required in adult
      newt forelimb regeneration. The objectives of the current study were 1) to detect
      insulin receptors in the liver (a classical target organ for insulin) and once
      verified, detection of insulin receptors in the adult newt forelimb regenerate;
      and 2) to determine whether locally implanting insulin antibody-soaked hydrolyzed
      polyacrylamide beads (hypa beads) into a regenerating forelimb blastema would
      affect its growth and/or differentiation. The results show that insulin receptors
      are detectable in the plasma membranes of newt liver and forelimb regenerates.
      Radioiodinated bovine insulin binding is time-dependent and specific; unlabeled
      bovine insulin competes with labeled insulin for binding to NLPM more effectively
      than does insulin-like growth factor-I, guinea pig insulin, and glucagon. The
      newt hepatic insulin receptor binds insulin with high affinity (1.1 nM-1) and low
      capacity (63 +/- 8 fmoles/mg). The size of the alpha subunit of the newt insulin
      receptor is 130 kDA and that of the beta subunit is 95 kDa. The beta subunits
      undergo insulin-stimulated phosphorylation in response to insulin. An
      autoantibody against the human insulin receptor recognizes the newt receptor
      protein. Insulin receptors are also detectable in 15 and 20 day newt forelimb
      regenerates. Specific immunogold labelling of the receptor-bound antibody appears
      to be restricted to the cellular processes of the regenerate. Implanting hypa
      beads soaked with purified insulin antibody into regenerating adult newt
      forelimbs results in abnormal growth and differentiation of the regenerates,
      confirming that insulin plays an essential role in adult newt forelimb
      regeneration.

PMID- 8354994
TI  - Immunological detection of an oviductal glycoprotein in the rat.
AB  - In the golden hamster, high-molecular-weight glycoproteins are secreted by the
      epithelial cells of the oviduct. The present study was designed to investigate
      the possibility that the rat oviduct produces specific glycoproteins similar to
      the oviductal glycoproteins (GHOGPs) of the golden hamster. Oviductal extracts
      and oviductal fluids obtained from ovulatory rats were analysed by immunoblotting
      for the presence of glycoproteins that cross-react with a monoclonal antibody
      (MAb) against GHOGPs. The MAb immunoreacted with a broad band of proteins with a
      range of molecular weights (MWs) of above 330 kD in oviductal extracts or
      oviductal fluid after fractionation by electrophoresis under reducing conditions,
      but these proteins were not present in serum and uterine flushings. An
      immunohistochemical study demonstrated that the MAb bound strongly to the
      epithelial cells of the oviduct and, to a lesser extent, to those of the large
      intestine. Weak reactions were also observed with some other tissues. However,
      similar material of high MW was not detected in extracts of tissues from the
      other organs, suggesting that the glycoprotein of high MW that reacted with the
      MAb is specific for the oviduct. Ultrastructural immunocytochemistry revealed
      that the MAb reacted specifically with putative secretory granules of nonciliated
      cells in the oviductal epithelium. These results indicate that the oviductal
      epithelial cells of the rat produce a specific glycoprotein that is
      immunologically similar to GHOGPs.

PMID- 8354995
TI  - A simple technique for age estimation in adult corpses: the two criteria dental
      method.

PMID- 8354996
TI  - An anthropometric study of pedophiles and rapists.
AB  - Anthropometric measurements were obtained on pedophiles (n = 23) and rapists (n =
      13) who were in a forensic treatment facility. Hand grip strength was measured
      with a Jamar hand dynamometer. Ten separate body measurements were taken
      including height and weight. As an indicator of body fat, triceps skinfold
      thickness was obtained with calipers on the non-dominant arm. The findings
      provided mild support for the hypothesis that the rapists in the sample would be
      stronger, more muscular, and have less body fat than the pedophiles.

PMID- 8354997
TI  - Sex determination from metacarpals and the first proximal phalanx.
AB  - Sex determination using metacarpals and the first proximal phalanx was carried
      out on a sample (n = 60) of documented sex. Six measurements were taken on each
      of metacarpals 1 to 5 and the first proximal phalanx. Regression equations were
      calculated for determining sex from the bones. The equations were then applied to
      a second sample (n = 20) also of documented sex to establish the degree of
      accuracy they produced in assigning sex. The equations for metacarpal 1 produced
      the highest degree of correct sex determination and overall the degree of
      accuracy ranged from 74% to 94%.

PMID- 8354998
TI  - Osteometry of the human iliac crest: patterns of normality and its utility in
      sexing human remains.
AB  - We recorded nine measurements and one index of the iliac crest in 42 human hip
      bones from a Spanish skeletal collection. Common values of seven of these
      parameters and index are reported. We could detect statistically significant
      differences of means depending on side for two of these parameters (iliac crest
      rise, distance from the upper point of the iliac crest to the anterior superior
      spine) and for the iliac crest index, and relating to sex for three parameters
      (iliac crest arch, iliac crest rise, distance from the upper point of the iliac
      crest to the anterior superior spine) and for the index. These measurements and
      index are useful for sexing human remains.

PMID- 8354999
TI  - Identification of rib number and assessment of intercostal variation at the
      sternal rib end.
AB  - A technique for the identification of anatomical rib number is presented here.
      Preliminary tests indicate that with experience, percent accuracy for
      identification may approach 100%. This technique was then applied to a skeletal
      collection where rib number was not documented in order to determine the effects
      of intercostal variation on the application of rib four age-at-death estimation
      standards to other ribs. Spearman rank correlations between rib four and ribs
      three through nine range from 0.89 to 0.91. No significant differences were found
      between ribs conforming to or deviating from the phase observed on rib four.
      There is a significant proportion of deviations falling below the phase set by
      rib four, however these deviations are not statistically associated with rib
      number and are usually within one phase. These results indicate that rib four
      standards can be cautiously applied to other sternal ends when rib four is not
      preserved.

PMID- 8355000
TI  - Determination of human immunodeficiency virus antibody status in forensic autopsy
      cases using a rapid and simple FDA-licensed assay.
AB  - Evaluation of an FDA-licensed rapid assay to detect antibodies to human
      immunodeficiency virus (HIV) was accomplished by testing 414 serum samples
      collected sequentially from autopsy cases at the Office of the Chief Medical
      Examiner, State of Maryland. The time of postmortem collection ranged from 8 to
      30 hours. All samples were tested for the presence of antibodies to HIV using a
      rapid peptide microfiltration assay (SUDS HIV-1 test, Murex Corporation,
      Norcross, GA), and an enzyme-linked immunosorbent assay (ELISA). Samples yielding
      repeatedly reactive results were confirmed by Western blot. Of the 414 specimens,
      23 (5.6%) produced reactive results by both SUDS and ELISA, and were confirmed by
      Western blot. One additional sample was repeatedly reactive by ELISA but negative
      by the SUDS test. This sample produced an indeterminate profile by Western blot
      (reactivity to only p24) and was negative by several additional retroviral
      assays. Of the 23 HIV infected cases, 16 had risk factors for HIV infection; 19
      were blacks and 18 were male. The SUDS, 10 minute test, exhibited a 100%
      sensitivity and 100% specificity in comparison to FDA-licensed ELISA and Western
      blot assays for detecting HIV antibody in autopsy serum specimens. We conclude
      that this rapid, simply performed assay is accurate and applicable for use in
      several testing situations, including autopsy rooms.

PMID- 8355001
TI  - Disappearance of soft tissue and the disarticulation of human remains from
      aqueous environments.
AB  - Human remains recovered from aquatic environments were scored for regional
      presence of soft tissue, exposure of bone, and loss of body parts to determine
      the general pattern of soft tissue loss and loss of body parts. Regions scored
      were: the cranium, mandible, neck, hands, forearms, upper arms, feet, legs,
      pelvic girdle, and trunk. Initial disappearance of soft tissue, resulting in
      exposure of underlying bones, occurred in areas thinly overlain by soft tissue
      beginning with the head, hands, and anterior lower legs. Disappearance of body
      parts followed the general sequence: bones of the hands and wrists, bones of the
      feet and ankles, and the mandible and cranium. The lower legs, forearms, and
      upper arms are the next units to separate from the body. Known postmortem
      intervals for remains analyzed ranged from weeks to years and could not reliably
      be estimated based on the condition of the body at the time of recovery. As parts
      drop away from a floating carcass in large or current-driven bodies of water,
      they are often separated from the major body unit. This complicates recovery.
      Knowledge of disarticulation sequences allows more informed assessment of
      skeletal element recoveries to be expected and assists in the interpretation of
      artifacts and events produced by different disarticulating environments.

PMID- 8355002
TI  - A computer program for the estimation of time of death.
AB  - In the 1960s Marshall and Hoare presented a "Standard Cooling Curve" based on
      their mathematical analyses on the postmortem cooling of bodies. Although fairly
      accurate under standard conditions, the "curve" or formula is based on the
      assumption that the ambience temperature is constant and that the temperature at
      death is known. Also, Marshall and Hoare's formula expresses the temperature as a
      function of time, and not vice versa, the latter being the problem most often
      encountered by forensic scientists. A simple BASIC program that enables solving
      of Marshall and Hoare's equation for the postmortem cooling of bodies is
      presented. It is proposed that by having a computer program that solves the
      equation, giving the length of the cooling period in response to a certain rectal
      temperature, and which allows easy comparison of multiple solutions, the
      uncertainties related to ambience temperature and temperature at death can be
      quantified, substantiating estimations of time of death.

PMID- 8355003
TI  - Infant death in San Francisco 1989-1990.
AB  - This paper examines all of the unexplained and violent deaths of children less
      than one year of age in the City and County of San Francisco during the years
      1989-1990. A total of 62 cases were collected and analyzed retrospectively. Among
      the cases we examined, 34 deaths were determined as SIDS, while seven were moded
      as accidents and two as homicides. The deaths were examined with respect to the
      following parameters: sex, race, age, height and weight, cause and manner of
      death, significant autopsy and microscopic findings; circumstances of death
      including place, the person discovering or reporting the death, the presence of
      siblings or previous child death in the family and previous illness in the same
      child. A particular stress is given to the definition and diagnosis of SIDS,
      according to the international literature, and to the criteria adopted to
      distinguish SIDS cases from accidents and homicides. A review of both the
      American and European literature shows that most articles do not include
      comparisons of data from both the autopsy and the scene. Additionally there is
      little standardization in the investigation and the extent of postmortem
      examinations performed. An international standardization of these methods appears
      necessary and the use of protocols to assure complete investigation and
      postmortem examination will allow more intensive evaluation of data. Here we give
      a brief presentation of the necropsy protocol for Sudden Unexpected Infant Death
      recently written and approved by the California Department of Health Services and
      used in the Chief Medical Examiner's Office in San Francisco.

PMID- 8355004
TI  - Gang-related homicides in Los Angeles County.
AB  - The incidence of gang homicides in Los Angeles County has increased faster than
      that of non-gang homicides in the past decade. This study compares
      characteristics of gang homicide victims with those of non-gang homicide victims
      for the year 1987. In 1186 cases, gang members were more likely to be young Black
      men who died of gunshot wounds. Gang homicide victims were more likely to die of
      firearm injuries in the early evening, and were more likely to die in a
      relatively small area of Los Angeles County. Drive-by shooting was highly
      associated with gang homicide.

PMID- 8355005
TI  - A comparative study of erotomanic and obsessional subjects in a forensic sample.
AB  - Erotomania is the delusional belief that one is passionately loved by another.
      These persons often go to great lengths to approach their object of desire, often
      necessitating the attention of the law. We have reviewed a forensic sample to
      select subjects who meet criteria for the diagnosis of erotomania. Case histories
      from all of the case files of the Threat Management Unit of the Los Angeles
      Police Department were reviewed to compare erotomanic subjects with those who
      were suffering from other disorders. Various demographic and other relevant data
      were examined to determine if the erotomanic subjects presented similar or
      different profiles.

PMID- 8355006
TI  - Postmortem alcohol production in fatal aircraft accidents.
AB  - During 1989 and 1990, the Civil Aeromedical Institute received specimens from 975
      victims of fatal aircraft accidents. The maximum concentration of ethanol allowed
      under FAA regulations (0.04%, 40 mg/dL) was exceeded in 79 of these cases (8%).
      It was determined based on the distribution of ethanol in urine, vitreous humor,
      blood, and tissue that 21 of the positive cases (27%) were from postmortem
      alcohol production. Twenty-two of the positive cases (28%) were found to be from
      the ingestion of ethanol. In 36 cases (45%), no determination could be made
      regarding the origin of the ethanol. In two cases, postmortem alcohol production
      exceeded 0.15% (150 mg/dL). The opinion held by some toxicologists that
      postmortem alcohol production can be inferred from the presence of acetaldehyde,
      acetone, butanol, and other volatiles was found to be incorrect. Several cases
      with postmortem ethanol had no other volatiles. Volatile compounds were found in
      several cases where no ethanol was present. In addition a case was found in which
      the relative ethanol concentrations in blood, bile, and vitreous humor were
      solely consistent with the ingestion of ethanol, but acetaldehyde, acetone, and 2
      butanol were also found in blood. This clearly indicates that the presence or
      absence of other volatiles does not establish postmortem ethanol production.

PMID- 8355007
TI  - Improved long-term stability of blood cocaine in evacuated collection tubes.
AB  - A study was undertaken to determine if a relatively minor modification of our
      existing specimen collection tubes could enhance the long-term stability of blood
      cocaine. We added cocaine, benzoylecgonine (BE) and ethanol to whole sheep blood
      in glass tubes that were prepared to contain one of several combinations of
      preservatives and anticoagulant. On day 1 and at intervals of up to one year, the
      drugs were measured by gas chromatography-mass spectrometry (cocaine and BE) or
      headspace gas chromatography (ethanol). Storage of blood containing 200 ng/mL
      cocaine at 4 degrees C for one year resulted in 100% loss of the drug using our
      normal 10 mL specimen collection tubes containing 100 mg sodium fluoride and 20
      mg potassium oxalate. The substitution of oxalic acid for potassium oxalate
      reduced this loss to 76% without any significant effect on the benzoylecgonine or
      ethanol concentrations. Further addition of 10 mg echothiophate iodide, a
      quaternary ammonium compound, brought the cocaine loss down to 60% of the
      original concentration by one year. Further work will be required to determine if
      oxalic acid and/or echothiophate iodide could be used in blood collection vials
      intended for forensic toxicological purposes without any detrimental effect on
      other assays.

PMID- 8355008
TI  - Observations of differential decomposition on sun exposed v. shaded pig carrion
      in coastal Washington State.
AB  - The decomposition of two pig carcasses in close proximity to each other, one
      exposed and the other shaded, in a continuous woodland were observed and
      different rates of decay were recorded. The exposed pig decomposed much faster
      than the shaded pig, reaching a stable minimal weight two weeks before the shaded
      carcass. Bloat size, body weight, occurrence of blow fly larvae, and ambient air
      temperatures are compared. Maggot development appeared to be a major factor in
      the overall rate of decomposition and was affected primarily by different
      temperature patterns at the two sites.

PMID- 8355009
TI  - Cholinesterase activity in postmortem blood as a screening test for
      organophosphate/chemical weapon exposure.
AB  - This study was undertaken to determine whether postmortem blood cholinesterase
      activity could be used as a screening test for exposure to nerve agents. Whole
      blood cholinesterase activity at 25 degrees C was analyzed for a one week period
      in order to simulate the battle field collection problems of: hemolyzed blood
      samples, delayed recovery of the specimen, and unrefrigerated transfer to the
      testing facility. A total of 53 nonpreserved post-mortem whole blood specimens
      were analyzed in triplicate for cholinesterase activity by the delta pH method of
      Michel. There was a negligible loss of cholinesterase activity by the seventh day
      of the study. The enzyme activities of the specimens had a mean value (range) of
      0.48 (0.20 to 0.74) initially and 0.45 (0.07 to 0.70) pH units after one week.
      Whole blood from five healthy adults remained essentially unchanged during this
      period, with an initial value 0.59 (0.52 to 0.67) and a final value of 0.52 (0.46
      to 0.62) pH units. To compare postmortem and simulated nerve agent values,
      aliquots from 18 of the original 53 postmortem specimens were frozen during day
      one of the study, thawed on day seven and a cholinesterase inhibitor added. These
      specimens were then analyzed with the other specimens. All values from inhibited
      specimens were essentially zero (0.0 to 0.01) pH units compared to a range of
      0.07 to 0.61 pH units for matched, uninhibited, day seven postmortem specimens.
      Fifteen actual nonpreserved specimens from the battlefield were analyzed as
      verification of screen performance. Their results fell within the uninhibited
      postmortem range above.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355010
TI  - ABO blood grouping on dental tissue.
AB  - Twenty-five permanent teeth, including eight carious ones whose pulp cavities had
      been exposed, were used for this research 3-5 weeks after extraction. Phosphate
      buffered saline (PBS, at pH 7.2) was employed to extract ABO blood group
      substance from tooth powder. ABO grouping was performed on blood-stained
      compresses from the extraction wound (as controls), tooth fragment, tooth powder,
      and cotton fibers immersed in PBS extract by absorption-elution (AE) technique
      and on the PBS extracts by the two-dimensional absorption-inhibition (2-D AI)
      technique. It was found that blood grouping in PBS extracts by 2-D AI yielded
      reliable results: no false positive results, and a high rate of correct grouping,
      (24/25), while blood grouping on other dental materials, such as tooth fragments,
      tooth powders, immersed fibers, by AE gave an unacceptable rate of false
      positive/negative results.

PMID- 8355012
TI  - Two deaths involving isoflurane abuse.
AB  - Two deaths due to isoflurane abuse are reported. One case was a suicide and the
      other a multiple drug death including isoflurane. A simple headspace gas
      chromatographic method was used for isoflurane quantitation. A review of the
      literature did not reveal blood and tissue concentrations of isoflurane. Drug
      tissue distributions and a discussion of the toxicological findings are
      presented.

PMID- 8355011
TI  - Identification of human DNA in complex biological samples using the Alu
      polymerase chain reaction.
AB  - Alu-Polymerase chain reaction (PCR) was used to amplify human DNA from complex
      mixed sources of DNA. Amplification of human DNA sequences by Alu-PCR could be
      accomplished in samples containing low concentrations of template in the presence
      of excess heterologous DNA sequences. Thus, sensitivity and specificity are
      maintained in complex DNA mixtures allowing positive identification of the
      presence of human DNA sequences by this technique.

PMID- 8355013
TI  - Transection of trachea due to improper application of automatic seat belt
      (submarine effect).
AB  - The seat belt has been a major contributor in minimizing injuries in automobile
      accidents. However, it often causes characteristic patterned injuries to the body
      relative to its application at the time of an accident. We report an unusual case
      of a driver who sustained a transection of the trachea due to the "submarine
      effect" from improper application of the seat belt.

PMID- 8355014
TI  - Sudden death due to ruptured hydatid cyst of the liver.
AB  - The cyst stage of Echinococcus granulosus is commonly located in the liver, which
      frequently results in a long symptomless period. We present a sudden death due to
      a freshly hemorrhagic hydatid cyst following blunt trauma to the liver in a 19
      year-old boy. The possible mechanism was thought to be an anaphylactoid reaction
      to the leakage of the cyst fluid.

PMID- 8355015
TI  - A suicide by self-decapitation.

PMID- 8355016
TI  - Positive identification in a case of intentional extreme fragmentation.
AB  - The investigation of the first of the murders of young males to which Jeffrey
      Dahmer confessed led to systematic survey of two acres of semirural property in
      Bath Township, Ohio. The survey revealed the fragmentary skeleton of a young
      adult male, as well as bones of several species of animals. Through
      archaeobiological analysis, the animal bones were identified and taphonomic
      modifications documented. The human bones were dry and weathered, and many were
      rodent-gnawed, indicating that they had been exposed for many years. The human
      bones displayed an extreme degree of splintering, warping, bending, and spiral
      breakage. The only relatively complete bone was a cervical vertebra.
      Dismemberment and breakage had been accomplished by cutting, blunt force, and, in
      the case of the ribs, manual bending. Even in so extreme a case of intentional
      fragmentation, however, forensic anthropological analysis resulted in positive
      identification, with the primary criteria based on matching osteological features
      evident in premortem and postmortem radiographs of a cervical vertebra.

PMID- 8355017
TI  - Radiographic identification of human remains through deformities and anomalies of
      post-cranial bones: a report of two cases.
AB  - Human remains can be identified radiographically by anomalies and deformities of
      the post-cranial bones when there are no old fractures and the cranium and
      extremities are not available. These anomalies and deformities of the sternum,
      vertebrae, sacrum and innominate bone are often protected from damage by
      scavengers. We report their use to exclude a proposed identity in one case and to
      confirm identity in another case. The value and number of these criteria and
      their pathogenesis is discussed with reference to their prevalence and their
      expression of inter- and intraindividual variability.

PMID- 8355018
TI  - Nine-year follow-up study of a plasma-derived hepatitis B vaccine in a rural
      African setting.
AB  - One hundred and one of 255 recipients of a plasma-derived hepatitis B vaccine
      were evaluated in 1990, 9 years after the first vaccine dose in a study in Zambia
      to evaluate the efficacy of one, two, or three doses. In 1983, 2 years after the
      first vaccine dose, antibody to the hepatitis B surface antigen (anti-HBs) had
      been detectable in 90 of these 101 participants (89%). In 1990, anti-HBs was
      still detectable in 72 of 101 (71%), and was present at a protective level (> or
      = 10 mIU/mL) in 68 of 101 (67%). Although the original vaccine study elicited a
      protective level of antibody in a greater percentage of children and adolescents
      than in adults, there were no significant differences among the three groups at 9
      years. (In 1990, anti-HBs was still detectable in 52 of 70 [74%] who had had no
      serologic markers of the hepatitis B virus in 1981, and a protective level was
      detected in 47 of 70 [67%].) A protective level of anti-HBs was detected in 1990
      in 26 of 36 (72%) recipients of three doses and in 23 of 31 (74%) recipients of
      two doses; the slightly lower prevalence among recipients of one dose (19 of 34
      [56%]) was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355019
TI  - Lassa virus activity in Guinea: distribution of human antiviral antibody defined
      using enzyme-linked immunosorbent assay with recombinant antigen.
AB  - More than 3,100 households in 27 selected villages distributed in the main
      geographic regions of Guinea were surveyed for the presence of Lassa virus
      specific IgG antibodies (LVA), using an enzyme-linked immunosorbent assay (ELISA)
      with Lassa virus nucleocapsid protein expressed in insect cells infected with a
      recombinant baculovirus as antigen. The highest prevalence of LVA (25-55%) was
      found among inhabitants of tropical secondary forest (areas near Gueckedou,
      Yomou, and Lola) and guinea savannah (Faranah and Kindia areas), near the
      southern frontiers with Sierra Leone and Liberia. A much lower prevalence (4-7%)
      was found among inhabitants of mountainous (Pita, Labe, and Mali) and coastal
      (Boffa, Boke) areas. We found no discernible differences in LVA prevalence
      between males and females or among various age groups. Testing of 406 hospital
      staff members of the eight central hospitals in these areas for LVA revealed a
      similar distribution of seropositivity among hospitals in various prefectures.
      The highest prevalence of LVA in hospital staff (29-40%) was in the Gueckedou and
      Lola hospitals. Sera of LVA-positive persons were tested via Western blot
      analysis. Antibodies bound predominantly to NP and GP2 proteins.

PMID- 8355020
TI  - Serological studies of an enterically transmitted non-A, non-B hepatitis in
      Somalia.
AB  - An outbreak of an acute sporadic viral hepatitis occurring at three villages in
      the lower Shebli region of southern Somalia was studied. Sera were examined for
      antibodies to hepatitis E virus (HEV) antigen by a recently developed enzyme
      linked immunosorbent assay. The prevalence of anti-HEV ranged from 77.8% to 94.0%
      among the three villages. Anti-HEV prevalence did not differ significantly with
      age or sex. HEV infections were widely distributed among all age groups, without
      a preponderance in any specific age category. Overall, 97.6% of afflicted
      patients who were examined 6-10 days after onset of jaundice developed either IgM
      or IgG anti-HEV.

PMID- 8355021
TI  - Human parvovirus B19 infections: routine diagnosis by a new nested polymerase
      chain reaction assay.
AB  - A nested primer PCR assay was developed to detect human parvovirus B19 in various
      clinical specimens in a routine diagnostic laboratory. Under optimized conditions
      the highly specific assay had a sensitivity of less than 10 genome units. For
      practical reasons, however, this sensitivity was adjusted to 10-100 virus genomes
      in diagnostic applications. Using clinical specimens from 200 patients with
      suspected B19 infection, nested PCR was shown to have important diagnostic
      advantages over the detection of B19 specific antibodies. The data suggest that
      on the basis of serological data as obtained with currently available test
      systems a considerable proportion of B19 infections would be misdiagnosed.
      Examples for the usefulness of the PCR assay in routine diagnosis are given.

PMID- 8355022
TI  - Detection of measles, mumps, and rubella antibodies in saliva using antibody
      capture radioimmunoassay.
AB  - Antibody capture radioimmunoassays were developed for detecting virus specific
      IgM (MACRIA) and IgG (GACRIA) to measles, mumps, and rubella and used to
      investigate saliva as an alternative specimen to serum for diagnosis. Saliva was
      collected from 63 patients with measles, 19 with mumps, and 150 with rubella,
      which were all clinically diagnosed and serologically confirmed. Virus specific
      IgM was detected in 92% of measles, 75% of mumps, and 100% of rubella saliva
      samples collected during the first week of illness. Between 1 and 5 weeks after
      onset virus specific IgM was detected in 100% of saliva specimens. After the 5th
      week the proportion of reactive specimens declined. The specificity of the MACRIA
      tests was established by testing saliva samples collected from blood donors for
      measles (88), mumps (88), and rubella IgM (91). All of the saliva specimens
      tested for measles and rubella specific IgM were unreactive, 1/88 specimens
      tested for mumps specific IgM contained significant reactivity. Saliva specimens
      collected from acute cases of MMR were tested in all 3 MACRIAs. A small
      proportion of saliva samples contained detectable IgM of more than one virus
      infection. Rubella and measles specific IgG was detected in the saliva of all
      cases from the 4th or 5th day of illness, respectively. Detection of mumps
      specific IgG was less successful. We have demonstrated that virus specific IgM
      can be reliably detected in saliva samples collected from acute cases of measles,
      mumps, and rubella and identified 1-5 weeks after onset of illness as the optimum
      time for collection of samples.

PMID- 8355023
TI  - Inflammatory myopathies. A review.

PMID- 8355024
TI  - Microvascular and neuronal consequences of common carotid artery thrombosis and
      platelet embolization in rats.
AB  - The microvascular and neuronal consequences of nonocclusive common carotid artery
      (CCA) thrombosis were documented in rats. Thrombosis of the CCA was produced by a
      rose bengal-mediated photochemical insult and regional patterns of blood-brain
      barrier (BBB) disruption were documented by horseradish peroxidase (HRP)
      histochemistry at 15 min (n = 12), 4 h (n = 3), 1 day (n = 5) or 7 days (n = 5)
      after vascular injury. At 15 min and 4 h after thrombosis, multiple foci of BBB
      disruption were present throughout the thrombosed hemisphere; protein leakage was
      occasionally detected contralaterally. Extravasated HRP was associated with well
      perfused arterioles and arterioles containing luminal platelet aggregates at
      different stages of degranulation. Evidence for local platelet adhesion and
      aggregation or endothelial disruption at these sites was not detected. However,
      HRP-containing endothelial plasmalemmal vesicles were present at leaky sites.
      Variable degrees of parenchymal injury were documented including dendritic and
      astrocytic swelling with neuronal necrosis. By 1 day after CCA thrombosis, the
      overall frequency of permeable sites, more commonly associated with luminal
      leukocytes and parenchymal necrosis, was reduced. At 7 days, vessels permeable to
      HRP were associated with tissue necrosis, reactive astrocytes and microglial
      infiltration. Arteriole wall thickening and leukocyte accumulation within
      arterioles and venules were also detected. Widespread platelet embolization
      leading to variable degrees of BBB disruption and tissue injury occurs after CCA
      thrombosis. Acute abnormalities in vascular permeability are thus hypothesized to
      play an important role in the acute pathogenesis of cerebrovascular thrombosis.
      Delayed leukocyte accumulation in this model of embolic infarction may represent
      a secondary insult to the injured brain.

PMID- 8355025
TI  - Ultrastructural morphometric features of human sural nerve endoneurial
      microvessels.
AB  - We studied the morphometric features of 366 transversely sectioned endoneurial
      microvessels in sural nerves from 50 healthy volunteers (mean age 34.5 +/- 15.8,
      range 20 to 66 years). Nerves were obtained and processed by the same techniques
      and standards used to study biopsied nerves from patients with neuropathy.
      Endothelial area, basement membrane area, number of endothelial nuclei and
      junctions, and number of periendothelial nuclei all increase significantly with
      vessel size as judged by mural area. Periendothelial cell coverage of endothelial
      perimeter does not correlate with vessel size. Components of endoneurial
      microvessels, specifically the area containing basement membrane, do not change
      significantly with age. The present report provides a detailed characterization
      of the ultrastructural features of endoneurial microvessels with age in humans
      and provides optimal reference values for study of microvessel pathologic changes
      in disease.

PMID- 8355026
TI  - X-ray-induced cell death in the developing hippocampal complex involves neurons
      and requires protein synthesis.
AB  - Sprague-Dawley rats aged 1 or 15 days were irradiated with a single dose of 200
      cGy X-rays and killed at different intervals from 3 to 48 hours (h). Dying cells
      were recognized by their shrunken and often fragmented nuclei and less damaged
      cytoplasm in the early stages. On the basis of immunocytochemical markers, dying
      cells probably represented a heterogeneous population which included neurons and
      immature cells. In rats aged 1 day the number of dying cells rapidly increased in
      the hippocampal complex with peak values 6 h after irradiation. This was followed
      by a gentle decrease to reach normal values 48 h after irradiation. The most
      severely affected regions were the subplate and the cellular layer of the
      subiculum, gyrus dentatus and hilus, and the stratum oriens and pyramidale of the
      hippocampus (CA1 more affected than CA2, and this more affected than CA3). X-ray
      induced cell death was abolished with an injection of cycloheximide (2
      micrograms/g i.p.) given at the time of irradiation. X-ray-induced cell death was
      not changed after the intraventricular administration of nerve growth factor
      (NGF; 10 micrograms in saline) at the time of irradiation. Cell death was not
      induced by X-irradiation in rats aged 15 days. These results indicate that X-ray
      induced cell death in the hippocampal complex of the developing rat is subjected
      to determinate temporal and regional patterns of vulnerability; it is an active
      process mediated by protein synthesis but probably not dependent on NGF.

PMID- 8355027
TI  - Muscle hypertrophy experimentally induced by administration of denervated muscle
      extract.
AB  - The effects of systemic administration of muscle extract on normal muscle were
      studied. Male Wistar rats received intraperitoneal injections of normal and
      denervated muscle extract over 5 consecutive days. Soleus muscles were then
      submitted to histological, histochemical and quantitative-morphometric analysis.
      The group receiving denervated muscle extract showed considerable muscle fiber
      hypertrophy, together with the formation of new fibers suggestive of hyperplasia.
      The systemic administration of denervated muscle extract was shown to have a
      considerable myotrophic effect on normal muscle, evident in the hypertrophy and
      hyperplasia of muscle fibers.

PMID- 8355028
TI  - A syndrome of acute severe muscle necrosis in intensive care unit patients.
AB  - Four septic patients and one asthmatic patient are described who developed a
      severe paralytic disorder in an intensive care unit (ICU), associated with a rise
      in serum creatine kinase and a severe necrotizing myopathy. All cases had
      received non-depolarizing muscle blocking agents and large intravenous doses of
      glucocorticoids. Three patients developed myoglobinuria. No improvement or very
      little improvement in muscle function was noted in the four fatal cases. The
      single survivor recovered his strength after 6 months. This syndrome
      ("necrotizing myopathy of intensive care") provides one of the differential
      diagnoses for ICU-acquired weakness. The myopathy appears to have several
      interdependent causes and it is proposed that these should be classified as
      myonecrosis "priming" factors (glucocorticoids, myotropic infections, sepsis) and
      "triggering" factors (non-depolarizing muscle blocking agents).

PMID- 8355029
TI  - Abnormal neuritic architecture identified by Di-I in Pick's disease.
AB  - The fluorescent stain Di-I combined with confocal microscopy identified an
      abnormal neuritic pattern in the cortices of frontal and anterior temporal lobes
      in postmortem tissues from patients with Pick's disease (PD). Focal, dense
      neuritic aggregates 50 to 200 microns in diameter were scattered throughout all
      cortical layers. The three-dimensional analysis provided by confocal microscopy
      revealed the neuritic clusters to consist of enlarged, randomly arrayed,
      dystrophic neurites that were not associated with amyloid deposits, astrocytic
      processes or capillaries. In the intervening neuropil, there were fewer neurites
      compared to controls. The occipital cortex, which is unaffected in PD, showed a
      neuritic architecture comparable to normal controls as did affected brain tissues
      from patients with Alzheimer's disease or remote, ischemic infarction. This
      neuritic pattern is, thus far, unique to PD and may reflect the loss of specific
      subpopulations of cortical neurons and proliferation of neurites of the remaining
      neurons.

PMID- 8355030
TI  - CD44 expression in human astrocytes and oligodendrocytes in culture.
AB  - CD44 is a glycoprotein present on the surface of some lymphocyte cell populations
      and other non-lymphoid cells, and is involved in many functions related to cell
      cell and cell-matrix interactions. In this study, expression of CD44 antigen in
      primary neural cell cultures derived from fetal and adult human brains was
      investigated. In cultures processed for double immunofluorescence staining,
      approximately 80% of fetal astrocytes and more than 95% of adult astrocytes
      expressed the CD44 antigen on the cell bodies and processes; CD44 was also
      detected in 50-60% of adult oligodendrocytes. Neurons in fetal brain cell
      cultures did not express CD44 at all. Western blot analysis performed in
      astrocyte- and in neuron-enriched cultures confirmed the results from
      immunostaining and showed that the antibody against CD44 reacted with a
      polypeptide, of approximately 80 kD, that is present exclusively in the astrocyte
      enriched cultures, but absent in neuron-enriched cultures. Our results indicate
      that CD44 glycoprotein is constitutively expressed in the human cells of glial
      cell lineage and its role is likely to be associated with normal neuroglia
      mediated adhesion/recognition processes.

PMID- 8355031
TI  - Immunocytochemical analysis of the cellular infiltrate in the spinal cord lesions
      in HTLV-I-associated myelopathy.
AB  - Immunocytochemical staining of spinal cords from five autopsied patients with
      HAM/TSP was performed using a panel of monoclonal antibodies reactive with T
      cells. T cell subsets, B cells, macrophages, natural killer cells, IL-2 receptor
      positive cells, and HLA-ABC and HLA-DR. In the spinal cords of patients with a
      shorter duration of illness, CD4+ cells, CD8+ cells and macrophages were evenly
      distributed in active-chronic inflammatory lesions. In striking contrast, we
      noted the predominance of CD8+ cells over CD4+ cells in the inactive-chronic
      inflammatory lesions of patients with longer duration of illness. Natural killer
      cells, IL-2 receptor-positive cells and B cells were only rarely present in both
      the active-chronic and inactive-chronic lesions. HLA-ABC was positive in
      endothelial cells and infiltrating mononuclear cells, and HLA-DR was positive in
      endothelial cells, microglia and infiltrating mononuclear cells. This study
      suggests that immune responses in the spinal cord lesions of HAM patients
      gradually change along with the duration of illness.

PMID- 8355032
TI  - Modulation of multidrug resistance: at the threshold.

PMID- 8355033
TI  - The clinical cancer researcher--still an embattled species.

PMID- 8355034
TI  - Persistence of circulating t(14;18)-positive cells in long-term remission after
      radiation therapy for localized-stage follicular lymphoma.
AB  - PURPOSE: To determine the prevalence of circulating t(14;18)-positive cells in
      patients with long-term remission after radiation therapy for stage I and II
      follicular lymphoma. PATIENTS AND METHODS: Peripheral-blood mononuclear cells
      from 21 patients in continuous remission were examined by a two-step polymerase
      chain reaction (PCR) assay for the detection of cells carrying a t(14;18)
      translocation with a breakpoint within the major breakpoint region (MBR) or minor
      cluster region (mcr). RESULTS: Follow-up duration was between 25 and 160 months,
      with a median of 6.5 years. Thirteen patients (62%) showed negative results on
      repetitive testing. Cells that were t(14;18)-positive were found in eight
      patients (38%), all carrying a breakpoint in the MBR. One patient relapsed in
      each group. CONCLUSION: Circulating t(14;18)-positive cells can persist in a high
      percentage of follicular lymphoma patients in long-term complete remission (CR)
      after radiation treatment for stage I and II disease. The significance of minimal
      residual t(14;18)-positive cells with regard to the risk of relapse needs to be
      investigated in further prospective long-term studies.

PMID- 8355035
TI  - Clinical activity of a cytotoxic fusion protein in the treatment of cutaneous T
      cell lymphoma.
AB  - PURPOSE: A phase I trial in patients with refractory hematologic malignancies was
      performed at our institution to test the clinical relevance of the selective
      cytotoxic activity of the interleukin-2 (IL-2)-diphtheria toxin fusion protein,
      DAB486IL-2. A subset of five patients from this trial, all with cutaneous T-cell
      lymphomas (CTCL), forms the basis of this report. PATIENTS AND METHODS: Two
      treatment schedules were used. One patient received DAB486IL-2 at a dose of 0.075
      mg/kg/d intravenous (i.v.) bolus over 15 minutes daily for 5 consecutive days.
      The other four patients received DAB486IL-2 at a dose of 0.1 mg/kg as an i.v.
      infusion over 180 minutes weekly for 5 consecutive weeks. RESULTS: Three of the
      five CTCL patients achieved significant tumor responses. One patient attained a
      complete clinical and pathologic response (CR), which has been sustained without
      any interval treatment for 33+ months. Two other patients achieved partial
      responses (PRs) of 17+ and 4 months' duration, respectively. Treatment was well
      tolerated. The most common adverse effect was a transient increase in hepatic
      transaminases experienced by all five patients. CONCLUSION: The growth factor
      cytotoxin fusion protein DAB486IL-2 demonstrated significant clinical activity
      with acceptable toxicity in a group of heavily pretreated patients with CTCL.

PMID- 8355036
TI  - Novel oral combination chemotherapy in the treatment of intermediate-grade and
      high-grade AIDS-related non-Hodgkin's lymphoma.
AB  - PURPOSE: To determine the toxicity, response, and survival rate of orally
      administered combination chemotherapy in patients with AIDS-related intermediate-
      and high-grade non-Hodgkin's lymphoma. Secondary objectives included prospective
      quality-of-life assessment and quantitation of cell-associated p24 antigen (p24
      Ag) by flow cytometry. PATIENTS AND METHODS: Eighteen patients with biopsy-proven
      lymphoma were treated with oral chemotherapy consisting of lomustine (CCNU) 100
      mg/m2 on day 1, etoposide 200 mg/m2 on days 1 through 3; cyclophosphamide 100
      mg/m2 on days 22 through 31, and procarbazine 100 mg/m2 on days 22 through 31 at
      6-week intervals. A variety of clinical assessments were performed: prospective
      quality-of-life assessment using the Functional Living Index-Cancer (FLIC) and
      Brief Symptom Inventory (BSI) instruments; indirect immunofluorescence with flow
      cytometry to measure cell-associated p24 antigen; and price of the oral regimen
      compared with two other intravenous combination chemotherapy regimens. RESULTS:
      The overall objective response rate using Eastern Cooperative Oncology Group
      (ECOG) criteria was 61% (95% confidence interval, 39% to 84%), with seven
      complete remissions (39%) and four partial remissions (22%). The median survival
      duration was 7 months, with a range of 11 days to 36 months. The treatment
      related mortality rate was 11%. One patient developed CNS progression.
      Myelosuppression was the most frequent and severe toxicity encountered. Predictor
      variables of performance status (PS), prior history of thrush, and CD4 lymphocyte
      count were found to be of prognostic value. In a separate analysis, scores on the
      three subscales of the BSI were also found to be predictive of complete response.
      The price of this regimen is several thousand dollars less than that of other
      intravenous combination chemotherapy regimens. CONCLUSION: This regimen is active
      in patients with AIDS-related non-Hodgkin's lymphoma. Because it is important to
      design systemic cytotoxic chemotherapy regimens that are cost-effective,
      considerate of quality-of-life issues, and efficacious in this patient
      population, this approach should be compared with standard intravenous
      combination chemotherapy regimens in randomized controlled clinical trials.

PMID- 8355037
TI  - One versus 2 years of CMFVP adjuvant chemotherapy in axillary node-positive and
      estrogen receptor-negative patients: a Southwest Oncology Group study.
AB  - PURPOSE: To determine if prolonged adjuvant treatment (2 years v 1 year) with
      combination chemotherapy (cyclophosphamide, methotrexate, fluorouracil [5-FU],
      vincristine, and prednisone [CMFVP]) in poor-prognosis breast cancer patients
      (estrogen receptor [ER]-negative, stage II to IIIA) would result in improved
      disease-free and overall survival rates. PATIENTS AND METHODS: Four hundred forty
      five women with ER-negative node-positive breast cancer were enrolled by the
      Southwest Oncology Group (SWOG) over a period of 5 years (1979 to 1984).
      Randomized assignments were made to either 1 or 2 years of adjuvant CMFVP. Doses
      were daily oral cyclophosphamide 60 mg/m2, intravenous (i.v.) weekly methotrexate
      15 mg/m2, i.v. weekly 5-FU 400 mg/m2, i.v. weekly vincristine .625 mg/m2 for the
      first 10 weeks, and prednisone weeks 1 through 6 with doses decreasing from 30
      mg/m2 to 10 mg/m2. RESULTS: The median follow-up duration is 8.6 years, with a
      maximum of 11.3 years. Treatment arms were not significantly different as regards
      either survival or disease-free survival rates (P = .33 and P = .24,
      respectively). The five-year survival rate is 57% on the 1-year arm and 62% on
      the 2-year arm. Patients with three or fewer nodes and premenopausal status were
      associated with improved survival. Compliance on the 2-year arm was poor, with
      only 37% completing the full 2 years of treatment. SWOG grade 3 to 4 toxicity was
      experienced by 47% of patients on the 1-year arm and by 52% on the 2-year arm.
      There were no treatment-related deaths. CONCLUSION: We conclude that 2-year
      adjuvant treatment with CMFVP is not an improvement over 1-year treatment.
      Moreover, 2 years of CMFVP is difficult to complete. However, the results are not
      definitely negative. A moderate improvement attributed to prolonged chemotherapy,
      especially among patients with four or more positive nodes, cannot be ruled out.

PMID- 8355038
TI  - S-phase fraction is a prognostic factor in stage I breast carcinoma.
AB  - PURPOSE AND METHODS: The prognostic significance of cell proliferation, estimated
      as cytometric S-phase fraction (SPF), was investigated in node-negative breast
      cancer patients with small tumors (T1, NO). The 219 stage I patients originated
      from two series and were diagnosed either from 1978 to 1981 or from 1981 to 1985.
      The tumors were analyzed for estrogen receptors (ERs) by isoelectric focusing and
      for cellular DNA content by static cytofluorometry or flow cytometry. RESULTS: A
      high SPF correlated with the absence of ERs and abnormal DNA content, and was
      less often found in tumors smaller than 11 mm compared with those with a diameter
      between 11 and 20 mm. Among the variables age, tumor size, DNA ploidy, ER status,
      and SPF, only SPF showed a significant association with distant recurrence and
      breast cancer survival in systemically untreated patients. The relative
      recurrence rate for patients with an SPF of 10% or greater was three times that
      for patients with lower SPFs. Estimated 8-year breast cancer survival rates for
      the same groups were 72% and 91%, respectively. CONCLUSION: This study suggests
      that cytometric SPF has prognostic significance in stage I breast carcinoma.

PMID- 8355039
TI  - Assessment of estrogenic recruitment before chemotherapy in advanced breast
      cancer: a double-blind randomized study. European Organization for Research and
      Treatment of Cancer Breast Cancer Cooperative Group.
AB  - PURPOSE: In the present phase III study, the specific effect of estrogenic
      recruitment was assessed by comparing two groups of patients with advanced breast
      cancer receiving either ethinylestradiol (EE2) or placebo (PL) before
      chemotherapy (CT). PATIENTS AND METHODS: The therapeutic regimen consisted of (1)
      estrogen suppression by aminoglutethimide (AGL) 1 g/d plus hydrocortisone (HC) 40
      mg/d, with surgical castration performed on premenopausal patients; (2)
      fluorouracil (5-FU) 500 mg/m2, doxorubicin 50 mg/m2, and cyclophosphamide (CPA)
      500 mg/m2 (FAC) intravenously (IV) every 3 weeks; (3) following randomization,
      patients were double-blinded to receive either PL or EE2 50 micrograms exactly 24
      hours before receiving FAC. All patients had advanced breast cancer presumably
      sensitive to endocrine therapy (estrogen receptor-positive [ER+] and/or
      progesterone receptor-positive [PgR+] status) with measurable lesions; none had
      received prior systemic antineoplastic therapy for metastatic disease; prior
      adjuvant hormonal therapy (HT) or CT (without anthracyclines) was allowed if
      interval since completion was longer than 1 year. RESULTS: Among 154 patients
      treated according to the protocol, tolerance, response rates, time to
      progression, and median survival duration were identical in the PL and EE2
      groups. Only performance status, dominant metastatic site, and menopausal status
      seemed to influence response (overall response, 64%), with the highest levels of
      partial remission (PR) and complete remission (CR) being achieved in
      premenopausal women (CR plus PR, 26% plus 55%) and in those with dominant soft
      tissue lesions (CR plus PR, 45% plus 28%). CONCLUSION: We conclude that the
      validity of the hormonal recruitment concept has not yet been established in
      clinical practice so that this approach remains experimental. The results
      achieved by combining (near) complete estrogenic suppression and cyclical FAC
      chemotherapy are not significantly different from those to be expected with the
      more conventional use of HT followed by CT in presumably hormone-responsive (ER+)
      patients.

PMID- 8355040
TI  - Venoocclusive disease of the liver: development of a model for predicting fatal
      outcome after marrow transplantation.
AB  - PURPOSE: Hepatic venoocclusive disease (VOD) is a common complication of
      cytoreductive therapy for marrow transplantation. Only 25% of patients who
      develop VOD have severe disease. We tested the hypothesis that early clinical
      signs of VOD would predict which patients would recover and which would die.
      PATIENTS AND METHODS: We evaluated 355 consecutive patients who had transplants
      between August 6, 1987 and July 21, 1988 for occurrence of VOD and whether it was
      reversible within 100 days of transplant. Total serum bilirubin and weight gain
      from day -7 through day +16 posttransplant were compared among patients with no,
      severe, or nonsevere VOD. Logistic regression models were developed to estimate
      probabilities of severe VOD at each of six time intervals. The accuracy of these
      models was tested by applying them to 392 consecutive patients who underwent
      transplantation between July 22, 1988 and July 20, 1989. RESULTS: As early as day
      -1, bilirubin and weight gain were significantly different between patients whose
      VOD proved to be severe and patients with reversible VOD or no disease.
      Regression models were used to generate coefficients (beta 0, beta 1, beta 2) for
      the equation P = 1/(1 + e-z), where P is the probability of severe VOD and z =
      beta 0 + beta 1 (In total serum bilirubin [mg/dL]) + beta 2 (percent weight
      gain). Application of this equation to the next 392 patients allowed us to
      calculate sensitivity, specificity, and positive predictive value for a range of
      probabilities. CONCLUSION: The course of VOD after cytoreductive therapy can be
      predicted by knowing the serum bilirubin and weight gained within 1 to 2 weeks of
      transplantation. Probability estimates derived from patient data are highly
      specific and moderately sensitive. Such probability estimates may be useful when
      considering potentially risky interventions to treat VOD, such as recombinant
      human tissue plasminogen activator.

PMID- 8355041
TI  - Phase II study of fluorouracil, leucovorin, and interferon alfa-2a in metastatic
      colorectal carcinoma.
AB  - PURPOSE: To test the activity of a regimen of interferon alfa-2a (IFN alpha-2a) 5
      x 10(6) U/m2 subcutaneously (SC) days 1 through 7 combined with leucovorin 500
      mg/m2/d intravenously (IV) over 30 minutes and fluorouracil (5-FU) 370 mg/m2/d
      through IV push 1 hour after leucovorin days 2 through 6 in a phase II study.
      PATIENTS AND METHODS: Forty-six patients with a good performance status (PS) with
      measurable colorectal cancer and no prior therapy for metastatic disease were
      entered. Cycles were repeated at 3-week intervals if toxicity had resolved. The 5
      FU dose was increased by 15% if toxicity was mild, and decreased by 15% for grade
      3 to 4 nonhematologic or grade 4 hematologic toxicity. RESULTS: Three complete
      responses (CRs) and 21 partial responses (PRs) were seen among 44 assessable
      patients (54%; 95% confidence interval, 39% to 70%). A moderately strong
      association was noted between PS and response: PS O (n = 26), two CRs and 15 PRs
      (65%); PS 1 (n = 13), one CR and six PRs (54%); PS 2 (n = 5), zero CRs and zero
      PRs (0%; two-tailed P = .026). With a median follow-up duration of 18.8 months,
      the median time to treatment failure (TTF) and survival were 7.8 months and 16.3
      months, respectively. Doses were escalated to 425 mg/m2/d 5-FU in 10 patients,
      but only four tolerated the higher dose. When expressed as the most severe degree
      of toxicity experienced by each patient across all cycles, grade 3 to 4 toxicity
      of the following types was observed; mucositis, 37%; diarrhea, 40%; rash, 7%;
      fatigue, 14%; granulocytopenia, 13%. Dose-limiting toxicity at 370 mg/m2/d 5-FU
      eventually occurred in 28 patients (61%). Twelve patients (26%) required an IFN
      alpha-2a dose reduction for constitutional toxicity. CONCLUSION: This regimen has
      promising activity in advanced colorectal cancer, particularly in patients with
      an Eastern Cooperative Oncology Group (ECOG) PS of 0 to 1.

PMID- 8355042
TI  - Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early
      stage melanomas of the head and neck.
AB  - PURPOSE: We developed intraoperative lymphatic mapping with selective
      lymphadenectomy (SLND) to identify micrometastatic spread of cutaneous melanoma
      to regional lymph nodes. This study was undertaken to assess the sensitivity and
      specificity of our technique in patients with clinical stage I (CS-I) melanoma of
      the head or neck. PATIENTS AND METHODS: Seventy-two CS-I melanoma patients
      underwent intraoperative lymphatic mapping of primary cutaneous melanomas located
      on the head, neck, or upper chest/back draining to the neck. Key (sentinel)
      cervical lymph nodes in the regional lymphatic drainage basin were identified,
      selectively excised during SLND, and examined for microscopic evidence of tumor
      cells. If these sentinel nodes were tumor-negative, the surgery was concluded; if
      the sentinel nodes were tumor-positive, all nodes in the drainage basin were
      removed during en bloc lymphadenectomy (LND). RESULTS: Intraoperative lymphatic
      mapping identified sentinel nodes in 90% of the regional drainage basins. Fifteen
      percent of these nodes were tumor-positive, indicating the need for LND. There
      were no false-negative sentinel nodes, and extended follow-up showed no local
      nodal recurrences in patients whose sentinel-node histology did not indicate the
      need for LND. CONCLUSION: Intraoperative lymphatic mapping and SLND is a
      minimally invasive and highly accurate screening technique for determining which
      patients with CS-I head and neck melanomas have subclinical node metastases and
      therefore might benefit from cervical LND.

PMID- 8355043
TI  - Prognostic significance of histopathologic response to chemotherapy in
      nonmetastatic Ewing's sarcoma of the extremities.
AB  - PURPOSE: To evaluate more accurately the effectiveness of preoperative
      chemotherapy in the treatment of patients with Ewing's sarcoma, we studied
      histopathologically the chemotherapeutic response and correlated it to oncologic
      outcome. PATIENTS AND METHODS: Between June 1983 and December 1989, 68 patients
      with nonmetastatic Ewing's sarcoma of the extremities were treated at our
      institute with preoperative chemotherapy (without radiation therapy) and surgery.
      The specimens were retrospectively evaluated for areas of viable tumor cells and
      graded from I to III (macroscopic, microscopic, or no residual disease,
      respectively) in a blinded fashion. Clinical follow-up data were available on all
      patients for a mean of 60 months (range, 32 to 111). RESULTS: This
      histopathologic analysis was strongly correlated with oncologic outcome (P =
      .004). Patients who demonstrated grade III response (no identifiable viable tumor
      nodules present) had improved 5-year disease-free survival rates as compared with
      patients with grade II (microscopic nodes present; P = .023; 90% v 53%) and grade
      I responses (macroscopic nodules present; P = .0003; 90% v 32%). Patients with
      grade II necrosis had statistically improved survival rates over those with grade
      I necrosis (53% v 32%; P = .074). CONCLUSION: This new histopathologic analysis
      technique for the evaluation of neoadjuvant chemotherapy effectiveness (which
      does not rely on tumor volume for its assessment) is a valuable prognostic
      indicator for patients with Ewing's sarcoma treated with surgery. Based on this
      preliminary report, cases of grade I or II chemotherapeutic tumor response should
      be considered clinical failures and a different, more aggressive postoperative
      chemotherapy regimen should be considered.

PMID- 8355045
TI  - Comparative pharmacokinetic studies of three asparaginase preparations.
AB  - PURPOSE: As part of pharmacologic studies of asparaginase (ASNase), we determined
      the half-life of ASNase activity and protein, and the effect of dose, repeated
      doses, different drug preparations, and hypersensitivity reactions on the half
      life (t1/2) of serum ASNase activity. PATIENTS AND METHODS: We measured ASNase
      activity (spectrophotometric assay) in serum samples obtained from patients with
      acute lymphoblastic leukemia (ALL) at various times during their therapy with
      intramuscular ASNase. ASNase protein was measured by enzyme-linked
      immunoadsorbent assay (ELISA). RESULTS: Studies following the initial dose of
      Escherichia coli-derived ASNase demonstrated no difference in apparent t1/2
      following 25,000 IU/m2 versus 2,500 IU/m2 (1.24 v 1.35 days, P = .2). The
      apparent t1/2s following maintenance doses of E coli ASNase (middle dose t1/2,
      1.28 days, or last dose t1/2, 1.14 days) showed no difference when compared with
      the initial dose of ASNase (P = .3 to .9). There was no significant difference
      between the apparent t1/2s of ASNase activity and ASNase protein (n = 8, P = .2
      to .6). The serum t1/2 was 0.65 and 5.73 days for patients receiving Erwinia or
      polyethylene glycol (PEG)-modified E coli ASNase, respectively, as the induction
      dose. ASNase activity was undetectable in sera of four patients studied in the
      week following an anaphylactic reaction to E coli ASNase and the t1/2 was
      significantly shorter in five patients with a history of allergic reaction to E
      coli ASNase who were studied following a dose of PEG ASNase, (t1/2, 1.80 days).
      CONCLUSION: We conclude that (1) the apparent t1/2 of ASNase is dependent on
      enzyme preparation used, but is not affected by dose or by repeated use; (2) the
      apparent t1/2 of E coli ASNase as a protein is the same as the apparent t1/2 of
      enzymatic activity; and (3) patients who have had a hypersensitivity reaction to
      E coli ASNase have a decreased apparent t1/2 with both E coli and PEG ASNase.

PMID- 8355044
TI  - Localized but unresectable neuroblastoma: treatment and outcome of 145 cases.
      Italian Cooperative Group for Neuroblastoma.
AB  - PURPOSE: To define factors that influence outcome in children with localized but
      unresectable neuroblastoma by retrospective investigation of response to therapy
      and outcome in 21 Italian institutions. PATIENTS AND METHODS: Of 145 assessable
      children diagnosed between 1979 and 1990, 77 were treated between 1979 and 1984
      with three consecutive standard-dose (SD) protocols, and 68 between 1985 and 1990
      with a high-dose (HD) protocol. All protocols included chemotherapy, followed by
      resection of primary tumor if feasible. If at least partial resection was
      achieved, consolidation therapy followed, except that from 1985 onward, patients
      considered disease-free following surgery received no further treatment. RESULTS:
      Ninety-four of 145 patients (65%) achieved a complete response (CR) or partial
      response (PR) with chemotherapy and 75 (52%) subsequently underwent complete
      resection of the primary tumor. Eighty-one patients are alive (73 without
      disease, eight with disease), 63 have died, and one is lost to follow-up. The 5
      year overall survival (OS) rate is 55% and progression-free survival (PFS) rate
      50%. Both OS and PFS correlated with response to chemotherapy, removal of primary
      tumor, HD therapy, and serum lactate dehydrogenase (LDH) levels. Infants (< 1
      year), independent of primary tumor site, and children aged 1 to 15 years with a
      nonabdominal primary tumor, did better compared with children aged 1 to 15 years
      with an abdominal primary tumor (PFS, 72% and 64% v 30%; P < .001 and < .01,
      respectively). Outcome of this last group improved with the HD protocol (PFS, 40%
      v 23%; P = .01). CONCLUSION: In children with unresectable neuroblastoma, risk
      categories can be defined by age and primary tumor site. HD chemotherapy should
      be investigated for the poor-risk category age 1 to 15 years with an abdominal
      primary tumor.

PMID- 8355046
TI  - Phase I clinical trial of carboplatin and 41.8 degrees C whole-body hyperthermia
      in cancer patients.
AB  - PURPOSE: To evaluate the biologic interactions and toxicities of carboplatin
      combined with 41.8 degrees C whole-body hyperthermia (WBH) for 60 minutes in a
      phase I clinical trial. PATIENTS AND METHODS: Thirty assessable patients with
      cancer refractory to conventional therapy were treated. During induction therapy,
      patients received WBH alone in week 1, WBH plus carboplatin in week 2, and
      carboplatin alone in week 5. Carboplatin dose was escalated (three patients per
      group) as follows: 100, 150, 200, 250, 300, 350, 400, 480, and 575 mg/m2; three
      additional patients were entered at 480 mg/m2. Carboplatin was administered at
      target temperature. RESULTS: Comparisons of the mean/median WBC and platelet
      nadirs for carboplatin alone and carboplatin plus WBH demonstrated no enhancing
      effect by WBH. Toxicities including nausea and/or vomiting, as well as
      myelosuppression, were within acceptable limits, allowing for escalation to a
      dose of 575 mg/m2; three of three patients at this dose level experienced grade 4
      myelosuppression with no associated infection or bleeding. No renal toxicity was
      observed. Analysis of platinum in plasma ultrafiltrate and urine showed only
      slight effects of WBH on the pharmacokinetics and renal excretion of platinum.
      Responses included the following: lung--minor response (200 mg/m2);
      gastrointestinal neuroendocrine--complete response (CR) (400 mg/m2); pancreatic-
      partial response (PR) (480 mg/m2); small bowel--PR (575 mg/m2); ovarian--CR, two
      patients (575 mg/m2), with marker data suggesting WBH enhancement of carboplatin
      cytotoxicity. Another three patients experienced clinical improvement after WBH
      plus carboplatin, but progression with carboplatin alone (lung, 400 mg/m2;
      gastrointestinal neuroendocrine, 480 mg/m2; melanoma, 480 mg/m2). CONCLUSION: We
      conclude that carboplatin with WBH is well tolerated even at conventional
      carboplatin doses. Clinical results are consistent with preclinical predictions
      of an increased therapeutic index for this combination, which encourages future
      clinical studies.

PMID- 8355047
TI  - Subcutaneous interleukin-2 plus interferon alfa-2a in metastatic renal cancer: an
      outpatient multicenter trial.
AB  - PURPOSE: A prospective multicenter phase II trial was undertaken to define the
      activity of a low-dose subcutaneous regimen of interleukin-2 (IL-2) and
      interferon alfa-2a (IFN) in patients with metastatic renal cancer. PATIENTS AND
      METHODS: Between December 1990 and October 1991, 42 patients with metastatic
      renal cancer who had received no prior immunotherapy were treated with IL-2 (4 x
      10(6) U) days 1 through 4 and IFN (9 x 10(6) U) day 1 and 4 each week of a 4-week
      treatment course followed by a 2-week rest period. Maximum duration of therapy
      was 1 year. Concomitant therapy with acetaminophen, diphenhydramine, and
      indomethacin was recommended. Treatment was administered on an outpatient basis.
      RESULTS: With a median follow-up duration of 18 months, responses occurred in
      five of 42 patients (12%; 95% confidence interval [Cl], 2% to 22%). One
      pathologic complete remission, one surgical complete remission, and three partial
      remissions occurred. Toxicity was modest, with a symptom complex of rash, fever,
      anorexia, fatigue, mild weight loss, lymphocytosis, and eosinophilia occurring in
      85% to 90% of patients. Renal dysfunction (creatinine > 2 mg/dL) occurred in 19%
      of patients, while three patients (7%) refused further IL-2 and IFN. No toxic
      deaths occurred. The median survival duration was 14.5 months. CONCLUSION: This
      outpatient low-dose subcutaneous regimen induced mild toxicity, a modest response
      rate, and an excellent median survival duration in previously untreated patients.
      Phase III trials are now needed to compare IL-2 plus IFN with IL-2 alone or to
      various IL-2/IFN regimens. However, the major task is to identify unique new
      agents with activity in renal cancer.

PMID- 8355048
TI  - Does interleukin-2 have a role in the management of acute leukemia?
AB  - PURPOSE: To discuss the possibility that interleukin-2 (IL-2)-based
      immunotherapeutic protocols may have a role in the management of acute leukemia.
      DESIGN: The preclinical results that have led to the clinical use of IL-2 in
      acute leukemia will be reviewed. The clinical data obtained with the
      administration of IL-2 to acute leukemia patients in different phases of their
      disease will be discussed, together with the clinicohematologic and immunologic
      modifications induced following the infusion of IL-2. Finally, the possibility
      that limitations associated with the exogenous administration of high-dose IL-2
      may be circumvented by engineering techniques aimed at inserting the IL-2 gene
      directly into the tumor cells, will be addressed. RESULTS: The data indicate that
      high-dose IL-2 may be administered to acute leukemia patients. Toxicity, recorded
      in all patients, appears to be controllable using a continuous intravenous (i.v.)
      infusion protocol based on a daily dose-escalating administration. Complete
      remissions have been documented in acute myeloid leukemias (AMLs) with a limited,
      but detectable proportion of residual marrow blasts. Numerous phenotypic and
      functional changes have been recorded within the immune system of the host. Using
      retroviral vectors, the IL-2 gene may be productively transduced into human acute
      leukemia cell lines. CONCLUSION: IL-2 appears to represent a therapeutic option
      for AML patients with limited/minimal residual disease. The results of the
      ongoing randomized trials in patients in first or second remission are awaited.

PMID- 8355049
TI  - Intravenous mercaptopurine: life begins at 40.
AB  - PURPOSE: This review is intended to provide a concise portrayal of the
      background, rationale, and current use of intravenous infusions of mercaptopurine
      (6MP) in patients with acute leukemia. DESIGN: After a brief description of the
      mode of action of 6MP and the formulation, pharmacokinetics, and history of its
      intravenous administration, the rationale for current use of intravenous 6MP
      infusion is explained. Subsequently, the review summarizes and discusses clinical
      experience with intravenous 6MP alone and in combination with intravenous
      methotrexate (Mtx) and cytarabine (Ara-C). RESULTS: Although still an
      investigative drug, intravenous 6MP has been used for 40 years and currently is
      being administered extensively to children with previously untreated acute
      lymphoid leukemia (ALL) in frontline protocol studies. The reasons are the better
      and more consistent bioavailability of intravenous versus oral MP, higher blood
      and CSF levels, compliance, and preliminary evidence suggesting superior
      remission experience for intravenous Mtx and 6MP than for Mtx alone. The apparent
      lack of late adverse sequelae with 6MP as compared with other antileukemia drugs
      adds to this interest. CONCLUSION: The new life of intravenous 6MP at age 40
      years illustrates the need for continued investigation of significant anticancer
      drugs as insights and technology progress.

PMID- 8355050
TI  - High-dose melphalan is not associated with extramedullary relapses in high-risk
      multiple myeloma.

PMID- 8355051
TI  - More on follicular lymphomas.

PMID- 8355052
TI  - Adoptively transferred anti-CD3-activated T cells for human tumor immunotherapy.

PMID- 8355053
TI  - Palindromic baldness: cytotoxic drugs correct alopecia.

PMID- 8355054
TI  - Physician advocacy deficit.

PMID- 8355055
TI  - Scintimetric evaluation of remodeling after bone fractures in man.
AB  - In a review of bone scans of 2000 post-trauma patients, the following rules of
      bone remodeling after fracture were found: different bones behave differently;
      lesions in the vicinity of joints show an early and high accumulation of the
      tracer within the first days after the trauma, whereas fractures of the axial
      skeleton and shafts of long bones sometimes need up to 12 days to appear on scan;
      all except skull fractures demonstrate a steady rise of accumulation intensity
      compared to normal bone for 2-5 wk; the steepness of increase and time of maximum
      differ significantly for different fracture sites. Calculating a ratio 24:4 hours
      after injection helps differentiate fractures from soft tissue lesions since
      fresh fractures show a ratio > 1:1. We found no clinically relevant dependence on
      sex and age. The scintigraphic/scintimetric behavior of fractures is reproducible
      and predictable, adding specificity to the well-known high sensitivity of bone
      scans.

PMID- 8355056
TI  - Diagnosis of partial and total physeal arrest by bone single-photon emission
      computed tomography.
AB  - Bone single-photon emission computed tomography (SPECT), capable of creating maps
      of the distribution of osteoblastic activity in every spatial plane of a physis,
      should provide images of diagnostic value in the case of patients suffering from
      growth arrests (epiphysiodeses). Seventy-five bone SPECT scans were obtained in
      64 children suspected to have developed physeal arrests. The transaxial slices of
      the physis, in the case of partial epiphysiodeses: (a) indicated the percentage
      of the remaining normal physis, (b) located the bony bridge within the physis and
      (c) showed the slowdown of the growth of the remaining normal physis induced by
      the bony bridge in some children. Misdiagnosis occurred in six patients. For
      total epiphysiodeses, the radionuclide diagnosis was confirmed in 20 of 21
      patients. Radionuclide, x-ray and MRI examinations in the study of growth
      disturbances were found to be complementary.

PMID- 8355057
TI  - Quantitative analysis of the technetium-99m-DTPA captopril renogram: contribution
      of washout parameters to the diagnosis of renal artery stenosis.
AB  - Retrospective analysis of precaptopril and postcaptopril DTPA renograms from 88
      hypertensive patients was performed to refine the quantitative criteria used to
      diagnose renal artery stenosis (RAS). Of the 88 patients, 45 had RAS and 43 had
      normal renal arteries at angiography. Using time-activity curves from the
      essential hypertensive group, diagnostic washout criteria for a positive DTPA
      renogram were developed. These were based on the 20 and 30 min/peak activity
      ratios in each kidney. When the washout criteria were retrospectively applied to
      patient data as a whole, sensitivity and specificity for RAS were 67% and 79%,
      respectively. When previously described uptake criteria, based on the time to
      peak activity in each kidney and the GFR ratio between the kidneys, were applied
      to the same data, sensitivity and specificity for RAS were 89% and 84%,
      respectively. Quantitative analysis of the DTPA renogram using the time to peak
      and GFR ratio was both sensitive and specific for RAS. Measurement of 20 and 30
      min/peak renal activity ratios did not improve the accuracy of the test.

PMID- 8355058
TI  - Initial assessment of positron emission tomography using 2-fluorine-18-fluoro-2
      deoxy-D-glucose in the imaging of malignant melanoma.
AB  - To assess the feasibility and accuracy of positron emission tomography (PET) in
      the detection of metastatic malignant melanoma, the authors studied 12 patients
      approximately 1 hr following a 10-mCi injection of 2-[18F]-fluoro-2-deoxy-D
      glucose (FDG). Scan findings were compared to physical examination, imaging and
      biopsy results. For intra-abdominal visceral and lymph node metastases, the
      sensitivity of FDG-PET was 100% (15/15). PET also identified three metastatic
      foci noted only retrospectively on CT, and two metastatic foci seen only on
      follow-up CT several months later. Eight additional intense foci of FDG uptake
      that were seen on PET have not yet been confirmed as tumors. In superficial lymph
      nodes, PET correctly identified seven of seven metastatic lesions (including
      three cases involving normal-sized lymph nodes) and correctly predicted the
      absence of tumor in six of six lymph node regions, for an overall accuracy of
      100% (13/13). The sensitivity of the PET technique for detecting small pulmonary
      lesions was lower than CT but this could be due to respiratory motion or prior
      cancer treatment. This initial experience demonstrates the feasibility and
      clinical potential of FDG-PET for the detection of regional and systemically
      metastatic malignant melanoma, particularly in extra-pulmonary lesions.

PMID- 8355059
TI  - Technetium-99m-HMPAO-labeled leukocytes and technetium-99m-labeled human
      polyclonal immunoglobulin G in diagnosis of focal purulent disease.
AB  - To evaluate the usefulness of 99mTc-HMPAO-labeled leukocytes and 99mTc-labeled
      polyclonal human immunoglobulin G (Technescan HIG) in the diagnosis of focal
      purulent disease, 31 comparative scintigraphies were done in 30 patients with
      known or strongly suspected focal infection. Focal purulent disease was the final
      diagnosis in 19 patients. Technetium-99m-labeled leukocytes showed 16 true
      positive, no false-positive, 11 true-negative and 3 false-negative findings. The
      corresponding figures for 99mTc-labeled HIG were 11, 2, 9 and 8. The sensitivity
      and specificity of imaging with labeled leukocytes were 84% and 100%,
      respectively, and with labeled HIG, 58% and 82%, respectively. The overall
      accuracy of the leukocyte scan was significantly better than that of the HIG scan
      (90% versus 67%, p < 0.001). Thus, if focal infection is suspected, scintigraphy
      with 99mTc-labeled leukocytes is the preferable method. No cases exhibited a
      better imaging result with 99mTc-HIG scintigraphy than with 99mTc-labeled
      leukocytes.

PMID- 8355060
TI  - Lymphoscintigraphy in high-risk melanoma of the trunk: predicting draining node
      groups, defining lymphatic channels and locating the sentinel node.
AB  - Lymphoscintigraphy was performed in 209 patients with high-risk melanoma of the
      trunk referred to the Sydney Melanoma Unit and considered for lymph node
      dissection. Lymphoscintigraphy accurately defined the draining lymph node groups
      and was 94% sensitive in detecting draining sites that contained metastases. When
      combined with the clinical finding of palpable lymph nodes, the sensitivity rose
      to 98%. Most patients showed lymph drainage to one or two node groups and only 22
      patients showed drainage to 3 or more node groups. The major lymph channels could
      also be marked on the skin prior to incontinuity dissection. Most patients had
      multiple draining lymph channels and these often diverged significantly from each
      other in the path to the draining node group. The number and location of interval
      nodes could be determined and marked on the skin. These and the major lymph
      channels could thus be excised at the time of surgery. Unusual drainage patterns
      were sometimes seen; for example, three patients displayed a new lymph pathway
      with direct drainage from the back anteriorly to the para-aortic nodes. The
      location of the sentinel nodes in each draining lymph-node group could also be
      marked on the skin prior to surgery, enabling quick and accurate identification
      of this node, using the blue-dye technique if biopsy were to be performed. These
      findings lead us to recommend lymphoscintigraphy prior to wide local excision in
      patients with truncal melanoma who are candidates for surgery. Lymphoscintigraphy
      results will help plan surgery and lead to minimum surgical intervention,
      consistent with effective surgical management.

PMID- 8355061
TI  - Evaluation of pulmonary systemic blood flow using ECG gated acquisition.
AB  - We propose a functional parametric analysis method using ECG-gated 99mTc-labeled
      red blood cell (RBC) imaging for detection and characterization of periodic
      variations in local blood activity in the lungs during cardiac cycle. We
      validated in animal experiments that such count variations correlate with
      cyclical pulmonary blood flow and may be used for evaluation of systemic-to
      pulmonary shunts. Clinical studies were performed in 48 patients. After labeling
      the RBC pool with 99mTc, ECG-gated gamma camera images of both lung fields were
      acquired and processed to obtain Fourier transforms of time/activity functions in
      selected regions. The first harmonic parametric images of amplitude and phase
      were derived. There was an excellent correlation (r = 0.92) between activity
      variations and pulsatile flow measured by our method with that obtained by the
      thermodilution method in dog experiments (n = 10) after implantation of a
      systemic-to-pulmonary shunt. Patient studies showed the technique to be sensitive
      in detecting and quantifying abnormal systemic-to-pulmonary blood flow. Lung
      pulsatile flow can thus be noninvasively measured from functional parametric
      phase and amplitude images; the technique may be useful for detecting and
      quantifying abnormal systemic-to-pulmonary blood flow in man.

PMID- 8355062
TI  - SPECT in patients with cortical visual loss.
AB  - Single-photon emission computed tomography (SPECT) with 99mTc
      hexamethylpropyleneamine oxime (HMPAO) was used to investigate changes in
      cerebral blood flow in seven patients with cortical visual impairment. Traumatic
      brain injury (TBI) was the cause of cortical damage in two patients, cerebral
      ischemia in two patients and carbon monoxide (CO) poisoning, status epilepticus
      and Alzheimer's Disease (AD) each in three separate patients. The SPECT scans of
      the seven patients were compared to T2-weighted magnetic resonance image (MRI)
      scans of the brain to determine the correlation between functional and anatomical
      findings. In six of the seven patients, the qualitative interpretation of the
      SPECT studies supported the clinical findings (i.e., the visual field defect) by
      revealing altered regional cerebral blood flow (rCBF) in the appropriate regions
      of the visual pathway. MR scans in all of the patients, on the other hand, were
      either normal or disclosed smaller lesions than those detected by SPECT. We
      conclude that SPECT may reveal altered rCBF in patients with cortical visual
      impairment of various etiologies, even when MRI studies are normal or
      nondiagnostic.

PMID- 8355063
TI  - Regional cerebral blood flow-SPECT in chronic alcoholism: relation to
      neuropsychological testing.
AB  - To determine the prevalence of central nervous system damage due to ethanol, we
      evaluated 40 asymptomatic chronic alcoholics and 20 age-matched controls. Studies
      included neuropsychological testing, brain 99mTc-HMPAO SPECT, and morphometric
      analysis by CT scan. In the qualitative analysis, 30 of the 40 alcoholics showed
      hypoperfused areas on SPECT scan. In the semiquantitative analysis, alcoholics
      exhibited significant reduction in regional cerebral blood flow (rCBF) ratio of
      all brain lobes compared to controls (p < 0.001). The rCBF ratio was mainly
      reduced in frontal lobes (65%). Only 11 alcoholics showed significant frontal
      lobe atrophy in the morphometric analysis; most also had abnormalities on SPECT
      scan. Alcoholics exhibited significant impairment of frontal tasks and
      visuospatial skills. Frontal test impairment was independently related to both
      frontal atrophy and hypoperfusion. In a group of ten alcoholics in whom another
      SPECT scan was performed after 2 mo of ethanol abstinence, rCBF ratio of the
      frontal lobes normalized in eight, without frontal atrophy. In patients without
      frontal atrophy, reduced rCBF ratio of the anterior portion of the frontal lobes
      correlated negatively with frontal test results (r = -0.6535, p < 0.001). A
      significant negative correlation between cerebral perfusion and the amount of
      ethanol consumed in the month prior to study was observed (r = -0.6289, p <
      0.001). In conclusion, asymptomatic chronic alcoholics frequently showed
      reversible frontal lobe hypoperfusion, which is related to recent ethanol intake,
      reflects brain function impairment and is independent of brain atrophy.

PMID- 8355064
TI  - Comparability of FDG PET studies in probable Alzheimer's disease.
AB  - Results of studies with positron emission tomography (PET) of 18F-2-fluoro-2
      deoxy-D-glucose (FDG) in patients with probable Alzheimer's disease (AD) were
      compared among three European centers with different PET scanners (in-plane
      resolution ranging between 6.75 mm and 9.2 mm). A ratio of glucose metabolism in
      the most typically affected regions over the least typically affected regions was
      calculated to quantitatively analyze the characteristic pattern of AD. Diagnostic
      accuracy of this composite ratio was high (95.8%) and was superior to that of
      most ratios derived from single regions. Correspondingly, there was a consistent,
      highly significant difference between patients (mean ratio 0.77 +/- 0.11) and
      normals (mean 0.99 +/- 0.04) without significant differences among laboratories.
      Possible small effects of rate constant variation and region size were analyzed
      by computer simulation. The results demonstrate that a common investigation
      protocol may yield FDG PET data in different laboratories that are closely
      comparable in spite of differences between scanners and imaging equipment.

PMID- 8355065
TI  - Impact of antianginal medications, peak heart rate and stress level on the
      prognostic value of a normal exercise myocardial perfusion imaging study.
AB  - We sought to determine whether antianginal medications or the level of achieved
      stress affect the prognostic value of a normal exercise 201Tl study. We studied
      261 patients with a normal exercise 201Tl study for 23 +/- 6 mo. Antianginal
      medications were taken at the time of stress testing in 128 patients. Peak heart
      rate ranged from 82 to 217 bpm; percent maximal predicted heart rate ranged from
      42% to 136%. Chi-square analysis was used to determine the relationship of
      cardiac events to antianginal medications and stress indices. Primary cardiac
      events were defined as cardiac death or nonfatal myocardial infarction. Primary
      cardiac events occurred in six patients yielding an annual incidence of 1.2% per
      year. There was no significant relationship between cardiac event rate and
      antianginal medication use or any stress index, including Bruce stage, peak heart
      rate or blood pressure or percent maximal predicted heart rate achieved. The risk
      of cardiac death or nonfatal myocardial infarction in patients with a normal
      exercise 201Tl is low and is not affected by concurrent antianginal treatment or
      degree of stress achieved.

PMID- 8355066
TI  - Nitrates improve detection of ischemic but viable myocardium by thallium-201
      reinjection SPECT.
AB  - Thallium-201 reinjection imaging improves myocardial viability detection when
      compared to standard 3-4-hr redistribution imaging, however, the extent of
      ischemic but viable myocardium is still underestimated. We tested whether the
      sensitivity of reinjection imaging could be increased by giving nitrates
      postexercise to improve blood flow during the redistribution period. Twenty
      patients with coronary artery disease were included, 11 of them with a recent
      myocardial infarction. All patients underwent two exercise/4-hr redistribution
      201Tl SPECT protocols: one with reinjection alone and the other with nitrates and
      reinjection. In the latter case, 20 mg of Isosorbide Dinitrate were given to
      patients immediately after postexercise imaging. Fifteen patients had reversible
      defects with reinjection alone, three additional patients were defined as
      ischemic with nitrates/reinjection protocol. Reinjection alone identified 41
      reversible segmental defects, all except one were also evaluated as reversible
      with nitrates/reinjection. However, among the 54 segments showing fixed defects
      after reinjection only, 14 (26%) presented as reversible with the
      nitrates/reinjection protocol. The redistribution extent (segments/patient) was
      2.05 +/- 0.41 segments with reinjection alone and 2.75 +/- 0.38 (p < 0.01) with
      nitrates/reinjection. In 15 patients showing reversible defects with both
      protocols, the redistribution extent was 2.73 +/- 0.41 segments with reinjection
      alone and 3.20 +/- 0.40 (p < 0.05) with nitrates/reinjection. Thallium-201 SPECT
      with nitrates and reinjection improves the detection of ischemic but viable
      myocardium in comparison to SPECT with reinjection alone.

PMID- 8355067
TI  - Myocardial perfusion imaging and dynamic analysis with technetium-99m
      tetrofosmin.
AB  - Technetium-99m tetrofosmin is a new myocardial perfusion imaging agent that
      accumulates rapidly and shows slow clearance from the myocardium. Dynamic
      acquisition and SPECT imaging were performed in a total of 26 patients. Using
      exercise-rest protocol, the single-photon emission computed tomography (SPECT)
      findings of 130 myocardial segments were classified as infarction, ischemia and
      partial filling and compared to those with 201Tl. Complete concordance of
      findings was obtained in 108 segments (83%) between images with 99mTc tetrofosmin
      and 201Tl. Partial filling was observed in 24 segments with 201Tl and 14 segments
      with tetrofosmin, showing a greater number of ischemic regions in 201Tl. However,
      in comparison with coronary arteriography (n = 19), overall sensitivity and
      specificity for detecting coronary artery stenosis (> or = 75%) was 15 of 25
      (0.60) and 27 of 32 (0.84), respectively, which did not differ significantly from
      those of 201Tl, which was 18 of 25 (0.72) and 27 of 32 (0.84), respectively.
      Graphic analysis that assumes unidirectional transfer of the tracer was applied
      to initial dynamic changes and uptake constant k and distribution volume V were
      computed. Multiple vessel disease and congestive heart failure showed a low
      perfusion index (k/V), and may be used in this type of tracer with unidirectional
      uptake. This preliminary study in the clinical trial showed the usefulness of
      99mTc tetrofosmin as a myocardial perfusion imaging agent.

PMID- 8355068
TI  - Rapid back to back adenosine stress/rest technetium-99m teboroxime myocardial
      perfusion SPECT using a triple-detector camera.
AB  - Technetium-99m-teboroxime is characterized by a high extraction fraction over a
      wide range of blood flow rates, rapid myocardial clearance and avid hepatic
      uptake. This study determined the imaging parameters and examined the clinical
      efficacy of a rapid back to back adenosine stress/rest teboroxime myocardial
      perfusion SPECT protocol using a triple-detector camera. Acquisition parameters
      were determined using cardiac phantom studies which were then applied in SPECT
      studies of 51 catheterized patients (22 with prior myocardial infarction) and 20
      patients with a "low" (7.9% +/- 4.3%) likelihood of coronary artery disease.
      Technetium-99m-teboroxime (20-25 mCi) was injected at the third minute of
      adenosine infusion. Teboroxime (20-25 mCi) was also injected at rest, 15 min
      later. Stress followed by rest SPECT were completed within 25 min using a triple
      detector camera and sequential, 1-min continuous rotations in alternating
      directions. Summed raw data from the first to second (1-2 min), second to third
      (2-3 min) and second to fifth (2-5 min) minutes of imaging following stress
      teboroxime injection were reconstructed and compared for image quality, degree of
      liver interference, and accuracy for diagnostic efficacy. In a subgroup of 30
      patients, 2-8-min summed images were also reconstructed to compare this more
      conventional imaging protocol with our rapid acquisition. Image quality was fair
      to good in 75% of the 1-2-min, 84% of the 2-3-min and 2-5-min studies and 53% of
      the 2-8-min scans. The frequency of severe liver interference appeared to
      increase with the duration of imaging time (1-2 min: 3%; 2-3 min: 7%; 2-5 min:
      8%) and was greatest (30%, p = 0.08) with 2-8-min images. Three patients (4%) had
      uninterpretable studies due to intense hepatic uptake. Overall sensitivity (95%)
      and specificity (71%) were equal for the 2-3-min and 2-5-min stress images and
      appeared better than in the 1-2-min images (84% and 57%, respectively). For the 2
      8-min scans, vessel sensitivity (69%) and specificity (63%) appeared poorer than
      with 2-3-min studies (83% and 81%, respectively). Normalcy rates were 89% for the
      2-3-min and 2-5-min and 79% for 1-2-min images. The back to back adenosine
      stress/rest teboroxime SPECT can be performed in 30 min using a triple-detector
      camera. Although overall high sensitivity and normalcy rates were achieved, the
      protocol is technically demanding. Interference due to intense liver uptake
      remains problematic.

PMID- 8355069
TI  - Quantitative same-day rest-stress technetium-99m-sestamibi SPECT: definition and
      validation of stress normal limits and criteria for abnormality.
AB  - Gender-matched stress normal limits and criteria for abnormality for rest-stress
      99mTc-sestamibi same-day myocardial perfusion imaging were developed and
      validated in 160 patients who were imaged using previously developed optimized
      acquisition, processing and quantitative protocols. The gender-matched mean and
      standard deviation of the normal response were calculated using 35 male and 25
      female patients with a < 5% likelihood of coronary artery disease. Receiver
      operating curve analysis using expert visual interpretation as the "gold
      standard" was used to determine the optimal criteria for abnormality detection,
      in terms of standard deviations from the mean and minimum defect size for each of
      the four major zones of the polar map, in a pilot population consisting of an
      additional 35 male and 25 female patients with a variety of perfusion defects.
      The optimum standard deviations resulted in the following true-positive/true
      negative rates when quantitative results were compared to visual analysis for the
      anterior, septal, lateral, and inferior segments in the combined male and female
      pilot populations: 84%/86%, 70%/75%, 86%/76% and 69%/76%, respectively. The final
      criteria were then applied to a prospective population consisting of 33 male and
      7 female patients. This analysis resulted in the following true-positive/true
      negative rates for overall perfusion abnormalities and abnormalities of the LAD,
      LCX and RCA vascular territories: 97%/67%, 94%/73%, 73%/90% and 72%/91%,
      respectively. The optimized 99mTc-sestamibi stress normal limits and criteria for
      abnormality correlate well with expert visual interpretation of stress myocardial
      perfusion defects.

PMID- 8355070
TI  - Detection of doxorubicin cardiotoxicity in patients with sarcomas by indium-111
      antimyosin monoclonal antibody studies.
AB  - To assess myocardial cell damage due to doxorubicin cardiotoxicity, we
      prospectively studied 30 patients with sarcomas who were receiving chemotherapy,
      including doxorubicin. Sixteen patients were treated by continuous infusion over
      72 hr and 14 patients were treated by bolus injection. Antimyosin studies and
      left ventricular ejection fraction (LVEF) measurements were performed before
      chemotherapy and at intermediate and maximal cumulative doses. Myocardial
      antimyosin uptake was quantified by a heart-to-lung ratio (HLR). Myocardial
      antimyosin uptake was observed in all patients at 240-300 mg/m2 when ejection
      fraction was still maintained. Seven patients presented with a decrease of > or =
      10% in absolute ejection fraction units at 420-600 mg/m2. Five of these patients
      had mild congestive heart failure. All patients who presented with a decrease in
      LVEF > or = 10% at 420-600 mg/m2 had increased antimyosin uptake with HLR > or =
      1.90 at a cumulative dose of 240-300 mg/m2. Patients who were treated with
      continuous infusion had less antimyosin uptake than those who were treated with
      bolus administration (mean HLR of 1.70 +/- 0.09 versus HLR of 2.01 +/- 0.16 at a
      cumulative dose of 240-300 mg/m2, p < 0.01; HLR of 1.86 +/- 0.12 versus HLR of
      2.32 +/- 0.34 at a cumulative dose of 420-600 mg/m2, p < 0.01). Two of 16
      patients treated by continuous infusion and 5 of 14 patients treated by bolus
      injection presented with a decrease in ejection fraction > or = 10%. LVEF after
      chemotherapy in the infusion group was 56% +/- 5% and 48% +/- 8% (p < 0.05) in
      the bolus group. Antimyosin studies are helpful in the assessment of doxorubicin
      cardiotoxicity. Intense antimyosin uptake at intermediate cumulative doses
      identifies patients at risk of cardiotoxicity before ejection fraction
      deteriorates. Patients with sarcomas treated by continuous infusion present with
      less antimyosin uptake than those treated with bolus injection, indicating less
      severe cardiotoxicity.

PMID- 8355071
TI  - Antimyosin positivity in doxorubicin cardiotoxicity: earlier than the
      conventional evidence.

PMID- 8355072
TI  - Teboroxime, sestamibi and thallium-201 as markers of myocardial hypoperfusion:
      comparison by quantitative dual-isotope autoradiography in rabbits.
AB  - The scintigraphic assessment of myocardial hypoperfusion depends on the ability
      of imaging agents to delineate flow disparities. Accordingly, we compared the
      differential uptake of teboroxime, sestamibi and 201Tl in normal and hypoperfused
      myocardium using quantitative dual isotope autoradiography. Rabbits with acute
      coronary occlusions (n = 29) received dual isotope injections of teboroxime 201Tl
      or sestamibi 201Tl or single isotope tracer injections. A group of sham-operated
      controls (n = 15) received teboroxime and/or 201Tl. Multiple 30-mu short axis
      slices were collected from each heart and mounted on x-ray film along with tissue
      standards to independently generate separate 99mTc and 201Tl autoradiographs.
      Teboroxime and sestamibi produced greater normal-to-defect activity contrast than
      201Tl in each dual isotope heart (range 8.4-48.9 [teboroxime] versus 2.6-12.3
      [201Tl], p < 0.02 and 4.5-10.4 [sestamibi] versus 3.6-7.3 [201Tl], p < 0.03).
      Similar profiles were obtained in the single isotope hearts. Teboroxime produced
      larger autoradiographic defects than 201Tl in the dual-isotope hearts [16.0% +/-
      5.6% (teboroxime) versus 12.9% +/- 5.3% (201Tl) of the LV, p < 0.02]. We conclude
      that the 99mTc-based perfusion agents teboroxime and, to a lesser extent,
      sestamibi, delineate hypoperfused myocardium more clearly than 201Tl. Teboroxime
      detects the largest area of hypoperfusion and may provide the most accurate
      assessment of myocardium at risk.

PMID- 8355073
TI  - Measurement of myocardial blood flow by radiolabeled tracers.

PMID- 8355074
TI  - Load independence of early diastolic filling parameters in the anesthetized
      canine model.
AB  - To evaluate radionuclide diastolic filling indices during acute pharmacologic
      changes in ventricular loading, 11 atrially paced dogs underwent simultaneous
      micromanometer left atrial and left ventricular pressure measurements. During
      phenylephrine infusion, systolic blood pressure increased from 110 +/- 16 (s.d.)
      to 147 +/- 19 mmHg (p < 0.01), causing the atrioventricular gradient to increase
      from 5 +/- 2 to 8 +/- 5 mmHg (p < 0.03) with no change in the time constant of
      isovolumic relaxation (Tau). Absolute peak filling rate increased from 40 +/- 21
      to 59 +/- 44 kcts/sec (p < 0.05), but there was no change in first-half filling
      fraction. During dobutamine infusion, Tau shortened from 43 +/- 13 msec to 33 +/-
      5 msec (p < 0.01) and first-half filling fraction increased from 39% +/- 19% to
      56% +/- 18% (p < 0.05), with no change in atrioventricular gradient or absolute
      peak filling rate. Absolute changes from baseline for the first-half filling
      fraction were inversely proportional to absolute changes in Tau (r = -0.76, p <
      0.05). We conclude that the left ventricular absolute peak filling rate is a load
      dependent index of diastolic function. In contrast, the radionuclide first-half
      filling fraction is independent of loading conditions, but is sensitive to
      substantial alterations in the rate of left ventricular isovolumic myocardial
      relaxation.

PMID- 8355075
TI  - Myocardial substrate utilization and left ventricular function in adriamycin
      cardiomyopathy.
AB  - We evaluated alterations of substrate utilization in a rat model of adriamycin
      cardiomyopathy with deteriorating left ventricular function. Rats were treated
      with adriamycin (2 mg/kg), once a week for 6, 8, 9 and 10 wk. Fluorine-18-F
      deoxyglucose (18F-FDG) and 125I-beta-methyl-branched fatty acid (125I-BMIPP) were
      used as tracers of glucose and fatty acid metabolism and 99mTc-hexakis (2
      methoxyisobutyl-isonitrile) (99mTc-MIBI) was used as a myocardial blood flow
      tracer. Left ventricular ejection fraction (LVEF) calculated from gated blood
      pool images was used as an indicator of cardiac function. LVEF was normal in the
      6-wk group (78.0% +/- 4.8%), abruptly decreased in the 8-wk group (43.1% +/-
      10.1%) and further deteriorated in the 9-wk group (27.6% +/- 13.4%). Accumulation
      of 18F-FDG (%kgID/g) in the hearts of adriamycin treated animals progressively
      decreased compared to controls (2.19% +/- 0.38%); 1.47% +/- 0.42% (p < 0.01) at 6
      wk, 1.22% +/- 0.27% (p < 0.001) at 8 wk, 0.69% +/- 0.56% (p < 0.001) at 9 wk and
      0.50% +/- 0.08% (p < 0.001) at 10 wk. This decrease occurred earlier than the
      deterioration in LVEF. Myocardial accumulation of 125I-BMIPP decreased in the
      advanced stages of adriamycin cardiomyopathy and was well correlated with the
      decrease in 18F-FDG accumulation. However, the decrease was less profound than
      for 18F-FDG; 53.7% +/- 9.8% versus 31.6% +/- 25.4% of control at 9 wk (p = NS),
      49.5% +/- 15.3% versus 22.6% +/- 3.5% of control at 10 wk (p < 0.05).
      Accumulation of 99mTc-MIBI did not differ between controls and the adriamycin
      treated groups. There were no differences in blood glucose levels between
      controls and adriamycin treatment groups. Both glucose and fatty acid utilization
      are decreased in adriamycin-induced cardiomyopathy and these critical impairments
      in energy metabolism are associated with heart failure. Impaired myocardial
      glucose utilization measured with 18F-FDG may be a particularly sensitive marker
      of adriamycin cardiomyopathy.

PMID- 8355076
TI  - A distributed pharmacokinetic model of two-step imaging and treatment protocols:
      application to streptavidin-conjugated monoclonal antibodies and radiolabeled
      biotin.
AB  - Two-step imaging and treatment protocols involve injecting a suitably prepared
      monoclonal antibody that can bind both to a specific tumor antigen and to a
      second reagent which carries a drug or radionuclide. The second component is
      injected later, after the antibody has distributed throughout the target tumors
      and been largely cleared from the plasma and normal tissues. We introduce a
      mathematical model for the analysis of such protocols and apply it to the case of
      a streptavidinylated monoclonal antibody and radiolabeled biotin diffusing into
      small, prevascular, densely cellular nodules that represent either primary or
      metastatic tumors. We examine the distribution of streptavidinylated antibody and
      radiolabeled biotin within a tumor nodule and compare the two-step protocol to a
      one-step protocol using radiolabeled antibody. Our analysis predicts that (1)
      streptavidinylation reduces both the amount of antibody that distributes into the
      tumor nodule and the homogeneity of that distribution; (2) streptavidinylated
      antibody in the nodule can be saturated by initial plasma concentrations of free
      radiolabeled biotin substantially lower than the initial plasma concentration of
      free streptavidinylated antibody; (3) radiolabeled biotin diffuses rapidly, but
      binds so quickly that it will not penetrate deeply into the nodule if too low a
      dose is given. Hence, nonuniform localization of radiolabel may result from a
      "binding site barrier" to diffusion of either or both components; and (4) the two
      step protocol permits imaging sooner after injection of radiolabeled material
      than the one-step protocol and produces a higher exposure in tumor relative to
      plasma, even in the presence of antigen turnover.

PMID- 8355077
TI  - SIMS microscopy imaging of the intratumor biodistribution of
      metaiodobenzylguanidine in the human SK-N-SH neuroblastoma cell line xenografted
      into nude mice.
AB  - Microdosimetric evaluations of targeted radiotherapy of neuroblastoma with
      metaiodobenzylguanidine (MIBG) require precise assessment of the intracellular
      and intratumor distribution of the drug. We report the use of secondary ion mass
      spectrometry (SIMS) microscopy, a technique capable of mapping any chemical
      element within a biological specimen, to determine 127I-MIBG biodistribution in
      human neuroblastoma SK-N-SH xenografted into nude mice. Highly specific images of
      127I-MIBG biodistribution were mapped within the tumor after in vivo
      administration of the drug and sample processing with cryotechniques (high-speed
      freezing and cryo-embedding), which prevent MIBG diffusion from original sites of
      uptake. We showed that the biodistribution of the tracer was highly nonuniform
      within the tumor. At the cellular level, most of the drug accumulated in the
      cytosol and perinuclear areas. In contrast, chemical sample processing provided
      not only a considerable loss in sensitivity due to passive diffusion of the drug
      in the organic solvents, but also artefactual images mainly due to MIBG
      redistribution onto the cell nuclei. Based on our findings in this SK-N-SH
      experimental tumor model, we suggest that MIBG should be attached to long-range
      emitters, in the hope of irradiating the many tumorous areas that remain carrier
      free.

PMID- 8355078
TI  - Paradoxical changes in iodine-131 scintigraphic findings in advanced follicular
      thyroid cancer.
AB  - We present the findings on iodine-131 (131I) scintigraphy, thallium-201 (201Tl)
      scintigraphy and quantitative thyroglobulin (QTG) estimation in two patients with
      follicular carcinoma of the thyroid with extensive metastases. The lesions were
      initially seen on 131I scintigraphs, but were not subsequently visualized with
      scanning doses of 131I (5 mCi), while retaining their ability to produce
      increasing amounts of thyroglobulin and take up 201Tl. Implications in choosing
      the appropriate diagnostic tests in the management of differentiated thyroid
      cancer are discussed.

PMID- 8355079
TI  - Fast transmission CT for determining attenuation maps using a collimated line
      source, rotatable air-copper-lead attenuators and fan-beam collimation.
AB  - We describe a technique using a line source and a rotatable air-copper-lead
      assembly to acquire gamma transmission computed tomographic (TCT) data for
      determining attenuation maps to compensate SPECT emission scans. The technique
      minimizes problems associated with discriminating 99mTc transmission and 201Tl
      emission photons and requires only a modest increase in total study time. A 99mTc
      line source and a stacked foil ("multislat") collimator are placed near the focal
      line of a fan-beam collimator (114 cm focal length) mounted on one detector of a
      triple-camera SPECT system. We acquired TCT data of plastic rod and
      anthropomorphic thorax phantoms to investigate the capability of the line source
      and rotatable air-copper-lead attenuators to determine attenuation maps. The data
      were acquired with and without 5.4 MBq (145 microCi) of 201Tl placed in the
      myocardial chamber of the thorax phantom. Phantoms also were scanned using a
      curved transmission slab source mounted to a parallel-hole collimator. Fan-beam
      TCT images have improved resolution compared with parallel-beam TCT images. Two
      patient scans also were performed to evaluate the clinical usefulness of fan-beam
      TCT. The rotatable air-copper-lead attenuator method eliminates contamination of
      emission data by transmission photons and reduces spill-over of emission data
      into the transmission energy window for some cases. Results show the feasibility
      of using fast, sequential or interlaced transmission scans of a line source
      within a rotatable air-copper-lead attenuator assembly to obtain accurate
      attenuation maps for SPECT attenuation compensation.

PMID- 8355080
TI  - Accuracy of registration of PET, SPECT and MR images of a brain phantom.
AB  - Accuracy of a surface-fitting algorithm for three-dimensional image registration
      of single photon emission computed tomography (SPECT), positron emission
      tomography (PET), and magnetic resonance (MR) images was tested using a three
      dimensional, water-fillable brain phantom. Multislice or volume image sets were
      acquired for each modality. Small fiducial markers were attached to assess
      accuracy of surface fitting and provide an alternate fitting technique. A maximum
      gradient technique was found to work well for SPECT and PET edge detection.
      Transformation parameters for translation, rotation and scaling were determined
      by surface fit to match each SPECT and PET scan with MR images. Using the
      markers, overall translation errors were found to be < 2 mm in each direction and
      rotational errors < 2 degrees in every case. Errors for specific internal regions
      were also determined to be < 2 mm for most regions, with only a few fits
      resulting in errors > 3 mm for some cortical regions. Results indicate surface
      fitting to be sufficiently accurate for visual comparison of registered images
      and for enhanced SPECT and PET region of interest (ROI) determination and image
      reconstruction.

PMID- 8355081
TI  - Left ventricular systolic and diastolic function measurements using an ambulatory
      radionuclide monitor: effects of different time averaging on accuracy.
AB  - The accuracy of an ambulatory radionuclide detector (VEST) for left ventricular
      systolic (ejection fraction, EF) and diastolic (peak filling rate, PFR)
      measurements was assessed at different time averaging of the nuclear and
      electrocardiographic data. Fifty-one patients, in a total of 67 studies,
      underwent equilibrium radionuclide angiography (RNA) immediately before a VEST
      study. VEST data were analyzed using single-beat analysis and different time
      averaging of 5, 10, 15, 30 and 60 sec. Agreement between VEST and RNA in
      estimating EF and PFR was evaluated by computing limits of agreement (LA). These
      were computed as 1.96 times the s.d. of the mean differences between the two
      methods, expressed in the same unit as EF and PFR. Differences between the two
      methods were plotted against their mean, allowing investigation of any possible
      relationship between measurement error and the true value (whose best estimate is
      the mean between the two methods). The entire statistical analysis was repeated
      at each different time averaging. LAs for EF measurement by VEST were -10.4:8.8
      (single-beat analysis), -11.2:9.9 (5-sec averaging), -5.4:4.8 (10-sec averaging),
      -4.9:4.5 (15-sec averaging), -6.2:5.6 (30-sec averaging), -6.9:4.5 (60-sec
      averaging). Results indicate good agreement between VEST and RNA in measuring EF,
      at least for time averaging > or = 10 sec. LAs for PFR ranged from -0.6:0.6
      (single beat) to -1.0:0.6 (60-sec averaging), which was considered a clinically
      acceptable agreement between VEST and RNA. No relationship between measurement
      error and true value was found either for EF and PFR.

PMID- 8355082
TI  - A scintigraphic sign for detection of right-to-left shunts.
AB  - We evaluated the usefulness of a new scintigraphic sign, a quantum mottling
      pattern, in diagnosing right-to-left shunt using 99mTc-MAA particles. The quantum
      mottling pattern is characterized by random distribution of discrete clumps of
      radioactivity that are more intense than the general body background. Forty-nine
      99mTc-MAA scintigrams were analyzed retrospectively for presence of a quantum
      mottling pattern in extrapulmonary soft tissues and brain. This distinctive
      pattern was observed in every patient (18/18) in whom a right-to-left shunt was
      confirmed by nonscintigraphic means and was noted only in one patient in whom
      independent proof of a right-to-left shunt was not available. In contrast,
      application of conventional criteria yielded a true-positive interpretation for
      15/18 patients with right-to-left shunts and a false-positive interpretation for
      another four patients. Presence of a quantum mottling pattern on 99mTc-MAA images
      appears to be a reliable aid for detecting a right-to-left shunt. Use of this
      sign is likely to improve accuracy of the scintigraphic test in patients with
      small shunts.

PMID- 8355083
TI  - Uptake of technetium-99m MDP in primary amyloidosis with a review of the
      mechanisms of soft tissue localization of bone seeking radiopharmaceuticals.

PMID- 8355085
TI  - Nuclear medicine: more than just medical imaging.

PMID- 8355084
TI  - Noninvasive real-time monitoring of renal function.

PMID- 8355086
TI  - Gallium-67 citrate in liquid gastric emptying scintigraphy.

PMID- 8355087
TI  - Low-level radioactive waste sites: still a political football.

PMID- 8355088
TI  - NRC proposed amendments: too little, too late?

PMID- 8355089
TI  - The future of nuclear medicine: autonomy or integration?

PMID- 8355090
TI  - Osseous guided tissue regeneration using a collagen barrier membrane.
AB  - The formation of mature, fibrous tissue in surgical osteotomy sites during the
      healing process can produce clinically undesirable results such as nonunion or
      encapsulation of alloplastic implants. The techniques of guided tissue
      regeneration have been used to ameliorate this problem by presenting a barrier to
      the invasion of fibrous tissue elements into the wound-site clot. The most
      frequently used barrier material, polytetrafluoroethylene is effective, but
      suffers the disadvantage of requiring surgical removal after clot organization is
      completed. A biocompatible, resorbable membrane that will effectively control the
      type of tissue that can invade and organize a clot would be advantageous, because
      it would not require surgical removal. In the present study, the efficacy of a
      collagen membrane to effect guided tissue regeneration in a rabbit zygomatic arch
      osteotomy model was tested. Complete, bilateral narrow (1 mm) or wide (5 mm)
      vertical osteotomies were created in eight adult New Zealand white male rabbits.
      On one side, the wound site was surrounded by a collagen barrier membrane prior
      to closure, while the other side was left uncovered (control side). Four animals
      were killed at 2 and 4 weeks postoperatively for gross radiologic and histologic
      examination of the wound site. The wide osteotomy sites without a barrier
      membrane showed invasion by fibroblasts resulting in fibrous nonunion, while the
      contralateral sides with the barrier membrane showed no fibrous tissue ingrowth
      and bony union by 4 weeks postoperatively. Although narrow wound sites without
      the barrier membrane showed fibrous tissue formation, the perimeter of the
      defects showed some new bone deposited at the periosteal surface, bridging the
      osteotomy site and producing osseous union.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355091
TI  - Conduction velocity of the human inferior alveolar nerve: a preliminary report.
AB  - This preliminary report describes a technique to consistently record
      electrophysiological signals from the uninjured inferior alveolar nerves of human
      subjects. Bilateral recordings were obtained from 15 consecutive human
      volunteers. The mean conduction velocity was 67.6 m/s, with no differences shown
      for right or left sides or gender. Conduction velocity testing could offer a new
      objectivity in the clinical study of the inferior alveolar nerve, aiding in the
      documentation, diagnosis, management, and follow-up of the sometimes complex
      neural lesions that oral and maxillofacial surgeons routinely see.

PMID- 8355092
TI  - Retromolar trigone mass.

PMID- 8355093
TI  - Benign cementoblastoma: report of an unusual case and analysis of 14 additional
      cases.

PMID- 8355094
TI  - Dirofilaria tenuis infection of the oral mucosa and cheek.

PMID- 8355095
TI  - Congenital epulis: review of the literature and case report.

PMID- 8355096
TI  - Aggressive infantile fibromatosis: report of a case undergoing spontaneous
      regression.

PMID- 8355097
TI  - A simple appliance for controlling mandibular movement following segmental
      resection.

PMID- 8355098
TI  - A modified technique for the sagittal split osteotomy.

PMID- 8355099
TI  - Problems with the ABOMS certification process. American Board of Oral and
      Maxillofacial Surgery.

PMID- 8355100
TI  - Watching out for public safety.

PMID- 8355101
TI  - Management of midface fractures: fifty years later.
AB  - Much has changed in the 50 years since Dr Parker described the development of
      rapid means of transportation as a portent of an increase in maxillofacial
      trauma. Contemporary surgeons must concern themselves with a host of nonsurgical
      care issues that are an integral part of oral and maxillofacial surgery practice.
      Expectations related to the patient, government, insurance carrier, and hospital
      staff have created a new practice environment. Standards of care are high and
      surgeon and patient needs are more complex. Dramatically improved diagnostic
      capabilities, use of open surgical techniques, improved rigid fixation devices,
      advances in techniques of resuscitation, and more focused surgical training have
      markedly improved the care of the facial trauma patient. The midface remains the
      central focus of our gaze when we engage in interpersonal relationships.
      Developmental and acquired aberrations of this region are likely to be more
      obvious than lower face abnormalities and, therefore, perceived as more
      disfiguring. Complex midface trauma repair requires precise surgical technique,
      with little margin for error. When ideal results are not achieved, the common
      contributing factors are intercurrent serious injury, anatomic and wound repair
      considerations, and failure to execute fracture repair principles. Hard and soft
      tissue volume changes may further compromise midface fracture repair,
      irrespective of the quality of the surgical outcome. Despite the advances made in
      the last 50 years, there is still room for future progress. An interdisciplinary
      committee of surgeons treating facial trauma should convene to establish a
      classification system for midface fractures that would satisfy medical record
      keeping and coding requirements, and facilitate fair and consistent
      reimbursement.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355102
TI  - Treatment of mandibular angle fractures using two 2.4-mm dynamic compression
      plates.
AB  - Sixty-five consecutive patients with fractures of the mandibular angle were
      treated by open reduction and internal fixation using two dynamic compression
      plates placed through a transoral incision using transbuccal trochar
      instrumentation and 2.4-mm screws. In the first 20 cases, the screws were
      inserted without tapping the drill holes. In the remaining 45 cases, the drill
      holes were tapped. No patient was placed into postsurgical maxillomandibular
      fixation or training elastics. Overall, 21 fractures (32%) developed infections
      requiring secondary surgical intervention. The infection rate was higher in those
      fractures where the holes were not tapped (40%) than those cases when the holes
      were tapped (29%). Of the 21 fractures that required hardware removal, 9
      fractures were healed and required no further treatment; 12 had no firm bony
      union and required postsurgical maxillomandibular fixation. Only one case
      resulted in a malunion with resulting malocclusion. The use of two dynamic
      compression plates was found to be relatively easy, but resulted in an
      unacceptable rate of infection.

PMID- 8355103
TI  - A quantitative computer-assisted analysis of disc displacement in patients with
      internal derangement using sagittal view magnetic resonance imaging.
AB  - Forty patients diagnosed clinically as having internal derangement of one or both
      temporomandibular joints underwent magnetic resonance imaging. Seventy-three
      films were obtained: 26 films from 13 patients with bilateral symptoms; 40 films
      from 20 patients with unilateral symptomatic joints; and seven films from only
      the symptomatic joint in the remaining seven patients. Disc positions were
      evaluated in all of these films, and also in 17 films obtained from 10
      asymptomatic volunteers. A system for quantitative measurement of disc position
      relative to the condyle in the closed-mouth position was used in two ways:
      manually, with an operator locating reference points and measuring them; and
      computer-assisted, with a special program developed to locate and measure these
      points. There was no significant difference in the results produced by these two
      methods. Important findings of this study were as follows: 1) 35% of the joints
      in the asymptomatic volunteers were found to have moderately or severely
      displaced discs; 2) only 75% of the joints diagnosed clinically as having an
      internal derangement were found to have significant disc displacement, which
      suggests that the other 25% must have had a different pathologic basis for the
      symptoms; and 3) the contralateral disc in the unilateral patients was found to
      be displaced as often as the disc on the symptomatic side (75%).

PMID- 8355104
TI  - Clinical evaluation of antibiotic-supplemented bone allograft.
AB  - Antibiotic-supplemented bone allograft (ASBA) was originally developed for
      treatment of combat-acquired, avulsive defects of the oral and maxillofacial
      skeleton. Earlier findings in experimental wound models showed that ASBA resulted
      in significantly improved wound repair of infected osseous defects when compared
      with conventional treatment. In this study, ASBA was evaluated in paired,
      comparable, mandibular third molar sockets and compared with the findings
      following conventional surgical removal. The results of this assessment showed
      that wound healing was significantly improved with the use of ASBA. Evidence
      produced by this clinical evaluation of ASBA suggests its potential use for other
      surgical bone defects when grafting is precluded by the risk of infection as a
      result of contamination by oral flora.

PMID- 8355105
TI  - Reduction of postoperative facial swelling by low-dose methylprednisolone: an
      experimental study.
AB  - The effectiveness of a low-dose, preoperative regimen of methylprednisolone for
      the reduction of postoperative facial edema after impacted third molar surgery
      was evaluated using the facial plethysmograph. Eleven patients were given 16 mg
      methylprednisolone orally the evening before surgery, combined with 20 mg
      methylprednisolone intravenously immediately preoperatively, in a double blind,
      randomized, crossover study. Facial contour was measured preoperatively, and then
      on days 1, 2, 3, 4, and 7 postoperatively. The low dose of methylprednisolone
      reduced swelling by 42% at 24 hours and 34% at 48 hours postoperatively. By the
      third day the difference was only 19%, suggesting the need for either a sustained
      release formulation or a multiday course. Trismus or the need for analgesic
      medication were not affected by this dose of methylprednisolone.

PMID- 8355106
TI  - Effects of maxillomandibular fixation on respiration.
AB  - The effects of maxillomandibular fixation (MMF) on respiration were studied by
      measuring pulmonary function in 27 healthy volunteer subjects and in six post
      operative patients who underwent MMF after sagittal split ramus osteotomies. In
      addition, airflow resistance of the mouth was measured in seven healthy subjects
      under MMF. In the healthy subjects, the ratio of forced expiratory volume in one
      second to forced vital capacity and peak expiratory flow rate were reduced by
      22.9% and 52.1%, respectively, after application of MMF, indicating the presence
      of respiratory obstruction, whereas the ratio of forced vital capacity to
      predicted forced vital capacity, an indicator of restrictive respiratory defects,
      was not significantly affected. The obstructive type of respiratory defect was
      found to be the result of increased airflow resistance with MMF. The decrease of
      forced expiratory volume was greater in all postoperative patients than in the
      healthy subjects. The results indicate that careful preoperative and
      postoperative airway management is essential for the safety of patients
      undergoing MMF for the treatment of oral and maxillofacial conditions.

PMID- 8355107
TI  - Masticatory function in patients with mandibular prognathism before and after
      orthognathic surgery.
AB  - Masticatory function was analyzed in 54 patients with mandibular prognathism
      before or after orthognathic treatment and in 40 adults with normal occlusion.
      Masticatory efficiency was evaluated spectrophotometrically by measuring the
      amount of adenosine triphosphate eluted from masticated adenosine triphosphate
      granules. Occlusal contact was evaluated by calculating the number and area of
      occlusal contacts from the illuminated images of a silicone record of the
      occlusion that was stored in the image analysis system with the aid of a charge
      coupled device camera. The mean masticatory efficiency of the preoperative group
      was approximately half that of the control group. The value for the postoperative
      group was slightly higher than that for the preoperative group, but there was no
      statistical difference between the two groups. Likewise, the number and area of
      occlusal contacts in the preoperative group were also approximately half or less
      as compared with those of the control group, and they did not show significant
      changes postoperatively. Statistically, there were correlations between the
      masticatory efficiency and the number and area of occlusal contacts. The results
      indicate that although the occlusal relationship of the upper and lower teeth
      were greatly improved by orthognathic treatment, the postoperative occlusion is
      not tight enough and may need further adjustment at the end of the treatment.

PMID- 8355108
TI  - Venous thromboembolic complications in children.

PMID- 8355110
TI  - Pediatric critical care and hospital costs under reimbursement by diagnosis
      related group: effect of clinical and demographic characteristics.
AB  - OBJECTIVE: To determine the relationship of demographic and clinical variables to
      cost, to revenue based on diagnosis-related groups, and to profit in patients in
      a pediatric intensive care unit (PICU). DESIGN: Prospective collection of
      clinical and demographic data of patients sampled. Detailed financial data for
      all patients discharged from the hospital were compiled by the office of
      financial planning. A combined data set was used for analysis. SETTING: A
      multidisciplinary PICU within a general, tertiary-care, teaching hospital in an
      urban environment. PATIENTS: Consecutive sample of 1174 pediatric patients
      discharged from the PICU during a 24-month period. MEASUREMENTS AND MAIN RESULTS:
      Hospital cost (not charges) determined according to industry standards. Revenue
      was determined by the DRG system. Of the 1174 cases identified, DRG coding and
      financial data were 97% complete. The mean loss (negative profit) per patient was
      $9218 +/- $33,676. Profit was significantly and adversely affected by outlier
      status, death, high risk of death, interhospital transfer, emergency admission,
      young age, and mechanical ventilation. Multivariate analysis revealed that
      duration of stay, death, interhospital transfer, and age negatively correlated
      with profit. CONCLUSION: Under a DRG-based reimbursement system, the operation of
      an active PICU with a broad referral base may not be desirable from a financial
      perspective. Similar studies at other institutions could help establish a data
      base with which the DRG system can be refined.

PMID- 8355109
TI  - Distinction between transient hyperglycemia and early insulin-dependent diabetes
      mellitus in childhood: a prospective study of incidence and prognostic factors.
AB  - We prospectively studied 63 children with transient hyperglycemia to determine
      their risk of acquiring insulin-dependent diabetes mellitus (IDDM) and to
      evaluate the predictive value of immunologic markers of prediabetes and of the
      intravenous glucose tolerance test. Children with transient hyperglycemia were
      identified by a prospective systematic review of the laboratory reports of a
      large children's hospital and an office-based pediatric practice and by referral
      from pediatricians. Transient hyperglycemia occurred in 0.46% of children seen in
      the children's hospital and in 0.013% of children attending a pediatric office
      practice. Insulin-dependent diabetes mellitus developed within 18 months of
      identification in 32% of children in whom transient hyperglycemia was discovered
      in the absence of a serious illness, compared with 2.3% of children identified
      during a serious illness (relative risk, 13.9; 95% confidence interval, 1.56 to
      123.5). Islet cell antibodies and competitive insulin autoantibodies each had a
      100% positive predictive value for IDDM; the negative predictive value of islet
      cell antibodies and competitive insulin autoantibodies was 96% and 98%,
      respectively. The stimulated insulin release during an intravenous glucose
      tolerance test, adjusted for age, had the highest overall accuracy of prediction.
      All children less than 6 years of age with stimulated insulin release levels < 85
      pmol/L (12 microU/ml) subsequently had IDDM, as did an 11-year-old child whose
      stimulated insulin release level was below the 1st percentile of 170 pmol/L (24
      microU/ml). To date, no child whose stimulated insulin release level was above
      the 5th percentile has had IDDM. We conclude that when transient hyperglycemia
      occurs during a serious intercurrent illness, the risk of progression to IDDM is
      low. In contrast, one third of children in whom transient hyperglycemia is
      identified without a serious illness can be expected to have IDDM within 1 year.
      A combination of islet cell antibodies, competitive insulin autoantibodies, and
      stimulated insulin release levels during an intravenous glucose tolerance test
      can accurately distinguish children with prediabetes from those with presumed
      benign transient increases in plasma glucose concentrations.

PMID- 8355111
TI  - Effect of hypogonadism and deficient calcium intake on bone density in patients
      with galactosemia.
AB  - Forty children and adults with classic galactosemia had vertebral bone density
      determined by standard quantitative computed tomography at 3.4 to 44.2 years of
      age. Compared with age- and sex-matched control subjects, patients with
      galactosemia had diminished bone density (p = < 0.001). Prepubertal patients of
      both sexes had bone density determinations below those of the control group (p =
      0.008); similar findings were seen in postpubertal patients as well (women, p =
      0.001; men, p = 0.008). Women receiving replacement estrogen-progestin therapy
      for premature ovarian failure had abnormal bone density (136.3 +/- 17.3 mg/cm3 vs
      166.0 +/- 17.5 mg/cm3 for control subjects; p = 0.002); patients with evidence of
      ovarian insufficiency not receiving replacement sex steroids had even lower bone
      density (92.4 +/- 14.3 mg/cm3 vs 160.2 +/- 20.2 mg/cm3 for control subjects; p <
      0.001). Calcium intake for the entire galactosemia group was 540 +/- 344 mg/day.
      Calcium intake correlated positively with bone density in women given exogenous
      estrogen (r = 0.87; p = 0.002) and in men (r = 0.74; p = 0.009). Thus the
      diminished mineralization of bones appears to be another abnormality associated
      with galactosemia. The results of our study suggest that this is likely secondary
      to abnormal levels of sex steroids in female patients, low calcium intake, and
      perhaps an intrinsic defect in the normal galactosylation of the collagen matrix
      of bone caused by the enzyme defect. Strategies to improve bone formation should
      be considered to diminish morbidity in patients with this inborn error of
      metabolism.

PMID- 8355112
TI  - Percutaneous gastrojejunostomy versus Nissen fundoplication for enteral feeding
      of the neurologically impaired child with gastroesophageal reflux.
AB  - To determine the optimal method of providing enteral feeding to neurologically
      impaired children with gastroesophageal reflux, Nissen fundoplication with
      simultaneous gastrostomy tube placement (NGT) was compared with anterograde
      percutaneous gastrojejunostomy (APGJ), a nonsurgical procedure performed under
      fluoroscopic guidance. The records of 112 neurologically impaired children with
      gastroesophageal reflux were retrospectively reviewed; 68 had undergone NGT and
      44 APGJ. Follow-up data were available for 45 NGT patients (mean age, 6.4 years)
      and 34 APGJ patients (mean age, 7.9 years). Mean follow-up was 1.8 years in the
      NGT group and 2.5 years in the APGJ group. Complications resulting from either
      procedure were classified either as major, which included treatment failures or
      morbidity resulting in prolonged hospitalization, or as minor, those requiring
      outpatient treatment only or not directly caused by the procedure. The NGT group
      had a significantly higher incidence of major complications in comparison with
      the APGJ group (33.3% vs 11.8%, p < 0.05). Ten patients (22.2%) in the NGT group
      required reoperation for complications; six required a second NGT for wrap
      hernia, failure, and continued gastroesophageal reflux. Two patients (5.9%) in
      the APGJ group required surgery for complications; one of these eventually
      required an NGT, and the other had an intussusception that necessitated a small
      bowel resection. Minor complications were more common in the APGJ group than in
      the NGT group (44.1% vs 6.6%); the majority of complications were related to the
      jejunostomy tube. Premature replacement or reinsertion of the jejunostomy tube
      was necessary in 14 APGJ patients (32%). The mortality rate was 8.8% in the NGT
      group and 5.9% in the APGJ group (p = not significant). No death occurred within
      30 days of either procedure. We conclude that APGJ is a safe alternative method
      for feeding the neurologically impaired child with gastroesophageal reflux.

PMID- 8355113
TI  - Utility of magnetic resonance imaging for management of hemophilic arthropathy in
      children.
AB  - We hypothesized that magnetic resonance imaging (MRI) would improve clinical and
      plain-radiograph assessments of children with hemophilic arthropathy. Thirteen
      children, aged 7 to 16 years, with severe factor VIII deficiency and one or more
      target joints were identified. A target joint was defined as a joint into which
      hemorrhage had occurred at least twice a month for at least the previous 6
      months. After review of history, examination, and plain radiography, a
      recommendation regarding synovectomy or prophylaxis with factor VIII concentrate
      was made for each target joint. The MRI of each target joint was then reviewed.
      Fourteen target joints (three elbows, three knees, eight ankles) were evaluated.
      On the basis of clinical and plain-radiograph data, synovectomy was recommended
      for five and prophylaxis for seven joints. Discontinuation of prophylaxis was
      recommended for two ankles in one child. The MRI examination confirmed that four
      of five potential synovectomy candidates had markedly hypertrophied synovium and
      could benefit from surgery; one of five was excluded from synovectomy because
      synovial hypertrophy was minimal. Two of seven children recommended for
      prophylaxis were given substantially altered plans after MRI. In all,
      approximately 40% of joint assessments were modified as a result of the MRI
      findings. We conclude that MRI should be included in the evaluation of some
      children with hemophilic arthropathy.

PMID- 8355114
TI  - Normal values for random urinary calcium to creatinine ratios in infancy.
AB  - OBJECTIVE: To determine normal values for the urinary calcium/creatinine ratio
      (UCa/Cr) in infants. To assess the impact of short-term supplementation of infant
      formula with calcium and phosphorus on UCa/Cr in a group of infants. DESIGN: We
      determined UCa/Cr in randomly collected urine samples from a group of children
      and adults. Short-term supplementation of infant formula with calcium
      glycerophosphate was carried out in 21 infants, and UCa/Cr was monitored in a
      before-and-after trial. SETTING: A pediatric clinic at an academic center
      (infants and adults), and a day-care center (older children). PARTICIPANTS: A
      total of 103 infants between 5 days and 7 months of age, 40 infants between 8 and
      17 months of age, 41 children between 18 months and 6 years, and 31 adults.
      RESULTS: The 95th percentiles for molar UCa/Cr for the different age groups were
      as follows: less than 7 months, 2.42 (0.86 mg/mg); 7 to 18 months, 1.69 (0.60
      mg/mg); 19 months to 6 years, 1.18 (0.42 mg/mg); and adults, 0.61 (0.22 mg/mg).
      Regression analysis indicated a statistically significant decline in average
      UCa/Cr with age (R2 = 0.115, p < 0.0001 for log (UCa/Cr) vs log (age)). The
      geometric means for the two groups of infants were significantly greater than
      those of the older children and the adults (p < 0.05). Values for UCa/Cr in
      adults in our sample were comparable to those previously reported. We detected no
      significant changes in mean UCa/Cr during week-long periods of calcium
      supplementation of up to 1.8 gm of calcium and 1.39 gm of phosphorus per liter of
      formula. CONCLUSION: We conclude that normal values for UCa/Cr are much higher in
      infants than in older children and adults; UCa/Cr is age-related and declines
      gradually in the first several years of life, and short-term supplementation of
      infant formula with calcium glycerophosphate has minimal effect on UCa/Cr.

PMID- 8355115
TI  - Urethral obstruction sequence and lower limb deficiency: evidence for the
      vascular disruption hypothesis.
AB  - We reviewed five unreported examples and 23 previously reported cases of urethral
      obstruction sequence with associated lower limb deficiency. There was no evidence
      of amniotic bands or exposure to vasoactive drugs during pregnancy in any case.
      In three infants a gangrenous lesion at the distal part of the affected leg was
      found; in another three infants, necrotic tissue was noted in the stump of the
      affected leg. This type of lesion can be explained only on a vascular ischemic
      basis. In five cases, signs of compression of the external iliac artery by the
      grossly distended bladder, by grossly distended ureters, or both were found. A
      vascular disruption in the territory of the external iliac artery caused by
      compression by the distended urinary tract is the proposed mechanism for the
      associated limb deficiency.

PMID- 8355117
TI  - Prospective payment and pediatric intensive care.

PMID- 8355116
TI  - Variable phenotypes in velocardiofacial syndrome with chromosomal deletion.
AB  - Velocardiofacial syndrome (VCF) has overlapping features with DiGeorge sequence;
      both result from a developmental field defect and probably represent contiguous
      gene deletion syndromes. The association of chromosome 22q11 deletion with
      DiGeorge sequence led us to do molecular analysis of chromosome 22 in 18 patients
      with VCF, who ranged in age from 6 to 42 years. All 18 patients had monosomy for
      the chromosome region 22q11. Retrospectively, we correlated the presence of the
      deletion with various clinical findings: 100% had cleft palate, 67% the facial
      phenotype, 83% cardiac disease, 94% learning disabilities, 70% ophthalmologic
      findings, 50% short stature, 22% psychiatric disorders, and 17% hypocalcemia.
      Both severely phenotypically affected and mildly affected patients had the
      deletion. These findings stress the importance of continued surveillance of all
      patients with VCF for the many medical problems that may not be present at
      initial diagnosis. We conclude that the presence of the gene deletion does not
      predict the phenotypic expression in VCF. Further studies to characterize the
      size of the gene deletion may facilitate better prediction of the phenotype.

PMID- 8355118
TI  - Recurrent apparent life-threatening events during infancy: a manifestation of
      inborn errors of metabolism.
AB  - To determine how often inborn errors of metabolism may cause unexplained apnea or
      recurrent apparent life-threatening events in infants, we retrospectively
      reviewed the records of 166 infants who were referred for apnea evaluation. A
      metabolic disorder was identified in 7 infants (4.2%), all of whom had recurrent
      apparent life-threatening events.

PMID- 8355119
TI  - Microbiology of kerions.
AB  - Qualitative and semiquantitative bacterial culture specimens were obtained from
      44 patients with kerions. Staphylococcus aureus was isolated from the scalp
      surface overlying the kerion in 29% of patients and from the pus within the
      kerion in 48% of patients. Gram-negative bacteria were found in the same
      locations in 11.3% and 18% of patients, respectively. The data indicate that
      bacteria are frequently cultured from kerions.

PMID- 8355120
TI  - A new, rapid, noninvasive screening test for celiac disease.
AB  - Serum levels of IgA and IgG antigliadin antibodies were evaluated in 267 subjects
      by using both the classic enzyme-linked immunosorbent assay and a rapid test
      (strip-AGA test) performed on a drop of whole blood. This new test was easy to
      perform and gave results comparable to those of the enzyme-linked immunosorbent
      assay; it could be useful in screening for celiac disease in both at-risk and
      normal populations.

PMID- 8355121
TI  - Transient improvement of congenital lactic acidosis in a male infant with
      pyruvate decarboxylase deficiency treated with dichloroacetate.
AB  - A comatose male newborn infant with congenital lactic acidosis caused by pyruvate
      decarboxylase deficiency was treated with dichloroacetate (DCA), which stimulated
      an 88% drop in serum lactate concentration and reversed his coma. The response to
      DCA was temporary and the lactic acidosis worsened until his death, but DCA may
      confer more lasting benefit in less severely affected infants.

PMID- 8355122
TI  - Hereditary motor-sensory neuropathy (Charcot-Marie-Tooth disease) with nerve
      deafness: a new variant.
AB  - Hereditary motor-sensory neuropathy with sensorineural deafness is described in a
      family; the neurologic features and deafness were apparent in early childhood and
      infancy. The clinical syndrome in the family was not closely linked to the Duffy
      blood group, nor was duplication demonstrated at the disease-associated locus 17
      p11.2. This family may represent a different form of this heterogeneous disease.

PMID- 8355123
TI  - Plasma nitric oxide levels in newborn infants with sepsis.
AB  - Nitric oxide is thought to play an important role in the mediation of the
      cardiovascular features of septic shock. We determined plasma levels of nitrite
      and nitrate (not differentiated in measurement) in neonates with sepsis and found
      these levels to be elevated at the time of entry compared with those of control
      subjects (p < 0.05); the levels were significantly higher in the patients with
      sepsis and shock than in those without shock (p < 0.05). Elevations of nitrite
      plus nitrate were correlated with tumor necrosis factor and severity of illness
      judged by pediatric risk of mortality (PRISM) scores at onset (p < 0.05). Of 8
      newborn infants with a nitrite-plus-nitrate value > 200 mumol/L, 6 had septic
      shock; none of 12 not reaching that cutoff value had septic shock (p < 0.05).
      Levels of nitrite plus nitrate were elevated as much in gram-positive as in gram
      negative sepsis. We conclude that the determination of circulating plasma levels
      of nitrite plus nitrate may be useful in forecasting the severity of illness and
      the occurrence of septic shock; therapeutic approaches associated with inhibition
      of nitric oxide synthesis may be worth trying in infants with septic shock.

PMID- 8355124
TI  - Growth and bone mineral status of discharged very low birth weight infants fed
      different formulas or human milk.
AB  - The objective of this study was to determine whether the growth and bone mineral
      status of discharged preterm infants fed human milk differed from those of
      infants fed one of three different formulas varying in calcium content (545 mg/L,
      660 mg/L, or 1290 mg/L). A randomized, blinded study was conducted for 16 weeks
      after discharge in 16 human milk-fed and 43 formula-fed infants. All formula-fed
      infants received one of the three study formulas from discharge to 8 weeks
      afterward, and the standard formula, which contained 545 mg/L calcium, from 8 to
      16 weeks. The human milk-fed infants gained weight more slowly than the formula
      fed infants. The human milk-fed infants also had lower gains in length and higher
      serum alkaline phosphatase values than the formula-fed infants. The infants who
      received the formula containing the highest calcium concentration (1290 mg/L) had
      greater bone mineral density during the first 8 weeks of the study. We conclude
      that preterm infants recently discharged from the hospital may benefit from
      higher calcium intake than is provided by either human milk or standard term
      formula.

PMID- 8355125
TI  - Measurement of true absorption, endogenous fecal excretion, urinary excretion,
      and retention of calcium in term infants by using a dual-tracer, stable-isotope
      method.
AB  - A dual-tracer, stable-isotope method was used to measure the percentage of true
      calcium absorption (alpha), true calcium absorption rate (Va), endogenous fecal
      calcium excretion rate (Vf), urinary calcium excretion rate (Vu), and calcium
      retention rate (Vr). Twenty-seven infants with a mean gestation of 30.6 +/- 1.7
      weeks and a mean birth weight of 1.4 +/- 0.21 kg were studied at 2 or 3 weeks of
      age, or both, during feedings of human milk (HM), fortified human milk (HMF), and
      commercially available formula (20 or 24 calories per ounce) for premature
      infants (EPF-20/780 and EPF-24/940) (part 1 of our study). Of 13 additional
      infants with a mean (+/- SD) birth weight of 1.26 +/- 0.25 kg and gestation of
      29.6 +/- 2.5 weeks, 11 completed a crossover-design study at 2 and 3 weeks of
      age, receiving two identical formulas containing calcium, 940 mg/L, and
      phosphorus, 470 mg/L (EPF-24/940 formula) or calcium 1340 mg/L, and phosphorus,
      680 mg/L (EPF-24/1340 formula) (part 2 of our study). The alpha value was higher
      in infants receiving HM (76.4 +/- 15.1%) or HMF (68.0 +/- 7.8%) than in those
      receiving EPF-20/750 formula (54.1% +/- 5.6%) or in previously reported infants
      fed standard formula (47.1% +/- 11.5%); those given EPF-24/940 formula had
      intermediate values (63.9% +/- 13.9%, part 1; 56.1% +/- 16.5%, part 2). No
      significant differences existed among groups for either Vu or Vf per kilogram. In
      the crossover study (part 2), no significant differences were seen between
      formulas for alpha and for Va, Vf, or Vr per kilogram. However, Vu per kilogram
      was significantly decreased in infants receiving the higher mineral formula (EPF
      24/940: 3.6 +/- 2.3; EPF-24/1340: 2.9 +/- 2.3 mg/kg per day; p = < 0.005). With
      all feedings, alpha, Vu per kilogram, and Vf per kilogram were not related to
      gestational age, age at study, calcium intake, or each other. However, Vf per
      kilogram was inversely related to birth weight. Thus, alpha, Vu, and Vf appear to
      be independent and may be differentially affected by factors altering calcium
      dynamics. We conclude that increasing formula mineral content does not ensure
      increased retention; careful monitoring of individual infants remains indicated.

PMID- 8355126
TI  - Measurement of nutrient intake by deuterium dilution in premature infants.
AB  - To assess whether a simple nonrestrictive method of determining nutrient intake
      could be applied to premature infants, we compared actual measured formula intake
      during a 7-day period with intake calculated from deuterium dilution in 13
      hospitalized, growing, premature newborn infants. An oral dose of deuterium oxide
      (D2O) was administered, and urine samples were analyzed by deuterium nuclear
      magnetic resonance spectrometry for D2O concentration. Using an exponential
      model, we calculated formula intake from the decline in D2O concentration during
      the 7-day study period. Intake as assessed by the deuterium model correlated well
      with actual intake (r = 0.93; p < 0.001). However, because the deuterium dilution
      model measures both dietary and nondietary water intake (metabolic and cutaneous
      water influx), deuterium dilution-derived intake exceeded actual intake by 25 +/-
      18 ml/kg per day (16% +/- 11%). When corrections were applied to account for
      nondietary water intake, deuterium dilution-derived nutrient intake (160 +/- 30
      ml/kg per day) closely approximated actual intake (155 +/- 17 ml/kg per day). If
      corrections are made for nondietary water intake, the deuterium dilution method
      may be a useful nonrestrictive method of measuring nutrient intake in a variety
      of neonatal populations.

PMID- 8355127
TI  - Subcutaneous fat necrosis in a neonate, in association with aberrant plasma lipid
      and lipoprotein values.
AB  - A newborn infant with subcutaneous fat necrosis after perinatal hypoxia was found
      to have several abnormalities of plasma lipids. Further studies are needed to
      determine whether such abnormalities contribute to the pathophysiology of the
      skin lesions.

PMID- 8355128
TI  - Lymphocyte subpopulations in healthy newborn infants: comparison of cord blood
      values with values five days after birth.
AB  - Significant differences (p < 0.0001) were demonstrated in lymphocyte
      subpopulations both in cord blood and in venous blood samples obtained at day 5
      from the same healthy infants. Numbers of T lymphocytes increased, especially
      CD4+/CD45RA+ cells, whereas numbers of B lymphocytes and natural killer cells
      decreased without changes in CD8+ and other cytotoxic cells.

PMID- 8355129
TI  - Rapid cocaine screening of urine in a newborn nursery.
AB  - A rapid cocaine screening test, the Abuscreen OnTrak assay, was compared with the
      EMIT (enzyme-multiplied immunoassay technique) screening test to determine
      relative accuracy in 450 newborn infants sequentially tested for urinary cocaine
      during a 6-week period at a large urban hospital. The Abuscreen Ontrak screen had
      a sensitivity of 96% and a specificity of 100%.

PMID- 8355130
TI  - Clement Andrew Smith.

PMID- 8355131
TI  - Identifying febrile infants at risk for a serious bacterial infection.

PMID- 8355132
TI  - Beclomethasone for treating premature infants with bronchopulmonary dysplasia.

PMID- 8355133
TI  - Nebulized salbutamol versus racemic epinephrine in the treatment of infants with
      bronchiolitis.

PMID- 8355134
TI  - Blood lactate concentrations and neonatal sepsis.

PMID- 8355135
TI  - Group B streptococcus serotype V.

PMID- 8355136
TI  - Treatment of congenital alveolar proteinosis.

PMID- 8355137
TI  - Hypercalcemic phase of Williams syndrome.

PMID- 8355139
TI  - Does childhood personality predict longevity?
AB  - Key models relating personality and health predict that personality in childhood
      is indicative of later health and longevity. Longevity predictions are tested
      using data derived from the 7-decade longitudinal study initiated by L. M. Terman
      1921 (L. M. Terman & M. H. Oden, 1947). Variables representing major dimensions
      of personality are used in statistical survival analyses of longevity in 1,178
      males and females. Conscientiousness in childhood was clearly related to survival
      in middle to old age. This finding (a) establishes that childhood personality is
      related to survival decades into the future, (b) confirms the validity of the
      conscientiousness dimension in conceptualizing personality, and (c) points to
      likely and unlikely pathways linking personality to health. Contrary to
      expectation, cheerfulness (optimism and sense of humor) was inversely related to
      longevity, suggesting a possible need for reconceptualization of its health
      relevance.

PMID- 8355138
TI  - Effects of motivationally significant stimuli on the regulation of dominant
      responses.
AB  - In 4 experiments, Ss responded as quickly as possible to indicate whether
      character strings consisted of letters or numbers. Following a warning stimulus
      that was or was not designed to trigger a motivational-emotional response in
      particular subgroups (viz., those with high anxiety, discrepant self-concepts,
      and eating disorders), strings were presented in a central (dominant) location on
      75% of the trials or in 1 of 4 peripheral (nondominant) locations. Consistent
      with hypotheses, response times to peripherally located strings were
      significantly slower following motivationally significant than following neutral
      warning stimuli. Contrary to hypotheses, such stimuli did not facilitate
      responding to centrally located strings. It is proposed that motivationally
      significant stimuli engender a temporary reduction in control processing that
      hinders regulation of dominant responses.

PMID- 8355140
TI  - Self-esteem and counterfactual thinking.
AB  - Two studies examined the relation between self-esteem and counterfactual thinking
      (consideration of "might-have-been" alternatives to reality). Ss imagined
      themselves in scenarios with another actor that resulted in either success or
      failure. Ss then "undid" the outcome by altering events that preceded the
      outcome. Following success, high self-esteem (HSE) Ss were more likely than low
      self-esteem (LSE) Ss to mutate their own actions. Following failure, LSE Ss were
      more likely than HSE Ss to mutate their own actions. Also, the structure of
      counterfactuals was influenced by outcome valence but not by self-esteem:
      Subtractive structures (in which antecedents are removed) were elicited by
      success, whereas additive structures (in which antecedents are added) were
      elicited by failure. The importance of the self and individual differences in
      self-esteem to counterfactual thinking is discussed.

PMID- 8355141
TI  - Duration neglect in retrospective evaluations of affective episodes.
AB  - Two experiments documented a phenomenon of duration neglect in people's global
      evaluations of past affective experiences. In Study 1, 32 Ss viewed aversive film
      clips and pleasant film clips that varied in duration and intensity. Ss provided
      real-time ratings of affect during each clip and global evaluations of each clip
      when it was over. In Study 2, 96 Ss viewed these same clips and later ranked them
      by their contribution to an overall experience of pleasantness (or
      unpleasantness). Experimental Ss ranked the films from memory; control Ss were
      informed of the ranking task in advance and encouraged to make evaluations on
      line. Effects of film duration on retrospective evaluations were small, entirely
      explained by changes in real-time affect and further reduced when made from
      memory. Retrospective evaluations appear to be determined by a weighted average
      of "snapshots" of the actual affective experience, as if duration did not matter.

PMID- 8355142
TI  - Rudimentary determinants of attitudes. II: Arm flexion and extension have
      differential effects on attitudes.
AB  - In the pain-flexor reflex, arm extension is temporally coupled with the onset of
      the unconditioned aversive stimulus, whereas flexion is associated with its
      offset; when retrieving desirable stimuli, arm flexion is more closely coupled
      temporally to the acquisition or consumption of the desired stimuli than arm
      extension. It was posited that these contingencies foster an association between
      arm flexion, in contrast to extension, and approach motivational orientations.
      Six experiments were conducted to examine this hypothesis. Ideographs presented
      during arm flexion were subsequently ranked more positively than ideographs
      presented during arm extension, but only when the Ss' task was to evaluate the
      ideographs when they were presented initially. Arm flexion and extension were
      also each found to have discernible attitudinal effects. These results suggest a
      possible role for nondeclarative memory in attitude formation.

PMID- 8355143
TI  - Is human mating adventitious or the result of lawful choice? A twin study of mate
      selection.
AB  - Pairs of middle-aged twins and their spouses provided data on 74 mainly
      psychological variables. Neither spousal similarity nor idiosyncratic criteria
      could account for specific mate selection in these 738 couples. Of the twins (and
      their spouses), 547 independently rated their initial attraction to their twin's
      mate (or to their spouse's twin): Findings suggest that characteristics both of
      the chooser and the chosen constrain mate selection only weakly. This article
      proposes that it is romantic infatuation that commonly determines the final
      choice from a broad field of potential eligibles and that this phenomenon is
      inherently random, in the same sense as is imprinting in precocial birds.

PMID- 8355144
TI  - They don't all look alike: individuated impressions of other racial groups.
AB  - Reliability, content, and homogeneity of own- and other-race impressions were
      assessed: U.S. White, U.S. Black, and Korean students rated faces of White,
      Black, or Korean men. High intraracial reliabilities revealed that people of 1
      race showed equally high agreement regarding the traits of own- and other-race
      faces. Racially universal appearance stereotypes--the attractiveness halo effect
      and the babyface overgeneralization effect--contributed substantially to
      interracial agreement, which was only marginally lower than intraracial
      agreement. Moreover, similar attention to variations in appearance yielded
      similar degrees of own- and other-race trait differentiation. When own- and other
      race differences in the differentiation of faces on babyfaceness were
      statistically controlled, differences in trait differentiation were eliminated.
      Despite the individuated impressions of other-race faces, certain racial
      stereotypes persisted.

PMID- 8355145
TI  - [Development and pharmaceutical evaluation of hydrophobic cyclodextrin
      derivatives as modified-release drug carriers].
AB  - Hydrophobic cyclodextrin (CyD) derivatives, such as 2,6-di-O-ethyl-beta-CyD (DE
      beta-CyD), 2,3,6-tri-O-ethyl-beta-CyD (TE-beta-CyD), carboxymethylethyl-beta-CyDs
      (CME-beta-CyDs) with different degrees of substitution, 2,3,6-tri-O-acyl-beta
      CyDs with different alkyl chains (C1-C12) were prepared and their chemical
      structures and physicochemical properties were elucidated. Furthermore, possible
      utilities of hydrophilic and hydrophobic CyD derivatives as modified-release drug
      carriers were evaluated on the basis of in vitro/in vivo correlations. The
      results obtained in this study are as follows: (1) Hydrophilic CyDs such as 2
      hydroxypropyl-beta-CyD are useful as immediate-release type carriers for poorly
      water-soluble drugs such as nifedipine. (2) Hydrophobic CyDs such as ethylated
      and acylated beta-CyDs can be used as prolonged-release type carriers for water
      soluble drugs such as diltiazem hydrochloride, buserelin acetate and molsidomine.
      (3) Enteric CME-beta-CyD derivatives are useful as delayed-release type carriers,
      and also as stabilizers for prostaglandin E and carmofur which are labile under
      alkaline conditions. (4) Various release rates can be obtained by combining
      hydrophilic and hydrophobic CyD derivatives in appropriate mixing ratios, e.g.,
      double-layer tablets consisting of beta-CyD complex and DE-beta-CyD/CME-beta-CyD
      complexes released drugs rapidly at an initial stage, followed by slow release.
      The combination of CyD derivatives and pharmaceutical additives was also useful
      to modify the release rate of various drug molecules.

PMID- 8355146
TI  - [Synthesis of acyclic 1,3-polyols and its application to structural study of
      natural products].
AB  - A 1,3-polyhydroxylated chain is often found on the backbone of biologically
      important natural products. The acyclic nature and the regular array of many
      hydroxyl groups are main obstacles to structural and synthetic studies, and many
      efforts have been made to this end. We have developed a new general synthetic
      method of 1,3-polyols based on the coupling of a chiral dithiane, a four-carbon
      unit, and an epoxide, followed by 1,3-diastereoselective reduction. We applied
      the method to the synthesis of polymethoxy-1-alkenes isolated from blue-green
      algae to establish their absolute stereochemistry. Moreover, a general procedure
      for assigning the absolute stereochemistry of acyclic 1,3-polyols by the
      difference circular dichroism (CD) method have been established. Combination of
      the method and a reiterative degradation enables one to determine the absolute
      configuration of 1,3-polyols, even if the relative stereochemistry is unknown.

PMID- 8355147
TI  - [Quenching of ethidium-DNA fluorescence by novel acridines with antitumor
      activities. II. The structure-activity relationship in acridines with
      fluorescence quenching of ethidium-DNA].
AB  - In order to elucidate the structure-activity relationship between the antitumor
      activity and the molecular structure of novel DNA-intercalator acridine
      derivatives (1a-g and 2a-i in Chart 1), DNA-binding properties (intercalation) of
      these acridines were examined by quenching in the fluorescence of the ethidium
      DNA complex. The mechanism of quenching is caused by the displacement of DNA
      bound ethidium by a second DNA binding ligand, acridines. The concentration (C50
      value) of acridine necessary to reduce the initial fluorescence of DNA-bound
      ethidium by 50% showed a good correlation with their antitumor activities. The
      quenching of fluorescence for acridines was examined using amsacrine (AMSA) as a
      typical standard of the second DNA-bound ligand, and calf thymus DNA with an
      apparent site size of two base pair. Some of the acridine derivatives showed more
      potent quenching of fluorescence than amsacrine (AMSA).

PMID- 8355148
TI  - [Chemical fluctuation of the constituents during the drying of Ginseng radix and
      Ginseng radix Rubra. Crude drug processing by far-infrared treatment].
AB  - In order to evaluate the utility of far-infrared drying method for crude drugs,
      the efficiency in the drying process of Ginseng Radix and Ginseng Radix Rubra was
      examined. Furthermore, chemical fluctuation of the constituents of Ginseng Radix
      and Ginseng Radix Rubra, which may occur during their drying process, has been
      investigated by means of HPLC quantitative analysis for ginsenosides and malonyl
      ginsenosides, and TLC qualitative analysis for lipophylic constituents. It has
      been found that the far-infrared drying method (oven temperature 45 degrees C)
      dried Ginseng Radix faster without reducing both ginsenosides and malonyl
      ginsenosides in comparison with the conventional drying methods such as an air
      drying and a hot-air drying.

PMID- 8355149
TI  - Learning from the mistakes of the past.

PMID- 8355150
TI  - One year postoperative astigmatic comparison of sutured and unsutured 4.0 mm
      scleral pocket incisions.
AB  - The postoperative astigmatic course of unsutured and sutured 4.0 mm scleral
      pocket incisions was followed for one year in a small pilot study. Initially,
      with-the-rule changes were noted only in the sutured group; eventually both
      groups demonstrated a small against-the-rule change that did not differ
      clinically or statistically. At one year after surgery the group without suture
      closure developed a -0.45 diopter (D) shift while a -0.34 D change was noted in
      the group closed with the anchor suture method. The unsutured group of eyes
      demonstrated physical stability as did those eyes with suture closure; no cases
      developed wound leaks, hypotony, or filtration blebs. Mean intraocular pressure
      was statistically unchanged from preoperative levels at one day after surgery for
      both groups. No case demonstrated postoperative endophthalmitis. Properly
      performed no-stitch corneal valve incisions provide physical and astigmatic
      stability that is indistinguishable from sutured incisions.

PMID- 8355151
TI  - Relative strength of scleral tunnel incisions with internal corneal lips
      constructed in cadaver eyes.
AB  - We constructed scleral tunnel wounds with internal corneal lips and sutureless
      closures in ten cadaver eyes without previous intraocular surgery. Each wound
      differed in width, total incision length, and internal corneal lip size. At a low
      and high range of initial intraocular pressure (IOP, 10 to 15 mm Hg or 20 to 25
      mm Hg), we compared the wounds' resistance to leakage during application of
      external pressure. A square wound with a 4.0 mm width and 4.0 mm overall length,
      including a 1.5 mm corneal lip, had the optimum wound dimensions. These produced
      a stable incision that resisted leakage at external pressures up to 525 pounds
      per square inch equally well at both IOP ranges. Leakage occurred at lower
      external pressures for wounds with greater width, smaller corneal lips, or wound
      widths that were greater than wound lengths; such wounds were also more prone to
      leakage at the low IOP range. When constructed properly and adequately, the 4.0
      mm wide scleral tunnel incision with 1.5 mm internal corneal lip is a strong and
      safe wound for sutureless cataract surgery.

PMID- 8355152
TI  - Inhibition of posterior capsule opacification: the effect of colchicine in a
      sustained drug delivery system.
AB  - We investigated the effect of colchicine in a sustained drug delivery system on
      posterior capsule opacification (PCO) in rabbit eyes. A polymer matrix wafer,
      which diffused colchicine at a steady rate, was implanted in the capsular bag of
      34 eyes after the lens material was removed by endocapsular phacoemulsification.
      Three different drug concentrations were used in the rabbit eyes, which were
      compared with control eyes containing the polymer matrix wafer without
      colchicine. The mean PCO score was highest in the control group without
      colchicine and increased steadily over 12 weeks. The rate of PCO formation in all
      eyes treated with colchicine was significantly lower than in the control group.
      There was no statistically significant improvement in PCO inhibition with the
      higher colchicine dosages. Side effects included inflammatory anterior chamber
      reaction and corneal and retinal complications and were most notable with the
      highest drug concentration. Slow release of colchicine reduces PCO formation in
      the rabbit. The optimal biocompatible dosage must be carefully determined and
      warrants further investigation.

PMID- 8355153
TI  - Early central posterior capsular fibrosis in sulcus-fixated biconvex intraocular
      lenses.
AB  - A series of 228 eyes implanted with one-piece all poly(methyl methacrylate)
      (PMMA) biconvex posterior chamber intraocular lenses was examined for posterior
      capsule opacification. One hundred forty-one eyes (61.8%) had opacification at an
      average postoperative period of 19.7 months. Seventy eyes (30.7%) developed an
      unusual form of early central posterior capsular fibrosis (ECPCF), which was
      confined to the capsulorhexis opening, sparing the peripheral aspect of the
      anterior and posterior capsules. Risk factors for developing this form of
      opacification were close apposition of peripheral anterior and posterior capsules
      caused by placing a posteriorly vaulted biconvex optic anterior to a
      capsulorhexis opening smaller than the optic diameter. This opacification
      occurred most often in cases of haptic fixation in the ciliary sulcus. The
      cumulative capsulotomy rate in this series was 5.26% at three months, 9.1% at 12
      months, and 13.2% at 20 months. Of the ECPCF cases, 34.3% eventually required
      neodymium: YAG (Nd:YAG) laser capsulotomy; the capsulotomy rate for ECPCF was 4.8
      times higher than that for Elschnig pearls. Early onset of ECPCF (average onset =
      19.4 weeks) resulted in early Nd:YAG capsulotomy (average = 8.0 months after
      surgery). One-piece all-PMMA biconvex intraocular lenses may promote early
      central fibrosis of the posterior capsule if the lens optic is anterior to a
      capsulorhexis opening smaller than the optic diameter. The early onset of this
      form of opacification predisposes to earlier Nd:YAG capsulotomy with a higher
      risk of complications.

PMID- 8355154
TI  - Flurbiprofen 0.03% for the control of inflammation following cataract extraction
      by phacoemulsification.
AB  - We conducted a double-masked, vehicle-controlled study to evaluate the anti
      inflammatory effect of topical flurbiprofen in cataract surgery by
      phacoemulsification and implantation of a posterior chamber intraocular lens. The
      233 patients were randomized to receive either flurbiprofen or vehicle
      immediately prior to and for two weeks following surgery. No concomitant
      corticosteroid use was allowed. The flurbiprofen group had significantly less
      anterior chamber cells and flare at day 7 and significantly less conjunctival
      erythema, corneal edema, and lid edema at day 14. The investigator's global
      effectiveness rating was higher in the flurbiprofen group at day 14. Blood
      aqueous barrier disruption, as measured by aqueous fluorophotometry, was
      statistically significantly diminished in the flurbiprofen group. Burning and
      stinging were rated significantly greater in the flurbiprofen group than in the
      vehicle group. Foreign-body sensation and photophobia were significantly more
      severe in the vehicle group than in the flurbiprofen group. Flurbiprofen provided
      postsurgical anti-inflammatory efficacy in clinical signs of inflammation and in
      blood-aqueous barrier disruption, and also showed improved subjective signs.

PMID- 8355155
TI  - Incidence and management of complications of transsclerally sutured posterior
      chamber lenses.
AB  - Thirty eyes with an average follow-up of 23 months following transscleral
      fixation of a posterior chamber intraocular lens (IOL) were retrospectively
      reviewed for complications. The most common complication was erosion of the
      polypropylene suture knots through half thickness scleral flaps (22 eyes, 73%).
      The average time for suture erosion through the sclera was 9.4 months (range one
      to 12). The polypropylene suture knots eroded through the conjunctiva in five
      eyes (17% incidence) at an average of 12 months postoperatively (range six to 18
      months). All conjunctival erosions were surgically repaired. Other complications
      included clinically significant lens tilt/decentration (3/30, 10%), open angle
      glaucoma (5/30, 17%), and suprachoroidal hemorrhage (1/30, 3%). The complications
      associated with transscleral fixation of posterior chamber IOLs are distinctly
      different from those associated with anterior chamber IOLs. Prospective clinical
      trials may provide further information about pseudophakic rehabilitation in the
      absence of capsular support.

PMID- 8355156
TI  - Effect of incision size on early postoperative visual rehabilitation after
      cataract surgery and intraocular lens implantation.
AB  - One hundred fifty-one unilateral cataract patients were randomly assigned to
      receive either a one-piece Staar AA-4203 silicone intraocular lens inserted
      through a 3.5 mm incision, an loptex 5 mm x 6 mm oval optic lens inserted through
      a 5.5 mm incision, or an AMO three-piece modified C-loop 6.0 round optic
      poly(methyl methacrylate) lens inserted through a 6.5 mm incision. Follow-up was
      97% at two days postoperatively and 84% at one week and two months
      postoperatively. At one week postoperatively, 62% of 3.5 mm incision cases had
      uncorrected visual acuity of 20/40 or better compared with 33% of 5.5 mm (P <
      .01) and 43% of 6.5 mm incision cases. At two months postoperatively, 85% of 3.5
      mm incision cases had uncorrected visual acuity of 20/40 or better compared with
      64% of 6.5 mm (P < .05) and 71% of 5.5 mm incision cases. The 3.5 mm incision
      cases had significantly less total keratometric cylinder than other cases at all
      postoperative examinations (P < or = .001) and less surgically induced cylinder
      at two days and one week post-operatively (P < or = .02). The 5.5 mm and 6.5 mm
      incision cases did not differ significantly in visual acuity or astigmatism at
      any examination.

PMID- 8355157
TI  - Intraocular lens performance in air, in water, and in situ: a computer study.
AB  - Computer analysis is used to predict performance of four intraocular lenses with
      assigned values of aberration. Cylinder error and asphericity error are used as
      examples of possible manufacturing errors. Three measures of performance are
      calculated: maximum optical path difference, root mean square optical path
      difference, and modulation transfer function. For evaluation in air these
      standard test conditions are assumed: collimated green light incident on the
      convex surface of a plano-convex lens, with a 3 mm aperture. All four lenses show
      substantially improved performance in water compared to air, and a further
      improvement in the simulated eye (i.e., in situ). However, an aberrated 30
      diopter (D) lens with performance in air comparable to an aberrated 20 D lens,
      performs worse in situ than does the 20 D lens. This suggests that a performance
      test in air that is suitable for a 20 D lens (e.g., 100 line pairs per millimeter
      resolution) may not be adequate for a 30 D lens. A test in air at 30% resolution
      efficiency may be more suitable.

PMID- 8355158
TI  - Interpreting multifocal intraocular lens modulation transfer functions.
AB  - The optical performance of new multifocal intraocular lens designs is frequently
      assessed using the modulation transfer function (MTF). We discuss the
      relationship between the MTF and clinical measures of human visual function, such
      as threshold visual acuity and contrast sensitivity. Using in vitro MTF
      measurements of a human eye model containing a multifocal or monofocal
      intraocular lens, we predict relative changes in acuity and contrast sensitivity
      and outline the techniques using a simple model of human retinal threshold
      detection. Specific concepts introduced include the visual acuity graph,
      predicted visual acuity graph, and predicted contrast sensitivity function.

PMID- 8355159
TI  - Evaluation of contrast acuity and defocus curve in bifocal and monofocal
      intraocular lenses.
AB  - We compared visual quality of the following intraocular lenses in a prospective
      study: monofocal, True Vista bifocal, 3M diffractive bifocal, and Nordan aspheric
      VariFocal silicone. Four to six months postoperatively we measured distance
      acuity, Snellen near acuity (Lighthouse chart), reading acuity (Nieden chart),
      and contrast acuity at far and near focus (Regan charts: 96%, 50%, 25%, 11%
      contrast) with different pupil sizes. A defocus curve was obtained by spectacle
      defocus (+1 diopter [D] to -5 D). Eleven patients had True Vista in one eye and
      monofocal in the fellow. Contrast acuity at far focus decreased with decreasing
      contrast and increasing pupil size. This decrease was more pronounced with the
      True Vista than with the monofocal lenses. These differences were significant,
      with a 4.5 mm pupil at lower contrast (25%, P = .02; 11%, P = .01). Depth of
      focus was 4.5 D (+1.0 D to -2.0 D) with True Vista lenses and 2.5 D (+1.0 D to 
      1.5 D) with monofocal lenses. Corrected distance acuity was 20/22 with True
      Vista, 20/25 with 3M, and 20/20 with VariFocal. Distance corrected Snellen near
      acuity was 20/39 with True Vista, 20/34 with 3M, and 20/57 with VariFocal.
      Distance corrected reading acuity was 20/29 with True Vista, 20/23 with 3M, and
      20/44 with VariFocal (P = .005). Contrast acuity at far focus was best with the
      VariFocal IOL, followed by True Vista and 3M. At near focus it was best with 3M,
      followed by True Vista and VariFocal. Contrast acuity at near focus was lower
      than at far focus. Average acuity differences were as follows: VariFocal 0.43, P
      = .01; True Vista 0.19, P = .05; 3M 0.04, P = .3. Depth of focus was 4.5 D (+1.0
      D to -3.5 D) with True Vista and 3M and was 3 D (+1.0 D to -2.0 D) with
      VariFocal. Each design offers unique features. VariFocal is best at distance, but
      near vision is not sufficient. The 3M lens is best at near vision but distance
      contrast acuity is somewhat reduced. The True Vista lens provides a good
      compromise as distance contrast acuity is good and near vision is sufficient.

PMID- 8355160
TI  - A new method of analyzing vectors for changes in astigmatism.
AB  - This method of astigmatism analysis recognizes the need to define an astigmatism
      goal, thus allowing the surgeon to obtain precise, separate measures of the
      magnitude and the angle of surgical error. From this, the surgeon can evaluate
      what surgery may be required to achieve the initial preoperative goal. An index
      that measures surgical success is adjusted for the level of preoperative
      astigmatism. The resulting data allow statistical comparison of multiple
      surgeries and techniques. This method also assists in resolving the case when
      spectacle and corneal astigmatism do not coincide.

PMID- 8355161
TI  - Acute intraoperative suprachoroidal hemorrhage in capsular bag
      phacoemulsification.
AB  - Two cases of limited (nonexpulsive) acute intraoperative suprachoroidal
      hemorrhage (AISH) were identified in a consecutive series of 3,096 cataract
      surgeries accomplished by capsular bag phacoemulsification--an incidence of
      0.06%. This is lower than that reported by me in 1986 when I was using iris plane
      phacoemulsification (0.81%). I believe the reduction is the result of decreased
      anatomical distortion from reducing the number and amplitude of intraocular
      pressure swings experienced by the globe during surgery. The pressure swings
      result from technique-mandated oscillations in infusion and aspiration dynamics,
      which are greater in number and amplitude in the iris plane technique.

PMID- 8355162
TI  - Cataract and intraocular lens implantation after remote trabeculectomy for Sturge
      Weber syndrome.
AB  - A 6-year-old patient with Sturge-Weber syndrome and secondary glaucoma had
      trabeculectomy and subsequent reconstruction of a shallow anterior chamber. Six
      months later, a dense fibrin clot and anterior capsule cataract developed,
      requiring surgery. Using the anterior chamber maintainer technique, extracapsular
      cataract extraction with posterior chamber intraocular lens implantation was
      performed. Twelve months later visual acuity was 20/30, intraocular pressure was
      14 mg Hg, and the anterior chamber was deep and quiet.

PMID- 8355163
TI  - Corneal incision dehiscence during penetrating keratoplasty nine years after
      radial keratotomy.
AB  - As the use of radial keratotomy (RK) to correct myopia increases, more patients
      are having penetrating keratoplasty (PK). Radial keratotomy incisions are known
      to show incomplete wound healing. When the radial corneal RK incisions are cut by
      the corneal trephine, the peripheral part of each incision may open, even years
      after surgery. In this case, a 56-year-old man had visual distortion and diplopia
      in one eye nine years after RK. Contact lenses did not correct the problem, and
      the patient could not tolerate the contact lenses. Penetrating keratoplasty was
      performed. During surgery about one-third of the peripheral RK incisions
      spontaneously opened, making suturing difficult. Although the final visual result
      was 20/20 corrected acuity, this case shows that RK incisions may remain
      incompletely healed and easily open during PK surgery as long as nine years after
      the RK surgery.

PMID- 8355165
TI  - Intraocular lens dislocation in the bag.
AB  - We report a case in which an intraocular lens dislocated entirely within the
      capsular bag. The patient was myopic with a large anterior segment. A standard 5
      mm x 6 mm phaco profile intraocular lens was found to be completely dislocated on
      the fifth postoperative day. The dislocated lens was replaced with another
      posterior chamber intraocular lens sutured at the ciliary sulcus.

PMID- 8355164
TI  - Intraocular lens encapsulation by shrinkage of the capsulorhexis opening.
AB  - A 57-year-old man with retinitis pigmentosa and subcapsular cataract had
      phacoemulsification with a continuous curvilinear capsulorhexis and implantation
      of a poly(methyl methacrylate) intraocular lens. Six months later, the patient
      presented with blurred vision and severe anterior capsule fibrosis which led to
      complete posterior chamber lens encapsulation.

PMID- 8355166
TI  - V-style phacoemulsification.
AB  - A technique designed to reduce zonular stress and ensure safe intercapsular
      phacoemulsification is described. This one-handed method is especially effective
      in eyes with strong adhesions between nucleus and cortical layers where
      hydrodissection is not possible. Early experiences in 150 eyes yielded a
      reduction in emulsification time and such intraoperative complications as
      posterior capsule rupture and zonulysis.

PMID- 8355167
TI  - Phacoemulsification with poorly dilated pupils.
AB  - Tilting the viewing angle of the operating microscope during phacoemulsification
      provides the surgeon a better view of the cataractous lens. This technique,
      combined with continuous curvilinear capsulorhexis, divide and conquer
      nucleofractis, and lens rotation in the capsular bag, allows the surgeon to
      perform most of the phacoemulsification procedure near a well-visualized 6
      o'clock meridian. This procedure can eliminate the need for iris surgery in cases
      with small pupils. Also discussed is the removal of the upper half of the
      cortical substance in patients with small pupils.

PMID- 8355168
TI  - Knife for performing the initial groove for sutureless cataract surgery.

PMID- 8355169
TI  - Keratome for sutureless cataract surgery.

PMID- 8355170
TI  - Consultation section. Request for vision improvement six years after bilateral
      radial keratometry.

PMID- 8355171
TI  - Peribulbar block injection volume.

PMID- 8355172
TI  - Potential difference in astigmatism obtained by manual and automated
      keratometers.

PMID- 8355173
TI  - Night glare and excimer laser ablation diameter.

PMID- 8355174
TI  - Transscleral suturing of posterior chamber lenses.

PMID- 8355175
TI  - Caines produce pain.

PMID- 8355176
TI  - Blood in the capsular bag--endocapsular hematoma not a hyphema.

PMID- 8355177
TI  - Phaco interruptus.

PMID- 8355178
TI  - Myocardial uptake and pharmacodynamics of procainamide in patients with coronary
      heart disease and sustained ventricular tachyarrhythmias.
AB  - Little information is available currently regarding the time course of myocardial
      accumulation and the onset of the electrophysiologic effects of antiarrhythmic
      drugs in humans. The myocardial uptake and pharmacodynamics of the antiarrhythmic
      drug, procainamide, were studied during i.v. infusion in nine patients with
      ventricular tachycardia undergoing electrophysiologic study. Myocardial
      procainamide uptake was determined by serial measurements of arterial-coronary
      sinus drug concentration differences and measurement of coronary sinus blood flow
      during a 50-min procainamide infusion. The myocardial uptake of procainamide was
      10 +/- 4% (mean +/- S.D.) of the total dose at 50 min. Coronary sinus
      procainamide concentrations equilibrated with arterial concentrations within 30
      min of the start of the infusion. However, peripheral venous procainamide
      concentrations did not reach equilibrium with the arterial compartment during the
      50-min drug infusion. Changes in the QRS duration, ventricular conduction time,
      QTc and ventricular refractory periods correlated in a linear fashion with
      changes in the plasma procainamide concentrations. The slopes of the arterial and
      coronary sinus concentration-effect relationships were similar and significantly
      greater than the slopes of the peripheral venous concentration-effect
      relationships (P < .05). Thus, procainamide equilibrates rapidly, but not
      instantaneously, in the myocardium. Short-term electrophysiologic effects
      correlate best with the arterial and coronary sinus drug concentrations. During
      this period, venous procainamide concentrations do not accurately reflect the
      myocardial concentration, effects or the eventual steady-state relationships.

PMID- 8355179
TI  - A decomposition product of a contaminant implicated in L-tryptophan eosinophilia
      myalgia syndrome affects spinal cord neuronal cell death and survival through
      stereospecific, maturation and partly interleukin-1-dependent mechanisms.
AB  - The L-tryptophan eosinophilia myalgia syndrome (L-TRP-EMS), an inflammatory
      syndrome characterized by eosinophilia, myalgias, perimyositis, fasciitis and
      neuropathies, occurred in epidemic proportions in the United States in the summer
      and fall of 1989. The neuropathic clinical features in L-TRP EMS are complex and
      mixed. In the present study, one of the impurities most highly associated with
      development of L-TRP EMS, 1,1'-ethylidenebis[L-tryptophan] (EBT), and two of its
      diastereoisomeric breakdown products, were compared for evidence of neurotoxicity
      in vitro. In 1-month-old spinal cord cultures derived from fetal mice, synthetic
      (-)-(1S,3S)-1-methyl-1,2,3,4-tetrahydro-beta-carboline-3-carboxylic acid (1S-beta
      C) produced a 30 to 35% loss in numbers of neurons. Toxicity was not apparent
      after treatment with the R-isomer of the same compound or with the parent
      compound, EBT. Cotreatment of cultures with 1S-beta-C and neutralizing antiserum
      to interleukin-1 alpha (IL-1 alpha), or with 1S-beta-C and neutralizing antiserum
      against the murine IL-1 receptor, prevented neuronal cell death associated with
      1S-beta-C. Recombinant IL-1 alpha also produced neuronal killing that was not
      additive to that observed with the 1S-beta-C treatment. In contrast, in immature
      spinal cord neuronal cultures, the 1S-beta-C, but not the 1R-beta-C or EBT,
      prevented the 30% cell death which normally occurs in these cultures. Neither
      neutralizing anti-IL-1 antibody, nor anti-IL-1 receptor antibody blocked the
      neuronal survival effect, suggesting that 1S-beta-C induces neuronal survival
      through a receptor-mediated mechanism independent of IL-1.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8355180
TI  - Elucidation of a specific binding site for angiotensin II(3-8), angiotensin IV,
      in mammalian heart membranes.
AB  - Data are presented describing a new angiotensin binding site in rabbit and guinea
      pig heart, distinct from AT1 and AT2, that demonstrates high specificity and
      affinity for the hexapeptide fragment angiotensin II(3-8), which will be referred
      to here as angiotensin IV (AIV). Equilibrium binding in rabbit heart membranes
      was achieved in 2 hr at 37 degrees C and produced a calculated kinetic KD of .174
      +/- .018 nM. Saturation equilibrium binding data for rabbit and guinea pig heart
      were best fit to a one-site model with Hill coefficients near unity. Guinea pig
      membranes exhibited a KD = 1.33 +/- .02 nM and a Bmax = 144 +/- 19 fmol/mg
      protein, and rabbit heart membranes had a KD = 1.70 +/- .50 nM and a Bmax = 731
      +/- 163 fmol/mg protein. The binding site showed a high specificity for AIV,
      although it exhibited low affinity for angiotensin II, angiotensin III, Sar1,Ile8
      angiotensin II, DuP 753, CGP42112A and PD123177. A large number of nonangiotensin
      related peptides were unable to compete effectively for 125I-AIV binding.
      Deletions made from the C-terminal end of AIV caused a decrease in affinity: AIV
      > AII(3-7) >> AII(3-6) >> AII(3-5). Extension of the C-terminal end of AIV
      corresponding to the amino acids of human angiotensinogen caused little change in
      affinity. GTP gamma S had no effect on binding, suggesting non-G protein linkage.
      Binding was widely distributed throughout the heart; it was observed on
      cardiocytes and blood vessels as well as in the epicardium and the endocardium.

PMID- 8355181
TI  - Fluoro-gold and pentamidine inhibit the in vitro and in vivo release of dopamine
      in the striatum of rat.
AB  - Fluoro-Gold (FG), first developed as an antifungal/antiparasitic agent, is now
      also used extensively as a retrograde tracer in histological studies of nervous
      tissue. The fact that FG is taken up by dopamine (DA) terminals before its
      retrograde transport to DA cell bodies implies a presynaptic interaction, though
      the biochemical target(s) and mechanism(s) are unknown. To further elucidate, FG
      and another aromatic diamidine, pentamidine, were tested on [3H]DA release and
      uptake in vitro from striatal slices and synaptosomes. Neither compound affected
      [3H]DA uptake in synaptosomes and slices, and neither inhibited DA efflux
      mediated through reversal of DA uptake mechanisms. NMDA-mediated glutamate-evoked
      DA release was completely inhibited by either FG (IC50 approximately 3 microM) or
      pentamidine (IC50 approximately 1 microM), and 20 mM K(+)-evoked DA release was
      inhibited by similar concentrations but only to 60% of control. Arginine (up to
      500 microM) and spermidine (200 microM) failed to reverse 33 microM FG inhibition
      of either the spontaneous or the glutamate-evoked DA release, indicating that FG
      inhibition of release was not necessarily via blockade of either nitric oxide
      generation or spermidine binding to NMDA receptors. Interestingly, FG (33 microM)
      and pentamidine (10 microM) inhibited 1 and 5 microM D-methamphetamine (METH)
      evoked [3H]DA release to approximately 50% of control, and in striatal
      synaptosomes, FG (33 microM) and pentamidine (10 microM) inhibited 5 microM METH-
      and 1.25 mM Ca(++)-evoked DA release. Additionally, in vivo brain microdialysis
      supported the in vitro results; 100 microM FG in the microdialysis buffer
      inhibited 70% of the increase in extracellular DA in the striatum produced by 2.5
      mg/kg METH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355182
TI  - Electrophysiological effects of cocaine in the rat nucleus accumbens:
      microiontophoretic studies.
AB  - The nucleus accumbens (NAc) is intricately involved in maintaining cocaine self
      administration. Cocaine inhibits the firing of most NAc cells due to its ability
      to prevent the reuptake of dopamine (DA) and 5-hydroxytryptamine (5-HT), both of
      which predominantly inhibit NAc cell discharge in vivo. The present studies
      investigated the roles of DA and 5-HT in the effects of iontophoretically applied
      cocaine. Most NAc cells exhibited negative/positive waveforms (Type I cells).
      These cells were significantly more sensitive to cocaine than Type II cells
      (positive/negative waveforms), apparently due to differences in the actions of 5
      HT. Whereas DA was equipotent at inhibiting Type I and Type II cells, 5-HT
      inhibited Type I cells but, primarily excited Type II cells. Thus the ability of
      cocaine to potentiate the effects of both DA and 5-HT resulted in a pronounced
      inhibition of Type I cells, whereas the 5-HT-mediated excitation of Type II cells
      appeared to reduce DA-mediated inhibition. Combined administration of selective
      DA (GBR 12909) and 5-HT (fluoxetine) uptake inhibitors was required to mimic the
      effects of cocaine on Type I and Type II NAc cells. Acute depletion of DA (86%)
      produced by alpha-methyl-p-tyrosine (AMPT) significantly reduced the inhibitory
      effects of cocaine on all NAc cells. Acute depletion of 5-HT (74%) produced by p
      chlorophenylalanine (PCPA) significantly reduced the inhibitory effect of cocaine
      on Type I cells, but it significantly enhanced the inhibition of Type II cells.
      Simultaneous reduction of DA and 5-HT levels produced a significantly greater
      reduction of cocaine-induced inhibition of Type I neurons than did AMPT or PCPA
      alone. These findings are discussed in relation to proposed roles of DA and 5-HT
      in cocaine self-administration.

PMID- 8355184
TI  - Rapamycin, a potential disease-modifying antiarthritic drug.
AB  - Rapamycin (RAPA), a potent immunosuppressive agent that prevents organ graft
      rejection in animal models of transplantation, possesses a mechanism of action
      different than that of cyclosporin A and FK-506. In this study, the
      pharmacological activity of RAPA in a variety of immune and inflammatory models
      was assessed in order to define better its potential utility as an antiarthritic
      agent. RAPA inhibited T cell-mediated inflammation in mouse methylated bovine
      serum albumin-induced delayed-type hypersensitivity (ED40 = 4.7 mg/kg p.o.) and
      produced oral ED50 of 2.0 mg/kg against developing adjuvant arthritis in rats (3
      day dosing schedule) and 9.5 mg/kg in established adjuvant arthritis in rats
      (daily dosing schedule). In both models of adjuvant arthritis, effects of RAPA
      were maintained even after cessation of drug dosing. In contrast, after
      discontinuation of cyclosporin A (5- and 10-mg/kg doses), disease activity
      returned. RAPA was also effective in another T cell-mediated model, experimental
      allergic encephalomyelitis (ED50 approximately 5 mg/kg p.o.). At higher doses,
      RAPA significantly inhibited carrageenan paw edema in rats, a model of acute
      inflammation (ED40, 56 mg/kg p.o.), without increasing serum corticosterone
      levels. In this model, doses approximately 10 to 20 times greater than active
      doses in T cell-mediated models were required. RAPA at 1 to 50 microM did not
      inhibit in vitro human synovial phospholipase A2 or 5-lipoxygenase and cyclo
      oxygenase activity in the human blood leukocyte assay. The total profile of RAPA
      suggests that it may be effective in the treatment of rheumatoid arthritis,
      multiple sclerosis and other autoimmune diseases.

PMID- 8355183
TI  - Atherosclerosis-related remodeling of aortic relaxation to purines in the
      Watanabe heritable hyperlipidemic rabbit.
AB  - The mechanism of the unimpaired relaxant effect of ATP in the Watanabe heritable
      hyperlipidemic rabbit aorta was investigated to elucidate the involvement of P2y
      purinoceptor at the endothelial level during atherosclerosis. Experiments were
      carried out on isolated thoracic aorta from such rabbits that were 12 months of
      age. The potent P2y purinoceptor agonist, 2-methylthio-ATP, did not induce any
      endothelium- or smooth muscle-dependent relaxation, thus excluding any
      involvement by the P2y purinoceptor. ADP, but not AMP, produced relaxation of the
      aorta by acting at both endothelial and smooth muscle levels. Adenosine relaxed
      the vessel by acting only in smooth muscle. The maintained endothelial relaxant
      effect of ATP and ADP is therefore not due to activation of P1 or P2y
      purinoceptors but may involve activation of a remodeled purinergic receptor site
      that emerges with the progression of atherosclerosis. This site is antagonized by
      methylene blue. The disorganization of the endothelial monolayer observed in the
      morphological analysis may be related to functional remodeling of the endothelial
      purinergic activity in atherosclerosis.

PMID- 8355185
TI  - Effects of the selective sigma receptor ligand, 6-[6-(4
      hydroxypiperidinyl)hexyloxy]-3-methylflavone (NPC 16377), on behavioral and toxic
      effects of cocaine.
AB  - Certain sigma receptor ligands have been shown to block locomotor stimulation
      produced by cocaine at doses that do not have significant behavioral activity
      when given alone. Using a potent and selective ligand of sigma binding sites, 6
      [6-(4-hydroxypiperidinyl)hexyloxy]-3-methylflavone (NPC 16377), we further
      investigated the influence of sigma ligands on additional behavioral and toxic
      effects of cocaine in mice. A behaviorally inactive dose of NPC 16377 shifted the
      dose-effect function for the locomotor stimulant effects of cocaine to the right
      by a factor of 2.5. A higher dose of NPC 16377 produced an insurmountable
      blockade of this stimulant effect of cocaine. Prior exposure to cocaine enhances
      the locomotor stimulant effects of cocaine (sensitization). NPC 16377 prevented
      the development of cocaine sensitization without producing behavioral effects of
      its own. However, NPC 16377 was unable to block the expression of sensitization
      in mice previously exposed to cocaine. NPC 16377 also did not consistently alter
      the discriminative stimulus effects of cocaine or methamphetamine in rats
      discriminating either 3 or 10 mg/kg of cocaine, or 1 mg/kg of methamphetamine
      from saline. The potential phencyclidine-like behavioral effects of NPC 16377
      were also evaluated. Unlike the NMDA channel ligand, dizocilpine, NPC 16377 did
      not increase responding under a fixed-interval schedule of food presentation in
      rats nor did it substitute for the discriminative stimulus effects of either 1.5
      mg/kg of phencyclidine or 0.2 mg/kg of dizocilpine in rats discriminating these
      drugs from saline. NPC 16377 displayed limited but significant anticonvulsant
      activity against diazepam-sensitive cocaine convulsions. The lethal effects of
      higher doses of cocaine were neither significantly blocked nor enhanced in rats
      or mice with NPC 16377. These findings extend earlier observations on the cocaine
      blocking effects of sigma ligands to a novel structure with exceptional
      selectivity for sigma sites. These data indicate that some sigma ligands may be
      capable of altering certain behavioral and toxic actions of cocaine without
      notable behavioral side effects as evidenced in preclinical tests. As such, these
      compounds may ultimately be useful in the treatment of cocaine abuse.

PMID- 8355186
TI  - Effect of protein binding on 4-methylumbelliferyl sulfate desulfation kinetics in
      perfused rat liver.
AB  - 4-Methylumbelliferyl sulfate (4MUS), a polar metabolite of 4-methylumbelliferone
      (4MU), is known to undergo desulfation and participate in futile cycling with
      4MU. Unusual parabolic or increasing profiles of the steady-state extraction
      ratio (Ess) of 4MUS with respect to concentration in rat livers perfused with a
      red cell (20%)-albumin (1%) medium have been reported (Ratna et al., 1993). In
      order to study this unusual phenomenon, we examined the desulfation of 4MUS in
      the single-pass rat liver in the absence of albumin. We further employed a
      tubular-flow model to describe the present observations and data previously
      obtained on 4MUS in order to predict the effects of protein binding and enzymatic
      constants for conjugation/deconjugation on the hepatic processing of 4MUS and its
      metabolites. The net hepatic extraction ratio from albumin-free perfusate
      decreased from 0.465 to 0.326 when the 4MUS input concentration was increased
      from 122 to 908 microM; moreover, the unusual profiles previously observed for
      ESS with increasing concentration in albumin-containing perfusate were not
      apparent. The hepatic clearances and desulfation rates of 4MUS were essentially
      identical to those observed in the presence of albumin, when the latter were
      expressed in terms of unbound concentrations (unbound input and logarithmic
      average unbound concentration of the input and output blood). Initial modeling
      indicated that first nonlinear protein binding (dissociation constant KD of 93
      microM) and then saturable desulfation (Km of 382 microM) were responsible for
      the unusual increasing and then decreasing trend of ESS with concentration in the
      presence of albumin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355187
TI  - The in vivo antiplatelet effects of thromboxane A2 synthase inhibitors are
      potentiated by simultaneous thromboxane A2/prostaglandin H2 receptor blockade.
AB  - The aim of the present study was twofold: 1) to assess whether inhibition of
      thromboxane A2 (TxA2) synthase exerts more potent antiplatelet effects when
      applied concomitantly with TxA2 and prostaglandin (PG)H2 receptor blockade and 2)
      whether these effects are mediated through redirection of PG endoperoxides toward
      the synthesis of antiplatelet PGs, such as PGI2 and PGE2. Thus, cyclic flow
      variations (CFVs), due to recurrent platelet aggregation, were initiated in the
      stenotic, endothelially injured carotid arteries of 39 rabbits. After 30 min of
      CFVs, the animals received: 1) SQ29548 (up to 0.6 mg/kg bolus + 0.2 mg kg-1 hr-1,
      n = 13), a TxA2/PGH2 receptor antagonist; 2) dazoxiben (up to 15 mg/kg bolus + 5
      mg kg-1 hr-1, n = 13), a TxA2 synthase inhibitor and 3) picotamide (up to 20
      mg/kg bolus + 20 mg kg-1 hr-1, n = 13), a drug with simultaneous TxA2 synthase
      and receptor blocking properties. CFVs were abolished in 6, 7, and 12 animals
      treated with SQ29548, dazoxiben, and picotamide, respectively (P < .01 for
      picotamide versus SQ29548 and dazoxiben). The animals in which CFVs were not
      abolished by SQ29548 or dazoxiben received the other drug at the same dose. CFVs
      were abolished by dazoxiben in five of seven rabbits that initially did not
      respond to SQ29548 and by SQ29548 in five of six animals that did not respond to
      dazoxiben. All animals that responded to the combination of SQ29548 and
      dazoxiben, as well as those that responded to picotamide, received increasing
      intravenous infusions of epinephrine to restore CFVs.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8355188
TI  - Apparent mediation of the stimulus properties of a low dose of quinpirole by
      dopaminergic autoreceptors.
AB  - This study examined the hypothesis that, if the stimulus properties of the D2
      agonist quinpirole (QUIN) were mediated by autoreceptors, then pharmacological
      treatments engendering a decline in dopamine (DA) release and consequent decrease
      in postsynaptic DA receptor stimulation should result in QUIN-appropriate
      responding; those that activate postsynaptic receptors should result in saline
      appropriate responding. In rats trained to discriminate 0.05 mg/kg of QUIN from
      saline using standard operant drug discrimination procedures, QUIN (up to the
      training dose), two other putative D2 autoreceptor agonists (low-dose apomorphine
      and N-propylnorapomorphine), the DA depeleter alpha-methyl-p-tyrosine (AMPT) and
      the D1 antagonist SCH 23390 all produced primarily QUIN-lever responding.
      Moreover, coadministration of alpha-methyl-p-tyrosine with QUIN potentiated QUIN
      stimulus properties. Higher doses of apomorphine, known to stimulate postsynaptic
      D1 and D2 receptors and pretreatment with the D2 antagonist haloperidol decreased
      QUIN-lever responding. Neither the D1 agonist SKF38393, the indirect D1/D2
      agonist d-amphetamine, the D2 antagonist haloperidol or coadministration of SCH
      23390 and d-amphetamine substituted for QUIN. Coadministration of either SKF
      38393 or d-amphetamine with QUIN decreased levels of QUIN responding. Taken
      together, the data are consistent with the contention that the stimulus
      properties of 0.05 mg/kg of QUIN are primarily mediated by D2-type presynaptic
      autoreceptors and that these stimulus properties involve a decline in DA release
      and consequent decreased postsynaptic stimulation.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8355189
TI  - RS 42358-197, a novel and potent 5-HT3 receptor antagonist, in vitro and in vivo.
AB  - The pharmacological activity of RS 42358-197, a novel 5-HT3 receptor antagonist
      has been evaluated in vitro and in vivo. In functional experiments in vitro, RS
      42358-197 behaved as a competitive antagonist against 5-HT-induced contractions
      in the guinea pig ileum (low-potency phase), yielding a pA2 estimate of 8.1. RS
      42358-197 was devoid of any agonistic or antagonistic activity at 5-HT1-like
      receptors (contraction of canine saphenous vein), 5-HT2 receptors (contraction of
      rabbit aorta) or 5-HT4 receptors (contraction of guinea pig ileum, high-potency
      phase). RS 42358-197 failed to affect the concentration-effect curve to substance
      P in guinea pig ileum. In anesthetized rats. RS 42358-197, administered by the
      intravenous, intraduodenal or transdermal route, dose-dependently inhibited the
      Bezold-Jarisch reflex induced by 2-methyl 5-HT (ID50:0.05 micrograms/kg; i.v.,
      5.7 micrograms/kg; i.d., and 11.6 micrograms/chamber, respectively). In this
      regard, when administered intraduodenally, RS 42358-197 was more potent and
      exhibited a longer duration of action than either ondansetron or granisetron. In
      dogs, RS 42358-197, administered either intravenously or orally, dose-dependently
      inhibited the emesis induced by cisplatin, actinomycin and cyclophosphamide, but
      not that induced by apomorphine. When tested at maximally effective doses against
      cisplatin-induced emesis in dogs, RS 42358-197 had a longer duration of
      antiemetic activity (> 6 h) than ondansetron (2 h). RS 42358-197, administered
      orally, also afforded protection against cisplatin-induced emesis in ferrets. At
      doses that showed marked anti-emetic activity in dogs (10-100 micrograms/kg; i.v.
      and 100-1000 micrograms/kg; i.d.), RS 42358-197 did not produce any hemodynamic
      changes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355190
TI  - Role of the hydrophobic face of amphipathic alpha-helical peptides in synthetic
      pulmonary surfactants.
AB  - The sequence requirements for the peptide component of a totally synthetic lung
      surfactant mixture were examined. A series of model amphipathic alpha-helical
      peptides (MAP) with six to 18 residues were synthesized by solid phase
      techniques, mixed with dipalmitoylphosphatidylcholine (DPPC) and tested for
      efficacy in an in vitro adult rat lung model. The most effective peptide in these
      mixtures contained 10 residues. Peptides containing eight and 14 residues were
      also highly active when mixed with DPPC in buffer, but a six-residue peptide was
      inactive. Longer peptides were active only when mixed with DPPC in
      trifluoroethanol before swelling in buffer; no other lipids were required to
      elicit high activity. Biologically effective peptides, when combined with DPPC,
      formed translucent mixtures that were significantly less turbid than ineffective
      mixtures, dramatically decreased the enthalpy of the main phase transition of
      DPPC and reduced the gamma min in the pulsating bubble surfactometer. Turbidity
      and minimal surface tensions were significantly correlated with activity in this
      series of peptides. These data show that effective synthetic lung surfactants may
      be prepared with mixtures of DPPC and idealized amphipathic alpha-helical
      peptides containing as few as eight to 10 residues. They lend further support to
      the hypothesis that amphipathic alpha-helical peptides with hydrophobic surface
      areas greater than approximately 6.5 nm2 in simple mixtures with DPPC are
      biologically active.

PMID- 8355191
TI  - Effects of the putative polyamine antagonists diethylenetriamine and 1,10
      diaminodecane on N-methyl-D-aspartic acid-stimulated [3H]norepinephrine release
      from rat hippocampal slices.
AB  - N-Methyl-D-aspartic acid (NMDA, 500 microM) stimulated the net release of
      [3H]norepinephrine from rat hippocampal slices. The putative polyamine inverse
      agonist 1,10-diaminodecane (DA10) dose-dependently inhibited NMDA-stimulated
      release with a calculated IC50 value of 33 microM. The putative polyamine
      competitive antagonist diethylenetriamine (DET) partially inhibited (maximum
      effect 40%) NMDA-stimulated release at 1 mM which was the highest concentration
      tested. DET (1 mM) but not DA10 also partially inhibited potassium-stimulated
      release of norepinephrine from hippocampal slices. Neither DET or DA10
      significantly altered the nonstimulated basal efflux of neurotransmitter. The
      inhibition of NMDA-stimulated release produced by 100 microM DA10 or 1 mM DET was
      not attenuated by addition of the polyamines spermine or spermidine up to 1 mM.
      In addition, the IC50 value for DA10-induced inhibition of NMDA-stimulated
      neurotransmitter release was not altered by the addition of DET (100-1000
      microM). The combination of the glycine antagonist 7-chlorokynurenic acid (3
      microM) and DA10 (100 microM) inhibited NMDA-stimulated release by approximately
      70%. The addition of the glycine agonist D-serine (3-100 microM) partially
      attenuated the inhibition produced by these two compounds. No further enhancement
      was observed when D-serine was added in the presence of spermine or spermidine.
      Finally, the NMDA open channel blocker (+)-5-methyl-10,11- dihydro-5H
      dibenzo[1,d]cyclo-hepten-5,10-imine maleate dose-dependently inhibited NMDA
      stimulated release with an IC50 value of 25 nM. The inhibitory potency of (+)-5
      methyl-10,11- dihydro-5H-dibenzo[1,d]cyclo-hepten-5,10-imine maleate was not
      significantly altered by the presence of either DET (100 microM) or DA10 (30 or
      100 microM).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355192
TI  - Discriminative stimulus properties of cocaine in relation to dopamine D2 receptor
      function in rats.
AB  - Previous studies indicate that the discriminative stimulus effects of cocaine are
      mediated predominantly by indirect activation of dopamine (DA) D2 postsynaptic
      receptors, although DA D1 receptors may also be involved. In the present study,
      full or partial D2 agonists and D2 antagonists were tested for their ability to
      substitute for, potentiate or antagonize the stimulus effects of cocaine in rats
      (n = 15) trained to discriminate cocaine (10 mg/kg) from saline in a two-lever,
      water-reinforced task. The full D2 agonists bromocriptine (1.25-20 mg/kg) and
      quinpirole (0.013-0.2 mg/kg) engendered substantial cocaine-lever responding (>
      80% drug-lever responding), whereas the partial D2 agonists preclamol (2.5-10
      mg/kg) and terguride (0.313-1.25 mg/kg) produced less than 50% cocaine-lever
      responding. Co-administration of a threshold dose of cocaine (1.25 mg/kg) with
      low doses of bromocriptine (1.25-5 mg/kg) or quinpirole (0.025-0.1 mg/kg) induced
      higher percentages of cocaine-lever responding as compared with occasions when
      these D2 agonists were given alone. However, co-administration of this dose of
      cocaine with preclamol (2.5-10 mg/kg) or terguride (0.313-1.25 mg/kg) did not
      alter the percentage of cocaine-lever responding observed when these partial D2
      agonists were administered alone. Pretreatment with the D2 antagonists bromuride
      (0.25-1 mg/kg) and haloperidol (0.125-0.5 mg/kg) significantly reduced the
      percentage of cocaine-lever responding. Preclamol (0.625-10 mg/kg) and terguride
      (0.019-5 mg/kg), but not bromocriptine (2.5-20 mg/kg) or quinpirole (0.01-0.08
      mg/kg), significantly reduced the percentage of cocaine-lever responding. These
      results suggest that full D2 agonists substitute completely for cocaine, whereas
      partial D2 agonists do not produce cocaine-like responding.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8355193
TI  - Further biological activities of the novel choline analogs selenonium choline and
      acetylselenonium choline.
AB  - The pharmacological actions of the novel choline analog, selenonium choline
      [(CH3)2Se+CH2CH2OH] and its acetyl ester acetylselenonium choline (ASeCh) were
      studied in vivo and in vitro. ASeCh produced a dose-related decrease in mean
      arterial pressure in the rat similar to acetylcholine (ACh) but was 1% to 2% as
      potent. ASeCh demonstrated agonist activity on the rat isolated ileum and was
      approximately 2% as active as ACh. Selenonium chlorine (SeCh) was taken up and
      acetylated in brain tissue slices in a time- and concentration-dependent manner.
      The use of KCl as a loading stimulus did not increase the uptake of SeCh but
      increased tissue levels of ASeCh 1.5-fold over the control concentrations. The
      uptake of SeCh was described by a single low-affinity uptake component (Km = 167
      microM) that was not blocked by hemicholinium-3. In contrast, hemicholinium
      significantly blocked the acetylation of SeCh. Compared with basal release,
      depolarization with KCl caused a significant release of ASeCh into the incubation
      medium. A neural specificity was suggested for the in vitro uptake of SeCh.
      Acetylation of SeCh in vivo in the rat after intraventricular administration was
      similar to the extent of acetylation of [2H4]-choline. ASeCh bound to both M1 and
      M2 cholinergic receptors with 2% to 3% of the affinity observed for ACh. These
      data suggest that SeCh may satisfy criteria for a false neurotransmitter
      precursor.

PMID- 8355194
TI  - Selective potentiation by an A1 adenosine receptor enhancer of the negative
      dromotropic action of adenosine in the guinea pig heart.
AB  - The drug (2-amino-4,5-dimethyl-3-thienyl)-[3(trifluoromethyl)-phenyl]methanone
      (PD 81,723) has been shown to enhance allosterically A1 adenosine receptor
      binding in brain membranes. The objective of this study was to determine the
      specificity and selectivity (A1 versus A2) of PD 81,723 as an enhancer of the
      negative dromotropic effect of exogenous adenosine in guinea pig isolated and in
      situ hearts. In isolated hearts, PD 81,723 alone produced only a small stimulus
      to His bundle (S-H) interval prolongation of 1.5 to 4 msec, which was completely
      reversed by the A1 adenosine receptor antagonist 8-cyclopentyltheophylline and
      adenosine deaminase. PD 81,723 (5 microM) significantly decreased the EC50 value
      of adenosine for prolongation of the S-H interval from 6.7 +/- 0.6 to 4.4 +/- 0.5
      microM. The potentiation of the negative dromotropic effect of adenosine by PD
      81,723 was dose dependent, i.e., 5 and 10 microM PD 81,723 enhanced the maximal S
      H interval prolongation caused by 3 microM adenosine by 207% and 609%,
      respectively. In contrast, the same concentration of PD 81,723 had no effect on
      either the S-H interval prolongation caused by carbachol or MgCl2 or the coronary
      vasodilatory effect of adenosine. In in situ hearts, PD (2 mumol/kg i.v.) alone
      caused only a small but not significant negative dromotropic effect, increasing
      the atrium to His interval from 58 +/- 2 to 61 +/- 1 msec. However, the same dose
      of PD 81,723 caused a significant leftward and upward shift of the adenosine dose
      response curve for inducing atrium to His bundle interval prolongation and
      increased the degree of atrioventricular block caused by adenosine.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8355195
TI  - Potency of 5-hydroxytryptamine1a agonists to inhibit adenylyl cyclase activity is
      a function of affinity for the "low-affinity" state of [3H]8-hydroxy-N,N
      dipropylaminotetralin ([3H]8-OH-DPAT) binding.
AB  - In this study, the radiolabeled 5-hydroxytryptamine1A agonist, [3H]8-hydroxy-N,N
      dipropylamino tetralin ([3H]8-OH-DPAT), was shown to have both a high (Kd, 0.7 +/
      0.2 nM) and a low (Kd, 17 +/- 4 nM) affinity binding component in rat
      hippocampal homogenate preparations in the absence of guanine nucleotides. The
      high-affinity binding component was markedly reduced by the elimination of Mg++
      from the incubation medium and the addition of both the nonhydrolyzable guanine
      nucleotide guanylylimidodiphosphate (Gpp(NH)p) (100 microM) and 1.0 mM EDTA to
      the incubation medium. Under these latter conditions, a single binding affinity
      component was observed with a Kd of 11 +/- 1 nM, a value in good agreement with
      the value for the low-affinity component measured in the absence of Gpp(NH)p.
      Further, the Bmax value for the single low-affinity binding component measured in
      the presence of Gpp(NH)p was essentially equivalent to the total of the two Bmax
      values found in the absence of Gpp(NH)p. A binding assay was developed using 15
      nM [3H]8-OH-DPAT to determine the affinities of serotonergic drugs for the low
      affinity component of [3H]8-OH-DPAT binding and these values were compared with
      their affinities for the high-affinity binding component as well as their
      potencies in a hippocampal adenylyl cyclase assay. For agonists, the Ki value for
      the high-affinity binding component was always less than the low-affinity Ki
      value, whereas the antagonist spiperone had similar values for both the high
      affinity and low-affinity binding components.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355196
TI  - Effect of some products of protein catabolism on the endothelium-dependent and 
      independent relaxation of rabbit thoracic aorta rings.
AB  - We have investigated the effect that some products of protein catabolism have on
      endothelium-dependent and -independent relaxation of rabbit aorta rings
      precontracted with phenylephrine (PE). All the products tested, i.e., creatinine
      (CRT), guanidinosuccinic acid (GSA), urea (UR), guanidine (GND) and
      methylguanidine (MG), are structurally related to L-arginine (L-ARG), the
      substrate for nitric oxide (NO) biosynthesis which accounts for the biological
      properties of endothelium-derived relaxing factor (EDRF). Endothelium-derived NO
      (EDNO) release was induced by agents acting via a receptor- [acetylcholine (ACh)]
      or a nonreceptor-mediated mechanism (calcium ionophore A23187), and the
      endothelial-independent relaxation was induced by the NO donor glyceryl
      trinitrate (GTN). CRT (0.1-10 mM) did not modify the endothelium-dependent
      relaxation caused by ACh or A23187 but produced a small increase in the response
      to the endothelium-independent vasorelaxant GTN. Concentrations of GSA up to 1 mM
      did not affect the relaxation of rabbit aortic rings induced by either ACh or
      A23187, but at 10 mM, GSA enhanced the relaxation produced by these agents. UR (1
      100 mM) inhibited, in a concentration-dependent manner, the relaxation induced by
      ACh, but not that caused by A23187 or GTN. By comparison, GND and MG (0.1-10 mM)
      produced a concentration-related inhibition of both ACh- and A23187-induced
      relaxation. The inhibition by these compounds was either completely or partially
      reversed by L-ARG. In contrast, the relaxation induced by GTN was inhibited only
      by higher concentrations (10 mM) of GND or MG. These results indicate that some
      products of protein catabolism can reduce EDNO formation in vitro.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8355197
TI  - Alterations in vascular structure and function after short-term losartan
      treatment in spontaneously hypertensive rats.
AB  - The current study was performed to investigate the effects of a 2-week treatment
      regimen with either hydralazine or the nonpeptide angiotensin II subtype 1
      receptor antagonist losartan (both at 10 mg/kg daily s.c. injection) on blood
      pressure and vascular smooth muscle function and structure in male spontaneously
      hypertensive rats with established hypertension (24 weeks of age; systolic blood
      pressure = 174 +/- 7 mm Hg). Systolic blood pressure and body weight were
      recorded before and once weekly after initiation of treatment. Mean arterial
      pressure, heart rate and heart weight were determined and experiments were
      conducted to assess changes in vascular reactivity and arterial medial thickness
      in ring segments of aorta and tail artery at the end of the treatment period.
      Systolic blood pressure, as well as mean arterial pressure, were significantly
      decreased to normotensive levels in hypertensive rats after 2 weeks of either
      hydralazine or losartan treatment. No effect on heart rate was observed in
      response to either antihypertensive agent. Body weight was not affected in either
      of the treatment groups, but a significant decrease in artery ring weight,
      arterial medial thickness and heart weight was seen only in losartan-treated
      rats. Whereas no changes in vascular reactivity were seen in hypertensive rats
      receiving hydralazine, norepinephrine- and serotonin-induced contractions were
      attenuated and acetylcholine-induced relaxations were enhanced in the losartan
      treated rats. These data demonstrate that, although short-term 2-week treatment
      with either hydralazine or losartan results in normalization of blood pressure,
      only losartan resulted in significant alterations in vascular function and
      structure in spontaneously hypertensive rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355198
TI  - Ontogenic differences in the inhibition of gastric acid secretion by epidermal
      growth factor.
AB  - Gastric secretions were studied in rats by pyloric ligation in vivo. The effects
      of epidermal growth factor (EGF) administered s.c. on gastric secretion were
      evaluated at different stages of development (8, 14, 20 and 30 postnatal days).
      The rates of fluid, protein and acid outputs were very low in developing rats but
      increased in maturing rats. The rate of acid output in 8- day-old rats (3.83 +/-
      1.16) was not different from that in 14-day-old rats (4.84 +/- 0.99), whereas the
      rate of acid output in 20-day-old rats was 11-fold greater than that in 14-day
      old rats, and it was 21-fold greater in 30-day-old rats. Subcutaneous
      administration of 30 micrograms/kg b.wt. of EGF significantly suppressed the
      gastric secretion of fluid, protein and acid in 20- and 30-day-old rats. In 30
      day-old rats, acid output was 85% lower at 1 hr after EGF administration and in
      20-day-old rats it was 85% lower at 2 hr and 50% lower at 3 hr. Interestingly,
      EGF had no effect on basal gastric secretions in 8- and 14-day-old rats; EGF also
      had no effect on the gastric acid output that was stimulated by pentagastrin
      administration in 14-day-old rats. In 20-day-old rats, inhibitory effects of EGF
      lasted for 3 hr before gastric secretions rebounded to normal levels, but
      inhibition lasted for only 1 hr in 30-day-old rats.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8355199
TI  - 4-morpholinecarboximidine-N-1-adamantyl-N'-cyclohexylhydrochloride (U-37883A):
      pharmacological characterization of a novel antagonist of vascular ATP-sensitive
      K+ channel openers.
AB  - This study describes the in vitro and in vivo characteristics of a guanidine 4
      morpholinecarboximidine-N-1-adamantyl-N'-cyclohexyl-hydroc hloride (U-37883A), as
      an antagonist of vascular ATP-sensitive K+ channels (KATP). In isolated rabbit
      mesenteric artery, the antagonistic effects of U-37883A (0.5-5 microM) were
      studied against vasorelaxation produced by cromakalim (0.5 microM), minoxidil
      sulfate (5 microM), pinacidil (1 microM) and RP-49356 (1 microM). The dose
      response curves for U-37883A against all four potassium channel openers were
      similar with U-37883A, IC50S ranging from 0.78 to 1.4 microM, suggesting that U
      37883A is producing inhibition by acting at a step that is common to all four
      potassium channel openers during their activation of the vascular KATP. In
      contrast, U-37883A at 10 microM did not inhibit relaxation dose-response curves
      by nitroglycerine, forskolin or D600. U-37883A (1 or 10 microM) effectively
      inhibited as well as reversed 42K efflux-stimulated by cromakalim (1 microM) or
      minoxidil sulfate (5 microM). Finally, U-37883A (3 mg/kg i.v.) was found to
      inhibit significantly as well as reverse hypotension produced by minoxidil (1
      mg/kg i.v. or 3 mg/kg p.o.), cromakalim (0.5 mg/kg p.o.) and pinacidil (0.3 mg/kg
      i.v.) in rats, cats and dogs. In contrast, the in vivo responses to
      phenylephrine, nitroglycerine, sodium nitroprusside or isoproterenol were not
      altered. U-37883A thus appears to be the first nonsulfonylurea shown to block
      consistently and selectively the in vitro as well as the in vivo pharmacological
      responses to various potassium channel openers. This structurally novel KATP
      antagonist therefore would be useful for further characterizing the mechanisms of
      pharmacological modulation of the KATP in a variety of cell systems.

PMID- 8355200
TI  - Vanilloid (capsaicin) receptor in the rat: positive cooperativity of
      resiniferatoxin binding and its modulation by reduction and oxidation.
AB  - Specific [3H]resiniferatoxin (RTX) binding is thought to represent the postulated
      vanilloid (capsaicin) receptor. In the present report, this binding has been
      reevaluated using a modified [3H] RTX binding assay in which the high nonspecific
      binding, which limited the previous characterization, was reduced by adding alpha
      1-acid glycoprotein, a plasma protein that binds RTX, to the usual binding assay
      after RTX binding by the vanilloid receptor had been terminated. Specific [3H]RTX
      binding by both dorsal root ganglion (DRG) and spinal cord membranes of the rat
      followed sigmoidal saturation kinetics indicating apparent positive
      cooperativity. The cooperativity index determined by fitting the data to the Hill
      equation was 1.7 in DRG and 1.9 in spinal cord. Apparent dissociation constants
      were estimated as 24 pM for DRG and 11 pM for spinal cord preparations. As
      predicted by the modified Hill equation, at low receptor occupancy nonradioactive
      agonists (RTX, tinyatoxin, capsaicin) produced biphasic competition curves. The
      initial (enhancement) phase of these curves correlated with the biological
      potency of the agonist. Dithiothreitol reduced both positive cooperativity and
      apparent binding affinity; the oxidizing agent 5,5'-dithiobis-(2-nitrobenzoic
      acid) reduced the cooperativity index without a major effect on binding affinity.
      These findings suggest that the vanilloid receptor is a receptor cluster in which
      the subunits cooperate; cooperation is, at least in part, subject to redox
      modulation.

PMID- 8355201
TI  - Purine nucleoside phosphorylase inhibitors: biochemical and pharmacological
      studies with 9-benzyl-9-deazaguanine and related compounds.
AB  - Certain derivatives of 9-deazaguanine that contain arylmethyl, heteroarylmethyl
      or cycloalkylmethyl groups at the 9-position are potent inhibitors of purine
      nucleoside phosphorylase (PNP, E.C. 2.4.2.1). To determine whether these agents
      can produce metabolically significant inhibition of PNP in cells and in animals,
      the authors performed pharmacological studies with a representative member of the
      series, 9-benzyl-9-deazaguanine (BzDAG). BzDAG was a potent inhibitor of PNP from
      calf spleen (Ki = 12 nM). It was also an effective inhibitor of PNP in cells and
      in animals as shown by the findings that it 1) inhibited the conversion of
      inosine to nucleotides in L1210 cells in culture at concentrations that had
      little effect on the utilization of hypoxanthine; 2) potentiated the toxicity of
      deoxyguanosine to CCRF-CEM cells in culture; 3) increased the pools of deoxy GTP
      in CCRF-CEM, Molt-3 and Molt-4 cells that had been treated with deoxyguanosine;
      4) prevented the toxicity of 6-thioguanosine to HEp-2 cells in culture; 5)
      increased the plasma levels of endogenous inosine in rats; and 6) increased the
      plasma levels of 2',3'-dideoxyinosine in rats that had received BzDAG and
      dideoxyinosine in combination. Pharmacokinetic analysis of BzDAG in the rat
      showed it to be 48% orally bioavailable (at a dose of 5 mg/kg). About 95% of
      BzDAG was protein bound. After i.v. administration of BzDAG (5 mg/kg), more than
      50% of the erythrocyte PNP was inhibited for 40 min. These results indicate that
      the 9-substituted-9-deazaguanines are potent orally active PNP inhibitors and are
      therefore of potential clinical interest as immunosuppressive and anti
      inflammatory agents.

PMID- 8355202
TI  - Human hepatic cytochrome P450 2D6-like activity in nonhuman primates: catalytic
      characterization in vitro.
AB  - Previous studies have identified the monkey as an animal model for the genetic
      polymorphism affecting human hepatic cytochrome P450 2D6 enzyme. However,
      contrary to an earlier in vivo observation, the present study failed to find
      evidence of polymorphism of this enzyme activity in liver preparations of 84
      African green (Cercopithecus aethiops) monkeys. The kinetics of dextromethorphan
      O-demethylation were similar in liver microsomes from African green (n = 21) and
      Crab eater (Macaca fascicularis, n = 7) monkeys (Km = 1.1 +/- 0.07 and 1.7 +/-
      0.27 microM; Vmax = 215 +/- 71.7 and 152 +/- 21.1 nmol/mg/h, respectively). These
      Km values were lower and less variable than those in liver microsomes from 10
      human extensive metabolizers (5.3 +/- 2.43 microM). Furthermore, the Vmax of the
      reaction in human liver microsomes was significantly lower (32 +/- 15.7
      nmol/mg/h; P < .001). Inhibitor constants (Ki values) determined in monkey and
      human liver microsomes were highly correlated (r = 0.97), but two high-affinity
      inhibitors of the human enzyme (quinidine and lobeline) were approximately 40
      fold less potent in monkey livers than in human livers. These data show that the
      monkey enzyme is functionally homologous, but is not identical to human hepatic
      cytochrome P450 2D6. Failure to observe poor metabolizer monkeys does not
      preclude their potential usefulness in evaluating the role of human hepatic
      cytochrome P450 2D6 activity in drug addiction and neurotoxicity because of the
      possibility of producing poor metabolizer phenocopies by potent hepatic
      cytochrome P450 2D6-like enzyme inhibitors in monkeys.

PMID- 8355204
TI  - Effects of emetine on the specific association of T-2 toxin with mammalian cells.
AB  - The effects of emetine on the association of T-2 toxin with Chinese hamster ovary
      cells were examined. T-2 toxin-cell association at both 4 degrees C and 37
      degrees C was reduced by up to 90% after preincubation of cells with emetine.
      Emetine-induced reduction in T-2 toxin-cell association was time-, temperature-,
      and concentration-dependent. A 4-min preincubation with emetine at physiological
      temperature was required to develop the maximum inhibitory effect. After brief
      exposures (< or = 5 min), emetine's inhibitory effects on toxin-cell association
      were reversible. However, after longer exposure periods to emetine (60 min),
      toxin-cell association was irreversibly blocked. The addition of emetine to cells
      prebound with toxin resulted in dissociation at a rate 2 to 3 times slower than a
      competitive chase with nonlabeled toxin. Emetine did not compete directly for T-2
      toxin binding to its receptor on isolated, purified, run-off ribosomes. However,
      the binding of toxin to purified ribosomes prepared from cells preincubated with
      emetine was markedly reduced. Scatchard analysis indicated that emetine's
      inhibitory effects on T-2 toxin-cell association were mediated through mixed
      allosteric and competitive types of inhibition at specific, intracellular, T-2
      toxin ribosomal binding sites.

PMID- 8355203
TI  - Synergistic effect of nicotinamide and choline administration on extracellular
      choline levels in the brain.
AB  - Experimental studies indicate that the availability of free choline is a rate
      limiting step for acetylcholine synthesis in central cholinergic neurons,
      especially when the release of acetylcholine is increased. In the present study
      we applied the microdialysis technique to measure the concentration of
      extracellular choline in the rat hippocampus. The i.p. injection of 6, 20 and 60
      mg/kg of choline chloride led to short-lasting elevations of the basal choline
      efflux (1.78 pmol/min) by 14, 26 and 131%. N-Methylnicotinamide, a metabolite of
      nicotinamide, has been reported to inhibit the outward transport of choline from
      the cerebrospinal fluid to the blood. The s.c. injection of 5 and 10 mmol/kg of
      nicotinamide caused increases of extracellular choline by 54 and 113%,
      respectively, and choline levels remained elevated for several hr. Moreover, the
      administration of 10 mmol/kg of nicotinamide dramatically potentiated the effects
      of exogenous choline administration on choline availability in the central
      nervous system. The effects of 6 and 20 mg/kg of choline chloride were increased
      by a factor of more than 10-fold when determined as area under the curve.
      Additional experiments demonstrated that neither nicotinamide nor N
      methylnicotinamide (100 microM) have an influence on the uptake, metabolism or
      release of choline in the hippocampal slice preparation. It is likely, therefore,
      that nicotinamide, after metabolic conversion in the brain to N
      methylnicotinamide, leads to a blockade of choline clearance from the brain. The
      combined administration of choline and of a choline transport blocker analogous
      to nicotinamide may be of potential use in central cholinergic dysfunction.

PMID- 8355205
TI  - Effect of emetine on T-2 toxin-induced inhibition of protein synthesis in
      mammalian cells.
AB  - Chinese hamster ovary cells were used to examine the effect of emetine upon the
      toxicity of T-2 toxin and several related trichothecene inhibitors of polypeptide
      synthesis. Emetine inhibited protein synthesis and T-2 toxin-cell association in
      a concentration-dependent manner. The dose-response curves for these two effects
      were nearly identical. Over a narrow concentration range (0.3-3.0 micrograms/ml),
      emetine's inhibition of protein synthesis was partially reversible, whereas its
      inhibition of toxin-cell association was maintained for extended periods. This
      sustained inhibition of toxin-cell association, resulted in "desensitized" cells
      with reduced sensitivity to the inhibitory effects of T-2 toxin on protein
      synthesis. Similar results were obtained when emetine-preincubated cells were
      challenged with diacetoxyscirpenol, verrucarin A and roridin A. In contrast,
      there were no measurable effects of emetine upon the response of the cells to the
      less potent trichothecenes, deoxynivalenol, T-2 tetraol and verrucarol. In
      addition to emetine, several other inhibitors of polypeptide synthesis were
      examined for their effects on T-2 toxin-cell association and sensitivity to T-2
      toxin. Of these, only cycloheximide inhibited toxin-cell association. Unlike
      emetine, sustained protection against the effects of T-2 toxin was not observed
      with cycloheximide.

PMID- 8355206
TI  - Cerebral catecholamine depletion in mice withdrawn from repeated morphine
      treatment and development of tolerance to the enhancing effect of morphine on
      noradrenaline depletion.
AB  - The effect of repeated morphine administration on the alpha-methyl-rho-tyrosine
      (alpha M rho T)-induced depletion of catecholamines was investigated in various
      brain areas of mice withdrawn for 1, 2, 3 and 7 days from 5-day morphine
      treatment. In addition, to clarify the development of tolerance, the effect of
      acute morphine administration on alpha M rho T-induced depletion of
      catecholamines was studied in these selected brain areas of mice withdrawn from
      repeated morphine treatment. Dopamine depletion was significantly (P < .01)
      retarded in the striatum and "rest of forebrain + midbrain" of mice withdrawn for
      1 day from morphine treatment. Withdrawal from morphine treatment did not alter
      alpha M rho T-induced noradrenaline depletion in the lower brain stem, rest of
      forebrain + midbrain or hypothalamus. The 10-mg/kg test dose of morphine
      significantly enhanced alpha M rho T-induced dopamine depletion in the rest of
      forebrain + midbrain of control mice withdrawn for 2 days, but did not clearly
      enhance it in mice withdrawn from morphine. The test dose significantly enhanced
      noradrenaline depletion in all selected brain areas of control mice withdrawn for
      1 to 3 days from saline, but tolerance to the test dose developed in morphine
      withdrawn mice. These results suggest that dopamine depletion is retarded in the
      striatum and rest of forebrain + midbrain of mice withdrawn for 1 day from
      repeated morphine treatment. However, noradrenaline depletion remains unchanged
      in all selected brain areas of mice withdrawn from morphine, and tolerance
      develops to the enhancing effect of morphine on the depletion of noradrenaline in
      mice withdrawn for 1 to 2 days from morphine.

PMID- 8355207
TI  - Evaluation of the reinforcing and discriminative stimulus effects of cocaine in
      combination with (+)-AJ76 or clozapine.
AB  - Because self-administration and discrimination of a drug by animals correlate
      with its abuse and subjective effects in humans, interventions that modify the
      reinforcing and discriminative stimulus effects of the drug may be useful in the
      treatment of its abuse. The present study was designed to evaluate the effects of
      the putative dopamine autoreceptor antagonist (+)-AJ76 (AJ) or the atypical
      antipsychotic clozapine (CLZ) on the reinforcing and discriminative stimulus
      effects of cocaine in monkeys. One group of rhesus monkeys (n = 6) was allowed to
      self-administer cocaine (0.03 or 0.1 mg/kg/injection i.v. fixed-ratio 10, 2
      hr/day). A second group of monkeys (n = 5) was trained to discriminate cocaine
      (0.2 or 0.4 mg/kg i.m., 10 min presession) from saline in a two lever, food
      reinforced, drug discrimination paradigm. When behavior was stable, AJ or CLZ was
      administered i.m., 15 or 30 min presession. Intermediate doses of both compounds
      (1.0-3.0 mg/kg of AJ; 0.3-1.0 mg/kg of CLZ) increased cocaine self
      administration, while responding remained evenly distributed over the session. A
      higher dose of CLZ decreased cocaine self-administration in an apparently
      nonspecific manner. When combined with saline, partial substitution for cocaine
      was seen in one of three monkeys with AJ and in none with CLZ. In combination
      with the training dose of cocaine in the discrimination experiment, both AJ and
      CLZ decreased drug appropriate responding by at least 50% in two of four monkeys,
      but had little or no effect in the other monkeys up to doses that completely
      suppressed lever pressing (6.4 mg/kg of AJ; 3.2 mg/kg of CLZ). Taken together,
      the present findings suggest that any blockade of the reinforcing and
      discriminative stimulus effects of cocaine by AJ and CLZ was, at best, partial.
      Furthermore, the stimulant effects of AJ observed in rats were not prominent in
      monkeys.

PMID- 8355208
TI  - Development of fluorinated 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine analogs
      with potent nigrostriatal toxicity for potential use in positron emission
      tomography studies.
AB  - The discovery of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) toxicity
      stimulated intense interest in neurotoxicology and in the possible toxic etiology
      of Parkinson's disease. Better understanding of MPTP neurotoxicity may be
      achieved by studies using 18F-radiolabeled MPTP analogs and positron emission
      tomography in nonhuman primates. We synthesized three fluorinated analogs of
      MPTP: 1-methyl-4-(2-fluorophenyl)-1,2,3,6-tetrahydropyridine (2'-F-MPTP), 1
      methyl-4-[2-(trifluoromethyl)phenyl]-1,2,3,6-tetrahydropyridine (2'-CF3-MPTP) and
      1-methyl-4-[2-(fluoromethyl)phenyl]-1,2,3,6-tetrahydropyridine (2'-CH2F-MPTP),
      and developed a method for preparing the latter in 18F-labeled form. We now
      studied the suitability of 2'-CH2F-MPTP and its hydrolysis products as substrates
      for monoamine oxidase (MAO) from mouse and monkey brain preparations, and
      investigated the neurotoxic effect of 2'-CH2F-MPTP and 2'-F-MPTP on the
      nigrostriatal dopaminergic system in mice. We found that 2'-CH2F-MPTP is a better
      substrate for MAO and that both 2'-CH2F-MPTP and 2'-F-MPTP were more potent
      neurotoxins than MPTP. Like MPTP, 2'-F-MPTP was exclusively oxidized by MAO-B and
      its toxicity blocked by pargyline or deprenyl but not by clorgyline. In contrast,
      2'-CH2F-MPTP was oxidized by both MAO-A and MAO-B, and its toxicity was not
      blocked by pargyline, clorgyline or deprenyl when given separately, but required
      clorgyline and deprenyl together.

PMID- 8355209
TI  - N-acetyl-aspartylglutamate modulation of N-methyl-D-aspartate-stimulated
      [3H]norepinephrine release from rat hippocampal slices.
AB  - The release of preloaded radiolabeled norepinephrine ([3H]NE) from slices of rat
      hippocampus can be stimulated by excitatory amino acids that interact with the N
      methyl-D-aspartate (NMDA) receptor. The acidic dipeptide N-acetyl-L
      aspartylglutamate (NAAG) is colocalized with NE in the cell bodies of locus
      coeruleus (the origin of the noradrenergic projections to the hippocampus) and
      the hippocampus itself. The function of NAAG in these neurons has not been
      demonstrated, although evidence exists that it may serve as a neuromodulator in
      other neuronal pathways. NAAG inhibited the release of [3H]NE stimulated by NMDA
      and L-glutamate in a concentration-related manner. The maximal inhibition
      produced by NAAG was about 25% of the control release stimulated by 25 microM
      NMDA. The effects observed were caused by the intact dipeptide and not the
      degradation artifacts produced by the enzyme N-acetylated-alpha-linked-acidic
      dipeptidase because N-acetyl-L-aspartate had no significant effect on the release
      and L-glutamate was stimulatory. The activity of this enzyme appears to be
      suppressed under the assay conditions used. Although the addition of glycine did
      not enhance NMDA-stimulated release, 7-chlorokynurenate and 1-hydroxy-3-amino
      pyrrolidone-2 decreased the release in a concentration-dependent manner.
      Furthermore, the attenuation produced by NAAG plus 7-chlorokynurenate or 1
      hydroxy-3-aminopyrrolidone-2 was greater than the inhibitory actions of either
      glycine antagonist alone. Similarly, NAAG produced additional inhibition over
      that produced by either of two different voltage-dependent calcium channel
      blockers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355210
TI  - Acute effects of cocaine on anterior pituitary hormones in male and female rhesus
      monkeys.
AB  - The effects of acute cocaine administration (0.4 or 0.8 mg/kg) on anterior
      pituitary hormones were studied in four male and six female adult rhesus monkeys
      during the midluteal phase of the menstrual cycle (days 20-23). Progesterone
      levels averaged 15.7 +/- 3 and 10.6 +/- 2.8 ng/ml before low and high dose
      cocaine administration. Integrated plasma samples were collected every 10 min for
      40 min before i.v. administration of cocaine, and 11 postcocaine samples were
      collected over 110 min. Cocaine (0.8 mg/kg) stimulated a significant increase in
      luteinizing hormone (LH) within 10 to 20 min (P < .01) and LH reached peak levels
      (59-60% above base line) within 30 min after cocaine administration in both males
      and females. Plasma cocaine levels averaged 289 +/- 23 and 346 +/- 73 ng/ml at 10
      min after i.v. cocaine (0.8 mg/kg) administration in males and females,
      respectively. Follicle stimulating hormone levels were unchanged in midluteal
      females. Male testosterone increased by 50% above average base-line levels 50 min
      after the LH peak (80 min postcocaine). These data are consistent with our
      previous findings that cocaine increased LH and enhanced luteinizing hormone
      releasing hormone-stimulated LH in early follicular females. The low dose of
      cocaine did not change basal levels of LH and follicle stimulating hormone in
      midluteal females and both LH and testosterone were unaffected in males. Cocaine
      plasma levels averaged 97.6 +/- 29 and 68.3 +/- 9.1 ng/ml at 10 min after 0.4
      mg/kg of cocaine in males and females, respectively.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8355211
TI  - Effect of active sensitization on the bronchopulmonary responses to tachykinins
      in the guinea pig. Modulation by peptidase inhibitors.
AB  - The i.v. administration of substance P (SP, 0.25-16 micrograms/kg) or of the
      selective metabolic stable NK-1 agonist, [Glp6,Pro9]SP-(6-11) (septide, 0.03-0.25
      microgram) to atropine-treated guinea pigs or to isolated perfused lungs
      triggered a dose-dependent bronchoconstriction, which was enhanced in animals
      actively sensitized to ovalbumin. In vivo, bronchial hyper-responsiveness was
      restricted to SP and to septide, inasmuch as neurokinin A (0.06-1 microgram/kg)-
      or capsaicin (0.5-32 micrograms/kg)-induced bronchoconstriction were not
      modified. In contrast, isolated lungs from sensitized guinea pigs exhibited an
      increased bronchoconstriction also in response to capsaicin (0.01-10 micrograms),
      which was inhibited by atropine in the medium. Pretreatment of actively
      sensitized guinea pigs either with indomethacin plus mepyramine, the lipoxygenase
      inhibitor BW A4C or with the platelet-activating factor antagonist SR 27417, did
      not modify bronchial hyper-reactivity to SP. Captopril (5 mg/kg i.v.), but not
      thiorphan (0.8 mg/kg i.v.), increased the SP-induced bronchoconstriction in
      actively sensitized animals, whereas both inhibitors were equally effective in
      nonsensitized guinea pigs. Thiorphan, however, did not modify the in vivo
      response to septide. Our results demonstrate that guinea pigs sensitized to
      ovalbumin exhibit bronchial hyperreactivity to SP, but not to neurokinin A, as
      compared to nonsensitized animals, suggesting a decrease in the neutral
      endopeptidase activity in the airways brought by the immunization. However, the
      results obtained by using septide indicate that other mechanisms may be involved
      in the bronchial hyper-reactivity to SP.

PMID- 8355212
TI  - Modulation of enantioselective metabolism and inversion of ibuprofen by
      xenobiotics in isolated rat hepatocytes.
AB  - R-ibuprofen undergoes chiral inversion by the formation of a coenzyme A (CoA)
      thioester and subsequent epimerization and hydrolysis. Using isolated rat
      hepatocytes, the interaction of xenobiotics with the inversion and oxidation
      pathways of ibuprofen enantiomers was determined from the time course of R- and S
      ibuprofen and ibuprofenyl-CoA during 4-hr incubations with R- or S-ibuprofen (25
      microM). By fitting a first-order model, the rate constants of the formation of
      ibuprofenyl-CoA (K12), oxidation of R-ibuprofen (K10), hydrolysis of ibuprofenyl
      CoA (K21) and oxidation of S-ibuprofen (K30) were 1.306, 0.284, 6.858 and 0.496
      hr-1, respectively. The fractional inversion of R-ibuprofen was 0.75 and the area
      under the curve for ibuprofenyl-CoA was 203.8 microM min. Coincubation with 50
      microM of the cytochrome P450 inhibitors metyrapone and proadifen resulted in
      significant reductions of K10 and K30; the fractional inversion of R-ibuprofen
      increased to 116% and 127% and the area under the curve of ibuprofenyl-CoA to
      145% and 144% of controls, respectively. Valproic acid and pivalic acid at 50
      microM significantly reduced the K12 and increased the K21; the fractional
      inversion was unchanged but the area under the curve of ibuprofenyl-CoA was
      significantly reduced to 57% and 28% of controls, respectively. Valproic acid
      also significantly reduced K10 and K30. p-nitrobenzoic acid at 50 microM
      significantly increased K21 and reduced the area under the curve of ibuprofenyl
      CoA to 44% of control but did not influence the fractional inversion. Selective
      inhibitors of ibuprofen oxidation were found to enhance significantly
      hepatocellular exposure to the potentially reactive ibuprofenyl-CoA intermediate.

PMID- 8355213
TI  - Down-regulation of motilin receptors on rabbit colon myocytes by chronic oral
      erythromycin.
AB  - Acutely, erythromycin stimulates colonic smooth muscle contraction via action on
      motilin receptors, but the effects of chronic erythromycin exposure are unknown.
      Thus contraction and motilin binding studies were performed on rabbit colonic
      smooth muscle after 2 weeks of oral erythromycin ethyl succinate (25 mg/kg, twice
      a day). Isolated colon myocytes from untreated rabbits contracted to erythromycin
      with an EC50 of 30 +/- 17 pM and peak shortening of 24.1 +/- 0.8% at 10 nM.
      Motilin evoked similar contractions with an EC50 of 63 +/- 13 pM and peak
      shortening of 26.8 +/- 0.9% at 10 nM. Myocytes from treated rabbits exhibited
      reduced contractile responses to erythromycin with an EC50 of 203 +/- 27 pM (P <
      .002) and decreased peak shortening to 20.1 +/- 2.9% at 100 nM (P < .05). Motilin
      responses were also blunted [EC50 of 326 +/- 16 pM, peak shortening of 16.2 +/-
      1.2% at 1 microM (P < .002)]. [125I]motilin binding to untreated colon smooth
      muscle homogenates was saturable and specific with a Kd of 0.53 +/- 0.10 nM and a
      Bmax of 48 +/- 6 fmol/mg protein. Muscle from treated rabbits exhibited no change
      in motilin receptor affinity (Kd = 0.50 +/- 0.08 nM) but showed a 63% reduction
      in receptor density (Bmax = 18 +/- 4 fmol/mg protein; P < .03). In conclusion,
      chronic erythromycin administration results in decreased contractile potency and
      efficacy of motilin and erythromycin on colonic myocytes, associated with
      decreased motilin receptor density but no change in receptor affinity. Thus
      chronic erythromycin exposure leads to tolerance to its colonic smooth muscle
      motor effects via motilin receptor down-regulation.

PMID- 8355214
TI  - Droperidol exerts dual effects on repolarization and induces early
      afterdepolarizations and triggered activity in rabbit Purkinje fibers.
AB  - This study was designed to clarify discrepancies concerning the effects of
      droperidol on cardiac repolarization. Myocardial electrical activity was recorded
      by using microelectrode technique in rabbit Purkinje fibers and guinea pig
      ventricular muscle. In Purkinje fibers stimulated at 60 pulses/min, low
      concentrations (0.01-0.3 microM) of droperidol increased in a dose-dependent
      fashion action potential duration (APD) without altering the other parameters. At
      1 and 3 microM, droperidol led to the reversal of the prolonging effect. The
      highest concentrations used (10 and 30 microM), produced shortening in APD at 50%
      repolarization concomitantly with a significant decrease in Vmax, action
      potential amplitude and resting membrane potential. Inexcitability occurred in 4
      of 15 preparations exposed to 30 microM. In 8 of 15 Purkinje fibers, the
      prolonging effect induced by low concentrations was so important that APD
      exceeded the 1000-msec period of basal stimulation and early afterdepolarizations
      (EADs) and triggered activity developed. In guinea pig ventricular muscle, these
      effects were notably less pronounced. Prolongation of action potential showed a
      reverse use-dependence (i.e., much greater at the lowest stimulation
      frequencies), whereas Vmax depression was use-dependent. Decreasing extracellular
      K concentration from 4.0 to 2.7 mM enhanced the incidence of EADs in Purkinje
      fibers, whereas elevating the K concentration from 2.7 to 5.4 mM abolished them
      completely and shortened drastically APD. EADs were also eliminated by increasing
      magnesium concentration from 1 to 5 mM. Addition of isoproterenol favored EADs,
      whereas these were suppressed at plateau level by exposure to 0.3 microM
      nifedipine. The results indicate that in rabbit Purkinje fibers, droperidol
      exerts a dual effect on repolarization, prolongation with low concentrations with
      development of EADs and subsequent triggered activity. These abnormalities were
      suppressed at high concentrations concomitantly with a marked depression of other
      characteristics. These observations suggest multiple ionic channel activities and
      further studies are required to precise the underlying mechanisms at channel
      level.

PMID- 8355215
TI  - Stereoselective verapamil disposition and dynamics in aging during racemic
      verapamil administration.
AB  - Stereoselective verapamil disposition and dynamics were evaluated after racemic
      verapamil administration of single i.v. doses, simulated steady-state intravenous
      infusions, chronic (1 week) administration of oral immediate-release tablets (120
      mg three times daily) and chronic (1 week) administration of oral sustained
      release tablets (240 mg once daily) to 15 young (mean +/- S.E.M. age 22 +/- 1
      year) and 15 older (69 +/- 1 year) healthy male volunteers. After single i.v.
      doses S-verapamil clearance (young, 102 +/- 6 vs. older, 77 +/- 6 l/hr; P < .01)
      and R-verapamil clearance (young, 61 +/- 3 vs. older, 45 +/- 3 l/hr; P < .01)
      were similarly decreased. Electrocardiographic P-R prolongation using S-verapamil
      concentrations and an Emax model (young Emax, 69 +/- 8 vs. older, 42 +/- 6 msec;
      P < .05: young EC50, 15 +/- 1 vs. older, 23 +/- 3 ng/ml; P < .05) was greater in
      the young. Simulated steady-state i.v. S-verapamil clearance (young, 76 +/- 3 vs.
      older, 49 +/- 2 l/hr; P < .01) and R-verapamil clearance (young, 47 +/- 2 vs.
      older, 28 +/- 1 l/hr; P < .01) were similarly less in older subjects and this was
      unrelated to infusion rate. Qualitatively similar findings were observed during
      chronic oral (immediate release) treatment and chronic oral (sustained release)
      treatment. Plasma protein binding of S-verapamil was less in both groups (young,
      8.5 +/- 0.4 and older, 8.0 +/- 0.5% unbound) than that of R-verapamil (young, 5.4
      +/- 0.2 and older, 5.1 +/- 0.3% unbound) and not different between
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355216
TI  - DOI and alpha-methylserotonin: comparative vascular and nonvascular smooth muscle
      effects and central 5-hydroxytryptamine2 receptor affinities.
AB  - Both alpha-methylserotonin and 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane
      (DOI) are agonists at 5-hydroxytryptamine2 (5-HT2) receptors. The present study
      compared these agonists for their binding affinities at the high- and low
      affinity states of the 5-HT2 receptor and for their contractile activities in
      certain smooth muscle preparations. Both agonists contracted the rat aorta and
      rat jugular vein, tissues possessing 5-HT2 receptors, and contraction was blocked
      by ketanserin. However, alpha-methylserotonin produced greater maximal response
      (80-90% maximum response to serotonin) than DOI. In the rat jugular vein, the
      calculated dissociation constant of DOI (-log Kb = 7.7) corresponded well with
      its affinity for [3H]ketanserin- (pKi = 7.5) but not [125I]DOI- (pKi = 8.6)
      radiolabeled sites. This might suggest that binding to the agonist low-affinity
      state of the 5-HT2 receptor is more relevant to vascular agonist activity. alpha
      Methylserotonin was slightly more potent than serotonin in contracting the rat
      aorta but not the jugular vein, whereas DOI was more potent in the jugular vein
      than in the aorta. In the jugular vein but not the aorta, the relative potency of
      these agents corresponded well with their relative affinities for either the
      [3H]ketanserin- or the [125I]DOI-labeled 5-HT2 receptor.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8355217
TI  - Cytochrome P450 2B isoenzymes are responsible for the pulmonary bioactivation and
      toxicity of butylated hydroxytoluene, O,O,S-trimethylphosphorothioate and
      methylcyclopentadienyl manganese tricarbonyl.
AB  - O,O,S-Trimethylphosphorothioate and methylcyclopentadienyl manganese tricarbonyl
      damage the type I pneumocytes of the alveolar epithelium in rats. Butylated
      hydroxytoluene causes similar damage in mice. The toxicity of these compounds is
      dependent on their bioactivation by the cytochrome P-450 (CYP) system. A range of
      compounds, that modifies the activity of specific CYP isoenzymes, has been used
      to establish those particular isoenzymes involved in bioactivation. Pulmonary
      toxicity was assessed by measurement of lung weight and changes in the activity
      of gamma-glutamyltranspeptidase and alkaline phosphatase in bronchoalveolar
      lavage fluid. O,O,S-Trimethylphosphorodithioate, bromophos, p-xylene and 2,4
      dichloro-(6-phenyl-phenoxy)ethylamine all inhibited the dealkylation of
      pentoxyresorufin, an indicator of CYP2B1 activity, and also prevented pulmonary
      toxicity. There was a significant negative correlation between the level of
      pulmonary pentoxyresorufin dealkylation after pretreatment with O,O,S
      trimethylphosphorodithioate and the severity of lung injury. This pretreatment
      also reduced the toxicity of butylated hydroxytoluene by a factor of 20 and
      methylcyclopentadienyl manganese tricarbonyl by a factor of 10. Modification of
      the activity of CYP1A1, CYP2E1 and CYP4B1 did not alter the toxicity of these
      compounds. These results indicate that pulmonary CYP2B1 is responsible for the
      bioactivation and toxicity of O,O,S-trimethylphosphorothioate and
      methylcyclopentadienyl manganese tricarbonyl in rats and the orthologous 2B
      isoenzyme in mice activates butylated hydroxytoluene.

PMID- 8355218
TI  - Interaction of the enantiomers of fluoxetine and norfluoxetine with human liver
      cytochromes P450.
AB  - (R)- and (S)-fluoxetine were found to be competitive inhibitors of P450 2D6
      mediated bufuralol 1'-hydroxylation in vitro, yielding Ki values of 1.38 +/- 0.48
      and 0.22 +/- 0.11 microM, respectively. Their N-demethylated metabolites were
      also found to be potent inhibitors (Ki, (R)-norfluoxetine, 1.48 +/- 0.27 microM;
      (S)-norfluoxetine, 0.31 +/- 0.04 microM). The microsomal (R)- and (S)-fluoxetine
      N-demethylase activities for 14 human liver samples were on average 29.6 +/- 13.5
      and 19.4 +/- 11.8 pmol of product/min/mg of protein, respectively. The individual
      rates of N-demethylation correlated with microsomal immunodetectable P450 2D6
      levels; (R)-fluoxetine, r = 0.64, P < .05; (S)-fluoxetine, r = 0.63, P < .05.
      However, this correlation was significantly weaker than the excellent correlation
      obtained for P450 2D6-marker bufuralol 1'-hydroxylase activity and P450 2D6
      levels (r = 0.92, P < or = .01). Quinidine, a potent inhibitor of P450 2D6,
      inhibited the demethylation of each enantiomer by only approximately 20% at a
      concentration 300 times greater than the Ki determined for the quinidine
      inhibition of bufuralol 1'-hydroxylase. Furthermore, antiserum recognizing P450
      2D6 inhibited 82% of microsomal bufuralol 1'-hydroxylase activity but only 27% of
      the (R)-fluoxetine N-demethylase activity in the same human liver sample. In
      summary, these data indicate that the enantiomers of fluoxetine and norfluoxetine
      are potent inhibitors of P450 2D6 and that P450 forms other than P450 2D6 appear
      to be responsible for the majority of microsomal fluoxetine N-demethylation.

PMID- 8355219
TI  - Interaction of thiazide and loop diuretics with the basolateral para
      aminohippurate transport system in isolated S2 segments of rabbit kidney proximal
      tubules.
AB  - The effect of thiazide and loop diuretics on the tubular uptake of [3H]para
      aminohippurate ([3H]PAH), a marker of the organic anion transport system, was
      tested in vitro on single S2 segments of the proximal tubule of rabbit kidneys.
      Because the tubules were not perfused, and hence were collapsed, the tubular [3H]
      PAH uptake reflects [3H]PAH transport across the contraluminal membrane. The
      diuretics were added to the bath solution in at least six different
      concentrations. The concentration of [3H]PAH in the bath solution amounted to 1.3
      mumol/l, and was 12 times lower than the PAH concentration (16 mumol/l) at half
      maximum PAH uptake. The results show that all of the nine diuretics tested
      inhibited [3H]PAH uptake. The IC50 values of the individual drugs ranged from 3
      to 400 mumol/l. In general, thiazide diuretics had a lower affinity to the PAH
      transporter than loop diuretics. This probably results from differences in the
      pKa values which range from 3.6 to 4.1 for the loop diuretics and from 9.2 to 10
      for the thiazide diuretics. Furthermore, there was a highly significant
      dependence of affinity on the hydrophobic properties of the diuretics. At
      concentrations 10- to 100-fold lower than the IC50 values all diuretics
      stimulated [3H]PAH uptake which may indicate a positive cooperative interaction
      of these drugs with the PAH transporter. Within the group of loop diuretics the
      order of the affinity to the PAH transporter and to the Na, 2 Cl, K cotransporter
      in the thick ascending limb of Henle's loop was identical.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8355220
TI  - Proceedings of the scientific meetings of The Physiological Society. June, July,
      and September 1992. Abstracts.

PMID- 8355221
TI  - Proceedings of the scientific meetings of The Physiological Society. December
      1992, January and April 1993. Abstracts.

PMID- 8355222
TI  - Pathology of intraoral sebaceous glands.
AB  - Large clinical studies have shown that intraoral sebaceous glands are present in
      70 to 95% of the population. In many individuals these small white to yellow
      macules and papules are so numerous that they dominate the buccal mucosa. Despite
      their prevalence, pathological changes of these glands are considered uncommon.
      This paper reviews the pathologic spectrum of intraoral sebaceous glands
      including Demodex infestation, cystic lesions, sebaceous hyperplasia and
      neoplastic lesions. New data is presented on the true sebaceous cyst and the
      second reported case of intraoral steatocystoma simplex is documented.

PMID- 8355223
TI  - Tissue markers of potentially malignant human oral epithelial lesions.
AB  - Tissue markers of potential malignancy have been sought for many years. Cell
      surface markers, particularly blood group and histocompatibility antigens, have
      shown great promise and several squamous carcinoma antigens have been identified-
      but not fully studied in potentially malignant lesions. Growth factors and
      receptors also need further study. Cytoplasmic markers of potential malignancy
      have been examined and, of these, keratins, filaggrin, and some carcinoma
      antigens show most promise. Nuclear analyses have promise but are time-consuming
      and expensive. Image cytometric analyses appear to be sensitive and predictive:
      oncogene and tumour suppressor analyses remain to be fully evaluated. New
      investigative techniques at the cellular and molecular level show increasing
      promise at defining potentially malignant oral epithelial lesions but more
      prospective studies are required.

PMID- 8355224
TI  - Comparing flow cytometric analysis and nucleolar organizer region enumeration in
      archival oral premalignant lesions.
AB  - Flow cytometric analysis (FCA) and silver colloidal nucleolar organizer region
      associated protein staining (AgNOR) have been used individually in assessing the
      histopathologic nature of various human tumors. However, few researchers have
      investigated the relationship between the two techniques in a single series. In a
      retrospective study, we examined 36 premalignant lesions of the oral cavity by
      FCA and AgNOR on formalin-fixed, paraffin-embedded tissue submitted to the
      University of Tennessee, Memphis, oral pathology laboratory. Three categories of
      epithelial dysplasia were represented (9 mild, 9 moderate, 6 severe), as well as
      four epithelial hyperplasias without dysplasia, three squamous cell carcinomas,
      and five fibrous nodules as controls. Parameters recorded for each case included
      age, race, gender, site, light microscopic diagnosis (LMD), DNA index (DI), total
      proliferative index (TPI), S-phase (S), range of nucleolar organizer regions
      (RNOR), and mean number of nucleolar organizer regions (MNOR). The average
      maximum nucleolar organizer region count (AMXNOR) for each LMD category was also
      calculated. The objective of the study was to determine if FCA or AgNOR aided in
      the subjective LMD of oral premalignant lesions and if the parameters recorded
      for the specimens exhibited any positive correlation. The FCA results indicated
      an abnormal DI in 6 of the 24 dysplastic lesions. A positive partial correlation
      was seen between DI and MNOR (r = 0.434; P < 0.012) and TPI and S (r = 0.774; P <
      0.0001), holding gender and race constant. Additionally, the AMXNOR exhibited a
      slight tendency to increase for each increasing grade of dysplasia but this could
      not be confirmed statistically.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355225
TI  - Cartilage in the walls of odontogenic keratocysts.
AB  - Only one histologically documented case of cartilage in the wall of an
      odontogenic keratocyst has been reported in the English language literature. Four
      new cases are presented with the clinical, radiographic and histopathologic
      features described. To our knowledge this finding has not been reported in
      association with any other type of odontogenic cyst.

PMID- 8355226
TI  - The terminally ill patient on an acute psychiatric unit. A case study.
AB  - 1. As mental health professionals, we frequently fail to realize that we are
      subject to the same emotions and coping mechanisms as the lay community. 2. At
      times it seems safer to focus on a patient's medical condition than to deal with
      difficult, unresolved psychological issues. 3. By using existing resources within
      our institution, our interdisciplinary team faced many of their unresolved issues
      about death, such as countertransference, and were able to then help our patient
      through his final stage of life.

PMID- 8355227
TI  - Coming out. My experience as a mental patient.
AB  - 1. There is still a strong stigma attached to mental illness, and surprisingly
      many psychiatric nurses reinforce that stigma. Although some professionals may go
      into therapy to improve self-esteem and become better professionals, they may run
      the risk of destroying their career. 2. The experience as a patient in a mental
      health facility can result in nightmares and flashbacks, and damage due to
      restraints. Because "coming out" can destroy one's career, the safest place for a
      nurse with a history of hospitalization or substance abuse may be "in the
      closet." 3. If the stigma of mental illness is going to be changed, then it must
      start with the changing of the attitudes and perceptions of mental health
      professionals.

PMID- 8355228
TI  - Social organization of length of stay of psychiatric patients.
AB  - 1. Length of stay (LOS) is the major factor determining the use of resources in
      hospitals and is the primary component in reducing hospital costs. However,
      relatively little is known about the anatomy of the hospital stay. 2. The stage
      model of treatment is used to examine the LOS of psychiatric patients. The model
      assumes the patient is admitted to the hospital, undergoes testing or observation
      to verify a diagnosis or establish a new diagnosis, and then proceeds to therapy,
      recovery, and discharge. 3. In practice, the treatment process does not follow a
      stage model, but is much more complicated. Various kinds of information are
      revealed throughout the course of hospitalization and treatment continues as
      events unfold. Diagnosis, therapy, and recovery occur in a dialectical process
      constantly being reconstructed as it is informed by interpretations of everyday
      events.

PMID- 8355229
TI  - Depression in the elderly.
AB  - 1. Depression in the elderly is a major health concern that can be life
      threatening if not recognized and treated. An untreated depression may result in
      needless suffering, institutionalization, and suicide. Lack of treatment may
      occur because the signs and symptoms of depression in the elderly are different
      from those in the young, and because depressive symptoms may be viewed by the
      older person, the family, and the physician as a normal part of aging. 2.
      Depression can occur secondarily to physical illness. Because physical illnesses
      occur frequently in the older population, the combination of physical illness and
      depression is common. 3. Through noninvasive procedures, such as positron
      emission tomography (PET), a greater understanding of depression will be achieved
      that will result in development of more specific and effective treatment.
      Accurate and early diagnosis and adequate treatment favor a good prognosis.

PMID- 8355231
TI  - Just between us.

PMID- 8355230
TI  - Expanding uses of anticonvulsants in the treatment of bipolar disorder.

PMID- 8355232
TI  - Networking: a vital tool.

PMID- 8355233
TI  - Use of the brief psychiatric rating scale by nurses.
AB  - 1. Nurses are intimately involved in the assessment of patients in inpatient
      clinical settings and in community settings--and nurses have a role to play in
      the systematic rating of severe psychopathology. 2. The Brief Psychiatric Rating
      Scale (BPRS) provides a means of assessing mental health status from an interview
      using 16 rating concepts. Analysis of BPRS rating profiles obtained from a
      variety of patients and settings have consistently revealed four syndromes:
      withdrawal-retardation, anxious depression, hostile-suspiciousness, and thinking
      disturbance. 3. Once properly trained regarding the BPRS, nurses can use the
      scale effectively in the assessment and ongoing monitoring of patient conditions.
      The scale is an added tool for nurses to use in monitoring the effectiveness and
      outcome of both medical and nursing interventions.

PMID- 8355234
TI  - Community care.

PMID- 8355235
TI  - Prevention and management of panic in personnel facing a chemical threat--lessons
      from the Gulf War.
AB  - During the Gulf War a number of subjects presented with panic, hyperventilation,
      and inability to wear respirators when chemical alarms were sounded, despite a
      perceived real chemical threat. Twenty-five such sufferers were seen at the
      Psychiatric Department of 33 General (Surgical) Hospital. This paper considers
      the aetiology of such responses, describes a mode of treatment which can be used
      in the threat situation, and considers issues of future training.

PMID- 8355236
TI  - Acetic acid used for the elimination of Pseudomonas aeruginosa from burn and soft
      tissue wounds.
AB  - Acetic acid was used topically at concentrations of between 0.5% and 5% to
      eliminate Pseudomonas aeruginosa from the burn wounds or soft tissue wounds of 16
      patients. In-vitro studies indicated the susceptibility of P. aeruginosa to
      acetic acid; all strains exhibited a minimum inhibitory concentration of 2 per
      cent. P. aeruginosa was eliminated from the wounds of 14 of the 16 patients
      within two weeks of treatment. Acetic acid was shown to be an inexpensive and
      efficient agent for the elimination of P. aeruginosa from burn and soft tissue
      wounds.

PMID- 8355237
TI  - The RAF Community Psychiatry Service in Cyprus.

PMID- 8355238
TI  - Brief therapy in a battleshock recovery unit: three case studies.
AB  - Combat stress reactions may present in many forms. This study presents three
      cases from the Gulf War which illustrate the diversity of presentation and
      demonstrate the ways in which the principles of the management of Combat Stress
      Reactions--Proximity, Immediacy and Expectancy--can be combined with specific
      individual therapies.

PMID- 8355239
TI  - Necrotising fasciitis of the leg as a complication of ischiorectal abscess.
AB  - This case report describes the rare complication of necrotising fasciitis of the
      right thigh and calf after drainage of an ischiorectal abscess. The important
      early symptoms and signs of this life threatening infection, and the need for
      urgent treatment with aggressive surgical debridement and broad spectrum
      antibiotics, are emphasised in order to facilitate early recognition and prompt
      initiation of the appropriate therapy in future cases.

PMID- 8355240
TI  - A case of 'epilepsy' successfully treated by cardiac pacing.

PMID- 8355241
TI  - Herpes simplex virus encephalitis.

PMID- 8355242
TI  - Penetrating chest trauma.

PMID- 8355244
TI  - Sports medicine.

PMID- 8355243
TI  - The blue epidemic cholera--some aspects of treatment in the mid 19th century.
AB  - Cholera was first recorded in the Indian sub-continent in 1817 from where
      pandemics reached Europe via trade and pilgrim routes. Notwithstanding the
      numerous therapeutic methods prescribed, the virulence of cholera remained
      unabated. This article describes some of the proposed treatment regimes in
      relation to the assumed pathophysiology.

PMID- 8355245
TI  - Activated ketone based inhibitors of human renin.
AB  - Application of the concept of activated ketones to the design of novel and potent
      transition-state analog inhibitors of the aspartyl protease renin is described.
      Three different classes of peptidic activated ketones were synthesized: 1,1,1
      trifluoromethyl ketones, alpha-keto esters, and alpha-diketones. The
      corresponding alcohols were also evaluated as renin inhibitors in each series.
      While the trifluoromethyl alcohol 12 (I50 = 4000 nM) was equipotent to the simple
      methyl alcohol 7 (I50 = 3200 nM), the structurally similar alpha-hydroxy esters
      (32 and 30, I50's = 5.3 and 4.7 nM, respectively) and alpha-hydroxy ketones (41
      and 42, I50 = 23 and 15 nM, respectively) were 150-300-fold more active. The
      hydrating capability of the activated ketone functionality was important for
      intrinsic potency in the case of trifluoromethyl ketones, as illustrated by the
      significantly better activity of trifluoromethyl ketone 13 (I50 = 250 nM)
      compared to its alcohol analog 12 (I50 = 4000 nM). It was however unimportant for
      the alpha-keto ester (20 and 31, I50 = 15 and 4.1 nM, respectively) and alpha
      diketone (43 and 44, I50 = 52 and 28 nM, respectively) based inhibitors, since
      their activity was essentially similar to that of the corresponding alcohols.
      These results collectively suggest that, whereas the trifluoromethyl ketones
      derive their renin inhibitory potency primarily from their ability to become
      hydrated, this is not a critical feature for the activity of alpha-dicarbonyl
      based inhibitors. The alpha-keto ester and alpha-diketone based renin inhibitors
      benefit predominantly from the hydrophobic and/or H-bonding type binding
      interactions of the neighboring ester or acyl group itself, rather than the
      ability of this group to deactivate the adjacent ketone group and thereby make it
      susceptible to hydration.

PMID- 8355246
TI  - Synthesis, physicochemical properties, and biological evaluation of N-substituted
      2-alkyl-3-hydroxy-4(1H)-pyridinones: orally active iron chelators with clinical
      potential.
AB  - The synthesis of a range of novel bidentate ligands containing the chelating
      moiety 3-hydroxy-4(1H)-pyridinone is described. The pKa values of the ligands and
      the stability constants of their iron(III) complexes have been determined. The
      crystal structures of one of the ligands and one of the iron(III) complexes are
      presented. The distribution coefficients of the ligands are reported and are
      related to the ability of the ligands to remove iron from hepatocytes. The
      influence of 3-hydroxy-4(1H)-pyridinones on oxidative damage to cells is
      described. In contrast to the iron chelator in current therapeutic use,
      desferrioxamine-B, many of the bidentate ligands described in this study are
      orally active in iron-overloaded mice.

PMID- 8355247
TI  - Tyrosine kinase inhibitors. 1. Structure-activity relationships for inhibition of
      epidermal growth factor receptor tyrosine kinase activity by 2,3-dihydro-2-thioxo
      1H-indole-3-alkanoic acids and 2,2'-dithiobis(1H-indole-3-alkanoic acids).
AB  - A series of 2,3-dihydro-2-thioxo-1H-indole-3-alkanoic acids, and their methyl
      esters were prepared, the majority by oxidation of 1H-indole-3-alkanoic acids
      (DMSO/HCl), followed by thiation of the corresponding 2,3-dihydro-2-oxo-1H-indole
      3-alkanoic acid esters. The monomeric thiones undergo facile and reversible
      oxidation to the corresponding 2,2'-dithiobis(1H-indole-3-alkanoic acids). The
      compounds were evaluated for their abilities to inhibit the tyrosine kinase
      activity of the epidermal growth factor receptor using a native complex contained
      in plasma membrane vesicles shed from cultured A431 cells, and to inhibit the
      growth of Swiss 3T3 mouse fibroblast in culture. Enzyme inhibitory activity is
      dependent on the length of the side chain, with propanoic acid derivatives
      showing the highest activity. The acids are generally significantly more potent
      than the corresponding esters, and the disulfides more active than the
      corresponding monomers. An ability to undergo the thione-thiol tautomerism
      necessary for dimerization is essential, with 3,3-disubstituted compounds being
      inactive. Overall, the data suggest that the disulfide is the more active form,
      with much of the activity of the monomeric thiones being due to varying degrees
      of conversion to the disulfide during the assay. In the growth inhibition assay,
      the methyl esters are more potent than their corresponding carboxylic acids, and
      the dimers are generally more potent than the monomers. The data show these
      compounds to be a novel and potent class of inhibitors of epidermal growth factor
      receptor tyrosine kinase activity.

PMID- 8355248
TI  - A pharmacological, crystallographic, and quantum chemical study of new inotropic
      agents.
AB  - The cardiac activity of a series of milrinone analogues, 2-substituted 3-acyl-1,6
      dihydro-6-oxo-5-pyridinecarbonitriles, 1,6,3,2,11,12-hexahydro-6,3-dioxo-5
      quinolinecarbonitriles, the correlated carboxylic acids, 2-substituted 3-acyl
      6(1H)-pyridones, and 7,8-dihydro-2,5(1H,6H)-quinolinediones, was evaluated in
      spontaneously beating and in electrically driven atria from reserpine-treated
      guinea pigs. Their effects were compared with those induced by amrinone and
      milrinone in both the atria preparations. Compounds SF28 (3-acetyl-1,6-dihydro-2
      methyl-6-oxo-5-pyridinecarbonitrile) and SF40 (7,8-dihydro-7-methyl-2,5(1H,6H)
      quinolinedione) were the most effective positive inotropic agents. An inhibition
      of the negative influence exerted by endogenous adenosine on heart preparations
      seems to be involved in their contractile activity. SF38 (3-benzoyl-2-phenyl
      6(1H)-pyridinone), on the contrary, reduced the contractile force and the
      frequency rate of guinea pig atria with a mechanism not related to an activation
      of cholinergic or purinergic inhibitory receptors on the heart. X-ray analysis
      carried out on the three model compounds, SF28, SF40 (positive inotropic agents),
      and SF38 (negative inotropic agent), and molecular modeling evidenced that the
      change from phenyl (SF38) to methyl (SF28) or the introduction of a side cyclic
      aliphatic chain (SF40) results in a variation of conformational preference and
      topography which may address the different molecules toward distinct receptor
      pockets according to the resulting inotropic effect.

PMID- 8355249
TI  - Antihyperglycemic activity of novel naphthalenyl 3H-1,2,3,5-oxathiadiazole 2
      oxides.
AB  - A series of naphthalenyl 3H-1,2,3,5-oxathiadiazole 2-oxides was prepared and
      tested for antihyperglycemic activity in the db/db mouse, a model for type 2 (non
      insulin dependent) diabetes mellitus. Substitution at the 1-, 5-, or 8-positions
      of the naphthalene ring with a halogen was found to be beneficial to
      antihyperglycemic activity. 4-[(5-Chloronaphthalen-2-yl)methyl]-3H-1,2,3,5
      oxathiadiazole++ + 2-oxide (45), one of the most potent compounds in this series,
      was selected for further pharmacological evaluation.

PMID- 8355250
TI  - Mono- and bis(aminomethyl)phenylacetic acid esters as short-acting antiarrhythmic
      agents. 2.
AB  - The synthesis, antiarrhythmic activity, and blood hydrolysis properties of a
      series of mono- and bis(aminomethyl)phenylacetic acid esters related to a
      previously reported class Ic antiarrhythmic agent (ACC-9358) are described. Of
      the various oxa-, aza-, thia-, and carbacyclic esters initially prepared in the
      bis(pyrrolidinomethyl)-4-hydroxyphenylacetic acid series, the 1,4-benzodioxanyl-2
      methyl(3q) and the thienyl-2-methyl(31) esters were evaluated in vivo for
      antiarrhythmic efficacy. In addition, a number of monoappended phenylacetic
      esters of 3q with or without the 4-hydroxy group were also prepared for
      evaluation of antiarrhythmic, lipophilic, and metabolic properties. Of these
      compounds, 3q possessed the most desirable pharmacological and pharmacokinetic
      profile.

PMID- 8355251
TI  - Synthesis and binding properties of MK-801 isothiocyanates; (+)-3-isothiocyanato
      5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten- 5,10-imine hydrochloride: a
      new, potent and selective electrophilic affinity ligand for the NMDA receptor
      coupled phencyclidine binding site.
AB  - Three new site-directed irreversible (wash-resistant) ligands for the high
      affinity phencyclidine (PCP) binding site associated with the N-methyl-D
      aspartate (NMDA) receptor were synthesized and their binding characteristics were
      studied. (+)-3- And (+)-2-isothiocyanato-5-methyl-10,11-dihydro-5H
      dibenzo[a,d]cycl ohepten-5,10 - imine hydrochloride ((+)-8a,b.HCl) were prepared
      in four steps from the corresponding nitro derivatives (+)-4a,b, which were
      obtained by nitration of (+)-3 (MK-801). In the same way the optical antipode (-)
      8a.HCl was synthesized from (-)-3. At a concentration of 100 nM, the 3
      isothiocyanate derivative (+)-8a irreversibly labeled approximately 50% of the
      (+)-[3H]-3 binding sites, compared to 20 microM needed for its optical antipode (
      )-8a and the 2-isothiocyanate (+)-8b. The apparent Ki values for reversible
      inhibition of (+)-[3H]-3 binding by (+)- and (-)-8a and (+)-8b were 37,838, and
      843 nM, respectively. In contrast, metaphit (1b) and etoxadrol m-isothiocyanate
      (2b), two previously reported irreversible ligands for the PCP binding site,
      label about 50% of the (+)-[3H]-3 binding sites at 100 microM and 250 nM,
      respectively, with apparent Ki values for reversible inhibition of 535 and 94 nM.
      Compound (+)-8a is also a selective affinity ligand, displaying little or no
      irreversible in vitro affinity at 100 microM for opioid, benzodiazepine,
      muscarinic, and dopamine receptors. At a 25 microM concentration, (+)-8a caused
      an irreversible 52% reduction of binding to sigma 1-receptors. Compound (+)-8a is
      the most potent known electrophilic affinity label for the PCP binding site. Its
      potency and selectivity should enable it to be a valuable tool for the
      elucidation of the structure and function of the NMDA receptor-associated PCP
      binding site in the mammalian central nervous system.

PMID- 8355252
TI  - Adenosine A1 antagonists. 3. Structure-activity relationships on amelioration
      against scopolamine- or N6-((R)-phenylisopropyl)adenosine-induced cognitive
      disturbance.
AB  - The effects of a variety of adenosine A1 and A2 antagonists on N6-((R)
      phenylisopropyl)adenosine (R-PIA)- and scopolamine-induced amnesias were
      investigated in rodents in order to clarify the role of adenosine receptors in
      learning and memory. Some of the selective adenosine A1 antagonists exhibited
      antiamnesic activities at several doses where they did not induce an increase of
      spontaneous locomotion. These results suggest that the blockade of A1 receptors
      is more important than that of A2 receptors in learning and memory. Detailed
      studies of structure-activity relationships of adenosine A1 antagonists in two
      amnesia models demonstrated that there were three types of adenosine A1
      antagonists: (A) Compounds 3-5 (8-substituted 1,3-dipropylxanthines) ameliorated
      the shortened latency in both models. (B) Compounds 7-11 (8-substituted 1,3
      dialkylxanthines) and 19-21 (imidazo[2,1-i]purin-5(4H)-one derivatives)
      ameliorated the shortened latency in the (R)-PIA-induced amnesia model but not in
      the scopolamine-induced amnesia model. (C) Compounds 14-16 ameliorated the
      shortened latency in the scopolamine model but not in the (R)-PIA model.
      Aminophenethyl-substituted compounds C did not exhibit adenosine A1 antagonism in
      vivo presumably due to rapid metabolism. The dramatic change in the activities of
      A and B could not be explained by their simple pharmacokinetic differences
      because both types of compounds showed clear blockade of central adenosine A1
      receptors in the (R)-PIA model. 8-(3-Dicyclopropylmethyl)-1,3-dipropylxanthine
      (5) (KF15372) was chosen for further studies and is currently under preclinical
      development as a cognition enhancer.

PMID- 8355254
TI  - Synthesis and antimalarial activity of some 9-substituted artemisinin
      derivatives.
AB  - Several 9-substituted derivatives of the antimalarial drug artemisinin have been
      prepared by functionalizing the double bond of artemisitene and related
      compounds. Stereochemical assignments for these compounds were made using a
      combination of NMR experiments, an X-ray diffraction study of one compound, and
      chemical correlations of several other compounds with this one compound of
      unambiguous structure and with its epimer. The compounds synthesized show a wide
      variation in in vitro antimalarial activity.

PMID- 8355253
TI  - Antagonism of 1-(2,5-dimethoxy-4-methylphenyl)-2-aminopropane stimulus with a
      newly identified 5-HT2- versus 5-HT1C-selective antagonist.
AB  - DOM [i.e., 1-(2,5-dimethoxy-4-methylphenyl)-2-aminopropane] is a 5-HT1C/2
      serotonin agonist that exerts stimulus control of behavior in animals. In order
      to determine if the discriminative stimulus effect of DOM is 5-HT1C- or 5-HT2
      mediated, it would be informative to conduct tests of stimulus antagonism with a
      5-HT1C- or 5-HT2-selective antagonist. To date, no such agents exist. Although
      the neuroleptic agent spiperone binds at D2 dopamine receptors and 5-HT1A
      serotonin receptors, (a) it displays about a 1000-fold selectivity for 5-HT2
      versus 5-HT1C sites and (b) it has been used as a "5-HT2-selective" antagonist.
      Because spiperone is a behaviorally disruptive agent, it is not suitable for use
      in drug-discrimination studies. Using the spiperone molecule as a starting point,
      a limited structure-affinity investigation was conducted in order to identify a
      suitable antagonist with high affinity and selectivity for 5-HT2 receptors, and
      yet an antagonist that might lack the disruptive actions of spiperone. Various
      modifications of the spiperone molecule were examined, but most resulted in
      decreased 5-HT2 affinity or in loss of selectivity. One compound, 8-[3-(4
      fluorophenoxy)propyl]-1-phenyl-1,3,8-triazaspiro[4.5]de can-4-on e (26), was
      shown to bind at 5-HT2 sites with high affinity (Ki = 2 nM) and > 2,000-fold
      selectivity versus 5-HT1C sites. In tests of stimulus antagonism using rats
      trained to discriminate 1 mg/kg of DOM from saline vehicle, 26 behaved as a
      potent antagonist (ED50 = 0.003 mg/kg) and lacked the disruptive effects
      associated with spiperone. As such, (a) it would appear that the DOM stimulus is
      primarily a 5-HT2-mediated, and not 5-HT1C-mediated, phenomenon, and (b) compound
      26 may find application in other pharmacologic investigations where spiperone may
      not be a suitable antagonist.

PMID- 8355255
TI  - Triazolinones as nonpeptide angiotensin II antagonists. 1. Synthesis and
      evaluation of potent 2,4,5-trisubstituted triazolinones.
AB  - A series of 2,4-dihydro-2,4,5-trisubstituted-3H-1,2,4-triazol-3-ones was prepared
      via several synthetic routes and evaluated as AII receptor antagonists in vitro
      and in vivo. The preferred compounds contained a [2'-(5-tetrazolyl)biphenyl-4
      yl]methyl side chain at N4 and an n-butyl group at C5. A number of these bearing
      an alkyl or aralkyl substituent at N2 showed in vitro potency in the nanomolar
      range (rabbit aorta membrane receptor), and several of these, e.g., the 2,2
      dimethyl-1-propyl analogue (54, IC50 = 2.1 nM), effectively blocked the AII
      pressor response in conscious rats with significant duration (2.5 h at 1 mg/kg
      orally for 54). Among analogues possessing aryl substituents at N2, ortho
      substitution on the phenyl moiety resulted in several derivatives with in vitro
      potency in the low nanomolar range. One of these, featuring a 2
      (trifluoromethyl)phenyl substituent at N2 (25, IC50 = 1.2 nM), was effective at 1
      mg/kg orally in the rat model, with a duration of > 6 h. Implications for
      hydrophobic and hydrogen-bonding interactions with the AT1 receptor are
      discussed.

PMID- 8355256
TI  - Peptidomimetic HIV protease inhibitors: phosphate prodrugs with improved
      biological activities.

PMID- 8355257
TI  - Nitrobenzyl mustard quaternary salts: a new class of hypoxia-selective cytotoxins
      showing very high in vitro selectivity.

PMID- 8355258
TI  - Ethyl substitution at the 7 position extends the half-life of 10
      hydroxycamptothecin in the presence of human serum albumin.

PMID- 8355259
TI  - Effects of carbon tetrachloride, menadione, and paraquat on the urinary excretion
      of malondialdehyde, formaldehyde, acetaldehyde, and acetone in rats.
AB  - Excretions of the lipid peroxidation products, formaldehyde (FA), acetaldehyde
      (ACT), malondialdehyde (MDA), and acetone (ACON), were simultaneously identified
      and quantitated in the urine of female Sprague-Dawley rats by gas chromatography
      mass spectroscopy (GC-MS) and high pressure liquid chromatography (HPLC)
      following the acute administration of carbon tetrachloride, a model alkylating
      agent that does not induce glutathione depletion, and the redox cycling compounds
      paraquat and menadione. All three xenobiotics are well-known inducers of
      oxidative stress. Oxidative stress was induced by oral administration of single
      doses of 2.5 mL of carbon tetrachloride/kg, 60 mg menadione/kg, and 75 mg
      paraquat/kg. These doses are approximately 50% of the LD50's for the three
      xenobiotics. Urinary excretion of FA, ACT, MDA, and ACON increased relative to
      control animals following treatment with all xenobiotics. Over the 48 hours of
      the study, the greatest increases in the excretion of MDA, FA, ACT, and ACON
      occurred after paraquat administration, with increases of approximately 2.7-, 2.6
      , 4.3-, and 11.0-fold, respectively. This technique may have wide-spread
      applicability as an effective biomarker for investigating altered lipid
      metabolism in disease states and exposure to environmental
      pollutants/xenobiotics.

PMID- 8355260
TI  - Immobilized rhodanese: some aspects of anion inhibition kinetics and modulation
      by cations.
AB  - The rat liver rhodanese (thiosulphate: cyanide sulfurtransferase EC 2.6.1.1) has
      been immobilized on polyacrylamide gels. The immobilized enzyme had a pH optimum
      of 7.4 and Km values of 3.25 mM and 1.12 mM for S2O3(2-) and KCN, respectively.
      The enzyme was competitively inhibited by NaNO2 and CH3COONa and noncompetitively
      by amyl-nitrite. A modulation of activity was observed in the presence of Ca2+,
      Zn2+, and Cu2+. The results are discussed in line with the detoxicating function
      of liver rhodanese.

PMID- 8355261
TI  - Isolation and characterization of mitochondrial acyl-CoA: glycine N
      acyltransferases from kidney.
AB  - When bovine kidney mitochondria were assayed in the presence of Triton X-100,
      they were found to contain glycine N-acyltransferase activity toward the CoA
      adducts of benzoate, butyrate, isovalerate, naphthylacetate, phenylacetate, and
      salicylate. Heptanoyl-CoA activity was masked by high acyl-CoA hydrolase
      activity. All activities found in detergent-lysed mitochondria, and also that
      toward heptanoyl-CoA, could be released in soluble form by repeated cycles of
      freeze-thawing. Activity in the particle-free lysate decreased in the order:
      phenylacetyl-CoA > benzoyl-CoA > salicylyl-CoA > butyryl-CoA > naphthylacetyl-CoA
      > heptanoyl-CoA > isovaleryl-CoA. This is quite different from liver, where the
      activity toward the arylacetic acids is much lower and the other activities are
      higher. This reflects a major difference in the relative expression of the
      aralkyl and arylacetyl transferases between liver and kidney. The phenylacetyl
      CoA and naphthylacetyl-CoA activity purified with a single protein which is
      termed the arylacetyl transferase. This enzyme was similar to the hepatic
      arylacetyl transferase in terms of its sensitivity to sulfhydryl reagents,
      response to cations, and molecular weight (33,500). Activity toward benzoyl-CoA
      also purified as a single form which was similar to the hepatic form in its
      molecular weight (34,000), response to cations, and kinetic properties.
      Conditions leading to the inhibition of this kidney form and also the hepatic
      form by p-mercuribenzoate are described.

PMID- 8355262
TI  - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) alters pancreatic membrane tyrosine
      phosphorylation following acute treatment.
AB  - To understand the basic mechanisms of TCDD's action to cause hypoinsulinemia in
      several experimental animals, we have studied TCDD-induced changes in various
      protein kinase activities in membrane preparations of guinea pig pancreas. For
      this purpose, young male guinea pigs were treated through a single
      intraperitoneal injection with 1 or 3 micrograms/kg of TCDD in vivo, and, after
      given time periods, pancreas samples were obtained and membranes were isolated
      through homogenization and centrifugation procedures. Several sets of incubation
      conditions were selected for protein kinase activity assay, each favoring a
      specific type of protein kinase. It was found that overall protein
      phosphorylation activities were higher in the preparation from TCDD-treated
      animals as compared to those found in pair-fed controls and that this trend was
      more pronounced when the assay medium contained Mn2+ in place of Mg2+ and EGTA.
      These are the conditions that are known to favor protein tyrosine kinases. Other
      types of protein kinases from the treated animals did not show any significant
      differences from the pair-fed control animals, though that of protein kinase C in
      the treated preparation showed a modest increase. To establish that the type of
      protein kinases stimulated by TCDD are protein tyrosine kinases, we have carried
      out phosphoamino acid analyses, KOH digestion, and western blot analyses using an
      antibody to phosphotyrosine. All the results were consistent in supporting the
      idea that TCDD causes a rise in protein-tyrosine kinases in pancreas at early
      stages of poisoning.

PMID- 8355263
TI  - The effect of the cytochrome P-450 system inducers on the development of
      Drosophila melanogaster.
AB  - D. melanogaster development was markedly retarded and its survival decreased by
      larvae treatment with compounds being strong inducers of the cytochrome P-450 2B
      in mammals--phenobarbital (PB*), perfluorodecaline (PFD), transtilbene oxide
      (TSO), and triphenyldioxane (TPD). At the same time, the weak inducer
      hexobarbital or the selective cytochrome P-450 inducer in mice but not in rats
      1,4-bis[2-(dichloropyridyl-oxy)]-benzene (DPB) did not affect the larvae
      development. The cytochrome P-450 1A1 inducers benzo(a)anthracene (BA) and beta
      naphtoflavone (BNF) were also not effective. The toxicity of phenobarbital was
      shown to be decreased by the cytochrome P-450 inhibitor piperonyl butoxide by
      adding 20-hydroxyecdysone or by treatment with aminophylline--the indirect
      enhancer of ecdysone production in the larval prothoracic gland. The hypothesis
      of the moulting hormone degradation as the cause of elevated larvae mortality
      resulting from the induced high mixed function oxidase activity has been
      discussed.

PMID- 8355264
TI  - Crystallization of barley (1-3,1-4)-beta-glucanase, isoenzyme II.
AB  - The (1-3,1-4)-beta-glucanase from barley (Hordeum vulgare, cv Alexis) degrades
      mixed linked beta-glucan in the cell wall of the starchy endosperm. Isoenzyme II
      of the (1-3,1-4)-beta-glucanase forms large single crystals when a protein
      solution is equilibrated against 20% (w/w) polyethylene glycol 8000 at acidic pH
      using the hanging drop vapour diffusion method. The crystals diffract to better
      than 2 A resolution. They are monoclinic, space group P2(1), with cell dimensions
      a = 49.58 A, b = 82.99 A, c = 77.56 A and beta = 104.36 degrees. Two protein
      molecules are estimated to fill the asymmetric unit.

PMID- 8355265
TI  - Crystallization of bacteriophage fr and its recombinant capsids.
AB  - Single crystals of Escherichia coli bacteriophage fr and its recombinant capsids
      have been obtained by the vapour diffusion technique in the presence of ammonium
      sulphate. They diffract X-rays to at least 3.5 A. Electron microscopic
      observation of the crystals revealed a three-dimensional lattice of particles
      with RNA phage morphology and dimensions.

PMID- 8355267
TI  - A model of the three-dimensional structure of ice nucleation proteins.
AB  - Bacterial ice-nucleation proteins are among the most active natural ice nucleants
      and can reduce the supercooling point of water in plants, thereby reducing the
      ability of sensitive plants to avoid damaging ice formation. We describe a
      structural model for bacterial ice-nucleation proteins based on molecular
      modelling. This model predicts a largely planar extended molecule, with one side
      serving as a template for orienting water into an ice lattice and the other side
      interacting with the membrane. The model also predicts that single molecules can
      form aggregates of unlimited size by interdigitation.

PMID- 8355266
TI  - Crystallization of a genetically engineered water-soluble primary penicillin
      target enzyme. The high molecular mass PBP2x of Streptococcus pneumoniae.
AB  - A genetically engineered water-soluble derivative of PBP2x of Streptococcus
      pneumoniae has been produced, purified and crystallized in a form suitable for X
      ray diffraction analysis. The best crystals have been grown at 15 degrees C, from
      solutions containing 8% polyethylene glycol 10,000 at pH values ranging from 3.9
      to 6.0. These crystals diffract to a resolution of 3.5 A and have a space group
      P6(1)22 (or enantiomorph) with unit cell dimensions of a = b = 162.2 A, c = 171.8
      A, alpha = beta = 90 degrees, gamma = 120 degrees. The molecular mass and cell
      dimensions suggest that there is one molecule of enzyme per asymmetric unit. The
      breakdown of a chromogenic cephalosporin derivative diffused into a crystal
      reveals clearly that the enzyme is active in the crystalline state.

PMID- 8355268
TI  - The phase transition between a compact denatured state and a random coil state in
      staphylococcal nuclease is first-order.
AB  - Three mutants of staphylococcal nuclease containing a tryptophan substitution
      have been examined in the full length (149 residues) protein and in a large
      fragment (residues 1 to 136). The large fragments are not in the native state and
      are a good model of the denatured state. However, these large fragments do show
      signs of residual structure that breaks down upon titration with guanidine
      hydrochloride. They share some similarities with what has become known as the
      molten globule state. The thermal unfolding of these mutant fragments was
      followed by tryptophan fluorescence. Tryptophan fluorescence was treated as an
      order parameter and analyzed to determine the order of the observed transition.
      The critical exponent of the order parameter as the transition temperature is
      approached is significantly higher than the value of 1/2 predicted by mean field
      theory for a second-order transition and is similar to that observed for the
      transition of the full length, wild-type, protein. This is strong evidence that
      the breakdown of this intermediate compact denatured state is a cooperative,
      first-order phenomenon.

PMID- 8355269
TI  - RIP60 dimers and multiples of dimers assemble link structures at an origin of
      bidirectional replication in the dihydrofolate reductase amplicon of Chinese
      hamster ovary cells.
AB  - We show assembly of low and high multimers of HeLa cell nuclear protein, RIP60,
      at the origin of bidirectional replication (OBR) identified by Burhans, Vassilev,
      Caddle, Heintz and DePamphilis in Chinese hamster ovary cells. RIP60 binds a 5'
      ATT-3' reiterated sequence downstream of the OBR and a second, homologous ATT
      sequence of opposite orientation situated within the OBR zone. Specifically bound
      structures were studied by conventional electron microscopy (EM) and quantitative
      scanning transmission electron microscopy (STEM). Dimers and multiples of dimers
      link the downstream binding site that overlaps a bent DNA sequence and the
      homologous upstream OBR sequence, looping out 700 bp of intervening DNA.
      Superposed dimers are found at individual unlinked sites, stabilized presumably
      through protein-protein interaction, and such superposition appears to occur also
      in the basic link structure. Along the loop, single crossovers and extended
      twists are observed by conventional EM. By STEM, loop DNA is laterally compacted,
      with diameter and mass equivalent to double-duplex DNA strands. Supercoiled 736
      bp and 5243 bp circular DNAs assume similar laterally compacted geometries that
      are mostly absent from relaxed forms. These observations parallel the compacted,
      interwound superhelices viewed by cryo-electron microscopy in vitrified solutions
      containing magnesium ions, and provide structural evidence in agreement with that
      from conventional EM for superhelical tension in RIP60 loop DNA. Loop
      superhelicity could arise as a topological response to linking and suggests a
      functional role for link formation.

PMID- 8355270
TI  - Homologous DNA targeting with RecA protein-coated short DNA probes and electron
      microscope mapping on linear duplex molecules.
AB  - We demonstrate that RecA protein-coated, short single-stranded DNA probes paired
      with a specific homologous DNA sequence in a linear duplex target molecule and
      accurately targeted the selected DNA sequence. RecA protein-coated complementary
      ssDNA probes were reacted with linear duplexes, and the homologously paired
      molecules were observed by electron microscopy. The sites of interaction between
      the RecA protein-coated DNA probes and the uncoated duplex DNA targets were
      directly visible on individual target DNA molecules by high-resolution darkfield
      electron microscopy, without chemical fixation or sample shadowing. The
      efficiency and specificity of pairing were verified with 446 and 222 base single
      stranded DNA probes that shared no homology with one another, and several linear
      duplex target DNAs with their respective probe homology sites at different
      locations with respect to the ends of the double-stranded DNA molecules.
      Measurements of the position of RecA protein-coated probes paired to individual
      target molecules, observed at high magnification, showed that DNA probes
      specifically paired at their corresponding homologous target sequences. This RecA
      protein-mediated DNA mapping method allows homologous sequence positioning and
      gene mapping on individual double-stranded DNA molecules. Targeting reactions in
      which two different probe/target sites were 900 bases apart on a single duplex
      target molecule allowed both sites to be mapped in the same targeting reaction;
      although targets displaying both probes simultaneously were seen much less
      frequently than expected. The possible torsional or mechanistic constraints
      related to these reactions are briefly discussed.

PMID- 8355271
TI  - Modulation of P(RM) activity by the lambda PR promoter in both the presence and
      absence of repressor.
AB  - When the transcription startsites of the phage lambda promoters PRM and PR are
      separated by 82 bp (the wild-type spacing), mutating PR increases the rate of
      open complex formation at PRM at all RNA polymerase (RNAP) concentrations tested
      in vitro. This is reflected in a fourfold increase in kappa f (the rate constant
      for isomerization of closed to open complexes) and a threefold decrease in KB
      (the equilibrium constant for formation of closed complexes). These effects of
      mutating PR resemble qualitatively those we observed when the separation between
      the two promoters was decreased by a single base-pair, but are quantitatively
      less dramatic. Although mutating PR has the additional effect of uncovering a
      weak promoter, P alpha, which overlaps both PRM and PR, the presence of P alpha
      does not account for the effects of PR mutations on open complex formation at
      PRM. In fixed-time assays at a single RNAP concentration, repressor stimulated
      PRM approximately threefold on a PR- template, indicating that activation is
      mediated substantially by a direct interaction between repressor and RNAP. That
      is, activation of PRM is not merely an indirect consequence of repressing PR.
      Kinetic data confirm this conclusion. In a PR- genetic background, repressor
      increased kappa f six- to eightfold and decreased KB approximately twofold.
      Similar results were obtained when OR3 was mutated, indicating that the effect on
      KB is not due to repressor binding to OR3. Thus, repressor causes a significant
      increase in the rate of open complex formation at PRM even when PR is inactive.
      On a PR+ template, 75 nM repressor stimulated PRM by increasing kappa f
      eightfold, with no effect on KB, which agrees with previous results. However,
      increased repressor concentrations stimulated kappa f by an additional factor of
      two to four, indicating that previous experiments underestimated the effect of
      repressor on kappa f. At the same time, increasing the repressor concentration
      decreased KB for PRM on a wild-type template. At the highest repressor
      concentration tested (275 nM), KB decreased 15-fold, presumably due to OR3
      mediated repression of PRM. However, at an intermediate repressor concentration
      (170 nM) values of kappa f and KB for PRM on a PR+ template were in close
      agreement with the corresponding parameters obtained on a PR- template. These
      data lead us to suggest that repressor causes a decrease in KB for PRM on both a
      PR+ and a PR- template independent of its ability to bind to OR3.

PMID- 8355272
TI  - Prediction of protein structure by evaluation of sequence-structure fitness.
      Aligning sequences to contact profiles derived from three-dimensional structures.
AB  - The problem of protein structure prediction is formulated here as that of
      evaluating how well an amino acid sequence fits a hypothetical structure. The
      simplest and most complicated approaches, secondary structure prediction and all
      atom free energy calculations, can be viewed as sequence-structure fitness
      problems. Here, an approach of intermediate complexity is described, which
      involves; (1) description of a protein structure in terms of contact interface
      vectors, with both intra-protein and protein-solvent contacts counted, (2)
      derivation of sequence preferences for 2 up to 29 contact interface types, (3)
      generation of numerous hypothetical model structures by placing the input
      sequence into a large set of known three-dimensional structures in all possible
      alignments, (4) evaluation of these models by summing the sequence preferences
      over all structural positions and (5) choice of predicted three-dimensional
      structure as that with the best sequence-structure fitness. Evolutionary
      information is incorporated by using position-dependent core weights derived from
      multiple sequence alignments. A number of tests of the method are performed: (1)
      evaluation of cyclic shifts of a sequence in its native structure; (2) alignment
      of a sequence in its native structure, allowing gaps; (3) alignment search with a
      sequence or sequence fragment in a database of structures; and (4) alignment
      search with a structure in a database of sequences. The main results are: (1) a
      native sequence can very well find its native structure among a large number of
      alternatives, in correct alignment; (2) substructures, such as (beta alpha)n
      units, can be detected in spite of very low sequence similarity; (3) remote
      homologous can be detected, with some dependence on the set of parameters used;
      (4) contact interface parameters are clearly superior to classical secondary
      structure parameters; (5) a simple interface description in terms of just two
      states, protein-protein and protein-water contacts, performs surprisingly well;
      (6) the use of core weights considerably improves accuracy in detection of remote
      homologues; (7) based on a sequence database search with a myoglobin contact
      profile, the C-terminal domain of a viral origin of replication binding protein
      is predicted to have an all-helical fold. The sequence-structure fitness concept
      is sufficiently general to accommodate a large variety of protein structure
      prediction methods, including new models of intermediate complexity currently
      being developed.

PMID- 8355273
TI  - The phage 434 OR2/R1-69 complex at 2.5 A resolution.
AB  - The crystal structure of the DNA-binding domain of bacteriophage 434 repressor
      (R1-69) in complex with a 20 base-pair DNA fragment has been determined to 2.5 A
      resolution. The DNA fragment contains the sequence of the OR2 operator site,
      which differs from the previously studied OR1 site at three of the variable six
      central base-pairs. Comparison of the two structures shows that the overall bent
      conformation of the DNA backbone as well as the pattern of DNA-protein
      interactions seen in the OR1/R1-69 complex are maintained in the OR2 complex.
      However, the conformations of the DNA base-pairs are different in the two
      structures. In particular, the central base-pairs of OR2/R1-69 structure are more
      co-planar than in OR1/R1-69, and there are no cross-strand "bifurcated" hydrogen
      bonds. These results show that binding of the protein causes operator DNA to
      adopt a particular, well-defined backbone conformation, and they reinforce the
      notion that the energetic cost of achieving this conformation, most likely
      different for different sequences, can determine, at least in part, the relative
      affinity of the repressor for different operator sites.

PMID- 8355274
TI  - Crystal structure of a porcine pancreatic phospholipase A2 mutant. A large
      conformational change caused by the F63V point mutation.
AB  - The highly homologous bovine and porcine pancreatic phospholipase A2 (85% amino
      acid residue identity) show a large conformational difference in the loop from
      residue 59 to 71. In bovine phospholipase A2 residues 59 to 66 adopt an alpha
      helix conformation, while residues 67 to 71 are in a surface loop. Residues 59 to
      66 in the porcine enzyme have a random coil conformation, and residues 67 to 71
      form a short 3(10)-helix. It has been suggested that most probably this
      conformational difference is caused by the substitution Val63 (bovine) to Phe63
      (porcine) in the otherwise invariant loop 59 to 70. To test this hypothesis, a
      mutant porcine phospholipase A2 was constructed in which residue Phe63 was
      replaced by a Val. The activity of this F63V mutant towards aggregated substrates
      was about half the activity of wild-type porcine phospholipase A2, but
      significantly different from that of the bovine enzyme. The affinity for
      zwitterionic interfaces was found to be intermediate between porcine and bovine
      phospholipase. The mutation did not have any effect on the stability of the
      enzyme towards denaturation by guanidine.HCl. The F63V mutant was crystallized in
      space group P2(1)2(1)2(1) with cell dimensions a = 79.88 A, b = 65.23 A, c =
      52.62 A, with two molecules per asymmetric unit. Its three-dimensional structure
      was solved by molecular replacement methods, and refined to a crystallographic R
      factor of 17.6% for all data between 10 and 2.2 A resolution. In one molecule the
      58 to 71 loop is in very weak density, suggesting a high degree of disorder or
      flexibility. The conformation of the same loop in the other molecule could be
      determined unambiguously. It shows a conformation which resembles more that of
      bovine phospholipase A2 than that of porcine phospholipase. It is concluded that
      indeed the single F63V substitution causes a dramatic conformational change.

PMID- 8355275
TI  - Refined X-ray structures of haloalkane dehalogenase at pH 6.2 and pH 8.2 and
      implications for the reaction mechanism.
AB  - The crystal structure of haloalkane dehalogenase from Xanthobacter autotrophicus
      GJ10 has been refined at 1.9 A resolution at two different pH values, the pH of
      crystallization (pH 6.2) and the pH of optimal activity (pH 8.2), to final R
      factors of 16.8% and 16.4%, respectively. Both models show good stereochemical
      quality. Two non-glycine residues have main-chain torsion angles that are located
      outside the "allowed" regions in a Ramachandran plot. One of them is the
      nucleophilic residue Asp124, which, together with the two other active site
      residues His289 and Asp260, is situated in an internal, predominantly hydrophobic
      cavity. The other residue, Asn148, helps stabilize the conformations of two of
      these active-site residues, Asp124 and Asp260. Comparison of the models at pH 6.2
      and pH 8.2 revealed one major structural difference. At pH 6.2, a salt-bridge is
      present between the N epsilon 2 atom of His289 and the O delta 1 atom of Asp124,
      while at pH 8.2, this salt-bridge is absent, indicating that the N epsilon 2 atom
      of the histidine residue is mostly deprotonated at the pH of optimum activity.
      This is in agreement with the putative reaction mechanism in which the O delta 1
      atom of Asp124 performs a nucleophilic attack on the substrate, resulting in an
      intermediate ester. This ester is subsequently cleaved by a hydrolytic water
      molecule. The high-resolution data sets clearly show the exact position of this
      water molecule. It is in an ideal position for donating a proton to the N epsilon
      2 atom of His289 and subsequently cleaving the covalently bound intermediate
      ester, releasing the alcohol product. Detailed investigation of both refined
      models showed a number of unusual structural features. Four out of 11 helices
      contain an internal proline residue other than in the first turn. Two other alpha
      helices have adopted in their central part a 3(10) conformation. A novel four
      residue turn between a helix and a strand, the alpha beta 4 turn, is located at
      the site of the bend in the central eight-stranded beta-sheet of the dehalogenase
      structure.

PMID- 8355276
TI  - Determination of the disulphide bonding pattern in proteins by local and global
      analysis of nuclear magnetic resonance data. Application to flavoridin.
AB  - This paper describes a new method for the elucidation of the disulphide bonding
      pattern in a protein from an initial set of unrefined nuclear magnetic resonance
      solution structures. The use of both local and global proton-proton nuclear
      Overhauser enhancement (NOE) distance information for the identification of the
      disulphide bridge network in cysteine-rich polypeptides was investigated by
      statistical analysis of the crystal structures of a selected group of proteins.
      There are six different types of inter-cysteine proton-proton distances which can
      potentially be used for the prediction of disulphide links. The uniqueness and
      the extent to which disulphide bonds could be identified by these distances was
      evaluated. Only NOEs between C beta H/C beta H and C alpha H/C beta H were shown
      to have positive predictive values for the characterization of disulphide links.
      Contrarily, the observation of an NOE between C alpha H and NH is a strong
      indication for the absence of a disulphide bridge between the two residues. The
      global analysis of the nuclear magnetic resonance data starts with the
      calculation of an initial set of conformers. First, pairing weights wij were
      assigned to all putative cysteine pairs in the protein according to a Gaussian
      type distribution function from the C beta-C beta interatomic distances. In a
      second step, all conceivable disulphide patterns were formed by an exhaustive
      combinatorial enumeration. Statistical weights were then assigned to all patterns
      from the weights of the participating cysteine pairs. This method was validated
      with protein crystal structures deposited in the Brookhaven Protein Data Bank
      having three or more cysteine residues. It was then used to determine the
      previously unknown disulphide bonding pattern of the 12 cysteine residues of
      flavoridin.

PMID- 8355277
TI  - The nuclear magnetic resonance solution structure of flavoridin, an antagonist of
      the platelet GP IIb-IIIa receptor.
AB  - The snake venom protein flavoridin, a polypeptide of 70 amino acid residues, is a
      potent inhibitor of blood platelet aggregation. It binds to cell-surface integrin
      receptors such as the fibrinogen receptor glycoprotein IIb/IIIa. The inhibitory
      properties of flavoridin have been attributed to the tripeptide segment Arg-Gly
      Asp (residues 49 to 51). This paper describes the determination of the three
      dimensional structure of flavoridin in aqueous solution based on two-dimensional
      nuclear magnetic resonance spectroscopy. A family of 18 conformers was selected
      to characterize the solution structure. The molecule comprises two structural
      domains, an N-terminal unit extending from residues 1 to 25, and a C-terminal
      unit from residues 26 to 70. Whereas the mutual spatial orientation of these
      regions is not well defined, each one is well organized within itself. The
      segment 26 to 70, which is homologous to the sequence of the snake toxins
      echistatin and eristostatin, shows an average value of 1.0 A for the root-mean
      square deviations of the backbone atoms among the 18 conformers. The structure of
      flavoridin consists essentially of non-repetitive elements such as tight turns
      and loops, whose location and conformation are characterized in this paper. With
      the exception of two short regions of antiparallel beta-sheet, no classic element
      of protein secondary structure is present. The six disulphide bridges, which have
      been mapped by applying a novel computational strategy (see accompanying paper),
      are the dominant organizational feature of the polypeptide fold of flavoridin.
      Two of the bridges are located in the N-terminal domain, three in the C-terminal
      domain and one connects the two structural units. The mobile RGD recognition
      sequence for integrins is located peripheral to the core region of the C-terminal
      domain at the most exposed end of a nine residue loop structure, which is
      attached to a short beta-sheet. The C terminus is close to this loop structure.

PMID- 8355278
TI  - Characterization of a triple helix-specific ligand. BePI (3-methoxy-7H-8-methyl
      11- [(3'-amino)propylamino]-benzo[e]pyrido[4,3-b]indole) intercalates into both
      double-helical and triple-helical DNA.
AB  - A benzo[e]pyridoindole derivative, 3-methoxy-7H-8-methyl-11-[(3'
      amino)propylamino] -benzo[e]pyrido[4,3-b]indole (BePI), and its interactions with
      double and triple-helical DNA have been investigated by a variety of
      fluorescence, spectrophotometric, hydrodynamic and molecular modeling techniques.
      Binding to DNA stabilizes the doubly charged (+2) form of BePI, increasing the
      apparent pKa of the 10-NH proton by approximately 1 pH unit. Binding to DNA also
      quenches the fluorescence of BePI, with a greater extent of quenching upon
      binding triplex relative to duplex DNA. BePI preferentially binds (and
      stabilizes) triple-helical relative to double-helical DNA. This preferential
      binding is not restricted to triplexes containing solely T x A.T base triplets.
      In addition, BePI preferentially stabilizes the poly(dA).poly(dT) relative to the
      poly[d(A-T)].poly[d(A-T)] duplex. Viscosity studies demonstrate that, upon
      binding, BePI induces the unwinding of negative supercoils in the pBR322 plasmid,
      and increases the relative contour lengths of double and triple-helical
      polydeoxynucleotides. Fluorescence studies reveal that energy transfer occurs
      from polynucleotide bases to bound BePI molecules in both BePI/duplex and
      BePI/triplex complexes. In a BePI/triplex complex, an average of 4.8 bases appear
      to transfer excitation energy totally to a bound BePI molecule, while in various
      BePI/duplex complexes an average of only 2.5 bases appear to do so, indicating
      that energy transfer is more efficient in the former complex. Measurements of
      fluorescence quenching indicate that BePI is protected from quenching by
      acrylamide when bound to either double or triple-helical polynucleotides. The
      viscosity and fluorescence behavior of BePI are fully consistent with the
      conclusion that BePI intercalates into both double and triple-helical DNA.
      Molecular modeling studies suggest that stronger stacking interactions between
      intercalated BePI and adjacent bases in BePI/triplex relative to BePI/duplex
      complexes may account for the enhanced thermal stability of the former complex.

PMID- 8355279
TI  - Structure of human des(1-45) factor Xa at 2.2 A resolution.
AB  - The structure of a large molecular fragment of factor Xa that lacks only a Gla
      (gamma-carboxyglutamic acid) domain (N-terminal 45 residues) has been solved by X
      ray crystallography and refined at 2.2 A resolution to a crystallographic R-value
      of 0.168. The fragment identity was clearly established by automated Edman
      degradation. X-ray structure analysis confirmed the biochemical characterization
      and also revealed that the N-terminal epidermal growth factor (EGF)-like domain
      is flexibly disordered in crystals. The second EGF module, however, is
      positionally ordered making contacts with the catalytic domain. The overall
      folding of the catalytic domain is similar to that of alpha-thrombin, excluding
      the insertion loops of the latter with respect to simpler serine proteinases. The
      C-terminal arginine of the A-chain interacts in a substrate-like manner with the
      S1 specificity site of the active site of a crystallographically neighboring
      molecule. Based on this interaction and the structure of D-PheProArg methylene
      thrombin, a model of the commonly used dansylGluGlyArg methylene inhibitor-factor
      Xa interaction is proposed. The region of factor Xa corresponding to the
      fibrinogen recognition site of thrombin has a reversed electrical polarity to the
      anion binding fibrinogen recognition site of thrombin but possesses a site
      similar to the Ca2+ binding site of trypsin and other serine proteinases. The
      structure of the C-terminal EGF domain of factor Xa is the first to be determined
      crystallographically. Its folding has been comprehensively compared with similar
      domains determined by NMR. Although the A-chain makes 44 contacts at less than
      3.5 A with the catalytic domain, only 16 involve the EGF module. In addition, the
      A-chain makes 30 intermolecular contacts with a neighboring catalytic domain.

PMID- 8355280
TI  - Secondary structure and temperature-induced unfolding and refolding of
      ribonuclease T1 in aqueous solution. A Fourier transform infrared spectroscopic
      study.
AB  - The secondary structure of ribonuclease T1 (RNase T1) in aqueous solution and its
      temperature-induced structural changes have been investigated by Fourier
      transform infrared (FT-IR) spectroscopy. 13 to 14% alpha-helix and 32 to 33% beta
      sheet were estimated from the resolution-enhanced FT-IR spectra, in agreement
      with the crystal structure which indicates 16% alpha-helix and 35% beta-sheet.
      Specific IR-marker bands are assigned to the different beta-sheet structures, to
      the slightly bent alpha-helix, and to beta-turn and irregular conformations
      present in RNase T1. The temperature dependence of the infrared spectra shows
      that the thermal unfolding and refolding of RNase T1 is fully reversible. This
      permitted the detailed analysis of structural changes that occur as a function of
      temperature by evaluating quantitatively the various secondary structure-related
      amide I band components and some amino acid side-chain vibrations as specific
      monitors. The secondary structure of RNase T1 is essentially retained in the
      temperature range between 20 and 50 degrees C. Significant perturbation of
      protein structure is initiated between 50 and 55 degrees C within regions of beta
      sheet structures while the alpha-helix remains virtually intact up to 55 degrees
      C suggesting a "premelting" of RNase T1. Between 55 and 60 degrees C, a highly co
      operative unfolding process is indicated by the simultaneous breakdown of all
      secondary structure components and by distinct changes of some specific side
      chain vibrations. An analysis of the amide I band contour of RNase T1 at 70
      degrees C proves that the unfolded state is predominantly, but not completely,
      irregular or "random coil". Residual, turn-like structures persisting even in the
      unfolded state are suggested by minor, turn related band components in the amide
      I region. From IR-spectra collected along a linear temperature gradient,
      intensity/temperature and frequency/temperature profiles were constructed using
      some peptide backbone and amino acid side-chain marker bands as local, structure
      sensitive monitors. From these profiles individual transition temperatures tm and
      transition enthalpies delta H (van't Hoff) were calculated. The tm and delta H
      values revealed a small but distinct hysteresis between repetitive cycles of
      unfolding and refolding of the protein, suggesting slow refolding kinetics of
      RNase T1. Furthermore, the various infrared "marker bands" indicate a slightly
      different response towards temperature increase/decrease for different regions of
      the protein. The data demonstrate that infrared spectroscopy permits both the
      detailed analysis of structural changes occurring in a protein as a function of
      temperature and the determination of thermodynamic parameters characterizing its
      folded/unfolded state transition.

PMID- 8355281
TI  - Crystallization and preliminary X-ray analysis of the DNA binding domain of the
      Hin recombinase with its DNA binding site.
AB  - The Hin recombinase catalyzes site-specific inversion of DNA. Chemical and
      genetic studies on Hin binding to the recombination sites indicates that both
      major and minor DNA groove interactions are critical. In order to determine the
      molecular nature of these interactions, we have crystallized a synthetically
      derived 52 amino acid peptide consisting of the DNA binding domain of Hin with a
      14 base-pair oligonucleotide representing a recombination half-site. This
      communication presents preliminary diffraction and analysis of these cocrystals
      and a packing model for the complex within the crystal.

PMID- 8355282
TI  - Crystallization and preliminary X-ray diffraction analysis of crystals of
      Thermoascus aurantiacus xylanase.
AB  - Crystals suitable for high resolution X-ray diffraction analysis have been grown
      of the 29,774-Da protein, xylanase (1,-4-beta-xylan xylanohydrolase EC 3.2.1.8)
      from the thermophilic fungus Thermoascus aurantiacus. This protein, an
      endoxylanase demonstrates the hydrolysis of beta-(1-4)-D-xylose linkage in xylans
      and crystallizes as monoclinic pinacoids in the presence of ammonium sulphate
      buffered at pH 6.5, and also with neutral polyethylene glycol 6000. The crystals
      belong to space group P2(1) and have cell dimensions, a = 41.2 A, b = 67.76 A, c
      = 51.8 A; beta = 113.2 degrees.

PMID- 8355283
TI  - Preliminary crystallographic study of cyclohexadienyl dehydratase from
      Pseudomonas aeruginosa.
AB  - Single crystals of cyclohexadienyl dehydratase from Pseudomonas aeruginosa have
      been obtained by vapour diffusion from ammonium sulphate solution (pH 6.0) at 4
      degrees C. The crystals belong to the tetragonal space group P4(3)2(1)2 or
      P4(1)2(1)2 with a = b = 105.5 A and c = 165.0 A. The asymmetric unit contains at
      least one dimeric protein molecule with M(r) = 72 kDa. The crystals diffract to 3
      A resolution and are suitable for an X-ray analysis.

PMID- 8355284
TI  - Crystallization of a chitosanase from Streptomyces N174.
AB  - Chitosanases are produced by many soil fungi and bacteria to degrade chitosan
      present in fungal cell walls. Here, we report the crystallization of a 29,500
      dalton protein with chitosan endo-hydrolase activity isolated from Streptomyces
      N174. The crystals were grown by vapor diffusion. They are mechanically strong
      and diffract to at least 1.9 A resolution. The crystals belong to the monoclinic
      space group P2(1) with unit cell parameters a = 56.4 A, b = 59.6 A, c = 86.1 A
      and beta = 96.6 degrees. Cell parameters and crystal density are consistent with
      two chitosanase molecules per asymmetric unit.

PMID- 8355285
TI  - A toxin that recognizes muscarinic acetylcholine receptors. Preparation and
      characterization of crystals suitable for structural analysis.
AB  - Muscarinic toxin 2 from Dendroaspis angusticeps has been crystallized by vapour
      diffusion, in sodium acetate using sodium thiocyanate as a precipitant. Trigonal
      crystals (space group P3(1)21 or P3(2)21) have been obtained. The unit cell
      parameters are a = b = 64.2 A and c = 37.1 A. The presence of one molecule per
      asymmetric unit is estimated.

PMID- 8355286
TI  - Preliminary crystallographic studies on scytalone dehydratase from Magnaporthe
      grisea.
AB  - Magnaporthe grisea are pathogenic, directly penetrating fungi which cause rice
      blast disease. Isolated, non-pathogenic mutant strains which are defective in the
      biosynthesis of dihydroxynapthalene-derived melanin fail to infect host plants
      and have been shown to lack certain key enzymes in melanin biosynthesis. One such
      enzyme is scytalone dehydratase that converts scytalone to 1,3,8-trihydroxy
      naphthalene. Crystallization trials of scytalone dehydratase were undertaken with
      the expectation that structural information on this enzyme would facilitate
      design of high affinity inhibitors which might find use in the control of rice
      blast disease. We now report that recombinant scytalone dehydratase, complexed
      with a tight binding inhibitor, has been crystallized with PEG 4000 as a
      precipitant. The crystals are trigonal and belong to the space group P321 with
      the cell dimension: a = b = 75.5 A, c = 73.8 A. The observed diffraction extends
      to 2.5 A. Analysis of the packing in the cell suggests that scytalone dehydratase
      forms a symmetric trimer. These results are consistent with sedimentation
      equilibrium experiments indicating that the solution aggregation state of
      scytalone dehydratase was trimeric over a 24,000-fold concentration range.

PMID- 8355287
TI  - Teratogenicity study (segment II) of recombinant granulocyte-macrophage colony
      stimulating factors (LBD-005) in rats.
AB  - A teratogenicity study was carried out in Sprague-Dawley rats subcutaneously
      injected recombinant Granulocyte-Macrophage Colony Stimulating Factors (LBD-005),
      the growth of stem cell and the development of the hematopoietic cell, at dose
      levels of 250, 500 and 1000 micrograms/kg/day for a period of 11 days from day 7
      to day 17 of gestation. Two-thirds of the pregnant females in each group were
      sacrificed on day 20 of gestation and their fetuses were examined. The remaining
      dams were allowed to litter naturally, and the postnatal development of the
      offspring was observed. The incidences of external, internal and skeletal
      anomalies were not significantly increased in the fetuses of any treated groups.
      Recombinant GM-CSF caused no effects on parturition, lactation, postnatal growth
      and reproductive ability of the male and female offsprings.

PMID- 8355288
TI  - Peri- and postnatal study (segment III) of recombinant granulocyte-macrophage
      colony stimulating factors (LBD-005) in rats.
AB  - A perinatal and postnatal study was carried out in Sprague-Dawley rats
      subcutaneously injected recombinant Granulocyte-Macrophage Colony Stimulating
      Factors (LBD-005), the growth of stem cell and the development of the
      hematopoietic cell, at dose levels of 250, 500 and 1000 micrograms/kg/day for a
      period from day 17 of gestation to day 21 after delivery. All pregnant dams were
      allowed to litter naturally, and the postnatal development of the offsprings was
      observed. The incidences of external, internal and skeletal anomalies were not
      significantly increased in the F1 and F2 fetuses of any treated groups.
      Recombinant GM-CSF caused no effects on parturition, lactation, postnatal growth
      and differentiation, behaviour and reproductive ability of the male and female
      offsprings.

PMID- 8355289
TI  - An acute toxicity study of recombinant human interferon alpha A (LBD-007) in
      Sprague-Dawley rats.
AB  - The acute toxicity of a recombinant human interferon alpha A (code name: LBD-007)
      was evaluated in both sexes of Sprague-Dawley rats, 5 weeks old, by the oral,
      subcutaneous and intravenous routes of administration. Based on the results, LBD
      007 was not considered to induce any toxicological effect on the rats in
      mortalities, clinical findings, body weights and gross findings. It is suggested
      that LD50 values in rats would be > 48 x 10(8) IU/kg in the study of oral
      administration and > 24 x 10(8) IU/kg in the study of subcutaneous or intravenous
      administration.

PMID- 8355290
TI  - A 4-week subcutaneous toxicity study of recombinant human interferon alpha A (LBD
      007) in Sprague-Dawley rats.
AB  - Recombinant human interferon alpha A (code name: LBD-007) was subcutaneously
      administered to both sexes of Sprague-Dawley rats at the doses of 0, 6, 12 and 24
      x 10(6) IU/kg of body weight five days per week for 4 weeks to evaluate the
      subchronic toxicity. 20 to 50% of rats except the male control group showed
      minimal to mild, focal to multifocal renal mineralization. Whether renal
      mineralization is related to the test substance is not elucidated. Male rats
      dosed at 24 x 10(6) IU/kg showed the decrease of the absolute kidney weights and
      the increase of the brain relative weights. Female rats dosed at 24 x 10(6) IU/kg
      showed the increase of the absolute and relative ovary weights, and the decreases
      of specific gravity, bilirubin and urobilinogen in urine. However, no drug
      related changes were noted in clinical findings, body weights, food consumption,
      water consumption, hematology, blood clinical chemistry and necropsy findings.
      Based on the results it is concluded that the estimated subcutaneous non-toxic
      dose of the recombinant human interferon alpha A (LBD-007) in rats is (6
      approximately 12) x 10(6) IU/kg.

PMID- 8355291
TI  - A 6-month subcutaneous toxicity study of recombinant human interferon alpha A
      (LBD-007) in Sprague-Dawley rats.
AB  - Recombinant human interferon alpha A (code name: LBD-007) was subcutaneously
      administered to both sexes of Sprague-Dawley rats at the doses of 0, 3, 6 and 12
      x 10(6) IU/kg of body weight six days per week for 6 months to evaluate the
      chronic toxicity. Male rats dosed at 12 x 10(6) IU/kg for 26 weeks showed a
      decrease of ketone body in the urine, and female rats dosed at 12 x 10(6) IU/kg
      for 26 weeks showed a decrease of serum alkaline phosphatase. Microscopic changes
      with remarkable incidence were nephropathy, renal mineralization and
      ultimobranchial cysts of the thyroid gland in all groups of both sexes of rats.
      These changes were not considered to be drug-related toxicity because they
      appeared to be minimal, occasionally mild in severity and did not have dose
      dependency as well as clinical significance. In general, no drug-related change
      was noted in clinical findings, body weights, food consumption, water
      consumption, hematology, organ weights and necropsy findings. Based on the
      results, it is concluded that the estimated subcutaneous non-toxic dose of the
      recombinant human interferon alpha A (LBD-007) in rats would be 6 x 10(6) IU/kg.

PMID- 8355292
TI  - A study on antigenicity of recombinant human interferon alpha A (LBD-007) in mice
      and guinea pigs.
AB  - Antigenicity of recombinant human interferon alpha A (LBD-007), a newly developed
      drug for myeloid leukemia and hepatitis, was investigated in mice and guinea
      pigs. The following results were obtained: 1. Mice showed no production of
      antibodies against LBD-007 inoculated with aluminum hydroxide gel (alum) as an
      adjuvant, judged by the heterologous anaphylaxis (PCA) test using rats. On the
      other hand, antibodies against ovalbumin (OVA) inoculated with alum were
      definitely detected. 2. In the studies with guinea pigs, both the inoculation of
      LBD-007 only and of LBD-007 with complete Freund's adjuvant (CFA) as an adjuvant
      did not produce positive reactions in any of homologous active systemic
      anaphylaxis (ASA). On the other hand, the inoculation of ovalbumin with complete
      Freund's adjuvant (CFA) produced positive reaction in both of PCA and ASA. 3.
      These findings suggested that LBD-007 has no antigenic potential in mice or
      guinea pigs.

PMID- 8355293
TI  - Focused ultrasound examinations by surgeons: the time is now.

PMID- 8355294
TI  - Should motorcycles be operated within the legal alcohol limits for automobiles.
AB  - A motorcycle simulator was used to assess operating performance of 14 experienced
      motorcyclists with varying breath alcohol concentrations. Riding error scores in
      three defensive and evasive maneuvers plus distance traveled in a standard time
      period were documented at baseline and at predetermined intervals following
      controlled alcohol consumption. The results revealed a positive correlation
      between total errors and breath alcohol concentrations within a range well below
      the commonly accepted legal limit of intoxication of 0.10 mg/dL. There was a
      highly significant increase (p < 0.0055) in an operator's tendency to leave the
      roadway (an error that is frequently fatal for motorcyclists), as well as a
      reduction in ability to complete a timed course. Moreover, performance errors
      increased while operators were "sobering up," a dramatic finding not heretofore
      established in previous studies. Since the present definition of the legal limit
      of intoxication for motorcyclists is based on automobile studies, noted increases
      in reaction time and performance errors support the hypothesis that "legal
      alcohol levels" should be lowered for motorcycle operators.

PMID- 8355295
TI  - Femoral catheters and deep venous thrombosis: a prospective evaluation with
      venous duplex sonography.
AB  - Femoral vein cannulation (FVC) with 8.5F Swan-Ganz catheter introducers allows
      expeditious intravenous access and rapid volume infusion; however, the incidence
      of associated iliofemoral deep venous thrombosis (DVT) is unknown. Trauma
      patients (n = 76) requiring unilateral FVC were prospectively entered into a
      study where they were resuscitated via FVC and serially evaluated with bilateral
      venous duplex sonography (VDS). The incidence of DVT in catheterized femoral
      veins was compared with that in uncatheterized femoral veins. Catheters were
      removed promptly and VDS was performed within 24 hours and weekly for 1 month.
      Iliofemoral DVTs were identified in 11 of the 76 patients (14%). Iliofemoral DVTs
      occurred on the cannulated side in 9 (81.8%) compared with 2 (18.2%) on the
      uncannulated side (p < 0.05). We conclude that the use of the 8.5F FVC is
      associated with an increased incidence of DVT and that despite its convenience,
      this technique should not be routine.

PMID- 8355296
TI  - Endoscopic retrograde cholangiography in the nonsurgical management of blunt
      liver injury.
AB  - Injury to the intrahepatic bile duct has not been routinely examined in patients
      with blunt liver injury, despite the risk of formation of a biloma and hemobilia.
      In this study we examined the role of endoscopic retrograde cholangiography (ERC)
      in the evaluation of blunt liver injuries. Sixty-four of 106 (60.3%) patients
      with blunt hepatic injuries, admitted from April 1986 through March 1992, were
      managed nonsurgically; ERC was performed in conjunction with computed tomographic
      (CT) scanning to rule out injury to the bile duct in 28 patients. Injury to the
      bile duct was detected in six patients (21.4%), five of whom developed a biloma.
      Patients with hepatic parenchymal injuries that were observed on the CT scans
      were at greatest risk for injury to the intrahepatic bile duct, and our data
      suggested that the incidence of injury to the intrahepatic bile duct after blunt
      hepatic trauma is higher than previously reported. Patients with serious hepatic
      parenchymal injuries who are candidates for nonsurgical management should be
      considered for ERC to exclude the possibility of injury to the bile duct.

PMID- 8355297
TI  - Establishment of accurate incidence rates for head and spinal cord injuries in
      developing and developed countries: a capture-recapture approach.
AB  - Prevention of head and spinal cord injuries is defined as a reduction in the
      incidence of these disabilities. Accurate incidence data are fundamental to any
      prevention program. The current approaches toward determining incidence rates for
      head and spinal cord injuries are summarized. Previous research has focused on
      passive surveillance systems and population-based registries. An alternative
      system for monitoring the incidence of head injuries is discussed that uses a
      surveillance methodology called capture-recapture. This method employs multiple
      population-based sources to identify cases and uses the cases that overlap
      between the sources to estimate the degree of undercount in the population. This
      estimate in turn is used to produce an ascertainment-corrected incidence
      estimate. Through the use of methods such as capture-recapture, accurate
      monitoring of the incidence of head and spinal injuries across developing and
      developed countries is indeed feasible.

PMID- 8355298
TI  - Mortality from accidental falls among the elderly in the United States, 1962
      1988: demonstrating the impact of improved trauma management.
AB  - Falls in elderly persons primarily occur because of increasing intrinsic frailty
      rather than extrinsic environmental hazards. Thus declining mortality from
      accidental falls in the elderly predominantly reflects improved trauma management
      rather than injury prevention. Mortality attributed to accidental falls among
      individuals aged 60 to 85 years in the United States from 1962 through 1988 was
      analyzed using the Strehler-Mildvan modification of the Gompertz relationship of
      aging and mortality. This method of analysis can be used to define a disorder
      specific age at which etiopathogenic influences are directly proportional to the
      mortality rate. From 1962 through 1988, the mortality rates (per 100,000) from
      accidental falls in the United States declined 63.5% (from 165.6 to 60.4) among
      men at age 83.4 years, and declined 76.3% (from 86.2 to 20.4) among women at age
      77.5 years. This analysis suggests that trauma management, at the population
      level, was 2.74 times more effective in men and 4.22 times more effective in
      women at reducing mortality from accidental falls among the elderly in 1988 than
      in 1962.

PMID- 8355299
TI  - Internal fixation of open unstable pelvic fractures.
AB  - From 1980 through 1990 14 patients with severely complicated unstable fractures
      of the pelvis were treated. There were 13 men and one women (mean age, 28 years).
      Eight fractures also involved the acetabulum. The injuries were accompanied by
      anorectal (nine), urogenital (eight), vascular (three), and nerve (three)
      injuries. After resuscitation, fractures were stabilized immediately, preferably
      using internal fixation, notwithstanding fecal contamination in certain cases.
      Anorectal ruptures were treated with lavage of the distal colon and a divergent
      stoma. The urogenital lesions also were treated primarily. Two patients died
      early after treatment of accompanying injuries. Infectious complications were
      seen seven times. In one patient internal fixation broke down. All fractures
      healed with good functional results. At last follow-up examination all patients
      were continent for feces. It is concluded that early internal stabilization of
      these complex injuries achieves a low mortality rate and good functional results.
      Immediate repair of urogenital and sphincter lesions, with concomitant divergent
      stoma and lavage of the distal colon, gives good results notwithstanding the risk
      of infectious complications.

PMID- 8355301
TI  - Trauma fellowship training: the insiders' perspective.
AB  - Trauma care is in a period of transition from care given by surgeons at the
      closest community hospital to care given by trauma specialists at trauma centers
      and within emergency medical systems. It has thus become increasingly important
      for the educational goals of trauma fellowship training to reflect the needs of
      the future system as well as the views of future practitioners. These views
      differ from those of surgical colleagues practicing trauma surgery, and the views
      of future trauma specialists should be considered during the formulation of
      training guidelines. This survey appears to be the first attempt to interpret the
      views of trauma fellows: 48 of the 83 fellows (57.8%) in the 1991-1992 national
      cohort responded. They made suggestions about their own training, including ways
      to increase surgical experiences and opportunities for academic pursuits, but
      gave no insight as to an appropriate mix of critical care training. Although
      critical care certification is a major attraction for fellowship training, the
      cohort does not want to be thought of as nonoperating surgical intensivists. A
      second year of fellowship training is seen as necessary for research and trauma
      systems-related studies.

PMID- 8355300
TI  - Surgical treatment of humeral shaft fractures--the Basel experience.
AB  - One hundred twenty seven patients with fractures of the humeral shaft were
      treated by open reduction and internal fixation using 4.5-mm dynamic compression
      plates (DCP). Seventy one osteosyntheses were performed primarily, 36 following
      attempted closed reduction, and 20 secondarily after a failed conservative
      treatment of about 8 weeks. A primary radial nerve palsy was present in 19
      patients, and appeared subsequently in four additional patients. One hundred two
      of the 127 patients could be clinically and radiologically examined 1 year after
      internal fixation: 89 patients (87.3%) had excellent or good results with full
      functional recovery. Thirteen patients (12.7%) showed a limited range of motion
      of either the shoulder or elbow or both. This was mostly because of other
      fractures of the same limb or persistent neurologic impairment. We observed two
      transitory postoperative nerve palsies, five early failures of internal fixation
      because of technical errors, two pseudarthroses and four postoperative
      infections, which healed with one exception by suction drainage and early removal
      of the plate. We conclude that a correct plate fixation of humeral shaft
      fractures in a selected group of patients represents an alternative to
      conservative treatment with the advantage of greater patient comfort.

PMID- 8355302
TI  - Trauma center accreditation in Canada--a proposal: 1992 Presidential Address,
      Trauma Association of Canada.

PMID- 8355303
TI  - Psychosocial characteristics and follow-up of drinking and non-drinking drivers
      in motor vehicle crashes.
AB  - Eight hundred fifty-four consecutive motor vehicle crash (MVC) victims admitted
      from August 1, 1986, through August 31, 1989, were prospectively assessed
      including measurement of blood alcohol concentration (BAC). One hundred six in
      hospital interviews were conducted on competent consenting drivers > or = 18
      years old; 22.9% (n = 22) of those who were BAC tested (n = 96) were positive for
      alcohol on admission. The blood alcohol concentration positive [BAC(+)] and the
      BAC negative (-) drivers differed significantly on the following variables;
      driver education [BAC(-) > BAC(+): p < 0.01], license suspension < or = 2 years
      before admission [BAC(+) > BAC(-): p < 0.01], frequency of self-reported
      intoxication in month before crash [BAC(+) > BAC(-): p < 0.05], driving within 2
      hours of drinking < or = 1 month before admission [BAC(+) > BAC(-): p = 0.01] and
      self-reported driving with BAC > 17 mmol/L < or = 1 month before admission
      [BAC(+) > BAC(-): p < 0.01]. Follow-up interviews (n = 106) were conducted 1 year
      after discharge; drivers originally testing BAC(+) were more likely to drive
      within 2 hours of drinking (p < 0.05), and were more likely to admit to driving
      with a BAC > 17 mmol/L (p < 0.01). Original BAC(+) drivers were also more likely
      to report a subsequent MVC in the year following discharge (not statistically
      significant). There is a need to develop an assessment system to identify high
      crash-risk drivers and establish rehabilitation programs to reduce crash
      recidivism.

PMID- 8355304
TI  - In vivo study of bleeding time and arterial hemorrhage in hypothermic versus
      normothermic animals.
AB  - This in vivo study confirmed impaired hemostasis during hypothermia in a swine
      model. Group I (normothermic, n = 8) and group II (hypothermic, n = 8) animals
      were anesthetized and instrumented for continuous peritoneal irrigation and
      monitoring of heart rate and blood pressure. The effects of hypothermia,
      hypotension, and inotrope on bleeding time and bleeding from two types of
      arterial injuries were evaluated. Our findings were that (1) bleeding time was
      significantly prolonged in hypothermic animals; (2) the differences in blood loss
      from partially torn artery (PTA) and completely cut artery (CCA) at both
      normothermic and hypothermic temperatures did not reach statistical significance;
      and (3) blood loss from PTA was greater than CCA when norepinephrine (Levophed)
      was infused to elevate blood pressure in hypotensive animals at normal core
      temperature.

PMID- 8355305
TI  - A comparison of right and left blunt traumatic diaphragmatic rupture.
AB  - Since right blunt traumatic diaphragmatic rupture (BTDR) is reported with
      increasing frequency, BTDR may be a disease in evolution. Data were collected on
      59 left, 16 right, and five bilateral BTDRs at a level 1 trauma center. Patients
      with right BTDR had lower Glasgow Coma Scale (GCS) scores (p < 0.05), were more
      likely to be initially in hypovolemic shock, and were admitted directly from the
      field (p < 0.01). Left and right BTDRs were diagnosed from chest films in 37% and
      0% of cases, respectively (p < 0.05). Diagnostic peritoneal lavage results were
      negative in 16% of left and left of 0% of right BTDRs. For right BTDRs, the liver
      was more likely to be injured (p < 0.001). The mortality rates were similar and
      ICU and hospital stays, complications, and duration of mechanical ventilation
      were similar for early survivors with right and left BTDRs. The clinical signs
      and symptoms, diagnosis, and surgical findings associated with right and left
      BTDR are different.

PMID- 8355306
TI  - A comparison between a Canadian regional trauma unit and an American level I
      trauma center.
AB  - Although there has been recent comparison of the Canadian and American health
      care systems, the issue of trauma has received little attention. Data were
      collected on all adult motor vehicle crash (MVC) victims admitted to the
      Sunnybrook Trauma Unit (CAN), Toronto, Canada, and the R Adams Cowley Shock
      Trauma Center (USA), Baltimore, Maryland from July 1986 through July 1990.
      Similar MVC victims at CAN and USA had equivalent mortality rates with similar
      discharge dispositions (p = NS), but patients at USA were twice as likely to be
      admitted to the ICU and had longer ICU stays (p < 0.01). The hospital-based cost
      for an average MVC patient at CAN was significantly less than for an average
      patient at USA and professional charges were at least five times greater at USA.
      This study provides some insight into the differences in trauma care between
      Canada and the United States.

PMID- 8355308
TI  - Priorities in the management of multiple trauma: intracranial versus intra
      abdominal injury.
AB  - Setting priorities in the management of patients with suspected injuries to both
      the head and the abdomen is difficult and depends on the likelihood of different
      injuries. Eight hundred trauma patients were retrospectively reviewed to
      determine the likelihood of a surgically correctable cerebral injury. All 800
      patients, at the time of initial evaluation, were thought to have potentially
      correctable injuries to both the head and the abdomen. Of these, 52 had a head
      injury requiring craniotomy; 40 required a therapeutic celiotomy. Only three
      patients required both craniotomy and therapeutic celiotomy. There were more
      cases of delay in therapeutic celiotomy because of negative results of computed
      tomographic (CT) scanning of the head (13 cases) than there were delays in
      craniotomy because of nontherapeutic celiotomy (four cases). Need for craniotomy,
      based on emergency department evaluation, was indicated by the presence of
      lateralizing neurologic signs. Low Glasgow Coma Scale score, anisocoria,
      fixed/dilated pupils, loss of consciousness, facial or scalp injuries, and age
      were of no independent value in predicting the need for craniotomy. CONCLUSIONS:
      Patients with surgically correctable injuries of both the head and the abdomen
      are rare. In stable patients with altered mental status and potential injuries to
      both the head and the abdomen, the abdomen is best evaluated first by diagnostic
      paracentesis. If paracentesis does not return gross blood, CT scanning of the
      head should be done.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355307
TI  - Prospective comparison of diagnostic peritoneal lavage, computed tomographic
      scanning, and ultrasonography for the diagnosis of blunt abdominal trauma.
AB  - From January through December 1990, a prospective study comparing the accuracy of
      diagnostic peritoneal lavage (DPL), abdominal computed tomographic (CT) scanning,
      and abdominal ultrasonographic (US) scanning was carried out. Patients with
      stable vital signs following their initial resuscitation coupled with equivocal
      physical examination findings received both CT and US scanning. A DPL was then
      done. If any of these three examinations produced positive findings, a laparotomy
      was done and the surgical findings were compared with the results of the
      diagnostic studies. Fifty-five patients were studied (44 men, 11 women), with a
      mean age of 43 years and a mean ISS of 18.5 +/- 10.5. The sensitivity,
      specificity, and accuracy were 100%, 84.2%, and 94.5% for DPL, 97.2%, 94.7%, and
      96.4% for CT scanning, and 91.7%, 94.7%, and 92.7% for US scanning. Problems do
      exist in identifying isolated small intestinal perforations with ultrasonography.
      Since more and more trauma centers are using ultrasonography in the emergency
      department as a screening method in the management of patients with blunt
      abdominal trauma, it is important to avoid overestimating its capability.
      Frequent re-evaluation of the patient's condition, repeat ultrasonographic scans,
      diagnostic peritoneal lavage, and CT scanning are complementary and important in
      the diagnosis of blunt abdominal trauma.

PMID- 8355309
TI  - Renal gunshot wounds: methods of salvage and reconstruction.
AB  - Over the past 14 years, 2079 patients have been seen at our institution with
      renal trauma. Of these, 84 sustained gunshot wounds (81 unilateral, 3 bilateral;
      a total of 87 renal units). We evaluated this group to characterize the nature of
      their injuries and establish a methodology for renal salvage and reconstruction.
      Preoperative radiographic staging was performed with excretory urography (IVP) or
      computed tomographic (CT) scanning. The injuries were classified into five
      categories: 16 contusions (18.4%), 12 minor lacerations (13.8%), 44 major
      lacerations (50.5%), six vascular injuries (6.9%), and nine combination
      laceration and vascular injury (10.3%). Most patients had multiple organ
      injuries, with 79 requiring associated surgical procedures (94%). The mean injury
      Severity Score (ISS) was 26.7 (range, 4-59). Based on radiographic and clinical
      staging criteria, 69 renal injuries were surgically explored (79.3%), and 12
      patients underwent nephrectomy (13.8%). Forty-six renal units were reconstructed
      (66.6%) by various methods, including renorrhaphy, omental pedical flaps, mesh or
      peritoneal patch grafts, partial nephrectomy, and vascular repair. Overall, 75
      renal units were salvaged (86.2%). Early renal vascular control was achieved in
      all patients who underwent renal exploration. Follow-up functional studies were
      done in 24 (28.5%): none had delayed nephrectomy or postinjury hypertension.
      Overall, 79 patients survived (94%); however, mortality was not related to renal
      injury. These findings suggest that aggressive radiographic staging coupled with
      early vascular control and careful selection of reconstructive techniques can
      ensure a high renal salvage rate in patients with renal gunshot injuries.

PMID- 8355310
TI  - Vascular complications of continuous arteriovenous hemofiltration in trauma
      patients.
AB  - Continuous arteriovenous hemofiltration (CAVH) has recently become useful in the
      treatment of acute renal failure following trauma. It allows continuous volume
      removal and avoids the acute hemodynamic changes often seen with hemodialysis. To
      determine the risks of CAVH catheters, the records of trauma patients undergoing
      CAVH from August 1989 through May 1992 were reviewed. Of 4685 trauma patients, 29
      developed renal failure requiring dialysis, with 26 managed with CAVH. Vascular
      access was obtained via 126 percutaneous 8F femoral arterial and venous catheters
      (64 arterial, 62 venous) and four Scribner shunts. There was a total of 309 CAVH
      D days, with an average of 11.9 days per patient. Complications included one
      femoral arteriovenous fistula, one pseudoaneurysm, and one deep venous
      thrombosis, resulting in a 3.1% (2 of 64) arterial complication rate and a 1.6%
      (1 of 62) venous complication rate. The incidence of arterial complications
      compares with that of angiography, but complications were major and required
      surgery. Alternative techniques such as continuous venovenous hemofiltration may
      prove beneficial.

PMID- 8355311
TI  - Candiduria as an early marker of disseminated infection in critically ill
      surgical patients: the role of fluconazole therapy.
AB  - The significance of candiduria in critically ill patients remains unclear. It may
      represent harmless colonization or a potentially life-threatening infection. We
      analyzed 47 patients in the surgical intensive care unit (SICU) (trauma: 20,
      general surgery: 15, neurosurgery: 12) who had candiduria, defined by a colony
      count greater than 100,000/mL. Twenty-seven of these patients were studied
      retrospectively. Twenty were evaluated prospectively. All patients were receiving
      broad-spectrum antibiotics for bacterial infections. Retrospective group: ten
      patients (group A) did not develop disseminated candidiasis, whereas 17 patients
      (group B) did. Group B had higher APACHE II scores on admission (13.4 +/- 7.8)
      and at the time of candiduria (13.7 +/- 4.4) when compared with group A
      [admission: 5.0 +/- 4.6; candiduria: 6.7 +/- 3.6 (p < 0.02)]. In group B,
      disseminated candidiasis was not diagnosed and treated until 9.9 +/- 4.4 days
      after development of candiduria. Prospective group: twenty patients with
      candiduria were treated with systemic fluconazole (group C) at the time of
      candiduria. The APACHE II scores of group C on admission (12.8 +/- 3.9) and at
      the time of candiduria (10.5 +/- 4.0) were comparable with those of group B. No
      patient in Group C developed disseminated candidiasis. The septic mortality rates
      of groups A, B, and C were 0%, 53%, and 5%, respectively (p < 0.05-0.0001). In
      patients exhibiting ongoing sepsis and organ failure (high APACHE scores),
      candiduria may be an early indicator of systemic infection. Diagnosis of
      disseminated infection and its treatment may be delayed if conventional criteria
      for candidiasis (positive blood cultures, multiple site isolation) are
      awaited.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355312
TI  - Computed tomography in the management of blunt thoracic trauma.
AB  - Computed tomographic (CT) scanning has proved to be valuable in evaluating the
      head and abdomen of victims of blunt trauma; CT scans of the thorax often are
      obtained on patients with blunt torso trauma, but their value for this purpose is
      unclear. We conducted a prospective study to evaluate the role of chest CT
      scanning in thoracic trauma. Hemodynamically stable patients at least 18 years
      old with an estimated Abbreviated Injury Scale--Thorax score of 2 or greater
      underwent a contrast-enhanced CT scan of the chest, usually in conjunction with
      CT scans of the head, abdomen, or both. Thirteen patients were dead on arrival,
      14 required emergency surgical procedures, and 13 were too unstable to undergo
      chest CT scan. Thirty-three patients were not included because they refused to
      participate or the protocol was not followed. Forty-six men (69%) and 21 women
      with a mean age of 42.7 years completed the study. Sixty-one were injured in
      motor vehicle crashes, four were injured in falls, and one each was injured by
      assault and by crushing forces. Injury Severity Scores ranged from 4 to 45, with
      a mean of 20.5. Four patients died (6%), three from head injury and one from
      multiple organ dysfunction. Chest roentgenography (CXR) was superior to CT
      scanning in identifying rib fractures, but CT scanning was more sensitive than
      CXR for pneumothorax, fluid collections, and infiltrates (p < 0.001); CT scanning
      also was more specific for aortic injury. Despite this quantitative superiority,
      the abnormalities missed by CXR but identified by CT scanning infrequently led to
      a change in management.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355313
TI  - Empiric monotherapy versus combination therapy of nosocomial pneumonia in trauma
      patients.
AB  - Combination therapy for nosocomial pneumonia with a beta-lactam and
      aminoglycoside is widely accepted because of synergy and reduction of resistant
      bacteria. This prospective study of 109 trauma patients (94 blunt, 15
      penetrating) with nosocomial pneumonia was performed in consecutive phases. In
      phase 1, patients were randomized to an anti-pseudomonal third-generation
      cephalosporin--cefoperazone or ceftazidime. Gentamicin was added to each regimen
      in phase 2. The mean age of the patients was 37 years, the mean ISS was 31, and
      there were no differences among the four treatment groups relative to associated
      injuries. Patients receiving monotherapy had a 56% cure rate compared with 31%
      for combination therapy (p < 0.04). Persistence rates were similar in these two
      groups (15% and 20%), but superinfection was significantly higher in the
      combination group (49% vs. 28%; p < 0.04). The predominant superinfecting
      organism was methicillin-resistant Staphylococcus aureus (MRSA). Nine patients
      died (5% monotherapy, 10% combination), and eight had a superinfection. We
      conclude that monotherapy had a higher cure rate than combination therapy for
      empiric therapy of pneumonia in our trauma patients. Combination therapy failed
      because of superinfection (primarily MRSA). Emergence of MRSA may be from host
      overgrowth or plasmid-mediated induction of resistance, possibly caused by
      gentamicin.

PMID- 8355314
TI  - Isolated lateral traumatic dislocation of the radial head in a boy: case report.
AB  - Lateral traumatic dislocation of the radial head occurred in a 9-year-old boy
      with cubitus varus. Reduction of the dislocation and immobilization of the arm in
      flexion and supination in a plaster cast for 4 weeks were done and after 6 months
      the boy returned to school, with no problems in daily living.

PMID- 8355315
TI  - An in vitro evaluation of cocaine hydrochloride adsorption by activated charcoal
      and desorption upon addition of polyethylene glycol electrolyte lavage solution.
AB  - Cocaine body-packers and body-stuffers have become a common medical problem.
      Significant morbidity and mortality result when cocaine is absorbed from the
      gastrointestinal tract due to cocaine package compromise. The clinical prevention
      of gastrointestinal absorption of cocaine includes oral activated charcoal and/or
      whole bowel irrigation with polyethylene glycol--electrolyte lavage solution.
      This in vitro study investigates the maximal adsorptive capacity of activated
      charcoal for cocaine at varying activated charcoal:cocaine ratios, at pH 1.2 and
      pH 7.0, and the effect of polyethylene glycol--electrolyte lavage solution upon
      this binding. The percent adsorption of cocaine to activated charcoal was
      significantly better at pH 7.0 for all ratios of activated charcoal:cocaine
      tested and the maximal adsorptive capacity was 29% greater at pH 7.0 (273
      micrograms/mg) than at pH 1.2 (212 micrograms/mg) (p < 0.05). Addition of
      polyethylene glycol--electrolyte lavage solution to the cocaine-activated
      charcoal slurry caused significant desorption of cocaine from activated charcoal
      at all pHs and ratios tested (except the 1:1 ratio at pH 7.0) and was most
      pronounced at pH 1.2. The addition of polyethylene glycol--electrolyte lavage
      solution to activated charcoal prior to adding cocaine solution further decreased
      the adsorption of cocaine to activated charcoal. This difference was significant
      at both pHs and all ratios tested except the 1:1 ratio at pH 1.2. The maximal
      adsorptive capacity of activated charcoal for cocaine at pH 1.2 was reduced 75%
      by pretreatment with polyethylene glycol--electrolyte lavage solution from 212 to
      54.2 micrograms/mg, while at pH 7.0 the maximal adsorptive capacity was reduced
      by 11%, from 273 to 243 micrograms/mg. Polyethylene glycol--electrolyte lavage
      solution significantly reduces the adsorption of cocaine to activated charcoal
      particularly if the two are combined at a low pH prior to the addition of
      cocaine. The in vitro effects suggest that activated charcoal mixed in water
      should be administered first, followed by the polyethylene glycol--electrolyte
      lavage solution.

PMID- 8355316
TI  - Colorimetric and gas chromatographic procedures for glycolic acid in serum: the
      major toxic metabolite of ethylene glycol.
AB  - Monitoring of individuals poisoned with ethylene glycol involves analysis of
      ethylene glycol in serum. The objective of this procedure was to validate a
      colorimetric and gas chromatographic procedure for glycolic acid in serum. The
      colorimetric procedure requires no sophisticated instrumentation and has been
      shown to be specific for glycolic acid. A gas chromatographic procedure has also
      been developed involving methyl derivatization of glycolic acid and the internal
      standard (propionic acid). These methods have been used for the analysis of serum
      specimens from ethylene glycol poisoned patients. Glycolic acid has been
      recognized as the major toxic agent in ethylene glycol poisoning but current
      methods available do not allow analysis in a clinically relevant turnaround time.
      These two procedures allow glycolic acid quantitation by procedures readily set
      up in most clinical toxicology laboratories.

PMID- 8355317
TI  - Medications which can kill a toddler with one tablet or teaspoonful.
AB  - To identify medicinal preparations which can be fatal to a toddler upon ingestion
      of one standard dose unit, four major texts in medical toxicology were reviewed
      for reported cases of fatal poisoning in small children as well as for fatal
      doses in adults when no fatalities were reported in children. Using the
      Physicians Desk Reference, the largest dose unit commercially available for
      various drugs was identified. Subsequently, the number of dose units that have to
      be ingested by a toddler to cause fatality was calculated. To compare these data
      to the clinical reality, the annual reports by the American Association of Poison
      Control Centers National Collection System were reviewed between 1983-1989. Very
      few drugs are fatal for a 10 kg toddler upon ingestion of one commercially
      available dose unit. These include camphor, chloroquine, tricyclics,
      phenothiazines, quinine, methyl salicylate and theophylline. This short list of
      drugs was responsible for almost half (42%) of fatal cases following acute
      ingestion in young children (< 2 yrs) in the US between 1983-1989. Labelling of
      these drugs in a unique way may help decrease the number of serious and
      potentially fatal toxicities in small children.

PMID- 8355318
TI  - Radiopacity of household deodorizers, air fresheners, and moth repellents.
AB  - Household deodorizers and moth repellents are common agents implicated in many
      childhood poisonings. Their ingredients usually include either
      paradichlorobenzene or naphthalene compressed into a solid ball or another shape,
      sometimes with added essential oils and fragrances. Because medically naphthalene
      is a more important toxin than paradichlorobenzene, with hematologic and nervous
      system effects, clinicians often seek to discern which product has been ingested.
      We discovered fortuitously that a mothball swallowed by a retarded adult was
      radiopaque, and so designed an in vitro experiment to study the radiopacity of a
      variety of household deodorizers and products. Of 10 products screened for
      radiopacity by two radiologists, those containing paradichlorobenzene were
      consistently strongly radiopaque; those containing naphthalene were radiolucent.
      A third alternative ingredient which is used in some toilet bowl deodorizers,
      cetrimonium bromide, was also radiopaque. Radiopacity of paradichlorobenzene or
      cetrimonium bromide-containing products did not dissipate with time. We speculate
      that the halogen within the chemical structure of these compounds accounts for
      their radiopacity. We conclude that paradichlorobenzene-containing commercial
      products can be distinguished clinically from those containing naphthalene by the
      performance of an abdominal radiograph.

PMID- 8355319
TI  - When should dialysis be performed in lithium poisoning? A kinetic study in 14
      cases of lithium poisoning.
AB  - Lithium kinetics were studied in 14 patients with lithium poisoning. Three
      patients were treated by hemodialysis. Serum lithium peak concentrations ranged
      between 1.4 and 9.6 mmol/L. The apparent mean serum half-life was 23.16 +/- 9 h,
      the mean total clearance was 26.5 +/- 13.3 mL/min and the mean renal clearance
      was 17.2 +/- 5.4 mL/min. The kinetic parameters were dependent on the duration of
      the study and on the type of the poisoning: acute, acute upon chronic or chronic.
      During the first 12 h after admission ten patients were in a distribution phase,
      three were in an elimination phase and one was in an absorption phase. The serum
      half-life during hemodialysis ranged from 3.6 to 5.7 h and hemodialysis clearance
      was 63.2 to 114.4 mL/min. The mean volume of distribution calculated in six cases
      was 0.63 +/- 0.09 L/kg. The evolution of the lithium pools showed a different
      kinetic pattern between the extra- and the intracellular pool which decreased
      more slowly. During hemodialysis the decrease of the extracellular pool was about
      twice that of the cellular pool. Among the factors which may modify lithium
      toxicity and kinetics, are the type of the poisoning, the presence of an
      underlying disease and renal impairment. No general and rigid indication for
      hemodialysis can be set, but the need for hemodialysis should be based on
      clinical and kinetic data determined during the 12 h following admission.

PMID- 8355320
TI  - Clinical features in 28 consecutive cases of laboratory confirmed massive
      poisoning with carbamazepine alone.
AB  - A retrospective study of consecutive cases of massive carbamazepine poisoning
      treated in an intensive care unit during the period 1981-1991 was performed,
      mainly to determine whether serum carbamazepine levels were predictive of
      toxicity. Out of a total of 51 admissions with a diagnosis of carbamazepine self
      poisoning, 28 (25 patients) were included. The reasons for exclusion were
      coingestion of other drugs (11 cases), incorrect diagnosis or inadequate
      information (6 cases), a peak observed serum concentration of carbamazepine below
      76 mumol/L [18 mg/L] (4 cases), and lack of any documented serum carbamazepine
      assay (2 cases). The peak serum concentrations ranged from 78 to 285 mumol/L
      [18.4 to 67.4 mg/L]. It was found that serum levels equal to or above 170 mumol/L
      [40 mg/L] were significantly associated with an increased risk of serious
      complications such as coma, seizures, respiratory failure and cardiac conduction
      defects. In 60% of the 10 patients with a serum level > or = 170 mumol/L at least
      two of these symptoms occurred, in 50% at least three, and in 40% all four. There
      were two fatalities. Among the 16 patients (18 admissions) with a serum
      carbamazepine concentration below 170 mumol/L, only one was comatose and none had
      any of the other severe symptoms. It is concluded that serum carbamazepine levels
      accurately predict the severity of toxicity in massive carbamazepine poisoning in
      adults.

PMID- 8355321
TI  - Carbamazepine overdose: serum concentration less predictive in children.

PMID- 8355322
TI  - Effects of epinephrine and norepinephrine on hemodynamic parameters and
      arrhythmias during a continuous infusion of amitriptyline in rats.
AB  - Epinephrine and norepinephrine were evaluated in treatment of hemodynamic
      compromise in amitriptyline intoxication. One hundred and one male Wistar rats
      were monitored hemodynamically during amitriptyline intoxication and given one of
      three infusion rates (0.1, 0.5 or 5.0 mg/kg/min) of either epinephrine or
      norepinephrine. Sixteen rats served as controls and received only glucose after
      intoxication. Amitriptyline intoxication lowered mean arterial pressure, heart
      rate, left ventricular max dP/dt, and increased left ventricular end-diastolic
      pressure. All doses of norepinephrine and the two higher doses of epinephrine
      increased mean arterial blood pressure and left ventricular max dP/dt. Heart rate
      increased with both drugs, more with epinephrine, but not beyond pre-intoxicated
      levels at any dose. Left ventricular end-diastolic pressure was unaltered by both
      drugs. Malignant arrhythmias appeared in 7% of all animals, whereas a progressive
      decline of cardiac contractility caused cardiac arrest in 36% of all animals.
      This suggests that myocardial depression is the aspect most likely to cause
      death. At intermediate doses epinephrine resulted in significantly fewer
      arrhythmias and lower mortality compared to norepinephrine. We conclude that
      epinephrine and norepinephrine each appeared effective in reversing amitriptyline
      induced hemodynamic alterations. Epinephrine had fewer arrhythmogenic properties
      than norepinephrine and may be preferable to norepinephrine.

PMID- 8355323
TI  - Fatal inhalational isopropyl alcohol poisoning in a neonate.
AB  - A 37 weeks gestation, 1500 gram male infant with multiple dysmorphic features
      underwent surgery for gastroschisis several hours after birth. During post
      operative mechanical ventilation, 70% isopropyl alcohol was accidentally placed
      in the humidifier of the ventilator, resulting in an estimated 2 h exposure.
      While the baby seemed clinically stable, initial neurological examination was
      confounded by recent sedation and pancuronium paralysis. Initial post-operative
      hypotension was corrected with fluid administration and remained stable for the
      remainder of the clinical course. By 2 h post-exposure, he was moving, breathing
      spontaneously and opening his eyes. Isopropyl alcohol and acetone levels at 1, 6,
      10 h post exposure were 31/10, 22/15, 15/20 mmol/L respectively. Isopropyl
      alcohol elimination t1/2 was 9.6 h. Dialysis or exchange transfusion were
      considered but due to their high risk and the stable infant condition, it was
      elected to continue with supportive care only. 12.5 h post-exposure, he suddenly
      became cyanotic, bradycardic, then asystolic. Resuscitation efforts were
      unsuccessful. To our knowledge, this is the youngest patient reported to have
      toxic inhalational exposure to isopropyl alcohol and the first report on
      isopropyl alcohol pharmacokinetics at this age.

PMID- 8355324
TI  - Butane inhalation and hemiparesis.
AB  - We report a case of hemiparesis resulting from acute intoxication following
      inhalation of butane gas from a canister in a 15 year-old boy.

PMID- 8355325
TI  - Massive oral ingestion of elemental mercury.
AB  - A 42 year old male, while repairing a sphygmomanometer, intentionally ingested an
      estimated 3 kg (220 mL) of metallic mercury. During admission, only tremor,
      irritability, forgetfulness and fatigue were noted. There were no obvious
      gastrointestinal or hepatic complications. Blood and urine mercury levels were
      significantly elevated. Most of the metallic mercury was cleared from the gut
      within 10 days. A few months later, hepatic dysfunction with jaundice developed.
      Serial investigations did not suggest a viral etiology or alcoholism. Liver
      function tests and blood and urine mercury levels returned to normal over the
      next 10 months. The observation suggests that massive and prolonged retention of
      metallic mercury may facilitate the conversion of metallic, elemental mercury to
      divalent mercury and its subsequent absorption with development of hepatic
      dysfunction.

PMID- 8355326
TI  - Non-traumatic rhabdomyolysis complicating antihistamine overdose.
AB  - Antihistamines are common over the counter medications which are frequently
      involved in overdoses. The usual clinical course is dominated by the
      anticholinergic affects of these agents; it includes significant autonomic and
      central nervous system effects and direct cardiac toxicity (1). We report a case
      of a suicide attempt in a young adult male where ingestion of the antihistamines
      diphenhydramine and doxylamine was complicated by non-traumatic rhabdomyolysis
      and acute renal failure.

PMID- 8355327
TI  - Organophosphate poisoning complicated by rhabdomyolysis.

PMID- 8355328
TI  - Urine butoxyacid acid as a therapeutic guide.

PMID- 8355329
TI  - Peripheral pulmonary lesions: ultrasonic features and ultrasonically guided fine
      needle aspiration biopsy.
AB  - When transthoracic biopsy is required for diagnosing lung diseases, radiographic
      procedures are the methods of choice, sonographic application being still
      limited. Sixty-four consecutive patients with pulmonary lesions adjacent to the
      chest wall underwent sonography. Findings showed hypoechoic homogeneous lesions
      (56 cases) with posterior regular margin (57 cases). Increasing echoes deep to
      the mass and sonographic interruption of hyperechoic surface were seen in all
      patients. In two cases, chest wall invasion had been diagnosed. Histologic
      diagnosis was made in 55 of the 64 patients (85.9%). Two pneumothoraces occurred.
      Sonography is a useful, accurate, and safe technique for diagnosing selected
      pulmonary lesions.

PMID- 8355330
TI  - New challenge for endorectal sonography: diagnosis of fecal incontinence.
AB  - The puborectalis muscle is a major determinant in the control of fecal
      continence. With endorectal sonography puborectalis function was assessed by
      determining puborectalis length in the resting (D1) and contracted (D2) states
      and calculating the percentage of shortening (D1-D2/D1)(100). The puborectalis
      length was defined as the shortest distance between the symphysis pubis and the
      rectal mucosa. The mean puborectalis length at rest did not differ in control
      subjects (29.5 +/- 1.0 mm) and incontinent patients (29.0 +/- 2.9 mm). With
      voluntary contraction a statistically significant difference (P < 0.001) was seen
      in the percentage of shortening between control subjects (15.4 +/- 1.1%) and
      incontinent patients (4.7 +/- 2.8%). Endorectal ultrasonography is a useful
      method to diagnose fecal incontinence.

PMID- 8355331
TI  - The fetal transverse cerebellar diameter/abdominal circumference ratio: a
      gestational age-independent method of assessing fetal size.
AB  - The relationship between the fetal TCD and the AC throughout pregnancy was
      investigated in a prospective, cross-sectional study of 700 well dated, normal
      pregnancies between 14 and 42 weeks of gestation and tested in 30 known SGA
      infants. Fetal measurements included the TCD, AC, BPD, HC, and FL. The TCD/AC
      ratio was calculated for each patient. Statistical analysis using linear
      regression and Student's t-test was performed. Strong correlation existed between
      gestational age and transcerebellar diameter (R2 = 0.9464), between gestational
      age and AC (R2 = 0.9685), and between TCD and AC (R2 = 0.9561). The TCD/AC ratio
      was normally distributed with a mean +/- SD of 13.69 +/- 0.94% (median, 13.71%).
      The 10th and 90th percentiles were 12.50% and 14.86%, respectively. The ratio
      remained constant throughout pregnancy with respect to gestational age (R2 =
      0.0084). A TCD/AC ratio greater than the 90th percentile was present in 87%
      (26/30) known SGA infants. The TCD/AC ratio is a stable, gestational age
      independent parameter that may be useful in the early detection of fetal growth
      abnormalities.

PMID- 8355332
TI  - Pregnancy outcome after a first trimester sonogram demonstrating fetal cardiac
      activity.
AB  - We conducted a prospective study to assess pregnancy outcome after a first
      trimester sonogram demonstrating a singleton intrauterine gestation with fetal
      cardiac activity. In each of the 556 cases, data recorded included indication for
      the sonogram, results of the sonogram, and pregnancy outcome. Sonographic
      abnormalities were found more frequently in patients scanned because of symptoms
      (14.0%) than among patients scanned for routine indications (6.0%) (P < 0.05, chi
      squared). Among 556 patients with known outcomes, the overall loss rate was 9.4%.
      A trend was seen toward a higher loss rate in patients with abnormal than normal
      sonograms (15.2% versus 8.8%). The loss rate after a normal scan was similar in
      symptomatic (10.6%) and asymptomatic patients (9.1%) and declined progressively
      with gestational age from 17.0% at 6 to 7.9 weeks to 4.3% at 12 to 13 weeks (P <
      0.01, chi-squared). These results can be used to convey prognostic information to
      patients after a normal first trimester sonogram demonstrating fetal cardiac
      activity. The likelihood of a good pregnancy outcome can be stated as a function
      of gestational age, and a symptomatic patient can be reassured after a normal
      scan that her prognosis is similar to that of an asymptomatic patient with a
      normal sonogram.

PMID- 8355333
TI  - Screening for ovarian cancer in women with breast cancer with transvaginal
      sonography and color flow imaging.
AB  - The aim of the present study was to determine the efficacy of transvaginal color
      flow imaging as a screening tool for ovarian cancer. Six hundred patients with
      previous breast carcinoma were screened for ovarian cancer. Screening was
      performed using transvaginal sonography with color flow imaging. Serum CA 125
      levels were measured in patients with abnormal sonographic findings. Eighty-three
      percent of the ovaries were detected in the premenopausal patients by
      ultrasonographic scanning and only 26% of the ovaries were detected in the
      postmenopausal patients. Intraovarian blood vessels were detected in 11% of the
      premenopausal women. The PI was less than 1 in 80% of these ovaries, but, on
      repeated examinations, the values of PI increased in all the blood vessels to
      greater than 1. Intraovarian blood vessels were detected in 1.8% of the normal
      ovaries observed in the postmenopausal women, but PI was always greater than 1.
      Eleven women with complex ovarian cysts (not simple) and one woman with enlarged
      ovaries underwent explorative laparotomy. In three women, primary malignant
      ovarian tumors were diagnosed and in one woman metastatic ovarian cancer was
      diagnosed. The specificity of sonography in detecting malignant ovarian tumors
      was 97.5% and the positive predictive value was 25%. The specificity of color
      flow imaging in detecting primary malignant ovarian tumors was 99.8% and the
      positive predictive value was 60%. In selected groups of women, screening for
      ovarian cancer with transvaginal color flow imaging may be justified.

PMID- 8355334
TI  - Imaging of the vertebrobasilar system by transcranial color-coded real-time
      sonography.
AB  - The vertebrobasilar system was investigated in 75 persons by TCCS to evaluate the
      applicability and diagnostic capacity of this transcranial Duplex technique.
      Transforaminal and transtemporal acoustic windows were employed to identify the
      vertebral arteries, basilar artery (PCA) and major branches of the
      vertebrobasilar system. The frequency of identifying the basilar artery and the
      PCA ranged from 84 to 94% but was poor for the distal segment of the basilar
      artery (45.3%). The origin of the basilar artery was disclosed by transcranial
      Duplex sonography at an average depth of 7.0 cm (range 6.0 to 8.0 cm). The
      assignment of the obtained flow signals to specific vascular segments was
      improved by this new technique. In addition, four persons received a maximum of
      six intravenous injections of a transpulmonary stable sonographic contrast agent
      (SHU 508 A) to enhance Doppler signal intensity derived from the vertebrobasilar
      system. The vascular trunk and all major branches of the vertebrobasilar system
      were identified in these four persons. We conclude that TCCS of the
      vertebrobasilar system will improve reliability of transcranial sonographic
      examination.

PMID- 8355335
TI  - Traumatic central retinal artery occlusion: diagnosis by color Doppler imaging.

PMID- 8355336
TI  - Changing ultrasonographic appearance of a fetal ovarian cyst twisted in utero.

PMID- 8355337
TI  - Development and disappearance of anterior cerebral artery collateral flow
      detected by transcranial Doppler sonography in a stroke patient.

PMID- 8355338
TI  - Idiopathic hypertrophy of gastric folds in children.

PMID- 8355339
TI  - Prenatal ultrasonic diagnosis of retroperitoneal cystic lymphangioma.

PMID- 8355340
TI  - Epizootiology of canine distemper in New Jersey raccoons.
AB  - Seventeen epizootics of canine distemper (CD) involving at least 615 raccoons
      (Procyon lotor) were identified between 1 September 1977 and 25 March 1991 in New
      Jersey (USA). Epizootics occurred three times at four year intervals in three
      areas. Based on this cycling, the wide distribution of CD cases, and their
      occurrence between epizootics, I propose an enzootic status for CD in New Jersey
      raccoons. The peak period prevalence of raccoon canine distemper cases occurred
      at the end of the mating season in March. Another period of CD activity began
      with increased movements of the young in September. Epizootics were associated
      with river drainages and other wetlands. Age and sex distribution of raccoons
      with CD was not significantly different (P > 0.05) from that of an asymptomatic
      composite sample of four northern New Jersey raccoon populations. Lethargy was
      the most commonly reported clinical sign in raccoons with alert or aggressive
      behavior rarely observed.

PMID- 8355341
TI  - Rabies in African wild dogs (Lycaon pictus) in the Serengeti region, Tanzania.
AB  - Rabies was confirmed as the cause of death of one African wild dog (Lycaon
      pictus) in the Serengeti region, Tanzania. One adult African wild dog in the same
      pack showed central nervous signs consistent with rabies infection. Inactivated
      rabies vaccine was administered intramuscularly to African wild dogs in two
      packs, by dart or by hand following anesthesia. These individuals comprised all
      known adults in the Serengeti National Park. In a limited study of seroprevalence
      of rabies antibody carried out at the time of vaccination, 3 of 12 African wild
      dogs sampled in the Serengeti had rabies serum neutralizing antibody titers
      before vaccination. Paired serum samples from two individuals sampled after
      vaccination showed increased antibody titers.

PMID- 8355342
TI  - Prevalence of Brucella sp. antibodies in feral swine in Florida.
AB  - Serum samples collected from feral swine (Sus scrofa) throughout Florida (USA)
      from 1974 to 1989 were tested for antibodies to Brucella sp. by the card test,
      the standard tube test, the rivanol test or the complement fixation test.
      Seropositive swine were detected at six of 18 sites with a composite prevalence
      of 23.4% (238 of 1,015 samples; range = 5.5% to 33.3%) for sites with
      seropositive swine. At one site for which age and sex data were available there
      was no significant difference (P = 0.50) in seroprevalence between males and
      females. Antibody prevalence in adult (> or = 8 mo) and juvenile swine (< 8 mo),
      however, was significantly different (P < 0.05). Based on these data, Brucella
      sp. infections are limited only to certain populations of feral swine. To avoid
      the spread of Brucella sp. organisms, however, relocation of feral swine is not
      recommended.

PMID- 8355343
TI  - The groundhog tick Ixodes cookei (Acari: ixodidae): a poor potential vector of
      Lyme borreliosis.
AB  - Evidence for infection with the spirochete, Borrelia burgdorferi, was sought in
      Ixodes cookei and in groundhogs (Marmota monax) in southern Ontario, Canada, and
      ticks fed on experimentally inoculated hosts were examined for the spirochete.
      Borrelia burgdorferi was not detected by immunofluorescent examination of 110
      larval, nymphal or adult I. cookei collected from the environment, or taken from
      humans and other animals. Three groundhogs inoculated with B. burgdorferi
      developed titers of 1:20 to 1:80 by the indirect immunofluorescent antibody test,
      but B. burgdorferi was not isolated from the spleens, kidneys, or urinary
      bladders of these animals. One of 30 wild groundhogs had an antibody titer of
      1:20 to B. burgdorferi. Three (5%) of 59 I. cookei larvae fed on B. burgdorferi
      infected hamsters became infected, in comparison with 23 (28%) of 82 I. dammini
      larvae fed on the same hosts. Borrelia burgdorferi was present in 5%, 16% and 4%
      of molted I. cookei nymphs fed on infected hamsters, rats or a groundhog,
      respectively; prevalences of infection in I. dammini fed on the same hosts were
      significantly (P < 0.05) higher (45%, 36%, and 23%, respectively), as was the
      intensity of infection. A naive groundhog on which I. cookei nymphs from an
      infected cohort fed did not become infected with B. burgdorferi, but it is
      uncertain whether an infected tick engorged on the experimental host. Ixodes
      cookei seems to be an inefficient vector of B. burgdorferi, and is unlikely to be
      significant in nature. Groundhogs are potential wildlife reservoirs of B.
      burgdorferi, based on their capacity to transmit infection to I. dammini.

PMID- 8355344
TI  - Findings in pinnipeds stranded along the central and northern California coast,
      1984-1990.
AB  - Personnel at The Marine Mammal Center (The Center) treated 1,446 stranded marine
      mammals recovered from the central and northern California (USA) coast from 1984
      through 1990, including California sea lions (Zalophus californianus), northern
      elephant seals (Mirounga angustirostris), Pacific harbor seals (Phoca vitulina
      richardsi), northern fur seals (Callorhinus ursinus), Steller sea lions
      (Eumetopias jubatus), and Guadalupe fur seals (Arctocephalus townsendi). The
      primary disease findings in stranded California sea lions were renal disease,
      renal disease complicated by severe verminous pneumonia, verminous pneumonia,
      seizures of unknown etiology, and renal disease complicated by severe pneumonia
      of unknown etiology. Stranded elephant seals included pups, yearlings with
      dermatological problems, and neonates. Most harbor seals admitted to The Center
      were underweight and premature pups. Stranded northern fur seals included animals
      with seizures of unknown etiology and emaciated pups. Stranded Steller sea lions
      included underweight pups and aged adult females with pneumonia. Two Guadalupe
      fur seals had hemorrhagic gastroenteritis. Incidental findings at the time of
      stranding among the six species included verminous pneumonia and pneumonia of
      unknown etiology, renal disease, internal parasitism, ophthalmologic problems,
      gastrointestinal disorders, otitis externa, and external wounds.

PMID- 8355345
TI  - Experimental infection of domestic ducks and rodents by Notocotylus attenuatus
      (Trematoda: Notocotylidae).
AB  - In order to study transmission patterns of Notocotylus attenuatus five 3-wk-old
      domestic ducks, five 8-wk-old rats and ten 4-wk-old mice were infected with the
      parasite. All ducks became infected and all flukes were recovered from the
      intestinal ceca. Worms moved down the length of the cecum during development and
      as the parasites grew they changed their method of attachment. Flukes became
      gravid by day 16 post-infection, after which growth ceased. Egg filaments appear
      to play a role in the formation and movement of worm egg clusters from the distal
      portion of the cecum to the lumen of small intestine. Rodents also became
      infected with the parasite producing granulomatous nodular lesions in the lower
      small intestine but all flukes in the granulomata were dead. It is unlikely that
      transmission of this trematode can depend on mice and rats.

PMID- 8355346
TI  - Parasites of the arctic fox (Alopex lagopus) in Iceland.
AB  - Forty-four of 50 arctic foxes (Alopex lagopus) in Iceland harbored 15 species of
      intestinal parasites, including Protozoa: Eimeria sp. or Isospora sp. (in 4%);
      Trematoda: Cryptocotyle lingua (24%), Plagiorchis elegans (4%), Brachylaemus sp.
      (12%), Tristriata sp. (10%), and Spelotrema sp. (8%); Cestoda: Mesocestoides
      canislagopodis (72%), Schistocephalus solidus (2%), and Diphyllobothrium
      dendriticum (4%); Nematoda: Toxascaris leonina (50%), Toxocara canis (2%),
      Uncinaria stenocephala (4%), and eggs of the lung worm Capillaria aerophila (6%);
      and Acanthocephala: Polymorphus meyeri (8%) and Corynosoma hadweni (2%). Only
      four of the species previously had been recorded in Iceland. Eleven species are
      new records in Iceland and six appear to be new host records. Two additional
      nematodes, Stegophorus stercorarii and Syphacia sp., probably were ingested
      accidentally with the prey. Foxes from coastal habitats harbored 14 parasitic
      species while only five species were found in foxes from inland habitats. Arctic
      foxes from coastal habitats generally had higher helminth burdens and harbored
      more parasitic species per fox than foxes from inland habitats.

PMID- 8355347
TI  - Injuries and behavior of raccoons (Procyon lotor) captured in the Soft Catch and
      the EGG traps in simulated natural environments.
AB  - The behavior and injuries of raccoons held for 12 and 24 hr in the Soft Catch and
      the EGG traps were studied in simulated natural environments. Nine raccoons held
      for 12 hr in the Soft Catch received minor injuries. However, one of nine
      raccoons held for 24 hr in this trap mutilated itself. The EGG trap caused only
      minor injuries to nine raccoons held for 12 hr, and nine others held for 24 hr.
      Thus the EGG trap can be expected, at a 95% level of confidence, to hold > or =
      70% of the raccoons on traplines for 24 hr without serious injury. Raccoons
      captured in the Soft Catch fought their surroundings more than the trap. Those
      captured in the EGG trap fought the trap more than their surroundings. During the
      24-hr capture study, escape behavior was more intense during the first 12 hr of
      capture, during both day and night.

PMID- 8355348
TI  - Hematologic, serologic values, histopathologic and fecal evaluations of bison
      from Yellowstone Park.
AB  - Hematologic and blood chemistry parameters were measured in 149 free-ranging
      American bison (Bison bison) from Yellowstone National Park, Wyoming (USA).
      Additionally, histopathologic evaluations of lung, liver, spleen, kidney, and
      mesenteric and bronchial lymph nodes were made from ten animals. Forty-five fecal
      samples were screened for the presence of helminth ova. Leukopenia and markedly
      low blood urea nitrogen concentrations were the most notable differences observed
      from other bison populations. All tissues examined were essentially normal; there
      was evidence of moderate intestinal parasite burdens.

PMID- 8355349
TI  - Response of Canada geese to a turf application of diazinon AG500.
AB  - We investigated the effects of a turf application of the insecticide diazinon
      AG500 on Canada geese (Branta canadensis) on a golf course in coastal Washington
      (USA). On both 19 and 26 March 1987, 1 ha of turf on a golf course located in
      Birch Bay, Washington was treated with diazinon AG500 at a target application
      rate of 2.2 kg active ingredient per hectare (AI/ha). Treated areas were then
      irrigated with 6 mm water. Grass and water samples were collected from three
      different sites one day before and 1, 3, 7 and 14 days after each application.
      Diazinon residues > or = 20 ppm were found in golf course grasses for one week
      after each application. Diazinon residues in study area ponds and creeks were >
      or = 17 ppb. Samples from two irrigation puddles one day post-application had
      1.00 and 0.20 ppm of diazinon, respectively. Numbers of geese present declined
      following diazinon application; however, no goose mortality was observed. Geese
      spent 422 and 538 min feeding on the treated areas after the first and second
      diazinon applications, respectively. One goose feeding in treated areas
      demonstrated signs of poisoning (lethargy, ataxia) for several hours. Two other
      geese feeding in the treated areas may have been slightly intoxicated. During
      carcass searches, three American wigeon (Anas americana) carcasses were found.
      Based on brain cholinesterase (ChE) levels and gastrointestinal (GI) tract
      residues of diazinon present, we concluded that these wigeon died from diazinon
      poisoning. Numerous songbirds (Passeriformes) also fed on the treated turf but no
      apparent response to the insecticide was observed.

PMID- 8355350
TI  - Phocine distemper in harbor seals (Phoca vitulina) from Long Island, New York.
AB  - The first occurrence of phocine distemper (PD) disease in harbor seals (Phoca
      vitulina) from the United States is reported. Two seals stranded on Long Island,
      New York (USA) in February 1992 with clinical signs of respiratory distress,
      fever, and depression. Pneumonia and diffuse pulmonary congestion were the most
      significant post mortem findings. On histologic examination one seal had a
      diffuse broncho-interstitial pneumonia with formation of syncytia. The principal
      lesion in the second animal was nonsuppurative meningoencephalitis. Using
      immunoperoxidase staining, PD viral antigen was found in the cytoplasm of
      bronchiolar epithelium and cerebral cortex neurons. With a differential virus
      neutralization test, there were higher titers against phocine distemper virus
      (PDV) than against canine distemper virus. Thus, PDV is the most likely agent
      responsible for the observed lesions.

PMID- 8355351
TI  - Further studies on the susceptibility of raccoons (Procyon lotor) to a rabies
      virus of skunk origin and comparative susceptibility of striped skunks (Mephitis
      mephitis).
AB  - Two raccoons (Procyon lotor) were inoculated in the masseter muscles with 10(5.9)
      mouse intracerebral lethal dose50 (MICD50) of a rabies virus isolated from a
      naturally infected Iowa (USA) striped skunk (Mephitis mephitis). Five striped
      skunks were inoculated with either 10(0.7) or 10(2.1) MICLD50 of the same
      isolate. All five skunks died within 35 days following inoculation. Both raccoons
      survived 273 days without adverse effects, and virus was not isolated from saliva
      samples taken at between 25 and 273 days following inoculation.

PMID- 8355352
TI  - Isolation of Borrelia burgdorferi from the blood of a bushy-tailed wood rat in
      California.
AB  - Borrelia burgdorferi was isolated from the blood of a bushy-tailed wood rat
      (Neotoma cinerea) from northeastern California, USA. This is the first isolation
      of live B. burgdorferi spirochetes from a wild animal in California. Spirochetes
      were observed in stained tissues from the brain, liver, spleen, and kidneys.

PMID- 8355353
TI  - Serological evidence of Coxiella burnetii infection in wild animals in Japan.
AB  - One hundred and thirty-four (26%) of 511 sera from 11 wild animal species in
      eight prefectures in Japan had antibody titers to Coxiella burnetii by the enzyme
      linked immunosorbent assay. High prevalences were observed in Japanese black
      bears (Ursus thibetanus) (78%), Hokkaido deer (Cervus nippon yesoensis) (69%),
      Japanese hares (Lepus brachyurus) (63%), Japanese deer (Cervus nippon centralis)
      (56%), and to some extent in Japanese monkeys (Macaca fuscata) (28%). A low
      prevalence (13%) was observed in nutrias (Myocastor coypus). Japanese serows
      (Capricornis crispus), wild rats (Muroides sp.), raccoon dogs (Nyctereutes
      procyonoides viverrinus), wild pigs (Sus scrofa leucomystax), and masked palm
      civets (Paguma larvata) had no detectable antibodies to C. burnetii. Thus, six of
      11 wild animal species in Japan were exposed to C. burnetii. Based on the high
      prevalences in some species, they may be a potential source of infection to both
      domestic animal and human populations.

PMID- 8355354
TI  - Mucor amphibiorum infection in platypus (Ornithorhynchus anatinus) from Tasmania.
AB  - Mucor amphibiorum, a fungus previously isolated from frogs and toads, is reported
      from free-living platypus, Ornithorhynchus anatinus, from rivers in northern
      Tasmania. This fungus is responsible for the severe ulcerative skin condition
      originally described by Munday and Peel (1983). Mucor amphibiorum was isolated
      from dermal lesions on four separate occasions. The gross and histopathological
      appearance of the fungal lesions were similar to the earlier description. In vivo
      this fungus develops as spherical forms containing a number of daughter
      spherules; no mycelia are seen in tissue sections. By contrast, the in vitro
      growth consists of aerial aseptate mycelia and sporangia, features typical of the
      genus Mucor. This is the first report of this organism causing a fatal disease in
      a mammal. Susceptibility to infection may be due to the platypus having a body
      temperature of 32 C while the maximum temperature for growth of M. amphibiorum is
      36 C.

PMID- 8355355
TI  - Lobo's disease in a bottlenose dolphin (Tursiops truncatus) from Matagorda Bay,
      Texas.
AB  - Lobo's disease was diagnosed in a free-ranging male bottlenose dolphin Tursiops
      truncatus examined as part of a live-capture and release program conducted in
      Matagorda Bay, Texas, USA, during July 1992. Diagnosis was based on typical
      presentation of a raised skin lesion, with sub-epidermal granuloma and
      demonstration of typical features of the organism by light microscopy, using
      hematoxylin and eosin, and methenamine silver stains. This is the first instance
      of Lobo's disease found in a dolphin on the western coast of the Gulf of Mexico.

PMID- 8355356
TI  - Epizootic mortality of free-living green turtles, Chelonia mydas, due to
      coccidiosis.
AB  - At least 70 wild green sea turtles, Chelonia mydas, died in the Moreton Bay area
      of southeast Queensland, Australia over 6 wk in spring 1991. Based on the
      necropsy of 24 turtles, there was a severe enteritis or encephalitis associated
      with Caryospora cheloniae, a coccidial pathogen previously recorded only in farm
      reared Ch. mydas hatchlings. Infection was characterized by the presence of
      coccidia in extra-intestinal lesions. Oocysts were observed to sporulate, after
      which sporozoites escaped into seawater to form a novel stellate configuration.
      We conclude that C. cheloniae is pathogenic for life stages other than hatchling
      Ch. mydas and that naturally-occurring coccidiosis is a significant disease of
      free-living Ch. mydas.

PMID- 8355357
TI  - Enteric coccidia (Apicomplexa) in the small intestine of the northern spotted owl
      (Strix occidentalis caurina).
AB  - Sporulated oocysts (mean dimensions = 13.0 x 10.8 microns) and sporocysts (11.3 x
      5.5 microns) of a coccidian resembling Frenkelia sp. or Sarcocystis sp. were
      present in the lamina propria of the small intestine of a naturally-infected
      northern spotted owl (Strix occidentalis caurina) collected near Medford, Oregon
      (USA). Dimensions of these oocytes and sporocysts appear to be considerably
      smaller than those from other sarcocystid species with avian definitive hosts.
      Additionally, numerous developmental stages and unsporulated oocysts (mean
      dimensions 22.8 x 17.8 microns) of a possible species of Isospora also were
      observed in the intestinal epithelium. This constitutes the first report of
      enteric coccidia from spotted owls. Neither parasite appeared to cause the death
      of the bird.

PMID- 8355358
TI  - Evaluation of fox-chasing enclosures as sites of potential introduction and
      establishment of Echinococcus multilocularis.
AB  - Following detection of Echinococcus multilocularis in red foxes (Vulpes vulpes)
      illegally imported into South Carolina (USA) for release in fox-chasing
      enclosures, a survey for E. multilocularis was conducted in four enclosures in
      Georgia (USA) and six enclosures in South Carolina. Survey methods included
      examination of potential small mammal intermediate hosts (n = 390) for E.
      multilocularis larvae, examination of fox and coyote (Canis latrans) scats (n =
      59) for taeniid eggs, and examination of one possible canine definitive hosts for
      adult E. multilocularis. All intermediate and definitive hosts examined were
      negative for E. multilocularis and taeniid eggs were not recovered from fox and
      coyote fecal samples. Thus, E. multilocularis may not yet be established in fox
      chasing enclosures in Georgia and South Carolina. Despite the failure to
      demonstrate E. multilocularis in the fox-chasing enclosures surveyed,
      translocation of wild canids from known enzootic regions should be discouraged
      because E. multilocularis is known to be ecologically adaptable and because
      contact with potentially infected definitive hosts during translocation is a
      public health risk.

PMID- 8355360
TI  - The lungworm, Halocercus spp. (Nematoda: Pseudaliidae) in cetaceans from
      California.
AB  - Three cetaceans from Monterey Bay, California (USA), were infected with lung
      nematodes. A beaked whale calf, Mesoplodon sp. was infected with adult Halocercus
      sp. This represents a new host record for this nematode. The lungs of a northern
      right whale dolphin calf, Lissodelphis borealis, contained an unidentified
      nematode similar in size to Halocercus sp. The presence of Phyllobothrium
      delphini-type cestode larvae in its blubber is evidence that the calf was feeding
      on invertebrates. A pregnant harbor porpoise, Phocoena phocoena was infected with
      the lung nematode H. invaginatus, but the fetus was uninfected. We found no
      direct evidence of a transplacental mode of transmission for Halocercus sp.

PMID- 8355359
TI  - Parasitic meningoencephalitis in nurse sharks (Ginglymostoma cirratum).
AB  - Based on microscopic examination of the brains of seven wild-caught nurse sharks
      (Ginglymostoma cirratum), we observed a severe meningoencephalitis associated
      with numerous parasitic granulomas. The parasites were larval nematodes with
      morphological characteristics of the Superfamily Dracunculoidea. Although
      meningeal larval aggregates were associated with chronic inflammation, additional
      parasitic nodules found on the endocardial surface and perimandibular region did
      not provoke an inflammatory response. Neither the route of infection nor life
      cycle were determined.

PMID- 8355361
TI  - Spiroxys contorta (Nematoda: spirurida) in gastric granulomas of Apalone
      spinifera pallida (Reptilia: testudines).
AB  - Non-caseating granulomas containing larval spirurid nematodes (Spiroxys contorta)
      were observed in the gastric submucosa and muscularis externa of two pallid spiny
      softshells (Apalone spinifera pallida) from northcentral Texas (USA). In early
      granulomas, nematodes were not surrounded by a fibrous capsule but in older,
      mature granulomas, a fibrous capsule was present. Granulomas without nematodes
      also were present.

PMID- 8355362
TI  - Spiculopteragia spiculoptera and S. asymmetrica (Nematoda: Trichostrongyloidea)
      from red deer (Cervus elaphus) in Texas.
AB  - Specimens of Spiculopteragia spiculoptera and S. asymmetrica were recovered from
      the abomasa of five of ten naturally infected red deer (Cervus elaphus) in Texas
      (USA). Female specimens of Spiculopteragia were present in all five animals. Male
      specimens of S. spiculoptera and S. asymmetrica were present in one of five and
      three of five red deer, respectively. Spiculopteragia spiculoptera has not
      previously been recognized in the United States and the present report
      constitutes the first records of Spiculopteragia spp. in red deer from North
      America. It is likely that species of Spiculopteragia have been introduced to
      North America with the import of exotic cervids on several occasions. Focal
      populations of these nematodes have been established in North America; however,
      distribution of the parasites likely coincides with areas of residence of
      introduced populations of red deer and fallow deer (Cervus dama) in the Nearctic.

PMID- 8355363
TI  - Longistrongylus curvispiculum (Nematoda: Trichostrongyloidea) in free-ranging
      exotic antelope in Texas.
AB  - Longistrongylus curvispiculum was recovered from free ranging sable (Hippotragus
      niger), addax (Addax nasomaculatus) and biesa oryx (Oryx beisa) on two ranches in
      central Texas (USA). These nematodes represented a small portion of the total
      abomasal worm burden dominated by Haemonchus contortus. Female L. curvispiculum
      easily could be confused with other ostertaginae, but the spicules of the males
      were diagnostic.

PMID- 8355365
TI  - Direct consumer advertising of prescription drugs.

PMID- 8355364
TI  - Hepatic capillariasis in muskrats (Ondatra zibethicus).
AB  - We present the first prevalence data of hepatic capillariasis in muskrats in
      Pennsylvania and Connecticut (USA). The prevalence of hepatic capillariasis in
      five groups of muskrats coming from different locations and numbering 81, 229,
      11, 19, and 20 animals, was 42%, 78%, 36%, 16%, and 0%, respectively. Liver
      lesions varied from minimal to severe multifocal granulomatous hepatitis, often
      containing adult worms or eggs.

PMID- 8355367
TI  - National Medical Association unveils billboard campaign to promote health in
      black communities.

PMID- 8355366
TI  - A piece of my mind. The legacy.

PMID- 8355368
TI  - New telecommunications relay services, other communication advances, will aid
      disabled people.

PMID- 8355369
TI  - From the National Institutes of Health.

PMID- 8355370
TI  - From the Centers for Disease Control and Prevention. Emergency department
      response to domestic violence--California, 1992.

PMID- 8355371
TI  - From the Centers for Disease Control and Prevention. Update: hantavirus disease-
      United States, 1993.

PMID- 8355372
TI  - 'Windows of opportunity' to address patients' concerns: too small and too few?

PMID- 8355373
TI  - 'Windows of opportunity' to address patients' concerns: too small and too few?

PMID- 8355374
TI  - 'Windows of opportunity' to address patients' concerns: too small and too few?

PMID- 8355376
TI  - Pressure ulcer prevention with low-air-loss beds.

PMID- 8355375
TI  - Survival after ovarian cancer treatment.

PMID- 8355377
TI  - Beauty parlor stroke: when a beautician becomes a physician.

PMID- 8355378
TI  - Giving pediatric immunizations the priority they deserve.

PMID- 8355379
TI  - Giving pediatric immunizations the priority they deserve.

PMID- 8355380
TI  - Giving pediatric immunizations the priority they deserve.

PMID- 8355381
TI  - Giving pediatric immunizations the priority they deserve.

PMID- 8355382
TI  - Assessment of splanchnic oxygenation by gastric tonometry in patients with acute
      circulatory failure.
AB  - OBJECTIVE: To investigate the importance of splanchnic ischemia in patients with
      acute circulatory failure by comparing gastric intramucosal pH as measured by
      tonometry with conventional methods of assessing adequacy of tissue oxygenation.
      DESIGN: Prospective cohort of patients with acute circulatory failure in first 24
      hours after admission to the intensive care unit. SETTING: Two general intensive
      care units in London, England. PATIENTS: Consecutive sample of 83 patients of
      varying diagnostic categories that required pulmonary artery catheterization.
      MAIN OUTCOME MEASURES: Gastric intramucosal pH and hemodynamic, oxygen transport,
      and metabolic variables were measured on admission and at 12 hours and 24 hours
      after admission. Prediction of outcome (death or survival) by each measurement
      was assessed by sensitivity, specificity, and logistic regression analysis.
      RESULTS: Mean 24-hour Acute Physiology and Chronic Health Evaluation (APACHE II)
      score was 20.3. There were significant differences in mean gastric intramucosal
      pH between survivors and nonsurvivors on admission and at 24 hours, (7.40 vs
      7.28, 7.40 vs 7.24, respectively; P < .001). Admission heart rate was higher (116
      vs 101 beats per minute; P < .003) and mean arterial pressure lower (82 vs 97 mm
      Hg; P < .01) in nonsurvivors. There were no consistent differences in cardiac
      index, oxygen delivery, and oxygen uptake between survivors and nonsurvivors.
      Admission arterial pH was significantly lower (7.3 vs 7.36; P < .003), base
      excess more negative (-5.3 vs -1.9; P < .001), and lactate concentration higher
      (3.14 vs 1.91 mmol/L; P < .03) in nonsurvivors. Gastric intramucosal pH had a
      sensitivity of 88% for predicting death and a likelihood ratio of 2.32, higher
      than for any other variable. Only gastric intramucosal pH at 24 hours
      independently predicted outcome. CONCLUSIONS: Gastric intramucosal pH was the
      most reliable indicator of adequacy of tissue oxygenation in this group of
      patients. Inadequate regional blood flow as detected by a reduction in gastric
      intramucosal pH, but not by systemic measures, is an important contributor to
      morbidity and mortality in intensive care units.

PMID- 8355383
TI  - Prehospital-initiated vs hospital-initiated thrombolytic therapy. The Myocardial
      Infarction Triage and Intervention Trial.
AB  - OBJECTIVE: To determine the effect of prehospital-initiated vs hospital-initiated
      treatment of myocardial infarction on clinical outcome. DESIGN: Randomized,
      controlled clinical trial. SETTING: Multicenter study involving 19 hospitals and
      all paramedic systems in the Seattle, Wash, metropolitan area. PATIENTS: A total
      of 360 patients with symptoms for 6 hours or less, no risk factors for serious
      bleeding, and ST-segment elevation were selected by paramedics and a remote
      physician for inclusion into the trial. They represented 4% of patients with
      chest pain who were screened and 21% of those with acute infarction.
      INTERVENTIONS: Patients were allocated to have aspirin and alteplase treatment
      initiated before or after hospital arrival. Intravenous sodium heparin was
      administered to both groups in the hospital. MAIN OUTCOME MEASURE: The primary
      endpoint was a ranked composite score (combining death, stroke, serious bleeding,
      and infarct size). The relation between time to treatment and outcome (composite
      score, infarct size, ejection fraction, and mortality) was also assessed.
      RESULTS: Initiating treatment before hospital arrival decreased the interval from
      symptom onset to treatment from 110 to 77 minutes (P < .001). Although more
      patients whose therapy was initiated before hospital arrival had resolution of
      pain by admission (23% vs 7%; P < .001), there were no significant differences in
      the composite score (P = .64), mortality (5.7% vs 8.1%), ejection fraction (53%
      vs 54%), or infarct size (6.1% vs 6.5%). A secondary analysis of time to
      treatment and outcome showed that treatment initiated within 70 minutes of
      symptom onset was associated with better outcome (composite score, P = .009;
      mortality, 1.2% vs 8.7%, P = .04; infarct size, 4.9% vs 11.2%, P < .001; and
      ejection fraction, 53% vs 49%, P = .03) than later treatment. Identification of
      patients eligible for thrombolysis by paramedics reduced the hospital treatment
      time from 60 minutes (for patients not in the study) to 20 minutes (for study
      patients allocated to begin treatment in the hospital). CONCLUSION: There was no
      improvement in outcome associated with initiating treatment before hospital
      arrival; however, treatment within 70 minutes of symptom onset--whether in the
      hospital or in the field--minimized the infarct process and its complications.

PMID- 8355384
TI  - Anabolic-androgenic steroid use in the United States.
AB  - OBJECTIVE: To estimate the size of the anabolic-androgenic steroid (AAS) user
      population in the United States, to examine characteristics of AAS users, and to
      explore the association between AAS use and the use of other illicit drugs as
      well as self-reported aggressive behaviors. DESIGN: A cross-sectional study using
      data from the 1991 National Household Survey on Drug Abuse. STUDY POPULATION: The
      survey covered the population aged 12 years and older living in households in the
      United States. The results of the survey were based on personal interviews
      combined with self-administered questionnaires from 32,594 respondents. These
      respondents were randomly selected by means of a stratified multistage area
      sample of the household population. RESULTS: Estimates based on data from the
      National Household Survey on Drug Abuse indicated that there are more than 1
      million current or former AAS users in this country, with more than half of the
      lifetime user population being 26 years of age or older. More than 300,000
      individuals used AAS in the past year. Males had higher levels of AAS use during
      their lifetime than females (0.9% and 0.1%, respectively; P < .01). The median
      age of first use of AAS for the study population was 18 years; for 12- to 17-year
      olds, the median age of initiation was 15 years. Among 12- to 34-year-olds, AAS
      use was significantly and positively associated with the use of other illicit
      drugs (P < .05), cigarettes (12- to 17-year-olds only; P < .01), and alcohol (P <
      .01). Furthermore, AAS use is highly correlated with self-reported aggressive
      behavior (P < .01) and crimes against property (P < .01). CONCLUSIONS: These
      results indicate that AAS use impacts a large number of men and women from
      various racial and age groups across the nation. While causal inferences cannot
      be made regarding the associations between AAS use and use of other drugs as well
      as antisocial behavior, these findings should enhance our ability to profile the
      typical AAS user.

PMID- 8355385
TI  - Alcohol-related hospitalizations of elderly people. Prevalence and geographic
      variation in the United States.
AB  - OBJECTIVE: To determine the prevalence, geographic variation, and charges to
      Medicare of alcohol-related hospitalizations among elderly people in the United
      States. DESIGN: A cross-sectional prevalence study using 1989 hospital claims
      data from the Health Care Financing Administration (HCFA). Rates were determined
      using (1) hospital claims records from the HCFA's Medicare Provider Analysis and
      Review Record (MEDPAR) database for all Medicare Part A beneficiaries aged 65
      years and older; (2) county population estimates for 1985 from the Bureau of the
      Census; and (3) per capita consumption of alcohol by state in 1989 as estimated
      by the US Department of Health and Human Services. SETTING: Data include all
      hospital inpatient Medicare Part A beneficiaries aged 65 years and older in the
      United States in 1989. RESULTS: The prevalence of alcohol-related
      hospitalizations among people aged 65 years and older nationally in 1989 was 54.7
      per 10,000 population for men and 14.8 per 10,000 for women. Comparison with
      hospital records showed that MEDPAR data had a sensitivity of 77% to detect
      alcohol-related hospitalizations. There was considerable geographic variation;
      prevalence ranged from 18.9 per 10,000 in Arkansas to 77.0 per 10,000 in Alaska.
      A strong correlation existed between alcohol-related hospitalizations and per
      capita consumption of alcohol by state (Spearman correlation coefficient, .64; P
      < .0001). In 1989, the hospital-associated charges to Medicare for all admissions
      where the primary diagnosis was alcohol related (N = 33,039) totaled
      $233,543,500. Median charge per hospital stay was $4514. CONCLUSIONS: Alcohol
      related hospitalizations among elderly people are common; rates were similar to
      those for myocardial infarction as detected by the same method. The charges to
      Medicare for this preventable problem are considerable. Ecological analysis
      suggests that per capita consumption in the total US population predicts alcohol
      related hospitalizations in the elderly population.

PMID- 8355386
TI  - Fee-for-time system. A conceptual framework for an incentive-neutral method of
      physician payment.

PMID- 8355387
TI  - Endometrial ablation complicated by fatal hyponatremic encephalopathy.
AB  - OBJECTIVES: To investigate the occurrence of hyponatremic encephalopathy and the
      effects of therapy for symptomatic hyponatremia on outcome in women undergoing
      endometrial ablation. DESIGN AND SETTING: Consultations from university
      affiliated and community hospitals from June 1991 to June 1992. PATIENTS: Four
      generally healthy women who underwent elective endometrial ablation for
      dysfunctional bleeding and developed hyponatremic encephalopathy. INTERVENTIONS:
      Three patients were promptly treated with hypertonic (514 mmol/L) sodium chloride
      such that the serum sodium level increased from 102 to 123 mmol/L within 24
      hours. The fourth patient was not treated until after suffering grand mal
      seizures followed by respiratory arrest. MAIN OUTCOME MEASURES: Of the four
      patients who developed hyponatremic encephalopathy, the diagnosis was established
      before respiratory arrest occurred in three. The operative procedure was
      terminated and all three were aggressively treated with intravenous hypertonic
      sodium chloride, which raised the serum sodium level to modestly hyponatremic
      levels (120 to 130 mmol/L). All three completely recovered without sequelae. The
      fourth patient suffered respiratory arrest before therapy could be initiated. The
      patient remained comatose, and central diabetes mellitus and insipidus developed.
      She never regained consciousness and died after several days. Autopsy revealed
      cerebral edema and tonsillar herniation. RESULTS: The mean (+/- SD) preoperative
      serum sodium level was 138 +/- 1 mmol/L; at the time of diagnosis of
      hyponatremia, it was 107 +/- 13 mmol/L. In two patients, hyponatremic
      encephalopathy was diagnosed intraoperatively because of tremulousness and either
      hypothermia or hypoxemia. In the other two patients, the diagnosis was made
      postoperatively because of headache, nausea, emesis, and in one of these
      patients, respiratory arrest. CONCLUSIONS: Women undergoing elective endometrial
      ablation can develop severe symptomatic hyponatremia, which can be fatal. The
      presence of symptoms suggesting hypo-osmolality should lead to immediate
      measurement of plasma sodium level. If hyponatremia with hypo-osmolality is
      present, early and appropriate therapy for the hyponatremia should be instituted
      before respiratory insufficiency occurs.

PMID- 8355388
TI  - The clinical evaluation of new drugs for sepsis. A prospective study design based
      on survival analysis.
AB  - OBJECTIVE: To develop a survival model and severity assessment method to estimate
      the 28-day mortality risk for patients with sepsis syndrome entering phase 2 and
      3 drug evaluations. DESIGN: Retrospective analysis of intensive care unit
      admissions with sepsis syndrome by means of log-normal regression to identify
      risk factors for 28-day mortality. Prospective application of the model to
      patients with gram-negative infection meeting sepsis syndrome criteria from
      separate data collection (validation group). PATIENTS: A total of 58,737
      intensive care unit admissions at 107 hospitals in the United States and Western
      Europe screened to yield 1195 patients meeting entry criteria for the sepsis
      syndrome study for the original model; 295 hospitalized patients with gram
      negative infection meeting criteria for sepsis syndrome for validation. MAIN
      OUTCOME MEASURES: Survival time and mortality at 28 days after fulfillment of the
      sepsis syndrome criteria. RESULTS: Acute physiologic abnormalities were the most
      important prognostic factors influencing outcome (82% of total chi 2). Specific
      disease resulting in intensive care unit admission and the time the patient was
      in the hospital and intensive care unit before qualification were also
      independent risks, as were age and a clinical history of cirrhosis. The model's
      overall classification accuracy was a Somers' Dyx of .52 (rank correlation
      between predicted risk and 28-day mortality) (receiver operating characteristic
      area, 0.76), with equal accuracy (Dyx = .59; receiver operating characteristic
      area, 0.80) in the independent group of patients. CONCLUSIONS: We created an
      accurate independent estimate for 28-day mortality risk for patients with sepsis
      syndrome (severe sepsis). This estimate could improve the evaluation of new drugs
      by investigating whether the drug's benefit varies by patient risk and then
      determining the amount of benefit for individual patients.

PMID- 8355389
TI  - Does this patient have sinusitis? Diagnosing acute sinusitis by history and
      physical examination.

PMID- 8355390
TI  - The gastrointestinal tract. The canary of the body?

PMID- 8355391
TI  - House of Delegates reaffirms editorial independence for AMA's scientific
      journals.

PMID- 8355392
TI  - Morphological study on vagal innervation in human atrioventricular valves using
      histochemical method.
AB  - To demonstrate innervation in human atrioventricular valves, we examined the
      tricuspid and mitral valves of apparently normal autopsied hearts of four men
      (ages ranging from 50 to 74 years). Whole valve tissues were stained for
      acetylcholinesterase by a histochemical method. Acetylcholinesterase-positive
      nerve fibers with a diameter of 2 to 5 microns were distributed widely in the
      deep atrialis of the atrioventricular valves and partly in the fibrosa. The nerve
      fibers formed a network or plexus from the base to the anatomical edge of the
      valves. Meshes of the nerve fiber network were more dense towards the base and at
      the commissure than either towards the edge or at the body. Thicker nerve fibers,
      which were interspersed coarsely in the leaflets, were intercalated by special
      varicose apparatuses at a few sites in their long running course. On the
      contrary, thinner nerve fibers which were distributed abundantly, ended, as a
      rule, in small dotor brush-like formations. Approximately half of the chordae
      tendineae were innervated by the nerve fibers. The mode of vagal innervation
      suggests that the nerve system may assist valve movement by moderating myocyte
      contraction in the valve base and change valve structure by sensing a stress in
      the valves.

PMID- 8355393
TI  - Age-related changes of sinus node function and autonomic regulation in subjects
      without sinus node disease--assessment by pharmacologic autonomic blockade.
AB  - To assess the relationship between aging and autonomic regulation of sinus node
      function, 56 subjects of various ages (range 14-75 years, mean 43 +/- 19 years)
      without sinus node disease were studied. Heart rate, corrected sinus node
      recovery time and sinoatrial conduction time were measured before (basic) and
      after (intrinsic) pharmacologic autonomic blockade (propranolol + atropine i.v.).
      Percent chronotropies of the above parameters were calculated by a modified
      Jordan's method. Basic heart rate and basic corrected sinus node recovery time
      did not vary with age (r = -0.15, r = 0.08, respectively), while basic sinoatrial
      conduction time tended to increase with age (r = 0.32, p < 0.05). Intrinsic heart
      rate decreased (r = -0.76, p < 0.001), and intrinsic corrected sinus node
      recovery time and intrinsic sinoatrial conduction time both increased with age (r
      = 0.55, p < 0.001; r = 0.56, p < 0.001, respectively). The younger the subject,
      the more negative the percent chronotropies of the above parameters were, and the
      percent chronotropies correlated positively with age (r = 0.68, p < 0.001; r =
      0.52, p < 0.001 and r = 0.34, p < 0.05, respectively). In conclusion, intrinsic
      sinus node functions deteriorated with age. Furthermore, parasympathetic tone on
      the sinus node functions decreased with age, which may compensate for age-related
      deterioration of intrinsic sinus node function.

PMID- 8355394
TI  - Determinants of beneficial effect of heparin exercise treatment on treadmill
      capacity and long-term efficacy of the therapy in patients with chronic effort
      angina.
AB  - The purpose of the present study was to evaluate the factors which influence the
      effect of heparin exercise treatment on treadmill capacity, and to examine the
      long-term efficacy of the treatment in 16 patients with chronic effort angina.
      Treadmill exercise was performed 20 times for 2 to 3 weeks according to standard
      Bruce protocol. A single intravenous dose of heparin (5,000 IU) was given 10 min
      before each exercise period. Exercise with heparin pretreatment increased the
      total exercise duration from 6.6 +/- 1.6 (SD) to 9.4 +/- 1.9 min (p < 0.05) and
      the maximal rate-pressure product from 19,200 +/- 4,700 to 24,700 +/- 5,900
      mmHg.beats/min (p < 0.05). The rate-pressure product at the onset of angina was
      also increased by 32% (p < 0.05). The ST segment depression at the same exercise
      time as in control exercise was ameliorated from 0.16 +/- 0.05 to 0.12 +/- 0.06
      mV (p < 0.05). Multivariate analysis of the determinants of the effect of the
      treatment on treadmill capacity indicated that the treatment is more effective in
      patients without previous myocardial infarction. All of the above-mentioned
      variables of treadmill capacity did not change significantly during a follow-up
      period of 13 +/- 7 months (range; 4-24 months). These findings lend further
      support to heparin exercise treatment as a possible therapeutic approach in
      patients with chronic stable effort angina, and particularly in those without
      previous infarction.

PMID- 8355395
TI  - Augmentation of smoking cessation education by urinary cotinine measurement.
AB  - Monitoring the current smoking status by an objective method may augment the
      effects of smoking cessation instruction. To quantitatively evaluate smoking
      status and its modification by smoking cessation instruction, urinary cotinine, a
      major metabolite of nicotine, was measured by radioimmunoassay in 64 patients
      with a smoking habit before and during smoking cessation instruction. Urinary
      cotinine levels were used to discriminate between smokers and nonsmokers (with 50
      ng/ml used as a threshold). In 49 patients who claimed to have stopped smoking,
      urinary cotinine concentrations 1 month after instruction indicated that only 30
      (61%) of them had actually stopped (before: 243 +/- 104, after: 1 +/- 3 ng/ml)
      (mean +/- standard deviation). In the remaining 15 patients who failed to stop
      smoking while reporting a reduction of cigarette consumption (before: 27 +/- 12,
      after: 7 +/- 5/day), there was no appreciable reduction in urinary cotinine
      levels (before: 298 +/- 140, after: 229 +/- 171 ng/ml). When the patients who had
      failed to stop smoking again received intensive smoking cessation instruction,
      the success rate increased from 47% (30/64) to 69% (44/64) (p < 0.05). Thus,
      urinary cotinine measurement may provide a useful and quantitative method for
      monitoring actual smoking habits and thus augment the efficacy of smoking
      cessation educational programs.

PMID- 8355396
TI  - The relationship between serum lipoprotein(a) and restenosis after initial
      elective percutaneous transluminal coronary angioplasty.
AB  - The purpose of this study was to elucidate the possible link between
      lipoprotein(a) (Lp(a)) and the occurrence of restenosis after initial elective
      percutaneous transluminal coronary angioplasty (PTCA). Serum lipids, including
      Lp(a), total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol,
      apolipoprotein A-I (Apo A-I), and apolipoprotein B (Apo B), and the Apo B/Apo A-I
      ratio were examined in 63 consecutive patients (41 men and 22 women, average age
      63 +/- 8 years) who underwent initial elective PTCA in our department. Forty two
      target lesions were in left anterior descending, 10 were in left circumflex and
      11 were in right coronary branches. Restenosis was observed in 22 patients (35%)
      6.4 +/- 2.6 months after PTCA. The serum Lp(a) level was significantly higher in
      the restenosis group than in the non-restenosis group (38.0 vs 19.9 mg/dl, p <
      0.05). A significant correlation was observed between serum Lp(a) levels and the
      degree of % restenosis after PTCA (r = 0.557, p < 0.001). However, other lipids
      showed no significant relationship to restenosis. In addition, the % stenosis
      before PTCA was found to be related to the occurrence of restenosis after
      successful PTCA. We conclude that the serum Lp(a) level has a close correlation
      with the degree of % restenosis after PTCA, and may be a useful index for
      predicting the possibility of restenosis after PTCA, especially in patients with
      an Lp(a) level above 30 mg/dl.

PMID- 8355397
TI  - Functional limitation of recruitable collaterals in human subjects--ST segment
      deviation on intracoronary electrocardiogram during transient coronary occlusion
      induced by balloon inflation.
AB  - Three patients showed ST elevation on precordial electrocardiogram and ST
      depression on intracoronary electrocardiogram during angioplasty of the left
      anterior descending coronary arteries (LAD). While none of the patients had
      spontaneously visible collaterals, all showed transient recruitable collaterals
      to the LAD. No evident collaterals into the diagonal branches were observed.
      Possibly, if the intracoronary electrocardiogram represents the potential changes
      of the epicardial surface in the vicinity of the guidewire tip, then endocardial
      ischemia may have developed even though epicardial ischemia was not observed, due
      to relatively sufficient blood flow through the recruitable collaterals to the
      LAD. ST elevation on the precordial electrocardiogram may have represented
      epicardial and endocardial ischemia of the diagonal branches, where the
      recruitable collaterals could not protect against transmural ischemia. These
      phenomena suggests that the recruitable collaterals are functionally limited
      during acute coronary occlusion, even though the collaterals are well developed.

PMID- 8355398
TI  - Influence of right ventricular ischemia on precordial ST depression during right
      coronary artery occlusion.
AB  - To determine the cause of precordial ST depression in acute inferior myocardial
      infarction, we evaluated the relationship between precordial ST deviation and
      ventricular involvement. Forty-nine patients who were admitted to the hospital
      with an acute inferior myocardial infarction, and 60 patients who were treated
      with elective angioplasty to the right coronary artery, were analyzed. All
      patients had single vessel disease and were divided into 2 groups (A and B)
      according to the site of the lesion. Patients in group A had a lesion proximal to
      the largest right ventricular branch, while in group B the lesion was distal to
      that branch. There were no differences in inferior ST elevation between the 2
      groups, but precordial ST segments were more depressed in group B than in group
      A. A significant correlation was observed between inferior and precordial ST
      deviation in group B, but not in group A. These results were similar in patients
      with myocardial infarction and in those treated by angioplasty. These results
      suggest that precordial ST depression in an evolving inferior infarction is due
      to reciprocal ST deviation which reflects inferoposterior involvement. In
      addition, when inferior infarction is accompanied by right ventricular
      involvement the precordial ST depression is lessened.

PMID- 8355399
TI  - Evaluation of the effectiveness of 5'-nucleotidase inhibitor and allopurinol in
      myocardial ischemia.
AB  - The effect of 5'-nucleotidase inhibitor (AMP-C) and xanthine oxidase inhibitor
      (Allopurinol: ALLO) on myocardial functional recovery and the restoration of
      myocardial high energy phosphates after 15 min of normothermic global ischemic
      insult, was studied in the isolated isovolemic Langendorff rat heart model. Fifty
      nine rats were divided into 4 groups: Group I; saline, Group II; AMP-C plus ALLO,
      Group III; AMP-C, Group IV; ALLO. Intermittent infusion of drugs was delivered in
      3 ml of solution at 5 min intervals during ischemia. Percent recovery of left
      ventricular systolic function was as follows: Group I; 74.2 +/- 3.6%, Group II;
      87.7 +/- 1.7%, Group III; 83.5 +/- 3.1%, Group IV; 86.4 +/- 2.6%. Improved
      recovery was statistically significant only in Group II (p < 0.05 vs Group I).
      Suppression of reactive hyperemia was seen with reperfusion in the groups which
      had been treated with AMP-C (i.e., Groups II and III). Myocardial adenine
      nucleotides and purines were measured in 6 hearts in each group using high
      performance liquid chromatography. Myocardial ATP levels was 0.89 +/- 0.16
      nmol/mg left ventricular wet weight in Group I, 1.37 +/- 0.12 in Group II (p <
      0.05 vs Group I), 1.42 +/- 0.17 in Group III (p < 0.05) and 1.17 +/- 0.15 in
      Group IV. This study demonstrates that intermittent infusion of AMP-C plus ALLO
      during global myocardial ischemia results in improved myocardial functional
      recovery and improved preservation of high energy phosphates.

PMID- 8355400
TI  - Efficacy of carbon monoxide laser in selectively intimal thermal welding-
      implications for laser balloon angioplasty.
AB  - Excessive vascular damage causes excessive vascular repair, which results in
      restenosis. To limit the thickness of the coagulation layer in laser balloon
      angioplasty, we used a carbon monoxide (CO) laser, which has high tissue
      absorption, as a therapy laser source instead of a Nd: YAG laser. To investigate
      the benefit of short-penetration CO laser light to vascular tissue, excised human
      abdominal aorta was irradiated with a CO laser through a 30 microns polyethylene
      membrane. The temperature of the vascular tissue was continuously monitored
      during irradiation. CO laser irradiation of 20 W/cm2 was performed in either a
      continuous mode or an intermittent mode with various duty ratios
      (exposure/interval duration). With a total fluence of 200 J/cm2, the adventitial
      temperature decreased as the duty ratio was reduced. The adventitial temperature
      at a duty ratio of 1:2 was 43 degrees C. Microscopic examination of aorta which
      had been intermittently irradiated duty ratio of 1:2 showed thermal coagulation
      localized within the intima and a flattened intimal surface. These results
      suggest that intermittent laser irradiation with a CO laser can be used to limit
      the depth of thermal coagulation, and can selectively weld the intima without
      excessive thermal damage. Laser balloon angioplasty using a CO laser may help to
      prevent restenosis.

PMID- 8355401
TI  - Use of biplane transesophageal echocardiographic guide in radiofrequency catheter
      ablation of Wolff-Parkinson-White syndrome with left side Kent bundle.
AB  - We report 2 patients with Wolff-parkinson-White Syndrome, who underwent
      radiofrequency (RF) catheter ablation under observation by biplane
      transesophageal echocardiography. One of the patients had Kent bundle in the
      lateral wall of the left ventricle, and the tip of the catheter could be easily
      confirmed with transverse views. Since perforation was observed where the valve
      was attached to the posterior leaflet of the mitral valve during the 39th
      administration of RF energy, ablation was discontinued. The other patient had
      Kent bundle in the posterior septum of the left ventricle. The tip of the
      catheter could be easily confirmed with sagittal views. Ablation was successful
      after the 4th administration of RF energy, but particulate contrast echoes
      appeared from the site of the tip of the electrode which had been used for
      ablation during the 4th RF delivery. When the delivery of RF energy was
      discontinued, the contrast echo disappeared, and a thrombus was found at the tip
      of the removed catheter. TEE in RF catheter ablation was helpful for confirming
      the site of the tip of the catheter and for early detection of complications.

PMID- 8355402
TI  - Anomalous origin of left coronary artery from pulmonary artery in a 54-year-old
      woman presenting ventricular tachycardia from anteroseptal scar.
AB  - We report a 54-year-old female with anomalous origin of the left coronary artery
      from the pulmonary artery who came to our hospital complaining of dizziness
      presumably due to ventricular tachycardia. Electrocardiography, echocardiography
      and myocardial scintigraphy were indistinguishable from anteroseptal myocardial
      infarction. Only coronary angiography enabled us to differentiate between
      atherosclerotic ischemic heart disease and anomalous origin of left coronary
      artery from the pulmonary artery.

PMID- 8355403
TI  - [Automatic analyzing systems for blood chemistry and urinalysis].
AB  - We constructed two new automatic analyzing systems for blood chemistry and
      urinalysis. The blood chemistry system consists of centrifuge station, on-line
      allotting station, belt line, Hitachi 736 -60, -40, off-line allotting station,
      storage allotting station and sample stocker, these are connected with belt line.
      If only specimens are set and switched on, analytical process from serum
      separation to measurement is advanced automatically, and then printed out the
      analytical results, it is the highest speed of 1.8 test/sec, in the world.
      Urinalysis system consists of qualitative analyzing station, quantitative
      analyzing station and urinary sediment analyzer, two station are logically
      coupled with belt line. It is a unique system of urinalysis that qualitative and
      quantitative analysis of urine is logically done by computerizing program.

PMID- 8355404
TI  - [Hematological study in 27 patients with myelodysplastic syndrome (MDS)].
AB  - The clinical, histologic, and cytogenetic features of myelodysplastic syndrome
      (MDS) were analyzed in 27 patients consisting of 21 males and 6 females (M: F
      ratio = 3.5:1) whose median age was 60.9 years. Analysis of the peripheral blood
      of the patients revealed pancytopenia (8 patients), bicytopenia (12), and
      cytopenia in one cell lineage (5). The patients had high serum iron value and low
      UIBC value. More than 20% of all erythroid cells in the bone marrow consisted of
      ringed sideroblasts in not only RARS patients but also RAEB, CMMoL, and RAEB-T
      patients. Morphological changes of the bone marrow cells were observed in
      patients with all types of MDS. Eighty percent and 60% of RAEB and RAEB-T
      patients, respectively, showed trilineage myelodysplasia. Chromosomal
      abnormalities were observed in 52% of MDS patients. The rate of leukemic
      transformation was high in RAEB, CMMoL, and RAEB-T patients.

PMID- 8355405
TI  - [Current status of ultrasound examination of the superficial organs (breast and
      thyroid)].
AB  - The ultrasound examination of superficial organs began with the application of
      the breast and thyroid. After the development of the high resolution real-time
      echography, this method has also been used for the examination of the salivary
      gland, parathyroid and lymph nodes, and it has become an indispensable diagnostic
      equipment, owing to low price, high diagnostic accuracy rate, short examination
      time and no invasiveness. Recently, colour Doppler equipment has developed and it
      has altered the reliability of ultrasound. [Breast]. The real-time method brought
      about the evaluation of compressibility and mobility by the dynamic test, and the
      interruption of the borderline of the mammary gland was added to the diagnostic
      criteria for breast cancer. Colour Doppler imaging will become a useful method to
      diagnose tumours, by evaluating the vascularity, blood flow volume or flow
      velocity. For nonpalpable tumours, ultrasonically guided aspiration cytology and
      biopsy were devised and they showed good results. [Thyroid]. Thyroid echography,
      together with aspiration cytology, became an integral part of the diagnostic
      method for thyroid cancer, and the necessity of the X-ray of the thyroid has
      decreased. The accuracy rate for papillary carcinoma recorded more than 80%. In
      the screening, the detection rate of carcinoma is now 1%. The differential
      diagnosis between carcinoma and adenoma, which both have a follicular pattern, is
      a problem yet to be solved. [Parathyroid]. Hyperplasia and adenoma of the
      parathyroid show hypoechoic and hypervascular area. In addition, the salivary
      gland and lymph nodes can also be evaluated with echography.

PMID- 8355406
TI  - [Rheumatoid factors--recent advances in measurement techniques, their fine
      specificities and mechanisms of their production].
AB  - Rheumatoid factors (RF) are autoantibodies directed to the Fc of IgG. RF are
      present in the blood and synovial fluid of most patients with rheumatoid
      arthritis, and are also commonly detected in Sjogren syndrome and other
      autoimmune diseases, in chronic infectious diseases such a viral hepatitis and
      subacute bacterial endocarditis, and even in healthy individuals at low titers.
      Although vast studies have been made so far, the precise mechanisms leading to RF
      production and the fine specificity of human RF have not been well delineated. In
      this report, we present recent observations of RF concerning the following items:
      1) changes in measurement techniques, 2) biological significance of RF in
      diseased and healthy states, 3) analysis of specificity of RF, and 4) mechanisms
      inducing RF production.

PMID- 8355407
TI  - [The physician executive and laboratory tests].
AB  - Sera Central Hospital was founded in 1953 as Sera District Medical Center under
      the auspices of the neighboring five towns. At that time, the hospital had 3
      doctors, 10 nurses, and 20 beds. But now in 1992, we have 12 doctors, 53 nurses
      and 110 beds. The present medical specialists are physician (4), surgeon (2),
      orthopedist (3), pediatrician (1), clinical laboratory physician (1), and dentist
      (1). Although the yearly income and expenditures were well balanced until 1989,
      thereafter the income began to decrease insidiously and expenditures began to
      increase year by year. In this symposium titled "Suggestions for Clinical
      Laboratory Medicine by Experienced Hospital Directors," I must refer to the issue
      of "Clinical Laboratory Medicine Administrator's Standpoint". Recently, the
      unaccustomed phrase "Physician Executive" is occasionally heard as the details of
      medical care become more numerous and more intricate and economic efficiency is
      strictly persued. From this perspective, the clinical laboratory physician is
      responsible for managing the laboratory department with well disciplined
      knowledge and technique. Therefore, training as "Physician Executive" has
      developed naturally within the field of Clinical Laboratory Medicine. So, I
      cannot help coming to the conclusion that the management of a hospital, as a
      matter of course, will be entrusted to a doctor including clinical laboratory
      physician who can do his best for the citizens, for the patients, and ultimately
      for ourselves.

PMID- 8355408
TI  - [Laboratory medicine, my philosophy and prospect].
AB  - I have been working in the field of laboratory medicine for 45 years including
      the period of working as a physician. During my career, some of my dreams in
      laboratory diagnosis have been realized, and some have not. Although the issues
      changed with time, our basic philosophy has not changed at all. In this session,
      I would like to discuss "my philosophy of laboratory medicine", that is, what I
      have intended and what I have done. First, I describe the role of laboratory
      medicine in the field of clinical medicine. Second, I discuss the value of
      laboratory tests especially for clinical diagnostics. Third, I summarize the
      history of clinical pathology with reflection of the past, and my anticipation
      for the future. Fourth, I mention about the task and responsibility of the
      laboratory technicians and clinical pathologists, in view of their common
      purpose, clinical diagnosis. Finally, I discuss the future aspect of laboratory
      medicine.

PMID- 8355409
TI  - [The future of clinical laboratory medicine--a viewpoint from hospital
      administration].
AB  - Net profits estimated from the operation of about 10,000 public and private
      hospitals here in Japan, showed a 0.6 per cent decrease in 1991. This reflects
      the severity of hospital management under governmental policy requiring the rate
      of increase in medical expenses to be less than the rate of increase for the GNP.
      Changes in medical fee reimbursement in the National Health Insurance in April
      1992, reduced the fees for many medical tests, resulting in decreased income
      especially in outpatient clinics. Because of this, it is necessary to review the
      maintainance or existence of hospital laboratories from the standpoint of medical
      needs and cost efficiency. Laboratory tests must be done promptly, even on
      holidays. Only hospital laboratories can do this. Many bedside tests will need to
      be instituted. Doctors preferably, or technicians should fully explain the need
      for tests to the patient. "Informed consent" is important. Test results should be
      reported to the doctors not only with the test data, but also with interpretation
      by clinical pathologists to expedite the doctor's decision or diagnosis. The need
      for commercial laboratories is increasing because of difficulty caused by new and
      expensive equipment and techniques of modern laboratory service even in large
      hospitals. Commercial laboratories should serve not only as a subcontractor, but
      also as symbiotic partner of hospitals, clinics or medical offices in both
      medical and business management.

PMID- 8355410
TI  - [What is the ideal attainment of clinical laboratory works?].
AB  - This is the specified address delivered at the 20th meeting of the Chugoku
      Shikoku District of the Japanese Society of Clinical Pathologists (JSCP). More
      than 40 years have elapsed since the incipient epoch of clinical pathology in
      this country, when physicians, surgeons and pathologists gathered, for the first
      time, to institute a scientific medical association (JSCP) for the purpose of
      elevating daily medical services to the modernized level through active use of
      clinical laboratory examination. Since then the laboratory examination has
      undergone a rapid progress and many new techniques have appeared. Excellent
      equipments and reagents are being supplied from the engineering and
      pharmaceutical companies. Thus, the clinical laboratories have assumed an out
      look of a big factory equipped with a variety of automatic analysers and a large
      number of computers, and the figures of many laboratory staffs are peeped among
      them. In this situation there arose several problems urgently needed for control
      to hole the laboratory ideal in service to the medical doctors as well as to the
      patients. 1. Management of personnels (medical technologists and others) who are
      dissatisfied with daily robot-like works and discordant human relations. 2.
      Report sheets sent to the medical doctors are not employed adequately for the
      care of patients, because they are handed over in uncooked style without clinical
      laboratory interpretation and recommendation. Therefore, the laboratory medical
      doctors are ranked below the medical doctors on the wards and outpatient clinic.
      3. Too many tests are ordered to the laboratory without adequate recognition of
      their usefulness.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355412
TI  - [Evaluation of a one step sandwich enzymeimmunoassay for serum erythropoietin-
      serum erythropoietin values in polycythemia vera and related hematological
      disorders].
AB  - We evaluated a newly developed enzymeimmunoassay for serum erythropoietin (Epo)
      and investigated relationship between Epo levels and hematological disorders.
      This method has several advantages including simplicity, high sensitivity, good
      precision. Moreover, the procedure requires only about 2.5 hours. Samples from
      134 healthy subjects showed a normal logarithmic distribution, and its normal
      range was 4.5 approximately 21.3 mU/ml. The levels of Epo in normal subjects and
      various hematological disorders were as follows: 10.5 +/- 4.1 (mean +/- SD mU/ml)
      in normal subjects, 2.2 +/- 1.7 in polycythemia vera (PV), 6.1 +/- 3.1 in
      essential thrombocythemia, 17.8 +/- 27.3 in chronic myelogeneous leukemia, 3.6 +/
      1.8 in stress erythrocytosis, 39.4 and 14.1 in two cases of primary
      myelofibrosis, 1289 +/- 4798 in iron deficiency anemia and 6564 +/- 10870 in
      aplastic anemia. In patients with PV, serum Epo were low and did not correlate
      with hemoglobin concentration. However, inverse correlation was found between
      changes of Epo levels and hemoglobin levels in most patients. In cases in which
      PV progressed into myelofibrosis, anemia developed and Epo levels increased
      accordingly. These results suggest that the method is thought to be useful and
      reliable for the diagnosis and monitoring of PV and related hematological
      disorders.

PMID- 8355411
TI  - Mayo Clinic Laboratory Medicine: present and future.

PMID- 8355414
TI  - [Clinical markers in endocrine-metabolic diseases].
AB  - We attempted to reevaluate the clinical significance of two parameters, 1,5
      anhydroglucitol (AG) and type IV collagen, which are widely available in the
      fields of clinical activity. 1) 1,5 AG 1,5 AG was measured as a marker of
      glycemic control for diabetic patients by means of a column-enzymatic test
      (Nippon Kayaku Co., Ltd). Serum 1, 5 AG levels in diabetic patients (3.0 +/- 5.8
      micrograms/ml, mean +/- SD) were significantly lower than in normal subjects
      (22.4 +/- 6.9 micrograms/ml). 75 g OGTT was performed on 428 subjects with
      urinary glucose detected on previous medical examination. According to the
      selectivity index (sensitivity value x specificity value) and the receiver
      operating characteristic curve (ROC) for diabetes, glycosylated hemoglobin
      (HbA1c) was slightly superior to 1,5 AG and fructosamine for diabetes screening.
      Furthermore, unexpectedly high levels of 1, 5 AG were obtained from the plasma of
      diabetic patients with this kit, when the patients were given a drip infusion
      containing maltose. We found that the maltose contained in the assay system
      interfered with measurement of 1, 5 AG. Nevertheless, 1, 5 AG measurements are
      thought to be useful in the diagnosis and screening of diabetes mellitus because
      of its wideranging fluctuations under relatively good glycemic control, as
      suggested by Yamanouchi, et al. 2) type IV collagen The type IV collagen peptide
      is known as a useful marker of progressive liver diseases and early stages of
      diabetic nephropathy. Type IV collagen was measured by one step sandwich enzyme
      immunoassay (EIA) using monoclonal antibodies (Panaassay IV CL; Fuji Chem. Ind.,
      Ltd).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355413
TI  - [Factor VII for a molecular marker in hypercoagulable state].
AB  - We measured factor VII activity and antigen levels in plasma of pregnant women
      and patients with elevated serum FDP including patients with DIC who were
      supposed to be in hypercoagulable state, and compared the values with normal
      subjects. Both FVII activities measured by human placenta thromboplastin
      (hTF/FVIIc) and bovine brain thromboplastin (bTF/FVIIc) in normal plasma were
      correlated well with the FVII antigen levels (FVIIag). Measured hTF/FVIIc,
      bTF/FVIIc and FVIIag in pregnant women were 163 +/- 44%, 205 +/- 49% and 175 +/-
      44% respectively, and each value had correlation. Thrombin-antithrombin III
      complex in these subjects was increased (7.85 +/- 2.25 mg/ml). However,
      antithrombin III, plasmin-plasmin inhibitor complex and FDP D-dimer were within
      normal range. These observations indicated that pregnant women were in
      hypercoagulable state but not in hyperfibrinolytic state. hTF/FVIIc, bTF/FVIIc
      and FVIIag in plasma from patients with elevated serum FDP were 59.6 +/- 29%, 94
      +/- 65% and 61.6 +/- 26% respectively. We divided these patients into 2 groups:
      Group A (both prolonged PT and APTT) and Group B (shortened APTT). hTF/FVIIc,
      bTF/FVIIc and FVIIag in plasma of Group A were 47 +/- 21%, 48 +/- 24% and 48 +/-
      21% respectively. The corresponding values of Group B were 80 +/- 24%, 155 +/-
      54% and 74 +/- 23% which were correlated each other. Low levels of FVII observed
      in Group A seemed to be due to increased consumption of coagulation factors. In
      Group B, the pattern of FVII activities and FVII antigen was similar to that of
      pregnant women, though FVII levels were lower.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355415
TI  - [Detection of drug resistant-gene in cisplatin-resistant colon carcinoma cells by
      RT-PCR assay. I].
AB  - Expression of the TS and DNA polymerase beta genes as a drug resistant-gene were
      compared with the human colon carcinoma cell line HCT8S and a subline that was
      4.5 fold resistant to cisplatin. Resistant cells (HCT8DDP) exhibited 3.4 fold and
      2.5 fold increase in mRNA for both TS and DNA polymerase beta gene when compared
      with the parent cells by Northern blotting analysis, respectively. The RT
      (reverse transcription)-PCR (polymerase chain reaction) method has been modified
      to quantify a sequence of a drug resistance gene. This method exhibited greater
      sensitivity than conventional methods (Northern blotting analysis), requiring
      less than 1 fetogram of mRNA from cell lines. The RT-PCR assay could be an
      effective device in the early detection of resistance to chemotherapy.

PMID- 8355416
TI  - Brown adipose tissue thermogenesis as physiological strategy for adaptation.

PMID- 8355417
TI  - Sleep and respiration under acute hypobaric hypoxia.
AB  - The purpose of this study was to elucidate the effects of acute hypobaric hypoxia
      on nocturnal sleep architecture and respiratory responses in a hypobaric
      simulator. Five healthy young males (19-23 years old) were recruited to sleep for
      8 h at sea level and at simulated altitudes of 1,500, 3,000, and 4,000 m in the
      simulator (61.2 m3, 20 degrees C, and 60% RH). Each experimental run was
      separated by at least 3 d. Standard polysomnograph, respiration, and arterial
      oxygen saturation (SaO2) during sleep were observed. 1) SaO2 decreased
      significantly with increasing altitude. At 4,000 m, SaO2 showed its lowest value
      during 1 to 3 h after sleep onset. 2) Sleep architecture below 3,000 m showed
      almost the same pattern. However, reduction in REM sleep and increased
      wakefulness were observed at 4,000 m, though such sleep disturbance was not
      observed in the first one-third of the night spent in bed. 3) Periodic breathing
      (PB) with apnea and/or hypopnea developed in all subjects above 3,000 m. PB
      tended to appear in light sleep, though sleep was not always disturbed by PB. It
      might be concluded that there was no sleep disturbance up to 3,000 m altitude.
      Nocturnal sleep at 4,000 m, however, was disturbed after a few hours from sleep
      onset by severe hypoxemia induced by multiplicative effects of hypoxia and
      hypoventilation during deep sleep. At high altitude, PB seems to not induce
      arousals consistently, which was different from sleep apnea syndrome at sea
      level.

PMID- 8355418
TI  - Characterization of functional antagonism of adenosine and isoproterenol in
      guinea-pig atrial myocytes.
AB  - The role of adenosine action in modulating the action potential duration (APD) of
      single isolated guinea-pig atrial myocytes during beta-adrenergic stimulation
      with isoproterenol was investigated. Membrane potential and ionic currents were
      measured by the tight-seal, whole-cell patch-clamp technique. Adenosine (10
      microM) antagonized isoproterenol (20 nM)-stimulated L-type calcium inward
      current (ICa). In the presence of isoproterenol, adenosine (10 microM) also
      increased holding and late outward currents. Isoproterenol (20 nM) caused a
      significant prolongation in atrial action potential at the level of 0 mV, rather
      than at 90% repolarization. Adenosine shortened atrial action potential dose
      dependently in the presence of isoproterenol. The respective values for EC50 and
      maximally shortened action potential duration at 0 mV of adenosine with or
      without isoproterenol (20 nM) were 3.0 vs. 2.2 microM and 42.9 vs. 30.4 ms. In
      summary, during beta-adrenergic stimulation with isoproterenol, in guinea-pig
      atrial myocytes, adenosine elicited the specific K(+)-outward current and
      concomitantly attenuated the isoproterenol-stimulated ICa. These phenomena may
      account for the modulation of atrial action potential by adenosine with or
      without isoproterenol effect.

PMID- 8355419
TI  - Impaired fibrinolysis in hypertension and obesity due to high plasminogen
      activator inhibitor-1 level in plasma.
AB  - In order to elucidate the influence of the risk factors of coronary heart disease
      on the fibrinolytic activity, relationships between blood pressure, body mass
      index (BMI), plasma lipoprotein (a) (Lp(a)) level and the plasma levels of tissue
      plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) were
      analyzed in the subjects with mild hypertension. Systolic blood pressure showed a
      positive correlation with total PAI-1 and free PAI-1. Diastolic blood pressure
      showed no correlation with these proteins involved in the fibrinolytic system.
      BMI had a positive correlation with total PAI-1, free PAI-1 and euglobulin clot
      lysis time (ECLT). Plasma Lp(a) level showed correlation with neither blood
      pressure nor fibrinolytic parameters, but it showed weak negative correlation
      with body mass index (BMI). These results suggest that high blood pressure and
      obesity tend to increase free PAI-1 which reduces fibrinolytic activity. Lp(a),
      however, seems not to influence directly the fibrinolytic system but may work to
      decrease fibrinolytic activity only in conjunction with other risk factors. The
      effects of daily drinking of alcohol and smoking on the fibrinolytic system were
      also investigated in the present study and we obtained the results that habitual
      drinking increased plasma levels of both tPA and PAI-1 whereas smoking did not
      affect fibrinolytic activity. These results suggest that risk factors for
      coronary heart disease such as hypertension and obesity are closely related to
      the impaired fibrinolysis.

PMID- 8355421
TI  - Time course of acid-base regulation following intraperitoneal CO2 administration
      in man.
AB  - Chronological changes in acid-base status during laparoscopic CO2 insufflation
      were studied for 2 h in 10 patients who underwent laparoscopic cholecystectomy.
      Carbon dioxide pressure in alveolar air as well as arterial blood promptly and
      significantly increased within 5 min whereas amount of pulmonary CO2 elimination
      significantly increased after 15 min. Pulmonary gas exchange ratio (R) exceeded
      the level of unity at 10 min and progressively increased toward the end of 2 h
      observation. These results indicated that CO2 equilibrium process between
      different body compartments with different time constant took place and apparent
      equilibrium was not completed during observation. In vivo buffer value of the
      arterial blood started to decrease after 5 min and decreased to about one-third
      the in vitro buffer value until the end of observation. This indicated that CO2
      equilibrium between blood and interstitial fluids took place slowly during entire
      period of study and no significant contribution of cellular buffering was
      developed. We conclude that slower development of acid-base regulation in the
      present study than those reported in the previous studies may have been derived
      from small diffusion area and blood perfusion for CO2.

PMID- 8355420
TI  - Inhibitory effects of cyanide on mechanical and electrical activities in the
      circular muscle of gastric antrum of guinea-pig stomach.
AB  - Effects of cyanide (CN) on spontaneous mechanical and electrical activities were
      studied in the circular muscle of the guinea-pig gastric antrum. CN (0.05-0.5 mM)
      inhibited both mechanical and electrical activities, but the inhibition was
      stronger in the former than the latter (slow wave). When glucose was removed for
      more than 30 min, slow wave was also blocked by CN. It is likely that ATP
      necessary for the generation of spontaneous activity can be supplied through
      either glycolysis or oxidative phosphorylation. CN slightly depolarized the
      membrane and the inhibition by CN was not affected by glibenclamide, a blocking
      agent of ATP-regulated K+ channel, suggesting that this channel is not activated
      by CN treatment. Basal level of intracellular Ca2+ measured with fura-2 tended to
      increase during the mechanical inhibition by CN. This was also clearly
      demonstrated in excess (60 mM) K+ solution. These results suggest that
      intracellular Ca2+ regulation is impaired and that there is uncoupling between
      intracellular Ca2+ and tension development in the presence of CN.

PMID- 8355422
TI  - Lipolytic actions of hormones on adipocytes in exercise-trained organisms.
AB  - Adipocytes from sportsmen exhibited lower basal rate of lipolysis but higher
      response to adrenaline than those from untrained persons. Dexamethasone exposure
      for 30 min enhanced the adrenaline effect both in sportsmen and trained rats.
      Insulin abolished this glucocorticoid action. A rapid permissive action of
      glucocorticoids was suggested in the trained organism.

PMID- 8355423
TI  - Effects of cardioplegic reperfusion on ATP recovery of rod-shaped myocytes
      isolated from rat ventricles.
AB  - ATP content [ATP] and fraction of rod-shaped myocytes (Rrod) were measured in
      ventricular myocytes isolated from the rat heart. [ATP] (nmol (10(6) cells)-1)
      and Rrod (%) were 72.0 and 60.5, respectively, and significantly reduced to 18.8
      and 41.8 by no-flow ischemia for 30 min. Reperfusion for 15 min with cardioplegic
      solutions restored [ATP] of rod-shaped myocytes to the control level.

PMID- 8355424
TI  - An improved method for perforated patch recordings using nystatin-fluorescein
      mixture.
AB  - This paper describes an improved method for solubilizing nystatin in an aqueous
      solution without the aid of organic solvents. The patch pipette was filled with a
      solution of nystatin and fluorescein sodium mixed in a molar ratio of 1:10. The
      success rate of perforated patch recordings was substantially improved, and the
      access resistance of 20-40 M omega was readily achieved.

PMID- 8355425
TI  - [Self-efficacy predictiveness and its determinants among preschoolers].
AB  - Precision of self-efficacy predictions on a ball-throwing task was compared
      between the younger group (3-year-olds; N = 40) and the older group (5-year-olds;
      N = 40). Three factors underlying the development of accurate efficacy
      expectations were examined. They were the effect of experience, the complexity of
      the task, and information of task performance. Results indicated that the
      predictions of the older group were more accurate than those of the younger
      group, and their predictions were significantly related to subsequent
      performance. They did more realistic efficacy predictions by using information of
      task performance and experience. The younger group showed no accuracy of self
      efficacy predictions. But the presentation of information about task performance
      enabled them to make realistic efficacy predictions.

PMID- 8355426
TI  - [The effect of group size on salience of member desirability].
AB  - This study tested the hypothesis that undesirable members are salient in a small
      group, while desirable members become salient in a larger group. One hundred and
      forty-five students were randomly assigned to twelve conditions, and read
      sentences desirably, undesirably, or neutrally describing each member of a
      college student club. The twelve clubs had one of three group sizes: 13, 39, or
      52, and the proportion of the desirable or undesirable to the neutral was either
      11:2 or 2:11, forming a three-way (3 x 2 x 2) factorial. Twelve subjects each
      were asked to make proportion judgments and impression ratings. Results indicated
      that proportion of the undesirable members was over estimated when the group size
      was 13, showing negativity bias, whereas proportion of the desirable was
      overestimated when the size was 52, displaying positivity bias. The size 39
      showed neither positivity nor negativity bias. These results along with those
      from impression ratings suggested that salience of member desirability interacted
      with group size. It is argued that illusory correlation and group cognition
      studies may well take these effects into consideration.

PMID- 8355427
TI  - [A study on job satisfaction of clinical psychologists working in the medical
      field].
AB  - The purpose of this study was to examine the relationship of job satisfaction to
      job difficulty and worthiness, reported by the clinical psychologists who worked
      at medical institutions. A mail survey of 748 clinical psychologists working at
      hospital and clinics revealed the following results. First, job satisfaction was
      related more to job situation than job content. Also, job satisfaction was low
      among those who worked at non-university psychiatric or geriatric hospitals, who
      did not practice psychotherapy, and who were not in education, research, or
      management. In addition, compared to the high job satisfaction group, the low
      group perceived more incongruity between institutional climate and their
      psychological work, felt being less valued by other professionals, were less able
      to function fully as a practicing psychologist, and experienced more role
      ambiguity as a clinical psychologist in a hospital setting.

PMID- 8355428
TI  - [A study of organizational communication in a school during the pre- and post
      innovation periods].
AB  - The purpose of this study was to examine changes in organizational communication
      behavior in an elementary school during the pre- and post-innovation periods. The
      turning point of the pre- and post-innovation periods were determined by
      transference of decision making systems in the school. Data were collected
      through participant observation, and the analyses indicated the following
      results. Compared to the pre-innovation period, during the post-innovation
      period, 1) overall communication level increased; 2) discussions, rational
      persuasion , and proposals increased, while assertions decreased as the contents
      of communication; and 3) the number of those who spoke at teaching staff meetings
      increased. Concerning downward communication, 1) rational persuasive
      communication was used most frequently throughout the pre- and post-innovation
      periods; and 2) communication suggesting a compromise increased during the post
      innovation period. These findings were discussed in terms of organizational
      effectiveness of the school.

PMID- 8355430
TI  - [Effects of loud noise on nasal skin temperature].
AB  - It has been demonstrated that stress conditions for babies such as a brief mother
      infant separation cause the nasal skin temperature to drop. Changes in skin
      temperature may be taken as a representative sample of bodily reaction correlated
      with emotional changes. The purpose of this study is to investigate nasal skin
      temperature changes under loud noise situation. Fifty-two undergraduates were
      divided into two groups. Each group had 13 male and 13 female subjects. One group
      was given 100 dB and another was given 45 dB white noise. The Infrared
      Telethermograph Imager was used to measure nasal skin temperature changes. The
      results showed that the nasal skin temperature under 100 dB white noise decreased
      by about 0.5 degree C. However, under 45 dB no significant change was found.
      These findings suggest that the facial skin temperature will be one of the
      promising indices to detect various emotional changes.

PMID- 8355429
TI  - [Schizophrenia and reverse-Stroop interference in the group version of the Stroop
      and reverse-Stroop test].
AB  - Previous studies showed that attentional task performance of schizophrenics was
      significantly inferior to that of normals. The classical Stroop Color-Word
      Interference Test is an example of such attentional tasks and performance on the
      "reverse" Stroop task is reported to discriminate schizophrenics from normals
      better than the regular Stroop task. These results suggest that schizophrenics
      are more susceptible to "reverse" Stroop interference in reading incongruent word
      color combinations than normals. The group version of the Stroop and reverse
      Stroop Color-Word Test, where the response is to choose a matching alternative,
      was used to test the hypothesis. The results virtually supported the hypothesis.
      In addition, interference was closely related to the patient's control of
      impulsiveness. It was suggested that schizophrenics have generation (or
      translation) deficits between different codes.

PMID- 8355431
TI  - [Effect of information generation on incidental memory of words].
AB  - The present study was carried out to investigate the effect of information
      generation on incidental memory of words. Subjects in the subject-generated group
      were asked to generate a converging associate of three targets in each triplet.
      Subjects in the experimenter-provided group were asked to rate the relation
      between targets and a paired-presented word on 5-point scale. Each subject in
      both groups were given an unexpected free recall test. Recall performance for
      targets in each unrelated triplet in the subject-generated group was higher than
      in the experimenter-provided one. Conditional probability of recalling targets
      given relational information was an index of effectiveness of within-item
      elaboration. This index was higher in the subject-generated group. These results
      were interpreted as showing that the effect of information generation was caused
      by the effectiveness of within-item elaboration.

PMID- 8355432
TI  - [Observation of the effects of warming-up and role-playing in psychodrama in
      terms of mood rating].
AB  - The purpose is to make an appropriate list of terms that describe person's moment
      to-moment changes in moods during psychodrama sessions. Seventy nurse students
      participated in a series of psychodrama sessions, consisting of a session of
      warming-up and two sessions of role playing. They rated their moods at the
      beginning of the sessions and after each session, on a five-point scale for each
      of the 55 terms, which were supposed to cover all kinds of moods during
      psychodrama sessions. After analyzing variations (using factor analyses) of
      subjects' ratings, three factors were found to be sufficient for describing their
      moods, and the terms in the list were eventually reduced to sixteen. Changes of
      moods analyzed through the ratings of sixteen scales were related significantly
      with subjects' performances of warming-up and role playing.

PMID- 8355433
TI  - [Short intertrial interval as a phrasing cue in the reinforcement-pattern
      learning in rats].
AB  - The effect of short intertrial interval as a phrasing cue on the reinforcement
      pattern learning was investigated in a rat experiment using a runway. In the
      acquisition session, 20 rats were trained for NNR sequence in which two
      nonreinforced trials were followed by a reinforced one with equal ITI of 30 min.
      In the sequence-addition session, a new sequence with consisting of three
      nonreinforced trials with 30-min ITI was added 30 min and 30 s after the original
      sequence of trials for Group L-ITI and for Group S-INT, respectively. Rats of
      Group S-INT responded on trials 4-6 with the similar pattern of running speed as
      they showed on Trials 1-3 from the second day. In Group L-ITI, the running speed
      on Trial 4 did not decrease. This suggests that Group S-INT rats learn to use the
      ITI of 30 s as a phrasing cue not on the first day but from the second day on.
      The phrasing effect of short ITI (30 s) was discussed in comparison with that of
      longer ITI (30 min).

PMID- 8355434
TI  - [Recognition and categorization of butterfly patterns].
AB  - Two experiments are reported which deal with the nature of categorization of
      visual patterns. Stimulus materials were schematic butterfly patterns. Systematic
      transformations of five physical features (fore wing, hind wing, size, body
      length and color) were applied to a prototype to generate a set of instances. In
      Experiment 1, subjects were asked to judge the visual similarity between each
      instance and the prototype. Similarity ratings were found to be related to an
      each instance's transformational distance from the prototype. In Experiment 2,
      subjects were exposed to a subset of instances of the pattern which varied in
      their transformational distance from the prototype, and then given a recognition
      test with confidence ratings. The recognition item consisted of the old and new
      instances including the prototype. Recognition ratings were found to be related
      to each instance's family resemblance score rather than its transformational
      distance and subjective similarity to the prototype. These results support Rosch
      and Mervis's family resemblance model of categorization.

PMID- 8355435
TI  - [Statistical analysis of recurrent factors in superficial bladder cancer. Natural
      history of superficial bladder cancer].
AB  - Three hundred thirty-six patients with superficial bladder cancers underwent
      their initial surgery at the Department of Urology of Okayama University School
      of Medicine from 1961 to 1985. They have been followed-up until December 1988
      (the median: 68 months). Among the 336 cases, excluding 9 cases which were
      treated initially with total cystectomy or incomplete resection, the remaining
      327 cases were reviewed in order to study the pattern of their local recurrences
      in the bladder. Major factors affecting recurrences of superficial bladder cancer
      were evaluated by the multivariate analysis using Cox's proportional hazard
      model. The examined factors included age on admission, sex, tumor's number, size,
      stage, histological grade and shape, operative method, intravesical chemotherapy,
      systemic chemotherapy, radiotherapy, frequency of recurrences and the date of
      operation. During the follow-up period, 179 cases out of the 327 cases did not
      show any recurrences. The remaining 148 cases recurred from once to 11 times,
      therefore, a total number of recurrences was counted to be 406. In the 406
      recurrences, 338 recurrences were treated by TUR, SVR, or SR. The remaining 68
      recurrences were treated with total cystectomy or untreated. Fifty-seven cases
      out of the 148 cases demonstrated recurrences more than 3 times. Only 4 cases
      were free from recurrences more than 24 months following the surgery for their
      last recurrences. The analysis in the 327 primary cases showed that the number of
      tumors was the most important factor. On the other hand the analysis in 338
      recurrences showed that the second most important factor was the frequency of
      recurrences, following the number of tumors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355436
TI  - [Tissue concentration of intravesically instilled (2"R)-4'-o-tetrahydropyranyl
      adriamycin or adriamycin in superficial bladder cancer].
AB  - Twenty-one patients with superficial bladder cancer entered an analysis of single
      dose (2'R)-4'-O-tetrahydropyranyladriamycin (THP) or adriamycin (ADM)
      administration. The patients in each group that have been or not have been
      treated previously with anti-cancer drugs were randomized into two groups, one
      was given THP and the other ADM. Thirty-mg of THP or ADM dissolved in 30 ml of
      physiologic saline was instilled into the bladder, and retained for 1 hour. After
      1 hour retention of the drugs, tumor tissues and normal mucosas were removed by
      punch biopsy forceps transurethrally. The tissue concentrations of THP and ADM
      were estimated by high performance liquid chromatography. The tissue
      concentrations of THP and ADM in the tumors were significantly greater (p < 0.05)
      than those in the normal bladder mucosas. The tissue concentration of THP in the
      tumors were greater than that of ADM. The tissue concentrations of THP and ADM in
      the tumor of patients who have been treated with anti-cancer drugs previously
      were less than those of patients who have not. This results demonstrated that
      prior therapy with anti-cancer drug may cause a resistance for intravesical
      instillation chemotherapy. However in patients with prior therapy, the tissue
      concentration of THP in the tumors were greater than that of ADM. Based on these
      findings, THP has been shown to be were effective as an intravesical instillating
      agent especially, in cases with prior chemotherapy.

PMID- 8355437
TI  - [Autologous blood transfusion in transurethral resection of the prostate].
AB  - With the purpose to avoid the risk of transfusion mediated infection and
      complication, predeposited autologous blood transfusion was performed. From April
      1990 to March 1991, transurethral resection of the prostate (TUR-P) were
      performed in 27 patients (mean age: 72.5 years) with benign prostatic hypertrophy
      (BPH). Autologous blood (200-400 ml, mean 244 ml) was predeposited 3 weeks prior
      to TUR-P in 18 patients (mean age: 73.9 years) and transfused during or just
      after the operation in 16 (five patients required some homologous blood in
      addition to their own banked blood). Another three patients were transfused with
      homologous blood only. The mean values for hemoglobin concentration were 13.7 +/-
      0.4 g/dl before blood deposition and 12.8 +/- 0.5 g/dl on the day of operation
      (recovery rate: 92.5 +/- 2.7%). Although no complication was found in autologous
      blood transfusion group (11 patients), one case of systemic exanthema and one
      case of type C hepatitis were observed in homologous blood transfusion group (8
      patients). In TUR-P, positive correlations were observed among resected prostate
      weight (Pro-wt), blood loss (B.) and operation time (Op-T.). Correlation
      efficient between Pro-wt. and B. was 0.80, that of B. and Op-T. was 0.77 and that
      of Pro-wt. and Op-T. was 0.85. From these results and ultransomographic
      measurement of the prostate weight, the amount of blood loss can be calculated
      preoperatively, there by the amount of blood needed for transfusion will be
      estimated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355438
TI  - [Phenotypic difference of lymphocytes circulating in tumorous renal artery and
      renal vein in patients with renal cell carcinoma].
AB  - Phenotypic difference of lymphocytes circulating in tumorous renal artery and
      renal vein in patients with renal cell carcinoma was studied. Fifteen patients
      with no prior treatment were studied, from whom blood samples were taken at the
      time of radical nephrectomy. Mononuclear cells separated from tumorous renal
      arterial and venous blood were analyzed for cell surface markers. CD3, CD4, CD8,
      CD11b, CD16, CD25, CD57, Leu8 HLA-DR were compared. CD25 positive cells were
      significantly increased in venous blood than in arterial blood in the kidneys
      with tumor. No significant difference was found regarding the other surface
      markers.

PMID- 8355439
TI  - [Effect of hydronephrosis on the contralateral blood flow and glomerular volume].
AB  - We designed a following experiment to appraise the effect of unilateral
      hydronephrosis on the contralateral kidney using weanling rats whose kidneys were
      in a growing stage. Rats were divided into 4 groups. Complete unilateral (left)
      ureteral obstruction (CUUO) was made on the experiment rats, and these went
      through the following procedures on the day 3 after CUUO; 1) Group R: CUUO
      released, 2) Group N: left nephrectomy performed, 3) Group S: CUUO continued.
      Sham-operations were performed on the days 0 and 3 to the controls. Renal
      cortical blood flow and glomerular volume of the contralateral (right) kidneys
      were determined on the days 5, 7, 9, 14 and 21. Blood flow to the renal cortex
      per unit volume (ml/min/100 cm3; measured with Laser blood perfusion monitor) in
      the contralateral kidneys increased gradually in the all groups, but statistical
      significance was not confirmed in the observed period between any groups.
      Increases in total renal blood flow (wet kidney weight times renal cortical blood
      flow per unit volume; g x ml/min/100 cm3) were proportional to the measured wet
      kidney weight in the all groups. Notably in the group N, a significant increase
      was noted compared to the group R and the controls. Glomerular volume (GV) of the
      contralateral kidneys did not show significant changes on the day 3 compared to
      the controls. GV significantly grew up during the day 5 to the day 14 (2 to 11
      days after the relief of CUUO) in the group R and then it settled to the level of
      the controls on the day 21.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355440
TI  - [A study of muscarinic cholinergic receptor subtypes in human detrusor muscle
      using radioligand binding techniques].
AB  - The subtypes of the muscarinic cholinergic receptor in human detrusor muscle were
      studied using radioligand binding techniques. It was found that there were
      significant amount of M1, M2 and M3 receptors labeled by 3H-pirenzepine, 3H-AFDX
      and 3H-4DAMP, respectively, in human detrusor muscle. The rank order of the
      amount of these receptors was M3 > M1 > or = M2. The amount of M3 receptors was
      about 10-fold of M1 or M2. In the inhibition experiment of 3H-QNB binding to
      human detrusor muscle, the Ki values of pirenzepine or AFDX was 50-100 fold of
      that of 4DAMP and the rank order of Ki values was pirenzepine > AFDX > 4DAMP. The
      M3 selective drug, 4DAMP showed smallest Ki value among the three drugs studied,
      indicating that the affinity of M3 receptor was highest among the three
      muscarinic subtypes. These data suggest that M3 receptors are predominant in
      human detrusor muscle biochemically.

PMID- 8355441
TI  - [The surgical management of renal cell carcinoma involving the right atrium].
AB  - Between January 1985 and November 1992, 12 patients with renal cell carcinoma
      involving the inferior vena cava were evaluated and treated at this hospital. In
      4 of the 12 patients (33%), the tumors extended into the right atrium. These 4
      patients underwent radical nephrectomy with tumor thrombus extraction. Of the 4
      patients one had metastases to regional lymph nodes, but no patient had distant
      metastases. We used a cardiopulmonary bypass and a right atriotomy in all
      patients for the removal of thrombus under direct vision. We also performed in
      the intra-operative transesophageal ultrasonography for monitoring of intra
      atrial thrombus. The average blood loss during operation was 10,430 ml. One of
      these patients died in the postoperative period and the other patient died from
      inferior vena caval emboli without long term sequelae. However, the remaining 2
      patients of this group are free of disease, with a mean follow-up of 21 months.
      Although the numbers are small, these results suggest that patients with intra
      atrial tumor thrombus had a worse prognosis than those with other types of vena
      cava tumor thrombus. One reason for this poor prognosis is due to the complicated
      surgical management and we believe that a complete removal of tumor thrombus and
      a complete vascular control are key points of this operation.

PMID- 8355442
TI  - [Treatment of urinary tract anomalies detected by prenatal ultrasonography].
AB  - Twelve pediatric patients with antenatal diagnosed urinary tract anomalies from
      1988 to 1992 in Niigata University Hospital were clinically examined. 1: All
      patients were diagnosed by ultrasonography. Eleven cases did not have any
      abnormal pregnancy and other had oligohydramnious. 2: Postnatal surgical
      treatments were performed in 11 cases, but antenatal therapy was not performed in
      any case. 3: Temporary percutaneous nephrostomy (PNS) were carried out on 7
      kidneys in 6 cases during infantile period seems to be effective in preserving
      function of congenital obstructed kidneys.

PMID- 8355443
TI  - [Evaluation of bladder tumor staging by submucosonography].
AB  - Submucosonography to stage tumors of the esophagus and stomach is well reported.
      Here we report our experience with a modified procedure to evaluate the stage of
      bladder tumor cystoscopically and compare the results of staging by other
      methods. The evaluation was carried out on accuracy 10 patients (10 bladder
      tumors). A water soluble contrast medium (CM: lohexol 33 mg/ml) was injected into
      the submucosa of the bladder cystoscopically. Usually the injected point was one
      centimeter to the urethral margin of the tumor and up to three points were
      selected. Within 30 minutes after the injection, the lateral and frontal X-ray
      pictures were taken. The accuracies of staging by submucosonography were compared
      with the results of other methods, i.g., ultrasonography (US), computed
      tomography (CT), magnetic resonance imaging (MRI). By submucosonography, three
      categories depending on the diffusion of CM were classified as follows. Type I:
      (diffuse type) without disturbance of diffusion. Type II: (borderline type)
      between type I and III. Type III: (defect type) local disturbance of diffusion.
      Overall accuracies of each were 70.0% (submucosonography), 62.5% (US), 44.4%
      (CT), 66.7% (MRI) respectively. The accuracies of submucosonography were high in
      stage Ta, above stage T2 and low in stage T1.

PMID- 8355445
TI  - [Study of immunosuppressive mechanism of deoxymethylspergualin in vitro].
AB  - Mechanism of action of Deoxyspergualin (DSG) in vitro has not been clarified,
      because it is unstable in solution. I studied its mechanism in vitro using
      Deoxymethylspergulin (MeDSG) that is stable in solution. Action of MeDSG was
      studied using human lymphocyte and a human T cell clone which was established in
      our laboratory. MeDSG showed dose dependent inhibition of blastogenesis in MLR.
      MeDSG inhibited the response by about 50% at the concentration of 10
      micrograms/ml. It is a very interesting point that MeDSG added at 3 days later
      suppressed MLR. But MeDSG did not suppress MLR added at 4 days later or 2nd MLR.
      MeDSG did not have effects on the production of IL-1, IL-2 and the expression of
      IL-2 receptor on stimulated lymphocyte by mitogen. But MeDSG suppressed IFN-gamma
      production induced stimulation of alloantigen at only concentration of 1
      microgram/ml. MeDSG did not suppress proliferation of helper T cell clone. On the
      other hand, CsA suppressed IL-2 receptor expression and proliferation of helper T
      cell clone. These results showed MeDSG act on relatively late phase of
      immunoreaction. From in vitro results, when we use DSG for clinical acute
      rejection, it is more appropriate to use DSG and Methylprednisolone at the same
      time to get early recovery.

PMID- 8355447
TI  - Eosinophilia-myalgia syndrome and fasciitis with an active alveolitis.
AB  - This patient clearly had the EMS with eosinophilic fasciitis, apparently due to L
      tryptophan. He also had an active alveolitis with a DIP-UIP-like picture. The
      lung findings were not similar to those reported in the Mayo series. It is
      perhaps most likely that his interstitial lung disease was of the cryptogenic
      variety and unrelated to the L-tryptophan. However, a more direct association
      cannot be ruled out until more cases with similar findings are thoroughly
      evaluated. We suggest that special consideration of pertinent studies for
      interstitial lung disease is merited in all patients with suspected EMS. These
      might include diffusing capacity, gallium scans of lungs, broncho-alveolar lavage
      and possibly lung biopsy.

PMID- 8355446
TI  - [A case report of an ectopic ureter in a patient treated for chronic
      prostatitis].
AB  - A male aged 20 had been treated for anal and lower abdominal pain after
      ejaculation for about 2 years under the diagnosis of chronic prostatis. Because
      of worsening of the pain, he was admitted to our hospital in September 24, 1991.
      On the rectal examination, a cystic tumor was palbable on the left side of the
      prostate. The left kidney was not detected by IVP and ultrasonography. CT
      revealed two retrovesical cystic lesions in the left side. Cystourethroscopy
      showed an absence of ureteral orifice and ureteral ridge on the left side. Left
      uretero-seminal vesiculectomy was performed on October 3rd, under the diagnosis
      of an ectopic ureter entering into the seminal vesicle or ejaculatory duct.
      Histopathologically, the left ectopic ureter entering into the lower portion of
      the seminal vesicle or ejaculatory duct and the left renal agenesis were
      diagnosed. It was remarkable that ureteral epithelium was not transitional but
      columnar epithelium.

PMID- 8355444
TI  - [Expression of progesterone-binding protein in normal and neoplastic human
      adrenals].
AB  - Specific progesterone-binding protein (P4-BP) is demonstrated in adrenocortical
      nuclei of the guinea pig, but, not in nuclei of other animals. We tried to
      demonstrate the progesterone-binding activity in nuclei of human normal adrenals
      and adrenal tumors. Normal adrenals were obtained from six patients with renal
      cell carcinomas undergoing radical nephrectomy. Seven adrenocortical adenomas
      were obtained: five tumors from patients with Cushing's syndrome, one tumor from
      non-functioning adenoma, and one from aldosteronoma. Nuclei were purified from
      the tissues, and progesterone binding assay was performed. We could not
      demonstrated progesterone-binding activity in nuclei of six normal human
      adrenals. However, we demonstrated progesterone-binding activity in nuclei
      purified from human adrenocortical adenomas associated with Cushing's syndrome.
      Saturation analysis revealed a Kd of 13.85 +/- 1.99 nM (mean +/- SD, n = 5) and a
      binding capacity of 1.95 +/- 0.37 pmol/mg DNA (mean +/- SD, n = 5). A Kd of
      progesterone-binding activity in human adrenocortical adenoma was similar to that
      of guinea pig P4-BP, and a binding capacity was about one-fifteenth of guinea pig
      P4-BP. However, nuclei purified from a non-functioning adrenocortical adenoma and
      an aldosteronoma failed to demonstrate progesterone-binding activity. The binding
      activity was specific for progesterone. 5 alpha-pregnane-3,20-dione was a modest
      competitor, while 17 beta-estradiol, testosterone, cortisol, and other related
      steroids were poor competitors. Thus the progesterone-binding activity in human
      adrenals was similar to guinea pig P4-BP in the affinity and specificity of
      binding.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355448
TI  - Stroke-free survival after infarction.

PMID- 8355449
TI  - Schistosomal glomerulopathies.

PMID- 8355450
TI  - Abnormal hemodynamics and elevated angiotensin II plasma levels in polydipsic
      patients on regular hemodialysis treatment.
AB  - To investigate the cause and the mechanisms responsible of the compulsive thirst
      and excessive fluid intake observed in many patients on chronic dialysis
      treatment, we measured plasma antidiuretic hormone (ADH), angiotensin II (Ang II)
      and some hemodynamic parameters in seven polydipsic and in six normodipsic
      patients before hemodialysis, at the end of it and several times during the
      interdialytic interval. Before dialysis we found that ADH was elevated in both
      groups (6.9 +/- 1.9 vs. 6.9 +/- 1.3 pg/ml, respectively in polydipsics and
      controls), whereas Ang II was abnormally high only in polydipsics (51 +/- 12 vs.
      11 +/- 3 pg/ml, P < 0.01); these patients also had significantly higher heart
      rate and cardiac indices and lower total peripheral resistances than control
      patients. Overall these hemodynamic indices were related with Ang II but not with
      ADH. Ang II rose markedly in polydipsics after dialysis, reaching a peak at the
      fourth hour after its termination (136 +/- 12 pg/ml) and remained consistently
      elevated throughout the interdialytic period, whereas in controls Ang II was
      practically unchanged with respect to baseline. In contrast, ADH had minor and
      similar modifications in both groups, in whom also the hemodynamic changes were
      superimposable. Significant correlations were found between the absolute and
      percent changes of Ang II and those of plasma volume during the interdialytic
      interval (P < 0.001 for both), and between the individual values of Ang II
      measured during the whole study and the interdialytic weight gain (P < 0.05).
      These results demonstrate that polydipsic patients have abnormally high levels of
      Ang II before and after the hemodialysis-induced volume depletion.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8355451
TI  - Serum albumin is a strong predictor of death in chronic dialysis patients.
AB  - We examined the predictive value of various clinical variables in assessing
      survival in chronic hemodialysis patients (N = 1,243, 524 females, 719 males) who
      were under treatment with hemodialysis as of January 1991 in Okinawa, Japan and
      who were followed up until April 1992. Basal clinical data such as sex, starting
      date of dialysis, primary renal disease, blood pressure, blood chemistry values,
      and dialysis prescription data obtained just prior to dialysis were registered at
      the start of the study. As of the end of April 1992, 104 had died, 16 were
      transplant recipients, and five had been transferred. Those who died had
      significantly lower levels of total protein, serum albumin, total cholesterol,
      triglyceride, BUN, serum creatinine, body weight, body height, diastolic blood
      pressure, and duration of hemodialysis than those who survived. Older patients
      and those with diabetes mellitus had a poorer prognosis. A forward stepwise
      logistic procedure by SAS was used to determine the predictive value of the above
      clinical variables. With the addition of laboratory variables, the predictive
      value of diabetes was lost, as the diabetic patients had low serum levels of
      albumin and creatinine. The standardized coefficient was -0.380 (P = 0.0001) at
      age of entry, 0.316 (P = 0.0001) for serum albumin, 0.280 (P = 0.0001) for serum
      creatinine, 0.138 (P = 0.043) for body mass index (BMI), and -0.139 (P = 0.016)
      for male sex. The prescribed dialysis dose (M2 hr per week) was significantly
      correlated with serum creatinine (r = 0.48, P = 0.0001), serum albumin (r =
      0.135, P = 0.0001) and BMI (r = 0.275, P = 0.0001).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8355452
TI  - Calculation of titratable acidity from urinary stone risk factors.
AB  - Using urine samples and standard solutions, this study demonstrates that the
      existing procedure for measuring titratable acidity in the urine is not reliable
      and may result in overestimates of up to 25%. The accuracy is affected by loss of
      CO2, the presence of uric acid crystals, and the precipitation of
      calciumphosphate phases during the titration. A method is presented for
      calculating titratable acidity, using a number of routinely-measured urine
      components and a computer program for calculating complex equilibria in the
      urine. The calculated titratable acidity is shown to be more reliable then the
      measured one. The results are compiled in a nomogram from which the titratable
      acidity can be directly read. When the parameters of urine pH, PO4 content and
      pCO2 are used, the accuracy of the nomogram is > 96% for urine samples with a pH
      value above 6.0 and > 89% for urine samples with a pH value below 6.0. For all
      samples, the accuracy is improved to > 97% when the nomogram using uric acid and
      citrate content is used in additionally.

PMID- 8355453
TI  - Sodium-lithium countertransport and triglycerides in diabetic nephropathy.
AB  - Elevated erythrocyte sodium-lithium countertransport (SLC) activity is an
      intermediate phenotype of essential hypertension among Caucasians, and is
      controversially associated with nephropathy in Type 1 (insulin-dependent)
      diabetes. Hypertriglyceridemia is a frequent concomitant of elevated SLC in the
      general population, and may be found in diabetic nephropathy. The present study
      was designed to investigate the influence of kidney disease, serum triglycerides
      and blood pressure on the interindividual variability of SLC in Type 1 diabetes.
      SLC and fasting major serum lipids were studied in 35 Type 1 diabetic patients
      with persistently elevated urinary albumin excretion and in a group of patients
      matched for age, sex and duration of diabetes, but with normoalbuminuria. SLC was
      elevated in patients with clinical nephropathy (N = 10; median: 420 mumol.1RBC
      1.hr-1) and in patients with microalbuminuria (N = 25; median: 405 mumol.1RBC
      1.hr-1) compared with normoalbuminuric patients (median: 296 mumol.1RBC-1.hr-1; P
      < 0.01 vs. both groups). Hypertriglyceridemia and hypercholesterolemia were found
      only among patients with macroalbuminuria. Analysis of covariance indicated that
      the association of elevated SLC with kidney disease (P < 0.006 in all models) was
      largely independent of serum triglycerides, but also of total cholesterol,
      insulin dose and measures of glycemic control. Only diastolic blood pressure was
      positively associated with SLC (P < 0.02) independently from nephropathy (P <
      0.005) also after restricting analysis to the normoalbuminuric patients. Kidney
      disease and raised blood pressure remain major concomitants of elevated SLC in
      Type 1 diabetics.

PMID- 8355454
TI  - Lower affinity for substrate for extrarenal synthesis of calcitriol in chronic
      uremia.
AB  - Previous studies from our laboratory have shown that anephric patients have very
      low, but detectable, levels of 1,25(OH)2D3 (calcitriol) that can be increased to
      normal by administration of large doses of 25(OH)D3. The report of 1 alpha
      hydroxylase activity in pig liver with an affinity for substrate significantly
      lower than that of the renal enzyme, led us to use the rat as an experimental
      model to further clarify the need of supraphysiological levels of 25(OH)D3 to
      correct calcitriol deficiency in chronic uremia. We have measured 1,25(OH)2D3
      production by rat liver. Cytosol free liver homogenates (CFH) from normal rats
      were incubated with 25(OH)D3 and the production of 1,25(OH)2D3 was measured using
      the thymus radioreceptor assay after solid phase C18 extraction and HPLC
      purification of the samples. 1,25(OH)2D3 production was linear up to 30 minutes
      and a CFH protein concentration up to 20 mg. Saturability was attained for a
      substrate concentration of approximately 60 microM. Ketoconazole, a cytochrome
      P450 inhibitor, blocked calcitriol production in a dose dependent fashion. Total
      inhibition of the liver 1 alpha-hydroxylase was achieved with 180 microM
      ketoconazole. We next compared the kinetics of the 1 alpha-hydroxylases of normal
      and uremic rat livers. Maximal velocities were not statistically different (139.6
      +/- 22.3 pg/mg/min for normals and 217.1 +/- 73.3 pg/mg/min for uremic rats).
      However, the apparent Km was 35.9 +/- 3.2 microM for uremic animals,
      significantly higher (P < or = 0.001) than that of normal rats (16.6 +/- 0.7
      microM).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355455
TI  - Role of hyperglycemia and insulin resistance in determining sodium retention in
      non-insulin-dependent diabetes.
AB  - Sodium retention has been advocated to give rise to hypertension in humans.
      Increases in blood glucose and insulin concentrations ensue in the stimulation of
      sodium reabsorption by the kidney. Although the combined occurrence of
      hyperglycemia and hyperinsulinemia, frequently secondary to insulin resistance
      with regard to carbohydrate metabolism, is a hallmark of non-insulin dependent
      diabetes (NIDDM), the role of these abnormalities in determining an impaired
      natriuresis in NIDDM is not yet fully understood. We studied sodium homeostasis
      in 14 control subjects and 59 NIDDM normotensive, normoalbuminuric patients who
      were divided into two groups with markedly impaired (Group 2 NIDDM: 30) and less
      severely impaired (Group 1 NIDDM: 29) insulin sensitivity during euglycemic
      hyperinsulinemic (80 to 90 microU/ml plasma insulin) clamp. A hyperglycemic (9
      mmol/liter plasma glucose)--nearly euinsulinemic (20 to 40 microU/ml plasma
      insulin) clamp was also performed in the same 14 controls and in two cohorts of
      22 Group 2 and 17 Group 1 NIDDM patients. The two groups of patients had similar
      overnight fasting glucose levels (Group 1 NIDDM vs. Group 2 NIDDM: 176 +/- 13 vs.
      185 +/- 15 mg/dl, mean +/- SE). Conversely, overnight fasting plasma insulin was
      significantly higher in Group 2 NIDDM than in Group 1 NIDDM patients (Group 1
      NIDDM vs. Group 2 NIDDM: 12 +/- 3 vs. 18 +/- 3 microU/ml, P < 0.05). Both NIDDM
      Groups had higher plasma glucose and insulin than controls (75 +/- 4 mg/dl and 6
      +/- 3 microU/ml). Blood pressure levels and albumin excretion rates were slightly
      but significantly higher in Group 2 NIDDM, but not in Group 1 NIDDM patients,
      than in controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355456
TI  - Stage- and segment-specific expression of cell-adhesion molecules N-CAM, A-CAM,
      and L-CAM in the kidney.
AB  - CAM expression was investigated immunohistochemically in tissue sections and in
      pure cultures of human proximal and distal tubular cells. In the fetal kidney, N
      CAM immunoreactivity was detected in the non-induced and condensing
      metanephrogenic mesenchyme, and in all stages until the S-shaped bodies. A-CAM (N
      cadherin) first appeared in the non-induced mesenchyme and remained present
      thereafter. Its expression became exclusively associated with the lower limb of
      the S-shaped bodies and the developing proximal tubule. In contrast, L-CAM (E
      cadherin; uvomorulin) staining was observed in the fetal collecting duct, the
      upper limb of the S-shaped bodies, and the developing distal tubule. This segment
      specific expression of A-CAM and L-CAM in the early developing nephron was
      maintained in the adult kidney: A-CAM staining was restricted to adherens
      junctions in the proximal tubule and thin limb, whereas L-CAM was expressed in
      Bowman's capsule and in all tubular segments except the proximal convoluted and
      straight tubule. Also after in vitro culture, A-CAM expression was an exclusive
      property of proximal tubular cells, while L-CAM was confined to distal tubular
      cells. In conclusion, each major subdivision of the fetal and adult nephron
      displays a characteristic combination of L-CAM and A-CAM, suggesting that they
      may be the basis of segmental differentiation and border formation between
      adjacent nephron segments.

PMID- 8355457
TI  - Renal osteodystrophy in diabetic patients.
AB  - To assess the effects of diabetes mellitus on renal osteodystrophy, we examined
      the database of 256 patients (45% on hemodialysis and 55% on peritoneal dialysis)
      who were prospectively studied in three Toronto dialysis centers between October
      of 1987 and 1989. All patients had serial documentation of their clinical,
      laboratory and risk parameters of bone disease, and completed a series of
      investigations that included the deferoxamine test, measurement of intact 1-84
      PTH levels, and an iliac crest bone biopsy. Twenty-five percent of these patients
      were diabetic. When compared to non-diabetic patients, they were on dialysis for
      a shorter duration (2.4 +/- 0.3 vs. 4.7 +/- 0.3 years; P < 0.0002), used calcium
      carbonate as the only phosphate binder more frequently (40 vs. 25%; P < 0.007),
      and had lower parathyroid hormone levels (12 +/- 1.4 vs. 24 +/- 2.3 pmol/liter; P
      < 0.002). High-turnover bone disorders (that is, osteitis fibrosa and mixed
      disorder) were distinctly uncommon (8 vs. 33%; P < 0.01 by Fisher's exact test),
      while the mild (19 vs. 9%; P = NS) and the aplastic disorders (with mean
      stainable bone surface aluminum of 6.5 +/- 0.7%) (46 vs. 31%; P = NS) tended to
      be more common in diabetic patients. The prevalence of aluminum bone disease was
      the same in both groups (27%). Diabetic patients ingested a smaller cumulative
      dose of aluminum gels (3.7 +/- 0.6 vs. 9.3 +/- 1.1 kg; P < 0.005), yet had a
      higher rate of aluminium accumulation on bone surfaces than non-diabetic patients
      (1.5 +/- 0.19 vs. 0.96 +/- 0.10% per month on dialysis; P < 0.015).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8355458
TI  - Role of the renin-angiotensin system on the renal functional reserve in renal
      transplant recipients.
AB  - To determine the renal functional reserve in renal transplant recipients, we
      measured the glomerular filtration rate by inulin clearance and the renal plasma
      flow by PAH clearance before and during an amino acid infusion (Totamine, 6 to 8
      mg/kg/min for 90 to 120 min) in 18 transplanted patients with stable renal
      function. To test the role of the renin-angiotensin system on the renal
      functional reserve, we performed a crossover placebo-controlled randomized trial
      of acute blockade of the renin-angiotensin system by injection of perindoprilat
      (2 mg i.v.), an inhibitor of angiotensin converting enzyme before amino acid
      infusion, each patient being studied twice at seven day intervals. Amino acid
      infusion induced a time-dependent increase in the glomerular filtration rate (P =
      0.04), whether or not the renin-angiotensin system was blocked. Maximal increases
      were from 49.1 +/- 4.1 to 58.9 +/- 5.4, mean +/- SE (18.5%), in control
      conditions and from 52.4 +/- 5.6 to 62.1 +/- 5.5 ml/min/1.73 m2 (19.7%) after
      perindoprilat. The increase in glomerular filtration rate was less pronounced in
      patients taking cyclosporin A than in patients treated with steroid and
      azathioprine. Amino acid infusion also induced a significant and time-dependent
      increase (15.2 to 20.2%) in the renal plasma flow (P < 0.01) whether or not
      perindoprilat had been given. Furthermore, perindoprilat alone increased renal
      plasma flow by 13.6%, and this effect seemed additive with that of amino acids.
      Perindoprilat injection decreased filtration fraction (from 0.20 +/- 0.01 to 0.19
      +/- 0.01). This parameter returned to basal values after amino acid infusion
      (0.20 +/- 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355459
TI  - Parathyroid removal prevents the progression of chronic renal failure induced by
      high protein diet.
AB  - The influence of PTH in the progression of renal failure induced by a high
      protein diet was investigated in either sham operated (SHAM) or
      parathyroidectomized (PTX) and subtotally nephrectomized (NX) rats. NX-SHAM rats
      were pair-fed either a high (HPr, 40% casein) or a normal (NPr, 20% casein)
      protein diet and NX-PTX rats a HPr diet. The results indicate that PTX markedly
      improved the survival rate and prevented the deterioration of renal function
      induced by the HPr diet. The number of rats alive after 33 weeks was 0 of 11, 6
      of 10, and 9 of 10 in NX-SHAM-HPr, NX-PTX-HPr and NX-SHAM-NPr, respectively. The
      increases in plasma urea and creatinine were consistently delayed or prevented in
      NX-PTX as compared to NX-SHAM rats fed the HPr diet. The increment in the mass
      and calcium content of the kidney remnant induced by HPr was prevented by
      parathyroidectomy. In addition, PTX completely prevented the rise in the
      circulating level of cholesterol observed in response to HPr. Normalization of
      plasma calcium in NX-PTX rats with 1,25-dihydroxyvitamin D3 restored the
      increment in the renal mass and calcium content and reduced the protective effect
      of PTX on the progression of renal failure induced by high protein diet. In
      conclusion, in the subtotal nephrectomized rat model of chronic renal failure,
      the progression of kidney damage induced by a high protein diet can be prevented
      by removal of the parathyroid glands. This observation suggests that PTH could be
      implicated in the mechanism whereby a high protein regimen accelerates the course
      of chronic renal failure.

PMID- 8355460
TI  - Effect of erythropoietin therapy and withdrawal on blood coagulation and
      fibrinolysis in hemodialysis patients.
AB  - Erythropoietin (EPO) therapy in hemodialysis patients may be associated with an
      enhanced risk of vascular access and extracorporeal thrombosis. Assessment of
      blood coagulation and fibrinolysis was performed monthly on a group of 21
      hemodialysis patients treated with EPO, and on four iron-deficient hemodialysis
      patients treated with iron dextran infusions alone. Seventeen of the EPO treated
      patients were also monitored after withdrawal of EPO to allow hemoglobin to fall
      to pre-EPO levels, and 16 of these patients during a second subsequent phase of
      EPO therapy with EPO administered using the alternative route
      (subcutaneous/intravenous) from the first phase of treatment. Ten untreated
      hemodialysis patients with intrinsically high hemoglobins were studied as
      controls. EPO was associated with significant increases in the endothelial
      product Factor VIII von Willebrand factor antigen (FVIIIvWFAg), and plasma
      fibrinogen, to levels comparable to those observed in the untreated control
      patients. Both FVIIIvWFAg and fibrinogen remained significantly elevated when EPO
      was withdrawn. Whole blood platelet aggregation (spontaneous, collagen, and ADP
      induced) also increased following EPO, collagen and ADP-induced aggregation,
      increasing further when EPO was withdrawn. Transient but significant changes
      occurred in plasma measures of thrombin-antithrombin III complex, prostacyclin
      stimulating factor, and protein C during the first EPO treatment phase, and also
      thrombin-antithrombin III complex during the second treatment phase, all favoring
      a tendency to thrombosis. D-dimer increased significantly following EPO
      withdrawal. Erythrocyte deformability, and granulocyte aggregation did not
      change. There was no effect of route of EPO administration (subcutaneous or
      intravenous) or EPO dose on any of these parameters.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8355461
TI  - Therapeutic efficacy of non-peptide ADH antagonist OPC-31260 in SIADH rats.
AB  - The present study was undertaken to determine whether the non-peptide V2
      antidiuretic hormone (ADH) antagonist 5-dimethylamino-1[4-(2-
      methylbenzoylamino)benzoyl]-2,3,4,5-tetrahydro-1H-benzazepine (OPC-31260)
      normalized hyponatremia in rats with an experimental syndrome of inappropriate
      secretion of ADH (SIADH). Rats were administered V2 agonist 1-deamino-8-D
      arginine vasopressin (dDAVP) subcutaneously at a rate of 5 ng/hr using an osmotic
      minipump and a 40 ml/day liquid diet. Serum sodium levels (SNa) and serum
      osmolality (SOsm) markedly decreased to 119 mEq/liter and 249 mOsm/kg H2O,
      respectively, 48 hours after the start of dDAVP administration. Hyponatremia
      persisted in a similar magnitude during the observation period of 14 days. On
      days 7 to 13 OPC-31260, administered 5 mg/kg per day orally, promptly raised SNa
      and SOsm to 134 mEq/liter and 282 mOsm/kg H2O in half a day, respectively,
      followed by the normalization of SNa and SOsm during the rest of the observation
      period. The cease of administration of OPC-31260 again decreased SNa and SOsm in
      rats receiving dDAVP. In contrast, SNa and SOsm were within the normal values in
      rats receiving 0.15 M NaCl, a vehicle for dDAVP, in the presence or absence of
      OPC-31260. The administration of OPC-31260 promptly caused marked water diuresis
      on day 7 in the hyponatremic rats receiving dDAVP, namely 5 mg/kg OPC-31260
      markedly increased urinary volume and decreased UOsm. These results indicate that
      there is dilutional hyponatremia in rats receiving dDAVP and 40 ml/day liquid
      diets, and that OPC-31260 is an effective therapeutic for hyponatremia associated
      with dDAVP-induced SIADH.

PMID- 8355462
TI  - Contributing factors to the inhibition of phagocytosis in hemodialyzed patients.
AB  - Although polymorphonuclear (PMNL) glucose consumption as an index of metabolic
      response to phagocytosis in the production of free radical species is depressed
      in hemodialyzed patients, substantial interindividual differences are registered.
      Studies evaluating to what variables these differences are related are, however,
      lacking. In the present study, the relation of several factors to PMNL functional
      capacity in the breakdown of glucose to CO2 by the hexose monophosphate shunt
      (HMS) is considered in an individual and multifactorial regression analysis.
      Starting from a database, collected in 126 stabilized hemodialysis patients, PMNL
      HMS-response to standard quantities of latex and zymosan was correlated to 14
      numerical parameters: time since the start of dialysis, hematocrit, serum
      creatinine, phosphorus, ferritin, albumin, parathormone, albumin before and after
      administration of desferrioxamine, residual creatinine clearance, PCR, TACurea,
      Kt/V and age. In addition, the non-numeric parameters of sex, biocompatibility of
      dialyzers, and primary diagnosis were also considered. A significant correlation
      was found for time on dialysis (P < 0.001), hematocrit (P < 0.001), ferritin (P <
      0.05), PTH (P < 0.001) and aluminum (P < 0.05). The highest correlation
      coefficients were found for time on dialysis (latex: N = 126, r = 0.50, P <
      0.001; zymosan: N = 126, r = 0.58, P < 0.001). Multivariate correlation analysis
      of one clinical parameter together with time on dialysis to PMNL response showed
      that the correlation was strongly weakened or disappeared for ferritin, aluminum
      and PTH, but not for hematocrit. Our data indicate that time since the start of
      dialysis is an important, but not unique factor, influencing polymorphonuclear
      functional capacity in a hemodialysis population.

PMID- 8355463
TI  - Clonidine, but not bradykinin or ANP, inhibits Na+ and water transport in Dahl SS
      rat CCD.
AB  - We examined the actions of potentially natriuretic autacoids in the isolated
      perfused cortical collecting duct (CCD) dissected from inbred Dahl (Rapp strain)
      salt-sensitive rats (SS). Atrial natriuretic peptide (ANP, 10 nM), bradykinin
      (BK, 10 nM), and clonidine (1 microM) were studied to determine their effects on
      the lumen-to-bath flux of 22Na+ (J1-->b, pmol min-1 mm-1), hydraulic conductivity
      (Pf, micron/s), and transepithelial voltage (VT, mV). ANP and BK have been shown
      by others to significantly reduce net Na+ reabsorption and hydraulic conductivity
      in the Sprague-Dawley (SD) rat CCD, but previous results from our laboratory
      showed no ANP or BK effect in the SD CCD. In the present study, we were also
      unable to observe any effect of either ANP or BK in the SS rat CCD. However, in
      the presence of AVP, clonidine (a partial alpha 2-adrenergic receptor agonist)
      significantly reduced J1-->b and Pf from 139 +/- 6 (SEM) to 88 +/- 7 and from 959
      +/- 176 to 490 +/- 73, respectively. In addition, clonidine significantly
      depolarized VT from -14.5 +/- 2.8 to -11.2 +/- 1.8. However, unlike its effects
      in the SD rat CCD, yohimbine (300 nM, an alpha 2-adrenergic receptor antagonist)
      did not significantly reverse the effects of clonidine on J1-->b, Pf or VT in the
      SS rat CCD.

PMID- 8355464
TI  - Novel ligands BQ123 and BQ3020 characterize endothelin receptor subtypes ETA and
      ETB in human kidney.
AB  - Endothelins (ET), a group of vasoconstrictor peptides, are expressed in a wide
      range of tissues and species and bind to specific receptors of which there are at
      least two subtypes, ETA and ETB. The kidney has been found in animal studies to
      be highly sensitive to the effects of ET. We have used two new peptide ligands,
      which are selective for particular ET receptor subtypes (the antagonist BQ123 for
      ETA and the agonist BQ3020 for ETB) in binding studies to characterize human
      renal ET receptors. Saturation studies gave equilibrium dissociation constants
      (Kd) for [I125]ET-1 of 0.17 +/- 0.04 nM and for [I125]BQ3020 of 0.36 +/- 0.06 nM.
      Hill coefficients were 0.86 +/- 0.03 and 0.77 +/- 0.04, respectively. Macro- and
      microautoradiography using [I125]-labeled ligands with BQ123 and BQ3020 as
      competing blockers showed the majority of ET binding to be in the medulla with
      concentration in the vasa recta bundles, and ETA binding localizing to vascular
      smooth muscle. The ETB subtype predominated over ETA receptors by about 2:1, and
      was more generally distributed, with concentration in the collecting system.
      These findings were confirmed by competition binding assays giving Bmax values
      (ETB/ETA, fmol/mg protein), for medulla and cortex, respectively, of 18.7 +/-
      2.2/11.3 +/- 2.7 and 12.7 +/- 3.9/7.6 +/- 3.5 for BQ3020; and 36.2 +/- 5.6/11.1
      +/- 4.1 and 14.9 +/- 1.6/5.3 +/- 0.2 for BQ123. This study establishes ETA and
      ETB receptor distribution in human kidney and demonstrates that the novel ligands
      BQ123 and BQ3020 have at least thousand-fold selectivities for the ETA- and ETB
      receptor subtypes, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355465
TI  - Interferon-gamma regulation of human renal cortical epithelial cell-derived
      monocyte chemotactic peptide-1.
AB  - The chemoattractant signal(s) that results in the transmigration of
      monocytes/macrophage into the tubulointerstitium during acute inflammation is not
      known. Monocyte chemotactic peptide-1 (MCP-1), a recently described chemotactic
      cytokine, may function as both a potent monocyte chemotaxin and activator in
      renal inflammation. We have studied the proinflammatory conditions in which
      cultured human renal cortical epithelial cells (RCEC) of tubular origin may be
      stimulated to produce MCP-1. RCEC were stimulated in a dose-time dependent manner
      with: IL-1 beta (0.01 to 1.0 ng/ml), TNF (0.1 to 10 ng/ml), LPS (0.1 to 10
      micrograms/ml) or INF-gamma (10-1000 U/ml). Conditioned media from RCEC
      stimulated with either IL-1 beta or INF-gamma produced a monocyte chemoattractant
      activity which was significantly suppressed with neutralizing antibody to MCP-1.
      Stimulation of RCEC with either IL-1 beta or INF-gamma resulted in a significant
      (4- to 5-fold) increase in steady state levels of MCP-1 mRNA. MCP-1 antigenic
      peptide in RCEC conditioned media was significantly increased over control (2- to
      2.5-fold) after stimulation with either IL-1 beta or IFN-gamma. In contrast,
      production of interleukin-8 (IL-8), a neutrophil chemotactic cytokine, was not
      stimulated by IFN-gamma in RCEC. Thus, the chemokine signaling repertoire of
      renal tubule cells may be selectively controlled by IFN-gamma.

PMID- 8355466
TI  - IFN-gamma mediates stimulation of complement C4 biosynthesis in human proximal
      tubular epithelial cells.
AB  - The liver has been presumed to be the main source of complement deposited in
      inflammatory lesions such as in glomerulonephritis. In a previous study, however,
      it was demonstrated that renal tubular cells synthesize C3 in vitro. Furthermore,
      it was shown by others that C4 gene transcripts were detectable in situ in renal
      tubular cells. Therefore studies were initiated to investigate the synthesis of
      C4 by proximal tubular epithelial cells (PTEC) in vitro. Biosynthetic labeling
      experiments showed de novo synthesis of C4 by PTEC. The synthesis of C4 by PTEC
      and its regulation by IFN-gamma was fully inhibitable by the addition of
      cycloheximide, indicating that protein synthesis is required for an increase in
      C4 secretion. Addition of increasing concentrations of IFN-gamma enhanced the
      production of C4 by PTEC in a dose dependent fashion, with a 2.5-fold maximum.
      Kinetic experiments demonstrated higher levels of C4 production when stimulated
      with IFN-gamma for up to 72 hours. The hemolytic activity of C4 present in
      culture supernatants of PTEC decreased during the culture period as assessed by
      hemolytic titration. Northern blot analysis showed no enhancement of C4 mRNA in
      IFN-gamma treated PTEC, indicating that IFN-gamma regulates C4 production at a
      post-transcriptional level. Antibody blocking experiments confirmed that
      regulation of C4 production was directly mediated by IFN-gamma. From this study
      it was concluded that renal cells are able to synthesize complement components
      that could possibly play a role in inflammatory responses evolving in the kidney.

PMID- 8355467
TI  - Activation of protein kinase C reduces thromboxane receptors in glomeruli and
      mesangial cells.
AB  - The potential role of protein kinase C (PKC) in the modulation of thromboxane A2
      (TX) receptor density was evaluated in intact glomeruli and cultured renal
      mesangial cells (MC) from the rat. Incubation of glomeruli with 0.1 microM
      phorbol dibutyrate (PDBu) or 30 mM glucose for four hours activated PKC as
      reflected by increased in situ phosphorylation of the 80 kDa MARCKS protein, a
      specific endogenous substrate for PKC. High affinity binding to TX receptors, as
      assessed from the binding of the stable TX antagonist [3H]-Sq-29548 (Sq), was
      decreased 30% in glomeruli exposed to PDBu and 28% in glomeruli incubated in 30
      mM D-glucose for four hours. Concurrent incubation with 0.05 microM of the PKC
      inhibitor staurosporine blocked both MARCKS protein phosphorylation and the
      decrease in TX receptor sites in response to either PDBu or 30 mM glucose.
      Neither 30 mM L-glucose nor 30 mM mannitol altered glomerular PKC activity or TX
      receptor density, thus excluding an osmotic effect of D-glucose, and implicating
      cellular metabolism of glucose in the expression of these actions. Inhibition of
      endogenous production of TX with indomethacin during exposure of glomeruli to 30
      mM glucose did not prevent the decrease in TX binding. Homologous down-regulation
      of TX receptors mediated by endogenous TX was therefore not implicated in this
      action of glucose. The affinity of the glomerular receptor sites for [3H]-Sq was
      not affected by PKC activation. MC in passages 3 to 7 also demonstrated high
      affinity sites for [3H]-Sq (Kd, 2.8 nM). Culture of MC with PDBu (0.05 or 0.1
      microM) for four hours decreased TX receptor density.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8355468
TI  - Shared idiotypes in mesangial deposits in IgA nephropathy are not disease
      specific.
AB  - The antigenic specificity of the mesangial IgA in IgA nephropathy (IgAN) remains
      unknown. Because shared antigenic specificities may be reflected in the usage of
      shared idiotypes, we prepared five monoclonal anti-idiotypic antibodies (MoAbs)
      specific for the mesangial IgA eluted from the kidney of an IgAN patient. All
      five MoAbs reacted with the same idiotype, which proved to be of a public nature.
      Although the idiotype could be identified in the mesangial deposits of the
      majority of IgAN patients studied, it was not specific for the disease because it
      was also found in the glomerular deposits of other types of glomerulonephritis.
      The idiotype was also expressed in polyethylene glycol precipitates of sera and
      in pokeweed mitogen-induced plasma cells from both IgAN patients and healthy
      controls. The conclusion that no disease-specific idiotypes are present in the
      renal eluate was further supported by the failure to produce polyclonal anti
      idiotypic antibodies by immunizing a rabbit with the eluted mesangial IgA. Our
      results support the concept that mesangial IgA deposits in IgAN are of a
      polyclonal nature.

PMID- 8355469
TI  - Fish oil in lupus nephritis: clinical findings and methodological implications.
AB  - Our objective was to determine the effects of fish oil on renal function,
      symptoms, and serum lipids in patients with lupus nephritis. A double-blind,
      randomized crossover trial of fish oil versus placebo (olive oil) was done on 26
      patients with confirmed systemic lupus; 21 completed the study. Intervention was
      fish oil or placebo, 15 g/day, for one year followed by a 10 week wash-out
      period, and then the reverse treatment for one year. At baseline and six month
      intervals, we measured platelet membrane fatty acids, indices of renal function,
      a disease activity index, serum lipid levels, blood pressure, serum viscosity and
      red cell flexibility. We found that platelet membrane phospholipids were
      uniformly affected by fish oil supplementation (P < 0.001) but with significant
      carry-over effects despite a 10 week wash-out period. Glomerular filtration rate
      and serum creatinine were not affected. A non-significant reduction in mean (SE)
      24-hour proteinuria occurred, from 1424.1 mg (442.7) on placebo to 896.7 mg
      (352.2) on fish oil (P = 0.21). Fish oil lowered serum triglycerides from 1.89
      (0.25) mmol/liter to 1.02 (0.11) mmol/liter (P = 0.004). VLDL cholesterol
      decreased markedly whether patients initially received fish oil or placebo (P =
      0.004). The size of the reduction was affected by the order of treatment (P =
      0.03), but parallel comparisons were significant before the crossover (P =
      0.0006). With the possible exception of bleeding time, no other treatment effects
      were shown with fish oil. However, treatment order effects were seen in urinary
      IgG excretion (P = 0.03), whole blood viscosity (P < 0.0001), red cell
      flexibility (P = 0.004), and bleeding time (P = 0.06). In conclusion, one year of
      dietary supplementation with fish oil in patients with stable lupus nephritis did
      not improve renal function or reduce disease activity, but did alter some lipid
      parameters. Hitherto unreported carry-over effects and treatment order effects
      caused by the olive oil created a risk of type II error, and bear methodologic
      consideration in the design of future studies.

PMID- 8355470
TI  - Intra-peritoneal free elastase in CAPD peritonitis.
AB  - Neutrophil (PMN) recruitment into the peritoneum during acute bacterial
      peritonitis is an important part of the host defense barrier in CAPD patients.
      However, the subsequent phagocytosis of bacteria may also lead to PMN
      degranulation and the release of lysosomal enzymes. We determined the
      concentration of neutrophil elastase, both in complex with its natural inhibitor
      alpha 1Pi (E alpha 1Pi), and in uncomplexed, free form, in infected and normal
      CAPD peritoneal fluid by ELISA. In addition elastase activity was estimated in a
      casein degradation assay. Infected fluid contained a median (range) of 1.4 nM (0
      to 9.2) free elastase by ELISA and 1.2 nM (0 to 11.9) activity. There were strong
      correlations between the peritoneal leukocyte count and both immunoreactive
      elastase and activity (r = 0.816, P < 0.001, 0.687, P < 0.01, respectively). In
      contrast, normal fluid contained 0.0 nM (0 to 0.32) immunoreactive elastase (P <
      0.01) and 0.0 nM (0 to 0.6) elastase activity (P < 0.001). E alpha 1Pi complexes
      were raised significantly during peritonitis at 6.2 nM (0 to 34.3) and were
      barely detectable in normal fluid 0.0 nM (0 to 0.17; P < 0.005). The study shows
      that small but significant quantities of uninhibited elastase can be detected in
      the peritoneal fluid of CAPD patients with acute bacterial peritonitis. This
      observation may have important implications for the pathogenesis of peritoneal
      membrane damage and the phlogistic response to infection.

PMID- 8355472
TI  - Epiphyseal impaction as a cause of severe osteoarticular pain of lower limbs
      after renal transplantation.
AB  - A syndrome of severe osteoarticular pain of lower limbs occurring early after
      renal transplantation (TP) has been recently identified. We describe its
      prevalence, clinical presentation and outcome. Symptomatic patients have been
      studied with conventional X-rays, magnetic resonance (MR) imaging, and
      99mTechnetium scintigrams of the painful areas. Among 86 patients transplanted
      over a two-year period, nine (4 men, 5 women; mean age of 40.4 years; range 32 to
      59) developed unexplained severe spontaneous osteoarticular pain of lower limbs
      19 to 105 (mean 58) days after TP. Pain affected hip(s), knee(s), and/or
      ankle(s). Clinical examination was usually unremarkable. Favorable outcome was
      the rule; mean duration of pain was 86 (range 19 to 175) days. Radiographs were
      abnormal (joint swelling, patchy osteoporosis and/or periosteal reactions) in
      41%, MR (epiphyseal fatty marrow replacement by edema and/or hemorrhages) in 83%,
      and bone scans (one to several epiphyseal foci of increased uptake) in 81% of the
      symptomatic examined areas. Among joints re-examined 9 to 12 months after
      resolution of the symptoms, X-rays showed periosteal reactions in 31%, and the
      bone scans disclosed persistent increased uptake in 53% of the joints, whereas
      epiphyseal MR abnormalities had completely disappeared in 86%. There was no
      difference in dialysis duration, post-TP weight gain, evidence of
      hyperparathyroidism, and steroid and cyclosporine doses between symptomatic and
      an appropriately selected group of asymptomatic patients. By contrast, serum
      alkaline phosphatase levels were transiently higher (at the onset of symptoms) in
      the symptomatic group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355471
TI  - Role of elevated lecithin: cholesterol acyltransferase and cholesteryl ester
      transfer protein activities in abnormal lipoproteins from proteinuric patients.
AB  - Lecithin:cholesterol acyltransferase (LCAT) and cholesteryl ester transfer
      protein (CETP) are key factors in the esterification of free cholesterol, and the
      distribution of cholesteryl ester among lipoproteins in plasma. Alterations in
      these processes may play a role in the lipoprotein abnormalities associated with
      glomerular proteinuria. The activities of LCAT and CETP were measured using
      excess exogenous substrate assays in nine patients with nephrotic-range
      proteinuria and in 18 matched controls. The proteinuria-lowering effect of four
      weeks of angiotensin converting enzyme (ACE) inhibition with enalapril was also
      studied. Plasma very low lipoprotein and low density lipoprotein (VLDL and LDL)
      cholesterol, triacylglycerol and apolipoprotein B levels were significantly
      elevated in the patients compared with controls. High density lipoprotein (HDL)
      total cholesterol, free cholesterol, cholesteryl ester and the free
      cholesterol/cholesteryl ester ratio in HDL were lower. Total plasma
      apolipoprotein A1 was normal. Plasma LCAT and CETP activities were elevated in
      the patients by 30% (P < 0.01) and by 39% (P < 0.01), respectively, and were both
      inversely related to serum albumin. VLDL and LDL cholesterol levels were
      positively related to LCAT and CETP activities, whereas the HDL free cholesterol
      content was inversely related to LCAT activity. ACE inhibition resulted in a 40%
      reduction of proteinuria, a partial normalization of LCAT activity, and a
      decrease in VLDL and LDL cholesterol. In conclusion, elevated activities of LCAT
      and CETP may provide a mechanism that contributes to the low proportion of
      cholesterol in HDL relative to that in VLDL and LDL, as well as to the
      compositional changes of HDL seen in glomerular proteinuria.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8355473
TI  - Torsion of the gallbladder in a thirteen year old boy--case report.
AB  - Torsion of the gallbladder in a child is rare and only 23 cases in children have
      been reported in Japan. A preoperative diagnosis is very difficult and only four
      cases have been diagnosed, preoperatively, to date. In the case reported here the
      suspected preoperative diagnosis was an acute cholecystitis. During the
      operation, the gallbladder was found to be enlarged to twice the normal size and
      twisted 540 degrees in a clockwise direction around the cystic duct. A
      cholecystectomy with abdominal drainage was successfully performed; and the
      patient was discharged in good condition, 13 days after the operation. It was
      concluded that one of the most important features for the preoperative diagnosis
      of torsion of the gallbladder is a dislocation on ultrasonography.

PMID- 8355474
TI  - Laparoscopic treatment of ectopic pregnancies--reports of two cases.
AB  - Two cases with ectopic pregnancy were successfully treated by laparoscopic
      injection of methotrexate (MTX). Case 1: A 29 year-old housewife was
      laparoscopically treated with a 15 mg MTX injection to the left Fallopian tube.
      After the laparoscopy, the human chorionic gonadotropin (HCG) was reduced to the
      normal range. Case 2: A 34 year-old housewife was also laparoscopically treated
      with a 35 mg MTX injection to the right Fallopian tube. After the laparoscopy,
      the HCG was quickly reduced to the normal range. The endoscopic approach can be
      used as the surgical treatment of choice for ectopic pregnancies.

PMID- 8355475
TI  - Acute obstructive hydrocephalus due to an unruptured basilar bifurcation aneurysm
      associated with bilateral internal carotid occlusion--a case report.
AB  - A patient with a higherly positioned and large basilar bifurcation aneurysm
      associated with bilateral internal carotid occlusion was described. A 63 year-old
      man was admitted to Yokokura Hospital with disturbed consciousness and mild left
      hemiparesis. On admission, an initial plain CT-scan showed an acute obstructive
      hydrocephalus with periventricular lucency caused by an abnormal lesion in the
      anterior part of the third ventricle. An emergency ventriculo-peritoneal shunt
      was inserted. The postoperative course was uneventful. The patient regained his
      consciousness with normal motor function by the following day. Postoperative
      cerebral angiography disclosed a large basilar bifurcation aneurysm at a higher
      position, 19 mm from the dorsum sellae. Bilateral internal carotid occlusion had
      occurred, but rich collateral blood supply from the vertebro-basilar artery via
      the bilaterally enlarged posterior communicating arteries to the anterior
      circulation was observed. This rich collateral blood supply to the
      vertebrobasilar artery might be responsible for the development of the aneurysmal
      formation due to the increased hemodynamic stress.

PMID- 8355476
TI  - Increased incidence of cholestasis during total parenteral nutrition in children-
      factors affecting stone formation.
AB  - Cholelithiasis is extremely unusual in infants and children. Recently, some cases
      of cholelithiasis associated with total parenteral nutrition (TPN) have been
      reported. A group of 400 children receiving TPN were evaluated prospectively for
      the presence of gallstones and sludge in this report. Eight children (2%) were
      determined by ultrasonography to have developed cholelithiasis. All of these
      patients had received large amounts of amino acids (> or = 1.8g/kg/day) and
      relatively low amounts of fat (< or = 1.7g/kg/day) with a high ratio of non
      protein: kcal/ml (> 0.8). It was concluded that the administration of large
      amounts of amino acids and a high ratio of non-protein: kcal/ml enhanced the risk
      for formation of gallstones and sludge. Conversely, these are prevented by the
      administration of appropriate amounts of fat.

PMID- 8355477
TI  - What's in a picture?

PMID- 8355478
TI  - Two rat isolates of B. Piliformis are different based on protein banding patterns
      in acrylamide gels and immunoblots.

PMID- 8355479
TI  - A review of laboratory animal anesthesia with chloral hydrate and chloralose.
AB  - Chloral hydrate (CH) and alpha-chloralose (CS) are often used to anesthetize
      laboratory animals although, to our knowledge, there have been no controlled
      studies of their anesthetic or analgesic effects. Induction of and recovery from
      anesthesia can be stressful, and anesthesia and analgesic quality have been
      questioned. Intraperitoneal (i.p.) administration of CH has resulted in adynamic
      ileus and peritonitis in rats, gastric ulcers in rats, and peritonitis in swine.
      Light anesthesia is induced in rats. In dogs, CH induces sedation to deep
      anesthesia when given intravenously. Gastric irritation in dogs can occur when CH
      is given orally. Chloral hydrate is considered a good sedative-hypnotic for farm
      animals. Intravenously administered CS anesthetizes dogs and cats for 5 to 10
      hours, but the animals may require respiratory support. Chloralose appears to be
      a satisfactory anesthetic for dogs when stage III thiobarbiturate anesthesia is
      first induced. It is difficult to gauge the depth of anesthesia and analgesia
      with CS. In our clinical experience with swine and calves, CH given i.p. leads to
      adynamic ileus. We have found that CS given i.p. causes an inflammatory response
      in guinea pigs, rats, and calves. We observed that CS analgesia varies with the
      type of surgical procedure performed. Based on a literature review and our
      clinical experience, we suggest that CH or CS anesthesia should be preceded by
      administration of barbiturates, opioids, alpha-2 agonists, or phenothiazine
      tranquilizers. Chloral hydrate should only be used as a sedative or hypnotic for
      dogs; CS should not be used as a sole anesthetic agent. Neither drug should be
      used i.p. for survival surgery.

PMID- 8355480
TI  - Pathologic features associated with decreased longevity of mutant sphha/sphha
      mice with chronic hemolytic anemia: similarities to sequelae of sickle cell
      anemia in humans.
AB  - A colony of sphha/sphha mice with congenital hemolytic anemia and an abnormality
      in erythrocyte spectrin assembly was screened to determine the cause of premature
      death. Sphha/sphha mice have decreased life span, with 50% of animals dying by 6
      months of age. The phenotype of these mutant mice includes moderate anemia
      (hematocrit: 21 to 28%), reticulocytosis, leukocytosis, lymphocytosis, extensive
      extramedullary hematopoiesis in spleen and liver, lymph node hyperplasia and
      membranoproliferative glomerulonephritis. With increased surveillance of this
      mouse colony, 20 clinically sick anemic mice were evaluated (complete blood
      counts and cultures of blood), euthanized and necropsied. Compared with anemic
      mice without clinical signs of disease, sick anemic mice had significantly higher
      white blood cell counts with only 4 (20%) of 20 animals being severely anemic
      (hematocrit: 4 to 8%). Blood from 11 (45%) of 20 animals was culture-positive for
      Pasteurella pneumotropica, Enterococcus, and/or Escherichia coli. In addition to
      the usual lesions in sphha/sphha mice, sick anemic mice had pneumonitis (95%)
      with thrombosis and infarction (80%) of one or more organs (spleen, myocardium,
      pancreas, liver, or bone marrow). The thrombotic tendency that accompanies the
      chronic hemolytic anemia in sphha/sphha mice, as well as the other
      clinicopathologic changes in these mutant mice, bears a striking resemblance to
      some poorly understood sequelae in human patients with sickle cell anemia. This
      mouse model may be useful in studying the pathophysiology of complications
      associated with sickle cell anemia in humans.

PMID- 8355481
TI  - Pharmacokinetics of minocycline and vancomycin in rabbits.
AB  - The pharmacokinetic disposition of minocycline and vancomycin was studied in New
      Zealand White rabbits before initiating an experimental staphylococcal
      endocarditis protocol. Minocycline was administered in a multiple-dose regimen of
      3 mg/kg i.v. every 12 h, 3 mg/kg i.v. every 8 h, and 6 mg/kg i.v. every 8 h.
      Vancomycin was given in a similar fashion using regimens of 75 mg/kg i.v. every
      12 h and 50 mg/kg i.v. every 8 h. Multiple serum samples were obtained after the
      fifth dose and drug concentrations were analyzed by microbiologic assay. The
      pharmacokinetic parameters for each of the drug regimens were calculated using a
      two-compartment model by nonlinear least-squares regression. No statistically
      significant differences were noted in the volume of distribution or the half-life
      of the individual dosing regimens for either agent. As a result of this study, it
      appears that a minocycline regimen of 6 mg/kg i.v. every 8 h and a vancomycin
      regimen of 50 mg/kg i.v. every 8 h are appropriate dosing schemes for a
      comparative study of these agents in rabbits.

PMID- 8355482
TI  - Laboratory survival, growth, and digestive gland histologic features of squids
      reared on living and non-living fish diets.
AB  - The effects of non-living diets on the survival, growth, and digestive gland
      histologic features of the bigfin reef squid (Sepioteuthis lessoniana Lesson,
      1830) cultured in the laboratory were evaluated during one-half of their life
      cycle (95 days). Two groups of squids (n = 16 per group) were held in closed
      seawater systems with similar water volume, temperature, salinity, water
      filtration, and water flow velocities. Food for the control group consisted of
      live, freely swimming fish (Cyprinodon variagatus); the test group was trained to
      grab freshly dead fish (days 1 to 45) and then thawed, frozen fish (days 46 to
      95). The two groups were evaluated for differences in (1) food intake, (2)
      survival, (3) growth (wet weight, mantle length, instantaneous growth rate), (4)
      morphologic (mantle thickness in four locations, digestive gland weight), and (5)
      digestive gland histologic features (indices for nuclear density and relative
      vacuolar density). Unexpectedly, no significant differences were found between
      the two groups. Mean wet weight increased from 32.1 g to 342.9 g for the control
      group and from 58.6 g to 372.0 g for the group fed dead food. The results
      demonstrate that laboratory-cultured squids can survive and grow when fed dead
      fish (fresh or frozen) as well as live fish without adverse effects on growth,
      survival, or digestive gland histologic features.

PMID- 8355483
TI  - Effects of halothane anesthesia on the motility of the sphincter of Oddi and
      transsphincteric flow in Australian brush-tailed possums.
AB  - We evaluated the effect of halothane anesthesia on the motility of the sphincter
      of Oddi and simultaneous transsphincteric flow in Australian Brush-tailed possums
      (Trichosurus vulpecula). Halothane levels in the range of 0.25 to 2% were
      administered and decreased transsphincteric flow in a dose-dependent manner.
      Sphincter of Oddi basal pressure was higher than normal, but not in a dose
      dependent manner. Additionally, halothane anesthesia influenced the sphincter of
      Oddi motility by decreasing the motility index (mean amplitude multiplied by
      frequency of contractions). This decrease was dose dependent. These findings
      indicate that sphincter of Oddi basal pressure is a major component of sphincter
      of Oddi motility responsible for regulating transsphincteric flow in this
      species. For studies of the sphincter of Oddi motility in anesthetized Australian
      Brush-tailed possums, we recommend anesthetic induction with ketamine (50 mg/kg,
      i.m.) and the inspired halothane level should not exceed 0.75% during the study
      period, as the effects we have demonstrated were most evident at levels greater
      than 0.75%. If higher halothane levels are required to maintain satisfactory
      anesthesia, an alternative anesthetic agent should be considered.

PMID- 8355484
TI  - Clinical parameters of the normal baboons (Papio species) and chimpanzees (Pan
      troglodytes).
AB  - Improved equipment and advanced progressive techniques by scientists using
      baboons and chimpanzees in biomedical research have resulted in improved clinical
      laboratory data. The use of state-of-the-art clinical laboratory instruments,
      methodologies with improved accuracy, and an increased variety of individual
      tests routinely requested and performed has necessitated the comparison of
      current data with prior data produced in our laboratory and with those values
      reported in the literature. In addition to an expanded hematologic profile,
      including red blood cell distribution width and mean platelet volume, and a more
      comprehensive chemical profile of 28 individual tests, additional data collected
      included values for coagulation profiles, arterial blood gases, serum protein
      electrophoresis, and urine osmolalities. Samples for evaluation were obtained
      from clinically normal sedated adult baboons (Papio species) and chimpanzees (Pan
      troglodytes) and processed conventionally according to Good Laboratory Practice
      Act standards. Arithmetic means were calculated, values of 3 standard deviations
      or greater were eliminated, and means were recalculated to include 2 standard
      deviations. All data correlated well with prior in-house values, and no
      remarkable differences from established data were detected, thus indicating the
      reliability of past and present data. Data compared favorably with normal
      clinical values established for humans.

PMID- 8355485
TI  - Prophylactic treatment of swine with bretylium for experimental cardiac
      catheterization.
AB  - We evaluated a cryothermic ablation catheter for potential use in treating
      supraventricular tachycardia by cardiac catheterization in miniature swine.
      Cardiac catheterization was performed on anesthetized miniature swine by using
      multiple catheters that were inserted bilaterally by either percutaneous or
      cutdown techniques into the femoral veins. We performed electrophysiologic tests
      according to standard atrial and ventricular electrical stimulation protocols.
      Manipulation of catheters in the tricuspid valve area and right ventricle was an
      essential part of the study. During an initial study of five swine, catheter
      manipulation produced sustained and nonsustained ventricular tachycardia and
      ventricular fibrillation. To prevent arrhythmias, bretylium (5 mg/kg) was
      administered intravenously 10 minutes before catheter manipulation and repeated
      every 30 minutes throughout the procedure. Since the use of bretylium was
      instituted, there have been no cases of ventricular fibrillation in a series of
      20 animals. We determined that bretylium is effective in the suppression of
      ventricular arrhythmias in swine undergoing cardiac catheterization.

PMID- 8355486
TI  - A case of adenomyosis in a pigtailed monkey diagnosed by magnetic resonance
      imaging and treated with the novel pure antiestrogen, ICI 182,780.

PMID- 8355487
TI  - Cavernous lymphangioma in a squirrel monkey.

PMID- 8355488
TI  - Imperforate anus, colo-colic intussusception, and bowel rupture in a neonatal
      guinea pig.

PMID- 8355489
TI  - Leptospirosis in a white-lipped tamarin (Saguinus labiatus).

PMID- 8355490
TI  - Use of medroxyprogesterone acetate to reduce aggression in a male chimpanzee (Pan
      troglodytes).

PMID- 8355491
TI  - Chronic epidural implantation of vascular access catheters in the cat
      lumbosacrum.

PMID- 8355492
TI  - A reliable method of anesthesia for extensive surgery in small rabbits.

PMID- 8355493
TI  - Partial splenic resection using nylon cable tie ligatures in rhesus monkeys.

PMID- 8355494
TI  - Assessing the severity of depressive states in recently detoxified alcoholics.
AB  - The problem of how to assess "unbiased" symptoms of depression meaningfully in
      the context of alcoholism bedevils studies of concomitant alcoholism and
      affective disorder. This study summarizes this controversy and discusses its
      implications for developing improved measures of depression severity among
      alcoholics. The Beck Depression Inventory (BDI) responses of 130 alcoholic
      applicants applying for inpatient care were evaluated using a two-parameter
      normal item response model. This study demonstrates that a single dimension of
      depression severity accounts for patient responses well, but that seven BDI items
      were relatively poor markers of syndrome severity for these alcoholics. The study
      documents growing consensus among investigators as to which BDI items constitute
      a fair scale of depression severity among alcoholic patients The availability of
      "unbiased criteria" for assessing the severity of depression among alcoholics
      applying for inpatient treatment will enable investigators and clinicians to
      recognize patients with concomitant alcoholism and affective disorder for special
      attention and/or treatment. The modified BDI scale proposed here is a candidate
      for a clinical definition of depression severity among alcoholic patients by
      virtue of this study's demonstration that it defines a distinct syndrome in this
      patient sample; but the modified scale must undergo independent tests of validity
      before its clinical utility can be established.

PMID- 8355495
TI  - A comparison of functional indexes, derived from screening tests, of chronic
      alcoholic neurotoxicity in the cerebral cortex, retina and peripheral nervous
      system.
AB  - Thirty abstinent alcoholics and 30 age-, education- and occupation-matched normal
      control subjects were tested with the Category test, the Lanthony-15 test of
      color discrimination and the Biothesiometer test of vibration detection
      threshold. Multivariate analysis of covariance revealed significant impairment of
      the alcoholics on these tasks (p < .007), but univariate analysis revealed that
      only the Category test yielded a significant difference (p < .001). Canonical
      correlation analysis, with age and education partialed out, was calculated on the
      alcoholics' data to determine whether duration, mean and maximum alcohol
      consumption, age of onset of alcoholism and duration of abstinence predicted
      performance on the tasks. The prediction was significant (p < .001). Multiple
      regression analysis revealed that vibration threshold, color preception and
      Category test performance were decreasingly predicted by the alcohol-related
      variables (p < .001, .006, .051, respectively). There was no higher incidence of
      hereditary dyschromatopsia in the alcoholic group than the control group. It was
      therefore concluded that all three functions (Category test performance, color
      discrimination, vibrotactile sensitivity) were impaired as a result of alcohol
      consumption.

PMID- 8355496
TI  - The correspondence between saliva and breath estimates of blood alcohol
      concentration: advantages and limitations of the saliva method.
AB  - Increased awareness of the devastating effects of alcohol misuse on our highways,
      workplaces and families, as well as on the individual, has resulted in increased
      social pressure to enforce driving-while-intoxicated laws and to develop
      educational, prevention and treatment programs. One aspect of this movement is to
      develop improved sobriety testing to ensure that laws are properly and fairly
      enforced and that there is compliance with abstinence in treatment. Although
      sophisticated blood and breath testing devices are available, field tests suggest
      that saliva alcohol tests based on alcohol-oxidase methodology offer advantages
      in portability, ease of administration, and cost and time efficiency. We
      evaluated the validity and reliability of a simple saliva test, based on the
      enzymatic oxidation of alcohol by alcohol oxidase, for estimating blood alcohol
      concentration. Ten subjects consumed various doses of alcohol and multiple saliva
      samples were obtained using alcohol sensitive saliva strips that change color in
      proportion to the concentration of alcohol. The reflectance values of reacted
      saliva strips were read by meter and estimates of blood alcohol concentration in
      the range of 10-90 mg/dl were compared to simultaneous estimates obtained from
      breath analysis using a Breathalyzer Model 900A. We also examined how alcohol
      levels changed over time in alcohol reacted saliva strips. The results of
      regression analysis indicated that the saliva strips and the Breathalyzer gave
      reasonably close estimates (r = 0.89-.90) of blood alcohol concentration.
      Correlation coefficents for the values of saliva samples read by meter measured
      at 10 minutes and at 18 days after collection ranged from .90 to 1.00, showing
      high test-retest reliability despite storage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355497
TI  - Alcoholic beverage server liability and the reduction of alcohol-involved
      problems.
AB  - Legal liability of alcoholic beverage servers has been suggested as a means to
      stimulate preventive serving practices and thus reduce alcohol-involved problems.
      A number of variables contribute (both negatively and positively) to the
      potential of such liability and a conceptual model that links these variables was
      developed. In this project, an expert legal panel was used to identify and rate
      the major legal factors contributing to server liability. As a result each state
      was ranked according to its relative level of liability exposure. States that
      ranked highest in server liability were found to have more publicity about such
      liability, greater awareness and higher concern among licensed establishment
      owners/managers and different serving practices compared to states with lowest
      liability exposure. As a result we conclude that server liability has a real
      potential for reducing alcohol-involved problems but additional research is
      needed.

PMID- 8355498
TI  - A cross-study contextual analysis of effects from individual-level drinking and
      group-level drinking factors: a meta-analysis of multiple longitudinal studies
      from the collaborative alcohol-related longitudinal project.
AB  - In contextual (cross-level) analysis within multiple longitudinal general
      population studies, individual-level drinking behaviors (quantity per typical
      occasion, frequency of drinking per month and total volume of drinks per month)
      at final measurement are assessed by three models that simultaneously enter
      individual- and group-level measures. Two age groups (15-20 and 21-30) are
      independently assessed. In each model, the Time 1 individual-level drinking
      behavior and one of three group-level factors are entered. The group-level
      factors are (1) the percentage of abstainers at Time 1 for each age/sex cohort,
      (2) the Time 1 group mean for the drinking measure for the age/sex cohort and (3)
      the mean difference of the age/sex cohort's change in the drinking measure over
      time. All variables in the model are controlled by variations to exposure in per
      capita consumption of alcohol during the age/sex cohort's formative years and at
      Time 2. Meta-analysis assesses the homogeneity of the findings across studies.
      Models were proposed with the rationale that (1) understanding of individual
      drinking behavior can be advanced if individual-level data and group-level data
      are considered in the same models, and (2) integration of these two levels of
      analyses are, to date, rare. The rationale for using meta-analysis is that
      findings from the models can be assessed across social contexts with respect to
      their generalizability. The mean difference model, controlling for individual
      drinking at Time 1, is the most influential of the group-level models for the
      younger age group: the degree to which the group changes its drinking pattern is
      positively related to individual-level drinking behavior at final measurement,
      over and above the individual's drinking behavior at Time 1, for individual-level
      frequency of drinking among males (homogeneous among drinkers only). Younger
      females show more significant relationships for the mean difference females show
      more significant relationships for the mean difference model. Findings are
      significant for all relationships examined for the mean difference of the
      drinking of the group and the individual drinking among the older males and
      females. Measures of individual-level drinking for all measures at Time 1,
      controlling for the group-level effects, are significantly related to individual
      level drinking at final measurement. The results are homogeneous for quantity
      (drinkers only) and volume among the young. Findings indicate that
      characterizations of the drinking for both the individual and the group to which
      the individual belongs predict measures of drinking practices on the individual
      level over time.

PMID- 8355499
TI  - The association between fast-flushing response and alcohol use among Japanese
      Americans.
AB  - This study investigated the association between the flushing response and alcohol
      use among Japanese Americans in the greater Los Angeles area. Epidemiolocial data
      collected through a telephone survey and a mail survey were utilized to test the
      flushing-alcohol use relationship in the Japanese population, and to explore the
      effects of socioenvironmental variables. Results showed that, as predicted, those
      Japanese Americans who exhibited the fast flushing response tended to drink less
      than those who did not flush, in the general community sample, but the
      relationship was weaker in the college student sample. Logistic regression
      analysis identified several covariates that predicted alcohol use among the
      general community residents: being a male, being single and being of the
      third/fourth generation. A separate logistic regression analysis with the college
      students only revealed a moderately significant interaction effect of flushing
      response and "Greek" affiliation (membership in a campus fraternity or sorority)
      on alcohol use (i.e., 6 drinks or more in a 24-hour period), indicating that the
      social context appeared to have a moderating effect on the relationship between
      the flushing response and alcohol use among Japanese Americans. Eighty out of 300
      individuals completely abstained from alcohol consumption and therefore did not
      know if they possessed the fast-flushing response. Results were discussed with
      respect to further investigation of the role played by ALDH-I deficiency in
      varying social situations in the Japanese population.

PMID- 8355500
TI  - Biases in the perceptions of the consequences of alcohol use among college
      students.
AB  - Previous studies have shown that college students' perceptions of the quantity
      and frequency of peer alcohol consumption are biased. Most students report that
      their social referents drink more than they themselves do. In the current study
      members of two fraternities and two sororities (N = 252) were asked to make two
      types of ratings of alcohol-related consequences across four target individuals.
      The ratings were: (1) the frequency of occurrence of predefined alcohol-related
      negative consequences and (2) the degree to which certain alcohol-related
      consequences are considered "problems." The targets were: themselves, their best
      friend, a typical member of their fraternity or sorority and a typical student at
      the university. Estimates of frequency of problem behaviors for typical member of
      the residence and typical student at the university were significantly higher
      than ratings for self (p < .001). Data from ratings of behavioral definitions of
      alcohol problems for the same four targets replicated the bias, although to a
      lesser degree. Correlational analyses suggest that biased perceptions of problems
      were unrelated to personal levels of alcohol consumption. Results are discussed
      in terms of the cognitive and motivational factors that could result in this
      misrepresentation of peer behavior.

PMID- 8355501
TI  - Alcohol consumption and work performance.
AB  - This study examines the work performance of 136 males, including both self
      reports and reports of workplace collaterals. Comparisons are made on several
      dimensions of work performance and different levels of alcohol consumption.
      Different levels of drinking are not associated with scales of self-reported work
      performance, but relatively heavy drinkers are less frequently absent and late to
      work than their lighter drinking counterparts. Collateral reports of work
      performance, however, indicate that heavier drinkers are more likely to score
      lower on self-direction at work, conflict avoidance at work and interpersonal
      relations at work. The relationship of alcohol consumption to the technical
      aspects of work performance is less clear. There is, however, an overall negative
      relationship between alcohol consumption and technical aspects of work
      performance as indicated by workplace collateral reports. The implications for
      the design of workplace intervention programs are considered.

PMID- 8355502
TI  - Validity of children's reports of parental alcohol abuse.
AB  - Data from interviews with parents and 9-12 year old children from 303 families
      were used to test the validity of children's reports of parental alcoholism or
      problem drinking status. Children's responses to several single-item screening
      questions that had been used previously to identify children of alcoholics, as
      well as their responses to the Short Michigan Alcoholism Screening Test for each
      parent, were compared to parents' alcoholism diagnosis and screening test scores.
      In general, children's responses correctly identified only a small portion of
      alcoholic parents and, when all screening items were combined into a single
      screening tool to increase sensitivity, the false positive rate became
      unreasonable for most applications. The screening items were better at
      identifying active alcoholics than abstaining alcoholics but were also better at
      identifying problem drinking parents than alcoholic parents. None of the
      screening options tested had optimal characteristics for use in research or
      intervention applications.

PMID- 8355503
TI  - Reliability of sibling reports on parental drinking behaviors.
AB  - Questionnaire data from the Colorado Alcohol Research on Twins and Adoptees
      (CARTA) were analyzed to explore the reliability of sibling responses to items
      from the CARTA Family Alcoholism History Questionnaire (FHQ) concerning parental
      drinking behaviors. Subjects included 142 pairs of male and female, twin and
      nontwin siblings who reported on paternal and maternal problem drinking. FHQ
      items were summed to produce drinking-problem scales for fathers and mothers.
      There was generally good concordance across sibling reports of parental problem
      drinking symptoms. There was a significant gender difference in that male
      offspring were more in agreement about their mothers' drinking behavior, while
      female offspring were more in agreement about their fathers' drinking behavior.
      For the most part, objective items, such as having two or more drunk-driving
      arrests, were more reliable (paternal kappa total = .56, maternal = .66) than
      subjective items, such as being happy only when drinking (paternal = .24,
      maternal = -.03). This evidence for reliability of sibling reports about parental
      drinking does seem to validate the use of such questionnaire data in alcohol
      studies.

PMID- 8355504
TI  - Severely dependent alcohol abusers may be vulnerable to alcohol cues in
      television programs.
AB  - The self-reported ability of 96 alcohol abusers to resist the urge to drink
      heavily was assessed after they viewed a videotape of a popular prime time
      television program complete with advertisements. Different versions of the
      videotape were used to evaluate the effects of a television program with and
      without alcohol scenes as crossed with the effects of three different types of
      commercials (i.e., beer, nonalcoholic beverages, food). Before and after viewing
      the videotape, subjects, who were led to believe that they were participating in
      two separate and unrelated sets of experimental procedures, completed several
      drinking questionnaires. Responses to one of the questionnaires provided an
      unobtrusive measure of self-reported ability to resist the urge to drink heavily.
      Results indicated that alcohol cues in a television program affected some alcohol
      abusers' perceived ability to resist the urge to drink heavily. In particular,
      those with higher alcohol dependence scores showed a decrease in confidence after
      viewing a television program with alcohol cues compared to subjects who watched
      the same program but without the alcohol scenes. The clinical implications of
      these findings are discussed. Until further research is forthcoming, given the
      artificial nature of the study setting, the results of this study must be viewed
      with some caution.

PMID- 8355505
TI  - A randomized phase II trial of low-dose aclarubicin vs very low-dose cytosine
      arabinoside for treatment of myelodysplastic syndromes.
AB  - We performed a randomized phase II trial comparing low-dose aclarubicin (LC-ACR)
      with very low-dose cytosine arabinoside (VLD-AC) in 39 consecutive untreated
      patients with myelodysplastic syndromes (MDS), including refractory anemia (RA),
      RA with excess of blasts (RAEB) and RAEB in transformation (RAEB-t). Nineteen
      patients received the VLD-AC therapy; 2 good responses (GR) and 2 partial
      responses (PR) were obtained in 11 patients with RAEB and RAEB-t, while 2 PR were
      obtained in 8 RA patients. Eighteen patients received the LD-ACR therapy; 2 GR
      and 4 PR were obtained in 11 RAEB/RAEB-t patients while 2 PR in 7 RA patients.
      There was no significant difference in the therapeutic effects and survival
      between these two groups of patients. These observations suggest that the LD-ACR
      therapy is effective in some patients with MDS and can be used as an alternative
      to the low-dose Ara-C therapy.

PMID- 8355506
TI  - Human promyelocytic cell line HL60 has the specific binding sites for prolactin
      and its ornithine decarboxylase, DNA synthesis and cellular proliferation are
      induced by prolactin.
AB  - Human prolactin (hPRL) induced ornithine decarboxylase (ODC) activity,
      subsequently DNA synthesis and cellular proliferation on human promyelocytic
      cells, HL60, cultured in a serum-free medium. HL60 cells had 2100 specific
      binding sites for hPRL per cell, showing a dissociation constant of 1.1 x 10(-10)
      M. Binding of 125I-PRL to the cells was not blocked by simultaneous addition of
      human growth hormone. ODC activity and DNA synthesis were activated maximally at
      5 and 20 h, respectively, after the addition of 0.05 nM hPRL. These effects of
      PRL on cellular proliferation, ODC activity and DNA synthesis were abolished by
      the simultaneous addition of anti-hPRL antibody. Simultaneous addition of an
      irreversible inhibitor of ODC, difluoromethyl ornithine (DFMO), also abolished
      the inductions of ODC and DNA synthesis by hPRL. The inhibitory effect of DFMO on
      hPRL-induced DNA synthesis was reversed by the addition of putrescine to the
      culture medium. These results suggest that hPRL binds to the prolactin receptor
      on HL60 cells and induces ODC activity to increase cellular polyamine levels,
      which eventually stimulates DNA synthesis and cellular proliferation.

PMID- 8355507
TI  - Expression of differentially phosphorylated Rb and mutant p53 proteins in myeloid
      leukemia cell lines.
AB  - We studied the structure and expression of Rb and p53 genes in six myeloid
      leukemia cell lines (HL-60, KBM3, K562, KBM5, EM2, KBM7) in the light of the
      published reports that structural abnormalities of these genes are rarely seen in
      leukemic cells and also a recent finding that Rb gene expression can be regulated
      by the p53 protein. Except for HL-60 cells which have a truncated p53 gene, none
      of the other cell lines revealed any gross structural abnormalities in the Rb and
      p53 genes. KBM3, KBM5 and EM-2 expressed lower levels of Rb mRNA than HL-60, K562
      and KBM7. The amount of Rb protein was lowest in KBM3 cells and in this and two
      other cell lines (KBM5, KBM7) Rb was markedly hypophosphorylated compared to the
      other three cell lines. HL-60 and K562 did not express p53 m-RNA, while the other
      four cell lines all expressed high levels of mutant p53 protein. Thus even in the
      absence of gross structural alterations, subtle abnormalities in the expression
      pattern of Rb and p53 genes occur in myeloid leukemia cells.

PMID- 8355508
TI  - Thermal stress as an inducer of differentiation of U937 cells.
AB  - The individual and combined effects of heat shock, all-trans retinoic acid and
      1,25-dihydroxyvitamin D3 on inhibition of cell growth and initiation of
      differentiation were investigated on U937 human leukemia cells. Incubation of
      U937 cells at 43 degrees C for 1 h did not affect cell viability but induced a
      reduction of cell growth and the emergence of a differentiated phenotype,
      characterized by the acquisition of chemiluminescent responses to various
      oxidative burst inducers and by the capacity to produce IL-6 in response to
      bacterial lipopolysaccharide. Heat shock alone, therefore, appears to be an
      efficient inducer of cell differentiation. In addition, heat shock primed the
      cells to respond more efficiently to the action of retinoic acid and vitamin D,
      and amplified the phenotypic changes initiated by pretreatment of U937 cells with
      these agents.

PMID- 8355509
TI  - Phorbol ester induction of early response gene expression in lymphocytic leukemia
      and normal human B-cells.
AB  - The spectrum of early response genes induced following phorbol ester (phorbol 12
      myristate 13-acetate-PMA) stimulation of B-chronic lymphocytic leukemia cells was
      compared with that in normal tonsillar B-cells by using a panel of 20 gene
      probes. Of these, 2 (fos-B and Fra-1) were not expressed in either cell type; 11
      displayed a comparable pattern and magnitude of induction in both the cell types,
      and one anonymous gene (5L3) that was inducible in leukemic cells was not
      detectably expressed in normal B-cells. Four further anonymous cDNAs (1R21, 10A,
      1R19 and 3L11) detected transcripts that were constitutively expressed in normal
      B-cells with a concomitant reduction in inducibility compared with leukemic B
      cells, whilst jun-B and jun-D, which were both inducible in normal B-cells, were
      constitutively expressed and only marginally PMA-inducible in leukemic B-cells.
      These data demonstrate clear differences in the PMA-activated early response gene
      regulatory pathways between normal and lymphocytic leukemia B-cells, which may
      reflect perturbations in signal transduction pathways that manifest in the
      differentiation arrest characteristic of these malignant B-cells.

PMID- 8355510
TI  - Decreased blood flow to rat bone marrow, bone, spleen, and liver in acute
      leukemia.
AB  - An acute promyelocytic leukemia in the rat (BNML) has been used in model studies
      on pathogenesis and therapy of human acute myeloid leukemia. The blood supply to
      bone marrow during BNML development has hitherto not been examined, even though
      in general, blood flow to hematopoietic tissues might affect drug treatment and
      marrow transplantation regimes. We measured the perfusion of various organs
      during the course of the disease in untreated rats and in rats given one
      injection of cyclophosphamide treatment. Organ perfusion was measured with
      radioactive microspheres. Blood flow per gram tissue to the bone marrow, bone,
      spleen, and liver declined gradually during the leukemic progression, thus
      paralleling the growth of leukemic deposits. Cyclophosphamide treatment retarded,
      but did not reverse, the decreasing perfusion of these tissues.

PMID- 8355511
TI  - Immunophenotypic and idiotypic characterisation of the leukaemic B-cells from
      patients with prolymphocytic leukaemia: evidence for a selective expression of
      immunoglobulin variable region (IGV) gene products.
AB  - B-cell prolymphocytic leukaemia (B-PLL) is a rare chronic lymphoproliferative
      disease characterised by a massive splenomegaly associated with a mild or no
      lymphadenopathy and a high leukocyte count, mostly representing prolymphocytic
      features. We have studied membrane expression of certain Ig VK and VH gene
      products in five patients with B-PLL using a panel of monoclonal anti-subgroup
      and anti-cross-reactive idiotype (CRI) antibodies. Membrane expression of
      leukocyte-associated markers has also been investigated. The leukaemic cells from
      four patients expressed VKIII and VKIIIb subgroup and sub-subgroup kappa light
      chains. The VKIIIb and VHI-associated CRI identified by the monoclonal antibodies
      (MoAb) 17-109 and G8 were co-expressed in one patient. No B-cells from the
      patients expressed the VHIII-associated CRI. The same pattern of CRI expression
      was observed in a serum paraprotein collected from one of the patients. These
      results suggest a biased selection for the IG VKIII and VKIIIb light chains in B
      PLL.

PMID- 8355512
TI  - Minimal residual disease status in pre-B acute lymphoblastic leukemia patients
      after chemotherapy and bone marrow transplantation: assessment of the anti
      leukemic effects of chemotherapy and BMT.
AB  - We prospectively analyzed minimal residual disease (MRD) in four patients with B
      cell precursor acute lymphoblastic leukemia who had been in complete remission
      for more than one year after chemotherapy and allogenic or autologous bone marrow
      transplantation (BMT). MRD was quantitatively estimated using polymerase chain
      reaction amplification to detect the complementarity-determining region III of
      the immunoglobulin heavy chain gene at limiting dilution DNA samples. Our study
      showed that remission induction chemotherapy reduced at most 2-logs of leukemia
      cells, and that subsequent consolidation chemotherapy induced further reduction
      of leukemia cells. In two cases, 10(-5) levels of MRD were detected two months
      after BMT. However, no MRD was detected four months after BMT. We also showed the
      effectiveness of ex vivo purging with anti-CALLA monoclonal antibodies which
      eliminated at least 2-logs of leukemia cells in autologous BMT. Our results
      suggest that this detection system is useful for assessing the reduction of the
      original leukemia clone, and that the presence of MRD within three months after
      BMT is not related to clinical outcome.

PMID- 8355514
TI  - Unbalanced translocation (1;7) and inversion 16 in a patient with acute
      myelocytic leukemia.
AB  - Pericentric inversion of chromosome 16 has been delineated as a characteristic
      chromosome abnormality of acute myelomonocytic leukemia with abnormal eosinophils
      and a favorable prognosis. By contrast, unbalanced translocation (1;7) has been
      reported as frequently associated with therapy-related leukemia, and patients
      with this karyotypic abnormality are susceptible to severe infections which lead
      to a poor prognosis. Here we report the first case of acute myelocytic leukemia
      in which the complexed chromosomal aberrations of der(7)t(1;7)(cen;cen) and
      inv(16) were found simultaneously in the patient's leukemia cells. Eosinocytosis
      has not been observed so far, but life-threatening pneumonia developed during the
      remission induction therapy.

PMID- 8355513
TI  - Prediction of chemotherapy response in human leukemia using in vitro
      chemosensitivity test.
AB  - We performed the dye exclusion assay (DEA) and the MTT dye reduction assay to
      determine the drug sensitivity of acute leukemia using short-term microplate
      cultures. The in vitro results were compared with the clinical response of 31
      patients with acute leukemia treated by combination chemotherapy. The true
      positive rates of the DEA and MTT assays were 86.7 and 91.3%, respectively; the
      true-negative rates were 33.3 and 77.8%, respectively; and the predictive
      accuracy was 62.5 and 87.5%, respectively. The DEA and MTT assays gave comparable
      results in drug sensitivity testing of leukemic blast cells. Our data suggest
      that MTT assay is the more suitable for assessing chemosensitivity in acute
      leukemia.

PMID- 8355515
TI  - Treatment of 11 patients with chronic myelogenous leukemia with interferon-alpha
      2C and low-dose cytosine arabinoside.
AB  - Patients with Philadelphia (Ph) chromosome-positive chronic myelogenous leukemia
      (CML) and on interferon (IFN)-alpha-2c treatment for at least two months were
      entered in the present pilot study. IFN-alpha treatment was maintained
      identically and cytosine arabinoside (Ara-C) was added at monthly cycles of 10
      mg/m2/day for ten days subcutaneously. In the case of a leukocyte nadir above 10
      G/l, the Ara-C dose was increased to 20 mg/m2/day for 10 days per month. Ten of
      the eleven patients entered in this study were evaluable for toxicity and
      response. They received a total of 87 IFN-alpha/Ara-C cycles (3-14/patient). Five
      patients received 1-5 cycles with Ara-C dose intensification to 20 mg/m2/day. The
      following gastrointestinal and hematological toxicities were attributable to Ara
      C, as they had not been observed in these patients during the preceding IFN-alpha
      monotherapy period. Gastrointestinal side effects consisted of nausea grade 1 (n
      = 5) and diarrhea grade 2 (n = 1). Hematotoxicity was observed in eight patients,
      grade 1 in five patients and grades 2, 3 and 4 in one of the patients each. Both
      episodes of grades 3 and 4 toxicity were seen during dose escalation to 20 mg/m2.
      Small cytogenetic responses (4-14%) were observed in 3 patients and a larger one
      (50%) in one patient, hematological improvement or stable disease in an
      additional three patients. These preliminary data suggest that the combination of
      IFN-alpha and low-dose Ara-C is active in inducing cytogenetic responses in CML
      patients at an acceptable rate of toxicity and therefore warrant further
      investigation.

PMID- 8355516
TI  - Isochromosome 17q as a sole anomaly: a distinct myelodysplastic syndrome entity?
AB  - We report four patients with myelodysplastic syndrome (MDS) with isochromosome
      i(17q) as the sole chromosomal anomaly. One patient was classified as refractory
      anemia (RA) and three as refractory anemia with excess of blasts (RAEB). All four
      patients shared several features such as male sex, advanced age, severe anemia,
      as well as a bone marrow with myeloproliferative characteristics:
      hypercellularity, prominent baso- and eosinophilia, and marked increase of
      micromegakaryocytes. We suggest that patients with i(17q) as the sole chromosomal
      anomaly may identify a distinct MDS with characteristics between MDS and chronic
      myeloproliferative disorders (CMPD).

PMID- 8355517
TI  - Rearrangement of the N-myc oncogene in acute leukemias: a case report.
AB  - Rearrangements of the N-myc oncogene have not been described in the literature.
      The authors present a case of ANLL with the N-myc gene rearranged out of 16 ANLLs
      and 11 ALLs. While the proportion of the blast cells in the case reported was
      85%, the rearranged gene gave a hybridization band which was less intense than
      that of the germline band, making it probable that this gene rearrangement is
      present in a leukemia subclone. The c-myc oncogene as well as Ig and TcR genes
      were in germline configurations. The presence of the rearranged N-myc in the
      reported case could imply an alternative mechanism of mutation of this oncogene
      in the pathogenesis of hematological malignancies.

PMID- 8355518
TI  - Estimation of lymph flow by relating lymphatic pump function to passive flow
      curves.
AB  - Active pumping in postnodal lymphatic vessels is an important factor influencing
      lymph flow. However, the output of the lymphatic pump also depends on the rate of
      flow into the pump. This arrangement is similar to the blood circulation where
      cardiac output depends on the rate of blood flow through the veins into the heart
      (venous return) and on the pumping characteristics of the heart itself (cardiac
      function curves). One common way to analyze the blood circulation rate is to
      interrelate venous return and cardiac function curves. In this study, we used a
      similar technique to analyze lymph flow. We used lymphatic flow vs. outflow
      pressure (passive flow) relationships for nonpumping lymphatics to represent the
      inflow of lymph to the lymphatic pump. We used data on the pumping
      characteristics of postnodal lymphatic vessels to generate relationships between
      lymphatic pump outflow and pump inflow pressure (pump function curves), and then
      interrelated these curves. The results were not only similar to previously
      measured lymph flow data obtained from experimental animals, but also support the
      observation that under normal circumstances lymph flow is periodic and in surges
      (active pumping) but in edematogenic states lymph flows more continuously (i.e.,
      passively).

PMID- 8355519
TI  - Disorders of the intestinal mesenteric lymphatic system.
AB  - Disorders of the intestinal lymphatic transport system are rare and typically
      associated with protein losing enteropathy (PLE). Hypoproteinemia caused by
      intestinal lymphangiectasia is often associated with lymphedema of the legs and
      occasionally with chyluria, chylometrorrhea and chylous ascites. This article
      examines the varied presentations of lymphangiectasia syndromes including its
      pathophysiology. Diagnosis is based on signs and symptoms, specific laboratory
      findings, and confirmed by contrast small bowel series, lymphography and best of
      all laparoscopy. We describe 12 patients with PLE secondary to primary intestinal
      lymphangiectasia (1980-1991). Treatment was non-operative (dietary) in 8 patients
      and surgical in 4 including segmental resections of the jejunum in two, lymphatic
      mesenteric venous anastomosis in one, and peritoneal-venous (LeVeen) shunt in one
      with overall satisfactory results.

PMID- 8355520
TI  - Terminal endothelial cells of lymph capillaries as active transport structures
      involved in the formation of lymph in rat skin.
AB  - Electron microscopic examination of lymph capillaries of the dermal papillae of
      rat scalp skin revealed continuous extension of the lymph collection system into
      4 to 10 micron diameter lumen capillaries with thin walls, scant basement
      lamellae (membranes), and blind-endings of 1 to 4 micron lumen diameter within
      endothelial-type cells. These terminal endothelial cells also displayed
      intracytoplasmic channels and pinocytotic vesicles, extensive cytoplasmic
      processes and a high cytoplasmic volume-percent of mitochondria suggesting active
      transport capabilities of lymphatic endothelia. The mitochondrial cytoplasmic
      volume-percent (mean 14.5%) exceeded that present in blood capillary endothelial
      cells of the rat brain (the anatomic substrate of the blood-brain barrier), that
      have a volume-percent of mitochondria of 10 to 12% (1). Active transport
      processes centered in such endothelial cells could account for a portion of lymph
      formation, and explain the continued accumulation of lymphedema distal to blocked
      lymphatic collection ducts when lymphatic intraluminal pressure is greatly
      increased. The small lumen diameter capillaries, which correspond spatially to
      the prelymphatics of other authors (2), typically converge in groups of three to
      form larger diameter lymph capillaries corresponding to the lymph "initials"
      previously described (2,3).

PMID- 8355521
TI  - Endothelial transdifferentiated phenotype and cell-cycle kinetics of AIDS
      associated Kaposi sarcoma cells.
AB  - The nature of Kaposi sarcoma (KS) (vascular malignancy vs. discordant
      angiogenesis) and lineage of the progenitor cell remain unclear. Therefore, AIDS
      KS enzyme isolate cultures were prepared from excised skin lesions. Endothelial
      marker positivity for Factor VIII related antigen (F8RAg), Ulex europaeus
      agglutinin (UEA), and angiotensin-converting enzyme (ACE) were determined by
      fluorescence microscopy (FM) and flow cytometry (FCM). DNA cell-cycle analysis
      was performed using FCM. KS lesions showed large thick-walled channels (F8RAg and
      UEA strongly +), narrow vascular slits and thin-walled lakes (F8RAg and UEA
      weakly +), and non-prominent spindle cells (F8RAg and UEA almost uniformly
      negative). KS cultures yielded heterogenous populations of spindle, stellate, and
      flattened endothelial-like cells, displaying positivity for F8RAg (64 +/- 3%;
      mean +/- SE), UEA (40 +/- 9%), and ACE (81 +/- 9%). When injected subcutaneously
      in the nude mouse these cells failed to produce tumors. During contact inhibition
      induced quiescence, KS cultures exhibited a high G2M (18 +/- 3%) compared to non
      KS (7 +/- 4%; p < 0.04), evidence of an altered proliferative potential
      consistent with a transdifferentiated or transformed phenotype.

PMID- 8355522
TI  - Morpho-physiological function and role of omental milky spots as omentum
      associated lymphoid tissue (OALT) in the peritoneal cavity.
AB  - The morpho-physiological function and role of milky spots in the greater omentum
      are reviewed. These milky spots are composed of cellular aggregations of
      mesenchymal cells, mainly macrophages and lymphocytes, surrounding capillary
      convolutions termed omental glomeruli. Initial lymphatics of the omentum begin at
      the milky spots and drain into lymph collectors. The lymphatic capillaries in the
      omental milky spots take part in the absorption of various substances from the
      peritoneal cavity. Omental milky spots probably act as the first line of defense
      in the peritoneal cavity and therefore are immunologically important. In human
      infants, most of the cells in these milky spots are macrophages (49%); less
      common are B lymphocytes (29%) and T lymphocytes (12%). Whereas macrophages form
      clusters near the peritoneal surface of the milky spots and are oriented toward
      the peritoneal cavity for migration, clusters of B and T lymphocytes are
      typically found in periarteriolar locations within the milky spots. This cell
      zonation facilitates phagocytosis and processing of circulating antigens and
      foreign bodies which emanate from the peritoneal cavity. During inflammation, the
      number and size of omental milky spots dramatically increase, and some develop
      germinal centers within the lymphatic follicles and produce antibodies. During
      intraperitoneal immunotherapy, the omental milky spots and their cellular
      elements may be activated by intraperitoneal administration of biological
      response modifiers, and thereby represent an important immunoregulatory system
      for the peritoneal cavity. Omental milky spots are also closely linked to the
      dissemination of cancer cells. Thus, intraperitoneally inoculated experimental
      tumor cells selectively invade the milky spots and proliferate there to form
      tumor nodules. This occurrence is relevant to clinical practice where nodular
      metastases to the omentum are common. Omental milky spots are analogous to
      regional lymph nodes and as such are the omentum-associated lymphoid tissues and
      participate in intraperitoneal immune reactions.

PMID- 8355523
TI  - [The evolution of the Spanish health system].

PMID- 8355524
TI  - [The image of the family physician].

PMID- 8355525
TI  - [Euthanasia, yes; euthanasia, no].

PMID- 8355526
TI  - [Capacity, equality, and life expectancy].

PMID- 8355527
TI  - [To what extent can pollution affect our health?].

PMID- 8355528
TI  - [Stress].

PMID- 8355529
TI  - [The teaching of medicine, should the model be changed?].

PMID- 8355530
TI  - [The transplantation age].

PMID- 8355531
TI  - [HIV infection. When will the cure be found?].

PMID- 8355532
TI  - [Ambulatory major surgery: an alternative to traditional surgery?].

PMID- 8355533
TI  - [Teleinformation in medicine, where is it heading to?].

PMID- 8355534
TI  - [Artificial intelligence in medicine. Current status and perspectives].

PMID- 8355535
TI  - [The future of diagnostic aids in medicine].

PMID- 8355536
TI  - [The human genome project: reality and hope].

PMID- 8355537
TI  - [Financing medical research].

PMID- 8355538
TI  - [The way the ideal hospital should be].

PMID- 8355539
TI  - [Clinical usefulness of adrenal gland computed tomography in the etiologic
      diagnosis of Addison's disease].
AB  - BACKGROUND: The aim of this study was to evaluate adrenal gland morphology by
      computerized tomography (CT) in the etiologic diagnosis of Addison's disease.
      METHODS: Twenty-two patients were grouped according to their etiology based on
      the study of antiadrenal antibodies at diagnosis of the disease: 7 were positive
      (autoimmune etiology or EAA), 11 were negative (tuberculous etiology or EAT) and
      in four serologic study was not available (undetermined etiology or EAI). Adrenal
      gland CT was performed with contiguous sections every 5 mm. In eight cases the
      examination was carried out upon diagnosis of the disease (initial stage) and in
      14 between 2 and 17 years following diagnosis (evolutive stage). RESULTS: In all
      the patients of the EAA group, examined in either the initial or evolutive
      stages, the adrenal glands appeared atrophic without calcifications. In the
      patients of the EAT group adrenal masses of proven tuberculous origin were found
      in five who were studied in the initial stage and with atrophic glands with
      calcifications in the remaining patients examined in the evolutive stage, with
      the exception of two cases with atrophic adrenal glands without calcifications
      which could serologically be considered as false negatives having autoimmune
      etiology. The patients in the EAI groups were studied in the evolutive stage with
      three having atrophic glands with calcifications and one atrophic adrenal glands
      without calcifications. CONCLUSIONS: Adrenal gland computerized tomography is an
      useful examination to differentiate between autoimmune or tuberculous origin in
      Addison's disease. Clinical application may be justified in all patients of
      recent diagnosis when the study of the antiadrenal antibodies is negative or not
      possible.

PMID- 8355540
TI  - [Inhalation chambers: an alternative to the conventional inhalator?].
AB  - BACKGROUND: Aerosol inhalers constitute the most commonly used form of
      administration of medication by most of the patients with respiratory disease
      although incorrect usage is a demonstrated fact in many studies. A previous study
      demonstrated that, despite correct instruction by health care staff and the
      patients, 30% of the same use these inhalers incorrectly. In the present study,
      the efficacy of inhalation chambers (750 ml) and spacers (50 ml) versus the
      conventional inhaler was evaluated by quantification of bronchodilator response.
      METHODS: Fifty-six stable patients with chronic obstruction to air flow in
      habitual treatment with aerosol inhalers (AI) were studied. For this study 27
      patients used the chamber and 29 the spacer. The patients using the maneuvers
      correctly (n = 42) and those that did not (n = 14) were studied together and
      separately. RESULTS: Patients using the inhaler incorrectly were found to benefit
      significantly from either of the procedures. Upon comparison of the chambers (750
      ml) with the spacers (50 ml) a significant improvement was observed with the
      former. CONCLUSIONS: The response to bronchodilator treatment in patients not
      using aerosol inhalers correctly improves significantly upon use of either
      inhalation chambers or spacers with the former demonstrating the best results.

PMID- 8355541
TI  - [The effect of continuous positive pressure in the nasal airway on the right
      ventricular function in obstructive apnea sleep syndrome].
AB  - BACKGROUND: The aim of this study was to evaluate the right ventricular function
      in the obstructive apnea sleep syndrome (OSAS) and to determine the effect of the
      continuous use of a continuous positive pressure nasal device on the airway
      (CPSPn) produces on this aspect of the disease. METHODS: Forty patients were
      diagnosed of OSAS by study of spontaneous night sleep. A functional respiratory
      study was performed in all the patients as was a calculation of the index of body
      mass (IBM) and isotopic ventriculography for the calculation of the right and
      left ventricular ejection fractions (RVEF and LVEF). Twenty-six patients were
      followed after 8.4 +/- 3.3 months of home treatment with CPAPn in which these
      studies were repeated. RESULTS: Twenty-four of the 40 patients (60%) had RVEF
      lower than 0.45. These 24 patients had paO2 in vigil state (69.9 +/- 13.6 mmHg)
      than those with a normal RVEF (80.1 +/- 8.7 mmHg) (p < 0.05). After treatment
      with CPAPn an elevation was observed in the RVEF in the group which was followed.
      This increase was significant in the subgroup sharing low RVEF (n = 16) prior to
      starting treatment upon passing from 0.39 (+/- 0.02) to 0.45 (+/- 0.04) (p <
      0.001). CONCLUSIONS: Right ventricular dysfunction in frequent in patients with
      the obstructive apnea sleep syndrome and is more frequent in patients maintaining
      hypoxemia in vigil. The continual use of continuous positive pressure in the
      nasal airway produces improvement in right ventricular function particularly in
      those in whom this was most disturbed.

PMID- 8355542
TI  - [Information needs of the health professional. Available resources and ways of
      access].

PMID- 8355543
TI  - [New diagnostic and therapeutic aspects of hyper-IgE syndrome. Report of 3
      cases].
AB  - Three female patients, 46, 34, and 19 years old, diagnosed of hyper-IgE syndrome
      are reported. The most relevant clinical findings are recurrent sinopulmonary
      tract infections, cold staphylococcal abscesses and chronic dermatitis. All
      patients presented elevated serum IgE levels (> 3,000 U/ml) and blood
      eosinophilia (> 0.6 x 10(9) cel/l). Two patients presented impaired antibody
      forming capacity to tetanus and pneumococcal antigens; one of these patients also
      had low serum IgG2 levels. After initiation of the intravenous gammaglobulin
      therapy, a marked improvement of infectious problems was observed. The
      controversial pathophysiology of this syndrome, the antibody deficiency present
      in some patients and the rationale for intravenous gammaglobulin therapy are
      discussed.

PMID- 8355544
TI  - [New techniques for nucleic acid amplification].

PMID- 8355545
TI  - [The world of serotonin and its receptors. Physiopathologic, clinical, and
      therapeutic aspects].

PMID- 8355546
TI  - [Reiter's syndrome and IgA glomerulonephritis].

PMID- 8355547
TI  - [Acute pancreatitis in acute poisoning caused by organophosphate insecticides.
      Report of 3 cases].

PMID- 8355548
TI  - [Acute hemolysis and dermonecrosis secondary to bite of Loxosceles (brown
      spider)].

PMID- 8355549
TI  - [Bronchoalveolar lavage and diffusion capacity of carbon monoxide in the
      diagnosis of diffuse alveolar hemorrhage].

PMID- 8355550
TI  - [The Fisher's test].

PMID- 8355551
TI  - [Hyperthyroidism secondary to interferon therapy].

PMID- 8355552
TI  - [Campylobacter jejuni sepsis and chronic terminal kidney insufficiency].

PMID- 8355553
TI  - [Treatment with thalidomide and production of tumor necrosis factor alpha].

PMID- 8355554
TI  - Endothelin peptides: biological actions and pathophysiological significance in
      the lung.
AB  - Endothelins (ETs) are a family of novel regulatory peptides. Besides their
      effects on the cardiovascular system, which have been extensively described,
      several lines of evidence suggest an important role for ETs in regulating
      pulmonary functions. ETs are present in the pulmonary tissues, bronchoalveolar
      space and pulmonary circulation. Release of ETs from macrophages, endothelial and
      epithelial cells is modulated by a variety of chemical and physical stimuli and
      is regulated at the level of transcription or translation. Specific endothelin
      receptors have been identified in the airways as well as in the pulmonary
      vasculature. ETs are among the most potent bronchoconstrictors yet described. In
      the pulmonary circulation, ETs can elicit both vasodilation and vasoconstriction
      and can enhance vascular permeability. ETs could also modulate activation of
      inflammatory cells. Enhanced ET expression and/or production have been detected
      in asthma, certain pulmonary tumors, shock states associated with adult
      respiratory distress syndrome and pulmonary hypertension. These findings suggest
      that by regulating pulmonary vascular and airway tone, activation of inflammatory
      cells and cellular growth and/or differentiation, ETs may play an important role
      in pulmonary pathophysiology.

PMID- 8355555
TI  - Reversal of activity profile in analogs of the antiprogestin RU 486: effect of a
      16 alpha-substituent on progestational (agonist) activity.
AB  - 16 alpha-Ethyl-17 beta-acetyl substitution in the D-ring of steroids having an 11
      beta-aryl-4,9-dien-3-one structure resulted in compounds with strong
      progestational activity. These compounds caused endometrial proliferation in the
      uterus of estrogen-primed rabbits with a potency greater than that of
      progesterone and had no detectable antiprogestational activity in this model.
      This is in stark contrast with the marked antiprogestational activity in rabbits,
      rats and humans reported for most 11 beta-aryl-4,9-diene-3-keto steroids such as
      RU 486 and its 17 beta-acetyl-17 alpha-acetoxy analog, 17 alpha-acetoxy-11 beta
      (4-N,N-dimethylaminophenyl)-19-norpregna-4,9-diene- 3,20-dione. Examination of
      structure activity relationships in combination with computer aided molecular
      modelling suggests that a binding interaction of the 16 alpha-ethyl group with
      the progesterone receptor (PR) or the PR-progestin response element complex may
      play the major role in this reversal of activity profile.

PMID- 8355556
TI  - Metabolism of benzo(a)pyrene by lung microsomes from rabbits pretreated with
      polychlorinated biphenyls and 2,3,4,7,8-pentachlorodibenzofuran.
AB  - The polychlorinated biphenyls (PCBs) mixture, Aroclor 1254, is a weak inducer of
      aryl hydrocarbon hydroxylase (AHH) activity in rabbit lung. In contrast,
      2,3,4,7,8-pentachlorodibenzofuran (PCDF), like 3-methylcholanthrene (3-MC),
      caused a 3-fold increase in pulmonary AHH activity. An important finding of the
      present studies was that AHH activity, whether assayed by the flourometric or
      HPLC methods, was dependent on the buffer used in the incubation mixture. The
      metabolism of benzo(a)pyrene (BP) to its oxidative metabolites, as assayed by
      HPLC, revealed that PCBs, PCDF and 3-MC pretreatments caused greater than 15-fold
      and about 3- to 4-fold increase in the formation of the tumorigenic metabolites
      9,10- and 7,8-dihydrodiols, respectively. In contrast to 3-MC and PCDF, PCBs
      caused a 75% decrease in the formation of the K-region metabolite, BP-4,5
      dihydrodiol. These studies strongly suggest that the catalysis of BP metabolism
      is mediated by more than one isoform of cytochrome P450 (P450).

PMID- 8355557
TI  - Adjuvant use of warm butyl alcohol vapor in experimental pulmonary edema.
AB  - Studies were done to determine if warm n-butyl alcohol vapor might be effective
      for the destruction of respiratory tract foam bubbles and for alleviation of the
      arterial hypoxemia accompanying severe acute pulmonary edema. In vitro studies
      showed that warm butyl alcohol vapors made from 5% and 7% butyl alcohol solutions
      at 39 degrees C were much more effective in antifoam activity against synthetic
      foam bubbles than ethyl alcohol vapors, made from 20% and 30% ethyl alcohol at 22
      degrees C. Warm butyl alcohol vapor also slowly destroyed in vitro the fine foam
      bubbles of alveolar lining origin made in rabbit lung post mortem. Evolving lung
      edema was induced in anesthetized rabbits by aspiration of 1.1 ml/kg of 1.2 molal
      sorbitol/0.14 molal sodium chloride/0.01 molal hydrochloric acid solution of pH
      2.0. After established severe arterial hypoxemia and in the absence of overt
      foam, inhalation of warm butyl alcohol/H2O vapor-air mixture, made by air
      humidification from 7% butyl alcohol at 39 degrees C, alleviated promptly the
      hypoxemia. The improvement was progressive over the first 45 minutes of continued
      vapor therapy. The lessened hypoxemia occurred without concurrent improvement in
      the amount of formed lung edema fluid. Control inhalations of warm 100% H2O vapor
      air mixture did not improve the hypoxemia. The only noted side effects of warm
      butyl alcohol vapor treatments were slight hypotension and slight metabolic
      acidosis which developed very slowly. The results suggest that warm butyl alcohol
      vapor might prove to be an effective adjuvant agent to lessen critically severe
      hypoxemia in selective cases of acute pulmonary edema in man.

PMID- 8355558
TI  - The effect of propylene glycol on the P450-dependent metabolism of acetaminophen
      and other chemicals in subcellular fractions of mouse liver.
AB  - Propylene glycol (PG) decreases the hepatotoxicity of acetaminophen (APAP). To
      elucidate the mechanism for this response, we measured the effect of PG on the in
      vitro metabolism of APAP by subcellular liver fractions from 6-10 week-old male
      B6C3F1 mice. The fractions were assayed for their ability to bioactivate APAP to
      N-acetyl-p-benzoquinone imine, which was trapped as APAP-glutathione conjugates
      or APAP-protein adducts, and for dimethyl-nitrosamine-N-demethylase (DMN), 4
      nitrophenol hydroxylase (4-NPOH), and phenacetin-O-deethylase (PAD) activities.
      Activity in the crude mitochondrial-rich (10,000 x g pellet) fraction was low and
      PG had no effect. PG inhibited DMN and 4-NPOH, indicators of IIE1-dependent
      activity, and the formation of APAP-glutathione conjugates and APAP-protein
      adducts in both heavy (15,000 x g pellet) and light (100,000 x g pellet)
      microsomes. PAD, a measure of IA2-dependent activity, was not inhibited. These
      data demonstrate that PG selectively inhibits IIE1 activity, including the
      bioactivation of APAP, and implicates this as the mechanism for PG-mediated
      protection of APAP hepatotoxicity in mice.

PMID- 8355560
TI  - The effect of chronic administration of cyclosporin A on phenytoin
      pharmacokinetic parameters in the rat.
AB  - The potential for a drug interaction between cyclosporin A and phenytoin was
      investigated in rats. Rats were treated daily for 14 days with cyclosporin A (50
      mg/Kg, s.c.) and on the day of the experiment phenytoin (10 mg/Kg) was
      administered intravenously. The mean residence time, the elimination half-life
      and the volume of distribution at steady state were significantly higher in the
      cyclosporin A-treated group than in the control group. However, total body
      clearance was similar in both groups. Plasma levels of urea, aspartate
      aminotransferase (AST) and glucose were significantly higher in the cyclosporin A
      treated group than the control group. It was concluded that the observed changes
      could have been, at least in part, due to an inhibitory effect of cyclosporin A
      on liver drug metabolizing enzymes and/or liver and kidney damage.

PMID- 8355559
TI  - Effects of cholecystokinin and gastrin on gastroduodenal motility and
      coordination in chickens.
AB  - Cholecystokinin (CCK) has not been isolated from chicken gut yet and there has
      been no study on the effects of chicken gastrin (CG), the only gastrin/CCK
      peptide isolated from avian gut, on gastrointestinal motility. The main objective
      was to study the effects of CCK and CG on gastroduodenal motility and
      coordination in chickens. Electrodes for electromyography were implanted in the
      stomach and proximal and distal duodenum of 4 wk old chickens. Sulphated CCK
      octapeptide (CCK8) (10(-10) to 10(-8) moles/kg), CCK-tetrapeptide (CCK4) (2 x 10(
      10) to 2 x 10(-8) moles/kg) and CG (3 x 10(-10) to 10(-8) moles/kg) were given in
      a 10 min i.v. infusion. All these peptides induced a dose-dependent inhibition of
      gastric motility. CCK8 induced a duodenal hyperactivity whereas CCK4 and CG
      induced a duodenal inhibition. Neither the CCK-A receptor antagonist L364,718 nor
      the CCK-B receptor antagonist L365,260 (10(-9)-10(-7) moles/kg) antagonized CCK8
      actions. From these results we suggest that the receptors mediating CCK effects
      are different from those of mammals. The site of action for these peptides is the
      same in the stomach whereas in the duodenum there are two different ones, one
      mediating excitation and the other inhibition. These results suggest a
      physiological role for CCK regulating gastroduodenal motility in birds.

PMID- 8355561
TI  - Increased concentrations of atrial and plasma atrial natriuretic peptide in
      castrated male rats.
AB  - The effects of orchiectomy and testosterone replacement on the plasma
      concentration and the atrial stores of atrial natriuretic peptide (ANP) were
      studied in the rats. Male rats were orchiectomized (Orc) three weeks before
      replacement with testosterone propionate (TP, 20 mg/ml/kg body weight) or sesame
      oil for five days. Immunoreactive ANP (IR-ANP) in the extracted right atria and
      plasma of experimental rats was measured. Plasma ANP concentrations were 206 +/-
      22, 927 +/- 151, and 264 +/- 61 pg/ml in normal control, Orc, and Orc + TP rats,
      respectively. ANP contents in right atria were higher in Orc (108 +/- 9 ng/mg
      tissue) and TP-treated Orc rats (123 +/- 9 ng/mg tissue) than in normal animals
      (32 +/- 7 ng/mg tissue). These results indicate an increased plasma concentration
      and atrial stores in the castrated male rats. Replacement of testosterone in the
      castrated male rats does not decrease the atrial ANP stores, but decreases the
      plasma ANP concentration.

PMID- 8355562
TI  - Cytosolic lipogenic enzymes: effect of fibric acid derivatives in vitro.
AB  - The effect of fibric acid derivatives, clofibric acid (CFB), bezafibrate (BFB),
      and gemfibrozil (GFB) on hepatic cytosolic enzymatic activities involved in
      saturated fatty acid synthesis has been estudied in vitro. From all the
      activities tested (fatty acid synthetase, acetyl-CoA carboxylase, ATP-citrate
      lyase, malic enzyme, malic dehydrogenase, glucose-6-phosphate dehydrogenase, and
      6-phosphogluconate dehydrogenase), only acetyl-CoA carboxylase and glucose-6
      phosphate dehydrogenase were significantly inhibited by fibrates, with the
      following order of potency: GFB > BFB > > CFB. The characteristics of the
      inhibition phenomena (IC50, kinetic analysis, time and protein dependence, etc)
      and their transcendence to the effects of fibric acid derivatives in vivo are
      discussed.

PMID- 8355563
TI  - In vivo uptake of ethanol and release of acetate in rat liver and GI.
AB  - The concentration gradients of ethanol and acetate across liver and GI were
      determined in overnight starved rats infused with ethanol at a rate (15 mu
      mol/min/rat) below and a rate (30 mu mol/min/rat) exceeding the rate of ethanol
      disposal in the animals. Plasma concentrations of ethanol in the systemic
      circulation reached steady-state levels of approximately 0.6 mM between 30 and 60
      min during low rate of infusion; increased steadily from 3.5 mM at 30 min to 6.4
      mM at 2 h during high rate of infusion. GI metabolism was determined by
      concentration differences in aorta and portal vein; hepatic metabolism by
      differences in hepatic influx and hepatic veins. Hepatic influx was the sum of
      the concentrations in aorta and portal vein, each multiplied by their fractional
      contributions to hepatic blood supply. At low rate of infusion, hepatic
      extraction of ethanol was nearly complete and could be accounted for entirely by
      the acetate released from liver. The concentrations of ethanol in aorta were
      greater but not significantly than that in portal vein. At high rate of infusion,
      hepatic and GI gradients of ethanol remained constant despite changes in
      circulating concentrations of ethanol. The concentration gradients of ethanol and
      acetate across liver, though different in signs, were identical in magnitude. GI
      gradient indicating uptake of ethanol was statistically significant and was about
      30% of hepatic gradient. Enzyme activity of alcohol dehydrogenase in stomach was
      found to be about 10% of that in liver. Our results thus show that acetate
      generated during ethanol oxidation is completely released from liver in rats, in
      either conscious or anesthetized state under submaximal or maximal condition of
      ethanol disposal, and that GI metabolism of circulating ethanol can be as high as
      one third of the metabolism in liver.

PMID- 8355564
TI  - Cardiovascular effects of adenosine and its analogs in anaesthetized rats.
AB  - In order to define the purinergic receptors subtype involved in the control of
      cardiovascular activity, the effects of intracerebroventricular (icv 3rd
      ventricle) or intravenous (i.v.) injection of purinergic agonists and antagonists
      were evaluated on arterial blood pressure and heart rate of anaesthetized
      normotensive adult male rats. Adenosine (Ado) an A1 and A2 purinergic receptors
      agonist, N6-cyclohexyladenosine (CHA), an A1 receptor agonist and 5'-(N
      cyclopropyl)-carboxamidoadenosine (CPCA), an A2 purinergic receptor agonist, were
      administered in rats by icv (0.01-0.05-0.1 microgram) and i.v. (0.1-0.5-1
      microgram/kg) injections. The animals treated with adenosine were either
      pretreated with an A1 (8-cyclopenthyl-1,3-dimethylxanthine, CPT) an A2
      (3,7dimethyl-1-propargylxanthine, DMPX) or an A1-A2 (aminophylline, APH)
      purinergic receptor antagonist by icv (0.05 microgram) or i.v. (0.5 microgram/kg)
      injected or not at all pretreated. Ado, CPCA and CHA produced a dose-dependent
      decrease in arterial blood pressure and heart rate. The effects of CHA were less
      marked than those caused by Ado and CPCA. The icv and i.v. pretreatment with
      aminophylline, CPT and DMPX inhibited arterial hypotension and bradycardia
      induced by Ado, CHA and CPCA. The inhibitor effects of aminophylline and DMPX
      were stronger than those caused by CPT. These results showed that in the cerebral
      areas near the 3rd ventricle the purinergic system plays an important role in the
      control of cardiovascular function. The involvement of A2 purinergic receptors
      after administration of adenosine or its analogs on central and peripheral
      cardiovascular activity was also confirmed.

PMID- 8355565
TI  - Production of fibroblast-pneumocyte-like factor by fetal rabbit lung fibroblasts:
      isolation and effects of it and related factors on fetal type II cells in vitro.
AB  - Fetal lung fibroblasts interact with type II epithelial cells, inducing their
      maturation. This interaction arises by secretion of factors which alter fetal
      type II cell function. To analyze these factors, conditioned medium (CM) was
      produced by exposing serum-free minimum essential medium, with [35S]methionine (5
      microCi/ml), to confluent cultures of fetal rabbit lung fibroblasts. This medium
      was tested for ability to stimulate [3H]choline incorporation by fetal type II
      cells and subsequently fractionated on molecular weight filtration columns P60
      (2.5cm x 90cm; NMW cutoff, 60kd; 1M acetic acid) and A1.5m (2.5cm x 90cm; NMW
      cutoff, 1,500kd; Tris-buffered saline) and a hydroxyapatite column (HT) (1.5cm x
      30cm; NaCl and 0.01-0.3M phosphate). Crude medium stimulated choline
      incorporation into phosphatidylcholine. [35S]methionine was resolved in void
      volume material and in material of apparent molecular weight of 6000 daltons on
      the P60 filtration column. Filtration on the A1.5m column showed two major
      fractions with radiolabel incorporation. Each of these was resolved into two
      subfractions on HT chromatography. The high molecular mass fraction contained
      material which stimulated [3H]choline incorporation by fetal type II cells. The
      low molecular mass fraction tended to inhibit [3H]choline incorporation. The
      second subfractions of both the first and second primary fractions inhibited
      [3H]thymidine incorporation into DNA by fetal type II cells. SDS-PAGE
      electrophoresis and autoradiography showed that under reducing conditions, each
      peak contained several proteins. However few of these displayed radioactivity.
      These results indicate that protein factors produced by fetal lung fibroblasts
      may be involved in regulating both differentiation and replication of fetal type
      II cells.

PMID- 8355566
TI  - Disparate effects of phosphoramidon on blood pressure in SHR and DOCA-salt
      hypertensive rats.
AB  - Phosphoramidon inhibits both endothelin converting enzyme (ECE) and neutral
      metalloendopeptidase (NEP). The contribution of ECE and NEP inhibition to the
      antihypertensive effects of phosphoramidon was investigated in SHR and DOCA-salt
      hypertensive rats. SCH 32615, an active acid of the potent and selective NEP
      inhibitor prodrug SCH 34826 was used as a reference compound. Intravenous
      infusion of SCH 32615 (1.0 mg/kg/min x 2 hr) or phosphoramidon (0.3 and 1.0
      mg/kg/min x 2 hr) did not reduce blood pressure (BP) in conscious SHR. The
      combination of SCH 32615 (100 mg/kg + 1.0 mg/kg/min) and phosphoramidon (0.3
      mg/kg/min) also did not alter BP in SHR. In comparison, the BP of conscious DOCA
      salt rats was significantly reduced by phosphoramidon (0.01, 0.1 and 1.0
      mg/kg/min x 2 hr) (-28 +/- 6, -51 +/- 5 and -85 +/- 6 mmHg, respectively). SCH
      32615 (100 mg/kg, i.v.) over 5 min followed by a sustained infusion of 1.0
      mg/kg/min for 2 hr also reduced BP by 49 +/- 7 mmHg (P < .05) in DOCA-salt rats.
      However, phosphoramidon (0.1 mg/kg/min x 2 hr) failed to cause a further
      reduction in BP in DOCA-salt rats concurrently receiving SCH 32615. In contrast,
      a higher dose of phosphoramidon (0.3 mg/kg/min) in combination with SCH 32615
      caused a greater reduction in BP in DOCA-salt rats than SCH 32615 alone. In
      anesthetized normotensive rats, phosphoramidon (0.01-1.0 mg/kg/min x 30 min) dose
      dependently inhibited the BP responses to big endothelin-1 (BET-1) without
      blocking the pressor responses to ET-1. SCH 32615 failed to attenuate the pressor
      responses to either BET-1 or ET-1. The results indicate that SCH 32615 lacks in
      vivo ECE inhibitory activity. It is concluded that the antihypertensive action of
      SCH 32615 and low doses of phosphoramidon can be attributed to the inhibition of
      NEP which may presumably cause an accumulation of ANF. In comparison, at higher
      doses phosphoramidon causes a further reduction of BP in DOCA-salt hypertensive
      rats by inhibition of endothelin bioconversion.

PMID- 8355567
TI  - 16 beta-[18F]fluoromoxestrol: a potent, metabolically stable positron emission
      tomography imaging agent for estrogen receptor positive human breast tumors.
AB  - 16 beta-[18F]Fluoromoxestrol (beta FMOX, 1) is a highly selective, metabolically
      stable estrogen with potential as a receptor imaging agent. It demonstrates
      receptor-mediated uptake in the immature rat in the estrogen receptor-rich
      primary target tissues, uterus and ovaries, as well as, in receptor-poor
      secondary target tissues, muscle, thymus and kidneys; uptake in the uterus is
      nearly four times that of the clinically useful 16 alpha-[18F]fluoroestradiol
      (FES), most likely due to the extended lifetime of the labeled beta FMOX in the
      blood afforded by its relatively slow metabolism. In vivo and in vitro studies
      demonstrate a nearly four-fold decrease in metabolism rate between beta FMOX and
      FES. Dosimetry studies indicate radiation absorbed doses comparable to FES. beta
      FMOX possesses desirable imaging characteristics and may prove to be a clinically
      useful imaging agent.

PMID- 8355569
TI  - Naltrexone treatment attenuates the inhibitory effect of nicotine treatment on
      serum LH in rats.
AB  - The hypothesis that endogenous opioids might have a role in mediating the
      suppressive effects of nicotine on serum LH concentrations in rats was
      investigated. Naltrexone treatment prevented the inhibitory effect of high doses
      of nicotine on serum LH concentrations. Nicotine treatment also prevented the
      stimulatory effect of naltrexone on serum LH concentrations. These results
      suggest that the inhibitory effects of nicotine on serum LH concentrations
      involve an opioidergic component.

PMID- 8355568
TI  - Radiochemical quantitation of conjugated dienes in rat hepatocytes exposed to
      oxyradicals.
AB  - Conjugated dienes are fingerprint signatures of oxidant damage in cells. We used
      a radiochemical method based on the Diels-Alder reaction of 14C-labeled
      tetracyanoethylene with conjugated dienes to delineate the changes of its levels
      in ischemia-reperfusion in the rat liver. To more directly illustrate the
      kinetics of diene appearance in hepatocytes, we have applied the same
      radiochemical assay to rat hepatocytes exposed to xanthine oxidase and
      hypoxanthine. We observed that the conjugated dienes rose to a maximum under our
      condition at approximately 10 min, while Trolox--an antioxidant derived from
      vitamin E found previously to protect rat hepatocytes from oxyradical damage (2)-
      markedly reduced the formation of conjugated dienes.

PMID- 8355570
TI  - The influence of reproductive hormones on ANF release by rat atria.
AB  - The effects of subcutaneous (sc) administration of estradiol (50 micrograms/100
      microliters/day x 10 day) or testosterone (15 mg/100 microliters twice a week x 2
      weeks) on ANF release were examined in isolated perfused rat atria. The
      concentration of ANF in the perfusate was measured by radioimmunoassay, under
      basal conditions (atrial wall unstressed), and during atrial distention
      (intraluminal pressure raised to 4, 6, and 10 cm water). In both male and female
      control (vehicle-injected) groups, increased atrial pressure resulting in
      distention of the atrium caused a significant increase in ANF release. Estradiol
      increased basal secretion of ANF but did not influence stretch-induced
      stimulation of ANF secretion. By contrast, although testosterone did not affect
      basal secretion, it completely abolished the stretch-induced increase in ANF
      secretion. Neither estradiol nor testosterone affected atrial compliance.

PMID- 8355571
TI  - Increased content of epidermal growth factor in platelet lysates in non-insulin
      dependent diabetes mellitus.
AB  - We evaluated the content of EGF in platelet lysates obtained from 49 patients
      with non-insulin-dependent diabetes mellitus (NIDDM)(18 males, 31 females, age 58
      +/- 13 years) and from 23 clinically healthy control subjects (11 males, 12
      females, age 53 +/- 18 years). Platelets were collected from platelet-rich plasma
      and lysed. EGF was determined by radioimmunoassay. The immunoreactive EGF content
      in the platelet lysates in diabetic patients significantly exceeded that of
      control subjects (44.9 +/- 18.5 pg/mm3platelet vs. 34.2 +/- 7.8 pg/mm3platelet,
      mean +/- SD p < 0.008). In performing multiple regression analysis with ten
      clinical parameters, urinary albumin excretion (F = 16.1, r = 0.551, p < 0.001),
      duration of diabetes (F = 13.0, r = 0.511, p < 0.001) and the presence of
      diabetic proliferative retinopathy (F = 8.8, p < 0.01) were significantly
      associated with irEGF content in platelet lysates. These observations suggest
      that the amount of EGF in platelets may increase with the progression of diabetic
      complications. The mechanism for the increase of EGF in platelets remains to be
      clarified.

PMID- 8355572
TI  - Recombinant interleukin-1 receptor antagonist protein prevents sensitization and
      intestinal anaphylaxis in guinea pigs.
AB  - Recombinant interleukin-1 receptor antagonist protein (rlRAP, 0.5 mg/kg)
      administered intraperitoneally in guinea pigs one hour before primary and booster
      parenteral sensitization (1 ml) by cow milk, led to a reduced immunoglobulin E
      (IgE) production, as displayed by a passive cutaneous anaphylaxis test. rlRAP
      administered intraperitoneally in sensitized guinea pigs at 0.5 mg/kg 10 min
      before challenge administration (beta-lactoglobulin, 100 mg per os), also
      prevents the colonic motor and secretory changes induced by intestinal
      anaphylaxis. These results suggest the involvement of interleukin-1 in food
      allergy and evidence a double protective role for rlRAP in food hypersensitivity.

PMID- 8355573
TI  - Chronic effects of monoamine oxidase-B inhibitors on the behaviour of aged mice.
AB  - In order to measure the chronic effects of monoamine oxidase-B (MAO-B) inhibitors
      on the physical and cognitive condition of 60 aged male mice, 1-deprenyl or N
      methyl-N-(2-pentyl)-propargylamine (M-2-PP) were administered in drinking water
      (10 micrograms/ml/day) for 37 weeks. The spontaneous open-field locomotion,
      balancing ability and weight gain of the mice were assessed continuously. At the
      end of the study the spatial learning ability of all surviving mice was assessed
      in a Morris water maze. Both drug groups exhibited a reduction in spontaneous
      locomotion at the same rate as the control group, while there were no changes in
      balancing ability. The mice receiving 1-deprenyl, however, performed the water
      maze task less well than the control group. The mice receiving 1-deprenyl also
      gained weight at a significantly reduced rate compared to both the M-2-PP and
      water treated groups. A brain MAO assay indicated that MAO-B was completely
      inhibited by both drugs while MAO-A remained unchanged. The implications of these
      data on longevity studies using 1-deprenyl and other MAO-B inhibitors are
      discussed.

PMID- 8355575
TI  - Effect of clofibric acid on the turnover of the fatty acid-binding protein
      identified in cultured endothelial cells from bovine aorta.
AB  - Several types of fatty acid-binding proteins are found in mammalian cells.
      Cultured endothelial cells from bovine aorta were shown to contain exclusively
      the cardiac-type fatty acid-binding protein (cFABP) with a mean concentration of
      90 ng cFABP/mg extract protein. Only small variations were observed from passage
      to passage. In pulse-chase labeling experiments with L-[35S]methionine, a half
      life of 4.0 d was measured for cFABP which is about two times longer than the
      average half-life of the extracted proteins. These data imply that in aortic
      endothelial cells cFABP is not subject to short-term regulation. However,
      addition of clofibric acid to the culture medium led to a shortening of the half
      life of cFABP, which was compensated for by an increase in its biosynthesis. The
      turnover of the bulk of extract proteins remained unchanged when the cells were
      challenged with clofibric acid.

PMID- 8355574
TI  - Protein kinase C-dependent stimulation of phospholipase D in phospholipase C
      treated fibroblasts.
AB  - Treatment of [14C]choline- or [14C]ethanolamine-labeled NIH 3T3 fibroblasts with
      Bacillus cereus phosphatidyl-choline-specific phospholipase C (PLC) enhanced
      phospholipase D (PLD)-mediated hydrolysis of the respective 14C-labeled
      phospholipids. PLD activity was stimulated by 1.5 U/mL of PLC and by 100 nM of
      the protein kinase C (PKC) activator phorbol 12-myristate 13-acetate (PMA) to
      similar extents. Treatment of [14C]palmitic acid-labeled fibroblasts with PLC in
      the presence of ethanol also enhanced PLD-mediated formation of
      phosphatidylethanol; the effects of PLC and PMA were nonadditive. PLC had no
      effect on PLD activity in fibroblasts in which PKC was down-regulated by
      prolonged (24 h) treatment with 300 nM PMA. These data indicate that treatment of
      fibroblasts with exogenous PLC results in PKC-dependent activation of PLD.

PMID- 8355576
TI  - Role of lipid structure in the activation of phospholipase A2 by peroxidized
      phospholipids.
AB  - The time course of hydrolysis of a mixed phospholipid substrate containing bovine
      liver 1,2-diacyl-sn-glycero-3-phosphocholine (PC) and 1,2-diacyl-sn-glycero-3
      phosphoethanolamine (PE) catalyzed by Crotalus adamanteus phospholipase A2 was
      measured before and after peroxidation of the lipid substrate. The rate of
      hydrolysis was increased after peroxidation by an iron/adenosine diphosphate
      (ADP) system; the presence of iron/ADP in the assay had a minimal inhibitory
      effect. The rate of lipid hydrolysis was also increased after the substrate was
      peroxidized by heat and O2. Similarly, peroxidation increased the rate of
      hydrolysis of soy PC liposomes that did not contain PE. In order to minimize
      interfacial factors that may result in an increase in rate, the lipids were
      solubilized in Triton X-100. In mixtures of Triton with soy PC in the absence of
      PE, peroxidation dramatically increased the rate of lipid hydrolysis. In
      addition, the rate of hydrolysis of the unoxidizable lipid 1-palmitoyl-2-[1
      14C]oleoyl PC incorporated into PC/PE liposomes was unaffected by peroxidation of
      the host lipid. These data are consistent with the notions that the increase in
      rate of hydrolysis of peroxidized PC substrates catalyzed by phospholipase A2 is
      due largely to a preference for peroxidized phospholipid molecules as substrates
      and that peroxidation of host lipid does not significantly increase the rate of
      hydrolysis of nonoxidized lipids.

PMID- 8355577
TI  - Structure-function relationships of alkyl-lysophospholipid analogs in selective
      antitumor activity.
AB  - This investigation was initiated in order to delineate the structure-function
      relationship of the anticancer alkyl-lysophospholipids and assess their degree of
      selective cytotoxicity toward neoplastic cells. A series of glycerol
      phosphocholine analogs with varying substitutions in the sn-1 and sn-2 position
      were tested for their inhibitory activity as measured by thymidine incorporation,
      clonogenic assays and effects on protein kinase C activity against a series of
      human leukemic cell lines and healthy bone marrow progenitor cells. The IC50 was
      determined for each of the compounds in each cell line and healthy bone marrow
      cells following a 4-h incubation. The data indicated that a 16-18 carbon chain at
      the sn-1 coupled with a short substitution at sn-2 had the broadest antitumor
      activity and was the least toxic to normal bone marrow cells. The results provide
      a number of useful leads toward the design and development of potentially more
      active phospholipid compounds.

PMID- 8355578
TI  - Differential utilization of eicosapentaenoic acid and docosahexaenoic acid in
      human plasma.
AB  - It has recently been shown that the omega 3 fatty acid status in humans can be
      predicted by the concentration of eicosapentaenoic (EPA) and docosahexaenoic
      (DHA) acids in plasma phospholipids [Bjerve, K.S., Brubakk, A.M., Fougner, K.J.,
      Johnsen, H., Midjthell, K., and Vik, T. (1993) Am. J. Clin. Nutr., in press]. In
      countries with low intake of omega 3 fatty acids, the level of EPA in plasma
      phospholipids is often only about one-fifth the concentration of DHA. The purpose
      of this study was to investigate whether this difference in the concentration of
      these two fatty acids was due to a selective loss of EPA relative to DHA or to a
      lower dietary intake of EPA. Seven female volunteers ingested four grams of
      MaxEPA daily for 2 wk and in the following 4 wk they ate a diet almost completely
      devoid of the long-chain omega 3 fatty acids. The concentrations of the omega 3
      fatty acids in the plasma cholesteryl esters, triglycerides and phospholipids and
      the high density lipoprotein phospholipids were examined at weekly intervals
      throughout the study. There was a more rapid rise in the concentration of EPA
      than in DHA levels in the supplementation period in all lipid fractions, but
      there was a disproportionate rise in DHA relative to EPA in the plasma lipids
      compared with the ratio in the supplement. In the depletion phase there was a
      rapid disappearance of EPA from all fractions, such that pre-trial levels were
      reached by one week post-supplementation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355579
TI  - Interrelationship of stearic acid content and triacylglycerol composition of
      lard, beef tallow and cocoa butter in rats.
AB  - We investigated modes whereby stearic acid (18:0) exerts a neutral or cholesterol
      lowering effect using dietary fats which provided graded levels of 18:0 and
      distinct triacylglycerol (TAG) profiles. Male Sprague-Dawley rats (150-175 g)
      were fed diets containing 0.2% cholesterol and 16% fat from corn oil, or from 1%
      corn oil plus 15% lard (13.2% 18:0), beef tallow (19.2% 18:0) or cocoa butter
      (34.7% 18:0) for 3 wk, and then killed in a fasted or fed state. Chylomicron (CM)
      fatty acid profiles suggested reduced absorption of 18:0 with greater 18:0
      intake. CM TAG profiles indicated a reduction or loss of two TAG species compared
      to the TAG profiles of the stearate-rich diets: 1-palmitoyl-2-oleoyl-3-stearoyl
      glycerol (POS) and 1,3-distearoyl-2-oleoyl glycerol (SOS). Hepatic total
      cholesterol concentrations were 54-77% lower (P < 0.01) in the cocoa butter-fed
      than the lard-and beef tallow-fed groups. The cocoa butter group showed a
      significantly lower ratio of high-density lipoprotein esterified/free cholesterol
      than all other groups. Hepatic stearoyl-CoA and oleoyl-CoA concentrations, the
      substrate and product for hepatic delta 9 desaturase, were not significantly
      different for corn oil-fed and cocoa butter-fed groups in spite of a large
      difference in 18:0 intake. These data suggest that the neutral or cholesterol
      lowering effect of 18:0 is not due to hepatic conversion of stearic to oleic
      acid, and that POS and SOS are poorly absorbed from stearate-rich dietary fats.

PMID- 8355580
TI  - Cholesterol synthesis and esterification in isolated enterocytes: regulation by
      cholesterol and cholestyramine feeding.
AB  - The purpose of the present study was to investigate the physiological control of
      the main regulatory enzymes of cholesterol metabolism in isolated enterocytes
      obtained from chick duodenum, jejunum and ileum. Cholesterol feeding resulted in
      an inhibition of 3-hydroxy-3-methyl-glutaryl-CoA reductase and mevalonate 5
      pyrophosphate decarboxylase, while cholestyramine feeding increased reductase
      activity in all the regions studied and decarboxylase activity only in duodenum.
      Cholesterol feeding markedly increased acyl-CoA:cholesterol acyltransferase, but
      the effects of cholestyramine were less clear. The effects on transferase
      activity cannot be due to differences in the availability of acyl-CoA as
      exogenous substrate as no significant differences were found in acyl-CoA
      hydrolase activity after any of the dietary treatments. The effects of
      cholesterol feeding were related to changes in the cholesterol content of
      epithelial cells, whereas in the case of cholestyramine this relationship was
      less apparent.

PMID- 8355581
TI  - Radioprotection of mice by dietary squalene.
AB  - Male C3H mice were fed a diet containing 2% squalene for 14 d prior to and 30 d
      subsequent to exposure to 6, 7 or 8 Gy of whole body gamma-irradiation (Cesium
      137). After 14 d on squalene-supplemented diet, plasma and jejunal tissue
      squalene levels were 2X and 15X that of controls. Seven days after irradiation,
      total white cell counts and total lymphocyte counts were substantially depressed
      in a radiation dose-dependent manner. Although counts in the squalene group were
      consistently (18-119%) higher than those in the corresponding dietary control
      group, the differences between dietary groups at any single dose were not
      significant. Nuclear area of villus cells in the jejunum of both dietary groups
      was significantly reduced (20%) by day 11 post-irradiation but the nuclear area
      in squalene-fed mice was significantly greater (15%) than in controls, before and
      after irradiation. There were no differences in body weight as a function of
      either diet or radiation dose prior to the first observations of animal
      lethality. Animal survival was decreased from 100 to 0% at 30 d post-irradiation
      by radiation doses of 6-8 Gy, with the greatest difference between dietary groups
      being observed at 7 Gy (median survival times of 12 and 16 d for control and
      squalene groups, respectively). Overall, survival of squalene-fed mice was
      significantly prolonged compared with control-fed mice (P = 0.0054 by censored
      multiple regression analysis). It is concluded that squalene conferred some
      cellular and systemic radioprotection to mice receiving these lethal whole-body
      radiation doses.

PMID- 8355582
TI  - 2-Alkenyl-4,4-dimethyloxazolines as derivatives for the structural elucidation of
      isomeric unsaturated fatty acids.
AB  - Several types of unsaturated fatty acid methyl esters were converted into 4,4
      dimethyloxazoline (DMOX) derivatives and analyzed by mass spectrometry to further
      evaluate the feasibility of using this derivative for locating the positions of
      double bonds in isomeric fatty acids. Five isomeric 20-carbon tetraenoic acids
      were analyzed in which the four cis double bonds were systematically moved from
      the 4,7,10,13- to the 8,11,14,17-positions. It was possible to locate the
      positions of all four double bonds in the 7,10,13,16- and 8,11,14,17-isomers by
      appropriate ions differing by 12 atomic mass units. In a similar way the three
      terminal double bonds in the 4,7,10,13-, 5,8,11,14- and 6,9,12,15-isomers could
      be assigned. Odd-numbered ions at m/z 139, 153 and 167 which are accompanied by
      an even mass ion at 138, 152 and 166, respectively, are diagnostic for DMOX
      derivatives of acids with their first double bond, respectively, at positions 4,
      5 and 6. It was thus possible to assign the location of all four double bonds in
      these three isomers. A comparison of the spectra of the DMOX derivatives of
      17,17,18,18-d4 vs. 9,10,12,13-d4 linoleic acid suggests that double bonds
      preferentially migrate toward the polar end of the molecule prior to
      fragmentation. The merit of using DMOX derivatives to locate double-bond
      positions in mono- and dicarboxylic acids, produced during beta-oxidation of
      polyunsaturated fatty acids, was evaluated. The spectra of 3-cis- and 4-cis
      decenoic acids differ as do the spectra of 8-carbon dicarboxylic acids with their
      double bonds at positions 3 and 4.

PMID- 8355583
TI  - Acidic hydrolysis of plasmalogens followed by high-performance liquid
      chromatography.
AB  - A simple, quantitative method for determining the plasmalogen content of small
      samples is reported here. The method uses the different susceptibility to acid
      catalyzed hydrolysis of the alkyl, alkenyl and acyl linkages to separate the
      plasmalogen subclass from the other two non-labile subclasses. Hydrolysis of
      plasmenylethanolamine and plasmenylcholine was complete after 4 and 1 min of acid
      treatment, respectively. The acid-catalyzed hydrolysis did not alter the
      phospholipid fatty acid composition, making this method useful for fatty acid
      compositional analysis of the plasmalogen subclass. High-performance liquid
      chromatography was used for separations, and phospholipids were quantitated by
      assay of lipid phosphorus or by direct quantitation of peak area. Using this
      method, small amounts (10 nmol) of ethanolamine glycerophospholipid and choline
      glycerophospholipid are subjected to acid-catalyzed hydrolysis and subsequent
      separation of the resulting lysocompounds obtained from plasmalogens from the
      more acid-stable alkylacyl and diacyl glycerophospholipid fractions. Our values
      for plasmalogens from commercial preparations of choline and ethanolamine
      glycerophospholipids agree with literature values. The usefulness of the method
      is demonstrated for small glycerophospholipid samples that are equivalent to
      samples from cultured neural cells.

PMID- 8355584
TI  - Time response of cholesterol synthesis inhibition by compactin-related compounds.
      In vitro quantitation of the "escape phenomenon".
AB  - The time course of the inhibition of cholesterol synthesis by low and high doses
      of mevinolin and monacolin X were studied in normal human skin fibroblasts,
      fibroblasts without low density lipoprotein receptor and HepG2 hepatoma cells.
      Low doses of the inhibitors (0.2 ng/mL) caused a sharp decrease in the rate of
      cholesterol synthesis during the first 2-3 h, which gradually increased to about
      40% during the next 6 h. Further incubation led to a decrease or stabilization of
      the cholesterol synthesis rate. High doses of the drugs (100 mg/mL) strongly
      inhibited cholesterol synthesis during the first 2-3 h, followed by a moderate
      increase during the next 20 h. No drug or tissue selectivity was observed.

PMID- 8355585
TI  - Oxidative modification of triglyceride-rich lipoproteins in hypertriglyceridemic
      rats following magnesium deficiency.
AB  - Hypertriglyceridemia observed in magnesium (Mg)-deficient rats was associated
      with a significant increase in the very low-density lipoprotein (VLDL) plus low
      density lipoprotein (LDL) fractions. The results from in vitro copper-induced
      lipid peroxidation, expressed in terms of conjugated dienes and thiobarbituric
      acid reactive substances content, showed that VLDL + LDL particles from Mg
      deficient rats were more susceptible to oxidative damage than lipoproteins from
      control rats. These results suggest that the mechanism responsible for the
      atherogenicity and tissue damage characteristic of Mg deficiency may be mediated
      by an increased susceptibility of triglyceride-rich lipoproteins to peroxidation
      in hypertriglyceridemic animals.

PMID- 8355586
TI  - Lipid biosynthesis in cultured arterial smooth muscle cells is related to their
      phenotype.
AB  - During the atherogenic process in vivo, arterial smooth muscle cells (SMC)
      undergo changes in their phenotype. In the present study, rat SMC from primary
      cultures and from subcultures before 10 and after 200 passages, showing
      contractile-like, synthetic and transformed phenotypes, respectively, were
      compared in regard to their lipid content and biosynthesis. The rationale for
      comparing these phenotypes rests in the similar changes in phenotype of SMC that
      occur in the formation and progression of atherosclerotic lesions. Phenotype
      changes were shown to be associated with changes in the phospholipid content of
      SMC. Phospholipid levels increased, but not as significantly as did cholesterol
      levels when passing from contractile to synthetic and transformed cells (1.23 +/-
      0.18, 2.28 +/- 0.26 and 3.25 +/- 0.23 micrograms/10(6) cells, respectively).
      Cholesterol normalized in respect to cell protein was increased to the same
      extent. Lipid synthesis as judged by [14C]acetate incorporation was increased 3-
      to 12-fold in the synthetic and transformed cells, respectively, compared to
      contractile cells. After thin-layer chromatography, radioactivity was shown to be
      markedly increased in most of the lipid fractions, but label in the cholesterol
      fraction of synthetic and transformed cells was increased by 7- and 21-fold,
      respectively. Thus, SMC in vitro were shown to drastically increase cholesterol
      biosynthesis associated with phenotype changes. Such changes are known to occur
      in vivo and might represent a critical step in the deposition of excess
      cholesterol within foam cells.

PMID- 8355587
TI  - The esterified plasma fatty acid profile is altered in early HIV-1 infection.
AB  - Previous studies have shown that alterations in micronutrient utilization occur
      in patients with Acquired Immune Deficiency Syndrome. In this study, total plasma
      fatty acid composition was measured in 36 homosexual men infected with the Human
      Immunodeficiency Virus 1 (HIV-1) and in 17 HIV-1 seronegative homosexual men in
      order to evaluate differences associated with early HIV-1 infection. Immunologic
      assessment included CD4 cell number count and lymphocyte blastogenesis in
      response to the mitogens phytohemagglutinin (PHA) and pokeweed (PWM). The mean
      total amount of omega 6 polyunsaturated fatty acids (18:2 and 20:4) was
      significantly lower in the HIV-1 seropositive subjects (38 +/- 8.1% SD) as
      compared to HIV-1 seronegative subjects (43 +/- 4.2%; P = 0.0027). This was also
      reflected in a higher level of total saturated fatty acids (16:0 and 18:0) in HIV
      1 seropositive subjects (30 +/- 2.2% vs. 26 +/- 2.8%; P = 0.0001). The ratio of
      linoleic to arachidonic acid (18:2 to 20:4) was higher in the HIV-1 seropositive
      group (6.76 +/- 4.88) compared to the HIV-1 seronegative group (4.86 +/- 1.37; P
      = 0.0213). The response to PHA in seropositive subjects correlated inversely with
      total plasma omega 6 fatty acids (r = -0.36; P = 0.027), and directly with the
      18:2 to 20:4 ratio (r = 0.33; P = 0.046). CD4 cell counts and the response to PWM
      did not correlate with plasma fatty acid levels in HIV-1 seropositive
      subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355588
TI  - Atherosclerosis and plasma and liver lipids in nine inbred strains of mice.
AB  - Nine inbred strains of mice, which are progenitors of recombinant inbred sets,
      were evaluated for aortic lesion formation and plasma and liver lipid levels.
      This survey was done to determine if a semi-synthetic high-fat diet could elicit
      the same extent of diet-induced atherosclerosis as that observed in mice fed a
      natural ingredient high-fat diet and to discover strain-specific plasma and liver
      lipid variants for future genetic characterization. Evaluation of aortic lesions
      after 18 wk of diet consumption showed that strains C57BL/6J, C57L/J, SWR/J and
      SM/J were susceptible to atherosclerosis and that A/J, AKR/J, C3H/HeJ, DBA/2J and
      SJL/J were relatively resistant. High-density lipoprotein cholesterol (HDL-C)
      levels were negatively correlated to lesion formation. Susceptible strains had
      decreased HDL-C levels when switched from chow to the semi-synthetic high-fat,
      high cholesterol diet, whereas resistant strains either showed no change or a
      slight increase in HDL-C levels. The exception to this pattern was found in SM
      mice, which were susceptible to aortic lesion formation but maintained the same
      HDL-C level on both chow and high-fat diets. HDL size differed among the strains,
      and levels of plasma apolipoprotein A-I and A-II correlated with HDL-C levels.
      Liver damage was not correlated to HDL-C levels or to susceptibility to
      atherosclerosis. Mice from strain A, which are resistant to atherosclerosis, had
      evidence of liver damage as observed by elevated levels of plasma alanine
      aminotransferase activity, by liver histology, by increased liver weight and by
      exceptionally high hepatic cholesterol content.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355589
TI  - Adipose glycerolipid formation: effect of nutritional and hormonal states.
AB  - The potential of glycerolipid formation from sn-glycerol-3-phosphate (GP) and 2
      monoacylglycerol (MG) was studied in adipose microsomal fractions under various
      nutritional and hormonal states. Glycerolipid formation from GP was followed in
      the presence of [14C]glycerol-3-phosphate and palmitoyl-CoA and was assayed by
      measuring the formation of butanol-soluble product, consisting mainly of
      [14C]phosphatidate. Glycerolipid formation from MG was determined in the presence
      of 2-mono-oleyl glycerol and [14C]palmitoyl-CoA, and was estimated by the
      formation of both [14C]di- and triacylglycerol. Glycerolipid formation from GP
      was decreased significantly during food deprivation, in experimental diabetes, in
      the presence of lipolytic hormone, and during aging. Glycerolipid formation from
      MG did not change under these conditions and continued at the same rate as
      observed in control animals. The rate of glycerolipid formation from GP was 7-20
      times greater than from MG in the various fat depots. Measurement of the adipose
      monoacylglycerol concentration did not show any correlation with the glycerolipid
      formation from MG. The studies suggest that glycerolipid formation from MG is
      active in various fat depots, and is substantial when glycerolipid formation via
      GP is impaired.

PMID- 8355590
TI  - The esterification of cholesterol in the yolk sac membrane of the chick embryo.
AB  - The uptake of lipid from the yolk by the yolk sac membrane of the chick embryo is
      accompanied by the rapid esterification of a large proportion of the yolk
      cholesterol. This could arise from enhanced acyl-CoA:cholesterol acyltransferase
      (ACAT) activity and/or inhibition of cholesteryl ester hydrolase (CEH) activity.
      The activity of ACAT was therefore measured in microsomes obtained from yolk sac
      membranes at various stages of development. A high level of activity (up to 929
      pmol of cholesteryl oleate formed per min per mg protein) was found during the
      second half of this period. Supplementation with exogenous cholesterol stimulated
      ACAT activity in microsomes obtained from the tissue at the earlier, but not at
      the later, stages of development suggesting that the enzyme became saturated with
      microsomal cholesterol as development proceeded. Correlating with this, the
      concentration of cholesterol in the microsomes increased 4-fold between 9 and 20
      d of development. The activity of CEH was very low in the microsomes and could
      not be detected in the cytosolic fraction. The activity of a protein, which has
      been shown to function as an inhibitor of CEH, was found to be present at all
      stages of development. The high activity of ACAT, together with the low activity
      of CEH and an active CEH inhibitor protein is a combination well suited to
      promote an essentially unidirectional conversion of cholesterol to cholesteryl
      ester. This process may be a major determinant of the rate of lipid transfer from
      the yolk to the embryo.

PMID- 8355591
TI  - Nervonic acid in red blood cell sphingomyelin in premature infants: an index of
      myelin maturation?
AB  - The present study addresses the question whether nervonic acid (24:1n-9)
      accumulation in sphingomyelin (SM) of red blood cells (RBC) could yield
      information on cerebrum maturation in premature infants. The study included 28
      premature eutrophic infants of 31.5 wk gestational age. Eleven were fed with
      human milk, nine with a regular formula and eight with an alpha-linolenate
      enriched formula. The fatty acid composition of the SM fraction was determined by
      gas-liquid chromatography on a 50-m fused silica capillary column. At 32 wk
      gestational age, the main fatty acids in SM were 16:0, 18:0, 20:0, 22:0, 24:0 and
      24:1n-9. After five weeks of feeding, at week 37 of postconceptional age, the
      most striking variation was a rise in 24:1n-9, from 9.9 +/- 0.7 to 12.8 +/- 0.9
      (P < 0.02), regardless of regimen in all three feeding groups. The rise in 24:1n
      9 after birth in premature eutrophic infants is the beginning of a trend toward
      the higher levels in 24:1n-9 observed in mature newborns and older infants. The
      24:1n-9 level in SM of RBC from premature infants may reflect 24:1n-9 levels in
      SM of brain and could thus reflect brain maturity.

PMID- 8355592
TI  - Phospholipid molecular species from human placenta lipids.
AB  - The phospholipid molecular species from a large-scale preparation of human
      placenta lipids were analyzed. The major placental phospholipids were choline
      glycerophospholipids (CPL) (53.2 wt%), sphingomyelin (21.7 wt%) and ethanolamine
      glycerophospholipids (EPL) (14.6 wt%). 1,2-Diacyl-glycerophosphocholine was the
      most abundant subclass of CPL (91.7 mol%), while EPL contained 1,2-diacyl (54.6
      mol%) and 1-alk-1'-enyl-2-acyl (43.8 mol%) subclasses. The level of
      polyunsaturated fatty acids (PUFA) in total phospholipids was remarkably constant
      (38.4-39.9 mol%) within all placental batches tested. The long-chain PUFA, mainly
      20:4n-6 and 22:6n-3 of the n-6 and n-3 series, respectively, were found in high
      proportion in all phospholipid classes, especially in EPL (46.7 mol%) and in
      inositol glycerophospholipids (IPL) (39.9 mol%). CPL and serine
      glycerophospholipids were much richer in 18:1n-9 and 18:2n-6. High levels of
      molecular species with arachidonic acid in the sn-2 position were found
      particularly in 1-alk-1'-enyl-2-acyl-glycerophosphoethanolamine (with 24.0 mol%
      16:0 and 22.0 mol% 18:0 in sn-1 position) and in 1,2-diacyl
      glycerophosphoinositol with 42.6 mol% 18:0 in sn-1 position. EPL subclasses were
      rich in 22:6n-3, which occurs mainly as 16:0/22:6n-3 (11.7 mol%) in the
      plasmalogen form and as 18:0/22:6n-3, 16:0/22:6n-3 and 18:1/22:6n-3 in the diacyl
      forms. Based on their availability and composition, placental phospholipids could
      be of interest, for example, for supplementing artificial milk preparations with
      n-3 and n-6 long-chain PUFA for newborn infants with insufficiently developed
      18:2n-6 and 18:3n-3 desaturation/elongation.

PMID- 8355593
TI  - Triacylglycerol structure of human colostrum and mature milk.
AB  - Because triacylglycerol (TAG) structure influences the metabolic fate of its
      component fatty acids, we have examined human colostrum and mature milk TAG with
      particular attention to the location of the very long chain polyunsaturated fatty
      acid on the glycerol backbone. The analysis was based on the formation of various
      diacylglycerol species from human milk TAG upon chemical (Grignard degradation)
      or enzymatic degradation. The structure of the TAG was subsequently deduced from
      data obtained by gas chromatographic analysis of the fatty acid methyl esters in
      the diacylglycerol subfractions. The highly specific TAG structure observed was
      identical in mature milk and colostrum. The three major fatty acids (oleic,
      palmitic and linoleic acids) each showed a specific preference for a particular
      position within milk TAG: oleic acid for the sn-1 position, palmitic acid for the
      sn-2 position and linoleic acid for the sn-3 position. Linoleic and alpha
      linolenic acids exhibited the same pattern of distribution and they were both
      found primarily in the sn-3 (50%) and sn-1 (30%) positions. Their longer chain
      analogs, arachidonic and docosahexaenoic acids, were located in the sn-2 and sn-3
      positions. These results show that polyunsaturated fatty acids are distributed
      within the TAG molecule of human milk in a highly specific fashion, and that in
      the first month of lactation the maturation of the mammary gland does not affect
      the milk TAG structure.

PMID- 8355594
TI  - Dietary saturated, monounsaturated, n-6 and n-3 fatty acids, and cholesterol
      influence platelet fatty acids in the exclusively formula-fed piglet.
AB  - Platelet lipid composition is important to normal platelet morphology and
      function, and is influenced by dietary fatty acids and cholesterol. The fatty
      acid composition and cholesterol content of infant formulas differs from those of
      human milk, but the possible effects on platelet lipids in young infants is not
      known. This was studied in piglets fed from birth to 18 d of age with one of
      eight formulas differing in saturated fatty acid chain length, or content of
      18:1, 20:5n-3 plus 22:6n-3, or cholesterol. A reference group of piglets fed sow
      milk was also studied. Sow milk has a fatty acid composition and cholesterol
      content similar to that of human milk. Piglets fed formulas high in 18:1 (34.9
      40.8% wt fatty acids) and low in 16.0 (< or = 6.5% wt fatty acids) had lower
      platelet counts and greater platelet size than piglets fed sow milk (40.4% 18:1,
      30.7% 16:0). Piglets fed formulas high in 16:0 (27-29.6%) and 18:1 (40-40.6%), or
      low in both 16:0 (5.9-6.1%) and 18:1 (10.8-11.2%), had similar platelet counts
      and size to piglets fed sow milk. Platelet phospholipid % 20:4n-6 was lower in
      all the groups of piglets fed formula than in the group fed sow milk. Addition of
      fish oil with 20:5n-3 plus 22:6n-3 to the formula further decreased platelet
      phospholipid 20:4n-6. Addition of cholesterol to the formula increased the
      platelet phospholipid % 20:4n-6 and platelet volume.

PMID- 8355595
TI  - Dietary fat effects on hepatic lipid peroxidation and enzymes of H2O2 metabolism
      and NADPH generation.
AB  - The purpose of this study was to determine the effects of dietary fat quantity
      and fatty acid composition on hepatic H2O2-metabolizing systems, activities of
      NADPH-generating enzymes and lipid peroxidation. One-month-old male C57BL/6J mice
      were fed one of six diets: (i) 5% fat, rich in 18:2n-6 fatty acid (5% N-6); (ii)
      20% fat, rich in 18:3n-3 (N-3); (iii) 20% fat, rich in 18:2n-6 (N-6); (iv) 20%
      fat, rich in 18:1n-9 (N-9); (v) 20% fat, rich in saturated fatty acids (SAT); and
      (vi) 20% fat, deficient in essential fatty acids (EFAD); for 11 wk. Comparisons
      between animal groups receiving different fat quantities showed that activities
      of glucose-6-phosphate dehydrogenase (G6PDH, EC 1.1.1.49) and malic enzyme (ME,
      EC 1.1.1.40) and the levels of conjugated dienes were significantly lower in the
      N-6 than in 5% N-6 group. Conversely, activities of catalase (CAT, EC 1.11.1.6)
      and selenium-glutathione peroxidase (SeGSHPx, EC 1.11.1.9) were higher in the N-6
      than in 5% N-6 group. Among the five dietary groups receiving 20% fat but
      differing in fatty acid composition, CAT activity was lower in the N-9 group,
      SeGSHPx activity was lower in the EFAD group, and glutathione reductase (GSSGR,
      EC 1.6.4.2) activity was higher in the N-6 than in the N-3, N-9, SAT and EFAD
      group. The EFAD group had much higher levels of total lipids and conjugated
      dienes, as well as activities of NADPH-generating enzymes, including G6PDH, ME
      and isocitrate dehydrogenase (EC 1.1.1.42), than the other four high-fat
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355596
TI  - Diabetes increases excretion of urinary malonaldehyde conjugates in rats.
AB  - The effect of streptozotocin-induced diabetes on the urinary excretion of
      thiobarbituric acid test-positive materials was examined. In diabetic rats,
      urinary excretion of thiobarbituric acid reactive substances was increased 5-fold
      over that in nondiabetic animals. High-performance liquid chromatography of urine
      samples revealed that five of the six fractions previously found to be increased
      in vitamin E deficiency [Lee, H.-S., Shoeman, D.W., and Csallany, A.S. (1992)
      Lipids 27, 124-128] were also significantly increased in streptozotocin-induced
      diabetes. The data suggest that a high level of oxidative stress is induced by
      uncontrolled diabetes in rats.

PMID- 8355597
TI  - A major difference between the divergence patterns within the lines-1 families in
      mice and voles.
AB  - L1 retroposons are represented in mice by subfamilies of interspersed sequences
      of varied abundance. Previous analyses have indicated that subfamilies are
      generated by duplicative transposition of a small number of members of the L1
      family, the progeny of which then become a major component of the murine L1
      population, and are not due to any active processes generating homology within
      preexisting groups of elements in a particular species. In mice, more than a
      third of the L1 elements belong to a clade that became active approximately 5 Mya
      and whose elements are > or = 95% identical. We have collected sequence
      information from 13 L1 elements isolated from two species of voles (Rodentia:
      Microtinae: Microtus and Arvicola) and have found that divergence within the vole
      L1 population is quite different from that in mice, in that there is no abundant
      subfamily of homologous elements. Individual L1 elements from voles are very
      divergent from one another and belong to a clade that began a period of elevated
      duplicative transposition approximately 13 Mya. Sequence analyses of portions of
      these divergent L1 elements (approximately 250 bp each) gave no evidence for
      concerted evolution having acted on the vole L1 elements since the split of the
      two vole lineages approximately 3.5 Mya; that is, the observed interspecific
      divergence (6.7%-24.7%) is not larger than the intraspecific divergence (7.9%
      27.2%), and phylogenetic analyses showed no clustering into Arvicola and Microtus
      clades.

PMID- 8355598
TI  - Conserved sequence and functional domains in satellite 2 from three families of
      salamanders.
AB  - Thirteen satellite 2 elements from Ambystoma talpoideum and 16 from Amphiuma
      tridactylum were cloned, sequenced, and compared with the satellite 2 consensus
      from Notophthalmus viridescens. These elements have maintained a high degree of
      similarity during the 65-200 Myr that the salamander families, represented by the
      three species, have been separated. The DNA sequences of the consensus elements
      from A. talpoideum and A. tridactylum are 81% similar, and both are approximately
      65% similar to the N. viridescens consensus. In addition to its DNA sequence, the
      functional properties of satellite 2 have also been conserved. By selecting and
      analyzing clones that closely mimicked the consensus of each species, we were
      able to demonstrate that satellite 2 from each species was capable of promoting
      transcription after injection into Xenopus laevis oocytes and that synthetic
      transcripts of satellite 2 from each species were capable of catalyzing their own
      site-specific cleavage. These properties may be related to the process of
      retroposition, which was previously proposed to be responsible for the genomic
      proliferation of satellite 2. Each of these functional properties also has
      general biological interest.

PMID- 8355599
TI  - Mitochondrial phylogeny of the endemic mouthbrooding lineages of cichlid fishes
      from Lake Tanganyika in eastern Africa.
AB  - Of the three cichlid species flocks in eastern Africa, Lake Tanganyika harbors
      the oldest species assemblage, which is also the most diverse morphologically and
      behaviorally. For 12 species (20 individuals) of 12 genera of the tribe Ectodini,
      852 bp from two segments (cytochrome b and control region) of the mitochondrial
      genome were sequenced. In addition, orthologous sequences were obtained from
      eight species (11 individuals) representing other mouthbrooding lineages from
      Lake Tanganyika. Comparisons of sequence divergences revealed that the single
      Tanganyikan tribe Ectodini appears to be approximately five times older than the
      whole Lake Malawi cichlid species flock, suggesting that the radiation of the
      Tanganyikan mouthbrooding lineages took place long before the species flocks of
      Lakes Malawi and Victoria evolved. Seven of nine surveyed tribes of Tanganyikan
      cichlids appear to be approximately equally divergent, and this seems to
      corroborate the hypothesis of a rapid simultaneous formation of lineages at an
      early stage in the history of the Lake Tanganyika species flock. The close
      genetic relationship between the endemic Tropheus lineage and a nonendemic
      "Haplochromine," Astatotilapia burtoni, indicates that members of the tribe
      Tropheini may be the sister group of the cichlid flocks of Lakes Malawi and
      Victoria. The phylogenetic analyses demonstrate the monophyly of the Ectodini and
      identify the Cyprichromini as their sister group among the Tanganyikan cichlids.
      Within the tribe Ectodini the molecular data suggest both a branching pattern
      different than that previously proposed and a subdivision of the Ectodini into
      four clades, instead of the two originally described. The previously postulated
      model of morphological transformations believed to be responsible for the
      drastically different types of ecological specialization found among the Ectodini
      might therefore be in need of reinterpretation. Characters immediately related to
      foraging and nutrition seem to be particularly prone to homoplasy, even among
      members of a single lineage of cichlid fishes.

PMID- 8355600
TI  - Conservation of alternative splicing and genomic organization of the myosin
      alkali light-chain (Mlc1) gene among Drosophila species.
AB  - The Mlc1 gene of Drosophila melanogaster encodes two MLC1 isoforms via
      developmentally regulated alternative pre-mRNA splicing. In larval muscle and
      tubular and abdominal muscles of adults, all of the six exons are included in the
      spliced mRNA, whereas, in the fibrillar indirect flight muscle of adult, exon 5
      is excluded from the mRNA. We show that this tissue-specific pattern of
      alternative splicing of the Mlc1 pre-mRNA is conserved in D. simulans, D.
      pseudoobscura, and D. virilis. Isolation and sequencing of the Mlc1 genes from
      these three other Drosophila species have revealed that the overall organization
      of the genes is identical and that the genes have maintained a very high level of
      sequence identity within the coding region. Pairwise amino acid identities are
      94%-99%, and there are no charge changes among the proteins. Total nucleotide
      divergence within the coding region of the four genes supports the accepted
      genealogy of these species, but the data indicate a significantly higher rate of
      amino acid replacement in the branch leading to D. pseudoobscura. A comparison of
      nucleotide substitutions in the coding portions of exon 5 and exon 6, which
      encode the alternative carboxyl termini of the two MLC1 isoforms, suggests that
      exon 5 is subject to greater evolutionary constraints than is exon 6. In addition
      to the coding sequences, there is significant sequence conservation within the 5'
      and 3' noncoding DNA and two of the introns, including one that flanks exon 5.
      These regions are candidates for cis-regulatory elements. Our results suggest
      that evolutionary constraints are acting on both the coding and noncoding
      sequences of the Mlc1 gene to maintain proper expression and function of the two
      MLC1 polypeptides.

PMID- 8355601
TI  - Population genetics and phylogenetics of DNA sequence variation at multiple loci
      within the Drosophila melanogaster species complex.
AB  - Two regions of the genome, a 1-kbp portion of the zeste locus and a 1.1-kbp
      portion of the yolk protein 2 locus, were sequenced in six individuals from each
      of four species: Drosophila melanogaster, D. simulans, D. mauritiana, and D.
      sechellia. The species and strains were the same as those of a previous study of
      a 1.9-kbp region of the period locus. No evidence was found for recent balancing
      or directional selection or for the accumulation of selected differences between
      species. Yolk protein 2 has a high level of amino acid replacement variation and
      a low level of synonymous variation, while zeste has the opposite pattern. This
      contrast is consistent with information on gene function and patterns of codon
      bias. Polymorphism levels are consistent with a ranking of effective population
      sizes, from low to high, in the following order: D. sechellia, D. melanogaster,
      D.mauritiana, and D. simulans. The apparent species relationships are very
      similar to those suggested by the period locus study. In particular, D. simulans
      appears to be a large population that is still segregating variation that arose
      before the separation of D. mauritiana and D. sechellia. It is estimated that the
      separation of ancestral D. melanogaster from the other species occurred 2.5-3.4
      Mya. The separations of D. sechellia and D. mauritiana from ancestral D. simulans
      appear to have occurred 0.58-0.86 Mya, with D. mauritiana having diverged from
      ancestral D. simulans 0.1 Myr more recently than D. sechellia.

PMID- 8355602
TI  - On the detection of nonrandom associations between DNA polymorphisms in natural
      populations of Drosophila.
AB  - The capacity to detect nonrandom associations between restriction-map variants
      was examined in eight gene regions of Drosophila melanogaster (yellow
      achaetescute, white, Zw, Adh, Est6, and rosy) and D. pseudoobscura (Adh and Xdh),
      on the basis of published population data. The statistical power from individual
      pairwise tests was both heterogeneous and generally low across gene regions.
      Sample sizes larger than those currently being used are needed to ensure any
      power to detect disequilibrium by individual tests. It is found that the
      heterogeneity in power is mostly explained by large differences in the intensity
      of sample disequilibrium among regions. The yellow-achaete-scute, Zw, and Adh
      loci of D. melanogaster displayed both the highest mean power (approximately 0.4)
      and a very great disequilibrium (mean absolute values of D' were 0.8-1). By
      contrast, all the other gene regions exhibited lower mean power (approximately
      0.2) and moderate levels of disequilibrium (0.4-0.6). Although the proportion of
      significant pairwise associations, especially for white, Est6, and rosy in D.
      melanogaster and for Adh and Xdh in D. pseudoobscura, is more or less close to
      the type I error, simultaneous-inference significance tests show that gametic
      disequilibrium is occurring at the eight DNA regions examined.

PMID- 8355603
TI  - Analysis of a genetic hitchhiking model, and its application to DNA polymorphism
      data from Drosophila melanogaster.
AB  - Begun and Aquadro have demonstrated that levels of nucleotide variation correlate
      with recombination rate among 20 gene regions from across the genome of
      Drosophila melanogaster. It has been suggested that this correlation results from
      genetic hitchhiking associated with the fixation of strongly selected mutants.
      The hitchhiking process can be described as a series of two-step events. The
      first step consists of a strongly selected substitution wiping out linked
      variation in a population; this is followed by a recovery period in which
      polymorphism can build up via neutral mutations and random genetic drift. Genetic
      hitchhiking has previously been modeled as a steady-state process driven by
      recurring selected substitutions. We show here that the characteristic parameter
      of this steady-state model is alpha v, the product of selection intensity (alpha
      = 2Ns) and the frequency of beneficial mutations v (where N is population size
      and s is the selective advantage of the favored allele). We also demonstrate that
      the steady-state model describes the hitchhiking process adequately, unless the
      recombination rate is very low. To estimate alpha v, we use the data of DNA
      sequence variation from 17 D. melanogaster loci from regions of intermediate to
      high recombination rates. We find that alpha v is likely to be > 1.3 x 10(-8).
      Additional data are needed to estimate this parameter more precisely. The
      estimation of alpha v is important, as this parameter determines the shape of the
      frequency distribution of strongly selected substitutions.

PMID- 8355604
TI  - Protein evolution in different cellular environments: cytochrome b in sharks and
      mammals.
AB  - DNA sequences for the mitochondrial cytochrome b gene were determined for 13
      species of sharks. Rates and patterns of amino acid replacement are compared for
      sharks and mammals. Absolute rates of cytochrome b evolution are six times slower
      in sharks than in mammals. Bivariate plots of the number of nonsynonymous and
      silent transversions are indistinguishable in the two groups, however, suggesting
      that the differences in amino acid replacement rates are due primarily to
      differences in DNA substitution rates. Patterns of amino acid replacement are
      also similar in the two groups. Conserved and variable regions occur in the same
      parts of the cytochrome b gene, and there is little evidence that the types of
      amino acid changes are significantly different between the groups. Similarity in
      the relative rates and patterns of protein change between the two groups prevails
      despite dramatic differences in the cellular environments of sharks and mammals.
      Poor penetrance of physiological differences through to rates of protein
      evolution provides support for the neutral theory and suggests that, for
      cytochrome b, patterns of evolution have been relatively constant throughout much
      of vertebrate history.

PMID- 8355605
TI  - Phylogenetic analysis of the outer-membrane-protein genes of Chlamydiae, and its
      implication for vaccine development.
AB  - Examination of 18 complete and 6 partial sequences of the major outer-membrane
      protein from 24 chlamydiae isolates was used to reconstruct their evolutionary
      relationships. From this analysis, assuming that the clades with 100% bootstrap
      support are correct, come the following conclusions: (1) The tree of these
      sequences is not congruent with the phylogeny of the hosts, and thus host
      switching would seem to have occurred, thereby limiting the extent to which there
      has been coevolution of parasite and host. (2) The tree is also noncongruent with
      clustering by type of cell infected, thereby limiting the extent to which there
      has been coevolution of parasite and the cell type that it infects. (3) The tree
      is also noncongruent with clustering by the organ infected (eyes or genitalia),
      thereby limiting the extent to which there has been coevolution of parasite and
      the organ that it infects. (4) The tree is also noncongruent with genital strains
      arising from lymphogranuloma venereum strains. (5) The tree is also noncongruent
      with the geographic site at which the isolates were obtained, thereby limiting
      the extent of divergence explained by geographic separation. (6) There are
      estimated to be 185 amino acid positions that are invariable (as opposed to
      unvaried) in the major outer-membrane protein. There are 10 unvaried positions in
      the variable domains, of which 9 appear to be invariable, giving some reason to
      hope that development of a vaccine might be possible. (7) The rate of change of
      this protein is too small to see increased divergence over the time span of
      isolation of these genes, giving hope to any vaccine having longevity.
      Bootstrapping supports those portions of the tree on which the first five
      conclusions above depend. The picture that these results provide is more one of
      pathogen versatility than one of coevolutionary constraints. In addition, we
      examined 10 60-KDa, outer-membrane protein-2 genes, all but one of which were
      from these same strains. The tree was not, among the trachomatis strains,
      congruent with the major-outer-membrane protein tree, suggesting that gene
      exchange could be occurring among strains. Moreover, there is an apparent
      slowdown in divergence in this gene, among the trachomatis strains.

PMID- 8355606
TI  - Rolling circle-replicating plasmids from gram-positive and gram-negative
      bacteria: a wall falls.
AB  - Rolling circle-replicating plasmids constitute a group of small, promiscuous
      multicopy replicons spread among eubacteria. Until recently, rolling circle
      replication seemed to be limited to small plasmids from Gram-positive hosts and
      to single-stranded bacteriophages from Gram-negative bacteria. However,
      characterization of two small plasmids from Gram-negative hosts has shown that
      this replication mechanism is general among eubacteria. This review focuses on a
      family of highly related promiscuous plasmids that replicate by the rolling
      circle mechanism, and that have been isolated from various Gram-positive bacteria
      and from the Gram-negative bacterium Helicobacter. They all share homologies at
      the leading-strand origins and at the initiator of replication proteins. The
      plasmids of this family have directly repeated sequences at their plus origin of
      replication, which is located 5' from the start point of the mRNA for the
      initiation of replication protein. Replication is controlled by an antisense RNA
      and by a transcriptional repressor protein. The features and regulatory circuits
      of replication of this plasmid family seem to be unique among rolling circle
      replicating plasmids. Members of this family replicate autonomously in Gram
      positive and -negative hosts.

PMID- 8355607
TI  - Electrophoretic karyotyping of the lignin-degrading basidiomycete Phanerochaete
      chrysosporium.
AB  - Electrophoretic karyotyping of the two most widely studied strains of
      Phanerochaete chrysosporium, BKMF-1767 and ME-446, has been determined using
      transverse alternating field electrophoresis. The genomic DNA of BKMF-1767 was
      resolved into 10 chromosomes ranging in size from 1.8-5.0 Mb, amounting to a
      total genome size of about 29 Mb. The genomic DNA of strain ME-446, on the other
      hand, was resolved into 11 chromosomes, amounting to a total genome size of about
      32 Mb. Lignin peroxidase genes have been localized to five chromosomes in strain
      BKMF-1767 and to four chromosomes in strain ME-446.

PMID- 8355608
TI  - An M protein with a single C repeat prevents phagocytosis of Streptococcus
      pyogenes: use of a temperature-sensitive shuttle vector to deliver homologous
      sequences to the chromosome of S. pyogenes.
AB  - The major virulence factor of the important human pathogen Streptococcus pyogenes
      is the M protein, which prevents phagocytosis of the bacterium. In different
      strains of streptococci, there are over 80 serologically different M proteins and
      there are additional M-like proteins, some of which bind immunoglobulins.
      Although the sequence of the M molecules differs among different S. pyogenes
      strains, all M proteins, and some of the immunoglobulin-binding molecules, have
      at least two copies of the C repeat region. We describe construction of a
      deletion mutation in S. pyogenes, which has only one C repeat copy, and show that
      the mutant strain is still resistant to phagocytosis. The mutation was
      constructed in vitro and used to replace the resident emm allele in an S.
      pyogenes strain. To facilitate homologous recombination into the streptococcal
      chromosome, we adapted a shuttle vector which is temperature sensitive for
      replication in Gram-positive bacteria but not in Gram-negative hosts. This new
      method for delivery of a homologous DNA fragment to the S. pyogenes chromosome is
      efficient and reproducible and should be of general use.

PMID- 8355609
TI  - Sequence and analysis of the genetic locus responsible for surfactin synthesis in
      Bacillus subtilis.
AB  - The chromosomal region of Bacillus subtilis comprising the entire srfA operon,
      sfp and about four kilobases in between have been completely sequenced and
      functionally characterized. The srfA gene codes for three large subunits of
      surfactin synthetase, 402, 401 and 144 kDa, respectively, arranged in a series of
      seven amino acid activating domains which, as shown in the accompanying
      communication, recognize and bind the seven amino acids of the surfactin peptide.
      The srfA amino acid activating domains share homologies with similar domains of
      other peptide synthetases; in particular, regions can be identified which are
      more homologous in domains activating the same amino acid. A fourth gene in srfA
      encodes a polypeptide homologous to grsT. Four genes are positioned between srfA
      and sfp, the disruption of which does not affect surfactin biosynthesis.

PMID- 8355610
TI  - Characterization of the srfA locus of Bacillus subtilis: only the valine
      activating domain of srfA is involved in the establishment of genetic competence.
AB  - srfA is a locus required for the production of the lipopeptide antibiotic
      surfactin. This locus is also necessary for efficient sporulation and competence
      development. Mutations in the 5' portion of the srfA operon affect all three of
      these processes, whereas mutations in the 3' portion of srfA only affect
      sporulation and surfactin production. Analysis of the proteins encoded by the
      srfA locus revealed seven large domains which are likely to be responsible for
      the activation and binding of the seven amino acids of surfactin. Identification
      of the amino acid that is activated by the srfA domains was determined by amino
      acid-dependent pyrophosphate exchange reactions on partially purified cell
      extracts of strains carrying different srfA mutations. These results indicate
      colinearity between the order of the domains in the srfA locus and the amino acid
      sequence of surfactin. The minimal genetic element of srfA required for the
      establishment of competence was shown to be the 5' region of the second open
      reading of srfA, which encodes the valine activation domain. This portion of
      srfA, when cloned on a plasmid, complemented the competence deficiency of a srfA
      deletion mutant in trans.

PMID- 8355611
TI  - Identification of cpsD, a gene essential for type III capsule expression in group
      B streptococci.
AB  - We showed previously that a mutant strain of group B Streptococcus (GBS)
      defective in capsule production was avirulent. This study describes the
      derivation of an unencapsulated mutant from a highly encapsulated wild-type
      strain of type III GBS, COH1, by transposon mutagenesis with Tn916 delta E. The
      mutant, COH1-13, was sensitive to phagocytic killing by human leukocytes in vitro
      and was relatively avirulent in a neonatal rat sepsis model compared with the
      wild-type strain. No capsular polysaccharide was evident in the cytoplasm or on
      the cell surface of the mutant strain. The Tn916 delta E insertion site in COH1
      13 was mapped to the same chromosomal location as the Tn916 insertion site in the
      unencapsulated type III mutant COH31-15 reported previously. Nucleotide
      sequencing of DNA flanking the insertion site in COH1-13 revealed an open reading
      frame, designated cpsD, with significant homology to the rfbP gene of Salmonella
      typhimurium. RfbP encodes a galactosyl transferase enzyme that catalyses the
      transfer of galactose to undecaprenol phosphate, the initial step in O
      polysaccharide synthesis. A particulate fraction of a lysate of wild-type strain
      GBS COH1 mediated the transfer of galactose from UDP-galactose to an endogenous
      acceptor. The galactose-acceptor complex partitioned into organic solvents,
      suggesting it is lipid in nature or membrane-associated. Galactosyl transferase
      activity was significantly reduced in the unencapsulated mutant strain COH1-13.
      These results, together with the similarity in deduced amino acid sequence
      between cpsD and rfbP suggest that cpsD encodes a galactosyl transferase
      essential for assembly of the GBS type III capsular polysaccharide.

PMID- 8355612
TI  - Proteins essential for expression of the Hms+ phenotype of Yersinia pestis.
AB  - One characteristic of pigmented (Pgm+) cells of Yersinia pestis is the adsorption
      of sufficient quantities of exogenous haemin during growth at 26 degrees C to
      form dark-brown colonies. Carriage of the cloned haemin-storage (hms) locus in
      pHMS1 restores this phenotype to spontaneous Pgm- chromosomal deletion mutants of
      Y. pestis. We have mapped the location of the structural genes for four proteins
      encoded on pHMS1 using minicell, in vitro transcription/translation, and
      complementation analysis. The hmsH and hmsF genes encode 90 kDa and 72 kDa
      protein precursors processed to surface-exposed, outer membrane proteins of 86
      kDa and 70 kDa, respectively. Beta-galactosidase positive MudII1734 insertions in
      hmsR suggest that it encodes a protein that is also essential for haemin storage.
      Finally, the structural gene for a 41 kDa protein lies distal to the hmsH gene
      but, unlike hmsH, hmsF, and hmsR, its expression is not essential for the Hms+
      phenotype in Y. pestis.

PMID- 8355613
TI  - Synthesis of the Escherichia coli K-12 nucleoid-associated DNA-binding protein H
      NS is subjected to growth-phase control and autoregulation.
AB  - Mutations in the structural gene (hns) for the Escherichia coli nucleoid
      associated DNA-binding protein H-NS cause highly pleiotropic effects on gene
      expression, site-specific recombination, transposition of phage Mu, the stability
      of the genetic material and the topological state of the DNA. We have
      investigated the regulation of hns expression and found that hns transcription is
      subjected to stationary phase induction and negative autoregulation. A set of hns
      lacZ protein and operon fusions was constructed in vitro and integrated in single
      copy into the attB site of the bacterial genome. Quantification of beta
      galactosidase activity along the bacterial growth curve showed that hns
      expression increases approximately 10-fold in stationary phase compared with
      exponentially growing cells. Immunological detection of the H-NS protein in
      growing and stationary phase cells supported the genetic data and showed that H
      NS synthesis varies with growth phase. In addition, primer extension experiments
      demonstrated that the amount of hns mRNA is elevated in stationary phase cultures
      and that hns transcription is directed by a unique promoter functioning in both
      log and stationary phase. Disruption of the hns gene by an insertion mutation led
      to the derepression (approximately fourfold) of the expression of an hns-lacZ
      operon fusion integrated at the attB site, showing that hns transcription is
      subjected to negative regulation by its own gene product. Autoregulation of hns
      expression is particularly pronounced in log phase. Both stationary phase control
      and autoregulation of hns transcription are associated with a 130 bp fragment
      that contains the hns promoter. In order to study the interaction of H-NS with
      its own regulatory region, we developed an efficient overproduction procedure and
      a simple purification scheme for H-NS. DNA gel retardation assays showed that the
      H-NS protein can preferentially interact with a restriction fragment carrying the
      hns promoter. This restriction fragment showed features of curved DNA as judged
      by two-dimensional polyacrylamide gel electrophoresis performed at 4 degrees C
      and 60 degrees C.

PMID- 8355614
TI  - The role of galE in the biosynthesis and function of gonococcal
      lipopolysaccharide.
AB  - Lipopolysaccharide is an essential component of the outer membrane of Gram
      negative bacteria and an important virulence factor of many pathogens, such as
      Neisseria gonorrhoeae. We have cloned the gonococcal galE gene which was found to
      be located in the gonococcal homologue of the meningococcal capsule gene complex
      region D. Sequence alignment indicated extensive homology with the Escherichia
      coli and Salmonella GalE proteins. Mutants with insertions in the galE gene were
      used as a tool to characterize the structure and function of gonococcal
      lipopolysaccharide. They displayed deep rough phenotypes, and chemical analysis
      confirmed the loss of galactose from the mutant lipopolysaccharide. Functional
      analysis indicated that the terminal oligosaccharides contain galactose and that
      these are lost in galE mutants. The importance of these oligosaccharides in
      gonococcal biology is clear from the fact that they contain the epitopes that are
      the targets for killing by normal human serum, and the acceptor site for sialic
      acid, which acts to protect the gonococcus from this killing. Furthermore,
      infection experiments in vitro indicate that the galE mutants exhibit unaltered
      intergonococcal adhesion as well as adhesion to, and invasion of, epithelial
      cells.

PMID- 8355615
TI  - Sequence, genetic, and lacZ fusion analyses of a nifR3-ntrB-ntrC operon in
      Rhodobacter capsulatus.
AB  - Transcription of Rhodobacter capsulatus genes encoding the nitrogenase
      polypeptides (nifHDK) is repressed by fixed nitrogen and oxygen. Regulatory genes
      required to sense and relay the nitrogen status of the cell are glnB, ntrB
      (nifR2), and ntrC (nifR1). R. capsulatus nifA1 and nifA2 require ntrC for
      activation when fixed nitrogen is limiting. The polypeptides encoded by nifA1 and
      nifA2 along with the alternate sigma factor RpoN activate nifHDK and the
      remaining nif genes in the absence of both fixed nitrogen and oxygen. In this
      study we report the sequence and genetic analysis of the previously identified
      nifR3-ntrB-ntrC regulatory locus. nifR3 is predicted to encode a 324-amino-acid
      protein with significant homology to an upstream open reading frame cotranscribed
      with the Escherichia coli regulatory gene, fis. Analysis of ntrC-lacZ fusions and
      complementation data indicate that nifR3 ntrBC constitute a single operon. nifR3
      lacZ fusions are expressed only when lacZ is in the proper reading frame with the
      predicted nifR3 gene product. Tn5, a kanamycin-resistance cassette, and miniMu
      insertions in nifR3 are polar on ntrBC (required for nif transcription). This
      gene organization suggests that the nifR3 gene product may be involved in
      nitrogen regulation, although nifR3 is not stringently required for nitrogen
      fixation when ntrBC are present on a multicopy plasmid. In addition, a R.
      capsulatus strain with a 22-nucleotide insert in the chromosomal nifR3 gene was
      constructed. This nifR3 strain is able to fix nitrogen and activate nifA1 and
      nifA2 genes, again supporting the hypothesis that nifR3 is not stringently
      required for ntrC-dependent gene activation in R. capsulatus.

PMID- 8355616
TI  - Formation of a putative relaxation intermediate during T-DNA processing directed
      by the Agrobacterium tumefaciens VirD1,D2 endonuclease.
AB  - During the initial stages of crown gall tumorigenesis, the T-DNA region of the
      Agrobacterium tumefaciens Ti-plasmid is processed, resulting in the production of
      T-DNA molecules that are subsequently transferred to the plant cell. Processing
      of the T-DNA in the bacterium involves the nicking of T-DNA border sequences by
      an endonuclease encoded by the virD locus, and the subsequent tight (possibly
      covalent) association of the VirD2 protein with the 5' end of the processed
      single-stranded or double-stranded T-DNA molecule. To investigate the interaction
      of the VirD1,D2 endonuclease with a right T-DNA border, a set of plasmids
      containing both the border and virD sequences on the same high-copy-number
      replicon has been constructed and introduced into Escherichia coli. In this model
      system a tight nucleoprotein complex is formed between the relaxed double
      stranded substrate plasmid and the VirD2 protein. This putative T-DNA processing
      complex may be analogous to the covalent relaxation complex formed between the
      pilot protein and plasmid DNA during bacterial conjugation. VirD2 attachment to
      the relaxed substrate plasmid was resistant to denaturing agents but sensitive to
      S1 nuclease digestion, indicating a single-stranded region near the site of
      protein attachment. We speculate that this structure may be an intermediate
      formed prior to T-strand unwinding from the substrate plasmid in a host
      bacterium.

PMID- 8355617
TI  - Molecular cloning of a gene involved in glucose sensing in the yeast
      Saccharomyces cerevisiae.
AB  - Cells of the yeast Saccharomyces cerevisiae display a wide range of glucose
      induced regulatory phenomena, including glucose-induced activation of the RAS
      adenylate cyclase pathway and phosphatidylinositol turnover, rapid post
      translational effects on the activity of different enzymes as well as long-term
      effects at the transcriptional level. A gene called GGS1 (for General Glucose
      Sensor) that is apparently required for the glucose-induced regulatory effects
      and several ggs1 alleles (fdp1, byp1 and cif1) has been cloned and characterized.
      A GGS1 homologue is present in Methanobacterium thermoautotrophicum. Yeast ggs1
      mutants are unable to grow on glucose or related readily fermentable sugars,
      apparently owing to unrestricted influx of sugar into glycolysis, resulting in
      its rapid deregulation. Levels of intracellular free glucose and metabolites
      measured over a period of a few minutes after addition of glucose to cells of a
      ggs1 delta strain are consistent with our previous suggestion of a functional
      interaction between a sugar transporter, a sugar kinase and the GGS1 gene
      product. Such a glucose-sensing system might both restrict the influx of glucose
      and activate several signal transduction pathways, leading to the wide range of
      glucose-induced regulatory phenomena. Deregulation of these pathways in ggs1
      mutants might explain phenotypic defects observed in the absence of glucose, e.g.
      the inability of ggs1 diploids to sporulate.

PMID- 8355618
TI  - The importance of morphological events and intercellular interactions in the
      regulation of prespore-specific gene expression during sporulation in Bacillus
      subtilis.
AB  - We have established a time course for the early morphological events of
      sporulation in Bacillus subtilis and related this to changes in gene expression,
      particularly those occurring in the prespore compartment. We have also
      systematically studied the effects of mutations in various regulatory (spo) genes
      on prespore-specific gene expression. On the basis of these results, and those of
      other laboratories, at least four distinct temporal classes of prespore-specific
      gene expression can now be distinguished. The first class begins within 15 min of
      the formation of the spore septum, and requires the sigma F form of RNA
      polymerase. The second class, also directed by RNA polymerase containing sigma F,
      begins soon after the completion of prespore engulfment, and depends on an
      intercellular signal from the mother cell. This transcription results in
      synthesis of sigma G. However, sigma G activity, directing the third class of
      gene expression, appears only about 30 min later and is dependent on the
      completion of prespore engulfment and on further interactions with the mother
      cell. The fourth class of gene expression has been described. The results
      demonstrate that the prespore programme of gene expression incorporates a series
      of control points modulated by information from the mother cell and on progress
      through the morphogenetic process.

PMID- 8355619
TI  - Nucleotide substitutions and small-scale insertion produce size and antigenic
      variation in group A streptococcal M1 protein.
AB  - The presence of M protein on the surface of group A streptococci (GAS) confers
      the ability of the cell to resist phagocytosis in the absence of type-specific
      antibodies. It undergoes antigenic variation with more than 80 different
      serotypes having been defined. We have sequenced the M protein gene (emm1.1) from
      strain CS190 and present evidence that individual nucleotide substitutions are
      responsible for sequence variation in the N-terminal non-repeat region of emm1.1
      and these substitutions have altered antibody recognition of opsonic epitopes.
      The N-terminal non-repeat domains of two other closely related strains, 71-155
      and 76-088, were found to have sequence identical to emm1.1 with the addition of
      a 21 bp insert. This study provides the first evidence that nucleotide
      substitutions and small insertions are responsible for size and antigenic
      variation in the N-terminal non-repeat domain of the M protein of GAS.

PMID- 8355620
TI  - In vitro modification of human immunodeficiency virus type 1 (HIV-1) infectivity
      by the U937 cells.
AB  - The effect of host cell factors on infectivity of human immunodeficiency virus
      type 1 (HIV-1) was studied by infecting a monoblastoid cell line (U937) or a T
      cell line (MOLT-4) with a highly infective single clone of HIV-1 and comparing
      the infectivity of the produced viruses to different cell lines. Chronically
      infected U937 cells consistently produced viruses with minimal infectivity. This
      phenotypic change was host-dependent as the back-passage of the U937-produced low
      infective viruses into MOLT-4 cells resulted in regaining their original high
      infectivity. Southern and Northern blot analyses of the HIV-1 grown in U937 cells
      did not reveal any genomic difference between it and the virus grown it MOLT-4
      cells. The radioimmunoprecipitation analysis of viral proteins showed that the
      HIV-1-infected U937 cells had a different pattern of envelope glycoproteins and
      core proteins, which well correlated with the low infectivity of the produced
      viruses. This experimental system using MOLT-4 and U937 cell lines would be
      useful to further explore host cell factor(s) which play an important role in the
      regulation of HIV-1 infectivity.

PMID- 8355621
TI  - Yersinia pseudotuberculosis in Italy. Attempted recovery from 37,666 samples.
AB  - From 1981 to 1991, 37,666 human, animal, food and environmental samples were
      cultured for Yersinia pseudotuberculosis using direct plating methods and/or cold
      enhancement techniques. Despite an intensive surveillance and adequate culture
      methods, Y. pseudotuberculosis was isolated from stools of 0.05% (5/9,720) of
      patients with acute enteritis, and alimentary tracts of 0.1% (10/6,849) of
      apparently healthy animals. No Y. pseudotuberculosis strains were recovered from
      stools of 4,726 health controls nor from the appendices (656), mesenteric lymph
      nodes (84), and stools (421) of 656 patients operated for suspected appendicitis.
      Of the 10,842 food and 4,368 environmental samples, none yielded positive
      cultures for Y. pseudotuberculosis.

PMID- 8355622
TI  - Similarity in nucleotide sequence of the gene encoding nontoxic component of
      botulinum toxin produced by toxigenic Clostridium butyricum strain BL6340 and
      Clostridium botulinum type E strain Mashike.
AB  - The complete nucleotide and deduced amino acid sequence of the nontoxic component
      of botulinum type E progenitor toxin is determined in recombinant plasmid pU9BUH
      containing about 6.0 kb HindIII fragment obtained from chromosomal DNA of
      Clostridium butyricum strain BL6340. The open reading frame (ORF) of this
      nontoxic component gene is composed of 3,486 nucleotide bases (1,162 amino acid
      residues). The molecular weight calculated from deduced amino acid residues is
      estimated 13,6810.1. The present study revealed that 33 nucleotide bases of 3,486
      are different in the nontoxic component gene between C. butyricum strain BL6340
      and C. botulinum type E strain Mashike. This corresponds to the difference of 17
      amino acid residues in these nontoxic component.

PMID- 8355623
TI  - Studies on hemolytic action of a hemolysin produced by Vibrio mimicus.
AB  - Some properties and mechanism of action of a hemolysin (VMH) produced by an
      enteropathogenic Vibrio mimicus strain was examined. VMH was heat-labile and
      inhibited by addition of divalent cations, including Ca2+, Mg2+ and Mn2+. The
      hemolysis by VMH was inhibited by incubating with gangliosides, suggesting that
      the ganglioside was the binding site on the erythrocyte membrane for VMH.
      Existence of a galactose moiety on reducing end of the ganglioside molecule and a
      sialic acid on the galactose moiety was suggested to be important for the binding
      of VMH molecule. Colloid osmotic manner of the hemolysis by VMH was demonstrated.

PMID- 8355624
TI  - Identification and characterization of heat-stable enterotoxin II-producing
      Escherichia coli from patients with diarrhea.
AB  - Stock strains of Escherichia coli isolated from patients with traveller's
      diarrhea were examined for production of heat-stable enterotoxin II (STII). Of
      400 strains examined, 3 were found to produce STII. The nucleotide sequence of
      the STII gene of these human strains was shown to be identical to that of porcine
      strains. Cultured cells of these strains induced fluid accumulation in ligated
      mouse intestinal loops and the activity was neutralized by anti-STII antiserum.
      These results suggest that STII-producing enterotoxigenic E. coli can cause human
      diarrhea.

PMID- 8355625
TI  - [The role of Bacillus thuringiensis in natural biocenoses].
AB  - The results of the author's data and those from literature on ecology and genetic
      exchange of Bacillus thuringiensis strains have been analyzed in this brief
      review. It has been concluded that there is no strict confinement of B.
      thuringiensis strains of the particular serotypes to certain habitat and that the
      bacteriocinogenicity is of great importance in the intraspecies competition and
      stability of strains in nature. It has been emphasized that the plasmid
      conjugation process in B. thuringiensis can serve as a main factor of genetic
      variability to establish ecological placement of these bacteria.

PMID- 8355626
TI  - [Inhibitors of nucleic acid synthesis as a means of identifying the forms of DNA
      dependent DNA polymerases in Acholeplasma laidlawii PG-8 and of determining their
      functions].
AB  - Antibiotics, inhibitors of nucleic acids' synthesis from the group of
      chromomycins (olivomycin of sodium salt), anthracyclines (carminomycin and
      doxorubicin) and streptonigrin (bruneomycin) have been studied for their effect
      on DNA synthesis in vitro performed by DNA polymerases (1st and 2nd forms) of
      Acholeplasma laidlawii PG-8. It has been stated that olivomycin inhibits the
      function of both the first and second forms of DNA polymerases in proportion to
      an increase of the antibiotic concentration in the medium. Carminomycin in the
      concentration of about 1 microgram/ml almost completely inhibited the activity of
      both DNA polymerases. However, doxorubicin also belonging to the group of
      anthracyclins completely inhibited the activity of the first form of DNA
      polymerase in the concentration of 1 microgram/ml and practically has no effect
      in the concentration up to 100 micrograms/ml on the activity of the second form
      possessing 3'-->5'-function. Streptonigrin also proved to be suitable for
      differentiate the forms of DNA polymerases and to determine their functions. The
      first form of DNA polymerase with 5'-->3'-polymerase and exonuclease functions
      was not sensitive by this antibiotic in the concentration of 1000 micrograms/ml,
      while the activity of the second form of DNA polymerase with 3'-->5'-exonuclease
      functions was fully inhibited by this concentration of the antibiotic in the
      medium. The combination of doxorhubicin and streptonigrin in the medium can be
      used to determine the form of DNA polymerases and to identify their 5'-->3'- or
      3'-->5'-exonuclease function and for selectivity inhibition of the function of
      one or another DNA polymerase in the medium.

PMID- 8355627
TI  - D. K. Zabolotny Institute of Microbiology and Virology of the Academy of Sciences
      of the Ukraine (to the 65th anniversary of foundation).

PMID- 8355628
TI  - [The growth and sporulation of Bacillus subtilis under different aeration
      conditions].
AB  - The dynamics of accumulation of Bacillus subtilis 39 cells and spores under
      different conditions of aeration has been studied. It is shown possible to
      intensify the process of growth, biomass accumulation and sporulation of bacteria
      using aeration conditions. The growth of cells of the studied bacilli proceeds
      under conditions of providing the culture with oxygen according to its real
      demands for the whole period of fermentation. The mathematical models have been
      obtained which connect the aeration conditions with the rate of biomass
      accumulation and sporulation of the studied bacteria. It has been stated that
      with an increase of aeration the yield of microbic cells, degree of using the
      substrate by them as well as the specific growth rate become higher. Intensive
      aeration 4.4 = 5.8 g O2/l.h promotes the creation of the most optimal conditions
      for the growth of bacteria. While deteriorating the aeration to 3.2 g O2/l.h and
      over, the specific growth rate and yield of viable cells decrease. The optimal
      conditions of air feed and medium agitation rate decrease the duration of
      fermentation exerting no effect on the final yield of biomass. It is shown that
      yield of biomass and spores depends on the growth phase.

PMID- 8355629
TI  - [The interaction of pathogenic microorganisms with the sorbent
      polymethylsiloxane].
AB  - The method of electron microscopy has been used to study adhesion of the microbic
      cells of standard strains of Staphylococcus aureus, Escherichia coli and fungi of
      genus Candida on the organosilicon sorbent polymethylsiloxane (PMS) and
      medicamentous complex containing it. This complex contains furazolidone and
      metronidazole immobilized on silver ions-modified PMS. It is shown that the
      adhesion of microorganisms is accompanied by their destruction whose rate on pure
      PMS and medicamentous complex is different. Using experimental data the
      assumptions are advanced concerning the mechanism of the PMS interaction with
      Gram-positive and Gram-negative microorganisms as well as with fungi of genus
      Candida.

PMID- 8355630
TI  - [The use of the polymerase chain reaction method in studying the causative agents
      of diphtherial infection].
AB  - A method for identification of genomic polymorphism of strains belonging to
      different biovars Corynebacterium diphtheriae has been described. The method is
      based on the polymerase chain reaction (PCR) using universal inter-species
      oligonucleotide primer N 45. Using this method 17 strains of C. diphtheria,
      isolated in the western region of Ukraine during epidemic activity in 1992, were
      studied. The study has shown high similarity of PCR patterns of toxicogenic and
      non-toxicogenic strains of both mitis and gravis biovars. It is supposed that the
      method will be used in molecular epidemiology to identify new pathogenic isolates
      from different regions and countries.

PMID- 8355631
TI  - [The physiological-biochemical properties of Klebsiella pneumoniae strains of
      different origins].
AB  - While comparatively analyzing the properties of Klebsiella pneumoniae from three
      studied sources (patients, healthy people, environment), no reliable differences
      between the comparable strains have been revealed. No differences have been found
      in the toxin formation, hemagglutinating and antilysozymic activity, adhesivity
      and invasive properties as well as in the peculiarities of gas exchange, while
      growing on media with different nitrogen and carbon sources. The studied
      microorganisms differed only in antibiotic resistance: strains isolated from the
      environment were sensitive to antibiotics, whereas strains of human origin were
      resistant to them.

PMID- 8355632
TI  - [The bacteriological and immunological efficacy of biosporin in nonspecific
      ulcerative colitis].
AB  - The results from examination of intestinal microflora and immune status in 75
      patients with nonspecific ulcerative colitis with different degree of disease
      seriousness are presented. The deviations in the composition of normal microflora
      were primarily expressed in a decrease of the number of bifidobacteria. In 64.9%
      of patients the disease proceeded against the background of deficit of T-cellular
      immunity link. The sufficiently expressed bacteriological and immunological
      efficiency of complex therapy including preparation from spore-forming bacteria
      as a normalizer of microflora is shown.

PMID- 8355633
TI  - [The use of soil micromycetes for treating industrial sewage].

PMID- 8355634
TI  - [The count and distribution of saprophytic bacteria and bacteria of the E. coli
      group in the water of Odessa Bay and the adjacent waters].
AB  - The quantity and distribution of heterotrophic and enteric bacteria as indicators
      of the human activity influence on the marine ecosystem have been studied in
      water thickness of the Odessa Bay. It has been established that in the late
      autumn period the average quantity of heterotrophic bacteria in Bay waters is
      6500 cells/ml and the number of the enteric ones--2400 cells/l. The spatial
      distribution of the heterotrophic bacterioplankton was mosaic and a tendency to
      decrease their quantity while moving away from the shore was not observed. This
      indicated the absence of the shore flow influence on the distribution of
      heterotrophic bacteria. On the contrary, the number of enteric bacteria
      significantly decreased with an increase of the distance from the shore, but on
      the greater part of the Bay they were absent at all. As to the vertical
      distribution of the heterotrophic bacteria quantity their maximum was in the
      water layer (0.5) below the surface, whereas the distribution of enteric bacteria
      did not correspond to this rule. Proceeding from the number of heterotrophic
      bacteria in the late autumn period waters of the Odessa Bay can be characterized
      as mesoeutrophic and according to the value of coli-index--as mesosaprobic ones.

PMID- 8355635
TI  - [The species composition of the micromycetes in feed and their role in animal
      kojic acid toxicosis].
AB  - Microflora of more than 100 samples of different sorts of foodstuff (coarse
      fodder, grain forage, mixed fodder, premixes, silo, whole milk substitute etc.)
      selected in 1989-1992 in the period of mass diseases and death of animals in
      farms of Ukraine has been studied. It is shown that the amount of spore material
      included in lg of fodder, depends on the sort of feed substrate. Grains and grain
      forage (94.5 thou. spores in 1 g) occupy the first place in sporification with
      fungi; vetch-oat mixture and whole milk substitute (82-89 thou. spores)--the
      second place; mixed fodder granules and maize briquettes (79.5-66.5 thou. spores)
      -the third place; the latter are mixed fodder plants hay, cereals straw (11.8
      43.5 thou. spores). Aspergillus mainly occurred on the concentrated forage,
      grain, grain forage, in less amount--in grass stand, cereals straw. Penicilli,
      fusari and other species of saprophytic fungi dominated on hay of natural
      meadows, on mixed fodder plants and cereals straw. It has been stated that the
      highest toxicity was typical of the fodder samples infected with Aspergillus
      strains producing kojic acid. Under conditions of our experiments out of 67
      strains of genus Aspergillus kojic acid was synthesized by 48.6% of the total
      number of the tested fungus cultures. The greatest number of kojic acid producers
      was found among Aspergillus flavus isolates (56.8%) the less number--among A.
      fumigatus (36.7%). Kojic acid has been revealed to exert a pathological effect on
      the organism of different animal species.

PMID- 8355636
TI  - [The determination of tetanus antitoxin by the latex agglutination reaction].
AB  - A new method to detect the protective value of antitetanic antibody in latex
      agglutination test (LAT) has been described. The new method is highly sensitive
      and fast, and requires no special equipment. The optimal conditions of
      sensibilization, latex types, test providing procedure have been selected. New
      LAT detects approximately 0.0015 IU antitoxin per ml. This method can be used to
      determine the state of immunization of population against tetanus and to detect
      the protective antibodies in production series of human and horse antitetanic
      immunoglobulins.

PMID- 8355637
TI  - [The modification of a nutrient medium for determining the toxigenicity of
      Corynebacterium diphtheriae].
AB  - The nutrient medium has been developed on the basis of home components to
      determine toxigenicity of Corynebacterium diphtheriae using the biological method
      of diphtheria diagnosis. The advantage of the proposed nutrient medium is
      independence of delivers of commercial dry nutrient agar from Dagestan Research
      Institute of Nutrient Media.

PMID- 8355638
TI  - [Synchronization of bacterial division in rapid change of tryptone
      concentration].
AB  - Rapid decrease from 1 to 0.4% or rapid increase from 0.4 to 15 in tryptone
      concentration caused synchronization of cell division in a culture of Escherichia
      coli. The effect was not observed for the mutants impaired in reception of taxis
      system AW-569 and AW-618. Maintenance of the constant concentration of serine
      prior to and after alteration in tryptone concentration prevented synchronization
      in wild-type strains J621 and AW-405. Based on the results obtained, it was
      inferred that reception of the change in the concentration of the substrates
      attractants is necessary for synchronization of bacterial cell division this way.

PMID- 8355639
TI  - Thalamic vacuolation in acute Wernicke's encephalopathy [corrected].
AB  - Two patients with acute Wernicke's encephalopathy, with the diagnosis confirmed
      pathologically at autopsy, showed substantial vacuolation and neuronal
      degeneration in discrete nuclei of the thalamus. Thalamic vacuolation has not
      been described previously in acute Wernicke's encephalopathy. The use of frozen
      sections to minimize processing artifact was fundamental in demonstrating this
      pathology. The pathogenic mechanism underlying this change appears to be
      different to that seen in the more typical periventricular, mamillary body and
      brainstem lesions. We hypothesize that a specific neural pathway may be involved
      and suggest that this pathway could be the ascending nitric oxide-containing
      cholinergic pathway from the brainstem.

PMID- 8355640
TI  - Metabolic changes in axotomized fetal and early postnatal hamster facial
      motoneurons: an autoradiographic study.
AB  - The developing facial neurons of a series of hamsters ranging in age from the 14
      day fetus to the 9 day postnatal were axotomized. Postoperative times were graded
      for each age so that the retrograde response could be observed before any
      significant amount of cell degeneration or death occurred. The incorporation of
      tritiated uridine was followed by the autoradiographic procedure. Although grain
      counts, relative to control values, were significantly reduced only in the
      axotomized fetus and at 24 hours postoperatively in 4-day postnatal animals,
      there was also a repression of isotopic incorporation in all the other axotomized
      animals. These results support data obtained from previous work with the hamsters
      which indicate that it is not until after the nerve cell nucleolus reaches full
      cytomorphic maturity (between 15 and 20 days postnatal age in hamster facial
      neurons) that the axotomized neurons respond with significantly increased
      incorporation levels of isotope over that of control neurons.

PMID- 8355643
TI  - [Reflections on the use of ultrasonic diagnosis in pediatrics].

PMID- 8355641
TI  - Binding of the ligand [3H]MK-801 to the MK-801 binding site of the N-methyl-D
      aspartate receptor during experimental encephalopathy from acute liver failure
      and from acute hyperammonemia in the rabbit.
AB  - Binding of the ligand [3H]MK-801 to the MK-801 binding site of the N-methyl-D
      aspartate (NMDA) receptor population on brain homogenates in rabbits was studied
      during experimental encephalopathy from acute liver failure and from acute
      hyperammonemia in the rabbit. Homogenates were prepared from brain cortex,
      hippocampus and striatum. Hepatic encephalopathy was induced by a two-stage liver
      devascularization procedure and acute hyperammonemia by a prolonged ammonium
      acetate infusion; rabbits receiving a sodium-potassium-acetate infusion served as
      controls. In these animal models extracellular brain glutamate levels are known
      to be elevated. However no significant alterations in the number nor the affinity
      of the MK-801 binding sites of the NMDA receptors were found during acute liver
      failure and acute hyperammonemia. These findings suggest that the NMDA receptor
      population remains unaltered in experimental encephalopathy from acute liver
      failure and acute hyperammonemia, despite alterations in extracellular brain
      glutamate levels.

PMID- 8355642
TI  - Neuronal and glial marker proteins in encephalopathy associated with acute liver
      failure and acute hyperammonemia in the rabbit.
AB  - Neuronal and glial cell marker proteins were quantified in order to evaluate the
      possibility of increased proteolysis in the brain of rabbits with acute liver
      failure and acute hyperammonemia. Acute liver failure was induced by a two-stage
      devascularization procedure. Acute hyperammonemia was induced by a prolonged
      infusion of ammonium acetate, which simulates the plasma ammonia level in acute
      liver failure. Control animals received an infusion of sodium/potassium acetate.
      After development of severe encephalopathy, the animals were sacrificed (13.7 +/-
      1.3 hours for rabbits with acute liver failure and 20.2 +/- 0.8 hours for rabbits
      with hyperammonemia) (x +/- S.E.M./n = 6) and their brains were dissected into
      cerebral cortex, hippocampus, cerebellum and brain stem. The total protein
      content and the concentrations of the neuronal cell marker proteins NSE (neuron
      specific enolase), NF68 and NF200 (68 kD and 200 kD neurofilament polypeptides)
      and the glial cell marker proteins GFAP (glial fibrillary acidic protein) and S
      100 were determined. Total protein content was decreased in the brain stem in
      acute hyperammonemia only. The content of neuronal and glial cell markers was not
      affected in either of the two conditions. However, low molecular weight
      proteolytic fragments of the NF 68 kD polypeptide were observed in the
      hippocampus of three out of six animals in both experimental groups. No
      proteolytic degradation of GFAP was observed. The results show that, in
      experimental encephalopathy due to acute liver failure and acute hyperammonemia,
      no major changes occur in the marker proteins. The finding of proteolytic
      fragments of the NF68 polypeptide indicates that the neuronal population is
      affected prior to glial alterations. These findings are in agreement with the
      concept that acute hepatic encephalopathy is reversible and induces only slight
      structural changes.

PMID- 8355644
TI  - [Pulmonary complications after bone marrow transplantation].
AB  - Pulmonary toxicity occurs in approximately 10 to 50% of patients undergoing bone
      marrow transplantation (BMT). Bacterial pneumonia very commonly affects patients
      within the first 6 months post-BMT. Etiologic factors include neutropenia and the
      presence of graft-versus-host disease (GVHD). Pulmonary fungal infections, due to
      candida and aspergillus, may develop in 16% of patients receiving BMT, with a
      high mortality rate, being about 80%. A prolonged neutropenia as well as GVHD and
      associated immunosuppressive treatments are important factors in predisposing a
      patient to develop fungal pneumonitis. Interstitial pneumonitis occurs in 10-40%
      of patients; herpes viruses are the most commonly documented cause, with
      cytomegalovirus (CMV) being the most common pathogen. No causative organism is
      identified in up to 60% of the cases. It is likely that some of these cases may
      result from drug or radiation toxicity. Lung shielding and fractionation of the
      dose have decreased the incidence of interstitial pneumonitis to less than 5%.
      Patients with GVHD are predisposed to lung infections because of the
      immunosuppression that accompanies GVHD and its treatment. In addition, GVHD
      itself appears to have a direct effect on pulmonary epithelium. Cultural and
      serologic studies as well as radiographic investigations and other diagnostic
      procedures (ie bronchoalveolar lavage) are needed for appropriate management of
      pulmonary complications.

PMID- 8355645
TI  - [The timing of the start of rehabilitative intervention with the newborn infant
      at neurological risk].
AB  - The few studies related to the effect of the timing of intervention of high-risk
      infants, ie. early vs late, have produced equivocal results. The aim of this
      study was to investigate whether "critical periods" for intervention exist. Among
      the high-risk infants (previously assigned to one of 3 random samples), who
      achieved follow-up at 5 yrs of age, 36 received a prescribed intervention as soon
      in NICU (very early treatment group: ET Gr). The other 21 infants began to
      receive the treatment after discharge (postdischarge treatment group: PDT Gr.).
      The remaining 27 received only traditional care both during hospitalization and
      after discharge (control group: C Gr.). Treated infants both ET Gr. and PDT Gr.,
      exhibit significantly better neurological status than control infants, as
      assessed by Touwen Neurological Examination. They also scored significantly
      higher at standard psychological tests and have a significantly lower incidence
      of developmental sequelae. Insteated not significant differences of any of the
      measured outcomes were found between the ET Gr. and the PDT Gr. Delay in
      initiating intervention does not appear to reduce the benefits. Recent advances
      in the field of the developmental psychology have resulted in some new
      understandings of the early human behavior and the role of learning experiences
      in the developmental processes. Although learned changes in behavior occur from
      the earliest 2 and 4 months, when major physiologic/maturational changes are
      occurring (Lipsitt, 1986). Our findings are in accordance with the above
      statement and suggest that the crucial period for intervention is in 2 to 4 first
      months of life. Further studies are needed to solve the many unanswered questions
      in this controversial filed.

PMID- 8355646
TI  - [Boutonneuse fever in childhood: a pathology often underdiagnosed. A report of 2
      clinical cases].

PMID- 8355648
TI  - Missouri State Medical Association. 1993-1994 membership directory.

PMID- 8355647
TI  - [The Simpson-Golabi-Behmel syndrome. The stages of a diagnostic procedure].
AB  - We report on an Italian patient with growth excess, course face and normal
      psychomotor development, who had a diagnosis of Simpson-Golabi-Behmel. The
      clinical difference between this syndrome and lysosomal diseases and other
      syndromes with overgrowth is discussed.

PMID- 8355649
TI  - Isolation and characterization of genome-specific DNA sequences in Triticeae
      species.
AB  - Two contrasting genome-specific DNA sequences were isolated from Aegilops
      speltoides (wild goat grass) and Hordeum chilense (wild barley), each
      representing more than 1% of the genomes. These repetitive DNA fragments were
      identified as being genome-specific before cloning by genomic Southern
      hybridization (using total genomic DNA as a probe), and hence extensive screening
      of clones was not required. For each fragment, up to six recombinant plasmid
      clones were screened and about half were genome-specific. Clone pAesKB52 from Ae.
      speltoides was a 763 bp EcoRI fragment, physically organized in simple tandem
      repeats and shown to localize to sub-telomeric chromosome regions of species with
      the Triticeae S-genome by in situ hybridization to chromosomes. The sequence data
      showed an internal duplication of some 280 bp, which presumably occurred before
      sequence amplification and dispersion, perhaps by unequal crossing-over or
      reciprocal translocation. In situ hybridization showed that the sequence
      distribution varied between closely related (S-genome) species. Clone pHcKB6 was
      a 339 bp DraI fragment from H. chilense, also tandemly repeated but more
      variable; loss of the DraI site resulting in a ladder pattern in Southern blots
      which had little background smear. In situ hybridization showed that the tandem
      repeats were present as small clusters dispersed along all chromosome arms except
      at a few discrete regions including the centromeres and telomeres. The clone
      hybridized essentially specifically to the H-genome of H. chilense and hence was
      able to identify the origin of chromosomes in a H. chilense x Secale africanum
      hybrid by in situ hybridization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355650
TI  - Characterization of the Nicotiana tabacum L. genome by molecular cytogenetics.
AB  - Nicotiana tabacum (2n = 48) is a natural amphidiploid with component genomes S
      and T. We used non-radioactive in situ hybridization to provide physical
      chromosome markers for N. tabacum, and to determine the extant species most
      similar to the S and T genomes. Chromosomes of the S genome hybridized strongly
      to biotinylated total DNA from N. sylvestris, and showed the same physical
      localization of a tandemly repeated DNA sequence, HRS 60.1, confirming the close
      relationship between the S genome and N. sylvestris. Results of dot blot and in
      situ hybridizations of N. tabacum DNA to biotinylated total genomic DNA from N.
      tomentosiformis and N. otophora suggested that the T genome may derive from an
      introgressive hybrid between these two species. Moreover, a comparison of
      nucleolus-organizing chromosomes revealed that the nucleolus organizer region
      (NOR) most strongly expressed in N. tabacum had a very similar counterpart in N.
      otophora. Three different N. tabacum genotypes each had up to 9 homozygous
      translocations between chromosomes of the S and T genomes. Such translocations,
      which were either unilateral or reciprocal, demonstrate that intergenomic
      transfer of DNA has occurred in the amphidiploid, possibly accounting for some
      results of previous genetic and molecular analyses. Molecular cytogenetics of N.
      tabacum has identified new chromosome markers, providing a basis for physical
      gene mapping and showing that the amphidiploid genome has diverged structurally
      from its ancestral components.

PMID- 8355651
TI  - Consequences of unique double-stranded breaks in yeast chromosomes: death or
      homozygosis.
AB  - We have developed a system in which a unique double-stranded break (DSB) can be
      introduced into a yeast chromosome during mitotic growth. The recognition site
      for the endonuclease I-SceI was inserted at different places in the yeast genome
      in haploid and diploid cells expressing this endonuclease. Induction of the break
      in haploids results in cell death if no intact copy of the cleaved region is
      present in the cell. If such a copy is provided on a plasmid, as an ectopic gene
      duplication, or on a homologous chromosome, the break can be repaired. Repair
      results in two identical copies in the genome of the locus which has been cut. We
      call this phenomenon homozygotization by reference to diploids heterozygous for
      the cut site in which repair leads to homozygosis at this site. We have compared
      the efficiencies of repair in the various topological situations examined, and
      conclude that some mechanism must search for regions of homology to both sides of
      the DSB and that repair is successful only if the homologies are provided by the
      same template molecule.

PMID- 8355652
TI  - Chromosome mapping in Alcaligenes eutrophus CH34.
AB  - Mutants and mobilizing plasmids were developed as genetic tools in Alcaligenes
      eutrophus CH34. In order to map the chromosome, spontaneous and ethyl methane
      sulphonate (EMS)-induced mutants (mostly auxotrophs) were isolated. Another
      source of mutants was provided by the phenomenon of temperature-induced mortality
      and mutagenesis that is observed at 37 degrees C and is characteristic of many
      metallotolerant strains of A. eutrophus. Plasmid pULB113 (RP4::miniMu) was used
      to map the available mutations. Twenty-five loci were ordered in a circular map.
      pMOL50, a rearranged derivative of plasmid pMOL28, which was obtained in a
      survivor at 37 degrees C and displayed chromosome mobilizing activity (Cma+), was
      also used to mobilize chromosomal markers: resulting linkages were stronger than
      with pULB113, allowing confirmation of the circularity of the A. eutrophus CH34
      chromosome with a small number of crosses.

PMID- 8355653
TI  - Characterization of the ntrBC genes of Azospirillum brasilense Sp7: their
      involvement in the regulation of nitrogenase synthesis and activity.
AB  - A 7.1 kb EcoRI fragment from Azospirillum brasilense, that hybridized with a
      probe carrying the ntrBC genes from Bradyrhizobium japonicum, was cloned. The
      nucleotide sequence of a 3.8 kb subfragment was established. This led to the
      identification of two open reading frames, encoding polypeptides of 401 and 481
      amino acids, that were similar to NtrB and NtrC, respectively. A broad host range
      plasmid containing the putative Azospirillum ntrC gene was shown to restore
      nitrogen fixation under free-living conditions to a ntrC-Tn5 mutant of
      Azorhizobium caulinodans. Several Tn5 insertion mutants were isolated in the
      ntrBC coding region in A brasilense. These mutants were prototrophic and Nif+.
      However, their nitrogenase activity was slightly lower than in the wild type and
      they were unable to grow on nitrate as sole nitrogen source. Under
      microaerobiosis and in the absence of ammonia, a nifA-lacZ fusion was expressed
      in the mutants at about 60% of the level in the wild type. In the presence of
      ammonia, the fusion was similarly expressed (60% of the maximum) both in the wild
      type and mutants. Addition of ammonia to a nitrogen-fixing culture of ntrBC
      mutants did not abolish nitrogenase activity, in contrast with the wild type. It
      thus appears that in Azospirillum the ntrBC genes are not essential for nitrogen
      fixation, although NtrC controls nifA expression to some extent. They are,
      however, required for the switch-off of nitrogenase activity.

PMID- 8355654
TI  - Sequence-specific binding of protein factors to two independent promoter regions
      of the acidic tobacco pathogenesis-related-1 protein gene (PR-1).
AB  - Gel shift mobility analysis, using the proximal 0.3 kb fragment of the tobacco
      pathogenesis-related protein 1a gene (PR-1a) and nuclear extracts from healthy
      Samsun NN tobacco leaves, which do not produce PR-1 proteins, showed a broad
      shifted signal with low mobility. This signal was not detected with nuclear
      proteins from the interspecific hybrid of Nicotiana glutinosa x Nicotiana
      debneyi, which constitutively produces the PR-1a protein. Similar shifted signals
      were detected with both proximal and distal regions of the 0.3 kb fragment using
      nuclear proteins from healthy Samsun NN tobacco, but not with proteins from the
      interspecific hybrid. Further experiments, performed using 5' or 3' truncated
      fragments of the 0.3 kb fragment, identified two independent binding sites: a
      distal site between -179 and -168 bp from the transcription start site, and a
      proximal site between -61 and -37 bp. Footprint analysis revealed two protected
      sequences, a distal region between -184 and -172 bp, and a proximal region
      between -68 and -51 bp. These results indicate the presence of regulatory
      factor(s) for expression of the acidic PR-1a gene. The possibility of negative
      regulation of the gene is discussed.

PMID- 8355655
TI  - Nitrate reductase of Neurospora crassa: the functional role of individual amino
      acids in the heme domain as examined by site-directed mutagenesis.
AB  - The enzyme nitrate reductase, which catalyzes the reduction of nitrate to
      nitrite, is a multi-redox center homodimeric protein. Each polypeptide subunit is
      approximately 100 kDa in size and contains three separate domains, one each for a
      flavin, a heme-iron, and a molybdopterin cofactor. The heme-iron domain of
      nitrate reductase has homology with the simple redox protein, cytochrome b5,
      whose crystal structure was used to predict a three-dimensional structure for the
      heme domain. Two histidine residues have been identified that appear to
      coordinate the iron of the heme moiety, while other residues may be important in
      the folding or the function of the heme pocket. Site-directed mutagenesis was
      employed to obtain mutants that encode nitrate reductase derivatives with eight
      different single amino acid substitutions within the heme domain, including the
      two central histidine residues. Replacement of one of these histidines by alanine
      resulted in a completely nonfunctional enzyme whereas replacement of the other
      histidine resulted in a stable and functional enzyme with a lower affinity for
      heme. Certain amino acid substitutions appeared to cause a rapid turnover of the
      heme domain, whereas other substitutions were tolerated and yielded a stable and
      fully active enzyme. Three different single amino acid replacements within the
      heme domain led to a dramatic change in regulation of nitrate reductase
      synthesis, with significant expression of the enzyme even in the absence of
      nitrate induction.

PMID- 8355656
TI  - Tissue- and stage-specific modulation of RNA editing of the psbF and psbL
      transcript from spinach plastids--a new regulatory mechanism?
AB  - The psbE operon of spinach chloroplasts, which includes the genes psbE, psbF,
      psbL and psbJ, encodes two RNA editing sites. One site corresponds to the
      initiation codon of the psbL transcript, as has been described earlier for the
      homologous transcript from tobacco, while at a second editing site, newly
      reported here, an internal phenylalanine codon of the psbF transcript is
      restored. Both these sites were investigated with respect to the extent of
      editing in spinach plastids at various developmental stages. The apparent
      existence of only completely edited transcripts in etioplasts and chloroplasts,
      indicates that light-induced processes are not acting as determinants in
      eliciting the editing process. Reduced editing is, however, observed in the psbF
      and psbL transcript from seeds and roots. This finding suggests that the RNA
      editing process is differentially down-regulated in leucoplasts and proplastids
      and that editing may, therefore, function as a regulatory device in plastid gene
      expression.

PMID- 8355658
TI  - Construction of a barley (Hordeum vulgare L.) YAC library and isolation of a Hor1
      specific clone.
AB  - We have constructed an EcoRI-based YAC (yeast artificial chromosome) library from
      barley (Hordeum vulgare L. cv. Franka) using the vector pYAC4. The library
      consists of approximately 18,000 recombinant YACs with insert sizes ranging
      between 100 and 1000 kb (average of 160 kb) corresponding to 50% of the barley
      genome. Size fractionation after ligation resulted in an increased average insert
      size (av. 370 kb) but also in a substantial decrease in cloning efficiency. Less
      than 1% of the colonies showed homology to a plastome-specific probe;
      approximately 50% of the colonies displayed a signal with a dispersed, highly
      repetitive barley-specific probe. Using a primer combination deduced from the
      sequence of a member of the small Hor1 gene family coding for the C-hordein
      storage proteins, the library was screened by polymerase chain reaction and
      subsequently by the colony hybridization technique. A single YAC, designated
      Y66C11, with a 120 kb insert was isolated. This DNA fragment represents a
      coherent stretch from the terminal part of the Hor1 gene region as judged from
      the correspondence of the restriction patterns between Y66C11 DNA and barley DNA
      after hybridization with the Hor1-specific probe. Restriction with the
      isoschizomeric enzymes HpaII/MspI suggests a high degree of methylation of the
      Hor1 region in mesophyll cells but not in YAC-derived (yeast) DNA.

PMID- 8355657
TI  - Potentially rapid walking in cellular regulatory networks using the gene-gene
      interference method in yeast.
AB  - The recognition that cellular regulatory circuitry is composed of antagonistic
      elements has made possible a new approach to the selection of regulatory genes,
      called the gene-gene interference method. The method was used to identify and
      isolate genes possibly related in an antagonistic way to protein kinase A. Two
      such genes were recovered: ART1 encodes a potential regulator of cytokinesis and
      KAI1 appears to be involved in the Start control. The principles of the gene-gene
      interference method are discussed, as well as its possible general use for
      'walking' within the cellular regulatory networks of eukaryotes.

PMID- 8355659
TI  - Extent of polytene in the pericentric heterochromatin of polytene chromosomes of
      pseudonurse cells of otu (ovarian tumor) mutants of Drosophila melanogaster.
AB  - In the polytene nuclei of germ-line cells (ovarian pseudonurse cells) of
      Drosophila melanogaster females mutant for otu11 (ovarian tumor), the pericentric
      heterochromatin is much more abundant than in somatic salivary gland cells. This
      is due to the degree of heterochromatin compaction (and consequently the level of
      underreplication) being lower in the nurse cells than in the salivary gland
      cells. The lower level of compaction probably results in a very low degree of
      position effect gene inactivation in the ovarian nurse cells.

PMID- 8355660
TI  - The gdhA1 point mutation in Escherichia coli K12 CLR207 alters a key lysine
      residue of glutamate dehydrogenase.
AB  - gdhA1 is a spontaneous mutant of Escherichia coli that causes complete loss of
      activity of the NADP-specific glutamate dehydrogenase (GDH) encoded by the gdhA
      gene. The gdhA1 mutational site has been identified by recombinational mapping,
      polymerase chain reaction (PCR) amplification and DNA sequencing, as an A to G
      transition at nucleotide 274 of the gdhA coding sequence, resulting in an amino
      acid change of lysine 92 to glutamic acid. The mutant enzyme forms hybrid
      hexamers with a wild-type GDH, providing a useful system for analysis of
      conformational integrity of mutational variants.

PMID- 8355661
TI  - Partial characterization of the Nicotiana tabacum actin gene family: evidence for
      pollen-specific expression of one of the gene family members.
AB  - The actin gene family of Nicotiana tabacum has been partially characterised by
      Southern hybridisation and by isolating lambda EMBL4 recombinants from a genomic
      library having homology to the soybean actin gene, Sac3. The number of actin
      genes with homology to Sac3 is estimated at between 20 to 30, based on Southern
      hybridisation and library screening, though the total gene family may be larger.
      Twenty-four recombinant lambda clones were isolated, 18 had unique restriction
      profiles and from these, 2 clones, Tac9 and Tac25, were selected for further
      study. The region of Tac25 hybridizing to Sac3 was sequenced and shown to contain
      an open reading frame (ORF) with homology to actin. Partial sequencing of Tac9
      revealed a sequence with homology to the third exon of Tac25 and Sac3. The two
      tobacco actin sequences were compared to other reported actin gene sequences;
      Tac25 was closely related to the allelic potato actins, Pac58 and Pac85, while
      Tac9 was more related to Pac79 than to other plant actins. Northern hybridisation
      analysis showed that while Tac9 detected actin transcripts in RNA from root,
      leaf, stigma and pollen, Tac25 transcripts were only detected in pollen RNA.

PMID- 8355663
TI  - Selective enhancement of the interaction of curare with the nicotinic
      acetylcholine receptor.
AB  - Alteration of the ligand-binding domain of the nicotinic acetylcholine receptor
      through site-directed mutagenesis offers a powerful approach to the elucidation
      of structure-function relations in the receptor. Several conserved tyrosine
      residues in the large extracellular amino terminus of the alpha subunit of the
      receptor have been implicated by both chemical labeling and mutagenesis studies
      as playing an important role in the interaction of acetylcholine with the
      receptor. We and others have previously shown that substitution of phenylalanine
      for tyrosine at position 198 of the alpha subunit (alpha Y198F) leads to a
      rightward shift in the dose-response curve for acetylcholine-elicited currents.
      We have further investigated this particular mutation by examining the
      interaction of the competitive antagonist d-tubocurarine (curare) with the
      receptor. In contrast to the effect on the interaction of agonists with the
      receptor, this mutation leads to a marked increase in the affinity of the
      receptor for curare. Furthermore, this enhancement in affinity is selective for
      curare and is not seen with other competitive antagonists (pancuronium, beta
      erythroidine, and gallamine). Examination of the structures of these competitive
      antagonists leads to the proposal that this enhancement is due to the formation
      of an aromatic-aromatic interaction between the phenylalanine ring at position
      alpha 198 in the mutant and one of the aromatic rings of curare and that this can
      provide information about the spatial arrangement of this residue in the binding
      site.

PMID- 8355664
TI  - Heterogeneity of insulin receptors in rat tissues as detected with the partial
      agonist B29,B29'-suberoyl-insulin.
AB  - Using the insulin receptor partial agonist B29,B29'-suberoyl-insulin, a
      covalently dimerized insulin derivative, we previously demonstrated a
      heterogeneity of signal transduction by insulin receptors in two cell systems.
      The present study was designed to characterize the heterogeneity of insulin
      receptors in different rat tissues with this agent. Binding of 125I-insulin to
      insulin receptors and its inhibition by B29,B29'-suberoyl-insulin or by unlabeled
      insulin were assayed in plasma membranes from brain, spleen, adipocytes, and
      liver. IC50 values of B29,B29'-suberoyl-insulin were different in all tissues
      investigated (brain < spleen < adipocytes < liver). In contrast, IC50 values of
      insulin were identical, with the exception of spleen membranes (spleen < brain =
      adipocytes = liver). Furthermore, the IC50 ratios (B29 dimer/insulin) were
      significantly different, ranging from 0.7 (brain) to 12.8 (liver). Solubilization
      and partial purification of insulin receptors failed to abolish the marked
      difference between brain and liver (IC50 ratios of 1.8 and 7.1, respectively).
      The apparent molecular masses of the alpha subunits of insulin receptors, as
      labeled with a photoreactive insulin derivative, appeared identical in liver and
      spleen but were significantly lower in adipocytes and brain (liver = spleen >
      adipocytes > brain). The tissue-specific expression of the known insulin receptor
      isoforms generated by alternative splicing (insulin receptor types A and B), as
      assessed by polymerase chain reaction amplification with oligonucleotide primers
      flanking exon 11, was not correlated with the differences in the IC50 values and
      ratios for insulin and B29,B29'-suberoyl-insulin. Furthermore, IC50 values of
      both insulin and the B29 dimer were 3-fold lower in membranes from Rat1 cells
      overexpressing insulin receptor type A, compared with membranes with insulin
      receptor type B; the IC50 ratios were identical. No additional alternative
      splicing of insulin receptor mRNA was found by polymerase chain reaction
      amplification and digestion with HaeIII and AluI of seven overlapping domains of
      the receptor alpha subunit. These data suggest a heterogeneity of insulin
      receptors in rat tissues that is unrelated to alternative splicing of the insulin
      receptor gene.

PMID- 8355662
TI  - Inducibility of the SOS response in a recA730 or recA441 strain is restored by
      transformation with a new recA allele.
AB  - Escherichia coli RecA protein plays an essential role in both genetic
      recombination and SOS repair; in vitro RecA needs to bind ATP to promote both
      activities. Residue 264 is involved in this interaction; we have therefore
      created two new recA alleles, recA664 (Tyr264-->Glu) and recA665 (Tyr264-->His)
      bearing mutations at this site. As expected both mutations affected all RecA
      activities in vivo. Complementation experiments between these new alleles and
      wild-type recA or recA441 or recA730 alleles, both of which lead to
      constitutively activated RecA protein, were performed to further investigate the
      modulatory effects of these mutants on the regulation of SOS repair/recombination
      pathways. Our results provide further insight into the process of polymerization
      of RecA protein and its regulatory functions.

PMID- 8355665
TI  - Isolation and expression of a novel angiotensin II receptor from Xenopus laevis
      heart.
AB  - A Xenopus laevis heart cDNA library was screened using the human angiotensin type
      1 (AT1) receptor cDNA coding sequence as a hybridization probe. A cDNA was
      isolated that encodes a protein of 363 amino acids that shares 63% sequence
      identity with the human AT1 receptor. Radioligand binding studies with the cloned
      receptor expressed in COS cells indicated that it is an angiotensin II receptor
      that possesses pharmacological properties distinct from those of the two known
      mammalian receptor subtypes, AT1 and AT2. Electrophysiological studies with the
      recombinant receptor expressed in X. laevis oocytes revealed that the amphibian
      receptor, like the mammalian AT1 receptor, can functionally couple to a second
      messenger system, leading to the mobilization of intracellular stores of calcium.
      However, nonpeptide antagonists selective for the mammalian AT1 and AT2 receptors
      do not block angiotensin II-stimulated functional responses in injected oocytes,
      which confirms that the amphibian receptor is a pharmacologically unique
      angiotensin II receptor. Nevertheless, based on conservation of structural
      features and motifs and similarity in coupling mechanisms, we speculate that the
      cloned Xenopus receptor is the amphibian counterpart of the mammalian AT1
      receptor, having acquired its unique pharmacology as a consequence of
      evolutionary divergence.

PMID- 8355666
TI  - Identification and characterization of type A endothelin receptors in MMQ cells.
AB  - Recently the identification of endothelin (ET) receptors and ET in the pituitary
      gland has induced much interest in studying the potential role of ET in
      neuroendocrine regulation. MMQ, isolated from rat pituitary, is a prolactin
      secreting cell line. Similar to primary pituitary cells, the secretory response
      in MMQ cells is regulated by calcium and cAMP. In this report, by combining
      radioligand binding, cross-linking, and reverse transcription-polymerase chain
      reaction (RT-PCR) techniques, we characterized the properties of ET receptors in
      MMQ cells. 125I-ET-1 bound to membranes prepared from MMQ cells in a time
      dependent manner, reaching a plateau at 150 min at 25 degrees. 125I-ET-1 binding
      was inhibited by ET-1 with an IC50 value of 0.17 nM but was only partially
      (approximately 60%) inhibited by 1 microM ET-3. BQ123 (cyclo[D-Trp-D-Asp-Pro-D
      Val-Leu]) and FR139317 (cC6N-L-Leu-D-Trp-Me-D-2Pya-OH), two antagonists that are
      selective for the ETA receptor, inhibited 125I-ET-1 binding with IC50 values of 5
      nM and 0.9 nM, respectively. RT-PCR detected mRNA for the ETA receptor but not
      the ETB receptor. RT-PCR detected mRNA for both ETA and ETB receptors in control
      experiments using rat kidney RNA. 125I-ET-1 binding was saturable, reaching a
      plateau at 0.1 nM. Scatchard analysis of the data from saturation studies yielded
      a straight line, with Bmax and Kd values of 0.11 pmol/mg and 0.038 nM,
      respectively. The number of receptors was 6.6 x 10(10) sites/mg of protein or
      13,200 sites/cell. Cross-linking studies using bis(sulfosuccinimidyl)suberate
      revealed an apparent molecular mass of 65 kDa for the ET receptor. Labeling of
      the 65-kDa protein was abolished by ET-1, BQ123, or FR139317 at 0.1 microM. ET-1
      stimulated the formation of total inositol phosphates in a dose-dependent manner,
      with an EC50 of 0.1 nM. The phosphatidylinositol hydrolysis response was also
      inhibited by BQ123 and FR139317. We conclude that MMQ cells express the ETA
      receptor, which is coupled to phosphatidylinositol hydrolysis. MMQ cells may be
      useful for elucidating the mechanisms through which ET exerts its regulatory
      effects on pituitary cells.

PMID- 8355667
TI  - Characterization of ligand and substrate specificity for the calcium-dependent
      and calcium-independent protein kinase C isozymes.
AB  - Analysis of [3H]phorbol-12,13-dibutyrate (PDBu) binding was performed with
      protein kinase C (PKC)-alpha, -beta 1, -gamma, -delta, -epsilon, -eta, and -zeta
      produced in Sf9 insect cells using the baculovirus expression system. With the
      exception of PKC-zeta, all of the PKC isozymes bound [3H]PDBu with high affinity
      (Kd < 1 nM), either in the presence or in the absence of calcium. Scatchard
      analysis using 100% phosphatidylserine vesicles revealed slightly lower affinity
      for the calcium-independent isozymes (PKC-delta, -epsilon, and -eta) than for the
      calcium-dependent isozymes (PKC-alpha, -beta, and -gamma). Competition for
      [3H]PDBu binding by different classes of PKC activators showed that 12
      deoxyphorbol esters, mezerein, and octahydromezerein likewise possessed lower
      affinity for the calcium-independent isozymes. The mezerein analog thymeleatoxin
      was the most marked example, being almost 20-fold less potent for binding to PKC
      epsilon and -eta than to PKC-beta 1. In contrast, the indole alkaloids (-)
      indolactam V and (-)-octylindolactam V and the postulated endogenous activator
      1,2-diacylglycerol bound with similar affinities to all of the PKC isoforms,
      suggesting that different residues/configurations in the binding sites of the
      different PKC isozymes might be involved in interaction with the pharmacophore of
      the activators. The seven PKC isozymes also showed clearly different substrate
      specificities with exogenous peptide and protein substrates. The heterogeneous
      behavior of the different members of the PKC family with ligands and substrates
      may contribute to the heterogeneity of PKC-mediated pathways at the cellular
      level.

PMID- 8355668
TI  - Functional effects of a naturally occurring amino acid substitution in human
      thymidylate synthase.
AB  - A major mechanism underlying the cytotoxicity of fluoropyrimidine analogs such as
      5-fluorouracil and 5-fluoro-2'-deoxyuridine (FdUrd) occurs via the formation of 5
      fluoro-2'-deoxyuridylate (FdUMP), a tight-binding inhibitor of thymidylate
      synthase (TS). Genetic variation in the structure of the TS molecule is an
      important determinant of response to fluoropyrimidines, because such variation
      may affect the binding of FdUMP to the enzyme. Previous studies have shown that
      the colonic tumor cell line HCT116 expresses two structurally distinct TS
      polypeptides that differ by the presence of tyrosine or histidine at residue 33.
      Compared with the Tyr-33 form, the His-33 form confers a 3-4-fold level of FdUrd
      resistance to cells; this was postulated to be derived from the reduced affinity
      of the enzyme for FdUMP and N5,N10-methylenetetrahydrofolate, ligands required
      for the formation of a stable inhibitory complex. In the present study, the Tyr
      33 and His-33 forms have been purified to homogeneity, and their properties have
      been compared in detail. The Km values for dUMP and N5,N10
      methylenetetrahydrofolate in the TS reaction were not significantly different
      between the two enzymes. In contrast, the catalytic efficiency (kcat) was 8-fold
      lower for the His-33 form. Kinetic and equilibrium binding measurements
      demonstrated that the dissociation constant for FdUMP binding into the ternary
      complex was 3-4-fold higher for the His-33 form; this was shown to be due to both
      a decrease in the rate of FdUMP association with the enzyme and an increase in
      the rate of FdUMP dissociation from the ternary complex. A TS form containing
      phenylalanine at residue 33 was created by site-directed mutagenesis and was
      shown to be very similar to the Tyr-33 enzyme with regard to kcat, pH/activity
      profile, and effect on FdUrd response. Thus, it is the presence of histidine at
      residue 33, rather than the absence of tyrosine, that is responsible for the
      alterations in catalytic and ligand-binding functions exhibited by the His-33
      form. Possible mechanisms by which the histidine residue perturbs the structure
      of the TS active site are discussed.

PMID- 8355669
TI  - Phosphoramidon modulates the number of endothelin receptors in cultured Swiss 3T3
      fibroblasts.
AB  - Endothelin (ET) is generated from prepro-ET by dibasic pair proteolysis, followed
      by specific proteolytic cleavage between Trp21 and Val22. Currently, intense
      research efforts are focused on the investigation of a metalloprotease-like ET
      converting enzyme that is inhibited by phosphoramidon but not by other inhibitors
      of neutral metalloproteases. In this report, we show that ET binding was
      increased significantly in cultured Swiss 3T3 fibroblasts after phosphoramidon
      treatment. Saturation studies using membranes prepared from cells or using intact
      cells assayed at 4 degrees showed that Bmax increased from 0.13 pmol/mg or 0.038
      pmol/1 x 10(6) cells in untreated cells to 0.66 pmol/mg or 0.22 pmol/1 x 10(6)
      cells in cells treated with 100 microM phosphoramidon for 24 hr, equivalent to a
      net increase of 100,000 ET binding sites/cell. The effect of phosphoramidon was
      time and dose dependent. Other protease inhibitors, such as thiorphan, pepstatin
      A, E-64, phenylmethylsulfonyl fluoride, bestatin, and leupeptin, failed to exert
      a similar effect. Reverse phase high performance liquid chromatography analysis
      indicated that the effect of phosphoramidon was not due to inhibition of 125I-ET
      1 degradation. The effect of phosphoramidon remained evident after cells were
      treated with actinomycin D or cycloheximide to inhibit protein synthesis,
      suggesting that the phenomenon was not due to the effect of phosphoramidon
      stimulating the synthesis of ET receptors. Degradation studies suggested that the
      effect of phosphoramidon was due to inhibition of a protease responsible for
      degrading the ET receptor. The fact that Swiss 3T3 cells treated with
      phosphoramidon exhibit an increase in the number of ET receptors is likely to
      complicate the interpretation of results when phosphoramidon or related compounds
      are used to block the putative ET-converting enzyme.

PMID- 8355670
TI  - Tityustoxin-K alpha, a structurally novel and highly potent K+ channel peptide
      toxin, interacts with the alpha-dendrotoxin binding site on the cloned Kv1.2 K+
      channel.
AB  - The interaction between two nonhomologous K+ channel toxins, Tityus serrulatus
      (scorpion) toxin tityustoxin-K alpha (TsTX-K alpha) and Dendroaspis angusticeps
      (snake) toxin dendrotoxin (alpha-DTX), was investigated on K+ currents in B82
      fibroblast cells transformed to express the Kv1.2 K+ channel. As demonstrated
      previously, alpha-DTX was a potent blocker of the K+ current (Kd, 2.8 nM).
      Recombinant TsTX-K alpha produced a similar block of the current but was 1 order
      of magnitude more potent (Kd, 0.21 nM). TsTX-K alpha did not affect the kinetic
      properties of the current or its voltage dependence of activation. Experiments
      with excised and cell-attached patch recordings demonstrated that TsTX-K alpha
      blocks the K+ channel by binding to an extracellular site. In the presence of
      TsTX-K alpha the blocking potency of alpha-DTX was reduced, whereas the potency
      of 4-aminopyridine, which also blocks the channel, was unaffected. alpha-DTX
      caused a rightward shift in the scaled concentration-response curve for TsTX-K
      alpha, the magnitude of which was reasonably well predicted by a model in which
      there is a competitive interaction between the two peptide toxins. We conclude
      that TsTX-K alpha and alpha-DTX block the Kv1.2 K+ channel by binding to the same
      or closely related sites.

PMID- 8355671
TI  - Long-lasting modification of the N-methyl-D-aspartate receptor channel by a
      voltage-dependent sulfhydryl redox process.
AB  - Ionic currents through the N-methyl-D-aspartate (NMDA) receptor channel are
      modulated by sulfhydryl redox reagents. We report here a novel form of redox
      modulation that alters NMDA channel kinetics in a voltage-dependent manner. The
      effects of the thiol reductant dithiothreitol (DTT) and the oxidizing agent 5,5'
      dithio-bis(2-nitrobenzoic acid) (DTNB) on NMDA-activated whole-cell currents were
      examined at various transmembrane voltages in cultured rat cortical neurons. DTT
      produced a similar level of potentiation of NMDA-induced currents at both -60 mV
      and +30 mV. However, the reversal of this potentiation by a sulfhydryl-oxidizing
      agent was dependent on the holding potential, because DTNB decreased the DTT
      potentiated NMDA responses more effectively at negative voltages. Interestingly,
      the NMDA peak current-voltage relationship became substantially outwardly
      rectifying when sequential DTT/DTNB treatments took place at a positive holding
      potential, but not under any other circumstances. Single-channel recordings from
      outside-out patches revealed that this phenomenon was likely produced by a
      significant and long-lasting 2.3-fold prolongation of the mean open time of NMDA
      channels at a positive holding potential. Thus, a voltage-dependent chemical
      alteration in NMDA receptor structure modified the kinetic properties of the
      associated ion channel.

PMID- 8355672
TI  - Development of lipoprotein-like lipid particles for drug targeting: neo-high
      density lipoproteins.
AB  - The possibility was explored of synthesizing, from commercially available lipids,
      high density lipoprotein (HDL)-like particles (neo-HDL) with the same physico
      chemical and biological properties as native HDL. A preparation method involving
      egg yolk phosphatidylcholine, cholesterol, and apoproteins from HDL led to the
      formation of particles with a composition, size, electrophoretic mobility, and
      density similar to those of discoidal HDL. In vitro experiments with isolated
      parenchymal liver cells showed that unlabeled HDL and neo-HDL competed for the
      same high affinity binding sites as did radiolabeled neo-HDL, whereas an excess
      of unlabeled low density lipoprotein was ineffective. In vivo experiments with
      radio-labeled neo-HDL indicated that neo-HDL showed a slow decay upon injection
      into rats, whereas the liver uptake did not exceed > 10% of the injected dose.
      The small additional liver uptake of radioactivity from neo-HDL, compared with
      HDL, was due to enhanced uptake by endothelial and Kupffer cells. Lactosylation
      of neo-HDL led to a markedly increased decay rate and a rapid uptake by rat liver
      (80% in 10 min). Parenchymal cells accounted for > 90% of the total liver uptake
      of radiolabeled lactosylated neo-HDL. Because the liver uptake of lactosylated
      125I-neo-HDL could be blocked by preinjection of N-acetylgalactosamine, we
      conclude that the asialoglycoprotein receptor, which is specifically localized on
      parenchymal liver cells, is responsible for the avid liver uptake. With a
      fibroblast cell line transfected with the human asialoglycoprotein receptor, it
      was found that lactosylated neo-HDL binds with high affinity (Kd, 40 nM), in a
      galactose-specific way. It can be concluded that, with commercially available
      lipid components, HDL-like particles (neo-HDL) with virtually the same
      characteristics as found for native apolipoprotein E-free HDL can be
      reconstituted. Lactosylated neo-HDL, which is rapidly taken up by galactose
      specific receptors on parenchymal liver cells, might be used to transport
      antiviral drugs specifically to parenchymal liver cells.

PMID- 8355673
TI  - An E box mediates activation and repression of the acetylcholine receptor delta
      subunit gene during myogenesis.
AB  - The genes encoding the skeletal muscle acetylcholine receptor (AChR) are induced
      during muscle development and are regulated subsequently by innervation. Because
      both the initiation and the subsequent regulation of AChR expression are
      controlled by transcriptional mechanisms, an understanding of the steps that
      regulate AChR expression following innervation is likely to require knowledge of
      the pathway that activates AChR genes during myogenesis. Thus, we sought to
      identify the cis-acting sequences that regulate expression of the AChR delta
      subunit gene during muscle differentiation. We transfected muscle and nonmuscle
      cell lines with gene fusions between 5'-flanking DNA from the AChR delta-subunit
      gene and the human growth hormone gene, and we show here that 148 bp of 5'
      flanking DNA from the AChR delta-subunit gene contains two regulatory elements
      that control muscle-specific gene expression. One element is an E box, which is
      important both for activation of the delta-subunit gene in myotubes and for its
      repression in myoblasts and nonmuscle cells. Mutation of this E box, which
      prevents binding of MyoD-E2A and myogenin-E2A heterodimers, decreases expression
      in myotubes and increases expression in myoblasts and nonmuscle cells. An E-box
      binding activity, which does not contain MyoD, myogenin, or E2A proteins, is
      present in muscle and nonmuscle cells and may be responsible for repressing the
      delta-subunit gene in myoblasts and nonmuscle cells. An enhancer, which lacks E
      boxes, is also required for expression of the delta-subunit gene but does not
      confer muscle-specific expression.

PMID- 8355674
TI  - A small segment of the MAT alpha 1 transcript promotes mRNA decay in
      Saccharomyces cerevisiae: a stimulatory role for rare codons.
AB  - Differences in decay rates of eukaryotic transcripts can be determined by
      discrete sequence elements within mRNAs. Through the analysis of chimeric
      transcripts and internal deletions, we have identified a 65-nucleotide segment of
      the MAT alpha 1 mRNA coding region, termed the MAT alpha 1 instability element,
      that is sufficient to confer instability to a stable PGK1 reporter transcript and
      that accelerates turnover of the unstable MAT alpha 1 mRNA. This 65-nucleotide
      element is composed of two parts, one located within the 5' 33 nucleotides and
      the second located in the 3' 32 nucleotides. The first part, which can be
      functionally replaced by sequences containing rare codons, is unable to promote
      rapid decay by itself but can enhance the action of the 3' 32 nucleotides
      (positions 234 to 266 in the MAT alpha 1 mRNA) in accelerating turnover. A second
      portion of the MAT alpha 1 mRNA (nucleotides 265 to 290) is also sufficient to
      destabilize the PGK1 reporter transcript when positioned 3' of rare codons,
      suggesting that the 3' half of the MAT alpha 1 instability element is
      functionally reiterated within the MAT alpha 1 mRNA. The observation that rare
      codons are part of the 65-nucleotide MAT alpha 1 instability element suggests
      possible mechanisms through which translation and mRNA decay may be linked.

PMID- 8355675
TI  - Termination and pausing of RNA polymerase II downstream of yeast polyadenylation
      sites.
AB  - Little is known about the transcriptional events which occur downstream of
      polyadenylation sites. Although the polyadenylation site of a gene can be easily
      identified, it has been difficult to determine the site of transcription
      termination in vivo because of the rapid processing of pre-mRNAs. Using an in
      vitro approach, we have shown that sequences from the 3' ends of two different
      Saccharomyces cerevisiae genes, ADH2 and GAL7, direct transcription termination
      and/or polymerase pausing in yeast nuclear extracts. In the case of the ADH2
      sequence, the RNA synthesized in vitro ends approximately 50 to 150 nucleotides
      downstream of the poly(A) site. This RNA is not polyadenylated and may represent
      the primary transcript. A similarly sized nonpolyadenylated [poly(A)-] transcript
      can be detected in vivo from the same transcriptional template. A GAL7 template
      also directs the in vitro synthesis of an RNA which extends a short distance past
      the poly(A) site. However, a significant amount of the GAL7 RNA is polyadenylated
      at or close to the in vivo poly(A) site. Mutations of GAL7 or ADH2 poly(A)
      signals prevent polyadenylation but do not affect the in vitro synthesis of the
      extended poly(A)- transcript. Since transcription of the mutant template
      continues through this region in vivo, it is likely that a strong RNA polymerase
      II pause site lies within the 3'-end sequences. Our data support the hypothesis
      that the coupling of this pause site to a functional polyadenylation signal
      results in transcription termination.

PMID- 8355676
TI  - Transgenic expression of COL1A1-chloramphenicol acetyltransferase fusion genes in
      bone: differential utilization of promoter elements in vivo and in cultured
      cells.
AB  - To directly compare the patterns of collagen promoter expression in cells and
      tissues, the activity of COL1A1 fusion genes in calvariae of neonatal transgenic
      mice and in primary bone cell cultures derived by sequential digestion of
      transgenic calvariae was measured. ColCAT3.6 contains 3.6 kb (positions -3521 to
      +115) of the rat COL1A1 gene ligated to the chloramphenicol acetyltransferase
      (CAT) reporter gene. ColCAT2.3 and ColCAT1.7 are 5' deletion mutants which
      contain 2,296 and 1,672 bp, respectively, of COL1A1 DNA upstream from the
      transcription start site. ColCAT3.6 activity was 4- to 6-fold lower in primary
      bone cell cultures than in intact calvariae, while ColCAT2.3 activity was at
      least 100-fold lower in primary bone cells than in calvariae. These changes were
      accompanied by a threefold decrease in collagen synthesis and COL1A1 mRNA levels
      in primary bone cells compared with collagen synthesis and COL1A1 mRNA levels in
      freshly isolated calvariae. ColCAT3.6 and ColCAT2.3 activity was maintained in
      calvariae cultured in the presence or absence of serum for 4 to 7 days. Thus,
      when bone cells are removed from their normal microenvironment, there is parallel
      downregulation of collagen synthesis, collagen mRNA levels, and ColCAT3.6
      activity, with a much greater decrease in ColCAT2.3. These data suggest that a
      624-bp region of the COL1A1 promoter between positions -2296 and -1672 is active
      in intact and cultured bone but inactive in cultured cells derived from the bone.
      We suggest that the downregulation of COL1A1 activity in primary bone cells may
      be due to the loss of cell shape or to alterations in cell-cell and/or cell
      matrix interactions that normally occur in intact bone.

PMID- 8355677
TI  - Functional domains of wild-type and mutant p53 proteins involved in
      transcriptional regulation, transdominant inhibition, and transformation
      suppression.
AB  - The wild-type (wt) p53 protein has transcriptional activation functions which may
      be linked to its tumor suppressor activity. Many mutant p53 proteins expressed in
      cancers have lost the ability to function as transcriptional activators and
      furthermore may inhibit wt p53 function. To study the mechanisms by which mutant
      forms of p53 have lost their transactivation function and can act in a dominant
      negative manner, a structure-function analysis of both mutant and engineered
      truncated forms of p53 was carried out. We show that different mutant p53
      proteins found in cancers vary in the ability to inhibit the transcriptional
      transactivation and specific DNA binding activities of wt human p53. This
      transdominant effect was mediated through the carboxy-terminal oligomerization
      region. The role of the transactivation activity in transformation suppression by
      wt p53 was also examined by constructing an N-terminal deletion mutant lacking
      the transactivation domain. This mutant was unable to transactivate but could
      bind specifically to DNA. Although it was impaired in its ability to suppress
      transformation of primary rat embryo fibroblasts by adenovirus E1A plus activated
      ras, the N-terminal deletion mutant still had some suppression activity,
      suggesting that additional functions of p53 may contribute to transformation
      suppression.

PMID- 8355678
TI  - Structure, mapping, and expression of erp, a growth factor-inducible gene
      encoding a nontransmembrane protein tyrosine phosphatase, and effect of ERP on
      cell growth.
AB  - We have characterized a growth factor-inducible gene, erp, and demonstrated that
      it encodes a 367-amino-acid nontransmembrane tyrosine phosphatase protein with
      significant similarity to the vaccinia virus H1 protein. Immunoprecipitation
      analyses show that the erp protein, ERP, is rapidly induced following serum
      stimulation of quiescent fibroblasts. ERP has been expressed as a fusion protein
      with glutathione S-transferase and shown to have tyrosine as well as serine
      protein phosphatase activity. The enzymatic activity of ERP depends on the
      presence of reducing agents such as dithiothreitol, and its tyrosine phosphatase
      activity is inhibited by sodium vanadate, a potent inhibitor of protein tyrosine
      phosphatases. The number of stable NIH 3T3 clones obtained after transfection
      with a vector expressing the complete ERP protein is reduced more than 90%
      compared with that after transfection with a vector expressing a mutated inactive
      ERP protein. The remaining ERP-expressing clones present a significant increase
      in the proportion of bi- and multinucleated cells and a decrease in proliferation
      rate. Studies on the genomic structure reveal that the erp transcription unit is
      2.8 kbp long and split into four exons. The erp gene maps to the 17A2-17C region
      of the murine genome. Our results demonstrate that the protein product of the
      immediate-early gene erp has a negative effect on cell proliferation.

PMID- 8355679
TI  - Overlapping positive and negative regulatory elements determine lens-specific
      activity of the delta 1-crystallin enhancer.
AB  - Lens-specific expression of the delta 1-crystallin gene is governed by an
      enhancer in the third intron, and the 30-bp-long DC5 fragment was found to be
      responsible for eliciting the lens-specific activity. Mutational analysis of the
      DC5 fragment identified two contiguous, interdependent positive elements and a
      negative element which overlaps the 3'-located positive element. Previously
      identified ubiquitous factors delta EF1 bound to the negative element and
      repressed the enhancer activity in nonlens cells. Mutation and cotransfection
      analyses indicated the existence of an activator which counteracts the action of
      delta EF1 in lens cells, probably through binding site competition. We also found
      a group of nuclear factors, collectively called delta EF2, which bound to the 5'
      located positive element. delta EF2a and -b were the major species in lens cells,
      whereas delta EF2c and -d predominated in nonlens cells. These delta EF2 proteins
      probably cooperate with factors bound to the 3'-located element in activation in
      lens cells and repression in nonlens cells. delta EF2 proteins also bound to a
      promoter sequence of the gamma F-crystallin gene, suggesting that delta EF2
      proteins are involved in lens-specific regulation of various crystallin classes.

PMID- 8355680
TI  - Inducible transcriptional activation of the human immunodeficiency virus long
      terminal repeat by protein kinase inhibitors.
AB  - The protein kinase inhibitor 2-aminopurine (2-AP) greatly stimulated expression
      in human promonocytes-macrophages of plasmid constructs carrying various reporter
      genes (chloramphenicol acetyltransferase, lacZ, firefly luciferase [luc], and
      Salmonella typhimurium histidinol dehydrogenase [his]) driven by the human
      immunodeficiency virus type 1 (HIV-1) long terminal repeat. Adenine, adenosine,
      and caffeine were also effective inducers, but other purine or pyrimidine
      derivatives were ineffective. Experiments with mutant derivatives of the HIV-1
      long terminal repeat revealed no specific eukaryotic promoter elements necessary
      for 2-AP induction but indicated the need for some minimum combination of such
      elements. Induction of HIV-1-directed gene expression appeared not to require
      action of the transcription factor NF-kappa B. The mechanism of induction was
      investigated by using the luc and his genes linked to the HIV-1 long terminal
      repeat. 2-AP induced marked, steady rises in mRNA accumulation from both
      transfected and chromosomally integrated HIV-1 constructs but no increases from
      an endogenous gene encoding gamma-actin or glucose 6-phosphate dehydrogenase.
      Thus, induction is selective and not an artifact induced by transfecting DNA into
      cells. In run-on transcription experiments, the rates of transcription initiation
      of both transfected and integrated copies of the his gene increased about sixfold
      in cells treated with 2-AP. Thus, while increased initiation accounted for a
      portion of 2-AP induction, it could not cause the far greater increase in steady
      state mRNA levels. 2-AP induction did not change mRNA decay rates and differed
      from the phorbol ester (phorbol myristate acetate)-induced activation of the
      protein kinase C-NF-kappa B pathway in its time course and in its requirement for
      new protein synthesis. Gel retardation assays showed that unlike phorbol
      myristate acetate induction, 2-AP induction is enhancer independent. Whereas many
      previous studies have implicated the activation of various protein kinases in
      gene induction, we here describe a mechanism of gene activation that appears to
      involve protein kinase inhibition as a component of the induction response.

PMID- 8355681
TI  - Distal regulatory elements from the mouse metallothionein locus stimulate gene
      expression in transgenic mice.
AB  - DNA regions of 10 and 7 kb that flank the mouse metallothionein II (MT-II) and MT
      I genes, respectively, were combined with a minimally marked MT-I (MT-I*) gene
      and tested in transgenic mice. This construct resulted in (i) position
      independent expression of MT-I* mRNA and copy number-dependent expression, (ii)
      levels of hepatic MT-I mRNA per cell per transgene that were about half that
      derived from endogenous MT-I genes, (iii) appropriate regulation by metals and
      hormones, and (iv) tissue distribution of transgene mRNA that resembled that of
      endogenous MT-I mRNA. These features were not observed when MT-I* was tested
      without the flanking regions. These MT-I flanking sequences also improved the
      expression of rat growth hormone reporter genes, with or without introns, that
      were under the control of the MT-I promoter. Moreover, they enhanced expression
      from two of four heterologous promoters/enhancers that were tested. Deletion
      analysis indicated that regions known to have DNase I-hypersensitive sites were
      necessary but not sufficient for high-level expression. These data suggest that
      the DNA regions flanking the mouse MT-I and MT-II genes have functions like the
      locus control regions described for other genes.

PMID- 8355682
TI  - C/EBP, NF-kappa B, and c-Ets family members and transcriptional regulation of the
      cell-specific and inducible macrophage inflammatory protein 1 alpha immediate
      early gene.
AB  - Macrophage inflammatory protein 1 alpha (MIP-1 alpha) cytokine gene expression is
      restricted to a limited number of cells of hemopoietic origin and is rapidly and
      transiently induced by serum and endotoxin in macrophages. A single nuclear DNase
      I-hypersensitive site, which maps to the proximal promoter of the MIP-1 alpha
      gene, was identified in macrophage cells but was absent in cells which do not
      express basal levels of MIP-1 alpha mRNA. The proximal promoter sequences (+36 to
      -220 bp) are sufficient to confer cell-specific and inducible transcription in
      transfection assays. In vitro DNA-binding studies revealed five major nuclear
      protein binding sites in the proximal promoter which bind C/EBP, NF-kappa B,
      and/or c-Ets family members. Cell-specific differences in DNA binding by members
      of the NF-kappa B and c-Ets families correlate with the cell-specificity of MIP-1
      alpha gene expression and the chromosomal conformation of the promoter. Changes
      in promoter binding by members of the C/EBP and NF-kappa B families correlate
      with the transcriptional up-regulation observed in serum- or endotoxin-stimulated
      macrophages in functional studies.

PMID- 8355683
TI  - Elements regulating an alternatively spliced exon of the rat fibronectin gene.
AB  - We have investigated the regulation of splicing of one of the alternatively
      spliced exons in the rat fibronectin gene, the EIIIB exon. This 273-nucleotide
      exon is excluded by some cells and included to various degrees by others. We find
      that EIIIB is intrinsically poorly spliced and that both its exon sequences and
      its splice sites contribute to its poor recognition. Therefore, cells which
      recognize the EIIIB exon must have mechanisms for improving its splicing.
      Furthermore, in order for EIIB to be regulated, a balance must exist between the
      EIIIB splice sites and those of its flanking exons. Although the intron upstream
      of EIIIB does not appear to play a role in the recognition of EIIIB for splicing,
      the intron downstream contains sequence elements which can promote EIIIB
      recognition in a cell-type-specific fashion. These elements are located an
      unusually long distance from the exon that they regulate, more than 518
      nucleotides downstream from EIIIB, and may represent a novel mode of exon
      regulation.

PMID- 8355684
TI  - A unique ribonucleoprotein complex assembles preferentially on ecdysone
      responsive sites in Drosophila melanogaster.
AB  - The protein on ecdysone puffs (PEP) is associated preferentially with active
      ecdysone-inducible puffs on Drosophila polytene chromosomes and contains sequence
      motifs characteristic of transcription factors and RNA-binding proteins (S. A.
      Amero, S. C. R. Elgin, and A. L. Beyer, Genes Dev. 5:188-200, 1991). PEP is
      associated with RNA in vivo, as demonstrated here by the sensitivity of PEP
      specific chromosomal immunostaining in situ to RNase digestion and by the
      immunopurification of PEP in Drosophila cell extract with heterogeneous nuclear
      ribonucleoprotein (hnRNP) complexes. As revealed by sequential immunostaining,
      PEP is found on a subset of chromosomal sites bound by the HRB (heterogeneous
      nuclear RNA-binding) proteins, which are basic Drosophila hnRNPs. These
      observations lead us to suggest that a unique, PEP-containing hnRNP complex
      assembles preferentially on the transcripts of ecdysone-regulated genes in
      Drosophila melanogaster presumably to expedite the transcription and/or
      processing of these transcripts.

PMID- 8355685
TI  - A phylogenetically conserved sequence within viral 3' untranslated RNA
      pseudoknots regulates translation.
AB  - Both the 68-base 5' leader (omega) and the 205-base 3' untranslated region (UTR)
      of tobacco mosaic virus (TMV) promote efficient translation. A 35-base region
      within omega is necessary and sufficient for the regulation. Within the 3' UTR, a
      52-base region, composed of two RNA pseudoknots, is required for regulation.
      These pseudoknots are phylogenetically conserved among seven viruses from two
      different viral groups and one satellite virus. The pseudoknots contained
      significant conservation at the secondary and tertiary levels and at several
      positions at the primary sequence level. Mutational analysis of the sequences
      determined that the primary sequence in several conserved positions, particularly
      within the third pseudoknot, was essential for function. The higher-order
      structure of the pseudoknots was also required. Both the leader and the
      pseudoknot region were specifically recognized by, and competed for, the same
      proteins in extracts made from carrot cell suspension cells and wheat germ.
      Binding of the proteins is much stronger to omega than the pseudoknot region.
      Synergism was observed between the TMV 3' UTR and the cap and to a lesser extent
      between omega and the 3' UTR. The functional synergism and the protein binding
      data suggest that the cap, TMV 5' leader, and 3' UTR interact to establish an
      efficient level of translation.

PMID- 8355686
TI  - Identification of the ligand-binding regions in the macrophage colony-stimulating
      factor receptor extracellular domain.
AB  - The c-fms gene encodes the receptor for the macrophage colony-stimulating factor
      (M-CSF), and its extracellular domain consists of five immunoglobulin-like
      subdomains. To identify which of the five immunoglobulin-like regions are
      involved in ligand binding, we polymerase chain reaction-cloned five segments of
      the extracellular domain of the murine c-fms gene, each starting with the normal
      initiation codon and containing successive additions of the immunoglobulin-like
      subdomains. These protein segments are designated A, B, C, D, and E and contain,
      from the N-terminal end, either one, two, three, four, or all five immunoglobulin
      like subdomains, respectively. Each segment was expressed as a secreted soluble
      protein from a baculovirus expression vector in Sf9 insect cells. In addition,
      segments A, B, C, and E were produced as soluble alkaline phosphatase fusion
      proteins, as was a segment containing only the fourth and fifth immunoglobulin
      domains. These segments of the Fms extracellular domain were used to assess M-CSF
      binding by competition radioimmunoassays, plate binding immunoassays, and
      immunoprecipitation analyses. The results indicated that the first two N-terminal
      immunoglobulin-like domains did not interact with M-CSF but, in combination with
      the third immunoglobulin-like domain, provided high-affinity M-CSF binding. The
      fourth and fifth immunoglobulin-like domains near the cell membrane did not
      exhibit M-CSF binding and may inhibit interaction of M-CSF with the first three
      immunoglobulin domains. These results suggest that the three N-terminal
      immunoglobulin-like domains constitute the high-affinity M-CSF binding region and
      that the fourth and fifth immunoglobulin-like domains may perform functions other
      than ligand binding.

PMID- 8355688
TI  - Identification of residues in the human DNA repair enzyme HAP1 (Ref-1) that are
      essential for redox regulation of Jun DNA binding.
AB  - The DNA binding activity of the c-jun proto-oncogene product is inhibited by
      oxidation of a specific cysteine residue (Cys-252) in the DNA binding domain. Jun
      protein inactivated by oxidation of this residue can be efficiently reactivated
      by a factor from human cell nuclei, recently identified as a DNA repair enzyme
      (termed HAP1 or Ref-1). The HAP1 protein consists of a core domain, which is
      highly conserved in a family of prokaryotic and eukaryotic DNA repair enzymes,
      and a 61-amino-acid N-terminal domain absent from bacterial homologs such as
      Escherichia coli exonuclease III. The eukaryote-specific N-terminal domain was
      dispensable for the DNA repair functions of the HAP1 protein but was essential
      for reactivation of the DNA binding activity of oxidized Jun protein. Consistent
      with this finding, exonuclease III protein could not reactive Jun. A minimal 26
      residue region of the N-terminal domain proximal to the core of the HAP1 enzyme
      was required for redox activity. By site-directed mutagenesis, cysteine 65 was
      identified as the redox active site in the HAP1 enzyme. In addition, it is
      proposed that cysteine 93 interacts with the redox active site, probably via
      disulfide bridge formation. It is concluded that the HAP1 protein has evolved a
      novel redox activation domain capable of regulating the DNA binding activity of a
      proto-oncogene product which is not essential for its DNA repair functions.
      Identification of a putative active site cysteine residue should facilitate
      analysis of the mechanism by which the HAP1 protein may alter the redox state of
      a wide range of transcription factors.

PMID- 8355687
TI  - cis-acting components in the replication origin from ribosomal DNA of
      Saccharomyces cerevisiae.
AB  - The ribosomal DNA (rDNA) repeats of Saccharomyces cerevisiae contain an
      autonomously replicating sequence (ARS) that colocalizes with a chromosomal
      origin of replication. We show that a minimal sequence necessary for full ARS
      function corresponds to a 107-bp rDNA fragment which contains three 10-of-11-bp
      matches to the ARS consensus sequence. Point mutations in only one of the 10-of
      11-bp matches, GTTTAT GTTTT, inactivate the rDNA ARS, indicating that this
      consensus sequence is essential. A perfect match to a revised ARS consensus is
      present but not essential. Sequences up to 9 bp 5' from the essential consensus
      are dispensable. A broad DNA region directly 3' to the essential consensus is
      required and is easily unwound as indicated by: (i) hypersensitivity to nicking
      of an approximately 100-bp region by mung bean nuclease in a negatively
      supercoiled plasmid and (ii) helical instability determined by thermodynamic
      analysis of the nucleotide sequence. A correlation between DNA helical
      instability and replication efficiency of wild-type and mutated ribosomal ARS
      derivatives suggests that a broad region 3' to the essential ARS consensus
      functions as a DNA unwinding element. Certain point mutations that do not
      stabilize the DNA helix in the 3' region but reduce ARS efficiency reveal an
      element distinct from, but overlapping, the DNA unwinding element. The nucleotide
      sequence of the functionally important constituents in the ARS appears to be
      conserved among the rDNA repeats in the chromosome.

PMID- 8355689
TI  - The phylogenetically invariant ACAGAGA and AGC sequences of U6 small nuclear RNA
      are more tolerant of mutation in human cells than in Saccharomyces cerevisiae.
AB  - U6 small nuclear RNA (snRNA) is the most highly conserved of the five
      spliceosomal snRNAs that participate in nuclear mRNA splicing. The proposal that
      U6 snRNA plays a key catalytic role in splicing [D. Brow and C. Guthrie, Nature
      (London) 337:14-15, 1989] is supported by the phylogenetic conservation of U6,
      the sensitivity of U6 to mutation, cross-linking of U6 to the vicinity of the 5'
      splice site, and genetic evidence for extensive base pairing between U2 and U6
      snRNAs. We chose to mutate the phylogenetically invariant 41-ACAGAGA-47 and 53
      AGC-55 sequences of human U6 because certain point mutations within the
      homologous regions of Saccharomyces cerevisiae U6 selectively block the first or
      second step of mRNA splicing. We found that both sequences are more tolerant to
      mutation in human cells (assayed by transient expression in vivo) than in S.
      cerevisiae (assayed by effects on growth or in vitro splicing). These differences
      may reflect different rate-limiting steps in the particular assays used or
      differential reliance on redundant RNA-RNA or RNA-protein interactions. The
      ability of mutations in U6 nucleotides A-45 and A-53 to selectively block step 2
      of splicing in S. cerevisiae had previously been construed as evidence that these
      residues might participate directly in the second chemical step of splicing; an
      indirect, structural role seems more likely because the equivalent mutations have
      no obvious phenotype in the human transient expression assay.

PMID- 8355690
TI  - Inactivation of YME1, a member of the ftsH-SEC18-PAS1-CDC48 family of putative
      ATPase-encoding genes, causes increased escape of DNA from mitochondria in
      Saccharomyces cerevisiae.
AB  - The yeast nuclear gene YME1 was one of six genes recently identified in a screen
      for mutations that elevate the rate at which DNA escapes from mitochondria and
      migrates to the nucleus. yme1 mutations, including a deletion, cause four known
      recessive phenotypes: an elevation in the rate at which copies of TRP1 and ARS1,
      integrated into the mitochondrial genome, escape to the nucleus; a heat-sensitive
      respiratory-growth defect; a cold-sensitive growth defect on rich glucose medium;
      and synthetic lethality in rho- (cytoplasmic petite) cells. The cloned YME1 gene
      complements all of these phenotypes. The gene product, Yme1p, is immunologically
      detectable as an 82-kDa protein present in mitochondria. Yme1p is a member of a
      family of homologous putative ATPases, including Sec18p, Pas1p, Cdc48p, TBP-1,
      and the FtsH protein. Yme1p is most similar to the Escherichia coli FtsH protein,
      an essential protein involved in septum formation during cell division. This
      observation suggests the hypothesis that Yme1p may play a role in mitochondrial
      fusion and/or division.

PMID- 8355691
TI  - The DNA-binding activity of the human heat shock transcription factor is
      regulated in vivo by hsp70.
AB  - The human heat shock transcription factor (HSF) is maintained in an inactive non
      DNA-binding form under nonstress conditions and acquires the ability to bind
      specifically to the heat shock promoter element in response to elevated
      temperatures or other conditions that disrupt protein structure. Here we show
      that constitutive overexpression of the major inducible heat shock protein,
      hsp70, in transfected human cells reduces the extent of HSF activation after a
      heat stress. HSF activation was inhibited more strongly in clones that express
      higher levels of hsp70. These results demonstrate that HSF activity is negatively
      regulated in vivo by hsp70 and suggest that the cell might sense elevated
      temperature as a decreased availability of hsp70. HSF activation in response to
      treatment with sodium arsenite or the proline analog azetidine was also depressed
      in hsp70-expressing cells relative to that in the nontransfected control cells.
      As well, the level of activated HSF decreased more rapidly in the hsp70
      expressing clones when the cells were heat shocked and returned to 37 degrees C.
      These results suggest that hsp70 could play an active role in the conversion of
      HSF back to a conformation that does not bind the heat shock promoter element
      during the attenuation of the heat shock response.

PMID- 8355692
TI  - Nuclear protein-binding sites in a transcriptional control region of the rabbit
      alpha-globin gene.
AB  - The 5'-flanking and internal regions of the rabbit alpha-globin gene, which
      constitute a CpG island, are required for enhancer-independent expression in
      transfected cells. In this study, electrophoretic mobility shift assays revealed
      that a battery of nuclear proteins from both erythroid and nonerythroid cells
      bind specifically to these regulatory regions. Assays based on exonuclease III
      digestion, methylation interference, and DNase I footprinting identified
      sequences bound by proteins in crude nuclear extracts and by purified
      transcription factor Sp1. In the 5' flank, recognition sites for the
      transcription factors alpha-IRP (positions -53 to -44 relative to the cap site),
      CP1 (-73 to -69), and Sp1 (-95 to -90) are bound by proteins in K562 cell nuclear
      extracts, as are three extended upstream regions. Two recognition sites for Sp1
      in intron 1 are also bound both by proteins in crude nuclear extracts and by
      purified Sp1. The sequences CCAC in intron 2 and C5 in the 3'-untranslated region
      also bind proteins. A major binding site found in exon 1, TATGGCGC, matches in
      sequence and methylation interference pattern the binding site for nuclear
      protein YY1, and binding is inhibited through competition by YY1-specific
      oligonucleotides. The protein-binding sites flanking and internal to the rabbit
      alpha-globin gene may form an extended promoter.

PMID- 8355693
TI  - Control of BEK and K-SAM splice sites in alternative splicing of the fibroblast
      growth factor receptor 2 pre-mRNA.
AB  - The fibroblast growth factor receptor 2 gene pre-mRNA can be spliced by using
      either the K-SAM exon or the BEK exon. The exon chosen has a profound influence
      on the ligand-binding specificity of the receptor obtained. Cells make a choice
      between the two alternative exons by controlling use of both exons. Using
      fibroblast growth factor receptor 2 minigenes, we have shown that in cells
      normally using the K-SAM exon, the BEK exon is not used efficiently even in the
      absence of the K-SAM exon. This is because these cells apparently express a
      titratable repressor of BEK exon use. In cells normally using the BEK exon, the K
      SAM exon is not used efficiently even in the absence of a functional BEK exon.
      Three purines in the K-SAM polypyrimidine tract are at least in part responsible
      for this, as their mutation to pyrimidines leads to efficient use of the K-SAM
      exon, while mutating the BEK polypyrimidine tract to include these purines stops
      BEK exon use.

PMID- 8355694
TI  - Genetic transfer and expression of reconstructed yeast artificial chromosomes
      containing normal and translocated BCL2 proto-oncogenes.
AB  - The goal of this study was to determine whether it will be feasible to study the
      expression of a large, human gene, such as the BCL2 proto-oncogene, by DNA
      transfection. The BCL2 proto-oncogene is 230 kb in size and is deregulated in
      tumor cells by translocation into the immunoglobulin heavy-chain locus. Yeast
      artificial chromosomes (YACs) containing the human BCL2 gene were altered by
      homologous recombination in Saccharomyces cerevisiae to yield replicas of the
      normal and translocated alleles. Constructions containing either allele and
      ranging in size from 360 to 800 kb were integrated stably into a mouse tumor
      line. Fifty-eight percent of the clones contained a copy of the entire YAC
      insert. Over 50% of these clones expressed appropriate levels of human BCL2 RNA
      and protein. These studies suggested that the expression of large human genes and
      their pathologic rearrangements can be studied by transfection techniques
      employing YACs propagated in S. cerevisiae.

PMID- 8355695
TI  - Selective DNA bending by a variety of bZIP proteins.
AB  - We have investigated DNA bending by bZIP family proteins that can bind to the AP
      1 site. DNA bending is widespread, although not universal, among members of this
      family. Different bZIP protein dimers induced distinct DNA bends. The DNA bend
      angles ranged from virtually 0 to greater than 40 degrees as measured by phasing
      analysis and were oriented toward both the major and the minor grooves at the
      center of the AP-1 site. The DNA bends induced by the various heterodimeric
      complexes suggested that each component of the complex induced an independent DNA
      bend as previously shown for Fos and Jun. The Fos-related proteins Fra1 and Fra2
      bent DNA in the same orientation as Fos but induced smaller DNA bend angles. ATF2
      also bent DNA toward the minor groove in heterodimers formed with Fos, Fra2, and
      Jun. CREB and ATF1, which favor binding to the CRE site, did not induce
      significant DNA bending. Zta, which is a divergent member of the bZIP family,
      bent DNA toward the major groove. A variety of DNA structures can therefore be
      induced at the AP-1 site through combinatorial interactions between different
      bZIP family proteins. This diversity of DNA structures may contribute to
      regulatory specificity among the plethora of proteins that can bind to the AP-1
      site.

PMID- 8355696
TI  - In vivo protein-DNA interactions at the c-jun promoter: preformed complexes
      mediate the UV response.
AB  - Irradiation of cells with UV light triggers a genetic response, called the UV
      response, which results in induction of a set of genes containing AP-1-binding
      sites. The c-jun gene itself, which codes for AP-1-binding activity, is strongly
      (> 100-fold) and rapidly activated by UV. The UV induction of c-jun is mediated
      by two UV response elements consisting of AP-1-like sequences within its 5'
      control region. We have analyzed protein-DNA interactions in vivo at the c-jun
      promoter in noninduced and UV-irradiated HeLa cells. In vivo footprint analysis
      was performed by using dimethyl sulfate on intact cells and DNase I on
      lysolecithihin-permeabilized cells in conjunction with ligation-mediated
      polymerase chain reaction to cover about 450 bp of the c-jun promoter, including
      the transcription start sites. We find that this region does not contain
      methylated cytosines and is thus a typical CpG island. In uninduced cells, in
      vivo protein-DNA interactions were localized to an AP-1-like sequence
      (nucleotides [nt] -71 to -64), a CCAAT box element (nt -91 to -87), two SP1
      sequences (nt -115 to -110 and -123 to -118), a nuclear factor jun site (nt -140
      to -132), and a second AP-1-like sequence (nt -190 to -183). These results
      indicate that complex protein-DNA interactions exist at the c-jun promoter prior
      to induction by an external stimulus. Surprisingly, after stimulation of c-jun
      expression by UV irradiation, all in vivo protein-DNA contacts remained
      essentially unchanged, including the two UV response elements located at the AP-1
      like sequences. The UV-induced signalling cascade leads to phosphorylation of c
      Jun on serines 63 and 73 (Y. Devary, R.A. Gottlieb, T. Smeal, and M. Karin, Cell
      71:1081-1091, 1992). Taken together, these data suggest that modification of the
      transactivating domain of DNA-bound c-Jun or a closely related factor may trigger
      the rapid induction of the c-jun gene.

PMID- 8355697
TI  - MPTP delta, a putative murine homolog of HPTP delta, is expressed in specialized
      regions of the brain and in the B-cell lineage.
AB  - Protein tyrosine phosphatases (PTPs), together with protein tyrosine kinases
      (PTKs), are involved in the regulation of cell activation, growth, and
      differentiation. To further elucidate the fine tuning of cell growth and
      differentiation through tyrosine phosphorylation, we tried to isolate mouse
      receptor-type PTP (RPTP) cDNA clones by screening mouse brain cDNA libraries with
      mouse CD45 PTP domain probes under reduced-stringency conditions.
      Characterization of isolated cDNA clones for RPTP showed that the cytoplasmic
      region contains two tandem repeats of PTP domain of about 230 amino acids with
      intrinsic phosphatase activity. The extracellular region was composed of
      immunoglobulin (Ig)-like domains and fibronectin type III (FN-III)-like domains.
      The gene was highly homologous to human PTP delta (HPTP delta) and thus was named
      MPTP delta (murine counterpart of HPTP delta). The MPTP delta gene appeared to
      generate at least three species of mRNA, which differ in the composition of the
      extracellular domain: type A, one Ig-like and four FN-III-like domains; type B,
      one Ig-like and eight FN-III-like domains; and type C, three Ig-like and eight FN
      III-like domains. Interestingly, the 5' untranslated region and the leader
      peptide of types A and B were completely different from those of type C. Northern
      (RNA) blot analysis demonstrated that brain, kidney, and heart cells express
      three mRNA species of about 7 kb. Antibody directed against part of the
      extracellular domain of type A MPTP delta recognized a 210-kDa protein in brain
      and kidney lysates. In situ hybridization of brain samples revealed that MPTP
      delta mRNA is present in the hippocampus, thalamic reticular nucleus, and
      piriform cortex, where some Src family PTKs have been also demonstrated to exist.
      Although MPTP delta mRNA was not detected in lymphoid tissues, all of the pre-B
      cell lines tested and one of three B-cell lines tested expressed MPTP delta mRNA,
      whereas antibody-producing B-cell hybridomas and T-cell and macrophage lines did
      not. Finally, the MPTP delta locus was tightly linked to the brown (b) locus on
      mouse chromosome 4.

PMID- 8355698
TI  - Identification and purification of a protein that binds DNA cooperatively with
      the yeast SWI5 protein.
AB  - The Saccharomyces cerevisiae SWI5 gene encodes a zinc finger protein required for
      the expression of the HO gene. A protein fusion between glutathione S-transferase
      and SWI5 was expressed in Escherichia coli and purified. The GST-SWI5 fusion
      protein formed only a low-affinity complex in vitro with the HO promoter, which
      was inhibited by low concentrations of nonspecific DNA. This result was
      surprising, since genetic evidence demonstrated that SWI5 functions at the HO
      promoter via this site in vivo. A yeast factor, GRF10 (also known as PHO2 and
      BAS2), that promoted high-affinity binding of SWI5 in the presence of a large
      excess of nonspecific carrier DNA was purified. Final purification of the 83-kDa
      GRF10 protein was achieved by cooperative interaction-based DNA affinity
      chromatography. In vitro binding studies demonstrated that SWI5 and GRF10 bind
      DNA cooperatively. Methylation interference and missing-nucleoside studies
      demonstrated that the two proteins bind at adjacent sites, with each protein
      making unique DNA contacts. SWI5 and GRF10 interactions were not detected in the
      absence of DNA. The role of cooperative DNA binding in determining promoter
      specificity of eukaryotic transcription factors is discussed.

PMID- 8355699
TI  - Demethylation of somatic and testis-specific histone H2A and H2B genes in F9
      embryonal carcinoma cells.
AB  - In contrast to many other genes containing a CpG island, the testis-specific H2B
      (TH2B) histone gene exhibits tissue-specific methylation patterns in correlation
      with gene activity. Characterization of the methylation patterns within a 20-kb
      segment containing the TH2A and TH2B genes in comparison with that in a somatic
      histone cluster revealed that: (i) the germ cell-specific unmethylated domain of
      the TH2A and TH2B genes is defined as a small region surrounding the CpG islands
      of the TH2A and TH2B genes and (ii) somatic histone genes are unmethylated in
      both liver and germ cells, like other genes containing CpG islands, whereas
      flanking sequences are methylated. Transfection of in vitro-methylated TH2B,
      somatic H2B, and mouse metallothionein I constructs into F9 embryonal carcinoma
      cells revealed that the CpG islands of the TH2A and TH2B genes were demethylated
      like those of the somatic H2A and H2B genes and the metallothionein I gene. The
      demethylation of those CpG islands became significantly inefficient at a high
      number of integrated copies and a high density of methylated CpG dinucleotides.
      In contrast, three sites in the somatic histone cluster, of which two sites are
      located in the long terminal repeat of an endogenous retrovirus-like sequence,
      were efficiently demethylated even at a high copy number and a high density of
      methylated CpG dinucleotides. These results suggest two possible mechanisms for
      demethylation in F9 cells and methylation of CpG islands of the TH2A and TH2B
      genes at the postblastula stage during embryogenesis.

PMID- 8355700
TI  - Multiple proteins interact with the fushi tarazu proximal enhancer.
AB  - The expression of the Drosophila segmentation gene fushi tarazu (ftz) is
      controlled at the level of transcription. The proximal enhancer, located
      approximately 3.4 kb upstream of the transcription start site, directs lacZ
      fusion gene expression in a ftz-like seven-stripe pattern in transgenic fly
      embryos. We have taken a biochemical approach to identify DNA-binding proteins
      that regulate ftz gene expression through the proximal enhancer. DNase I
      footprinting and methylation interference experiments with staged Drosophila
      embryo nuclear extracts identified nine protein binding sites in the proximal
      enhancer. Ten different sequence-specific DNA-binding complexes that interact
      with eight of these sites were identified. Some interact with multiple sites,
      while others bind to single sites in the enhancer. Two of the complexes that
      interact with multiple sites appear to contain the previously described ftz
      regulators, FTZ-F1 and TTK/FTZ-F2. These in vitro studies allowed us to narrow
      down the proximal enhancer to a 323-bp DNA fragment that contains all of the
      protein binding sites. Expression directed by this minimal enhancer element in
      seven ftz-like stripes in transgenic embryos is identical to that directed by the
      full-length enhancer. Internal deletions of several sites abolish reporter gene
      expression in vivo. Thus, the ftz proximal enhancer, like other cell-type
      specific eukaryotic enhancers, interacts with an array of proteins that are
      expected to mediate the establishment, maintenance, and repression of
      transcription of the ftz gene in seven stripes in the developing embryo.

PMID- 8355701
TI  - Differentiation arrest and stromal cell-independent growth of murine
      erythroleukemia cells are associated with elevated expression of ets-related
      genes but not with mutation of p53.
AB  - The ELM erythroleukemia is novel in that long-term survival of leukemic cells in
      culture (ELM-D cells) is dependent on contact with a bone marrow-derived stromal
      feeder cell layer. However, a number of stroma-independent (ELM-I) mutants that
      vary in their ability to differentiate in vitro in response to erythropoietin and
      interleukin-3 have been derived. We have attempted to define the genetic changes
      responsible for these different phenotypes. At the p53 locus in the primary
      leukemic cells, one copy of the gene has been lost whereas the other contains an
      18-bp depletion, implicating its mutation as an early step in the development of
      the leukemia. Changes in ets gene expression have also been found. The Fli-1 gene
      region is rearranged in the primary tumor because of the insertion of a
      retrovirus inserted upstream of one Fli-1 allele, but this does not result in Fli
      1 gene activation in any of the ELM-D or ELM-I cell lines except one. It seems
      significant that this line is the only one to have lost the ability to
      differentiate in response to erythropoietin. In addition, up-regulation of erg is
      associated with stromal cell-independent growth, since all ELM-I mutants have
      moderate levels of erg mRNA, whereas only low or undetectable levels are found in
      primary leukemic cells in vivo or in ELM-D cells in vitro. This up-regulation of
      erg mRNA seems to be important for stromal cell-independent growth, since ELM-D
      cells show elevated expression of the erg gene after separation from stromal
      cells. This seems to be made permanent in ELM-I mutants, since they do not down
      regulate erg mRNA when grown in contact with stromal cells. We therefore propose
      that ets family members regulate both the survival and differentiation of
      erythroid cells.

PMID- 8355703
TI  - Purification of the human NF-E2 complex: cDNA cloning of the hematopoietic cell
      specific subunit and evidence for an associated partner.
AB  - The human globin locus control region-binding protein, NF-E2, was purified by DNA
      affinity chromatography. Its tissue-specific component, p45 NF-E2, was cloned by
      use of a low-stringency library screen with murine p45 NF-E2 cDNA (N. C. Andrews,
      H. Erdjument-Bromage, M. B. Davidson, P. Tempst, and S. H. Orkin, Nature [London]
      362:722-728, 1993). The human p45 NF-E2 gene was localized to chromosome 12q13 by
      fluorescent in situ hybridization. Human p45 NF-E2 and murine p45 NF-E2 are
      highly homologous basic region-leucine zipper (bZIP) proteins with identical DNA
      binding domains. Immunoprecipitation experiments demonstrated that p45 NF-E2 is
      associated in vivo with an 18-kDa protein (p18). Because bZIP proteins bind DNA
      as dimers, we infer that native NF-E2 must be a heterodimer of 45- and 18-kDa
      subunits. Although AP-1 and CREB copurified with NF-E2, no evidence was found for
      heterodimer formation between p45 NF-E2 and proteins other than p18. Thus, p18
      appears to be the sole specific partner of p45 NF-E2 in erythroid cells. Cloning
      of human p45 NF-E2 should permit studies of the role of NF-E2 in globin gene
      regulation and erythroid differentiation.

PMID- 8355702
TI  - NonO, a non-POU-domain-containing, octamer-binding protein, is the mammalian
      homolog of Drosophila nonAdiss.
AB  - We have cloned the ubiquitous form of an octamer-binding, 60-kDa protein (NonO)
      that appears to be the mammalian equivalent of the Drosophila visual and
      courtship song behavior protein, no-on-transient A/dissonance (nonAdiss). A
      region unprecedently rich in aromatic amino acids containing two ribonuclear
      protein binding motifs is highly conserved between the two proteins. A ubiquitous
      form of NonO is present in all adult tissues, whereas lymphocytes and retina
      express unique forms of NonO mRNA. The ubiquitous form contains a potential helix
      turn-helix motif followed by a highly charged region but differs from prototypic
      octamer-binding factors by lacking the POU DNA-binding domain. In addition to its
      conventional octamer duplex-binding, NonO binds single-stranded DNA and RNA at a
      site independent of the duplex site.

PMID- 8355704
TI  - An mRNA-type intron is present in the Rhodotorula hasegawae U2 small nuclear RNA
      gene.
AB  - Splicing an mRNA precursor requires multiple factors involving five small nuclear
      RNA (snRNA) species called U1, U2, U4, U5, and U6. The presence of mRNA-type
      introns in the U6 snRNA genes of some yeasts led to the hypothesis that U6 snRNA
      may play a catalytic role in pre-mRNA splicing and that the U6 introns occurred
      through reverse splicing of an intron from an mRNA precursor into a catalytic
      site of U6 snRNA. We characterized the U2 snRNA gene of the yeast Rhodotorula
      hasegawae, which has four mRNA-type introns in the U6 snRNA gene, and found an
      mRNA-type intron of 60 bp. The intron of the U2 snRNA gene is present in the
      highly conserved region immediately downstream of the branch site recognition
      domain. Interestingly, we found that this region can form a novel base pairing
      with U6 snRNA. We discuss the possible implications of these findings for the
      mechanisms of intron acquisition and for the role of U2 snRNA in pre-mRNA
      splicing.

PMID- 8355705
TI  - A heterodimer of HEB and an E12-related protein interacts with the CD4 enhancer
      and regulates its activity in T-cell lines.
AB  - A T-lymphocyte-specific enhancer located 13 kb upstream of the murine CD4 gene
      was recently shown to be required for the developmentally regulated expression of
      CD4. We have previously identified three nuclear protein binding sites in this
      enhancer; one of these sites, CD4-3, is essential for expression and contains two
      E-box core motifs (CANNTG) adjacent to each other in the sequence
      TAACAGGTGTCAGCTGGT. In electrophoretic mobility shift assays using the CD4-3
      oligonucleotide as a probe, three nuclear protein complexes, termed CD4-3A, -B,
      and -C, were detected with nuclear extracts from T-cell lines. CD4-3A, which
      involves nuclear protein binding to the 5' E-box, was detected only with nuclear
      extracts from lymphoid cells. Specific antisera were used to show that the CD4-3A
      complex contains a heterodimer or heterooligomer of basic helix-loop-helix
      transcriptional factors, E12 or a related factor and HEB, which is expressed
      predominantly in thymus. Consistent with this finding, in vitro-translated E12
      and HEB proteins, as homodimers or heterodimers, bound preferentially to the 5' E
      box. Point mutations in the 5' E-box, but not in the 3' E-box, abolished CD4
      enhancer activity. Furthermore, overexpression of Id, a protein that forms
      inactive heterodimers with E12/E47, blocked CD4 enhancer activity in T cells.
      These results suggest that a heterodimer composed of HEB and E12 or a closely
      related protein plays a critical role in CD4 enhancer function by interacting
      with the 5' E-box motif of the CD4-3 site in vivo.

PMID- 8355706
TI  - Saccharomyces cerevisiae HSP70 heat shock elements are functionally distinct.
AB  - The Saccharomyces cerevisiae HSP70 gene SSA1 has multiple heat shock elements
      (HSEs). To determine the significance of each of these sequences for expression
      of SSA1, we analyzed expression from a set of promoters containing point
      mutations in each of the HSEs, individually and in pairwise combinations. Of the
      three HSE-like sequences, two (HSE2 and HSE3) were active promoter elements; only
      one, HSE2, was active under basal growth conditions. Either HSE2 or HSE3 alone
      was able to drive SSA1 transcription at near-normal rates after heat shock. Both
      HSE2 and HSE3 were capable of driving basal transcription when placed in the
      context of the CYC1 promoter. Previous analysis had identified an upstream
      repressing sequence overlapping HSE2 that repressed basal transcription driven by
      HSE2. Our analysis showed that basal transcription driven by HSE3 was repressed
      both by the distant upstream repressing sequence and by closer flanking
      sequences. The ability to drive basal transcription is not inherent in all
      natural HSEs, since the HSEs from the heat-inducible SSA3 and SSA4 genes showed
      no basal activity when placed in the CYC1 vector. Gel mobility shift experiments
      showed that the same population of heat shock transcription factor molecules
      bound to HSEs capable of driving basal activity and to HSEs having very low or
      undetectable basal activity.

PMID- 8355707
TI  - Distinct properties of c-myc transcriptional elongation are revealed in Xenopus
      oocytes and mammalian cells and by template titration, 5,6-dichloro-1-beta-D
      ribofuranosylbenzimidazole (DRB), and promoter mutagenesis.
AB  - A block to c-myc transcription elongation has been observed in Xenopus oocytes
      and mammalian cells. Here, we show that the distribution of RNA polymerase II
      transcription complexes in the c-myc promoter proximal region in Xenopus oocytes
      is different from that observed previously in mammalian cells. Thus, there are
      major differences in the c-myc elongation block observed in the two systems. In
      addition, as first reported for a Xenopus tubulin gene (K. M. Middleton and G. T.
      Morgan, Mol. Cell. Biol. 10:727-735, 1990). c-myc template titration experiments
      reveal the existence of two classes of RNA polymerase II transcription complexes
      in oocytes: one (at low template concentration) that is capable of reading
      through downstream sites of premature termination, and another (high template
      concentration) that does not. We show that these classes of polymerases are
      distinct from those previously identified by 5,6-dichloro-1-beta-D
      ribofuranosylbenzimidazole (DRB), which distinguishes transcription complexes on
      the basis of transcribed distance, rather than on the basis of differential
      elongation through sites of premature termination. We also show that mutations
      that affect the efficiency of initiation of transcription from the c-myc P2
      promoter can influence premature termination by at least two mechanisms: TATA box
      mutations function by the titration effect (decrease in transcription initiation
      results in a relative decrease in premature termination), while an upstream
      activator (E2F) site functions by contributing to the assembly of polymerase
      complexes competent to traverse the downstream sites of premature termination.

PMID- 8355708
TI  - The Ets-related transcription factor PU.1 immortalizes erythroblasts.
AB  - In vivo studies of Friend virus erythroleukemia have implied that proviral
      integrations adjacent to the gene for the Ets-related transcription factor PU.1
      may inhibit the commitment of erythroblasts to differentiate and cause their
      capability for indefinite transplantation (C. Spiro, B. Gliniak, and D. Kabat, J.
      Virol. 62:4129-4135, 1988; R. Paul, S. Schuetze, S. L. Kozak, C. Kozak, and D.
      Kabat, J. Virol. 65:464-467, 1991). To test this hypothesis, we ligated PU.1 cDNA
      into a retroviral vector and studied its effects on cultured cells. Infection of
      fibroblasts with PU.1-encoding retrovirus resulted in PU.1 synthesis followed by
      nuclear pyknosis, cell rounding, and degeneration. In contrast, in long-term bone
      marrow cultures, erythroblasts were efficiently and rapidly immortalized. The
      resulting cell lines were polyclonal populations that contained PU.1, were
      morphologically blast-like, required erythropoietin and bone marrow stromal cells
      for survival and proliferation, and spontaneously differentiated at low frequency
      to synthesize hemoglobin. After 9 months in culture, erythroblasts became stroma
      independent, and they then grew as clonal cell lines. We conclude that PU.1
      perturbs the pathway(s) that controls potential for indefinite proliferation and
      that it can be used to generate permanent erythroblast cell lines.

PMID- 8355709
TI  - Stimulation of kappa light-chain gene rearrangement by the immunoglobulin mu
      heavy chain in a pre-B-cell line.
AB  - B-lymphocyte development exhibits a characteristic order of immunoglobulin gene
      rearrangements. Previous work has led to the hypothesis that expression of the
      immunoglobulin mu heavy chain induces rearrangement activity at the kappa light
      chain locus. To examine this issue in more detail, we isolated five matched pairs
      of mu- and endogenously rearranged mu+ cell lines from the Abelson murine
      leukemia virus-transformed pro-B-cell line K.40. In four of the five mu+ cell
      lines, substantial expression of mu protein on the cell surface was observed, and
      this correlated with an enhanced frequency of kappa immunoglobulin gene
      rearrangement compared with that in the matched mu- cell lines. This increased
      kappa gene rearrangement frequency was not due to a general increase in the
      amount of V(D)J recombinase activity in the mu+ cells. Consistently, introduction
      of a functionally rearranged mu gene into one of the mu- pre-B-cell lines
      resulted in a fivefold increase in kappa gene rearrangements. In three of the
      four clonally matched pairs with increased kappa gene rearrangements, the
      increase in rearrangement frequency was not accompanied by a significant increase
      in germ line transcripts from the C kappa locus. However, in the fourth pair,
      K.40D, we observed an increase in germ line transcription of the kappa locus
      after expression of mu protein encoded by either an endogenously rearranged or a
      transfected functional heavy-chain allele. In these cells, the amount of the germ
      line C kappa transcript correlated with the measured frequency of rearranged
      kappa genes. These results support a regulated model of B-cell development in
      which mu protein expression in some way targets the V(D)J recombinase to the
      kappa gene locus.

PMID- 8355710
TI  - The ht beta gene encodes a novel CACCC box-binding protein that regulates T-cell
      receptor gene expression.
AB  - A gene encoding a novel CACCC box-binding protein that binds to the promoter
      region of the human T-cell receptor (TCR) V beta 8.1 gene and the mouse TCR alpha
      gene silencer has been cloned. This gene, termed ht beta, contains four zinc
      fingers of the class Cys2-X12-His2 that may be responsible for DNA binding and a
      highly negatively charged region that defines a putative transcriptional
      activation domain. Analysis of the expression of ht beta mRNA revealed similar
      expression levels and patterns in various cell lines. The bacterially expressed
      ht beta protein can bind to the CACCC box in both the human TCR V beta 8.1 gene
      promoter and the mouse TCR alpha gene silencer. The CACCC box is essential for
      efficient transcription of the V beta 8.1 promoter. Cotransfection with an ht
      beta expression plasmid and a reporter vector indicated that ht beta can activate
      human TCR V beta 8.1 gene transcription. ht beta also is able to counteract the
      silencing effect of the mouse TCR alpha gene silencer. The CACCC box has been
      found in almost all V beta 8.1 gene subfamily members and in both TCR alpha and
      beta gene enhancers in humans and mice. These results suggest that the CACCC box
      binding protein may have an important regulatory function for TCR gene expression
      in alpha beta T cells versus gamma delta T cells.

PMID- 8355711
TI  - Transcriptional regulator Leu3 of Saccharomyces cerevisiae: separation of
      activator and repressor functions.
AB  - The Leu3 protein of Saccharomyces cerevisiae binds to specific DNA sequences
      present in the 5' noncoding region of at least five RNA polymerase II-transcribed
      genes. Leu3 functions as a transcriptional activator only when the metabolic
      intermediate alpha-isopropylmalate is also present. In the absence of alpha
      isopropylmalate, Leu3 causes transcription to be repressed below basal levels. We
      show here that different portions of the Leu3 protein are responsible for
      activation and repression. Fusion of the 30 C-terminal residues of Leu3 to the
      DNA-binding domain of the Gal4 protein created a strong cross-species activator,
      demonstrating that the short C-terminal region is not only required but also
      sufficient for transcriptional activation. Using a recently developed Leu3
      responsive in vitro transcription assay as a test system for repression (J. Sze,
      M. Woontner, J. Jaehning, and G. B. Kohlhaw, Science 258:1143-1145, 1992), we
      show that mutant forms of the Leu3 protein that lack the activation domain still
      function as repressors. The shortest repressor thus identified had only about 15%
      of the mass of the full-length Leu3 protein and was centered on the DNA-binding
      region of Leu3. Implications of this finding for the mechanism of repression are
      discussed.

PMID- 8355712
TI  - Repeated CT elements bound by zinc finger proteins control the absolute and
      relative activities of the two principal human c-myc promoters.
AB  - Transcription of the human proto-oncogene c-myc is governed by two tandem
      principal promoters, termed P1 and P2. In general, the downstream promoter, P2,
      is predominant, which is in contrast to the promoter occlusion phenomenon usually
      observed in genes containing tandem promoters. A shift in human c-myc promoter
      usage has been observed in some tumor cells and in certain physiological
      conditions. However, the mechanisms that regulate promoter usage are not well
      understood. The present studies identify regulators which are required to promote
      transcription from both human c-myc promoters, P1 and P2, and have a role in
      determining their relative activities in vivo. A novel regulatory region located
      101 bp upstream of P1 was characterized and contains five tandem repeats of the
      consensus sequence CCCTCCCC (CT element). The integrity of the region containing
      all five elements is required to promote transcription from P1 and for maximal
      activity from P2 in vivo. A single copy of this same element, designated CT-I2,
      also appears in an inverted orientation 53 bp upstream of the P2 transcription
      start site. This element has an inhibitory effect on P1 transcription and is
      required for P2 transcription. The transcription factor Sp1 was identified as the
      factor that binds specifically to the tandem CT elements upstream of P1 and to
      the CT-I2 element upstream of P2. In addition, the recently cloned zinc finger
      protein ZF87, or MAZ, was also able to bind these same elements in vitro. The
      five tandem CT elements can be functionally replaced by a heterologous enhancer
      that only in the absence of CT-I2 reverses the promoter usage, similar to what is
      observed in the translocated c-myc allele of Burkitt's lymphoma cells.

PMID- 8355713
TI  - Saccharomyces cerevisiae BUF protein binds to sequences participating in DNA
      replication in addition to those mediating transcriptional repression (URS1) and
      activation.
AB  - The heteromeric BUF protein was originally shown to bind to URS1 elements which
      are situated upstream of many genes in Saccharomyces cerevisiae and mediate
      negative control of their transcription. Among the genes regulated through the
      URS1 site and the proteins interacting with it are those participating in carbon,
      nitrogen, and inositol metabolism; electron transport; meiosis; sporulation; and
      mating-type switching. We show here that pure BUF protein, in addition to binding
      to the negatively acting URS1 site, also binds to CAR1 sequences supporting
      transcriptional activation (upstream activation sequences). To determine the BUF
      protein structure, we cloned and sequenced the BUF1 and BUF2 genes and found them
      to be identical to the RF-A (RP-A) gene whose products participate in yeast DNA
      replication as single-stranded DNA binding proteins. These data argue that BUF
      protein-binding sites serve multiple roles in transcription and replication.

PMID- 8355714
TI  - Retention of fibroblast growth factor 3 in the Golgi complex may regulate its
      export from cells.
AB  - The fibroblast growth factors (FGFs) fall into two distinct groups with respect
      to their mode of release from cells. Whereas FGF1 and FGF2 lack conventional
      signal peptides, the remaining members have typical features of secreted
      proteins. However, the behavior of mouse FGF3 is anomalous, since, despite
      entering the secretory pathway and undergoing primary glycosylation, its release
      from transfected COS-1 cells is very inefficient compared with that of FGF4 and
      FGF5. To investigate the unusual properties of FGF3, we analyzed the processing,
      secretion, and intracellular localization of a series of site-directed mutants as
      well as chimeras produced by fusing parts of FGF3, FGF4, and FGF5. Wild-type FGF3
      was shown to accumulate in an immature form in the Golgi complex, from where it
      is slowly released into the extracellular matrix. Removing or relocating the Asn
      linked glycosylation site further impaired its release, and exchanging the signal
      peptide or carboxy terminus had little effect. In contrast, a chimeric protein
      with an amino terminus from FGF5 was efficiently secreted and biologically active
      in cell transformation assays. The data suggest that a structural feature of FGF3
      involving the amino-terminal region and glycosylation site has a significant
      bearing on its passage through the Golgi complex and may regulate the secretion
      of the ligand.

PMID- 8355715
TI  - SPK1 is an essential S-phase-specific gene of Saccharomyces cerevisiae that
      encodes a nuclear serine/threonine/tyrosine kinase.
AB  - SPK1 was originally discovered in an immunoscreen for tyrosine-protein kinases in
      Saccharomyces cerevisiae. We have used biochemical and genetic techniques to
      investigate the function of this gene and its encoded protein. Hybridization of
      an SPK1 probe to an ordered genomic library showed that SPK1 is adjacent to PEP4
      (chromosome XVI L). Sporulation of spk1/+ heterozygotes gave rise to spk1 spores
      that grew into microcolonies but could not be further propagated. These colonies
      were greatly enriched for budded cells, especially those with large buds.
      Similarly, eviction of CEN plasmids bearing SPK1 from cells with a chromosomal
      SPK1 disruption yielded viable cells with only low frequency. Spk1 protein was
      identified by immunoprecipitation and immunoblotting. It was associated with
      protein-Ser, Thr, and Tyr kinase activity in immune complex kinase assays. Spk1
      was localized to the nucleus by immunofluorescence. The nucleotide sequence of
      the SPK1 5' noncoding region revealed that SPK1 contains two MluI cell cycle box
      elements. These elements confer S-phase-specific transcription to many genes
      involved in DNA synthesis. Northern (RNA) blotting of synchronized cells verified
      that the SPK1 transcript is coregulated with other MluI box-regulated genes. The
      SPK1 upstream region also includes a domain highly homologous to sequences
      involved in induction of RAD2 and other excision repair genes by agents that
      induce DNA damage. spk1 strains were hypersensitive to UV irradiation. Taken
      together, these findings indicate that SPK1 is a dual-specificity (Ser/Thr and
      Tyr) protein kinase that is essential for viability. The cell cycle-dependent
      transcription, presence of DNA damage-related sequences, requirement for UV
      resistance, and nuclear localization of Spk1 all link this gene to a crucial S
      phase-specific role, probably as a positive regulator of DNA synthesis.

PMID- 8355716
TI  - Functionally distinct elements are required for expression of the AMPD1 gene in
      myocytes.
AB  - AMP deaminase (AMPD) is an enzyme found in all eukaryotic cells. Tissue-specific
      and stage-specific isoforms of this enzyme are found in vertebrates, and
      expression of these different isoforms is determined by selective expression of
      the multiple genes. The AMPD1 gene is expressed predominantly in skeletal muscle,
      in which transcript abundance is controlled by stage-specific and fiber type
      specific signals. This enzyme activity is presumed to be important in skeletal
      muscle because a metabolic myopathy develops in individuals with an inherited
      deficiency of AMPD1. In the present study, cis- and trans-acting factors that
      control expression of AMPD1 have been identified. Two cis-acting elements located
      within 100 nucleotides of the transcriptional start site are required for muscle
      specific expression of AMPD1. One element (-100 to -79) behaves like a tissue
      specific enhancer, and it interacts with protein(s) found predominantly in nuclei
      of myoblasts and myotubes. This element is similar in sequence to an MEF2 binding
      motif, and it contains an A/T core that is essential for enhancer activity and
      binding of a nuclear protein(s). The second element (-60 to -40) has properties
      of a stage-specific promoter in that it is essential for muscle-specific
      expression of the AMPD1 promoter, does not confer muscle-specific expression on a
      heterologous promoter construct, and interacts with a protein(s) restricted to
      nuclei of differentiated myotubes. Interaction between these functionally
      distinct elements may be required for regulating the expression of AMPD1 during
      myocyte differentiation and in different muscle fiber types.

PMID- 8355717
TI  - Elements controlling follicular expression of the s36 chorion gene during
      Drosophila oogenesis.
AB  - An 84-bp proximal regulatory protein (PRR) of the Drosophila melanogaster s36
      chorion gene is sufficient for directing proper temporal and spatial expression
      of a reporter gene in three domains of the follicle: anterior, posterior, and
      main body. Here we show that the fidelity of PRR-directed s36 expression is
      dependent on the proper dorsal-ventral differentiation of the follicular
      epithelium, which requires the Drosophila epidermal growth factor receptor
      homolog. Transgenic analysis of site-directed mutants of the PRR suggests that
      s36 expression is regulated by the concerted action of multiple positive
      activators. Several cis-acting transcriptional elements have been identified:
      some appear to function in a quantitative manner, while others either are
      essential or appear to regulate expression in particular spatial domains. The
      approximate locations of these regulatory elements have been defined; some map
      within sequences that are strongly conserved in widely divergent dipteran
      species. In fact, the PRR analog of the medfly Ceratitis capitata Ccs36 gene
      directs expression in a manner similar to the D. melanogaster s36 PRR. We propose
      a model for transcriptional regulation of s36 based on the prechoriogenic
      polarization of the follicular epithelium that surrounds the developing egg
      chamber.

PMID- 8355719
TI  - Femoral mononeuropathy induced by the lithotomy position: a report of 5 cases
      with a review of literature.
AB  - We report 5 young women who developed femoral mononeuropathy (FMN) after
      placement in the lithotomy position. Three had uncomplicated vaginal deliveries
      and 2 underwent exploratory laparoscopies. EMG was performed on 3 patients. The
      lesions were localized to the inguinal ligament and probably demyelinating,
      accounting for their excellent prognosis. On reviewing the literature, however,
      we believe that lithotomy position can cause FMN, not only by nerve compression
      at the inguinal ligament, but also by stretching of the nerve by excessive hip
      abduction and external rotation.

PMID- 8355718
TI  - In vitro transcription of a Drosophila U1 small nuclear RNA gene requires TATA
      box-binding protein and two proximal cis-acting elements with stringent spacing
      requirements.
AB  - Transcription of a Drosophila U1 small nuclear RNA gene was functionally analyzed
      in cell extracts derived from 0- to 12-h embryos. Two promoter elements essential
      for efficient initiation of transcription in vitro by RNA polymerase II were
      identified. The first, termed PSEA, is located between positions -41 and -61
      relative to the transcription start site, is crucial for promoter activity, and
      is the dominant element for specifying the transcription initiation site. PSEA
      thus appears to be functionally homologous to the proximal sequence element of
      vertebrate small nuclear RNA genes. The second element, termed PSEB, is located
      at positions -25 to -32 and is required for an efficient level of transcription
      initiation because mutation of PSEB, or alteration of the spacing between PSEA
      and PSEB, severely reduced transcriptional activity relative to that of the wild
      type promoter. Although the PSEB sequence does not have any obvious sequence
      similarity to a TATA box, conversion of PSEB to the canonical TATA sequence
      dramatically increased the efficiency of the U1 promoter and simultaneously
      relieved the requirement for the upstream PSEA. Despite these effects,
      introduction of the TATA sequence into the U1 promoter had no effect on the
      choice of start site or on the RNA polymerase II specificity of the promoter.
      Finally, evidence is presented that the TATA box-binding protein is required for
      transcription from the wild-type U1 promoter as well as from the TATA-containing
      U1 promoter.

PMID- 8355720
TI  - Persistent and transient "conduction block" in motor neuron diseases.
AB  - Although conduction block indicates dysfunction of peripheral nerve, it may occur
      in patients with clinically typical motor neuron disease. There are no
      universally accepted criteria to identify conduction block, so diagnosis may be
      difficult. In some peripheral neuropathies, conduction block persists over long
      periods of time. If conduction block persists in motor neuron disease, then a
      more reproducible means for identification would be available. We repeatedly
      studied 9 patients with different forms of motor neuron diseases; conduction
      block was suspected because of excessive loss of the amplitude of motor evoked
      responses between distal and proximal stimulation sites. Five showed persistent
      amplitude loss at intervals between 12 and 36 months. All had focal loss of
      amplitude and area across a specific segment; all were men; none had definite
      upper motor neuron signs, 2 had probable and 3 had no upper motor neuron signs; 1
      had IgM paraproteinemia, one elevated anti-GM1 titers; the duration of symptoms
      spanned 4-13 years. Four patients had transient loss of amplitude that was not
      reproduced in intervals between 3 and 13 months. None had focal loss of both
      amplitude and area; 2 were men; all had definite upper motor neuron signs and
      none had symptoms for more than 3-13 months; and none had immunological
      abnormalities. Thus, patients with persistent amplitude loss fulfill other
      criteria for conduction block, have prolonged survival but otherwise have
      clinical syndromes indistinguishable from ALS, except that definite upper motor
      neuron signs seem to be exceptional.

PMID- 8355721
TI  - Hereditary motor-sensory neuropathy and movement disorders.
AB  - To explore the relationship between hereditary motor and sensory neuropathy
      (HMSN) and movement disorders, we examined 7 patients with HMSN referred to our
      Movement Disorders Clinic and surveyed members of the Charcot-Marie-Tooth
      association. The following movement disorders were observed in the index
      patients: postural tremor in 6, rest tremor in 3, and Parkinsonism and dystonia
      in 2. Tremor, present in 40% of the 201 patients who responded to the survey, was
      first noted at a mean age of 36 years, and mostly involved the hands. Family
      history of tremor was more frequent in the tremor group (P < 0.005), which also
      had a significantly worse writing score than the nontremor group (P < 0.001). The
      overlap in clinical features between HMSN-associated tremor and essential tremor
      (ET), the high frequency of family history of tremor, and the lack of a
      relationship between the severity of tremor and of peripheral neuropathy suggest
      that the tremor in HMSN is pathogenically related to ET.

PMID- 8355722
TI  - Mechanisms of fatigue in normal intercostal muscle and muscle from patients with
      myasthenia gravis.
AB  - Fatigue mechanisms in normal intercostal muscle and muscle from patients with
      myasthenia gravis (MG) were evaluated by monitoring the compound muscle action
      potential (CMAP) and tetanic tension responses to repetitive nerve or muscle
      stimulation in vitro. When fatigue was induced by nerve stimulation at 30 Hz for
      0.5 s every 2.5 s, about half of the original tension decreased after 30 min in
      normal muscle and 5 min in MG muscle. Analysis of the changes in area of CMAPs
      and tension indicated that impairment of neuromuscular transmission, muscle
      membrane excitation, and excitation-contraction (E-C) coupling and contractility
      accounted for 40%, 29%, and 31% of fatigue in normal muscle, and 83%, 0%, and 17%
      of fatigue in MG muscle. When fatigue was induced by muscle stimulation at 30 Hz,
      tension declined by a quarter after 30 min in normal muscle, but by a half after
      17 min in MG muscle. Impairment of muscle membrane excitation and E-C coupling
      and contractility accounted for 58% and 42% of fatigue in normal muscle, and 22%
      and 78% of fatigue in MG muscle. Thus, fatigue of normal muscle is caused by
      impairment of at least four processes, and enhanced fatigue of MG muscle is
      caused by greater impairment of neuromuscular transmission, E-C coupling, and
      contractility.

PMID- 8355723
TI  - Na+ currents near and away from endplates on human fast and slow twitch muscle
      fibers.
AB  - Fast and slow twitch muscle fibers have distinct contractile properties. Here we
      determined that membrane excitability also varies with fiber type. Na+ currents
      (INa) were studied with the loose-patch voltage clamp technique on 29
      histochemically classified human intercostal skeletal muscle fibers at the
      endplate border and > 200 microns from the endplate (extrajunctional). Fast and
      slow twitch fibers showed slow inactivation of endplate border and
      extrajunctional INa and had increased INa at the endplate border compared to
      extrajunctional membrane. The voltage dependencies of INa were similar on the
      endplate border and extrajunctional membrane, which suggests that both regions
      have physiologically similar channels. Fast twitch fibers had larger INa on the
      endplate border and extrajunctional membrane and manifest fast and slow
      inactivation of INa at more negative potentials than slow twitch fibers. For
      normal muscle, the differences between INa on fast and slow twitch fibers might:
      (1) enable fast twitch fibers to operate at high firing frequencies for brief
      periods; and (2) enable slow twitch fibers to operate at low firing frequencies
      for prolonged times. Disorders of skeletal membrane excitability, such as the
      periodic paralyses and myotonias, may impact fast and slow twitch fibers
      differently due to the distinctive Na+ channel properties of each fiber type.

PMID- 8355724
TI  - Sympathetic skin response abnormalities in amyotrophic lateral sclerosis.
AB  - The sympathetic skin response (SSR) was evaluated in 25 patients with amyotrophic
      lateral sclerosis (ALS) to assess for involvement of the autonomic nervous
      system. Twenty-two age-matched normals and 6 patients with muscular dystrophy
      served as controls. The SSR was intact in all normal volunteers and all patients
      with muscular dystrophy. The mean SSR latency in the ALS patients was prolonged
      compared to that of normals (2.29 +/- 0.28 versus 2.13 +/- 0.16 s, P < 0.05). The
      SSR was absent in one or both legs of 10 ALS patients (40%). Absence or abnormal
      latency of SSR in patients with ALS without clinical findings of autonomic
      failure suggests involvement of the autonomic nervous system in addition to the
      motor system.

PMID- 8355725
TI  - Chronic immune activation in the eosinophilia-myalgia syndrome.
AB  - Eosinophilia-myalgia syndrome (EMS) is a multisystem illness of uncertain
      pathogenesis that occurred in an epidemic related to the ingestion of
      contaminated L-tryptophan. To investigate the role of immune dysfunction in EMS
      we prospectively measured a serologic index of T-cell activation, the soluble
      interleukin-2 receptor (sIL-2R), in 7 patients followed into the late stages of
      the illness. As a group, EMS patients had significantly elevated sIL-2R levels
      throughout the study. Five patients suffered chronic symptoms of myalgia,
      arthralgia, muscle cramps, fatigue, or subjective memory impairment and all had
      persistently elevated sIL-2R levels. Two patients had near-resolution of EMS and
      normal sIL-2R levels. We conclude that chronic symptoms are common in EMS and are
      associated with persistent T-cell activation as measured by serum sIL-2R levels.
      These findings suggest that immunosuppressive treatment may be beneficial in EMS.

PMID- 8355726
TI  - Vocal cord paralysis: clinical and electrophysiologic features.
AB  - Vocal cord paralysis may occur in isolation or as part of a constellation of
      findings in neurological disease. We investigated the pathophysiology of these
      disorders with laryngeal electromyography (LEMG). We studied 44 patients with
      idiopathic vocal cord paralysis, confirmed by laryngoscopy. The major LEMG
      finding, present in 29 vocal cords, was evidence of active or chronic denervation
      in the thyroarytenoid (TA), indicating recurrent laryngeal neuropathy.
      Denervation of the cricothyroid (CT) in 5 patients indicated superior laryngeal
      neuropathy. TA and CT involvement in 1 patient indicated proximal laryngeal or
      vagus nerve damage. LEMG was performed in 48 patients with other laryngeal
      disorders. LEMG proved to be a safe and effective procedure in the diagnosis of
      laryngeal neuropathy as distinguished from supranuclear and mechanical disorders
      of the larynx.

PMID- 8355727
TI  - Increased spike-frequency adaptation and tea sensitivity in dorsal root fibers
      after sciatic nerve injury.
AB  - Excitability of rat dorsal root axons were studied 3 weeks after injury to the
      sciatic nerve. Whole nerve recordings were obtained from injured and control
      nerves in a sucrose gap chamber. Constant current depolarization pulses (30-200
      ms) applied approximately 50% above the stimulus strength required for maximal
      amplitude compound action potentials (CAPs) evoked a burst of action potentials
      in the dorsal root which displayed spike adaptation. The depolarization-induced
      burst response of the dorsal roots was greatly reduced after crush or transection
      of the sciatic nerve. However, application of the potassium channel blocker,
      tetraethylammonium (TEA), restored the burst discharge in injured dorsal root
      axons. Brief tetanic stimulation of the dorsal root also induced an
      afterhyperpolarization (AHP) that was twice as large in the transection group as
      compared to the control group, and which was blocked by TEA. There were no
      changes seen in the amplitude of the compound action potential, frequency
      following characteristics, refractory properties, or 4-AP sensitivity in the
      dorsal roots after peripheral nerve injury. These results suggest that there is
      enhanced spike adaptation that occurs at the same time as an increase in the
      sensitivity to the potassium channel blocker, TEA, in axon regions proximal to
      the site of nerve injury and have implications for the pathophysiology of nerve
      injury.

PMID- 8355728
TI  - Quantifying how location and dose of botulinum toxin injections affect muscle
      paralysis.
AB  - Despite the widespread use of botulinum toxin to treat muscle dystonias, no
      method exists to quantify muscle paralysis in either human or nonhuman models. In
      this study we examined how the location, dose, and volume of botulinum injection
      affects paralysis in the rat tibialis anterior muscle. Paralysis was quantified
      by electrically stimulating the nerve to the tibialis anterior and then staining
      sections of the muscle for glycogen. The areas of glycogen-containing fibers
      represented regions of botulinum action. The results showed that the most
      important injection technique is to inject botulinum directly into the motor
      endplate region of a muscle. Injections only 0.5 cm from the motor endplate
      resulted in a 50% decrease in paralysis. Increases in dose increased paralysis,
      however, some of that increase was simply due to the increased volume of
      injection. Thus, delivering toxin in small volumes near the MEP band of a muscle
      should produce the most effective paralysis.

PMID- 8355730
TI  - Use of laryngeal electromyography in prediction of recovery after vocal cord
      paralysis.

PMID- 8355729
TI  - Are nerve conduction studies useful for monitoring the adequacy of renal
      dialysis?
AB  - When hemodialysis was first used clinically, a peripheral neuropathy frequently
      emerged. The discovery that sufficient dialysis time would prevent the emergence
      of symptomatic neuropathy led to the routine use of nerve conduction studies
      (NCS) to monitor the "adequacy" of dialysis. Modern dialysis practice has evolved
      since then, and the patient population is markedly different. This report
      addresses the question of whether there is evidence to indicate that routine use
      of NCS is helpful to monitor the adequacy of present-day dialysis. A critical
      review of the available literature reveals that there is insufficient evidence to
      allow one to answer the question.

PMID- 8355731
TI  - Early involvement of motor nerve dysfunction in atypical cases with familial
      amyloidotic polyneuropathy (FAP) type I.

PMID- 8355732
TI  - Marfan's syndrome in association with cervical rib syndrome.

PMID- 8355733
TI  - In vivo and in vitro muscle tensions in wobbler mouse motor neuron disease.

PMID- 8355734
TI  - Intrapontine generation of myokymia in multiple sclerosis.

PMID- 8355735
TI  - Kineceptic ankle-foot orthosis in neuromuscular disease.

PMID- 8355736
TI  - Tuberculosis of striated muscle.

PMID- 8355737
TI  - Serial measurements of nerve conduction velocity and F-wave latency in
      diphtheritic neuropathy.

PMID- 8355738
TI  - Lambert-Eaton myasthenic syndrome associated with an ameloblastoma of the tibia.

PMID- 8355739
TI  - Macro-EMG and motor unit recruitment threshold.

PMID- 8355740
TI  - Effect of prenatal ultrasound screening on perinatal outcome. RADIUS Study Group.
AB  - BACKGROUND: Many clinicians advocate routine ultrasound screening during
      pregnancy to detect congenital anomalies, multiple-gestation pregnancies, fetal
      growth disorders, placental abnormalities, and errors in the estimation of
      gestational age. However, it is not known whether the detection of these
      conditions through screening leads to interventions that improve perinatal
      outcome. METHODS: We conducted a randomized trial involving 15,151 pregnant women
      at low risk for perinatal problems to determine whether ultrasound screening
      decreased the frequency of adverse perinatal outcomes. The women randomly
      assigned to the ultrasound-screening group underwent one sonographic examination
      at 15 to 22 weeks of gestation and another at 31 to 35 weeks. The women in the
      control group underwent ultrasonography only for medical indications, as
      identified by their physicians. Adverse perinatal outcome was defined as fetal
      death, neonatal death, or neonatal morbidity such as intraventricular hemorrhage.
      RESULTS: The mean numbers of sonograms obtained per woman in the ultrasound
      screening and control groups were 2.2 and 0.6, respectively. The rate of adverse
      perinatal outcome was 5.0 percent among the infants of the women in the
      ultrasound-screening group and 4.9 percent among the infants of the women in the
      control group (relative risk, 1.0; 95 percent confidence interval, 0.9 to 1.2; P
      = 0.85). The rates of preterm delivery and the distribution of birth weights were
      nearly identical in the two groups. The ultrasonographic detection of congenital
      anomalies had no effect on perinatal outcome. There were no significant
      differences between the groups in perinatal outcome in the subgroups of women
      with post-date pregnancies, multiple-gestation pregnancies, or infants who were
      small for gestational age. CONCLUSIONS: Screening ultrasonography did not improve
      perinatal outcome as compared with the selective use of ultrasonography on the
      basis of clinician judgment.

PMID- 8355741
TI  - Reversibility of unawareness of hypoglycemia in patients with insulinomas.
AB  - BACKGROUND: A lack of appropriate autonomic warning symptoms before the
      development of neuroglycopenia occurs frequently in patients with diabetes
      mellitus. The pathogenesis of this phenomenon is unclear, but it is associated
      with intensive insulin therapy, prolonged duration of diabetes, frequent episodes
      of hypoglycemia, and impaired glucose counterregulation. Recently, it has been
      proposed that repeated episodes of hypoglycemia may themselves induce the
      phenomenon. METHODS: To test this hypothesis and to determine whether the
      phenomenon is reversible, we assessed autonomic and neuroglycopenic symptoms,
      counterregulatory hormonal responses, and cognitive function during stepped
      hypoglycemic-clamp studies in 6 patients with insulinomas before and
      approximately six months after curative surgery and in 14 normal subjects matched
      for age, weight, and sex. RESULTS: Before surgery, the patients with insulinomas
      had lower scores than the normal subjects for autonomic symptoms (mean [+/- SD],
      3.5 +/- 0.8 vs. 9.6 +/- 4.5) and neuroglycopenic symptoms (2.8 +/- 1.5 vs. 8.9 +/
      5.3). The patients also had impaired counterregulatory hormonal responses (their
      plasma epinephrine, norepinephrine, glucagon, growth hormone, and cortisol
      responses before surgery were 187 +/- 227 pg per milliliter [1.03 +/- 1.25 nmol
      per liter], 223 +/- 85 pg per milliliter [1.32 +/- 0.50 nmol per liter], 86 +/-
      21 ng per liter, 7.4 +/- 5.2 micrograms per liter, and 12.1 +/- 1.5 micrograms
      per deciliter [334 +/- 41 nmol per liter], respectively, as compared with 842 +/-
      439 pg per milliliter [4.63 +/- 2.41 nmol per liter], 519 +/- 150 pg per
      milliliter [3.07 +/- 0.89 nmol per liter], 201 +/- 58 ng per liter, 25.3 +/- 13.7
      micrograms per liter, and 26.3 +/- 1.2 micrograms per deciliter [726 +/- 33 nmol
      per liter] in the normal subjects) and less deterioration in cognitive function
      than the normal subjects during hypoglycemia (sum of z scores for seven tests of
      cognitive function, 1.7 +/- 1.9 vs. 8.9 +/- 3.5) (P < 0.02 for all comparisons).
      Surgical cure reversed all these abnormalities (P not significant for all
      comparisons with the normal subjects). CONCLUSIONS: Hypoglycemia itself can
      induce unawareness of the autonomic and neuroglycopenic symptoms of hypoglycemia
      and decrease the counterregulatory hormonal responses to hypoglycemia.

PMID- 8355742
TI  - Marrow transplantation in patients with thalassemia responsive to iron chelation
      therapy.
AB  - BACKGROUND: Patients with homozygous beta-thalassemia, who have a good prognosis
      during treatment with conventional therapy, appear to have an especially high
      probability of hematologic cure with bone marrow transplantation, although the
      morbidity and mortality associated with such treatment are not established.
      METHODS: The records of all patients with thalassemia who received bone marrow
      transplants from HLA-identical donors in Pesaro, Italy, were examined from
      October 1982 through May 1992. Detailed evaluation of the outcome was conducted
      in the 89 patients identified as being in class 1 according to the Pesaro
      classification, in which hepatomegaly, portal fibrosis, and the inadequacy of
      iron chelation therapy are considered independent risk factors, and the patients
      are classified as being in class 1 if none of these factors are present, class 2
      if one or two of the factors are present, and class 3 if all three factors are
      present. Sixty-four of the patients had been prepared for transplantation with a
      drug regimen in current use that includes busulfan and cyclophosphamide followed
      by cyclosporine as prophylaxis against acute graft-versus-host disease (protocol
      6). RESULTS: There were seven deaths, all within 101 days of transplantation. Two
      of the 64 patients treated according to protocol 6 died. The probabilities of
      survival, rejection-free survival, death from causes unrelated to rejection, and
      rejection were 0.92, 0.85, 0.06, and 0.08, respectively, in the total group and
      0.97, 0.93, 0.03, and 0.04 in the 64 patients treated according to protocol 6.
      Preliminary evidence suggests that there was useful unloading of tissue iron
      deposits. CONCLUSIONS: The high probability of cure with little early or late
      morbidity and mortality suggests that patients with class 1 thalassemia who have
      HLA-identical donors available should be treated by bone marrow transplantation.
      However, this was not a controlled trial, so we cannot directly compare the
      outcome with that of conventional treatment.

PMID- 8355743
TI  - Images in clinical medicine. Tinea Capitis.

PMID- 8355744
TI  - Prevalence and magnitude of perinatal substance exposures in California.
AB  - BACKGROUND: Perinatal substance exposure has been linked to many neonatal and
      obstetrical complications. There have been few population-based epidemiologic
      studies to identify the prevalence and demographic profiles associated with
      drugs, alcohol, and smoking during pregnancy. METHODS: We studied a fully
      probabilistic stratified-cluster sample to estimate the prevalence of perinatal
      substance exposures in California in 1992. Urine samples from 29,494 women
      presenting for delivery in 202 hospitals were coded and screened for toxins; the
      results of toxicology screening were later linked by code number to the subjects'
      demographic variables and their reported use of tobacco and prescribed drugs.
      Urinary toxicologic tests provide conservative estimates because they can detect
      only very recent substance use. RESULTS: The weighted prevalence for perinatal
      substance exposure was 5.16 percent for the use of one or more drugs, 6.72
      percent for alcohol (analyzed independently), and 8.82 percent for self-reported
      smoking. The percentage of women testing positive for any drug, including
      alcohol, was 11.35 percent. Estimates for racial and ethnic groups varied widely.
      Black women had the highest prevalence of total drug use (14.22 percent), alcohol
      use (11.58 percent), cocaine use (7.79 percent), and tobacco use (20.12 percent).
      Most drug exposures occurred among white non-Hispanic and Hispanic women. White
      non-Hispanic women had the second highest prevalence rate for the use of one or
      more drugs (6.79 percent) and self-reported tobacco use (14.82 percent). Hispanic
      women had the second highest prevalence rate for alcohol (6.87 percent).
      CONCLUSIONS: In California in 1992, there were 67,361 estimated perinatal
      exposures to one or more drugs, including alcohol, and 52,346 self-reported
      exposures to tobacco. These findings have clinical and public health
      implications.

PMID- 8355745
TI  - Nuclear cardiology (2).

PMID- 8355746
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 37-1993. A 48-year-old woman with an atrial septal defect and
      pulmonary hypertension.

PMID- 8355747
TI  - Should every pregnant woman undergo ultrasonography?

PMID- 8355748
TI  - Reversal of unawareness of hypoglycemia.

PMID- 8355749
TI  - Managed competition and the patient-physician relationship.

PMID- 8355750
TI  - The marketplace in health care reform.

PMID- 8355751
TI  - The marketplace in health care reform.

PMID- 8355752
TI  - The marketplace in health care reform.

PMID- 8355753
TI  - The marketplace in health care reform.

PMID- 8355754
TI  - Controlling costs through "managed competition".

PMID- 8355755
TI  - Controlling costs through "managed competition".

PMID- 8355756
TI  - Controlling costs through "managed competition".

PMID- 8355757
TI  - Eisenmenger's syndrome in pregnancy.

PMID- 8355759
TI  - Post-polypectomy surveillance.

PMID- 8355758
TI  - Post-polypectomy surveillance.

PMID- 8355760
TI  - Use of anabolic steroids among adolescents.

PMID- 8355762
TI  - Medical journals and the popular media.

PMID- 8355761
TI  - Infectious diseases in Somalia.

PMID- 8355763
TI  - Lidocaine for severe hiccups.

PMID- 8355764
TI  - Images in clinical medicine. Secondary syphilis.

PMID- 8355765
TI  - Images in clinical medicine. Left ventricular aneurysm.

PMID- 8355766
TI  - Images in clinical medicine. Necrobiosis lipoidica diabeticorum.

PMID- 8355767
TI  - Images in clinical medicine. Streptococcus pneumoniae.

PMID- 8355768
TI  - Images in clinical medicine. Basal-cell carcinoma.

PMID- 8355769
TI  - Psychiatric care in further trouble.

PMID- 8355770
TI  - Clean drugs for Italy?

PMID- 8355771
TI  - Push for Gulf syndrome research.

PMID- 8355772
TI  - Brazil's proposed law threatens animal experimentation.

PMID- 8355773
TI  - Italian health sector in disarray following more scandals.

PMID- 8355774
TI  - Epidemic misuse.

PMID- 8355775
TI  - Competition in science.

PMID- 8355776
TI  - Fetal tissue.

PMID- 8355777
TI  - Insurance risks.

PMID- 8355778
TI  - Making more of academic assets.
AB  - Why is the UK's biotechnology industry still nascent? Academic institutions must
      exploit the commercial opportunities of the research they support if Britain is
      to remain internationally competitive.

PMID- 8355779
TI  - Physiology. And brother begat nephew.

PMID- 8355780
TI  - Muscular dystrophy. Muscling in on gene therapy.

PMID- 8355781
TI  - Ancient use of cannabis.

PMID- 8355782
TI  - Hormonally mediated inheritance of acquired characteristics in Mongolian gerbils.
AB  - The intrauterine position relative to members of the same or opposite sex that a
      rodent fetus occupies affects both its morphology and behaviour when adult.
      Female fetuses that mature between males are androgenized by testosterone
      crossing fetal membranes, and their phenotypes as adults differ significantly
      from those of sisters that received less intrauterine exposure to exogenous
      testosterone. We report here that adult female Mongolian gerbils that gestated
      between male fetuses produce litters containing a significantly greater
      proportion of sons than the litters produced by those that gestated between
      female fetuses. Consequently, daughters delivered by dams that gestated between
      male fetuses are more likely to have gestated between male fetuses and be
      androgenized in utero than are daughters of dams that gestated between female
      fetuses. Female gerbils thus tend to inherit the phenotype (either androgenized
      or not androgenized) of their respective mothers.

PMID- 8355783
TI  - Rapid sequence evolution of the mammalian sex-determining gene SRY.
AB  - In mammals, induction of male sex determination requires the Y-chromosome gene
      SRY. SRY encodes a protein with a central 'high mobility group' domain (HMG box)
      of about 78 amino acids. HMG boxes are found in a wide variety of proteins that
      bind to DNA with high affinity but differing degrees of sequence specificity. The
      human SRY protein binds to linear DNA with sequence specificity and to cruciform
      DNA structures without sequence specificity. The DNA-binding activity of the SRY
      protein resides in the HMG box and mutations in this region are associated with
      sex reversal in XY females. No function has been ascribed to the portions of the
      SRY protein outside the HMG box. SRY belongs to a family of genes that are
      related by sequence homology within the DNA-binding domain: the genes most
      similar to SRY (> 60%) have been named SOX genes (SRY box genes). None of the
      known SOX genes is homologous to SRY outside the HMG-box region. Although SRY is
      an important developmental regulator, its sequence is poorly conserved between
      species apart from the HMG-box domain. Here we investigate the coding sequence of
      SRY in primates and find that evolution has been rapid in the regions flanking
      the conserved domain. The high degree of sequence divergence and the frequency of
      non-synonymous mutations suggest either that the majority of the coding sequence
      has no functional significance or that directional selection has occurred.

PMID- 8355784
TI  - Rapid evolution of the sex determining locus in Old World mice and rats.
AB  - The Y chromosome-linked sex determining locus (Sry) responsible for testis
      determination in mammals contains a DNA-binding motif (HMG box) that is conserved
      across species of marsupial and placental mammals (infraclasses Metatheria and
      Eutheria, respectively). But little to no sequence similarity is observed in
      flanking sequences between these two infraclasses, or among orders within each
      infraclass. We investigated the rate and pattern of evolution for the coding
      sequence of Sry in Old World mice and rats (subfamily Murinae). We found typical
      rates of synonymous substitution throughout the gene, but high rates of non
      synonymous substitution, especially in the C-terminal (non-HMG box) region, when
      compared to other genes. This region is also characterized by a frame-shift
      mutation and variation in a trinucleotide repeat motif. These data suggest that
      the non-box region is either functionally unconstrained or has undergone species
      specific adaptive divergence.

PMID- 8355785
TI  - Isolation of a Miller-Dieker lissencephaly gene containing G protein beta-subunit
      like repeats.
AB  - Lissencephaly (agyria-pachygyria) is a human brain malformation manifested by a
      smooth cerebral surface and abnormal neuronal migration. Identification of the
      gene(s) involved in this disorder would facilitate molecular dissection of normal
      events in brain development. Type 1 lissencephaly occurs either as an isolated
      abnormality or in association with dysmorphic facial appearance in patients with
      Miller-Dieker syndrome. About 15% of patients with isolated lissencephaly and
      more than 90% of patients with Miller-Dieker syndrome have microdeletions in a
      critical 350-kilobase region in chromosome 17p13.3 (ref. 6). These deletions are
      hemizygous, so haplo-insufficiency for a gene in this interval is implicated.
      Here we report the cloning of a gene (LIS-1, lissencephaly-1) in 17p13.3 that is
      deleted in Miller-Dieker patients. Non-overlapping deletions involving either the
      5' or 3' end of the gene were found in two patients, identifying LIS-1 as the
      disease gene. The deduced amino-acid sequence shows significant homology to beta
      subunits of heterotrimeric G proteins, suggesting that it could possibly be
      involved in a signal transduction pathway crucial for cerebral development.

PMID- 8355786
TI  - Spectral motion produces an auditory after-effect.
AB  - Distortions of perception following prolonged exposure to an unvarying sensory
      stimulus have been observed since at least the third century BC. The motion after
      effect is a familiar experience in which, after a few minutes of viewing objects
      moving in a single direction, a stationary object appears to move in the opposite
      direction. Similar after-effects have been observed for many visual stimuli,
      including tilted lines, colours, stereoscopic depth, curvature, spatial
      frequency, contrast, rotation and motion in depth. In contrast to the rich
      variety of visual after-effects reported since the 1960s, reports of analogous
      auditory adaptation effects only appeared in the 1970s, but have continued since
      then. Some effects of sound source spatial movement perception after adaptation
      to a spatially moving sound source have been reported. Here we report an auditory
      perceptual after-effect analogous to the visual motion after-effect, which is
      caused by adaptation to auditory spectral (frequency) motion. After a few minutes
      of listening to a simple spectral pattern moving upwards or downwards in
      frequency space, the same pattern sounds as though it is drifting in the opposite
      direction when it is stationary. The effect shows binaural transfer, implying
      that it is generated at the level after binaural interaction. After-effects
      produced by the motion of spectral peaks are independent of those produced by
      spectral notches, suggesting separate processing channels for spectral peaks and
      notches.

PMID- 8355787
TI  - Heightened synaptic plasticity of hippocampal CA1 neurons during a
      cholinergically induced rhythmic state.
AB  - Brain cholinergic neurons are critical for memory function and their loss may
      contribute to memory impairment in Alzheimer's disease. One role of cholinergic
      neurons is to elicit an oscillatory activity called theta rhythm in the
      hippocampus, a brain region involved in memory processing. Theta rhythm occurs
      during periods of learning, but its effect on the synaptic plasticity that
      underlies learning remains unclear. We have studied synaptic plasticity in
      hippocampal slices during theta-frequency oscillations induced by a cholinergic
      agonist. Here we report that during these oscillations, synapses are in a state
      of heightened plasticity and can be modified by what would otherwise be
      ineffective stimulation. This heightened plasticity is sensitive to the timing of
      incoming stimuli with respect to the oscillatory activity. The results suggest
      that cholinergic systems may affect memory formation through the induction of an
      oscillatory state in which the requirements for synaptic plasticity are
      dramatically altered.

PMID- 8355788
TI  - Overexpression of dystrophin in transgenic mdx mice eliminates dystrophic
      symptoms without toxicity.
AB  - Duchenne and Becker muscular dystrophy (DMD and BMD) are X-linked recessive
      diseases caused by defective expression of dystrophin. The mdx mouse, an animal
      model for DMD, has a mutation that eliminates expression of the 427K muscle and
      brain isoforms of dystrophin. Although these animals do not display overt muscle
      weakness or impaired movement, the diaphragm muscle of the mdx mouse is severely
      affected and shows progressive myofibre degeneration and fibrosis which closely
      resembles the human disease. Here we explore the feasibility of gene therapy for
      DMD by examining the potential of a full-length dystrophin transgene to correct
      dystrophic symptoms in mdx mice. We find that expression of dystrophin in muscles
      of transgenic mdx mice eliminates the morphological and immunohistological
      symptoms of muscular dystrophy. In addition, overexpression of dystrophin
      prevents the development of the abnormal mechanical properties associated with
      dystrophic muscle without causing deleterious side effects. Our results provide
      functional evidence for the feasibility of gene therapy for DMD.

PMID- 8355789
TI  - Helper T-cell development in the absence of CD4-p56lck association.
AB  - The CD4 and CD8 glycoproteins are expressed on helper and cytoxic T lymphocytes,
      respectively, and have important functions in the differentiation and activation
      of these cells. These molecules are thought to participate in signal transduction
      by binding to the same class II or class I major histocompatibility complex
      molecules that are engaged by the T-cell antigen receptor. The cytoplasmic
      domains of both CD4 and CD8 interact with the protein tyrosine kinase p56lck
      (refs 14-17), an essential participant in thymocyte maturation and T-cell
      activation. This interaction is required for effective in vitro responses to
      antigen, suggesting that signalling through p56lck is a major function of CD4 and
      CD8. Here we investigate the role of the CD4-p56lck interaction during T
      lymphocyte development by expressing wild-type and truncated products of CD4
      transgenes in mice that lack endogenous CD4 and hence have defective helper-cell
      development. We find that transgenic CD4, which cannot associate with p56lck, can
      nevertheless rescue the helper-cell lineage when overexpressed. This result
      indicates that the contribution of CD4 to lineage development need not involve
      signalling through p56lck, and provides insight into the general function of CD4
      and CD8.

PMID- 8355790
TI  - Coated vesicle assembly in the Golgi requires only coatomer and ARF proteins from
      the cytosol.
AB  - Transport vesicles derived from the Golgi apparatus are thought to mediate
      biosynthetic transport across the Golgi stack. These vesicles are surrounded by a
      protein coat whose principal constituents are coatomer (a complex of seven
      distinct subunits or COPs) and ADP-ribosylation factor (ARF, an N-myristylated
      small GTP-binding protein). The coat proteins of the COP-coated vesicles were
      originally defined by ultrastructural criteria, however, and it is possible that
      important but minor coat proteins or cytoplasmic proteins needed for coat
      assembly may have been overlooked. Here we show that coatomer and ARF are the
      only cytoplasmic proteins needed for the assembly and budding of COP-coated
      vesicles. COP-coated buds may therefore form essentially by self-assembly from
      Golgi cisternae after an initial step in which GTP is used to allow ARF binding.

PMID- 8355791
TI  - Science research and philanthropy. Government funding dominant.

PMID- 8355792
TI  - Science research and philanthropy. Charities taking the strain.

PMID- 8355793
TI  - Science research and philanthropy. A new trend for Japan.

PMID- 8355794
TI  - Pfizer donates drugs.

PMID- 8355795
TI  - Gene bill still controversial.

PMID- 8355796
TI  - MicroGeneSys goes on trial.

PMID- 8355797
TI  - A strange discipline...

PMID- 8355798
TI  - Molecular biology.

PMID- 8355799
TI  - Racial science.

PMID- 8355800
TI  - A home for the mighty mouse.

PMID- 8355801
TI  - Neurobiology. Two ears and two eyes.

PMID- 8355802
TI  - Potassium channels. The response to vagusstoff.

PMID- 8355803
TI  - Sequence data as evidence.

PMID- 8355804
TI  - Disparity-sensitive cells in the owl have a characteristic disparity.
AB  - We experience the visual world as being three-dimensional. A major source of
      depth information derives from the slightly different views of each eye, leading
      to small variations in the retinal images ('disparities'). Neurons sensitive to
      visual disparities are thought to form the neural basis of stereo vision. Barn
      owls as well as several mammalian species have neurons that are sensitive to
      visual disparities. But how visual disparities are represented in the brain has
      been a matter of discussion ever since the first disparity-sensitive neurons were
      found some 25 years ago. Here we adopt a new approach to this problem and study
      the neural computation of visual disparities with a paradigm borrowed from
      auditory research. The measurement of interaural time difference (ITD) has many
      similarities with the measurement of visual disparity on the formal, algorithmic
      level. We speculate that the similarities might extend to the level of neural
      computation. The neural representation of ITD is well understood, and we have
      studied the representation of disparities with visual stimuli analogous to those
      successfully used in acoustic experiments. For example, ITD is converted in the
      brain to a pathlength on an axon that, owing to the finite conduction velocity in
      neurons, exactly matches the external ITD. This pathlength is called
      'characteristic delay'. Our results suggest that there is an analogue of the
      characteristic delay in stereo vision which we propose to call 'characteristic
      disparity'.

PMID- 8355805
TI  - Primary structure and functional expression of a rat G-protein-coupled muscarinic
      potassium channel.
AB  - Parasympathetic nerve stimulation causes slowing of the heart rate by activation
      of muscarinic receptors and the subsequent opening of muscarinic K+ channels in
      the sinoatrial node and atrium. This inwardly rectifying K+ channel is coupled
      directly with G protein. Based on sequence homology with cloned inwardly
      rectifying K+ channels, ROMK1 (ref. 11) and IRK1 (ref. 12), we have isolated a
      complementary DNA for a G-protein-coupled inwardly rectifying K+ channel (GIRK1)
      from rat heart. The GIRK1 channel probably corresponds to the muscarinic K+
      channel because (1) its functional properties resemble those of the atrial
      muscarinic K+ channel and (2) its messenger RNA is much more abundant in the
      atrium than in the ventricle. In addition, GIRK1 mRNA is expressed not only in
      the heart but also in the brain.

PMID- 8355806
TI  - Emptying of intracellular Ca2+ stores releases a novel small messenger that
      stimulates Ca2+ influx.
AB  - Intracellular Ca2+ signals that last more than a few minutes after the onset of
      stimulation depend critically on influx of extracellular Ca2+. Such Ca2+ influx
      can be triggered in many cell types by depletion of intracellular Ca2+ stores
      without detectable elevations of known messengers. The mechanism by which store
      depletion can control plasma membrane Ca2+ permeability remains controversial.
      Here we present evidence for a novel soluble mediator. Calcium depletion of a
      lymphocyte cell line caused the messenger to be released from intracellular
      organelles into the cytoplasm and to a much lesser extent into the extracellular
      medium. The messenger caused Ca2+ influx when applied to macrophages, astrocytoma
      cells, and fibroblasts and was therefore named CIF (for Ca(2+)-influx factor).
      CIF appears to have hydroxyls (or hydroxyl and amino groups) on adjacent carbons,
      a phosphate, and a M(r) under 500.

PMID- 8355807
TI  - Fission yeast wee1 protein kinase is not required for DNA damage-dependent
      mitotic arrest.
AB  - Checkpoints maintain the dependency relationships between discrete events in the
      cell cycle (for example, ensuring mitosis does not occur before DNA replication
      is complete). In Schizosaccharomyces pombe, mitotic checkpoints monitor DNA
      synthesis and the presence of DNA damage. The replication-dependent mitotic
      checkpoint prevents mitosis by inactivating p34cdc2 kinase. The mechanism by
      which the DNA damage checkpoint interacts with the mitotic machinery is distinct
      from that used by the replication checkpoint. The activity of p34cdc2 is
      controlled, in part, by the wee1 protein kinase, which inactivates cdc2 through
      phosphorylation at tyrosine-15 (ref. 7). Here we report normal mitotic arrest
      after DNA damage in S. pombe cells in which the wee1 gene is defective or
      missing. We suggest why these findings contradict a recent report which suggested
      that the wee1 gene product was required for DNA damage-dependent mitotic arrest.

PMID- 8355808
TI  - Development of the cortical dysplasia of type II lissencephaly.
AB  - A detailed neuropathological study of five immature brains with type II
      lissencephaly is reported. The cases described include two pairs of siblings. One
      infant survived for 2 months after birth, the others died at 18, 20, 20 and 32
      weeks of gestation. This series of cases demonstrates the sequence in which the
      malformation develops from mid-gestation to post-natal life and shows that type
      II lissencephaly is not an intracortical malformation but is the result of
      massive glial and neuronal ectopia in the leptomeninges. This results from a
      failure of arrest of neuronal migration due to defects in the integrity of the
      pial/glial barrier.

PMID- 8355809
TI  - Axonal neurofilamentous accumulations: a comparison between human and canine
      giant axonal neuropathy and 2,5-HD neuropathy.
AB  - The neuropathy produced by the hexacarbon 2,5-hexanedione (2,5-HD) resembles
      human and canine inherited giant axonal neuropathy (GAN) in the presence of giant
      axonal swellings that contain accumulations of neurofilaments. The accumulations
      are both paranodal and internodal in GAN and 2,5-HD induced neuropathy. Detailed
      morphometry on the neurofilaments reveals that the changes in human and canine
      GAN are closely similar and differ from those of 2,5-HD neuropathy, suggesting
      that the mechanisms underlying the formation of the axonal neurofilamentous
      accumulations differ between the two conditions. In both human and canine GAN,
      the neurofilaments are more closely spaced and are of greater diameter than in
      2,5-HD neuropathy. The changes in the NF in GAN may be the consequence of
      flattening of the side-arms of the neurofilaments against the axis of the
      filaments.

PMID- 8355810
TI  - The neurotoxicity of alpha-chlorohydrin in rats and mice: I. Evolution of the
      cellular changes.
AB  - Mice and rats are found to be equally susceptible to developing symmetrical brain
      stem lesions on exposure to alpha-chlorohydrin and in both species the earliest
      neurotoxic changes are strictly confined to glial cells, particularly astrocytes;
      haemorrhages are not found in either species. Minimal evidence of increased
      vascular leakage of horse-radish peroxidase (HRP) in rats is shown by increased
      HRP content of perivascular cells within the lesions. Later macrophage invasion
      and capillary proliferation is accompanied by rare focal leakiness of HRP. Gross
      astrocytic damage, therefore, does not necessarily impair integrity of the blood
      brain barrier. While early in intoxication, astrocytes are severely distended
      with fluid and their organelles seriously disorganized, they do not die but
      rapidly regenerate their processes. They thus appear to undergo a process of
      'clasmatodendrosis' from which they recover. Comparisons are made with the
      genesis of symmetrical brain stem lesions in other acute energy deprivation
      syndromes, including Wernicke's encephalopathy.

PMID- 8355811
TI  - Cerebral amyloid in human prion disease.
AB  - The clinical and neuropathological features of 21 patients with prion disease
      were reviewed with special reference to the morphology and immunoreactivity of
      cerebral amyloid. Six cases had a mutation at codon 102 of the prion protein
      (PrP) gene and in these the characteristic pathology was the formation of
      multicentric amyloid plaques which were stained with PrP antibody, whereas
      spongiform changes were absent in one and minimal in two. In one case, with a 216
      base-pair insertion in the PrP gene, there was no spongiform encephalopathy (SE)
      but cerebellar amyloid was a prominent feature of the pathology. One case with a
      PrP gene mutation at codon 200 had severe SE but no amyloid. Two iatrogenic and
      11 sporadic cases had SE and some form of amyloid was identified in all but
      three. Amyloid angiopathy and senile neuritic plaques, which stained with
      antibody to beta-protein, were present in familial as well as in sporadic cases,
      including some who were rather young to be regarded as having Alzheimer's
      disease. Cerebellar amyloid and degeneration of granule and Purkinje cells were
      particularly common findings in sporadic as well as in genetically determined
      cases. This study serves to emphasize the association between prion disease and
      amyloid deposition in the brain. PrP is a component of some amyloid plaques in a
      high proportion of cases with inherited prion disease but may also be found in
      cases of sporadic SE without known mutations or base-pair insertions in the PrP
      gene.

PMID- 8355812
TI  - The cellular pathology associated with Alzheimer beta-amyloid deposits in non
      demented aged individuals.
AB  - In this study, we have compared the cellular pathology associated with beta
      amyloid (beta A) deposits which characterize Alzheimer's disease (AD) in demented
      patients with pathologically confirmed AD, with that in non-demented aged
      individuals. Brain sections from two severely demented AD cases, six non-demented
      individuals with beta A deposits, and six age-matched controls devoid of beta A
      deposits were double-immunostained with antibodies against beta A, and antibody
      markers for neurofibrillary tangles (NFT), astrocytes and microglial cells. We
      found that the severely demented patients displayed numerous plaques of variable
      morphology, most of which were associated with NFT, hypertrophied astrocytes and
      reactive microglial cells. In contrast, non-demented patients showed fewer
      plaques, few or not NFT and less astroglial and microglial reaction. The number
      of plaques with associated abnormal cellular elements were much lower in non
      demented than in demented cases. Furthermore, classical plaques were more likely
      to be associated with abnormal cellular elements than diffuse plaques, which were
      most often devoid of any associated cellular change. These findings suggest that:
      (i) beta A plaques in non-demented individuals may represent an early stage of
      AD; (ii) beta A deposition is the first recognizable pathological abnormality of
      AD; and (iii) NFT, and astro- and microglial proliferation are later features,
      possibly secondary to the known dystrophic effects of the beta A peptide and
      other fragments of its precursor protein.

PMID- 8355813
TI  - Corpora amylacea could be an indicator of neurodegeneration.
AB  - We describe an investigation of corpora amylacea (CA) in the brain tissue of
      Alzheimer's disease (AD) cases and normal ageing controls, using both light (LM)
      and electron (EM) microscopic techniques. CA populations were shown by routine
      histological staining of LR White resin sections with methenamine silver and PAS,
      and were compared with those shown by immunocytochemistry using antibodies to
      tau, GFAP, tubulin, ubiquitin, beta-amyloid and serum amyloid P component in
      serial sections. All CA were immunoreactive with anti-tau and all were unreactive
      with anti-beta-amyloid. Most were immunoreactive with anti-serum amyloid P
      component, although this was often weak in AD. CA from normal ageing brain were
      immunoreactive for proteins that are associated with the neuronal cytoskeleton
      and cell injury. CA from AD brain shared some of these but differed from those in
      normal ageing brain by being in much larger number and more variable in their
      immunoreactivity. In all CA, X-ray microanalysis illustrated the presence of the
      metallic elements Ca, Fe and Cu. Aluminium, often associated with AD, was not
      present, even in CA from AD brain. Phosphorus and sulphur, probably from
      phosphorylated proteins associated with degenerating cytoskeleton elements, were
      usually detected. In AD brain, the greater numbers of CA and their variable
      biochemical and elemental composition, when compared with CA in the normal ageing
      brain, suggests that they may derive from a number of sources both neuronal and
      glial as a result of the neurodegenerative disease.

PMID- 8355814
TI  - Differential pattern of beta-amyloid protein deposition within cortical sulci and
      gyri in Alzheimer's disease.
AB  - We have quantified the pattern of beta-amyloid protein (beta AP) deposition in
      the sulci and gyri of the frontal cortex in Alzheimer's disease. The distribution
      pattern in the frontal cortex gyri is unequivocally different from the pattern
      found in the frontal sulci. These findings, in conjunction with our previous
      studies, reflect a differential vulnerability between the sulci and the gyri with
      respect to Alzheimer's disease pathology, sulci being affected to a greater
      extent. It is probable that the different patterns of deposition relate to the
      underlying cytoarchitecture of the cortex.

PMID- 8355815
TI  - Intracranial lipoma of the Sylvian region.
AB  - The incidental autopsy finding of an intracranial lipoma in the left Sylvian
      region is reported. This is a rare location for an uncommon lesion. A recent
      theory on its pathogenesis as a congenital lesion is presented and current
      methods of diagnosis and treatment are discussed.

PMID- 8355816
TI  - Eye movements in a familial vestibulocerebellar disorder.
AB  - Eye movement abnormalities consisting of poor or absent smooth pursuit and
      vestibulo-ocular reflex suppression, gaze-paretic and rebound nystagmus, slow
      build-up of optokinetic nystagmus, mildly hyperactive vestibulo-ocular reflex,
      and a high incidence of strabismus were inherited in an autosomal dominant
      fashion in 10 members of a non-consanguineous English caucasian family. The onset
      was in early childhood, but was not congenital. In 7 cases there was no tremor,
      dizziness, consistent ataxia, or other cerebellar signs that are often associated
      with these ocular motor deficits, and apart from strabismus, patients were
      asymptomatic. Magnetic resonance imaging of the propositus was normal. After
      childhood there appears to be no progression, with the oldest affected member
      being 40 years. Two members had been prone to falling in childhood, and one
      admitted to dizziness when tired. This condition, which is probably benign, has
      not been previously described and may represent a very mild variant of episodic
      ataxia or a new vestibulocerebellar syndrome.

PMID- 8355817
TI  - Clinical application of a noninvasive multi-electrode array EMG for the recording
      of single motor unit activity.
AB  - Using a recently developed noninvasive EMG recording technique with multi
      electrode arrays we investigated the pattern and distribution of motor unit
      action potentials (MUAP) following maximal voluntary contraction of the musculus
      abductor pollicis brevis. An additional parameter, i.e. muscular conduction
      velocity (CV) in single motor units, was calculated from the multi-electrode
      array EMG recordings. From 63 healthy children of various age the normal EMG
      pattern and CV were derived and compared to the EMG of diagnosed patients known
      to suffer from Duchenne muscular dystrophy and from spinal muscular atrophy. In
      normal individuals the muscular CV in neonates was lowest at 1-2 m/s and
      gradually reached a plateau of 2.9-4 m/s from the age of 4 years onwards. The EMG
      in 31 children with Duchenne muscular dystrophy showed an abnormal pattern with
      low amplitude action potentials. In 30 out of 31 patients a significantly lower
      muscular CV was found. In 10 children with spinal muscular atrophy the EMG showed
      action potentials of abnormally large amplitude and a reduced recruitment of
      firing motor units. The muscular CV remained within the normal range. Compared to
      classical needle EMG the application of this new noninvasive EMG technique in
      children is painless and offers an easy-to-handle diagnostic tool to
      differentiate between neuromuscular diseases of denervating or of myopathic
      origin.

PMID- 8355818
TI  - Molybdenum-cofactor deficiency: an easily missed cause of neonatal convulsions.
AB  - Intractable seizures in the neonatal period may be caused by molybdenum-cofactor
      deficiency, an inborn error which combines the deficiencies of sulphite oxidase
      and xanthine dehydrogenase. The neurological symptoms of molybdenum cofactor and
      isolated sulphite oxidase deficiencies are identical. Two new cases are reported,
      and the literature on neonatal convulsions due to molybdenum-cofactor and
      sulphite deficiencies is reviewed. Because of the high incidence of neonatal
      convulsions a search for this deficiency is advocated in each case of unexplained
      refractory neonatal convulsions. Diagnosis may be missed or delayed on standard
      metabolic screening for several reasons discussed. By simply using a sulphite
      strip test in a fresh urine sample an indication for the defect can be obtained.
      Antenatal diagnosis can be performed by assay of sulphite oxidase activity in a
      chorionic villus sample.

PMID- 8355819
TI  - Cortical laminar abnormalities--occurrence and clinical significance.
AB  - Cortical laminar necrosis is a histopathological entity, related to conditions of
      cerebral energy depletion. Clinical correlates are supposed to be spastic motor
      deficits, decreased intellectual capacity and epilepsy. A study was performed in
      45 children with cortical laminar abnormalities in signal intensity on MRI. The
      purpose of the study was to evaluate causes and clinical consequences of these
      cortical abnormalities on MRI in order to find indirect evidence for the
      hypothesis that they may represent cortical laminar necrosis. In view of the
      frequently present concomitant white matter damage, two contrast groups were
      formed: one group of 40 children with periventricular white matter abnormalities,
      part of them with subcortical extensions of the white matter damage; and another
      group of 53 children without abnormalities on MRI. Data concerning history,
      present clinical condition and final diagnosis were collected. The presence of
      cortical laminar abnormalities on MRI was found to be strongly associated with a
      history of cerebral energy depletion, especially hypoxia-ischemia, either in the
      perinatal period or later in life. Whereas white matter abnormalities tended to
      be more frequent in premature children, cortical laminar abnormalities tended to
      occur more frequently in term neonates and older children. The presence of
      cortical laminar abnormalities on MRI was correlated with an increased risk of
      spasticity in children without concomitant white matter abnormalities. In
      children with white matter lesions, cortical laminar abnormalities did not
      contribute to the risk of spasticity, which was already highly increased by the
      presence of white matter damage. No association was found between cortical
      abnormalities on MRI and epilepsy or psychomotor retardation.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8355820
TI  - Visual functions in relation with neonatal cerebral ultrasound, neurology and
      cognitive development in very-low-birthweight children.
AB  - In order to determine the relationship between visual functions and neonatal
      cerebral ultrasound, neurological examinations and cognitive development, a
      prospective longitudinal study was conducted in 69 high-risk very-low-birthweight
      children. Visual development was studied at 1 and 2.6 years of corrected age by
      assessment of visual acuity, binocular visual fields, optokinetic nystagmus and
      strabismus. Visual impairments were found in 33% at age 1 and in 28% at age 2.6.
      Visual impairments were related to intraparenchymal damage, as detected by
      neonatal cerebral ultrasound, as well as to abnormal neurological examinations
      and lower mean developmental indices. A stepwise multiple regression analysis
      with neonatal cerebral ultrasound as the dependent variable and visual functions
      at ages 1 and 2.6 and neurological examinations at ages 1 and 2 as independent
      variables, however, demonstrated that standardized neurological examinations were
      better markers of neonatal cerebral damage than visual functions. In cognitive
      development at ages 1 and 2, the neurological examination at age 1 was the most
      important variable. In cognitive development at age 3.6, visual functions at age
      2.6 were more important. Early visual impairments might thus influence later
      cognitive development. The effectiveness of appropriate early intervention
      strategies to stimulate visual and cognitive development in infants with less
      severe visual impairments should be subject to further study.

PMID- 8355821
TI  - New subform of the late infantile form of neuronal ceroid lipofuscinosis.
AB  - Clinicopathological studies of a series of nine children with a new subform of
      Jansky-Bielschowsky disease or late infantile neuronal ceroid lipofuscinosis
      (LINCL) is presented. The onset of this subform is between 2.5-3.5 years of age
      with initial neurological symptoms of abnormal motor skills caused by cerebellar
      and extrapyramidal signs. Soon after dementia, myoclonic seizures are followed.
      Visual impairment is more clearly seen after the age of 5 or 6 years. The
      ultrastructural studies of the skin and/or buffy coat showed abundant lysosomal
      storage of curvilinear profiles, rarely intermixed with fingerprint profiles. The
      MRI of the head performed in seven cases, showed initially enlargement of the
      ventricles that is secondary to basal ganglia atrophy and presence of cerebellar
      and cerebral atrophy. In 4 of 7 cases (Cases 1, 5, 6, 8) abnormalities in the
      deep white matter showing increased signals of T2-weighted imaging in the
      periventricular areas of the fronto-parietal region, internal capsule, tracks of
      the brainstem, and white matter of cerebellum were seen. These abnormalities were
      also observed by post-mortem neuropathological studies in three cases (nos. 7-9).
      The MRI in Cases 7 and 9 was not performed. The electrophysiological
      abnormalities (EEG, ERG, VER) are similar as described in the classical LINCL.
      Neuropathological studies done in 3 of 9 cases showed generalized brain atrophy
      and unique type of neuronal cytoplasmic inclusion body in the basal ganglia,
      brainstem, dentate nuclei, and rarely, cerebral cortex. These large, round
      neuronal cytoplasmic inclusions were pink in hematoxylin (HE), violet in cresyl
      violet, and dark blue with Kluver-Barrera method.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8355822
TI  - Chronic GM1 gangliosidosis presenting as dystonia: clinical and biochemical
      studies in a new case.
AB  - Clinical and biochemical findings in a patient affected by chronic GM1
      gangliosidosis, presenting as progressive dystonia and mental deterioration, are
      reported. The patient, a 13-year-old male, showed, at the age of 3 years, an
      impairment of gait with frequent falls, dysarthria and stuttering. At the age of
      6, writing dystonia appeared and subsequently mental deterioration and dystonic
      postures of arms and legs became evident. The clinical features presented by this
      patient are similar to those shown by the cases of adult/chronic GM1
      gangliosidosis previously reported, except for the early onset. This observation
      emphasizes the occurrence of dystonia as prominent symptom in chronic GM1
      gangliosidosis, underlining that this disease must be considered in the
      diagnostic approach to the progressive dystonias of the early infancy.

PMID- 8355823
TI  - Parasomnia with rhythmic movements manifesting as nocturnal tongue biting.
AB  - The case of a healthy 2-year-old girl with repeated nocturnal tongue biting as a
      result of rhythmic movements of the jaw associated with body rocking in non-REM
      sleep is described. Parasomnias manifesting with rhythmic, stereotyped movements
      of the head, trunk and extremities are well described in healthy children. The
      term rhythmic movement disorders (RMD) was introduced for these repetive
      movements in sleep which may appear as head banging (jactatio capitis), body
      rocking or leg rolling. Severe injuries including fractures, subdural effusions
      and eye injures are reported. Repeated tongue injuries have not been described as
      a consequence of RMD. The differential diagnosis from nocturnal seizures is
      crucial to avoid overtreatment of this benign albeit dramatically presenting
      condition.

PMID- 8355824
TI  - Cerebral hemodynamics in subarachnoid hemorrhage evaluated by transcranial
      Doppler sonography. Part 1. Reliability of flow velocities in clinical
      management.
AB  - During recent years, the management of subarachnoid hemorrhage (SAH) has changed,
      resulting in an increase in early operations and routine administration of
      nimodipine. Both influenced the indication for transcranial Doppler sonography
      (TCD). Furthermore, investigations detected discrepancies between Doppler
      findings and neurological status. In a prospective study, the reliability of TCD
      was investigated in patients with SAH treated with intravenously administered
      nimodipine. Patients with large hematomas were excluded. Neurological deficits
      immediately after surgery or within the first 48 hours were classified as not
      delayed, and therefore not necessarily due to vasospasm. The most remarkable
      points of this study are that there is no significant difference between the flow
      velocities for Hunt and Hess Grades I and II when compared with those for Grade
      III, and that Grades IV and V seem to be affiliated with the lowest velocities.
      When the flow velocities of 11 patients who developed delayed ischemic deficits
      (DIDs) were compared with those of patients with no deficit, no significant
      difference was seen. A significant increase in velocity in the days before the
      onset of DID was found only in 3 of 11 cases. Eight patients showed either
      constant high or constant low velocities or even, in some cases, decreasing time
      courses. High flow velocities did not necessarily mean impending neurological
      deficits: 8 of 66 patients tolerated flow velocities over 200 cm/s. Therefore, it
      no longer seems to be justified to proclaim that TCD is able to predict
      neurological deficits, although it is doubtless able to detect
      vasospasm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355826
TI  - Cerebrovascular histopathology after intracarotid infusion of Gelfoam in the rat.
AB  - To evaluate the histopathology of Gelfoam on the cerebral vasculature, 42 Sprague
      Dawley rats weighing 250 to 300 g received internal carotid artery infusions of
      0.3 ml of Gelfoam solution (5 mg/ml) or normal saline (0.9%). The animals were
      killed at 1 hour, 5 hours, 3 days, 1 week, 2 weeks, and 4 weeks after the
      infusion. The brains were removed, sectioned, and stained with hematoxylin and
      eosin. Examination of brain sections revealed Gelfoam emboli lodged primarily in
      the small leptomeningeal arteries. At 5 hours after infusion, inflammatory cells
      were noted in the arterial walls with vessel occlusion. Further canalization of
      vessels was noted at 1 week. At 4 weeks, Gelfoam was not seen in the specimens.
      This study suggests that Gelfoam acts as an embolic agent in vessels over short
      periods of time with no residual inflammatory activity postinfusion.

PMID- 8355825
TI  - Cerebral hemodynamics in subarachnoid hemorrhage evaluated by transcranial
      Doppler sonography. Part 2. Pulsatility indices: normal reference values and
      characteristics in subarachnoid hemorrhage.
AB  - In previous publications on the diagnostic value of transcranial Doppler
      sonography (TCD), conflicting results concerning predictive capacities for
      evaluating vasospasm by measuring flow velocities were reported, and the
      necessity to examine pulsatility indices (PIs) was stressed. PIs are known to
      give useful information on cerebral hemodynamics in cases of stenosis of the
      extracranial internal carotid artery and cerebral arteriovenous malformations.
      Whether the examination of PIs can give additional information in cases of
      subarachnoid hemorrhage (SAH) and allow prediction of impending delayed ischemic
      deficits (DIDs) is still unclear. Normal reference values for the Gosling
      pulsatility index, the Pourcelot resistance index, and the first Fourier
      pulsatility index were established in a series of 97 normal subjects. A
      significant increase in the indices was found as age increased, and there was a
      strong relation between the indices. There were no statistically significant
      differences between the right and left sides. An inverse relation was found
      between the flow velocity and PIs in the middle cerebral artery. In a prospective
      study of 455 follow-up TCD examinations in 66 SAH patients treated routinely with
      nimodipine, three different groups were analyzed separately: Group I, patients
      without DIDs; Group II, patients with DIDs; and Group III, patients with
      neurological deficits not strictly classifiable as DIDs. The analysis of all
      three groups together showed a typical time course after the onset of SAH:
      initially elevated PIs normalized around the tenth day after bleeding. According
      to Fisher grading, the amount of subarachnoid blood influences the increase in
      PIs significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355827
TI  - Giant aneurysms of the proximal anterior cerebral artery: report of three cases.
AB  - Aneurysms of any size involving the A1 segment of the anterior cerebral artery
      are unusual, but giant aneurysms in this location are exceedingly rare, with only
      five cases previously reported in the literature. We report three cases of A1
      segment giant aneurysms presenting with mass effect that were successfully
      treated. A discussion of the salient features of diagnosis and treatment are
      presented, along with a brief review of the literature describing these
      aneurysms. The role of newer imaging modalities, including magnetic resonance
      imaging, magnetic resonance angiography, and intraoperative angiography, is
      discussed. The three patients were treated by direct exploration, trapping, and
      endaneurysmal decompression. Giant A1 segment aneurysms present a unique
      opportunity to safely trap and decompress the aneurysm with definitive cure.

PMID- 8355828
TI  - Spinal arterial aneurysm: case report.
AB  - Isolated aneurysms of the spinal artery (not associated with arteriovenous
      malformations) are exceptionally rare. Fewer than 17 cases have been reported in
      the literature. We report a case of an isolated spinal artery aneurysm causing
      acute subarachnoid hemorrhage. Spinal artery aneurysms are contrasted with the
      more common intracranial aneurysms in terms of presentation and pathogenesis. The
      various clinical presentations of spinal artery aneurysms are discussed as well.
      A summary of all reported cases of spinal aneurysms, with and without associated
      arteriovenous malformations, is listed.

PMID- 8355829
TI  - Pachymeningoencephalitis: case report.
AB  - Hypertrophic cranial pachymeningitis is uncommon. We report the first case of
      pachymeningitis extending to the cerebral parenchyma (pachymeningoencephalitis)
      and involving the bone and extracranial soft tissue. The clinical features and
      pathogenesis are discussed.

PMID- 8355830
TI  - Neuro-ophthalmic complications of intracranial catheters.
AB  - We report four patients who sustained direct injury to the brain after insertion
      of intraventricular shunts and pressure monitoring lines, which resulted in
      permanent neuro-ophthalmic deficits. These included hemianopsia from an optic
      tract lesion, esotropia and residual bilateral facial paresis from dorsal pontine
      injury, unilateral blindness from damage to the optic nerve, and dorsal midbrain
      syndrome from catheter compression in the region of the posterior commissure.
      Although presumably rare, such injuries should be considered in diagnosing
      patients with neuro-ophthalmic complaints after insertion of such devices.

PMID- 8355831
TI  - Successful radiosurgical treatment of a dural arteriovenous malformation: case
      report.
AB  - An anterior fossa dural arteriovenous malformation was treated with radiosurgery.
      The lesion was irradiated with 3000 cGy to the 80% isodose line of an 18-mm
      collimator. Angiography revealed complete thrombosis 3 years after treatment. The
      case is described in detail, and the pertinent literature is reviewed.

PMID- 8355832
TI  - Isolated metastatic melanoma of the cerebellopontine angle: case report.
AB  - Malignant melanoma is a common cause of central nervous system metastases. This
      report describes an extremely rare case of metastatic melanoma presenting as an
      isolated cerebellopontine angle tumor. Clinically and radiographically, the
      lesion mimicked an acoustic neuroma. The patient had neuro-otological symptoms,
      including tinnitus, vertigo, sensorineural hearing loss, facial nerve
      dysfunction, and prominent cerebellar dysfunction. Magnetic resonance images
      showed a lesion of the internal auditory canal and cerebellopontine angle that
      was hypointense on T1-weighted images, hyperintense on T2-weighted images, and
      enhanced after the administration of gadolinium. T2-weighted images showed
      significant cerebellar edema. Subtotal resection of the tumor through a
      suboccipital craniotomy palliated the symptoms, but the patient died of tumor
      progression 6 months later. In contrast to other metastatic tumors of the
      temporal bone, melanoma initially metastasizes to the internal auditory canal and
      is characterized by early neurovascular infiltration. This report highlights the
      pathophysiological characteristics, radiological findings, differential
      diagnosis, and treatment of metastatic melanoma of the internal auditory canal
      and cerebellopontine angle.

PMID- 8355833
TI  - Simultaneous presentation of symptomatic subependymomas in siblings: case reports
      and review.
AB  - Two young adult siblings independently developed similar neurological complaints
      that included headaches, photophobia, nausea, and intermittent lancinating facial
      pains. Magnetic resonance imaging revealed fourth ventricular lesions that
      required surgery in both patients. A pathological review revealed subependymomas
      with virtually identical histological features. The clinical features and common
      pathological findings of both patients suggest that familial subependymomas may
      have a maldevelopmental origin with genetic implications.

PMID- 8355834
TI  - Percutaneous catheterization of the jugular bulb with a Doppler probe: technical
      note.
AB  - On-line measurement of jugular venous bulb oxygen saturation may be of clinical
      value in patients with head injuries. Cannulation of the jugular bulb may be
      technically difficult in this group of patients. Trendelenberg positioning and
      head rotation may be associated with increased morbidity or mortality. A
      technique is described whereby catheterization can be performed with the head of
      the bed elevated and the neck in a neutral position. A needle with a Doppler
      probe is used to distinguish between the carotid artery and the internal jugular
      vein. The needle and the probe are then directed to the audible signal
      representative of the jugular vein. Once the vein is penetrated, placement of a
      fiberoptic oxygen saturation catheter is performed in the usual fashion. This
      technique allows auditory feedback to guide the course of the needle and
      decreases the morbidity that may be associated with the "blind" technique.

PMID- 8355835
TI  - A micrometric multiple electrode array for the exploration of gasserian and
      retrogasserian trigeminal fibers: preliminary report. Technical note.
AB  - The determination of the target for percutaneous thermocoagulation of the
      trigeminal rootlets has been generally based on the analysis of subjective
      clinical verbal and motor responses as assessed by freehand displacement of an
      electrode active at its straight or curved distal tip. In a previous report, we
      demonstrated that sensory and motor trigeminal evoked potentials are of practical
      value when attempting to localize the position of trigeminal electrodes. This
      report describes the technical features of a multiple electrode array designed to
      provide simultaneous access to various segments along a chosen trigeminal
      division or divisions, correlating at each segment clinical and
      electrophysiological data with radiological landmarks in the individual patient.
      The system consists of an outer needle with four windows at a distance of 15 mm
      from the tip. A multiple electrode array occludes the windows with four isolated
      caps for stimulation and recording. After correlating clinical verbal and motor
      responses with sensory and motor evoked potentials at each window and inter se, a
      target window is selected. A thermocouple fitted with a micromanipulator allows
      the accurate placement of the center of the active tip at the center of the
      chosen window. Preliminary data from 25 patients indicate that the technique
      provides a reliable sequential analysis of clinical, electrophysiological, and
      radiological data along the explored tract.

PMID- 8355836
TI  - Thompson-Farley spinal retraction system.

PMID- 8355837
TI  - Thompson-Farley spinal retraction system.

PMID- 8355838
TI  - Synthes spine drill instrumentation.

PMID- 8355839
TI  - Biomagnetic technologies: magnetic source imaging (MSI). Magnes Biomagnetometer.

PMID- 8355840
TI  - A temporal transsylvian approach to anterior circulation aneurysms.

PMID- 8355841
TI  - Pull-out strength of Caspar cervical screws.

PMID- 8355842
TI  - Management of unruptured intracranial arteriovenous malformations: a decision
      analysis.

PMID- 8355843
TI  - The influence of halothane, enflurane, and isoflurane on motor evoked potentials.

PMID- 8355844
TI  - Glucose consumption in recurrent gliomas.
AB  - In order to investigate the clinical significance of glucose consumption (GC) in
      recurrent gliomas, positron emission tomography with 18F-labeled
      fluorodeoxyglucose was measured in 18 cases of histologically verified recurrent
      gliomas. The GC of the tumors were categorized into four groups. Five tumors were
      in Group IV, the highest GC, four were in Group III, eight were in Group II, and
      one was in Group I. Masses in Groups III and IV were clearly defined as a hot
      spot higher than or similar to the GC of the contralateral cortex. Half of the
      recurrent gliomas showed the lower GC of Group I or II, but two thirds of these
      were histologically high-grade gliomas. Although GC in the recurrent gliomas did
      not always increase as expected, a focal increase of GC, even mild and small, in
      the area of previous surgery is diagnostically important. Tumors with high GC
      showed high histological malignancy, irrespective of tissue damage. Patients with
      tumors of low GC had longer survival rates than those with high GC, although
      statistical significance was not obtained. Thus, positron emission tomography
      with 18F-labeled fluorodeoxyglucose was useful for detecting the recurrence of
      gliomas and suggesting their histological malignancy and prognosis. Care should
      be taken because viable tumor cells could be present in areas of low GC and small
      recurrent masses could be missed because of the poor spatial resolution of
      positron emission tomography.

PMID- 8355845
TI  - Relationship between Glasgow Outcome Scale and neuropsychological measures after
      brain injury.
AB  - The present study was conducted to further our understanding of the relationship
      between performance on neuropsychological tests and functional status after head
      injury and to provide information on the relative usefulness of
      neuropsychological tests as outcome measures in clinical trials of brain injury.
      We sought to select the fewest number of 19 neuropsychological tests administered
      to 110 patients that, in combination, were most closely related to outcome (as
      measured by the Glasgow Outcome Scale (GOS) and to the remaining
      neuropsychological measures. The relationship of memory and intellectual deficits
      to functional status was also considered. To address these questions, we analyzed
      19 neuropsychological measures and GOS scores of 110 severely brain injured
      patients from the Traumatic Coma Data Bank. Of 19 neuropsychological measures
      compared with GOS at 3 and 6 months, four tests (Controlled Oral Word
      Association, Grooved Pegboard, Trailmaking Part B, and Rey-Osterrieth Complex
      Figure Delayed Recall) provided the closest relationship to GOS and to the
      remaining 15 tests. Similar analyses were performed on 30 moderately injured
      patients to test the generality of our findings across different levels of
      patient severity. The same four tests were found to be highly predictive of GOS.
      Grooved Pegboard, a test of fine motor coordination, accounted for 80% of the
      variation in GOS. Fifteen percent of 116 patients with severe brain injury could
      not complete a neuropsychological battery and 39% were excluded because of
      previous brain injury or known substance abuse.

PMID- 8355847
TI  - Subtemporal amygdalohippocampectomy for treating medically intractable temporal
      lobe epilepsy.
AB  - A SUBTEMPORAL AMYGDALOHIPPOCAMPECTOMY technique has been developed for mesial
      temporal lobe epilepsy. The conventional subtemporal approach has been modified
      to diminish temporal lobe retraction and the risk of damage to the temporal lobe.
      In the new technique, the surgeons' position has moved from above to below and
      the approach has been changed from anterolateral to posterolateral, thereby
      avoiding the voluminous and steeply inclined anterior temporal lobe. By this
      modified approach, it was unnecessary to remove the roof of the external auditory
      meatus and it was estimated that both the retraction pressure and the extent of
      temporal lobe retraction were reduced. To date, surgeons using this approach have
      operated on four patients with temporal lobe epilepsy whose epileptic foci were
      in the mesial temporal structure; the inferior temporal gyrus, the temporal tip,
      the vein of Labbe, and the ventral bridging veins were preserved. After surgery,
      two patients became completely free of seizures and the other two showed over 90%
      reduction in seizure frequency without neurological sequelae. Postoperative
      visual field examination revealed full visual fields without quadrantanopsia.
      This approach can preserve the temporal stem and lateral temporal lobe, it can be
      used to remove as much of the posterior hippocampus as necessary, and it can be
      extended to conventional lobectomy if it is indicated.

PMID- 8355846
TI  - Sigmoid diverticular perforation in neurosurgical patients receiving high-dose
      corticosteroids.
AB  - Perforation of colonic diverticula is a complication of corticosteroid use that
      has not been described in the neurosurgical literature. Between 1987 and 1992,
      719 patients who underwent surgery for primary and metastatic brain and spinal
      tumors of the central nervous system received 2246 to 4936 mg of
      methylprednisolone given over at least 7 days. Five patients in this group (all
      men, ages 50-69 yr) experienced a sigmoid diverticular perforation at a mean dose
      of 3947 mg of methylprednisolone (range, 2240-6160 mg). Of these five, two had a
      known history of diverticular disease. In contrast, during this same period, 3749
      patients who underwent neurosurgical procedures for non-neoplastic conditions did
      not receive corticosteroids and experienced no colonic perforations. All five
      patients with colonic perforations presented with abdominal pain and had free
      intraperitoneal air that was revealed on radiographs of the abdomen. Perforation
      of a sigmoid diverticulum was confirmed in all five at exploratory laparotomy.
      Four patients had good outcomes, and one died. We conclude the following: 1)
      patients over age 50 who receive high-dose corticosteroids are at risk for
      sigmoid colonic perforation, and these medications should be used with caution in
      such patients; 2) if possible, lower total doses of perioperative corticosteroids
      should be used in patients with known diverticular disease; and 3) because
      corticosteroids mask many of the inflammatory signs of perforation, this
      diagnosis should be considered in any patient with abdominal discomfort, fever of
      unknown origin, or unexplained leukocytosis.

PMID- 8355848
TI  - Thoracic disc disease: experience with the transpedicular approach in twenty
      consecutive patients.
AB  - TWENTY CONSECUTIVE PATIENTS were treated for symptomatic thoracic disc herniation
      with the transpedicular approach. Most patients had severe, incapacitating local
      or radicular pain. Myelopathy was uncommon as magnetic resonance imaging allowed
      an early diagnosis. Computed tomography, after myelography, provided further
      information necessary for surgical planning. Three patients had disc disease at
      two levels. Nine central and 14 lateral disc herniations were found. Disc
      calcification or an associated osteophyte was identified in six instances.
      Although the size of the disc herniation correlated with the amount of cord
      compression, no radiological features were found to be correlated with
      neurological function. The transpedicular approach was used in all patients. New
      curettes, specifically designed for the procedure, allowed the removal of all
      discs, including central and calcified fragments. A modified arthroscope was used
      to confirm neural decompression in some instances. One year after surgery, all 20
      patients were significantly improved and 8 patients were asymptomatic. Apart from
      the duration of the symptoms, no other factors were found to affect outcome. The
      findings suggest that the prognosis of thoracic disc herniation is excellent if
      the disease is recognized early. The transpedicular approach, using curettes
      specifically designed for the procedure, can be an effective and safe method of
      surgical decompression in carefully selected patients.

PMID- 8355849
TI  - Chronic subdural hematoma: the role for craniotomy reevaluated.
AB  - The management of chronic subdural hematoma in the adult patient is approached
      with a variety of different surgical techniques. The trend in recent years has
      been toward treatment with burr holes or twist-drill holes rather than
      craniotomy. The rationale for this has been based on the assumption that burr
      holes and twist-drill holes offer equivalent efficacy and lower morbidity and
      mortality. This viewpoint is not, however, universally accepted, and many
      surgeons feel that craniotomy is superior to a burr hole for the management of
      this condition. In a review of 92 patients presenting over a 3-year period with
      112 chronic subdural hematomas, 49 underwent craniotomy and 43 underwent burr
      hole treatment. The recurrence of hematomas, requiring another operation,
      occurred in 8.6%; operative mortality was 2.2% at hospital discharge and 4.4% at
      follow-up. No patient died as a consequence of the operative procedure. There was
      no significant difference in the incidence of postoperative complications,
      hematoma recurrence, or operative mortality among the different surgical groups.
      Previous reports concerning the superiority of burr holes over craniotomy are not
      substantiated by this review. Although the issue concerning optimal therapy has
      not been resolved by this review, at this time, craniotomy remains a valid and
      safe technique for the management of patients with chronic subdural hematoma.

PMID- 8355850
TI  - A risk/benefit analysis of spinal manipulation therapy for relief of lumbar or
      cervical pain.
AB  - Approximately 12 million Americans undergo spinal manipulation therapy (SMT)
      every year. Renewed interest in this method requires an analysis of its reported
      risks and possible benefits. This review describes two patients with spinal cord
      injuries associated with SMT and establishes the risk/benefit ratios for patients
      with lumbar or cervical pain. The first case is a man who underwent SMT for
      recurrent sciatica 4 years after chemonucleolysis. During therapy, he developed
      bilateral sciatica with urinary hesitancy. After self-referral, myelography
      demonstrated a total block; he underwent urgent discectomy with an excellent
      result 3 months after surgery. The second patient with an indwelling Broviac
      catheter and a history of lumbar osteomyelitis underwent SMT for neck pain.
      Therapy continued for 3 weeks despite the development of severe quadriparesis.
      After self-referral, he underwent an urgent anterior cervical decompression and
      removal of necrotic bone and an epidural abscess with partial neurological
      recovery. An analysis of these cases and 138 cases reported in the literature
      demonstrates six risk factors associated with complications of SMT. These include
      misdiagnosis, failure to recognize the onset or progression of neurological signs
      or symptoms, improper technique, SMT performed in the presence of a coagulation
      disorder or herniated nucleus pulposus, and manipulation of the cervical spine.
      Clinical trials of SMT have been summarized in several recent articles.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8355851
TI  - The surgical anatomy of the perforating branches of the basilar artery.
AB  - The perforating branches of the basilar artery were examined in 14 brain stems
      injected with india ink or methylmethacrylate. Three groups of the perforators
      were distinguished: the caudal, the middle, and the rostral. The caudal
      perforators varied in number from two to five and in diameter from 80 to 600
      microns. In addition to their terminal branches, which entered the foramen cecum,
      the perforators occasionally branched off the pontomedullary artery, the
      pyramidal vessels, and the hypoglossal branches. The middle perforators arose
      either separately from the basilar artery or along with the basilar artery
      collateral branches. They ranged in number from five to nine and in diameter from
      210 to 940 microns. The perforators gave rise to the pontomedullary artery
      (8.3%), the long pontine arteries (25.0%), and the anterolateral vessels (100%).
      The rostral perforators originated from the terminal part of the basilar artery
      (91.6%), as well as from the superior cerebellar artery (91.6%) and the
      posterolateral artery (16.6%). They varied in number from one to five and in
      diameter from 190 to 800 microns. The anastomoses among various perforating
      vessels were noted in 41.6 to 66.6% of the cases. The authors discussed the
      possible clinical significance of the anatomical data observed in this study.

PMID- 8355852
TI  - The frequency of intradural conjoined lumbosacral dorsal nerve roots found during
      selective dorsal rhizotomy.
AB  - The frequency of occurrence of conjoined nerve roots (CR) in the cauda equina has
      been reported to range from 0.3% to 2%. We found intradural conjoined nerve roots
      in 13 of 123 (10.6%) patients undergoing selective dorsal rhizotomy for
      spasticity due to cerebral palsy. The anomaly occurred most commonly at L5-S1 and
      S1-S2. There was no consistent relationship to other anomalies of segmental
      anatomy. Our finding of a significantly higher number of conjoined nerve roots in
      these patients is primarily due to the surgical exposure of the entire cauda
      equina. This anomaly is more common than previous reports have indicated.

PMID- 8355853
TI  - Neurofibromatosis 2 in the pediatric age group.
AB  - Bilateral acoustic neurofibromatosis or neurofibromatosis 2 (NF2) is an autosomal
      dominant disease predisposing to the formation of multiple tumors in the central
      and peripheral nervous system. Vestibular schwannomas (VSs) are considered to be
      the hallmark of the disease, but other tumors and ocular findings occur as well.
      In patients that do not carry the NF2 mutation, VSs usually occur in the fifth or
      sixth decade of life. VSs in patients with NF2 are often bilateral and become
      symptomatic in the third or fourth decade of life. In order to define the early
      manifestations of NF2, we examined nine children who either had one parent with
      NF2 or had multiple skin or spinal tumors suggestive of NF2. In addition to
      neurological, dermatological, and ocular examinations, all patients were studied
      by gadolinium-enhanced magnetic resonance imaging of the brain and spine. None of
      the children exhibited symptoms or signs due to VSs. However, VSs were detected
      during the neuroradiological work-up in six children. Seven children developed
      symptoms or signs due to skin or spinal tumors. Slit lamp examination detected
      cataracts in four patients as young as 10 years of age. The diagnosis of NF2 in
      the pediatric age group requires a high degree of suspicion and should be
      considered in children with multiple central nervous system or skin tumors
      without cafe-au-lait spots or Lisch nodules. Because VSs are unlikely to produce
      the signs seen at the time of admission, careful examination of the skin and eyes
      is necessary and should be followed by gadolinium-enhanced magnetic resonance
      imaging of the brain and spine. First-degree relatives need to be examined as
      well.

PMID- 8355854
TI  - Ruptured suprasellar dermoid cyst presenting olfactory delusion (Eigengeruchs
      erlebnis).
AB  - A 24-year-old man sought treatment of a long-standing olfactory delusion
      (Eigengeruchs erlebnis) and associated psychotic symptoms, which disappeared
      after the removal of a suprasellar dermoid cyst. The pathophysiology of the
      phenomenon is discussed.

PMID- 8355855
TI  - [The natural history of peripheral arteriopathy].
AB  - An the content of atherosclerosis, knowledge of the natural history of peripheral
      arteriopathy of the lower limbs is of fundamental importance. The authors review
      the literature involved; in particular they examine the prevalence of peripheral
      arteriopathy, its incidence and multimodal course in time. It is very interesting
      to state the cardiovascular morbility and mortality owing to pathology of the
      coronary district as well as the cerebral one during the course of peripheral
      arteriopathy. The literature conclusions are not univocal; this matter is
      principally due to different approach methodologies. As far as arteriopathy of
      inferior limbs is concerned, the literature shows that we can have a worsening in
      the local picture for 25% of the cases involved, considering the worst
      hypothesis; amputation involves at the most 5% of the cases. The real problem in
      these patients is the presence of arteriosclerotic disease involving other
      different vascular districts.

PMID- 8355856
TI  - [Biochemical-physical and rheologic changes in the blood of patients with angina
      pectoris].
AB  - Viscosity, erythrocyte flexibility, haematocrit value and fibrinogen
      concentration have been studied in fifty patients: twenty-five of them suffering
      from angina pectoris and the other twenty-five in good health. The parameters
      considered in the first group have been found out to be much higher in comparison
      with the control group. In particular, when the values of blood viscosity are
      corrected for the standard haematocrit as to 45 per cent, the significance of the
      values themselves between the two groups of patients is cancelled. In such a way
      the dependence of viscosity on haematocrit is demonstrated. The results obtained
      are discussed in relation to the literature data which are not always univocal.

PMID- 8355857
TI  - [ST elevation during ergometric test: correlation with coronary angiography].
AB  - BACKGROUND: ST elevation during ergometric stress test (EST) is relatively rare.
      Its prevalence depends upon the tested population but occurs more frequently in
      patients who have had myocardial infarction or variant angina. This phenomenon is
      very rare in patients with typical exertional angina and its pathogenesis is
      still unclear. MATERIAL AND METHODS: We studied a group of 75 consecutive
      patients with exertional angina who underwent EST and coronary angiography. A
      symptom limited EST was performed in the upright position on a cycloergometer
      with load increases of 25 watts every 3 minutes and 12 leads were monitored
      during all test. Coronary angiography was performed according to Judkins
      technique. From these patients, according to Froelicher's criteria, a group of 49
      patients (age 32-68, mean 51.6 years), without myocardial infarction and/or left
      ventricular asynergy, was selected. RESULTS: All patients had a coronary artery
      disease (16 patients with 3 vessels, 11 patients with 2 vessels and 22 patients
      with 1 vessel disease). The EST was positive for ST depression in 31 patients
      (63.3%) and for ST elevation in 5 patients (10.1%), while 13 patients (26.6%) had
      a non diagnostic EST. The ST elevation occurs in V1-V2 and it was associated in
      all cases with a stenosis in the left anterior descending (LAD) artery. Therefore
      we divided the 19 patients with LAD stenosis into two subgroups: subgroups A (9
      patients, mean age 49.6 years) with LAD stenosis > or = 90% and subgroups B with
      LAD stenosis between 70% and 90%. ST elevation occurs in 5 patients (55.5%) of
      subgroup A and in no patient of the subgroup B. Moreover, in the subgroup A ST
      elevation seems to be related to the anatomic localization of the stenosis: in
      fact it appears in 83.3% of patients with LAD stenosis located before the onset
      of the first diagonal branch. CONCLUSIONS: From these data it can be desumed that
      ST elevation in V1-V2 that occurs in patients with exertional angina and without
      myocardial infarction or variant angina is strongly predictive of a very
      important LAD stenosis.

PMID- 8355858
TI  - [Safety of the dipyramidole echocardiography test in elderly coronary disease
      patients].
AB  - We prospectively studied the feasibility and safety of high-dose dipyridamole
      echocardiography in 166 patients (77 younger and 89 elderly patients) referred
      for clinical evaluation of coronary artery disease. The feasibility of
      dipyridamole echocardiography test was 80.5% in the young and 82% in the elderly
      (p = n.s.). The incidence of side effects during dipyridamole echocardiography
      was similar in two groups, except for dyspnea which was observed in 20% in the
      older and 4% in the younger (p < 0.01). Our data demonstrate that the
      dypiridamole test combined with echocardiographic monitoring of regional
      myocardial contractility may be considered a valid non invasive method for
      evaluating coronary artery disease in the elderly.

PMID- 8355860
TI  - [Effect of cilazapril therapy on diastolic filling and left ventricular
      hypertrophy in patients with arterial hypertension].
AB  - BACKGROUND: Of the main aspects of hypertension, left ventricular hypertrophy and
      appearance of cardiac dysfunction seem to be the most common and to produce an
      early and severe cardiac deterioration. Even in the presence of normal systolic
      function diastolic filling abnormalities are described. The efficacy of many
      antihypertensive drugs to decrease blood pressure and to reduce left ventricular
      hypertrophy has already been demonstrated. Cilazapril is a new ACE-inhibitor that
      in previous studies showed a very important antihypertensive effect. To assess
      its capacity, in long-term treatment, to reduce left ventricular hypertrophy we
      performed a prospective study on patients with mild hypertension. MATERIAL AND
      METHODS: Nineteen patients (aged 48 +/- 15 years) with mild hypertension (mean
      arterial pressure automatically recorded for 24 hours with blood pressure
      ambulatorial monitoring) were treated with cilazapril (5 mg/day) for 1 year.
      Doppler echocardiography was performed: at the beginning, after 6 months and
      after one year of therapy. The following parameters were evaluated:
      interventricular septal and posterior wall thickness, LV end-diastolic diameter,
      LV mass index, early (E) and late (A) diastolic filling flow velocities and the
      ratio E/A. RESULTS: A significant decrease was observed in mean arterial pressure
      (from 130 +/- 14 mmHg at beginning to 102 +/- 11 mmHg at six months of therapy
      and to 103 +/- 9 mmHg at one year of therapy). A significant reduction in LV
      hypertrophy and an improved diastolic filling pattern of the left ventricle was
      shown after six months of therapy with cilazapril; this improvement still
      remained after 1 year of therapy. CONCLUSIONS: In this study antihypertensive
      efficacy of cilazapril has been confirmed. Moreover, in long treatment,
      cilazapril has been useful to reduce left ventricular hypertrophy and to improve
      diastolic filling without significant side effects.

PMID- 8355859
TI  - [Treatment of ischemic heart disease in the elderly. Comparison of diltiazem,
      verapamil and gallopamil].
AB  - The medical therapy of myocardial ischemia in elderly patients has not been well
      evaluated. We studied the age-related changes in 127 patients with proved
      coronary artery disease and stable effort angina the efficacy and the safety of
      diltiazem 120 mg tid, verapamil 120 mg tid and gallopamil 50 mg tid a medium term
      parallel, double blind cross-over placebo controlled study. All patients have
      been clinically and ergometrically evaluated. In middle-age patients diltiazem,
      verapamil and gallopamil induced a significant increasing of exercise duration
      and time to onset ST segment depression > or = 1 mm. In the elderly patients both
      verapamil and diltiazem as increased the exercise duration and ischemic
      threshold, while the diltiazem did not increased the exercise duration even if
      the time of onset ST segment depression > or = 1 mm is increased. At peak
      exercise the ST segment depression have been reduced both in middle-age and
      elderly patients after active drugs. Weekly angina and DNT consumption have been
      significantly reduced after diltiazem, verapamil and gallopamil in middle-age and
      elderly patients. Side effects have not been relevant even if gallopamil as a
      lower frequency of them in comparison to diltiazem and verapamil. No patients
      stopped the treatment because major side effects. Our experience suggests that
      diltiazem, verapamil and gallopamil have a similar efficacy and rare well
      tolerated. The choice of one instead of another must be suggested on the basis of
      side effects developing.

PMID- 8355861
TI  - [Increase in capillary permeability induced by endotoxin: protection with
      antioxidants and glutathione].
AB  - Endotoxin administration increases capillary permeability in experimental animals
      and this is one of the most relevant events in the pathophysiology of endotoxin
      shock; the aim of the present experiment was to demonstrate that the action of
      endotoxin on capillary permeability is due to oxygen-free radicals generation.
      Experiments were performed on the mesocecum of male Wistar rats; fluorescent
      labeled bovine albumin (FITC-BSA) was injected intra-arterially to evaluate the
      capillary permeability; the mesocecum microcirculation was observed by
      fluorescent light. Permeability was quantified by changes in the number of leaky
      sites at 10 minute intervals for an hour. The effects of Endotoxin (DIFCO
      0111:B4, 30 mg/kg i.a.) were assessed in rats receiving 1) saline, 2) reduced
      glutathione (250 or 500 mg/kg i.p.), 3) three different nitrones (PBN, DMPO,
      POBN) (6.25 mg/kg i.p.) whose action is to "trap" oxygen radicals. Capillary
      permeability largely increased in a few minutes in control rats but it was quite
      unaffected in rats receiving glutathione or nitrones. As a conclusion the
      increased capillary permeability observed after endotoxin injection in rats may
      be due to an oxygen-radicals generation.

PMID- 8355862
TI  - [Charcoal and isoflurane alveolar washout in low-flow circuit].
AB  - The inclusion of charcoal filters in anaesthetic low-flow systems contributes to
      the acceleration of the kinetics of isoflurane (Forane). In twenty subjects,
      scheduled for extra- and intracranial surgery, ventilated with a low-flow system
      (Ohmeda Excel OAV7750 with rebreathing cassette) with a mean total flow of 0.7
      l/min, awakening was complete within 5 minutes from stopping isoflurane and
      including charcoal in the circuit. At the awakening, the expiratory concentration
      of isoflurane was 0.23% (95% confidence intervals: 0.19-0.27%): these values are
      similar to those of MACawake of isoflurane after fast alveolar washout. The use
      of charcoal during low-flow anaesthesia makes low-flow systems more flexible in
      their use; the anaesthetic level is more easily controllable and accidental
      overdosing of volatile anaesthetics can be immediately removed.

PMID- 8355863
TI  - [Subarachnoid anesthesia with Sprotte 24-G needle in ambulatory surgery].
AB  - In order to evaluate the possibility of using a selective subarachnoid anesthesia
      in ambulatory surgery we studied its feasibility with a Sprotte needle 24 G in
      103 patients (range 15-67 years) undergoing a knee joint arthroscopy. The
      subarachnoid anesthesia was achieved with Sprotte needle 24 G with introducer
      with patient on lateral decubitus. Hyperbaric bupivacaine 1% (0.05 mg/cm height)
      was used in order to obtain a selective homolateral metameric anesthesia between
      L1 and S3. The numbers of attempts were 1.29 (range 1-4). We involved the
      homolateral determatomeres in 94% of our attempts, adding a weak anesthetic
      action on contralateral ones. In the remaining 6% of the patients the anesthesia
      was bilateral and extending in an overlying manner. Anesthesia was adequate for
      the time needed to perform all the surgical procedures. Nevertheless in 3
      patients the tourniquet was painful. We registered systemic hypotension only in
      2% of the patients (a reduced systolic pressure value > 30%). No cases of
      postdural puncture headache were registered. Non postural atypical headache was
      seem in 3.9% of the patients. Urinary retention necessitating catheterization was
      noted only in 3 cases. A weak backache was revealed in 8.8%. When interviewed
      after surgery, 98% of our patients fulfilled the technique. In spite of technical
      difficulties that the use of the Sprotte needle may present, the selective
      subarachnoid anesthesia may be a safe alternative to the other anesthetic
      procedures for ambulatory surgery of the legs.

PMID- 8355864
TI  - [Effects of clonidine vs trinitroglycerin on myocardial oxygen balance and on
      pulmonary gas exchange after myocardial revascularization].
AB  - The authors examined the effects of clonidine, a preferential alpha-adrenergic
      agonist, upon myocardial oxygen balance and pulmonary function during the
      perioperative period in patients undergoing CABG surgery. Anesthesia was provided
      by fentanyl infusion reaching the final dose of 100 micrograms.kg.min-1 in 10
      minutes before skin incision. Ten patients received clonidine 0.125 mg
      intravenously after induction of anesthesia; a group of 10 patients was managed
      identically except for nitroglycerin infusion during the pre-CPB period, in order
      to keep the aortic pressure in the normal range. Intergroup differences in
      hemodynamics, respiratory data, rewarming time, post-operative ST-tract pattern
      and enzyme values were evaluated. Results are suggestive (in the clonidine group)
      for ameliorating myocardial oxygen balance by reducing oxygen consumption indexes
      (systolic aortic pressure, cardiac index, rate pressure product) and increasing
      coronary blood flow [coronary perfusion pressure (p < 0.01)] at the end of the
      surgery and intensive care. Global oxygen consumption reduction, recorded in the
      clonidine group patients, the oxygen available being unchanged, ameliorated the
      total oxygen balance mainly after sternotomy (p < 0.05) and at the end of bypass
      (p < 0.05). Cardiac index was greater during the awakening and rewarming period
      in intensive care and the ventilatory/perfusion ratio was improved, allowing a
      minor minute ventilation required in clonidine group patients, specially during
      admission to intensive care.

PMID- 8355865
TI  - [Gabexate mesilate (FOY), a new synthetic protease inhibitor, in the treatment of
      shock. An Italian multicenter study].
AB  - BACKGROUND: Circulatory shock has been accepted as a consequence of a chain of
      biochemical events beginning with production of proteases and ending with an
      uncontrolled generation of oxygen radicals. OBJECTIVE: To evaluate the efficacy
      of gabexate-mesilate (FOY) in circulatory shock in man. Gabexate-mesilate is a
      new wide-range synthetic protease inhibitor that also has antioxidant properties.
      DESIGN: Clinical multicenter study with open design that has been compared with
      some Japanese controlled studies performed using identical parameters and very
      similar protocols. EXPERIMENTS: 59 shocked patients were treated with FOY in 9
      italian intensive therapy units. Circulatory shock was traumatic (n = 14),
      traumatic-hemorrhagic (n = 25), septic (n = 11) or of mixed type (n = 9).
      Evaluation of seriousness of shock on beginning of therapy and during the follow
      up period was performed on the basis of the same "shock score" (Ogawa and Fujita,
      Jap J Surg 12:122, 1982) that was used in Japanese clinical studies on FOY in
      shock. 1.45 mg/kg/hour of FOY were injected i.v. during 48 hours. Conventional
      therapy was permitted but steroids and aprotinin were excluded. The follow-up
      period was 9 days. RESULTS: 8 patients died. The mean initial score of the
      survivors was 8.2; after 8 hours it was 5.0 and after 12 it was 4.0. No adverse
      reactions were reported. The above quoted survival was greater than that of
      Japanese studies although the initial score was quite the same. However these
      studies were controlled and demonstrated gabexate-mesilate to be significantly
      more active in shock therapy than placebo. They also demonstrated an activity of
      FOY greater than that of aprotinin when shock was associated to acute respiratory
      insufficiency and to coagulopathies. CONCLUSIONS: Gabexate mesilate might be
      useful in therapy of circulatory shock due to its wide-range inhibition of
      proteases and to its antioxidant properties.

PMID- 8355866
TI  - [Diazepam and dehydrobenzperidol: comparison of 3 protocols of oral premedication
      in children].
AB  - Oral diazepam, oral droperidol and oral diazepam plus droperidol were compared as
      premedicants in 75 children weighting from 10 to 20 kg. The sedation and anti
      salivary action were more satisfactory with droperidol alone and with droperidol
      plus diazepam.

PMID- 8355867
TI  - [The Mallampati's scale: a study of reliability in clinical practice].
AB  - The need to predict the rank of difficulty of tracheal intubation is of paramount
      importance in anaesthesia as has been well documented in numerous studies. We
      assessed the use of the Mallampati scale as possible predictive indicator of
      difficult tracheal intubation in a study conducted on 700 patients. The rank of
      difficulty determined during the pre-anaesthesiological examination by the
      Mallampati scale, was compared to the Cormack scale as assessed by the laryngeal
      direct examination at the beginning of anaesthesia. The correlation between the
      two first ranks of both scales was highly significant. The evaluation by the
      scale of Mallampati showed a good sensibility and a low specificity with
      incorrect overestimation only for the difficult intubation. In our study
      orotracheal intubation was rated difficult in 10.4% of the patients by the
      Mallampati scale and in 11% of the patients score by the Cormack scale. The chin
      to jugulum distance, also studied as a possible predictive parameter, did not
      correlate with the Cormack scale.

PMID- 8355868
TI  - [Quality of care at a regional emergency medical system].
AB  - The Emergency Medical System (EMS) in the district of Florence is based upon the
      activity of 13 Emergency Mobile Unit (EMU). The activity of such a huge system is
      difficult to evaluate: we have concentrated our attention upon the diagnostic
      process assuming that "correct diagnosis = correct treatment = benefit for the
      patient". Then we compared diagnoses set on EMU to diagnoses made in hospitals,
      giving to each comparison a score from 1 to 5. In terms of quality the services
      of the EMS in Florence seem to be effective, since in 72% of cases the Hospital
      Emergency Department has confirmed the diagnoses achieved under emergency
      conditions, and in 12% only there has been remarkable difference. Comparing the
      diagnoses made on EMU to that at the hospital discharge, in two thirds of cases
      there is excellent correlation.

PMID- 8355869
TI  - [General anesthesia for endobronchial laser therapy in a heart and lung
      transplant recipient].
AB  - The introduction of heart, lung and heart-and-lung transplants, only recently
      performed in Italy, has presented the anesthetist with the problem of the
      anesthesiological treatment of newly transplanted patients whose number will
      increase over time. For some time our unit has used general anesthesia using
      spontaneous breathing for endotracheal and endobronchial laser therapy. This
      solution was adopted in the case of a patient who had undergone a heart-lung
      transplant using an "a domino" technique some 90 days earlier. The authors
      discuss the results of the anesthesiological technique used taking into account
      the particular hemodynamic and respiratory characteristics of these patients.

PMID- 8355870
TI  - [Treatment of pheochromocytoma in children. Experience with 3 clinical cases].
AB  - The authors report their own experience in three cases of paediatric
      phaeochromocytoma. Before surgery the patients received alpha-adrenergic blocking
      drugs; two of them also received calcium channels blocking drugs and in one of
      them was employed a beta-adrenergic blocking drug too. Before surgery the
      patients received blood and plasma expandera infusions for two weeks.
      Hypertension during surgery was treated with phentolamine infusion. The
      employment of an invasive haemodynamic monitoring was very important. The authors
      believe that such management, already employed in adult patients, is the best
      choice in paediatric patients too.

PMID- 8355871
TI  - [Cholecystectomy by video celioscopy in the elderly. An obligatory choice?].
AB  - The videocelioscopic technique is becoming increasingly widely used in the
      treatment of cholelithiasis. In view of the results obtained, the authors
      underline the advantages of this method in geriatrics.

PMID- 8355872
TI  - [Tumors of the breast in old age].
AB  - After reviewing the literature on this topic the authors studied all patients
      admitted to the Institute of Surgical Pathology I at the University of Pavia for
      breast cancer between 1-1-1974. An analysis of the findings revealed that: (a)
      Out of 993 patients with breast cancer, 204 (20.54%) belonged to the geriatric
      age group (> 65 years old) and of the latter 135 (66.17%) belonged to the 3rd age
      group and 69 (33.82%) belonged to the 4th age group (> 75 years old). (b) In the
      3rd age group 25 (18.51%) were benign tumours and 110 (81.48%) were malignant,
      whereas in the 4th age group 4 (5.79%) were benign and 65 (94.20%) were
      malignant. (c) Familial patterns were also examined and were found to be positive
      in 47 (23.03%) cases in the 3rd age group and in 30 (14.71%) in the 4th age
      group. (d) In the physiological anamnesis it is interesting to note that there
      was 1 menarche before 12 (0.9%) in the 3rd age group; delayed menopause (after
      50) in 66 cases (60%) in the 3 rd age group and in 29 cases (44.61%) in the 4 th
      age group. (e) In the pathological anamnesis of the patients in question it was
      observed that the most frequent site of previous tumours was the breast (72
      cases, equivalent to 10.9% in the 3rd age group; 9 cases, 13.8% in the 4th age
      group). (f) In the next pathological anamnesis and at EOL it was observed that
      the tumours was most often found in the supero-external quadrant, in the right
      breast in the 3rd age group (66 cases, 48.89%) and in the left one in the 4th age
      group (42 cases, 60.87%). (g) Test included breast cancer scan, mammography,
      aspirated needle and biopsy where required. (h) Surgery in the form of Halsted's
      mastectomy was the preferred therapy and as early as possible. Some Authors use
      conservative therapy. (i) Histological tests were performed in all patients and
      revealed that the most frequent malignant tumour was ductal carcinoma. (j)
      Postoperative complications took the form of wound suppuration. (k) Only one
      tumour (carcinoma) was observed in male patient aged 83 years old, without
      metastasis. From the above findings it can be concluded that the most evident
      risk factor for breast cancer is the influence of the estrogen hormone.

PMID- 8355873
TI  - [Immediate reconstruction after radical mastectomy for breast carcinoma with a
      Becker-type expander prosthesis].
AB  - In recent years, the breast has won importance from the female psychology point
      of view. After ablative surgery for cancer, the loss of the breast gives rise in
      the woman to a feeling of refusal of her new body shape. Reconstruction produces
      positive feelings in the patient. The best-used surgical technique for operable
      breast cancer is modified radical mastectomy. An immediate reconstruction of the
      missing breast is considered when the following conditions are fulfilled: desire
      for reconstruction, age of the patient, clinical and pathologic evaluation (tumor
      size-tumor grade-lymph-node status). After modified radical mastectomy with "en
      bloc" removal of axillary lymph nodes, an immediate reconstruction is performed
      by lining the surfaces with human fibrin glue (Tissucol) followed by the
      insertion of a prosthesis of appropriate size (Becker Expander Mammary Prosthesis
      Type 1) in the subserratus-subpectoral position. Human fibrin lining reduces the
      incidence of capsular contracture and effusion production. A suction drain is
      placed in the axillary area and is removed after 5 days. The use of expanding
      type prostheses means that the patient must return for further expanding. When
      the pathologic features are negative, the delayed nipple areola reconstruction is
      possible with the full-thickness skin grafts in the groin or in pre-existent
      appendectomy incision. By this procedure, adjuvant chemotherapy or radiation
      therapy can be performed if required. From 1987 to 1991 the procedure has been
      performed in 35 cases of mammary neoplasm (mean age 40 years) at INRCA Department
      of Surgery of Ancona). No evidence of adverse effect on the natural course of the
      breast disease for have been seen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355874
TI  - [The role of node-picking lymphadenectomy in the treatment of differentiated
      carcinoma of the thyroid].
AB  - A retrospective analysis of the treatment of spreading of differentiated thyroid
      carcinoma to regional lymph nodes was performed in 201 patients observed in 1973
      1991. In 183 patients with no clinical metastatic involvement (A group), no lymph
      node excision was performed. In 36 patients with limited metastatic lymph node
      involvement (B group), a node-picking lymphadenectomy was performed. After 1977,
      all patients were treated also with metabolic radiotherapy postoperatively.
      Actuarial 15-year survival was 98.28% in A group and 87.50% in B group (n.s.
      difference). In 15 patients with lymph nodal relapse, actuarial 10-year survival
      was 83.4%. The survival figures are not different from those obtained after more
      radical operations. So, in limited metastatic involvement of neck lymph nodes by
      differentiated thyroid carcinoma, in the opinion of the Authors, node-picking
      lymphadenectomy is equally effective as more radical surgical procedures.

PMID- 8355875
TI  - [The surgical treatment of renovascular hypertension in subjects with a single
      kidney].
AB  - Renovascular hypertension in subjects with a solitary kidney, though an
      infrequent condition, requires surgical direct revascularization procedures
      either to reduce the hypertensive state and, more important, to preserve renal
      function. This paper reports a series of six surgically treated cases between
      1982 and 1990, with at least two years follow-up. Preoperative renal function, as
      evaluated by BUN and blood creatinine, was reduced in 5 cases, the remaining one
      being normal. All subjects were hypertensive at admission: in four cases drug
      therapy was ineffective for restoring normal pressure values. All subjects had
      previously undergone surgical nephrectomy: in 3 cases for shrunk kidney, in 2 for
      failure of a previous attempt of renal revascularization, and one for renal
      tuberculosis. 3 subjects were concomitantly affected with abdominal aortic
      aneurysm, and one had previously undergone aortobifemoral bypass. Treatment of
      the concomitant aortic lesion and renal artery revascularization were carried out
      at the same operation. Operations performed were TEA of residual renal artery in
      3 cases, prosthetic reconstruction in 2 and intraoperative transluminal
      angioplasty by Gruentzig balloon catheter in one. Over a two-year follow-up renal
      function remained good in 4 cases, while one subject required a second surgical
      revascularization due to late acute thrombosis of a previous aortorenal saphenous
      vein graft. Acute early postoperative renal failure occurred in one case and
      permanent haemodialysis was instituted. No deaths were recorded in this series.

PMID- 8355876
TI  - [Traumatic lesions of the colon].
AB  - Four patients operated on at the Clinica Chirurgica II of IRCCS--Policlinico San
      Matteo of Pavia for trauma involving the colon were reviewed. All were males and
      their ages ranged from 14 to 84 years (mean 43.5 years). Injuries of the colon
      were found on 9 per cent of all patients operated on for abdominal penetrating
      injuries and on 6 per cent of patients with blunt injuries. The authors recall
      the pathogenetic mechanisms, clinical patterns, some grading systems proposed for
      quantifying the severity of the lesion. Our experience has shown that in blunt
      trauma the prognosis is worse because there were many associated organ injuries.
      These condition the early mortality for shock and exsanguination.

PMID- 8355877
TI  - [Burn patients in major emergencies. The preparation of air-drop kits for
      emergency surgical-resuscitation use].
AB  - The kit described is for air-dropping for immediate use in the surgical treatment
      and resuscitation of burn victims in major emergencies when there is no direct
      access to the disaster area by rescue teams or vehicles. The kit can also be used
      to make up for deficiencies in medicines or medical materials in remote hospitals
      that have admitted people with severe burns who are not immediately transferable
      to other hospitals.

PMID- 8355878
TI  - [Necrotizing enterocolitis].
AB  - Necrotizing enterocolitis (NEC) is an important cause of neonatal morbidity and
      mortality. During the last few years, there was an increase in the incidence of
      this disease, associated with a better knowledge of NEC, and an increase in
      survival rate, associated with the development, even from a technological point
      of view, of neonatal intensive care units. In this study, the authors first
      perform the diagnostic procedures and describe the anatomical and clinical
      characteristics of NEC, then evaluate by standard criteria a series of patients
      observed during the last 5 years, revising the various surgical treatments
      adopted and the results obtained.

PMID- 8355879
TI  - [A proposal for a computerized clinical records file for a department of general
      surgery].
AB  - The author suggest a computerized program for filing clinical records of surgical
      institution. The proposed file is written in DB III plus (Ashton-Tate) and
      consists of one file .dbf and 4 files .prg. The database file contains anagraphic
      and clinical data of the patients. The program files make it possible to
      attribute a personal code to patients, print records of single patients,
      calculate the time of operation and assist in codifying diagnostic related groups
      (DRGs). The author stresses the utility of a medical computerized records system
      containing only few but important clinical data. It makes it possible to perform
      the most analysis of surgical series without the aid of a professional
      programmer.

PMID- 8355880
TI  - [Injuries due to seat belts. Comments on a clinical case].
AB  - The authors report a case of associated injuries (thoracoabdominal trauma with
      multiple rib and sternum fractures, perforation of the small intestine, abdominal
      cutaneous ecchymosis) caused by a seat belt, and describe the possible seat-belt
      mechanisms of lesion in road accidents. Some clinical aspects are discussed; in
      particular the diagnostic problems concerning a seat-belt syndrome as well as the
      limits of effectiveness in the use of belts.

PMID- 8355881
TI  - [Umbilical flowmetry: effect of measurement sites on the results].
AB  - Pulsed Doppler duplex sonography was performed longitudinally on 11 uncomplicated
      singleton pregnancies from 20 to 41 week's gestation (87 measurements). Blood
      flow velocities were recorded at 3 locations: abdominal insertion site (O), in
      the free floating part (C), placental insertion site (PL). The objective of the
      study was to determine whether the C site S/D ratio, the quickest and easiest to
      perform, relates to the other sites. The S/D ratio measurements fell from the
      near abdomen (O) to the free floating part (C) to the placental insertion site
      (PL) between 25-35 week's gestation. Statistical analysis, including analysis of
      variance for repeated measures and student t test, showed no significant
      difference in S/D ratio among the locations before 25 and after 35 week's
      gestation. The S/D ratio at the O site was significantly higher than at the PL
      site between 25-35 week's gestation; the C site was not significantly different
      from the PL site.

PMID- 8355882
TI  - [The role of laparoscopy in the evaluation of chronic pelvic pain].
AB  - Chronic pelvic pain, defined as cyclic or acyclic pain reported for a minimum of
      six months, is one of the most common gynecological symptoms and one of the most
      important in terms of social costs. From January 1987 to December 1991, 127
      patients suffering from chronic pelvic pain were submitted to diagnostic
      laparoscopy at the Department of Obstetrics and Gynecology of the Universita
      Cattolica del Sacro Cuore in Rome. The mean age of the patients was 30 years,
      ranging from 14 to 46. All patients were submitted to bimanual pelvic examination
      upon hospital admission, and most of them (No. = 99, 78%) to pelvic
      ultrasonographic examination. In 117 patients (92%) samples for the isolation of
      Chlamydia trachomatis in 5-iodo-2-deoxiuridine treated McCoy cell cultures were
      obtained from the cervix, the endometrium and the cul-de-sac peritoneal fluid. At
      laparoscopy, in 25 patients (20%) the exam showed normal pelvic anatomy, whereas
      in 102 patients (80%) some pelvic pathology was found. The most frequent
      conditions observed were: pelvic adhesions in 55% (No. = 70), endometriosis in
      29% of the cases (No. = 37), and other pathologies (non-endometriotic ovarian
      cysts, hydrosalpinges, myomas, etc.) in 25% of the cases (No. = 32). At the
      comparison of bimanual examination and laparoscopic findings, out of 71 patients
      with normal findings at bimanual examination, 75% (No. = 53) were found to have
      abnormal findings at laparoscopy; out of 55 patients with abnormal bimanual
      examination, 11% (No. = 6) were found to have normal laparoscopic
      findings.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8355883
TI  - [Echography in the diagnosis of postoperative complication in gynecology].
AB  - The authors report their experience regarding the use of ultrasonic instruments
      to control the postoperative iter of gynecological, oncological or urological
      surgery. These types of surgery may be complicated by urethral lesions,
      retroperitoneal or subfascial sero-hematic stasis, lymphocele,
      urethrohydronephrosis or vescical dysfunctions with urinary stasis which, if
      identified at an early stage, can be resolved by surgery. Out of 88 cases of
      gynecological surgery with a high risk of complications which were followed using
      ultrasound during the postoperative period, complications occurred in 11 cases
      (12.5%): their early identification also enabled adequate treatment to be
      performed using an echo-guided aspirated needle technique or using the
      application of drainage catheters.

PMID- 8355884
TI  - [Lymphocytic subpopulations in malignant ascites of ovarian origin. Flow
      cytometric analysis].
AB  - A flow-cytometric analysis of ascitic fluid (AF) and peripheral blood lymphocyte
      subpopulations (LS) was performed on 16 patients with ovarian malignancy (OM) and
      5 with metastatic peritoneal carcinomatosis (MPC). AF lymphocytes are 58% of
      total leukocytes in OM patients, 37% in MPC patients, while blood lymphocytes are
      14% and 17%, respectively. AF absolute lymphocyte count (total and individual LS)
      is higher in OM patients. OM patients AF lymphocytes are: T = 70%, CD4+ = -37%,
      CD8+ = 32% (CD4/CD8 = 1.39), B = 5%, NK cells = 4-10%, CD25+ = 20%, CD69+ = 15%,
      CD71+ = 3%. In MPC patients the values are generally similar, though CD4+ cells
      are +7%, CD8+ cells = -14% (CD4/CD8 = 3.17), CD69+ cells = -8%. Untreated OM
      patients have a AF total and percent lymphocyte count higher than treated ones.
      Among the latter, however, the CD4/CD8 ratio as well as the number of CD4+,
      inducer, CD25+ and CD71+ cells are higher. In terms of percent values, the most
      striking differences involve total T and B lymphocytes (81-87% vs 56-62%, and 10%
      vs 2%, respectively). With the only exception of absolute NK cell count, OM
      patients show no correlation between AF and peripheral blood LS pattern. These
      results agree only partially with data from the literature. Pathophysiologic and
      clinical considerations support the practical usefulness of LS analysis in AF
      from OM patients.

PMID- 8355885
TI  - [The effect of pregnancy and breast feeding on bone mineral content].

PMID- 8355886
TI  - [Fetal choroid plexus cysts: a real dilemma!].
AB  - The clinical significance of the fetal choroid plexus cysts, observed by prenatal
      sonographic examination, is now a days still discussed. A consequence of this
      situation is the discordance of opinions about the question of whether karyotype
      analysis is always necessary to evaluate chromosomal anomalies sometimes
      correlated, especially in the presence of (as some authors have reported) large
      (> 1 cm), bilateral, persistent cysts and of other structural abnormalities. We
      have effected a prospective study to estimate the incidence of fetal choroid
      plexus cysts and to establish the obstetrical behaviour to be adapted in these
      cases. During 834 routine ultrasonographic examinations at 18-21 weeks'
      gestational age, we have evaluated the presence of fetal choroid plexus cysts in
      9 fetuses, with an incidence of 1.07%. Three of these cysts were larger than 1
      cm, three were bilateral. Karyotype analysis, effected in all cases, diagnosed a
      case of Trisomy 18 in a fetus who ultrasonographically showed, in addition to a
      unilateral cyst of 1.2 cm, also a diaphragmatic hernia. Careful ultrasound follow
      up revealed that all the cysts disappeared spontaneously, but two of them (whose
      dimensions were larger than 1 cm) were still visible at 24 weeks' gestation and
      probably this age will be too advanced to begin a chromosome analysis. In
      conclusion, we think that the presence of fetal choroid plexus cysts always
      imposes a careful ultrasonographic evaluation of fetal morphology and, since
      there is always the risk that other small fetal anomalies (evocative of abnormal
      fetal karyotypes) wight not be noted, we believe that it is better, in any case,
      to recommend to the patient a prenatal cytogenetical analysis.

PMID- 8355887
TI  - [Cholestasis in pregnancy].
AB  - The authors report the main morphological and functional alterations of the liver
      during the course of pregnancy. The size of the organ does not change and there
      is a slight (20%) reduction of hepatic flow. Hepatic function is partially
      modified in view of the following factors: reduced protein synthesis (in
      particular the albumin component), increased serum levels of cholesterol and
      triglycerides mediated by steroid hormones, inhibition of canalicular secretion
      and consequent diminution of the liver's excretory function, variations in serum
      levels of many markers of cholestasis so much so that they become unreliable due
      to pregnancy. The high level of sexual steroids also influences cholecystic
      kinetics: progesterone, in particular, negatively affects the contractile
      response to cholecystokinin-pancreozymin stimulus. The paper then reports some
      historical data including those which led to the definition of "gravidic
      cholestasis" as a clinical condition. The incidence of the disease varies
      considerably in relation to the geographical area and genetic factors. In Sweden
      and Finland the percentage ranges between 1 and 3%, whereas much higher values
      (12-22%) are reported in Chile and among the American Indians. The latest data
      for Italy reveal an incidence of 0.34%. The onset of disease is conditioned by
      familial predisposition due to an enhanced sensitivity to estrogens or excessive
      production of estrogenic metabolites. Among the hepatocytic changes induced by
      estrogens are the reduced fluidity of sinusoidal plasmatic membranes and the
      inhibition of vasolateral Na+K+ ATPase pump activity. The last months of
      gestation are characterized by a "cholestatic state" which may vary in severity
      from slight symptoms, to itching and idiopathic jaundice.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8355888
TI  - [The effect of two contraceptive methods (EP vs. IUD) in relation to inflammatory
      changes and CIN].
AB  - The authors examine Smear Test phlogistic picture repair processes, endometrial
      cells and preneoplastic lesions in women who used IUD and EP. The research has
      pointed out that infection due to Actinomyces is only (present) in IUD carriers.
      CIN affects for 4.2% of IUD carriers.

PMID- 8355889
TI  - [Endometriosis of the abdominal wall after cesarean section].
AB  - The finding of endometriosis of the abdominal wall is a rare event; we describe
      three cases observed after cesarean section. The first case is an endometriosis
      of the rectus abdominis, first occurrence in literature. The second case
      describes a localization limited to the subcutaneous tissue. The third case
      describes the involvement of the entire abdominal wall. Only two patients
      complained about excruciating abdominal pain during menstrual bleeding. In one
      case pain was only an occasional event.

PMID- 8355890
TI  - Home infusion therapy: comparison of costs for intravenous immunoglobulin.
AB  - Increasing utilization of intravenous immunoglobulin home therapy has stimulated
      a scramble by various home health agencies for this high-priced business. A
      comparison of costs illustrates wide disparity among companies serving patients
      in New Jersey.

PMID- 8355891
TI  - Management of upper extremity ischemia.
AB  - Upper extremity ischemia is insidious in onset and debilitating. It accounts for
      1 to 4 percent of all peripheral vascular procedures. Once the site of the
      symptomatic lesion is determined, an extrathoracic extra-anatomic bypass often
      can provide long-lasting relief.

PMID- 8355892
TI  - Adenosquamous carcinoma of the pancreas.
AB  - Adenosquamous carcinoma of the pancreas is an unusual tumor. The authors review
      the case report of a 70-year-old male. Radiologic and computer tomography (CT)
      findings for adenosquamous carcinoma were indistinguishable from adenocarcinoma
      of the pancreas.

PMID- 8355893
TI  - Radiographic assessment of traumatic rupture of the thoracic aorta.
AB  - The authors discuss the advantages and limitations of radiographic modalities in
      assessing traumatic rupture of the thoracic aorta (TRTA). TRTA is one of the most
      frequent causes of death from high-speed deceleration accidents and other blunt
      trauma sustained during motor vehicle accidents.

PMID- 8355894
TI  - The Evers case: 1984 decision has lasting impact.
AB  - In 1984, the Supreme Court of New Jersey established the standard for determining
      physician liability for the delay in the diagnosis of cancer. The effects and
      implications of that 1984 decision are lasting. The case involved a failure to
      diagnose breast cancer.

PMID- 8355895
TI  - Ventricular dysfunction and pulmonary function in OSA syndrome.
AB  - Patients with obstructive sleep apnea (OSA) have increased cardiovascular
      morbidity and death as a result of myocardial ischemia and both pulmonary and
      systemic hypertension. Early detection allows for proper risk stratification and
      treatment.

PMID- 8355896
TI  - Peripheral alpha-agonists provide another option for hypertension.

PMID- 8355897
TI  - ANA concerned with prescription denial by out-of-state pharmacies.

PMID- 8355898
TI  - The clinical challenge of progressive myoclonus epilepsy.
AB  - Health care providers who care for patients with seizure disorders should be able
      to recognize progressive myoclonus epilepsy. Progressive myoclonus epilepsy is a
      syndrome confused with myoclonic seizures and other epilepsies. The main symptom
      is myoclonus, a brief involuntary muscle jerk of varying intensity that can throw
      a patient against a wall or to the ground. This article describes major types of
      progressive myoclonus epilepsy, a typical case presentation and two clinical drug
      trials available for these patients. The focus of clinical drug trials is to
      identify a drug that controls the myoclonus and improves the quality of life for
      the affected individual. There is no cure for patients with progressive myoclonus
      epilepsy. 5-hydroxy-L-tryptophan and piracetam are two drugs available through
      clinical-research protocols to patients with progressive myoclonus epilepsy.

PMID- 8355899
TI  - Urban, low-income, African-American and Hispanic youths' negative experiences
      with condoms. Implications for nursing intervention.
AB  - Research suggests that the rate of HIV infection is increasing dramatically in
      African-American and Hispanic youths who live in low-income, urban areas. Nurses
      need information about these youths' negative experiences with condoms to
      intervene effectively in the spread of acquired immune deficiency syndrome. This
      article discusses negative experiences with using condoms that were reported by a
      subsample of condom users (n = 975) from a household probability sample of low
      income, urban, African-American and Hispanic youths. Condom users were asked
      about 12 different negative experiences with condoms. Results from this household
      survey highlight a need for nurses to provide clients with specific directions
      about how to use condoms correctly and to encourage clients to practice putting
      on condoms.

PMID- 8355900
TI  - Nurse-managed clinics provide access and improved health care.
AB  - With the closing of hospitals, communities must work together to provide access
      to health care. This article reports on the development of a prenatal nurse
      managed clinic, and its expansion to include a birth center, well-child/sick
      child clinic, teen-pregnancy program and family planning clinic. The staff
      includes four certified nurse midwives, five pediatric nurse practitioners, a
      bilingual certified clinical nurse specialist and a bilingual social worker.
      Through the innovative management of these professionals, the incidences of low
      birth-weight infants and pregnancy-induced hypertension have decreased. Since
      1988 when the clinic first opened, first trimester enrollment has increased from
      12 percent to 25 percent and third trimester enrollment has decreased from 44
      percent to 21 percent because clients go to the clinic earlier. At the largest
      emergency room in the county, visits by Medicaid recipients under six years of
      age have decreased 27 percent from the time the pediatric clinic opened.

PMID- 8355902
TI  - Women in dentistry.

PMID- 8355901
TI  - Simvastatin, pravastatin and lovastatin: three options for lowering cholesterol.

PMID- 8355903
TI  - Dentists' opinions of the effect of changes in Accident Compensation Corporation
      regulations on dental practice and patient access to dental services.
AB  - A 50 percent random sample of practising dentists in New Zealand was invited to
      complete a questionnaire aimed at determining their opinions on the effects of
      changes to Accident Compensation Corporation regulations on dental practice and
      patient access to treatment. Seventy-six percent of those surveyed returned the
      survey form. The results suggested that the introduction of a fee schedule for
      dental treatment in 1989 restricted practitioners' treatment decisions, and
      prevented some patients from receiving what was considered to be ideal care,
      largely on the basis of cost. Although the scheduled fee did not always cover the
      cost of treatment, many practitioners absorbed this shortfall. However, since the
      15 percent cut in fees payed by ACC, which was introduced in 1992, practitioners
      are now finding it necessary to charge the patient for the amount not covered by
      ACC. Dentists state that this is further restricting the kind of treatment they
      can provide, and that patients can afford. Some patients are now unable to have
      any treatment for dental injuries resulting from accidents as they cannot afford
      it. Some practitioners feel that the introduction of a fee schedule and the
      requirement of a patient contribution to treatment costs have had some positive
      effects, but the majority feel that significant barriers to treatment have been
      created by the ACC changes.

PMID- 8355904
TI  - A combined orthodontic and orthognathic surgery approach to the treatment of
      extreme deep overbite in an adult.
AB  - This report describes a combined orthodontic and orthognathic surgery approach to
      the treatment of extreme deep overbite in an adult male. An aesthetically
      pleasing and stable result was achieved without extensive restorative or
      prosthetic treatment and their inevitable sequelae. The functioning occlusion
      exhibited bilateral canine rise and an absence of non-working side interferences
      on lateral excursion. Incisal guidance with disclusion of posterior occlusal
      surfaces occurred on protrusive function.

PMID- 8355905
TI  - The small faces of Romania--a report on a dental tour to Romania in August 1992.

PMID- 8355906
TI  - Occlusion and restorative dentistry: Part II.
AB  - When planning treatment for major reconstruction of a dentition, occlusal factors
      which can affect the comfortable functioning of the masticatory system are a
      prime consideration. Anterior guidance and posterior support contribute
      significantly to the comfortable functioning of the masticatory system. Aesthetic
      factors are also significant for, in providing anterior guidance, the alignment,
      lengths, and proportions of incisors are as critical as their shape, colour and
      surface texture. Finally, treatment does not end with the insertion of the fixed
      and removable prostheses. Continual maintenance over the years can be as
      challenging as the reconstruction.

PMID- 8355907
TI  - Restoration of primary anterior teeth with composite crowns.
AB  - For children with extensive caries of primary teeth, or with deformed or
      traumatised teeth, restoration with composite using a crown form gives excellent
      results. Strength is gained by full crown coverage. The aesthetics are very
      acceptable. The technique also allows primary teeth to be modified to resemble
      permanent teeth when these are missing and the primary teeth are being kept until
      more definitive treatment is provided. Caries is usually well controlled, and
      space loss due to further tooth breakdown is avoided.

PMID- 8355908
TI  - Dental caries in 5-year-olds.

PMID- 8355909
TI  - Penile radionuclide studies in impotence: an overview.

PMID- 8355910
TI  - Evaluation of 99Tcm-teboroxime scintigraphy for the differentiation of reversible
      from fixed defects: comparison with 201T1 redistribution and reinjection imaging.
AB  - The aim of this study was to compare 99Tcm-teboroxime and 201T1 myocardial
      studies with particular regard to the classification of perfusion defects as
      reversible or fixed. Twenty patients with a history of previous myocardial
      infarction and suspected effort ischaemia underwent exercise 201T1 scintigraphy
      with early (4 h) redistribution and reinjection scans, exercise and rest 99Tcm
      teboroxime imaging and coronary angiography. Using a qualitative scoring of
      static planar images, the perfusion defects were classified as reversible or
      fixed. 201T1 and 99Tcm-teboroxime gave comparable results in the evaluation of
      the individual vessels (sensitivity 65%, specificity 80% and 85%, respectively).
      The stress-redistribution 201T1 sequence classified 45 defects as reversible and
      28 as fixed, the stress-rest 99Tcm-teboroxime studies classified 47 as reversible
      and 26 as fixed (NS). The stress-reinjection 201T1 images, however, characterized
      64 defects as reversible and nine as fixed (P < 0.005 versus 201T1
      redistribution, P < 0.0005 versus 99Tcm-teboroxime rest). In conclusion, this
      study shows that rest 99Tcm-teboroxime and 201T1 redistribution give comparable
      results but that significantly more defects are classified as fixed by 99Tcm
      teboroxime than by 201T1 if reinjection of the latter tracer is performed.

PMID- 8355911
TI  - Delayed recovery of myocardial perfusion after successful coronary angioplasty of
      infarct-related artery in patients with prior myocardial infarction.
AB  - We studied the status of myocardial perfusion before and after coronary
      angioplasty (PTCA) of infarct-related artery using stress thallium scan in
      patients with prior myocardial infarction. Twenty-six patients who had anterior
      myocardial infarction caused by single-vessel disease at the left anterior
      descending coronary artery were involved. Patients were classified into the
      following four groups according to the stress-redistribution thallium
      scintigraphic findings before PTCA: complete redistribution (two cases),
      incomplete redistribution (12 cases), partial redistribution (seven cases) and no
      redistribution (five cases). In the group with complete redistribution, the
      extent of residual ischaemia in the infarct area decreased significantly after
      PTCA but infarct size only slightly. In the groups with incomplete and partial
      redistribution, the extent of residual ischaemia and infarct size decreased
      significantly after PTCA. In contrast, the group with no redistribution showed a
      slight decrease in the extent of residual ischaemia and a gradual decrease in
      infarct size beginning 3 months after PTCA. Clinical findings including
      electrocardiogram indicated that the patients with incomplete redistribution had
      more viable myocardium and the patients with no redistribution had more scarring.
      The groups with incomplete and partial redistribution showed characteristics
      intermediate between complete and no redistribution. The change of infarct area
      after PTCA was different between the four groups, but both residual ischaemia and
      infarct size decreased in all groups. Thus, PTCA of the infarct-related coronary
      artery is useful even in the patients with prior myocardial infarction, even in
      patients with no redistribution shown by stress thallium scan.

PMID- 8355912
TI  - The detection of ventricular dysfunction and carditis in children with Kawasaki
      disease using equilibrium multigated blood pooling ventriculography and 99Tcm
      HMPAO-labelled WBC heart scans.
AB  - Thirty-seven children (11 girls, 26 boys; aged 2.8 +/- 2.2 years) with Kawasaki
      disease (KD) were included in the study. The biventricular functions were
      evaluated by equilibrium multigated blood pooling ventriculography (EMBPV) and
      the severity of carditis was decided by Tc-hexamethylpropyleneamine oxime (HMPAO)
      labelled white blood cell (WBC) heart scans (Tc-WBC). The results showed that 43%
      (16/37) of the KD cases with the severe carditis by Tc-WBC had the worst left
      ventricular ejection fraction (LVEF) (55.4 +/- 15.6%) and right ventricular
      ejection fraction (RVEF) (43.7 +/- 12.2%) by EMBPV; 24% (9/37) of the cases with
      the mild carditis had the best LVEF (63.5% +/- 8.2%) and RVEF (53.7% +/- 11.2%);
      the remaining 32% (12/37) had moderately severe carditis and biventricular
      function (LVEF: 58.2 +/- 17.2% and RVEF: 46.9 +/- 19.5%). Because Tc-WBC cannot
      only detect the severity of carditis but also predict impairment of ventricular
      function accurately, the choice of Tc-WBC should be preferable for KD-a common
      inflammatory cardiovascular disease in children.

PMID- 8355913
TI  - An alternative method for rapid preparation of 99Tcm-sestamibi.
AB  - The availability of 99Tcm-sestamibi is limited, especially in emergency cases due
      to the time-consuming preparation procedure that requires a 10-min boiling water
      bath and a 30-min radiochemical purity (RCP) analysis. These two restrictions
      have been surmounted by the combined use of a microwave oven heating method and a
      minipaper chromatography system. However, use of the microwave oven heating
      method presents some potential problems: (1) technical error in setting the
      microwave oven heating time and power setting; (2) ejection of the rubber septum
      if the vial is not evacuated; (3) breakage of the vial during the microwave
      heating process; (4) inconsistent and inhomogeneous microwave heating; (5)
      reevaluation process required for use of a different type of microwave oven.
      Although a 1-min boiling water bath time is sufficient to provide an acceptable
      RCP for 99Tcm-sestamibi, additional time is required to heat the water to a
      boiling state. An instant hot water machine was evaluated for possible
      replacement of the microwave heating method. Three millilitres of 5500 MBq (150
      mCi) 99Tcm was added to a Cardiolite kit and then placed in a 150-ml insulated
      beaker filled with hot water (86.2 +/- 1.9 degrees C, n = 45) from an instant hot
      water machine. A minipaper chromatography system was used to determine the RCP of
      samples after 1, 1.5, 2, 3, 4 and 5 min incubation periods. Our results show that
      2 min was the shortest incubation time that yielded an acceptable RCP of 94.7 +/-
      0.4% (n = 60) over the 24 h evaluation time. The use of an instant hot water
      machine not only avoids those problems associated with the microwave heating
      method, but also provides a rapid, efficient and relatively simple option for
      preparation of 99Tcm-sestamibi.

PMID- 8355914
TI  - Somatostatin receptors in meningiomas: a scintigraphic study using 111In-DTPA-D
      Phe-1-octreotide.
AB  - 111In-octreotide (Octreoscan) planar scintigraphy was performed in 12 patients
      with suspected meningioma. The scan was positive in 10 patients with meningioma
      and negative in two patients with acoustic neurinoma assisting in the
      differential diagnosis. Good quality images were obtained as early as 2 h after
      injection and there was no increase in diagnostic quality at 24 h. No adverse
      effects were observed to radiopharmaceutical administration. The following
      conclusions are drawn: 111In-octreotide is a safe and fast test which can
      increase the specificity of traditional neuroimaging procedures.

PMID- 8355915
TI  - A method to improve the quality of bone marrow scintigraphy by scatter radiation
      correction with the use of two opposing views.
AB  - Bone marrow scintigraphy using radiocolloids labelled with 99Tcm allows imaging
      of the active marrow with moderate effort. However, most of the administered
      colloid is trapped in the liver and spleen giving rise to a considerable amount
      of scattered photons, which cause considerable problems when evaluating the
      adjacent bone marrow. There are scatter correction methods developed for single
      photon emission computed tomography. The application of such a technique to bone
      marrow scintigraphy in the liver region using two opposing views is described.
      Phantom measurement and patients studies show that substantially improved
      visualization of the bone marrow close to the liver is possible using this
      technique for scatter correction.

PMID- 8355916
TI  - 99Tcm-MDP global skeletal uptake and markers of bone metabolism in patients with
      bone diseases.
AB  - 99Tcm-methylene diphosphonate (MDP) global skeletal uptake (4 h GSU) was
      determined by quantitative measurement of activity on bone scan images 4 h after
      injection in whole skeleton regions of interest (ROI) in 16 normal subjects, in
      five patients with hypertrophic pulmonary osteoarthropathy (HPO) and in 12 with
      Paget's disease. Values were correlated with those of whole body retention (24 h
      WBR), and serum bone gla protein (BGP), i.e. osteocalcin, alkaline phosphatase
      (AP) and type 1 procollagen (P1CP). They were 40% higher in HPO than in the
      normal controls, while in Paget's disease they increased more in polyostotic than
      in monostotic patients. A statistically significant difference was noted between
      4 h GSU and 24 h WBR values in the two groups of patients compared with the
      controls. Of the bone metabolism markers, serum AP and P1CP were higher in the
      patients and positively correlated with their enhanced 4 h GSU values, whereas
      BGP was always within the normal range. This method may thus be regarded as a
      useful way of simultaneously determining bone 99Tcm-MDP uptake and altered bone
      turnover sites, especially in patients with systemic bone disease.

PMID- 8355917
TI  - Dose response from pharmacological interventions for CBF changes in a baboon
      model using 99Tcm-HMPAO and SPECT.
AB  - This study assesses the sensitivity of the baboon model under anaesthesia to
      determine by single photon emission computed tomography (SPECT) and 99Tcm
      hexamethylpropyleneamine oxime (HMPAO) dose responses from drugs (acetazolamide)
      with known regional cerebral blood flow (rCBF) effects on humans. Three dosages
      of acetazolamide were chosen: 250, 500 and 750 mg. The effects of these were
      studied by conventional SPECT 5 min after intravenous (i.v.) administration and
      compared to previous studies of rCBF with the baboons under anaesthesia only. An
      additional study concerned the effect of 500 mg acetazolamide at 15 min after
      administration. Haemodynamic parameters and blood gases were also monitored. No
      statistically significant regional effects were noted (P > 0.05). The largest
      increase in CBF (39%) was observed from 500 mg acetazolamide after 5 min. This
      was statistically significantly different from control values only at a 10% level
      of confidence; then followed a 27% increase above control values after 750 mg (5
      min). At 15 min 500 mg yielded values lower by 10% than the high dose. No effects
      were observed from 250 mg acetazolamide; only pO2 showed changes which largely
      confirm the CBF findings. The model did not give significant results at a 5%
      level of confidence but large fluctuations were observed, also in the
      haemodynamic and blood gas values. At a 10% level a significant dose response was
      confirmed for acetazolamide.

PMID- 8355918
TI  - Immunoscintigraphy of ovarian carcinoma using a monoclonal antibody (111In
      NCRC48) defining a polymorphic epithelial mucin (PEM) epitope.
AB  - An anti-polymorphic epithelial mucin (PEM) monoclonal antibody NCRC48 (IgG3) has
      been tested for its capacity to localize in tumours according to accepted
      guidelines for human administration. Following radiolabelling with 111In, 1 mg
      antibody was administered to 19 patients with a clinical suspicion of ovarian
      malignancy. Initial imaging and biodistribution studies confirm the safety of
      this conjugate although six out of 11 patients tested developed an antibody
      response to the monoclonal antibody. Immunoscintigraphy with this antibody was
      compared with magnetic resonance imaging and ultrasound in relation to the final
      tumour histology, the final accuracies being 79, 79 and 64% respectively.
      Positive localization of antibody was confirmed in malignant tissue with little
      evidence of uptake in benign tissue.

PMID- 8355919
TI  - Body and blood clearance and marrow radiation dose of 131I-Lym-1 in patients with
      B-cell malignancies.
AB  - Fifty-eight per cent of patients with B-cell malignancies had durable responses
      to treatment with 131I-Lym-1. Myelosuppression manifested by peripheral blood
      cytopenia was the radiation dose-limiting toxicity. The mean biologic half-times
      were 3.3 and 31.2 h for the fast and slow phases, respectively, of the blood
      clearance and 33.5 h for the clearance from the total body. Nonpenetrating
      radiation from the blood contributed 0.18 rad and penetrating radiations from the
      total body contributed 0.18 rad per administered mCi to the bone marrow. The
      average total contribution from both of these sources was 0.36 +/- 0.14 rad mCi
      1. Clearances and marrow radiation doses were remarkably constant among different
      patients and among different therapy doses for the same patient. These results
      are potentially useful as an initial approximation for other mouse monoclonal
      antibodies of the same isotype. While radiation to normal marrow from 'spill
      over' incident to specific targeting of 131I-Lym-1 on malignant B-cells in the
      marrow is not addressed in this publication because it is unique for each
      patient, it should be considered in the case of individual patients.

PMID- 8355920
TI  - Pancreatic cancer detected by positron emission tomography with 18F-labelled
      deoxyglucose: method and first results.
AB  - In order to evaluate the utility of positron emission tomography (PET) with 18F
      labelled deoxyglucose (FDG) for detection of pancreatic cancer 15 patients with
      pancreatic masses shown by computed tomography were investigated. Static PET
      scans covering an axial field of view of 15 cm were obtained 45 min after
      intravenous injection of 150-300 MBq FDG. Focally increased FDG accumulation was
      present in 12 out of 13 patients with histologically proven adenocarcinoma, in
      particular in eight of nine lymph node and four of five liver metastases. Scans
      of two patients with chronic pancreatitis confirmed by surgery revealed a normal
      FDG distribution. Contrast between tumour and normal tissue depended the
      metabolic situation prior to FDG injection. High ratios were found in fasting
      patients whereas no elevated FDG uptake was measured in an insulin-dependent
      diabetic suffering from carcinoma of the pancreatic head. We conclude that FDG
      PET might have the potential for detection and even differentiation of pancreatic
      carcinoma from chronic pancreatitis. Further studies are necessary to
      substantiate these preliminary findings and to optimize results in diabetic
      patients.

PMID- 8355921
TI  - In vivo determination of radiation dose in kidneys and bladder during renogram: a
      new approach.
AB  - The radiation dose absorbed by a patient from a radiopharmaceutical is usually
      calculated with the help of the equations published by the Society's Medical
      Internal Radiation Dose (MIRD) Committee and the use of a Reference Man. However,
      the (MIRD) estimations are based on the assumption that the patient is a normal
      subject with the characteristics of the Reference Man. This is not always true
      particularly in some pathological situations which present large deviations from
      normal. The purpose of this paper is to determine the dose in kidneys and
      bladder, during renograms, on the basis of real data. A protocol is formulated by
      means of which the processing of the frames acquired in the various stages of the
      renogram enables the determination of the kidney and bladder mass as well as the
      time distribution of radioactivity in these organs. Our results are in accordance
      with MIRD estimations for normal cases, whereas very significant deviations are
      observed in pathological ones. This is due to the fact that the mass of the
      'source' and 'target' organs as well as the biodistribution of the
      radiopharmaceuticals are essential in the dose determination and large deviations
      are expected between estimated and real doses when in some pathological cases the
      mass of kidney is particularly reduced or its clearance retarded.

PMID- 8355922
TI  - Letter from the Mayo Clinic.

PMID- 8355923
TI  - The Human Genome Project: impact on obstetrics and gynecology.

PMID- 8355924
TI  - Prostaglandin synthetase inhibitors in pregnancy.
AB  - The use of indomethacin as a tocolytic agent in patients with premature labor was
      first reported by Zuckerman in 1974. Since then, prostaglandin synthetase
      inhibitors (PSI) have been used in pregnancy for a variety of indications.
      However, serious fetal side effects of this category of drugs continue to be
      reported. We present a review of the literature and the experience at our
      institution on the use of indomethacin, the most commonly prescribed
      antiprostaglandin in pregnancy. Therapeutic guidelines and surveillance
      recommendations for the use of PSI in pregnancy are proposed. The role of newer
      PSI in pregnancy and their side effect profile are also presented.

PMID- 8355925
TI  - Percutaneous balloon valvuloplasty for severe mitral stenosis during pregnancy: a
      review of therapeutic options.
AB  - A woman presented at 29 weeks' gestation with previously undiagnosed severe
      mitral stenosis. She did not respond to medical therapy, and underwent successful
      percutaneous balloon mitral valvuloplasty with complete resolution of her
      symptoms. The remainder of her pregnancy was uncomplicated, and she delivered a
      healthy infant at 40 weeks' gestation. Percutaneous balloon valvuloplasty offers
      an innovative alternative to standard surgical therapy if medical management is
      unsuccessful.

PMID- 8355927
TI  - Randomized comparison of home uterine activity monitoring and routine care in
      patients discharged after treatment for preterm labor.
AB  - OBJECTIVE: To determine whether home uterine activity monitoring reduces the
      likelihood of preterm birth in women successfully treated for preterm labor in
      their current pregnancies. METHODS: Women between 20-34 weeks' gestation who had
      been treated successfully for preterm labor were solicited to participate in a
      randomized clinical trial of home uterine activity monitoring versus routine high
      risk care. The sample size of 56 was based on power calculations using the
      results of earlier investigators. Twenty-eight women were randomized to home
      uterine activity monitoring and 29 were assigned to the type of care appropriate
      for women discharged after hospitalization for parenteral treatment of preterm
      labor. One of the routine-care subjects was lost to follow-up. The two groups
      were comparable in distribution for race, insurance status, multiple gestation,
      marital status, gestational age at beginning of the study, and incidence of prior
      preterm birth. RESULTS: The 28 women receiving routine care had a 54% incidence
      of preterm birth, whereas the incidence was 57% in monitored women (relative risk
      1.08, 95% confidence interval 0.6-1.9; P = .79). The incidences of delivery
      before 32 weeks and 34 weeks also were unaffected by the intervention.
      CONCLUSION: Home uterine activity monitoring is not effective in reducing the
      likelihood of preterm delivery in patients successfully treated for preterm labor
      in their current pregnancies.

PMID- 8355926
TI  - Estrogen effects on the urethra: beneficial effects in women with genuine stress
      incontinence.
AB  - The urethra, which originates from the urogenital sinus, is under the influence
      of estrogen just like the vagina. The concentration of estrogen receptors in the
      urethral mucosa is similar to that of the vaginal mucosa. Estrogen deprivation
      will result in atrophic urethritis and sometimes urinary incontinence, and
      estrogen replacement therapy may reverse this trend. Estrogens have been shown to
      increase urethral pressure in up to 30 per cent of women and to significantly
      improve or cure stress urinary incontinence in many cases. Adding alpha
      sympathomimetic drugs to estrogens may further improve symptoms in women with
      stress incontinence. It seems that vaginal estrogens have more beneficial effect
      on the urethra, compared with the oral medication, although prospective control
      studies have not always supported these findings. Overall, it seems that
      estrogens have beneficial effects on urethral function in women with
      postmenopausal stress incontinence, although more prospective randomized control
      studies are needed to assess the effect of estrogens on the lower urinary tract.

PMID- 8355928
TI  - Pregnancy in heart transplant recipients: management and outcome.
AB  - OBJECTIVE: To determine the outcome of pregnancies in cardiac allograft
      recipients. METHODS: Thirty women who became pregnant after heart transplantation
      were identified from cases managed personally, questionnaires sent to all cardiac
      transplant centers, and review of the literature. Mothers were evaluated for
      evidence of rejection and for obstetric complications. The infants were observed
      for congenital abnormalities and perinatal morbidity or mortality. RESULTS:
      Frequent pregnancy complications included chronic hypertension (48%),
      preeclampsia (24%), and preterm labor (28%). The rate of cesarean delivery was
      32%. Six episodes of rejection required treatment, and three late maternal deaths
      occurred. Among the 27 live births, 17 infants were born after 36 weeks'
      gestation and ten were preterm, five were small for gestational age, and four had
      neonatal complications. There were no congenital anomalies. CONCLUSION:
      Pregnancies in heart transplant recipients present management problems similar to
      those seen in patients with other allografts and should be considered high risk.

PMID- 8355929
TI  - A randomized, double-blind, placebo-controlled trial of the safety of vaginal
      recombinant human relaxin for cervical ripening.
AB  - OBJECTIVE: To assess the safety of vaginal recombinant human relaxin in pregnant
      women treated before the induction of labor and to collect preliminary data on
      the efficacy of recombinant human relaxin in promoting cervical ripening.
      METHODS: In a multi-center, randomized, double-blind placebo-controlled trial, 40
      women were studied before induction of labor because of post-dates. The women
      were randomized to receive either 1.5 mg recombinant human relaxin in 3%
      methylcellulose gel or gel only, placed into the posterior vaginal fornix after a
      cervical assessment on the evening before scheduled induction. If a subject did
      not go into spontaneous labor overnight, another cervical assessment was
      performed 15 hours following treatment, immediately before the standard induction
      regimen of the hospital. RESULTS: No important maternal or fetal-neonatal
      complications could be attributed to the drug. The differences between the
      recombinant human relaxin group and the placebo group for all the outcome
      measures of efficacy did not achieve statistical significance. Placebo patients
      were more likely to report moderate or strong uterine contractions in the first 4
      hours following treatment than were the recombinant human relaxin-treated
      patients. CONCLUSIONS: The use of recombinant human relaxin at a dose of 1.5 mg
      was not associated with any significant maternal or fetal-neonatal complications.
      The relatively small number of subjects in this study was chosen deliberately
      because this was the first use of the drug in pregnant subjects. Assessment of
      efficacy will require studies that include more patients and a range of relaxin
      doses.

PMID- 8355930
TI  - Peripartum changes in maternal cerebral blood flow velocity in normotensive and
      preeclamptic patients.
AB  - OBJECTIVE: To compare the effect of delivery on cerebral blood flow velocity
      between normotensive and preeclamptic women, adjusting for mode of delivery and
      change in hematocrit values. METHODS: Twenty-three normotensive and 46
      preeclamptic women had maternal middle cerebral blood flow velocity assessed
      antepartum and at 24 and 48 hours postpartum. In addition, hematocrit changes and
      method of delivery were recorded. We then compared the effect of delivery on
      cerebral blood flow velocity changes using analysis of variance with Student t
      test for significance. RESULTS: Cerebral blood flow velocity was significantly
      higher in preeclamptic than in normotensive women (P < .05) and rose
      significantly in the postpartum period (P < .004). Neither hematocrit change nor
      mode of delivery affected cerebral blood flow velocity changes. CONCLUSION:
      Cerebral blood flow velocity showed minimal peripartum changes in the
      normotensive group but increased significantly postpartum in preeclamptic women
      in a setting of minimal arterial pressure change.

PMID- 8355931
TI  - Penicillin levels following the administration of benzathine penicillin G in
      pregnancy.
AB  - OBJECTIVE: To investigate the distribution of penicillin in the maternal
      placental-fetal unit at term gestation. METHODS: Twenty-five healthy gravidas at
      38-39 weeks' gestation scheduled for elective repeat cesarean delivery under
      spinal anesthesia received benzathine penicillin G, 2.4 million units
      intramuscularly (IM) preoperatively. Ten women delivered 1 day after injection,
      five delivered 2-3 days after, and ten delivered 7 days after. We collected
      maternal serum and cerebrospinal fluid, amniotic fluid (AF), and cord serum at
      delivery. Penicillin levels were measured using a validated agar disc diffusion
      method (sensitivity 0.006 micrograms/mL) with Micrococcus lutea as the test
      organism. RESULTS: There was no significant difference in mean penicillin levels
      at day 1, day 2-3, or day 7 for maternal serum, maternal cerebrospinal fluid,
      cord serum, or AF. The mean (+/- standard error) penicillin concentration (range
      0.005-0.59 micrograms/mL) in maternal serum declined from 0.14 +/- 0.04
      micrograms/mL 1 day after injection to 0.08 +/- 0.06 micrograms/mL 7 days after
      injection. The proportion of patients with a penicillin concentration at or above
      0.018 micrograms/mL in the maternal serum declined significantly from day 1 to
      day 7 (P = .03). Overall, nine of 25 women (36%) had serum penicillin levels that
      were less than 0.018 micrograms/mL. CONCLUSION: A wide range of penicillin levels
      were observed in gravidas at term in the maternal serum, cerebrospinal fluid,
      umbilical cord serum, and AF within 1 week after 2.4 million units of benzathine
      penicillin G IM. We speculate that altered pharmacokinetics may affect the
      efficacy of this drug for prevention of congenital syphilis in the near-term
      gestation.

PMID- 8355932
TI  - Prenatal use of metronidazole and birth defects: no association.
AB  - OBJECTIVE: To determine whether the use of metronidazole by pregnant women
      increases the risk of birth defects in the offspring. METHODS: Two cohorts of
      pregnant women who delivered live-born or stillborn infants between January 1,
      1983 and December 31, 1988 were identified from the Tennessee Medicaid enrollment
      files. The exposed cohort consisted of 1387 women who filled a prescription for
      metronidazole between 30 days before and 120 days after the onset of their last
      normal menstrual period. The unexposed cohort consisted of 1387 comparable women
      who did not fill a prescription for metronidazole during the same time. Medical
      records for 94% of the offspring of both study cohorts were then reviewed to
      ascertain the occurrence of birth defects. RESULTS: Pregnancy outcomes were
      similar for the exposed and unexposed cohort members. There was no excess of
      overall birth defect occurrence in the offspring of exposed women (risk ratio
      1.2, 95% confidence interval 0.9-1.6), nor could an excess risk be detected for
      any category of birth defects. CONCLUSION: This study provides no evidence that
      prenatal use of metronidazole increases the risk of overall birth defect
      occurrence.

PMID- 8355933
TI  - Erythropoietin in human fetuses with immune hemolytic anemia and hydrops fetalis.
AB  - OBJECTIVE: To determine whether plasma erythropoietin is increased in fetuses
      with anemia due to Rh isoimmunization. METHODS: Hemoglobin and erythropoietin
      were measured in samples obtained by funipuncture from 15 fetuses with Rh
      isoimmunization (gestational age 26.2 +/- 5.0 weeks, mean +/- standard deviation)
      and from 13 control fetuses (23.1 +/- 6.7 weeks). Hemoglobin and erythropoietin
      also were determined in umbilical cord blood collected at birth from 20 term
      fetuses delivered by elective cesarean. RESULTS: Fetuses with Rh isoimmunization
      had lower hemoglobin and higher plasma erythropoietin measurements than mid
      gestation controls (6.1 +/- 3.9 versus 10.7 +/- 1.5 g/dL and 105.5 +/- 168.1
      versus 12.5 +/- 3.1 mU/mL, P < .05, respectively). Hemoglobin and plasma
      erythropoietin increased with gestational age in control fetuses. There was an
      inverse association between hemoglobin and plasma erythropoietin in control and
      Rh-isoimmunized fetuses (r = -0.56, P < .005). Using multiple linear regression,
      hemoglobin and gestational age were associated independently with plasma
      erythropoietin (overall F2,25 = 12.3, multiple r2 = 0.49, P < .001). Despite
      marked decreases in hemoglobin, fetuses below 24 weeks' gestation had minimal
      increases in plasma erythropoietin compared to fetuses above that gestational
      age. Mildly anemic Rh-isoimmunized fetuses (hemoglobin 11.6 +/- 2.0 g/dL)
      delivered vaginally had significantly higher erythropoietin levels in umbilical
      cord plasma than Rh-isoimmunized fetuses with comparable hemoglobin (10.9 +/- 3.5
      g/dL) delivered by elective cesarean without labor (1246 +/- 856 versus 106 +/-
      66 mU/mL, respectively, P < .05). CONCLUSION: Fetuses with anemia at mid to late
      gestation respond with increases in plasma erythropoietin, but these changes are
      substantially attenuated before 24 weeks' gestation.

PMID- 8355934
TI  - Ultrasonic estimation of fetal weight: use of targeted formulas in small for
      gestational age fetuses.
AB  - OBJECTIVE: To derive a formula for calculating fetal weight in small for
      gestational age (SGA) fetuses and to determine prospectively whether the use of
      such a targeted formula reduces birth weight prediction errors. METHODS: Standard
      ultrasonic measurements were made in 159 SGA fetuses within 7 days of delivery.
      Three classes of fetal weight formulas (linear, quadratic, and cubic) were fitted
      to the data using stepwise regression analysis. Birth weight predictions using
      these three formulas were then compared prospectively with five previously
      reported formulas in 187 SGA fetuses. RESULTS: R2 was 0.97 for each of the three
      derived formulas. The 95% prediction intervals were comparable for the three
      formulas (eg, cubic model -11.6, 17.8%), and none were statistically superior to
      previous formulas. Each of the formulas evaluated prospectively had a systematic
      error and, with the exception of the present study's linear formula, all had
      percentage errors that varied systematically over the range of actual birth
      weights. CONCLUSION: Clinically useful birth weight predictions can be made in
      SGA fetuses, although no particular formula estimates birth weight significantly
      more accurately than any other.

PMID- 8355935
TI  - Sonographic estimation of fetal weight based on a model of fetal volume.
AB  - OBJECTIVES: To derive a formula for sonographic estimated fetal weight (EFW)
      based on a two-compartment model of fetal volume and to test it against two
      widely used formulas, especially at the extremes of fetal weight for which
      existing formulas are generally inaccurate. METHODS: We analyzed 865 consecutive
      sonograms that met the following inclusion criteria: singleton pregnancy, normal
      anatomy, delivery within 3 days of sonography, and measurements of biparietal
      diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur
      length (FL). The weight of the fetal head was modeled to be proportional to HC3,
      and the weight of the trunk proportional to AC2 x FL. The proportionality
      constants were found by multiple linear regression on 380 sonograms performed in
      1990 (the "derivation set"). The new formula was tested for accuracy of
      prediction of actual birth weight against the formulas of Hadlock et al and
      Shepard et al using 485 sonograms from 1991-1992 (the "validation set"). RESULTS:
      In the derivation set, the formula EFW = (0.23718 x AC2 x FL) + (0.03312 x HC3)
      was fit; the correlation with actual birth weight had an r value of 0.996. In the
      validation set, the new formula produced smaller systematic errors and smaller
      absolute errors than either the Hadlock or Shepard formula both overall and in
      fetal weight strata from less than 1000 g to over 4000 g. CONCLUSION: The new
      formula makes geometric sense and provides accurate estimates of fetal weight
      across a broad range of weights.

PMID- 8355936
TI  - The use of vibroacoustic stimulation during the abnormal or equivocal biophysical
      profile.
AB  - OBJECTIVE: To determine whether vibroacoustic stimulation during the biophysical
      profile can change the fetal behavioral state and thus improve the score without
      increasing the false-negative rate of the test. METHODS: Eighty-one patients
      whose biophysical profile scores were 6 or lower after 15 minutes of observation
      had an electronic artificial larynx applied to the maternal abdomen in the region
      of the fetal head for 3 seconds, followed by continued observation for fetal
      movement, tone, and breathing for 15 minutes. We compared the obstetric and
      neonatal outcomes of 41 patients whose biophysical profile scores improved to
      normal after vibroacoustic stimulation with those of 283 patients whose scores
      were normal without vibroacoustic stimulation. RESULTS: Vibroacoustic stimulation
      did improve an abnormal or equivocal biophysical profile score to normal in 67 of
      81 cases (82%). No antepartum stillbirths or perinatal deaths occurred. There was
      no increase in the obstetric and neonatal complication rates of cesarean delivery
      for fetal distress, meconium staining of the amniotic fluid, and the incidence of
      small for gestational age infants. CONCLUSION: Vibroacoustic stimulation improved
      the biophysical profile scores in most cases, an effect seen throughout the third
      trimester. Vibroacoustic stimulation did not appear to increase the false
      negative rate of the biophysical profile and may reduce the incidence of
      unnecessary obstetric intervention.

PMID- 8355937
TI  - Phenytoin and magnesium sulfate effects on fetal heart rate tracings assessed by
      computer analysis.
AB  - OBJECTIVE: To compare the effects of maternally administered phenytoin and
      magnesium sulfate on the fetal heart rate (FHR) using computer analysis. METHODS:
      Thirty-six nonlaboring preeclamptic women between 27-41 weeks' gestation were
      treated with either phenytoin or magnesium sulfate in a nonrandomized fashion.
      All fetuses were deemed to be well by traditional electronic-biophysical
      criteria. One-hour FHR recordings were analyzed by computer analysis before
      treatment. No other medications were administered. Tracings recorded 1 hour after
      drug administration were analyzed. Therapeutic serum levels were achieved in both
      groups before FHR tracings were reevaluated. Statistical analysis used paired
      Student t test, with significance set at P < or = .05. RESULTS: There were no
      differences in birth weight, gestational age, Apgar scores, or computer-analyzed
      FHR characteristics between the groups before treatment. Magnesium sulfate
      reduced significantly the frequency of accelerations of ten and 15 beats per
      minute; caused a 62% reduction in reactivity, defined as accelerations of 15
      beats per minute in 20 minutes of FHR tracing (but no change in reactivity with
      accelerations of ten beats per minute); and reduced short- and long-term
      variability. Phenytoin reduced short-term variability only. CONCLUSION: Phenytoin
      does not confound the computer analysis of FHR tracings and may offer some
      advantage over magnesium sulfate when used for prophylaxis against eclampsia.

PMID- 8355938
TI  - The effect of vaginal dissection on the pudendal nerve.
AB  - OBJECTIVE: To determine the effect of vaginal dissection on the pudendal nerve.
      METHODS: Pudendal and perineal nerve terminal motor latencies were measured
      before and at least 6 weeks after either abdominal or vaginal surgery for genital
      tract prolapse with or without urinary and fecal incontinence. Forty-eight women
      were studied prospectively in a randomized, blinded fashion. RESULTS: All women
      in this study had pelvic floor prolapse, and their mean preoperative pudendal and
      perineal nerve terminal motor latencies were prolonged compared to previously
      established normal values. The 27 women undergoing vaginal dissection
      demonstrated significant mean increases in pudendal nerve terminal motor latency
      (0.63 milliseconds, 95% confidence interval [CI] 0.33-0.93; P = .001) and
      perineal nerve terminal motor latency (1.33 milliseconds, 95% CI 0.80-1.86; P =
      .0001). In the 21 who had abdominal operations without vaginal dissection,
      essentially no mean change was noted. Clinically significant increases (more than
      2 standard deviations) in pudendal or perineal nerve terminal motor latency
      occurred in 20 women (74%) in the vaginal dissection group and in seven women
      (33%) in the abdominally operated group. The odds ratio of producing such
      neuropathy by vaginal dissection compared to operating abdominally without
      vaginal dissection was 5.78 (95% CI 1.6-20). CONCLUSIONS: All women had abnormal
      preoperative pudendal nerve function, supporting previous reports linking
      pudendal neuropathy with pelvic floor prolapse. Pelvic floor surgery involving
      vaginal dissection produces neuropathy of the pudendal nerve as measured by
      terminal motor latency.

PMID- 8355939
TI  - Cosmetic result of lower midline laparotomy wounds: polybutester and nylon skin
      suture in a randomized clinical trial.
AB  - OBJECTIVE: To compare the cosmetic outcome of lower midline laparotomy scars
      using either nylon or polybutester suture for skin closure. METHODS: A randomized
      clinical trial compared polybutester skin suture with nylon for lower midline
      laparotomy wounds in 50 women undergoing gynecologic surgery. Scar hypertrophy,
      scar width, scar color, the presence of cross-hatching marks, and a total score
      were assessed in all patients at 18 months following surgery and compared by
      nonparametric statistical tests. RESULTS: The wounds closed with polybutester
      suture were significantly less hypertrophic than those closed with nylon.
      Regardless of the suture material used, the lower part of the laparotomy scar
      showed an inferior cosmetic result compared with the upper part underneath the
      umbilicus for scar hypertrophy, scar width, and the total scar score.
      CONCLUSIONS: Polybutester skin suture diminishes the risk of hypertrophic
      scarring because of its special properties allowing it to adapt to changing
      tensions in the wound. Increased closure tension of the skin in the midline
      region above the pubic bone may be caused by a relative immobility of the skin.
      Scar cosmetics in this area may be improved by extra subcuticular suture support.

PMID- 8355940
TI  - Cervical conization with frozen section before planned hysterectomy.
AB  - OBJECTIVE: To report our institutional experience with the accuracy and
      usefulness of cervical conization with frozen section before planned
      hysterectomy. METHODS: One hundred fifty-nine patients who planned to have
      hysterectomies for or with a concomitant diagnosis of cervical intraepithelial
      neoplasia (CIN) underwent preliminary cone biopsies with frozen section. The
      frozen and permanent pathologic diagnoses were compared retrospectively. Detailed
      analysis was directed at the indications for cone biopsy and the patients who
      were found to have invasive cancer. RESULTS: Among 108 patients with negative
      specimens or CIN, the frozen section was accurate within one degree of CIN in
      106. Cone biopsy for a positive endocervical curettage, unsatisfactory
      colposcopy, or discrepant cytology did not contribute to the diagnosis of
      invasive cancer but did lead to an ultimate diagnosis of CIN III. One of 12 women
      with a frozen-section diagnosis of microinvasion had deeper invasion on permanent
      sections. CONCLUSIONS: Frozen-section evaluation of a cone biopsy carries a
      degree of accuracy that enables the surgeon to make an immediate decision about
      definitive therapy. Exact indications, use during pregnancy, and accuracy for the
      diagnosis of microinvasion require further study.

PMID- 8355941
TI  - Strategy for screening pregnant women for chlamydial infection in a low
      prevalence area.
AB  - OBJECTIVE: To assess the prevalence and risk factors for chlamydial infection in
      pregnant women in the Quebec City area and to propose strategies for a screening
      program. METHODS: From January 1990 to July 1991, pregnant women from six centers
      were cultured for Chlamydia trachomatis. One hundred thirty-six with positive
      results and 536 with negative results were included in a case-control study on
      risk factors for this infection. RESULTS: The prevalence of C trachomatis was
      1.9% (136 of 7305). In a logistic regression analysis, young age (P < .0001, test
      for trend), nulliparity (odds ratio [OR] 3.3; P < .00001), and a new sexual
      partner in the last year (OR 3.3; P = .0012) were independently associated with
      infection. With screening restricted to pregnant women under age 25 or those with
      at least one risk factor, 81.7% of women positive for C trachomatis would have
      been detected, whereas only 40.6% of all women would have been cultured.
      CONCLUSION: In a low-prevalence area for chlamydial infection in pregnant women,
      pre-screening criteria could optimize the use of specific diagnostic tests.

PMID- 8355942
TI  - Efficacy of clindamycin vaginal cream versus oral metronidazole in the treatment
      of bacterial vaginosis.
AB  - OBJECTIVE: To compare the efficacy and tolerance with 2% clindamycin vaginal
      cream versus oral metronidazole for the treatment of bacterial vaginosis.
      METHODS: This was a multicenter, randomized, double-blind study in which patients
      were randomly assigned to one of the following two regimens in a 1:1 ratio:
      clindamycin phosphate vaginal cream 2% (5 g intravaginally at bedtime for 7 days)
      plus two placebo capsules (twice a day for 7 days) or metronidazole 500 mg (two
      250-mg capsules orally twice a day for 7 days) plus placebo vaginal cream (5 g
      intravaginally at bedtime for 7 days). The patients were seen for follow-up at 5
      10 days and 25-39 days after completion of therapy. RESULTS: Seven investigators,
      four in Germany, two in Austria, and one in Switzerland, enrolled 407 patients.
      Four patients never received either protocol drug, leaving 403 evaluable for
      safety. Two hundred thirty-four patients were evaluable for efficacy. The
      analysis for all evaluable patients showed no significant difference between
      treatment groups. The cure or improvement rate at 1 month after therapy was 83%
      in the clindamycin group versus 78% in the metronidazole group. The incidence of
      drug-related adverse medical events was approximately 12% in both groups.
      CONCLUSIONS: Oral metronidazole and intravaginal clindamycin cream had a similar
      efficacy of 78 to 83%. Both drugs were tolerated, with vaginal candidiasis
      developing in 8.5 and 4.7% of the patients in the clindamycin and metronidazole
      groups, respectively.

PMID- 8355943
TI  - The effect of same-day pregnancy testing on the incidence of luteal phase
      pregnancy.
AB  - OBJECTIVE: To assess the impact of same-day pregnancy testing on the incidence of
      luteal phase pregnancy (pregnancy in which conception occurs before
      sterilization). METHODS: Retrospectively, all patients (N = 1006) undergoing
      laparoscopic tubal ligations at the Regional Medical Center, Memphis, from May
      1990 through December 1991 were reviewed for sterilization failures. Negative
      urine pregnancy tests were documented on all scheduled patients at their
      preoperative examination. After the first 401 sterilizations, same-day pregnancy
      testing with enzyme-linked immunosorbent assay (ELISA) pregnancy tests was
      instituted. We reviewed the records of all presumed sterilization failures as
      well as all patients with a positive pregnancy test on the day of surgery. Last
      menstrual period, ultrasound records, and date of delivery were analyzed to
      determine time of conception. RESULTS: Seven luteal phase pregnancies were
      discovered among the first 401 sterilization cases (17 per 1000). No luteal phase
      pregnancies occurred in the next 605 sterilizations after institution of same-day
      pregnancy testing. Eight patients' sterilizations were canceled because of a
      positive pregnancy test on the morning of surgery. If these patients had not been
      eliminated, the incidence of luteal phase pregnancies in this second group would
      have been 13 per 1000 sterilization procedures. CONCLUSION: Same-day pregnancy
      testing with an ELISA-type pregnancy test is a rapid, inexpensive, and effective
      means of reducing the incidence of luteal phase pregnancy.

PMID- 8355944
TI  - Diagnostic and operative hysteroscopy in the management of persistent
      postmenopausal bleeding.
AB  - OBJECTIVE: To determine the cause and possible treatment of postmenopausal
      bleeding of 6 months' duration or longer. METHODS: One hundred ten women between
      the ages of 40-90 years with persistent postmenopausal bleeding were evaluated by
      diagnostic hysteroscopy and managed by operative hysteroscopy. All had
      endometrial sampling and/or office hysteroscopy before operative hysteroscopy.
      RESULTS: A benign organic cause was noted in 95 cases (polyps in 42 and submucous
      fibroids in 53). Thirteen women had no significant disease and two had an early
      adenocarcinoma. Resection of the polyps or myomas without ablation was performed
      in 45 women, and all but one were satisfied with the results of treatment.
      Resection and ablation with performed in the remaining 50 patients with organic
      causes, and all but one were satisfied with the results. Twelve of 13 women
      without organic causes were satisfied with their treatment. The two
      adenocarcinomas were early lesions, grade 1 without invasion, and were managed by
      simple hysterectomy. CONCLUSION: Diagnostic and operative hysteroscopy was
      effective in controlling postmenopausal bleeding of at least 6 months' duration.
      Almost 90% of the patients had either polyps or submucous fibroids as the primary
      cause of the bleeding. Resection alone and resection with ablation were equally
      effective in controlling the bleeding.

PMID- 8355945
TI  - Post-ablation-tubal sterilization syndrome.
AB  - OBJECTIVE: To determine the cause of unilateral or bilateral pelvic pain
      associated with vaginal spotting in women who had previously undergone tubal
      ligation followed by roller-ball endometrial ablation. METHODS: Women who had
      undergone previous tubal sterilization followed by rollerball endometrial
      ablation were evaluated laparoscopically and hysteroscopically when they
      presented with a symptom complex of intermittent vaginal bleeding associated with
      severe cramping pain in the lower abdomen. RESULTS: During a 1.5-year observation
      period, six women with the symptom complex had laparoscopy and hysteroscopy. In
      all cases, marked endometrial scarring was noted. In every case, the proximal
      portions of either one or both fallopian tubes were swollen, and two cases had
      the appearance of an early ectopic pregnancy. In the remaining cases, the
      fallopian tubes were rubbery and swollen to as much as twice normal size.
      Symptoms in five of six patients subsided after laparoscopic removal of the
      oviduct. CONCLUSION: It appears that women who have had a tubal sterilization
      followed by endometrial ablation are at risk of developing an ectopic-like
      symptom complex. Salpingectomy appears to be effective in relieving symptoms.
      Whether this represents a new syndrome or just an unusual association between
      tubal sterilization and endometrial ablation remains to be seen.

PMID- 8355946
TI  - Accuracy of the Papanicolaou smear in the diagnosis of asymptomatic infection
      with Trichomonas vaginalis.
AB  - OBJECTIVE: To assess the accuracy of Papanicolaou smears in reporting cytologic
      evidence of Trichomonas vaginalis in asymptomatic women attending a resident
      clinic. METHODS: In phase I of this study, we prospectively enrolled 100
      asymptomatic gynecologic patients to be screened for vaginal trichomoniasis using
      wet preparation, vaginal culture, and Papanicolaou smear. During phase II,
      asymptomatic patients (40 gynecologic and 20 obstetric) whose screening
      Papanicolaou smears showed cytologic evidence of trichomoniasis returned for wet
      preparation, culture, and repeat Papanicolaou smear. Patients were considered
      infected with T vaginalis if either the wet preparation or culture was positive,
      and uninfected if both tests were negative. The cytopathologist was not informed
      of the patient's enrollment in this study or of the results of culture or wet
      preparation. RESULTS: The prevalence of asymptomatic trichomonas infection in
      gynecologic patients enrolled in phase I was 6%. In asymptomatic gynecologic
      patients enrolled in phase II, repeat Papanicolaou smear had a sensitivity and
      specificity of 86 and 83%, respectively, when diagnosing infection. Thirty
      percent of these patients would have been treated unnecessarily for
      trichomoniasis based upon screening Papanicolaou smear. In obstetric patients,
      the sensitivity of repeat Papanicolaou smear was 94% and specificity was 100%.
      Had therapy been initiated based on screening cytology, 20% of obstetric patients
      would have received unindicated therapy. The differences in sensitivity and
      specificity between the groups were statistically significant (P < .05).
      CONCLUSION: When a screening Papanicolaou smear reports cytologic evidence of T
      vaginalis infection in the asymptomatic patient, a confirmatory test should be
      performed before initiating therapy.

PMID- 8355947
TI  - The mode ages of women with cervical dysplasia.
AB  - OBJECTIVE: To resolve the discrepancy that women seem to have Papanicolaou smears
      with dysplasia at younger ages than the reported mean ages. METHODS: Every other
      Papanicolaou smear diagnosed during a 5-year period at our institution was
      reviewed. There were 1947 cases with dysplasia or carcinoma. Dysplasia was
      defined as a lesion of disordered squamous epithelial differentiation and was
      graded by standard criteria. The mean, median, and mode ages of the women were
      determined by diagnosis. Normal (symmetrical) distribution was tested for each
      population, and significant differences were sought by diagnosis. RESULTS: Normal
      distribution was rejected for the ages of women with all grades of dysplasia and
      carcinoma in situ, but not for the ages of women with carcinoma. CONCLUSIONS:
      Because the ages of women with dysplasia are not distributed normally, but are
      asymmetrically skewed to younger women, we suggest that the mode better describes
      the central tendency for ages of women with dysplasia. The difference between the
      mean and mode ages of these women explains the apparent discrepancy between the
      reported mean ages and our clinical impression. Appropriate descriptive
      statistics like these help the clinician evaluate individual patients in the true
      context of the disease.

PMID- 8355948
TI  - Thermal artifacts and inter-gynecologist variation of laser cone biopsies of the
      cervix.
AB  - OBJECTIVE: To evaluate the extent of thermal artifacts and the inter-gynecologist
      variation in CO2 laser cone biopsies for cervical intraepithelial neoplasia (CIN)
      using high power density. METHODS: All 1180 histologic sections from 93 CO2 laser
      cone biopsies performed by nine gynecologists were evaluated by morphometry.
      Power density of 19,700 W/cm2 and spot size of 0.43 mm were used. The lengths of
      different epithelia, the distance from CIN to the excision margins, the thermal
      artifacts, and the extension of denudation were analyzed. Mean values and
      standard deviations were analyzed for all indices. The inter-gynecologist
      variation was analyzed using one-way analysis of variance, Tukey-Kramer Honestly
      Significant Difference test, and chi 2 contingency table analysis regarding cones
      classified as "good" or "not good". RESULTS: The mean length of analyzed surface
      per cone was 134 mm. In 3% of the sections, the sum of artifacts at the external
      excision margin exceeded the average "minimum free distance" from CIN to the
      margin (2.88 mm). At the endocervical excision margin, the free distance was
      exceeded in 17% of the sections. Eighteen percent of the cones had CIN at the
      excision margins, with no significant differences between gynecologists (P =
      .83). Differences existed between gynecologists regarding free minimum distance
      and minor thermal artifacts at the external margin, but when clinically relevant
      groups were applied, no significant differences were found (P > .05). CONCLUSION:
      We found that a high power density at CO2 laser cone biopsy resulted in specimens
      with minimal thermal artifacts compared to other authors who used low power
      density. No clinically relevant differences were found between the gynecologists
      regarding free margins or artifacts.

PMID- 8355949
TI  - Management of patients with positive margins after cervical conization.
AB  - OBJECTIVE: To evaluate conservative management of patients undergoing cervical
      conization with cone margins positive for dysplasia. METHODS: The outcomes of 93
      patients with cone biopsies that had margins positive for dysplasia were
      tabulated. RESULTS: Thirty of 47 patients (64%) undergoing conization only and
      followed by cytology had negative Papanicolaou smears for at least 2 years.
      Twenty-one of 37 women (57%) with conization and immediate hysterectomy had no
      residual disease in the cervix. Three of nine women (33%) with conization and
      delayed hysterectomy had no detectable dysplasia in the remaining cervix. There
      was no case of progression to invasive disease. The overall resolution rate was
      58%. Persistence of disease was found most often at the endocervical margins
      associated with cervical intraepithelial neoplasia grade III. CONCLUSION:
      Patients with cone margins positive for dysplasia can be followed appropriately
      with cytology. In cases of recurrent abnormal Papanicolaou smears, colposcopy,
      biopsies, and endocervical curettage should be repeated.

PMID- 8355950
TI  - Cytologic examination of ovarian cyst fluid for the distinction between benign
      and malignant tumors.
AB  - OBJECTIVE: To assess the feasibility of using cytologic examination of ovarian
      cyst fluid for distinguishing between benign and malignant tumors. METHODS: Cyst
      fluid was aspirated at surgery in 83 women with benign and 35 women with
      malignant (25 invasive and ten borderline) ovarian tumors and submitted for
      routine cytologic examination. RESULTS: The specificity of the cytologic
      examination was 100%, but the sensitivity and negative predictive value were only
      26 and 76%, respectively. CONCLUSION: The low sensitivity and negative predictive
      value of cytologic cyst fluid examination preclude its use for the distinction
      between benign and malignant ovarian tumors.

PMID- 8355951
TI  - Three-year results after neoadjuvant chemotherapy, radical surgery, and
      radiotherapy in locally advanced cervical carcinoma.
AB  - OBJECTIVE: To evaluate the complications and results of neoadjuvant treatment
      before surgery and radiotherapy in locally advanced cervical carcinoma. METHODS:
      Between March 1988 and June 1989, 24 consecutive patients with locally advanced
      cervical carcinoma received chemotherapy consisting of six weekly courses of
      cisplatin (50 mg/m2), vincristine (1 mg/m2), and bleomycin (30 mg), followed by
      radical hysterectomy and radiotherapy. Lymph node metastases were detected by
      means of lymphangiography and confirmed by fine-needle aspiration in 21 patients.
      RESULTS: Twenty-one women (87.5%) completed the planned sequence of treatment and
      16 (66.7%) achieved objective responses. Three patients did not complete
      chemotherapy (one refusal, one myocardial infarction, one severe allergic
      reaction) and were treated further by radiotherapy. Nineteen subjects (79%)
      underwent subsequent radical surgery and radiotherapy without serious
      complications. After a minimal follow-up of 3 years, 16 patients had died of
      disease. Distant recurrences developed in only three of eight women in whom the
      nodes were negative originally, possibly reflecting systemic effectiveness of the
      chemotherapy. CONCLUSION: This sequence of treatment, although feasible, does not
      seem to improve long-term survival compared to standard treatment.

PMID- 8355952
TI  - The effect of lactation on glucose and lipid metabolism in women with recent
      gestational diabetes.
AB  - OBJECTIVE: To investigate the effect of lactation in the puerperium on glucose
      and lipid metabolism in women with recent gestational diabetes. METHODS: In women
      with recent gestational diabetes, we examined the effect of 4-12 weeks of
      lactation on glucose tolerance (2-hour oral glucose tolerance test) and on
      fasting serum lipids (total cholesterol, high-density lipoprotein [HDL]
      cholesterol, low-density lipoprotein [LDL] cholesterol, and triglycerides). Of
      809 women tested in the puerperium, 404 elected to breast-feed and 405 did not
      lactate. RESULTS: The mean (+/- standard deviation) maternal age (31.6 +/- 5.9
      versus 30.5 +/- 6.3 years), body mass index (28.8 +/- 5.1 versus 28.8 +/- 4.5
      kg/m2), and parity (3.0 +/- 1.6 versus 2.8 + 1.7) were not different between the
      lactating and nonlactating groups, respectively. Glucose metabolism improved in
      the lactating group, indicated by a significantly lower total area under the
      glucose tolerance curve (17.0 +/- 4.2 versus 17.9 +/- 5.0 g.minute/dL; P = .01),
      mean fasting serum glucose (93 +/- 13 versus 98 +/- 17 mg/dL; P = .0001), and
      mean 2-hour glucose level (124 +/- 41 versus 134 +/- 49 mg/dL; P < .01). These
      differences were significant after adjusting for maternal age, body mass index
      (BMI), and the use of insulin in pregnancy. Nursing had no effect on total
      cholesterol, LDL cholesterol, or triglyceride levels. However, the mean serum HDL
      cholesterol was elevated in the lactating group after adjusting for maternal age,
      BMI, and pregnancy insulin use compared with the nonlactating group (48 +/- 11
      versus 44 +/- 10 mg/dL; P < .01). CONCLUSIONS: Lactation, even for a short
      duration, has a beneficial effect on glucose and lipid metabolism in women with
      gestational diabetes. Breast-feeding may offer a practical, low-cost intervention
      that helps reduce or delay the risk of subsequent diabetes in women with prior
      gestational diabetes.

PMID- 8355954
TI  - Determinants of utilization of Tay-Sachs screening.
AB  - OBJECTIVE: To identify the characteristics of patients associated with optimal
      utilization of Tay-Sachs screening. METHODS: Medical records of patients
      undergoing amniocentesis for genetic diagnosis were reviewed. Three hundred
      twenty-nine of 537 charts evaluated were from individuals at risk for Tay-Sachs
      heterozygosity. Among these, 213 couples had previously been screened for Tay
      Sachs. In 116 couples, neither member of the couple had been screened before
      amniocentesis. A concurrent reference group consisted of 208 couples without an
      indication for Tay-Sachs screening. Patient characteristics, including ethnicity,
      genetic screening history, parental ages, and pregnancy history, were reviewed
      for each group. Analysis of variance and likelihood chi 2 test were used for
      statistical analysis. RESULTS: There were no significant differences in maternal
      age or reproductive history among the groups. The most common indication for
      amniocentesis was advanced maternal age for all three groups. However, the
      previously screened group was more than twice as likely to self-refer because of
      a positive family history or patient anxiety than was the unscreened group (P =
      .006). Conversely, the unscreened group was more than twice as likely as screened
      couples to be referred because of a positive high or positive low maternal serum
      alpha-fetoprotein level (P = .002). CONCLUSION: Despite 2 decades of professional
      and lay education, many couples are unaware of their individual risk for Tay
      Sachs heterozygosity. Additional education, most likely at the professional
      level, is needed to maximize informed participation.

PMID- 8355955
TI  - Referees: their roles, rights, and responsibilities.

PMID- 8355953
TI  - Transfer of carbetocin into human breast milk.
AB  - OBJECTIVE: To study the transfer of carbetocin into human breast milk. METHODS:
      Five healthy nursing women, 7-14 weeks postpartum, emptied their breasts using a
      breast pump and then received 70 micrograms carbetocin by intramuscular
      injection. Using a radioimmunoassay, the concentrations of carbetocin were
      measured in plasma and breast milk samples obtained before carbetocin
      administration and at 15, 30, 60, 90, 120, and 240 minutes after drug
      administration. RESULTS: For plasma, the mean (+/- standard deviation) area under
      the curve (AUC) of carbetocin versus time was 1119.3 +/- 315.9 pg/mL, a value
      about 50 times higher than the mean AUC for carbetocin in breast milk (18.6 +/-
      13.7 and 29.0 +/- 23.8 pg/mL for the right and left breast, respectively). The
      ratio of milk to plasma AUC was low: 1.7 +/- 0.9 and 3.1 +/- 2.8% for the left
      and right breast, respectively. No serious adverse reactions occurred and no
      clinically significant changes in vital signs were found. CONCLUSION: Very little
      carbetocin is transferred into human breast milk, presenting little risk to
      breast-fed infants.

PMID- 8355956
TI  - Is deception for reimbursement in obstetrics and gynecology justified?
AB  - Deceptive reporting to insurers of procedure indications to obtain reimbursement
      for non-covered services creates ethical and legal problems for practitioners.
      The motive for deceptive reporting is rooted in the expectation that any medical
      intervention recommended by the physician--even if of marginal benefit--should be
      covered. This traditional expectation collides with changing medical economics.
      Patient expectations of medical technology and insurance also promote deception.
      The deceptive physician fails to acknowledge a changed paradigm of medical
      economics, threatens his or her future practice, and does not model technical and
      ethical virtues to residents and students. Such deception preempts any possible
      dialogue with insurers that might result in coverage for a larger group of
      patients. The harmful outcomes of false reporting, present and future, far
      outweigh any temporary monetary gain for the patient or physician.

PMID- 8355957
TI  - Racial differences in oral glucose screening test results: establishing race
      specific criteria for abnormality in pregnancy.

PMID- 8355958
TI  - [Wilhelm His (the elder)].

PMID- 8355959
TI  - [The crystalline lens as a model for studying the cellular and molecular
      mechanisms of differentiation in the adult organism].
AB  - This review summarizes the published and authors own data about characteristics
      of expression of tissue-specific lens proteins (crystallins) during
      differentiation of lens epithelial cells into lens fibers in adult mammals,
      birds, reptiles, and amphibians. Information is analyzed about the presence,
      synthesis, and localization of different crystallins in lens epithelium and fiber
      cells of lens cortex and nucleus which correspond to sequential stages of lens
      cell differentiation. The data available suggest that morphologically similar
      differentiation of lens epithelial cells into fibers in different classes of
      vertebrates is accompanied by different programs for activation (and/or increase)
      of tissue-specific protein synthesis.

PMID- 8355960
TI  - [The DNA content of the neurons in the embryonic cerebellum transplanted into the
      cerebral cortex of adult rats].
AB  - Cerebellum of rat embryos at day 17 of gestation was transplanted into sensomotor
      cortex of adult syngenic rats. DNA content in granule and Purkinje cells of the
      transplant was determined cytophotometrically on day 30 after surgery. It is
      shown that granule cells are diploid; about 3% Purkinje cells contain
      hyperdiploid and tetraploid nuclei which corresponds to the content of such cells
      in the adult cerebellum. The conclusion is drawn that cell hyperploidy does not
      depend on the functional load but is essential property of the tissue.

PMID- 8355961
TI  - [Bilateral symmetry of the dermatoglyphic characteristics in Down's syndrome].
AB  - Dermatoglyphic traits were analyzed in 132 patients with Down syndrome. The level
      of bilateral symmetry of dermatoglyphic indices in these patients was found to be
      higher than in normal people (control). By this parameter, patients with Down
      syndrome showed lower intragroup variation than the control group. It is
      suggested that such difference is due to a more primitive developmental pathway.

PMID- 8355962
TI  - Intraocular pressure and mechanical ventilation.
AB  - Mechanical ventilation increases superior vena cava pressure and should
      theoretically increase episcleral venous pressure and intraocular pressure (IOP).
      A Keeler Pulsair Non Contact Tonometer was used to measure the IOP's of six
      subjects with no history of glaucoma or ocular hypertension. At 30 min of supine
      mechanical ventilation of tidal volume with low (7 to 15 cm H2O) peak inspiratory
      pressures, the IOP's were no different than at the end of a 30-min control period
      of supine spontaneous ventilation. However, using high (60 cm H2O) peak
      inspiratory pressures for 1 min after tidal volume ventilation, IOP's were 32.7%
      higher than at the end of the supine spontaneous ventilation control period (p <
      0.05). Patients requiring long-term mechanical ventilation at high peak
      inspiratory pressures may be at increased risk of vision impairment secondary to
      machine-induced increase of IOP.

PMID- 8355963
TI  - Decreased uncorrected vision after a period of distance fixation with spectacle
      wear.
AB  - Myopes of low degree commonly report that their vision seems poorer upon removal
      of their spectacles compared to that after a period without spectacle wear.
      Notably, this difference in vision can be appreciated after distance fixation. In
      this paper, we propose and test several alternative hypotheses to explain the
      phenomenon: an accommodative response to spectacles, sensory adaptation, or
      altered criteria for blur of psychological origin. We measured visual acuity
      (VA), refractive error, and lens thickness on 10 subjects with less than 2.00 D
      of myopia. Testing was performed after two 90-min sessions viewing at distance.
      At one session, the subjects wore their current spectacle correction and, at the
      other session, no correction was worn. VA underwent a slight but significant
      decrease (0.4 of a line) after the session in which spectacles were worn, but no
      difference in refractive error or lens thickness was found. The change in acuity
      in the absence of a refractive shift suggests sensory adaptation to blur.
      However, the demonstrated change in VA appears to be less than that which is
      subjectively reported; accordingly, psychological input cannot be ruled out.

PMID- 8355964
TI  - Dark focus of accommodation and nervous system activity.
AB  - The purpose of this study was to evaluate the relation between physical exercise
      and dark focus of accommodation. Varsity intercollegiate runners (N = 12)
      participated in the experiment. Measurements of dark focus and pulse rates were
      taken before and after running 400 m. The hypothesis that arousal of the
      sympathetic nervous system through physical exercise would result in an inward
      shift of the dark focus was investigated. A repeated measures t-test was used to
      analyze the difference of dark focus between resting and running. These findings
      suggest that arousal of the sympathetic nervous system does have a significant
      effect on dark focus of accommodation.

PMID- 8355965
TI  - Measurement of elastic modulus of the bovine cornea by means of holographic
      interferometry. Part 1. Method and experiment.
AB  - Holographic interferometry of the cornea of fresh, enucleated bovine eyes placed
      in air was used for determination of the elastic modulus of the central part of
      the cornea. The high sensitivity of the method enables measurement of the radial
      distension of the cornea even for intraocular pressure (IOP) changes equal to 5
      Pa (0.05 mbar or approximately 0.0375 mm Hg). The method of calculation of the
      tangent Young's modulus of the cornea Et, based on data obtained from double
      exposure as well as real-time holographic interferograms and on some geometrical
      data describing the form of the cornea are presented. The average value of Et
      amounting to 1.42.10(5) Pa was calculated from 2 interferograms of the same eye.

PMID- 8355966
TI  - Astigmatic optical systems with separated and prismatic or noncoaxial elements:
      system matrices and system vectors.
AB  - A general system of noncoaxial separated astigmatic optical elements is examined.
      Allowance is made for prismatic elements including decentered lenses and
      refracting surfaces, prisms, and plane interfaces. The directions and positions
      of a ray entering and emerging from the system are related by a system matrix and
      a system vector. Given an incident ray one can readily obtain the emergent ray.
      The analysis is of fundamental importance for visual optics. Two numerical
      examples are presented. One is a model eye with astigmatic and obliquely crossing
      astigmatic and decentered surfaces.

PMID- 8355967
TI  - Measurement of central and peripheral dynamic visual acuity thresholds during
      ocular pursuit of a moving target.
AB  - Previously, visual acuity thresholds for eccentric retinal points have been
      documented for targets that oscillate while the observer fixates a central point.
      This research describes the situation where the observer tracks a moving target
      in constant linear motion, thereby involving the pursuit and saccadic eye
      movements. The increase of visual acuity thresholds with target motion (0 to 70
      degrees/s) was evaluated as a function of retinal eccentricity. Nine retinal
      points were evaluated, (central, 5 degrees and 10 degrees nasal, 5 degrees and 10
      degrees temporal, 5 degrees and 10 degrees superior, and 5 degrees and 10 degrees
      inferior to the fovea). Eight normal subjects viewed computer-generated randomly
      oriented E's monocularly through a horizontally rotating mirror. A computer
      automatically calculated the minimal angle of resolution (MAR) threshold values.
      Result indicated that the change in visual acuity thresholds was dependent upon
      retinal location. The thresholds for central and peripheral eccentricities
      plotted as a function of angular velocity were linear but the slope of the linear
      function was much reduced for peripherally viewed targets compared to centrally
      viewed targets. Although both peripheral and central visual acuity thresholds may
      increase with increasing target velocity due to velocity mismatch errors and
      saccadic suppression and/or omission, the reduction in slope for peripherally
      viewed targets may be due to differential temporal summation, retinal smear,
      and/or separate retinogeniculate pathway processing.

PMID- 8355968
TI  - Subjective assessment of contact lens wear by army aircrew.
AB  - Because 23% of Army aviators are ametropic, contact lenses have drawn increased
      attention as a spectacle substitute to solve system compatibility problems. From
      November 1988 until October 1991, a series of contact lens research protocols
      were conducted to develop a comprehensive database on contact lens wear in varied
      environments. Questionnaires were used to assess suitability and acceptability of
      routine contact lens wear. Responses from 202 subjects were obtained from
      September 1989 through September 1991. The questions explored operational and
      safety of flight issues of contact lens wear. Subjects overwhelmingly approved of
      contact lens use in all settings: 95% expressed greater combat readiness and
      effectiveness with contact lenses, 98% felt contact lens use (and maintenance) in
      the cockpit had no adverse impact on safety of flight, and 98% endorsed the
      routine use of contact lenses. These data highlight Army aircrew acceptance of
      contact lens use.

PMID- 8355969
TI  - Potential applications of ocular thermography.
AB  - Thermography is an investigative technique which allows rapid color-coded display
      of the temperature across a wide surface by means of infrared detection. We
      describe an ocular thermographic study of a normal population and present case
      studies describing the application of this technique for patients with ocular
      disease. We found that 95% of the normal population have an interocular
      temperature difference (temperature of center of right cornea minus temperature
      of center of left cornea) of 0.60 degrees or less. There appears to be a greater
      difference in temperature between the limbus and the center of the cornea in
      patients with dry eyes. This technique has potential for evaluating tear film
      disorders and inflammatory conditions, for monitoring the progress of such
      conditions, and for evaluating the efficacy of various treatments.

PMID- 8355970
TI  - Humidity-conditioned gravimetric method to measure the water content of hydrogel
      contact lens materials.
AB  - A method to determine the humidity-conditioned gravimetric water content of
      hydrogel contact lens materials has been developed, in which errors due to
      blotting have been eliminated by conditioning the lens in a series of relative
      humidity (RH) environments before measuring the water content gravimetrically,
      and then extrapolating the water content to 100% RH. This method has been used to
      determine the water contents of representative materials from each of the four
      FDA lens groups, which were compared with their labeled values, as well as with
      values obtained from refractive index measurements. The deviation of the water
      content of soft contact lenses as measured by refractive index from that obtained
      gravimetrically increased as the water content decreased. The humidity
      conditioned gravimetric method to determine water content of hydrophilic contact
      lenses is being proposed as an International Organization for Standardization
      (ISO) standard, as an improvement over the gravimetric and refractive index
      methods.

PMID- 8355971
TI  - Redefining the optometric examination: addressing the vision needs of older
      adults.
AB  - The aging of America's population will result in an increased number of older
      adult patients in optometric practices. Although older patients frequently report
      declines in their vision, the results of high contrast testing procedures often
      do not correlate with the symptoms. Age-related functional vision decrements can
      impact upon an individual's ability to perform the activities of daily living. I
      explored the relation between reported visual complaints and the results of
      objective tests for older adults (N = 50) as compared with middle-aged adults (N
      = 20). Decrements in visual acuity, contrast sensitivity, glare sensitivity,
      color vision, and stereopsis were apparent in the older group and all were
      significant at alpha = 0.05. Open-ended questions elicited more visual complaints
      from older adults than from middle-aged adults. However, only the reported
      complaint of decreased vision was related to visual decrements as determined by
      clinical testing (chi 2; p = 0.0596). These results indicate that task-specific
      case history questions may provide greater insight into older adults' visual
      performance in their normal environment. Additional testing in the areas of
      contrast sensitivity, glare sensitivity, stereopsis, and color vision should also
      be included in the optometric examination when warranted.

PMID- 8355972
TI  - Optometry research. Part 3: Faculty publications.
AB  - I compared the production of faculty-produced publications among the U.S. schools
      and colleges of optometry and the Department of Veterans Affairs (VA) Optometry
      Service. These publication rates were viewed against the schools' rankings in
      National Eye Institute (NEI) funding (see Part 2), student/faculty ratios,
      faculty salaries, and the presence of a graduate degree program. The schools and
      the VA grouped into three levels of publication production with five of first
      rank, four of middle rank, and eight of lower rank. The five leading producers in
      the period 1982 through 1991 were Berkeley, Alabama, Houston, VA, and State
      University of New York (SUNY). Since 1982 VA optometrists have authored the
      largest number of articles published in the Journal of the American Optometric
      Association and since 1985 have been the leading group of continuing education
      (CE) lecturers at the Academy.

PMID- 8355973
TI  - Optometry in the lead: public education and ultraviolet radiation.

PMID- 8355974
TI  - Aniseikonia with intraocular lenses.

PMID- 8355975
TI  - [Adjuvant BCG immunotherapy in the management of superficial bladder tumors].
AB  - The net benefit of BCG immunotherapeutic prophylactic effect on recurrence of
      superficial bladder tumours was investigated. The BCG treatment group consisted
      of 121 stage Ta, T1 patients, while the control group, 49 patients, was treated
      only with transurethral resection. During 3-year follow-up recurrence rate in the
      control group was 55.1%, while in the BCG group in the two-and-a-half-year follow
      up it was 23.9%. The yearly repeated 6-week cycles resulted in decrease of
      recurrence rate to 11.8%. The recurrence indexes were 2.2 and 0.6 in the control
      group and in the repeated treatment group respectively. A progression rate of
      18.8% was recorded in the control group and 4.1% in the treatment group. Finally
      both clinical and investigative results were summarised and the necessity of
      repeated immunotherapeutic BCG courses were emphasized.

PMID- 8355976
TI  - [Pen-type insulin dispenser for intensive insulin therapy].
AB  - The authors investigate the advantage of the intensified insulin therapy and the
      use of pen-type devices in the practice of the Diabetic Outpatient Clinic of
      National Institute of Cardiology. The metabolic control improved markedly during
      intensified insulin therapy already after a short time as three months without
      any change in the applied dosage. Furthermore pen-type devices have been
      recognized to let the patients better accept the daily more than two injections,
      to improve the life-style, and last but not least to decrease the waste quantity
      of insulin. Authors want to draw attention to the fact that more than 33% of
      diabetic patients with intensified insulin therapy have a higher demand for
      insulin, then it could be injected by the pen devices used at this time and by
      cartridges available in Hungary at this moment. Therefore, availabilities of both
      cartridges of 3 ml volume would become necessary without any delay.

PMID- 8355977
TI  - [Repair of an electrode breakage in a permanent pacemaker by internal bypassing].
AB  - A possible complication of the definitive pacemaker therapy is the fracture on
      the electrode which usually needs new electrode replacement. A new method is
      discussed as the electrical fault caused by fracture is resolved by internally
      bypassing the broken part of the electrode with a guide-wire. This method is more
      simple and economical and quicker than the electrode replacement and provides
      more safety for the patients. This method is therefore recommended to be spread.

PMID- 8355978
TI  - [Fatal myocardial lesion in systemic lupus erythematosus].
AB  - The authors present the case of a 47-year old female patient. She suffered from a
      moderate activity SLE for two years. The outcome of SLE was changed by an ulcer
      because of leg injury, which was repeatedly infected. Severe polyarthritis,
      leucopenia, thrombocytopenia, clinical signs of vasculitis and in the last two
      months fever, high ESR, and pericarditis appeared. The angina pectoris, the
      cardiac decompensation, the electrocardiogram, the echocardiogram was suspect to
      diffuse myocardial lesion. Cardiac decompensation caused the death of the
      patient. Besides the activation of her autoimmune disease, infection was suspect
      in the patient taken immunosuppressive and steroid drugs, though it could not be
      verified. Autopsy verified besides the recent necrosis of heart without reaction,
      and multifocal myocardial abscess, which appeared possible in the terminal phase.

PMID- 8355979
TI  - [Remembering Mor Kaposi at Kaposvar].

PMID- 8355980
TI  - [W. Griesinger and the "Thubingen Triad"].

PMID- 8355981
TI  - [Successful treatment of hemorrhaging necrotizing pancreatitis with peritoneal
      dialysis].

PMID- 8355982
TI  - Characterization and physical mapping of the genome of bacteriophage phi Aa from
      Actinobacillus actinomycetemcomitans.
AB  - The size, configuration and restriction map of Actinobacillus
      actinomycetemcomitans bacteriophage phi Aa DNA was determined by means of
      restriction endonuclease analysis. Digestion of the phi Aa DNA with restriction
      enzymes Hind III, Eco RI and Sal I produced 6, 5, and 4 fragments, respectively.
      Based upon the sum of the sizes of the restriction fragments of these enzymes,
      the DNA was estimated to be 47.2 kilobase pairs in length. A restriction map was
      constructed using Hind III and Sal I. Incubation with exonuclease Bal 31 for
      increasing lengths of time resulted in progressive hydrolysis of the DNA, as
      expected for a linear molecule. No sub-molar fragments or diffuse bands were
      observed in the agarose gels of the restriction endonuclease digests of the phi
      Aa DNA. Attempts at ligating the ends of the DNA were consistently unsuccessful.
      Therefore, we found no evidence for cohesive ends, a circular permutation of the
      genome or for headful packaging mechanism from a concatameric DNA precursor.

PMID- 8355983
TI  - Identification of Actinobacillus actinomycetemcomitans: polymerase chain reaction
      amplification of lktA-specific sequences.
AB  - Actinobacillus actinomycetemcomitans has been strongly implicated in the etiology
      of localized juvenile periodontitis. Techniques used in the identification of
      this periodontal pathogen include cultural, biochemical, immunological and DNA
      hybridization analysis. In this study, we report the use of polymerase chain
      reaction (PCR) to amplify unique sequences of A. actinomycetemcomitans. Specific
      oligonucleotide primers LKT2 and LKT3 were designed to hybridize to the A.
      actinomycetemcomitans lktA gene, which encodes leukotoxin, a putative A.
      actinomycetemcomitans virulence factor. The LKT2 and LKT3 primers amplified lktA
      specific sequences from all 12 A. actinomycetemcomitans strains tested. In
      another set of experiments, 13 other bacterial species, most of which are normal
      residents of the oral cavity, were tested with these primers. These PCR
      amplifications also contained 2 additional primers, RRN4 and RRN5, which served
      as positive controls; RRN4 and RRN5 were designed to amplify specific sequences
      of eubacterial 16S ribosomal DNA (rDNA). PCR amplifications of all bacterial
      species tested, including A. actinomycetemcomitans, yielded 16S rDNA-specific DNA
      fragments. Furthermore, each bacterial species tested, with the exception of A.
      actinomycetemcomitans, failed to amplify lktA sequences. The LKT and RRN primers
      were used in further PCR experiments to detect A. actinomycetemcomitans directly
      from gingival fluid samples. The results clearly demonstrate the simplicity,
      rapidity, specificity and accuracy of the LKT primers in the identification of A.
      actinomycetemcomitans.

PMID- 8355984
TI  - Seroclassification of hitherto nontypeable Actinobacillus actinomycetemcomitans
      strains: evidence for a new serotype e.
AB  - Serotyping of 89 Actinobacillus actinomycetemcomitans isolates by indirect
      immunofluorescence with serotype-specific monoclonal antibodies yielded 10
      nontypeable strains. The aim of the present study was to re-evaluate the
      seroclassification of these strains with a different assay. Electroblotted
      antigens of nontypeable isolates and selected reference strains were
      immunostained with 37 human sera containing high antibody titers to A.
      actinomycetemcomitans. Such immunoblots typically showed an immunodominant,
      serotype-specific antigen smear. Twelve human sera were found to recognize
      specifically serotype a, 10 serotype b and 9 serotype c. Three sera contained
      antibodies to 2 or all 3 serotype antigens; 3 sera had no activity to any
      reference strain smear antigen. There was complete agreement between the
      seroclassification of the reference strains with the monoclonal and the
      polyclonal reagents. Seven of the 10 strains, nontypeable with monoclonal
      antibodies, could also not be typed by the human sera. Of the remaining 3
      strains, one belonged to a previously unrecognized serovar of serotype a, and 2
      isolates expressed a novel smear antigen detected by the 3 human sera containing
      no antibodies to the serotype a, b, or c antigens. We propose that these 2
      strains be assigned to a new A. actinomycetemcomitans serotype, designated
      serotype e.

PMID- 8355985
TI  - Effect of outer membrane of Treponema denticola on bone resorption.
AB  - The effect of the outer membrane (outer sheath) of Treponema denticola on bone
      resorption was studied. Bone resorption was measured by the release of previously
      incorporated 45Ca from the shafts of the radii and ulnae of 19-day fetal rats. A
      treated-over-control ratio (T/C ratio) significantly greater than 1 indicated the
      stimulation of bone resorption by the test substance. The addition of outer
      membrane of T. denticola increased the release of 45Ca from the assay bones. The
      minimum concentrations required to yield significant 45Ca release from the assay
      bones were 15, 22 and 75 micrograms protein/ml for serovars a, b and c,
      respectively. These protein values corresponded to estimated lipopolysaccharide
      contents of 0.6, 0.8 and 2.8 micrograms/ml, based on 3-deoxy-2-manno-octulosonate
      analysis. Heat treatment of outer membrane (60 degrees for 30 min) did not change
      the effect on 45Ca release. Parathyroid hormone or prostaglandin E2, known to act
      synergistically with lipopolysaccharides in bone resorption, was also added to
      the assay system. Neither prostaglandin E2 at 10(-7) M nor parathyroid hormone at
      40 ng/ml, by itself, increased 45Ca release. However, in the presence of 10
      micrograms protein/ml of outer membrane of serovar b at 120 h, the T/C ratio was
      increased to 1.31 +/- 0.07 and 1.58 +/- 0.118, respectively. These results
      suggest that a lipopolysaccharide-like material is present in the outer membrane
      of T. denticola that may be responsible for bone resorption in the in vitro
      system.

PMID- 8355986
TI  - Salivary effects on polymorphonuclear leukocyte functions.
AB  - Respiratory burst, enzymatic degranulation and bacterial killing were
      investigated on peripheral blood polymorphonuclear leukocytes (polymorphonuclear
      leukocytes) incubated with a pool of salivary fluids elicited from healthy
      donors. Low saliva concentrations primed polymorphonuclear leukocytes for
      enhancement of O2 consumption, O2- and beta-glucuronidase release and
      Staphylococcus aureus killing. Whole saliva, on the contrary, depressed all
      tested phagocytic activities.

PMID- 8355987
TI  - Bacteria reactive to plaque-toxin-neutralizing monoclonal antibodies are related
      to the severity of gingivitis at the sampled site.
AB  - Certain monoclonal antibodies (Mabs) neutralize the inhibition of HL60 cell
      growth by bacterial plaque extracts. The aim of this study was to enumerate and
      identify the bacteria reactive to these Mabs at sites where periodontal disease
      was measured by gingival index, pocket depth and attachment loss. The bacterial
      colonies were grown on blood agar and the colonies counted directly and after
      immunoblotting. Sites that bled on probing (n = 15) had a mean of 3.35% Mab
      positive colonies (SEM = 0.52%) and sites that did not bleed (n = 9) had a mean
      of 1.61% (SEM = 0.41%). The percentage of Mab-positive colonies also correlated
      with gingival index but not with the total number of colonies sampled, attachment
      loss or pocket depth. Antigen was expressed by 4 genera: strains of Streptococcus
      sanguis and/or Eikenella corrodens (8 sites), Staphylococcus epidermidis (4
      sites) and Corynebacterium minutissimus (1 site). The results suggest that the
      antigens detected on these bacteria by the Mabs may be processed to form toxins
      and maintain gingivitis by irritating the surrounding cells.

PMID- 8355988
TI  - Changes in the prevalence of subgingival enteric rods, staphylococci and yeasts
      after treatment with penicillin and erythromycin.
AB  - The changes in the balance of microbial flora in the periodontium after
      antibiotic treatment were investigated in a blind study. The prevalence of gram
      negative enteric rods, staphylococci and yeasts was followed before and during
      penicillin or erythromycin treatment of 72 periodontitis patients without
      periodontal cleaning. The prevalence of subgingival coagulase-positive
      staphylococci increased significantly following systemic penicillin therapy.
      After systemic erythromycin therapy, the prevalence of subgingival gram-negative
      enteric rods increased. Ten of 24 (42%) patients receiving systemic penicillin
      therapy developed clinical evidence of periodontal abscesses. In the absence of
      conventional mechanical cleaning, systemic administration of penicillin and
      erythromycin antibiotic to patients with pre-existing periodontitis may lead to
      periodontal superinfection with opportunistic organisms.

PMID- 8355989
TI  - A successful method for quantifying viable oral anaerobic spirochetes.
AB  - Spirochetes are markedly prevalent in periodontal disease but are not included as
      predominant cultivable organisms because of the inability to quantify them by
      viable count. A successful method was developed for enumerating viable oral
      spirochetes as colony-forming units (CFU) in an agarose-based medium. Treponema
      denticola, Treponema vincentii and Treponema socranskii in log-phase growth in
      new oral spirochete (NOS) broth were used for evaluation of the method. Critical
      components of the method include enzyme-free low temperature-gelling (37 degrees
      C) agarose in NOS medium in small tissue-culture flasks into which the
      spirochetes were seeded and diluted. The flasks were anaerobically incubated in a
      glove-box. Reliable, consistent and reproducible viable counts of pure spirochete
      cultures were obtained. The injurious effects of spirochete temperature
      sensitivity were averted by using molten agarose at 37 degrees C. Distinctive
      colony morphologies of spirochete species could be compared from pure cultures.
      Addition of rifampin into the medium showed no decrease in spirochete CFU count.
      The method as described allows for selection of mutants and detection of
      biochemical activity and is potentially useful for enumeration of spirochetes
      from periodontal pockets as members of the predominant cultivable flora.

PMID- 8355990
TI  - Attachment of Treponema denticola strains to monolayers of epithelial cells of
      different origin.
AB  - The attachment of 10 different Treponema denticola strains to monolayers of 4
      types of epithelial cells derived from rat palatal epithelium, guinea pig ear,
      human buccal epithelium and human corneal epithelium was screened
      microscopically. Most T. denticola strains were able to attach to all four types
      of epithelial cells. The T. denticola strains seemed to attach better to
      epithelial cells derived from primary cultured material. The T. denticola strains
      showed different degrees of attachment. Scanning electron microscopy studies
      revealed that the attachment of T. denticola was not only tip-associated but
      occurred also at random points in close contact with microvilli of the epithelial
      cells. Attached spirochetes were non-uniformly distributed over the monolayers,
      indicating the presence of receptive subpopulations of epithelial cells in the
      monolayers.

PMID- 8355991
TI  - Identification of plasmids in Actinobacillus actinomycetemcomitans and
      construction of intergeneric shuttle plasmids.
AB  - A collection of 39 isolates of Actinobacillus actinomycetemcomitans, obtained
      from laboratories located in 5 different geographical regions of the United
      States, was examined for the presence of plasmid DNA. Only 2 of the strains
      examined, designated VT736 and VT745, harbored detectable plasmids. Strain VT736
      contained a 1.9 kb plasmid species (pVT736-1) and a larger ( > 30 kb) species
      (pVT736-2). Both plasmids were detected in the covalently closed circular DNA
      fraction of dye buoyant density gradients. However, only the smaller plasmid was
      observed in agarose gels containing plasmid-enriched cell lysates prepared by a
      rapid screening procedure. Strain VT745 contained a single, 24 kb, plasmid
      (pVT745) that was observed consistently in plasmid-enriched lysates, as well as
      in the plasmid band of dye buoyant density gradients. A restriction endonuclease
      map of pVT736-1 was constructed. The plasmid contained one site each for the
      enzymes HincII, KpnI and XhoI, located 600 to 700 bp from each other on the
      pVT736-1 map. HincII-digested pVT736-1 DNA could not be cloned in Escherichia
      coli. However, intact pVT736-1 digested with KpnI or XhoI could be cloned in E.
      coli on pUC19 or pGEM7Zf(-), respectively. KpnI-digested pVT736-1 was cloned in
      both orientations on pUC19, but XhoI-digested pVT736-1 was clonable in only one
      orientation on pGEM7Zf(-). Each of the 3 types of chimeric plasmid constructs
      provided a potential A. actinomycetemcomitans/E. coli shuttle plasmid for the
      development of a genetic transfer system in A. actinomycetemcomitans.

PMID- 8355992
TI  - The methionine synthesis cycle and salvage of methyltetrahydrofolate from host
      red cells in the malaria parasite (Plasmodium falciparum).
AB  - Plasmodium falciparum, P. knowlesi and P. chabaudi showed a significant activity
      of methylenetetrahydrofolate reductase (MTHFR). The presence of this enzyme
      completes the methionine synthesis cycle, in which the one-carbon fragment from
      serine side-chain can be transferred to methionine. However, while metabolic
      labelling of methionine from L-3 [14C]serine could not be demonstrated in P.
      falciparum, the significance of MTHFR was implicated by a novel pathway for
      salvage of exogenous 5-methyltetrahydrofolate from the host cell. The methyl
      group of the cofactor was incorporated into methionine, and the folate cofactor
      was found in the same pool as that derived from de novo synthesis with p
      aminobenzoic acid as the precursor, shown previously as polyglutamylated 5
      methyltetrahydrofolate. It is proposed from these results that the function of
      MTHFR and the methionine synthesis cycle is not the supply of methionine, but the
      generation of active folate cofactors from more stable precursors salvaged by the
      parasites.

PMID- 8355993
TI  - Rapid changes in the surface of parasitic nematodes during transition from pre-
      to post-parasitic forms.
AB  - All mammalian-parasitic stages of a range of nematode species investigated
      (Brugia pahangi, Acanthocheilonema viteae, Strongyloides ratti, Nippostrongylus
      brasiliensis, Trichinella spiralis and Ostertagia ostertagi) labelled in a
      surface-restricted manner with the fluorescent lipid analogues 5-N
      (octadecanoyl)aminofluorescein (AF18) or nitrobenzoxadiazole-cholesterol (NBD
      chol), but failed to bind other similar probes. In contrast, the surfaces of the
      'pre-parasitic' infective stages of these species had affinity for neither AF18
      nor NBD-chol. This exclusion of lipid analogues changed rapidly upon exposure of
      the larvae to tissue culture conditions which mimic the mammalian tissue
      environment (e.g. RPMI 1640/37 degrees C) such that the above probes could then
      insert into the surface layer of the larvae. The dauer larva of Caenorhabditis
      elegans also excluded the probes, but became permissive to labelling upon
      stimulation to emerge from the dauer state. The time taken for the surface
      transformation to occur ranged from less than 10 min in the vector-borne
      parasites to approximately 5 h in those which enter by the oral route, with
      direct skin-penetrators occupying an intermediate position. In all cases, the
      alteration proceeded too rapidly for it to have been associated with a moult.
      Fluorescence Recovery After Photobleaching (FRAP) studies of A. viteae larvae
      showed that approximately 50% of the AF18 probe was free to diffuse within the
      plane of the surface immediately after transformation. This is only a transitory
      state because AF18 was found to be highly restricted in its lateral diffusion on
      the surface of adult parasites. In the larvae of S. ratti, the change in affinity
      for AF18 was accompanied by the rapid shedding of an otherwise stable surface
      coat of polyanionic material, here visualized by labelling with fluorescein
      conjugated cationized ferritin. Incubation of larvae in lipid-rich host serum
      during the induction of transformation inhibited subsequent labelling with AF18.
      This possibly reflects competition for insertion sites and an in vivo propensity
      towards the acquisition of host lipid by invading parasites.

PMID- 8355994
TI  - Frequency of cross-fertilization in the human malaria parasite Plasmodium
      falciparum.
AB  - Two clones of the human malaria parasite Plasmodium falciparum, denoted 3D7 and
      HB3, were grown in vitro under conditions permitting the development of
      gametocytes. The two clones differ in their allelic forms of two antigen genes
      MSP1 and MSP2. The alleles can be distinguished as size differences of polymerase
      chain reaction (PCR) amplified fragments of repetitive regions of each gene.
      Mosquitoes (Anopheles stephensi) were fed on a mixture of these gametocytes. A
      total of 128 oocysts was isolated from the midguts of infected mosquitoes from 9
      crossing experiments between the clones. DNA extracted from these oocysts was
      amplified by PCR. Oocysts which contained both alleles of each gene (MSP1 and
      MSP2) had developed from heterozygotes produced by cross-fertilization events
      between 3D7 and HB3 gametes. The remaining oocysts contained single alleles of
      each gene, in parent clone combinations, and these had developed from homozygotes
      formed by self-fertilizations. The results suggest that gametes in the original
      mixture fed to mosquitoes had undergone random mating.

PMID- 8355995
TI  - Modelling toxoplasma incidence from longitudinal seroprevalence in Stockholm,
      Sweden.
AB  - Age-stratified data on toxoplasma seroprevalence in pregnant women in Stockholm,
      Sweden for the years 1969, 1979 and 1987 provide the basis for an analysis of
      temporal patterns of Toxoplasma gondii infection, and estimation of the risk of
      maternal toxoplasmosis, in this population. A catalytic infection model, in which
      the rate or force of infection is assumed to be a function of time (and not, as
      is more usual, age), was employed to describe the observed changes in levels of
      toxoplasma seropositivity. A range of simple incidence functions (up to 3
      parameters) were fitted using a method of maximum likelihood. The data were
      significantly better described by a linear or an exponential decay in the rate of
      infection through time compared with a constant level. More complex incidence
      functions gave no better data description. Thus, whilst there is strong evidence
      for declining incidence in Stockholm over the past 4-5 decades, the data do not
      allow discrimination between different possibilities for the nature of this
      decline. Based on these modelling results, best estimates of the force of
      infection in 1987 acting on susceptible women are within the range 0 to
      0.0045/susceptible/year (95% confidence limits), yielding a possible risk of
      maternal toxoplasmosis of between 0 and 2.7 cases/1000 pregnancies. These values
      are shown to be significantly lower than estimates based upon an assumption of
      temporal stability in toxoplasma incidence, which may be of practical
      significance to public health policy.

PMID- 8355996
TI  - The influence of host blood on infection rates in Glossina morsitans sspp.
      infected with Trypanosoma congolense, T. brucei and T. simiae.
AB  - Trypanosoma congolense, T. brucei and T. simiae isolated from wild-caught
      Glossina pallidipes were fed to laboratory-reared G. morsitans centralis and G.m.
      morsitans to determine the effect of host blood at the time of the infective feed
      on infection rates. Bloodstream forms of trypanosomes were membrane-fed to flies
      either neat, or mixed with blood from cows, goats, pigs, buffalo, eland,
      waterbuck and oryx. The use of different bloods for the infective feed resulted
      in differences in infection rates that were repeatable for both tsetse subspecies
      and most parasite stocks. Goat, and to a lesser extent, pig blood facilitated
      infection, producing high infection rates at low parasitaemias. Blood from cows
      and the wildlife species produced low infection rates, with eland blood producing
      the lowest. Addition of D(+)-glucosamine (an inhibitor of tsetse midgut lectin)
      increased infection rates in most cases. These results indicate the presence of
      species-specific factors in blood that affect trypanosome survival in tsetse. In
      certain hosts, factors actually appear to promote infection. The nature of these
      factors and how they might interact with midgut lectins and proteases are
      discussed.

PMID- 8355997
TI  - Endotoxins and the pathogenesis of Trypanosoma brucei brucei infection in mice.
AB  - The involvement of endotoxins in Trypanosoma brucei brucei infection in CD-1 mice
      was investigated by the Limulus amoebocyte lysate (LAL) test. At 7 days post
      infection mean serum endotoxin level was elevated by 2.5 times (36.4 pg/ml cf.
      control 14.25 pg/ml, P < 0.001) and a similar increase was maintained throughout
      the infection (survival 28-35 days). Purified disrupted parasites contained
      significant endotoxin activity (mean value 280 pg/mg protein). The mouse
      infections were also associated with progressive Gram-negative bacteraemia
      (present in 4 out of 5 infected animals by day 28 p.i.). The increased endotoxin
      levels may be due to parasite products, the products of intercurrent bacterial
      infections, other unidentified sources (e.g. from the gut), or a combination of
      these. It is concluded that the raised endotoxins may be important contributive
      factors in the pathogenesis of experimental murine trypanosomiasis.

PMID- 8355998
TI  - Characterization of Megatrypanum trypanosomes from European Cervidae.
AB  - Megatrypanum trypanosomes have been isolated from a number of different European
      Cervidae, but on the basis of morphology it has not been possible to define the
      species to which these isolates belong. We isolated Trypanosoma (Megatrypanum)
      theileri from 10 cattle, and Megatrypanum trypanosomes from 11 fallow deer
      (Cervus dama), 9 red deer (Cervus elaphus), and 4 roe deer (Capreolus capreolus)
      by blood culture on a biphasic medium (NNN agar slopes). Trypanosomes were
      propagated in Schneider's Drosophila medium and characterized by isoenzyme
      analysis and molecular karyotyping. Isocitrate dehydrogenase and
      phosphoglucomutase were visualized after starch gel electrophoresis of
      trypanosome lysates. By cluster analysis of this data all isolates from deer were
      clearly separated from the T.(M.) theileri isolates from cattle. Isolates from
      roe deer were different not only from T. (M.) theileri but also from the other
      deer isolates. Isolates from fallow deer and red deer were grouped together.
      Thus, there are probably at least two different species of Megatrypanum
      trypanosomes in the three Cervidae. One parasitizing roe deer, the other,
      apparently less host specific species, infecting red deer and fallow deer.
      Separation of the chromosomes of Megatrypanum trypanosomes by pulsed-field
      gradient gel electrophoresis (PFGE) showed that each isolate contained a large
      number (> 18) of chromosomes ranging in size from 300 to > 2200 kb. The molecular
      karyotypes were similar for all isolates, although no isolate was identical to
      another.

PMID- 8355999
TI  - A quantitative study of the susceptibility of cockroach species to Moniliformis
      moniliformis (Acanthocephala).
AB  - We exposed 19 species of cockroaches to Moniliformis moniliformis by
      administering shelled acanthors orally and by injecting hatched acanthors
      directly into the body cavity. The exposure method had little influence on
      susceptibility: with one exception, species that were susceptible to oral
      exposure were also susceptible to injected acanthors and, in no case, did
      acanthors develop in injected animals when they did not develop in orally exposed
      conspecifics. We found no support for the hypothesis that the intestine may be a
      barrier to M. moniliformis establishment in cockroaches. There is, however, clear
      interspecific variation in susceptibility to M. moniliformis infection.

PMID- 8356000
TI  - Dipstick dot ELISA for the detection of Taenia coproantigens in humans.
AB  - A dipstick dot ELISA for detection of Taenia-specific coproantigens was
      developed. The test was based on a sandwich ELISA using antibodies raised against
      adult Taenia solium. Antibodies were absorbed to nitrocellulose paper previously
      adhered to acetate plastic to form dipsticks. Once blocked with 5% skimmed milk
      and dried the antibody-coated dipsticks were stable for several weeks at room
      temperature. Both micro and dot ELISA formats were genus specific although the
      dot ELISA was less sensitive than the micro ELISA based on the same antiserum.
      During field studies, in which the majority of samples were tested in rural
      villages soon after collection, 3728 samples were tested. All samples were also
      examined by microscopy using formol ether concentration and individuals
      questioned to determine whether they were aware of being infected. After the
      initial diagnostic work individuals were treated with taeniacidal drugs for worm
      recovery. Use of the coproantigen test significantly increased the number of
      cases diagnosed. Of the 41 cases diagnosed by the three diagnostic techniques
      combined 31 were detected by the dipstick assay making it the most sensitive
      technique employed. The specificity of the dipstick assay was 99.9% with a
      positive predictive value of 88.6%. The combined diagnostic approach did not,
      however, diagnose all cases. The coproantigen test was fast and easy to use.
      Further improvements may make the dipstick test suitable for wide-scale use in
      field studies and diagnostic laboratories.

PMID- 8356001
TI  - Experimental onchocerciasis in chimpanzees: cellular responses and antigen
      recognition after immunization and challenge with Onchocerca volvulus infective
      third-stage larvae.
AB  - Immunization of chimpanzees with radiation-attenuated infective 3rd-stage larvae
      (L3) of Onchocerca volvulus did not induce strong protective immunity against a
      subsequent challenge infection; only 1 out of 4 immunized animals remained non
      patent (i.e. microfilariae-negative) after challenge, and may have been
      protected. However, during immunization and before challenge, a broad range of
      adult O. volvulus-derived antigens (OvAg) and also uterus-derived OvAg were
      recognized by circulating antibodies; moreover, the repertory of antigens
      recognized increased further in subsequently patent animals after challenge,
      particularly in the range of M(r) 12-42 kDa. In the immunized and non-patent
      chimpanzee, by contrast, serological recognition of uterus-derived OvAg with M(r)
      14 kDa and 105 kDa disappeared by 19 months post-challenge (p.c.). During
      immunization, Acanthocheilonema viteae L3 antigens of M(r) 11-12 kDa were
      strongly recognized only by the non-patent animal, suggesting that recognition of
      these antigens may have supported resistance to the subsequent challenge
      infection. In immunized chimpanzees, a substantial increase in the cellular
      reactivity to OvAg was induced; this, however, declined by 19 months p.c. to
      levels similar to those seen prior to immunization. At that time, 3 out of 4
      immunized animals were patently infected. The effect of exogenous cytokines on in
      vitro-reactivity of PBMC to OvAg was examined. Addition of exogenous IL-2 alone,
      IFN-gamma alone, and IFN-gamma in combination with IL-2, did not augment net
      cellular responses to OvAg by PBMC from infected and control chimpanzees. In the
      presence of IL-4 alone, IL-6 alone, IL-2 with IL-4, IL-2 with IL-4 and IFN-gamma,
      or IL-2 with IL-4 and IL-6, the net cellular reactivity to OvAg increased
      significantly in patent chimpanzees and reached levels similar to non-patent
      animals. Thus, non-patent chimpanzees maintain high cellular reactivity to OvAg
      and in vitro cellular unresponsiveness to OvAg on the part of patent chimpanzees
      is reversible after addition of several cytokines which act individually or
      synergistically.

PMID- 8356003
TI  - Centrocytic lymphoma: a distinct clinicopathologic, immunophenotypic, and
      genotypic entity.

PMID- 8356002
TI  - Estimation of intestinal nematode prevalence: influence of parasite mating
      patterns.
AB  - Prevalence of infection with intestinal helminths is usually assessed through
      stool examination. There are limitations in using this technique to measure
      infection status, since some infected individuals have no patent infection. The
      relationship between infection assessed by stool examination and actual infection
      prevalence is investigated for the three major nematode species--Ascaris
      lumbricoides, Trichuris trichiura and the hookworms--using a model which
      describes the presence of non-egg producing worm combinations. The analysis
      demonstrates that stool examination under-estimates the actual infection
      prevalence, and that the degree of under-estimation is dependent on the level of
      infection, the nematode species and the parasite sex ratio. These findings have
      implications for the validity of epidemiological surveys and the evaluation of
      control programmes.

PMID- 8356004
TI  - Limited forms of Churg-Strauss syndrome.

PMID- 8356005
TI  - Metastatic malignant neoplasms and secondary lymphomatous involvement of the
      breast: a study of 43 cases.

PMID- 8356006
TI  - Sources of variability in classifying common ovarian cancers using the World
      Health Organization classification. Application of the pathtracking method.

PMID- 8356007
TI  - Cervical adenocarcinoma and related lesions. Cytodiagnostic criteria and
      pitfalls.

PMID- 8356008
TI  - Neuroendocrine tumors of the nasal cavity.

PMID- 8356009
TI  - Targeting zinc protoporphyrin liposomes to the spleen using reticuloendothelial
      blockade with blank liposomes.
AB  - Metalloporphyrin inhibitors of heme oxygenase have been studied for use in the
      prevention of hyperbilirubinemia of the neonate. One report has suggested that
      incorporation of these drugs into liposomes can increase their localization to
      the spleen, dramatically reducing heme oxygenase activity in that important heme
      degrading organ. We sought to further increase porphyrin delivery to the spleen
      by using reticuloendothelial blockade with blank liposomes 2 h before injection
      of 0.3 microns extruded zinc protoporphyrin liposomes (L-ZnPP). Control adult
      rats without hemolysis had splenic heme oxygenase activity of 1.07 +/- 0.09 nmol
      carbon monoxide (CO)/h/mg protein. Rats treated with L-ZnPP alone had splenic
      heme oxygenase activity of 0.53 +/- 0.16 nmol CO/h/mg protein 6 h after L-ZnPP
      dosing. However, rats treated with 1000 mumol of blank liposomes per kg to
      saturate the reticuloendothelial system 2 h before L-ZnPP administration had
      splenic heme oxygenase activity of 0.25 +/- 0.16 nmol CO/h/mg protein at t = 6 h,
      which is significantly less than that of the L-ZnPP alone group (p < 0.05). In
      adult rats treated with heat-damaged red blood cells (RBC) to simulate hemolysis,
      treatment with 10 mumol of aqueous ZnPP per kg or 10 mumol of untargeted L-ZnPP
      per kg did not produce a difference from control in total body bilirubin
      production as estimated by CO excretion. However, RBC-treated rats given 1000
      mumol of blank liposomes per kg 2 h before L-ZnPP administration produced
      significantly less CO than control, aqueous ZnPP-treated, and untargeted L-ZnPP
      treated rats from 8 to 12 h after RBC treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8356010
TI  - Molecular and genetic analyses of two patients with Pearson's marrow-pancreas
      syndrome.
AB  - Pearson's syndrome, a rare and fatal disorder characterized by refractory
      sideroblastic anemia and pancreatic insufficiency in infancy, is classified into
      mitochondrial cytopathies. To understand the molecular and genetic bases of this
      disorder, we have investigated the mitochondrial respiratory chain enzymes and
      the mitochondrial DNA (mtDNA) in two Japanese patients with Pearson's syndrome.
      Immunoblot analysis from various tissues showed the different grades of defects
      in the subunits of respiratory enzyme complexes. The analyses of mtDNA showed
      that the deletion in patient 1 spanned 4977 bp from the ATPase 8 gene to the NADH
      dehydrogenase 5 gene between 13-bp direct repeats, whereas the deletion in
      patient 2 spanned 3151 bp from the transfer RNA(His) gene to the cytochrome b
      gene unrelated to any repeated sequences. The deleted mtDNA was heteroplasmic in
      all the analyzed tissues, but the proportions of deleted mtDNA were quite
      different. We observed a tendency for the tissue with low percentages of normal
      sized mtDNA to show low contents of complex I subunits. Analysis of the entire
      sequence of both patient's mtDNA showed several nucleotide substitutions
      including alteration of the initiation codon of the NADH dehydrogenase 5 gene.
      Some of these nucleotide substitutions might contribute to the phenotypic
      expression of Pearson's syndrome synergistically with the deletion.

PMID- 8356011
TI  - Identification of very-long-chain acyl-CoA dehydrogenase deficiency in three
      patients previously diagnosed with long-chain acyl-CoA dehydrogenase deficiency.
AB  - Long-chain acyl-CoA dehydrogenase (LCAD) deficiency is a disorder of fatty acid
      beta-oxidation. Its diagnosis has been made based on the reduced activity of
      palmitoyl-CoA dehydrogenation, i.e., in fibroblasts. We previously showed that in
      immunoblot analysis, an LCAD band of normal size and intensity was detected in
      fibroblasts from all LCAD-deficient patients tested. In the present study, we
      amplified via polymerase chain reaction and sequenced LCAD cDNA from three of
      these LCAD-deficient cell lines, and found perfectly normal LCAD sequences in two
      of them, indicating that at least these patients were not deficient in LCAD. The
      third patient was homozygous for an A to C substitution at 997, although it is
      unknown whether or not 997-C is a normal polymorphism. Although the LCAD sequence
      data were puzzling, a new enzyme, very-long-chain acyl-CoA dehydrogenase (VLCAD),
      was recently identified. Because VLCAD also has high activity with palmitoyl-CoA
      as substrate, it was possible that defective VLCAD may cause reduced palmitoyl
      CoA dehydrogenating activity. We performed immunoblot analysis of VLCAD in six
      "LCAD-deficient" patients; VLCAD was negative in three of them, two of whom had a
      normal LCAD cDNA sequence. These results indicated that a considerable number of
      the patients who had previously been diagnosed as having LCAD deficiency in fact
      have VLCAD deficiency.

PMID- 8356012
TI  - Pretreatment with monosialoganglioside GM1 protects the brain of fetal sheep
      against hypoxic-ischemic injury without causing systemic compromise.
AB  - The purpose of this study was to determine whether prophylaxis with
      monosialoganglioside GM1 can protect the fetus from hypoxic-ischemic
      encephalopathy in utero. Because some protective strategies can compromise the
      fetus, the effect of GM1 treatment on metabolic status and blood pressure was
      also evaluated. Chronically instrumented near-term fetal sheep (119-133 d) were
      subjected to 30 min of severe cerebral ischemia. Six were given 30 mg/kg GM1
      through the umbilical vein 2 h before insult followed by continuous infusion of
      30 mg/kg/d over the next 60 h, and these were compared with seven vehicle-treated
      control sheep. The time course of electrocorticographic activity and cytotoxic
      edema within the parasagittal cortex were determined with real-time spectral
      analysis and continuous impedance measurements, respectively. Histologic outcome
      was assessed 72 h later. Pretreatment with GM1 improved recovery of primary
      edema, reduced the duration of epileptiform activity (15 +/- 2 versus 31 +/- 5 h;
      p < 0.05) and the magnitude of secondary edema (p < 0.05). At 72 h, histologic
      damage was reduced, particularly in the cortex (p < 0.05) and hippocampus (p <
      0.01), and residual electrocorticographic activity was increased in the GM1
      treated group (-5 +/- 1 versus -9 +/- 3 dB, p < 0.01). GM1 infusion did not alter
      arterial blood pressure or metabolic status. These results indicate that GM1 can
      protect the fetal brain against hypoxic-ischemic injury without causing
      hypotension or metabolic compromise.

PMID- 8356013
TI  - Scavengers of free oxygen radicals in combination with magnesium ameliorate
      perinatal hypoxic-ischemic brain damage in the rat.
AB  - The effect of oxygen radical scavengers in combination with magnesium
      administered after a hypoxic-ischemic insult was evaluated in a model of
      perinatal brain damage. A mixture of scavengers of oxygen-derived free radicals
      (L-methionine, 0.2 g; mannitol, 0.5 g) and magnesium sulfate (0.3 g) per kg body
      weight was given to 34 1-wk-old rat pups immediately after a session of
      unilateral carotid artery ligation and 2 h of hypoxia (8% O2 in N2). Thirty-four
      littermates served as controls; they received a placebo. At 3 wk of age, there
      was a significantly smaller reduction of hemisphere weight ipsilateral to the
      ligation in the treated animals compared with the controls (0.7 versus 8.8% of
      contralateral hemisphere weight median values, p < 0.01). The difference was
      especially marked for the most severe degrees of brain damage. Only one of the 34
      treated animals, compared with 13 of 34 control animals, had a reduction of
      ipsilateral hemisphere weight > 25%. The protection offered by the mixture used
      was larger than in previously published studies using this model and treatment
      after the hypoxic exposure with only one protective agent. It is concluded that a
      combination of oxygen radical scavengers and magnesium administered in the phase
      of resuscitation mitigates perinatal postasphyxial brain damage in the rat. An
      additive protective effect of different therapeutic strategies on the brain
      damage may be present in this situation.

PMID- 8356014
TI  - Differential gene expression of antioxidant enzymes in the perinatal rat lung.
AB  - It has been previously demonstrated that the developing rat lung markedly
      increases its catalase (CAT) and glutathione peroxidase (GP) activities during
      the final 10 to 15% of gestation. In the present studies, we tested whether four
      major antioxidant enzymes (AOE) in perinatal rat lungs might share a similar
      pattern of developmental AOE gene expression via a pretranslational mechanism.
      The left lungs of 18-d to term fetuses and early postnatal rat pups were used to
      measure the concentrations of AOE mRNA by solution hybridization and the right
      lungs of the same group of animals were assayed for AOE activities. Results
      revealed differential AOE gene expression in developing rat lungs. Whereas the
      CAT and GP activities progressively increased prenatally, the superoxide
      dismutase (SOD) activity either declined [copper-zinc SOD (Cu, ZnSOD)] or
      remained constant [manganese SOD (MnSOD)] in late gestation. Postnatally,
      Cu,ZnSOD and CAT activities progressively increased, whereas MnSOD remained
      constant and GP activity declined slightly. For Cu,ZnSOD, MnSOD, and CAT, the
      activity changes were generally consistent with the patterns of changes in their
      mRNA concentrations in both the prenatal and postnatal period, but for GP they
      were not. At the time of birth, however, the mRNA levels of Cu,ZnSOD and CAT
      decreased approximately 40%, whereas their enzyme activities increased. For
      MnSOD, only a slight rise in mRNA level was observed versus approximately 100%
      increase in its activity at the time of birth. These findings suggest that the
      AOE are not coordinately regulated, and that developmental regulation of AOE gene
      expression in the perinatal rat lung is complex and likely exerted at different
      levels of regulation.

PMID- 8356015
TI  - Intrinsic microbicidal activity and pulmonary hypertension in isolated newborn
      piglet lungs.
AB  - The lung appears to be one of the dominant sites of bacterial clearance from the
      blood of infant piglets. Part of the lung bacterial clearance involves activation
      of an oxygen radical bactericidal mechanism that may be central to induction of
      acute pulmonary hypertension. The present study determined whether this
      bactericidal activity was intrinsic to resident lung cells. Isolated piglet lung
      preparations perfused with blood-free salt solution were used to delineate the
      amount of group B streptococci (GBS) extracted and killed upon transit through
      pulmonary vasculature. Approximately 45% of infused GBS was deposited in the lung
      during a single pulmonary transit, whereas nearly 40% of the organisms
      sequestered in the lung were killed within a 30-min period. Pretreatment with
      dimethylthiourea, a scavenger of hydroxyl radical that inhibits GBS-induced
      pulmonary hypertension, attenuated both bacterial uptake and killing to similar
      extents. Along with its deposition in the lung, GBS also induced concentration
      dependent increases in total pulmonary resistance, which were related principally
      to increases in upstream arterial resistance. Lung weight also increased in a
      concentration-dependent manner. Both the increase in total pulmonary resistance
      and lung weight were temporally related to elevation in perfusion medium content
      of the stable thromboxane degradation product, thromboxane B2. Pretreatment with
      indomethacin, a prostaglandin H synthase inhibitor, or sodium(E)-3[4-(1
      imidazolyl-methyl)phenyl]-2-propenoic acid a thromboxane synthase inhibitor,
      reduced GBS-induced pulmonary hypertension and edema. These results suggest that,
      in isolated piglet lungs, GBS evokes an intrinsic bactericidal response residing
      within lung cells, probably pulmonary intravascular macrophages, which may be
      responsible for the initiation of pulmonary hemodynamic changes.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8356016
TI  - The effects of hypoxic acidemia on left ventricular end-systolic elastance in
      fetal sheep.
AB  - Using the conductance catheter technique, we measured the effects of hypoxic
      acidemia on left ventricular end-systolic elastance in anesthetized, 133-d
      gestation, in utero fetal sheep (n = 7). Conductance and Millar catheters were
      introduced into the left ventricle through a carotid artery cutdown. Fetuses were
      rendered progressively hypoxic and acidemic by placental embolization with
      repeated injections of 5 x 10(5) 50-microns plastic spheres every 15 min via a
      catheter placed in the fetal abdominal aorta. We recorded pressure-volume data
      and arterial blood gases at 15-min intervals. End-systolic elastance was computed
      using a single-beat method of extrapolating maximum isovolumic pressure. A mean
      of five boluses was required to cause fetal death. Placental embolization caused
      progressive fetal acidemia. Mean baseline fetal arterial pH was 7.32 +/- 0.06
      (mean +/- SD) and gradually decreased with embolization (p < 0.0001). A linear
      relationship was found to exist between elastance and pH with a mean decrease of
      0.46 kPa/mL per 0.1-unit drop in pH (r = 0.96; p < 0.0001). Despite the decrease
      in end-systolic elastance, stroke volume and left-ventricular output were
      maintained due to a parallel decrease in afterload. The decrease in end-systolic
      elastance was gradual and extended over the entire clinically important range of
      pH, rather than being a terminal event. This study, which, to our knowledge, is
      the first to use the conductance catheter to measure fetal left ventricular
      function demonstrates that hypoxic acidemia adversely affects myocardial
      contractility assessed by end-systolic elastance.

PMID- 8356017
TI  - Hemodynamic parameters of stage 20 to stage 35 chick embryo.
AB  - Hemodynamic parameters of the chick embryo from stage 20 (3 d of a 21-d
      incubation) up to stage 35 (8 d) are described. Normal values of dorsal aortic
      flow velocity wave forms were measured with a 20-MHz directional-pulsed Doppler
      velocity meter that was validated to be accurate above 5 mm/s. An analysis of
      variance was carried out for each of the flow velocity parameters. The
      correlation coefficient that represents the reproducibility was satisfactory (r >
      0.90). There was a 17-fold rise in mean dorsal aortic blood flow (mm3/s). Heart
      rate doubled from 123 +/- 12 to 239 +/- 8 bpm, and stroke volume increased from
      0.14 +/- 0.08 to 1.28 +/- 0.55 mm3. A stage-related rise was seen in peak
      systolic and mean velocities and peak acceleration. These data may serve as a
      basis for flow velocity wave form investigation and interpretation in
      developmental stages of cardiac malformations.

PMID- 8356018
TI  - Sympathoadrenal, metabolic, and regional blood flow responses to cold in fetal
      sheep.
AB  - Because environmental temperature falls when the fetus is delivered from the
      uterus, the role of cold in stimulating cardiovascular and sympathoadrenal
      responses at the time of birth was examined in fetal lambs. In eight fetuses
      (gestational age 140 +/- 2 d), catheters were inserted into hind-limb and neck
      arteries and veins, and into an umbilical vein. After returning the fetus to the
      uterus and administering a muscle relaxant (succinylcholine chloride), blood
      gases, glucose and lactate concentrations, and plasma catecholamine and atrial
      natriuretic peptide concentrations were measured. Fetal combined ventricular
      output and organ blood flows were measured by the radionuclide-labeled
      microsphere technique. Measurements were repeated after delivering the fetus into
      a warm water bath (40 degrees C) and at 15 and 30 min after the bath temperature
      was cooled to 25 degrees C. Fetal cooling stimulated a sympathoadrenal response,
      which was manifested by an immediate increase in heart rate and arterial blood
      pressure, a rise in atrial natriuretic peptide, and modest increase in
      norepinephrine concentration. Contrary to earlier reports that investigated the
      effect of cold on fetal lambs using an intrauterine cooling coil, we did not find
      a decrease in fetal arterial oxygen tensions and pH, an increase in plasma
      glucose and lactate concentrations, or changes in fetal oxygen consumption.
      Combined ventricular output did not increase with cooling, and blood flow to most
      organs did not change significantly; however, blood flow to the skin decreased
      markedly, particularly in the lower body.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8356019
TI  - Carotid, not aortic, chemoreceptors mediate the fetal cardiovascular response to
      acute hypoxemia in lambs.
AB  - The fetal cardiovascular response to acute hypoxemia consists of a decrease in
      heart rate, a variable change in mean arterial pressure, and an increase in
      peripheral vascular resistance. This response is mediated by the arterial
      chemoreceptors. To determine whether chemoreceptors in the carotid artery or in
      the aorta mediate the fetal cardiovascular response to acute hypoxemia, we
      studied the response to acute hypoxemia in fetal lambs at 125 to 130 d of
      gestation after selective carotid (six fetuses) or aortic (five fetuses)
      denervation. One to 3 d after insertion of catheters, hypoxemia was induced by
      inflating a balloon occluder around the ewe's hypogastric artery or by giving the
      ewe 95% N2 and 5% O2 to breathe. The chemoreflex response was measured as
      decrease in heart rate per decrease in Hb O2 saturation. To validate our results,
      we also studied the response to chemical stimulation of the chemoreceptors by
      injection of sodium cyanide into the inferior vena cava. We found that carotid
      denervation abolished the heart rate and peripheral vascular resistance responses
      to hypoxemia but that aortic denervation did not. Responses after injection of
      sodium cyanide were similar to those seen during acute hypoxemia. We conclude
      that the carotid chemoreceptors, and not the aortic chemoreceptors, mediate the
      fetal cardiovascular response to acute hypoxemia.

PMID- 8356020
TI  - Brainstem bilirubin toxicity in the newborn primate may be promoted and reversed
      by modulating PCO2.
AB  - The auditory brainstem response (ABR) was monitored during infusion of bilirubin
      in six ventilated newborn rhesus monkeys (138-145 d gestation) while acute
      changes in pH were produced by varying inspired CO2. Prolonged respiratory
      acidosis without bilirubin infusion produced minimal changes in the ABR (one
      animal). CO2 exposure, usually initiated when the bilirubin level reached
      approximately 20 mg/dL, decreased arterial pH to values ranging from 6.85 to
      7.10. ABR changes, including prolongation of the wave II-IV peak to peak
      intervals and decreased wave amplitudes, first developed 2-4 h after initial
      exposure to CO2. Total and unbound bilirubin levels at this time ranged from 376
      to 564 mumol/L (22-33 mg/dL) and 38 to 65 nmol/L (2.5-3.8 micrograms/dL),
      respectively. Correction of respiratory acidosis produced partial to complete
      reversal of ABR changes within 3 to 20 min. Reexposure to CO2 immediately
      reproduced the ABR abnormality. Production and reversal of the abnormal ABR was
      obtained through two to three cycles in three animals. Thus, when the brainstem
      bilirubin level was near the threshold for toxicity, the effect of changes in
      PCO2 on the ABR were immediate, suggesting that auditory pathway toxicity is
      initially mediated by a reversible pH-dependent bilirubin-membrane complex. In
      contrast to humans, in monkeys auditory toxicity appeared to be a late
      manifestation of bilirubin toxicity, inasmuch as all monkeys were obtunded and
      apneic 30-70 min before ABR abnormalities appeared. Notwithstanding these
      limitations, the results support the hypothesis that bilirubin toxicity can be
      both promoted and reversed by modulating brain pH.

PMID- 8356021
TI  - Glucose but not a mixed amino acid infusion regulates plasma insulin-like growth
      factor-I concentrations in fetal sheep.
AB  - The influence of fetal glucose and amino acid supply on the regulation of fetal
      plasma IGF-I levels was investigated in fetuses from starved ewes. Paired
      maternal and fetal blood samples were taken during an initial 2-d control period,
      after 48 h of maternal starvation, during a 24-h fetal infusion of glucose (n =
      6) or an amino acid mixture (Synthamin 17, n = 5) with continued starvation, and
      after 48 h of maternal refeeding. After 48 h of starvation, maternal and fetal
      plasma IGF-I, insulin, and blood glucose fell significantly in both groups
      compared with control values (IGF-I for glucose group: maternal, -18.53 +/- 6.60;
      fetal, -5.23 +/- 1.81 nmol/L; amino acid group: maternal, -18.2 +/- 6.97, fetal, 
      5.12 +/- 1.61 nmol/L; both p < 0.05). Fetal glucose but not mixed amino acid
      infusion raised fetal plasma IGF-I, insulin, and blood glucose to near control
      values (glucose group fetal IGF-I, -1.77 +/- 1.98; amino acid group, -5.93 +/-
      2.22 nmol/L; both p < 0.05). Maternal plasma IGF-I remained depressed during
      glucose infusion (-16.33 +/- 8.32 nmol/L), but continued to fall in the amino
      acid group (-21.41 +/- 8.20 nmol/L, p < 0.05). After 48 h of maternal refeeding,
      all values had returned to near control values for both groups (glucose group IGF
      I: maternal, -5.2 +/- 3.86; fetal, 0.01 +/- 2.2; nmol/L; amino acid group:
      maternal, -11.66 +/- 3.2; fetal, -0.70 +/- 2.61 nmol/L). We conclude that in the
      ovine fetus glucose may have a more important role than amino acids in the
      regulation of fetal plasma IGF-I.

PMID- 8356022
TI  - In vitro insulin-like growth factor-I, growth hormone, and insulin resistance
      occurs in symptomatic human immunodeficiency virus-1-infected children.
AB  - Poor growth is a common feature of symptomatic children (Centers for Disease
      Control stage P2) infected with human immunodeficiency virus-1 (HIV-1). However,
      several previous studies have failed to show any relationship between serum
      hormone levels and poor growth. To assess the roles of hormone deficiency and
      hormone resistance in the development of poor growth in HIV-1-infected children,
      we studied six asymptomatic Centers for Disease Control stage P1 [height SD score
      = 0.01 +/- 1.0 (mean +/- SD)], 10 P2 (height SD score = -2.0 +/- 1.0), and six
      short, normal children (height SD score = -2.4 +/- 1.2). Mean weight:height SD
      scores were similar in all three groups, suggesting that gross nutritional status
      did not differ between groups. There were no significant differences between
      groups with respect to mean plasma levels of IGF-I, thyroid hormones, TSH, and
      cortisol. As an index of hormone sensitivity, we quantified in vitro colony
      formation of erythroid progenitor cells, isolated from peripheral blood of study
      subjects, in response to IGF-I, growth hormone (GH), and insulin. P2 subjects had
      a quantitative mean reduction in erythroid progenitor cells colony formation in
      response to IGF-I of 32% compared with P1 subjects (p = 0.001 by analysis of
      variance) and 21% compared with controls (p = 0.006); in response to GH of 21%
      compared with controls (p = 0.015); and in response to insulin of 35% compared
      with P1 subjects (p = 0.038) and 34% compared with controls (p = 0.004).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8356023
TI  - Influence of treatment on the maturation of the somesthetic pathway in infants
      with primary congenital hypothyroidism during the first year of life.
AB  - To assess the influence of treatment on the development of the somesthetic
      pathway in infants with congenital hypothyroidism receiving early treatment,
      median nerve somatosensory evoked potentials were measured during the 1st y of
      life. Twenty-nine infants were studied with six to seven somatosensory evoked
      potential tests per infant. The cervical latency (N13) divided by arm length and
      the first (N19) and second (N32) cephalic latencies as well as N13-N32 latency
      were measured. At diagnosis, all components showed a small but significant delay,
      which was not related to thyroxine (T4) levels before treatment. During
      treatment, T4 ranged from 50 to 290 nmol/L. At 12 mo, the cervical latency
      divided by arm length had normalized, whereas N19 and N13-N32 were more abnormal
      than at diagnosis. For N19, these abnormalities were related to a slow initial
      rise of T4 (< or = 100 nmol/L after 1 wk of treatment) and the initial N19
      values. Abnormal N13-N32 values were associated with high T4 values during
      treatment (> 200 nmol/L) and the type of congenital hypothyroidism (partial or
      total deficiency in T4 production). Induction of therapy with l-triiodothyronine
      rather than l-thyroxine and the occurrence of low T4 values (< 100 nmol/L) after
      the 4th wk of therapy had no such effect. Our data suggest that, for normal CNS
      development, euthyroidism should be reached as soon as possible by adequate
      induction therapy. Thereafter, T4 supplementation should be strictly dosed,
      keeping the serum T4 values within narrow limits around the mean normal for age,
      because overtreatment, like initial undertreatment, may lead to CNS abnormalities
      at the end of the first year.

PMID- 8356024
TI  - The role of I and B in peritonitis associated with the nephrotic syndrome of
      childhood.
AB  - Children with nephrotic syndrome (NS) are susceptible to bacterial infections,
      including primary bacterial peritonitis. Immunologic abnormalities associated
      with NS include low serum levels of the complement proteins I and B of the
      alternative complement pathway. We developed a novel and highly sensitive enzyme
      immunoassay using murine MAb to I and B to quantitate urinary concentrations of
      these proteins. We studied 22 patients with minimal change NS, including seven
      with a history of peritonitis (1.6 +/- 0.3 episodes, mean +/- SEM) and 15 without
      such a history. The two groups did not differ significantly in age, sex, race,
      age at onset of disease, or duration of disease. Children with minimal change NS
      complicated by peritonitis had 1) increased urinary excretion of both I (p <
      0.05) and B (p < 0.05) in relapse versus remission, 2) greater excretion of I in
      both relapse (p < 0.01) and remission (p < 0.05) compared with patients without
      peritonitis, 3) greater excretion of B in relapse compared with patients without
      peritonitis (p < 0.05), and 4) decreased plasma levels of I compared with
      patients without peritonitis and controls (p < 0.01) and decreased plasma levels
      of B compared with controls. Increased urinary excretion of I correlated with
      decreased plasma levels of I (r = 0.88, p < 0.001). These data support our
      initial hypothesis that depressed plasma concentrations of these proteins of the
      alternative complement pathway may predispose patients with minimal change NS to
      peritonitis and that urinary loss of these proteins is a tenable mechanism.

PMID- 8356025
TI  - Renal handling of carnitine in secondary carnitine deficiency disorders.
AB  - Reduced plasma and tissue concentrations of carnitine, a cofactor required for
      fatty acid oxidation, are present in patients with inherited disorders of
      mitochondrial acyl-CoA oxidation that are associated with accumulations of
      acylcarnitines. To determine whether the secondary carnitine deficiency in these
      patients is due to excessive urinary loss of acylcarnitines, the development of
      carnitine deficiency was examined in patients with four different acyl-CoA
      oxidation disorders, including medium-chain and long-chain fatty acyl-CoA
      dehydrogenase deficiencies, isovaleric acidemia, and propionic acidemia. After a
      3-mo period of treatment with oral carnitine to raise plasma total carnitine
      concentrations to or above normal, patients were started on a carnitine-free diet
      and the changes in plasma total and free carnitine levels and urinary total and
      free carnitine excretion were followed for 5 d. Patients with all four disorders
      showed a return of plasma carnitine levels and urinary carnitine excretion to
      baseline within 2 to 4 d. The rapidity of these changes could not be explained
      solely by excessive acylcarnitine wasting. Continued excretion of free carnitine
      in all patients indicated the additional presence of an impairment in renal
      transport of free carnitine. Consistent with this interpretation, estimates of
      renal thresholds for free carnitine gave values that were less than that for a
      control child in all four disorders and ranged as low as one half those reported
      in normal individuals. These results suggest that secondary carnitine deficiency
      in the acyl-CoA oxidation disorders is due to indirect as well as direct effects
      of accumulated acylcarnitines.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8356027
TI  - A season of new challenges. 4th Annual Fall Institute. Oncology Nursing Society.
      Seattle, Washington, October 29-31, 1993. Program.

PMID- 8356026
TI  - Evidence for human placental synthesis of 24,25-dihydroxyvitamin D3 and 23,25
      dihydroxyvitamin D3.
AB  - The two principal dihydroxylated metabolites of the vitamin D prohormone 25
      hydroxyvitamin D3 [25(OH)D3] are 1 alpha,25-dihydroxyvitamin D3 [1,25(OH)2D3, the
      active hormone] and 24R,25-dihydroxyvitamin D3 [24,25(OH)2D3, a putative
      regulator of developmental bone formation]. Although several studies have
      demonstrated placental synthesis of 1,25(OH)2D3 from 25(OH)D3, placental
      production of 24,25(OH)2D3 has not been thoroughly investigated. Therefore, we
      studied 25(OH)D3 metabolism in term human placenta using a villous explant model
      and cultures of isolated trophoblast and villous mesenchymal cells. We determined
      that both vitamin D-replete and vitamin D-deficient trophoblast metabolize
      25(OH)D3 predominantly via 24-hydroxylation. Placental 24,25(OH)2D3 was
      identified by cochromatography with authentic standard on four different HPLC
      systems, scanning UV spectrophotometry profile of the metabolite, sensitivity to
      periodate cleavage, and mass spectrometry of the putative placental 24,25(OH)2D3
      and its periodate cleavage product. We also identified for the first time
      placental synthesis of 23,25(OH)2D3 using cochromatography with authentic
      standard on two different HPLC systems, scanning UV spectrophotometry, resistance
      to periodate cleavage, and mass spectrometry. When trophoblast was incubated for
      up to 4 h with physiologic concentrations of [3H]25(OH)D3 (6 nM) significant
      amounts of [3H]24,25(OH)2D3 were produced, but [3H]1,25(OH)2D3 could not be
      consistently detected. In contrast, when we incubated trophoblast with
      supraphysiologic concentrations of 25(OH)D3 (6-10 microM), both 24,25(OH)2D3 and
      1,25(OH)2D3 were synthesized. These results provide unequivocal evidence for
      placental synthesis of both 24,25(OH)2D3 and 23,25(OH)2D3.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8356028
TI  - Structures of the "open" and "closed" state of trypanosomal triosephosphate
      isomerase, as observed in a new crystal form: implications for the reaction
      mechanism.
AB  - The structure of trypanosomal triosephosphate isomerase (TIM) has been solved at
      a resolution of 2.1A in a new crystal form grown at pH 8.8 from PEG6000. In this
      new crystal form (space group C2, cell dimensions 94.8 A, 48.3 A, 131.0 A, 90.0
      degrees, 100.3 degrees, 90.0 degrees), TIM is present in a ligand-free state. The
      asymmetric unit consists of two TIM subunits. Each of these subunits is part of a
      dimer which is sitting on a crystallographic twofold axis, such that the crystal
      packing is formed from two TIM dimers in two distinct environments. The two
      constituent monomers of a given dimer are, therefore, crystallographically
      equivalent. In the ligand-free state of TIM in this crystal form, the two types
      of dimer are very similar in structure, with the flexible loops in the "open"
      conformation. For one dimer (termed molecule-1), the flexible loop (loop-6) is
      involved in crystal contacts. Crystals of this type have been used in soaking
      experiments with 0.4 M ammonium sulphate (studied at 2.4 A resolution), and with
      40 microM phosphoglycolohydroxamate (studied at 2.5 A resolution). It is found
      that transfer to 0.4 M ammonium sulphate (equal to 80 times the Ki of sulphate
      for TIM), gives rise to significant sulphate binding at the active site of one
      dimer (termed molecule-2), and less significant binding at the active site of the
      other. In neither dimer does sulphate induce a "closed" conformation. In a mother
      liquor containing 40 microM phosphoglycolohydroxamate (equal to 10 times the Ki
      of phosphoglycolohydroxamate for TIM), an inhibitor molecule binds at the active
      site of only that dimer of which the flexible loop is free from crystal contacts
      (molecule-2). In this dimer, it induces a closed conformation. These three
      structures are compared and discussed with respect to the mode of binding of
      ligand in the active site as well as with respect to the conformational changes
      resulting from ligand binding.

PMID- 8356029
TI  - Conformational deformation in deoxymyoglobin by hydrostatic pressure.
AB  - Pressure effect on the equilibrium conformation in sperm whale deoxymyoglobin and
      its volume fluctuation are studied by the normal mode analysis and strain tensor
      analysis. The pressure-induced deformation of interhelix regions are found to be
      remarkably more compressed than the other parts of the molecule. The intrahelix
      compressibility is shown to be relatively small. We also calculate the
      compressibility of the three hydrophobic clusters, located at the bottom, distal,
      and proximal side of the heme. Its value is found to decrease in the indicated
      order. The average compressibility of these hydrophobic clusters is less than the
      average interhelix compressibility, even though there are large cavities in these
      clusters. In order to study overall deformation, we define a linear
      compressibility and calculate it for all pairs of C alpha atoms. The pressure
      induced deformation is observed to be heterogeneous also in this analysis. The
      calculated root-mean-square displacement of the constituent atoms in the
      equilibrium conformation at 1,000 atm from those at 0 atm is 0.12 A, which is
      much smaller in magnitude than the average value of the atomic fluctuations at
      room temperature. In the water solvent, the volume excluded by the protein
      molecule in the equilibrium conformation is reduced by 0.9%, when the pressure is
      raised from 0 to 1,000 atm. The calculated magnitude of the root-mean-square
      volume fluctuation is 0.3% of the excluded volume at room temperature. The square
      of the volume fluctuation is given as a sum of contributions from individual
      normal modes. Contributions from low frequency normal modes are found to dominate
      over those from higher frequency normal modes. The estimated value of the
      isothermal compressibility of deoxymyoglobin is 9.37 x 10(-12) cm2/dyn.

PMID- 8356030
TI  - Secondary structural features of modules M2 and M3 of barnase in solution by NMR
      experiment and distance geometry calculation.
AB  - Proteins consist of structural units such as globular domains, secondary
      structures, and modules. Modules were originally defined by partitioning a
      globular domain into compact regions, each of which is a contiguous polypeptide
      segment having a compact conformation. Since modules show close correlations with
      the intron positions of genes, they are regarded as primordial polypeptide pieces
      encoded by exons and shuffled, leading to yield new combination of them in early
      biological evolution. Do modules maintain their native conformations in solution
      when they are excised at their boundaries? In order to find answers to this
      question, we have synthesized modules of barnase, one of the bacterial RNases,
      and studied the solution structures of modules M2 (amino acid residues 24-52) and
      M3 (52-73) by 2D NMR studies. Some local secondary structures, alpha-helix, and
      beta-turns in M2 and beta-turns in M3, were observed in the modules at the
      similar positions to those in the intact barnase but the overall state seems to
      be in a mixture of random and native conformations. The present result shows that
      the excised modules have propensity to form similar secondary structures to those
      of the intact barnase.

PMID- 8356031
TI  - Localization of hydrogen-bonds within modules in barnase.
AB  - Proteins in eukaryotes are composed of structural units, each encoded by discrete
      exons. The protein module is one such structural unit; it has been defined as the
      least extended or the most compact contiguous segment in a globular domain. To
      elucidate roles of modules in protein evolution and folding, we examined roles of
      hydrogen bonds and hydrophobic cores, as related to the stability of these
      modules. For this purpose we studied barnase, a bacterial RNase from Bacillus
      amylolique-faciens. Barnase is decomposed into at least six modules, M1-M6; the
      module boundaries are identified at amino acid residues 24, 52, 73, 88, and 98.
      Hydrogen bonds are localized mainly within each of the modules, with only a few
      between them, thereby indicating that their locations are designed to primarily
      stabilize each individual module. To obtain support for this notion, an analysis
      was made of hypothetical modules defined as segments starting at a center of one
      module and ending at the center of the following one. We found that the hydrogen
      bonds did not localize in each hypothetical module and that many formed between
      the hypothetical modules. The native conformations of modules of barnase may be
      specified predominantly by interactions within the modules.

PMID- 8356032
TI  - Crystal structure of Escherichia coli TEM1 beta-lactamase at 1.8 A resolution.
AB  - The X-ray structure of Escherichia coli TEM1 beta-lactamase has been refined to a
      crystallographic R-factor of 16.4% for 22,510 reflections between 5.0 and 1.8 A
      resolution; 199 water molecules and 1 sulphate ion were included in refinement.
      Except for the tips of a few solvent-exposed side chains, all protein atoms have
      clear electron density and refined to an average atomic temperature factor of 11
      A2. The estimated coordinates error is 0.17 A. The substrate binding site is
      located at the interface of the two domains of the protein and contains 4 water
      molecules and the sulphate anion. One of these solvent molecules is found at
      hydrogen bond distance from S70 and E166. S70 and S130 are hydrogen bonded to K73
      and K234, respectively. It was found that the E. coli TEM1 and Staphylococcus
      aureus PC1 beta-lactamases crystal structures differ in the relative orientations
      of the two domains composing the enzymes, which result in a narrowed substrate
      binding cavity in the TEM1 enzyme. Local but significant differences in the
      vicinity of this site may explain the occurrence of TEM1 natural mutants with
      extended substrate specificities.

PMID- 8356033
TI  - Molecular dynamics study of structure and stability of a model coiled coil.
AB  - This paper employs methods used earlier to study helix propensity in a model
      alpha-helix. The methods are extended to simulations of a motif structure of the
      alpha-helical coiled coil, i.e., a structure with a simple amino acid sequence,
      containing only alanine, leucine, and valine, with leucine and valine forming
      hydrophobic contacts in the helix interface (positions "d" and "a"). Dynamic
      simulations of the model coiled-coil structure reproduce characteristic features
      of the coiled-coil motif seen in experimental studies. Free energy simulations
      were used to assess the change in stability of the model when a leucine pair or a
      valine pair in the helix interface was replaced with an alanine pair. A leucine
      pair at position d was found to contribute 3.4 kcal/mol to the stability of the
      coiled coil relative to an alanine pair, and a valine pair at position a was
      found to contribute 0.8 kcal/mol relative to an alanine pair. The value for the
      leucine pair agrees with reports in two experimental studies with molecules
      having different amino sequence. The value for the valine pair is reasonable
      given the smaller size of the valine side chain and the intrinsic low helix
      propensity of valine. No experimental value was available for comparison.

PMID- 8356034
TI  - An analysis of the conformational paths of citrate synthase.
AB  - Previous simulation studies have provided reaction pathways leading from the
      closed to the open form of citrate synthase. We now undertake a detailed analysis
      of these pathways using a variety of different tools including backbone dihedral
      angles, P-Curves helicoidal parameters, inter-helix geometrical parameters, and
      accessibility calculations. The results point to a relatively small number of
      residues, mostly in loop regions, which are responsible for the majority of the
      conformational changes observed. An important role is attributed to transient
      changes in the backbone which facilitate movement along the reaction coordinate.
      Comparisons between the two pathways show that they share many common features
      despite the different algorithms used to generate them.

PMID- 8356035
TI  - Normal mode analysis of mouse epidermal growth factor: characterization of the
      harmonic motion.
AB  - Normal mode analysis of mouse epidermal growth factor (mEGF) has been carried out
      at room temperature. The value of the lowest frequency is 4.1 cm-1. This mode
      corresponds to hinge-bending motion between the N-terminal and C-terminal domains
      of mEGF. This hinge-bending motion corresponds to the "mitten mode." In this
      motion, the N-terminal domain is almost rigid. However, the C-terminal domain is
      found to consist of three rigid segments. Two segments, C33-D46 and G51-R53, are
      observed moving in the same direction, but L47-W50 moves in the opposite
      direction. For this mode, the effective Young's modulus turned out to be 1.1 x
      10(9) dyn.cm-2. This value is a little larger than that of the mode with the
      lowest frequency 4.4 cm-1 of BPTI. The difference may be related to the fraction
      of residues involved in beta-sheets in the molecule. Similar analyses are carried
      out for other low frequency modes.

PMID- 8356036
TI  - Levels of DNA polymorphism and divergence yield important insights into
      evolutionary processes.

PMID- 8356037
TI  - A new use for intracellular antibody expression: inactivation of human
      immunodeficiency virus type 1.

PMID- 8356038
TI  - Protein-DNA complexes: the cost of recognition.

PMID- 8356040
TI  - Peroxisome biogenesis in the yeast Hansenula polymorpha is controlled by a
      complex set of interacting gene products.
AB  - We have studied the genetic interactions between mutant alleles in 12 genes,
      designated PER1-PER12, which are essential for peroxisome biogenesis in the yeast
      Hansenula polymorpha. Recessive mutations in any of these genes determined three
      different morphological phenotypes: (i) complete absence of peroxisomes (Per-);
      (ii) presence of small peroxisomes in conjunction with a major fraction of
      peroxisomal matrix proteins in the cytosol (Pim-); and (iii) presence of
      peroxisomes with aberrant crystalline matrix substructure (Pss-). Extensive
      complementation analysis showed many cases of noncomplementation--that is,
      diploids that contained both wild-type and mutant alleles of two different PER
      genes were unable to grow on methanol and showed peroxisomal defects. The
      observed cases of unlinked noncomplementation appeared to be gene and allele
      specific and were predominantly observed at lower temperatures (cold sensitive).
      The genetic results obtained were used to formulate a model of PER gene product
      interactions. In this model, five PER gene products are key or core components of
      the complex. Other PER gene products appear to play a more peripheral role.

PMID- 8356039
TI  - Cloning a plant amino acid transporter by functional complementation of a yeast
      amino acid transport mutant.
AB  - Amino acids are transported across the plasma membrane of plant cells by proton
      amino acid symports. We report here the successful cloning of a neutral amino
      acid carrier by functional complementation. A histidine transport deletion mutant
      of Saccharomyces cerevisiae was transformed with an Arabidopsis thaliana cDNA
      library constructed in a yeast expression vector. Forty transformants, out of
      10(5), allowed growth on a histidine-limiting medium. The acquired ability to
      grow on low histidine was shown to be strictly dependent on the protein encoded
      by the expression plasmid. Histidine and alanine transport activity were 10- to
      20-fold greater in the transformants. The transport kinetics, inhibitor
      sensitivity, and substrate specificity match those of neutral system II, a
      neutral amino acid carrier we previously described in plasma membrane vesicles
      isolated from leaf tissue. The cDNA insert is 1.7 kb with an open reading frame
      that codes for a protein containing 486 amino acids with a calculated molecular
      mass of 52.9 kDa and three sites of potential N-linked glycosylation. Hydropathy
      analysis of the deduced amino acid sequence suggests this is an integral membrane
      protein with 10-12 membrane-spanning alpha-helices. Overall, the sequence of this
      amino acid carrier is not closely related to any other protein sequences in the
      GenBank data base. Interestingly, however, there are small regions of sequence
      that exhibit significant levels of similarity with at least seven other integral
      membrane proteins.

PMID- 8356041
TI  - Evidence for adaptive evolution of the G6pd gene in the Drosophila melanogaster
      and Drosophila simulans lineages.
AB  - Proponents of the neutral theory argue that evolution at the molecular level
      largely reflects a process of random genetic drift of neutral mutations. Under
      this theory, levels of interspecific divergence and intraspecific polymorphism
      are expected to be correlated across classes of nucleotide or amino acid
      sequences with different degrees of functional constraint, such as synonymous and
      replacement sites. Nucleotide sites with reduced polymorphism should show
      comparably reduced levels of interspecific divergence. To examine this
      hypothesis, we have sequenced 32 and 12 copies of the glucose-6-phosphate
      dehydrogenase (G6pd) gene in Drosophila melanogaster and Drosophila simulans,
      respectively. Both species exhibit similar levels of nucleotide polymorphism at
      synonymous sites. D. melanogaster shows two amino acid polymorphisms, one
      associated with the cosmopolitan allozyme polymorphism and a second with an
      allozyme polymorphism endemic to European and North African populations. In
      contrast, D. simulans shows no replacement polymorphism. While synonymous
      divergence between species is 10%, which is typical of other genes, there are 21
      replacement differences. This level of amino acid sequence divergence, when
      contrasted with levels of amino acid polymorphism, silent polymorphism, and
      divergence, is in 10-fold excess over that expected under the neutral model of
      molecular evolution. We propose that this excess divergence reflects episodes of
      natural selection on G6pd resulting in fixation of advantageous amino acid
      mutations in these two recently separated lineages.

PMID- 8356043
TI  - Photochemically induced cataracts in rat lenses can be prevented by AL-3823A, a
      glutathione peroxidase mimic.
AB  - Oxidative stress is known to cause cataracts in lens culture systems and is
      believed to be an important factor contributing to human cataracts. In this
      communication, it is demonstrated that cataract development of cultured rat
      lenses produced as a result of photochemically induced oxidation in a 4% oxygen
      atmosphere similar to the native environment of the lens can be blocked by the
      transition metal complex AL-3823A. In this system, riboflavin is added to the
      medium as a photosensitizer. AL-3823A acts primarily as a glutathione peroxidase
      mimic, which catalytically metabolizes H2O2 and also has low superoxide dismutase
      like activity. Measurements of H2O2, O2.-, and OH. indicate that appreciable
      levels of the first two of these oxidants and low levels of OH. are produced by
      this photochemical stressing system. The H2O2 concentrations are similar to those
      found in some patients with cataracts. The development of cataracts was followed
      over a 96-hr period. Transparency, hydration, glyceraldehyde-3-phosphate
      dehydrogenase activity, and protein and nonprotein thiol were monitored. All
      parameters show marked changes during the 96-hr period. However, in the presence
      of 200 microM AL-3823A, no difference between control and light-exposed lenses
      was observed with respect to these parameters. The results suggest that in vivo
      human cataract development caused by oxidative stress may be prevented by
      compounds of this type.

PMID- 8356042
TI  - The synonymous substitution rate of the major histocompatibility complex loci in
      primates.
AB  - Because the divergence of many allelic lineages at the major histocompatibility
      complex (MHC) loci predates species divergence, standard methods of calculating
      synonymous substitution rates are not applicable to this system. We used three
      alternative methods of rate estimation: one based on the minimum number of
      substitutions (Dm), another on the nucleotide difference (Dxy), and the third on
      the net nucleotide difference (Dn). We applied these methods to the protein
      encoding sequences of primate MHC class I (A, B, and C) and class II (DRB1)
      genes. To determine the reliability of the different estimates, we carried out
      computer simulation. The distribution of the estimates based on Dxy or Dn is
      generally much broader than that based on Dm. More importantly, the Dm-based
      method nearly always has the highest probability of recovering true rates,
      provided that Dm is not smaller than 5. Because of its desirable statistical
      properties, we used the Dm-based method to estimate the rate of synonymous
      substitutions. The rate is 1.37 +/- 0.61 for A, 1.84 +/- 0.40 for B, 3.87 +/-
      1.05 for C, and 1.18 +/- 0.36 for DRB1 loci, always per site per 10(9) years.
      Hence despite the extraordinary polymorphism, the mutation rate at the primate
      MHC loci is no higher than that of other loci.

PMID- 8356044
TI  - A closed curve is much more than an incomplete one: effect of closure in figure
      ground segmentation.
AB  - Detection of fragmented closed contours against a cluttered background occurs
      much beyond the local coherence distance (maximal separation between segments) of
      nonclosed contours. This implies that the extent of interaction between locally
      connected detectors is boosted according to the global stimulus structure. We
      further show that detection of a target probe is facilitated when the probe is
      positioned inside a closed circle. To explain the striking contour segregation
      ability found here, and performance enhancement inside closed boundaries, we
      propose the existence of a synergetic process in early vision.

PMID- 8356045
TI  - Molecular and structural composition of phospholipid membranes in livers of
      marine and freshwater fish in relation to temperature.
AB  - The compositions and physical states of the liver phospholipids of marine and
      freshwater fish adapted to relatively constant but radically different
      temperatures were investigated. Fish adapted to low temperature (5-10 degrees C)
      accumulated more unsaturated fatty acids than those in a warm (25-27 degrees C)
      environment. There were no measurable differences in the gross fatty acid
      compositions of the total liver phospholipids from identical thermal
      environments. Docosahexaenoic acid (22:6) did not seem to participate in the
      process of adaptation. Cold adaptation was coincidental with oleic acid (18:1)
      accumulation, preferentially in the phosphatidylethanolamine. Determination of
      the molecular species composition of phosphatidylethanolamine revealed a 2- to 3
      fold and 10-fold increase in the level of 18:1/22:6 and 18:1/20:5 species,
      respectively. ESR spectroscopy revealed a 7-10% compensation in the ordering
      state of native phospholipids with temperature. Combination of 16:0/22:6
      phosphatidylcholine with phosphatidylethanolamines of cold-adapted marine fish
      showed a drastic fluidization near the C-2 segment of the bilayer, but not in the
      deeper regions. An appropriate combination (75:25) of phosphatidylcholines from
      warmth-adapted marine fish with phosphatidylethanolamines from cold-adapted
      marine fish mimicked a 100% adaptational efficacy in the C-2 segment as compared
      with the phosphatidylethanolamines of warmth-adapted marine fish. A specific role
      of 18:1/22:6 phosphatidylethanolamine in controlling membrane structure and
      physical state with thermal adaptation is proposed.

PMID- 8356047
TI  - Plants transformed with a cistron of a potato virus Y protease (NIa) are
      resistant to virus infection.
AB  - An oligonucleotide carrying signals for translation initiation in plants was
      engineered upstream to a cDNA clone containing nucleotides 5812-7260 of the
      potato virus Y (PVY) genome. This fragment contains all but the first 100 5'
      terminal bases of the cistron encoding one of the PVY proteases (NIa) as well as
      the first 251 bases of the next cistron (NIb). Nicotiana tabacum cv. SR1 plants
      were transformed with this fragment. The presence of the NIa sequences in
      transformed plants was determined by hybridization or PCR, and its expression was
      ascertained by reverse transcription coupled to PCR. Plants expressing NIa were
      self-pollinated, and the R1 kanamycin-resistant progeny were rechecked for NIa
      expression. Several of these plants were found to be resistant to PVY infection,
      inasmuch as they did not develop symptoms for at least 50 days (the duration of
      the experiments), and no viral accumulation could be detected in their leaves by
      ELISA. All of the descendents of resistant homozygous R2 plants were also
      resistant. Several of the plants transformed with the last three cistrons of PVY
      (bases 5812-9704; NIa-NIb-coat protein) were also resistant to PVY. None of the
      transformed plants exhibited resistance to tobacco mosaic virus. Exposure of the
      plants to 35 degrees C for 48 hr prior to inoculation lowered, but did not
      abolish, resistance.

PMID- 8356046
TI  - Triplet structure of von Willebrand factor reflects proteolytic degradation of
      high molecular weight multimers.
AB  - High molecular weight (HMW) and low molecular weight (LMW) forms of von
      Willebrand factor (vWF) were isolated from normal human plasma in the presence of
      protease inhibitors. HMW and LMW vWF preparations were subjected to reduction of
      interdimeric disulfide bridges under mild reducing conditions. Following sodium
      dodecyl sulfate electrophoresis in 3% agarose, the vWF bands were detected by
      immunoblotting with a polyclonal rabbit anti-vWF antiserum as well as with two
      monoclonal antibodies directed against epitopes located in the NH2-terminal (MAb
      418) or in the COOH-terminal (MAb 9) region of the vWF subunit. Our results
      suggest that the slowest migrating band of the dimeric triplet set of LMW vWF
      represents an asymmetric structure composed of an intact subunit to which one NH2
      terminal and one COOH-terminal fragment are linked by disulfide bridges. The
      intermediate band of the first triplet of LMW vWF strongly reacted with MAb 9 but
      not with MAb 418, indicating that it represents a dimer of COOH-terminal
      fragments. The fastest migrating band of the same triplet is apparently a dimer
      of the NH2-terminal fragments because it reacted with MAb 418 but not with MAb 9.
      Each next higher family of triplets seems to contain one more asymmetric fragment
      of dimeric size. These results are compatible with a model according to which LMW
      forms of vWF are derived from HMW vWF by proteolytic cleavage in the circulating
      blood.

PMID- 8356048
TI  - Molecular mechanics calculations of the structures of polyamide nucleic acid DNA
      duplexes and triple helical hybrids.
AB  - Polyamide nucleic acids (PNAs) have emerged as useful agents for recognition of
      single- and double-stranded nucleic acids. Interresidue hydrogen bonds between
      the amide carbonyl nearest the nucleobase and chain NH moieties provide inherent
      stability to the helical conformation of PNA 1. Moving the amide carbonyl away
      from the nucleobase to the backbone, and replacing it with a methylene group,
      results in 2 lacking the stabilizing hydrogen bond. Oligomers of 2 do not
      interact with DNA. Modeling suggests that 2 displays a more extended conformation
      than 1, and nucleobase orientation is disrupted in 2 in the absence of a
      complementary DNA strand. This is in contrast to 1, which retains a
      centrosymmetric arrangement of nucleobases. Structures for 1-T10.DNA and (1
      T10)2.DNA species spanned by a pyrimidine strand (D-loop) were constructed. In
      the triple helical (1-T10)2.DNA structure, the two PNA strands form the
      complementary Watson-Crick paired strand and the Hoogsteen base-paired strand in
      the major groove of the 1.DNA duplex. The PNA strands are proposed to bind
      antiparallel to one another in (1-T10)2.DNA structure. The factors suggested to
      account for the stability of this 2:1 complex are (i) a hydrophobic attraction
      between two PNA backbones and (ii) a favorable electrostatic effect resulting
      from replacement of a phosphodiester backbone by a neutral peptide backbone.

PMID- 8356049
TI  - Crystal structures of medium-chain acyl-CoA dehydrogenase from pig liver
      mitochondria with and without substrate.
AB  - The three-dimensional structure of medium-chain acyl-CoA dehydrogenase from pig
      mitochondria in the native form and that of a complex of the enzyme and a
      substrate (product) have been solved and refined by x-ray crystallographic
      methods at 2.4-A resolution to R factors of 0.172 and 0.173, respectively. The
      overall polypeptide folding and the quaternary structure of the tetramer are
      essentially unchanged upon binding of the ligand, octanoyl (octenoyl)-CoA. The
      ligand binds to the enzyme at the rectus (re) face of the FAD in the crevice
      between the two alpha-helix domains and the beta-sheet domain of the enzyme. The
      fatty acyl chain of the thioester substrate is buried inside of the polypeptide
      and the 3'-AMP moiety is close to the surface of the tetrameric enzyme molecule.
      The alkyl chain displaces the tightly bound water molecules found in the native
      enzyme and the carbonyl oxygen of the thioester interacts with the ribityl 2'
      hydroxyl group of the FAD and the main-chain carbonyl oxygen of Glu-376. The C
      alpha--C beta of the fatty acyl moiety lies between the flavin and the gamma
      carboxylate of Glu-376, supporting the role of Glu-376 as the base that abstracts
      the alpha proton in the alpha--beta dehydrogenation reaction catalyzed by the
      enzyme. Trp-166 and Met-165 are located at the sinister (si) side of the flavin
      ring at the surface of the enzyme, suggesting that they might be involved in the
      interactions with electron transferring flavoprotein. Lys-304, the prevalent
      mutation site found in patients with medium-chain acyl-CoA dehydrogenase
      deficiency, is located approximately 20 A away from the active site of the
      enzyme.

PMID- 8356050
TI  - Functional analysis of Arabidopsis thaliana rRNA gene and spacer promoters in
      vivo and by transient expression.
AB  - In eukaryotes, RNA polymerase I transcription is controlled by DNA elements
      located within the spacers that separate the tandemly arranged rRNA genes. Unlike
      rRNA coding sequences, the intergenic spacers evolve rapidly and have little
      sequence similarity even among closely related species. Nonetheless, the
      arrangement of functional elements, such as spacer promoters and enhancers, is
      thought to be highly conserved. Here, we identify spacer promoters in the plant
      Arabidopsis thaliana, thereby demonstrating their existence in both the plant and
      animal kingdoms. We also use an Arabidopsis transient expression system to
      perform transcriptional analysis of the ribosomal gene promoter. Spacer promoters
      share sequence similarity with the gene promoter from -91 to +22 relative to the
      transcription start site, +1. Deletion analysis shows that sequences required for
      RNA polymerase I transcription reside within these boundaries. Spacer sequences
      upstream of the gene promoter have only a small positive effect on transcription
      in transfected protoplasts but can increase transcription from a Xenopus
      ribosomal gene promoter in injected frog oocytes. This trans-kingdom enhancer
      effect further suggests that the functional elements within eukaryotic ribosomal
      genes are highly conserved.

PMID- 8356051
TI  - Fetal liver kinase 1 is a receptor for vascular endothelial growth factor and is
      selectively expressed in vascular endothelium.
AB  - Vascular endothelial growth factor (VEGF), also known as vascular permeability
      factor, induces endothelial proliferation in vitro and vascular permeability in
      vivo. The human transmembrane c-fms-like tyrosine kinase Flt-1 has recently been
      identified as a VEGF receptor. Flt-1 kinase has seven immunoglobulin-like
      extracellular domains and a kinase insert sequence, features shared by two other
      human gene-encoded proteins, kinase insert domain-containing receptor (KDR) and
      FLT-4. In this study we show that the mouse homologue of KDR, Flk-1, is a second
      functional VEGF receptor. Flk-1 binds VEGF with high affinity, undergoes
      autophosphorylation, and mediates VEGF-dependent Ca2+ efflux in Xenopus oocytes
      injected with Flk-1 mRNA. We also demonstrate by in situ hybridization that Flk-1
      protein expression in the mouse embryo is restricted to the vascular endothelium
      and the umbilical cord stroma. VEGF and its receptors Flk-1/KDR and Flt-1 may
      play a role in vascular development and regulation of vascular permeability.

PMID- 8356052
TI  - A recombinant immunotoxin containing a disulfide-stabilized Fv fragment.
AB  - B3(dsFv)-PE38KDEL is a recombinant immunotoxin composed of the Fv region of
      monoclonal antibody B3 connected to a truncated form of Pseudomonas exotoxin
      (PE38KDEL), in which the unstable Fv heterodimer (composed of heavy- and light
      chain variable regions) is held together and stabilized by a disulfide bond
      [termed disulfide-stabilized Fv (dsFV)]. A computer modeled structure of the
      B3(Fv), made by mutating and energy minimizing the amino acid sequence and
      structure of McPC603, enabled us to identify positions in conserved framework
      regions that "hypothetically" could be used for disulfide stabilization without
      changing the structure or affecting antigen binding. This prediction was
      evaluated experimentally by constructing a disulfide-linked two-chain dsFv
      immunotoxin that was produced in Escherichia coli. The activity and specificity
      of this immunotoxin was indistinguishable from its single-chain Fv (scFv)
      counterpart, indicating that, as in B3(scFv), the structure of the binding region
      is retained in B3(dsFv). Because we introduced the stabilizing disulfide bond in
      between two framework residues in a position that is conserved in most Fv
      molecules, this method of linkage between the heavy- and light-chain variable
      regions should be generally applicable to construct immunotoxins and dsFv
      molecules using other antibodies. Furthermore, the finding that B3(dsFv) was much
      more stable at 37 degrees C in human plasma than B3(scFv) indicates that dsFvs
      are possibly more versatile for therapeutic application than scFvs.

PMID- 8356054
TI  - Facilitated distortion of the DNA site enhances EcoRI endonuclease-DNA
      recognition.
AB  - We have measured the binding of EcoRI endonuclease to a complete set of purine
      base analogue sites, each of which deletes one functional group that forms a
      hydrogen bond with the endonuclease in the canonical GAATTC complex. For five of
      six functional group deletions, the observed penalty in binding free energy is
      +1.3 to +1.7 kcal/mol. For two of these cases (replacement of adenine N7 with
      carbon) a single protein-base hydrogen bond is removed without deleting an
      interstrand Watson-Crick hydrogen bond or causing structural "adaptation" in the
      complex. This observation establishes that the incremental energetic contribution
      of one protein-base hydrogen bond is about -1.5 kcal/mol. By contrast, deletion
      of the N6-amino group of the inner adenine in the site improves binding by -1.0
      kcal/mol because the penalty for deleting a protein-base hydrogen bond is
      outweighed by facilitation of the required DNA distortion ("kinking") in the
      complex. This result provides direct evidence that the energetic cost of
      distorting a DNA site can make an unfavorable contribution to protein-DNA
      binding.

PMID- 8356053
TI  - In vitro isolation and identification of human immunodeficiency virus (HIV)
      variants with reduced sensitivity to C-2 symmetrical inhibitors of HIV type 1
      protease.
AB  - Protease inhibitors are another class of compounds for treatment of human
      immunodeficiency virus (HIV)-caused disease. The emergence of resistance to the
      current anti-HIV drugs makes the determination of potential resistance to
      protease inhibitors imperative. Here we describe the isolation of an HIV type 1
      (HIV-1) resistant to an HIV-protease inhibitor. Serial passage of HIV-1 (strain
      RF) in the presence of the inhibitor, [2-pyridylacetylisoleucylphenylalanyl-psi
      (CHOH)]2 (P9941), failed to yield a stock of virus with a resistance phenotype.
      However, variants of the virus with 6- to 8-fold reduced sensitivity to P9941
      were selected by using a combination of plaque assay and endpoint titration.
      Genetic analysis and computer modeling of the variant proteases revealed a single
      change in the codon for amino acid 82 (Val-->Ala), which resulted in a protease
      with lower affinity and reduced sensitivity to this inhibitor and certain, but
      not all, related inhibitors.

PMID- 8356055
TI  - Association of the low molecular weight GTP-binding protein rap2B with the
      cytoskeleton during platelet aggregation.
AB  - The intracellular distribution of the low-molecular-weight GTP-binding protein
      rap2B was investigated in resting and agonist-activated human platelets. In both
      cases, platelets were lysed by Triton X-100, and cell fractions were obtained by
      differential centrifugations. Using a specific polyclonal antiserum, we found
      that rap2B in resting platelets was completely detergent-soluble. When platelets
      were aggregated with thrombin, the thromboxane analogue U46619, or the Ca(2+)
      ATPase inhibitor thapsigargin, a significant amount of rap2B became associated
      with the cytoskeleton. This association was paralleled by a decrease of rap2B in
      the Triton X-100-soluble fraction. Translocation of rap2B to the cytoskeleton
      strictly depended on platelet aggregation, and maximal incorporation was found
      when approximately 50% aggregation was measured. Inhibition of fibrinogen binding
      to the glycoprotein IIb-IIIa complex completely prevented the interaction of
      rap2B with the cytoskeleton. These results clearly demonstrate that changes in
      the intracellular localization of rap2B occur during platelet activation and
      represent evidence that this low molecular weight GTP-binding protein may be
      involved in platelet function.

PMID- 8356056
TI  - Improved prediction of protein secondary structure by use of sequence profiles
      and neural networks.
AB  - The explosive accumulation of protein sequences in the wake of large-scale
      sequencing projects is in stark contrast to the much slower experimental
      determination of protein structures. Improved methods of structure prediction
      from the gene sequence alone are therefore needed. Here, we report a substantial
      increase in both the accuracy and quality of secondary-structure predictions,
      using a neural-network algorithm. The main improvements come from the use of
      multiple sequence alignments (better overall accuracy), from "balanced training"
      (better prediction of beta-strands), and from "structure context training"
      (better prediction of helix and strand lengths). This method, cross-validated on
      seven different test sets purged of sequence similarity to learning sets,
      achieves a three-state prediction accuracy of 69.7%, significantly better than
      previous methods. In addition, the predicted structures have a more realistic
      distribution of helix and strand segments. The predictions may be suitable for
      use in practice as a first estimate of the structural type of newly sequenced
      proteins.

PMID- 8356057
TI  - Identification and characterization of an essential, activating regulatory
      element of the human SIS/PDGFB promoter in human megakaryocytes.
AB  - The SIS/PDGFB gene, encoding the B polypeptide of platelet-derived growth factor
      (PDGF-B), is transcriptionally activated (> 50 fold) in human K562
      erythroleukemia cells when they are induced to differentiate into megakaryocytic
      cells by treatment with phorbol 12-myristate 13-acetate ("tetradecanoylphorbol
      acetate," TPA). A 250-bp PDGF-B gene promoter attached to a reporter gene was
      shown to reproduce this TPA-induced activation. In a series of mutants that we
      constructed, a 10-bp linker sequence was systematically moved across the 250-bp
      PDGF-B promoter sequence, and the effect upon luciferase reporter activity was
      measured to identify a site through which this TPA-induced transcriptional
      activation occurred. We identified a site, which we named the SIS proximal
      element (SPE), at positions -58 to -39 relative to the PDGF-B mRNA initiation
      site that was essential for the TPA-induced activation. The SPE site contains two
      repeated sequences (TCTC and CACC) arranged in an ABBA configuration. The SPE
      sequence was not found in the existing list of consensus sequences for
      transcription factor binding sites. Gel mobility-shift assays using an SPE
      oligonucleotide and K562 cell nuclear extracts showed three shifted complexes,
      one of which was formed only following TPA treatment of K562 cells. In a time
      course study, TPA induction of the endogenous PDGF-B mRNA and formation of the
      TPA-inducible complex occurred over the same time frame, and both events were
      specifically blocked by the addition of cycloheximide. The 20-bp SPE sequence was
      highly conserved (19/20) in both the cat and the mouse PDGF-B promoter, and
      conserved portions of the SPE sequence were also found at two sites within the
      human PDGF-A promoter. The role of the SPE in regulating the concurrent
      expression of the PDGF-B and PDGF-A genes in megakaryocytes, as well as various
      human tumor cells, is considered.

PMID- 8356058
TI  - Ly-GDI, a GDP-dissociation inhibitor of the RhoA GTP-binding protein, is
      expressed preferentially in lymphocytes.
AB  - The Ras-related small GTP-binding proteins are involved in diverse cellular
      events, including cell signaling, proliferation, cytoskeletal organization, and
      secretion. The interconversion of the active, GTP-bound form of the protein to
      the inactive, GDP-bound form is influenced by two types of regulatory proteins,
      those that alter the intrinsic GTPase activity of the GTP-binding protein and
      those that affect the rate of GDP/GTP exchange. By utilizing a subtractive
      hybridization approach, we have isolated a human gene encoding Ly-GDI, a protein
      that has striking homology to the product of a previously cloned gene, Rho-GDI,
      which inhibits GDP/GTP exchange on the Rho family of GTPases. In contrast to Rho
      GDI, which is ubiquitously expressed, Ly-GDI is expressed only in hematopoietic
      tissues and predominantly in B- and T-lymphocyte cell lines. The full-length Ly
      GDI cDNA encodes a 27-kDa protein which binds to RhoA and inhibits GDP
      dissociation from RhoA. Stimulation of T lymphocytes with phorbol ester leads to
      phosphorylation of Ly-GDI, suggesting an involvement of Ly-GDI in lymphocyte
      activation pathways. Cell type-specific regulators of the Ras-like GTP-binding
      proteins may provide one mechanism by which different cell types respond uniquely
      to signals transduced through the same cell surface receptor or may provide a way
      by which the GTP-binding proteins can be uniquely engaged by tissue-restricted
      receptors.

PMID- 8356059
TI  - Identification of CD4 and major histocompatibility complex functional peptide
      sites and their homology with oligopeptides from human immunodeficiency virus
      type 1 glycoprotein gp120: role in AIDS pathogenesis.
AB  - CD4 molecules interact with class II major histocompatibility complex molecules
      as a critical costimulatory signal in CD4+ cell immune activation. CD4 also
      recognizes a specific region of the human immunodeficiency virus type 1 (HIV-1)
      envelope glycoprotein gp120 forming a binding site for early stages of HIV-1
      infection. We designed two software packages, AUTOMAT and CRITIC, which allowed
      us to identify similarities between regions of HIV-1 proteins and
      immunoregulatory protein sequences stored in data banks. In this report we have
      characterized (i) a pentapeptide, SLWDQ, found in both CD4 and HIV-1 gp120, which
      surprisingly had remained undetected in these two well-studied molecules until
      now, and (ii) an HLA sequence corresponding to the putative functional site of H2
      I-A. We found that a region of gp120 (residues 254-263) known to be similar to a
      sequence in HLA class II beta chain overlaps this functional region. We showed
      experimentally that these two CD4 and HLA peptide segments inhibit CD4+ cell
      immune activation. There is strong inhibition (50% up to 80%) of immune
      activation by SLWDQ-containing gp120 segments and a lesser inhibition by the
      gp120 HLA-homologous segment. In addition, we found that SLWDQ induced in HIV-1
      infected individuals a humoral (antibody) and cellular (cytotoxic T lymphocyte)
      immune reaction. We propose that these HIV-1 gp120 segments, together with the
      known CD4-binding region, may contribute to the HIV-1-induced immunosuppression
      by two mechanisms affecting CD4-HLA interaction during T-cell immune activation:
      autoimmune reaction toward CD4 and direct interference with the CD4-HLA
      costimulatory signal inducing CD4+ cell anergy with, as a consequence, generation
      of immunosuppression.

PMID- 8356060
TI  - Localization of E2A mRNA expression in developing and adult rat tissues.
AB  - E2A helix-loop-helix proteins are involved in the control of various
      developmental pathways. We show here by in situ hybridization that E2A
      transcripts are present in most embryonic and adult tissues. However, no E2A
      expression is detectable in heart and nonproliferative regions of the brain and
      spinal cord. Highest levels of E2A expression are found in the ependyma cell
      layer surrounding the cerebral ventricles in the embryonic rat brain. In
      addition, in the embryo, E2A transcripts were found in secretory cells of the
      pancreas, the bronchial tubes of the lung, glomeruli of the kidney, and the
      lining of the stomach. Interestingly, high levels of E2A transcripts are
      selectively found in the germinal center of the lymphatic nodules in the adult
      rat spleen. Thus, E2A, like its Drosophila homolog daughterless, is expressed in
      most tissues. The most notable feature of the E2A expression pattern is its high
      levels of expression in some areas of rapid cell proliferation and
      differentiation and in certain epithelial cell types.

PMID- 8356061
TI  - Transgenic mice containing a 248-kb yeast artificial chromosome carrying the
      human beta-globin locus display proper developmental control of human globin
      genes.
AB  - Transgenic mice were generated using a purified 248-kb yeast artificial
      chromosome (YAC) bearing an intact 82-kb human beta-globin locus and 148 kb of
      flanking sequence. Seventeen of 148 F0 pups were transgenic. RNase protection
      analysis of RNA isolated from the blood of 13 gamma- and beta-globin-positive
      founders showed that only the human beta-globin gene was expressed in the adult
      founders. Studies of F1 and F2 fetuses demonstrated that the genes of the beta
      locus YAC displayed the proper developmental switches in beta-like globin gene
      expression. Expression of epsilon- and gamma-globin, but not beta-globin, was
      observed in the yolk sac, there was only minor gamma and mostly beta expression
      in the 14-day liver, and only beta mRNA in the blood of the adult animals.
      Structural data showed that the locus was intact. These results indicate that it
      is now possible to dissect regulatory mechanisms within the context of an entire
      locus in vivo by using the ability to perform mutagenesis efficiently in yeast
      via homologous recombination, followed by purification of the altered YAC and its
      introduction into mice.

PMID- 8356062
TI  - Peripheral T-cell tolerance induced in naive and primed mice by subcutaneous
      injection of peptides from the major cat allergen Fel d I.
AB  - T cells control the majority of antigen-specific immune responses. Therefore,
      influencing the activation of the T-cell response in order to modify immune
      responsiveness is an obvious therapeutic goal. We have used a mouse model of
      response to Fel d I, the major cat protein allergen in humans, to explore the
      ability of peptides derived from Fel d I to inhibit T-cell-dependent immune
      responses to the peptides themselves and to larger polypeptides. T cells from
      B6CBAF1 mice respond to the Fel d I peptide IPC-2 after challenge with IPC-2.
      However, subcutaneous tolerization with IPC-2 prevents this response as measured
      by production of interleukins 2 and 4 and interferon gamma. Fel d I immunization
      of B6D2F1 mice results in T-cell responses primarily to one peptide derived from
      Fel d I. Injecting this peptide in soluble form inhibits T-cell activation (as
      measured by interleukin 2 production) and antibody production in Fel d I-primed
      animals when they are subsequently challenged with peptide in adjuvant. Most of
      the cat-allergic human T-cell response to Fel d I is specific for two peptides on
      one of its two chains. Immunization of B6CBAF1 mice with recombinant Fel d I
      chain 1 results in T-cell responses to the same peptides. Subcutaneous
      administration of these two peptides, which contain some, but not all, of the T
      cell epitopes from Fel d I chain I, decreases the T-cell response to the entire
      recombinant Fel d I chain 1. The ability to tolerize T-cell responses with
      subcutaneous injections suggests a practical approach to treating human diseases
      with peptides containing T-cell epitopes.

PMID- 8356064
TI  - Inhibition of CD10/neutral endopeptidase 24.11 promotes B-cell reconstitution and
      maturation in vivo.
AB  - The common acute lymphoblastic leukemia antigen [(CALLA) CD10, neutral
      endopeptidase 24.11 (NEP)] is a cell-surface zinc metalloprotease expressed by a
      subpopulation of early murine B-lymphoid progenitors and by bone marrow stromal
      cells that support the earliest stages of B lymphopoiesis. In previous in vitro
      studies in which uncommitted murine hematopoietic progenitors plated on a stromal
      cell layer differentiate into immature B cells, the inhibition of CD10/NEP
      increased early lymphoid colony numbers. To further characterize CD10/NEP
      function during lymphoid ontogeny in vivo, we utilized a Ly5 congenic mouse model
      in which the lymphoid differentiation of uncommitted hematopoietic progenitors
      from Ly5.1 donors was followed in sublethally irradiated Ly5.2 recipients treated
      with a specific long-acting CD10/NEP inhibitor (N-[L-(1-carboxy-2-phenyl)ethyl]-L
      phenylalanyl-beta- alanine (SCH32615)). The expression of Ly5.1, B220, and
      surface IgM (sIgM) was utilized to characterize donor-derived hematopoietic cells
      (Ly5.1+), B lymphocytes (B220+), and mature B cells (B220+ sIgM+) from the
      lymphoid organs of recipient animals treated with SCH32615 or vehicle alone.
      SCH32615-treated animals had higher percentages of Ly5.1+ donor splenocytes than
      animals treated with vehicle alone (16.9% vs. 10.4%, 63% increase, P = 0.013).
      Animals treated with the CD10/NEP inhibitor also had relatively more Ly5.1+
      splenic B (B220+) cells than vehicle-treated animals (14.4% vs. 8.2%, 75%
      increase, P = 0.018). To more specifically characterize the effects of CD10/NEP
      inhibition on B-cell differentiation, Ly5.1+ splenocytes from animals treated
      with SCH32615 or vehicle alone were analyzed for coexpression of B220 and sIgM.
      Animals treated with the CD10/NEP inhibitor had a significantly higher percentage
      of mature donor B cells (Ly5.1+ B220+ sIgM+, 10.2% vs. 5.2%, 90% increase, P =
      0.006) and a more modest relative increase in immature donor B cells (Ly5.1+
      B220+ sIgM-, 4.7% vs. 3.4%, 38% increase, P = not significant). Taken together,
      these results suggest that CD10/NEP inhibition promotes the reconstitution and
      maturation of splenic B cells. Therefore, CD10/NEP may function to regulate B
      cell ontogeny in vivo by hydrolyzing a peptide substrate that stimulates B-cell
      proliferation and/or differentiation.

PMID- 8356063
TI  - Ferritin synthesis is controlled by iron-dependent translational derepression and
      by changes in synthesis/transport of nuclear ferritin RNAs.
AB  - Ferritin synthesis, maintained at a very low basal rate when extracellular iron
      levels are low, is elevated up to 50-fold when iron levels are increased.
      Previous examinations of this iron-dependent activation have concluded that
      changes in ferritin synthesis results from selective translational activation
      conferred by an "iron response element" that lies near the 5' terminus of all
      known ferritin mRNAs. By placing an iron response element in an optimal position
      in other mRNAs, we find the iron response element to be a potent translational
      repressor whose influence can only partially be abrogated under optimal inducing
      conditions. Further, we show that the 25- to 50-fold iron-mediated increase in
      ferritin synthesis results from coupling a 5- to 6-fold iron-dependent
      translational derepression with a similar 5- to 6-fold nuclear-dependent increase
      in mRNA level.

PMID- 8356065
TI  - Human mitochondrial carbonic anhydrase: cDNA cloning, expression, subcellular
      localization, and mapping to chromosome 16.
AB  - A full-length cDNA clone encoding human mitochondrial carbonic anhydrase (CA), CA
      V, was isolated from a human liver cDNA library. The 1123-bp cDNA includes a 55
      bp 5' untranslated region, a 915-bp open reading frame, and a 153-bp 3'
      untranslated region. Expression of the cDNA in COS cells produced active enzyme.
      The 34-kDa precursor and 30-kDa mature form of CA V were identified on Western
      blots of COS-cell homogenates by a CA V-specific antibody raised to a synthetic
      peptide corresponding to the C-terminal 17 aa of CA V. Both 34-kDa and 30-kDa
      bands were also present in mitochondria isolated from transfected COS cells,
      whereas only the 30-kDa band was present in mitochondria isolated from normal
      human liver. The N-terminal sequence determined directly on the 30-kDa soluble CA
      purified from transfected COS cells indicated that processing of the precursor to
      mature human CA V involves removal of a 38-aa mitochondrial leader sequence. The
      267-aa sequence deduced for mature human CA V shows 30-49% similarity to amino
      acid sequences of previously characterized human CAs (CA I-CA VII) and 76%
      similarity to the corresponding amino acid sequence deduced from the mouse cDNA.
      PCR analysis of DNAs from human-rodent somatic cell hybrids localized the gene
      for CA V to human chromosome 16, the same chromosome to which CA VII has
      previously been mapped.

PMID- 8356066
TI  - Identification of small GTP-binding rab proteins in human platelets: thrombin
      induced phosphorylation of rab3B, rab6, and rab8 proteins.
AB  - The activation of platelets by specific agonists is a tightly regulated mechanism
      that leads to the secretion of the dense- and alpha-granule contents. Platelets
      have been shown to possess small GTP-binding proteins thought to be involved in
      central biological processes; however, no rab proteins, which may regulate the
      exocytic process at different stages, have been reported. This study has shown
      that rab1, rab3B, rab4, rab6, and rab8 proteins, but not rab3A protein, were
      present in platelets and in endothelial cells. To probe their functional
      significance in platelets, rab3B, rab6, and rab8 proteins were further
      characterized with regard to their intracellular localization and their
      phosphorylation properties. Whereas rab3B protein was found to be mainly
      cytosolic, rab6 and rab8 proteins were preferentially targeted to the plasma
      membrane and to the alpha granules. The activation of platelets by thrombin, a
      potent inducer of secretion, resulted in the phosphorylation of rab3B, rab6, and
      rab8 proteins, whereas no phosphorylation was observed in the presence of
      prostaglandin E1, which stimulates cAMP-dependent protein kinase and inhibits the
      secretion process. These findings provide evidence that members of the subfamily
      of rab proteins, rab6 and rab8, are localized in platelets to one type of
      specific secretory vesicle, the alpha granule, and would suggest their possible
      implication in the secretion process through phosphorylation mechanisms.

PMID- 8356067
TI  - Masking generates contiguous segments of metal-coated and bare DNA for scanning
      tunneling microscope imaging.
AB  - To date, no microscopic methods are available to confirm scanning tunneling
      microscope (STM) images of DNA. The difficulties encountered in repeating these
      images may be attributed to inadequate distribution of molecules on the
      substrate, poor adhesion to the substrate, or the low conductivity of the
      molecules. However, these factors are difficult to assess in an STM experiment
      where they may act simultaneously. A method to isolate these factors involves
      partly masking the deposited molecules before coating them with a conductive film
      to produce adjacent segments of coated and bare DNA after the mask is removed.
      The coated DNA segments are conductive and mechanically stable to allow easy
      identification of DNA by the STM. Furthermore, the path of a molecule can be
      traced from a coated to an uncoated region to test STM imaging of bare DNA.
      Masked preparations of DNA deposited on platinum/carbon-coated mica and highly
      oriented pyrolytic graphite were examined with a tunneling current 1000 times
      lower than the usual nanoamps. The tip apparently displaces molecules adsorbed to
      graphite to preclude imaging whereas more stably bound DNA on platinum/carbon
      coated mica appears in reversed contrast.

PMID- 8356069
TI  - Mediation of osmoregulatory influences on neuroendocrine corticotropin-releasing
      factor expression by the ventral lamina terminalis.
AB  - Chronic exposure to a hyperosmolar challenge invokes coordinate, differential,
      and ostensibly adaptive alterations in the expression of mRNA encoding
      corticotropin-releasing factor (CRF) in the endocrine hypothalamus. Rats
      maintained on 2% (wt/vol) saline for 7 days displayed the expected reduction in
      CRF mRNA levels in the parvocellular neurosecretory compartment of the
      paraventricular nucleus, as well as a concomitant increase in CRF transcripts in
      oxytocin-containing magnocellular neurosecretory neurons. Also detected in salt
      loaded animals was a prominent induction of the immediate-early gene product Fos
      in magnocellular neurosecretory cell groups and in several brain regions that are
      known to provide major projections to the endocrine hypothalamus. These included
      a triad of cell groups making up the lamina terminalis of the third ventricle,
      and, to a lesser extent, catecholaminergic cell groups in the caudal brain stem.
      Discrete transections of descending projections from structures associated with
      the lamina terminals, as well as excitotoxin lesions centered in one lamina
      terminalis-associated structure, the organum vasculosum, abolished the effects of
      salt loading in both the magno- and parvocellular neurosecretory systems. Knife
      cuts in the lamina terminalis complex that spared only projections from the
      organum vasculosum region or cuts that disrupted ascending catecholaminergic
      projections failed to modify either effect of salt loading. The results suggest
      the existence of a simple circuit through which osmotic influences on gene
      expression in the magnocellular and parvocellular neurosecretory systems are
      effected.

PMID- 8356068
TI  - In vivo and in vitro evidence for slipped mispairing in mammalian mitochondria.
AB  - Slipped mispairing between repeated sequences during DNA replication is an
      important mutagenic event. It is one of several suggested mechanisms thought to
      be responsible for generating polymorphic regions and large-scale deletions found
      in mammalian mitochondrial DNA. In the porcine mitochondrial genome, a domain
      carrying a 10-bp tandemly repeated sequence displays a unique in vivo pattern of
      repeat copy number polymorphs. Upon passage in Escherichia coli, a recombinant
      plasmid containing this domain also displays a unique polymorphic pattern that is
      different from that seen in the animal. To test the hypothesis that these
      polymorphisms were slippage induced and that the different polymorphic patterns
      reflected differences in modes of replication, we performed a series of in vitro
      primer extension reactions. By utilizing either single- or double-stranded
      templates containing the repeat domain we were able to correlate in vitro
      generated repeat polymorphism patterns with those seen in the mitochondria or the
      bacteria, respectively, thus providing experimental evidence that slippage
      replication is responsible for a major class of mammalian mutations.

PMID- 8356070
TI  - Amino acid residues essential for biological activity of a peptide derived from a
      major histocompatibility complex class I antigen.
AB  - The stimulatory activity of peptides from the alpha 1 domain of the major
      histocompatibility complex (MHC) class I antigen on adipose cell glucose
      transport was previously shown to require a preformed, ordered conformation of
      the peptide. The two peptides studied previously were Dk-(61-85)
      (ERETQIAKGNEQSFRVDLRTLLRYY) and Dk-(69-85). We now show that systematic alanine
      substitution in Dk-(69-85) identifies residues that are essential for biological
      activity. Ordered structure of the peptides, estimated by circular dichroism, was
      found in all peptides with activity, but with a complex variety of spectra.
      Inactive peptides were in either a random coil or an ordered structure. Ordered
      structure, therefore, is not sufficient for activity. The peptides self-interact
      in the absence of cells and form aggregates that precipitate upon centrifugation.
      The tendency to aggregate is correlated with biological potency. Only MHC class I
      molecules have significant homology to the peptides studied here. The peptide
      self-interaction suggests that the biological effects in cells, which result from
      inhibition of receptor and transporter internalization, may be due to the binding
      (tantamount to self-interaction) of the peptide to the homologous sequences in
      the alpha 1 domain of the MHC class I molecule.

PMID- 8356071
TI  - The Src family tyrosine kinases are required for platelet-derived growth factor
      mediated signal transduction in NIH 3T3 cells.
AB  - Three members of the Src family of protein tyrosine kinases Src, Fyn, and Yes
      associate with the activated platelet-derived growth factor (PDGF) receptor in
      vivo. This interaction requires the Src homology 2 (SH2) domain of the Src family
      member and causes activation of the intrinsic activity of the Src family kinases.
      We microinjected cells with DNA encoding catalytically inactive forms of the Src
      and Fyn proteins and examined their effects on PDGF-mediated signaling in vivo.
      Kinase-inactive Src and Fyn inhibited PDGF-stimulated entry of cells into S
      phase, whereas kinase-active forms of the proteins had no inhibitory effects. An
      intact SH2 domain was required for inhibition. Furthermore, when kinase-inactive
      Fyn was comicroinjected with a plasmid expressing activated Ras, the cells could
      enter S phase, indicating that the expression of kinase-inactive Fyn did not
      damage cell viability. Injection of an antibody specific for Src, Fyn, and Yes
      also reduced signal transduction through the PDGF receptor but only when injected
      within 8 hr of PDGF stimulation. Together these results indicate that the
      ubiquitously expressed Src family members are required for PDGF-induced mitogenic
      signaling.

PMID- 8356072
TI  - Relevance of chemistry to conservation of isolated populations: the case of
      volatile leaf components of Dicerandra mints.
AB  - Chemical analysis of the essential oils of four congeneric species of mint plant
      (Dicerandra spp.) endemic to Florida revealed a pattern of chemical similarity
      and dissimilarity that would not have been predicted on morphological or
      geographic criteria. Dicerandra christmanii differs fundamentally from its
      congeners in that it produces fewer compounds and lacks the acyclic components.
      Yet D. christmanii is more closely similar to Dicerandra frutescens than to other
      Dicerandra species in morphological characters and geographic range. We conclude
      that the potential chemical value of a species should not be prejudged on the
      basis of nonchemical characters and that designation of surplus plant populations
      by conservationists should be resisted unless such populations have also been
      chemically studied.

PMID- 8356073
TI  - The N-terminal coiled-coil domain of beta is essential for gamma association: a
      model for G-protein beta gamma subunit interaction.
AB  - We have identified the N terminus of the beta subunit as an essential domain for
      G-protein beta gamma assembly. A C-terminal fragment, beta 1-(130-340), fails to
      bind gamma unless coexpressed with the complementary N-terminal fragment, beta 1
      (1-129). Deletion of the N-terminal 33 residues of beta 1, a region identified by
      computer algorithm to favor coiled-coil formation, abolishes gamma 2 association.
      On the basis of these findings, we propose a coiled-coil model of beta gamma
      interaction and refine this by computer-assisted molecular modeling. The model is
      tested by further mutagenesis: reversing the charge of residues in beta 1 that
      are hypothesized to be involved in interhelical salt bridges precludes gamma
      association. Insertions in the coiled-coil region, which disrupt the proposed
      hydrophobic interface, prevent gamma association. This structural basis for beta
      gamma dimerization provides a starting point for the design of beta and gamma
      mutants that can be used to map regions in beta gamma critical for interactions
      with the alpha subunit, receptors, and effectors.

PMID- 8356074
TI  - Three-dimensional structure of a heteroclitic antigen-antibody cross-reaction
      complex.
AB  - Although antibodies are highly specific, cross-reactions are frequently observed.
      To understand the molecular basis of this phenomenon, we studied the anti-hen egg
      lysozyme (HEL) monoclonal antibody (mAb) D11.15, which cross-reacts with several
      avian lysozymes, in some cases with a higher affinity (heteroclitic binding) than
      for HEL. We have determined the crystal structure of the Fv fragment of D11.15
      complexed with pheasant egg lysozyme (PHL). In addition, we have determined the
      structure of PHL, Guinea fowl egg lysozyme, and Japanese quail egg lysozyme.
      Differences in the affinity of D11.15 for the lysozymes appear to result from
      sequence substitutions in these antigens at the interface with the antibody. More
      generally, cross-reactivity is seen to require a stereochemically permissive
      environment for the variant antigen residues at the antibody-antigen interface.

PMID- 8356075
TI  - Evolutionary games and computer simulations.
AB  - The Prisoner's Dilemma has long been considered the paradigm for studying the
      emergence of cooperation among selfish individuals. Because of its importance, it
      has been studied through computer experiments as well as in the laboratory and by
      analytical means. However, there are important differences between the way a
      system composed of many interacting elements is simulated by a digital machine
      and the manner in which it behaves when studied in real experiments. In some
      instances, these disparities can be marked enough so as to cast doubt on the
      implications of cellular automata-type simulations for the study of cooperation
      in social systems. In particular, if such a simulation imposes space-time
      granularity, then its ability to describe the real world may be compromised.
      Indeed, we show that the results of digital simulations regarding territoriality
      and cooperation differ greatly when time is discrete as opposed to continuous.

PMID- 8356076
TI  - A transmissible Creutzfeldt-Jakob disease-like agent is prevalent in the human
      population.
AB  - The etiology of most human dementias is unknown. Creutzfeldt-Jakob disease (CJD),
      a relatively uncommon human dementia, is caused by a transmissible virus-like
      agent. Molecular markers that are specific for the agent have not yet been
      defined. However, the infectious disease can be transmitted to rodents from both
      brain and infected buffy coat (blood) samples. To determine whether human CJD
      infections are more widespread than is apparent from the low incidence of
      neurological disease, we attempted to transmit CJD from buffy coat samples of 30
      healthy volunteers who had no family history of dementing illness. Primary
      transmissions from 26 of 30 individuals produced CJD-like spongiform changes in
      the brains of recipient hamsters at 200-500 days postinoculation. This positive
      evidence of viremia was found for individuals in all age groups (20-30, 40-50,
      and 61-71 years old), whereas 12 negatively scored brain samples failed to
      produce similar changes in hamsters observed for > 900 days in the same setting.
      We suggest that a CJD agent endemically infects humans but only infrequently
      produces an infectious dementia. Disease expression is likely to be influenced by
      several host factors in combination with viral variants that have altered
      neurovirulence.

PMID- 8356077
TI  - Molecular regulation of human interleukin 2 and T-cell function by interleukin 4.
AB  - Distinct functional T-cell subsets, differing in the patterns of lymphokines
      produced, regulate cell-mediated and humoral immune responses. The two major
      types and their principal products, interleukin 4 and interferon gamma (IL-4 and
      IFN-gamma), are reciprocally negatively interactive. To analyze the molecular
      mechanism of IL-4-mediated suppression of cell-mediated immunity we studied its
      effects on expression of interleukin 2 (IL-2) and IFN-gamma. IL-4 pretreatment of
      Jurkat cells prior to stimulation resulted in a decrease in transcription of the
      IL2 gene. IL-4 suppressed IL-2 and IFN-gamma mRNA levels in primary human T
      cells, and addition of anti-CD28 antibodies relieved this suppression. Using
      enhancer-reporter constructs, IL-4 specifically down-regulated the NFIL-2B
      element. Electrophoretic mobility shift assays using a DNA oligomer containing
      the NFIL-2B binding site indicated that IL-4 inhibited the NFIL-2B complex and
      that the NFIL-2B DNA binding factor is distinct from AP-1. These results suggest
      that IL-4 may regulate development and function of T-cell subsets involved in
      cell-mediated immunity in part by inhibiting factors required for transcription
      of the IL2 gene.

PMID- 8356078
TI  - Characterization of the human CD4 gene promoter: transcription from the CD4 gene
      core promoter is tissue-specific and is activated by Ets proteins.
AB  - We analyzed the 5' transcription control sequences of the human CD4 gene. We
      located the transcription initiation site and showed that the CD4 core promoter
      (positions -40 to +16) lacks a classical "TATA" or initiator positioning
      consensus sequence but directs precise and efficient transcription when coupled
      to the ubiquitously active simian virus 40 enhancer. The transcriptional activity
      of the CD4 gene promoter correlated with CD4 expression in various cell types.
      Interestingly, the CD4 core promoter also displayed a tissue-specific
      transcriptional activity. Within this fragment, three nucleic acid sequences are
      completely conserved in the murine CD4 gene. One of these sequences contains a
      perfect ETS consensus sequence. Another ETS consensus sequence is located 1060 nt
      upstream. Electrophoretic-mobility-shift assays showed that the core promoter ETS
      motif binds an Ets-related protein specifically expressed at high levels in CD4+
      cells. Moreover, in CD4- cells, overexpression of Ets-1 or Ets-2 efficiently and
      specifically activated transcription from the CD4 promoter and core promoter.
      These data indicate that Ets transcription factors play a central role in
      controlling CD4 gene expression, by binding to both a classical remote site and
      an unusual proximal activator sequence.

PMID- 8356079
TI  - Replication of UV-irradiated DNA in human cell extracts: evidence for mutagenic
      bypass of pyrimidine dimers.
AB  - We have examined the efficiency and fidelity of simian virus 40-origin-dependent
      replication of UV-irradiated double-stranded DNA in extracts of human cells.
      Using as a mutational target the alpha-complementation domain of the Escherichia
      coli lacZ gene in bacteriophage M13mp2 DNA, replication of undamaged DNA in HeLa
      cell extracts was highly accurate, whereas replication of DNA irradiated with UV
      light (280-320 nm) was both less efficient and less accurate. Replication was
      inhibited by irradiation in a dose-dependent manner. Nonetheless, covalently
      closed, monomer-length circular products were generated that were resistant to
      digestion by Dpn I, showing that they resulted from semiconservative replication.
      These products were incised by T4 endonuclease V, whereas the undamaged
      replication products were not, suggesting that pyrimidine dimers were bypassed
      during replication. When replicated, UV-irradiated DNA was used to transfect an
      E. coli alpha-complementation host strain to score mutant M13mp2 plaques, the
      mutant plaque frequency was substantially higher than that obtained with either
      unirradiated, replicated DNA, or unreplicated, UV-irradiated DNA. Both the
      increased mutagenicity and the inhibition of replication associated with UV
      irradiation were reversed by treatment of the irradiated DNA with photolyase
      before replication. Sequence analysis of mutants resulting from replication of UV
      irradiated DNA demonstrated that most mutants contained C-->T transition errors
      at dipyrimidine sites. A few mutants contained 1-nt frameshift errors or tandem
      double CC-->TT substitutions. The data are consistent with the interpretation
      that pyrimidine dimers are bypassed during replication by the multiprotein
      replication apparatus in human cell extracts and that this bypass is mutagenic
      primarily via misincorporation of dAMP opposite a cytosine (or uracil) in the
      dimer.

PMID- 8356080
TI  - Plasma arginine and citrulline kinetics in adults given adequate and arginine
      free diets.
AB  - The fluxes of arginine and citrulline through plasma and the rate of conversion
      of labeled citrulline to arginine were estimated in two pilot studies (with a
      total of six adult subjects) and in a dietary study with five healthy young men.
      These latter subjects received an L-amino acid-based diet that was arginine-rich
      or arginine-free each for 6 days prior to conduct, on day 7, of an 8-hr (first 3
      hr, fast; final 5 hr, fed) primed continuous intravenous infusion protocol using
      L-[guanidino-13C]arginine, L-[5,5-2H2]citrulline, and L-[5,5,5-2H3]leucine, as
      tracers. A pilot study indicated that citrulline flux was about 20% higher (P <
      0.05) when determined with [ureido-13C]citrulline compared with [2H2]citrulline,
      indicating recycling of the latter tracer. Mean citrulline fluxes were about 8-11
      mumol.kg-1.hr-1 for the various metabolic/diet groups and did not differ
      significantly between fast and fed states or arginine-rich and arginine-free
      periods. Arginine fluxes (mean +/- SD) were 60.2 +/- 5.4 and 73.3 +/- 13.9
      mumol.kg-1.hr-1 for fast and fed states during the arginine-rich period,
      respectively, and were significantly lowered (P < 0.05), by 20-40%, during the
      arginine-free period, especially for the fed state, where this was due largely to
      reduced entry of dietary arginine into plasma. The conversion of plasma
      citrulline to arginine approximated 5.5 mumol.kg-1.hr-1 for the various groups
      and also was unaffected by arginine intake. Thus, endogenous arginine synthesis
      is not markedly responsive to acute alterations in arginine intake in healthy
      adults. We propose that arginine homeostasis is achieved largely via modulating
      arginine intake and/or the net rate of arginine degradation.

PMID- 8356081
TI  - Insulin stimulates the biosynthesis of chiro-inositol-containing phospholipids in
      a rat fibroblast line expressing the human insulin receptor.
AB  - HIRc-B cells (rat fibroblasts expressing the human insulin receptor) were
      incubated with myo-[3H]inositol for 48 hr, and the biosynthesis of chiro
      [3H]inositol was investigated in the absence and presence of insulin following a
      time course up to 60 min. After phase separation, treatment with insulin for 15
      min caused a 2.2-fold increase in the specific radioactivity of chiro
      [3H]inositol-containing phospholipids in contrast to a 1.2-fold increase in the
      specific radioactivity of myo-[3H]inositol-containing phospholipids. No insulin
      mediated change in the specific radioactivity was observed in the inositol
      phosphates or free inositols. Further detailed analysis of individual
      [3H]inositol-containing phospholipids demonstrated marked increases in specific
      activity of the chiro-[3H]inositol phospholipids after 15 min of incubation with
      insulin: phosphatidylinositol 4-phosphate and 4,5-bisphosphate, 4.2-fold;
      lysophosphatidylinositol, 1.5-fold; phosphatidylinositol, 3.2-fold. In contrast,
      myo-[3H]inositol-containing phospholipids demonstrated relatively small increases
      (1.1- to 1.4-fold) after 5 min of incubation with insulin. These findings
      indicate that insulin stimulates de novo synthesis of chiro-inositol-containing
      phospholipids at the inositol phospholipid level.

PMID- 8356082
TI  - Serine/threonine phosphorylation regulates binding of C hnRNP proteins to pre
      mRNA.
AB  - The C hnRNP proteins bind to nascent pre-mRNA and are thought to participate in
      an early step of the pre-mRNA splicing pathway. We report here that C hnRNP
      proteins are phosphorylated by a casein kinase II activity in a HeLa cell nuclear
      extract and that dephosphorylation of C hnRNP proteins is inhibited by the
      specific protein-serine/threonine-phosphatase 1/2A inhibitor okadaic acid. We
      further find that dephosphorylation of C hnRNP proteins is required for their
      binding to adenovirus and human beta-globin pre-mRNAs. These results indicate
      that the participation of C hnRNP proteins in pre-spliceosome assembly is coupled
      to a dynamic cycle of their phosphorylation and dephosphorylation.

PMID- 8356083
TI  - The N-terminal region of the 37-kDa translocated fragment of Pseudomonas exotoxin
      A aborts translocation by promoting its own export after microsomal membrane
      insertion.
AB  - The 37-kDa C-terminal fragment of Pseudomonas exotoxin A (PE; termed PE37 and
      composed of aa 280-613 of PE) translocates to the cell cytosol to cause cell
      death. PE37 requires a C-terminal endoplasmic reticulum retention sequence to be
      cytotoxic, indicating that the toxin may translocate to the cytosol from the
      endoplasmic reticulum. We show here that the N-terminal region of nascent PE37
      can be inserted into the membrane of canine pancreatic microsomes by the
      preprocecropin signal sequence but then is exported or released from microsomes.
      The 34 N-terminal amino acids of the toxin fragment are sufficient to arrest
      translocation and prevent the microsomal accumulation of nascent chains that
      otherwise are sequestered into microsomes. These data support a role for the N
      terminal region of PE37 in the translocation of the toxin from the endoplasmic
      reticulum to the cytosol in mammalian cells.

PMID- 8356084
TI  - Ultrastructural localization of a neutral and basic amino acid transporter in rat
      kidney and intestine.
AB  - A sodium-independent neutral and basic amino acid transporter (NBAT) from rat
      kidney was recently cloned and its amino acid sequence deduced. We used light and
      electron microscopic immunoperoxidase labeling to determine the cellular
      localization of NBAT in rat kidney and small intestine. The localization was
      carried out using site-directed antisera raised against synthetic peptides within
      NBAT. The most prominent localization of NBAT was in microvilli of epithelial
      cells lining renal proximal tubules. Microvilli of small intestinal epithelia
      were less frequently immunoreactive. Unexpectedly, the most intense labeling in
      the small intestine was seen within enteroendocrine cells and submucosal neurons.
      The neuronal labeling was highly localized within dense core vesicles in axon
      terminals apposed to the basal lamina near fenestrated blood vessels. These
      results support the proposal that NBAT plays a role in reabsorption of amino
      acids in renal tubules. In addition, they suggest that NBAT (or NBAT-like
      proteins) may have multiple functions in the small intestine, including luminal
      uptake of amino acids and vesicular uptake of related substrates into
      enteroendocrine cells and enteric neurons.

PMID- 8356085
TI  - Tau protein kinase I is essential for amyloid beta-protein-induced neurotoxicity.
AB  - Pathological changes of Alzheimer disease are characterized by cerebral cortical
      atrophy as a result of degeneration and loss of neurons. Typical histological
      lesions include numerous senile plaques composed of deposits of amyloid beta
      protein and neurofibrillary tangles consisting predominantly of ubiquitin and
      highly phosphorylated tau proteins. Previously, tau protein kinase I (TPK I) was
      purified and its cDNA was cloned. To examine the biological role of this enzyme
      in neurons, we have studied the induction of its kinase activity in primary
      cultures of embryonic rat hippocampal neurons. Treatment of cultures with amyloid
      beta-protein significantly increased TPK I activity and induced the appearance of
      tau proteins recognized by the Alz-50 monoclonal antibody. In addition, though
      amyloid beta-protein was neurotoxic, either cycloheximide or actinomycin D
      prevented neuronal death. Death was also prevented by TPK I antisense
      oligonucleotides but not by sense oligonucleotides. These observations suggest
      that rat hippocampal neurons undergo programmed cell death in response to amyloid
      beta-protein and that TPK I is a key enzyme in this process.

PMID- 8356086
TI  - Social regulation of the brain-pituitary-gonadal axis.
AB  - Reproduction in vertebrates is regulated by the hypothalamic-pituitary-gonadal
      axis via neural and hormonal feedback. This axis is also subject to exogenous
      influences, particularly social signals. In the African cichlid fish Haplochromis
      burtoni, gonadal development in males is socially regulated. A small fraction of
      the males, which are brightly colored, maintain territories and aggressively
      dominate inconspicuously colored nonterritorial males. Here we show through
      manipulation of the social and endocrine environment that changes in social
      status and gonadal state are accompanied by soma size changes in a population of
      gonadotropin-releasing hormone-containing neurons in the ventral forebrain. In
      territorial males, these cells are significantly larger than in nonterritorial
      males. When an animal switches from being territorial to nonterritorial through a
      change in social situation, these cells shrink; in animals that change from
      nonterritorial to territorial status, the cells enlarge. These gonadotropin
      releasing hormone-containing cells project to the pituitary and are ultimately
      responsible for regulating gonadal growth. This mechanism of socially induced
      cell size change provides the potential for relatively quick adaptive changes in
      the neuron-endocrine system without nerve cell addition or death. Since the
      structure of this regulatory axis is conserved among all vertebrates, other
      species with socially modulated reproductive physiology may exhibit a similar
      form of physiological regulation.

PMID- 8356087
TI  - Neural control of the endocrine rat heart.
AB  - Although atrial stretch is the accepted stimulus for atrial natriuretic factor
      (ANF), in vivo studies suggest a stretch-independent, neurally induced ANF
      release mechanism. Thus the hypothesis that cardiac nerves can stimulate ANF
      secretion was tested in the Langendorff-perfused, paced rat heart. Venom from the
      scorpion Centruroides sculpturatus was used to activate neuronal sodium channels,
      veratridine was added to activate sodium channels (predominantly in myocytes),
      and electrical stimulation was applied to the right atrial appendage. The
      efficacy of nerve stimulation was verified by measurements of increased
      neuropeptide Y in the effluent. ANF levels in the effluent increased by 120% over
      baseline with 0.5 microM scorpion venom and by 88% with 0.5 microM veratridine (P
      < 0.01). Cardiac mechanics did not explain the large, concentration-dependent ANF
      response to the scorpion venom, since changes in the left ventricular developed
      pressure were small, opposite to those induced by veratridine, and unaffected by
      sympathectomy or adrenergic receptor blockade. Prior chemical sympathectomy and
      adrenergic receptor blockade almost abolished the ANF response to scorpion venom
      but hardly affected the ANF response to veratridine. Addition of 1 microM
      tetrodotoxin abolished all ANF responses. Electrical stimulation of the atrial
      appendage increased the ANF secretion by 60.2% (P < 0.02), in conjunction with
      neuropeptide Y, whereas control stimulations were ineffective. These studies
      unequivocally demonstrate that stimulation of cardiac sympathetic nerves potently
      stimulates ANF secretion.

PMID- 8356088
TI  - The ornithine decarboxylase gene is a transcriptional target of c-Myc.
AB  - Constitutive c-myc expression suppresses cell cycle arrest, promotes entry into S
      phase, and results in the growth factor-independent expression of ornithine
      decarboxylase (ODC; EC 4.1.1.17). The ODC gene contains a conserved repeat of the
      Myc binding site, CACGTG, in intron 1. In this report, we demonstrate that c-Myc
      is a potent transactivator of ODC promoter-reporter gene constructs in
      fibroblasts that requires the CACGTG repeat. These sites conferred Myc
      responsiveness on heterologous promoter constructs, suggesting that ODC is
      regulated by Myc at the level of transcription initiation. Analysis of deletion
      and point mutants of c-myc revealed that domains required for transactivation of
      the ODC promoter did not include the leucine zipper of the Myc protein. This
      suggests that Myc may interact with transcription factors other than Max to
      transactivate the ODC gene.

PMID- 8356089
TI  - Application of physical organic chemistry to engineered mutants of proteins:
      Hammond postulate behavior in the transition state of protein folding.
AB  - Transition states in protein folding may be analyzed by linear free-energy
      relationships (LFERs) analogous to the Bronsted equation for changes in
      reactivity with changes in structure. There is an additional source of LFERs in
      protein folding: the perturbation of the equilibrium and rate constants by
      denaturants. These LFERs give a measure of the position of the transition state
      along the reaction coordinate. The transition state for folding/unfolding of
      barnase has been analyzed by both types of LFERs: changing the structure by
      protein engineering and perturbation by denaturants. The combination has allowed
      the direct monitoring of Hammond postulate behavior of the transition state on
      the reaction pathway. Movement of the transition state has been found and
      analyzed to give further details of the order of events in protein folding.

PMID- 8356090
TI  - Crystallization of ribozymes and small RNA motifs by a sparse matrix approach.
AB  - The three-dimensional structures of RNA enzymes form catalytic centers that
      include specific substrate binding sites. High-resolution determination of these
      and other RNA structures is essential for a detailed understanding of the
      function of RNA in biological systems. The crystal structures of only a few RNA
      molecules are currently known. These include tRNAs, which were produced in vivo
      and contained modified bases, and short oligonucleotide duplexes lacking tertiary
      interactions. Here we report that a number of different RNA molecules of 4-50
      kDa, all synthesized in vitro, have been crystallized. A highly successful method
      for the growth of RNA crystals based on previously reported conditions for tRNA
      crystallization is presented. This method is rapid and economical, typically
      requiring 1.1 mg of RNA to set up an experiment and 2 weeks to complete the
      observations. Using this technique, we have obtained crystals of 8 of 10
      different RNA molecules tested, ranging in size from a dodecamer duplex to a 208
      nucleotide catalytic intron. Several of these crystal forms diffract to high
      resolution; in one case, we have collected a 2.8-A native data set for a 160
      nucleotide domain of the group I self-splicing intron from Tetrahymena
      thermophila. The solution of these RNA structures should reveal aspects of
      tertiary structure that relate to RNA function and catalytic mechanisms.

PMID- 8356091
TI  - Females have a larger hippocampus than males in the brood-parasitic brown-headed
      cowbird.
AB  - Females of the brood-parasitic brown-headed cowbird (Molothrus ater) search for
      host nests in which to lay their eggs. Females normally return to lay a single
      egg from one to several days after first locating a potential host nest and lay
      up to 40 eggs in a breeding season. Male brown-headed cowbirds do not assist
      females in locating nests. We predicted that the spatial abilities required to
      locate and return accurately to host nests may have produced a sex difference in
      the size of the hippocampal complex in cowbirds, in favor of females. The size of
      the hippocampal complex, relative to size of the telencephalon, was found to be
      greater in female than in male cowbirds. No sex difference was found in two
      closely related nonparasitic icterines, the red-winged blackbird (Agelaius
      phoeniceus) and the common grackle (Quiscalus quiscula). Other differences among
      these species in parental care, migration, foraging, and diet are unlikely to
      have produced the sex difference attributed to search for host nests by female
      cowbirds. This is one of few indications, in any species, of greater
      specialization for spatial ability in females and confirms that use of space,
      rather than sex, breeding system, or foraging behavior per se, can influence the
      relative size of the hippocampus.

PMID- 8356092
TI  - Activation of mast cell K+ channels through multiple G protein-linked receptors.
AB  - The rat basophilic leukemia (RBL) mast cell line possesses cell surface receptors
      for adenosine whose ligation markedly potentiates antigen-driven Ca2+ influx and
      secretion. Here we show that engagement of these receptors and of separate P2
      purinergic receptors rapidly activates an outwardly rectifying K+ conductance
      [GK(OR)] in RBL cells. Activation of GK(OR) by the ligands 5'-(N
      ethylcarboxamido)adenosine (NECA), ADP, and ATP was prevented by cytoplasmic
      guanosine 5'-[beta-thio]diphosphate as well as by pretreatment of the cells with
      pertussis toxin, implicating mediation by a G protein. Multiple cycles of
      induction and decay of GK(OR) were produced upon application and removal of
      ligand. Induction of GK(OR) by either ligand was much faster than the induction
      caused by guanosine 5'-[gamma-thio]triphosphate (t1/2 < 10 sec vs. 210 sec.). In
      control cells the maximal whole-cell conductance elicited by ADP (2.25 +/- 0.30
      nS) or ATP (2.50 +/- 0.33 nS) was about twice as large as that induced by NECA
      (1.03 +/- 0.11 nS), and similar to that previously reported for the guanosine 5'
      [gamma-thio]triphosphate-elicited GK(OR) in RBL cells (2.58 +/- 1.59 nS).
      Treatment of RBL cells with dexamethasone upregulated Ca2+ responses to NECA, and
      it also nearly doubled the maximal conductance elicited by NECA without
      appreciable effect on responses to ADP or ATP. The failure of water-soluble
      second messengers to activate GK(OR) and the inability of 11 mM EGTA (< 10 nM
      Ca2+) to prevent activation by ADP suggest that the relevant pathway is membrane
      delimited. Two ion-channel blockers inhibited antigen-stimulated secretion with
      IC50 values similar to those at which they blocked GK(OR), suggesting that
      activity of the outwardly rectifying K+ channel may be important for stimulus
      response coupling in these cells. Potentiation of the secretory response by NECA
      may reflect, in part, the activation of GK(OR), which serves to repolarize the
      membrane more effectively than does the constitutive mechanism, thereby enhancing
      antigen-driven Ca2+ influx. This channel and its functionally associated
      receptors may allow neighboring cells of the host to modulate the response of
      mast cells to exogenous antigen.

PMID- 8356093
TI  - Two different forms of metarhodopsin II: Schiff base deprotonation precedes
      proton uptake and signaling state.
AB  - Rhodopsin is a retinal protein and a G-protein-coupled receptor; it shares with
      both of these families the seven helix structure. To generate the G-interacting
      helix-loop conformation, generally identified with the 380-nm absorbing
      metarhodopsin II (MII) photoproduct, the retinal Schiff base bond to the
      apoprotein must be deprotonated. This occurs as a key event also in the related
      retinal proteins, sensory rhodopsins, and the proton pump bacteriorhodopsin. In
      MII, proton uptake from the aqueous phase must be involved as well, since its
      formation increases the pH of the aqueous medium and is accelerated under acidic
      conditions. In the native membrane, the pH effect matches MII formation
      kinetically, suggesting that intramolecular and aqueous protonation changes
      contribute in concert to the protein transformation. We show here, however, that
      proton uptake, as indicated by bromocresol purple, and Schiff base deprotonation
      (380-nm absorption change) show different kinetics when the protein is
      solubilized in suitable detergents. Our data are consistent with a two-step
      reaction:

PMID- 8356094
TI  - Polymer models for interphase chromosomes.
AB  - The overall geometry of chromosomes in mammalian cells during interphase is
      analyzed. On scales larger than approximately 10(5) bp, a chromosome is modeled
      as a Gaussian polymer subjected to additional forces that confine it to a
      subvolume of the cell nucleus. An appropriate partial differential equation for
      the polymer Green's function leads to predictions for the average geometric
      length between two points on the chromosome. The model reproduces several of the
      experimental observations: (i) a square root dependence of average geometric
      distance between two marked chromosome locations on their genomic separation over
      genomic length scales from approximately 10(5) to approximately 10(6) bp; (ii) an
      approach of the geometric distance to a maximum value for still larger genomic
      separations of the two points; (iii) overall chromosome localization in
      subdomains of the cell nucleus, as suggested by fluorescent labeling of whole
      chromosomes and by radiobiological evidence. The model is also consistent with
      known properties of the 30-nm chromatin fiber. It makes a testable prediction:
      that for two markers a given number of base pairs apart on a given chromosome,
      the average geometric separation is larger if the configuration is near one end
      of the chromosome than if it is near the center of the chromosome.

PMID- 8356095
TI  - Differential expression of nerve growth factor receptors leads to altered binding
      affinity and neurotrophin responsiveness.
AB  - The low-affinity p75 neurotrophin receptor is believed to participate with the
      Trk receptor tyrosine kinase in the formation of high-affinity binding sites for
      nerve growth factor (NGF). To investigate the functional significance of the two
      NGF receptors, a truncated p75 receptor was stably expressed in PC12 rat
      pheochromocytoma cells, yielding cells with greatly reduced levels of wild-type
      p75 and normal Trk levels. Although these cells were capable of normal
      differentiation by NGF, very few high-affinity NGF binding sites were detected.
      These findings indicate that high-affinity binding may be functionally
      dissociated from biological responses. Furthermore, an increased responsiveness
      to neurotrophin 3 was observed, as manifested by increased neurite outgrowth.
      These results suggest that a correct ratio of p75 and p140trk is required to
      create high-affinity sites and that p75 expression may assist in the
      discrimination between related but different neurotrophin factors.

PMID- 8356096
TI  - The SCL gene product is regulated by and differentially regulates cytokine
      responses during myeloid leukemic cell differentiation.
AB  - Differentiation induction in murine M1 leukemia cells by interleukin 6 (IL-6),
      leukemia inhibitory factor (LIF), and oncostatin M (OSM) is postulated to occur
      via a common receptor chain, gp130. In this study, growth factor-induced
      differentiation of M1 cells was accompanied by a late and persistent decrease in
      levels of mRNA and protein for a helix-loop-helix transcription factor, the SCL
      gene product. To evaluate whether reduced SCL expression was instrumental in
      monocyte differentiation, an SCL cDNA expression vector was introduced into M1
      cells to obtain cell lines in which overexpression of SCL mRNA and protein was
      enforced. This resulted in a reduction in cells differentiating in response to
      LIF and OSM but not in response to IL-6. Scatchard analysis indicated that both
      parental and SCL-transfected cell lines exhibited similar receptor numbers and
      receptor affinities for LIF, OSM, and IL-6, suggesting that the differential
      responsiveness was not due to selective receptor down-modulation. Thus, these
      data implicate SCL in monocytic differentiation and provide evidence for
      differential receptor signaling pathways despite utilization of a common gp130
      subunit by all three receptors.

PMID- 8356097
TI  - Targeted mutagenesis of DNA using triple helix-forming oligonucleotides linked to
      psoralen.
AB  - Oligonucleotides can bind as third strands of DNA in a sequence-specific manner
      in the major groove in homopurine/homopyrimidine stretches in duplex DNA. Here we
      use a 10-base triplex-forming oligonucleotide linked to a psoralen derivative at
      its 5' end to achieve site-specific, targeted mutagenesis in an intact, double
      stranded lambda phage genome. Site-specific triplex formation delivers the
      psoralen to the targeted site in the lambda DNA, and photoactivation of the
      psoralen produces adducts and thereby mutations at that site. Mutations in the
      targeted gene were at least 100-fold more frequent than those in a nontargeted
      gene, and sequence analysis of mutations in the targeted gene showed that 96%
      were in the targeted region and 56% were found to be the same T.A to A.T
      transversion precisely at the targeted base pair. The ability to reproducibly and
      predictably target mutations to sites in intact duplex DNA by using modified
      oligonucleotides may prove useful as a technique for gene therapy, as an approach
      to antiviral therapeutics, and as a tool for genetic engineering.

PMID- 8356099
TI  - Free energies for refolding of the common beta turn into the inverse-common beta
      turn: simulation of the role of D/L chirality.
AB  - Quantitative estimates of the Gibbs free-energy change (delta G) for refolding of
      one beta-turn conformation into another would assist rational protein design. For
      beta-turn models, we studied a chirally representative set of nine peptides of
      the form CH3CO-L1-L2-NHCH3, where loop residues L1 (i + 1) and L2 (i + 2) are
      achiral Gly (G), L-Ala (A), or D-Ala (a). The stabilities of their common (type
      I) and inverse-common (type I') beta-turn conformers (GGI is the type-I GG
      conformer, etc.) were estimated by free-energy simulations using explicit water
      molecules. An alpha-hydrogen atom of a Gly residue at L1 or L2 was replaced by a
      methyl group by slow growth. The resulting conformers were less stable than GGI
      and GGI' by about 1-3 kcal/mol (delta G = 0.9 kcal/mol for AGI and aGI', 1.0
      kcal/mol for GAI and GaI', 2.1 kcal/mol for aGI and AGI', and 2.8 kcal/mol for
      GaI and GAI'; 1 kcal = 4.18 kJ). The delta G value for simultaneous growth of one
      methyl group at L1 and another at L2 was the sum of the two component delta G
      values. The delta G values for I-->I' refolding of the common beta-turn conformer
      into the inverse-common beta-turn conformer ranged over 6 kcal/mol (-3.0 for aa, 
      1.8 for Ga, -1.1 for aG, -0.7 for Aa, 0 for GG, 0.7 for aA, 1.1 for AG, 1.8 for
      GA, and 3.0 for AA). Thus, replacing L-Ala by D-Ala at both L1 and L2 of a common
      beta turn may contribute as much as 6 kcal/mol toward its refolding as an inverse
      common beta turn.

PMID- 8356100
TI  - Platelet-derived growth factor B chain promoter contains a cis-acting fluid shear
      stress-responsive element.

PMID- 8356098
TI  - Design, intracellular expression, and activity of a human anti-human
      immunodeficiency virus type 1 gp120 single-chain antibody.
AB  - A single-chain antibody, derived from a human monoclonal antibody that recognizes
      the CD4 binding region of the human immunodeficiency virus type 1 (HIV-1)
      envelope protein, has been designed for intracellular expression in eukaryotic
      cells. The single-chain antibody is composed of an immunoglobulin heavy-chain
      leader sequence and heavy- and light-chain variable regions that are joined by an
      interchain linker. The antibody is stably expressed and retained in the
      endoplasmic reticulum and is not toxic to the cells. The antibody binds to the
      envelope protein within the cell and inhibits processing of the envelope
      precursor and syncytia formation. The infectivity of the HIV-1 particles produced
      by cells that express the single-chain antibody is substantially reduced. These
      studies illustrate the feasibility of designing antibodies that bind and
      inactivate molecules intracellularly. Antibodies that act on target molecules
      within cells should provide a useful tool for research as well as for control of
      infectious and other diseases.

PMID- 8356101
TI  - Effects of veratridine and cocaine on the kinetics of synaptosomal dopamine
      release.
AB  - Following preloading of striatal synaptosomes with 3H-dopamine (DA), the kinetics
      of release have been followed for a 60-min incubation period. DA appears to be
      totally releasable under both depolarizing (veratridine) and nondepolarizing
      conditions. Cocaine has no significant effect on release under either condition.
      Release is consistent with a model consisting of two parallel, linear
      compartments (when plotted as a log function). It is proposed that the slower
      compartment might represent the operation of the DA transporter, while the faster
      compartment might represent vesicular release.

PMID- 8356102
TI  - Ouabain cardiotoxicity is enhanced by GABA in anesthetized rats.
AB  - Potential alteration of ouabain-induced cardiotoxicity by gamma-aminobutyric acid
      (GABA) in rats was tested by infusing ouabain for 10 min (0.7 mg/kg/min, i.v.)
      before or after continuous infusion of Ringer's solution with or without GABA (1
      mg/min, i.v.). GABA evoked hypotension and bradycardia of similar magnitude under
      both conditions. The incidence of ouabain-induced ventricular fibrillation (VF)
      or cardiac arrest (CA) was similar in both groups. However, the time intervals to
      onset of VF and CA, in rats given ouabain before, but not after, GABA were
      shorter than in rats treated with Ringer's solution (p < 0.05). In experiments
      where baclofen (0.034 mg/min, i.v.) was infused after ouabain, hypotension and
      bradycardia occurred, but the incidence and times of ouabain-induced VF and CA
      were similar to control values. These results suggest that the enhancement in
      ouabain cardiotoxicity was mediated by GABAA receptors.

PMID- 8356103
TI  - Studies on the mechanism of action of colloidal bismuth subcitrate. II.
      Interaction with pepsin.
AB  - The effects of colloidal bismuth subcitrate (CBS) on porcine pepsin have been
      studied in vitro. CBS inhibited pepsin activity in a pH-dependent manner. CBS was
      not active at pH 4.0 but inhibited pepsin activity at pH 1.0 (IC50: 2.3 +/- 0.09
      mmol/l) and pH 2.0 (IC50: 8.9 +/- 0.7 mmol/l). This inhibition was reversible. In
      the presence of the sulfhydryl ligand mercaptoethanol, which prevents
      precipitation of CBS, the inhibitory potency of CBS increased. CBS bound to both
      positively (Amberlite) and negatively charged (Dowex) ion exchangers in a pH
      dependent manner. With increasing acidity, binding to Amberlite increased,
      whereas binding to Dowex decreased. From these data we conclude that negatively
      charged bismuth salts derived from CBS bind at pH 2.0 and 1.0 via an ionic
      interaction to positively charged groups of pepsin, thereby inactivating the
      enzyme.

PMID- 8356104
TI  - Effects of chronic treatment with phenazone on the hot-plate test and
      [3H]serotonin binding sites in pons and cortex membranes of the rat.
AB  - Many reports indicate that nonsteroidal anti-inflammatory drugs exert their
      antinociceptive effect through adrenergic and serotoninergic systems. We
      investigated the acute and chronic effects of phenazone on the pain threshold and
      on brain serotonin binding sites. A relationship between phenazone serum levels
      and the antinociceptive effect was found; acute treatment with phenazone provokes
      a significant decrease in serotonin binding sites both in the pons and cerebral
      cortex after 2, 4 and 8 h, but not after 24 h. After 15 and 30 days of treatment,
      the number of binding sites increases both in the pons and cortex.

PMID- 8356105
TI  - Melatonin decreases brain serotonin release, arterial pressure and heart rate in
      rats.
AB  - The effects of intravenous administration of melatonin (30-60 mg/kg) or vehicle
      (10% alcohol) on arterial pressure, heart rate, blood gases or brain serotonin
      release were assessed in rats under urethane anesthesia. Administration of
      melatonin, but not the vehicle, produced a dose-related fall in mean arterial
      pressure, heart rate, or serotonin release in both the corpus striatum and the
      hypothalamus. Melatonin treatment had an insignificant effect on either PaCO2,
      PaO2 or pH. In addition, the melatonin-induced depressor responses were abolished
      by pretreatment with spinal transection, whereas melatonin-induced bradycardia
      was abolished by pretreatment with bilateral vagotomy. These results suggest that
      melatonin decreases brain serotonin release and results in sympathetic inhibition
      or parasympathetic stimulation which leads to hypotension and bradycardia in
      rats.

PMID- 8356107
TI  - Perceptions of acute care physical therapy practice: issues for physical
      therapist preparation.
AB  - BACKGROUND AND PURPOSE: Acute care physical therapists have experienced the
      effects of dramatic changes in health care reimbursement systems and population
      demographics. Acute care hospitals now serve a patient population of much older,
      chronically ill patients who are hospitalized for shorter periods of time in a
      practice environment in which physical therapy staffing resources are often
      inadequate. The purposes of this study were to document common experiences in the
      practice of acute care physical therapy and to identify differences in the
      perceptions of physical therapists with varying levels of experience and in
      various sizes of acute care facilities. SUBJECTS AND METHODS: A survey
      questionnaire was mailed to 500 randomly selected physical therapists employed in
      acute care facilities. The therapists answered questions regarding the frequency
      of various physical therapy evaluation and treatment practices, problems
      encountered in delivering physical therapy services, coordination of the
      discharge planning process, and perceptions of staffing trends in the acute care
      setting. The responses of 188 physical therapists who completed the survey were
      compared by their experience levels and the size of the institutions in which
      they practiced. RESULTS: Subjects reported that patient factors, such as medical
      complications and cooperation; organizational factors, such as staffing shortages
      and large caseloads; and health care system constraints, such as difficulty
      changing orders and limited time in which to work with the patient interfered
      with patients reaching physical therapy goals. CONCLUSION AND DISCUSSION:
      Inadequate skills for successful acute care practice and maladaptive therapist
      beliefs about acute care career possibilities may adversely affect physical
      therapist career longevity in the acute care setting.

PMID- 8356106
TI  - Diagnosis and treatment in physical therapy: an investigation of their
      relationship.
AB  - BACKGROUND AND PURPOSE: The diagnosis made by a physical therapist gives
      direction to the selection of therapeutic interventions. Therefore, in an
      investigation, specific relationships between diagnoses and therapeutic
      interventions are expected. This study was designed to test whether such
      relationships exist. SUBJECTS AND METHODS: Data on diagnosis, treatment goals,
      and interventions were gathered on 8,714 patients by 74 physical therapists. The
      diagnosis and treatment goals were defined in terms of impairments and
      disabilities. RESULTS: Specific relationships were found to exist between those
      impairments and disabilities that were chosen as a basis for forming treatment
      goals and the application of interventions. These relationships are particularly
      marked at the impairment level. CONCLUSION AND DISCUSSION: It is concluded that
      the diagnostic categories validly predict which interventions are applied and
      that the selection of interventions depends on which treatment goals are pursued.

PMID- 8356108
TI  - Test-retest reliability of two tiltboard tests in children.
AB  - BACKGROUND AND PURPOSE: Most clinical evaluations of postural control in children
      are relatively subjective and have not been tested for reliability of scoring.
      The purpose of this study was to investigate the test-retest reliability of
      measurements obtained with two tiltboard tests. SUBJECTS: Subjects were 18
      children, aged 53 to 81 months (mean = 64.4, SD = 8.3), who were typically
      developing (TD group) and 18 children, aged 50 to 79 months (mean = 63.3, SD =
      8.4), with developmental delays (DD group). METHODS: Each child was tested using
      the two tilt-board tests and was then retested using the same tests approximately
      1 week later. The maximum angle of tiltboard tilt prior to any postural
      adjustment by the child was recorded. RESULTS: Intraclass correlation
      coefficients for test-retest reliability (two-way, random-effects, repeated
      measures model) ranged from .49 to .54 for the TD group and from .52 to .82 for
      the DD group. Angles were higher for both groups for the second test. CONCLUSION
      AND DISCUSSION: The results suggest that these tiltboard tests do not give stable
      and reliable measurements across test sessions. Before these tests can be used to
      document change in postural control abilities across time, further research is
      warranted.

PMID- 8356110
TI  - APTA policy.

PMID- 8356109
TI  - Intrasubject reliability of spinal range of motion and velocity determined by
      video motion analysis.
AB  - BACKGROUND AND PURPOSE: The purpose of this study was to investigate the
      repeatability of spinal range of motion (ROM) and movement velocity measurements
      of patients with chronic low back pain, using a two-dimensional motion analysis
      system. This apparatus uses reflective markers placed on anatomical landmarks and
      video digitization to derive ROM measurements from three segments of the spine
      and associated velocities through the respective ROMs. SUBJECTS: Forty-two
      patients with chronic LBP underwent ROM and movement velocity testing. METHODS:
      Each subject was tested twice without removal of the markers to minimize error
      contribution from differences in marker placement. RESULTS: Results indicated
      that both the ROM measures and the velocity measures were highly repeatable.
      Intraclass correlations for the ROM measures ranged from .77 to .96. Velocity
      measures were also reliable, with intraclass correlation coefficients ranging
      from .75 to .97. CONCLUSION AND DISCUSSION: Overall, the results seem to indicate
      that the video motion analysis system used in this study yields repeatable ROM
      and velocity measures on a clinical population. In practice, however, the
      measures may reflect greater errors due to the need of examiners to relocate
      markers at different testing sessions. These systems also offer distinct
      advantages over other means of obtaining ROM and velocity measures. The results
      of this study indicate that these measures may be obtained without undue concern
      for measurement artifact due to the instrumentation reliability.

PMID- 8356111
TI  - Continuing education rating system needed.

PMID- 8356112
TI  - RepFIB: a basic replicon of large plasmids.
AB  - The distribution of the RepFIB replicon among a total of 20 plasmid
      incompatibility groups was determined using Southern blot and polymerase chain
      reaction analysis. The presence of the replicon was confirmed in 25 of 55
      plasmids tested. The majority of plasmids carrying RepFIB are from the IncF
      incompatibility groups, but one plasmid from IncI and one plasmid from IncP also
      possess the replicon. Seven different examples of RepFIB were sequenced in the
      minimal replicon region to obtain 1525 bp of sequence information covering the
      repA gene and flanking repeat regions for comparison. An analysis of these
      sequences plus three sequences previously reported showed almost perfect
      conservation of the predicted protein sequence of RepA and of the flanking DNA
      repeats. DNA sequence data were analyzed using maximum parsimony techniques to
      describe the possible evolutionary relationships of the 10 examples of RepFIB.

PMID- 8356113
TI  - Transcription of the kalilo linear senescence plasmid from Neurospora intermedia.
AB  - The 8.6-kb kalilo linear mitochondrial plasmid of Neurospora intermedia was found
      to give rise to multiple transcripts of 8.6, 4.4, 4.0, 1.3, 1.2, and 0.9 kb.
      Plasmid transcripts were found in all the developmental stages tested and were
      present in cells with and without plasmid integration into mtDNA. The 4.4- and
      4.0-kb transcripts corresponded to the two known ORFs in size, position, and
      polarity. An analysis of RNA fractions has confirmed the mitochondrial location
      of kalilo. The kalilo-specific RNA appears to be selectively unstable in affected
      strains of N. intermedia; this may be a general property of linear plasmid RNA.
      Transcripts are most likely initiated from near the termini of the linear
      plasmid. Primer extension and sequencing showed a clear 5' RNA end at nucleotide
      101. However, the sequence in this region does not show homology with any known
      mitochondrial, plasmid, or nuclear promoter. The sequence does show homology with
      the tip of the plasmid and marks the border of a long series of direct repeats.
      Possibly the plasmid RNA polymerase may be bifunctional, recognizing sequences at
      the plasmid tip as well as the promoter.

PMID- 8356114
TI  - Optimization of methods for transfecting Spiroplasma citri strain R8A2 HP with
      the spiroplasma virus SpV1 replicative form.
AB  - Seven methods for the transfection of bacteria were compared and optimized for
      use in Spiroplasma citri strain HP using the spiroplasma virus SpV1 R8A2 B
      replicative form (RF). These methods included both chemical-mediated protocols
      [CaCl2, RbCl/CaCl2, polyethylene glycol (PEG)], liposome-mediated transfection,
      electroporation, freeze/thaw cycling, and natural competence. The best protocols
      were those which utilized PEG or electroporation, yielding transfection
      frequencies of 1.4 x 10(-4) and 9.1 x 10(-4) transfectants/colony-forming unit
      (CFU), respectively. For both of these protocols, transfection frequencies were
      higher using CsCl-purified, covalently closed, circular DNA. In the PEG-mediated
      protocol, Sigma 8000 brand PEG at a final concentration of 44%, and the presence
      of carrier DNA proved to be optimal with a PEG exposure time of 2 min. Using
      electroporation, a 1-2 ms pulse of a 6.5 kV/cm electric field was best; washing
      the host cell pellet prior to electroporation enhanced efficiencies by 50%.
      Linearization of the DNA resulted in lower transfection efficiencies by either
      method.

PMID- 8356115
TI  - Genetic organization and evolution of the cryptic plasmid of Neisseria
      gonorrhoeae.
AB  - Three promoters have been identified on the phenotypically cryptic plasmid of
      Neisseria gonorrhoeae that can direct transcription in Escherichia coli. These
      promoters do not seem to function at a detectable level when N. gonorrhoeae is
      grown in vitro under normal growth conditions. The T7 RNA polymerase expression
      system has been used to identify the proteins encoded by this plasmid, and a
      series of subclones were constructed and used to localize the gene encoding each
      protein. In a search of the sequence databases, we have discovered that the
      derived amino acid sequence of a 1.2-kb segment of the plasmid shows a high
      degree of sequence similarity to the Mob proteins encoded by the colicinogenic
      plasmids ColA, ColE1, and ColK of E. coli. The 1.2-kb segment contains part of a
      Col mobilization region that has subsequently been inactivated by a small
      duplication. During the recombination event that formed the cryptic plasmid one
      of the mobilization genes was fused to a cryptic plasmid open reading frame to
      form the cppB gene. Despite the manner in which it was formed, we have shown that
      the cppB gene can be expressed when N. gonorrhoeae is grown under the appropriate
      environmental conditions.

PMID- 8356116
TI  - A natural A/T-rich sequence from the yeast FBP1 gene exists as a cruciform in
      Escherichia coli cells.
AB  - Palindromic or semipalindromic sequences can adopt cruciform structures in DNA in
      vitro. It has been demonstrated in some cases that A/T-rich cruciforms exist also
      in vivo in Escherichia coli. The biological function of those structures is not
      understood although putative cruciforms have been found in interesting locations
      on replication origins, operators, or transcriptional termination regions. Here
      we show by means of the use of structure-dependent nucleases that the 3' end of
      the yeast FBP1 gene contains a stable cruciform both in vitro and in E. coli
      cells and that in both cases, its extrusion depends on the DNA supercoiling
      state.

PMID- 8356117
TI  - Clostridium perfringens-Escherichia coli shuttle vectors that carry single
      antibiotic resistance determinants.
AB  - Two versatile Clostridium perfringens-Escherichia coli shuttle vectors were
      constructed. Each plasmid carried a single antibiotic resistance gene which was
      expressed in both organisms. The plasmid pJIR750 encoded resistance to
      chloramphenicol and pJIR751 encoded resistance to erythromycin. Each plasmid
      contained the pUC18-derived multiple cloning site and the lacZ' gene which
      enabled direct screening for recombinants in E. coli. These plasmids should prove
      invaluable for the genetic manipulation of C. perfringens.

PMID- 8356119
TI  - Refinements using free-tissue transfer for complex cranial base reconstruction.
AB  - Resection of skull base tumors may sometimes result in massive extirpation
      defects that are not amenable to local tissue closure. Closure of large
      basicranial defects can be performed with either a myocutaneous, a
      deepithelialized myocutaneous, or a simple muscle free flap designed from the
      ample rectus abdominis vascular territory. This free-tissue donor site has
      abundant and reliable well-vascularized tissue that can easily be customized to
      seal these tenuous areas. The rectus abdominis muscle and its vascularized
      territory were used in 18 of 19 consecutive patients at our center to close
      basicranial ablation defects. Of these, 6 were rectus abdominis muscle flaps, 5
      were myocutaneous rectus abdominis flaps, and 7 were deepithelialized rectus
      abdominis muscle flaps. All free flaps survived. The intracranial space was
      sealed successfully in all but one patient. This patient underwent reconstruction
      with a muscle free flap and had a postoperative cerebrospinal fluid leak. This
      complication could have been avoided by using a deepithelialized myocutaneous
      flap to obliterate the central dead space with the vascularized subcutaneous fat.
      Two patients experienced minor wound infections, and one had a subdural abscess
      that was fully contained by a free flap placed over the duraplasty. One patient
      had a donor-site hernia. There was no incidence of meningitis. Knowledge of the
      anatomy of the vascular territory of the deep inferior epigastric vessels can be
      used judiciously to secure three-dimensional reconstruction of the skull base.
      The donor site supplies ample tissue for reconstruction and allows individual
      tailoring for obliteration of geometrically complex extirpation defects in and
      around the cranial base without the need to reposition the patient.

PMID- 8356118
TI  - Overproduction and purification of the colicin E1 immunity protein.
AB  - Colicin E1 immunity protein encoded by the plasmid colicin E1 was overproduced in
      Escherichia coli from an expression plasmid which was constructed by placing the
      immunity protein-encoding sequence downstream of the tac promoter and by properly
      positioning the ribosome binding site on a run-away replication vector. The
      immunity protein was solubilized with 0.5% Brij 58 from the membrane fraction and
      purified to homogeneity by a simple batch procedure with hydroxyapatite gel and
      reverse-phase chromatography. A 15-residue NH2-terminal amino acid sequence was
      determined to be the same as that deduced from the DNA sequence. The effect of
      the purified immunity protein on membranes was tested in vitro using solute
      loaded liposomes. The immunity protein added to the liposomes showed a small but
      significant channel or lytic activity that is an indicator of its hydrophobic
      nature.

PMID- 8356120
TI  - Computer-assisted three-dimensional planning in craniofacial surgery.
AB  - Three-dimensional surface reconstruction from computed tomographic (CT) data has
      been used to plan craniofacial operations. Cephalometric and anthropometric
      databases were integrated with three-dimensional CT reconstructions to quantitate
      the skeletal deformity and to assist in the design of the surgical procedure.
      Interactive techniques were developed to simulate osteotomies and skeletal
      movements in three dimensions on the computer-generated surface images. The
      ocular globes were referenced to position the orbital segments; i.e., the
      osteotomized segments were transposed into normal anatomic relationship with
      respect to the eyes. The measurements from the computer graphic simulation were
      used intraoperatively to establish the correct position of the skeletal segments.

PMID- 8356121
TI  - [Measurement of normal eyeball position and its application for evaluation of
      exophthalmos in craniofacial synostosis].
AB  - The chronologic changes in eyeball position in relation to bony landmarks were
      studied by CT scans. The results were applied to the preoperative evaluation in
      16 craniofacial synostosis patients. Ten subjects from each age group were
      selected from more than 2000 subjects who underwent CT scanning of the skull
      without any brain and skull diseases. These age groups ranged from birth to 20
      years of age. The following four distances were measured on the CT section
      incorporating lenses: (1) the distance from the dorsum sellae to the lenses, (2)
      the distance between the lateral orbital rim and the lenses, (3) the distance
      from the nasal root to the lenses, and (4) the width between the lenses. These
      distances also were measured in 16 craniofacial synostosis patients
      preoperatively, and the results were compared with those of the healthy
      individuals in the same age group. The distances of the lenses from the nasal
      root and from the lateral orbital rim were larger than in the healthy individuals
      in almost all craniofacial synostosis patients. However, the distance from the
      dorsum sellae to lenses was the same as that in healthy individuals on the whole.

PMID- 8356122
TI  - Nasopharyngeal profile and velopharyngeal valve mechanism.
AB  - Proper management of velopharyngeal insufficiency requires an understanding of
      normal velopharyngeal anatomy and function. The present cephalometric study
      correlates the nasopharyngeal profile at rest with velopharyngeal function as
      observed by nasendoscopy and fluorographic and videofluoroscopic studies. Fifty
      two normal individuals and 23 patients with insufficient velopharyngeal valves
      were examined. A correlation was found between nasopharyngeal profiles at rest
      and the closure patterns of the velopharyngeal valve. It was found that when
      existent, Passavant's ridge is subsequently formed where thick soft tissue
      corresponding to the superior constrictor muscle is found beneath the mucosa of
      the posterior pharyngeal wall at rest. Our conclusion is that Passavant's ridge
      is formed by the superior constrictor. The present study represents additional
      confirmation that differences in velopharyngeal closure patterns are the result
      of differences in anatomy. A biomechanical model of velopharyngeal valving is
      presented based on individual spatial muscular orientation and the hierarchical
      recruitment of the velopharyngeal muscles. This recruitment is progressive and is
      dependent on the effort required to achieve tighter velopharyngeal sealing.

PMID- 8356123
TI  - The split-lip advancement technique (SLAT) for the treatment of congenital
      sinuses of the lower lip.
AB  - In this paper we present 7 cases of Van der Woude syndrome and describe a new
      surgical technique for the treatment of congenital sinuses of the lower lip. Our
      technique is essentially a new modification of the elastic lip flap technique of
      Goldstein. We term this procedure the split-lip advancement technique, in which
      two opposite labial artery--based flaps including the whole thickness of the
      vermilion and the mucosal surface of the lip are used to repair the median defect
      that resulted from excision of the sinuses. To our knowledge, there have been no
      reports of the use of this technique in the treatment of congenital sinuses of
      the lower lip.

PMID- 8356124
TI  - A method of treatment of constricted ears with a conchal cartilage graft to the
      posterior auricular plane.
AB  - In order to make natural auricular features in a simple and certain way and also
      to prevent the occurrence of a postoperative lop-eared deformity, we contrived a
      new method to treat constricted ears. Our method consists of correction of the
      anthelical deformity according to a modified Converse method and a cartilage
      graft harvested from the posterior region of the concha to fix as a support on
      the posterior auricular plane which enables the auricle to maintain a normal
      shape. This method resulted in very satisfactory treatment of prominent ears or
      ears with mild helical constriction, categorized as group I, IIa, or IIb on
      Tanzer's classification, and the patients did not have marked postoperative
      problems. Thus, in this respect, our technique is considered to be a very
      effective and safe method.

PMID- 8356125
TI  - Recipient vessels in head and neck microsurgery: radiation effect and vessel
      access.
AB  - Historical cohort analysis compared free-flap survival rates in 226 irradiated
      and 108 nonirradiated head and neck reconstructions. The failure rate for the
      irradiated flaps (3.5 percent) did not differ significantly from that for the
      nonirradiated group (2.9 percent). A case-control study of the failed irradiated
      flaps revealed infection and lag time between radiotherapy and surgery as the
      only factors significantly associated with free flap failure. Salvage techniques
      (vein grafting, cephalic transposition, and Corlett looping) for recruiting
      recipient vessels into radically ablated head and neck beds are reviewed.

PMID- 8356127
TI  - Face lift without preauricular scars.
AB  - A subperiosteal rhytidectomy is described that corrects aging of the forehead,
      the orbital region, the nasolabial fold, and the cheeks. It substantially
      improves muscular tone, consistency of subcutaneous tissue, and projection of
      malar volume. Its use with proper preoperative evaluation of the grade of facial
      aging reduces the indication for preauricular incision.

PMID- 8356126
TI  - Frostbite in the prairies: a 12-year review.
AB  - A 12-year retrospective review of inpatient frostbite injury was undertaken in
      three tertiary hospitals serving a northern prairie population of 650,000. In the
      125 patients identified, the mean age was 41 years, with a range of 3 to 90
      years. Predisposing factors were alcohol consumption (46 percent), psychiatric
      illness (17 percent), vehicular trauma (19 percent), vehicular failure (15
      percent), and drug use (4 percent). Profound hypothermia with a core temperature
      less than 32 degrees C was present in 12 percent. Anatomic distribution was 19
      percent upper extremity, 47 percent lower extremity, 31 percent combined upper
      and lower extremity, and 3 percent facial or trunk only. Factors correlating with
      amputation of parts (p < 0.05) were duration of exposure, lack of proper attire,
      remote site of injury, presence of wound infection, and delay in seeking
      treatment. Prophylactic systemic antibiotics did not decrease the incidence of
      wound infection. Comparison with nine other civilian series revealed striking
      similarities in the patient populations.

PMID- 8356128
TI  - Causes for cancellation of aesthetic and reconstructive procedures.
AB  - Cancellation of plastic surgical procedures has several deleterious effects,
      including emotional distress and economic ramifications. This prospective study,
      conducted over a 12-month period in a solo practice, reviewed the factors that
      contributed to surgical cancellations. Cancellations occurred despite many strict
      measures such as at least two preoperative visits, in-depth counseling and
      reinforcement by surgeon and staff, laboratory testing done 2 weeks prior to
      surgery, detailed evaluation of medical background, extensive written and verbal
      instructions to avoid medications that adversely affect surgery, and thorough
      discussion of payment plans and insurance coverage, including predetermination of
      any third-party coverage. Of the 952 patients (667 males, 285 females) scheduled
      for surgery, 113 experienced cancellation of the operation, either by the surgeon
      and staff or by the patient. Cancellations were proportionally fewer in male
      patients (p < 0.025). The total number of scheduled procedures was 1590 (some
      patients scheduled for more than one procedure); 727 of these were cosmetic (46
      percent), and 863 were reconstructive (54 percent). Of the 205 procedures
      canceled, cosmetic procedures were more likely to be canceled (p < 0.001), since
      123 (16.9 percent) cosmetic procedures were canceled in contrast to 82 (9.5
      percent) canceled reconstructive procedures. Because of multiple cancellations,
      there were a total of 119 cancellations for 113 patients. Thirty of the 113
      patients were rescheduled at a later date. Of these 30, 24 did undergo surgery,
      while 6 canceled for a second time. Thirty-two of the 113 canceled patients (28.3
      percent) were patients in their fifth decade of life.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8356129
TI  - A one-stage nipple reconstruction with the "modified star" flap and immediate
      tattoo: a review of 100 cases.
AB  - Nipple reconstruction employing both grafts and local flaps has historically been
      a staged procedure. This paper presents a one-stage procedure using a local flap
      with immediate tattoo that has the advantages of high patient satisfaction and
      low cost. The procedure can be performed in a minor surgery suite with local or
      no anesthetic in 15 to 30 minutes. In this series of 100 nipples there has been
      only one partial necrosis, which was easily corrected with a "boost" procedure.
      Only 8 percent of patients required revision procedures in the office, and there
      have been no infections or wound complications. Patient satisfaction and
      compliance have been excellent because the procedure is fast and easy with
      minimal morbidity. Modifications in technique are presented, based on the type of
      breast reconstruction (implant versus flap), local scarring, and size and color
      of the opposite nipple-areola complex.

PMID- 8356130
TI  - Definitive diagnosis of breast implant rupture using magnetic resonance imaging.
AB  - Breast implant rupture is an important complication of augmented and
      reconstructed breasts. Although several techniques such as mammography,
      xeromammography, ultrasound, thermography, and computed tomographic (CT) scanning
      have been proven to be useful to detect implant rupture, they have several
      disadvantages and lack specificity. In the current study, we have established
      magnetic resonance imaging (MRI) as a definitive, reliable, and reproducible
      technique to diagnose both intracapsular and extracapsular ruptures. The study
      was conducted in 100 symptomatic patients. Our imaging parameters were able to
      identify ruptures in implants with silicone shells. All the ruptures showed the
      presence of wavy lines, free-floating silicone shell within the gel ("free
      floating loose-thread sign" or "linguine sign"). We had a 3.75 percent incidence
      of false-positive and false-negative results. The sensitivity for detection of
      silicone implant rupture was 76 percent, with a specificity of 97 percent. In
      addition, we also were able to identify the artifacts that may interfere with the
      definitive diagnosis of implant rupture.

PMID- 8356131
TI  - The role of microvascular surgery in limb-sparing procedures for malignant tumors
      of the knee.
AB  - Limb-sparing surgery has proven to be a feasible alternative to amputation for
      treatment of malignant tumors about the knee. Microvascular surgery and the
      possibility of providing healthy, stable soft-tissue coverage to the affected
      limb have expanded the possible role of limb-sparing techniques. Microvascular
      free flaps were utilized in 26 patients undergoing resection for large malignant
      tumors of the knee or adjacent to the knee. Patients were then followed for a
      minimum of 3 years to a maximum of 7 years and evaluated for tumor recurrence and
      limb function. Survival and disease-free interval were 68 and 77 percent,
      respectively, in stage II patients and only 50 and 0 percent, respectively, in
      stage III patients. Function, as determined by the MSTS functional evaluation
      system, was found to be fair to good in all patients. Microvascular free-tissue
      transfer has proven to be a valuable adjunct in limb-sparing surgery.

PMID- 8356132
TI  - Application of maxillofacial miniplating and microplating systems to the hand.
AB  - During the past several years, a profound change in our approach to bone
      stabilization in the hand has occurred. Today, standard management of almost any
      fracture requiring open reduction as well as most arthrodeses and osteotomies
      will incorporate rigid fixation employing one of the maxillofacial systems. Many
      of the early concerns, such as increased complexity of the procedure, the need
      for extensive periosteal stripping, bulkiness of the plates (with potential
      palpation, tenderness, and the impingement on tendon and joint motion), and the
      anticipated frequent need for removal, have been allayed. Thinner plates, the
      smallest screws from the miniplating systems, and the introduction of the
      microplating systems (Luhr and Synthes) have obviated much of the anticipated
      difficulty with tendon gliding and have made the necessity for subsequent plate
      removal a rarity in our practice. The use of these systems allows much earlier
      mobilization postoperatively, reducing the incidence of joint stiffness and
      tendon adhesion. This paper discusses our series of 143 patients (average follow
      up time over 18 months) and the application of miniplating and microplating
      systems for a variety of fractures, osteotomies, and arthrodeses in the hand.

PMID- 8356133
TI  - Histomorphologic changes in expanded skeletal muscle in rats.
AB  - Tissue expansion is one of the powerful tools for various reconstructive
      procedures and has proven to provide more available local tissues. However,
      limited attention has been given to the characteristics of expanded skeletal
      muscle. Using a rat model (n = 41), we expanded the rat gracilis muscle and
      investigated the histomorphologic changes in the expanded skeletal muscle. By
      expansion, the gracilis muscle after 3 weeks increased 50.4 to 58.4 percent in
      length and 60.5 percent in width and decreased 39.0 to 42.0 percent in thickness.
      Histologically, the expanded muscle demonstrated a normal striation and no signs
      of inflammation or necrosis. The cross-sectional areas of muscle fibers indicated
      that expanded muscle consisted of predominantly smaller fibers. Vasculature in
      the expanded muscle demonstrated a longer network of arteries and a more obvious
      and developed arterial arcade. The average number of sarcomeres in a fiber
      estimated from the sarcomere length and fiber length was significantly greater
      (46.5 percent) in the expanded muscle. These findings suggest that the expansion
      of skeletal muscle is not a "stretching" process of muscle but rather a growth
      process of the muscle accompanied by an increase in the number of sarcomeres per
      fiber. Furthermore, the expanded skeletal muscle appears to preserve normal
      skeletal muscle architecture, vasculature, and function while undergoing the
      ischemic stress of expansion.

PMID- 8356134
TI  - Cross-chest C7 nerve grafting followed by free muscle transplantations for the
      treatment of total avulsed brachial plexus injuries: a preliminary report.
AB  - The number of donor nerves available for nerve transfer in the reconstruction of
      total root avulsion injuries of the brachial plexus is always insufficient. Use
      of the contralateral normal C7 cervical nerve as a donor nerve is a new approach
      to obtain more nerve fibers but also is a controversial procedure. Fifteen
      patients with total root avulsion of the brachial plexus received cross-chest C7
      nerve grafting as the first stage of reconstruction. Eight of these patients,
      after an interval of 11 to 20 months, had free muscle transplantations (one to
      three muscles transferred per individual) to the affected limb. A long period of
      rehabilitation (at least 2 years) is required. The donor limbs of the 15 patients
      showed negligible deficits of motor and sensory function. Although independent
      movement of the transferred muscles from the contralateral limb has not been
      achieved, useful function of the reconstructed limb is possible. The preliminary
      results are encouraging.

PMID- 8356135
TI  - Reinnervation of denervated Pacinian corpuscles: ultrastructural observations in
      rats following free nerve grafts.
AB  - Nerve transection and immediate free nerve grafts using rat sciatic nerves were
      employed to observe the morphologic changes in periodical denervation and
      reinnervation of Pacinian corpuscles located on the interosseous membrane between
      the fibula and tibia. During periods of from 2 weeks to 20 months after the
      surgery, a total of 28 corpuscles were obtained under an operating microscope and
      processed for morphologic analysis using light and electron microscopes. Based on
      our morphologic findings, normal corpuscles were composed of an axon terminal and
      inner and outer cores. The axon terminal disappeared within 2 weeks after the
      nerve grafts, but the original inner and outer core cells remained for up to 20
      months. In addition, a small number of collagen fibrils was observed between the
      inner and outer core cells. After 4 months, multiple axon terminals began to
      regenerate in the inner core. From 7 to 20 months, these axon terminals in some
      corpuscles developed a structure resembling that of normal terminals. Some of
      these terminals were located in the center of the inner core, but a few were in
      contact with the outside of the inner core. The production of collagen fibrils in
      denervated corpuscles was periodically activated in the intercellular spaces.
      These findings suggest that the morphologic changes in denervated corpuscles
      correspond to those in denervated nerves. Inner core cells, which are continuous
      with Schwann cells, remain in their original condition in denervated corpuscles
      until regenerating nerves enter the inner core and are essential for corpuscle
      regeneration, because they may produce some trophic substances that induce the
      regeneration of multiple axon terminals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8356136
TI  - Chest-wall reconstruction for spondylocostal dysostosis.
AB  - A child with respiratory insufficiency due to a lethal syndrome known as
      spondylocostal dysostosis is described. Severe chest-wall deformities with
      resultant paradoxical chest-wall motion were successfully corrected by surgical
      reconstruction of the right thorax. We conclude that patients with the severe
      lethal form of the syndrome may benefit from aggressive surgical correction of
      the thoracic abnormality.

PMID- 8356137
TI  - Advances in cosmetic micropigmentation.
AB  - Cosmetic micropigmentation for implanting pigments into the skin is a relatively
      new and beneficial procedure. We have found patient satisfaction to be high and
      complication rate low. We do stress that the help of an aesthetician is necessary
      in determining the color of pigmentation.

PMID- 8356138
TI  - Reversed cephalic vein: a lifeboat in head and neck free-flap reconstruction.
AB  - Free flaps always followed surgical resection in head and neck cancer patients as
      a means of reconstruction. Problems may be encountered in recurrent patients who
      have received postoperative cervical irradiation, since finding a good, healthy
      vein for microanastomosis is sometimes difficult. The internal jugular vein, with
      or without vein grafting, as the recipient vessel may solve the problem. However,
      we encountered two patients in whom the internal jugular vein was very fibrotic
      as a result of irradiation. A long vein graft to the nonirradiated, healthy area
      was the only choice in this condition. A new method in which a reversed cephalic
      vein is used as the recipient vessel was designed. It seems that the reversed
      cephalic vein can play the role of lifeboat as recipient vein and solve the most
      difficult problem encountered in head and neck free-flap surgery.

PMID- 8356139
TI  - "Iris" technique for immediate umbilical reconstruction.

PMID- 8356140
TI  - Extended transverse rectus abdominis musculocutaneous flap.
AB  - The transverse rectus abdominis musculocutaneous flap is widely used for breast
      reconstruction, but it does not have a rich blood supply. A previous article
      described the inclusion of superficial epigastric vessels and superficial
      circumflex iliac vessels to "supercharge" the flap. Subsequent experience has
      shown that the external pudendal vessels also can be used for "supercharging."

PMID- 8356141
TI  - Presternal bronchogenic cyst in an adult.

PMID- 8356142
TI  - Kaposi sarcoma limited to the glans penis.

PMID- 8356143
TI  - Lip augmentation.

PMID- 8356144
TI  - Thyroid "storm" after cervical facial rhytidectomy.

PMID- 8356145
TI  - Treatment for trichiasis.

PMID- 8356146
TI  - Repair of anterior tibial muscle hernia.

PMID- 8356147
TI  - American center for plastic and reconstructive surgery through the eyes of a
      surgeon from Russia.

PMID- 8356148
TI  - Where to use superficial lipoplasty (liposuction)?

PMID- 8356149
TI  - Reports in the media on breast implants.

PMID- 8356150
TI  - Possible hemorrhage after inferior turbinectomy.

PMID- 8356151
TI  - Prevention of violence.
AB  - Primary care physicians can easily incorporate efforts toward the primary and
      secondary prevention of family violence into their practices. By designing a
      preventive effort using the phases of the family life cycle, a developmentally
      appropriate system of prevention is created. The anticipatory guidance at each
      (annual) visit acknowledges family transitions and assures the family that abuse
      is a health issue and that the physician is a resource for issues of violence
      prevention. Using the FLC, the first phase is Coupling, when there is a risk of
      partner violence that continues as long as there is a partnership. Pregnancy and
      childbirth bring concerns of child neglect and battery. Older children are at
      additional risk for child sexual abuse. As families age, risks develop for elder
      abuse, too. The regular discussion of these issues raises the awareness that the
      potential for family violence continues over the life span and allows the
      physician opportunities to assess the risk of violence in that family and make
      appropriate preventive referrals. Primary care physicians are optimally
      positioned to address violence and its prevention in the office: they know and
      care for family units over time. Physicians are respected and trusted advisors
      who can become effective in preventing violence.

PMID- 8356152
TI  - Domestic violence.
AB  - Domestic violence is an enormous health care issue that primary care physicians
      are powerfully suited to address. Rarely, however, do primary care physicians
      recognize that many of the patients who regularly and routinely present to them
      are victims of abuse. This article is designed to empower America's front-line
      doctors to recognize and appropriately treat the many victims of domestic
      violence who currently suffer from this silent epidemic. The reader will come to
      understand that it is via relatively simple-to-learn techniques that physicians
      can significantly impact the health and well-being of their communities.

PMID- 8356153
TI  - Psychological child maltreatment. A developmental view.
AB  - This article explores the concept of psychological child maltreatment. It begins
      with a definition of psychological maltreatment in terms of care-giver behavior
      that thwarts the meeting of the needs of children. It focuses on five forms of
      psychological maltreatment that are of concern to the practitioner: rejecting
      (sending messages of rejection to the child), ignoring (being psychologically
      unavailable to the child), terrorizing (using intense fear as a weapon against
      the child), isolating (cutting the child off from normal social relationships),
      and corrupting (missocializing the child into self-destructive and antisocial
      patterns of behavior).

PMID- 8356154
TI  - Child physical abuse.
AB  - Child abuse is an age-old problem for which we have had documentary records for
      as long as we have had recorded history. This article reviews the ethical
      dilemmas, diagnosis, interviewing guidelines, physical examination, and treatment
      for child physical abuse. Also discussed are unusual manifestations and
      differential diagnosis.

PMID- 8356155
TI  - Initial evaluation and interview techniques for child sexual abuse.
AB  - Because physicians are often the first professionals to have contact with a
      sexually abused child, they must be alert to the symptoms and prepared to respond
      knowledgeably. Early and effective intervention affects the overall prognosis for
      the child and family positively. As physicians become aware of child sexual
      abuse, protocols can be used routinely as part of a child's medical care. Regular
      checks on potentially abusive situations can prevent the tragic and traumatic
      occurrence of child sexual abuse.

PMID- 8356156
TI  - Medical evaluation of the sexually abused child.
AB  - Clearly, there are numerous troubling variations in the medical diagnosis of
      child sexual abuse. These variations include delays in disclosure; rapid healing;
      maturational changes; variations in normal congenital findings; the technique of
      the examiner; patient position, relaxation, and cooperation; and additional
      medical conditions that mimic abuse. For these reasons, physical evidence is
      often inconclusive and can be an unreliable source of information in child sexual
      abuse cases. The reader is logically cautioned against attempts to diagnose child
      sexual abuse based on a single finding, particularly that of the diameter of the
      hymenal orifice. Emphasis on the child's history in documenting the abuse is
      increasing. As physicians, we must develop interviewing techniques that will
      assist in child protection, and we must listen and believe the comments made by
      our patients.

PMID- 8356157
TI  - Treatment of child abuse.
AB  - Standards of care have recently been established for the diagnosis and treatment
      of child abuse. This article addresses the key areas of treatment with which each
      primary care physician should be acquainted. As part of a community-based
      approach to this problem, the physician can positively impact the prognosis for
      the victimized child and his or her family.

PMID- 8356158
TI  - Elder abuse.
AB  - Elder abuse is a tragedy both for the individual and for society because it
      occupies a pivotal position in the family life cycle of violence. Great variety
      exists among victims, abusers, and situations; thus, no single model is adequate
      to explain cause and direct treatment. Primary care physicians must be alert to
      the possibility of elder abuse in their patients and aware of resources within
      their community for managing cases once identified. Federal laws and regulations
      must take a proactive, long-term approach to the solution of this problem and
      must respect the autonomy of competent elderly patients.

PMID- 8356159
TI  - Survivors of abuse. Health care issues.
AB  - This article has discussed the most common sequelae of victimization with regard
      to incest, rape, and battering. Although legislators and law-enforcement
      officials have traditionally been viewed as having primary responsibility for the
      prevention and control of violence, it is now known that physicians must also act
      in this regard. Their action is especially required with regard to victim
      assessment and treatment. Physicians serve as the entry points not only to the
      health care system, but also to other resources for victims of violence. By
      identifying their victimized patients and by understanding the antecedents of
      their patients' symptoms, physicians can go much further in meeting their
      patients' needs for physical, mental, and social well-being. Given the scope and
      impact of violence, physicians have a moral and ethical obligation to inquire
      about the possibility of current violence, past violence, or both in their
      patients' lives.

PMID- 8356160
TI  - Legal considerations in cases of child abuse.
AB  - Child abuse is a common pediatric problem that can be recognized and treated
      appropriately by all primary care physicians who care for children. One of the
      necessary skills in this process involves being prepared to interface with the
      legal system. The physician is mandated to report suspected child abuse according
      to his or her state laws. He or she must be aware of the legal recourses for
      child protection in cases when the child remains at risk. When interacting with
      the child, a number of legal considerations can guide the physician in obtaining
      information with history, physical examination, and specimen collection. Finally,
      the physician may be called to testify. An understanding of how to prepare for
      court and how to conduct oneself in court is the final necessary skill for the
      primary care physician who sees children. This article provides the primary care
      physician with a practical understanding of the legal considerations in child
      abuse.

PMID- 8356161
TI  - The biologic basis of posttraumatic stress.
AB  - The psychological effects of trauma are accompanied by biologic changes in the
      stress response that persist when people develop posttraumatic stress disorder
      (PTSD). This article explores the nature of this altered stress response;
      provides a review of the symptomatology of PTSD; describes how developmental
      level affects the biology of the trauma response, the stress response, and the
      psychobiology of PTSD; and discusses the implications for psychopharmacologic
      treatment.

PMID- 8356162
TI  - Adult survivors of sexual abuse.
AB  - Adult survivors of child sexual abuse suffer a range of physical, psychological,
      and interpersonal aftereffects. These patients are increasingly evident in health
      care settings where they seek medical or psychological treatment for symptoms
      related to the abuse. The recognition of an abuse history as the traumatic
      antecedent is critical in differential diagnosis, treatment, and management. This
      paper reviews the aftereffects of child sexual abuse and provides recommendations
      to the primary care professional about identifying and treating adult survivors
      in their practices.

PMID- 8356163
TI  - Sadistic ritual abuse. An overview in detection and management.
AB  - Sadistic ritual abuse, including satanic cult abuse, is emerging as a syndrome
      among people with severe dissociative disorders, including multiple personality
      disorder. This article discusses the essential features that compose the clinical
      picture of sadistic ritual abuse in adults, adolescents, and children. Particular
      attention is paid to the differences between adolescents who may have been
      victimized by adults in sadistic and ritualized ways and disenfranchised "teenage
      dabblers" who may temporarily adopt a ritualized lifestyle as a way of expressing
      or acting out. The article also covers guidelines for appropriate medical,
      pharmacologic, and referral interventions. The controversy surrounding sadistic
      ritual abuse is discussed thoroughly, and primary care physicians are advised of
      the current status of understanding and validation in this area.

PMID- 8356164
TI  - The physician as perpetrator of abuse.
AB  - Although the exploitation and abuse of patients is forbidden by every code of
      medical ethics, physicians are in a power position vis-a-vis their patients, and
      this power may be misused. The spectrum of abusive physician behaviors includes
      doctors functioning as agents of control, exploiting physicianly perogatives,
      acting out personal problems in the medical setting, allowing subversion of their
      judgment, deliberately delivering suboptimal care, dehumanizing care, and
      sexually exploiting patients. Guidelines for the treatment of patients with such
      prior experiences are offered.

PMID- 8356165
TI  - Surviving survivors. Coping with caring for patients who have been victimized.
AB  - Caring for survivors of victimization is very hard work, in ways that are similar
      to and different from other difficult patient interactions. Careful attention to
      basic physiologic and psychological needs of the physicians is necessary to
      tolerate the stress and to prevent the burnout that can accompany this work. In
      addition, understanding survivors' interpersonal dynamics may help physicians
      provide better care. Consultation with colleagues is essential to remaining
      healthy and effective as givers of care.

PMID- 8356166
TI  - Community responses to violence.
AB  - Community level efforts are effective in the reduction of violence. Community
      level interventions have three goals: to prevent the escalation of risk for
      violence among the families in the community, to assist families at risk of or
      using violence, and to protect victims of abuse. To prevent violence or reduce
      its prevalence, community groups need to collaborate to reduce the community
      level risk factors. Assisting families and protecting victims of violence
      requires coordination of community services, including law enforcement, schools,
      therapists, courts, child care, and social services. All of these goals can best
      be achieved through the efforts of a community level, multidisciplinary council
      or board that directs the programs. A community process to establish an
      integrated program involves several steps. The leaders that are identified need
      to represent all the disciplines and the entire geographic area involved in the
      project. Once the leaders start meeting, the baseline information and plan can be
      developed. Then the project itself can be undertaken, with the support of the
      media and other appropriate organizations. Several examples of effective projects
      document this process and its success; the best efforts involve coalitions of
      private and governmental agencies working together. Physicians are integral to
      this process. The practice of medicine provides opportunities every day to
      prevent and intervene in potential cases of abuse and violence. Also, by
      participating actively in the community, physicians can be effective leaders to
      change attitudes and behaviors and institute programs toward reducing violence.

PMID- 8356167
TI  - [A case of jealous fantasy].

PMID- 8356168
TI  - [A quantitative pharmaco-EEG study on psychotropic properties of cerebral
      metabolic enhancers: comparison between young and elderly healthy volunteers].
AB  - In order to investigate psychotropic properties of cerebral metabolic enhancers
      (CMEs), the author carried out two identical quantitative pharmaco-EEG studies in
      different age groups of healthy volunteers; the young group (group-Y) consisted
      of six males between the ages of 21-26 years and elderly group (group-E)
      consisted of six males between the ages of 60-66 years. The drugs tested were
      five CMEs, dihydroergotoxine mesylate (DHE), propentofylline (PPF), nicergoline
      (NCG), lisuride maleate (LIS) and ibudilast (IDL). Each volunteer received either
      of the five test drugs or inert placebo in six one-day weekly sessions' according
      to single-blind, randomized crossover design. In each session, a single oral
      dose, equivalent to the clinically recommended daily dose, of either drug or
      placebo was administered and EEGs were recorded before and 1.3 and 6 hours after
      the drug administration. Firstly, the background EEGs before the drug
      administration were compared between the two groups. Group-E showed less slow
      activities and more alpha and fast activities than group -Y. This difference in
      background EEG profiles between two groups are considered to be due to
      physiological aging process. Secondly, drug effects on EEGs in two groups were
      compared. There were discrepancies in drug-induced EEG changes between the
      groups. In group-Y, any of the five tested CMEs did not induce EEG changes that
      were significantly different from placebo, whereas, in group-E, drug-induced EEG
      changes were more apparent. In group-E, DHE and PPF induced similar EEG changes,
      which were characterized by a decrease of alpha activity associated with marked
      decreases of slow and fast activities, the EEG profile similar to thymoleptics
      with sedative effects. LIS and IDL induced a decrease of alpha activity and an
      increase of fast activities, the profile close to thymoleptics with mood
      elevating (stimulant) effects. NCG induced an increase of slow activities, the
      profile close to central depressants. These results in this study coincided with
      the experimental and subjective classification of the clinical effects of CMEs.
      Further analysis of EEG profiles based on principal component analysis indicated
      that there were two major components in background EEGs. There were discrepancies
      in the response to CMEs between two groups. In group-Y, CME-induced changes were
      seen mainly in the second principal component, while in group-E, the changes were
      seen mainly in the first principal component. These results suggested CMEs
      provoked thymoleptic effects by affecting the essential component of the EEG
      basic rhythm.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8356169
TI  - [On compulsive hand-washing--psychopathology of "touching"].
AB  - Compulsive hand-washing has been well known to the psychiatrists, since Legrand
      du Saulle described this disorder by the name of "delire du toucher" (1866),
      which refers to mysophobia or contact-phobia. But its clinical significance seems
      to have been not fully examined, except from the psychoanalytical point of view,
      that has observed the repression of sexuality in its pathology. This report
      presents four cases of compulsive hand-washing, and explores why they exclusively
      wash their hands. In order to elucidate the reason for their hand-washing and its
      significance, this report aims to study the relation of following three elements;
      "Sexuality", "hand" and "touching". As the idioms using "hand" often represent
      the various modes of sexual life in Japanese language as well as in English, so
      the "touching by hand" is reasonably considered to evoke the sexual impulsions,
      which the hand-washers fear and wish to avoid. On the other hand, "touching" is,
      necessarily in nature, to be touched by the touched object. For example, one who
      touches the lover's hand is inevitably to be touched by hers. That is; one is
      forced to be an object of one's object, which becomes to be a subject. In this
      sense, the act of "touching" means to lose one's "being subject" and to melt
      oneself into the situation where the structural distinction of subject and object
      can disappear. So one's act of "touching" or vivid contact with the other can
      cause anxiety by means of losing one's ego, which may be also a critical point to
      introduce to create something new. A compulsive hand-washer fears and avoids this
      critical moment that can make him lose his "being subject", so he "washes his
      hands of (cuts off relation with)" the situation that can undermine his ego. This
      avoidance of having contact can be compared to "the lose of vivid contact with
      the reality (la perte du contact avec la realite (Minkowski)" observed in
      schizophrenia. In their ways of life, many hand-washers are not less autistic
      than the schizophrenics.om

PMID- 8356170
TI  - [Human values and respect of human rights in oppressive conditions].
AB  - Human rights, an issue of political debates in the last decades, listed in the
      United Nations Declaration of 1946 are rooted in the humanistic tradition of
      philosophy and religion. The UN declared their universal character and made state
      organizations responsible for their observation. Among all human rights that for
      freedom is usually perceived as crucial. Psychiatry developed in Europe primarily
      a caring function. The medical model developed in psychiatry through the 19th c.
      supplied the criteria for medical diagnosis of mental disturbance, and elaborated
      a system of treatment which included long term hospitalization. Medicalization of
      psychiatry (recently coming back) is a force which gives courage to those who
      suffer, to their families, and to professionals as well. This power however, can
      be easily abused, when a psychiatrist adopts a position of someone who knows
      better that which is good for his/her patient. Legal regulations of the
      circumstances of psychiatric treatment, especially treatment against the
      patient's will should prevent the abuse of the mentally disturbed person's right
      for freedom. The goal is usually achieved by clear description of clinical and
      other conditions under which a person can be committed, and by establishing the
      committed person's right to claim the decision to be unjust. Poland is a country
      without legal regulation in the area of mental health (there are only
      administrative acts). For more than sixty years several projects on mental health
      law have been worked on. The last one which came to the Sejm (parliament) in 1980
      was withdrawn by the "Solidarity" Trade Union. At present, the membership of
      Poland in international organizations makes an introduction of mental health law
      an obligation. Having no legal regulation, Polish psychiatry has been a self
      regulating system. It is worth to note that even in the hard Stalinist period
      (1947-1956) there was no abuse of psychiatry for political reasons. The main
      reason for Polish psychiatry staying free from political abuse is seen in the
      role of internalized norm of human dignity. But others should also be taken into
      account. It was a specificity of the political situation that the ruling powers
      did not insist that psychiatrists cooperate. On the other hand the integration of
      the Polish psychiatric community was helpful in observing the rule of non
      collaboration. One of the most important factors is seen as the experience and
      memory of NAZI crimes in the field of psychiatry in Poland. Extermination of
      psychiatric patients had to leave the feeling of the importance of psychiatrist's
      own responsibility.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8356171
TI  - [Panel discussion at the 37th Congress of Polish psychiatrists in Poznan in May,
      1992].

PMID- 8356172
TI  - [Confrontation with frustration in psychiatric practice].
AB  - In the educational programs for psychiatrists one often meets emissions in the
      confrontation with difficult situations during the first steps in that specialty.
      In the background of frustrogenic cases, which trainees have in their first years
      of their practice, the author outlines an adequate program, which could improve
      this situation. A discussion about these themes would also be useful in
      postgraduate training.

PMID- 8356173
TI  - [Affective disorders in the fourth edition of the classification of mental
      disorders prepared by the American Psychiatric Association -- diagnostic and
      statistical manual of mental disorders].

PMID- 8356175
TI  - [Further research into the formation of the syntonic-autistic relationship in
      paranoid schizophrenia].
AB  - Research was conducted on a sample of 100 patients. The diagnosis was carefully
      verified according to the DSM-III. The "Syntonic" Scale and the "Autism" Scale,
      described in a separate paper were used. A literature review was performed with
      special attention to the fact that surprisingly rarely are references made to
      syntonia in research upon schizophrenic patients. The results are presented in
      table 1 and Figures 1 and 2. In all of the 100 subjects both factors studied were
      present though to varying degrees of severity. Both factors showed evident
      characteristics of selectivity. The numerical data revealed a definite
      predominance of autism over syntony, which is a well known fact in schizophrenia,
      however, of significant importance is the presence of syntony as an additional
      factor. The correlation variable of both scales is expressed by r = -0.79, which
      indicates that there is a strong negative relationship. For the needs of further
      analysis the groups were split into smaller subgroups. Subgroup I was
      characterized by the predominance of autism over syntony (47 cases). In subgroup
      II a predominance of syntony over autism was found (33 cases). On the basis of
      greater confidence the subgroup III was described, which contained the cases in
      which neither factor was predominant (20 cases). The majority of the sample of
      patients ill with schizophrenia showed the ability to react syntonically. The
      obtained results support the view that autism and syntony are two poles of the
      same dimension, they also support the hypothesis which states that there is
      evidence to suggest that the are two basic subgroups of paranoidal schizophrenia.

PMID- 8356174
TI  - [Computer tomography in diagnosis of mental disorders].
AB  - The article includes a review of literature discussing the results of CT
      (computed tomography) usage with psychiatric patients and a range of
      recommendations for using this diagnostic method in psychiatry. Recommended
      indications for ordering a CT scan for psychiatric patients have ranged from
      narrow guidelines (only patients with focal neurological findings) to a broad
      spectrum, including any of the following: confusion and/or dementia of unknown
      cause, a first episode of a psychosis of unknown etiology, a movement disorder of
      unknown etiology, a diagnosis of anorexia nervosa, prolonged catatonia, and a
      first episode of major affective disorder or personality change after 50.

PMID- 8356176
TI  - [Further research into the formation of the "vitality and adequacy of emotion
      emotional blunting" relationship in paranoid schizophrenia].
AB  - A sample of 100 paranoidal schizophrenic patients were assessed. Scales of
      "vitality and the adequacy of emotion" and "emotional blunting" which are
      described in a separate paper were used. At the beginning attention was focused
      on the fact that several synonimous terms are used to describe the blunting of
      emotion (flatness of affect, blunted or inappropriate affect, presence of affect
      as opposed to flatness). The results indicate that in only a very few cases the
      intensity of both studied qualities was negligible, however in the majority of
      the cases it appeared that the quality of "vitality" and its opposite is present.
      In 62 patients the emotional blunting was moderate. Emotional vitality in these
      cases remained in the wide range from moderate to significant. Both factors may
      be considered to be additional factors on the basis of the size and type of
      correlation. The coefficient of both Scales is expressed by r = -0.77. The
      correlation between the studied proportion and the syntonic-autistic proportion
      is expressed by r = 0.69. The cases of emotional blunting which occurred at
      different levels of intensity were generally accompanied by relative vitality and
      adequate emotional reaction. The formation of the studied proportion and in
      particular the high correlation coefficient between this proportion and the
      syntonic-autistic proportion suggests that autistic schizophrenia and syntonic
      schizophrenia form two basic subgroups of paranoidal schizophrenia.

PMID- 8356177
TI  - [The disturbance of the sense of time in schizophrenia].

PMID- 8356178
TI  - [Current views of the mechanism of action of antidepressants].
AB  - Considering the ever growing number of new discoveries and changes in ideas in
      the field of psychopharmacology, the authors present the actual state of
      knowledge about the mechanism of action of antidepressant drugs. Three periods
      characterize the research and the development of antidepressants. In the first
      period the presynaptic monoamine neuron was considered as the target structure
      both with respect to the search for the origin of depression and the mechanism of
      action of antidepressants. Two types of antidepressants, monoamine uptake
      inhibitors and monoamine oxidase inhibitors (IMAO) are representative of this
      period. In the second period, the research focused its interest primarily on
      monoaminergic receptors, anticipating that they were critically involved in the
      pathophysiology of depression. Such research sought to explain the antidepressant
      properties of iprindole and mianserine which are neither monoamine uptake
      inhibitors nor inhibitors of MAO. The onset of the third period is recent and it
      is characterized by the shift in research emphasis to intracellular transmission
      events. This period started with the discovery of the antidepressant properties
      of the phosphodiesterase inhibitor rolipram.

PMID- 8356179
TI  - [Rat's nigrostriatal dopamine system under the influence of insulin in alloxan
      diabetes].

PMID- 8356180
TI  - A description of the forensic outpatient and the opinions of mental health
      professionals who work with these clients.
AB  - This paper presents a descriptive profile of clients placed on Conditional
      Release in New York State between September 1980 and September 1987 (N = 331).
      Data on the client's sociodemographic characteristics, prior mental health
      history, prior criminal justice history, and target offense are presented, as
      well as information on the conflicts faced by the primary therapists working with
      this population.

PMID- 8356181
TI  - The assessment of dangerousness and predictions of violence: recent research and
      future prospects.
AB  - Recent research on clinical and actuarial assessments of dangerousness leaves
      many important questions unanswered regarding the relative validity and utility
      of such assessments. Moreover, the focus that has existed on determining the
      false-positive and false-negative rates of predictions of violence may be
      fundamentally misplaced. Clinical evaluations of dangerousness should be viewed
      as assessments of risk rather than as predictions of violence; and future
      research should focus on understanding and evaluating how clinical assessments of
      dangerousness-regarding truly representative types of possibly dangerous patients
      -are (or should be) made. In the meantime, the research to date on clinical
      assessments of dangerousness cannot properly be taken to conflict with the
      Supreme Court's recent affirmations of the admissibility of such assessments in
      courtroom proceedings.

PMID- 8356182
TI  - The ongoing risk assessment in the treatment of forensic patients on conditional
      release status.
AB  - In New York State, patients who have been found not criminally responsible by
      reason of mental disease or defect, eventually become outpatients while still
      under the supervision of the courts. The treatment of these patients on
      outpatient orders of condition poses special problems. Treatment needs to center
      on the issues related to patient's potential for harmful/violent behavior.
      Therefore, outpatient clinicians need to conduct periodic risk assessments and
      must continuously monitor identified risk indicators. The author outlines steps
      for information gathering and evaluation necessary for risk assessment. Treatment
      of these patients is conceptualized as ongoing clinical risk identification and
      management. It is framed by a treatment contract that integrates mandates of the
      Orders of Conditions with information gathered through ongoing risk assessments
      and spells out legal and other consequences that may arise from non-compliance.

PMID- 8356183
TI  - Providing outpatient services to criminal procedure law patients: the clinician's
      perspective.
AB  - This presentation identifies a number of the elements involved in implementing an
      effective program for the care and treatment of the Conditionally Released CPL
      Patient. The component parts to be explored include: societal and agency issues,
      the identified patient and, issues relating to the clinician and the clinical
      treatment team. The outpatient clinician fulfills numerous role/task functions.
      The roles of therapist, educator, teacher, advocate, casemanager, and "parole
      officer" will be discussed. Techniques for identifying and working through the
      worker's own "blocks" will be discussed as a prelude to establishing a
      therapeutic alliance. Principles of utilizing authority and contracts as basic
      therapeutic techniques will also be noted. Recognizing that the patients who
      comprise the conditionally released CPL 330 category are heterogeneous and
      multiply disabled, techniques for active focused rehabilitation treatment will be
      explored.

PMID- 8356184
TI  - Semiotic aspects of cognitive development: illustrations from early mathematical
      cognition.
AB  - The premise of this article is that cognitive development involves both
      conceptual and semiotic achievements. From this perspective, the authors
      emphasize the distinctness of the semiotic issues and develop a differentiated
      appreciation of semiotic aspects of cognition, particularly in the field of
      elementary mathematical cognition. The authors provide semiotic analyses of the
      differences between counting, adding, and multiplying and of the conventional
      place-value sign system. The authors introduce the concept of the field of
      reference of a sign, the differentiation of the field into foreground and
      background, and the dynamics within the field of reference. Finally, the authors
      relate these ideas to the dynamics between two dimensions of semiotic relations:
      the sign-referent dimension and the sign-sign dimension.

PMID- 8356185
TI  - Decision field theory: a dynamic-cognitive approach to decision making in an
      uncertain environment.
AB  - Decision field theory provides for a mathematical foundation leading to a
      dynamic, stochastic theory of decision behavior in an uncertain environment. This
      theory is used to explain (a) violations of stochastic dominance, (b) violations
      of strong stochastic transitivity, (c) violations of independence between
      alternatives, (d) serial position effects on preference, (e) speed-accuracy trade
      off effects in decision making, (f) the inverse relation between choice
      probability and decision time, (g) changes in the direction of preference under
      time pressure, (h) slower decision times for avoidance as compared with approach
      conflicts, and (i) preference reversals between choice and selling price measures
      of preference. The proposed theory is compared with 4 other theories of decision
      making under uncertainty.

PMID- 8356186
TI  - The perception of natural contour.
AB  - The observation that natural curves and surfaces are often fractal suggests that
      people may be sensitive to their statistical properties. The perceptual protocols
      that underlie discrimination between fractals and between other types of random
      contour and fractals are examined. Discrimination algorithms that have precisely
      the same sensitivities as human observers are constructed. These algorithms do
      not recognize the integrated scale hierarchy intrinsic to fractal form and
      operate by imposing a metatheory of structure that is based on a signal-noise
      distinction. The success of the algorithms implies that (a) self-affinity in
      random fractals is not perceptually recovered and (b) people have a natural
      disposition to view contour in terms of signal and noise. The authors propose
      that this disposition be understood as a principle of perceptual organization.

PMID- 8356187
TI  - Social contagion and adolescent sexual behavior: a developmental EMOSA model.
AB  - Epidemic Models of the Onset of Social Activities (EMOSA models) describe the
      spread of adolescent transition behaviors (e.g., sexuality, smoking, and
      drinking) through an interacting adolescent network. A theory of social contagion
      is defined to explain how social influence affects sexual development. Contacts
      within a network can, with some transition rate or probability, result in an
      increase in level of sexual experience. Five stages of sexual development are
      posited. One submodel proposes a systematic progression through these stages; a
      competing submodel treats each as an independent process. These models are
      represented in sets of dynamically interacting recursive equations, which are fit
      to empirical prevalence data to estimate parameters. Model adjustments are
      substantively interpretable and can be used to test for and better understand
      social interaction processes that affect adolescent sexual behavior.

PMID- 8356188
TI  - Metrics and mappings: a framework for understanding real-world quantitative
      estimation.
AB  - Estimation is influenced by a variety of processes: application of heuristics,
      domain-specific reasoning, and intuitive statistical induction, among them. In
      this article, we propose the metrics and mapping framework to account for how
      these processes are integrated to generate estimates. This framework identifies 2
      types of information as critical: knowledge of distributional properties (metric
      knowledge) and knowledge of relative status of individual entities within the
      distribution (mapping knowledge). Heuristics and domain-specific knowledge are
      both viewed as cues that contribute to mapping knowledge; intuitive statistical
      induction is viewed as providing cues to metric properties. Results of 4
      experiments illustrate the framework's usefulness for integrating these types of
      information and for predicting when people emphasize heuristics and when they
      emphasize domain-specific knowledge.

PMID- 8356189
TI  - The regularities of recognition memory.
AB  - Three regularities in recognition memory are described with supporting data: the
      mirror effect, the order of receiver operating characteristic slopes, and the
      symmetry of movement of underlying distributions. The derivation of these
      regularities from attention/likelihood theory is demonstrated. The theory's
      central concept, which distinguishes it from other theories, is the following: Ss
      make recognition decisions by combining information about new and old items, the
      combination made in the form of likelihood ratios. The central role of the
      likelihood ratios extends the implications of signal detection theory for
      recognition memory. Attention/likelihood theory is fitted to data of 2 series of
      experiments. One series involves yes-no tests and confidence ratings, the other
      forced-choice experiments. It is argued that the regularities require a revision
      of most current theories of recognition memory.

PMID- 8356190
TI  - The influence of perceptual and motor factors on bimanual coordination in a
      polyrhythmic tapping task.
AB  - In this study the role of perceptual and motor factors on the motor organization
      (integrated versus parallel) adopted by musically skilled and unskilled subjects
      in a polyrhythmic tapping task was investigated. Subjects tapped a 3:2 polyrhythm
      to match the timing of two isochronous tone trains, one tone train for each hand.
      Perceptual factors were examined by the manipulation of the frequency difference
      between the tone trains to produce either an integrated or a streamed percept.
      Motor factors were examined by comparison of performance on two versions of the
      3:2 polyrhythm. In one (simultaneous) version, each cycle of the polyrhythm began
      with a simultaneous left- and right-hand tap. In the other (shifted) version a
      100-ms interval was introduced between the initial left and right taps in each
      cycle. Examination of the pattern of variances and covariances among intertap
      intervals suggested that most of the subjects in this study adopted an integrated
      motor organization that involved interleaving the timing of the two hands.
      Further analysis revealed that a serial chained model described the pattern of
      covariances best for the simultaneous pattern, whereas a hierarchical
      organization described the pattern of covariances for the shifted pattern best.
      The finding that performance was more accurate with integrated tones than with
      streamed tones provides some support for a perceptual-motor facilitation
      hypothesis.

PMID- 8356191
TI  - The effect of temporal and force changes on the patterning of sequential
      movements.
AB  - This article examines the programming of relatively long sequences of action with
      the control of sequential movements being effected through the use of a tapping
      task involving a sequence of five taps. Subjects were required to tap with their
      right hand at rates of 150, 200, and 250 ms. There were two conditions, with
      subjects being required either to increase, in condition 1, or to decrease, in
      condition 2, the force at one of the five tap positions (all five tap positions
      were examined), then return to the previous force level. Changes in timing
      resulting from variations in the force characteristics have previously been
      discussed in terms of changes in the organizational time required (Semjen, Garcia
      Colera, & Requin, 1984). The current study breaks the intertap interval down into
      two separate components: the contact interval (finger in contact with the key)
      and the non-contact interval (interval preceding the tap). Although changes in
      the non-contact interval could be explained in terms of changes in the
      organizational time required, changes in the contact interval appeared to be a
      result of the mechanical changes in force.

PMID- 8356192
TI  - Central and peripheral coordination in movement sequences.
AB  - Motor coordination has been too poorly defined to be a useful construct in
      studying the control of movement. In general, motor coordination involves
      controlling both the timing and the kinematics of movement. Yet the motor
      behaviors typically used for the study of coordination have required controlling
      only the timing or the spatial aspects of a movement. To understand better the
      basis of motor behavior, this study examined movement sequences, a class of
      movement in which both the timing and the kinematics must be controlled. In one
      experiment we studied a reaching and grasping movement sequence to characterize
      the central coordination of movement sequences. In another experiment we studied
      a throwing movement sequence to characterize the peripheral (kinesthetic)
      coordination of movement sequences. An heuristic model is presented to explain
      how central and peripheral mechanisms of coordination might interact to produce
      accurate movement.

PMID- 8356193
TI  - Searching for the minimal essential information for skilled perception and
      action.
AB  - A common concern for both cognitive/computational and ecological/dynamical models
      of human motor control is the isolation of the minimal essential information
      needed to support skilled perception and action. In perception isolating
      essential features of the optic flow field, which are reliably informative
      regarding the nature of current events, from nonessential features provides a
      valuable step towards understanding how the computational complexity of
      perceptual information processing may be reduced to manageable levels and how
      relatively direct linkages of low dimensionality may be established between
      information and control variables. Likewise, in the study of action,
      discrimination of the movement features that remain immutable (invariant?) across
      changes in task conditions from the variables that are situationally determined
      provides a principle insight into the structural framework upon which skilled
      movement is built. Controversy abounds, however, in the study of perception and
      action as to whether features isolated as informative and immutable are centrally
      represented (in the form of a template or program) or are rather directly picked
      up (in the case of perceptual variables) or are simply an emergent consequence of
      the underlying dynamics (in the case of action variables). In this paper some
      examples of putative minimal essential information sources in perception and
      action are provided, strategies for uncovering such sources are discussed, and
      attention is directed, with the use of some recent data collected on natural
      skills, to some systematic expert-novice differences in the utilization of
      essential information and control variables. Expert-novice differences are
      highlighted because of the insight they may provide regarding the nature of
      perceptual-motor skill acquisition.

PMID- 8356194
TI  - Detection and execution of movements.
AB  - Detection thresholds for movements imposed on the relaxed joints in upper limbs,
      when expressed in terms of angular or linear displacement, differ from joint to
      joint. However, when they are expressed in terms of proportional changes in the
      lengths of fascicles of the muscles serving the joints, they are found to be
      similar. When the execution of finely graded voluntary movements is analysed,
      performances of similar accuracy occur when the movements at different joints
      require alterations of the lengths of active muscle fascicles by similar
      proportions. These findings suggest that muscle length is a variable of
      importance to the CNS in both the detection and execution of movements. For
      faster contractions, another category of movement must be considered. This is the
      triggered response, which can be voluntarily pre-formulated and stored in the
      brain, to be released subsequently by some sensory input. Such triggered
      responses can be demonstrated in experiments in which subjects respond to masked
      stimuli--low-intensity sensory stimuli which, while readily detected when
      presented alone, are not detected when followed very soon afterwards by a high
      intensity stimulus. Subjects are able to react with simple and more complex
      movements to low-intensity stimuli whether these are detected (delivered alone)
      or undetected.

PMID- 8356195
TI  - Judgments of moving and intending to move in a timed-response task.
AB  - Subjects performed a timed-response task in which they attempted to synchronize a
      rapid flexion of the index finger of their preferred hand with the last of a
      train of four regularly spaced acoustic clicks. The task was used to stabilize
      the execution time of a simple voluntary response in order to facilitate
      psychophysical judgments about the subjects' perception of having responded and
      of having intended to respond. In the first experiment, male subjects (N = 6)
      adjusted the appearance time of a reference stimulus (a brief percutaneous pulse
      to the responding finger) until it appeared to be simultaneous with their
      perception of having made the response. All subjects adjusted the reference
      stimulus to appear after response onset during the latter half of the force
      impulse. This finding suggests that the perception of having responded is based
      on peripheral feedback from the response. In the second experiment, male subjects
      (N = 6) performed the same motor task, but adjusted the time of the reference
      stimulus so that it appeared to be simultaneous with their intention to respond.
      Two subjects were not able to do the task successfully; the remaining four
      subjects adjusted the reference stimulus to appear from 101 to 145 ms before
      response onset. This finding suggests that the intention to respond is
      perceptually separable from the response itself and occurs at a measurable time
      before response onset.

PMID- 8356197
TI  - Correction processes in early reaching: reaches by infants to prismatically
      displaced targets.
AB  - A comparison was made between trajectories of reaches to visual targets by 6
      months-old infants, with and without lateral prismatic displacement. In the No
      Prism condition, the major element of the movement veered towards the target,
      confirming the results of Mathew and Cook (1990). In the Prism condition, the
      prism did not affect hand position or movement direction at the beginning of the
      major element, but a lateral displacement was evident by the end of the element.
      This is taken as evidence that shifts in trajectory during the element were not
      due to visual guidance. It is suggested instead that these shifts may reflect
      correction based upon somatic feedback about position in relation to the visually
      specified goal of the movement. Evidence that the hand approached the virtual
      target supports the suggestion that any visual guidance was confined to the
      approach phase of the reach. Nevertheless, it appears that visual guidance was
      operating at this stage, since movement direction was displaced away from the
      virtual target and towards the real target.

PMID- 8356196
TI  - The amendment of large-magnitude aiming-movement errors.

PMID- 8356198
TI  - Perceptual-motor development and prevention of clumsiness.
AB  - This longitudinal study, following children's development over three years,
      examines the developmental trends in the processes underlying perceptual-motor
      behaviour. Entry into the study was at first year of primary school, at age 6.
      The study has three aims: (1) to obtain developmental trends in kinaesthesis and
      motor-programming processes; (2) to examine the relationship between slow
      kinaesthetic and motor development; (3) to establish the effect of accelerated
      kinaesthetic development and prevention of perceptual-motor dysfunction
      (clumsiness). The results to date show that over 60% of children entering primary
      school have not developed the kinaesthetic ability necessary for the acquisition
      and learning of educationally demanded motor skills. Kinaesthetic development is
      accelerated spontaneously in some children as a response to educational demands;
      in others a single exposure to kinaesthetic input triggers significant
      improvement. In the remaining 17% kinaesthetic training can alleviate the
      kinaesthetic dysfunction. At age 5-6 years only 25 children (8.1%) performed the
      Perceptual-Motor Abilities Test at levels indicative of perceptual-motor
      dysfunction. Of these, 13 children (4.2%) were identified as having motor
      difficulties. These low incidence rates indicate that a low level of kinaesthetic
      ability has no effect on general motor function at the beginning of schooling,
      and that only when competence in complex motor skills is expected, from the third
      year of schooling, does perceptual-motor dysfunction (PMD) become manifest.

PMID- 8356199
TI  - Motor functions of the basal ganglia.
AB  - A study of movement disorders such as Parkinson's disease and Huntington's
      disease can provide an indication of the motor functions of the basal ganglia.
      Basal-ganglia diseases affect voluntary movement and can cause involuntary
      movement. Deficits are often manifested during the coordination of fine multi
      joint movements (e.g., handwriting). The disturbances of motor control (e.g.
      akinesia, bradykinesia) caused by basal-ganglia disorders are illustrated. Data
      suggest that the basal ganglia play an important role in the automatic execution
      of serially ordered complex movements.

PMID- 8356200
TI  - Stability and change in children's skill.
AB  - This paper explores age-related performance variability, both within trials and
      between sessions, in repetitive hopping. The mean, the standard deviation (SD),
      and the coefficient of variation (CV) of several timing and ground-reaction-force
      variables of hopping were analysed by repeated-measures ANOVA for age-related
      effects across test sessions and foot used. Forty-five subjects in five age
      groups (3-4 years, 4-5 years, 6-7 years, 8-9 years, or Adult) performed self
      paced, one-footed hopping on three occasions within one week. As was expected,
      the results showed main effects for Age in all force and time variables, with the
      exception of CV of medio-lateral force. No significant main effects for Feet were
      revealed. However, significant Feet x Session interactions were found in flight
      time measures, with higher flight-time SD and lower CV for the non-preferred foot
      in Session 1, a reversal in Session 2, and a negligible difference in Session 3.
      Across sessions, decreased SD and CV for both vertical and medio-lateral force
      and shorter flight time indicated more efficient hopping. Overall, it was
      concluded that SD and CV measures were more sensitive measures of children's
      performance across repeated sessions than were mean scores and that the order of
      testing the limbs is an important consideration in experimental protocols when
      lateralized tasks are measured.

PMID- 8356201
TI  - Motor control and sensory-motor integration.

PMID- 8356203
TI  - Public health research.

PMID- 8356202
TI  - Structural constraints on bimanual movements.
AB  - A theoretical framework is outlined, according to which structural constraints on
      bimanual movements can at least in part be understood as coupling between
      parameters of generalized motor programs. This framework provides a conceptual
      link between reaction-time data from experiments with bimanual responses,
      successive unimanual responses, and choice between left-hand and right-hand
      responses on the one hand and performance data obtained with concurrently
      performed continuous movements or sequences of discrete responses on the other.
      On the basis of data obtained with different methods for the study of intermanual
      interactions, a distinction is drawn between steady-state and transient
      constraints, and the hypothesis that the tendency to coactivate homologous
      muscles originates from a transient coupling of program parameters is applied to
      a variety of observations on performance in different tasks. Finally, the notion
      of transient constraints is applied to other types of intermanual
      interdependencies, and to interpersonal coordination; the possible emergence of
      transient constraints from steady-state constraints through progressive
      development of inhibitory pathways in childhood is discussed, as is the potential
      biological significance of transient constraints.

PMID- 8356204
TI  - 9th Duncan Memorial Lecture, University of Liverpool, November 1991. Gaia and
      health.

PMID- 8356205
TI  - How do we measure consumer opinions of outpatient clinics?
AB  - Consumer opinion of care in outpatient departments is increasingly seen as an
      important measure in the process of quality assurance. However, there are many
      ways of measuring consumer opinion. The aim of this series of studies was to
      compare different methods so as to throw light on when and where to use them.
      What is revealed is that there is no one right answer; instead, a combination of
      methods will allow the development of a balanced view of consumer opinion and an
      agenda for action.

PMID- 8356206
TI  - Maternal and child health services: evaluating mothers' perceptions and
      participation.
AB  - Urban mothers' perceptions and their actual practices in respect of antenatal
      care, postnatal care, childbirth and breast-feeding were reviewed through a
      predesigned questionnaire provided to all mothers (n = 114) staying for a day in
      the Clinical Research Centre of the International Centre for Diarrhoeal Disease
      Research, Bangladesh. Only 8% of mothers surveyed were pregnant and 71% had
      access to a maternal and child health clinic near their homes. Although 61% of
      the mothers replied that antenatal care is needed, 45% of all mothers actually
      used the service. Similarly, 79% of them felt that postnatal care is needed, yet
      only 26% attended the clinics. Only 6% of all mothers had their previous children
      delivered at a hospital or clinic. The majority (91%) were delivered at home,
      traditional birth attendants assisting in childbirth in most cases (74%). In
      spite of mass campaigning against the use of pre-lacteal foods (like honey and
      sugar water), these were given to 90% of the newborns. Underutilization of
      maternal and child health clinics was mostly due to the clinics only being open
      during the busy hours of family work and because of the misbehaviour of the
      staff. Changing clinic opening times, supervising staff properly and educating
      mothers will help to overcome their taboos and to motivate them to use
      'institutional services'.

PMID- 8356207
TI  - Social class and health behaviour in Danish adults: a longitudinal study.
AB  - Health behaviours were examined in a random sample of 3,608 men and women aged
      30, 40, 50 and 60 years, living in the western part of Copenhagen, Denmark. Data
      were collected by standardized questionnaires completed by each individual in
      1982 and by 2,987 subjects who attended for follow up five years later. Smoking,
      leisure time inactivity and infrequent intake of vegetables were interrelated and
      highly influenced by social class. Between 1982 and 1987 the proportion of
      smokers decreased in both sexes. However, an inverse association with social
      status persisted in the men and increased by 8% in the women. The proportion of
      physically inactive subjects remained nearly constant. Infrequent intake of
      vegetables decreased in both sexes, but an inverse association with social status
      persisted in men and increased by 10% in women from 1982 to 1987. In the
      multivariate analysis high social status predicted quitting smoking in both sexes
      and increased intake of vegetables in women. It is suggested that the
      inequalities in health behaviours between social status groups may to some extent
      be attributed to the way health promotion has been carried out in Denmark. This
      observation provides a challenge for the future design of effective public health
      strategies.

PMID- 8356208
TI  - A study of some psycho-social characteristics of blind and deaf male students in
      Abha City, Asir region, Saudi Arabia.
AB  - Psychosocial characteristics including depression, attitude towards their
      handicap, hobbies and problems of living situations have been studied among 152
      male students in the Institute for the Blind (n = 44) and in the Institute for
      the Deaf (n = 108) in Abha City. All students were subjected to a constructed
      Arabic version of the rating scale 'Children Depression Inventory (CDI)'. They
      were categorised according to their scores on this CDI, into depressed and non
      depressed. Also, an interview questionnaire was administered to collect data
      related to the handicap, such as age of onset, and its cause and family history
      of the same handicap. The effect of the handicap upon the attitudes of students
      in relation to their social tendencies, hobbies and problems in living situations
      was studied. The mean ages for blind and deaf students were 15.70 and 13.04 years
      respectively. About 91.% and 75.% of blind and deaf students respectively were
      born with their handicap. Depression was more prevalent among the blind (14%)
      than among the deaf (6.5%) students. Difficulty in mobility was the main problem
      among blind students (44%) while difficulty in communication with people was the
      main problem among the deaf (52%). Reading was the commonest hobby for the blind
      (51%), while playing football was the commonest among the deaf (62%). This
      information should be considered when planning for rehabilitative services for
      these groups.

PMID- 8356209
TI  - Trends in nutrition in Greece: use of international data to monitor national
      developments.
AB  - With the purpose of studying trends in nutrition in Greece, data from the Food
      Balance Sheets about the calorie and nutrient intakes were analysed. During the
      period 1961-86, the average per capita consumption of calories increased by
      26.6%, while the calories obtained exclusively from animal sources increased by
      106%. The average protein intake rose by 29.9%. Animal proteins increased by
      90.6% and their proportion reached 51.5%. Lipid intake increased by 62.2%; in
      particular animal fats went up by 114.3%. It is concluded that the most important
      changes in nutrition in Greece during the study period were (a) the increase in
      total calorie intake, and (b) the rise in total fat consumption and especially
      the vertical increase in consumption of animal fats. These developments show a
      change to the traditional pattern of the Greek diet.

PMID- 8356210
TI  - Chemical disasters, real and suspected.

PMID- 8356211
TI  - Control of falciparum malaria.

PMID- 8356212
TI  - Design and discovery of new drugs by stepping-up and stepping-down approaches.

PMID- 8356213
TI  - Present status of luteolytic agents in fertility regulation.

PMID- 8356214
TI  - Aldose reductase inhibitors: recent developments.

PMID- 8356215
TI  - [Structure of 3-isopropylmalate dehydrogenase from an extreme thermophile--a new
      model enzyme molecule for the study of structure-function and structure-stability
      relationships].

PMID- 8356216
TI  - [Recent progress of mitochondrial fatty acid oxidation system].

PMID- 8356217
TI  - [The contractile proteins and the contractile apparatus of platelets].

PMID- 8356218
TI  - [What brings certain molecular species of membrane phospholipids?].

PMID- 8356219
TI  - Management of Hodgkin's disease patients with mediastinal adenopathy and
      pulmonary involvement (stage IIE).
AB  - Two hundred and fifty-five patients with Hodgkin's disease and with localized
      pulmonary involvement (Stage IIE) were retrospectively assessed for their
      response to different treatment programmes while considering the size of
      mediastinal lymph nodes and the extent of pulmonary disease (involvement of lung
      subsegment, segment or lobe). Five-year overall and disease-free survival rates
      in 255 patients were 89.6% and 72.3%, respectively. In patients with mediastinal
      index < 1/3 and lung segment and/or subsegment involvement, 5-year overall and
      disease-free survival rates were 96.6%. For patients with mediastinal index > 1/3
      and similar lung involvement the corresponding values were, respectively, 88.6%
      and 73.5%; and for those with a lung lobe involvement the values were 76.4% and
      56.7%, respectively. Patients were treated according to the following programmes:
      1 combination chemotherapy cycle + radiotherapy (RT) + 4-5 combination
      chemotherapy cycles; 3 combination chemotherapy cycles + RT; 6 combination
      chemotherapy cycles + RT. The best results were obtained with the programme
      consisting of 1 combination chemotherapy cycle + lymphoid irradiation above the
      diaphragm and irradiation of the spleen to a total tumour dose of 40 Gy and
      irradiation of involved lung sites to a total tumour dose of 20 Gy + 4-5
      combination chemotherapy cycles.

PMID- 8356220
TI  - Radiotherapy for supratentorial low-grade gliomas: results and prognostic factors
      with special focus on tumour volume parameters.
AB  - From 1973 to 1990, 67 patients with a diagnosis of low-grade glioma were treated
      in our hospital. Overall survival was analysed as well as the influence of
      patient, tumour- and treatment-related factors with special focus on tumour
      volume parameters. Our study group included 49 patients treated by surgery and
      post-operative radiotherapy (RT) (40 patients) or post-biopsy irradiation alone
      (9 patients). Total or almost total resection was performed in 16 patients;
      partial excision was done in 24. With the available pre-surgery and pre-RT CT
      scan and/or MRI images we were able to calculate tumour volumes by measuring the
      largest tumour dimensions in the three axes D1, D2, D3 and by assuming an
      ellipsoidal growth (i.e., tumour volume = D1D2D3 pi/6). RT was delivered to
      involved regions: either the residual tumour volume or the tumour bed. The median
      RT dose was 56 Gy (45-60, range). The 60- and 90-month overall survival (Kaplan
      Meier) was 79% and 67%, respectively. Female sex, > 70% Karnofsky (Kf) score,
      oligodendroglioma and < 71 cm3 (approximately 5 cm diameter sphere) tumour
      residuals before RT were associated with better overall survival rates (p < 0.05,
      log-rank). However, a Cox proportional hazards model showed that only the
      histological subtype and Kf significantly determined the patients' outcome: 60
      month overall survival of 100%, 62%, 83% and 64% for oligodendrogliomas, mixed
      oligo-astrocytomas and grade-I and grade-II astrocytomas, respectively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8356221
TI  - Blood tests and prognosis in bladder carcinomas treated with definitive
      radiotherapy.
AB  - The value of some commonly recorded blood tests as prognostic factors in patients
      with bladder carcinomas treated with definitive radiotherapy has been assessed.
      This study included 202 consecutive patients (T2, n = 46; T3, n = 82 and T4, n =
      74) treated during the period 1980-1987. The median total dose received was 56 Gy
      [50-67] and the median cumulative radiation effect was 1750 reu (radiation effect
      unit) (1515-1823). The blood tests examined in survival analyses were erythrocyte
      sedimentation rate (ESR), hemoglobin (Hb), leucocyte and thrombocyte count,
      alkaline phosphatase (ALP), gamma-glutamyltransferase (GT), lactate dehydrogenase
      (LD), creatinine and albumin. In the univariate survival analyses six blood tests
      were significant prognostic factors (ESR, albumin, creatinine, Hb, ALP and GT).
      In the multivariate analysis of all 202 patients, the following five variables
      were significantly associated with shorter survival: T4 tumors, ESR > 30 mm/h,
      albumin < 35 g/l, LD > 400 U/I and age > 75 years. Our conclusion is that several
      commonly recorded blood tests are powerful prognostic factors in bladder cancer
      treated with definitive radiotherapy. These tests can replace other more
      expensive laboratory investigations used for prognostication.

PMID- 8356222
TI  - Changes in the oxygenation of head and neck tumors during carbogen breathing.
AB  - The oxygenation of head and neck tumors and changes during carbogen breathing
      were assessed in 20 patients. The median oxygen tension (pO2) for each patient
      was lower in tumors before breathing carbogen than in normal tissues. The median
      pooled pO2 of all the tumors was 20 mmHg; for normal tissue it was 60 mmHg. Low
      values (below 10 mmHg) were found in 4 patients for the normal tissue and in 18
      patients for tumors. During carbogen breathing, the median (61 mmHg) pO2 readings
      for all tumors was higher than that recorded before carbogen breathing. The
      frequency of low (< 10 mmHg) pO2 values decreased with carbogen breathing in 11
      patients; only 4 patients still exhibited very low values (< 2 mmHg). Maximal
      effect was obtained within 1-6 min of gas exposure. The pO2 stayed high under
      carbogen breathing in 15 out of 16 patients. Return to pre-carbogen levels of
      oxygenation occurred in 1 min after the end of gas exposure. These data suggest
      that carbogen breathing increases tumor oxygenation as assessed by polarography.
      The breathing time appears to be important for therapeutical use and should to be
      taken into consideration.

PMID- 8356223
TI  - Nicotinamide pharmacokinetics in humans and mice: a comparative assessment and
      the implications for radiotherapy.
AB  - Healthy human volunteers orally ingested escalating doses of up to 6 g
      nicotinamide in capsule form on an empty stomach. Some side-effects were seen
      although these were mild and transient. HPLC analysis of blood samples showed
      peak plasma levels, typically within 45 min after ingestion, which were linearly
      dependent on dose ingested. The elimination half-life and AUC were also found to
      increase with drug dose, although these increases were non-linear.
      Pharmacokinetic studies were also performed in female CDF1 mice with C3H mammary
      carcinomas grown in the right rear foot. Analysis of blood and tumour samples
      taken from mice injected i.p. with nicotinamide doses between 100-1000 mg/kg
      showed similar characteristics as the human data, although the elimination half
      lives were not dose-dependent. The average peak plasma concentration of 160
      micrograms/ml measured in humans after taking 6 g of nicotinamide was equivalent
      to that seen in mice after injecting 171 mg/kg. Using a regrowth delay assay the
      enhancement of radiation damage by nicotinamide in this mouse tumour was found to
      be independent of drug dose from 100-1000 mg/kg, resulting in a constant 1.3-fold
      increase in radiation response. Doses of nicotinamide that can be tolerated
      clinically should therefore produce adequate enhancements of radiation damage in
      human tumours.

PMID- 8356224
TI  - Effects of the radiosensitising agent nicotinamide on relative tissue perfusion
      and kidney function in C3H mice.
AB  - Nicotinamide is an effective radiosensitiser of murine tumours, functioning by
      improving tumour perfusion by decreasing the proportion of intermittently closed
      capillaries. The effect of nicotinamide on relative tissue perfusion of RIF-1
      tumour and normal skin, muscle, lung, liver, kidney and spleen were investigated
      using the 86Rb extraction technique. A dose of 1000 mg/kg was shown to have
      transient effects on tumour, skin and lung perfusion but to have sustained
      effects on muscle (a drop to 80% of control), liver, kidney and spleen (with
      increases ranging from 165% to 280% of control) from 0.5 to 4 h after treatment
      i.e. during the period of maximum radiosensitisation. These increases were
      evident at doses as low as 100 mg/kg. The data suggest that the
      radiosensitisation induced by nicotinamide in the mouse may be associated with
      these perfusion changes. Nicotinamide was also shown to have a substantial
      inhibitory effect on renal function, inhibiting 51CrEDTA clearance by a factor
      (+/- 2 SE) of 2.56 +/- 0.19 and 125I-iodohippurate clearance by a factor of 2.07
      +/- 0.45 at 1000 mg/kg. These effects were shown to be dose-related, and to be
      evident at doses from 400 mg/kg upwards. This suggests that nicotinamide
      potentiation of co-administered cytotoxic agents may be mediated by reduced renal
      clearance of the cytotoxic drug, thus increasing the plasma half-life.

PMID- 8356226
TI  - Dose intercomparison at the radiotherapy centers in The Netherlands. 3.
      Characteristics of electron beams.
AB  - Dosimetric characteristics of a number of clinically applied electron beams were
      analyzed as part of a dosimetry intercomparison program performed at the
      radiotherapy centers in The Netherlands. Absorbed dose values, determined under
      reference conditions, were compared during site visits with stated dose values.
      The mean deviation was 0.2% with a standard deviation (SD) of 2.5%. The maximum
      deviation was 5.7%. The largest differences were due to differences in the
      calibration procedures and differences in the numerical values of conversion
      factors adopted from different dosimetry protocols. In addition, a number of
      clinically relevant parameters of the dose distribution on the central beam axis
      were analyzed including the depth of the 85% and 50% relative dose, the dose
      reduction at the depth of the 50% relative dose and the surface dose. The average
      difference between the stated and measured therapeutic depth (85% dose level) was
      -0.4 mm with an SD = 1.2 mm. Due to this dosimetric uncertainty observed a safety
      margin of about 3 mm at the therapeutic depth is recommended. The maximum
      difference between stated and observed mean energy of the electron beams had only
      a small influence, < 1%, on the absorbed dose determination. The normalized dose
      gradient is not an adequate parameter to describe the dose reduction beyond the
      therapeutic depth. The depth of a low dose level is a better parameter. The
      relative dose at the surface showed differences up to 10% between scanning
      electron beams and beams from accelerators with a single scattering foil and
      closed wall collimating system.

PMID- 8356225
TI  - Radiosensitivity, blood perfusion and tumour oxygenation after perflubron
      emulsion injection.
AB  - The effect of 90% and/or 100% w/v perflubron (perfluorooctyl bromide (PFOB);
      Alliance Pharmaceutical Corp.) emulsions on radiosensitivity, tumour relative
      perfusion and oxygenation was studied using EMT6 tumours in nude mice. Perflubron
      (2-15 ml/kg) emulsion was injected. The mice inhaled carbogen for 30 min and 60
      min prior to irradiation. The radiosensitizing effect of the 90% w/v emulsion was
      maximal at 4 ml/kg. The tumour relative perfusion diminished after injection of
      both 100% and 90% w/v emulsions in carbogen-breathing mice at a dose of 15 ml/kg.
      This drop could explain the lack of efficiency of these treatments at this high
      concentration. Lastly, tumour oxygenation was increased after administration of
      perflubron emulsion plus carbogen.

PMID- 8356227
TI  - Recurrent endometrial adenocarcinoma after surgery alone: prognostic factors and
      treatment.
AB  - Twenty-six patients with a local and/or regional relapse of a previously
      surgically treated adenocarcinoma of the endometrium were referred to the Dr.
      Daniel den Hoed Cancer Center (DDHCC) in Rotterdam, The Netherlands between 1965
      and 1985 for external radiotherapy (ERT) and/or brachytherapy (BT). The 5-year
      overall survival was 44%. Tumour volume seemed to be an important prognostic
      factor in locoregional control; 1 out of 17 patients with tumour sizes smaller
      than or equal to 4 cm relapsed locoregionally, while in 3 out of 9 patients with
      tumour sizes of more than 4 cm a locoregional recurrence developed. Another
      important finding is the impact of RT on treatment outcome: none of the 16
      patients treated with a combination of ERT and BT failed locoregionally, while 4
      out of 10 patients treated with either ERT or BT relapsed.

PMID- 8356228
TI  - Development of a computer-controlled moving bar (CCMB) conformal technique for
      neck irradiation.
AB  - The development of an original conformal technique for neck cancer is in progress
      in our Institute. This technique uses a computer-controlled moving bar (CCMB): a
      portion of a blocking bar rotates during the rotation of the gantry in a 2 pi arc
      field in order to shield the spinal cord over the whole irradiated volume. This
      technique should solve in a relatively simple way some problems for different
      clinical situations when cervical node irradiation is required together with the
      primary tumor. The technique has been tested in an acrylic cylindrical phantom
      and in the humanoid RANDO phantom for two different irradiation conditions (neck
      completely bent and partially aligned).

PMID- 8356229
TI  - Hormonal abnormalities in survivors of primary brain tumours.

PMID- 8356230
TI  - Using the LQ model in the clinic: definition of normalized total doses.

PMID- 8356231
TI  - The time variable dose-rate in HDR stepping source brachytherapy.

PMID- 8356232
TI  - Use of micronuclei formation following graded doses of radiation as a marker for
      the intrinsic sensitivity of tumors in vivo.

PMID- 8356233
TI  - Gamma knife radiosurgery for acoustic tumors: multivariate analysis of four year
      results.
AB  - In order to evaluate the results of radiosurgery for acoustic tumors and to
      identify optimum treatment parameters, an analysis of tumor control, as well as
      incidences of hearing loss, facial and trigeminal neuropathies was undertaken.
      Between August 1987 and August 1991, 134 patients with 136 acoustic tumors
      received stereotactic gamma knife radiosurgery at the University of Pittsburgh.
      Median follow-up was 24 months (range: 6-56 months). Tumor volumes ranged from
      0.10 to 17.00 cm3 (median = 2.75 cm3). From one to ten isocenters were utilized
      per tumor treated (median = 3). Minimum tumor doses varied from 12 to 20 Gy
      (median = 17 Gy). The 4-year actuarial tumor control rate was 89.2 +/- 6.0%. Some
      degree of hearing (by pure tone audiometry) was preserved in 71.0 +/- 4.4% of
      patients. The actuarial rates for preservation of either pretreatment hearing
      level or useful hearing were 34.4 +/- 6.6% and 35.1 +/- 97% respectively.
      Respectively, the actuarial incidences of postradiosurgery facial and trigeminal
      neuropathies were 29.0 +/- 4.4% and 32.9 +/- 4.5%, respectively. No significant
      factors affecting tumor control were identified. Multivariate analysis identified
      a significantly increased risk of hearing loss in patients with neurofibromatosis
      (p = 0.0003) as well as decreased risks of facial and trigeminal neuropathies
      with both decreasing tumor diameter (p = 0.001) and increasing number of
      isocenters treated (p = 0.003). Radiosurgery is a safe and effective treatment
      for acoustic neuromas with acceptable morbidity that may be lowered by the use of
      multiple isocenter treatment techniques and by earlier treatment of small tumors.

PMID- 8356234
TI  - Non-Hodgkin's lymphoma of the testis.
AB  - Primary non-Hodgkin's lymphoma of the testis is rare. From 1976 to 1989 32
      patients have been registered with the British National Lymphoma Investigation
      and two with the Institute of Urology. All 34 patients had disease of high grade
      histology (BNLI) although in four patients there were some areas with features
      similar to those described in lymphomas of Mucosal Associated Lymphoid Tissue
      (MALT). Twenty-three of 34 (67.5%) patients had early stage disease (I/II); 17/34
      (50%) achieved complete remission from their initial treatment, and the relapse
      free survival of these patients was 66% at 5 years. The disease-free survival for
      the 34 patients as a whole was 33% and their overall survival 39% at 5 years. The
      life expectancy for those presenting with advanced (stage III/IV) disease was
      very poor (median survival 9 months) with a low complete remission rate from
      chemotherapy. The salvage rate from recurrent disease (17%) was poor. Bilateral
      testicular involvement (18%) and a high rate of central nervous system disease
      (21%) occurred in the series, and two patients were HIV positive. Stage at
      presentation was the most important prognostic factor.

PMID- 8356235
TI  - The present controversial approach to the diagnosis and treatment of prostatic
      carcinoma.

PMID- 8356236
TI  - Clinical examination, radiology and markers in the follow-up of prostatic
      carcinoma.

PMID- 8356237
TI  - US, CT, MR imaging and radiology in the diagnosis and staging of prostatic
      carcinoma.

PMID- 8356238
TI  - Prostatic carcinoma: histopathologic classification, grading, receptors and
      markers.

PMID- 8356239
TI  - External beam radiotherapy in the treatment of prostatic carcinoma: technical
      procedures.

PMID- 8356240
TI  - Brachytherapy in prostatic carcinoma: technical considerations.

PMID- 8356242
TI  - Indications and results of radiotherapy in prostatic carcinoma.

PMID- 8356241
TI  - New 125I dosimetry in prostatic brachytherapy planning.

PMID- 8356243
TI  - External or interstitial radiotherapy: what indications for the management of
      prostatic carcinoma?

PMID- 8356244
TI  - The role of chemotherapy in the treatment of prostatic carcinoma.

PMID- 8356245
TI  - The role of hormonal therapy in the treatment of prostatic carcinoma.

PMID- 8356246
TI  - Do antineutrophil cytoplasmic autoantibodies cause Wegener's granulomatosis and
      other forms of necrotizing vasculitis?
AB  - The in vitro experimental observations support the theoretical pathogenic
      scenario depicted in Figure 14. A similar scenario could be portrayed for
      monocytes. ANCA in the circulation are unable to interact with unprimed
      neutrophils because the target antigens are within the cytoplasm (Fig. 14A).
      Synergistic priming of neutrophils, e.g., by an infection, causes small amounts
      of target antigens to be released at the cell surface (Fig. 14B) where they can
      interact with ANCA (Fig. 14C). ANCA-activated neutrophils then adhere to
      endothelial cells via adhesion molecule interactions that may require prior
      priming of the endothelial cells (Fig. 14C). These activated and adherent
      neutrophils then injure endothelial cells (and eventually underlying vessel wall
      structures) by releasing granule enzymes and toxic oxygen metabolites (Fig. 14D).
      Although many research groups throughout the world have been attempting to create
      an animal model of ANCA-induced disease based on the theoretical paradigm
      proposed in Figure 14, as well as on other paradigms, no one has reported
      complete success. Until this is accomplished, the role of ANCA in the
      pathogenesis of Wegener's granulomatosis and other forms of ANCA-associated
      vasculitides will remain conjectural.

PMID- 8356248
TI  - What is the natural history of rheumatoid arthritis?
AB  - Analyses of the natural history of RA, recognizing that all patients receive
      therapies, indicate the following: 1. Classification criteria for RA identify
      individuals with (at least) three different types of pathogenetic processes and
      long-term outcomes; most patients seen in clinical settings have progressive
      disease. 2. Results of therapies documented to be efficacious in clinical trials
      are not applicable to the long-term course of RA, in part due to patient
      selection and the short-time frame of observation in clinical trials; most
      therapies for RA are not effective in most patients over long periods. 3. Over
      periods of 10 years or longer, most patients with RA experience radiographic
      progression and severe functional declines, and work disability is seen in 60% of
      patients after 10 years of disease. 4. Mortality rates are increased in patients
      with RA, although RA is generally not listed on death certificates. 5. Individual
      patients with RA who are at risk for early mortality may be identified through
      clinical markers, including many involved joints, comorbid cardiovascular
      disease, and poor functional status according to questionnaires and physical
      measures. 6. Patient behaviors and lifestyles identified through formal
      educational level as a marker appear of great importance in the prevalence,
      morbidity, and mortality of RA.

PMID- 8356247
TI  - Do nonimmunologically mediated pathways play a role in the pathogenesis of
      rheumatoid arthritis?
AB  - The association between elevated serum rheumatoid factor and rheumatoid arthritis
      (RA) has been confirmed repeatedly and interpreted as strong evidence for an
      immunologic basis for the disease. In recent years, considerable additional
      evidence supporting this view has been obtained, strongly suggesting a role for
      CD4+ T cells in the pathogenesis of RA. An alternative view has also gained
      support, however. Based on studies of animal models and of RA itself, several
      lines of evidence have emerged that indicate that nonimmunologic pathways are
      operative in established RA. These observations have fostered the hypothesis that
      the evolution of RA may be associated with the emergence of non-T-cell-dependent
      autonomous pathways that dominate the latter stages of the disease.

PMID- 8356249
TI  - The interplay of nature versus nurture in predisposition to the rheumatic
      diseases.
AB  - The revolution in microbiology and genetics that has transpired in the past few
      years has brought fresh debate in the question of the relative contributions of
      nature and nurture in susceptibility to the rheumatic diseases. For nature, a
      variety of immunologically relevant genes have been identified whose presence has
      been shown to be associated either with an increased risk for certain diseases or
      for complications or subsets thereof. For nurture, the role of infectious agents
      in disease triggering and modification has been found.

PMID- 8356250
TI  - The need for aggressive therapy of rheumatoid arthritis.
AB  - We are on the threshold of a new era in the treatment of RA if we learn from the
      experience of the past and utilize new techniques and therapeutic modalities that
      the future will bring. New strategies and treatment of RA in the future will need
      to include earlier recognition of progressive disease, earlier interventions, new
      preparations for use in therapeutic armamentarium, combinations of agents, and
      monitoring of long-term outcomes to assess results over 5 to 10 years. There is
      always concern about new therapies and strategies. As noted by Huskisson,
      however, "In the absence of knowledge about the cause of disease and the mode of
      action of the drugs, the only way forward is by clinical trials of different
      preparations. With trial, there is always the risk of error." Our greatest error,
      however, will be if we ignore lessons from the past, fail to control the
      inflammatory process early, and continue to spend years writing "doing well" in
      the charts of patients who become progressively disabled before our eyes.

PMID- 8356251
TI  - Aggressive therapy does not substantially alter the long-term course of
      rheumatoid arthritis. So what else is new?
AB  - A consensus has evolved that there is little evidence supporting the view that
      the second line agents significantly alter long-term outcomes in rheumatoid
      arthritis. Consequently, changes in approaches to treatment currently being
      employed include earlier use of existing second line agents, their use in
      combinations, and greater use of corticosteroids. Our awareness that our current
      drugs, at best, fall considerably short of attaining the therapeutic results we
      would like to achieve causes us to look forward to the development of rationally
      derived biologic agents with considerable anticipation.

PMID- 8356252
TI  - The curious case of intramuscular gold.
AB  - Controlled clinical trials, meta-analysis, and observational studies provide
      strong evidence of short-term gold efficacy. There is also substantial evidence
      for the retardation of radiographic abnormality. Although gold therapy is
      discontinued by most patients within 2 years of onset, a minority of patients
      sustain important long-term benefit.

PMID- 8356253
TI  - Should steroids be used in the management of rheumatoid arthritis?

PMID- 8356254
TI  - Reflections on unproven remedies.
AB  - The use of unproven remedies is widespread in the United States. Most rheumatic
      disease patients, regardless of socioeconomic or educational background, try a
      number of these. This essay presents a somewhat tolerant view of nontraditional
      arthritis remedies, which, when considered thoughtfully, may advance our art.

PMID- 8356255
TI  - Microbial superantigens as etiopathogenic agents in autoimmunity.
AB  - A recently characterized group of immunologically active microbial products,
      termed superantigens, may provide the etiopathogenic link between antecedent
      infection and the subsequent development of autoimmunity in the genetically
      susceptible host. In this article, the authors review the cellular interactions
      that underlie autoimmune disease and emphasize the central role played by T
      lymphocytes. Based on the unique properties of the superantigen and data derived
      from experimental animal models and clinical studies of human autoimmune disease,
      a hypothesis that these molecules could trigger both systemic and organ-specific
      autoimmunity was developed.

PMID- 8356256
TI  - What is lupus? What is not lupus?
AB  - Present understanding suggests that lupus reflects a spectrum of syndromes that
      share many clinical, inflammatory, and immunologic features. Those patients not
      fulfilling criteria for systemic lupus erythematosus (SLE) do not seem to evolve
      frequently to classic SLE, tend to have a good prognosis, and may be managed
      conservatively. This is important for clinical management. Whether this pertains
      to etiopathogenesis is speculative and will await information not yet available.

PMID- 8356257
TI  - Which patients with antiphospholipid antibody should be treated and how?
AB  - The tests for antiphospholipid antibody are relatively crude but usable.
      Asymptomatic persons with incidentally discovered antiphospholipid antibody do
      not need treatment. Those with symptoms are best treated with anticoagulation,
      but data specifically supporting aspirin, heparin, or warfarin or combinations
      thereof remain to be generated. High-dose corticosteroid therapy has at best
      equivocal efficacy and much toxicity and should be used only for lupus activity
      and not for phenomena of the antiphospholipid antibody syndrome. The roles of low
      dose corticosteroid therapy, immunosuppressive agents, and other treatments are
      unknown.

PMID- 8356258
TI  - Is aggressive therapy effective for lupus?
AB  - Intravenous cyclophosphamide is an effective form of aggressive therapy for the
      management of a wide range of serious manifestations of systemic lupus
      erythematosus. Although it has been best studied in patients with progressive
      lupus nephritis, recent evidence indicates an important role for this therapy for
      other clinical lupus indications, particularly acute neurologic diseases. The
      available comparative data suggest that intravenous cyclophosphamide is far more
      effective than intensive corticosteroid therapies, including conventional high
      dose oral therapy as well as bolus intravenous therapy. Differences in efficacy
      compared with oral regimens of cyclophosphamide or azathioprine are less clear,
      although clinical experience would seem to suggest that intravenous
      cyclophosphamide has a more rapid onset of action clinically than low-dose oral
      therapies. Finally, the toxicity profile of intravenous cyclophosphamide compares
      favorably with other aggressive approaches to drug management and does not pose
      an unacceptable risk. The future impact of several current investigational
      therapies remains to be defined.

PMID- 8356259
TI  - Is "aggressive" therapy necessary for systemic lupus erythematosus?
AB  - Much of the initial attention in therapeutic studies for systemic lupus
      erythematosus (SLE) has justifiably been focused on the severe forms of the
      disease such as diffuse proliferative glomerulonephritis or central nervous
      system manifestations. Unfortunately, to all forms of SLE, thereby submitting
      patients with more benign variants of lupus have been submitted to aggressive,
      toxic, and probably unnecessary treatments. The thesis of this article is that
      aggressive therapy is not always necessary for SLE.

PMID- 8356261
TI  - Fibromyalgia and the rheumatisms. Common sense and sensibility.
AB  - Chronic musculoskeletal pain syndromes are common problems, but the etiology,
      pathogenesis, and pathology of many of them are very poorly understood. Because
      the currently used nomenclature suggests an understanding that we do not have, I
      propose that names like "myofascial pain," "tension myalgia," and "FM" be
      abandoned in favor of the more indefinite (but more honest) terms like "regional"
      and "generalized rheumatism." No matter what we rheumatologists call it, however,
      the condition of chronic generalized musculoskeletal pain probably is only one
      part of an even more generalized condition that includes IBS, chronic headaches,
      regional migratory numbness, TMJ syndrome, and a whole host of other somatic pain
      syndromes. The same patients end up seeing many specialists who themselves feel
      frustrated with the labels at their disposal, and these specialists end up
      resembling the blind men confronting the elephant. In this regard, the new ACR
      criteria for the diagnosis of fibrositis, by emphasizing tenderness and ignoring
      the presence of these other syndromes, are too circumscribed and represent a step
      backward in our attempts to understand. Although the chronic rheumatisms are
      problems difficult to manage and frustrating for both the patient and the
      physician, when patience can be applied and confidence achieved, a positive
      relationship can result and the patient can be helped.

PMID- 8356260
TI  - Should nonsteroidal anti-inflammatory drugs be used to treat osteoarthritis?
AB  - Millions of individuals with osteoarthritis have experienced relief of joint pain
      and improvement in mobility as a result of taking nonsteroidal anti-inflammatory
      drugs (NSAIDs). These agents are currently considered the drug of choice for
      treatment of osteoarthritis (OA). Despite their efficacy and nearly universal use
      in OA, the role of NSAIDs in managing this disorder recently has become
      controversial. This article reviews the issues that lie at the heart of the
      problem.

PMID- 8356262
TI  - Lyme disease: testing and treatment. Who should be tested and treated for Lyme
      disease and how?
AB  - LD can mimic a number of other disease, and vice versa. It is imperative that
      clinicians understand LD and be able to use serologic diagnostic techniques
      appropriately. LD is not a diagnosis that can be made on the basis of serologic
      testing. By this is meant that vague symptoms plus a positive serologic test do
      not assure that the patient has LD. On the other hand, a patient with ECM or
      other manifestations of LD may still be seronegative. In addition, therapy for LD
      must be tailored to the clinical problems of the individual patient. Especially
      in patients with chronic or persisting complaints, it is important to be precise
      in making the correct diagnosis and in understanding the underlying pathogenetic
      mechanisms at work so that an appropriate and ultimately successful therapeutic
      plan can be made.

PMID- 8356263
TI  - Is measurement of bone density useful?
AB  - Bone density testing is safe, accurate, and useful. Specific clinical indications
      and the types of equipment available to assess them are reviewed. A positive
      effect on the practice of a clinical rheumatologist with resultant improved
      patient care appears likely in light of the information available.

PMID- 8356264
TI  - Extraosseous Tc-99m MDP uptake: a pathophysiologic approach.
AB  - Scintigraphy with technetium-99m methylene diphosphonate (MDP) delineates a wide
      spectrum of nonosseous disorders. Neoplastic, hormonal, inflammatory, ischemic,
      traumatic, excretory, and artifactual entities demonstrate abnormal soft-tissue
      uptake of Tc-99m MDP. Mechanisms leading to increased extraosseous Tc-99m MDP
      uptake include extracellular fluid expansion, enhanced regional vascularity and
      permeability, and elevated tissue calcium concentration. The composition of the
      calcium deposition and the presence of other metallic ions (eg, iron and
      magnesium) are important. Soft-tissue Tc-99m MDP uptake is seen in benign
      (tumoral calcinosis, myositis ossificans) and malignant (sarcomas,
      adenocarcinomas, metastases) neoplastic entities. Hormonal disturbances in
      calcium metabolism, especially in hyperparathyroidism, can lead to metastatic
      calcification, visualized with Tc-99m MDP scintigraphy. Tissue damage from
      inflammation, infection, or physical trauma results in localized hyperemia,
      edema, or calcium (and hemosiderin) deposition based on their pathophysiologic
      characteristics. Urinary tract obstruction, anomalies, or dysfunction are
      demonstrated by Tc-99m MDP imaging. Common artifacts are related to faulty
      radiopharmaceutical preparation, Tc-99m MDP administration, and imaging
      technique. Recognition of these modes of extraskeletal Tc-99m MDP uptake can
      enhance the diagnostic value of bone scintigraphy.

PMID- 8356265
TI  - CT in abdominal and pelvic trauma.
AB  - Computed tomography (CT) is valuable in the evaluation of the abdomen and pelvis
      in victims of blunt trauma and stab wounds to the back if their condition is
      stable or if results of their physical examination are unreliable (eg, due to
      altered mental status). The appearance of blood at CT depends on window width,
      hematocrit, physical state of blood, use of intravenous contrast material, and
      attenuation of adjacent organs. Rapid infusion of contrast material improves
      visualization of hematoma. CT is most useful in evaluating injuries to the
      spleen, liver, pancreas, kidney, duodenum, and small and large bowel. Although CT
      can be accurate in demonstrating lacerations and hematoma, radiologists must
      beware of pitfalls in the CT diagnosis of splenic injuries (normal lobulation or
      cleft within the spleen, elongation of the left hepatic lobe, adjacent
      unopacified bowel loop, previous splenic infarct), hepatic injuries (beam
      hardening artifact from adjacent ribs, air-contrast level in the stomach), and
      pancreatic injuries (streak artifacts from nasogastric tubes, folding of the
      pancreas, misinterpretation of adjacent structures, pancreatic contusion or
      hematoma, intrinsic elasticity of the pancreas). Delayed scanning or scanning
      with slow infusion rates may also obscure hematoma. Knowledge of the various
      appearances of the posttraumatic abdomen and pelvis on CT scans is essential for
      prompt and effective treatment of patients.

PMID- 8356266
TI  - Imaging of pregnancy-related complications.
AB  - Thirty-six cases of pregnancy-related complications were studied with plain
      radiography, ultrasonography (US), computed tomography (CT), and magnetic
      resonance (MR) imaging alone or in combination. Among the complications diagnosed
      with these various techniques were venous thromboembolic disorders, deep vein
      thrombosis, ovarian vein thrombosis, endometritis and pyometra, HELLP syndrome
      (hemolysis, elevated liver enzyme levels, and low platelet counts), hepatic
      hematoma and rupture, fatty liver, uterine rupture, various hematomas and a
      foreign body, tubo-ovarian abscess, cerebral venous thrombosis, cerebral
      ischemia, and cerebral edema. Prompt detection and appropriate management of many
      of these complications could result in decreased maternal and fetal mortality and
      morbidity. Although US should be considered first because it can be performed
      bedside, does not require use of ionizing radiation, and is cost-effective, CT is
      superior in demonstrating the extent of the abnormality and MR imaging is best
      for detection of neurologic complications of pregnancy. The radiologist should
      select the best available method and tailor the examination according to the
      presumptive clinical diagnosis and the individual problem to be solved.

PMID- 8356268
TI  - Imaging of complications of lung transplantation.
AB  - With the increasing number and improved survival of lung transplant recipients,
      radiologists should be aware of the imaging features of lung transplants and the
      associated complications. Reimplantation response, a noncardiogenic pulmonary
      edema seen 48 hours after transplantation that subsequently resolves, varies in
      appearance from a mild perihilar haze to a dense consolidation in the perihilar
      areas and lung bases. A late complication of omentopexy (used to prevent
      bronchial dehiscence) is herniation of abdominal contents through the
      diaphragmatic incision into the thorax. Extrabronchial air collections are a
      radiologic manifestation of anastomotic dehiscence. Stricture formation that
      compromises the bronchial lumina is usually visible with plain radiography, but
      computed tomography can aid in the evaluation. Acute rejection is evident
      radiographically as new or increasing pleural effusions, septal lines, subpleural
      edema, peribronchial cuffing, and air-space disease, without increase in cardiac
      size. Radiographic features of chronic rejection include both increased and
      diminished lung volumes, central and peripheral bronchiectasis, localized air
      space disease, partial lobar atelectasis, thin linear irregular areas of
      increased opacity, pleural thickening, and diminished peripheral lung markings.
      Infection is frequently seen, especially gram-negative pneumonias, with fewer
      occurrences of cytomegalovirus infection, candidiasis, and invasive
      aspergillosis.

PMID- 8356267
TI  - Pattern recognition of the pulmonary manifestations of AIDS on CT scans.
AB  - More than 50% of patients with acquired immunodeficiency syndrome (AIDS) develop
      pulmonary disease during the course of their illness. The authors reviewed 96
      computed tomographic (CT) scans of patients with AIDS in an attempt to describe
      disease entities by the patterns seen on the scans. Such patterns included
      isolated ground-glass and interstitial infiltrates, which are suggestive of
      Pneumocystis carinii pneumonia (PCP). If pleural effusions or parenchymal nodules
      are also present, AIDS-related lymphoma (ARL) or Kaposi sarcoma (KS) is more
      likely. Although diffuse alveolar infiltrates are most commonly present in PCP, a
      segmental alveolar infiltrate is suggestive of a bacterial pneumonia, especially
      when associated with cavitation or ipsilateral pleural effusion. Well-defined
      nodules are typical for ARL, whereas ill-defined nodules are more commonly
      suggestive of KS. Accompanying adenopathy or effusion with nodules further
      suggests ARL. Different combinations of parenchymal, nodular, and pleural
      abnormalities may be suggestive for additional diagnoses, including Mycobacterium
      tuberculosis, M avium-intracellulare, and Cryptococcus neoformans infections and
      human immunodeficiency virus adenopathy. The authors believe that a specific
      pattern of involvement can help suggest a likely diagnosis in many instances.

PMID- 8356269
TI  - Spinal fixation. Part 3. Complications of spinal instrumentation.
AB  - Spinal fixation devices can be used to form a rigid construct with the spine to
      replace bone, restore alignment, maintain position, and prevent motion in the
      treatment of fractures, degenerative disease, neoplasm, and congenital
      deformities. Because most spinal constructs will eventually fail if bone fusion
      does not occur, bone graft material is often used along with the implant to
      promote fusion. Conventional radiographs, obtained in two projections, remain the
      mainstay of implant evaluation, demonstrating the position of the spinal
      elements, hardware, graft material, and evidence of complication. Possible
      complications connected with use of fixation devices include intraoperative soft
      tissue injuries, postoperative hematomas, and infection. The components (through
      incorrect use, malpositioning at surgery, and later dislodgment or fracture) may
      also contribute to complications such as instability; failure of fusion; or pain,
      with possible resultant neurologic damage. Bone graft material can migrate or
      hypertrophy, resulting in impingement on the spinal canal or neural foramen.
      Radiologists should be familiar with the various spinal fixation devices and
      techniques to better identify evolving complications.

PMID- 8356271
TI  - Preservation of augmented breasts in patients with breast cancer.
AB  - It is not uncommon for a patient who has previously undergone breast augmentation
      to be diagnosed with breast cancer. The options available to such a patient are a
      modified radical mastectomy and breast conservation treatment. If the patient
      chooses breast conservation treatment, the concerns that need to be addressed are
      whether the breast prosthesis should be removed before irradiation and whether
      the presence of the prosthesis would impair local control of the tumor or
      cosmetic results. This article presents the feasibility of breast conservation
      treatment without impairing the augmentation. Five patients underwent lumpectomy,
      perioperative placement of interstitial catheters in the tumor bed for immediate
      postoperative boost brachytherapy, and external beam irradiation to the entire
      breast. Results of follow-up examinations for a median of 60 months revealed
      successful local control and satisfactory cosmetic results. No long-term effects
      of radiation therapy on the breast prostheses have been observed. Thus, it seems
      feasible to conserve the breast and the augmentation with limited surgical
      resection and radiation therapy, including an immediate interstitial boost.

PMID- 8356270
TI  - Painful conditions affecting the first metatarsal sesamoid bones.
AB  - The sesamoid bones of the first metatarsal exhibit a special anatomic
      configuration, enveloped by the tendons of the flexor hallucis brevis and lying
      within the capsule of the first metatarsophalangeal joint. Painful conditions of
      the hallux sesamoid bones are many and include congenital, traumatic, arthritic,
      infectious, and ischemic conditions. Because of the complex anatomy and the
      numerous pain-sensitive structures in the region of the first metatarsophalangeal
      joint, a differential diagnosis can be challenging. The imaging examination
      should always begin with conventional radiography, including special axial and
      lateromedial views of the sesamoid bones. In cases in which results of routine
      radiography are inconclusive, scintigraphy, conventional or computed tomography,
      xeroradiography, or magnetic resonance imaging can be used. A thorough
      understanding of the anatomy; pathophysiology; and clinical, laboratory, and
      imaging findings is often helpful in the establishment of a diagnosis and
      management plan for painful conditions of the hallux sesamoid bones.

PMID- 8356272
TI  - Spiculated lesions of the breast: mammographic-pathologic correlation.
AB  - Spiculated breast lesions may be caused by both benign and malignant processes,
      including sclerosing adenosis, postsurgical scar, radial scar, tuberculosis
      (rare), posttraumatic oil cysts, infiltrating ductal carcinoma, ductal carcinoma
      in situ (rare), infiltrating lobular carcinoma, and tubular carcinoma.
      Mammographically, such lesions are often similar, and only some can be
      differentiated on the basis of morphologic characteristics. Although
      microcalcifications are often associated with breast carcinoma, not all
      spiculated lesions with microcalcifications are malignant. Sclerosing adenosis
      occurs with punctate microcalcifications, but the lesion often has a radiolucent
      center, compared with the opaque center generally found in malignant spiculated
      lesions. Radial scar may occasionally occur with microcalcifications and usually
      has a radiolucent center, but the latter is not a reliable criterion for
      differentiation from carcinoma. The spicules of benign lesions are often caused
      by fibrous tissue, lipid-filled spaces surrounded by histiocytes, or sclerotic
      stroma, whereas the spicules of malignant lesions are due to tumor infiltration,
      desmoplastic response, or periductal fibrosis. Mammography alone is frequently
      not reliable for making the specific diagnosis. Clinical breast examination,
      additional mammographic views, and needle or surgical biopsy are often required.

PMID- 8356273
TI  - From the archives of the AFIP. Extraskeletal osseous and cartilaginous tumors of
      the extremities.
AB  - Extraskeletal osseous and cartilaginous tumors and tumorlike conditions of the
      extremities can often be differentiated radiologically; for those that cannot,
      knowledge of the spectrum of lesions will allow a suitably ordered differential
      diagnosis. Of the osseous lesions--myositis ossificans, fibro-osseous
      pseudotumor, fibrodysplasia ossificans progressiva, soft-tissue osteoma, and
      extraskeletal osteosarcoma--all but myositis ossificans are relatively rare.
      Myositis ossificans has a distinct mineralization pattern that can be observed
      radiologically as a peripheral rim of lamellar bone. Fibro-osseous pseudotumor
      typically occurs in the digits of the hand and lacks the well-defined zoning
      pattern of myositis ossificans. The cartilaginous entities include the true
      tumors, soft-tissue chondroma and extraskeletal chondrosarcoma, and the tumorlike
      process, synovial osteochondromatosis. The tumors are relatively rare; synovial
      osteochondromatosis commonly affects middle-aged men, especially in the knee, and
      is associated with osteoarthritis. The differential diagnosis for these
      extraskeletal osseous and cartilaginous lesions includes soft-tissue sarcoma,
      benign mesenchymoma, malignant mesenchymoma (rare), calcified tophi in gout,
      melorheostosis (rare), pilomatricoma (rare), and tumoral calcinosis (rare).

PMID- 8356274
TI  - Advances in clinical neuroimaging: functional MR imaging techniques.

PMID- 8356275
TI  - Interventional MR imaging.

PMID- 8356276
TI  - MR imaging of the breast: technical approach and clinical experience.

PMID- 8356277
TI  - Current trends in MR imaging of the female pelvis.

PMID- 8356278
TI  - MR angiography of the peripheral vasculature.

PMID- 8356279
TI  - Computer-aided instruction for radiologic education.

PMID- 8356281
TI  - Medical records: mind what you say.

PMID- 8356280
TI  - Searching on-line data bases.

PMID- 8356282
TI  - Single-element transducers.

PMID- 8356283
TI  - Pediatric case of the day. Ewing sarcoma of the thumb with multiple metastases.

PMID- 8356284
TI  - Ultrasound case of the day. Combined iatrogenic CFA pseudoaneurysm and CFA-CFV
      arteriovenous fistula.

PMID- 8356285
TI  - General case of the day. Enterolith in a blind pouch (blind pouch syndrome
      secondary to side-to-side enteroanastomosis).

PMID- 8356286
TI  - [Infection and systemic lupus erythematosus: analysis of a series of 145
      patients].
AB  - Systemic lupus erythematosus (SEL) is a chronic inflammatory disease, which often
      requires corticosteroid treatment, being infection a common cause of both
      morbidity and mortality. We report the infectious episodes from 145 SLE patients
      revisited through 1975-1991, with a 6.8 years mean follow-up period. The
      relationship between each episode and several variables, especially
      corticosteroid treatment a month before the infectious episode, was analyzed.
      Forty two infections were diagnosed in 32 patients (22.06%). A significant
      increase in the number of infections among SLE patients with daily
      corticosteroids treatment was observed with respect to that of SLE patients with
      alternate day treatment (p < 0.001). The administration corticosteroids in
      alternate day form, if possible, can decrease the infection incidence in SLE
      patients.

PMID- 8356287
TI  - [Cancer mortality in women from Cadiz. 1975-1983].
AB  - Both in Spain and in the rest of industrialized countries, cancer is the second
      caused mortality in accordance with its incidence. Respect to the different
      Autonomous Communities, Andalucia is that where men are at most unfavorable
      situation, and women are within the most unfavored. Out of all the Provinces
      which constituted this Community, mainly Cadiz attracted attention by its
      systematically and constantly growing rates of that tumors present in the most
      common localizations. The aim of the present work is to study, by means of death
      certificate dates, the mortality rate of women from Cadiz between 1975-1983.
      Mortality rate was 104.08 decease per 100,000 inhabitants. The cut off rate of
      female population older than 40 years was 287.77. The temporal trend of women
      cancer in our ambient was studied comparing the mortality rates with the
      incidence rates from some Spanish Populational-Based Cancer Registers (Granada,
      Murcia, Tarragona and Navarra). We conclude that in Cadiz Province there is a
      higher number of women decreased by cancer, mainly by liver cancers.

PMID- 8356288
TI  - [Liver disease in patients with human immunodeficiency virus infection. Study of
      100 biopsies].
AB  - Human immunodeficiency virus (HIV)-related liver disease is frequently diagnosed.
      We report a study about 100 liver biopsy samples (LB) in patients with HIV
      infection. The aim of the study has been to analyze the liver biopsy yield when a
      systemic disease (group A) or a chronic liver disease (group B) are suspected.
      Tuberculosis, all of them disseminated, was the most common finding in group A
      biopsy samples, and a 81% yield was obtained. Chronic active hepatitis was the
      most common finding group B, and profitability reached 90%. We conclude that LB
      is the elective method to diagnose systemic disease, in patients previously
      selected according to their clinical findings, and that final diagnoses and safe.

PMID- 8356289
TI  - [Scleromyxedema associated with myopathy].
AB  - We describe a 45 year-old man, with scleromyxedema associated to systemic
      manifestations, including myopathy. After 6 years of dermatologic manifestations,
      muscular weakness, with proximal predominance resulting in incapacity, was
      established. Corticosteroids plus cyclophosphamide treatment suppressed muscular
      symptomatology, and a second biopsy was normal. The common association between
      scleromyxedema and myopathy and other systemic alterations suggest that this
      entity should probably be considered as a systemic disease instead as a skin
      disease.

PMID- 8356290
TI  - [Evolution of the emergency consultations in patients with human immunodeficiency
      virus infection in various levels of medical care in an urban area of Barcelona].
AB  - Medical emergencies involving patients with Human Immunodeficiency Virus (HIV)
      infection comprise an increasing number of the total hospitalary consults and
      contribute to their overflow. In order to evaluate possible alternative solutions
      to this problem, we performed a retrospective study of urgent medical consults by
      HIV patients at three different levels of medical care (primary assistance,
      extrahospitalary and hospitalary emergencies centers) all included in the same
      urban area of Barcelona. We demonstrated a growing excess in hospitalary
      emergencies, with high requirements of complementary explorations and hospitalary
      admittances. In the extrahospitalary emergency center, we can observe a
      progressive increasing of emergency consults, but still reasonable in number and
      adequate to the real possibilities of the center. At primary care level, HIV
      patients consulted because of less severe reasons. We conclude that a possible
      solution in order to decrease the assistance requirements in the hospitalary
      emergencies level could be to try to attend these patients in emergency
      extrahospitalary centers. These centers should be technically provided and with a
      close relationship both with the primary assistance care level and with the
      reference hospital.

PMID- 8356291
TI  - [Intra-abdominal paraganglioma: clinical, functional, structural, and
      immunohistochemical study of an exceptional case].
AB  - Paragangliomas are tumors, derived from paraganglionary system, able to
      synthesize and to liberate substances with neuroregulatory activity. They are
      rare, mainly in the neck located, difficult to anatomo-pathologic diagnose, and
      of poor prognosis. They may present as space-occupying lesions or as secondary
      syndromes due to the liberation of biologically active substances. Whenever it is
      possible, surgical excision is the treatment of choice. Nor chemotherapy, nor
      immunomodulators, like alpha-2b-interferon, have provided satisfactory results. A
      57 year-old man, with a non-surgical paraganglioma characterized by abdominal
      mass associated with liver and bone metastasis, is presented. The rarity of the
      intra-abdominal presentation, the image study findings, the histopathological and
      immunohistochemical examinations, and the evolution after alpha-2b-interferon
      therapy are analyzed.

PMID- 8356292
TI  - [Malignant lumbosciatic syndrome. Report of 21 cases with vertebral metastases].
AB  - We describe twenty one cases of tumoral metastasis on the vertebral column
      simulating initially discal herniation. All of them presented sciatica as a
      primary clinical manifestation of the malignant tumor. We describe here the
      differential diagnosis with other pathologies and the different outcome, like the
      poor response to regular treatment, alteration of the normal status, and
      alteration of the laboratory data. The radiologic findings and the laboratory
      abnormalities found in the emergency analysis should induce us to do more
      complete studies of the patient aimed to identify an underlying tumoral
      pathology.

PMID- 8356293
TI  - [Pharmacological knowledge among general physicians].
AB  - We inquired to 200 physicians about the 50 pharmaceutical products most dispensed
      in Seville during 1989. The most significative results were: 68.5% of the
      inquired answered the questionnaire. 98.5% knew the product, but only 80.3%
      prescribed it. The principal sources of information to know the drug were books
      and scientific journals (67.3%), followed by detailers (62%). 86.1% knew the
      composition of the product, and 94.9% knew its indications. 71.5% described the
      side effects, 66.4% the contraindications, and 25.5% the interactions with other
      drugs. Only 56.9% mentioned a therapeutic alternative.

PMID- 8356294
TI  - [Cancer of unknown origin: diagnostic and therapeutic yield].
AB  - Patients with carcinoma of unknown origin represents at least 5% on the total
      neoplastic patients. A review of the main metastatic locations and the different
      histological types has been done; giving special attention to the most frequent
      primitive neoplasms. Diagnostic yield in this type of cancer is emphasized, since
      many times, it is advisable to limit the number of explorations directed to find
      the primary tumor, as they decrease patient quality of life while no profit is
      obtained from the knowledge of the primary tumor, for most of the patients.
      However, this must not drive us to the opposite end: diagnostic and therapeutic
      nihilism. We have to rule out, in a reasonable way, certain types of tumors which
      have an useful treatment even in advanced phases (oat all carcinoma, germinal
      neoplasms, lymphomas).

PMID- 8356295
TI  - [Muscular tumors of the digestive tract].
AB  - We report the experience of the General Surgery Service of Segovia General
      Hospital. In a 15-years-period (1976-1991), we have cared for 32 patients with
      muscular tumors of the gastrointestinal tract, including 22 leiomyomas and 11
      leiomyosarcomas. These tumors were localized in stomach (46.8%), small intestine
      (40.6%), esophagus (9.3%) and colon-rectum (3.1%). A histologic study was
      developed on the basis of the mitosis number in 10 high power fields. Clinical
      manifestations, histological dates, treatment, and prognosis factors, outstanding
      the histological grade, size lesser than 10 cm, and tumor origin localization,
      are reviewed.

PMID- 8356296
TI  - [Hypersensitivity to aromatic anticonvulsive agents. Report of 2 cases].

PMID- 8356297
TI  - [Pentamidine-induced diabetes mellitus].

PMID- 8356298
TI  - [Incidentalomas and serendipity].

PMID- 8356299
TI  - [Adrenal gland incidentalomas smaller than 6 cm and their gammagraphic imaging
      diagnosis].

PMID- 8356300
TI  - [The therapy of hypertension].

PMID- 8356301
TI  - [Good health].

PMID- 8356302
TI  - [The relations between atrial natriuretic factor release and adrenergic
      activation in hypertrophic cardiomyopathy].
AB  - Atrial natriuretic factor (ANF) is a potent natriuretic and vasoactive
      (vasorelaxant) peptide localized in the secretory-like atrial specific granules.
      The main peptide in this storage granules is the 126 amino acid proatrial
      natriuretic peptide, but the principal circulating form in human plasma is the 28
      amino acid, alpha-human natriuretic peptide. Animal and in vitro studies have
      suggested that ANF modulates autonomic circulatory control, probably with a dose
      dependent mechanism. Moreover, recent human studies have resulted contradictory.
      In particular, it is still unclear if high circulating levels of ANF, which are
      present in congestive heart diseases constantly, may be correlated with
      sympathetic nervous system activity in man. Previously we have shown that in
      congestive diseases there is a relation between ANF and catecholamine secretion.
      From these basis, the aim of this study was to investigate on the
      pathophysiological relations between atrial natriuretic factor (ANF) release and
      adrenergic activation in patients with obstructive hypertrophic cardiomyopathy (n
      = 6) and non obstructive hypertrophic cardiomyopathy (n = 4). Sympathetic
      activation in physiologic way was induced by cycloergometer sub-maximal exercise.
      Then specimens of venous blood were achieved for plasma determination of ANF and
      catecholamines pre- and post-exercise. Results have shown that in obstructive
      hypertrophic cardiomyopathy patients basal levels of ANF and catecholamines were
      higher than levels of these parameters in non obstructive hypertrophic
      cardiomyopathy patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8356303
TI  - Oxidative burst and lysosomal enzyme release by polymorphonuclear cells in type
      IIa, type IIb and type IV primary hyperlipoproteinaemia.
AB  - Several findings pint out the occurrence of a strict relationship between
      lipoproteins and immunoresponsiveness. In this regard, in vitro lipoproteins
      pretreatment of mononuclear cell suspensions leads to an inhibition of Natural
      Killer (NK) cytotoxicity or T- and B-mediated immune functions. These results
      have an in vivo counterpart, since an impairment of either T-driven B cell
      polyclonal differentiation or phagocyte chemotaxis, phagocytosis and killing has
      been shown in patients with type IIa and type IIb primary hyperlipoproteinaemia.
      On the contrary, these activities fall within normal range in type IV
      hyperlipoproteinaemic subjects. To further address the potential role of
      polymorphonuclear cells (PMN) in atherosclerotic process, in the present report
      PMN-mediated superoxide anion (O2-) generation, hydrogen peroxide (H2O2)
      production, beta-glucuronidase and myeloperoxidase release have been assessed in
      similar groups of patients. Results provide a clearcut evidence for a significant
      enhancement of oxidative metabolism by either suspended or adherent to plastic
      PMN in type IIa primary hyperlipoproteinaemia only. These data were further
      confirmed by the observation that the same cell suspensions exhibit a significant
      increase of H2O2 generation and/or beta-glucuronidase and myeloperoxidase
      release. By contrast, PMN metabolic pathway in type IIb and type IV patients
      mimics that observed in healthy individuals. In the light of the well known
      increase of serum low-density lipoproteins (LDL) in type IIa primary
      hyperlipoproteinaemia, these findings suggest that also PMN may play an important
      role in the development of atherosclerosis. The augmented oxidative
      responsiveness may, in fact, give rise to LDL oxidation, which is in turn
      responsible for foam cell generation through an exaggerated uptake of oxidized
      LDL by macrophages.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8356304
TI  - [Chronic kidney failure: dialysis and kidney transplantation. The medicolegal and
      social considerations].
AB  - The authors carried out a research on the social and labour problems of the
      people affected by chronic renal failure, either on dialysis treatment or already
      transplanted since two years. It has been given a questionnaire based on
      questions about the person, the working position, the social insurance situation,
      the family and personal problems. The results show a good social reinsert and a
      good recover of the transplanted in opposition of the many problems had by those
      on dialysis; in particular it has been considered also the problem of the
      periodic absences from work. It has been also considered the italian law
      situation regarding the people affected by chronic renal failure in some
      different social insurance fields.

PMID- 8356305
TI  - [Atraumatic rupture of the renal pelvis].

PMID- 8356306
TI  - [Mastocytosis. A case of urticaria pigmentosa with a systemic malignant
      evolution].
AB  - A case of systemic mastocytosis with a malignant course, started as urticaria
      pigmentosa in adult age, is reported. The progression from cutaneous to systemic
      involvement has been marked by increasing hypereosinophilia which can be
      considered an important sign of adverse prognosis.

PMID- 8356308
TI  - Impaired growth hormone response to growth hormone releasing hormone in myotonic
      dystrophy.

PMID- 8356307
TI  - [Recombinant granulocyte colony-stimulating factor in the long-term treatment of
      AIDS-related neutropenias].
AB  - Neutropenia is a common finding in patients with AIDS or AIDS-related complex
      (ARC), and limits their survival and therapies. We administered recombinant human
      granulocyte colony-stimulating factor (rG-CSF) 300 micrograms/day to 15 AIDS
      patients with severe neutropenia (< 1000/microliters). without discontinuing
      zidovudine, ganciclovir or other myelosuppressive drugs (e.g. antineoplastic
      chemotherapy). All patients showed correction of neutropenia and/or limitation of
      drug myelosuppressive action. Neutrophil count was > 1000/microliters during the
      whole follow-up (11 months). No patient showed sepsis, opportunistic infections
      or side effects. These data confirm the efficacy and tolerability of rG-CSF in
      AIDS-related neutropenia.

PMID- 8356309
TI  - [The therapy of peripheral obstructive arteriopathies: rational bases].
AB  - The authors underline the relations among the anatomical lesion progression, the
      appearance of the clinical signs (claudicatio) of tissue ischaemia and the
      thromboembolic event in vascular districts like myocardium and brain, at high
      morbidity and mortality risk. They widely state the pathogenetic mechanism of the
      atherosclerotic arterial disease and the compensative mechanisms that may prevent
      the ischaemic effects of the vascular obstruction. It has been considered the
      importance of the hemorheologic changes and their influence on the development of
      the ischaemic syndrome. The therapeutic choice in relation to physiopathologic
      and hemorheologic events in the peripheral obstructive arterial disease is
      considered.

PMID- 8356310
TI  - [Insulin resistance: related clinical syndromes].
AB  - The authors, after having defined and listed the pathogenetic mechanisms of
      insulin resistance, describe the main, more or less frequent, syndromes with
      accompany this condition, classified on the basis of the prevalent etiology
      (dismetabolic, disendocrine, genetic, mixed), identifying of each one, when
      possible, the modes of determining the same insulin resistance. The more frequent
      diseases, whose common feature is the insulin resistance (obesity, non insulin
      dependent diabetes mellitus, acanthosis nigricans, polycystic ovarian syndrome)
      are particularly considered on the basis of recent literature and of personal
      data.

PMID- 8356312
TI  - Genetic determinants in carcinogenesis.

PMID- 8356311
TI  - [Mycoplasmas and mycoplasmosis: the etiopathogenetic problems and nosological,
      clinical and diagnostic advances].
AB  - Authors point out, on the basis of literature and of their own experience, the
      following aspects of Mycoplasma infections: 1) Genetical and biological
      progresses, especially related to pathogenetic aspects and diagnostic procedures.
      2) Recent clinical and diagnostic findings of M. pneumoniae infections: "bacteria
      like" pulmonary presentations by mycoplasmas (and, on the contrary, "virus-like"
      pulmonary presentations by bacteria); atypical kinds of pulmonary presentations
      by mycoplasmas; role of autoimmunity in extrapulmonary involvement. 3)
      Relationship among mycoplasmas, immune system and autoimmune diseases, with
      particular regard to animal models and to the Mycoplasma "superantigen". 4)
      Appearance of new pathogens and of a new spectrum of Mycoplasma infections:
      genito-urinary involvement by Ureaplasma urealyticum and by M. Hominis;
      relationship between Mycoplasma spp. and HIV infection.

PMID- 8356313
TI  - Dysplastic nevi-dysplastic nevus syndromes: clinical features and genetic
      aspects.

PMID- 8356314
TI  - Integrins and melanoma progression.

PMID- 8356315
TI  - Growth regulation in normal and malignant melanocytes.

PMID- 8356316
TI  - Transforming growth factor regulation of keratinocyte growth.

PMID- 8356317
TI  - Keratinocyte carcinogenesis: introduction.

PMID- 8356318
TI  - Diversity of epithelial skin tumors: thoughts and comments on some basic
      principles.

PMID- 8356319
TI  - Cellular and molecular changes during mouse skin tumor progression.

PMID- 8356320
TI  - Influence of aging and malignant transformation on keratinocyte gene expression.

PMID- 8356321
TI  - Molecular mechanisms of skin carcinogenesis induced by chemicals and ionizing
      radiation.

PMID- 8356322
TI  - Threshold-like dose response of mouse skin cancer induction by repeated beta
      irradiation and its relevance to radiation-induced human skin cancer.

PMID- 8356323
TI  - Environmental risk factors for skin cancer.

PMID- 8356324
TI  - Ultraviolet carcinogenesis: environmental effects of ozone depletion.

PMID- 8356325
TI  - Experimental ultraviolet carcinogenesis.

PMID- 8356326
TI  - Xeroderma pigmentosum patients from Germany (the Mannheim XP collection):
      clinical and biochemical characteristics.

PMID- 8356327
TI  - The in vitro analysis of biochemical changes relevant to skin carcinogenesis.

PMID- 8356328
TI  - Positive and negative growth control in multistage skin carcinogenesis.

PMID- 8356329
TI  - Epithelial stem cells, hair follicles, and tumor formation.

PMID- 8356330
TI  - The role of endogenous factors in skin carcinogenesis.

PMID- 8356332
TI  - Skin carcinogenesis: a health problem meets with a scientific challenge
      concluding remarks and future prospects.

PMID- 8356331
TI  - In vitro transformation and tumor progression.

PMID- 8356333
TI  - The skin: initiation and target site of immune responses.

PMID- 8356334
TI  - Melanocyte carcinogenesis: facts and fancies.

PMID- 8356335
TI  - The German melanoma registry and environmental risk factors implied.

PMID- 8356336
TI  - Fair complexion and risk of malignant melanoma of the skin based on experience
      from the Danish Cancer Registry.
AB  - Our Danish study shows that many pigmented naevi, a tendency to freckle and light
      hair colours are significant, important, and independent host factors which
      increase the risk of development of malignant melanoma of the skin. These results
      are in line with what has been consistently shown in previous and in more recent
      case-control studies. Light hair colour may be a measure of light complexion. The
      finding that individuals with a large number of naevi, a tendency to freckle and
      a sensitive skin constitute a risk group may be of importance. Such individuals
      could be warned about signs of early melanoma development and be instructed to
      avoid excessive sun exposure, especially damaging sunburn, with the aim of
      reducing melanoma mortality and melanoma incidence, respectively.

PMID- 8356337
TI  - A new pressure chamber to study the biosynthetic response of articular cartilage
      to mechanical loading.
AB  - A prototype chamber was used to apply a precise cyclic or static load on
      articular cartilage explants under sterile conditions. A variable pressure,
      pneumatic controller was constructed to power the chamber's air cylinder, capable
      of applying, with a porous load platen, loads of up to 10 MPa at cycles ranging
      from 0 to 10 Hz. Pig articular cartilage explants were maintained successfully in
      this chamber for 2 days under cyclic mechanical loading of 0.5 Hz, 0.5 MPa.
      Explants remained sterile, viable and metabolically active. Cartilage responded
      to this load with a decreased synthesis of fibronectin and a small but
      statistically significant elevation in proteoglycan content. Similar but less
      extensive effects on fibronectin synthesis were observed with the small static
      load (0.016 MPa) inherent in the design of the chamber.

PMID- 8356339
TI  - Transient early metabolic and functional hyperreactivity and late areactivity of
      lymphocytes in preleukemic AKR mice.
AB  - The dynamics of changes in the metabolic and functional activities of thymus,
      lymph node and spleen lymphocytes and spleen macrophages of AKR mice was examined
      during the preleukemic period. The MTT colorimetric assay was used to determine
      the mitochondrial enzyme activity of viable cells, the local xenogeneic GVH
      reaction and the IL-2 assay for measuring T cell responses, and the IL-1 assay as
      an indicator of macrophage activity. In the early preleukemic period (at 1.5
      months of age), lymphocyte dehydrogenase enzyme hyperactivity was accompanied by
      a highly increased production of IL-2, positive local xenogeneic GVH reaction and
      increased IL-1 production. Later on, at the age of 4-5 months, AKR mice
      demonstrated a progressive decrease in the metabolic activity of lymphocytes,
      negative local GVH reaction and reduction or lack in IL-2 and IL-1 production.
      This early hyperreactivity and late, gradually evolving, areactivity of
      lymphocytes and macrophages was not found in other, non-leukemic strains of mice
      (RFM, CBA, C57BL).

PMID- 8356338
TI  - Cell proliferation and prevalence of ras gene mutations in 7,12
      dimethylbenz(a)anthracene (DMBA)-induced rat mammary tumors.
AB  - Exposure of female inbred Sprague-Dawley Curl rats to intragastric 7,12
      dimethylbenz(a)anthracene (DMBA) resulted in a variety of benign and malignant
      mammary tumors exhibiting a wide spectrum of proliferative activity as measured
      by [3H]-thymidine autoradiography. On the basis of earlier observations of 21% H
      ras codon 61 mutations in DMBA-induced rat mammary tumors reported by Zarbl et
      al., the prevalence of this type of ras gene mutation was studied in relation to
      the rate of proliferation in individual benign and malignant tumors. In a series
      of 50 mammary tumors exhibiting highly different proliferation activities we did
      not detect any H-ras codon 61 mutations after allele-specific dot blot
      hybridization of PCR-amplified material obtained from paraffin sections. Neither
      mode of proliferation nor type of differentiation appears related to H-ras codon
      61 mutations. The relevance of activated ras genes for rat mammary carcinogenesis
      appears restricted to model systems using N-methyl-N-nitro-sourea (MNU) as
      initiating carcinogen.

PMID- 8356340
TI  - Recovery of pressor response to norepinephrine following relief of the obstructed
      common bile duct in the rat.
AB  - Jaundice caused by common bile duct (CBD) obstruction is associated with a
      blunted pressor response to norepinephrine (NE). We studied the rate and extent
      of recovery of the pressor response in the rat following relief of the
      obstruction. Three groups of male Wistar rats underwent CBD ligation. In the
      first and second group blood pressure measurements were obtained at 72 and 144 h
      after CBD ligation, respectively. In the third group pressure measurements were
      recorded 72 h after the relief of a 72-h obstruction. A fourth group served as
      control, and measurements were obtained 72 h after a sham operation. In all four
      groups measurements included basal blood pressure and pressure change following
      escalating doses of NE, ranging from 0.5 to 10 micrograms/kg. Basal blood
      pressure was similar in all four groups. In the control group the change of blood
      pressure was 23.4% +/- 6.7% in response to the lowest dose of NE, and 83.5% +/-
      24.9% in response to the highest dose. A blunted pressor response to NE was
      recorded in all three groups with CBD obstruction. The duration of CBD ligation
      (72 or 144 h) did not affect this blunded response. Re-establishment of bile flow
      for 72 h made only a slight improvement in the response to NE. Obstruction of the
      CBD was associated with hyperbilirubinemia which disappeared following the re
      anastomosis of the CBD to the duodenum. This most significant decrease in serum
      bilirubin was not associated with a similar improvement in pressor response to
      NE. We conclude that in the rat CBD obstruction is associated with a blunted
      pressor response to NE, that relief of CBD obstruction for 72 h is insufficient
      to abolish this response, and that there is no full correlation between serum
      bilirubin and pressor response.

PMID- 8356341
TI  - Electromyographic evaluation of the gastrointestinal tract in dogs with short
      bowel syndrome.
AB  - Seven dogs were subjected to resection of 80% of the total length of the small
      bowel. Seven pairs of electrodes were implanted in the seromuscular layer of the
      antrum and remaining small bowel. Electromyographic recordings were obtained
      during fasting and after milk ingestion. Slow waves were identified in all sites
      studied and their frequencies were 4.7 +/- 0.4/min in the antrum; 17.5 +/-
      0.58/min in D1; 17.5 +/- 0.61/min in D2; 17.43 +/- 0.65/min in J1; 17.40 +/-
      0.62/min in J2; 10.28 +/- 0.77/min in I1; and 9.81 +/- 0.53/min in I2. The phase
      III of the migrating motor complex was identified in only one recording.
      Ingestion of milk caused the appearance of the fed pattern in all recording
      sites, except the antrum. It is concluded that extensive resection of the small
      bowel causes reduction of the slow wave frequency in the gut distal to the
      resection and disappearance of phase III of the migrating motor complex.

PMID- 8356342
TI  - Cardiovascular and catecholamine responses to acute haemorrhage in anaesthetized
      potassium-adapted rats.
AB  - The experiments were designed to determine whether potassium-loaded rats have a
      deficient recovery of blood pressure after a rapid arterial haemorrhage.
      Potassium loading was achieved by providing a 0.75% KCl solution as drinking
      fluid for 14 days, while control rats had either distilled water or tapwater.
      MAP, HR, Hct, and plasma electrolytes were determined before and after 1 and 2%
      body weight haemorrhage in anaesthetized Sprague-Dawley rats. Potassium-loaded
      rats had significantly reduced blood pressure recovery within 20 min after
      haemorrhage. HR was significantly reduced within 5 min only after 2% haemorrhage
      in potassium-adapted rats. Haemorrhage induced significant hyperkalaemia which
      was greater and significantly prolonged after 2% haemorrhage. The significant
      fall in Hct after haemorrhage was not affected by the magnitude of haemorrhage.
      In an additional group of rats, the pressor response to intravenous infusion of
      vasopressin was unaffected by potassium loading, whereas that to noradrenaline
      and angiotensin II was significantly reduced throughout the 20 min of infusion.
      The peak increase in blood pressure after phenylephrine injection was, however,
      unaffected by potassium loading. Basal plasma catecholamines concentration as
      well as concentrations after 1% haemorrhage were unaffected by potassium loading.
      It is concluded that the reduced vascular response to noradrenaline and
      angiotensin contributed to the reduced recovery of blood pressure after
      haemorrhage in potassium-loaded rats. Furthermore, the result with phenylephrine
      suggest a mechanism that is unrelated to direct vascular effects of noradrenaline
      and angiotensin II.

PMID- 8356343
TI  - Identification of viruses with bi- and trisegmented double-stranded RNA genome in
      faeces of children with gastroenteritis.
AB  - Polyacrylamide gel electrophoresis of nucleic acid extracted from faecal samples
      of diarrhoeic children revealed the presence of group A rotavirus in 50 (23.4%)
      samples and group C rotavirus in 1 (0.5%) sample out of 214 tested. One other
      sample showed the presence of three bands (with apparent length of 2.92, 2.37 and
      1.32 kbp) which by enzymatic digestion analysis, were shown to consist of double
      stranded RNA (dsRNA). The sample was shown by electron microscopy to contain
      virus particles with a diameter of 32-34 nm. On the basis of morphology and
      genomic characteristics, this virus closely resembles a virus hitherto described
      only in chickens by Leite et al. in 1990 and tentatively named "picotrirnavirus".
      From the same group of 214, one sample containing a "picobirnavirus" was also
      identified. Thus, small icosahedral viruses with either a bior trisegmented dsRNA
      genome appear to infect humans. However, their pathogenic potential remains to be
      established.

PMID- 8356345
TI  - Detection of HIV1 DNA by a simple procedure of polymerase chain reaction, using
      "primer-dimer" formation as an internal control of amplification.

PMID- 8356344
TI  - Coronary artery lesions and human immunodeficiency virus infection.
AB  - The postmortem anatomopathological examination of eight heart-and-lung specimens
      obtained from eight HIV-seropositive patients was performed. Three patients were
      CDC stage II and five patients were CDC stage IV. The mean age was 27 (range: 23
      32). Distal and proximal vascular lesions of the coronary arteries were observed.
      These impairments were marked by major excentric atherosclerosis (with 80-90%
      obstruction of the arterial lumen) or by fibrosis two-fold or six-fold the
      thickness of the tunica media. Sclero-hyalinosis of the smaller arteries and
      myocardial interstitial fibrosis lesions was also revealed. In view of the
      severity of the described lesions, the absence of any associated cardiovascular
      risk factors and the context of immunodepression, the role of a virus in the
      genesis of these lesions is suggested, in particular a virus of the herpes group.

PMID- 8356346
TI  - Neurocysticercosis.

PMID- 8356347
TI  - Echinococcosis affecting the central nervous system.

PMID- 8356348
TI  - Trichinosis of the central nervous system.

PMID- 8356349
TI  - Amebic brain abscess and meningoencephalis.
AB  - Infections caused by the free-living amebae remind us of the fine line that
      divides environmental and pathogenic microorganisms, and the number and
      complexity of the threats our natural defenses must cope with routinely. The
      comparative rarity of amebic brain infections, and their devastating
      consequences, demand utmost vigilance from the clinician. Although in many cases
      nothing can be done to save the lives of persons with these maladies, early
      diagnosis and prompt therapy can be effective in some cases. Much remains to be
      discovered about the pathogenesis, diagnosis, and effective therapy of amebic CNS
      infections.

PMID- 8356350
TI  - Eosinophilic meningitis.

PMID- 8356351
TI  - Disseminated strongyloidiasis.

PMID- 8356352
TI  - Visceral and ocular larva migrans.

PMID- 8356353
TI  - Cerebral malaria.

PMID- 8356354
TI  - Spinal and cerebral schistosomiasis.

PMID- 8356355
TI  - Cerebral paragonimiasis.

PMID- 8356356
TI  - Trypanosomiasis of the central nervous system.
AB  - American (Chagas' disease) and African (sleeping sickness) trypanosomiasis are
      diseases that are endemic in parts of Latin American and Africa, respectively.
      Physicians in developed countries may occasionally see cases because of extensive
      travel and immigration from endemic countries. In addition, in American
      trypanosomiasis, transmission via contaminated blood transfusions poses
      significant risks of causing acute Chagas' disease in immunocompromised patients.
      Both forms of trypanosomiasis have neurologic manifestations. Chagas' disease can
      present as acute meningoencephalitis in children and some immunocompromised
      patients. Additionally, there are increasingly frequent reports of neurologic
      syndromes, including CNS mass lesions, in HIV-infected patients. African sleeping
      sickness has prominent CNS pathologic features in stage II disease. Proposed
      pathogenetic mechanisms and diagnostic and therapeutic considerations are
      reviewed in this article.

PMID- 8356357
TI  - Serodiagnosis of parasitic infection of the central nervous system.

PMID- 8356358
TI  - Luther in worms and vice versa.

PMID- 8356359
TI  - Patient satisfaction and design of treatment. Results from a study of two
      different ways of treating hypertension.
AB  - OBJECTIVE: To compare patients' experiences of two different treatments of
      hypertension (non-pharmacological and pharmacological) and study to what extent
      seven specified factors of treatment differ between the two groups and the impact
      of these factors on patient satisfaction. DESIGN: Postal questionnaire with
      structured and open questions concerning the treatment. SETTING: Ten health
      centres in mid-Sweden. PARTICIPANTS: The 165 patients in the non-pharmacological
      group participated in a two-year-long study called Non-pharmacological treatment
      of hypertension (NPTH) at eight health centres. The 85 patients in the control
      group were recruited from two health centres providing traditional,
      pharmacological treatment of hypertension. MAIN OUTCOME MEASURE: Statistical
      comparisons between (the questionnaires from) the two groups. RESULTS: The
      results show that the patients in the NPTH-group considered that six out of seven
      factors had a more positive influence on them than the C-group. The six factors
      are doctor continuity, patient-doctor relation, patient participation,
      responsibility, control, and knowledge. The seventh factor is accessibility.
      CONCLUSIONS: The NPTH-group to a greater extent than the C-group had positive
      experience of all but one of seven factors of treatment studied. The factors
      studied are assumed to be an important part of patient satisfaction in outpatient
      health care.

PMID- 8356360
TI  - Patterns of abuse of the elderly in their own homes as reported by district
      nurses.
AB  - This study aimed at describing patterns of abuse of elderly persons living in
      their homes as experienced by district nurses in a county of Sweden. 12% of the
      district nurses (n = 153) reported 30 cases. Those abused were 78.7 years old
      (mean) and half of them had disturbed memory and mental state and were mostly
      isolated. The abuser was a relative of the abused person and 64.2 years old
      (mean). Psychological abuse was the most frequently reported kind of abuse. Along
      with the abuse the abusers' behaviour was commonly experienced as unpleasant and
      aggressive and/or combined with family conflicts. The results indicated that
      abuse is very much a family affair. To guide district nurses in a family-oriented
      approach is justified by the results. It also seems important further to
      investigate the pattern of how the different types of abuse occur.

PMID- 8356361
TI  - Dementia day care and its effects on symptoms and institutionalization--a
      controlled Swedish study.
AB  - OBJECTIVE: To examine the effects of Day Care (DC) on demented patients. DESIGN:
      A prospective non-randomized concurrent-control study. PARTICIPANTS: 55 demented
      patients in DC and 44 controls. SETTING: Sundsvall, an industrial community in
      northern Sweden. MAIN OUTCOME MEASURE: Cognition, ADL-functions, behaviour and
      institutionalization. RESULTS: Measurements of cognition, ADL-functions, and
      behaviour showed no or only small differences between the groups. After one year,
      24% of the patients in the DC-group were institutionalized, compared with 44% of
      the controls. In the control group, the exhaustion of spouse and supervision need
      were highly correlated to institutionalization (p < 0.001), while high physical
      nursing load was correlated to institutionalization in the DC-group (p < 0.01).
      CONCLUSION: DC postpones institutionalization, probably because of less
      exhaustion of spouses and decreased supervision need.

PMID- 8356362
TI  - The Danish version of the Nottingham Health Profile: its adaptation and
      reliability.
AB  - OBJECTIVE: To test the reliability of the Danish version of the Nottingham Health
      Profile. DESIGN: Test-retest reliability with an interval of four weeks between
      administrations of the measure. SETTING: Copenhagen. PARTICIPANTS: Seventy
      patients suffering from osteoarthrosis, living at home and awaiting hip
      replacement operation. The patients' ages ranged from 37 to 90 years, with a
      median of 72 years. OUTCOME MEASURE: The Danish version of the Nottingham Health
      Profile, a measure of perceived health status, widely used in Europe. The measure
      consists of six sections; pain, physical mobility, energy level, sleep, social
      isolation, and emotional reactions. RESULTS: The respondents scored highly on the
      measure, particularly on the pain, physical mobility, and energy sections. No
      major differences in scores associated with age or sex were found. The test
      retest correlation coefficients obtained for the six sections were high (ranging
      from 0.76 to 0.86) and comparable with those found in Sweden and the UK. The test
      retest correlation for the whole measure was 0.93. CONCLUSION: The Danish version
      of the Nottingham Health Profile has been shown to be reliable and to be
      acceptable and relevant to patients with chronic disability. Should the formal
      tests of validity currently in progress prove satisfactory, Danish clinicians and
      researchers will have a valuable tool available for gaining insight into the
      impact of illness and its treatment on patients.

PMID- 8356363
TI  - Clinical assessment of pregnant women's psychosocial conditions, prematurity and
      birth weight.
AB  - OBJECTIVE: To seek a relation between pregnant women's psychosocial condition,
      assessed clinically in general practice, and prematurity and birth weight of the
      child. DESIGN: Clinical assessment early and late in pregnancy of psychosocial
      condition based on all accessible information, which included an extended history
      on psychosocial condition supplemented by background information about the woman
      and her social network and clinical observations. SETTING: Antenatal care in a
      general practice. RESULTS: The women assessed as having psychosocial difficulties
      were younger, had less education, and gained less weight in pregnancy. Birth
      weight was related to parity, body mass index before pregnancy, and total weight
      gain in pregnancy. A relationship was found between difficult psychosocial
      conditions and prematurity and low birth weight of the child. If the assessment
      of psychosocial condition had been based on the women's verbal descriptions of
      their problems alone, no relationship would have been found between psychosocial
      difficulties and prematurity and birth weight of the child. CONCLUSION: A
      clinical assessment of a woman's psychosocial condition, in which all accessible
      information is used, and an emphasis on emotional and social support for women
      when needed, may be necessary for improvement of antenatal care.

PMID- 8356364
TI  - The value of screening for retinopathy and microalbuminuria in patients with type
      2 diabetes in primary health care.
AB  - Patients with type 2 diabetes (NIDDM) attending the Primary Care Centre in
      Molnlycke, Sweden, were evaluated regarding their metabolic status,
      microalbuminuria (UAER), and hypertension. An ophthalmological examination was
      performed, and two diagnostic methods, slit-lamp biomicroscopy and fundus
      photography, were compared. Nearly half the patients (42%) had diabetic
      retinopathy, mainly of the background type. Retinopathy was associated only with
      the duration of the disease, but the prevalence was as high as 20% within 0-4
      years of the diagnosis. Fundus photography was easy to apply, except in the age
      groups above 80 years, in otherwise healthy and mentally cooperative patients.
      Fundus photography could not be applied in only 7% of the patients for
      ophthalmological reasons. The prevalence of microalbuminuria (20-200
      micrograms/min) was high--34%--with another 8% above that range. Male sex, mode
      of antidiabetic treatment, and hypertension were associated with an increased
      UAER. Screening for retinopathy and microalbuminuria is valuable in primary
      health care in order to detect treatable diabetic retinopathy and to trace
      patients with microalbuminuria, a risk factor for clinically overt nephropathy as
      well as for cardiovascular diseases.

PMID- 8356366
TI  - Health service consumption and parent reported episodes of illness in children 0
      3 years.
AB  - OBJECTIVE: To describe health service consumption and to find out whether a
      series of possible explanatory variables can help us to predict the number of
      contacts among children. DESIGN: A prospective study following a cohort of
      children during the first four years of life. SETTING: A municipality in southern
      Norway. PARTICIPANTS: 183 children born in the community from October 1979 to and
      including December 1980. MAIN OUTCOME MEASURE: Direct and indirect encounters
      with general practitioners (GPs) from the bills to the national insurance office,
      outpatient encounters and hospital admissions from the hospital files, and
      episodes of illness as reported in postal questionnaires to the parents. RESULTS:
      Each child had on average 10.6 GP contacts (2.6 per year), and the frequency of
      contacts decreased as they grew. Telephone contacts were almost as frequent as
      consultations at the doctor's surgery, and the doctors made more home visits to
      the youngest children. Of the contacts, 4/5 took place in the day time, but most
      of the home visits took place during the evening/night/weekend. Each child had
      1.9 hospital contacts in 4 years, i.e. 0.3 admissions and 1.6 outpatient
      department contacts. The parents reported an average of 11.5 episodes of illness
      during the period, more than twice as many in the first year as in the last year.
      Information about sex, duration of breast feeding, smoking in the family, family
      history of allergy, parents' education, whether in kindergarten, and presence of
      psychosocial problems cannot help in predicting health care consumption.
      CONCLUSION: The low number of contacts with GPs can partly be explained by the
      fact that the children also have contact with a well-baby clinic. In our study, a
      series of possible explanatory factors did not help us to predict the amount of
      health care consumption during the first four years of life.

PMID- 8356365
TI  - Myocardial infarction risk factors and well-being among 50-year-old women before
      and after the menopause. The population study "50-year-old people in Kungsor".
AB  - OBJECTIVE: To examine whether early menopause has a negative influence on the
      traditional ischaemic heart disease (IHD) risk factor pattern and on well-being.
      DESIGN: Cross-sectional population study. SETTING: Kungsor, a semirural community
      in mid-Sweden. PARTICIPANTS: All 155 women in Kungsor who became 50 years old in
      1984-7. MAIN OUTCOME MEASURES: Traditional IHD risk factors and self assessed
      well-being measures. RESULTS: Women who smoked had an earlier menopause than
      others. Postmenopausal women had significantly higher serum cholesterol levels
      (and haemoglobin levels), and more sleep disturbances than premenopausal women.
      There were no significant differences in other self-rated well-being, but home
      and family situation, patience, anxiety, and sleep disturbances tended to become
      worse with time from menopause. CONCLUSIONS: These findings may be interpreted as
      evidence indicating that the menopause affects the IHD risk factor profile and
      well-being negatively.

PMID- 8356367
TI  - Alcohol-use patterns in young university students in Finland.
AB  - OBJECTIVE: To obtain descriptive data on the alcohol-use patterns and the factors
      affecting them among Finnish first-year university students. DESIGN: Cross
      sectional survey with a self-administered questionnaire. SETTING: Finnish first
      year university students. PARTICIPANTS: 3,836 students during the academic year
      1989/90. The participation rate was 73.7% for female and 53.6% for male students.
      MAIN OUTCOME MEASURE: Frequency of drinking alcohol, heavy drinking, and drinking
      for intoxication, average alcohol consumption. RESULTS: The mean alcohol
      consumption for female students was 2.6 kg and for male students 6.5 kg of pure
      alcohol per year. 6.5% of the female students and 5.1 of the male students were
      abstainers. The heaviest drinking 10% consumed 42% of all consumed alcohol. 4.9%
      of the female students reported a consumption of at least 10 kg of pure alcohol
      per year and 11.7% of male students reported a consumption of at least 15 kg. The
      median for the frequency of drinking was every second week for the females and
      once a week for the males. Furthermore, drinking for intoxication was more
      frequent among the male than the female students. CONCLUSION: Male students have
      a higher alcohol consumption, drink more frequently, and are more often
      intoxicated than female students.

PMID- 8356368
TI  - Characteristics of young female smokers in a Swedish primary health care area.
AB  - OBJECTIVE: To analyse the correlation between smoking, socioeconomic
      characteristics, and sexual and contraceptive patterns in young women. DESIGN:
      Cross-sectional population study, smokers compared with non-smokers. SETTING:
      Nattraby-Hasslo, a rural area in southern Sweden. PARTICIPANTS: All women between
      15-34 years of age (n = 541). RESULTS: 26% smoked daily. Smokers on average had
      less schooling, lower 9th grade results, less satisfaction in school, and more
      unskilled professions than non-smokers. Apart from a higher parental divorce rate
      among smokers, no correlation between parental factors and smoking was found.
      Smokers on average reported an earlier sexual debut, more unprotected first
      intercourse, more life-time sexual partners, and more legal abortions.
      CONCLUSION: Smoking is associated with sexual habits, which may reflect a higher
      tendency to take personal risks among smokers.

PMID- 8356369
TI  - Medical theories derived from clinical practice.

PMID- 8356370
TI  - Manual therapy with steroid injections in low-back pain. Improvement of quality
      of life in a controlled trial with four months' follow-up.
AB  - OBJECTIVE: To compare prospectively the effect of manual treatment such as
      manipulation, specific mobilization, muscle stretching, auto-traction, and
      cortisone injections with standardized conventional but optimized activating
      treatment by primary health care teams. DESIGN: Prospective controlled
      multicentre trial with four months' follow-up. SETTING: Kopparberg County,
      Sweden. Six primary health care or occupational health care centres, representing
      a catchment area of 56000 residents participated. PARTICIPANTS: 101 outpatients
      with acute or subacute low-back pain were, during the period February 1988 to
      April 1989, randomly allocated to one of two treatment groups. MAIN OUTCOME
      MEASURE: Quality of life was assessed at baseline and at four months by means of
      visual analogue scales (VAS). The occurrence of 27 different symptoms of a
      psychosomatic character was surveyed initially and at four months by questions
      answered by "yes" or "no" in a questionnaire. RESULTS: There were significant
      differences concerning quality of life and presence of general symptoms in favour
      of the group receiving manual treatment with steroid injections. CONCLUSION:
      Manual treatment with steroid injections was superior to conventional treatment
      in minimizing mental and somatic symptoms and increasing quality of life, in
      parallel with other measures of improvement.

PMID- 8356372
TI  - Patients' perceptions--a shift in medical perspective.
AB  - Based on an empirical study in general practice, patients' perceptions and a
      fundamental shift in medical perspective are described. The research material was
      collected in a prospective interview-study that included 13 general practitioners
      and 35 patients (24 female and 11 male). Patients and doctors were interviewed
      before and after the consultation. A semistructured schedule was followed, and
      all 175 interviews were performed by the investigator, and taped. A patient
      perception-model of health, based on the analysis of the interviewdata, became
      the framework for describing the complexities of illness experiences. The
      coupling of viewpoints revealed that patients and doctors live in different
      conceptual worlds. Often they did not know the extent to which their perceptions
      were different, nor why. The aspects of disease that lie outside the biomedical
      field have not hitherto been of great interest in medical research. However, our
      ability to act on the humanistic dimensions in everyday clinical settings depends
      on knowledge about these as well. Medical human science research may give us new
      conceptions and theories in this complex territory.

PMID- 8356371
TI  - Ketoprofen controlled release (CR) in the treatment of osteoarthrosis; a double
      blind, randomized multicentre study of single morning versus evening dose.
      Norwegian Study Group of General Practitioners.
AB  - OBJECTIVE: To compare the morning and evening dose of 200 mg ketoprofen
      controlled release formulation with regard to both efficacy and GI tolerability.
      DESIGN: Double-blind, randomized multicentre prospective trial with cross-over
      design combined with a parallel design. PARTICIPANTS: One hundred and eight
      female and 55 male patients with osteoarthrosis in hip(s) or knee(s)
      necessitating treatment with nonsteroidal antiinflammatory drugs. MAIN OUTCOME
      MEASURE: The degrees of pain and stiffness and joint movement ability in joints
      with osteoarthrosis. RESULTS: Both the morning and the evening dose demonstrated
      a significant effect (p < 0.01) on all efficacy variables. The reduction in
      degree of pain in the afternoon and in the evening was significantly higher (p <
      0.01) for the morning dose. The total frequency and degree of gastrointestinal
      discomfort increased significantly (p < 0.01) during both treatment periods. The
      increases were mainly caused by increased gastric pain and constipation. No
      significant differences were found between the two regimes regarding
      tolerability. CONCLUSION: Ketoprofen controlled release given once daily in the
      morning compared to the evening to patients with osteoarthrosis may increase the
      efficacy without reducing the tolerability of the drug.

PMID- 8356373
TI  - 'Sports anaemia'. Does it exist?

PMID- 8356374
TI  - Exercise-induced hypoxaemia in elite endurance athletes. Incidence, causes and
      impact on VO2max.
AB  - Arterial oxygenation is well maintained in healthy untrained or moderately
      trained individuals during exercise. In contrast, approximately 40 to 50% of
      healthy elite endurance athletes (cyclists and runners) demonstrate a significant
      reduction in arterial oxygenation during exercise at work rates approaching
      VO2max. The mechanism(s) to explain this exercise-induced hypoxaemia (EIH) remain
      controversial. However, hypoventilation and venoarterial shunt do not appear to
      be involved. By elimination, this suggests that ventilation-perfusion inequality
      and/or pulmonary diffusion limitations must contribute to EIH in this population.
      Theoretical and direct experimental evidence exists to support the notion that
      both ventilation-perfusion inequality and diffusion disequilibrium contribute to
      EIH; however, the relative contribution of each factor remains to be determined.
      In athletes who exhibit a profound EIH, the exercise-induced decline in arterial
      oxygenation results in a limitation of VO2max. Further, athletes who exhibit EIH
      at sea level suffer more severe gas exchange impairments during short term
      exposure to altitude than athletes or nonathletes who do not exhibit EIH at sea
      level. This finding explains much of the observed variance in the decline in
      VO2max among individuals during short term altitude or hypoxia exposure.

PMID- 8356375
TI  - Physical fitness and adults with mental retardation. An overview of current
      research and future directions.
AB  - The deinstitutionalization movement of the past 25 years has focused on the
      placement of people with mental retardation into community-based settings. There
      is a need for exercise- and health-related professionals to demonstrate a
      thorough understanding of the term mental retardation and all of the intellectual
      and behavioural ramifications that coexist with this condition before addressing
      the 'how to' of fitness evaluation. Therefore, the article outlines the range of
      intellectual and behavioural characteristics of this population, based on the
      level of retardation. Many researchers investigating body composition have
      reported that a disproportionate number of adults with mental retardation carry a
      percentage of body fat that would be considered unhealthy (e.g. it increases the
      risk of early onset of such diseases as hypertension and adult onset diabetes
      mellitus). Living arrangements (i.e. institution vs smaller residences) play a
      role in the prevalence of obesity. Many attempts of researchers to control weight
      in adults with mental retardation through caloric restriction, exercise, and a
      combination of diet and exercise, have had a varied outcome. Cardiovascular
      capacity is considered by most exercise physiologists as the major physiological
      indicator for overall fitness. The majority of researchers who have evaluated the
      cardiovascular fitness levels of adults with mental retardation have reported
      fitness levels representative of a very sedentary population. Therefore, one
      would expect a keen sense of urgency among researchers to develop training
      regimens targeted specifically for people with mental retardation. Many have been
      developed, but to date only 2 cardiovascular training regimens have been reported
      that specifically describe the necessary components of an exercise programme
      (i.e. frequency, duration, intensity) that would allow for reproducibility--a
      stationary bicycle routine using the Schwinn 'Air-Dyne' ergometer and a run/walk
      programme. Of these, only the programme using the Schwinn 'Air-Dyne' ergometer
      reported significant improvements in cardiopulmonary fitness. Researchers have
      demonstrated that: (1) body strength is valuable for recreation activities and
      activities of daily living; (2) competence in upper body muscular skills is a
      prerequisite for many available vocational opportunities; and (3) positive
      correlations have been established between muscular strength and industrial work
      performance in people with mental retardation. Therefore, there is a need for
      appropriate evaluation procedures for determining the muscular strength and
      endurance of people with mental retardation. The future directions for
      researchers and professionals concerned with the fitness status of people with
      mental retardation includes answering question such as: What will be the effect
      of obesity on general health status?(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8356377
TI  - Weight-training injuries. Common injuries and preventative methods.
AB  - The use of weights is an increasingly popular conditioning technique, competitive
      sport and recreational activity among children, adolescents and young adults.
      Weight-training can cause significant musculoskeletal injuries such as fractures,
      dislocations, spondylolysis, spondylolisthesis, intervertebral disk herniation,
      and meniscal injuries of the knee. Although injuries can occur during the use of
      weight machines, most apparently happen during the aggressive use of free
      weights. Prepubescent and older athletes who are well trained and supervised
      appear to have low injury rates in strength training programmes. Good coaching
      and proper weightlifting techniques and other injury prevention methods are
      likely to minimise the number of musculoskeletal problems caused by weight
      training.

PMID- 8356376
TI  - Blood lactate measurement in recovery as an adjunct to training. Practical
      considerations.

PMID- 8356378
TI  - Golfing injuries. An overview.
AB  - Golf is becoming an increasingly available and popular sport. It is played by
      people of all ages and abilities, which accounts for a wide spectrum of injury.
      Few reports of injuries exist, but increasing media attention of the golfing
      injuries of professional players has raised the profile of these medical
      conditions. Numerically, the vast majority of problems occur from soft tissue
      musculoskeletal injuries rising principally from overuse. The injury pattern seen
      is influenced by the age, ability and amount of play. Anatomically, most injuries
      are localised to the back, wrist, elbow and shoulder. In addition to causing new
      injuries the game may cause recrudescence of old injuries and exacerbate pre
      existing degenerative disease. A different injury pattern is seen among elite
      players compared with recreational players, and this relates to skill and amount
      of practice. Appropriate conditioning and attention to technique may help to
      reduce the incidence of injury. There are no injuries exclusive to golf, however
      fracture of the hamate bone is an uncommon injury seen in sports involving the
      use of a club or bat. The high number of childhood golf-related head injuries is
      disturbing. Most of these arise from blows to the head from a golf club and
      highlight the need for early tuition in the safety aspects of the game.

PMID- 8356379
TI  - Will multimodality therapy solve the enigma of long-term survival for squamous
      cell carcinoma of the esophagus?
AB  - Squamous carcinoma of the esophagus is a disease with a poor prognosis which
      fortunately occurs seldom in the United States. Because patients present with
      more advanced disease here, surgical therapy has not equaled results reported
      from Asia. Although, claims of equality have appeared in the literature,
      radiation therapy alone has not been very effective for this disease. There are a
      myriad of small reports which extol a variety of combined approaches. Based upon
      a review of these series it is obvious that a Phase III trial is required to
      establish the best multimodality therapy for management of squamous carcinoma of
      the esophagus. Components of such a trial are reviewed and suggestions are made
      for design and reporting of such a trial.

PMID- 8356380
TI  - Efficacy of multimodality therapy in gastric adenocarcinoma.
AB  - Multimodality therapy has not reproducibly improved the survival of patients with
      gastric adenocarcinoma. This is largely because the staging of disease has been
      imprecise and because the current regimens have only limited efficacy against
      advanced disease. Until staging is improved and active regimens are found, it
      will be difficult to identify synergism between surgery and other treatment
      modalities.

PMID- 8356381
TI  - Influence of multimodality therapy on the management of pancreas carcinoma.
AB  - Carcinoma of the pancreas has an especially grim prognosis. Only 1-3% of patients
      survive for 5 years. Radical pancreaticoduodenectomy, especially for minimal
      disease, is currently the only chance for cure. While radiation therapy does not
      improve overall survival, it may improve local control following radical
      resection and decrease pain in locally advanced cancers. Although chemotherapy
      has led to significant improvements in survival in patients with locally advanced
      disease, the overall effect is small. When surgery, radiotherapy, and
      chemotherapy are administered to localized carcinomas in randomized, prospective
      trials, survival is significantly lengthened. Similar trials in locally advanced,
      unresectable pancreatic cancer also confirm the concept of synergistic
      interaction between therapies. Thus, pancreas carcinoma is one neoplasm where
      multimodality therapy has had a demonstrable, although small effect.

PMID- 8356382
TI  - Evolving role of surgery after induction chemotherapy and primary site radiation
      in head and neck cancer.
AB  - Chemotherapy, as preliminary treatment before surgery and/or radiation for
      advanced squamous cell carcinoma of the head and neck, is no longer novel. In
      prospective trials to date, however, multiple agent induction chemotherapy has
      yet to demonstrate the initial presumptive promise of improved rates of cure. As
      an alternate goal, there has emerged a renewed attentiveness toward limiting
      treatment morbidity, several strategies for which may be considered. Extirpative,
      often radical, surgery on the primary site of disease usually represents the most
      significant threat to life quality. Various ways of limiting surgical morbidity
      will be considered by way of introduction. The trends of head and neck cancer
      treatment over the decades, leading into the era of induction chemotherapy and
      refined radiation techniques, will be described. At the combined Dana-Farber/New
      England Deaconess Head and Neck Oncology Clinic, an experience with over 300
      patients receiving induction chemotherapy for advanced head and neck cancer has
      been analyzed with an emphasis on the postulate of lessening the extent of
      surgery in appropriately selected patients. In a comparison between trials
      initiated in 1980 and 1987, improved complete response rates from 26 to 57% were
      documented. Survival rates were identical, but the use of planned primary site
      ablative surgery was decreased from 47 to 14%. While some increase in local
      failure has been noted in patients treated by primary site radiation alone,
      surgical salvage appeared to be more effective. The implication of these trends
      for patterns of failure and surgical salvage and data concerning the need for
      neck dissection in this group of patients will be briefly summarized. Other
      trials addressing organ-preservation strategies will also be referenced and the
      dichotomy between survival-based studies and morbidity-limiting studies
      illustrated. Independent trends in radiation technique as a potential substitute
      for traditional surgical practice will be reviewed.

PMID- 8356383
TI  - Impact of combined modality therapy on the treatment of adenocarcinoma of the
      colon.
AB  - An emphasis on careful surgical staging of adenocarcinoma of the colon has
      improved the predictive value of tumor staging systems. As a result of improved
      staging and carefully conducted randomized clinical trials, adjuvant therapy of
      locally advanced colon cancer, based on 5-fluorouracil chemotherapy, has been
      proven to substantially reduce recurrence rates and significantly increase
      overall survival for selected patients. Improved treatments and schedules are
      currently being studied in randomized trials and may increase the efficacy of
      this adjuvant therapy. Radiation therapy has not as yet been integrated into the
      adjuvant treatment of colon carcinoma. The application of a combined approach of
      surgery and chemotherapy in selected patients with liver metastases may also
      improve cure rates and long-term survival. The developing understanding of
      molecular determinants for the biological behavior of these cancers will increase
      the opportunities to identify, on the one hand, those patients who will benefit
      from specific therapies, and, on the other hand, new therapeutic strategies and
      treatments.

PMID- 8356384
TI  - Conservative management of rectal carcinoma: the efficacy of a multimodality
      approach.
AB  - The goals of the conservative management of adenocarcinoma of the distal rectum
      are to preserve rectal sphincter function and achieve excellent local tumor
      control. Multimodality therapy for more advanced disease suggests that these
      goals will be met by conservative surgery combined with radiation therapy and
      chemotherapy. Over 100 patients with T0-3 N0-1 lesions have been treated in
      prospective single institution trials with either local excision or anterior
      resection with coloanal anastomosis, usually combined with chemotherapy and
      radiotherapy. The typical criteria for local excision have been for lesions to be
      4.0 cm or less, mobile, and not poorly differentiated or mucinous. Patients with
      larger or more advanced lesions may undergo anterior resection with coloanal
      anastomosis. Following resection, radiotherapy is delivered to the pelvis and
      tumor bed often with concomitant chemotherapy. The overall rate of local failure
      in the trials in which local excision is performed with postoperative
      chemoradiotherapy is 3% for T1 lesions, 5% for T2 lesions, and 30% for T3 lesions
      with a median follow-up of at least 25 months. Local failure in patients with a
      coloanal anastomosis is 9% overall. Salvage was successful in about half of the
      patients who failed locally. Importantly, nearly all patients remained continent.
      These institutional studies show that sphincter preservation can be used in
      patients who are objectively selected for this procedure. However, before this
      multimodality approach may be considered standard therapy the rate of local
      control must be confirmed in a large, Phase II, multicenter, prospective trial
      such as that now underway in many of the cooperative groups.

PMID- 8356385
TI  - Effect of combined modality therapy on the surgical management of locally
      advanced rectal carcinoma.
AB  - The treatment of locally advanced rectal carcinoma is one of the more complicated
      problems in the management of colorectal carcinoma. More than any other site
      successful treatment requires a multimodality approach as surgery alone is
      frequently insufficient to completely eradicate all disease. This review focuses
      primarily on the management of patients who present without prior treatment and
      discusses the role of preoperative radiation therapy as well as intraoperative
      radiation therapy. Although much less gratifying, patients who present after
      failing previous therapy may also benefit from an aggressive multimodality
      approach.

PMID- 8356386
TI  - Laparoscopy/thoracoscopy for staging: I. Staging endoscopy in surgical oncology.
AB  - The application of laparoscopy to the staging of solid abdominal tumors is
      reviewed. The current evidence support the use of laparoscopy particularly in
      hepatic tumors. There is evidence that the hospital length of stay for a patient
      with a nonresectable hepatic tumor can be reduced from 5.6 +/- 0.4 days with a
      laparotomy to 1.5 +/- 0.3 days with a laparoscopy. Where the palliative and
      bypass issues are not limiting, cases of pancreatic and gastric carcinoma also
      appear to benefit in having a staging laparoscopy before a formal laparotomy for
      resection. Current instrumentation does produce limits, but with future prospects
      of laparoscopic ultrasound, and tumor staining, staging laparoscopy will become
      an important diagnostic tool in surgical oncology.

PMID- 8356387
TI  - Laparoscopy/thoracoscopy for staging: II. Pretherapy nodal evaluation in
      carcinoma of the esophagus.
AB  - Many surgical studies show a significant stratification of survival following
      resection of esophageal cancer based upon accurate pathologic staging. However,
      investigators are moving away from single modality therapy toward multimodality
      trials for the treatment of this disease. This presents a problem in staging of
      patients before therapy is begun. Chemotherapy and/or radiation therapy may alter
      the local tumor characteristics and nodal metastases, thus confounding evaluation
      of treatment results. Although CT scanning and transesophageal ultrasound help in
      assessing nodal status, they have not reached the precision necessary for study
      purposes. Pretherapy nodal staging using video-assisted exploration may provide
      the same level of accuracy as mediastinoscopy does for lung cancer.

PMID- 8356388
TI  - Laparoscopic surgery for colon and rectal cancer.
AB  - Laparoscopic techniques are now being applied to increasing numbers of general
      surgical procedures. Technical feasibility, margins, number of lymph nodes, and
      recurrence rates need to be assessed with the application of this new technique
      to colon or rectal malignancies. Technically, the right colon, sigmoid, and
      proximal rectum appear to be the most amenable to laparoscopic assisted or
      complete laparoscopic resection. Early results from a registry of laparoscopic
      assisted colectomies shows that there is no significant difference in the number
      of lymph nodes in the lymphovascular bundle compared to conventional colon
      resections. Early retrospective reports indicate that there may be a significant
      decrease in post op length of stay. We conclude that the technique of
      laparoscopic assisted colectomy for colon or rectal cancer needs to follow the
      same oncologic principles as that of conventional surgery, and ultimately a trial
      will be needed to compare conventional and laparoscopic cancer resections of the
      large bowel.

PMID- 8356389
TI  - Relevance of quality of life assessment to the evaluation of combined-modality
      therapy.
AB  - Quality of life (QOL) assessment is a research tool which is incorporated into
      clinical trials to provide information about the ways in which the treatment
      affects the individuals sense of well-being and his physical, psychologic, and
      social functions. In the appropriate setting QOL assessment offers additional
      endpoints, beyond the traditional response rates and survival durations, to
      evaluate cancer treatments in ways which can be particularly meaningful to
      patients. Selected aspects of QOL methodology and the application of QOL
      assessment to the evaluation of combined-modality therapies for gastrointestinal
      cancers are discussed.

PMID- 8356390
TI  - Interleukin-6 in synovial fluid is closely associated with chronic synovitis in
      rheumatoid arthritis.
AB  - Interleukin-6 (IL-6) was detected at low levels in plasma [0.014 +/- 0.006 ng/ml
      (mean +/- SEM] and in high amounts in synovial fluid [SF; 2.6 +/- 2.2 ng/ml (mean
      +/- SEM)] of patients with rheumatoid arthritis. No correlation of IL-6 levels in
      plasma or SF with the ESR (n = 15) or with histological parameters of acute local
      synovitis (n = 10) was observed. In contrast, SF IL-6 was positively correlated
      with histological characteristics of chronic synovitis (n = 10; P < or = 0.01)
      and elevated plasma IgG concentrations (n = 15; P < or = 0.05). In vitro
      concentrations of IL-6 comparable to those detected in SF increased the
      production of both IgG and IgM by synovial membrane mononuclear cells. The
      present results contribute to the view that high local IL-6 concentrations in SF
      promote chronic synovitis in RA.

PMID- 8356391
TI  - Differential expression of gelatinase B (MMP-9) and stromelysin-1 (MMP-3) by
      rheumatoid synovial cells in vitro and in vivo.
AB  - Primary cultures of adherent rheumatoid synovial cells (ASC) are comprised of
      variable proportions of fibroblasts, macrophages and stellate cells (activated
      fibroblasts). These cultures were shown to produce the metalloproteinases
      stromelysin-1 (MMP-3), gelatinase A (MMP-2) and gelatinase B (MMP-9) by Western
      blotting and zymography techniques. Immunolocalisation studies showed that MMP-3
      was mainly produced by the fibroblastic cells whereas MMP-9 was restricted to
      macrophages (CD68 positive). Subcultured synovial fibroblasts, devoid of
      macrophages, did not produce MMP-9 as judged by zymography and
      immunolocalisation; but when stimulated with phorbol myristate acetate and
      interleukin-1 alpha both MMP-9 and MMP-3 were co-expressed. These 'activated'
      fibroblasts assumed a dendritic or stellate morphology, which in localisation
      studies was usually associated with enhanced enzyme production.
      Immunolocalisation studies of rheumatoid synovial tissue showed that relatively
      few cells were positive for MMP-3 and MMP-9. Localisation of MMP-9 corresponded
      to a proportion of macrophages positive for the CD68 marker throughout the
      synovial tissue. MMP-3 localisation was not associated with the macrophage
      marker, but was observed in both the synovial lining layer and deeper stromal
      locations. Widespread distribution of both enzymes was not observed in fresh
      tissues, but this increased in tissues subjected to short-term explant cultures.
      Thus, both in vitro and in vivo studies indicated that synovial fibroblasts or B
      cells are effective producers of MMP-3 whereas macrophages elaborate MMP-9,
      observations that demonstrated different metalloproteinase phenotypes under
      similar environmental conditions.

PMID- 8356392
TI  - Analysis of the HLA-DR gene frequencies in Japanese cases of juveniles rheumatoid
      arthritis and rheumatoid arthritis by oligonucleotide DNA typing.
AB  - HLA-DR gene frequencies in 59 Japanese children with juvenile rheumatoid
      arthritis (JRA) and 62 Japanese adults with rheumatoid arthritis (RA) were
      analyzed by oligonucleotide DNA typing. As in other studies, the frequency of
      DRB1*0405 in RA patients was significantly higher than in the Japanese controls.
      In a comparison of non-classified JRA patients with Japanese controls, no
      significant differences were observed in the frequency of DR types. However, when
      the JRA patients were classified into four clinical types, i.e., a rheumatoid
      factor-positive [RF(+)] polyarticular type, a rheumatoid factor-negative [RF(-)]
      polyarticular type, a pauciarticular type, and a systemic onset type, DRB1*0405
      was found to be significantly higher in the RF(+) polyarticular JRA patients than
      in the controls (P < 0.05). Thus, the RF(+) polyarticular type of JRA had the
      same HLA association as RA. This result is consistent with the fact that both
      RF(+) polyarticular JRA and RA cases have a similar clinical course.

PMID- 8356393
TI  - Toxicity of complement for chondrocytes. A possible source of cartilage
      degradation in inflammatory arthritis.
AB  - Cartilage from patients with rheumatoid arthritis and from animals with antigen
      induced arthritis is frequently contaminated with complement-containing immune
      complexes. A possible role for complement activation in cartilage degradation was
      modeled in vitro by exposing cultured bovine chondrocytes to homologous serum,
      and determining cytotoxicity by monitoring the release of intracellular 51Cr.
      Complement activation was found to be cytotoxic, having maximal effect at 20-30%
      serum by 18 h. Serum toxicity was ablated by heat (50 degrees C, 20 min) or
      methylamine treatment but not by EGTA, suggesting that in these experiments
      activation occurred by the alternate route. The implications of the results are
      discussed in relation to ultrastructural evidence for the involvement of
      complement in the pathogenesis of cartilage degradation in inflammatory
      arthritis.

PMID- 8356395
TI  - The T-cell antigen receptor enters its second decade.

PMID- 8356394
TI  - Detection of tumour necrosis factor alpha and interleukin-1 beta in the
      rheumatoid osteoarthritic cartilage-pannus junction by immunohistochemical
      methods.
AB  - During inflammation the rheumatoid synovial membrane is invaded by a number of
      different cell types. When activated most of these cells produce cytokines
      including tumor necrosis factor alpha (TNF alpha) and interleukin-1 beta (IL-1
      beta). These cytokines are believed to stimulate production of degradative
      enzymes and disturb the equilibrium between such enzymes and their inhibitors
      resulting in tissue damage. In this study we investigated the localisation of TNF
      alpha and IL-1 beta at the cartilage-pannus junction (CPJ). Here, cytokines are
      well placed to influence the integrity of articular cartilage. Tissue was derived
      from advanced rheumatoid (RA) and, as a comparison, osteoarthritic (OA) joints at
      the time of replacement surgery (arthroplasty). Antibody staining of fixed serial
      sections of tissue localised cells that were associated with IL-1 beta and TNF
      alpha. Cell markers for macrophages and endothelial cells were included to
      provide positive identification of the cytokine-associated cells. Analysis of
      these sections revealed that both TNF alpha and IL-1 beta were associated with
      macrophages, particularly those in the synovium overlying cartilage (pannus) and
      endothelial cells. Positive staining was seen at the CPJ in RA and in similarly
      located tissue in OA. The similar distribution of cytokines in OA was unexpected
      even if the overall numbers of tissue and infiltrating cells in the CPJ were
      different in the two diseases. This highlights the possible role played by
      endogenous inhibitors [1, 2] in influencing the degree of cytokine activity
      necessary to explain the different pathogenic mechanisms in RA and OA.

PMID- 8356396
TI  - A rapid method for selecting specific hybridoma clones using paramagnetic
      Dynabeads.
AB  - This paper describes how specific hybridoma clones can be rapidly selected using
      paramagnetic beads coated with the antigen used for immunization. Spleen cells
      from a mouse immunized with fragment D dimer (DD) from plasminolysed fibrin were
      first fused with X-63 mouse myeloma cells. Paramagnetic monodisperse beads
      (precoated with sheep anti-mouse antibodies) were then coated with S4, a
      monoclonal antibody to DD, and subsequently with DD. Mixing such beads with the
      fused cells allowed selective harvesting of cells with membrane-expressed anti-DD
      gammaglobulins using a magnetic particle concentrator. Within 24 h, the cells
      spontaneously detached from the beads and were plated out on 96-well plates.
      Supernatants from the clones obtained were tested by the ELISA technique.
      Antibodies specific for DD were produced by 40-79% of the tested clones. It is
      concluded that it is possible to use antigen-coated paramagnetic beads to select,
      prior to cloning, hybridomas that produce specific antibodies. Implementation of
      this technique has significantly reduced costs and time in our efforts to obtain
      hybridoma clones of interest.

PMID- 8356397
TI  - T-cell responsiveness to LCMV segregates as a single locus in crosses between
      BALB/cA and C.B-17 mice. Evidence for regulation by a gene outside the Igh
      region.
AB  - The course of systemic infection with lymphocytic choriomeningitis virus (LCMV)
      was studied in BALB/cA and C.B-17 mouse strains differing in the immunoglobulin
      heavy chain region (Igh). Susceptibility to intracerebral infection and the
      ability to clear the virus differed significantly between these presumably
      congenic strains, suggesting that a gene in the Igh region might influence the
      course of this infection. A difference in virus spread prior to appearance of the
      immune response could not explain the observed differences. On the other hand,
      the differences in course of infection correlated with a difference in virus
      specific T-cell responsiveness measured in terms of virus-specific cytotoxicity
      in vitro and delayed-type hypersensitivity in vivo. Analysis of F1, BC1 and F2
      progeny showed that differential T-cell responsiveness was influenced by a single
      gene or gene complex; however, no linkage was found between this locus and the
      Igh-C region. Taken together, these results indicate that an additional, and
      previously unknown, genetic difference exists between these two mouse strains,
      and that the involved locus carries a gene which significantly affects T-cell
      responsiveness to LCMV.

PMID- 8356398
TI  - Preferential damage to IgM production by ultraviolet B in the cells of patients
      with Bloom's syndrome.
AB  - In most patients with Bloom's syndrome (BS), selective IgM deficiency is commonly
      found. We examined proliferative responses by incorporation of [3H]-thymidine and
      the production of immunoglobulin after ultraviolet B (UVB) irradiation in the
      cells of two patients with BS. With regard to the proliferative responses in
      peripheral blood mononuclear cells (PBMC) cultured with pokeweed mitogen (PWM),
      the patients' PBMC were more sensitive to UVB irradiation than controls. Although
      the effect of UVB irradiation in lymphoblastoid cell lines (LCL) after 0 days of
      culture showed no difference between one patient and controls, the patient's LCL
      were more sensitive to UVB than the controls after 3 and 7 days of culture. These
      results suggest that the proliferative responses of the patient's LCL recovered
      later than those of controls. IgM production was the most sensitive to UVB in the
      patients' PBMC and LCL. IgG and IgA production in the patients' PBMC and LCL
      showed the same sensitivity as controls. From our results, it is suspected that
      the preferential damage to IgM production by UVB is connected with the selective
      IgM deficiency of BS.

PMID- 8356399
TI  - Effects of growth factors on cytokine production in serum-free cultures of human
      thymic epithelial cells.
AB  - Human thymic epithelial cells (TEC) of medullary phenotype were cultured for 14
      days in a growth factor-defined serum-free medium. The effects of added growth
      factors on cell numbers and the production of cytokines were investigated by
      separate exclusion of the various growth factors from the medium. We found that
      hydrocortisone stimulated cell proliferation but inhibited the differentiation of
      TEC and significantly reduced the production of interleukin-1 alpha, interleukin
      6 and granulocyte-macrophage colony stimulating factor. Insulin was found to
      enhance the differentiation of TEC and the production of the three cytokines.
      Transferrin and choleratoxin were found to inhibit cell proliferation, but they
      did not affect production of the cytokines. Exclusion of epidermal growth factor,
      however, leads to cell death. We conclude that it is essential to exclude
      hydrocortisone from the medium to optimize production of cytokines, and that
      transferrin and choleratoxin seem to be unnecessary constituents in serum-free
      cultures of human TEC.

PMID- 8356400
TI  - Specific activation of human peripheral blood gamma/delta + lymphocytes by
      sonicated antigens of Mycobacterium tuberculosis: role in vitro in killing human
      bladder carcinoma cell lines.
AB  - Tumour regression induced in cancer patients by local instillation of Bacillus
      Calmette-Guerin (BCG) into the bladder has been considered to be mainly mediated
      by activated cellular immunity and inflammatory reactions. In the present study
      we investigated the cytotoxicity of T cells bearing gamma/delta T-cell receptors
      (gamma/delta + cells) against bladder carcinoma cells in vitro. Long-term
      cultured gamma/delta + T-cell lines from peripheral blood lymphocytes of healthy
      donors were established by stimulation with sonicated cell wall-associated
      antigens of Mycobacterium tuberculosis (SMA). These gamma/delta + T cells lack
      the natural killer (NK) markers CD16 and CD56, as determined by flow cytometry.
      The SMA-specific gamma/delta + T cells exhibited profound cytotoxicity against
      two NK-resistant bladder tumour cell lines as well as against NK-sensitive tumour
      cells in a non-major histocompatibility complex-restricted manner. The pattern of
      tumour cells killed by gamma/delta + T cells differed significantly from those of
      NK cells and lymphokine-activated killer LAK cells. Furthermore, we tested the
      effects of recombinant human cytokines, including interleukin (IL)-1, IL-2, IL-4,
      IL-6, interferon (IFN)-gamma and tumour necrosis factor (TNF), on gamma/delta + T
      cell-mediated cytotoxicity. It was shown that the addition of recombinant TNF in
      co-incubation could augment gamma/delta + T-cell-mediated killing of two bladder
      tumour cell lines, but not of cells of the erythroleukaemia cell line K562. Based
      on these results it was concluded that mycobacterial antigens could specifically
      activate resting gamma/delta + T cells. The cytotoxicity of gamma/delta + T cells
      against bladder tumour cells and its selective enhancement by TNF may be an
      important mechanism involved in bladder tumour regression induced by intravesical
      instillation of BCG.

PMID- 8356401
TI  - Phenotypic and molecular characterization of human monoclonal TCR gamma/delta T
      cell lines from jejunum and colon of healthy individuals.
AB  - We have performed a phenotypic and molecular analysis of monoclonal TCR
      gamma/delta T-cell lines derived from jejunal and colonic biopsies of healthy
      individuals. Flow cytometric analysis employing a panel of 24 monoclonal
      antibodies (MoAbs) demonstrated that intestinal TCR gamma/delta intraepithelial
      lymphocytes (IEL) constitute a phenotypically heterogeneous population.
      Nucleotide sequence analysis of expressed TCR delta variable (V) regions revealed
      the dominant utilization of the V delta 2 and D delta 3 gene segments and
      frequent rearrangement of J delta 3. IEL V delta regions displayed extensive
      junctional diversity as a result of N and P insertion and the utilization of D
      delta 3 in all three reading frames. The results demonstrate that intestinal TCR
      gamma/delta T cells from healthy individuals constitute a phenotypically
      heterogeneous population expressing V delta regions that differ from their
      systemic counterparts.

PMID- 8356402
TI  - Expression of human IL-2 receptor alpha- and beta-chains using the baculovirus
      expression system.
AB  - The genes encoding the alpha- and beta-chains of the human interleukin-2 receptor
      were expressed in lepidopteran insect cells using the baculovirus expression
      vector system. The corresponding genes were inserted under the polyhedrin
      promoter of the Autographa california nuclear polyhedrosis virus and expressed in
      the Spodoptera frugiperda insect cell line during viral infection. The
      recombinant receptor proteins were identified in the insect cell lysates by using
      protein dot blot and ELISA techniques. At 36 h post infection the corresponding
      proteins were clearly detected using anti-IL-2 alpha- and beta-receptor-specific
      antibodies. A large amount of the alpha-chain was also found in the supernatant
      culture media at 72 h post infection and metabolic labelling with [35S]
      methionine indicated that it was proteolytically cleaved into a 32 kDa soluble
      form. A similar soluble or secreted form of the beta-chain was, however, not
      observed. Both receptor proteins were expressed on the surface of the insect
      cells as determined by flow cytometry analysis. Studies performed with the
      different IL-2 receptor forms (alpha- and beta-chains alone or in combination) in
      the presence or absence of rIL-2 suggest that the receptor proteins when
      expressed in infected insect cells are non-functional with respect to tyrosine
      phosphorylation.

PMID- 8356403
TI  - Leucocyte endothelial cell adhesion: a study comparing human umbilical vein
      endothelial cells and the endothelial cell line EA-hy-926.
AB  - EA-hy-926 is a cell line produced by hybridizing human umbilical vein endothelial
      cells (HUVEC) and the epithelial cell line A549. To establish whether EA-hy-926
      could be used as a model for endothelial cells (EC) in leucocyte-EC adhesion
      interactions, the effect of interleukin-4 (IL-4), tumour necrosis factor (TNF) or
      interferon-gamma (IFN) stimulation on their adhesiveness and expression of E
      selectin, vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion
      molecule-1 (ICAM-1) was compared with that of HUVEC and A549. Although HUVEC
      exhibited increased adhesiveness and adhesion molecule expression with IL-4, TNF
      or IFN, EA-hy-926 exhibited these responses only with TNF. CD11/CD18-dependent
      binding accounted for a significant component of basal binding to HUVEC and EA-hy
      926, but did not account for the increased binding of T cells, JY, J6, ICH-BJ or
      ICH-KM cell lines to TNF-stimulated monolayers. At least part of the CD11/CD18
      independent adhesion was attributable to VCAM-1 induction on HUVEC and EA-hy-926.
      TNF-stimulation also induced E-selectin expression on EA-hy-926 and HUVEC and an
      accompanying increase in neutrophil (PMN) binding. The EA-hy-926 cells used in
      this study, therefore, showed responses similar to HUVEC when stimulated with TNF
      but not when stimulated with IL-4 or IFN.

PMID- 8356404
TI  - Up-regulation by cyclosporine (CsA) of the in vitro release of soluble CD23
      (sCD23) and of the in vitro production of IL-6 and IgM.
AB  - In the present study, we examined the effect of CsA on the in vitro production of
      Ig and on the in vitro production of molecules known to have B-cell growth and
      differentiation activities, such as IL-6 and sCD23. For the purpose of this
      study, we developed an experimental in vitro system closely resembling an in vivo
      model of ongoing B-cell activation. Pre-activated B cells proliferated and
      produced IgM optimally when they were re-cultured in the presence of IL-2/IL-6.
      CsA down-regulated the IL-2/IL-6-induced proliferative responses of pre-activated
      B cells by at least 50%, but it up-regulated IgM production in the same
      experiments. This up-regulating effect was not cytokine-related since it was also
      seen when cells were re-cultured in the absence of any cytokines. Optimal release
      of sCD23 was observed when SAC-pre-activated B cells were re-cultured in the
      presence of IL-4 or IL-4 plus IL-2 and CsA up-regulated significantly the release
      of this molecule in these cultures. Finally, CsA was shown to inhibit PHA-induced
      cell proliferation of PBMC and to up-regulate IL-6 production in the same
      cultures. We conclude that CsA can amplify in vitro both the production of Ig and
      the release of sCD23 by pre-activated B cells. This finding, in combination with
      the CsA-induced up-regulation of lectin-induced IL-6 production, may have
      clinical implications in disease states with an ongoing immune activation, where
      prolonged administration of CsA might be anticipated.

PMID- 8356405
TI  - Immunogenicity of HILDA/LIF either in a soluble or in a membrane anchored form
      expressed in vivo by recombinant vaccinia viruses.
AB  - Insertion of various cDNAs in the genome of the vaccinia virus (VV) enables the
      in vivo and in vitro study of the functional role and/or the immunogenicity of
      the virally encoded recombinant proteins. We have prepared a recombinant VV
      expressing the cDNA of the human cytokine HILDA/LIF (human interleukin for DA
      cells/leukaemia inhibitory factor), and used this virus to immunize mice against
      this protein, which is very homologous to its murine counterpart (approximately
      80% homology). We also constructed and expressed by the same system a chimeric
      gene encoding the HILDA/LIF protein fused to the 37 COOH-terminal amino-acids of
      the human decay accelerating factor (DAF). This sequence proved to be sufficient
      for the targeting of the fusion protein to the cell membrane, where it is linked
      to the phosphatidylinositols. Both recombinant VVs induced cytokine-specific
      antibodies in mice as analysed with an ELISA where the recombinant HILDA/LIF was
      plastic-coated and a cytofluorometric assay where the LIF-DAF molecule was
      present at the cell surface of stably transfected P815. In the latter case
      HILDA/LIF remained biologically active suggesting that it was expressed in its
      native form. The LIF-DAF fusion protein was found to exhibit a better capacity to
      elicit an antibody response against the native form of the cytokine as detected
      in cytofluorometric assays. Whatever the recombinant virus used to immunize the
      mice, the MoAbs obtained were positive either in the ELISA or in the
      cytofluorometric assays but one, which suggested that the plastic coating induced
      a conformational change of HILDA/LIF.

PMID- 8356406
TI  - Occurrence of autoimmune diseases and relationship of autoantibody expression
      with HLA phenotypes in multicase rheumatoid arthritis families.
AB  - Presence of autoimmune diseases and relationship of autoantibody expression with
      HLA association has been studied in 44 multicase rheumatoid arthritis (RA)
      families of Asian Indian origin. An increased prevalence of systemic lupus
      erythematosus (SLE) was observed in relatives (2.3%). Although HLA-DR4 segregated
      preferentially with seropositivity in general, no difference was observed among
      seropositive versus seronegative RA. On the other hand, no HLA association was
      observed with ANF positivity in these families. An increased frequency of DR7 in
      the ANF negative and RF negative group of RA patients compared to positive groups
      suggests that it may act as protective element for the development of
      autoantibodies in RA. An increased occurrence of DR4 in relatives affected with
      SLE was observed. While RA segregated mostly with HLA-DR4 in these families,
      autoimmune thyroid disease and insulin dependent diabetes mellitus (IDDM)
      segregated with HLA-DR3 suggesting the involvement of at least two sets of HLA
      linked autoimmunity favouring susceptibility genes in the Indian population.

PMID- 8356407
TI  - Amyloidosis--incidence and early risk factors in patients with rheumatoid
      arthritis.
AB  - In a 15-year follow-up examination, reactive secondary amyloidosis (RSA) was
      found by subcutaneous fat biopsy in six out of 74 still living patients (8.1%) of
      an original population of 102 with erosive and seropositive rheumatoid arthritis
      (RA). Five of the 24 deceased patients had had RSA. Thus the 15-year incidence of
      RSA in RA was at least 10.9% (11/102). To study early prognostic aspects of RSA,
      comparison was made of 14 entry variables and the initial treatment in the RSA
      group (n = 11) and the control group (n = 81) respectively. At onset (< or = 6
      months) of RA only serum orosomucoid, but after three years morning stiffness,
      ESR, serum CRP and orosomucoid were significantly worse in patients whom later
      developed RSA. Three out of 48 patients treated with gold sodium thiomalate and
      seven out of 30 treated with chloroquine developed RSA (p = 0.04). It is
      concluded that continuously active disease was the risk factor underlying RSA.
      The role of early chloroquine therapy is discussed.

PMID- 8356408
TI  - Polyclonal IgG anti-dsDNA antibodies exert cytotoxic effect on cultured rat
      mesangial cells by binding to cell membrane and augmenting apoptosis.
AB  - IgG anti-double stranded DNA antibodies (anti-dsDNA) purified from serum of
      patients with active systemic lupus erythematosus (SLE), have been found to be
      cytotoxic to the cultured rat mesangial cells (MC). In the present study, by use
      of immunofluorescent staining, immunoblotting, radioimmunoprecipitation, and cell
      cycle analysis, we showed that IgG anti-dsDNA could bind to the membrane of MC.
      The bound epitope was a 28 kDa protein, which would disappear if the cells were
      treated in advance with proteinase K (100 micrograms/ml). In addition, binding of
      MC by 20 micrograms/ml of anti-dsDNA IgG F(ab')2 activated plasma membrane
      (equivalent to 80 IU/ml of calf thymus double-stranded DNA binding activity)
      resulted in release of much more 3H-arachidonic acid than binding by 20
      micrograms/ml of human IgG F(ab')2 (26.71 +/- 3.75% in the case of anti-dsDNA vs.
      4.73 +/- 2.86% in the case of IgG). To understand further the cytotoxic mechanism
      of anti-dsDNA, we incubated MC with anti-dsDNA, for a variety of periods (from 10
      minutes to 24 hours). After incubation, the cells were fixed and stained with
      hematoxylin-eosin for morphologic observation. Simultaneously, the genomic DNA
      was extracted and analyzed in 1.8% agarose gel electrophoresis. We found that
      cell death caused anti-dsDNA followed a process of apoptosis rather than
      necrosis. These results suggest that binding of anti-dsDNA with MC membrane may
      activate endonuclease which will fracture the DNA and lead to programmed cell
      death.

PMID- 8356409
TI  - Low serum vitamin D metabolites in women with rheumatoid arthritis.
AB  - The etiology of osteoporosis associated with rheumatoid arthritis (RA) is
      unknown. We studied the calcium and vitamin D metabolism in 143 women with RA
      (mean age 50.7 years). Albumin corrected serum calcium was normal. Serum alkaline
      phosphatase was increased in 29 percent of cases. Serum vitamin D levels were
      frequently very low. In 16 percent of the RA patients serum 25(OH)D concentration
      was below 12.5 nmol/L, which is arbitrarily considered as the limit of vitamin D
      deficiency osteomalacia. In the winter season 73 percent of the patients had
      serum 1,25(OH)2D levels below the seasonally adjusted normal range. The lowest
      values were found in patients with high disease activity. We suggest that there
      is a disturbance in vitamin D metabolism in RA. This might play a role in
      osteoporosis associated with RA.

PMID- 8356410
TI  - The recognition of rheumatoid arthritis in the eighteenth century. The
      contribution of Linne and Boissier de la Croix de Sauvages.
AB  - Linne and Boissier de la Croix de Sauvages, two botanists and physicians of the
      mideighteenth century, proposed systems for the classification of diseases. Their
      medical works have been examined for passages suggestive of rheumatoid arthritis
      (RA). References to gouty arthritis dominated in Linne's works. Sauvages
      described chronic joint diseases with affection of small and large joints which
      might have been RA. William Musgrave described similar cases in 1703. In a single
      passage in Linne's works such cases are also described. The conclusion is that RA
      probably has existed throughout the eighteenth century, and that its supposed
      emergence around the year 1800 is not well-founded.

PMID- 8356411
TI  - Total and free plasma and total synovial fluid piroxicam concentrations:
      relationship to antiinflammatory effect in patients with reactive arthritis and
      other arthritides.
AB  - Twenty-five patients (14 males, 11 females), sixteen with reactive arthritis and
      9 with other arthritides were treated with piroxicam, 40 mg at day 1 and 20 mg
      daily the following 9 days. Both local knee joint and general disease activity
      were assessed at day 0 and day 10. At day 10, plasma and synovial fluid were
      drawn. Total and free (determined after equilibrium dialysis) plasma
      concentrations and total synovial fluid concentrations were measured by HPLC.
      Total plasma piroxicam concentrations (micrograms/ml) were 4.1 (0.5-8.3) [median
      (range)], free piroxicam plasma concentrations were 0.051 (0.012-0.118), total
      synovial fluid concentrations were 2.2 (0.3-4.6) and ratios total synovial to
      total plasma concentration were 0.51 (0.39-0.90). The effect of piroxicam
      treatment varied among the patients. We found no relationship between drug
      concentration and change in any of the disease activity parameters nor any
      correlation between the ratio of synovial fluid to plasma piroxicam concentration
      and the local knee joint disease activity parameters.

PMID- 8356412
TI  - Successful treatment of the anemia of rheumatoid arthritis with subcutaneously
      administered recombinant human erythropoietin. Slower response in patients with
      more severe inflammation.
AB  - We performed a 24-week open clinical study in which 12 patients with rheumatoid
      arthritis (RA) and anemia (mean hemoglobin (Hb) value 102 g/l, range 90-109 g/l)
      were treated with recombinant human erythropoietin (rHuEPO). rHuEPO was given as
      a subcutaneous injection twice weekly with an initial dose of 300 U/kg/week. Nine
      of the 11 patients who completed the study responded with an increase in Hb value
      of 15 g/l or more within 3 to 17 weeks. Three months after treatment the Hb
      levels were significantly lower than the highest Hb levels (p < 0.0001). There
      was an inverse correlation between the response rate and the mean serum
      concentrations of C-reactive protein and serum amyloid A protein (p < 0.001 and p
      < 0.003, respectively). We conclude that rHuEPO can correct anemia in patients
      with RA, but the response seems to be adversely influenced by the inflammatory
      activity of the disease.

PMID- 8356413
TI  - Rifamycin SV versus triamcinolone in local treatment of rheumatoid synovitis.
AB  - This study was aimed to evaluate the usefulness of rifamycin SV as an agent for
      local treatment of rheumatoid synovitis. Rifamycin SV was compared with
      triamcinolone acetonide in a randomized controlled trial on 87 patients with
      rheumatoid arthritis and with persistent knee synovitis. The treatment with
      rifamycin consisted of several weekly intra-articular injections, whereas
      triamcinolone was given as a single intra-articular injection. At the end of the
      therapy, 27 (61.4%) of the 44 rifamycin patients and 39 (91%) of the 43 steroid
      patients responded well to the treatment, and this difference was significant (p
      < 0.01). Rifamycin SV was responsible for unpleasant local side effects in all
      cases. In both groups, after 1 year of follow-up the synovitis had relapsed in
      about 42% of cases. We conclude that rifamycin SV is less useful than
      triamcinolone acetonide in the local treatment of rheumatoid synovitis.

PMID- 8356414
TI  - Verrucous endocarditis and sicca syndrome.

PMID- 8356415
TI  - Use of unconventional remedies for arthritis in Brazil.

PMID- 8356416
TI  - Lack of effect of recombinant alpha interferon in the treatment of rheumatoid
      arthritis.

PMID- 8356417
TI  - [3 reports of success].

PMID- 8356418
TI  - [Dental caries (DMFT) in adults in Switzerland 1988].
AB  - In 1988, 864 adults were examined for dental and periodontal conditions in 47
      dental offices in Switzerland according to WHO methods. Among the 57 offices
      selected at random 10 dentists were unwilling to cooperate. Within each office,
      36 patients were chosen by a randomizing mechanism. 51 percent of the selected
      patients presented themselves for the examination whereas 14 percent refused to
      participate in the study; of the remaining subjects one third could not be
      reached during the three to five days available for contacting them and two
      thirds were unable to come to the respective dental office at the preset day of
      examination. The DMF data obtained were similar to the results of previous local
      surveys, part of which were based on random samples. Up to age 74, it was
      concluded that the data of the present survey are fairly representative of the
      Swiss resident population. In the age group 75 and above, the number of missing
      teeth (MT) was too low, mainly due to edentulous persons, institutionalized and
      other, being obviously underrepresented. The Swiss DMFT of 22.3 in the age group
      35-44 was almost the highest mean among 26 European countries. However,
      prevention efforts at school age, already obvious in the age group 30-34, will
      substantially improve the results at age 35-44 by the year 1998. The number of DT
      was 1.0 and 1.3 for the ages up to 29 and below 1.0 in the older groups. Up to
      age 54, FT was the most important component of the DMFT while in the older
      groups, MT was highest.

PMID- 8356419
TI  - Microstructure and strength analysis of ultrasonically shaped ceramics.
AB  - In this study, the influence of a new ultrasonic shaping procedure on the surface
      quality, microstructure, bending strength and fatigue behaviour of a feldspathic
      porcelain was investigated. A total of 120 standardized (ISO 6872) autoglazed,
      ground, lapped and ultrasonically machined porcelain test bars were analyzed.
      Another 24 equiformat experimental alumina ceramics, which were ultrasonically
      machined, as well as 24 nontreated fload glass specimen served as controls. It
      could be shown that the porcelain removal process with diamond grinding wheels
      yielded a rough surface microrelief and lead to structural subsurface damage,
      decreasing bending strength and fatigue behaviour. In contrast, ultrasonic
      shaping resulted in a smoother surface and prevented damage to the subsurface
      layer of the machined brittle porcelain, although, the smoothest surfaces were
      achieved by lapping. Both bending strength and fatigue behaviour of the
      conventional dental porcelain were increased by ultrasonic machining. However,
      the fracture toughness of the experimental alumina was substantially higher and
      was not subjected to a decrease in fatigue.

PMID- 8356420
TI  - [Efficiency and margin quality in the computer-assisted molding and grinding of
      ceramic inlays].
AB  - The life of diamond-coated discs during CAD/CAM machining of ceramic inlays was
      evaluated using the standard hydro-drive (H) and an electric drive (E) as a part
      of the Cerec 3rd generation unit. E-drive discs (40 mm diameter, 0.5 mm
      thickness) with four experimental diamond coatings, i.e. different grain sizes,
      E126 (106-125 microns), E64 (53-63 microns), E46-3 (38-45 microns; triple
      coating), E46-1 (38-45 microns; single coating) were used. The standard H-drive
      disc (30 mm diameter, 0.3 mm thickness) and H126 (106-125 microns) coating were
      used as a control. The same standard mesio-occluso-distal molar inlay was
      machined from blocks (size 1-8) of Dicor MGC light glass-ceramic and of Vita MkII
      feldspathic fine porcelain as many times as possible with one disc in each group
      and the number of machined inlays per disc was counted. Additionally the edge
      roughness (Ra) of the machined inlays was measured using a Talysurf 50
      instrument. The numbers of inlays machined with H126 were 21 porcelain/12 glass
      ceramic inlays. The numbers of inlays machined from porcelain/glass-ceramic with
      the E-drive test discs were E126: 180/68; E64: 93/29; E46-3: 80/21 and E46-1
      (current limited to 2.5 ampere): 44/19 inlays. The edge roughness of
      porcelain/glass-ceramic inlays machined with the E-drive discs was significantly
      lower than the roughness of inlays machined using the H-drive. E126: 16% (p <
      0.05)/43% (p < 0.001); E64: 49%/66%; E46-1: 62%/73%; E46-3: 83%/87% (all
      differences p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8356421
TI  - [Food-induced granuloma of oral tissues].

PMID- 8356422
TI  - [Impression and registration methods for difficult complete-denture cases].

PMID- 8356423
TI  - [Dental filling materials/amalgam. The joint statement of the university dental
      institutes of Switzerland and of the Swiss Dental Society].

PMID- 8356424
TI  - Is a healthy diet always healthy?

PMID- 8356425
TI  - Percutaneous endoscopic gastrostomy (PEG): a major advance in enteral feeding.

PMID- 8356427
TI  - Dental disease, fibrinogen and white cell count; links with myocardial
      infarction?
AB  - Plasma fibrinogen and white blood cell count were compared in fifty patients aged
      25-50 years with periodontal disease and in fifty age-matched controls with
      relatively healthy periodontal tissues. Patients had significantly higher levels
      of fibrinogen and white cell count, and dental indices correlated significantly
      with these two cardiovascular risk factors on multivariate analyses. We suggest
      that inflammatory dental disease may be a determinant of fibrinogen level and
      white cell count in the general population, and that fibrinogen and white cell
      count may be two mediators of the link between dental disease and myocardial
      infarction.

PMID- 8356426
TI  - Minimal change nephropathy in the west of Scotland: a review of sixty-four
      patients.
AB  - Sixty-four patients with a histological diagnosis of minimal change nephropathy
      have been followed for a median of 110 months. Patients transferred from
      paediatric units (11%) had a worse prognosis in that all became frequent
      relapsers. Patients who relapsed within three months or who went on to become
      frequent relapsers had a higher 24 hour urine protein excretion at presentation
      than patients who did not relapse. After fifteen months of remission relapse was
      rare; 97% of those who relapsed did so within 36 months. Patients who have been
      off steroids and proteinuria free for 36 months might therefore be considered
      cured.

PMID- 8356428
TI  - An audit of the activities of the paediatric oncology unit in Edinburgh, 1982
      1991.
AB  - The activities of the paediatric oncology unit at the Royal Hospital for Sick
      Children, Edinburgh during 1982-1991 were audited. There were 254 new patients of
      whom 240 had a malignancy, seven had Langerhans cell histiocytosis and seven had
      non malignant tumours. Of the 254,131 (52%), 78 (31%), 14 (65), were normally
      resident within the Lothian, Fife and Borders regions respectively. Therefore,
      although the unit is a part of the Lothian Health Board, it is in practice, the
      referral centre for S.E. Scotland. A majority (92%) of patients were treated
      according to national or international protocols during the last five years and
      of the 240 children diagnosed to have cancer, 158 (66%) are at present in
      clinical remission. These figures compare favourably with national averages for
      protocol compliance and survival. During these ten years, an additional 69
      children with cancer from S.E. Scotland were treated at other centres. Therefore,
      while the unit justifies its existence it has yet to realise its full potential.

PMID- 8356429
TI  - When should patients with bacterial meningitis be referred to a neurosurgical
      unit?
AB  - The case records of 97 patients with proven bacterial meningitis who were
      referred to a regional neurosurgical unit between 1964 and 1991 were reviewed.
      Mortality declined from 34% in the first cohort referred between the years 1964
      82 to 5% for 1983-91 (X2 = 11.78; p < 0.001). Fewer patients were admitted in
      coma, (X2 = 4.43; p < 0.05), or with focal neurological signs (X2 = 7.57; p <
      0.01) in the second cohort. The rate of referral increased in the later period
      but the incidence of unsuspected brain abscess (16% and 15%) did not change.
      There was a strong correlation between coma on admission and death, (X2 = 17.3; p
      < 0.001) and with brain abscess and death (X2 = 6.73; p < 0.01). In conclusion
      patients with known or suspected bacterial meningitis coupled with a decreasing
      level of consciousness or focal neurological signs should be referred to a
      neurosurgical centre.

PMID- 8356430
TI  - Defibrillation by general practitioners: an audit of resuscitation in a Scottish
      rural practice.
AB  - The objective was to review the outcome of resuscitation attempts in a small
      remote two-partner practice of 2700 patients in Galloway, South West Scotland
      during the period 1985-1992. During the study period 15 attempts were made to
      resuscitate the victims of cardiac arrest. Two sub-groups were identified. In the
      first, nine out of ten patients whose arrest occurred in the presence of a doctor
      were successfully resuscitated and all proved to be long term survivors. In the
      second group of five patients whose arrest took place before the arrival of the
      doctor there were no survivors. We conclude that defibrillation by general
      practitioners has a valuable contribution to make in reducing the mortality from
      myocardial infarction in rural practice.

PMID- 8356431
TI  - Pasteurella multocida abscess complicating a femoral vein thrombosis.

PMID- 8356432
TI  - A patient with neurosyphilis presenting as chorea.
AB  - Despite the marked decline in frequency of neurosyphilis over the past three
      decades in the United Kingdom, new cases continue to appear both sporadically and
      as a complication of HIV infection. There is clinical evidence that neurosyphilis
      is becoming less typical. We describe a case of neurosyphilis presenting
      predominantly with choreoathetosis and associated hemiparesis in an otherwise
      healthy, immunocompetent patient. Only six cases of neurosyphilis presenting with
      features of basal ganglia damage have been reported in the recent literature,
      five of whom had HIV infection.

PMID- 8356433
TI  - Reflections on Dr Henderson of Perth's case of impracticable labour: an early
      case (1820) in which the caesarean operation was performed.
AB  - The rediscovery of a female pelvis with features characteristic of osteomalacia
      stimulated an enquiry into the clinical history of the woman involved. It was
      established that she died in 1820, aged 30. Despite being severely debilitated
      and confined to bed for some years with increasing skeletal deformities, she
      became pregnant, and in due course laboured unsuccessfully for about 102 hours.
      An elective caesarean section was performed, but she died some hours later,
      though her daughter survived and was appropriately christened Caesar Anna. This
      represents one of the earliest cases in which the caesarean operation was
      performed where the full obstetric history was carefully recorded by the
      obstetrician involved, Dr. Henderson of Perth. The case was clearly considered
      important, and in 1836 engravings of this pelvis were used to illustrate
      Professor Hamilton's "Practical Observations of Various Subjects Related to
      Midwifery". Such cases are now of great rarity in the developed world.

PMID- 8356434
TI  - Recent developments in secondary prevention of stroke.

PMID- 8356435
TI  - Models of health care for stroke.

PMID- 8356436
TI  - Management of change in the NHS.

PMID- 8356437
TI  - Cost of stroke.

PMID- 8356439
TI  - Developments in acute stroke care.

PMID- 8356438
TI  - Recent developments in primary prevention of stroke.

PMID- 8356440
TI  - Three good choices.

PMID- 8356441
TI  - "Critical fat".

PMID- 8356442
TI  - The true cost of a free AIDS vaccine.

PMID- 8356443
TI  - Misconduct: views from the trenches.

PMID- 8356444
TI  - Innovative techniques on display at Boston meeting.

PMID- 8356445
TI  - Putting antibodies to work inside cells.

PMID- 8356446
TI  - Frog venom cocktail yields a one-handed painkiller.

PMID- 8356447
TI  - Is NIH's crown jewel losing luster?

PMID- 8356448
TI  - Life history variables preserved in dental cementum microstructure.
AB  - The age and season of death of mammals, as well as other aspects of their life
      history, can be estimated from seasonal bands in dental cementum that result from
      variations in microstructure. Scanning electron micrographs of goats fed
      controlled diets demonstrate that cementum bands preserve variations in the
      relative orientation of collagen fibers that reflect changes in the magnitude and
      frequency of occlusal forces from chewing different quality diets. Changes in the
      rate of tissue growth are also reflected in cementum bands as variations in the
      degree of mineralization.

PMID- 8356449
TI  - Deletion of the paired alpha 5(IV) and alpha 6(IV) collagen genes in inherited
      smooth muscle tumors.
AB  - The gene encoding alpha 6(IV) collagen, COL4A6, was identified on the human X
      chromosome in a head-to-head arrangement and within 452 base pairs of the alpha
      5(IV) collagen gene, COL4A5. In earlier studies, intragenic deletions of COL4A5
      were detected in a subset of patients with Alport syndrome (AS), a hereditary
      defect of basement membranes. In some families, AS cosegregates with diffuse
      leiomyomatosis (DL), a benign smooth muscle tumor diathesis. Here it is shown
      that patients with AS-DL harbor deletions that disrupt both COL4A5 and COL4A6.
      Thus, type IV collagen may regulate smooth muscle differentiation and
      morphogenesis.

PMID- 8356450
TI  - Identification of a structural glycoprotein of an RNA virus as a ribonuclease.
AB  - One of the three structural glycoproteins of classical swine fever virus (CSFV)
      is E0, a disulfide-bonded homodimer that induces virus-neutralizing antibodies
      and occurs in a virion-bound as well as a secreted form. E0 was shown to be
      similar to a family of fungal and plant ribonucleases. Purified E0 from CSFV
      infected cells was a potent ribonuclease specific for uridine and inhibitable by
      zinc ions.

PMID- 8356451
TI  - Lack of N regions in antigen receptor variable region genes of TdT-deficient
      lymphocytes.
AB  - During the assembly of immunoglobulin and T cell receptor variable region genes
      from variable (V), diversity (D), and joining (J) segments, the germline-encoded
      repertoire is further diversified by processes that include the template
      independent addition of nucleotides (N regions) at gene segment junctions.
      Terminal deoxynucleotidyl transferase (TdT)-deficient lymphocytes had no N
      regions in their variable region genes, which shows that TdT is responsible for N
      region addition. In addition, certain variable region genes appeared at increased
      frequency in TdT-deficient thymocytes, which indicates that N region addition
      also influences repertoire development by alleviating sequence-specific
      constraints imposed on the joining of particular V, D, and J segments.

PMID- 8356452
TI  - Mice lacking TdT: mature animals with an immature lymphocyte repertoire.
AB  - In adult animals, template-independent (or N) nucleotides are frequently added
      during the rearrangement of variable (V), diversity (D), and joining (J) segments
      of lymphocyte receptor genes, greatly enhancing junctional diversity. Receptor
      genes from adult mice carrying a mutation in the terminal deoxynucleotidyl
      transferase (TdT) gene have few N nucleotides, providing proof that this enzyme
      is essential for creating diversity. Unlike those from normal adults, receptor
      genes from adult mutant mice show extensive evidence of homology-directed
      recombination, suggesting that TdT blocks this process. Thus, switch-on of the
      TdT gene during the first week after birth provokes an even greater expansion of
      lymphocyte receptor diversity than had previously been thought.

PMID- 8356454
TI  - Fibrinogen: its role in the hemostatic regulation in atherosclerosis.
AB  - Numerous epidemiologic studies have clearly shown that high plasma fibrinogen
      levels are strongly correlated with the frequency of myocardial infarction,
      stroke, and peripheral atherosclerosis. These data indicate that measurements of
      fibrinogen should be included in cardiovascular risk factor profiles. Since
      thrombosis is recognized as the central mechanism of these atherosclerotic
      complications, it seems advisable to accept the predictive value of this protein.
      Fibrinogen is involved in platelet aggregation, blood rheology, and endothelial
      cell injury, which are thought to play a key role in thrombogenesis. Fibrinogen
      may predict bypass occlusion but appears to have no significant influence on
      restenosis following successful coronary angioplasty. Furthermore, fibrinogen
      represents an acute-phase protein, being of no specificity. Its level varies
      genetically, as well as circadian and seasonal variations, and is influenced by a
      number of circumstances and drugs. Plasma levels of fibrinogen decrease by life
      style changes, smoking cessation, and different medications such as fibrates, but
      the risk-lowering effect is not proven yet.

PMID- 8356453
TI  - Genotypic and phenotypic characterization of HIV-1 patients with primary
      infection.
AB  - Better characterization of human immunodeficiency virus-type 1 (HIV-1) in
      patients with primary infection has important implications for the development of
      an acquired immunodeficiency syndrome (AIDS) vaccine because vaccine strategies
      should target viral isolates with the properties of transmitted viruses. In five
      HIV-1 seroconverters, the viral phenotype was found to be uniformly macrophage
      tropic and non-syncytium-inducing. Furthermore, the viruses were genotypically
      homogeneous within each patient, but a common signature sequence was not
      discernible among transmitted viruses. In the two cases where the sexual partners
      were also studied, the sequences of the transmitted viruses matched best with
      minor variants in the blood of the transmitters. There was also a stronger
      pressure to conserve sequences in gp120 than in gp41, nef, and p17, suggesting
      that a selective mechanism is involved in transmission.

PMID- 8356455
TI  - Blood cell activation: new perspectives from ultrastructural morphometry.
AB  - The new computerized approaches for image analysis available for a few years
      permit, in an excellent and detailed way, monitoring cellular structural
      modifications during activation processes. Here, we presented morphometric data
      obtained on blood cells (platelets, monocytes, and PMN cells) after in vitro
      activation and under in vivo conditions related to atherosclerosis studied by
      means of electron microscopy. Area and perimeter form factors, nucleus to
      cytoplasma area ratio, and the surface density of platelet plasma membrane
      openings of SCCS presented significant differences compared with the respective
      significant differences compared with the respective controls. Ultrastructural
      markers of blood cell activation were revealed by the computerized morphometry
      applied on ultrastructural images.

PMID- 8356456
TI  - Hypercholesterolemia and platelets.

PMID- 8356457
TI  - Platelets in diabetes: the role in the hemostatic regulation in atherosclerosis.
AB  - Vascular diseases and related complications still represent the main cause of
      death in diabetic patients. Neuropathy, nephropathy, retinopathy, and disturbed
      nutritive tissue perfusion may result from reduced capillary microcirculation.
      These disturbances are diabetes specific. Macroangiopathy does not differ
      structurally from atherosclerotic lesions of nondiabetic subjects, but leads to
      accelerated cerebral, coronary, and peripheral artery disease. Occurrence of life
      terminating thrombotic events, which are superimposed on those vascular lesions,
      are increased. Thus, morbidity and mortality of diabetics depend mainly on
      vascular complications. Normal blood flow is a prerequisite of adequate organ
      perfusion and results from vasomotion, plasma components, corpuscular blood
      elements, vascular architecture, and the undisturbed interaction of these
      components at the endothelial interface. Functional thromboresistance of the
      endothelial layer is reduced in the diabetic state. Increased intravascular
      thrombin generation, reduced fibrinolytic potential, and hyperactive platelets
      lead to a prethrombotic state. This thrombotic diathesis increases the permanent
      danger of acute flow interruption. Activated platelets operate by three
      mechanisms: (1) Microembolization of the capillaries; (2) local progression of
      preexisting vascular lesions by secretion of constrictive, mitogenic, and
      oxidative substances; (3) trigger of the prognosis-limiting arterial thrombotic
      event. We were able to show that the increased functional properties of diabetic
      platelets result from the primary release of larger platelets with enhanced
      thromboxane formation capacity and increased numbers of functional glycoprotein
      receptors GPIb and GPIIb/IIIa, which are synthesized in the megakaryocytes. The
      megakaryocyte-platelet system is turned on in diabetes mellitus. It could be
      demonstrated with the Duesseldorf III method of flow cytometric activation marker
      testing (CD62, CD63, thrombospondin) that predominantly large platelets circulate
      in an activated state in diabetes mellitus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8356458
TI  - Omega-6 and omega-3 essential fatty acids in atherosclerosis.

PMID- 8356459
TI  - Lipoproteins and prostacyclin stability.
AB  - PGI2 is an important local mediator keeping circulating blood cells apart from
      the vessel wall, thus regulating hemostasis. Alterations of locally available
      amounts of this compound may be associated with either bleeding or thrombotic
      events. Factors influencing synthesis, transmission, and degradation coregulate
      the amount of biologically active PGI2 available at a certain vascular site.
      Plasmatic T1/2 of PGI2 is shortened either due to an inherited disorder or an
      acquired disease, its underlying cause being unknown. Generally, this is
      associated with thrombotic events and extremely low concentrations of both HDL
      cholesterol and apoA1. In contrast, the only patient we saw with a prolonged PGI2
      T1/2 repeatedly experienced extremely severe bleeding complications. Recovery
      from severe diseases such as shock and malaria, for example, results in
      normalization of both PGI2 T1/2 and lipoprotein (HDL) and apoA values. Although
      these findings have not yet been verified at a molecular level, it is likely,
      that apoA1 contributes to the stabilization of PGI2 in human blood, thus
      representing one further link between lipid metabolism and hemostasis.

PMID- 8356460
TI  - 13,14-Dihydro-prostaglandin E1 in atherosclerosis.

PMID- 8356461
TI  - Altering vessel wall fatty acid metabolism: a new strategy for antithrombotic
      treatment.

PMID- 8356463
TI  - Heparin, polycations, and atherosclerosis.

PMID- 8356462
TI  - Endothelium-derived nitric oxide, endothelin, and platelet vessel wall
      interaction: alterations in hypercholesterolemia and atherosclerosis.
AB  - The endothelium modulates vascular tone by releasing NO, which is a potent
      vasodilator and inhibitor of platelet aggregation. Thus, the endogenous nitrate
      has an important protective role in preventing vasospasm and thrombus formation.
      In addition, the endothelium is a source of contracting factors, such as
      endothelin-1. Due to its strategical anatomic position, the endothelium is a
      primary target for injurious stimuli and cardiovascular risk factors. Oxidized
      LDL reduce the endothelial production of NO and enhance that of endothelin-1. The
      same pattern of endothelial dysfunction occurs in hypercholesterolemia and in
      part in atherosclerosis. These alterations of endothelial function may contribute
      to vasospasm and thrombus formation, which are common events in patients with
      atherosclerosis.

PMID- 8356464
TI  - Hemorheology, thrombogenesis, and atherosclerosis.

PMID- 8356465
TI  - [A study of transpial migration of implanted serotonergic neurons in rat spinal
      cord].
AB  - Transpial migration of implanted 5-HT neurons from the subarachnoid space into
      the spinal cord was studied in adult Wistar rats. Embryonic raphe tissue or cell
      suspension containing 5-HT cells was used as grafts. The implanted 5-HT cells
      were monitored by 5-HT immunohistochemical method. The results are as follows:
      (1) 10 d after cutting the spinal cord at lower thoracic level, 5-HT fibers
      disappeared in the transected spinal cord. (2) Raphe tissue was implanted into
      the subarachnoid space of the thoracic lumbar segment after the spinal cord was
      cut. One month later, 5-HT positive cells could be found in the transected spinal
      cord with fibers extending into both the grey and the white matters. (3) If the
      raphe cell suspension instead was implanted, a number of 5-HT positive cells
      appeared in the grey matter near the implanted region and the distribution of
      these cells in the grey matter was quite consistent with the implanted range of
      the cell suspension in the subarachnoid space. The 5-HT positive cells which had
      entered into the spinal cord sent out fibers and reestablished a new fiber
      network in the grey matter. (4) After implantation, the number of the 5-HT
      positive fibers in the transected grey matter became more and more sparsely
      distributed with increasing distance from the cell bodies and the 5-HT positive
      fibers reappeared in the white matter were much less than that in the grey
      matter. Present results show that the implanted 5-HT neurons are able to migrate
      transpially from the subarachnoid space into the spinal cord.

PMID- 8356466
TI  - [Effects of 6-OHDA lesions of the bilateral dorsal noradrenergic bundle on
      learning-dependent long-term synaptic potentiation in dentate gyrus].
AB  - In the present study, the role of NE in learning-dependent long-term potentiation
      (LdLTP) was investigated by examining the effects of 6-hydroxydopamine (6-OHDA)
      lesion made in the bilateral dorsal noradrenergic bundle on the changes of
      synaptic efficacy in dentate gyrus (DG) and related conditioned response during
      drinking conditioning. Bilateral injection of 6-OHDA (12 micrograms/4
      microliters) into the dorsal noradrenergic bundle caused a continuous decrease of
      the amplitude of population spike (PS) reaching a value of 50 +/- 6.3% and 28 +/-
      6.4% respectively at the 6th and the 12th day after injection of the drug. During
      this period of 7 days, the LdLTP could not be produced in spite of 20 trainings
      per day for a total of 140 trials, and the conditioned drinking response could
      not be established. The above results indicate that normal levels of
      norepinephrine in the hippocampus are necessary to the establishment of LdLTP in
      the DG and suggest that the development of LdLTP in the DG may be modulated by
      the nucleus locus ceruleus via the dorsal noradrenergic bundle.

PMID- 8356467
TI  - [Measurement of the single muscle fiber action potentials and jitter value in
      tibialis anterior muscles of rabbits in situ].
AB  - With a home-made jitter data processing board and microcomputer for recording
      extracellular single fiber action potential (SF-AP), variations of the time
      intervals of the SF-AP pairs, or the jitters, from two adjacent muscle fibers in
      the unique motor unit in tibialis' anterior in response to repeated stimuli were
      measured. The jitter distribution of 936 recorded from 7 rabbits was positively
      showed with a percentile value of P75-P25 of 54.99-14.61 microseconds. The data
      suggested that the lower limit was smaller than that of skeletal muscles in
      normal human and that there exists also some differences in the jitter values of
      SFEMG between human and rabbit muscles.

PMID- 8356468
TI  - [Expression of left ventricular ANF-gene in rat with cardiac hypertrophy].
AB  - Plasma concentration of ANF and expression of left ventricular ANF-gene in rats
      with cardiac hypertrophy induced by abdominal aortic partial ligation were
      analyzed by RIA and Northern blot respectively. Results showed that plasma
      concentration of ANF and level of left ventricular ANF-mRNA in cardiac
      hypertrophic rats increased markedly, indicating that the cardiac load may induce
      transcription and expression of left ventricular ANF-gene. This effect could be
      potentiated by intracellular calcium modulator taurine and inhibited by
      vasodilator hydralazine.

PMID- 8356469
TI  - [Modulating effects of nucleus termination nervi trigemini on the activities of
      genioglossus in rabbits].
AB  - The effects of electrical stimulation to the nucleus termination nervi trigemini
      (NTV) on the activities of genioglossus were studied in 35 rabbits anesthetized
      with urethane. Electrical stimulation of NTV could cause facilitatory response of
      genioglossal muscle markedly. Monosodium glutamate microinjected into NTV also
      produced significant increase of genioglossal activities. The latency of
      genioglossal response to electrical stimulation of dorsal or ventral part of NTV
      were respectively 5.9 +/- 0.7 ms and 3.0 +/- 0.4 ms. When the nucleus hypoglossus
      was stimulated, the latency was 2.2 +/- 0.2 ms. These results suggested that the
      excitation of NTV could enhance the genioglossal activities so that the
      resistance of upper airway might be decreased.

PMID- 8356470
TI  - [Descending cord dorsum potentials evoked by stimulation at "Yong Quan"
      acupoint].
AB  - Segmental spinal cord potential (Y-sCDP) evoked by stimulation at "Yong Quan"
      acupoint of Sprague-Dawley rat vanished gradually when the recording electrode
      was moved rostrally along the dorsal surface of the spinal cord. When the
      recording electrode was placed more rostrally, for example at C6, another
      positive slow potential, Y-dCDP, could be recorded. Y-dCDP disappeared completely
      when the spinal cord had been sectioned at a higher cervical level. Electrolytic
      lesions of ventral periaqueductal gray (PAG) could also decrease remarkably the
      amplitude of Y-dCDP. This facet suggests that the PAG, an analgesia related
      nucleus, is involved in the generation of Y-dCDP induced by stimulation at "Yong
      Quan" acupoint.

PMID- 8356471
TI  - [Changes of calcium transport capacity of myocardium and myocardial mitochondria
      during sepsis].
AB  - On the isolated perfused heart model of septic rats, the present study showed
      that: (1) Calcium content and 45Ca-influx of myocardium increased 190%, 208% (P <
      0.01) and that of mitochondria elevated 332%, 178% (P < 0.01) respectively with
      no change of myocardial 45Ca-release during sepsis. (2) 10(-8) mol/L calcitonin
      gene-related peptide (CGRP) or 10(-7) mol/L atriopeptin (ANP) added into the
      Krebs-Henseleit solution could effectively reduce 45Ca-influx to myocardium and
      mitochondria with no effect on myocardial 45Ca-release. (3) The calcium uptake
      reserve of mitochondria evaluated in vitro showed that the maximal calcium uptake
      and uptake velocity of mitochondria during sepsis were reduced 34.6%, 33.3% (P <
      0.01) respectively. The data suggested that the net increase of myocardial Ca2+
      content resulted from increase of 45Ca-influx with no change of 45Ca-efflux and
      the reduction of mitochondrial Ca2+ buffering capacity during sepsis were key
      events in the pathogenesis of intracellular Ca(2+)-overload. CGRP and ANP could
      effectively alleviate Ca(2+)-overload of myocardium and mitochondria. This may
      have some cellular protection action during sepsis.

PMID- 8356472
TI  - [Effect of electrical stimulation of hyperstriatum on nucleus dorsalis
      intermedius ventralis anterior thalami somatosensory units in pigeon].
AB  - Discharges of 88 somatosensory units in the nucleus dorsalis intermedius
      ventralis anterior thalami (DIVA) in response to afferent impulses of radial
      nerve on 55 urethane anesthetized pigeons were recorded and analysed. Among the
      88 units, part of them also responded to the stimulation of sciatic nerve.
      Following electrical stimulation of somatic projecting area of hyperstriatum, the
      spontaneous discharges and the responses of DIVA somatosensory units to radial
      inputs were obviously inhibited and the degree of inhibition was linearly
      correlated with the frequency and intensity of stimulation. The inhibitory effect
      on the responses to radial inputs may cause an increase in latency and a decrease
      in number of spikes. These results indicate that the DIVA certainly belongs to
      somatosensory system, and the somatic projecting area of hyperstriatum has a
      descending inhibitory effect on the DIVA somatosensory units. The hyperstriatum
      may thus exert feedback control over its sensory inputs through descending
      inhibition. It appears that the functional connection between the highest region
      of central nervous system and thalamus in avian is similar to that of mammal.

PMID- 8356473
TI  - [Changes of Leu-enkephalin in striatum and hypothalamus of rats during hyperbaric
      oxygen exposure].
AB  - The purpose of this study is to investigate the changes of Leu-Enkephalin (L-Enk)
      content in striatum and hypothalamus of rats during hyperbaric (HBO) oxygen
      exposure. Thirty-two male rats in the experiment were randomly divided into four
      groups: normobaric air group, normoxic hyperbaric nitrox group, nonconvulsion HBO
      group and convulsion HBO group. L-Enk content in striatum and hypothalamus was
      determined by radioimmunoassay. The results show that L-Enk content in the
      striatum and hypothalamus of rats exposed to hyperbaric oxygen environment were
      markedly higher than that of rats exposed to normobaric air and normoxic
      hyperbaric nitrox. The experimental results suggest that the elevation of L-Enk
      content in striatum and hypothalamus shows a positive relationship with the HBO
      exposure duration of animals and that there was no marked relationship with
      normoxic hyperbaric nitrox environment and compression-decompression method.

PMID- 8356474
TI  - [Glucocorticoid receptor-like antigen on neuronal plasma membrane of rat brain].
AB  - The existence of glucocorticoid receptor-like antigen on the synaptic plasma
      membrane (SPM) isolated from rat brain was demonstrated by ABC-gold technique.
      The SPM was first incubated with McAb 250 (a monoclonal antibody to the
      glucocorticoid receptor) and then biotinylated horse-anti-mouse IgG and
      streptavidin-gold (SAG) was added in proper order to the reacting system. The
      gold particles could be visualized on the external surface of neuronal processes
      under electron microscope. This is the first morphological demonstration of the
      existence of glucocorticoid receptor-like antigen on neuronal membranes.

PMID- 8356475
TI  - [A method for repairing the tip of tungsten-in-glass microelectrode].
AB  - When glass insulating tungsten microelectrodes are made, the insulating glass is
      usually drawn apart at an earlier than desired moment leaving a longer
      uninsulated metallic tip. A simple method for removing the excessively protruded
      part of the tungsten tip and triming it to any desirable length and shape is
      described.

PMID- 8356476
TI  - [A model for perfusing the carotid body in the awake goat and its evaluation].
AB  - A model for perfusing the carotid body (CB) in the awake goat was described in
      detail. The main surgical procedures were: (1) to ligate the occipital artery,
      cut the carotid sinus nerve and excise the CB on one side; (2) to rearrange some
      arteries, which supply the brain and neck on the other side (perfusion side), for
      isolating the CB; (3) to place cannulae in the jugular vein and the carotid
      artery for drawing blood and perfusing the intact CB on the perfusion side.
      Perfusion of the CB with goat own blood can be carried out via an extracorporal
      circuit during the experiment. The remark able advantages of this perfusion model
      are: (1) the animal can be kept in a normal physiological condition; (2) the
      arterial gases and pH in the CNS and CB can be controlled separately. The NaCN
      test was done in three steps to evaluate the model by judging the sensitivity of
      the peripheral chemoreceptors including the aortic and perfused carotid bodies.
      Applications of this model were also discussed.

PMID- 8356477
TI  - Anthropological perspectives on chronic illness. Introduction.

PMID- 8356478
TI  - 'High-pertension'--the uses of a chronic folk illness for personal adaptation.
AB  - Chronic illness exerts a lasting and pervasive influence on personal experience
      of the world. It is commonly viewed as a phenomenon to be coped with, requiring
      an adaptive response on the part of an individual. Chronic illness, however, is a
      culturally-influenced tool which in itself can be used to organize and implement
      an adaptive response to personal experience. Employing Hallowell's concept of the
      self in the behavioral environment, the uses of a chronic folk illness, 'high
      pertension', for personal adaptation are discussed. Data from research on health
      beliefs about hypertension and illness behavior in a sample of 60 older African
      American women in New Orleans are presented. 'High-pertension', a chronic folk
      illness related to the biomedical 'hypertension', and involving blood and
      'nerves', is described. Health beliefs and illness behavior associated with high
      pertension are considered as part of an individual's total effort at adaptation
      within the behavioral environment. These points are made: (1) Chronic illness can
      be used as a means to express one's self in relation to the behavioral
      environment. (2) Chronic illness can be used to manipulate and manage the
      relation of self to environment. (3) Chronic illness can be used to legitimize
      and announce role change. These uses are available to the individual by virtue of
      social interaction, cultural precedent and the chronicity and meaning of the
      illness itself. For persons in a severely stressed, constrained, and
      disadvantaged social position, as are many older African-American women, chronic
      illness offers one of the few means of controlling the behavioral environment
      available to the individual. Although in anthropology and biology we speak of
      adaptation in terms of human groups, we are ultimately considering person
      environment fit, that is, personal adaptation. Chronic illness can be a part of a
      culturally-influenced adaptive response.

PMID- 8356479
TI  - Redefining health: living with cancer.
AB  - The patients presented in this paper were being treated for cancer. None denied
      the diagnosis, and all were adhering to the medical regimen. Yet these patients
      also said that they were healthy in the face of the implications of their disease
      and the physical toll imposed by the treatments. The definition of health
      currently used by the American health care system is too restrictive to encompass
      the perception voiced by these individuals. This paper proposes to broaden the
      concept of health to help provide a legitimate place in society for individuals
      with chronic, life-threatening illnesses. A theoretical framework is proposed
      which might explain how these patients could still see themselves as healthy
      despite their disease. The core concept of health in this model is a sense of
      self-integrity, and the construct of health has two dimensions, Physical Status
      and Social Function. Individuals with chronic, life-threatening diseases like
      cancer use both of these dimensions simultaneously in order to negotiate and
      reestablish a sense of self-integrity based on their continued social functioning
      even in light of their acknowledged physical condition. Implications for
      restructuring our thinking about health, disease, and the mechanisms used to cope
      with cancer are outlined in order to develop a more realistic definition of
      health which is contextually based in the lives of the individuals with the
      disease. The criteria for assessment would not be biologic integrity alone, but a
      complex compromise between personal needs, social obligations, and physical
      abilities.

PMID- 8356480
TI  - The dilemma of seeking urgent care: asthma episodes and emergency service use.
AB  - Asthma is an invisible and unpredictable chronic illness characterized by
      recurrent episodes of airflow obstruction and airway inflammation. Until
      recently, psychological factors were thought to play a major role in this
      condition. The notion of an emotionally-based illness serves to discredit asthma
      as a 'real' illness among health professionals and patients alike, contributes to
      the sense of stigma that persons who have asthma experience, and impedes
      effective management. Findings from research with a sample of 95 adults with
      physician diagnosed and documented asthma indicate that persons who have asthma
      walk a tightrope between delaying formal medical intervention and seeking
      treatment too soon. Uncertainty about the quality and speed of care available in
      an emergency department shapes, in part, the nature of the lived experience of
      asthma and affects feelings of control over the illness. These concerns create a
      push-pull dynamic, as individuals struggle to make decisions about emergency
      department use that will provide relief, ensure autonomy, deter the experience of
      stigma, and diminish the threat of death.

PMID- 8356481
TI  - Self-care and multiple sclerosis: a view from two cultures.
AB  - The role of self-care in the management of chronic illnesses is essential to
      successful patient care. This paper compares and contrasts self-initiated self
      care practices of 51 Danish and 35 American persons with multiple sclerosis at
      various levels of disability. Respondents were asked about ways they managed
      their symptoms and problems during periods of non-medical contact--including
      methods of following the medical regimen; alternative treatments; use of lay
      referral systems; and, sources of information regarding physical, psychological,
      social, and environmental dimensions of coping with the illness. The two groups
      of respondents varied regarding adaptation strategies and primary sources of
      information used. The ultimate aim, however, of using these strategies was
      similar; to gain control over uncertainty, dependency, and physical and emotional
      decline. This study suggests that the empowering role of self-initiated self-care
      strategies in chronic illness may transcend differences in health care systems.

PMID- 8356482
TI  - Life stress, social support and clinical depression: a reanalysis of the
      literature.
AB  - In recent years, theorists and researchers have disagreed about the relationship
      between social support and mental health. Some believe that support is a direct
      provoking agent (i.e. lack of support constitutes strain), whereas others
      maintain that support is a vulnerability factor moderating the effect of life
      stress. Focusing on clinical depression, the article reviews the arguments and
      evidence supporting a strain hypothesis of social support versus a vulnerability
      hypothesis. Reanalyzing cross-classified data from 12 community studies of
      clinical depression, the study shows that the choice of model depends on the
      specification of functional form of the stress-clinical depression relationship.
      The linear probability specification suggests a vulnerability hypothesis, whereas
      the logit and probit specifications support a strain hypothesis. However,
      theoretical and statistical arguments tend to favor a logit or probit
      specification, and an additional analysis of data from Brown and Harris [Social
      Origins of Depression: A Study of Psychiatric Disorder in Women. The Free Press,
      New York, 1978] supports these arguments. Thus, the study concludes that the
      strain hypothesis of social support is more consistent with the available data.

PMID- 8356484
TI  - Health care behavior on Nicaragua's Atlantic Coast.
AB  - Survey methods are used to investigate health behavior in five communities on
      Nicaragua's Atlantic Coast. Eighteen health behaviors classified as 'biomedical'
      or 'traditional' are analyzed according to the ethnicity and educational level of
      the respondent. Household location (urban vs rural) and material wealth are also
      analyzed as predictors of health care behavior. Traditional behaviors are found
      to vary considerably among the six ethnic groups and among the various
      socioeconomic groupings. Biomedical behaviors are not found to be clearly related
      to ethnicity, wealth, or education.

PMID- 8356483
TI  - Health care financing for the elderly in Japan.
AB  - This paper examines the financing of elderly health care in Japan for medical
      institutions, nursing homes, and at home. The analysis demonstrates that the
      conventional figures for elderly health expenditures in Japan systematically
      underestimate the real costs by excluding the costs of uninsured services,
      nursing homes, and home health care. The paper estimates these costs and shows
      that they add about 10% to the conventional figure for elderly health care costs
      in Japan. This inquiry also shows how government policy for health care financing
      shaped distinctive Japanese patterns of elderly care provision. The financing
      system provided a hidden subsidy--through national health insurance coverage of
      long-term hospitalization--that encouraged high institutionalization rates of
      elderly in medical facilities. Public financing for long-term elderly
      hospitalization, however, has not been matched by government attention to quality
      of care, resulting in serious quality problems and reflecting a social trade-off
      between cost and quality. Also, until recently the financing system rarely
      reimbursed home health care, thereby creating strong disincentives to the
      development of formal home health care services. This analysis has important
      implications for reforms now being considered by the Japanese government in the
      financing and provision of health care for the elderly, especially the
      limitations of relying on reimbursement price policy. The reforms could have
      unintended negative consequences for equity, efficiency, and quality of care.

PMID- 8356485
TI  - User fees plus quality equals improved access to health care: results of a field
      experiment in Cameroon.
AB  - Since the Bamako Initiative was launched in 1988, many African countries have
      embarked on comprehensive primary health care programs relying, at least
      partially, on revenues generated through user fees to revitalize health care
      delivery systems. Although these programs contain two critical components, user
      fees and improved quality, policy debates have tended to focus on the former and
      disregarded the latter. The purpose of this study is to provide a net assessment
      of these two components by testing how user fees and improved quality affect
      health facility utilization among the overall population and specifically among
      the poorest people. A "pretest-posttest controlled" experiment was conducted in
      five public health facilities in the Adamaoua province of Cameroon. Three health
      centers which were to introduce a user fee and quality improvement (i.e. reliable
      drug supply) policy were selected as "treatment" centers and two comparable
      facilities not yet phased into this policy were selected as "controls". Two
      rounds of household surveys were conducted (each to 800 households in 25 villages
      surrounding the five study sites) to measure the percentage of ill people seeking
      care at the health center before and after the implementation of the policy. The
      experiment was tightly controlled by conducting monthly observations at each
      study site. Results indicate that the probability of using the health center
      increased significantly for people in the "treatment" areas compared to those in
      the "control" areas. Travel and time costs involved in seeking alternative
      sources of care are high; when good quality drugs became available at the local
      health center, the fee charged for care and treatment represented an effective
      reduction in the price of care and thus utilization rose. Moreover, contrary to
      previous studies which have found that the poorest quintile is most hurt by user
      fees, this study found that probability of the poorest quintile seeking care
      increases at a rate proportionately greater than the rest of the population.
      Since the poor are most responsive to price changes, they appear to be
      benefitting from local availability of drugs more than others.

PMID- 8356487
TI  - The general practitioner's use of time: is it influenced by the remuneration
      system?
AB  - The practice pattern of 116 general practitioners in 60 rural municipalities in
      Northern Norway was studied with respect to length of consultation, the weekly
      number of consultations and the proportion of return visits. The average length
      of consultation was 14 mins, and only slightly lower for fee-for-service (FFS)
      doctors (13.7) than for salaried ones (14.8). The weekly average number of
      surgery consultations was higher for FFS doctors than for the salaried (63 vs
      49), but the weekly number of hours spent consulting and the proportion of return
      visits were about the same. Further, the characteristics of the health care
      system (doctor density and doctor turnover) were associated with variations in
      the doctors' use of time. The most consistent effects, even if weak, were the age
      and sex of the patients. The strongest effects on the length of consultation were
      referrals and various medical procedures. This suggests that in this instance the
      medical condition at hand would appear to have a greater influence on the
      doctors' use of time than either the remuneration system or other characteristics
      of the health care system. Although the association between the doctors' use of
      time and the type of remuneration was weak, the study indicates that the type of
      remuneration does matter. Consequently, financial incentives can be used to
      influence the practice pattern of GPs.

PMID- 8356486
TI  - Ways of coping with chronic fatigue syndrome: development of an illness
      management questionnaire.
AB  - Chronic fatigue syndrome (CFS) is a disorder of uncertain aetiology, and there is
      uncertainty also about the appropriate way in which patients should manage the
      illness. An illness management questionnaire (IMQ) was designed to assess coping
      in CFS. This was completed by 207 patients, in parallel with the COPE scales (a
      general measure of coping that can be applied situationally), and measures of
      functional impairment, anxiety and depression. The IMQ yielded four factors:
      maintaining activity, accommodating to the illness, focusing on symptoms and
      information-seeking. Scales based upon these factors together predicted 26, 27
      and 22% of the variance in functional impairment, anxiety and depression,
      respectively, and each scale had significant relationships with relevant scales
      of the COPE, supporting the interpretation of the factors. It is suggested that
      the IMQ may be employed to relate ways of coping to outcomes in CFS, and to
      assess coping as a mediator of change in cognitive-behavioural interventions.

PMID- 8356489
TI  - Assessment of trends in geographical inequalities in infant mortality.
AB  - After discussing the comparative effectiveness of different measures of
      dispersion used as indices of inequality, the Weighted Coefficient of Variation
      is proposed as an appropriate indicator of geographical inequality attending
      infant death. Furthermore, this paper proposes a methodology based on simple
      linear regression to be employed for the purposes of assessing the percentage of
      the observed change in said inequality over any given period, as is required by
      the terms of Target 1 of the WHO policy document "Health for All by the Year
      2000". To this end, trends in Infant, Neonatal, Postneonatal and Perinatal
      Mortality in Spain for the period 1975-1986 have been analysed. For the 12 years
      examined, the Average Spanish Rate for these four indicators fell by over 50%. We
      observed a statistically significant decrease (34.8%) in geographical
      inequalities in the case of Postneonatal Mortality. However for the same period,
      geographical inequalities in Perinatal Mortality showed an important and
      significant rise (79.33%). It is suggested that, where Spain is concerned, it is
      Perinatal Mortality which should be assigned priority status for monitoring
      purposes. A plan of action should be drawn up, duly targeted at reducing
      geographical inequalities in health services, in the mother-and-child care sector
      above all.

PMID- 8356488
TI  - Sexual behaviors relevant to HIV transmission in a rural African population. How
      much can a KAP survey tell us?
AB  - KAP surveys have been proposed as a means to gather quantitative information on
      AIDS-related sexual behaviors, but the validity of survey results has not been
      tested. The validity of data gathered during a KAP survey in a rural district in
      Northern Uganda (N = 1486) was examined analyzing expected behavioral patterns,
      agreement of partner reports, and concordance of number of sexual contacts across
      gender. Patterns of sexual behavior and age trends are as expected. More men
      (50%) than women (18.5%) reported premarital sex. The likelihood of sexual
      intercourse before marriage increases with age at first marriage and with
      education. Women marry 5 years earlier than men, and the number of marriages
      increases with age. Peak incidence of casual sex occurs before age 25. The
      male/female ratio of casual sex is 4, as compared to about 3 in other African
      surveys. Single men are 2.5 times more likely to engage in casual sex than
      married males. Agreement of partner reports was examined for 392 couples selected
      by chance. 86% of the couples agreed on being polygamous or monogamous. On
      average men reported 1.3 (SD = 0.7) wives as compared to women reporting 1.5 (SD
      = 0.89) wives (P < 0.001). 16.8% of women declared more, and 2.8% less cowives
      than their husband (r = 0.65). Self-reports on frequency of sexual intercourse in
      the past month were examined for 256 monogamous couples. Mean frequencies differ
      (5.24 +/- 5.1 for men, 4.43 +/- 4.7 for women, P < 0.001). 42.8% of couples are
      in agreement within +/- 1 unit (r = 0.44). The total number of extra-marital and
      marital sex acts, as well as the total number of partners reported by each gender
      are similar. There is, however, a striking gender difference in reporting of
      casual partners in the past year. Data were found to be accurate at the aggregate
      level. However, accuracy of reporting at the individual level was found to be
      low. The gender difference in reporting of casual partners may be due to female
      underreporting, to not having captured prostitutes or to a different perception
      of the meaning of casual partnership. All KAP surveys should include a validity
      analysis, so as to provide a sense of the accuracy of the surveys and allow for
      comparison of the quality of different KAP surveys. There is an urgent need for a
      standardized approach to validating the findings from AIDS-related KAP surveys.
      Some of the indirect methods described here could be relevant for further use.

PMID- 8356490
TI  - Motorcycling safety research: a review of the social and behavioral literature.
AB  - The literature on motorcycling safety research is reviewed, and it is argued that
      there have been two main periods. The first, spanning the 1970's, was based on
      accident analysis, and the main objective was to identify and control factors
      that contribute to the severity of motorcycling accidents. The main concerns were
      to reduce head and brain injuries through safety helmets, to reduce multi-vehicle
      collisions through daytime use of headlamps, and to reduce drink-riding. The
      second period, the 1980's shifted the emphasis of research to what might be
      called 'riding analysis'--that is, analysis of the process of motorcycle riding.
      Particular attention was paid to skills testing, training evaluation and
      perceived risk. Now, in the early 1990's, a third period is developing, in which
      the rider is seen as 'active agent'. The theoretical basis of the new research
      has come from the models of social psychology, and the main concern is to use
      riders' beliefs and attitudes about safe riding to predict their behaviour on the
      roads and so their accident involvement. The three periods of research are
      reviewed in turn, and the paper concludes with an outline of the key research
      issues that remain to be addressed.

PMID- 8356491
TI  - Concurrent utilization of chiropractic, prescription medicines, nonprescription
      medicines and alternative health care.
AB  - This study examines the use of chiropractic, prescription medicines,
      nonprescription medicines and alternative health care for two independent samples
      representative of the population of Edmonton, Alberta, Canada in 1979 (n = 439)
      and again in 1988 (n = 464). While the usage of prescription medicines was
      unchanged from 1979 to 1988, utilization of nonprescription medicines,
      chiropractic and alternative health care increased. Users of chiropractic tended
      to be concurrent users of the conventional health care system, although they were
      also more likely to utilize alternative health care. This study shows that
      Edmontonians tend to select their health care concurrently from various health
      care modalities including both prescription and nonprescription medicines and
      conventional and alternative health care.

PMID- 8356492
TI  - A fifteen year experience with open drainage for infected pancreatic necrosis.
AB  - Advances in the understanding of the pathophysiologic factors of acute
      pancreatitis, combined with several recent technologic breakthroughs, have led to
      the establishment of infected pancreatic necrosis as the most common, the most
      severe and the most lethal of the infectious complications of acute pancreatitis.
      In this report, a single institutional experience in the surgical management of
      infected pancreatic necrosis during a 15 year period is chronicled. Using open
      drainage with scheduled abdominal re-explorations, the overall mortality rate was
      15 percent in 71 consecutive patients with infected pancreatic necrosis. In the
      most recent 25 instances, sequential re-explorations were performed until
      retroperitoneal granulation occurred, at which time the abdomen was closed over
      lesser sac lavage catheters. Compared with the original 46 patients permitted to
      heal entirely by secondary intention, patients undergoing delayed secondary
      closure and lavage had a significant decrease during the hospitalization period
      (48.8 versus 30.1 days; p < 0.05), without a significant change in the mortality
      rate. In the most recent patients, dynamic pancreatography and fine needle
      aspiration bacteriologic factors were accurate in the preoperative prediction of
      pancreatic necrosis and microbial infection in 95 and 97 percent of the patients,
      respectively. Preoperative endoscopic retrograde cholangiopancreatography
      demonstrated leakage of contrast material from necrotic pancreatic ducts in seven
      of eight patients, while postoperative pancreatograms revealed abrupt truncation
      or other abnormalities in 11 of 13 patients. These observations establish that
      necrotizing pancreatitis involves pancreatic parenchyma as well as peripancreatic
      adipose tissue. Open drainage with contingent secondary closure and high volume
      lavage deserves a place in the management of patients with extensive infected
      pancreatic necrosis.

PMID- 8356493
TI  - Surgical management of gastroduodenal ulcer associated with hiatal hernia.
AB  - The problem of surgical management of gastric and duodenal ulcers associated with
      the hiatal esophageal hernias is reported. The authors have summed up the results
      of simultaneous surgical treatment of 97 patients. Good follow-up results were
      obtained in 69.2 percent of the patients, satisfactory in 26.9 percent and
      unsatisfactory in 3.9 percent of the patients. Of the 28 patients with reflux
      esophagitis who had previously undergone gastric resection, it was noted that
      nonresection of the associated hiatal hernia during the primary operation for
      ulcer disease decreased the effect of surgical treatment. A new method of
      surgical management of reflux esophagitis of the resected stomach is presented.
      The authors conclude that simultaneous operation for gastroduodenal ulcers
      associated with hiatal hernia is a promising area of surgical treatment and
      ensures high medical, social and economic efficiency.

PMID- 8356494
TI  - The significance of a positive test of morphine cholescintigraphy in hospitalized
      patients.
AB  - Morphine-augmented radionuclide cholescintigraphy (MC) is a useful adjunctive
      diagnostic tool for the identification of acute cholecystitis (AC) in patients
      who are hospitalized and critically ill with occult sepsis. The results of
      previous studies have demonstrated a reduction in false-positive rates, that is,
      nonvisualization, from 40 percent with standard radionuclide cholescintigraphy to
      5 percent with MC in these high-risk patient groups, with an overall accuracy of
      92 percent. This study was performed to determine the significance of a positive
      test result from MC in patients with occult sepsis. We reviewed the records of
      all 20 patients at high risk in whom MC was positive during the 35-month period
      ending 31 May 1992. AC was confirmed by laparotomy in all 16 patients who
      underwent surgical treatment. There were two patients who recovered with
      antibiotic therapy alone (considered false-positives) and two additional patients
      who died without operation or a confirmed diagnosis of AC (excluded from
      analysis). Thus, in this series, MC was associated with a positive predictive
      value of 0.89, confirming that it is a valuable adjunct in establishing the
      diagnosis of AC in patients who are seriously ill and hospitalized with occult
      sepsis.

PMID- 8356495
TI  - Results of a prospective study with comparison of clinical, endosonographic,
      computed tomography, magnetic resonance imaging and pathologic staging of
      advanced gynecologic carcinoma and recurrence.
AB  - Between January 1988 and April 1991, 57 patients with advanced gynecologic
      carcinoma were preoperatively evaluated by gynecologic examination and
      endosonography (ESG) using general anesthesia. Abdominopelvic computed tomography
      (CT) was performed in 49 patients and magnetic resonance imaging (MRI) in 21
      patients. There were 34 primary tumors and 23 instances of recurrence. Causes of
      gynecologic carcinoma were 38 carcinomas of the cervix uteri (26 primary and 12
      recurrences), eight carcinomas of the ovary (four primary and four recurrences),
      three recurrences of carcinoma of the endometrium, five sarcomas of the uterus
      (one primary and four recurrences) and three primary carcinomas of the vagina.
      All of the patients were operated upon. This perspective study compares the data
      from clinical and imaging examinations to the data obtained from histologic
      examination of surgical sections. According to anterior or posterior tumor
      extension, the accuracy of clinical evaluation and preoperative imaging were
      studied for the posterior vesical wall and the vesicovaginal septum and the
      anterior rectal wall and the rectovaginal septum. Histologic examination revealed
      vesical involvement in 17 patients and of the involvement of vesicovaginal septum
      in 21 patients. The accuracy of the clinical examination, ESG, cystoscopy, CT and
      MRI was 83, 88, 87, 75 and 81 percent, respectively, for vesical extension.
      Cystoscopy was not taken into account for evaluation of extension to the
      vesicovaginal septum--accuracy was 80, 90, 67 and 86 percent for clinical
      examination, ESG, CT and MRI. Histologic examination showed involvement in the
      rectum in 14 patients and involvement in the rectovaginal septum in 19 patients.
      Rectoscopy was performed 13 times. The accuracy of clinical examination, ESG, CT
      and MRI was 91, 98, 89 and 71 percent, respectively, for extension to the
      anterior rectal wall. Rectoscopy was not taken into account for evaluation of
      extension to the rectovaginal septum--accuracy was 80, 96, 75 and 57 percent for
      clinical examination, ESG, CT and MRI. Endosonography would seem to be useful to
      complete examinations for regional extension of advanced gynecologic carcinomas.
      Its accuracy is superior to that of other examinations. Because it is performed
      using general anesthesia, there is no discomfort for the patient during this low
      cost procedure.

PMID- 8356496
TI  - Identifying the low-risk patient with penetrating colonic injury for selective
      use of primary repair.
AB  - As the mortality rate for penetrating colonic injuries approaches zero, emphasis
      has shifted toward reducing associated morbidity. This study was done to identify
      patients at low risk for colon-related extensive morbidity after primary repair
      of a penetrating colonic injury. The records of 100 consecutive patients admitted
      to the District of Columbia General Hospital (DCGH) between 1984 to 1990,
      surviving more than 24 hours after full-thickness penetrating colonic injuries,
      were retrospectively reviewed. Data collection included mechanism, management and
      anatomic location of the colonic injury. Severity of injury was evaluated by the
      Trauma Score (TS), Penetrating Abdominal Trauma Index (PATI), Flint Colon Injury
      Score (FCIS), time in the operating room, blood transfused during the first 24
      hours and presence of preoperative shock (systolic blood pressure less than 90
      millimeters of mercury). Mechanism of injury included 97 gunshot wounds and three
      stab wounds. Fifty-seven patients had primary repair (17 having resection and
      anastomosis) and 43 had colostomy. The anatomic location of injury was right
      colon in 37, transverse colon in 27, left colon in 35 and multiple sites (two) in
      one patient. In this series, only two patients had colon-related extensive
      morbidity--a parastomal hernia and wound dehiscence, both requiring operative
      intervention. There were no instances of intraperitoneal abscess formation. One
      patient died from overwhelming pneumonia after segmental resection of the colon
      with primary anastomosis. The literature reports a 12 to 42 percent colon-related
      morbidity rate in patients sustaining penetrating colonic injuries. This series
      from DCGH represents the lowest colon-related extensive morbidity and mortality
      rates reported to date in any substantial series of penetrating abdominal trauma.
      We attribute the 2 percent extensive morbidity rate to high TS (mean of 15.7),
      low PATI (mean of 24.2), low FCIS (mean of 1.9) and few associated intra
      abdominal injuries (59 percent of patients with less than two). We have
      identified a group of patients with full-thickness penetrating injuries to the
      colon, few associated intra-abdominal injuries, high TS, low PATI and low FCIS
      who can be managed safely and judiciously by primary repair without undue
      morbidity and mortality.

PMID- 8356497
TI  - Surgical scar endometrioma.
AB  - Relatively few instances of surgical scar endometrioma have been reported. Herein
      we review 24 patients treated for this condition at the institutions at which we
      work between 1972 and 1992. The age of the patients ranged from 17 to 47 years,
      with an average age of 31.7 years. Surgical scar endometriomas occurred after
      operations including cesarean section (19 patients), appendectomy (two patients),
      episiotomy (two patients) and hysterectomy (one patient). The interval between
      prior surgical treatment and the onset of symptoms ranged from one to 20 years,
      with an average of 4.8 years. All patients were treated by wide excision.
      Seventeen of 24 patients were available for follow-up evaluation. The interval
      between excision and follow-up evaluation ranged from 1.2 to 14.0 years, with an
      average of 6.4 years. None of the patients had recurrence of surgical scar
      endometrioma. Patients with the classic presentation of a painful surgical scar
      mass that increases in size or tenderness during menstruation need no further
      evaluation of the lesion before excision. Ultrasonographic examination and fine
      needle aspiration biopsy should be used preoperatively in women who have a
      constantly painful or asymptomatic mass in a surgical scar. Because medical
      management yields poor results, wide excision of surgical scar endometriomas is
      the treatment of choice.

PMID- 8356499
TI  - A randomized comparison of Verres needle and direct trocar insertion for
      laparoscopy.
AB  - Two hundred and fifty-two women scheduled to undergo laparoscopy were randomly
      assigned to a Verres needle or direct insertion group. The groups were similar
      with respect to incidence of obesity, prior surgical treatment, indication for
      operation and level of training of the surgeon performing the procedure. There
      were no major complications associated with either technique. Minor complications
      (preperitoneal insufflation, failed entry or more than three attempts necessary
      to enter the peritoneal cavity with the trocar) were significantly more frequent
      (p < 0.05) in the Verres needle technique group. One hundred and thirteen of
      these patients underwent sterilization procedures. The mean times for performance
      of the laparoscopic procedure using the direct insertion and Verres needle
      techniques was 15.3 and 19.6 minutes, respectively. The time saved using the
      direct insertion technique is explained by a significant (p < 0.01) reduction in
      the mean laparoscope insertion time, which was 2.2 minutes and 5.9 minutes for
      the direct insertion and Verres needle techniques, respectively. We prefer the
      direct insertion technique for trocar placement because it has fewer minor
      complications and requires less operating time.

PMID- 8356498
TI  - Superior mesenteric arteriovenous fistula in vascularized whole organ pancreatic
      allografts.
AB  - Despite improved results in vascularized pancreatic transplantation, the
      incidence of technical complications continues to be high. Vascular complications
      are an important source of morbidity. Previously undescribed is the occurrence of
      an arteriovenous fistula (AVF) in the transplanted mesenteric bundle. We have
      identified this unusual complication in three of 90 consecutive recipients of
      pancreatic transplant. The first patient presented with severe and protracted
      endocrine insufficiency, which was effectively reversed by direct surgical
      ligation of the AVF. The second patient presented with hematuria, which likewise,
      resolved with correction of the AVF. The third instance was diagnosed immediately
      after transplant and was successfully corrected by direct surgical ligation. The
      operative approach with establishment of proximal vascular control differed in
      each instance. Clinical presentation was variable and diagnosis was suggested by
      physical examination, duplex ultrasonography and radionuclide perfusion scanning.
      Arteriography was confirmatory. Mesenteric AVF can be easily identified and
      corrected at the time of reoperation without compromising allograft function.

PMID- 8356501
TI  - Appendectomy incidental to cholecystectomy among elderly Medicare beneficiaries.
AB  - To assess the risks of adverse outcomes after appendectomy incidental to
      cholecystectomy among elderly Medicare beneficiaries, 8,936 persons undergoing
      cholecystectomy with incidental appendectomy and 44,461 persons undergoing
      cholecystectomy without incidental appendectomy were studied. Controlling for
      age, race, gender and co-morbidity status, the risk for wound infection in
      persons with incidental appendectomy was 83 percent higher than in persons
      without incidental appendectomy (95 percent confidence interval, 1.53 to 2.18).
      The risks for having other adverse outcomes, including other infections,
      extensive intrahospital complications and mortality rate at 30 days, were also
      higher for the former group, although these differences were not statistically
      significant. In addition, the demographic characteristics and health status of
      persons undergoing cholecystectomy with incidental appendectomy with persons
      undergoing cholecystectomy only were compared. Males, persons of younger ages, of
      white race or with no co-morbid conditions, were significantly more likely to
      undergo cholecystectomy with incidental appendectomy. Variables to control for
      differences in the demographic characteristics and health status between persons
      receiving and not receiving incidental appendectomy were included in the
      regression models for adverse outcomes. However, these models may not completely
      control for differences between the two groups. As a result, the actual
      relationship between incidental appendectomy and adverse outcomes may be
      underestimated. The preventive effect of incidental appendectomy on morbidity and
      mortality rates from future instances of appendicitis was assessed by determining
      the remaining lifetime risk for acute appendicitis. For persons 65 to 69 years of
      age, 115 incidental appendectomies would be required to prevent one future
      instance of appendicitis and 4,472 incidental appendectomies would be needed to
      prevent a single future death from acute appendicitis. Because incidental
      appendectomy increases the risk for wound infection among persons undergoing
      cholecystectomy and because the lifetime risk for acute appendicitis is
      relatively low for persons of this age group, surgeons should carefully consider
      the risks and benefits of incidental appendectomy in the elderly.

PMID- 8356500
TI  - Optimal outcome after tibial arterial bypass.
AB  - To evaluate factors for the optimal outcome after tibial arterial bypass for
      lower extremity ischemia, we analyzed our experience with 1,359 such bypasses
      during the last ten years. There were 869 males and 490 females, of whom 739
      patients (54 percent) had diabetes. The average age was 68 years. One thousand
      and twenty-four bypasses were performed using the atraumatic valve incision in
      situ technique, 281 bypasses using free vein grafts and 54 bypasses with
      synthetic materials. These bypasses were taken to the anterior tibial (312
      patients), posterior tibial (341 patients), peroneal (520 patients) and dorsalis
      pedis arteries (125 patients). Inflow arteries included external iliac (two
      patients), common (435 patients), superficial (472 patients) and profunda femoris
      arteries (259 patients). In certain instances, popliteal and tibial arteries were
      used for inflow (short bypasses). Limb salvage was the significant indication (95
      percent). The overall cumulative primary patency rate at five years was 68
      percent and secondary patency was 76 percent. In situ bypasses had the best
      secondary patency rate of 80 percent at five years followed by free vein grafts
      of 70 percent and synthetic bypasses of 33 percent. The choice of inflow or
      outflow arteries did not influence the patency rate in any category. The overall
      limb salvage rate was 94 percent at five years. Short bypasses using free vein
      grafts had a similar patency to long free vein graft but lower patency than long
      in situ bypasses. These data demonstrate that bypasses to tibial arteries, using
      autogenous vein for ischemia of the lower extremity and limb salvage, have long
      term durability. In situ bypass with a complete saphenous vein is the best
      conduit for such reconstructions. We suggest that tibial arterial bypass should
      be strongly considered in all instances for limb salvage when autogenous vein is
      available before resorting to primary amputation.

PMID- 8356502
TI  - A direct approach to the left and middle hepatic veins during left-sided
      hepatectomy.
AB  - A direct surgical approach to the MHV during left-sided hepatectomy is
      anatomically feasible. The procedure should be applied with appropriate safety
      measures. Prior verification of the precise anatomic relationship of the hepatic
      veins is necessary and the MHV should be isolated and secured by the described
      stepwise technique.

PMID- 8356503
TI  - Four steps to local anesthesia for endarterectomy of the carotid artery.

PMID- 8356504
TI  - Integrins, adhesion molecules and surgical research.
AB  - Integrins and adhesion molecules are a group of closely related glycoproteins
      expressed by a wide variety of cells. In vitro experiments have shown these
      families of cell surface receptors to be essential to the interactions between
      the cytoskeleton and the extracellular matrix. Although the designations of
      families of integrins and adhesion molecules is complex, this review attempts to
      present an organization in which the result is to provide surgeons with an
      understanding of their structure and function. This is particularly important
      because integrins and adhesion molecules have a critical role in such diverse
      processes as embryogenesis, inflammation, wound healing, thrombosis,
      transplantation and oncogenic transformation. It is, therefore, highly probable
      that they will be critical to future advances in surgical research and ultimately
      in surgical practice. It should be remembered that this area of investigation is
      so dynamic that the interval involved in publication of this article will in
      itself be characterized by a plethora of publications in the basic science and
      surgical literature, which warrants careful attention.

PMID- 8356505
TI  - [Questions and aspects of radiotherapy of adult patients with localized
      supradiaphragmatic stage (CS I/II) Hodgkin's disease. 1. Questions and aspects on
      indications for primary and adjuvant radiotherapy].
AB  - Important studies of the therapy in patients with early stages of Hodgkin's
      disease aim at reducing the long-term risks, yet maintaining the high cure rate.
      Several prospective studies and two large meta-analyses did not observe a
      significant difference of the ten- or 15-year survival rate after radiotherapy or
      combined radio- and chemotherapy in the total group of patients with CS I/II A
      Hodgkin's disease, not withstanding a significant reduction of the recurrence
      risk after combined therapy. There is some evidence but no proof, that certain
      subgroups of patients with early stage, have a higher survival after combined
      therapy compared to that after radiotherapy alone. Most studies of therapy in
      Hodgkin's disease have a statistical power much too low, in order to demonstrate
      significant differences of the survival rate in the order of 10 to 15%.
      Randomized studies of chemo- versus radiotherapy in patients with PS I/II A and
      some PS III A have shown conflicting results. Patients with supradiaphragmatic
      Hodgkin's disease and CS I/II can be subdivided according to the recurrence risk
      after primary radiotherapy in the following subgroups: 1. Patients with a very
      low or a low recurrence risk of approximately 10 to 20%: patients less than 40
      years old and CS I/II A NS/LP with less than three involved regions and no bulky
      mediastinal mass and an ESR below 30 mm. If there is only unilateral suprahyoidal
      lymph node involvement, primary radiotherapy of the involved region or a mini
      mantle or a mantle field is acceptable and achieves a recurrence free survival of
      90% or higher. If there is only non bulky mediastinal involvement, mantle field
      radiotherapy is acceptable and achieves a recurrence-free survival of at least
      90%. In the other patients, primary irradiation of an extended mantle field
      without a staging laparotomy is an acceptable primary treatment, achieving a
      recurrence-free survival rate of approximately 80%. Another option is a staging
      laparotomy with splenectomy and a mantle radiotherapy for PS I/II. Few groups
      prefer primary chemotherapy alone or some type of a reduced chemotherapy with
      lesser toxicity combined with localized radiotherapy and long-term observations
      of a larger group of patients after the last type of treatment have to confirm
      the excellent early results. 2. Patients with an intermediate recurrence risk of
      approximately 20 to 40%: patients, who do not belong to group one or group
      3.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8356506
TI  - Prognostic factor of radiotherapy for squamous cell carcinoma of oropharynx
      without clinically positive nodes.
AB  - Local control rates of oropharynx carcinoma treated with radiation alone were
      reported as 40 to 71%. We investigate the factors which affect the local control
      rate for oropharynx carcinoma. From 1967 through 1982, 62 cases of squamous cell
      carcinoma of oropharynx without positive neck nodes were treated with external
      radiation at the Department of Radiology, Osaka University Hospital. Five-year
      actuarial survival rates of T1, T2, T3 and T4 cases were 53%, 63%, 47% and 0%,
      respectively. Five-year local control rates of T1, T2, T3 and T4 cases were 51%,
      46%, 34% and 0%, respectively. In 52 cases treated with a total dose of 60 Gy or
      more, tumor response could be evaluated at the dose level of 40 and 60 Gy. The
      local control rates of tumors which disappeared and persisted at 40 Gy were 88%
      (7/8) and 39% (17/44), respectively (p < 0.05). Of 44 cases which persisted at 40
      Gy, the local control rates of tumors which disappeared and persisted at 60 Gy
      were 48% (11/23) and 29% (6/21), respectively (p > 0.30). Evaluation of tumor
      response at 40 Gy was an important indicator of local control for N0 oropharynx
      carcinoma.

PMID- 8356507
TI  - High-dose-rate remote afterloading intestinal radiotherapy employing the template
      technique for recurrent cancer in the pelvic area.
AB  - Between December 1991 and August 1992, five patients with recurrent cancer in the
      pelvic area (four gynecological cancers and one rectal cancer) were treated at
      Osaka University Hospital with a remote afterloading interstitial implantation
      employing the template technique. External irradiation (40 to 50 Gy) was
      performed in four cases one to four weeks before brachytherapy. Interstitial high
      dose-rate brachytherapy (24 to 40 Gy/four to eight fractions/two to four days)
      was performed twice a day. Three of the five patients achieved complete local
      tumor control. The remaining two patients obtained symptom relief. There were no
      complications serious enough to need surgical treatment. Moreover, this procedure
      is well tolerated and therefore an effective modality for elderly and frail
      patients.

PMID- 8356508
TI  - A method for improving the output dose rate protocols for cobalt machines.
AB  - A method of correcting the output dose rate of the radiotherapeutic cobald units
      is presented. This method links measurements values with the decay formula for
      increasing the accuracy of output dose rate determining. The least squares method
      has been applied to mathematical processing of the data. Results were discussed
      on the record of output dose rate which had been measured since 1969.

PMID- 8356509
TI  - CT assisted computation of collimator angle and importance of off-axis planning
      of inclined lesions.
AB  - In the radiation treatment of inclined lesions the longitudinal axis of beam
      should be always parallel to the longitudinal axis of lesion in the treatment
      plane. Hence the choice of correct collimator angle is of prime importance in the
      oblique field off-axis treatment planning of inclined lesions. In this paper a
      graphical method is discussed to determine the collimator angles from the CT
      scans taken at different off-axis planes. A phantom was constructed which can
      simulate conditions like inclined lesion in the patient and CT scans were taken
      at different levels. The collimator angles estimated from CT scans are found to
      match with the collimator angles obtained from simulator within +/- 1 degree for
      various gantry angles. The method is applied to plan a case of cancer of the
      oesophagus (upper third), which is a typical example of inclined lesion.

PMID- 8356510
TI  - [Electron microscopic studies of the effect of x-rays and L-3,4
      dihydroxyphenylalanine (L-Dopa)--alone and in combination-- on Harding-Passey
      melanoma cells in monolayer cell culture].
AB  - Monolayer cultures of Harding-Passey melanoma cells in exponential growth phase
      were exposed to 8 or 16 Gy by X-ray treatment. The 8 Gy treated cells revealed
      little ultrastructural changes, while the 16 Gy exposed cells showed increased
      damage as segregates, swollen mitochondria and vacuoles. Sole treatment with L
      3,4-dihydroxyphenylalanine (2 x 10(-4) M L-Dopa) resulted in insignificant
      electronmicroscopically tangible cell alterations. Combined treatment--starting
      with 8 Gy irradiation followed by a six-day incubation in the presence of 2 x 10(
      4) M L-Dopa--revealed more pronounced cell damage with final cell disintegration;
      the cytoplasm contained an increased number of vacuoles and segregates, a
      strongly decreased endoplasmic reticulum as well as swollen mitochondria and less
      pinocytosis vesicles; the cell surface showed less microvilli. Melanin containing
      organelles increased after the combination treatment. The growth inhibitory and
      cell destructive influence of L-Dopa on X-ray pretreated melanogenic melanoma
      cells was explained with the formation of cytotoxic oxidation products of L-Dopa.

PMID- 8356511
TI  - Individualization of hernia repair: a new era.

PMID- 8356512
TI  - Liver transplant in complete situs inversus: a case report.
AB  - BACKGROUND: Several technical solutions have been proposed for patients with
      situs inversus (SI) needing liver transplantation. This report describes the
      hepatic replacement in a patient with complete SI with dextrocardia. In the only
      other reported patient with complete SI the donor right lobe was placed over the
      vertebral column and the stomach to align the donor cava with that of the
      recipient. METHODS: A 45-year-old woman with complete SI, suffering from
      Laennec's cirrhosis with frequent upper gastrointestinal hemorrhages, underwent
      transplantation in June 1991. The recipient weighed 48.2 kilograms and was 155
      centimeters tall. The donor weighed 77.3 kilograms and was 188 centimeters tall.
      The weight of the native liver was 1934 grams, and the donor liver weighed 1595
      grams. RESULTS: At hepatectomy of the native liver an intact vena cava was left
      behind. Donor liver was rotated 90 degrees to the left, making the donor left
      lobe point into the left iliac fossa and the donor right lobe fall into the
      recipient hepatic fossa. Donor infrahepatic vena cava was sewn end-to-side to the
      recipient vena cava. Suprahepatic vena cava was oversewn. Donor and recipient
      hila were well aligned, allowing a standard arterial reconstruction and a
      choledocholedochostomy. Patient's recovery was uneventful with no problems during
      the following 6 months. CONCLUSIONS: The proposed technique for a patient with
      complete SI and dextrocardia offers several advantages: no need to downsize the
      donor in comparison with the recipient; no need for cutdown of the liver; no risk
      of kinking of the venous outflow; hepatic hila are aligned; and it allows for a
      standard arterial and biliary reconstruction. We recommend this technique as a
      procedure of choice for patients with SI and an intact vena cava.

PMID- 8356513
TI  - Metachronous bilateral nonfunctional intercarotid paraganglioma (carotid body
      tumor) and functional retroperitoneal paraganglioma: report of a case and review
      of the literature.
AB  - BACKGROUND: The occurrence of an intercarotid paraganglioma and a paraganglioma
      in an anatomic distribution away from the head and neck in the same patient is
      rare. We have treated a patient with this combination of tumors and report this
      unusual case with the purpose of reviewing the paraganglion system. We endeavor
      to clarify the confusion that exists by use of the terms chemodectoma, glomus
      tumors, nonchromaffin paragangliomas, and pheochromocytoma and to present a
      rational nomenclature based on their ontogeny. METHODS: A computer-generated list
      of articles on this subject was obtained, and all articles relative to this rare
      combination of tumors were reviewed. RESULTS: We found 31 other cases. Functional
      intercarotid paragangliomas are extremely rare, with only five cases having been
      reported. CONCLUSIONS: All hypertensive patients who are found to have an
      intercarotid paraganglioma should be investigated for a functional tumor. Family
      members should also be made aware of their probabilities of having these tumors
      because a familial trend has been documented in certain cases.

PMID- 8356514
TI  - Closure of complex abdominal wall defects with bilateral rectus femoris flaps
      with fascial extensions.
AB  - Large full-thickness abdominal wall defects present a difficult reconstructive
      problem. Synthetic mesh has significant drawbacks and should be used only as a
      temporizing measure. Ideally abdominal wall defects should be resurfaced with
      well-vascularized autologous fascia and skin. A variety of myofascial,
      myocutaneous, and myofasciocutaneous flaps have been described. This report
      describes two cases of near-total abdominal wall reconstruction using bilateral
      rectus femoris myocutaneous flaps with fasciocutaneous extensions of superficial
      thigh fascia and skin. In both cases the rectus femoris flaps and fascial
      extensions healed, and the patients went on to full recovery. In one patient the
      skin over the fascial extension did not survive and had to be debrided and the
      underlying vascularized fascia resurfaced with a skin graft. The extended rectus
      femoris flap is a reliable and versatile flap that leaves negligible functional
      deficits. The fascial extensions are reliable and well perfused and should be
      included in the reconstruction of larger abdominal wall defects. The skin
      overlying the fascial extensions is less reliable, and selective use is
      recommended.

PMID- 8356515
TI  - Reflex sympathetic dystrophy after modified radical mastectomy: a case report.
AB  - Despite the long history of descriptions of reflex sympathetic dystrophy (RSD),
      much confusion remains regarding its pathogenesis, diagnosis, and treatment. It
      most commonly occurs after trauma and is more frequent in women, white persons,
      and the elderly. The first case of RSD after mastectomy is reported and the
      proposed pathophysiology and management of RSD are reviewed.

PMID- 8356517
TI  - Primary adenocarcinoma arising in an ileostomy.
AB  - Two cases are added to the world literature of patients in whom an adenocarcinoma
      developed at the ileostomy site after total proctocolectomy for ulcerative
      colitis. Fourteen additional cases have been reported in the world literature; of
      these, 12 cases have been in patients with ulcerative colitis, and four cases
      have been in patients with familial adenomatous polyposis. Adenocarcinoma of an
      ileostomy is not common. However, in the analysis of the reported cases, patients
      with long-standing ileostomies appear to be at a greater risk. With an aging
      ileostomy population, an increase in the number of cases may be seen. Three
      hypotheses are discussed as potential causative pathways to this entity.
      Continued analysis of these cases may yield information on the pathophysiology
      involved.

PMID- 8356516
TI  - Implant metastasis of gallbladder carcinoma in situ in a cholecystectomy scar: a
      case report.
AB  - A subcutaneous mass within the scar left by cholecystectomy with common bile duct
      exploration and T-tube drainage developed 6 years after surgery. Pathologic
      examination of this mass showed features of atypical villous hyperplasia, similar
      to that identified within the previously removed gallbladder, but with additional
      foci of carcinoma in situ. Since excision of the mass, the patient has had
      persistent fluid collections requiring frequent aspiration. Cytologic analysis of
      the fluid has revealed tumor cells. The cause of this spread has been unclear.
      Few literature reports have identified biliary drainage techniques as a source
      for metastatic seeding. The malignant or metastatic potential of severe dysplasia
      or carcinoma in situ of the gallbladder associated with T-tube drainage and
      implantation in the drainage tract is previously unreported.

PMID- 8356518
TI  - Long bone fractures and pulmonary dysfunction.

PMID- 8356519
TI  - Basis for beneficial effects of partial portal decompression.

PMID- 8356520
TI  - Laparoscopic cholecystectomy in neoplasms of the gallbladder.

PMID- 8356521
TI  - Laparoscopic surgery and tumor seeding.

PMID- 8356522
TI  - "Tension-free" inguinal herniorrhaphy: a preliminary report on the "mesh plug"
      technique.
AB  - BACKGROUND: Since 1984 we have completed 3897 inguinal herniorrhaphies. This
      article compares our results with a conventional Cooper ligament repair versus
      the "mesh hernia plug" method. METHODS: From 1984 through 1988 we performed 2886
      conventional Cooper ligament repairs. From 1989 through 1991 we completed 1011
      mesh hernia plug repairs. RESULTS: Despite an acceptable recurrence rate (1.8%),
      we abandoned the Cooper ligament technique because of persistent difficulties
      with immediate postoperative pain, inability to reasonably resume day-to-day
      activities, delayed capacity regarding return to work, and four cases of femoral
      vein compression. Of the hernias repaired by the mesh plug method, the recurrence
      rate remains remarkably low (0.2%), and except for four superficial infections
      and three cases of urinary retention, no other significant complications have
      been reported. CONCLUSIONS: Compared with conventional sutured surgical
      techniques, a plug repair uses less overall dissection and ensures a "tension
      free" hernioplasty. We believe that the two factors of no tissue tension and
      decreased dissection are the most important reasons for greater patient comfort,
      rapid rehabilitation, decreased recurrence, and lessened overall complication
      rates with the mesh hernia plug technique.

PMID- 8356523
TI  - Ruptured abdominal aortic aneurysms: predictors for early complications and
      death.
AB  - BACKGROUND: Urgent operation for ruptured aneurysm is still associated with a
      high operative mortality rate. The purpose of the study was to determine the risk
      factors that truly influence early complications and death. METHODS: Between 1979
      and 1991, 314 consecutive patients with a mean age of 69 years were treated
      surgically for a ruptured infrarenal abdominal aortic aneurysm. Twenty-two
      preoperative, perioperative, and intraoperative variables were subjected to a
      multivariate analysis to identify the independent predictors. RESULTS: Early
      death occurred in 92 (29%) of 340 patients. Significant primary predictors for
      early death were duration of cross-clamp (p < 0.0001), preoperative shock (p =
      0.0005), suprarenal cross clamp (p = 0.002), and a history of coronary artery
      disease (CAD) (p = 0.004). The following postoperative complications were risk
      factors for death: myocardial failure (p < 0.0001), renal failure (p < 0.0001),
      sepsis (p = 0.01), and colon ischemia (p = 0.03). Predictors for postoperative
      myocardial insufficiency were a history of CAD (p < 0.0001), amount of
      intraoperative volume substitution (p < 0.0001), suprarenal cross clamp (p =
      0.0007), and preoperative shock (p = 0.05). CONCLUSIONS: Preoperative and
      perioperative risk factors that result in fatal postoperative complications can
      be partially influenced by the surgeon. Short clamping time and infrarenal
      position of aortic clamp may lower overall early mortality rates. A history of
      CAD is a highly significant predictor for postoperative complications and early
      death.

PMID- 8356524
TI  - Effects of prostacyclin on spinal cord ischemia: an experimental study.
AB  - BACKGROUND: Paraplegia after thoracic aortic aneurysm has an incidence of 2.2% to
      24%. This study was planned to show the beneficial effects of prostacyclin on
      spinal cord ischemia. METHODS: Twelve rabbits underwent 30 minutes of aortic
      occlusion. Six rabbits received prostacyclin, whereas the remaining rabbits did
      not. Prostacyclin administration was started with a rate of 5 ng/kg/min 5 minutes
      before aortic occlusion. This dosage was increased to 25 ng/kg/min during aortic
      occlusion. Prostacyclin administration after aortic occlusion was maintained for
      a period of 5 minutes. During this period, prostacyclin dosage was 5 ng/kg/min.
      RESULTS: One rabbit in the prostacyclin group and five rabbits in the control
      group were paraplegic. Arterial pressure proximal to the clamp was 65 +/- 7 mm Hg
      before aortic occlusion and 78 +/- 10 mm Hg during aortic occlusion in the
      control group and 68 +/- 12 mm Hg before aortic occlusion and 65 +/- 6 mm Hg
      during aortic occlusion in the prostacyclin group. Arterial pressure distal to
      the clamp was 11 +/- 4 mm Hg during aortic occlusion in the control group and 18
      +/- 5 mm Hg during aortic occlusion in the prostacyclin group (p = 0.02).
      CONCLUSIONS: Intravenous prostacyclin reduced the neurologic injury caused by
      spinal cord ischemia and reperfusion after 30 minutes of aortic occlusion in the
      rabbit model.

PMID- 8356525
TI  - Extracorporeal venovenous recirculation for the treatment of hypothermia during
      elective aortic surgery: a phase I study.
AB  - BACKGROUND: Hypothermia caused by massive transfusion or prolonged exposure
      during operation is difficult to reverse and is associated with adverse side
      effects. This prospective, randomized study evaluated a technique using
      extracorporeal venovenous recirculation (EVR) through a roller pump-driven device
      with a commercial countercurrent heat exchanger used for treatment of hypothermia
      (temperature < 35.5 degrees C) occurring during elective aortic operation.
      METHODS: Patients undergoing aortic operation had routine prophylaxis against
      hypothermia including ventilator cascades, warming blankets, and low-velocity
      fluid warmers. When core temperature was less than 35.5 degrees C, patients were
      randomized to continue existing therapy (control, n = 7) or EVR (n = 8),
      performed through two large-bore venous lines. RESULTS: There were no differences
      in age, sex, weight, body surface area, Acute Physiology and Chronic Health
      Evaluation II score, fluid replacement, length of operation, blood lost or given,
      induction temperature, red blood cell or platelet structure, hemolysis, length of
      intensive care unit or hospital stay, complications, or mortality rates. EVR was
      associated with increased final core temperature (35.5 degrees +/- 0.8 degrees
      [EVR] vs 33.8 degrees +/- 0.9 degrees [control]; p < 0.005) and body heat content
      (-13.9 +/- 62.3 kcal [EVR] vs -118.2 +/- 62.2 kcal [control]; p < 0.01), with
      heat gained being proportional to flow rate. CONCLUSIONS: These data show that
      EVR provides a safe and effective method for the treatment of hypothermia.

PMID- 8356526
TI  - Contralateral disease progression after carotid endarterectomy.
AB  - BACKGROUND: We report the natural history of the carotid artery contralateral to
      the ipsilateral endarterectomized carotid artery. METHODS: The incidence of new
      symptoms and disease progression of the patient contralateral side after
      unilateral carotid endarterectomy (CE) was studied by clinical follow-up and
      serial duplex scanning in 127 patients. RESULTS: During a mean follow-up of 44
      months, new hemispheric events occurred in nine (7%) and significant progression
      was recorded in 27 (21%) patients. In 97 patients with initial stenosis of less
      than 50% (group I), contralateral progression to greater than 50% was noted in
      22% and new symptoms (one transient ischemic attack and one cerebrovascular
      accident) in 2% of patients; three patients underwent CE. In 30 patients with
      initial stenosis between 50% and 99% (group II), new symptoms (all transient
      ischemic attacks) occurred in seven (23%) (group II vs group I; p < 0.003) and
      nine underwent CE (group II vs group I; p < 0.001). Progression in 26 patients
      with 50% to 79% stenosis within group II to greater than 80% was noted in 19% of
      patients (difference not significant compared with group I). CONCLUSIONS:
      Overall, new symptoms occurred in 7% and significant contralateral disease
      progression in 21% of patients; subsequent CE was performed in 9.4% of patients.
      Initial presence of greater than 50% contralateral stenosis is a predictor of
      future hemispheric symptoms, which are likely to be transient ischemic attacks.
      New symptoms did not necessarily correlate with disease progression. Because
      disease progression was observed in patients with varying degrees of initial
      contralateral stenosis, serial clinical and duplex scanning in all patients
      undergoing unilateral CE is recommended.

PMID- 8356527
TI  - Personal experience of right anterior segmentectomy (segments V and VIII) for
      hepatic malignancies.
AB  - BACKGROUND: Right anterior segmentectomy is the most difficult type of hepatic
      resection to perform and is reported only rarely. For patients with tumors
      limited to the anterior segment but complicated by mild liver dysfunction, this
      is the only type of hepatectomy that can be tolerated. This article described
      personal experience with this operation in 17 patients with liver malignancies.
      METHODS: Fourteen patients had hepatocellular carcinoma, one had
      cholangiocellular carcinoma, and two had metastases, one from rectal and the
      other from gastric carcinoma. Except in one case of dense adhesion of the
      hepatoduodenal ligament, hemihepatic vascular occlusion was used. Both the right
      and middle hepatic veins were fully exposed in 14 patients. RESULTS: The average
      operation time was 412 minutes and the average blood loss was 1482 ml. There was
      one operative death as a result of pneumonia and liver failure. Another patient
      had prolonged bile leakage with right pleural effusion and bleeding gastric
      erosions. The cumulative 1- and 5-year survival rates were 88% and 47%,
      respectively. CONCLUSIONS: The results of this experience indicate that in
      selected patients with hepatic malignancies this procedure is safe and compatible
      with improved survival. This may be the first report to describe the clinical
      features and operative technique in a series of patients treated by right
      anterior segmentectomy.

PMID- 8356528
TI  - Significance of hepatic vein reconstruction in hepatectomy.
AB  - BACKGROUND: To preserve remnant liver function, hepatectomy combined with hepatic
      vein (HV) reconstruction was performed in resection of the tumor located at the
      confluence of the HV and inferior vena cava. METHODS: Eight patients underwent HV
      reconstruction: the right HV in three, the middle HV in four, and the left HV in
      one. An external iliac vein graft was used in two patients, a superficial femoral
      vein graft in three, and a long saphenous vein graft in one. In one patient a
      patch graft was applied to the right HV; another patient underwent end-to-end
      anastomosis of the right HV without grafting. RESULTS: There were no operative
      deaths and liver function was adequate throughout the postoperative period.
      Complications included two cases of minor biliary fistula. The middle HV with a
      saphenous graft and the left HV with an external iliac graft became occluded
      because of size mismatch at the anastomosis. Six veins were patent at 1 month and
      three were still patent after 30 months. CONCLUSIONS: To prevent graft occlusion,
      it is important to select an autologous vein of optimal size and avoid
      inflammation of the liver stump. HV reconstruction appears to be a new surgical
      option for patients undergoing hepatectomy.

PMID- 8356529
TI  - Cystic enlargement of extrahepatic bile ducts.
AB  - BACKGROUND: Cystic enlargement of the extrahepatic bile duct system is a rare
      abnormal finding. A congenital origin is usually supposed; however, the
      pathogenesis is unknown. We report on our experience with extrahepatic bile duct
      cysts with special regard to cause, treatment, and recurrent disease. METHODS:
      From 1976 to 1991, 13 patients, 35 to 74 years of age, were treated for
      extrahepatic bile duct cysts. Seven patients had previously undergone
      cholecystectomy. Two patients were admitted because of recurrent disease; neither
      had undergone curative resection. RESULTS: In 11 patients a biliojejunal
      anastomosis with a Roux-en-Y was created after cyst resection; one patient
      underwent a diverticular stalk resection with end-to-end anastomosis of the
      choledochal duct. After a mean follow-up of 68 months eight of 10 patients were
      alive, two of whom complained about cholangitis. Recurrent diffuse dilatation of
      the remaining choledochus developed in one patient; one other patient died of
      cholangiocellular carcinoma 2 years after operation. CONCLUSIONS: In patients who
      had undergone previous cholecystectomy or with recurrent disease an acquired
      malformation cannot be excluded. Surgical treatment is always indicated because
      of imminent complications and should aim at complete resection of cystic tissue.
      Periodic postoperative evaluation is necessary to detect recurrent disease and
      malignant transformation.

PMID- 8356530
TI  - Preoperative chemotherapy and radiotherapy for cancer of the esophagus.
AB  - BACKGROUND: We wished to determine the role and significance of preoperative
      chemotherapy and radiotherapy in management of operable cancer of the esophagus.
      METHODS: Twenty-two patients with clinical stage I-II cancer of the esophagus
      were entered in a prospective study of preoperative chemotherapy (5
      fluorouracil/cisplatin) and radiotherapy (3405 cGy) administered concomitantly
      during 21 days followed by restaging and total esophagectomy. RESULTS: Five
      patients did not complete the protocol (three had toxicity, one refused surgery,
      and one had interim distant metastasis). Seventeen patients underwent total
      esophagectomy with cervical anastomosis. Two postoperative deaths resulted from
      sepsis. Thirteen (76%) of 17 patients were considered to have complete clinical
      response (esophagoscopy and computed axial tomographic scanning) before surgery,
      but only 5 (29%) of 17 were free of cancer. The median survival was 18 months
      (median follow-up 57 months). No difference in survival was seen between complete
      and partial pathologic response. CONCLUSIONS: (1) Preoperative chemotherapy and
      radiotherapy did not result in increased survival compared with historic controls
      (surgery alone). (2) Preoperative chemotherapy and radiotherapy clinical staging
      overestimates the incidence of complete tumor response. (3) Combination
      chemotherapy is well tolerated, but until newly developed drugs show their
      efficacy for treatment, surgery should continue to be the major modality for
      local control and an integral part of clinical investigational trials.

PMID- 8356531
TI  - Postoperative mental confusion--association with postoperative hypoxemia.
AB  - BACKGROUND: Postoperative confusion is a well-known complication, but the
      pathogenetic mechanisms, of which hypoxemia may be one, are not completely
      understood. METHODS: Thirty otherwise healthy patients undergoing major abdominal
      surgery and ten patients undergoing middle ear minor surgery, all under general
      anesthesia, were monitored for oxygen saturation (SpO2) with a pulse oximeter on
      a preoperative night and on the second night after operation (11:00 PM to 7:00
      AM). All patients were tested with a mental test questionnaire (the Hodkinson
      modification of the original Roth-Hopkins test) before operation and on the third
      and seventh day after operation. RESULTS: Postoperative hypoxemia did not develop
      in patients undergoing minor surgery, whereas major surgery was associated with
      severe constant and episodic hypoxemia on the second postoperative night (p <
      0.05). The patients undergoing major surgery had decreased mental function on the
      third day (p < 0.05) but not on the seventh day after operation, whereas minor
      surgery did not impair mental function. There was a significant correlation
      between mental function on the third day after operation and mean SpO2 on the
      second postoperative night after major surgery (rs = 0.53, p < 0.005) and minor
      surgery (rs = 0.74, p < 0.03). After major surgery there was also a correlation
      between decrease (preoperative to postoperative) in mental function on the third
      postoperative day and mean SpO2 on the second postoperative night (rs = -0.40, p
      < 0.04). During stepwise multiple regression analysis in patients undergoing
      major surgery, a significant relationship was found between postoperative mental
      test score and SpO2 (p < 0.05) but not between mental function and other
      perioperative variables (age, premedication dose, duration of operation, and
      intraoperative and postoperative opioid dose). CONCLUSIONS: These results suggest
      postoperative hypoxemia to be an important pathogenetic factor in postoperative
      mental dysfunction.

PMID- 8356532
TI  - Perioperative immune modulation.
AB  - BACKGROUND: The effects of operative trauma on systemic immunity were studied.
      The relative effects of skin incision and of breaching the peritoneum were
      determined. In addition, the role of the antiendotoxic agent taurolidine in
      preventing postoperative immune suppression was assessed. METHODS: Systemic
      immune responsiveness was measured as the delayed-type hypersensitivity (DTH)
      response to 2-4 dinitro l-fluorobenzene (DNFB) with an in vivo rat model. The
      effect of both laparotomy and taurolidine on the hepatic Kupffer cell population
      was determined by immunohistochemistry. RESULTS: This study confirmed that
      cellular immunity is significantly depressed after laparotomy (15.5%; range, 2.5%
      24.0%) compared with unoperated controls (26.77%; range, 9.2%-38.0%). Opening the
      peritoneum appeared to be a critical factor in inducing this immunosuppression,
      in which animals undergoing a similar midline incision without opening of the
      peritoneum displayed minimal alteration in their DTH response (20.5%; range,
      0.85%-41.5%). In addition, intraperitoneal administration of taurolidine in the
      perioperative period prevented this decrease in postoperative DTH response.
      Kupffer cell numbers were increased after intraperitoneal administration of
      taurolidine, compared with animals treated with intraperitoneal saline solution
      or unoperated controls. CONCLUSIONS: These findings confirm the presence of an
      operatively induced decrease in immune responsiveness and suggest that entering
      the peritoneum is an important factor in the induction of this effect. In
      addition, administration of taurolidine acts to prevent the impact of laparotomy
      on DTH response, possibly by preventing perioperative portal endotoxemia.

PMID- 8356533
TI  - Complex iliac arterial trauma: autologous or prosthetic vascular repair?
AB  - The methods for vascular reconstruction of iliac arterial trauma can be a
      challenging problem. Primary arterial repair is usually possible, but an
      extensive injury may require interposition grafting or extra-anatomic bypass.
      Some investigators have advocated prosthetic grafting as a reasonable method of
      repair for complex iliac arterial injuries. We challenge this concept and
      describe our experience with the exclusive use of autogenous vascular repair
      during involvement with 87 consecutive patients surviving iliac arterial trauma.

PMID- 8356534
TI  - Our technique of parathyroid autotransplantation in operation for papillary
      thyroid carcinoma.
AB  - BACKGROUND: For papillary thyroid carcinoma, we have used our standard operative
      method consisting of total thyroidectomy, bilateral lymph node dissection, and
      parathyroid autotransplantation. Our special parathyroid transplantation method
      involves transplantation of the minced glands into the pectoralis major muscle.
      We investigated whether this method is useful for preserving parathyroid
      function. METHODS: In 17 patients who underwent our standard operation for
      papillary thyroid carcinoma, the intact parathyroid hormone (PTH) and serum
      calcium levels were determined for 4 weeks after the operation. RESULTS: In all
      cases the intact PTH levels fell below detectable limits immediately after
      operation and then recovered to the preoperative level about 2 weeks after the
      operation. The same recovery patterns were observed in two groups undergoing
      transplantation of two glands and three or four glands. CONCLUSIONS: These
      recovery patterns of intact PTH levels seem to indicate that the glands were
      grafted successfully and recovered their function. Our method is thought to be
      useful for preserving parathyroid function after surgery.

PMID- 8356535
TI  - Preimplant radiographic assessment of available maxillary bone support.
      Comparison of tomographic and panoramic technique.
AB  - For maxillary implants it is essential that presurgical radiographic examination
      provides reliable assessment of the available bone support. Radiographic
      confirmation of the inclination of the alveolar crest is also necessary, to
      select optimum sites for insertion of implants. When preimplant radiographic
      assessment is based solely on a panoramic radiograph, only the bone height can be
      assessed and not the available bone volume or the inclination of the alveolar
      crest. Tomographic examination techniques allow for assessment not only of
      available bone height and volume but also of the inclination of the crest. In the
      present work tomographic and panoramic examinations of two cases are compared.
      The radiographic appearance of different alveolar crest forms is discussed. For
      preimplant assessment of the maxilla, tomography is the method of choice.

PMID- 8356536
TI  - Dental health in suburban Jordanian preschool children.
AB  - There is no previous report from Jordan on dental health in preschool children.
      In the present study, carried out from November 1988 to January 1989, 255
      Jordanian children aged 6 months to 6 years and living in a suburb of Amman were
      examined for dental caries and related factors. The disease was clinically
      visible in the second year of life. In the age group 3-6 years 72% had acquired
      caries, most of them severe. Boys and girls were affected similarly. The
      prevalence of caries was independent of social background factors. The reason for
      the high prevalence was probably early and uncontrolled intake of sweets combined
      with absence of dental cleaning. The authors pose that dental caries is becoming
      a major health problem among suburban Jordanian children and propose that this
      preventable disease should be tackled a the child health centers through teaching
      programmes directed to parents, commencing when the child is under one year of
      age.

PMID- 8356537
TI  - Development of periapical lesions.
AB  - The purpose of the present study was to follow the development of periapical
      lesions both radiographically and histologically in infected teeth with open and
      sealed root canals. The mandibular premolars from five adult monkeys were used in
      the experiment. Sealed infected teeth developed radiographic signs of periapical
      pathosis significantly earlier than unsealed teeth. Although, histological signs
      of pathology could be seen periapically at earlier observation periods, sealed
      teeth consistently developed these changes earlier than unsealed teeth.
      Furthermore, the histological periapical pathology differed somewhat between the
      two groups in that unsealed teeth showed a multi-focal diffuse pattern of
      spreading.

PMID- 8356539
TI  - [Review of a technic for the estimation of area under the concentration curve in
      pharmacokinetic analysis].
AB  - The determination of the area under concentration-time curve (AUC) is the most
      important parameter of a non-compartmental pharmacokinetic analysis. The
      calculation of AUC is usually performed by the trapezoidal rule. The aim of this
      work is to examine the reliability of this method still considered as a
      reference. The trapezoidal rule was compared to a selection of calculation
      methods often owning to other fields of research i.e., rectangular rule, Simpson
      and Tchebychev rules and log trapezoidal rule. The specific interest and limits
      of each method were discussed according to the kind and the type of
      pharmacokinetic profiles i.e., logarithmic or nonlogarithmic and the number of
      concentration-time couples. We obtained the following results: 1) The rectangular
      rule is the most simple and less effective method. 2) The trapezoidal rule
      remains an interesting method particularly when the profile is monologarithmic or
      nonlogarithmic. The efficacy of this method increases with the number of points
      of the pharmacokinetic profile. 3) The Simpson and the Tchebychev rules give very
      good results particularly when the number of points is higher than 7 and 6
      respectively. 4) The log trapezoidal rule is an excellent method for the
      treatment of a logarithmic profile. 5) Both Tchebychev and log trapezoidal rules
      give accurate results when compared to the true AUC values. Further, it must be
      pointed out that this determination is depending on an arbitrary choice of
      points. Finally, the trapezoidal rule is not always the best method to determine
      AUC. If the analyst has only a pocket-calculator, he will obtain best results
      with the Simpson method than with the trapezoidal rule.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8356538
TI  - Local inflammatory reactions in juvenile and adult rats.
AB  - The present investigation was designed for the study of the early phases of local
      inflammatory reactions in juvenile and adult rats. A recently developed
      experimental model, based on continuous diffusion of an inflammation inducing
      agent, was applied. Thirty-five juvenile (6 weeks) and thirty-five adult (6
      months) rats were used. Two sterile teflon tables were implanted subcutaneously
      on the back of each animal on each side of the midline. After three weeks, when a
      connective tissue capsula had developed, the tablets were replaced by one test
      tablet (containing lipopolysaccharide) and one fresh teflon tablet, respectively.
      In each group five animals were sacrificed on day 0 and fifteen animals on each
      of day 7 and 21. Biopsies comprising tablet and surrounding tissue were taken and
      exposed to routine histological treatment. The total number of cells was assessed
      in four defined areas in connection with each tablet. Cells classified as
      leukocytes were recorded separately. The analysis was performed at 1000x
      magnification in a light microscope. During the first seven days an increase in
      the number of leukocytes was seen in the tissue adjacent to the test tablets in
      both young and adult rats. After 21 days the number of leukocytes was still high
      in the adult group while in the juvenile group the number of leukocytes returned
      to the base-line level.

PMID- 8356540
TI  - [Review and use of decision rules for bioequivalence trials].
AB  - To declare bioequivalent two different formulations of one active drug,
      bioavailability studies are conducted, usually based on area under the plasma
      concentration-time curves and peak concentrations. The decision follows a
      statistical basis with right statement of the hypotheses of bioequivalence that
      are described. This procedure allows to control the consumer risk of falsely
      accepting bioequivalence while minimizing the new formulation risk of erroneously
      rejecting bioequivalence. Six decision rules meeting these criteria are reviewed
      and compared with numerical data: classic confidence interval; symmetric
      confidence interval; Hauck-Anderson method; two one-sided tests procedure;
      bayesian method; non parametric confidence interval. The six rules all have very
      similar performance. However, the bayesian procedure which gives a probability of
      the location of the true relative bioavailability could likely complete the two
      one-sided tests procedure and/or the classic confidence interval method that are
      recommended in regulatory guidelines. Some other statistical points that have
      received different interpretation in the international regulations are finally
      evoked and discussed.

PMID- 8356541
TI  - Pharmacokinetics of acipimox and of its N-deoxy metabolite following single and
      repeated oral administration to healthy volunteers.
AB  - The aim of the present study was to evaluate the plasma pharmacokinetics of
      acipimox and of its N-deoxy metabolite (5-methylpyrazine-2-carboxylic acid, MPCA)
      following single and repeated administration of 250 mg acipimox (thrice daily,
      for 6 days) to ten healthy volunteers. Mean maximum concentration, the
      corresponding time, area under the curve extrapolated to infinity and elimination
      half-life values of acipimox after single administration were equal to 5.74
      micrograms/ml (range 2.56-8.38 micrograms/ml), 1.7 h (1-3 h), 16.99
      micrograms/ml.h (11.28-22.17 micrograms/ml.h) and 1.15 h (0.79-1.48 h),
      respectively. Mean area under the curve over one dosing interval (8 h) and
      elimination half-life values of acipimox after repeated dosing were not
      significantly different from the corresponding values after the single dose. No
      significant accumulation was observed following the repeated treatment, since the
      mean accumulation ratio was 1.08 (range 0.74-1.52). The mean maximum
      concentration and corresponding time values in the 7 out of 10 subjects with
      detectable metabolite levels after the single dose were 0.19 microgram/ml (0.10
      0.34 microgram/ml) and 6.7 h (3-12 h), respectively, whilst after the repeated
      treatment, detectable concentrations of the metabolite were observed in all
      subjects, the mean maximum concentration value being equal to 0.48 micrograms/ml
      (0.11-1.19 microgram/ml). The average ratio of the parent/metabolite area under
      the curve values (8 h) after repeated dosing was equal to 14 (range 2-56). Inter
      subject variability in the extent of metabolite formation was very high.

PMID- 8356543
TI  - [Zopiclone. Data of experimental pharmacology and clinical use].
AB  - Zopiclone is the first of the cyclopyrrolones, a new class of psychotropic agents
      which is chemically different from the benzodiazepines (BZD). From an
      experimental point of view it has qualitatively the pharmacological profile of
      the tranquilizer-hyponotics, and activity quantitatively differs from hypnotic
      BZD by its lower myorelaxant. The electroencephalographic studies also
      demonstrated that its power spectrum is characteristic of a product having a
      tranquilizing hypnotic potential. The cyclopyrrolones interact with GABA ergic
      neurotransmission, and have a high affinity for GABA receptor complex. They act
      on sites close to BZD sites, but physically different. The sleep polygraphic
      studies have shown that zopiclone has a specific profile. It respects the sleep
      architecture, specially the delta sleep which is even increased, in some studies.
      Its residual effects are absent or minimal, and its acceptability is good in the
      usual conditions of hypnotic prescription.

PMID- 8356542
TI  - [Pharmacokinetic and clinical evaluation of rectal hydrophilic gel of
      methohexital in pediatric surgery].
AB  - The purpose of the study was to develop and to test a new form of rectal systemic
      gel for methohexitone administration in children undergoing minor surgery.
      Pharmacokinetics of methohexitone were determined in children following
      intravenous or intrarectal administration either at low or therapeutic dosage.
      Anaesthesic efficacy of this gel was performed in 11 patients receiving a
      therapeutic dosage (25 mg/kg). Pharmacokinetics of methohexitone appears
      independent of both dosage and route of administration in children. The
      bioavailability of the rectal gel appears sufficient to provide efficient
      clinical plasmatic concentrations. As a consequence of the rapid and good
      resorption of methohexitone from rectal lumen and of the low variability of
      plasmatic concentrations, a rapid and reliable sedation was observed in all
      patients. The clinical anaesthesic efficacy of the rectal hydrophilic gel
      associated with the absence of an apparent local intolerance and important side
      effects, make this new form suitable for methohexitone administration in
      children.

PMID- 8356544
TI  - Medications exposure during pregnancy. A study in a university hospital.
AB  - To collect informations about drugs prescribed during pregnancy in France we
      carried out a retrospective survey from august to december 1989. This study was
      based on a questionnaire at delivery for 225 women. Socio-economic status,
      obstetrical past history and patterns of prescribing medications were studied.
      99.5% of the women were found to have used drugs during pregnancy with a mean of
      6.84 medications per woman. There was no influence of age, geographic origins,
      number of previous pregnancies on drug consumption; socio-professional status was
      also found to have a poor correlation with drug intake. Patterns of prescribing
      were compared to those of a previous French study made in 1976: changing pattern
      of prescribing were found for progestatives, corticoids, neurotropes, aspirin and
      beta adrenergic agents. We also pointed out that self-administered drugs
      decreased from 25.9 to 17.9%. This evaluation supports the need of further
      epidemiological studies in our country.

PMID- 8356545
TI  - [Possible exploitation of a pharmacovigilance center concerning the risk of
      teratogenesis].
AB  - Evaluating a teratogenic risk remains a difficult problem, since the existing
      data in this field is fragmentary. One can consider using the material obtained
      by the follow-up of pregnancies which have motivated a telephone consultation to
      an Information Center. The material could, within limits, be used to give some
      security. If the present numbers do not change, it would take around four years
      to obtain data concerning 150 women exposed during the first trimester of their
      pregnancy.

PMID- 8356546
TI  - [Collection of familial data in pharmacogenetics. Methodological problems].
AB  - The purpose of this paper is to show the problems with family data collection in
      a pharmacogenetic study, the aim of which was to study the genetic polymorphism
      of inducibility of cytochromes P4501A by polycyclic aromatic hydrocarbon (PAH).
      Data were collected from 76 smoker nuclear families (315 volunteers). A caffeine
      test, a blood sample and answers to a questionnaire were obtained from each
      healthy volunteer. It was a crucial problem to recruit nuclear families with
      healthy smoker father and/or mother and 2 smoker children. On 127 answers, 22
      families were not eligible, 27 refused and 10 had a single child, that meant
      secondary refusals. Problems differed with origin of the recruitment. Included
      were 40 families obtained from 3 antismoking outpatient departments, 29 from
      general practitioners but 6 only from students. The family rates with 2 parents/2
      children were significantly higher with general practitioners (p < 0.01). This
      emphasized their part in epidemiologic studies. Problems with the use of
      methodology were bound to acceptability of the tests which were better in females
      (p < 0.05), and a change in caffeine form could improve this acceptability.
      Lastly, difficulties with laboratories constraints required a very good
      coordination between families, nurses and laboratories.

PMID- 8356547
TI  - [Survey of the incidence of undesirable events in geriatric services].
AB  - In elderly with the risk of side effects of drugs is more important due to the
      age-related changes in organs and the drug interactions. It's why 26 gerontologic
      centers performed a multicentric survey about side effects (SE) incidence during
      a short period of 15 days. This survey was realised by REGATES (Network of
      Evaluation in Gerontology of Activity of Treatments and Side Effects). 2829
      patients were included (8% acute patients, 23% Geriatric medicine, 69% nursing
      home). 74 SE were noticed in 64 patients among 21 centers. There were 23 men and
      41 women with an average age 81.2 +/- 6.5 y. taking 5.7 +/- 1.6 drugs/per day.
      The main SE were neurological or cardiovascular (26% each). SE incidence is high
      with extrapolation 636 SE per year for 1000 geriatric patients. Considering the
      100,000 hospital beds for elderly, we may measure the lack of informations which
      don't reach the pharmacovigilance centers, in relation to the weak medical
      density.

PMID- 8356548
TI  - [Value of the study of the stability of diltiazem and its metabolites in blood
      samples].

PMID- 8356549
TI  - [Bupivacaine concentration in newborn infants after epidural maternal
      anesthesia].

PMID- 8356550
TI  - Troleandomycin hepatotoxicity: a case report of overt jaundice and a placebo
      controlled trial.

PMID- 8356551
TI  - [Ventricular arrhythmia during fluvoxamine poisoning].

PMID- 8356552
TI  - [Interaction between fluvoxamine and tricyclic antidepressants. Some precise
      details].

PMID- 8356553
TI  - [Accidents with antivitamin K. Advantages of benefits over risks].

PMID- 8356554
TI  - [Reversible cardiomyopathy induced by interferon].

PMID- 8356555
TI  - [Hepatic involvement associated with indapamide therapy].

PMID- 8356556
TI  - [Furosemide (Lasilix) can be used in patients with G6PD deficiency. Apropos of a
      case].

PMID- 8356557
TI  - [Myasthenia induced by thiopronine in rheumatoid polyarthritis].

PMID- 8356558
TI  - Changes in the prescription patterns for hypercholesterolaemia in Upper Normandy.

PMID- 8356559
TI  - [Value of the theory of the optimal sampling scheme for bioequivalence studies].
AB  - Use of optimal sampling theory (OST) in pharmacokinetic studies allows a large
      reduction of the number of sampling times without loss in parameter estimation
      precision. OST has been applied to the determination of bioavailability
      parameters [area under the curve (AUC), maximal concentration (Cmax), time to
      reach maximal concentration, (Tmax)]. Three different Monte-Carlo simulations in
      twelve subjects have been performed, corresponding to different pharmacokinetic
      models: one-compartment with or without a lag time, two-compartment.
      Bioavailability parameters were estimated using a non-compartmental method (with
      12 to 16 sampling times) and OST method (6 to 7 sampling times). Estimates were
      compared with true values. Bias and RMSE were similar with both methods for AUC
      and Cmax, while Tmax was better estimated using OST method. However, when a
      posteriori identifiability of the model was poor, use of a maximum a posteriori
      Bayesian estimator improved considerably the efficacy of OST method. Potential
      interest of OST for increasing statistical power of bioequivalence studies at the
      same cost is discussed, as well as possible limitations.

PMID- 8356560
TI  - Adjunctive treatment with corticosteroids for Pneumocystis carinii pneumonia in
      AIDS.

PMID- 8356561
TI  - Weight gain under oral testosterone undecanoate in AIDS.

PMID- 8356562
TI  - [Study of the transplacental transfer of interferon alfa-2a on the model of
      isolated perfused cotyledon].
AB  - Interferon can be used for VIH+ pregnant women, to decrease materno-fetal
      contamination. Added to maternal circulation, its behaviour was studied by human
      placental cotyledon ex vivo perfusion. Human recombinant IFN 2a and reference
      substance 3H2O were injected in intervillous chamber and their behaviours in
      venous fetal and maternal circulations was followed. At steady state, in fetal
      circulation 3H2O concentration was 37% of injected rate whereas no IFN transfer
      rate was observed. In both venous circulations IFN amounts were lower than
      injected ones 56% versus of 82% for water (p < 0.05). IFN didn't cross placental
      filter and disappeared partially during placental contact.

PMID- 8356564
TI  - Rodent tissue distribution of 2-cyanoethylene oxide, the epoxide metabolite of
      acrylonitrile.
AB  - The direct acting mutagen 2-cyanoethylene oxide (CEO), formed in the liver by
      oxidation of acrylonitrile (ACN), is thought to mediate the extrahepatic
      carcinogenic effects of ACN in rats. This study determined the tissue
      distribution of CEO (3 mg/kg p.o.) in F-344 rats and B6C3F1 mice. Radioactivity
      from [2,3-14C]CEO was widely distributed in the major organs of rodents by 2 h
      and decreased by 71% to 90% within 24 h, demonstrating that there was no
      preferential tissue uptake or retention of CEO. CEO was detected in rodent blood
      and brain 5-10 min after an oral dose of ACN (10 mg/kg), demonstrating that this
      mutagenic epoxide metabolite circulates to extrahepatic target organs following
      ACN administration.

PMID- 8356563
TI  - Toxicity evaluations of L-cysteine and Procysteine, a cysteine prodrug, given
      once intravenously to neonatal rats.
AB  - Decreased enzymatic production of cysteine in premature and newborn infants may
      limit the synthesis of glutathione. Unfortunately, cysteine supplementation is
      limited by associated toxicity and product instability. Procysteine (L-2
      oxothiazolidine-4-carboxylate) is a prodrug of cysteine that is inert until
      metabolized to cysteine intracellularly, thus stimulating glutathione synthesis.
      The potential toxicities of cysteine and Procysteine were compared in two studies
      with neonatal rats (10 per group; 3 +/- 1 days of age) after a single intravenous
      administration. In one study, acute high dosage survivorship was compared for
      approximately equimolar cysteine dosages of L-cysteine and Procysteine. Mortality
      at 7 days after single intravenous dosages of L-cysteine at 1.52 or 1.14 g/kg or
      Procysteine at 1.80 or 1.35 g/kg was 80, 50, 10 and 0%, respectively. Clinical
      pathology parameters and body and organ weights were compared in a second study,
      following a moderate dosage of Procysteine or equimolar or lower dosages of L
      cysteine. No differences were observed in clinical pathology parameters nor body
      or organ weights at 14 days following single intravenous dosages of L-cysteine at
      369, 185 or 37 mg/kg or Procysteine at 450 mg/kg. Also, Procysteine solutions
      were considerably more stable than L-cysteine solutions (months vs. hours,
      respectively). These studies indicated that cysteine supplementation in infants
      may be enhanced by Procysteine administration.

PMID- 8356565
TI  - Stimulation of protein kinase C by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in
      rat thymocytes.
AB  - Exposure of immature thymocytes to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) (10
      nM) transiently increased detergent extractable protein kinase C (PKC) activity.
      The increase was apparent at 7.5 min after exposure of cells to TCDD. At later
      time points, PKC activity returned to control values. Addition of TCDD to cytosol
      significantly increased phospholipid-stimulated PKC activity. Thus, stimulation
      of PKC activity may be one of the early events affected by TCDD.

PMID- 8356566
TI  - Subchronic toxicity study of methyl hesperidin in mice.
AB  - A subchronic toxicity study of methyl hesperidin was performed using B6C3F1 mice.
      The flavonoid was administered to groups of ten males and ten females in dietary
      levels of 0, 0.3, 0.6, 1.25, 2.5 and 5.0% for 13 weeks. No significant treatment
      related differences were found in data for body weights, food and water
      consumption, hematology, clinical chemistry and organ weights. Furthermore, no
      effects of treatment were observed on gross and histopathological examination of
      the major organs. The present experiment thus demonstrated that methyl hesperidin
      exerts no obvious toxic effects in mice of either sex when administered at a
      level as high as 5.0% in the diet.

PMID- 8356567
TI  - Maternal and developmental toxicity of manganese in the mouse.
AB  - Manganese (II) chloride tetrahydrate was investigated in Swiss mice for maternal
      and developmental toxicity after subcutaneous (s.c.) exposure to doses of 0, 2,
      4, 8 and 16 mg/kg per day from gestation day 6 through 15. Females were
      sacrificed on gestation day 18, and fetuses were examined for external, visceral,
      and skeletal abnormalities. Maternal toxicity included significant reductions in
      weight gain and food consumption at 8 and 16 mg/kg/day, as well as several
      treatment-related deaths in the high dose-group. There were no treatment-related
      effects on the number of total implants, early resorptions, dead fetuses or sex
      ratio, whereas a significant increase in the number of late resorptions was found
      in the 4, 8, and 16 mg/kg/day groups. Fetotoxicity, consisting primarily of
      reduced fetal body weight and an increased incidence of morphological defects was
      also observed at 8 and 16 mg/kg/day. There were no differences between control
      and manganese-treated groups in the incidence of individual or total
      malformations. The no observable adverse effect level (NOAEL) for maternal
      toxicity of MnCl2 x 4H(2)0 in mice was 4 mg/kg/day, while the NOAEL for
      embryo/fetal toxicity was 2 mg/kg/day.

PMID- 8356568
TI  - In vitro cytotoxicity of 1,4-naphthoquinone derivatives to replicating cells.
AB  - The acute cytotoxicities of a series of alkyl-1,4-naphthoquinones (NQ) and of 2
      hydroxy-3-alkyl-1,4-NQs, as well as some amino derivatives, were evaluated with
      the neutral red cytotoxicity assay, using BALB/c mouse 3T3 fibroblasts. As
      compared to the unsubstituted 1,4-NQ: (i) Substitution at the 2 position reduced
      toxicity, with the extent of reduction following the sequence, hydroxyl >>
      dimethylamino >> C1-C5 alkyl group. (ii) Substitution with C2-C5 alkyl groups at
      position 3 enhanced toxicity. As noted with the n-alkyl-1,4-NQs, increasing the
      chain length of the 2-hydroxy-3-alkyl-1,4-NQs did not appreciably change potency
      of the test agent. (iii) Substitution with amino groups at position 3 had little
      effect on cytotoxicity. Some differences in cytotoxicity of specific test agent
      were noted between the 3T3 fibroblasts and isolated rat hepatocytes, as reported
      in the literature.

PMID- 8356569
TI  - The mechanism of chloroform toxicity in isolated rat hepatocytes.
AB  - Chloroform (CHCl3) is widely used in the manufacture of drugs, cosmetics,
      plastics and cleaning agents. It is also found in chlorinated drinking water.
      This study was designed to investigate the toxic effect of CHCl3 on isolated male
      rat hepatocytes using several toxicity parameters. The hepatocytes were isolated
      by a collagenase perfusion technique and the cell viability was determined by
      Trypan blue exclusion. The leakage of cytosolic enzymes such as aspartate
      transaminase (AST) and alanine transaminase (ALT) after treatment with CHCl3 was
      measured. Reduced glutathione content (GSH) and its related enzymes, glutathione
      reductase (GSH-Rx) and glutathione peroxidase (GSH-Px), were also evaluated to
      study the effect of CHCl3 on hepatocytes. Exposure to 100 and 1000 ppm CHCl3
      results in a significant decrease in cell after 30 min incubation. However, the
      effect of 1 and 10 ppm concentrations was observed at 60 min incubation. AST
      leakage was significantly increased in all treatment groups, while ALT was
      significantly increased at 100 and 1000 ppm CHCl3 after 60 and 30 min,
      respectively. As early as 15 min, GSH was decreased significantly at 1000 ppm,
      but at 100 and 10 ppm CHCl3 the decrease in GSH began after 30 and 120 min,
      respectively. GSH-Px activity did not changed. However, the activity of GSH-Rx
      was significantly decreased at 1000 ppm CHCl3 and at the same time GSH content
      was decreased. The data indicate that the toxic effect of CHCl3 was dose- and
      time-dependent. The degree of GSH depletion correlated with increased
      cytotoxicity and decreased GSH-Rx activity due to CHCl3.

PMID- 8356570
TI  - The mechanism of methyl mercury toxicity in isolated rat hepatocytes.
AB  - Mercury is the major component of dental amalgam restorative material, which
      typically has 50% pure elemental mercury. It is also used in some skin creams,
      and in the manufacturing of plastic, drugs and fungicides. The present study was
      designed to investigate the toxicity of methyl mercury (MeHg+) on isolated rat
      hepatocytes using several toxicity parameters. The hepatocytes were isolated by a
      collagenase perfusion technique and were incubated with different concentrations
      of MeHg+ (0.1-100 ppm) for 2 h. Through the incubation period the viability was
      determined by Trypan blue exclusion. Reduced glutathione (GSH) content and its
      enzymes, glutathione peroxidase (GSH-PX) and glutathione reductase (GSH-RX) were
      measured. Leakage of enzymes such as aspartate transaminase (AST), and alanine
      transaminase (ALT) were determined. The cell viability was reduced significantly
      after 1 h incubation when 0.1 and 1 ppm MeHg+ were applied. The decrease in the
      cell viability was dose- and time-dependent. A depletion of GSH content was
      observed with 100 ppm MeHg+ after 30 min of incubation. A significant decrease in
      GSH-RX was observed with 100 ppm during 15 and 30 min of incubation, while 10 ppm
      of MeHg+ significantly increased ALT leakage after 60 min. However, there was a
      significant increase in AST leakage with 100 ppm only. The present investigation
      indicates that the toxic effect of MeHg+ is most likely cytosolic enzyme related.

PMID- 8356572
TI  - Transformation of estrone, estradiol, and estrone sulfate in uterine and vaginal
      isolated cells of fetal guinea pig. Effect of various antiestrogens in the
      conversion of estrone sulfate to estradiol.
AB  - The metabolism of physiological concentrations (5 x 10(-9) M) of [3H]estrone
      (E1), [3H]estradiol (E2), and [3H]estrone sulfate (E1S) was studied in isolated
      fetal uterine and vaginal cells of guinea pigs in culture. After 24 hours of
      incubation in both cells, a large percentage (40-60%) of E1 is converted to E2;
      however, after incubation of E2, most of the radioactive material (45-65%)
      corresponds to unchanged E2. Similarly, in the incubation medium the
      concentration of E2 is significantly higher related to E1 after incubation with
      E1 or E2. An intense sulfotransferase activity is found for both estrogens,
      whereas in the culture medium the respective sulfates represent 27-45% of the
      total radioactive material after incubation with the uterine cells and 15-24% for
      the vaginal cells. Using E1S, significant hydrolysis is observed in both cells
      and the analysis of the freed radioactive material indicated a high percentage in
      E2 (66% in the uterine cells and 71% in the vaginal cells). The conversion of E1S
      to E2 was strongly decreased by the antiestrogens: tamoxifen, 4-hydroxy
      tamoxifen, and ICI 164,384. The inhibitory effect in relation to the incubation
      with E1S only was 43-66% in the uterine cells and 50-85% in the vaginal cells.
      The present data suggest that estrogen sulfates can play an important biological
      role in the target tissues of the fetus, and that the enzymatic mechanisms of the
      bioavailability of E2 for the biological responses of the hormone can be operated
      in the target tissue itself.

PMID- 8356571
TI  - Tetrapropylammonium perruthenate as a mild and efficient oxidant for sensitive
      steroidal alcohols.
AB  - Tetrapropylammonium perruthenate N-methylmorpholine N-oxide oxidation of
      steroidal alcohols is described. The reagent combination is mild and gave good
      yields of the corresponding ketones. Although the oxidation can generate ketones
      from 3-, 11-, 15-, 17-, and 20-hydroxy steroids, the oxidation of homoallylic
      alcohols proceeds in low yields. Finally, we observed that the oxidation reagents
      will convert 17 alpha-hydroxy-20-keto steroids to 17-keto systems in excellent
      yield.

PMID- 8356573
TI  - Alteration in proliferative and endocrine responsiveness of human mammary
      carcinoma cells by prototypic tumor-suppressing agents.
AB  - The experiments performed in this study were designed to establish that (1)
      acquisition of anchorage-independent growth, a biological characteristic of
      tumorigenically transformed phenotype, can be modulated by prototypic tumor
      suppressing agents, and (2) modulation of growth is influenced by the metabolic
      competence of the cells to biotransform estradiol, MCF-7 human breast carcinoma
      cells exhibited linear cell proliferative kinetics with a 41-hour population
      doubling time, and a 15% colony-forming efficiency in 0.33% agar. Indole-3
      carbinol (13C), a naturally occurring tumor-suppressive agent; tamoxifen (TAM),
      an antiestrogenic agent; and 4-hydroxytamoxifen (4-OHTAM), a metabolite of TAM,
      demonstrated 73.7%, 72.5%, and 89.9% suppression in anchorage-independent growth
      of MCF-7 cells, respectively. At the metabolic level, 13C and 4-OHTAM induced 2.3
      fold (P < 0.0001) and 1.3-fold increase (P = 0.001) relative to their own
      controls in the extent of 2-hydroxylation of estradiol. The results indicate that
      growth inhibition by 13C, TAM, and 4-OHTAM may in part be due to altered
      estradiol metabolism in MCF-7 cells. Thus, anchorage-independent growth and
      altered biotransformation of estradiol may constitute useful cellular and
      endocrine markers to evaluate the biological response of chemosuppressive agents.

PMID- 8356574
TI  - Steroids 49. Investigations on the dehydration of 17 alpha-ethynyl-17 beta
      hydroxysteroids.
AB  - The acidic dehydration of 17 alpha-ethynyl-17 beta-hydroxysteroids (1-3) was
      investigated. On reaction with thionyl chloride, phosphorus oxychloride, and
      formic acid, the desired dehydration was accompanied by chlorination, Wagner
      Meerwein rearrangement, and D-homoaromatic rearrangement. The structure of the
      product from the transformation of 17 beta-hydroxypregn-20-yne derivative (3) on
      reaction with formic acid was misjudged. It was regarded as a pregn-16-en-20-yne
      (10) instead of the actually rearranged D-homoaromatic compound (11). As a
      consequence, physical data corresponding to this latter structure have been cited
      in the literature as those of pregn-16-en-20-yne derivative (10). This confusion
      prompted us to prepare compounds of both types (4, 9, 10, and 11), the
      characterization of which is here described.

PMID- 8356575
TI  - The ozonation of cholesterol: separation and identification of 2,4
      dinitrophenylhydrazine derivatization products of 3 beta-hydroxy-5-oxo-5,6
      secocholestan-6-al.
AB  - The ozonation products of cholesterol, which are of interest as possible
      biomarkers of O3 exposure, were studied by derivatization with 2,4
      dinitrophenylhydrazine (DNPH). The DNPH derivatization of 3 beta-hydroxy-5-oxo
      5,6-secocholestan-6-al (2) produces the expected trans (3b) and cis (3c)
      derivatives of 3 beta-hydroxy-5-oxo-5,6-secocholestan-6-al, and the unexpected
      DNPH derivative of 3,5-dihydroxy-B-norcholestane-6-carboxaldehyde (3a). The
      structures of 3a, 3b, and 3c were identified with 1H nuclear magnetic resonance
      (NMR), 13C NMR, DEPT, COSY, and H-C correlation two-dimensional NMR techniques,
      and by comparison with the spectra of known compounds. A possible mechanism
      involving an enamine functionality is proposed for the formation of 3a. The ratio
      of 3a/(3b + 3c) depends on the concentration of acid used and the reaction time.

PMID- 8356576
TI  - Human placental cholesterol side-chain cleavage: enzymatic synthesis of (22R)-20
      alpha,22-dihydroxycholesterol.
AB  - (22R)-20 alpha,22-Dihydroxycholesterol is the second intermediate in the
      conversion of cholesterol to pregnenolone by cytochrome P450scc in steroidogenic
      tissues. We report a rapid method for the enzymatic synthesis of (22R)-20
      alpha,22-dihydroxycholesterol from (22R)-22-hydroxycholesterol using mitochondria
      from the human placenta.

PMID- 8356577
TI  - Preparation of 16-formylestradiol and the 16-(alpha-methylenebutanolide)
      derivative.
AB  - Routes to the preparation of 16-formylestradiol are described. Estrone was
      converted to (E)-16-methoxymethylene estrone via the 16-hydroxymethylene estrone.
      Reduction of the methoxymethylene estrone with NaBH4 in the presence of CeCl3
      gave 16-methoxymethylene estradiol. Deprotection by acid afforded the desired 16
      formylestradiol. Attempts to prepare the 16-formylestradiol via the 16
      butylthiomethylene derivative gave only 16-formylestra-1,3,5(10),16-tetraen-3-ol,
      and a route through the 16-dimethoxymethyl derivative gave a mixture of the 16
      formyltetraen-3-ol and the 16-formylestradiol in low yield. The 16
      formylestradiol was subsequently converted to the alpha-methylene lactone
      conjugate, 4-(3,17 beta-dihydroxyestra-1,3,5(10)trien-16-yl)-2-methylene-4
      butanol ide by reaction with methyl alpha-(bromomethyl) acrylate and zinc.

PMID- 8356578
TI  - Rejection of cultured keratinocyte allografts in presensitized mice.
AB  - The fate of cultured keratinocyte (KC) allografts remains controversial. Although
      prolonged survival of cultured KC allografts in naive mice has been reported, the
      detailed mechanisms remain undetermined. Furthermore, it was also reported that
      in the human cultured KC allografts do not survive permanently, and they are
      rapidly replaced by recipient cells. In the present study, we have addressed this
      issue and obtained findings that cultured KC allografts survive for a prolonged
      period in naive mice under the conditions in which reepithelization by recipient
      cells is prevented. However, the same cultured KC allografts were rejected when
      they were grafted onto recipients primed with allogeneic spleen cells or full
      thickness skin grafts. To clarify the mechanisms behind these findings, the
      allostimulatory ability of cultured KC and their susceptibility to alloreactive
      cytotoxic T cells were examined in vitro. In a mixed epidermal cell-lymphocyte
      reaction, cultured KC were unable to induce allospecific proliferative responses
      of naive T cells. On the other hand, primed T cells from presensitized mice
      showed weak but significant proliferative responses against allogeneic KC. It
      also was confirmed that cultured KC are susceptible to lysis by alloreactive
      cytotoxic T cells. These data indicate that prolonged survival of cultured KC
      allografts in naive mice is attributable to a defect in the afferent, but not the
      efferent, phase of the rejection process that is caused by the weak
      allostimulatory ability of cultured KC. This assumption was also supported by the
      finding that spleen cells from the recipient mice bearing long-surviving KC
      allografts retain in vitro responsiveness against stimulator cells syngeneic to
      the grafted KC. Taken together, these findings indicate that long-term survival
      of cultured KC allografts in naive mice may be due solely to the weak
      allostimulatory ability of cultured KC, but not to loss of susceptibility to
      alloreactive cytotoxic T cells after culture of KC or induction of tolerance in
      the recipient mice bearing KC allografts.

PMID- 8356579
TI  - Minimum number of islets required to maintain euglycemia and their reduced
      immunogenicity after transplantation into diabetic mice.
AB  - In streptozocin (SZ)-induced diabetic mice, 200 islets, but not 50 islets,
      consistently restore euglycemia within 1 week of transplantation. To determine
      the minimum number of islets sufficient to maintain euglycemia in a diabetic
      mouse, we first transplanted 50 and 150 syngeneic islets simultaneously into the
      right (RK) and left kidney (LK), respectively, and then removed the LK 1 week
      post-transplantation. The remaining 50 islets maintained euglycemia in 8 of 11
      mice with normal intravenous glucose tolerance tests (IVGTT). Protection of 50
      islets for at least 7 days was necessary because removal of the 150 islets at 5
      or 3 days resulted in a much lower incidence of persistent euglycemia. Similarly,
      25 islets were capable of maintaining euglycemia in 2 of 9 mice once
      hyperglycemia was reversed by split-transplantation of 25 (RK) and 175 (LK)
      islets. To examine if 50-islet allografts survive longer than 200-islet
      allografts, we split-transplanted 50 DBA/2 islets in the RK and 150 islets of
      either B6 (syngeneic), DBA/2 (allogeneic), or C3H/He (third party allogeneic)
      mouse origin in the LK in 3 groups of diabetic C57BL/6 (B6) mice. The survival of
      50 DBA/2 islets in each group after removal of the LK on day 7 was compared to
      that of 200 DBA/2 islets in control B6 mice. Maximum prolongation of allograft
      survival was obtained with 50 DBA/2 islets that were split-transplanted with
      syngeneic B6 islets. These results clearly demonstrate that 50 islets are
      sufficient to maintain normal glucose tolerance once euglycemia is induced by
      transplantation of a larger number (i.e., 200) of islets and that 50 islet
      allografts are much less immunogenic than 200-islet allografts.

PMID- 8356580
TI  - Rapamycin: immunosuppression, hyporesponsiveness, and side effects in a porcine
      renal allograft model.
AB  - Rapamycin prolongs allograft survival and induces donor-specific tolerance in
      some small animal transplant models. Large animal studies, however, are limited.
      We studied rapamycin in a porcine renal allograft model. Donor-recipient
      combinations were chosen based on high response in pretransplant MLCs. Allografts
      were anastomosed to the aorta and vena cava and the native kidneys removed. There
      were 5 treatment groups: (a) no immunosuppression; (b) triple therapy (CsA, 1
      mg/kg/day; AZA, 2-3 mg/kg/day; and PRED, 3-4 mg/kg/day); (c) rapamycin (0.75
      mg/kg/day i.m.) in carboxymethylcellulose (CMC); (d) rapamycin (0.25 mg/kg/day
      i.m. in CMC); and (e) a vehicle (CMC) control. Serum creatinine levels were
      determined every other day. Most allografts were biopsied once a week.
      Immunosuppression was stopped after 30 days. Mean graft survival in
      nonimmunosuppressed recipients was 6.8 +/- 3.6 days. Mean graft survival in
      triple therapy recipients (n = 10) was 45.7 +/- 36 days vs. 59.6 +/- 11.4 days in
      rapamycin (0.25 mg/kg/day) recipients (n = 7) (P = 0.51). Both triple therapy and
      rapamycin improved renal allograft survival versus nonimmunosuppressed controls
      (P = 0.0025 and 0.001, respectively). Serum creatinine levels were significantly
      lower (P < 0.05) in rapamycin versus triple therapy recipients. We conclude that
      rapamycin is a potent immunosuppressant in a porcine renal allograft model and
      may avoid the elevated serum creatinine levels associated with CsA.

PMID- 8356581
TI  - The effects of cold preservation on steatotic graft viability in rat liver
      transplantation.
AB  - Clinical experience suggests that grafts obtained from steatotic livers result in
      primary nonfunction more frequently than those from nonsteatotic livers. To date,
      however, only a few studies have been done to verify the accuracy of this
      observation. To investigate the effects of cold preservation on steatotic liver
      viability, liver grafts obtained from rats fed with a choline-deficient diet were
      transplanted after periods of cold preservation. Recipient survival rates with
      normal liver grafts were 8/8 (100%) and those with steatotic liver grafts were
      7/8 (88%) (P > 0.05) after 1-hr preservation with UW solution. After 9-hr
      preservation, however, these rates decreased significantly to 0/8 (0%) with
      steatotic grafts (P < 0.01), but were not significantly decreased with normal
      grafts. LDH levels in the effluent at the time of transplantation were 133 IU/L
      (1-hr) and 512 IU/L (9-hr) in normal livers, but in steatotic livers these were
      elevated to 598 and 3141 IU/L, respectively (P < 0.01). Recovery rates of hepatic
      blood flow measured by laser Doppler flowmeter after revascularization were 99%
      (1-hr) and 96% (9-hr) in normal grafts, but in steatotic grafts they were 98% (1
      hr) and 63% (9-hr, P < 0.01). In addition, the oxidative phosphorylation ability
      of liver mitochondria obtained from steatotic grafts was decreased significantly
      after cold preservation. The present results suggest that steatotic liver grafts
      are prone to lose their viability more easily than normal liver grafts after
      prolonged periods of cold preservation due to a combination of causes.

PMID- 8356582
TI  - Storage of porcine pancreatic digest prior to islet purification. The benefits of
      UW solution and the roles of its individual components.
AB  - The aim of this study was to establish the beneficial effect of storage of
      pancreatic digest in University of Wisconsin solution on porcine islet
      purification, the mechanism of this effect, and the components of UW responsible.
      Ten porcine pancreata were collagenase-digested, and samples of digest were
      washed and stored for 1 hr in either UW or minimum essential medium at 4 degrees
      C, prior to separation on continuous linear density gradients of bovine serum
      albumin. Samples of digest from a further ten pancreata were similarly treated,
      comparing storage in MEM, UW, and five solutions varying in lactobionate:chloride
      ratio and raffinose content. The purity of the islet preparations and the
      densities of islets and exocrine tissue were determined from insulin and amylase
      assay of aliquots aspirated from these gradients. Washing and storage of digest
      in UW markedly improved islet purity, compared with MEM, due to an increase in
      the density of exocrine tissue. Exocrine tissue density following storage was
      dependent upon the control of acinar cell volume, rather than exocrine enzyme
      discharge, and was determined primarily by the chloride:lactobionate ratio of the
      storage solution. Raffinose was of little additional benefit, while the
      beneficial effect of UW was greater than that due to its lactobionate and
      raffinose content alone. In conclusion, inadequate purification of islets results
      from exocrine tissue swelling. This swelling is reduced by storage of the
      pancreatic digest in UW solution, due primarily to the replacement of chloride by
      lactobionate in UW.

PMID- 8356583
TI  - The significance of a positive flow cytometry crossmatch test in primary kidney
      transplantation.
AB  - This study was conducted to determine the efficacy of the T cell flow cytometry
      crossmatch (T-FCXM) test in 841 first cadaver donor transplants. Results showed
      one-year graft survival rates were 82% for T-FCXM-negative patients, compared
      with 75% for T-FCXM-positive patients (P = 0.01). Early one-month graft failure
      was 13 percentage points higher in those with a positive T-FCXM than those with a
      negative T-FCXM. The positive crossmatch patients also had more frequent
      immunological failures. A positive T-FCXM was found in 39% of the sensitized
      patients (PRA > 10%) and 8% of those who had not been sensitized. Patients with a
      positive T-FCXM in either category had a 74% graft survival rate. Thus, most of
      the T-FCXM-positive results occurred in patients with complement-fixing
      antibodies. It is suggested that flow cytometry crossmatching (FCXM) be used
      prospectively, despite the fact that many patients with a positive crossmatch did
      have successful transplants (TXs). In the current climate of a cadaver kidney
      scarcity and large recipient waiting pools, utilization of kidneys for patients
      with the highest probability of success seems a most prudent policy.

PMID- 8356584
TI  - The impact of acute rejection episodes on long-term graft function and outcome in
      1347 primary renal transplants treated by 3 cyclosporine regimens.
AB  - To characterize factors of importance for the occurrence of acute rejection as
      well as study the impact of these episodes on long-term renal survival and
      function, a total of 819 acute rejection episodes were studied in 951 primary
      cadaveric donor kidney recipients (CD) and in 396 primary living donor kidney
      recipients (LD). The patients were treated by three immunosuppressive schedules,
      namely, CsA given in a high dose, a medium dose, or a low dose. Additionally, all
      patients received PRED and patients in the low-dose group received AZA. The
      incidence of acute rejection was higher and occurred earlier after
      transplantation in the CsA medium dose and low dose groups than in the CsA high
      dose group (P < 0.05 and P < 0.01, respectively). Although the incidence of first
      acute rejection was similar in CD and LD patients, 59.1% vs. 60.6%, it was
      successfully reversed by antirejection treatment in a higher percentage in LD
      patients. The estimated graft half-life was shorter in patients who had acute
      rejection episodes than those who did not, 6.6 years vs. 12.5 years in CD
      patients (P < 0.0001). Renal function at 1-5 years after transplantation was
      stable, but significantly poorer in CD patients who had experienced acute
      rejection than in patients who had not, with the mean creatinine clearance rates
      in the ranges 45-47 vs. 54-60 ml/min in the other groups (P < 0.0001). In a
      stepwise Cox regression analysis in CD recipients, risk factors for acute
      rejection were CsA (low dose) treatment schedule, immunization as displayed by
      presence of panel-reactive antibodies and positive B cell cross-match, young
      recipient age, disease of diabetes mellitus, and HLA-DR mismatching. In LD
      recipients, the corresponding risk factors were treatment schedule, young
      recipient, HLA mismatching, and transplantation from parent to child. Thus, the
      study has demonstrated some factors of importance for acute rejection episodes in
      CsA-treated patients as well as showing the detrimental effect of these episodes
      on long-term graft survival and renal function. These results suggest that a
      primary aim of future treatment strategies should be to reduce the incidence of
      these episodes.

PMID- 8356585
TI  - The unreliability of the lidocaine/monoethylglycinexylidide test for assessment
      of liver donors.
AB  - The serum monoethylglycinexylidide (MEGX) level 15 min (t15) after i.v.
      administration of lidocaine (1 mg/kg) in liver donors was retrospectively
      correlated with graft outcome and early hepatic function. Among the 35 orthotopic
      liver transplants studied, 4 recipients had to be retransplanted within 10 days
      post-OLT because of early graft nonfunction or dysfunction, and 3 recipients
      died, with a median (range) donor MEGX t15 (ng/ml) of 100 (86-119) and 169 (146
      182), respectively. The remaining 28 OLT patients living with functioning grafts
      had a donor MEGX of 87 (18-245). No significant correlations could be found
      between donor MEGX t15 and recipient mean and peak glutamic-oxaloacetic and 
      pyruvic transaminases, total serum bilirubin, or mean and minimum prothrombin
      time values studied from day 1 to day 5 post-OLT. Moreover, categorization of
      donors using the MEGX t15 cut-off point of 80 ng/ml could not predict liver graft
      quality, as previously suggested. In summary, MEGX t15 in liver donors correlated
      neither with graft outcome nor with early functional parameters. Accordingly, the
      MEGX test should not be used as an isolated discriminatory evaluation for organ
      utilization.

PMID- 8356587
TI  - Suppression of HLA-specific alloantibodies by high-dose intravenous
      immunoglobulins (IVIg). A potential tool for transplantation of immunized
      patients.
AB  - Renal transplantation in patients presenting end-stage renal failure can be
      hampered by the presence of alloantibodies against HLA antigens. In 4 out of 5
      patients with HLA-specific alloantibodies waiting for a renal allograft,
      treatment with high-dose i.v. Ig resulted in a prolonged suppression (over 3
      months) of most of the panel-reactive anti-HLA antibodies (PRA). Intravenous
      polyclonal human Ig (IVIg) and F(ab')2 fragments from IVIg inhibited the binding
      of patients' plasma and IgG fractions to peripheral blood lymphocytes from normal
      donors as well as their cytotoxicity, suggesting that the in vivo effect of IVIg
      was mediated by the presence, in the IVIg preparation, of anti-idiotypes directed
      against idiotypes borne on the anti-HLA antibodies. Thus, treatment with IVIg can
      be a valuable tool toward the transplantation of immunized patients.

PMID- 8356586
TI  - The appearance of donor heparin in the recipient after reperfusion of a liver
      graft.
AB  - The release of heparin has been mentioned as one of the causes of
      hypocoagulability after reperfusion of the liver graft. It has been ascribed to
      endogenous heparin released from the donor liver or to exogenous heparin in the
      preservation fluid that is released into the recipient after sequestration into
      the graft during preservation. The aim of this study was to investigate whether
      systemic administration of heparin to the donor before the hepatectomy
      contributes to the appearance of heparin in the recipient after reperfusion. We
      studied 20 patients undergoing an auxiliary heterotopic liver transplantation; 15
      donors had received heparin immediately before circulation arrest (median 300
      IU/kg body weight), but 5 had not. The thrombin time (TT), activated partial
      thromboplastin time (aPTT), and heparin neutralization test were determined at
      several intervals during the transplantation.

PMID- 8356588
TI  - A comparison of preoperative and postoperative nutritional states of lung
      transplant recipients.
AB  - Malnutrition is a documented problem in some types of endstage lung disease
      (ESLD). Recently, isolated lung transplants have successfully reversed the
      respiratory failure of patients suffering from ESLD. In this study, we compare
      the preoperative and postoperative nutritional states of lung transplant
      recipients using weight-to-height ratios, anthropometric measurements, subjective
      global assessment, and biochemical blood values. Patients with emphysema, cystic
      fibrosis, and other types of bronchiectasis, but not patients with pulmonary
      fibrosis or pulmonary hypertension, were malnourished preoperatively. All groups
      had normal biochemical profiles. Caloric intake of patients with cystic fibrosis
      and bronchiectasis was increased above predicted basal energy expenditure levels.
      By six months to one year postoperatively, all groups of malnourished patients
      had significantly improved their nutritional status. Emphysema patients improved
      nutrition by maintaining preoperative caloric intake levels--however, both cystic
      fibrosis and bronchiectasis patients were able to achieve the same goal with
      significantly decreased caloric intakes. We conclude that malnourished ESLD
      patients receiving isolated lung grafts are able to achieve normal nutrition
      within one year posttransplant. Since this occurs in all cases with a reduced, or
      at best maintained, caloric intake, more study is needed to elucidate the factors
      that contribute to ESLD malnutrition.

PMID- 8356589
TI  - Preclinical studies for adoptive immunotherapy in bone marrow transplantation.
      Generation of anti-CD3 activated cytotoxic T cells from normal donors and
      autologous bone marrow transplant candidates.
AB  - In order to obtain T cells for adoptive immunotherapy after autologous bone
      marrow transplantation (ABMT) for patients with resistant hematological
      malignancies, a culture system was developed for growing T cells and inducing non
      MHC-restricted cytotoxicity using anti-CD3 monoclonal antibody (OKT3) activation.
      In this investigation, we show that (1) peripheral blood lymphocytes or bone
      marrow mononuclear cells (BMMNC) from normal donors and cancer patients can be
      activated with OKT3 and grown in interleukin-2; (2) normal BMMNC activated with
      OKT3/IL-2 exhibited non-MHC-restricted cytotoxicity and surface markers
      comparable to that exhibited by normal PBL activated with OKT3/IL-2; (3) both
      proliferation and cytotoxic functions were IL-2-dependent; (4) PBL activated with
      OKT3/IL-2 after cryogenic storage grew and killed comparable to PBL activated
      with OKT3/IL-2 prior to cryopreservation; (5) OKT3/IL-2-activated PBL and BMMNC
      obtained from 5 patients with non-Hodgkin's lymphomas (NHL) and 1 patient with
      acute myelogenous leukemia (AML) increased cell numbers 41-75-fold in 2 weeks of
      culture; 5 of 6 patients with NHL or AML had PBL and BMMNC that exhibited
      cytotoxic activity; and (6) contaminating leukemic cells did not overgrow in
      OKT3/IL-2-activated cultures and could no longer be detected on cytospin
      specimens after 3 weeks of culture. These data show that T cells in PBL or BMMNC
      from ABMT candidates can be activated with OKT3/IL-2 for adoptive immunotherapy
      in combination with ABMT.

PMID- 8356590
TI  - The hemodynamic effects of intraoperative injection of muromonab CD3.
AB  - During anesthesia 5 mg of muromonab CD3 (OKT3), an anti-CD3 monoclonal antibody,
      was administered prophylactically to twelve patients undergoing cadaveric renal
      transplantation. Preoperatively, all patients were at or near their dry body
      weights. Methylprednisolone 500 mg on call to or in the operating room,
      azathioprine 2 mg kg-1 and diphenhydramine 50 mg were administered
      intraoperatively to reduce the probability and severity of reported effects of
      OKT3. After induction of anesthesia, the patients were monitored for changes in
      cardiovascular variables for up to 120 min after OKT3 administration. All
      patients had uneventful anesthetic courses. Analysis of variance showed no
      significant changes from pre-OKT3 administration in heart rate, mean blood
      pressure, mean pulmonary artery pressure, central venous pressure (CVP),
      pulmonary capillary wedge pressure (PCWP), and pulmonary vascular resistance
      (PVRI). CVP values were a reliable indicator of PCWP with the correlation
      coefficient of CVP to PCWP or r = 0.78 (P < 0.00005) and PCWP = .89 x CVP + 3.78.
      Cardiac index (CI) increased 22% at 105 min (P < 0.05). Systemic vascular
      resistance index (SVRI) decreased 21% at 105 min (P < 0.05). SVRI was increased
      16% at 10 min post-OKT3 (P < 0.05). All of these statistically significant values
      were within acceptable clinical limits. Euvolemic cadaveric renal transplant
      recipients receiving prophylactic steroids and diphenhydramine may receive OKT3
      in the operating room for induction immunosuppression without any appreciable
      risk of cardiovascular compromise.

PMID- 8356591
TI  - Prevention of Pneumocystis carinii pneumonia in cardiac transplant recipients by
      trimethoprim sulfamethoxazole.
AB  - Pneumocystis carinii pneumonia (PCP) continues to cause significant morbidity in
      recipients of solid-organ transplants. While some programs administer
      trimethoprim-sulfamethoxazole (TMP-SMX) prophylactically following
      transplantation, a prospective determination of the safety and efficacy of TMP
      SMX in cardiac transplant recipients has not previously been reported. We
      therefore prospectively randomized 58 cardiac transplant recipients to receive
      TMP (160 mg)-SMX (800 mg) twice daily either three days per week (group B), or
      seven days per week (group C), or to receive no treatment (group A). Treatment
      began 14 days after transplantation and continued for four months. Age, sex,
      preexisting pulmonary pathology and immunosuppressive protocols did not differ
      among the groups. Of 17 patients in the control group (A), 7 developed a clinical
      syndrome compatible with PCP, with the diagnosis histologically confirmed by
      bronchoalveolar lavage during the first four months following transplantation. In
      contrast, no patients in either the daily or intermittent therapy groups
      developed PCP during the study period (P < 0.005). Both doses of TMP-SMX were
      well tolerated, and discontinuation of therapy was not necessary in any patient.
      Total white blood cell count, azathioprine dose, and number of treated episodes
      of rejection per patient did not differ among the three groups. We conclude that
      TMP-SMX can safely and effectively be administered to prevent the occurrence of P
      carinii pneumonia during the first four months following cardiac transplantation.

PMID- 8356592
TI  - The endocrine pancreas in brain-dead donors. A prospective study in 25 patients.
AB  - To determine whether hyperglycemia in brain-dead donors is a sign of endocrine
      pancreas insufficiency, we studied pancreatic function in 25 consecutive brain
      dead patients. Blood samples were drawn at 2-hr intervals from donor referral
      until organ procurement to analyze glucose, insulin, and C-peptide levels. After
      donor retrieval, two specimens were taken from the pancreas for a subsequent
      immunohistochemical examination. At referral mean glycemia was 13.60 +/- 1.49
      mmol/L, and there was a large range of plasma glucose levels (4.6-31.6). Of 25
      patients, 16 had glycemia above 10 mmol/L. At organ procurement a mean of 20 hr
      later, mean glycemia as 8.61 +/- 0.58 mmol/L (P < 0.005 with paired t test), and
      only 5 patients had glycemia above 10 mmol/L. Hyperglycemia was associated with
      elevated insulin and C-peptide levels during donor management. An elevated C
      peptide/glucose molar ratio might be considered a sign of peripheral insulin
      resistance. Hyperglycemia above 25 mmol/L could not be related to the amount of
      glucose administered during donor maintenance. Severe hyperglycemia had a natural
      tendency to be partly corrected. Histologic and immunohistochemical examinations
      were available in 17 cases and can be considered normal. It is concluded that
      endocrine pancreatic function can be considered effective after brain death. The
      mechanism of the relative insulin resistance of these patients requires further
      study. Blood glucose levels, in the range observed in this study, are not a good
      donor criterion of endocrine pancreatic function before pancreas transplantation.

PMID- 8356594
TI  - The effect of donor-recipient strain combination on rejection and graft-versus
      host disease after small bowel/liver transplantation in the rat.
AB  - The initial clinical experience with simultaneous small bowel/liver
      transplantation (SBL) suggests that liver grafting may protect the small bowel
      from rejection. A pilot study of SBL in DA (RT1a) rats with Lewis (RT1l)
      allografts in our laboratory provided experimental support for this concept.
      However, the clinical applicability of the data was questioned because the
      transplants were performed in a low-immune-responder rat strain combination. This
      study examined the outcome of SBL in several rat strain combinations. Isolated
      small bowel transplants (SB) and SBL were performed in three groups: DA-->PVG
      (low immune responder), BN-->LEW (intermediate immune responder) and ACI-->LEW
      (high immune responder). Lewis-->Lewis isografts were used as controls. All of
      the rats with SB rejected their allografts, whereas all of the rats with
      simultaneous liver grafts had minimal or no signs of intestinal rejection. The
      outcome of SBL was profoundly affected by the donor-recipient strain combination.
      The low immune responders developed severe graft-versus-host disease. The
      intermediate immune responders developed mild-to-moderate GVHD and moderate liver
      rejection. The high immune responders developed severe liver rejection. In this
      study, the outcome of small bowel transplantation depended upon the strain
      combination used and whether or not a simultaneous liver graft was transplanted.
      The immune interactions that occur after multi-visceral transplantation are
      complex and cannot be easily predicted.

PMID- 8356593
TI  - The antilymphocytic activity of brequinar sodium and its potentiation by
      cytidine. Effects on lymphocyte proliferation and cytokine production.
AB  - Based on its capacity to inhibit de novo pyrimidine biosynthesis by blocking
      dihydroorotate dehydrogenase activity, the antitumor agent brequinar sodium (BQR)
      has emerged as a new immunosuppressive agent. Since BQR is known to prevent the
      synthesis of nucleotides during cell proliferation, we hypothesized that it would
      be highly effective in controlling strong lymphocyte proliferative responses but
      might be less effective in controlling comparatively weak responses that do not
      necessarily involve new nucleotide synthesis. We addressed this question by
      culturing murine spleen cells with different types of stimuli, including Con A,
      phorbol myristate acetate +/- ionomycin, anti-CD3, and anti-Igs. Addition of BQR
      (0.001 microgram/ml to 10 micrograms/ml) at the start of a 72-hr culture period
      caused dose-dependent inhibition of strong proliferative responses, induced
      either by Con A (5 micrograms/ml) or PMA+ionomycin. A residual degree of
      proliferation persisted, however, even at the highest BQR concentrations. In
      contrast, no impairment of low-concentration Con A (0.5 or 0.1 microgram/ml),
      anti-CD3, or anti-Igs responses was observed. In order to ascertain its role in
      arresting nucleotide synthesis, we attempted to reverse the inhibitory effect of
      BQR by adding exogenous uridine or cytidine to lymphocyte cultures. BQR's
      inhibitory activity was reversed completely by adding uridine at 0.1 mM. In
      contrast, combination of BQR and cytidine (0.1 mM) potentiated BQR's activity and
      abrogated anti-CD3 or anti-Igs-induced lymphocyte proliferation in a dose
      dependent manner. A synergistic inhibitory action between BQR and cytidine was
      observed when the BQR concentration was higher than 0.1 microgram/ml and with
      cytidine at 0.1 mM. Production of interleukin-2 and IL-4 was only slightly
      affected by BQR, but was significantly suppressed by coadministration of BQR and
      cytidine. Neither BQR (5 micrograms/ml) on its own, however, nor combination of
      BQR with cytidine affected production of mRNA for IL-2, IL-4, or interferon
      gamma, as determined by reverse-transcription polymerase chain reaction. Our
      observations suggest that BQR may not only affect dihydroorotate dehydrogenase
      activity, but may also inhibit the enzyme cytidine deaminase, which converts
      cytidine to uridine. These antimetabolic effects of BQR complement the well-known
      cytokine synthesis inhibitory actions of FK506 or CsA. The combination of BQR and
      cytidine, however, offers a further possibility for inhibition of both cytokine
      production and T and B cell proliferation, and may have potential for the control
      of graft rejection.

PMID- 8356595
TI  - Abrogation of secondary skin allograft rejection by veto-like cells in donor bone
      marrow.
AB  - To investigate whether a veto cell phenomenon is involved in the ability of donor
      strain bone marrow cells (BMC) to inactivate second-set skin graft rejection
      induced by the adoptive transfer of sensitized spleen cells (SSC), mice were
      grafted with ear skin allografts and injected on the following day with recipient
      strain SSC or SSC plus donor strain BMC. When skin and BMC donors from an F1
      strain (B6AF1) were combined with a parental strain (C57BL/6) as recipient and
      SSC donors, the BMC were fully active in abrogating second-set rejection even
      though the SSC were naturally tolerant of the BMC. Thus, immunological
      recognition of the SSC by the BMC is not necessary for this abrogation. The
      suppressive activity of the BMC is specific in a manner similar to that reported
      for veto cells (i.e., they suppress an anti-self response). If BMC from various
      strains of mice were used to alter the rejection of C3H grafts by B6AF1
      recipients, only BMC expressing the MHC antigens to which the SSC had been
      sensitized significantly suppressed the activity of SSC. Sharing of additional
      antigens between the graft and BMC (e.g., MHC antigens not recognized by the SSC
      or minor antigens) was neither necessary nor sufficient. Mitomycin C-treated BMC
      were unable to inhibit SSC-induced accelerated rejection. Overall, the
      characteristics of the SSC-suppressive activity of BMC are consistent with a veto
      cell nature of the BMC.

PMID- 8356596
TI  - Induction of TNF alpha and TNF beta gene expression in rat cardiac transplants
      during allograft rejection.
AB  - The expression of the cytotoxic cytokines tumor necrosis factor alpha and TNF
      beta or lymphotoxin (LT) was assessed in rat cardiac transplants during
      rejection. Newborn rat cardiac grafts placed in adult rat ear pinnae were
      retrieved on days 1 through 10 posttransplantation; the average time to
      rejection, assessed by the absence of detectable electrocardiographic activity,
      was determined to be 7 days. Total cellular RNA and tissue homogenates were
      prepared from cardiac transplants in order that relative levels of TNF alpha and
      LT mRNA and TNF protein could be determined. A biphasic pattern of TNF alpha gene
      expression was consistently seen in cardiac allografts. TNF alpha mRNA
      transcripts were detected as early as day 2 post-tx, with peak levels appearing
      on day 3 post-tx. Although transcript levels decreased by day 4, a significant
      increase appeared again on day 6 post-tx, coincident with the onset of rejection.
      Similar to TNF alpha gene expression, LT transcripts demonstrated a biphasic
      pattern of induction. LT mRNA transcripts also reached peak levels on day 3 post
      tx, with a second increase in transcript levels coincident with rejection. TNF
      protein levels in allografts displayed a biphasic pattern, similar to that shown
      by the cytokine mRNAs. Peak levels of TNF protein were detected on day 3 post-tx,
      with a second increase again coinciding with rejection. In contrast to TNF
      expression found in allografts, TNF alpha and LT mRNA transcripts were not
      detected in isografts on days 1 through 10 post-tx. TNF protein levels in cardiac
      isografts were consistently at or below the standard limits of detection, and on
      days 3 through 7 post-tx were significantly reduced (P < or = 0.001) when
      compared with time-matched allografts. Increased expression of the cytotoxic
      cytokines TNF alpha and LT, therefore, appears to be allograft-specific and is an
      early event during rat cardiac allograft rejection. In conclusion, induction of
      TNF gene expression may be an important early indicator of transplant rejection.

PMID- 8356597
TI  - Similar levels of granzyme A and perforin mRNA expression in rejected and
      tolerated heart allografts in donor-specific tolerance in rats.
AB  - Congenic LEW.1W (RT1u) heart grafts in LEW.1A (RT1u) recipient rats are rejected
      within 15 +/- 6 days. Tolerance (> 100 days) can be induced by pretransplant
      donor-specific blood transfusions. In both cases, the graft is heavily
      infiltrated by recipient cells, and class I and class II molecules of the major
      histocompatibility complex are strongly expressed. Moreover, T lymphocytes
      extracted from both tolerated and rejected grafts are similarly cytotoxic in
      vitro against donor cells. However, it cannot be excluded that this cytotoxicity
      does not operate in vivo. To answer this important question, we have studied the
      expression of granzyme A and perforin mRNA expression, in situ, by Northern
      blotting. Our data show that the two corresponding mRNAs accumulate with the same
      kinetic and at the same level in rejected and tolerated grafts. These results
      strongly suggest that infiltrating cells are cytotoxic in vivo and that a
      "cellular rejection" does occur in the "tolerated" grafts. In addition, these
      findings show that cytotoxic T lymphocytes are not sufficient to impair graft
      survival and lead to a revaluation of the relevance, in general, terms of
      granzyme and perforin expression as a correlate of rejection.

PMID- 8356598
TI  - Acute graft-versus-host-like disease induced by transplantation of human
      activated natural killer cells into SCID mice.
AB  - Whereas T lymphocytes are essential for the initiation of acute graft-versus-host
      disease (aGVHD), it is not at all clear whether they or other cells or
      noncellular factors actually mediate the characteristic lesions. This report
      describes the in vivo effects of human NK cells, T cells, and cytokines on the
      induction of aGVHD in 4 Gy sublethally irradiated C.B-17 scid/scid (SCID) mice.
      Human NK and T lymphocytes were obtained separately by antibody- and complement
      mediated negative selection from the peripheral blood of normal donors and
      expanded in medium containing rIL-2 and irradiated autologous feeder cells. The
      characteristics of the two groups of cells were analyzed before injection into
      SCID mice. Cytofluorometric phenotyping demonstrated that 70-95% of NK-enriched
      cells expressed CD3-, CD16+, CD56+, and CD8-dim+; ninety-seven per cent of T
      cells expressed CD3+, TCR-alpha/beta+, CD4+, or CD8-bright+. Analysis of K562 and
      Daudi cultured target cell lines demonstrated 40-50% higher cytotoxicity by NK
      enriched cells as compared with activated T lymphocytes. TNF-alpha cytokine
      production was greatly increased in activated NK cells (250 pg/ml) as compared
      with T cells (25 pg/ml) and fresh PBMC (12.5 pg/ml). IFN-gamma was increased in
      both NK and T cells. After i.v. injection of 1-5 x 10(7) cells into irradiated
      SCID mice, minor to severe skin lesions, diarrhea, and weight loss occurred in NK
      but not the T cell-injected animals. In NK-injected animals, thinning and focal
      loss of epithelium with pyknotic nuclear change and degeneration and loss of skin
      appendages were observed. Single cell necrosis, crypt abscess formation, and loss
      of glandular epithelium developed in the colon of NK but not in T cell-injected
      animals. These findings are very similar to allogeneic aGVHD in SCID mice
      injected with C57BL/6 mouse splenocytes. Immunohistological staining with anti
      human CD56, CD3, TNF-alpha, and IFN-gamma antibodies demonstrated CD56+ cells in
      association with TNF-alpha and IFN-gamma secretion in the bowel of NK-injected
      animals. CD3+ cells were not found in the same tissues. These findings were not
      observed in T cell-injected and control mice. In summary, aGVHD-like lesions were
      induced by transplantation of xenogeneic human activated NK cells into SCID mice.
      We hypothesize that cytokines released from human NK cells play a central role in
      the pathogenesis of clinical aGVHD.

PMID- 8356599
TI  - Modulation of the kinetics of the initial leukocyte migration into renal
      allografts by 16,16-dimethyl PGE2.
AB  - Host sensitization to vascular allografts is induced by the interaction between
      host lymphocytes, antigen-presenting cells, and the allograft. However, little is
      known concerning the nature or kinetics of the initial host leukocyte migration
      into the transplanted organ prior to immune sensitization. Employing a model of
      donor-irradiated renal allografts and isografts, we have characterized the
      participating cell types and the kinetics of the leukocyte influx during the
      first 96 hr after engraftment. Both isografts and allografts experience a marked
      initial influx of host leukocytes into the renal interstitium, peaking at 48 hr
      after transplantation. Concomitant glomerular accumulation of leukocytes is much
      less marked. By 96 hr, the leukocyte influx into isografts has significantly
      diminished, while allografts demonstrate a subsequent additional rise in
      interstitial leukocytes coincident with the development of allosensitization. In
      allografts, the predominant cell type in the influx of the first 24-48 hr of the
      leukocyte influx is the monocyte/macrophage, with a smaller component of T
      lymphocytes. Neutrophils and B lymphocytes are not found in this initial
      infiltrate. Intragraft infusion of dimethyl PGE2 markedly inhibits the monocyte
      influx during the first 24-48 hr into the renal interstitium, but not the
      glomeruli, of allografts, while having relatively little effect on the migration
      of leukocytes into the renal glomerulus or renal interstitium of isografts. The
      results suggest that one mechanism by which PGE may inhibit host sensitization to
      allografts may be suppression of the initial influx of donor monocytes into the
      newly allografted organ.

PMID- 8356600
TI  - Cell transplantation of genetically altered cells on biodegradable polymer
      scaffolds in syngeneic rats.
AB  - Many severe metabolic deficiencies in children are caused by a single gene defect
      with a resultant single gene product deficiency. These diseases may be amenable
      to permanent cure using new techniques of gene transfer and cell transplantation.
      In many in vivo models of retroviral mediated gene therapy, a significant
      limiting factor is the ability to transplant a sufficient number of modified
      cells. To potentially circumvent this problem, we have developed a biodegradable
      polymer implant system capable of supporting large numbers of genetically
      modified cells. In this study, we inserted a reporter gene into syngeneic
      cultured normal fibroblasts and then transplanted these genetically modified
      cells into animals using synthetic biodegradable polymer fibers as temporary cell
      delivery scaffolds. To begin to develop a system capable of delivering desirable
      proteins secreted by genetically modified cells, Fischer 344 adult rat
      fibroblasts were transduced in tissue culture with a retrovirus containing the
      reporter gene Lac Z. These genetically modified cells (1.1 x 10(7) cells/graft)
      were then attached to the biodegradable polymer fibers and the polymer-cell graft
      was transplanted subdermally into syngeneic recipients (n = 9). There was
      persistence of the modified cells with expression of the reporter gene for at
      least 30 days. The estimated number of genetically modified cells per implanted
      graft decreased from a pretransplant value of 1.1 +/- 0.6 x 10(7) to 3.2 +/- 0.7
      x 10(6) by 15 days after transplantation (P < 0.01). Thereafter, the cell number
      did not vary significantly to the conclusion of the study at day 30 (3.6 +/- 1.0
      x 10(6) cells/graft). Evidence of ingrowth and incorporation of other stromal
      elements was present in the graft by 1 week post-transplantation, as judged by
      counterstained hematoxylin and eosin micrograph sections. Migration of modified
      cells to areas outside of the polymer-cell graft was not detected. Over the
      course of the study, there was little degradation of the polymer implant,
      although by day 30, evidence of early dissolution was evident. The number of
      polymer fibers per high power field increased slightly from 62.5 +/- 5.8 on day 1
      to 77.3 +/- 26.6 on day 30 (P > 0.2). These data suggest that the use of
      biodegradable polymer fibers may permit the transplantation of genetically
      modified cells in sufficient numbers to deliver a therapeutically useful product.
      Polymer matrices allow for the attachment and site-specific transplantation of
      genetically modified cells.

PMID- 8356601
TI  - Continuous systemic secretion of a lysosomal enzyme by genetically modified mouse
      skin fibroblasts.
AB  - Lysosomal enzymes secreted or externally supplied into the extracellular medium
      can be internalized by cells and targeted to lysosomes after binding to specific
      membrane receptors. This process allows for the replacement of the missing enzyme
      activity in deficient cells. Using a retroviral vector, we have introduced the
      human beta-glucuronidase cDNA into primary mouse skin fibroblasts. The
      genetically modified cells were then engrafted into neo-organs that had been
      previously implanted into the peritoneal cavity of syngeneic recipient mice. The
      hypervascularized structures, made of collagen and basic fibroblast growth factor
      coated synthetic fibers embedded into extracellular matrix gel, allowed in vivo
      survival of engrafted fibroblasts that expressed the human beta-glucuronidase
      cDNA for at least 3 months. The human enzyme was detected in the liver, lung, and
      spleen of experimental animals, but became undetectable after removal of the neo
      organ. This observation indicated that the human enzyme was secreted into the
      serum and then captured by distant organs. The use of genetically modified
      fibroblasts implanted into neo-organs may, therefore, represent a convenient
      approach to enzyme replacement therapy in lysosomal storage diseases.

PMID- 8356602
TI  - Ventricular expression of atrial natriuretic peptide after orthotopic cardiac
      transplantation.
AB  - In order to determine if atrial natriuretic peptide is produced by the human
      ventricle after transplantation, specimens were obtained from 54 separate right
      ventricular endomyocardial biopsies from 14 transplant recipients (age range 10
      19 years) and were analyzed with simultaneous plasma samples. Radioimmunoassay
      techniques were used to determine plasma and tissue levels of atrial natriuretic
      peptide in each biopsy specimen, and blot hybridizations with the atrial
      natriuretic peptide c deoxyribonucleic acid probe were performed once for each
      patient. Mean plasma levels of atrial natriuretic peptide were obtained from the
      right ventricle (106 +/- 12 pg/ml); there was a positive correlation with end
      diastolic pressure (r = 0.7, P < 0.0001). Plasma levels, however, were not
      significantly increased during rejection episodes. Atrial natriuretic peptide was
      detectable in all ventricular biopsy specimens--mean 989 +/- 164 pg/mg soluble
      protein. Mean tissue level during rejection episodes was 1163 +/- 17 and
      following treatment of rejection was 411 +/- 147--however, this difference was
      not significant (P = 0.55). In 6 patients biopsied within 1 month of
      transplantation initial myocardial levels were significantly higher than those
      obtained at the following biopsy (P < 0.05). Despite these initially high tissue
      levels no correlation was found with time posttransplantation. Ventricular tissue
      levels positively correlated with systolic ventricular pressure, r = 0.3, P <
      0.05, but there was no significant correlation with other hemodynamic parameters.
      The normalized atrial natriuretic peptide messenger ribonucleic acid signal from
      the slot blot hybridization was 59 +/- 6 mm (peak height of signal intensity)
      range 20-110 mm. The expression of atrial natriuretic peptide gene was also
      confirmed by Northern blot analysis. The ventricular messenger ribonucleic acid
      signal contained a single hybridizing band of approximately 920 nucleotides.
      Thus, we have demonstrated that atrial natriuretic peptide production by the
      human ventricle is independent of innervation. The consistent atrial natriuretic
      peptide gene expression and detection by radioimmunoassay in apparently healthy
      ventricles was unexpected but may reflect the use of immunosuppressive drugs, or
      perhaps subclinical graft dysfunction.

PMID- 8356603
TI  - Detection of cytokine mRNA in vivo by polymerase chain reaction. Problems and
      solutions.
AB  - The expression of cytokine mRNAs in murine sponge matrix graft infiltrates was
      studied using the polymerase chain reaction (PCR). In infiltrates of both C57B1/6
      > C57B1/6 isografts and DBA/2 > C57B1/6 allografts, a similar pattern of cytokine
      expression was observed. On days 6, 8, and 10 postimplant, mRNAs encoding IL-4,
      IL-6, and IFN-gamma were detected. On days 8 and 10, mRNAs encoding IL-1 alpha,
      TNF, and lymphotoxin/TNF beta were also expressed. Surprisingly, no IL-2 mRNA was
      observed in isografts or allografts. Two modified PCR techniques were utilized to
      compare the level of expression of cytokine mRNAs in isografts versus allografts
      and to detect the expression of IL-2 mRNA in this system. A semiquantitative PCR
      protocol based on limiting cycles of amplification is described that was used to
      determine the amount of IL-4 mRNA expressed in isograft and allograft infiltrates
      relative to beta-actin mRNA. Using this method, no difference was found in the
      amount of IL-4 mRNA in infiltrates of day 8 isografts and allografts. The
      validation of this technique by analysis of samples with known relative mRNA
      levels is presented. A nested PCR protocol is described that provided greatly
      enhanced sensitivity over standard PCR analysis. Using this technique, IL-2 mRNA
      was detected in infiltrates from sponge allografts on all days tested, beginning
      on day 2 postimplant. No IL-2 mRNA was detected in isograft infiltrates or in
      peripheral blood from allograft-bearing animals. The pattern of cytokine mRNA
      expression observed in sponge matrix allografts is consistent with the presence
      of a weak alloreactive response superimposed upon an intense granulomatous
      process that occurs in both the isografts and allografts. This report
      demonstrates modified PCR techniques that can be used to resolve experimental
      problems associated with the analysis of cytokine mRNA expression in vivo.

PMID- 8356604
TI  - Clinically significant anti-A derived from B lymphocytes after single lung
      transplantation.

PMID- 8356605
TI  - Jaundice associated with concomitant use of norethandrolone and cyclosporine.

PMID- 8356607
TI  - Umbilical cord blood transplantation in a patient with Philadelphia chromosome
      positive chronic myeloid leukemia.

PMID- 8356606
TI  - Liver preservation with lidoflazine and the University of Wisconsin solution: a
      dose-finding study.

PMID- 8356608
TI  - Hamster coagulation and serum proteins in rat recipients of hamster xenografts.

PMID- 8356609
TI  - Production of interference in the TDx polarization immunoassay by fluorescein
      angiography.

PMID- 8356610
TI  - Esophageal candidiasis, omeprazole therapy, and organ transplantation--a word of
      caution.

PMID- 8356611
TI  - The genetics of race.

PMID- 8356612
TI  - Introduction to the African American Histocompatibility Workshop: goals and
      overview.

PMID- 8356613
TI  - HLA diversity in African Americans.

PMID- 8356614
TI  - Association of HLA phenotypes with hypertension in African Americans and
      Caucasoid Americans with type II diabetes, a population at risk for renal
      disease.

PMID- 8356615
TI  - Comparison of HLA phenotypes among African Americans from Alabama, Maryland, and
      North Carolina.

PMID- 8356616
TI  - Beneficial effects of HLA-DR3 gene expression on renal allograft survival in
      black recipients.
AB  - We have shown that there is a subgroup of black recipients who lack DR3 antigen
      expression and have decreased graft survival in comparison to black recipients
      who express DR3 antigen. Overall, the 3-year renal graft survival was equivalent
      between white and black recipients in our series and white recipients were not
      affected by DR3 antigen expression. We suspect that altered immune activity in
      the DR3-positive black patients may afford a benefit in overcoming immunologic
      barriers. This needs further investigation both in light of the possible
      association of the linked antigens A1-Cw7-B8-DR3 which are associated with loss
      of suppressor cell activity, as well as the issue of DR3 subtyping. However,
      there clearly exists the possibility of targeting higher risk groups such as the
      DR3-negative black recipients for more intense immunosuppressive regimens as well
      as eliminating pretransplant transfusion of third-party donors. Finally, we must
      reconsider the question of whether HLA matching is especially punitive to blacks,
      since matching for broad DR specificities in black recipients does not
      necessarily match for subtypes unique to blacks. Modifying or de-emphasizing the
      UNOS point system for organ allocation based on MHC antigen should be seriously
      considered as a mechanism for increasing the percentage of black kidney
      transplant recipients.

PMID- 8356617
TI  - Presensitization and frequency of positive crossmatches in black and nonblack
      renal transplant candidates.

PMID- 8356618
TI  - Risk factors for end-stage renal disease among minorities.
AB  - Blacks, Hispanics, and American Indians are at increased risk of ESRD. Among
      blacks, hypertension, type II DM, and possibly type I DM are classic risk factors
      and pose an increased risk for disease. A unifying concept in both DM and
      hypertension appears to be increased glomerular pressures. The role of diuretics
      as an independent risk factor for ESRD is further advanced. At a minimum
      diuretics appear not to be renal protective. Glomerulonephritis also occurs more
      commonly in blacks. The underlying pathology is largely unknown. There is an
      increased rate of HAN- and HIV-associated nephropathy which does not explain the
      excess risk. Patterns of referral or other biases may be in effect. The increased
      incidence of ESRD in Hispanics is mainly related to DM although, hypertension
      also plays a role. There is also evidence that HIV-associated nephropathy may
      occur relatively more often than in whites. We have alluded to the increased
      incidence of ESRD among American Indians and noted that diabetes mellitus occurs
      more commonly in most tribal groups while glomerulonephritis occurs more
      frequently in the Zuni. That groups at increased risk of ESRD are at the lower
      spectrum of the SES raises this issue as a common risk factor for disease. It is
      unlikely that SES is an independent risk factor. Education, access to early
      interventions, and social behavioral factors must be incorporated into any model
      which proposes a reduction in the rate of ESRD in these groups. The treatment of
      hypertension with medications that may be renal protective or pose increased
      risk, especially insofar as diuretics are concerned, must be considered urgent
      grounds for future research.

PMID- 8356619
TI  - Hypertensive renal disease in blacks.

PMID- 8356620
TI  - Renal microvascular susceptibility in African American pedigrees.

PMID- 8356621
TI  - Diabetic renal disease: racial and ethnic differences from an epidemiologic
      perspective.
AB  - In summary, Native Americans, Hispanics, and blacks are at higher risk of
      diabetic ESRD relative to whites, particularly among subjects with NIDDM, even
      after controlling for the higher prevalence of diabetes in these groups.
      Incidence of diabetic ESRD is increasing in all race and ethnic groups,
      particularly in Native Americans and Hispanics. This increase may be real or
      artifactual. Based on the results of a few studies, controlling for several risk
      factors for diabetic ESRD does not explain the excess risk in blacks and
      Hispanics. Survival after beginning treatment for diabetic ESRD is longer in
      blacks, Native Americans, and Asian/Pacific Islanders when compared to whites.
      Longer survival in blacks compared with whites occurs among dialysis patients,
      but not in transplant patients, after controlling for type of diabetes and
      comorbidity present at onset of ESRD. The higher incidence of diabetic ESRD in
      blacks, Hispanics, and Native Americans, combined with an increased incidence
      over time and longer survival after ESRD onset, indicate that these racial and
      ethnic groups will comprise a large portion of diabetic ESRD in the future.

PMID- 8356622
TI  - Diabetic nephropathy in blacks.

PMID- 8356624
TI  - A decade of human immunodeficiency virus-associated nephropathy (HIVAN).

PMID- 8356623
TI  - Improving renal transplant outcomes in African Americans with OKT3 induction
      therapy.

PMID- 8356625
TI  - Collaborative Transplant Study analysis of graft survival in blacks.

PMID- 8356626
TI  - HLA polymorphisms, ethnicity, and graft survival: united network for organ
      sharing. UNOS Scientific Renal Transplant Registry.

PMID- 8356627
TI  - Twenty-five-year review of race and transplantation at a single institution.

PMID- 8356628
TI  - Matching and the black recipient.

PMID- 8356629
TI  - Decreased HLA matching does not preclude successful renal transplantation in
      African Americans.

PMID- 8356630
TI  - Effect of donor race on graft survival in black South African recipients of
      cadaveric renal allografts.

PMID- 8356631
TI  - Posttransplant hypertension in blacks versus nonblacks.

PMID- 8356632
TI  - Effect of recipient race on waiting time for renal transplantation at the
      University of Pittsburgh.

PMID- 8356633
TI  - Influence of race on delayed renal allograft function and outcome in the
      cyclosporine era.

PMID- 8356634
TI  - Blacks and whites on the UNOS renal waiting list: waiting times and patient
      demographics compared.

PMID- 8356635
TI  - Organ allocation: current problems and future issues.

PMID- 8356636
TI  - In vitro response to immunosuppressive agents in blacks.

PMID- 8356637
TI  - Influence of length of time on dialysis before transplantation on long-term renal
      allograft outcome.

PMID- 8356638
TI  - Correlation of CD3+ lymphocyte depletion with rejection and infection in renal
      transplants.

PMID- 8356639
TI  - Cadaveric renal transplant in the highly sensitized African-American patient.
AB  - A statistically significant difference was discovered when comparing the 1-year
      graft survival of CAUC and AA. The difference was due in part to nine AA failures
      that occurred within the first week posttransplant (Fig 3). Using a multivariant
      analysis both the AA and CAUC were found to be normally distributed in regard to
      CIT, HLA mismatch, transplant number, and PRA. If these traditional variables
      thought to have relevance on graft survival in cadaveric renal transplantation
      are ruled out as contributing factors other avenues must be explored. If credence
      is given to the theory that the difference in function between AA and CAUC is due
      to the difference in the number of transplants that failed within the first week
      then factors such as immunosuppressive therapy and noncompliance can also be
      ruled out. One possible area of explanation may lie in the area of specificity to
      HLA antibody. It is possible that these recipients received transplants from a
      donor to which they were sensitized. A closer analysis of donor and recipient HLA
      typing as well as the recipient's transfusion and transplant history is
      recommended. Despite the fact that all transplants occurred in the presence of
      negative preliminary and final XM's using American Society for Histocompatibility
      and Immunogenetics (ASHI) certified techniques (Table 2), transplant centers may
      wish to consider using a more sensitive XM technique such as flow cytometry for
      these patients. We hope that these recommendations will enable transplant centers
      to continue their commitment to transplanting the highly sensitized recipient.

PMID- 8356640
TI  - Hepatic transplantation in the United States.

PMID- 8356641
TI  - Organ donation and referrals among African-Americans.
AB  - Solid organ referrals for AA have been growing since 1989. One third of AA
      referrals are in the 16 to 30 year age group with the majority of these males
      suffering traumatic injury. AA donors have increased from 11 in 1989 to 32 in
      1992. This is in spite of AA and minority consent rates that are 20% to 30% below
      that of the CAUC group. This gap represents a vital opportunity for improvement.
      Increased education to minority groups with a message that considers the ethnic
      and cultural diversity of the minority community coupled with an increase in the
      number of minority transplant coordinators should help to increase the number of
      AA referrals and donors.

PMID- 8356642
TI  - Increasing African American organ donation: the St Louis experience.

PMID- 8356643
TI  - Review of black donor awareness in New York City.

PMID- 8356644
TI  - Hispanic experience of organ donation in New York City.

PMID- 8356645
TI  - Continuing dilemma of organ procurement for clinical transplantation.

PMID- 8356646
TI  - Moving toward cultural competence in the transplant milieu.

PMID- 8356647
TI  - Postrenal transplant compliance: report of 519 responses to a self-report
      questionnaire.

PMID- 8356648
TI  - Treatment options for end-stage renal disease: patient perceptions and factors
      influencing choice of modality.

PMID- 8356649
TI  - Rehabilitation following a kidney transplant.

PMID- 8356650
TI  - Rehabilitation revisited.

PMID- 8356651
TI  - Effects of cultural preferences on nutrition.

PMID- 8356652
TI  - Influence of mind in the healing process.

PMID- 8356653
TI  - A tribute to Veretta Woodhouse Blake.

PMID- 8356654
TI  - Summation of the Third International Samuel L. Kountz Symposium on renal disease
      and transplantation in blacks.

PMID- 8356655
TI  - Evaluation of preservation of the intra-abdominal organs.

PMID- 8356656
TI  - Defibrotide use during preservation favors the metabolic function of grafted
      kidneys in rats.

PMID- 8356657
TI  - Long-term renal preservation and prevention of acute tubular necrosis by
      inhibition of arachidonate metabolism.

PMID- 8356658
TI  - Effects of Carolina rinse on hepatic microcirculation and leukocyte-endothelium
      interaction in rat liver transplantation.

PMID- 8356659
TI  - Essential components of Carolina rinse for attenuation of reperfusion injury in
      rat liver transplantation.

PMID- 8356660
TI  - Increased flow rate of preservation solution in the hepatic artery during organ
      preservation can improve postischemic liver function.

PMID- 8356661
TI  - Platelet-activating factor antagonist BN52021 improves survival in normothermic
      liver ischemia in rats.

PMID- 8356662
TI  - Failure of PGE1 to prevent liver allograft reperfusion injury in a prospective
      randomized trial.

PMID- 8356663
TI  - Role of eicosanoids in reperfusion injury in rat liver transplantation.

PMID- 8356664
TI  - Rinsing with warm Ringer's lactate reduces microvascular reperfusion injury in
      rat liver transplantation.

PMID- 8356665
TI  - Influence of SOD, catalase, and epoprostenol on 24-hour liver preservation in
      pigs.

PMID- 8356666
TI  - Comparison of HTK solution and UW solution in 24- and 48-hour preservation of
      canine hepatic allografts.

PMID- 8356667
TI  - Morphological and functional evaluation of the quality of preservation of the rat
      pancreas.

PMID- 8356668
TI  - Ex vivo normothermic preservation of rat multiple organ blocks using a
      perfluorooctyl bromide emulsion as oxygen carrier.

PMID- 8356669
TI  - Impact of preservation solution on early function and graft survival in cadaveric
      renal transplantation.

PMID- 8356670
TI  - Pretransplant assessment of renal viability by using ion-selective electrodes--a
      pilot study.

PMID- 8356671
TI  - Transplantation of abdominal organs in children.

PMID- 8356672
TI  - The Stockholm experience with pediatric renal transplantation.

PMID- 8356673
TI  - Significance of duplex and color encoded Doppler sonographic monitoring in
      children with renal transplants.

PMID- 8356674
TI  - Sequential color and pulsed Doppler sonography for monitoring antirejection
      therapy in pediatric patients.

PMID- 8356675
TI  - Comparison of adjusted-dose vs standard-dose OKT3 therapy of acute rejection in
      pediatric kidney transplant recipients.

PMID- 8356676
TI  - 24-hour blood pressure monitoring for the control of antihypertensive therapy in
      pediatric kidney transplant recipients.

PMID- 8356677
TI  - Long-term effect of cyclosporine on renal function in children after liver
      transplantation.

PMID- 8356678
TI  - Growth in children after liver transplantation on cyclosporine alone or in
      combination with low-dose azathioprine.

PMID- 8356679
TI  - Hemodynamic changes during intra-abdominal organ transplantation.

PMID- 8356680
TI  - Hemodynamics during the anhepatic phase in orthotopic liver transplantation with
      vena cava preservation: a comparative study.

PMID- 8356681
TI  - Shuntflow vs renal perfusion pressure during venovenous bypass in human
      orthotopic liver transplantation.

PMID- 8356682
TI  - Effect of high shuntflows during portofemoro-subclavian venovenous bypass in
      human orthotopic liver transplantation.

PMID- 8356684
TI  - Splenic artery steal syndrome after orthotopic liver transplantation: diagnosis
      and treatment.

PMID- 8356683
TI  - Continuous indirect calorimetry during orthotopic liver transplantation with and
      without venovenous bypass.

PMID- 8356685
TI  - Assessment of microhemodynamics after liver transplantation by in vivo microscopy
      in the rat.

PMID- 8356686
TI  - Analysis of hepatic hemodynamics after orthotopic liver transplantation: an
      experimental study in pigs.

PMID- 8356687
TI  - Power spectrum analysis of heart rate variability following kidney
      transplantation.

PMID- 8356689
TI  - Persistence of abnormal left ventricular filling following renal transplantation.

PMID- 8356688
TI  - Colour Doppler recording of renal blood flow in kidney grafts.

PMID- 8356690
TI  - Prevention of early postoperative graft thrombosis in pancreatic transplantation.

PMID- 8356691
TI  - Causes of early vascular complications in renal transplantation.

PMID- 8356692
TI  - Kidneys from pediatric donors: a source of increased risk for graft failure in
      recipients.

PMID- 8356693
TI  - Causes of early graft failure at less than 12 months after renal transplantation.

PMID- 8356694
TI  - Effects of piretanide on early graft function in kidney transplantation: a pilot
      study.

PMID- 8356695
TI  - Obesity in kidney transplant patients as a risk factor.

PMID- 8356696
TI  - Diagnostic value of antegrade pyelography in renal transplants: a comparison of
      imaging modalities.

PMID- 8356697
TI  - Can split liver grafting increase the overall success rate of liver
      transplantation?

PMID- 8356698
TI  - Donor selection and surgical technique for en bloc liver-small bowel graft
      procurement.

PMID- 8356699
TI  - Imported grafts in hepatic transplantation.

PMID- 8356700
TI  - Early graft function in liver transplantation: comparison of two techniques of
      graft procurement.

PMID- 8356701
TI  - Procurement, grafting, and early graft function in liver transplantation,
      including reduced size and split livers from cadaveric and living related donors.

PMID- 8356702
TI  - Relationship between cytochrome P-450 3A content of orthotopically transplanted
      liver and postoperative morbidity.

PMID- 8356703
TI  - Angiography and vascular radiologic intervention before and after liver
      transplantation.

PMID- 8356704
TI  - Liver transplantation for posthepatic B-delta cirrhosis: prevention of recurrence
      with high-dose anti-HBs immunoglobulins.

PMID- 8356705
TI  - Acute liver allograft rejection and liver function: quantitative evaluation using
      the [14C]aminopyrine breath test.

PMID- 8356706
TI  - Reticuloendothelial system clearance capacity following liver transplantation as
      a predictor of early graft function.

PMID- 8356707
TI  - General aspects of the pathology of rejection of kidney and liver in the early
      posttransplant period.

PMID- 8356708
TI  - Preliminary analysis of HLA matching in pancreas and liver transplantation.
      Collaborative Transplant Study.

PMID- 8356709
TI  - Immune monitoring: does the reality fulfill the promise?

PMID- 8356710
TI  - Relationship between HLA compatibility and first liver allograft survival.
      l'ESPRIT Study Group.

PMID- 8356711
TI  - The number of granulocytes in "time-zero" biopsy as a parameter of prognosis of
      graft function after liver transplantation.

PMID- 8356712
TI  - Monitoring of plasma endothelin in relation to Doppler signal in human liver
      transplantation.

PMID- 8356713
TI  - Leucocyte elastase in the early diagnosis of rejection after liver
      transplantation.

PMID- 8356714
TI  - Balancing cyclosporine A nephrotoxicity and rejection late after adult liver
      transplantation.

PMID- 8356715
TI  - Cytokine secretion capacity of mononuclear cells in renal transplant recipients:
      the effect of two different dose schedules.

PMID- 8356716
TI  - Nitric oxide synthesis during rejection of orthotopic small bowel allografts is
      not a strain-specific phenomenon.

PMID- 8356717
TI  - Recurrent HBV/HDV infections under different immunoprophylaxis protocols.

PMID- 8356718
TI  - Efficacy of rapamycin in orthotopic small bowel transplantation in the rat.

PMID- 8356719
TI  - A new immunosuppressive drug, brequinar sodium, suppresses liver allograft
      rejection in the rat.

PMID- 8356720
TI  - Mizoribine as an alternative to azathioprine in triple-therapy immunosuppressant
      regimens in cadaveric renal transplantation.

PMID- 8356721
TI  - Antithymocyte globulin or interleukin 2 receptor antibody for immunosuppressive
      induction therapy after orthotopic liver transplantation: a follow-up study.

PMID- 8356722
TI  - Induction therapy with anti-T-lymphocyte globulin following orthotopic liver
      transplantation.

PMID- 8356723
TI  - Management of induction phase of immunosuppression in liver graft recipients:
      prevention of oversuppression by immune monitoring.

PMID- 8356724
TI  - Significant effect of HLA-DRB1 typing by linkage disequilibrium on kidney graft
      outcome.

PMID- 8356725
TI  - Study of the effect of HLA class II antigens (serotyping and mixed lymphocyte
      reaction) on kidney graft outcome.

PMID- 8356726
TI  - Complement-dependent immunosuppressive anti-tissue factor monoclonal antibody:
      the establishment of monoclonal antibodies and their effect on mixed lymphocyte
      reaction.

PMID- 8356727
TI  - Lipid peroxidation of parenchymal hepatocytes during cold preservation and after
      reoxygenation in rats.

PMID- 8356728
TI  - Childbirth after renal transplantation.

PMID- 8356729
TI  - Altered disposition of pravastatin following concomitant drug therapy with
      cyclosporin A in transplant recipients.

PMID- 8356731
TI  - Financial compensation for cadaver organ donation: good idea or anathema.

PMID- 8356730
TI  - Influenza vaccine does not cause rejection after cardiac transplantation.

PMID- 8356732
TI  - Cloned veto cells as immunoregulators.

PMID- 8356733
TI  - Effect of rapamycin on islet and skin xenograft survival.

PMID- 8356734
TI  - Tuberculosis control learning games.
AB  - In teaching health workers about tuberculosis (TB) control we frequently
      concentrate on the technological aspects, such as diagnosis, treatment and
      recording. Health workers also need to understand the sociological aspects of TB
      control, particularly those that influence the likelihood of diagnosis and cure.
      Two games are presented that help health workers comprehend the reasons why TB
      patients often delay in presenting for diagnosis, and why they then frequently
      default from treatment.

PMID- 8356735
TI  - A study of prescribing patterns with special reference to drug use indicators in
      Dar es Salaam Region, Tanzania.
AB  - Drug prescribing patterns were studied in 720 retrospective and 779 prospective
      outpatient prescriptions from 20 dispensaries in Dar es Salaam region, and these
      revealed a mean drug exposure of 2.0 and 2.3, respectively. The percentage of
      patients leaving the dispensaries with no prescribed drugs was 1.3% and 0.7%,
      respectively. Prescriptions containing antibiotics were 36.8% (retrospective) and
      39.8% (prospective), while injections accounted for 24.6% and 34% of the total
      encounters, respectively. Over 70% of prescriptions conformed to the Tanzania
      essential drug list (EDP) and/or standard treatment guidelines and consisted of
      83.9% and 79.1% generic prescriptions, respectively. Interestingly, only 15% of
      the surveyed dispensaries had an EDP book and/or calendar. Despite the consulting
      and dispensing times being short (2.98 min and 77.7 s, respectively), 70% of the
      patients could remember the dosing instructions. Only 64% of the patients had a
      minimum physical examination.

PMID- 8356736
TI  - How can growth monitoring and special care of underweight children be improved in
      Zambia?
AB  - Despite widespread promotion and implementation, very few growth monitoring
      programmes have been evaluated. Where they have, the findings have often been
      disappointing and the value of routine growth monitoring has been questioned.
      There is a concern that the process has become more of a weighing ritual rather
      than growth promotion. This paper highlights the findings of the evaluation study
      carried out to assess the performance of the Lusaka urban growth monitoring
      programme in Zambia. The problems faced and reasons are identified and alternate
      ways of offering the service are presented. Since the shortfalls are not unique
      to the Lusaka programme, it is hoped that this paper will stimulate a re-think in
      the way growth monitoring would be best implemented.

PMID- 8356737
TI  - Indications for operative fracture treatment in tropical countries.
AB  - In the period 1 January 1987 to 30 June 1989, 3003 operations were performed at
      the regional hospital of Gbadolite, northern Zaire. In 123 patients fractures
      were reduced operatively, in 86 patients by internal fixation and in 37 patients
      by external fixation. There was no additional bone infection after external
      fixation but six of 28 patients (21%) with internal fixation by plate and screws
      developed postoperative osteitis. Non-union was observed in 12% after
      intramedullary nailing, in 4% after screw fixation alone, and 14% after internal
      fixation by Kirschner wires. Based on these data, indications and
      contraindications for operative fracture treatment in tropical countries are
      defined.

PMID- 8356738
TI  - Spectrum of cholangitis in a rural setting in North-eastern Peninsular Malaysia.

PMID- 8356739
TI  - Statistics of perinatal mortality due to error or omission: a suggestion of how
      to improve care.

PMID- 8356740
TI  - Missed dislocation of the hip.

PMID- 8356741
TI  - Indirect immunofluorescence used as confirmatory test for HIV-2 infection in
      developing countries.

PMID- 8356742
TI  - The value of family planning user profiles in better targeting of family
      planning: the case of Vanuatu.

PMID- 8356743
TI  - The use of filter paper in sero-epidemiological studies: a community based
      approach.

PMID- 8356744
TI  - TB control and HIV.

PMID- 8356745
TI  - Leper--what's in a name?

PMID- 8356746
TI  - Chloroquine.

PMID- 8356747
TI  - Ultrasonography in biliary ascariasis.

PMID- 8356748
TI  - Late presentation of vulval carcinoma in Trinidad.

PMID- 8356749
TI  - Surgical complications of typhoid fever.

PMID- 8356750
TI  - The abdominal cocoon.

PMID- 8356751
TI  - Primary mycetoma of the calcaneum.

PMID- 8356753
TI  - Spontaneous delivery of the placenta before the fetus in uterine rupture.

PMID- 8356752
TI  - Amoebic splenic abscess.

PMID- 8356754
TI  - Venous air embolism: another cause.

PMID- 8356755
TI  - Bird-related eye injuries.

PMID- 8356756
TI  - Use of intravenous infusion set tubing for puncture suprapubic cystostomy.

PMID- 8356757
TI  - Management of tuberculosis.

PMID- 8356758
TI  - Osteomyelitis in Uganda.

PMID- 8356759
TI  - Teaching through games.

PMID- 8356760
TI  - Mothers monitor growth.

PMID- 8356761
TI  - [Psychopharmacological therapy].

PMID- 8356762
TI  - [The effect of serum monitoring on concentration of perphenazine and
      zuclopenthixole].
AB  - The effect of therapeutic drug monitoring (TDM), including pharmacokinetic
      guidance, was examined in 994 psychiatric patients treated with perphenazine
      (Trilafon) or zuclopentixol (Cisordinol). Before monitoring of the serum level,
      half of the serum concentrations from patients given perphenazine tablets (466
      patients) was below the therapeutic level, and about one third was above. For
      perphenazine depot (208 patients), almost no patients had a serum concentration
      below the therapeutic level whereas 40% had concentrations above. For
      zuclopentixol tablets (231 patienter) and zuclopentixol depot (163 patients),
      about 60% of the patients had concentrations above the therapeutic level. For all
      four groups, it was found that slightly more than half of the patients with serum
      concentrations outside the therapeutic level was reexamined. The dosage was
      changed in most of these patients (80-90%) in order to bring the concentration
      within the therapeutic level. Half of those in whom the dose was changed obtained
      concentrations within the therapeutic level. It is concluded that since the
      recommendations for changes of the dosage is followed to a wide extent, the
      therapeutic drug monitoring service does influence the treatment significantly.

PMID- 8356763
TI  - [Vaginal bleeding in the first trimester].
AB  - Significant changes in attitudes towards patients with vaginal bleeding during
      the first trimester of pregnancy are taking place at the moment, and it is with
      this in mind that the relevant literature dealing with these patients is
      reviewed. The rate of miscarriage in an asymptomatic population of pregnant women
      is 2-4%. If vaginal bleeding occurs, about half the fetuses will have no
      detectable heartbeat by the time symptoms appear and miscarriage is taking place.
      Of the remainder, where heartbeat is demonstrated, only ten percent will miscarry
      despite the bleeding. The presence of an intrauterine haematoma will at most have
      marginal significance for the prognosis. There is no treatment that has a
      documented effect amongst these patients, which is why hospitalization can no
      longer be recommended. A possible investigational program is suggested.

PMID- 8356764
TI  - [Pouchitis: acute inflammation in the pelvic ileal reservoir. Diagnostic
      criteria, frequency, possible etiological factors and treatment].
AB  - Pouchitis is a significant long-term complication of restorative proctocolectomy.
      Pouchitis is characterized by diarrhoea, fever, malaise, abdominal pain and in
      few a patients a worsening of already present extraintestinal manifestations may
      occur. The estimated probability of pouchitis occurring within five years is
      approximately 35%. Standard diagnostic criteria have not yet been established,
      but clinical symptoms, endoscopic and histological features should be included.
      The cause of pouchitis is unknown, bacterial over-growth, faecal stasis, oxygen
      free radicals, secondary and deconjugated bile acids, shortchain fatty acids,
      gastrointestinal hormones and an immunologically-mediated reaction have all been
      suggested as possible etiological factors. Metronidazole is the most commonly
      used treatment and has prompt effect in more than 90% of the patients. Steroids
      and 5-aminosalicylic acid derivatives also seem to be effective. A diverting
      ileostomy is necessary in only five to seven percent of the patients, and in less
      than one percent does pouchitis result in excision of the pouch. Controlled
      trials with uniform diagnostic criteria are required to assess the effectiveness
      of the individual regimens.

PMID- 8356765
TI  - [Parenchymal surgery in patients aged 80 and over--a coming crisis? An analysis
      of current status and results and an attempt to illuminate future needs].
AB  - This study reviews 594 admissions of 434 patients aged 80 years or more to the
      departments of general surgery in Ringkobing County, Denmark, during one year.
      Half of the patients were admitted as emergencies, and 60% underwent surgery. The
      overall mortality was 9%, the postoperative mortality 8%. The number of
      postoperative complications and the postoperative mortality rate increased in
      emergency cases and in patients with complicating medical diseases. 72% of all
      admissions were uncomplicated and 69% of the patients were discharged directly
      home. Generally, these patients do not block beds, but are discharged as soon as
      medical care is no longer indicated. During this decade it is expected that the
      number of admissions of patients aged 80 years or older will increase by about
      25%, and unless additional resources are provided, new standards must be
      considered for the distribution of resources and of indications for surgery in
      both young and old. Also, the development of less traumatic methods of operative
      surgery with lower morbidity rates, earlier recovery and reduced hospital stay
      must be encouraged.

PMID- 8356766
TI  - [Surgical treatment of hydronephrosis. Late results after surgery using the
      Anderson-Hynes method].
AB  - Twenty-one patients with hydronephrosis mean age 37 years (11-72) were operated
      using Anderson-Hynes pyeloplasty, without routine use of a nephrostomy catheter.
      One patient developed urinary leakage postoperatively, which ceased after
      insertion of a ureteric catheter. Follow-up assessment was performed after a mean
      observation time of 85 months (44-142). Clinical examination, laboratory
      investigations, urography and renography were performed preoperatively and at
      follow-up. No signs of stones or stenosis in the pelvis were found. The patients
      operated upon before the age of 30 showed improved postoperative renal function.
      All patients had symptoms preoperatively, but only one had symptoms
      postoperatively. It can be concluded that the results of surgical intervention in
      hydronephrosis are excellent, especially in patients below 30 years.

PMID- 8356767
TI  - [Unrecognized Hodgkin's disease as cause of death. A review of 27 cases diagnosed
      post mortem].
AB  - The purpose of the study was to examine the incidence of unrecognised Hodgkin's
      disease (HD) as cause of death and to search for clinical features that could
      have ensured a correct pre-mortem diagnosis. A review of cases of HD reported to
      the Danish Cancer Registry from 1976 through 1987 in patients younger than 70
      years old disclosed 27 where HD was the primary cause of death and the diagnosis
      was unrecognised at the time of death. The majority of the patients had no
      concurrent diseases and may have benefitted from a correct diagnosis and a
      potentially curative treatment. Most of the patients had persistent unexplained
      fever and weight loss. Pancytopenia, hepatic involvement, bone marrow
      involvement, advanced stage disease, and lymphocytic depletion histology were
      also frequent findings. Peripheral or retroperitoneal lymphadenopathy was noted
      in nine patients without biopsy. The many uncommon features of HD together with
      the frequent findings of falsely negative chest X-ray, bone marrow examination,
      liver biopsy, and abdominal ultrasound contributed to the difficulty in
      diagnosis. However, in about 1/3 of the patients clinical findings suggestive of
      lymphoma did not result in relevant diagnostic procedures.

PMID- 8356768
TI  - [Fatal poisonings in Jutland 1980-1989].
AB  - A description is given of trends in the pattern of fatal poisonings examined at
      the Department of Forensic Medicine, Aarhus University during the period 1980
      through 1989 (638 men and 391 women). These cases comprised 36% of all fatal
      poisonings in the area during the decade. In more than half of the medicolegally
      examined cases, death was categorized as accident. In two thirds of the examined
      cases death was caused by drugs, whereas non-medical substances (alcohol, carbon
      monoxide etc.) accounted for one third of the deaths. During the ten-year period,
      a decline was seen in the number of barbiturate-related deaths, whereas the
      number of deaths caused by analgesics increased. Propoxyphene was the drug found
      to have caused most deaths during the period, and developments concerning fatal
      poisonings involving this drug must still be watched closely.

PMID- 8356769
TI  - [Penetration of a sliding screw into the pelvis. A rare complication in
      osteosynthesis of hip fractures].
AB  - Penetration into the pelvis by a sliding screw, with screwplate disengagement, is
      a rare complication after osteosynthesis of intertrochanteric fractures of the
      femur. This case highlights such an unusual event with fatal outcome. Unstable
      fracture, osteoporosis, and full weight bearing combined with the failure of the
      screw to slide within the barrel of the plate and with the absence of a
      compression screw increases the risk of complications. Optimal reposition and
      screw placement with a high plate angle, full screw-plate engagement and use of
      the compression screw is recommendable in unstable fractures.

PMID- 8356770
TI  - [Injuries of the hand caused by high-pressure air].
AB  - Based on two cases of accidental high-pressure air injection injury to the hand,
      we describe pathology, symptoms and therapeutic principles. Despite nontoxicity
      of injected air, the importance of acute surgical intervention must be
      emphasized, as there is a risk of high-pressure soft tissue damage. The treatment
      suggested is: 1) systemic medication including tetanus toxoid and antibiotics, 2)
      adequate incision, decompression, exploration, drainage and debridement under
      either general, plexus or i.v. anaesthesia. Postoperatively, the hand should be
      elevated, and a program of physical mobilisation should be started as soon as
      possible.

PMID- 8356771
TI  - [Infarct of the tongue and hyperlipidemia].
AB  - We describe a case of a 49 year-old woman, predisposed to arteriosclerosis, who
      developed and infarct of the tongue caused by hyperlipidaemia. Treatment and
      differential diagnoses, including giant cell arteritis, are discussed.

PMID- 8356772
TI  - [Primary malignant lymphoma in the appendix vermiformis].
AB  - Primary gastrointestinal lymphoma (PGL) is a rare condition. A case story
      concerning a 17 year old boy is presented and discussed. The symptoms were fever
      and pain in the lower right quadrant of the abdomen, where a tender tumor was
      palpable. The tentative diagnosis was periappendicular abscess and the patient
      was treated with antibiotics. As the tumor persisted, a laparotomy with resection
      of the coecum was performed. Histologic diagnosis was malignant lymphoma
      originating in the appendix. There was no sign of dissemination in the abdomen.
      Postoperative treatment with chemotherapy and radiation was carried out. PGL in
      the appendix in young patients, almost entirely males, will as here often be of
      the Burkitt type. The histologic type of the tumor, the staging and the
      radicality at operation are important with regard to prognosis.

PMID- 8356774
TI  - [On paternalistic cancer science].

PMID- 8356773
TI  - [Chordoma localized in the spine].

PMID- 8356775
TI  - Applications of a post-column imaging filter in biology and materials science.
AB  - We have developed an energy-selecting imaging filter which can be attached to
      most transmission electron microscopes, and is capable of operating at primary
      energies of up to 400 keV. We review the filter's design and operation, and
      illustrate them with several applications including imaging of thick biological
      materials, energy-filtered diffraction, energy-filtered high-resolution imaging,
      and elemental mapping. We conclude the paper with a discussion of the areas of
      transmission electron microscopy in which the filter is likely to make especially
      significant contributions.

PMID- 8356776
TI  - The present status of ultrasonic imaging in medicine.
AB  - The ultrasonic techniques that are used routinely in medical imaging have
      resulted from basic scientific discoveries, new methods of signal analysis and
      image processing, the development of transducer materials and fabrication
      techniques, and the application of digital electronics. The system designer is
      constrained by the ultrasonic properties of tissues, especially speed and
      attenuation: these properties determine the optimum choices of ultrasonic
      frequency, and spatial contrast and temporal resolutions. Ultrasonic Doppler
      techniques provide information about moving targets, including blood flow. Two
      dimensional images of anatomical structure and blood flow can be combined in real
      time displays. Other advances include sonoelasticity imaging, computed
      tomography, three-dimensional imaging, contrast agents and quality assurance.
      Contemporary ultrasonic diagnostic techniques seem to be safe, but the search for
      possible hazards is continuing with emphasis on thermal effects and cavitation.

PMID- 8356777
TI  - Recent activity in ultrasonic tomography.
AB  - During the past two decades there have been significant developments in many
      aspects of acoustical imaging techniques for various applications. One aspect of
      this development has been the application of ultrasonic tomography to medical
      imaging and diagnosis instrumentation, and also to non-destructive evaluation of
      materials, to oceanographic systems for measurements of such factors as
      temperature and currents etc, and to seismic exploration. This paper reviews the
      theoretical and practical work in acoustical tomography to the present time.

PMID- 8356778
TI  - Doppler colour flow mapping of fetal intracerebral arteries in the presence of
      central nervous system anomalies.
AB  - The adjunctive role of Doppler colour flow mapping in the evaluation of
      intracerebral morphology and arterial blood flow in the presence of normal and
      abnormal central nervous system morphology was determined. A total of 59 fetuses
      with suspected central nervous system pathology between 14 and 37 weeks of
      gestation was studied (median 31 weeks). One hundred and one fetuses with normal
      central nervous system anatomy between 14 and 37 weeks (median 19 weeks) served
      as controls. Visualisation of blood flow in one or more intracerebral arterial
      vessels was successful in more than 80% of normal fetuses. For the anterior,
      middle and posterior cerebral artery, the percentages were 63%, 89% and 45%,
      respectively, at 14-25 weeks and 74%, 100% and 55%, respectively, at 26-37 weeks
      of gestation. Intracerebral arterial flow identification was attempted in 52/59
      (88%) affected fetuses. Identification of blood flow in one or more intracerebral
      arterial vessels was successful in 40/52 (77%) fetuses. End-diastolic flow
      velocities were present in at least one of the intracerebral arteries in 39/40
      fetuses, absent in one case of hydrocephaly and raised in the presence of an
      intracerebral vascular tumour. Doppler colour flow mapping seems to provide only
      limited additional information on intracranial structural pathology.

PMID- 8356779
TI  - Nonlinear propagation in Doppler ultrasound.
AB  - The nonlinear propagation of ultrasound was demonstrated using Doppler
      transducers on two commercial duplex machines. The influence of nonlinear
      propagation on Doppler measurements was studied on both a flow phantom and a
      string phantom. It was found that although the pulse waveforms showed clearly
      different degrees of nonlinear distortion, no effect due to the nonlinearity
      could be detected on the received Doppler spectrum both in terms of the maximum
      frequency or underlying Doppler spectral profile.

PMID- 8356780
TI  - Quantification of ventricular remodeling in the tight-skin mouse cardiomyopathy
      with acoustic microscopy.
AB  - To determine the role of ultrasonic tissue characterization for the detection of
      changes in myocardial architecture associated with cardiomyopathy, acoustic
      microscopy was performed on the hearts of 4- to 6-month-old tight-skin mice
      [TSK/+, C57-B10.D2 (58B)/SN strain], a model of cardiomyopathy characterized by
      diffuse interstitial fibrosis. Ultrasonic backscatter was measured from excised
      segments of left ventricular free walls of five TSK mice and five sex- and age
      matched normal controls with a 50 MHz broad band focused piezoelectric transducer
      operated in a saline-filled water tank at room temperature. Forty-nine radio
      frequency (RF) lines were digitized from each specimen at 2 ns/sample. Power
      spectral analysis of RF data was performed and mean integrated backscatter (IB)
      computed. The TSK group demonstrated greater IB (-53.6 +/- 0.6 dB, n = 5) than
      did the control group (-56.6 +/- 0.7 dB, n = 5; p < 0.02). Myocardial collagen
      content determined by hydroxyproline assay increased by 11% in the TSK group
      (2.54 +/- 0.08 microgram/mg dry wt, n = 5) over that in controls (2.28 +/- 0.07
      microgram/mg dry wt, n = 5; p < 0.05). A significant linear relationship was
      observed between myocardial hydroxyproline concentration and IB (r = 0.74; p <
      0.02). Thus, ultrasonic tissue characterization permits sensitive detection of
      modest changes in the extent of interstitial fibrosis that accompany tissue
      remodeling in the early stages of cardiomyopathy.

PMID- 8356781
TI  - In vitro evaluation of gallstone dissolution with methyl-tert-butyl ether and
      ultrasound energy.
AB  - Given the large number of cholecystectomies performed annually, a nonsurgical
      approach to gallstone therapy is of great interest. A laboratory ultrasound
      system has been developed to study enhancement of methyl-tert-butyl ether (MTBE)
      dissolution of human gallstones in vitro. A mathematical model that
      quantitatively characterizes the dissolution process via a rate constant has been
      developed. Using this model, the kinetics of 15 gallstones from a single patient
      were evaluated for three dissolution methods: 1) unstirred MTBE, 2) aspirated
      MTBE, and 3) ultrasonically enhanced MTBE. The results showed excellent fits
      between the model and measured dissolution rates. 195 kHz continuous-wave (CW)
      ultrasonically enhanced dissolution rates exhibited a 6.2 fold gain over the
      manually aspirated MTBE and a 49.5 fold gain over static MTBE dissolution.
      Investigation of 50% duty cycle pulsed mode ultrasound revealed that total power
      appears to be the determinant of the observed dissolution rates. Gallstone
      calcification showed a strong correlation with dissolution rates measured by the
      model.

PMID- 8356782
TI  - Effects of pulsed ultrasound on the frog heart: I. Thresholds for changes in
      cardiac rhythm and aortic pressure.
AB  - High intensity pulsed ultrasound at 1.2 MHz is shown to change the cardiac rhythm
      and aortic pressure of frog hearts in vivo. Threshold levels for these effects
      occur at acoustic pressure amplitudes of the order of 10 MPa for 5 ms pulse
      lengths. Depending upon the phase of the heart cycle, a pulse of ultrasound
      either may cause a premature ventricular contraction, a reduction in the strength
      of contraction as measured by the aortic pressure, or an enhanced relaxation of
      the heart muscle. There is an increase in the effectiveness of the ultrasound
      with increase in pulse length in the range from 1 to 5 ms.

PMID- 8356783
TI  - Effects of pulsed ultrasound on the frog heart: II. An investigation of heating
      as a potential mechanism.
AB  - This study investigated heating as the possible mechanism for the reduction in
      aortic pressure observed as a result of exposure of frog hearts in vivo to a
      single, high intensity pulse of ultrasound. The threshold for producing reduced
      aortic pressure with 5 ms pulses of ultrasound was found to be approximately 5-10
      MPa peak positive pressure (ISPPA approximately 350-1000 W/cm2) at both 1.2 MHz
      and 3.7 MHz. Theoretical estimates and experimental measurements of heating,
      though, indicate that heating rates at threshold exposures for these two
      frequencies differ by as much as a factor of 10. As a result, heat alone does not
      appear to be the primary mechanism responsible for the observed effects on the
      heart.

PMID- 8356784
TI  - Biological effects of high energy shock waves in mouse skeletal muscle:
      correlation between 31P magnetic resonance spectroscopic and microscopic
      alterations.
AB  - To investigate the in vivo effects of electromagnetically generated high energy
      shock waves (HESW) on skeletal muscle, we used in vivo 31P nuclear magnetic
      resonance (NMR) spectroscopy (MRS) measurements and correlated the results with
      microscopical studies. Mouse skeletal muscle (calf muscle) was exposed to 200 or
      800 HESW (Pmax: 37.5 MPa, Pmin: 5.2 MPa, tr: 30-120 ns, tw: 340 ns, frequency:
      1.25 Hz). In the 31P MRS spectra, transient alterations were observed. A
      prominent increase of inorganic phosphate (Pi) peaks was found, as well as the
      appearance of Pi with different chemical shifts, reflecting the presence of
      different pH values (5.4-7.1) in cellular or tissue compartments. Within 20-96 h
      after exposure, pH values and Pi levels returned to normal. The changes were more
      pronounced in the animals treated with 800 HESW as compared to 200 HESW. Light
      and electron microscopy demonstrated focal degenerations of muscle fibers. This
      process consisted of disorganization of myofilaments and structural changes in
      sarcoplasmic organelles and was progressive in time. The (ultra)structural
      changes were not present in all myofibers (i.e., between affected degenerating
      fibers unaffected intact fibers were seen). Several ultrastructural abnormalities
      were also found in capillaries even up to severe dilatation and disruption, as
      well as in the peripheral nerves. The degeneration of the preexisting myofibers
      was predominantly confined to type 1 fibers and was followed by a regeneration of
      the muscle tissue by proliferation of myoblasts. A notable amount of myotubes
      still showed vacuolization. We conclude that in vivo HESW exposure of skeletal
      muscle tissue results in a degeneration of myofibers. The cellular effects are
      present in foci and associated with changes in the 31P NMR spectra. The NMR
      spectroscopy technique provides us with a noninvasive method to evaluate in a
      longitudinal way the biological effects of HESW.

PMID- 8356785
TI  - Ultrasound-induced enhancement of ACh, AChE and GABA in fetal brain tissue of
      mouse.
AB  - Pregnant mice were exposed to continuous-wave (CW) ultrasound of 875 kHz
      frequency at 1 W/cm2 for 300 and 400 s, spread over five days, starting from the
      sixth day of pregnancy. The neurotransmitters, acetylcholine (ACh) and gamma
      amino butyric acid (GABA), and the associated enzyme acetylcholinesterase (AChE)
      levels, were estimated in the exposed fetal brains. Enhanced levels, significant
      at p < 0.001, were observed in the brains excised on day 10, day 15 and day 20 of
      gestation compared to sham-exposed and cage-control brains.

PMID- 8356786
TI  - Heating of guinea-pig fetal brain during exposure to pulsed ultrasound.
AB  - Ultrasound-induced temperature elevations in fresh and formalin-fixed fetal
      guinea-pig brains were measured during in vitro insonation, with a stationary
      beam in a tank containing water at 38 degrees C. The pulsing regimen used 6.25
      microseconds pulses, repeated at a frequency of 4 kHz emitted from a focussed
      transducer operating with a centre frequency of 3.2 MHz. The greatest temperature
      rise in brain tissue occurred close to bone and correlated with both gestational
      age and progression in bone development. After a 2 min insonation with a spatial
      peak temporal average intensity (ISPTA) of 2.9 W/cm2, a mean temperature
      elevation of 5.2 degrees C was recorded in fetuses of 60 days gestation (dg). The
      same exposure produced an increase of 2.6 degrees C in the centre of whole brains
      of 60 dg fetuses when the bony cranium was removed. As most of the heating occurs
      within 40 s, these findings have implications for the safety of pulsed Doppler
      examinations where dwell-time may be an important factor.

PMID- 8356787
TI  - Mutations in the transmembrane domain of the HN protein of Newcastle disease
      virus affect the structure and activity of the protein.
AB  - To explore the role of the transmembrane domain of the HN protein in the
      structure and function of the molecule, three conserved leucine residues in this
      domain which occur in a heptad-repeat motif were changed to alanine singly or in
      combination by site-specific mutagenesis. None of the mutant proteins were
      defective in translocation and intracellular transport. All mutant proteins
      formed disulfide-linked dimers. However, tetrameric structures of proteins with
      mutations in the third or most carboxy-terminal leucine could not be detected by
      sucrose gradient analysis, and mutant proteins with changes in both the first and
      second leucine formed less-stable tetramers. These results suggest that the
      transmembrane domain plays a role in the tetrameric structure of the HN protein.
      These mutations also altered the biological activities of the protein. Mutant
      proteins with alterations in the third leucine were very defective in attachment
      activity and somewhat defective for neuraminidase activity while all other mutant
      proteins had wild-type levels of attachment and neuraminidase activity. While all
      mutant proteins showed diminished fusion-promotion activity, proteins with
      mutations in the third leucine and proteins with changes in both the first and
      second leucines were very defective in fusion promotion. These results suggest
      that elimination or destabilization of the tetrameric structure affects
      attachment activity and fusion-promotion activity of the HN protein.

PMID- 8356788
TI  - Probing of the receptor-binding sites of the H1 and H3 influenza A and influenza
      B virus hemagglutinins by synthetic and natural sialosides.
AB  - To compare features of the receptor-binding sites (RBSs) of different influenza
      virus hemagglutinins (HA), binding of a number of synthetic sialic acid (SA)
      analogs and natural sialosides by a panel of about 30 human influenza A and B
      virus strains was studied in a competitive ligand binding assay. For all the
      viruses tested, the N-acetyl group of Neu5Ac, as well as the natural orientation
      of the carboxylic group at C2 and the hydroxylic group at C4, was essential for
      binding. Significant type- and subtype-specific differences were observed in
      virus recognition of asialic parts of sialosides. H1 strains, unlike H3 and type
      B viruses, were found to bind alpha 2-6-sialyl-N-acetyllactosamine with about an
      order of magnitude higher affinity than alpha 2-6-sialyllactose (6'SL). The H1
      viruses and the H3 strains with Gln in position 226 of HA, but not the H3 strains
      with Leu-226, bound 6'SL with a lower affinity than alpha 2-3-sialyllactose; this
      effect correlated clearly with the preferential binding by the former viruses of
      unsubstituted alpha Neu5Ac compared to methyl alpha-glycoside of Neu5Ac. Thus,
      differentiation between the types of the SA-Gal linkage by the A viruses appeared
      to depend, at least partially, upon the recognition by the HA of the first
      hydrocarbon group of the aglycon. Type B virus strains were distinct in having a
      lower affinity for the Neu5Ac moiety and in providing a higher contribution of
      the asialic portions of sialosides to the HA-ligand interactions. The last
      effects are presumably due to the amino acid insertions in the type B HA
      surrounding the RBS, which makes the receptor-binding pocket deeper. The results
      obtained in the present investigation indicate that while the functional groups
      of Neu5Ac studied are recognized by the RBSs of all influenza viruses, the
      magnitude of their contribution to the binding energy, as well as the
      contribution of the asialic portion of the receptor, may vary in dependence upon
      the virus type, subtype, and strain.

PMID- 8356789
TI  - Regulation of HIV-1 envelope protein synthesis by Tat and Rev in 293 cells.
AB  - A plasmid expression vector (B2) with the HIV-1 envelope sequence downstream of
      the adenovirus type 5 early region 3 promoter could direct the synthesis of
      envelope protein in the absence of Rev when transfected into 293 cells. We
      investigated this further using pNL4.3 delta TR, and HIV-1 mutant which lacks the
      first exon of Tat and Rev and pNL4.3 delta R, an HIV-1 mutant with a premature
      termination codon in the second coding exon of Rev. In cells transfected with
      pNL4.3 delta TR and a Tat-expressing vector or with pNL4.3 delta R alone,
      analysis of RNA revealed the accumulation of cytoplasmic Env mRNA in the absence
      of Rev. However, envelope protein synthesis was observed in the absence of Rev
      only in cells transfected with pNL4.3 delta TR and a Tat-expressing vector, not
      in cells transfected with pNL4.3 delta R. The Env mRNAs synthesized from pNL4.3
      delta R can have 536 to 548 nucleotides of 5' non coding sequence, whereas the
      Env mRNA from pNL4.3 delta TR will have a shortened noncoding sequence of 321
      nucleotides. These results indicate that the mRNA sequences 5' to the Env protein
      initiation codon have a role in Env expression.

PMID- 8356790
TI  - Influence of host cell-mediated variation on the international surveillance of
      influenza A (H3N2) viruses.
AB  - Growth of clinical specimens of influenza viruses in eggs can result in the
      selection of antigenic variants distinct from corresponding viruses grown in
      mammalian tissue culture. To evaluate the contribution of host cell selection on
      the antigenic diversity of human influenza isolates, as seen in annual
      surveillance studies, viruses grown in embryonated eggs were compared by
      antigenic and genetic analyses with their mammalian tissue culture-grown
      counterparts. Clinical specimens were gathered from around the world from late
      1987 to 1990 and the antigenicity of isolated viruses was assessed by
      hemagglutination-inhibition assays using immune ferret sera as is currently
      performed for routine surveillance and the selection of vaccine strains. In
      addition, viruses were assessed using a panel of anti-H3 HA monoclonal
      antibodies. The extent of antigenic variation exhibited by the egg-grown strains
      was far greater than the relative antigenic homogeneity of the tissue culture
      grown viruses. Nucleotide sequence analysis of HA1 gene PCR products of 28 MDCK
      cell and egg derived pairs allowed identification of amino acid substitutions
      responsible for the antigenic differences observed and the adaptation to growth
      in eggs. Among these substitutions was a change at amino acid position 186 of HA1
      (Ser in tissue culture viruses and lle in egg-grown viruses) which was observed
      at relatively high frequency. Egg- and MDCK-grown pairs with this single amino
      acid difference were classified into distinct antigenic groups by ferret sera
      raised to WHO reference viruses. Given the additional antigenic diversity
      observed among egg-grown strains, considerable care should be taken in the
      selection of reference and vaccine strains grown in eggs. Rapid sequence
      comparisons of MDCK- and egg-grown viruses allow identification of variants
      arising through egg selection and will prove to be a useful adjunct to antigenic
      surveillance for the selection of reference and vaccine strains.

PMID- 8356791
TI  - Comparison of envelope and precore/core variants of hepatitis B virus (HBV)
      during chronic HBV infection.
AB  - We analyzed entire pre-C/C and pre-S/S coding genes of hepatitis B virus (HBV) in
      serial serum samples from four chronic HBV carriers with 4-5 years of follow-up.
      Two patients with chronic active hepatitis became seronegative for HB e antigen
      (HBeAg), but the hepatitis did not subside, while the other two were persistent
      asymptomatic carriers with normal aminotransferase values. DNAs amplified by PCR
      were cloned and sequenced (subtype adr). After HBeAg became negative, one patient
      had 96-183 bp deletions in 4/6 clones for C gene. In addition, both patients had
      129-183 bp deletions in 3/6 and 2/5 clones for pre-S1 gene, respectively.
      Divergence rate of deduced amino acid for both pre-C/C and pre-S/S regions from
      the adr subtype was significantly higher in patients with chronic hepatitis than
      in asymptomatic carriers. Furthermore, the divergence rate for pre-S/S region was
      usually greater in asymptomatic carriers as well as chronic hepatitis patients
      compared with that for pre-C/C region. However, no significant difference was
      found in the rate of amino acid divergence for the entire HBV genes between the
      serial samples in all patients studied here. These results suggest that active
      hepatitis induces variation of HBV gene and defective virus is often selected
      along with the disappearance of HBeAg. In addition, the fact that patients with
      active liver disease possess greater numbers of mutant clones than asymptomatic
      carriers suggests that viral mutants are being immune-selected.

PMID- 8356792
TI  - HTLV-1 gene expression by defective proviruses in an infected T-cell line.
AB  - We have examined human T-lymphotropic virus type I (HTLV-I) gene expression in
      the human T-cell line, C8166-45 (C81), as a model to define the gene products
      expressed from defective proviruses. C81 cells contain one complete and two
      different deleted proviral genomes. The internal deletions of the latter
      encompass most of the gag to env region. All three proviruses are
      transcriptionally active as evidenced by the presence of three unspliced nuclear
      mRNAs. Unspliced genomic mRNAs and singly spliced env mRNAs were present in the
      nucleus, but were not detected in the cytoplasm, suggesting a defect in Rex
      function. Three small cytoplasmic mRNAs were observed and are likely to
      correspond to the normal 1.8-kb Tax1/Rex1 mRNA, a 1.6-kb mRNA formed by splicing
      the 5'LTR to the pX region, and a 2.1-kb mRNA of unknown origin. Consistent with
      the subcellular mRNA distribution pattern, the viral structural proteins encoded
      by gag and env genes were not detected. The transcriptional transactivator
      protein, Tax1 (p40), was abundantly expressed in C81 cells; in addition, a 42-kDa
      Tax1 protein, unique to this cell line, was also detected. Although Tax1 and Rex1
      (p27) are translated from overlapping open reading frames in the same mRNA, Rex1
      was not detected in C81 cells. The presence of a premature termination codon in
      the Tax1/Rex1 mRNA encoded by the full-length provirus was inferred from the
      presence of small Rex1-related polypeptides lacking C-terminal sequences and
      confirmed by sequence analysis. Furthermore, a p21X protein lacking the N
      terminus of Rex1 was expressed at high levels; our data indicate that p21X is
      translated from the 1.6-kb mRNA which is derived primarily from deleted
      proviruses.

PMID- 8356793
TI  - Leader-mRNA junction sequences are unique for each subgenomic mRNA species in the
      bovine coronavirus and remain so throughout persistent infection.
AB  - The common leader sequence on bovine coronavirus subgenomic mRNAs and genome was
      determined. To examine leader-mRNA junction sequences on subgenomic mRNAs,
      specific oligodeoxynucleotide sets were used in a polymerase chain reaction to
      amplify junction sequences from either the positive-strand mRNA (eight of nine
      total identified species) or the negative-strand anti-mRNA (six of the nine
      species), and sequenced. The mRNA species studied were those for the N, M, S, and
      HE structural proteins and the 9.5-, 12.7-, 4.8-, and 4.9-kDa putative
      nonstructural proteins. By defining the leader-mRNA junction sequence as the
      sequence between (i) the point of mismatch between the leader and genome and (ii)
      the 3' end of the consensus heptameric intergenic sequence [(U/A)C(U/C)AAAC)], or
      its variant, a unique junction sequence was found for each subgenomic mRNA
      species studied. In one instance (mRNA for the 12.7-kDa protein) the predicted
      intergenic sequence UCCAAAC was not part of the junction region, and in its place
      was the nonconforming sequence GGTAGAC that occurs just 15 nt downstream in the
      genome. Leader-mRNA junction sequences found after 296 days of persistent
      infection were the same as those found during acute infection (< 18 hr
      postinfection). These data indicate that, in contrast to the closely related
      mouse hepatitis virus, the bovine coronavirus maintains a stable leader-mRNA
      junction sequence for each mRNA. Interestingly, this stability may be related to
      the fact that a UCUAA sequence element, postulated by others to be a regulator of
      the leader-mRNA fusion event, occurs only once within the 3' flanking sequence of
      the genomic leader donor and once at intergenic sites in the bovine coronavirus
      genome, whereas it occurs two to four times at these sites in the mouse hepatitis
      coronavirus.

PMID- 8356794
TI  - Differences between cell membrane fusion activities of two dengue type-1 isolates
      reflect modifications of viral structure.
AB  - The genetic diversity of dengue (DEN) virus was explored using two South American
      DEN-1 virus strains isolated from viremic human sera. DEN-1 virus strains BR/90
      and FGA/89 were selected on the basis of their membrane fusion properties in
      mosquito cell cultures. Infection of mosquito cell lines with BR/90 virus strain
      induced a cytopathic effect characterized by syncytium formation whereas no
      cytopathic changes were observed with FGA/89. Cell-to-cell fusion experiments
      indicated that the fusogenic activity of FGA/89 required a lower pH than BR/90.
      Immunoreactivity analysis of the DEN-1 envelope (E) protein with monoclonal
      antibodies revealed a minor difference between the antigenic structures of FGA/89
      and BR/90 virions. FGA/89 was less neurovirulent than BR/90 for newborn mouse. To
      determine the genetic origin of these modifications, the amino acid sequences of
      the structural proteins from these virus strains were compared. One amino acid
      difference was found within the carboxy-terminal domain of protein C. Five amino
      acid substitutions were found in the E proteins at positions 96, 180, 297, 379,
      and 473. Changes at positions 96, 297, and 379 map within two overlapping
      antigenic domains of protein E. These limited amino acid differences in the E
      protein could affect the biological properties and the antigenicity of the DEN
      virion.

PMID- 8356795
TI  - Attachment of the gammaherpesvirus bovine herpesvirus 4 is mediated by the
      interaction of gp8 glycoprotein with heparinlike moieties on the cell surface.
AB  - Cell surface heparan sulfate serves as the initial receptor for several
      alphaherpesviruses and at least one betaherpesvirus. This study shows that during
      the process of adsorption of the gammaherpesvirus bovine herpesvirus 4 (BHV-4),
      the viral glycoprotein gp8 interacts with heparinlike moieties of cell surface.
      This conclusion is based on the following findings. (i) Soluble heparin was
      capable of blocking BHV-4 infection of Georgia bovine kidney cells by inhibition
      of viral attachment. (ii) Nevertheless, after virus adsorption to Georgia bovine
      kidney cells, heparin was partially capable of removing adsorbed virus. (iii)
      Enzymatic digestion of cell surface heparan sulfate but not of chondroitin
      sulfates A, B, and C reduced the binding of the virus to the cells, and rendered
      the cells partially resistant to infection. (iv) Radiolabeled purified BHV-4
      bound to wild-type Chinese hamster ovary cells, whereas binding of the virus to
      mutant Chinese hamster ovary cell lines that where deficient in either all
      glycosaminoglycans or only heparan sulfate was significantly impaired. (v) Using
      heparin-affinity chromatography, gp8 glycoprotein was shown to bind specifically
      to immobilized heparin and to elute in the presence of soluble heparin. These
      data together showed that the gammaherpesvirus BHV-4, like alphaherpesviruses and
      one betaherpesvirus, adsorbs to cells by binding to cell surface heparin-like
      moieties. Therefore, this study extends the group of herpesviruses interacting
      with heparinlike moieties at the cell surface to a member of the
      gammaherpesvirinae subfamily.

PMID- 8356796
TI  - Molecular assembly of influenza virus: association of the NS2 protein with virion
      matrix.
AB  - The NS2 protein, one of the two nonstructural proteins of influenza A virus, was
      found to exist in virus particles. By immunochemical method, the average number
      of NS2 in a virus particle was estimated to be 130-200 molecules. After
      solubilization of viral envelope, NS2 was still associated with ribonucleoprotein
      cores, but was later dissociated upon removal of the M1 protein. A filter-binding
      assay in vitro indicated direct protein-protein contact between M1 and NS2.
      Following chemical cleavage of the M1 protein, NS2 bound only a C-terminal
      fragment of M1. By immunoprecipitation, NS2-M1 complexes were also detected in
      virus-infected cell lysates. These observations altogether indicate specific
      molecular association between M1 and NS2. Biological significance of M1-NS2
      interaction is discussed.

PMID- 8356797
TI  - In vivo infection of human T-cell leukemia virus type I in non-T cells.
AB  - Using three different procedures, immunomagnetic isolation, FACS and panning,
      each of the T4 cell, T8 cell, monocyte, and B cell population was fractionated
      from peripheral blood mononuclear cells (PBMC) obtained from 10 human T cell
      leukemia virus type I (HTLV-I)-associated myelopathy (HAM)/tropical spastic
      paraparesis (TSP) cases, 3 adult T cell leukemia and lymphoma (ATLL) cases and 9
      HTLV-I-infected healthy carriers. DNA from each fraction was then subjected to
      the quantitative polymerase chain reaction. Although T4 cells possessed the
      highest copy number of HTLV-I in general, we also detected a significant amount
      of HTLV-I provirus in T8 cells, monocytes, and B cells. To confirm virus
      infection of the non-T cell populations, especially the monocyte fraction, we
      performed further experiments and the following results were obtained: (1) HTLV-I
      tax RNA expression was confirmed simultaneously in the RNA of monocytes that were
      negative for T cell receptor beta chain (TCR beta) expression in vivo. (2) We
      cultured these monocytes for a short period of time and detected HTLV-I antigen
      expression in non-specific esterase-positive monocyte/macrophage cells. Our data
      indicate that HTLV-I has a broad host range in vivo and that monocytes or cells
      of monocyte lineage such as tissue macrophages might comprise a virus reservoir
      in vivo.

PMID- 8356798
TI  - BEL-1 transactivator responsive sequences in the long terminal repeat of human
      foamy virus.
AB  - Cis-regulatory elements in the long terminal repeat (LTR) of human foamy virus
      (HFV) were identified by using LTR mutants to transiently express the
      chloramphenicol acetyl-transferase gene after co-transfection with an expression
      plasmid for the virus bel-1 (transactivator) gene. The R-U5 region and an element
      in the 5' U3 region were found to negatively influence HFV gene expression. The
      complete BEL-1 responsive region was mapped to extend from nucleotide position 
      471 to position -93 relative to the start of transcription. Within this region,
      three elements were identified that in the homologous or a heterologous (SV40)
      promoter context can, independently and irrespective of their orientation, act as
      targets for BEL-1. These elements are located between nucleotide positions -413/
      378, -361/-291, and -124/93. The target elements do not share obvious sequence
      homologies. The mechanism of HFV transactivation appears to be novel among the
      complex retroviruses and is likely to involve, as yet, undiscovered cellular DNA
      binding factors.

PMID- 8356799
TI  - Multiple functions of the adenovirus DNA-binding protein are required for
      efficient viral DNA synthesis.
AB  - Mutational analysis within the amino-terminal (N-t) domain of the adenovirus DNA
      binding protein (DBP) defined a region (aa 2-38) important for DBP function.
      Several viruses carrying lesions in this region of DBP showed reduced
      accumulation of viral DNA and infectious virions. Characterization of one of
      these mutants, H5in800, indicated that the N-t domain affects viral DNA synthesis
      in vivo. The reduction in DNA synthesis was not due to a change in the amount or
      nuclear location of the H5in800 DBP. Expression of other early genes in H5in800
      infected cells was similar to that seen in wild-type Ad5-infected cells,
      suggesting that the depression of DNA synthesis was not due to disruption of
      DBP's role in early gene expression. The H5in800 and wild-type DBP also had
      comparable affinities for single-stranded DNA and functioned with similar
      efficiencies in two DNA elongation assays. Prior studies have shown that the
      carboxyl-terminal (C-t) domain of DBP was responsible for these two activities.
      Together these results suggest that DBP has at least two separable functions in
      viral DNA replication in vivo and that both domains of the protein are necessary
      for full activity. The intragenic complementation between the N-t mutant H5in800
      and the C-t mutant H5in804 supports this model.

PMID- 8356800
TI  - The direction and rate of bacteriophage T7 DNA packaging in vitro.
AB  - To determine the direction of the entry of DNA during in vitro bacteriophage T7
      DNA packaging, incompletely packaged DNA (ipDNA) was fractionated by agarose gel
      electrophoresis after degradation of DNA outside of capsids and then release of
      packaged DNA from capsids. After fractionation, quantitative in-gel probing with
      a right end-specific oligonucleotide detects heterogeneous ipDNA (called right
      end ipDNA). Most of the right-end ipDNA appears with kinetics expected of a
      precursor to the mature T7 DNA. In-gel probing with a left-end-specific
      oligonucleotide detects ipDNA (left-end ipDNA); the molar amount of left end
      ipDNA is always at least 50x less than the molar amount of right-end ipDNA. Left
      end ipDNA appears with the kinetics of an abortive end product of T7 DNA
      packaging. Thus, productive T7 DNA packaging occurs in a right-to-left direction.
      Quantitation of the conversion of right-end ipDNA to mature-length DNA yields an
      estimate of the mean rate of right-to-left in vitro T7 DNA packaging: 28 +/- 6
      kbp/min for the last 20-50% of the DNA packaged.

PMID- 8356802
TI  - Crystallization and preliminary X-ray characterization of tobacco streak virus
      and a proteolytically modified form of the capsid protein.
AB  - Isolated tobacco streak virus strain mild (TSV-M) top nucleoprotein component
      (TV) was crystallized by vapor diffusion with polyethylene glycol (PEG) and
      methyl pentanediol. The morphology of the crystal suggested a hexagonal space
      group, however, the crystals were disordered as analyzed by X-ray diffraction.
      Capsid protein from TSV (strains M and white clover) was treated with trypsin to
      remove 87 amino terminal residues. The modified capsid protein was purified by
      ion exchange chromatography and crystallized in both hexagonal and triclinic
      forms. Hexagonal crystals grown by vapor diffusion in PEG diffract X rays to 4.5
      A. The crystals, in the space group P6(2) or its enantiomorph, possess unit cell
      dimensions of a = 98.3 A, c = 108.7 A and probably contain 12 dimers/unit cell.
      Triclinic crystals grown by vapor diffusion in ammonium sulfate diffracted X rays
      to 2.4 A resolution when exposed to X-ray synchrotron radiation. The crystals
      have unit cell dimensions of a = 60.1 A, b = 77.5 A, c = 73.9 A with alpha = 67.8
      degrees, beta = 130 degrees, and gamma = 106 degrees and probably contain 4
      dimers/unit cell.

PMID- 8356801
TI  - A transgenic model of transactivation by the Tax protein of HTLV-I.
AB  - The human T-lymphotropic virus type I (HTLV-I) Tax protein is a transcriptional
      regulatory protein that has been suggested to play a causal role in the
      development of several HTLV-I-associated diseases. Tax regulates expression of
      its own LTR and of certain cellular promoters perhaps by usurping the function of
      the host transcriptional machinery. We have established a transgenic mouse model
      system to define the spectrum of tissues in vivo that are capable of supporting
      Tax-mediated transcriptional transactivation. Transgenic mice carrying the HTLV-I
      LTR driving expression of the Escherichia coli beta-galactosidase (beta gal) gene
      were generated, and this LTR-beta gal gene was transcriptionally inactive in all
      tissues. When LTR-beta gal mice were mated to transgenic mice carrying the same
      LTR driving expression of the HTLV-I tax gene, mice that carried both transgenes
      showed restricted expression of the beta gal reporter gene in several tissues
      including muscle, bone, salivary glands, skin, and nerve. In addition, a dramatic
      increase in the number of beta gal-expressing cells was seen in response to
      wounding. These observations provide direct evidence for viral transactivation in
      vivo, delimit the tissues capable of supporting that transactivation, and provide
      a model system to study the mechanism of gene regulation by Tax.

PMID- 8356803
TI  - An immune-selected point mutation in the transmembrane protein of human
      immunodeficiency virus type 1 (HXB2-Env:Ala 582(-->Thr)) decreases viral
      neutralization by monoclonal antibodies to the CD4-binding site.
AB  - An immune-selected point-mutation (HXB2-Env:Ala582(-->Thr)) in the transmembrane
      protein, gp41, of the human immunodeficiency virus type 1 confers relative
      insensitivity to neutralization by a number of sera from HIV-1-positive persons.
      Affinity-purified human antibodies to continuous epitopes spanning Ala582 do not
      neutralize the virus (C. Wilson, M. S. Reitz, Jr., K. Aldrich, P. J. Klasse, J.
      Blomberg, R. C. Gallo, and M. J. Robert-Guroff, J. Virol. 64, 3240-3248, 1990).
      The specificity of the antibodies that the mutation renders less active has not
      previously been determined. We now report that this substitution in gp41 reduces
      the neutralizing activity of monoclonal antibodies to discontinuous gp120
      epitopes, which overlap with the CD4-binding site. There was no such difference
      in sensitivity to neutralization by soluble CD4, CD4-immunoglobulin, or by two
      monoclonal antibodies to the V3 region of gp120. Furthermore, the ability of 10
      human HIV-1-positive sera to block the binding of soluble CD4 to mammalian
      recombinant gp120 correlated weakly with their differentiation of neutralization
      between the wild-type and the Env:Ala582(-->Thr)-mutant virus. We thus suggest
      that the substitution in gp41 modulates the conformation of gp120 so as to
      decrease viral sensitivity to one category of antibodies which is partly
      responsible for the group-specific neutralization of HIV-1 by human sera.

PMID- 8356804
TI  - Enhanced activity of human G6PD promoter transfected in HeLa cells producing high
      levels of HIV-1 Tat.
AB  - Glucose 6-phosphate dehydrogenase (G6PD) enzyme activity has an important role in
      the cell defence against oxidative damage produced by hydrogen peroxide, a
      compound known to activate HIV-1 expression through the intermediate of NF-kappa
      B. By means of CAT assays, in this paper we show that the Tat protein increases
      the rate of transcription from the human G6PD promoter in HeLa cells;
      furthermore, we report a similar effect of Tat on transcription driven from the
      viral RSV promoter. We did not observe Tat stimulation with the human CMV, SV40
      or the basic RSV promoters. Dose-response curves indicate that Tat activates G6PD
      and RSV through a mechanism different from the major one operating on the HIV-1
      LTR promoter. TAR-like structures are not involved, instead a short sequence
      close to the G6PD transcription start site and the RSV LTR enhancer is a good
      candidate for mediating the phenomena described in this paper. This sequence has
      some features in common with the NF-kappa B motif.

PMID- 8356805
TI  - A novel terminase activity associated with the DNA packaging protein gp17 of
      bacteriophage T4.
AB  - The mechanism of generation of circularly permuted ends in bacteriophage T4 by a
      strictly headful packaging process has remained unresolved since its proposal by
      Streisinger et al. (1967, Proc. Natl. Acad. Sci. USA 57, 292-295). In this paper,
      we show that the phage T4 DNA packaging proteins gp16 and gp17 act as T4
      terminase. Expression of gp16 and gp17 in Escherichia coli resulted in extensive
      cleavage of both plasmid as well as E. coli genomic DNAs. Analysis of a number of
      recombinant terminase constructs, and mutants in gene 17, demonstrated that the
      active site for cleavage of DNA is located in gp17, but not in gp16. Consistent
      with the circularly permuted nature of phage T4 ends, cleavage by gp17 occurred
      in a sequence independent manner generating random ends. The terminase cutting
      occurred preferentially on a DNA substrate that is transcriptionally active. We
      propose that a structural feature in the transcriptionally active region provides
      a site for attachment of terminase to DNA following which the terminase moves
      along the DNA, and cleaves at a random sequence.

PMID- 8356806
TI  - Evidence that HERV-K is the endogenous retrovirus sequence that codes for the
      human teratocarcinoma-derived retrovirus HTDV.
AB  - Human teratocarcinoma-derived viruses (HTDV) are retrovirus-like particles that
      are regularly observed by electron microscopy at low frequency in cell lines
      established from human teratocarcinomas. Over the last years, one of our
      teratocarcinoma cell lines spontaneously began to produce high amounts of HTDV.
      This cell line is stained in immunofluorescence tests by an antiserum raised
      against recombinant gag protein of HERV-K, an expressed human endogenous
      retrovirus sequence. In immunoelectron microscopy of ultrathin frozen sections,
      this anti HERV-Kgag-specific antiserum reacts specifically with HTDV particles.
      In Western blots, the antiserum recognizes predominantly a protein with an
      apparent molecular weight of 30 kDa, presumably the major core protein of HTDV
      particles. Taken together, these results provide evidence that HERV-K codes for
      HTDV.

PMID- 8356807
TI  - Complete nucleotide sequence of HTLV-II isolate NRA: comparison of envelope
      sequence variation of HTLV-II isolates from U.S. blood donors and U.S. and
      Italian i.v. drug users.
AB  - The entire nucleotide sequence of human T-cell lymphotropic virus type II (HTLV
      II) from a previously described isolate of patient NRA (HTLV-IINRA) was
      determined. Clones encoding the 5' LTR and gag, pol, env and tax/rex open reading
      frames were subcloned and sequenced on both strands. The provirus consisted of
      8957 nucleotides and showed 95.2% homology with the HTLV-IIMo prototype at the
      nucleotide level. Less than 5% amino acid variation between HTLV-IINRA and HTLV
      IIMo was observed for coding regions. Although isolate HTLV-IINRA had an
      additional 25 amino acids at the 3' end of tax/rex, this region was 96%
      homologous with the 5' end of HTLV-IIMo 3' LTR. To further investigate HTLV-II
      variability, a portion of the env gp46 gene derived from 9 HTLV-II infected
      persons was amplified by polymerase chain reaction and sequenced. Sequence was
      obtained for 320 nucleotides corresponding to HTLV-IIMo positions 5291 to 5610.
      Isolates similar to the HTLV-IIMo and HTLV-IINRA prototypes were identified, and
      sequences were highly conserved.

PMID- 8356809
TI  - [The optimization of academic classes in military hygiene].

PMID- 8356808
TI  - Alterations in cell membrane permeability by the lentivirus lytic peptide (LLP-1)
      of HIV-1 transmembrane protein.
AB  - Previously we reported that synthetic peptide homologs of an amphipathic region
      (designated the lentivirus lytic peptide, or LLP-1) near the carboxy terminus of
      HIV-1 transmembrane protein (TM) were toxic for both prokaryotic and eukaryotic
      cells when added exogenously to cell cultures. We postulated that these peptides
      may exert their toxic effects in much the same manner as natural cytolytic
      peptides such as magainins, cecropins, and melittin by forming pores through
      cellular membranes. Here we show the results of 51Cr-release assays and membrane
      flux measurements of peptide treated cells that support our hypothesis. We have
      also tested a limited panel of LLP-1 peptide analogs in these assays and found
      that relatively minor alterations in peptide charge or amphipathicity in the
      parent HIV LLP-1 sequence resulted in total loss of membrane perturbative
      properties. These results demonstrate that the peptide homolog of HIV-1 LLP-1 can
      indeed perturb membranes by forming pores of defined size in cytoplasmic
      membranes. Furthermore, the analog studies described here reveal that the
      amphipathy and high positive charge of this protein segment are required for the
      membrane perturbative properties.

PMID- 8356810
TI  - [The improvement of independent work--the most important factor in raising
      quality in the continuing education of physician administrators].

PMID- 8356811
TI  - [The work of a medical institute military department under the new socioeconomic
      conditions].

PMID- 8356812
TI  - [The effect of dalargin on the course of combined radiation lesions (experimental
      research)].

PMID- 8356813
TI  - [The use of the helium-neon laser in treating gunshot wounds].

PMID- 8356814
TI  - [The expansion of the indications for prescribing laser therapy in chronic
      recurrent dermatoses].
AB  - Besides the well-known methods applied for the treatment of chronic recurrent
      dermatoses, the authors propose to use laser therapy for management of its
      coexistent diseases. The article contains data which prove the high efficiency of
      laser therapy for treatment of chronic recurrent dermatoses with such coexistent
      diseases as tonsillitis, hymoritis, gastroduodenal erosion, ulcers and
      respiratory diseases. Methods of laser therapy are enclosed.

PMID- 8356815
TI  - [Skin diseases and the problems of military medical expertise under the
      conditions of the Far North].

PMID- 8356816
TI  - [The clinico-anatomical characteristics of dermatogenic sepsis in servicemen].

PMID- 8356817
TI  - [The effect of hyperbaric oxygenation on hemostasis in the treatment of jaw
      deformities].

PMID- 8356818
TI  - [The laboratory diagnosis of atherogenic disorders in servicemen].
AB  - In order to calculate the atherogenic coefficient the authors have made a
      comparative estimation of methods for determining alfa-cholesterin in serum
      applying various temperature regimes during sedimentation of beta and pre-beta
      lipoproteids. It was found out that the complete sedimentation of beta and pre
      beta-lipoproteids could be obtained after incubation of specimen into the ice
      bath for 30 min. (t 0-4 degrees C) with further centrifugation at room
      temperature. No differences were disclosed in comparison with the reference
      method based on refrigerated centrifugation at 2-4 degrees C.

PMID- 8356819
TI  - [The prospects for using inactivated influenza vaccines on the troops].
AB  - The article analyses the results of controlled epidemiologic observation made in
      military unit to estimate the immunological and clinico-epidemiological
      efficiency of national inactivated influenza vaccines with different valency and
      antigen charge in inoculative dose. The analysis proves the high immunogenic
      activity and protective features of inactivated influenza trivaccines with
      enhanced contents of hemagglutinins. The article substantiates the reasons for
      mass application of these vaccines in military units with obligatory addition of
      B-component and enhanced antigen contents of vaccine viruses in inoculative dose.

PMID- 8356820
TI  - [The prospects for the development of the laboratory diagnosis of HIV infection
      in military medicine].

PMID- 8356821
TI  - [The training of military physicians].
AB  - The article proposes to regard the training of military physicians as a
      cybernetic command system with an instructor as a command body, and a student as
      an object of command. During curriculum planning it is necessary to take into
      consideration the correlative factors of this system. The analysis of elements
      which form within students the concept of goal of study has shown that in some
      cases it was important to make corrections and take into account various
      motivations. The course of training has a number of new aspects, including
      computer application, which inevitably need adaptative period.

PMID- 8356822
TI  - [Solid-phase immunoenzyme analysis in the differential diagnosis of pulmonary
      tuberculosis and other infectious diseases with respiratory organ involvement].
AB  - The authors studied the information efficiency of stable-phased immunofermental
      analysis (IFA) in differential diagnosis of infectious diseases of respiratory
      system and pulmonary tuberculosis. IFA method was used on 60 infectious patients
      with non-tuberculous pathology, 64 patients with pulmonary tuberculosis and 200
      donors. It was found out that the minimal diagnostical IFA titer in pulmonary
      tuberculosis was 1:320 (antibody revealing frequency--up to 89.2%; specificity-
      95%). IFA method with phosphatide antigen has a great practical significance in
      differential diagnosis of influenza, acute respiratory viral infections and
      pneumonias with pulmonary tuberculosis.

PMID- 8356823
TI  - [Laboratory diagnostic experience in pyloric helicobacteriosis].

PMID- 8356824
TI  - [Hypobaric hypoxia as a method for correction and rehabilitation in aviation
      medicine].

PMID- 8356825
TI  - [The dynamics of the electroencephalogram indices in pilots with acute hypoxia].
AB  - In experimental conditions the authors have modelled the state of acute hypoxia
      in pilots with disorders of high psychic functions. In the result of these
      researches it was found out that the changes of peak frequency of alpha rhythm
      anticipated the slow delta and theta rhythms. This EEG characteristic feature
      could be used for the development of a device which would control these states in
      pilots.

PMID- 8356826
TI  - [The professional fitness of the pilot].

PMID- 8356827
TI  - [Typical pathology during the free immersion of a man under water].
AB  - The free immersion of a man under the water is accompanied by the threat of
      specific disorders which could cause the drowning. The article examines the
      causes, conditions and mechanisms of two most frequent pathological states, i.e.
      the compression of thorax and loss consciousness caused by CO2 action and
      hypoxia. The symptoms of these states, as well as prophylactic measures and first
      aid recommendations are enclosed.

PMID- 8356828
TI  - [A comparative evaluation of tents for the deployment of small medical units].

PMID- 8356829
TI  - [The medical evacuation work of Local Evacuation Point No. 44 of the Urals
      Military District during World War II].

PMID- 8356830
TI  - [The use of personal computers in a military medicine department].

PMID- 8356832
TI  - [A rapid assaying method for biotin determination and the computer program for
      data calculation].
AB  - A rapid auxanographic method for biotin determination was established by means of
      a biotin auxotrophic yeast strain, and a computer program was designed to
      calculate the data obtained. Its determination concentration ranges from 0.3 to
      5.0 micrograms/ml. The time-tested routine work in our laboratory proved that it
      is rapid, precis and reliable.

PMID- 8356831
TI  - [Purification and properties of beta-mannanases from alkalophilic Bacillus N16
      5].
AB  - Three extracellular alkaline beta-mannanases from an alkalophilic Bacillus N16-5
      were purified to electrophoretic homogeneity by (NH4)2SO4 precipitation, DEAE
      Sephadex A-25 chromatography, hydroxyapatite chromatography and preparative
      electrophoresis. Molecular weights and pI values of the beta-mannanases (M-1, M-2
      and M-3) were 51000, 38000 and 34700 by SDS-PAGE and 4.3, 2.5 and 2.5 by PAGEIEF,
      respectively. The optimum pH for enzyme catalysis were 9.0 for M-1 and 10.0 for M
      2 and M-3, respectively. All of three enzymes were the most active at 70 degrees
      C. The activities of three enzymes were strongly inhibited by Ag1+, Hg2+ and
      Mn2+. Michaelis constants (Km) of the enzyme M-1, M-2 and M-3 for mannase from
      konjak were 2.9, 1.7 and 12.5 mg/ml, maximum velocities (Vmax) for the saccharide
      were 27500, 47500 and 15700 mumol.min-1.mg-1, respectively. Konjak was hydrolyzed
      by the enzyme M-1, and major components in digests were mono-, di-, tri- and
      tetra-saccharides.

PMID- 8356833
TI  - Reliability/validity issues.

PMID- 8356834
TI  - Evaluation of breast self-examination beliefs using a decision model.

PMID- 8356835
TI  - Parental perceptions of ethical issues post-NICU discharge.

PMID- 8356836
TI  - Making behavior changes after a myocardial infarction.

PMID- 8356837
TI  - Perceived control in patients with chronic obstructive pulmonary disease.

PMID- 8356838
TI  - Psychometric properties of a cognitive functioning scale for patients with
      traumatic brain injury.

PMID- 8356839
TI  - Obtaining and evaluating data sets for secondary analysis in nursing research.
AB  - Secondary analysis of existing data offers many advantages to the nurse
      researcher. Data from large-scale studies may be reanalyzed and refined by
      secondary analysts with a fresh perspective, thus enhancing the original study's
      contribution to scientific knowledge. High-quality data can be obtained for
      comparatively little expenditure of time and money. The secondary analyst,
      however, must exercise care in evaluating and analyzing a data set to maximize
      the internal and external validity of the reanalysis. Because the secondary
      analyst's lack of involvement in data collection procedures may decrease insight
      into the original study's limitations, vigilant skepticism should accompany all
      phases of the research process in secondary data analysis, just as it should in
      all other research. Miller (1982) advised, "Begin by assuming the worst and seek
      out the same kinds of information about sample selection procedures, sample size,
      response rates, field procedures, and coding conventions that you would insist on
      if you were collecting your own data" (p. 722). By systematically evaluating
      potential data sets according to rigorous predetermined criteria, the nurse
      researcher can minimize the possible pitfalls inherent in secondary analysis. On
      the other hand, investigators who use secondary sources appropriately can make
      significant contributions to nursing science at less cost than that engendered by
      traditional research methods.

PMID- 8356840
TI  - The reporting of consent rates in nursing dissertations.

PMID- 8356841
TI  - Nurses' reasons for participating in a longitudinal panel survey.

PMID- 8356842
TI  - Of postulates and peccadilloes: Robert Koch and vaccine (tuberculin) therapy for
      tuberculosis.
AB  - In August 1890, Robert Koch dramatically announced that he had discovered a cure
      for tuberculosis, and the world rejoiced. The miracle substance was subsequently
      revealed to be tuberculin, inoculated as a 'vaccine therapy'. However, within a
      matter of months his claims were disputed and debunked, and his reputation was
      grievously damaged. The nationalistic pressures, professional jealousies and
      pecuniary interests that drove Koch's premature announcement are reviewed here
      and discussed in a context relevant to the development of therapeutic vaccines
      for human immunodeficiency virus infections.

PMID- 8356843
TI  - Role of central nervous system and behaviour in the immune response.
AB  - Recent advances in antigen preparation and delivery have led to a renewed
      interest in vaccination to control infectious disease. However, relatively less
      attention has been devoted to host factors which affect the outcome of immune
      responses. There is now increasing acceptance that the central nervous and immune
      systems interact, and that this can be a bidirectional process. A range of
      behavioural and psychological states, learned responses and reactions to external
      stimuli have all been implicated in immune modulation. These interactions may
      occur via the direct innervation of lymphoid compartments, by paracrine means
      through the release of mediators from nerves situated in close proximity to cells
      involved in immunity, or by neuroendocrine signals in the form of hypothalamic,
      pituitary and peripheral endocrine hormones. These effects may account to some
      extent for unexplained variability in response to vaccination and disease
      challenge, through inherited or acquired differences in neuroendocrine or
      neurotransmitter responses to stress, circadian effects or learned behavioural
      responses. This review addresses the effects of environmental stimuli and
      behavioural manipulations on immune outcome and the response to vaccination, and
      the potential for practical application of these techniques in human and animal
      disease control and health management.

PMID- 8356844
TI  - AroD deletion attenuates Shigella flexneri strain 2457T and makes it a safe and
      efficacious oral vaccine in monkeys.
AB  - The aromatic-dependent live Shigella flexneri 2a vaccine strain SFL1070, with a
      deleted aroD gene, had a much reduced intracellular growth in HeLa cells compared
      with its parent strain S. flexneri 2457T. S. flexneri SFL1070 gave no adverse
      effects in eight Macaca fascicularis monkeys orally vaccinated with four doses of
      1 x 10(11) live bacteria within a 5-week period, whereas S. flexneri 2457T caused
      dysentery in all eight non-vaccinated monkeys. Thus the aromatic dependency
      rendered S. flexneri SFL1070 significantly attenuated (p = 0.00008). Significant
      intestinal S. flexneri lipopolysaccharide (LPS)-specific sIgA responses were seen
      in seven of eight vaccinated monkeys (p < 0.01) after four doses with SFL1070.
      However, serum IgG or IgA responses to various S. flexneri LPS antigens and the
      invasion plasmid antigens (Ipa-s) were seen in only four of eight vaccinated
      monkeys. The serum IgG titre increases against S. flexneri Y and 2a LPS reached
      significant levels (p < or = 0.05). All but one of the vaccinated monkeys were
      protected against oral challenge with 1 x 10(10) or 1 x 10(11) live S. flexneri
      2457T given 2 weeks after the last vaccination. The protection was highly
      significant (p = 0.0007) as all non-vaccinated monkeys challenged with equal
      doses of strain 2457T developed dysentery. Three of them succumbed. Challenge
      infection of vaccinated monkeys elicited serum IgA and IgG responses to the
      homologous S. flexneri 2a LPS in three monkeys each (0.005 < or = p < or =
      0.025). Serum IgA and IgG responses to the Ipa-s were seen in five and four
      monkeys each (0.01 < p < or = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8356845
TI  - Prevention of transmission of simian immunodeficiency virus from vaccinated
      macaques that developed transient virus infection following challenge.
AB  - Macaque immunization with a mixture of four SIV peptides from conserved
      hydrophilic envelope regions has been shown to prevent virus persistence
      following challenge with SIVmne/E11s. Data shown here demonstrate that lymph node
      cells from all vaccinated monkeys and peripheral blood lymphocytes from one of
      the vaccinees were positive in a SIV-pol 'nested' polymerase chain reaction (PCR)
      amplification analysis. However, by 37 months after infection, all immunized
      monkeys were healthy while two of three controls had died and the remaining
      animal was virus culture-positive and had declining CD4+ lymphocytes. Viable
      lymph node cells and peripheral lymphoid cells in blood were transferred from the
      three immunized macaques to individual susceptible macaques. As a control for the
      transfer, one of the vaccine experiment controls that was actively producing
      virus in its peripheral blood was used. None of the recipients of cells from the
      vaccinated macaques seroconverted and all were virus coculture- and PCR-negative
      25 weeks post-transfer (p.t.). The recipient of cells from the control infected
      macaque became positive in these tests by 2-3 weeks p.t. These results suggest
      that, while peptide-vaccinated macaques permitted some level of SIV replication
      following challenge, the vaccine prevented disease progression and virus
      transmission.

PMID- 8356847
TI  - Protection of mice against respiratory Bordetella pertussis infection by
      intranasal immunization with P.69 and FHA.
AB  - Intranasal immunization of adult female Balb/c mice with the Bordetella pertussis
      antigens FHA or P.69, greatly enhanced their ability to clear B. pertussis from
      their lungs following aerosol challenge compared with ovalbumin-immunized
      controls. Low numbers of lymphocytes secreting antibodies (IgG, IgA and IgM)
      against the immunizing antigens could be isolated from the lungs of immunized
      mice. Following aerosol challenge with B. pertussis there was a large increase in
      the numbers of FHA or P.69-specific antibody-secreting cells in the lungs of mice
      immunized with these antigens. Intranasal immunization, particularly with FHA,
      also primed mice to develop a systemic serum anti-pertussis antibody response
      subsequent to challenge. However, pulmonary clearance of B. pertussis correlated
      most closely with the local antibody response. A strong anti-FHA response was
      demonstrated in the lungs of mice that received a booster dose of FHA 9 months
      after their previous exposure to FHA, demonstrating that long immunological
      memory can develop in the murine respiratory tract following direct application
      of pertussis antigens to the respiratory tract mucosa.

PMID- 8356848
TI  - Global immunization against AIDS: economic considerations.
AB  - Many knowledgeable people believe that the only real hope for halting the AIDS
      pandemic rests with safe and effective HIV vaccines that are delivered through a
      global immunization programme. When such vaccines become a reality, the size of
      potential target populations for HIV vaccines may well be over 100 million. The
      costs associated with such a large vaccination programme probably reach the multi
      billion dollar level. An international consideration of financing strategies
      should begin in the near future in order to avoid a repetition of the lag between
      vaccine availability and widespread use that accompanied the introduction of
      hepatitis B vaccine.

PMID- 8356846
TI  - Immunization of institutionalized asthmatic children and patients with
      psychomotor retardation using live attenuated cold-adapted reassortment influenza
      A H1N1, H3N2 and B vaccines.
AB  - Live attenuated cold-adapted reassortant (CR) influenza virus vaccines were
      evaluated in institutionalized asthmatic children and severe psychomotor-retarded
      (SPR) patients. Almost all the vaccinees were seropositive to the vaccine strains
      before immunization. Trivalent CR vaccine (containing A H1N1 (CR-125), A H3N2 (CR
      149) and B (CRB-117)), bivalent CR vaccine (CR-125 and CR-149) and monovalent CRB
      117 were inoculated to 19 asthmatic children and 36 and 16 SPR patients,
      respectively. Overall 49, 22, and 11% of vaccinees were infected by A H1N1, A
      H3N2 or B vaccine viruses, respectively, as indicated by significant
      haemagglutination-inhibition (HI) antibody titre rises 4 weeks after inoculation.
      No severe adverse reactions associated with CR vaccination were observed in the
      handicapped patients. A nosocomial outbreak of influenza A H1N1 occurred in the
      ward with asthmatic children, but none of the 19 CR-trivalent vaccinees became
      infected. However, five of 20 non-vaccinees in the same ward, and ten of 30
      vaccinees in another ward that received inactivated split vaccine became
      infected. The CR vaccines demonstrated significant protective effects against
      natural exposure to the A H1N1 virus, and were well tolerated and safe when given
      to patients with bronchial asthma and severe psychomotor retardation.

PMID- 8356849
TI  - [Cestode adaptation to life cycles].
AB  - There are two groups of cestode adaptations. One of them makes it possible for
      particular developmental stages to be adapted to their particular environment
      (including second order environment). The second one involves passing through the
      entire life circle: transition from one environment to another, releasing from
      protective shells, host intrusion, population density regulation at different
      developmental stages. Spectrum of adaptive reactions on the life cycles is
      determined by peculiarities of parasite systems.

PMID- 8356851
TI  - The effect of storage on ice and various freezing treatments on enzyme leakage in
      muscle tissue of rainbow trout (Oncorhynchus mykiss).
AB  - In order to study the biochemical changes in fish muscle during ice storage and
      freezing-thawing processes, the activities of certain marker enzymes in the cell
      interstitial fluid from muscle tissue of rainbow trout (Oncorhynchus mykiss) were
      measured. The enzymes analysed were: lysosomal alpha-glucosidase (E.C. 3.2.1.20),
      beta-N-glucosaminidase (E.C. 3.2.1.30) and acid phosphatase (E.C. 3.1.3.2). The
      activity in centrifuged tissue fluid (CTF) was compared with the activity in
      total homogenate. When ice storage was varied between 3 and 14 days, it did not
      affect enzyme leakage into the CTF significantly. However, there was a distinct
      difference between fresh fish and fish iced even for only 1 day, which gave
      increased leakage of marker enzymes. When the ice-stored samples were subject to
      a freezing-thawing cycle they showed a marked increase in enzyme activity in the
      press juice. When the freezing process was varied so as to achieve different
      freezing rates, the slowest freezing rate caused the highest enzyme leakage.

PMID- 8356850
TI  - Bitter taste of enzymic hydrolysates of casein. I. Isolation, structural and
      sensorial analysis of peptides from tryptic hydrolysates of beta-casein.
AB  - beta-Casein A2 was isolated from milk of a homozygous cow and hydrolysed with
      trypsin. The hydrolysate was separated by RP-HPLC into 18 peptides, all but one
      of which could be attributed to the sequence of beta-casein on the basis of the
      amino acid composition. Some peptides overlapped. In total, they represented
      about 97% of the protein sequence. Only three peptides had a bitter taste, namely
      I49-N68 (recognition threshold 1.0 mg/ml, 0.45 mmol/l), I49-K97 (1.5 mg/ml, 0.28
      mmol/l) and G203-V209 (0.175 mg/ml, 0.23 mmol/l). The contribution of the three
      peptides to the overall bitterness of the beta-casein hydrolysate (2.67 mg/ml)
      was about 11, 21, and 60%, respectively. Peptide I49-K97 was present in the
      hydrolysate together with its fragments I49-N68 and S69-K97. Remarkably, the
      smaller and more hydrophobic fragment I49-N68 was less bitter than I49-K97 on a
      molar basis, whereas the larger and more hydrophilic fragment S69-K97 had a
      neutral taste. These results show that in the case of larger peptides neither
      hydrophobicity nor size are responsible alone for bitter potency, but that
      conformational parameters must be of great importance. Furthermore, it can be
      concluded that only a part of the structure is responsible for the contact with
      the receptor. The bitterness of G203-V209 is discussed in connection with related
      synthetic peptides in the literature.

PMID- 8356852
TI  - [The effects of polylysine on the aggregation of surface and on the cleavage
      furrow of Rana amurensis eggs].
AB  - Polylysine synchronously aggregated pigment granules and egg surface stained
      uniformly with fluorescein isothiocyanate to form patches (Plate I, fig 1 & 2).
      Patches always appeared and aggregated first in the opposite grey crescent
      region, then in grey crescent region and next at animal hemisphere. A fluorescent
      ring formed at the upper side of the equatorial region. The ring and the patches
      at the animal hemisphere accumulated to the animal pole to make a cap (Plate I,
      Fig. 3). Finally the vegetal hemisphere broke due to the contraction of egg
      surface during aggregation. These indicated that four different domains: opposite
      grey crescent region, grey crescent region, animal and vegetal hemispheres, were
      present at the fertilized egg surface. Similar domains also occurred at the
      unfertilized egg surface as revealed by the same treatment suggesting that the
      opposite grey crescent region of fertilized egg, which corresponding to the sperm
      entrance region had existed at the mature egg surface. There were three modes in
      the early stage of patch formation: (1) the features of granular protrusions did
      not change greatly (Plate I, Fig. 5-7), (2) the granular protrusions elongated
      (Plate I, Fig 8-11) and (3) folds radiated from patch (Plate I, Fig. 12, 13).
      Around each patch new surface membrane arose, which was similar to the nascent
      membrane of cleavage furrow.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8356854
TI  - [The characteristics of monoclonal antibodies and their antigens associated with
      human sperm acrosome reaction. II. Effects of the monoclonal antibodies on sperm
      function, sperm antigen localization and immunoblotting].
AB  - By using microassay, the strong human sperm agglutination were caused by 9 of 23
      monoclonal antibodies (McAbs) obtained by immunization with fresh human acrosome
      reacted (AR) sperm, which was induced by ionophore A 23187, but no one of them
      demonstrated the ability to immobilize human sperm. In contrast to most studies
      reported by other laboratories, the antigens recognized by most of McAbs in the
      present study were located in equatorial segment and midpiece of human sperm, and
      no one in acrosome region of human sperm. The binding pattern of some McAbs on
      non-treated and AR sperm was found to be different. The human sperm proteins
      ranged in the size of 16-146 kDa were demonstrated to be reacted with 9 of 23
      McAbs by immunoblotting. Moreover, the cross reaction of 23 McAbs with mouse and
      tree shrew sperm was detected by indirect immunofluorescent assay. These results
      suggest that AR sperm possesses peculiar immunogenic properties.

PMID- 8356853
TI  - [The characteristics of monoclonal antibodies and their antigens associated with
      human sperm acrosome reaction. I. The induction of acrosome reaction and
      monoclonal antibody production].
AB  - Sperm released from the male genital tract must undergo capacitation and acrosome
      reaction (AR) before binding to oocyte membrane. Changes of sperm components have
      been found after the capacitation and AR. Based on these changes, the new
      contraceptive methods and the treatment of the male infertility might be
      approached. In the present study, in vitro capacitated human sperm were induced
      to undergo AR in BWW-BSA medium with calcium ionophore A 23187. The fresh human
      AR sperm in about 50% of sperm population assayed by triple stain technique
      and/or chlortetracycline fluorescence staining were used for immunization. Twenty
      three murine hybridomas secreting monoclonal antibodies (McAbs) to non-treated
      (NT) and/or AR human sperm have been obtained. Of them, 21 McAbs were classified
      as IgM, others as IgG1 and IgG2a. Based on the immunoreactions of 23 McAbs with
      NT and AR sperm, they were divided into three groups: group A reacted mainly with
      the AR sperm, group B with NT sperm, and group C with both AR and NT sperm. The
      cross reaction of these McAbs with human leukemia cell lines was detected by
      ELISA and the discrepant reactions were observed.

PMID- 8356855
TI  - [Plant regeneration from hypocotyl protoplasts of Lycium barbarum L].
AB  - The hypocotyl protoplasts of Lycium barbarum L. CV. Ningji No. 1 were isolated in
      an enzyme mixture solution containing 1% cellulase and 1% pectinase. The
      protoplasts were cultured in KM 8 p liquid medium containing 0.3 mg/L 2,4-D and
      0.3 mg/L BA, The first division of regenerated cells occurred 3 days after
      culture. The small cell clumps could be observed by naked eyes 20 days after
      culture. 40 days after culture, microcalli of 1-2 mm in size were transferred to
      MS solid differentiation medium containing 3% sugar, 0.1-0.4 mg/L BA and 0.05-0.1
      mg/L NAA. About 30 days after culture on MS solid medium, the calli with shoots
      were transferred to 1/2 MS medium containing 0.1 mg/L BA and 0.2 mg/L IBA, from
      which 80% of them differentiated roots and regenerated whole plantlets.

PMID- 8356856
TI  - Comparison of the ventilatory effects of morphine and buprenorphine in children.
AB  - This study was a prospective, randomized comparison of the ventilatory effects of
      equianalgesic single-doses of morphine, 100 micrograms/kg, and buprenorphine, 3.0
      micrograms/kg, administered intravenously to 20 children (5-8 years of age) after
      elective ophthalmic surgery. The decrease in ventilatory rate and acute change in
      the arteriolar oxygen saturation and the increase in end-tidal CO2 levels were
      statistically significantly greater in magnitude and duration after buprenorphine
      than after morphine. For both drugs, the time, duration and magnitude of
      ventilatory changes varied appreciably between individuals. No child had apnea or
      hypoventilation requiring assistance. The authors conclude that acutely
      administered buprenorphine depresses ventilation to a greater degree than
      morphine. The maximal ventilatory effect of buprenorphine occurs later than with
      morphine, and ventilatory depression after buprenorphine may develop late. For
      safety, all children given opioids intravenously should be observed until they
      are fully responsive and ventilatory control has stabilized.

PMID- 8356857
TI  - Glycopyrrolate vs. atropine during anaesthesia for laryngoscopy and bronchoscopy.
AB  - As glycopyrrolate has been reported superior to atropine with respect to
      reduction of salivation, stability of cardiac rate and rhythm, and recovery, a
      comparison of these properties of the two drugs and placebo was made in 45
      patients undergoing direct laryngoscopy and 45 patients undergoing bronchoscopy,
      in most cases followed by mediastinoscopy. When given i.m. 30 min before
      anesthesia (midazolam, alfentanil, thiopentone, and suxamethonium), the two test
      drugs were found to be equally potent regarding the antisialogogic effect. The
      same increase in heart rate after the test drugs was seen before induction, and
      during anaesthesia heart rate rose to the same level in the placebo group as the
      test groups. During anaesthesia, blood pressure was lowest in the atropine group.
      No differences could be demonstrated with respect to cardiac arrhythmias,
      possibly due to the small size of the material. The present study gives no reason
      for preferring either drug, and only the efficacy of both test drugs in
      controlling airway secretions provides an argument for using any anticholinergic
      drug when laryngoscopy or bronchoscopy is performed under the conditions of the
      present study.

PMID- 8356858
TI  - Effective concentration 50 for propofol with and without 67% nitrous oxide.
AB  - The Effective Blood Concentration (EC) of propofol required to prevent response
      to surgical incision was determined in 65 ASA I or II female patients breathing
      either 100% oxygen or 67% N2O in oxygen. Propofol was administered via a
      microcomputer-controlled infusion system programmed to maintain the blood
      propofol concentration at predetermined target values. The blood propofol
      concentrations predicted by the micro-computer were validated by measurement of
      whole blood propofol concentration. Predicted and measured concentrations
      differed during infusion of propofol, but became similar after discontinuing the
      infusion for at least 90 s, suggesting that equilibration within the central
      compartment was incomplete during infusion. The response to the initial incision
      was observed and probit analysis used to determine the predicted blood
      concentration at which 50% of patients responded. The predicted EC50 for
      propofol/N2O/O2 and propofol/O2 was 4.5 micrograms ml-1 and 6.0 micrograms ml-1
      respectively, and the measured EC50 propofol/N2O/O2 and propofol/O2 was 5.36
      micrograms ml-1 and 8.1 micrograms ml-1, 67% nitrous oxide in oxygen reducing the
      predicted EC50 by 25% and the measured EC50 of propofol by 33%. The predicted EC
      may be more representative of the equilibrated concentration in the central
      compartment and thus reflective of tissue propofol concentrations.

PMID- 8356859
TI  - Favorable effects of epidural analgesia on hemodynamics, oxygenation and
      metabolic variables in the immediate post-anesthetic period.
AB  - Fourteen adult patients undergoing elective major abdominal surgery were divided
      into two groups. One group received epidural and general anesthesia (epidural
      group), and 20 ml of 0.125% bupivacaine and 2 mg of morphine were administered
      epidurally about 30 min before the end of the operation for post-anesthetic
      analgesia. The other group (control group) received general anesthesia alone with
      nitrous oxide, oxygen and enflurane. Flow-directed pulmonary arterial and radial
      arterial catheters were inserted preoperatively, and hemodynamic, respiratory,
      neuroendocrine and metabolic variables were measured serially. The data were
      compared during anesthesia and the immediate post-anesthetic recovery period. In
      the control group, the plasma epinephrine level in the post-anesthetic recovery
      period increased about four times over the anesthetic period. Oxygen consumption
      was increased and mixed venous oxygen saturation was decreased significantly.
      There was a close linear correlation between oxygen consumption (Y) and plasma
      epinephrine (X) level: Y = 285.7X + 90.5 (P < 0.01, r = 0.72). On the other hand,
      plasma epinephrine, oxygen consumption and mixed venous oxygen saturation did not
      change significantly in the epidural group in the post-anesthetic recovery
      period. There was also a close linear correlation between oxygen consumption (Y)
      and oxygen delivery (X): Y = 0.22X-32.0 (P < 0.01, r = 0.89). We conclude that
      the surgical stress and anesthetic reversal may seriously influence
      neuroendocrine responses and subsequently increase plasma epinephrine. Tissue
      oxygenation and metabolic imbalance may occur due to the rapid increase of
      epinephrine in the post-anesthetic recovery period. Epidural analgesia at this
      period may play a more important role and have a more favorable effect on the
      tissue metabolism.

PMID- 8356860
TI  - Complications and late sequelae following nasotracheal intubation.
AB  - A total of 379 patients admitted to the ICU for mechanical ventilation were
      prospectively investigated for lesions on the nose, nasal cavity, ears and larynx
      during and after nasotracheal intubation. One to two years later, the surviving
      patients were questioned to investigate late persisting sequelae. During
      intubation and up to 5 days following extubation, inflammatory changes and
      ulceration of the nostrils or nasal septum were found in 76 (20%) and 110
      patients (29%), respectively. There were bleedings from the nasal cavity in 67
      (19%) and fractures of the conchae in 40 patients (11%). Hoarseness was noted in
      135 patients (42%). Inflammatory changes and ulcerations of the nostril and nasal
      septum were correlated to the duration of intubation. Among the 281 patients
      included in the follow-up study, 100 (35%) had symptoms from the nose and nasal
      cavity. Sixty-five (24%) had symptoms related to the ears, 56 (20%) to the
      maxillary sinus, 81 (29%) to the voice and 90 (32%) to the throat. Increasing
      duration of intubation was found to be correlated to persisting symptoms from the
      larynx. Former ulcerations of the nose were associated with a tendency to nasal
      bleeding. To avoid as many complications as possible from the nose and nasal
      cavity, we recommend orotracheal intubation. As late sequelae from the larynx
      increase with the duration of intubation, perhaps tracheostomy should be
      performed earlier than is general practice today, but that has to be proven in
      forthcoming studies.

PMID- 8356861
TI  - Effect of single-dose omeprazole and ranitidine on gastric juice acidity and
      volume in patients undergoing laparotomy.
AB  - The effects of oral omeprazole and oral ranitidine on gastric fluid volume and pH
      were compared in 95 elective surgical patients, randomly assigned to one of three
      groups. The patients received either 80 mg of omeprazole or 300 mg of ranitidine
      orally at 6.00 on the morning of surgery. One third of the patients received no
      antacid therapy. Following induction, a no. 18 nasogastric tube was passed into
      the stomach and all available gastric fluid was aspirated. pH and volumes were
      measured. In the omeprazole- and ranitidine-treated groups, the mean pH was > 5.4
      after induction, at completion of surgery and 1 h after operation, although at
      least one patient in both groups had pH < 2.5. The volumes of gastric aspirates
      were reduced equally by both drugs. Two patients in the omeprazole group, none in
      the ranitidine group and eight in the control group (26%) had pH < 2.5 with
      volume > 25 ml at induction. Both drugs appeared to be effective in reducing the
      volume of intragastric fluid and acidity to acceptable values.

PMID- 8356862
TI  - Fluidity state of lymphocyte plasma membrane in malignant hyperthermia
      susceptible pigs and humans.
AB  - Recent studies suggest that abnormalities occur at the lipid level in malignant
      hyperthermia susceptible humans and pigs. To test this hypothesis, we first
      investigated the physical state of plasma membranes of lymphocytes isolated from
      normal and malignant hyperthermia susceptible swine. In halothane-challenged
      pigs, malignant hyperthermia susceptibility was also assessed by ryanodine
      binding assay on purified sarcoplasmic reticulum membranes. The results clearly
      show that plasma membrane of lymphocytes from malignant hyperthermic pigs are
      significantly more fluid than controls. We then attempted to apply the same
      methodology to lymphocytes prepared from human patients previously diagnosed by
      the halothane and caffeine contracture test. In that case, there was no clear
      relationship between malignant hyperthermia susceptibility and the fluidity state
      of lymphocyte plasma membranes.

PMID- 8356863
TI  - The influence of different procedures of general anaesthesia on platelet
      function, coagulation and the fibrinolytic system.
AB  - We investigated whether different procedures during general anaesthesia alter
      platelet activation in vivo and/or activate coagulation and fibrinolysis. Forty
      one healthy adult patients, scheduled for elective ophthalmic surgery under
      general anaesthesia, were studied with regard to changes of plasma beta
      thromboglobulin (beta TG, index of platelet activation), thrombin-antithrombin
      III-complex (TAT, index of activation of coagulation) and d-dimer (index of
      fibrinolysis) during anaesthesia. The patients underwent either inhalation
      anaesthesia with enflurane and nitrous oxide or balanced anaesthesia with
      enflurane (0.5% end-tidal concentration) and alfentanil. Ten minutes after
      intubation the beta TG level was significantly reduced compared to the
      preoperative value in both general anaesthesia groups. Balanced anaesthesia
      caused a moderate but significant increase of TAT values at 10 min after
      extubation. No significant change in d-dimer levels was seen. Presuming a minimal
      effect of the surgical procedure on the determined variables, we conclude that
      none of the anaesthetic procedures induces platelet activation and fibrinolysis.
      The clinical relevance of the moderate coagulation activation during balanced
      anaesthesia remains to be investigated.

PMID- 8356864
TI  - Effects of propofol on mean arterial pressure and systemic vascular resistance
      during cardiopulmonary bypass.
AB  - This study was designed to evaluate the effects of propofol on mean arterial
      pressure (MAP) and systemic vascular resistance (SVR) during cardiopulmonary
      bypass (CPB). Twenty patients were divided randomly for administration of 2 mg.kg
      1 propofol (group Propofol, n = 10) or 0.9% saline solution (group Control, n =
      10) during CPB. The two groups were comparable with respect to sex, age, height,
      type of surgery (valvular or coronary), arterial hypertension and preoperative
      antihypertensive treatment. Only their weight and body surface area were
      significantly different (control group vs propofol group, respectively: 78.5 +/-
      14.4 vs 64.7 +/- 7.7 kg, P < 0.05; and 1.85 +/- 0.2 vs 1.68 +/- 0.13 m2, P <
      0.05). MAP, SVR and SVR index were significantly lower in the propofol group than
      in the control group at 10, 15 and 20 min of study, suggesting that the
      hypotensive effect of a bolus injection of propofol is due, at least in part, to
      a direct decrease in the SVR.

PMID- 8356865
TI  - CSF neuropeptides in cancer pain: effects of spinal opioid therapy.
AB  - The cerebrospinal fluid (CSF) levels of the opioid peptides met-enkephalin (ME),
      beta-endorphin (BE) and dynorphin (DYN) as well as the putative sensory
      neuropeptides substance P (SP), somatostatin (SOM), calcitonin gene related
      peptide (CGRP) and vasoactive intestinal polypeptide (VIP) were determined in 10
      patients with severe nociceptive pain due to malignancy, before and after
      initiation of spinal opioid therapy, and in 10 control patients. Pain intensity,
      evaluated by means of a 100-mm visual analog scale (VAS), was reduced from 39 +/-
      9 to 18 +/- 10 for continuous pain and from 70 +/- 10 to 10 +/- 8 for
      intermittent pain (means +/- s.e.mean). Lumbar CSF immunoreactive ME and DYN
      concentrations were significantly increased (P = 0.05) and BE and VIP were
      significantly decreased (P < or = 0.05) in the pain patients. A slight, but non
      significant (P = 0.06) decrease in SP-like immunoreactivity was found after
      initiation of spinal opioid therapy. Visceral pain seemed to be associated with
      low immunoreactive SP and ME concentrations compared to somatic pain. A highly
      significant correlation was found between SP and ME (P < 0.001) and to a lesser
      extent also between other peptides. We conclude that the concentrations of the
      endogenous opioids were more affected by nociceptive pain states than the non
      opioid peptides. The origin of pain may also influence the results. The
      postulated inhibition of peptide release by spinal opioid application seemed to
      be present for SP, but could otherwise not be confirmed.

PMID- 8356866
TI  - Low-flow isoflurane-nitrous oxide anaesthesia offers substantial economic
      advantages over high- and medium-flow isoflurane-nitrous oxide anaesthesia.
AB  - Isoflurane consumption was studied for three different fresh gas flows in
      patients scheduled for major elective abdominal, urological or gynaecological
      surgery under general anaesthesia with an expected duration of 2 h or more.
      Thirty patients were randomly assigned to either high-flow anaesthesia using a
      partial rebreathing system without carbon dioxide absorption (Mapleson D) or
      medium- or low-flow anaesthesia using a circle system with carbon dioxide
      absorption. Patients were anaesthetised with isoflurane in 40% oxygen and 60%
      nitrous oxide. The amount of isoflurane consumed was measured with a precision
      scale. The total consumption of liquid isoflurane (mean +/- s.d.) during the
      first 2 h was 40.8 +/- 12.2 ml in the high-flow group, 18.5 +/- 5.4 ml in the
      medium-flow group and 7.9 +/- 2.2 ml in the low-flow group. The corresponding
      cost of isoflurane for the three groups was 214 Danish kroner (DKK) (19.5
      pounds), 97 DKK (8.8 pounds) and 42 DKK (3.8 pounds), respectively. The
      calculated total cost of anaesthetics was 286 DKK (26 pounds), 155 DKK (14.1
      pounds) and 91 DKK (8.3 pounds), respectively. In conclusion, low-flow isoflurane
      nitrous oxide anaesthesia offers substantial economic advantages over high- and
      medium-flow isoflurane-nitrous oxide anaesthesia.

PMID- 8356867
TI  - Epidural anesthesia in a patient with myasthenia gravis.
AB  - We present a patient with myasthenia gravis who was safely managed by epidural
      anesthesia during and after thymectomy. An epidural catheter was inserted via the
      C7-T1 intervertebral space and 2% lidocaine was used during the surgery. The
      level of analgesia as determined by pinprick extending from C5 to T6. Epidural
      morphine or morphine and bupivacaine were used for postoperative pain relief. We
      evaluated ventilatory responses to CO2 and hypoxia after epidural anesthesia with
      lidocaine or morphine, and during continuous epidural infusion of the mixture of
      morphine and bupivacaine. Ventilatory responses to CO2 and hypoxia were both
      depressed following epidural injection of morphine. However, depression of
      ventilatory responses was not demonstrated following continuous epidural infusion
      of a mixture of morphine and bupivacaine. This case report suggests that epidural
      anesthesia is useful as a primary anesthetic and for postoperative pain control
      in patients with myasthenia gravis.

PMID- 8356868
TI  - Inhibition of brain cell excitability by lidocaine, QX314, and tetrodotoxin: a
      mechanism for analgesia from infused local anesthetics?
AB  - Local anesthetic infusions have been used to provide analgesia in a variety of
      painful conditions. The mechanism for this drug effect remains unknown. To better
      define the electrical effects of lidocaine concentrations comparable to those
      obtained during analgesic infusions, lidocaine (0.05-3 mmol.l-1), QX314 (an
      obligatorily charged, quaternary lidocaine derivative applied within the cells),
      and tetrodotoxin (10 mmol.l-1) were applied to rat hippocampal pyramidal cells.
      The three drugs, which inhibit Na+ currents by varying mechanisms, produced tonic
      increases in (firing) current threshold, and decreases in the amplitude of action
      potentials measured using an intracellular microelectrode technique. Lidocaine
      inhibited action potential spikes and increased current threshold in a
      concentration-dependent fashion. Lidocaine 50 and 100 mumol.l-1 did not inhibit
      action potentials, but increased firing threshold by nearly 100%. Lidocaine 1-3
      mmol.l-1 significantly inhibited action potential amplitude and increased
      threshold by as much as 800%. Similarly, QX314 and tetrodotoxin produced greater
      increases in current threshold than in action potential amplitude. QX314 produced
      phasic (or frequency-dependent) block during trains of stimuli at 1 Hz, even when
      almost no tonic block was present. Lidocaine produced less phasic block than
      QX314, and required both greater tonic block and more frequent stimulation to
      produce the phenomenon. Tetrodotoxin demonstrated no phasic block. Increases in
      current threshold occurred in lidocaine concentrations associated with analgesia
      and toxicity; inhibition of action potentials occurred scarcely at all at these
      concentrations. Thus, tonic increases in current threshold may underlie analgesia
      and supplementation of general anesthesia by intravenous lidocaine.

PMID- 8356869
TI  - Significance of centro-temporal spikes on the EEG.
AB  - In a prospectively studied group of 43 children with centro-temporal spikes on
      the EEG, only 26 had the classical epileptic syndrome related to this EEG
      abnormality. Ten patients never had epileptic manifestations. In the other seven
      cases two types of epileptiform activity were encountered: in addition to the
      centro-temporal spikes generalized spike-and-wave complexes or--in other patients
      -occipital epileptiform phenomena occurred. In these cases the clinical signs and
      symptoms correlated best with the non-Rolandic EEG abnormalities. Some patients
      had only a few centro-temporal spikes during the recording of the EEG; in others
      this epileptiform activity was almost continuously present. This quantitative
      difference had no clinical correlation. Centro-temporal spikes should probably be
      looked upon as an (epi)phenomenon of cerebral disfunction with a wide range of
      clinical and electroencephalographic expressions.

PMID- 8356870
TI  - Outcome of resective surgery for intractable partial epilepsy guided by subdural
      electrode arrays.
AB  - The aim of this paper was to evaluate the outcome and the factors predictive for
      a good prognosis of resective surgery for intractable partial epilepsy guided by
      subdural electrode arrays (SEA's) and operative electrocorticography. Sixty-four
      patients, aged 8-52 years, were evaluated with chronic SEAs in order to record
      interictal and ictal activity and delineate speech and motor areas by
      functionally mapping. Resection were individualized to each patient's SEA
      recorded electrocorticogram and operative electrocorticogram and functional
      mapping results (tailored resection). The follow-up time was a minimum of one
      year. Good seizure outcome was defined as seizure free from complex partial and
      secondary generalized seizures. After one year 70% of the patients with a
      temporal ictal focus was seizure free compared to 55% of the patients with an
      extra-temporal focus. Complete resection of interictal or ictal fields as mapped
      with SEAs, gave better prognosis than partial resection. Patients with no
      postresection spikes had a better prognosis than patients with residual
      postresection spikes evaluated with operative electrocorticography. Sex, age,
      duration of epilepsy prior to surgery, extent of temporal lobe resection and
      structural abnormalities determined by MRI were not associated with a favorable
      seizure outcome after surgery. We conclude that complete resection of the
      interictal and ictal field mapped with SEA's and absence of postresection spikes
      on operative electrocorticography are associated with an excellent seizure
      outcome.

PMID- 8356871
TI  - Epilepsy treatment in The Netherlands. Comparison of two medical centres.
AB  - In order to test if it is feasible to compare epilepsy treatment policies, a
      secondary (University Hospital) and a tertiary referral care centre (i.e. an
      Epilepsy Centre) were compared with respect to their characteristics, the
      treatment approaches, and the outcome of treatment using clinimetric indexes. At
      the Epilepsy Centre a greater variety of seizure types was seen than at the
      University Hospital. At the University Hospital more patients were treated with
      monotherapy (62.5%) than at the Epilepsy Centre (28.0%). The Composite Index of
      Impairments (CII), which reflects all treatment related impairments i.e. seizures
      and adverse events, was significantly higher at the Epilepsy Centre than at the
      University Hospital. No difference was seen in the groups of patients with a high
      score of the CII (> 100). Further analysis is needed to obtain an answer as to
      why differences between the two groups exist.

PMID- 8356872
TI  - Amyotrophic lateral sclerosis in Sardinia, Italy: an epidemiologic study.
AB  - The authors carried out an epidemiologic study on amyotrophic lateral sclerosis
      in Sardinia for the years 1957 through 1990. The duration of the disease and
      survival were significantly shorter in bulbar form. The distribution of ALS in
      various areas of the island was found to be not at all homogeneous. Mean yearly
      incidence showed no significant variations in the decades 1971-80 and 1981-90. In
      the last decade, an increase of bulbar forms was observed.

PMID- 8356873
TI  - Absence of brain antibodies in the sera of relapsing-remitting multiple sclerosis
      patients is not due to the formation of immune complexes.
AB  - Using an enzyme-linked immunoadsorbent assay, we looked, whether the formation of
      idiotype-anti-idiotype complexes was responsible for the absence of antibodies in
      the sera of MS patients. We tested 18 relapsing-remitting and 26 chronic
      progressive patients versus 44 age- and sex-matched controls. We did not find
      elevated titres of immune complexes in the sera of the multiple sclerosis
      patients.

PMID- 8356874
TI  - Effects of recombinant alpha-2b-interferon therapy in patients with progressive
      MS.
AB  - The effects of systemic recombinant interferon-alpha-2b were studied in 6
      carefully selected patients with progressive multiple sclerosis. 3.0 million IU
      were given as daily subcutaneous injections for 6 months, 5 patients showed
      worsening disability, and in 4 of them new or enlarged lesions were detected in
      MRI. In one patient no change in disability was found; his MRI showed regressed
      changes. The mean progression index during the treatment was significantly higher
      (p < 0.02) than during the previous 2 to 3 years' period of continuous
      progression. The frequency of peripheral blood natural killer (CD16+) cells
      declined significantly 3 months during the treatment, but returned to the
      pretreatment values after termination the treatment. An increase of intrathecal
      IgG synthesis and oligoclonal bands was demonstrated in 4 and 3 patients,
      respectively. Our experience suggests that long-term recombinant IFN-alpha-2b
      treatment may activate the immunological process of MS.

PMID- 8356875
TI  - Mercury and multiple sclerosis.
AB  - It has occasionally been claimed that multiple sclerosis (MS) may be due to a
      chronic mercury intoxication, e.g. from mercury liberated from dental fillings.
      Therefore, the present communication compares the mercury content assayed by
      neutron activation in 8 macroscopically normal areas (frontal lobe) of MS autopsy
      brains with those of 8 control samples. No significant differences could be
      traced between the two groups concerning total mercury. However, the lipid
      soluble mercury (preferably methyl mercury) expressed per cell unit (DNA) was
      found significantly decreased in MS. These data may be explained either by a wash
      out of lipid soluble mercury due to break-down of the blood-brain barrier in MS
      or to abnormalities in methylation processes probably related to the vitamin B12
      metabolism in MS.

PMID- 8356876
TI  - Serial study of neuropsychological performance and gadolinium-enhanced MRI in MS.
AB  - Many multiple sclerosis patients show cognitive decline, although no definite
      correlation between brain demyelination at MRI and neuropsychological performance
      has been found so far. We submitted a group of nine relapsing-remitting, mildly
      disabled patients to both serial gadolinium-DTPA enhanced MRI and
      neuropsychological evaluation in a follow up period of three months. Despite the
      great variability in acute lesions' load, no overall decline in test, performance
      was found. Furthermore, in selected cases whose test scores declined at follow
      up, no concordance with the new lesion load was found.

PMID- 8356877
TI  - Clinical characteristics of familial and sporadic Creutzfeldt-Jakob disease in
      Finland.
AB  - The clinical features of 44 Finnish patients with Creutzfeldt-Jakob disease (CJD)
      were analyzed with special emphasis on the differences between the sporadic and
      familial forms. The 32 sporadic patients comprised all neuropathologically
      verified cases of CJD in 1974-89 in Finland. The 12 familial patients were
      members of the same pedigree where CJD has been linked with a mutation at codon
      178 of the PRNP gene. The median age at the onset of the disease was 62.5 years
      and median duration 4.5 months in sporadic patients, and 49 years and 20.5 months
      in familial CJD, respectively. 90 percent of both sporadic and familial patients
      had myoclonus. Typical periodic EEG change was seen in 72% of sporadic patients,
      whereas the familial patients showed only a progressive slowing of EEG.

PMID- 8356878
TI  - Serum cobalamin and methylmalonic acid in Alzheimer dementia.
AB  - The cobalamin status was evaluated in Alzheimer dementia (n = 26), other
      dementias (n = 24), various gerontopsychiatric disorders (n = 25), and in neuro
      psychiatrically healthy controls (n = 20). Supplementing serum cobalamin we
      measured methylmalonic acid (MMA), a metabolite accumulating early in cobalamin
      deficiency. Subnormal cobalamin and/or clearly elevated MMA concentrations were
      found in 11 cases: 7 Alzheimer patients (27%), 2 with other dementias (8%), one
      psychiatric patient (4%), and one control (5%). None presented the typical
      neurologic features of cobalamin deficiency and macrocytosis was found in only
      one. The mean cobalamin concentration was significantly lower in Alzheimer
      patients (179 +/- 18 pmol/l) than in the age-matched controls (256 +/- 23 pmol/l)
      (p = 0.013) and the other patient groups. Correspondingly, the mean MMA level was
      higher in the Alzheimer group (0.480 +/- 0.062 mumol/l) than in any other
      diagnostic group (controls: 0.347 +/- 0.040 mumol/l). Comparing the Alzheimer
      group to the other groups as a whole, the elevation was significant (p = 0.0097).
      Our findings indicate that Alzheimer patients are particularly prone to cobalamin
      deficiency, and even subtle biochemical signs of deficiency seem to justify
      treatment.

PMID- 8356879
TI  - Chronobiological aspects of acute cerebrovascular diseases.
AB  - The study was aimed at further investigating the circadian and circannual
      patterns of stroke onset. Study design and type of participants: 977 strokes (475
      in men and 502 in women) concerning 926 subjects (457 men and 469 women) admitted
      to Ferrara Hospital in two calendar years (1990-1991), were prospectively
      investigated. The strokes were classified as based on cerebral infarction (CI),
      transient ischemic attack (TIA) and cerebral hemorrhage (CH: subarachnoid and
      intracerebral hemorrhage). Two statistical models of analysis were used. The
      assessment of circadian and circannual periodicity was performed utilizing the
      single cosinor method. A separate analysis was performed after distribution of
      events into 6-hour intervals, and chi-square test for fit was applied to the
      number of observed versus expected cases. The majority of strokes occurred in the
      morning between 7 a.m. and noon (35% of cases) and the hypothesis of a uniform
      distribution of the time onset was rejected on the basis of the chi-square for
      all subtypes of stroke. A circadian rhythm was found for CI and TIA with
      acrophase at the 11.56 and 12.41 respectively. Also a circannual periodicity was
      found for CI with a prevalent peak in October. The spectral analysis detected a
      circadian cycle for CH having a period of 4 h, and a circannual cycle for TIA
      with a period of 4 months. This study confirms that stroke is a high-chrono-risk
      disease, with specific circadian and circannual rhythms. This is very important
      for a better understanding and control of the underlying factors and in terms of
      prevention.

PMID- 8356880
TI  - Transcranial Doppler recordings in raised intracranial pressure.
AB  - The pulsatility index (PI) registered by the transcranial doppler (TCD) was
      examined in relation to arterial pCO2 (paCO2) and epidural pressure (ICP). In 10
      normal subjects PI was studied during variations in paCO2. In 10 neurosurgical
      patients with head injuries concomitant measurements of PI and ICP were obtained.
      The results showed a negative exponential correlation between PI and paCO2. PI
      changes with 3.2% pr mmHg paCO2. A positive exponential correlation between PI
      and ICP was observed. PI changed with 2.4% pr mmHg ICP. In the subgroup of
      patients with raised ICP (15 mmHg <) paCO2 was found not to influence the PI
      reflection of the ICP, probably because paCO2-changes affected PI as well as ICP.
      The results suggest that the noninvasive bedside TCD-registration may be a useful
      marker of the ICP and probably replace the former invasive methods of measuring
      ICP.

PMID- 8356881
TI  - Overlapping syndrome of MERRF and MELAS: molecular and neuroradiological studies.
AB  - We describe a 42-year-old woman with overlapping syndrome of MELAS (mitochondrial
      myopathy, encephalopathy, lactic acidosis and stroke-like episodes) and MERRF
      (myoclonus epilepsy and ragged-red fibers). Clinically, she had episodic
      headache, stroke-like episode with left hemiparesis and lactic acidosis commonly
      found in MELAS syndrome. However, myoclonus seizure, and ataxia with dyssynergic
      gait characteristic of MERRF were also noted. Computed tomographic scans showed a
      right temporo-parietal hypodense lesion. The lesion disappeared 20 months later,
      even magnetic resonance images also failed to reveal this abnormality. A
      molecular analysis of mitochondrial DNA was conducted by using restriction
      endonucleases ApaI and NaeI. A transition from A to G was found at the nucleotide
      position 3243, but not found at the 8344th nucleotide pair. In this report, we
      document the fluctuating CT changes and emphasize the importance of molecular
      analysis in patients with overlapping syndrome of mitochondrial
      encephalomyopathies.

PMID- 8356882
TI  - Diagnosis of X-adrenoleucodystrophy phenotypic variants.
AB  - We report the radiological and biochemical data of a familial X
      adrenoleucodystrophy with an extreme phenotypic variability, in which the
      diagnosis of several affected members was delayed for several years. The
      propositus developed a progressive dementia, while two of his brothers were
      diagnosed of primary Addison's disease several years previously. MRI in two cases
      with different phenotypes revealed hyperintense diffuse white matter lesions, and
      the diagnosis was confirmed by increased serum levels of very long chain fatty
      acids. We conclude that X-adrenoleucodystrophy should be included in the
      differential diagnosis of adult Addison's disease even though no neurological
      involvement or family history is recorded, and that MRI is a useful tool for
      diagnosis and follow-up of neurological involvement in this disease.

PMID- 8356883
TI  - Idiopathic intracranial hypertension after ofloxacin treatment.
AB  - We report the occurrence of idiopathic intracranial hypertension in a patient
      treated with ofloxacin, a fluoroquinolone antimicrobial agent, for 16 months. The
      withdrawal of ofloxacin and acetazolamide therapy were followed by a complete
      recovery of visual function.

PMID- 8356884
TI  - Post-traumatic segmental myoclonus associated with bilateral olivary hypertrophy.
AB  - We present clinical and magnetic resonance (MR) findings in three patients with
      segmental myoclonia occurring 11-18 months after severe brainstem injury. Palatal
      myoclonus and vertical ocular myorhythmia were present in all three patients and
      synchronous involuntary movements of the upper extremities ("wing beating") in
      two patients. MR-imaging showed multiple post-traumatic lesions within the
      dentato-rubro-olivary pathway ("myoclonic triangle"), associated with bilateral
      enlargement and increased signal intensity of the inferior olives. The signal
      abnormality was more prominent on proton density weighted images than on T2
      weighted images, suggesting underlying pathological changes different from
      typical gliosis.

PMID- 8356885
TI  - Impairment of Fos protein formation in the rat infarct borderzone by MK-801, but
      not by NBQX.
AB  - In the present immunocytochemical study, we investigated the mechanism of Fos
      protein induction and the regional distribution of the Fos protein in brains of
      spontaneously hypertensive rats subjected to 2 h of permanent middle cerebral
      artery occlusion (MCAO). Rats were administered either saline or a glutamate
      receptor antagonist; the non-competitive NMDA receptor antagonist MK-801 or the
      AMPA receptor antagonist NBQX which are known to be able to reduce infarct size
      in MCA occluded rats. The saline treated rats showed presence of Fos protein in
      nerve cell nuclei throughout the cortical and striatal infarct borderzone, but no
      staining in the infarct core or contralateral hemisphere. MK-801 almost totally
      abolished this expression of Fos protein whereas NBQX had no significant effect
      on Fos protein expression. It is suggested that the Fos protein induction is due
      to repeated spreading depressions mediated by NMDA receptors in the infarct
      borderzone, and that Fos protein due to its persistence in the tissue can be used
      as a histochemical marker of borderzone tissue at risk for eventually becoming
      recruited in the infarct.

PMID- 8356887
TI  - Satisfaction with care reported by psychiatric inpatients. Relationship to
      diagnosis and medical treatment.
AB  - In this survey, 274 patients were sent a questionnaire concerning satisfaction
      with psychiatric treatment and the ward 1 month after their discharge from
      hospital. Fifty-two percent of the patients responded. Answers to the 56 items of
      patient satisfaction were analyzed in relation to patient diagnoses and treatment
      given. Patients who were diagnosed as suffering from affective disorders or from
      reactive psychoses were more satisfied than patients with schizophrenia or
      paranoia or with transitory adjustment reactions. Patients who had no personality
      disorder diagnosis and patients with character neurosis were more satisfied than
      patients with antisocial or borderline personality disorders. Patients on
      antidepressant medication were much more satisfied than other patients. The
      results of the study are discussed with regard to the need of further research in
      this area and to quality assurance.

PMID- 8356886
TI  - Cross-cultural comparison of depression and depressive symptoms in older people.
AB  - This article presents data on the prevalence of depression and the profile of
      depressive symptoms in 2 groups of people aged 65 and over: 1070 living in
      Liverpool, United Kingdom, and 1080 living in Zaragoza, Spain. Similar prevalence
      figures were found for women (Liverpool first); 14.2% vs 14.8% and, for men, 7.2%
      vs 6.2%. No age differences were found. The figures are lower than those found
      using similar methods in London and New York, but higher than those from Iceland.
      The article also compares the profile of depressive symptoms between Liverpool
      and Zaragoza and explains these by reference to social and cultural differences.

PMID- 8356888
TI  - The anterior pituitary responds normally to protirelin in obsessive-compulsive
      disorder: evidence to support a neuroendocrine serotonergic deficit.
AB  - The prolactin and thyroid-stimulating hormone (TSH) responses to protirelin and
      the prolactin and cortisol responses to d-fenfluramine were measured in 8
      outpatients with DSM-III-R obsessive-compulsive disorder (OCD). The results were
      compared to those in 8 age- and sex-matched healthy controls. The responses to d
      fenfluramine were significantly attenuated in the OCD patients, but there was no
      significant difference between the responses to protirelin in OCD patients and
      healthy controls. The data suggest that, in OCD, blunting of prolactin responses
      to the serotonin-releasing agent d-fenfluramine is due to a central abnormality
      and not due to a pituitary deficit.

PMID- 8356889
TI  - Impulsivity and dyscontrol in bulimia nervosa: is impulsivity an independent
      phenomenon or a marker of severity?
AB  - Fifty-eight normal-weight DSM-III-R bulimia nervosa patients were compared with
      27 normal controls on measures of bulimia nervosa, depression, impulsivity,
      obsessionality and impulse control (dyscontrol) behaviours. Patients scored
      higher than controls on all these measures. Almost half the patient cohort met
      Lacey's multi-impulsive bulimia criteria. When bulimic symptoms were controlled
      for in an analysis of covariance, multi-impulsive bulimics did not score
      significantly differently to non-impulsive bulimics on psychometric measures of
      impulsivity, obsessionality and depression. The concept of impulsivity is
      critically reviewed and newer concepts linking obsessionality and impulsivity are
      explored.

PMID- 8356890
TI  - Psychotic features and the course of Alzheimer's disease: relationship to
      cognitive, electroencephalographic and computerized tomography findings.
AB  - Thirty-one of 50 patients satisfying the NINCDS-ADRDA criteria of probable or
      possible Alzheimer's disease showed psychotic features during a 2-year
      observation period. Paranoid delusions were reported in 23 patients, delusional
      misidentification in 17, visual hallucinations in 16 and auditory hallucinations
      in 8. All of the 7 patients who died within the observation period had suffered
      from psychotic features even before the preterminal phase of illness. A faster
      progression of illness towards more severe stages of dementia was associated with
      paranoid delusions and hallucinations but not with delusional misidentification.
      We could not prove a significant influence of age, age of onset, cognitive
      performance, ventricular enlargement or the severity of quantitative
      electroencephalographic changes at initial examination on the course of illness.
      This may indicate that specific psychotic features and their potential organic
      substrate exert an effect on the progression of illness and on survival in
      Alzheimer's disease, which is not related to gross brain atrophy and generalized
      neurophysiological changes.

PMID- 8356891
TI  - Reproductive rates in schizophrenic outpatients.
AB  - We investigated the marriage rates, the reproductive rates and the marital
      reproductivity of schizophrenic outpatients in Japan. A total of 553 patients
      with DSM-III-R-diagnosed schizophrenia at the Teikyo University Hospital, Tokyo,
      Japan were compared with age- and sex-matched outpatients at surgical clinics of
      the same hospital. Our findings indicate that the reproductivity of
      schizophrenics is reduced, even though the sample consists of outpatient
      population and modern operational diagnostic criteria have been used. The
      marriage rate and reproductive rate of the schizophrenics were reduced,
      especially in men. The number of married men was significantly less than that of
      married women and the reduced marital reproductivity was found in women but not
      men. These findings indicate that the reduced reproductivity of men in accounted
      for largely by a reduced rate of marriage, and that in women is accounted for
      partly by lower rate of reproductivity within marriage.

PMID- 8356892
TI  - Clinical significance of outcome in long-term follow-up of borderline patients at
      a day hospital.
AB  - All borderline patients admitted at a day hospital during a 6-year period were
      followed up with a postal questionnaire after 3-10 years. Patients who had chosen
      to leave the treatment within 4 months were analyzed as a separate group, and
      these drop-outs and the remaining patients were compared with a group of well
      adjusted people who were assumed to represent the functional norm. The patients
      who remained in treatment were clearly posited at a level of functioning between
      the norm and the drop-outs, although the variation among them was quite large.
      Depending on the stringency and content of the criterion of clinical
      significance, 25-75% of the patients remaining in treatment fell within the range
      of the norm group versus 20-50% of the drop-outs. The patients who had benefited
      most since termination had differed favorably from the other patients already at
      admission to treatment, but not as much as had the drop-outs. The drop-outs,
      however, at admission also had more ambivalent or negative attitudes towards
      treatment.

PMID- 8356894
TI  - Brief family therapy with alcohol-dependent men in Trinidad and Tobago.
AB  - This study--the first of its kind in the English-speaking Caribbean--investigated
      the efficacy of modified brief family therapy in the treatment of alcoholism.
      Thirty men were treated with family therapy and milieu therapy and compared with
      30 sex- and age-matched patients treated with milieu therapy alone. Follow-up
      over a period of 1 year showed significant levels of improvement in those treated
      with family therapy. The treatment group did not revert to their original
      drinking pattern. This can be attributed to family therapy. Family therapy was
      brief and involved seeing all significant members for 3 sessions, each session
      lasting 90 min. The role of family therapy and importance of culture in
      management of these patients are discussed. Our study confirms that a time
      limited problem-solving family therapy approach is of use in these ethnic groups.

PMID- 8356893
TI  - The pattern of regional cerebral blood flow during alcohol withdrawal--a single
      photon emission tomography study with 99mTc-HMPAO.
AB  - Cerebral blood flow was investigated during alcohol withdrawal in 15 male
      alcoholics by single photon emission computerized tomography with 99mTc-HMPAO and
      compared with the results of a second study 3 weeks later when all symptoms of
      withdrawal had disappeared and when the patients had been free of medication for
      at least 1 week. Slice images were reconstructed parallel to the orbitomeatal
      plane, and tracer activity was analyzed in 8 regions of interest per hemisphere.
      During alcohol withdrawal a special pattern of cerebral blood flow distribution
      could be observed. Relative perfusion was elevated in both inferior temporal
      regions, whereas it was reduced in the superior temporal region of both
      hemispheres. The changes of cerebral blood flow distribution did not correlate
      with neuropsychological findings nor with the severity of withdrawal syndrome.

PMID- 8356895
TI  - The Utrecht comparative study on psychiatric day treatment and inpatient
      treatment.
AB  - A prospective randomized comparative study on the effectiveness of psychiatric
      day treatment and inpatient treatment is described. The target population
      consisted of patients who would normally have been admitted to an open inpatient
      unit. Outcome indicators were psychopathology, social functioning, interpersonal
      functioning, social network and social support. No differences in effectiveness
      were found between the two forms of treatment, although more patients accepted
      and completed day treatment, and day patients were more satisfied. Although a
      uniform treatment programme for both departments was established, distinct
      differences did arise in the actual treatment programme offered to the patients.
      The duration of treatment for the day patients was considerably longer, and the
      intensity of treatment was more low-key. No striking differences in the amount of
      medication prescribed and in the occurrence of crisis situations (including
      suicide) were found. Day treatment turns out to be a realistic alternative for
      33% of all patients admitted for inpatient treatment. It was not possible to
      predict which type of patient in particular is suitable for day treatment.

PMID- 8356896
TI  - Outcome, recovery, relapse and mortality across six years in patients with
      clinical eating disorders.
AB  - The study describes course and outcome over 6 years for adults with eating
      disorders. Special interest is paid to clinically critical events such as relapse
      and premature death. Seventy-seven per cent of the 30 prospectively studied
      patients had no eating disorder diagnosis after 6 years. Among the recovered
      patients, the total risk of relapse was 48%. The mortality was 17.8 times higher
      than expected. The overall pattern of results confirm earlier ones for anorexia
      nervosa and extend the limited database for bulimia nervosa. Of particular
      importance may be 1) that no patient in this sample suffered more than one major
      relapse and 2) that the risk for premature death may be twice as high among
      bulimic as among restricting patients.

PMID- 8356897
TI  - Effect of a long-lasting gonadotrophin hormone-releasing hormone agonist in six
      cases of severe male paraphilia.
AB  - Six men with severe paraphilia had been treated with depot gonadotrophin
      luteinizing releasing hormone analogue (GnRHa) (triptorelin 3.75 mg per month
      intramuscularly). In 5 cases, the treatment ended their deviant sexual behavior
      and markedly decreased their sexual fantasies and activities without further
      significant side effects than those related to hypoandrogenism. This clinical
      improvement was parallel to the gradual decrease of plasma testosterone level to
      castration values within the first month. The beneficial effect of this treatment
      had been maintained at follow-up varying from 7 months to 3 years. One patient
      interrupted the treatment at the end of the first year and relapsed within 10
      weeks. GnRHa treatment, which leads to reversible castration, may constitute a
      promising treatment of paraphilic behavior and may favor the possibility of
      concurrent psychotherapy.

PMID- 8356899
TI  - Development of personality disorders in children and adolescents with obsessive
      compulsive disorder. A 6- to 22-year follow-up study.
AB  - Forty-seven people with admissions in childhood for obsessive-compulsive disorder
      (OCD) and 49 child psychiatric controls were followed up in young adulthood and
      assessed for DSM-III-R personality disorders with the Structured Clinical
      Interview for DSM-III-R Personality Disorders. The number of personality
      disorders in OCD patients did not differ significantly from the number in
      controls. The most common personality disorder was avoidant personality disorder
      (significantly more frequent than in controls), whereas obsessive-compulsive
      personality disorder (OCPD) was not found more often in the OCD group. Subjects
      with OCD in adulthood seemed to have OCPD more often than childhood OCD patients
      with no OCD at follow-up. In the whole group, histrionic personality disorders
      were more common in women than in men and OCPD more common in men than in women,
      whereas borderline personality disorder was most common among women in the OCD
      group. The presence of a personality disorder in adulthood could not be
      correlated with such childhood factors as social background, symptoms or age of
      onset of OCD.

PMID- 8356898
TI  - Suicide and attempted suicide reported by general practitioners in Belgium, 1990
      1991.
AB  - In 1990-1991 the Belgian sentinel network of general practitioners recorded
      suicide and suicide attempts within their practices. The annual attempted suicide
      rate is estimated at 13.0 cases per 10,000 inhabitants. The highest incidence
      rates are found among women and young people. The annual suicide rate is
      estimated at 2.3 cases per 10,000 inhabitants, with the highest rates in men and
      in elderly people. The highest incidence rates of suicide attempts as well as of
      suicide are found among divorced people. About 30% of the attempters and
      committers made at least one earlier attempt. Drug overdose and hanging are the
      most frequently used methods, respectively when attempting and committing
      suicide. About 60% of both committers and attempters contacted their general
      practitioner within a period of 1 month preceding the attempt. Nearly half of the
      attempters and of the committers were treated for a mental disorder in the year
      preceding the attempt.

PMID- 8356900
TI  - Peripheral nerve regeneration: role of growth factors and their receptors.
AB  - Growth factors play a central role in the regulation of normal and injury-induced
      regenerative cell growth. The purpose of this article is to summarize the
      available data on the expression of different growth factors and their receptors
      in the injured peripheral nervous system and to discuss their possible role in
      promoting peripheral nerve regeneration.

PMID- 8356901
TI  - Developmental profile of glucocorticoid binding to synaptic plasma membrane from
      rat brain.
AB  - The plasma membranes of several mammalian tissues including the brain are known
      to have specific binding sites for glucocorticoids. The developmental changes in
      specific glucocorticoid binding to synaptic plasma membrane (SPM) from rat brain
      were determined at various postnatal ages, using [3H]triamcinolone acetonide (TA)
      as the steroid ligand. The specific binding of the labeled glucocorticoid to SPM
      during the first 2 postnatal weeks was only 40% of the adult level. An increase
      of the specific binding occurred after day 15, and this developmental rise of
      binding reached the adult level approximately by the end of the fourth week.
      Methodologically, these developmental data are detailed in the present article to
      include nonspecific binding as well as specific binding. Scatchard analysis
      indicates that the developmental rise of the specific glucocorticoid binding was
      due to an increase in the membrane binding sites. The ontogenetic increase of
      membrane binding sites during postnatal brain development provides additional
      evidence that these binding sites have physiological significance in brain
      function.

PMID- 8356902
TI  - Trophic influences of human and rat amniotic fluid on neural tube-derived rat
      fetal cells.
AB  - Normal human (week 17-20) and rat (E16-17) amniotic fluids were used as culture
      media for primary cultures of rat fetal (E 16) cortical, mesencephalic and
      striatal cell dissociates, or astroglial subcultures from the same brain regions.
      Phase-bright and dark cells were identified under phase contrast microscopy and
      their cell processes were measured utilizing semi-automated procedures.
      Subcultured astroglia were immuno-reacted against glial fibrillary acidic protein
      and fibronectin. Rat and human amniotic fluid allowed survival and growth of
      neuronal and non-neuronal cells. Human amniotic fluid samples were trophic in
      variable degrees. Cerebral cortex subcultured astroglia usually expressed a
      radial-like morphotype. Although charcoal-adsorbed human amniotic fluid was
      trophic for primary cultures, its ability to sustain neuritic growth depended on
      its degree of trophism before treatment. Growth of cell processes in neuronal-
      and glial-like cells in primary cultures was inhibited to different degrees by
      the addition of antisera towards nerve or epidermal growth factors. It is
      concluded that amniotic fluid constitutes a trophic medium for astroglia and
      neurons. Both, nerve and epidermal growth factors appear to be necessary for
      growth of cell processes in neuronal and glial primary cultures in amniotic
      fluid. Trophic effect of amniotic fluid on subcultured astroglia did not seem to
      be diminished by nerve growth factor antiserum. The role of amniotic fluid during
      the early phases of brain organogenesis is discussed.

PMID- 8356903
TI  - Laminar expression of m1-, m3- and m4-muscarinic cholinergic receptor genes in
      the developing rat visual cortex using in situ hybridization histochemistry.
      Effect of monocular visual deprivation.
AB  - The postnatal development of laminar pattern of m1-, m3- and m4-mRNA-muscarinic
      acetylcholine receptor subtypes in the visual cortex of both normally raised and
      monocularly deprived rats (one eyelid sutured at the age of 11 days) was studied
      using in situ hybridization histochemistry and computer-assisted image analysis.
      From birth until day 15 the level of m1-receptor transcript in layer II/III
      increases markedly as compared to deeper layers. From day 15 up to day 18 a
      transient bimodal pattern develops with peaks in layers II/III and VI. Already on
      day 35 a more homogeneous distribution of m1-receptor mRNA level is detectable
      persisting until adulthood. In contrast, the m3-receptor mRNA shows already at
      birth a bimodal distribution with peaks in layers II/III and VI. Further
      development until adulthood results in transient changes in the ratio of the mRNA
      levels in these layers. In the adult visual cortex a similar laminar pattern as
      at birth is observed. From day 1 up to day 10 a relative increase in the mRNA
      level of the m4-receptor in layers II to IV is observed. From day 10 until day 15
      a bimodal distribution of receptor mRNA develops with peaks in layers III and VI
      which is similar to the adult stage. However, between days 18 and 35 a shift in
      the laminar receptor mRNA distribution occurs resulting in peaks in layers IV and
      VI. The labeling of the m5-receptor transcript in rat visual cortex was very weak
      and did not show any alteration with age. Unilateral eyelid closure from
      postnatal day 11 resulted in transient changes in the laminar distribution of m3-
      and m4-receptor mRNA between postnatal days 18 and 25, whereas the development of
      the laminar pattern of the m1-receptor mRNA was not affected regardless of the
      length of visual deprivation. The distinct laminar developmental pattern of mRNA
      muscarinic receptor subtypes in rat visual cortex suggests specific roles of the
      muscarinic receptor subtypes during the first weeks of postnatal maturation of
      visual function.

PMID- 8356904
TI  - Hippocampal cholinergic alterations and related behavioral deficits after early
      exposure to ethanol.
AB  - The present study was designed to ascertain septohippocampal cholinergic
      alterations and their related behavioral deficits after early exposure to
      ethanol. Mouse pups were exposed to ethanol, 3 g/kg by daily subcutaneous
      injection on postnatal days 2-14. At age 50 days, the ethanol-exposed mice had
      significant reductions from control levels in eight-arm maze performance. For
      example, on the fourth testing day, the number of correct entries in the ethanol
      group was 21% below control levels (P < 0.05) and the number of trials needed to
      enter all arms was 48% above control (P < 0.001). It took the ethanol-exposed
      mice twice the time to reach criterion than it did control (P < 0.01). A 33%
      increase from control level in muscarinic receptor number (Bmax) was found in the
      treated mice of age 22 days and a 64% increase at age 50 days (P < 0.001).
      However, no differences between control and treated groups could be detected in
      the presynaptic component of the cholinergic innervation, choline
      acetyltransferase activity. The results suggest that early ethanol exposure acts
      on hippocampal function similarly to phenobarbital, probably via alterations in
      postsynaptic processes in the septohippocampal cholinergic pathways.

PMID- 8356905
TI  - Structural aspects of N-hydroxy-N'-aminoguanidine derivatives as inhibitors of
      L1210 cell growth and ribonucleotide reductase activity.
AB  - Previous studies have shown that N-hydroxy-N'-aminoguanidine (HAG) derivatives
      [RCH = NNHC(= NH)NHOH-tosylate] inhibit ribonucleotide reductase activity and
      block the growth of leukemia L1210 cells and human colon carcinoma, HT-29, cells
      in culture. In the current studies, the role of the side chains and the location
      of the bond of the side chain moiety to HAG were investigated using a new series
      of HAG derivatives which contained as the R-group--cyclohexyl, phenyl-, pyridyl-
      or napthyl moieties. The effects of these compounds as inhibitors of L1210 cell
      growth and ribonucleotide reductase activity were compared with the parent
      compound. N-hydroxy-N'-aminoguanidine was less inhibitory to ribonucleotide
      reductase activity and L1210 cell growth than hydroxyurea. The phenyl-HAG
      compounds which included 1-benzyloxybenzylidene- and 4
      cyclohexylmethoxybenzylidene-HAG inhibited CDP reductase with IC50s which ranged
      from 50-110 microM. 1-Naphthylmethylene-HAG was more inhibitory than 2
      naphthylmethylene-HAG and more inhibitory than the phenyl-HAG compounds. 2
      Pyridylmethylene-HAG was more inhibitory than 3-pyridylmethylene- or 4
      pyridylmethylene-HAG. While HAG inhibited CDP and ADP reductase activities
      essentially to the same extent, the HAG-derivatives inhibited ADP reductase
      activity to a greater extent than CDP reductase activity. Cyclohexylmethylene-HAG
      did not inhibit either L1210 cell growth or ribonucleotide reductase activity.
      There was good correlation between the inhibition of ribonucleotide reductase
      activity and L1210 cell growth by these HAG-derivatives. These data indicate that
      not only is the nature of the side chain substitution important, but also the
      location of the HAG-moiety on the ring position.

PMID- 8356906
TI  - Regulation of proteasome expression in developing and transformed cells.
AB  - The proteasome is a unique protease complex found in all eukaryotic cells and has
      multiple functions for essential activities. In this work we showed that it is
      expressed at high level in immature, rapidly growing cells, such as those in
      early embryonic tissues and cancer cells (Fig. 7). The increase of its expression
      is down-regulated on differentiation of the cells. However, lymphatic blastocytes
      grow rapidly and express high levels of proteasomes, but are differentiated.
      Therefore, the proteasome is not expressed at high levels only in immature cells,
      but is also involved specifically in nuclear activities of cells during rapid
      growth, possibly regulating proteinous factors in the cell cycle.

PMID- 8356907
TI  - Peroxisomal leukotriene degradation: biochemical and clinical implications.
AB  - Degradation of the cysteinyl leukotrienes LTE4 and N-acetyl-LTE4, and of LTB4 by
      beta-oxidation from the omega-end has been recognized as an important pathway in
      the inactivation of these mediators. The contribution of peroxisomes to
      leukotriene degradation and inactivation was studied in isolated hepatocytes, in
      isolated liver peroxisomes, and in patients with inherited peroxisome deficiency.
      (1) Isolated hepatocytes from rats pretreated with the peroxisome proliferator
      clofibrate produced highly increased amounts of beta-oxidation products derived
      from omega-carboxy-LTB4 and omega-carboxy-N-acetyl-LTE4 as compared to normal
      hepatocytes. (2) Isolated peroxisomes purified from normal and clofibrate-treated
      liver produced omega-carboxy-dinor-LTB4 and omega-carboxy-tetranor-LTB3 when
      nucleotide cofactors, including CoA, ATP, NAD+, FAD, and NADPH, were added. beta
      Oxidation of the cysteinyl leukotriene omega-carboxy-N-acetyl-LTE4 was observed
      only with isolated peroxisomes together with a microsome fraction providing an
      acyl-CoA synthetase activity. (3) Peroxisomal leukotriene-binding proteins were
      identified by photo-affinity labeling with omega-carboxy-[3H]leukotrienes and
      precipitation of labeled polypeptides with antibodies against enzymes of the
      peroxisomal beta-oxidation system. (4) Peroxisomal degradation of leukotrienes in
      humans was studied by analyses of endogenous leukotrienes and their catabolites
      in urine from patients with an inherited peroxisomal deficiency disorder
      (Zellweger syndrome) and healthy infant controls. Urinary LTE4, relative to
      creatinine, was increased 10-fold in the patients, whereas the beta-oxidation
      product omega-carboxy-tetranor-LTE3 was only detectable in healthy infants. In
      addition, LTB4 was exclusively detected in the urine of patients with peroxisome
      deficiency. The increased levels of biologically active, proinflammatory
      mediators might be of pathophysiological significance. In addition, the altered
      pattern of leukotriene metabolites in urine may be of diagnostic value. The
      measurements in these patients underline the essential role of peroxisomes in the
      catabolism and inactivation of leukotrienes in humans.

PMID- 8356908
TI  - Role of glutathione in cellular resistance to alkylating agents.
AB  - Both elevated glutathione levels and increased activity of the enzyme glutathione
      S-transferase have been associated with the resistance of cells to alkylating
      agents. We have demonstrated that one mechanism of this resistance is the
      inactivation of the alkylating agents by conjugation with glutathione. This
      conjugation can be catalyzed by glutathione S-transferase. For the nitrogen
      mustard agents we have studied, both the spontaneous and enzyme catalyzed
      reactions proceed through the aziridinium intermediates of the alkylating agents,
      and the alpha isoenzymes of GST are involved. In a study of cyclophosphamide
      resistant medulloblastoma cell lines elevated cellular concentrations of
      glutathione correlated well with the resistance of the cell lines.

PMID- 8356909
TI  - Chemical modification of an arginine residue in aldose reductase is enhanced by
      coenzyme binding: further evidence for conformational change during the reaction
      mechanism.
AB  - Chemical modification of pig muscle aldose reductase (ALR2) with the arginine
      specific reagent phenylglyoxal resulted in the inactivation of the enzyme. This
      inactivation exhibited pseudo-first order kinetics typical of active-site
      directed chemical modification. Inactivation of ALR2 by [7-C14] phenylglyoxal in
      the absence of NADPH or NADP+ followed by tryptic digestion resulted in the
      isolation by HPLC of one major and one minor radioactive peptide. Protein
      sequencing revealed that the major peptide contained a modified arg268, a residue
      located in the coenzyme binding site. The minor radioactive peptide and the
      single radioactive peptide isolated from ALR2 inactivated in the presence of
      NADP+ contained chemically modified arg293. The arginine residue modified at the
      active site is positioned to bind the 2'-OH phosphate group of the ribose sugar
      of the adenine moiety of NADP+. Arg293 is present on the C-terminal loop of ALR2.
      The enhancement of Arg293 modification by phenylglyoxal in the presence of NADP+
      indicates that this C-terminal loop may be involved in the slow conformational
      change that occurs during the reaction sequence upon coenzyme binding.

PMID- 8356910
TI  - Nucleoside transport in normal and neoplastic cells.
AB  - The permeation of nucleosides across the plasma membrane of mammalian cells is
      complex and mediated by at least five distinct transporters that differ in their
      sensitivity to inhibitors and in their specificity for nucleosides. The basic
      properties and permeant specificity of these transporters are summarized in Table
      3. It appears that there may be differences in the distribution of these
      transporters in tumors and normal tissues that might be exploited for
      chemotherapeutic purposes. The human tumor cell lines examined express
      predominantly the NBMPR-sensitive equilibrative transporter es which can be
      blocked by low concentrations of NBMPR and dipyridamole. It is reasonable to
      expect that tumors with transport properties similar to the CCRF-CEM and Rh28
      cell lines (Table 1) that have no detectable NBMPR-insensitive transport activity
      will be highly susceptible to the therapeutic approach of combining a transport
      inhibitor such as dipyridamole or NBMPR with an inhibitor of de novo pyrimidine
      biosynthesis. On the other hand, this approach to therapy is unlikely to succeed
      against tumors with transport phenotypes similar to the WI-L2 cell line that may
      permit the salvage nucleosides in the presence of these inhibitors. The majority
      of tumor cells examined, however, fall between these extremes, and it is not yet
      known what level of NBMPR-insensitive transport activity can be tolerated without
      seriously compromising this therapeutic approach. With respect to normal tissues,
      the mature absorptive cells of the intestine have predominantly Na(+)-dependent
      nucleoside transporters that are insensitive to NBMPR and dipyridamole. The
      proliferating crypt cells also appear to have Na(+)-dependent nucleoside
      transport, although they may also have an NBMPR-sensitive component of transport
      (Belt, unpublished data). Bone marrow granulocyte-macrophage progenitor cells
      also appear to have one or more concentrative nucleoside transporters. Thus these
      tissues, which are most vulnerable to the toxicity of antimetabolites, may be
      able to salvage nucleosides in the presence of inhibitors of equilibrative
      transport and be protected from the toxicity of de novo synthesis inhibitors. It
      is likely, however, that a successful application of this therapeutic approach
      will require the analysis of the nucleoside transport phenotype of individual
      tumors in order to identify those patients that may benefit from such therapy.
      Since the development of antibodies and cDNA probes for the various nucleoside
      transporters is currently underway in several laboratories, it is likely that
      analysis of the nucleoside transport phenotype of tumors from biopsy material
      will be feasible in the future.

PMID- 8356911
TI  - Molecular cloning of the branched-chain alpha-keto acid dehydrogenase kinase and
      the CoA-dependent methylmalonate semialdehyde dehydrogenase.
AB  - The complete amino acid sequence of rat liver CoA-dependent methylmalonate
      semialdehyde dehydrogenase, the enzyme responsible for the oxidative
      decarboxylation of malonate- and methylmalonate semialdehydes to acetyl- and
      propionyl-CoA in the distal portions of the valine and pyrimidine catabolic
      pathways, has been deduced from overlapping cDNAs obtained by screening a lambda
      gt11 library with nondegenerate oligonucleotide probes synthesized according to
      PCR-amplified portions coding for the N-terminal amino acid sequence of the
      enzyme. Although unique because of its requirement for coenzyme A, the
      methylmalonate semialdehyde dehydrogenase clearly belongs to the aldehyde
      dehydrogenase superfamily of enzymes. Quantitation of mRNA and protein levels
      indicates tissue-specific expression of methylmalonate semialdehyde
      dehydrogenase. A large increase in expression of methylmalonate semialdehyde
      dehydrogenase occurs during 3T3-L1 preadipocyte differentiation into adipocytes.
      The complete amino acid sequence of rat liver branched-chain alpha-ketoacid
      dehydrogenase kinase, the enzyme responsible for phosphorylation and inactivation
      of the branched-chain alpha-ketoacid dehydrogenase complex, was deduced from a
      cDNA cloned by a procedure similar to that described above for the methylmalonate
      semialdehyde dehydrogenase. Expression of the cDNA in E. coli yielded a protein
      that phosphorylated and inactivated the branched-chain alpha-ketoacid
      dehydrogenase complex. Very little sequence similarity between branched-chain
      alpha-ketoacid dehydrogenase kinase and other eukaryotic protein kinases could be
      identified. However, a high degree of similarity within subdomains characteristic
      of prokaryotic histidine protein kinases was apparent. Thus, this first
      mitochondrial protein kinase to be cloned appears closer, evolutionarily, to the
      prokaryotic histidine protein kinases than eukaryotic ser/thr protein kinases.

PMID- 8356912
TI  - Suppression of ras-mediated transformation. Differential expression of genes
      encoding extracellular matrix proteins in normal, transformed and revertant
      cells.
AB  - A subtraction hybridization technique was used to identify genes specifically
      expressed in phenotypic revertants derived from cells transformed by the H-ras
      oncogene. The expression of genes coding for components of the extracellular
      matrix appears to be frequently down-regulated in transformed cells. Partial
      restoration is associated with the reexpression of the normal phenotype in
      revertants.

PMID- 8356913
TI  - The electrophile counterattack response: protection against neoplasia and
      toxicity.
AB  - Exposure of rodents or their cells in culture to low doses of a wide variety of
      chemical agents, many of which are electrophiles, evokes a coordinated metabolic
      response that protects these systems against the toxicity (including mutagenicity
      and carcinogenicity) of higher doses of the same or other electrophiles. This
      response involves enhanced transcription of Phase 2 enzymes: glutathione
      transferases, NAD(P)H:quinone reductase, UDP-glucuronsyltransferases, and epoxide
      hydrolase, as well as the elevation of intracellular levels of reduced
      glutathione. We suggest that this cellular adaptation, which occurs in the liver
      and many peripheral tissues, be designated as the "Electrophile Counterattack"
      response. Seven families of highly diverse chemical agents that elicit this
      response include: oxidatively labile diphenols and quinones; Michael reaction
      acceptors (olefins conjugated to electron-withdrawing groups); isothiocyanates;
      organic hydroperoxides; vicinal dimercaptans; trivalent arsenicals; heavy metals
      (HgCl2, CdCl2) as well as mercury derivatives with high affinities for sulfhydryl
      groups; and 1,2-dithiole-3-thiones. An analysis of the molecular mechanisms of
      these enzyme inductions was carried out by transient expression in hepatoma cells
      of a plasmid containing a 41-bp enhancer element derived from the 5'-upstream
      region of the mouse glutathione transferase Ya gene, and the promoter region of
      this gene, linked to a human growth hormone reporter gene. The concentrations of
      28 inducers (belonging to the seven chemical classes) required to double growth
      hormone production in this system spanned a range of four orders of magnitude and
      were closely and linearly correlated with the concentrations of the same
      compounds required to double the specific activity of quinone reductase in murine
      hepatoma cells. We therefore conclude that the regulation of these Phase 2
      enzymes (and possibly also that of glutathione synthesis) by all of these
      inducers is mediated by the same enhancer element that contains AP-1-like sites.
      Similar enhancer sequences are present in the rat glutathione transferase Ya
      gene, and in the upstream regulatory regions of the quinone reductase genes of
      rat and human liver.

PMID- 8356914
TI  - Lithium increases accumulation of second messenger inositol 1,4,5-trisphosphate
      in brain cortex slices in species ranging from mouse to monkey.
AB  - Historical aspects of the phosphoinositide field are briefly reviewed. The
      effects of the anti-manic depressive drug, lithium, on inositol 1,4,5
      trisphosphate accumulation in brain cortex slices in species ranging from mouse
      to monkey are presented. In the guinea pig, lithium, in the presence of
      acetylcholine, increases the accumulation of inositol 1,4,5-trisphosphate and
      inositol 1,3,4,5-tetrakisphosphate, but at therapeutic concentrations of lithium
      1 mM inositol is required to see a statistically significant effect. In previous
      studies in rat brain cortex slices, lithium inhibited accumulation of inositol
      1,4,5-trisphosphate by 15-20%. We have confirmed this and found a similar effect
      in mouse brain cortex slices. However, if we added 20-30 mM inositol we observed
      lithium-stimulated accumulations of inositol 1,4,5-trisphosphate and inositol
      1,3,4,5-tetrakisphosphate in these two latter species. These observations in rat
      and mouse appear to relate to the following facts: (1) brain cortices of mouse
      and rat contain in vivo concentrations of inositol half that of guinea pig, (2)
      incubated rat brain cortex slices are depleted of inositol by 80% and (3) the
      slices require 10 mM inositol supplementation to restore in vivo concentrations.
      More recently, we have shown that in monkey brain cortex slices, therapeutic
      concentrations of Li+ increase accumulation of inositol 1,4,5-trisphosphate.
      Inositol 1,3,4,5-tetrakisphosphate is not increased. Neither inositol, nor an
      agonist, is required. The same effects are seen whether inositol 1,4,5
      trisphosphate is measured by the [3H]inositol-prelabelling technique or by mass
      assay, although mass includes a pool of inositol 1,4,5-trisphosphate which is
      metabolically inactive. Thus, in a therapeutically relevant model for man, Li+
      increases Ins(1,4,5)P3 in brain cortex slices, as was previously seen in lower
      mammals at nonrate-limiting concentrations of inositol.

PMID- 8356915
TI  - Studies on the mechanism of the cytotoxic action of the mitomycin antibiotics in
      hypoxic and oxygenated EMT6 cells.
AB  - The mitomycin antibiotics, because of their preferential toxicities for hypoxic
      cells, have significant potential as adjuncts to ionizing radiation in the
      treatment of solid tumors. To gain information on the mechanism by which these
      agents exert their cytotoxicities to hypoxic and aerobic cells, the effects of
      MC, POR and several of their analogs were studied in EMT6 mammary carcinoma
      cells. The rate of uptake of POR by these cells was directly correlated with the
      cytotoxicity produced by this agent under both hypoxia and aeration. At
      equivalent concentrations, uptake of POR into hypoxic cells was more rapid than
      into aerobic cells. Hypoxic cells also accumulated the antibiotic in
      concentrations well in excess of that present in the extracellular medium,
      presumably as a result of reductive activation and covalent binding of POR to
      cellular structures. Such activation and binding occur to a much lesser degree in
      aerated cells, resulting in the rapid efflux of POR from these cells when the
      antibiotic is removed from the extracellular environment. To gain information on
      the reaction of POR with DNA, mono- and bis-adducts formed in EMT6 cells exposed
      to this agent were measured. Three major adducts were formed. Two were mono
      adducts consisting of deoxyguanosine linked at its N2-position to the C-1 of POR
      and of 10-decarbamoyl POR. The third was a bis-adduct in which POR was cross
      linked to two deoxyguanosines at their N2-positions. More adducts were formed in
      hypoxia than in air, and more bis-adducts were present in hypoxic cells.
      Simultaneous exposure of cells to both POR and DIC reduced the total adduct level
      and a new unknown adduct was formed, primarily under hypoxia. Several mitomycins
      were evaluated for their capacity to kill EMT6 cells and to produce DNA cross
      links in both hypoxia and aeration. The number of cross-links required to produce
      a given amount of cell kill was similar, regardless of the mitomycin employed or
      the degree of oxygenation. The findings support the concept that DNA is a
      critical target in the action of the mitomycins and that cross-linking of the DNA
      creates an important lesion for cytodestruction.

PMID- 8356916
TI  - Regulation of deoxycytidine kinase activity and inhibition by DFDC.
AB  - (1) Deoxycytidine kinase activity increased in a transformation- and progression
      linked fashion in rat hepatomas of different proliferation rates. The activity
      also increased and was growth rate-linked in a series of tissue culture cell
      lines of human and animal tumors. (2) Deoxycytidine kinase activity was
      stringently linked with expression of the neoplastic proliferative program as it
      sharply increased in log phase in tissue culture cells of hepatoma 3924A and
      several human carcinoma strains. (3) Deoxycytidine kinase is subject to
      nutritional and hormonal regulation. On starvation the activity in liver
      decreased and on refeeding it returned to normal. Steroid hormone increased liver
      enzymic activity. Deoxycytidine kinase is substrate-inducible, since
      deoxycytidine injections in rat led to a 2- to 3-fold increase in hepatic enzyme
      activity. (4) Actinomycin or cycloheximide treatment blocked the increase in
      liver deoxycytidine kinase activity induced by steroid or deoxycytidine
      treatment. Therefore, it is assumed that the rise in deoxycytidine kinase
      activity requires new RNA and protein synthesis. (5) Cycloheximide treatment of
      rats carrying hepatomas yielded a t1/2 = 3.4 hr in the tumor for deoxycytidine
      kinase activity which was the shortest among the examined enzymes of purine and
      pyrimidine biosynthesis. (6) Actinomycin treatment of rats carrying hepatomas
      yielded a t1/2 of 5.8 hr for deoxycytidine kinase activity in the tumor which was
      one of the shortest in the examined enzymes of purine and pyrimidine
      biosynthesis. (7) Difluorodeoxycytidine (DFDC) is a competitive inhibitor (Ki = 7
      28 microM) of deoxycytidine kinase from rat hepatoma and from human pancreatic
      carcinoma and ovarian carcinoma cells in culture.

PMID- 8356917
TI  - Regulation of human deoxycytidine kinase expression.
AB  - The human deoxycytidine kinase gene is a single copy gene and is comprised of
      seven exons that are spread over more than 34 kb of the genome. The 5'-flanking
      region is highly G/C rich and does not contain CAAT or TATA boxes. This region,
      when cloned into a recorder gene construct containing the chloramphenicol
      acetyltransferase gene, is capable of mediating CAT activity in human lymphoid
      cell lines and appears to have greater activity in human T, as compared to B,
      lymphoblast cell lines. The expression of the gene at the mRNA level does not
      appear to be cell-cycle regulated in that the levels of mRNA in human peripheral
      blood T lymphocytes remain constant as the cells progress from a resting to a
      proliferating state. Since this enzyme catalyzes the conversion of a number of
      chemotherapeutic agents to their corresponding monophosphate form and is thus
      essential for their activation, it will be important to define further the
      genetic elements which regulate the expression of this gene.

PMID- 8356918
TI  - Oxidation resistant muteins of antileukoproteinase as potential therapeutic
      agents.
AB  - Native antileukoproteinase (ALP) and two oxidant resistant mutants ALP 242 and
      ALP 231 were synthesized by means of recombinant DNA technology. In the ALP 242
      molecule the methionine residue located in the reactive centre of the binding
      loop is replaced by a leucine residue. In ALP 231 all four methionine residues of
      the second domain were substituted by leucine residues. The native inhibitor and
      the two oxidant resistant molecules show comparable inhibitory capacities towards
      human neutrophil elastase (HLE) and cathepsin G. All three inhibitors were
      treated with different reactive oxygen species. After incubation with chloramine
      T or supernatants of activated polymorphonuclear leukocytes (PMN's) a drastic
      drop of inhibitory capacity of the native molecule was observed. Compared to the
      native form of ALP the mutant ALP 242 was less inactivated, whereas ALP 231 was
      nearly totally resistant towards all reactive oxygen. (Heinzel-Wieland R. et al.,
      Biomed Biochim Acta 50: 677-681 (1991)) The intratracheal administration of HLE
      into the lung of Syrian Hamsters induced mild to moderate emphysematous lesions.
      The inhibitory potencies of native ALP and the ALP mutants were determined in
      this animal model by means of intratracheal instillation of the different
      molecules one hour prior to the administration of HLE. The inhibitory effects of
      ALP 242 and ALP 231 towards HLE-induced emphysema were significantly better than
      that of the native molecule. Surprisingly no significant differences between the
      two mutants were observed. (Rudolphus A. et al., Clin Sci 81: 777-784 (1991)) In
      a second animal model the emphysema was induced by repeated intratracheal
      administration of lipopolysaccharides (LPS) into the hamster lungs. This model is
      characterized by a chronic process of inflammation probably caused by a
      continuous release of endogenous elastase from infiltrating PMN's. Repeated
      applications of 1 mg of ALP 242 reduced the LPS-induced emphysema by 70 to 80%.
      In contrast, equal amounts of the native molecule resulted in significantly lower
      inhibition of the LPS-induced emphysema, only 23-30% reduction was observed.
      Repeated applications of 1 mg of ALP 231 reduced the LPS-induced emphysema only
      about 50%. So far it is not yet clear, why the totally oxidant resistant ALP 231
      was less effective than the ALP 242 molecule. (Stolk J. et al., Pulmonary
      Pharmacology in press (1992))

PMID- 8356919
TI  - Factor XII activation and inhibition in inflammation.
AB  - Biochemical observations during clinical sepsis using functional and
      immunological measurements of enzymes, cofactors and inhibitors of the kallikrein
      kinin system indicate that activation of these proteases occur during hypotensive
      gram-negative septicemia and adult respiratory distress syndrome. Using animal
      models of septicemia, we demonstrated that protease inhibitors or neutralizing
      monoclonal antibodies to proteins of the contact system inhibit or prevent the
      formation of kallikrein and the decrease in kininogen. In addition, the
      irreversible phase of hypotension can be prevented and survival prolonged. Thus,
      bradykinin is one of the important mediators of hypotension. In contrast, the
      contact system plays little role in the associated DIC. In cardiopulmonary
      bypass, the formation of kallikrein leads to neutrophil degranulation and release
      of elastase. Selective inhibitors of kallikrein not only block its activation but
      play a predominant role in inhibiting elastase release.

PMID- 8356920
TI  - The kinin system in inflammation.
AB  - Bradykinin and related kinins are important mediators of most kinds of
      inflammation. Mechanisms of kinin production in injury, infection and immune
      system activation are discussed. Bradykinin antagonists show great promise for
      development of new drugs for inflammation.

PMID- 8356922
TI  - Kinin antagonists as human therapeutics.

PMID- 8356921
TI  - Role of bradykinin in microbial infection: enhancement of septicemia by microbial
      proteases and kinin.
AB  - Data presented herein will show that bradykinin, microbial proteases which
      activate the kinin generating cascade, and kininase inhibitors can enhance
      septicemia by approximately 10 to 100 fold in mice infected intraperitoneally
      (i.p.) with a strain of bacteria, Pseudomonas aeruginosa 621, which does not
      usually produce a kinin generating protease. Bacterial spreading was evaluated
      either in the blood or in the spleen by colony formation on agar plates. Using
      the P. aeruginosa kaguma strain which produces a large amount of proteases,
      further experiments were carried out. Results showed that two different protease
      inhibitors (ovomacroglobulin and a synthetic peptide inhibitor against
      pseudomonal elastase) as well as a kinin antagonist suppressed bacterial
      dissemination to 1/10-1/100 of control. Similar results were observed in
      experiments using Vibrio vulnificus. These data support the hypothesis that
      microbial proteases and especially bradykinin is responsible for facilitation of
      microbial dissemination in vivo.

PMID- 8356923
TI  - Cytokine regulation of endothelial cell extracellular proteolysis.
AB  - The vascular endothelium plays a central role in the regulation of extrinsic
      fibrinolysis and thus maintains vascular patency through clot dissolution.
      Plasminogen activation provides an important source of localized proteolytic
      activity not only during fibrinolysis but also during a variety of other
      physiological and pathological processes. Numerous studies have indicated that
      human endothelial cells can directly synthesize and secrete plasminogen
      activators (PA) and inhibitors of these activators. PAs specifically hydrolyse a
      single arginine-valine bond in plasminogen, an abundant and widely distributed
      plasma zymogen, to form the broad spectrum serine protease, plasmin. Tissue type
      PA (t-PA) and urokinase type PA (u-PA) forms of PA have been described in
      endothelial cells, although t-PA production and secretion is elevated most
      frequently. The tPA form of PA functions predominantly in endothelial cell
      mediated fibrinolysis, while uPA is involved in tissue remodeling. During
      inflammatory reactions activated mononuclear phagocytes produce a variety of
      cytokines which may influence the phenotype of the endothelium through a process
      termed "endothelial cell activation". Tumor necrosis factor alpha (TNF alpha), a
      mononuclear cytokine, is a distinct polypeptide of Mr 17,000 and has been
      implicated as a mediator of gram negative induced sepsis as well as angiogenesis.
      TNF alpha is known to interact with specific endothelial cell receptors and to
      alter endothelial coagulant and anticoagulant properties implying that cytokines
      may be potent modulators of hemostasis. Recent observations have indicated that
      TNF alpha and lymphotoxin (TNF beta) can promote the expression, synthesis and
      secretion of urokinase plasminogen activator (uPA) in human endothelial cells.
      The upregulation of uPA results in an alteration in the fibrinolytic capacity of
      endothelial cells and allows cells the selective ability to degrade and invade
      underlying subendothelial extracellular matrix (ECM). Endothelial cells treated
      with TNF alpha also display, in an in vitro angiogenic assay, the ability to
      invade Matrigel and reorganize into tube-like structures, unlike control
      cultures. The effects of TNF alpha on the PA proteolytic system of endothelial
      cells, the biological significance of this event and potential in vivo
      consequences will be discussed. In addition, the influence of cytokine regulatory
      control systems will be described, since it is becoming increasingly clear that
      cytokines do not act in isolation. The vascular endothelium serves as a widely
      distributed anatomical interface between the blood and tissue with diverse
      capabilities, performing distinctive biologic functions at different sites and
      within specific organs.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8356924
TI  - Biochemical mechanisms for disrupting the proteinase-proteinase inhibitor balance
      in tissues.
AB  - The regulation of proteolytic activity in tissues by members of the Serpin family
      of inhibitors is normally tightly controlled. However, numerous mechanisms are
      available for interrupting this process in pathological tissues by depleting
      functional inhibitory activity at inflammatory foci. These include a) saturation
      of inhibitory activity due to excessive proteinase release from inflammatory
      cells, b) oxidative inactivation of inhibitory activity, c) proteolytic
      inactivation of inhibitory activity by non-complexing proteinases. In an attempt
      to regain a normal inhibitor-proteinase balance, however, it is now known that
      both inhibitor: enzyme complexes and inactive forms of inhibitors can act as
      signalling agents for the resynthesis of functionally active proteins. Thus,
      during inflammatory episodes where the levels of functional inhibitors are
      continually being depleted, mechanisms are in place to signal either directly or
      indirectly for their resynthesis.

PMID- 8356925
TI  - Different functional share of individual lysosomal cathepsins in normal and
      pathological conditions.

PMID- 8356926
TI  - Neuropeptide processing in pathophysiology.
AB  - Neuropeptides (peptides synthesized and secreted by neurons) perform many
      functions in the central nervous system as neurotransmitters, neuromodulators and
      neurotrophic factors. Neuropeptides are important regulators of amine
      neurotransmitter release, and can be identified as playing important roles in
      several pathological states. Neuropeptides are synthesized as protein precursors
      that are processed enzymatically to yield the biologically active peptides. Many
      neuropeptides having defined roles are further processed enzymatically to yield
      fragments having totally different actions. Examples discussed are substance P,
      adrenocorticotrophic hormone, endorphins and vasopressin.

PMID- 8356927
TI  - Endotoxin and eicosanoids.

PMID- 8356928
TI  - Oxidants, metalloproteases and serine proteases in inflammation.

PMID- 8356929
TI  - Proteases--structures, mechanism and inhibitors.
AB  - Proteases have been divided into four mechanistic classes: serine proteases,
      metalloproteases, aspartic proteases, and cysteine proteases. Once a new enzyme
      is classified by the use of general inhibitors, it is possible to design reactive
      inhibitors by using mechanistic information learned through study of other
      members of the same protease family. The most useful types of inhibitors for
      serine proteases are transition-state inhibitors including alpha-ketoesters and
      phosphonates, and mechanism-based inhibitors such as heterocyclic isocoumarin
      inhibitors. Some of these inhibitors are quite specific toward individual target
      serine proteases. Many proteases are involved in various disease states, and
      potent inhibitors of these enzymes have the potential to be developed as new
      therapeutic agents. In the future, it is likely than numberous specific protease
      inhibitors will be tested clinically for the treatment of human disease.

PMID- 8356930
TI  - Elastase and oxygen radicals: synergistic interactions.

PMID- 8356931
TI  - Proteolysis-induced pathomechanisms in acute inflammation and related therapeutic
      approaches.

PMID- 8356932
TI  - Synthesis and characterization of human neutrophil elastase inhibitors derived
      from aromatic esters of phenylalkanoic acids.

PMID- 8356933
TI  - In vivo evaluation of MDL 201,404YA, a novel inhibitor of human neutrophil
      elastase.
AB  - MDL 201,404YA (alternatively, CE-1037), a potent selective inhibitor of human
      neutrophil elastase (HNE), was tested both intratracheally and intravenously for
      its activity at inhibiting HNE. MDL 201,404YA given either i.t. or i.v. was
      effective in preventing the pulmonary hemorrhage which occurred after
      intratracheal instillation of HNE. Additional studies with MDL 201,404YA
      suggested that this compound remained active in the lung environment for at least
      6 hours. Further evaluation of MDL 201,404YA suggested that it could inhibit the
      ongoing proteolysis caused by HNE when given 15 minutes after the initial HNE
      challenge. These data suggest that MDL 201,404YA may be effective therapeutically
      in treating conditions which result from an imbalance between elastase and its
      endogenous inhibitor alpha-1-proteinase inhibitor (alpha 1-PI).

PMID- 8356934
TI  - Alpha 1-antitrypsin augmentation therapy.
AB  - Alpha 1-proteinase inhibitor (also known as alpha 1-antitrypsin) derived from
      pooled human serum (Prolastin, Miles Biologicals) has been available in the
      United States since 1988. Although no formal controlled prospective study has
      been performed to prove its efficacy, intravenous administration of Prolastin has
      been the accepted treatment for individuals with pulmonary emphysema due to alpha
      1-antitrypsin deficiency. In addition, Prolastin has been used experimentally by
      inhalation for the treatment of cystic fibrosis. It has been administered with
      some success to treat the panniculitis associated with alpha 1-antitrypsin
      deficiency. As a greater number of severely impaired alpha 1-antitrypsin
      deficient patients receive lung transplantation, the role of Prolastin in the
      post-transplant therapy of these patients will need evaluation. Newer
      antiproteases may render Prolastin obsolete with respect to its route of
      administration and its pricing, however, the safety record of this drug has been
      impressive.

PMID- 8356935
TI  - Covalent-binding native blot in the determination of specific IgE to latex gloves
      allergens. Comparison with other methods.
AB  - Six sera from patients with clinical symptoms of latex hypersensitivity and latex
      RAST values ranging from class 1 to 4 were used to characterize latex-glove
      allergens by immunoblotting. Twelve % acrylamide-SDS-PAGE of the latex glove
      crude extract revealed a single band with an estimated mol wt lower than 14,000
      D. The proteins bound to nitrocellulose after electrical transfer as shown by
      Ponceau red staining of the membrane. However, standard immunoblotting methods
      using alkaline-phosphatase anti-IgE did not detect the presence of specific IgE.
      Different variants of SDS-PAGE immunoblotting were also unsuccessful. On the
      other hand, the use of IEF and capillary transfer (native blot) to a covalent
      binding hydrophilic membrane was found to be the method of choice for the study
      of this allergen. The authors believe that this procedure can be helpful in the
      study of other antigen-antibody systems, particularly when standard
      immunoblotting assays fail.

PMID- 8356936
TI  - Deflazacort in the treatment of uveitis: a comparative study versus prednisone.
AB  - Since corticosteroids represent a fundamental tool in the treatment of uveitis,
      we evaluate the clinical efficacy and possible appearance of side effects of
      deflazacort, a new corticosteroid of third generation, versus prednisone at
      equiactive dosages. Sixty six patients suffering from recurring acute anterior
      uveitis (RAAU) and/or chronic anterior uveitis (CAU) were treated with
      deflazacort or alternatively prednisone in an "open" study. Clinical efficacy,
      ophthalmological parameters and haemato-bioassays were evaluated on admission and
      during the treatment period. All patients showed a complete remission of clinical
      signs and symptoms with both treatment and no statistically significant
      difference was evidenced between the studied groups. Concerning the possible
      appearance of side effects, the comparison between deflazacort and prednisone a
      statistically significant difference. These preliminary results are strongly
      encouraging and suggest further controlled studies on the employment of
      deflazacort in the treatment of uveitis.

PMID- 8356937
TI  - Nutrition and immunity: where are we standing?

PMID- 8356938
TI  - Relationship of blood EG2+ eosinophils in patients with bronchial asthma.
AB  - The presence of eosinophils in peripheral blood has been previously associated
      with different degrees of activity in the evolution of disease in asthmatics. The
      eosinophil cationic protein is a mediator released by the eosinophils when they
      are activated due to various stimuli. The monoclonal antibody EG2 binds to human
      ECP, the epitopes which EG2 recognizes is only present in the secreted form of
      ECP, hence it only stains eosinophils which are undergoing activation and/or
      secretion. Flow cytometry was used to measure the level of eosinophils stained by
      the monoclonal antibody EG2 (eosinophil EG2+) in the peripheral blood of subjects
      with unstable extrinsic bronchial asthma, stable extrinsic bronchial asthma and
      healthy control group. A statistically significant higher level of eosinophil
      EG2+ was found in the group with unstable asthma than in either the group with
      stable asthma or the group of healthy subjects (p < 0.0002). No difference was
      found between the patients with stable asthma and the control group. The level of
      eosinophil EG2+ in peripheral blood, measured by flow cytometry, could be used as
      an indicator of inflammatory activity in patients suffering from bronchial
      asthma.

PMID- 8356939
TI  - Hyperaggregation of platelets detected by whole blood platelet aggregometry in
      newly diagnosed noninsulin-dependent diabetes mellitus.
AB  - Twenty-five newly diagnosed cases of noninsulin-dependent diabetes mellitus were
      studied at the time of diagnosis and again after metabolic control of diabetes
      was achieved (approximately 3 months later) for platelet aggregation
      abnormalities in whole blood by the impedance method. Adenosine diphosphate in 10
      and 20 mumol/L final concentrations and arachidonic acid in 25 and 50 mmol/L
      final concentrations were used as agonists. Patients had a significant
      hyperaggregation of platelets (P < 0.01) at the time of diagnosis compared with
      age-matched healthy control subjects. After metabolic control of blood glucose
      was achieved using oral hypoglycemic agents (n = 20) and diet regulation alone (n
      = 5), there was a significant decrease in platelet aggregation (P < 0.01). There
      was a positive relationship between blood glucose levels and whole blood platelet
      aggregation with adenosine diphosphate (P < 0.02 and < 0.05, with 10 mumol/L and
      20 mumol/L, respectively), but there was no relationship between aggregation and
      glycosylated hemoglobin levels. Thus, platelet hyperaggregation was present even
      at the time of diagnosis in patients with diabetes mellitus in the absence of any
      vascular complications, and there was significant improvement in platelet
      hyperaggregation after metabolic control of blood glucose levels was achieved.

PMID- 8356940
TI  - Artifactual prolongation of the activated partial thromboplastin time mimicking a
      coagulopathy. A lesson relearned.
AB  - A markedly prolonged activated partial thromboplastin time (APTT) was observed in
      a 61-year-old woman with bruising and a decreasing hematocrit. Coagulation
      laboratory evaluation was sought to determine the cause of the prolonged APTT and
      bleeding. Evaluation demonstrated that, rather than identifying a coagulopathy,
      the APTT prolongation was most likely artifactual. The APTT was actually very
      short. With a combination of a relatively strong activating APTT reagent (Dade
      Actin; Dade, Miami, FL) and a fixed lag phase in the automated coagulation
      instrument (16 seconds), the clot formed before the instrument began to read.
      Thus, during the period of observation (120 seconds), no change in optical
      density was observed. This was interpreted by the laboratory as "> 120 seconds."
      This case reminds those involved in the performance and interpretation of APTTs
      of the importance of a manual or visual method of verifying markedly prolonged
      APTTs.

PMID- 8356941
TI  - Reference ranges for lymphocyte subsets in pediatric patients.
AB  - Peripheral blood lymphocyte subset reference ranges were examined in a large
      group (N = 130) of healthy pediatric patients ranging in age from 1 month to 17
      years. All samples were stained with monoclonal antibodies, processed with a
      whole blood lysis technique, and analyzed on a flow cytometer. Data analysis
      demonstrated statistically significant changes in most lymphocyte subsets at age
      3 years. The relative and absolute numbers of total lymphocytes, CD2, CD4, and
      CD19 cells; absolute numbers of CD3 and CD8 cells; and CD4/CD8 ratios were high
      at birth, decreased during early childhood, and closely approximated adult
      reference values after age 3 years. The relative numbers of CD8 lymphocytes were
      low in early childhood and then rose to adult values after 3 years of age. The
      relative percentage of CD3 cells remained stable over all ages studied. Although
      "adult" lymphocyte subset reference ranges may be similar to those in children
      older than 3 years, age-adjusted reference ranges should be used for the early
      childhood period.

PMID- 8356942
TI  - Higher white blood cell counts and band forms in newborns delivered vaginally
      compared with those delivered by cesarean section.
AB  - The authors retrospectively reviewed complete blood counts in the medical records
      of all babies admitted to a normal newborn nursery from January through December
      1989. The subjects consisted of 326 babies who were delivered vaginally (VgD) and
      138 who were delivered by Cesarean section (CS). All blood samples were drawn by
      warmed or unwarmed heel sticks or by venipuncture. The subject's age at the time
      of blood drawing was similar in both VgD and CS groups (13.4 vs. 13.9 hours, P =
      0.51). The number of total leukocytes, neutrophils, band forms, and platelets was
      significantly higher in VgD newborns than in CS newborns. The mean and standard
      error of the mean for each of these blood counts (each per microliter) were 23.9
      x 10(9) +/- 0.33 versus 21.1 x 10(9) +/- 0.6, 14.6 x 10(9) +/- 0.26 versus 12.8 x
      10(9) +/- 0.39, 1.18 x 10(9) +/- 0.08 versus 0.82 x 10(9) +/- 0.08, and 304 x
      10(9) +/- 4.1 versus 286 x 10(9) +/- 0.6, respectively (P values for the first
      three comparisons were all less than 0.005). However, there was no difference
      between the two groups with regard to hemoglobin, hematocrit, and absolute number
      of lymphocytes, eosinophils, basophils, and monocytes (P > 0.5). It was
      speculated that the higher leukocyte, neutrophil, and band counts in VgD babies
      are the consequences of physical stress and periodic hypoxia, which are more
      frequent and prolonged with VgD compared with CS delivery. The authors suggest
      that the mode of delivery should be considered when interpreting blood counts in
      neonates.

PMID- 8356943
TI  - Diagnosis of hereditary spherocytosis with dual-angle differential light
      scattering.
AB  - Efficacy in the diagnosis of hereditary spherocytosis (HS) using a system of dual
      angle differential light scattering of a monochromatic laser beam on sphere
      shaped and fixed erythrocytes was evaluated. Fifty-one nonsplenectomized patients
      with HS, 6 with autoimmune hemolytic anemia, and 140 control subjects were
      studied. The percentage of erythrocytes with hemoglobin concentration more than
      410 g/L (hyperhemoglobin) was significantly different in patients with HS and
      control subjects (P < 0.001). Hyperhemoglobin could be detected even in the
      mildest HS, in all patients with autoimmune hemolytic anemia, and in some control
      subjects, although none of the latter had more than 3%. This technique is
      extremely sensitive to the presence of spherocytes and the absence of
      erythrocytes with more than 410 g/L hemoglobin excludes HS. The presence of
      hyperhemoglobin is not specific for HS and increased amounts of hyperhemoglobin
      were found in patients with autoimmune hemolytic anemia and control subjects. To
      make a confident diagnosis of HS, the detection of hyperhemoglobin must be
      evaluated in the same clinical setting and with the same criteria as those
      applied to the osmotic fragility test.

PMID- 8356944
TI  - An evaluation of hemoglobin determination using sodium lauryl sulfate.
AB  - The standard reference method for hemoglobin determination for years has been the
      photometric quantitation of cyanmethemoglobin. Other existing methods have not
      gained popularity in North America. In an attempt to eliminate hazardous cyanide
      waste, a method to determine the hemoglobin concentration in whole blood using
      sodium lauryl sulfate has been devised and recently was released as a commercial
      reagent. The authors compare this new method with the cyanmethemoglobin method
      using two hematology analyzers. Their results show that there is excellent
      correlation between the two methods (r2 = 0.996). In addition, other elements of
      the complete blood count also show good correlation. Thus, it was confirmed that
      the sodium lauryl sulfate method of estimating hemoglobin concentration is an
      appropriate alternative to the cyanmethemoglobin method and avoids the generation
      of toxic wastes.

PMID- 8356945
TI  - Comparison of the HemoCue beta-glucose photometer and reflotron for open heart
      surgery.
AB  - The HemoCue beta-glucose photometer (Angelholm, Sweden) was evaluated for use in
      monitoring blood glucose in both diabetic and nondiabetic patients undergoing
      open heart surgery. Because occasional discrepancies were noted in patients with
      low total proteins when the Reflotron (Boehringer Mannheim, Indianapolis, IN) was
      used for this purpose, the effects of protein and hematocrit on glucose results
      from both instruments were investigated and compared with plasma values from a
      Paramax 720 ZX (Baxter Healthcare, Irvine, CA). Linear-regression analysis of the
      HemoCue results (y) versus Paramax (x) yielded y = 0.956x + 0.35, r2 = 0.980,
      with Sy/x = 0.57 mmol/L (10.3 mg/dL). Results from the Reflotron (y) versus
      Paramax (x) yielded y = 1.075x - 0.10, r2 = 0.964, with Sy/x = 0.99 mmol/L (17.8
      mg/dL). Bias plots of (HemoCue-Paramax) or (Reflotron-Paramax) versus glucose,
      hematocrit, or protein showed no effect of glucose on the results from either
      instrument and no effect of protein or hematocrit on the HemoCue findings. The
      Reflotron, however, showed a positive bias of up to 3.5 mmol/L (63 mg/dL) at
      protein concentrations between 30-40 g/L (3.0-4.0 g/dL) and a possible positive
      bias at low hematocrit levels.

PMID- 8356946
TI  - Tumoral presentation of amyloidosis (amyloidomas) in soft tissues. A report of 14
      cases.
AB  - Amyloidosis in its diverse types (immunocytic dyscrasia-associated, reactive, or
      heredofamilial) most often presents in a systemic form. Localized amyloidosis is
      uncommon in general and is exceedingly rare in the soft tissues. The authors
      discuss the cases of 14 patients in whom amyloidosis manifested as a localized
      mass ("amyloidoma") in the soft tissues (mostly mediastinal and retroperitoneal),
      leading to a clinical diagnosis of neoplasm in most cases. On the basis of the
      associated morphologically atypical and phenotypically monoclonal cell
      population, the resistance to potassium permanganate pretreatment, and the lack
      of reactivity with anti-AA antisera, 10 cases could be classified as immunocytic
      dyscrasia-associated AL-amyloidosis. However, four cases had histopathologic and
      histo- and immunohistochemical characteristics of reactive ("secondary") AA
      amyloidosis. This proportion (28.5%) was higher than that suggested by the
      sporadic AA-amyloidomas reported in the literature. The pathologic distinction
      between these two categories is important because patients with AA-amyloidomas of
      the soft tissues appear to have a better prognosis.

PMID- 8356948
TI  - Bednar tumor pattern in recurring giant cell fibroblastoma.
AB  - Giant cell fibroblastoma (GCF) and Bednar tumor (BT) have been perceived as two
      rare, not directly related, soft tissue neoplasms. Recent studies, separately
      conducted on each process, have presented evidence indicating that, in each
      instance, the tumor seemed to be related to the dermatofibrosarcoma protuberans.
      The case being reported provides additional evidence supporting those previous
      results and, for the first time, documents a direct link between GCF and BT, as
      seen in this girl who had a vulvar GCF resected at 1-year of age, with
      recurrence, 1.5 years later, as a mixed BT-GCF.

PMID- 8356947
TI  - Myocarditis associated with doxorubicin cardiotoxicity.
AB  - In contrast to previous reports, the authors were impressed by the frequency of
      myocarditis in the endomyocardial biopsy specimens of patients treated with
      anthracyclines. To examine this, they reviewed the histologic and electron
      microscopic results and immunoperoxidase stains of myocardial biopsy specimens
      from 11 patients with doxorubicin cardiotoxicity grades 1.0-3.0. Immunoperoxidase
      stains for lymphocytes, macrophages, and endothelial cells and induced expression
      of Class II antigen were performed using the avidin-biotin complex procedure. A
      full panel of monoclonal antibodies was employed on fresh-frozen tissue; a
      smaller panel was used with formaldehyde-fixed paraffin-embedded material. Four
      of the 11 endomyocardial biopsy specimens showed myocarditis, and 2 showed
      borderline myocarditis by the Dallas criteria. The infiltrating lymphocytes were
      generally characterized as T lymphocytes and were associated with induced Class
      II antigen expression by arterial endothelial cells. In addition, foci of
      replacement fibrosis, suggesting a chronic process, were identified. Although
      this association does not prove a causal relationship, these results suggest that
      myocarditis can be a component of doxorubicin-induced myocardial injury.

PMID- 8356949
TI  - Benign glandular schwannoma.
AB  - A rare example of a benign glandular schwannoma is reported. Further attention is
      drawn to this unusual subtype of schwannoma and the clinical parameters of the
      reported cases are compared with those of other types of schwannomas. The tumors
      tend to be small and superficial, and by contrast with malignant glandular
      schwannomas, the benign variant does not appear to be associated with von
      Recklinghausen neurofibromatosis.

PMID- 8356950
TI  - Cytologic diagnosis of metastatic epithelioid sarcoma. A cytologic mimic of
      squamous cell carcinoma.
AB  - A case of epithelioid sarcoma in a 39-year-old woman who had metastatic lesions
      in her lung from a primary arm tumor is presented. A review of the literature and
      analysis of this case did not identify any specific light microscopic or
      immunohistochemical way to separate definitively the lung cytologic smear in this
      case from squamous cell carcinoma. The authors believe cytologic smears from
      epithelioid sarcoma can closely mimic smears from squamous cell carcinoma.
      Pathologists should be alert to these similarities.

PMID- 8356951
TI  - The defective nature of hepatitis delta virus.

PMID- 8356952
TI  - Turnaround time, point-of-care testing, and a future role for the clinical
      pathologist.

PMID- 8356953
TI  - Tumoral amyloidosis of soft tissue (amyloidoma). New approaches to an old
      problem.

PMID- 8356954
TI  - Immediate management of mammographically detected breast lesions.

PMID- 8356955
TI  - Paradoxic effect of multiple mild coagulation factor deficiencies on the
      prothrombin time and activated partial thromboplastin time.
AB  - Single coagulation factor deficiencies predictably prolong the prothrombin time
      (PT) and activated partial thromboplastin time (APTT) at levels below 35% of
      normal activity. Acquired coagulopathies generally are characterized by multiple
      coagulation factor deficiencies. The effect was studied of such combined
      deficiencies on the PT/APTT using plasma from patients congenitally deficient in
      specific factors and pooled normal plasma. The PT begins to lengthen when
      individual factor levels fall below 25%. The APTT becomes prolonged when the
      levels of Factor V fall below 45%; the levels of Factors II and XI fall below
      40%; and the levels of Factors I, V, VII, VIII, IX, and XII fall below 25% of
      normal. When plasma samples containing 50% activity of a single factor and 100%
      of all other factors were prepared by mixing the congenitally deficient plasma
      samples with the normal pool, the resulting mixtures had normal PT and APTT
      values. However, when two of these 50% factor-deficient plasmas were combined so
      that the mixture contained 75% activity of two coagulation factors and 100% of
      all other factors, the resulting PT and APTT were prolonged over the clotting
      times of either 50% factor-deficient plasma. Similar findings were obtained in
      patients with mild factor reductions caused by warfarin treatment. These data
      indicate that prolongations of the PT and APTT in disorders of coagulation
      affecting multiple factors represent less of a reduction in factor levels than is
      generally appreciated. This may explain the poor clinical correlation between
      abnormalities in these test results and clinical bleeding in acquired disorders
      of hemostasis.

PMID- 8356956
TI  - Behavior of diluted activated partial thromboplastin time in pregnant women with
      a lupus anticoagulant.
AB  - The present study was developed to verify whether a reduction in phospholipid
      concentration could increase the activated partial thromboplastin time (APTT)
      sensitivity to detect lupus anticoagulant (LA) during pregnancy. The authors
      studied 38 pregnant women (10 normal subjects and 28 patients with associated
      clinical complications) and 40 nonpregnant control subjects. Tests to detect LA,
      including APTT, platelet neutralization procedure (standard APTT), the kaolin
      clotting time, the diluted Russell viper venom test neutralized by lysed
      platelets, and factor assays, were performed. Positive results were found in 5 of
      28 pregnant women with associated clinical complications. The APTT, using three
      different phospholipid concentrations (standard and more diluted cephalin), was
      performed on plasma samples and on its 1:1 mixture with normal plasma. The
      behavior of standard and diluted APTT was similar in negative LA pregnant women
      and nonpregnant control subjects. The mean values showed nonsignificant
      differences. Four of five pregnant women with positive LA findings had a
      prolonged APTT, which was not corrected by the addition of normal plasma using
      standard conditions. When diluted phospholipids were used, only one of them had a
      prolonged APTT that was corrected by the addition of normal plasma. Therefore,
      the highest sensitivity (80%) and specificity (100%) of the APTT to detect LA in
      pregnant women were obtained using the standard conditions.

PMID- 8356957
TI  - Selective screening for Chlamydia trachomatis infection in a primary care
      population of women.
AB  - The authors used cell cultures to assess the prevalence of cervical infection
      caused by Chlamydia trachomatis in a population-based sample of nonpregnant women
      aged 15 to 34 years who attended two primary care clinics at Group Health
      Cooperative of Puget Sound, Seattle, Washington, between January 1, 1988, and
      June 30, 1989. C. trachomatis was isolated from 67 of 1,804 women (3.7%),
      including 13% of those who were less than 20 years of age. Seven patient
      characteristics were independently predictive of chlamydial infection by stepwise
      multivariate logistic regression analysis: being unmarried, examination showing
      cervical ectopy, black race, douching, nulliparity, age of 24 years or less, and
      intercourse with two or more partners within the preceding year. Testing all
      women who had a score of 5 or more (28% of women) on a weighted index based on
      risk factors would detect 77% of all infections with a positive predictive value
      of 9%. These results suggest that it should be feasible to develop a risk factor
      based program to screen for cervical infection with C. trachomatis in populations
      where its prevalence is low.

PMID- 8356958
TI  - Tryptophan contaminants associated with eosinophilia-myalgia syndrome. The
      Eosinophilia-Myalgia Studies of Oregon, New York and New Mexico.
AB  - Eosinophilia-myalgia syndrome (EMS) has been linked to ingestion of tryptophan
      contaminated with 1,1'-ethylidene-bis[L-tryptophan] (EBT), but other contaminants
      have received little study. The authors identified 101 lots of L-tryptophan that
      had been consumed either by persons with EMS or by asymptomatic tryptophan users
      and quantified the amounts of EBT and five other contaminants in each lot. After
      stratification of case and noncase lots by time of manufacture to adjust for the
      strong sequential pattern over time among case and noncase lots, higher EBT
      levels were still associated with a lot's case status, but the association lacked
      statistical significance (p = 0.120, odds ratio = 1.56, 95% confidence interval
      0.758-3.23). While these findings do not rule out the possibility that EBT is the
      etiologic agent in EMS, they raise the possibility that other chemical
      contaminants in manufactured tryptophan modify the effects of EBT or that the
      causal agent of EMS is an entirely distinct compound.

PMID- 8356959
TI  - Relation between body size and bone mineral density in elderly men and women.
AB  - This cross-sectional study of the Rancho Bernardo, California, cohort examines
      the relation between bone mineral density and eight measures of body size (total
      weight, body mass index, waist-hip ratio, lean mass, fat mass, percentage fat
      mass, and current and maximum adult height) measured between 1988 and 1991 in
      1,492 ambulatory white adults aged 55-84 years. Lean mass, fat mass, and
      percentage fat mass were measured by bioelectric impedance. Bone mineral density
      was measured at the hip and lumbar spine with dual-energy x-ray absorptiometry
      and at the midshaft and ultradistal radius with single photon absorptiometry. In
      multiple linear regression models adjusted for age, smoking, exercise, alcohol,
      thiazide use, and estrogen use (in women), total weight was the most consistent
      marker of bone mineral density overall. In this cohort, all measures of body size
      were associated with bone mineral density in both sexes and were better markers
      of bone mineral density in the weight-bearing sites than in the non-weight
      bearing sites, implying a mechanical effect of weight on bone mineral density.

PMID- 8356960
TI  - Estimating the population prevalence of injection drug use and infection with
      human immunodeficiency virus among injection drug users in Glasgow, Scotland.
AB  - Although data on the prevalence of injection drug use are an essential
      prerequisite for estimating the number of individuals infected with the human
      immunodeficiency virus (HIV), there have been few attempts to utilize statistical
      methods of population estimation based on multiple data sources. Data on 3,670
      cases (2,866 individuals) were obtained from the HIV test register, drug
      treatment agencies, police records, and needle and syringe exchanges in Glasgow,
      Scotland, in 1990. Log-linear analysis was used to model the number of
      individuals in each of the sources. The model incorporating dependency among the
      three health care agencies (HIV test, drug treatment, and needle exchange) and
      independence of the police sample fitted the data well, with a residual chi 2
      value of 2.9 (6 df). The expected value of the missing cell corresponding to
      absence from all four samples was 5,628, yielding an overall estimate of 8,494
      injectors (95% confidence interval (CI) 7,491-9,721), for a prevalence rate of
      1.35% for people aged 15-55 years in Glasgow during 1990. The high ratio of known
      to unknown injectors (1:2) resulted from the extensive coverage of known
      injectors and the relatively high level of overlap between the combined health
      care agency sample and the police sample. While further analysis demonstrated
      that the probability of appearing in the four samples varied by age and sex,
      heterogeneity in the population did not affect the choice of model or
      substantially alter the estimates for the total number of unknown injectors. A
      concurrent study of a community-wide sample of 503 injectors resulted in an HIV
      prevalence rate of 1.1% (95% CI 0.4-2.5%). The results of these studies were
      combined to produce a further estimate of 93 HIV-infected current injectors in
      Glasgow (95% CI 33-214).

PMID- 8356961
TI  - Efficacy of measles vaccines after controlling for exposure.
AB  - The clinical efficacy of measles vaccines was investigated in Niakhar, a rural
      area of Senegal under demographic surveillance in 1987-1990. Three measles
      vaccines were tested: a standard Schwarz, a high-titer Edmonston-Zagreb, and a
      high-titer Schwarz. The two high-titer vaccines were administered at 5 months of
      age and the standard Schwarz vaccine at 10 months. In addition to a formal
      randomized vaccine trial, data from national campaigns using the standard Schwarz
      vaccine were also analyzed. Clinical efficacy was estimated after controlling for
      exposure. In the randomized trial, the estimate of the efficacy of the standard
      Schwarz vaccine was 97.2% (95% confidence interval (CI) 91.3-98.1). In the 1986
      1987 national campaign, the efficacy of the standard Schwarz vaccine was lower:
      92.5% (95% CI 88.8-94.6). In the randomized trial, the efficacy of the high-titer
      vaccines was lower than that of the standard vaccine. High-titer vaccines were
      not used in national campaigns. Other factors associated with vaccine efficacy
      were age at exposure, intensity of exposure, and age at vaccination. Controlling
      for the intensity of exposure did not change the relative ranking of the efficacy
      of the three vaccination strategies. The theoretical efficacy of the standard
      measles vaccine for a single unit of exposure was estimated at 98.0%.

PMID- 8356962
TI  - Associations between changes in physical activity and risk factors for coronary
      heart disease in a community-based sample of men and women: the Stanford Five
      City Project.
AB  - Aerobic exercise training studies involving volunteers generally result in an
      improved cardiovascular risk factor profile. Little is known, however, about
      associations between physical activity change and risk factor change in a more
      representative sample, such as a community. This investigation evaluated
      correlations between a composite physical activity change score and change in
      cardiovascular risk factors from 1979 to 1985 in the cohort sample of the
      Stanford Five-City Project. Men (n = 380) and women (n = 427) between the ages of
      18 and 74 years were evaluated for change in self-reported physical activity and
      change in total cholesterol, high density lipoprotein cholesterol (HDL
      cholesterol), systolic blood pressure, resting pulse rate, and body mass index
      (weight (kg)/height (m)2). For men, improvement in the composite physical
      activity score significantly correlated with an increase in HDL cholesterol (r =
      0.14, p = 0.005) and decreases in body mass index (r = -0.16, p = 0.001) and
      estimated 10-year coronary heart disease risk score (r = -0.10, p = 0.056). For
      women, improvement in the physical activity score was associated with changes in
      HDL cholesterol (r = 0.11, p = 0.028) and resting pulse rate (r = -0.15, p =
      0.001). These data demonstrate that an increase in physical activity over 5 years
      is favorably associated with changes in major cardiovascular disease risk factors
      in men and women and support the public health efficacy of community-wide
      promotion of physical activity.

PMID- 8356963
TI  - Dietary fat and sports activity as determinants for age at menarche.
AB  - A prospective study (1985-1991) was conducted to evaluate the role of nutrition,
      physical activity, and other life-style factors for the age at menarche, a known
      breast cancer risk factor. In 1988-1989, a total of 261 girls, aged 8-15 years,
      from a nationwide representative nutrition and activity survey (1985-1988)
      responded additionally to a mailed questionnaire on personal maturation and
      anthropometric data, physical activity, and information about nutritional habits,
      measured by a short food-frequency questionnaire. All girls without menarche at
      the time of questionnaire mailing were observed for 2 years or until the event of
      menarche. At the end of the follow-up period, 79% of the girls had experienced
      menarche. The survey and questionnaire data were analyzed for their relation to
      age at menarche using Cox's proportional hazards method. After excluding
      participants with largely deviating measurements between survey and
      questionnaire, the increased energy-adjusted fat intake was associated with
      accelerated menarche (relative risk = 2.1; 95% confidence interval 1.1-4.0;
      lowest vs. highest quartile), while increased sports activity was associated with
      a delay in menarche (relative risk = 0.3; 95% confidence interval 0.1-0.5; lowest
      vs. highest quartile). Parameters of physical development such as body weight or
      body fatness were found to be predictors of menarche. The study provides evidence
      that dietary effects on breast cancer risk might be indirect by influencing
      hormonal events like the age at menarche.

PMID- 8356964
TI  - Can men be trusted? A comparison of pregnancy histories reported by husbands and
      wives.
AB  - Agreement between pregnancies and pregnancy outcomes reported by husbands and
      wives was assessed in a sample of 857 couples interviewed between June 1989 and
      July 1990. The respondents were men employed in a semiconductor manufacturing
      plant in Burlington, Vermont, and their wives. The wives' reports were used as
      the standard against which the husbands' reproductive histories were evaluated.
      Measures included sensitivity, specificity, and percentage of agreement. Reports
      were considered to be congruent if an outcome reported by the husband agreed with
      the outcome reported by the wife within a period of +/- 6 months. Although men
      and women reported similar numbers of livebirths (1,478 and 1,500, respectively),
      men tended to misreport the timing of events; therefore, complete agreement on
      the numbers and dates of births was only 88.5%. Men also misreported the
      prevalence of low birth weight (sensitivity, 74%). Specificity was poorer for the
      younger (< 35 years) and less educated (< or = 12 years) respondents. Husbands'
      reports of spontaneous abortions had lower sensitivity (71.2%) than their reports
      of livebirths, particularly among the better educated (66.9%). Induced abortions
      were frequently omitted by the husbands (sensitivity, 35.1%), and events such as
      stillbirths or tubal pregnancies were too few in number to permit meaningful
      analysis. It is concluded that husbands' misreporting of their wives'
      reproductive histories may be substantial and sufficient to compromise the
      validity of epidemiologic studies. It would, therefore, be prudent to avoid the
      use of husbands as proxy informants of their wives' reproductive histories.

PMID- 8356965
TI  - Effect of fecal contamination on diarrheal illness rates in day-care centers.
AB  - Contact spread of enteropathogens in day-care centers is supported by the
      recovery (presence vs. absence) of fecal coliforms from hands and day-care center
      fomites. This prospective study was conducted to determine what, if any,
      quantitative measures of fecal coliforms predict the risk of diarrhea among day
      care center attendees. Diarrheal illness without concomitant respiratory symptoms
      was monitored among 221 children aged < 3 years in 37 classrooms (24 day-care
      centers) through biweekly parental telephone interviews from October 1988 to May
      1989 in Cumberland County, North Carolina. The risk of diarrhea was expressed as
      new episodes/classroom-fortnight. Contamination was expressed as the log10 fecal
      coliform count per unit of surface area, per toy, and per child and staff hands.
      Significant predictors of diarrheal risk were any hand contamination (p = 0.003)
      and the number of contaminated moist sites (hands, faucets, and sinks) (p =
      0.006). After adjusting for the child/staff ratio using weighted multiple
      regression, the authors found that classrooms with either any hand contamination
      (p = 0.0015) or contamination on all moist sites (p = 0.015) had a significant
      twofold increased rate of diarrhea compared with classrooms without
      contamination. This was the first study to demonstrate an increased risk of
      diarrhea associated with fecal contamination and the frequent sink contamination
      in day-care centers.

PMID- 8356967
TI  - Epidemiologic analysis of Kaposi's sarcoma as an early and later AIDS outcome in
      homosexual men.
AB  - The authors separately studied the epidemiology (risk and risk factors) of
      Kaposi's sarcoma occurring as an initial acquired immunodeficiency syndrome
      (AIDS) outcome (early Kaposi's sarcoma) and later after a different initial AIDS
      outcome (later Kaposi's sarcoma) in a cohort of 2,591 human immunodeficiency
      virus type 1-infected gay men of the Multicenter AIDS Cohort Study between 1984
      and 1992. Among 844 AIDS cases, 202 presented with early Kaposi's sarcoma, 101
      subsequently developed later Kaposi's sarcoma, and 541 were not diagnosed with
      Kaposi's sarcoma. Overall, 37.4% of AIDS cases were diagnosed with Kaposi's
      sarcoma prior to death. Kaposi's sarcoma diagnosed on the skin was significantly
      more common with early Kaposi's sarcoma (77.3%) than with later Kaposi's sarcoma
      (65.1%). Men presenting with an AIDS outcome other than Kaposi's sarcoma were at
      high risk for later Kaposi's sarcoma. Later Kaposi's sarcoma onset in men with a
      previous AIDS outcome was associated with the following characteristics: 1) lower
      immune status prior to AIDS and 2) longer post-AIDS survival. A Kaposi's sarcoma
      diagnosis in a man with a previous AIDS illness approximately doubled the risk
      (hazard) for death. Histories of urethral gonorrhea and scabies prior to study
      entry were more common in early Kaposi's sarcoma cases than in later Kaposi's
      sarcoma cases. However, self-reported sexual activity at study entry and prior to
      AIDS onset was highest in the later Kaposi's sarcoma group. In this cohort,
      cigarette smoking had a protective association against all Kaposi's sarcoma in
      univariate and multivariate models. Only 21.0% of the later Kaposi's sarcoma and
      25.0% of the early Kaposi's sarcoma men smoked at least one-half pack of
      cigarettes daily at study entry compared with 33.8% of non-Kaposi's sarcoma and
      35.5% of seroprevalent men still AIDS free. The reasons for this surprising
      association are unclear. However, other evidence which documents that habitual
      smoking alters the immune system (and possibly cytokine levels) in ways that
      could perhaps influence Kaposi's sarcoma pathogenesis should be considered.

PMID- 8356966
TI  - Composite risk score for Kaposi's sarcoma based on a case-control and
      longitudinal study in the Multicenter AIDS Cohort Study (MACS) population.
AB  - The possibility that an agent in addition to human immunodeficiency virus type 1
      may be involved in the etiology of Kaposi's sarcoma in acquired immunodeficiency
      syndrome (AIDS) patients was investigated between 1984 and 1992 in this nested
      case-control analysis from the Multicenter AIDS Cohort Study (MACS) of homosexual
      and bisexual men. A total of 316 cases of Kaposi's sarcoma were identified and
      compared with 510 participants with AIDS and no evidence of cancer. More of the
      Kaposi's sarcoma cases were from Los Angeles and used a higher number of
      recreational drugs. The Kaposi's sarcoma cases were also more active sexually.
      There was a dose-response relation between Kaposi's sarcoma and the number of
      sexual partners, with an odds ratio of 2 between the most and least sexually
      active subgroups. The odds ratio for Kaposi's sarcoma increased to 4.18 (95%
      confidence interval 1.29-14.1) in the presence of a history of five infections.
      Hepatitis and gonorrhea contributed the most to this relation. The various
      observed odds ratios did not change after multivariate adjustment for the other
      risk factors. A model was developed combining all predictive associations into a
      composite risk score ranging from one to 12 and based on history of infections,
      sexual activity, use of poppers/nitrites, and having had sexual partners from the
      West Coast of the United States. The subgroup with the highest scores, compared
      to the subgroup with the lowest score, had an odds ratio of 8.93 (95% confidence
      interval 3.21-30.44) for Kaposi's sarcoma. A longitudinal proportional hazards
      analysis among all 2,190 human immunodeficiency virus type 1-seroprevalent men at
      study entry, based on this risk score and CD4 cells at baseline, confirmed these
      findings. Identifying these specific subgroups that are at high and low risk for
      Kaposi's sarcoma will help future investigations to be more focused in their
      search for an additional etiologic factor for Kaposi's sarcoma in AIDS.

PMID- 8356968
TI  - Sources of variability in waist and hip measurements in middle-aged women.
AB  - The reliability of single measurements of waist and hip circumference and the
      ratio of waist circumference to hip circumference (a widely used measure of body
      fat distribution) has not been fully examined. The authors analyzed measurements
      of waist and hip circumference, as well as self-reported weight and height,
      repeated 3-6 times between 1986 and 1991 among 1,851 participants in the New York
      University Women's Health Study. Quetelet index (weight (kg)/height (m)2) was
      positively correlated with waist circumference (r = 0.88), hip circumference (r =
      0.89), and waist/hip ratio (r = 0.52). Mean weight was positively correlated with
      the within-subject variance of waist circumference (r = 0.27) and, to a lesser
      degree, with the within-subject variance of hip circumference (r = 0.08) and
      waist/hip ratio (r = 0.10). The within-subject variance of weight was positively
      correlated with the within-subject variance of waist (r = 0.30) and hip (r =
      0.23) measurements, and less so with waist/hip ratio (r = 0.05). Intraclass
      correlations for waist, hip, and waist/hip ratio were 0.89, 0.81, and 0.74,
      respectively; adjustment for Quetelet index reduced the intraclass correlations
      for waist and hip measures by 33% and 48%, respectively. Such adjustment can
      provide a more realistic determination of the reliability associated with an
      exposure variable in the design and analysis of studies investigating the
      relation between body fat distribution and disease.

PMID- 8356969
TI  - Mortality-discriminating power of some nutritional, sociodemographic, and
      diarrheal disease indices.
AB  - This study compared the predictive power of selected nutritional
      (anthropometric), socioeconomic, and diarrheal disease morbidity variables for
      subsequent childhood mortality over a 1-year period. The data consisted of
      observations of approximately 1,900 children aged 6-36 months obtained from a
      longitudinal demographic surveillance system located in a rural area of
      Bangladesh in 1988-1990. The results suggested that weight-for-age (%) was the
      best predictor of subsequent mortality over a 1-year period, followed by weight
      velocity (monthly weight gain or loss in grams). Standardization of weight
      velocity by the US National Center for Health Statistics standard did not improve
      the mortality-discriminating power of this variable. Reported diarrheal morbidity
      was also a useful criterion for predicting mortality. Neither maternal education
      nor sex of the child had significant mortality-discriminating power.

PMID- 8356970
TI  - Malaria and low birth weight in central Sudan.
AB  - A nested case-control hospital study and a midwife-based community cohort study
      were conducted in Central Sudan during 1989 and 1990 to assess the contribution
      of mesoendemic malaria to low birth weight. Malarial infection was determined by
      maternal history, parasitology, and histopathology. There were significant
      associations between a maternal history of malaria and low birth weight in the
      hospital study (adjusted odds ratio (OR) = 1.6, 95% confidence interval (CI) 1.2
      2.1) and the community study (OR = 1.7, 95% CI 1.3-2.3). Attributable risk
      percentages were high and were comparable in the hospital study (22.2%) and the
      community study (24.5%). A significant trend of increased risk of low birth
      weight was observed with increasing number of reported malaria attacks, with
      attacks occurring earlier in pregnancy, and with higher parasitemia. In addition,
      the risk of low birth weight associated with malaria was higher among primiparous
      women than among multiparous women. The mean birth weight of infants whose
      mothers had malaria during pregnancy was significantly lower than the mean birth
      weight of infants whose mothers did not. Malaria treatment, chemoprophylaxis, and
      use of insecticides decreased the risk of low birth weight and are recommended as
      appropriate interventions. These measures should target primigravid women and
      should be initiated early in pregnancy.

PMID- 8356971
TI  - The bacterial etiology of conjunctivitis in early infancy. Eye Prophylaxis Study
      Group.
AB  - The authors conducted this study to determine the etiologic agents of
      conjunctivitis in early infancy. From 1985 to 1990, 630 infants enrolled in a
      randomized, controlled, double-masked study of eye prophylaxis were observed for
      60 days after delivery for signs of conjunctivitis. The following isolates were
      categorized as pathogens: Haemophilus influenzae, Streptococcus pneumoniae,
      Neisseria cinerea, Klebsiella pneumoniae, and Chlamydia trachomatis. Using
      conditional logistic regression for analysis of 97 infant pairs, the authors
      identified isolates categorized as pathogens almost exclusively among cases (odds
      ratio (OR) = 18.0, 95% confidence interval (CI) 2.3-128). Among the
      microorganisms which have not usually been regarded as pathogens in the etiology
      of infant conjunctivitis, Streptococcus mitis was the only microorganism
      associated with an increased risk of conjunctivitis (OR = 5.3, 95% CI 1.8-15.0).
      The findings concerning the species of bacteria most often associated with
      conjunctivitis, as well as the finding that method of delivery is unimportant,
      suggest that bacteria were transmitted to the infants' eyes after birth and not
      from the birth canal.

PMID- 8356972
TI  - Day care attendance and other risk factors for invasive Haemophilus influenzae
      type b disease.
AB  - Two hundred and ninety-five of 373 (79%) children with reported cases of invasive
      Haemophilus influenzae type b (Hib) occurring in the state of Oklahoma from
      January 1, 1986, through December 31, 1987, were matched according to birth date
      with two controls each. Conditional logistic regression was used to assess the
      independent roles of day care attendance, number of young children in the home,
      crowding, passive smoking, maternal education, household income, and race in Hib
      disease. Statistically significant odds ratios (ORs) were found for day care
      attendance (OR = 2.9), the presence of two or more children in the home under 6
      years of age (OR = 2.4), crowding (ratio of number of people in the home to
      number of bedrooms > or = 2) (OR = 2.0), and exposure to cigarette smoking in the
      home (OR = 1.4). Household income was independently associated with Hib disease.
      African Americans were at increased risk even after adjustment for income and
      crowding (OR = 4.1). Although there were no important differences in risk for
      other factors by type of Hib disease, there was a large and statistically
      significant difference in risk for day care attendance between meningitis
      (adjusted OR = 5.1, 95% confidence interval (CI) 3.1-8.2) and other types of Hib
      disease (combining nonmeningitis cases, adjusted OR = 1.6, 95% CI 0.9-2.7).
      Increasing numbers of hours per week of day care attendance and children per room
      were associated with increasing risk of Hib meningitis in a dose-response
      pattern. The highest day care ORs for meningitis were observed in the youngest (<
      6 months) and oldest (> or = 24 months) children. The adjusted OR for exposure to
      breast feeding was 0.5 (95% CI 0.3-0.8). A protective effect for Hib
      polysaccharide vaccination among children aged > or = 18 months was suggested but
      did not reach statistical significance (OR = 0.4, 95% CI 0.2-1.1).

PMID- 8356973
TI  - Survival and mortality patterns of an acquired immunodeficiency syndrome (AIDS)
      cohort in New York State.
AB  - The survival experience and causes of death of acquired immunodeficiency syndrome
      (AIDS) patients were studied using a cohort of 3,699 AIDS patients in New York
      State, excluding New York City, whose illness was diagnosed before January 1990
      at age 13 years or older. The median length of survival for all cases was 11.5
      months, and survival increased over time from 5.3 months pre-1984 to 9.3 months
      in 1984-1986 and to 13.2 months in 1987-1989. In a Cox proportional hazards
      model, risk of dying was higher for persons aged 35 years or more at diagnosis
      and for persons with a diagnosis other than Pneumocystis carinii pneumonia or
      Kaposi's sarcoma whose illness was diagnosed before 1986. In this AIDS cohort,
      2,834 (77 percent) persons died before 1991; 87 percent of the death certificates
      listed human immunodeficiency virus (HIV)/AIDS or an AIDS indicator disease as
      one of the multiple causes of death. The finding that 13 percent of the death
      certificates did not mention AIDS/HIV suggests that use of death certificates
      alone to count HIV-related deaths would result in an undercount. The recent
      expansion of the federal AIDS case definition is expected to add HIV-infected
      persons who die from conditions, such as recurrent pneumonia, that were not
      included in the earlier definition.

PMID- 8356974
TI  - Re: "Validity of exposure data derived from a structured questionnaire".

PMID- 8356975
TI  - Re: "Reproductive factors and risk of myocardial infarction".

PMID- 8356976
TI  - The American Society of Human Genetics 43rd annual meeting. New Orleans,
      Louisiana, October 5-9, 1993. Abstracts.

PMID- 8356977
TI  - Attempted cardiopulmonary resuscitation in nursing homes.

PMID- 8356978
TI  - Outcomes of cardiopulmonary resuscitation in nursing homes: can we predict who
      will benefit?
AB  - PURPOSE: To determine the benefits of cardiopulmonary resuscitation (CPR) in
      nursing home patients and assess possible prearrest and arrest predictors of
      survival. PATIENTS AND METHODS: During a 4-year period (1986 to 1989),
      consecutive nursing home patients from Milwaukee, Wisconsin, who sustained
      cardiac arrest and received CPR by paramedics were studied. The patients'
      prearrest clinical characteristics were determined including age, length of stay
      in nursing home, medical diagnoses, medications, circumstances surrounding the
      arrest, laboratory studies, and baseline functional status. Cardiac arrest data
      were obtained from a paramedic computer data base and included whether the arrest
      was witnessed, initial cardiac rhythm, and success of CPR. Survival was defined
      as the discharge of the patient alive from the hospital, and the patient's pre-
      and post-arrest functional status was compared. Possible predictors of survival
      were analyzed from the patient's prearrest characteristics and arrest
      characteristics. RESULTS: Of the total 196 patients who received CPR, 37 (19%)
      were successfully resuscitated and hospitalized, and 10 (5%) survived to be
      discharged. However, 27% of patients survived whose arrests were witnessed and
      who demonstrated ventricular fibrillation at the time of the arrest. In
      comparison, only 2.3% of all other nursing home patients who received CPR
      survived (p < 0.0002). Age, mental or functional status, hematocrit, renal
      dysfunction, pulmonary disease, cancer, and cardiovascular disease were not
      significant predictors of survival. At the time of hospital discharge, the
      functional status of the majority (80%) of the survivors was comparable to their
      prearrest status and 40% of the survivors lived for greater than 12 months.
      CONCLUSION: We conclude that only a small percentage of nursing home patients who
      sustain cardiac arrest will benefit from CPR. However, greater than 25% of
      nursing home patients whose arrest is witnessed and who demonstrate ventricular
      fibrillation will survive. This is comparable to the survival rate of elderly
      community-dwelling persons who sustain cardiac arrest. Our data suggest that CPR
      should be initiated only in nursing home patients whose cardiac arrest is
      witnessed and should only be continued in patients whose initial documented
      cardiac rhythm is ventricular fibrillation or ventricular tachycardia.

PMID- 8356979
TI  - Effect of an energy-restrictive diet, with or without exercise, on lean tissue
      mass, resting metabolic rate, cardiovascular risk factors, and bone in overweight
      postmenopausal women.
AB  - PURPOSE: To study the effect of exercise added to an energy-restrictive diet in
      overweight postmenopausal women. SUBJECTS AND METHODS: In a longitudinal clinical
      study, 121 healthy, overweight postmenopausal women (age 53.8 +/- 2.5 years, body
      mass index: 29.7 +/- 3.1 kg/m2) were randomly assigned to 3 groups: controls, a
      4,200 kJ/d diet, or a 4,200 kJ/d diet with combined aerobic and anaerobic
      exercise. Body composition (measured by dual-energy x-ray absorptiometry), fat
      distribution, resting metabolic rate, blood pressure, serum lipids and
      lipoproteins, bone mineral densities, and markers of collagen and bone turnover
      were measured before and after 12 weeks of intervention. RESULTS: One hundred
      eighteen women completed the study. The mean loss of body weight (9.5 kg versus
      10.3 kg, NS) was similar in the intervention groups, but compared with the diet
      only group, the diet-plus-exercise group lost more fat (7.8 kg versus 9.6 kg, p <
      0.001) and no lean tissue mass (1.2 kg versus -0.0 kg, p < 0.001). The resting
      metabolic rate (per kg wt) was increased in the diet-plus-exercise group compared
      with the control group (11% versus 4%, p < 0.009). The levels of serum
      triglycerides, total cholesterol, low-density lipoprotein, and very-low-density
      lipoprotein decreased, and the ratio of high-density lipoprotein to low-density
      lipoprotein increased by 20% to 30% in both intervention groups compared with the
      control group (p < 0.001). The systolic blood pressure dropped, and the waist-to
      hip circumference ratio and abdominal-to-total body fat decreased in both
      intervention groups compared with the control group (10%, p < 0.003, and 3.5%, p
      < 0.0001). There were no consistent, major differences between the groups in
      terms of changes in total body, spinal, or forearm bone mineral densities, or in
      markers of collagen and bone turnover. CONCLUSION: Overweight postmenopausal
      women benefit from addition of combined aerobic and anaerobic exercise to an
      energy-restrictive diet. The diet itself has a positive effect on cardiovascular
      risk factors.

PMID- 8356980
TI  - Prophylaxis of urinary tract infection in persons with recent spinal cord injury:
      a prospective, randomized, double-blind, placebo-controlled study of trimethoprim
      sulfamethoxazole.
AB  - PURPOSE: To determine the efficacy of trimethoprim-sulfamethoxazole (TMP-SMX) for
      prophylaxis of urinary tract infection in persons with recent spinal cord injury,
      during the first 4 months of intermittent catheterization. PATIENTS AND METHODS:
      One hundred twenty-nine adults (112 men, 17 women) with recent acute spinal cord
      injury participated in a randomized, double-blind, placebo-controlled trial, and
      were studied for up to 16 weeks. Low-dose TMP-SMX (TMP 40 mg, SMX 200 mg) or
      placebo was given once daily. Clinical observations, urine cultures, and cultures
      of rectal and urethral swabs were made weekly. Subjects who developed
      breakthrough bacteriuria received conventional antimicrobial therapy and
      prophylaxis was continued. RESULTS: Sixty-six TMP-SMX recipients (57 men, 9
      women) and 60 placebo recipients (52 men, 8 women) are evaluable for efficacy.
      Among male subjects, bacteriuria was present during 50% or more of study weeks in
      30% of TMP-SMX recipients and in 56% of placebo recipients (p = 0.003). The
      interval to the onset of bacteriuria was prolonged in TMP-SMX recipients (p <
      0.0001). TMP-SMX recipients without bacteriuria in any given week had a lower
      probability of having bacteriuria the subsequent week (0.26) than did placebo
      recipients (0.49) (p < 0.0001). At least 1 episode of definite symptomatic
      bacteriuria (bacteriuria and fever and at least 1 classical manifestation of
      urinary infection) occurred in 4 of 57 TMP-SMX-treated men and in 18 of 52
      placebo-treated men (p < 0.0003). We observed similar trends in women, but
      differences did not reach statistical significance, perhaps because the number of
      females was small. Adverse events suspected to be due to medications were
      frequent in this population of patients with recent severe injuries and led to
      discontinuation of the study in 10% of the TMP-SMX group and 8% of the placebo
      group. Adverse events included neutropenia (TMP-SMX: two; placebo: three),
      pseudomembranous colitis (TMP-SMX: one), severe skin rash (TMP-SMX: two; placebo:
      one), and drug fever (TMP-SMX: one). The proportion of all episodes of
      bacteriuria that were due to TMP-SMX-resistant organisms was unexpectedly high in
      the placebo group (51%), and increased progressively according to year of
      enrollment in the study. By Year 3, all subjects in the placebo group had at
      least one episode of TMP-SMX-resistant bacteriuria. Gram-negative enteric bacilli
      resistant to TMP-SMX were recovered from rectal swabs (TMP-SMX 49%, placebo 42%)
      and urethral swabs (TMP-SMX 33%, placebo 26%) in similar proportions of subjects
      in the two study groups. CONCLUSIONS: Prophylaxis with TMP-SMX significantly
      reduces bacteriuria and symptomatic urinary tract infection in persons with
      recent acute spinal cord injury during bladder retraining using intermittent
      catheterization. However, adverse reactions attributable to TMP-SMX are common in
      this population. Colonization and breakthrough bacteriuria with TMP-SMX-resistant
      organisms are frequent and may seriously limit the usefulness of this strategy,
      particularly in an institutional setting.

PMID- 8356981
TI  - Neuropsychiatric disease in Sjogren's syndrome: anti-ribosomal P and anti
      neuronal antibodies.
AB  - PURPOSE: Patients with Sjogren's syndrome (SS) may develop nonfocal (i.e.,
      psychiatric and/or cognitive dysfunction) as well as focal, neuropsychiatric
      disease (CNS-SS). Anti-ribosomal P and anti-neuronal antibodies have been
      associated with nonfocal neuropsychiatric disease in systemic lupus erythematosus
      (SLE), particularly psychosis and depression. This study examines the spectrum of
      psychiatric and cognitive dysfunction observed in SS patients with focal, as well
      as nonfocal, central nervous system (CNS) disease and relates these observations
      to the presence of serum and cerebrospinal fluid (CSF) anti-ribosomal and anti
      neuronal antibodies. PATIENTS AND METHODS: One hundred thirty-one patients-
      patients with primary SS (n = 91), patients with secondary SS (n = 34), and
      mothers of infants with neonatal lupus erythematosus (NLE) (n = 6)--were studied.
      Patients were referred to a large tertiary referral center and the population was
      highly selected for CNS disease. Patients were evaluated clinically for focal and
      nonfocal CNS disease. Sera from 131 patients and 34 paired sera/CSF samples were
      examined by enzyme-linked immunosorbent assay and radioimmunoassay for the
      presence of anti-ribosomal P and anti-neuronal autoantibodies, respectively.
      Clinical features were categorized and autoantibody profiles obtained and
      correlated independently for statistical significance. Data were analyzed using
      the two-tailed Fisher exact test. RESULTS: Psychiatric or cognitive impairment,
      usually mild or moderate, occurred in over 80% (63 of 77) of this highly selected
      population of SS patients, and more than 60% of patients (48 of 77) had both.
      Anti-ribosomal P antibodies occurred in six (4.6%) patients with SS and related
      disorders. None of the patients with primary SS had anti-ribosomal P antibodies,
      whereas they were present in a small number of patients with secondary SS (i.e.,
      4 of 34 [12%]) and in 2 of 6 mothers of infants with NLE. There was no
      correlation between nonfocal CNS disease, including psychosis or severe
      depression, and the presence of anti-ribosomal P antibodies. Paired serum CSF
      samples from 34 SS patients with active CNS disease, including 6 with psychosis
      and 5 with severe depression, did not contain either anti-ribosomal P or anti
      neuronal antibodies. Anti-ribosomal P and anti-neuronal antibodies were present
      in a control subset of SLE patients defined serologically by the presence of anti
      nDNA antibodies. CONCLUSION: Patients with primary SS associated with CNS
      disease, including psychosis and depression, do not have serum or CSF
      autoantibodies to ribosomal P peptide or neuronal antigens, detected by binding
      to neuroblastoma cells. Thus, autoantibodies associated with nonfocal or diffuse
      CNS disease in classical SLE (particularly psychosis and depression) are not
      present in CNS-SS. The observations suggest that nonfocal CNS disease in CNS-SS
      and CNS-SLE may be mediated by different immunopathologic mechanisms.
      Potentially, these observations may have diagnostic and therapeutic implications
      in the management of patients with CNS-SS and patients with CNS-SLE.

PMID- 8356982
TI  - Autoimmune C1 inhibitor deficiency: report of eight patients.
AB  - PURPOSE: In this study, we investigated the clinical and biochemical features and
      the responses to treatment of eight patients with auto-antibody-mediated C1
      inhibitor (C1-INH) deficiency and symptoms of angioedema. PATIENTS AND METHODS:
      In addition to the 8 patients with acquired angioedema (AAE), we also studied 36
      subjects with hereditary angioedema (HAE), 15 of them treated with C1-INH plasma
      concentrate, and 26 patients with different autoantibodies in their plasma (10
      with systemic lupus erythematosus, 6 with lupus-like anticoagulant, and 10 with
      chronic liver disease). Functional C1-INH was measured with the reagent kit of
      Immuno (Vienna, Austria); C1-INH, C4, and C1q antigen were determined by radial
      immunodiffusion; and autoantibodies to C1-INH were detected by an enzyme-linked
      immunosorbent assay method. RESULTS: Four patients with AAE had no other
      diseases, one had breast cancer, one liver hydatidosis, one Waldenstrom's
      disease, and one a benign M component. Functional C1-INH levels were below 30% of
      normal, and C1q plasma levels were low in seven patients but normal in one.
      Autoantibodies to C1-INH were detectable in all eight AAE patients but in none of
      the others. Prophylactic treatment with attenuated androgens was successful in
      one of four patients, and with antifibrinolytic agents (tranexamic acid) in six
      of seven patients. Laryngeal attacks in five patients were treated with C1-INH
      plasma concentrate; two patients had marked clinical and biochemical responses.
      In three, the symptoms resolved only with high doses, and the biochemical
      parameters did not significantly increase. CONCLUSIONS: Our results suggest that
      patients with autoimmune AAE are clinically and biochemically heterogeneous. They
      have different responses to treatment that seem to be related to variable C1-INH
      consumption.

PMID- 8356983
TI  - Primary hyperparathyroidism: incidence of cardiac abnormalities and partial
      reversibility after successful parathyroidectomy.
AB  - PURPOSE: This prospective study was designed to assess the effect of primary
      hyperparathyroidism on heart muscle, valves, and myocardial function.
      Echocardiography was used to evaluate changes in mechanical performance, the
      thickness of the left ventricular wall, myocardial calcific deposits, and
      valvular calcifications in patients with primary hyperparathyroidism. METHODS:
      Echocardiography was performed in 54 patients with hyperparathyroidism prior to
      surgery and 12 +/- 2 months after successful parathyroidectomy. A matched control
      group was followed for comparison. RESULTS: In a blinded fashion, aortic and
      mitral valve calcifications were detected in 63% and 49% of patients with primary
      hyperparathyroidism (controls: 12% and 15%, respectively). Calcific deposits in
      the myocardium were found in 69% of patients with hyperparathyroidism and 17% of
      the control subjects. After parathyroidectomy and 12 months of normocalcemia, a
      significant regression of left ventricular hypertrophy (p < 0.001) was observed.
      CONCLUSIONS: The present data show a high incidence of left ventricular
      hypertrophy, calcific deposits in the myocardium, and/or aortic and mitral valve
      calcification in patients with primary hyperparathyroidism. A 1-year follow-up
      after parathyroidectomy (and restoration of normocalcemia) discloses regression
      of hypertrophy, while calcifications persist without evidence of progression.

PMID- 8356984
TI  - Clinical characteristics of vasodepressor, cardioinhibitory, and mixed carotid
      sinus syndrome in the elderly.
AB  - PURPOSE: Carotid sinus syndrome (CSS) is frequently overlooked as a cause of
      syncope in the elderly. It is diagnosed when carotid sinus massage (CSM) produces
      asystole exceeding 3 seconds (cardioinhibitory CSS), a reduction in systolic
      blood pressure exceeding 50 mm Hg independent of heart rate slowing
      (vasodepressor CSS), or a combination of the two (mixed CSS). Most published data
      pertain to the cardioinhibitory subtype. The recent availability of noninvasive
      phasic blood pressure monitoring has allowed accurate routine assessment of the
      vasodepressor response to CSM. The aim of this study was to assess the clinical
      characteristics of vasodepressor, cardioinhibitory, and mixed CSS. PATIENTS AND
      METHODS: CSM was carried out on 132 consecutive patients over 65 years referred
      for investigation of dizziness, falls, or syncope. Massage was performed both
      supine and upright with continuous electrocardiographic and phasic blood pressure
      monitoring. Patients exhibiting greater than 1.5-second asystole were given 600
      micrograms of intravenous atropine to abolish heart rate slowing and allow
      assessment of the pure vasodepressor response. RESULTS: Carotid sinus
      hypersensitivity was documented in 64 patients (mean age 81 +/- 7 years, 31
      male). The response was vasodepressor in 37%, cardioinhibitory in 29%, and mixed
      in 34%. Thirty-six patients had recurrent syncope, 17 presented with unexplained
      falls, and the remainder had dizziness alone. Symptoms had been present for a
      median of 24 months, and the median number of syncopal episodes was four. Twenty
      five percent had sustained a fracture and, of these, 93% had not experienced a
      prodrome. Head movement precipitated symptoms in 47% and vagal stimuli in 73%.
      Episodes were unwitnessed in two thirds of patients. Twelve patients who
      presented with falls denied syncope but had witnessed loss of consciousness
      during CSM. Mean cardioinhibition was 5 +/- 2 seconds and mean vasodepression 61
      +/- 9 mm Hg. The blood pressure nadir occurred rapidly at 18 +/- 3 seconds after
      massage, and baseline values were regained at 30 +/- 6 seconds. The clinical
      characteristics of patients with vasodepressor, cardioinhibitory, and mixed
      responses were similar. CONCLUSION: CSS is an underdiagnosed cause of dizziness,
      falls, and syncope in the elderly. The vasodepressor form occurs more frequently
      than previously reported and has clinical characteristics similar to those of the
      cardioinhibitory and mixed subtypes. Elderly patients with this condition may
      deny syncope and present with recurrent unexplained falls. CSM, ideally with
      noninvasive phasic blood pressure monitoring, should be routinely performed in
      elderly patients with unexplained bradycardic or hypotensive symptoms.

PMID- 8356985
TI  - Etiology of large pericardial effusions.
AB  - PURPOSE: To determine the effectiveness of the preoperative evaluation and
      overall diagnostic efficacy of subxiphoid pericardial biopsy with fluid drainage
      in patients with new, large pericardial effusions. DESIGN: A prospective
      interventional case series of consecutive patients admitted with new, large
      pericardial effusions. PATIENTS AND METHODS: Fifty-seven of 75 consecutive
      patients admitted to a university tertiary-care center and a university
      affiliated Veterans Administration Medical Center with new, large pericardial
      effusions were studied over a 20-month period. Each patient was assessed by a
      comprehensive preoperative evaluation followed by subxiphoid pericardiotomy. The
      patients' tissue and fluid samples were studied pathologically and cultured for
      aerobic and anaerobic bacteria, fungi, mycobacteria, mycoplasmas, and viruses.
      RESULTS: A diagnosis was made in 53 (93%) patients. The principle diagnoses
      consisted of malignancy in 13 (23%) patients; viral infection in 8 (14%)
      patients; radiation-induced inflammation in 8 (14%) patients; collagen-vascular
      disease in 7 (12%) patients; and uremia in 7 (12%) patients. No diagnosis was
      made in four (7%) patients. A variety of unexpected organisms were cultured from
      either pericardial fluid or tissue: cytomegalovirus (three), Mycoplasma
      pneumoniae (two), herpes simplex virus (one), Mycobacterium avium-intracellulare
      (one), and Mycobacterium chelonei (one). The pericardial fluid yielded a
      diagnosis in 15 (26%) patients, 11 of whom had malignant effusions. The
      examination of pericardial tissue was useful in the diagnosis of 13 (23%)
      patients, 8 of whom had an infectious agent cultured. Of the 57 patients
      undergoing surgery, the combined diagnostic yield from both fluid and tissue was
      19 patients (33%). CONCLUSIONS: A systematic preoperative evaluation in
      conjunction with fluid and tissue analysis following subxiphoid pericardiotomy
      yields a diagnosis in the majority of patients with large pericardial effusions.
      This approach may also result in the culturing of "unusual" infectious organisms
      from pericardial tissue and fluid.

PMID- 8356987
TI  - Noninvasive monitoring.
AB  - Noninvasive monitors are finding increased use in the intensive care unit both as
      labor-saving tools and as a means to reduce complications associated with
      invasive techniques. The current technology allows for the replacement of a
      number of invasive devices with a noninvasive counterpart capable of providing
      similar information. The potential reduction in morbidity and mortality realized
      with a greater reliance on noninvasive monitors should result in widespread
      application of these modalities.

PMID- 8356986
TI  - Needle exchange decreases the prevalence of HIV-1 proviral DNA in returned
      syringes in New Haven, Connecticut.
AB  - PURPOSE: To report on the deployment of the syringe tracking and testing system
      in the New Haven needle exchange program, which is the first federally funded
      evaluation of a needle exchange program conducted in the United States. PATIENTS
      AND METHODS: A legal needle exchange for intravenous drug users began in New
      Haven, Connecticut, in November 1990. All syringes distributed by the program
      received unique tracking codes. Syringes were tracked and HIV-1 proviral DNA
      prevalence in returned syringes was assessed using polymerase chain reaction and
      Southern blotting. RESULTS: At the outset of the program, the prevalence of HIV-1
      proviral DNA in syringes exceeded two thirds. Prevalence decreased rapidly to
      less than 45% during the first 3 months of the program and remained at this level
      for the following 10 months. During the periods of decreasing prevalence and
      subsequent steady state, no changes in the demographics of program participants
      or in the drug use habits of newly enrolling clients that could account for the
      decrease in HIV-1 prevalence in needles were detected. In addition, the program
      referred almost 20% of its clients to drug treatment programs. CONCLUSION: The
      needle exchange program in New Haven has decreased the percentage of syringes
      testing positive for HIV-1 proviral DNA among needle exchange clients while
      simultaneously serving as an entry point for drug treatment.

PMID- 8356988
TI  - Build it and they will come.

PMID- 8356989
TI  - Retooling academic internal medicine: the challenge to departmental leadership.

PMID- 8356990
TI  - Acute pulmonary coccidioidomycosis mimicking bacterial pneumonia and septic
      shock: a report of two cases.
AB  - Two patients with acute pulmonary coccidioidomycosis presenting as acute
      bacterial pneumonia and sepsis are described. One patient died despite
      appropriate antifungal therapy, whereas the diagnosis in the other patient was
      only established after postmortem examination. In both cases, coccidioidomycosis
      had disseminated beyond the lungs. Factors leading to overwhelming
      coccidioidomycosis are discussed, and the relation of the sepsis syndrome to
      coccidioidomycosis is reviewed.

PMID- 8356991
TI  - Coma due to ciguatera poisoning in Rhode Island.
AB  - A patient is presented who developed an acute gastrointestinal and neurologic
      syndrome progressing to coma after ingestion of a fish soup made in Rhode Island.
      Laboratory studies confirmed the clinical diagnosis of ciguatera poisoning.
      Physicians should be aware of the diagnostic features of this disease even in non
      endemic areas.

PMID- 8356992
TI  - Adrenal abscess as a complication of adrenal fine-needle biopsy.

PMID- 8356993
TI  - Didanosine-induced hypertriglyceridemia.

PMID- 8356994
TI  - Omeprazole-induced acute interstitial nephritis.

PMID- 8356995
TI  - Para-articular manifestations of palindromic arthritis.

PMID- 8356996
TI  - Continuing Developments with Nabumetone: An Investigators' Update. Proceedings of
      a symposium.

PMID- 8356997
TI  - Safety experience with nabumetone versus diclofenac, naproxen, ibuprofen, and
      piroxicam in osteoarthritis and rheumatoid arthritis.
AB  - The comparative safety of nabumetone (1,000-2,000 mg/day) versus diclofenac (100
      200 mg/day), naproxen (500-1,500 mg/day), piroxicam (10-20 mg/day), and ibuprofen
      (1,200-3,200 mg/day) was evaluated in a 12-week, randomized, open-label,
      multicenter study. Patients with osteoarthritis (OA) or rheumatoid arthritis (RA)
      were enrolled in a 3:1 ratio (nabumetone:one of the four comparator NSAIDs). The
      incidence of > or = 1 adverse event considered by the investigator to be related
      or probably related to therapy was similar in all groups. However, significantly
      (p < 0.02) more diclofenac-treated patients experienced abdominal pain and/or
      gastritis than nabumetone-treated patients. Naproxen-treated patients experienced
      significantly (p < 0.002) more dyspepsia as compared with patients treated with
      nabumetone or ibuprofen and significantly (p < or = 0.001) more nabumetone
      treated patients experienced diarrhea than patients treated with naproxen,
      ibuprofen, or piroxicam. Ulcers occurred in one (0.03%) nabumetone-treated
      patient versus six (0.5%) patients treated with one of the comparator NSAIDs (p =
      0.001). A decrease in hemoglobin > or = 1.5 g/dL occurred in fewer nabumetone
      treated patients than in patients treated with diclofenac (p < 0.04), ibuprofen
      (p < or = 0.04), or piroxicam (p = 0.055). Finally, a similar percentage of
      patients in all treatment groups withdrew from the study because of adverse
      events related or probably related to treatment. More (p < 0.001) diclofenac
      treated patients withdrew because of elevated hepatic transaminases than patients
      treated with the other agents. Withdrawal because of gastritis was also noted for
      more diclofenac-treated patients than nabumetone-treated patients (p < 0.04). In
      conclusion, nabumetone was demonstrated to be at least as safe as diclofenac,
      piroxicam, ibuprofen, and naproxen as related to subjective complaints, such as
      dyspepsia or gastritis. However, more serious events, such as ulcers or
      meaningful decreases in hemoglobin, seem to occur less often with nabumetone.

PMID- 8356998
TI  - Efficacy and safety of nabumetone versus diclofenac, naproxen, ibuprofen, and
      piroxicam in the elderly.
AB  - In a randomized, open-label, controlled, multicenter, 12-week study, the efficacy
      and safety of nabumetone (1,000-2,000 mg/day) versus diclofenac (100-200 mg/day),
      naproxen (500-1,500 mg/day), ibuprofen (1,200-3,200 mg/day), or piroxicam (10-20
      mg/day) were evaluated in patients with osteoarthritis (OA) or rheumatoid
      arthritis (RA). The results in elderly patients (> or = 65 years of age) are
      presented. Nabumetone was as effective as the comparator nonsteroidal
      antiinflammatory drugs (NSAIDs) in the treatment of elderly OA and RA patients.
      Ibuprofen and diclofenac caused significantly (p < 0.05) more abdominal pain than
      nabumetone (8.5%, 13.1%, and 4.1%, respectively). The frequency of abdominal pain
      was dose related for all NSAIDs except nabumetone. Diarrhea was reported by
      significantly (p < 0.02) more nabumetone-treated (6.6%) than ibuprofen-treated
      (0.9%) elderly patients, but the incidence of diarrhea was not dose related.
      There were no clinically significant changes in renal function with nabumetone or
      the comparator NSAIDs. A significant change in hepatic enzymes occurred in
      elderly patients treated with diclofenac (3.3%), which was different than for
      patients treated with nabumetone (p < 0.04), naproxen (p < 0.06), or ibuprofen (p
      < 0.06). With regard to withdrawals for adverse events, more (p < 0.04) piroxicam
      treated patients (4.9%) withdrew than nabumetone-treated patients (1%). In
      addition, doubling the dose of nabumetone from 1,000 mg/day to 2,000 mg/day did
      not result in a proportional increase in adverse events. However, with the
      comparator NSAIDs, proportional increases in adverse events occurred with
      increased dose. Finally, the efficacy and safety of nabumetone in elderly
      patients were similar to the efficacy and safety observed in nonelderly patients.

PMID- 8356999
TI  - Efficacy of nabumetone versus diclofenac, naproxen, ibuprofen, and piroxicam in
      osteoarthritis and rheumatoid arthritis.
AB  - The efficacy of nabumetone was compared with that of diclofenac, naproxen,
      ibuprofen, and piroxicam in patients with osteoarthritis (OA) or rheumatoid
      arthritis (RA) in a randomized, controlled, open-label, multicenter trial.
      Patients > or = 18 years with clinical and radiographic evidence of OA or RA
      (functional class I, II, or III), who provided written informed consent, were
      eligible. To mimic real-life therapy, no washout phase preceded randomization.
      Eligible patients were assigned in a 3:1 ratio to receive nabumetone or a
      comparator NSAID for 12 weeks. Thus a total of 4,411 eligible patients were
      randomized to receive nabumetone (N = 3,315) or one of the comparator NSAIDs (N =
      1,096). Initial daily doses were: nabumetone, 1,000 mg; diclofenac, 100 mg;
      naproxen, 500 mg; ibuprofen, 1,200 mg; piroxicam, 10 mg. Dosage increases were
      permitted after a 2-week trial period. All patients were evaluated at baseline,
      and at 4 and 12 weeks. Of all patients randomized, approximately 46% had RA and
      approximately 54% had OA. Demographic characteristics were similar for the
      nabumetone and comparator NSAID treatment groups. In OA, nabumetone was as
      effective as the comparator NSAIDs in the physician and patient global
      assessments of disease activity, in improving the Activities and Lifestyle Index,
      and in decreasing the degree of pain. There was no significant difference in the
      percentage of patients withdrawn for lack of efficacy when treated with
      nabumetone or one of the comparator NSAIDs. In contrast, nabumetone was
      significantly (p < or = 0.02) more effective than the comparator NSAIDs in RA
      patients for the global assessments of disease activity, pain relief, and
      improving the Activities and Lifestyle Index, primarily due to the poor response
      in the ibuprofen and piroxicam treatment groups. Furthermore, fewer nabumetone
      treated RA patients (8.8%) withdrew for lack of efficacy than those treated with
      diclofenac (10.3%), naproxen (11%), piroxicam (13.5%), or ibuprofen (13.2%). In
      conclusion, in a large, randomized, open-label trial that mimicked real-life
      therapy, nabumetone was as effective as diclofenac, naproxen, piroxicam, and
      ibuprofen for the treatment of patients with OA. However, in RA, nabumetone was
      significantly more effective than the comparator NSAIDs, and fewer patients were
      withdrawn because of lack of efficacy.

PMID- 8357000
TI  - Nonsteroidal antiinflammatory drug use in patients receiving warfarin: emphasis
      on nabumetone.
AB  - Phenylbutazone has been clearly demonstrated to interact pharmacokinetically and
      clinically with warfarin, although several other nonsteroidal antiinflammatory
      drugs (NSAIDs) also have the potential to interact with warfarin to cause
      alterations in prothrombin time. Aspirin is known to inhibit platelet aggregation
      irreversibly, whereas nonaspirin NSAIDs are thought to inhibit platelet
      aggregation reversibly. In contrast, nabumetone was not shown to cause
      significant inhibition of platelet aggregation, which may be related to the fact
      that nabumetone preferentially inhibits the prostaglandin synthase-2 isozyme
      instead of the prostaglandin synthase-1 isozyme. Furthermore, in studies in
      patients and normal volunteers stabilized on warfarin, nabumetone did not cause
      alterations in the prothrombin time or international normalized ratio. Based on
      data evaluating the concomitant use of nabumetone and warfarin, the relative lack
      of platelet inhibition, and the relatively lower risk of nabumetone-induced
      gastrointestinal mucosal damage as assessed by radiolabeled chromium-51 fecal
      blood loss studies and endoscopic evaluations, nabumetone may be preferred if
      concomitant therapy with warfarin is indicated.

PMID- 8357001
TI  - Gastrointestinal damage demonstrated with nabumetone or etodolac in preclinical
      studies.
AB  - Nabumetone, a nonacidic, nonsteroidal antiinflammatory drug (NSAID), and
      etodolac, an acidic NSAID, were compared to assess the gastrointestinal (GI)
      tolerability of these agents and their effects on gastric prostaglandins in rats.
      In a single-dose study, etodolac caused a significant increase in both gastric
      and intestinal damage 6, 24, 48, and 144 hours after dosing. In contrast, no
      significant GI damage was noted with nabumetone. Chronic, 28-day studies
      comparing five times the ID25 (the dose that reduces carrageenan-induced
      inflammation by 25% in 50% of animals) of nabumetone with twice the ID25 of
      etodolac demonstrated a significant increase in both gastric and intestinal
      damage with etodolac, but no GI damage with nabumetone, despite the higher dose
      employed. In single-dose studies comparing gastric damage and prostaglandin
      synthesis 4 hours after dosing, both nabumetone and etodolac did not
      significantly reduce gastric prostaglandin I2 production. However, there was a
      significant increase in gastric damage with etodolac, but not with nabumetone. It
      was hypothesized, and confirmed in a second study, that there is a transient
      inhibition of gastric prostaglandin synthesis with etodolac that is responsible,
      in part, for the gastric damage noted. In conclusion, acute and chronic dosing of
      nabumetone at doses up to five times the ID25 did not cause GI damage in rats. In
      contrast, etodolac did result in GI damage, which is thought to be, in part, the
      result of a transient inhibition of gastric prostaglandin synthesis, observed at
      minimally effective antiinflammatory doses.

PMID- 8357002
TI  - PGH synthase isoenzyme selectivity: the potential for safer nonsteroidal
      antiinflammatory drugs.
AB  - With the recent cloning of a second gene coding for the prostaglandin
      endoperoxide (PGH) synthase (cyclooxygenase), it has become obvious that
      mammalian cells contain two related, but unique, isozymes of PGH synthase. Both
      of these isozymes catalyze the conversion of arachidonic acid to PGH2, leading to
      production of biologically active prostaglandins. Although the first of these
      isozymes, PGH synthase-1 (PGHS-1), has long been thought to be the primary and
      sole site of action of nonsteroidal antiinflammatory drugs (NSAIDs), it is now
      known that the second isozyme, PGH synthase-2 (PGHS-2), is also sensitive to
      NSAIDs. Cloning of complementary DNAs for murine PGHS-1 and PGHS-2 has permitted
      individual expression of these two isozymes in the cos-1 cell system and
      comparison of their relative inhibition by several common NSAIDs in vitro. These
      studies have demonstrated that the two mouse isozymes, PGHS-1 and PGHS-2, are
      pharmacologically distinct. PGHS-1 is a constitutively expressed enzyme that
      early observations indicate is the principal enzyme involved in producing
      prostaglandins that regulate cellular housekeeping functions, such as gastric
      cytoprotection, vascular homeostasis, and kidney function. In contrast, PGHS-2
      appears only to be expressed in inflamed tissue or following exposure to growth
      factors, lymphokines, or other mediators of inflammation. Expression of PGHS-2 is
      inhibited by antiinflammatory glucocorticoids, lending further support to the
      hypothesis that this enzyme produces prostaglandins involved in inflammation. We
      have identified NSAIDs that preferentially inhibit murine PGHS-1 or PGHS-2 or
      inhibit both isozymes equally. The finding that the two isozymes can be
      differentially inhibited provides a possible mechanism for identifying safer,
      more effective NSAIDs. Screening for drugs that preferentially inhibit PGHS-2 may
      allow identification of NSAIDs that reduce inflammation, but spare renal and
      gastric prostaglandin synthesis, thus reducing the untoward side effects commonly
      associated with most NSAIDs. Thus far, nabumetone is the only NSAID identified
      that preferentially inhibits murine PGHS-2.

PMID- 8357003
TI  - Fronto-nasal dysostosis, callosal agenesis, crossed-fused ectopia, tibial
      hemimelia, and preaxial polydactyly of feet: severe expression of the
      acrocallosal syndrome?
AB  - We report on a girl with frontonasal "dysostosis," callosal agenesis, crossed
      fused ectopia, tibial hemimelia, and preaxial polydactyly of feet. This pattern
      of the developmental defects suggests a severe form of the acrocallosal syndrome.
      Implications for genetic counselling are discussed.

PMID- 8357004
TI  - New form of spondyloepimetaphyseal dysplasia (SEMD) in Jewish family of Iraqi
      origin.
AB  - We report a distinct type of spondyloepimetaphyseal dysplasia seen in 2 sibs and
      their second cousin, characterized by early onset severe short stature, small
      chest, and distended abdomen. They had short neck, severe lumbar lordosis, and
      marked genu varum due to fibular overgrowth and joint laxity. Radiographically,
      the patients had platyspondyly, initially noted during the first years of life,
      with central hypoplasia of the vertebral bodies. At a later age, the vertebrae
      appear squared with mild interpedicular narrowing. The long bone changes, which
      at early age resemble those seen in achondroplasia, later include general
      metaphyseal irregularities and significant epiphyseal ossification delay. These
      patients present a previously undescribed form of spondyloepimetaphyseal
      dysplasia, most probably transmitted as an autosomal recessive tract.

PMID- 8357005
TI  - Mental retardation locus in Xp21 chromosome microdeletion.
AB  - Xp21 microdeletion syndrome is associated with variable size Xp21 deletions that
      usually include the glycerol kinase locus. The clinical phenotypes we studied in
      this chromosome region include: Xpter - Aland Island eye disease (AIED) -adrenal
      hypoplasia (AH) -glycerol kinase (GKD) -Duchenne muscular dystrophy (DMD) 
      retinitis pigmentosa (RP) -ornithine transcarbamylase (OTC) -centromere. In a
      compilation of 18 individuals in 14 families with the AH, GKD, and DMD loci
      deleted, 17 were male and all were developmentally delayed. In contrast, we
      report mentally retarded female carriers in two Xp21 deletion syndrome families
      with DMD, GKD, and AH in affected males. In the first family with normal
      karyotypes, a submicroscopic deletion was associated with DMD in the retarded
      male and with retardation in carrier females. In the second family an X
      chromosome with a cytogenetically deleted Xp21 distal to the OTC and RP genes
      segregated in the affected male and retarded female carriers. DNA analysis at the
      DMD locus verified the cytogenetic findings. This report of mental retardation in
      otherwise asymptomatic female carriers of Xp21 deletion classifies one form of
      mental retardation in females.

PMID- 8357006
TI  - Alopecia universalis as a single abnormality in an inbred Pakistani kindred.
AB  - A Pakistani kindred comprising 5 generations contained 9 males and 4 females with
      alopecia universalis as a single abnormality without any associated defects. The
      skin biopsy from the scalp showed hair follicles without hair. Analysis of the
      pedigree is strongly suggestive of autosomal recessive inheritance, and
      consanguineous loops could account for all affected persons being homozygous for
      the abnormal allele.

PMID- 8357007
TI  - Study of isolated apparent amniogenic limb deficiency in Hungary, 1975-1984.
AB  - A population-based and validated data set of 206 cases with apparent amniogenic
      limb deficiency was ascertained in Hungary between 1975 and 1984. Such limb
      defects frequently (36%) associated with nonlimb abnormalities. In 134 cases with
      isolated defects typically more limbs are affected, upper and lower limbs, right
      and left sides, and both sexes are equally affected. Case-control analysis of
      such isolated cases indicates a lower socioeconomic status of parents, a higher
      parity, more frequent unwanted pregnancies, preterm birth, and a higher rate of
      threatened abortion. Familial occurrence was not found in 415 first-degree
      relatives.

PMID- 8357008
TI  - Preaxial acrofacial dysostosis (Nager syndrome) associated with an inherited and
      apparently balanced X;9 translocation: prenatal and postnatal late replication
      studies.
AB  - We report on an infant with preaxial acrofacial dysostosis (Nager syndrome) who
      was diagnosed prenatally as having an apparently balanced X/autosome
      translocation [46,X,t(X;9)(p22.1;q32)mat] inherited from a previously diagnosed
      mosaic translocation carrier mother [46,XX/46,X,t(X;9)(p22.1;q32)]. Replication
      studies on amniocytes showed the normal X chromosome to be late replicating while
      the same studies repeated on the infant's lymphocytes showed the translocated X
      chromosome to be late replicating in most cells. Late replication studies of the
      mother's lymphocytes demonstrated that the normal X chromosome was late
      replicating in most cells. The presence of Nager syndrome in this infant may be
      the result of critical breakpoints and/or position effects on chromosome 9,
      inducing expression of a gene responsible for the syndrome.

PMID- 8357009
TI  - Isochromosome 18p in a mother and her child.
AB  - We present a familial case of isochromosome 18p [i(18p)] as a supernumerary
      chromosome. The mother, who is a mosaic for i(18p) with partial tetrasomy 18p
      syndrome, transmitted the isochromosome to her only child. The child has the full
      syndrome of tetrasomy 18p. This is the first case of mosaicism i(18p) in an adult
      patient with clinical manifestations.

PMID- 8357010
TI  - Pseudoaminopterin syndrome.
AB  - We report on a boy with a combination of manifestations reminiscent of
      aminopterin embryopathy: brachyturricephaly with craniosynostosis, poorly
      mineralised vault, upslanted palpebral fissures, malar hypoplasia, high-arched
      palate, micrognathia, thick, abnormal auricles, ASD, minor hand anomalies, growth
      and mental retardation. Three convincing cases of "Aminopterin Syndrome Sine
      Aminopterin" have been reported (the fourth case possibly having the Juberg
      Hayward syndrome). Variability and heterogeneity of cases with apparent
      aminopterin embryopathy are discussed.

PMID- 8357011
TI  - Cultural and psychosocial considerations in screening for thalassemia in the
      Southeast Asian refugee population.
AB  - The combination of a high incidence of thalassemia and a high fertility rate in
      the Southeast Asian refugee population mandates effective screening programs, but
      unique cultural and psychosocial factors often impede optimal screening and
      genetic counseling. This paper identifies cultural and psychosocial barriers
      often associated with refugee thalassemia screening, and offers practical
      guidelines for remediation.

PMID- 8357012
TI  - Hirsutism-skeletal dysplasia-mental retardation syndrome with abnormal face and a
      uric acid metabolism disorder.
AB  - We report on a German boy, born to nonconsanguineous parents, with an apparently
      new combination of multiple congenital anomalies including extraordinary
      hirsutism, marked brachycephaly, abnormal position of thumbs, pedes excavati with
      claw-toes, an abnormal face, and mental retardation. Additionally the boy
      manifests a disorder of uric acid metabolism. This sporadic case may represent a
      new syndrome due to a fresh autosomal or X-linked mutation, or chance-isolated
      case due to segregation of an autosomal recessive gene.

PMID- 8357013
TI  - Oral zinc therapy in the treatment of alpha-mannosidosis.
AB  - Human alpha-mannosidosis is a lysosomal storage disorder characterized by mental
      retardation, dysostosis multiplex, and hepatosplenomegaly. Deficiency of the
      enzyme leads to accumulation of mannose-rich glycoconjugates in tissues. Zinc
      sulphate has been shown to stimulate alpha-mannosidase activity in vitro. Oral
      zinc therapy was attempted on a 4-year-old boy with alpha-mannosidosis for 3
      years. After almost 10 years of follow-up on and off zinc therapy, we must
      conclude that oral zinc does not substantially affect the clinical course of
      alpha-mannosidosis.

PMID- 8357014
TI  - Effect of fragile X on physical and intellectual traits estimated by pedigree
      analysis.
AB  - A maximum likelihood scoring technique for analysis of pedigree data, which
      allows for estimation of random effects (variance components) concurrently with
      other "fixed" effects in a quantitative trait, was applied to establish the
      effect of the fragile X condition in the variation of intellectual and physical
      traits. In 52 fragile X families, intellectual status was represented by measures
      of vocabulary knowledge (PPVT) and of nonverbal visuospatial skills (BDT), and
      physical status by a combined physical (anthropometric) score, and jaw length.
      The fixed effects included fragile X and sex and their interaction on the mean
      and covariances between relatives for the intellectual and physical scores. The
      random effects included environmental (common and individual) and genetic
      (additive and dominance) components. Different genetic models were tested by the
      likelihood ratio criterion, and the maximum likelihood parameters for each of the
      three scores were based on the most appropriate models. The effect of fragile X
      on the mean values was found to be significant for all the traits, and much more
      conspicuous in male than in female individuals, the effects in the PPVT and the
      anthropometric score being intercorrelated. The effect of fragile X on growth of
      a single physical trait relative to height was demonstrated using jaw length as
      an example. We have also demonstrated an effect of fragile X on genetic
      (additive) variance, as well as on the mean of the BDT score, and the effect of
      age on the nongenetic variance of PPVT, and jaw length.

PMID- 8357015
TI  - Pattern of cardiac malformation in oculoauriculovertebral spectrum.
AB  - The reported prevalence of congenital heart defects (CHD) in the
      oculoauriculovertebral "spectrum" (OAVS) is 5-58%. This variability is mainly due
      to differences in the diagnostic criteria used, and to ascertainment bias
      introduced by selection of patients from different specialty databases. Two
      thirds of the cardiac anomalies reported are either tetralogy of Fallot (TOF) or
      ventricular septal defect (VSD). We found a CHD frequency of 19% in a series of
      32 patients identified either through a genetic or autopsy database. The cardiac
      lesions were much more varied and complex than previously reported and included
      asplenia syndrome, ventricular inversion associated with double outlet right
      ventricle, pulmonary atresia with VSD, double outlet right ventricle, and
      infradiaphragmatic total anomalous pulmonary venous connection. Pulmonary and
      renal abnormalities were more common in OAVS patients with CHD than in those
      where the heart was normal.

PMID- 8357016
TI  - Causal study of isolated ulnar-fibular deficiency in Hungary, 1975-1984.
AB  - A population-based and validated data set of 114 cases with isolated ulnar
      fibular deficiency was evaluated in Hungary, 1975-1984. Ulnar-fibular type had
      the third most common birth prevalence (0.07 per 1000) among isolated congenital
      limb deficiency types. This type is relatively rarely associated with nonlimb
      defects, a single limb is affected in two-thirds of cases, nearly all other cases
      had femur-fibula-ulna (FFU) dysostosis. Upper and lower limbs, right and left
      sides, are equally affected, however, there is an obvious male excess (71%). Case
      control analysis indicated a lower birth weight due to intrauterine growth
      retardation, higher birth order, lower socioeconomic status of parents, and a
      more frequent reported subfertility. The family study identified one familial
      cluster (one siboccurrence) among 331 first-degree relatives.

PMID- 8357017
TI  - Confirmation of trisomy 22 in two cases using chromosome painting: comparison
      with t(11;22).
AB  - We present a nonmosaic case of trisomy 22 in a liveborn, abnormal infant and a
      second case of a fetus who died in utero. Both have been verified cytogenetically
      and confirmed by in situ hybridisation with a centromeric alphoid probe and
      chromosome painting. The accuracy of the combined cytogenetic and molecular
      cytogenetic approaches in the karyotype determination is highlighted by
      comparison with a case showing partial translocation of chromosome 22 in t(11;22)
      (q23;q11).

PMID- 8357018
TI  - Absence of chromosome fragility at 19q13.3 in patients with myotonic dystrophy.
AB  - Myotonic dystrophy (DM) is an autosomal dominant disorder characterized by a
      trinucleotide (AGC) amplification at 19q13.3. The degree of trinucleotide
      amplification may increase in successive generations and generally correlates
      with severity of the disorder. Because amplification of a trinucleotide repeat is
      also associated with the observation of a fra(X)(q27.3) in the fragile X
      syndrome, we investigated whether chromosome fragility at 19q13.3 might be
      inducible in patients with DM. Using 3 different culture stress systems (medium
      199, RPMI 1640 with excess TdR, and RPMI 1640 with FudR) and high resolution
      chromosome analyses, we studied 6 individuals with DM and 5 unaffected relatives
      representing two unrelated families. Molecular studies were done on two of the
      most affected patients and showed AGC repeat sequences of 970 and 1,260 at
      19q13.3. The normal range of AGC repeat is 5 to 30. We found no indication of
      fragility at 19q13.3 in any of these individuals.

PMID- 8357019
TI  - Newly recognized autosomal dominant disorder with craniosynostosis.
AB  - We report a family with a newly recognized form of autosomal dominant
      craniosynostosis. The disorder has high penetrance and variable expression with
      respect to sutural involvement and cranial abnormalities, ranging from fronto
      orbital recession to clover-leaf skull deformity. Associated problems included
      headache, poor vision, and seizures; intelligence, however, is normal. Assignment
      of a well-described syndromic designation, e.g., Crouzon, Pfeiffer, Saethre
      Chotzen, or Jackson-Weiss, is precluded based upon the absence of characteristic
      changes, i.e., midfacial hypoplasia, orbital hypertelorism, blepharoptosis, hand
      anomalies, or foot anomalies. The large size of this family and high penetrance
      of the disorder suggests that this may be an excellent candidate for positional
      cloning of a locus important in craniofacial development.

PMID- 8357020
TI  - Assessment of subcutaneous fat using ultrasonography in the Ullrich-Turner
      syndrome.
AB  - Subcutaneous fat was measured using an ultrasonic method (SF-US) in girls with
      Ullrich-Turner syndrome (UTS) and in height and weight-matched controls. The
      method is not influenced by changes in cutaneous compressibility, which is
      frequently abnormal in UTS especially at a younger age. SF-US in the arms was
      significantly less in UTS patients (ulnar SF-US: P < 0.05; triceps SF-US: P <
      0.005) than in the control girls. Results in suprailiac SF-US measurement was
      also similar (P < 0.05). Though the mean SF-US in the subscapular region was less
      in UTS patients than the control girls, there was no statistically significant
      difference. It is demonstrated that subcutaneous fat in UTS patients is less in
      their arms than in girls without UTS and that trunkal fatness is not increased
      but rather decreased in the UTS. The ratio of lean body mass to weight seems
      higher in UTS patients than in girls with similar weight and height.

PMID- 8357021
TI  - Kohlschutter-Tonz syndrome: epilepsy, dementia, and amelogenesis imperfecta.
AB  - Kohlschutter-Tonz syndrome is a central nervous system (CNS) degenerative disease
      with convulsions and mental regression in which the affected children present
      with yellow teeth due to defective enamel. We present a family in which 2
      affected children (a boy and a girl) were born to consanguineous parents. This
      report confirms the autosomal recessive inheritance of the disorder. The
      combination of a CNS and an enamel defect may represent pleiotropy or a
      contiguous gene syndrome.

PMID- 8357022
TI  - E. coli sepsis as a presenting sign in neonatal propionic acidemia.

PMID- 8357023
TI  - Discrepancy in mosaic findings between chorionic villi and amniocytes: a
      diagnostic dilemma involving 45,X, 46,XY, and 47,XYY cell lines.
AB  - Discrepancies between cytogenetic findings in chorionic villi (CV) and fetal
      tissue have been reported. Several embryogenic models have been proposed to
      explain such discrepancies. We describe a case in which analysis of the direct
      preparation showed 24% 45,X and 76% 46,XY, with 43% 45,X and 57% 46,XY cells in
      cultured villi. Amniocentesis results disclosed 97% 46,XY and 3% 47,XYY. No 45,X
      cells were found in cultured amniocytes. These findings suggest that
      nondisjunction occurred early in postzygotic cleavage resulting in 3 cell lines.
      It is postulated that through selection, the less viable 45,X cells died out
      among those destined to become fetus proper but persisted among the
      cytotrophoblast and extraembryonic mesoderm cells. While there is probably
      selection against all aneuploid cell lines, 47,XYY cells are more likely to
      survive in the fetus. An explanation for the lack of 47,XYY cells in the CV might
      be simply that the tissue sampled was not representative of the cytogenetic make
      up of the entire placenta.

PMID- 8357024
TI  - Monitoring for new multiple congenital anomalies in the search for human
      teratogens.
AB  - The ability of birth defects monitoring to detect new human teratogenic and
      mutagenic agents may be limited if only isolated defects are monitored.
      Surveillance for "new" multiple congenital anomalies (MCA) may improve the
      detection of environmental agents associated with new defect patterns. To
      evaluate the feasibility of such monitoring, we examined data from two programs:
      1) the Metropolitan Atlanta Congenital Defects Program (MACDP), which ascertains
      infants with serious defects diagnosed in the first year of life, and, 2) the
      Italian Multicenter Register for Congenital Malformations (IPIMC), which
      ascertains newborn infants with birth defects from many hospitals in Italy. We
      focused on 24 relatively serious defects and defect groups. For a baseline period
      (MACDP: 1968-1988, 581,000 births; IPIMC: 1986-1989, 448,000 births), we
      identified all possible combinations of defects occurring in the same baby. For a
      test period (MACDP: 1989-1990, 77,000 births; IPIMC: 1990, 91,500 births), we
      identified babies with "new" MCA (i.e., combinations of defects not observed
      before in the system). During this period in MACDP, of the 85 babies with two or
      more defects, 9 babies had new MCAs. In IPIMC, of the 54 babies with two or more
      defects, 10 babies had new MCAs. A review of the records of infants with new MCAs
      in MACDP and IPIMC did not identify commonalities in maternal characteristics.
      This analysis illustrates the feasibility of monitoring for new MCAs in
      surveillance systems. This approach, complemented by an evaluation of exposures,
      may be a powerful additional tool in searching for human teratogens and mutagens.

PMID- 8357025
TI  - Steinfeld syndrome: report of a second family and further delineation of a rare
      autosomal dominant disorder.
AB  - We report on a fetus with alobar holoprosencephaly, microphthalmia, midline cleft
      lip and palate, absent nose, dysplastic ears, radial defects, pentalogy of
      Fallot, unilateral renal aplasia, absent gallbladder, vertebral anomalies, and
      absence of ribs. The father had a cleft palate, bilateral colobomas of the iris
      and retina, a bifid uvula, vertebral anomalies, and unilateral congenital hearing
      loss. His sister had a cleft lip. On the basis of this family and the family
      reported by Steinfeld [1982], this malformation syndrome can be defined as a rare
      autosomal dominant syndrome whose main component manifestations are
      holoprosencephaly, predominantly radial limb deficiency, heart defects, kidney
      malformations, absence of gallbladder, and vertebral anomalies.

PMID- 8357026
TI  - Caroline Crachami, the Sicilian fairy: a further note.

PMID- 8357027
TI  - Exclusion of the neurofibromatosis 1 locus in a family with inherited cafe-au
      lait spots.
AB  - We have performed linkage analysis in a small family with autosomal dominant
      inheritance of multiple cafe-au-lait spots (CLS) in order to clarify its
      relationship to classical von Recklinghausen disease (NF 1). We found that an
      affected woman had transmitted a different haplotype for markers flanking the NF1
      gene to both of her affected daughters. These results exclude an allelic mutation
      of the NF 1 gene on chromosome 17 as the cause for inherited cafe-au-lait spots
      in this family.

PMID- 8357028
TI  - Cytomegalic type of congenital adrenal hypoplasia due to autosomal recessive
      inheritance.

PMID- 8357029
TI  - Another case of spondylocostal dysplasia and severe anomalies.

PMID- 8357030
TI  - Position statement on interphase in situ hybridization prenatal diagnosis. Report
      of the Southeastern Regional Genetics Group (SERGG).

PMID- 8357031
TI  - Presymptomatic DNA-testing for Huntington disease: pretest attitudes and
      expectations of applicants and their partners in the Dutch program.
AB  - We studied the baseline attitudes, prior to testing, of 70 applicants at risk for
      Huntington disease (HD) and their partners in the Dutch presymptomatic DNA
      testing program. Two thirds of the applicants were female; 36% already had
      children. The main reason (60%) for undertaking the test was for family planning.
      Other reasons were either to reduce uncertainty (43%) or to obtain certainty
      (38%). Partners of applicants stated that planning for the future was for them
      the most important reason (76%). Significantly more at-risk females (42%) than
      males (16%) anticipated an unfavorable test outcome. Quite remarkably, most
      applicants and partners denied that a positive result might have adverse effects
      on either personal mood, quality of life, or marriage. Only a few did not expect
      that a favorable result would induce relief. The eventual outcome of the test was
      expected to enable applicants to gain control over their future, whatever the
      results. Hence, we propose that the applicants form a self-selected group, based
      on their expectation that they will not be emotionally affected by either result.

PMID- 8357032
TI  - Legal and ethical issues in psychiatric genetic research.
AB  - Genetic research may uncover the causes of severe mental disorders, and many
      projects have been undertaken to locate the genes responsible for schizophrenia,
      bipolar disorder, and Alzheimer disease. A number of sensitive legal and ethical
      issues have been raised, including 1) protection of confidential data concerning
      research subjects; 2) the assessment of types and degree of risk to subjects who
      participate in such studies; 3) the legal and ethical acceptability of
      substituted judgement on behalf of patients who may not be competent to provide
      informed consent; and 4) the separation of research and clinical roles in areas
      such as genetic counseling. Federal regulations and other guidelines are of
      limited value in dealing with such concerns, and many important human subjects
      issues will need to be dealt with by the investigator, subject to approval by a
      local Institutional Review Board. There does seem to be general agreement that
      informed consent must be obtained, potential risks of research need to be
      minimized, and confidentiality of sensitive data must be protected.

PMID- 8357033
TI  - Do genes influence exposure to trauma? A twin study of combat.
AB  - Data from 4,029 male-male twin pairs who served in the United States military
      during the Vietnam era (1965-1975) were used to examine genetic and non-genetic
      factors that influence wartime exposure to traumatic events. Specific events
      examined were volunteering for service in Vietnam, actual service in Southeast
      Asia, a composite index of 18 combat experiences, and information from military
      records about being awarded combat decorations. Correlations within monozygotic
      (MZ) and dizygotic (DZ) twin pairs for volunteering for service in Vietnam were
      0.40 and 0.22, respectively. For actually serving in Southeast Asia, the MZ
      correlation was 0.41 and the DZ correlation was 0.24. Analysis of twin pairs in
      which both siblings served in Southeast Asia (n = 820) demonstrated a correlation
      for self-reported combat experiences within MZ and DZ pairs of 0.53 and 0.30,
      respectively. Heritability estimates ranged from 35 to 47%. The family
      environment did not have a significant effect on any of the variables. Analyses
      of data from military records regarding being awarded a combat decoration
      provided very similar results to those found for self-reported combat
      experiences.

PMID- 8357034
TI  - Novel association approach for determining the genetic predisposition to
      schizophrenia: case-control resource and testing of a candidate gene.
AB  - We have developed a two-tiered approach to elucidating the genetic predisposition
      to schizophrenia. The approach first involves the examination of candidate genes
      in a subset of schizophrenic individuals to identify DNA sequence variations of
      likely functional significance, i.e., that produce either structural alterations
      in the protein or affect the level of gene expression. Once identified, the
      prevalence of the aberrant allele is examined in a large group of unrelated
      schizophrenic cases and controls to assess whether a true disease association
      exists. Herein, we describe the establishment of a DNA bank on nearly 200
      unrelated schizophrenic cases defined by DSM-III-R criteria and on over 300
      unrelated, ethnically similar controls. Characteristics of the study sample are
      described. The study approach then is illustrated by testing known mutations in
      the phenylalanine hydroxylase gene, responsible for the autosomal recessive
      disease of phenylketonuria, in the case-control sample to determine if
      carriership of a mutant allele is associated with an increased risk of
      schizophrenia. Using PCR amplification of specific alleles (PASA), we screened
      190 schizophrenic cases and 336 controls for two common point mutations in the
      phenylalanine hydroxylase gene. Two carriers were found among the controls, while
      none of the cases was shown to carry a mutant allele. Thus, carriership of either
      of two common mutations in the phenylalanine hydroxylase gene does not appear to
      be associated with an increased risk of schizophrenia. As additional candidate
      genes are tested in this case-control resource, adjustment for multiple
      comparisons will become crucial in order to reduce the chance of false positive
      findings.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357035
TI  - Schizophrenia: genetics and the maternal immune response to viral infection.
AB  - Thirty years ago, Eliot Slater suggested that the reason schizophrenia was not
      progressively eliminated from the population was that the responsible gene also
      conveyed a compensatory advantage in terms of increased resistance to infection.
      If this selective advantage lies in the antibody response to certain viral
      infections, this could explain recent studies suggesting that exposure to
      influenza in the second trimester of gestation increases the risk of later
      schizophrenia. We propose that prenatal exposure to influenza induces maternal
      antibodies which then cross-react with proteins in the developing foetal brain,
      becoming foetal autoantibodies. Thus an immunogenetic response by the mother
      results in aberrant foetal neurodevelopment, the biological substrate for a
      proportion of adult schizophrenia. Initial research strategies to test this
      hypothesis are proposed.

PMID- 8357036
TI  - Usefulness of twin studies for exploring the etiology of childhood and adolescent
      psychiatric disorders.
AB  - It is estimated that approximately 12% of the individuals under the age of 18 in
      the United States have a diagnosable mental illness [Institute of Medicine,
      1989]; however, only a minority of the etiological research in psychopathology
      focuses on disorders with childhood onset. The present report demonstrates the
      usefulness of twin studies in exploring the etiology of childhood and adolescent
      psychiatric psychopathology and reviews the design, methodology, and results from
      traditional twin studies of various behavioral disorders. Alternative twin
      designs are also reviewed in an effort to address the future direction of twin
      studies in the area of childhood and adolescent psychopathology and to illustrate
      that twin data have much more to offer the field of psychopathology than merely
      an initial test to rule in or to rule out a significant genetic contribution to
      the development of such behaviors.

PMID- 8357037
TI  - Agenesis of the corpus callosum with mental retardation and osseous lesions.
AB  - We report on a patient with agenesis of corpus callosum, mental retardation, and
      unusual hitherto undescribed bone changes. The latter include multiple Wormian
      bones, thin ribs, short, straight, laterally tapering clavicles, small iliac
      bodies, high iliac angles, triangular areas of sclerosis in the iliac bones,
      minimal metaphyseal irregularity, striated trabecular pattern in some metaphyses,
      granular ossification pattern of the patellae, hypoplastic distal phalanges,
      minimal flatness of phalangeal epiphyses, and retarded bone age. This patient
      represents a new mental retardation syndrome with agenesis of corpus callosum and
      unusual bone changes.

PMID- 8357038
TI  - DSM-III-R personality disorders in parents of schizophrenic patients.
AB  - This study examines the frequency of DSM-III-R personality disorders in parents
      of 58 patients who were admitted consecutively to a New York State psychiatric
      hospital with a first admission for a schizophrenia-like psychosis. For
      comparison, a control group of 65 families were randomly recruited who were in
      the same age group and denied any psychiatric history in their immediate
      families. Significantly more parents of the patients had a diagnosed personality
      disorder than controls. These were classified as schizoid, schizotypal,
      histrionic, and sadistic types by DSM-III-R criteria. While paranoid personality
      disorder was frequent, it was equally distributed among both groups of parents.
      These data suggest that the genetic boundaries to a "schizophrenia spectrum"
      disorder may extend further than previously thought and particularly the specific
      characteristics that are common to a wide variety of these disorders need to be
      examined in further analyses.

PMID- 8357039
TI  - Linkage of familial Alzheimer disease to chromosome 14 in two large early-onset
      pedigrees: effects of marker allele frequencies on lod scores.
AB  - Alzheimer disease (AD) is a devastating neurodegenerative disease leading to
      global dementia. In addition to sporadic forms of AD, familial forms (FAD) have
      been recognized. Mutations in the amyloid precursor protein (APP) gene on
      chromosome (CHR) 21 have been shown to cause early-onset AD in a small number of
      pedigrees. Recently, linkage to markers on CHR 14 has been established in several
      early-onset FAD pedigrees. We now report lod scores for CHR 14 markers in two
      large early-onset FAD pedigrees. Pairwise linkage analysis suggested that in
      these pedigrees the mutation is tightly linked to the loci D14S43 and D14S53.
      However, assumptions regarding marker allele frequencies had a major and often
      unpredictable effect on calculated lod scores. Therefore, caution needs to be
      exercised when single pedigrees are analyzed with marker allele frequencies
      determined from the literature or from a pool of spouses.

PMID- 8357041
TI  - Bacterial Vaginosis. Conference proceedings. Seattle, Washington, August 8, 1990.

PMID- 8357040
TI  - History and review of bacterial vaginosis.
AB  - OBJECTIVES: Review publications that significantly impacted on the knowledge of
      bacterial vaginosis. STUDY DESIGN: Assessment of information on the epidemiology,
      bacteriology, and pathology of bacterial vaginosis. RESULTS: Bacterial vaginosis
      has a complex microbiology. Further information is required on the epidemiology.
      The large increase in the concentration of vaginal bacteria among patients with
      bacterial vaginosis is associated with postpartum and postsurgical infections and
      with preterm delivery. CONCLUSIONS: Bacterial vaginosis is the most important
      vaginal infection because of its potential to cause upper genital tract infection
      in specific settings.

PMID- 8357042
TI  - Epidemiology of bacterial vaginosis.
AB  - Studies of the prevalence of and risk factors for bacterial vaginosis are flawed
      by imprecision in diagnosis, failure to study large and well-characterized
      populations, selection bias, and failure to correct for confounding variables.
      Prevalences range from 5% for women without any symptoms to 25% for those with
      gynecologic symptoms. Although bacterial vaginosis is associated with nonwhite
      race and intrauterine contraceptive device use, these may represent surrogate
      markers for other presently unappreciated risk factors.

PMID- 8357043
TI  - The microbiology of bacterial vaginosis.
AB  - A group of microorganisms are present concurrently in high concentrations in the
      vaginas of women with bacterial vaginosis. The major members of the group are
      Gardnerella vaginalis, anaerobic gram-negative rods belonging to the genera
      Prevotella, Porphyromonas and Bacteroides, Peptostreptococcus species, Mycoplasma
      hominis, Ureaplasma urealyticum, and often Mobiluncus species. Facultative
      species of Lactobacillus are present in lower concentrations and are less
      prevalent in bacterial vaginosis than in women with a normal vaginal examination.
      The exact microbe(s) responsible for bacterial vaginosis is unknown whether among
      the organisms listed above or an unknown agent. The high concentrations of
      anaerobic gram-negative rods, peptostreptococci, and other opportunistic
      pathogens in the lower genital tract place women with bacterial vaginosis at
      increased risk for genital infections and adverse pregnancy outcomes.

PMID- 8357044
TI  - Diagnostic microbiology of bacterial vaginosis.
AB  - Bacterial vaginosis is characterized microbiologically by replacement of the
      Lactobacillus-predominant vaginal flora by Gardnerella vaginalis, Bacteroides
      species, Mobiluncus species, and genital mycoplasmas. A standardized, laboratory
      based diagnostic test for bacterial vaginosis is desirable in those instances in
      which a microscope is unavailable in the clinic or when the evaluator of the wet
      mount examination is inexperienced at recognizing clue cells. Vaginal cultures
      have excellent sensitivity for the diagnosis of bacterial vaginosis, but because
      the predictive value of a positive G. vaginalis culture is less than 50%,
      cultures are not recommended. Vaginal Gram smears are objective and reproducible,
      have 62% to 100% sensitivity, and have a positive predictive value of 76% to
      100%. Diagnosis of bacterial vaginosis with use of Papanicolaou-stained smears
      has been reported, but standardized criteria have not been widely adopted. A
      rapid, office-based oligonucleotide probe test for high concentrations of G.
      vaginalis has been developed and may be useful when direct microscopy is
      unavailable or confidence in microscopic examination is low. Laboratory tests
      that detect microbial products unique to the vaginal fluid of women with
      bacterial vaginosis include detection of amines (putrescine, cadaverine, and
      trimethylamine), measurement of the relative levels of succinate and lactate in
      the vaginal fluid by gas chromatography, detection of proline aminopeptidase by
      colorimetric assay, or detection of sialidases in the vaginal fluid. Although
      these tests are not yet applicable to routine use, these research tests could be
      adapted for wider use in office laboratories. Vaginal Gram stains are more useful
      than culture for laboratory confirmation of bacterial vaginosis.

PMID- 8357045
TI  - Chorioamnionitis and bacterial vaginosis.
AB  - An improved understanding of bacterial vaginosis and of clinical intraamniotic
      infection and histologic chorioamnionitis has produced data showing strong
      associations among these conditions. It has recently been shown that the
      microorganisms in both bacterial vaginosis and clinical intraamniotic infection
      are similar, of which anaerobes, Gardnerella vaginalis, and Mycoplasma hominis
      are the predominant organisms in both. Furthermore, in the amniotic fluid of
      women with intraamniotic infection, strong associations among anaerobes, G.
      vaginalis, and M. hominis have recently been observed. In two epidemiologic
      studies (one in a high-risk group of women in labor and another in a lower risk
      group of antepartum women), the presence of bacterial vaginosis has been
      associated with the development of intraamniotic infection. Additional recent
      studies have provided new evidence that histologic inflammation of the placental
      membranes is associated with both clinical intraamniotic infection and positive
      cultures of the placenta. Multiple logistic regression analysis has shown a
      relationship between isolation of organisms from the chorioamnion and bacterial
      vaginosis.

PMID- 8357046
TI  - Premature rupture of membranes and bacterial vaginosis.
AB  - OBJECTIVE: Critically review obstetric, epidemiologic, microbiologic, and
      pathophysiologic information regarding the possible casual associations of
      bacterial vaginosis with premature rupture of membranes. METHODS: Observational
      and experimental studies are reviewed and correlated with in vitro and clinical,
      microbiologic, and pathophysiologic experiments in an effort to define possibly
      casual relationships with bacterial vaginosis and premature rupture of membranes
      and its maternal and perinatal sequelae. RESULTS: Considerable information shows
      that bacterial vaginosis, a common vaginal microbe-associated condition of
      reproductive age women, can be strongly (risk ratios up to 7.3, confidence
      interval 95%, 1.8 to 29.4) associated with preterm premature rupture of membranes
      as well as preterm labor and birth. Microorganisms of bacterial vaginosis produce
      factors including proteases (IgAse, collagenase, etc.) that can facilitate
      transport of bacteria to fetal membranes and impair fetal membrane integrity in
      experimental models. CONCLUSIONS: Controlled investigations are required to
      evaluate if treatment of bacterial vaginosis is associated with reduction of
      premature rupture of membranes and preterm birth.

PMID- 8357047
TI  - Bacterial vaginosis and postoperative infections.
AB  - Postoperative infections are common complications of obstetric and gynecologic
      surgery. The pathophysiology of both postcesarean endometritis and postoperative
      cuff cellulitis involves the ascending spread of potentially pathogenic
      microorganisms found in the vagina. Bacterial vaginosis is associated with
      increased vaginal concentrations of certain anaerobic and facultative bacteria.
      Bacterial vaginosis appears to be a risk factor for the development of
      postoperative infections in obstetrics and gynecology.

PMID- 8357048
TI  - Vaginal flora and pelvic inflammatory disease.
AB  - Forty-one patients with acute pelvic inflammatory disease were evaluated for the
      coexistence of bacterial vaginosis. Because all patients had a copious purulent
      vaginal discharge, microscopic criteria could not be used and microbiologic
      criteria were employed. The vaginal bacterial flora were not consistent with that
      of bacterial vaginosis, because Lactobacillus and other gram-positive bacteria
      dominated with colony counts of 10(3) to 10(5) cfu/ml (colony-forming units per
      milliliter). Endocervical specimens yielded Neisseria gonorrhoeae from 20
      patients and Chlamydia trachomatis from 11 patients. Anaerobes were not dominant
      in any site sampled. A total of 147 bacteria were isolated from the endometrium,
      16 (11%) of which were anaerobes. Thus the endogenous bacterial flora were not
      consistent with that of the microbiologic definition of bacterial vaginosis. N.
      gonorrhoeae was the most common isolate from the endocervix and endometrium; it
      was isolated three times more frequently from the endocervix and two times more
      frequently from the endometrium than was C. trachomatis.

PMID- 8357049
TI  - Historical review of the treatment of bacterial vaginosis.
AB  - The review of the treatment of bacterial vaginosis parallels the history of this
      syndrome. Before the syndrome was defined, treatment was local and nonspecific.
      Gardner and Dukes defined nonspecific vaginitis in 1955 as an infection caused by
      Haemophilus vaginalis. Therapy was directed toward this aerobic "pathogen" and
      included oral tetracycline and a triple sulfa vaginal cream. Subsequent studies
      indicated success with this regimen as well as with ampicillin, a drug with good
      aerobic activity. Since 1977, studies have shown the importance of anaerobes in
      this clinical syndrome. Both metronidazole and clindamycin have been found to
      have clinical success. The clinical definition of the disease makes evaluation of
      treatment difficult, because it includes women without symptoms.

PMID- 8357050
TI  - New approaches for the treatment of bacterial vaginosis.
AB  - OBJECTIVE: Review alternative approaches to oral metronidazole for the treatment
      of bacterial vaginosis. STUDY DESIGN: Assessment of clinical trials on the
      treatment of bacterial vaginosis with regimens other than 5 to 7 days of
      metronidazole. RESULTS: Single-dose metronidazole, 2 gm orally, is as effective
      as 5- to 7-day courses of oral metronidazole, with cure rates in the 80% to 90%
      range. Oral clindamycin results in more than a 90% clinical cure rate.
      Intravaginal clindamycin cream 2% and intravaginal metronidazole gel 0.75% are
      associated with clinical cure rates similar to those for oral metronidazole.
      CONCLUSIONS: Single-dose metronidazole, oral clindamycin, intravaginal
      clindamycin cream, and intravaginal metronidazole gel are effective and safe
      alternatives to a 5- to 7-day course of oral metronidazole for the treatment of
      bacterial vaginosis.

PMID- 8357051
TI  - Effect of the vitreous on the prognosis of full-thickness idiopathic macular
      hole.
AB  - We studied 112 eyes with full-thickness idiopathic macular holes (mean follow-up
      period, 5.7 years) to ascertain the effect of the vitreous on prognosis. Eyes
      were divided as follows: group 1, 58 eyes with no posterior vitreous detachment;
      group 2, 25 eyes with no posterior vitreous detachment initially and development
      of complete posterior vitreous detachment during follow-up; and group 3, 29 eyes
      with complete posterior vitreous detachment. In group 1, the macular hole
      enlarged in 37 eyes (64%), and the surrounding retinal detachment enlarged in 29
      (50%); visual acuity decreased in 20 eyes (34%) by two or more Snellen lines.
      These percentages were significantly higher than in group 3 (14%, 10%, and 10%; P
      = .01, P = .01, and P = .03, respectively). Eyes with a full-thickness macular
      hole with no posterior vitreous detachment may have a greater risk of enlargement
      of the macular hole and surrounding retinal detachment, and thus a worse
      prognosis than eyes with posterior vitreous detachment.

PMID- 8357053
TI  - Association of herpes zoster ophthalmicus with acquired immunodeficiency syndrome
      and acute retinal necrosis.
AB  - We conducted a review to investigate the prevalence of human immunodeficiency
      virus (HIV), or acquired immunodeficiency syndrome (AIDS), in patients with
      herpes zoster ophthalmicus, as well as the incidence of acute retinal necrosis
      after herpes zoster ophthalmicus. All charts of patients seen at our institution
      between 1987 and 1992 with a primary diagnosis of herpes zoster ophthalmicus were
      reviewed. Of 112 patients with herpes zoster ophthalmicus, 29 (26%) had HIV or
      AIDS. All these patients were younger than 50 years at the time of diagnosis.
      Five of 29 (17%) immunocompromised patients had acute retinal necrosis after
      herpes zoster ophthalmicus. No acute retinal necrosis was identified in the
      nonimmunocompromised patients after herpes zoster ophthalmicus. We recommend that
      all patients younger than 50 years who have herpes zoster ophthalmicus at initial
      examination be tested for HIV. Additionally, HIV-infected patients should be
      monitored closely after herpes zoster ophthalmicus for development of acute
      retinal necrosis. Long-term oral prophylactic as well as initial high-dose
      intravenous acyclovir may be appropriate in HIV-infected individuals with herpes
      zoster.

PMID- 8357052
TI  - Risk factors for branch retinal vein occlusion. The Eye Disease Case-control
      Study Group.
AB  - The objective of our clinic-based case-control study was to identify risk factors
      for branch retinal vein occlusion. Between 1986 and 1990 data were obtained at
      five clinical centers from 270 patients with branch retinal vein occlusion and
      1,142 controls. Data were collected from interviews, clinical examinations, and
      laboratory analyses of blood specimens. An increased risk of branch retinal vein
      occlusion was found in persons with a history of systemic hypertension, a history
      of cardiovascular disease, an increased body mass index at 20 years of age, a
      history of glaucoma, and higher serum levels of alpha 2-globulin. Risk of branch
      retinal vein occlusion decreased with higher levels of alcohol consumption and
      high-density lipoprotein cholesterol. The data suggest a cardiovascular risk
      profile for patients with branch retinal vein occlusion and indicate that 50% of
      patients with branch retinal vein occlusion may be attributable to hypertension.
      Our findings support current public health recommendations to diagnose and treat
      hypertension, reduce weight, increase physical activity, and maximize serum high
      density lipoprotein levels.

PMID- 8357054
TI  - Giant retinal pigment epithelial tears in acute retinal necrosis.
AB  - We observed large peripheral tears of the retinal pigment epithelium in two
      patients, a 59-year-old man and a 15-year-old girl, who had acute retinal
      necrosis. These tears ranged from 90 to 180 degrees of the circumference of the
      peripheral retinal pigment epithelium and occurred in areas of previous retinal
      viral infection. Both patients had curled folds of tissue at the posterior edge
      of the retinal pigment epithelial tear. During vitrectomy at the time of fluid
      air exchange, we noted the edge of these tears to sag posteriorly. Because of the
      area that was denuded of retinal pigment epithelium by the tears, we selected a
      more posterior location for argon laser endophotocoagulation in both patients.
      These large retinal pigment epithelial tears did not appear to have an adverse
      effect on the outcome of surgical treatment of the retinal detachments.

PMID- 8357055
TI  - A double-masked comparison of betaxolol and dipivefrin for the treatment of
      increased intraocular pressure.
AB  - Noncardioselective beta-adrenoceptor antagonists are used for treatment of
      increased intraocular pressure. Because these agents may be absorbed
      systemically, their use is of concern in patients with restricted pulmonary
      function. We compared the efficacy of betaxolol, a cardioselective beta
      adrenoceptor antagonist, and dipivefrin, an alpha/beta-adrenergic agonist.
      Seventy-six patients with open-angle glaucoma or ocular hypertension were
      randomly assigned to receive either betaxolol 0.5% or dipivefrin 0.1%. Patients
      were examined at two weeks, one month, two months, and three months. Intraocular
      pressure reductions were similar, with a mean decrease of 4.1 mm Hg in the
      betaxolol group and 3.5 mm Hg in the dipivefrin group. Both treatments caused
      similar minor increases in heart rate, typical with alpha-adrenergic agonists but
      atypical with beta-blockers. Stinging or burning in the betaxolol group was
      significantly (P = .008) greater than in the dipivefrin group. Our findings
      suggest that betaxolol and dipivefrin therapy are effective, equivalent ocular
      hypotensive agents.

PMID- 8357056
TI  - Ocular hypotony after trabeculectomy with mitomycin C.
AB  - Because mitomycin C reduces the resistance to aqueous outflow normally provided
      by postoperative subconjunctival fibrosis, we would expect to see more frequent
      hypotony after trabeculectomy with mitomycin C than after standard
      trabeculectomy. To evaluate the incidence of hypotony in trabeculectomy with
      intraoperative mitomycin C use, we performed a retrospective analysis on 52 eyes
      of 48 patients who underwent trabeculectomy with mitomycin C. Mitomycin C
      concentration was 0.4 mg/ml in all eyes, and treatment time ranged from 3 1/2 to
      seven minutes. We defined hypotony as intraocular pressure lower than 5 mm Hg on
      two examinations at least four weeks apart and six weeks or more postoperatively.
      Overall, average intraocular pressure was 22.7 +/- 10.7 mm Hg preoperatively and
      10.4 +/- 5.0 mm Hg postoperatively (P < .001), a mean reduction in intraocular
      pressure of 12.3 +/- 11.5 mm Hg (47.0%). Hypotony occurred in 17 of 52 eyes
      (32.7%). Seven eyes required trabeculectomy revision for hypotony. Hypotonous
      eyes received longer treatment with mitomycin C intraoperatively, with a mean
      application time of 5.3 +/- 1.0 minutes for hypotonous eyes and 4.7 +/- 0.8
      minutes for nonhypotonous eyes (P = .03). Sixteen of 43 eyes (37.2%) undergoing
      primary filtration became hypotonous, as compared to one of nine (11.1%) eyes
      that had previous filtering procedures (chi 2 = 2.30, P = .13). Nine of 17
      hypotonous eyes (52.7%) and five of 35 nonhypotonous eyes (14.3%) had loss of two
      or more lines of Snellen visual acuity. Hypotony occurred in nearly one third of
      eyes treated with mitomycin C during trabeculectomy in our study. There was a
      statistically significant (P = .03) association of hypotony with longer
      application time of mitomycin C, and a trend toward increased incidence of
      hypotony in primary filtration.

PMID- 8357057
TI  - Treatment and prognosis of secondary glaucoma in Fuchs' heterochromic
      iridocyclitis.
AB  - After reviewing the records of 111 patients with Fuchs' heterochromic
      iridocyclitis, we studied the therapy and prognosis of secondary glaucoma in 30
      of these 111 patients (27%) who had glaucoma or could be considered glaucoma
      suspects. Maximal medical therapy was unsuccessful in 22 of the 30 patients
      (73%). Surgical intervention (mostly trabeculectomies, half with 5-fluorouracil)
      successfully controlled intraocular pressure (< or = 21 mm Hg with or without
      medication) in 13 of the 18 operated-on patients (72%) after a mean follow-up of
      26 months. All successfully operated-on patients retained a visual acuity of
      20/80 or better. We had favorable results, possibly because of modern surgical
      techniques (use of 5-fluorouracil, sodium hyaluronate) or earlier surgical
      intervention, or both.

PMID- 8357058
TI  - An ultrasound biomicroscopic analysis of angle-closure glaucoma secondary to
      ciliochoroidal effusion in IgA nephropathy.
AB  - Immunoglobulin A nephropathy is a common glomerulonephritis of unknown cause.
      Episcleritis, scleritis, anterior uveitis, and keratoconjunctivitis sicca have
      been associated with this disease. We diagnosed angle-closure glaucoma secondary
      to ciliochoroidal effusion in a patient with IgA nephropathy confirmed by biopsy.
      High-frequency ultrasound biomicroscopy was used to determine internal
      relationships of angle structures and to follow changes with treatment.
      Supraciliary effusion undetected by B-scan ultrasound and retinal examination was
      easily imaged by ultrasound biomicroscopy. Glaucoma mechanisms included forward
      rotation of the ciliary processes, which caused direct angle closure in a manner
      similar to plateau iris. Ultrasound biomicroscopy showed that cycloplegia
      improved this mechanism by retracting the ciliary processes, but angle closure
      secondary to forward iris bowing from pupil block remained. Iridectomy was
      performed and immediately opened the angle. Ultrasound biomicroscopy proved a
      useful method of defining mechanisms and a helpful guide to treatment in this
      type of glaucoma.

PMID- 8357059
TI  - Postoperative endophthalmitis resulting from prosthesis contamination in a
      monocular patient.
AB  - Monocular patients who wear an ocular prosthesis may harbor pathogenic
      conjunctival flora both in the socket and in the contralateral eye. They may
      therefore be at increased risk of developing endophthalmitis after intraocular
      procedures. We studied a monocular, prosthesis-wearing, 86-year-old man who
      underwent cataract extraction, subtotal transpupillary vitrectomy, and
      intraocular lens insertion. Fulminant endophthalmitis ensued postoperatively, and
      despite complete vitrectomy and administration of intraocular antibiotics, the
      eye lost light perception. Intravitreal as well as conjunctival cultures
      bilaterally grew Proteus mirabilis. The patient disclosed that he cleaned the
      prosthesis frequently because of discharge. We considered an association between
      this bacterial colonization and the risk of developing postoperative
      endophthalmitis and suggest prophylactic measures for treatment of monocular
      patients undergoing intraocular procedures.

PMID- 8357061
TI  - Anophthalmic socket pain.
AB  - We examined and treated four patients with anophthalmic socket pain. Conditions
      responsible for this problem in this series included scleritis after
      evisceration, amputation neuroma, pain from a skull-base meningioma, and chemical
      dependency with drug-seeking behavior. The pain associated with the scleritis
      after evisceration responded to removal of the scleral remnant. The pain
      associated with the amputation neuroma responded to removal of the orbital
      implant and its pseudocapsule in which the amputation neuroma was embedded. The
      pain associated with the meningioma was intractable. The pain associated with the
      chemical dependency remained a persistent problem. A careful history and physical
      examination are critical in the evaluation of anophthalmic socket pain. Computed
      tomography or magnetic resonance imaging may be helpful in some cases.

PMID- 8357060
TI  - Corneal iron lines associated with the intrastromal corneal ring.
AB  - Corneal epithelial iron lines commonly occur, and their shape is
      characteristically influenced by the underlying corneal surface topography. We
      studied a pattern of iron deposition, observed after implantation of the
      Intrastromal Corneal Ring (KeraVision, Inc., Santa Clara, California). In five of
      ten patients undergoing placement of the Intrastromal Corneal Ring, an arcuate
      pattern of epithelial iron deposition was observed eight to 12 months
      postoperatively. There was no significant clinical or topographic difference over
      time among the corneas of patients who developed an iron line vs those who did
      not. Of the five patients with an arcuate epithelial iron line, three underwent
      explantation of their Intrastromal Corneal Ring at 12 months according to the
      study protocol. Iron deposition either reverted to a Hudson-Stahli pattern or
      disappeared in each of these three patients.

PMID- 8357062
TI  - The effect of optical defocus on the pattern electroretinogram in normal subjects
      and patients with Alzheimer's disease.
AB  - The pattern electroretinogram, thought to originate from the spatially sensitive
      inner retinal layers, was recorded in 16 patients with Alzheimer's disease and 16
      age- and gender-matched control subjects under the following two test conditions:
      (1) optical defocus or inattention, without laser pointer, and (2) optical focus
      or attention, with laser pointer. By correcting for optical defocus with the
      laser pointer, control subjects increased their pattern electroretinogram
      amplitudes by 8% from a mean value of 2.65 microV (standard deviation, 1.12) to
      2.87 microV (standard deviation, 0.93), whereas patients with Alzheimer's disease
      had a 19% increase in pattern electroretinogram amplitude from 2.20 microV
      (standard deviation, 0.86) to 2.62 microV (standard deviation, 0.64). By
      controlling for optical defocus, the coefficient of variation (standard
      deviation/mean) was reduced by 10% (from 42% to 32%) in normal subjects and by
      14% (from 39% to 25%) in patients with Alzheimer's disease. A two-way analysis of
      variance (ANOVA) did not show a significant difference in amplitudes between
      populations, which indicates that the pattern electroretinogram may not be
      valuable in establishing an early diagnosis of Alzheimer's disease. In a second
      study conducted in 20 young, healthy normal subjects, plus lenses were used to
      defocus the checkerboard stimuli, before recording the pattern electroretinogram.
      We found that the pattern electroretinogram was extremely sensitive to optical
      defocusing such that the response amplitude decreased by 13% at 20/25 visual
      acuity and 19% at 20/30. Reduction of pattern electroretinogram amplitude caused
      by change in visual acuity is an independent source of artifact.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8357063
TI  - Laser weapons designed to produce blindness.

PMID- 8357064
TI  - Retinopathy associated with low-dose tamoxifen.

PMID- 8357065
TI  - The prevalence of retinitis pigmentosa and congenital stationary night blindness
      in Israel.

PMID- 8357066
TI  - Symptomatic intraocular reflections from oval intraocular lens implants.

PMID- 8357067
TI  - Intracorneal hemorrhage with acute glaucoma.

PMID- 8357068
TI  - Application of mitomycin C during filtering surgery.

PMID- 8357069
TI  - Substitution of acetohexamide for acetazolamide.

PMID- 8357070
TI  - Microsporidal keratoconjunctivitis.

PMID- 8357071
TI  - Tarantula hair ophthalmia nodosa.

PMID- 8357073
TI  - Spontaneous orbital hemorrhage in a child with autoimmune hepatitis.

PMID- 8357072
TI  - Rosai-Dorfman disease involving four eyelids.

PMID- 8357074
TI  - Peripunctal eyelid oncocytoma.

PMID- 8357075
TI  - Paresis of the abducens nerve after trivial head injury.

PMID- 8357076
TI  - New challenges for tropical medicine.

PMID- 8357077
TI  - Three simple devices for preventing development of Aedes aegypti larvae in water
      jars.
AB  - We developed three types of covers that are easily fabricated from plastic screen
      locally manufactured in Thailand. The covers were designed to permit normal use
      of water jars for drinking, utility water uses, and water storage. Tests of the
      covers in the laboratory and field demonstrated that they could completely
      prevent successful development of Aedes aegypti (L.) in water jars. Initial
      experience in a village setting demonstrated that these devices were readily
      manufactured and used in a community-based program. Village residents adapted the
      covers to local patterns of water use, collecting rainwater through the screen
      and adjusting cover use to water depth.

PMID- 8357078
TI  - Humoral immune responses in volunteers immunized with irradiated Plasmodium
      falciparum sporozoites.
AB  - Volunteers immunized with gamma-irradiated Plasmodium falciparum sporozoites
      serve as the gold standard for protective immunity against mosquito-borne malaria
      transmission and provide a relevant model for studying protective immune effector
      mechanisms. During a 7-12 month period, we immunized four volunteers via the
      bites of irradiated, infected mosquitoes. Following these exposures to attenuated
      sporozoites, all four volunteers developed antibodies to sporozoites as measured
      by an immunofluorescence assay and by an enzyme-linked immunosorbent assay using
      the circumsporozoite (CS) protein repeat-based molecule R32LR as capture antigen.
      Three volunteers also developed antibodies against the nonrepeating (flanking)
      regions of the CS protein; the level of these antibodies paralleled the serum
      activity to inhibit sporozoite invasion of hepatoma cells in vitro. These three
      volunteers were protected against malaria transmitted by the bites of five
      infected mosquitoes. Two of these protected volunteers received additional
      immunizing doses of irradiated sporozoites and were subsequently protected
      against challenge with a heterologous P. falciparum clone. No detectable
      fluctuations were observed in circulating levels of tumor necrosis factor,
      interferon-gamma, or interleukin-6 during the course of this study. Analysis of
      the humoral and cellular immune responses of these protected volunteers is
      expected to yield important clues to additional targets of immunity against the
      pre-erythrocytic stages of malaria parasites.

PMID- 8357079
TI  - Effects of ingested human anti-sporozoite sera on Plasmodium falciparum sporogony
      in Anopheles stephensi.
AB  - We investigated the effects of human anti-sporozoite antibodies on the sporogonic
      development of Plasmodium falciparum in Anopheles stephensi. Equal volumes of
      washed human erythrocytes and human sera from 1) volunteers with protective
      immunity induced by immunization with irradiated P. falciparum sporozoites, 2)
      the same volunteers before immunization, or 3) Kenyans exposed to natural
      sporozoite transmission, were fed to cohorts of P. falciparum-infected A.
      stephensi on either day 5, 8, or 11 after infection. A fourth group of infected
      mosquitoes from the same cohort were not refed. In two experiments, the effects
      of anti-sporozoite antibodies were evaluated by determining the infection rates
      and parasite densities for oocysts and salivary gland sporozoites. There was no
      evidence that anti-sporozoite antibodies had any effect on the development or
      intensity of P. falciparum infection in A. stephensi. However, accelerated oocyst
      maturation was associated with mosquitoes taking a second blood meal, independent
      of serum source. Salivary gland sporozoites from mosquitoes that fed on immune
      human sera contained bound human IgG, which was detectable by indirect
      immunofluorescence assay. The infectivity and transmission potential of human IgG
      coated sporozoites is unknown.

PMID- 8357080
TI  - Leishmania (Viannia) panamensis-specific IgE and IgA antibodies in relation to
      expression of human tegumentary leishmaniasis.
AB  - Leishmania (Viannia) panamensis-specific IgE and IgA antibodies were quantified
      in patients with parasitologically confirmed American tegumentary leishmaniasis
      using a radioallergosorbent test (RAST) and an enzyme-linked immunosorbent assay
      (ELISA), respectively. The RAST values, presented as the mean +/- SEM percentage
      of total isotope added, were significantly elevated in patients having disease
      evolution greater than 12 months (3.14 +/- 0.91), as compared with those with an
      evolution time of 12 or fewer months (1.66 +/- 0.15) (P = 0.017). A separate
      group of patients, those with eosinophils in the biopsy specimen of their lesion,
      also had elevated mean RAST values (2.55 +/- 0.58) when compared with patients
      who did not demonstrate these cells in their biopsy specimens (1.32 +/- 0.24) (P
      = 0.038). Leishmania-specific IgA levels, presented as the mean +/- SEM optical
      density, were significantly higher for patients with mucocutaneous disease (0.40
      +/- 0.03) than for patients with cutaneous disease (0.28 +/- 0.023) (P = 0.0063).
      Inhibition testing with homologous and heterologous antigens confirmed the
      specificity of these assays, and were used to assess cross-reactivity among L.
      (Viannia) subspecies and other kineto-plastic hemoparasites. Results demonstrate
      that patients with more severe forms of American tegumentary leishmaniasis,
      defined either as increased duration of disease or invasion of the mucosa, have
      elevated levels of Leishmania-specific IgE and IgA antibodies, respectively.

PMID- 8357081
TI  - Serologic response to Helicobacter pylori among children and teenagers in
      northern Chile.
AB  - The serologic response to Helicobacter pylori was determined in 388 children and
      teenagers living in Iquique, Chile by using an IgG enzyme-linked immunosorbent
      assay. Serum antibody levels, as measured by optical density, correlated strongly
      with age. Increases in the mean antibody level were seen primarily after age
      five, with rates of seropositivity increasing to > or = 70% among teenagers. The
      reasons for this age-related pattern of acquisition of infection remain to be
      determined.

PMID- 8357082
TI  - Mechanism of increased dissemination of chikungunya virus in Aedes albopictus
      mosquitoes concurrently ingesting microfilariae of Dirofilaria immitis.
AB  - We investigated whether concurrent ingestion of chikungunya virus and
      microfilariae of Dirofilaria immitis increases viral dissemination and
      multiplication in a mosquito vector. The increased rate of dissemination of this
      virus in mosquitoes concurrently ingesting both agents was found when homogenates
      of bodies and those of legs only were examined. It was significantly higher than
      that of controls ingesting the virus alone through the end of the experiment on
      day 14 after infection. We next studied the mechanism by which the presence of
      microfilariae enabled the virus to enter into the hemocoel and to reach the
      salivary glands. We checked our results using histopathologic procedures and
      electron microscopy by identifying holes produced by the microfilariae that
      penetrated the midgut epithelial layer. When the midgut of mosquitoes was
      punctured with a thin needle immediately after the mosquitoes ingested viruses,
      higher infection rates were observed than in mosquitoes without such punctures.

PMID- 8357083
TI  - Differential serodiagnosis of alveolar and cystic hydatid disease in the People's
      Republic of China.
AB  - Western blot analysis was carried out using crude antigens of Echinococcus
      multilocularis and 33 serum samples from the People's Republic of China to
      differentiate patients with alveolar hydatid disease (AHD) with active lesions
      from those with inactive lesions, those with other parasitoses including cystic
      hydatid disease (CHD), and healthy persons. This analysis was based on the
      detection of antibody responses against two polypeptides, Em18 and Em16, which
      appeared to be species specific and good indices for the differentiation of AHD
      with active lesions from AHD with inactive lesions. Twenty-one of the 33 samples
      showed antibody responses against Em18 and/or Em16. Fifteen were antibody
      positive for both Em18 and Em16, five were antibody-positive for Em18 only, and
      one was antibody-positive for Em16 only. Of the subjects from which the 33
      samples were obtained, 12 patients had AHD with active lesions, two had AHD, but
      their lesions were resolved by surgical resections, 14 had CHD with active
      lesions, and five were apparently healthy people. Western blot analysis confirmed
      all 14 cases of AHD, three of the 14 cases of CHD, and showed that one of the
      five apparently healthy individuals had a positive serologic response for AHD.
      This apparently healthy person with a positive serologic response for AHD by
      Western blot analysis was found to be positive for the disease on re-examination.
      Thus, Western blot analysis based on the antibody responses against Em18 and
      Em16, especially against Em18, was extremely reliable for the detection of AHD
      with active lesions, although it failed to differentiate two of the 14 patients
      with CHD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357084
TI  - Evaluation of the polymerase chain reaction for diagnosis of Lassa virus
      infection.
AB  - We evaluated the polymerase chain reaction (PCR) and hybridization procedures for
      diagnosis of Lassa fever. Primers were derived from a region of the small RNA
      segment of Lassa virus coding for the glycoprotein. Serum samples stored for a 14
      year period from patients in Sierra Leone, West Africa were examined
      retrospectively. Blinded samples were then tested prospectively. Eighty-eight
      virus isolation-negative control sera were negative by PCR and hybridization. In
      the retrospective study, virus was isolated from 51 of 98 specimens from patients
      with Lassa fever, and 33 of these were positive for Lassa virus RNA by PCR, and
      42 by PCR and hybridization. Fifteen were positive by PCR and hybridization but
      isolation-negative, and nine were positive by isolation but PCR/hybridization
      negative. Thirty-two were negative by all methods (sensitivity by
      PCR/hybridization compared with virus isolation 0.82, specificity 0.68). In a
      prospective blinded study of 195 patient sera, 51 were positive by PCR and virus
      isolation, and 24 were PCR positive but virus isolation-negative (sensitivity
      0.66, specificity 0.71). After hybridization, 66 virus isolation-positive sera
      were positive. The sensitivity was 0.86 and the specificity was 0.59, and the
      probability of false-positive results compared with virus isolation was 32%, (chi
      2 = 21.9, by McNemar's test). Since some specimens may not have contained viable
      virus, we re-analyzed the data of individual patients using laboratory-confirmed
      case definitions for Lassa fever. All specimens from patients in whom Lassa fever
      was excluded by serologic tests were negative by PCR/hybridization.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8357085
TI  - Brazilian spotted fever in Espirito Santo, Brazil: description of a focus of
      infection in a new endemic region.
AB  - Although Brazilian spotted fever is known to occur in several adjacent states,
      infection with spotted fever group (SFG) rickettsiae has not previously been
      documented in the Brazilian state of Espirito Santo. We report a cluster of two
      proven and four suspected cases of Brazilian spotted fever in a small valley near
      Colatina, Espirito Santo. Four patients died without confirmatory serologic or
      pathologic studies. The two surviving patients had serologic and/or pathologic
      evidence of infection with SFG rickettsiae. Results of a survey done in 1991
      confirmed the presence of antibodies reactive with SFG rickettsiae in the serum
      of dogs living in this region. Two of 25 dogs had elevated microimmunofluorescent
      antibody titers (1:64 and 1:256). Both seropositive dogs were pets of the index
      cases and lived in the valley where all six human cases were presumed to have
      acquired their infections. These cases and the results of the canine serosurvey
      suggest that a focus of virulent disease exists in an area not previously known
      to be endemic for SFG rickettsiae.

PMID- 8357086
TI  - Amblyomma americanum: a potential vector of human ehrlichiosis.
AB  - Polymerase chain reaction primers specific for Ehrlichia chaffeensis were used to
      amplify DNA from extracts of pooled ticks. Amplification was performed on
      extracts from 140 pools (1,579 total ticks) consisting of three tick genera
      collected from five states. The characteristic 389-basepair product was observed
      after amplification of extracts from seven different pools of adult Amblyomma
      americanum (117 pools, 1,462 ticks), but not from pools of nymphs. No specific
      product was observed after amplification of 20 pools (105 ticks) of Dermacentor
      variabilis and three pools of Ixodes scapularis (12 ticks). Ehrlichia chaffeensis
      was present in A. americanum at a minimum frequency of > or = 0.48%, suggesting
      that A. americanum may be a vector of human ehrlichiosis.

PMID- 8357087
TI  - Low-level Plasmodium falciparum transmission and the incidence of severe malaria
      infections on the Kenyan coast.
AB  - The transmission of Plasmodium falciparum was studied in relation to the
      incidence of severe malaria infections at Sokoke and Kilifi town, Kilifi
      District, Kenya. Intensive mosquito sampling during a one-year period yielded
      Anopheles gambiae s.l., An. funestus, and An. coustani. Anopheles gambiae s.l.
      was the predominant vector, comprising 87.9% and 97.9% of the total anophelines
      collected in Sokoke and Kilifi town, respectively. The proportion of An. gambiae
      s.l. with P. falciparum sporozoite infections was 4.1% (20 of 491) in Sokoke and
      2.2% (3 of 138) in Kilifi town; no infections were detected in An. funestus or in
      An. coustani. Entomologic inoculation rates indicated that residents were exposed
      to only 8.0 infective bites per year in Sokoke and 1.5 in Kilifi town.
      Transmission was detected during only six months in Sokoke and three months in
      Kilifi town despite low-level, year-round vector activity. The yearly incidence
      of severe P. falciparum infections in children, 1-4 years of age was 24.1 per
      1,000 in Sokoke and 4.2 per 1,000 in Kilifi town. Monthly patterns of
      transmission corresponded closely with the incidence of severe infections. At
      these sites on the coast of Kenya, the spatial and temporal incidence of severe
      malaria infections is associated with low-level P. falciparum transmission by
      vector populations.

PMID- 8357088
TI  - Trypanosomes and microfilariae in feral owl and squirrel monkeys maintained in
      research colonies.
AB  - A group of 358 owl and squirrel monkeys imported from Colombia, Peru, and Bolivia
      for the U.S. Agency for International Development Malaria Vaccine Development
      Program was examined for trypanosomes and microfilariae. Trypanosoma rangeli,
      isolated by hemoculture from Aotus nancymai, Saimiri b. boliviensis, and S. b.
      peruviensis, accounted for 76.6% of all trypanosome infections. Trypanosoma cruzi
      was isolated from 25 of 194 S. b. boliviensis, including two mixed infections
      with T. rangeli. Identifications of trypanosomes were confirmed by blinded tests
      with a panel of five rRNA probes on a subsample of cultures identified
      morphologically. Although no trypanosomes were isolated from Aotus vociferans or
      A. lemurinus griseimembra, positive serologic responses to T. cruzi were observed
      by indirect immunofluorescence assay in all species of monkeys examined and
      ranged from 42.1% among S. b. peruviensis to 92.3% among A. vociferans. Among T.
      rangeli-infected monkeys, 43.7% were seronegative for T. cruzi. No microfilariae
      were found in S. b. boliviensis or A. l. griseimembra. Mansonella barbascalensis
      and Dipetalonema caudispina were observed in A. vociferans, M. panamensis in A.
      nancymai, and M. saimiri and D. caudispina in S. b. peruviensis. Such naturally
      occurring infections in imported animal models are potential sources of
      accidental transmission to animal handlers and uninfected laboratory animals and
      can introduce confounding variables into otherwise well-planned and well-executed
      studies.

PMID- 8357089
TI  - A comparative field study of the relative importance of Lutzomyia peruensis and
      Lutzomyia verrucarum as vectors of cutaneous leishmaniasis in the Peruvian Andes.
AB  - A two-year field study of Andean cutaneous leishmaniasis (uta) in the valley of
      Purisima, Ancash Department, Peru has provided quantitative epidemiologic and
      entomologic evidence for the predominant role of Lutzomyia peruensis in the
      transmission of Leishmania peruviana in this endemic area. The monthly incidence
      in the valley was greatest in the wet season (from December to May), when Lu.
      peruensis was particularly endophilic. A significant correlation was detected
      between intradomiciliary (but not extradomiciliary) Lu. peruensis abundance and
      the monthly incidence of uta in the valley following a one-month time lag. In
      contrast, no significant correlation was detected between any measure of Lu.
      verrucarum abundance and the incidence of uta. Lutzomyia peruensis and Lu.
      verrucarum comprise more than 98% of all the sand fly captures made in this
      valley. The increase in incidence of uta with altitude, which reached a peak rate
      between 2,250 and 2,750 meters above sea level, was associated with an increase
      in the relative abundance of Lu. peruensis as compared with Lu. verrucarum.
      Seasonal and altitudinal variation was also detected in the peak time of activity
      for both sand fly species, a phenomenon that could significantly influence the
      transmission rate: later host-seeking sand flies being more likely to find
      sleeping, nondefensive, human hosts.

PMID- 8357090
TI  - Environmental sources of Cryptosporidium in an urban slum in northeastern Brazil.
AB  - Cryptosporidium is an important cause of diarrheal disease in children worldwide.
      To elucidate the environmental sources of this parasite, we selected an urban
      slum in Fortaleza, Brazil, a community with a known high incidence of
      cryptosporidiosis, and examined both stool smears from household animals (n =
      127) and filtrates from local water sources (n = 18) for Cryptosporidium oocysts.
      Because previous work in this community has demonstrated the seasonal nature of
      human infection with Cryptosporidium, collections were made separately for the
      dry and rainy seasons. Of the 64 stools collected during the dry season
      (September-December 1990), four (6.3%) were positive by acid-fast staining for
      Cryptosporidium. Of the 63 rainy season samples (March-May 1991), nine (14.3%)
      were positive. Overall, oocysts were detected in 13 (10.2%) of 127 animal stool
      samples. Freshwater samples were obtained from a variety of sources including
      open and closed wells, and running city water and then processed. Four of 18
      samples (22.2%), including a sample from city water were positive by at least one
      of two staining techniques (acid-fast and immunofluorescence). In summary,
      animals may serve as a reservoir of Cryptosporidium, with potential for the
      contamination of immediate household water sources. These findings may help to
      explain the high incidence of cryptosporidiosis among infants in this
      impoverished community.

PMID- 8357091
TI  - Is anemia an accurate predictor of vitamin A status in Pakistani children?
AB  - Serum retinol and hemoglobin levels were determined in 532 children aged 6-60
      months living in urban slums of Karachi, Pakistan. Overall 67% (358 of 532) of
      children had hemoglobin levels of less than 11 g/dl, the World Health
      Organization definition of anemia for this age group. Estimations for red blood
      cell indices (hematocrit, mean corpuscular volume, mean corpuscular hemoglobin,
      mean corpuscular hemoglobin concentration, and red blood cell count) were done on
      a sample of 391 children to classify anemia morphologically. A similar percentage
      (69.8% [273 of 391 children]) of anemia was found in this group. The anemia was
      predominantly microcytic and hypochromic. Normocytic normochromic anemia was
      present in only 16.5%. Serum retinol levels were significantly correlated with
      hemoglobin (P < 0.002), hematocrit (P < 0.01), and red blood cell (P < 0.001)
      levels. However, anemia was found to be a poor predictor (positive predictive
      value [PPV] = 2.5%) for the presence of vitamin A deficiency (retinol < 10
      micrograms/dl). The PPV increased to 54% if 20 micrograms/dl, which is an
      indicator of marginal vitamin A status, was used as the cutoff point. The
      sensitivity of the hemoglobin test was found to be 75% in correctly identifying
      vitamin A deficiency when retinol levels of 10 micrograms/dl and 20 micrograms/dl
      were both used as the cutoff points for deficiency. The specificity for the
      hemoglobin test varied from 33% to 40% when levels of 10 micrograms/dl and 20
      micrograms/dl were used as the cutoff points for vitamin A deficiency.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8357092
TI  - Clinical and angiographic determinants of initial percutaneous transluminal
      coronary angioplasty success.
AB  - Clinical and anatomic determinants of primary success of percutaneous
      transluminal coronary angioplasty were retrospectively evaluated in 299 patients.
      Successful angioplasty (residual stenosis < 50%) was achieved in 350 (94%) of 373
      lesions. The success rate in patients chronically treated with aspirin was higher
      than that of patients not treated with aspirin (95% versus 86%, P < 0.03). An
      additional finding was that the success rate in patients referred for coronary
      angioplasty because of acute myocardial infarction or postinfarction angina was
      lower than that of those without these characteristics (89% versus 96%, P <
      0.01). No other clinical features studied influenced the outcome of coronary
      angioplasty. The angiographic characteristics of the lesions did not differ
      between patients with successful or failed angioplasty except for the degree of
      stenosis prior to the procedure, being lower in patients with successful
      procedure (92.4 +/- 7.6% versus 97.3 +/- 3.1%), P < 0.002). Thus coronary
      angioplasty can be performed with a high rate of success. Long-term pretreatment
      with aspirin may have a beneficial effect.

PMID- 8357093
TI  - The deltopectoral triangle as a landmark for percutaneous infraclavicular
      cannulation of the subclavian vein.
AB  - An anatomic landmark is identified and described that simplifies the technique of
      central venous cannulation via the subclavian vein. The commonly used techniques
      are an approach to the subclavian at the junction of the medial and middle thirds
      of the clavicle or at the midclavicular line. A described anatomic landmark, the
      deltopectoral triangle, is easily identified in virtually all patients and
      requires no measuring or extensive knowledge of anatomy for localization.
      Penetration of the skin at this landmark facilitates the procedure and produces
      less patient discomfort. Using this technique, the authors have successfully
      cannulated the subclavian vein in 92.7% (51/55) of attempts with a 5.5% (3/55)
      complication rate. The only complications were arterial punctures, which were
      treated with pressure and were of no consequence to the patient.

PMID- 8357094
TI  - Arterial mapping with color flow duplex imaging of the lower extremities after
      excimer-laser-assisted angioplasty.
AB  - The purpose of the present study was to evaluate the role of color flow duplex
      imaging (CFDI) in the follow-up of patients who have undergone excimer-laser
      assisted angioplasty of peripheral arteries. Sixty-one patients (40 men and 21
      women) were studied (mean age +/- SD sixty-three +/- nine years). All patients
      were affected by peripheral vascular disease and, for this reason, underwent
      percutaneous excimer-laser-assisted angioplasty. Digital angiography and CFDI
      were performed before the laser procedure. CFDI was repeated at months 1, 3, 6,
      9, and 12 after the laser procedure, whereas angiography was repeated after
      twelve months. Common, superficial, and profunda femoral arteries and popliteal
      arteries were visualized in looking for the presence of lesions and occlusions,
      and spectral analysis of Doppler signals was recorded. After the initial success,
      claudication was reported again by 9 patients, 7 of whom showed total occlusions.
      All reocclusions were discovered by CFDI and confirmed by angiography; 3 of these
      7 patients underwent a second laser procedure. The remaining 2 symptomatic
      patients showed patent vessels and did not undergo angiography. Another 9
      patients redeveloped an occlusion, unsuspected from clinical history and
      symptoms. All the reocclusions, confirmed by angiography, were diagnosed by CFDI.
      The data show that CFDI provides an accurate noninvasive technique for following
      up patients after excimer laser angioplasty, allowing for asymptomatic
      reocclusions to be recognized and treated if necessary, and permitting symptoms
      not due to reocclusions to be properly identified, thus avoiding unnecessary
      angiography.

PMID- 8357096
TI  - Circulating platelet aggregates indicative of in vivo platelet activation in
      pulmonary hypertension.
AB  - The authors investigated the existence of circulating cellular aggregates in 12
      patients with moderate to severe pulmonary hypertension, using scanning electron
      microscopy. Peripheral venous blood was collected in the presence of 11.5 mM
      buffered ethylenediaminetetraacetic acid, in order to disperse freshly formed
      disaggregable aggregates. Irreversible aggregates represented by platelet
      clusters and/or platelet attachment to either leukocytes or red cells were
      identified in 7 patients with pulmonary hypertension. Endogenous platelet
      activation was further confirmed by a significant increase in plasma levels of
      beta-thromboglobulin in comparison with controls (33.8 +/- 14.1 vs 22.7 +/- 11.5
      ng/mL respectively, p < 0.025). The presence of irreversible aggregates in the
      blood stream strongly suggests that cell-cell interactions actually occur in vivo
      in these patients. If so, therapeutic measures aimed at preventing in situ
      thrombosis and its consequences may be beneficial in this disorder.

PMID- 8357095
TI  - Prophylaxis of recurrent deep venous thrombosis. A randomized, prospective study
      using indobufen and graduated elastic compression stockings.
AB  - After an episode of deep venous thrombosis (DVT) 224 patients were randomized
      into four groups: a control group (A; 63 subjects); one receiving prophylaxis
      with indobufen (B; 60 patients)--an oral antiplatelet agent; one using graduated
      elastic compression stockings (C; 53); and one receiving prophylaxis with both
      indobufen and graduated stockings (D; 48). Patients were monitored over a three
      year period with color duplex scanning repeated every three months. In 46% of the
      controls there was at least one episode of recurrent DVT (RDVT). In patients
      receiving indobufen (group B) and using graduated compression stockings (group C)
      the incidence of RDVT was significantly lower (5% and 9.43%, respectively). The
      incidence of RDVT was further significantly reduced by the combination of the two
      methods (group D) (2.08%). In conclusion, RDVT is common and often asymptomatic
      and can be effectively prevented by prophylaxis with indobufen or graduated
      compression and more effectively by the combination of the two methods.

PMID- 8357097
TI  - Angina and coronary artery disease in patients with aortic valve disease.
AB  - The significance of angina pectoris in patients with aortic valve disease (AVD)
      and the need for coronary arteriography before valve replacement are
      controversial. The history of chest pain and coronary arteriographic findings
      were reviewed in 333 patients > or = forty years old, with AVD: 142 with aortic
      stenosis, 87 with mixed AVD and 104 with aortic regurgitation. The prevalence of
      coronary artery disease (CAD) was similar among different types of AVD. Angina
      pectoris was more frequent in patients with aortic stenosis (56%) and mixed AVD
      (53%) than in patients with aortic regurgitation (24%) (p < 0.0001). Similar
      results were found in patients with and without CAD. Twenty-six of 95 (27%)
      patients with CAD had no chest pain at all. The absence of any chest pain in CAD
      patients was more frequent in those > or = sixty years old than in those < sixty
      (p < 0.05). Thus, since a significant number of patients had CAD in the absence
      of any chest pain, the authors recommend coronary arteriography for all patients
      > or = forty years of age before aortic valve replacement.

PMID- 8357098
TI  - Abnormal erythrocyte rheology in patients with morbid obesity.
AB  - The objectives of this study were to investigate the rheological properties of
      the erythrocyte in patients with morbid obesity and to follow them up after a
      short-term weight loss. A fluorescent polarization method was used to assess
      erythrocyte membrane biorheology and to measure its fluidity. Eighteen subjects
      participated in the study: 8 healthy controls and 10 patients with morbid
      obesity. The erythrocyte membrane fluidity was obtained in the healthy subjects
      and in the patients with morbid obesity prior to and after a ten-day zero-calorie
      diet. Fluidity was determined by steady-state fluorescence polarization after
      incorporation of the lipophilic probe 1,6-diphenyl-1,3,5 hexatriene (DPH). With
      this method, the anisotropy parameter at 37 degrees C, which is inversely related
      to membrane fluidity, was obtained. The patients with morbid obesity revealed an
      abnormal erythrocyte rheology. The exhibited an abnormally low erythrocyte
      membrane fluidity as compared with normal subjects. The anisotropy parameter at
      37 degrees C was 1.417 +/- 0.093 in these obese patients compared with 1.279 +/-
      0.043 in normal-weight controls (p < 0.01). Upon a short-term significant weight
      loss from a body mass index (BMI) (weight/height2) of 39 +/- 5 to 36 +/- 5 kg/m2
      (p < 0.05), the anisotropy parameter did not change (1.401 +/- 0.190). Thus,
      fluidity measurements permit recognition of an abnormal erythrocyte rheology in
      patients with morbid obesity. This abnormality may partially explain the excess
      cardiovascular and thromboembolic morbidity in morbid obesity.

PMID- 8357099
TI  - Increased plasma endothelin levels in Kawasaki disease: a possible marker for
      Kawasaki disease.
AB  - Plasma immunoreactive endothelin (iET) levels were investigated in patients with
      Kawasaki disease (KD). The iET level was 2.49 +/- 0.13 pg/mL in KD patients and
      1.32 +/- 0.06 in age-matched control subjects, showing a significant increase
      with KD. The iET level was not increased in patients with febrile inflammatory
      diseases of bacterial origin without KD (non-KD group). Parameters indicating an
      inflammatory reaction, such as C-reactive protein, platelet count, white blood
      cell count, and interleukin-6 level, were increased in the KD patients. However,
      they were similarly increased in the patients with febrile diseases of bacterial
      origin and showed no significant differences between the two groups. This study
      is the first to report that plasma iET levels are elevated in a disease mainly
      involving vasculitis. These results suggest that blood iET levels are increased
      in KD patients as a result of the associated vascular endothelial damage and that
      iET can be a useful marker for the diagnosis of KD.

PMID- 8357100
TI  - Fatal bile pulmonary embolism following percutaneous transhepatic
      cholangiodrainage: case report and literature review.
AB  - Bile pulmonary emboli were present at autopsy in a seventy-year-old woman who had
      undergone percutaneous transhepatic cholangiodrainage for pancreatic carcinoma
      obstructing the common bile duct. The patient also developed hemobilia following
      the drainage. In spite of emergency surgery, she died on the third day after the
      operation. Microscopic findings of the lungs at autopsy disclosed numerous bile
      emboli in the smaller arteries, arterioles, and capillaries. Review of the
      literature showed 13 cases of bile pulmonary embolism, 10 of which had an obvious
      history of marked jaundice and trauma to the liver, like the present case. Bile
      enters the systemic circulation through a fistulous communication made by trauma
      between the biliary tree and the hepatic vein.

PMID- 8357101
TI  - Hyperparathyroidism associated with Raynaud's phenomenon--a case history.
AB  - The authors describe a patient with hyperparathyroidism and Raynaud's phenomenon.
      This association was hitherto undescribed.

PMID- 8357102
TI  - A variant of Noonan's syndrome: a case history.
AB  - The authors describe a variant of Noonan's syndrome hitherto undescribed. The
      special findings in this case were anomalous origin of the aortic arch vessels
      and focal glomerulonephritis.

PMID- 8357103
TI  - Invasive development of right atrial myxoma--a case report.
AB  - A thirty-nine-year-old man was admitted to the authors' department complaining of
      exertional dyspnea and high fever. An echocardiogram showed a mass in the right
      atrium, which was observed to move to the right atrium during the systolic phase
      and to the right ventricle during the diastolic phase. Magnetic resonance imaging
      showed that the mass developed from the right atrium to the superior vena cava.
      Intravenous digital subtraction angiography also showed a partial defect of the
      right atrium as well as obstructions of both the superior vena cava and the
      bilateral innominate veins. A pulmonary hemodynamic scintigram showed multiple
      defects at the mid and inferior areas of each lung, suggesting multiple pulmonary
      infarctions. The right atrial tumor was surgically removed. The superior vena
      cava and the innominate veins were found to be obstructed by organized thrombi,
      and the tumor had invasively grown into the right atrial wall. Histologic
      findings demonstrated that most of the tumor was composed of organized thrombi
      with scattered myxomatous tissue and was diagnosed as cardiac myxoma. These
      histologic findings suggest that the histogenesis of this right atrial myxoma
      might be thrombogenic.

PMID- 8357104
TI  - Association of congenital afibrinogenemia and K-dependent protein C deficiency--a
      case report.
AB  - The authors describe a rare case of congenital afibrinogenemia with concomitant K
      dependent protein C deficit that was brought to our observation for ischemic
      lesions of the foot in association with fibrinogen concentrate infusions. These
      lesions can be attributed to the association of various factors: fibrinogen
      infusion without heparin coverage, microtrauma, and protein C (PC) deficit. In
      fact, thromboembolic complications during afibrinogenemia were previously
      reported usually in association with substitutive therapy, and it is also known
      that PC deficit predisposes to thrombotic complications. The the authors'
      knowledge, the case described by them is the first in which PC deficit is
      associated with afibrinogenemia. This association cannot be explained by a common
      genetic mechanism because the genes for fibrinogen and for protein C are located
      on different chromosomes (chromosomes 4 and 2 respectively).

PMID- 8357105
TI  - Patent ductus arteriosus involving three generations--a case history.

PMID- 8357106
TI  - Relief of acute lower limb ischemia with percutaneous fenestration of intimal
      flap in a patient with type III aortic dissection--a case report.
AB  - Acute right lower limb ischemia developed in a patient with type III aortic
      dissection. Aortography revealed complete occlusion of the right common iliac
      artery by dissecting intima. Immediately percutaneous transfemoral fenestration
      with angioplasty balloon catheter was performed and marked improvement was
      obtained in clinical symptoms and angiographic findings. Unfortunately the
      patient died of rupture of the thoracic aorta about eleven hours after the
      procedure. The cause of death was not thought to be related to this procedure.
      The authors conclude that percutaneous fenestration should be considered as the
      treatment of choice for visceral or limb ischemia due to acute aortic dissection.

PMID- 8357107
TI  - The institutional review board as a mirror of scientific and ethical standards.
AB  - Decisions by institutional review boards (IRBs) are presumed to reflect the norms
      and standards of the scientific community. Such criteria have shifted as changes
      have occurred in experimental interventions and protocols, codes of federal
      regulatory agencies, norms among investigators, and expectations of participants.
      The tension created by shifting norms and standards raises two questions: (a)
      Should IRBs evaluate the scientific (e.g., design) features of the proposed
      research, and (b) should consistent standards be expected even in areas that are
      in constant flux (e.g., AIDS research)? We discuss these questions and propose a
      mechanism to keep IRBs abreast of emergent issues and sensitized not only to the
      costs of doing research but also to the costs of not doing it.

PMID- 8357108
TI  - The public's knowledge about psychologists and other mental health professionals.
AB  - A random sample of New London County, CT, residents received a questionnaire
      about nine mental health professions or professionals (MHPs): clergyperson,
      marriage and family counselor, nonpsychiatric physician, psychiatrist,
      psychiatric nurse, psychologist, psychotherapist, social worker, and telephone
      crisis counselor. Respondents defined each MHP and reported their satisfaction
      with treatment, which MHP they would recommend, their referral source(s),
      licensure requirements, and fees. A mixed-design analysis of variance was
      computed, with comfortableness as the dependent variable; age, sex, saw an MHP,
      and education, the between-subjects variables; and the nine MHPs, the within
      subjects variable. A significant MHP effect showed that physicians were perceived
      as slightly more comfortable than were psychologists (nonsignificant), who,
      nevertheless, were perceived as exceeding all other trained MHPs in the
      comfortableness experienced by their clients.

PMID- 8357109
TI  - Utility of nocturnal home oximetry for case finding in patients with suspected
      sleep apnea hypopnea syndrome.
AB  - OBJECTIVE: To evaluate prospectively the validity of home oximetry for case
      finding in patients clinically suspected of having the sleep apnea hypopnea
      syndrome (SAHS). DESIGN: Blinded comparison of home oximetry and polysomnographic
      nocturnal recordings. SETTING: Sleep clinic of a tertiary referral center.
      PATIENTS: A total of 240 outpatients referred because of reported sleep
      disturbances or daytime hypersomnia compatible with the diagnosis of SAHS.
      MEASUREMENTS: All participants had nocturnal home oximetry followed by a
      conventional polysomnographic study. The two recordings were interpreted blindly.
      Home oximetry test results were classified as abnormal (suspicion of sleep
      related breathing abnormalities) in the presence of repetitive, short-duration
      arterial oxyhemoglobin saturation. (SaO2) fluctuations without any absolute or
      relative decrease in the SaO2 threshold. The diagnosis of SAHS was confirmed when
      the apnea-plus-hypopnea index was greater than 10. RESULTS: Based on the results
      of the polysomnographic sleep study, 110 patients had SAHS (apnea-plus-hypopnea
      index, 38.1 +/- 2.5/h; mean +/- SE). Home oximetry test results were interpreted
      as abnormal in 176 patients (this included 108 patients with SAHS and 68 without
      SAHS) and were read as normal in 62 patients without SAHS and in 2 with SAHS.
      Home oximetry testing had a sensitivity of 108/110 or 98.2% (95% Cl, 93.6% to
      99.8%); a specificity of 62/130 or 47.7% (Cl, 38.8% to 56.6%); a positive
      predictive value of 108/176 or 61.4%; and a negative predictive value of 62/64 or
      96.9%. CONCLUSIONS: A negative home oximetry test result is helpful in ruling out
      the diagnosis of SAHS in patients clinically suspected of having this syndrome,
      because a negative test result reduced the probability from 54.1% to 3.1% in our
      patients. However, a positive oximetry test increased the probability from 46% to
      61.4% in our group of patients.

PMID- 8357110
TI  - A reassessment of the importance of "low-count" bacteriuria in young women with
      acute urinary symptoms.
AB  - OBJECTIVE: To determine whether a statistical association exists between "low
      count" bacteriuria (> 10(2) to 10(4) colony-forming units/mL) and acute urinary
      symptoms in young women. DESIGN: Prospective, case-control study. SETTING:
      Gynecology clinic at a student health center. PATIENTS: Women with or without
      urinary or vaginal symptoms. MEASUREMENTS: History of urinary infections and
      sexual activity. Quantitative determination of bacteriuria and pyuria and
      bacterial species; urine leukocyte esterase test; specific gravity; creatinine
      levels; vaginal leukocytes; and in-vitro culture of urine. RESULTS: The frequency
      of recent sexual activity, pregnancies, and contraceptive practices was not
      statistically different between women with acute urinary symptoms and
      asymptomatic controls. Escherichia coli and Staphylococcus saprophyticus were the
      only microorganisms statistically associated with urinary symptoms and pyuria (P
      < 0.001). Low counts of these organisms were found in 10.2% of asymptomatic
      women. As the bacterial count increased, the association between these organisms
      and symptoms increased, and a step-wise increase occurred in the frequency and
      magnitude of pyuria, but the specific gravity and urine creatinine levels
      remained unchanged. Escherichia coli, even at low counts, grew well in the
      patients' own urine. Pyuria (> 20 leukocytes/mm3) was present in 19.6% of
      asymptomatic women and was associated with vaginal leukorrhea. CONCLUSIONS: "Low
      count" bacteriuria was statistically more frequent among young women with urinary
      symptoms than among asymptomatic controls. The low counts could not be explained
      by dilution of the urine or failure of the bacteria to grow well in the patients'
      urine. These findings suggest that the infection was not established in the
      bladder urine and that "low-count" bacteriuria might be an early phase of urinary
      tract infection.

PMID- 8357111
TI  - The prevalence of deep venous thrombosis in patients with suspected paradoxical
      embolism.
AB  - OBJECTIVE: To determine the prevalence of venous thrombosis in patients with
      suspected paradoxical embolism. DESIGN: Observational study. PATIENTS: Two
      hundred sixty-four patients with clinically suspected embolic events underwent
      contrast transesophageal echocardiographic evaluation. Forty-nine patients (24
      women, 25 men) had a patent foramen ovale. Forty-one patients had acute stroke,
      and 8 had acute limb ischemia. SETTING: Echocardiography laboratory of a
      community hospital. MEASUREMENTS: The presence of a patent foramen ovale was
      assessed by transesophageal contrast echocardiography. Forty-two patients had
      venographic evaluation of the lower-extremity venous system. RESULTS: Venous
      thrombosis was clinically suspected in 6 patients and documented in 24 of the 42
      patients with patent foramen ovale who underwent venographic study (57%; 95% Cl,
      41% to 72%). Venous thrombosis was confined to calf or popliteal veins in 15
      cases. Fifteen of 17 patients who had venographic evaluation within 7 days of the
      index event had thrombosis compared with 9 of 25 patients who had later
      evaluations (P = 0.001). More patients with venous thrombosis than without venous
      thrombosis had a history of previous thromboembolism (13 of 24 compared with 1 of
      18 [corrected], respectively; P = 0.001). CONCLUSION: When a patent foramen ovale
      is detected in a patient with embolism, occult leg vein thrombosis is frequently
      present.

PMID- 8357112
TI  - A predictive model for delirium in hospitalized elderly medical patients based on
      admission characteristics.
AB  - OBJECTIVE: To prospectively develop and validate a predictive model for the
      occurrence of new delirium in hospitalized elderly medical patients based on
      characteristics present at admission. DESIGN: Two prospective cohort studies done
      in tandem. SETTING: University teaching hospital. PATIENTS: The development
      cohort included 107 hospitalized general medical patients 70 years or older who
      did not have dementia or delirium at admission. The validation cohort included
      174 comparable patients. MEASUREMENTS: Patients were assessed daily for delirium
      using a standardized, validated instrument. The predictive model developed in the
      initial cohort was then validated in a separate cohort of patients. RESULTS:
      Delirium developed in 27 of 107 patients (25%) in the development cohort. Four
      independent baseline risk factors for delirium were identified using proportional
      hazards analysis: These included vision impairment (adjusted relative risk, 3.5;
      95% Cl, 1.2 to 10.7); severe illness (relative risk, 3.5; Cl, 1.5 to 8.2);
      cognitive impairment (relative risk, 2.8; Cl, 1.2 to 6.7); and a high blood urea
      nitrogen/creatinine ratio (relative risk, 2.0; Cl, 0.9 to 4.6). A risk
      stratification system was developed by assigning 1 point for each risk factor
      present. Rates of delirium for low- (0 points), intermediate- (1 to 2 points),
      and high-risk (3 to 4 points) groups were 9%, 23%, and 83% (P < 0.0001),
      respectively. The corresponding rates in the validation cohort, in which 29 of
      174 patients (17%) developed delirium, were 3%, 16%, and 32% (P < 0.002). The
      rates of death or nursing home placement, outcomes potentially related to
      delirium, were 9%, 16%, and 42% (P = 0.02) in the development cohort and 3%, 14%,
      and 26% (P = 0.007) in the validation cohort. CONCLUSIONS: Delirium among elderly
      hospitalized patients is common, and a simple predictive model based on four risk
      factors can be used at admission to identify elderly persons at the greatest
      risk.

PMID- 8357113
TI  - Clinical trial of clarithromycin for cutaneous (disseminated) infection due to
      Mycobacterium chelonae.
AB  - OBJECTIVE: To determine if clarithromycin monotherapy is safe and effective in
      treating cutaneous disease (especially disseminated disease) due to Mycobacterium
      chelonae (formerly M. chelonae subspecies chelonae). DESIGN: An open,
      noncomparative trial of clarithromycin as single-drug therapy. SETTING:
      Nationwide referrals. PATIENTS: Culture-positive patients whose M. chelonae came
      from a cutaneous source and whose isolate was submitted to a single referral
      laboratory for susceptibility testing. INTERVENTION: Clarithromycin, 500 mg twice
      a day by mouth for 6 months. No attempt was made to alter use of
      immunosuppressive drugs. MAIN OUTCOME MEASURES: Acid-fast bacilli smears and
      cultures of skin lesions during and after treatment, with monitoring of clinical
      response, side effects, and development of new lesions. RESULTS: Fourteen
      patients (10 with disseminated disease) were enrolled in the study and completed
      at least 3 months of therapy. Underlying diseases included rheumatoid arthritis,
      other autoimmune disorders, and organ transplantation. All were taking
      corticosteroids (93%) or cyclophosphamide (7%). All patients had an excellent
      response to therapy, with only mild side effects from the drug. Two patients died
      of other diseases after improving clinically but while still taking medication.
      One noncompliant patient who prematurely discontinued therapy after 3.5 months
      relapsed 1 month later with an isolate resistant to clarithromycin. The remaining
      11 patients have all completed therapy given for a mean of 6.8 months (range, 4.5
      to 9 months). Therapy has been discontinued for 9 of the 11 patients for at least
      6 months (mean, 7.1 months; range, 6 to 12 months), with no evidence of relapse.
      No remaining patient had positive acid-fast bacilli smears or cultures of skin
      lesions after 1 month of therapy. CONCLUSIONS: Clarithromycin may be the drug of
      choice for cutaneous (disseminated) disease due to M. chelonae, although more
      patients with long-term clinical follow-up need to be studied.

PMID- 8357114
TI  - Echocardiographic manifestations in a patient with pseudoxanthoma elasticum.

PMID- 8357115
TI  - Rapid brain calcification after ischemic stroke.

PMID- 8357116
TI  - Levothyroxine therapy in patients with thyroid disease.
AB  - PURPOSE: To review the indications for and the proper monitoring of levothyroxine
      therapy in patients with thyroid disease. DATA SOURCES: Relevant English language
      articles published from 1966 to 1992 were identified through a MEDLINE search and
      manual searches of both identified articles and selected endocrinology texts.
      STUDY SELECTION: Studies, case reports, and review articles that contained data
      on the pathophysiologic aspects of relevant thyroid disorders and on the
      pharmacologic aspects of, indications for, and administration of levothyroxine
      therapy. DATA EXTRACTION: Data on the epidemiology, clinical manifestations,
      complications, and treatment of thyroid disorders were analyzed with respect to
      patient selection, methods, diagnostic criteria, and conclusions. These data were
      used to develop a rational approach to the management of such patients. RESULTS
      OF DATA SYNTHESIS: Levothyroxine is a reliable and commonly prescribed drug to
      treat thyroid disease, but excessive dosage may have adverse effects. In patients
      with hypothyroidism, levothyroxine is used as replacement therapy. For most
      patients, therapy can be initiated with a full replacement dosage (1.6
      micrograms/kg body weight), which is usually 75 to 100 micrograms/day for women
      and 100 to 150 micrograms/d for men. The goal is to normalize the serum thyroid
      stimulating hormone concentration. Levothyroxine is also used to suppress the
      serum thyroid-stimulating hormone concentration. A trial of thyroid-stimulating
      hormone suppressive therapy is indicated for most patients with benign solitary
      nonfunctioning thyroid nodules and for those with a history of thyroid cancer.
      Levothyroxine in non-thyroid-stimulating hormone-suppressive doses may also be
      indicated for patients with nontoxic multinodular goiter and for certain patients
      after lobectomy for benign thyroid nodules. CONCLUSIONS: With proper patient
      monitoring, levothyroxine replacement therapy should be effective, inexpensive,
      and free of complications. Recommendations for thyroid-stimulating hormone
      suppression with levothyroxine are based on risk-benefit considerations of the
      biologic characteristics of the thyroid disorder and the individual patient.

PMID- 8357117
TI  - Empiric parenteral antibiotic treatment of patients with fibromyalgia and fatigue
      and a positive serologic result for Lyme disease. A cost-effectiveness analysis.
AB  - PURPOSE: To examine the cost-effectiveness of empirical, parenteral antibiotic
      treatment of patients with chronic fatigue and myalgia and a positive serologic
      result for Lyme disease who lack classic manifestations. DATA SOURCES: Peer
      reviewed journals, opinion of experts in the field, and published epidemiologic
      reports. STUDY SELECTION: Consensus by authors on articles that indicated methods
      for patient selection; on criteria used for diagnosis; on immunologic methods
      used for classifying patients; on the dose and duration of therapy; and on
      criteria by which responses to therapy were ascertained. DATA EXTRACTION: In a
      cost-effectiveness model, the costs and benefits of empirical parenteral therapy
      for patients seropositive for Lyme disease were compared with a strategy in which
      only patients having classical symptoms of Lyme disease were treated. DATA
      SYNTHESIS: In areas endemic for Lyme disease, the incidence of false-positive
      serologic results in patients with nonspecific myalgia or fatigue exceeds by four
      to one the incidence of true-positive results in patients with nonclassical
      infections. Treatment of the former group of patients costs $86,221 for each true
      positive patient treated. The empirical strategy causes 29 cases of drug toxicity
      for every case in the more conservative strategy. If patients were willing to pay
      $3485 to eliminate anxiety about not treating possible true Lyme disease, the
      empirical strategy would break even. CONCLUSION: For most patients with a
      positive Lyme antibody titer whose only symptoms are nonspecific myalgia or
      fatigue the risks and costs of empirical parenteral antibiotic therapy exceed the
      benefits. Only when the value of patient anxiety about leaving a positive test
      untreated exceeds the cost of such therapy is the empirical treatment cost
      effective.

PMID- 8357119
TI  - Appropriateness of parenteral antibiotic treatment for patients with presumed
      Lyme disease. A joint statement of the American College of Rheumatology and the
      Council of the Infectious Diseases Society of America.

PMID- 8357118
TI  - Chronic active hepatitis: the challenge for a new nomenclature.
AB  - OBJECTIVES: To review the etiologic agents and pathogenic mechanisms of chronic
      active hepatitis, to describe the current nomenclature for this disease and
      highlight its shortcomings, and to propose guidelines for change. DATA SOURCES:
      Relevant references were identified through a MEDLINE search (1982 to 1992),
      through prominent review articles and texts, and through a personal library of
      journals and reprints. Additional references were selected from the
      bibliographies of identified articles. STUDY SELECTION: All pertinent articles on
      the etiologic agents, pathogenic mechanisms, and nomenclature of chronic active
      hepatitis were studied. DATA SYNTHESIS: Subtypes of chronic active hepatitis can
      be defined by etiologic agent or immunoserologic marker, and these subtypes may
      have different clinical features, prognoses, pathogenic mechanisms, and
      treatments. An unauthorized jargon has evolved to accommodate these subtypes, and
      it may wrongly or prematurely connote their validity. Patients with cryptogenic
      disease, mixed viral and immunologic features, and atypical findings lack a
      formal designation. No established mechanism exists for modification of the
      nomenclature. CONCLUSIONS: Chronic hepatitis can be subclassified into different
      subtypes that are defined by etiologic agent or by predominate pathogenic
      mechanism. A new nomenclature must be based on this knowledge. Formal mechanisms
      must be established to revise the nomenclature and to promulgate change.

PMID- 8357120
TI  - Brain death: reconciling definitions, criteria, and tests.
AB  - Brain death has been discussed extensively for the last 25 years. Most
      investigators now believe that requiring death of the entire brain as the
      criterion for brain death in the Uniform Determination of Death Act and the
      standard clinical tests of brain death outlined in the Report of the Medical
      Consultants to the President's Commission have produced a satisfactory resolution
      of the issues surrounding the determination of death. However, we show that
      satisfying the standard medical tests does not guarantee that all brain functions
      have actually ceased and that there is tension between the legal criterion and
      the standard clinical tests. After considering and rejecting six possible
      reconciliations, we present an alternative approach that does not acknowledge any
      sharp dichotomy between life and death and incorporates the proposition that the
      questions of when care can be unilaterally discontinued, when organs can be
      harvested, and when a patient is ready for the services of an undertaker should
      be answered independent of any single account of death.

PMID- 8357121
TI  - Predator and prey.

PMID- 8357122
TI  - A magnificent whole.

PMID- 8357123
TI  - Large-scale trials of thrombolytic therapy for acute myocardial infarction: GISSI
      2, ISIS-3, and GUSTO-1.

PMID- 8357124
TI  - Rochalimaea infections.

PMID- 8357125
TI  - Aminophylline and cardiac arrest.

PMID- 8357126
TI  - Cost and effectiveness of hepatitis B immunization.

PMID- 8357127
TI  - The benefit of increasing sulfonylurea dose.

PMID- 8357128
TI  - The benefit of increasing sulfonylurea dose.

PMID- 8357129
TI  - Vital capacity as a predictor of premature death.

PMID- 8357130
TI  - The familial Muir-Torre syndrome.

PMID- 8357131
TI  - Differential collapsing pulses: a new clinical sign.

PMID- 8357132
TI  - Standardizing criteria for logistic regression models.

PMID- 8357133
TI  - The Mendoza Line and in-training examination scores.

PMID- 8357134
TI  - What is internal medicine?

PMID- 8357135
TI  - What is internal medicine?

PMID- 8357136
TI  - What is internal medicine?

PMID- 8357138
TI  - What is internal medicine?

PMID- 8357137
TI  - What is internal medicine?

PMID- 8357139
TI  - [Local anesthesia in hernia surgery].
AB  - After a short historical outline, the advantages of, the indication for, and the
      contraindications for local anaesthesia in hernial surgery are considered. The
      principal pharmacological characteristics of the most widely-employed local
      anaesthetics are set out. Preoperative preparation of the patient, intraoperative
      monitoring and the technique of local anaesthesia employed by the authors are
      described in detail.

PMID- 8357140
TI  - Inguinal and femoral hernioplasty utilizing polypropylene patch and plug.

PMID- 8357141
TI  - The office hernioplasty and the Trabucco repair.

PMID- 8357142
TI  - The Shouldice operation.

PMID- 8357143
TI  - Femoral hernia.

PMID- 8357144
TI  - [Complicated extremely large hernias. The technical problems].
AB  - The surgical repair of giant hernias is a serious problem. To return the viscera
      that are contained within the hernia sac, to the abdominal cavity, we can cause
      an increase of abdominal pressure, that influences the motion of the diaphragm.
      In fact, post-operative acute respiratory failure is always possible, in these
      patients. To have a good operation, the preoperative preparation by physiotherapy
      is very important, it helps the patient to utilize at most his pulmonary
      capacity. In the surgical repair of these cases, it is necessary to increase the
      volume of the abdominal cavity by some different techniques, in order that the
      intra-abdominal pressure does not increase too much. The reabsorbable prosthesis
      is placed in direct contact with viscera and fixed to the peritoneum and
      posterior rectus sheaths, so that it allows to increase the volume of the
      abdominal cavity. Dacron mesh is fixed to fascia and muscles and assures a long
      time contentitive function. To choose the right operation depends on every single
      case, so the techniques are different and they often can not be codified. In the
      text there are described three complicated cases and the surgical repair that has
      been used. The last case describes a personal techniques that uses two prosthesis
      to create a new peritoneal cavity and a new pre-peritoneal space. The results
      obtained let us say that the surgery which has a functional base and the
      alloplastic prostheses have permitted to operate some clinical cases very
      difficult.

PMID- 8357145
TI  - [The repair of inguinal hernias with a large Dacron-mesh prosthesis and the
      preperitoneal approach].

PMID- 8357146
TI  - [The complications of hernia surgery].

PMID- 8357147
TI  - [The effect of ionizing radiation on the onset of breast carcinoma].
AB  - The authors examine the influence of ionogenic radiations on the onset of breast
      cancer. They remark the connection between the doses of radiations and the
      incidence of cancer and point out that the danger increases when the women is
      exposed to radiations during her fertile age. They present five cases of patients
      suffering from breast cancer where the exposition to radiations may have been a
      cause of the cancer.

PMID- 8357148
TI  - [The epidemiology of gallbladder cancer in Italy. ISTAT data 1970-1987].
AB  - The Italian surgeon needs to know the real situation about gallbladder carcinoma
      in Italy, his professional field of action: real incidence, sex and age
      characteristics and regional distribution with useful correlations to define the
      risk population. We can use nowadays the ISTAT data (since 1969 also in magnetic
      tape) about such neoplasia, based on death denunces. These differentiate
      gallbladder carcinoma from others hepatobiliary neoplasms and are referred to the
      whole national territory and allow and analyze for the various regions a period
      of 18 years (from 1970 to 1987). We have therefore the facility of a statistical
      index which give us the possibility to compare directly the specific mortality
      taxes between very different regions of residence from the point of view of
      population density, sex and age distribution on each year of the period
      considered. Also in Italy incidence of gallbladder carcinoma shows an absolute
      and relative increasing with age in both sexes, reaching the peak in the
      seventy's, with a M/F rate between 1/3 to 1/2, and with global incidence that is
      increasing in the last years. Risk factors could be in the age older than 50
      years, in the females, in the long standing gallbladder lithiasis with wide
      cholesterinic stones on the basis of a chronic inflammation and consequent
      dysplasia, in the diet more far from the mediterranean's, and finally in
      papillomas and papillomatosis of gallbladder.

PMID- 8357149
TI  - [The risk factors and prevention of recurrences in rectal surgery].
AB  - The authors report their own experience of 34 patients operated on for rectal
      cancer. In 8 cases abdomino perineal resection and in 26 anterior resection with
      anastomoses (6 in second time) were performed. Operatory mortality was nil and
      with an average follow up of 34 months 5 local recurrences were observed 16%.
      Among the risk factors examined the most important seems to be the stage of the
      disease; imperative it is therefore a correct surgical approach which warranted a
      significant reduction of local recurrences. This surgical approach includes a
      safety distal clearance from the tumour (at least 2.5 cm.), radical
      lymphadenectomy and complete removal of the mesorectum.

PMID- 8357150
TI  - [The current state of adjuvant treatment in carcinoma of the resected colon].
AB  - After radical surgery for colo-rectal cancer, the prevention of local recurrence
      and/or distant metastasis, represents the key factor of the active measures
      adopted by surgeons and oncologists. Recent trends of the research in this field,
      show that an effective chemotherapy is the goal to achieve. Our review of the
      literature on this subject, is aimed to make some remarks about the results of
      the main randomized protocols of adjuvant chemotherapy conducted in recent years,
      comparing the efficacy of different treatments. We should consider two ways of
      administering the chemotherapy: the systemic route, the classic one, and the
      portal route, especially designed to prevent liver metastasis. At the end of our
      review, we can conclude the following: poly-chemotherapy (MF or MOF) did not show
      real advantages compared to 5-FU alone the combination of 5-FU + Levamisole,
      showed an undoubtable efficacy in Dukes' C colorectal cancer the efficacy of
      intra-portal vein chemotherapy for Dukes' B colorectal cancer, has been proved in
      one report only, therefore we are waiting for a confirmative answer from the
      several similar investigations prompted recently. The analysis of such
      investigations may contribute, in future, to establish new protocols combining
      chemotherapy with immunotherapy and particularly, systemic chemotherapy with loco
      regional one.

PMID- 8357151
TI  - [Hemangioma of the masseter: a rare location of a pathology not always accurately
      diagnosed].
AB  - The hemangiomas of the skeletal muscles are rare. The authors describe a case of
      masseter muscle hemangioma, dwelling upon the problems of differential diagnosis
      that are present for the straight rapport that the muscle contract with the
      parotid gland. Thus, the surgeon is led to confuse the malformation with a
      neoplasm of the parotid gland.

PMID- 8357152
TI  - [Laparoscopic cholecystectomy and percutaneous echo-guided cholecystostomy. Their
      applications in acute cholecystitis].
AB  - Laparoscopic cholecystectomy is nowadays proposed as elective treatment in acute
      cholecystitis; the advantages obtained with this method are comparable with those
      of laparoscopic cholecystectomy outside inflammatory complications. Moreover in
      emergency we have the advantage of better diagnostic definition and less surgical
      trauma. When acute cholecystitis affects high risk patients from the
      anesthesiologic view percutaneous US-assisted cholecystostomy is considered more
      valuable than the medical conservative treatment. Drainage of gallbladder is
      followed from a dramatic clinical improvement with more time for a laparoscopic
      cholecystectomy or for a percutaneous lithotripsy or eventually for the simple
      withdrawal of the catheter.

PMID- 8357153
TI  - [The laparoscopic treatment of splenic rupture, a case report].
AB  - The case report refers to a splenic traumatic rupture treated conservatively by
      diagnostic and interventional laparoscopy. The peculiarities of the method are
      discussed and related to the various problems of the situation: direct
      observation, washing and the use of fibrin glue are the key of the success.

PMID- 8357154
TI  - [A case of a left-sided gallbladder treated surgically via laparoscopy].
AB  - The authors relate about a case of symptomatic cholelithiasis, in which the organ
      was located in the inferior face of III hepatic segment and the surgical
      treatment was performed by laparoscopy. They discuss about etiopathogenesis of
      this anomaly, symptomatology referred by the patients and diagnostic procedures.
      Finally, they stress the necessity, in this case, to perform the cholecystectomy
      by anterograde approach in order to well visualize the anatomic structures and be
      safe to avoid injury of hepatic pedicle.

PMID- 8357155
TI  - An immunogenic self-peptide for T cells in mice with experimental myasthenia.

PMID- 8357156
TI  - In situ production of interleukins in hyperplastic thymus from myasthenia gravis
      patients.

PMID- 8357157
TI  - Myf-4 does not mediate AChR receptor subunit mRNA expression in thymic tissues.
AB  - We investigated whether a MyoD gene family member plays a role in the expression
      of AChR or AChR-like proteins in human thymus. We amplified from thymic tissue,
      mRNA of subunits of the fetal- and adult-type AChR, and Myf-4, a gene product
      that appears to regulate AChR expression. RNA extracted from paraffin-embedded
      thymic tissue of five myasthenics and five nonmyasthenics was subjected to
      reverse transcription followed by polymerase chain reaction using primers
      specific for these mRNAs. Thymic RNA from eight of ten patients contained
      transcripts of the alpha- and epsilon-subunits (specific for the adult-type
      AChR). Presence of these transcripts did not correlate with thymic pathology or
      clinical presentation. No gamma-subunit (specific for the fetal-type AChR) or Myf
      4 transcripts were found. Our results indicate that mRNA for the adult-type AChR
      is expressed in thymic tissue and is expressed by mechanisms not involving Myf-4.
      Thymic AChR subunits may be the primary epitope that initiates the immune
      response in MG against the adult-type AChR.

PMID- 8357158
TI  - Myasthenia gravis-associated thymic epithelial tumors express neurofilaments and
      are associated with antiaxonal autoimmunity.

PMID- 8357159
TI  - Thymus histology and acetylcholine receptor antibodies in generalized myasthenia
      gravis.

PMID- 8357160
TI  - Molecular evolution of the binding site of the acetylcholine receptor.

PMID- 8357161
TI  - Degradation of acetylcholine receptors at vertebrate neuromuscular junctions.

PMID- 8357163
TI  - Stereo view of conformation and myasthenogenicity in synthetic peptides of
      acetylcholine receptor alpha-subunit.

PMID- 8357162
TI  - cDNA and genomic clones encoding the human muscle acetylcholine receptor.

PMID- 8357164
TI  - Approaches for studying the pathogenic T cells in autoimmune patients.
AB  - Our provisional conclusions from this work are as follows. (1) For screening
      responses of established lines, native human AChR is not prohibitively scarce,
      especially if it is concentrated onto beads, and class II-transfected TE671 cells
      may be useful too; both may give vital evidence of AChR-specificity, but it is
      still crucial to confirm that with synthetic peptides. (2) For mapping epitopes,
      panels of full-length and shorter recombinant human polypeptides, and of
      synthetic peptides, are invaluable complementary material: longer peptides tend
      to stimulate particularly strongly. (3) Initial selection with pooled synthetic
      peptides can easily generate interesting lines from both patients and controls,
      but they may depend on the artificial processing sites that are an inevitable
      consequence of arbitrarily chosen start and stop points. Of course, these might
      conceivably be employed in unusual antigen-presenting cells (such as thymic myoid
      cells), so we cannot totally dismiss such "cryptic" epitopes. This system can
      sometimes select T cells responding to "natural" epitopes too, as now reported
      for tetanus toxin. Nevertheless, for these and other reasons, at present, we
      strongly favor using the longest human recombinant material possible, because it
      is apparently processed more naturally. This must be combined with rigorous
      screening for reactivity to E. coli-derived contaminants plus concomitant mapping
      of epitopes as above. Use of intact AChR for initiating lines may yet become
      feasible. (4) The T cells thus isolated and characterized so far are proving to
      be heterogeneous in the epitopes and presenting class II molecules they
      recognize, and in their T-cell receptor gene usage. It is premature to claim key
      myasthenogenic epitopes or clonotypes, but HLA-DR3 and the linked -DQw2 do not
      appear to monopolize presentation. (5) Assessing the disease-relevance of these T
      cells is a separate problem, highlighted by their apparent similarity in healthy
      controls. In the meantime, to test their potential pathogenicity, we are assaying
      their cytokine profiles and ability to help specific antibody production in
      vitro. In the hope that they do prove to be relevant, we are also using some of
      them to test possible therapeutic strategies that might prove applicable in the
      patients.

PMID- 8357165
TI  - Differences in acetylcholine receptor-antibody interactions between extraocular
      and extremity muscle fibers.
AB  - There are two types of motor nerve innervation patterns and AChR distributions in
      human EOM: single and multiple. The latter is further divided into two subgroups
      that are restricted to EOM and are not found in limb muscles. Epitopes that are
      unique to EOM end-plates exist. Some OMG patients have antibodies that are
      specifically targeted to those epitopes. These antibodies are functionally active
      and can cause AChR loss in EOM end-plates. In addition to AChRs, specific
      components constructing the microenvironment surrounding them may also be
      involved in the susceptibility of EOM in myasthenia gravis.

PMID- 8357167
TI  - Molecular structure of a monoclonal antiacetylcholine receptor antibody and of a
      corresponding monoclonal antiidiotopic antibody.

PMID- 8357166
TI  - Effector mechanisms of myasthenic antibodies.

PMID- 8357169
TI  - Abnormal immunoregulation involving the IL-2/IL-2 receptor complex in myasthenia
      gravis.

PMID- 8357168
TI  - Differential recognition by T cells of the P3A+ and P3A- isoforms of the human
      acetylcholine receptor alpha-subunit.

PMID- 8357171
TI  - Stimulation of specific T cells by human AChR adsorbed to immunomagnetic
      particles.

PMID- 8357170
TI  - VH gene family utilization of antiacetylcholine receptor antibodies in
      experimental autoimmune myasthenia gravis.

PMID- 8357172
TI  - Steps in the generation of autoantibodies.

PMID- 8357173
TI  - T-cell receptor expression in murine myasthenia gravis.

PMID- 8357174
TI  - EAMG induced in rabbits by immunization against peptides representing human AChR
      alpha 138-199.

PMID- 8357175
TI  - A novel therapy for myasthenia gravis by reducing the endocytosis of
      acetylcholine receptors.

PMID- 8357176
TI  - The hu-SCID myasthenic mouse. A new tool for the investigation of seronegative
      myasthenia gravis.

PMID- 8357177
TI  - Tolerance to AChR induced by AChR-coupled syngeneic cells: clonal anergy?

PMID- 8357178
TI  - Acetylcholine receptor-specific T cells are present in the normal immune
      repertoire. A study with recombinant polypeptides of the human acetylcholine
      receptor alpha-subunit.

PMID- 8357179
TI  - T-cell receptor gene usage of acetylcholine receptor-specific T-helper cells.

PMID- 8357180
TI  - Production of interferon gamma and interleukin-2 by peripheral blood lymphocytes
      of patients with myasthenia gravis and other autoimmune diseases.

PMID- 8357181
TI  - Cells from mice exposed chronically to D-penicillamine show proliferative
      responses to D-penicillamine-treated self (macrophage/dendritic cells): a graft
      versus-host response?

PMID- 8357182
TI  - Response of peripheral blood mononuclear cells from myasthenia gravis patients to
      exogenous interleukin-2.

PMID- 8357183
TI  - Acetylcholine receptor presentation by B cells using heterobifunctional antibody
      conjugates.

PMID- 8357184
TI  - T-cell receptor genes in autoimmunity.
AB  - T cells are primary participants in the pathogenesis of the MHC-dependent
      autoimmune diseases, and therefore, evidence for association of TCR V-gene
      repertoires with such disorders has been actively sought. With very few
      exceptions, no clear-cut evidence for correlation of particular RFLP-defined V-C
      region genomic polymorphisms with autoimmune disease predisposition has thus far
      been demonstrated. With regard to TCR V-gene repertoires engaged in responses to
      autoantigens, restricted use of certain V beta and V alpha genes in response to
      myelin basic protein has been documented in animal models. In many spontaneous
      and experimentally induced animal and human autoimmune diseases, however, the
      picture is far from clear. Although dominance of certain TCR V genes has been
      noted, the clonal restrictions are not absolute; they differ from one study to
      another and from one patient to another. Such variations may be caused by MHC
      allele-dependent determinant selection mechanisms, secondary T-cell infiltrates
      in inflammatory sites, different patient populations and stages of disease, or
      the involvement of different pathogens that, nevertheless, lead to the same
      clinical entity. Overall, the results indicate that efforts to intervene
      therapeutically in autoimmune diseases by vaccination with modified T-cell
      clones, V region-synthetic peptides, or TCR blocking analogues may not be easily
      applicable. Further studies on the characterization of the specific antigens
      involved in autoimmune disease pathogenesis is required in order to accurately
      address the issue of TCR utilization in autoimmune diseases.

PMID- 8357185
TI  - Regulation of experimental autoimmune myasthenia gravis by synthetic peptides of
      the acetylcholine receptor.

PMID- 8357187
TI  - Muscarinic receptor-mediated modulation of acetylcholine release in mice with
      passively transferred Lambert-Eaton myasthenic syndrome.

PMID- 8357186
TI  - Human muscle acetylcholine receptor reactive T and B lymphocytes in myasthenia
      gravis.

PMID- 8357188
TI  - The thymus in myasthenia gravis.

PMID- 8357189
TI  - Congenital myasthenic syndrome attributed to an abnormal interaction of
      acetylcholine with its receptor.

PMID- 8357191
TI  - The thymus and T-cell tolerance.

PMID- 8357190
TI  - Myasthenic syndromes attributed to mutations affecting the epsilon subunit of the
      acetylcholine receptor.

PMID- 8357192
TI  - Congenital end-plate acetylcholine receptor deficiency and short channel open
      time.

PMID- 8357193
TI  - Strategies for treatment of myasthenia gravis.

PMID- 8357194
TI  - A clinical therapeutic trial of cyclosporine in myasthenia gravis.
AB  - We randomly assigned 39 patients with steroid-dependent generalized myasthenia
      gravis to treatment with cyclosporine (5 mg/kg per body weight in divided doses)
      or placebo. Duration of treatment was 6 months. Patients were evaluated monthly.
      Primary measures of efficacy were quantified strength testing, antihuman
      acetylcholine receptor antibody titer, and dosage of corticosteroid medication.
      At the end of the study, patients in the cyclosporine group had significantly
      greater improvement in strength (p = 0.004) and a reduction in antireceptor
      antibody titer (p = 0.01). Percentage reduction of steroid medication was greater
      in the cyclosporine group, although the difference was not statistically
      significant (p = 0.12). There were no treatment failures, and there was one drug
      failure in the cyclosporine group. In the placebo group, there were three
      treatment failures. No significant nephrotoxicity was noted at this dosage during
      the first 6 months. During the subsequent 18 months of open-label therapy,
      continued reduction in steroid dosage occurred. Cumulative side effects, however,
      caused 35% of patients to discontinue the medication; 10% did so secondary to
      slowly progressive nephrotoxicity.

PMID- 8357195
TI  - Clinical improvement of myasthenia gravis by treatment with a chimeric anti-CD4
      monoclonal antibody.

PMID- 8357197
TI  - Infections occurring in hospitalized myasthenia gravis patients.

PMID- 8357196
TI  - Searching for prognostic factors at the time of thymectomy for myasthenia gravis.
      Correlation between outcome after long-term follow-up and immunophenotype of
      thymic and peripheral blood lymphocytes.

PMID- 8357198
TI  - Therapies for exacerbation of myasthenia gravis. The mechanism of action of
      intravenous high-dose immunoglobulin G.

PMID- 8357199
TI  - Single-fiber EMG and repetitive stimulation of the same muscle in myasthenia
      gravis.

PMID- 8357200
TI  - Analysis of HLA DPB1 allele in patients with myasthenia gravis in Japan.

PMID- 8357202
TI  - How reliable are imaging procedures in detecting residual thymus after previous
      thymectomy?

PMID- 8357201
TI  - Myasthenia gravis is associated with two DQ alpha/beta heterodimers.

PMID- 8357203
TI  - An in vitro model for disease-specific immunotherapy in myasthenia gravis using
      soluble MHC class II bound to AChR-derived peptide.

PMID- 8357205
TI  - Electrophysiological characteristics in seronegative myasthenia gravis.

PMID- 8357204
TI  - HLA haplotype in myasthenia gravis (MG) of Japanese children. Correlative studies
      between MG patients and their normal siblings and parents.

PMID- 8357206
TI  - 3,4-Diaminopyridine in Lambert-Eaton myasthenic syndrome and myasthenia gravis.

PMID- 8357207
TI  - Relapses in patients with myasthenia gravis treated with azathioprine.

PMID- 8357208
TI  - Immunosuppressive treatments. Their efficacy on myasthenia gravis patients'
      outcome and on the natural course of the disease.

PMID- 8357209
TI  - Treatment strategies in myasthenia gravis.

PMID- 8357210
TI  - Transplantation of myasthenia gravis thymus to SCID mice.

PMID- 8357211
TI  - Molecular analysis of intrathymic nicotinic acetylcholine receptor.

PMID- 8357212
TI  - Nicotinic neuronal acetylcholine receptor alpha-3 subunit transcription in normal
      and myasthenic thymus.
AB  - Thymic transcription of the alpha-3 subunit of the AChR was studied through
      sequencing and PCR analysis of thymic cDNA clones, Northern blotting, and
      ribonuclease protection assays. This analysis revealed at least three, 3' end
      sequence variants for the alpha-3 subunit as well as a variant that results from
      the alternative splicing of an antisense 122 bp Alu sequence between exons 5 and
      6 of the normal transcript. The spliced Alu sequence not only shifts the exon 6
      reading frame but also carries an in-frame stop codon. If translated, this
      variant transcript would produce a truncated peptide lacking the fourth
      transmembrane domain of the subunit and carrying a carboxy terminus dodecapeptide
      not found in any other known AChR subunit sequence. The putative variant subunit
      may lack biological activity and should differ antigenically from its normal
      counterpart. In comparing the normal, the MG hypertrophic, and the MG thymoma for
      transcription of the alpha-3 subunit and its 122 bp variant, it was found that
      there were no qualitative or quantitative changes in alpha-3 transcript
      expression in the MG hypertrophic thymi. Thymomas, however, showed an overall
      decrease in alpha-3 transcription and a comparative increase in beta-amyloid
      precursor transcription. The decrease in the levels of alpha-3 transcription in
      thymomas may be related to the proliferation of thymic epithelial cells.

PMID- 8357213
TI  - High IL-6 gene expression and production by cultured human thymic epithelial
      cells from patients with myasthenia gravis.

PMID- 8357214
TI  - Microsurgical scalp and skull reconstruction using a serratus anterior myo
      osseous flap.
AB  - In reconstruction of large scalp and skull defects, the usefulness of
      microvascular free tissue transfer is manifest. We have performed 4 scalp and
      skull reconstructions by free serratus anterior osteomuscle flap transfer. The
      usefulness of serratus anterior osteomuscle flap for reconstruction of combined,
      extensive scalp and skull defects is emphasized.

PMID- 8357215
TI  - Platysma myocutaneous flap for intraoral and surface reconstruction.
AB  - Different procedures have been described for facial and oral reconstruction after
      malignant tumor removal, such as skin grafts and local and distal staged flaps.
      Myocutaneous island or free flaps are the method of choice for these
      reconstructions. Our experience concerns the use of the platysma myocutaneous
      flap in 12 patients after intraoral and extraoral malignant tumor resection. Six
      patients had squamous cell carcinomas, i.e., 2 malignant melanomas of the skin
      and 4 squamous cell carcinomas of the oral mucosa. The complete tumor resection
      was controlled by frozen-section biopsy in all patients, but for 7 of them a
      functional or radical neck dissection was performed. We suggest including in the
      flap the external jugular vein. The results were evaluated from an oncological,
      functional, and aesthetic point of view. We noticed 2 recurrences in a minimum
      follow-up of 4 years. The functional and aesthetic results were quite
      satisfactory and no serious complications were noticed in our series. However,
      the primary disadvantage of this interesting flap is that the dominant
      vasculature derived from the submental branch of the facial artery is seldom
      visualized. In spite of this, it should be regarded as very useful for limited
      intraoral or surface coverage problems in an arc extending 10 cm from the level
      of the facial artery at the mandible. This arc includes the cheek, the lower lip,
      the chin, the floor of the mouth, and the mastoid area.

PMID- 8357216
TI  - Experimental effects of intraorbital tissue expansion on orbitomaxillary growth
      in anophthalmos.
AB  - A skeletal growth study evaluating an intraorbital tissue expander as a globe
      replacement in anophthalmos was conducted in an infant animal model. Twenty-one
      21-day-old kittens were equally divided into the following three groups: a
      control, a unilaterally enucleated, and an enucleated-expanded group.
      Postoperative three-dimensional computed tomographic scans were obtained at 5
      months of age immediately before study termination. Linear orbital,
      orbitomaxillary, and zygomaticomaxillary dimensions were measured on the scans
      and compared at necropsy with orbital volume assessment on the dry skulls.
      Control animal orbits averaged 21.5 mm in height, 21.0 mm in width, and 5.1 cm3
      in orbital volume, and an orbitomaxillary-zygomaticomaxillary height-to-width
      ratio of 31.0: 24.5. The control side, its contralateral side, and the
      contralateral orbits of the treated sides were not significantly different. By
      study completion, enucleation resulted in a significant loss of orbital volume
      (mean, 1.9 cm3; p < 0.001) confirmed by deficient orbitozygomaticomaxillary
      measurements. The expanded orbits showed no loss of volume (mean, 5.2 cm3; p >
      0.1) and normalization of all linear midfacial structures. This study
      demonstrates that early expansion emanating from within the orbital soft tissue
      positively affects both the skeletal and lid anomalies associated with congenital
      globe loss or early enucleation.

PMID- 8357217
TI  - The perineal artery axial flap.
AB  - We have found the perineal artery axial flap to be useful in reconstruction of
      moderate defects of the perineum. The experimental surgical technique and
      clinical applications of the perineal artery axial flap are updated. Our
      experience with 10 patients over the past 5 years is reviewed. The advantages of
      this flap are that it is thin and the donor site morbidity is minimal.

PMID- 8357218
TI  - Diagnostic criteria of vascular lesions in the face.
AB  - Diagnostic criteria of vascular lesions in the face were studied in a series of
      57 patients investigated and treated during the years 1980 to 1990. Twenty-eight
      had hemangiomas and malformations, and 29 had telangiectasia. At present, the
      histological diagnoses are most commonly used to describe vascular lesions, but
      unfortunately this gives little idea of the actual appearance of the lesion. In
      the present study, the clinical appearance was compared and correlated with the
      findings at the time of surgery, with the angiographs, and with the histological
      diagnosis. An attempt was undertaken to coordinate the accepted clinical,
      microscopic, and angiographic classifications with our own results. Based on the
      modern concepts of pathology of angiogenesis and the conclusions drawn from our
      present investigation, the "new," unifying classification of vascular lesions was
      compiled. This classification is presented in the form of a diagram.

PMID- 8357219
TI  - A new classification of vascularized flaps in plastic and reconstructive surgery.
AB  - Advances during the last 15 years in microsurgical technique and in our
      understanding of vascular anatomy have led to the development of two new branches
      of plastic and reconstructive surgery. The first is the transfer of free
      composite flaps with microvascular anastomoses. The second is transposition of
      island flaps solely on a proximal or distal vascular bundle. Both types of
      operations require an adequate vascular pedicle to provide sufficient blood
      circulation for flap viability and survival in the recipient site.

PMID- 8357221
TI  - Midfacial fracture repair in the adult rat.
AB  - The consensus in the literature is that fracture healing within the midface
      occurs via fibrous union. Clinical experience with the surgical correction of
      established traumatic deformities has not borne this out. An earlier histological
      examination with human biopsy specimens demonstrated that eventually repair
      occurred by direct bony union. However, a recent study in a rabbit model
      challenged this conclusion and indicated that the process of new formation
      resembles secondary bone formation as in endochondral formed bone. The purpose of
      our inquiry is to elucidate further the process of midfacial bony repair in an
      adult male Sprague-Dawley rat model.

PMID- 8357220
TI  - Identification of xanthine oxidase activity following reperfusion in human
      tissue.
AB  - In this series of experiments, we surveyed xanthine oxidase activity after
      microvascular transfer in the venous effluent after reperfusion of human rectus
      abdominis muscle (n = 8) and jejunum (n = 4). Enzyme activity was correlated with
      duration of ischemia and biochemical markers of cellular injury. Xanthine oxidase
      (XO) activity was measured spectrofluorometrically using a pterin assay, whereas
      cellular injury was measured with commercial creatinine phosphokinase activity
      assay and lipid peroxidation products using a spectrophotometer. The data
      demonstrated that XO activity was statistically significantly increased in muscle
      flaps kept at room temperature during ischemia compared with muscle flaps that
      were cooled (p < 0.05). Creatinine phosphokinase activity was also increased
      after 15 minutes of reperfusion in muscle flaps that were not cooled (p < 0.05).
      Two of the jejunal free flaps had ischemia times of > 1 hour and had elevated XO
      activity after reperfusion despite cooling (p < 0.05). Two other jejunal flaps
      had ischemia times of < 1 hour, but in one case, the XO activity was increased
      before harvest. The other case had no increase in XO activity.

PMID- 8357222
TI  - Ultrasound analysis of 150 patients with silicone gel breast implants.
AB  - One-hundred fifty patients with silicone gel breast implants were investigated
      using ultrasound (US) studies, to assess the integrity of their implants. US
      testing demonstrated 8 patients (5.33%) with implant rupture, which was
      subsequently confirmed at surgery. A further 4 patients were "false negatives,"
      wherein they presented with normal US tests, but at subsequent surgery,
      demonstrated secondary alterations in their implant envelopes. Two of these
      patients demonstrated profound local silicone gel "bleed," whereas the 2 others
      had frank implant rupture. There was also one "false positive" patient. The total
      known prevalence of patient implant alteration was therefore 12, i.e., 10 with
      ruptures and 2 with profound local gel "bleed," in 150 patients (8.0%). Five of
      the 10 patients with ruptured implants had undergone multiple closed
      capsulotomies in the past. The mean time of diagnosis after implant insertion was
      8.5 years (range, 2.0-18 yr). US analysis may provide a safe, simple,
      inexpensive, noninvasive tool to assist in the identification of ruptured
      silicone gel breast implants. There were significant limitations with technique,
      however, in that there were 4 false negatives, and 1 false positive result, and
      US analysis was not helpful in diagnosing profound silicone gel bleeds.

PMID- 8357223
TI  - Effects of magnetic resonance imaging fields on gold eyelid loads.
AB  - Magnetic resonance imaging is frequently used for visualization of soft tissues
      of the head and neck. It was the purpose of this study to determine whether gold
      eyelid weights, used for treatment of lagophthalmos in facial palsy, would be
      deflected at high magnetic strengths during imaging. Ex vivo study of six
      incrementally increasing weights at two magnetic strengths was performed. There
      was no deflection of any of the gold eyelid loads at either 0.5-tesla or 1.5
      tesla magnetic strengths. We conclude that patients with gold eyelid weights are
      not at risk of damage from movement of the prostheses during magnetic resonance
      imaging examination.

PMID- 8357224
TI  - Control of hemorrhage during renal failure with triglycyl-lysine-vasopressin.
AB  - A 35-year-old man with chronic renal failure developed toxic epidermal necrolysis
      due to combination antibiotic therapy for a community acquired pneumonia. During
      wound care for his toxic epidermal necrolysis, he developed massive bleeding, a 4
      to 6 unit blood loss at each dressing change, due to uremia-associated platelet
      dysfunction and thrombocytopenia. After failure of standard therapy, the man was
      treated with intravenous triglycyl-lysine-vasopressin, a selective peripheral
      vasoconstrictor. Transfusion requirements stopped during treatment. This man went
      on to full recovery with complete wound healing. Triglycyl-lysine-vasopressin
      effectively reduced skin blood loss in this man with toxic epidermal necrolysis
      and an intrinsic hemostatic defect, and may be useful in other patients with
      cutaneous blood loss.

PMID- 8357225
TI  - Emergency free flap reconstruction of a facial gunshot wound.
AB  - An emergency free rectus abdominis myocutaneous flap was used to reconstruct a
      massive facial gunshot wound with associated cranial communication immediately
      after the primary debridement. The bony defect was reconstructed with split
      calvarial and rib grafts, plates, and screws. The free flap provided adequate
      coverage of the bony reconstruction and separation of the cranial and sinus
      cavities.

PMID- 8357226
TI  - Osteoid osteoma of the hamate: report of a case and review of the literature.
AB  - There are 7 reported patients with osteoid osteoma of the hamate. Only 1 of these
      has involved the hook of the hamate. This article reports the second patient with
      osteoid osteoma involving the hook of the hamate. The clinical features, the
      diagnostic problems, and the management of this lesion are reviewed.

PMID- 8357227
TI  - Dermatofibrosarcoma protuberans appearing during pregnancy.
AB  - Dermatofibrosarcoma protuberans is an uncommon skin tumor with a high potential
      for local recurrence if not adequately excised. There are only two reports in the
      literature describing dermatofibrosarcoma protuberans that enlarged considerably
      during pregnancy. On the other hand, the new development or enlargement of
      dermatofibromas in pregnancy is well documented. We present 2 additional patients
      in whom a dermatofibrosarcoma protuberans appeared and grew rapidly during
      pregnancy. Immunohistochemical studies were negative for estrogen and
      progesterone receptors. The possible pathophysiology and surgical management are
      presented and discussed.

PMID- 8357228
TI  - But is it significant?

PMID- 8357229
TI  - Re: Free muscle transfer for reconstruction after melanoma resection of the leg.

PMID- 8357230
TI  - Intravascular ultrasound.

PMID- 8357231
TI  - Imaging for planned hepatic resection.

PMID- 8357232
TI  - Percutaneous recanalization and stents of the biliary tree.
AB  - Biliary obstruction can be treated by surgical, endoscopic or percutaneous
      methods. Interventional radiology has the following recanalization methods to
      offer: external-internal drainage, balloon dilatation of strictures and permanent
      stent placement. Metallic expandable stents are becoming very popular. In many
      centers, endoscopic interventions of the biliary tract have replaced the
      percutaneous route as a primary procedure. Combined radiologic and endoscopic
      methods are helpful in complicated interventions.

PMID- 8357234
TI  - Ultrasound guided drainage of abdominal abscesses and fluid collections.

PMID- 8357233
TI  - Imaging of the kidney, liver, and pancreas transplant.
AB  - Imaging of the renal, hepatic, and pancreas allograft is essential for evaluation
      of postoperative complications. Surgical complications after organ
      transplantation can generally be specifically diagnosed. These complications
      include obstruction, leakage, peritransplant fluid collections, and vascular
      problems such as vascular stenosis or thrombosis, arteriovenous fistula, and
      pseudoaneurysm. Using computed tomography (CT) or ultrasound guidance,
      interventional procedures can often be performed to treat various surgical
      complications. On the other hand, medical causes of allograft transplant
      dysfunction such as rejection, acute tubular necrosis, drug toxicity, ischemia,
      infection, inflammation, or the development of recurrent disease are frequently
      associated with nonspecific imaging findings. Allograft biopsy is still usually
      necessary for definitive diagnosis in these cases. In this article, we will
      briefly outline the spectrum of abnormalities that can be seen in the allograft
      recipient and show some examples of these complications.

PMID- 8357236
TI  - Surgical aspects of diagnostic and interventional radiology. Special issue.

PMID- 8357235
TI  - Percutaneous treatment of lumbar disc herniation.
AB  - Nine hundred and eighteen patients were subjected to percutaneous treatment of
      lumbar herniated disc. 733 of these were treated through enzymatic nucleolysis
      with chymopapain, for a total 883 levels (150 of whom were treated at two
      levels): 185 patients were treated with Onik's automate discectomy.
      Chemonucleolysis was carried out on 733 patients (79.8%) and automated discectomy
      in 185 cases (20.1%). Chemonucleolysis has led to the resolution of the symptoms
      in a high percentage of cases (82.2%). Nucleotomy was an effective method of
      management in 74.6% of the cases. The availability of several therapeutic methods
      has allowed us to respond in a more appropriate way to the patient's requirements
      and, in the case of failure, offer a more flexible therapeutic spectrum, and to
      consider surgery as the last resort. As regards the relation between enzymatic
      nucleolysis with chymopapain and disc nucleoaspiration, we feel that the two
      should not be in competition, for the indications are precise for both methods:
      in the enzymatic treatment, the hernia can be medium-large sized, in a sub- or
      extra-ligamentous position. The treatment of patients with moderately severe
      symptoms is preferable. In disc nucleoaspiration, the hernia must be small-sized.

PMID- 8357237
TI  - The role of coronary angioplasty in the management of coronary artery disease.
AB  - Coronary angioplasty is well established as a treatment modality for coronary
      artery disease. Clinical experience leaves no doubt that it can be very effective
      in relieving symptoms in patients with unstable angina and with chronic stable
      angina. There are, at present, no controlled trials to demonstrate its efficacy,
      though several are under way. In straightforward cases the initial success rate
      is about 90%, but for each lesion dilated, there is about a 30% chance of
      significant re-stenosis. Re-stenosis (which is the main chronic complication)
      usually occurs early--often within a few weeks of the procedure--and it rarely
      develops later than six months after the procedure. Acute closure of the dilated
      artery (usually within an hour or two of procedure) is the most feared acute
      complication and is the main factor contributing to the 0.2% acute mortality rate
      and to the 1-5% risk of emergency coronary artery bypass grafting. The procedural
      risk does not increase progressively with serial interventions (in contrast to
      coronary artery surgery). Furthermore, angioplasty is often undertaken following
      surgery when stenoses have developed within the grafts, at the graft-vessel
      anastomosis, in the native vessels distal to the graft insertion or in native
      ungrafted vessels. Angioplasty is less costly than coronary surgery, although the
      30% re-stenosis rate implies a requirement for additional interventions as a
      result of which the cost differential is not as great it initially appears.

PMID- 8357238
TI  - Magnetic resonance angiography: current clinical applications.
AB  - Magnetic Resonance Angiography (MRA) is the newest non-invasive procedure for the
      evaluation of the vascular system. The basis to obtain images of vessels from
      Magnetic Resonance (MR) data rely upon the specific signal alteration determined
      by flowing blood. By using special techniques only these signals are evidenced,
      with cancelling of the surrounding stationary tissues. Clinical applications are
      reviewed in this paper. They include: Evaluation of intracranial vessels with
      important adjunct information to those obtained by conventional MR images;
      Definition of cerebrovascular disease including the carotid artery with good
      correlation with Digital Subtraction Angiography (DSA); Evidence of abdominal
      vessels, with clear imaging of abdominal aortic aneurysms; Definition of renal
      arteries; although problems exist, the technique may become useful in the future
      for the screening of renovascular hypertension; Visualization of peripheral
      vessels; initial results indicate a potential application in the evaluation of
      peripheral run-off distal to occlusions.

PMID- 8357239
TI  - Percutaneous recanalisation of arteries.

PMID- 8357240
TI  - Survival and growth of Escherichia coli O157:H7 on salad vegetables.
AB  - The influence of modified-atmosphere packaging, storage temperature, and time on
      survival and growth of Escherichia coli O157:H7 inoculated onto shredded lettuce,
      sliced cucumber, and shredded carrot was determined. Growth of psychotrophic and
      mesophilic microorganisms and changes in pH and sensory qualities of vegetables,
      as judged by subjective evaluation, were also monitored. Packaging under an
      atmosphere containing 3% oxygen and 97% nitrogen had no apparent effect on
      populations of E. coli O157:H7, psychotrophs, or mesophiles. Populations of
      viable E. coli O157:H7 declined on vegetables stored at 5 degrees C and increased
      on vegetables stored at 12 and 21 degrees C for up to 14 days. The most rapid
      increases in populations of E. coli O157:H7 occurred on lettuce and cucumbers
      stored at 21 degrees C. These results suggest that an unknown factor(s)
      associated with carrots may inhibit the growth of E. coli O157:H7. The reduction
      in pH of vegetables was correlated with initial increases in populations of E.
      coli O157:H7 and naturally occurring microfloras. Eventual decreases in E. coli
      O157:H7 in some samples, e.g., those stored at 21 degrees C, are attributed to
      the toxic effect of accumulated acids. Changes in visual appearance of vegetables
      were not influenced substantially by growth of E. coli O157:H7. The ability of E.
      coli O157:H7 to growth on raw salad vegetables subjected to processing and
      storage conditions simulating those routinely used in commercial practice has
      been demonstrated.

PMID- 8357241
TI  - Purification and preliminary characterization of permethrinase from a pyrethroid
      transforming strain of Bacillus cereus.
AB  - Bacillus cereus SM3 was isolated on a mineral salts medium with Tween 80 as the
      primary carbon source. It was able to hydrolyze second- and third-generation
      pyrethroids, thereby generating noninsecticidal products. The enzyme responsible
      for this hydrolytic reaction was named permethrinase for this study. This is the
      first instance in which pyrethroid detoxification has been achieved with a cell
      free microbial enzyme system. Permethrinase was purified by ion-exchange
      chromatography and gel filtration chromatography. The molecular mass of native
      permethrinase was 61 +/- 3 kDa, as estimated by Sephadex G-100 gel filtration.
      This novel microbial esterase seems to be a carboxylesterase. Permethrinase
      activity had an optimum pH of 7.5 and a temperature optimum of 37 degrees C. No
      cofactors or coenzymes were required for permethrinase activity. The enzyme may
      be a serine esterase, as it seems to be sensitive to the organophosphorus
      compound tetraethylpyrophosphate at concentrations in the micromolar range.
      Addition of dithiothreitol afforded permethrinase protection against the
      inhibitory effects of the sulfydryl agents p-chloromercuribenzoate and N
      ethylmaleimide. The enzyme was stable over a range of temperatures. Cell extracts
      of strain SM3 also contained another esterase, which was active towards beta
      naphthylacetate, but this enzyme was distinct from permethrinase.

PMID- 8357242
TI  - Isolation and characterization of the lantibiotic salivaricin A and its
      structural gene salA from Streptococcus salivarius 20P3.
AB  - A bacteriocin-like inhibitory substance, salivaricin A, was purified from
      cultures of Streptococcus salivarius 20P3 and was shown by ion spray mass
      spectrometry to have a molecular mass of 2,315 +/- 1.1 Da. Amino acid composition
      analysis demonstrated the presence of lanthionine, indicating that salivaricin A
      may be a member of the lantibiotic class of antibiotic substances. The sequence
      of eight amino acids at the N terminus of the molecule was determined by Edman
      degradation, and mixed oligonucleotide probes based on part of this sequence
      (GSGWIA) were used to detect the salivaricin A structural gene. A 6.2-kb EcoRI
      fragment of chromosomal DNA from strain 20P3 that hybridized with the probes was
      cloned, and the hybridizing region was further localized to a 379-bp DraI-AluI
      fragment. Analysis of the nucleotide sequence of this fragment indicated that
      salivaricin A is synthesized as a 51-amino-acid prepeptide that is
      posttranslationally modified and cleaved to give a biologically active 22-residue
      peptide containing one lanthionine and two beta-methyllanthionine residues. The
      secondary structure of presalivaricin A was predicted to be similar to that of
      type A lantibiotics, with a hydrophilic alpha-helical leader sequence and a
      propeptide region with potential for beta-turn formation and a lack of alpha
      helicity. The sequence around the cleavage site of presalivaricin A differed from
      that of other type A lantibiotics but was similar to that of several bacteriocin
      like inhibitory substances produced by lactic acid bacteria.

PMID- 8357243
TI  - Combined effects of sulfites, temperature, and agitation time on production of
      glycerol in grape juice by Saccharomyces cerevisiae.
AB  - Analysis of variance was used to evaluate the simultaneous effects of strain,
      incubation temperature (15 to 25 degrees C), agitation time (0 to 24 h), and
      initial sulfite concentration (100 to 300 ppm) on glycerol production in grape
      juice by Saccharomyces cerevisiae. Fourteen strains were studied to determine
      their growth patterns in the presence of sulfites and ethanol. Baker's yeast
      strains were more sensitive to sulfite than wine strains, and little growth
      occurred at initial sulfite levels greater than 150 ppm. Sensitivity to sulfite
      increased with increasing levels of ethanol. Three strains exhibiting the best
      growth in the presence of sulfites and ethanol were selected for interaction
      studies. Fermentations were carried out until the solids content had decreased to
      less than 6 degrees Brix, which was the point that glycerol content became
      stable. For the three strains used, the greatest level of glycerol production was
      observed in the presence of 300 ppm of sulfite for most incubation temperatures
      and agitation times. There was significant interaction between the strain,
      incubation temperature, and agitation time parameters for glycerol synthesis, and
      a response surface method was used to predict the optimal conditions for glycerol
      production. Under static conditions, the highest level of glycerol production was
      observed at 20 degrees C, while incubation at 25 degrees C gave the best results
      when the cultures were agitated for 24 h. Response surface equations were used to
      predict that the optimum conditions for glycerol production by S. cerevisiae Y11
      were a temperature of 22 degrees C, an initial sulfite concentration of 300 ppm,
      and no agitation, which yielded 0.68 g of glycerol per 100 ml.

PMID- 8357244
TI  - Isolation and characterization of Selenomonas ruminantium strains capable of 2
      deoxyribose utilization.
AB  - Microbes from ruminal contents of cattle were selectively enriched by using 2
      deoxyribose (2DR) as a substrate for growth. Bacterial isolates growing on 2DR
      were gram-negative, curved, motile rods. The isolates grew on a broad range of
      substrates, including deoxyribose, glucose, ribose, mannitol, and lactate as well
      as ribonucleosides and deoxyribonucleosides. The strains also grew on rhamnose (6
      deoxymannose) but not DNA. Organic acids produced from growth on hexoses and
      pentoses included acetate, propionate, lactate, and succinate. The isolates were
      identified as Selenomonas ruminantium subsp. lactilytica on the basis of
      morphology, substrate specificity, and other biochemical characteristics. Several
      characterized species of ruminal bacteria were also screened for growth on 2DR,
      with only one strain (S. ruminantium PC-18) found able to grow on 2DR. Ethanol
      was produced by 2DR when strains were grown on ribose or 2DR.

PMID- 8357245
TI  - Sodium chloride, potassium chloride, and virulence in Listeria monocytogenes.
AB  - Virulence, as determined in a mouse model, and the virulence factor activities of
      catalase, superoxide dismutase, and listeriolysin O were examined in a parental
      strain (10403S) and in a nonhemolytic mutant strain (DP-L224) of Listeria
      monocytogenes. The cells were propagated in media containing various
      concentrations of sodium chloride or potassium chloride. Strains 10403S and DP
      L224 exhibited significant increases in catalase activity and listeriolysin O
      activity when grown in medium containing either salt at 428 mM. The superoxide
      dismutase activities for both strains increased when they were grown in medium
      containing either salt. The superoxide dismutase activity was significantly
      increased only when cells were propagated in medium containing no salt compared
      with that when they were propagated in medium containing either salt at 1,112 mM.
      In addition, the listeriolysin O activity was highest for cells propagated in
      medium containing KCl at 428 mM, while the activity was significantly less for
      cells propagated in medium containing NaCl at an equal concentration. Virulence
      was examined in mouse livers and spleens after intravenous infection, and
      approximate 50% lethal doses were determined after intragastric and
      intraperitoneal infection. Each method of infection indicated that listeriolysin
      O is required for virulence, while growth in salt-containing medium or the
      production of higher levels of catalase, superoxide dismutase, and listeriolysin
      O do not appear to enhance the virulence of L. monocytogenes.

PMID- 8357246
TI  - Purification and partial characterization of an elastolytic serine protease of
      Prevotella intermedia.
AB  - Elastolytic strains of Prevotella intermedia were isolated from pus samples of
      adult periodontal lesions. Elastase was found to associate with envelope, and it
      could be solubilized with guanidine-HCl. The enzyme was purified to homogeneity
      by sequential procedures including ion-exchange chromatography, gel filtration,
      and hydrophobic interaction chromatography. This elastase was a serine protease,
      and its mass was 31 kDa. It hydrolyzed elastin powder, but collagen and azodye
      conjugated proteins were not degraded by this enzyme. Both synthetic substrates
      for human pancreatic (glutaryl-L-alanyl-L-alanyl-L-prolyl-L-leucine p
      nitroanilide) and leukocyte elastase (methoxy succinyl-L-alanyl-alanyl-L-prolyl-L
      valine p-nitroanilide) were hydrolyzed.

PMID- 8357247
TI  - Fate of Agrobacterium radiobacter K84 in the environment.
AB  - Agrobacterium radiobacter K84 is an effective, commercially applied, biological
      control agent for the plant disease crown gall, yet little is known about the
      survival and dissemination of K84. To trace K84 in the environment, spontaneous
      antibiotic-resistant mutants were used. Growth rates and phenotypes of
      streptomycin- or rifampin-resistant K84 were similar to those of the parental
      K84, except the rifampin-resistant mutant produced less agrocin 84 as determined
      by bioassay. K84 and a strain of Agrobacterium tumefaciens established
      populations averaging 10(5) CFU/g in the rhizosphere of cherry and persisted on
      roots for 2 years. K84 established rhizosphere populations between 10(4) and
      10(6) CFU/g on cherry, ryegrass, and 11 other herbaceous plants. Populations of
      K84 declined substantially in fallow soil or water over a 16-week period. K84 was
      detected in the rhizosphere of ryegrass located up to 40 cm from an inoculum
      source, indicating lateral dissemination of K84 in soil. In gall tissue on
      cherry, K84 established populations of 10(5) CFU/g, about 10- to 100-fold less
      than that of the pathogen. These data demonstrate that K84 persists for up to 2
      years in a field environment as a rhizosphere inhabitant or in association with
      crown gall tissue.

PMID- 8357248
TI  - Effects of medium and trace metals on kinetics of carbon tetrachloride
      transformation by Pseudomonas sp. strain KC.
AB  - Under denitrifying conditions, Pseudomonas sp. strain KC transforms carbon
      tetrachloride (CT) to carbon dioxide via a complex but as yet undetermined
      mechanism. Transformation rates were first order with respect to CT concentration
      over the CT concentration range examined (0 to 100 micrograms/liter) and
      proportional to protein concentration, giving pseudo-second-order kinetics
      overall. Addition of ferric iron (1 to 20 microM) to an actively transforming
      culture inhibited CT transformation, and the degree of inhibition increased with
      increasing iron concentration. By removing iron from the trace metals solution or
      by removing iron-containing precipitate from the growth medium, higher second
      order rate coefficients were obtained. Copper also plays a role in CT
      transformation. Copper was toxic at neutral pH. By adjusting the medium pH to
      8.2, soluble iron and copper levels decreased as a precipitate formed, and CT
      transformation rates increased. However, cultures grown at high pH without any
      added trace copper (1 microM) exhibited slower growth rates and greatly reduced
      rates of CT transformation, indicating that copper is required for CT
      transformation. The use of pH adjustment to decrease iron solubility, to avoid
      copper toxicity, and to provide a selective advantage for strain KC was evaluated
      by using soil slurries and groundwater containing high levels of iron. In samples
      adjusted to pH 8.2 and inoculated with strain KC, CT disappeared rapidly in the
      absence or presence of acetate or nitrate supplements. CT did not disappear in pH
      adjusted controls that were not inoculated with strain KC.

PMID- 8357249
TI  - Hydroxylation and biodegradation of 6-methylquinoline by pseudomonads in aqueous
      and nonaqueous immobilized-cell bioreactors.
AB  - Selective culturing of pseudomonads that could degrade quinoline led to
      enrichment cultures and pure cultures with expanded substrate utilization and
      transformation capabilities for substituted quinolines in immobilized and batch
      cultures. Immobilized cells of the pseudomonad cultures rapidly transformed
      quinolines to hydroxyquinolines in bioreactors and were able to tolerate higher
      substrate concentrations compared with batch cultures. After prolonged incubation
      on a mixture of quinoline and 6-methylquinoline, a quinoline-degrading culture of
      Pseudomonas putida developed the ability to biodegrade 6-methylquinoline, which
      initially was resistant to microbial attack, as a sole source of carbon and
      energy. 6-Methylquinoline was also degraded in a nonaqueous solution by this
      strain of P. putida when a solution of 6-methylquinoline in decane was flowed
      through an immobilized-cell fixed-bed bioreactor.

PMID- 8357250
TI  - Direct polymerase chain reaction detection of Campylobacter jejuni and
      Campylobacter coli in raw milk and dairy products.
AB  - A polymerase chain reaction (PCR) method designed to sensitively detect and
      identify Campylobacter jejuni and Campylobacter coli without the need for
      isolating and culturing strains is described. The intergenic sequence between the
      flagellin genes flaA and flaB was amplified and characterized with a triple
      primer or seminested primer approach. A total of 50 bacterial strains, 27 of C.
      jejuni and C. coli and 23 of other species, were tested, giving no false-positive
      or false-negative results. The detection limit as determined by ethidium bromide
      staining of amplification products on agarose gels was 10 bacteria or less in
      artificially contaminated water, milk, and soft cheese samples with the
      seminested primer PCR assay. As an application of the PCR system, a set of 93
      samples of milk and other dairy products was screened for the presence of C.
      jejuni and C. coli. We identified six positive samples (6.5%), while none were
      found with a conventional culture method.

PMID- 8357251
TI  - Initial-phase optimization for bioremediation of munition compound-contaminated
      soils.
AB  - We examined the bioremediation of soils contaminated with the munition compounds
      2,4,6-trinitrotoluene (TNT), hexahydro-1,3,5-trinitro-1,3,5-triazine, and
      octahydro-1,3,5,7-tetranitro-1,3,5,7-tetraazocine by a procedure that produced
      anaerobic conditions in the soils and promoted the biodegradation of
      nitroaromatic contaminants. This procedure consisted of flooding the soils with
      50 mM phosphate buffer, adding starch as a supplemental carbon substrate, and
      incubating under static conditions. Aerobic heterotrophs, present naturally in
      the soil or added as an inoculum, quickly removed the oxygen from the static
      cultures, creating anaerobic conditions. Removal of parent TNT molecules from the
      soil cultures by the strictly anaerobic microflora occurred within 4 days. The
      reduced intermediates formed from TNT and hexahydro-1,3,5-trinitro-1,3,5-triazine
      were removed from the cultures within 24 days, completing the first stage of
      remediation. The procedure was effective over a range of incubation temperatures,
      20 to 37 degrees C, and was improved when 25 mM ammonium was added to cultures
      buffered with 50 mM potassium phosphate. Ammonium phosphate buffer (50 mM),
      however, completely inhibited TNT reduction. The optimal pH for the first stage
      of remediation was between 6.5 and 7.0. When soils were incubated under aerobic
      conditions or under anaerobic conditions at alkaline pHs, the TNT biodegradation
      intermediates polymerized. Polymerization was not observed at neutral to slightly
      acidic pHs under anaerobic conditions. Completion of the first stage of
      remediation of munition compound-contaminated soils resulted in aqueous
      supernatants that contained no munition residues or aminoaromatic compounds.

PMID- 8357252
TI  - Presumptive fecal streptococci in environmental samples characterized by one
      dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis.
AB  - The use of fecal streptococci as fecal indicators requires better knowledge of
      the ecology of these bacteria. We isolated 371 presumptive fecal streptococci
      from environmental samples--domestic wastewater, forest industry wastewater,
      contaminated surface and seawater, well water, cow dung, bird droppings, and
      pristine waters--and clustered them according to their protein profiles in one
      dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis.
      Some clusters could be tentatively identified with the help of reference strains.
      Samples from each environment had a typical composition of streptococcus types.
      Enterococcus faecalis was present, but not as a dominating enterococcal species,
      in samples in which fecal contamination was probable. Enterococcus faecium,
      Enterococcus durans, Enterococcus hirae, and Enterococcus mundtii had protein
      profiles that were difficult to distinguish from each other. These bacteria were
      found in a variety of samples. Enterococcus casseliflavus and Enterococcus
      gallinarum had identical protein profiles. On the basis of the maximum
      temperatures for growth and pigment production, isolates of this protein profile
      group common in forest industry wastewaters were identified as E. casseliflavus.
      Lactococcus lactis subsp. lactis was also found in this environment. Nearly all
      strains from pristine waters belonged to protein profile groups which could not
      be identified with the aid of known Aerococcus, Enterococcus, Lactococcus, or
      Streptococcus strains. The maximum temperatures for growth and the results of
      fatty acid analysis were in general agreement within each protein profile group.

PMID- 8357253
TI  - Inhibitory effect against pathogenic and spoilage bacteria of Pseudomonas strains
      isolated from spoiled and fresh fish.
AB  - The antibacterial effects of 209 Pseudomonas strains isolated from spoiled iced
      fish and newly caught fish were assessed by screening target organisms in agar
      diffusion assays. One-third (67 strains) inhibited the growth of one or several
      of six target organisms (Escherichia coli, Shewanella putrefaciens, Aeromonas
      sobria, Pseudomonas fluorescens, Listeria monocytogenes, and Staphylococcus
      aureus), of which S. aureus and A. sobria were the most sensitive. The inhibitory
      action was most pronounced among the strains producing siderophores, and the
      presence of iron eliminated the antibacterial effect of two-thirds of the
      inhibitory strains. Siderophore-mediated competition for iron may explain the
      inhibitory activity of these strains. All but nine of the inhibiting strains were
      found to inhibit the growth of 38 psychrotrophic S. putrefaciens strains isolated
      from spoiling fish and fish products. Siderophore-containing Pseudomonas culture
      supernatants inhibited growth of S. putrefaciens, as did the addition of iron
      chelators (ethylenediamine dihydroxyphenylacetic acid [EDDHA]). In particular,
      Pseudomonas strains isolated from newly caught and spoiled Nile perch (Lates
      niloticus) inhibited S. putrefaciens. This suggests that microbial interaction
      (e.g., competition or antagonism) may influence the selection of a microflora for
      some chilled food products.

PMID- 8357254
TI  - Isolation and identification of eight microcystins from thirteen Oscillatoria
      agardhii strains and structure of a new microcystin.
AB  - Microcystins (cyclic heptapeptide hepatotoxins), isolated from 13 freshwater
      Oscillatoria agardhii strains from eight different Finnish lakes by high
      performance liquid chromatography, were characterized by amino acid analysis,
      fast atom bombardment mass spectrometry (FABMS), and tandem FABMS
      (FABMS/collisionary-induced dissociation/MS). All strains produced two to five
      different microcystins. In total, eight different compounds, of which five were
      known microcystins, were isolated. The known compounds identified were [D
      Asp3]MCYST (microcystin)-LR, [Dha7]MCYST-LR, [D-Asp3]MCYST-RR, [Dha7]MCYST-RR,
      and [D-Asp3,Dha7]MCYST-RR. This is the first time that isolation of these toxins
      from Oscillatoria spp., with the exception of [D-Asp3]MCYST-RR, has been
      reported. Three of the strains produced a new microcystin, and the structure was
      assigned as [D-Asp3,Mser7]MCYST-RR. The structures of two new microcystins,
      produced as minor components by one Oscillatoria strain, could not be determined
      because of the small amounts isolated from the cells. Four strains produced
      [Dha7]MCYST-RR as the main toxin, but [D-Asp3]MCYST-RR was clearly the most
      abundant and most frequently occurring toxin among these isolates of O. agardhii.

PMID- 8357255
TI  - Simple solutions to false-positive staphylococcal enterotoxin assays with seafood
      tested with an enzyme-linked immunosorbent assay kit (TECRA).
AB  - The TECRA kit, a commercial staphylococcal enterotoxin visual immunoassay kit, is
      an enzyme-linked immunosorbent assay system which utilizes polyvalent antisera
      against staphylococcal enterotoxin types A to E. The test is simple and rapid to
      perform (4 h) and has therefore been widely used for screening purposes. In this
      study, the TECRA kit produced a number of false-positive reactions with seafood;
      25% of 218 samples of seven types of seafood gave false-positive results,
      particularly shellfish such as mussels (85%), clams (32%), oysters (23%), winkles
      (20%), and squid (13%). Some nonshellfish samples also gave false-positive
      results with the TECRA kit (smelt [20%] and trout [10%]). The substance
      contributing to the false-positive results differed from true staphylococcal
      enterotoxins in that it was: (i) heat labile, being completely inactivated by
      heating for 3 min at 70 degrees C, compared with 5% inactivation of true
      staphylococcal enterotoxins by the same heat treatment, (ii) in a selective
      reaction with normal rabbit or calf serum (nonspecific reactions were completely
      abolished by these sera, whereas staphylococcal enterotoxins were not affected),
      and (iii) incapable of binding to a copper-chelate Sepharose gel (all of the
      substance remained in the unbound wash fraction, whereas staphylococcal
      enterotoxins were quantitatively bound to the gel). The false-positive reactions
      occurring with seafood were not associated with substances produced by
      microorganisms, since the bacterial isolates from the samples did not give
      positive results with the TECRA kit.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357256
TI  - Genetic instability and strain degeneration in Streptomyces rimosus.
AB  - During a strain selection program to improve oxytetracycline production in
      Streptomyces rimosus R6, isolates that showed extreme morphological instability
      appeared. Propagation via spores gave much higher instability than did
      propagation via mycelial fragments. Five phenotypic traits were affected:
      sporulation, pigmentation, colony morphology, oxytetracycline production, and
      oxytetracycline resistance. The variants were classified on the basis of
      oxytetracycline resistance into three classes. Class I variants (99% of variants)
      showed parental levels of resistance but were very heterogeneous regarding the
      other phenotypes. No DNA rearrangements were detected in primary class I
      variants. Class II variants (1% of variants, oxytetracycline sensitive) were
      phenotypically uniform, and most variants carried the same large deletion of ca.
      455 kb, including the oxytetracycline resistance gene otrB. Class III variants
      (0.1% of variants, increased oxytetracycline resistance) were phenotypically
      uniform and overproduced a brown pigment and oxytetracycline. Most of these
      variants also showed a reproducible large-scale DNA rearrangement, which probably
      included deletion and a low-level reiteration (three or four copies) of a DNA
      fragment. "Revertants" of some class I variants show a similar DNA rearrangement
      to the class III variants, but there is extensive reiteration of sequences of
      about 200 kb, including the otrB gene. The significance of these results for the
      problem of strain degeneration and overproduction of antibiotics is discussed.

PMID- 8357257
TI  - Biodegradation of 4-nitrotoluene by Pseudomonas sp. strain 4NT.
AB  - A strain of Pseudomonas spp. was isolated from nitrobenzene-contaminated soil on
      4-nitrotoluene as the sole source of carbon, nitrogen, and energy. The organism
      also grew on 4-nitrobenzaldehyde, and 4-nitrobenzoate. 4-Nitrobenzoate and
      ammonia were detected in the culture fluid of glucose-grown cells after induction
      with 4-nitrotoluene. Washed suspensions of 4-nitrotoluene- or 4-nitrobenzoate
      grown cells oxidized 4-nitrotoluene, 4-nitrobenzaldehyde, 4-nitrobenzyl alcohol,
      and protocatechuate. Extracts from induced cells contained 4-nitrobenzaldehyde
      dehydrogenase, 4-nitrobenzyl alcohol dehydrogenase, and protocatechuate 4,5
      dioxygenase activities. Under anaerobic conditions, cell extracts converted 4
      nitrobenzoate or 4-hydroxylaminobenzoate to protocatechuate. Conversion of 4
      nitrobenzoate to protocatechuate required NADPH. These results indicate that 4
      nitrotoluene was degraded by an initial oxidation of the methyl group to form 4
      nitrobenzyl alcohol, which was converted to 4-nitrobenzoate via 4
      nitrobenzaldehyde. The 4-nitrobenzoate was reduced to 4-hydroxylaminobenzoate,
      which was converted to protocatechuate. A protocatechuate 4,5-dioxygenase
      catalyzed meta-ring fission of the protocatechuate. The detection of 4
      nitrobenzaldehyde and 4-nitrobenzyl alcohol dehydrogenase and 4-nitrotoluene
      oxygenase activities in 4-nitrobenzoate-grown cells suggests that 4-nitrobenzoate
      is an inducer of the 4-nitrotoluene degradative pathway.

PMID- 8357258
TI  - Distribution of uidA gene sequences in Escherichia coli isolates in water sources
      and comparison with the expression of beta-glucuronidase activity in 4
      methylumbelliferyl-beta-D-glucuronide media.
AB  - The uidA gene, which encodes the beta-glucuronidase enzyme, was detected in 97.7%
      of 435 Escherichia coli isolates from treated and raw water sources by DNA-DNA
      hybridization; 92.4% of the strains expressed the translational product in 4
      methylumbelliferyl-beta-D-glucuronide-containing media after reinoculation. Upon
      initial isolation from water samples, the minimal medium o-nitrophenyl-beta-D
      galactopyranoside-4-methylum-belliferyl -beta-D-glucuronide preparations failed
      to detect more than 50% of the E. coli isolates that possessed uidA gene. Treated
      water gave the lowest recovery, with Colilert producing 26% positive samples and
      Coliquik producing 48% positive samples. There appears to be no relationship
      between the intensity of the autoradiographic signals of the uidA gene and the
      expression of beta-glucuronidase activity. Therefore, another variable such as
      physiological condition of the bacteria could be responsible for the
      nonexpression of the enzyme activity.

PMID- 8357259
TI  - Microcosm and in situ field studies of enhanced biotransformation of
      trichloroethylene by phenol-utilizing microorganisms.
AB  - The ability of different aerobic groundwater microorganisms to cometabolically
      degrade trichloroethylene (TCE), 1,2-cis-dichloroethylene (c-DCE), and 1,2-trans
      dichloroethylene (t-DCE) was evaluated both in groundwater-fed microcosms and in
      situ in a shallow aquifer. Microcosms amended with phenol or toulene were equally
      effective in removing c-DCE (> 90%) followed by TCE (60 to 70%), while the
      microcosm fed methane was most effective in removing t-DCE (> 90%). The microcosm
      fed ammonia was the least effective. None of the microcosms effectively degraded
      1,1,1-trichloroethane. At the Moffett Field groundwater test site, in situ
      removal of c-DCE and TCE coincided with biostimulation through phenol and oxygen
      injection and utilization, with c-DCE removed more rapidly than TCE. Greater TCE
      and c-DCE removal was observed when the phenol concentration was increased. Over
      90% removal of c-DCE and TCE was observed in the 2-m biostimulated zone. This
      compares with 40 to 50% removal of c-DCE and 15 to 25% removal of TCE achieved by
      methane-grown microorganisms previously evaluated in an adjacent in situ test
      zone. The in situ removal with phenol-grown microorganisms agrees qualitatively
      with the microcosm studies, with the rates and extents of removal ranked as
      follows: c-DCE > TCE > t-DCE. These studies demonstrate the potential for in situ
      TCE bioremediation using microorganisms grown on phenol.

PMID- 8357260
TI  - Biodegradation of ortho-cresol by a mixed culture of nitrate-reducing bacteria
      growing on toluene.
AB  - A mixed culture of nitrate-reducing bacteria degraded o-cresol in the presence of
      toulene as a primary growth substrate. No degradation of o-cresol was observed in
      the absence of toluene or when the culture grew on p-cresol and 2,4
      dimethylphenol. In batch cultures, the degradation of o-cresol started after
      toluene was degraded to below 0.5 to 1.0 mg/liter but continued only for about 3
      to 5 days after the depletion of toluene since the culture had a limited capacity
      for o-cresol degradation once toluene was depleted. The total amount of o-cresol
      degraded was proportional to the amount of toluene metabolized, with an average
      yield of 0.47 mg of o-cresol degraded per mg of toluene metabolized. Experiments
      with [ring-U-14C]o-cresol indicated that about 73% of the carbon from degraded o
      cresol was mineralized to CO2 and about 23% was assimilated into biomass after
      the transient accumulation of unidentified water-soluble intermediates. A
      mathematical model based on a simplified Monod equation is used to describe the
      kinetics of o-cresol degradation. In this model, the biomass activity toward o
      cresol is assumed to decay according to first-order kinetics once toluene is
      depleted. On the basis of nonlinear regression of the data, the maximum specific
      rate of o-cresol degradation was estimated to be 0.4 mg of o-cresol per mg of
      biomass protein per h, and the first-order decay constant for o-cresol-degrading
      biomass activity was estimated to be 0.15 h-1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357261
TI  - In situ identification of bacteria in drinking water and adjoining biofilms by
      hybridization with 16S and 23S rRNA-directed fluorescent oligonucleotide probes.
AB  - Free-water-phase and surface-associated microorganisms from drinking water were
      detected and roughly identified by hybridization with fluorescence-labeled
      oligonucleotide probes complementary to regions of 16S and 23S rRNA
      characteristic for the domains Bacteria, Archaea, and Eucarya and the beta and
      gamma subclasses of Proteobacteria. Samples of glass-attached biofilms and
      plankton were taken from a Robbins device installed in a water distribution
      system. More than 70% of the surface-associated cells and less than 40% of the
      planktonic cells visualized by 4',6-diamidino-2-phenylindole staining bound
      detectable amounts of rRNA-targeted probes. These findings are an indication for
      higher average rRNA content and consequently higher physiological activity of the
      attached microbial cells compared with the free-living cells. All detectable
      cells hybridized with the bacterial probe, whereas no Archaea and no Eucarya
      cells could be detected. Simultaneous hybridization with probes specific for the
      beta and gamma subclasses of Proteobacteria revealed that microcolonies already
      consisted of mixed populations in early stages with fewer than 50 cells. These
      observations provide further evidence that the coexistence and interaction of
      bacteria in drinking water biofilms may be an integral part of their growth and
      survival strategies.

PMID- 8357262
TI  - Estimation of ruminal bacteriophage numbers by pulsed-field gel electrophoresis
      and laser densitometry.
AB  - To investigate phage activity in the rumen, a method for quantifying phage has
      been developed. By differential centrifugation and ultrafiltration, phage
      particles were separated and concentrated from ruminal fluid. Linear double
      stranded DNA from this fraction containing predominantly tailed phage was
      isolated and separated by size, using pulsed-field gel electrophoresis (PFGE).
      Laser densitometry of gel photographs allowed the numbers of phages with DNA in
      each size region to be calculated and, therefore, the total numbers per
      milliliter of ruminal fluid to be estimated. Phage numbers were estimated to be
      between 3 x 10(9) and 1.6 x 10(10) particles ml of ruminal fluid-1. The phage
      population, as gauged by the appearance of DNA on PFGE gels, had two major
      components. A broad region of DNA between 30 and 200 kb was always present on
      PFGE gels. It appears this region comprises DNA from a great many different
      phages and would include most of the temperate phages. In addition, discrete DNA
      bands ranging in size from 10 to 850 kb were frequently observed. DNA from one
      such band, of 12 kb in size, was shown to consist primarily of a single DNA type,
      suggesting that it originated from a specific phage. It is postulated that the
      discrete bands are due to epidemics or blooms of phage activity from specific,
      probably lytic, phages. The method that has been developed will greatly enhance
      future investigations into the interactions between the ruminal phage population,
      the ruminal bacterial population, and animal nutrition and growth.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8357263
TI  - Effect of treated-sewage contamination upon bacterial energy charge, adenine
      nucleotides, and DNA content in a sandy aquifer on Cape Cod.
AB  - Changes in adenylate energy charge (ECA) and in total adenine nucleotides (A(T)
      and DNA content (both normalized to the abundance of free-living, groundwater
      bacteria) in response to carbon loading were determined for a laboratory-grown
      culture and for a contaminated aquifer. The latter study involved a 3-km-long
      transect through a contaminant plume resulting from continued on-land discharge
      of secondary sewage to a shallow, sandy aquifer on Cape Cod, Mass. With the
      exception of the most contaminated groundwater immediately downgradient from the
      contaminant source, DNA and adenylate levels correlated strongly with bacterial
      abundance and decreased exponentially with increasing distance downgradient. ECAS
      (0.53 to 0.60) and the ratios of ATP to DNA (0.001 to 0.003) were consistently
      low, suggesting that the unattached bacteria in this groundwater study are
      metabolically stressed, despite any eutrophication that might have occurred.
      Elevated ECAS (up to 0.74) were observed in glucose-amended groundwater,
      confirming that the metabolic state of this microbial community could be altered.
      In general, per-bacterium DNA and ATP contents were approximately twofold higher
      in the plume than in surrounding groundwater, although ECA and per-bacterium
      levels of A(T) differed little in the plume and the surrounding uncontaminated
      groundwater. However, per-bacterium levels of DNA and A(T) varied six- and
      threefold, respectively, during a 6-h period of decreasing growth rate for an
      unidentified pseudomonad isolated from contaminated groundwater and grown in
      batch culture.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357264
TI  - Brochocin-C, a new bacteriocin produced by Brochothrix campestris.
AB  - Brochotrix campestris ATCC 43754 produces a bacteriocin inhibitory towards
      Brochothrix thermosphacta, lactobacilli, Listeria spp., and other gram-positive
      bacteria. This antimicrobial agent is heat stable, sensitive to proteases,
      catalase insensitive, and free of organic acids. No phage particles were detected
      by transmission electron microscopy. Muramidase activity was not detected in the
      preparations. On the basis of established criteria, the antimicrobial agent was
      classified as a bacteriocin and named brochocin-C.

PMID- 8357265
TI  - Degradation of dicamba by an anaerobic consortium enriched from wetland soil.
AB  - The biodegradability of dicamba was investigated under anaerobic conditions with
      a consortium enriched from wetland soil. Degradation proceeded through an initial
      demethylation reaction, forming 3,6-dichlorosalicylic acid, followed by reductive
      dechlorination, forming 6-chlorosalicylic acid. The consortium, consisting of a
      sulfate reducer, three methanogens, and a fermenter, was unable to mineralize the
      aromatic ring.

PMID- 8357266
TI  - Is an activator protein-2-like transcription factor involved in regulating gene
      expression during nitrogen limitation in fungi?
AB  - The upstream sequences of all published lignin peroxidase and manganese
      peroxidase genomic clones from Phanerochaete chrysosporium were analyzed. This
      analysis revealed the presence of putative activator protein-2 (AP-2) recognition
      sequences in 11 of 15 lignin peroxidase genes. The lignin peroxidase clone GLG6
      and the manganese peroxidase gene (mnp-1) have two copies of putative AP-2
      sequence in the upstream region. Interestingly, the lignin peroxidase gene VLG4
      of another white rot fungus, Trametes versicolor, and the nit-2 gene of
      Neurospora crassa also contain putative AP-2-binding sequences. Since all of
      these genes are regulated by nutrient nitrogen, I hypothesize that an AP-2-like
      transcription factor may be involved in inducing gene expression during nitrogen
      limitation in fungi.

PMID- 8357267
TI  - Colony immunoblot assay of botulinal toxin.
AB  - Botulinal neurotoxin in and around colonies of Clostridium botulinum types A, B,
      and E and of toxigenic Clostridium butyricum was detected by an enzyme-linked
      immunoassay procedure whereby the toxin was transferred from the agar medium to a
      nitrocellulose support and the immobilized toxin was probed with type-specific
      antibodies. The method identified the toxin types of the colonies grown from a
      mixed inoculum of C. botulinum serotypes. The specificity of the antitoxins for
      type A and B toxins was improved by adsorption of the antitoxins with the
      antigens of heterologous type cultures.

PMID- 8357268
TI  - Enzymatic determination of itoic acid, a Bacillus subtilis siderophore, and 2,3
      dihydroxybenzoic acid.
AB  - A specific enzymatic method to determine the amounts of itoic acid, a Bacillus
      subtilis siderophore, and 2,3-dihydroxybenzoic acid (2,3-DHBA) was devised. A
      sample was incubated first with hippurate hydrolase and then with 2,3-DHBA-3,4
      dioxygenase. Itoic acid was estimated from the increase in A374. The incubation
      with the first enzyme was omitted for the determination of 2,3-DHBA.

PMID- 8357269
TI  - Associations of London, England, daily mortality with particulate matter, sulfur
      dioxide, and acidic aerosol pollution.
AB  - During the extreme pollution episodes of 1952 and 1962 in London, England,
      excesses in daily mortality were clearly evident. In this study, we examined
      daily British Smoke, sulfur dioxide, acid aerosols, and weather variables for
      their short-term associations with daily mortality in the more typical
      (nonepisodic) winters of 1965-1972. Consideration of the acid aerosol data was of
      special interest because this chemical component has been suspected as a causal
      agent in past episodes. Temporal lag structures between the variables were
      examined after removal of long-term components from each series in order to
      obtain "rational" cross-correlations. Significant associations between same-day
      and lagged pollution variables and mortality were found. Alternative regression
      models with pollution and weather variables were also developed. The coefficients
      obtained were applied to the 1962 pollution episode to examine the continuity of
      the estimated slopes. The pollution-predicted deaths fit the observed deaths
      well, which supports the applicability of such deviation-derived coefficients to
      the absolute scale. These models were also employed to estimate mean excess daily
      deaths attributed hypothetically to air pollution. On average, mean effect ranged
      from 2-7% of all deaths during the nonepisodic winters in Greater London, but the
      95% confidence intervals of these estimates overlapped for all model
      specifications examined. This estimated pollutant mixture "effect" cannot be
      attributed to a particular pollutant because of a lack of quantitative
      information on the relative downward biases caused by both analytical errors and
      errors in the spatial representativeness of each respective pollution index.

PMID- 8357270
TI  - The hair-organ relationship in mercury concentration in contemporary Japanese.
AB  - The hair-organ relationship of mercury concentration was investigated in 46
      autopsy samples in Tokyo, Japan. Hair mercury levels were highly significantly
      correlated with organ Hg levels in the cerebrum, cerebellum, heart, spleen,
      liver, kidney cortex, and kidney medulla, when the total mercury or methyl
      mercury value in the organ was compared with the hair total mercury or organic
      mercury, respectively. When the inorganic mercury value was tested, significant
      correlations remained, with weaker coefficients in all the organs but the spleen.
      Stepwise multiple regression analysis evidenced that the hair organic mercury
      value was the major explanatory variable for the organ total mercury or organ
      methyl mercury value in all the organs. To explain the organ inorganic mercury
      value, the hair organic mercury value was the major variable for the cerebrum and
      kidney (both cortex and medulla), the hair inorganic mercury value was the major
      variable for the cerebellum and heart, and the hair phosphorous and hair organic
      mercury were the major variables for the liver; no explanatory variable existed
      for the spleen. Auxiliary explanatory variables accounted for the organ total
      mercury and inorganic mercury levels, among which the hair selenium value was
      conspicuous with negative regression coefficients.

PMID- 8357271
TI  - Questionnaire data as predictors of urinary cotinine levels among nonsmoking
      adolescents.
AB  - The strength of association between urinary cotinine and questionnaire data on
      passive smoking among 542 adolescents was evaluated. There were 103 individuals
      with urinary cotinine higher than 30 ng/ml; they were compared with all other
      subjects. The single variable that best predicted the urinary cotinine level was
      maternal smoking. A strong effect was made by house size and, consequently, house
      crowding. Maternal smoking and house crowding had a synergic effect. The
      subject's perception of passive smoking at home also was an independent
      indication of a high cotinine level. The final model had a fairly good
      sensitivity, whereas the specificity was somewhat lower. The results suggest that
      maternal smoking, house crowding, and subject's perception of a smoky environment
      could be surrogate indices of high passive smoking exposure in this age group and
      could be useful for epidemiologic studies.

PMID- 8357273
TI  - Increased risk of esophageal cancer among workers exposed to combustion products.
AB  - Alcohol and tobacco habits have been identified as strong risk factors for
      esophageal cancer. Increased risks of esophageal cancer have also been reported
      to be associated with occupational exposure to asbestos and various metals, among
      vulcanization workers, asphalt workers, and workers in the petrochemical
      industry. Mortality and cancer incidence were investigated in a series of studies
      of workers exposed to combustion by-products, i.e., chimney sweeps, waste
      incinerator workers, gas workers, and bus garage workers exposed to diesel
      exhausts. The SMRs for esophageal cancer ranged from 150-386 in these cohorts,
      and a combined SMR of 289 (95% C.I. 174-452) was obtained. Available data on
      smoking habits and indirect indicators of alcohol consumption show that the
      excess cannot be attributed solely to these factors. It seems likely that
      occupational exposure to combustion products is associated with an increased risk
      of esophageal cancer.

PMID- 8357272
TI  - Evidence for interaction between air pollution and high temperature in the
      causation of excess mortality.
AB  - Studies have demonstrated repeatedly that air pollution in Athens is associated
      with a small but statistically significant increase in mortality. Extremely high
      air temperatures can also cause excess mortality. This study investigated whether
      air pollution and air temperature have synergistic effects on excess mortality in
      Athens. Data concerning the increased number of deaths in July 1987 (when a major
      "heat wave" hit Greece) were compared to the deaths in July of the 6 previous
      years. This comparison revealed a greater increase in the number of deaths in
      Athens (97%), compared to all other urban areas (33%) and to all non-urban areas
      (27%). Data on the daily levels of smoke, sulfur dioxide, and ozone; the number
      of deaths that occurred daily; and meteorological variables were collected for a
      5-y period. The daily value of Thom's discomfort index was calculated. Multiple
      linear regression models were used to investigate main and interactive effects of
      air temperature and Thom's discomfort index and air pollution indices. The daily
      number of deaths increased by more than 40 when the mean 24-h air temperature
      exceeded 30 degrees C. The main effects of an air pollution index are not
      statistically significant, but the interaction between high levels of air
      pollution and high temperature (> or = 30 degrees C) are statistically
      significant (p < .05) for sulfur dioxide and are suggestive (p < .20) for ozone
      and smoke. Similar results were obtained when the discomfort index was used,
      instead of temperature in the models.

PMID- 8357274
TI  - Air pollution-type fluorosis in the region of Pingxiang, Jiangxi, Peoples'
      Republic of China.
AB  - This paper reports on the epidemiology, environmental factors, geological
      features, and total amount of fluoride intake by residents of the Pingxiang
      region in the Peoples' Republic of China where there is a high incidence of
      endemic fluorosis. The results demonstrate that the type of endemic fluorosis is
      related to air pollution, the major source of which comes from coal that is
      burned by the residents in their homes. Air pollution also originates from the
      small kilns that are used to make bricks and tile. The fluorine content in the
      coal and mud used to mix the coal is considerably high; the content in the mud
      used as adobe for tiles exceeds 10,000 mg/kg. During the process of burning coal
      or baking bricks or tiles, a large amount of nonsoluble fluorine is converted
      into water-soluble fluoride, which can have major human health effects.

PMID- 8357275
TI  - Chloroform in alveolar air of individuals attending indoor swimming pools.
AB  - Alveolar air samples were collected from 163 subjects at indoor swimming pools
      and from 77 nonexposed subjects. Chloroform was present in all samples collected
      from exposed subjects (median = 695.02 nmol/m3). It was found at very low levels
      in 53% of samples from nonexposed subjects. Alveolar air chloroform levels from
      people attending indoor swimming pools (mean value within each sampling session)
      were correlated with environmental air concentration (r = 0.907, p = .002).
      Analysis of variance showed that levels of chloroform in alveolar air depend on
      environmental air concentration, age, intensity of the sport activity, and kind
      of swimming. Chloroform levels in samples collected from competitive swimmers
      versus nonswimming visitors were different (F = 10.911, p = .001). Moreover,
      their pattern of swimming may affect chloroform concentration in alveolar air.
      The analysis of chloroform in alveolar air assesses indoor exposure in healthy
      subjects simply and at low cost.

PMID- 8357276
TI  - Acute myeloid leukemia among petrol station attendants.
AB  - The risk of acute myeloid leukemia (AML) within different occupations was
      studied, using occupational information obtained from the Swedish 1970 census.
      Follow-up in the Swedish Cancer Register was carried out from 1971 to 1984. Among
      male petrol station attendants, 10 cases were observed versus 2.8 expected
      (observed/expected = 3.6, 95% confidence interval 1.7-6.6). For several decades,
      Swedish petrol has contained 3-5% of benzene. Thus, a hypothesis was that benzene
      had contributed to the excess risk. The work histories of the 10 cases were
      reconstructed through interviews with surviving relatives and were compatible
      with the hypothesis. However, because the air benzene exposures at petrol
      stations always have been lower than benzene exposures associated previously with
      an increased risk of AML, the leukemogenic effect of benzene may have been
      potentiated by other petrol or vehicle exhaust components.

PMID- 8357277
TI  - Hypersensitivity pneumonitis resulting from Aspergillus fumigatus in a
      greenhouse.
AB  - A 57-y-old female who had cultivated vegetables in a plastic greenhouse developed
      a case of hypersensitivity pneumonitis from Aspergillus fumigatus. This report
      exemplifies a potential hazard caused by a thermotolerant fungus, A. fumigatus,
      in a poorly constructed greenhouse.

PMID- 8357278
TI  - Evaluation of the relationship between heart rate and ventilation for
      epidemiologic studies.
AB  - Estimation of pulmonary exposure and dose in air pollution epidemiology has been
      impaired by the lack of methods for directly measuring ventilation in ambulatory
      subjects. Heart-rate monitoring offers an approach to estimate ventilation by
      using ventilation-on-heart-rate (VE-HR) regressions established during exercise
      testing to estimate ventilation in the field. Conventional methods and protocols
      for testing were used to evaluate the relationship between VE and HR during three
      tasks: (1) exercising on a cycle ergometer, (2) lifting, and (3) vacuuming. The
      relationship between VE and HR was curvilinear and was best fit with linear
      regression models, using a natural log transformation of VE. Considerable
      interindividual variability in slopes and intercepts was observed across all
      types of exercise tests. The variability about the fitted regression lines for
      individual subjects was minimal; for example, individual R2 values for the
      maximum exercise test on 15 men ranged from 0.90 to 0.99 (mean = 0.97). The
      regression slopes established during upper-body exercise were greater by
      approximately 30%, relative to those derived in lower-body exercise (paired t
      test, p < .001). However, VE-HR regression slopes derived from tests in which
      progressively increasing workloads were used were comparable to those obtained
      during variable and nonprogressive protocols. These findings indicate that
      predictive accuracy is maximized by deriving VE-HR regressions for individual
      subjects and for both lower- and upper-body activities.

PMID- 8357279
TI  - Experimental model of lead nephropathy. III. Continuous low-level lead
      administration.
AB  - We sought to determine whether continuous low-level lead exposure (100 ppm lead
      acetate in drinking water) for periods of 1, 3, 6, 9, or 12 mo would produce
      adverse effects on kidney function or morphology in rats. Maximum blood lead
      levels in experimental animals were reached at 3 mo and averaged 29.4 +/- 4.1
      micrograms/dl. Glomerular filtration rate, determined by single-injection 125I
      iothalamate clearance, was found to be significantly increased above pair-fed
      controls at 1 and 3 mo, but it was normal at other time periods. Levels of
      urinary N-acetyl-beta-D-glucosaminidase exceeded levels found in controls at all
      time periods, except at 12 mo, when the normal increase with aging obscured
      differences between experimental animals and controls. In contrast, urinary
      ligandin (glutathione S transferase), a more specific marker of metal-associated
      proximal tubular injury, was normal at all time periods. Proximal tubular nuclear
      inclusion bodies were sparse and were observed only at 1 and 3 mo. There were no
      other pathological alterations in the kidneys, except at 12 mo, at which time
      mild tubular atrophy and interstitial fibrosis were seen. Therefore, low-level
      lead exposure in rats produced no significant changes in renal function and
      produced only mild alterations in renal morphology after 12 mo. The absence of
      changes in urinary ligandin accorded with the relative absence of morphological
      changes, whereas the observed increases in urinary N-acetyl-beta-D
      glucosaminidase suggest that this enzyme may be an overly sensitive indicator of
      tubular injury.

PMID- 8357280
TI  - Hepatorenal syndrome. New perspectives in pathogenesis and treatment.
AB  - Hepatorenal syndrome is a life-threatening complication of severe liver disease.
      It is generally accepted that the syndrome is the final stage of complex
      hemodynamic derangements associated with portal hypertension, ie, peripheral
      arterial vasodilation, effective hypovolemia, and hyperkinetic status. In spite
      of reduced systemic resistances, intrarenal vascular resistances are increased.
      This is probably the consequence of the activation of systemic vasoactive
      factors, such as the renin-angiotensin system, the sympathetic nervous system,
      and vasopressin aimed at restoring arterial filling pressure. Recently, it has
      been shown that intrarenal vasoconstrictors, such as leukotrienes and
      endothelins, are activated with the progression of liver disease. The renal
      vasoconstriction is counterbalanced by the intrarenal hyperproduction of
      vasodilating prostaglandins and kallikreins. When this balance is lost, for
      whatever mechanism, the renal vascular resistances dramatically increase and the
      hepatorenal syndrome develops. In spite of increased knowledge about
      pathogenesis, the treatment of hepatorenal syndrome remains unresolved. Low-dose
      dopamine or ornipressin are currently employed in many liver units to avoid
      further deterioration of renal function in patients with severe liver disease who
      are waiting for liver transplantation that remains, at present, the only
      effective treatment for hepatorenal syndrome.

PMID- 8357281
TI  - Ketoconazole and fluconazole drug interactions.
AB  - This article reviews potential drug interactions that exist between ketoconazole
      or fluconazole and other drugs. English-language data sources included human
      subjects' computerized databases and published indexes. Case reports and studies
      demonstrate decreased dosage requirements of cyclosporine sodium,
      methylprednisolone sodium succinate, and possibly anticoagulants and phenytoin
      after ketoconazole or fluconazole administration, suggesting hepatic enzyme
      inhibition. Increased dosage requirements of ketoconazole are necessary after
      rifampin administration, suggesting rifampin's induction of hepatic microsomal
      enzymes. Possibly a similar effect may occur with concomitant fluconazole and
      rifampin. The effect of ketoconazole administration on prednisolone sodium
      phosphate and theophylline warrants further study. Fluconazole, a more selective
      agent for fungal P-450, seems to be of less concern regarding the potential for
      drug interactions than ketoconazole.

PMID- 8357282
TI  - DNA screening for breast/ovarian cancer susceptibility based on linked markers. A
      family study.
AB  - BACKGROUND: Linkage to chromosome 17q has been identified in hereditary breast
      cancer and hereditary breast/ovarian cancer syndrome. A hereditary breast/ovarian
      cancer syndrome kindred was identified that yielded a highly significant lod
      score (4.20) when 17q markers were studied, enabling us to identify those who
      probably carried the cancer-associated gene among the high-risk members of the
      family. METHODS: High-risk members of the hereditary breast/ovarian cancer
      syndrome kindred were offered counselling on the basis of 17q markers. Family
      members responding positively received one-to-one genetic counseling in a
      structured setting. Subjects were educated before disclosure, and the immediate
      impact of this information was assessed after disclosure. RESULTS: We provided
      genetic counseling on the basis of linkage findings to 32 relatives (four men and
      28 women). Women who were told they were linkage positive expressed an increased
      motivation for surveillance and prophylactic surgery. Most women who were told
      they were linkage negative indicated that they would not proceed with
      prophylactic surgery but would continue careful surveillance. To date, there has
      been no evidence of serious emotional disturbances resulting from this
      disclosure. We believe that this experience can be used by cancer geneticists and
      physicians in developing protocols for genetic counseling in cancer-associated
      hereditary disorders. CONCLUSIONS: Physicians must understand current
      developments in cancer genetics and linkage so that they can be applied to
      genetic counseling and treatment of high-risk patients.

PMID- 8357283
TI  - Evaluating chest pain. The patient's presentation style alters the physician's
      diagnostic approach.
AB  - BACKGROUND: Clinical prediction rules rely largely on objective data to estimate
      coronary artery disease (CAD) likelihood. However, characterization of chest
      pain, which is central to such prediction rules, depends in part on a physician's
      subjective judgments. We performed a clinical trial to assess the influence of
      the patient's presentation style on the physician's approach to evaluating chest
      pain. METHODS: Forty-four internists were randomized to one of three treatment
      groups. Two groups viewed videotapes of the same actress performing the role of a
      patient in a scripted physician-patient interview in two distinct styles: one
      group saw a "histrionic" characterization, the other a "businesslike" portrayal.
      The interviewer was not seen or heard by the subjects; they saw only words on the
      screen. The third group read a verbatim transcript of the interview. After their
      initial CAD-likelihood estimates and impressions of probable cause for the
      patient's symptoms, which were based on history only, the participants in all
      three groups were given the same laboratory data and a second CAD-likelihood
      estimate was made. Finally, recommendations for further workup were elicited.
      RESULTS: Initial diagnostic impressions differed dramatically: a cardiac cause
      was suspected by 50% of physicians viewing the businesslike portrayal but by only
      13% of those viewing the histrionic portrayal. Likewise, those viewing the
      histrionic and businesslike videos provided different CAD-likelihood estimates
      initially (10% vs 20%). However, after the patient's laboratory data were
      revealed, the difference in CAD-likelihood estimates was no longer significant.
      Despite their making a similar risk appraisal after receiving all of the data,
      internists viewing the histrionic portrayal were far less likely to pursue a
      cardiac workup (53% vs 93%). CONCLUSIONS: Although physicians may evaluate
      patients who have the same history word for word and the same laboratory data and
      whom they regard as having nearly identical likelihoods of CAD, the physician's
      ultimate diagnostic approach can be profoundly affected by the patient's
      presentation style.

PMID- 8357284
TI  - Factors influencing physicians in recommending in-hospital cardiopulmonary
      resuscitation.
AB  - BACKGROUND: Cardiopulmonary resuscitation (CPR) is a dramatic, costly, and often
      futile intervention whose appropriate use is under scrutiny. Physicians often ask
      patients and families to make decisions about resuscitation for themselves or
      loved ones. Clinical variables and personal beliefs may influence physician
      recommendations about CPR. METHODS: Physicians (N = 451) at a tertiary care
      hospital were surveyed to determine the following: (1) the factors they consider
      when recommending in-hospital CPR, (2) the conditions under which they discuss
      CPR with patients, (3) their recent participation in CPR attempts, (4) their
      perceptions of its effectiveness, (5) their personal wishes regarding their own
      resuscitation, and (6) their personal and professional characteristics. RESULTS:
      The patient's self-reported wishes about resuscitation and physician judgment of
      medical utility were the most important influences on physician recommendations.
      Most physicians believe that patients with metastatic cancer or late Alzheimer's
      disease should not be resuscitated. Age alone was not viewed as an important
      clinical consideration. Guidance from hospital policies and ethics committees had
      the least influence on physicians. Physicians overestimated the likelihood of
      survival to hospital discharge after in-hospital CPR by as much as 300% for some
      clinical situations and predicted an overall success rate of 30%. CONCLUSION:
      These findings suggest that most physicians are thoughtful and discriminating in
      their recommendations to patients about CPR. Patient's wishes are of paramount
      importance, followed by physician judgment of medical utility. However,
      physicians do overestimate the efficacy of CPR and may thus misrepresent the
      potential utility of this therapy to patients and their families.

PMID- 8357285
TI  - Early administration of heme arginate for acute porphyric attacks.
AB  - BACKGROUND: We investigated the efficacy of early administration of heme arginate
      in acute porphyric attacks. METHODS: The series consisted of 51 consecutive acute
      attacks in 22 patients with acute intermittent porphyria and in two patients with
      variegate porphyria referred to a hospital in France or in Finland. Four attacks
      were associated with pareses, and 47 attacks were not. Heme in a dose of 250 mg
      or 3 mg/kg was started within 24 hours after admission in 37 (72.5%) of the
      attacks and within 4 days in 49 (96%) of the attacks. During all except five
      attacks, four daily infusions were given. RESULTS: The mean (+/- SD) duration of
      abdominal or nonabdominal pain was 2.5 +/- 0.97 days, and opiates were stopped an
      average of 2.8 +/- 0.72 days after the first heme infusion was started. All
      patients responded. In 46 (90%) of the attacks, the total hospitalization time
      was 7 days or less. The mean urinary excretion of porphobilinogen decreased to
      16.2% +/- 7.7% and that of 5-aminolevulinic acid to 11.6% +/- 5.6% of
      pretreatment values. The only side effect was moderate thrombophlebitis in one
      patient. CONCLUSION: Favorable responses in every attack suggest specific effects
      of heme. In patients with acute attacks, heme therapy should be started
      immediately on admission.

PMID- 8357286
TI  - Infectious complications in heart-lung transplantation. Analysis of 200 episodes.
AB  - BACKGROUND: Infection remains an important cause of morbidity and mortality in
      heart-lung transplant recipients. This study was designed to assess the
      frequency, type, and timing of infection in heart-lung transplant recipients.
      METHODS: A retrospective analysis of 200 episodes of serious infections occurring
      in 73 heart-lung recipients at Stanford (Calif) University Medical Center between
      1981 and 1990. RESULTS: Bacterial infections accounted for half of all
      infections, with the highest incidence in the first month after transplantation.
      Fungal infections (14%) were also common in the first month. Cytomegalovirus was
      the most common viral agent (15%), occurring primarily in the second month after
      transplantation. Other viruses (herpes simplex, adenovirus, and respiratory
      syncytial virus) accounted for a further 15% of total infections. Pneumocystis
      carinii infections were common 4 to 6 months after transplantation, and Nocardia
      typically infected recipients later than 1 year after transplantation. There was
      no significant difference in incidence of infections between patients receiving
      triple (cyclosporine, prednisone, immuran) or double (cyclosporine and
      prednisone) immunosuppression therapy. Mortality due to infection accounted for
      40% of all deaths. CONCLUSIONS: Knowledge of the incidence and timing of
      infection should help in the prevention, early detection, and initiation of
      therapy in these patients.

PMID- 8357287
TI  - A negative trial of inpatient geriatric consultation. Lessons learned and
      recommendations for future research.
AB  - PURPOSE: To determine the effectiveness of inpatient interdisciplinary geriatric
      consultation provided during hospitalization to frail, elderly subjects. SUBJECTS
      AND SITE: Admission cohort of 197 men admitted from 1985 through 1989, aged 65
      years or more, meeting proxy criteria for frailty, living within follow-up area,
      without terminal illness, and without prolonged nursing home residence. METHODS
      AND MEASURES: Randomized controlled trial of inpatient geriatric consultation at
      a tertiary care Veterans Affairs hospital. Differences were determined between
      groups in the Physical Self-Maintenance Scale, Instrumental Activities of Daily
      Living, Mini-Mental State Examination, Morale Scale, and nursing home and health
      care utilization. RESULTS: No differences were seen between groups in any measure
      after the intervention or during 1 year of follow-up. Intervention implementation
      may have been incomplete due to compliance and resource availability.
      CONCLUSIONS: This trial is not definitive in determining whether geriatric
      consultation is effective or ineffective. Lessons learned from this research
      indicate that future studies should target frail subjects, include intervention
      specific measures, and be conducted with direct control of comprehensive
      resources.

PMID- 8357288
TI  - Prevalence of hepatitis C in a chemically dependent population.
AB  - BACKGROUND: Drug abuse is the major risk factor for hepatitis C in the United
      States. The objective of this study was to determine the prevalence of hepatitis
      C virus (HCV), to identify risk factors for HCV, and to correlate HCV and liver
      function in patients presenting for inpatient detoxification of substances of
      abuse. METHODS: A total of 687 patients were tested for the presence of antibody
      to HCV (anti-HCV). Histories related to drug use, sexually transmitted diseases,
      blood transfusion, and human immunodeficiency virus were obtained, as were serum
      tests for human immunodeficiency virus, syphilis, hepatitis B, aminotransferases,
      total bilirubin, and alkaline phosphatase. RESULTS: The overall prevalence of
      anti-HCV was 63%: 68% in men vs 54% in women (P < .001), with no difference by
      race. Remarkably, 86% of injecting drug users tested positive for anti-HCV.
      Identified risk factors for anti-HCV were injecting drug use (P < .001), human
      immunodeficiency virus infection (P = .003), exposure to hepatitis B virus (P <
      .001), and a positive rapid plasma reagin test (P = .04). Previous transfusion
      and history of previous infection with gonorrhea or syphilis did not correlate
      with the presence of anti-HCV. Patients positive for anti-HCV had significant
      elevations in aspartate aminotransferase and alanine aminotransferase levels when
      compared with patients negative for anti-HCV: 50.8 vs 36.7 U/L (P = .002) and
      56.0 vs 36.9 U/L (P < .001), respectively. CONCLUSION: Injecting drug users have
      an extremely high prevalence of anti-HCV. This is the first demonstration, to our
      knowledge, that the presence of anti-HCV in drug users is associated with
      significantly increased levels of serum aminotransferases.

PMID- 8357289
TI  - Renal cell carcinoma presenting as polymyalgia rheumatica. Resolution after
      nephrectomy.
AB  - Renal cell carcinoma can present as a variety of paraneoplastic, nonmetastatic
      conditions, including vasculitis. We describe a patient who presented with the
      polymyalgia rheumatica syndrome but did not respond to a trial of prednisone. An
      asymptomatic, nonmetastatic renal cell carcinoma was found during this patient's
      evaluation. Nephrectomy led to resolution of the systemic complaints. Malignancy,
      in this case, renal cell carcinoma, can present as polymyalgia rheumatica and
      resolve after surgical removal of the underlying tumor.

PMID- 8357290
TI  - Severe reversible hyperglycemia as a consequence of niacin therapy.
AB  - Hypocholesterolemic drug therapy has become a major focus of cardiovascular
      medicine because recent evidence has demonstrated that optimization of serum
      lipid levels results in decreased atherosclerotic cardiovascular risk. Niacin, a
      B-complex vitamin, is capable of lowering total serum cholesterol and
      triglyceride levels while simultaneously raising serum high-density lipoprotein
      cholesterol levels. However, the use of niacin can be complicated by the
      development of hepatotoxicity, hyperuricemia, and modest hyperglycemia. A patient
      is described who had an excellent lipid response to niacin therapy but developed
      the previously undescribed complication of severe, life-threatening
      hyperglycemia. Therefore, despite its low cost and demonstrated efficacy, because
      of potential very toxic side effects, niacin therapy needs to be carefully
      monitored.

PMID- 8357291
TI  - The bedside Valsalva maneuver: a continually overlooked clinical tool.

PMID- 8357292
TI  - Pheochromocytoma as a cause of blue toes.

PMID- 8357293
TI  - Malignant melanoma. Effects of an early structured psychiatric intervention,
      coping, and affective state on recurrence and survival 6 years later.
AB  - OBJECTIVES: We evaluated recurrence and survival for 68 patients with malignant
      melanoma who participated in a 6-week structured psychiatric group intervention 5
      to 6 years earlier, shortly after their diagnosis and initial surgical treatment.
      We also explored the role of several factors as possible predictors of outcome.
      DESIGN: This was a randomized controlled experimental study. The Cox proportion
      hazards regression model was used to quantify the relationship between treatment
      and the outcomes adjusted by the covariates (age, sex, Breslow depth, tumor site,
      baseline Profile of Mood States Total Mood Disturbance, baseline active
      behavioral coping, baseline natural killer cell activity, and treatment [ie,
      group intervention]). The stepwise procedure was used for covariate selection.
      RESULTS: For control patients, there was a trend for recurrence (13/34) and a
      statistically significant greater rate of death (10/34) than for experimental
      patients (7/34 and 3/34, respectively). We found that being male and having a
      greater Breslow depth predicted greater recurrence and poorer survival. Analysis
      of multiple covariates found that only Breslow depth and treatment (ie, group
      intervention) were significant. Adjusting for Breslow depth, treatment effect
      remained significant. Finally, baseline affective distress and baseline coping
      were significant psychobehavioral predictors for recurrence and survival.
      Surprisingly, higher levels of baseline distress as well as baseline coping and
      enhancement of active-behavioral coping over time were predictive of lower rates
      of recurrence and death. CONCLUSION: Psychiatric interventions that enhance
      effective coping and reduce affective distress appear to have beneficial effects
      on survival but are not proposed as an alternative or independent treatment for
      cancer or any other illness or disease. However, the exact nature of this
      relationship warrants further investigation.

PMID- 8357294
TI  - Alcoholism and major depression in women. A twin study of the causes of
      comorbidity.
AB  - BACKGROUND: Although major depression (MD) and alcoholism co-occur in clinical
      and epidemiologic samples of women more often than expected by chance, the
      magnitude and causes of this comorbidity are uncertain. METHODS: Personal
      interviews were conducted with 2163 female twins from a population-based twin
      registry. Bivariate twin analysis was performed using two definitions of MD and
      three definitions of alcoholism of varying diagnostic breadth. RESULTS: Odds
      ratios ranged from 2.7 to 6.0 and were consistently higher using narrower
      diagnostic criteria for either disorder. Twin analyses found (1) no evidence for
      familial environmental factors for either MD or alcoholism; (2) significant
      genetic correlations, ranging from +.4 to +.6, between MD and alcoholism, which
      were higher using narrower criteria for alcoholism; (3) significant individual
      specific environmental correlations, ranging from +.2 to +.4, for all but one of
      the diagnostic combinations, which were higher using narrower criteria for MD.
      CONCLUSIONS: Comorbidity between MD and alcoholism in women is substantial and
      appears to result largely from genetic factors that influence the risk to both
      disorders, but common environmental risk factors also contribute. However,
      genetic factors exist that influence the liability to MD without influencing the
      risk for alcoholism and vice versa. Narrowing the diagnostic criteria for MD or
      alcoholism increases comorbidity, but for different reasons narrow diagnostic
      criteria for MD increase the environmental sources of comorbidity while narrow
      diagnostic criteria for alcoholism increase the genetic sources of comorbidity.

PMID- 8357295
TI  - A pilot Swedish twin study of affective illness, including hospital- and
      population-ascertained subsamples.
AB  - OBJECTIVE: We sought to compare the probandwise concordance rate (PRC) for
      affective illness (AI) in monozygotic (MZ) and dizygotic (DZ) twins in samples
      ascertained through psychiatric hospitalization vs samples from the general
      population. METHODS: Twins were ascertained through psychiatric hospitalization
      for AI from the Swedish Psychiatric Twin Registry or as a matched sample from the
      population-based Swedish Twin Registry. Lifetime diagnoses were based on a mailed
      questionnaire containing, in self-report format, DSM-III-R criteria for mania and
      major depression. Returned questionnaires were obtained from 1484 individuals and
      both members of 486 pairs, of whom 154 were classified as MZ, 326 as DZ, and six
      of unknown zygosity. RESULTS: No evidence was found for violations of the equal
      environment assumption. Using either a narrow or broad diagnostic approach, the
      risk for AI in cotwins of proband twins was independent of the gender, polarity
      (ie, unipolar vs bipolar) and mode of ascertainment of the affected proband (ie,
      via hospitalization vs from the general population). Combining both subsamples,
      PRC for total AI using narrow diagnostic criteria was 48.2% in MZ and 23.4% in DZ
      twins. Using broad diagnostic criteria, the parallel figures were 69.7% and
      34.9%. The risk for bipolar illness was substantially increased in the cotwins of
      probands with bipolar AI. CONCLUSIONS: Genetic factors play a major role in the
      etiology of AI in Sweden, as assessed by self-report questionnaire. Heritable
      factors appear to be equally important in AI as ascertained in clinical and
      epidemiological samples.

PMID- 8357296
TI  - Lifetime DSM-III-R diagnostic outcomes in the offspring of schizophrenic mothers.
      Results from the Copenhagen High-Risk Study.
AB  - OBJECTIVES: To perform a long-term prospective follow-up of children at high risk
      for schizophrenia to identify risk factors for the development of this disorder.
      DESIGN: Prospective follow-up population study of children of schizophrenic
      mothers and their matched controls from age 15 years to age 42 years, with
      multiple diagnostic assessments performed by senior clinicians using structured
      interviews blindly with respect to the group membership of the subject.
      PARTICIPANTS: Two hundred seven offspring of schizophrenic mothers and 104
      control children without schizophrenic parents matched to the index group on age,
      sex, paternal socioeconomic status, urban/rural residence, and the amount of time
      spent during childhood in institutional rearing. MAIN OUTCOME MEASURE: The
      prevalence of the DSM-III-R disorders during the subjects lifetime. RESULTS: A
      significant aggregation of schizophrenia (16.2%) and other nonaffective,
      nonorganic psychosis (4.6%), and Cluster A personality disorders (21.3%) occurred
      among the offspring of schizophrenic mothers compared with the controls (1.9%,
      0.9%, and 5%, respectively). No evidence of increased aggregation of (psychotic
      and nonpsychotic) affective disorders was noted among the offspring of
      schizophrenics. CONCLUSION: These results coincide with the results of other
      family studies in demonstrating a significant and specific familial aggregation
      of schizophrenia and nonpsychotic schizophrenia spectrum disorders among the
      biological relatives of schizophrenics.

PMID- 8357297
TI  - Plasma alprazolam concentrations. Relation to efficacy and side effects in the
      treatment of panic disorder.
AB  - A series of 237 patients with DSM-III-diagnosed panic disorder, or agoraphobia
      with panic attacks, received alprazolam as part of the placebo-controlled Cross
      National Collaborative Panic Study. After a 1-week drug-free period, alprazolam
      dosage was titrated upward with the objective of reaching 6.0 mg/d in all
      patients. At week 3 of treatment, alprazolam plasma levels were significantly
      correlated with daily dosage (regression slope: 11.7 ng/mL per milligram per day)
      but with considerable individual variation. Among patients with spontaneous panic
      attacks, 70% of those with plasma alprazolam levels greater than 20 ng/mL
      achieved complete remission vs 31% of those with levels less than 20 ng/mL.
      Situational panic attack remission increased in frequency with increasing plasma
      levels, but the relationship was not significant. Patient- and physician-rated
      global improvement and Hamilton Anxiety and Depression Scale score reductions
      were maximal at 20 to 39 ng/mL, with no further benefit at higher levels. Central
      nervous system-depressant side effects increased in frequency with higher plasma
      levels. Between weeks 3 and 8 of treatment, physicians were permitted to adjust
      dosage (maximum: 10 mg/d) to optimize response. At week 8, the dose-concentration
      relationship was essentially identical (regression slope: 10.8 ng/mL per
      milligram per day), but plasma levels were no longer related to efficacy or side
      effects. Thus, monitoring of plasma alprazolam concentrations may have a
      clinically useful role during short-term treatment of panic disorder.

PMID- 8357298
TI  - An epidemiologic study of Gilles de la Tourette's syndrome in Israel.
AB  - OBJECTIVES: The goal of this study was to estimate the lifetime prevalence of
      Gilles de la Tourette's syndrome (GTS) in adolescents aged 16 to 17 years.
      DESIGN: Population-based epidemiologic study. SUBJECTS: Eighteen thousand three
      hundred sixty-four males and 9673 females aged 16 to 17 years screened for
      induction into the Israel Defense Force. RESULTS: Of the 28,037 individuals
      screened, 12 met diagnostic criteria for GTS. The point prevalence in this
      population was 4.3 +/- 1.2 (mean +/- SE) per 10,000. The 95% confidence interval
      for this estimate is 1.9 to 6.7 per 10,000. The point prevalence was 4.9 +/- 1.6
      per 10,000 for males (95% confidence interval, 1.8 per 10,000) and 3.1 +/- 1.8
      per 10,000 for females (95% confidence interval, 0 to 6.6 per 10,000). The rate
      of obsessive-compulsive disorder (OCD) was significantly elevated among the
      subjects with GTS (41.7%) compared with the population point prevalence of OCD
      (3.4) in those without GTS. In contrast, the rate of attention deficit
      hyperactivity disorder was only 8.3% compared with the population point
      prevalence of 3.9% in those individuals without GTS. CONCLUSIONS: The prevalence
      estimates from this population-based study are in agreement with previous results
      based on surveys of younger children. The sex ratio observed in this study is not
      as large as reported in previous studies and remains to be explored in other
      studies of adolescents and adults.

PMID- 8357299
TI  - Some conceptual and statistical issues in analysis of longitudinal psychiatric
      data. Application to the NIMH treatment of Depression Collaborative Research
      Program dataset.
AB  - Longitudinal studies have a prominent role in psychiatric research; however,
      statistical methods for analyzing these data are rarely commensurate with the
      effort involved in their acquisition. Frequently the majority of data are
      discarded and a simple end-point analysis is performed. In other cases, so called
      repeated-measures analysis of variance procedures are used with little regard to
      their restrictive and often unrealistic assumptions and the effect of missing
      data on the statistical properties of their estimates. We explored the unique
      features of longitudinal psychiatric data from both statistical and conceptual
      perspectives. We used a family of statistical models termed random regression
      models that provide a more realistic approach to analysis of longitudinal
      psychiatric data. Random regression models provide solutions to commonly observed
      problems of missing data, serial correlation, time-varying covariates, and
      irregular measurement occasions, and they accommodate systematic person-specific
      deviations from the average time trend. Properties of these models were compared
      with traditional approaches at a conceptual level. The approach was then
      illustrated in a new analysis of the National Institute of Mental Health
      Treatment of Depression Collaborative Research Program dataset, which
      investigated two forms of psychotherapy, pharmacotherapy with clinical
      management, and a placebo with clinical management control. Results indicated
      that both person-specific effects and serial correlation play major roles in the
      longitudinal psychiatric response process. Ignoring either of these effects
      produces misleading estimates of uncertainty that form the basis of statistical
      tests of hypotheses.

PMID- 8357300
TI  - Synthesis and evaluation of sulfur-containing glutethimide derivatives for
      aromatase and desmolase inhibitory activity.
AB  - Novel sulfur-containing glutethimide derivatives, substituted with either thiol
      or methylsulfide groups in the ortho/para positions of the aromatic ring, were
      synthesized and tested for both human placental aromatase and bovine
      adrenocortical desmolase inhibitory activities. The synthesis was achieved by the
      chlorosulfonation of gluthethimide, which yielded a 3:1 mixture of the para to
      ortho sulfonyl chlorides 2a/b. The sulfonyl chlorides of gluthethimide were
      reduced with Zn/H2SO4 to give the thioglutethimides 3a/b, which in turn were
      methylated with MeI/EtOH to give the corresponding methylsulfides 4a/b. In
      comparison to aminoglutethimide (AG), 3a/b and 4a/b were weak inhibitors of
      aromatase, with 3a/b being more potent than 4a/b. Aromatase inhibition by the
      thiol compound was pH-dependent; 3a/b was most potent at higher pH (7.4) than at
      lower (6.6). This suggested that the thiolate form of 4 coordinates with the
      ferric heme of aromatase. Likewise, both 3a/b were less potent at inhibiting
      bovine adrenal desmolase than AG. Possible reasons for the surprisingly poor
      aromatase inhibitor activity of these compounds are discussed.

PMID- 8357301
TI  - Ketomethylenebestatin: synthesis and aminopeptidase inhibition.
AB  - The synthesis of (6R,5S,2RS)-6-amino-5-hydroxy-2-isobutyl-4-oxo-7-
      phenylheptanoic acid (9), a carbaanalogue of the aminopeptidase (AP) inhibitor
      bestatin (1) is described. This synthesis was carried out by a malonic ester
      alkylation with the suitably protected halomethyl ketone of (2S,3R)-AHPBA*),
      followed by a second alkylation with isobutyl bromide of the resulting 4
      ketodiester, and subsequent decarboxylation and deprotection. The inhibitory
      potencies of the 1:1 diastereomeric mixture 9 against AP-B, AP-M and Leu-AP were
      approximately 10-fold lower than those of bestatin.

PMID- 8357302
TI  - Platelet aggregation inhibiting and anticoagulant effects of oligoamines, XXII:
      Bisoxazol-, bisimidazol-, bisthiazol- and oligo-1,2,4-thiadiazolimines.
AB  - One mesoionic 4,4'-propylene-bis-oxazol-5-imine (5), two 2,2'-m-phenylene-bis
      imidazol-4-imines (9a,b), five 4,4'-benzene-bis-(and tris)-thiazol-2-amines
      (13a,b, 14a-c) and 14 3,3'-benzene-bis-(and tris)-1,2,4-thiadiazolimines (18a-o)
      were synthesized and assayed for their antiplatelet and anticoagulant activities.
      The most potent compound was the tris-thiadiazole derivative 18m which inhibited
      the aggregation of platelets induced by collagen at a concentration of 10 mumol/L
      by 50 percent (Born-test). No anticoagulant effects (Quick-test) were observed up
      to 400 mumol/L. In the thiazolamine series combined antiplatelet and
      anticoagulant activities were seen.

PMID- 8357303
TI  - Mammary tumor inhibiting [1,2-bis(2,6-dihalo-3
      hydroxyphenyl)ethylenediamine]platinum(II) complexes, III: Relationship between
      structure and estrogenic activity of the diamine ligands, their
      sulfatoplatinum(II) and diiodoplatinum(II) complexes.
AB  - 1,2-Bis(2,6-dihalo-3-hydroxyphenyl)ethylenediamines with 2,6-Cl2, 2-F-6-Cl, 2
      Cl,6-F, and 2,6-F2 substituents (meso-1 to meso-4, D,L-1 and D,L-4) and their
      sulfatoplatinum(II) complexes were tested in the immature mouse uterine weight
      test. The only complex with marked estrogenic properties proved to be meso-1
      PtSO4. Surprisingly its diamine ligand meso-1 was only marginally active. 1H-NMR
      spectroscopic studies on the 1,2-diphenylethylenediamine ligand reveal that the
      2,6-standing Cl-atoms in meso-1 (antiperiplanar phenyl residues) hinder the
      rotation of the aromatic rings, which results in very stable conformers with
      different O-O distances owing to the unsymmetric arrangement of the ring
      substituents. On transformation into the Pt(II) complex the conformations of meso
      1 change (synclinal phenyl residues) and a delta and lambda interconversion takes
      place already at physiological temp. (37 degrees C). This process is accompanied
      by a rotation of phenyl rings, which is supposed to allow an optimal fit for the
      formation of hydrogen bridges to the estrogen receptor, resulting in a marked
      estrogenic activity. The other ligands and complexes are inactive presumably due
      to a diminished hydrophobic interaction with the estrogen receptor, resulting
      from their R,R/S,S-configuration or the reduced number of Cl-atoms.

PMID- 8357304
TI  - A new approach to electrical safety testing of electromedical equipment.
AB  - The "New Approach" to electrical safety testing in Sir Charles Gairdner Hospital
      (SCGH) is based on the results and experience we have obtained in carrying out
      such tests for a period of over twenty years. Until recently our testing was
      carried out according to the annual procedures as described in Standards
      Australia recommendations. Test protocol changes have, however, now been made
      since it seemed from our records that we had been carrying out testing to an
      extent not justified by our test results. The paper describes the safety testing
      programme now in place at SCGH. This programme has resulted in substantial
      reduction in the testing time without, in our opinion, compromises in safety. The
      main elements in electromedical equipment test procedures are:- Acceptance tests
      In-Service tests Tests after repair We have found that the main consumer of time
      in electrical safety testing, aside from the test procedure itself, is gaining
      access to the equipment. This can be particularly difficult in areas where
      equipment is in constant use, e.g. in CCU, ICU, Renal Dialysis, Operating
      Theatres, etc. We have developed an earth integrity meter for the purpose of
      checking medical equipment without the need to disconnect it from the mains
      supply or from the patient. By means of this device, together with our new
      testing protocol, access problems have been largely eliminated.

PMID- 8357305
TI  - Biomechanical simulations of scoliotic spinal deformity and correction.
AB  - A new approach to surgical correction of scoliosis has been advanced by us, in
      the form of simulation of the surgical correction system and technique. For this
      purpose, we developed a finite-element model of the spinal column (SFEM), applied
      tractions to it and determined the model stiffness so as to watch the actual
      spinal geometry. Having patient-simulated this SFEM, we applied to this SFEM
      corrective forces and determined the optimal set of forces to gain the best
      correction of the spinal deformity. We then developed a special instrumentation
      to measure the applied corrective forces during surgery using a particular
      fixation system. The SFEM corrected geometry was shown to compare favourably with
      the post-surgical curve. We have now developed an elastic beam-column model
      (EBCM) to which muscle activation forces, representing asymmetrical paralysis of
      the vertebral column muscles, can be applied to generate a given scoliotic curve.
      In that process the stiffness properties of the patient-simulated EBCM are
      determined. Now on these patient-simulated EBCM(s), identical corrective force
      systems are applied as developed by the finite-element model (SFEM) and
      implemented surgically for these patients. It is shown that the EBCM corrected
      geometries compare favourably with both SFEM corrected geometries as well as with
      the post-surgical curves for similar corrective force systems. Thus the EBCM can
      be employed to presurgically simulate scoliolic correction, specify the optimal
      corrective system of forces so as to gain the best surgical correction.

PMID- 8357306
TI  - Absorbance measurement with a helium-neon laser for chemical dosimetry.
AB  - A laser-based system for absorbance measurement has been developed for use in
      chemical dosimetry as an alternative to the spectrophotometer. The system
      incorporating a Helium-Neon laser operating at 543.5 nm is designed specifically
      for measurement of absorbed doses below 10 Gy with the ferrous sulphate-benzoic
      acid-xylenol orange (FBX) dosimeter. Absorbance measurement for the FBX dosimeter
      is normally carried out at 540 nm with a spectrophotometer. The performance of
      the laser-based system in measurement of absorbance is comparable to that of a
      standard spectrophotometer and it is concluded that the absorbance measurement
      technique is not the limiting factor in the sensitivity of the FBX dosimeter for
      absorbed doses below 1 Gy.

PMID- 8357307
TI  - Integration of 3-D medical imaging and rapid prototyping to create
      stereolithographic models.
AB  - This paper describes current research into the creation of solid models which
      replicate anatomical structures using rapid prototyping techniques.
      Stereolithography is particularly efficient in the production of highly-complex
      structures. This technique was applied to the fabrication of a plastic model of a
      human skull. A geometric definition of the object was obtained by transferring
      the three-dimensional medical image volume (x-ray CT) and processing the data on
      a computer graphics workstation. A 3-D biomedical visualisation software package
      (ANALYZETM) was used to perform segmentation of structures. A 3-D triangular-mesh
      representation of the selected structure was calculated and converted to a format
      suitable for processing and construction using stereolithography (SLA).
      Improvements in the quality of the anatomical model produced will result from
      improved data processing techniques. Future work is proposed to investigate the
      influence of imaging parameters and data processing techniques on the resultant
      plastic models.

PMID- 8357308
TI  - The validity of the geometric mean method for estimating internal activities in
      nuclear medicine.
AB  - The activity of an internal radioactive source may be calculated by comparing the
      geometric mean of the regional counts in a pair of conjugate gamma camera images
      with the geometric mean of the counts from a small surface reference source of
      known activity. Allowance must be made for the effects of differential forward
      scatter in the detector count rates from the internal and reference sources. The
      magnitude of these can be predicted, and a suitable correction factor for a given
      collimator and energy acquisition window calculated by applying a simple count
      rate build-up model to the observed count rate-depth data for a point and plate
      source in a water tank. Using a high resolution collimator with 99mTc sources in
      three sets of phantom trials, the model shows that a scatter build-up correction
      factor of 1.20-1.22 is suitable for an internal 99mTc source in a typical adult
      chest or abdomen.

PMID- 8357309
TI  - Alpha radiation detection using silicon memory chips--preliminary studies.
AB  - Alpha radiation dosage is an important occupational health factor in the mining
      of uranium and mineral sands. Alpha radiation induced errors in the data of
      silicon based memory chips provide the foundation for a new type of sensor, with
      the potential for affordable and prompt measurement of personal alpha doses. With
      particular reference to Dynamic Random Access Memories (DRAM) this paper
      introduces the operating principle of a memory based radiation sensor, which is
      the error mechanism in silicon integrated circuits.

PMID- 8357310
TI  - Influence of temperature and metabolic rate on work performance with Canadian
      Forces NBC clothing.
AB  - This study examined the effects of environmental temperature and metabolic rate
      on soldiers' work tolerance time (WTT) while wearing various levels of nuclear,
      biological, and chemical (NBC) defence protective clothing. There were 23
      unacclimatized males (23 +/- 3 years, 76 +/- 8 kg, 1.77 +/- 0.08 m) assigned to
      exercise at either a light (walking 1.11 m.s-1 0% grade, alternating with lifting
      10 kg) or heavy metabolic rate (walking 1.33 m.s-1 7.5% grade, alternating with
      lifting 20 kg) in an environmental chamber at either 18 degrees C, 50% R.H.
      (cool) or 30 degrees C, 50% R.H. (warm). Subjects were tested wearing three
      levels of clothing protection: combat clothing (L); combats and a semi-permeable
      NBC overgarment (M); combats and NBC overgarment, gloves, boots and respiratory
      (H). WTT was the time until rectal temperature (Tre) reached 39.3 degrees C,
      heart rate reached 95% maximum, dizziness or nausea precluded further exercise,
      or 5 h had elapsed. During the light and cool trials (N = 5), wearing M or H did
      not impair WTT (277 +/- 47 min). For the light and warm experiments (N = 6), WTT
      was significantly impaired with H (82.7 +/- 10.6 min). With the heavy and cool
      condition (N = 6), WTT was reduced with M (240.5 +/- 73.8 min) and H (56.7 +/-
      17.9 min). Finally, during the heavy and warm trials (N = 6), WTT was
      progressively impaired for L (172.5 +/- 52.8 min), M (65.8 +/- 18.2 min), and H
      (34.0 +/- 9.7 min) levels of protection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357311
TI  - Continuous vs. intermittent work with Canadian Forces NBC clothing.
AB  - This study examined the benefits of work and rest schedules on soldiers' work
      tolerance (WTT) while wearing various levels of nuclear, biological and chemical
      (NBC) defence protective clothing in a warm environment (30 degrees C and 50%
      R.H.). Eight unacclimatized males were assigned to exercise at either a light
      (walking 1.11 m.s-1 0% grade, alternating with lifting 10 kg) or heavy metabolic
      rate (walking 1.33 m.s-1 7.5% grade, alternating with lifting 20 kg). Subjects
      were tested wearing three levels of clothing protection: combat clothing (L);
      combats and a semi-permeable NBC overgarment with the hood down (M); combats and
      NBC overgarment, gloves, boots and respirator (H). For each clothing
      configuration, subjects were evaluated using both a "continuous" exercise
      protocol and an intermittent work and rest schedule. WTT was defined as the time
      until rectal temperature (Tre) reached 39.3 degrees C, heart rate reached 95%
      maximum, dizziness or nausea precluded further exercise, or 5 h had elapsed.
      Assuming a resting VO2 of 4 ml.kg-1 x min-1 an average metabolic rate was
      calculated for all trials. A decreasing hyperbolic function described the
      relationship between WTT and metabolic rate for M and H. These relationships
      facilitate quantification of appropriate work and rest schedules if the metabolic
      rate of a task is known.

PMID- 8357312
TI  - Hemodynamic and hormonal correlates with exposure to lower body negative pressure
      after 12 hours head-down tilt.
AB  - Hemodynamic and hormonal responses to lower body negative pressure (LBNP) after
      12-h head-down tilt (HDT) were examined to investigate the mechanism of
      orthostatic intolerance following spaceflight. Ten young healthy male volunteers
      participated in the experiment. After 6 degrees HDT for 12 h, the tolerance to 1
      h continuous -30 mm Hg LBNP was tested. Variables were measured before and after
      HDT, during LBNP, and 1 and 10 min after LBNP. Significant reduction in leg
      volume and plasma volume were observed at the end of 12-h HDT (500 ml and 5.5%,
      respectively). In the tolerant group, stroke volume index (SI) was decreased by
      35% after 15 min LBNP, and carotid arterial blood flow (CBF), by 27% at the end
      of LBNP compared to the pre-LBNP value. Of the 10 subjects, 5 developed
      presyncope during LBNP; they exhibited remarkable reduction in SI, CBF, and heart
      rate, and increased secretion of ADH and adrenaline during or just prior to
      presyncope. This non-tolerant group tended to be hemo-concentrated from the start
      of the experiment. However, it will require a prospective study to determine if
      this variable is a reliable predictor of the outcome of the post-HDT LBNP test
      from data collected at the end of HDT.

PMID- 8357313
TI  - Hormonal responses during orthostasis following 4 hours of head-down tilt.
AB  - The purpose of this investigation was to test the hypothesis that endurance
      exercise trained (ET) subjects would demonstrate a greater reduction in
      orthostatic tolerance as compared to untrained (UT) subjects following prior
      exposure to -6 degrees head-down tilt (HDT) because vasoactive hormone and enzyme
      responses to head-up tilt (HUT) would be decreased following HDT so as to
      predispose ET subjects to orthostatic intolerance. Six ET subjects (VO2peak =
      4.52 +/- 0.20 L/min) were matched for age and height with six UT subjects
      (VO2peak = 3.26 +/- 0.22 L/min; p < 0.01). After 30 min of supine rest, subjects
      were exposed to 30 min of head-up tilt (HUT) at 70 degrees, then on a separate
      occasion, 4 h of HDT (-6 degrees) followed by 30 min of HUT. The HUT involved
      passive standing for 30 min or until subjects became presyncopal. Blood sampled
      from the antecubital vein at min 1, 15, and 30, or at presyncope was analyzed for
      atrial natriuretic peptide (ANP), aldosterone (PA), arginine vasopressin (AVP),
      plasma renin activity (PRA), and norepinephrine (NE), while BP and HR were
      continuously monitored. All subjects tolerating 30 min of HUT, after either
      condition, had significantly increased (p < 0.05) levels of PRA at the 30th min.
      Following 4 h of HDT, five of six UT subjects and only one of six ET subjects
      endured 30 min of HUT. The most marked difference during HUT after prior exposure
      to HDT was a significant increase in AVP (p < 0.05) at the onset of HUT observed
      only for the UT subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357315
TI  - Correlates of military tank simulator sickness.
AB  - A military tank driving simulator is currently widely used as a training aid for
      tank drivers. The purpose of this study was to investigate the relationship
      between possible correlates of simulator sickness and the occurrence of sickness
      and performance test results among simulator drivers. The average number of
      motion sickness-like symptoms reported after driving the simulator among subjects
      with a history of susceptibility to motion sickness was 3.4, significantly higher
      than the average of 1.6 reported among subjects who did not report previous
      susceptibility to motion sickness (p < 0.05). Subjects driving the simulator
      while screen image quality was disturbed had a longer reaction time (42.0 s) than
      when driving the simulator without screen interferences (18.4 s, p = 0.001).
      Subjects driving the simulator for a short period had the same number of symptoms
      as did those driving for a longer period, but had better digit symbol test
      results. There was no statistically significant association between the
      development of sickness and tank driving experience. Suggested countermeasures
      are expected to prevent simulator sickness among some of the simulator trainees
      and to make simulator training more effective.

PMID- 8357314
TI  - Changes in the dark focus of accommodation associated with simulator sickness.
AB  - The relationship between the dark focus of accommodation and simulator sickness,
      a form of motion sickness, was examined in three experiments. In Experiment 1,
      dark focus was measured in 18 college students in a laboratory setting before and
      after they viewed a projected motion scene depicting low altitude helicopter
      flight. In Experiments 2 and 3, dark focus was measured in pilots (N = 16 and 23,
      respectively) before and after they "flew" in moving-base helicopter flight
      simulators with optical infinity CRT visual systems. The results showed that
      individuals who experienced simulator sickness had either an inward (myopic)
      change in dark focus (Experiments 1 and 3) or attenuated outward shifts in dark
      focus (Experiment 2) relative to participants who did not get sick. These results
      are consonant with the hypothesis that parasympathetic activity, which may be
      associated with simulator sickness, should result in changes in dark focus that
      are in a myopic direction. Night vision goggles, virtual environments, extended
      periods in microgravity, and heads-up displays all produce related visual
      symptomatology. Changes in dark focus may occur in these conditions, as well, and
      should be measured.

PMID- 8357316
TI  - Helmet slippage during visual tracking: the effect of voluntary head movements.
AB  - The influence of visual tracking on head movement and on the head/helmet system
      was investigated for two different helmets (a motorcycle helmet and a flying
      helmet) under static laboratory conditions. Subjects visually refixated between
      pairs of illuminated targets located at various horizontal (up to 160 degrees)
      and vertical (up to 90 degrees) distances apart while head position and helmet
      slippage were measured in azimuth, pitch, roll, X, Y, and Z using a double
      magnetic coil system. Results showed that for both helmets, root mean square
      (RMS) head movement increased with refixation distance, especially in the main
      axis of refixation, and that RMS helmet slippage can be a function of RMS head
      motion. Further, large individual differences in the degree of head motion were
      found. These findings may have implications for designers and investigators of
      helmet-mounted avionics.

PMID- 8357317
TI  - Acceleration-induced effects on baboon blood chemistry.
AB  - Gravity-induced loss of consciousness (G-LOC) is known to have occurred in pilots
      since the early 1920's. Most of the research in this area has shown that G-LOC
      occurs due to a decrease in cerebral blood pressure and a concomitant reduction
      in brain perfusion. Since a reduction in cerebral blood flow can cause transient
      hypoxia, it is important to study the cerebral metabolism during high +Gz
      exposure. One component of these studies should include measurements of substrate
      availability and degradative products. In the present study, adult baboons were
      given multiple high +Gz exposures (2 to 6) using the Armstrong Laboratory human
      centrifuge. Venous blood was collected by an automatic syringe withdrawal pump
      before, during and after centrifuge exposures. The concentration of blood gases,
      glucose and lactate tended to decrease during the centrifuge exposure followed by
      an increase after the run. Total creatine kinase activity in serum was not
      significantly altered. These results suggest that during +Gz exposure, anaerobic
      glycolysis is stimulated resulting in elevated lactate production due to a
      reduction in cerebral blood flow (CBF). The elevated tissue lactate is released
      into the central circulation upon resumption of normal CBF (after the termination
      of centrifuge run). Therefore, the observed decrease in lactate concentration
      during the run may result from a lag in the release of tissue lactate into the
      blood due to a reduction in CBF. It is speculated that at high +6 Gz, G-LOC may
      occur as a protective response to reduce the brain metabolic rate, to maintain
      energy levels and to prevent severe cellular acidosis.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8357318
TI  - Perceptual scaling of whole-body low frequency linear oscillatory motion.
AB  - Evidence that Z-axis oscillation in the Earth-vertical plane is more provocative
      of motion sickness than the equivalent imposed oscillation acting in the Earth
      horizontal raises the possibility that horizontal oscillation is perceived as
      less intense than equivalent vertical oscillation. In Experiment 1, subjects (n =
      8) were oscillated through their head Z-axis in both the Earth-vertical and
      horizontal planes. In Experiment 2, another group (n = 10) were oscillated
      through their head Y-axis in the Earth-horizontal. Stimuli were 5 cycles of
      motion at 0.3 Hz ranging in 3.5 dB intervals from 0.19 to 2.15 m.s-2 (Expt. 1)
      and from 0.1 to 3.98 m.s-2 (Expt. 2). Perceptual scaling of intensity against
      acceleration was similar irrespective of direction of oscillation in the Earth
      plane or head-body axis. Displacement tended to be overestimated, this being most
      marked for the lower acceleration levels in the horizontal condition. Results
      supported the notion that Stevens' Power Law exponents decrease as a function of
      increasing stimulus range. Differences in perception of oscillation intensity and
      displacement do not seem to explain the markedly greater nauseogenic potential of
      vertical oscillation.

PMID- 8357319
TI  - Flight crew sleep during multiple layover polar flights.
AB  - This study investigated changes in sleep after multiple transmeridian flights.
      The subjects were 12 B747 airline pilots operating on the following polar flight:
      Tokyo (TYO)-Anchorage (ANC)-London (LON)-Anchorage-Tokyo. Sleep polysomnograms
      were recorded on two baseline nights (B1, B2), during layovers, and, after
      returning to Tokyo, two recovery nights were recorded (R1, R2). In ANC
      (outbound), total sleep time (TST) was reduced and, sleep efficiency was low
      (72.0%). In London, time in bed (TIB) increased slightly, but sleep efficiency
      was still reduced. On return to ANC (inbound), there was considerable slow wave
      sleep (SWS) rebound and multiple awakenings reduced sleep efficiency to 76.8%.
      Sleep efficiency on R2 was significantly lower than on B1 (t-test, p < 0.05) but
      not different from R1. To sum up, sleep of aircrews flying multiple transmeridian
      flights is disrupted during layovers and this effect persists during the two
      recovery nights. As a result, there is a marked cumulative sleep loss during
      multi-legs polar route trip in comparison to single leg flights. These findings
      suggest that following such extensive transmeridian trips, crews should have at
      least three nights of recovery sleep in their home time zone before returning to
      duty.

PMID- 8357320
TI  - Explosive outbreak of gastroenteritis on an aircraft carrier: an infectious
      disease mass casualty situation.
AB  - An aircraft carrier experienced 777 cases of acute gastroenteritis while deployed
      in the eastern Mediterranean over a 16-d period. These cases were noted in the
      5,000-man crew, suggesting a cumulative incidence rate of 15%, though many
      sailors did not seek medical care for their symptoms. The onboard medical
      department response included epidemiological investigation with unique shipboard
      facility considerations, development of a treatment plan, and implementation of
      preventive/educational programs. Implications for nontrauma related mass casualty
      situations are discussed. Flight surgeons and operational medicine physicians
      must have a solid foundation in general preventive medicine to fulfill their
      responsibilities.

PMID- 8357321
TI  - Determinants of +Gz-related neck pain: a preliminary survey.
AB  - The aim of the present study was to detect determinants of acute inflight neck
      pain in a cohort of 27 student fighter pilots frequently exposed to high +Gz
      forces. Strenuousness of work, job satisfaction, psychological distress, smoking
      habits, and frequency of muscle strength, muscle endurance, and aerobic training
      regimens were inquired about by questionnaire. Physical examination determined
      the subjects' height, body weight, body mass index, head and neck circumference,
      passive cervical range of motion, grip strength, and isometric strength of neck
      muscles. The frequency of muscle endurance training was the only possible
      determinant related to experienced acute inflight neck pain.

PMID- 8357322
TI  - Coccidioidomycosis: a persistent threat to deployed populations.
AB  - The world-wide deployability of aircrew members exposes them to a peculiar array
      of medical problems. Non-immune populations, upon deployment to endemic areas,
      may present to the deployed flight surgeon with acute, poorly recognizable
      syndromes, such as acute coccidioidomycosis. Alternatively, the acquisition of
      the chronic progressive form of coccidioidomycosis in endemic areas may be a
      problem for the flight surgeon, who may be faced with a poorly recognizable
      syndrome which first manifests itself weeks to months after the crewmember's
      return from deployment. We describe three cases of coccidioidomycosis in service
      members that highlight the difficulty in the diagnosis of this disease. These
      cases prompted an epidemiologic survey of recent cases of coccidioidomycosis
      among Air Force beneficiaries, presented here, to better define the impact of
      this disease on personnel assigned to endemic areas. A brief discussion of the
      epidemiologic and clinical features of the disease and of the aeromedical
      disposition of the aviator is presented.

PMID- 8357323
TI  - Hazardous materials incidents in military aircraft.
AB  - We evaluated 10 years of reported hazardous cargo incident information from the
      U.S. Air Force and Naval Safety Centers. In this first of two papers describing
      the hazardous cargo problems reported by the two services, we describe types of
      aircraft and types of hazardous cargo involved in incidents not causing aircraft
      mishaps. Normally, hazardous cargo must be manifested as such and no passengers
      are allowed on such flights. Unauthorized hazardous cargo was found on military
      aircraft carrying passengers. The most common problem was fuel spills or fumes.
      The most frequent cause of a hazardous cargo incident was improper manifest of
      same. Improvements are recommended for the incompatible or inconsistent hazardous
      cargo incident reporting systems, in order to improve prevention of hazardous
      cargo incidents.

PMID- 8357324
TI  - Physiological problems caused by transportation of hazardous cargo in military
      aircraft.
AB  - This is the second of two articles describing reported incidents involving
      hazardous cargo on U.S. military aircraft over a 10-year period. In this article,
      we describe the various physiological responses reported on the incident reports.
      These physiological incidents may have involved either the aircrew, the
      passengers, or both. We also list the substances that caused the problems.
      Physiological responses ranged from nausea and lightheadedness to loss of
      consciousness. We discuss why flights involving a physiological incident may not
      have been aborted. The present military hazardous cargo incident reporting system
      is deficient in that there appears to be no requirement for reporting whether
      passengers were on board the incident aircraft, or whether passengers or aircrew
      suffered physiological responses to various toxic substances.

PMID- 8357325
TI  - Inflight medical aspects of a massive air evacuation.

PMID- 8357326
TI  - Inbuilt obsolescence in conventionally piloted advanced fighter aircraft.
AB  - If pilot and fighter plane capability to sustain accelerations in the 10 to 15 G
      range for many seconds or minutes provides an important tactical advantage, as
      some fighter pilots believe, currently used anti-G procedures, including the
      Combat Edge Technology (29), will provide only partial, questionably safe
      protection. Therefore, relative to preservation of maximal pilot effectiveness,
      current and future advanced fighters, if flown in seated positions, are
      physiologically outdated in respect to blackout and G-LOC prevention.
      Consequently, future victories in the air may come to the adversary first to
      discard conventional upright or partially supinated seats in favor of a
      biomedically advanced fighter, developed for flight in the fully horizontal,
      preferably prone, position.

PMID- 8357327
TI  - You're the flight surgeon. Flatus.

PMID- 8357328
TI  - Ventricular remodeling after myocardial infarction. Experimental and clinical
      studies.
AB  - Changes of ischemic myocardium following coronary occlusion, including active and
      passive functions, and adaptive changes of non-ischemic surviving myocardium have
      been summarized under the term "left ventricular remodeling" post myocardial
      infarction. An increase in left ventricular volume may be a consequence, and
      associated with an adverse prognosis. Although left ventricular dilatation may
      increase stroke volume and, thus, be compensatory at first, in about one-fifth of
      patients it ultimately results in progressive dysfunction and heart failure.
      Major determinants of this process are time, infarct size, infarct location,
      global left ventricular function assessed 4 days after infarction by radionuclide
      ejection fraction and right heart catheter (stroke volume), and morphology of the
      infarct-associated coronary artery. The surviving myocardium hypertrophies and
      may also dilate structurally. Depression of left ventricular ejection fraction
      chronically after the infarct is due to deterioration of wall motion of chamber
      segments initially classified normal by radionuclide analysis. Biochemical
      changes may also occur, including reduction of phosphocreatine, prolongation of
      time to peak Cai2+, and changes in myosin isoforms. Systemic or local humoral
      factors may be involved in these changes, however, clear evidence is still
      lacking. Perfusion of surviving myocardium may be altered under various
      conditions due to morphologic and functional changes of coronary vasculature.
      Successful prevention of heart failure and death by angiotensin converting enzyme
      inhibitors in asymptomatic patients with left ventricular dysfunction post
      myocardial infarction has supported the pathophysiologic concepts of remodeling.

PMID- 8357329
TI  - "Cardioprotection" by ACE-inhibitors in acute myocardial ischemia and infarction?
AB  - Coronary artery occlusion results in the acute activation of the renin
      angiotensin system and production of angiotensin II, a potent vasoconstrictor and
      positive inotropic agent. This has raised the possibility that angiotensin
      converting enzyme (ACE) inhibitors might be "cardioprotective" (that is, might
      attenuate myocardial injury, dysfunction and necrosis) in the setting of acute
      ischemia and infarction. Captopril, enalapril and ramipril have, in fact, been
      reported to acutely limit myocardial injury and necrosis in models of permanent
      coronary artery occlusion. The mechanisms responsible for this cardioprotection
      are complex, but include favorable alterations in myocardial oxygen
      supply/demand, and, in some instances, inhibition of bradykinin metabolism and/or
      increased prostaglandin synthesis. Other studies, however, have failed to
      document a reduction in infarct size with ACE inhibitor treatment. Results
      obtained in models of coronary occlusion/reperfusion have also been mixed. In
      models of brief transient ischemia not associated with necrosis, captopril and
      zofenopril have consistently been found to attenuate postischemic contractile
      dysfunction of the viable but "stunned" myocardium during the early hours
      following relief of ischemia. In contrast, there is no consensus on the effects
      of enalapril on the stunned myocardium: both positive and negative results have
      been obtained. Similar disparity has been reported in models of more prolonged
      ischemia/reperfusion resulting in subendocardial necrosis: some studies have
      reported myocardial salvage, while others have provided disturbing evidence of
      apparent exacerbation of myocardial necrosis with captopril and enalapril
      therapy. Thus, after a decade of investigative effort, the question of whether
      ACE inhibitors are "cardioprotective" in the setting of acute myocardial ischemia
      and infarction remains unresolved. Nonetheless, clinical protocols are in
      progress to assess the effects of early ACE inhibitor treatment in patients with
      acute myocardial infarction.

PMID- 8357330
TI  - Angiotensin, ACE-inhibitors and endothelial control of vasomotor tone.
AB  - The renin angiotensin system and endothelium-derived vasoactive substances are
      both important regulators of vascular tone. Recent evidence suggests that the two
      systems may be tightly interconnected and drugs interfering with one system may
      also affect the other. Beside the circulating renin angiotensin system, a
      vascular wall renin angiotensin system has been postulated and various components
      of it have been demonstrated in endothelial and vascular smooth muscle cells. Of
      particular importance is the angiotensin converting enzyme (ACE) which is
      identical to kininase II, which breaks down bradykinin into inactive components.
      Bradykinin is a potent activator of the L-arginine nitric oxide system
      (endothelium-derived relaxing factor). Hence, ACE-inhibitors not only deactivate
      the pressor system, but increase the local concentrations of bradykinin and
      thereby stimulate a potent endothelium-derived vasodilator system. Angiotensin II
      not only can activate vascular smooth muscle cells (where it causes contraction
      and proliferation), but also endothelial cells. In certain blood vessels,
      angiotensin II can stimulate prostacyclin production; in addition, angiotensin II
      activates endothelin messenger RNA in endothelial cells. This activation of the
      endothelin vasopressor system increases vascular tone and enhances the local
      vasoconstrictor responses (due to the amplifying effects of endothelin on
      noradrenaline- and serotonin-induced contractions). Although the acute effects of
      ACE-inhibitors in isolated blood vessels are restricted to inhibition of
      angiotensin I-induced contractions and augmentation of bradykinin-induced
      endothelium-dependent relaxations, chronic therapy with the drugs appears to
      enhance endothelium-dependent responses to several agonists, particularly in
      hypertensive animals. Hence, this mechanism of action of ACE-inhibitors may
      account for an important vascular protective effect of the drugs. Thus, in
      summary, the renin angiotensin system and endothelium-derived vasoactive
      substances are tightly interconnected. This may be important under physiological
      and pathophysiological conditions, and is of importance for the action of
      currently available cardiovascular drugs, in particular, ACE-inhibitors.

PMID- 8357331
TI  - Effect of angiotensin-converting enzyme inhibitors on myocardial
      ischemia/reperfusion injury: an overview.
AB  - There are multiple mechanisms whereby ACE inhibitors could be beneficial during
      myocardial ischemia and reperfusion, including: i) reduced formation of
      angiotensin II, ii) decreased metabolism of bradykinin, iii) antioxidant
      activity, and iv) possibly other unknown mechanisms. Reduced formation of
      angiotensin II should be beneficial because this peptide exerts several actions
      that are potentially detrimental to the ischemic/reperfused myocardium, including
      vasoconstriction, increased release of norepinephrine, stimulation of
      phospholipase C and/or A2, and increased afterload with an attendant increase in
      oxygen demands. Reduced metabolism of bradykinin could be beneficial by
      increasing myocardial glucose uptake, by causing vasodilation, and by stimulating
      production of endothelium-derived relaxing factor and prostacyclin. Although
      earlier studies suggested that sulfhydryl-containing ACE inhibitors scavenge
      superoxide anions, recent data have shown that these drugs scavenge hydroxyl
      radical and hypochlorous acid with no effect on superoxide anion. Studies in
      isolated hearts have demonstrated that ACE inhibitors attenuate the metabolic,
      arrhythmic, and contractile dearrangements associated with ischemia and
      reperfusion, and have suggested that such beneficial effects are mediated by
      potentiation of bradykinin and/or increased synthesis of prostacyclin. Studies in
      models of myocardial stunning after brief (15-min) ischemia in vivo (anesthetized
      dogs) suggest that ACE inhibitors enhance the recovery of contractile function
      after a single brief ischemic episode. No data are available regarding the effect
      of these drugs on myocardial stunning after a prolonged, partly reversible
      episode, after multiple consecutive brief ischemic episodes, and after global
      ischemia. The mechanism for the salutary effects of ACE inhibitors on stunning
      remains a mystery. It may involve an antioxidant action (in the case of thiol
      containing molecules) or potentiation of prostaglandins (in the case of non-thiol
      containing molecules). What is clear is that the enhanced recovery of function
      effected by these drugs is not due to hemodynamic effects, inhibition of the
      converting enzyme per se, or an "antischemic" action (since the drugs were
      effective when given at the time of reperfusion). The effects of ACE inhibitors
      on myocardial infarct size remain controversial. Further studies will be
      necessary to conclusively establish whether ACE inhibitors can protect against
      the detrimental effects of myocardial ischemia and reperfusion. Nevertheless, the
      evidence provided thus far is encouraging and warrants an in-depth assessment of
      the role of these drugs in attenuating myocardial ischemia/reperfusion injury.

PMID- 8357332
TI  - Angiotensin-converting enzyme inhibitor in a human model of restenosis. MERCATOR
      ("Multicenter European Research Trial with Cilazapril after Angioplasty to
      Prevent Transluminal Coronary Obstruction and Restenosis") Study Group.

PMID- 8357333
TI  - Pathophysiology of heart failure and the renin-angiotensin-system.
AB  - For more than a decade, the inhibition of the renin-angiotensin system in heart
      failure has been regarded as pure vasodilator therapy. Consequently, the role of
      the renin-angiotension system has been seen as contributing to hemodynamic
      overload by vasoconstriction and volume retention. Meanwhile, clinical experience
      was indicated that important additional aspects of ACE-inhibition in heart
      failure are attenuation of the enhanced neuroendocrine activity and reversal or
      prevention of inappropriate trophic reactions of the overloaded myocardium. In
      overloaded hearts there is enhanced intracardiac formation of angiotensin due to
      enhanced expression of angiotensinogen and ACE, and due to accumulation of
      circulating, nephrogenic active renin. In human hearts, a mast-cell-derived
      chymase, which is not blocked by ACE-inhibition, contributes to intracardiac
      angiotensin formation. The enhanced intracardiac angiotensin-II formation in
      overloaded hearts is involved in coronary constriction, impairment of diastolic
      relaxation, myocyte enlargement and interstitial fibrosis, which aggravate the
      diastolic impairment. The major problem in overloaded, hypertrophied cardiocytes
      is the dedifferentiation with instabilization of Ca(++)-homeostasis due to an
      altered program of gene expression. Dedifferentiated cardiocytes have a reduced
      expression of sarcoplasmic reticulum Ca(++)-ATPase and an enhanced expression of
      the sarcolemmal Na+/Ca(++)-exchanger, resulting in an attenuation of active
      diastole (Ca(++)-reaccumulation into the sarcoplasmic reticulum), a depressed
      force-frequency relation, and an enhanced susceptibility for fatal arrhythmias.
      Furthermore, an enhanced local renin-angiotensin system in distensible coronary
      and systemic arteries seems to contribute to a reduced releasability of
      endothelium-derived relaxing factor, probably by reducing bradykinin
      availability. This modulation of endothelial function appears to contribute to
      the localization and progression of atheroma development in presence of risks
      factors for atherosclerosis.

PMID- 8357334
TI  - Angiotensin-converting enzyme inhibitors in the treatment of clinical heart
      failure.
AB  - During the last decade, angiotensin-converting enzyme inhibitors (ACE-I) have
      become cornerstones in the treatment of clinical congestive heart failure. There
      is convincing evidence that they improve survival and that, in this respect, they
      are superior to ordinary vasodilators. ACE-I administration also improves New
      York Heart Association functional class and the left-ventricular function, but
      their long-term effects on exercise tolerance and quality of life appear modest.
      During prolonged administration to patients with ischemic left-ventricular
      dysfunction, ACE-I also significantly reduce the incidence of new ischemic events
      (myocardial infarction, unstable angina).

PMID- 8357335
TI  - ACE-inhibitors in coronary artery disease?
AB  - Angiotensin converting enzyme (ACE)-inhibitors are established in the treatment
      of arterial hypertension and heart failure. In recent years ACE-inhibitors have
      also been used in the treatment of patients with coronary artery disease (CAD),
      since from experimental data an antiischemic action of these agents is suggested.
      Antiischemic effects of ACE-inhibitors may be exerted through a reduction of
      myocardial oxygen demand, by a reduction of angiotensin-mediated coronary
      vasoconstriction, by an interaction with bradykinin and the prostaglandin system,
      by a modulation of endothelial control of vascular tone, and by an interaction
      with the sympathetic nervous system. However, clinical findings on potential
      beneficial effects of ACE-inhibitors in patients with CAD are inconsistent and
      controversial. While in hypertensive patients with CAD ACE-inhibitors generally
      seem to attenuate myocardial ischemia at rest and during exercise, a significant
      fraction of about 30% of normotensive patients with CAD does not benefit or even
      deteriorates. Lowering of coronary perfusion pressure and alteration of
      transmural blood flow distribution may be responsible for this. In patients with
      left ventricular dysfunction (SOLVD) or congestive heart failure (CONSENSUS,
      SOLVD) ACE-inhibitors have been proven to prevent progressive deterioration in
      left ventricular function and to reduce mortality. In patients with asymptomatic
      left ventricular dysfunction after myocardial infarction (SAVE), long-term
      administration of captropril was associated with an improvement in survival and
      reduced morbidity and mortality due to major cardiovascular events. Therefore,
      from a prognostic viewpoint patients with CAD and left ventricular dysfunction or
      congestive heart failure should be treated with ACE-inhibitors, although the
      clinical use of ACE-inhibitors in patients with ongoing angina pectoris may be
      limited by an aggravation of angina, presumably due to critically lowering
      coronary perfusion pressure. Finally, ACE-inhibitors failed to prevent restenosis
      after successful PTCA. In conclusion, from a prognostic viewpoint patients with
      CAD and congestive heart failure or left ventricular dysfunction should be
      treated with ACE-inhibitors. In hypertensive patients ACE-inhibitors generally
      seem to attenuate myocardial ischemia. In normotensive patients with CAD and
      angina pectoris but without left ventricular dysfunction ACE-inhibitors cannot
      generally be recommended at present, unless the patients, which may have benefit
      from ACE-inhibitor treatment can be better defined.

PMID- 8357336
TI  - Molecular mechanisms of cardiac gene expression.
AB  - Although the physiological properties of the myocardium and their dynamic
      character have been the focus of intense research during the past three decades,
      the biochemical and molecular correlates underlying cardiac development and
      performance have, until recently, remained poorly understood. The development of
      modern cellular and molecular biology has provided the necessary tools to
      undertake the study of the mechanisms involved in cardiac development and to
      understand the basis for important clinical and experimental problems in
      cardiovascular physiology. Most of the gene encoding contractile proteins have
      been cloned and characterized. The availability of molecular probes and the
      ability to introduce genes into individual cell types and tissues of living
      animals, are the most important breakthroughs of molecular and cell biology. This
      permits not only to analyze basic mechanisms of gene expression but has also
      significant practical applications for gene therapy. It is now possible to
      analyze the role of different regulatory gene sequences and identify their
      corresponding trans-active factors. In addition, direct gene injection makes it
      possible to study gene expression in a natural context, under conditions that are
      physiologically relevant and controllable.

PMID- 8357337
TI  - Myocardial perfusion dependent and independent mechanisms of regional myocardial
      dysfunction in hypertrophy.
AB  - Reduced coronary reserve is one of the hallmarks of ventricular hypertrophy.
      Although this reduced coronary reserve may not affect baseline left ventricular
      (LV) function, it could be of greater importance during periods of stress such as
      occurs during exercise where increased metabolic demands induced by the stress
      may not be fully met by increases in coronary blood flow. The impaired
      subendocardial coronary reserve is caused not only by the hypertrophy but also by
      the hemodynamic changes, e.g., the LV subendocardial wall stress, which increases
      markedly upon exercise. In the severely hypertrophied heart during exercise there
      is impaired subendocardial wall function even after 10 beats, i.e., the first 3 s
      of exercise, at a time when LV pressures and stresses had not increased, and
      subendocardial perfusion was still preserved. During more severe exercise,
      subendocardial dysfunction persisted and was associated with reduced
      subendocardial perfusion. After beta-adrenergic receptor blockade with
      propanolol, the most intense level of exercise was associated with lesser
      increase in systolic and diastolic LV wall stresses, heart rate, and LV dP/dt,
      and the endo/epi blood flow ratio, an index of adequacy of subendocardial
      perfusion, was no longer reduced below unity, and there were no decreases in
      subendocardial wall thickening. Thus, the subendocardial dysfunction occurred
      rapidly, before alterations in LV systolic or diastolic wall stress or an
      alteration in the endo/epi blood flow ratio. However, the subendocardial
      hypoperfusion and depression in subendocardial wall thickening observed during
      more severe exercise in dogs with LV hypertrophy was prevented by pretreatment
      with beta-adrenergic receptor blockade. Therefore, myocardial perfusion dependent
      and independent mechanisms mediate regional myocardial dysfunction during
      exercise in the hypertrophied heart.

PMID- 8357338
TI  - ACE-inhibitors and coronary microcirculation.
AB  - Arterial hypertension is the most frequent cause of a disturbance of coronary
      microcirculation. Inspite of having normal epicardial coronary arteries, patients
      with arterial hypertension often have symptoms of angina pectoris and a positive
      exercise tolerance test. The angina pectoris-symptoms in patients with arterial
      hypertension are due to functional and structural alterations of the coronary
      microcirculation. Consequently, an antihypertensive therapy should not only aim
      at lowering blood pressure and reversing myocardial hypertrophy, but also improve
      coronary microcirculation in order to avoid the consequences of chronic ischemia
      on the myocardium. Until now, only experimental studies have indicated that
      antihypertensive therapy can improve coronary flow reserve. To determine to what
      extent under clinical conditions coronary flow reserve can be improved, in
      hypertensive patients maximal coronary blood flow, minimal coronary resistance,
      and coronary reserve (Dipyridamol) were studied before and after a long-term
      antihypertensive treatment (9-12 months) with the ACE-inhibitor enalapril (10-20
      mg/d). To assess the chronic effects rather than the acute effects of the
      antihypertensive pharmacon, the coronary microcirculation was studied after
      intermission of medical therapy for a period of 1 week. Along with a decrease in
      LV muscle mass by about 8%, coronary reserve was improved after enalapril by 48%.
      It is likely that the observed increase in coronary reserve is related to the
      reversal of structural vascular abnormalities at the level of the coronary
      microcirculation. Consequently, it seems that reparation of hypertensive
      remodeling of the coronary microcirculation can be induced by ACE-inhibitor
      therapy.

PMID- 8357339
TI  - Genetic control of fungal differentiation: the three sporulation pathways of
      Neurospora crassa.
AB  - Sporulation in the mold Neurospora crassa can proceed along three very different
      pathways, leading to the production of three types of spores. Two asexual
      sporulation pathways that lead to the formation of macroconidia and microconidia
      involve budding from hyphae by two different mechanisms. A much more complex
      sexual reproductive pathway involves the formation of a fruiting body called a
      perithecium, in which meiosis takes place and ascospores are formed in sac-like
      cells called asci. Numerous mutations exist that affect these developmental
      pathways and genes have been isolated that are expressed preferentially during
      sporulation. The Neurospora sporulation pathways offer a simple system with which
      to study mechanisms and regulation of development that are usually obscured by
      complex cell-cell interactions involved in animal and plant development.

PMID- 8357340
TI  - Integrins hold Drosophila together.
AB  - The Drosophila position-specific (PS) integrins are members of the integrin
      family of cell surface receptors and are thought to be receptors for
      extracellular matrix components. Each PS integrin consists of an alpha subunit,
      alpha PS1 or alpha PS2, and a beta PS subunit. Mutations in the beta PS subunit
      and the alpha PS2 subunit have been characterised and reveal that the PS
      integrins have an essential role in the adhesion of different cell layers to each
      other. The PS integrins are especially required for the function of the cell
      matrix-cell junctions, where the muscles attach to the epidermis and where one
      surface of the developing wing adheres to the other. These junctions are similar
      to vertebrate focal adhesions and hemidesmosomes, which also contain integrins.
      Integrin-mediated cell to cell adhesion via the extracellular matrix provides a
      way for tissues to adhere to each other without intermingling of their cells.

PMID- 8357341
TI  - Dynamic aspects of adhesion receptor function--integrins both twist and shout.
AB  - The recognition of extracellular molecules by cell surface receptors is the
      principal mechanism used by cells to sense their environment. Consequently,
      signals transduced as a result of these interactions make a major contribution to
      the regulation of cellular phenotype. Historically, particular emphasis has been
      placed on elucidating the intracellular consequences of growth factor and
      cytokine binding to cells. In addition to these interactions, however, cells are
      usually in intimate contact with a further source of complex structural and
      functional information, namely immobilised extracellular matrix and/or cell
      surface adhesion proteins. A key question in recent years has been whether cells
      use the myriad of adhesion protein-receptor interactions purely for structural
      and migratory function, or whether these interactions also make a more varied
      contribution to cell phenotype. Here we review dynamic aspects of the function of
      one major class of adhesion receptor, the integrins. In particular, we focus on
      the evidence for shape changes in integrin molecules, the mechanisms responsible
      for regulating ligand binding, and the signals transduced following integrin
      occupancy.

PMID- 8357342
TI  - Meiosis, mitosis and microtubule motors.
AB  - A framework for understanding the complex movements of mitosis and meiosis has
      been provided by the recent discovery of microtubule motor proteins, required for
      the proper distribution of chromosomes or the structural integrity of the mitotic
      or meiotic spindle. Although overall features of mitosis and meiosis are often
      assumed to be similar in mechanism, it is now clear that they differ in several
      important aspects. These include spindle structure and assembly, and timing of
      chromosome segregation to opposite poles. Here we review progress in the
      functional characterization of several newly identified microtubule motor
      proteins, emphasizing their possible roles in spindle structure and function.

PMID- 8357343
TI  - The role of DNA repeats and associated secondary structures in genomic
      instability and neoplasia.
AB  - Tumour-associated genetic changes frequently involve DNA translocation or
      deletion. Many of these events will have arisen from initial genomic damage,
      induced by either the activity of endogenous metabolic processes or from exposure
      to environmental genotoxic agents. Although initial genomic damage will have been
      widely distributed, tumorigenic events are confined to certain DNA target sites.
      Furthermore, within these target sites there appear to be regions of preferential
      DNA rearrangement, and examination of these sites implies that the location and
      extent of such rearrangement may be influenced by DNA primary and secondary
      structure rather than simply by the point of damage. We selectively review
      evidence relating to DNA structures that may predispose certain regions of the
      genome to damage-induced rearrangement, and discuss the possible role of
      interstitial, inverted telomere-like sequence arrays in promoting chromosomal
      events of a type known to be associated with some human and animal tumours.

PMID- 8357344
TI  - Dystrophin as a mechanochemical transducer in skeletal muscle.
AB  - This review is primarily concerned with two key issues in research on dystrophin:
      (1) how the protein interacts with the plasma membrane of skeletal muscle fibres
      and (2) how an absence of dystrophin gives rise to Duchenne muscular dystrophy.
      In relation to the first point, we suggest that the post-translational acylation
      of dystrophin may contribute to its interaction with the plasma membrane.
      Regarding the second point, it is generally considered that an absence of
      dystrophin makes the plasma membrane susceptible to damage by
      contraction/relaxation cycles. In this connection, we propose that the
      progressive nature of Duchenne dystrophy, and the phenotypic characteristics of
      mdx mice, are more consistent with dystrophin functioning as a mechanical
      transducer that transmits growth stimuli from the enlarging skeleton to the
      muscle. On the basis of this hypothesis, dystrophin-deficient muscles would be
      unable to grow at the same rate as the skeleton.

PMID- 8357345
TI  - Werner syndrome and biological ageing: a molecular genetic hypothesis.
AB  - Werner syndrome (WS) is an inherited disorder that produces somatic stunting,
      premature ageing and early onset of degenerative and neoplastic diseases.
      Cultured fibroblasts derived from subjects with WS are found to undergo premature
      replicative senescence and thus provide a cellular model system to study the
      disorder. Recently, several overexpressed gene sequences isolated from a WS
      fibroblast cDNA library have been shown to possess the capacity to inhibit DNA
      synthesis and disrupt many normal biochemical processes. Because a similar
      constellation of genes is overexpressed in WS and senescent normal fibroblasts,
      these data suggest the existence of a common molecular genetic pathway for
      replicative senescence in both types of cell. We propose that the primary defect
      in WS is a mutation in a gene for a trans-acting repressor protein that reduces
      its binding affinity for shared regulatory regions of several genes, including
      those that encode inhibitors of DNA synthesis (IDS). The mutant WS repressor
      triggers a sequence of premature expression of IDS and other genes, with
      resulting inhibition of DNA synthesis and early cellular senescence, events which
      occur much later in normal cells.

PMID- 8357346
TI  - Biological, physical, and electrical parameters for in vitro studies with ELF
      magnetic and electric fields: a primer.
AB  - This paper presents material which is intended to assist researchers in
      identifying and controlling a range of biological, electrical, and other physical
      parameters that can affect the outcome of in vitro studies with extremely low
      frequency (ELF) magnetic and electric fields. Brief descriptions of power line
      magnetic and electric fields are provided and methods for the generation of 60 Hz
      as well as other ELF fields in the laboratory are surveyed. Methods for
      calculating and measuring exposure parameters in culture medium are also
      described. Relating in vitro and internal in vivo exposure conditions across
      different animal species is discussed to aid researchers in selecting levels of
      field exposure. The text is purposely elementary, and sometimes brief, with
      references provided to aid the interested reader in obtaining a fuller
      understanding of the many topics. Because the range of experimental parameters
      that can influence the outcome of in vitro studies with ELF fields is so broad, a
      multidisciplinary approach is normally required to carry out the research.

PMID- 8357347
TI  - Immunodetection of human atherosclerotic plaque with 125I-labeled monoclonal
      antifibrin antibodies.
AB  - To test the affinity of a new F(ab')2 monoclonal antibody (TRF1) against human
      fragment D dimer of cross-linked fibrin for atherosclerotic plaques free of
      detectable thrombi, 6 atherosclerotic segments of carotid and femoral artery, and
      as a control 5 segments of atherosclerosis-free internal mammary artery, were
      drawn from 11 male patients undergoing bypass surgery. All segments were
      carefully washed in order to remove possible endoluminal thrombi, and cut to
      obtain pairs of intimal fragments of similar weight, containing either plaques (n
      = 16), or fatty streaks (n = 12), or normal endothelium (n = 20). Each fragment
      underwent a direct binding test to TRF1, or to a non-specific antibody, both
      labeled with 125I. The activity in each fragment was measured after 3 h of
      incubation at 37 degrees C, and after washing the fragments every hour for 3 h.
      TRF1 binding (as percentage of initial activity) was significantly higher (P <
      0.001) in atherosclerotic than in normal fragments (26% +/- 11.5%, vs. 9.2% +/-
      3.9% in fatty streaks, and 1.9% +/- 0.6% in normal endothelium), and indirect
      immunofluorescence confirmed TRF1 uptake within the plaque wall. By contrast, the
      non-specific antibody did not show any significant binding. These preliminary
      results demonstrate the high specific affinity of TRF1 for atherosclerotic
      plaques, probably due to the hemorheologic phenomena that activate platelets and
      provoke the formation of fragment D dimers of cross-linked fibrin on the plaque
      surface.

PMID- 8357348
TI  - Ramipril prevents impaired endothelium-dependent relaxation in arteries from
      rabbits fed an atherogenic diet.
AB  - Endothelium-dependent relaxation in arteries is attenuated in clinical and
      experimental atherosclerosis. This study investigates the endothelial
      preservation properties of the angiotensin converting enzyme inhibitor, ramipril,
      by assessing its ability to restore endothelium-dependent responsiveness in blood
      vessels from rabbits fed an atherogenic diet (0.25% cholesterol; 3% coconut oil;
      12 weeks). Seven rabbits fed the atherogenic diet received ramipril (3 mg/kg
      mixed into their food daily) and 6 rabbits were maintained on the atherogenic
      diet alone. Control rabbits (n = 6) were fed a standard diet and did not receive
      ramipril. At the end of the dietary intervention, the rabbits were killed and
      blood was collected for measurement of the lipid profile. The thoracic aorta was
      isolated and half was frozen for pathologic review while the other half was cut
      into rings and placed in a muscle bath for measurement of isometric force
      development. Dose response curves to phenylephrine (10(-9) to 10(-5) M) and
      angiotensin II (10(-10) to 3 x 10(-7) M) were completed. There was a minimal
      decrease in responsiveness to phenylephrine in vessels from rabbits eating the
      atherogenic diet compared with controls and no significant differences in the
      response to angiotensin II for any of the vessels. Following contraction by
      phenylephrine, acetylcholine (10(-9) to 10(-5) M) and nitroglycerin (10(-10) to
      10(-5) M) dose response curves were completed. Relaxation to acetylcholine in
      aortic rings from control rabbits was observed, although in arteries from
      atherogenic rabbits relaxation was attenuated. This effect was prevented in the
      atherogenic rabbits fed ramipril. Responsiveness to the endothelium-independent
      vasodilator, nitroglycerin, was similar in arteries from the three rabbit
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357349
TI  - Probucol inhibits mononuclear cell adhesion to vascular endothelium in the
      cholesterol-fed rabbit.
AB  - Mononuclear cells, isolated from the blood of hyperlipidaemic patients, are hyper
      reactive and possess an increased propensity to adhere to vascular endothelial
      cells. Hyperlipidaemia is also associated with a dysfunctional endothelium, to
      which mononuclear cells stick with greater avidity. In order to assess the
      importance of lipid peroxidation and free-radical generation in these processes,
      we have investigated the effects of probucol on mononuclear cell adhesion to
      vascular endothelial cells in vivo and in vitro in the cholesterol-fed rabbit.
      New Zealand White rabbits were fed either: (i) control chow (n = 15), (ii) 2%
      cholesterol (n = 11), or (iii) 2% cholesterol with 1% probucol (n = 11).
      Mononuclear cell adherence to endothelium in the common carotid artery was
      assessed 5 weeks after the start of the experimental diet using the Hoechst 33342
      staining technique. The 2% cholesterol diet caused a more than 6-fold increase in
      mean mononuclear cell adherence (P < 0.001). Concurrent probucol therapy
      abrogated the effects of cholesterol feeding, and in animals in this group, in
      vivo mononuclear cell adherence did not differ significantly from control
      animals. In vivo mononuclear cell adherence was directly related to serum
      cholesterol levels (r = 0.68, P < 0.0001) and inversely related to serum probucol
      concentrations (r = -0.63, P < 0.002). Concurrent probucol therapy also reduced
      the in vitro binding of mononuclear cells, isolated from hypercholesterolaemic
      animals, to endothelial cell monolayers (P < 0.01). These data suggest that the
      increased binding of mononuclear cells to vascular endothelium of cholesterol-fed
      rabbits may be a free radical mediated process that is inhibited by antioxidants.

PMID- 8357350
TI  - Lp(a) levels and antiestrogen antibodies in women with and without thrombosis in
      the course of oral contraception.
AB  - Several reports have shown that lipoprotein(a) is associated with ischemic
      diseases. Two characteristics might explain this association. Firstly, Lp(a) is
      an LDL-like lipoprotein which may be implicated in the atherosclerotic process
      and secondly, Lp(a) possesses an additional apolipoprotein(a) whose structure is
      close to that of plasminogen and might confer to the molecule prothrombotic
      properties. It seemed of interest to see whether Lp(a) was a risk factor in oral
      contraceptive users with thrombotic complications, a group of young women with
      presumably little or no atherosclerosis. Three groups of women were compared: 25
      of them served as controls and did not use oral contraceptives (OC) (group 1); 25
      women were healthy current users of OC (group 2); 35 women suffered thrombotic
      complications in the course of OC (group 3). Mean levels of Lp(a), estimated by
      RID, were not found to be significantly different in the 3 groups: 19 +/- 18, 20
      +/- 23 and 16 +/- 22 mg/dl, respectively. Levels above 30 mg/dl were similarly
      distributed. Among the other risk factors studied, antiestrogen antibodies were
      absent in group 1, present in 24% of group 2 and 71.4% of group 3 (P < 0.01).
      Serum cholesterol levels were similar in the 3 groups: 209 +/- 33, 220 +/- 41,
      213 +/- 45 mg/dl respectively. Mean serum triglyceride levels were higher in
      group 2 than in group 1 (61 +/- 18 and 83 +/- 32, P < 0.01), and higher in group
      3 than in group 2 (116 +/- 66 and 83 +/- 32, P < 0.05).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8357351
TI  - Effect of linoleic acid hydroperoxide on production of matrix metalloproteinases
      by human aortic endothelial and smooth muscle cells.
AB  - The effect of linoleic acid hydroperoxide on the production of proforms of matrix
      metalloproteinase-1, -2, and -3 (proMMP-1, -2, and -3) in cultured human arterial
      endothelial and smooth muscle cells was investigated. Upon cultivation of the
      endothelial cells in the absence of the hydroperoxide, only proMMP-1 was
      detected, and its amount was increased by cultivation with the hydroperoxide. In
      the cultures of the intimal smooth muscle cells in the absence of the
      hydroperoxide, a large amount of proMMP-2 and small amounts of proMMP-1 and -3
      were detected, and the hydroperoxide treatment increased remarkably the amounts
      of proMMP-1 and -3, but rather decreased the amount of proMMP-2. In the cultures
      of the medial smooth muscle cells, the same tendency was observed. However, the
      amounts of these proenzymes found in the intimal smooth muscle cells exceeded
      those found in the medial smooth muscle cells, both in the absence and in the
      presence of the hydroperoxide. Possible involvement of these phenomena in
      atherogenesis was discussed.

PMID- 8357352
TI  - Ultrastructural studies on the phenotypic modulation of human intimal smooth
      muscle cells.
AB  - The present study was carried out to clarify the mechanism of intimal thickening
      at the ostia of celiac and superior mesenteric arteries. The cell components
      involved in the process were analyzed under electron microscope. Autopsy samples
      from cases without significant atherosclerotic diseases were examined and the
      percentages of smooth muscle cells in either synthetic or contractile state,
      macrophages, and foam cells in the intima of mesenteric and celiac arteries were
      calculated. Smooth muscle cells in the synthetic state were predominant in the
      proximal region and those in the contractile state were predominant in the distal
      region. Few macrophages were present in both regions. The intima in the proximal
      and distal regions of celiac arteries in autopsy samples was further divided into
      three layers and the percentages of various smooth muscle cell phenotypes in each
      layer were calculated and compared in patients at different ages. In the proximal
      region, the phenotype of the smooth muscle cells changed from the synthetic to
      the contractile state from the deeper to the superficial layers with the advance
      of age. In the distal region, the contractile state was dominant regardless of
      the age. These results suggest that the phenotypic modulation of human intimal
      smooth muscle cells is reversible dedifferentiation-redifferentiation process;
      this phenomenon plays an important role in the initiation of atherosclerosis.

PMID- 8357353
TI  - Targeting of experimentally induced atherosclerotic lesions by liposome-delivered
      Zn(II)-phthalocyanine.
AB  - Zn(II)-Phthalocyanine (Zn-Pc) is an exogenously administrable dye which is
      accumulated by tumors and other rapidly proliferating tissues. This property
      could be used for visualising atherosclerotic plaques. In order to define the
      feasibility and the optimal conditions for in vivo labelling of atheroma, we
      evaluated the ability of Zn-PC to be accumulated by experimentally induced
      atherosclerotic lesions in rabbits. We also performed pharmacokinetic
      investigations to assess photosensitizer delivery system, difference in
      phthalocyanine concentration between normal and atherosclerotic vessels, and the
      time interval after administration, which yields a large difference between
      normal and diseased vessels. We observed a preferential accumulation of Zn-Pc by
      atherosclerotic lesions which accumulated about a tenfold larger amount of
      photosensitizer, and the retention of significant amounts for prolonged periods.
      Zn-Pc can be considered as a potentially useful fluorescence marker for atheroma.
      The feasibility of photodiagnosis and phototherapy of atheroma deserves further
      investigation.

PMID- 8357354
TI  - Changes in antioxidant enzymes activities, aggregability and malonyldialdehyde
      concentration in blood platelets from patients with coronary heart disease.
AB  - In 41 patients with coronary heart disease (CHD) the concentrations of total
      blood platelet malonyldialdehyde (MDA: 2.11 +/- 0.25 nmol/10(9) platelets) and
      MDA corresponding to thromboxane A2 (TXA2 0.84 +/- 0.13 nmol/10(9) platelets)
      were increased in comparison with values in blood platelets of healthy subjects
      (1.19 +/- 0.09 and 0.71 +/- 0.05 nmol/10(9) platelets), respectively. The
      increased aggregability with ADP and thrombin of patient platelets was also
      observed. In relation to the blood platelets of healthy subjects, the antioxidant
      enzymes activities of patient blood platelets were significantly (P < 0.001)
      decreased. Platelet glutathione peroxidase (GSH-Px) activity of the patients
      (11.3 +/- 0.85 U/g protein) was significantly lower than controls (18.3 +/- 1.12
      U/g protein). In patients with CHD the activities of the other antioxidative
      platelet enzymes: catalase (Cat, 7.37 +/- 1.38 U/g protein) and superoxide
      dismutase (SOD, 1529.4 +/- 167 U/g protein) were also significantly decreased in
      comparison with values for healthy subjects (Cat: 9.06 +/- 1.30 U/g protein and
      SOD: 1987 +/- 230 U/g protein, respectively). It is suggested that antioxidative
      defense in blood platelets may affect the haemostatic processes and lipid
      peroxidation in patients with CHD.

PMID- 8357355
TI  - Effects of a high-fat, sucrose diet on serum insulin and related atherosclerotic
      risk factors in rats.
AB  - Hyperinsulinemia, hypertension, hypertriglyceridemia and obesity are all risk
      factors for atherosclerosis. The clustering of these risk factors in the same
      individual greatly increases the risk for atherosclerosis and has been termed
      'Syndrome X' or 'The Deadly Quartet' The purpose of the present study was to
      investigate the effects of diet on these risk factors in inbred, female Fischer
      344 rats. Animals were raised on ad lib diets consisting of high-fat, sucrose
      (HFS) or low-fat, complex-carbohydrate (LFCC). After 2 years, the HFS rats were
      obese (38% +/- 1% vs. 15% +/- 1% body fat), hypertensive (140 +/- 3 vs. 123 +/- 3
      mmHg), hyperinsulinemic (439 +/- 118 vs. 98 +/- 10 pmol/l), and
      hypertriglyceridemic (1.1 +/- 0.2 vs. 0.4 +/- 0.07 mmol/l). The HFS rats also
      exhibited enhanced clotting and impaired fibrinolytic response to streptokinase.
      All these differences between the two groups were statistically significant (P <
      0.05). Insulin was significantly correlated with body weight (r = 0.71),
      triglycerides (r = 0.48), and systolic blood pressure (r = 0.70). Total
      cholesterol was slightly, but not significantly higher, in the HFS group (2.8 +/-
      0.3 vs 2.2 +/- 0.1 mmol/l) while HDL-cholesterol was unchanged. These results
      show that many risk factors for atherosclerosis can be induced in inbred rats by
      feeding a HFS diet. Aggregation of risk factors was found in the HFS group but
      not in the LFCC group. In fact, most of the rats on the LFCC diet developed no
      risk factors after 2 years, indicating that the development of risk factors is
      not an aging phenomenon.

PMID- 8357356
TI  - Monocyte/macrophage accumulation and smooth muscle cell phenotypes in early
      atherosclerotic lesions of human aorta.
AB  - In a search for early atherosclerotic lesions, we have investigated grossly
      normal areas of human thoracic aortas taken at autopsy from 40 trauma victims
      aged from 3 to 40 years. Two areas of aorta were compared: lesion predisposed to
      atherosclerosis (LP) area localized on the dorsal aspect of the vessel along the
      row of intercostal branching sites, and lesion resistant (LR) area located on the
      ventral aspect of the vessel. Accumulation of apolipoprotein B (apo B) was found
      in LP aortic area of each child older than 6 years. Similar retention of apo B in
      LR area appeared only in aortas of teenagers. The apo B staining increased with
      age in both areas tested but was usually of a greater extent in LP area than in
      LR area. Typical smooth muscle cells (SMCs) and a few monocytes/macrophages
      (Mn/Mph) were revealed in the intimal layer of all aortas examined. The number of
      Mn/Mph dramatically increased in LP areas of individuals over 17 years.
      Quantitative study of double stained sections has shown a 2- to 6-fold enhanced
      number of Mn/Mph in LP area compared with LR aortic area of 10 men over 21 years.
      Focal infiltration of Mn/Mph in aortas of young adults occurred without
      endothelial denudation. In addition, some intimal SMCs in LP area of 12 aortas
      out of 29 expressed desmin and contained well-developed endoplasmic reticulum,
      while such cells were seldom detected in LP area of the vessels. Thus, focal
      accumulation of apo B with subsequent Mn/Mph infiltration and SMC phenotypic
      modulation in LP aortic area of young adults may be causally involved in fatty
      streak and atherosclerotic plaque formation.

PMID- 8357357
TI  - Westernized food habits and concentrations of serum lipids in the Japanese.
AB  - To investigate the association of westernized food habits and concentrations of
      serum lipids in the Japanese, we studied 1200 healthy Japanese living in
      Hiroshima prefecture and 1483 ethnic Japanese from Hiroshima prefecture living in
      the Hawaii Islands and Los Angeles. The nutritional assessments were made by the
      same dietitians. No major difference was observed in the total energy intake
      between the Japanese and the Japanese-Americans in both males and females.
      However, the intake of animal fat and simple carbohydrates (especially fructose)
      were markedly greater, and that of complex carbohydrates lower, in the Japanese
      Americans compared with the Japanese. The mean serum cholesterol (CH), LDL-CH and
      serum triglyceride (TG) levels were significantly higher in the Japanese
      Americans in both sexes. The mean HDL-CH concentration was similar between the
      two groups in males, but it was approximately 7 mg/dl higher in Japanese-American
      females. Using the 75 percentile values of CH and TG in the Japanese in
      Hiroshima, the frequency of WHO types IIa and IIb hyperlipidemia was about twice
      as high in the Japanese-Americans. These results suggest that westernized food
      habits in the Japanese include qualitative changes in animal fat, simple
      carbohydrate and complex carbohydrate diet rather than an increase in the total
      energy intake. These changes are associated with marked increases in the
      concentrations of serum CH and TG and increased prevalence of types IIa and IIb
      hyperlipidemia.

PMID- 8357358
TI  - Seasonal variation in high density lipoprotein cholesterol.
AB  - We investigated the seasonal variation in high density lipoprotein cholesterol
      (HDL) in 142 dyslipidemic (non-HDL-cholesterol > or = 5.2 mmol/l) middle-aged men
      in the placebo group of the Helsinki Heart Study over the 5-year trial period. A
      seasonal pattern was found in HDL fluctuation, with a 4.5% drop during mid-winter
      (5-year mean 1.192 +/- 0.265 mmol/l) compared with a stable level (5-year mean
      1.248 +/- 0.281 mmol/l) during the rest of the year (P < 0.001). A less
      pronounced seasonal variation in HDL was observed in 85 subjects receiving
      gemfibrozil. Although affecting pretrial HDL level in cross-sectional analyses,
      age, alcohol consumption, dietary adherence, physical activity and serum
      triglycerides had no influence on the seasonality of HDL variation. Smoking had a
      slight attenuating effect on the variation pattern. Pretrial HDL was influenced
      by relative weight, but there was also an inverse relationship between HDL and
      body weight variations, i.e. the annual drop in HDL coincided with the annual
      peak in body weight. However, seasonal HDL variation was not directly reflected
      in the annual variation in CHD incidence.

PMID- 8357359
TI  - Inhaled nitric oxide for the adult respiratory distress syndrome.
AB  - BACKGROUND: The adult respiratory distress syndrome is characterized by pulmonary
      hypertension and right-to-left shunting of venous blood. We investigated whether
      inhaling nitric oxide gas would cause selective vasodilation of ventilated lung
      regions, thereby reducing pulmonary hypertension and improving gas exchange.
      METHODS: Nine of 10 consecutive patients with severe adult respiratory distress
      syndrome inhaled nitric oxide in two concentrations for 40 minutes each.
      Hemodynamic variables, gas exchange, and ventilation-perfusion distributions were
      measured by means of multiple inert-gas-elimination techniques during nitric
      oxide inhalation; the results were compared with those obtained during
      intravenous infusion of prostacyclin. Seven patients were treated with continuous
      inhalation of nitric oxide in a concentration of 5 to 20 parts per million (ppm)
      for 3 to 53 days. RESULTS: Inhalation of nitric oxide in a concentration of 18
      ppm reduced the mean (+/- SE) pulmonary-artery pressure from 37 +/- 3 mm Hg to 30
      +/- 2 mm Hg (P = 0.008) and decreased intrapulmonary shunting from 36 +/- 5
      percent to 31 +/- 5 percent (P = 0.028). The ratio of the partial pressure of
      arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2), an index of the
      efficiency of arterial oxygenation, increased during nitric oxide administration
      from 152 +/- 15 mm Hg to 199 +/- 23 mm Hg (P = 0.008), although the mean arterial
      pressure and cardiac output were unchanged. Infusion of prostacyclin reduced
      pulmonary-artery pressure but increased intrapulmonary shunting and reduced the
      PaO2/FiO2 and systemic arterial pressure. Continuous nitric oxide inhalation
      consistently lowered the pulmonary-artery pressure and augmented the PaO2/FiO2
      for 3 to 53 days. CONCLUSIONS: Inhalation of nitric oxide by patients with severe
      adult respiratory distress syndrome reduces the pulmonary-artery pressure and
      increases arterial oxygenation by improving the matching of ventilation with
      perfusion, without producing systemic vasodilation. Randomized, blinded trials
      will be required to determine whether inhaled nitric oxide will improve outcome.

PMID- 8357360
TI  - Effects of walnuts on serum lipid levels and blood pressure in normal men.
AB  - BACKGROUND: In a recent six-year follow-up study, we found that frequent
      consumption of nuts was associated with a reduced risk of ischemic heart disease.
      To explore possible explanations for this finding, we studied the effects of nut
      consumption on serum lipids and blood pressure. METHODS: We randomly placed 18
      healthy men on two mixed natural diets, each diet to be followed for four weeks.
      Both diets conformed to the National Cholesterol Education Program Step 1 diet
      and contained identical foods and macronutrients, except that 20 percent of the
      calories of one diet (the walnut diet) were derived from walnuts (offset by
      lesser amounts of fatty foods, meat, and visible fat [oils, margarine, and
      butter]). RESULTS: With the reference diet, the mean (+/- SD) serum values for
      total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL)
      cholesterol were, respectively, 182 +/- 23, 112 +/- 16, and 47 +/- 11 mg per
      deciliter (4.71 +/- 0.59, 2.90 +/- 0.41, and 1.22 +/- 0.28 mmol per liter). With
      the walnut diet, the mean total cholesterol level was 22.4 mg per deciliter (0.58
      mmol per liter) lower than the mean level with the reference diet (95 percent
      confidence interval, 28 to 17 mg per deciliter [0.72 to 0.44 mmol per liter]);
      the LDL and HDL cholesterol levels were, respectively, 18.2 mg per deciliter
      (0.47 mmol per liter) (P < 0.001) and 2.3 mg per deciliter (0.06 mmol per liter)
      (P = 0.01) lower. These lower values represented reductions of 12.4, 16.3, and
      4.9 percent in the levels of total, LDL, and HDL cholesterol, respectively. The
      ratio of LDL cholesterol to HDL cholesterol was also lowered (P < 0.001) by the
      walnut diet. Mean blood-pressure values did not change during either dietary
      period. CONCLUSIONS: Incorporating moderate quantities of walnuts into the
      recommended cholesterol-lowering diet while maintaining the intake of total
      dietary fat and calories decreases serum levels of total cholesterol and
      favorably modifies the lipoprotein profile in normal men. The long-term effects
      of walnut consumption and the extension of this finding to other population
      groups deserve further study.

PMID- 8357361
TI  - Anaphylactoid reaction following local anaesthesia for epidural block.
AB  - A potentially serious complication of epidural bupivacaine used for a repeat,
      elective Caesarean section is presented. The main features of this reaction were
      erythema, itching, generalised and pulmonary oedema. In addition, pulmonary
      oedema was subsequently noted in the baby. An immunological hypersensitivity to
      bupivacaine or lignocaine is the likely cause.

PMID- 8357362
TI  - Activated glutaraldehyde.

PMID- 8357363
TI  - [Children with minimal brain dysfunction in the family].

PMID- 8357364
TI  - Indications for hysterectomy.

PMID- 8357365
TI  - The new face of AIDS.

PMID- 8357367
TI  - Trends in prenatal diagnosis of Down's syndrome.

PMID- 8357366
TI  - Condoms and contraceptives in junior high and high school clinics. What do you
      think?

PMID- 8357368
TI  - Early soft-tissue complications after distal radius fractures.

PMID- 8357369
TI  - [The international in nursing. Ethics and foreign cultures].

PMID- 8357370
TI  - Weighting in the dark: resource allocation in the new NHS.
AB  - National allocation of resources to regional health authorities and by them to
      districts is now determined by a weighted capitation formula. The national
      formula was derived from regression analysis, with hospital utilisation as an
      index of need for health care--a method which has fundamental limitations. This
      paper argues that the search for an empirically based resource allocation formula
      of high precision in the name of promotion of equity is largely fruitless given
      the impossibility of measuring the true need for, and costs of, providing health
      care, especially with the limited data available. The inclusion of measures of
      social deprivation is also poorly thought out. The availability of data from the
      1991 census, which included a question regarding long-standing illness, together
      with the intention of the Department of Health to review the weighted capitation
      formula using this information may stimulate much work but little light. It is
      essential that the impact of resource allocation formulas is justifiable on
      grounds other than the composition of any particular formula.

PMID- 8357371
TI  - Health prevention messages may have paradoxical effect.

PMID- 8357373
TI  - Early diagnosis of staphylococcal toxaemia.

PMID- 8357372
TI  - Coronary bypass surgery should not be offered to smokers.

PMID- 8357374
TI  - Health policy and the courts: a new approach.

PMID- 8357375
TI  - Reader responds to April JMAG editorial.

PMID- 8357376
TI  - Unfunded research? I am shocked, shocked!

PMID- 8357377
TI  - Race and crack cocaine.

PMID- 8357378
TI  - Caffeine use during pregnancy: how much is safe?

PMID- 8357379
TI  - Article appreciated.

PMID- 8357380
TI  - Measles statistics inaccurately reported in poverty article.

PMID- 8357381
TI  - Patterns of internal echoes in lymph nodes in the diagnosis of lung cancer
      metastasis.

PMID- 8357382
TI  - Catheter-associated sepsis due to Alcaligenes xylosoxidans in a child with AIDS.

PMID- 8357383
TI  - Complications related to gastrostomy button placement.

PMID- 8357384
TI  - Simultaneous trapezium and Bennett's fractures.

PMID- 8357385
TI  - Psychosomatic medicine.

PMID- 8357386
TI  - Inhaled nitric oxide for the adult respiratory distress syndrome.

PMID- 8357387
TI  - The affliction of internal medicine.

PMID- 8357388
TI  - Hypertrophic sternal scars.

PMID- 8357389
TI  - Lipomatous hypertrophy of the interatrial septum.

PMID- 8357390
TI  - Refrigeration of used multidose vials.

PMID- 8357391
TI  - Doxapram in tubeless anaesthesia for microlaryngeal surgery.

PMID- 8357392
TI  - Isolated antibody to hepatitis B core antigen in blood donors and immune response
      to hepatitis B vaccination.

PMID- 8357393
TI  - Restenosis after coronary angioplasty: a proposal of new comparative approaches
      based on quantitative angiography.

PMID- 8357394
TI  - Primary hyperoxaluria type 1--liver transplantation before end-stage renal
      disease?

PMID- 8357395
TI  - Access to heart surgery for smokers. The NHS can't treat only saints.

PMID- 8357396
TI  - Psychiatry services for elderly people. Doctors should be in the front line.

PMID- 8357397
TI  - Injecting drug users in Edinburgh. General practitioners reluctant to prescribe.

PMID- 8357398
TI  - Sleep disorders. Liver damage warning with insomnia remedy.

PMID- 8357399
TI  - Triazolam. Weight of evidence supports increased risk.

PMID- 8357400
TI  - Sleep disorders. "Working treatment" best for night terrors.

PMID- 8357401
TI  - Chickenpox in pregnancy. Acyclovir for uncomplicated chickenpox?

PMID- 8357402
TI  - Antenatal HIV testing. Named testing is unevaluated and costly.

PMID- 8357403
TI  - Reporting deaths to the coroner. Death certification needs urgent overhaul.

PMID- 8357404
TI  - Asthma management guidelines.

PMID- 8357405
TI  - Lasers in surgery.

PMID- 8357406
TI  - Hereditary hydronephrosis and the short arm of chromosome 6.

PMID- 8357408
TI  - Preventive medicine: what does it prevent.

PMID- 8357407
TI  - Dangers of iron and vitamin C supplements.

PMID- 8357409
TI  - Screening and informed consent.

PMID- 8357410
TI  - More on compensating egg donors.

PMID- 8357411
TI  - Physical measurements and their reliability in low back pain patients.

PMID- 8357412
TI  - Re: Bleeding from a Meckel's diverticulum after the use of ibuprofen.

PMID- 8357413
TI  - Vaginal foreign body extraction by obstetric soft vacuum cup: an alternative to
      forceps.

PMID- 8357414
TI  - Disulfiram-induced lead intoxication.

PMID- 8357415
TI  - HCG positive mesothelioma.

PMID- 8357416
TI  - Animal research.

PMID- 8357417
TI  - You paid for the block. Why throw it away?

PMID- 8357418
TI  - Cricoid pressure and the laryngeal mask airway.

PMID- 8357419
TI  - Functional improvement in stunned myocardium.

PMID- 8357420
TI  - Comments on 'Blood vitamin and lipid levels in overweight and obese women', by A.
      Moor de Burgos et al.

PMID- 8357421
TI  - Comments on chlamydiosis.

PMID- 8357422
TI  - Screening for colorectal cancer: the accuracy of fecal occult blood.

PMID- 8357423
TI  - Walnuts and serum lipids.

PMID- 8357424
TI  - Duesberg: rights and wrongs.

PMID- 8357425
TI  - Reform options for peer review.

PMID- 8357426
TI  - Floppy eyelids and crack eye syndrome.

PMID- 8357427
TI  - More on condoms in school clinics.

PMID- 8357428
TI  - Hypercalcemia due to hard well water in a home hemodialysis patient.

PMID- 8357430
TI  - Injury to the superficial flexor tendon.

PMID- 8357429
TI  - Bleeding time and oral anticoagulant therapy.

PMID- 8357431
TI  - Update on drug therapy for HIV and related infections in adults.

PMID- 8357432
TI  - There is a need to modify the Sprotte needle.

PMID- 8357433
TI  - Checking anaesthetic machines.

PMID- 8357434
TI  - Impedance plethysmography and DVT diagnosis.

PMID- 8357435
TI  - More on the doctor's anguish.

PMID- 8357436
TI  - Alopecia areata, topical minoxidil, and balanced reviews.

PMID- 8357437
TI  - C reactive protein and neutrophil band forms in neonates.

PMID- 8357438
TI  - Treatment of ethylene glycol poisoning.

PMID- 8357439
TI  - Is surgery in Costa Rica really cheaper?

PMID- 8357440
TI  - Diet and colorectal adenomatous polyps.

PMID- 8357441
TI  - Lactic acidosis and AIDS.

PMID- 8357442
TI  - [Immunologic risk in blood transfusion].

PMID- 8357443
TI  - [Passive transmission of granulo-agglutinating anti-HLA antibodies without
      pulmonary involvement].

PMID- 8357444
TI  - [Practice of delayed autologous transfusion in Saint-Louis (Senegal)].
AB  - In Saint-Louis' Regional Hospital, transfusional risks and blood shortage led us
      to introduce the delayed autologous transfusion despite a great number of
      difficulties. Our study aimed at finding the most adapted technique to the
      conditions in an African peripheral hospital, and lasted four months (from April
      to July 1992). In this paper, our first results are given that encourage us to
      continue in this way.

PMID- 8357445
TI  - [HIV seropositivity in blood donors from 1990 to 1992: prevalence, estimation of
      residual risk of transfusion-related infections and epidemiology].
AB  - In France, HIV seroprevalence in blood donations still decreased from 1990 to
      1992 with an important diminution in 1992, in first time donors as well as in
      regular donors. During the last 1992 semester, this prevalence reached 0.051%:
      0.19% and 0.026% in donations from first time and regular donors respectively.
      The residual risk was estimated to be 1 for 580,000 donations in 1992 (CI 95% =
      1/2,000,000 to 1/330,000). Sex ratio was 3.7 and 3.4 in 1990 and 1991 and
      increased to 5.5 in 1992 due to a very small number of seropositive women, which
      seems to be an important epidemiological indicator. The major at-risk group is
      still represented by homo-bisexual men.

PMID- 8357446
TI  - [Immunologic aspects of bone marrow transplantation].
AB  - Allogeneic bone marrow transplantation is concerned by immunology by at least two
      aspects: the first one is the acceptance of the graft by the host and
      reciprocally and the second one is that it constitutes an unique human model of
      immune reconstitution. In this review of the immunological aspects, we deal with
      the selection of the bone marrow donor (related or not) especially on the base of
      HLA compatibility and the graft-versus-host disease (GVH) with the clinical
      manifestations, the usual treatments, the supposed cellular mechanisms and the
      risk factors of developing such complications. The graft versus leukemia effect
      (GVL) which may be linked to the GVH disease and the mechanisms of rejection and
      take of the graft are also reviewed as well as the immune reconstitution
      following the immune deficiency due to the conditioning treatment and the
      occurrence of a GVH disease.

PMID- 8357447
TI  - [Description and validation of a flow cytometric method to estimate residual
      leukocytes in leukocyte-depleted red cell concentrates].
AB  - We describe a flow-cytometric method for estimating residual white blood cells
      (WBC) counts in WBC depleted blood components, namely units of packed red cells.
      The method uses fluorescent staining of nuclear ADN with ethidium bromide. WBC
      nuclei are discriminated from background events using fluorescence ratio (585 nm
      versus 650 nm). A facultative procedure of concentration is described, in order
      to get better sensitivity at very low WBC counts. Main steps of validation are
      dilution assays and correlation with hemocytometer counts. The method can be used
      to explore very low concentrations (less than 100 WBC/ml) and should be useful in
      quality control of blood products.

PMID- 8357448
TI  - [Irregular erythrocyte antibody screening using gel-test. Analysis of 35,882
      samples].
AB  - The results of screening for irregular blood-group antibodies in 35,882 blood
      specimens using the gel-test method were analysed. The samples came from
      different clinics and hospital units. 1,179 samples from 728 different
      individuals (3.2%) contained one or several irregular antibodies. The gel low
      ionic strength antiglobulin test detected Kell, Duffy, and Ss antibodies with a
      normal frequency compared to bibliographic data, whereas Kidd antibodies seemed
      to be abnormally infrequent. The best detection of Rhesus antibodies was obtained
      with the gel enzyme test (papain). The prevalence of cold, naturally occurring,
      anti-Lewis and anti-P1 antibodies was low. The gel enzyme test with papain
      treated red blood cells seems to be necessary for detecting Lewis antibodies
      (only 10 out of 95 were detected with the gel low ionic strength antiglobulin
      test). As a counterpart, the gel enzyme test also detected many antibodies with
      doubtful clinical significance: anti-E and anti-Cw reacting only with the gel
      enzyme test, autoantibodies with Rhesus specificity (82 examples), antibodies
      mimicking Jka (4 examples) and S (1 example) specificities in individuals with
      the corresponding antigen.

PMID- 8357449
TI  - A comparison of alcohol-related driving behavior of white and nonwhite North
      Carolina drivers.
AB  - This paper broadens the knowledge of drinking/driving behavior by examining the
      involvement of North Carolina (NC) nonwhite drivers in alcohol-related (A/R)
      crashes and fatal crashes involving alcohol for the period of 1980 through 1988.
      The study identifies an A/R crash involvement problem for nonwhites, particularly
      nonwhite males above the age of 25 and nonwhite females above the age of 54. For
      ages 25 and higher, the A/R crash rates per licensed nonwhite male are at least
      twice those of white (Euro-caucasian) males. In addition, the driving while
      intoxicated (DWI) arrest rates per driver are approximately twice as high for
      nonwhite males as for white males of the same age. Through analysis of other data
      related to arrests for drinking and driving, single-vehicle nighttime (SVNT)
      crashes, breath alcohol concentration (BAC) levels of those arrested for DWI, and
      those involved in A/R crashes, and blood alcohol concentration of those involved
      in fatal crashes, a series of alternative explanations for this nonwhite
      involvement are examined. It is concluded that while nonwhite males and females
      may be involved in more crashes than whites at the same BAC level (as
      hypothesized by other researchers), there is also evidence that nonwhites appear
      to drive more often after drinking and also drive at slightly higher levels of
      BAC.

PMID- 8357450
TI  - Development of a work behavior taxonomy for the safety function in industry.
AB  - A safety job activity questionnaire incorporating 24 job tasks was developed for
      describing the safety function within industry. This instrument was mailed to a
      stratified-proportionate sample of 1,190 working safety professionals
      representing 10 major industrial categories. Respondents rated the relative
      importance and amount of time spent on each of the 24 job activities. The overall
      response rate was 40%, producing 465 usable questionnaires. Factor analytic
      techniques were applied to each set of ratings to derive the principal dimensions
      of the safety position. Similar five-factor solutions emerged for both importance
      and time spent, accounting for 56% and 52% of the variance, respectively. The
      five job dimensions were: (i) serving as safety consultant and advisor, (ii)
      coordinating compliance and control activities, (iii) assessing the effectiveness
      of controls, (iv) analyzing hazards and losses, and (v) conducting specialized
      studies and reviews. Respondents, classified by industrial group and size of
      operation, were then compared using the job dimensions from the factor analyses.
      There were very few differences in the safety function across different
      industries or sizes of operations.

PMID- 8357451
TI  - Subjective probability of accident and apprehension in relation to self-other
      bias, age, and reported behavior.
AB  - Responses from over 900 male drivers were examined on items measuring the
      subjective probability of two adverse driving scenarios (accident and
      apprehension) for a number of speeding and drink-driving-related events. The
      items were constructed to focus on self versus average referent driver
      comparisons. Respondents were categorised into "offenders" and "non-offenders"
      according to their reported behaviour concerning speeding and drink-driving. The
      data were analysed using repeated measures analysis of variance. The results
      indicated that both accident and apprehension are seen as less probable when self
      is the reference compared to the average driver. There was evidence to suggest
      that this self-favouring bias did vary over presented scenarios. It was suggested
      that such perceptions may vary in relation to the perceived influence of driver
      skill within scenarios. Weak age effects were found, but it was concluded that,
      generally, self-favouring biases were common across all age groups. Concerning
      the offender/nonoffender classification, the results indicated that speeders and
      drink-drivers generally perceived the probability of apprehension and accident as
      being lower than did the nonoffender groups. There was no evidence to suggest
      that self-average driver biases were associated with offender/nonoffender
      grouping.

PMID- 8357452
TI  - The effects on accidents of compulsory use of daytime running lights for cars in
      Norway.
AB  - The use of daytime running lights was made mandatory for new cars in Norway in
      1985 and for all cars in 1988. This paper examines the effectiveness of this
      regulation as an accident countermeasure. The paper relies on the same study
      design and method of analysis as previous studies of similar laws in Finland and
      Sweden. Four hypotheses concerning the effects of daytime running lights are
      tested. None of them was supported. The total number of multiparty accidents in
      daylight was not reduced. Pedestrian accidents and accidents in twilight were not
      reduced. The number of rear-end collisions increased by about 20%. Daytime
      running lights appear to reduce daytime multiparty accidents only during summer
      (by about 15%) and only for multivehicle accidents, excluding rear-end
      collisions. The possibility that confounding factors may have influenced study
      results is examined. It is concluded that such an influence cannot be ruled out.
      The discussion of the results highlights the difficulties of reaching clear and
      defensible conclusions in nonexperimental accident research of the kind reported
      in this paper.

PMID- 8357453
TI  - Typical accidents encountered by assembly workers: six scenarios for safety
      planning identified using multivariate methods.
AB  - This study highlights the most typical accidents encountered by assembly workers
      employed in a variety of different workshops at a large automobile and truck
      factory in Sweden. Following site visits and the collection of data from accident
      registers, statistics on 28 accident characteristics were compiled on the basis
      of the 145 accidents involving assemblers in 1986 and 1987. For data treatment,
      two statistical methods complemented one another: the factorial analysis of
      correspondence (FAC) and the hierarchical ascendant classification (HAC). Six
      typical accident profiles were extensively portrayed, quantified, and illustrated
      graphically: overexertion; falls and stumbling; injuries related to the handling
      of tools; superficial wounds to the (left) hand; cuts/pinches from moving machine
      parts and the handling of objects; miscellaneous blows from work pieces. The
      distribution of these types of accidents across the workshops was studied. It is
      emphasized that the search for typical accident patterns using multivariate
      statistical methods helps to structure and define the accident problems of a
      target group and therefore provides benefits for the evaluation of the need for
      preventive measures.

PMID- 8357454
TI  - Alcohol and drug use among motor vehicle collision victims admitted to a regional
      trauma unit: demographic, injury, and crash characteristics.
AB  - This study examined the incidence of alcohol and drugs in a sample of seriously
      injured motor vehicle collision victims, and differences related to pre-crash use
      of alcohol and/or other drugs on demographic variables, injury severity measures,
      and crash variables. The sample selected were all motor vehicle collision
      admissions to the Regional Trauma Unit at the Sunnybrook Health Science Centre in
      Toronto, Ontario, over a 37-month period (N = 854). Prospective demographic and
      injury-related information were collected from hospital charts, and crash data
      were collected from motor vehicle collision police reports. Blood samples were
      routinely collected on admission and tested for blood alcohol concentration
      (BAC). We found 32.0% of the BAC-tested motor vehicle collision admissions and
      35.5% of drivers tested positive for blood alcohol. The drivers' mean BAC on
      admission was found to be 145.2 mg/100 ml, and the mean estimated BAC at crash
      time was 181 mg/100 ml. Drug screens were performed on a two-year subsample (n =
      474), of whom 339 were drivers. Drug screens revealed that 41.3% of drivers
      tested positive for other drugs in body fluids, and 16.5% were positive for
      alcohol in combination with other drugs. Other than alcohol, the drugs most
      frequently detected in the drivers were cannabinoids (13.9%), benzodiazepines
      (12.4%), and cocaine (5.3%). Investigation of differences on demographic, injury,
      and crash characteristics related to precrash use of alcohol and/or drugs yielded
      significant findings. In the drug screened sample we found sex, admission type,
      and occupant status were related to precrash alcohol use. Also, use of drugs was
      found to interact with admission type and mean BAC on admission. Elapsed time was
      found to be significantly different for BAC by other drug use, with a greater
      length of elapsed time found for the subjects testing other drug positive but BAC
      negative. We found that BAC-positive drug-screened drivers were significantly
      more likely to be male, involved in a single-vehicle collision, not wearing a
      seat belt, ejected from the vehicle, and travelling at higher speeds than BAC
      negative drivers. No significant differences were found between BAC and/or other
      drug use on injury severity measures.

PMID- 8357455
TI  - Does the use of child safety seats increase as a result of loan schemes?
AB  - This population-based study carried out in central Sweden is concerned with
      parents' attitudes towards infant restraints in cars and whether the loaning of
      infant car seats leads to increased use during and after the first nine months of
      the infant's life. Of 937 infants born in a defined geographical area with a
      population of 86,000 (test group) 84.8% of parents borrowed a seat for their
      newborn infants. No such loan was available to the control group. Use increased
      greatly during the first nine months (loan period) when the seat was freely
      available to the test group; but no important difference emerged between the test
      and control groups after nine months of age concerning long or short journeys. In
      the test group use of the seat was lower for short than for long journeys during
      the first nine months. In the control group, in which the parents had to obtain
      their own seat, the difference was marginal. A total of 19 accidents involving
      infants in the study group occurred during a one-year period. In some respects
      the findings of the present study differ from those of two other comparable
      studies, particularly regarding the number of parents who chose to borrow a seat,
      the age of the child when starting to use the seat, and parents' views on the
      comfort of the seat.

PMID- 8357456
TI  - Self-bias in older drivers' judgments of accident likelihood.
AB  - Drivers generally perceive their own chance of having a road accident to be
      significantly lower, and their own skill to be greater, than that of their peers.
      Previous research has shown this effect to be reduced in middle-aged drivers as
      opposed to young ones. This study examines the extent to which this positive self
      bias in relation to driving continues or changes with increasing age beyond 50
      years, examining the relationship of self-bias to driving experience and also to
      locus of control. Eighty subjects aged between 50 and 79 completed a self-rating
      questionnaire on the likelihood of having different types of accidents (driving
      and nondriving) when in control themselves and when someone else was in control,
      comparing themselves to "average others" of different ages. In the nondriving
      accidents, the self-bias for people in their 70s comparing themselves with an
      average other aged 70, was far greater than for those in their 50s (comparing
      themselves with an average other aged 50). In the driving accident scenarios
      there was little self-bias at all when the comparison was with same aged peers
      only. In this analysis, people in their 50s showed no self-bias, whereas their
      self-bias had been considerable when comparing themselves with three age groups
      (30s, 50s, and 70s were used). Amount of positive self-bias generally decreased
      with increasing age, increased with greater current driving experience (mileage),
      and increased with amount of perceived control. Number of years of driving
      experience had no effect. However, in regression analysis on the same aged peers
      comparison, only internality of locus of control was a significant independent
      predictor of the variance in self-bias in the driving situation. Age and current
      driving experience were not significant independent predictors. Results were
      discussed with reference to the importance of the comparison group when assessing
      differences in self-bias and to the potential implications for road safety
      education.

PMID- 8357457
TI  - Work-related road fatalities in Australia, 1982-1984.
AB  - A study of work-related fatalities, based on coroners' records, has provided
      national data on work-related road fatalities. A total of 1,544 work-related
      fatalities were identified over 1982-1984. Of these, 600 (39%) resulted from
      injuries sustained in road vehicle accidents on public roads; 366 (24%) in the
      course of work, and 234 (15%) while commuting between home and work. These
      figures are likely to underestimate work-related road fatalities because the
      coroners' records often did not contain the required information. The incidence
      of road fatalities declined slightly over the three years, although the
      proportion amongst all work-related fatalities remained constant. The at-work
      victims tended to be older than victims of road death generally. Fifty-six
      percent of the at-work cases were in the occupational group "drivers, road
      transport". Articulated trucks accounted for 41% of the at-work cases. Drivers
      made up 79% of the at-work group. In contrast, drivers accounted for only 38% of
      all road deaths. Two-thirds of the at-work road fatalities occurred outside
      capital city districts, the proportion of nonmetropolitan cases being highest for
      deaths involving articulated trucks. This is striking, in view of Australia's
      highly urbanised population. Blood alcohol data were available for 76% of the at
      work cases and 79% of the commuting fatalities. Of these, 15% and 13%,
      respectively, had a blood alcohol of 0.05 g/100mL or more. In contrast, 6% of
      other workplace fatalities for which blood alcohol data were available had such
      levels. This difference may reflect more assiduous blood-alcohol testing of road
      accident victims.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357458
TI  - Application of an injury surveillance system to injuries at an industrial
      facility.
AB  - We developed a computerized surveillance database employing the Abbreviated
      Injury Scale (AIS) and sampled three months of nonfatal injuries at a large
      industrial facility. Data from 197 injury visits to the plant medical department
      were collected. With the addition of some new AIS codes for injuries specific to
      the workplace, most injuries could be coded and severity scores calculated with
      good interrater reliability. Neither Maximum AIS nor Injury Severity Score (ISS)
      predicted restricted or lost work time. Because of its ease of automation and
      reliability, the AIS can serve as a useful tool for occupational injury
      surveillance, but its current severity scoring system is not predictive of
      disability.

PMID- 8357459
TI  - The effect of laser speed-measuring devices on speed limit law enforcement in
      Charleston, South Carolina.
AB  - Drivers exceeding the speed limit by more than 10 mph were identified and
      ticketed by the Charleston County, South Carolina police using two types of speed
      measuring devices: conventional police radar and a new laser device. The two
      types of enforcement were used alternately on the same roads at similar times.
      Under the laser enforcement condition, the police issued 534 tickets (54%)
      compared with 457 (46%) under radar enforcement. The increase in tickets issued
      under laser enforcement was observed at three of the four study sites, and the
      number of tickets per traffic volume increased at two of the three sites for
      which traffic volumes were available. Speeders ticketed under the laser
      enforcement condition were four times as likely to have radar detectors as those
      ticketed under the radar enforcement condition. Most of the additional speeders
      caught by the laser were using radar detectors. These data indicate that some
      speeders with radar detectors are avoiding detection when the police enforce the
      limit with radar.

PMID- 8357460
TI  - A temporal analysis of rain-related crash risk.
AB  - The study presents empirical evidence of accident risk during and following rain
      events in the cities of Calgary and Edmonton, Canada. The matched sample approach
      is used to examine data for 169 rain events and over 15,000 accidents that
      occurred during the years 1979-1983. The overall accident risk during rainfall
      conditions was found to be 70% higher than normal. The data suggest that accident
      risk returns to normal as soon as the rainfall has ended, despite the lingering
      effects of wet road conditions.

PMID- 8357461
TI  - Exposure corrected risk estimates for childhood product related injuries.
AB  - This study assesses the effect of exposure correction on injury risk estimates
      for children, using Chicago-area survey data on age-specific exposure of children
      to seven products: amusement park rides, sleds, bunkbeds, skateboards, fireworks,
      toboggans, and air guns and rifles. National Electronic Injury Surveillance
      System estimates for 1987 were used as numerators with two denominators: (i)
      uncorrected age-specific U.S. Census estimates for 1987 and (ii) these estimates
      corrected for exposure. Except for bunkbeds, skateboards and sleds, corrected
      injury risk decreased as age increased. Uncorrected population injury rates
      underestimated the risk posed to product-using children, especially those who are
      youngest and those who use skateboards.

PMID- 8357463
TI  - Road accident trends in Nigeria.
AB  - A study of road accident trends in Nigeria between the period 1960 and 1989
      revealed a sharp increase in fatal accident occurrence. Between 1960 and 1969, it
      was observed that over 18,000 deaths occurred as a result of road accidents. By
      the third decade (1980-1989), this figure had increased to about five times, i.e.
      more than 92,000 deaths. Reasons for the severity of road accidents in Nigeria
      are discussed.

PMID- 8357462
TI  - Incidence of alcohol and drugs in fatally injured car drivers in Norway.
AB  - Blood samples from 159 fatally injured drivers from 1989 and 1990, corresponding
      to 57% of all fatally injured drivers in Norway during this period, were analysed
      for alcohol and psychoactive drugs. Alcohol was found in 28.3% of the drivers,
      27.0% above the legal limit of 0.05%. Drugs were found in 16.4% of the drivers;
      benzodiazepines and tetrahydrocannabinol were the drugs most frequently found.
      Among 79 drivers fatally injured in single-vehicle accidents, 41.8% were positive
      for alcohol and 21.5% were positive for drugs.

PMID- 8357464
TI  - Synthesis and pharmacological screening of a group of piperazine derivatives.
      Analgesic activity.
AB  - Fifteen original piperazine derivatives were synthesized: 11 esters of 1
      substituted-4-(3'-phenyl-3'-hydroxypropyl)-piperazines with acetic, propionic,
      benzoic and phenylacetic acids and 4 symmetrical esters of 1,4-bis-(3'-phenyl-3'
      hydroxypropyl)-piperazine with acetic, propionic, benzoic and phenylacetic acids.
      The compounds were tested with respect to their analgesic and behavioural
      activity, as well as toxicity. Three nociceptive tests were used: chemical
      intraperitoneal irritation with acetic acid, thermal contact irritation and
      thermal radiation irritation. The tests were performed on albino mice breed H.
      All tested compounds were biologically active and showed analgesic effect. The
      "therapeutic index" was determined on the basis of the mean effective doses
      (ED50) and the mean lethal doses (LD50). Most favorable "therapeutical" indices
      were distinguished in 1,4-bis[3'-phenyl-3'-acetoxypropyl]-piperazine (12), 1
      benzhydryl-4[3'-benzyloxypropyl]-piperazine (10) and 1-benzhydryl-4[3'-phenyl-3'
      phenylacetyloxypropyl]-piperazine (11).

PMID- 8357465
TI  - Synthesis and antimicrobial activity of some new indolo[2,1-b]quinazolin
      6(12H)ones.
AB  - A series of indolo[2,1-b]quinazolin-6(12H)ones 4a-i was prepared and tested for
      the antimicrobial activity. The synthesis of the new compounds and the results of
      the antimicrobial screening are reported.

PMID- 8357466
TI  - Fungicidal activity of new O-derivatives of phenylpyridylketoximes.
AB  - Some alkyl- and acylderivatives of phenylpyridylketoximes were prepared and
      tested in vitro and in vivo against fungal plant pathogens of different taxonomic
      classes. The tested compounds exhibited remarkable activities, especially when an
      ethyl group was present on the oxime function.

PMID- 8357467
TI  - Synthesis of 4-quinolylazide derivatives and evaluation of their antitumor and
      antimicrobial activity.
AB  - Synthesis and pharmacological evaluation of a series of 4-quinolylazide
      derivatives are reported. These were screened against P388 lymphocitic leukemia
      in mice, but they resulted inactive. All the compounds were also tested for their
      antimicrobial activity against gram-positive, gram-negative strains and fungi;
      only three derivatives exhibited poor activity.

PMID- 8357468
TI  - Synthesis and antimycobacterial activity of some 4-pyridinecarboxyamidrazone
      derivatives.
AB  - A series of N1-aryliden-4-pyridinecarboxyamidrazone derivatives was prepared.
      Some of the synthesized compounds showed interesting in vitro antimycobacterial
      activity against some strains of Mycobacterium and clinical isolates of
      Mycobacterium tuberculosis.

PMID- 8357470
TI  - [Risk factors for allergy to hymenoptera stings].
AB  - Hymenoptera stings are common and potentially serious. The clinical, paraclinical
      and therapeutic aspects of allergy to hymenoptera venom are being better and
      better understood. A retrospective descriptive enquiry of hymenoptera stings in
      270 consultations in a Central General Hospital has established three risk
      factors in the possibility of a serious reaction (R.A.G.): Men: 2.4 times more
      allergic reactions (R.A.). Severity of R.A. increases with age, especially after
      50 years. Hornet stings have a risk 5 times greater than that of bees and 4.3
      times greater than wasp.

PMID- 8357469
TI  - N-substituted 4-carboxy-1-phenyl-1H-pyrazole-5-propanamides with
      antiinflammatory, analgesic, antipyretic and platelet antiaggregating activities.
AB  - The synthesis of a series of N-substituted 4-carboxy-1-phenyl-1H-pyrazole-5
      propanamides by reaction of 1-phenyl-1H-oxepino[4,3-c]pyrazole-4(8H),6(7H)-dione
      with aromatic primary amines is described. Some amides showed a platelet
      antiaggregating activity in vitro superior or comparable to that of
      acetylsalicylic acid, as well as moderate antiinflammatory, analgesic and
      antipyretic activities in rats or mice.

PMID- 8357471
TI  - [Preliminary study of the importance of trace elements in immunostimulation].
AB  - Stimunal is an original immuno-stimulant of which the action is between adapted
      therapy and probability. It has a composition of trace elements which are usually
      recognised to be useful for the function of immune defences and this requires a
      clinical research of two populations: Those subjects who are predisposed to
      infections of the upper and lower respiratory tract. Those allergic subjects who
      do not respond overall to the protocols for specific desensitisation. The study
      of 27 cases shows a modality of modest but not negligible response in particular
      in 8 patients who showed objective clinical and complementary improvement. This
      study should be extended to a larger sample.

PMID- 8357472
TI  - [Double-blind comparative study of terfenadine and cetirizine in chronic
      idiopathic urticaria].
AB  - Our randomised study in parallel groups, double-blind double placebo, has
      compared the efficacy, onset of action and safety of terfenadine and cetirizine
      in chronic idiopathic urticaria. Over a fourteen day period, patients of the
      first group received a tablet containing 120 mg of terfenadine, those of the
      second group a tablet containing 10 mg of cetirizine. Symptoms were assessed
      every two hour period for the ten first hours on the first day (D1), and before
      and at the end of the study by the investigators. 193 patients were included by
      48 dermatologists between May 1989 and July 1990. Both groups were well matched
      for all general characteristics and baseline symptoms scores. The onset and the
      intensity of regression of symptoms (pruritus, erythema and discomfort during
      sleeping time) were similar in both treatment groups public physicians:
      improvement of pruritus in over 90% of the patients. Meanwhile the tolerability
      was good or excellent for dermatologists and allergologists for 92% of the
      patients under terfenadine against 81% of the patients under cetirizine (p <
      0.05). Adverse events (fatigue and drowsiness) were significantly reported less
      frequently (p < 0.05) in patients on terfenadine (19%) than on cetirizine (33%).
      This study confirms the efficacy of terfenadine compared with cetirizine in the
      treatment of chronic idiopathic urticaria. Adverse events were less significant
      for terfenadine (n = 18) than for cetirizine (n = 29) (p < 0.05).

PMID- 8357473
TI  - [Sublingual specific immunotherapy for rhinoconjunctivitis caused by grass
      pollens].
AB  - Fifty eight patients with rhino-conjunctivitis caused by grass pollen were
      included in a double-blind study in which they received, by the sub-lingual route
      over 5 months, either a solution of purified and standardised allergen or a
      placebo. Assessment of the effect of this immunotherapy, which was done with
      drops of Stallergenes "5-grass pollen" was by clinical symptoms and the use of
      authorized drugs and treatments. Compared with the placebo group, the patients on
      active treatment showed significantly less (P = 0.05 to P = 0.01) rhinitis
      symptoms (sneezing and rhinorrhea) and conjunctivitis (reddening and tears)
      during the pollen season. Consumption of nasal cromoglycate solution, of
      betamethasone and dexchlorpheniramine was significantly lower (p = 0.01) in the
      desensitised group. Secondary effects were negligible. From this study, it can be
      concluded that immunotherapy with grass pollen extract, by the sub-lingual route,
      of patients with rhino-conjunctivitis who were sensitive to these allergens, is
      efficacious, easy to do, economic and sure.

PMID- 8357474
TI  - [Determination of total IgE (tIgE) and specific IgE (sIgE) using the IMX and
      MATRIX techniques].
AB  - This study, on 185 subjects, has given evaluation of total IgE by the IMX
      technique in comparison with CAP PRIST, and of the MATRIX* technique for the
      measurement of sIgE in comparison with the reference technique of CAP RAST**,
      skin tests and clinical history. The two techniques of CAP and MATRIX are judged
      to be comparable (Correlation percentage 88.2%). The correlation of MATRIX with
      skin tests and clinical history is satisfactory (respectively 85.9% and 95%). The
      results were obtained with four allergens (D. pteronyssinus, Timothy grass, cat
      and dog). Separate assays confirmed the reliability of the technique.

PMID- 8357475
TI  - Studies of tissue cultured sliced dermis as a skin substitute.
AB  - A dermis slicer designed by the authors enabled us to prepare about 10 sheets of
      sliced dermal grafts (SDG), 300 micron(s) thick, from the dermis harvested from
      the back or buttocks of adult patients during operations. Such a sliced dermal
      sheet was stretched with one surface stuck on the base of a culture dish. It was
      then incubated in Dulbecco's essential medium for tissue culture, to which
      epidermal growth factor had been added. By the first week only its upper side was
      epithelialized from epithelial components in sliced dermis. The formation of
      basement membrane with anchoring fibrils was confirmed by electron microscopy.
      The appearance of type IV collagen and laminin was observed between
      epithelialized basal cells and the dermal layer. Thus, it is thought that the SDG
      is useful not only for immediate grafting, when epithelialization follows, but
      also as a substitute for free split thickness skin grafts following tissue
      culture.

PMID- 8357476
TI  - A novel approach to extend the survival of skin xenografts without entailing
      general immunosuppression or systemic toxicity.
AB  - The feasibility of using antigenically disguised skin xenotransplants to cover
      extensive burns for a suitable time lag without administering immunosuppressive
      drugs was tested experimentally. Pieces of human skin that had been preincubated
      for 3 h at 37 degrees C with either mouse anti-human beta 2-microglobulin
      monoclonal antibody (beta 2m-McAb) or PBS (controls) were grafted onto the backs
      of immunologically competent Swiss mice, and the time required for their
      rejection or substitution by normal autogenous skin was determined. Thus, it was
      found that the beta 2m-McAb-pretreated xenografts had a significantly longer mean
      survival time than the control grafts. An even longer skin xenograft MST was
      obtained when beta 2m-McAb was repeatedly injected, at weekly intervals, just
      beneath the transplants. Parallel immunohistochemical studies showed that the
      beta 2m-McAb entered the grafts and was bound to its targets both in epidermis
      and dermis. Moreover, a small amount of beta 2m-McAb administered at the outset
      significantly hindered the reactive proliferation of primed mouse spleen cells
      cultured in the presence of human epidermal cells. Finally, neither toxic effects
      nor a weakening of immune competence were elicited by repeated intraperitoneal
      injections of beta 2m-McAb. Therefore, it seems expedient to propose the use of
      beta 2m-McAb to delay the rejection of skin xenografts as this antibody
      harmlessly prevents, wholly or in part, the activation of the recipients'
      lymphocytes. This would positively aid any patient urgently needing xenograft
      cover of extensive burns.

PMID- 8357477
TI  - Effect of corticotropin releasing factor on acid-base alterations and bacterial
      translocation in a murine model of thermal injury.
AB  - Corticotropin-releasing factor (CRF) is a 41 amino acid polypeptide produced by
      the hypothalamus which has been shown to decrease inflammation and tissue oedema
      when administered following burns, cold and acid injuries in some animal models,
      and to increase mesenteric blood flow. We determined whether systemic
      administration of CRF to burned mice would decrease metabolic acidosis and
      protect the gastrointestinal (GI) tract from ischaemic injury leading to
      bacterial translocation (BT). Synthetic CRF was administered by intraperitoneal
      injection in doses of 20 and 200 micrograms/kg to mice immediately following 25
      and 32 per cent TBSA burn injuries; the doses were repeated at 8 and 16 h
      postburn. Severe metabolic acidosis, measured 12 h after burn injury, was not
      improved in mice which received CRF treatment. Bacterial translocation, measured
      by quantifying bacteria in mesenteric lymph nodes harvested from animals 48 h
      postburn, was also not decreased with CRF treatment. CRF does not improve general
      tissue perfusion nor decrease GI derangements leading to bacterial translocation
      in this animal model of burn injury.

PMID- 8357478
TI  - Topical phenytoin in the treatment of split-thickness skin autograft donor sites:
      a comparative study with polyurethane membrane drape and conventional dressing.
AB  - The effectiveness of topical phenytoin as a wound healing agent was compared with
      that of OpSite (Smith & Nephew) and a conventional topical antibiotic dressing
      (Soframycin, Roussel) in a controlled study of 60 patients with partial-thickness
      skin autograft donor sites on the lower extremities. Mean time to complete
      healing (complete epithelialization) was 6.2 +/- 1.6 days in the phenytoin
      treated group (30 patients), compared to 8.6 +/- 2.2 days with OpSite (15
      patients), and 12.6 +/- 3.4 days in the 15 Soframycin-treated patients. The
      differences between the treatment groups were significant at P < 0.001. Mean pain
      scores were also lower in the phenytoin-treated group, 0.40 +/- 0.55 vs. 0.66 +/-
      0.60 with OpSite (P < 0.05) and 1.4 +/- 0.50 with the conventional dressing (P <
      0.001). Both phenytoin and OpSite were superior to the Soframycin dressing with
      respect to bacterial contamination and wound infection as measured by Gram stains
      of wound smears, swab and aspirate (OpSite) cultures, and clinical assessments (P
      < 0.001) carried out on the fifth day of treatment. No local or systemic adverse
      effects of the three agents used were noted. Phenytoin appears to be an
      effective, low-cost and safe method for the treatment of partial-thickness skin
      graft donor sites, comparing very favourably with, and in some aspects superior
      to, occlusive dressings. Further clinical use and evaluation of topical phenytoin
      are merited.

PMID- 8357479
TI  - Experimental study on alkaline skin injuries--periodic changes in subcutaneous
      tissue pH and the effects exerted by washing.
AB  - A skin alkaline injury model was constructed using rats and 2N-NaOH. The changes
      over time, paying special attention to subcutaneous tissue pH, were recorded and
      included a comparative study of the effect on subcutaneous tissue pH of washing
      with water at 1, 10 and 30 min after injury. After inflicting alkaline injury,
      the subcutaneous tissue pH reached its peak value at the 32nd minute and had not
      recovered to the pre-experimental level by the 90th minute. The peak pH values of
      the 1-, 10- and 30-min delays before washing groups were 7.97, 10.57 and 12.17,
      respectively. When washing was started within 1 min of injury the tissue pH
      values did not exceed 8.00. Washing had virtually no effect on lowering the
      raised pH levels when the delay between injury and the start of washing was 10
      and 30 min.

PMID- 8357480
TI  - A burn patient resuscitation therapy designed by computer simulation (BET). Part
      1: Simulation studies.
AB  - This study presents an analysis of the fluid, electrolyte and colloid needs of
      burn patients during the shock phase. A digital simulation technique was used
      which had previously been validated and published in burned patients (Roa et al.,
      1988). After analysing the repercussions of both burns and various resuscitation
      procedures, a fluid therapy method (BET) has been designed using a burn patient
      simulator, which has been characterized by its effectiveness and minimal side
      effects. The characteristics of the BET method are a low volume of infusion
      resuscitation solution (220 ml/h/m2 burned body surface area (BBSA)) and a rapid
      and large volume of colloidal substances (with colloid concentrations of 10, 7.5
      and 5 g/100 ml during the first three 8 h periods of the first postburn day and
      2.5 g/100 ml until the 40th h postburn).

PMID- 8357481
TI  - A burn patient resuscitation therapy designed by computer simulation (BET). Part
      2: Initial clinical validation.
AB  - The clinical results obtained from the first 40 burned patients resuscitated with
      220 ml/h x BBSA (m2) of human serum albumin with concentrations of 10, 7.5, 5 and
      2.5 per cent in lactated Ringer's (0-8, 8-16, 16-24 and 24-40 h post injury
      respectively), which we have called BET fluid therapy, were compared with those
      obtained in 58 patients resuscitated with lactated Ringer's 4 ml/kg of body
      weight/%BBSA during the first 24 h after burning. The results confirm the
      effectiveness of the BET form of fluid therapy during the shock phase after
      burning. The BET fluid therapy method differs from other procedures because of
      its lower volume of infused resuscitation solution with the rapid infusion of
      large amounts of colloid. These preliminary results have encouraged us to
      continue analysing this new method of fluid therapy.

PMID- 8357482
TI  - Burns in Madras, India: an analysis of 1368 patients in 1 year.
AB  - Analyses were made of 1368 patients who attended Kilpauk Medical College
      Hospital, Madras with burns between 1 May 1987 and 30 April 1988. Nine hundred
      and sixty-five patients were admitted, of whom 505 died. The peak age incidence
      was in young adults (11-30 years; 58.9 per cent of all burns). Three quarters of
      the patients came from the low family income group, 39.5 per cent were illiterate
      and 86.2 per cent of burns occurred in the home. Of those admitted 81 per cent of
      the injuries were flame burns; in 31.3 per cent the burn affected more than half
      of the body surface. Of the 505 deaths 94.8 per cent were the result of flame
      burns (at least 323 being caused by kerosene), and 20.4 per cent were suicide.
      Most of the deaths (91 per cent) occurred in the first 5 days. The urgent need
      for burn prevention in the Madras area is discussed.

PMID- 8357483
TI  - Infection and antibiotic therapy in 4000 burned patients treated in Milan, Italy,
      between 1976 and 1988.
AB  - The pathogenic flora, isolated from burn wounds of patients admitted to a burn
      care unit during the years between 1976 and 1988 were typed and the in vitro
      susceptibility to antibacterial agents was recorded. Between 1976 and 1988 the
      general therapeutic approach was changed three times, in congruence with the
      prevalent nosocomial bacterial resistance. The most frequent isolates were:
      Pseud. aeruginosa, Staphylococcus aureus, Enterococcus spp., Proteus mirabilis,
      Escherichia coli, Enterobacter cloacae, Klebsiella spp. and other
      Enterobacteriaceae, such as Acinetobacter, Citrobacter. The most striking finding
      was the increase in antibiotic-resistant Enterococcus isolates. Staph. aureus,
      Klebsiella and E. cloacae showed susceptibility to cephalosporins, imipenem,
      pefloxacin, vancomycin; Enterococcus susceptibility to pefloxacin and vancomycin,
      and Pseud. aeruginosa sensitivity to piperacillin, amikacin, tobramycin was
      generally good. E. coli showed a satisfactory susceptibility on average, and P.
      mirabilis showed a good sensitivity to piperacillin, cephalosporins, amikacin,
      tobramycin, aztreonam and imipenem. Thus, the general bacterial flora and
      susceptibility have remained mostly unchanged over the years, with the
      conspicuous exception of Enterococcus spp. and E. cloacae, which demonstrated a
      marked increase in incidence, with a concomitant dramatic decrease in the
      sensitivity of Enterococcus spp. to antibiotics.

PMID- 8357484
TI  - Entry to the burns team: stressors, supports and coping strategies.
AB  - Employment as a member of a multidisciplinary burns team presents the individual
      with an enticing professional and personal challenge. Patients sustaining major
      burns require intense physical and psychological rehabilitation over an extended
      period of time, often drawing upon the services of a sole therapist. Although
      more attention is being paid to professional issues of 'burn-out' and general
      care of the health professional, there has been little published with regard to
      actual stressors experienced by burn staff. An understanding of stressors faced,
      and current support systems utilized, by an occupational therapist in the first
      12 months in a major burns unit, illustrates the unique demands placed upon
      junior staff. Following this review possible coping strategies for the individual
      and institution at large are discussed. It is suggested that continuing
      education, supervision by senior staff and better staff/patient ratios, may
      facilitate an easier transition into the burns team and render staff better able
      to cope with continuing stressors.

PMID- 8357485
TI  - Epidemiology of burns in the Tel Aviv area.
AB  - Between 1 August 1988 and 31 January 1992, 421 burn patients were admitted to the
      Burn Unit at Beilinson Medical Center. Name, age, sex, month of the year, cause
      of burn, area and degree of burn and duration of stay in hospital were recorded.
      Of these patients, 37 per cent were treated surgically and the remainder were
      treated conservatively. The male to female ratio was 2:1. Burns occurred most
      frequently in July and January; the peak average age was the first decade of
      life. The most frequent cause in children was scalding (domestic burns), and in
      adults open fires (work accidents). Patients treated by early tangential excision
      and skin grafting (204 operations on 157 patients) had a shorter stay in hospital
      than conservatively treated patients. In accordance with others, we suggest that
      early surgery of burn injuries decreases morbidity and mortality and leads to
      better aesthetic results and improved motor function. Secondly, burn injury can
      be prevented in children and the elderly by increasing safety measures at home,
      and in adults by enforcing strict safety measures at work.

PMID- 8357486
TI  - Chemical burn due to contact with soda lime on the playground: a potential hazard
      for football players.
AB  - Two football players were treated for chemical burns of their genitalia and
      medial thighs caused by contact with soda lime used to line a playground. The
      cases are reported and the unusual mechanism causing the injury is described.

PMID- 8357487
TI  - Acquired tracheo-oesophageal fistula following tracheal intubation in a burned
      patient.
AB  - A 27-year old male sustained a 60 per cent TBSA burn with inhalation injury
      following a road traffic accident. He developed respiratory distress on day 3
      postburn, and was intubated and ventilated. He was noted to have greenish
      aspirate from his trachea on day 17 of ventilation. He succumbed from sepsis and
      died on day 21 post injury. At post-mortem, a large tracheo-oesophageal fistula
      (TOF) was found at the level of the cuff of the nasotracheal tube.

PMID- 8357488
TI  - A summary of the workshop on child and adolescent obesity: what, how, and who?

PMID- 8357489
TI  - Defining obesity in children and adolescents: epidemiologic approaches.
AB  - This article discusses the use of epidemiologic and statistical approaches in
      developing definitions of obesity for children and adolescents. Definitions of
      adult obesity have been derived from mortality data or from statistical data on
      reference populations. Both approaches pose problems when applied to children and
      adolescents. The choice of appropriate measurements can be difficult. Data on
      childhood weight and adult outcomes are sparse and hard to interpret. Statistical
      definitions based on reference populations are more straightforward, but require
      arbitrary assumptions that limit their usefulness for prevalence estimates or
      comparisons across age, sex, or race/ethnic groups. Examples illustrate some
      issues in defining childhood obesity, including a case study of two groups of
      researchers who used the same data sets, but arrived at different conclusions. At
      present there is no generally accepted objective definition of obesity for
      children or adolescents.

PMID- 8357490
TI  - Defining obesity in children and adolescents: clinical approaches.
AB  - For clinical utility, obesity should be defined as a condition of excess adipose
      tissue associated with adverse health outcomes. Based on a number of criteria,
      body mass index (BMI) (weight/height) is the most appropriate measure for
      clinical assessment of adiposity in children and adolescents. However, sufficient
      information regarding associations between adiposity and current or future
      morbidity is lacking. Available data suggest a definition of obesity based on
      adiposity alone would perform poorly as a clinical screening test for adverse
      health outcomes. In addition, labeling and attempted weight control therapy may
      produce more harm than benefit. Therefore, until better information regarding the
      risks of adiposity and risks of treatment are available, recommendations for
      weight control therapy should be focused primarily on those children and
      adolescents who currently manifest adiposity-related morbidity, those with a BMI
      above the 95th percentile, or those above the 85th percentile who perceive their
      adiposity to be a significant psychosocial problem. To produce a clinically
      useful definition of obesity, longitudinal data should be used to determine the
      sensitivities, specificities, and predictive values of comparative measures of
      childhood and adolescent adiposity for predicting current and future morbidity,
      and to evaluate the utilities of including characteristics such as age, age of
      adiposity rebound, persistence of increased adiposity, family adiposity, family
      morbidities, and fat distribution to improve predictive values and minimize
      misclassification. Weight control research should attempt to identify patient
      characteristics that predict long-term treatment success, treatment failure, and
      treatment side effects.

PMID- 8357491
TI  - Physical activity assessment in children and adolescents.
AB  - This article provides a review of the techniques that have been developed for
      measurement of physical activity in children and adolescents. Physical activity
      has been measured in youngsters using three major approaches: direct observation,
      heart rate or motion monitors, and self-report measures. Each of these techniques
      has relative benefits and deficiencies. Direct observation is a valid procedure
      requiring little interference and can provide good information concerning
      contextual variables (i.e., physical and social environment). However, direct
      observation is costly in terms of investigator and observer time. Motion sensors
      and heart rate monitors overcome problems associated with subject recall of
      activity and are less costly than direct observation. However, these instruments
      can be prone to technical problems and they provide no information concerning
      specific activities or the context in which activities are performed. Self-report
      and proxy report (e.g., by parents or teachers) techniques are relatively
      inexpensive, but their validity is limited by the ability of the subject (or
      proxy) to recall and report activity behavior. A major limitation in this field
      has been the lack of a "gold standard" measure of energy expenditure. The lack of
      such a criterion measure has precluded validation of the aforementioned activity
      measures as indicators of energy expenditure in children and youth.

PMID- 8357492
TI  - Obesity in children and adolescents: development of predictive equations and
      their application to epidemiologic studies.
AB  - Epidemiological studies of body fatness cannot be based on laboratory measures.
      One alternative is to analyze values related to body composition such as skinfold
      thicknesses, but it is better to apply an equation that accurately predicts a
      body composition variable. If an equation is to be developed, the choice of the
      dependent variable affects the selection of the independent variables to be
      tested for inclusion. The validation group should have a wide distribution of
      values for the dependent and independent variables. To develop an equation that
      works well on validation and with other groups, all possible sub-set regression
      should be applied, multicollinearity examined, and ridge and robust regression
      used if these are needed. An equation chosen from the literature should have been
      developed and tested by appropriate methods and it should be validated against
      data from a sub-group of the study sample.

PMID- 8357493
TI  - Obesity genes and diabetes induction in the mouse.
AB  - Obesity, a phenotype having high heritability in humans, constitutes the major
      risk factor predisposing an individual to non-insulin-dependent diabetes mellitus
      (NIDDM). However, most obese humans do not develop NIDDM, indicating that
      diabetogenesis entails a complex interaction between obesity genes and other
      predisposing susceptibility traits. The possible nature of some of these
      background modifiers is being elucidated by analysis of genetically obese mice.
      Mutations at loci on six different mouse chromosomes produce obesity, but
      development of insulin-resistant diabetes requires an interaction between the
      obesity mutation and other factors in the genetic background. Analysis of the
      interaction between three distinct obesity genes expressed on the same genetic
      background has shown that virilization of hepatic sex steroid metabolism mediated
      via aberrant shifts in sex steroid sulfotransferase activities is a prerequisite
      for diabetogenesis. The analogies between the development of a hyperandrogenized
      tissue state in obese mice with obesity-diabetes syndromes in humans are
      discussed.

PMID- 8357494
TI  - Genetic models of human obesity--family studies.
AB  - Childhood obesity is predictive of obesity as an adult, and individual
      differences in body weight relative to height (body mass index) in adults are
      important predictors of morbidity as well as mortality from atherosclerotic
      cardiovascular disease. The observation of strong familial correlations does not
      ensure that genes are involved in the determination of body mass index, because
      individuals in families share environments as well as genes. However, several
      recent studies have found evidence for both additive (polygene) and nonadditive
      (major gene) components. A question that results from these analyses is--what
      gene(s) has been inherited that carries an associated risk, most likely mediated
      by environmental exposures, for obesity? Studies to identify genetic loci linked
      to familial obesity should add to our understanding of the genetic factors
      involved in the determination of obesity and may lead to early identification of
      individuals and families at high risk for the chronic disorders that are
      associated with obesity.

PMID- 8357495
TI  - Genetic influences on energy expenditure in humans.
AB  - Variations in human energy expenditure are partly because of an influence of the
      genotype, even after control for the well-established concomitants of energy
      expenditure. Using the techniques of genetic epidemiology, we have found that
      about 40% of the variance in resting metabolic rate, thermic effect of food, and
      energy cost of low-to-moderate intensity exercise (< or = 5 times the resting
      metabolic rate) is explained by inherited characteristics. A significant genetic
      effect has also been reported for the level of habitual physical activity. The
      existence of a genotype-environment interaction has also been investigated. Thus,
      in response to chronic overfeeding, as well as negative energy balance, changes
      in the components of energy expenditure exhibit significant identical twin pair
      resemblance. Nutrient partitioning is emerging as a major determinant of the
      individual differences in metabolic rate responses to overfeeding or negative
      energy balance conditions. Taken as a whole, these observations consistently
      support the hypothesis that heredity plays a significant role in the various
      components of energy expenditure in humans.

PMID- 8357497
TI  - Metabolic efficiency of macronutrient utilization in humans.
AB  - Macronutrient utilization in humans is a complex phenomenon, with each
      macronutrient having its separate storage and utilization pathways. Carbohydrate
      and fat are to some extent interdependent, but while carbohydrate utilization is
      greatly dependent on intake, fat is not. The food quotient of the diet is
      important in determining how nutrients are utilized and stored, and thus is an
      important determinant of body composition. Also, the effect of these two
      macronutrients on food intake differs. The bioenergetics of utilization of the
      macronutrients are discussed.

PMID- 8357496
TI  - Strategies for the molecular genetic analysis of obesity in humans.
AB  - Studies of twins, adopted children, and some human populations indicate that body
      composition is significantly influenced by genetic factors. However, in no
      specific instance in either man or animals is the precise etiology of obesity
      known at the molecular level. Attempts to identify the molecular basis of obesity
      in humans have been hampered by difficulties in measuring food intake and energy
      expenditure with sufficient accuracy, as well as the apparent polygenic control
      of body composition in man. These constraints have stimulated interest in inbred
      animal strains, particularly mice, that have a genetic predisposition to obesity.
      Using the techniques of positional cloning, molecular markers flanking two
      autosomal recessive mouse obesity mutants (ob and db), which demonstrate a
      metabolic/behavioral phenotype similar to that observed in obese humans, have
      been identified. These markers are being used: (1) as starting points for
      chromosome walks to identify these genes, (2) as an aid in identifying
      genetically obese rodents prior to the development of the experimentally
      confounding obese phenotype, and (3) to investigate the possible contribution of
      the ob and db gene products to obesity in families segregating an obese
      phenotype. Additionally, genetic crosses segregating these obesity mutations are
      being used to identify "polygenes" that influence the severity of obesity and
      type II diabetes. Such studies may ultimately lead to the characterization of
      genes that influence the development and severity of obesity and non-insulin
      dependent diabetes (NIDDM) in humans.

PMID- 8357498
TI  - Metabolic rate and body composition of Pima Indian and Caucasian children.
AB  - A low metabolic rate for a given body size and body composition may be a risk
      factor for body weight gain. Because the prevalence of obesity exceeds 75% in the
      Pima Indian population, we investigated whether Pima Indian children have a low
      resting metabolic rate (RMR) when compared with Caucasian children. Body
      composition (bioelectrical resistance) and RMR were measured in 43 Pima Indian
      children (22 male/21 female, means +/- SD = 9.9 +/- 1.1 year) and 42 Caucasian
      children (21 male/21 female, 9.7 +/- 1.2 year). Pima Indian children were taller
      (p < 0.001), heavier (p < 0.001), and fatter (p < 0.0001) than Caucasian
      children. Absolute values of RMR were higher in the Pimas than in the Caucasians
      (p < 0.001), but were similar when adjusted for differences in body size, body
      composition, and sex. In Pima Indian girls before puberty (< 10 years; n = 8),
      adjusted values of RMR were negatively correlated with the mean body mass index
      (BMI) of the parents (r = -0.88; p < 0.005). Inasmuch as resting metabolic rate
      was not low in Pima children, the data suggest that the major factors in the
      weight gain of 10-year-old Pima children may be reduced physical activity and/or
      excess energy intake. However, this study does not exclude the possibility that a
      low metabolic rate may be a predisposing factor at an earlier age.

PMID- 8357499
TI  - Impact of experimental manipulation of energy intake and expenditure on body
      composition.
AB  - There is persuasive evidence that much obesity is due to underexercising rather
      than overeating. In a series of randomized, controlled trials we found that
      sedentary men who take up jogging lose body fat in proportion to miles run,
      increase their energy intake, and improve their lipoprotein pattern. In a 1-year
      comparison of fat loss by dieting vs. fat loss by exercise without dieting, both
      methods were found to be effective in moderately overweight men, and both
      approaches raised plasma HDL cholesterol. We also demonstrated in overweight men
      and women losing weight on a prudent diet (low fat, low cholesterol) that adding
      exercise to energy restriction further increased loss of body fat and reduced
      waist-to-hip girth ratio, especially in men. Risk of coronary heart disease was
      also substantially further reduced by addition of exercise, in both sexes. These
      studies suggest that regular exercise is a valuable addition to dietary change
      for weight control and reduction of risk of chronic disease in people of all
      ages. In this article I shall describe studies done by our group in the past 10
      years to investigate the effects of varying energy expenditures and varying
      caloric intakes on body composition, in particular body fat content. The
      intervention studies are of relatively long duration (1 or 2 years) and have been
      conducted in free-living men and women. Such long-term investigations are rare in
      children and adolescents. Although experience in adults cannot be translated
      directly to children, our findings may indicate profitable research directions
      for future obesity research in the young.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357500
TI  - Trends in body composition for infants and children in the U.S.
AB  - Nationally representative health examination surveys have collected
      anthropometric measurements on children and adolescents in the U.S. These data
      may serve as very crude indicators of total fat or fat-free body mass, but do not
      yield information on body composition per se. Attempts to accurately describe
      trends in obesity for children and adolescents have been complicated by a number
      of limitations associated with body measurements taken over time in sequential
      surveys. Inferences from limited anthropometric measures should be made
      cautiously. Factors to consider include the selection of cutpoints for trend
      analysis, changes that may be within range of technical measurement error, and
      use of data at extreme percentiles. Ostensible trends may be genuine, but they
      may also be influenced by methodological differences across surveys. Comparative
      data are presented for selected body measures from 1963 to 1980 for U.S. children
      and adolescents sampled in national health examination surveys, and apparent
      differences are discussed.

PMID- 8357501
TI  - Ethnic variation in the prevalence of obesity in North American children and
      youth.
AB  - The estimated prevalence of obesity in North American children and youth (6 to 17
      years) in the 1960s through the 1980s is reported. Use of the triceps skinfold
      and BMI independently and in combination as indicators of obesity provides
      different estimates of prevalence due to ethnicity. With the triceps skinfold as
      the indicator, there is an increase in the prevalence of obesity and a reduction
      in variation between Black and White children and youth from the 1960s to 1980;
      however, with the BMI as the indicator, there is no change in the prevalence of
      obesity and negligible ethnic difference in these national data sets. On the
      other hand, the prevalence of obesity has increased over time in Mexican American
      and American Indian children and youth. Data for American children and youth of
      Asiatic ancestry are limited.

PMID- 8357502
TI  - Obesity and cardiovascular disease risk factors in prepubescent and pubescent
      black and white females.
AB  - A total of 2379 females equally divided between black and white were enrolled at
      9 or 10 years of age. Participants were seen yearly for 5 years for a complete
      medical examination, evaluation of socioeconomic status, and patterns of eating
      and physical activity. Parents were seen in year 1 and responded to a
      questionnaire in years 3 and 5. At baseline, black females 9 to 10 years of age
      were taller and heavier and had greater BMI and skinfold thickness than white
      females. On the basis of dietary history, black females consumed more total
      energy and more calories as fat than white females. White females were physically
      more active and spent less time than black females watching television. More
      black than white females expressed a desire to be on the fat side, and black
      mothers were noted to be 20 lb. heavier than white mothers.

PMID- 8357503
TI  - Epidemiology of physical activity and fitness in children and adolescents.
AB  - Variations in physical activity and aerobic power are examined in relation to age
      and gender of children and adolescents. Reviews of the world literature show
      aerobic power relative to body mass remains stable from ages 6 to 16 for males,
      but for females it declines about 2% per year. Overall, males are about 25% more
      fit than females. Reviews of nine studies using standardized self-reports or
      objective measures of physical activity revealed that males are about 15 to 25%
      more active than females. Over the school age years, a consistent decline in
      physical activity is seen, with males decreasing about 2.7% per year and females
      decreasing about 7.4% per year. These data suggest that older youth and females
      are at increased risk of obesity because of a sedentary lifestyle.

PMID- 8357504
TI  - Trends and patterns in height and weight status of low-income U.S. children.
AB  - To better define the trends and patterns of growth for low-income children, we
      studied the anthropometry data collected by the second National Health and
      Nutrition Examination Survey (NHANES II) and the CDC Pediatric Nutrition
      Surveillance System (PNSS). Based on NHANES II, we found that low-income children
      appear to have a greater prevalence of shortness (low height-for-age), but do not
      have a greater prevalence of overweight (high weight-for-height) when compared
      with children from higher income families. Based on 12 states that were monitored
      continuously by the PNSS from 1980 to 1989, low-income children under 5 years of
      age appear to have a stable trend of height and weight status, with the exception
      of Asian children, most of whom were from Southeast Asian refugee background,
      showed a dramatic improvement in height status. However, based on PNSS data for
      the years 1977 to 1990 from Louisiana and Michigan, school-aged children and
      adolescents appear to have become slightly taller as well as having significant
      increases in body weight in relation to height. An additional investigation is
      needed to verify this trend of increasing excess weight among older, low-income
      children.

PMID- 8357505
TI  - Does childhood obesity track into adulthood?
AB  - Between 1971 and 1981 the Muscatine Coronary Risk Factor Project measured, in six
      biennial school surveys, 2631 schoolchildren 9 to 18 years of age. Beginning in
      1981, these individuals were measured near their 23rd, 28th, and 33rd birthday.
      This article examines the tracking from childhood into young adult years of the
      heights, weights, body mass indices (BMI), and triceps skinfold thicknesses (TSF)
      of these individuals. Depending on age and gender, tracking correlations for
      height ranged from 0.41 to 0.97; for weight they ranged from 0.51 to 0.88; for
      BMI they ranged from 0.58 to 0.91; and for TSF they ranged from 0.26 to 0.58.
      From 49 to 70% of children in the upper quintile of weight were found in the
      upper quintile of weight as adults, from 48 to 75% of children in the upper
      quintile of BMI were again in the upper quintile as adults, and from 25 to 56% of
      children in the upper quintile of TSF were again in the upper quintile as adults.
      These measures track from childhood into young adult life, and the majority of
      obese children become obese adults. However, about 31% of children from the upper
      quintile of BMI became adults with substantially lower levels, while a similar
      number of lean children become obese adults. Why some obese children become obese
      adults and others do not remains an unanswered question. The data presented
      herein indicate that obesity is often acquired during childhood and adolescence
      when preventive measures could be applied.

PMID- 8357506
TI  - A review of the impact of fluoride on adult caries.

PMID- 8357507
TI  - Development and verification of the proximal/marginal plaque index.
AB  - The purpose of this study was to compare the ability of experienced and newly
      trained investigators to use the published Global Plaque Index and a newly
      developed Proximal/Marginal Index (PMI) that focuses on disclosed plaque at
      clearly defined proximal and marginal surfaces. Four independent clinical studies
      were performed, two with each index, on 11 subjects per study. In each study,
      examinations were conducted before and after brushing, to determine inter- and
      intra-examiner comparisons over a range of plaque levels. Inter-examiner
      reliability estimates for the PMI were at a level below Global Plaque index
      means. Intra-examiner agreement values were similar for both indices. Both
      scoring systems are considered sufficiently validated to detect product
      differences in clinical studies.

PMID- 8357508
TI  - Clinical plaque removal efficacy of three toothbrushes.
AB  - A single-blind, randomized clinical study compared plaque removal efficacy of
      three toothbrush designs under conditions simulating normal use. Ninety (90)
      subjects with substantially complete dentition used one of the three
      toothbrushes: Advanced Design Reach, Crest Complete and Oral-B 40. Subjects were
      examined for plaque before and after a single brushing using the Global Plaque
      Index to estimate plaque on the entire tooth surface, and the Proximal/Marginal
      Plaque Index (PMI), a new index, was used to estimate plaque at proximal and
      marginal surfaces of the teeth. The Advanced Design Reach toothbrush reduced
      plaque scores significantly more than did the other toothbrushes tested (p <
      0.05) using either scoring method. At marginal and proximal sites, combined or
      separate, Advanced Design Reach toothbrush was significantly more effective than
      the other toothbrushes in plaque removal and produced significantly more plaque
      free sites than the other two toothbrushes. Evaluation of all anterior and
      posterior parts of the dentition with the Global Plaque Index indicated that
      Advanced Design Reach was superior in removing plaque in these regions. Both
      plaque indices were highly correlated (correlation coefficient 0.91) indicating
      excellent consistency by the dental examiner.

PMID- 8357509
TI  - Plaque removal efficacy of two children's toothbrushes: a one-month study.
AB  - Reach Wonder Grip toothbrush for children was evaluated for plaque removal
      efficacy and compared to the Colgate Plus Junior (extra soft). The subjects
      appeared at the test site with overnight (14-18 hours) plaque accumulation. After
      qualifying for the study, sixty-eight (68) subjects were randomly assigned one of
      the test brushes. They then participated in the test evaluation at the clinical
      site wherein plaque levels were measured before and after a one minute brushing.
      Plaque removal efficacy was evaluated by the Global Plaque Index (percent of
      tooth surface covered by stained deposit). The subjects then used the assigned
      toothbrush at home for one month and returned to the test site to repeat the
      baseline evaluations. After their final plaque evaluations, the subjects were
      given a new toothbrush from each brand to use at home for one week and the
      subject and the parent were asked to complete a preference questionnaire. Sixty
      seven (67) subjects completed the one month study. After one month's use of twice
      per day brushing, neither of the test toothbrushes demonstrated any evidence of
      oral irritation that could be related to toothbrushing. The results indicated
      that Reach Wonder Grip for Children was significantly more effective (p < 0.05)
      than Colgate Plus Junior in removing overall (Global) plaque at the initial exam
      period. The preference questionnaire indicated that the Reach Wonder Grip
      toothbrush was preferred by both the children and their parents. It is concluded
      that the new Reach Wonder Grip toothbrush for children is safe and effective for
      plaque removal.

PMID- 8357510
TI  - Second malignancies after chemotherapy and transplantation.

PMID- 8357511
TI  - Current advances in the treatment of gastrointestinal malignancy.

PMID- 8357512
TI  - Macrophage function activating cytokines: potential clinical application.

PMID- 8357513
TI  - Recent advances in diagnosis of hemoglobinopathies.

PMID- 8357514
TI  - [Brainstem auditory evoked potentials in low and high risk newborns].
AB  - Brainstem auditory evoked potentials (BAEP) were performed in a population of
      preterm infants of 32-34, 35-37 and 38-41 weeks of gestational age (GE) high risk
      newborns, and in 38-41 weeks GE low risk newborns. Statistical differences were
      found between both 38-41 weeks GE groups. High risk newborns showed longer
      latencies of waves III and V (P < 0.001), and I-III and I-V interwave intervals
      (P < 0.01). Our data show that auditory brainstem system suffer in high risk
      newborns. Results is discussed in relationship with other brainstem auditory
      evoked potentials studies in high risk newborns due it's clinical implications of
      present data.

PMID- 8357515
TI  - [Child abuse: a disturbing problem].
AB  - This current information on "battered child syndrome" (BCS) was obtained during
      1990 from nine institutions in Tijuana, Baja California; 549 cases of BCS were
      studied, of which 338 were female, 203 male, eight of indeterminate sex due to
      loss documentation. Child abuse was manifested in all its forms: beatings, sexual
      abuse, neglect, and affective indifference. The victim's and perpetrator's
      characters were analyzed together with other factors which had to be taken into
      consideration in order to detect results which were similarly described in the
      literature. It is of utmost importance to alert all medical staff to this
      terrible social problem for the complete treatment of the affected child and the
      family environment. Community support, and legislation to adequately cover rights
      of minors and their protection are imperative to elimination of the battered
      child syndrome.

PMID- 8357516
TI  - [Pharyngo-tonsillitis and necrosing submaxillary adenitis caused by Streptococcus
      pyogenes associated with toxic shock syndrome in children from Mexico City].
AB  - We report on six previously healthy children between nine months and nine years
      old, who suffered streptococcal faringoamigdalitis and cervical adenitis with
      scarlet fever and toxic shock syndrome; four of them died in a fulminant course
      and two survived. These patients behave similarly to others reported from United
      States of America, England and Australia, and in similar way these clinical
      entity could be due to bacterial pyrogenic exotoxins according to the clinical
      fulminant course.

PMID- 8357517
TI  - [Neonatal conjunctivitis caused by Chlamydia trachomatis].
AB  - 32 newborns with neonatal Chlamydia trachomatis conjunctivitis were reported.
      Diagnosis was carried out through immunofluorescent monoclonal antibody of
      conjunctiva scraping staining; 37 conjunctiva samples were taken from same number
      of newborn patients not responds to topical antibiotic treatment. The sample came
      out from two different third level institutions with maternal facilities and
      attending more than five thousand deliveries per year each one of them. Were
      studied incidence and clinical picture from neonatal C. trachomatis
      conjunctivitis. Positive immunofluorescent and conjunctive culture of secretion
      to C. trachomatis in the sample were 86 per cent (32 out of 37). 19 of the
      newborns acquired Staphylococcus associated to C. trachomatis (59%): nine with S.
      aureus in six Staphylococcus negative coagulase was isolated and four with the
      latest two. Out of 32 patients who demonstrated positive cultures to C.
      trachomatis (86%), 22(69%) were males and ten (31%) were females. Significant
      proportion of newborns were identified as small for gestational age. 18 of them
      were born by natural way and 14 by cesarean section. In 16/32 (50%) had
      interstitial pneumonia by Chlamydia. The main clinical findings were stated as:
      conjunctiva exudate in different stages including purulent secretion and oedema
      or inflammation of the ophthalmic conjunctiva. Those newborns where topical
      therapy did not irradiate the organism and demonstrated clinical picture
      persistence or relapse and diagnosis of C. trachomatis infection, systemic
      treatment with erythromycin and topic tetracycline were installed, disappearing
      all symptoms. Maternal history related to neonatal disease were mainly:
      endocervical infection, miscarriages and or preterm delivery.

PMID- 8357518
TI  - [Validity of a scale of vital prognosis in multiorgan failure syndrome:
      experience at a pediatric ICU].
AB  - In order to evaluate the utility of modified score index for multiple organ
      failure syndrome (MOFS) detection, we studied 31 critically ill pediatric
      patients at University Hospital of Puebla. They had a critical illness and they
      were successfully animated and developed two or more organ failure other than
      initial lesion. Were calculated sensibility, specificity, positive predictive
      value and negative predictive value of clinical and biochemical criterion of
      modified score index and results were few consistent. Were assessed that scale
      for know its predictive value and results were significant: sensitivity 81%,
      specificity 30% and accuracy, 54.5%. Finally we recommended caution to use anyone
      score system in evaluating MOFS.

PMID- 8357519
TI  - [Changes in the consciousness as a manifestation of intestinal intussusception].
AB  - Many reviews have included the salient features of the clinical spectrum of
      intussusception: abdominal pain, vomiting, bloody stools and abdominal mass. We
      report a case with atypical presentation of the illness, presenting as altered
      consciousness. A misdiagnosis and delay of treatment is often associated with
      increased morbidity. Either plain radiographs, supplemented by ultrasonography of
      the abdomen, or a barium enema should be performed in infants with unexplained
      lethargy.

PMID- 8357520
TI  - [Hereditary blepharophimosis with visual alterations].
AB  - We report a Mexican family with two members (mother and daughter) affected with
      blepharophimosis hereditary syndrome: ptosis of the eyelids, blepharospasm and
      epicanthus inversus. The daughter presented: hyperopia, astigmatism, hemispheric
      asymmetry, superficial mental deficiency and ovarian cyst. The mother with
      ophthalmological affectation, present too border line intellectual quotient.
      Clinical findings in this family illustrate autosomal dominant trait;
      differential diagnosis should be taken into account for genetic counselling.

PMID- 8357521
TI  - [Funicular torsion with testicular necrosis in the newborn].
AB  - Three cases of extravaginal torsion of the spermatic cord with infarct of the
      testicle in the newborn are presented. All three cases had acute fetal distress.
      They had in common being the products of multiparous women, born in a distocic
      fashion with a prolonged labor without prenatal control. One of the had a
      shoulder impaction with required forceps use. Two of them were delivered on
      vaginal way and the other one by cesarean section. In all three cases, torsion
      was present at birth. Diagnosis was made between third and fifth day of life; the
      clinical findings were: enlargement of the right scrotal bag, purple
      discoloration of the skin, a painless hard mass that did not permit the passage
      of light (transillumination) and the absence of cremasteric reflex. A right
      resolution ultrasound was useful in determining the inflammatory tumoral mass. A
      right orchidectomy and pexy of the contralateral testicle were done in the three
      cases with nonabsorbable sutures and no testicular implants. The following
      diagnoses should be discarded prior to a definitive diagnosis: scrotal edemas,
      hydrohematocele, strangled inguinal hernia with infarct and testicular neoplasia.

PMID- 8357522
TI  - [Alport's syndrome: new findings].
AB  - The Alport's syndrome is a disease characterized by a symptomatic triad:
      nephropathy, hypoacusia and ocular alterations. This syndrome is genetically
      heterogeneous and results from numerous mutations in COL4A5 gene, whose locus
      resides on the long arm of the X chromosome (Xq22). This gene codifies for IV
      collagen alpha 5 chain, which is a fundamental constituent of the glomerular,
      lens and Corti's organ basal membranes. Present knowledge on molecular genetics
      and the characterization of the different mutations that affect the Alport's gene
      will lead to classification of this syndrome in subtypes, according to those
      mutations, and to its phenotypic expressions; in addition, some syndromes,
      phenotypically similar, will probably have to be distinguished from Alport's
      disease, in a future, if a genetic alteration is found in genes other than
      COL4A5.

PMID- 8357523
TI  - Gordon James Mogenson (1931-1991).

PMID- 8357524
TI  - A special issue dedicated to Gordon James Mogenson (1931-1991).

PMID- 8357525
TI  - Bibliography of Dr. Gordon J. Mogenson.

PMID- 8357526
TI  - Differential effects of excitotoxic lesions of the basolateral amygdala, ventral
      subiculum and medial prefrontal cortex on responding with conditioned
      reinforcement and locomotor activity potentiated by intra-accumbens infusions of
      D-amphetamine.
AB  - The experiments reported here have investigated the impact on reward-related
      processes of lesioning the basolateral amygdala, ventral subiculum and prelimbic
      cortex which represent the major limbic sources of afferents to the ventral
      striatum. The results showed that, while lesions of the prelimbic cortex were
      without effect on the approach to a CS predictive of sucrose reinforcement and
      the acquisition of a new response with conditioned reinforcement, lesions of the
      other two structures significantly impaired both responses. However, there were
      important differences between the effects of basolateral amygdala and ventral
      subiculum lesions. Thus, lesions of the ventral subiculum completely abolished
      the locomotor response to intra-accumbens infusions of D-amphetamine, in addition
      to blocking the potentiative effect of the same treatment on responding with
      conditioned reinforcement. Lesions of the basolateral amygdala, by contrast,
      reduced the control over behaviour by a conditioned reinforcer, but not the
      potentiation of that control by intra-accumbens D-amphetamine except at the
      highest dose. Moreover, the locomotor response to D-amphetamine-induced increases
      in dopamine in the nucleus accumbens was unaffected by amygdala lesions over the
      dose range blocked by ventral subiculum lesions. The results suggest a rather
      selective effect of amygdala-ventral striatal interactions on processes
      subserving conditioned reinforcement and a more fundamental influence of ventral
      subiculum-ventral striatal interactions in mediating the psychomotor stimulant
      effects of D-amphetamine.

PMID- 8357527
TI  - Relationship between schedule-induced polydipsia and amphetamine intravenous self
      administration. Individual differences and role of experience.
AB  - It has been suggested that drug abuse belongs to a larger class of addictive
      behaviors, including smoking, eating or gambling, which are mediated by common
      processes. Since laboratory animals can be induced to develop drug self
      administration as well as indulge in compulsive eating or drinking, the present
      experiments were designed to find out if the same animals were susceptible to
      both behaviors. Only certain rats develop amphetamine intravenous self
      administration (SA), and this susceptibility can be predicted from their enhanced
      locomotor response in a novel environment. Furthermore, excessive, non-regulatory
      drinking, referred to as schedule-induced polydipsia (SIP), in response to the
      periodic delivery of small amounts of food is only observed in certain rats.
      Since the propensity to SA has been shown to be influenced by experimental
      factors and testing for SIP was found to modify behavioral and biological
      parameters related to the propensity for drug-seeking, we also investigated
      whether experience of SIP influenced the subsequent development of SA. In Expt.
      1, the rats that developed SA also acquired SIP, and had a higher locomotor
      response to novelty. The results of Expt. 2 showed that testing for SIP
      influenced the predisposition to develop amphetamine SA. When animals were tested
      for SIP first, the polydipsic rats subsequently failed to acquire SA, and had a
      reduced locomotor response to novelty. These changes seemed to be specific to the
      experience of SIP, as individual differences in the locomotor response to novelty
      were unchanged when animals were housed in standard laboratory conditions over a
      period of one month between the two tests.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357528
TI  - Effects of repeated amphetamine injections on lateral hypothalamic brain
      stimulation reward and subsequent locomotion.
AB  - Intracranial self-stimulation was assessed by the curve-shift method before and
      after D-amphetamine (1 mg/kg, i.p.) or vehicle injections given 8 times at 48-h
      intervals. Locomotor was assessed, in a separate test box, for the hour following
      the 35-min self-stimulation sessions. Amphetamine facilitated self-stimulation,
      shifting to the left the function relating response rate to stimulation
      frequency. The drug was most effective the first time it was given; the effects
      were weaker but unchanging across the remaining 7 days of repeated testing. When
      control animals that had been given vehicle for the eight initial days of testing
      were subsequently treated with amphetamine, it facilitated the behavior to the
      same extent as was seen the first time it was given in the experimental group.
      Amphetamine significantly increased locomotion in the period following the self
      stimulation tests, and the degree of increase grew slightly but steadily with
      repeated testing; there was more rapid sensitization to this response in animals
      that were not subjected to self-stimulation testing prior to activity testing.
      These data do not fit well with earlier reports of sensitization to the reward
      enhancing effects of amphetamine and reflect a potential dissociation between the
      locomotor-stimulating and reward-facilitating effects of amphetamine.

PMID- 8357529
TI  - Cholecystokinin-dopamine interactions within the nucleus accumbens in the control
      over behaviour by conditioned reinforcement.
AB  - Cholecystokinin (CCK) is colocalised with dopamine in the postero-medial nucleus
      accumbens (NAS). We have utilised an acquisition of a new response procedure to
      investigate the interaction between CCK and dopamine in the control over
      behaviour by conditioned reinforcers. A conditioned reinforcer (CR) may be
      defined as an initially neutral stimulus which gains control over behaviour
      through selective association with a primary reinforcer. Here, rats learned to
      associate a light/noise compound stimulus with the imminent availability of 10%
      sucrose reinforcement. Later, in the absence of sucrose, responding on one of two
      novel levers (the CR lever) was acquired and maintained by contingent
      presentation of the CR alone, while responding on the second lever had no
      programmed consequences. In Expt. 1, infusion of 10 micrograms D-amphetamine
      within the postero-medial NAS enhanced responding selectively on the CR lever.
      Infusion of sulphated CCK octapeptide (CCK: 1 or 10 ng) alone within the same
      area had no effect on response rate. However, infusion of CCK immediately prior
      to D-amphetamine caused a dose-dependent potentiation of the impact of D
      amphetamine upon rates of response on the CR lever. In Expt. 2, infusion of D
      amphetamine (10 micrograms) within the postero-medial NAS again enhanced
      responding selectively upon the CR lever. Intra-accumbens infusion of CCK (10
      ng), or s.c. administration of the CCKA receptor antagonist devazepide had no
      effect upon response rates. However, CCK again potentiated the D-amphetamine
      induced increase in rates of response, and this potentiation was blocked by
      pretreatment with devazepide. These results are discussed in terms of the co
      modulation by CCK and dopamine of the processing of reward-related stimuli within
      the NAS.

PMID- 8357530
TI  - Acquisition of a spatial conditioned place preference is impaired by amygdala
      lesions and improved by fornix lesions.
AB  - This experiment examined the role of the lateral nucleus of the amygdala, the
      hippocampus and the dorsal striatum in the acquisition of a conditioned place
      preference (CPP). The CPP was established on a radial maze which was rotated
      before each daily trial so that only distal cues could be used to distinguish
      among locations on it. Each rat was assigned a paired location in which the arm
      contained food, and an unpaired location in which the arm was empty. A training
      trial consisted of 30-min confinements in the paired and unpaired locations on
      successive days. Groups of animals received between 1 and 4 training trials,
      after which they were tested for their preference between their two assigned
      locations with no food in either one. Normal animals acquired a CPP after 4
      training trials, an instance of stimulus--reward learning. Electrolytic and
      neurotoxic lesions of the lateral nucleus of the amygdala prevented acquisition
      of the CPP in 4 training trials, suggesting that some function of this structure
      (or of a neural system that includes it) is required for acquisition and/or
      expression of stimulus--reward associations. Striatal lesions had no effect on
      the CPP. Fornix lesions facilitated acquisition of the CPP after 1-3 training
      trials, but no CPP was observed in animals with combined fornix and amygdala
      lesions, suggesting that exposure to the maze environment led to the processing
      of information in a hippocampal system that interfered with acquisition or
      expression of the amygdala-based CPP. Fornix lesions also increased the number of
      entries into maze arms on the test day, and concurrent amygdala lesions
      attenuated this increase. This finding suggests that the increase in arm entries
      may have been generated by the amygdala and suppressed by the hippocampus. Arm
      entries were interpreted as an instance of a particular type of exploratory
      behavior. Therefore, the present results suggest that a neural system including
      the lateral nucleus of the amygdala mediates both stimulus--reward learning and
      at least one form of exploration, possibly through its connections with the motor
      output system in ventral striatum. A hippocampal system appears to suppress or
      interfere with both of these behaviors in normal animals.

PMID- 8357531
TI  - Two types of motivation revealed by ibotenic acid nucleus accumbens lesions:
      dissociation of food carrying and hoarding and the role of primary and incentive
      motivation.
AB  - Rats with dopamine-depleting lesions of the nucleus accumbens (NAcc) no longer
      carry food and leave it in a refuge (carry-to-leave or hoard). The present study
      replicates this finding and extends it to rats with ibotenic acid lesions. The
      same rats, however, were found to carry food to a refuge to eat it (carry-to
      eat). Thus, within a test session, control rats would first carry food to eat it,
      and when sated, carry the remaining food to leave it in the refuge. NAcc food
      deprived rats carried food to eat it but when sated engaged mainly in exploratory
      behavior. When carrying-to-eat, NAcc rats modulated responses normally to food
      size and eating time, their movement speed and motor patterns were normal, and
      their eating times were normal. Nevertheless, they were slower to return for food
      after eating, and they did not show normal slowing of eating times with
      successively presented food pellets. The failure of NAcc rats to carry-to-leave
      when sated was not related to general inactivity. In activity tests, they were as
      active in the light, more active in the dark, and did not differ from control
      rats under amphetamine (1.25 and 2.5 mg/kg). Their impairments were also not
      related to damage to other forebrain related structures, as they displayed normal
      neocortical and hippocampal atropine-sensitive and atropine-resistant
      electroencephalograms (EEG). The finding that NAcc rats carry-to-eat when hungry
      but do not carry-to-leave when sated suggests two separate conclusions. First,
      food carrying can be dissociated into two separate actions with respect to neural
      control, carrying-to-eat and carrying-to-leave. Second, the selective involvement
      of the NAcc in only carrying-to-leave suggests that it is associated with
      recruiting actions in response to the secondary incentive features of food but is
      not required for behaviors associated with food consumption. Other structures are
      presumably activated by the primary drive-reducing features of food. The results
      are discussed in relation to two-factor theories of motivation.

PMID- 8357532
TI  - Microbial metabolism of quinoline and related compounds. XVIII. Purification and
      some properties of the molybdenum- and iron-containing quinaldic acid 4
      oxidoreductase from Serratia marcescens 2CC-1.
AB  - Serratia marcecens 2CC-1 utilizes quinaldic acid (quinoline 2-carboxylic acid) as
      sole source of carbon, nitrogen and energy. Growth of strain 2CC-1 on quinaldic
      acid as well as on nicotinic acid and hypoxanthine was inhibited completely by
      the molybdate antagonist tungstate, whereas growth on kynurenic acid and 6
      hydroxynicotinic acid was not affected by tungstate. The synthesis of the
      molybdenum-containing hydroxylases quinaldic acid 4-oxidoreductase and nicotinic
      acid 6-oxidoreductase was found to be inducible. In addition, Serratia marcescens
      2CC-1 produced a constitutively expressed xanthine oxidoreductase. Quinaldic acid
      4-oxidoreductase was purified 1075-fold with a recovery of 5%. For catalytic
      activity, artificial electron acceptors were necessary. The 95-100-kDa enzyme was
      a heterodimer with subunit molecular masses of 75-80 kDa and 18-19 kDa. Quinaldic
      acid 4-oxidoreductase contained 2.3-3.7 g atom of iron and 0.5-0.6 g atom of
      molybdenum per mol of enzyme. The absorption spectrum exhibited maxima at 280 nm,
      334 nm, 480 nm and a shoulder at 550 nm, with A280/A334 = 4.8, A280/A450 = 10.0,
      A280/A480 = 9.4, and A450/A550 = 1.6, suggesting the absence of a flavin
      cofactor. Acridine, quinacrine, ethylenediaminetetraacetate, 2,2'-dipyridyl, 1,10
      phenanthroline and iodoacetate did not affect enzyme activity. p
      Hydroxymercuribenzoate, m-arsenite, cyanide and methanol were effective
      inhibitors of quinaldic acid 4-oxidoreductase. Cyanide-inhibited enzyme was
      reactivated by treatment with S2-, indicating the presence of a pterin molybdenum
      cofactor with a monooxo-monosulfidotype molybdenum center. Quinaldic acid 4
      oxidoreductase showed a very high substrate specificity, quinaldic acid being the
      only substrate found to be transformed significantly.

PMID- 8357533
TI  - Isolation and characterization of a new ribosomal protein from the thermophilic
      eubacteria, Thermus thermophilus, T. aquaticus and T. flavus.
AB  - A ribosomal protein, showing no homology with other known prokaryotic ribosomal
      proteins, was isolated and characterized from the thermophilic eubacteria,
      Thermus thermophilus, T. aquaticus and T. flavus. This small (26 amino acids) and
      strongly basic (1 acidic and 13 basic residues) protein displayed the same
      primary structure from all three sources. Interestingly, it shows about 65%
      homology with a ribosomal protein from spinach chloroplasts (J. Schmidt, personal
      communication).

PMID- 8357534
TI  - The isoforms of human neutrophil elastase and cathepsin G differ in their
      carbohydrate side chain structures.
AB  - The two proteinases found in human neutrophil granules, elastase and cathepsin G,
      each are normally isolated as a mixture of isoforms differing only in
      carbohydrate content. Elastase has two N-glycosylation sites occupied (Asn-45 and
      Asn-144), whereas cathepsin G has only one (Asn-64). Analysis of a minor form of
      elastase (E-1) and cathepsin G (C-1) indicates that the carbohydrate structures
      at each glycosylation site are complex-type bi-antennary chains usually
      associated with secretory glycoproteins. In contrast, the isoforms E-3 and C-3,
      the major forms of elastase and cathepsin G respectively, contain exclusively
      truncated, oligomannose-type chains at the same positions in the sequence of each
      protein. These data suggest the possibility that certain elastase and cathepsin G
      isoforms (E-1 and C-1) might be destined for secretory, others (E-3 and C-3) for
      lysosomal functions.

PMID- 8357535
TI  - Limited proteolysis of chloroplast glyceraldehyde-3-phosphate dehydrogenase
      (NADP) from Spinacia oleracea.
AB  - The structural and functional properties of chloroplast glyceraldehyde-3-P
      dehydrogenase I (D-Glyceraldehyde-3-phosphate: NADP oxidoreductase
      (phosphorylating) EC 1.2.1.13) from Spinacia oleracea were investigated by
      limited proteolysis. The enzyme is insensitive to trypsin and chymotrypsin, while
      Staphylococcus aureus V8 protease cleaves the C-terminal region of its subunits.
      Subunit A (36 kDa) is only partially cleaved at Glu 317. No intact subunit B (39
      kDa) is found at the end of the proteolytic experiment: two forms are originated
      from this subunit which is cleaved at Glu 342 and Glu 320. Proteolytic cleavage
      at these sites does not significantly alter enzymatic activity, but leads to
      destabilization of the protein. Unlike the intact parent enzyme (600 kDa) the
      cleaved enzyme behaves as a 150-kDa species in size exclusion chromatography.

PMID- 8357536
TI  - Specific interactions of the allosteric effector 2,3-bisphosphoglycerate with
      human hemoglobin--a difference FTIR study.
AB  - The specific interactions of 2,3-bisphosphoglycerate (BPG) with human deoxy
      hemoglobin (deoxy-HbA) are studied by difference FTIR spectroscopy. Due to these
      interaction effects the O2 affinity of the hemoglobins is regulated. In deoxy-HbA
      a NH+ ... -OOC hydrogen bond is formed between beta 82 Lys and the carboxylate
      group of BPG. The phosphate groups of BPG are completely deprotonated causing a
      strong electrostatic stress within the Hb molecule. The aminotermini (beta 1 Val)
      interact with the phosphate groups but no hydrogen bonds are formed. The
      interaction is limited to an electrostatic interaction between the NH3+ and the
      negatively charged phosphate group, i.e. only ionic bonds are built up. The
      histidines beta 2 and beta 143 of the two beta-chains form hydrogen bonds with
      the phosphates. To each phosphate two bonds are formed. These bonds polarize each
      other and hence only the polar structures NH+ ... -OP of the hydrogen bonds are
      realized. This follows since no protons are present at the BPG molecules. Thus,
      caused by the hydrogen bonds and the electrostatic interaction the conformation
      of HbA is changed by BPG in the way that the T-structure is favored and hence the
      affinity for oxygen is decreased.

PMID- 8357537
TI  - 8th conversation in biomolecular stereodynamics. June 22-26, 1993. Abstracts.

PMID- 8357538
TI  - Flexibility of DNA within transcriptionally active nucleosomes: analysis by
      circular dichroism measurements.
AB  - The conformational flexibility of DNA in transcriptionally active chromatin
      fractions has been estimated by circular dichroism spectroscopy analysis and was
      found to be restricted in the same fashion as in bulk chromatin. The observation
      is discussed in the context of different models of active chromatin organization.

PMID- 8357539
TI  - Dynamics of unfolded nucleosomal fiber.
AB  - The "rigidity" of chromatin fiber solenoidal structure in different states of
      condensation was evaluated with the help of gel-electrophoresis. A new property
      of the unfolded nucleosomal fiber-the capacity to condense with temperature-was
      demonstrated. These results together with our previously obtained data (W.A.
      Krajewski et al., Mol. Gen. Genet. 230, pp. 442-448, 1991; W.A. Krajewski et al.,
      Ibid. 231, pp. 17-22, 1991) testify that changes in DNA linking number of
      transcriptionally active minichromosomes arise in vivo from alteration of
      nucleosomal solenoid parameters (i.e. from supernucleosomal level of chromatin
      organization), rather than from core histone modifications only or from increased
      flexibility of DNA within nucleosomes.

PMID- 8357540
TI  - Stereochemical effects of methylphosphonate in B- and Z-DNA helices: variation in
      hydrophobicity and effective widths of grooves.
AB  - Stereochemical effects of methylphosphonate (MP) in B-DNA and Z-DNA duplexes are
      studied through molecular mechanics approach. Duplexes of different lengths,
      tetramers, hexamers, dodecamers are examined to assess the interstrand and
      intrastrand electrostatic effects due to MPs vis-a-vis phosphates. A variety of
      models which include duplexes with alternating S-MP and R-MP, alternating
      phosphate and MP and, duplexes possessing MPs in only one of the strands, are
      examined by considering both the S- and R-stereoisomers. Majority of the
      calculations are performed with CG sequences to delineate factors responsible for
      the stability of B- and Z-DNA, as well as B-->Z-DNA transition under nonionic
      conditions. The results show that both B- and Z-DNA duplexes are energetically
      favoured in the presence of MP due to overwhelming reduction in intrastrand as
      well as interstrand electrostatic repulsive interactions. The effect is distinct
      in oligomers longer than tetramers. Comparison of energetics of MP B- and Z-DNA
      duplexes suggests that an oligodeoxynucleotide such as d(CG)6 with all phosphates
      replaced by MPs may favour equally both B- and Z-DNA conformations. The analysis
      further provides an estimate of electrostatic interactions, operating at the
      grooves under a variety of conditions. Several specific and localised effects due
      to S-MP and R-MP are seen at CG and GC steps in various B-DNA and Z-DNA models. S
      MP in B-DNA reduces the effective major groove width by nearly 3 A hence denying
      access to the functional groups of endonucleases thereby enhancing the resistance
      of MP-DNA to enzymatic digestion. Further, methyl groups of MP render the surface
      of the DNA helix to be significantly hydrophobic which may explain higher
      permeability of MP-DNA in membranes as well as its less soluble nature in aqueous
      media.

PMID- 8357541
TI  - Comparative study of thermostability and structure of close homologues--barnase
      and binase.
AB  - Parameters of heat denaturation and intrinsic fluorescence of barnase and its
      close homologue, binase in the pH region 2-6 have been determined. The barnase
      heat denaturation (pH 2.8-5.5) proceeds according to the "all-or-none" principle.
      Barnase denaturation temperature is lower than that of binase and this difference
      increases from 2.5 degrees C at pH 5 to 7 degrees C at pH 3. Enthalpy values of
      barnase and binase denaturation coincide only at pH 4.5-5.5, but as far as pH
      decreases the barnase denaturation enthalpy decreases significantly and in this
      respect it differs from binase. The fluorescence and CD techniques do not reveal
      any distinctions in the local environment of aromatic residues in the two
      proteins, and the obtained difference in the parameters of intrinsic fluorescence
      is due to fluorescence quenching of the barnase Trp94 by the His 18 residue,
      absent in binase. Secondary structures of both native and denaturated proteins
      also do not differ. Some differences in the barnase and binase electrostatic
      characteristics, revealed in the character of the dipole moments distribution,
      have been found.

PMID- 8357542
TI  - An exact description of five-membered ring configurations. I. Parameterization
      via an amplitude S, an angle gamma, the pseudorotation amplitude q and phase
      angle P, and the bond lengths.
AB  - A method is developed which exactly parameterizes the configurations of five
      membered rings. In addition to the five bond lengths, (bj), four other parameters
      are needed to describe completely all configurations of a three-dimensional
      figure with five sides. Two of these parameters are taken as the phase angle, P,
      and amplitude, q (A), introduced by Cremer and Pople (J. Am. Chem. Soc. 97, 1354
      (1975)) which give exactly the displacements of the atoms in any five-membered
      ring from a special plane (the CP plane). For the two other parameters, a second
      amplitude, S (A), and an orientation angle, gamma (the upper case Greek letter
      "gamma"), are introduced. These two new parameters describe the "distortion" of
      the projection of the ring in the CP plane. gamma is the angle in the CP plane at
      which the projected ring is maximally "spread" or "stretched," where the stretch
      is a least squares measure of position along a line through the ring center. S
      measures the difference between maximum stretch (in direction gamma) and minimum
      stretch (in direction gamma +/- 90 degrees) such that S = 0 denotes maximum
      symmetry. Transformations from Cartesian coordinates to the new internal
      coordinates, and from the new internal coordinates to the Cartesian set, are
      exact inverse transformations. Fortran source codes MAKERING and BREAKRING for
      these transformations are available. The set of four parameters aids in direct
      comparisons of ring structures and in detailed numerical analyses of data. They
      also aid the systematic generation of all possible rings, useful for theoretical
      studies of ring conformation. To demonstrate the descriptive method, we have
      generated distributions of q, P, S, and gamma for furanose rings in the
      structures of 665 nucleosides determined by X-ray crystallography.

PMID- 8357543
TI  - Laser photofootprinting of d(C).d(G).d(G) intramolecular triplex.
AB  - Supercoiling-induced structural transition of the d(C24GC21).d(G21CG24) sequence
      in plasmid DNA in the presence of Mg2+ at neutral pH results in alterations of
      efficiencies of not only single-quantum (pyrimidine[6-4]pyrimidone adducts) but
      also two-quantum (alkali-sensitive lesions of dG residues) photomodifications of
      nucleoside residues within this sequence. The generation of both types of
      photoreactions was achieved by the application of high-intensity laser UV
      radiation (intensity approximately 10(11) W/m2, pulse duration approximately 10(
      8) s, lambda = 266 nm) for irradiation of a plasmid DNA. The modification extent
      sufficient for analysis of photoreaction efficiency distributions along both
      strands of the insert (photofootprinting) was obtained by the action of a single
      nanosecond pulse of laser UV radiation. The pattern of a laser photofootprinting
      is consistent with the d(C).d(G).d(G) triplex formation in the presence of Mg2+
      within the insert and shows some details of this triplex structure.

PMID- 8357544
TI  - Modeling study on the cleavage step of the self-splicing reaction in group I
      introns.
AB  - A three-dimensional model of the Tetrahymena thermophila group I intron is used
      to further explore the catalytic mechanism of the transphosphorylation reaction
      of the cleavage step. Based on the coordinates of the catalytic core model
      proposed by Michel and Westhof (Michel, F., Westhof, E. J. Mol. Biol. 216, 585
      610 (1990)), we first converted their ligation step model into a model of the
      cleavage step by the substitution of several bases and the removal of helix P9.
      Next, an attempt to place a trigonal bipyramidal transition state model in the
      active site revealed that this modified model for the cleavage step could not
      accommodate the transition state due to insufficient space. A lowering of P1
      helix relative to surrounding helices provided the additional space required.
      Simultaneously, it provided a better starting geometry to model the molecular
      contacts proposed by Pyle et al. (Pyle, A. M., Murphy, F. L., Cech, T. R. Nature
      358, 123-128. (1992)), based on mutational studies involving the J8/7 segment.
      Two hydrated Mg2+ complexes were placed in the active site of the ribozyme model,
      using the crystal structure of the functionally similar Klenow fragment (Beese,
      L.S., Steitz, T.A. EMBO J. 10, 25-33 (1991)) as a guide. The presence of two
      metal ions in the active site of the intron differs from previous models, which
      incorporate one metal ion in the catalytic site to fulfill the postulated roles
      of Mg2+ in catalysis. The reaction profile is simulated based on a trigonal
      bipyramidal transition state, and the role of the hydrated Mg2+ complexes in
      catalysis is further explored using molecular orbital calculations.

PMID- 8357545
TI  - Counterion-type characteristic effects on intrinsic bending components of calf
      thymus DNA; hydrodynamic investigations.
AB  - This paper stresses structural differences in A.T clusters of the ammonium salt
      of calf thymus (ct) DNA (ctNH4DNA) and the respective sodium salt, ctNaDNA.
      Sequence mediated intrinsic helix bends of ctNaDNA, distributed along the
      molecule partially randomly and partially phased with the helix screw
      (accompanying paper), are enhanced in ctNH4DNA. Additionally, the number of the
      most strongly bent segments (of A-tract character) is raised in ctNH4DNA by a
      counterion mediated shift of the equilibrium between at least two local DNA
      conformations. Nevertheless, the apparent DNA elongation, induced by the
      abolition of a single apparent solenoid-related DNA tertiary structure component
      which generates a special intrinsic DNA bend, is the same for NH4DNA and NaDNA.
      These conclusions follow from two independent sets of experimental results: (1.)
      Titration viscometric measurements with ctNH4DNA as a function of the cation
      concentration in comparison to ctNaDNA (KER et al., JBSD 9,537 (1991)) and
      respective DNA conformational analyses. (2.) Quantitative viscometric analysis of
      DNA conformational changes on netropsin (Nt) interaction of ctNH4DNA at different
      temperatures and comparison with the respective data for ctNaDNA (KER et al., NAR
      9,2335 (1981).

PMID- 8357546
TI  - The reliability and validity of two HIV-specific health-related Quality-of-Life
      measures: a preliminary analysis.
AB  - OBJECTIVE: To evaluate the reliability and validity of two HIV-specific Quality
      of-Life (QoL) questionnaires in a UK sample. METHOD: Subjects were 99 HIV
      seropositive gay men (23 were asymptomatic, 41 were asymptomatic, 35 had AIDS).
      QoL was measured using two HIV-specific QoL questionnaires. MEASURES: An
      adaptation of the Medical Outcomes Study questionnaire and a self-completion
      version of the Health-Related Quality-of-Life Questions. Affect was measured
      using the Hospital Anxiety and Depression (HAD) Scale. Disease measures included
      Centers for Disease Control and Prevention (CDC) stage, and CD4 and CD8 cell
      count. RESULTS: Both QoL instruments showed good internal reliability on all
      scales used. Many of the scales, particularly those related to physical health
      and functional performance, showed significant correlations with CD4 cell count
      and other measures of disease progression. Measures of physical health showed a
      deterioration in QoL as disease progressed from asymptomatic disease to AIDS. In
      contrast, most subscales purporting to measure psychological aspects of QoL did
      not correlate significantly with measures of disease progression, nor was there
      any difference between CDC stages. Subjects' global ratings of QoL were most
      strongly correlated with the HAD depression scale, although there were also
      significant correlations with most other QoL scales. CONCLUSION: This study
      provides further evidence for the reliability and validity of two HIV-specific
      QoL questionnaires in a wider range of disease stages than hitherto reported and
      raises issues relevant to the practical use of QoL scales in HIV disease.

PMID- 8357547
TI  - Development of AIDS in people with transfusion-acquired HIV infection.
AB  - OBJECTIVE: To determine the rate of development of AIDS, and the demographic and
      clinical cofactors for development of AIDS in a group of 117 people with
      transfusion-acquired HIV infection, who were infected between 1980 and 1985 in
      New South Wales, Australia. RESULTS: By December 1991, 67 (57%, 95% CI 48-66%) of
      the study subjects had developed AIDS. The estimated median time to development
      of AIDS was 7.2 years from the date of infection. There was no significant
      difference in median age at infection or sex between individuals who did and did
      not develop AIDS. The median time to development of AIDS was shorter in older
      individuals (median time to AIDS for age groups 13-39, 40-59 and > 59 was 7.8,
      7.1 and 5.4 years, respectively; P = 0.20). A significantly greater proportion of
      individuals who had never received treatment with zidovudine developed AIDS
      compared with individuals who had (P = 0.04). But in a statistical analysis which
      took account of the changing availability of zidovudine over time, there was no
      significant association between the development of AIDS and treatment with
      zidovudine (P = 0.44). CONCLUSION: Consistent with other studies, age appeared to
      increase the rate of progression to AIDS, although not significantly so in this
      study.

PMID- 8357548
TI  - Pneumocystis carinii choroidopathy in AIDS patients.

PMID- 8357549
TI  - Liposomal amphotericin B for leishmaniasis treatment of AIDS patients
      unresponsive to antimonium compounds.

PMID- 8357550
TI  - Pyomyositis in patients with HIV infection.

PMID- 8357551
TI  - High triglyceride levels as a predictor of mortality in AIDS patients.

PMID- 8357552
TI  - Vertical transmission of hepatitis C virus and HIV.

PMID- 8357553
TI  - Comparison of eight commercial test kits for detecting anti-HIV antibodies in
      saliva specimens.

PMID- 8357554
TI  - HIV DNA and antibodies in syringes from injecting drug users: a comparison of
      detection techniques.
AB  - OBJECTIVE: Direct HIV testing of individual injecting drug users is not always
      feasible. As an alternative, we have evaluated the sensitivity and specificity of
      several techniques for detecting HIV-1-specific products in used syringes.
      DESIGN: Polymerase chain reaction (PCR) and antibody-capture assays were compared
      using syringes prepared with blood from HIV-1-positive and -negative individuals.
      METHODS: PCR sensitivity was maximized, enabling detection of single copies of
      HIV-1-specific proviral DNA. The limits of detection from used syringes were
      determined for PCR by diluting extracts and correlated to CD4+ cell counts.
      Similarly, limits of detection were determined for enzyme immunoassays (EIA) and
      Western blot. RESULTS: All techniques were highly specific, although with PCR
      false-positives were detected occasionally. EIA proved more sensitive than
      Western blot in detecting needles containing HIV-1-infected individuals' blood.
      Even after prolonged storage of syringes at room temperature, EIA was equal to or
      better than PCR as an HIV-1 detection technique. The most sensitive method for
      detecting HIV-1 was the viral-based EIA when the recommended predilution step was
      omitted. CONCLUSIONS: EIA proved preferable to PCR because of their higher
      sensitivity, absence of false-positives and easier sample preparation and
      analysis.

PMID- 8357555
TI  - A dose escalation study to determine the toxicity and maximally tolerated dose of
      foscarnet.
AB  - OBJECTIVE: To determine the maximum tolerated dose of intravenous foscarnet
      (trisodium phosphonoformate hexahydrate); and to examine antiviral activity at
      plasma levels shown to inhibit HIV-1. DESIGN: Dose escalation study in three male
      subjects with AIDS who received foscarnet by continuous intravenous infusion at a
      dose of 200 mg/kg per day, after a 20 mg/kg loading dose. The dose was increased
      until a plasma level > 150 micrograms/ml was attained. RESULTS: Foscarnet was
      discontinued due to progressive renal insufficiency in all three patients (days
      11, 19, and 21). Renal function normalized in all three, and no adverse sequelae
      due to foscarnet were observed at 1 year of follow-up. A seizure was observed in
      one patient on day 19. Maximum daily doses of foscarnet achieved were 395 mg/kg,
      389 mg/kg, and 523 mg/kg. No changes in serum Ca2+, Mg2+, or PO4- were observed.
      CONCLUSIONS: Renal effects and toxicity of foscarnet in evolving renal
      insufficiency is self-limiting and reversible when the drug is discontinued.
      Incremental increases in dose can result in rapid rises in the plasma level with
      renal failure and may be compounded by concomitant medications and underlying
      illnesses.

PMID- 8357556
TI  - Longitudinal study on the Quality of Life of symptomatic HIV-infected patients in
      a trial of zidovudine versus zidovudine and interferon-alpha.
AB  - OBJECTIVES: To compare the effect of treatment with zidovudine (ZDV) or a
      combination of ZDV and interferon-alpha (IFN-alpha) on patient Quality-of-Life
      (QoL); and to document changes over time in QoL. DESIGN: This study is part of a
      longitudinal, randomized, controlled clinical trial comparing the efficacy and
      tolerance of ZDV monotherapy and ZDV plus IFN-alpha. Patients were followed-up
      for 1 year. SETTING: Seven academic or general medical hospitals. PARTICIPANTS:
      Thirty-six symptomatic HIV-infected patients (Centers for Disease Control and
      Prevention stage IV) with a CD4+ count > or = 150 x 10(6)/l and Karnofsky
      Performance Status score > or = 60, who had not received ZDV or IFN-alpha before.
      METHODS: QoL was assessed using two self-report questionnaires (the European
      Organization for Research and Treatment of Cancer Core Quality-of-Life
      Questionnaire and an AIDS-specific questionnaire), administered before and every
      3 months after the start of the treatment. RESULTS: There were no significant
      differences in QoL between the two treatment groups over a 1-year period.
      Emotional, cognitive and social functioning improved in the entire group, and
      patients reported fewer symptoms (for example, shortness of breath, nausea and
      vomiting, influenza-like symptoms, diarrhoea, lack of appetite, taste
      disturbances, dizziness, weight loss, trouble in vision) and a better overall QoL
      until month 9. Thereafter, emotional, cognitive and social functioning and
      overall QoL deteriorated and patients reported more symptoms. Major complaints at
      baseline and follow-up were associated with fatigue and emotional functioning:
      patients reported a strong need to rest, and felt very tired, worried, tense and
      irritable. CONCLUSIONS: These results show that both treatments may have a
      temporary beneficial effect on patient QoL. QoL research may contribute to
      evaluation of clinical trials and provide patients with information about the
      effects of treatment on their QoL, thus enabling them to make informed decisions.

PMID- 8357558
TI  - A prospective study of vertical transmission of HIV-2 in Bissau, Guinea-Bissau.
AB  - OBJECTIVES: To determine the vertical transmission rate of HIV-2 and clinical
      findings associated with vertically transmitted HIV-2 infection. DESIGN: A
      prospective study of HIV-2 transmission in children of HIV-2-seropositive
      mothers, and a comparison of clinical findings between children of seropositive
      and seronegative mothers. SETTING: Recruitment of women delivering at the
      national hospital in Bissau, Guinea-Bissau. Follow-up by home visits. SUBJECTS
      AND METHODS: Eighty-six newborns of 82 HIV-2-seropositive mothers and a control
      group of 102 newborns of HIV-seronegative mothers were followed-up clinically and
      by HIV serology until the children reached the age of 20 months. RESULTS: Of the
      86 children of seropositive mothers, 51 had a complete follow-up, 22 died and 13
      were lost due to change of residence. Of the 102 children of seronegative
      mothers, 63 had a complete follow-up, 13 died and 26 were lost due to change of
      residence. None of 51 children of seropositive mothers had serological evidence
      of HIV-2 infection at the end of the follow-up period. There was no significant
      difference in the frequency of clinical symptoms between the children in the
      study group and the children in the control group. The mortality during the first
      year of life was not significantly different between the children of seropositive
      and seronegative mothers (13 out of 80 and 11 out of 94, respectively, P > 0.05,
      excluding children lost to follow-up). Only three of the dead children of
      seropositive mothers and one of the dead children of seronegative mothers had any
      symptoms that might be related to HIV-2 infection (diarrhoea > 1 month).
      CONCLUSION: Vertical transmission of HIV-2 appears to be rare.

PMID- 8357557
TI  - The impact of HIV on infectiousness of pulmonary tuberculosis: a community study
      in Zambia.
AB  - OBJECTIVE: To examine the impact of HIV on infectiousness of pulmonary
      tuberculosis (TB). DESIGN: A cross-sectional tuberculin survey carried out among
      household contacts of HIV-1-positive and negative patients with bacteriologically
      confirmed pulmonary TB. Contacts were also examined for active TB. SETTING: Index
      cases were recruited from patients attending the University Teaching Hospital in
      Lusaka, Zambia and household contacts were examined during visits to their homes
      within Lusaka. PATIENTS, PARTICIPANTS: A total of 207 contacts of 43 HIV-positive
      patients, and 141 contacts of 28 HIV-negative patients with pulmonary TB were
      examined. MAIN OUTCOME MEASURES: Proportion of contacts of HIV-positive and
      negative index cases with a positive tuberculin response (diameter of induration
      > or = 5 mm to a dose of 2 tuberculin units). RESULTS: Fifty-two per cent of
      contacts of HIV-positive pulmonary TB patients had a positive tuberculin response
      compared with 71% of contacts of HIV-negative patients (odds ratio, 0.43; 95% CI,
      0.26-0.72; P < 0.001). This difference persisted after allowing for between
      household variations in the tuberculin response. Tuberculin response in the
      contact was related to age of contact, intimacy with the index case and crowding
      in the household. However, the effect of HIV status of the index case was not
      confounded by these variables. Tuberculin response in the contact was also
      related to the number of bacilli seen in the sputum smear of the index case which
      partially explained the effect of HIV status of the index case. Active TB was
      diagnosed in 4% of contacts of HIV-positive and 3% of contacts of HIV-negative
      cases, respectively (P = 0.8). CONCLUSIONS: HIV-positive patients with pulmonary
      TB may be less infectious than their HIV-negative counterparts and this may
      partly be explained by lower bacillary load in the sputum.

PMID- 8357559
TI  - Blood transfusion practices and blood-banking services in a Kenyan hospital.
AB  - OBJECTIVES: To identify ways to improve the operation of blood-screening programs
      and to decrease the inappropriate use of blood by evaluating blood-transfusion
      practices and blood-banking services in a Kenyan hospital. DESIGN: Prospective
      cohort. SETTING: The study was conducted in a rural district hospital in western
      Kenya between September 1990 and July 1991. METHODS: We collected data on all
      transfusion requests (blood donation, grouping, HIV screening) and blood
      recipients (age, sex, diagnosis, and for a 3-month period on the pediatric,
      maternity, and female wards, admission hemoglobin and outcome). RESULTS: During
      the 11-month study period, 799 patients received 927 transfusions: 67% were
      children < 15 years of age, 27% were adult women and 6% were adult men.
      Transfusions were often delayed due to reliance on patient-recruited donors.
      Patients who received blood donated on or after the date of request waited longer
      for transfusion (median, 3 days) than patients who received blood that had been
      banked and screened before the request (median, 1 day). Patient-recruited donors
      had a higher HIV-seropositivity rate than volunteer donors (13.4 and 4.6%,
      respectively; chi 2 test, P < 0.001). Overall, 47% of pediatric transfusions were
      classified as inappropriate: 23% did not meet the criteria of having hemoglobin <
      5.0 g/dl and clinical evidence of respiratory distress, and 27% were transfused 2
      or more days after requested. Among adults, 68% received one unit of blood or
      less. CONCLUSIONS: Improved laboratory services, reduction of unnecessary
      transfusions, and increased recruitment of volunteer donors are critical for
      improving the appropriate and timely use of blood and reducing transfusion
      associated HIV transmission.

PMID- 8357560
TI  - Townes-Brocks syndrome in an infant with translocation t (5;16).
AB  - We report the occurrence of Townes-Brocks syndrome (TBS) in an infant with a two
      break reciprocal translocation between chromosome 5 and chromosome 16. The
      occurrence of both abnormalities in the same subject could be due to chance.
      However, it is of interest to note that a familial case of TBS associated with an
      inv(16) with the same breakpoint at 16q12.1 has been reported. We suggest the
      possible disruption of the TBS gene at this breakpoint.

PMID- 8357561
TI  - The Noonan syndrome. The Nancy experience revisited.
AB  - 67 patients with Noonan syndrome seen over the last 29 years were selected
      preferentially on cardiac involvement. The cardiac anomalies consisted in the
      association of dysplastic pulmonary stenosis with asymmetric cardiomyopathy. In
      one patient, a translocation (3;22) was found. The relationship with cardio-facio
      cutaneous syndrome and with the group of phacomatoses is discussed. The familial
      occurrence (10 families) seems compatible with autosomal dominant inheritance. A
      gene location on chromosome 22 cannot be excluded.

PMID- 8357562
TI  - Twelve cases with hemihypertrophy: etiology and follow up.
AB  - Twelve patients with hemihypertrophy are described. All but one are sporadic
      cases. The parents were unrelated. Family and pregnancy histories are otherwise
      unremarkable in all cases. Diagnosis was always performed at birth or in the
      weeks following birth. There were 5 boys and 7 girls including one mother and her
      daughter. Hemihypertrophy was localized to the upper limb in one case and to the
      lower limb in one case. One patient had some features of Mc Cune Albright
      syndrome. Hemihypertrophy was associated with Silver-Russel syndrome in two
      patients. In all other cases hemihypertrophy was idiopathic. Mental and motor
      development were normal in all cases, as was puberty. During growth the body
      asymmetry was unchanged. Orthopedic problems complicated growth in some cases.
      The most obvious of these problems was scoliosis. Limb lengthening was necessary
      in 2 cases. One of our patients developed an abdominal tumor. One of our patients
      had two normal children. Hemihypertrophy is usually not inherited. However, the
      mother of one of our patients also had hemihypertrophy.

PMID- 8357563
TI  - Potter sequence due to renal aplasia and postaxial hexadactyly. A distinct
      entity?
AB  - Report on a prematurely born female with the Potter sequence, postaxial
      hexadactyly of both hands, and bilateral short metacarpals I. Autopsy findings
      included severely hypoplastic lungs, bilateral renal aplasia as well as aplasia
      of the vagina and uterus. Chromosomes were normal (46,XX). Similar--though not
      identical--observations have been published by Holzgreve et al. (5), by Bonnet et
      al. (2), and by Legius et al. (6).

PMID- 8357565
TI  - Nager acrofacial dysostosis and preaxial polydactyly: a further example with
      lethal outcome.
AB  - A sporadic malformed premature stillborn showing the typical craniofacial
      features of mandibulofacial dysostosis combined with unilateral extra thumb and
      visceral anomalies is described and classified as a preaxial acrofacial
      dysostosis of the Nager type (NAFD). Comparison with other rare similar cases
      reported in the literature is made and genetic heterogeneity discussed.

PMID- 8357564
TI  - Miller postaxial acrofacial dysostosis. The phenotypic changes with age.
AB  - We report data on the clinical and psychological follow-up of a boy with Miller
      postaxial acrofacial dysostosis syndrome between the ages of 1 and 7 years. After
      an initial psychomotor retardation intellectual and social function improved
      significantly after the use of hearing aids (50-70 db bilateral hearing loss).
      The facial appearance changed with age: the face became asymmetric and triangular
      with more pronounced ectropion and fine, thin lips.

PMID- 8357566
TI  - Mental retardation, ataxia, seizures, dysmorphia, and hydrocephaly in two sibs.
      Angelman syndrome or new syndrome.
AB  - We report two sibs with Angelman syndrome or an apparently new syndrome. In
      addition to severe mental retardation and seizures, clinical examination showed
      an ataxic and stiff legged gait, truncal hypotonia with hypertonia of the limbs,
      dysmorphic facial features (brachycephaly, large mouth, pointed chin and a
      prominent jaws) and scoliosis. Brain CT scan and MRI revealed ventricular
      enlargement and squared frontal horns. Pregnancy and delivery were uneventful.
      Karyotypes were normal. No deletion of chromosome 15q11-13 region was shown by
      molecular genetic techniques. The parents who are normal are second cousins. The
      condition is therefore probably inherited as an autosomal recessive one.

PMID- 8357567
TI  - The Larsen syndrome. The diagnostic contribution of the analysis of the
      metacarpophalangeal pattern profile.
AB  - In this report we illustrate the variable expression and the different modes of
      inheritance in Larsen syndrome. The important contribution of the
      metacarpophalangeal profile pattern analysis in the final diagnosis is
      emphasized.

PMID- 8357568
TI  - Characteristic facial dysmorphism, arachnodactyly and mental handicap in two
      unrelated girls: a distinct MCA/MR syndrome?
AB  - Two nonrelated, moderately mentally retarded girls are described with identical
      clinical signs and symptoms, i.e. brachycephaly, typical facies with thin lips
      and microstomia, ectomorphic habitus with extreme long, thin fingers and toes and
      hypoplastic external genitalia. The clinical findings in the present patients
      allow for the delineation of a new MCA/MR syndrome.

PMID- 8357569
TI  - Goldston syndrome reconsidered.
AB  - We describe two siblings with the combination of central nervous system
      malformations, renal dysplasia and hepatic ductal plate malformation. Based on
      the occurrence of a cerebellar Dandy-Walker malformation (variant), the diagnosis
      of Goldston syndrome was proposed in the first case. The second sibling however,
      showed a typical Meckel syndrome with occipital encephalocele. Both cases had a
      cranium bifidum with two defects in the squamous part of the occipital bone. This
      observation confirms that Goldston syndrome is not a distinct entity but merely a
      variant of Meckel syndrome, and that a cerebellar Dandy-Walker malformation can
      be a component of Meckel syndrome.

PMID- 8357570
TI  - Spire Corporation: a paradigm for success in the 90s.
AB  - There is much talk now of "defense conversion" and the need to turn a given
      country's "peace dividend" into improving its "infrastructure." Beyond the
      obvious political rhetoric, those terms bode well for the field of biotechnology.
      Every facet of technology must attend to its "delivery system," for the same
      obvious reason, roads and bridges must be maintained and improved. In the case of
      biosensors and their delivery into the human body, for example, it stands to
      reason that adequate focus should be paid to advancements in the field of the
      biomaterials from which they are made, or that house or carry them.

PMID- 8357571
TI  - Continuous non-diluted serum sample measurement with an ISFET glucose sensor.
AB  - An ion-sensitive field-effect transistor (ISFET) glucose sensor with a new
      membrane structure is fabricated and its characteristics are evaluated in
      continuous measurement of non-diluted serum glucose. This sensor chip is composed
      of two ISFETs and a gold electrode. An albumin-glutaraldehyde crosslinked
      membrane, patterned on one of the ISFET gates and the gold electrode, contacts an
      enzyme membrane deposited on the other gate in edge to edge. Making an electrical
      connection between the gold electrode and two ISFETs, this membrane enables
      stable sensor responses to be made. This sensor is mounted on a flow cell into
      which serum samples and air are alternately fed. The sensor output shows a good
      linear relationship, up to 300 mg dl-1 glucose, and correlates well with a
      conventional glucose analyzer. This sensor shows promise as a key device in the
      development of portable glucose monitors.

PMID- 8357572
TI  - An immunosensor for syphilis screening based on surface plasmon resonance.
AB  - In this paper the development of a surface plasmon resonance (SPR) immunosensor
      for syphilis screening is described. This immunosensor is based on the detection
      of antibodies in serum against the causative organism Treponema pallidum. In
      order to achieve selectivity a recombinant Treponema pallidum membrane protein A
      (TmpA) was used. This antigen can react with antibodies to T. pallidum, present
      in serum of syphilitic patients. Reproducible results have been obtained, using a
      'sandwich SPR' method: binding of a sandwich antibody to the treponemal antibody
      after serum incubation was measured in real time while the binding was taking
      place. The SPR results obtained from ten blind-coded sera corresponded well with
      classical syphilis tests (Treponema pallidum haemagglutination assay (TPHA),
      fluorescent treponemal antibody-absorbed test (FTA-ABS), venereal diseases
      research laboratory flocculation test (VDRL) and TmpA-based enzyme-linked
      immunosorbent assay (TmpA-ELISA)). Preliminary experiments showed that direct
      measurement of serum (in the 'one step SPR') is not yet possible, probably as a
      result of non-uniformity of serum samples. The application of latex beads is
      considered to solve this problem.

PMID- 8357573
TI  - Non-leaking amperometric biosensors based on high-molecular ferrocene
      derivatives.
AB  - Poly(ethylene glycol)-bound ferrocene derivatives, synthesized after activation
      of ferrocene carboxylic acid with 1,1'-bis carbonyl diimidazol, are able to
      transfer electrons from the active site of reduced glucose oxidase to electrode
      surfaces. This opens a route to non-leaking mediated enzyme electrodes for the
      determination of glucose.

PMID- 8357574
TI  - The 3D structure of glucose oxidase from Aspergillus niger. Implications for the
      use of GOD as a biosensor enzyme.
AB  - The tertiary structure of glucose oxidase (GOD) from Aspergillus niger was
      determined by x-ray crystallography (to be described elsewhere). The overall
      folding of the enzyme is described with regard to its application in biosensors,
      and conclusions are drawn from experiments on electrical communication between
      the enzyme and the electrodes.

PMID- 8357575
TI  - Bienzyme strip-type glucose sensor.
AB  - A strip-type glucose biosensor, prepared using screen-printing technology and
      comprising glucose oxidase (E.C.1.1.3.4.), peroxidase (E.C.1.1.3.13.) and
      ferrocyanide as mediator incorporated into graphite-hydroxyethyl cellulose
      matrices is described. The sensor acted at 0.0 V vs Ag/AgCl electrode, and the
      response time was 50-60 s. The calibration was linear up to 25 mM of glucose. The
      sensor response was constant in the range of pH 7.0-8.5. At 25 degrees C the
      biosensor temperature coefficient was 2.7% degrees C(-1). The sensor was
      insensitive to a physiological level of ascorbic acid (40 microM) and was used
      for glucose determination in whole blood.

PMID- 8357576
TI  - Portable system for continuous ex vivo measurements of lactate.
AB  - The lactate profile in serum was monitored continuously in volunteers under
      physical exercise on a test bicycle. The assay was operated ex vivo by means of
      continuous sampling through a coaxial catheter. After dialysis online, lactate
      was converted by means of lactate oxidase immobilized to porous glass, and the
      depletion of oxygen was registered by means of a Clark electrode. Good agreement
      between the continuous monitoring and off-line analyses was found.

PMID- 8357578
TI  - Regulatory aspects of modified release dosage forms: clinical studies.
AB  - In a recently drafted "Note for guidance" of the European Community it is stated
      that "The therapeutic objective and rationale for developing the prolonged
      release product should be provided". This implies that any therapeutic claim
      should be documented by ad hoc clinical trials. Another "Note for guidance"
      describes "the studies to be conducted in man, which are specific to new extended
      release forms containing recognized active and safe medicinal substances so as to
      ensure a more prolonged action than the conventional pharmaceutical forms already
      marketed". From this second "Note for guidance" it appears clearly that three
      situations must be distinguished: a) a modified release dosage form is intended
      for use with a new active principle; b) the active principle is already available
      in a conventional pharmaceutical form; and c) the active principle is available
      as a modified release dosage form with which the new form is not bioequivalent.
      In case a) drug development clearly proceeds as with any other new clinical
      entity, but in addition "the therapeutic objectives and rationale for developing"
      a prolonged release product must be provided. Unless the reasons appear evident,
      some forms of comparison with a conventional release form or a solution will
      probably be needed for marketing authorization to be granted. In case b),
      recommendations contained in the "Note for Guidance" on clinical testing will
      have to be followed. For case c) no clear recommendations are available and it
      would probably be more efficacious to develop a new and bioequivalent modified
      release dosage form rather than to embark into a full clinical program.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8357577
TI  - Microbiosensors for acetylcholine and glucose.
AB  - Microbiosensors based on carbon and and platinum fibers are described. Carbon
      fibers were used to construct microelectrodes of 7 microm diameter.
      Electrochemical operations for pre-electrolysis and measuring were examined for
      the highly sensitive determination of hydrogen peroxide. A triangular potential (
      2 to +2V vs Ag/AgCl) was applied before measuring each pair of double pulses
      (first pulse: 750 mV; second pulse: 1100 mV). The determination limit was 0.1
      microM of hydrogen peroxide. The reproducible determination of hydrogen peroxide
      is possible even in samples containing albumin protein. The separation of
      hydrogen peroxide from ascorbic acid is also possible because the oxidation
      potential of ascorbic acid is different from that of hydrogen peroxide. An
      acetylcholine microsensor was fabricated by immobilizing acetylcholine esterase
      and choline oxidase on the carbon fiber by entrapment with poly(vinyl alcohol)
      quarternized stilbazole (PVA-SbQ). This sensor gave a linear calibration plot for
      the range 0.1-1.0 mM with a linear correlation coefficient of 0.9842. Glucose
      oxidase (GOD) and glucose dehydrogenase (GDH) immobilized cylindrical platinum
      microelectrodes were fabricated, and their characteristics were evaluated,
      respectively, by using 1,4-benzoquinone (BQ) and ferricyanide as electron
      mediators. Each enzyme was immobilized by using PVA-SbQ on a cylindrical
      microelectrode of 2 microm diameter. A linear range in the calibration curve of
      the GOD-based glucose microsensor was observed to be wider than that obtained
      using a disk electrode of 1 mm diameter. The mediated response of the 2 microm
      glucose sensor was compared with the response resulting from hydrogen peroxide
      detection. This result showed that a higher response and a wider linear range
      were observed with highly concentrated mediator. A much higher response of the
      GDH immobilized 2 microm microelectrode was obtained when not only ferricyanide
      but also diaphorase was employed to reoxidize the NADH produced by the enzyme
      reaction of GDH. The GHD-based glucose microsensor was found to be unaffected by
      the concentration of dissolved oxygen.

PMID- 8357579
TI  - Extraction, purification and evaluation of structures and physico-chemical
      properties of glycosaminoglycans.
AB  - Heparin was extracted and purified from beef intestinal mucosa. The two
      components, fast moving heparin and slow moving heparin were purified by
      selective precipitation as barium salts. Heparan sulfate was extracted and
      purified from beef spleen. Dermatan sulfate was purified from beef intestinal
      mucosa and chondroitin sulfate from bovine trachea. The purity of the purified
      glycosaminoglycans was evaluated by agarose-gel and cellulose polyacetate
      electrophoresis and by specific optical rotation. The relative molecular masses
      of glycosaminoglycans were estimated by high performance-size exclusion
      chromatography and the sulfate to carboxyl ratio by titrimetric analysis. The
      disaccharide pattern of heparin, fast moving and slow moving heparins and heparan
      sulfate were determined by specific enzymatic cleavage using heparinase I, II and
      III; the disaccharide composition of dermatan sulfate and chondroitin sulfate was
      evaluated by cleavage by chondroitinase ABC. The disaccharides obtained by
      enzymatic cleavage were qualitatively and quantitatively analysed by strong anion
      exchange-high performance liquid chromatography. The sulfate to carboxyl ratios
      of glycosaminoglycans were also determined by this technique and compared with
      the values obtained by titrimetric analysis.

PMID- 8357580
TI  - Transconjunctival approach vs subciliary skin-muscle flap approach for orbital
      fracture repair.
AB  - OBJECTIVE: To compare the transcutaneous and transconjunctival approaches for
      repair of orbital rim and floor fractures. DESIGN: We conducted a retrospective
      study of the occurrence of eyelid retraction following the repair of 63 orbital
      fracture, 27 with the subciliary skin-muscle flap approach and 36 with the
      transconjunctival preseptal approach. SETTING: Academic tertiary referral medical
      center. PARTICIPANTS: Fifty-nine patients underwent 63 orbital explorations.
      INTERVENTIONS: Of the 27 transcutaneous explorations, 24 were done early within
      the first 2 weeks of injury and three were performed for correction of late
      posttraumatic enophthalmos. Of the 36 transconjunctival explorations, 25 were
      done early and 11 were performed for correction of late posttraumatic
      enophthalmos. OUTCOME MEASURE: Clinically noted complications. RESULTS: We found
      a 12% rate of transient ectropion and a 28% rate of permanent scleral show with
      the subciliary skin-muscle flap approach compared with no transient ectropion and
      a 3% rate of permanent scleral show with the transconjunctival approach.
      CONCLUSIONS: We believe that the transconjunctival approach provides excellent
      exposure with less risk of postoperative eyelid retraction and ectropion.

PMID- 8357581
TI  - Expanded polytetrafluoroethylene (Gore-Tex soft-tissue patch) in facial
      augmentation.
AB  - BACKGROUND: Expanded polytetrafluoroethylene (EPTFE) (Gore-Tex soft-tissue patch)
      has received favorable clinical reports for use in facial augmentation
      procedures. We evaluated the EPTFE soft-tissue patch in short-term (3-week),
      intermediate-term (6-month), and long-term (12-month) animal models. METHODS:
      Nine pathogen-free male and female New Zealand white rabbits weighing 2 to 4 kg
      were used. After implantation of the EPTFE soft-tissue patch, the animals were
      carefully observed on a daily basis for signs of wound infection, seroma, or
      hematoma formation. The stability of the implant was evaluated and graded after
      the animals were killed. Tissue specimens, including skin, implant, and
      underlying bone, were removed en bloc. These blocks were sectioned and stained
      for histologic evaluation. A portion of these blocks were used for scanning
      electron microscopy. RESULTS: The material increased in stability over time and
      showed minimal inflammatory cell response and only a delicate fibrous capsule,
      even in long-term implants. Ultrastructural analysis demonstrated close
      apposition of the material to tissue, suggesting good interface bioactivity.
      CONCLUSIONS: The EPTFE soft-tissue patch appears to be safe and reliable material
      for augmentation, demonstrating high biocompatibility, low tissue reactivity, and
      increasing stability over time.

PMID- 8357582
TI  - Verapamil enhances the survival of primary ischemic venous obstructed rodent skin
      flaps.
AB  - The effect of verapamil, a calcium channel blocker, on the survival of skin flaps
      subjected to primary venous obstruction was studied. Skin flaps 9 x 4 cm, which
      are axial patterns with random extension, were elevated in Sprague-Dawley rats. A
      microvascular clamp was placed on the vein alone for 8 hours. Group 1 received
      verapamil (0.3 mg/kg) before flap elevation and before clamp release; group 2
      received saline on the same schedule. Group 3 received verapamil (0.3 mg/kg) as
      above, plus every 8 hours for 5 days postoperatively. Group 4 received saline on
      the same schedule. There was no difference in survival between groups 1 and 2.
      Group 3 had 100% improvement in the flap survival compared with group 4 (78% vs
      37%). Verapamil, if administered for the duration of the experiment,
      significantly increased flap survival.

PMID- 8357583
TI  - Botulinum toxin for the treatment of hyperfunctional lines of the face.
AB  - OBJECTIVE: To determine the effectiveness of botulinum toxin injections for the
      management of hyperfunctional facial lines in patients with dystonia. DESIGN:
      Twenty-six patients were included in the study: 24 patients had dystonic movement
      of the face as either a primary or secondary component, and two patients were
      treated for purely hyperfunctional lines. Botulinum toxin type A was injected via
      a monopolar hollow-bore Teflon-coated electromyography needle into the facial
      muscles associated with the hyperfunctional lines. Doses were divided into 1.25-
      to 10-U aliquots. Qualitative assessments by the patient and physician were made
      before injection and 2 to 3 weeks after injection. PATIENTS: Twenty-six patients
      (two male and 24 female) with hyperfunctional lines were included. The ages were
      from 32 to 84 years with an average age of 59 years. Twenty had dystonia, four
      had hemifacial spasm, and two had pure hyperfunction without neuromuscular
      disease. RESULTS: All of the patients had an effect of toxin within the first 24
      to 72 hours. All of the patients experienced benefit from the toxin injections
      with partial or total resolution of painful contractions or unsightly
      hyperfunctional lines and spasms. The effects of the injection lasted 3 to 6
      months. No systemic side effects were noted. Adverse effects included mild,
      temporary eyelid or lip weakness. CONCLUSION: Based on this initial pilot study,
      botulinum toxin may be an important new option for the treatment of patients with
      hyperfunctional facial lines.

PMID- 8357585
TI  - Long-term stability of two different mandibular bridging systems.
AB  - To evaluate the benefits of narrow-beam roentgenography and spiral tomography for
      examination and monitoring of screw and plate fixation to bone we studied 22
      rigid plate bridgings of mandibular defects. The plate reconstructions were of
      long duration or considered permanent. In 13 patients, AO-THORP (AO:
      Arbeitsgemeinschaft fur Osteosynthesefragen; THORP: Titanplasma-beschichteten
      Hohl- und Vollkern-Rekonstruktionsplatten-Systems) reconstructions were used and
      in nine classic AO stainless steel plate bridgings. With the AO-THORP system,
      good bone apposition to the screws was evident in 96% (73/76 screws) of the
      cases. Fixation using the classic AO screws, however, was inadequate in 30%
      (20/66 screws) of the cases. Plate loosening was noted in 56% (5/9 plates).
      Examination using narrow-beam roentgenography and spiral tomography provided
      detailed information about bone resorption around the screws and provided a
      reliable tool for deciding on a follow-up regimen. When complications occur, they
      can be detected and treated early, reducing patient morbidity. In our opinion,
      classic AO plate bridging should always be considered temporary.

PMID- 8357586
TI  - Cause for intractable chronic cough: Arnold's nerve.

PMID- 8357587
TI  - Allergic Aspergillus sinusitis.

PMID- 8357584
TI  - Surgical treatment of obstructive sleep apnea. Technical variations.
AB  - OBJECTIVE: To determine the effectiveness of the two basic surgical types of
      uvulopalatopharyngoplasty (UPPP), as classified by us. The two basic surgical
      variations of UPPP differ for the width of the anteroposterior palatal resection,
      being 1 to 2 cm (type 1) and 0.5 to 1.0 cm (type 2). DESIGN: Randomized,
      retrospective study. PATIENTS: Eighty-seven patients with obstructive sleep apnea
      hospitalized in our department from 1983 to 1991. All patients had a complete
      preoperative and postoperative polysomnographic evaluation. RESULTS: The
      operation was found to be an effective treatment of obstructive sleep apnea in
      most patients. Snoring improvement was found in 95% (29/31) of patients with type
      1 UPPP and in 96% (54/56) of the patients with type 2 UPPP, whereas, apnea index
      improvement was detected in 65% (20/31) of the patients with type 1 UPPP vs 64%
      (36/56) of the patients with type 2 UPPP. Postoperative dysphagia was found in
      94% (29/31) vs 79% (44/56), P = .0025; nasal reflux was found in 81% (25/31) vs
      11% (6/56), P = .0001; and hypernasality was found in 100% (31/31) vs 13% (7/56),
      P = .0001, in type 1 and type 2 UPPP operations, respectively. Chi-square
      analysis shows highly significant differences. CONCLUSIONS: Type 2 UPPP is the
      recommended surgical procedure of obstructive sleep apnea, mainly due to the
      minimal postoperative morbidity.

PMID- 8357588
TI  - Cleft lip and palate surgery in La Ceiba, Honduras.

PMID- 8357589
TI  - Chlamydia species and Mycoplasma species in recurrent tonsillitis.

PMID- 8357591
TI  - Pathologic quiz case 1. Clear cell carcinoma of the nasal cavity.

PMID- 8357590
TI  - Pathologic quiz case 2. Benign mesenchymoma.

PMID- 8357592
TI  - Case report.

PMID- 8357593
TI  - Smokeless tobacco usage associated with oral carcinoma. Incidence, treatment,
      outcome.
AB  - Smokeless tobacco usage, particularly by young men and boys, has increased
      dramatically in the United States. To assess their possible risk, we reviewed the
      records of 128 patients with oral carcinoma who had used smokeless tobacco
      exclusive of other carcinogens. Most were elderly white women (average age, 78
      years), 78% of whom had used smokeless tobacco for 40 or more years. The median
      duration of symptoms before presentation was only 3 months, yet initially 42% of
      these patients had T3 or T4 lesions and 30% had nodal metastases. Forty-two
      percent had posttreatment recurrence at the presenting site (average, 8.2
      months); 26% had a second oral-cavity tumor at a new site more than 24 months
      after treatment (average, 49.3 months), indicative of a field cancerization
      phenomenon. Forty-seven percent were alive after 3 years and 37% after 5 years.
      These findings emphasize that strong preventive programs are needed if today's
      young users of smokeless tobacco are not to form future oral cancer patient
      populations.

PMID- 8357594
TI  - Total glossectomy with laryngeal preservation.
AB  - OBJECTIVE: To evaluate the results of a planned combined therapy with surgery and
      postoperative radiotherapy in the management of large (T3 to T4) squamous cell
      carcinomas of the tongue-tongue base in properly selected patients. PATIENTS AND
      METHODS: Twenty-one patients underwent this procedure in a 4-year period. The
      selection criteria were directed to identify those patients in whom laryngeal
      preservation was feasible and who were motivated. Five categories of patients
      were included: those with (1) large primary tumors of the tongue-tongue base; (2)
      recurrence after initial radiotherapy, brachytherapy, chemotherapy, or a
      combination of these modalities; (3) recurrence after initial surgery and
      radiotherapy; (4) double primary tumors; and (5) second or third primary tumors
      arising in the tongue or base of the tongue. Preoperative investigation included
      examination under anesthetic and magnetic resonance imaging. Depending on the
      proximity of the primary tumor to the mandible, a mandibular split, a marginal
      resection, or a segmental resection was carried out. Soft-tissue replacement was
      achieved by a myocutaneous or a muscle flap of the pectoralis muscle with split
      skin. Whenever possible tissues of the contralateral floor of the mouth were also
      used. Laryngeal suspension was performed in all cases. Postoperative radiotherapy
      consisted of megavolt therapy, 66 Gy in 6 weeks to the primary site and both
      sides of the neck. RESULTS: Resumption of swallowing and speech was achieved in
      all patients. External deformity was slight. Patients were able to return to
      their families. CONCLUSIONS: Total glossectomy with laryngeal preservation in
      properly selected patients provides local and regional control and preserves
      quality of life.

PMID- 8357595
TI  - Clinical underestimation of laryngeal cancer. Predictive indicators.
AB  - OBJECTIVE: To evaluate the accuracy of clinical staging of advanced laryngeal
      cancer and to morphologically analyze the underestimated cases. DESIGN: We
      conducted a retrospective histopathologic study of larynges from patients who had
      had total laryngectomy and were seen over a 21-year period. SETTING: Academic
      tertiary referral medical center. PARTICIPANTS: Forty-one patients had clinically
      staged T3 laryngeal cancer and 16 patients had T4 cancer. INTERVENTION: Patients
      all underwent wide-field total laryngectomy. All larynges were processed as whole
      organ serial sections in the coronal plane. OUTCOME MEASURE: The incidence of
      clinically underestimated laryngeal cancer. During this investigation, it became
      obvious that predictive indicators of thyroid cartilage involvement could be
      established. RESULTS: Clinical underestimation had been made in approximately 50%
      of all T3 laryngeal cancer cases. The extent of the cartilage involvement in the
      underestimated group was characterized by microinvasion without penetration;
      approximately 90% of the cartilage involvement affected the thyroid notch and
      adjacent area. We established five objective indicators of thyroid cartilage
      involvement: (1) extensive cartilage ossification (risk for cartilage
      involvement, 73%); (2) glottic fixation (54%); (3) transglottic cancer (74%); (4)
      tumor length longer than the entire vocal fold length or longer than 2 cm (66%);
      and (5) extensive involvement of the anterior commissure (67%). CONCLUSIONS:
      Clinical underestimation of T4 laryngeal cancer was high because thyroid
      cartilage involvement was not accurately diagnosed. We believe our indicators of
      thyroid cartilage involvement will provide objective guidelines for laryngeal
      cancer staging and will contribute to more reliable clinical cancer-staging
      decisions.

PMID- 8357596
TI  - Supraomohyoid neck dissection in the treatment of head and neck tumors. Survival
      results in 212 cases.
AB  - Elective supraomohyoid neck dissection is considered part of standard treatment
      of oral and oropharyngeal cancer in most institutions, but its role in the
      treatment of clinically positive neck cancer remains a subject of controversy.
      The main object of this study is to report the results of 212 consecutive
      patients who underwent supraomohyoid neck dissections from 1954 to 1990. Most
      patients had squamous cell carcinoma of the oral cavity. Eighty-six patients
      (40.6%) had histologically positive lymph nodes in the surgical specimen
      (sensitivity, 0.55; specificity, 0.53). At the study closing date there were
      58.8% actuarial 10-year overall survival rates. Forty-five patients (21.2%) had
      50 tumor recurrences (32 local, 13 regional, five distant), and in 40 patients
      (18.8%) a second primary tumor was diagnosed. A multivariate regression technique
      based on Cox's proportional hazards model was used, and age (65 years or younger
      vs older than 65 years) represented the variable with the highest predictive
      strength with respect to overall survival (relative risk, 2.3). Tumor site, sex,
      and histologically proved metastasis were also associated with overall survival
      rates. The same variables were also related to the risk of recurrence. In
      conclusion, the death rate is mainly related to the control of the primary site
      tumor and the occurrence of a second primary tumor rather than to neck
      recurrences. It confirms that supraomohyoid neck dissection is an adequate
      elective procedure and possibly sufficient in the treatment of a selected group
      of patients with lip cancer with positive nodes at level 1.

PMID- 8357597
TI  - Squamous cell carcinoma of the maxillary sinus.
AB  - Eighty-five patients with squamous cell cancer of the maxillary sinus received
      all of their treatment at The University of Texas M.D. Anderson Cancer Center
      between the years 1971 and 1986. Their records were evaluated according to stage,
      disease at presentation, symptoms and signs at presentation, treatment, and
      outcome. There were no differences in locoregional control or survival between
      groups treated with surgery alone vs surgery plus radiotherapy. Careful analysis
      of the data indicates that there was almost certainly some selection bias for the
      patients undergoing combination therapy, as most of this group had historically
      adverse prognostic factors identified. Those patients who underwent radiotherapy
      alone or chemotherapy presented with either metastatic or locally advanced
      disease and were treated with palliative intent; therefore, comparison between
      this group and standard therapy groups was impossible in this retrospective
      review. Although it is tempting to speculate that combination therapy improved
      locoregional control and survival in patients with more advanced disease, none of
      the data presented in this review reach statistical significance. Furthermore,
      there is no difference in survival in this population compared with a study at
      this institution 20 years ago. Squamous cell cancer of the maxillary sinus
      continues to be a challenging neoplasm. Radiotherapy may improve locoregional
      control and survival in a group of patients with more advanced disease and may
      have its greatest utility in earlier-stage disease. A multi-institutional
      prospective trial is needed to find ways to improve outcome in this patient
      population.

PMID- 8357598
TI  - Angiosarcoma of the head and neck. The UCLA experience 1955 through 1990.
AB  - Between 1955 and 1990, 28 patients with angiosarcoma of the head and neck were
      seen at UCLA Medical Center, Los Angeles, Calif. Half the lesions arose on the
      scalp; the remainder occurred in the soft tissues of the face and neck. Nine
      patients presented with multifocal disease. Follow-up ranged from 3 to 159
      months, with a median of 32 months. The overall prognosis was poor, with a 5-year
      disease-free survival of 26% (7/27 patients). Of 21 patients having recurrences
      after primary treatment, 90% (19/21 patients) had a component of local failure.
      Distant metastasis had developed in nine patients at last follow-up. Of patients
      treated initially with surgery alone, 8% (1/12 patients) remain disease free vs
      67% (4/6 patients) who received postoperative radiation therapy, with or without
      chemotherapy. Only one (14%) of seven patients treated primarily with radiation
      therapy with or without chemotherapy was rendered disease free. Angiosarcoma
      usually presents with high-grade histologic features and frequently with
      multifocal disease. There is propensity for both local recurrence and distant
      metastasis. Our results and a review of the literature suggest that combined
      modality therapy offers the best chance for long-term control in patients with
      angiosarcoma of the head and neck.

PMID- 8357599
TI  - External septorhinoplasty in children: Outcome and effect on growth of septal
      excision and reimplantation.
AB  - Outcome and effect on nasal growth of external septorhinoplasty was evaluated in
      32 children. All had septal disease anterior to the nasal spine. In all cases,
      the cartilaginous septum was totally excised, refashioned, and then reinserted.
      Sixteen children with follow-up for more than 2 years were identified. Nine
      children had preoperative and postoperative nasal airflow studies and
      demonstrated a reduction in total nasal airway resistance, from a mean untreated
      value of 6.1 cm of water per centimeter per second preoperatively to a mean of
      2.5 cm of water per centimeter per second postoperatively. IN 10 of these 16
      children, six postoperative anthropometric measures and one index were
      determined, and these measurements were within the range of age- and sex-specific
      normative data from the Craniofacial Measurements Laboratory at the Hospital for
      Sick Children, Toronto, Ontario.

PMID- 8357600
TI  - Transconjunctival blepharoplasty. Complications and their avoidance: a
      retrospective analysis and review of the literature.
AB  - The transconjunctival approach to lower eyelid blepharoplasty is becoming
      increasingly popular. From 200 transconjunctival blepharoplasties performed
      between 1984 and 1991, 40 randomly selected cases were reviewed to identify the
      complications associated with this technique. This represents the largest
      reported series (to our knowledge) in the English-language otolaryngology head
      and neck surgery literature. A review of the literature was performed to compare
      this series with reported complications associated with this approach, as well as
      to compare the reported complications from the transcutaneous method. Discussion
      on how to best avoid these complications is included. We found that the
      transconjunctival approach avoided the most common complication associated with
      transcutaneous blepharoplasty, lower lid malposition. Inadequate fat removal, the
      most common complication when the transconjunctival method was used, was believed
      to be best avoided by the careful graded and through removal of herniated lower
      lid fat. Patients exhibiting prominent fat without excess lower lid skin were
      found to be ideal candidates for transconjunctival blepharoplasty.

PMID- 8357602
TI  - Lysozyme and lactoferrin in human maxillary sinus mucosa during chronic
      sinusitis. An immunohistochemical study.
AB  - Immunohistochemistry was used to study the localization of lysozyme (LZ) and
      lactoferrin (LF) in the human sinus mucosa during recurrent and chronic
      sinusitis. Serous cells of submucosal mixed glands and polymorphonuclear
      leukocytes both displayed a strongly positive staining reaction to both LZ and LF
      in the normal mucosa. A positive though weak staining for LZ and LF could also be
      found occasionally within goblet cells. In the mucosa from patients with
      recurrent or chronic sinusitis, the staining reaction to LZ appeared to intensify
      in goblet cells. Furthermore, an increased immunoreactivity of glands vis-a-vis
      LZ and LF was also noted occasionally. Atypical glands were frequently found in
      mucosa from patients with chronic sinusitis. The epithelium of these latter
      glands often showed an intense staining reaction to LF, but a rather weak
      reaction to LZ. The results of the present study suggest that the observed
      increase in LZ and LF secreting activity of goblet cells, epithelial cells and
      newly formed atypical glands may play a part in the defense mechanism of the
      sinus mucosa during the course of chronic sinusitis.

PMID- 8357603
TI  - Keratosis of the tympanic membrane and deep external auditory canal. A defect of
      auditory epithelial migration.
AB  - We have previously described the pathways of movement of epithelium on the
      tympanic membrane, showing that there are two discrete and separate zones. Four
      cases of keratosis of the tympanic membrane and deep external auditory canal are
      here reported. All patients complained of tinnitus and other aural symptoms.
      Sequences of otoscopic photography of daubs of dye placed on the tympanic
      membrane showed an abnormal anterior movement over the whole tympanic membrane in
      two cases and complete paralysis of movement in the two others. These findings
      suggest that the disorder arises from damage to basal epidermal cells caused by
      inflammation, which is probably due to infection. Treatment is by suction
      stripping of keratin from the eardrum. Careful examination of the eardrum under
      magnification is required in all cases of tinnitus so as to detect this
      condition.

PMID- 8357601
TI  - The nature of the head and neck cancer.
AB  - Squamous cell carcinoma of the head and neck is a disease predominantly of males
      and is due to a variety of known environmental irritants, notably cigarette
      smoke. Dietary, viral and immunological factors may also be relevant. Head and
      neck squamous cancers express epidermal growth factor receptors and some show
      weak levels of oestrogen receptor activity, but a reliable serum marker of tumour
      burden remains to be identified. The prognosis is found to be less favourable in
      females, in those with advanced T stage, in association with multiple node
      involvement, especially where extracapsular spread is present and where the T4/T8
      ratio is elevated. Administration of heterologous blood during therapy may also
      have an adverse effect on prognosis. Interested clinicians must remember that
      most cases are preventable.

PMID- 8357604
TI  - Benign keratoma of the vocal cords.
AB  - Benign keratomas are true benign tumors of the vocal cords that are to be
      differentiated clinically and histologically from malignant, inflammatory and
      reactive lesions which may also result in superficial keratinization. Clinically,
      keratomas present as flat, warty or papillary lesions with varying keratinization
      surrounded by a normal-appearing ("healthy") epithelium. They are usually
      unilateral, with their extents varying from 2 to 3 mm in diameter to tumors
      occupying the entire vocal cord. Histology shows grade I or grade II epithelial
      hyperplasia without any signs of inflammation. In the present study 61 patients
      with benign keratomas were treated by excisional biopsies alone. Fifty-seven
      patients were followed for a minimum of 7 months and a maximum of 16.5 years. Two
      patients developed recurrent keratomas. To date none of the patients has
      developed an invasive vocal cord carcinoma or a carcinoma in situ.

PMID- 8357605
TI  - Nucleolar organizer regions in carcinomas of the oropharynx and hypopharynx.
AB  - It is supposed that the nucleolar organizer regions (NORs), genes on which
      ribosomal RNA is coded, may contain information on the structure of the nucleolus
      and on nucleolar activity which permits discrimination between normal and
      neoplastic cells and their proliferation activity. In the present study, the
      histological sections of 144 patients with carcinomas of the oropharynx and
      hypopharynx were studied in a retrospective approach to determine the absolute
      NOR counts per 100 nuclei and investigate their influence on the prognosis and
      extent of lymphogenic formation of metastases. An absolute NOR count of 681 per
      100 nuclei was found to give reliable discrimination between stage N0 or N1
      carcinomas and stage N2 or N3 disease.

PMID- 8357606
TI  - A peptide-like putative marker substance of laryngeal cancer patients.
AB  - Acidic ethanol precipitation, gel-filtration chromatography (Sephadex G-25) and
      capillary isotachophoresis were performed on serum and tumor tissue samples from
      eight patients with stage III and IV laryngeal cancers. An anionic 0.3-5 kDA
      molecular mass substance that was probably peptide was recorded in both the serum
      and cancer tissue, but could not be shown in the serum of five control subjects.
      This substance disappeared from the sera of four patients after total
      laryngectomy and they have now lived without tumor recurrence for about 2 years.
      Three of the other four patients developed tumor recurrences while one patient
      has remained tumor-free. Our findings support a hypothesis that the peptide-like
      molecule is characteristic of laryngeal cancer and can possibly be used for
      monitoring the disease.

PMID- 8357607
TI  - A quantitative study of nerve fibers in the human facial nerve.
AB  - The facial and intermediate nerves were quantitatively evaluated in seven
      patients who died from systemic malignancies not involving the facial nerve. In
      addition, five of the specimens were also qualitatively evaluated by measuring
      the total and axon diameters of the facial and intermediate nerve fibers. In two
      cases the facial nerve fibers were counted at five different levels. The total
      number of myelinated nerve fibers in the facial nerve varied from 7500 to 9370.
      The total number of myelinated nerve fibers in the intermediate nerve varied
      between 3120 and 5360. The peak diameter of the facial nerve axon was between 4
      and 6 microns, and was between 2 and 3 microns in the intermediate nerve. When
      comparing nerve segments at different anatomical levels, the largest amount of
      nerve fibers was found at the level of the middle mastoid portion. However, this
      number did not reach the amount of nerve fibers counted in the internal acoustic
      meatus.

PMID- 8357608
TI  - Chondrosarcoma of the larynx.
AB  - Chondrosarcoma of the larynx is a rare, slow-growing malignant tumor. One hundred
      and fifty cases of this entity have been reported in the literature. In 75% of
      cases the site of involvement was the cricoid cartilage, while 20% have involved
      the thyroid cartilage. The tumor presents as a space-occupying lesion in the
      subglottic region, or as a neck mass. An insidious, slowly progressing disease
      course associated with hoarseness and dyspnea accounts for usual delays in
      arriving at a diagnosis. We report our experiences with six cases of this entity
      and discuss a diagnostic and therapeutic approach. Whenever possible a
      conservative surgical management should be attempted.

PMID- 8357609
TI  - Inner ear damage due to lipoid nephrosis.
AB  - Inner ear pathology was studied in adult rats with lipoid nephrosis induced by
      puromycin aminonucleoside. Although no abnormality was observed in auditory brain
      stem responses, significant changes were noted in the stria vascularis. The most
      striking observation was that intermediate cells were markedly swelled, there-by
      pressing adjacent marginal cells. Severely affected marginal cells have vacuoles
      and increased lysosomes and protruded toward the endolymphatic space. The organ
      of Corti remained virtually intact. Although the vestibular maculae were
      relatively normal, type I hair cells in the semicircular canal underwent a
      conspicuous vaculolization. These findings support a postulate that the inner ear
      is liable to damage in lipoid nephrosis.

PMID- 8357610
TI  - Biochemical characterization of mucous glycoproteins secreted by in vitro
      chinchilla middle ear epithelial cells.
AB  - A method for middle ear epithelial (CMEE) cell culture with active mucus
      secretory function has been successfully developed, using the chinchilla as an
      animal model. CMEE cells were dissociated by protease digestion from the middle
      ear mucosa. The CMEE cells grown in primary culture incorporated [3H]glucosamine
      into a glycoconjugate after its release into medium. This substance was
      characterized biochemically as mucin, although the production of mucin by the
      cells required growth on a substratum of collagen gel. These cultures provide an
      excellent model for studying factors that regulate synthesis and secretion of
      glycoproteins in CMEE cells.

PMID- 8357611
TI  - An immunohistochemical and electrophysiological study on Isk protein in the stria
      vascularis of the guinea pig.
AB  - The reaction product against rat Isk protein antibody was demonstrated on the
      endolymphatic surface of the marginal cell of the guinea pig, using an
      immunohistochemical method. Clofilium, a potassium channel blocker which has been
      previously found to block rat kidney Isk channels, decreased the endocochlear
      potential (EP) when applied by perilymphatic perfusion and iontophoresis into
      endolymph. This finding of a decreased EP supports the presence of Isk protein on
      the endolymphatic surface of the marginal cell.

PMID- 8357612
TI  - A three-dimensional reconstructive study of the layer structure of the human
      vocal cord.
AB  - The purpose of this investigation was to clarify the detailed histological
      structure of the human larynx and to clarify the cause of adaptation in high
      frequency vibrations using three-dimensional histological reconstructions of
      human true vocal cords. In a first series of studies, 54 intact adult larynges
      were obtained from 398 human cavaders with known histories. Four of these
      laryngeal specimens were fixed in 10% formalin. Three of these were decalcified
      and embedded in paraffin and the other in Technovit-7100. The layer structure of
      each larynx was investigated with a three-dimensional reconstruction method using
      a personal computer. Results demonstrated that the elastic fiber layer in the
      superior surface of the vocal cord was wider than that in the inferior surface.
      The collagen fiber layer extends from the anterior commissure in a posterior
      direction. The elastic fiber layer connected both the anterior and the posterior
      macula flava, while the collagen fiber layer connected the thyroid cartilage and
      the anterior macula flava.

PMID- 8357613
TI  - Innovations in auxiliary dental education.

PMID- 8357614
TI  - A WDA interview with MUSOD's Dean...Dr. Kenneth L. Zakariasen, Jr.. Interview by
      Dr. Peter H. Jacobsohn.

PMID- 8357615
TI  - Microbial purification technique of mineral dressing plants reject waters.
AB  - Earlier investigations on laboratory and pilot plant scale have shown the resort
      to microorganisms to be a practicable approach to the problem of purifying
      mineral dressing plant reject waters from residual flotation reagents and/or
      metal ions. In spite of the proven effectiveness of this method, one major
      drawback, namely the pathogenicity of some microorganisms, has so far hampered
      its application on a commercial scale. A research programme, aimed at developing
      a microbial reject water purification technique utilizing non-pathogenic strains
      was thus drawn up and is currently being implemented. Strains such as Bacillus
      subtilis, Saccharomyces cerevisiae, Bifidobacterium bifidum, Lactobacillus
      acidophilus and Acinetobacter calcoaceticus, which are not harmful to human
      health, some of them being commonly found in the human intestine, have been
      successfully tested for removing alkylsulphates, alkylamines and fatty acids from
      solutions simulating flotation plant tailings waters. Removals as high as 90% in
      less than 48 h can be easily achieved with no nutrient requirements, since in
      most cases the flotation reagent residue to be removed is metabolized by the
      microorganisms themselves.

PMID- 8357616
TI  - Amplification of ribulose biphosphate carboxylase/oxygenase large subunit
      (RuBisCO LSU) gene fragments from Thiobacillus ferrooxidans and a moderate
      thermophile using polymerase chain reaction.
AB  - Southern blot analysis of DNA from an iron-oxidising moderate thermophile NMW-6
      and from Thiobacillus ferrooxidans strain TFI-35 demonstrated sequences
      homologous to the RuBisCO LSU gene of Synechococcus. DNA fragments (457 bp)
      encoding part of the RuBisCO LSU gene (amino acids 73-200) were amplified from
      the genomic DNA of Thiobacillus ferrooxidans and the moderate thermophile NMW-6
      using the polymerase chain reaction (PCR) technique (Saiki et al. (1985) Science
      233, 1350-1354). A comparison with the LSU sequences from T. ferrooxidans,
      Alcaligenes eutrophus, Chromatium vinosum, Synechococcus and Spinacea oleracea,
      which all have RuBisCOs with a hexadecameric structure, showed that the RuBisCO
      LSU gene sequence from NMW-6 appeared to be most closely related to that of the
      hydrogen bacterium A. eutrophus which showed 71.9% homology at the amino acid
      level. Despite its physiological similarity, T. ferrooxidans showed only 64.1%
      homology to the amino acid sequence from NMW-6 and had the lowest DNA homology
      (60.9%) of the hexadecameric type RuBisCOs. In the region sequenced, T.
      ferrooxidans and the RuBisCOs of the phototrophs C. vinosum, Synechococcus and S.
      oleracea, had 17 residues that were completely conserved which were substituted
      in both NMW-6 and A. eutrophus, 11 of these being identical substitutions.
      Comparison of the nucleotide and derived amino acid sequences of the RuBisCO LSU
      fragment from T. ferrooxidans with other RuBisCO sequences indicated a closer
      relationship to the hexadecameric type LSU genes of photosynthetic origin than to
      that of A. eutrophus. The T. ferrooxidans amino acid sequence showed 93.8%, 78.9%
      and 77.3% homology, respectively, to the C. vinosum, Synechococcus and S.
      oleracea (spinach) sequences but only 56.2% to A. eutrophus. The DNA sequence
      from Rhodospirillum rubrum, which has the atypical large subunit dimer RuBisCO
      structure with no small subunit, showed 39.2% and 42.7% homology, respectively,
      with the sequences of NMW-6 and T. ferrooxidans, and 25.0% and 29.7% amino acid
      homology, indicating that the DNA homology was substantially random in nature.
      PCR fragments (126 bp) that overlaped the last 15 codons of the fragments above
      were also amplified and sequenced. They showed incomplete homology with the
      larger fragments, supporting evidence obtained from Southern hybridizations that
      T. ferrooxidans and the moderate thermophile NMW-6 have multiple copies of
      RuBisCO LSU genes.

PMID- 8357617
TI  - Enzymes of aerobic respiration on iron.
AB  - Bacteria capable of aerobic respiration on ferrous ions are spread throughout
      eubacterial and archaebacterial phyla. Comparative spectroscopic analyses
      revealed that phylogenetically distinct organisms expressed copious quantities of
      spectrally distinct redox-active biomolecules during autotrophic growth on
      soluble iron. Thiobacillus ferroxidans, Leptospirillum ferrooxidans,
      Sulfobacillus thermosulfidooxidans, and Metallosphaera sedula possessed iron
      respiratory chains dominated by a blue copper protein, a novel red cytochrome, a
      novel yellow protein, and a novel yellow cytochrome, respectively. Further
      investigation of each type of respiratory chain will be necessary to deduce the
      advantages and disadvantages of each.

PMID- 8357618
TI  - Imaging the sphenoid bone and basiocciput: anatomic considerations.
AB  - The sphenoid bone is a complex structure with an intricate embryologic origin. It
      is centrally located within the skull base and articulates with almost every
      structure in the skull and face. The sphenoid bone contains multiple foramina and
      fissures accommodating numerous vessels and nerves. This report reviews the
      embryology of the sphenoid bone and its normal postnatal changes, and describes
      the normal anatomy of the sphenoid bone and its numerous foramina and fissures.
      Computed tomography (CT) and magnetic resonance (MR) are used to illustrate
      developmental changes and normal anatomy.

PMID- 8357619
TI  - Imaging the sphenoid bone and basiocciput: pathological considerations.
AB  - Many diverse pathologic processes can involve the sphenoid bone because of its
      complex embryologic origin. In addition to primary neoplasia, the central
      location of the sphenoid predisposes it to involvement by many intracranial and
      extracranial lesions. The presence of multiple foramina and fissures offer "paths
      of least resistance" that allow the spread of pathology across the skull base.
      Sphenoid sinus disease also accounts for a number of pathologic entities
      occurring in this vicinity. This article reviews the more common lesions
      affecting the sphenoid bone as well as their CT and MR appearance.

PMID- 8357620
TI  - The sellar/parasellar endocrinopathies: a brief clinical overview.
AB  - Endocrine disorders of the pituitary and other hypothalamic structures are
      reviewed. Anterior and posterior pituitary physiology is described as well as
      hormone-producing tumors that cause Cushing's disease, hyperprolactinemia,
      acromegaly-gigantism, and precocious and delayed puberty. The diagnosis and
      management of diabetes insipidus caused by hypothalamic-posterior pituitary
      disorders complete the overview.

PMID- 8357621
TI  - Imaging of the sella: anatomy and pathology.
AB  - The hypophysis cerebri, or pituitary gland, is a complex neuroendocrine organ
      involved in the control of a variety of homeostatic mechanisms. Subtleties in the
      internal anatomy of this gland are now becoming appreciated, such as the
      topographic arrangements of pituitary cell types and specializations in its
      regional microcirculation. A large number of potential lesions may affect the
      pituitary, including tumors (adenomas, Rathke cleft cysts, and
      craniopharyngiomas), inflammatory processes (adenohypophysitis, infections), and
      vascular lesions (apoplexy, infarction). Diseases isolated to the posterior lobe
      and stalk (eg, pituitary dwarfism, choristoma, diabetes insipidus) are also well
      recognized. Modern radiologic techniques like computed tomography (CT) and
      magnetic resonance (MR) imaging have provided new insights into the morphologic
      changes of the gland that occur both in health and in a variety of diseases. The
      picture of the gland that has emerged from this research is a dynamic one: The
      pituitary undergoes dramatic changes in size and shape throughout life that must
      be recognized when assessing it for pathologic change.

PMID- 8357622
TI  - Normal imaging anatomy of the suprasellar cistern and floor of the third
      ventricle.
AB  - This article discusses the gross, functional, and imaging anatomy of the
      suprasellar cistern and its contents as well as the structures that form its
      borders, among the most important being the floor of the third ventricle and
      associated structures. Specific structures discussed include the optic chiasm and
      optic tracts, the anterior third ventricle, the tuber cinereum, the pituitary
      stalk (infundibulum), the choroidal fissure, the lamina terminalis, the gyrus
      rectus, the uncus, and the cerebral peduncles.

PMID- 8357623
TI  - Clinical manifestations of lesions of the suprasellar and parasellar regions: a
      neuro-ophthalmologic perspective.
AB  - Radiologists, neurologists, and ophthalmologists must develop common ground in
      describing the clinical manifestations of and terminology used in lesions of the
      basilar cisterns and parasellar region. This article attempts to bridge that
      communications gap using lesions of the orbital apex, cavernous sinus, sella
      turcica, and parasellar regions as examples.

PMID- 8357624
TI  - Suprasellar masses: diagnosis and differential diagnosis.
AB  - Suprasellar masses are neoplastic, vascular, congenital, or
      infectious/inflammatory in origin. Magnetic resonance imaging (MRI) is the study
      of choice for evaluating suprasellar masses, although computed tomography (CT)
      may provide complementary information. Suprasellar masses present with a variety
      of neurologic or endocrine dysfunctions depending on their site of origin and
      mass effect on adjacent structures. Imaging characteristics of the most common
      suprasellar lesions are described with particular emphasis on MR findings.

PMID- 8357625
TI  - Petrous apex and cavernous sinus: anatomy and pathology.
AB  - The cavernous sinus (CS) and petrous apex (PA) are contiguous. The cavernous
      space and cranial nerves III and VI are intimately associated with each. To
      accurately interpret computed tomography (CT) and magnetic resonance (MR) images
      of this region, one must understand thoroughly the anatomy of the PA and CS. This
      article begins with a detailed review of this anatomy, followed by a discussion
      of pathology. Intrinsic diseases of the CS and PA are emphasized specifically.

PMID- 8357626
TI  - [Clinicopathologic prognostic factors of laryngeal and pharyngeal tumors. III:
      Supraglottic carcinoma].
AB  - The factors which influenced the prognosis of 306 supraglotic carcinomas were
      studied. The determinate survival at 3 and 5 years was 7.8% and 57.5%
      respectively. The lymph node metastases and the presence of recurrence affected
      significantly the survival. Also showed a worse prognosis those with an advanced
      local stage, and the patients with excessive alcoholic consumption. Without
      significative prognostic influence were the grade of tumor differentiation,
      involvement of surgical margins, previous tracheostomy, and the existence of a
      second primary tumour.

PMID- 8357627
TI  - [Oncoprotein p21-ras expression in epidermoid carcinoma of the laryngopharynx].
AB  - Ras genes can acquire transforming properties by qualitative and quantitative
      mechanisms. The mutated products of ras oncogenes (p21 protein) exhibit a
      decreased ability to hydrolyze GTP that lead to the stabilization of ras proteins
      in their active state and cause a continuous flow of signal transduction which
      may result in malignant transformation. These biochemical aberrant properties can
      also be achieved by an increased expression of the normal p21 protein. In this
      work we have analyzed the presence of ras gene mutations and the overexpression
      of the oncogene product p21 in the same series of squamous cell carcinoma of
      pharynx and larynx. Of 13 cases studied we have detected mutations in seven cases
      and in nine we have observed overexpression of the p21 protein. There is no
      correlation between ras mutations and overexpression of the p21 protein.

PMID- 8357628
TI  - [Correlation of auditory brainstem evoked potentials and pure tone audiometric
      thresholds].
AB  - This work is on relation existing between the objective threshold of auditory
      brainstem responses in adults and those existing in the different frequencies of
      audiometry pure-tone, in order to make the audiometry from the objective
      threshold of the ABR, from the subjective threshold to the click, and the type of
      hearing loss in question. Such results can be transferred to children, and
      starting from the ABR in children we could guess their probable audiometric
      profiles. On that purpose we have studied the auditory brainstem responses and
      the pure-tone audiometry in 168 ears suffering from hearing-loss, both conductive
      and sensory neurals with and without recruitment, with different degrees of
      hearing losses and audiometric profiles. The results have confirmed the relation
      existing between the threshold of evoked brainstem responses and those of high
      frequencies, 2,000, 4,000 and 8,000 herzs. We have also proved that the threshold
      ABR has a predicting value on the audiometry of patients, and that the difference
      between the objective threshold ABR and the subjective one represents the
      inclination degree of the pure tone audiometry, which considerably reduces the
      great variability presented by the prediction of thresholds of low tones starting
      from ABR.

PMID- 8357629
TI  - [Psychological alterations in patients with cancer of the larynx before and after
      laryngectomy].
AB  - Our work, about the psychological disorders associated with cancer of the larynx
      and its therapeutics, study a group of 54 neoplasicos patients who have undergone
      a laryngectomy, before and after surgical treatment. We analyze in the pre
      operation period, the relationship between the cancer and anxiety/state,
      comparing the patients with a serious neoplasia and those with a more benign
      pathology. After the operation, we study the relationship between the loss or
      retention of speech and the existence of anxiety/state and depression. We
      evaluate anxiety through the (STAI) of Spielberger and depression through the SDS
      scale of Zung. The pre-operative results indicate that the patients have levels
      of A/E significantly greater (p < 0.0001) than the mean score in the control
      group, without there being any significant difference according to the gravity of
      the cancer. Patients that have lost the capacity to speak after the surgical
      treatment, have significantly higher levels of anxiety and depression than the
      control group and those patients that have retained the capacity to speak (p <
      0.0005). Other results about the relationship between the two disorders studied
      and variables of personality, can be found in the analysis section and in the
      discussion of the results.

PMID- 8357630
TI  - [Partial horizonto-vertical laryngectomy: experience of 44 cases (follow up of
      more than five years].
AB  - The horizontal-vertical partial laryngectomy combines supraglottic and
      hemilaryngeal excisions of one side of the larynx and is indicated, as first
      choice, in the supraglottic tumours with unilateral glotoaryntenoid involvement.
      We have followed this theory and practice since 1974, and have studied 44
      patients operated on using this technique up to 1986, who have now (1992) been
      followed up for more than five years. Analysis of the results shows the number of
      patients alive and free of tumour, and the number of decannulations, to be
      sufficiently high for the recommendation of this technique in the treatment of
      such tumours.

PMID- 8357631
TI  - [Epidemiologic aspects of cancer of the nasopharyngeal cavum].
AB  - We have made a retrospective study of 22 patients with CC. We have studied
      epidemiologic and clinical factors and we related them with similar studies.

PMID- 8357632
TI  - [Applied anatomy for the radiologic and computed tomography study of the
      paranasal sinuses].
AB  - The current diagnosis by images has a significant importance in the medical
      and/or surgical treatment of the sinusal incidences due to its great sensibility
      to detect local pathological signs, their limits and neighboring relations. These
      data are of unvaluable importance at the moment of a therapeutical decision and
      should be based upon common interests among otorrhinolaringologists and
      neuroradiologists, speaking the common language given by a firm and shared
      knowledge of regional anatomy. This presentation is based on the comparison
      between drawings which show the essential anatomical data and the computed
      tomography findings, supplying the necessary technical data to obtain veracious
      images which coincide with the surgeons' angle of view in the direct as well as
      in the endoscopic approach.

PMID- 8357633
TI  - [Comparative study of the effect of different chemical procedures on the
      antigenicity of allogenic transplants of the human trachea].
AB  - Replacement of long tracheal segments poses some unsolved problems, specially the
      undisponibility of an adequated substitution material. This study deals with some
      of the immunological aspects of the transplantation and preservation of human
      tracheal grafts. Since immunological rejection occurs in the first place as a
      consequence of incompatibility for class II antigens (HLA-DR, -DP and -DQ), their
      presence and distribution was studied using monoclonal antibodies and the
      immunoperoxidase method. Class II expressing cells were recognized in the mucosa
      and the mixed glandular tissue. Furthermore we investigated the influence of
      different preservation methods on the antigenicity of tracheal allografts. The
      results showed a total destruction of these antigens. We can conclude that
      chemically preserved human tracheal allografts are immunologically suitable for
      reconstructive surgery of the trachea.

PMID- 8357634
TI  - [Study of the vestibulospinal reflex. Clinical applications of posturography].
AB  - The vestibulo-spinal reflex is of great importance in maintaining balance--hence
      the interest in evaluating it objectively in patients suffering from vertigo. A
      review is made of the objective exploratory methods currently available, i.e.,
      static posturography, stimulation posturography, dynamic posturography and
      craneocorpography. The clinical applications of posturographyare discussed,
      fundamentally as applied to the diagnosis of central vestibular pathology,
      treatment planning and evolutive monitoriacion of the patient with vertigo.

PMID- 8357635
TI  - [Pseudosarcoma of the larynx. Presentation of two clinical cases in our service
      with distinct laryngeal localization].
AB  - We present two pseudosarcoma of larynx with different localization. Both with
      pedunculate morphologic, one in vocal cord true, another case in supraglottic.

PMID- 8357636
TI  - [Mucoepidermoid carcinoma of the larynx].
AB  - A case report of mucoepidermoid carcinoma of the larynx es presented and the
      literature reviewed. The inherent difficulties in histologic mucoepidermoid
      carcinoma is discussed. At the present time, mucoepidermoid carcinoma of the
      larynx should be regarded as a separate entity, its treatment based in
      histological grade as well as clinical behavior.

PMID- 8357637
TI  - [Malignant otitis externa with disfunction of the temporomandibular
      articulation].
AB  - Here we present a case of a female patient 70 years old stricken with diabetes
      mellitud 40 years of evolution with manifestations of malignant external otitis
      accompanied by disfunction of the temporomandibular articulation. Here we will
      show the clinical characteristics and the diagnosis in our patient likewise its
      treatment. We will expound the most important aspects of the entity at this
      present time.

PMID- 8357638
TI  - [Solitary extramedullary plasmacytoma of the larynx. Presentation of a clinical
      case].
AB  - Extramedullary plasma cell tumours are uncommon neoplasia. Their highest
      incidence is in the upper respiratory tract, specially in the nasal cavity,
      paranasal sinuses and nasopharynx. They represent the 4% of all the non
      epithelial tumours of this site. Their evolution is unsteady and a 30% of the
      cases develop into a multiple mieoloma.

PMID- 8357639
TI  - [Geographic distribution of mortality from cancer of the stomach and the colon in
      Spain].
AB  - The present study analyzes the mortality of gastric and colon cancer in Spain
      from 1975 to 1985, and examines the figures obtained for each Spanish province as
      well as in several major cities. During the study period, proportional mortality
      for all cancers increased, except for gastric cancer which decreased both for men
      and women. We found that Soria the highest mean mortality rate due to gastric
      cancer (81.83), whereas figures were highest for men in Segovia (97.71) and for
      women in Soria (66.69). By contrast, Gran Canaria had the lowest mean mortality
      rate due to gastric cancer (6.26), whereas lowest values were obtained for men in
      Tenerife (8.42) and for women in Gran Canaria (4.11). On the other hand, the
      highest mortality rate due to colon cancer was found in Gerona (19.11), and the
      sex distribution was as follows: for men the rate was highest in Gerona (22.22),
      and for women in Burgos (19.75). Albacete had the lowest mortality rate due to
      colon cancer (1.09); for men the lowest was obtained in Avila (1.20), and for
      women in Albacete (0.90). This geographical distribution suggest that
      environmental as well as dietary factors may play a role in cancer mortality.

PMID- 8357640
TI  - [Colorectal cancer in elderly patients: postoperative mortality and survival].
AB  - Twenty percent of colorectal cancers develop in elderly patients. Since the size
      of the geriatric population increases this percentage will get higher. The data
      collected from the Cantabria Colorectal Cancer Population Registry (1989-90) were
      divided into two groups: patients aged > or = 80 years at diagnosis and patients
      aged < 80. The postoperative mortality rates were 11% vs. 7%. Emergency surgery
      on patients over 80 years was associated with a significantly higher incidence of
      perioperative deaths (26%). Three-year survival rates for the two groups (20%)
      were not significantly different. These data suggest that elderly patients
      suffering from colorectal cancer can be treated by standard methods.

PMID- 8357641
TI  - [Effect of antibiotic prophylaxis with vancomycin on methicillin-resistant
      Staphylococcus aureus infection following liver transplantation].
AB  - An epidemic outbreak of Methicillin-resistant Staphylococcus Aureus (MRSA)
      infections affecting liver transplantation patients was detected in our hospital.
      In this study we describe the special characteristics of the infections and the
      results of prophylactic treatment with Vancomycin. Between april 1990 and
      december 1991, 47 patients with mean age of 54.4 +/- 10 years underwent liver
      transplantation. The patients were included in two chronological groups: 1) Group
      I: 20 patients not treated prophylactically with Vancomycin; 2) Group II: 27
      consecutive patients treated with Vancomycin. Systematical cultures of body
      fluids for bacteria and fungi were done in every patient, and were repeated after
      24 hours. The cultures were repeated again in case of sepsis. Group I patients
      had a significantly higher frequency of MRSA infections than group II patients.
      Furthermore, in patients with MRSA infection, independently of the group,
      duration of transplantation (p < 0.01), reoperations (p < 0.001) and prophylactic
      treatment with Vancomycin (p < 0.001) were significative factors. In conclusion,
      Vancomycin appears to be an elective prophylactic antibiotic in case of high risk
      of MRSA sepsis after liver transplantation.

PMID- 8357642
TI  - [Primary lithiasis of the choledochus: etiologic factors and structural
      characteristics].
AB  - OBJECTIVE: To study clinical and morphological characteristics of primary gall
      stones in the common bile duct in order to establish a differential diagnosis
      with migrating stones. DESIGN: To analyze a number of clinical parameters (age,
      parity, evolution, number of stones and diameter), qualitative parameters (sex,
      obesity, cholecystitis, cholangitis, liver disease or previous biliary surgery)
      and statistic evaluation. To show composition of stones throw stereomicroscope,
      electronic microscope and dispersion analysis by X-Ray. PATIENTS: We studied 56
      patients who were diagnosed and operated of choledocholithiasis. RESULTS: 21
      cases (37.5%) were considered as primary stones (group "a") and 35 (62.5%) were
      considered as migrating stones (group "b"). We have found significant statistical
      differences in relationship with the age of patients (p < 0.05) and diameter of
      stones (p < 0.01). They were both greater in primary stones, while the rest of
      parameters were not significant. Brown pigment stones dominate in primary stones
      followed by calcium palmitate and cholesterol stones. We identified bacteria or
      their traces (38.1%), foreign bodies (19.04%), carbonate of calcium (38.1%) and
      phosphate of calcium (9.5%). CONCLUSIONS: They are clinical and morphological
      characteristics which may differentiate between primary and migrating common duct
      stones. The high incidence of germs or foreign bodies found in the core layer of
      stones show their importance in the formation of brown pigment.

PMID- 8357643
TI  - [Long-term results of endoscopic sphincterotomy].
AB  - A review is made of the results of long-term endoscopic sphincterotomy. We
      studied 81 endoscopic sphincterotomies performed between 1980 and 1985. The
      technique performed, its indications and immediate complications were evaluated,
      along with the follow-up carried out in these patients (minimum 6 years). In view
      of the results obtained, the patients were classified as asymptomatic or
      symptomatic. Thus, immediate complications (21.9%) were all minor, with the
      exception of one case (1.2%) of severe complication due to acute pancreatitis.
      One death was recorded three days after sphincterotomy, corresponding to an
      elderly patient with in situ gallbladder as a consequence of biliary sepsis. In
      turn, 91.4% of the patients followed-up at long term remained asymptomatic. The
      overall results show the method to be effective, with few either immediate or
      long-term complications.

PMID- 8357644
TI  - [Methods to evaluate the hepatic metabolic capacity: pharmacologic tests].

PMID- 8357645
TI  - [Composite gastric lymphoma: MALT gastric lymphoma associated with Hodgkin's
      disease].
AB  - We report a case of MALT (Mucosa Associated Lymphocytic Tissue) gastric lymphoma
      which occurred in a 52-year-old woman, associated with Hodgkin's disease,
      Lymphocyte Predominant type, in epiploic nodes. Although many cases of composite
      lymphomas have been reported, we were not able to find cases of gastric MALT
      lymphoma associated with Hodgkin's disease. This is probably the first case
      reported in the literature.

PMID- 8357646
TI  - [Metachronous adenocarcinoma of the duodenum associated with previous colorectal
      carcinoma].
AB  - We present two patients who developed a carcinoma of the duodenum years after a
      colectomy was performed adenocarcinoma of the colon. Duodenal carcinoma has been
      reported in patients with villous tumor of the colon, familial adenomatous
      polyposis, Gardner's syndrome, celiac disease and Crohn's disease. A relationship
      between carcinoma of the Vater's ampulla and adenocarcinoma of the colon has also
      been reported. However, we have not found in the literature this association in
      patients without familial adenomatous polyposis or Gardner's syndrome.

PMID- 8357647
TI  - [Enteritis caused by small intestine irradiation].
AB  - Two cases of small bowel postradiation enteritis after abdominoperineal resection
      are presented. The interval between radiation of 60 Gy to the pelvis and perineal
      area and the occlusive symptoms were 3 and 6 years. One patient required a
      massive small bowel resection, and the second an ileo-transverse colon bypass.
      The first case had a partial dehiscence of the anastomosis, and the second a
      colonic fistula 8 months after surgery that closed after total parenteral
      nutrition. Both patients had abdominal wall closure defects.

PMID- 8357649
TI  - [Massive rectal hemorrhage caused by nonspecific colonic ulcers].
AB  - Nonspecific colon ulcers are a rare disease which may produce lower
      gastrointestinal bleeding. A history of previous nonsteroidal anti-inflammatory
      drugs ingestion may be recorded in most patients. The right colon is the main
      location, being the cecum the most frequent site. However, they may be
      distributed in all the large intestine, including the rectum. We present a case
      of lower massive gastrointestinal hemorrhage produced by nonspecific colic ulcers
      requiring emergency total colectomy. Although infrequent, they have to be
      considered in every patient with lower gastrointestinal bleeding and previous
      nonsteroidal anti-inflammatory drugs ingestion.

PMID- 8357648
TI  - [Peutz-Jeghers syndrome with malignization of hamartomatous polyp].
AB  - Peutz-Jeghers syndrome is characterized by hamartomatous polyps in the
      gastrointestinal tract associated with mucocutaneous melanin spots; the condition
      is inherited in an autosomic dominant fashion. Although the hamartomatous polyps
      are not regarded as malignant, there is an association between the Peutz-Jeghers
      syndrome and the development of carcinomas of the gastrointestinal tract.
      Similarly, there is an increasing evidence suggesting that hamartomas can give
      rise to adenocarcinomas. We present a patient with Peutz-Jeghers syndrome who
      developed an adenocarcinoma in an hamartomatous jejunal polyp.

PMID- 8357650
TI  - [Primary angiosarcoma of the spleen].
AB  - Primary spleen angiosarcoma is a malignant neoplasia based on vascular tissue and
      it is a rare tumor (65 cases published). The clinical aspects are obscure and the
      specific diagnosis is made by laparotomy. The prognosis is very poor in any case
      and survival isn't more than two years, whenever the spleen undergoes spontaneous
      rupture in which case the survival should be less than six months. The
      splenectomy before rupture could increase survival. Patients with or without
      metastatic disease may be treated by chemotherapy but with poor results.
      Radiotherapy is used for relief the pain produced for bone metastasis.

PMID- 8357651
TI  - [Colonoscopic diagnosis of the origin of a right inguinal abscess].

PMID- 8357652
TI  - [Basal and postprandial blood gastrin in duodenal ulcer].

PMID- 8357653
TI  - [Stercoral perforation of the colon].

PMID- 8357654
TI  - [Iron deficiency anemia as onset form of duodenal leiomyosarcoma].

PMID- 8357655
TI  - [Acute myocardial infarction following vasopressin injection for portal
      hypertension syndrome].

PMID- 8357656
TI  - [Incidence of digestive system neoplasms. Trends. Soria 1981-1990].
AB  - The aim of this study was to evaluate, to compare and to identify the various
      incidence rate trends in digestive tract malignant tumours in the province of
      Soria. Tumor sites and histological types, patient's age, sex and town and area
      residence were studied. All new cases of digestive tract malignant tumours were
      collected during the 1981-1990 period. 30.4% of all malignant tumours in men
      (1906 patients) and 29% in women (1,256 patients) came from digestive tract
      sites. Incidence rates for each site were calculated for the two 1981-1985 and
      1986-1990 subperiods. The histology, rates and trends of the tumours were
      compared with the other national and international cancer registries. Gastric
      cancer showed the highest adjusted rate for men (35.1 x 10(5) and colo-rectal
      cancer one for women (14.7 x 10(5). The lowest rates were for men in the
      gallbladder (0.5) and liver (1.1) sites; and for women in the gallbladder (1.6),
      whose diminishing trend was significant (2.92/0.75) (p < 0.05) and liver (0.5).
      Colorectal cancer showed a marked increase between the two subperiods for both
      sexes (men: 13.1/27.6) (women: 9.8/19.2). Pancreas cancer trends ascended for
      both sexes (men: 1.22/2.74) (women: 0.13/1.46). Gastric cancer rates in Soria are
      higher than the rest of the cancer registries in Spain while gallbladder, liver,
      and colorectal, cancer rates are one of the lowest for both sexes. Trends are
      significantly increasing in colorectal sites for both sexes (p < 0.01), and for
      women only in the pancreas (p < 0.05). The other cancer rate sites showed lesser
      variations and are not statistically significant.

PMID- 8357657
TI  - Comparison of clinical treatment decisions with US National Institutes of Health
      consensus indications for lower third molar removal.
AB  - Treatment decisions about lower third molar surgery have important clinical and
      cost implications. Although indications for surgery have been the subject of a
      National Institutes of Health (NIH) consensus conference at which several
      unambiguous criteria were agreed, no prospective investigations have been carried
      out to compare clinic treatment decisions with these consensus criteria.
      Treatment decisions made by six Hospital Service oral surgeons were therefore
      evaluated for 72 consecutive patients (28 men, 44 women) aged 15-44 years (mean
      age 25 years), referred for lower third molar assessment. The presence of local
      disease; recurrent pericoronitis; caries not amenable to restorative measures;
      follicular cyst formation; internal/external resorption and periodontal disease
      was recorded by an independent observer immediately after treatment planning had
      been completed. Of the 139 third molars present, 55 were unerupted, 79 partially
      erupted and 5 fully erupted. Thirty patients had been scheduled for surgery under
      general anaesthesia (GA), 36 under local anaesthesia and six patients had not
      been scheduled for surgery. A total of 42 teeth, according to NIH consensus
      criteria, had no indications for removal, of which 27 had been scheduled for
      surgery. These excluded disease-free contralateral teeth that had been scheduled
      for removal under GA. When a single episode of pericoronitis was excluded as a
      valid indication, 39 teeth did not meet criteria for removal but had been
      scheduled for surgery. It was concluded that two-thirds of lower third molars not
      meeting NIH consensus criteria for surgery had been scheduled for removal. The
      reasons for this, which may include inappropriate criteria, require further
      research.

PMID- 8357658
TI  - Allergy to octyl gallate causing stomatitis.
AB  - Octyl gallate is an antioxidant (European Community number 311). It is used as a
      preservation agent in a wide variety of foods and other non-dietary substances.
      We report a case of a 49-year-old female with a 10-year history of 'burning
      mouth' and clinical erythema of the tongue, who, after investigation, proved to
      be allergic to octyl gallate. Management with an exclusion diet proved effective
      in both controlling the burning sensation and resolving the erythema of the
      tongue.

PMID- 8357659
TI  - Dentistry down-under.
AB  - It was with some trepidation that I entered into private practice in the City of
      Perth, Western Australia. I had left behind a collapsing NHS style of dentistry
      in England, where the average high street dentist has to work increasingly harder
      and faster to maintain the same salary, with barely time for luxuries such as
      leisurely consultations with patients or experimenting with new equipment or
      materials.

PMID- 8357660
TI  - Dental needs in Bosnia.
AB  - The dental needs of the growing number of refugees in Bosnia-Hercegovina were all
      too apparent on my recent visit to work with children in Medugorje in the Mostar
      province of Hercegovina. While this area has not undergone the sustained
      destruction of central Bosnia it is a natural first haven for refugees from the
      fighting.

PMID- 8357661
TI  - Peace of mind.

PMID- 8357662
TI  - Research in general practice.

PMID- 8357663
TI  - From crisis to crisis.

PMID- 8357664
TI  - Treatment of a dental phobic with pronounced aversion to rubber gloves by
      swallowing relaxation in two appointments.
AB  - This case illustrates where excessive dental stress on the swallowing reflex
      caused retching then nausea and eventually dental phobia. Swallowing relaxation
      enabled normal variable function to be quickly restored, which rapidly cured the
      phobia.

PMID- 8357665
TI  - What value market research?
AB  - Whether you have just left your hotel, purchased a new car or eaten at a roadside
      cafe, the chances are someone will have asked your views about their services,
      products and delivery. Why? Perhaps because the market oriented business knows
      better than to assume it understands its customers. A safer approach is to seek
      their views through market research, and that is the approach the new Quality
      Development Awards initiated by the BDJ, Denplan and Colgate have taken.

PMID- 8357666
TI  - 'Dentists and general'.

PMID- 8357667
TI  - 'Mercury spillage'.

PMID- 8357668
TI  - 'Revised guidelines for HIV-infected health care workers'.

PMID- 8357669
TI  - 'Personal orthodontic audit: the first 100 cases'.

PMID- 8357670
TI  - Non-setting pastes.

PMID- 8357671
TI  - An investigation into sugar-containing and sugar-free over-the-counter medicines
      stocked and recommended by pharmacists in the north western region of England.
AB  - Sugar-containing paediatric medicines can contribute to the aetiology of dental
      caries, and as many are sold over-the-counter (OTC) as are prescribed. This study
      evaluated a dental health education initiative among pharmacists in the north
      west of England in an effort to increase the sales of sugar-free preparations. It
      also investigated the stocks they held, their recommendations to their customers
      and their knowledge of, and attitudes to, sugar in medicine as a cause of dental
      caries. Following a baseline questionnaire, a randomly selected group of
      pharmacists were sent a dental health education leaflet informing them of the
      role of sugar-containing medicines in the aetiology of dental caries and a list
      of sugar-free alternatives which they were asked to stock and recommend. Twelve
      months later, a second questionnaire was completed by both the test and control
      groups of pharmacists. The most commonly stocked and recommended OTC paediatric
      medicines contained sugar. Of the 14 preparations stocked by over 90% of the
      pharmacists only two were sugar-free. During the year of the study the mean
      number of sugar-free medicines stocked by the pharmacists in the test group
      reduced from 7.70 to 7.12 (P < 0.05) and in the control group from 8.39 to 7.45
      (P < 0.05). Seventy-seven per cent of the pharmacists thought that sugar in
      medicines could contribute to caries, but recommended sugar-containing
      preparations more frequently than sugar-free alternatives. The dental profession
      needs to actively promote medicines that are sugar-free if there is to be a
      change from the use of iatrogenic sugar-containing preparations.

PMID- 8357672
TI  - A follow-up study of incisor teeth which had been treated by apical closure and
      root filling.
AB  - A follow-up study was conducted of 93 non-vital immature incisor teeth treated by
      apical closure and root filling. Only six teeth had been lost and these losses
      were due to trauma, failed restorative treatment or root resorption. Life table
      analysis suggested that 86% of teeth would still be present after 5 years. The
      number of teeth at risk was too small after 5 years to provide precise enough
      estimates of the percentage of survivors.

PMID- 8357673
TI  - Panorama: a retrospect.

PMID- 8357674
TI  - Deafness and dentistry.
AB  - An article published last year in the British Medical Journal has illustrated
      that severe deafness does not preclude a career in medicine. My own experience
      and that of others prompts me to write that the same is true of dentistry. For
      patients who are deaf, dentists need to be aware of simple measures that may ease
      communication and avoid misunderstanding.

PMID- 8357675
TI  - 'Temporomandibular joint and orofacial pain'.

PMID- 8357676
TI  - 'A comparative study in the treatment of acute dentoalveolar infection'.

PMID- 8357677
TI  - Glass ionomer cement.

PMID- 8357678
TI  - A clinical trial of prostaglandin E2 in recurrent aphthous ulceration.
AB  - Thirty-five patients suffering from minor recurrent aphthous ulceration (RAU)
      entered a single-phase double-blind clinical trial of treatment with topical
      prostaglandin E2 (PGE2). The PGE2 was applied as a gel at a dose of 0.3 mg twice
      daily for 10 days. The vehicle alone acted as control. Patients were examined on
      days 1, 3, 5, 7 and 10 and also maintained daily diary cards. Of the 33 patients
      (94%) who completed the study, 18 had been allocated the active PGE2 and 15 the
      placebo. The two volunteers who failed to complete were excluded on technical
      grounds related to the strict study design and did not withdraw on the basis of
      adverse reactions to the trial preparation. Patients using the active PGE2 gel
      experienced significantly fewer new lesions than those on placebo (P < 0.05) over
      the 10-day trial period. There were no significant differences between the PGE2
      and placebo gels in terms of speed of healing or pain relief of established
      aphthous ulcers. Prostaglandin E2 may, therefore, have useful prophylactic
      activity in RAU.

PMID- 8357679
TI  - A rare complication of dental treatment: Streptococcus oralis meningitis.
AB  - A case of Streptococcus oralis meningitis is reported. This followed extraction
      of a normal tooth during routine orthodontic treatment. No focus of infection
      could be demonstrated, either local to or distant from the extraction site. Full
      recovery followed hospital admission and intravenous benzyl penicillin.

PMID- 8357680
TI  - Dentistry and anaesthesia.

PMID- 8357681
TI  - 'Extended duties' orthodontic auxiliaries--an insight into the training and
      practice in America and Canada.

PMID- 8357682
TI  - Personnel auxiliary to dentistry.

PMID- 8357683
TI  - [Results of treatment of multiple ventral shoulder dislocation and surgical
      stabilization by Weber rotational osteotomy. 78th Annual Meeting of the Swiss
      Society of Trauma Surgery and Occupational Diseases 4-5 September 1992 in Olten].
AB  - The treatment of recurrent anterior shoulder dislocation with the rotational
      humeral osteotomie by Weber showed best results in the follow-up of 53 operations
      when combined with a shortening of the capsule and the musculus subscapularis.
      Rotational humeral osteotomie alone showed in 20% redislocations. The rate of
      redislocation could significantly be reduced by additional shortening of the soft
      tissue.

PMID- 8357685
TI  - [Differential diagnosis and therapy of multi-fragment humeral head fracture--an
      analysis of three clinical studies].
AB  - Out of the total number of patients of three Centers for Orthopaedic and Trauma
      Surgery, 93 comminuted humeral head fractures were clinically and radiologically
      controlled by means of a retrospective analysis. The classification of the
      fractures was made according to C.S. Neer, the clinical evaluation according to
      the Constant-Score. The analysis of the results in relation to the respective
      therapeutic methods revealed fundamental differences between the various types of
      fractures depending on the number of fragments. The prognosis of the three-part
      fractures appears essentially determined by the biomechanical conditions. This
      means that the therapeutic method has to be applied according to the restitution
      of the respective position of the fragments. Open reduction and internal fixation
      (mean Constant-Score 83 resp 91 points) or conservative treatment (78 points)
      seem to be primarily indicated in these cases. The prognosis of the four-part
      fractures, on the contrary, is largely determined by the problems of vascular
      supply of the head fragment, with a high risk of a humeral head necrosis. For
      this reason a primary prosthetic replacement (mean Constant-Score in case of
      primary implantation 75 points, compared with 54 points in case of conservative
      treatment and 52 points for open reduction and internal fixation), should be
      recommended for this type of fracture. For therapeutic and prognostic reasons,
      fractures at the proximal end of the humerus require an exact classification on
      the radiological basis of at least a so-called "trauma series". However, for a
      more accurate visualisation especially of the region of the lesser tuberosity
      (which is difficult to assess by means of conventional radiology), and
      consequently for the precise determination of the number of fracture-parts and
      their respective positions, we consider a CT Scan to be compulsory.

PMID- 8357684
TI  - [Fractures of the scapula and injuries of the acromioclavicular joint. The
      traumatized shoulder and its sequelae].
AB  - Fractures of the scapula are rare and mainly result from a severe direct trauma.
      Most fractures may be treated non-operatively, only severely displaced and
      unstable fractures of the neck and/or the clavicula, unstable intraarticular
      fractures of the glenoid or open fractures (especially in combination with
      neurovascular lesions) should be fixed operatively. A dislocated fracture of the
      clavicula or glenoid should be approached first ventrally. Displaced fractures of
      the neck and body may also require an open reduction and fixation through a
      dorsal approach. Careful preoperative planning and anatomical studies are
      required to prevent intraoperative damage of innervation and vascularization.
      Cannulated single screws, 1/3 tubular plates or 3.5 LC-DC plates are recommended
      for the stable fixation of the scapula, whereas a Bosworth screw or a hook plate
      are helpful to stabilize the lateral clavicula and the acromioclavicular joint.
      Postoperative treatment: Temporary immobilization in a Gilchrist or Desault
      bandage for about 3 to 4 days thereafter careful passive and active mobilization.

PMID- 8357686
TI  - [Possibilities of shoulder arthroscopy in comparison with magnetic resonance
      tomography and arthro-computerized tomography].
AB  - In the last 15 years the methods of examination of the shoulder have intensively
      expounded. According to a well documented retrospective study we describe the
      value of the shoulder arthroscopy and its correlation to MRI and arthro-CT
      findings. MRI represents nowadays the best way of exploring rotator cuff lesions
      and of investigating an impingement syndrome. Associated with a contrast medium
      its ability to clear up an anterior or posterior shoulder instability is now
      superior to the arthro-CT's. The arthroscopy allows the dynamic exploration of
      the joint and can be used not only as a diagnostic but also as a therapeutic
      procedure.

PMID- 8357687
TI  - [Long-term results of replacement of the head of the radius with a silastic
      prosthesis].
AB  - 22 patients after head fracture were treated with replacement of the radial head
      by a silastic prosthesis. 11 patients were followed up after 91 +/- 48.8 months.
      The results are good to excellent. Twice a fracture of the prosthesis was
      detected at control. No prosthetic synovitis occurred in our patients.

PMID- 8357688
TI  - [The AO universal femur intramedullary nail: problems and their amelioration.
      Retrospective quality control study of 57 femur shaft fractures].
AB  - Today intramedullary nailing is considered the treatment method of choice in
      fractures of the femoral diaphysis. In this retrospective quality control study
      57 femoral fractures treated with the AO-Universal Femoral Nail have been
      reviewed. The average follow up time was 2.9 years. Intramedullary nailing was
      done as a primary procedure in 40 cases and in 17 cases as a secondary procedure
      following various initial operations. The results were evaluated according to the
      Stromsoe score. 27 of the 40 primary procedures went on to an uneventful healing
      and showed good to excellent final result. Technical errors (7), non-unions (4)
      and 1 deep infection required various secondary procedures. Thereafter the final
      number of good to excellent results amounted to 35 out of 40 patients. In the
      group with secondary i.m. nailing 9 out of 17 patients showed a good to excellent
      final result. 2 non unions persisted. In conclusion the AO-Universal Femoral Nail
      proved to be suited for the treatment of femoral shaft fractures for both primary
      and secondary procedures. In this series, however, technical imperfections led to
      a high rate of secondary procedures. Strict observation of the recommended
      operative technique is therefore mandatory.

PMID- 8357689
TI  - Effect of direct current stimulation on triradiate physeal cartilage. In vivo
      study in young rabbits.
AB  - Electrical stimulation with 8 microA direct current was applied to the triradiate
      physeal cartilage of young rabbits for periods of 3, 4, and 5 weeks. The effect
      was evaluated by morphometric measurement and histological observation. We tried
      to improve some previously described technical problems (e.g., movement of
      electrode during experiment) in this model of the growing acetabulum.
      Statistically significant differences in acetabular depth were found between the
      experimental and the control side in the 3-week group, but no obvious differences
      were found among the other measurements. Characteristic thickening of the growing
      physeal cartilage, especially proliferating cells, was found in the stimulated
      sides. Electricity affects the cell behavior in the triradiate physeal cartilage
      as well as the growth plate of long bone, but further study is still necessary to
      find more appropriate conditions to gain actual growth.

PMID- 8357690
TI  - Cellular and humoral immune responses after fresh meniscal allografts in mice. A
      preliminary report.
AB  - To date, no study of allogeneic meniscal transplantation has investigated both
      the host cellular immune response and the humoral immune response. Using inbred
      mice, we examined cellular immunity to meniscal allografts by assaying mixed
      lymphocyte culture and investigated humoral immunity through a complement
      dependent cytotoxicity test. The level of the stimulation index of the mixed
      lymphocyte culture seen after placing fresh meniscal allografts subcutaneously
      was not significantly higher than when isograft controls were similarly placed.
      Following placement of the allografts, no specific antibodies were detected in
      serum throughout the 24-week period after grafting. Thus, in mice, fresh meniscus
      apparently is not immunogenic. Our results tentatively suggest that a fresh
      allogeneic meniscus might be transplanted without any special treatment to
      decrease its immunogenicity.

PMID- 8357691
TI  - Allograft in the treatment of benign cystic lesions of bone.
AB  - Seventeen patients with benign cystic osseous lesions were treated by curettage
      and grafting using allogenic decalcified bone. Human bones were partially
      decalcified using 0.6 N HCl and preserved in 90% ethanol in a deep freezer at -16
      degrees C. The cystic lesions were: 5 cases of fibrous dysplasia, 4 aneurysmal
      bone cysts, 3 simple bone cysts, 2 giant-cell tumours, 1 chondromyxoid fibroma, 1
      non-ossifying fibroma and 1 fibrous cortical defect. The bones involved were:
      femur, tibia, humerus, fibula and calcaneum. Infection was a complication in
      three patients. In two of these it did not interfere with healing, but in one it
      persisted for more than 1 year with partial resorption of the graft. The time to
      adequate incorporation of the graft varied from 6 to 9 months in children and 9
      to 15 months in adults. The overall response compares favourably with that to
      allograft from more sophisticated bone banks.

PMID- 8357692
TI  - Different healing patterns of experimental osteotomies treated by intramedullary
      nailing.
AB  - The healing of 52 diaphyseal osteotomies in rabbit tibiae was followed up
      histologically from 3 to 24 weeks after rigid intramedullary nailing. The
      histological evaluation was made from longitudinal sections through the osteotomy
      area. Particular attention was paid to the fracture healing pattern. A bulky
      periosteal response was visible in every specimen. At 24 weeks, the external
      callus was always well remodeled. The osteotomy line rapidly filled with bone
      from 6 weeks onwards. At 24 weeks, the site of osteotomy was detectable only on
      the basis of slight irregularity in the cortex. The secondary gap healing seen in
      19 specimens was the most common type of bone union from 6 weeks onwards. In 13
      specimens, the exact type of osteonal healing was not definable, since a solid
      union with good cortical reconstruction was always the final outcome. Altogether,
      four nonunions were detected throughout the study, none of these, however, in the
      specimens at 24 weeks. Considerable endosteal resorption was detected at 24
      weeks, at which time at least one third of the original cortex had disappeared in
      all specimens. The rigid nail seems to ensure a relatively uneventful healing of
      the experimental osteotomies. Vast endosteal resorption and some nonunions make
      the use of medullary reaming in this connection doubtful.

PMID- 8357693
TI  - Foot and ankle fusions in Charcot-Marie-Tooth disease.
AB  - We reviewed 15 patients with Charcot-Marie-Tooth disease who were treated with
      foot or ankle fusions. Altogether, 26 feet were treated with fusions and the
      average follow-up time was 14 years. In half of the patients the principal
      symptom leading to fusion operation was instability of the ankle. In four
      patients, in two of them bilaterally, soft tissue corrections were performed
      before the fusion. In 21 cases, a subtalar triple arthrodesis was performed and
      each time correction to neutral position was the aim. In six feet, the triple
      arthrodesis was complemented by soft tissue plasties, e.g., plantar release,
      Achilles elongation, or transposition of tibial or peroneal tendons in order to
      achieve proper balance. Other primary fusions were a Grice-type fusion in one
      case, pantalar arthrodesis in one case, talocrural fusion in one case, and
      interphalangeal fusions in both feet in one patient with extreme claw foot. In
      four cases the triple arthrodesis failed to fuse (three nonunions and one delayed
      union), and new fusions were successful in three of them. The one pantalar fusion
      in the series was done for a 58-year-old man with late onset of the disease who
      had a very severe cavovarus deformity at the time of the operation, and this
      fusion failed to unite. In 17 of 26 feet, other operations than the primary
      fusion were performed, and five feet were operated on three or four times. In
      four feet the result was judged as excellent, in 15 good, in four fair, and in
      three poor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357694
TI  - Usefulness of MRI in the preoperative diagnosis of cervical disk herniation.
AB  - We investigated the preoperative diagnostic value of MRI, myelography, and CT
      myelography (CTM) in a retrospective analysis of 17 patients (15 men and two
      women) who were surgically treated for cervical disk herniation. Their ages
      ranged from 29 to 63 years, with a mean of 49 years. Anterior interbody fusion
      using iliac bone grafts was performed following microscopic diskectomy in all
      patients. MRI, myelography, and CTM were performed in 13 patients, while four
      patients were operated on after MRI alone. Neurological improvement was observed
      in all 17 patients after the surgery. MRI proved useful for determining the level
      of symptomatic cervical disk herniation. Surgery can be carried out on the basis
      of MRI findings alone when there is disk herniation at a single level which
      corresponds with the patient's symptoms and signs.

PMID- 8357695
TI  - Acute torticollis in children due to atlanto-axial rotary fixation.
AB  - Acute, painful torticollis in a child is not uncommon. When no local changes can
      explain the disease, atlanto-axial rotary fixation should be considered. The
      position of the head is typical but the roentgenological diagnosis is difficult,
      and as early treatment is mandatory, it should be initiated even if the
      roentgenogram is "normal". We present a review of nine patients.

PMID- 8357696
TI  - Surgical treatment of acute type-V acromioclavicular injuries in athletes.
AB  - In a prospective study, 18 consecutive athletes with an acute type-V
      acromioclavicular sprain were treated with a coracoclavicular repair using a
      double velour Dacron graft. All patients were reviewed after a mean follow-up
      period of 6 years (range: 2-9 years). At follow-up, 12 patients (66.7%) showed a
      good or excellent result according to the Imatani evaluation system, and six
      patients (33.3%) demonstrated a fair or poor result according to the same system.
      Loss of reduction was encountered in eight shoulders (44.4%) despite an initial
      anatomical reduction. No correlation was seen between the overall scores at
      follow-up and the degree of residual dislocation, between the overall scores and
      the presence of coracoclavicular calcifications or ossifications, between the
      overall scores and the development of post-traumatic arthritic changes, or
      between the overall scores and the presence of osteolysis of the distal clavicle.

PMID- 8357697
TI  - Accelerometric assessment of osseous union.
AB  - Study of the dynamic structure response of the long bone has demonstrated the
      potential to provide an objective quantitative test of fracture healing. The
      method described consists of monitoring the propagation of a mechanical wave
      across the fracture site. This wave--generated by the fall of a steel ball from a
      constant height on a subcutaneous bony protuberance--was monitored on the side
      opposite the fracture gap by a light-weight accelerometer and traced on a beam
      storage oscilloscope. The signals received were found to correlate linearly with
      the different stages of the fracture welding, as shown by accepted clinical and
      radiological practice. It seems feasible that the method, being noninvasive,
      reproducible, simple, painless, and inexpensive, may be used to measure the
      parameters of fracture healing that are of clinical and scientific interest.

PMID- 8357698
TI  - Ulnar-shortening osteotomy after fracture of the distal radius.
AB  - The ulnar impingement syndrome due to a relatively long ulna is one of the
      complications of a fracture of the distal radius. We performed ten ulnar
      shortening osteotomies to restore distal radioulnar joint congruity. The mean
      relative ulna length was 4-5 mm. Insufficient bone healing was encountered in
      four osteotomies. Replating and cancellous bone grafting was necessary in two
      cases because of nonunion. The functional outcomes were good in six, fair in two,
      and poor in two cases. Nonunion and poor functional outcome were related to a
      malunion of the radius with a volar radiocarpal angle of 20 degrees or 25
      degrees. It appeared that incongruity of the distal radioulnar joint favored
      nonunion.

PMID- 8357699
TI  - Traumatic anterior dislocation of the shoulder in a child.
AB  - Dislocation of the shoulder joint is a rare occurrence in children. This paper
      reports on traumatic anterior dislocation of the shoulder in a 3-year-old boy and
      a 9-year-old boy, together with a discussion of the relevant literature.

PMID- 8357700
TI  - Spontaneous regression of aneurysmal bone cyst. A case report.
AB  - Generally, aneurysmal bone cyst is considered to be a benign lesion that occurs
      rarely. Its etiology and treatment vary considerably, but curettage and grafting
      is the widely accepted treatment. Due to the nature of the disease recurrence is
      always expected. It rarely regresses and we report here a case that showed an
      improvement spontaneously after open biopsy. Follow-up for more than 4 years has
      shown no progression.

PMID- 8357701
TI  - High resolution EEG.

PMID- 8357702
TI  - The estimation of a realistic localization of dipole layers within the brain
      based on functional (EEG, MEG) and structural (MRI) data: a preliminary note.

PMID- 8357703
TI  - Models of source currents in the brain.
AB  - Electroencephalography (EEG) and magnetoencephalography (MEG) provide signals
      that are weighted integrals of source currents in the brain. In addition to
      technical aspects, the two methods differ in their sensitivities to various
      cerebral sources. Moreover, it is more difficult to determine the lead fields of
      EEG than of MEG. If it can be assumed that only one localized source is active at
      a particular time, the source location, direction, and amplitude can be found
      with the dipole model. However, if the assumption of a single localized source is
      violated, erroneous results are obtained. If a few sources are responsible for
      the measured fields, multiple-dipole models can be used. In the general case one
      must start from the fundamentals of estimation theory. The use of a priori
      information, together with experimental data, will provide the best possible
      solution to the inverse problem. In the case of minimal prior information, the so
      called minimum-norm solution is obtained. With the help of supplementary
      information, the resolution can be further improved.

PMID- 8357704
TI  - The influence of the volume conductor on electric source estimation.

PMID- 8357705
TI  - EEG/EP: new techniques.
AB  - The topographic analysis of electrical brain activity consists of the extraction
      of quantitative features which adequately describe the scalp recorded electrical
      fields of the brain. In the beginning of brain electrical activity mapping most
      methods centered mainly around the graphical display of multichannel EEG and
      evoked potential data. Meanwhile quantitative analysis strategies have been
      developed, and such methods are applied to topographic EEG and evoked potential
      data enabling the statistical evaluation of the effects of different experimental
      conditions as well as the comparison of various clinical populations. Major new
      analysis techniques comprise the computation of global field power and global
      dissimilarity for determination of components of evoked potential fields, the
      segmentation of map series by topographical features, time range analysis, FFT
      approximation for the spatial analysis of EEG frequency bands as well as
      correlation analysis and spatial principal components analysis (Spatial PCA).
      Data from experiments dealing with evoked brain activity will illustrate the
      application of these quantitative methods that also can be used for the analysis
      of the spontaneous EEG.

PMID- 8357706
TI  - MEG: new techniques.

PMID- 8357707
TI  - Equivalent dipole source localization of EEG and evoked potentials: sources of
      errors or sources with confidence?

PMID- 8357709
TI  - Magnetic source imaging based on the minimum-norm least-squares inverse.
AB  - The flow of ionic currents within the neurons of cerebral cortex produces a
      magnetic field that can be detected outside the human scalp. The dominant
      contribution is attributed to pyramidal cells, which are preferentially oriented
      perpendicular to the cortical surface. In general, it is not possible to deduce a
      unique representation of the spatial configuration of these cortical sources from
      a measurement of their field pattern alone. However, accurate a priori knowledge
      of the geometry of the underlying cerebral cortex makes it possible to infer the
      spatial configuration of these transcortical current sources, moment by moment,
      without imposing a simplified model such as a small set of current dipoles. To
      achieve such a realistic magnetic source image, we have introduced what we call
      the "Minimum-Norm Least-Squares Inverse" (MNLS inverse) for the magnetic problem.
      The MNLS inverse provides the least residual error in accounting for the measured
      field pattern, with a source current distribution having minimum power. An
      extension of this procedure provides an inverse solution for average field power,
      as opposed to field per se. This makes it possible to define spatial
      configurations of spontaneous cortical activity not phase-locked to a sensory
      stimulus. Rhythmic activity such as the occipital alpha rhythm is one example.
      Thus, it is possible to determine spatial patterns of enhanced or suppressed
      cortical rhythms that accompany cognitive processes and some pathological
      conditions. This paper provides the necessary background for understanding these
      recent developments, as well as examples of how they might be used.

PMID- 8357708
TI  - Comparison of high resolution EEG methods having different theoretical bases.
AB  - Mathematically simulated data is used to obtain direct comparisons of the
      accuracies of spline/Laplacian and cortical imaging algorithms in predicting
      cortical potential. Even though the two approaches have quite different
      theoretical bases, the two methods provide nearly identical estimates of cortical
      activity at scales greater than about 2 or 3 cm when 64 electrodes are used.

PMID- 8357710
TI  - Empirical bases for constraints in current-imaging algorithms.

PMID- 8357711
TI  - Magnetoencephalography using high temperature rf SQUIDs.
AB  - We have developed high-critical-temperature radio-frequency Super conducting
      QUantum Interference Devices (SQUIDs) with step-edge grain-boundary Josephson
      junctions and large flux focusers. These planar devices were fabricated from
      epitaxial YBa2Cu3O7 films and operated in the magnetometer and first-order
      gradiometer configurations while immersed in liquid nitrogen. At the temperature
      of 77K, we have attained a magnetic field resolution for the magnetometer better
      than 200 fT/Hz1/2 down to less than 1 Hz, i.e., over the low signal frequency
      range important for medical diagnostics. The results to date show a high promise
      for biomagnetic diagnostics. For the first time, we recorded the evoked responses
      from human brains using a high-temperature magnetometer and a first-order
      electronic gradiometer channel simultaneously. These results were obtained in a
      magnetically shielded room. An improvement in the magnetic field resolution by
      another order of magnitude is possible and probable.

PMID- 8357712
TI  - Topography and source analysis of brain activity associated with selective
      spatial attention and memory search.
AB  - We investigated the topographical aspects of the ERP reflections of visual
      spatial attention and memory search. Spatial attention was found to enhance the
      amplitudes of the P1 and N1 deflections. The brain activity in the P1-N1 latency
      range could be modeled with a single moving equivalent dipole, or alternatively
      with two stationary dipoles in a spatio-temporal dipole model. The dipoles were
      located in mesial and lateral posterior brain regions. Similar dipole solutions
      were obtained for ERPs to attended and unattended stimuli. Increasing the memory
      search requirements of the task resulted in an increase of late negativity, which
      was topographically distinguishable from the P3 component.

PMID- 8357713
TI  - EEG reactivity in high and low symptomatic schizophrenics, using source modelling
      in the frequency domain.
AB  - A dipole localization method in the frequency domain was used (FFT Dipole
      Approximation) to assess spatial differences in the spectral EEG reactivity
      (orienting response) between high and low symptomatic schizophrenics. Frequency
      bands of interest were determined empirically by comparing the two dichotomized
      patient groups with two matched control groups. Evidence for a correlation
      between EEG reactivity and severity of schizophrenic symptomatology was found,
      especially in the higher beta frequency range (16-25.5 Hz). Opposite effects were
      found in the two beta ranges of 20.5-22.5 Hz and 23.0-25.5 Hz, supporting the
      hypothesis that different EEG frequency bands have specific functional
      significances and that these bands are not necessarily those that are
      conventionally selected.

PMID- 8357714
TI  - Dynamic changes of alpha power as a probe of linguistic processes in normal and
      dyslexic children.

PMID- 8357716
TI  - Localization of topographic quantitative EEG in neurological disorders.

PMID- 8357715
TI  - Brain electrical correlates of psychological measures: strategies and problems.
AB  - We explore relationships between brain electrical activity and cognitive
      performance where qEEG data are correlated with psychological variables gathered
      at a different time. For a population of 202 healthy adults using univariate and
      multivariate correlation techniques in a split half replication design, we
      confirm prior findings that subjects with better psychological scores show
      shorter evoked potential (EP) latency, suggesting that speed of processing is an
      important factor in cognitive performance. By canonical correlation we
      demonstrate a consistent, replicable relationship between electrophysiological
      and behavioral data. We suggest that reliance upon univariate correlation may
      have fueled early controversies about relationships between electrophysiology and
      IQ. In addition we correlate psychological factors with the entire qEEG data set
      (both EP and spectral analyzed EEG) and demonstrate the use a multidimensional
      image graphics techniques to assist in visual assessment of the resulting
      correlation matrices.

PMID- 8357717
TI  - Models of brain sources.
AB  - Two categories of models are available for the functional imaging of scalp
      recorded electric brain activity: single-time-point and spatio-temporal.
      Instantaneous models require strict assumptions that do not conform with the
      underlying physiology, because they rely on the few voltage differences measured
      at only one sampling point. Spatio-temporal models create a spatial image of
      discrete multiple sources and a temporal image of source current wave forms which
      reflect the time course of the local activity in circumscribed brain areas at a
      macroscopic level. The spatial image may be limited in accuracy because it
      depends both on model and data, but it can be validated by scanning the brain
      with regional dipole sources. In many cases of temporal lobe epilepsy, for
      example, interictal spikes can be described adequately by as few as two
      equivalent dipoles, which image the vertical source current arising from the
      medio-basal aspect of the temporal lobe and the horizontal source current from
      its lateral surface.

PMID- 8357718
TI  - Clinical applications of MEG in epilepsy.

PMID- 8357719
TI  - Expectancy revisited.

PMID- 8357720
TI  - CHIRBASE, a graphical molecular database on the separation of enantiomers by
      liquid-, supercritical fluid-, and gas chromatography.
AB  - In order to cope with the increasing number of publications on the separation of
      enantiomers by chromatography on a chiral stationary phase, the graphical
      molecular database CHIRBASE was created. In the present state, the database
      package covers information (structural, bibliographic, and chromatographic data)
      on liquid-, supercritical fluid-, and gas chromatography; other methods will
      follow. CHIRBASE, running on the MDL software Chembase, meets the requirements of
      contemporary information management in the chemical and pharmaceutical industry.
      (Detailed information including a demo-version of each part of CHIRBASE can be
      obtained from the authors on request).

PMID- 8357721
TI  - [Incentives and competition mechanisms].

PMID- 8357722
TI  - [Neuroblastoma in childhood. Review of clinical aspects and of 2 forms of
      treatment].
AB  - The optimum time for a surgical resection of the primary lesion in the advanced
      neuroblastoma has not been defined properly. Recently the therapeutic results of
      the advanced neuroblastoma have improved through the use of preoperative
      chemotherapy. We check on our patients who were affected by this disease in the
      last 15 years. From 185 malignant tumours diagnosed in our department, 52
      belonged to neuroblastomas with more than 12 months of evolution. Most of them
      were diagnosed during the year after their birth and it was not observed a
      difference of sexes. The location was the habitual one, except 2 cases of
      thoracoabdominal tumour and 1 of stesioneuroblastoma the most common
      manifestation was the metastatic disease. Catecholamines in 24 hours urine were
      positive in 74% of our patients, and enolase in 100% of the same ones. The
      longest percentage of patients is distributed in the advanced stages of Evans.

PMID- 8357723
TI  - [Complications of the use of implantable reservoirs of central venous access++ in
      pediatrics: causes and treatment].
AB  - The use of a totally implantable reservoir venous system (RIAV) in children
      improved the quality of life of a large group of patients undergoing long-term
      drug therapy. We have routinely used RIAV in the last four years with specific
      therapeutic indications. One hundred and seven Low Profile model Port-a-Cath
      (PAC) and two PAS-Port were followed in 104 patients, for a total of 43.000 days,
      i.e. 395 days per system. Complications which arose in our series were classified
      as severe (requiring system withdrawal) and slight (resolved medically). There
      were 17 severe complications: 9 obstructions, 5 infections, 2 skin necrosis and 1
      catheter roture, and 5 slight complications including 2 obstructions, 2 system
      infections and 1 haematoma. Analysis of complications provided the experience
      necessary to establish a protocol, in order to reduce the number of catheter
      withdrawals to a minimum.

PMID- 8357724
TI  - [Biliary complications in hepatic transplantation in children].
AB  - Biliary reconstruction continuous to be a source of severe complications in
      paediatric liver transplantation (PLT). Five (7%) biliary complications in 70 PLT
      in patients aged from 8 months to 13 years with a body weight of 4-37 Kg. were
      studied. End-to-end common duct anastomosis (group I) with Kehr drainage was
      performed in 18 cases. End-to-side common duct jejunostomy (group II) was
      performed in the remaining 52 cases. In this group, two patients were found to
      have stenosis and biliary stones or sludge respectively and one obstruction with
      sludge without evident stenosis. All cases required surgery and there was no
      mortality. Transparietohepatic cholangiography has provided early diagnosis of
      these complications and has proved to be a reliable method of choice. The use of
      inert biological material in Kher tubes and steroids slow down the organization
      of a fistulous tract, thereby causing the complications which arose in group I.

PMID- 8357725
TI  - [Barrett++ esophagus in children. Presentation of 12 cases].
AB  - This paper describes 12 cases of Barrett's oesophagus selected out of a
      population of 364 refluxing children studied from 1986 to 1990. Their mean age
      was 14, seven were cared for in special institutions for brain damaged and 2 had
      been operated upon for oesophageal atresia at birth. Excessive acid exposure was
      documented in 8/10 patient studied and simultaneous gastric and oesophageal pH
      monitoring demonstrated massive duodeno-gastric alkaline reflux in 3.
      Histological studies revealed that columnar-lined epithelium was of fundic type
      in 2 cases, of junctional type in 7 and of specialized type in three.
      Helicobacter pylori was found in the mucosa of 8 patients. The present series
      confirms that BE should be looked for endoscopically in children with GER and
      provides further evidence of the long duration of GER disease and the excessive
      acid-alkaline chemical exposure of the oesophageal lining in the pathogenesis of
      mucosal changes.

PMID- 8357726
TI  - [Treatment of colonic atresia. Report of 3 cases].
AB  - Atresia of the colon (AC) is an uncommon cause of neonatal intestinal obstruction
      requiring prompt surgery. However, its optimal operative management is matter of
      discussion. We report the surgical therapy and evolution of three cases
      successfully treated at our department. A type I case was submitted to a
      coloplasty plus resection of the diaphragm; two cases of type III underwent a two
      staged procedure, i.e., colostomy with subsequent anastomosis without resection.
      After analysing the different operative procedures we suggest that a colostomy
      with later establishment of intestinal continuity may be an advantageous
      procedure even in the healthy patients with proximal lesions. A coloplasty is a
      safe alternative to type I atresias.

PMID- 8357727
TI  - [Bladder psoas hitch. Report of 11 cases].
AB  - Bladder psoas hitch is an surgical technique which, in very complicated cases,
      like repeated failures of vesico-ureteral re-implants or undiversions, allow us
      to bridge the shortness of the ureter and obtain a good vesico-ureteral
      reimplant. The surgical maneuver is described and several of the 11 cases
      operated by this technique are commented. The results are presented.

PMID- 8357728
TI  - [Airway obstruction associated with gastroesophageal reflux: experimental study].
AB  - Gastro-oesophageal reflux (GER) frequently complicates the clinical course of
      children suffering from conditions leading to upper airway obstruction (UAO)
      (choanal atresia, tracheomalacia, oesophageal atresia, vascular rings etc.). In
      an attempt to explore whether partial airway obstruction causes changes in the
      normal thoraco-abdominal pressure gradients, we measured end-inspiratory
      intrathoracic and intra-abdominal pressures in anesthesized rats under
      spontaneous breathing conditions, after tracheostomy and under upper airway
      obstruction induced by tracheal intubation with three progressively narrower
      cannulae (inner diameters 1.0 mm, 0.5 mm. and 0.2 mm.). We also measured the
      lower oesophageal sphincter pressure (LESP) and length (LESL) and calculated the
      thoraco-abdominal end-inspiratory pressure gradient (TAEIPG). Neither LESP nor
      LESL changed significantly before or after maximal tracheal obstruction but
      TAEIPG significantly increased from 5.58 +/- 1.34 cm H2O to 17.62 +/- 4.27 cm.
      H2O (p < 0.01) under the same conditions, mainly as a result of progressively
      stronger intra-thoracic pressures during inspiration. These experiments prove
      that the powerful thoraco-abdominal pressure gradients developed after partial
      UAO may contribute to the pathogenesis of GER by overcoming the anti-reflux
      barrier function.

PMID- 8357729
TI  - [Neonatal tracheomalacia. Study of 3 cases treated with aortopexy+].
AB  - Neonatal tracheomalacia is a disease in which there is a softening of the
      tracheal wall with lost of this consistency. This cause expiratory collapse cough
      and respiratory difficulty it is generally associated with Esophageal atresia and
      Vascular Rings. Exceptionally is a primary disease. In this paper we present
      three cases of neonatal tracheomalacia treated by aortopexy who is at the moment
      the best treatment that we have in severe cases. Soft cases will remit with
      conservative treatment.

PMID- 8357730
TI  - [Paraplegia following surgical repair of a ductus and of a coarctation of the
      aorta in childhood].
AB  - The cases of two girls with 4 and 7 years of age presented. They had a patent
      ductus and an aortic coarcation which were subsequently surgically repaired.
      After the operation paraplegia was diagnosed. With rehabilitation they are able
      to walk, however paraparexis persist. Anatomy of the arterial irrigation of the
      spinal cord is reviewed and also the pathophysiology and mechanisms of medullar
      ischemia.

PMID- 8357731
TI  - [Cerebral abscess secondary to esophageal dilatations].
AB  - We report two cases of cerebral abscess secondary to esophageal dilations in
      children with caustic stenosis of the esophagus. High fever and neurological
      findings postdilation lead us to suspect this complication. Cranial C.T.
      confirmed the diagnosis. Clinical course was favourable in both patients, with
      antibioterapy on the first case and combined therapy with surgical drainage and
      parenteral antibiotics on the second patient. We remark the importance of suspect
      this complication on the basis of clinical and tomographic findings on the
      pediatric patients subjected to esophageal dilations. Pathogenic ways of
      bacterial dissemination from the esophagus to the brain are discussed and
      reviewed.

PMID- 8357732
TI  - [Intestinal obstruction caused by milk curds in newborns].
AB  - Intestinal obstruction due to milk curds syndrome may present with a clinical
      picture and radiological findings which suggest the correct diagnosis. This type
      of intestinal obstruction usually affects neonates, previously healthy, with
      concentrated formula feeding. Surgical treatment may be avoided in some cases by
      the administration of Gastrografin enemas. Two patients with milk curd
      obstruction treatment in our Hospital, are presented.

PMID- 8357733
TI  - [Hemi-splenectomy in epidermoid cyst of the spleen. Presentation of a case].
AB  - We report a case of non-parasitic splenic cyst, diagnosed by abdominal ultrasound
      scan. These were treated by partial splenectomy. The anatomopathological study
      indicated the existence of epithelial coating.

PMID- 8357735
TI  - [European board of pediatric surgery].

PMID- 8357736
TI  - Spondyloarthropathies.

PMID- 8357734
TI  - [Solitary intestinal fibromatosis: an unusual cause of neonatal intestinal
      obstruction].
AB  - We report a new case of solitary intestinal fibromatosis (SIF) in a neonate with
      intestinal obstruction in the first day of life. At the laparotomy was found to
      be due to a solid mass in the jejunum. A segmental jejunal resection with
      anastomosis was performed. Histologic examination showed a SIF. The postoperative
      course was excellent in contrast to cases of congenital fibromatosis with
      multiples lesions, which carries a poor prognosis.

PMID- 8357737
TI  - Clinical features and management of ankylosing spondylitis.
AB  - The clinical features and management of ankylosing spondylitis are reviewed here.
      Important descriptions of the paleopathology of ankylosing spondylitis are
      discussed, and articles are reviewed in which the characteristics of some extra
      articular complications are described. Controversy persists on the bone mineral
      content of patients with ankylosing spondylitis and its relationship with disease
      duration and outcome, as well as on the role of sulfasalazine in the management
      of ankylosing spondylitis.

PMID- 8357738
TI  - Infectious agents in reactive arthritis.
AB  - It is now clear that the deposition and persistence of bacterial antigens in the
      joint are significant features of reactive arthritis. It is possible that in some
      instances this represents persistence of live bacteria, and several studies point
      to the potential value of antimicrobial therapy. Searches for bacterial DNA and
      RNA have yielded conflicting data, however, so further developments in this area
      will be of great importance. It is likely that bacterial antigens interact in
      some way with class I major histocompatibility complex (MHC) antigens in the
      pathogenesis of reactive arthritis. However, with the increasing understanding of
      the structure and function of HLA molecules, some evidence of a classic antigen
      class I MHC-CD8 T-lymphocyte interaction is now emerging. Thus far, the
      mechanisms that link HLA-B27 and bacterial antigens with reactive arthritis
      remain unclear.

PMID- 8357739
TI  - Psoriatic arthritis and synovitis, acne, pustulosis, hyperostosis, and osteitis
      syndrome.
AB  - Psoriatic arthritis is an inflammatory arthropathy associated with psoriasis, and
      its clinical presentation varies from case to case. Distal interphalangeal
      involvement is characteristic but not seen in all patients. Enthesopathy,
      including that of the spine, is common and contributes to the classification of
      psoriatic arthritis as a seronegative spondyloarthropathy. The etiopathogenesis
      of psoriatic arthritis is not well understood, and evolution as measured by
      follow-up is variable. Treatment includes nonsteroidal anti-inflammatory drugs
      and some of the drugs used in the treatment of rheumatoid arthritis.
      Sulfasalazine and, in the more severe cases, cyclosporine, are being studied for
      efficacy and tolerance. Some cases of psoriatic arthritis are associated with an
      inflammatory bone disease, frequently seen on the anterior chest wall, which is
      part of the newly described SAPHO (synovitis, acne, pustulosis, hyperostosis, and
      osteitis) syndrome. SAPHO syndrome is characterized by this bone involvement,
      which can affect the spine and peripheral bones. Various skin conditions are
      associated with this syndrome, but they do not necessarily occur in all cases.
      Chronic recurrent multifocal osteomyelitis, which is seen mostly in children, may
      be a presentation of SAPHO syndrome. Associations with sacroiliitis, bowel
      disease, and psoriasis link SAPHO syndrome with the spondyloarthropathies.

PMID- 8357740
TI  - Immunogenetics of the spondyloarthropathies.
AB  - In this review, recent data relevant to better understanding of the
      immunogenetics of the spondyloarthropathies are discussed or, in a somewhat
      broader sense, the HLA-B27 disease associations. Although in 1993 much more is
      known about the B27 molecule than was known in 1992, its contribution to the
      pathogenesis of disease is unclear. Peptide presentation to the T-cell receptor
      is still the basic, if not the only, function of HLA class I molecules. Nothing
      special was found for the B27 gene, molecule assembly, protein sequence, and
      crystal and peptide-binding motif, nor for the function dependent on these
      physical properties. Nevertheless, the theory regarding an "arthritogenic
      peptide" seemed to promise an explanation. However, this theory is rather an
      assembly of older views modified by the new data and is missing any detail or
      perspective that would answer the specific question: why B27 and not other HLA
      molecule(s)? If the solution is simple, and B27 is qualified to bind certain
      (bacterial) peptides that are not bound by any other class I molecule, or the
      unique complex, B27 + x, has special properties resulting in a "dysfunction,"
      there is still no answer to the question: which peptide and why does its binding
      with B27 result in disease?

PMID- 8357741
TI  - Bacterial arthritis.
AB  - The 1992 literature on septic arthritis reiterated the factors that portend a
      poor outcome in septic arthritis. However, we still know very little about how to
      improve the outcome for such patients. Infections of the musculoskeletal system
      may be more common among patients with HIV than the reported cases indicate.
      Bacterial endocarditis is frequently associated with musculoskeletal complaints.
      Low back pain may be a presenting manifestation. Acute gout and septic arthritis
      can cause peripheral arthritis in some patients with bacterial endocarditis.
      Septic arthritis can present unusual manifestations and can occur as a
      complication of arthroscopic surgery; the risk factors for its development after
      arthroscopy have been identified. Arthroscopy as a therapeutic procedure to drain
      an infected joint is discussed.

PMID- 8357743
TI  - Reactive arthropathy and autoimmunity in non-HIV-associated immunodeficiency.
AB  - The spectrum of arthropathy in non-HIV immune deficiency states includes
      arthritis due to prevalent infectious pathogens and autoimmunity that may in some
      instances be triggered by microorganisms. Joint symptoms may be clinical
      manifestations of disease, or they may develop later during therapy for
      immunodeficiency. Pathogenesis can be related to occult infection, loss of
      mucosal barrier function, defective clearance of immune complexes, or aberrant
      immune responses. Proper treatment includes an appreciation of likely pathogens,
      an understanding of the nature of immunologic deficits, and rigorous exclusion of
      immune dysfunction that may be secondary to treatment.

PMID- 8357742
TI  - Infections complicating joint replacement and other orthopedic conditions.
AB  - The principles underlying the diagnosis and management of infection in the
      orthopedic patient are well established. Despite this, the patient with an
      infected implant still presents the orthopedic surgeon with a challenging
      problem. In this review, I consider the recent developments in the diagnosis and
      management of the infected arthroplasty, infected tibial nonunions, spinal
      infections, and disease transmission by bone allografts.

PMID- 8357744
TI  - Osteoarthritis and crystal deposition diseases.

PMID- 8357745
TI  - Management of osteoarthritis of the hip and knee joints.
AB  - Osteoarthritides of the hip and knee represent two of the most important causes
      of pain and physical disability in the community. Recent studies have helped
      delineate the different patterns, rates of progression, and determinants of
      outcome in these two conditions. For example, patellofemoral and tibiofemoral
      osteoarthritis of the knee appear to have different associations and
      consequences; psychosocial factors and muscle strength seem to be the key
      determinants of pain and disability. These insights have contributed to a
      parallel development in new treatment strategies for established hip and knee
      osteoarthritis, including increased psychosocial support, educational and fitness
      programs, and different drugs and physical interventions. Therapeutic regimens
      geared to the specific needs of patients with lower limb osteoarthritis are
      emerging. They should replace the inappropriate application of treatments
      designed for inflammatory arthropathies to patients with osteoarthritis.

PMID- 8357746
TI  - Imaging in osteoarthritis and crystal deposition diseases.
AB  - The challenge in imaging joints and articular cartilage is to detect both early
      and subtle changes that may influence the treatment of osteoarthritis and crystal
      deposition diseases. Although radiographs show gross changes, they cannot show
      cartilage surfaces directly. Both ultrasonography and magnetic resonance imaging
      are able to demonstrate both the surface and internal details of articular
      cartilage. Advances in magnetic resonance imaging have begun to show internal
      details of articular cartilage that correspond with histologic zones. These
      changes can be shown using minor modifications of conventional imaging
      techniques. More elaborate studies using experimental contrast agents and sodium
      nuclear magnetic resonance imaging have shown changes in the magnetic resonance
      signal intensity that appear to correlate with the distribution of proteoglycans
      in the cartilage matrix. The application of these techniques may be possible in a
      clinical setting to enhance the detection and monitor the changes of degenerative
      joint disease.

PMID- 8357747
TI  - Gout and mechanisms of crystal-induced inflammation.
AB  - Since last year's review of gout and hyperuricemia, investigators have described
      new potential mechanisms that may contribute to urate crystal deposition and the
      propagation, self-limitation, and therapeutic control of gouty inflammation. The
      clinical presentation of gout in women continues to be described in greater
      detail. Also, new information on oral allopurinol desensitization is now
      available to help approach the difficult problem of allopurinol hypersensitivity.

PMID- 8357749
TI  - Epidemic neuropathy in Cuba.

PMID- 8357748
TI  - Calcium pyrophosphate dihydrate crystal deposition and other crystal deposition
      diseases.
AB  - Recent advances in understanding the pathogenesis and mechanisms of tissue damage
      related to calcium-containing crystals are highlighted in this review. The
      clinical spectrum of diseases related to crystal deposition has broadened and
      includes distinct neurologic syndromes associated with hypertrophy and
      calcification of the ligamentum flavum or posterior longitudinal ligament in the
      cervical spine. Diagnostic methods of crystal identification are also reviewed.

PMID- 8357750
TI  - Evaluation of epidemiology course in Haiti.

PMID- 8357751
TI  - Tracing infection by T. cruzi in El Salvador.

PMID- 8357752
TI  - Selective media for detecting and enumerating foodborne yeasts.
AB  - No one medium is satisfactory for detecting, isolating and enumerating all yeasts
      in all foods. Antibiotic-supplemented media such as dichloran rose Bengal
      chloramphenicol agar, tryptone glucose yeast extract chloramphenicol agar,
      oxytetracycline glucose yeast extract agar and rose Bengal chloramphenicol agar
      are superior to acidified potato dextrose agar and other acidified media for
      enumeration of the vast majority of spoilage yeasts. Dichloran glycerol (18%)
      agar performs well for enumerating moderately xerotolerant yeasts. Malt extract
      yeast extract glucose (up to 60%) can be used for detecting and enumerating
      moderate and extreme xerophiles. These media also support the growth of moulds.
      Lysine agar, Schwarz differential agar and Lin's wild yeast differential agar are
      used by the brewing industry to differentiate wild yeasts from brewer's strains.
      Lysine agar is selective for apiculate yeasts and ethanol sulfite yeast extract
      agar is selective for Saccharomyces. Both have application in wineries. Modified
      molybdate agar can be used to selectively isolate yeasts from tropical fruits.
      Preservative-resistant yeasts can be detected on malt acetic agar. The
      recommended incubation temperature is 25 degrees C, but incubation time between
      plating and counting colonies ranges from 5 days for determination of general
      populations of yeasts to 10 days for more for xerotolerant yeasts. There is need
      for new and improved media for selectively isolating various groups, genera,
      species and strains of yeasts capable of growing only under specific
      environmental conditions in specific types of foods and beverages.

PMID- 8357754
TI  - Methods for the separation of yeast cells from the surfaces of processed, frozen
      foods.
AB  - More aggressive pre-isolation treatments of samples, such as vigorous shaking,
      jet-streaming with excess of water and sonication, were applied in sequence to
      the study of yeast ecology of the surface of several frozen foods. The
      conventional isolation method based on bland shaking was unable to disengage
      yeast cells from their substrates in most of the cases, while each more
      aggressive treatment caused progressive separation of colony-forming units (cfu)
      along the sequence of application of the three procedures. Altogether, in the
      majority of cases, a few colony forming units were found on the surface of frozen
      fish, poultry, vegetables and mushrooms. Conversely, the numerically poor yeast
      flora is almost constantly represented by many species, always different from
      those found on the surface of the same foods in nature before processing. The
      uniformity of the composition of the yeast flora throughout the four different
      categories of foods excludes any possible occasional origin of the yeast
      colonization and probably indicates a processing plant origin.

PMID- 8357753
TI  - Simplified techniques for identifying foodborne yeasts.
AB  - Four problematic areas associated with the identification of foodborne yeasts are
      discussed. These consist of (1) the inability of conventional identification
      tests to recognize some common and important foodborne yeasts characterized by
      genomic differences (e.g., Saccharomyces cerevisiae, S. bayanus and S.
      pastorianus); (2) the delay in application of non-traditional identification
      methods such as DNA fingerprinting, chromosome karyotyping, protein
      electrophoretic patterns and fatty acid profiles for routine identification
      purposes; (3) the lack of commercially available manual or automated
      identification systems dedicated to the diagnosis of foodborne yeasts; and (4)
      the disregard for considering ecological frequency of yeasts in computerized
      probabilistic identification systems.

PMID- 8357755
TI  - Application of fatty acid profiles in the identification of yeasts.
AB  - In order to develop a rapid yeast identification technique using fatty acid
      profiles, an extensive survey has been conducted in our laboratory on the long
      chain fatty acid composition (CLFAC) of yeasts representing the endomycetous and
      basidiomycetous yeast domain. It was accomplished by cultivating the yeast
      strains under standardized conditions in a synthetic liquid medium. When
      stationary phase was reached the cells of each culture were freeze-dried and the
      CLFAC was examined by gas chromatography. It was found that the fatty acid
      profile obtained for each strain was reproducible. However, as work progressed,
      it became clear that variation exists within species and that the relative
      percentages of some strains from different species may overlap. Identification of
      species could therefore not be achieved in all attempts, even when the resolution
      of the fatty acid analyses was enhanced by using capillary columns, useful for
      the detection of minor fatty acids. When used in isolation, CLFAC analyses is
      therefore not a generally applicable identification technique for yeast species.
      However, the technique was found to be a valuable chemotaxanomical tool to
      distinguish between strains of certain species, species of certain genera and
      species from particular environments. The technique currently finds application
      in the South African food and beverage industry as a quick, cheap and easy way to
      distinguish between strains of Saccharomyces cerevisiae. It is also used by an
      industry which produces bioprotein from Geotrichum candidum, to determine fungal
      contaminants in a quality control process.

PMID- 8357756
TI  - Immuno-assay techniques for detecting yeasts in foods.
AB  - A brief literature review on immuno-assay of yeast cell wall antigens is given.
      Special attention is paid to extracellular, thermostable yeast antigens (EPS),
      which are released to the growth medium by many yeast species. The EPS of
      Saccharomyces cerevisiae and of Stephanoascus ciferrii (syn. Candida ciferrii)
      could be specifically and sensitively detected by a sandwich ELISA, using an IgG
      raised in rabbits immunized with the EPS of these yeasts. The EPS ELISA of three
      basidiomycetous yeasts tested was not specific, that of Geotrichum candidum was
      genus-specific but was not sensitive. The EPS of Zygosaccharomyces bailii could
      be detected in a highly specific competitive ELISA but not in a sandwich ELISA or
      in a latex agglutination test.

PMID- 8357758
TI  - Children have a right to AIDS facts.

PMID- 8357757
TI  - Use of electrophoretic karyotyping and DNA-DNA hybridization in yeast
      identification.
AB  - Contour-clamped homogeneous electric field (CHEF) gel electrophoresis was used to
      separate intact, chromosome-size DNA of different species of Saccharomyces and
      Zygosaccharomyces. Strains of the same Saccharomyces species had similar
      electrophoretic karyotypes. However, reproducible differences between individual
      bands indicated that strain-specific chromosome length polymorphism (CLP) is
      widely spread in these organisms. Strains of Zygosaccharomyces spp. showed
      karyotype differences beyond chromosome length polymorphism. A new, DNA-DNA
      hybridization technique was developed to test conspecificity, using individual
      chromosomes as templates to prepare randomly primed, radioactive probes. Under
      our conditions of stringency, species and chromosome-specific hybridization
      reactions were achieved with these probes. Using isolated chromosomes of Sacch.
      cerevisiae, Sacch. bayanus, and Zygosacch. rouxii as templates for probe
      preparation, conspecificity of strains was established, and closely related yeast
      species were distinguished with high reproducibility. This method is an efficient
      tool for studying genetic diversity of a given yeast species. Also, it can assist
      in yeast species identification and taxonomy.

PMID- 8357759
TI  - HIV health education needs reassessing.

PMID- 8357760
TI  - Behind the headlines: death by waiting list?

PMID- 8357761
TI  - Community health: a brush with bureaucracy. Interview by Maura Thompson.

PMID- 8357762
TI  - Organ donation: a gift of life. Interview by Simon Canning.

PMID- 8357763
TI  - Setting standards in diabetes education.
AB  - The project described in this article was undertaken to develop and improve the
      levels of nursing knowledge on diabetes mellitus and subsequently improve the
      quality of patient education on diabetes. A written standard on health education
      was devised and an educational programme for nurses was implemented to prepare
      nurses to meet the requirements of the standard. The project is ongoing, and
      initial results suggest that while there have been problems, nurses appear to be
      more confident in assuming their roles as patient educators.

PMID- 8357764
TI  - Job opportunities: growth or decline?
AB  - If and when those much promised green shoots of economic recovery start
      sprouting, the effect on nursing remains open to question. The growth in general
      unemployment has tailed off, but nurses are increasingly concerned about their
      own future employment prospects. This article discusses whether career
      opportunities look set to improve or diminish beyond mid-decade.

PMID- 8357765
TI  - Statistical tests (Part 1): Descriptive statistics.
AB  - This series of three articles has been designed to facilitate an understanding of
      some commonly used statistical terms encountered when reading research articles.
      In addition, it is hoped that the nurse researcher who has access to a personal
      computer containing basic statistical software will gain some insight into which
      statistical tests to use and in what circumstances. The articles do not attempt
      to provide any understanding of the mathematics of the statistical tests
      employed.

PMID- 8357766
TI  - Helping male victims of sexual abuse.
AB  - The author recounts his experience of working in an extra care psychiatric unit
      in which a proportion of the male attenders had been subject to sexual abuse as
      children. While there is a paucity of literature on the subject of male sexual
      abuse, his experience of looking after victims suggests that many commonalities
      with female sexual abuse survivors exist. A model is presented as guidance for
      practitioners in helping men who have suffered sexual abuse as children.

PMID- 8357767
TI  - Up and away. The Barry Clifton column.

PMID- 8357768
TI  - Sister Susie. Susie goes grammy bashing.

PMID- 8357769
TI  - A matter of Trust. Interview by Trevor Clay.

PMID- 8357770
TI  - Size and moans.

PMID- 8357771
TI  - Workwise: banking on work.

PMID- 8357772
TI  - One minute wisdom.

PMID- 8357773
TI  - Hypertensive labeling: does it have therapeutic implications.
AB  - Screening for hypertension within the proper setting potentially leads to the
      detection of numerous (mild) hypertensives, some of whom in due time may well
      qualify for treatment. One disadvantage of the procedure appears to be that
      hitherto unwitting hypertensives may develop some adverse psychological and
      physiological phenomena. Behavioral effects seem to be particularly obvious after
      screening on the worksite, where newly identified hypertensive employees tend to
      respond with increased absenteeism and allied symptoms of labeling. In the
      clinical setting, physiological studies in recently informed hypertensives have
      demonstrated a series of signs of increased sympathetic activity: heart rate,
      cardiac index, circulating catecholamines, and renin, and even blood pressure
      itself, tend to be higher in aware vs. unaware young hypertensives. Although some
      correlations between psychological and physiological sequelae have been observed,
      the true nature of such links is far from clear. Simple anxiety does not seem to
      be the main mechanism. Pending further research, the question is discussed as to
      whether these phenomena are harmful enough to warrant a need for counseling or
      treatment.

PMID- 8357774
TI  - Effects of the single and repeated administration of benazepril on systemic and
      forearm circulation and cardiac function in hypertensive patients.
AB  - The hemodynamic and cardiac effects of the new angiotensin-converting enzyme
      inhibitor, benazepril, were studied in 28 hypertensives in a double blind,
      placebo-controlled, between-patient study. Hemodynamic studies were performed
      noninvasively by means of M-mode echo (central hemodynamics and left ventricular
      systolic function), 2-D echo-Doppler (left ventricular diastolic function), and
      pulsed Doppler flowmetry (forearm circulation). Examinations were done at the end
      of a placebo run-in period and 3 hours after benazepril administration, both on
      the first day and after 6 weeks of treatment (10 or 20 mg once daily, according
      to patient response). In comparison with placebo, benazepril reduced systolic (p
      = 0.04) and diastolic (p = 0.003) blood pressure, because of a significant
      reduction in systemic vascular resistance (p = 0.03), while cardiac output was
      unchanged. Forearm vascular resistance was reduced and brachial artery compliance
      increased, although not to a statistically significant level (both p = 0.07).
      Both systolic and diastolic left ventricular function were positively influenced
      by the afterload reduction: End-systolic stress was reduced by 12% (p = 0.07), as
      was the late diastolic peak flow velocity (p = 0.02). All hemodynamic changes
      were evident after acute benazepril administration, and no differences was
      observed between acute and repeated treatment. We conclude that, similar to other
      ACE-inhibitors, benazepril reduces blood pressure through a reduction in vascular
      resistance, while cardiac output and heart rate are unaffected. These hemodynamic
      effects occur as early as after the first administration and exert a favorable
      influence on left ventricular dynamics.

PMID- 8357775
TI  - Arrhythmogenicity of antiarrhythmic drugs and intraventricular conduction
      disorders: possible aggravation by myocardial ischemia--study in the porcine in
      situ heart.
AB  - The effects of three antiarrhythmic drugs were investigated in anesthetized, open
      chest pigs, in a left ventricular area, under pacing at a constant high rate (180
      beats/min), in the absence and presence of ischemia. Ischemia was produced by
      transient complete occlusion of the left anterior descending coronary artery near
      its origin. In addition to the surface electrocardiogram, conduction time and
      monophasic action potential were recorded in the contractile fibers. In the
      absence of ischemia, intravenous flecainide and propafenone 2.5 mg/kg, and
      intravenous cibenzoline 2.0 mg/kg considerably lengthened conduction time (by 50
      90%) but had no significant effect on the monophasic action potential duration.
      Consequently, the cited antiarrhythmic drugs enhance the prolongation of
      conduction time by 60% but do not limit the 30% shortening of the monophasic
      action potential caused by ischemia. Contrary to what was expected, they largely
      reduced the time to onset of the fibrillation due to ischemia from about 120 to
      25 seconds. Thus, they manifested profibrillatory properties (more pronounced
      than those of other antiarrhythmic drugs of class I), which might be explained by
      their potent action on depolarization.

PMID- 8357776
TI  - Attenuation of reperfusion-induced ventricular fibrillation in the rat isolated
      hypertrophied heart by preischemic diltiazem treatment.
AB  - The ability of the calcium antagonist diltiazem to protect against reperfusion
      induced arrhythmias in hypertrophied myocardium was studied. Hearts from
      normotensive and DOCA-salt hypertensive rats were Langendorff perfused and
      subjected to 10 minutes of stabilization, 10 minutes of left coronary artery
      occlusion, and 5 minutes of reperfusion. The incidence and duration of
      ventricular tachycardia (VT) and ventricular fibrillation (VF) during reperfusion
      were determined and the effects of diltiazem or vehicle (given as a single bolus
      3 minutes before coronary artery occlusion) were assessed in hypertrophied and
      normal hearts. In vehicle-treated (control) hypertrophied hearts, VF incidence
      was 91% compared with 67% in normal hearts, and the median duration of VF was 272
      seconds (mean 207.4 +/- 32.3) compared with 27 seconds (mean 110.6 +/- 36.6; p <
      0.05), respectively, suggesting that reperfusion VF is more severe in
      hypertrophied hearts. In normal hearts, diltiazem 18 micrograms reduced VT
      incidence from 92% to 55%, reduced VF from 67% to 27%, and sustained VF from 42%
      to 9%. In hypertrophied hearts, 18 micrograms diltiazem reduced the VT incidence
      from 100% to 58%, reduced VF from 91% to 25% (p < 0.01), and sustained VF from
      82% to 8% (p < 0.01). Median VF duration in this group was reduced to 0 seconds
      (p < 0.05; mean 24.7 +/- 22.6). Diltiazem did not significantly affect heart rate
      or coronary flow rate decreases during ischemia. However, developed tension, at
      the onset of ischemia, was lower in diltiazem-treated groups than in the control
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357777
TI  - Actions and interactions of E-4031 and tedisamil on reperfusion-induced
      arrhythmias and QT interval in rat in vivo.
AB  - The effects of the Ito blocker, tedisamil (0.1, 1.0, and 3.0 mg/kg, IV), and the
      IK blocker, E-4031 (0.1, 1.0, and 3.0 mg/kg, IV), on the incidence and duration
      of reperfusion-induced arrhythmias were compared in the anesthetized rat (n = 12
      per group). Reperfusion arrhythmias were evaluated after a 5 minute occlusion
      period of the left main coronary artery. In the absence of any pronounced effect
      on blood pressure, tedisamil and E-4031 reduced heart rate in a dose-dependent
      manner. During the preischemic period, QTc interval was increased by tedisamil
      but was not changed by E-4031. Both compounds increased the QTc interval during
      the ischemic period and also during the reperfusion. E-4031 was unable to reduce
      the incidence and duration of reperfusion-induced ventricular arrhythmias after 5
      minutes of coronary artery occlusion. Tedisamil dose-dependently reduced the
      duration of reperfusion arrhythmias and their incidence. In a second set of
      experiments, the combination of tedisamil (1.0 mg/kg) with E-4031 (1.0 mg/kg) was
      administered. The electrocardiographic action of this combination was similar to
      that observed with tedisamil given alone. However, with the combination the
      incidence of fibrillation was reduced from 83% in the control group to 8% in the
      treated group (p < 0.001), and the mortality was reduced from 67% to 0% (p <
      0.001), that is, to a greater extent than with tedisamil (1.0 mg/kg) alone. The
      results show that the blockade of Ito by tedisamil allows a reduction of
      reperfusion-induced mortality and that a specific IK blocker (E-4031) is devoid
      of antifibrillatory action in the anesthetized rat.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8357778
TI  - Effect of propionyl-L-carnitine in a rat model of peripheral arteriopathy: a
      functional, histologic, and NMR spectroscopic study.
AB  - Propionyl-L-carnitine (PLC) has been shown to exert beneficial effects in
      experimental models of peripheral arterial diseases, such as ergotamine-induced
      tail gangrene and bilateral femoral arteries occlusion in rats. These models,
      however, present some drawbacks. The present study was performed to determine
      whether repeated oral administration of PLC improves the functional, histologic,
      and metabolic parameters in rats with long-lasting chemically induced peripheral
      arteriopathy. Peripheral arteriopathy was induced by injecting Na laurate in both
      the femoral arteries of rats. The walking capacity of the animals (treadmill
      test) was evaluated at different times and up to 5 weeks after Na laurate
      injection. Histological examination of vessels and muscles was performed at the
      end of the experimental period (5 weeks). In separate experiments the level of
      high-energy phosphates was determined with 31P NMR methodology in the leg
      muscles. Injection of Na laurate impaired (p < 0.05) the walking capacity of
      rats, caused thickening of the intima and marked narrowing of the vasal lumen,
      and reduced the ATP and PCr levels in muscles by 42% and 25%, respectively. PLC
      given orally for 7 days at 30, 60, 120, and 250 mg/kg dose-dependently decreased
      the severity of walking capacity impairment by 19%, 41%, 64%, and 71%,
      respectively. Long-term administration (4 weeks) of PLC (60 and 250 mg/kg os)
      caused a significant improvement of walking capacity throughout the entire
      period. The improvement persisted 1 week after discontinuation of the treatment.
      The severity of the vascular and muscular damages was markedly reduced,
      particularly in animals treated with the highest dose. Alterations in ATP and PCr
      levels were significantly (p < 0.05) diminished by PLC (120 mg/kg os)
      administered daily for 15 days starting 24 hours after Na laurate injection, or
      for 11 days starting 4 days after Na laurate. The dextro-isomer of the compound
      was completely inactive, and L-carnitine improved motor performance to a much
      lesser degree than an identical dose of PLC. It is suggested that the activity of
      PLC is linked to its metabolic effects on fatty acid oxidation, with consequent
      preservation of high-energy phosphate levels.

PMID- 8357779
TI  - Effects of cicletanine on the urinary excretion of prostanoids and kallikrein,
      and on renal function in man.
AB  - The effects of cicletanine, a new antihypertensive agent, on the prostaglandin
      kallikrein system and the renin-angiotensin system were studied. A single oral
      dose of 200 mg cicletanine or placebo was administered to 9 healthy male
      volunteers, with samples of blood and urine obtained before and 2 hours after
      drug administration. Cicletanine increased the urine flow, urinary excretion of
      sodium, and fractional excretion of sodium by 47%, 115%, and 104%, respectively.
      While the excretion of 6-keto-prostaglandin-F1 alpha was enhanced significantly,
      urinary excretion of thromboxane-B2, prostaglandin-E2, and kallikrein were
      unchanged. Cicletanine also did not alter plasma renin activity, plasma
      aldosterone concentration, or creatinine clearance. These observations suggest
      that cicletanine may suppress sodium reabsorption at the nephron, and it may
      stimulate prostacyclin generation with no effect on that of thromboxane-A2. Thus
      cicletanine may be beneficial in the management of cardiovascular disorders in
      which the equilibrium between prostacyclin and thromboxane is disturbed.

PMID- 8357780
TI  - Inhibitory effect of clentiazem (TA-3090), a new calcium antagonist, on balloon
      catheter-induced intimal thickening of rabbit aorta.
AB  - Male Japanese white rabbits were fed a restricted amount (100 g/head/day) of an
      atherogenic diet containing 0.2% cholesterol and 6% peanut oil during an 8-week
      experimental period. Atherosclerotic lesions, characterized by intimal thickening
      with lipid deposition, were produced by de-endothelialization of the rabbit aorta
      with a 4 F balloon catheter halfway through the experiment. Clentiazem (TA-3090),
      a new calcium antagonist, was administered at an oral dose of 30 mg/kg/day for 4
      weeks starting on the day of deendothelialization. Clentiazem significantly
      depressed the intimal thickening without any effect on serum lipid levels.
      Clentiazem (1, 3, and 10 microM) significantly and dose-dependently inhibited the
      in vitro proliferation of smooth muscle cells that had been explanted from the
      neointima of the deendothelialized aorta. At a higher concentration, this drug
      markedly inhibited collagen-induced aggregation of rabbit platelets. Diltiazem
      also showed similar effects, but the effects of clentiazem were more potent than
      those of diltiazem. These results suggest that clentiazem exhibits an
      antiatherogenic effect, at least partly through prevention of smooth muscle cell
      proliferation in atheromatous lesions, in addition to its hypotensive action.

PMID- 8357781
TI  - Effects of a new calcium antagonist, CD-832, on experimental coronary artery
      spasm in miniature pigs.
AB  - The effects of a new calcium antagonist, CD-832, on experimental coronary artery
      spasms were studied in Gottingen miniature pigs. Pigs underwent endothelial
      denudation at the left anterior descending coronary artery using a balloon
      catheter. Changes in the diameter of the denuded and nondenuded site in response
      to an intracoronary administration of serotonin (10 micrograms/kg) or histamine
      (10 micrograms/kg) were assessed quantitatively by selective coronary
      arteriography 1 week after endothelial denudation. Percent reductions of the
      coronary artery diameter induced by serotonin or histamine in the denuded site
      were significantly greater than those in the nondenuded site (p < 0.01). Coronary
      artery spasm induced by serotonin or histamine in the denuded site was attenuated
      in a dose-dependent manner by intravenous infusion of CD-832 (10 and 30
      micrograms/kg/min) or nifedipine (1 and 3 micrograms/kg/min). The degrees of
      inhibition of coronary artery spasm by CD-832 were similar to those produced by
      nifedipine. CD-832 and nifedipine at the high dose caused comparable increases in
      the basal coronary artery diameter. These results suggest that CD-832 may be a
      useful drug for the treatment of coronary artery spasm.

PMID- 8357783
TI  - Trends in cardiac medicine: the American Heart Association meeting, New Orleans,
      November 16-19, 1992.

PMID- 8357784
TI  - Effects of cytokines, anti-cancer agents and cocarcinogen on DNA synthesis in
      hair bulb cells.
AB  - We analysed the effects of cytokines, anti-cancer agents and cocarcinogen on DNA
      synthesis in human hair germinative cells cultured in serum-free media. Epidermal
      growth factor and gamma interferon were found to inhibit DNA synthesis slightly,
      while strong inhibition was demonstrated by doxorubicin, cytosine arabinoside and
      tetradecanoyl-phorbolacetate. Basic fibroblast growth factor had very little
      influence on DNA synthesis. This organ culture model in serum-free media is a
      useful method by which to examine the effects of various cytokines and drugs on
      DNA synthesis in hair germinative cells and/or to study the pathogenesis of
      various alopecia diseases.

PMID- 8357782
TI  - The QUinapril Ischemic Event Trial (QUIET) design and methods: evaluation of
      chronic ACE inhibitor therapy after coronary artery intervention.
AB  - The rationale, trial design, and statistical aspects of QUIET, the QUinapril
      Ischemic Event Trial, are described. QUIET is a prospective, double-blind placebo
      controlled study that will assess the ability of the angiotensin-converting
      enzyme (ACE) inhibitor quinapril to reduce the rate of cardiac ischemic events
      and to slow or prevent the development of coronary artery atherosclerosis as
      assessed by serial angiography in a normolipidemic population without left
      ventricular dysfunction. The study began in September 1991 and has completed
      recruitment with 1740 patients across 38 centers (28 U.S., 4 Canada, 6 Europe) by
      the end of 1992. Patients are randomized to 20 mg of quinapril or placebo once
      daily and continue in the study for 3 years. Study completion is projected for
      1995.

PMID- 8357786
TI  - Histocompatibility antigens in Egyptians with cutaneous leishmaniasis: a
      preliminary study.
AB  - The frequency of human leucocytic antigens (HLA) were studied in 27 patients with
      cutaneous leishmaniasis to evaluate the role of HLA antigens as genetic markers
      in the pathogenesis of this protozoal skin infection. A significant statistical
      association was observed between HLA-A11, -B5 and -B7 antigens and diffuse
      cutaneous leishmaniasis. In conclusion, study of immune response genes could be
      of value to understand the pathogenic mechanisms responsible for cutaneous
      leishmaniasis.

PMID- 8357785
TI  - Expression of basement membrane components in skin equivalents--influence of
      dermal fibroblasts.
AB  - We have made a skin equivalent constructed of fibroblasts embedded in a type I
      collagen, with an overlying stratified keratinocyte epithelium to examine
      formation of the basement membrane. We assessed the influence of the existence
      and species of fibroblasts in the collagen gel. Cultured human keratinocytes were
      well attached to the dermal equivalent. Plating efficiency was not clearly
      different among several types of gel. On the control and mouse fibroblast gel,
      sheet formation was delayed and epithelial stratification on the human fibroblast
      gel was more remarkable than on the control gel. On the human fibroblast gel, we
      observed the expression of basement membrane components (bulbous phemphigoid
      antigen, laminin, type IV collagen and fibronectin) between the sheet of cultured
      keratinocytes and the human fibroblast gel earlier than those on the control gel
      and mouse fibroblast gel. Type VIII collagen was not observed in any of the
      models at 4 weeks.

PMID- 8357787
TI  - Skin barrier defect in atopic dermatitis: increased permeability of the stratum
      corneum using dimethyl sulfoxide and theophylline.
AB  - The existence of a defect in the skin barrier of patients with atopic dermatitis
      (AD) was demonstrated and its importance in the pathogenesis of AD was
      emphasized. In order to evaluate the penetration properties of the stratum
      corneum of AD patients, the in vivo skin response to the penetration of dimethyl
      sulfoxide (DMSO) and in vitro response to the penetration of theophylline
      utilizing a diffusion chamber were studied. Both methods demonstrated an
      increasing level of penetration through the epidermal stratum corneum, with
      greatest penetration being evident with lesional skin, followed by AD non
      lesional and then the normal control. However, statistical significances existed
      only between non-lesional and lesional skins in the case of the DMSO test, and
      between the normal control and non-lesional skin in the case of the diffusion
      chamber analysis using theophylline. Increased penetration of a non-specific
      nature is important in the pathogenesis of AD.

PMID- 8357788
TI  - Labeling of fractured human skin with antibodies to BM 600/nicein, epiligrin,
      kalinin and other matrix components.
AB  - A variety of methods were used to fracture the dermal-epidermal junction (DEJ) of
      human skin. These included warm and hot phosphate buffered saline, trypsin, cold
      1 M salt, potassium bromide and proteolytic digestion with dispase. The
      localization and sensitivity of basement membrane components (bullous pemphigoid
      antigen, BM 600/nicein, epiligrin, kalinin, laminin, collagens IV and VII (EBA
      antigen) and linkin) were determined after the DEJ was fractured by each method.
      We found that the basement membrane zone proteins, BM 600/nicein, epiligrin and
      kalinin remained with the dermal side of the DEJ fractured through the lamina
      lucida by cold salt, phosphate buffered saline and potassium bromide. BM
      600/nicein, epiligrin and kalinin were not detected after treatment with trypsin.
      In contrast, laminin, another glycoprotein in the lamina lucida, was insensitive
      to all of the procedures, but co-localized to the dermal side of DEJ-fractured
      skin. We also found that separation of the DEJ with brief exposure of skin to 56
      degrees C provided a useful substrate for testing the autoantibodies in the sera
      of patients with epidermolysis bullosa acquisita (EBA). Heat-separated skin can
      be prepared in a significantly shorter period of time than salt-separated skin.

PMID- 8357789
TI  - Transmission of conformational change from the heparin binding site to the
      reactive center of antithrombin.
AB  - Heparin greatly increases the rates at which antithrombin inhibits target
      proteinases. An important part of this rate acceleration is a heparin-induced
      conformational change in antithrombin. To answer the question of whether or not
      this change is transmitted to the reactive center, we have prepared a recombinant
      P1 mutant of antithrombin, R393C, labeled the cysteine with nitrobenzofuran (NBD)
      fluorophore, and examined the perturbation of NBD fluorescence intensity as a
      function of bound sulfated oligosaccharide. Two high-affinity heparins, low
      affinity heparin, and dextran sulfate were used. We found (i) that binding to
      antithrombin of all these oligosaccharides resulted in transmission of
      conformational change to P1 in the reactive center, (ii) that these
      oligosaccharides all gave enhancements of the rate of inhibition of factor Xa
      beyond any contribution from surface approximation, and (iii) that the degree of
      perturbation of P1 correlated with the enhancement of the rate of factor Xa
      inhibition that was not due to surface approximation.

PMID- 8357790
TI  - Atomic force microscope measurements of nucleosome cores assembled along defined
      DNA sequences.
AB  - We have found that the atomic force microscope (AFM) can be used to image the
      "beads-on-a-string" chromatin structure in a normal air environment following
      adsorption onto a cover glass substrate. Individual nucleosome cores and linker
      DNA could be resolved clearly along chromatin fibers that were reconstituted
      using histone octamers and a tandemly repeated 208-bp nucleosome positioning DNA
      sequence (208-18). AFM measurements showed that the compaction of the 3780-bp DNA
      by different loadings of histone octamers was consistent with 146 bp of DNA
      wrapped 1.75 turns about the histone octamer to form the 11-nm nucleosome core.
      Precise internucleosome core spacing measurements could be performed along the
      chromatin fiber axis. In other experiments, AFM images of chromatin reconstituted
      using closed circular DNA showed highly tangled beaded fibers, as expected. These
      images and measurements demonstrate that AFM can provide useful high-resolution
      structural information about chromatin that can be used to complement other more
      established techniques such as electron microscopy.

PMID- 8357791
TI  - Nuclear matrix association of multiple sequence-specific DNA binding activities
      related to SP-1, ATF, CCAAT, C/EBP, OCT-1, and AP-1.
AB  - The association of DNA binding proteins with the nuclear matrix may be related to
      a functional role of this subcellular structure in chromatin organization and
      gene regulation. In this study, nuclear matrix preparations from human HeLa S3
      cervical carcinoma and rat ROS 17/2.8 osteosarcoma cells were assayed for the
      presence of DNA binding activities using consensus binding sequences of well
      characterized transcription factors as probes. Competition analysis shows that
      each probe interacts with different nuclear matrix proteins in a sequence
      specific manner and that DNA binding activities related to or identical with SP
      1, ATF, CCAAT, C/EBP, OCT-1, and AP-1 are present in the nuclear matrix fraction
      of different cell types. Comparison of the relative abundance of these
      transcription factor binding activities in nuclear matrix and nonmatrix nuclear
      fractions suggests that the distribution between these two fractions is cell type
      specific, cell growth dependent, or independent of these biological parameters.
      These results are consistent with the postulated role of the nuclear matrix in
      transcriptional regulation of gene expression.

PMID- 8357792
TI  - Three-dimensional structures and properties of a transforming and a
      nontransforming glycine-12 mutant of p21H-ras.
AB  - The three-dimensional structures and biochemical properties of two mutants of the
      G-domain (residues 1-166) of p21H-ras, p21 (G12D) and p21 (G12P), have been
      determined in the triphosphate-bound form using guanosine 5'-(beta,gamma
      imido)triphosphate (GppNHp). They correspond to the most frequent oncogenic and
      the only nononcogenic mutation of Gly-12, respectively. The G12D mutation is the
      only mutant analyzed so far that crystallizes in a space group different from
      wild type, and the atomic model of the protein shows the most drastic changes of
      structure around the active site as compared to wild-type p21. This is due to the
      interactions of the aspartic acid side chain with Tyr-32, Gln-61, and the gamma
      phosphate, which result in reduced mobility of these structural elements. The
      interaction between the carboxylate group of Asp-12 and the gamma-phosphate is
      mediated by a shared proton, which we show by 31P NMR measurements to exist in
      solution as well. The structure of p21 (G12P) is remarkably similar to that of
      wild-type p21 in the active site, including the position of the nucleophilic
      water. The pyrrolidine ring of Pro-12 points outward and seems to be responsible
      for the weaker affinity toward GAP (GTPase-activating protein) and the failure of
      GAP to stimulate GTP hydrolysis.

PMID- 8357793
TI  - Heteronuclear nuclear magnetic resonance studies of cobalt corrinoids. 15. The
      structure of glutathionylcobalamin: a 1H and 13C two-dimensional nuclear magnetic
      resonance study at 600 MHz.
AB  - Glutathionylcobalamin (GSCbl), the complex formed between glutathione (GSH, gamma
      glutamylcysteinylglycine) and aquacobalamin (H2OCbl), has been implicated as an
      intermediate in the pathway for the formation of the cobalamin coenzymes. In
      chemical model studies, GSCbl has been shown to be a substrate for
      methylcobalamin formation in the presence of S-adenosylmethionine and a thiol
      reductant. Although GSCbl was first described in 1964, the structure of this
      compound, particularly the site of GSH coordination, has been unknown. GSCbl was
      prepared by reacting GSH (5-fold molar excess) with H2OCbl in 0.1 M sodium
      phosphate (pH 6.5) and was purified by gel-permeation chromatography on a Bio-Gel
      P2 polyacrylamide column. By use of a combination of homonuclear [homonuclear J
      correlated spectroscopy (COSY), homonuclear Hartmann-Hahn spectroscopy (HOHAHA),
      and absorption-mode nuclear Overhauser effect spectroscopy (NOESY)] and inverse
      detected heteronuclear [1H-detected heteronuclear multiple-quantum coherence
      (HMQC) and 1H-detected multiple-bond heteronuclear multiple-quantum coherence
      (HMBC) spectroscopies] two-dimensional NMR methods at 600 MHz, the complete 1H
      and 13C NMR spectra of GSCbl have now been assigned. Comparison of the 1H and 13C
      NMR chemical shifts of the GS moiety of GSCbl to those of free GSH and GS- shows
      that by far the largest differences occur at the cysteine alpha and beta
      positions. This result strongly suggests that GSH is coordinated to the cobalt
      atom in GSCbl via the cysteine sulfur atom.

PMID- 8357794
TI  - The solution structures of mutant calbindin D9k's, as determined by NMR, show
      that the calcium-binding site can adopt different folds.
AB  - The complete 1H NMR assignments have been obtained for five mutant proteins of
      calbindin D9k and the three-dimensional solution structures determined for two of
      the mutants. The structures have been determined using distance geometry and
      simulated annealing, with distance constraints from NMR. All mutants have
      modifications in the first calcium-binding site of calbindin (the N-terminal site
      designated the pseudo-EF-hand). The 3D structure of the mutant with the most
      extensive modifications in the pseudo-EF-hand shows that the site has turned
      inside-out and coordinates calcium as in the normal EF-hand (the C-terminal
      site). In a pseudo-EF-hand loop the calcium is coordinated by main-chain
      carbonyls, whereas calcium in the normal EF-hand is coordinated by side-chain
      carboxylates. The 3D structures and 1H NMR assignments show that in order to
      accomplish a change in the coordinating ligands of the pseudo-EF-hand the loop
      must be 12 residues long and have glycine in the sixth position. It does,
      however, seem possible to have alanine instead of aspartic acid in the first
      calcium coordinating position. The overall global fold of the proteins has not
      been affected by the mutations in the calcium-binding site, as compared to the
      wild-type calbindin D9k [Kordel, J., Skelton, N. J., Akke, M., & Chazin, W. J.
      (1993) J. Mol. Biol. (in press)]. The structures consist of two helix-calcium
      binding loop-helix motifs, the so called EF-hands, and the loops are connected by
      a short antiparallel beta-sheet. All helices are pairwise in an antiparallel
      orientation.

PMID- 8357795
TI  - Crystal structure of a fluorescent derivative of RNase A.
AB  - The crystal structure of RNase A chemically modified with the fluorescent probe,
      N-[[(iodoacetyl)-amino]ethyl]-5-naphthylamine-1-sulfonic acid (1,5-IAENS), has
      been solved and refined to high resolution. It yields information on the mode of
      binding, the mobility of a probe commonly used in spectroscopic studies, and
      anion binding sites in RNase A. Trigonal crystals of the fluorescent derivative
      grown in sodium or cesium chloride and ammonium sulfate, pH 5.1, were nearly
      isomorphous with those of a semisynthetic RNase [DeMel, et al. (1992) J. Biol.
      Chem. 267, 247-256]. Refinement starting from semisynthetic RNase led to a model
      with R = 20% against 1.7-A diffraction data from crystals in ammonium sulfate and
      another model with R = 17% against 1.9-A data taken in the presence of 3 M NaCl.
      The second model contains three chloride ions: one is at the active site, and the
      other two are at molecular interfaces. Otherwise, the two models are very
      similar. The fluorophore has very little effect on the protein conformation. It
      is found to be covalently attached to the active site His-12 with the naphthyl
      group stacked on the imidazole ring of His-119. It remains largely accessible to
      solvent and in a polar environment on the protein surface, even though the
      fluorescence emission spectrum is blue shifted as it is in nonpolar solvents.

PMID- 8357796
TI  - X-ray crystallographic determination of the structure of bovine lens leucine
      aminopeptidase complexed with amastatin: formulation of a catalytic mechanism
      featuring a gem-diolate transition state.
AB  - The structure of the complex of bovine lens leucine aminopeptidase (blLAP) with
      the slow-, tight-binding inhibitor amastatin has been determined by X-ray
      crystallography. X-ray diffraction data were collected at -150 degrees C from a
      single blLAP-amastatin crystal which under the data collection conditions was of
      the space group P6(3)22 with unit cell parameters a = 130.3 A and c = 121.9 A.
      The structure of the blLAP-amastatin complex was determined by molecular
      replacement, using the structure of native blLAP as the starting model.
      Refinement of the blLAP-amastatin model plus 132 water molecules against data
      from 10.0- to 2.4-A resolution resulted in a final structure with a
      crystallographic residual of 0.198. The binding mode of amastatin is similar to
      that of bestatin, the structure of whose complex with blLAP has previously been
      determined. Of particular note, the N-terminus-to-C-terminus orientation of the
      two bound inhibitors is the same. The two N-terminal residues of amastatin and
      bestatin occupy the same binding sites, which are most likely S1 and S'1. The
      slow binding of amastatin and bestatin may be partially attributable to a binding
      mechanism in which the two active site metals are sequentially coordinated by the
      P1 amino and hydroxyl groups of these inhibitors. A catalytic mechanism for blLAP
      is proposed based on the binding modes of amastatin and bestatin and plausible
      binding modes of a dipeptide substrate and its putative gem-diolate transition
      state which were modeled into the active site of blLAP after the binding mode of
      amastatin. The proposed catalytic mechanism invokes roles for the catalytic
      metals in binding and activating the substrate and in stabilizing the transition
      state. The mechanism also includes roles for Asp-255 as a general base, Arg-336
      as an additional electrophilic substrate activator and transition state
      stabilizer, and Lys-262 as a proton shuttle.

PMID- 8357797
TI  - Role of conformational change in the fumarase reaction cycle.
AB  - Activation of fumarase by high concentrations of either malate or fumarate, often
      referred to as negative cooperativity, can be explained without assuming
      additional sites of substrate action or subunit-subunit interactions. The
      following observations support a model based on a rate-dependent recycling of
      free enzyme through a sequence of conformational states that differ in substrate
      specificity and catalytic activity: (1) Displacement from equilibrium of a
      radiolabeled malate/fumarate probe is readily induced by moderate concentrations
      of either substrate. This phenomenon, called substrate-induced countertransport,
      indicates that the steady-state ratio of free enzyme forms is very dependent on
      substrate concentration. (2) Related to this, the back-labeling that can be
      observed with either 14C product with either substrate in the steady state is
      more rapid than expected for a single free enzyme state model. (3) Fumarate, more
      strongly than malate, shows competitive effects as a product. This may reflect a
      higher affinity of fumarate for an isoform that also reacts with malate. (4)
      P(i), an activator of fumarase at midrange substrate concentration, overcomes
      strong competitive inhibition by fumarate of the M-->F reaction and increases
      recycling as shown by its effect on counterflow. To the extent that these effects
      are due to buffer activation, they suggest that proton transfer between solvent
      and the enzyme site is important in determining the recycling rate. (5)
      Transaconitate, a competitive inhibitor, overcomes counterflow induced by either
      substrate, indicating that recycling events occur in the enzyme-transaconitate
      complex.

PMID- 8357798
TI  - Low-density lipoprotein modification and arterial wall accumulation in a rabbit
      model of atherosclerosis.
AB  - Chemically or enzymatically modified low-density lipoproteins (LDL), with and
      without changes in surface charge, were studied in vivo in the healing, balloon
      catheter-deendothelialized rabbit aorta to determine the effect of LDL
      modification on its accumulation in arterial lesions. In this model, in which
      healing (reendothelialization) proceeds radially outward from individual aortic
      branch arteries, it was previously shown by autoradiography that two kinetically
      distinct compartments accumulated 125I-labeled LDL. In aortic regions which were
      still deendothelialized, accumulation was diffuse and labile. In contrast, at the
      edges of the islands of regenerating endothelium, LDL accumulation was intensely
      focal, as it is in human atherosclerotic lesions, and persisted for at least 40 h
      after injection in spite of falling levels of radiolabeled LDL in plasma [Chang,
      M. Y., et al. (1992) Arterioscler. Thromb. 12, 1088-1098]. In the present study,
      modified LDLs with gradations in charge change were prepared to clarify the role
      of changes in surface charge on focal aortic LDL accumulation. Oxidized LDL
      (weakly anionized), desialated LDL (weakly cationized), and reductively
      methylated LDL (no change in net charge) all accumulated focally. Focal
      accumulation of native LDL also occurred in ballooned rabbits fed probucol to
      inhibit LDL oxidation. Strongly anionized succinylated and
      diazobenzenearsonylated LDL and strongly cationized dimethylpropanediamine LDL
      did not accumulate focally. The results support the concept that focal
      sequestration of LDL in arterial lesions is mediated by specific, oxidation
      independent patterns of charge and polarity on LDL which are disrupted by major
      changes in LDL surface charge.

PMID- 8357799
TI  - Primary structure of and studies on Acanthamoeba actophorin.
AB  - We determined the amino acid sequence of the actin monomer binding/actin filament
      severing protein actophorin from Acanthamoeba castellanii by automated Edman
      degradation of peptide fragments and by sequencing of full-length cDNA.
      Actophorin consists of 138 amino acids (calculated molecular weight of 15,543)
      and shares a high degree of sequence similarity to other low molecular weight
      actin monomer sequestering proteins, especially vertebrate cofilin, vertebrate
      actin depolymerizing factor/destrin, and echinoderm depactin. Actophorin is
      smaller and does not contain a nuclear localization sequence like the related
      vertebrate proteins. Southern blot analysis indicates that actophorin is a single
      copy gene; however, Northern blots show two distinct mRNA species of 1 and 0.9 kb
      in size. Homogeneous recombinant actophorin purified from Escherichia coli is
      indistinguishable from the native protein in its physical properties and in
      biochemical assays of its interaction with actin, but is less reactive with three
      monoclonal antibodies raised against the native protein. The NH2 terminus of
      native actophrin is blocked, while the initiating methionine residue is removed
      from recombinant actophorin. This difference has no measurable effect on
      activity. By fluorescent antibody staining of Acanthamoeba, actophorin
      colocalizes with actin filaments in the cortical cytoplasm, especially at the
      leading edge of the cell. Additionally, actophorin binds phosphatidylinositol
      4',5'-bisphosphate. The recombinant actophorin forms X-ray diffraction quality
      crystals of superior quality in poly(ethylene glycol)/2-propanol and, like the
      native crystal form, belongs to space group P2(1)2(1)2(1).

PMID- 8357800
TI  - Three-dimensional model for the membrane domain of Escherichia coli leader
      peptidase based on disulfide mapping.
AB  - We have mapped the interface between the two transmembrane alpha-helices in the
      membrane domain of the Escherichia coli enzyme leader peptidase by analyzing
      disulfides formed between pairs of cysteine residues introduced near their
      respective periplasmic ends. The interface is formed primarily from aliphatic
      amino acids, and the two helices appear to pack against each other in a left
      handed supercoil. We suggest that disulfide mapping may be a generally applicable
      approach for the construction of models of helix-helix interfaces in membrane
      proteins.

PMID- 8357801
TI  - The substrates of a sodium- and chloride-coupled gamma-aminobutyric acid
      transporter protect multiple sites throughout the protein against proteolytic
      cleavage.
AB  - Fragments of the (Na(+) + Cl-)-coupled GABAA transporter were produced by
      proteolysis of membrane vesicles and reconstituted preparations from rat brain.
      The former were digested with Pronase, the latter with trypsin. Fragments with
      different apparent molecular masses were recognized by sequence-directed
      antibodies raised against this transporter. When GABA was present in the
      digestion medium, the generation of these fragments was almost entirely blocked.
      At the same time, the neurotransmitter largely prevented the loss of activity
      caused by the protease. The effect was specific for GABA; protection was not
      afforded by other neurotransmitters. It was only observed when the two
      cosubstrates, sodium and chloride, were present on the same side of the membrane
      as GABA. The results indicate that the transporter may exist in two
      conformations. In the absence of one or more of the substrates, multiple sites
      located throughout the transporter are accessible to the proteases. In the
      presence of all three substrates--conditions favoring the formation of the
      translocation complex--the conformation is changed such that these sites become
      inaccessible to protease action.

PMID- 8357802
TI  - Minimum intron requirements for tRNA splicing and nuclear transport in Xenopus
      oocytes.
AB  - The presence or absence of an intron defines two classes of eukaryotic nuclear
      tRNA genes whose transcripts differ in a requirement for splicing. Using
      quantitative nuclear microinjection, we have previously found that
      nucleocytoplasmic transport of these two classes of tRNAs involves pathways which
      differ in one or more limiting components. To examine substrate features which
      distinguish these two pathways, a series of variants of a Xenopus tRNA(Tyr) gene
      were constructed in which the intron size was altered. The splicing and transport
      properties of the resulting transcripts were examined in oocyte microinjection
      and in vitro processing assays. The addition of one or two nucleotides at the
      splice site equivalent in an intronless gene produced transcripts which could be
      transported without splicing. However, transport was reduced relative to the
      mature-sequence tRNA, suggesting the anticodon loop (interrupted in pre-tRNAs)
      may be recognized by the intronless tRNA transport apparatus. Transcripts with
      four- or six-nucleotide intervening sequences were incompletely spliced with
      cleavage at only the 3' splice site. Neither unspliced precursor nor partially
      processed intermediates were efficiently transported. The results of coinjection
      experiments using tRNA and pre-tRNA competitors suggest that simple retention by
      the splicing apparatus may not account for failure to export these RNAs. Finally,
      a requirement for splicing is not unique to transport of pre-tRNA(Tyr) since a
      pre-tRNA(3Leu) variant which was not spliced was also not exported.

PMID- 8357803
TI  - Photoaffinity labeling of the vesamicol receptor of cholinergic synaptic
      vesicles.
AB  - On the basis of the high-affinity vesamicol analog 4-aminobenzovesamicol (ABV), a
      tritiated, arylazido ligand (azidoABV) of the vesamicol receptor (VR) in
      cholinergic synaptic vesicles was synthesized. azidoABV is an inhibitor of
      acetylcholine (AcCh) active transport, and it binds to the VR with higher
      affinity than vesamicol. The rate of dissociation of azidoABV from synaptic
      vesicles is 0.058 +/- 0.003 min-1 at 20 degrees C (about 3-fold slower than that
      of vesamicol), and the equilibrium dissociation constant is 2 nM (about 4-fold
      lower than that of vesamicol). Photolysis of [3H]azidoABV in the presence of a
      stoichiometric excess of the VR led to incorporation of 28% of the radiolabel, of
      which 57% was blocked by 50 microM vesamicol. Sodium dodecyl sulfate
      polyacrylamide gel electrophoretic analysis of the labeled vesicles revealed,
      after autofluorography, specific labeling over a broad molecular weight range
      that extended from about 50 to 200 kDa. This labeling pattern was essentially the
      same as that obtained with an azido analog of AcCh that was used to label the
      AcCh transporter (Rogers, G.A., & Parsons, S. M. (1992) Biochemistry 31, 5770
      5777). In addition, about 6% of the radioligand that was specifically
      incorporated into proteins with M(r) greater than 12 kDa labeled four
      polypeptides that corresponded to bands in the Coomassie image at M(r) = 23, 33,
      35, and 38 kDa. The results suggest that the VR exists as part of a complex
      system of subunits.

PMID- 8357804
TI  - A high-affinity site for acetylcholine occurs close to the alpha-gamma subunit
      interface of Torpedo nicotinic acetylcholine receptor.
AB  - Affinity labeling techniques have been used to investigate the location of high
      affinity binding sites for cholinergic agonists on the Torpedo acetylcholine
      receptor and the extent of overlap of these sites with those for long alpha
      neurotoxins. Following reduction of the receptor by dithiothreitol, reaction with
      [3H]bromoacetylcholine leads to covalent incorporation into each of the two alpha
      subunits. At high concentrations of [3H]bromoacetylcholine (240 microM) and with
      prolonged incubation times (1-2 h), this labeling was not inhibited by either
      alpha-bungarotoxin or alpha-najatoxin. Following maximum labeling by
      [3H]bromoacetylcholine, no residual high binding sites for [125I]-alpha
      bungarotoxin could be detected in the membrane-bound receptor, but 50% of the
      original sites were recovered by receptor solubilization. Since it has previously
      been reported that one of the two sites for alpha-bungarotoxin in the membrane
      bound receptor is readily reversible but is converted to a high-affinity state by
      solubilization [Conti-Tronconi, B. M., Tang, F., Walgrave, S., & Gallagher, W.
      (1990) Biochemistry 29, 1046-1054], these results demonstrate that the covalently
      bound agonist inhibits the binding of alpha-bungarotoxin only to its higher
      affinity site in the membrane. When [3H]bromoacetylcholine labeling was carried
      out after reduction of the receptor by sodium borohydride rather than
      dithiothreitol, both alpha and gamma subunits of the receptor were labeled.
      Labeling of both subunits was completely inhibited if the receptor was first
      reduced with dithiothreitol and the alpha subunit sites were previously
      covalently labeled by unlabeled bromoacetylcholine.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8357805
TI  - Mechanism of fluorescent fatty acid transfer from adipocyte fatty acid binding
      protein to membranes.
AB  - Adipocyte fatty acid binding protein (A-FABP) is a 15-kDa protein found in high
      abundance in the cytosol of adipose cells. To better understand the role of this
      protein in intracellular free fatty acid (ffa) transport, the mechanism of ffa
      transfer from A-FABP to model membranes was examined by monitoring the transfer
      of fluorescent anthroyloxy ffa (AOffa) to small unilamellar phospholipid
      vesicles, using a resonance energy transfer assay. Structural features of ffa
      that increase aqueous solubility, such as shorter chain length and unsaturation,
      did not increase the AOffa transfer rate. In addition, solution conditions that
      increase the aqueous solubility of ffa, such as decreasing ionic strength and
      increasing pH, had little effect on AOffa transfer from A-FABP to membranes.
      These results suggest that AOffa do not transfer through the aqueous phase. The
      small entropic contribution to the free energy of the transfer process provides
      further evidence that AOffa may not travel through the surrounding aqueous
      environment when transferred from A-FABP to phospholipid membranes. Finally, the
      rate of AOffa transfer from A-FABP was directly dependent on the concentration of
      the acceptor membranes. These studies suggest that AOffa transfer from A-FABP to
      phospholipid vesicles may occur via transient collisional interactions between
      the protein and membranes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357806
TI  - G protein beta gamma subunit: physical and chemical characterization.
AB  - The beta gamma subunits of heterotrimeric G proteins play a central role in
      regulating the function of the G protein alpha subunits and in modulating the
      activity of several enzymes and ion channels. We have used the signature tryptic
      cleavage pattern of native beta gamma from bovine brain as a starting point for
      our analysis of its physical and chemical properties. Digestion of bovine brain
      beta gamma with trypsin yields only 2 beta-derived fragments, with relative
      mobilities on SDS-PAGE of 14 kDa (amino terminal) and 27 kDa (carboxyl terminal),
      despite the presence of 32 potential tryptic cleavage sites in the beta 1
      subunit. Trypsin-cleaved beta gamma remains in a complex that has the same
      apparent sedimentation coefficient as intact beta gamma, and retains its ability
      to associate functionally with the alpha o subunit. Comparison of the
      incorporation of [14C]iodoacetamide into reduced denatured beta and unreduced
      denatured beta showed that there are no disulfide bonds in the molecule to hold
      the complex together. The brain beta and gamma subunits can be cross-linked by
      1,6-bis(maleimido)hexane to form a 46-kDa product on SDS-PAGE, and trypsin
      cleavage of cross-linked beta gamma shows that gamma is cross-linked to the 14
      kDa amino-terminal fragment of the beta subunit. On the basis of its primary
      sequence, the beta subunit is predicted to form a repetitive structure
      encompassing the 27-kDa fragment and part of the 14-kDa fragment. Analysis of the
      thermal denaturation of trypsin-cleaved beta gamma supports this prediction and
      confirms that both fragments retain stable tertiary structures following tryptic
      cleavage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357807
TI  - The class I major histocompatibility complex related Fc receptor shows pH
      dependent stability differences correlating with immunoglobulin binding and
      release.
AB  - Maternal immunoglobulin G (IgG) in milk is transported to the bloodstream of
      newborn rodents via an Fc receptor (FcRn) expressed in the gut. The receptor
      shows a striking structural similarity to class I major histocompatibility
      complex (MHC) molecules, being composed of a related heavy chain and the
      identical light chain (beta 2-microglobulin). FcRn binds IgG at the pH of milk in
      the proximal intestine (pH 6.0-6.5) and releases it at the pH of blood (pH
      approximately 7.5). We have compared the stability of a soluble form of FcRn in
      these two pH ranges and find that the heterodimer is markedly more stable at the
      permissive pH for IgG binding. Using the rate of beta 2m exchange as a correlate
      of heterodimer stability, we find that exchange is more than 10 times slower at
      pH 6.1 compared to pH 7.8. Thermal denaturation profiles of FcRn heterodimers at
      pH 8.0 indicate a two-step, sequential heavy-chain (Tm = 52 degrees C) and beta
      2m (Tm = 67 degrees C) denaturation. By contrast, at pH 6.0, a single transition
      is observed, centered at 62 degrees C, corresponding to denaturation of both
      chains. The striking difference in stability does not appear to be correlated
      with the binding of peptide as in class I MHC molecules, because analysis of
      purified FcRn by acid dissociation and sequencing suggests that FcRn is not
      associated with cellular peptides. These results are indicative of pH-dependent
      conformational changes in the FcRn heterodimer, which may be related to its
      physiological function.

PMID- 8357808
TI  - Alcohol-induced protein folding transitions in platelet factor 4: the O-state.
AB  - Platelet factor 4 (PF4) (7800 daltons) is an anti-parallel beta-sheet, alpha/beta
      class protein whose tertiary structure is stabilized by the presence of two
      disulfide bonds. Titration of PF4 with 2-propanol or similar low molecular
      weight, aliphatic alcohols induces reversible protein folding transitions which
      are observed to be in slow exchange on the 600-MHz 1H NMR time scale. Line
      fitting of resolved resonances assigned to ring protons of Y60, H35, H23, and
      alpha H of K50 in native and alcohol-induced states (O-states) allows derivation
      of folding equilibrium constants and exchange kinetics. Folding exchange rates
      vary between 5 and 100 s-1 on going from 9.8 to 3.3 M2-propanol. Simple linear
      extrapolation to 0 M2-propanol yields an O-state to N-state exchange rate of
      about 500 s-1, i.e., millisecond time scale. At relatively high 2-propanol
      concentration (>9.5 M), where the O-state is predominant (>90%), NMR spectra
      suggest a more "unfolded" structure, while CD data indicate the preservation of
      considerable secondary structure. Increasing 2-propanol from 3.3 to 9.8 M,
      however, shifts the CD-derived fractional compositions significantly, with
      overall beta-structure decreasing by about 20% and alpha-helix composition
      increasing by about 25%. Alcohol-jump experiments, which identify O-state long
      lived NHs in the NMR spectrum of native PF4, indicate folding transition
      reversibility and conservation of about 15 long-lived NHs in native and O-states.
      Most of these NHs are assigned to residues in anti-parallel beta-sheet structure.
      Of these 15 NHs, H/D exchange rates, although variably reduced in the O-state,
      are generally still long-lived compared with random coil H/D exchange. Overall,
      the PF4 O-state is a stable intermediate with an apparently more highly
      fluctuating anti-parallel beta-sheet structure and a more stabilized C-terminal
      alpha-helix.

PMID- 8357809
TI  - Structural effects of the C2-methylhypoxanthine:cytosine base pair in B-DNA: A
      combined NMR and X-ray diffraction study of d(CGC[m2I]AATTCGCG).
AB  - C2-Methylhypoxanthine (m2I) is a synthetic analog of guanine with the N2-amino
      group replaced by a methyl group. We have studied the structural consequence of
      the m2I incorporation in DNA by a combination of X-ray crystallographic, NMR, and
      enzymatic analyses. The crystal structure of d(CGC[m2I]AATTCGCG) has been solved
      and refined to an R factor of 20.7% at 2.25-A resolution. In the DNA duplex, the
      two independent m2I:C base pairs maintain the Watson-Crick scheme. While the C2
      methyl group of m2I is in van der Waals contact with the O2 of the base-paired
      cytosine, it only causes the base pair to have slightly higher propeller twist
      and buckle angles. Its solution structure was analyzed by the NMR refinement
      procedure SPEDREF [Robinson, H., & Wang, A. H.-J. (1992) Biochemistry 31, 3524
      3533] using 2D nuclear Overhauser effect data. Two starting models, a relaxed
      fiber model and an X-ray model, were subjected to the NOE-constrained refinement
      using 1518 NOE cross-peak integrals to arrive at the final models with (NOE) R
      factors of 13.8% and 14.3%, respectively. The RMSD between the two refined models
      (all atoms included) is 1.23 A, which presently seems to be near the limit of
      convergence of NOE-based refinement. The local structures of the two models are
      in better agreement as measured by the RMSD of the dinucleotide steps, falling in
      the range 0.54-0.98 A. Both refined solution structures confirm that the m2I
      dodecamer structure is of the B-DNA type with a narrow minor groove at the AT
      region, as observed in the crystal. However, significant differences exist
      between the crystal and solution structures in parameters such as pseudorotation
      angles, propeller twist angles, etc. The solution structure tends to have a more
      uniform backbone conformation, an observation consistent with that concluded from
      the laser Raman study of d(CGCAAATTTGCG) [Benevides, J. M., Wang, A. H.-J., van
      der Marel, G. A., van Boom, J. H., & Thomas, G. J., J. (1988) Biochemistry 27,
      931-938]. Three related dodecamers, d(CGCGAATTCGCG), d(CGC[m2I]AATTCGCG), and
      d(CGC[e6G]AATTCGCG), were tested as substrates for the restriction endonuclease
      EcoRI. The m2I dodecamer was active, but the e6G dodecamer was not. Our results
      illustrate the complementarity in terms of the structural information provided by
      the two methods, X-ray diffraction and NMR.

PMID- 8357810
TI  - Strand orientation in the DNA quadruplex formed from the Oxytricha telomere
      repeat oligonucleotide d(G4T4G4) in solution.
AB  - The structure formed from the DNA oligonucleotide d(G4T4G4) (Oxy-1.5), which
      contains the Oxytricha telomere repeat T4G4, has been investigated by two
      dimensional 1H and 31P NMR spectroscopy. Sequence-specific assignments have been
      obtained for the 1H and 31P resonances, using a combination of methods including
      comparisons to the inosine- and uracil-containing derivatives d(G4T4G3I) and
      d(G4UT3G4). The oligonucleotide forms a symmetrical bimolecular G-quadruplex with
      four G-quartets and thymine loops at opposite ends of the G-quartets. Guanines
      are alternatively syn and anti along each "strand" and all of the thymines are
      anti. The thymines loop diagonally across the G-quartet, resulting in a structure
      in which adjacent strands are alternately parallel and antiparallel and the
      glycosidic torsion angles are syn-syn-anti-anti around each G-quartet. There are
      three different types of grooves, a wide, a narrow, and two medium grooves. A
      diagonally looped quadruplex is formed in the presence of both Na+ and K+
      counterions. The model structure of Oxy-1.5 is compared to the recently published
      crystal structure of Oxy-1.5 (Kang et al., 1992), which contains many of the same
      features as those found in solution but differs in that the thymines loop across
      an edge of the G-quartet.

PMID- 8357811
TI  - Modulation of the stability of a Lac repressor mediated looped complex by
      temperature and ions: allosteric regulation by chloride.
AB  - The lactose repressor of Escherichia coli (LacI) associates to a bidentate
      tetramer in solution and can simultaneously bind two operators to form a protein
      mediated "looped complex". Studies have been conducted of the binding of LacI to
      two operators separated by approximately 11 helical turns of DNA. Quantitative
      DNase I footprint titration analysis of the stability of the LacI-mediated looped
      complex reveals that the Gibbs free energy of cyclization (delta Gzeroj) of the
      looped complex of 11.7 +/- 0.4 kcal/mol is invariant with temperature. van't Hoff
      analysis reveals a large and positive enthalpy of cyclization (delta H degrees =
      12.3 +/- 2.4 kcal/mol) and an entropy that is small and positive (delta S degrees
      = 2.2 cal/deg). Quantitative DNase I footprint titration and kinetic dissociation
      studies were also conducted as a function of counter-ion type and concentration.
      Increasing concentrations of KCl or potassium glutamate destabilize the looped
      complex, a result completely accounted for by increases in the intrinsic DNA
      binding free energies. While the value of delta Gzeroj is invariant with ion
      concentration, chloride is a positive regulator. The value of delta Gzeroj
      decreases by 1.5 kcal/mol upon substitution of chloride for glutamate.
      Measurements of delta Gzeroj conducted as a function of chloride concentration at
      constant ionic strength reveal that approximately one chloride ion per tetramer
      is bound upon looped complex formation. These results demonstrate specific
      allosteric regulation of the formation of the LacI-mediated looped complex by a
      mechanism distinct from the regulation of the constituent protein--DNA
      interactions.

PMID- 8357812
TI  - Conformational properties of DNA hairpins with TTT and TTTT loops.
AB  - The DNA hairpins d[CGATCG-Tn-CGATCG] (n = 3, 4) have been studied by NMR in order
      to gain information on hairpin conformation and flexibility. Resonance
      assignments were made using a combination of DQF-COSY, DQF-COSY[31P], NOESY, and
      1H-31P-COSY. These data also provide approximate coupling constant information
      which points out exceptionally flexible regions of the phosphate backbone. The
      data for both hairpins reveal substantial flexibility within the loop segments.
      For n = 4, NOESY data alone are insufficient to distinguish between two loop
      folding motifs, although coupling constant data favor a conformation in which Tb
      is folded toward the minor groove and is highly exposed to solvent. This is in
      agreement with chemical shift data and susceptibility to modification by KMnO4.
      The phosphate backbone between Tc and Td is exceptionally flexible, undergoing a
      facile exchange between (beta t,gamma+) and (beta+,gamma t) conformers. A similar
      flexible phosphate is observed between Tc and C7 when n = 3. Differences in stem
      conformation and dynamics in both hairpins are restricted to the two base pairs
      adjacent to the stem-loop junction. The C7pG8 stem phosphate appears to flip
      easily between (zeta-,alpha-) and (zeta-,alpha t) conformers when n = 4 but not
      when n = 3. Hairpin loop size thus affects the conformational flexibility of the
      adjacent stem segment.

PMID- 8357813
TI  - Correlation of DNA sequence specificity of anthramycin and tomaymycin with
      reaction kinetics and bending of DNA.
AB  - Anthramycin and tomaymycin are potent antitumor antibiotics belonging to the
      pyrrolo[1,4]-benzodiazepine [P[1,4]B] group. Their potent biological effects are
      thought to be due to their ability to react with DNA within the minor groove,
      forming covalent adducts through the N2 of guanine with the drug molecules
      overlapping with a 3-4 bp region. In spite of their small molecular weights, the
      P[1,4]B's show a surprising degree of sequence selectivity, with 5'-PuGPu
      sequences being the most reactive and 5'-PyGPy sequences being the least reactive
      [Hertzberg, R. P., Hecht, S. M., Reynolds, V. L., Molineux, I. J., & Hurley, L.
      H. (1986) Biochemistry 25, 1249-1258]. It has been proposed that inherent DNA
      flexibility may be one important component of the sequence recognition process
      for P[1,4]B bonding to DNA, and in this regard, molecular modeling studies are
      reflective of the experimentally determined hierarchy of bonding sequences
      [Zakrzewska, K., & Pullman, B. (1986) Biomol. Struct. Dyn. 4, 127-136]. In this
      study, we have used chemical and enzymatic probes (hydroxyl radical, DNase I) to
      evaluate drug- and sequence-dependent changes in DNA-adduct conformation, gel
      electrophoresis to measure drug-induced bending in DNA, and HPLC to measure the
      reaction kinetics of anthramycin bonding to different sequences. The results show
      that tomaymycin bonding to DNA induces greater conformational changes in the DNA
      (i.e., bending and associated narrowing of the minor groove) than anthramycin. In
      addition, we find that within each drug species (i.e., tomaymycin or
      anthramycin), sequence specificity correlates with the degree of bending and
      reaction kinetics such that those sequences with the highest sequence selectivity
      produce more bending of DNA and react faster with DNA and vice versa. On the
      basis of these results, we propose that sequence-dependent conformational
      flexibility may be an important factor in determining the hierarchy of bonding
      sequences for the P[1,4]B's.

PMID- 8357814
TI  - Fura-2 transport in toad urinary bladder epithelium: effects of antidiuretic
      hormone, colchicine and osmotic gradients.
AB  - Fluorescence is transferred across the toad urinary bladder when fura-2/AM is
      added to the mucosal or serosal sides of the epithelium. It was now observed
      that: (1) Oxytocin (20 nM, serosal) increased fluorescence transfer from the
      mucosal to the serosal but not from the serosal to the mucosal baths. The ratio
      between the fluorescence intensities recorded with excitation wavelengths of 340
      and 380 nm indicates that the calcium sensitive probe (free fura-2) was
      transferred to the serosal but not to the mucosal compartment by an oxytocin
      sensitive transport. (2) Preincubation with probenecid did not change
      fluorescence transfer in basal conditions but significantly reduced the oxytocin
      induced increase in free fura-2 transport. (3) Fluorescence accumulation inside
      the tissue was strongly reduced by oxytocin, but only when fura-2/AM was added to
      the mucosal side. (4) An osmotic gradient, in the presence of oxytocin, further
      increased the transfer of fluorescence at 380 nm but not at 340 nm. This
      indicated that the transfer of a calcium-insensitive fraction was being
      stimulated. (5) Preincubation with colchicine strongly inhibited fluorescence
      transfer across the tissue, at both 340 and 380 nm (the 340/380 ratio did not
      change). (6) Tissue accumulation was increased by colchicine. (7) Vanadate did
      not inhibit fura-2 transfer in the toad urinary bladder. We conclude that
      intracellularly-generated free fura-2 is only transported across the basolateral
      border, and that this transfer is stimulated by ADH. The calcium-insensitive
      fraction is transferred by a temperature-dependent process, sensitive to an
      osmotic gradient and colchicine.

PMID- 8357815
TI  - Electric field-mediated glycophorin insertion in cell membrane is a localized
      event.
AB  - Purified soluble glycophorin, an intrinsic protein, can be back 'electroinserted'
      in the membrane of Chinese hamster ovary cells by submitting the cell/protein
      mixture to short electric field pulses. Previous studies showed that this complex
      between pulsed cells and proteins, which is detected only when the cell membrane
      is electropermeabilized, was very stable. This strongly suggested that the
      protein was indeed inserted in the membrane. The basic processes involved in this
      phenomena are studied in the present work. The association is observed at the
      single cell level by means of videoimmunofluorescence. Electric field-mediated
      insertion occurs firstly in a limited patch of the cell surface, which size is in
      agreement with the prediction of Electropermeabilization theory. A free diffusion
      of the inserted proteins then follows on the cell surface. The diffusion
      coefficient is computed to be less than 10(-10) cm2/s as observed for
      transmembranous proteins. This slow process gives an homogeneous distribution of
      the inserted protein.

PMID- 8357816
TI  - The state of association of Band 3 of the human erythrocyte membrane: evidence of
      a hexamer.
AB  - Band 3 of the human erythrocyte membrane was isolated from 32P-labelled
      erythrocytes in non-ethyleneglycol n-dodecyl ether (C12E9), Triton X-100, and
      Brij 58 solutions, and its states of association were studied by sucrose gradient
      sedimentation and by Sepharose 4B column chromatography. The sedimentation and
      elution profiles indicated that Band 3 exists under two stable forms in each
      detergent solution, a slow form and a fast form. The fraction of the fast form in
      a Brij 58 solution was 2-3-times higher than those of the fast forms in C12E9 and
      Triton X-100 solutions. Moreover, depending of the conditions of isolation, only
      the slow form or the fast form was present in a Brij 58 solution. The apparent
      values of sedimentation coefficients, Stokes radii, and effective masses of the
      slow and fast forms in C12E9, Triton X-100, and Brij 58 solutions were
      determined. On the basis of these values, we have concluded that the slow and
      fast forms of Band 3 were dimer and tetramer in C12E9 and Triton X-100 solutions
      but were dimer and hexamer in a Brij 58 solution.

PMID- 8357817
TI  - Influence of hydroxylation and conjugation in cross-inhibition of bile acid
      transport across the human trophoblast basal membrane.
AB  - Taurocholate (TC) transport across the basal plasma membrane of the human
      trophoblast is a carrier-mediated process, whose specificity is probably not
      restricted to TC. The aim of this work was to gain further insight into the role
      of hydroxylation and conjugation in the behavior of the carrier system vs. bile
      acid (BA) species. Radiolabeled TC transport by basal plasma membrane (BPM)
      vesicles obtained from human term placenta was measured by a rapid filtration
      technique. Glycocholate (GC), taurochenodeoxycholate (TCDC) and taurodeoxycholate
      (TDC) inhibited TC binding to BPM. These bile acids compete with TC for the
      binding sites. Symmetry properties for GC- and TCDC-induced inhibition of TC
      transport was found in experiments where GC or TCDC were at the cis-side of the
      membrane (uptake and efflux experiments). GC and TCDC-induced inhibition seems to
      be of mixed type. By contrast, TDC was observed to affect TC transport
      differently, depending on whether the experiments addressed uptake or efflux. At
      the intracellular side of the membrane (uptake), TDC induced a marked increase in
      both Vmax and Kt. However, at the fetal side (efflux) a significant reduction in
      both Vmax and Kt was found. In spite of these peculiarities, the values for Ki
      were very close for GC, TCDC and TDC at the intracellular side but not at the
      fetal side, where the decreasing order for Ki was GC > TCDC > TDC. TC uptake by
      BPM vesicles was not modified in the presence of a wide range of estrone sulfate
      concentrations (0.002-1.0 mM). In summary, these results indicate that a
      particular bile acid molecular structure is necessary for steroid-related
      compounds to interact with the bile acid carrier located in BPM. They also
      suggest that changes in the number and position of hydroxy groups, as well as in
      the amino-acid moiety in amidated bile acids modify the behavior of the carrier,
      which may play an important role in the net vectorial transfer of bile acids
      across the placenta.

PMID- 8357818
TI  - Biosynthesis and initial processing of the cardiac sarcolemmal Na(+)-Ca2+
      exchanger.
AB  - Based on the deduced amino-acid sequence of the cardiac Na(+)-Ca2+ exchanger,
      there are six potential N-linked glycosylation sites and a potential cleaved
      signal sequence. To study the post-translational modifications of the exchanger,
      in vitro translation was examined in the presence and absence of canine
      pancreatic microsomes. Glycosylation, detected as endoglycosidase H induced
      shifts in molecular size, was examined for proteins having different numbers of
      potential N-linked glycosylation sites by using full and partial length RNA
      transcripts. In the presence of microsomes, the molecular mass of the full-length
      clone increased from 110 to 113 kDa. Endoglycosidase H treatment led to a
      reduction to 108 kDa, indicating that glycosylation increases the molecular mass
      by approx. 5 kDa and a signal sequence of approx. 2 kDa is cleaved during
      processing. Analysis of molecular-mass shifts obtained with partial transcripts
      suggested that glycosylation occurs at position N-9. This was confirmed by site
      directed mutagenesis studies. A molecular mass of approx. 120 kDa was measured
      for Western blots of cardiac sarcolemmal membrane or oocytes expressing the wild
      type exchanger. The molecular mass was reduced by approx. 10 kDa for the N9Y
      mutant or from exchanger obtained from a baculovirus-infected insect cell line
      where glycosylation does not occur. The giant excised patch technique was used to
      determine the functional consequences of glycosylation. Na(+)-Ca2+ exchange
      current was examined in patches from oocytes expressing either the wild-type or
      N9Y mutant. The non-glycosylated mutant exhibited the same properties as the
      native exchanger with respect to voltage, sodium dependence, and the effects of
      chymotrypsin. The results indicate that glycosylation does not affect exchanger
      function in Xenopus oocytes and help to define exchanger topology.

PMID- 8357819
TI  - Interaction of hydrophobic peptides with model membranes: slow binding to
      membranes and not subtle variations in pore structure is responsible for the
      gradual release of entrapped solutes.
AB  - Investigation of the mechanism of action of membrane-perturbatory peptides often
      involves monitoring the release of entrapped solutes from small unilamellar
      vesicles. Complete release of vesicular contents can take 15 min or more.
      Theoretical calculations suggest that the process should be of the order of
      seconds and not minutes. We have investigated the membrane-perturbatory abilities
      of hydrophobic peptides corresponding to regions of pardaxin that are important
      for toxin action. Peptide-induced release of entrapped carboxyfluorescein (CF)
      from lipid vesicles under various conditions was monitored by fluorescence
      spectroscopy. Several minutes were required for the complete release of CF. This
      has been shown to be due to lack of instantaneous and complete association by all
      the added peptide with the lipid vesicles. In addition, for a given peptide/lipid
      molar ratio, an increase in lipid concentration causes an increase in the rate of
      CF-release. It is likely that increased binding following a greater number of
      collisions between peptide and vesicles is responsible for this observation. A
      Fast Protein Liquid Chromatography assay confirms that a significant amount of
      peptide remains unbound from the vesicles. Other investigators have reported the
      requirement for a similar time span for the complete release of vesicular
      contents by pardaxin and several other membrane-perturbatory peptide toxins. The
      proposed reason for the delay in lysis may therefore be applicable to a large
      variety of membrane-perturbants. Thus, the assay of peptide-induced release of
      vesicular contents is likely to predominantly reflect only the rate of
      association of peptide with the membrane, and not more subtle variations in the
      nature of the pore formed.

PMID- 8357820
TI  - In vitro cytostatic effect of TNF (tumor necrosis factor) entrapped in
      immunoliposomes on cells normally insensitive to TNF.
AB  - The cytostatic activity of TNF entrapped in novel immunoliposomes with a specific
      antibody against target cells is described. A two step conjugation method was
      used for the preparation of these targeted immunoliposomes. In the first step,
      liposomes containing N-4-(p-maleimidophenyl)butyryl phosphatidylethanolamine (MPB
      PE) were conjugated with a goat anti-mouse IgG Fab' fragment which recognizes the
      Fc portion of a mouse antibody against the target cell markers. In the second
      step, the mouse antibody against human tumor cells was conjugated to the
      liposomes. Using these targeted immunoliposomes, we demonstrated that cells
      usually insensitive to TNF such as Daudi cells, MT-2 cells and T-24 cells could
      become sensitive to TNF in vitro. The cytostatic activity of these
      immunoliposomes was blocked by the addition of a lysosomotropic agent such as
      NH4Cl or chloroquine. Significant uptake of 125I-TNF into T-24 cells was observed
      when these immunoliposomes were used, and this uptake of TNF was inhibited by
      cytochalasin B or chloroquine. Free 125I-TNF was not taken up by these cells.

PMID- 8357821
TI  - Novel radioactive phospholipid probes as a tool for measurement of phospholipid
      translocation across biomembranes.
AB  - In an attempt to develop a new method to measure transbilayer phospholipid
      translocation, with a higher sensitivity and higher temporal resolution, novel
      radioactive phospholipid probes (*C5-PC, *C5-PE, and *C5-PS) with a short acyl
      chain at the 2-position were synthesized. The *C5-PC probe was made by coupling
      lysophosphatidylcholine with [14C]pentanoic acid, using N,N-carbonyldiimidazole
      as a coupling agent (yield 37%), and *C5-PE and *C5-PS were synthesized by
      exchanging the choline moiety of *C5-PC for ethanolamine and L-serine,
      respectively, as catalyzed by phospholipase D. The usefulness of the probes was
      confirmed by measuring phospholipid translocation across the human erythrocyte
      plasma membrane, in which the presence of aminophospholipid translocase was
      revealed using EPR techniques (Zachowski, A., Farve, E., Cribier, S., Herve, P.
      and Devaux, P.F. (1986) Biochemistry 25, 2585-2590). Using the present probes,
      ATP-dependent and SH-reagent-inhibitable translocation of *C5-PS and *C5-PE from
      outer to inner leaflets, which is characteristic to the translocation mediated by
      aminophospholipid translocase, was detected with a higher sensitivity than seen
      with the EPR technique. These radioactive phospholipid probes will be useful to
      measure phospholipid translocation with a high sensitivity and have the potential
      for application in measurements of transbilayer lipid-translocation for a wide
      variety of membranes.

PMID- 8357822
TI  - Oligomeric structure of the sodium-dependent phlorizin binding protein from
      kidney brush-border membranes.
AB  - Immunodetection of solubilized kidney brush-border proteins on Western blots
      using antibodies against the 70 kDa phlorizin binding component of sodium-glucose
      cotransporter allows to identify an additional protein band with apparent
      molecular mass of 120 kDa in the presence of reducing agent dithiothreitol.
      Antibodies specifically eluted from the 70 kDa protein still recognize the 120
      kDa protein on Western blot. The lack of dissociation of the 120 kDa protein from
      native brush borders or Triton X-100 extract in the presence of dithiothreitol
      can be improved by an extended incubation at 25 degrees C; this protein is full
      dissociated when purified by electroelution from polyacrylamide gel and gives two
      subunits with apparent molecular masses of 70 and 60 kDa by Coomassie staining
      and Western blot analysis. The effect of dithiothreitol on the renal brush-border
      membrane phlorizin binding is studied; a decrease in the number of high-affinity
      phlorizin binding sites without modification of the affinity to the binding
      molecule is observed. These data suggest that the high-affinity phlorizin binding
      moiety of sodium-glucose cotransporter exists in the kidney as a dimeric
      structure.

PMID- 8357823
TI  - The role of E2F in the mammalian cell cycle.

PMID- 8357824
TI  - Oncogenes and protein kinases in neuronal growth-factor action.

PMID- 8357825
TI  - Signals and genes in the control of cell-cycle progression.

PMID- 8357826
TI  - The tumor suppressor p53.

PMID- 8357827
TI  - Peptide growth factors and the regulation of early amphibian development.

PMID- 8357828
TI  - src-related protein tyrosine kinases and their surface receptors.
AB  - The CD4-p56lck and CD8-p56lck complexes have served as a paradym for an expanding
      number of interactions between src-family members (p56lck, p59fyn, p56lyn,
      p55blk) and surface receptors. These interactions implicate src-related kinases
      in the regulation of a variety of intracellular events, from lymphokine
      production and cytotoxicity to the expression of specific nuclear binding
      proteins. Different molecular mechanisms appear to have evolved to facilitate the
      receptor-kinase interactions, including the use of N-terminal regions, SH2
      regions and kinase domains. Variation exists in stoichiometry, affinity and the
      nature of signals generated by these complexes in cells. The CD4-p56lck complex
      differs from receptor-tyrosine kinases in a number of important ways, including
      mechanisms of kinase domain regulation and recruitment of substrates such as PI 3
      kinase. Furthermore, they may have a special affinity for receptor-substrates
      such as the TcR zeta, MB1/B29 or CD5 receptors, and act to recruit other SH2
      carrying proteins, such as ZAP-70 to the receptor complexes. Receptor-src kinase
      interactions represent the first step in a cascade of intracellular events within
      the protein-tyrosine kinase/phosphatase cascade.

PMID- 8357829
TI  - The differential induction of alpha 1-acid glycoprotein and serum amyloid A genes
      by heavy metals.
AB  - We have investigated the differential regulation of the mouse (Balb/c) acute
      phase reactants, alpha 1-acid glycoprotein and serum amyloid A by heavy metals
      (Hg, Cd, Pb, Cu, Ni and Zn). Mice have two distinct alpha 1-acid glycoprotein
      mRNAs encoded by alpha 1-acid glycoprotein gene-1, (AGP-1) and alpha 1-acid
      glycoprotein gene-2 (AGP-2) and 3 distinct serum amyloid A mRNAs encoded by serum
      amyloid A gene-1, (SAA-1), serum amyloid A gene-2 (SAA-2) and serum amyloid A
      gene-3 (SAA-3). Using specific oligonucleotides as probes we have demonstrated
      that the AGP-1 and AGP-2 genes, and the SAA-1 and SAA-2 genes are differentially
      induced by heavy metals in the liver. At the peak of induction, AGP-2 mRNA is 80
      100-fold higher than the AGP-1 mRNA level; the SAA-1 mRNA level is approx. 40
      fold higher than SAA-2, and SAA-3 mRNA is not detected. A similar differential
      pattern of expression is observed in bacterial lipopolysaccharide mediated
      inductions. However, low levels of SAA-3 are also seen in this treatment.
      Adrenalectomy has no effect on the inductions by heavy metals of AGP-2 and the
      SAAs, indicating that the glucocorticoid receptor pathway may not function in
      this regulation. However, AGP-1 induction is significantly delayed, indicating
      that glucocorticoid may be essential for a rapid response to Hg. The liver is the
      major site of heavy metal induction of AGP and SAA genes; Hg induces AGP-1 and 2,
      and SAA-1 and 2 only in the liver. Our studies clearly show that the AGP and SAA
      genes belong to a subgroup of acute-phase reactants that respond to heavy metals.
      CRP is another member of this family. Furthermore, our data suggest that the
      mechanism is not directly mediated by glucocorticoid or cytokine induction
      pathways.

PMID- 8357830
TI  - Heat-shock-induced protein synthesis is responsible for the switch-off of hsp70
      transcription in Tetrahymena.
AB  - We had previously described that new RNA synthesis is required for expression of
      the heat shock protein HSP70. Here, we find that the HSP70 mRNA decreases its
      levels under stress conditions, heat shock (HS) or arsenite (As), and that its
      levels start to decline at the same time as maximal HSPs synthesis (including
      HSP70) occurs. This suggests that regulation of the hsp70 gene is mainly exerted
      at the transcriptional level. Accumulation of the HSP70 mRNA in cells stressed in
      presence of cycloheximide (CHX), indicates that (a) protein(s) non-existent
      before stress, possibly HSP70 itself (which is shown here to be relatively
      stable), is involved in negatively regulating hsp70 expression. Since degradation
      of the HSP70 mRNA is also shown to occur in cells heat-shocked under CHX, as seen
      from decay of its levels upon addition of actinomycin D (AMD), the protein(s)
      must repress hsp70 expression at the transcriptional level. Other conditions that
      affect normal protein synthesis, namely the translation inhibitor puromycin and
      the arginine-analog canavanine (shown here to be stress inducers in Tetrahymena
      pyriformis), also cause a delay in transcription-arrest of the HSP70 mRNA. Under
      severe stress conditions of HS (36 degrees C) or As (350 microM), the levels of
      HSP70 mRNA are higher than under mild stress conditions, however, no significant
      difference is seen in the pattern of HSP70 mRNA decay.

PMID- 8357831
TI  - Isolation and characterization of a cDNA clone encoding for rat CSF-1 gene. Post
      transcriptional repression occurs in myogenic differentiation.
AB  - A major CSF-1 (Colony-Stimulating Factor 1) mRNA 4.0 kb long was expressed during
      the proliferation of the L6 alpha 1 rat myogenic cells and was down-regulated
      after their differentiation into myotubes. A complete cDNA encoding the rat CSF-1
      gene (rmCSF-1) was isolated from a cDNA library of L6 alpha 1 myoblasts and
      sequenced. The overall deduced amino acid sequence was 100% and 68% identical to
      the mouse and human CSF-1, respectively. While the previously reported mechanisms
      about the regulation of CSF-1 expression in TPA-treated-monocytes (Horiguchi, J.,
      Sariban, E. and Kufe, D. (1988) Mol. Cell. Biol. 8, 3951-3954) and in fibroblasts
      (Falkenburg, J.H.F., Harrington, M.A., De Paus, R.A., Walsh, M.K., Daub, R.,
      Landegent, J.E. and Broxmeyer, H.E. (1991) Blood 78, 658-665) involved a control
      at the transcriptional level, in contrast, the CSF-1 mRNA (half-life
      approximately 3 h in L6 alpha 1 myoblasts) was post-transcriptionally down
      regulated during myogenesis. Inhibition of protein synthesis with cycloheximide
      (CHX) increased differentially the half-life of CSF-1 mRNA in L6 alpha 1 myotubes
      compared to L6 alpha 1 myoblasts. Finally, L6 alpha 1 myoblasts were shown to
      synthesize a 140 kDa homodimeric form of CSF-1. Thus, these findings, together
      with other results, indicate that CSF-1 gene products may play a role in the
      normal and neoplastic proliferation of muscular cells.

PMID- 8357832
TI  - Regulation of the uncoupled GTPase activity of elongation factor G (EF-G) by the
      conformations of the ribosomal subunits.
AB  - The elongation factor G (EF-G) GTPase activity is induced by either 70S ribosomes
      or 50S ribosomal subunits. The GTPase activity induced by 50S ribosomal subunits
      is predominant at low concentrations of monovalent cations and decreases with
      increasing concentrations of K+ or NH4+. Double-logarithmic plots of the data
      reveal straight lines with different slopes for low and high concentrations of
      monovalent cations, respectively, intersecting at the same concentration of
      monovalent cations where maximal EF-G GTPase activity is measured in the presence
      of both ribosomal subunits. Substantially the same curves are obtained when 50S
      ribosomal subunits are substituted by 50S CsCl-core particles partially
      reconstituted by addition of purified 50S split proteins L7/L12. Intact 30S
      ribosomal subunits, but not 30S CsCl-core particles are able to associate with
      50S ribosomal subunits and to modulate ribosome-dependent EF-G GTPase activity.
      Therefore, our data clearly show that the biphasic courses of the NH4+ and K+
      curves of EF-G GTPase activity induced by 50S ribosomal subunits are not due to
      contaminations with 30S ribosomal subunits but result from different
      conformations of EF-G/50S ribosomal-subunit complexes at low and high
      concentrations of monovalent cations, respectively. CD spectra of 50S ribosomal
      subunits measured under different salt conditions have shown that the
      conformation of the 50S ribosomal subunits is strongly dependent on the
      concentration of monovalent cations. The conformation of 30S ribosomal subunits
      is, however, considerably stronger influenced by the Mg2+ than by the
      concentration of monovalent cations. The salt effects on the conformation of the
      30S ribosomal subunits correspond to the salt effects on the association of
      ribosomal subunits and the modulation of EF-G GTPase activity by 30S ribosomal
      subunits. Since, in the presence of both ribosomal subunits, EF-G GTPase activity
      is maximal at the same concentration of monovalent cations where obviously a
      spontaneous conformation change of 50S ribosomal subunits takes place, we
      postulate that EF-G GTPase primarily acts on the ribosomes by changing the
      conformation of 50S ribosomal subunits. The resulting model is based on the
      assumption that EF-G GTPase activity is considerably more strongly induced by the
      'substrate conformation' ('state I') than by the 'product conformation' of the
      50S ribosomal subunits ('state II'). A spontaneous transformation of 'state II'
      to 'state I' is expected to occur in the absence of mRNA, aminoacyl-tRNA and EF-T
      especially under salt conditions favouring state I.

PMID- 8357833
TI  - Purification and characterization of nuclear scaffold proteins which bind to a
      highly repetitive bent DNA from rat liver.
AB  - Our previous work (Hibino et al. (1992) Biochem. Biophys. Res. Commun. 184, 853
      858) has shown that the binding affinities of a highly repetitive DNA component
      for rat nuclear scaffold proteins, P123 and P130, depend on the degree of
      sequence-directed bending of the helix axis. In the present experiment, these
      proteins have been purified and finally isolated by DNA-Sepharose column
      chromatography. The pI values of P123 and P130 were 7.2 and 8.1, respectively.
      The southwestern blotting revealed that a highly repetitive bent DNA (370-bp XmmI
      fragment) from rat liver binds readily to the isolated proteins under a hypotonic
      condition (50 mM NaCl) and that the level of the binding affinity for each
      protein was lowered with increasing NaCl concentration. The sedimentation
      analysis predicted that direct interaction between the XmnI fragment and P123 or
      P130 results in the formation of a complex which consists of two of the fragments
      and one molecule of the protein, alternatively, one of the fragment and three
      molecules of the proteins. Distamycin A, an antibiotic which binds specifically
      to AT-rich DNA, removed the bend in the XmnI fragment and inhibited binding of
      the fragment to P123 or P130, whereas neither removal of the bend nor binding
      inhibition was observed with chromomycin A3, an antibiotic specific for GC-rich
      sites in DNA. These results imply that AT-rich regions in a highly repetitive DNA
      component cause bending of the helix axis to be recognized by some of nuclear
      scaffold proteins.

PMID- 8357834
TI  - Molecular and biochemical characterization of a recombinant human PKC-delta
      family member.
AB  - Two cDNA clones coding for the human protein kinase C-delta (PKC-delta) were
      fortuitously isolated during the process of screening a human library for a cDNA
      clone of an unrelated protein, the nucleolar protein fibrillarin. The two human
      homologues have about 88% nucleotide sequence identity to the rat and mouse PKC
      delta cDNA clones. A comparison of the predicted amino acid sequences of the two
      human PKC-delta clones with the rat and mouse homologues indicated a greater
      degree of sequence divergence (89-90% homology) compared to the high degree of
      sequence conservation observed with other human PKC family members and their
      mammalian counterparts. Expression of the clones in the baculovirus insect-cell
      expression system indicated that both proteins exhibited phorbol ester binding
      activity, and were dependent upon phosphatidylserine and diacylglycerol for
      maximal activation. Further characterization of the properties of the human PKC
      delta revealed substrate and lipid dependencies distinct from other members of
      the protein kinase C family; including PKC-deltas isolated from other species.
      The dissimilarities in the predicted amino acid sequences between the human and
      other mammalian species could account in part for some of these observed
      biochemical differences.

PMID- 8357835
TI  - Cloning, sequencing and expression of the gene encoding NADH oxidase from the
      extreme anaerobic thermophile Thermoanaerobium brockii.
AB  - The gene encoding the enzyme NADH oxidase from the extreme thermophile
      Thermoanaerobium brockii has been isolated from a recombinant library of genomic
      DNA and sequenced. An open reading frame corresponds to the 651 amino acids of
      the enzyme's subunit, which include characteristic FAD- and NADH-binding
      sequences, as well as cysteines which are involved in the FeS cluster present in
      the enzyme. The enzyme is expressed either from its own promoter or from vector
      promoters in Escherichia coli. After heat-treating the recombinant extracts at 70
      degrees C, most of the host proteins are denatured, leaving the NADH oxidase 5-
      to 10-fold enriched.

PMID- 8357836
TI  - Cloning and sequencing of a soybean nuclear gene coding for a chloroplast
      translation elongation factor EF-G.
AB  - A plant nuclear gene coding for a chloroplast specific translation elongation
      factor EF-G (cEF-G) was cloned and sequenced for the first time. We screened two
      partial soybean genomic libraries with a short PCR amplified pea DNA probe
      constructed according to the N-terminal peptide sequence of pea chloroplast EF-G.
      The gene is three times split, codes for a chloroplast type transit peptide and a
      protein very similar to bacterial translation elongation factor EF-G. The gene is
      expressed as evidenced by Northern hybridisations.

PMID- 8357837
TI  - The nucleotide sequence of human aminoacylase-1.
AB  - The nucleotide sequence of a cDNA coding for human aminoacylase-1 (N-acylamino
      acid aminohydrolase, ACY-1, EC 3.5.1.14) subunit has been determined. The amino
      acid sequence of human ACY-1 subunit deduced from its cDNA nucleotide sequence
      showed a high degree of identity (87.7%) with the corresponding protein from
      porcine [1], although the former is one amino acid residue longer than the
      latter. Of 12 histidine and 3 cysteine residues, conserved between the proteins
      from two species, some are anticipated to form the active site of ACY-1 as either
      catalytic residues or ligands for an essential Zn2+ atom.

PMID- 8357838
TI  - Structure and deduced amino acid sequence of the human fibromodulin gene.
AB  - We have determined the structure and partially sequenced the human fibromodulin
      gene. The translated region of the gene is composed of two exons. An exon in the
      5'-non translated region is separated from the next exon by a 1 kb intron. This
      exon, which encodes the major part of the translated region, is 983 bp and is
      followed by an approx. 5 kbp intron. The last 50 nucleotides of the translated
      region as well as the 3'-nontranslated region are located on the last exon. This
      exon arrangement is different from the arrangement reported for the gene of the
      structurally related biglycan. The translated region of the gene was sequenced
      and compared with bovine fibromodulin. The amino acid sequences of human and
      bovine fibromodulin show an overall homology of 90%.

PMID- 8357840
TI  - Sequence and genomic organization of the Drosophila proteasome PROS-Dm25 gene.
AB  - The genomic region encoding the Drosophila proteasome alpha-type subunit Dm25 has
      been isolated and analysed with regard to its nucleotide sequence and structure.
      Our data show that the Dm25 coding region is interrupted by four introns and that
      the 5' upstream region contains no sequence motifs common with the two previously
      described proteasome genes.

PMID- 8357839
TI  - Nucleotide sequence of cDNA encoding ZP3 alpha, a sperm-binding glycoprotein from
      zona pellucida of pig oocyte.
AB  - We isolated a cDNA encoding the pig oocyte zona pellucida protein ZP3 alpha from
      a pig ovary lambda gt11 cDNA library. The 1699 bp cDNA contains a short 3'
      untranslated region characteristic of cDNAs encoding zona proteins. The deduced
      amino acid sequence for ZP3 alpha consists of 536 amino acid residues and shares
      66% overall identity with a 55 kDa rabbit zona protein. Important features of the
      ZP3 alpha polypeptide include a predicted N-terminal signal sequence, twenty-two
      cysteine residues, an O-glycosylated domain and potential attachment sites for
      five N-linked sugar chains. A multibasic tetrapeptide occurs upstream of a
      predicted C-terminal transmembrane sequence; this suggests proteolytic processing
      of an integral membrane precursor within the constitutive secretory pathway.

PMID- 8357841
TI  - Cloning, expression and characterization of horse L-ferritin in Escherichia coli.
AB  - Horse L-ferritin cDNA was cloned from horse liver, and the base sequence was
      determined. The L-ferritin was expressed using pTZ18U encoding lac promoter, and
      found to possess an additional 8-amino acid sequence at the N-terminus as
      compared with commercially obtained horse spleen (natural) ferritin. It was
      determined that there was Pro at position 94 in both the recombinant and natural
      L-ferritin, although it was previously reported that Leu was in this position in
      the natural species. Transmission electron microscopy showed that this
      recombinant ferritin formed a 24-mer shell.

PMID- 8357842
TI  - Recent developments in certain X-linked genetic eye disorders.
AB  - Over the past few years, genetic diseases of the ocular system have become very
      active and fast-growing research areas in the vision field. The rapid development
      of the recombinant DNA techniques together with somatic cell genetics, during the
      last two decades has fueled this progress. As a result, many genetic disease
      genes have been localized in the human chromosome and several of them have been
      isolated and characterized. These and other studies have profoundly enriched our
      basic understanding of genetic eye disorders. Although gene replacement therapy,
      prenatal diagnosis and carrier detection have not been extensively tried for
      genetic eye diseases, such attempts will now be feasible. Molecular analyses made
      it clear that there are many challenging problems that need attention. This
      report highlights some of these initial developments, particularly on the X
      linked major genetic eye diseases. In order to help the beginners and general
      audience, a brief description of the clinical pathology and the molecular probes
      used to locate the genetic defects of certain disorders are presented. Disorders
      are arranged according to their linkage from telomere to telomere on the
      chromosome to give a coherent structure. It is hoped that this information is
      useful and of general interest for the beginners, established investigators and
      ophthalmologists.

PMID- 8357843
TI  - Polyamines in testosterone-induced hypertrophic and antifolate-induced
      hyperplastic mouse kidney. Differential effect of alpha-difluoromethylornithine.
AB  - In the testosterone-induced hypertrophic and antifolate (N10-propargyl,5,6
      dideazafolic acid, CB 3717)-induced hyperplastic mouse kidney models, a marked
      increase of two diamine levels--putrescine and cadaverine--occurred which
      paralleled induced ornithine decarboxylase (ODC) activity. Under these conditions
      the augmentation of spermidine levels was much smaller, while spermine levels
      were affected differentially--increased by testosterone and decreased by CB 3717;
      this resulted in an increase of spermidine/spermine ratio in hyperplastic, but
      not hypertrophic kidney. alpha-Difluoromethylornithine (DFMO) prevented
      testosterone- or CB 3717-induced increment of both diamine levels. Spermidine and
      spermine depletion in response to DFMO was significant in hyperplastic kidney
      only. DFMO also significantly affected the other biochemical markers of
      hyperplasia, namely lowered CB 3717-induced cell proliferation rate and increased
      S-adenosylmethionine decarboxylase (AdoMetDC) activity. In contrast, testosterone
      induced hypertrophy was not influenced by DFMO, as judged by the lack of its
      effect on S-adenosylmethionine synthetase and cystathionine and synthase
      activity. These results indicate that the increase of putrescine levels does not
      mediate testosterone-induced renal hypertrophy and possibly also antifolate
      induced hyperplasia. The involvement of spermidine in mediation of renal
      hyperplasia is highly possible, while that of spermine is excluded.

PMID- 8357844
TI  - Molecular basis of an adult form of Sandhoff disease: substitution of glutamine
      for arginine at position 505 of the beta-chain of beta-hexosaminidase results in
      a labile enzyme.
AB  - Sandhoff disease is a lysosomal storage disorder characterized by accumulation of
      GM2 ganglioside due to mutations in the beta-chain of beta-hexosaminidase.
      Hexosaminidase activity is negligible in infantile Sandhoff disease whereas
      residual activity is present in juvenile and adult forms. Here we report the
      molecular basis of the first described adult form of Sandhoff disease. Southern
      analysis of chromosomal DNA indicated the absence of chromosomal deletions in the
      gene encoding the beta-chain. Northern analysis of RNA from cultured fibroblasts
      demonstrated that at least one of the beta-chain alleles was transcribed into
      normal-length mRNA. Sequence analysis of the entire cDNA prepared from poly
      adenylated RNA showed that only one point mutation was present, consisting of a G
      ->A transition at nucleotide position 1514. This mutation changes the electric
      charge at amino acid position 505 by substitution of glutamine for arginine in a
      highly conserved part of the beta-chain, present even in the slime mold
      Dictyostelium discoideum. The nucleotide transition generated a new restriction
      site for DdeI, which was present in only one of the alleles of the patient.
      Reverse transcription of mRNA followed by restriction with DdeI resulted in
      complete digestion at the mutation site, demonstrating that the second allele was
      of an mRNA-negative type. Transfection of COS cells with a cDNA construct
      containing the mutation but otherwise the normal sequence resulted in the
      expression of a labile form of beta-hexosaminidase. These results show that the
      patient's is a genetic compound, and that the lability of beta-hexosaminidase
      found in this form of Sandhoff disease is based on a single nucleotide
      transition.

PMID- 8357845
TI  - Ceramide composition of the psoriatic scale.
AB  - This paper investigates the ceramide composition of the psoriatic scale compared
      with that of normal human SC. A method was optimalized, based on TLC separation
      followed by densitometry, allowing the provision of good resolution and
      quantification of ceramide fractions from both normal and pathological specimens.
      Seven ceramide fractions were isolated and submitted to compositional analysis.
      The obtained results suggested a revisitation of previous ceramide designation.
      Therefore a simple classification is suggested, based on grouping ceramides
      carrying structural similarities under common codes. According to these rules,
      ceramides were grouped into five classes designated as: (1) Cer[EOS], which
      contains ester-linked fatty acids, omega-OH fatty acids and sphingosines; (2)
      Cer[NS], which contains non-OH fatty acids and sphingosines; (3) Cer[NP], which
      contains non-OH fatty acids and phytosphingosines; (4) Cer[AS], which contains
      alpha-OH fatty acids and sphingosines; (5) Cer[AP], which contains alpha-OH fatty
      acids and phytosphingosines. Analysis of ceramides from the psoriatic scale,
      compared to those from normal human SC, resulted in an impairment of the Cer[EOS]
      content as well as of the ceramides containing phytosphingosine, with concurrent
      increase in ceramides containing sphingosine, being the total amount maintained
      identical. Since one of the suggested pathways for phytosphingosine biosynthesis
      involves the water addition to the corresponding sphingosine double bond, we can
      speculate that the observed alteration is due to a deranged water
      bioavailability, associated with psoriasis.

PMID- 8357846
TI  - Renal corticosterone 6 beta-hydroxylase in the spontaneously hypertensive rat.
AB  - Excess 6 beta-OH-corticosterone production by family 3A cytochromes P-450 may
      play a role in genesis of hypertension in the spontaneously hypertensive rat
      (SHR), by producing a renal defect in Na+ excretion. Renal cytochromes P-450 may
      be a causal factor in this genetic model. Since family 3A P-450 is present in rat
      kidney (collecting duct), the renal family 3A catalytic (6 beta-OHase) and
      immunoreactive activities were compared in SHR and normotensive control (Wistar
      Kyoto; WKY) rats. Corticosterone 6 beta-hydroxylation is markedly higher in SHR
      than in WKY renal microsomal preparations. Western blot analysis with antibodies
      to rat and rabbit liver family 3A isoforms demonstrated related proteins.
      Densitometry revealed greater relative intensity of staining in SHR compared to
      WKY with both antibodies. Both antibodies inhibited corticosterone 6 beta
      hydroxylation by SHR renal microsomes. Increased renal 6 beta-OH-corticosterone
      production by increased renal family 3A cytochromes P-450 may play a role in the
      blood pressure elevation in SHR.

PMID- 8357847
TI  - Structural and functional studies in vitro on the p6 protein from the HIV-1 gag
      open reading frame.
AB  - Protein p6 from HIV-1 gag open reading frame is reported to affect both the final
      phase of assembly of the viral particle and the early stage of the gag
      polyprotein maturation in vitro. Two separate hypotheses have been proposed, on
      only one of these reported effects. We think that both observations may be
      eventually explained if p6 protein strongly inhibits the HIV-1 proteinase.
      Protein p6 was synthesised by solid-phase peptide synthesis. Several methods of
      folding the p6 protein were tested, each resulting in the random structure
      according to both CD and 1D proton NMR spectra. A uniformly high exposure of NH
      protons to the solution was confirmed by temperature-dependent NMR spectra and
      isotope exchange experiments. Thus the p6 protein does not have any rigid
      conformation in solution. A rigid structure is not formed after further cleavage
      by HIV-1 proteinase as neither the protein nor its fragments are cleaved by this
      proteinase. In addition, the p6 protein itself does not act as inhibitor of HIV-1
      proteinase. This excludes a direct role of p6 protein and supports the hypothesis
      that p6 is involved in forming the appropriate structure of gag polyprotein
      precursor. The role of slowly cleaved tight gag-proteinase in the final stage of
      maturation may be to slow down maturation of the precursor polyproteins prior to
      their transport to final location in the membrane.

PMID- 8357848
TI  - A carbon-13 nuclear magnetic resonance investigation of the metabolic fluxes
      associated with glucose metabolism in human erythrocytes.
AB  - We have used [2-13C]D-glucose and carbon-13 nuclear magnetic resonance (NMR)
      spectroscopy to investigate metabolic fluxes through the major pathways of
      glucose metabolism in intact human erythrocytes and to determine the interactions
      among these pathways under conditions that perturb metabolism. Using the method
      described, we have been able to measure fluxes through the pentose phosphate
      pathway, phosphofructokinase, the 2,3-diphosphoglycerate bypass, and
      phosphoglycerate kinase, as well as glucose uptake, concurrently and in a single
      experiment. We have measured these fluxes in normal human erythrocytes under the
      following conditions: (1) fully oxygenated; (2) treated with methylene blue; and
      (3) deoxygenated. This method makes it possible to monitor various metabolic
      effects of stresses in normal and pathological states. Not only has 13C-NMR
      spectroscopy proved to be a useful method for measuring in vivo flux through the
      pentose phosphate pathway, but it has also provided additional information about
      the cycling of metabolites through the non-oxidative portion of the pentose
      phosphate pathway. Our evidence from experiments with [1-13C]-, [2-13C]-, and [3
      13C]D-glucoses indicates that there is an observable reverse flux of fructose 6
      phosphate through the reactions catalyzed by transketolase and transaldolase,
      even in the presence of a net flux through the pentose phosphate pathway.

PMID- 8357849
TI  - Measurement of fluxes through the pentose phosphate pathway in erythrocytes from
      individuals with sickle cell anemia by carbon-13 nuclear magnetic resonance
      spectroscopy.
AB  - Erythrocytes from individuals with sickle cell anemia have previously been shown
      to have increased levels of intracellular oxidants and increased oxidative
      damage. Oxidative damage has been implicated in the events leading to the painful
      crises and hemolytic anemia found in sickle cell anemia. Since the pentose
      phosphate pathway (PPP) is an important source of reducing capacity in
      erythrocytes, we have investigated the fluxes through the PPP in normal and
      sickle cell erythrocytes using [2-13C]D-glucose and carbon-13 nuclear magnetic
      resonance (NMR) spectroscopy. Our results indicate that sickle cell erythrocytes
      have a flux through the PPP of 0.13 +/- 0.02 mumol/h per ml erythrocytes that is
      comparable to that in normal erythrocytes, 0.21 +/- 0.02 mumol/h per ml
      erythrocytes. However, when stimulated with methylene blue, sickle cell
      erythrocytes show a decreased response, 0.59 +/- 0.10 mumol/h per ml
      erythrocytes, compared to normal erythrocytes, 1.64 +/- 0.10 mumol/h per ml
      erythrocytes. When homogeneous populations of sickle cell erythrocytes are
      isolated by density gradient centrifugation, the rate of flux through the PPP in
      methylene blue-stimulated sickle cell erythrocytes, 1.16 +/- 0.16 mumol/h per ml
      erythrocytes, approaches that in methylene blue-stimulated normal erythrocytes.
      In addition, by analyzing the dose response to methylene blue, we have found that
      the decreased stimulation of the PPP by methylene blue in heterogeneous
      populations of sickle cell erythrocytes is a failure of methylene blue to
      stimulate the PPP rather than a deficiency in the PPP in sickle cell
      erythrocytes.

PMID- 8357850
TI  - Fibronectin fragments bind to and penetrate cartilage tissue resulting in
      proteinase expression and cartilage damage.
AB  - We have reported that fibronectin (Fn) fragments added to bovine articular
      cartilage slices in culture causes marked cartilage damage by enhancing
      proteinase expression and resultant degradation and release of proteoglycan (PG).
      Several different non-overlapping Fn fragments, an amino-terminal 29-kDa, gelatin
      binding 50-kDa and integrin-binding 140-kDa Fn fragment, representing nearly all
      of the polypeptide chain, were compared in terms of ability to cause PG release
      from cartilage and to bind cartilage. The most active fragment, the 29-kDa
      fragment, was able to enter cartilage in an intact metacarpophalangeal joint in
      culture and cause PG release at the same rate as with surgically cut cartilage.
      Further, when radiolabelled 29-kDa fragment was added to cartilage, a large
      proportion bound the intact articular surface, while a lesser amount diffused
      throughout the tissue matrix and concentrated in clusters near the mid-section of
      full thickness cartilage. The 29-kDa, 50-kDa, 140-kDa Fn fragments and Fn,
      respectively, showed PG degradation activities 9-, 6-, 2- and 1.1-fold that of
      control levels and bound cartilage to the extent of 180, 20, 18 and 2 pmol/100 mg
      cartilage, respectively. Therefore, the PG degradation activities were greatest
      for the smaller fragments, which bound to the greatest extent. The apparent Kd
      values for interaction of the 29-kDa, 50-kDa, 140-kDa fragments and Fn for
      cartilage tissue were about 1.2, 0.3, 0.1 and 0.02 microM, respectively, and the
      order was inversely related to PG degradation activities. We conclude that the
      smaller the Fn fragment, the greater the degradation activity and extent of
      binding to cartilage tissue, but the weaker the affinity.

PMID- 8357851
TI  - Biological distribution of 99mTc-labeled YIGSR and IKVAV laminin peptides in
      rodents: 99mTc-IKVAV peptide localizes to the lung.
AB  - Two laminin-derived peptides containing either YIGSR or IKVAV (single amino acid
      code) sequences were radiolabeled with 99mTc and their biological distribution
      evaluated in rodents. Both 99mTc-peptides cleared rapidly from the circulation
      though the kidney, and to a lesser extent, through the liver. 99mTc-YIGSR peptide
      did not accumulate in any organ examined in normal, tumored, and emphysemic mice.
      The 99mTc-IKVAV peptide localized within 10 min to the lung of normal animals,
      resulting in lung-to-blood ratios of approximately 23:1. The 99mTc-IKVAV peptide
      localized to lung after submicron filtration and after intraperitoneal injection,
      suggesting that particulates do not major role in localization. Pre-incubation of
      99mTc-IKVAV peptide in whole blood decreased lung localization, suggesting that
      margination of radiolabeled cells does not play a major role in the lung
      localization. When 99mTc-IKVAV was injected into mice with tumored lungs
      (melanoma), the lung uptake was markedly increased (up to 20% injected dose
      higher than control lungs) at all time points examined (10, 30, and 120 min).
      When 99mTc-IKVAV was injected into mice with genetic emphysema, the lung uptake
      was markedly decreased at all time points. The localization of the 99mTc-IKVAV
      containing peptide to the lung is consistent with a receptor-based mechanism.

PMID- 8357852
TI  - Calpain activity alters in rat myocardial subfractions after ischemia or
      reperfusion.
AB  - To examine whether calpain is activated during ischemic or reperfusion injury, we
      measured calpain activity of the subfractions of rat myocardia after global
      ischemia for 60 min or the ischemia followed by 30 min reperfusion by the
      Langendorff procedure. The myocardial homogenate was fractionated into 600 x g,
      10,000 x g and 100,000 x g pellet fractions as well as 10,000 x g supernatant
      fraction. The supernatant fraction was further subjected to DEAE cellulose and
      phenyl-Sepharose chromatographies to separate mu- and m-calpains. The m-calpain
      activity of the DEAE fractions after global ischemia for 60 min was higher but
      that after ischemia-reperfusion was lower than that of the control. On the other
      hand, the ischemia-reperfusion but not ischemia by itself raised the calpain
      activity of the phenyl-Sepharose fraction (mu-calpain) and the 10,000 x g pellet
      measured at 100 microM and 5 mM Ca2+. Treatment with verapamil but not with
      ryanodine during ischemia attenuated the increase in m-calpain activity. A dot
      blotting analysis of calpain antigenicity showed a decrease in soluble but no
      change in the particulate fractions after ischemia-reperfusion. An immunoblotting
      technique did not detect proteolysis of the calpain 80-kDa subunit. These
      observations suggest that calpain is activated by Ca2+ influx during ischemia and
      reperfusion without gross changes in its amount. Some unknown processes other
      than translocation or autolysis are thought to be involved in the alterations.

PMID- 8357853
TI  - Determination of an acetylcholinesterase inhibitor, MDL 73745, in dog plasma and
      urine by combined gas chromatography/negative ion chemical ionization mass
      spectrometry.
AB  - A highly sensitive and specific assay has been developed for the determination of
      MDL 73745 [2,2,2-trifluoro-1-(3-trimethylsilyl-phenyl) ethanone] (I) and the
      internal standard (MDL 74398) at the nanomolar level in dog plasma and urine by
      gas chromatography/mass spectrometry. After a single-step extraction process, an
      aliquot was directly injected onto the gas chromatograph column. The mass
      spectrometer was run in the negative ion chemical ionization mode with ammonia as
      reagent gas, and was set to monitor the abundant M-. ion at m/z 246 of both
      compounds. The method yielded a linear response over the concentration range 0.1
      10 pmol 100 microliters -1 plasma or urine. Within-day reproducibility at a
      concentration of 0.25, 1 and 5 pmol 100 microliters -1 plasma was 8.6%, 1.0% and
      1.0%, respectively. The method was applied to the determination of I in plasma
      and urine after administration of 1 mg kg-1 i.v. and 10 mg kg-1 p.o. to dogs.

PMID- 8357854
TI  - A simplified method for deuterium/hydrogen isotope ratio measurements on water
      samples of biological origin.
AB  - Equilibration of hydrogen gas with the water in a variety of biological sample
      materials was carried out in Vacutainers using platinum-on-alumina catalyst
      physically isolated from the liquid water. The equilibration takes 3 days at room
      temperature--much slower than with catalysts which float on the water surface-
      but this reduces the short-term temperature sensitivity of the procedure, and the
      inexpensive materials used allow convenient disposal of biologically contaminated
      samples after analysis. The slow equilibration also allows time for complete
      exchange with water contained in a complex sample matrix such as plant stems or
      soil without the need for prior isolation of the water sample. The method has
      particular application in studies of human total body water where repeated
      studies can be carried out over a short time period without the need to wait for
      the previous dose to wash out. Water turnover rates from total diurnal energy
      expenditure studies measured by this method were not significantly different from
      those obtained by the zinc reduction method.

PMID- 8357855
TI  - Quantitative measurement of 4-hydroxy tamoxifen in human plasma and mammary
      tumours by combined gas chromatography/negative chemical ionization mass
      spectrometry.
AB  - A highly sensitive and specific assay was developed for the quantitative
      measurement of 4-hydroxy tamoxifen (4-OH Tam) at the femtomole level in human
      plasma and mammary tumours. The drug and deuterated internal standard (4-OH Tam
      D4) were measured by gas chromatography/negative chemical ionization mass
      spectrometry with methane as the reactant gas. The two compounds of interest were
      isolated from the complex biological matrices using a solid-phase extraction
      procedure with Extrelut 1 columns. Soft operating conditions were required to
      convert 4-OH Tam to the fluorinated derivatives with pentafluorobenzyl chloride.
      The mass spectrometer was tuned to monitor the abundant and stable molecular ions
      at m/z 581 and 585 which were generated in the ion source by an electron capture
      process. This assay required only 0.5 ml of plasma or 0.5 g of mammary tissue,
      and the quantification limits of the method were 20 pg ml-1 for the body fluids
      or 100 pg g-1 for the tissue samples. The very low relative standard deviation
      and mean percentage error calculated during the different within-day or day-to
      day repeatability assays have clearly demonstrated the ruggedness of the
      technique for routine analysis of 4-OH Tam.

PMID- 8357856
TI  - Effect of the biological matrix on the urinary testosterone/epitestosterone ratio
      measured by gas chromatography/mass spectrometry in doping analysis.
AB  - Testosterone doping in sport is detected by measurement of an increased
      testosterone/epitestosterone (T/E) ratio in urine. The critical limit is 6. The
      present study concerns calibration curves for the T/E ratio measured by gas
      chromatography/mass spectrometry (electron impact) according to the guidelines of
      the International Olympic Committee. Testosterone (T) and epitestosterone (E) are
      measured as trimethylsilyl (TMS)-enol-TMS ethers in selected ion monitoring mode
      using m/z 432 with methyltestosterone (MT) (m/z 446) as internal standard.
      Calibration curves corresponding to T/E = 1, 6 and 12 prepared directly, i.e.
      without extraction of T and E, were non-linear. The non-linearity was caused by
      an increase of the relative molar response of T with respect to the internal
      standard MT with increasing concentration level. A mean increase of 82% was
      observed from T/E = 1 to T/E = 12 (E fixed). Adding T/E corresponding to 1/1, 6/1
      and 12/1 to urine without endogeneous hormone content resulted in an almost
      linear calibration curve along the diagonal, with only a slight increase of the
      relative molar response of testosterone (16% from T/E = 1 to 12). Apparently, the
      biological matrix stabilizes the relative molar response over a wide
      concentration range. At a molar ratio of about 1/1 for T/MT, the relative molar
      response for direct measurement of T is identical to that observed in the
      presence of urine matrix, which is explained on the basis of a simple
      mathematical model. The practical conclusion of this study is that, contrary to
      the present-day practice, calibration curves for the T/E ratio should be based on
      T/E added to blank urine taken through the extraction procedure. Otherwise, the
      T/E ratio of urine sample is systematically easily underestimated by 30% or more.

PMID- 8357857
TI  - Plasma kinetics of magnesium and calcium stable isotope tracers in a human
      subject after simultaneous oral ingestion of 25Mg and 44Ca determined by thermal
      ionization mass spectrometry.
AB  - The plasma concentrations of stable isotope tracers of magnesium (25Mg) and
      calcium (44Ca) were determined during a 50 h period, after simultaneous oral
      tracer ingestion in an adult man. The measurements were performed by magnetic
      sector field mass spectrometry using surface ionization ion sources. The data
      were used to evaluate the potential of this method in long-term kinetic studies.
      It is concluded that under the experimental conditions specified, the isotopic
      tracers will be detectable in blood plasma with sufficient precision and accuracy
      for approximately 600 h after oral ingestion. The differences in the plasma
      concentration curves of 25Mg and 44Ca were analysed by means of the convolution
      integral method. These differences indicate inhomogeneities in the distribution
      of absorption activity relative to magnesium and calcium within the upper small
      intestine.

PMID- 8357858
TI  - Characterization of the primary structure of H-protein from Pisum sativum and
      location of a lipoic acid residue by combined liquid chromatography/mass
      spectrometry and liquid chromatography/tandem mass spectrometry.
AB  - A purified extract of H-protein, a subunit of the glycine cleavage complex of the
      pea leaf mitochondria, was investigated by liquid chromatography/mass
      spectrometry (LC/MS) and liquid chromatography/tandem mass spectrometry
      (LC/MS/MS), using both continuous flow fast atom bombardment (CF-FAB) and
      electrospray ionization (ESI) mass spectrometry. Determination of the molecular
      weight of the entire protein, a 14 kDa subunit of the glycine decarboxylase
      complex, was achieved by ESI mass spectrometry and revealed covalent binding of
      the protein to the stabilizing agent beta-mercapto-ethanol. On-line LC/MS
      analysis of peptides arising from the endoproteinase Glu-C digestion of the H
      protein was achieved using capillary columns (0.25 mm i.d.), and permitted
      confirmation of the previously reported sequence deduced from cDNA cloning
      experiments. The detailed interpretation of data extracted from these LC/MS
      experiments facilitated identification of peptides containing modified amino acid
      residues. In particular the identification of a lipoic acid cofactor, a rather
      unusual modified lysine residue which interacts with different active sites in
      the enzyme complex, was achieved using both LC/CF-FAB-MS and LC/ESI-MS. The exact
      location of this modified lysine residue was determined by obtaining fragment
      spectra of multiply protonated precursor ions of selected peptides, using on-line
      LC/MS/MS techniques.

PMID- 8357859
TI  - Gas chromatographic/electron impact mass spectrometric selective confirmatory
      analysis of clenbuterol in human and bovine urine.
AB  - A method for the confirmatory analysis of clenbuterol in human and bovine urine
      was developed. After a double washing of the acidified sample with tert-butyl
      methyl ether (only for bovine urine), and a solid-phase extraction with Bond-Elut
      Certify columns, derivatization was performed with trimethylboroxine. The extract
      was then analysed by gas chromatography/electron impact mass spectrometry. The
      advantages of the methylboronate derivative with respect to other derivatives are
      discussed in terms of chromatographic properties and, above all, of specificity
      of the electron impact mass spectrum. The method was successfully used for the
      confirmatory analyses of clenbuterol during the XXV Olympic Games of Barcelona.

PMID- 8357860
TI  - Low-energy fast atom bombardment tandem mass spectrometry of monohydroxy
      substituted unsaturated fatty acids.
AB  - The low-energy collision-induced dissociation (CID) of the carboxylate anions
      generated by fast atom bombardment ionization of monohydroxy unsaturated fatty
      acids derived from oleic, linoleic, linolenic and arachidonic acids were studied
      in a tandem quadrupole mass spectrometer. The collisional activation spectra
      revealed structurally informative ions as to the position of the hydroxyl
      substituent in relationship to the sites of unsaturation. Five mechanisms are
      proposed for the fragmentation of hydroxyl substituted unsaturated fatty acids
      and are dependent upon the presence of alpha- or beta-unsaturation sites. These
      mechanisms include charge-remote allylic fragmentation, charge-remote vinylic
      fragmentation, charge-driven allylic fragmentation, charge-driven vinylic
      fragmentation, and homolytic fragmentation by an oxy-Cope rearrangement process.
      The assignment of specific fragmentation pathways was supported in many instances
      with deuterium-labeled analogs. Although no single fragmentation mechanism
      appears to predominate, a rational approach to the interpretation of these CID
      spectra is proposed. The CID spectra of unknown compounds could be used to
      establish the hydroxyl substituent position in relationship to certain sites of
      unsaturation but would not be indicative of all double bond locations. The oxy
      Cope rearrangement is specific for a structural unit, namely the 3-hydroxy-1,5
      diene moiety.

PMID- 8357861
TI  - Determination of linkage positions in peracetylated (methyl) xylo
      oligosaccharides with fast atom bombardment mass spectrometry.
AB  - Distinction between the linkage types 1-->2, 1-->3 and 1-->4 of xylobioses can be
      achieved on the basis of the unimolecular decomposition spectra of the oxonium
      ions of the per-O-acetylated methyl glycosides. The spectra of the oxonium ions
      of various unbranched xylotri-, tetra- and pentaoses allow determination of the
      linkage position between the xylose residues. This indicates that in unbranched
      peracetylated xylo-oligosaccharides the linkage between the xylose residues at
      the non-reducing end can be determined.

PMID- 8357862
TI  - Concentration dependence of methyl palmitate isotope ratios by electron impact
      ionization gas chromatography/mass spectrometry.
AB  - Isotope ratios must be measured precisely when stable isotopic tracers are used
      for in vivo metabolic kinetic studies since low enrichments are generally
      achieved above relatively high natural abundance backgrounds. We have observed
      that the (m + 1)/(m + 0) isotope ratio for the molecular ion of methyl palmitate
      (measured by electron impact ionization selected ion monitoring gas
      chromatography/mass spectrometry) is limited by a dependence of the isotope ratio
      on the quantity of sample analyzed. Since it is not practical to analyze exactly
      the same quantity of sample in a series of samples, this concentration dependence
      decreases the apparent precision of the isotope ratio measurement. The apparent
      natural abundance (m + 1)/(m + 0) isotope ratio increased from approximately
      0.185 (0.2 nmol analyzed) to 0.20 (2.0 nmol). The concentration dependence was
      not altered as the quadrupole tuning resolution was varied and did not appear to
      arise from system non-linearity. The major source of concentration dependence
      derived from hydrogen abstraction during ion-molecule collisions within the
      ionization chamber. The concentration dependence was decreased as the repeller
      voltage increased and ion residence times in the source were reduced.
      Furthermore, the integrated (m + 1) peak ares increased with the square of the (m
      + 0) peak area, consistent with a bimolecular ion-molecule collision process. A
      simple mathematical correction for the concentration dependence afforded a ten
      fold improvement in the coefficient of variation of the isotope ratio
      measurement.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357863
TI  - 750 MHz 1H-NMR spectroscopy of human blood plasma.
AB  - The application of high-resolution 750 MHz 1H-NMR spectroscopy to a biological
      fluid is demonstrated for the first time and its advantages over 600 MHz 1H
      observation shown by reference to studies on human blood plasma. Improvements in
      signal dispersion were observed which facilitated improved signal assignments.
      Differences in lipid/lipoprotein signal line-widths between 600 and 750 MHz were
      noted indicating that ultrahigh field measurements may help to give insight into
      dynamic motional phenomena of lipids in whole plasma. The two-dimensional J
      resolved (JRES) technique and spin-echo spectra measured at 750 MHz have enabled
      new signal assignments to be made in control plasma. The application of 750 MHz
      JRES to the clinical chemical problem of the detection of abnormal metabolites
      associated with chronic renal failure is also demonstrated.

PMID- 8357864
TI  - Solid-phase extraction of 1,4-benzodiazepines from biological fluids.
AB  - The solid-phase extraction (SPE) of seven 1,4-benzodiazepines (oxazepam,
      diazepam, temazepam, nordazepam, brotizolam, adinazolam and midazolam) using
      prazepam as internal standard was investigated. The 1,4-benzodiazepines were
      recovered from an aqueous buffer of suitable pH, using C18 Sep-Pak cartridges and
      mixtures of methanol-water as elution solvent. The recovery of oxazepam using
      different sorbent materials (C2, C8, C18, cyanopropyl, phenyl and cyclohexyl Bond
      Elut) was also examined as a function of pH and the composition of the elution
      solvent. The SPE of oxazepam was investigated using spiked urine samples and the
      C2 cartridge gave rise to the cleanest urine extracts. The recoveries of the
      other 1,4-benzodiazepines from spiked urine and plasma samples using the C2
      cartridge was then found to be higher than 90%, without any interference from
      endogenous compounds of the samples. Finally, the influence of other factors such
      as drug concentration, sample volume and the number of times the SPE cartridge
      had been used was also examined.

PMID- 8357865
TI  - Optimization of the USP assay for hyaluronidase.
AB  - The current USP XXII assay for hyaluronidase (EC 3.2.1.35, HAse) determines
      activity indirectly by measuring the amount of undegraded hyaluronic acid (HA)
      substrate remaining after the enzyme is allowed to react with the HA for 30 min
      at 37 degrees C. To be acceptable as a substrate, the HA must pass a USP
      suitability test. In this study, seven HA samples, which differed in their
      anatomical origin, their commercial supplier, and their chondroitin sulphate
      content, were tested as substrates. One of these did not pass the USP suitability
      test and therefore would not be an officially acceptable substrate; however, it
      was carried through the investigation along with the others in order to
      demonstrate its effect on the analysis. All seven HAs were used as substrates to
      assay testicular hyaluronidases from three different suppliers. The standard by
      which the other hyaluronidase activities were measured was USP hyaluronidase
      reference standard. The activity values calculated for a particular hyaluronidase
      differed significantly depending on which HA was used as substrate in its assay.
      Optimal results, as judged on the bases of initial purity, suitability for the
      assay, linearity of the standard curve, and per cent relative standard deviation
      of the measured activity, were obtained with a HA substrate derived from vitreous
      humour.

PMID- 8357866
TI  - Characterization of polymorphs of a new anti-inflammatory drug.
AB  - The present study demonstrates the utility of a diversified analytical approach
      for the characterization and quantitative analysis for two polymorphs of a new
      anti-inflammatory agent, (+/-)-7-[3-(4-acetyl-3-methoxy-2-propylphenoxy)propoxy
      3,4-dihydro -8-propyl- 2H-1-benzopyran-2-carboxylic acid (SC-41930). The
      existence of two distinct crystal polymorphs of SC-41930 was qualitatively
      indicated through microscopy and application of thermal methods of analysis. The
      application of TGA was important for establishing that the two solid forms were,
      in fact, polymorphs, as opposed to solvated and unsolvated drug substances. The
      application of IR spectrometry revealed spectral features in the carbonyl
      stretching region, which were characteristic and unique to the two SC-41930
      polymorphs. DRIFT spectrometry was implemented as the sampling method of choice
      to eliminate the possibility of polymorphic transformations during conventional
      mulling or KBr pellet sampling procedures. The DRIFT spectrometry procedure
      permitted development of a quantitative assay for detection of the low-melting
      polymorph (as an impurity) in high-melting samples. Calibration plots showed
      acceptable linearity of response from 0 to 25% (w/w) low-melting samples spiked
      into the high-melting polymorph. The performance characteristics of the method
      indicated good run-to-run and day-to-day consistency for its intended use.

PMID- 8357867
TI  - Automatic determination of amylocaine and bromhexine by atomic absorption
      spectrometry.
AB  - An automatic method for the determination of amylocaine and bromhexine
      hydrochloride by atomic absorption spectrometry (AAS) is proposed. The drugs were
      determined indirectly by formation of reineckates, extraction into 1,2
      dichloroethane and measurement of chromium in the organic phase. The chemical
      conditions and experimental variables influencing the performance of the flow
      system of the liquid-liquid extractor were established. The proposed method
      allows the determination of amylocaine and bromhexine at concentrations between 3
      and 120 micrograms ml-1 with a relative standard deviation of 1 and 3%,
      respectively, even in the presence of other synthetic drugs.

PMID- 8357868
TI  - An automated aerosol actuator: application to the uniformity testing of
      pharmaceutical aerosol dosage forms.
AB  - An automated system for valve performance testing to determine net weight loss
      per actuation of pharmaceutical aerosol dosage forms has been developed and is
      described. The principal element of the system is a novel automatic aerosol
      actuation device. Details of the validation, comparison to manual methods of
      analysis and advantages are presented. The automated system has been shown to be
      a cost-effective, productive and facile alternative to manual testing.

PMID- 8357869
TI  - GC-MS procedure for the analysis of zipeprol.
AB  - A sensitive and specific quantitative method for the determination of zipeprol, a
      newly abused antitussive, in human fluids is described. Zipeprol and an internal
      standard, levallorphan, are isolated by a basic extraction and back-extraction
      process. The final extract is derivatizated with BSTFA + 1% TMCS and separated on
      a 12-m HP-1 capillary column. Drugs are detected by selected ion monitoring at
      m/z 335 and m/z 355 for zipeprol and the internal standard, respectively. The
      minimum detectable quantities are 0.6 and 0.4 ng ml-1, for zipeprol in plasma and
      urine, respectively. Relative standard deviations for within-run data are less
      than 6%.

PMID- 8357870
TI  - Influence of hydrolysis procedures on the urinary concentrations of codeine and
      morphine in relation to doping analysis.
AB  - A method is described for the GC-NPD determination of urinary codeine and
      morphine after derivatization with trifluoroacetic anhydride. The lower limit for
      accurate quantitative determination was 0.05 microgram ml-1. After the oral
      administration of Bisolvon Griblettes corresponding to 30 mg codeine phosphate to
      seven subjects maximum codeine concentrations were obtained after 1-2 h and
      codeine remained detectable generally 24 h post dosing. The mean maximum level
      was 5.1 +/- 2.8 micrograms ml-1 found after enzymatic hydrolysis with Suc Helix
      pomatia juice (SHP). Based on these and previous results (mean 6.3 +/- 3.4
      micrograms ml-1) a threshold level for codeine of 16 micrograms ml-1 is proposed.
      Significant differences were noticed between urinary codeine concentrations found
      after enzymatic hydrolysis with SHP, beta-glucuronidase from Patella vulgata and
      acid hydrolysis, respectively. Generally, highest values were obtained after SHP,
      while beta-glucuronidase and especially acid hydrolysis resulted in much lower
      levels. No morphine could be detected after acid hydrolysis. Concerning doping
      analysis, in particular the uniformity of methods and interpretation of the
      results, it is recommended that the hydrolysis method should be specified in the
      rules of those sporting federations allowing codeine and/or morphine.

PMID- 8357871
TI  - Liquid chromatographic study of the stability of 5-halogeno-2'-deoxyuridines.
AB  - The stability of a series of 5-halogeno-2'-deoxyuridines was investigated using
      liquid chromatography as the analytical technique. Characteristics and profiles
      of the acidic, neutral and alkaline degradation are described, together with
      Arrhenius relationships and activation parameters for weakly acidic media.

PMID- 8357872
TI  - Assay of citrate in pharmaceutical matrices by indirect photometric liquid
      chromatography.
AB  - The development of a simple HPLC procedure is described for the analysis of
      citrate in pharmaceutical formulations using the technique of indirect
      photometric chromatography. A novel mobile phase, using dual eluent species, was
      developed for rapid elution of citrate. The developed method was found to be
      linear over the range studied (1-12 micrograms of citrate injected), showed good
      per cent recoveries (+/- RSD) of 97.5 +/- 3.05% from a generalized matrix
      solution, and includes very simple sample preparation steps for analysis of
      commercial products. This method is quite specific for tricarboxylic acids as
      most other ions are not retained by the column using the developed mobile phase.
      The resolution of the method is also good as indicated by a baseline resolution
      (Rs = 1.5) obtained for citrate and tricarballylate, two structurally similar
      tricarboxylic acids. It is proposed that the developed method be evaluated as an
      alternative to the tedious procedures employed by the USP for assay of total
      citrate in some of its monographs.

PMID- 8357874
TI  - Determination of ampicillin in human plasma by high-performance liquid
      chromatography using ultraviolet detection.
AB  - A high-performance liquid chromatographic method with isocratic elution has been
      developed for the determination of ampicillin in human plasma. The method
      comprises injection of the plasma after protein precipitation on to a reversed
      phase C18 column, using phosphate buffer (pH3.5)-methanol as the mobile phase.
      The method involves UV detection at 225 nm. This method provides a simple
      technique for the rapid analysis of ampicillin within the concentration range 0.2
      25 micrograms ml-1 with a high degree of accuracy and precision.

PMID- 8357873
TI  - Comparison of separation and detection techniques for human growth hormone
      releasing factor (hGRF) and the products derived from deamidation.
AB  - Separation of the deamidation products, Asp8 Leu27 hGRF(1-32)NH2 (MH+ = 3654) and
      isoAsp8 Leu27 hGRF(1-32)NH2 (MH+ = 3654), from the parent analogue Leu27 hGRF(1
      32)NH2 (MH+ = 3653) was achieved by reversed-phase LC and CE, where the retention
      order was seen to change from tr isoAsp8 hGRF < tr Asn8 hGRF < tr Asp8 hGRF to tr
      Asn8 hGRF < tr Asp8 hGRF < tr isoAsp8 hGRF, respectively. Both reversed-phase LC
      and CE gave adequate separations, limits of detection and standard curves.
      However, CE was preferred due to shorter analysis time, better separation and a
      smaller demand for material. Packed capillary LC with ESI-MS was then compared
      with UV detection. On-line LC-MS was found to offer the most efficient approach
      to detection and identification of hGRF analogues within a single methodology.
      Identification of Asn8 hGRF from the isobaric deamidation products was achieved
      from analysis of the triply charged states, where the species were separated by
      0.5 amu. LC-MS separation and identification of degradation products offers a
      viable alternative to fraction collection and subsequent sequencing or enzymatic
      identification methods. The method becomes increasingly useful for such cases as
      trace degradation product identification, minimal sample availability or
      instability of resulting degradation products.

PMID- 8357875
TI  - Simultaneous determination of a new anticancer drug galocitabine and its
      metabolites in blood by high-performance liquid chromatography.
AB  - A relatively simple and sensitive high-performance liquid chromatographic (HPLC)
      method is described for measuring galocitabine (Ro 09-1390) and its meatbolites,
      i.e. 5'-deoxy-fluorocytidine (5'-DFCR), 5'-deoxy-fluorouridine (5'-DFUR) and 5
      fluorouracil (5-FU), in blood for the purpose of studying pharmacokinetics and
      toxicokinetics in small animals. The procedure for blood includes
      deproteinization with acetonitrile. Blood components were separated on a reversed
      phase C18 column with a linear gradient of acetonitrile and water and detected at
      a wavelength of 270 nm. The between-day relative standard deviation (RSD) was
      less than 10% for all compounds at concentrations of 10-100 micrograms ml-1. The
      calibration curves obtained from the analysis of blood samples were linear and
      the correlation coefficients ranged from 0.997 to 0.999. The calculated
      determination limits were 6.9 micrograms ml-1 for galocitabine, 3.0 micrograms ml
      1 for 5'-DFCR, 4.0 micrograms ml-1 for 5'-DFUR and 3.7 micrograms ml-1 for 5-FU.

PMID- 8357876
TI  - Modified high-performance liquid chromatographic method for analysis of
      drotaverine in human plasma.
AB  - An HPLC method is described for the determination of drotaverine in plasma;
      papaverine is used as the internal standard. The lower limit of quantitation is
      50 ng ml-1 with an inter-assay precision (RSD) of below 4%. The method has been
      validated and successfully used to assay clinical trial samples in healthy
      volunteers.

PMID- 8357877
TI  - Measurement of ascorbic acid in human aqueous humour and plasma and bovine
      aqueous humour by high-performance liquid chromatography with electrochemical
      detection.
AB  - High-performance liquid chromatography (HPLC) on ODS silica with
      cetyltrimethylammonium bromide as an ion-pairing reagent and electrochemical
      detection (ECD) was used to determine ascorbic acid in bovine and human aqueous
      humour and human plasma. Hydroquinone was used as the internal standard. A
      calibration curve plotted with ascorbic acid concentrations in the range 0.5-5
      micrograms ml-1 for peak height versus internal standard peak height had a
      correlation coefficient of 0.998. The RSD (precision) between analyses of the
      same diluted sample was 1.5% and the RSD (reproducibility) between analyses of
      separate aliquots of the same sample of aqueous humour was 1.6%.

PMID- 8357878
TI  - An improved extraction method for the HPLC determination of morphine and its
      metabolites in plasma.
AB  - A new, simple and rapid extraction procedure coupled with a combined coulometric
      fluorescence HPLC assay is described for the simultaneous determination of
      morphine (M) and morphine-3-glucuronide (M3G), morphine-6-glucuronide (M6G), and
      normorphine (NM) in plasma. The effect of concentration and pH of selected ion
      pairing agents on the extraction of these compounds from plasma by solid-phase
      extraction was investigated. The extraction procedure was optimized in terms of
      recovery, reproducibility and lack of interference from endogenous materials. The
      optimized method uses tetrabutylammonium hydrogen sulphate (TBAHS) at pH 10
      followed by separation on a single C18 solid-phase extraction cartridge. For
      routine analysis the procedure provides high and reproducible recoveries over a
      concentration range of 1.0-1000 ng ml-1 for morphine, M6G and normorphine and 20
      1000 ng ml-1 for M3G. The method was used successfully to analyse plasma samples
      from a pharmacokinetic study in which sheep had received an intravenous dose of
      0.015 mg kg-1 of M6G.

PMID- 8357880
TI  - [Assessment of portal hypertension in hepatic cirrhosis in relation to etiologic
      factors].
AB  - Hundred-forty-one patients, 78 affected by alcoholic liver cirrhosis and 63 by
      posthepatitic cirrhosis were studied in order to assess the degree of portal
      hypertension in liver cirrhosis of different etiology taking into account the
      developing stages of the disease. Etiological assessment was based on anamnesis,
      laboratory data, needle liver biopsy and patients of each group were divided into
      3 subgroups (grade A, B, C) according to Child-Turcotte classification. A > 1.3
      cm diameter of portal vein and a > 13 cm spleen size evaluated by means of real
      time ultrasonography together with the occurrence of esophageal varices at
      endoscopy were considered as signs of portal hypertension. Our study shows that
      such signs are more frequent in patients affected by posthepatitic cirrhosis in
      comparison with those affected by alcoholic cirrhosis. If the severity of the
      disease was considered, at the early stage (grade A) no significant difference
      was reported in portal diameters while splenomegaly and esophageal varices
      appeared more frequent in posthepatitic cirrhosis. In grade B patients the
      increase of portal and spleen size proved significantly greater in posthepatitic
      cirrhosis whereas prevalence of esophageal varices was similar in the two groups.
      The lack of differences in the three considered parameters at the end stage of
      the disease may be due to severe changes in liver morphology actually similar in
      the 2 groups apart from etiological factors.

PMID- 8357879
TI  - Indirect determination of diphenhydramine hydrochloride by atomic absorption
      spectrometry.

PMID- 8357881
TI  - [Palliative endoscopic intubation of esophago-gastric neoplastic stenosis:
      analysis of factors that may influence immediate results].
AB  - The paper examines a series of 172 patients undergoing endoscopic intubation with
      plastic stent due to unoperable esophago-gastric tumoral stenoses during the
      period 1980-1991. An analysis of the data enabled the following conclusions to be
      drawn: (1) The majority of perforations occur during the treatment of distal
      stenoses (15%), anastomotic stenosis (20%) and extrinsic compression stenoses
      (23% vs 7% in the case of stenosing primary esophageal neoplasia). (2) Severe
      respiratory problems may occur during treatment of cervical stenoses. (3)
      Malfunctioning of prostheses is more frequent in the treatment of cardias
      stenosis (10%). Having a few technical comments on the subject of passing the
      guide thread through the most twisting and narrow stenoses, the authors express
      the wish that expandable metal prostheses will be more widely used in order to
      render the method less traumatic, increase the percentage of success (extending
      the indications regarding the site and type of stenosis) and reduce severe
      complications.

PMID- 8357882
TI  - [Percutaneous endoscopic gastrostomy].
AB  - Surgical gastrostomies were first performed in the middle of the 19th century and
      modified during the following years, but the most important technical improvement
      was percutaneous endoscopic placement (PEG), in 1980 by Ponsky and Gauderer. This
      technique doesn't require anesthesia and it in possible also in patients with
      contraindications to surgical gastrostomy. The simple procedure involves a
      shorter hospitalization, lower risks and reduced costs. Many authors already
      reported the good results of this new technique, that can be performed on a day
      hospital regimen as well. The main indications are head and neck cancers,
      neurologic diseases involving food intake capacity, cancer cachexia, obstruction
      of the GI tract when there is enough space for an endoscopic procedure. Every
      disease that can compromise food intake for a period longer than 60 days can find
      an indication in placing a percutaneous gastrostomy. The advantage for the
      patient is a much better psychological tolerance compared with a naso-gastric
      tube. Also the incidence of mechanical complications of a PEG is much lower. In
      our experience from October '90 to July '92 we followed 34 patients with PEG, 22
      males and 12 females, with mean age of 69 years (range 41-88). We used 9-French
      tube placed using the pull-method technique. All patients received antibiotic
      therapy for 5 days. About 12 hours after PEG placement all patients began using
      the gastrostomy, initially with the administration of electrolyte solutions and
      later with enteral polymeric formulas. The constant increase led all patients to
      a 1500 non protein calories daily intake in 3-4 days.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8357883
TI  - [Intensive care management of diffuse septic peritonitis].
AB  - The function of the peritoneum in severe abdominal sepsis involves specific
      properties and defence mechanisms: large surface, efficient barrier, continuous
      mobility, capacity of migration, multiplication, secretion and absorption. The
      development of peritonitis supposes an initial lesion of the peritoneal surface
      by septic or biochemical mechanism. Peritoneal response consists of: septation of
      the abdominal wall, adhesion of the omentum to damaged surfaces or visceral
      perforation, massive stepping up of cellular and humoral defence mechanism. In
      our opinion therapeutic procedures consist of: early surgical approach and
      management of the patient in an intensive care unit. The aim of the medical
      therapy is: treatment of multiple organ failure (anti-infectious therapy,
      hemodynamic support, treatment of respiratory and renal failure, support of the
      hepatic failure and balancing of metabolic changes) and prevention of the most
      common complications: bleeding from upper gastrointestinal tract and
      thromboembolic risks.

PMID- 8357885
TI  - [Major clinical complications of hepatic cysts and angiomas. Report of 8 cases].
AB  - The detection of hepatic cysts and hemangiomas has become relatively frequent
      after the diffusion of US imaging, but rarely they cause major clinical problems.
      We report our experience with 8 cases (4 cysts and 4 hemangiomas) which caused
      either signs and symptoms simulating a hepatic disease or compression on vascular
      structures with systemic consequences.

PMID- 8357884
TI  - [Purified human IgG administration, after chemotherapy, to patients with
      colorectal carcinoma].
AB  - The authors, in the present study try to test the prophylactic effect of human
      IgG on surgical patients affected by colorectal cancer and undergoing
      chemotherapy in order to prevent microbial infections, supporting immunological
      host defences.

PMID- 8357886
TI  - [Alcohol-dependent mast cell activation in ulcer].
AB  - Numerous studies have shown that alcohol causes both acute and chronic damage to
      gastroduodenal mucosa. The methods of damage differ however, and experimental
      studies in animals have shown that the degranulation of mast cells in gastric
      mucosa causes acute hemorrhagic lesions after the consumption of alcohol. It is
      not known whether this mechanism also operates in man. The aim of the present
      study was therefore to evaluate whether there is a correlation between mast-cell
      activation, determined by assaying tryptase levels in gastric mucosa, and the
      consumption of alcohol in patients with ulcerative diseases. Thirty-one patients
      with cicatrized ulcerative lesions (13 gastric ulcers, 18 duodenal ulcers) were
      included in the study. Biopsies at the level of the gastric fundus and antrum and
      the duodenal bulb were performed in all patients to determine tryptase levels.
      Biopsy material was frozen and subsequently homogenized; the enzyme was assayed
      in the supernatant using a radioimmunometric method. The mean daily alcohol
      consumption was calculated in clinical terms for each patient over the past 5
      years and patients were subdivided into non-drinkers and moderate (< 60 g
      alcohol/day) and excessive (> 60 g alcohol/day) drinkers. It was found that
      tryptase concentrations were higher in the fundus compared to the gastric antrum
      and duodenal bulb, irrespective of alcohol consumption both in patients with
      gastric ulcer and duodenal ulcer. The importance of mast cells in provoking
      alcohol-dependent damage was studied at a gastric level. Alcohol leads to their
      degranulation and therefore contributes to the formation of gastric
      lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357887
TI  - Factors associated with heroin users' AIDS risk-taking behaviours.
AB  - A survey was undertaken in Sydney in 1989 to identify factors associated with
      behaviour involving risk for human immunodeficiency virus infection. Self-report
      data on needle-sharing and sexual practices were collected from 91 heroin users
      entering a residential, drug-free detoxification unit. Data were analysed using
      polytomous and ordinal logistic regressions. Heroin-dependent subjects who also
      had a current alcohol problem were significantly more likely than others to
      report high risk needle-sharing behaviour. Subjects with more than one sexual
      partner in the last three months were significantly more likely to use condoms
      while those with a current benzodiazepine problem were significantly less likely
      to use condoms. Qualitative data suggest that high risk needle-sharing behaviour
      most often occurred around the time of relapse to injecting drug use and among
      homeless drug users occupying derelict buildings in inner-city suburbs.

PMID- 8357888
TI  - Medication use and its correlates among the elderly.
AB  - Medication use and its correlates were examined in a randomly selected sample of
      178 urban-dwelling elderly people: 89 per cent were currently using medication
      and 44 per cent were using four or more medications concurrently. Forty percent
      were using at least one nonprescription medication, usually in combination with
      prescription medication. The treatment of hypertension was the most commonly
      given reason for medication use. Respondents demonstrated good knowledge of their
      medication and how to take it, and good compliance with prescribing instructions.
      Multiple medication use was associated with advanced age, living in supervised
      accommodation, and a range of measures indicative of reduced wellbeing. There was
      no association between cognitive functioning and multiple medication use. These
      findings suggest that stereotypical images of older people as being poor
      compliers and having little knowledge about their medication should be treated
      with caution. However, the extensive use of medication and of multiple
      medications and concerns about the appropriateness of use of some classes of
      medication highlight the need for more detailed study of medication use among the
      elderly.

PMID- 8357889
TI  - Generalism and specialism in public health.

PMID- 8357890
TI  - The benefits of exercise in postmenopausal women.
AB  - Physical exercise is commonly promoted as a panacea. However many of the claimed
      benefits, in particular any positive effects on bone density, have not been
      scientifically proved. We assessed the effects of a twice-weekly aerobic weight
      bearing exercise program on bone density in postmenopausal women. We tested bone
      density at the spine and hip in 19 exercisers with a mean age of 66.4 years (SEM
      +/- 1.2) before and after a two-year exercise program, and in 11 controls, mean
      age 65.4 years (SEM +/- 1.5). We also assessed risk factors for cardiovascular
      disease and tested wellbeing and cognitive function. The mean percentage change
      in lumbar bone mineral density was -0.8 in exercisers and -3.8 in controls
      (difference 3.0 per cent; 95 per cent confidence interval (CI) 0.3 to 5.7 per
      cent; P = 0.031). The mean percentage change in trochanteric bone mineral
      concentration was +9.6 in exercisers and -4.4 in controls (difference 14.0 per
      cent; CI 4.6 to 23.5; P = 0.0049). The exercisers also had significantly higher
      wellbeing and diastolic blood pressure. This study adds strong evidence that
      twice-weekly weight-bearing aerobic exercise has a protective effect on bone
      density in postmenopausal women as well as being associated with other measurable
      benefits.

PMID- 8357891
TI  - Testing for HIV infection among heterosexual, bisexual and gay men.
AB  - This paper answers the questions: who is and is not tested for human
      immunodeficiency virus (HIV) antibodies, why, where are they tested, and what do
      they find difficult about the testing process? The data came from two samples of
      sexually active heterosexual, bisexual and gay men in Perth (N = 545). Bisexual
      and gay men were much more likely to be tested than heterosexual men, although
      the commonest reason for testing for all three groups was risky sex. The three
      groups differed on reasons for not having the HIV antibody test: heterosexual men
      most commonly claimed that they were not at risk; bisexual men explained that
      they had been meaning to go but kept putting it off; and gay men primarily feared
      a positive test result and lacked trust in the confidential treatment of results.
      Gay men were more likely to trust their regular doctors than were heterosexual
      and bisexual men who had more trust in state health clinics. Waiting for test
      results was the most difficult part of the testing process for all respondents.
      Few respondents agreed that employers and the police should be notified by a
      doctor of an antibody-positive test result; nearly all agreed that those who had
      contracted HIV should be notified; notification of surgeons received moderate
      support. Knowing one's HIV infection status appears to be strongly associated
      with safer sex practices, and therefore the HIV antibody test could be promoted
      as part of a preventive health care program.

PMID- 8357892
TI  - Sexual practices, sexually transmitted diseases and other risk factors for HIV
      among injecting drug users.
AB  - Data were collected from 814 clients attending anonymously for counselling before
      tests for human immunodeficiency virus (HIV) infection at the Burnett Clinic in
      Auckland. Just over 10 per cent of clients (n = 83) reported ever having injected
      drugs. This group was matched according to age, gender, ethnicity and sexual
      orientation with an equal sized control group drawn from clients who had not
      injected drugs. The groups were compared in terms of their sexual practices,
      sexual partnerships, other drug use, current and past health status and their
      perception of HIV risk. The injecting drug users reported more sex partners than
      the nonusers, they were less likely to be in a relationship and they were less
      likely to be monogamous. Vaginal and oral sex were the most common practices in
      both groups but anal sex was more common among users than the nonusers. Regular
      condom use was reported by less than a quarter of each group. The health status
      of drug users was generally poorer than that of the nonusers. They reported
      greater use of alcohol and other drugs, more mental health problems, and more
      symptoms of ill health. They also had experienced more sexually-transmitted
      diseases. Only 1 per cent of users and 2 per cent of nonusers tested positively
      for HIV, although users saw themselves and their partners as at greater risk of
      HIV infection than the nonusers.

PMID- 8357893
TI  - A holosphere of healthy and sustainable communities.
AB  - Public health practice is in a transitory state, expanding considerably beyond
      medical and behavioural models of health and disease to encompass physical and
      social environmental health determinants. A new public health practice is
      emerging, apparent in initiatives like the international healthy
      cities/communities projects. This new public health practice must integrate the
      challenge of sustainable development, as defined by the 1987 World Commission on
      Environment and Development. The holosphere framework locates health as its
      central metaphor, and defines six interacting environmental spheres: a viable
      natural environment, a sustainable economic environment, a sufficient economy, an
      equitable social environment, a convivial community, and a livable built
      environment. There are five functional roles for local government: policy,
      legislation, education, partnerships and advocacy. Representative actions from
      each of the six environmental spheres of the holosphere framework are identified
      and discussed, using the five functional roles of local government. There is a
      need for new intersectoral forums to act upon the knowledge generated by
      integrative models such as the holosphere. Canadian Round Tables on Environment
      and Economy are encouraging examples of such intersectoralism.

PMID- 8357894
TI  - Cost-effectiveness of mammographic screening in Australia.
AB  - The purpose of this research was to estimate the cost-effectiveness of
      mammographic screening to supplement the results of the National Evaluation of
      Breast Cancer Screening which identified the mortality benefit as the most
      sensitive parameter. This appraisal used a different computer model, MISCAN,
      which models the effects of introducing a national screening program into a
      previously unscreened population, rather than basing estimates on the assumption
      of a fully established program. For the 40 to 49 age group a mortality reduction
      of 8 per cent was assumed, rather than the 30 per cent estimate utilised in the
      National Evaluation. The revised estimate is based on the two Swedish trials
      (Malmo and WE). New estimates for treatment costs were also incorporated into the
      MISCAN model. The cost-effectiveness of the policy recommended in the National
      Evaluation Report, $11,000 per life year saved with two-yearly screening of women
      over 40, is estimated by the MISCAN model to be $20,300. These differences arise
      partly from the difference in mortality effects for the 40 to 49 age group, but
      also from differences inherent in the steady-state and dynamic population
      approaches to modelling premature deaths averted. The MISCAN results confirm that
      screening for women over 50 is more cost-effective than screening women under 50.
      Screening all women aged 50 to 69 every two to three years is reasonable value
      for money. For women aged 40 to 49 the mortality benefit and cost-effectiveness
      is less clear, and it would be prudent to allow screening in this group until
      further evidence is available.

PMID- 8357895
TI  - Information-seeking behaviour and sources of health information: associations
      with risk factor status in an analysis of three Queensland electorates.
AB  - Making a special effort to gain health information has been associated with
      healthy behaviour. This paper identifies the information-seeking dimension and
      the sources of information people use and examines whether there is an
      association between these and individual health status. In November 1989 a
      randomly selected sample of 2134 adults in the electorates of Maryborough,
      Toowoomba and Port Curtis (Gladstone) completed a self-administered questionnaire
      which aimed to measure health-related knowledge, attitudes and behaviour. Factor
      analysis identified clusters of items representing different dimensions of risky
      health behaviour as well as different perceived barriers to seeking preventive
      health care. Multiple regression analysis was then used to determine
      sociodemographic, attitudinal and behavioural variables related to a tendency not
      to seek health information and to be at risk for preventable diseases. The
      findings have implications for the development of future health promotion
      programs in provincial Australian cities. Both age and sex were significant in
      predicting where people obtain information on health. Women were more likely than
      men to seek health information and their sources of information reflected this
      proactive attitude to health. While there was no significant difference between
      the perceived health status of males and females, reported behavioural risk
      factors were much more prevalent in males. Most respondents had consulted a
      general practitioner in the previous twelve months and stated that they would
      change their behaviour on the advice of a medical practitioner. However, few
      nominated medical practitioners as their main source of health information.

PMID- 8357896
TI  - Social controls, harm minimisation and interactive outreach: the public health
      implications of an ethnography of drug use.
AB  - This is a report on ethnographic research with the members of a social network of
      young, recreational, illicit drug users in Perth, Western Australia, with whom I
      maintained close social interaction for over twelve months. Following the work of
      Zinberg, the article outlines some of the main social controls employed by these
      young drug users to reduce drug-related harm. These social controls are of two
      types: sanctions (the rules prescribing certain behaviours and proscribing
      others) and rituals (the stylised behaviour surrounding the use of drugs). There
      exists an ideology of harm minimisation amongst drug users which may provide the
      basis for innovative programs. The implications of these findings are discussed
      with reference to one particular public health strategy, outreach, and the
      possibility of a more active, reciprocal and beneficial engagement between drug
      users and researchers, health educators and policy makers is suggested.

PMID- 8357897
TI  - Health and housing--seasonality in New Zealand mortality.
AB  - The common belief that New Zealand's climate is mild appears to be supported by
      the statistics of deaths directly attributable to cold. However an initial
      analysis of seasonality of mortality using the modified Edwards method suggests
      New Zealand has a greater seasonality of mortality than the more extreme climates
      of the United Kingdom, the United States, Australia, Japan or Sweden. Examination
      of New Zealand monthly mortality from 1976 to 1986 suggests this is driven by the
      seasonality of mortality of those aged 65 and over. Three surveys of temperatures
      within New Zealand homes have suggested that few are fully maintained in the 18
      degrees C to 24 degrees C comfort range. Mean temperatures close to or below 16
      degrees C were found in two of these surveys. Further research is suggested to
      examine the links between health and housing thermal performance. This research
      should combine both health and building science knowledge and techniques.

PMID- 8357898
TI  - Heart disease risk factors in the Vietnamese community of southwestern Sydney.
AB  - Despite low mortality from heart disease in the New South Wales Vietnamese
      community, the prevalence of risk factors for heart disease has been increasing.
      This study sought to identify the prevalence of heart disease risk factors in the
      Vietnamese community in southwestern Sydney. In 1991, 389 randomly selected
      Vietnamese-born residents of southwestern Sydney (79.2 per cent response rate)
      were interviewed by telephone about their risk status. Sixty-one per cent of this
      sample agreed to a second interview in their homes where physical measurements
      were taken. Smoking prevalence was high in males (53 per cent), whereas raised
      blood pressure (5.1 per cent), high blood cholesterol (21.1 per cent) and
      overweight (14.0 per cent) had a low prevalence compared to National Heart
      Foundation data for the general population. Interventions targeting males about
      smoking should be a health promotion priority, and the maintenance of the
      traditional Vietnamese diet should be encouraged.

PMID- 8357899
TI  - Bulk-billing of general practitioner services: the evidence.

PMID- 8357900
TI  - Bulk-billing of Medicare: more about the evidence.

PMID- 8357901
TI  - Prevalence of hearing loss.

PMID- 8357902
TI  - General practice smoking cessation.

PMID- 8357903
TI  - Cervical cancer screening by women's health nurses.

PMID- 8357904
TI  - Evaluating petrol-sniffing prevention programs.

PMID- 8357905
TI  - Clinical pathology reference ranges of laboratory animals. Working Group II,
      Nonclinical Safety Evaluation Subcommittee of the Japan Pharmaceutical
      Manufacturers Association.
AB  - We analyzed historical control data of clinical pathology testings provided by
      sixty-seven member companies of the Japan Pharmaceutical Manufacturers
      Association covering study populations of approximately 7,000 rats/sex, 5,000
      dogs/sex, and 700 monkeys/sex. This paper assesses the relationship between
      conditions of sample collection, methods of measurement, etc. and potential
      factors contributing to variations in reference data, based on weighted means and
      standard deviations thereof derived from data for rats, dogs and monkeys for
      those parameters measured using methods most common to the participating
      facilities. Parameters included erythrocyte count (RBC), hematocrit (Ht),
      hemoglobin concentration(Hb), reticulocyte count (Rt), platelet count, total
      leukocyte count (WBC), differential leukocyte count (%WBC), coagulation time
      (activated partial thromboplastin time: APTT, prothrombin time: PT), and
      serum/plasma levels of GOT, GPT, ALP, LDH, glucose, cholesterol, triglycerides
      (TG), total protein, albumin, urea nitrogen (UN), creatinine, sodium (Na),
      potassium (K), calcium (Ca), chloride (Cl), inorganic phosphorus (Ip), and CPK.
      Analyses of the data revealed species differences in RBC, Ht, Rt, platelet count,
      WBC, %WBC, ALP, LDH, glucose, cholesterol, TG, total protein, UN, creatinine, Ca,
      Ip, and CPK. There were strain differences in rats in platelet count, WBC, GOT,
      ALP, UN, creatinine, and CPK. Sex differences were noted for Hb, Ht, WBC, ALP,
      glucose, cholesterol, TG, total protein, A/G ratio, UN, and Ip. Age differences
      were observed with RBC, Hb, Ht, Rt, %WBC, GOT, GPT, ALP, LDH, cholesterol, TG
      total protein, Ip, and CPK. APTT, PT, ALP, glucose, TG and UN were found to be
      subject to the influence of fasting/feeding. In rats, Ht, WBC, CPK and K showed
      differences by the site of bleeding. Observed values for LDH and CPK varied with
      specimen type, plasma or serum; serum assay values showed greater variation than
      plasma values.

PMID- 8357906
TI  - Comparative study of Trichuris trichiura from non-human primates and from man,
      and their difference with T. suis.
AB  - Whipworms from the macaque and baboon were studied by light and scanning electron
      microscopy. They were identified as Trichuris trichiura, though a slight
      variation was observed in the length of spicule as compared with the whipworms
      collected from man. Moreover, a row of small knob-like structures was observed at
      the base of the pericloacal papillae of T. trichiura from the monkey by scanning
      electron microscopy. T. trichiura from non-human primates and man has been
      reported to be morphologically indistinguishable from T. suis. However, this
      study showed that males of T. trichiura from both the monkey and man can be
      differentiated from T. suis from the pig on the basis of the presence of a pair
      of pericloacal papillae and a cluster of small papillae near the caudal end in
      the former, which is totally absent in the latter.

PMID- 8357907
TI  - Visual dysfunction in aged Fischer 344 rats.
AB  - To investigate age-related changes in visual function in rats, male and female
      Fischer 344 (F344) rats at 30 months of age were examined electrophysiologically
      and histopathologically. The selection rate for the dark area in a T-shaped test
      box was 80% in aged rats, and the ability of light-dark discrimination was
      definitely depressed. Electroretinogram (ERG) was non-recordable in 25 out of the
      28 eye balls examined, and amplitudes of the ERG a- and b-waves were markedly
      depressed in the remaining three eye balls. Histopathologic examination of the
      retina revealed marked atrophy of photoreceptor cells on the outer nuclear and
      photoreceptor layers; the change was less extensive in the retina of eye balls in
      which ERG was recordable. Immunohistochemically, increased reactivity to anti
      glial fibrillary acid protein serum was observed in the retina of the aged
      animals. These results evidenced that the number of photoreceptor cells is
      decreased in age F344 rats, resulting in the reduced reactivity to light and the
      depressed light-dark discrimination.

PMID- 8357909
TI  - Constrictive effect of thyroxine on the ductus arteriosus in fetal rats.
AB  - This work was conducted to know whether thyroxine (T4) when injected into fetal
      rats would induce a constriction of the ductus arteriosus (DA). In Experiment 1,
      fetal rats on day 20 of gestation were given a subcutaneous injection of 1 or 10
      micrograms T4 through the maternal uterine wall, and were autopsied 3 or 6 hr
      later. Similarly, in Experiment 2, the mother rats were given an injection of
      hydrocortisone (10 mg/kg) just after fetal T4 injections. In either series of
      experiments, uninjected littermates served as controls. According to the whole
      body freezing and shaving method, the DA was exposed and calibrated under a
      dissecting microscope. In Experiment 1, the DAs of the T4-injected fetuses, 3 hr
      later, were significantly smaller in caliber than those of their controls, but
      recovered 6 hr later. In Experiment 2 with fetal T4 injection followed by
      maternal hydrocortisone injection, the DAs of the T4-injected fetuses were
      further smaller in caliber than those of their controls which were clearly
      shrunken as compared with those of controls in Experiment 1. These results
      indicate that T4 exerts a constrictive effect on the DA, an effect which is
      strengthened in the presence of hydrocortisone.

PMID- 8357908
TI  - Developmental changes in paramesonephric and mesonephric ducts and the external
      genitalia in swine fetuses during sexual differentiation.
AB  - The paramesonephric (Mullerian) duct was first observed in the vicinity of the
      mesonephric (Wolffian) duct in 30-day-old swine fetuses of both sexes at the
      level close to the gonad. The paramesonephric duct extended caudally in parallel
      with the mesonephric duct on day 35 of gestation. By day 40 the paramesonephric
      duct reached the urogenital sinus. At this stage, the paramesonephric duct began
      to degenerate in the male, while it continued to develop in the female. This
      suggests that an anti-Mullerian duct hormone (AMH) is produced before day 40 of
      gestation. By day 45 of gestation, the mesonephric duct began to decrease in
      diameter and was accompanied with the involution of the mesonephros in both
      sexes. By day 60, the male and female mesonephric ducts reduced in their diameter
      by 70%. Thereafter, the female mesonephric ducts disappeared, while the male
      ducts developed again. The sex differences was first observed on day 35 in the
      differentiation of the external genitalia when a small circular urogenital
      orifice and the anogenital raphe appeared at the sites caudal to the genital
      tubercle in the male. Such structures were not present in the female. These
      results suggest that the fetal pig testis is activated to secrete androgen before
      day 35 of gestation.

PMID- 8357910
TI  - Inhibitory effect of fenthion and diazinon on the contraction of rat aorta, and
      its contribution to lethality.
AB  - Fenthion and diazinon, P = S type organothiophosphates which are precursors of
      cholinesterase inhibitors, cause remarkable atropine-insensitive hypotension in
      rats when administered intravenously in lethal doses. We investigated their
      effects on isolated rat aorta and atria to reveal the site of action. Fenthion
      and diazinon inhibited both types of contractions induced by high K+ solution and
      norepinephrine in aortic preparations from which the endothelium was removed.
      IC50 values (under [Ca2+] = 1.5 mM) were 2 x 10(-5) M and 7 x 10(-5) M,
      respectively. However, the atrial preparations were relatively resistant, since
      fenthion showed no effect up to 10(-3) M and diazinon at 10(-4) M exhibited a
      slight inhibition which was antagonized by atropine. The hypotensive effect of
      fenthion or diazinon was therefore attributable to the direct inhibiting action
      on the arterial muscle tone, which may be independent of the activation of
      muscarinic receptors. The results suggested that fenthion and diazinon affect
      movement and/or utilization of calcium in the aortic muscle cells, since an
      increase in the calcium concentration in the bathing solution antagonized their
      inhibitory effect.

PMID- 8357911
TI  - DNA sequence of type 1 fimbrin, Fpul1, gene from a chicken pathogenic Escherichia
      coli serotype O78.
AB  - The gene encoding type 1 fimbriae of chicken pathogenic Escherichia coli serotype
      O78 (designated Fpul1) was cloned and the genetic region encoding fimbrial
      subunit was sequenced. The nucleotide sequence and its deduced amino acid
      sequence demonstrated that the Fpul1 was a novel variation among E. coli type 1
      fimbriae and showed an extensive homology to previously reported Klebsiella
      pneumoniae type 1 fimbriae. The E. coli K-12 strains carrying the Fpul1 genes did
      not show the acid-induced autoagglutination, suggesting that the Fpul1 was
      genetically distinct from the acid-induced autoagglutination.

PMID- 8357912
TI  - Purification of toxic saponins from Narthecium asiaticum Maxim.
AB  - Toxic substances in Narthecium asiaticum Maxim. were isolated and purified,
      monitoring the oral toxicity in guinea pigs. The crude extract prepared from the
      methanolic extract of the plant contained 2 major saponins (C8 and C9), and 7
      corresponding saponins (C1-7) on TLC. The crude extract was fractionated by a
      conventional method for saponin preparation. The 1-butanol fraction was rich in
      C8 and C9, and showed oral toxicity. C8 and C9 were isolated by fractional
      precipitation and silica gel column chromatography. On the basis of C-13 and H-1
      nuclear magnetic resonance (NMR) spectral data, and acid and enzymatic hydrolysis
      of C9, C9 was confirmed to be a mixture of two furostanol saponins (C9a, C9b); a
      branched trisaccharide composed of galactose, glucose, and arabinose, was linked
      at 3 beta-C, and glucose at 26-C of sarsasapogenin and smilagenin. C8 was
      considered to be a furostanol saponin containing xylose instead of arabinose in
      the structure of C9. Oral administration of C8 and C9 caused diarrhea,
      proteinuria, hematuria and death in guinea pigs.

PMID- 8357913
TI  - Preliminary results of short-term combination immunosuppressions of mizoribine,
      azathioprine, and prednisolone with pretreatment to canine kidney
      transplantation.
AB  - Serial combinations of immunosuppressive drugs (mizoribine: Mi, azathioprine: Az,
      and prednisolone: Pr) were administered for renal heterotopic allotransplantation
      in 50 mixed-breed dogs and 4 beagle dogs. The dogs were randomly divided in 5
      groups depending upon immunosuppressive protocols. All immunosuppressive
      protocols were started at 5 days prior to transplantation and discontinued on the
      eighth day after transplantation. The mean survival time for the allograft
      recipients in the group receiving Az and Pr [Az (2.5) & Pr group; Az dosage, 2.5
      mg/kg once a day with Pr] was 16.2 +/- 2.4 days and in the group receiving Az,
      Mi, and Pr (Mi & Az & Pr group; Mi dosage, 5.0 mg/kg once a day with Az and Pr),
      it was 14.0 +/- 2.6 days. These results were significantly longer than the
      control group (mean survival time, 8.7 +/- 2.4 days; P < 0.01). There was no
      statistical difference in survival time between these two groups. Groups with
      combinations of Az and Pr had significant elevations of hepatic enzymes (ALT and
      ALP) during the 7 days of immunosuppressive treatment after kidney
      transplantation. The Mi & Az & Pr group had lower elevations of hepatic enzymes
      than groups with combinations of Az and Pr. The combination immunosuppression of
      Mi, Az, and Pr with pre-treatment for canine, kidney transplantation revealed
      relatively fewer side-effects for the liver and longer survival-time.

PMID- 8357914
TI  - Species- and organ-specificity and expression of 105 kD liver cell membrane
      glycoprotein antigen during rat development.
AB  - Species- and organ-specificity of a rat liver cell antigen recognized by a
      monoclonal antibody (MoAb) from a hybridoma clone RM-1 was investigated
      immunohistologically and immunoelectronmicroscopically. In rats, the MoAb reacted
      specifically with liver cell membrane, but not with other organs tested,
      including the brain, thymus, heart, lung, stomach, spleen, kidney, small and
      large intestines, testis and muscle. Furthermore, it was found that liver from
      the human, monkey, mouse, rabbit, guinea pig, dog, cat, cattle and chicken showed
      no specific reaction with this MoAb. The results indicated that the antigen was
      organ- and species-specific and designated as rat liver cell-specific membranous
      antigen (RLSA). RLSA was expressed scarcely along cell junctions of immature
      hepatocytes at the 19th day of pregnancy. This increased gradually, and was
      expressed along all surface membranes after birth.

PMID- 8357915
TI  - The bronchial tree, lobular division and blood vessels of the masked palm civet
      (Paguma larvata) lung.
AB  - The right lung of the masked palm civet (Paguma larvata) consists of the cranial,
      middle, caudal and accessory lobes. The left lung has no cranial and accessory
      lobes and has a bilobed middle and caudal lobes. On either side, there are four
      bronchiole systems, i.e. dorsal, lateral, ventral and medial. The right cranial
      lobe is formed by the first bronchiole of the dorsal bronchiole system. However,
      this bronchiole arises from the right lateral side of the trachea, the so-called
      tracheal bronchus (bronchiole). The right middle lobe is formed by the first
      bronchiole of the lateral bronchiole system, and the right accessory lobe is
      formed by the first bronchiole of the ventral bronchiole system. The remaining
      bronchioles of the dorsal, lateral and ventral bronchiole systems and a
      bronchiole of the medial bronchiole system constitute the right caudal lobe. In
      the left lung, the left middle lobe is formed by the first bronchiole of the
      lateral bronchiole system. This bronchiole divides into two branches, each of
      which forms a lobule. The remaining bronchioles constitute the left caudal lobe
      as in the right lung. The branches of pulmonary arteries mostly run along the
      dorsal or lateral side of bronchioles. The pulmonary veins run the ventral or
      medial side of bronchioles and between the bronchioles.

PMID- 8357916
TI  - The bronchial tree and lobular division of the horse lung.
AB  - The lungs of five horses were examined. At present, in veterinary anatomy, the
      horse lung is divided into the cranial and caudal lobes by the cardiac notch on
      either side. In addition to these lobes, in the right lung, the accessory lobe is
      present. However, from the viewpoint of the bronchial ramifications, the horse
      lung can be divided into the cranial, middle, caudal and accessory lobes
      bilaterally. The horse lung has four bronchiole systems on either side, dorsal,
      lateral, ventral and medial. The cranial lobe is formed by the first bronchiole
      of the dorsal bronchiole system. The middle lobe is formed by the first
      bronchiole of the lateral bronchiole system. The accessory lobe is formed by the
      first bronchiole of the ventral bronchiole system. The remaining bronchioles of
      the dorsal, lateral and ventral bronchiole systems and all bronchioles of the
      medial bronchiole system constitute the caudal lobe. These features were compared
      with those of the lungs of other domestic animals.

PMID- 8357917
TI  - Pharmacokinetics and tolerability of chloramphenicol in budgerigars
      (Melopsittacus undulatus).
AB  - Pharmacokinetics and tolerability of chloramphenicol (CP) were evaluated in
      budgerigars. Following intramuscular administration of CP at 100 and 200 mg/kg of
      body weight, serum peak concentrations of 35.3 and 90.7 micrograms/ml,
      respectively, were obtained 0.25 hr following injection, and these values
      declined with a terminal half-life of 2.5 and 2.7 hr, respectively. Based on
      these results, an intramuscular dosage regimen of 100 mg/kg of CP 3 times a day
      or of 200 mg/kg twice daily was recommended as effective against many of the
      common bacterial infections in budgerigars. Red blood cell count, packed cell
      volume, hemoglobin, total plasma protein, serum AST, ALT, LDH and CK values were
      determined after intramuscular injection of either CP or physiological saline 2
      or 3 times a day for 5 days. The birds were weighed before and after treatment.
      Tissue samples from various organs were examined histologically. The most
      prominent adverse effect was muscular damage at the injection site. A dosage
      regimen of 200 mg/kg twice daily for 5 days was considered to be safe.

PMID- 8357918
TI  - The bronchial tree, lobular division and blood vessels of the Japanese deer
      (Cervus nippon) lung.
AB  - The bronchial tree, lobular division and blood vessels of the lungs were examined
      in three Japanese deer (Cervus nippon). The dorsal, lateral, ventral and medial
      bronchiole systems arose from the dorsal, lateral, ventral and medial sides of
      both bronchi, respectively. Furthermore, one bronchiole arose from the right side
      of the trachea, namely the tracheal bronchus (bronchiole). This bronchiole formed
      the right cranial lobe. The right middle lobe was formed by the first bronchiole
      of the lateral bronchiole system. The right accessory lobe was formed by the
      first bronchiole of the ventral bronchiole system. The remaining bronchioles of
      the four bronchiole systems constituted the right caudal lobe. In the left lung,
      the cranial and accessory lobes were absent. The left middle lobe was formed by
      the first bronchiole of the lateral bronchiole system. This bronchiole was well
      developed and formed a bilobed middle lobe. The remaining bronchioles constituted
      the left caudal lobe. The right lung consisted of the cranial, middle, caudal and
      accessory lobes. The left lung consisted of the middle and caudal lobes. The
      branches of the pulmonary arteries ran mostly along the dorsal or lateral side of
      the bronchioles. The pulmonary veins ran the ventral or medial side of the
      bronchiole, and between the bronchioles.

PMID- 8357919
TI  - A clinical trial of recombinant bovine interferon alpha 1 for the control of
      bovine respiratory disease in calves.
AB  - The effects of recombinant bovine interferon alpha 1 (rBoIFN alpha 1) on the
      incidence of bovine respiratory disease (BRD) were examined in 60 young male
      cattle. Each group of clinically healthy 30 male cattle was injected
      intramuscularly with either rBoIFN alpha 1 (5 mg/head) or physiological saline 5
      times in 6 months. They were examined daily for the clinical symptoms of
      respiratory distress. The clinical signs of respiratory distress in rBoIFN alpha
      1-treated cattle were significantly less severe than those of the placebo group.
      The incidence rate, relapse rate and mean sick days of respiratory disease in the
      rBoIFN alpha 1-treated group were 23%, 14% and 4.43 days, respectively, whereas
      those in the placebo group were 80%, 46% and 6.42 days, respectively.
      Furthermore, the mean increase of body weights in rBoIFN alpha 1-treated group
      and placebo group were 1.365 kg/day and 1.340 kg/day, respectively. These results
      suggest that rBoIFN alpha 1 has a potentially preventive effect on the incidence
      of BRD.

PMID- 8357920
TI  - An occurrence of equine transport pneumonia caused by mixed infection with
      Pasteurella caballi, Streptococcus suis and Streptococcus zooepidemicus.
AB  - An acute death occurred in a racehorse with pneumonia after long-distance
      transportation in December, 1990. Pasteurella caballi, Streptococcus suis and
      Streptococcus zooepidemicus were isolated from the lung at high rate. Specific
      antigens of these bacteria were also demonstrated immunohistologically in the
      pneumonic lesion. These findings indicated that the disease is equine transport
      pneumonia caused by a mixed infection of the three bacterial species. This is the
      first report on the isolation of P. caballi and S. suis from a racehorse in
      Japan.

PMID- 8357921
TI  - Spontaneous coronary arteriolosclerosis in broiler chickens.
AB  - Arteriolosclerotic changes were found in 202 out of 203 randomly collected heart
      specimens of broiler chickens. These chickens were reared in a poultry farm and
      killed at a poultry meat processing plant at 60 days of age with healthy
      appearance. Cellular intimal thickening due to a proliferation of smooth muscle
      cells of small arteries or arterioles were found mostly in the innermost layer of
      the left ventricle. Severity of the thickening varied from slight to severe. In 2
      cases, myocardial necrotic changes were found in the proximity of severely
      affected small arteries and arterioles.

PMID- 8357922
TI  - A simple method of hybridohistochemistry for detection of renin mRNA in the mouse
      kidney.
AB  - Hybridohistochemistry was applied for the detection of renin mRNA in the mouse
      kidney with a digoxigenin-labeled probe, synthesized as the sense and antisense
      RNAs from Ren-1 cDNA in the presence of digoxigenin-dUTP. Renin mRNA was detected
      in the juxtaglomerular cells located in the vicinity of the glomerular vascular
      poles of the kidney using the digoxigenin-labeled antisense RNA as a probe. Using
      the sense RNA as a probe, no signal was detected anywhere. In neighboring serial
      sections, the same cells reacted immunohistochemically to rabbit anti-mouse
      submandibular gland renin serum as in hybridohistochemistry. As we used the probe
      labeled with digoxigenin as a non-radioisotopic marker, there was no need for
      special handling other than that in immunohistochemistry. It was concluded that
      the simple procedure given in the present study is useful for the detection of
      mRNA.

PMID- 8357923
TI  - Lymphoplasmacytic lymphoma in a stallion.
AB  - Lymphoplasmacytic lymphoma found in a 6-year-old Anglo-Arabian stallion was
      investigated histologically, immunohistochemically and ultrastructurally. The
      animal showed a large mediastinal mass and generalized lymph node involvement.
      The neoplastic cells were in various differentiation stages of small lymphocyte,
      centrocyte, centroblast, immunoblast and plasma cell. Some neoplastic cells
      showed positive cytoplasmic reactivity for mu and lambda chains. There were well
      developed rough endoplasmic reticulum (RER) and Golgi complexes in plasmacytoid
      cells, and slightly developed RER or a few long strands of RER in medium-sized to
      large lymphoid cells. These findings suggest that this neoplasm is of B-cell
      origin.

PMID- 8357924
TI  - Immunothermotherapy and related TNS induction in mice.
AB  - Induction of tumor necrosis factor in sera (TNS) as a multidisciplinary cancer
      therapy by the administration of a combination of 2-carboxyethylgermanium
      sesquioxide (Ge-132) and lipopolysaccharide (LPS) on Meth-A sarcoma-bearing mice
      was attempted. In addition to the above TNS induction therapy (TNS therapy) per
      se, the potential on the above parameters by employing a multidisciplinary cancer
      therapy (immunothermotherapy), in which TNS therapy was coupled with regional
      hyperthermia treatment, was investigated. This immunothermotherapy enhanced the
      antitumor effects produced by the above TNS therapy.

PMID- 8357925
TI  - Detection of Mycoplasma hyorhinis in porcine eustachitis.
AB  - Pathologic study of the ear was performed on 179 young swine, ranging in age from
      1 day to 18.6 weeks. Histologically, eustachitis was the most common and its
      inflammatory reaction appeared to precede otitis. Immunohistochemically,
      Mycoplasma hyorhinis (Mhr) antigens were detected on the luminal surface of the
      auditory epithelia in 19 of 179 cases (10.6%). All the cases, positive for Mhr
      antigens, were associated with an acute eustachitis. Ultrastructural examination
      of two piglets confirmed these immunohistochemical data. The present results
      indicate that Mhr may be a primary cause of acute eustachitis in young swine.

PMID- 8357926
TI  - Placental and plasma cystine aminopeptidase in pregnant animals.
AB  - The placental and plasma cystine aminopeptidase (CAP) in pregnant animals was
      examined on stability after the treatment with L-methionine, ethylene diamine
      tetra-acetic acid (EDTA) and heat. Inhibitory effects of these treatments on
      enzyme activities were different among CAPs from the animal species, however,
      significant correlation in those effects between placental and plasma CAPs was
      observed. These results suggested that plasma CAP might reflect placental CAP and
      seemed to be available for estimating maternal gestational conditions.

PMID- 8357927
TI  - Protein kinase C and its endogenous substrate proteins in isolated cow liver
      parenchymal cells.
AB  - Protein kinase C activity was evaluated and its endogenous substrate proteins
      were explored in isolated cow liver parenchymal cells. Protein kinase C activity
      was detected in both cytosolic and total particulate fractions of the cells. At
      least four proteins in cytosolic and seven proteins in total particulate
      fractions were found to be substrates for protein kinase C. These results
      suggested that protein kinase C-catalyzed protein phosphorylation was involved in
      the regulation of functions of cow liver parenchymal cells.

PMID- 8357928
TI  - Heterotopic splenic tissue in the liver of a swine.
AB  - A heterotopic splenic tissue (HST) was observed in the diaphragmatic face of the
      right hepatic lobe of a 6-month-old, female mixed bred swine. Macroscopically,
      HST was a solitary, well-demarcated intrahepatic nodule, 1 x 0.5 x 0.5 cm in
      size. Other organs including original spleen showed no macropathological
      abnormalities. Histological findings of HST were essentially similar to those of
      the original spleen, receiving feeding blood vessels from hepatic portal vein. To
      our knowledge, the present case is the first report of HST in the liver not only
      of domestic animals but also of man.

PMID- 8357929
TI  - Biochemical polymorphisms in Long-Evans Cinnamon (LEC) inbred strain of rat.
AB  - Long-Evans Cinnamon (LEC) rat is an inbred strain of mutant rat which has been
      proposed to be an animal model for human Wilson's disease. In the present study,
      28 genetic marker proteins were analyzed by electrophoresis in sublines of LEC
      inbred strain held separately by four facilities. As expected, the 27 markers
      were homozygous and identical in all of examined animals. We further found a
      novel variant of esterase-2 (ES-2) showing an intermediate mobility between
      profiles of ES-2A and ES-2C types.

PMID- 8357930
TI  - Five cases of cranial duplication in calf.
AB  - Five cases of cranial duplications in calves were morphologically reported. Each
      calf had a single body with duplicated heads that showed various degrees of
      fusion. The medial sides of individual heads were asymmetrically supplied by the
      branches of hemilateral common carotid or lingual artery. No marked differences
      in the development of the duplicated head in any of the calves were observed.
      Cleft palates were observed in all heads. The development and general structures
      of the organs in the head and neck regions appeared to depend on the degree of
      duplication of the cranial nerves.

PMID- 8357931
TI  - Induction of serum haptoglobin by administration of ethionine to cows.
AB  - In order to assess the association of cow serum haptoglobin with fatty liver,
      haptoglobin concentrations were evaluated by single radial immunodiffusion in
      sera from cows after administration of ethionine (an analogue of methionine).
      Haptoglobin concentrations were found to be increased in the sera of the
      ethionine-administered cows. This result suggests that the induction of
      haptoglobin is associated in the pathogenesis of fatty liver.

PMID- 8357932
TI  - Immunosuppression in dogs naturally infected with Babesia gibsoni.
AB  - We examined lymphoproliferative response to phytohemagglutinin and anti-parasite
      antibody level in dogs naturally infected with Babesia gibsoni. The dogs with
      subclinical B. gibsoni infection exhibited suppressed lymphocyte blastogenesis.
      Prominent depression of lymphocyte blastogenesis and anti-parasite antibody
      production was observed in dogs suffering from relapses of clinical B. gibsoni
      infection.

PMID- 8357933
TI  - Production of cytolethal distending toxin (CLDT) by Campylobacter fetus subsp.
      fetus isolated from calves.
AB  - Cytolethal distending toxin (CLDT) production by Campylobacter fetus subsp. fetus
      isolated from calves was examined using CHO cells. Twenty-five of the 26 strains
      tested were positive for CLDT with titer of ranging 1:8 to 1:2,048. CLDT positive
      strains were divided into low and high cytotoxin titer groups. Isolates from
      diarrhea cases tended to produce a significant amount of CLDT compared with
      isolates from liver. CLDT produced by C. fetus showed no effect on Y-1 cells and
      was heat-labile and trypsin-sensitive.

PMID- 8357934
TI  - Outbreaks of Salmonella Dublin infection among calves on a dairy farm applying
      Salmonella bacterins in Zambia.
AB  - In Zambia, a dairy farm keeping about 600 cows and self-contained calves had
      applied S. Dublin and S. Typhimurium bacterins to pregnant cows and calves in
      combination with all-in all-out pen system for rearing calves. Only relatively
      small scale outbreaks of S. Dublin infection occurred repeatedly in these years
      from 1989 to 1991 among fattening calves on the farm. The results obtained from
      the epizootiological study suggest that the preventive measures including the
      vaccination with Salmonella bacterins gave insufficient protection against S.
      Dublin infection to the calves, but they might have prevented large scale
      outbreak of the disease. This is the first report of the epizootiological study
      on outbreak of bovine S. Dublin infection on farm in Zambia.

PMID- 8357935
TI  - Hydranencephaly in newborn calves in Zambia.
AB  - Hydranencephaly without arthrogryposis was observed in three newborn Holstein
      Friesian calves, born during one week in a 400-cow dairy herd in Zambia. The
      affected calves were blind and exhibited nystagmus and depressed behavior.
      Akabane virus infection was suspected based on the pathological findings and
      etiological data, however, we could not determine the exact causative agent.

PMID- 8357936
TI  - Establishment of reference ranges for thyrotropin, triiodothyronine, thyroxine
      and free thyroxine in neonates, infants, children and adolescents.
AB  - Thyrotropin, triiodothyronine, thyroxine and free thyroxine were determined in
      the sera of 714 euthyreotic neonates, infants, children and adolescents (age
      range 5 days to 18 years), using the IMx from Abbott Laboratories. Thyrotropin,
      triiodothyronine and free thyroxine were determined with microparticle enzyme
      immunoassays (MEIA). Thyroxine was determined with a fluorescence polarization
      immunoassay (FPIA). The proband collective was divided into 9 age groups, and
      each age group into males and females. In accordance with the recommendations of
      the International Federation of Clinical Chemistry, the 95% scatter range was
      taken as the reference range. In the different age groups, the ranges of some
      hormones showed significant differences between males and females. When no
      significant difference existed between the sexes, the results for males and
      females were evaluated statistically as a single group. Only a few reference
      groups showed normal Gaussian distributions. Therefore, in addition to the 50th
      percentile, the 2.5th and 97.5th percentiles were also calculated for all
      reference groups. Minimal and maximal values were also determined. The U-test of
      Mann & Whitney was used to test for significant differences between individual
      reference groups, and groups showing no significant differences were combined.
      The corresponding references ranges were then calculated.

PMID- 8357937
TI  - Assay of antinuclear antibodies by ELISA using nuclei as antigen.
AB  - An enzyme-linked immunosorbent assay to detect antinuclear antibodies in the sera
      of patients with autoimmune diseases is described. Goat liver nuclei were
      immobilized on polystyrene plates and antinuclear antibodies were used to
      standardize the assay. The effects of variables, such as the nuclei
      concentration, conditions of nuclei storage, and the length of the incubation
      period were investigated on the assay. Prototype sera with known antibody
      specificity were used to evaluate the assay. The method described is highly
      sensitive, autoantibodies being detectable at serum dilutions of 1:1000 or
      higher. According to the intra- and inter-assay coefficient of variation, the
      results were highly reproducible.

PMID- 8357938
TI  - Determination of lipoprotein(a): evaluation of three methods.
AB  - Lipoprotein(a) (Lp(a)) is a strong independent risk factor for premature
      atherosclerosis. Structurally, Lp(a) closely resembles LDL. Its protein moiety
      contains apolipoprotein B-100 and apolipoprotein(a). We evaluated two commercial
      enzyme immunoassays (EIAs) and an immunoradiometric assay (IRMA) for Lp(a). The
      three assays differed in their design and they used different antibodies. In the
      immunoradiometric assay, two different monoclonal antibodies were used. In the
      first EIA, monoclonal anti-apolipoprotein(a) was bound to the solid phase and
      Lp(a) was detected with polyclonal anti-apolipoprotein B (Lp(a):B-EIA). In the
      second EIA, polyclonal anti-apolipoprotein(a) was used as capturing antibody and
      as detecting antibody (apo(a)-EIA). Ninety three plasma samples were assayed for
      Lp(a) with the three methods. The best correlation was obtained between the IRMA
      and the Lp(a):B-EIA (r = 0.971). Correlations between the apo(a)-EIA on the one
      hand and the IRMA or the Lp(a):B-EIA on the other hand were 0.889 and 0.836,
      respectively. The methods significantly differed in their calibration. This
      resulted in different mean Lp(a) concentrations. When tested against purified
      Lp(a), the apo(a)-EIA appeared accurately calibrated, whereas the IRMA and the
      Lp(a):B-EIA overestimated Lp(a) by approximately twofold. In the Lp(a):B-EIA, the
      detecting antibody is directed against apolipoprotein B. The Lp(a):B-EIA is,
      therefore, not affected by apolipoprotein(a) size polymorphism. This allows
      expression of the concentration of Lp(a):B complexes on a molar basis. In
      contrast, the polyclonal antibody-based apo(a)-EIA measures the concentration of
      apolipoprotein(a) antigen, and may, therefore, be susceptible to inter- and intra
      individual polydispersity of apolipoprotein(a) and Lp(a) particles.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8357940
TI  - Self-organizing neural networks as a means of cluster analysis in clinical
      chemistry.
AB  - Connectionist systems (often termed "neural networks") are an alternative way to
      solve data processing tasks. They differ radically from conventional "von
      Neumann" computing devices. Recent work on neural networks in clinical chemistry
      was done using supervised learning schemes, resulting in models which resemble
      classical discriminant analysis. The aim of the present study is to make clinical
      chemists familiar with basic concepts of self-organizing neural networks
      employing unsupervised learning schemes. Using a benchmark data set on the
      composition of milk from 22 different mammals, it is demonstrated that self
      organizing neural networks are capable of performing tasks similar to classical
      cluster analysis and principal component analysis. Self-organizing neural
      networks could be envisaged to provide an alternative way for reducing the
      dimensionality of complex multivariate data sets, thus producing easily
      comprehensible low-dimensional "maps" of essential features.

PMID- 8357939
TI  - A high-performance liquid chromatographic method for the determination of
      hypoxanthine, xanthine, uric acid and allantoin in serum.
AB  - A method was developed for the simultaneous determination of hypoxanthine,
      xanthine, uric acid and allantoin based on isocratic reversed-phase
      chromatography. This HPLC-method additionally allows the direct determination
      with UV-detection of inosine-5'-phosphate, uridine, thymine, orotic acid,
      allopurinol and oxipurinol, besides hypoxanthine, xanthine and uric acid in the
      same chromatographic run. Allantoin elutes in this system near the void volume
      and a fraction is collected covering the retention time range for this substance.
      After hydrolysis allantoin is converted to glyoxylate-2,4-dinitrophenylhydrazone,
      rechromatographed and detected at 360 nm. The coefficient of variation for this
      method does not exceed 5.0% for a serum concentration of 0.3 mumol/l hypoxanthine
      and is not greater than 5.3% for a xanthine concentration of 0.3 mumol/l serum.
      Recoveries were 90-110% for both hypoxanthine and xanthine. The determination of
      uric acid had an imprecision and inaccuracy not exceeding 1.45% in the
      concentration range of 103-568 mumol/l. Due to the more complex procedure
      required for the determination of allantoin, the coefficient of variation between
      days was 13.6% for a sample containing 0.8 mumol/l allantoin and the recoveries
      for this analyte were in the range of 86-93%. Reference ranges (mean +/- SD)
      determined on 171 serum samples from healthy adults were 12.7 +/- 6.6 mumol/l for
      hypoxanthine, 3.3 +/- 1.4 mumol/l for xanthine, and 15.7 +/- 7.9 mumol/l for
      allantoin. No significant age or sex dependence was observed. Uric acid
      concentrations were 320 +/- 55 mumol/l serum for men and 206 +/- 55 mumol/l for
      women.

PMID- 8357941
TI  - The use of liquid chromatography-mass spectrometry for the identification and
      quantification of urinary iminodipeptides in prolidase deficiency.
AB  - It has been reported that the urine of patients with prolidase deficiency
      contains various iminodipeptides with a carboxyl-terminal proline
      (hydroxyproline). These iminodipeptides have hitherto been detected indirectly by
      acid hydrolysis or enzymatic digestion, followed by amino acid analysis. In the
      present study, it was shown that X-Pro could be distinguished from Pro-X when the
      iminodipeptides were analysed directly by liquid chromatography coupled with
      atmospheric pressure ionization mass spectrometry (LC/API-MS), with scanning of
      the protonated molecule ions ([M+H]+). The same procedure also successfully
      quantified urinary iminodipeptides from patients with prolidase deficiency. A
      quantitative investigation of two siblings with prolidase deficiency revealed
      that the patient with severe clinical symptoms excreted more iminodipeptides than
      the other who did not have serious symptoms. LC/API-MS also revealed
      iminodipeptides (Gly-Hyp and Pro-Hyp) in the urine of the mother of the patients
      and in normal volunteers. Patients excreted much more Pro-Hyp than normal
      volunteers, whereas no quantitative differences were found between the mother and
      controls. In patients, the excretion of large quantities of X-Pro is due to their
      very low prolidase activity towards this type of substrate. In the erythrocytes
      of patients, prolidase activity towards X-Hyp was extremely low; even in the
      mother and normal volunteers, it was remarkably low in comparison with the
      activity against X-Pro.

PMID- 8357943
TI  - Development and evaluation of a reagent carrier with a new reaction sequence for
      the determination of creatinine in blood, plasma, serum and urine.
AB  - After a short outline of the history of creatinine determination methods we
      describe the development of a dry-reagent-carrier system for the reflometric
      determination of the creatinine concentration in blood, plasma, serum and urine
      (Reflotron Creatinine (new)). The method is based on a sequence of enzymatically
      catalyzed reactions producing H2O2, but which in contrast to the previously used
      procedure do not lead to the formation of creatine as an intermediate. Hence,
      pretreatment of sample material to eliminate endogenous creatine is no longer
      necessary. In the indicator reaction, use is made of an imidazole derivative as
      the chromogen. The dye formed in the presence of peroxidase can be measured by
      reflectance photometry beyond the long-wave absorption bands of haemoglobin and
      bilirubin at 642 nm. We present in detail the results of the multicentre
      evaluation of the analytical properties of this new test principle. The data
      obtained show that Reflotron Creatinine (new) correlates well with the routine
      method Creatinine PAP, which was used as a comparison method, with respect to
      accuracy and precision and even surpasses it with respect to specificity.
      Advantages over the first generation of Reflotron Creatinine are: shorter
      reaction time, longer stability of the reagent carrier, no interference by
      bilirubin and reduced interference by haemoglobin.

PMID- 8357942
TI  - Falsely low results in CA 125 determination due to anti-idiotypic antibodies
      induced by infusion of [131I]F(ab')2 fragments of the OC125 antibody.
AB  - We investigated a one-step immunometric CA 125 assay, which employs new anti-CA
      125 antibodies as capture antibodies and OC125 antibodies for detection, for
      interference due to antibodies induced by repeated administration of F(ab')2
      fragments of the anti-CA 125 antibody OC125. Testing 33 samples, obtained from 13
      patients treated with OC125 fragments, we found falsely high CA 125
      concentrations only in samples with exceptionally high concentrations of both
      anti-idiotypic antibodies and non-specific human anti-mouse antibodies. In
      contrast, the recovery of added CA 125 was already diminished in the presence of
      low anti-idiotypic antibody concentrations. Both interferences disappeared after
      removal of serum IgG. It was possible to eliminate the falsely high results, but
      not the reduction in recovery rate, by adding non-specific murine IgG. When the
      binding of the detector antibodies was performed in a separate incubation step,
      no reduction in recovery rate was observed. Our results suggest that non-specific
      human anti-mouse antibodies are responsible for falsely high results. The
      reduction in the recovery rate is obviously due to an inhibition of the binding
      of OC125 detector antibodies by anti-idiotypic antibodies. In patients receiving
      OC125 antibodies CA 125 can be measured using OC125 detector antibodies if a two
      step assay is performed. An increase in CA 125 following OC125 infusion should be
      confirmed after the addition of non-specific murine IgG.

PMID- 8357944
TI  - Ibuprofen toxicity. A review of adverse reactions and overdose.

PMID- 8357945
TI  - Impurities in organic synthetic drugs: a review of regulatory and toxicological
      considerations.

PMID- 8357946
TI  - Famous names in toxicology. Paracelsus--born 500 years ago.

PMID- 8357947
TI  - Chloramphenicol toxicity.
AB  - Although high serum concentrations of chloramphenicol are related to toxicity, as
      shown experimentally and during treatment, the mechanism of toxicity remains
      unclear. Published work suggests that relatively minor metabolites may be
      causally related to toxic reactions in vitro and some of these metabolites have
      been detected in sera from treated patients. It is possible that all the major
      toxic manifestations of chloramphenicol may be explained by attack by free
      radicals. Depletion in compounds acting as cellular antioxidants, such as
      glutathione and vitamin E, may conceivably increase the vulnerability of an
      individual to chloramphenicol toxicity, while supplementation with an antioxidant
      might protect against it. Research into the metabolism of chloramphenicol and
      into the mechanism of its toxicity has declined since early work in the 1950s and
      1960s, but its continuing use worldwide means that there is justification for
      renewed interest in the toxicology of this useful antibiotic.

PMID- 8357948
TI  - Do chloramphenicol blood dyscrasias occur in Hong Kong?

PMID- 8357949
TI  - Two-dimensional tortuosity of the superficial femoral artery in early
      atherosclerosis.
AB  - Tortuosity of an artery can disturb fluid mechanics and cause flow separation,
      which might in turn promote atherogenesis. This study discusses theoretically
      several quantitative measures of arterial tortuosity and curvature in two
      dimensions and tests them with computations from digitized femoral arteriograms.
      When reproducibility, sensitivity to scaling and computational procedure, and
      agreement between the measures were all taken into account, the total curvature
      and distance factor were considered the most suitable measures. Significant
      correlations were found between tortuosity and atherosclerosis measures, but the
      interpretation of this finding is not straightforward.

PMID- 8357950
TI  - Morphogenic effects of endothelin-1 on vascular smooth muscle cells.
AB  - Endothelin-1 (ET-1), a vasoconstrictor peptide produced by endothelial and
      vascular smooth muscle cells (VSMC) might play a role in vascular remodelling. To
      investigate the proposed 'mitogenic' potential of ET-1, we examined the effects
      of chronic exposure of VSMC to ET-1 on cell cycle, growth/proliferation and
      differentiation under essentially mitogen-free culture conditions. Bulk cultures
      of thoracic aortic VSMC of spontaneously hypertensive (SHR) and normotensive
      Wistar Kyoto (WKY) rats, although exhibiting genetically determined differences
      in growth/proliferation (due to shortened G1 and G2 phases in SHR VSMC), respond
      in a similar manner to ET-1 exposure: long-term exposure (12-15 days) of VSMC
      from both sources to ET-1 in nonmitogenic medium did not promote cycling of
      cells. On the contrary, ET-1 attenuated the cycling of VSMC which had already
      cycled beyond the S phase. For cells which had not cycled beyond the S phase, ET
      1 interrupted progression through the cell cycle at the late G1/early S phase.
      The specific ability of SHR VSMC to grow in mitogen-free medium was abolished by
      ET-1, most likely via down-regulation of platelet-derived growth factor (PDGF)
      alpha receptors. Subsequent to ET-1 exposure, VSMC expressed increased levels of
      mRNA and protein for smooth-muscle-specific alpha-actin. However, expression of
      smooth muscle alpha-actin did not predominate over beta-actin as observed for
      adult contractile VSMC in vivo. The ET-1-induced expression of smooth-muscle
      specific alpha-actin mRNA was dose dependent (EC50 approx. 2 x 10(-9) M), and
      alpha-actin protein expressed was associated with organized actin fibers.

PMID- 8357951
TI  - Eicosapentaenoic acid potentiates the production of nitric oxide evoked by
      interleukin-1 beta in cultured vascular smooth muscle cells.
AB  - Experiments were designed to determine whether the omega 3-unsaturated fatty acid
      eicosapentaenoic acid affects the production of nitric oxide evoked by
      interleukin-1 beta in cultured vascular smooth muscle cells. Incubation of
      cultured rat or human aortic smooth muscle cells with interleukin-1 beta evoked a
      time- and concentration-dependent release of nitrite, an oxidation product of
      nitric oxide. The exposure of cells to interleukin-1 beta in combination with
      eicosapentaenoic acid caused a significantly larger production of nitrite than
      that evoked by the cytokine alone. The potentiation by eicosapentaenoic acid was
      concentration-dependent. The production of nitrite evoked by equieffective
      concentrations of interleukin-1 beta in the presence and absence of
      eicosapentaenoic acid were inhibited to a similar extent by nitro L-arginine (an
      inhibitor of nitric oxide synthase), transforming growth factor beta 1, platelet
      derived growth factorAB and thrombin. The addition of interleukin-1 beta
      activated smooth muscle cells to suspensions of washed and indomethacin-treated
      platelets inhibited the aggregation caused by thrombin. The inhibitory effect was
      enhanced when the smooth muscle cells were exposed to the cytokine in the
      presence of eicosapentaenoic acid prior to the experiment. Smooth muscle cells
      exposed to interleukin-1 beta and eicosapentaenoic acid did not affect platelet
      aggregation in the presence of oxyhemoglobin or methylene blue. Untreated cells
      or cells exposed to the fatty acid alone did not have such effects. These
      observations suggest that eicosapentaenoic acid potentiates the production of
      nitric oxide evoked by interleukin-1 beta in vascular smooth muscle.

PMID- 8357952
TI  - Renal versus femoral hemodynamic response to endothelium-derived relaxing factor
      synthesis inhibition.
AB  - Systemic inhibition of endothelium-derived relaxing factor (EDRF) synthesis leads
      to acute hypertension and increased peripheral vascular resistance. The changes
      in vascular resistance are not evenly distributed to all vascular beds. In this
      study, we compared the renal and femoral hemodynamic responses to EDRF synthesis
      inhibition. Renal blood flow (RBF) and femoral blood flow (FBF) were assessed in
      the presence and absence of DuP 753, an angiotensin II receptor antagonist.
      Inhibition of EDRF synthesis by a bolus dose of Lw-nitroarginine methyl ester (L
      NAME) increased blood pressure (BP) by 21 +/- 1 mm Hg (p < 0.001) and decreased
      RBF by 32 +/- 5% (from 5.9 +/- 0.5 to 3.9 +/- 0.3 ml/min/g kidney weight; p <
      0.005) while FBF remained unchanged (9.5 +/- 0.4 versus 9.4 +/- 0.4 ml/min).
      Renal vascular resistance (RVR) increased by 83 +/- 16% (p < 0.001), compared
      with only a 24 +/- 6% increase in femoral vascular resistance (FVR; p < 0.005).
      To eliminate the influence of systemic hypertension, we returned organ perfusion
      pressure to pre-L-NAME levels by partial aortic constriction. The kidney
      maintained RBF by decreasing RVR by 8 +/- 2% (p < 0.02), while FBF decreased by
      15 +/- 5% (p < 0.01). When rats were pretreated with DuP 753, L-NAME still
      increased BP by 22 +/- 2 mm Hg, but RVR increased by only 26 +/- 5% (from 13.2 +/
      1.6 to 16.8 +/- 2.7; p < 0.01) and RBF did not change. DuP 753 had no effect on
      the femoral vascular response to L-NAME.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357953
TI  - Contractility of the rabbit abdominal aorta 4 days after endothelium denudation.
AB  - The purpose of this study was to evaluate contractility of the rabbit abdominal
      aorta 4 days after de-endothelialization by balloon catheter. The isometric
      tension of ring-segments in response to vasoactive agents was monitored. A
      significant enhancement of contraction to noradrenaline and serotonin was found
      in aortas 4 days after endothelium denudation as compared with controls with
      endothelium. The enhancement, however, did not differ from that found already in
      acutely denuded vessels (immediate denudation). No significant difference in
      contractility to potassium chloride was found in either group of denuded
      preparations as compared with controls. The sensitivity to all three vasoactive
      agents (EC50) was not influenced by denudation. These results indicate that
      changes in the contractility of denuded vessels are predominantly a consequence
      of lacking the endothelium as a producer of endothelium-derived relaxing factor.
      The access of mitogens to the media does not seem to interfere with the magnitude
      of contraction 4 days after denudation.

PMID- 8357954
TI  - Arginine vasopressin increases perinuclear [Ca2+] in single cultured vascular
      smooth muscle cells of rat aorta.
AB  - The effects of arginine vasopressin (AVP, 10(-7) M) on the spatial dynamics of
      intracellular [Ca2+] in single cultured smooth muscle cells of the rat aorta were
      studied by digital imaging microscopy using the fluorescent Ca2+ indicator fura
      2. The nuclear and cytosolic regions were distinguished by the fluorescent image
      excited at 380 nm. Changes in intracellular [Ca2+] were expressed as percent
      increases in the ratios of fluorescence intensity at 500 nm excited by 340 and
      380 nm. AVP increased the nuclear and cytosolic [Ca2+] in Ca(2+)-containing
      (control) (285 +/- 27 and 172 +/- 22%, respectively) or Ca(2+)-free (203 +/- 26
      and 121 +/- 15%, respectively) solutions. However, caffeine (20 mM) and ryanodine
      (20 microM) greatly attenuated the [Ca2+] increase induced by AVP in both regions
      (61 +/- 21 and 42 +/- 15%, respectively). On the ratio image, the nuclear region
      was discriminated from other regions at the peak response to AVP in preparations
      treated with caffeine and ryanodine, whereas the outline of the nuclear region
      was indistinct in untreated preparations. The finding implies that caffeine- and
      ryanodine-responsive Ca2+ storage sites may exist in the region surrounding the
      nucleus. The results suggest that the region surrounding the nucleus may be one
      of the important Ca2+ storage sites with regard to the responses of rat aortic
      smooth muscle cells to AVP.

PMID- 8357955
TI  - Reduction of vein graft intimal hyperplasia by ex vivo treatment with
      desferrioxamine manganese.

PMID- 8357956
TI  - Human kappa chain expression in a lambda phage vector: methods of isolating
      amplified cDNA affects cloning efficiency.
AB  - Three common methods of isolating amplified DNA were evaluated for their effects
      on cloning efficiency in a phage vector designed to express human kappa chain.
      The "glass milk" technique gave higher cloning efficiency and protein expression
      than phenol-chloroform extraction or microfiltration. This shows that the quality
      of amplified cDNA should be considered when studying the human antibody
      repertoire using this vector system.

PMID- 8357957
TI  - Specific immunosuppression of human anti-murine antibody responses in hu-PBL-SCID
      mice.
AB  - Severe combined immunodeficient (SCID) mice were reconstituted with normal human
      peripheral blood leukocytes (PBLs) and were shown to produce a human anti-mouse
      immunoglobulin antibody response on immunization with heat-treated murine
      monoclonal IgG1 antibody to ovalbumin, referred to as ha-Mab-2. The human anti
      mouse antibody response was proportional tot the number of B cells and
      mononuclear cells transferred from a given batch of PBL. However, pretreatment of
      hu-PBL-SCID mice with a tolerogenic covalent conjugate of monomethoxypolyethylene
      glycol (mPEG) and Mab-2 suppressed this response on subsequent injections of ha
      Mab-2, and this suppression was shown to be antigen-specific, i.e., it did not
      suppress the antibody response to ovalbumin and did not affect the level of
      production of human immunoglobulin of hu-PBL-SCID mice. The suppression was due
      to the generation of human suppressor CD8+ T (Ts) cells, which down regulated
      CD4+ helper T cells in an antigen and HLA class I specific manner, i.e., these
      findings were in accord with the previously shown immunosuppressive effect of
      tolerogenic mPEG conjugates in normal mice.

PMID- 8357958
TI  - Suppression of human anti-mouse idiotypic antibody responses in hu-PBL-SCID mice.
AB  - Severe combined immunodeficient (SCID) mice were engrafted with appropriate
      numbers of T cells and B plus mononuclear cells, which had been fractionated from
      normal human peripheral blood leukocytes (hu-PBLs). Treatment of these hu-PBL
      SCID mice with a tolerogenic covalent conjugate of monomethoxypolyethylene glycol
      (mPEG) and an anti-ovalbumin, IgG1 murine monoclonal antibody, Mab-2, suppressed
      the human anti-mouse antibody responses to both the common (gamma 1,kappa) and
      the idiotypic determinants of Mab-2. Moreover, the Mab-2(mPEG)36 conjugate
      suppressed the immune responses of hu-PBL-SCID mice to the common and idiotypic
      determinants of murine monoclonal antibodies to the 2,4-dinitrophenyl residue and
      to human CD4, consisting also of gamma 1 and kappa chains. It is concluded that a
      tolerogenic mPEG conjugate of a murine monoclonal antibody induces pan
      suppression of the human lymphoid system with respect to other murine monoclonal
      antibodies that share the isotypic determinants of the original one (here, Mab-2)
      incorporated in the conjugate. Hence, it may be anticipated that human anti-mouse
      antibody responses to any murine IgG monoclonal antibody would be suppressed by
      one of eight mPEG conjugates, each incorporating one of the four subclasses of
      IgG and one of the two light chains.

PMID- 8357959
TI  - Immunoglobulin V region heavy and light chain gene sequences of the
      lymphoblastoid cell line GM 4672.
AB  - GM 4672 is an IgG2 kappa-producing lymphoblastoid cell line derived from a
      patient with multiple myeloma. It has been used by many laboratories as a fusion
      partner for the production of human-human hybridoma monoclonal antibodies. GM
      4672 immunoglobulin variable region heavy and light chain family usage was
      originally assigned to VH1 and VK1, respectively. This assignment was based on
      the positions of [3H]leucine of the heavy and light chain proteins using the
      Edman degradation method. Using the polymerase chain reaction and variable region
      leader primers and constant region primers, we report here the immunoglobulin
      variable region gene sequence expressed by GM 4672. The VH region belongs to the
      VH4 family and is most homologous with the V71-2 (87.9%), DK1, and JH4 germline
      genes. The entire heavy chain V region contained 41 mutations in 36 codons and
      included 11 N nucleotide additions flanking the D region. GM 4672 VK region
      contained a VK1 gene rearranged with a JK4 gene. The VK germline gene used by GM
      4672 light chain was not identified but showed the most homology with Vb'
      germline gene (87.7%). When compared to Vb' and JK4 genes, there were 37
      mutations in 30 codons with evidence of antigen selection as determined by the
      replacement to silent mutation ratio in the complementarity-determining regions.
      The high frequency of mutations in the V region genes of GM 4672 is comparable to
      the sequences of other myeloma proteins.

PMID- 8357960
TI  - Dendritic cell activity against primary tumors: an overview.
AB  - Bone marrow-derived dendritic cells (DC) function as antigen presenting cells
      (APC). Little is known of their capability to exert regulatory effects on the
      epithelial cells in various organs. It was reported that injection of the
      bacterial cell wall preparation OK432 into mouse skin resulted in the activation
      of IL-1 and TNF-alpha gene expression in Langerhans cells (LC). In addition to
      studies on LC/DC in normal tissues, numerous investigators reported that DC can
      infiltrate primary tumors in experimental animals and humans and cause tumor
      regression. Human tumors in which DC infiltrates were detected did not develop
      metastases. The presence of DC in tumor biopsies correlated with the survival of
      patients. Absence of DC from tumors suggested poor prognosis. Activation of DC by
      immunomodulators seemed to enhance the ability of DC to prevent the development
      of metastatic tumors. Information on the role of DC as anticancer cells was
      recently reviewed, but information on the molecular basis of the anticancer
      activity of DC is needed. Another problem which needs to be answered is the
      ability of some tumors to prevent DC from entering the tumor. It is possible that
      DC and tumor cells, interact and counteract by releasing cytokines which abrogate
      tumor cells or DC, respectively. In the present analysis the DC responses to
      extrinsic cytokines and immunomodulators will be discussed. The ability of DC to
      induce the expression of the nitric oxide synthase gene will be discussed in
      relation to the anticancer activity of DC and in comparison with the reported
      anticancer activity of macrophages.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8357961
TI  - The dendritic cell system and anti-tumour immunity.
AB  - Dendritic cells (DC) are essential for the initiation of T- and T-dependent
      immune responses by virtue of their capacities to acquire, process and present
      antigens and to deliver activation signals to mature resting T cells. In
      contrast, antigen presentation by other types of antigen-presenting cells (APC)
      may lead to peripheral T cell tolerance. This paper reviews the immunobiology of
      DC, and considers the possibility that immune unresponsiveness of tumour-bearing
      hosts may be due to clonal anergy of T cells. An important issue is whether it is
      possible to use DC to vaccinate tumour-free individuals, to overcome the
      immunological unresponsiveness of tumour-bearing hosts, and ultimately to cause
      rejection of primary and metastatic cancers.

PMID- 8357962
TI  - Langerhans cells in epithelial skin tumors. A quantitative immunohistological and
      morphometric investigation.
AB  - In the present study we investigated whether there is a correlation between
      Langerhans cell density, peritumoral infiltrate or intraepithelial T-lymphocyte
      density within 17 epithelial skin tumors using immunohistologic and morphometric
      methods. We found a significant difference between seborrheic keratosis, basal
      cell carcinoma, and squamous cell carcinoma. No correlation was found between the
      Langerhans cell density and the number of intraepithelial T lymphocytes or
      between Langerhans cell density and the peritumoral infiltrate. A significant
      (inverse) correlation was found between mean nuclear area of the epithelial
      tissue and the number of Langerhans cells. These data might indicate that the
      number of Langerhans cells does not influence the extent of the anti-tumoral
      immune response, but that there is an association between the differentiation
      state of the epithelium and Langerhans cell density.

PMID- 8357963
TI  - Role of Langerhans cells and other dendritic cells in disease states.
AB  - Langerhans cells belong to the dendritic cell lineage and function as potent
      antigen-presenting cells in the skin epidermis. During the last decade, much has
      been learned on dendritic cell involvement in the pathogenesis of disease states.
      This review briefly summarizes our current understanding of the role played by
      Langerhans cells and other dendritic cells in the pathogenesis of immune
      mediated, neoplastic and infectious disorders.

PMID- 8357964
TI  - Dendritic cells prevent lymph node metastasis in patients with gastric cancer.
AB  - Infiltration of S-100 protein positive dendritic cells into tumor tissues was
      investigated immunohistochemically. Although the survival time of patients with
      Stage I, II or IV gastric cancer did not relate to the density of dendritic
      cells, survival time in Stage III patients correlated with the density of
      dendritic cells. In patients with a marked infiltration, survival time was longer
      than in cases of only a slight infiltration (P < 0.001). The frequency in the
      marked infiltration group at the mucosal stage did not change in proportion to
      invasion into the deeper layers. There was a similar incidence of lymph node
      metastasis between the marked and slight infiltration groups in each grade of
      tumor invasion. However, marked infiltration of dendritic cells prevented
      widespread nodal involvement beyond the primary node in cases of advanced cancer
      (P < 0.05). This may be one of the reasons why the infiltration of dendritic
      cells is clinically effective in patients with Stage III gastric cancer.

PMID- 8357965
TI  - Dendritic cells in esophageal cancer and lymph node tissues.
AB  - The density of infiltrating S-100 protein-positive dendritic cells (DCs) on
      histological sections and that of CD1- and L-M2 positive DCs on cryostat sections
      of esophageal dysplastic and cancerous lesions were examined. There was no
      significant correlation between the number of S-100 protein-positive DCs and the
      degree of dysplasia, tumor of S-100 protein-positive DCs and the degree of
      dysplasia, tumor differentiation, depth of invasion or lymph node metastasis of
      esophageal cancer, but the numbers of these cells in patients after preoperative
      radiotherapy were significantly lower than those in patients without
      radiotherapy. Immunohistochemical staining of cryostat sections with anti-CD1
      antibody and L-M2 revealed that poorly differentiated squamous cell carcinoma
      (SCC) contained significantly more DCs than well differentiated SCC. Analysis of
      the numbers of Langerhans cells (LCs) and interdigitating cells (IDCs) revealed
      that well differentiated SCC contained 32.8% LCs and 67.2% IDCs, moderately
      differentiated SCC contained 37.0% LCs and 63.0% IDCs, and poorly differentiated
      SCC contained 2.1% LCs and 97.9% IDCs, the overall proportions being 24.2% for
      LCs and 75.8% for IDCs. Morphometrical analysis of regional primary lymph nodes
      revealed that the degree of paracortical hyperplasia with cancer metastasis was
      significantly higher than that without cancer metastasis, and that the degree of
      sinus hyperplasia with cancer metastasis was significantly lower than that
      without. Furthermore, lymph nodes with cancer metastasis contained significantly
      more S-100 protein-positive IDCs than those without.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8357966
TI  - Dendritic cells in various human thyroid diseases.
AB  - The aim of this study is to determine the presence of S-100 protein-positive and
      CD1-positive dendritic cells (DCs) in tissues with various human thyroid
      diseases. Infiltrating DCs were frequently observed in papillary carcinoma and
      Hashimoto's disease, and these DCs were composed primarily of IDCs. The number of
      DCs was closely correlated with the expression of thyrocytes for S-100 protein
      and Ia-antigen. These findings suggest that DCs may play an important role in the
      immunologic defence mechanisms against papillary carcinomas and in the
      progression and self perpetuation of autoimmunity.

PMID- 8357967
TI  - Antitumor activity of Langerhans cells in radiation therapy for cervical cancer
      and its modulation with SPG administration.
AB  - Correlations between infiltration of Langerhans cells (ILC) in tumor tissues and
      radiation curability were investigated in 449 patients with cervical cancer
      treated with radiation alone, including 390 squamous cell carcinomas and 59
      adenocarcinomas. No significant difference in prognosis was noted in stage I, II,
      and IV squamous cell carcinomas between positive and negative ILC. However, in
      the patients with stage III squamous cell carcinoma, a significantly better
      survival was observed for patients with ILC than for those without, 10 year
      survival rates being 78% vs. 54%, P < 0.01. In adenocarcinoma, the patients with
      ILC also showed significantly better survival than those without ILC, the 10
      years survival rates being 45% vs. 25%, P < 0.025. An analysis of failure
      patterns following radiation treatment demonstrated that the favorable prognosis
      in patients with ILC in squamous cell carcinoma was due to improvement of local
      control rates and somewhat lower metastatic rates, whereas in adenocarcinoma it
      was only due to better local control rate. The ILC was significantly associated
      with T-cell infiltration in tumor tissues. The immunological stimulation with
      Sizofiran in 20 patients led to an augmentation of ILC in tumor tissues. The
      present study suggests that the ILC in cancer tissues improves local response to
      radiation treatment partly by T-cell mediated anti-tumor activity.

PMID- 8357968
TI  - Modulation of antigen-presenting cell function as a potential regulatory
      mechanism in tumor-host immune reactions.
AB  - A growing body of information suggests that immunological defense mechanisms
      against newly emerging tumors may exist within the skin. In this regard, the
      recognition and presentation of tumor-associated antigens by cutaneous antigen
      presenting cells is a prerequisite for the establishment of specific tumor
      immunity. However, despite the recently demonstrated ability of normal I-A+
      epidermal cells (Langerhans cells) to effectively present tumor-associated
      antigens in vivo, even tumors with recognizable antigenic epitopes can grow
      progressively in situ. Therefore, regulatory mechanisms within the local
      microenvironment may exist that control the ability of resident epidermal APC to
      initiate and to elicit protective immunity against incipient cutaneous neoplasms.
      This report reviews the role of APC in tumor immunity and the effects of
      cytokines and ultraviolet radiation (UVR) on tumor antigen presentation by
      epidermal APC. Our data suggest that these agents can significantly modify the
      ability of epidermal cells to present tumor-associated antigens and may therefore
      control the type and effectiveness of tumor immune responses in situ.
      Furthermore, the induction of primary tumor immunity and the elicitation of
      secondary immune responses are independently regulated and respond differently to
      cytokine application.

PMID- 8357969
TI  - Topical retinoic acid inhibits changes in Langerhans cell density during
      carcinogenesis.
AB  - Ultraviolet radiation (UVR), chemical carcinogens and contact sensitisers all
      reduce the density of Langerhans cells (LC) in murine epidermis; UVR also lowers
      the number of Thy-1 dendritic epidermal cells (Thy-1+ dEC). Topical application
      of all-trans retinoic acid (RA) renders these cells insensitive to UVR and the
      tumour promoter 12-0-tetradecanoylphorbol 13-acetate (TPA) but does not inhibit
      LC migration from the epidermis in response to a contact sensitiser.
      Additionally, when the diet of mice was supplemented with the retinoid
      temarotene, UVR was unable to reduce the number of LC or Thy-1+ dEC. Hence one of
      the anti-carcinogenic mechanisms of retinoids may be to protect LC from
      carcinogens.

PMID- 8357970
TI  - Epidermal Langerhans cells and prognosis of patients with mycosis fungoides and
      Sezary syndrome.
AB  - Langerhans cells (LC) (CD1a-positive dendritic epidermal cells) have been
      proposed to favour the pathogenesis of mycosis fungoides (MF) and Sezary syndrome
      (SS). We therefore examined the influence of LC retrospectively on the survival
      of 35 patients. Two clinical parameters (age, stage of disease) were additionally
      evaluated. LC densities were morphometrically assessed on immunohistochemically
      stained cryostat sections of the respective diagnostic specimen. Death resulting
      from MF and SS was significantly (p = 0.003) less frequent in patients with CD1a
      positive epidermal cell densities higher than 90 cells/mm2 (optimal break point)
      as compared with patients with lower numbers, independently of the stage of
      disease. This result suggests that LC have a significant impact on the prognosis
      of patients with MF and SS, playing an important role in the host defense
      mechanisms against these lymphomas.

PMID- 8357971
TI  - Bone marrow-derived dendritic cells and the protection against X-ray-induced
      thymic leukemia in mice. A new interpretation.
AB  - About forty years ago, Henry Kaplan and collaborators reported that four weekly X
      ray doses of 160 rads each were highly leukemogenic in C57BL mice. A single dose
      of 350 Rads had a week leukemogenic effect. These authors also demonstrated that
      lead shielding of the thigh during irradiation prevented the development of
      leukemia. They reported that intravenous injection of syngeneic bone marrow cells
      into irradiated mice facilitated the regeneration of the thymus and prevented the
      development of X-ray-induced tumors. We characterized the thymic Ia+ dendritic
      cells (DC) with the aid of a fluorescence-activated cell-sorter (FACS). It was
      found that exposure of mice to a leukemogenic regimen of fractionated X
      irradiation treatment led to a gradual decrease in the number of thymic DC. The
      disappearance of thymic DC and the development of leukemia were prevented by
      intravenous injection of syngeneic bone marrow or by lead shielding of the femur
      during irradiation. These results indicated that the fractionated irradiation
      caused a decline in the number of DC and, as a result, diminution of the natural
      defense against the developing tumor. Homing of the injected bone marrow DC into
      the thymus can be connected to the prevention of tumor development. Since
      leukemogenic T cells produce interleukin-4(IL-4), we tested the effect of the
      conditioned medium in which YAB-3 cells (tumorigenic Th cells: CD4+, CD8-, Thy
      1+) were cultivated. Following injection of the conditioned medium into the mouse
      footpads, the number of skin Langerhans cells (LC) decreased.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8357972
TI  - The role of dendritic cells in the motility of melanoma cells in initial
      lymphatic metastasis.
AB  - Malignant melanoma is well known for its aggressive metastatic behavior,
      following upon the earliest initial stages. It is the purpose of this preliminary
      paper to add some new ideas, based on electron microscopy, to our understanding
      of the complex progression of malignant melanoma, using cutaneous melanoma as a
      model for the subtypes. Special attention is paid to cellular interaction in the
      progression of melanoma, with emphasis on the subtypes.

PMID- 8357973
TI  - Langerhans cell alterations in cutaneous carcinogenesis.
AB  - Analysis of the early stages of experimental skin cancer in mice has demonstrated
      that complete chemical carcinogens (e.g. DMBA or benzo(a)pyrene) and tumour
      promoters (e.g. TPA) but not tumour initiators (e.g. urethane) deplete or
      functionally alter epidermal Langerhans cells (LC). These changes result in
      altered local immunity as antigen presentation through LC depleted skin results
      in either immune tolerance due to the generation of suppressor T cells or anergy.
      Parallel studies in sheep have shown that, following the application of DMBA,
      depletion of LC is due to increased migration of these cells from the skin
      whereas tumour initiators did not alter LC migration. Likewise benzo(a)pyrene did
      not trigger enhanced LC migration from the epidermis. Experiments in mice suggest
      that part of this increased migration after the application of DMBA is due to the
      carcinogen being handled as an antigen by the epidermal LC. However, this fails
      to explain the prolonged migration which follows. The implication of these
      studies is that early in carcinogenesis, altered immune function occurs as a
      result of LC depletion/modification, allowing aberrant cells to proliferate in
      the absence of immune destruction.

PMID- 8357974
TI  - Epidemiological considerations in the role of dendritic/Langerhans cells in human
      cancer.
AB  - The roles of dendritic or Langerhans cells in human neoplasia have been studied
      in animal models and human subjects for some years. Much has already been learned
      concerning the operative immunological processes, relationships with other
      components of the reticuloendothelial system, and correlations with genetics and
      the aging process. Unfortunately, the present requirement for microscopic
      examination of human tissues to assay these cells greatly limits the types of
      study which can be under-taken and their scope. Investigations must presently be
      limited to human cancers occurring in readily accessible sites such as the
      uterine cervix, urinary bladder and skin. In the future, it is anticipated that
      new experimental approaches can be developed which permit the measurement of
      DC/LC activity levels without the need for biopsy specimens, thus greatly
      enhancing research possibilities in the important arena of biomedical
      investigation.

PMID- 8357975
TI  - Leukotriene A4 hydrolase: structural and functional properties of the active
      center.
AB  - Leukotriene (LT) A4 hydrolase (EC 3.3.2.6) is a bifunctional zinc metalloenzyme
      that possesses both an epoxide hydrolase activity, i.e., the well-known
      conversion of LTA4 into the proinflammatory substance LTB4, and a recently
      discovered peptidase activity. We have employed biochemical/kinetic analyses of
      native enzyme as well as site directed mutagenesis towards a recombinant enzyme
      to explore structural and functional properties of the enzyme active center.
      Thus, we have found that the peptidase activity is selectively stimulated by
      chloride ions, in a manner that suggests the presence of an anion binding site.
      Furthermore, a number of mutated enzymes have been constructed, expressed in E.
      coli, and purified to homogeneity to allow enzyme activity determinations and
      zinc analyses. The catalytic properties and zinc contents of these mutated
      enzymes establish the three zinc binding ligands of the protein and identify Glu
      296 as a catalytic amino acid, directly involved in the peptidase, but not in the
      epoxide hydrolase reaction. In conclusion, our data provide strong evidence that
      the two catalytic activities of LTA4 hydrolase are exerted via non-identical but
      overlapping active sites.

PMID- 8357977
TI  - Drug inhibition and cellular regulation of prostaglandin G/H synthase isoenzyme
      2.
AB  - Prostaglandin G/H synthase isoenzyme 2 (PGHS-2) was identified as an immediate
      early gene product induced by Rous sarcoma virus, serum, phorbol ester and a wide
      variety of other mitogens. Induction of PGHS-2 occurs through an increase in PGHS
      2 gene transcription. Dexamethasone inhibits both the basal and induced levels of
      PGHS-2 mRNA. In contrast, PGHS-1 gene transcription rate, mRNA, and protein
      levels are unaffected by mitogens and dexamethasone. Post-transcriptional down
      regulation of PGHS-2 mRNA plays a significant role in causing dexamethasone's
      effect. Specific cell systems have been identified which allow selective analysis
      of PGHS-1 and PGHS-2 at the nucleic acid and protein levels. These cell systems
      indicate that PGHS-1 and PGHS-2 may have different sensitivities to non-steroidal
      anti-inflammatory drugs. Furthermore, inhibition of PGHS activity correlates well
      with suppression of the transformed phenotype in an in vitro cell model.

PMID- 8357976
TI  - Anti-inflammatory glucocorticoid action: inhibition of griPGHS, a new
      cyclooxygenase.
AB  - Our understanding of the anti-inflammatory actions of glucocorticoid hormones has
      significantly advanced in the past year with the discovery of a second
      cyclooxygenase gene which we call 'glucocorticoid-regulated inflammatory
      prostaglandin G/H synthase' (griPGHS). In mouse fibroblasts and human monocytes
      levels of griPGHS mRNA and protein rise dramatically in response to growth
      factors, cytokines, and oncogene activation. These inductions are markedly
      suppressed by the glucocorticoid hormone, dexamethasone. This stands in contrast
      to the behavior of the previously cloned cyclooxygenase (PGHS), which appears to
      be constitutively expressed. Thus far, data show that griPGHS is increased in
      many other systems where prostaglandin biosynthesis is regulated, including
      models of inflammation, tissue injury, and hormonal control of reproductive
      processes. Thus, griPGHS is likely to be a key mediator of many clinically
      relevant processes and as such represents an important target for both steroidal
      and nonsteroidal anti-inflammatory agents.

PMID- 8357978
TI  - Expression of the murine prostaglandin (PGH) synthase-1 and PGH synthase-2
      isozymes in cos-1 cells.
AB  - Plasmid vectors were constructed which allowed expression of the mouse
      prostaglandin endoperoxide (PGH) synthase-1 and PGH synthase-2 isozymes in cos-1
      cells. Efficient expression of the PGHS-2 isozyme required the truncation of the
      entire 3'-untranslated region of the PGHS-2 cDNA, possibly due to the presence of
      multiple AUUUA sequences which may destabilize the PGHS-2 mRNA. The length of the
      3'-untranslated regions of the murine and ovine PGHS-1 isozymes, which do not
      contain AUUUA sequences, did not affect the efficiency of expression of these
      proteins. The murine PGHS-2 isozyme catalyzes the same cyclooxygenase and
      hydroperoxidase activities as the ovine and murine PGHS-1 isozymes. The maximal
      activities of the mouse enzymes expressed in cos-1 cells was about equal, but
      both were only about a third that seen with the sheep enzyme. Whether this
      reflects differences in the turnover rate of the mouse and sheep enzymes, or
      differences in the efficiency of expression in cos-1 cells is not known.

PMID- 8357979
TI  - Trp387 and the putative leucine zippers of PGH synthases-1 and -2.
AB  - The active site sequence 385-YHWH-388 of ovine prostaglandin endoperoxide
      synthase-1 (PGHS-1) has residues critical for cyclooxygenase and peroxidase
      catalysis. Tyr385 is essential for cyclooxygenase activity, His386, for
      peroxidase activity, and His388, for both activities. To determine the importance
      of Trp387, we used site-directed mutagenesis to replace Trp387 of PGHS-1 with
      arginine, phenylalanine, and serine. W387R and W387S lacked significant activity.
      W387F retained both cyclooxygenase and peroxidase activities. Thus, we conclude
      that Trp387 is not essential for catalysis by PGHS-1. Purified PGHS-1 is a
      homodimer. There are two putative leucine zipper regions in ovine PGHS-1
      involving residues 345-366 and 487-508. We tested for a role of these leucine
      zippers as determinants of dimer formation. Helix-breaking proline mutations were
      introduced at Leu359 or Leu501. Neither of these residues proved to be essential
      for peroxidase activity; but, mutations at each residue greatly reduced or
      eliminated cyclooxygenase activity. Both mutant proteins chromatographed as
      dimers on Sephacryl G-200. Thus, neither of these putative leucine zipper regions
      alone is responsible for PGHS-1 dimer formation.

PMID- 8357980
TI  - Molecular cloning and expression of human thromboxane synthase.

PMID- 8357982
TI  - Physiological aspects of a high affinity binding site for pancreatic-type
      phospholipase A2.
AB  - We characterized a specific binding site for pancreatic-type phospholipase A2
      (PLA2-I) in several tissues and cells. The PLA2-I binding protein was purified
      from bovine corpus luteum membranes, which had a mass of 190 kDa. The purified
      protein, which possessed a binding capacity with high affinity and specificity
      for a mammalian mature type of PLA2-I, was a glycoprotein having a core protein
      of approx. 150 kDa and its carbohydrate moieties might be required for ligand
      recognition. PLA2-I elicited several biological responses in tissues and cells;
      i.e., cell proliferation and eicosanoid production, possibly through its specific
      binding site.

PMID- 8357981
TI  - PAF-induced amplification of mediator release in septic shock: prevention or
      downregulation by PAF antagonists.

PMID- 8357983
TI  - Comparison of six mammalian lysophospholipases.
AB  - Lysophospholipases participate in the regulation of the levels of
      lysophospholipid, compounds with pleiotropic biological effects.
      Lysophospholipases were purified from a macrophage cell line (WEHI 265.1), a
      myelocytic leukemia cell line (HL-60) and peripheral blood eosinophils. WEHI
      265.1 cells contain three lysophospholipases 28, 27 and 110 kDa as determined by
      polyacrylamide gel electrophoresis. The 110 kDa lysophospholipase also exhibits
      phospholipase A2 activity and appears to be identical to a previously described
      110 kDa phospholipase A2. Similarly, the HL-60 cells have three
      lysophospholipases, the largest again a 110 kDa enzyme with phospholipase A2
      activity and the smaller are 20 and 21 kDa. The low molecular mass
      lysophospholipases have distinctive chromatographic properties and amino acid
      compositions. However, the two low molecular mass enzymes from a given cell type
      are not radically different, e.g., 15 of the 20 amino acids of the C-terminal
      sequences of the HL-60 enzymes are identical. A single lysophospholipase, approx.
      15 kDa, is a major eosinophil protein. This enzyme is different from those
      described above.

PMID- 8357984
TI  - Discovery of inhibitors of the 5-lipoxygenase activating protein (flap).

PMID- 8357985
TI  - A new class of leukotriene biosynthesis inhibitor: the development of MK-0591.
AB  - The evolution of MK-0591 (3-[1-(4-chlorobenzyl)-3-(t-butylthio)-5-(quinolin-2
      ylmethoxy+ ++)indol-2-yl]- 2,2-dimethylpropanoic acid), 12, a potent, orally
      active leukotriene biosynthesis inhibitor is described. MK-0591 is currently
      undergoing clinical evaluation as a potential agent for the treatment of asthma
      and inflammatory bowel disease. It acts through a novel mechanism by a specific
      interaction with a membrane protein, 5-lipoxygenase activating protein (FLAP),
      which has been shown to be essential for LT synthesis in inflammatory cells. A
      brief comparison of its biological activity with that of its progenitors MK-886
      and L-674,636 is described.

PMID- 8357986
TI  - Inflammation, prostaglandins, and loss of function.

PMID- 8357987
TI  - The role of lipocortin 1 in the regulation of A549 cell proliferation and
      leukocyte migration.

PMID- 8357988
TI  - Prostaglandins in human cartilage metabolism.
AB  - (1) Human cartilage, both non-arthritic (N) and arthritic, is extremely sensitive
      to inhibition of glycosaminoglycan (GAG) synthesis by low concentrations of
      interleukin 1 (IL1). Local episodic synthesis and secretion of sub-nanogram
      concentrates of the cytokine is considered to play a significant role in the
      pathogenesis of osteoarthritis (OA) by preventing matrix repair. (2) The
      synthesis of IL1 can be controlled by prostaglandins (PGs), which may explain why
      the inhibitory action can be at least partially overcome by the action of the PG
      analogue Misoprostol in the dose range 10-100 ng/ml. It is suggested that this
      action is due to the suppression of a positive feedback loop for local IL1
      synthesis and secretion. (3) Certain non-steroidal anti-inflammatory drugs
      (NSAIDs), in particular Indomethacin, Ibuprofen and Naproxen, cause inhibition of
      GAG synthesis, and hence may diminish the potentiality for repair in arthritic
      cartilage. It is suggested that these NSAIDs induce IL1 synthesis by diminishing
      PG levels. Misoprostol is able to reverse this effect at least partially. (4)
      Some cartilages in the presence of other NSAIDs, such as Diclofenac, which do not
      greatly inhibit chondrocyte matrix metabolism, nevertheless respond to the
      presence of Misoprostol by increased GAG synthetic activity. (5) The low mean
      matrix synthetic activity of human OA cartilages was significantly increased by
      Misoprostol. (6) Taken together, these studies substantiate the suggestion that
      Misoprostol is able to increase the repair potentiality of human OA cartilage,
      particularly during treatment with NSAIDs.

PMID- 8357989
TI  - Amino acid residues of 5-lipoxygenase-activating protein critical for the binding
      of leukotriene biosynthesis inhibitors.
AB  - 5-Lipoxygenase-activating protein (FLAP) plays an essential role in cellular
      leukotriene (LT) synthesis and represents the target of three classes of LT
      biosynthesis inhibitors. We have taken three approaches to localize regions of
      FLAP involved in the binding of these inhibitors. A comparison of the amino acid
      sequences of FLAP from eight mammalian species identifies regions of the protein
      which are highly conserved and consequently may be involved in functional and
      inhibitor binding properties of the protein. Conversely, amino acids not
      conserved amongst these species are unlikely to play an essential role in
      inhibitor binding. Immunoprecipitation of peptide fragments of FLAP cross-linked
      to photoaffinity analogues of LT biosynthesis inhibitors following site-specific
      peptide cleavage indicates that the inhibitor attachment site is amino-terminal
      to 72Trp. Taken together, the cross-species analysis and photoaffinity labelling
      studies suggest a region within the first hydrophilic loop of FLAP which may be
      important for inhibitor binding. Site-directed mutagenesis of human FLAP followed
      by the analysis of FLAP mutants in a radioligand binding assay was used to more
      accurately define critical amino acid residues within this region. Mutagenesis
      studies reveal that mutants containing deletions of amino acids in regions of
      FLAP not conserved between species retain the ability to specifically bind
      inhibitors. Furthermore, mutants containing deletions in a highly conserved
      region of the protein (residues 42-61) do not bind inhibitors. These studies have
      therefore localized specific amino acids of FLAP which are essential for
      inhibitor binding. The roles that these amino acids play in inhibitor binding and
      may play in 5-LO activation is under investigation.

PMID- 8357990
TI  - Formation and effects of leukotrienes and lipoxins in human bone marrow.
AB  - The present results demonstrate leukotriene and lipoxin synthesis in human bone
      marrow and link these findings to biological effects in the same tissue. However,
      the mechanisms behind the described effects on myeloid progenitor cell growth are
      presently unknown. It is conceivable that both leukotrienes and lipoxins may act
      through modulation of endogenous cytokine production. However, it should be
      noted, that these lipoxygenase products totally failed to induce colony growth in
      the absence of GM-CSF. Moreover, the role of lipoxins in the bone marrow needs to
      be further clarified, since LXA4 induced both synergistic (with GM-CSF) and
      antagonistic (with LTC4) effects on progenitor cell growth. A possible
      pathophysiological role for leukotrienes and lipoxins may be suggested in chronic
      myelogenous leukemia. Thus, the capacity of hematological cells from CML patients
      to synthesize LTC4 was significantly increased. In addition, we have recently
      reported that CML platelets possessed a markedly decreased ability to participate
      in transcellular synthesis of the potential inhibitors of myelopoiesis, LXA4 and
      5(S),12(S)-diHETE (Stenke et al., 1991b). Moreover, the production of these
      compounds was totally abolished in platelets obtained from CML patients in
      blastic crisis. Further studies should aim at defining the mechanisms behind the
      regulatory actions of leukotrienes and lipoxins in normal and leukemic human
      myelopoiesis.

PMID- 8357991
TI  - Cell-cell interactions between platelets, macrophages, eosinophils and natural
      killer cells in thromboxane A2 biosynthesis.
AB  - Biosynthesis of thromboxane A2 (TxA2) during cell-cell interactions between
      platelets and alveolar macrophages, eosinophils and natural killer cells from
      guinea pigs has been investigated. The stimulation of platelets incubated with
      varying numbers of macrophages or eosinophils or NK cells with 5 microM ionophore
      A23187 has induced an increase of TxA2 synthesis in comparison to the sum of TxA2
      production by each cell population stimulated alone. These results suggest that
      transcellular biosynthesis of TxA2 or cell cooperation occurred between platelets
      and the other cell population studied, which could correspond to cell-cell
      interactions of type IA and/or type III, according to the classification proposed
      by Marcus ((1986) Prog. Hemost. Thromb. 28, 127-42). When varying concentrations
      of platelets were incubated with the supernatant of cells previously stimulated
      with the ionophore A23187, an enhancement of TxA2 release was also observed.
      However, the supernatant of platelets stimulated with the ionophore A23187 did
      not induce a significant increase of TxA2 synthesis by the other cell
      populations. It is suggested that the biosynthesis of TxA2 during cell-cell
      interactions could account for the large amount recovered in biological fluid in
      various pathological conditions such as inflammatory and hypersensitivity
      reactions.

PMID- 8357992
TI  - Pathophysiologic role of eicosanoids in mesangial cell immune injury.
AB  - The pathophysiologic role of thromboxane and of arachidonate 5-lipoxygenation
      products in mediating changes in glomerular filtration rate (GFR) and renal blood
      flow (RBF) was investigated in a rat model of mesangial cell immune injury
      induced by a monoclonal antibody (ER4) directed against the mesangial cell
      membrane antigen, Thy 1. Following a single intravenous dose of the ER4 antibody
      acute decrements in GFR and RBF occurred at 1 h and were associated with enhanced
      glomerular leukocyte infiltration and synthesis of thromboxane A2, 12-HETE and
      LTB4. Pretreatment of animals with the thromboxane synthase inhibitor,
      Furegrelate, or the thromboxane receptor antagonist SQ-29,548 ameliorated or
      completely abolished the decrements in GFR and RBF without reducing glomerular
      leukocyte infiltration. Pretreatment with the arachidonate 5-lipoxygenase
      inhibitor MK-886 partially ameliorated the decrements in GFR and RBF, reduced the
      glomerular leukocyte infiltration and completely inhibited the glomerular LTB4
      synthesis. Combined treatment with Furegrelate and MK-886 completely abolished
      the decrements in GFR and RBF as well as the glomerular synthesis of thromboxane,
      LTB4 and 12-HETE without altering glomerular leukocyte infiltration. These
      observations indicate that in mesangial cell immune injury thromboxane A2 and
      arachidonate 5-lipoxygenation products originating from infiltrating inflammatory
      cells mediate the decrements in GFR and RBF. Selective inhibition of these
      eicosanoids could be of benefit in clinical forms of mesangial nephritis.

PMID- 8357993
TI  - Interleukin 1 and interleukin 6 inhibition of mesangial cell proliferation: role
      of PGE2.

PMID- 8357994
TI  - Functional aspects of eicosanoid hydroxylation by lung and kidney cytochromes
      P450. Expression of cDNAs in mammalian cells and E. coli.
AB  - A gene subfamily of cytochromes P450 with catalytic activity toward various
      eicosanoid substrates has been studied with a variety of techniques in this
      laboratory, including purification and characterization, localization at the
      tissue and subcellular levels, physiological function, and cloning and expression
      in prokaryotic and eukaryotic systems. This paper reports experiments directed
      toward determining the function of the cytochrome P4504A metabolite, 20
      hydroxyarachidonic acid (20-hydroxyeicosatetraenoic acid; 20-HETE), in cellular
      ion flux, immunohistochemical localization in lung, the effects of a mechanism
      based inhibitor, 12-hydroxy-16-heptadecynoic acid (12-HHDYA) on PGE1 omega
      hydroxylation, and the structure-function determinants which govern the
      activities of the enzymes encoded by this gene subfamily.

PMID- 8357995
TI  - Effect of aging on renal cytochrome P450-dependent arachidonic acid metabolism in
      Dahl rats.
AB  - We investigated the age-related changes of renal cytochrome P450-dependent
      arachidonic acid metabolism in 3-, 5-, 7-, 9-, 11-, 13- and 20-week-old male Dahl
      salt-sensitive (DS) and -resistant (DR) rats on a low sodium diet (0.3% NaCl).
      NADPH-dependent arachidonic acid metabolism was separated and measured by a radio
      HPLC system. The formation of 19-hydroxyeicosatetraenoic acid (HETE), 20 HETE,
      1,20-dioic acid, epoxyeicosatrienoic acids (EETs), and dihydroxyeicosatrienoic
      acid (DHET) was age dependent in both DS and DR rats. omega-Hydroxylase (20-HETE
      and 1,20-dioic acid formation) and (omega-1)-hydroxylase (19-HETE formation) were
      increased from 3 to 5 weeks age, then decreased with aging in DR rats. Whilst
      omega/(omega-1)-hydroxylase activities were increased from 3- to 9-week-old rats,
      they decreased with aging in DS rats. omega/(omega-1)-Hydroxylase activities were
      higher in 3-5-week-old DR than DS rats. Epoxygenase activities (EETs and DHET
      formations) were highest in 3-week-old DS and DR rats, and showed no significant
      differences between two strains of rats at any ages tested. Renal cytochrome P450
      dependent arachidonic acid metabolites have a wide and contrasting spectrum of
      biological and renal effects, and their relative rates of production may
      influence not only renal hemodynamics but also pro- and antihypertensive
      mechanisms of hypertension in Dahl rats.

PMID- 8357997
TI  - Formation by the endothelium of prostacyclin, nitric oxide and endothelin.
AB  - Prostacyclin and nitric oxide (NO) are two labile vasorelaxant and anti
      aggregatory substances which are released by receptor activation and in response
      to shear forces acting on endothelial cells, whereas the potent constrictor
      peptide, endothelin-1 (ET-1) is probably slowly released and exerts long-term
      control over the cardiovascular system. This review deals with the synthesis,
      release and pharmacological actions of prostacyclin, NO and ET-1, as well as the
      diseases which might result from their under- or over-production.

PMID- 8357996
TI  - Pheromonal and reproductive function of F prostaglandins and their metabolites in
      teleost fish.
AB  - Although the function of prostaglandins in fish reproduction has not been well
      studied, it is becoming increasingly clear that prostaglandin F2 alpha or a
      compound closely resembling it serves three critical roles mediating reproductive
      activities in teleost fish. First, it appears to play a paracrine role in the
      ovary stimulating and/or modulating follicular rupture. Second, circulating
      levels of F prostaglandins rise at the time of ovulation and travel to the brain
      where they elicit female sexual behavior. Third, recent studies indicate that F
      prostaglandin is metabolized and released to the water where it functions as a
      sex pheromone stimulating male sexual behavior. Although these roles have been
      best characterized in the goldfish, ongoing studies indicate that metabolites of
      prostaglandin F2 alpha may commonly function as pheromones in many fish. Many
      questions remain about the identity(ies), origins, and species-specificity of the
      prostaglandin pheromone.

PMID- 8357998
TI  - Diphenylmethylazine prostanoids with prostacyclin-like actions on human
      platelets.
AB  - A structure-activity study has been performed with respect to EP 157, a PGH2
      analogue with a diphenylmethoxime omega-chain which behaves as an IP-receptor
      agonist. Bicyclo[2.2.1]heptene/heptane and bicyclo[2.2.2]octene/octane analogues
      were the most potent, with a cyclohexene analogue being less potent.
      Oxabicyclo[3.2.2]nonane, oxabicyclo[3.2.1]octane and oxabicyclo[2.2.1]heptane
      analogues were of low potency. Introduction of ether oxygen(s) into the omega
      chain generally maintained potency, whereas 6-oxa-1,4-m- and 6-oxa-1,4-p
      interphenylene analogues were inactive. Diphenylmethylazine analogues were also
      potent platelet inhibitors, but saturation of one of the phenyl rings abolished
      activity. Replacement of the oxime function by an ether group abolished activity.
      The results are discussed in relation to octimibate, a
      triphenylimidazoloxyalkanoic acid which is also an IP-receptor agonist, and to
      the possibility of IP-receptor subtypes.

PMID- 8357999
TI  - Thromboxane biosynthesis and metabolism in cardiovascular and renal disease.

PMID- 8358000
TI  - Marked overproduction of non-cyclooxygenase derived prostanoids (F2-isoprostanes)
      in the hepatorenal syndrome.
AB  - In spite of extensive searching for clues to the pathogenesis of the hepatorenal
      syndrome (HRS), its cause remains an enigma. The renal dysfunction in HRS has
      been attributed to intense but reversible renal vasoconstriction. This has
      engendered the hypothesis that the renal vasoconstriction is caused by a
      circulating factor. Patients with HRS exhibit chronic endotoxemia and may have
      tissue hypoxia, an environment conducive for the formation of free radicals.
      Recently, we discovered a series of novel prostaglandin (PG) F2-like compounds,
      termed F2-isoprostanes, that are produced in vivo as products of free radical
      catalyzed lipid peroxidation independent of the cyclooxygenase enzyme. One of
      these compounds, 8-epi-PGF2 alpha, has been found to be an extremely potent renal
      vasoconstrictor. Therefore, we quantified levels of these prostanoids in patients
      with HRS and compared them to various control groups. Plasma levels of these
      compounds were markedly elevated only in patients with HRS (113 +/- 30 pg/ml) (p
      < 0.01) compared to normal controls (19 +/- 7 pg/ml), patients with compensated
      liver disease (20 +/- 4 pg/ml), patients with decompensated liver disease (22 +/-
      4 pg/ml), and patients with chronic renal failure (23 +/- 4 pg/ml). The increased
      levels of these compounds are unlikely the result of reduced hepatic and renal
      clearance of the compounds since levels are not markedly increased in patients
      with either decompensated liver disease or chronic renal failure alone. Whether
      F2-isoprostanes are the elusive mediators responsible for the renal
      vasoconstriction in HRS remains to be established. However, these findings do
      suggest that oxidant injury may be a fundamental abnormality involved in the
      pathogenesis of HRS.

PMID- 8358001
TI  - Prostaglandin D synthase is the key enzyme in the promotion of physiological
      sleep.

PMID- 8358003
TI  - Cellular origin of prostaglandins D2 and E2 in chick dorsal root ganglion: a
      biochemical and immunocytochemical study.

PMID- 8358002
TI  - 1,25-Dihydroxyvitamin D3 upregulates 5-lipoxygenase metabolism and 5-lipoxygenase
      activating protein in peripheral blood monocytes as they differentiate into
      mature macrophages.

PMID- 8358005
TI  - Control mechanisms for the ductus arteriosus and the perinatal pulmonary
      circulation.

PMID- 8358004
TI  - Phospholipase A2 (PLA2) activity in gerbil brain: characterization of cytosolic
      and membrane-associated forms and effects of ischemia and reperfusion on
      enzymatic activity.
AB  - Phospholipases A2 comprise a family of enzymes that hydrolyze the acyl bond at
      the sn-2 position of phospholipids to generate free fatty acids and
      lysophospholipids. In the central nervous system products of PLA2 regulate
      neurotransmission. In addition, the lysophospholipids, free fatty acids,
      eicosanoids, platelet activating factor and reactive oxygen species, generated by
      enhanced PLA2 activity and arachidonic acid metabolism, may be responsible for
      many destructive cellular processes in neuronal tissue. There are interactions
      between glutamate and PLA2 and its products which suggest that PLA2 activity
      plays an important role in excitotoxic neuronal cell injury associated with
      ischemia. Our laboratory has demonstrated that multiple forms of Ca(2+)-dependent
      PLA2 are present in the gerbil brain. These forms differ from previously
      described forms and from each other. After ischemia and reperfusion, cytosolic,
      mitochondrial/synaptosomal and microsomal PLA2 enzymatic activities are enhanced.
      These stable modifications of enzymatic activity cannot be explained by a direct
      effect of Ca2+ alone and our data suggest that regulatory influences other than
      Ca2+ may play an important role in PLA2 activation and mediation of cellular
      injury after an ischemic insult.

PMID- 8358006
TI  - The role of eicosanoids and endothelium-dependent factors in regulation of the
      fetal pulmonary circulation.
AB  - A complex interaction of mechanical, hormonal, vasoactive, morphological and
      gaseous factors is responsible for the transitional period and maintenance of
      these changes in the newborn period. Vasoactive eicosanoids, formed at multiple
      sites in the lungs exert multiple effects on the perinatal pulmonary circulation.
      By direct, as well as indirect interaction with other systems, eicosanoids appear
      to have a role in the rearrangement of the circulation at birth. At this time
      PGE1, acetylcholine, bradykinin, and endothelin appears to work, at least in
      part, to cause fetal pulmonary vasodilation via the release of EDRF. Products of
      the lipoxygenase pathway are powerful vasoconstrictors, but may not be important
      in regulation of high fetal pulmonary vascular tone or the pulmonary pressor
      response to hypoxia.

PMID- 8358007
TI  - PGE2 in the perinatal brain: local synthesis and transfer across the blood brain
      barrier.

PMID- 8358008
TI  - The role of prostanoids in neonatal cerebral blood flow autoregulation.
AB  - The regulatory role of prostanoids in acute cerebrovascular adaptations in
      newborns was determined using awake neonatal piglets (ages 0-5 days, n = 60).
      Cerebral blood flow (CBF) was measured by radiolabelled microspheres before and
      45 s after intracarotid injections of PGE1 (0.1-10 micrograms/kg, n = 6), PGE2
      (0.01-2 micrograms/kg, n = 6), PGF2 alpha (0.01 microgram/kg, n = 8) and PGI2
      (0.1 microgram/kg, n = 6). CBF increased with PGE1 (10 micrograms/kg) by 39.5%
      and with all doses of PGE2 (p < 0.01) compared to zero dose. PGF2 alpha, a known
      adult vasoconstrictor increased total CBF from 97 +/- 8 to 130 +/- 14 ml/min per
      kg. PGI2 also increased CBF by 27% (p < 0.01). When CBF and prostanoid levels
      were measured with balloon catheters placed at the aortic root and the descending
      aorta and were inflated to adjust arterial blood pressure (BP) from 17 to 117
      mmHg, sagittal sinus concentrations of prostanoids inversely correlated with
      total CBF (for PGs, tau = -0.52 to -0.66, p < 0.001; for TXB2, tau = -0.91 to
      0.99, p < 0.0001). During hypotension (MABP < 50 mmHg) PGE, PGF2(2)alpha, 6-keto
      PGF1 alpha and TXB2 increased by 311 +/- 56, 330 +/- 50, 301 +/- 44 and 658 +/-
      44%, respectively. Net cerebrovascular production [total CBF x (sagittal sinus
      arterial plasma prostanoid concentration)] of PGE, PGF2 alpha, and 6-keto-PGF1
      alpha and TXB2 increased during hypotension compared to normotension (BP = 50-90
      mmHg). At MABP = 91-117 mmHg, net production of prostanoids increased by 142
      31%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358009
TI  - Are prostaglandins mediators of mifepristone (RU 486)-induced cervical softening
      in early pregnancy?

PMID- 8358010
TI  - Mechanism of prostaglandin F2 alpha action in the ovary.

PMID- 8358011
TI  - Prostaglandin endoperoxide H synthase (PGHS) activity increases with gestation
      and labour in human amnion.

PMID- 8358012
TI  - Lipid mediators of implantation and decidualization.

PMID- 8358013
TI  - Site-directed mutagenesis of leukotriene A4 hydrolase: distinction of leukotriene
      A4 hydrolase and aminopeptidase activities.
AB  - Leukotriene (LT) A4 hydrolase catalyzes enzymatic hydration of LTA4 to
      biologically active substance, LTB4. Biochemical and immuno-histochemical studies
      have shown that this enzyme is ubiquitously distributed in various cells and
      tissues. A sequence domain of LTA4 hydrolase was found to be homologous to those
      of several zinc metalloproteases. Both native and recombinant enzymes were shown
      to possess equimolar zinc ion and aminopeptidase activity. To examine the
      molecular mechanism of this enzyme reaction, site-directed mutagenesis
      experiments were carried out. Single amino acid substitutions at Glu-297 revealed
      a distinction of two enzyme activities, and suggest that the glutamic acid
      residue at 297 is essential for aminopeptidase, while the side chain of Glu or
      Gln is required for LTA4 hydrolase activity. The loss of two enzyme activities in
      a mutant E319K confirmed the proposal that the presence of a zinc ion in the
      enzyme is required for both enzyme activities.

PMID- 8358014
TI  - The ocular effects of prostaglandins and the therapeutic potential of a new PGF2
      alpha analog, PhXA41 (latanoprost), for glaucoma management.
AB  - In the early days of prostaglandin (PG) research, the infusion of large PG doses
      into rabbit eyes already traumatized by cannulation, led to the conclusion that
      PGs have a profound ocular hypertensive effect that is associated with a
      breakdown of the blood-aqueous barrier. In contrast, repeated topical application
      of PGs to nontraumatized eyes of several species other than rabbits has later
      been shown to yield a maintained ocular hypotensive effect, without barrier
      breakdown. Due to its excellent pharmacokinetic properties, the isopropyl ester
      form of PGF2 alpha (PGF2 alpha-IE) is a much more potent ocular hypotensive agent
      and appeared to be better suited for the management of glaucoma, than PGF2 alpha
      itself or any currently used glaucoma drug. However, even this prodrug caused
      clinically unacceptable foreign-body sensation and conjunctival hyperemia, which
      could be reduced, or eliminated, only by some modifications of the omega chain of
      PGF2 alpha-IE. One such analog, PhXA41, maintained highly significant IOP
      reduction in glaucoma patients even with once-daily application at the remarkably
      low concentration of 0.006%. Because PhXA41 reaches intraocular tissues and the
      systemic circulation in its de-esterified free-acid form, which is a good
      substrate for the PG transport system, it retains the most important
      pharmacokinetic advantages of topically applied PGF2 alpha-IE. However, its
      greatly reduced side effects give PhXA41 a clear therapeutic advantage over PGF2
      alpha-IE, making it an effective new drug candidate for the long-term medical
      management of glaucoma.

PMID- 8358015
TI  - Intraocular pressure effects of selective prostanoid receptor agonists involve
      different receptor subtypes according to radioligand binding studies.
AB  - The receptors involved in the ocular hypotensive activity of prostaglandins (PG)
      E2 and F2 alpha in dogs and monkeys was investigated by examining the effects of
      putative receptor selective agonists on intraocular pressure. A diverse variety
      of receptor selective agonists lowered intraocular pressure in these species.
      Thus, FP-receptor agonists (17-phenyl PGF2 alpha, fluprostenol), agonists with
      potent activity at the EP3 receptor (MB 28767, sulprostone) and a prostanoid with
      activity at the EP2 receptor (11-deoxy PGE1) were all potent ocular hypotensives
      when administered as a single dose to dogs and monkeys or b.i.d. for 5 days in
      monkeys. These findings were regarded as surprising and prompted us to re-examine
      some aspects of the current classification for prostanoid receptors. At present
      certain receptor subtypes, notably EP2, EP3 and FP receptors, are defined only
      according to the potency rank order for agonists. In these studies, we employed
      radioligand binding studies to determine the degree of competition between
      prostanoid agonists claimed to be selective on the basis of functional assays.
      Competition studies with a diverse variety of prostanoids at the binding site for
      PGE2 and sulprostone on the myometrial plasma membrane prepared from the rat
      uterus were consistent with the presence of an EP3 receptor. Thus, EP3-receptor
      agonists (MB 28767 and sulprostone) potently inhibited PGE2 and sulprostone
      binding, whereas FP agonists (17-phenyl PGF2 alpha, fluprostenol), a DP agonist
      (BW 245C), an EP1 antagonist (AH 6809), an EP2 agonist (AH 13205) and TP-receptor
      ligands (BM 13505, I-BOP) afforded little or no inhibition.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8358016
TI  - Enhancement by GM-CSF of agonist-induced 5-lipoxygenase activation in human
      neutrophils involves protein synthesis and gene transcription.
AB  - We investigated the effects of granulocyte-macrophage colony-stimulating factor
      (GM-CSF) on the 5-lipoxygenase (5-LO) component of the leukotriene (LT)
      biosynthetic pathway of human neutrophils, in order to better understand the
      mechanism whereby the cytokine primes for LT synthesis. We found that GM-CSF
      increased 5-LO activation elicited by platelet-activating factor (PAF), N-formyl
      methionyl-leucyl-phenylalanine (fMLP), C5a, LTB4, IL-8 and calcium ionophore
      A23187, as determined by using an exogenous substrate. A close correlation was
      observed between the priming kinetics of GM-CSF on 5-LO activation and on LT
      synthesis; moreover, the effects of the cytokine on both 5-LO activation and LT
      synthesis were inhibited when the cells had been exposed to either the protein
      synthesis inhibitor, cycloheximide (CX), or the transcription inhibitor,
      actinomycin D (AD), prior to incubation with GM-CSF. These results raise the
      possibility that the priming by GM-CSF of LT synthesis may involve an effect of
      the cytokine on 5-LO protein synthesis and gene expression.

PMID- 8358017
TI  - Biochemical and molecular biological approaches to two types of arachidonate 12
      lipoxygenase.

PMID- 8358018
TI  - Human 15-lipoxygenase: induction by interleukin-4 and insights into positional
      specificity.
AB  - Arachidonate 15-lipoxygenase (15-lipoxygenase) is a lipid-peroxidizing enzyme
      associated with specific inflammatory cells seen in asthma and atherosclerosis.
      In atherosclerosis, 15-lipoxygenase is induced in the macrophages of human and
      rabbit lesions and has been implicated in foam cell formation. In human lung, 15
      lipoxygenase is preferentially expressed in airway epithelial cells and
      eosinophils. Our studies have focused both on the regulation of expression and on
      the structure-function relationships of the enzyme. To determine factors that
      could regulate expression, peripheral blood monocytes were purified and cultured
      with combinations of 18 factors. Only interleukin-4 (60 pM) induced 15
      lipoxygenase mRNA, protein and enzymatic activity. Interferon-gamma (100 pM)
      inhibited the interleukin-4 dependent induction of 15-lipoxygenase. Results with
      cultured human airway cells were similar. These data suggest that expression of
      15-lipoxygenase is regulated by interleukin-4, and that 15-lipoxygenase is a
      potential downstream effector molecule for this potent cytokine. In parallel
      studies, we have investigated determinants of positional specificity using site
      directed mutagenesis and bacterial expression of human 15-lipoxygenase.
      Hypotheses for mutagenesis were derived from an analysis of conserved differences
      among multiple lipoxygenase sequences. Switching four amino acids in 15
      lipoxygenase to their counterparts in 12-lipoxygenase resulted in a variant
      enzyme that produced equal 12- and 15-lipoxygenation. Further analysis has
      identified two amino acids that completely control the positional specificity of
      15-lipoxygenase. These data have led to a preliminary model of the enzyme's
      active site region.

PMID- 8358019
TI  - TIS10, a mitogen-inducible glucocorticoid-inhibited gene that encodes a second
      prostaglandin synthase/cyclooxygenase enzyme.

PMID- 8358020
TI  - Pharmacological profile of epiyangambin: a furofuran lignan with PAF antagonist
      activity.
AB  - The ability of a furofuran lignan, epiyangambin, to inhibit PAF-induced rabbit
      platelet aggregation in vitro and thrombocytopenia in rats was investigated.
      Epiyangambin dose-dependently inhibited PAF-induced platelet aggregation without
      modifying the amplitude of the maximal response, indicating a competitive
      antagonism. The IC50 value of epiyangambin for 10(-9) M PAF-induced aggregation
      was 6.1 x 10(-7) M and the Schild analysis provided a pA2 of 6.91 +/- 0.2 with a
      slope of 0.98 +/- 0.25 (n = 4) and a pKb of 6.94 +/- 0.19. Epiyangambin had no
      effect upon the platelet aggregation induced by collagen, thrombin or ADP. The in
      vivo administration of the lignan at 20 mg/kg significantly inhibited PAF-induced
      thrombocytopenia in rats. These data indicate that epiyangambin is a potent and
      selective antagonist of PAF both in vitro and in vivo.

PMID- 8358021
TI  - Involvement of platelet-activating factor (PAF) in endotoxin- or ischaemia
      induced intestinal hyperpermeability in the rat.
AB  - We have investigated the influence of BN 50727, a PAF antagonist, and
      allopurinol, a free radical scavenger, on the damaging effects of ischaemia
      reperfusion and endotoxin in the small intestinal mucosa. Using a rat
      experimental model, we determined the alterations in intestinal permeability and
      mucosal levels of PAF and lysoPAF following ischaemia or intravenous
      administration of endotoxin. Both of these treatments increased intestinal
      permeability and enhanced PAF levels in the mucosa. Preventive oral or
      intraduodenal administration of BN 50727 reduced both of these effects, by
      decreasing mucosal PAF formation, probably as a result of neutrophil infiltration
      and activation reduction. Pretreatment of the rats with allopurinol also resulted
      in similar protection except that the free radical scavenger was unable to
      inhibit the increase in PAF levels after ischaemia, suggesting that oxidative
      reagents are implicated in this pathology to a much greater extent than PAF.

PMID- 8358022
TI  - Stimulation of PGE2 synthesis in a co-culture of periosteal fibroblasts and
      osteoblast-like cells by parathyroid hormone.
AB  - In previous experiments, we demonstrated that hPTH 1-34 activates PGE2 synthesis
      and calcium mobilization by chick calvaria. In this report, we started to search
      for the PTH responsible cell population in this bone tissue. When the chick
      calvariae were subjected to sequential enzyme digestion, we found that the third
      cell population were the cells that reacted to human PTH 1-34 and bovine PTH 1
      34. A subsequent procedure was performed using the cells isolated from enzyme
      digestion and separated into two distinct populations--periosteal fibroblasts
      (PF) and osteoblast-like cells (OB)--by a two-step density gradient of Percoll.
      We found that PF and OB cells alone did not respond to PTH in terms of PGE2
      synthesis. However, when these two cell populations were mixed in the proportion
      of 50:50, the synthesis of PGE2 and PGF2 alpha was increased significantly by the
      treatment of PTH and calcitonin. No effects were demonstrated in the mixing
      proportions of 30:70 and 70:30. These results suggest that PTH responsiveness may
      need a local interaction between periosteal fibroblasts and osteoblast-like cells
      residing in chick calvaria.

PMID- 8358023
TI  - Leukotriene synthesis in U937 cells expressing recombinant 5-lipoxygenase.
AB  - The U937 human promyelocytic cell line does not express 5-lipoxygenase, but does
      express 5-lipoxygenase-activating protein (FLAP). U937 cells do not synthesize
      leukotrienes after stimulation by calcium ionophore A23187. Dimethyl sulfoxide
      (DMSO) differentiation of U937 cells, towards a more mature monocyte-macrophage
      lineage, induces the expression of FLAP but not 5-lipoxygenase. These DMSO
      differentiated U937 cells also lack the ability to synthesize leukotrienes. We
      infected viral RNA coding for 5-lipoxygenase into U937 cells using a retroviral
      vector and measured the synthesis of 5-lipoxygenase, FLAP, leukotrienes and 5
      hydroxyeicosatetraenoic acid (5-HETE) by these cells after stimulation with
      A23187. Undifferentiated U937 cells infected with 5-lipoxygenase RNA expressed 5
      lipoxygenase and FLAP but neither leukotrienes nor 5-HETE were detected after
      these cells were stimulated with A23187. Exposure of the 5-lipoxygenase-infected
      U937 cells to DMSO increased the expression of 5-lipoxygenase and FLAP, and these
      cells produced leukotrienes and 5-HETE in response to A23187. The synthesis of
      these products was inhibited by MK-886, a compound which specifically binds to
      FLAP.

PMID- 8358024
TI  - Effect of leukotrienes on sheep airway smooth muscle.
AB  - The effects of leukotrienes (LT) C4, LTD4, LTE4 and LTB4 on the development of
      isometric tension by sheep airway smooth muscle were determined in a tissue bath.
      LTE4 (1.5 x 10(-7) M) had no contractile effect. LTB4 contracted only lung
      parenchymal strips. LTC4 (8 x 10(-8) M) and LTD4 (1.1 x 10(-7) M) caused
      contractions in trachea, bronchi and lung parenchyma that developed slowly and
      persisted. The tracheal contractions caused by LTD4 and ACh were potentiated
      approx. 30% by the cyclooxygenase inhibitor meclofenamate (10(-6) M).
      Meclofenamate had no effect on leukotriene induced contractions in bronchi or
      lung parenchymal strips. The bronchodilator prostaglandins PGI2 and PGE2 were
      released from sheep trachea at rest and after contraction by LTD4. Inhibition of
      their release by meclofenamate may explain the potentiation of LTD4 contractions
      by meclofenamate. In vitro, LTD4 and LTC4 have potent contractile effects on
      sheep airway smooth muscle that are not mediated by the secondary release of
      constrictor cyclooxygenase products. These leukotrienes may play a substantial
      role in the pathogenesis of allergen and endotoxin induced lung mechanics changes
      in sheep.

PMID- 8358025
TI  - Activation of phospholipases D and A by amphiphilic cations of cultured LA-N-2
      cells is G protein- and protein kinase C-independent.
AB  - Several amphiphilic cations such as mepacrine, desipramine,
      didodecyldimethylamine, chlorpromazine, oleylamine and W-7 activated the
      phospholipase D (PLD) activity of cultured LA-N-2 cells. These compounds, except
      for oleylamine, provoked the release of fatty acids, suggesting phospholipase A
      activation. Melittin, a PLA2 stimulator, caused the robust release of the free
      fatty acids but was a poor PLD activator. Although PLD could be activated by GTP
      gamma S, the stimulation by these amphiphilic cations was not abolished by GDP
      beta S, an inhibitor of G protein function. There was no change in the PLD
      activation by these amphiphilic cations by DiC8, a PKC activator, or by H-7, a
      PKC inhibitor or in PKC down-regulated cells.

PMID- 8358026
TI  - Expression of the Arabidopsis AtAux2-11 auxin-responsive gene in transgenic
      plants.
AB  - Five constructions containing deletions of the promoter from an auxin-inducible
      gene of Arabidopsis thaliana, AtAux2-11, were fused to the coding region of the
      reporter gene LacZ, which encodes beta-galactosidase, and a polyadenylation 3'
      untranslated nopaline synthase sequence from Agrobacterium. These chimeric genes
      were introduced into Arabidopsis by Agrobacterium tumefaciens-mediated
      transformation, and expression of the gene was examined by spectrophotometric and
      histochemical analyses. A 600 bp fragment from the AtAux2-11 promoter conferred
      histochemical patterns of staining similar to the longest 5' promoter tested, a
      3.0 kb fragment. Localization of AtAux2-11/LacZ activity in the transgenic plants
      revealed spatial and temporal expression patterns that correlated with tissues
      and cells undergoing physiological processes modulated by auxin. LacZ activity
      was expressed in the elongating region of roots, etiolated hypocotyls, and anther
      filaments. Expression was detected in the vascular cylinder of the root and the
      vascular tissue, epidermis, and cortex of the hypocotyl, and filament. The AtAux2
      11/LacZ gene was preferentially expressed in cells on the elongating side of
      hypocotyls undergoing gravitropic curvature. Expression of the chimeric gene in
      the hypocotyls of light-grown seedlings was less than that in etiolated seedling
      hypocotyls. The AtAux2-11/LacZ gene was active in the root cap, and expression in
      the root stele increased at sites of lateral root initiation. Staining was
      evident in cell types that develop lignified cell walls, e.g. trichomes, anther
      endothecial cells, and especially developing xylem. The chimeric gene was not
      expressed in primary meristems. While the magnitude of expression increased after
      application of exogenous auxin (2,4-D), the histochemical localization of AtAux2
      11/LacZ remained unchanged. Transgenic plants with a 600 bp promoter construct (
      0.6 kb AtAux2-11/LacZ) had higher levels of basal and auxin-inducible expression
      than plants with a 3.0 kb promoter construct. Transgenic plants with a -500 bp
      promoter had levels of expression similar to the -3.0 kb construct. The -0.6 kb
      AtAux2-11/LacZ gene responded maximally to a concentration of 5 x 10(-6) to 5 x
      10(-5) M 2,4-D and was responsive to as little as 5 x 10(-8) M. The evidence
      presented here suggests that this gene may play a role in several auxin-mediated
      developmental and physiological processes.

PMID- 8358027
TI  - Investigation of the mechanism underlying the inhibitory effect of heterologous
      ras genes in plant cells.
AB  - The ras genes from yeast and mammalian cells were fused to plant expression
      promoters, and introduced into plant cells via Agrobacterium, to study their
      effect on cell growth and development. All introduced ras genes had a strong
      inhibitory effect on callus and shoot regeneration from plant tissues. This is
      consistent with earlier findings that heterologous ras genes were highly lethal
      to protoplasts following direct DNA uptake. These effects could not be reversed
      by increasing exogenous or endogenous cytokinin levels. These effects were also
      independent of the v-Ha-ras mutations in functionally important regions of Ras
      proteins such as effector-binding and membrane-binding sites. Similarly, co
      transformation with the genes encoding the Ras-negative regulators, GTPase
      activating protein and neurofibromin did not affect the ras inhibitory effect,
      indicating that the mechanism of ras inhibition of plant cells is not related to
      normal ras cellular functions. This conclusion was supported by further studies
      in which ras gene expression was modified using various promoters and antisense
      constructs. The introduced ras sequences remained fully inhibitory regardless of
      which promoters (inducible or tissue-specific) or which orientations (sense or
      antisense) were tested. This strongly suggests that the ras DNA sequence itself,
      rather than the Ras protein or ras mRNA, is directly involved in the inhibitory
      effect. The mechanism underlying this novel phenomenon remains unknown.
      Introduced ras genes may inhibit plant cell growth by inducing co-suppression of
      unknown endogenous ras or ras-related genes, thereby leading to the arrest of
      cell growth.

PMID- 8358028
TI  - Purification of chloroplast elongation factor Tu and cDNA analysis in tobacco:
      the existence of two chloroplast elongation factor Tu species.
AB  - We have purified a chloroplast elongation factor Tu (EF-Tu) from tobacco
      (Nicotiana tabacum) and determined its N-terminal amino acid sequence. Two
      distinct cDNAs encoding EF-Tu were isolated from a leaf cDNA library of N.
      sylvestris (the female progenitor of N. tabacum) using an oligonucleotide probe
      based on the EF-Tu protein sequence. The cDNA sequence and genomic Southern
      analyses revealed that tobacco chloroplast EF-Tu is encoded by two distinct genes
      in the nuclear genome of N. sylvestris. We designated the corresponding gene
      products EF-Tu A and B. The mature polypeptides of EF-Tu A and B are 408 amino
      acids long and share 95.3% amino acid identity. They show 75-78% amino acid
      identity with cyanobacterial and chloroplast-encoded EF-Tu species.

PMID- 8358029
TI  - Transgenic potato plants overexpressing the pathogenesis-related STH-2 gene show
      unaltered susceptibility to Phytophthora infestans and potato virus X.
AB  - The STH-2 gene is rapidly activated in potato leaves and tubers following
      elicitation or infection by Phytophthora infestans. However, its biochemical
      function remains unknown. In order to ascertain if STH-2 protein is directly
      involved in the defense of potato against pathogens, the STH-2 coding sequence
      under the control of the CaMV 35S promoter was introduced into potato plants.
      Transgenic plants expressing the STH-2 gene were analyzed for an altered pattern
      of susceptibility to a compatible race of P. infestans and to potato virus X.
      Results indicate that constitutive expression of the STH-2 gene did not reduce
      susceptibility of potato to these pathogens.

PMID- 8358030
TI  - WIP1, a wound-inducible gene from maize with homology to Bowman-Birk proteinase
      inhibitors.
AB  - We have cloned and sequenced a wound-inducible cDNA clone designated WIP1 (for
      wound-induced protein) from maize coleoptiles. It was isolated by differential
      screening of a cDNA library prepared from excised maize coleoptile segments. The
      deduced amino acid sequence predicts a secretory, cysteine-rich protein of 102
      residues with a calculated molecular mass of 11 kDa and a typical N-terminal
      signal sequence. The protein has about 30% identity with various Bowman-Birk type
      proteinase inhibitors. Most interestingly, it is novel in that it is double
      headed with exclusive specificity for chymotrypsin. WIP1 is strongly wound
      induced in contrast to other members of the Bowman-Birk proteinase inhibitor
      family, which occur in seeds and are regulated during development. The response
      is fast, similar to defence-induced genes, and measurable as early as 30 min
      after wounding. Induction can also be evoked in the intact coleoptiles and the
      signal is systematically transmitted in the coleoptile to adjacent regions of the
      wounded area. Isolation and analysis of the corresponding genomic clone reveals
      that WIP1 contains an intron of 90 nucleotides.

PMID- 8358031
TI  - The U6 small nuclear RNA gene family of potato.
AB  - Using the inverse polymerase chain reaction (IPCR), 19 U6snRNA gene promoters
      were isolated from the potato genome. Analysis of their nucleotide sequences
      revealed the existence of two subfamilies. Promoters from class 1 harbour the
      typical sequence elements required for plant snRNA gene transcription whereas
      those from class 2 do not have a TATA box. Three promoters were fused to a
      modified U6snRNA-coding sequence to allow their activity to be monitored in
      tobacco protoplasts. Two of the promoters, one from either class, were found to
      be active. Comparison of potato U6snRNA gene promoter sequences with those found
      in other plant species showed various degrees of homology. In addition, the
      entire nucleotide sequences of seven potato U6snRNA genes and one pseudogene were
      determined. The overall frequency of nucleotide changes after PCR was found to be
      1.15 x 10(-3). The mutations appeared to be clustered in a distinct area and were
      all A-to-G/T-to-C substitutions.

PMID- 8358032
TI  - Purification and characterization of (1-->3, 1-->4)-beta-glucan endohydrolases
      from germinated wheat (Triticum aestivum).
AB  - A (1-->3, 1-->4)-beta-glucan 4-glucanohydrolase [(1-->3, 1-->4)-beta-glucanase,
      EC 3.2.1.73] was purified to homogeneity from extracts of germinated wheat grain.
      The enzyme, which was identified as an endohydrolase on the basis of
      oligosaccharide products released from a (1-->3, 1-->4)-beta-glucan substrate,
      has an apparent pI of 8.2 and an apparent molecular mass of 30 kDa. Western blot
      analyses with specific monoclonal antibodies indicated that the enzyme is related
      to (1-->3, 1-->4)-beta-glucanase isoenzyme EI from barley. The complete primary
      structure of the wheat (1-->3, 1-->4)-beta-glucanase has been deduced from
      nucleotide sequence analysis of cDNAs isolated from a library prepared using
      poly(A)+ RNA from gibberellic acid-treated wheat aleurone layers. One cDNA,
      designated lambda LW2, is 1426 nucleotide pairs in length and encodes a 306 amino
      acid enzyme, together with a NH2-terminal signal peptide of 28 amino acid
      residues. The mature polypeptide encoded by this cDNA has a molecular mass of
      32,085 and a predicted pI of 8.1. The other cDNA, designated lambda LW1, carries
      a 109 nucleotide pair sequence at its 5' end that is characteristic of plant
      introns and therefore appears to have been synthesized from an incompletely
      processed mRNA. Comparison of the coding and 3'-untranslated regions of the two
      cDNAs reveals 31 nucleotide substitutions, but none of these result in amino acid
      substitutions. Thus, the cDNAs encode enzymes with identical primary structures,
      but their corresponding mRNAs may have originated from homeologous chromosomes in
      the hexaploid wheat genome.

PMID- 8358033
TI  - Upstream regulatory sequences from two beta-conglycinin genes.
AB  - Genes encoding the beta-conglycinin seed storage proteins of soybean are
      expressed only in seeds during specific stages of development. The different
      subunits of beta-conglycinin, alpha', alpha and beta, are encoded by distinct
      members of a gene family. Yet there are marked differences in the regulation of
      the genes encoding the alpha'/alpha and beta subunits. Previous work (Chen et
      al., EMBO J 7: 297-302, 1988) identified a seed specific transcriptional enhancer
      upstream of a gene encoding the alpha' subunit. Mutations were made within this
      region to discern its functional components. Among those identified is a 62 bp
      region (between -77 and -140) that contains a vicilin box consensus sequence as
      well as a sequence that binds the soybean nuclear factor SEF4 in vitro. A second
      region, which contains a sequence homologous to the core of the legumin box
      consensus (i.e., CATGCAT-like or RY repeat element) at -246, was also shown to
      affect the activity of this enhancer in transgenic plants. A series of 5'
      terminal deletions were used to identify regulatory elements upstream of the beta
      subunit gene. Two regions were identified (from -553 to -442 and from -308 to 
      72) that, when deleted, led to a marked reduction in gene expression. Both of
      these elements contain sequences that bind SEF4 in vitro. The distal element also
      contains an AT-rich segment that recognizes a second nuclear factor, SEF1, in
      vitro. Neither of these elements contains any homology to the vicilin box
      consensus.

PMID- 8358034
TI  - Structure of the intergenic spacer region from the ribosomal RNA gene family of
      white spruce (Picea glauca).
AB  - Five genomic clones containing ribosomal DNA repeats from the gymnosperm white
      spruce (Picea glauca) have been isolated and characterized by restriction enzyme
      analysis. No nucleotide variation or length variation was detected within the
      region encoding the ribosomal RNAs. Four clones which contained the intergenic
      spacer (IGS) region from different rDNA repeats were further characterized to
      reveal the sub-repeat structure within the IGS. The sub-repeats were unusually
      long, ranging from 540 to 990 bp but in all other respects the structure of the
      IGS was very similar to the organization of the IGS from wheat, Drosophila and
      Xenopus.

PMID- 8358036
TI  - A chimaeric tryptophan decarboxylase gene as a novel selectable marker in plant
      cells.
AB  - A novel selection system for plant genetic transformation was developed based on
      the enzyme tryptophan decarboxylase (TDC; EC 4.1.1.28) from Catharanthus roseus.
      This enzyme converts the toxic tryptophan analogue 4-methyl tryptophan (4-mT)
      into the non-toxic compound 4-methyl tryptamine. Expression of tdc in transgenic
      plants that have no endogenous TDC-activity allows selection on 4-mT. A vector
      was constructed containing a tdc cDNA clone under control of the constitutively
      expressed cauliflower mosaic virus 35S promoter. This vector was used in
      Agrobacterium-mediated tobacco leaf disc transformation experiments. The optimal
      concentration for selection with 4-mT was found to be 0.1 mM. The transformed
      nature of shoots obtained after tdc gene transfer and subsequent selection on 0.1
      mM 4-mT was confirmed by northern blot analysis.

PMID- 8358035
TI  - The petunia homologue of the Antirrhinum majus candi and Zea mays A2 flavonoid
      genes; homology to flavanone 3-hydroxylase and ethylene-forming enzyme.
AB  - The synthesis of anthocyanins in higher plants involves many enzymatic steps.
      Here we describe the isolation and characterization of a cDNA, ant17, which
      encodes a protein that has 73% amino acid sequence identity with the candi gene
      product of Antirrhinum majus and 48% with that of the maize a2 gene. This protein
      may therefore be involved in the synthesis of anthocyanins in the steps after the
      action of dihydroflavonol 4-reductase. This is consistent with the absence of
      ant17 expression in the regulatory anthocyanin mutants of petunia an1, an2 and
      an11. Furthermore, ant17 is predominantly expressed in corollas and anthers and
      is induced by gibberellic acid.

PMID- 8358037
TI  - A highly conserved alpha-tubulin sequence from Prunus amygdalus.
AB  - The sequence of an alpha-tubulin from Prunus amygdalus has been obtained by cDNA
      cloning. When this sequence is compared to that of the Tub alpha 1 gene from
      maize it shows a very high degree of similarity, much higher than any of the
      alpha-tubulin sequences reported so far from plants. The expression of this gene
      is high in the stages of seed development where a high divisional activity is
      present. It is preferentially expressed in the radicular tissues as it is gene
      Tub alpha 1 in maize. Southern analysis indicates that this gene may form a
      subfamily of alpha-tubulin genes having similar sequence and tissue specificity
      and existing at least in maize and in Prunus.

PMID- 8358038
TI  - cDNA cloning and expression of a potato (Solanum tuberosum) invertase.
AB  - A cDNA clone encoding an invertase isoenzyme has been isolated from a potato leaf
      cDNA library. The deduced amino acid sequence shows significant similarities to
      previously characterised invertases. The highest degree of overall similarity,
      including the signal peptide sequence, is to carrot cell wall invertase,
      suggesting that the potato gene encodes an apoplastic enzyme. Expression of the
      gene, as determined by RT-PCR, is detected in stem and leaf tissue, and at lower
      levels in tuber, but is absent from roots.

PMID- 8358039
TI  - In planta analysis of the Agrobacterium tumefaciens T-cyt gene promoter:
      identification of an upstream region essential for promoter activity in leaf,
      stem and root cells of transgenic tobacco.
AB  - The promoter region of the Agrobacterium tumefaciens T-cyt gene was fused to a
      beta-glucuronidase (gusA) reporter gene and introduced into tobacco plants.
      Detection of gusA expression in transgenic F1 progeny revealed that the T-cyt
      promoter is active in many, if not all, cell types in leaves, stems and roots of
      fully developed plants. Developmental stage-dependent promoter activity was
      observed in seedlings. Analysis of 5'-deleted promoter fragments showed that
      sequences located between positions -185 and -139 with respect to the T-cyt
      translational start codon are essential for T-cyt promoter activity in
      transfected tobacco protoplasts as well as in transformed tobacco plants.

PMID- 8358040
TI  - Comparative sequence analysis of cis elements present in Glycine max L.
      leghemoglobin lba and lbc3 genes.
AB  - The soybean leghemoglobin lba gene promoter sequence was determined and aligned
      with the promoter sequence of the soybean lbc3 gene from the same gene family.
      Five highly conserved regions were found. There are two large conserved regions,
      one of which overlaps the basic promoter while the other defines a minimal
      enhancer in the upstream positive elements. Within the minimal enhancer, an
      inverted repeat with similarity to the binding site of a yeast transcription
      factor, GCN4, was found. This particular repeat is conserved in the promoters of
      all functional soybean lb genes as well as in lb gene promoters from other
      legumes. This suggests that the inverted repeat is important for leghemoglobin
      gene expression.

PMID- 8358041
TI  - Detection of partial deletion and partial duplication of dystrophin gene in
      Japanese patients with Duchenne or Becker muscular dystrophy.
AB  - The dystrophin gene was analyzed in 59 Japanese patients with Duchenne muscular
      dystrophy (DMD) from 48 unrelated families, including 11 pairs of siblings, and
      three patients with Becker muscular dystrophy (BMD) from two unrelated families,
      including one pair of siblings. The relationship between the type of gene
      abnormality and clinical symptoms was examined. Twenty-seven of 50 (54.0%)
      unrelated DMD or BMD patients were found to have partial deletions, and five
      (10%) appeared to have partial duplications in the dystrophin gene. Nine DMD
      patients, including three pairs of siblings, showed mental retardation, the
      existence of which was coincident in each pair of siblings, but deletion of an
      identical exon was not always related to mental retardation in unrelated
      patients.

PMID- 8358043
TI  - PI*S(iiyama), a deficiency gene of alpha 1-antitrypsin: evidence for the
      occurrence in western Japan.
AB  - An alpha 1-antitrypsin deficiency associated with pulmonary emphysema was
      investigated in a 32-year-old Japanese male. Polymerase chain reaction (PCR)
      amplified fragments and dot blot hybridization with allele-specific
      oligonucleotide probes revealed that the patient was homozygous for a C to T
      transition at codon 53, resulting in the substitution of Phe53 for Ser53
      (PI*S(iiyama)). Crossed immunoelectrophoresis after isoelectric focusing and
      agarose gel electrophoresis showed atypical banding patterns. PI*S(iiyama) is a
      rare deficiency gene, but it can occur sporadically all over the Japan.

PMID- 8358042
TI  - Deletion detection for diagnosis of Duchenne muscular dystrophy in the Japanese
      population--comparison between the polymerase chain reaction and the Southern
      blot analysis.
AB  - We compared the efficacy of the multiplex PCR with that of the cDNA analysis for
      detection of deletions of the DMD gene in the Japanese patients. Thirty males
      with DMD from 27 Japanese families were studied by the multiplex PCR, and 24 of
      them were also investigated by Southern blot analysis. We used five dystrophin
      cDNA probes for deletion analysis. A total of 19 regions were amplified by the
      PCR to detect deletions, 9 regions by the method of Chamberlain et al. and
      another 10 regions by the method of Beggs et al. Deletions were detected in 14
      (52%) out of 27 DMD families by the PCR. Southern blot analysis detected
      deletions in 14 (64%) out of 22 families. Thirteen (93%) of the 14 DMD families
      with deletions detected by Southern blotting were also confirmed by the multiplex
      PCR. Provided care is taken in cases where the deletion is limited to a single
      exon, the multiplex PCR appears to be an efficient and useful alternative to
      conventional Southern blot analysis for detecting deletions during the prenatal
      and postnatal diagnosis of DMD.

PMID- 8358044
TI  - Two Japanese cases with microcephalic primordial dwarfism: classical Seckel
      syndrome and osteodysplastic primordial dwarfism type II.
AB  - A male infant with "classical" Seckel syndrome and a girl with osteodysplastic
      primordial dwarfism type II are described. The boy with classical Seckel syndrome
      had severe brain dysplasia, a finding hitherto unreported in patients with this
      syndrome. The patient with osteodysplastic dwarfism type II had skeletal
      abnormalities including lumbar scoliosis, a small and high pelvis, metaphyseal
      flaring of the distal radii and ulnae, V-shaped metaphyseal flaring of the distal
      femorae, and short metacarpals and phalanges. The mother of this girl was short,
      microcephalic, and had disproportionately short forearms and legs. In view of
      this, dominant inheritance of the disease was suggested.

PMID- 8358045
TI  - Interstitial deletion of the long arm of chromosome 11 determined by fluorescence
      in situ hybridization.
AB  - An interstitial deletion, del(11)(q14q22), found in a female infant was examined
      by fluorescence in situ hybridization with cosmid DNA markers mapped on the long
      arm of chromosome 11. Three cosmids mapped on 11q14.1-11q22.1 region were not
      hybridized to the del(11) chromosome, while all the other DNA markers mapped on
      11cen-11q14.1 and 11q23.1-11qter region gave hybridization signals on the del(11)
      chromosome. Cytogenetic analysis after R-banding confirmed an apparent deletion
      of 11q14-q22, but containing a small R-negative band, a part of 11q22.3 and/or
      11q14.1, in the middle part of del(11) chromosome. The karyotype thus was
      determined to be 46,XX,del(11)(q14.1q22.3).

PMID- 8358046
TI  - A case of Goldenhar syndrome associated with growth hormone deficiency.
AB  - We have experienced the case of a 10-year-old boy who had Goldenhar syndrome
      accompanied by growth hormone (GH) deficiency. His height increased after
      treatment with growth hormone was administered. We found no untoward effects of
      the hormone and we consider that treatment with GH is useful for patients who
      present with Goldenhar syndrome associated with growth hormone deficiency.

PMID- 8358047
TI  - A case of schizophrenia with a dicentric Y chromosome.
AB  - A case of DSM-III-R schizophrenia with a dicentric Y chromosome
      (46,X,dic(Y)(q11)) is reported. Structural chromosome abnormalities such as this
      case may provide clues to finding regions of the genome etiologically involved in
      schizophrenia.

PMID- 8358048
TI  - Effect and mechanism of sucralfate on healing of acetic acid-induced gastric
      ulcers in rats.
AB  - We examined the effect of sucralfate on spontaneous and delayed healing of
      experimental gastric ulcers and the underlying mechanism of action. Gastric
      ulcers were produced 5 days after submucosal injection of 20% acetic acid (0.03
      ml) into the antral-oxyntic border of rat stomachs. To delay the healing of
      ulcers, indomethacin was administered s.c. at 1 mg/kg once daily for 4 weeks from
      5 days after the acid injection. Sucralfate, administered p.o. three times daily,
      significantly accelerated the spontaneous healing of ulcers, the healing rates
      being 13.7%, 43.7% and 47.1% with 100 mg/kg, 300 mg/kg and 600 mg/kg,
      respectively. In addition, the drug also significantly prevented the delay in
      ulcer healing caused by indomethacin, the preventive rates being 56.6% and 83.9%
      with 300 mg/kg and 600 mg/kg, respectively. Sucralfate, even at 1000 mg/kg, had
      no effect on the mucosal prostaglandin E2 (PGE2) level around the ulcers and did
      not affect the reduced PGE2 content caused by indomethacin. A single dose of
      sucralfate significantly increased the volume and the pH of the gastric contents
      in a dose-dependent manner, the effects persisting for up to 8 hr. These results
      suggest that the mechanism by which sucralfate accelerates the healing of gastric
      ulcers is unrelated to endogenous PGs but related to the acid-neutralizing
      activity.

PMID- 8358049
TI  - Adenosine modulates reactive hyperemia in rat gut.
AB  - Intestinal reactive hyperemia is an abrupt blood flow increase following release
      from anterior mesenteric arterial occlusion. We investigated the role of
      adenosine in reactive hyperemia. In anesthetized rats, mesenteric arterial
      velocity of blood flow was determined with pulsed Doppler velocimetry and
      arterial pressure with a transducer. Three indices quantifying reactive
      hyperemias obtained following 30, 60, and 120 s arterial occlusions included
      duration, the volume of blood flow exceeding preocclusion blood flow, and the
      percentage increase in conductance. In six rat groups (half fasted and half with
      intrajejunal bile-oleate solutions), hyperemia parameters were determined before
      and after administration of either adenosine deaminase (ADA) or two adenosine
      receptor antagonists, namely 8-phenyltheophylline (8-PT) and 1,3-dipropyl-7
      methylxanthine (DPMX). In fasted gut the three agents had variable effectiveness
      against reactive hyperemia, although 8-PT was the most consistent inhibitor.
      Instillation of intrajejunal lipid evoked a stable hyperemia and increased
      duration and blood flow volume after each occlusive period. ADA and 8-PT were
      more effective against reactive hyperemia in fed gut than in fasted gut. Our
      findings suggest that adenosine is a vasodilator metabolite modulating mesenteric
      reactive hyperemia, especially during enhanced intestinal metabolic activity.

PMID- 8358050
TI  - Microcirculatory and motor effects of endogenous nitric oxide in the rat gut.
AB  - The aim of the study was to determine the role of endogenous nitric oxide (NO) as
      the mediator of intestinal blood flow and motility. Experiments were performed on
      anesthetized rats. Blood flow in the jejunum was determined by Laser-Doppler
      flowmeter. Motility was monitored on the basis of changes in intrajejunal
      pressure. Systemic arterial pressure was also recorded. To investigate the
      potential role of nitric oxide in the regulation of basal intestinal blood flow
      and motility the NO synthase inhibitor NG-nitro-L-arginine (L-NNA) was given
      systemically. Intravenous bolus of L-NNA (15 mg/kg) reduced basal intestinal
      blood flow and increased both intestinal motility and arterial pressure in the
      dose-dependent manner. To test the specificity of the NO synthase blockade we
      administered L-arginine alone or in combination with L-NNA. Pretreatment with L
      arginine (100.0 mg/kg i.v.) alone had no major influence but when combined with L
      NNA it reversed the intestinal circulatory and motor effects of L-NNA. The
      results of these studies suggest that endogenous NO exerts a tonic relaxatory
      influence on the smooth muscle of the intestinal vessels and intestinal wall.

PMID- 8358051
TI  - Inhibitory effects of indomethacin on growth and proliferation of gastric
      carcinoma cells KATO III.
AB  - The effects of indomethacin on growth and proliferation of gastric carcinoma
      cells KATO III were examined. Indomethacin (10(-4) and 10(-3) M) significantly
      inhibited cell growth and these effects were not affected by treatment with 16,16
      dimethyl prostaglandin E2 (3 x 10(-7) M and 3 x 10(-6) M). Indomethacin 10(-3) M
      significantly reduced cell viability and completely inhibited cell growth.
      Indomethacin 10(-4) M did not affect cell viability and its inhibitory effect of
      cell growth became apparent on the fifth day of culture. Indomethacin 10(-4) M
      reduced BrdU labeling index within 2 hours. These results suggest that
      indomethacin inhibited growth and proliferation of gastric carcinoma cells KATO
      III. This effect is not mediated by prostaglandins.

PMID- 8358052
TI  - Insulin-like immunoreactivity (IRI) in the rat hypothalamo-neurohypophysial
      system: effect of dehydration and haemorrhage.
AB  - Hypothalamic IRI was not affected in haemorrhaged rats, but diminished
      considerably in the dehydrated ones. In the neurohypohysis, IRI was distinctly
      higher both in dehydrated and haemorrhaged rats, i.e., under disorders which
      stimulated vasopressin and/or oxytocin release. It is suggested that insulin-like
      substance(s) may be someway involved in regulation of vasopressin or oxytocin
      secretion.

PMID- 8358053
TI  - Kinins and thrombolysis.
AB  - In cats with extracorporeal circulation arterial blood pressure and thrombolysis
      were assayed. In this model apart from their hypotensive properties kallikrein (3
      10 units/kg, i.v.) and captopril (> 200 micrograms/kg, i.v.) dissipated blood
      clots which were preformed on superfused collagen strips. Captopril at a lower
      dose of 50 micrograms/kg i.v. potentiated the thrombolytic effect of kallikrein
      while aprotinin (100,000 unit/kg, i.v.) abolished it. Thrombolysis by kallikrein
      was mediated by an unstable principle which was decomposed by blood during 15 min
      of incubation at 37 degrees C. Generation of this principle was inhibited by
      pretreatment of animals with aspirin (50 mg/kg, i.v.). The above analysis points
      to prostacyclin which owing to its platelet-suppressant and fibrinolytic
      properties induces thrombolysis when released by kinins.

PMID- 8358054
TI  - Effect of thyrotropin on phospholipid composition in thyroid plasma membranes.
AB  - Differences particular in phospholipid levels from pig thyroid membranes
      incubated in the presence of TSH were observed, but with exception of
      lysophosphatidylcholine, were not statistically significant. TSH evoked about a
      twice increase of lysophosphatidylcholine content. A slight decrease of
      phosphatidylcholine, phosphatidylinositol and phosphatidylserine were found, when
      at the same time a slight increase of phosphatidylethanolamine and sphingomyelin
      level was noted. There were no statistical differences in range fluctuation of
      individual phospholipid levels, but direction of fluctuation (i.e. decrease or
      increase) were identical for every single phospholipid in all experiments. An
      increase of lysophosphatidylcholine and a simultaneously decrease of
      phosphatidylcholine contents suggests the stimulation of phospholipase A2
      activity.

PMID- 8358055
TI  - Actions and interactions of endothelins, prostacyclin and nitric oxide in the
      gastric mucosa.
AB  - The modulation of the gastric mucosal microcirculation plays a key role in the
      maintenance of gastric integrity. Disruption of the balance between the local
      release of vasodilator and vasoconstrictor mediators could therefore be involved
      in the pathogenesis of mucosal injury. Thus, the endothelium derived peptide
      endothelin-1 (ET-1), induces mucosal injury following local administration. In
      contrast, the vasodilator prostanoids, prostacyclin and PGE2 can protect against
      gastric damage, while inhibition of endogenous prostanoid formation by cyclo
      oxygenase inhibitors augment mucosal damage, including that induced by ET-1.
      Sensory neuropeptides such as calcitonin gene-related peptide (CGRP) may also
      play a local protective role, since acute intragastric administration of
      capsaicin which stimulates neuropeptide release, protects against mucosal injury
      induced by ET-1, as does local infusion of CGRP. Furthermore, chronic
      administration of capsaicin which deplete primary sensory neurones augments
      gastric damage induced by a number of ulcerogens including ET-1. Nitric oxide
      (NO) synthesized from L-arginine can regulate gastric mucosal blood flow, both
      under resting conditions and following stimulation of acid secretion. Inhibition
      of NO biosynthesis alone does not induce acute mucosal injury, yet extensive
      haemorrhagic damage results from concurrent inhibition of NO formation, cyclo
      oxygenase inhibition and depletion of sensory neuropeptides. NO donors can
      protect against ulceration, although the unregulated release of high levels of NO
      can lead to mucosal injury. Thus, NO has a critical interactive role with other
      local protective mediators such as the prostanoids and sensory neuropeptides in
      the physiological regulation of mucosal integrity.

PMID- 8358056
TI  - Chemotherapy in esophageal cancer.
AB  - Esophageal cancer is a virulent malignancy, with the conventional approach of
      surgery or radiation therapy offering patients only a small chance for long-term
      disease-free survival. The frequent early systemic dissemination of disease has
      prompted an ongoing interest in the study of chemotherapy. A broad range of
      antitumor agents have been studied which demonstrate moderate antitumor activity.
      A number of combination chemotherapy regimens, mainly cisplatin-based, have been
      studied, which have consistently greater antitumor activity in local regional
      disease compared with metastatic disease. The use of preoperative chemotherapy in
      the surgical treatment of the disease remains investigational. Results from
      clinical trials comparing radiation therapy alone with concurrent radiation and
      chemotherapy demonstrate a survival benefit for the use of a combination of
      concurrent chemotherapy and radiation compared to radiation therapy alone.
      However, current studies with conventional chemotherapy, radiation and surgery
      are likely to impart at best a modest to moderate improvement in the treatment of
      esophageal carcinoma. The priority in chemotherapy trials, therefore, remains the
      identification of new active chemotherapy agents. The search for novel
      therapeutic approaches, exploiting advances in understanding of the molecular
      biology of the disease, continues.

PMID- 8358057
TI  - Update of hormonal treatment in cancer of the prostate.
AB  - Prostate carcinomas are heterogeneous tumors composed of hormone sensitive and
      hormone insensitive cells. Although all androgens have an effect on prostatic
      cells, it is believed that dihydrotestosterone (DHT) is the active metabolite
      primarily utilized by prostatic cancer cells for growth and division. Hormonal
      therapies are therefore designed to lower tissue levels of DHT or prevent its
      binding to receptors on prostatic cancer cells. The Veterans Administration
      Cooperative studies in the 1960s and 1970s laid the groundwork for the use and
      timing of hormonal therapy. Until recently orchiectomy and estrogens were the two
      main alternatives, but new compounds such as luteinizing hormone releasing
      hormone analogs and antiandrogens have shown to be as effective and less toxic
      than estrogens. Today, important controversies concerning the selection of the
      best primary treatment and the timing of initiating the hormonal therapy still
      exist. Second line hormonal strategies are used, but they still have to prove
      their impact on overall survival.

PMID- 8358058
TI  - Transient hyperammonemia related to chemotherapy with continuous infusion of high
      dose 5-fluorouracil.
AB  - Hyperammonemic encephalopathy has been reported in patients receiving
      chemotherapy (CT). It is characterized by abrupt alteration in mental status with
      markedly elevated plasma ammonium levels in the absence of obvious liver disease.
      This paper reports seven patients who developed transient hyperammonemia during
      chemotherapy. The regimens all included continuous infusion of high-dose 5
      fluorouracil (5-FU). The onset of hyperammonemic encephalopathy was 1.5-4 days
      after the start of CT. Five cases had infection and six had prerenal azotemia at
      the time of hyperammonemia. After management, plasma ammonium levels all returned
      to the normal range within 2 days. Except for one persistent coma, status of
      consciousness cleared completely. The true mechanism of transient hyperammonemia
      is unclear. The excess production of ammonium due to metabolites of 5-FU added to
      precipitating factors such as infection, hypovolemia or constipation may be the
      explanation for transient hyperammonemia in our study.

PMID- 8358059
TI  - Epidoxorubicin and high dose leucovorin plus 5-fluorouracil in advanced gastric
      cancer: a phase II study.
AB  - We conducted a multicentric phase II study on advanced gastric cancer to
      determine the efficacy and toxicity of treatment with epidoxorubicin (EPI) plus
      high doses of leucovorin (LV) and 5-fluorouracil (5-FU). Thirty-seven patients
      with measurable disease were enrolled into the trial and treated with EPI 75
      mg/m2 on day 1 and LV 200 mg/m2 plus 5-FU 450 mg/m2 from day 1 to 3, the cycle
      being repeated every 3-4 weeks from a median of five cycles per patients. The
      response rate was 49% in 35 evaluable patients, with two complete remissions and
      15 partial responses. Median response duration was 12.4 months; median survival
      for responding patients was 17.3 months, which was significantly longer than 8.7
      months for non-responding patients. General toxicity was usually mild,
      myelotoxicity was moderate and there was no evidence of cardiac toxicity. These
      results show that EPI-LV-5-FU is an effective regimen for advanced gastric
      carcinoma. The efficacy of this combination should now be tested as an adjuvant
      therapy in resectable gastric cancer.

PMID- 8358060
TI  - Metastatic adenocarcinoma of the endometrium treated with 13-cis-retinoic acid
      plus interferon-alpha.
AB  - Phase II trials of the novel biologic combination of 13-cis-retinoic acid plus
      interferon (IFN)-alpha have achieved major activity in advanced squamous cell
      carcinomas of the skin and cervix, but not of the lung or head and neck. Very
      limited study of this combination has occurred in cancers other than those of
      squamous type. Although uncommon, cases of unresectable or metastatic endometrial
      adenocarcinoma are virtually incurable, and chemotherapy has had no impact on
      survival in these cases. This report describes our use of 13-cis-retinoic acid
      plus IFN-alpha to treat a case of cisplatin- and hormone-resistant, locally
      advanced and distantly metastatic adenocarcinoma of the endometrium. In this
      worst-prognosis case, the biologic therapy achieved a major response, which
      persisted for 4 months. Based on the dramatic activity in this case, we believe
      that depthful mechanistic and clinical study of this promising new biologic
      combination should be expanded to include non-squamous tumors of many different
      sites and histopathologic types.

PMID- 8358062
TI  - Decrease in vivo of cysteine endopeptidases in blood of patients with tumor of
      the larynx.
AB  - Since cysteine endopeptidase (cathepsins B and L) have been proposed to be
      implicated in tumor malignancy, we have attempted to decrease these in vivo.
      Large amounts of urine cysteine peptidase inhibitors (UCPI) are present in the
      urine of patients. Our results indicate protective effects of a UCIP preparation
      against human serum cysteine endopeptidases.

PMID- 8358061
TI  - Effective salvage therapy using all-trans retinoic acid for relapsed and
      resistant acute promyelocytic leukemia.
AB  - All-trans retinoic acid (ATRA) has been shown to be active against acute
      promyelocytic leukemia (APL). Six patients with APL, either in relapse or
      resistant to initial chemotherapy were reinduced with ATRA 100 g/m2/day for 6
      weeks. Complete remission was achieved in all six of them. Side effects were seen
      in two of them. ATRA appears to provide a relatively safe and reliable means to
      induce a complete remission in patients with refractory or relapsed APL.

PMID- 8358063
TI  - Polyamine increase in rat tissues treated with 1-beta-D-arabinosylcytosine and 5
      fluorouracil.
AB  - The effects of 1-beta-D-arabinosylcytosine (ara-C) and 5-fluorouracil (5-FU) on
      body weight, and the contents of putrescine, spermidine and spermine in 14
      different tissues were examined in rats given these drugs for 5 days. There were
      statistically significant increases in all three polyamines in the small
      intestine, in spermidine in the lung, and in spermine in the thymus, spleen and
      liver of rats treated with ara-C and 5-FU. Putrescine content in the spleen,
      heart, muscle and liver, and spermidine and spermine contents in the stomach of
      the 5-FU-treated rats also showed significant increases.

PMID- 8358064
TI  - AS-101: a modulator of in vitro T-cell proliferation.
AB  - AS-101 is a tellurate compound originally designed as a drug with cytostatic
      activity. Nevertheless, in vivo it was found to be an immunomodulator agent due
      to a stimulation of cytokine production. Mitotic Index (MI) as an indicator of
      cytotoxicity and cell proliferation kinetics (CPK) in lymphocytes cultures are
      parameters used in the evaluation of the antineoplastic activity of drugs, such
      as mitomycin-C and cisplatin. For this reason, we evaluated the effects of AS-101
      upon these two parameters. The results show that AS-101 produces an inhibition of
      MI in proliferating lymphocytes higher than the inhibition mediated by cisplatin.
      When CPK was evaluated, AS-101 induced a retardation not related with dose, while
      cisplatin produced a stepwise inhibition. This effect contrasts with the
      stimulation observed when AS-101 was added to non-proliferating lymphocytes which
      was measured as an increased [3H]thymidine incorporation in culture. The results
      confirm the mode of action of AS-101 as a real modulating agent of cell
      proliferation.

PMID- 8358065
TI  - In vitro cytotoxic activity of 1-alkylpiperidine N-oxides and quantitative
      structure-activity relationships.
AB  - The main objective of the present investigation was to screen a series of 1
      alkylpiperidine N-oxides for in vitro cytotoxicity, and to find out whether there
      is a quantitative structure-activity correlation (QSAR) between cytotoxic effect
      represented here by inhibition of incorporation of [14C]adenine into nucleic acid
      or [14C]valine into proteins in Ehrlich ascites carcinoma (EAC) cells and
      structure (as a structural parameter the number of carbon atoms m in the alkyl
      chain was used). On the basis of primary screening, one of the most active
      compounds, i.e. 1-decylpiperidine N-oxide, was chosen for further biochemical
      study. The drug inhibited the incorporation rate of 14C-labeled precursors
      (adenine, thymidine, uridine, valine) into appropriate macromolecules of Ehrlich
      cells, the extent of inhibition being dependent on both time and concentration of
      the compound in the incubation medium. The lengthening of the alkyl chain in 1
      alkylpiperidine N-oxides positively affected their cytotoxic activity in Ehrlich
      cells. For these compounds the optimal m value is 12-15.

PMID- 8358066
TI  - Ethyl 4-isothiocyanatobutanoate--antiproliferative activity in vitro and in vivo.
AB  - A new isothiocyanate (ITC) derivate ethyl 4-isothiocyanatobutanoate (E-4IB)
      induces an immediate dose-dependent inhibitory action on the division of HeLa
      cells in the concentration range 1.0-0.1 mg/l. Concomitant with the decrease in
      cell proliferation which follows E-4IB treatment the protein:cell number ratio
      increases and DNA accumulates. Cells which have lost their ability to divide do
      not stop their glucose metabolism and only partly stop their glutamine
      metabolism. The increased content of DNA suggests that cells synthesize DNA
      without entering into mitosis and that dying cells are in late S or G2 phases
      prior to death. E-4IB produces a significant growth inhibition of transplanted
      sarcoma cells B77-RF in rats (at 28 mg/kg). A 57% regression in tumor volume was
      observed for at least 30 days following the completion of the in vivo treatment.
      These findings support the presumption that E-4IB is a potential anti-cancer
      drug. However, further studies are needed for the optimization of its in vivo
      activity.

PMID- 8358067
TI  - Enhancement of LAK-like activity and cytokine induction in regional lymph nodes
      and spleen cells of mice after intralymphnodal injection of OK-432, a killed
      streptococcal preparation.
AB  - A single dose of inactivated streptococci (OK-432) was injected into the
      popliteal lymph nodes of male CDF1 mice and its effects on popliteal, inguinal,
      and para-aortic lymph node cells and spleen cells were investigated and compared
      with the effects of subcutaneous injections of the same dosage of OK-432.
      Regional lymph node cells and spleen cells obtained from intralymphnodally
      injected mice lysed not only natural killer (NK)-sensitive YAC-1 cells, but also
      NK-resistant P-815 and meth-A cells. Lysis of target cells was inhibited when
      effector cells were treated with anti-Thy-1.2 or anti-Lyt-2.2 monoclonal antibody
      and complement, but no inhibition was apparent after treatment with anti-asialo
      GM1 or anti-Lyt-1.2 antibody and complement. These results suggest that the
      effector cells are lymphocyte-activated killer (LAK) cells. An enhanced capacity
      of lymph node cells to produce cytokines, tumor necrosis factor and interleukin 1
      upon restimulation with lipopolysaccharide was found only in intralymphnodally
      injected mice. Thus, the induction of LAK-like cells and cytokine production in
      regional lymph nodes and spleen cells by the intralymphnodal administration of OK
      432 should be effective for the inhibition or treatment of lymph node metastases.

PMID- 8358068
TI  - The cytotoxicity of N-substituted indazolones in murine and human tumor cells.
AB  - N-Substituted indazolones are effective cytotoxic agents, causing cell death in a
      number of tissue culture lines, e.g. L1210, Tmolt3, colon adenocarcinoma and HeLa
      S3. Selected agents were also active against the growth of KB, bronchogenic lung,
      osteosarcoma and glioma. The mode of action of the derivatives involves
      inhibition of de novo purine synthesis of L1210 cells, which reduces DNA and RNA
      syntheses. Agents lowered d(NTP) pools, further reducing DNA synthesis. DNA
      strand scission was evident after incubation with N-substituted indazolones for
      24 h at 100 microM, lowering DNA synthesis and causing cell death.

PMID- 8358069
TI  - Rhein inhibits glucose uptake in Ehrlich ascites tumor cells by alteration of
      membrane-associated functions.
AB  - Rhein (RH), 4,5 dihydroxyanthraquinone-2-carboxylic acid, is known to inhibit the
      glycolysis of neoplastic cells by impairing glucose uptake. In order to establish
      whether this might be due to a selective interaction of the carrier with the drug
      or to functional modifications of the cell membrane, the effect of RH on glucose
      uptake in Ehrlich ascites tumor cells has been investigated. RH strongly inhibits
      the uptake of both 2-deoxyglucose and 3-O-methylglucose, so the reduced influx
      therefore cannot be ascribed to an effect on glucose phosphorylation. The
      inhibition of glucose transport does not depend on a reduction of the number of
      the carriers as indicated by the inability of the drug to interfere with the
      synthesis of the transporter. Moreover, the extent of total binding of
      cytochalasin B, as well as the fact that glucose specificity is not altered,
      indicate that the intrinsic activity of the glucose carrier is not affected. We
      therefore conclude that the inhibition of glucose uptake must be ascribed to an
      interaction of the drug with cell membranes that results in an alteration of
      membrane-associated functions.

PMID- 8358070
TI  - Neosurugatoxin blocks an alpha-bungarotoxin-sensitive neuronal nicotinic
      acetylcholine receptor.
AB  - Neosurugatoxin (NSTX), a neurotoxin isolated from the Japanese ivory mollusc
      Babylonia japonica, is a potent neuronal nicotinic acetylcholine receptor (nAChR)
      antagonist. Hitherto, NSTX has been found to block only neuronal nAChRs that are
      insensitive to alpha-Bgt. Here, we report for the first time that NSTX blocks an
      alpha-Bgt-sensitive nAChR on an identified insect motor neurone. Bath-applied
      NSTX at a concentration of 10 nM and above reversibly blocks the nicotine-induced
      depolarizations recorded from the cockroach (Periplaneta americana) fast coxal
      depressor motor neurone (Df) and is without effect on GABA-induced responses
      detected on the same cell. NSTX is among the most potent blockers tested to date
      on nAChRs of motor neurone Df.

PMID- 8358071
TI  - Defense mechanisms in insects: certain integumental proteins and tyrosinase are
      responsible for nonself-recognition and immobilization of Escherichia coli in the
      cuticle of developing Ceratitis capitata.
AB  - A defense mechanism in the cuticle of developing C. capitata was demonstrated
      using an in vitro system consisting of isolated cuticular tyrosinase from C.
      capitata, cuticular tyrosinase-free proteins, tyrosine, and E. coli. The
      simultaneous presence of the above components resulted in the formation of large
      immobilized E. coli aggregates. By contrast, omission of any of the above
      components failed to produce such aggregates. In other words, E. coli retained
      their mobility and viability. The results indicate that certain cuticular
      proteins are responsible for the nonself-recognition, since they are able to bind
      to the E. coli surface in vitro, and a reactive tyrosine derivative is generated
      by the action of cuticular tyrosinase for the immobilization and probably killing
      of E. coli. Based on these studies the most likely explanation for the nonself
      recognition and immobilization and/or killing of bacteria is the production of E.
      coli-protein complexes and their crosslinking through quinone intermediate.

PMID- 8358072
TI  - On the control of ecdysone biosynthesis by the central nervous system of blowfly
      larvae.
AB  - Ecdysone was found to be the major secreted steroid of ring glands dissected from
      blowfly larvae and incubated in vitro. Other secretory products such as 3
      dehydroecdysone and 20-deoxy-makisterone A could not be detected when the glands
      were labelled with tritiated cholesterol. Ecdysone synthesis and secretion were
      found to be tightly coupled. The highest rate of secretion was observed a few
      hours before pupariation. In vitro, the rate of ecdysone secretion by ring glands
      was affected significantly by coincubation with the central nervous system (CNS).
      Modulating effects from the CNS to the gland were mediated both by culture medium
      and by nerve connections. Distinct parts of the CNS revealed multiple and
      partially opposite effects on ecdysone secretion, suggesting a more complex
      control than had been anticipated. Multiple neural control systems appear to be
      involved. Moreover, the observed effects changed with development during the
      second half of the third instar, reflecting a significant plasticity of neural
      control.

PMID- 8358073
TI  - Bacterial translocation and reticuloendothelial function after implantation of
      abdominal drainage in the rat.
AB  - Bacterial translocation and reticuloendothelial system (RES) function were
      measured in the rat after intraperitoneal (IP) implantation of rubber drain
      pieces (7.5 cm2). Six hours after implantation, enteric bacterial translocation
      was noted to mesenteric lymph nodes (MLNs), the liver, spleen, lungs, kidneys and
      portal and caval vein blood. RES function was evaluated in terms of blood
      clearance and organ uptake of intravenously injected 125I-labelled, heat-killed
      E. coli. A significant elevation of corrected phagocytic index (alpha) was found
      24 hours after IP implantation. Localization of 125I-labeled E. coli was
      significantly enhanced in systemic organs (kidneys, spleen, liver and lungs) 24
      hours after IP implantation, whereas it was locally impaired (MLNs and proximal
      jejunum) 6 hours after IP implantation and thereafter. An inverse correlation
      between the localization of radiolabelled E. coli in the liver, spleen and lungs
      and the incidence of bacterial translocation to these organs was found. The
      results suggest that an association exists between alterations in RES function
      and bacterial translocation in the early course following IP implantation of
      rubber drains.

PMID- 8358074
TI  - Oesophageal cancer in gastric surgery patients.
AB  - Oesophageal adenocarcinoma (which has been steadily increasing in incidence
      during the last 20 years) is thought to be promoted by gastric reflux. In a
      cohort of 5018 gastric surgery patients, 19 of whom developed oesophageal cancer,
      there was no increased proportion of adenocarcinomas. We conclude that the
      hypothesized aetiology was not supported.

PMID- 8358075
TI  - A randomized controlled trial of a new PEG-electrolyte solution compared with a
      standard preparation for colonoscopy.
AB  - The efficacy, tolerability and patient acceptance of a new flavoured PEG solution
      for gut lavage was compared with a standard preparation for bowel cleansing in a
      randomized controlled trial of patients undergoing colonoscopy. One hundred and
      sixty patients were randomly allocated either to a standard preparation (2-day
      semi-liquid diet, laxatives and cleansing enemas) or to gut lavage
      (fractionalized ingestion of lavage solution, two litres in the afternoon before
      and a third litre the morning of the examination). Adequacy of colon cleansing
      was scored evaluating residual stool in each colonic segment and overall mucosal
      visibility. Tolerability of methods was assessed by evaluating the incidence and
      severity of side-effects. Patient acceptance was graded (good, fair to good,
      poor) according to the patient's judgement about the ease of execution and
      interference with sleep and working activity. Less residual stool (p < 0.05) and
      better visualization of colonic mucosa (p < 0.05) were obtained with gut lavage
      than with standard preparation. Both methods were well-tolerated and a low
      incidence of side effects was recorded in both groups. Patient acceptance was
      good in more than 80% of patients in both groups. We conclude that gut lavage is
      a rapid, effective and well-tolerated method for bowel cleansing. The use of a
      flavoured solution in a fractionalized schedule seems to improve the tolerability
      and the patient acceptance of this method.

PMID- 8358076
TI  - Characterization of agarose as an encapsulation medium for particulate specimens
      for transmission electron microscopy.
AB  - Agarose, agar, and gelatin were initially compared as encapsulation media for 3
      structurally diverse particulate specimens: bacteria, yeast, and mitochondria.
      Agarose proved superior to both gelatin and agar for ease of handling and overall
      image quality (minimum background). All sample types exhibited high quality
      fixation and structural detail with no heat damage from the agarose medium. Based
      on this finding, we further characterized agarose encapsulation as affected by
      post-fixation, en bloc staining and resin type. Osmium tetroxide post-fixation,
      followed by en bloc uranyl acetate staining, could be performed without an
      increase in the electron density of the encapsulation medium. Agarose proved
      successful as an encapsulation medium regardless of the resin type or preparation
      protocol, thus providing flexibility in experimental design and excellent results
      over a range of variables.

PMID- 8358077
TI  - Subcellular calcium localization in Toxoplasma gondii by electron microscopy and
      by X-ray and electron energy loss spectroscopies.
AB  - The localization of calcium in Toxoplasma gondii tachyzoites was studied at the
      ultrastructural level, with a cytochemical pyroantimonate precipitation method
      (PA) and controlled by EGTA chelating and EDX and EELS microanalyses. Appropriate
      conditions for material preparation, fixation and embedding, were defined. The
      proportion of precipitates that were either free or inside vacuoles and their
      distribution inside Toxoplasma appeared to be PA dose-dependent. Precipitation
      mainly occurred in the anterior pole of the Epon-embedded tachyzoites. EDX and
      EELS analyses showed that out of 30 PA precipitates inside tachyzoites, 78%
      contained Ca. In Melamine sections, 96% of the tachyzoites had intracellular
      precipitates and the membrane complex was stained; 25% of the tachyzoites inside
      host cells contained PA-Ca precipitates, but most of them were retained in the
      reticular network of the parasitophorous vacuole. Melamine embedding appeared to
      improve the preservation of calcium pyroantimonate precipitates.

PMID- 8358078
TI  - Rapid primary microwave-glutaraldehyde fixation preserves the plasma membrane and
      intracellular structures of the protozoan Tritrichomonas foetus.
AB  - Tritrichomonas foetus, a pathogenic protozoan, was used as a model to analyse
      microwave-stimulated fixation as a procedure of preparation of biological samples
      for electron microscopy of thin sections and freeze-fracture replicas. Good
      preservation of the protozoan structure was achieved by microwave-stimulated
      fixation and Epon polymerization. The membrane structure, as visualized in freeze
      fracture replicas, was well preserved.

PMID- 8358079
TI  - Selective etching of AlAs for preparation of III-V semiconductor thin foils.
AB  - A new method of thin section preparation of III-V semiconductors and multilayers
      for transmission electron microscopy (TEM) is presented that exhibits
      considerable advantages over conventional methods such as ion beam milling and
      jet thinning. GaAs thin films and multilayers of GaAs/In chi Ga1-chi As/GaAs are
      grown over an etch release layer of AlAs on GaAs substrates by molecular beam
      epitaxy (MBE). Planar TEM sections prepared by selective etching from these
      samples show improved ability to image film morphology and dislocation
      arrangements, and the resulting large thin electron transparent areas facilitate
      dislocation density measurements and detection of spatial variations. Avoidance
      of radiation effects and wedge shaping, both common to ion milled samples, allows
      this method to be used to prepare uniform thickness standards of single layer
      GaAs films for EDS analysis or lattice imaging.

PMID- 8358080
TI  - High resolution and image processing of otoconia matrix.
AB  - This study was designed to investigate patterns of fibrils organization in
      histochemically stained otoconia. Transmission electron microscope and video
      imaging were used. These data indicate that otoconia of the chick (Gallus
      domesticus) inner ear may have central cores in vivo. The data also show that the
      ultrastructural organization of fibrils fixed with aldehydes and histochemical
      stains follows trajectories that conform to the hexagonal shape of otoconia.
      These changes in direction may contribute to the formation of a central core. The
      existence of central cores is important for the in vivo buoyancy of otoconia.
      Packing of fibrils is tighter after phosphotungstic acid (PTA) stained otoconia
      than with other histochemical stains, which usually produce looser packing of
      fibrils and seemingly larger central core. TEM of tilted and untilted material
      showed that turning of fibrils occurs at the points where the face angles of
      otoconia form and where central cores exist. Video image processing of the images
      allowed reconstructing a template which, if assumed to repeat and change
      trajectories, would fit the pattern of fibrils seen in fixed otoconia. Since it
      is highly unlikely that aldehyde primary fixation or PTA stain caused such
      drastic change in the direction of fibrils, the template derived from these
      results may closely approximate patterns of otoconia fibrils packing in vivo.
      However, if the above is correct, the perfect crystallographic diffraction
      pattern of unfixed otoconia do not correspond to patterns of fixed fibrils.

PMID- 8358081
TI  - Software for quantitative immunogold and in situ hybridization.
AB  - A well-deserved criticism of stereology is that it is often too difficult to
      understand and use. Nevertheless, it is rapidly becoming one of the most
      effective ways of collecting and interpreting structural data in experimental
      biology. Recent breakthroughs in theory have produced a remarkable set of tools
      that can be used to engineer new methods. The dilemma remains, however, in that
      some of these new methods continue to be too difficult to understand and use. One
      solution to this growing problem of technology transfer might be to simplify the
      methods with computer software. To test this idea, programs were written for
      quantitative immunogold and in situ hybridization. Simulators were used to
      develop and test new experimental designs, which, in turn, were translated into
      step-by-step laboratory tool kits. This paper shows how these tool kits can turn
      two-dimensional section data into estimates for the number of labeled molecules
      in three-dimensional organelles, cells, tissues, and organs. The results indicate
      that software can identify the key data of an experiment and reduce the
      computational requirements of a new stereological method to entering constants
      and variables into data entry forms.

PMID- 8358083
TI  - High-resolution transmission electron microscopy of hexagonal and rhombohedral
      molybdenum disulfide crystals.
AB  - Natural (molybdenite) and synthesized molybdenum disulfide crystals have been
      studied by high-resolution transmission electron microscopy. The image simulation
      demonstrates that the [0001] and [0110] HRTEM images of hexagonal and
      rhombohedral MoS2 crystals hardly disclose their stacking sequences, and that the
      [2110] images can distinguish the Mo and S columns along the incident electron
      beam and enable one to determine not only the crystal structure but also the
      fault structure. Observed [0001] images of cleaved molybdenite and synthesized
      MoS2 crystals, however, reveal the strain field around partial dislocations
      limiting an extended dislocation. A cross-sectional image of a single molecular
      (S-Mo-S) layer cleaved from molybdenite has been observed. Synthesized MoS2
      flakes which were prepared by grinding have been found to be rhombohedral
      crystals containing many stacking faults caused by glides between S/S layers.

PMID- 8358082
TI  - Software for counting cells and estimating structural volumes with the optical
      disector and fractionator.
AB  - We describe MS-DOS software for the optical volume fractionator (OVF), a
      stereological method combining the principles of the optical disector (Gundersen
      et al.: Acta Pathol. Microbiol. Immunol. Scand., 96:857-881, 1988) and
      fractionator (Gundersen: J. Microsc., 143:3-45, 1986). The OVF program estimates
      the volume of a fixed and embedded structure, the numerical density of cells, and
      the total number of cells in a structure. The hardware requirements include a PC
      computer (386 or 486 with VGA graphics) and a conventional light microscope
      fitted with a rotating stage, extension tube, and length gauge. The software
      includes an introduction, tutorial, simulator, laboratory tool kit, and report
      generator. The tool kit improves the efficiency of gathering stereological data
      with light microscopy and offers a convenient link between the data of light and
      electron microscopy. A novel algorithm, based on fractionator sampling, gives the
      volume of a fixed and embedded structure from the same set of sections used for
      cell counting. A laboratory example illustrates the operation of the software.

PMID- 8358084
TI  - A simplified mode of differential phase contrast Lorentz microscopy.
AB  - A simplified mode of differential phase contrast Lorentz microscopy for the study
      of magnetic domain structures in thin films is proposed and demonstrated. This
      mode employs a single annular detector in a scanning transmission electron
      microscope rather than the specialized split detectors that have been previously
      used. The resulting signal is sufficiently linear with magnetic field strength to
      allow quantitative data to be obtained on the domain configurations and the
      natures of the domain walls.

PMID- 8358085
TI  - A novel method for the cross-sectional TEM preparation of thin films deposited
      onto water-soluble substrates.
AB  - A preparational method was developed solving the problem of cross-sectional TEM
      preparation of thin films and layer systems deposited onto water-soluble
      substrates. The technique is based on the replacement of the sample onto steady
      substrate, followed by mechanical and ion beam thinning. Cross-sectional TEM
      micrographs of Ag and Ag/Ag2Se layers are shown presenting the efficiency of this
      novel technique.

PMID- 8358086
TI  - Yet another artifact of quantitative immunocytochemistry in electron microscopy:
      serial sections reveal inconsistent labeling.

PMID- 8358087
TI  - Medical education: Providence and Bologna.

PMID- 8358088
TI  - The Brown University School of Medicine class of 1993.

PMID- 8358089
TI  - The "reading" of patients.

PMID- 8358090
TI  - The status of women in medicine at the Brown University School of Medicine.
AB  - Although the number of women medical faculty appointed and promoted at the School
      of Medicine has increased gradually since 1987, the extent to which women have
      advanced in academic medicine and the timeliness of their movement forward are of
      concern. With women constituting nearly 20% of the medical faculty at Brown, and
      comprising only 5% of professorial appointments, it is easy to see the
      disparities. While the Brown University School of Medicine stands out as one of
      less than a dozen medical schools with an Office of Women in Medicine, clearly
      there is still much to accomplish in this domain. Progress may be accelerated
      through networking and advocacy promoted by professional development programs
      sponsored by offices for women in medicine and organizations as RIMWA. Offering
      women medical faculty a forum to discuss issues as departmental promotion
      criteria in academic medicine and to link up with other women physicians,
      ultimately serves not only women faculty but their institution. Providing role
      models is critical to assist women medical students in looking well ahead to plan
      for their own career development. In creating opportunities for dialogue among
      women in medicine at all levels in the medical school environment and among women
      physicians in the nearby community, institutions take an essential step forward
      towards supporting women's advancement in medicine.

PMID- 8358091
TI  - The practicing physicians of Rhode Island: a statistical profile.

PMID- 8358092
TI  - The unifying principles of family medicine: a historical perspective.

PMID- 8358093
TI  - Carrot juice xanthoderma: an orange patient with multiple myeloma.

PMID- 8358094
TI  - Patient education for screening mammography: the unmet need.

PMID- 8358095
TI  - Chloroquine stimulates the mitogen-driven lymphocyte proliferation in patients
      with psoriasis.
AB  - Chloroquine is known to exacerbate psoriasis. Since immunological stimuli are
      considered to be important for the pathogenesis of psoriasis, we compared the
      effects of chloroquine on cell-mediated immunity in 15 healthy control
      individuals and 15 patients with psoriasis. We employed the spontaneous and
      phytohemagglutin (PHA)-induced uptake of 3H-thymidine to measure lymphocyte
      proliferation. Chloroquine was added to the cultures at concentrations ranging
      from 0.022 to 220 microM. We found that both spontaneous and PHA-driven
      lymphocyte proliferations were significantly lower in patients with psoriasis (p
      < 0.002). The spontaneous blastogenesis in both controls and patients remained
      stable under chloroquine. In PHA-driven cultures in controls, 0.022-2.2 microM
      chloroquine had no effect, higher concentrations of the drug suppressed
      proliferation. In patients, 22 microM chloroquine surmounted the suppression of
      the PHA-induced proliferative response found in controls; moreover, 2.2-0.022
      microM chloroquine increased lymphocyte proliferation by > 300% (p < 0.002). Our
      data indicate that in psoriasis the lower lymphocyte transformation is abnormally
      stimulated by the addition of pharmacological doses of chloroquine.

PMID- 8358096
TI  - Pitting scars in progressive systemic sclerosis.
AB  - The digital pitting scar is a common clinical feature in patients with
      progressive systemic sclerosis (PSS). Its pathogenesis is unclear, but it may
      result in small ulcerations. The clinical and histological features of these
      lesions are poorly understood. Eighty-seven patients with PSS were examined at
      least once per year. Pitting scars were defined as pinhole-sized digital concave
      depressions with hyperkeratosis. They were seen in 34 cases (39%) and were
      located not only on the tips of the fingers, but also on the sides, especially on
      the radial border of the index and middle finger and the ulnar side of the thumb,
      where they had a linear arrangement. Additional pitting scars were noticed on the
      dorsal surface of the proximal interphalangeal and metacarpophalangeal joints.
      Pitting was closely associated with several signs of PSS, e.g. Raynaud's
      phenomenon, skin thickening or articular involvement (e.g. stiffness, swelling,
      pain). There was no relationship between the number of pitting scars and the
      duration of PSS. Biopsy samples were taken of the lesions on the lateral sides of
      fingers in 3 patients. Histologically, there was a plug-like hyperkeratosis with
      parakeratosis, homogenized collagen fibers and slight perivascular mononuclear
      cell infiltration. Calcification and altered collagen fibers were observed in the
      deep dermis. Although pitting scars of the fingertips may be different from those
      of the lateral sides of the fingers, both histologically and pathogenetically,
      they were similar clinically. The scar locations on the fingertips and finger
      joints (proximal interphalangeal and metacarpophalangeal) suggest that exogenous
      trauma, vibration injury and/or cold exposure may play a role in their
      pathogenesis.

PMID- 8358097
TI  - Occupational dermatitis from isothiazolinones in the nylon production.
AB  - Kathon is a biocide consisting of a mixture of two isothiazolinone derivatives (5
      chloro-2-methyl-4-isothiazolin-3-one and 2-methyl-4-isothiazolin-3-one) in an
      approximate ratio of 3:1, respectively, and with MgCl2 and Mg(NO3)2 present as
      stabilizers. The isothiazolinones are marketed under several brand names, and the
      concentration of the active ingredient varies according to their intended
      application. At a concentration of 3-15 ppm it shows activity against a wide
      spectrum of fungi, gram-positive and gram-negative bacteria. Contact allergy to
      it has been caused by cosmetics and also by products used in the pottery and
      various other industries. Recently we had the opportunity to observe 6 cases of
      occupational allergic contact dermatitis from an isothiazolinone mixture named
      Grotan TK 2 in a large textile industry producing nylon. An oil emulsion
      containing isothiazolinones is used in the spinning phase of the work cycle to
      prevent bacterial contamination that would damage yarn quality; furthermore, it
      helps to decrease the electrostatic charge that is produced by high speed at
      which the yarn moves and also to decrease the breakage possibility.

PMID- 8358098
TI  - Contact immunotherapy with squaric acid dibutylester for warts [corrected].
AB  - The efficacy of squaric acid dibutylester (SADBE), a topical allergen, was
      investigated in the treatment of 20 patients with warts. All patients had
      multiple or warts recalcitrant to other therapies or hesitated to have the
      painful cryotherapy. The patients with warts present for a mean of 15.3 months
      (range 1-36) were successfully sensitized with 2% SADBE in acetone. Then the
      warts were treated with a 0.1 or 0.01% SADBE application once a week or every
      other week, so as to maintain a mild contact dermatitis. Twelve of the 20
      patients (60%) were completely cured after an average of 6 applications (range 2
      12). Five patients (25%) showed either a poor or no response even after 9-18
      applications. Three patients (15%) exhibited contact dermatitis either at the
      sensitization or the treatment site. Our study shows that this therapy, although
      not always safe, is effective in treating warts in some patients, who either
      hesitate at conventional cryotherapy or have warts resistant to other therapies.
      The safety of this method remains to be evaluated.

PMID- 8358099
TI  - Microcystic adnexal carcinoma. Case report with an immunohistochemical study.
AB  - We report the case of 71-year-old Japanese woman with microcystic adnexal
      carcinoma (MAC) of the nose. Our histological and immunohistochemical
      observations suggest that MAC has both pilar and eccrine sweat gland
      differentiation.

PMID- 8358100
TI  - Subcorneal pustular dermatosis and IgA myeloma.
AB  - A case of subcorneal pustular dermatosis (SCPD), as a presenting feature in a
      patient with multiple myeloma, is described. This is the seventh case report of
      this association and the first from the Middle East. Five of these cases,
      including the present report, have been of the IgA paraprotein type, IgA
      intraepidermal deposits have been described in a few patients with SCPD
      associated with IgA paraproteinaemias but have not been detected in our patient.

PMID- 8358101
TI  - Diffuse erythrodermic cutaneous mastocytosis with bone marrow infiltration.
AB  - We report a case of diffuse erythrodermic cutaneous mastocytosis with bone marrow
      infiltration. An 11-month-old female patient was referred to our hospital for
      intermittent flushing, fever, intense itching, erythematous rash and bullous
      lesions. Cutaneous biopsy demonstrated diffuse cutaneous mastocytosis. The bone
      marrow aspirate revealed mast cell infiltration. Ketotifen treatment was very
      effective.

PMID- 8358102
TI  - Aquagenic pruritus as a presenting symptom of polycythemia vera.
AB  - A female patient was presented because of a prickling sensation that appeared
      shortly after warm water contact. Examination revealed no abnormality, but water
      exposure was followed by pruritus without any visible skin changes. Blood and
      bone marrow examinations revealed abnormalities typical of polycythemia vera.
      Skin biopsy before and after warm water challenge showed increased numbers of
      mononuclear cells in the papillary dermis and epidermis particularly after water
      exposure. Phlebotomy was associated with prompt cessation of pruritus.

PMID- 8358103
TI  - Pigmentary demarcation lines of pregnancy with erythema.
AB  - We describe two patients with pregnancy-associated pigmentary demarcation lines
      overlapped by erythematous changes. In both cases, there was a symmetrical well
      defined erythematous pigmentation involving the buttocks and flexor aspects of
      the legs. After normal delivery the erythema disappeared within 7-10 days,
      followed by slow resolution of the pigmentation. Compression by the enlarged
      uterus of peripheral nerves issuing at S1-S2 is proposed as a mechanism of these
      changes.

PMID- 8358104
TI  - Psoriasis and birdshot chorioretinopathy: response to aromatic retinoids.
AB  - Birdshot chorioretinopathy, also known as vitiliginous chorioretinitis, is a rare
      and serious retinochoroidopathy. We describe a case in a patient with long
      standing typical psoriasis. To our knowledge this association has not been
      previously reported in the dermatologic literature. Both psoriasis and
      chorioretinitis appeared to respond to aromatic retinoids. The incidence of
      birdshot chorioretinopathy in patients with psoriasis should be assessed.

PMID- 8358105
TI  - Fingertip tophi without gouty arthritis.
AB  - We report 2 patients without a history of acute gouty arthritis showing tophi
      located only on the fingertips, an unusual location. A review of the literature
      found a few similar reports; these patients might represent a subgroup of gout
      characterized by: (1) elderly patients, from the 7th to 9th decades; (2)
      hyperuricemia; (3) absence of a history of acute gouty arthritis; (4) tophi in
      the fingertips or fingerpads; (5) chronic renal failure, and (6) all taking drugs
      or suffering from a disease that affects urate renal excretion.

PMID- 8358106
TI  - Juvenile hyaline fibromatosis with skull-encephalic anomalies: a case report and
      review of the literature.
AB  - We report a case of juvenile hyaline fibromatosis. Besides the typical features
      of this syndrome, skull and encephalic abnormalities, not previously mentioned,
      are described. Clinical and microscopic characteristics, therapeutic
      possibilities and different theories concerning histopathogenesis are discussed.

PMID- 8358108
TI  - Odor in pemphigus.

PMID- 8358107
TI  - Use of topical lithium succinate in the treatment of seborrhoeic dermatitis.

PMID- 8358109
TI  - Is sustained production of tumor necrosis factor-alpha relevant to the
      development of pustular psoriasis?
AB  - Tumor necrosis factor-alpha (TNF-alpha) has been implicated as one of the
      critical mediators of psoriasis. Evidence for an important role on the
      progression of the disease is increasing, while recent clinical studies have
      suggested its beneficial role in the disease. Based on the results of our
      sequential analysis of the serum cytokine levels in a patient with pustular
      psoriasis, we speculate that immunologic effects of constitutive local release of
      TNF-alpha may be quite different from those of its systemic injection.

PMID- 8358110
TI  - Drug hypersensitivity syndrome.
AB  - Some types of hypersensitivity to drugs are defined either by the generic name of
      the drug or descriptive terms. They are sometimes assimilated to pseudolymphoma
      because the causative drugs are often the same, although the eruption lacks
      clinical and histopathological criteria of pseudolymphoma. It is then suggested
      to use 'idiosyncratic drug hypersensitivity syndrome' to define this type of drug
      reaction. As the skin and other organs may be involved, a generic name would help
      to determine a better definition and a surveillance program.

PMID- 8358111
TI  - Melanocytic nevi and tumor progression: perspectives concerning histomorphology,
      melanoma risk and molecular genetics.
AB  - Atypical variants of melanocytic nevi such as congenital nevi, acral nevi and
      Spitz nevi may share many architectural and cytologic abnormalities in common
      with conventional dysplastic nevi. Although largely undetermined, the degree of
      melanoma risk (if any) associated with the atypical nevus in question may
      correlate with the grade of atypia in the particular nevus and a variety of other
      factors such as the number of nevi and skin phototype.

PMID- 8358113
TI  - 'Anti-metastatic' nm23 gene product expression in keratoacanthoma and squamous
      cell carcinoma.
AB  - An inverse correlation has been demonstrated between nm23 gene expression and
      metastasis. The gene is located on chromosome 17q (q1.1-q2.1), a region distinct
      from tumour suppressor gene p53. We have previously reported expression of mutant
      products of p53 gene to be significantly associated with worsening degrees of
      differentiation in squamous cell carcinoma. nm23 gene product, which shows
      complete identity to human erythrocyte nucleoside diphosphate kinase, was used to
      raise an affinity-purified polyclonal antibody Ab-11 which is applicable to
      formalin-fixed and paraffin-embedded tissues. Keratoacanthomas and squamous cell
      carcinomas of the epidermis form a fascinating human tumour model in which to
      test the hypothesis that the nm23 gene confers 'anti-metastatic' properties,
      since the former never metastasise while the latter have this potential. Two
      observers rated immunohistochemistry for the nm23 gene product as the proportion
      of tumour positive from grades 1-4 (corresponding to 25, 50, 75 and 100% of
      tumour cells stained). Nineteen typical keratoacanthomas, 20 well, 21 moderately
      and 8 poorly differentiated epidermal squamous cell carcinomas were studied. The
      Jonckheere-Terpstra test statistic of association between staining grade and
      lesion type was 762.5, p = 0.189 (2 tails), p = 0.0945 (1 tail). There was no
      statistically significant trend in tumour staining from keratoacanthoma through
      decreasing grades of differentiation of squamous cell carcinoma. nm23 product
      expression does not appear to correlate with differentiation, itself an indicator
      of metastatic potential, in this system of human squamous cell
      neoplasms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358114
TI  - Gene therapy.

PMID- 8358112
TI  - Plastic occlusion stress test as a model to investigate the effects of skin
      delipidization on the stratum corneum water holding capacity in vivo.
AB  - The purpose of the study was to develop an in vivo model to study the effects of
      lipid removal on skin barrier. 16 subjects (age 41 +/- 8) were delipidized in
      vivo on the volar forearm using respectively ether/acetone (EA; 1:1) and
      chloroform/methanol (CM; 2:1). A third site served as control. Water holding
      capacity (WHC) was measured according to the plastic occlusion stress test (POST)
      procedure: the water desorption curve after removal of the occlusion was recorded
      in terms of skin surface water loss (SSWL) using an evaporimeter for 30 min. In
      the central part of the evaporation curve (bound water) the CM-treated site is
      significantly different from control and EA-treated sites (p < 0.01). The SSWL
      decay constants reflecting the desorption rate of water from SC are higher in the
      CM-treated site (p < 0.01). The data are consistent with the effect of CM
      delipidization (polar lipids) on bound water. No differences are recorded in the
      evaporation of free water. We conclude that polar lipids have a key role in
      modulating barrier function and WHC of the stratum corneum. The POST can
      represent a useful in vivo model to study the effects of lipid extraction on skin
      function.

PMID- 8358115
TI  - Postoperative pneumonia in elderly patients: incidence and mortality in
      comparison with younger patients.
AB  - To determine whether elderly patients have an increased incidence of
      postoperative pneumonia and/or an increased mortality, we conducted a
      retrospective study of 4,380 patients who underwent thoracic, abdominal or
      neurosurgery under general anesthesia. Thirty of these patients developed
      postoperative pneumonia (incidence, 0.68%). The elderly patients aged 65 years or
      older who underwent thoracic surgery had the highest incidence of pneumonia. Nine
      of the 30 patients with pneumonia died (mortality, 30%). Elderly patients did not
      show a higher mortality than the younger patients. The extent of pulmonary
      infiltrates on chest roentgenogram and the serum bilirubin level, both of which
      were determined at the onset of pneumonia, independently had a significant
      association with mortality. Our study suggests that advanced age is a risk factor
      for postoperative pneumonia in patients who undergo thoracic surgery.

PMID- 8358116
TI  - Lung abscess: analysis of 66 cases from 1979 to 1991.
AB  - Sixty-six patients with bacterial lung abscess were treated between 1979 and 1991
      in our hospital. Among these patients, death occurred in one of the 42 cases of
      community-acquired infection (mortality rate: 2.4%) and in 16 of the 24 cases of
      nosocomial infection (mortality rate: 66.7%). Of all 66 cases, 55 were culture
      positive, and the etiologic agents isolated from 24 of the culture-positive cases
      were found to be anaerobic bacteria. The most common aerobes isolated from the
      foci were identified as Staphylococcus aureus, Klebsiella spp. and Pseudomonas
      aeruginosa, while the most common anaerobes were Bacteroides spp.,
      Peptostreptococcus, Fusobacterium spp., microaerophilic Streptococcus and
      Veillonella. The mortality was higher in the cases with P. aeruginosa, Klebsiella
      spp. and Candida spp. than in those with other bacteria. The prognosis of lung
      abscess patients proved to depend on the presence of underlying diseases and on
      superinfection with aerobes.

PMID- 8358117
TI  - Percutaneous transluminal coronary angioplasty for acute myocardial infarction.
AB  - Between 1986 and 1991, direct coronary angioplasty was attempted in 79 patients.
      The procedure was successful in 76 patients (96%), unsuccessful without
      complications in 2 patients, and major complications occurred in 1 patient
      (ventricular fibrillation and cardiogenic shock). Reperfusion was obtained from 1
      to 7.5 hours (mean: 3.3 +/- 1.3 hours) after the onset of chest pain. Among the
      76 successfully dilated patients, there was one cardiac death and 68 had
      predischarge angiography (64 patent, 2 stenosed, and 2 occluded). Although only
      33 of the 58 patients (57%) angiographically followed after discharge showed
      persistence of primary patency, 52 of the 57 (91%) followed further obtained
      final patency when angioplasty was repeated up to 4 times. These results indicate
      that direct angioplasty in the community hospital setting can achieve a high
      primary success rate and a low reocclusion rate.

PMID- 8358118
TI  - Shunt nephritis: efficacy of an antibiotic trial for clinical diagnosis.
AB  - Coagulase negative staphylococcus, a normal skin flora, is especially nosopoietic
      under shunt management, because coagulase negative staphylococcus sometimes forms
      a biofilm around itself at catheter tips in vivo, which shields the organism from
      the effects of antibiotics. But it is difficult to distinguish this pathogen from
      a possible confounding contamination of a blood culture. In this article, we
      report a case, and discuss how a patient with suspected shunt nephritis should be
      examined and treated. In addition, to further histological and prognostic
      interpretation, we review the previously reported cases of shunt nephritis in
      Japanese adults.

PMID- 8358119
TI  - Ulcerative colitis in female siblings with an identical human leukocyte antigen
      haplotype (A24, Bw52, DR52 and DQw1).
AB  - Two female siblings with ulcerative colitis are reported. Both the 30-year-old
      elder sister and the 28-year-old younger sister developed bloody stools and
      diarrhea; ulcerative colitis was diagnosed by endoscopic and histologic
      examination of the colon. Their maternal aunt also suffered from the disease.
      Human leukocyte antigen analysis revealed an identical haplotype for the sisters
      (A24, Bw52, DR2 and DQw1), while the aunt had A24, Bw52 and DR2. The haplotypes
      of Japanese patients with familial ulcerative colitis are reviewed, and the role
      of human leukocyte antigens in this disease is discussed.

PMID- 8358120
TI  - Selective IgM deficiency in a patient with Hashimoto's disease.
AB  - A 70-year-old man with Hashimoto's disease had selective IgM deficiency, while
      other immunoglobulin levels were normal. In vitro mixing experiments were carried
      out in which B cells and T cells from the patient and from a healthy control
      donor were co-cultured in the presence of pokeweed mitogen, in order to
      investigate the etiology of IgM hypoproduction. The results indicated that the
      patient had B-cell dysfunction, involving the impairment of B-cell
      differentiation. In addition, both IgG of the healthy control donor and thyroid
      hormone may play important roles in the pathogenesis of this case.

PMID- 8358121
TI  - Fatal angioedema associated with enalapril.
AB  - A 37-year-old female with a history of hypertension for 5 years was brought to
      the emergency room with swelling of the tongue and neck after the second dose of
      enalapril. After administration of hydrocortisone by her physician, she went to
      the emergency room. Her dyspnea and dysarthria were relieved. However, she
      experienced recurrence of the symptoms followed by respiratory arrest. She
      suffered severe anoxic brain damage and died three days later. Although
      angioedema is a rare occurrence with the use of enalapril, it is potentially life
      threatening.

PMID- 8358122
TI  - Sclerosing peritonitis associated with keratoconjunctivitis sicca, pleurisy, and
      secretory otitis media.
AB  - A male case of sclerosing peritonitis of unknown cause, associated with
      keratoconjunctivitis sicca, pleurisy, and secretory otitis media, is presented.
      These unusual complications are very similar to the adverse reactions to the beta
      adrenergic blocking agent, practolol, which is known to cause sclerosing
      peritonitis. This similarity suggests an etiological association between the
      sclerosing peritonitis of this case and that caused by practolol. The sclerosing
      peritonitis of this case may be considered to occur as part of some systemic
      disorder, and thus casts doubt on the hitherto accepted hypothesis that
      sclerosing peritonitis results from infectious peritonitis.

PMID- 8358123
TI  - Lactic dehydrogenase anomaly in a patient with chronic renal failure.
AB  - A 67-year-old man with chronic renal failure (CRF) was defined to have lactic
      dehydrogenase (LDH)-immunoglobulin A (IgA) complex, the so-called "LDH anomaly",
      in his serum and pleural effusion. He was found to have a pleural effusion on the
      right side during maintenance dialysis at a satellite hospital. A LDH-IgA complex
      was detected in the serum and pleural effusion by the method of current
      electrophoresis. The immunoglobulin class was found to be IgA (K) by counter
      immunoelectrophoresis. LDH anomaly is extremely rare in patients with CRF; the
      clinical significance of this substance in serum and pleural effusion remains
      unclarified.

PMID- 8358124
TI  - Progressive external ophthalmoplegia and myositis.
AB  - We reported a senile male patient with progressive external ophthalmoplegia (PEO)
      and myositis. The ophthalmoplegia was severe, but other neuromuscular features
      were nearly normal. Muscle enzymes in serum were moderately elevated. Autoimmune,
      endocrinological or malignant diseases were not observed during the previous 4
      years. Pathology of non-weak limb muscles biopsied twice was consistent with
      active inflammatory myopathy. The ragged-red or cytochrome c oxidase-negative
      fibers, which are a hallmark of mitochondrial myopathy with PEO, were not
      increased in comparison with age-matched control muscles. Analysis of
      mitochondrial DNA in muscle by the Southern blot method did not reveal any
      deletions. It was concluded that the inflammatory myopathy, myositis clinically
      localized at the ocular muscles, is an important and distinct disorder in PEO.

PMID- 8358125
TI  - Silent lupus nephritis with fingerprint deposits.
AB  - A 26-year old woman with diffuse active lupus nephritis showed no proteinuria.
      Electron microscopy revealed a typical fingerprint pattern in glomerular
      subendothelial electron dense deposits. Out of 21 renal biopsy cases of lupus
      nephritis, we found fingerprint deposits in 4 cases (19%) including the present
      case. All of the cases showed diffuse proliferative glomerulonephritis with overt
      proteinuria, except the present case. To our knowledge, the present case is the
      first reported case of active lupus nephritis, where fingerprint deposits were
      found, with normal urinalysis.

PMID- 8358126
TI  - A patient with congenital plasminogen deficiency manifesting primary pulmonary
      hypertension.
AB  - A 25-year-old Japanese man was diagnosed as having primary pulmonary
      hypertension, on the basis of the findings of cardiac catheterization and
      ventilation-perfusion scintiscans. The plasma level of plasminogen in this
      patient was found to be reduced to 43% by a functional assay and 61 mg/l by an
      antigenic assay. Based on the family study, the patient was considered to have a
      heterozygous congenital plasminogen deficiency. Accordingly, it is suggested that
      the defective fibrinolysis in this patient may have played an important role in
      the development of primary pulmonary hypertension through microthrombosis.

PMID- 8358127
TI  - Sleep apnea and palatal myoclonus in a patient with neuro-Behcet syndrome.
AB  - A 50-year-old man with neuro-Behcet syndrome showed truncal imbalance, dementia,
      palatal myoclonus, snoring and rhythmic inspiration synchronized with palatal
      myoclonus. Magnetic resonance imaging showed hypertrophy of the bilateral
      inferior olivary nuclei with slight pontine atrophy. A polysomnographic recording
      disclosed sleep apnea during non-REM sleep: 6% central type, 46% mixed type, and
      48% obstructive type. We speculate that lesions of the respiratory center or
      related structures in the brainstem resulted in sleep apnea and that laryngeal
      myoclonus also affected the apnea.

PMID- 8358128
TI  - Aseptic localized peritonitis in a patient with chemical meningitis associated
      with craniopharyngioma cysts.
AB  - We report a rare case of a young woman with cystic craniopharyngioma who
      developed not only aseptic chemical meningitis as an initial sign but also
      aseptic localized peritonitis which was confirmed by the presence of ascites.

PMID- 8358129
TI  - Increased serum level of interleukin-5 in a patient with episodic angioedema and
      eosinophilia syndrome.
AB  - A case of episodic angioedema and eosinophilia syndrome is reported. An 18-year
      old male suffered from monthly episodes of angioedema, pruritic papules, weight
      gain, and fever for twelve years. During the episodes, peripheral eosinophils and
      serum levels of interleukin (IL)-5, an eosinophil proliferating cytokine were
      elevated. Extensive evaluations disclosed neither visceral involvement nor
      evidence of parasitic infections, collagen diseases, or neoplastic disorders.
      Corticosteroid treatment brought about a dramatic clinical improvement
      concomitant with decrement of eosinophils and serum IL-5 was observed. These
      observations suggest that IL-5 may be a causative factor for this pathological
      state.

PMID- 8358130
TI  - Right ventricular inflow obstruction due to giant hematoma formed by chronic
      constrictive pericarditis.
AB  - A 26-year-old man having chronic constrictive pericarditis with rare
      complications is described. Right ventricular inflow obstruction was caused by an
      intracavity giant mass which was surrounded by thick calcified pericardium. The
      mass consisted of old bloody fluid with some calcified tissue. The findings of
      auscultation closely mimicked those of tricuspid valvular stenosis.

PMID- 8358131
TI  - Treatment of ulcerative colitis with camostat mesilate, a serine protease
      inhibitor.
AB  - We were able to induce and maintain remission with camostat mesilate, a serine
      protease inhibitor, in two patients with ulcerative colitis, to whom
      salicylazosulfapyridine could not be administered due to previous side effects.
      The enzymatic activity of proteases from granulocyte, pancreatic juice and
      bacteria is possibly harmful to the inflamed colonic mucosa. Camostat mesilate
      can be expected to have an anti-inflammatory effect on the damaged mucosa of
      inflammatory bowel disease.

PMID- 8358132
TI  - Imported Plasmodium malariae malaria.

PMID- 8358133
TI  - Depression and the experience of chronic back pain: a study of related variables
      and age differences.
AB  - OBJECTIVE: To document the prevalence of depression and examine the relationship
      between depression and selected pain-related variables associated with chronic
      back pain among elderly and nonelderly samples. DESIGN: Survey with mailed
      questionnaire. SETTING: Patients seeking treatment at a spine diagnostic and
      treatment center. PATIENTS: Consecutive sample of elderly subjects (n = 69).
      Nonelderly subjects (n = 59) were randomly selected to achieve a sample size
      comparable to the elderly. Evaluation of depressed mood was determined by Beck
      Depression Inventory. MAIN OUTCOME MEASURES: Multidimensional Pain Inventory,
      Pain Disability Index, Pain Duration, Work-Related Disability, Medication Use,
      and Pain Severity. RESULTS: A high prevalence of dysphoria was found in both age
      groups. No significant differences were found between age and depressed mood. The
      only significant association between depressed mood and age occurred with pain
      duration, with the elderly experiencing fewer total hours per day in pain.
      Combining age groups, multivariate analysis of variance revealed that dysphoric
      chronic pain patients reported more antidepressant use, greater pain intensity,
      greater interference due to pain, and less life control than the nondepressed
      patients. Interference in activities demonstrated the strongest relationship with
      depressed mood in both age groups. CONCLUSIONS: There is a high prevalence of
      dysphoria in both the elderly and nonelderly with chronic back pain. The
      relationships between pain-related constructs and depressed mood in chronic back
      pain patients are similar in the elderly and nonelderly. The impact of the pain
      experience on the individual's activities, functioning, and feelings of life
      control should be considered in theoretical and clinical explanations of the
      association between pain and depression.

PMID- 8358134
TI  - Predictors of response to pain management treatment. The role of family
      environment and changes in cognitive processes.
AB  - OBJECTIVE: The purpose of the present study was to examine factors that influence
      individual differences in treatment response after multidisciplinary pain
      management. DESIGN: Pre-post assessment design. PATIENTS: 119 chronic pain
      inpatients. MAIN MEASURES: Outcome measures included pain report from the McGill
      Pain Questionnaire, emotional distress from the Symptom Checklist-90 Revised, and
      activity discomfort from the Activity Discomfort Scale. Process measures included
      the Family Environment Scale, the Coping Strategies Questionnaire, and the
      Inventory of Negative Thoughts in Response to Pain. RESULTS: Results indicated
      that pretreatment family environment, cognitive coping strategies, and negative
      thinking accounted for small yet significant proportions of the variance in
      outcome. The proportion of variance accounted for by the changes in cognitive
      coping and negative thinking was somewhat higher. An increase in pain control and
      rational thinking was related to decreases in depression and anxiety, pain
      report, and activity discomfort. Decreases in negative social cognitions were
      related to decreased depression at posttreatment. CONCLUSIONS: Changes in coping
      strategies and negative thinking may be important mechanisms related to
      improvement, or lack of improvement, in a range of outcome measures. Patients
      from families who are controlling and disorganized, and patients high on negative
      thinking at pretreatment may represent high-risk groups in need of further
      individually tailored interventions.

PMID- 8358135
TI  - False-positive rates of cervical zygapophysial joint blocks.
AB  - OBJECTIVE: To determine the false-positive rate of anesthetic blocks of the
      medial branches of the cervical dorsal rami in the diagnosis of cervical
      zygapophysial joint pain. DESIGN: Comparison between single diagnostic blocks,
      and a criterion standard of double-blind, controlled, differential anesthetic
      blocks. SETTING: Tertiary referral center. PATIENTS: The first 55 consecutive
      patients with neck pain for > 3 months after and attributable to a motor vehicle
      accident, and who had completed a second diagnostic block after an initial
      positive response. A total of 60 joints was studied, with five patients providing
      two joints each. The mean age was 41 years; 61% were female. METHODS: Each
      patient had been investigated with radiologically controlled blocks of the medial
      branches of the cervical dorsal rami to anesthetize the target cervical
      zygapophysial joint. The initial block was performed using either 0.5%
      bupivacaine or 2% lignocaine, randomly selected. The duration of pain relief was
      assessed in a double-blind fashion. The procedure was repeated with the
      complementary anesthetic. Only patients experiencing a longer period of pain
      relief from bupivacaine were considered to have true-positive responses. RESULTS:
      The second block failed to relieve pain in two of the tested joints. In a further
      14 joints, the control blocks relieved pain, but the patient failed to correctly
      discriminate the longer acting anesthetic. The remaining 44 joints met the
      criteria for true-positive responses. The false-positive rate of single blocks
      was 16 of 60 or 27% (95% confidence interval 15%, 38%). CONCLUSIONS: Uncontrolled
      diagnostic blocks are compromised by a significant false-positive rate that
      seriously detracts from the specificity of the test.

PMID- 8358136
TI  - Pain clinic records: a comprehensive form and computerized database.

PMID- 8358137
TI  - Combined stellate ganglion and sphenopalatine ganglion block in acute herpes
      infection.

PMID- 8358138
TI  - Head banger's whiplash.
AB  - OBJECTIVE: The current trend in dancing includes "head banging" with extreme
      flexion, extension, and rotation of the head and cervical spine. We suggest that
      dance-related severe pain in the cervical area may result from head banging.
      DESIGN: A cohort of 37 eighth graders ages 13 or 14 participated in a dance
      marathon for charity lasting 7 h. There were 26 girls and 11 boys. SETTING:
      During the dance marathon, three "heavy metal" songs were played during which
      head banging could be done. PATIENTS: The painful syndromes that relate to head
      banging were evaluated by a convenience sample of the 37 marathon dancers in the
      eighth grade. INTERVENTIONS: None. MAIN OUTCOME MEASURES: A self-selected age
      matched control group is included since 17 adolescents participated in head
      banging and 20 did not. RESULTS: Of the head bangers, 81.82% of the girls and
      16.6% of the boys had resultant cervical spine pain that lasted 1-3 days. Only
      26.2% of non-head-banging girls and 0% of non-head-banging boys had cervical
      spine pain lasting 1-3 days. Of all the 8th-grade participants, 62.16% had pain
      somewhere. Other types of pain included leg pain, back pain, and headache. Only
      three adolescents took any medication for their pain. CONCLUSIONS: The head
      banger's whiplash is a self-limiting painful disorder. The easy resolution of the
      pain problem in adolescents is a tribute to the resilience of youth.

PMID- 8358139
TI  - In response to letter by Drs. Clarke, Hill, and Barnes.

PMID- 8358140
TI  - In response to RSD article by Dr. Ochoa.

PMID- 8358141
TI  - In response to RSD editorial by Dr. Wilson.

PMID- 8358142
TI  - Errors and artifacts.

PMID- 8358143
TI  - McGill Pain Questionnaire translated into Danish: experimental and clinical
      findings.
AB  - OBJECTIVE: To develop a methodology for translating the McGill Pain Questionnaire
      (MPQ) into a Danish version, and to make comparisons to studies of patients
      speaking other languages. DESIGN: Finding suitable Danish adjectives using the
      same methodology as that in the original MPQ. Comparison of Danish descriptors to
      the words in the English version of MPQ. Survey in healthy subjects and patients
      with rheumatoid arthritis (RA) and fibromyalgia (F). SETTING: The general public
      and hospital outpatients. PATIENTS: A random sample of 186 healthy volunteers, 20
      patients with rheumatoid arthritis and 41 patients with fibromyalgia. MAIN
      OUTCOME MEASURES: Danish words translated as closely as possible to the
      descriptors in the original McGill Pain Questionnaire. A pain-assessment
      instrument making international pain description possible. RESULTS: A Danish
      version of the McGill Pain Questionnaire was developed with scale values of
      Danish descriptors not differing more than 5 x SEM from the 'patient' words in
      the English version. The subdivision into classes and subclasses was respected.
      In the reliability experiment, the same rank values were found in 85% of
      subclasses. In a study using two experimental pain stimulus intensities, seven of
      10 subjects obtained higher MPQ scores following the high-intensity stimulus. In
      the clinical study, the pain profiles of patients with RA and F in English,
      Italian, and Danish patients were almost the same. CONCLUSION: The present
      methodology of translating the McGill Pain Questionnaire permits comparison of
      studies from English-speaking and non-English-speaking populations, thus
      facilitating international research exchange.

PMID- 8358144
TI  - Physiological correlates of painful stimulation in preterm infants.
AB  - OBJECTIVE: The study investigates the physiological responses of preterm infants
      to procedures that are routinely performed in intensive care nurseries. Changes
      in heart rate, respiration rate, and oxygen saturation were examined as
      indicators of the level of discomfort experienced by the infant during the
      procedures. DESIGN: Clinical descriptive. Systematic observations of the infants
      were conducted during periods of rest as well as during routine interventions.
      SETTING: All observations were recorded from monitored preterm infants in the
      intensive care units of two urban hospitals. PATIENTS: Thirty-five preterm
      infants 24-30 weeks gestational age and weighing < 2,000 g at birth. Data were
      collected from all infants in the units who met the weight criterion.
      INTERVENTIONS: The researchers observed the infants while the intensive care
      nursery staff were performing routine care procedures. Observations were made
      during procedures that adults would consider to be painful, such as injection,
      heel stick, tape removal, and squeezing of the heel to induce blood flow after
      heel stick, as well as nonpainful procedures, such as handling, temperature
      taking, alcohol swabbing, patting, taping a tube, feeding, and placing a
      pacifier. MAIN OUTCOME MEASURES: Heart rate, respiration rate, and oxygen
      saturation were recorded from infant monitors. Mean values of the three measures
      during procedures were compared with mean values before and after procedures.
      RESULTS: Significant differences (p < 0.001) were found among pre-, peri-, and
      post-procedures for all three outcome measures. Heart rate and respiration rate
      means were significantly (p < 0.001) higher during procedures that adults
      consider to be painful than in those regarded as nonpainful. Oxygen saturation
      was lower (p < 0.001) for painful procedures than for nonpainful procedures.
      Gender and infant size comparisons yielded inconclusive results. CONCLUSION: The
      outcome measures appear to be reliable indices of preterm infant responses to
      painful stimulation.

PMID- 8358145
TI  - Strategies for coping with pain and psychological distress associated with
      temporomandibular joint osteoarthrosis and internal derangement.
AB  - OBJECTIVE: To analyse the relationship among a variety of emotional, cognitive,
      and behavioral coping strategies and pain/suffering and psychological distress in
      patients with temporomandibular joint (TMJ) pain. DESIGN: Cross-sectional,
      correlational study. SETTING: Department of Oral and Maxillofacial Surgery,
      University Hospital Groningen. SUBJECTS: A consecutive sample of 53 patients with
      a mean age of 25 with TMJ osteoarthrosis and internal derangement or synovitis
      without internal derangement. There were seven men and 46 women. No patient was
      excluded. MAIN OUTCOME MEASURES: Pain/suffering was assessed using the West Haven
      Yale Multidimensional Pain Inventory and visual analogue scales. Psychological
      distress was assessed by the General Health Questionnaire and the Symptom
      Checklist. Coping with pain was assessed by the Coping with Specific Symptoms
      Questionnaire. RESULTS: Psychological distress and pain severity were low, and
      there was little interference by pain with daily life. While none of the coping
      strategies were frequently used, these strategies did explain a significant
      proportion of the variance in pain and psychological distress measures (27-58% of
      the variance). Stepwise regression analysis showed that patients scoring high on
      expression of emotions and wishful thinking had significantly higher levels of
      pain/suffering and psychological distress. CONCLUSIONS: Previous studies of other
      subgroups of patients with temporomandibular disorders (TMDs) report higher
      degrees of psychological distress. The need to distinguish between specific
      subgroups of patients with TMD is emphasized by the results of this study.
      Cognitive-behaviorial interventions to improve ways of coping is not very useful
      for the subgroup in this study.

PMID- 8358146
TI  - N-glycosylation in trypanosomatid protozoa.
AB  - Trypanosomatid protozoa are parasites of considerable medical and economic
      importance in developing countries. The pathway leading to N-glycosylation in
      these microorganisms is characterized by the following features: (i) dolichols
      are composed of only 10-13 isoprene units; (ii) oligosaccharides transferred in N
      glycosylation have the compositions Man(6,7,9)GlcNAc2, depending on the species;
      (iii) trypanosomatids are unable to synthesize dolichol-P-Glc and, in addition,
      some species lack certain dolichol-P-Man-dependent mannosyltransferases; (iv) the
      oligosaccharyltransferase does not require the presence of glucose units in the
      oligosaccharide in order to catalyse an efficient transfer reaction; (v)
      trypanosomatids have a glucosidase II-like enzyme, but lack glucosidase I; (vi)
      glucosidase II is required for deglucosylation of oligosaccharides glucosylated
      by the UDP-Glc:glycoprotein glucosyltransferase, an activity first detected in
      those parasites; (vii) the structures of polymannose-type compounds in these
      protozoa have no significant differences with those of their mammalian
      counterparts except for the presence, in certain species, of oligosaccharides
      having galactofuranose units linked to external mannose residues; (viii)
      biantennary complex-type oligosaccharides having in some cases terminal alpha
      linked galactose units or poly-N-acetylactosamine extensions, but lacking sialic
      acid units, have been described in Trypanosoma brucei; (ix) complex-type
      oligosaccharides having alpha-linked galactose, fucose and sialic acid residues
      have been described in Trypanosoma cruzi. In this parasite, addition of sialic
      acid units to glycoproteins and glycolipids is mediated by a trans-sialidase
      located on the external surface of the parasite and not by an intracellular CMP
      sialic acid-dependent sialyltransferase.

PMID- 8358147
TI  - Sialic acids as important molecules in the regulation of the immune system:
      pathophysiological implications of sialidases in immunity.

PMID- 8358148
TI  - O-linked fucose and other post-translational modifications unique to EGF modules.
AB  - Three types of unusual post-translational modification have been found within
      conserved amino acid sequences in epidermal growth factor homology regions (EGF
      modules) of some multidomain proteins. beta-Hydroxyaspartate and beta
      hydroxyasparagine are found within -Cys-Xxx-Asp/Asn-Xxx-Xxx-Xxx-Xxx-Tyr/Phe-Xxx
      Cys-Xxx-Cys- sequences. (Xyl alpha 1-->3)Xyl alpha 1-->3Glc beta 1-->O-Ser
      glycans at conserved sites within -Cys-Xxx-Ser-Xxx-Pro-Cys- sequences have been
      reported in several proteins. Fuc alpha 1-->O-Thr/Ser modifications have been
      found at conserved sites within -Cys-Xxx-Xxx-Gly-Gly-Thr/Ser-Cys- sequences. More
      recently, it has been discovered that the Ser residue corresponding to the
      potential O-fucosylation site in human factor IX carries the novel
      tetrasaccharide NeuAc alpha 2-->6Gal beta 1-->4GlcNAc beta 1-->3Fuc alpha 1-->O
      Ser; this tetrasaccharide can be considered to be an extension of the Fuc alpha 1
      ->O moiety. The consensus sequences for these post-translational modifications
      are in close proximity to each other; e.g. human factor IX has all three unusual
      modifications within a 12 amino acid linear sequence. In proteins with multiple
      EGF modules, the O-glycosidic modifications have been found only within the N
      terminal EGF module; beta-hydroxyaspartate/asparagine residues are not restricted
      in the same fashion. Little is known yet about the functions of, or possible
      relationships between, any of these modifications.

PMID- 8358149
TI  - Human non-secretory ribonucleases. I. Purification, peptide mapping and lectin
      blotting analysis of the kidney, liver and spleen enzymes.
AB  - Human non-secretory neutral ribonucleases (RNases) from kidney, liver and spleen
      have been purified and characterized. SDS-PAGE indicates that all three RNases
      are highly purified and have apparent mol. wts of 17-18 kDa. Kinetic analysis
      indicates that all three RNases have a broad pH optimum centred around 6.5, and
      all three have similar substrate specificities with significant preference for
      RNA and poly(U) when compared to poly(C), poly(A) and poly(G). All of the above
      data, as well as immunoblotting data using three polyclonal antibodies (anti
      human liver RNase, anti-human pancreatic RNase, anti-human eosinophil-derived
      neurotoxin), indicate that the three proteins are highly purified and are non
      secretory RNases (IIN). Further characterization by cyanogen bromide peptide
      mapping and extensive lectin blotting indicated no significant differences
      between the three human RNases. All three RNases appear to have very similar, if
      not identical, protein backbones and all three are glycoproteins which are
      recognized by lectins with specificity for GlcNAc, Fuc and, to a lesser extent,
      with specificity for Gal beta(1-4)GlcNAc. No significant tissue-specific
      differences were found among the three human non-secretory RNases.

PMID- 8358150
TI  - Human non-secretory ribonucleases. II. Structural characterization of the N
      glycans of the kidney, liver and spleen enzymes by NMR spectroscopy and
      electrospray mass spectrometry.
AB  - The N-glycans have been removed by peptide-N-glycosidase F (PNGase F) from
      purified human non-secretory RNases derived from kidney, liver and spleen. The
      spleen RNase was purified by two procedures, one of which did not include the
      usual acid treatment step (0.25 M H2SO4, 45 min, 4 degrees C), to determine if
      acid treatment alters the carbohydrate moieties. The N-glycans of the RNases were
      fractionated by Bio-Gel P-4 chromatography and analysed by 600 MHz 1H-NMR
      spectroscopy and electrospray mass spectrometry. All four non-secretory RNase
      preparations contained the following structures: [formula: see text] The relative
      amounts of the trisaccharide, pentasaccharide and hexasaccharide appeared to vary
      slightly in the different tissue RNases. The overall results indicate: (i) that
      acid treatment during purification does not alter the N-glycans of non-secretory
      RNases; (ii) that the N-glycans from kidney, liver and spleen non-secretory
      RNases are very similar, if not identical, to one another, but different from the
      N-glycan structures reported for secretory RNase.

PMID- 8358151
TI  - Structural characterization of novel inositol phosphosphingolipids of
      Tritrichomonas foetus and Trichomonas vaginalis.
AB  - Two major ethanolamine phosphate-substituted inositol phosphosphingolipids have
      been identified in the unsaponifiable acidic lipid fractions of Tritrichomonas
      foetus and Trichomonas vaginalis. The compounds were radiolabelled and purified
      by high-performance thin-layer chromatography followed by high-performance liquid
      chromatography. The structures were determined by a combination of tandem mass
      spectrometry (MS/MS) and nuclear magnetic resonance (NMR) experiments, and gas
      liquid chromatography of components obtained by degradation and derivatization.
      Inositol in the T. foetus component was 1-linked to the phosphosphingolipid, had
      the phosphoethanolamine group at the 3-position and a fucosyl residue at the 4
      position. The T. vaginalis component lacked the fucosyl moiety. Both organisms
      also produced inositol phosphosphingolipids having the same long-chain base
      (sphingosine or dihydrosphingosine) and the same fatty acyl distribution as the
      inositol diphosphate compounds. These glycosphingolipids may represent metabolic
      intermediates for new types of membrane anchors for surface glycopeptides or
      glycolipids that mediate the host-parasite relationship of these trichomonads.
      The MS/MS and NMR spectroscopic data should provide reference information for
      structural determinations of other phosphorylated inositol derivatives.

PMID- 8358152
TI  - Mode of interaction between platelet factor 4 and heparin.
AB  - Platelet factor 4 (PF4) is a platelet-derived protein capable of binding to, and
      thus neutralizing, the biological activities of heparin and heparan sulphate. The
      mode of binding of PF4 to heparin was investigated in a comparative study also
      involving antithrombin (AT; previously shown to selectively bind a specific
      oligosaccharide sequence) and fibronectin (FN; non-specific electrostatic
      interaction). Heparin-derived saccharides were incubated with each of the three
      proteins, followed by separation of free and protein-bound carbohydrate on a
      nitrocellulose filter. The interaction systems involved either (i) competition
      for the protein ligand between 3H-labelled heparin and unlabelled, size
      fractionated heparin oligosaccharides (isolated after deaminative cleavage with
      HNO2) or (ii) direct binding of 3H-labelled oligosaccharides. Species smaller
      than octasaccharides were unable to bind AT, whereas binding to FN and PF4
      increased continuously throughout the series, with increasing size of the
      oligosaccharides. Further separation by anion-exchange chromatography showed that
      the PF4-binding and FN-binding octasaccharides represented essentially all
      components present in the initial octasaccharide fraction, the proportion of
      binding species increasing with charge (hence with the degree of sulphation). The
      AT-binding octasaccharides, on the other hand, selectively represented only a few
      of the total octasaccharide components, without any correlation to overall
      charge. These results indicate that the binding of PF4 to heparin occurs by
      relatively non-specific electrostatic interactions. The methodology delineated
      here may be generally useful in assessing specificity in glycosaminoglycan
      protein interactions.

PMID- 8358153
TI  - Spermatozoa-like cell invaders (nuclear vlimata) in human neoplasia.
AB  - Spermatozoa-like cells (nuclear vlimata) have been identified in malignant cell
      cultures and embryonic cells, also common in the cytology and histology of all
      types of human neoplasia even after chemotherapy. A new mechanism of invasion of
      malignant cells has been described, according to which neoplastic cells behave
      and function as parasites using host-cells to divide, survive and eventually
      produce nuclear vlimata (bullets). Nuclear vlimata are the end cell products of
      incomplete, unequal, assymetrical division of neoplastic cells. The nuclear vlima
      exhibits similar morphology to spermatozoa and virus (head with, or without,
      tail) and invades the cytoplasm and/or nucleus of surrounding host-cells by a
      similar mechanism to sperm-oocyte interaction (fertilization) or viral cell
      infection, in the events of nuclear vlima-->tumor-->nuclear vlima-->tumor. The
      nuclear vlima head contains and transfers DNA, and when incorporated into the
      host-nucleus is indistinguishable from nucleoli and when in the cytoplasm is
      similar to sperm pronucleus, observed after sperm penetration of the oocyte.
      Function of nuclear vlimata is directly dependent on the specific extracellular
      matrix produced by malignant cells, consisting of glycosaminoglycans-protease
      membranes. This mechanism of invasion constitutes the link of all scientific
      information concerning human neoplasia.

PMID- 8358154
TI  - A comparative immunohistochemical study of phaeochromocytomas and paragangliomas.
AB  - There is no definite morphological distinction between phaeochromocytomas and
      paragangliomas. We, therefore, attempted to determine the universality and
      differential utility of a panel of tumour markers for diagnosis in formalin
      fixed, paraffin-embedded specimens. Antibodies to neuron-specific enolase (NSE),
      chromogranin, synaptophysin, Leu-7, neurofilaments, cytokeratins,
      carcinoembryonic antigen (CEA), melanoma antigen HMB-45, S-100 protein and glial
      fibrillary acid protein (GFAP), were used on 11 phaeochromocytomas and 8
      paragangliomas. NSE reactivity was detected in 10 phaeochromocytomas and in all
      paragangliomas. Chromogranin reactivity was found in all but two cases (one
      phaeochromocytoma and one paraganglioma). Synaptophysin reactivity was present in
      10 phaeochromocytomas and in the 8 paragangliomas. Ten phaeochromocytomas stained
      for Leu-7, but none of the paragangliomas did. S-100-positive cells
      (sustentacular or type II cells) were found in 8 phaeochromocytomas and 7
      paragangliomas. GFAP stained sustentacular cells of only one paraganglioma. Only
      in 5 phaeochromocytomas was there a focal reaction by neurofilaments.
      Cytokeratins, CEA and HMB-45 were never detected. We conclude that NSE,
      chromogranin, synaptophysin and S-100 protein are useful markers of both types of
      tumour, whereas GFAP staining is limited to a small number of these neoplasms.
      Leu-7 reactivity seems to favour diagnosis of phaeochromocytoma rather than
      paraganglioma, but further studies with larger series are needed to confirm this.
      Unlike previous reports, we did not find cytokeratin or HMB-45 immunostaining in
      any case.

PMID- 8358155
TI  - Evaluation of volume-weighted mean nuclear volume in endometrial lesions.
AB  - The individual nuclear size was studied in three groups of endometrial samples
      (simple hyperplasia -SH-, atypical hyperplasia -AH-, and well-differentiated
      adenocarcinoma -WDA-). The application of recent semiquantitative systems in
      combination with stereological methods permits a simple, quick and unbiased
      estimation of the volume-weighted mean nuclear volume vv(nucl). We have found an
      increase in the vv(nucl) from SH to AH to WDA. There are significant differences
      between the mean of the three groups (p < 0.01). The variance associated with
      estimates of vv(nucl) is mainly provided by differences among lesions; i.e.
      patients. This capacity for discriminating may be associated with gland and lumen
      endometrial quantification to improve the correct diagnosis of endometrial
      samples.

PMID- 8358157
TI  - Fibronectin expression in cancer tissues from patients undergoing radiation
      therapy.
AB  - Fibronectin expression and distribution were examined in cancer tissues from 19
      patients with cancer of the head and neck regions. Samples taken before and after
      irradiation of approximately 10 Gy, 20 Gy or 30 Gy were analyzed by the avidin
      biotin-horseradish peroxidase method using mouse monoclonal antibodies against
      human fibronectin. The results were correlated with the patient's prognosis after
      radiation therapy. No remarkable changes in the fibronectin expression or
      distribution were found between tissue specimens taken before and after each dose
      of irradiation. The prognosis, however, varied according to the degree of
      expression and the distribution pattern of fibronectin. Seven patients in which
      the cancer tissue was encircled by a thick fibronectin network are still alive
      without recurrence 4.5-6 years after treatment, whereas 6 patients in which
      fibronectin was only faintly expressed or focally distributed died or developed
      recurrence soon after treatment. The present findings demonstrate that
      fibronectin expression and distribution in cancer tissue are intimately related
      to the patient's prognosis, and that the analysis of these two parameters is
      applicable as a predictive assay in radiotherapy of cancer of the head and neck
      regions.

PMID- 8358156
TI  - Ultrastructural changes induced by anabolic steroids in liver of trained rats.
AB  - The effects of anabolic steroid treatment in association with endurance training
      on biochemical serum parameters and liver ultrastructure have been investigated
      in male rats. Values of serum alanine aminotransferase, aspartate
      aminotransferase and alkaline phosphatase were not significantly affected by
      administration of high doses of fluoxymesterone or methylandrostanolone. Electron
      microscopic examination of hepatic tissue from treated animals revealed
      ultrastructural alterations of hepatocytes. The most prominent changes were
      swelling of mitochondria, which presented electron-lucent matrix and slightly
      defined cristae, and a marked increase in the number of lysosomes. These changes
      were evident in both sedentary and trained treated rats, indicating that liver
      cell damage is produced by anabolic-androgenic steroids despite the simultaneous
      realization of physical exercise. The alterations observed were not detected by
      means of conventional biochemical liver tests.

PMID- 8358159
TI  - Fusion mechanism of the myoblasts in the myotome of the chick embryo.
AB  - We have studied the fusion process of myoblasts in the mytome corresponding to
      H.H. stages 22, 23 and 24 from calcitonin-treated chick embryos and their
      untreated controls. The micrograph images of this process were studied to detect
      the ultrastructural changes in myoblast morphology that could be associated with
      the known hormonal and biochemical changes that take place in preparation of
      fusion. Once actin and myosin myofilament differentiation and sarcomerogenesis
      had begun, the myotome myoblasts fused in bundles of 10-14 myoblasts, and the
      following was observed during this process: plasmatic membrane interdigitation
      and invagination; the appearance of cytoplasmic flaps covering other myoblasts
      and fading at the point of contact; plasmatic membranes that fade and
      disintegrate; membrane rupturing; double closed lamina; small ringed lamina;
      large disperse vesicles; small vesicles (liposomes), and semi-dense amorphous
      material. Seven stages were established: 1--Membrane rupture; 2--Double closed
      and elongated lamina; 3--Small ringed lamina aligned lengthwise; 4--Large
      dispersed vesicles; 5--Imprecise boundaries with amorphous material in diffuse
      areas; 6--Cytoplasm fusion; and 7--Prefunctional syncitium. Answers to the
      questions: "how", "when", "where", "why" and "for what purpose" the fusion of
      myoblasts takes place are suggested.

PMID- 8358158
TI  - Matrix changes during long-term cultivation of cartilage (organoid or high
      density cultures).
AB  - In high density (organoid or micromass) cultures of prechondrogenic mesenchymal
      cells from limb buds of 12-day-old mouse embryos typical cartilaginous tissue
      develops after 3 days. Immunomorphological investigations have shown that it
      contains the typical components of the cartilaginous matrix, such as collagen
      type II and cartilage-specific proteoglycans. After a 2-week cultivation period
      hypertrophic cartilage cells develop to an increasing extent. Many of these cells
      as well as normal chondroblasts detach from the matrix from the 2nd week in vitro
      onwards to assume a fibroblast-like appearance. At the same time thick (25-65 nm)
      collagenous fibrils occur at the surface of these cells. These thick fibrils
      contain collagen type I, as shown by immunomorphology. Hence, in these older
      cartilage cultures chondroblasts change their synthesis programme or direction of
      differentiation. Consequently, a model for the study of "dedifferentiation" of
      cartilage and possibly also transformation of cartilage cells to osteoblasts has
      become available.

PMID- 8358160
TI  - Further histological observations on popliteal lymph nodes after interruption of
      the afferent lymphatic vessels.
AB  - Lymphatic vessels afferent to the popliteal nodes in young adult rats and guinea
      pigs were interrupted at the lowest edge of the popliteal fossa, and regressive
      changes in the nodes occurring 4 to 16 or 18 weeks after surgery were re-examined
      histologically. In the rat, some popliteal nodes were drained by lymphatic
      channel(s) from the tail. After surgery, the popliteal nodes without lymphatic
      channel(s) from the tail underwent regression of all their constituent deep
      cortical units and also the peripheral cortex comprising lymph follicles, until
      at 18 weeks, the lymphoid organization of the node reached a minimal level. On
      the other hand, in popliteal nodes having a lymphatic channel from the tail, some
      deep cortical units and the overlying peripheral cortex underwent hypotrophy,
      leaving the remaining units and their overlying peripheral cortex little
      affected. In the guinea pig, the treated nodes underwent progressive atrophy and
      ultimately became rudimentary, or even vanished, after 16 weeks. Treated
      rudimentary nodes were composed largely of stromal cells only, and these were
      replaced to a various extent by fat. The present results are discussed in
      relation to complete and incomplete inhibition of the afferent lymph flowing into
      the surgically treated nodes.

PMID- 8358161
TI  - Nuclear morphometry lacks prognostic value in squamous cell carcinoma of the
      oesophagus.
AB  - In order to determine the possible influence in oesophageal squamous cell
      carcinoma of nuclear measurements on patients' postoperative survival and on
      various histological tumour features, we performed a nuclear morphometry study on
      53 patients (50 males, 3 females) with a mean age of 57.4 years (37-79). A
      statistical correlation was revealed between area, perimeter and diameter and the
      analysis was, therefore, performed only in terms of nuclear area. No influence of
      nuclear area on postoperative survival was observed. Nor was a relationship found
      between mean nuclear area and either involvement of the oesophageal wall or
      degree of histological differentiation. The tumours showing expansive growth had
      a larger mean nuclear area than those of the infiltrative growth type, although
      differences did not reach statistical significance. The nuclear area standard
      deviation (reflecting anisocytosis of the tumour) showed no correlation with
      survival. In conclusion, our data do not support that measurement of nuclear
      parameters by static methods is of any prognostic value in surgically-treated
      squamous cell carcinoma of the oesophagus.

PMID- 8358162
TI  - Immunocytochemical distribution of serotonin and neuropeptide Y (NPY) in mouse
      adrenal gland.
AB  - By the use of immunocytochemical staining methods, we studied the morphology and
      distribution of 5HT and NPY immunoreactive cells and fibres in the mouse adrenal
      gland. The 5HT-immunoreactive cells were numerous and widely localized in the
      medullar tissue. These cells were arranged in three cellular types with regard to
      their morphological and immunocytochemical features. One of them showed cells
      with polygonal shape, being intensified like the typical medullary chromaffin
      cells. These immunoreactive cells were observed arranged in medullar islets. The
      second 5HT-immunoreactive cellular type was constituted by cells with polygonal
      shape and strong immunoreactivity. The third one was formed by cells with
      immunoreactive prolongations. We found some islets of chromaffin non
      immunoreactive cells surrounded by immunostained cells. We also observed some 5HT
      immunoreactive nerve fibres in the medullar tissue. NPY-like immunoreactivity was
      detected in both chromaffin and ganglion cells in adrenal medulla. NPY-like
      immunoreactivity was also detected in nerve fibres at cortical level. In a few
      cases, we observed medullar 5HT- and NPY-immunoreactive tissue in the adrenal
      cortex (monotremas).

PMID- 8358163
TI  - Ultrastructural alterations of the rat intestinal epithelium fed with polymeric,
      oligopeptidic or elementary full diet, following starvation.
AB  - In this study the ultrastructure of rat jejunal epithelial cells was examined,
      following a starvation period of 72 hours and an enteral refeeding period of 12
      days, with either Nutrison, Pepti 2000, or Nutri 2000. Most changes occurred in
      the animals examined immediately after the 72-hour starvation period; these
      mainly included a significant decrease in microvilli population, occasional cell
      membrane disintegration, and a usual microvesicular appearance and degranulation
      of the rough endoplasmic reticulum. No alterations were found in the normally-fed
      animals (control group). This was also practically the same for the Pepti 2000
      group. In the Nutrison group, a small amount of changes were found, while in the
      Nutri 2000 group many alterations were detected, which nevertheless were fewer
      than in the starved animals. The results demonstrate that the micromorphological
      alterations of the intestinal epithelium caused by starvation improve faster when
      an oligopeptidic formula is provided, which consequently results in faster and
      better absorption of the nutrients.

PMID- 8358164
TI  - Histomorphometric analysis of the reticulum of the sheep during development.
AB  - Histomorphometric and scanning electron microscopic analysis were performed on 74
      embryos and foetuses and on 20 sheep (early post-natal to adult age).
      Histodifferentiation of the reticulum took place at 33 days of foetal life.
      Reticular ribs were observed as evaginations of the epithelial stratum
      germinativum at 64 days. Neutral mucopolysaccharides first appeared in epithelial
      cells at 46 foetal days, thereafter to decrease gradually in number, subsequently
      stabilising in postnatal life. Acid mucopolysaccharides, mucins and mucoid
      compounds were not detected. Growth curves and formulae were constructed for each
      tissue layer. Initial test involved multiplicative (y = axb), linear (y = a+bx)
      and polynomial model (y = a+b+cx2+dx3).

PMID- 8358165
TI  - The ileocaecal junction.
AB  - The ileocaecal junction remains a controversial region of the gut. There are
      still a lot of questions concerning its anatomical structure and function. In
      this review, a concise overview is given of the recent and older literature on
      the embryology, anatomy, including the intrinsic and extrinsic innervation, and
      the pharmacology of this region. Based on the available data from the literature,
      evidence is accumulating for a sphincteric function.

PMID- 8358166
TI  - Origin and differentiation of gut endocrine cells.
AB  - The epithelium of the digestive tract contains endocrine cells which produce
      serotonin and an array of regulatory peptides. It is now irrefutably established
      that gut endocrine cells are not of neural crest nor even of neurectodermal
      origin. Furthermore, the proposal that they might originate from neuroendocrine
      programmed epiblast has been retused by recent evidence that they share the
      endodermal stem cell pool with the other epithelial cells of the gut. Based on
      the available evidence, a working hypothesis for the differentiation of gut
      endocrine cells has been developed. It is proposed that initially the developing
      gut acquires an underlying tendency to differentiate into intestine: the endoderm
      has the potential to form a wide range of endocrine cell types. A little later,
      some influence operative over the length of the presumptive gut imposes a
      regionally specific pattern on the tract. This process concerns morphogenesis and
      pre-selection of the range and proportions of the endocrine cell types.
      Thereafter, the mesenchyme feeds to the endoderm confirmatory signals reinforcing
      this pre-selected regional pattern of endocrine cells. Once the different
      endocrine cell types have started to differentiate, their maturation is effected
      by circulating factors which include glucocorticoid hormone: this process is
      mediated by the mesenchyme. Other factors concerned at various stages of gut
      endocrine cell differentiation could be other hormones, growth factors and or
      components of extracellular matrix: such factors are still untested in this
      context.

PMID- 8358167
TI  - Chemocytoarchitecture of the rat locus ceruleus.
AB  - I shall elaborate on the cytochemical classifications of the rat locus ceruleus
      (LC) and state how each of these could be identified. In the LC, 80%
      (1,309/1,642) of the noradrenergic (NA) neurons are also GABAergic. This is found
      by demonstrating that two immunoreactivities coexist in adjacent sections
      alternately immunostained by anti-TH or anti-GABA antibody. Pharmacological
      manipulations with pargyline (75 mg/kg, i.p., 2 h prior to perfusion) and L
      tryptophan (150 mg/kg, 1.5 h prior to perfusion) revealed 5-HT-like
      immunoreactivity (5-HT-LI) in most LC cells (masked 5-HT cells) that produce 5-HT
      but not other indoleamines. If 5-HTP is applied instead of tryptophan, 5-HT-LI is
      shown by the raphe nuclei and a few LC cells (masked indoleamine cells) in the
      marginal zone. Anti-GAD antibody reveals GAD-LI in 32% of GABA neurons
      predominantly in the dorsal division. In situ hybridization studies detected
      tryptophan hydroxylase mRNA and GAD mRNA in many small- and medium-sized neurons.
      It is concluded that the LC consists mostly of an NA population that is possibly
      synthesizing multiple transmitters, such as GABA, GAD and 5-HT in single neurons
      so that the system enables the LC simultaneously to innervate the entire CNS.

PMID- 8358168
TI  - N-ethyl-N-nitrosourea-induced prenatally lethal mutations define at least two
      complementation groups within the embryonic ectoderm development (eed) locus in
      mouse chromosome 7.
AB  - Two loci [l(7)5Rn and l(7)6Rn] defined by N-ethyl-N-nitrosourea (ENU)-induced,
      prenatally lethal mutations were mapped by means of trans complementation crosses
      to mice carrying lethal deletions of the albino (c) locus in Chromosome (Chr) 7.
      Both loci were found to map to the subregion of the Mod-2-sh-1 interval that
      contains the eed (embryonic ectoderm development) locus, eed has been defined by
      the inability of embryos homozygous for certain c deletions to develop beyond the
      early stages of gastrulation. Evidence for at least two loci necessary for normal
      prenatal development, rather than one locus, that map within the eed interval
      came from the observation that two prenatally lethal mutations, 3354SB
      [l(7)5Rn3354SB] and 4234SB [l(7)6Rn4234SB], could complement each other in trans,
      but could not each be complemented individually by c deletions known to include
      the eed locus. A somewhat leaky allele of l(7)5Rn [l(7)5Rn1989SB] was also
      recovered, in which hemizygotes are often stillborn and homozygotes exhibit
      variable fitness and survival. The mapping of the loci defined by these mutations
      is likely to be useful for genetic, molecular, and phenotypic characterization of
      the eed region, and mutations at either locus (or both loci) may contribute to
      the eed phenotype.

PMID- 8358169
TI  - A new Pax gene, Pax-9, maps to mouse chromosome 12.
AB  - Members of the Pax gene family have recently been shown to play important roles
      in mouse embryogenesis. Of eight so far characterized Pax genes, three have been
      associated with mouse developmental mutants. Here we report the cloning of a new
      Pax gene, Pax-9. Most of the DNA sequence encoding the highly conserved paired
      domain has been determined and compared with previously known paired domains.
      This comparison classifies Pax-9 as a member of the same subgroup as Pax
      1/undulated. By analysis of the segregation of a Pax-9 restriction fragment
      length polymorphism and a large number of simple sequence length polymorphisms in
      an interspecific C57BL/6 x Mus musculus mollosinus backcross, Pax-9 was mapped
      close to the D12Nds1 locus on the proximal part of Chromosome (Chr) 12.

PMID- 8358170
TI  - Genome mapping by arbitrary amplification of yeast artificial chromosomes.
AB  - Several methods have been described for using the polymerase chain reaction (PCR)
      to isolate fragments of DNA for genome mapping. We have developed an approach for
      isolating discrete fragments by amplifying DNA with single oligonucleotides (10
      mers) with arbitrarily selected sequences. The method is rapid and technically
      simple. We isolated fragments from a contig of three yeast artificial chromosomes
      (YACs) from the human Xq28 chromosomal region. We purified YACs yWXD37, yWXD348,
      and yWXD705 from a preparative pulsed field gel. Amplifications of each YAC were
      performed with single 10-mers as the PCR primers and the products were visualized
      on agarose gels. These fragments have been successfully used as hybridization
      probes against Southern blots containing the YACs and against blots containing
      human genomic DNA and somatic cell hybrids containing Xq28 as their only human
      constituent. The results have been concordant with the known order of the YACs.
      We have also successfully combined 10-mers with primers derived from vector arm
      sequences to isolate YAC ends. We discuss several uses of this method in
      comparative mapping and in filling in gaps in physical and genetic maps.

PMID- 8358171
TI  - The positions of 12 simple sequence repeat markers relative to reference loci on
      mouse chromosome 16.
AB  - The genetic map positions of 12 simple sequence repeat (SSR) markers spanning
      mouse Chromosome (Chr) 16 were determined relative to reference markers on that
      chromosome. Interval mapping data were obtained with a panel of DNAs from two
      intersubspecific backcrosses. All but one of the markers were typed by us of
      nonradioactive polymerase chain reaction (PCR) products analyzed on agarose gels.
      The marker order was determined to be Prm-1, D16Mit9, Igl-1, D16Mit29,
      D16Mit1/D16Mit2, Smst, D16Mit4, D16Mit11, Gap43, D16Mit14, D16Mit30, D16Mit5, Pit
      1, D16Mit27, D16H21S16 (formerly D21S16h), D16Mit19, App, D16Mit7, Sod-1. Two of
      these markers mapped to the known human Chr 21 (HSA21)/Chr 16 conserved linkage
      group. Nine additional SSR markers could not be typed because they were not
      polymorphic (four markers), did not amplify MOLD/Rk DNA (three markers), or
      failed to give PCR products under a range of conditions (two markers). A subset
      of the most robust SSRs provide a useful marker set for the analysis of
      previously unmapped crosses.

PMID- 8358173
TI  - Construction of a large-insert yeast artificial chromosome library of the mouse
      genome.

PMID- 8358172
TI  - Chromosomal localization of HSP70 genes in cattle.
AB  - Five genomic clones representing three HSP70 genes of cattle were biotin labeled
      and independently hybridized to cattle chromosomes. Fluorescence in situ
      hybridization localized HSP70-2 to Chromosome (Chr) 23 band 22 (the BoLA region),
      HSP70-3 to Chr 10 band 34, and HSP70-4 to Chr 3 band 13. Since HSP70-1, a fourth
      HSP70 gene, is tightly linked with HSP70-2 and the BOLA, HSP70-1 was also
      localized to Chr 23 band 22. The localization of HSP70-4 is the first assignment
      of a cattle U6 marker; thus, this entire syntenic group is tentatively placed in
      cattle Chr 3.

PMID- 8358174
TI  - Striking conservation of the brain-specific region of the dystrophin gene.

PMID- 8358176
TI  - Localization of the inhibin beta B gene on mouse chromosome 1.

PMID- 8358175
TI  - The serotonin 5-HT1B receptor subtype (Htr1b) gene maps to mouse chromosome 9.

PMID- 8358177
TI  - Emk, a protein kinase with homologs in yeast maps to mouse chromosome 19.

PMID- 8358178
TI  - Cell adhesion molecules and potential for pharmacological intervention in lung
      inflammation.

PMID- 8358179
TI  - Heterogeneity of guinea-pig lung muscarinic receptors revealed by [3H]4-DAMP
      binding.
AB  - Muscarinic receptors present in guinea-pig lung were characterized using the M3
      selective radioligand [3H]4-diphenylacetoxy-N-methyl-piperidine methiodide ([3H]4
      DAMP). In saturation studies, [3H]4-DAMP identified two populations of binding
      sites with approximately 4% of the sites displaying high affinity (Kd = 0.21 nM
      and Bmax = 10 fmol/mg prot.) while the remaining sites were low affinity ones (Kd
      = 18.11 nM and Bmax = 269 fmol/mg prot.). In competition studies with [3H]4-DAMP
      (0.35 nM), methoctramine and hexahydro-siladifenidol (HHSiD) identified 50 and
      70% of high affinity binding sites displaying the pharmacological profile of the
      M2 and the M3 receptors, respectively. No evidence was found for high affinity
      [3H]pirenzepine binding sites in guinea-pig lung. However, pirenzepine/[3H]4-DAMP
      competition experiments suggested that pirenzepine recognized an equal proportion
      of [3H]4-DAMP binding sites with intermediate and low affinity binding constants.
      The intermediate affinity binding constant was inconsistent with the presence of
      M1 receptors and reflected more the presence of M4 or a mixture of M3 and M4
      receptors. The low affinity pirenzepine binding sites may represent M2 receptors.
      These results provide further evidence for the occurrence of M2 and M3 receptors
      and suggest the presence of the M4 muscarinic receptor subtype in guinea-pig
      lung.

PMID- 8358180
TI  - The protective effect of inhaled levomepromazine (Nozinan) on histamine-induced
      bronchial constriction.
AB  - The effect of inhaled levomepromazine (Nozinan, Veractil) on bronchial
      responsiveness to inhaled histamine was investigated in asthmatics. In a double
      blind, randomized controlled study, 12 asthmatics (FEV1% pred 52-96%, and PC20
      histamine 1.01 mg/ml (geometric mean)) were challenged before and after
      inhalation of levomepromazine in three different doses. Before and after each
      inhalation of levomepromazine, PC20, FEV1, the continuous reaction time (CRT) and
      the subjective sedation score (VAS) were determined. A dose-dependent increase in
      PC20 was observed after inhalation of levomepromazine. PC20 was increased by up
      to 4.02 two-fold concentration differences (doubling), i.e. up to a 38-fold
      increase from the basic values. Inhalation of the two higher doses of
      levomepromazine had a small sedative effect evaluated from an increase in CRT and
      the VAS-score and corresponding to the plasma concentrations. We conclude that
      inhaled levomepromazine has a dose-dependent protective effect on histamine
      induced bronchial hyperresponsiveness in asthmatics and that inhalation of
      levomepromazine was well tolerated. The mechanism by which levomepromazine acts
      on histamine-induced bronchial hyperresponsiveness is not known but it could be
      partly explained by the antihistaminic effect. In this respect levomepromazine
      bears comparison with the most potent second generation antihistamines. The
      plasma concentrations of levomepromazine measured corresponded to those seen
      after oral intake of 5-10 mg levomepromazine.

PMID- 8358182
TI  - Effects of melatonin on isolated pulmonary artery and vein: role of the vascular
      endothelium.
AB  - The influence of melatonin on tension of isolated pulmonary vascular smooth
      muscle rings was examined in these experiments. Melatonin caused a dose-dependent
      relaxation of precontracted (30 mM KCl) pulmonary artery and pulmonary vein.
      Removal of the endothelium did not alter the relaxant response to melatonin in
      pulmonary artery. In pulmonary artery with endothelium intact, preincubation with
      indomethacin, but not L-NG-monomethyl-L-arginine (L-NMMA) or deferoxamine,
      antagonized the relaxant response to melatonin. In pulmonary artery with
      endothelium removed, preincubation with deferoxamine, but not indomethacin,
      phorbol esters, or lithium chloride, antagonized the relaxant response to
      melatonin. In pulmonary vein, removal of the endothelium significantly increased
      the maximum relaxation attained in response to melatonin. In pulmonary vein with
      endothelium intact, preincubation with indomethacin, but not L-NMMA or
      deferoxamine, antagonized the relaxant response to melatonin. On the other hand,
      preincubation of de-endothelialized pulmonary vein with lithium chloride
      significantly increased the relaxation response to melatonin. These experiments
      demonstrate that both pulmonary artery and vein relax in response to melatonin
      and the mechanisms are apparently different.

PMID- 8358181
TI  - The effects of indomethacin and thiorphan on bradykinin-induced albumin output
      and submucosal gland secretion in the ferret trachea in vivo.
AB  - In the ferret liquid-filled trachea in vivo, intraluminal bradykinin (BK, 3-300
      microM) produced concentration-dependent increases in the output of lysozyme from
      submucosal gland serous cells and albumin movement into the lumen. Baseline
      outputs of albumin and lysozyme were not altered significantly by intraluminal
      indomethacin (10 microM) or thiorphan (10 microM). However, intraluminal
      indomethacin completely blocked the BK-induced increase in albumin output.
      Intraluminal thiorphan (10 microM) did not significantly potentiate BK-induced
      albumin output, although mean output was higher. Neither indomethacin nor
      thiorphan significantly altered BK-induced lysozyme output, although mean output
      was reduced in the presence of indomethacin. Thus BK increases albumin output and
      may increase lysozyme output via the action of cyclooxygenase products.
      Inhibition of neutral endopeptidase activity may enhance the action of BK on
      albumin output.

PMID- 8358183
TI  - Effects of loop diuretics on airways and inflammatory cells both in vivo and in
      vitro.

PMID- 8358184
TI  - New perspectives in the pulmonary circulation and hypoxic pulmonary
      vasoconstriction.
AB  - In the past few years there has been a reawakening of interest in the systems
      that underly pulmonary vascular control and an increased awareness of the
      clinical potential of pharmacological manipulation of the pulmonary circulation.
      Nevertheless, although so much has been learned about the physiological role of
      the endothelium, vasoactive substances, and neural modulation of the pulmonary
      vasculature; how these disparate influences interact to control the matching of
      ventilation to perfusion remains uncertain. Consequently, even less is known of
      the way in which lung injury influences these regulatory processes. It is likely
      that the response to hypoxia may involve a system with many pathways and much
      redundancy, such that blockade of the production of a single agent has only a
      minor effect on HPV. We speculate that the products of arachidonic acid
      metabolism, PAF, adenosine and EDRF, may act in concert with neural pathways in a
      'microenvironment' bounded by the alveolus and endothelium to modify pulmonary
      vascular tone during both normoxic and hypoxic conditions.

PMID- 8358185
TI  - [Increase in infections caused by Salmonella enteritidis--causes and
      possibilities for intervention].
AB  - Recently published data document a worldwide increase of infections of humans and
      of food contamination by Salmonella enteritidis (SE). The results of our own
      analyses of animal foods reflect this general trend and indicate a clonal
      spreading of SE phage type (PT) 4 in animal foods in Northern Bavaria. In humans
      SE PT 4 shows high invasivity and virulence. In poultry an adaption of certain SE
      phage types is supposed to have taken place. Those types cause infections of
      poultry flocks without visible symptoms. Hens do lay eggs during infection, but
      1.5-2.0% of them are SE contaminated. Incorrect handling and incorrect processing
      and use of SE infected hens' eggs and/or of foods prepared with those eggs have
      caused a great number of infections in humans. The present state of scientific
      research leads us to assume that the increase in human SE infections is linked to
      the increase of the SE infections of poultry and hens' eggs. In order to stem
      further spreading of SE and to improve the protection of the consumer certain
      measures have to be taken in original/primary production, production and
      processing of poultry meat and eggs and in handling of eggs in commercial and
      private kitchens. These measures, which, from a veterinary point of view, should
      be surveyed and also be taken by the relevant authorities, are described in 5
      lists.

PMID- 8358186
TI  - [Timely consultation of psychiatric assessment by members of the public health
      services].
AB  - The present possibilities and limitations of psychiatric expertising
      (supplementary or main) by the Public Health services are explained taking the
      proband group of public servants as an example. The need, preconditions,
      planning, designing, interaction, methods, amount of work and cost involved in
      such expertising are described in detail and illustrated by brief case reports,
      including psychodynamic aspects and definition and outlining of various phases of
      the relevant examinations. A guiding thesis is proposed: Successful psychiatric
      assessment of an individual is always also a crisis intervention with therapeutic
      changes and effects--even if this aim has not been consciously aimed at, but
      better still if performed with this purpose in mind. Obsolete approaches are
      pinpointed and quality standards stipulated. Possibilities of improvement and
      preventive aspects are shown.

PMID- 8358187
TI  - [Results of breast milk examinations in Northern Bavaria].
AB  - During the years of 1984-1991 2069 samples of human milk from Northern Bavarian
      were analyzed for residues of organochlorined pesticides and polychlorined
      biphenyls. In this paper it is exclusively reported about substance residues in
      human milk which were toxicological valuated by the German Research Fellowship
      (Deutsche Forschungsgemeinschaft). Concerning the amount of pesticides and PCB
      residues in human milk a dependence to woman's age, number of children and time
      of suckle period could be found. There was not seen any dependence to kind of
      nutrition and smoking behavior. Residue-concentrations of forbidden
      organochlorined pesticides decrease during the whole research period.
      Nevertheless polychlorined biphenyls will continual regarded as critical
      substances where no decreasing of residue concentrations is observed. This
      substance class furthermore will be observed because of continual environment
      pollution. It is reported about a test in which during a suckle period milk of
      two women was analyzed after weekly sampling. After ten weeks significantly
      decreasing of residue amounts concerning the most observed substances were found.
      A conclusion to help in practical counsel for nursing mothers is given.

PMID- 8358188
TI  - [Data on the status of the organizational structures of hospital hygiene in
      Germany. II--Rehabilitation clinics, psychiatric hospitals].
AB  - The results of an inquiry about the personnel and organisation of the hospital
      hygiene in 657 German rehabilitation centres and psychiatric hospitals
      demonstrate that 24% of these hospitals have a hospital epidemiologist, 44% have
      infection control nurses and 74% infection control physicians. Infection control
      committees are present in 64% of these hospitals. 78% of the hospitals use the
      guideline of the Federal Public Health Office "On the Identification, Prevention
      and Control of Hospital Infections" as a basis for all decisions on hospital
      hygiene.

PMID- 8358189
TI  - [Hydrophobizing building facades and subsequent indoor air pollution and
      offensive odors--10 case reports].
AB  - Water repellent and facade protective solvent-containing agents applied to
      external facades (hydrophobizing) may in some cases cause considerable and long
      term indoor aerosol pollution with aliphatic and aromatic hydrocarbons. This may
      result in odor nuisance and other complaints that may even make the affected
      rooms uninhabitable. To date the entire phenomenon has not been subjected to
      conclusive scientific research although its existence has long been known.
      Administrative offices react inconsistently to complaints; in many cases their
      actions are unsystematic and they try to minimize the issue. Measurement data and
      results of investigations from 10 practical cases are juxtaposed to find causal
      links and to assess the relevance of the entire problem of hydrophobizing of
      facades. The type, extent and duration of indoor aerosol pollutions are discussed
      and assessed in respect of already existing guiding and reference values.
      Furthermore, suggestions are made to the Public Health Services in the sense of
      preventive health protection. A more far-reaching consequence would be to
      introduce a licence for facade hydrophobizing or weather-proofing of buildings;
      this suggestion is offered for discussion.

PMID- 8358190
TI  - [Heavy metal pollution of soil and garden products of Stolberg home gardens and
      lead and cadmium pollution of small farms in Stolberg].
AB  - Cadmium, lead and zinc were determined in garden soils and vegetable products
      from private gardens located in a lead/zinc smelter area (Stolberg, Germany). At
      the same time lead and cadmium were measured in blood and urine samples collected
      from 90 garden owners. Inspite of extraordinary high levels of cadmium and lead
      in garden soils and vegetables, blood lead, blood cadmium and urine cadmium
      levels were not or only slightly elevated in the gardeners when compared to a
      reference group of subjects from the same area who did not consume home-grown
      vegetables and fruits. The results show that high levels of pollutants in soil
      and vegetables are not necessarily associated with an increased burden of
      pollutants in the human body, and that the transfer of pollutants from soil to
      humans might have been overestimated in some cases. Moreover, the results
      underline the preventive character of the guideline values presently applied with
      respect to the evaluation of soil contaminants.

PMID- 8358191
TI  - [Possibilities of quality assurance in ambulatory rehabilitation].
AB  - Formal, structurally determined quality requirements (for medical and non-medical
      staff, space and equipment, respectively) are supplemented by guidelines that are
      able to inform about the actual course of rehabilitation. Not only externally
      controlled medical reports on the treatment are suited for this, but also
      inquiries of patients comparisons between sickness insurances (for example on
      duration of inability to work, need for hospital measures of rehabilitation) and
      the comparison with patients who did not take part in ambulant rehabilitation. A
      report system has to be built up that pictures the clientele of the "reha"
      institution, measures changes and documents results a long-term basis. The
      proposed periodical tests and final test serve not only for the control of
      patient progress in each single case with information for the practitioner, but
      also give financial committees hints on the efficiency of the work of the
      institutions for rehabilitation. Continuous attendance is proposed with a report
      system and scientific evaluation, whose results are sent concisely but anonymous
      by to the contract partners on a quarterly basis. A committee for quality
      assurance discusses new developments and improves ambulant rehabilitation.

PMID- 8358192
TI  - Demonstration of nucleolar organizer regions in lung carcinoma by silver
      staining.
AB  - Nucleolar organizer regions (NORs) were investigated in lung carcinomas by silver
      staining. This method was applied to 111 lung carcinoma specimens, including 40
      with squamous cell carcinoma (SCC), 42 with adenocarcinoma (ADENO), 8 with
      adenosquamous carcinoma (ADESQ), 8 with small cell carcinoma (SMCC), 6 with large
      cell carcinoma (LGCC), and 7 with typical carcinoid tumors (CAOID). The mean
      AgNOR counts of ADENO, SCC, ADESQ, SMCC, and LGCC were significantly higher than
      those of the normal bronchial surface and those of the glandular or alveolar
      epithelium. The mean AgNOR count of CAOID was significantly higher than those of
      the normal glandular and alveolar epithelium but not that of the surface
      epithelium. The mean AgNOR count of SCC was significantly higher than that of
      bronchial squamous metaplasia, and the count of SMCC was significantly higher
      than that of CAOID. Within the same cancer category, the mean number of AgNORs
      increased in parallel with the histological tumor grades. These results indicate
      that the AgNOR method is useful for differentiating lung carcinoma from its
      normal counterparts and for evaluating histological tumor grades in the same
      lineage of lung carcinoma.

PMID- 8358193
TI  - Elevation of carcinoembryonic antigen related to biliary malignancy in
      hepatolithiasis.
AB  - Bile duct neoplasms occur relatively often in patients with hepatolithiasis in
      Taiwan. In this study, 49 patients with a positive immunoperoxidase stain for
      carcinoembryonic antigen (CEA) in the bile duct glands were examined in relation
      to the concentration of CEA in serum and bile. The bile concentrations of CEA in
      15 control patients, 16 patients with hepatolithiasis only, 7 with
      hepatolithiasis and bile duct carcinoma, and 11 with bile duct carcinoma only
      were 4.09 +/- 4.12, 70.49 +/- 81.62, 137.73 +/- 66.15, and 144.3 +/- 117.31 ng/ml
      (mean +/- SD), respectively. A positive CEA stain from the bile duct was seen in
      13.33%, 81.23%, 85.71%, and 90.91% of each group, respectively. No strongly
      positive staining, (2+ or 3+) was found in the control group, but it was found
      frequently in the hepatolithiasis and bile duct carcinoma groups. The findings of
      this study therefore suggest the probability of a combined neoplasm in patients
      with hepatolithiasis if the CEA value is unusually elevated in the serum or bile.

PMID- 8358194
TI  - Surgery for cholelithiasis in cirrhotic patients.
AB  - Although biliary tract surgery for cholelithiasis is performed frequently in
      Japan, cirrhotic patients require special consideration. Postoperative
      complications after biliary tract surgery were studied in 23 patients with liver
      cirrhosis and associated cholelithiasis, 9 of whom had no complications, 8 had
      minor complications, and 6 had severe complications. Concerning the relation
      between Child's classification and postoperative complications, no complications
      were seen in four Child's type A patients, but seven of ten (70%) Child's type B
      patients and seven of nine (78%) Child's type C patients developed complications.
      Two (20%) of the Child's type B patients and four (44%) of the Child's type C
      were severe, and three of the latter group died. Regarding the preoperative
      laboratory findings, significant differences were seen between the patients
      without complications and those with severe complications in serum bilirubin,
      albumin, and ICG R15 values. Of the six patients with severe complications, five
      had choledocholithiasis, three of whom died of liver failure, while two developed
      biliary peritonitis caused by insufficient fistula formation after removal of the
      T-tube. Thus, for the treatment of choledocholithiasis in patients with severe
      cirrhosis, avoiding surgical invasion through the use of such techniques as
      endoscopic papillotomy is recommended whenever possible.

PMID- 8358195
TI  - The reticuloendothelial system and hepatocyte function in orthotopic liver
      transplantation.
AB  - The reticuloendothelial system function, especially phagocytic activity, and
      hepatocyte function were investigated in dogs undergoing an orthotopic liver
      transplantation. The donor's phagocytic index, measured by a lipid emulsion test,
      was higher in the Survivor group which survived more than 3 days after
      transplantation (0.063 +/- 0.008 vs 0.024 +/- 0.002; mean +/- standard error of
      the mean (SEM), P < 0.01). There was a statistically significant difference in
      the phagocytic index between the survivor and nonsurvivor groups. However, the
      hepatocyte function at an early phase after transplantation, indicated by the
      arterial ketone body ratio, hepaplastin test and lecithin cholesterol
      acyltransferase level, did not distinguish the Survivor group from the
      Nonsurvivor group at all. In the survivor group, the hepaplastin test and the
      lecithin cholesterol acyltransferase level were significantly decreased after
      liver transplantation, namely from 155 +/- 15% to 58 +/- 5% and from 57 +/- 12
      unit/ml to 19 +/- 1 unit/ml on the 2nd day after transplantation (P < 0.01, P <
      0.05), respectively. On the other hand, the reticuloendothelial system (RES)
      function, as estimated by the phagocytic index and serum complement activity (CH
      50), demonstrated no change throughout the experimental period. The present study
      therefore demonstrated that the operative results might be affected by the
      phagocytic activity.

PMID- 8358197
TI  - An unusual cause of hydropic gallbladder and biliary colic--heterotopic
      pancreatic tissue in the cystic duct: report of a case and review of the
      literature.
AB  - We present herein an unusual case of heterotopic pancreas in the cystic duct with
      hydrops of the gallbladder and concomitant chronic pancreatitis of the
      heterotopic tissue. A review of the relevant literature is discussed following
      the presentation of this case.

PMID- 8358196
TI  - Suppressive effect of doxorubicin on liver recurrence after resection of colonic
      VX2 cancer lesions: difference in efficacy according to the injection protocol.
AB  - An animal model with liver cancer recurrence was induced by resecting colonic VX2
      cancer lesions in 57 rabbits, and the effects of doxorubicin (ADR) on the
      recurrence were examined. Animals were divided into a control group and three
      chemotherapeutic groups: a portal injection group, to which ADR was injected into
      the portal vein after resection of the primary lesions; a peripheral injection
      group, to which ADR was injected into a peripheral vein after resection; and a
      preoperative injection group, to which an ADR dose of 0.5 mg/kg was peripherally
      injected 0, 1, and 2 days prior to resection followed by a portal injection of
      ADR 0.5 mg/kg after resection. The rate of liver recurrence was 100% in the
      control group, whereas it was 0% and 60% in the portal ADR 1.0 and 0.5 mg/kg
      injection groups, and 60% and 100% in the peripheral ADR 1.0 and 0.5 mg/kg
      injection groups. In the preoperative group, the rate was 0%, 100%, and 67% in
      the animals injected 2, 1, and 0 days prior to resection, respectively. These
      results suggest that portal injection or appropriate combinations of preoperative
      peripheral and portal injections of ADR are more effective than peripheral or
      portal injection alone in the suppression of liver recurrence.

PMID- 8358198
TI  - Bilateral femoral nerve compression by iliacus hematomas complicating
      anticoagulant therapy.
AB  - An unusual case of bilateral femoral nerve compression caused by iliacus
      hematomas in a patient on anticoagulant therapy is herein reported with special
      reference to the comparative diagnostic value of ultrasonography, computerized
      tomorgraphy, and magnetic resonance imaging. The importance of early surgical
      decompression is also emphasized.

PMID- 8358199
TI  - An infant with bilateral adrenal neuroblastoma found by mass-screening: report of
      a case.
AB  - A male infant with bilateral adrenal neuroblastoma found by mass-screening is
      herein reported. The patient presented with almost equal-sized tumors, each
      remaining confined to the respective adrenal gland without crossing the midline.
      No other tumorous lesion was evident. The two adrenal tumors had similar
      histologic features and appeared to have grown concurrently. Such simultaneous
      occurrence of primary adrenal neuroblastoma is unusual, and appears to reflect
      the multicentric origin of this tumor.

PMID- 8358200
TI  - A solid and papillary (solid-cystic) tumor of the pancreas occurring in a 36-year
      old man: report of a case.
AB  - A case of a solid and papillary (solid-cystic) tumor of the pancreas occurring in
      a 36-year-old man is herein reported. This patient was admitted with left
      hypochondrial pain and diagnostic imaging detected a large tumor consisting of
      both solid and cystic components in the tail of the pancreas. A distal
      pancreatectomy with splenectomy was performed. The resected tumor was diagnosed
      as a solid and papillary tumor of the pancreas by pathological examination.
      Detailed immunohistochemical studies showed that the tumor consisted of cells
      both exocrine and endocrine in character. Thus, this case appears interesting
      from the point of cellular differentiation in solid and papillary tumors, since
      they are generally considered to have an acinar cell origin.

PMID- 8358201
TI  - Intussusception caused by a carcinoma of the cecum during pregnancy: report of a
      case and review of the literature.
AB  - A case of intussusception due to a carcinoma of the cecum during pregnancy is
      reported. A 27-year-old pregnant female was admitted to Shimodate Municipal
      Hospital because of abdominal pain, nausea and vomiting. Her abdomen was
      distended, and a relatively hard mass was palpable in the right hypochondrium.
      Following a diagnosis of intussusception by ultrasonography, a laparotomy was
      performed. The lesion causing the intussusception was found to be a carcinoma of
      the cecum, and thus a right hemicolectomy with lymph node dissection was carried
      out. Histological examination revealed that the tumor was a well-differentiated
      adenocarcinoma which had invaded the muscularis propria but was superficial to
      the subserosa. None of the lymph nodes were cancerous. The incidence of colonic
      cancer above the peritoneal reflection during pregnancy is very low. Only 24
      cases have been previously reported; our patient is only the 25th case, as well
      as being the first case demonstrating Dukes' A. Due to the intussusception,
      ultrasonography was effective for diagnosis and the patient was able to undergo a
      curative operation at an earlier stage than other patients.

PMID- 8358202
TI  - Carcinosarcoma of the esophagus: a report of two cases.
AB  - Among 137 cases of esophageal neoplasms surgically treated at Kobe City General
      Hospital from 1983 to 1990, there were two patients with a huge polypoid lesion
      identified as carcinosarcoma by light microscopic examination, both of whom
      underwent radical resection and esophagogastrostomy. Microscopic examination of
      the resected specimens revealed the tumors to be composed of carcinomatous and
      sarcomatous elements. Additional immunohistochemical examination disclosed
      keratin-positive cells in the carcinomatous element and vimentin-positive cells
      in the sarcomatous element. In case 1, keratin-positive cells were also found in
      the sarcomatous element, which suggested that the sarcomatous cells were derived
      from epithelial cells. Despite the huge size of the tumors, the depth of invasion
      to the esophageal wall was limited to the mucosal layer in case 1 and the
      submucosal layer in case 2, and there has been no evidence of recurrence in
      either case since surgery.

PMID- 8358203
TI  - Effect of superoxide dismutase, allopurinol and glucocorticoids on liver and lung
      metallothionein induction by endotoxin in the rat.
AB  - Liver and lung metallothionein (MT) levels were increased by endotoxin. The
      administration of superoxide dismutase (SOD) or allopurinol (ALLO) before (30-60
      min) or after (24-32 h) the endotoxin treatment either increased or did not
      affect the effect of endotoxin on MT levels, depending on the particular
      treatment and tissue. SOD and ALLO also increased liver and lung MT levels in
      control rats. In contrast, liver MT levels tended to be decreased by the
      glucocorticoid prednisolone (PRED) when administered before the endotoxin and
      were significantly decreased when it was administered after endotoxin. The effect
      of PRED on lung MT levels was completely different, since it decreased the effect
      of endotoxin when injected before the lipopolysaccharide, but increased it when
      injected after the endotoxin. Liver lipid peroxidation, as measured by
      thiobarbituric acid reactants (TBARs), increased after endotoxin in the liver but
      not in the lung, an effect even potentiated in some cases by the antioxidants
      studied. As expected, tissue MT and TBARs could not be correlated.

PMID- 8358204
TI  - Ferric reductases of Legionella pneumophila.
AB  - Ferric reductase enzymes requiring a reductant for maximal activity were purified
      from the cytoplasmic and periplasmic fractions of avirulent and virulent
      Legionella pneumophila. The cytoplasmic and periplasmic enzymes are inhibited by
      zinc sulfate, constitutive and active under aerobic or anaerobic conditions.
      However, the periplasmic and cytoplasmic reductases are two distinct enzymes as
      shown by their molecular weights, specific activities, reductant specificities
      and other characteristics. The molecular weights of the cytoplasmic and
      periplasmic ferric reductases are approximately 38 and 25 kDa, respectively. The
      periplasmic reductase (Km = 7.0 microM) has a greater specific activity and twice
      the affinity for ferric citrate as the cytoplasmic enzyme (Km = 15.3 microM).
      Glutathione serves as the optimum reductant for the periplasmic reductase, but is
      inactive for the cytoplasmic enzyme. In contrast, NADPH is the optimum reductant
      for the cytoplasmic enzyme. Ferric reductases of avirulent cells show a 2-fold
      increase in their activities when NADPH is used as a reductant in comparison with
      NADH. In contrast, ferric reductases from virulent cells demonstrated an
      equivalent activity with NADH or NADPH as reductants. With the exception of their
      response to NADPH, the ferric reductase at each respective location appears to be
      similar for avirulent and virulent cells.

PMID- 8358205
TI  - Intestinal administration of copper and its transient release into venous rat
      blood serum concomitantly with metallothionein.
AB  - The molecular side of copper transport in biological systems is unknown. It was
      attempted to examine the copper and metallothionein (MT) release into the portal
      blood in rats in vivo. After direct administration of Cu(II) into the jejunum the
      copper and MT levels were distinctively higher in the portal venous serum
      compared with that of the vena cava inferior. MT in gel filtrated serum samples
      was analyzed immunologically employing ELISA and a monoclonal antibody to rat MT
      I. Affinity chromatography on Protein A-Sepharose resulted in a higher
      immunoreactivity in the portal compartment as deduced from an elevated MT
      antibody complex. It is assumed that MT serves as a genuine transport system for
      cuprous copper during the mucosal-to-serosal flux of this biologically important
      transition metal.

PMID- 8358206
TI  - Indirect utilization of the phytosiderophore mugineic acid as an iron source to
      rhizosphere fluorescent Pseudomonas.
AB  - The phytosiderophore mugineic acid (MA) was studied as a source of iron for
      rhizosphere fluorescent pseudomonads. 55Fe supplied as Fe-MA was taken up by
      Pseudomonas putida WCS358, B10 and St3 grown under iron deficient conditions. The
      uptake decreased when the bacteria were grown in the presence of iron. However,
      no differences in uptake were observed when a siderophore deficient mutant was
      tested. Since ligand exchange between pseudobactin and MA was shown to occur
      rapidly with a half-life of 2 h, MA mediated iron uptake probably proceeds
      through this indirect mechanism. The ecological implications of these findings
      are discussed.

PMID- 8358207
TI  - Influence of dietary iron deficiency on acute metal intoxication.
AB  - The influence of dietary iron deficiency on acute nickel, lead or cadmium
      toxicity as reflected by the induction of hepatic, renal and intestinal
      metallothionein (MT), disposition of the metals, and alterations in hematological
      parameters was investigated in rats. The administration of cadmium induced the
      hepatic, renal and intestinal MT while that of nickel or lead induced hepatic MT
      only. However, dietary iron deficiency did not influence the cadmium induced
      tissue MT but enhanced the ability of nickel or lead to restore the normal
      synthesis of renal and intestinal MT lowered under the influence of reduced body
      iron status. The accumulation of lead in liver and kidney and that of cadmium
      enhanced in liver only, while tissue deposition of nickel remained unaffected by
      iron deficiency. The induction of hepatic MT by three metals appears related to
      the concomitant rise in the hepatic zinc, calcium and iron levels in normal rats.
      However, dietary iron deficiency increased the hepatic zinc in response to nickel
      or cadmium and that of heptic calcium in response to lead.

PMID- 8358208
TI  - Involvement of metallothionein and copper in cell proliferation.
AB  - Metallothionein is a low-molecular weight, cysteine-rich, metal-binding protein
      which has been implicated in the detoxification of toxic metals (cadmium,
      mercury), metabolism of zinc and copper, as well as in the scavenging of free
      radicals. Recent evidence suggests that the protein may also be involved in cell
      proliferation. Based on the experiments carried out so far, it is assumed that
      the fundamental role of metallothionein in cell proliferation may be to detoxify
      and/or transfer copper ions from the cytoplasm to the nucleus at the G1/S phase,
      which in turn participate in some way in nuclear DNA synthesis.

PMID- 8358209
TI  - The effect of lead on iron uptake from transferrin in human erythroleukemia
      (K562) cells.
AB  - The effect of lead on cellular iron metabolism has been investigated using human
      erythroleukemia (K562) cells. When the cells were cultured with 100 microM Pb2+
      for 48 h, the rate of cellular iron uptake from transferrin decreased to 46% of
      that in untreated cells. Scatchard analysis of the binding data revealed that
      this reduction was the result of a decrease in the number of transferrin
      receptors rather than an alteration in ligand-receptor affinity. The results of
      immunoprecipitation of transferrin receptors on the cell surface also confirmed
      the decreased expression of transferrin receptors by lead-treated cells. The down
      regulation of transferrin receptors by treatment with lead did not result from a
      decrease in the total amount of the receptor, as determined by immunoblotting.
      Moreover, the biosynthesis of the receptor was unaffected by lead treatment.
      Thus, the down-regulation of surface transferrin receptors in lead-treated cells
      might be due to a redistribution of receptors rather than an actual loss of
      receptors from the cell. Using kinetic analysis, it was shown that redistribution
      of the receptor did not result from the alteration in the rates of transferrin
      receptor recycling. A comparison of the amounts of transferrin receptor on the
      cell surface and in the cycling pool revealed that the sequestration of the
      receptor from normal flow through the cycle might cause down-regulation of the
      surface receptor.

PMID- 8358210
TI  - Zinc affects siderophore-mediated high affinity iron uptake systems in the
      rhizosphere Pseudomonas aeruginosa 7NSK2.
AB  - Zinc concentrations ranging between 0.1 and 1 mM only slightly reduced maximal
      growth of wild-type Pseudomonas aeruginosa 7NSK2 in iron-limiting casamino acid
      medium, but had a clear negative effect on the growth of mutant MPFM1 (pyoverdin
      negative) and especially mutant KMPCH (pyoverdin and pyochelin negative).
      Production of pyoverdin by wild-type strain 7NSK2 was significantly increased in
      the presence of 0.5 mM zinc and could not be repressed by iron even at a
      concentration of 100 microM. Siderophore detection via isoelectrofocusing
      revealed that mutant KMPCH did not produce any siderophores, while mutant MPFM1
      overproduced a siderophore with an acidic isoelectric point, most likely
      pyochelin. Pyochelin production by MPFM1 was stimulated by the presence of zinc
      in a similar way as pyoverdin for the wild-type. Analysis of outer membrane
      proteins revealed that three iron regulated outer membrane proteins (IROMPs) (90,
      85 and 75 kDa) were induced by iron deficiency in the wild-type, while mutants
      were found to have altered IROMP profiles. Zinc specifically enhanced the
      production of a 85 kDa IROMP in 7NSK2, a 75 kDa IROMP in MPFM1 and a 90 kDa IROMP
      in KMPCH.

PMID- 8358211
TI  - [Biliary cystadenoma].
AB  - Biliary cystadenomas are rare biliary ductal neoplasms of congenital origin.
      There is an excellent correlation between CT and sonographic findings for number,
      size and location of the lesions. However, sonography can demonstrate better
      morphologic features such as thickened wall, mural nodules and septations. CT
      shows more clearly the accurate size and location of the neoplasm to surrounding
      structures. Angiography is not diagnostic; however, it can help to distinguish
      between benign and malignant lesions. MRI provides useful information for
      surgical planning, demonstrating well the relationship of the tumor to vascular
      structures and other organ systems. Complete excision is the treatment of choice
      to prevent recurrence or malignant transformation of biliary cystadenomas.

PMID- 8358212
TI  - Stereo-microvision. Development of an opto-electronic operating microscope.
AB  - A novel opto-electronic operating microscope has been designed and clinically
      tested. It consists of a small camera microscope, a central electronic unit, and
      a stereoscopic video monitor. Advanced miniaturization permitted ergonomics
      superior to those of conventional optomechanical microscopes. Electronic imaging
      facilitates coupling to an ultrasound navigation system which enables the
      neurosurgeon to verify the location of the focus in real time, correlated with CT
      and MRI pictures. A fully computerized, digital operating microscope will now be
      developed based on this prototype.

PMID- 8358213
TI  - Current status of the imaging modalities in the pre- and postoperative diagnostic
      workup of liver transplant patients.
AB  - Before transplantation, imaging procedures are mainly used to exclude factors
      which may serve as contraindications, render surgery difficult, or necessitate a
      modification of the operative technique. In addition, assessment of liver volume
      is necessary before segmental liver transplantation. Sonography or other cross
      sectional imaging modalities are sufficient for these purposes. After
      transplantation, imaging is principally required in cases with suspected
      complications. Sonography, including Duplex and Doppler sonography, is an
      excellent first investigative modality for this purpose in addition to assessment
      of the clinical and biochemical parameters. Sonography can diagnose not only
      vascular complications but also biliary and infective complications; the former
      may also be a concealed cause of the latter. In unclear infections sonography
      often has to be supplemented by other modalities like CT. In equivocal cases a
      puncture is indicated. Invasive procedures are necessary in only selected cases,
      in particular when an intervention is under consideration. At present MR plays a
      limited role in the diagnostic workup as it rarely offers additional information
      except in very few cases. The early diagnosis of rejection cannot be reliably
      made by any of the imaging modalities and is essentially dependent on the biopsy.

PMID- 8358215
TI  - [Dialysis-associated amyloidosis. Part 2: Incidence and site of osseous
      amyloidosis. Dialysis characteristics and clinical findings].
AB  - In a conventional radiographic skeletal survey of 90 hemodialyzed patients, 28%
      (25 patients) showed renal osteopathy; 27 patients (30%) had periarticular bone
      cysts and 3 patients (3%) presented radiological evidence of destructive
      spondylarthropathy. The bone cysts were most commonly identified in the carpal
      bones and around the hips and shoulders; destructive spondylarthropathy was seen
      in the cervical and lumbar spine. Whereas characteristic radiographic changes of
      renal osteodystrophy could already be identified in the 1st year of dialysis,
      periarticular bone cysts occurred at the earliest after 2 years, most frequently
      after 5 years of dialysis. Destructive spondylarthropathy was seen after more
      than 10 years of dialysis. A positive correlation between these bone lesions and
      secondary hyperparathyreoidism, dialysis membranes or renal diseases was not
      found.

PMID- 8358214
TI  - [Dialysis-associated amyloidosis. Part 1: Biochemistry, clinical aspects,
      roentgen morphology].
AB  - Dialysis-related amyloidosis is characterized clinically by the carpal tunnel
      syndrome, pain and swelling of joints. These alterations are due to amyloid
      deposits in the carpal tunnel, in the synovia, ligaments and bones. It has been
      shown that beta 2m is the major component of this amyloidosis. Serum and urine
      concentration of beta 2m are markedly elevated in chronic renal failure due to
      failure of filtration and lack of metabolism by the renal tubular epithelium.
      beta 2m-derived amyloid is identified by immunohistochemistry using antibodies
      derived against beta 2m. Radiology shows cyst-like periarticular bone defects,
      destructive arthropathy and spondylarthropathy.

PMID- 8358216
TI  - Relief of malignant obstructive jaundice by endoscopic or percutaneous insertion
      of metal stents.
AB  - From January 1990 through July 1992 we attempted to treat 42 patients (21 men, 21
      women; mean age 69 +/- 2 years) with obstructive jaundice due to inoperable
      malignant biliary obstructions with insertion of metal stents. 67% of the
      patients had stenoses of the distal common bile duct, 5% of the proximal common
      bile duct, and 28% had hilar lesions. Obstructions were due to pancreatic cancer
      (47%), gallbladder cancer (13%), cholangiocarcinoma (20%), and lymphoma of
      metastatic cancer (20%). We inserted a total of 51 Wallstents and 17 Strecker
      Stents with a technical success of 100%. The functional success was 95%. The mean
      bilirubin level decreased from 18.2 +/- 1.7 mg/dl before to 1.5 +/- 0.2 after
      stent insertion. In the first 30 days one patient (2%) with hilar malignancy
      developed an early reobstruction due to tumor bleeding and debris. The 30-day
      mortality rate was 2%. 2 (5%) patients developed recurrent jaundice within the 3
      month follow-up period; 1 had tumor overgrowth of the metal stent, 1 had tumor
      ingrowth through the mesh. Metal biliary endoprotheses offer sufficient initial
      relief of malignant obstructive jaundice with reduced morbidity and mortality
      compared to the placement of conventional plastic stents. However, the long-term
      results are impaired by stent occlusion due to tumor ingrowth or overgrowth.

PMID- 8358217
TI  - [Percutaneous intraductal ultrasound of the bile ducts].
AB  - Miniaturization of ultrasound probes (6 F, 20 MHz) enables to perform
      intraluminal sonography of the bile duct in patients in whom a percutaneous
      transhepatic access has been achieved for diagnostic or therapeutic reasons.
      Initial experiences in 13 patients with malignant bile duct obstruction and in 8
      patients with benign bile duct disease are described. Intraluminal ultrasound
      displays the normal anatomy and pathologic processes of the bile ducts and
      reveals information on therapeutic procedures within the bile ducts. Malignant
      tumors and benign strictures can be differentiated in most cases. In malignant
      disease, this diagnostic method improves the difficult staging of bile duct
      tumors and gives information on tumor extension, infiltration of adjacent tissues
      and vessels, and lymph node enlargement. The limited penetration depth of 1.5-2.0
      cm creates problems in the staging of tumors particularly at the hepatic hilum.
      The procedure is simple and devoid of risks, but requires some refinements and
      improvements to attain a wider use in different clinical problems.

PMID- 8358218
TI  - Diagnostic imaging of acute rupture of the thoracic aorta by blunt trauma.
AB  - Ten patients with acute rupture of the thoracic aorta by blunt trauma were
      studied. In all instances chest radiographs, computed tomography and aortography
      were performed. A diagnostic algorithm is proposed for subjects with suspected
      acute rupture of the thoracic aorta.

PMID- 8358219
TI  - [Value of radiologic procedures in diagnosis of osteoporosis of the axial
      skeleton].
AB  - Lateral radiograms of the lumbar spine are compared with quantitative
      mineralometry of vertebral spongiosa done by computed tomography. In 82% of
      cases, conventional x-rays of the spine give hints towards an increased loss of
      bone mass. More than 50% of patients with osteoporosis verified by histology are
      primarily detected by quantitative mineralometry. There is no strict correlation
      between the severity of osteoporotic disease and the level of mineral content of
      bone. Conventional x-radiographs of the spinal column are indispensable for
      estimation of the degree of osteoporosis. Mineralometry can monitor the course of
      the disease - either to recognize the onset of osteoporosis or to control
      therapeutic effects. Mineralometry is of less value in primary, early detection
      of osteoporosis.

PMID- 8358220
TI  - [Symptomless lung sequestration].
AB  - Two cases of asymptomatic intralobar pulmonary sequestrations are reported. Chest
      radiographs showed a solid intrapulmonary mass left posterior at the base. By
      computed tomography the exact localization and relationship of the sequesters to
      the surrounding tissue were demonstrated, and a bolus injection of contrast
      medium revealed the supplying arteries. The arteriography showed a single
      arterial supply in both cases and their exact course. In the late phase the
      pulmonary veins were visualized. Finally a suggested diagnostic workup is given.

PMID- 8358221
TI  - Regulation of biosynthesis of N-glycolylneuraminic acid-containing
      glycoconjugates: characterization of factors required for NADH-dependent cytidine
      5'monophosphate-N-acetylneuraminic acid hydroxylation.
AB  - The hydroxylation of CMP-NeuAc has been demonstrated to be carried out by several
      factors including the soluble form of cytochrome b5. In the present study, mouse
      liver cytosol was subjected to ammonium sulfate fractionation and cellulose
      phosphate column chromatography for the separation of two other essential
      fractions participating in the hydroxylation. One of the fractions, which bound
      to a cellulose phosphate column, was able to reduce the soluble cytochrome b5,
      using NADH as an electron donor. The other fraction, which flowed through the
      column, was assumed to contain the terminal enzyme which accepts electrons from
      cytochrome b5, activates oxygen, and catalyses the hydroxylation of CMP-NeuAc.
      Assay conditions for the quantitative determination of the terminal enzyme were
      established, and the activity of the enzyme in several tissues of mouse and rat
      was measured. The level of the terminal enzyme activity is associated with the
      expression of N-glycolylneuraminic acid in these tissues, indicating that the
      expression of the terminal enzyme possibly regulates the overall velocity of CMP
      NeuAc hydroxylation.

PMID- 8358222
TI  - Indications for the enzymatic synthesis of 9-O-lactoyl-N-acetylneuraminic acid in
      equine liver.
AB  - Fractionation of horse liver homogenate by centrifugation into heavy membranes at
      10,000 x g, microsomal fraction at 105,000 x g, and the supernatant revealed
      sialate 9-O-lactoyltransferase activity only in the latter fraction. For the
      enzyme assay, the various fractions were incubated with 14C labelled CMP-N
      acetylneuraminic acid, N-acetylneuramimic acid and glycoconjugate-bound N
      acetylneuramimic acid. Lactoylation was identified in three different TLC systems
      after acid hydrolysis and purification of the sialic acids in the incubation
      mixtures. Enzyme activity was found only in the supernatant fraction.
      Glycoconjugate-bound N-acetylneuramimic acid was the best substrate tested,
      although some lactoylation was also found when using CMP-N-acetylneuraminic acid.

PMID- 8358223
TI  - Synthesis of phosphites and phosphates of neuraminic acid and their glycosyl
      donor properties--convenient synthesis of GM3.
AB  - The importance and requirements for catalytic activation of sialyl donors are
      discussed, leading to the acid sensitive phosphite and phosphate moiety,
      respectively, as leaving group and nitriles as solvent. Therefore, from readily
      available N-acetylneuraminic acid, derivative 1 with phosphochloridites 2a-f and
      Huenigs' base sialyl phosphites 3a-f were prepared and isolated in high yields.
      Oxidation of 3a,c with tert-butyl-hydroperoxide afforded the corresponding
      phosphates 4a,c. As expected, phosphites 3 could be activated in acetonitrile by
      catalytic amounts of TMSOTf; thus, from 3a-e as donors and lactose derivatives
      8A,B as acceptors the ganglioside building blocks 9A and 9B, respectively, were
      obtained in good yields. The best results were obtained with diethyl phosphite
      derivative 3a as sialyl donor, which exceeded by far the results obtained with
      the corresponding phosphate derivative 4a. Trisaccharide 9B was transformed into
      known 9A and into the fully O-acetylated GM3-trisaccharide 10.

PMID- 8358224
TI  - Chemoenzymatic galactosialylation with integrated cofactor regeneration.
AB  - As a precursor for the chemical synthesis of sialylated oligosaccharides, the
      trisaccharide glycoside Neu5Ac alpha (2-8)Gal beta (1-4)GlcNAc beta (1-O)-pent-4
      ene was synthesized starting from GlcNAc beta (1-O)-pent-4-ene, UDP-glucose and N
      acetylneuraminic acid in a one pot reaction employing galactosyltransferase and
      alpha (2-6)sialyltransferase in a complete cofactor regeneration system.

PMID- 8358225
TI  - Inhibition of sialidases from viral, bacterial and mammalian sources by analogues
      of 2-deoxy-2,3-didehydro-N-acetylneuraminic acid modified at the C-4 position.
AB  - The inhibition of sialidase activity from influenza viruses A and B,
      parainfluenza 2 virus, Vibrio cholerae, Arthrobacter ureafaciens, Clostridium
      perfringens, and sheep liver by a range of 2-deoxy-2,3-didehydro-N
      acetylneuraminic acid analogues modified at the C-4 position has been studied.
      All substitutions tested resulted in a decrease in the degree of inhibition of
      the bacterial and mammalian sialidases. For sialidases from influenza viruses A
      and B, on the other hand, most of the substitutions tested either had no
      significant effect on binding or, in the case of the basic amino and guanidino
      substituents, resulted in significantly stronger inhibition. The results for
      parainfluenza 2 virus sialidase were mostly intermediate, in that inhibition was
      neither significantly increased nor decreased by most of the modifications. We
      conclude that only the influenza A and B sialidase active sites possess acid
      groups correctly positioned to participate in charge-charge interactions in the
      region of C-4 of bound substrate, and that the C-4 binding pockets of the
      bacterial and mammalian sialidases examined are considerably smaller than is
      observed for either the influenza virus or parainfluenza virus sialidases.

PMID- 8358226
TI  - Differential effect of various inhibitors on four types of rat sialidase.
AB  - The inhibitory effect of various compounds on the activities of four types of rat
      sialidase was investigated. 2-Deoxy-2,3-dehydro-N-acetylneuraminic acid and N
      acetylneuraminic acid were competitive inhibitors for the sialidases. The former
      was effective against cytosolic sialidase and intralysosomal sialidase more than
      two membrane-associated sialidases I and II, the latter being a much weaker
      inhibitor. A heavy metal ion such as Cu2+ (1 mM) and thiol-modifying 4
      hydroxymercuribenzoate (50 microM) caused complete inhibition of the activities
      of cytosolic sialidase and membrane sialidase I, while no decrease in the
      activities of intralysosomal sialidase and membrane sialidase II was observed.
      When 4-nitrophenyloxamic acid and siastatin B, inhibitors of bacterial
      sialidases, and synthetic thioglycoside GM3 analogue Neu5Ac alpha-s-(2-6)Gal
      beta(1-4)Glc beta(1-1) ceramide, an inhibitor of influenza virus sialidase, were
      tested, they did not affect any activity of the rat sialidases. By the
      differential effect of these inhibitors, the four types of rat sialidase could be
      discriminated from one another and furthermore from viral and bacterial
      sialidases.

PMID- 8358227
TI  - Isolation and properties of the natural and the recombinant sialidase from
      Clostridium septicum NC 0054714.
AB  - The natural sialidase of Clostridium septicum was purified and characterized in
      parallel with the recombinant enzyme expressed by Escherichia coli. The two
      enzymes exhibit almost identical properties. The maximum hydrolytic activity was
      measured at 37 degrees C in 60 mM sodium acetate buffer, pH 5.3. Glycoproteins
      like fetuin and saponified bovine submandibular gland mucin, most of them having
      alpha(2-6) linked sialic acids, are preferred substrates, while sialic acids from
      gangliosides, sialyllactoses, or the alpha(2-8) linked sialic acid polymer
      (colominic acid) are hydrolysed at lower rates. alpha(2-3) Linkages are more
      rapidly hydrolysed than alpha(2-6) bonds of sialyllactoses. The cleavage rate is
      markedly reduced by O-acetylation of the sialic acid moiety. These properties are
      similar to those of other secreted clostridial sialidases. The enzyme exists in
      mono-, di- and trimeric forms, the monomer exhibiting a molecular mass of 125
      kDa, which is close to the protein mass of 111 kDa deduced from the nucleotide
      sequence of the cloned gene.

PMID- 8358228
TI  - Identification of a developmentally regulated sialidase in Eimeria tenella that
      is immunologically related to the Trypanosoma cruzi enzyme.
AB  - Sporozoites and merozoites of three species of Eimeria, E. tenella, E. maxima,
      and E. necatrix, that cause diarrhea in chickens worldwide, were examined for
      their expression of sialidase (SA) activity. The enzyme was found in three
      species, and the activity of merozoites was 10-20 times higher than that of
      sporozoites. The enzyme was resistant to degradation by proteases that are
      normally present in the intestine, a site inhabited by the Eimeria parasites, and
      it was relatively resistant to heat, with optimum activity being at 40 degrees C,
      which is within the range of temperature in the chicken intestine (40-43 degrees
      C). E. tenella SA was immunoprecipitated by monoclonal and polyclonal antibodies
      raised against the Trypanosoma cruzi SA (TCSA), and enzyme activity was
      neutralized by these antibodies. E. tenella SA was identified by immunoblots as a
      doublet of molecular weight 190,000 and 180,000 using, as a probe, anti-TCSA
      antibodies and antibodies against a synthetic peptide (TR) derived from the long
      tandem repeat domain of TCSA. Binding of the monoclonal and polyclonal antibodies
      to E. tenella was completely blocked by TR, but not by an irrelevant peptide
      (BR). Therefore, E. tenella expresses a developmentally regulated SA that is
      structurally related to the T. cruzi counterpart. Because of the high SA activity
      in merozoites, and by analogy with other SA-producing microbes that inhabit mucin
      rich epithelia, we suggest that the Eimeria SA plays a role in desialylating
      intestinal mucins to reduce viscosity of the local environment and thereby
      facilitate parasite migration. The enzyme could also play a role in host cell
      parasite interaction.

PMID- 8358230
TI  - Action of rat liver Gal beta 1-4GlcNAc alpha(2-6)-sialyltransferase on Man beta 1
      4GlcNAc beta-OMe, GalNAc beta 1-4GlcNAc beta-OMe, Glc beta 1-4GlcNAc beta-OMe and
      GlcNAc beta 1-4GlcNAc beta-OMe as synthetic substrates.
AB  - Incubation of synthetic Man beta 1-4GlcNAc beta-OMe, GalNAc beta 1-4GlcNAc beta
      OMe, Glc beta 1-4GlcNAc beta-OMe, and GlcNAc beta 1-4GlcNAc beta-OMe with CMP
      Neu5Ac and rat liver Gal beta 1-4GlcNAc alpha(2-6)-sialyltransferase resulted in
      the formation of Neu5Ac alpha 2-6Man beta 1-4GlcNAc beta-OMe, Neu5Ac alpha 2
      6GalNAc beta 1-4GlcNAc beta-OMe, Neu5Ac alpha 2-6Glc beta 1-4GlcNAc beta-OMe and
      Neu5Ac alpha 2-6GlcNAc beta 1-4GlcNAc beta-OMe, respectively. Under conditions
      which led to quantitative conversion of Gal beta 1-4GlcNAc beta-OEt into Neu5Ac
      alpha 2-6Gal beta 1-4GlcNAc beta-OEt, the aforementioned products were obtained
      in yields of 4%, 48%, 16% and 8%, respectively. HPLC on Partisil 10 SAX was used
      to isolate the various sialyltrisaccharides, and identification was carried out
      using 1- and 2-dimensional 500-MHz 1H-NMR spectroscopy.

PMID- 8358229
TI  - The roles of enteric bacterial sialidase, sialate O-acetyl esterase and
      glycosulfatase in the degradation of human colonic mucin.
AB  - Sialidase activity in normal faecal extracts showed a preference for mucin
      related glycoprotein and oligosaccharide substrates, but the presence of two or
      more O-acetyl esters at positions C7-C9 on the sialic acids retarded the rate of
      hydrolysis. A specific sialate O-acetyl esterase was detected with a lower total
      activity relative to sialidase with mucin substrates and having a pH optimum of
      7.8 and a KM of approximately 1 mM sialate O-acetyl ester. A specific
      glycosulfatase activity was found in faecal extracts using the substrate lactit
      [3H]ol 6-O-sulfate with a pH optimum of pH 5.0 and a KM of approximately 1 mM.
      Faecal extracts from ulcerative colitis (UC) patients had higher sialate O-acetyl
      esterase and glycosulfatase activity, while mucin sialidase activity was
      unchanged. Metabolically labelled mucin isolated from UC patients contained less
      sulfate and had lower sialic acid O-acetylation compared with normal mucin.
      Colonic mucin was degraded more efficiently by faecal extracts from UC patients
      compared with normal extracts. The UC mucin was degraded more rapidly than the
      normal mucin by faecal enzyme extracts from both normal and UC subjects.

PMID- 8358232
TI  - The three-dimensional structure of acyl-coenzyme A binding protein from bovine
      liver: structural refinement using heteronuclear multidimensional NMR
      spectroscopy.
AB  - The 3D structure of bovine recombinant acyl-coenzyme A binding protein has been
      determined using multidimensional heteronuclear magnetic resonance spectroscopy
      in a study that combines investigations of 15N-labeled and unlabeled protein. The
      present structure determination is a refinement of the structure previously
      determined (Andersen, K.V. and Poulsen, F.M. (1992) J. Mol. Biol., 226, 1131
      1141). It is based on 1096 distance restraints and 124 dihedral angle restraints
      of which 69 are for phi-angles and 8 for chiral centers and 47 for prochiral
      centers. The new experimental input for the structure determination has provided
      an increase of 263 distance restraints, 5 phi-angle restraints, and 32 chi-angle
      restraints in 2 chiral centers, and 31 prochiral centers restraining an
      additional 23 chi 1, 8 chi 2, and 1 chi 3 angles. The increase of 300 distance
      and dihedral angle restraints representing an additional 30% of input parameters
      for the structure determination has been shown to be in agreement with the first
      structure. A set of 29 structures has been calculated and each of the structures
      has been compared to a mean structure to give an atomic root mean square
      deviation of 0.44 +/- 0.12 A (1 A is 0.1 nm) for the backbone atoms C, C alpha,
      and N in the four alpha-helices A1, residues 4-15, A2, residues 21-36, A3,
      residues 51-62 and A4, residues 65-84. The loop-region of residues Gly45-Lys50
      could not be defined by the restraints obtained by NMR. The program PRONTO has
      been used for the spectrum analysis, assignment of the individual nuclear
      Overhauser effects, the integration of the cross peaks, and the measurement of
      the coupling constants. The programs DIANA, X-PLOR and INSIGHT have been used in
      the structure calculations and evaluations.

PMID- 8358231
TI  - Sialyltransferase activity in FR3T3 cells transformed with ras oncogene:
      decreased CMP-Neu5Ac:Gal beta 1-3GalNAc alpha-2,3-sialyltransferase.
AB  - We have investigated the activity of CMP-Neu5Ac:Gal beta 1-3GalNAc alpha-2,3
      sialyltransferase (EC 2.4.99.4) in FR3T3 cells transformed by the Ha-ras oncogene
      in which we have previously demonstrated the higher expression of the beta
      galactosidase alpha-2,6-sialyltransferase (EC 2.4.99.1) [21]. We demonstrate that
      the presence of the activated ras gene decreases the activity of this specific
      alpha-2,3-sialyltransferase fourfold. According to the kinetic parameters and to
      mixing experiments, we can assume that this decreased enzymatic activity reflects
      a decrease in the number of active O-glycan alpha-2,3-sialyltransferase
      polypeptides in ras-transformed cells. However, no change in the binding of
      Peanut agglutinin was observed on the cell surface of ras-transformed FR3T3
      suggesting that no change in the sialylation of O-glycan core 1 appeared in these
      cells, although the activity of the alpha-2,3-sialyltransferase was decreased.

PMID- 8358233
TI  - Measurement of two- and three-bond 13C-1H J couplings to the C delta carbons of
      leucine residues in staphylococcal nuclease.
AB  - A new 1H-detected 3D NMR experiment is described that permits quantitative
      measurement of two- and three-bond 13C-1H couplings in proteins with selectively
      13C-enriched methyl sites. The method is demonstrated for staphylococcal nuclease
      selectively [5,5 13C]-labeled in all 11 leucine positions and ligated with
      thymidine 3',5'-biphosphate and Ca2+. Two- and three-bond 13C methyl-proton
      couplings are reported and, together with the measured three-bond JC alpha C
      delta in uniformly 13C-enriched staphylococcal nuclease, the chi 2-angles and the
      stereospecific assignments of the C delta methyl group with respect to the
      prochiral beta-protons were determined. The same residues that were previously
      found to have high degrees of internal mobility on the basis of 13C relaxation
      times have measured coupling constants that are indicative of motional averaging.

PMID- 8358234
TI  - [2-3H]ATP synthesis and 3H NMR spectroscopy of enzyme-nucleotide complexes: ADP
      and ADP.Vi bound to myosin subfragment 1.
AB  - The synthesis of [2-3H]ATP with specific activity high enough to use for 3H NMR
      spectroscopy at micromolar concentrations was accomplished by
      tritiodehalogenation of 2-Br-ATP. ATP with greater than 80% substitution at the 2
      position and negligible tritium levels at other positions had a single 3H NMR
      peak at 8.20 ppm in 1D spectra obtained at 533 MHz. This result enables the
      application of tritium NMR spectroscopy to ATP utilizing enzymes. The proteolytic
      fragment of skeletal muscle myosin, called S1, consists of a heavy chain (95 kDa)
      and one alkali light chain (16 or 21 kDa) complex that retains myosin ATPase
      activity. In the presence of Mg2+, S1 converts [2-3H]ATP to [2-3H]ADP and the
      complex S1.Mg[2-3H]ADP has ADP bound in the active site. At 0 degrees C, 1D 3H
      NMR spectra of S1.Mg[2-3H]ADP have two broadened peaks shifted 0.55 and 0.90 ppm
      upfield from the peak due to free [2-3H]ADP. Spectra with good signal-to-noise
      for 0.10 mM S1.Mg[2-3H]ADP were obtained in 180 min. The magnitude of the
      chemical shift caused by binding is consistent with the presence of an aromatic
      side chain being in the active site. Spectra were the same for S1 with either of
      the alkali light chains present, suggesting that the alkali light chains do not
      interact differently with the active site. The two broad peaks appear to be due
      to the two conformations of S1 that have been observed previously by other
      techniques. Raising the temperature to 20 degrees C causes small changes in the
      chemical shifts, narrows the peak widths from 150 to 80 Hz, and increases the
      relative area under the more upfield peak. Addition of orthovanadate (Vi) to
      produce S1.Mg[2-2H]ADP.Vi shifts both peaks slightly more upfield without
      changing their widths or relative areas.

PMID- 8358235
TI  - SESAME: a least-squares approach to the evaluation of protein structures computed
      from NMR data.
AB  - A method is proposed for defining a probability distribution on an ensemble of
      protein conformations from a 2D NOE spectrum, while at the same time back
      calculating the experimental spectrum from the ensemble. This enables one to
      assess the relative quality and significance of the conformations, and to test
      the consistency of the ensemble as a whole with the experimental spectrum. The
      method eliminates the need to integrate the cross-peak intensities and is
      surprisingly insensitive to random noise in the spectrum. In this communication,
      these advantages are demonstrated by applying the method to simulated data, for
      which the correct result is already known.

PMID- 8358236
TI  - Deficiency of dystrophin-associated proteins: a common mechanism leading to
      muscle cell necrosis in severe childhood muscular dystrophies.
AB  - Dystrophin is a large cytoskeletal protein encoded by the Duchenne muscular
      dystrophy (DMD) gene. Dystrophin is associated with a large oligomeric complex of
      sarcolemmal glycoproteins, including the novel laminin-binding glycoprotein
      called dystroglycan, which provides a linkage to the extracellular matrix. In
      DMD, the absence of dystrophin leads to a drastic reduction in all of the
      dystrophin-associated proteins. In severe childhood autosomal recessive muscular
      dystrophy with DMD-like phenotype (SCARMD), a specific deficiency of the 50 kDa
      dystrophin-associated glycoprotein is found. Thus, the disruption/dysfunction of
      the dystrophin-glycoprotein complex due to the deficiency of one or more of the
      dystrophin-associated proteins is presumed to cause the disruption of the linkage
      between the subsarcolemmal cytoskeleton and the extracellular matrix. This may
      render muscle cells susceptible to necrosis in two forms of severe childhood
      muscular dystrophy, DMD and SCARMD.

PMID- 8358237
TI  - Dystrophin-positive myotubes in innervated muscle cultures from Duchenne and
      Becker muscular dystrophy patients.
AB  - Nerve-muscle co-cultures from five Duchenne muscular dystrophy (DMD) patients and
      one Becker (BMD) patient, were studied by immunocytochemistry with antibodies
      against different portions of dystrophin. Four DMD patients had a deletion in the
      dystrophin gene. Some dystrophin-positive myotubes were detected in a few samples
      of all DMD cases. PCR amplification of exon 8 of the dystrophin gene ruled out a
      contamination from rat spinal cord during innervation. Our results in three DMD
      cases, may be explained by a clonal selection of dystrophin-positive fibers
      observed in muscle biopsies, while in the other two cases, a "frame-restoring"
      mutation might account for the presence of dystrophin-positive myotubes. The
      possible expression of "dystrophin-related protein" or dystrophin immature
      isoform was considered. In the BMD case an abnormal truncated dystrophin was
      found in innervated muscle cultures, as well as in muscle biopsy.

PMID- 8358239
TI  - Manifesting carriers of Xp21 muscular dystrophy; lack of correlation between
      dystrophin expression and clinical weakness.
AB  - Ten females presenting with muscle weakness and a raised serum creatine kinase
      revealed abnormalities in the expression of dystrophin in their muscle biopsies
      and were diagnosed as manifesting carriers of Xp21 Duchenne/Becker muscular
      dystrophy. Seven cases, aged 3-22 yr at the time of biopsy, had a variable
      proportion of dystrophin-deficient fibres and an abnormal expression on
      immunoblot. These were confidently diagnosed as manifesting carriers. Results in
      the remaining three cases, aged 8-10 yr, were less clear-cut. Dystrophin
      expression on immunoblots was slightly reduced and some unevenness and reduction
      of immunolabelling was seen on sections, but dystrophin-deficient fibres were not
      a feature of these cases. The weakness in the ten carriers ranged from minimal to
      severe and there was no correlation between the degree of weakness and the number
      of dystrophin-deficient fibres. Two minimally weak girls had a high proportion of
      dystrophin-deficient fibres. Our results show that analysis of dystrophin
      expression is useful for the differential diagnosis of carriers of Xp21 dystrophy
      and autosomal muscular dystrophy, but that dystrophin expression does not
      correlate directly with the degree of clinical weakness.

PMID- 8358238
TI  - Accumulating autofluorescent material as a marker for early changes in the spinal
      cord of the Mnd mouse.
AB  - The mouse mutant Motor neuron degeneration (Mnd) displays an adult-onset
      progressive degeneration of upper and lower motor neurons, with mild symptoms
      recognizable at 6 months, leading to spastic paralysis and premature death at 10
      12 months on the C57B1/6 background. Despite this late onset, abnormally
      accumulating autofluorescent material can be seen in both the spinal cord and
      other regions as early as the first month. This pigmented material is present in
      both increasing numbers of cells, and in increasing amounts within individual
      cells, as the animals age. Motor neurons then go on to degenerate, while most
      other cell types stabilize. The level of pathological involvement, well before
      the onset of clear clinical symptoms, suggests that the full degenerative process
      is an extremely gradual and protracted one with some selectivity for motor
      neurons.

PMID- 8358240
TI  - The glycinamide ribonucleotide transformylase (GART) gene is not responsible for
      familial amyotrophic lateral sclerosis.
AB  - Though the nature of the underlying metabolic defect which leads to amyotrophic
      lateral sclerosis (ALS) remains obscure, certain biochemical anomalies have been
      found, such as, reduced RNA content in ALS motor neurons. Recently, a gene
      causing the familial form of ALS (FALS) has been assigned to an interval of
      approximately 10 cM including the locus D21S58 on chromosome 21q22.1. This region
      includes the GART gene which encodes an enzyme catalyzing three steps in the de
      novo biosynthesis of purine nucleotides which are precursors for RNA. A defect of
      this gene might result in reduced RNA production and predispose to premature
      death of motor neurons. In order to test GART as a candidate we developed two
      highly informative DNA markers in this region and carried out linkage analyses
      for FALS. GART is excluded as a candidate for FALS.

PMID- 8358241
TI  - Molecular biology and pathology of skeletal and cardiac myogenesis. EMBO
      Workshop, Baia di Conti, Sardinia, 25 September-1 October 1992.

PMID- 8358242
TI  - Neuromuscular disorders: gene location.

PMID- 8358243
TI  - Continuing education and degree programs. Factors affecting nurses entry.

PMID- 8358244
TI  - Career challenges and distance education.

PMID- 8358245
TI  - Preceptors: a research study.

PMID- 8358246
TI  - The move to outcomes measurement.

PMID- 8358247
TI  - Top-level administrators. A study of continuing education needs.

PMID- 8358248
TI  - Stress decreases the serum level of osteocalcin.
AB  - During a study undertaken to characterize the time course of the osteocalcin
      response to bone fractures, lower than normal values of serum osteocalcin (1.7 +/
      0.9 vs. 3.3 +/- 1.3 ng/ml, P < 0.001) were found in the basal samples (blood
      obtained 48-72 h after fracturing). Suspecting that such a decrease could be due
      to the stress response induced by the fracture, for corticosteroids are known to
      diminish serum osteocalcin, we extended our study to another two stressful
      situations of high stress: acute myocardial infarction and elective abdominal
      surgery. Indeed, the concentration of osteocalcin was also significantly
      diminished in both of these (2.0 +/- 0.9 ng/ml, P < 0.0005; 1.5 +/- 1.0 ng/ml, P
      < 0.0001). To further characterize this phenomenon, the time course of
      osteocalcin changes during the 24 h following abdominal surgery was studied in a
      second group of patients. The decrease was found to begin soon after surgery. In
      order to exclude the immobilization present in those three situations as the
      cause of the decrease in serum osteocalcin, a group of patients with retinal
      detachment was studied. Their serum osteocalcin levels were normal. It is
      concluded that serum osteocalcin levels decrease in stressful situations.
      Therefore, they should be interpreted cautiously when used as a marker of
      osteoblastic activity in this setting.

PMID- 8358249
TI  - Declining bone loss rate variability with increasing follow-up time.
AB  - Bone loss rates are believed to vary substantially among post-menopausal women.
      The belief, however, might be largely based upon comparisons of loss rates
      measured with considerable error. This issue arises because the precision of the
      bone mass instrumentation (1-2% errors in measuring bone mass) is similar in
      magnitude to the loss rate (typically 1-2% of bone mass per year). The 'true'
      variability in loss rates, however, can be estimated by adjusting for instrument
      errors. An equation is presented which estimates the true variability in loss
      rates from a study sample. The adjustment was examined using a cohort of post
      menopausal, Japanese-American women living in Hawaii. The study examined the
      calcaneus, distal, and proximal radius sites. The results suggest that
      measurement errors did not markedly inflate the bone loss variability. Even after
      adjustment for measurement errors considerable variability in loss rates
      remained. The variability was examined for various follow-up durations. Both the
      observed and adjusted loss rates had smaller standard deviations over long
      intervals than over short intervals. This result suggests that the more extreme
      rates of change in bone mass over a year or two were often not sustained. The
      implications of this finding for sample size calculations in longitudinal studies
      are examined. The results also indicate that the length of follow-up and
      instrument precision should be taken into consideration when comparing the
      proportion of fast losers between populations.

PMID- 8358250
TI  - Determinants of lumbar bone mineral density in normal weight, non-smoking women
      soon after menopause. A study using clinical data and quantitative computed
      tomography.
AB  - OBJECTIVES: Is there an influence of oral contraceptive use, parity and lactation
      on early postmenopausal bone mass? Is assessment of reproductive history, body
      weight in combination with biochemical markers of bone metabolism suitable to
      predict lumbar bone mass soon after menopause? STUDY DESIGN: A cross-sectional
      study in 94 healthy, normal weight, non-smoking women, 1-3 years after
      spontaneous menopause. Bone mineral density (BMD) of the lumbar spine was
      measured with single energy quantitative computed tomography. RESULTS: Multiple
      regression analysis showed that only total duration of lactation and alkaline
      phosphatase (AP) levels are independently related to trabecular BMD (P = 0.001
      and P = 0.002 respectively). AP was also associated with cortical BMD (P =
      0.003). Assessment of reproductive history, body mass index and biochemical
      markers of bone metabolism could only account for 17% of the variation of
      trabecular BMD observed in the study population. CONCLUSION: This study suggests
      that total duration of lactation rather than parity is associated with trabecular
      BMD of the spine. Clinical assessment of risk factors unsuccessfully predicts
      lumbar BMD in healthy, early postmenopausal women.

PMID- 8358251
TI  - Cyclic stretch increases alkaline phosphatase activity of osteoblast-like cells:
      a role for prostaglandin E2.
AB  - We investigated the effects of applied cyclic stretch on osteoblast-like cells
      using a computerized, pressure-operated instrument that physically deforms the
      cells. Cyclic stretch increased DNA and collagenous protein synthesis and
      enhanced alkaline phosphatase activity in the cells. These effects were
      considered to be regulated through prostaglandin E2 production since this stretch
      reduced the levels of prostaglandin E2 in the medium and when prostaglandin E2
      was added exogenously, there was a significant decrease in the alkaline
      phosphatase activity.

PMID- 8358252
TI  - Effects of 1,25-dihydroxyvitamin D3 and growth hormone therapy on serum
      osteocalcin levels in children with growth hormone deficiency.
AB  - In order to investigate the influence on bone metabolism of growth hormone (GH),
      we evaluated the response to an acute load of 1,25(OH)2D3 (Rocaltrol) (1.5
      micrograms/day for 4 days) in 16 growth hormone-deficient prepubertal children
      (11 boys and 5 girls, aged from 6.2 to 9.6 years) both before and after 1 month
      of human GH (hGH) therapy (0.1 IU/kg/day, 6 times per week). Before and after the
      1,25(OH)2D3 load, serum IGF-I, osteocalcin, Ca, P, alkaline phosphatase (ALP) and
      urinary excretion of Ca and P were measured. The serum levels of osteocalcin rose
      significantly after the first 1,25(OH)2D3 load, without an increase in IGF-I
      values and with a slight non-significant increase in serum Ca and P. Almost
      superimposable increases of osteocalcin, Ca and P were observed after 1 month of
      hGH therapy, with a significant increase of IGF-I, but they did not rise further
      after the second 1,25(OH)2D3 load. On the basis of our results, 1,25(OH)2D3 seems
      to have a stimulatory action on osteoblastic activity even in the absence of
      normal levels of GH. However, there is no apparent additional stimulatory
      activity after administration of hGH. Osteocalcin level behaviour during our
      study might suggest that GH and 1,25(OH)2D3 have a common and easily saturable
      stimulatory pathway on osteoblastic function.

PMID- 8358253
TI  - Physical activity and bone mass: exercises in futility?
AB  - Growing bone responds to low or moderate exercise through significant additions
      of new bone in both cortical and trabecular moieties and results in adaptation
      through periosteal expansion and endocortical contraction. Intracortical
      activation frequency declines in growing bone in response to exercise, reducing
      porosity and the remodelling space. These adaptations can be maintained into and
      throughout adulthood. Young bones have a greater potential for periosteal
      expansion than aging bone, allowing them to adapt more rapidly and efficiently to
      an acute need for increased strength, but a threshold level of activity exists
      above which some bones respond negatively by suppressing normal growth and
      modelling activity, reducing geometric, mechanical and material properties in
      cortical and trabecular bone. From cross-sectional studies, differences in bone
      mass between exercising and non-exercising adults are generally less than 10%,
      but do not account for exercise history which may be very important, and often
      fail to consider important confounding variables. There is sufficient
      longitudinal data to demonstrate that moderate to intensive training can bring
      about modest increases of about 1-3% in bone mineral content (BMC) of men and
      premenopausal women. In young adults very strenuous training may increase BMC of
      the tibia up to 11% and its bone density (BD) by 7%, but may represent periosteal
      woven bone formation in response to excessive strain. Some evidence shows that
      exercise can also add bone mass to the post-menopausal skeleton, although the
      amounts are site-specific and relatively modest. Increases as high as 5-8% can be
      found after 1-2 years of intensive exercise, but additions of bone to the femur
      and radius are generally less than 2%, well within the range of the remodelling
      space and measurement precision. Although increases in bone mass of the post
      menopausal skeleton may be extremely modest, physical activity is important to
      preserve bone mass and muscle function. Detraining reduces any bone mass increase
      to pre-existing values so that long-term benefits are only retained with
      continuing exercise. Most importantly, the amount of bone gain that can be
      achieved appears dependent primarily on the initial bone mass suggesting that
      individuals with extremely low initial bone mass may have more to gain from
      exercise than those with moderately reduced bone mass.

PMID- 8358254
TI  - Prevention of alcohol-related accidents in the community.
AB  - This paper establishes a conceptual and operational basis for development of
      community prevention programs to reduce alcohol-related accidents. A public
      health perspective of accidents is proposed as the philosophical basis for local
      prevention interventions in which accidents are viewed as system problems (system
      outputs, if you will) not simply problems caused by a few alcohol-dependent
      individuals. Since there are no examples of controlled community prevention
      research projects (trials) which have demonstrated a reduction in community-level
      alcohol-related accidents, such controlled trials are needed in the future. An
      example of one being developed by the Prevention Research Center, Berkeley, CA is
      provided. Without such controlled trials, prevention research will be unable to
      demonstrate that such accidents can actually be reduced. This paper explores the
      applications of a public health perspective to the prevention of alcohol-involved
      accidents at the community level including a conceptual model of alcohol-involved
      trauma and suggested design, alternative local interventions, possible outcome
      measures, and phases for community prevention of alcohol-related accidents.

PMID- 8358255
TI  - The Stockholm County programmes for accident and alcohol prevention and injury
      surveillance--initial experiences.
AB  - A comprehensive programme for accident prevention and injury surveillance was
      established in Stockholm County in 1988. Its main objective is to reduce the
      morbidity and mortality of unintentional injuries by 25% by the year 2000, and by
      more than 25% in the high-incidence groups. An accident prevention unit has been
      assigned to task of planning and implementing an accident prevention programme,
      while a programme for prevention of alcohol-related problems was set up later. An
      injury epidemiological unit at the Karolinska Hospital is responsible for
      coordinating injury surveillance, which is an important contribution for
      monitoring and evaluation of the prevention programmes. On injured patients
      information about type of injury, extent of injury, place, activity, injury
      mechanism, external cause of injury, treatment and other items is entered on a
      special registration form. In (10%) of 11,327 injury events alcohol was
      considered by the physician to be a main or contributory cause of the injury,
      with a predominance among males. An act of violence was approximately three times
      as common among males and five times as common among females with alcohol
      involvement than among cases without alcohol involvement. The injury surveillance
      can be an important means for evaluation of programmes for prevention of injuries
      and alcohol-related events.

PMID- 8358256
TI  - Special issue: Alcohol-related accidents and injuries.

PMID- 8358257
TI  - Research on and prevention of alcohol-related trauma: phases, patterns, and
      issues.

PMID- 8358258
TI  - Societal norms and risk-taking behaviour: inter-cultural comparisons of
      casualties and alcohol consumption.
AB  - Inter-cultural comparisons point to associations among aggregate rates of
      consumption and certain alcohol-related complications, particularly chronic
      effects, such as liver cirrhosis mortality. Accidental, poisoning and violent
      incidents are not considered to have as strong an association with societal
      drinking patterns, since situational, environmental and interactional features
      contributing to the incident are likely to play a strong role relative to the
      volume of alcohol consumed. This paper compares annual alcohol consumption rates
      and male and female mortality rates for liver cirrhosis and 12 main
      accidental/violent causes of death for Canada, Finland, France, the Netherlands,
      Switzerland, and the US between 1965 and 1987. Using filtering techniques to
      account for autocorrelation, conservative measures of association were developed.
      The results indicate that while statistically significant correlations were
      evident with regard to liver cirrhosis and suicide in some jurisdictions, in most
      instances the comparisons were not significant. Further work is suggested with
      regard to the following: utilizing more refined approaches to examine the
      covariations of casualties and alcohol consumption, and studies combining
      aggregate level investigations with those focusing at the group or interactional
      level--in particular those specifying and examining societal norms and risk
      taking at the group and sub-population levels.

PMID- 8358259
TI  - Alcohol and non-traffic unintended injuries.
AB  - In a review of the English language literature on alcohol and unintentional
      injury we identified 21 studies on falls, 36 on drownings and 32 on burns from
      1947-1986. The proportion of fatal and non-fatal fall victims who had been
      drinking ranged from 21-77%, and 18-53% respectively. In three more recent
      studies, 35-63% of persons fatally injured in falls had been drinking. In five
      other studies 13-37% of persons injured in non fatal falls had been drinking. In
      our earlier review of drowning studies with complete ascertainment and duration
      of submergence specified, 27-47% of those who drowned had positive BAC's. In
      eight subsequent studies, alcohol was identified in 21-47% of drowning deaths. In
      our earlier review alcohol was involved in 9-86% of burn deaths. In five more
      recent US studies, alcohol was found in 12-61% of fatally injured burn victims.
      Case control studies are needed to establish whether alcohol increases the risk
      of trauma. Studies are also needed of interventions to reduce the proportion of
      these injuries where alcohol is involved.

PMID- 8358260
TI  - Methodological approaches and problems in research into alcohol-related accidents
      and injuries.
AB  - A classification system for methodologies and problems in research on alcohol
      related accidents and injuries is introduced. On the basis of this system,
      possible designs and statistical methods are presented, and their possible
      contributions to research on alcohol-related accidents/injuries are evaluated.
      Special consideration is given to potential biases in secondary data sources, and
      to methods of overcoming these biases. Finally, the need for more theory-driven
      research is established.

PMID- 8358261
TI  - Causal attributions in the explanation of alcohol-related accidents.
AB  - This paper discusses issues related to the cognitive and communicational activity
      of ascribing a causal role to alcohol use in accidents. It is argued that in
      addition to the empirical relationships to be explained causal attribution is
      limited by two other types of empirical contingencies: the cognitive processing
      of information available for causal attribution, and the representation of this
      information in language (encoding and decoding as part of communication). Only
      the latter two types of restrictions in causal attribution are discussed, since
      its logical requirements are covered by well known methodological principles. On
      the linguistic and communicative side, limitations and biases in causal
      ascription are introduced by (1) the three central concepts ('alcohol', 'cause',
      'accidents') due to properties inherent in language; (2) the (often implicit)
      selection of boundary conditions; (3) heuristic inference rules; and (4) the
      tendency towards thematic closure in describing and explaining phenomena. It is
      suggested that social, psychological and interactional causal processes have been
      overlooked in attributing causal links between alcohol use, hazardous behaviour
      and accidents.

PMID- 8358262
TI  - The measurement of alcohol-related accidents.
AB  - This paper examines some of the major ethical and research issues associated with
      the measurement and recording of alcohol-related problems. Because self-reports
      of the history of the amount of alcohol ingested are sometimes unreliable, the
      assessment of the role of alcohol in casualties often relies on a variety of
      methods which are both diverse and interrelated. The unique measurement problems
      posed by the diversity of alcohol measures are reviewed and issues in selection
      and recording bias of alcohol's involvement in injury are discussed. A number of
      fundamental ethical and moral issues related to measurement are identified.

PMID- 8358263
TI  - Personal willingness to pay for prevention: evaluating the consequences of
      accidents as a basis for preventive measures.
AB  - This paper argues that if scarce resources are to be allocated efficiently and to
      greatest advantage then it is necessary to have explicit monetary measures of the
      benefits of reduced accident rates so that these benefits can be weighed against
      costs in the process of determining the appropriate amount to expend on alcohol
      related accident prevention programmes. The conceptual issues related to the
      definition and estimation of monetary values of safety are discussed and the case
      in favour of basing such values on individual willingness to pay for safety is
      developed. The paper then summarises existing empirical estimates of willingness
      to-pay based values for the prevention of fatalities and reports the preliminary
      results of recent work aimed at estimating willingness-to-pay based values for
      the prevention of non-fatal injuries. The paper concludes by examining the
      applicability of existing empirical estimates of the value of safety in the
      alcohol-related accident context and the transferability of estimates derived in
      developed countries to the developing country context.

PMID- 8358264
TI  - Alcohol and injuries: a review of international emergency room studies.
AB  - This paper reviews emergency room (ER) studies from a number of countries which
      have focused on the association of alcohol and casualties. The review emphasizes
      studies which used probability sample of patients to represent the population of
      the emergency facility where the data were collected, and which separated injured
      patients from patients with medical conditions not due to injuries (the 'non
      injured'). Reviewed here are studies concerned with: (1) estimated prevalence of
      positive blood alcohol at the time of the ER visit; (2) self-reported alcohol
      consumption prior to the event resulting in a need for ER treatment; (3)
      patients' descriptions of their usual drinking patterns and alcohol-related
      problems; (4) predictions of casualties and of alcohol-related casualties.
      Comparisons of findings from several countries are also presented. Comments on
      limitations of ER studies as well as other issues pertaining to the usefulness
      and interpretation of such data, and future directions for research in emergency
      room populations are discussed.

PMID- 8358265
TI  - Alcohol in home and leisure injuries.
AB  - The part that alcohol plays in non-motor vehicle unintentional injuries is not
      well known. Injuries at home and during leisure form a very heterogeneous group.
      Alcohol involvement varies considerably from one subgroup to another: for
      example, all cases of alcohol poisoning involve alcohol by definition, whereas
      alcohol involvement is very infrequent in sports injuries. One-third of falls,
      half of drownings and fire deaths and two-thirds of hypothermia deaths involve
      alcohol. Young and middle-aged males form a risk group of alcohol-related trauma.
      Alcohol involvement varies also from country to country: deaths from alcohol
      poisoning are several times as common in Finland as in other Western countries.
      In contrast to experience in Western countries, in Dar es Salaam, Tanzania,
      wealthier injured Africans were found to have alcohol involvement more often than
      poor Africans. Alcohols seems to increase the risk of falling, bicycle and motor
      vehicle injuries largely to the same extent. The relative importance of the two
      main components of alcohol-related risk--risk-taking and impaired psychomotor
      functions--requires further exploration in each main external cause category of
      home and leisure injuries.

PMID- 8358266
TI  - The occurrence and epidemiologic features of alcohol-related occupational
      injuries.
AB  - This paper presents a review of published literature on alcohol-related
      occupational injuries. Based on the information presented the true magnitude of
      the problem of alcohol- and work-related injuries has not been accurately
      assessed and the epidemiologic features of this problem have not been properly
      evaluated. There is some evidence, albeit incomplete, that alcohol contributes to
      work-related injuries, but the extent is not known. Further, the risk of injury
      by specific industry and occupation has not yet been elucidated. Analytic studies
      which include control groups and which assess confounding variables are needed so
      as to aid in the design of effective countermeasure strategies. Even when alcohol
      is detected, its role in the causal pathway from the worker-energy interaction to
      injury onset (or exacerbation) has not been studied.

PMID- 8358267
TI  - Alcohol and civil aviation.
AB  - In aviation medicine until the early 1960s the idea that pilots would fly while
      under the influence of alcohol was taboo. In the United States of America, the
      taboo was broken when it became known that 30% of fatally injured pilots in
      general aviation had been under the influence of alcohol. Since then the rate has
      declined to 10%. No fatal accidents involving alcohol have been recorded in
      airline passenger transport. The prevalence of pilots flying under the influence
      of alcohol is unknown. The lowest studied blood alcohol concentration (BAC) with
      impaired flying skill today is 0.025%, effectively suggesting that the permitted
      level should be zero, but many aviation authorities have not yet translated such
      findings into rules and regulations. In the early 1970s the US Federal Air
      Surgeon began to re-issue licences for rehabilitated alcoholic pilots. Previously
      alcoholism had been a reason for mandatory permanent grounding. The possibility
      of returning to the cockpit first opened the way to early recognition of
      alcoholic pilots on a larger scale. Today many airlines have their own alcohol
      programmes. This paper gives a brief account of the Swissair programme with its
      four phases: observation, intervention, treatment and follow-up.

PMID- 8358268
TI  - Issues in cross-national comparisons of crash data.
AB  - While national accident record systems appear to provide an attractive method of
      comparing the effectiveness of traffic safety programs, differences in
      definitions, data collection methods and file structure may lead to misleading
      conclusions. Variations in crash definitions and methods for measuring alcohol
      involvement are described and illustrated with data from US crash files. Examples
      of international comparisons are provided.

PMID- 8358269
TI  - Alcohol and accidents in Switzerland--a critical review.
AB  - The analysis of alcohol-related traffic accidents points to a negative
      relationship between the average amount of alcohol consumed and the percentage of
      alcohol-related accidents. The data show that the officially registered problem
      rates among drivers under the influence of alcohol depend primarily neither on
      consumption trends nor on general preventive factors, but, rather on the capacity
      for accident detection, the recording practices of the authorities and a less
      tolerant public opinion. Regional differences in the willingness to enforce
      control measures are related to varying cultural drinking contexts. The under
      reporting of occupational accidents reflects an undue emphasis in insurance
      statistics which are based on a guilt/moral concept which is used to justify
      sanctions, such as cuts in insurance benefits. It is clear from the empirical
      evidence, that the broad press coverage on 'alcohol-related' ski accidents proves
      to be a typical case of problem amplification.

PMID- 8358270
TI  - Effects of mass media communications on health and safety habits: an overview of
      issues and evidence.
AB  - A review is presented of factors that have been investigated on their relevance
      in mass media communications that are specifically designed to alter health and
      safety related behaviours of the recipients. While alcohol consumption is a major
      concern in this paper, the evidence regarding the effective use of mass
      communications for the modification of other health and safety habits has also
      been incorporated. Specific topics include the choice of yardstick of effect,
      study methodology and the strength of conclusion this permits, as well as the
      dependency of the effect of mass communication upon its four constituent
      components: the source, the content of the message, the channel of communication,
      and the characteristics of the recipients. Reference is made to the effect of
      educational journalism related to the prevention of health problems and to
      efforts to increase the educational value of traffic accident reports in daily
      newspapers through the inclusion of information that is potentially helpful to
      accident avoidance.

PMID- 8358271
TI  - Punishment as a factor in preventing alcohol-related accidents.
AB  - As a humanitarian and economic 'bad', infliction of punishment requires
      justification in terms of compensating achievements, as well as moral
      appropriateness. In the context of road accidents, there is evidence that
      increasing the certainty and swiftness of threatened punishment may deter risky
      behavior, although increasing the severity of the threat seems ineffective. These
      effects may be generalizable to other kinds of accidents, but empirical evidence
      is lacking. A further possibility for the justifiable use of punishment is in its
      application to negligent service of alcohol.

PMID- 8358272
TI  - [The constant electrical potentials of the skin as an integral index of the
      functional state].
AB  - The electric potential difference between the head and hind limb of monkeys was
      studied before, during and after 2h-restraint in a supine position. The kinetics
      of electric potentials depended on the initial electric polarity of animals. The
      role and place of the basal system of epithelium (basal membrane and basal cell
      layer) in functioning of multicellular organisms is discussed.

PMID- 8358273
TI  - [The effects of the white gene on coat pigmentation in mouse aggregation
      chimeras].
AB  - We obtained eight Mi(wh)/+<==>Mi(wh)/Mi(wh) chimeras using embryos of two mutant
      substrains of Mi(wh)/Mi(wh) mice with different isozymes Gpi-1(aa) and Gpi-1(bb).
      Chimerism was determined by the mosaicism of retinal pigment epithelium and
      electrophoretically different variants of glucose phosphate isomerase. The
      patterns of coat pigmentation in all chimeras were similar to those in Mi(wh)/+
      heterozygotes. Despite the high proportion of the parental Mi(wh)/Mi(wh)
      component in three chimeras, the phenotype of their coat pigmentation was also
      similar with that of Mi(wh)/+ mice. The chimeras lacked mosaic-pigmented hairs.
      These data suggest presence only one cell population of Mi(wh)/+ melanoblasts
      that actively proliferate and colonize almost all forming hair follicles. Hence,
      the proliferation and/or differentiation of Mi(wh)/+ melanoblasts is not
      suppressed in the Mi(wh)/Mi(wh) dermis and epidermis. The Mi(wh) gene acting in
      melanoblasts leads to the block of their proliferation at the early stages of
      development in the homozygotes.

PMID- 8358274
TI  - [The role of glutathione in shaping the metabolic response of the cell to
      hypoxia].
AB  - The role of glutathione in metabolic response of the cell to hypoxia is
      discussed. Experiments were carried on random bred white female rats and their
      offspring. The antihypoxic effect of glutathione was studied using a low-pressure
      chamber model of acute hypoxic hypoxia and a perfused heart. When administered
      during the last third of pregnancy, glutathione stimulates in the female and in
      the foetus development of protective-adaptive reactions, thus increasing the
      resistance of hypoxia. This is expressed in an increased resistance to acute
      hypoxia and an improved mechano-energetic coupling of the myocardium. A proposed
      mechanism underlying the hypoxic, energizing effect of glutathione is related to
      decreased hyper-reduction of the NAD-dependent region of the respiratory chain
      and the recovery of its ability to synthesize ATP in the first site of oxidative
      phosphorylation. The results obtained allow us to outline perspectives of search
      for new compounds controlling the level of glutathione in the cells and, hence,
      activating the development of adaptational compensatory mechanisms for protection
      against de-energizing effect of hypoxia and similar factors.

PMID- 8358275
TI  - [The prospects for using marine algae].
AB  - Different aspects of utilization of the products of marine algae processing are
      discussed: phycocolloids, sterins, isoprenoids, etc. The natural resources of
      algae are decreased due to their intensive exploitation. Hence, the development
      of algal mariculture becomes very urgent.

PMID- 8358276
TI  - [The prediction of the superactivity of embryo-toxic benzine and indole
      derivatives by the discriminant analysis method].
AB  - The discriminant functions allowing to predict the phenomenon of superactivity
      for some embryotoxic neurochemicals by means of tabular electronic and lipophilic
      parameters are received. The prognosis possibility of the received functions for
      benzene and indole derivatives on the sea urchin embryos is about 93%.

PMID- 8358277
TI  - [A comparative study of the action on the hemostatic system of extracts from the
      flowers and seeds of the meadowsweet (Filipendula ulmaria (L.) Maxim.)].
AB  - Flowers and seeds of Filipendula ulmaria show a high level of anticoagulant
      activity. Their anticoagulant and fibrinolytic effects were demonstrated after
      per os administration of the extracts. The seed extracts exert equally high
      anticoagulating effects when administered in vivo and in vitro.

PMID- 8358278
TI  - [The inhibition of bile acid synthesis in cultured rabbit hepatocytes by
      bezafibrate].
AB  - Primary culture of rabbit hepatocytes was used for study the influence of
      hypolipidemic drug bezafibrate on bile acid production. Bezafibrate inhibits bile
      acid synthesis from endogenous and exogenous (lipoprotein) cholesterol at
      concentration range 1-10 micrograms/ml. Such inhibitory action of bezafibrate on
      bile acid synthesis should be kept in mind while applying hypolipidemic
      treatment.

PMID- 8358279
TI  - Food additives and contaminants and their contribution to the human cancer load.

PMID- 8358280
TI  - The epidemiological evidence concerning intake of mutagenic activity from the
      fried surface and the risk of cancer cannot justify preventive measures.
AB  - In the fried meat surface layer (the meat crust) mutagenic heterocyclic amines
      are formed during cooking. A human cancer risk is conceivable after intake of
      such mutagenic activity. We investigated the current literature mentioning fried
      foods, and six studies of colorectal cancer, three of stomach cancer and one each
      of cancer of the breast, lower urinary tract and pancreas are included. None of
      the reports tried to assess directly the intake of mutagenic activity from the
      fried surface. One indirect measure of mutagenic activity is to look at the
      browning of the meat surface; two investigations are available for this variable.
      The content of mutagenic activity in the surface may vary with the 'doneness' of
      meat and two studies consider this variable. Another indirect measure is to
      compare results from meat irrespective of cooking methods (ie, comparing meat not
      fried with fried meat or fried foods). There are several validity problems in the
      reviewed studies. Major potential sources of bias include, quite apart from
      misclassification of mutagenic activity, possible confounding factors from meat
      per se and fat. The epidemiological evidence in the field is sparse and cannot
      justify preventive measures.

PMID- 8358281
TI  - Self-administered faecal occult blood tests do not increase compliance with
      screening for colorectal cancer: results of a randomized controlled trial.
AB  - In the UK, compliance with conventional faecal occult blood (FOB) tests such as
      Haemoccult is about 50% in the general population. It has been postulated that
      characteristics of the performance of conventional tests, in particular the need
      for dextrous gathering and manipulation of faeces, delay in receiving results,
      and the recommended dietary restrictions, may all diminish compliance. New FOB
      tests have been developed, popularly termed 'magic toilet paper' tests, which not
      only minimize faecal manipulation but are also self-reported. Compliance rates
      with two self-administered faecal occult blood tests (Early Detector and
      Coloscreen Self-Test) were compared with Haemoccult in a randomized trial
      involving 1,842 subjects aged 40-74 years. Use of self-administered FOB tests did
      not increase compliance significantly, with rates of 52.1% for Early Detector,
      50.6% for Coloscreen and 49.1% for Haemoccult. Moreover, dietary restriction did
      not reduce compliance significantly (restricted 49.3%, unrestricted 51.8%). A
      wide variation (from 1.3% to 21.4%) in positivity rates was observed which was
      dependent on which of the three tests was used and whether dietary restrictions
      were applied. Since the physical aspects of test performance do not appear to
      determine an individual's decision to be screened, self-administered tests will
      not overcome the problem of poor compliance with FOB screening.

PMID- 8358282
TI  - Patterns of Pap smear use in the Rimini area: an analysis of women's attitudes to
      the test.
AB  - The use of the Pap test is a method of the prevention of cervical cancer in our
      local division of the Sanitary Unit and has been studied with the help of a
      questionnaire which was completed by women who had adopted this test. The
      socioeconomic characteristics, level of education, occupation and general
      attitudes regarding the Pap test as well as how the women had acquired knowledge
      of the test, have all been examined. From an analysis of the answers, we have
      been able to trace a precise social, economic and cultural profile of the type of
      women who take advantage of this test. Principally, we are dealing with women
      aged 40-49 years, often with children, with a medium to low level of education,
      who are mainly housewives and white-collar workers. Very few elderly women
      present themselves for the Pap test. We have noticed that there is a direct
      decrease in the use of preventive methods, proportional to the increase in age.
      These results demonstrate that an erratic use of this preventive method, in the
      absence of an organized screening programme, seems only to involve women who are
      among those at less risk from cervical cancer.

PMID- 8358283
TI  - Cancer patterns in three African populations compared with the United States
      black population.
AB  - Cancer incidence rates and patterns in three African populations in the Gambia,
      Mali and South Africa, have been compared with corresponding data on the Black
      population in Connecticut, USA. In the African populations, total rates for
      cancer are much lower than that of US Blacks, even allowing for under-reporting.
      Chief cancers are those of the oesophagus, liver and cervix. In Mali, stomach
      cancer is very common. As to trends, among South African Blacks, a population in
      transition, rates are rising, albeit slowly, of cancers of prosperity--prostate,
      lung, breast and colon-rectum. Salient questions are: can the number of cancers
      of underprivilege be lessened, and can cancers linked with rising socioeconomic
      states be restrained? Discussions of common risk factors, including diet,
      reproduction, smoking and drinking practices, indicate that for Africans as a
      whole, continuing poverty will prevent major changes in cancer pattern and rises
      in occurrence of the disease. However, should prosperity increase for Africans in
      big cities, rates are ultimately likely to attain those prevailing in the US
      Black population. Significant avoiding action seems almost impossible.

PMID- 8358284
TI  - Prevalence of Helicobacter pylori infection in patients with precancerous changes
      and gastric cancer.
AB  - Several papers suggested a role for H. pylori infection in gastric cancer. We
      evaluated the prevalence of H. pylori infection in an endoscopic population of
      patients with gastric precancerous conditions and lesions by studying biopsies
      from 252 patients and recording the presence and degree of H. pylori infection.
      Patients were subgrouped as follows: chronic non-atrophic gastritis (CG), chronic
      atrophic gastritis (CAG), intestinal metaplasia (IM), epithelial dysplasia (ED)
      and gastric cancer (K). As control populations, patients with duodenal ulcer (DU)
      and patients with no endoscopic and histologic damage (CO) were investigated. H.
      pylori infection rate increased with age, but became significantly lower (P <
      0.001) with the progression of gastric mucosal damage: DU 85%, CG 72%, CAG 58%,
      particularly in the antral type (39%), IM 63% overall, ED 44% and K 35%. The
      density of colonization showed the same trend (P < 0.001). Of the K patients,
      only 36% were H. pylori positive in the adjacent mucosa. Anti-H. pylori
      antibodies (IgG, IgA and IgM) were also tested. A concordance in the diagnosis
      between histology and serology was obtained in 82% of the cases. In our
      experience, H. pylori infection correlates inversely with the presence of gastric
      precancerous changes and cancer. A cautious interpretation of the epidemiological
      data regarding H. pylori infection and gastric cancer is therefore, in our
      opinion, mandatory.

PMID- 8358285
TI  - Effects of fruit juices, processed vegetable juice, orange peel and green tea on
      endogenous formation of N-nitrosoproline in subjects from a high-risk area for
      gastric cancer in Moping County, China.
AB  - The effects of four fruit juices, processed vegetable juice, orange peel, green
      tea and low dose vitamin C on endogenous N-nitrosation in 86 subjects from a high
      risk area for gastric cancer in Moping County, China were studied using urinary
      excretion of N-nitrosoproline (NPRO) as an indicator. After ingestion of 300 mg L
      proline, urinary excretion of NPRO was significantly increased from a baseline of
      2.5 +/- 1.6 micrograms/day to 8.7 +/- 6.2 micrograms/day. (P < 0.001). Vitamin C
      (75 mg) administration significantly reduced NPRO formation (62.3%, P < 0.002)
      although NPRO excretion remained higher than the baseline level (4.2 +/- 1.3 vs
      2.2 +/- 1.2 micrograms/day, P < 0.001). Intake of fruit juices and green tea
      extracts (containing 75 mg vitamin C) or of orange peel powder (containing 3 mg
      vitamin C) together with 300 mg L-proline inhibited NPRO formation effectively to
      the baseline level or to levels significantly lower than the baseline level (P <
      0.05-0.005). A processed juice of a number of vegetables (300 ml) significantly
      catalysed endogenous nitrosation (14.7 +/- 11.8 vs 9.4 +/- 4.7 micrograms/day, P
      < 0.05). Endogenous N-nitrosation was unaffected by the presence of intragastric
      lesions. The present study shows that endogenous nitrosation in this population
      is profoundly affected by environmental factors and that inhibitors, such as
      vitamin C, alpha-tocopherol and other non-nutritive compounds in the foods do
      inhibit endogenous nitrosation either synergistically or in an additive manner.
      The significance of fruits and vegetables in prevention of human cancers is
      discussed.

PMID- 8358286
TI  - Regional and national variation in lung cancer mortality in Italy and
      Czechoslovakia.
AB  - In developed countries lung cancer mortality has been shown to be related to
      lifestyle, occupational and environmental aspects, diet, and other factors which
      may vary widely from one region to another. To investigate inter-area differences
      in lung cancer mortality and cigarette smoking a descriptive study has been
      carried out in three areas of Italy and two republics of Czechoslovakia. The
      highest death rates from lung cancer were found in the Czech Republic and
      Northern Italy, for both sexes. Analysis of age-specific rates by birth cohort,
      comparing all five areas, showed the greatest differences in trends between
      Slovakia and Northern Italy in men, and between the Czech Republic and Southern
      Italy in women. The lowest rates were observed in Southern Italy throughout the
      period under study, particularly among women. Making allowance for the latency
      period between the onset of exposure and the development of the disease, data on
      the occurrence of lung cancer could be interpreted looking at previous smoking
      habits. An imperfect overlap between the trend of cigarette smoking and the
      corresponding lung cancer mortality pattern was present in Northern and Southern
      Italy, a finding suggesting that even non-smoking-related factors could have
      played a significant role in lung cancer aetiology.

PMID- 8358287
TI  - Occupational exposures and thyroid cancer: results of a case-control study.
AB  - A case-control study on thyroid cancer concerning 180 cases and 360 controls aged
      20-70 years at diagnosis was performed. Both females and males were included. Of
      the cases, 63% had had papillary thyroid cancer. Work with diagnostic X-ray
      investigations constituted a risk factor for thyroid cancer of the papillary type
      yielding an odds ratio (OR) of 2.9 with 95% confidence interval (CI) = 1.1-8.3.
      For women only OR was 3.3 (CI = 1.2-9.8). The results also indicated that work as
      a lineman, which entails exposure to electromagnetic fields and chemicals,
      increased the risk. Exposure to impregnating agents gave an increased OR = 2.8
      with CI = 1.0-8.6. For men only OR was 3.8 with CI = 1.1-16. Women who were
      previously smokers and female current smokers had significantly decreased risks
      with OR = 0.5 (CI = 0.2-0.96) and OR = 0.6 (CI = 0.3-0.96), respectively.

PMID- 8358288
TI  - Inhibition of dexamethasone-induced cytochrome P450-mediated mutagenicity and
      metabolism of aflatoxin B1 by Chinese medicinal herbs.
AB  - Oldenlandia diffusa (OD) and Scutellaria barbata (SB) have been used in
      traditional Chinese medicine for treating liver, lung and rectal tumours. We
      previously showed that they inhibited mutagenesis, DNA binding and metabolism of
      aflatoxin B1 (AFB1) and benzo(a)pyrene (BaP) bioactivated by Aroclor 1254-induced
      rat S9. The purpose of this study was to investigate the effects of OD and SB on
      the mutagenicity of AFB1 in Salmonella typhimurium TA100 using dexamethasone
      (DXM)-induced rat hepatic S9, on cytochrome P450-linked aminopyrine N-demethylase
      (APND) activity in DXM-induced hepatic microsomes and on the metabolism of AFB1
      by DXM-induced S9 using high-performance liquid chromatography (HPLC). The
      experimental results showed that OD and SB consistently inhibited the
      mutagenicity of AFB1 bioactivated by either non-induced or DXM-induced S9. These
      effects correlated with the inhibition of cytochrome P450-linked APND activity in
      DXM-induced microsomes and with an inhibition of DXM-induced S9 mediated
      metabolism of [3H]AFB1 as determined by HPLC. Since DXM treatment has been
      associated with an induction of the CYP3 enzyme family, these results suggest
      that OD and SB may possess antimutagenic and antitumorigenic activity towards
      AFB1 through an inhibition of CYP3-mediated metabolism of AFB1.

PMID- 8358289
TI  - Sex hormones and trace elements in rat CCL4-induced cirrhosis and hepatocellular
      carcinoma.
AB  - Several biochemical events accompany and mediate the development of chronic liver
      disease and its evolution into cancer. Low plasma zinc and high copper levels
      have been observed in various liver diseases, such as liver cirrhosis and viral
      hepatitis, while increased oestradiol levels have been documented in chronic
      liver damage and hepatocellular carcinoma. We administered CCL4 intragastrically
      to 10 female Sprague Dawley rats for 30 weeks. All animals developed cirrhosis
      and four also developed hepatocellular carcinoma. Plasma levels of zinc, copper
      and oestradiol were significantly higher in the latter group than in animals with
      simple cirrhosis. Progesterone, AST and bilirubin showed a trend toward
      significant differences whereas testosterone and ALP levels were unchanged. These
      findings add to the evidence that sex hormones and trace elements are involved in
      the process of the development of chronic liver damage and carcinogenesis.

PMID- 8358290
TI  - Pretreatment levels of CEA, CA 19-9, CA 50 and CA 72-4 in sera of patients with
      squamous cell carcinoma of the oesophagus.

PMID- 8358291
TI  - Structural engineering of the HIV-1 protease molecule with a beta-turn mimic of
      fixed geometry.
AB  - An important goal in the de novo design of enzymes is the control of molecular
      geometry. To this end, an analog of the protease from human immunodeficiency
      virus 1 (HIV-1 protease) was prepared by total chemical synthesis, containing a
      constrained, nonpeptidic type II' beta-turn mimic of predetermined three
      dimensional structure. The mimic beta-turn replaced residues Gly16,17 in each
      subunit of the homodimeric molecule. These residues constitute the central amino
      acids of two symmetry-related type I' beta-turns in the native, unliganded
      enzyme. The beta-turn mimic-containing enzyme analog was fully active, possessed
      the same substrate specificity as the Gly16,17-containing enzyme, and showed
      enhanced resistance to thermal inactivation. These results indicate that the
      precise geometry of the beta-turn at residues 15-18 in each subunit is not
      critical for activity, and that replacement of the native sequence with a rigid
      beta-turn mimic can lead to enhanced protein stability. Finally, the successful
      incorporation of a fixed element of secondary structure illustrates the potential
      of a "molecular kit set" approach to protein design and synthesis.

PMID- 8358292
TI  - In situ conversion of coproporphyrinogen to heme by murine mitochondria: terminal
      steps of the heme biosynthetic pathway.
AB  - Coproporphyrinogen oxidase (EC 1.3.3.3), protoporphyrinogen oxidase (EC 1.3.3.4),
      and ferrochelatase (EC 4.99.1.1) catalyze the terminal three steps of the heme
      biosynthetic pathway. All three are either bound to or associated with the inner
      mitochondrial membrane in higher eukaryotic cells. A current model proposes that
      these three enzymes may participate in some form of multienzyme complex with
      attendant substrate channeling (Grand-champ, B., Phung, N., & Nordmann, Y., 1978,
      Biochem. J. 176, 97-102; Ferreira, G.C., et al., 1988, J. Biol. Chem. 263, 3835
      3839). In the present study we have examined this question in isolated mouse
      mitochondria using two experimental approaches: one that samples substrate and
      product levels during a timed incubation, and a second that follows dilution of
      radiolabeled substrate by pathway intermediates. When isolated mouse mitochondria
      are incubated with coproporphyrinogen alone there is an accumulation of free
      protoporphyrin. When Zn is added as a substrate for the terminal enzyme,
      ferrochelatase, along with coproporphyrinogen, there is formation of Zn
      protoporphyrin with little accumulation of free protoporphyrin. When EDTA is
      added to this incubation mixture with Zn, Zn protoporphyrin formation is
      eliminated and protoporphyrin is formed. We have examined the fate of
      radiolabeled substrates in vitro to determine if exogenously supplied pathway
      intermediates can compete with the endogenously produced compounds. The data
      demonstrate that while coproporphyrinogen is efficiently converted to heme in
      vitro when the pathway is operating below maximal capacity, exogenous
      protoporphyrinogen can compete with endogenously formed protoporphyrinogen in
      heme production.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358293
TI  - Effects of alanine substitutions in alpha-helices of sperm whale myoglobin on
      protein stability.
AB  - The peptide backbones in folded native proteins contain distinctive secondary
      structures, alpha-helices, beta-sheets, and turns, with significant frequency.
      One question that arises in folding is how the stability of this secondary
      structure relates to that of the protein as a whole. To address this question, we
      substituted the alpha-helix-stabilizing alanine side chain at 16 selected sites
      in the sequence of sperm whale myoglobin, 12 at helical sites on the surface of
      the protein, and 4 at obviously internal sites. Substitution of alanine for bulky
      side chains at internal sites destabilizes the protein, as expected if packing
      interactions are disrupted. Alanine substitutions do not uniformly stabilize the
      protein, either in capping positions near the ends of helices or at mid-helical
      sites near the surface of myoglobin. When corrected for the extent of exposure of
      each side chain replaced by alanine at a mid-helix position, alanine replacement
      still has no clear effect in stabilizing the native structure. Thus linkage
      between the stabilization of secondary structure and tertiary structure in
      myoglobin cannot be demonstrated, probably because of the relatively small free
      energy differences between side chains in stabilizing isolated helix. By
      contrast, about 80% of the variance in free energy observed can be accounted for
      by the loss in buried surface area of the native residue substituted by alanine.
      The differential free energy of helix stabilization does not account for any
      additional variation.

PMID- 8358294
TI  - Crystal structure to 2.45 A resolution of a monoclonal Fab specific for the
      Brucella A cell wall polysaccharide antigen.
AB  - The atomic structure of an antibody antigen-binding fragment (Fab) at 2.45 A
      resolution shows that polysaccharide antigen conformation and Fab structure
      dictated by combinatorial diversity and domain association are responsible for
      the fine specificity of the Brucella-specific antibody, YsT9.1. It discriminates
      the Brucella abortus A antigen from the nearly identical Brucella melitensis M
      antigen by forming a groove-type binding site, lined with tyrosine residues, that
      accommodates the rodlike A antigen but excludes the kinked structure of the M
      antigen, as envisioned by a model of the antigen built into the combining site.
      The variable-heavy (VH) and variable-light (VL) domains are derived from genes
      closely related to two used in previously solved structures, M603 and R19.9,
      respectively. These genes combine in YsT9.1 to form an antibody of totally
      different specificity. Comparison of this X-ray structure with a previously built
      model of the YsT9.1 combining site based on these homologies highlights the
      importance of VL:VH association as a determinant of specificity and suggests that
      small changes at the VL:VH interface, unanticipated in modeling, may cause
      significant modulation of binding-site properties.

PMID- 8358295
TI  - Primary structure of a photoactive yellow protein from the phototrophic bacterium
      Ectothiorhodospira halophila, with evidence for the mass and the binding site of
      the chromophore.
AB  - The complete amino acid sequence of the 125-residue photoactive yellow protein
      (PYP) from Ectothiorhodospira halophila has been determined to be
      MEHVAFGSEDIENTLAKMDDGQLDGLAFGAIQLDGDGNILQYNAAEGDITGRDPKEVIGKNFFKDVAP+ ++
      CTDSPEFYGKFKEGVASGNLNTMFEYTFDYQMTPTKVKVHMKKALSGDSYWVFVKRV. This is the first
      sequence to be reported for this class of proteins. There is no obvious sequence
      homology to any other protein, although the crystal structure, known at 2.4 A
      resolution (McRee, D.E., et al., 1989, Proc. Natl. Acad. Sci. USA 86, 6533-6537),
      indicates a relationship to the similarly sized fatty acid binding protein
      (FABP), a representative of a family of eukaryotic proteins that bind hydrophobic
      molecules. The amino acid sequence exhibits no greater similarity between PYP and
      FABP than for proteins chosen at random (8%). The photoactive yellow protein
      contains an unidentified chromophore that is bleached by light but recovers
      within a second. Here we demonstrate that the chromophore is bound covalently to
      Cys 69 instead of Lys 111 as deduced from the crystal structure analysis. The
      partially exposed side chains of Tyr 76, 94, and 118, plus Trp 119 appear to be
      arranged in a cluster and probably become more exposed due to a conformational
      change of the protein resulting from light-induced chromophore bleaching. The
      charged residues are not uniformly distributed on the protein surface but are
      arranged in positive and negative clusters on opposite sides of the protein. The
      exact chemical nature of the chromophore remains undetermined, but we here
      propose a possible structure based on precise mass analysis of a chromophore
      binding peptide by electrospray ionization mass spectrometry and on the fact that
      the chromophore can be cleaved off the apoprotein upon reduction with a thiol
      reagent. The molecular mass of the chromophore, including an SH group, is 147.6
      Da (+/- 0.5 Da); the cysteine residue to which it is bound is at sequence
      position 69.

PMID- 8358296
TI  - Crystal structure of activated tobacco rubisco complexed with the reaction
      intermediate analogue 2-carboxy-arabinitol 1,5-bisphosphate.
AB  - The crystal structure of activated tobacco rubisco, complexed with the reaction
      intermediate analogue 2-carboxy-arabinitol 1,5-bisphosphate (CABP) has been
      determined by molecular replacement, using the structure of activated spinach
      rubisco (Knight, S., Andersson, I., & Branden, C.-I., 1990, J. Mol. Biol. 215,
      113-160) as a model. The R-factor after refinement is 21.0% for 57,855
      reflections between 9.0 and 2.7 A resolution. The local fourfold axis of the
      rubisco hexadecamer coincides with a crystallographic twofold axis. The result is
      that the asymmetric unit of the crystals contains half of the L8S8 complex
      (molecular mass 280 kDa in the asymmetric unit). The activated form of tobacco
      rubisco is very similar to the activated form of spinach rubisco. The root mean
      square difference is 0.4 A for 587 equivalent C alpha atoms. Analysis of
      mutations between tobacco and spinach rubisco revealed that the vast majority of
      mutations concerned exposed residues. Only 7 buried residues were found to be
      mutated versus 54 residues at or near the surface of the protein. The crystal
      structure suggests that the Cys 247-Cys 247 and Cys 449-Cys 459 pairs are linked
      via disulfide bridges. This pattern of disulfide links differ from the pattern of
      disulfide links observed in crystals of unactivated tobacco rubisco (Curmi,
      P.M.G., et al., 1992, J. Biol. Chem. 267, 16980-16989) and is similar to the
      pattern observed for activated spinach tobacco.

PMID- 8358298
TI  - Characterization of the stable, acid-induced, molten globule-like state of
      staphylococcal nuclease.
AB  - Titration of a salt-free solution of native staphylococcal nuclease by HCl leads
      to an unfolding transition in the vicinity of pH 4, as determined by near- and
      far-UV circular dichroism. At pH 2-3, the protein is substantially unfolded. The
      addition of further HCl results in a second transition, this one to a more
      structured species (the A state) with the properties of an expanded molten
      globule, namely substantial secondary structure, little or no tertiary structure,
      relatively compact size as determined by hydrodynamic radius, and the ability to
      bind the hydrophobic dye 1-anilino-8-naphthalene sulfonic acid. The addition of
      anions, in the form of neutral salts, to the acid-unfolded state at pH 2 also
      causes a transition leading to the A state. Fourier transform infrared analysis
      of the amide I band was used to compare the amount and type of secondary
      structure in the native and A states. A significant decrease in alpha-helix
      structure, with a corresponding increase in beta or extended structure, was
      observed in the A state, compared to the native state. A model to account for
      such compact denatured states is proposed.

PMID- 8358297
TI  - Leucine 332 influences the CO2/O2 specificity factor of ribulose-1,5-bisphosphate
      carboxylase/oxygenase from Anacystis nidulans.
AB  - The role of Leu 332 in ribulose-1,5-bisphosphate carboxylase/oxygenase from the
      cyanobacterium Anacystis nidulans was investigated by site-directed mutagenesis.
      Substitutions of this residue with Met, Ile, Val, Thr, or Ala decreased the
      CO2/O2 specificity factor by as much as 67% and 96% for the Ile mutant in the
      presence of Mg2+ and Mn2+, respectively. For the Met, Ile, and Ala mutants in the
      presence of Mg2+, no loss of oxygenase activity was observed despite the loss of
      greater than 65% of the carboxylase activity relative to the wild-type enzyme. In
      the presence of Mn2+, carboxylase activities for mutant enzymes were reduced to
      approximately the same degree as was observed in the presence of Mg2+, although
      oxygenase activities were also reduced to similar extents as carboxylase
      activities. Only minor changes in Km(RuBP) were observed for all mutants in the
      presence of Mg2+ relative to the wild-type enzyme, indicating that Leu 332 does
      not function in RuBP binding. These results suggest that in the presence of Mg2+,
      Leu 332 contributes to the stabilization of the transition state for the
      carboxylase reaction, and demonstrate that it is possible to affect only one of
      the activities of this bifunctional enzyme.

PMID- 8358299
TI  - Refolding and proton pumping activity of a polyethylene glycol-bacteriorhodopsin
      water-soluble conjugate.
AB  - Bacteriorhodopsin (BR), from the purple membrane (PM) of Halobacterium halobium,
      was chemically modified with methoxypolyethylene glycol (m-PEG; molecular weight
      = 5,000 Da) succinimidyl carbonate. The polyethylene glycol-bacteriorhodopsin (m
      PEG-SC-BR33) conjugate, containing one polyethylene glycol chain, was water
      soluble. The secondary structure of the conjugate in water appeared partially
      denatured, but was shown to contain alpha-helical segments by circular dichroism
      spectroscopy. The isolated bacteriorhodopsin conjugate, with added retinal, was
      refolded in a mixed detergent-lipid micelle and had an absorption maximum at 555
      nm. The refolded conjugate was transferred into vesicles that pumped protons,
      upon illumination, as efficiently as did native BR. Modification of the PM with m
      PEG did not alter the native structure or inhibit proton pumping, and therefore
      it is suggested that the glycol polymer is present as a moiety covalently linked
      to residues unnecessary for proton pumping and proper folding. The site of
      attachment of m-PEG was determined to be at either Lys 129 or Lys 159, with
      position Lys 129 the most probable site of attachment. The m-PEG-SC-BR33 could be
      stepwise refolded to the native conformation by the addition of trifluoroethanol
      to lower the dielectric constant, simulating the insertion of the BR into the
      phospholipid bilayer.

PMID- 8358301
TI  - Polarity of disulfide bonds.

PMID- 8358300
TI  - Cross-validation of protein structural class prediction using statistical
      clustering and neural networks.
AB  - We present an approach to predicting protein structural class that uses amino
      acid composition and hydrophobic pattern frequency information as input to two
      types of neural networks: (1) a three-layer back-propagation network and (2) a
      learning vector quantization network. The results of these methods are compared
      to those obtained from a modified Euclidean statistical clustering algorithm. The
      protein sequence data used to drive these algorithms consist of the normalized
      frequency of up to 20 amino acid types and six hydrophobic amino acid patterns.
      From these frequency values the structural class predictions for each protein
      (all-alpha, all-beta, or alpha-beta classes) are derived. Examples consisting of
      64 previously classified proteins were randomly divided into multiple training
      (56 proteins) and test (8 proteins) sets. The best performing algorithm on the
      test sets was the learning vector quantization network using 17 inputs, obtaining
      a prediction accuracy of 80.2%. The Matthews correlation coefficients are
      statistically significant for all algorithms and all structural classes. The
      differences between algorithms are in general not statistically significant.
      These results show that information exists in protein primary sequences that is
      easily obtainable and useful for the prediction of protein structural class by
      neural networks as well as by standard statistical clustering algorithms.

PMID- 8358302
TI  - Fibronectin type III modules in the receptor phosphatase CD45 and tapeworm
      antigens.

PMID- 8358303
TI  - The contributions of Stein and Moore to protein science.

PMID- 8358305
TI  - [Experimental-clinical study of a dual-micron holmium laser].

PMID- 8358304
TI  - [Formation of stabile complexes of myosin subfragment-1 with ADP and
      orthovanadate or beryllium fluoride in the presence of calcium ions].

PMID- 8358306
TI  - [The effect of a glycoprotein from bone marrow (an amplifying protein) on the
      functional activity of growth factors].

PMID- 8358307
TI  - [Rate of chromosome segregation in human-mouse somatic hybrids is controlled by
      murine genome].

PMID- 8358308
TI  - [A radiation situation on the Kola Peninsula, Novaia Zemlia, Franz-Josef Land and
      in the Barents Sea water].

PMID- 8358309
TI  - [Oligonucleotides forming highly stable, specific duplexes, their use as primers
      in sequencing and in the polymerase chain reaction].

PMID- 8358310
TI  - [The effect of NMDA and quinolinic acid on cortical neurons of the rat brain].

PMID- 8358311
TI  - [Reactions of reticulospinal neurons of the medulla oblongata on the stimulation
      of the inhibitory motion sites of the brain, thalamus, and frontal cortex].

PMID- 8358312
TI  - [Cyclic peptide hepatotoxins from spring water cyanobacteria (blue-green algae)
      from blooming water sources in the Ukraine and in the European part of Russia].

PMID- 8358313
TI  - [Xeno- and allotransplantation of insulin-producing tissues in the anterior eye
      chamber as a method of compensating for experimental diabetes].

PMID- 8358314
TI  - [The effect of specific formations in mouth corners on physiologo-morphological
      parameters of the adult Campbell hamster (Phodopus Campbelli, Thomas, 1905)].

PMID- 8358315
TI  - [Visual radiation fibers regenerate after replacing the visual cortex with a
      neocortical transplant].

PMID- 8358316
TI  - [Integration of hepatitis B virus DNA into the human neuroblastoma cell genome].

PMID- 8358317
TI  - [Expression of heat shock proteins in mycoplasma].

PMID- 8358318
TI  - [Structure of the anal gland of the Mongolian woodchuck].

PMID- 8358319
TI  - [Effect of synthesizing molecules of double-stranded RNA in transgenic tobacco
      plants on resistance to tobacco mosaic virus].

PMID- 8358320
TI  - [Morphofunctional adaptation of the Galliformes cecum to vegetable feedstuffs].

PMID- 8358321
TI  - [Structure and function of the hemiglandular and discoglandular stomachs of field
      mice (Rodentia, Clethrionomys)].

PMID- 8358322
TI  - Microheterogeneity in O-type sugar chains of carbohydrases secreted by Asp.
      awamori.
AB  - This paper deals with microheterogeneity in the structure of O-linked sugars of
      carbohydrases secreted by Asp. awamori, namely glucoamylase, alpha-galactosidase
      and alpha-glucosidase. Microheterogeneity was found to be related both to post
      secretion deglycosylation and to changes in transferase activity induced by the
      differences in culturing conditions.

PMID- 8358323
TI  - Adsorption of glucoamylase from Asp. awamori X-100/D27 on cell walls.
AB  - Upon secretion, the major form of glucoamylase from Asp. awamori adsorbs on
      fungal cell walls. Its substrate binding site showing affinity for alpha-1-4 and
      alpha-1-6 wall glucans is responsible for adsorption. The minor form in which
      this site is absent has no sorption ability for cell walls.

PMID- 8358325
TI  - New observations on proteases of the human hookworm Necator americanus.
AB  - Two protease populations have been identified in the somatic products of adult
      Necator americanus. One population (158, 138, 34 and 31 kDa) loses, whereas the
      other population (107, 74, 51 and 20 kDa) retains, its proteolytic activity after
      elution from substrate gels. The present study warns that hookworm proteases may
      oligomerise and/or lose their activity under the conditions necessary for their
      purification. We suggest that following assessment of protease activity on
      substrate gels, the protease of interest should be eluted from plain gels; their
      isolation from substrate gels may lead to a reduced or no yield.

PMID- 8358324
TI  - Structure and properties of the 26S protease complex from chick skeletal muscle.
AB  - The 26S protease complex was purified from chick skeletal muscle and shown to
      consist of unusually heterogeneous 21-140 kDa polypeptides, including the 21-32
      kDa subunits of the 20S proteasome. Electron microscopic analysis revealed that
      the 26S complex may have a symmetric morphology with two large rectangular
      terminal domains attached to a thinner central 20S proteasome domain. The 26S
      complex was capable of degrading the peptide substrates of the 20S proteasome,
      including Suc-LLVY-AMC, N-Cbz-LLE-NA and N-Cbz-ARR-MNA. The two enzyme complexes
      showed similar sensitivities to various site-specific protease inhibitors,
      although their sensitivities to SDS were differed from each other.
      Immunoprecipitation with anti-26S complex antibody reduced peptide hydrolysis by
      the 20S proteasome. Similarly, anti-20S proteasome antibody inhibited peptide
      hydrolysis by the 26S complex. These results demonstrate that the 26S protease
      complex contains the 20S proteasome as a functional and structural component.

PMID- 8358326
TI  - Dual role of free fatty acids in regulation of mitochondrial L-glycerol-3
      phosphate dehydrogenase.
AB  - In brown adipose tissue mitochondria, the influence of free fatty acids on FAD
      linked L-glycerol-3-phosphate dehydrogenase was investigated using either
      hydrophilic or hydrophobic electron acceptors. The apparent kinetic parameters
      were determined for substrate and electron acceptors in the presence of different
      concentrations of oleic acid. In contrast to the L-glycerol-3-phosphate
      dehydrogenase enzyme from mitochondrial hyperthyroid rat liver, the brown adipose
      tissue enzyme shows only a single detectable L-glycerol-3-phosphate binding site.
      The inhibition is of competitive type for L-glycerol-3-phosphate using either
      hydrophilic or hydrophobic electron acceptors, while for electron acceptors non
      competitive or uncompetitive inhibition was determined, respectively.

PMID- 8358327
TI  - Characterisation of 2S albumin with nutritionally balanced aminoacid composition
      from the seeds of Chenopodium album and its antigenic homology with seed proteins
      of some Chenopodiaceae and Amaranthaceae species.
AB  - The low molecular weight 2S albumin protein of Chenopodium album seeds has been
      isolated and characterized with respect to its subunit structure by SDS-PAGE and
      antigenic homology with low molecular weight seed storage proteins of several
      other phylogenetically related species by immunoprecipitation and Western
      blotting. These studies revealed the existence of antigenically homologous
      proteins of similar molecular weights in seeds of some other members of
      Chenopodiaceae and Amaranthaceae. However, Chenopodium 2S albumin is
      antigenically unrelated to low mol.wt. albumins of dicots belonging to other
      families. It has a nutritionally balanced aminoacid composition in respect of
      essential aminoacids.

PMID- 8358328
TI  - Influence of palm oil or its tocotrienol-rich fraction on the lipid peroxidation
      potential of rat liver mitochondria and microsomes.
AB  - The effect of palm oil, a widely used vegetable oil, rich in tocotrienols, on
      peroxidation potential of rat liver was examined. Long-term feeding of rats with
      palm oil as one of the dietary components significantly reduced the peroxidation
      potential of hepatic mitochondria and microsomes. As compared to hepatic
      mitochondria isolated from rats fed control or corn oil-rich diet, those from
      palm oil-fed group showed significantly less susceptibility to peroxidation
      induced by ascorbate and NADPH. However, in microsomes, only NADPH-induced lipid
      peroxidation was significantly reduced in rats fed palm oil rich-diet. Though the
      accumulation of thiobarbituric acid reactive substances during ascorbate-induced
      lipid peroxidation in mitochondria from rats fed corn oil-rich diet supplemented
      with tocotrienol-rich fraction (TRF) of palm oil was similar to that of control
      rats, the initial rate of peroxidation was much slower than those from control or
      corn oil fed diets. Our in vitro studies as well as analyses of co-factors
      related to peroxidation potential indicated that the observed decrease in palm
      oil-fed rats may be due to increased amount of antioxidants in terms of
      tocotrienol as well as decrease in the availability of substrates for
      peroxidation.

PMID- 8358329
TI  - The mechanism(s) of the alcohol-induced impairment in glycogen synthesis in
      oxidative skeletal muscles.
AB  - Ethanol is known to acutely inhibit glucose-stimulated glycogen deposition in
      skeletal muscles in the rat. This effect is selective for oxidative as opposed to
      non-oxidative muscles. This paper explores the biochemical basis for this
      selective impairment in muscle glycogen metabolism. 4-Methylpyrazole, a potent
      inhibitor of alcohol dehydrogenase, potentiated the ethanol-mediated impairment
      in glycogen deposition in oxidative muscles and was associated with abnormalities
      in glycogen deposition in non-oxidative muscles. By contrast, disulfiram, a
      potent inhibitor of aldehyde dehydrogenase had no effect on the ethanol-mediated
      impairment in glycogen deposition in both oxidative and non-oxidative muscles.
      The implication is that it is the ethanol molecule itself, and not one of its
      metabolites (acetaldehyde, acetate, excess NADH), that mediates the defect in
      glycogen metabolism.

PMID- 8358330
TI  - Increased platelet aggregation and fatty acid oxidation in diabetic rats.
AB  - The effects of diabetes on fatty acid oxidation in platelets was determined in
      streptozotocin-induced diabetic rats. In platelets isolated from diabetes, the
      oxygen consumption which reflects mainly the degree of fatty acid oxidation and
      ADP- and thrombin-induced aggregation were increased as compared to non-diabetic
      rat platelets. Carnitine palmitoyltransferase I (CPT I), the rate-limiting enzyme
      for fatty acid oxidation, in platelets obtained from diabetes showed a higher
      Vmax for palmitoyl-CoA and an increased I50 (concentration giving 50% inhibition
      of CPT I activity) for malonyl-CoA inhibition. These changes observed in fatty
      acid oxidation in platelets derived from diabetes returned to the control levels
      after insulin therapy. When platelets were stimulated with thrombin, platelet CPT
      I activity increased over time in both diabetic and non-diabetic rats. From these
      findings, fatty acid oxidation in platelets, as in the liver, is likely to be
      regulated by insulin and both increased CPT I activity and decreased sensitivity
      to malonyl-CoA inhibition are attributable to enhanced platelet fatty acid
      oxidation in diabetic rats.

PMID- 8358331
TI  - Antilipogenic action of synthetic C-terminal sequence 177-191 of human growth
      hormone.
AB  - The synthetic C-terminal peptide fragment of human growth hormone, Leu-Arg-Ile
      Val Gln-Cys-Arg-Val-Ser-Glu-Gly-Ser-Cys-Gly-Phe (hGH 177-191), was shown to have
      antilipogenic activity identical with that of the intact molecule of human growth
      hormone (hGH). No significant lipolytic effect of hGH 177-191 was found as
      determined by the rate of glycerol release from epididymal fat pads of the
      peptide-treated rats. The results support the suggestion that the functional
      domain responsible for the antilipogenic activity of hGH resides in the C
      terminal region of the molecule and that the main physiological effect of hGH in
      lipid metabolism is at the level of lipogenesis.

PMID- 8358332
TI  - Effects of tumour necrosis factor-alpha on the enzymatic activities related to
      glucose metabolism.
AB  - The effects of an intravenous administration of a single dose (100 micrograms/kg
      bw) of tumour necrosis factor-alpha (TNF, cachectin) on in vivo glucose oxidation
      and on several enzymatic activities related with glucose metabolism both in rat
      liver and skeletal muscle were studied. The treatment with the cytokine induced
      an increase in the oxidation of glucose, the differences being significant from
      minute 30. In contrast, TNF did not induce any change on the activities of
      glucokinase, hexokinase, pyruvate kinase and glucose-6-phosphate dehydrogenase,
      although significant increase in the activity of muscle phosphofructokinase was
      observed.

PMID- 8358333
TI  - Chronic tumour necrosis factor-alpha treatment modifies protein turnover in rat
      tissues.
AB  - Chronic TNF treatment for 8 days resulted in an increased protein turnover in
      most of the tissues studied. The increased turnover could be observed in both the
      synthetic and degradation fractional constants; however, in the majority of the
      tissues (muscle, diaphragm, heart, kidneys, lungs and brown adipose) the increase
      in Kd was higher than that of Ks resulting thus in a reduced protein accumulation
      (Ka). In contrast, chronic TNF treatment resulted in an increased brain protein
      accumulation. The data presented suggest that the cytokine could be involved in
      tissue wasting in pathological states such as sepsis and malignancy.

PMID- 8358334
TI  - The distribution of aldose and aldehyde reductases in different regions of human
      and bovine kidney.
AB  - Human and Bovine kidney aldose and aldehyde reductases from cortex, medulla and
      papilla have been purified by DE-52 column chromatography or chromatofocusing and
      have been biochemically characterized. In both human and bovine kidney, cortex
      contains only aldehyde reductase and papilla aldose reductase. Medulla however,
      contains aldose as well as aldehyde reductase.

PMID- 8358335
TI  - Purification of superoxide dismutase from placental haemolisate blood: a simple
      and efficient method.
AB  - Superoxide dismutase functions as a scavenger of superoxide radical protecting
      living organisms. This enzyme has potential use as anti-inflammatory or anti
      reperfusion injury drug. Here we present a simple and efficient SOD purification
      method from human placental blood. Superoxide dismutase from clarified haemolysed
      placental blood after chloroform and ethanol treatment was purified by DEAE
      Sepharose, Phenyl-Sepharose chromatographies and cross flow ultrafiltration. The
      purified product is 98% pure by SDS-PAGE with 71% yield and specific activity of
      2.8 x 10(5) U/mg protein.

PMID- 8358336
TI  - Comparison of changes in the uptake and mucosal processing of iron in riboflavin
      deficient rats.
AB  - Riboflavin deficiency in rats resulted in a reduction in the transfer of 59Fe
      from an intragastric dose to plasma compared to age-matched or weight-matched
      controls. The uptake of iron by brush-border membrane vesicles made from
      intestinal mucosa of riboflavin-deficient rats was much less than identically
      prepared vesicles from control groups. Although the mucosal content of 59Fe was
      smaller in riboflavin-deficient rats thirty minutes after dosing, the relative
      distribution of 59Fe between the mucosal iron-binding proteins, ferritin and
      transferrin, was not changed compared to the control groups. These studies
      suggest that the impairment in iron absorption in riboflavin deficiency is
      primarily the result of a reduced uptake of iron into the mucosal cell and not a
      redistribution of iron between iron-binding proteins inside the mucosal cell.

PMID- 8358338
TI  - 4-Hydroxyaminoquinoline 1-oxide can convert the Z-form of poly(dG-m5dC).poly(dG
      m5dC) back to B-form-DNA.
AB  - Reactions between the chemical carcinogen 4-hydroxyaminoquinoline 1-oxide (4HAQO)
      and poly(dG-dC).poly(dG-dC), poly(dG-m5dC).poly(dG-m5dC) and poly(dG
      br5dC).poly(dG-br5dC) were studied under B-form and Z-form conformation
      conditions. 4HAQO bound covalently to both B-form and Z-form-DNA. The extent of
      the B-form to Z-form-DNA transition was diminished by 4HAQO, as inferred by
      spectroscopic methods. Moreover, conversion of the Z-form-DNA back to a right
      handed DNA close to the B-form was observed with this carcinogen.

PMID- 8358337
TI  - Translocation of human platelet calpain-I.
AB  - Intracellular localization of calpain (calcium dependent cysteine proteinase) was
      studied in resting or activated human platelets. When stimulated with 2 U/ml
      thrombin, approximately 40% of total cellular calpain activity and 25% of antigen
      translocated mainly to the intracellular membrane fractions with autolytic
      activation. Translocation of calpain was completely abolished by the addition of
      EDTA to the sonication medium. However an endogenous calpain inhibitor
      (calpastatin) activity was not detected in the membrane fractions both in resting
      and in thrombin stimulated platelets. Translocation of calpain was also observed
      in the platelets stimulated with ionomycin, collagen or phorbor myristate acetate
      (PMA). These data suggest that cytosolic calpain reversibly translocates to the
      intracellular membranes during platelet activation without an interference by
      calpastatin.

PMID- 8358339
TI  - Effect of aging on insulin regulation of fructose 2,6-bisphosphate metabolism in
      human fibroblasts.
AB  - Fructose 2,6-bisphosphate (Fru-2,6-P2) content in human fibroblasts is under
      hormonal control and is strictly related to glycolytic flux. In the present study
      it has been examined whether aging process is accompanied with an impairment in
      the control exerted by insulin on the metabolite content. Upon insulin
      stimulation old fibroblasts show a reduced increase in Fru-2,6-P2 content and
      glycolytic flux. Similarly, 6-phosphofructo-2-kinase (PFK-2) activity in old
      fibroblasts is increased at a lesser extent by insulin treatment, suggesting that
      an impairment at post-receptor level in the signalling pathway of insulin might
      occur with aging. In addition in unstimulated senescent fibroblasts PFK-2
      displays higher activity and reduced Km for substrate, suggesting either that
      during senescence PFK-2 undergoes a post-translational modification or that a
      different PFK-2 isoenzyme is expressed.

PMID- 8358340
TI  - N-(2-hydroxybenzyl)-omega-amino carbonic acids and their derivatives as tools for
      biochemical and biophysical investigations.
AB  - We propose N-(2-hydroxybenzyl)-omega-amino carbonic acids (An) as multifunctional
      probes for fatty acid metabolism studies. Multifunctionality could be achieved by
      introduction of different isotopes into An molecule. Deuteration of An results in
      probes for 2H-NMR membrane studies. Introduction of radioactive iodine and
      bromine isotopes into An gives diagnosticums for gamma-tomography and PET. AnI
      and AnBr are fluorescence quenchers usable for membrane studies. This
      multifunctionality of An derivatives is valuable because they participate in such
      metabolic pathways of fatty acids as beta-oxidation and inclusion into lipids.
      They can also inhibit natural FA oxidation.

PMID- 8358341
TI  - Preclinical evaluation of intravenously administered 111In- and 90Y-labeled B72.3
      immunoconjugate (GYK-DTPA) in beagle dogs.
AB  - B72.3, a monoclonal antibody with reactivity against human adenocarcinomas was
      obtained from the Cytogen Corporation in the form of an immunoconjugate coupled
      with linker-chelator GYK-DTPA by using proprietary carbohydrate directed site
      specific chemistry. The immunoconjugate was radiolabeled with indium-111 or
      yttrium-90. A preclinical analysis was performed in 10 normal beagle dogs. The
      pharmacokinetics of intravenously administered indium- and yttrium-labeled
      immunoconjugates were compared serially in blood, bone marrow and urine samples.
      Compared to 90Y less of the 111In label ended up in urine and more was found in
      blood and bone marrow. Indium-labeled B72.3 GYK-DTPA had relatively higher uptake
      in most glandular tissues than 111In-labeled antiferritin immunoconjugate. Bone
      marrow toxicity was the dose limiting side effect after intravenous infusion of
      90Y-labeled B72.3 GYK-DTPA. Toxicity was also observed in the liver but not in
      other organ systems. Recently other investigators obtained similar results with
      these immunoconjugates in human patients. A preclinical pharmacokinetic analysis
      of radioimmunoconjugates in beagle dogs provided useful information regarding
      bone marrow toxicity, liver toxicity and in vivo instability of the
      immunoconjugate. Data suggest that for future trials in human patients, a more
      stable chelated immunoconjugate for yttrium is needed to achieve less liver
      uptake and a better correlation with the 111In-labeled product than the 90Y
      labeled B72.3 GYK-DTPA used in this investigation.

PMID- 8358342
TI  - Fractionated intravenous administration of 90Y-labeled B72.3 GYK-DTPA
      immunoconjugate in beagle dogs.
AB  - B72.3, a monoclonal antibody with reactivity against human adenocarcinomas, was
      coupled with linker-chelator GYK-DTPA using carbohydrate mediated conjugation
      chemistry and radiolabeled with yttrium-90. Single and double intravenous
      injections of radioimmunoconjugate were compared for acute and late normal tissue
      toxicity in 15 beagle dogs. The second injection was given 4 or 8 days after the
      first. Pharmacokinetics of the radioimmunoconjugate in blood, bone marrow and
      urine were similar for first and second injections. Only bone marrow (acute) and
      liver (late) toxicity were observed. Both liver and bone marrow toxicity were
      decreased by fractionation of the injections. After double injections, the total
      equitoxic dose was 15 and 60% higher for bone marrow and liver toxicity,
      respectively. The mechanisms of normal tissue protection offered by fractionated
      radioimmunoglobulin therapy (RIT) remain to be defined. Fractionated RIT will
      have a better therapeutic ratio than single injection RIT, if antitumor effects
      appear to be less susceptible to fractionation than normal tissues.

PMID- 8358343
TI  - Quantitation of thrombogenicity of hemodialyzer with technetium-99m and indium
      111 labeled platelets.
AB  - The platelet thrombogenicity of a hemodialyzer was quantified with 99mTc- and
      111In-labeled platelets. The platelets collected from blood of Beagle dogs,
      Yorkshire pigs and human volunteers were labeled with 111In-tropolone (detergent
      free) and 99mTc-HMPAO. Hemodialysis was performed with a hollow-fiber dialyzer
      (HFD) in a flow-loop, the temperature of which was maintained at 37 degrees C,
      with flow-rates of 7, 150 and 270 mL/min; after dialysis, the HFD radioactivity
      was measured with an ionization chamber and imaged with a gamma-camera. The
      radioactivity of samples of hollow-fibers taken from the top, middle and bottom
      of the dialyzer was determined with a gamma-counter. The mean values of
      hemodialyzer-adherent platelet radioactivity were calculated for both
      radionuclides. The canine platelets were found to be more thrombogenic than
      porcine and human platelets. The adhesivity of porcine platelets to the
      biomaterial (cellulose-acetate) of the dialyzer approximated that of human
      platelets. The 99mTc label underestimated the thrombus formation (P < 0.01). The
      dynamic processes of thrombosis and embolization from the hemodialyzer resulted
      in the large standard deviations around the mean values of the adherent thrombus.
      In spite of this limitation of the dynamic pathology, the quantitation of
      comparative thrombogenicity with 111In- and 99mTc-labeled platelets suggests that
      both radionuclides could be used for measurement of device-induced
      thrombogenicity and may provide an estimation of prosthesis-induced
      thrombogenicity of human platelets from animal studies.

PMID- 8358344
TI  - A pilot study using 99mTc to measure lead and platinum in the human kidney.
AB  - A pilot study has been conducted to investigate the hypothesis that the
      chemotherapeutic drug, cisplatinum, can mobilize skeletal lead. In vivo
      measurements of lead and platinum in the kidney of chemotherapy patients were
      performed with the technique of x-ray fluorescence, using 99mTc in a backscatter
      geometry. The results of the pilot study were inconclusive; the majority of
      patients exhibited no evidence of kidney lead at the level of system sensitivity,
      and negligible blood and urine lead levels.

PMID- 8358346
TI  - In vitro and in vivo testing of the dopamine D1 ligand [123I]SCH 23982 with
      respect to its potential application in SPET investigations.
AB  - [123I]SCH 23982, a dopamine D1 ligand, was labelled in a large scale process and
      then tested in vitro for binding to rat brain sections and membranes. Because of
      the promising values of KD = 1.5 x 10(-10) M and Bmax = 0.7 x 10(-11) mol/g, in
      vivo evaluation was performed on rats and normal volunteers to test its possible
      usefulness for SPET imaging. In competition experiments, a higher binding in the
      presence of sulpiride was found while ketanserin displaced [123I]SCH 23982 only
      at a 10,000-fold excess. Differences between rats and men were seen with respect
      to their metabolism. SPET investigations failed because the washout of [123I]SCH
      23982 was too rapid.

PMID- 8358345
TI  - Evaluation of the monoamine uptake site ligand [123I]methyl 3 beta-(4-iodophenyl)
      tropane-2 beta-carboxylate ([123I]beta-CIT) in non-human primates:
      pharmacokinetics, biodistribution and SPECT brain imaging coregistered with MRI.
AB  - The in vivo properties of a new radioiodinated probe of the dopamine and
      serotonin transporter, [123I]methyl 3 beta-(4-iodophenyl)tropane-2 beta
      carboxylate ([123I]beta-CIT) were evaluated in baboons and vervet monkeys. The
      labeled product was prepared in 65.2 +/- 2.8% yield (mean +/- SEM; n = 18) by
      reaction of the tributylstannyl precursor with [123I]NaI in the presence of
      peracetic acid followed by high pressure liquid chromatography (HPLC)
      purification to give a product with radiochemical purity of 97.5 +/- 0.5% and
      specific activity of 500-1200 Ci/mmol. After intravenous administration, whole
      brain activity peaked at 6-10% injected dose within 1 h post injection (p.i.) and
      washed out in a biphasic manner with clearance half-lives of 1-2 and 7-35 h for
      the rapid and slow components, respectively. Excretion occurred primarily through
      the hepatobiliary route, with about 30% of the injected dose appearing in the GI
      tract after 5 h. Estimates of radiation absorbed dose gave 0.01, 0.1, 0.2 and
      0.03 mGy/MBq to the brain, gall bladder wall, lower large intestine wall and
      urinary bladder wall, respectively. High resolution SPECT imaging in a baboon
      demonstrated high uptake of tracer in the region of the striatum
      (striatum:cerebellum ratio 4.0), in the hypothalamus (ratio 2.6) and in a
      midbrain region comprising raphe, substantia nigra and superior colliculus (ratio
      2.0), with regional brain uptakes measured at 210 min p.i. of [123I]beta-CIT. The
      anatomical locations of the regions on the SPECT image were confirmed by
      coregistration with MRI. Plasma metabolites and pharmacokinetics were analyzed in
      baboons and vervets by ethyl acetate extraction and HPLC. The major metabolite
      was a polar, non-extractable fraction, which increased to > 50% of the plasma
      activity by 30-45 min p.i. A minor lipophilic (extractable) metabolite was also
      observed, increasing to about 4% at 2-3 h p.i. The plasma protein bound fraction,
      determined by ultrafiltration, was 74.8 +/- 1.4% (n = 6). The arterial input
      function was characterized by the sum of three exponential terms with half-lives
      of 0.3-1.7, 9.7-24.9 and 77-166 min, respectively, for the concentration of free
      parent compound. [123I]beta-CIT promises to be a useful marker for SPECT study of
      the monoamine uptake system in primate brain.

PMID- 8358347
TI  - In vivo instability of reduction-mediated 99mTc-labeled monoclonal antibody.
AB  - A murine monoclonal antibody that reacts with human osteogenic sarcoma (OST7) was
      reduced and directly labeled with 99mTc without any loss of immunoreactivity. No
      fragmentation of the antibody was detected by high performance liquid
      chromatography after the labeling. However, SDS-PAGE analysis of the labeled
      antibody demonstrated the presence of low molecular weight species. Although more
      than 95% of the radioactivity remained bound at the antibody after incubation
      with human serum for 24 h, 99mTc-labeled OST7 was cleared faster from the
      circulation than 125I-labeled OST7 or 111In-labeled OST7 in mice. Urinary and
      fecal excretion of 99mTc were higher than those of 125I. When the 125I-labeled
      antibody was dual-labeled with 99mTc, the blood clearance of 99mTc was faster
      than that of 125I, suggesting release of 99mTc from the antibody in vivo. 99mTc
      labeled OST7, however, gave a higher tumor-to-blood ratio than 125I- or 111In
      labeled OST7 in mice bearing human osteogenic sarcoma. The 99mTc-labeled antibody
      prepared by the direct method was unstable in vivo, but retained a good tumor
      targeting ability.

PMID- 8358348
TI  - Synthesis of (+/-)-[18F]BMY 14802, its enantiomers and their anatomical
      distributions in rodents.
AB  - A potential antipsychotic drug, BMY 14802 was labeled with 18F and its
      distribution in rodents was studied. No-carrier-added (NCA) (+/-)-[18F]BMY 14802
      (5) was synthesized by two methods in 5-10% radiochemical yield in a synthesis
      time of 130-140 min from EOB with a specific activity of 0.5-1.5 Ci/microM. (+)-
      and (-)-[18F]BMY 14802 was synthesized by the chiral reduction of alpha-(4
      [18F]fluorophenyl)-4-(5-fluoro-2-pyrimidinyl)-1-piperazine-b utanone (4) with
      chiral reducing agent, (+)- and (-)-beta-chlorodiisopinocampheylborane [(+)- and
      (-)-DIP chloride] in 6-10% radiochemical yield in a synthesis time of 150 min
      from EOB. Animal studies in mouse and in rat revealed that the distribution of 5
      in each tissue was high at 5 min, the radioactivity then declined rapidly in all
      tissues studied except in the liver and in the small intestine. The radioactivity
      in the femur did not increase with time indicating in vivo defluorination may not
      occur. The uptakes of (+/-)-[18F]BMY 14802 and its enantiomers, (+)- and (-)
      [18F]BMY 14802 in rat cerebellum, brain stem, hippocampus and spinal cord were
      similar and were significantly reduced by prior treatment of rat with haldol.
      This suggests that (+/-)-[18F]BMY 14802 and its enantiomers bind to sigma
      receptors in a similar fashion.

PMID- 8358349
TI  - Simplified measurement of protein-bound iodine with epithermal neutron activation
      analysis.
AB  - A refined method for the measurement of protein-bound iodine (PBI) in blood serum
      was demonstrated by the use of epithermal neutron activation analysis (ENAA). PBI
      in ammonium sulfate-precipitated serum protein, after epithermal neutron
      activation, was determined by high resolution gamma-ray spectrometry. From our
      results, the PBI concentration was 67.8 +/- 2.2 ng/mL. Good agreement was
      obtained with published data, ranging from 40 to 80 ng/mL, which had been
      obtained using different analytical techniques. The validity of these techniques
      for PBI has been born out by a very good accuracy and simplicity without
      temperature dependence.

PMID- 8358350
TI  - Studies of quality control of 99mTc-labelled macroaggregated albumin--Part 1.
      Aggregation of non-mercaptalbumin and its conformation.
AB  - The aggregative condition of albumin was investigated using bovine serum albumin
      (BSA) as a model for quality control of 99mTc-macroaggregated albumin (99mTc
      MAA). Uniformalized aggregates were obtained from the oxidized non-mercapt-type
      of BSA by heating. The size of the aggregates was affected by the pH and the
      types of buffer solutions used as well as the concentrations of albumin and
      buffers. The beta form structure of the albumin was more stable on heating and
      this may contribute to its aggregation. Aggregation of oxidized non
      mercaptalbumin afforded a portion of smaller sized particles in MAA, this being
      an inappropriate factor for scintiscanning of lungs. Our results suggest that it
      is necessary to remove oxidized type albumin from human serum albumin as the
      starting material, in order to prepare MAA with a uniform and larger particle
      size.

PMID- 8358351
TI  - Chloramine-T induced binding of monoclonal antibody B72.3 to concanavalin-A.
AB  - The effects of chloramine-T (CT) on monoclonal antibody B72.3 were studied with
      particular reference to Con-A lectin binding. After exposure to chloramine-T
      concentrations from 0.8 to 4.0 mg/mL (115-574 mol CT/mol B72.3), B.72.3 showed
      progressive binding to agarose-linked Con-A. This behavior was paralleled by
      decreasing immunoreactivity and increasing fragmentation and aggregation of B72.3
      demonstrated by SDS-PAGE and size exclusion HPLC.

PMID- 8358352
TI  - Analysis of urine samples from metastatic bone cancer patients administered 153Sm
      EDTMP.
AB  - 153Sm-EDTMP is currently undergoing clinical evaluation as a radiotherapeutic
      agent for the relief of pain associated with cancer metastatic to bone. These
      clinical studies have demonstrated biodistributions similar to those seen earlier
      in animals, namely, rapid clearance from blood, selective uptake in bone and in
      particular metastatic bone lesions. The radioactivity not deposited in bone is
      cleared through the kidneys into the urine. In this study, urine samples
      collected from 9 patients injected with 153Sm-EDTMP underwent complexation
      analysis via Pharmacia SP-Sephadex C25 cation exchange chromatography. The
      results showed 96.9 +/- 1.7% of the radioactivity in the urine to be present as a
      complex of 153Sm. An HPLC method was developed and it was demonstrated that
      different complexes of 153Sm could be separated. A non-radioactive analytical
      standard of the Sm-EDTMP chelate was synthesized, characterized and shown to have
      the same HPLC retention profile as the 153Sm-EDTMP drug product. HPLC analysis
      was performed on six urine samples and in each case a single radioactivity peak
      with an elution profile the same as that of a 153Sm-EDTMP standard was observed.
      These results indicate that the 153Sm-EDTMP chelate is excreted intact in the
      urine of patients.

PMID- 8358353
TI  - Pharmacokinetics and biodistribution of radiolabeled avidin, streptavidin and
      biotin.
AB  - The extraordinary high affinity of avidin and streptavidin for biotin may be
      exploited in a two-step approach for delivering radiolabeled biotin derivatives
      suitable for imaging and therapy to target-bound streptavidin or avidin
      conjugated monoclonal antibodies (MAbs). The in vivo pharmacokinetics and
      biodistribution of radiolabeled avidin, streptavidin (SA) and DTPA-biocytinamide
      (DTPA-biotin) were studied in the rabbit and dog. SA circulated in the blood
      similar to other 60 kDa proteins, avidin cleared immediately and DTPA-biotin
      exhibited plasma clearance by glomerular filtration.

PMID- 8358354
TI  - Preparation of [1-11C]dopamine, [1-11C]p-tyramine and [1-11C]m-tyramine.
      Autoradiography and PET examination of [1-11C]dopamine in primates.
AB  - A method for no-carrier-added 1-11C-labelling of 3-hydroxy-, 4-hydroxy- and 3,4
      dihydroxy-substituted phenethylamines is described. [11C]Dopamine, [11C]p
      tyramine and [11C]m-tyramine were prepared from on-line produced
      [11C]nitromethane. Condensation of [11C]nitromethane with various protected and
      unprotected benzaldehydes was investigated. A one-pot two-step reduction of the
      substituted 11C-labelled nitrostyrene intermediates, gave after hydrolysis and
      reversed-phase semi-preparative HPLC-purification the corresponding labelled
      amines in a total radiochemical yield of 8-20% (based on [11C]CO2 and decay
      corrected). The total synthesis time was 45-50 min with a specific radioactivity
      of 400-1000 Ci/mmol (15-37 GBq/mumol). The radiochemical purity was higher than
      98% [11C]Dopamine was used for in vitro autoradiography on human post-mortem
      brain sections and for positron emission tomography (PET) on Cynomolgus monkeys.
      Autoradiographic examination of [11C]dopamine binding on human brain section post
      mortem demonstrated specific binding in the caudate putamen and the substantia
      nigra, regions with a dense dopaminergic innervation. Some binding was also seen
      in the globus pallidum, nucleus ventralis of the thalamus and in nucleus dentatus
      of the cerebellum, regions where the dopaminergic innervation is very low. In PET
      examinations of [11C]dopamine binding in Cynomolgus monkeys there was a high
      uptake of radioactivity in the pituitary, the kidneys and the heart. Any passage
      of [11C]dopamine across the blood-brain barrier could not be demonstrated. In
      human PET studies [11C]dopamine has potential as a radioligand for examination of
      the myocardium, pituitary and kidneys.

PMID- 8358355
TI  - Dose-dependent biodistribution of [153Gd]Gd(acetate)n in mice.
AB  - [153Gd]Gd(acetate)n was administered i.v. to mice to study the effect of dose on
      the distribution of free Gd. Distribution from blood was slow with the majority
      of the Gd distributing in the liver. Gd saturated in bone. Heart, lungs, kidneys,
      brain and skeletal muscle exhibited time-dependent decreases in Gd concentration.
      Gd that washed out of heart, lungs, kidneys and/or muscle redistributed in liver,
      spleen and femur. These results indicate a complex dose- and time-dependent
      tissue distribution for Gd and emphasize the importance of eliminating unchelated
      free Gd as a contaminant in Gd-chelates before testing in biodistribution
      experiments. The long-term residual accumulation of Gd suggests the need to
      minimize Gd-chelate dissociation in vivo.

PMID- 8358356
TI  - Radioassays of yttrium-90 used in nuclear medicine.
AB  - Yttrium-90 radioassays are required in nuclear medicine at the gigabecquerel
      activity level (GBq) for measuring injected activity, and at the becquerel level
      for measuring individual tissue samples in biodistribution studies. A method of
      standardizing 90Y for activity using high-efficiency liquid-scintillation
      counting is described. Solution standards were used to establish the calibration
      factors for commercial radionuclide calibrators. Detection efficiencies are also
      presented for liquid-scintillation counting, NaI(T1) bremsstrahlung counting and
      Cerenkov counting.

PMID- 8358358
TI  - Continuing education.

PMID- 8358357
TI  - Radiopharmacology of inhaled 133Xe in skeletal sites containing deposits of
      Gaucher cells.
AB  - Gaucher's disease is a lysosomal storage disease in which cells of the
      reticuloendothelial system accumulate the lipid glucocerebroside. It is
      characterized by slowly progressive visceral and osseous involvement. One of the
      latter manifestations includes lipid infiltration of bone marrow. We monitored
      the rate of inhaled 133Xe uptake and wash-out over diseased and normal
      metaphyseal and epiphyseal areas of the knee. Twenty-two patients (15 adults, 7
      children) with various degrees of previously diagnosed Gaucher's disease were
      positioned supine under a gamma-camera interfaced to a computer system. All
      patients rebreathed 133Xe gas from a closed system for 10 min followed by 14 min
      of wash-out. Digitized images of the lung, liver, spleen, bony sites and soft
      tissue were obtained at 1 min intervals during the wash-in and wash-out phases.
      Counts for each ROI were normalized per 100 pixels and plotted as a function
      (time). Maximum uptake was also calculated by relating the counts/ROI/100 pixels
      to the 10 min integrated lung count during equilibrium (the administered "dose").
      There was essentially no 133Xe uptake in liver and spleen involved with Gaucher's
      disease. Monophasic uptake and biphasic wash-out curves were observed in the
      limited investigative population. Skeletal Gaucher deposits released the 133Xe at
      a greater rate relative to soft tissue.

PMID- 8358359
TI  - Screening for psychological problems in temporomandibular disorder patients.
AB  - Research efforts have been directed to determine whether temporomandibular
      disorder (TMD) patients have psychological problems and whether these factors
      influence treatment outcome. Because there is no consensus about the best way to
      quickly assess psychological problems in TMD patients, this study was designed to
      evaluate a simple method for identifying psychological factors that may need to
      be addressed as part of a comprehensive treatment program. This method involved
      having TMD patients systematically rate themselves, using a brief screening
      questionnaire, for the presence or absence of psychological problems. These
      ratings were then compared to results from extensive psychological testing.
      Sensitivity, specificity, and ordinal rank-based association model analyses
      showed moderate to strong associations between patients' ratings and the
      corresponding psychometric measures. These results provide evidence that the
      brief self-ratings of psychological factors utilized in this study may be a
      useful first step to screening for psychological difficulties in TMD patients.

PMID- 8358360
TI  - Myogenous or arthrogenous limitation of mouth opening: correlations between
      clinical findings, MRI, and clinical outcome.
AB  - The reproducibility and predictive power of MRI diagnosis was evaluated in a
      group of 70 patients with limited mouth opening. The predictive reliability of
      the MRI findings was assessed by comparing the images with a final clinical
      diagnosis that was based on the initial clinical diagnosis, adjusted and refined,
      when possible, by findings made during the treatment period (conservative
      treatment in 51 patients, conservative and surgical treatment in 19 patients).
      The overall reproducibility of the MRI interpretation by the radiologist appeared
      very good. The predictive reliability was excellent for normal disc position and
      fair for anterior disc displacement with reduction. For disc displacement without
      reduction, however, the predictive power was questioned because of false-positive
      MRI findings.

PMID- 8358362
TI  - Clinical utility of mandibular movement ranges.
AB  - The range of mandibular movements was studied on 600 randomly selected people.
      Mandibular mobility varied widely from subject to subject. There were
      considerable age and sex differences but no differences were found between the
      mobility values of persons who were functionally healthy and those with
      dysfunctions. These factors make it difficult to construct cutoff values that
      reflect normalcy in mandibular mobility and thus render the clinical utility of
      such values questionable. The use of age- and sex-corrected border values for
      mandibular mobility is proposed. The clinical utility of patients' opinions
      concerning mouth-opening capacity is stressed. On the basis of statistically
      significant differences, the use of different border values for the protrusive
      and laterotrusive movements seems to be necessary.

PMID- 8358361
TI  - Association between malocclusion and temporomandibular disorders in orthodontic
      patients before treatment.
AB  - The association between malocclusion and the prevalence of temporomandibular
      disorders (TMD) was studied in an orthodontic patient population before
      orthodontic treatment was started. A total of 305 patients, 232 with general
      malocclusion and 73 who also had cleft lip or palate, were given a questionnaire
      about the subjective symptoms of TMD. Clinical examinations for type of
      malocclusion and TMD signs were also conducted. No significant differences in the
      prevalence of TMD were observed between the sexes or between the two patient
      groups. Temporomandibular joint sounds and difficulty of jaw movement were the
      most common of the TMD signs and symptoms. Open bite, posterior crossbite, and
      deep bite were the most prevalent types of malocclusion in both groups. Thus,
      some specific types of malocclusion were significantly associated with the
      occurrence of TMD.

PMID- 8358363
TI  - Parasagittal magnetic resonance imaging of the lateral pterygoid muscle: a
      preliminary study.
AB  - Ten anatomic territories, including both lateral pterygoid muscle and
      temporomandibular joint heads, were explored with magnetic resonance imaging in
      subjects with no dysfunctional disorders. The sequence used was one of inversion
      recovery, supplemented with image contrast reversal for better visualization. The
      muscles were observed in the resting position and in dynamic relation. Slice
      plane definition provided information on the anatomic variations of the superior
      head and on the muscle-articular junction, in particular on the fascicular aspect
      of the superior lateral pterygoid muscle and on the differentiation between
      condyle insertions under effort. The choice of technique and the results are
      discussed. Avenues are opened for the exploration of muscles utilizing magnetic
      resonance imaging.

PMID- 8358364
TI  - Prevalence of oromandibular dysfunction in a general population.
AB  - The prevalence of oromandibular dysfunction was studied in 735 subjects from a
      random sample population of 1,000 subjects aged 25 to 64 years. A diagnosis of
      oromandibular dysfunction was based on criteria established by the International
      Headache Society, as a subgroup to tension-type headache. Tenderness in
      pericranial or jaw muscles was not included. The most common symptoms were
      clenching (22%) and grinding of teeth (15%). The most common sign was irregular
      jaw movements on opening and closing (29%). The ratio of men to women for most
      symptoms and signs ranged from 2:3 to 1:3. This study serves as a base in
      evaluating the importance of oromandibular dysfunction as a causative factor for
      tension-type headache.

PMID- 8358365
TI  - Assessment of mandibular function impairment associated with temporomandibular
      joint osteoarthrosis and internal derangement.
AB  - Clinical assessment of function impairment associated with temporomandibular
      disorders should not only comprise diagnostic assessment of symptoms and signs
      but also function impairment assessment in the patient's value system. Regarding
      clinical assessment methods, the range of opening movement has been demonstrated
      to be one of the few variables that can be measured reliably. However, this
      variable allows no distinction to be made between articular and muscular causes
      of movement restriction. To assess joint mobility, a combination of indirect and
      direct assessments is proposed, including the range of opening movement after
      passive stretch, the range of horizontal excursion toward the opposite side, and
      the condylar translatory capacity by palpation. In clinical practice, signs and
      symptoms needed for diagnosis are frequently used as the only basis for
      mandibular function assessment. Function assessment in the patient's value
      system, however, is a neglected area in outcome assessment. The main objective of
      this study was to design and clinimetrically evaluate a mandibular function
      impairment questionnaire. The relationship between jaw function impairment and
      measures of pain, movement restriction, and psychological distress was assessed.
      The questionnaire appears to be a reliable and valuable complementary tool for
      assessing mandibular function impairment.

PMID- 8358366
TI  - The degree to which attrition characterizes differentiated patient groups of
      temporomandibular disorders.
AB  - Dental attrition severity as the cumulative record of parafunctional and
      functional wear was graded from study cast analysis using established
      methodology. Attrition severity was compared in anterior, posterior mediotrusive,
      and posterior laterotrusive segments. Attrition scores in 48 female and 100 male
      totally asymptomatic controls were compared to 239 female and 31 male patients
      differentiated into five patient groups of temporomandibular disorders: (1) disc
      displacement with reduction, (2) disc displacement without reduction, (3)
      osteoarthrosis with a history of prior derangement, (4) osteoarthrosis without a
      history of prior derangement, and (5) myalgia only. All the male patients were in
      the myalgia-only group. Age was controlled in the analysis to control for
      functional wear. Comparisons between patients and controls were made according to
      10-year age intervals. Analysis included ANCOVA confirmed by a Games-Howell post
      hoc test, with P < .01 interpreted as a significant difference in the attrition
      score. Only 1 of 112 ANCOVAs showed a significant difference, with younger men
      from 20 to 29 years of age in the myalgia-only group having lower mediotrusive
      attrition than the male controls. It would therefore be difficult if not
      impossible to differentiate patients from nonpatients based on the severity of
      dental attrition. Consequently, a major peripheral occlusal etiologic role for
      attrition in TMD is questioned. Some clinical implications are elaborated.

PMID- 8358368
TI  - Osteochondroma of the mandibular condyle mimicking TMJ syndrome: clinical and
      therapeutic appraisal of a case.
AB  - This paper describes a patient in whom a huge osteochondroma of the mandibular
      condyle was mistakenly treated as temporomandibular joint syndrome for
      approximately 6 months before an accurate diagnosis was made. While clinical and
      pathologic features of this lesion are discussed, further emphasis is placed on
      the surgical management and immediate reconstruction with autogenous
      costochondral grafting.

PMID- 8358367
TI  - The incidence of TMJ dysfunction in patients who have suffered a cervical
      whiplash injury following a traffic accident.
AB  - Forty consecutive patients with a cervical whiplash injury were examined and
      compared with 40 matched controls. The incidence of signs and symptoms was high
      in both groups. Temporomandibular joint pain (P < .001), limitation of mouth
      opening (P < .01), and masticatory muscle tenderness (P > .01) were found
      significantly more frequently in the patient group, while the presence of joint
      sounds, deviation during mouth opening, and the overall presence of a symptom
      were not significantly different between groups. When asked whether they would
      seek treatment for the observed signs and symptoms, a significantly higher number
      of the whiplash group responded positively when compared to the control group.
      These findings warrant further study and suggest the benefit of a routine
      examination of the temporomandibular joint and masticatory system in patients
      with cervical whiplash injury.

PMID- 8358369
TI  - Ciguatera fish poisoning--Florida, United States, 1991.

PMID- 8358371
TI  - The future of implant education: a prediction.

PMID- 8358370
TI  - An outbreak of severe paralytic shellfish poisoning in British Columbia.

PMID- 8358372
TI  - Osseous changes following placement of the transmandibular implant system in
      edentulous mandibles.
AB  - The transmandibular implant system is designed for the reconstruction and
      rehabilitation of the endentulous mandible utilizing an extraoral approach.
      Transmandibular implants were placed in 19 patients and mandibular bony changes
      were followed using standardized panoramic radiography. Eleven sites were
      identified on each postoperative radiograph and the percentage of radiographic
      enlargement was calculated for each site. The true bony changes were then
      computed for both short-term (9.4 months) and long-term (53.4 months) follow-up.
      Patients with an average mandibular height in the saddle areas of 3.5 to 8.9 mm
      showed bilateral bony regeneration in the saddle areas and over the most distal
      cortical screws of the implants. Most of these bony changes were seen in the
      first year, but continued beyond that time. Patients with residual bone height of
      9.0 to 12.9 mm had little bone change, while patients with bone height of 13.0 to
      20.5 mm demonstrated slight resorption. Theories for the observed changes are
      presented. The transmandibular implant is especially indicated for the severely
      atrophic mandible because its position within the mandible and the rigid box
      frame design of the implant promote bilateral bone regeneration distal to the
      framework of the implant.

PMID- 8358373
TI  - Chemotherapeutics in implant dentistry.
AB  - Adjunctive treatment with various chemotherapeutic regimens in implant dentistry
      are reviewed along with the indications for specific approaches. The use of
      systemic antibiotics, topical antimicrobials, and various mechanical modalities
      are discussed in relation to patient maintenance and the repair of ailing
      implants.

PMID- 8358374
TI  - The use of free gingival grafts in the treatment of peri-implant soft tissue
      complications: clinical report.
AB  - Soft tissue complications including gingival hyperplasia, peri-implantitis,
      inadequate vestibular depth, and insufficient attached tissue may occur adjacent
      to endosseous implants. In most clinical cases vestibuloplasty and grafting
      techniques to establish a wider zone of keratinized tissue are not needed. A
      clinical case is presented involving peri-implant mucosal areas exhibiting
      persistent inflammation and progressive recession. A free gingival palatal graft
      was used to correct the soft tissue defects and provide optimal peri-implant
      health in order to increase the long-term prognosis of the implant
      reconstruction.

PMID- 8358375
TI  - Mechanical tooth concepts in implant dentistry.
AB  - A brief history of mechanical tooth concepts is presented with an update and
      discussion of the three basic categories of designs presently available. The
      application of mechanical designs to implant dentistry is covered with a
      discussion of indications, contraindications, and technical requirements for each
      of the categories.

PMID- 8358376
TI  - The role of a hospital-based dental implant center.
AB  - The role of a hospital-based implant center with dental and medical specialists
      working as a team is discussed. Advantages to the team include the availability
      of sophisticated hospital equipment and facilities. Referring dentists are
      encouraged to participate in and/or observe treatment performed at the implant
      center. Four cases treated by an implant team within a hospital environment are
      presented.

PMID- 8358377
TI  - The use of demineralized freeze-dried bone and nonresorbable hydroxyapatite in
      the treatment of buccal dehiscences around implants: clinical reports.
AB  - A mixture of equal parts of demineralized freeze-dried human cortical bone and
      nonresorbable porous hydroxyapatite was used in conjunction with expanded
      polytetrafluoroethylene membrane to promote deposition of bone in buccal
      dehiscences around dental implants. Two case studies are presented.

PMID- 8358378
TI  - The edentulous mandible opposing maxillary natural teeth: treatment
      considerations utilizing implant overdentures.
AB  - The restoration of the edentulous mandible opposing all or part of the maxillary
      natural dentition with implant overdentures is described. There are many
      situations in which the maxillary teeth opposing an edentulous mandible can and
      should be retained. Mandibular implant overdentures can be utilized as long as
      health considerations, morphologic features of the resorbed mandible, and
      maxillomandibular jaw relationships are satisfactory.

PMID- 8358379
TI  - Providing optimum torque to implant prostheses: a pilot study.
AB  - Ten N/cm torque has been proposed as the optimum level for the tightening of
      implant retaining gold screws in order to preload the implant components to limit
      loosening and fracture. The purpose of this study was to determine the influence
      of instrumentation and operator experience on the torque generated during manual
      tightening of slotted gold screws. Sixteen subjects, divided into four groups
      based on experience, were instructed to tighten five screws into implant analogs
      with 20-mm and 37-mm slotted screwdrivers. The screws were then removed with a
      torque gauge. All of the groups of subjects were able to generate significantly
      greater torque with the 37-mm screwdriver. Dentists with no implant treatment
      experience generated significantly less torque than the other three groups. Of
      the 12 dentist subjects, only 3 generated the optimal amount of torque when using
      the 20-mm screwdriver. Operators who had little experience dealing with implant
      prostheses were not able to provide the recommended torque and experienced
      operators tended to generate more than the recommended amount. None of the
      subjects were able to generate consistent torque values.

PMID- 8358381
TI  - Separation and characterization of dermatan sulfate in normal human urine.
AB  - Dermatan sulfate excreted in normal human urine was isolated and characterized by
      TLC and cellulose acetate strip electrophoresis after cetylpyridinium chloride
      precipitation and pronase digestion. In these separation methods, dermatan
      sulfate and chondroitin sulfate were extracted and then monitored by sensitive
      HPLC methods with post column fluorometric derivatization coupled with
      chondroitinase ABC, ACII and B digestion. From the results, we demonstrated that
      human urinary dermatan sulfate contains iduronic acid as its major uronic acid
      (80-90% of total uronic acid), and is composed mainly of repeated mono-sulfated
      disaccharide units [Di-4S (structure shown in Fig. 1), 89%] and small numbers of
      di-sulfated disaccharide units (Di-diSB, 7% and Di-diSE, 1%).

PMID- 8358380
TI  - Structural diversity of mammalian hepatic dermatan sulfates.
AB  - Dermatan sulfate-proteoglycans (DS-PGs) were extracted from rabbit, rat and
      bovine defatted livers by magnesium chloride extraction and DEAE-cellulose
      chromatography, and then submitted successively to Asahipak GS-520 gel filtration
      chromatography, Asahipak ES-502N anion exchange chromatography, and cellulose
      acetate membrane electrophoresis. The disaccharide composition of the
      glycosaminoglycan chains was determined by differential digestion by
      chondroitinase ABC, AC, ACII and/or B followed by HPLC for analysis of the
      resulting unsaturated disaccharides. The hepatic dermatan sulfate chains
      contained disulfated disaccharide units; Di-diSB and Di-diSE. The hepatic DS-PGs
      were divided into two groups; Di-diSE-poor DS-PGs and Di-diSE-rich DS-PGs. The
      iduronic acid content of Di-diSE-poor dermatan sulfate chains was higher than
      that of Di-diSE-rich ones.

PMID- 8358382
TI  - Enzymatic properties of squalene epoxidase from Saccharomyces cerevisiae.
AB  - Squalene epoxidase is a microsomal membrane-associated enzyme that acts as an
      important regulator in the sterol biosynthetic pathway. In this study, the
      enzymatic properties of squalene epoxidase from Saccharomyces cerevisiae were
      examined. Unlike Candida squalene epoxidase, S. cerevisiae squalene epoxidase
      required NADPH for enzyme reaction. However, S. cerevisiae enzyme reaction did
      not require FAD or autologous S105 fraction. Unlike rat squalene epoxidase, the
      activity of S. cerevisiae was reduced by Triton X-100, a nonionic detergent.
      Terbinafine, an inhibitor of fungal squalene epoxidase, inhibited the enzyme in a
      non-competitive manner, while NB-598, an inhibitor of mammalian squalene
      epoxidase, barely inhibited it in a partially non-competitive manner. Thus, the
      properties of squalene epoxidase from S. cerevisiae were different from those of
      squalene epoxidase from rats and Candida, which were previously known. We propose
      that a species difference of squalene epoxidase exists not only between animals
      and fungi but between Candida and Saccharomyces.

PMID- 8358383
TI  - Purification and some properties of ribonuclease from Xenopus laevis eggs.
AB  - A 122 kDa RNase from eggs of Xenopus laevis was purified by sequential
      chromatography on Sephadex G-75, DEAE-cellulose, heparin-Sepharose and TSK gel
      G3000SW columns, and gave a single 60 kDa band on SDS-polyacrylamide gel
      electrophoresis under reducing and nonreducing conditions. The RNase composed of
      two 60 kDa subunits is able to recognize pyrimidine bases specifically. The pH
      optimum of the RNase was 7.5 in Tris-HCl buffer. The enzyme activity was
      abolished by treatment at 80 degrees C for 5 min and pH 2 or 12 for 1 h. Since
      egg lectins with RNase activity obtained from Rana catesbeiana and R. japonica
      and bovine pancreatic RNase A show about 30% protein homology and these three
      proteins are 12-14 kDa heat-stable RNases, [K. Titani, K. Takio, M. Kuwada, K.
      Nitta, F. Sakakibara, H. Kawauchi, G. Takayanagi and S. Hakomori, Biochemistry,
      26, 2189 (1987); Y: Kamiya, F. Oyama, R. Oyama, F. Sakakibara, K. Nitta, H.
      Kawauchi, Y. Takayanagi and K. Titani, J. Biochem. (Tokyo), 108, 139 (1990)], the
      data suggest that the X. laevis egg RNase is a unique protein compared with
      RNases from not only amphibians, but also mammals.

PMID- 8358384
TI  - Effects of synthetic trypsin inhibitors on the cell cycle of synchronized HeLa
      cells.
AB  - HeLa cells were synchronized by a double-thymidine block. After removal of
      thymidine, the cells immediately caused the uptake of [3H]thymidine into DNA and
      reached a half-maximum. The duration of the cell cycle was 23 h, and definite
      changes in cell density were observed between 12 and 13 h and between 35 and 36 h
      after removal of thymidine. Thus, the initiation time of S phase could be fixed.
      A trypsin-like proteinase appearing at around 17 h 17 min after removal of
      thymidine and correlated with the onset of the second S phase, tryptase 17:17
      [cf., M. Muramatu et al., Biochim. Biophys. Acta, 1087, 87 (1990)], was obtained.
      4-tert-Butylphenyl and 4-biphenyl esters of trans-4
      guanidinomethylcyclohexanecarboxylic acid (GMCHA) and amidinopiperidine-4
      alkanoic acids, trypsin inhibitors, strongly inhibited the tryptase activity, and
      these esters exert different effects on the cell cycle of HeLa cells at
      concentrations showing complete inhibition or maximal inhibitory effect on the
      tryptase. Both esters of GMCHA elongated the onset of the second S phase for 3 h.
      Esters of amidinopiperidine-4-acetic and 4-propionic acids showed a similar
      effect at lower concentrations than GMCHA esters. 4-tert-Butylphenyl esters of
      amidinopiperidine-4-propionic acid and butyric acids strongly suppressed the
      second S and M phases by probably affecting the G1 late phase, since they have no
      effect on the first S and M phases. The addition of amidinopiperidine-4
      carboxylic acid 4-tert-butylphenyl ester 0 min after removal of thymidine into
      the cells completely suppressed the first S and M phases.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8358385
TI  - Effects of highly purified ethyl all-cis-5,8,11,14,17-icosapentaenoate (EPA-E) on
      rabbit platelets.
AB  - The effects of ethyl all-cis-5,8,11,14,17-icosapentaenoate (EPA-E), highly
      purified ethyl ester of icosapentaenoic acid (EPA), on rabbit platelets were
      studied. In in vitro, highly purified EPA (62.5-3000 microM) suppressed the
      platelet aggregation induced by collagen, arachidonic acid (AA) and adenosine
      diphosphate (ADP). In ex vivo, a single administration of EPA-E (300 and 1000
      mg/kg, p.o.) and repeated administrations (30 and 300 mg/kg/d, p.o.) for 2 weeks
      showed no effects on collagen-, AA- and ADP-induced platelet aggregation.
      Repeated administrations (30 and 300 mg/kg/d, p.o.) for 4 weeks suppressed the
      collagen-induced platelet aggregation, but not the AA- and ADP-induced platelet
      aggregation. Repeated administrations for 4 weeks also suppressed thromboxane B2
      (TXB2) formation induced by collagen, but a single administration and repeated
      administrations for 2 weeks failed to inhibit TXB2 formation. The EPA level in
      the platelet phospholipids increased slightly with a single administration, and
      increased markedly with repeated administrations for 2 and 4 weeks. The AA level
      in the phospholipids showed practically no changes with a single and repeated
      administrations. These results suggested that highly purified EPA-E could reduce
      platelet aggregability by the change of the EPA level in the platelet
      phospholipids and should allow for a reasonable period of administration.

PMID- 8358386
TI  - Protective effects of dithiocarbamates against toxicity of cis
      diamminedichloroplatinum in mice.
AB  - The protective effects of various dithiocarbamates such as N-benzyl-D-glucamine
      dithiocarbamate (BGD), N-p-hydroxymethylbenzyl-D-glucamine dithiocarbamate
      (HBGD), N-p-carboxybenzyl-D-glucamine dithiocarbamate (CBGD), and
      diethyldithiocarbamate (DDTC) on cis-diamminedichloroplatinum (DDP)-induced
      toxicity in mice were studied. The mice were injected i.v. with a chelating agent
      (1 mmol/kg) immediately or 5 min after i.v. injection of DDP (15 or 20 mg/kg).
      The lethal toxicity of DDP (20 mg/kg) was completely prevented by treatment with
      HBGD or CBGD immediately after DDP. The survival time of mice treated with HBGD
      or CBGD 5 min after DDP tended to be longer than that treated with BGD or DDTC.
      Significant increases in blood urea nitrogen (BUN) level and plasma aspartate
      aminotransferase (AST) activity were observed 3d after DDP injection. The
      increase in BUN level was completely prevented only by HBGD and CBGD among these
      chelating agents, while increase in AST activity was significantly prevented by
      treatment with these two agents. Treatment with HBGD or CBGD immediately after
      DDP (20 mg/kg) completely protected against DDP-induced diarrhea. These chelating
      agents significantly decreased the platinum (Pt) contents in the kidney and liver
      after DDP administration. Treatment with HBGD or CBGD was the most effective in
      decreasing the renal Pt content, resulting in maximum protection against DDP
      induced renal damage. The antitumor efficacy of DDP (15 mg/kg) in the colon 26
      carcinoma-bearing mice was not affected by HBGD administration.

PMID- 8358387
TI  - Effect of preinduction of metallothionein on tissue distribution of silver and
      hepatic lipid peroxidation.
AB  - Silver ion causes a number of toxic effects, it decreases the activities of
      lactate dehydrogenase and glutathione peroxidase, and the peroxidation of
      membrane lipids. Silver ions complex strongly to sulfhydryl groups and the
      effects of preinduction of metallothionein, a sulfur-rich protein, on silver
      administration in rats were examined. The preinduction of metallothionein
      decreased the mortality of mice following silver administration. A major portion
      of the incorporated silver in the liver was bound to the basal membrane and
      cellular components, and the distribution of silver into cytosol was small. The
      preinduction of metallothionein decreased the amount of bound silver in the
      membrane and increased the distribution of silver in the cytosol; in addition, it
      depressed silver-induced lipid peroxidation in liver.

PMID- 8358388
TI  - Absorption mechanism of 1,3-bis(2-ethoxycarbonylchromon-5-yloxy)-2-((S)-lysyloxy
      )propane dihydrochloride (N-556), a prodrug for the oral delivery of disodium
      cromoglycate.
AB  - To clarify the absorption mechanism of 1,3-bis(2-ethoxycarbonylchromon-5-yloxy)-2
      ((S)-lysyloxy+ ++)propane dihydrochloride (N-556), a prodrug for the oral
      delivery of disodium cromoglycate (DSCG), a study was made using rats. N-556 gave
      the highest plasma level of DSCG following its injection into the loop at the
      upper part of the small intestine. N-556 was stable in acidic washings of gastric
      contents, but rapidly hydrolyzed to M1 with twin ethyl residues on DSCG in the
      washings of the small intestinal contents. N-556 and M1 were hydrolyzed to DSCG
      via M2 having a mono ethyl residue in the homogenate of the small intestinal
      mucosa. The oral absorption of M1 following its administration in 50% (v/v)
      propylene glycol solution was essentially the same as that of N-556. That of M1
      administered in aqueous suspension was low. After the oral administration of N
      556, a small amount of M2 and a trace of M3 having L-lysyl residue were detected
      in the portal plasma, but no hydrolytic intermediate except DSCG could be found
      in the general plasma. The major absorption mechanism of N-556 may thus be
      concluded as follows: N-556 given orally is transferred to the small intestine in
      essentially intact form. N-556 is then rapidly diffused to an aqueous layer on
      the surface of the mucosal membrane and hydrolyzed to M1. The resultant M1 is
      transported to the mucosal membrane and hydrolyzed to DSCG via M2. DSCG generated
      in the mucosal membrane is used for general circulation through the portal blood
      and liver.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358389
TI  - Antitumor activities of ellagitannins against sarcoma-180 in mice.
AB  - Forty-five ellagitannins and related compounds were intraperitoneally injected
      into mice once, 4 d before intraperitoneal inoculation of S-180 cells, and their
      antitumor activities were evaluated. When an antitumor-active tannin was defined
      as one producing a 70% increase or more in the mean life span of mice or one
      regressor out of six mice, twenty-one ellagitannins were active. Among monomeric
      ellagitannins, tellimagrandin II was most active. Most of the oligomeric
      ellagitannins, consisting of tellimagrandins I and II as the monomer unit, had a
      significant antitumor activity. Macrocyclic ellagitannins were all active.
      Oenothein B, among them, had the most potent antitumor activity. In contrast,
      ellagitannins containing a casuarictin or potentillin moiety in their molecules,
      except for extensively oligomerized ones, showed very low or negligible activity.
      These results suggest that tannins need the ellagitannin monomer units, having
      galloyl groups at the O-2 and O-3 positions on the glucose core(s), such as
      tellimagrandins, in order to exhibit a strong antitumor activity.

PMID- 8358390
TI  - p-Aminohippurate transport in rat renal brush-border membranes: a potential
      sensitive transport system and an anion exchanger.
AB  - Transport mechanisms of p-aminohippurate (PAH) were investigated in rat renal
      brush-border membrane vesicles. The uptake of PAH was stimulated by an inside
      positive membrane potential created by K+ and valinomycin. This potential
      stimulated uptake of PAH was inhibited by various anion transport inhibitors and
      was saturable. In addition, PAH uptake in the presence of valinomycin was
      linearly increased in proportion to log[K+]out/[K+]in. On one hand, PAH uptake
      was stimulated by [14C]PAH/PAH or [14C]PAH/Cl- exchange, and the [14C]PAH/PAH
      exchange was insensitive to the membrane potential. The uptake by the exchanger
      was also inhibited by anion transport inhibitors, but the potential-stimulated
      uptake of PAH was more sensitive to furosemide and 4,4'-diisothiocyano-2,2'
      disulfonic stilbene. On the contrary, [14C]PAH/PAH exchange was more sensitive to
      urate than the potential-stimulated uptake of PAH. These findings indicate that
      PAH is transported by two distinct transport systems in rat renal brush-border
      membranes, a potential-sensitive transport system and an anion exchanger.

PMID- 8358391
TI  - Freeze-drying of cephalothin sodium: granularly agglomerated crystallization
      during freezing. I.
AB  - Optimal conditions for the crystallization and subsequent freeze-drying of an
      aqueous cephalothin sodium (CET-Na) solution of supersaturated concentrations to
      obtain granular crystalline CET-Na have been discussed, as have the qualities of
      the product thus obtained. In general, CET-Na in supersaturated aqueous solution
      is barely recrystallized, even when in its frozen stage. Our previous report
      revealed that when the solution is kept at low temperatures for a long duration,
      the molecules begin to change structurally to as condensed a state as that of
      liquid crystals, and such change facilitates a spontaneous nucleation and seed
      independent crystal growth in the frozen solution. These findings prompted the
      authors to investigate optimal CET-Na concentrations and thermal histories during
      the crystallization and subsequent freeze-drying process without seeding. It has
      subsequently been found out that optimization of the latter conditions gives
      granular agglomerated crystalline CET-Na contaminated with neither the amorphous
      nor the quasi-crystalline form. The optimized conditions are: 25-28% CET-Na
      concentrations; storage before the freezing process at 0 degrees C for 2 h, and
      subsequent storage at 20-25 degrees C for 1 h; cooling in the freezing process at
      a rate not faster than 0.5 degrees C/min; warming of the solution for
      facilitating crystallization prior to vacuum application for drying at -4 degrees
      C. Under these conditions, the freeze-dried product of CET-Na in granular form
      has been successfully obtained in a shorter freeze-drying cycle, exhibiting a
      faster reconstitution time than those of CET-Na prepared according to seeded
      crystallization followed by a conventional freeze-drying.

PMID- 8358392
TI  - Freeze-drying of cephalothin sodium: granularly agglomerated crystallization
      during freezing. II.
AB  - The mechanism of granularly agglomerated crystallization during freezing of
      cephalothin sodium (CET-Na) in aqueous solution has been discussed. Our previous
      report noted that strict control of the following is important in order to obtain
      crystalline granular agglomerates of CET-Na: (1) thermal history of the solution
      before receiving freezing, (2) cooling rate in freezing, and (3) aging
      temperature level in the crystal growth step. In order to clarify the
      physico/chemical meanings of the individual controls, further investigations have
      been made: 1) with varying thermal history, aqueous 30-% CET-Na solutions were
      prepared for storage, first at 0 degrees C with its supersaturation and secondly
      at 25 degrees C, in an unsaturated state for observing any structural changes by
      viscosimetry, refractometry, and surface tensiometry; 2) morphological changes in
      ice crystals during freezing at varying cooling rates, as well as those during
      the crystal growth step, were observed by polarized-light cryomicroscopy and
      scanning electron microscopy; 3) melting, as well as crystal growth, at several
      aging temperature levels were observed by electrical conductometry and also by
      the above-mentioned techniques.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358393
TI  - Immunopharmacological characterization of a highly branched fungal (1-->3)-beta-D
      glucan, OL-2, isolated from Omphalia lapidescens.
AB  - The immunopharmacological activities of a fungal (1-->3)-beta-D-glucan, OL-2,
      isolated from "Leiwan" Omphalia lapidescens were examined. Intraperitoneal (i.p.)
      administration of OL-2 to ICR mice induced a significant number of peritoneal
      exudate cells (PEC) and white blood cells over the period of a few days. Spleen
      cell numbers were also increased by i.p. administration of OL-2 at about a week.
      These changes reverted to the normal level within a month. Responses of spleen
      cells and bone marrow cells (BM) to colony stimulating factors (CSF) were
      augmented by OL-2 administration assessed by cell proliferation assay. Sera from
      OL-2 administered mice contained an increased concentration of colony stimulating
      activity. Gene expressions of interleukin-1 beta, interleukin-6, and tumor
      necrosis factor alpha in the spleen were also increased. These results suggested
      the activation of hematopoietic responses, and would well relate to the
      incremental increase in PEC, white blood cell and spleen cell numbers. OL-2 also
      increased the serum concentration of fibronectin and complement component C-3.
      However, OL-2 did not show adjuvant activity to SRBC and antitumor activity
      against the solid form of Sarcoma 180 by i.p. administration. Yet, OL-2 did not
      interfere with the antitumor activity of SSG against the same tumor system. These
      facts suggested that OL-2 could enhance nonspecific host defense mechanisms by
      enhancing hematopoietic responses, but would not enhance or inhibit the specific
      immunity mediated by lymphocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358394
TI  - Preparation and evaluation of a controlled-release formulation of nifedipine
      using alginate gel beads.
AB  - Alginate gel beads containing nifedipine (NP) were prepared using a gelation of
      alginate with calcium cations. The dissolution and absorption of NP from alginate
      gel beads were evaluated as a controlled-release formulation of NP. The release
      of NP from alginate gel beads was affected by the composition of uronic acid in
      alginate, and by the NP content in alginate gel beads. NP absorption after oral
      administration to beagle dogs of alginate gel beads prepared by air-drying was
      significantly lower than that after the administration of NP powder alone, due to
      the limited release of NP from the alginate gel beads in the gastrointestinal
      tract. On the other hand, the alginate gel beads prepared by freeze-drying
      improved the absorption of NP because of the increasing disintegration of
      alginate gel beads with decreasing structural strength. However, this method had
      poor reproducibility, compared with air-dried alginate gel beads. The gel beads
      with added alginate propylene glycol ester (PGA) swelled and released calcium
      ions rapidly, even in water. This is because PGA gels weakly to the calcium
      cation. Consequently, it was observed that NP release from the PGA gel beads was
      highly accelerated compared to the release from alginate gel beads. The higher
      serum level of NP with large variance was obtained after the oral administration
      of the PGA gel beads. Gel beads consisting of a 1:1 ratio of PGA to alginate had
      intermediate characteristics between the alginate and PGA gel beads in respect to
      NP release and absorption.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358395
TI  - Influence of lacquer thinner and some organic solvents on reproductive and
      accessory reproductive organs in the male rat.
AB  - The effects of thinner and its main components, toluene, xylene, methanol, and
      ethyl acetate, on reproductive and accessory reproductive organs in male rats
      were studied. The vapour from these organic solvents was inhaled twice a day for
      7 d. Following inhalation of thinner vapour for 7 d, the weights of the testes
      and prostate fell and acid phosphatase activity in the prostate and plasma
      testosterone levels were significantly decreased compared with the control group.
      Both ethyl acetate and xylene caused a decrease in the weight of the testes and
      accessory reproductive organs, as well as reducing acid phosphatase activity in
      the prostate and plasma testosterone levels. In contrast, toluene and methanol
      had no effect on organ weights, circulating testosterone levels, or on enzyme
      activity. Body weight was decreased by inhalation of thinner or ethyl acetate
      vapour. Spermatozoa levels in the epididymis were decreased by inhalation of
      ethyl acetate and xylene vapour. These results suggest that thinner, particularly
      the components ethyl acetate and xylene, interfere with the functions of the
      testes and accessory reproductive organ; toluene has no effect on these
      functions.

PMID- 8358396
TI  - Cardiac glycoside-induced elevation of intracellular Na+ ion concentration in
      human erythrocytes studied by 23Na NMR spectroscopy: relationship between
      inotropy speed and elevation rate of intracellular Na+ ion concentration.
AB  - Elevation of intracellular sodium ion concentration in human erythrocyte induced
      by the cardiac glycoside, proscillaridin, and its four derivatives was measured
      using 23Na NMR spectrometry. In this examination, there was a significant
      correlation between the time to half maximum inotropic effect and the time to
      maximum of Na+ concentrations in human erythrocyte, determined by 23Na NMR.

PMID- 8358397
TI  - Lignified materials as medicinal resources. VI. Anti-HIV activity of
      dehydrogenation polymer of p-coumaric acid, a synthetic lignin, in a quasi-in
      vivo assay system as an intermediary step to clinical trials.
AB  - After the dehydrogenation polymer of p-coumaric acid, a synthetic lignin, was
      intravenously injected into mice, the serum was collected immediately, 15 min, 1
      h, 5 h, and 24 h after the injection. The serum thus obtained was added to the
      assay medium containing MT-4 cells infected with HTLV-IIIB (an HIV-1 strain).
      Inhibition of the cytopathogenicity of HIV by these serum preparations was
      assayed by the MTT method. The result revealed that lignins could be a promising
      class of anti-HIV agents with an unidentified unique mode of action.

PMID- 8358398
TI  - An efficient radiosynthesis of [18F]fluoromisonidazole.
AB  - An efficient preparation of the hypoxic cell tracer [18F]3-fluoro-1-(2'-nitro-1'
      imidazolyl)-2-propanol ([18F]fluoromisonidazole) is reported. This
      radiopharmaceutical is of interest to probe hypoxic tissue in infarcts and
      tumors. One-step radiolabeling and rapid protection group removal provided 55-80%
      yield in 50 min. The process is similar to common fluorine labeling procedures,
      simplifying the procedure for most laboratories, and offers an improvement over
      more difficult previous methods. The labeling precursor was prepared in five
      steps from readily available materials in a straightforward reaction scheme.

PMID- 8358399
TI  - Determination of 90Sr in milk by using two inorganic exchangers.
AB  - Two inorganic exchangers, consisting of PRTD (partially reduced tin dioxide) and
      CUCR (normal copper chromate), both prepared and studied by the authors, were
      investigated for radiochemical isolation and purification of 90Sr from milk
      samples. A procedure combining the use of both exchangers is reported and is
      recommended when it is necessary to remove a radiobarium interference. Due to the
      lack of appropriate samples the procedure was tested using defatted milk spiked
      with 90Sr and 133Ba.

PMID- 8358400
TI  - The use of cotton balls to collect infant urine samples for 2H/1H and 18O/16O
      isotope ratio measurements.
AB  - To test the validity of cotton balls as a urine collection medium for hydrogen
      and oxygen isotope ratio measurements, we moistened cotton balls with 1-, 5-, and
      10-mL aliquots of urine that contained either natural abundances or one of two
      enriched levels of 2H and 18O. The liquids were then expressed from the cotton
      balls, either at once, or after 30 or 60 min of atmospheric exposure, and
      analyzed for their 2H/1H and 18O/16O isotope ratios. The 2H abundances of the
      fluids expressed from the cotton balls were significantly lower than the original
      values. This dilution of 2H, however, diminished in the samples that had a
      greater volume of urine. We observed no effects of volume or time on 18O. Our
      results indicate that at low urine volumes, ambient moisture dilutes 2H in the
      cotton balls, but isotope exchanges and evaporation have little or no effect on
      the hydrogen and oxygen isotopic abundances of the urine samples. Total body
      water and energy expenditure values calculated from the 2H and 18O enrichments of
      5- and 10-mL urine samples were within 1% of the theoretical values. Therefore,
      cotton balls are suitable for collection of infant urine samples for hydrogen and
      oxygen isotope ratio measurements, if the volume of urine that can be expressed
      from a cotton ball is > or = 5 mL.

PMID- 8358401
TI  - Application of microwave heating to the synthesis of [18F]fluoromisonidazole.
AB  - A modified synthesis of [18F]fluoromisonidazole is reported which makes use of
      microwave heating to reduce the synthesis time to ca 70 min from EOB. A remote
      system for column purification, concentration and delivery to an HPLC syringe,
      which reduces the total absorbed dose to the operator, is also described.

PMID- 8358403
TI  - Abnormal patterns of speech breathing in dysarthric speakers following severe
      closed head injury.
AB  - The respiratory abilities of a group of 20 subjects with a speech disorder
      resulting from severe closed head injury (CHI) were assessed using both
      spirometric and kinematic techniques and compared with those of a group of 20 non
      neurologically impaired controls matched for age and gender. Results of the
      spirometric assessment showed that the CHI subjects as a group had lower vital
      capacities and lower forced expiratory volumes 1 second than the controls.
      Kinematic assessment also showed that the CHI subjects had problems co-ordinating
      the action of the rib-cage and abdomen when carrying out speech tasks such as
      vowel prolongations, syllable repetitions and reading. Results are discussed in
      terms of the effects of CHI on neuromuscular function.

PMID- 8358402
TI  - Statistical profile of traumatic brain injury: a Canadian rehabilitation
      population.
AB  - A retrospective clinical hospital chart study was undertaken to prepare a
      statistical profile of traumatic brain-injured patients in rehabilitation. It
      included 498 consecutive admissions to the Traumatic Brain Injury Rehabilitation
      Program of the Queen Elizabeth Hospital (Toronto, Canada) from 1978 to 1991.
      Descriptive statistics were obtained for age, gender, marital status, educational
      status, occupational status, history of drug and alcohol use, cause of injury,
      month of injury and length of coma. Comparisons are made between the studied
      population and several Canadian centres, as well as international brain injury
      demographics in the literature. Results are discussed in terms of the gender
      differences and lifestyle parameters associated with brain injury.

PMID- 8358404
TI  - Glasgow Outcome Scale: an inter-rater reliability study.
AB  - This study was set up to test the reliability of the Glasgow Outcome Scale (GOS)
      when information was obtained from different sources. Eighty assessments were
      carried out on a group of 58 patients at three different time intervals up to 24
      months post-injury. Each assessment consisted of three independently obtained GOS
      scores for each patient; (i) a score by a research psychologist after interview
      and neuropsychological testing of the patient; (ii) a score, obtained by post, by
      the patient's general practitioner (GP), and (iii) a score made by a research
      worker based on questionnaire information obtained from relatives by post. The
      agreement between the psychologist's score and that based on the relatives'
      information was high (r = 0.79 p = 0.001) whereas the correlation between the
      psychologist's score and that of the GP was low (r = 0.49 p = 0.001). The GPs
      tended to make overoptimistic assessments and this was most notable at 6 months
      post-injury when only 50% of the GPs' assessments agreed with those of the
      psychologist. We have shown that reliability of the GOS varies with the method of
      obtaining data. Ideally patients should be interviewed and tested by staff who
      have not been involved in the acute care of the patient. Failing this,
      information should be obtained from relatives of the patient and used by staff,
      trained in the use of the GOS, to assign a GOS score.

PMID- 8358405
TI  - A survey of accredited and other rehabilitation facilities: education, training
      and cognitive rehabilitation in brain-injury programmes.
AB  - Although it is routinely acknowledged that cognitive rehabilitation therapy
      comprises a major part of the services provided to survivors of brain injury,
      there continues to be no general consensus regarding the methods and training of
      those who provide cognitive rehabilitation services. This survey of 398 head
      injury rehabilitation facilities includes information on which disciplines are
      providing and supervising cognitive rehabilitation therapy, which therapy formats
      are used, and a first attempt to define the costs and providers for cognitive
      therapy staff training in Commission on Accreditation of Rehabilitation
      Facilities (CARF) approved and other (non-CARF) facilities. The education and
      training of junior and senior staff members is compared, and respondents suggest
      changes in the education and training of those who provide cognitive
      rehabilitation therapy. The results of this survey suggest no significant
      differences in the organization and delivery of cognitive rehabilitation therapy
      in CARF and non-CARF programmes. They indicate that cognitive rehabilitation
      therapy and the education and training of providers deserve further study and
      definition, given the widespread provision of cognitive rehabilitative services.

PMID- 8358406
TI  - A double-blind controlled study of methylphenidate treatment in closed head
      injury.
AB  - Closed head injuries (CHI) may produce permanent, disabling changes in cognitive
      functions and social behaviour. Recent clinical case reports have suggested that
      stimulant medications may improve neurobehavioural functioning in CHI patients.
      In the present study, we evaluated the effects of methylphenidate (0.3 mg/kg
      b.i.d.) in 12 chronic CHI patients (14 to 108 months post-injury) using a double
      blind, placebo-controlled, randomized, crossover design. Outcome measures
      consisted of cognitive tests of attention, learning and cognitive processing
      speed. In addition, a rating scale was completed by a close friend or relative to
      assess social behaviour. No significant differences were found between drug and
      placebo conditions on any of the neurobehavioural measures. These data do not
      support the clinical use of methylphenidate in the treatment of CHI patients.

PMID- 8358407
TI  - Oral hygiene following traumatic brain injury: a programme to promote dental
      health.
AB  - Dental care and oral hygiene programmes for persons with traumatic brain injury
      (TBI) have been relatively ignored areas of clinical care and research. Data
      regarding the need for structured oral hygiene programmes with this population
      are sorely lacking. Further, evidence to support or contraindicate the efficacy
      of such interventions is negligible. The purpose of the present study was to
      address the need for ongoing dental follow-up and oral hygiene programmes in the
      post-acute phase of rehabilitation care. A group of 20 TBI patients (10
      experimental, 10 control) who were at least 1 month post-injury and had Rancho
      Los Amigos Scale scores of 6 or greater, were randomly selected for participation
      in the study. Oral hygiene status was assessed by a dental hygienist using a
      plaque index score developed by Silness and Loe. The experimental group received
      individualized oral hygiene instruction along with dental supplies for their
      personal use, including a dental mirror and red disclosing tablets. The control
      group received no such instructions or supplies. At 5-6 weeks following initial
      evaluation, 18 patients (nine from each group) were reassessed via the plaque
      index score. Comparisons between the control and experimental groups revealed
      significant differences on follow-up plaque scores with a lower mean score for
      the experimental group only on baseline and follow-up data yielding a significant
      decrease in plaque scores over time. These results suggest that dental hygiene
      interventions for patients following TBI can effectively promote dental plaque
      control.

PMID- 8358408
TI  - Hyponatremia-associated cognitive impairment in traumatic brain injury.
AB  - The case of a traumatic brain injury (TBI) patient with dramatic cognitive
      deterioration in the absence of medical aetiology other than simultaneous decline
      in serum sodium led to an investigation of the association between declines in
      sodium levels and cognitive status. In a population of 50 persons undergoing TBI
      rehabilitation, 12 (24%) had relative (3 mEq/L) decreases in serum sodium while
      five (10%) experienced absolute hyponatremia (136 mEq/L). Correlation with
      cognitive status was significant when the absolute hyponatremia group was
      compared with those whose sodium levels remained above 136 mEq/L. A case-matched
      study of the relative hyponatremia group yielded no significant association
      between sodium-level decreases and cognitive status. These data support previous
      conclusions indicating wide variation in individual responses to changes in serum
      sodium. The threshold for significant effects of hyponatremia may be higher in
      patients with TBI than in populations studied previously.

PMID- 8358409
TI  - Protriptyline as an alternative stimulant medication in patients with brain
      injury: a series of case reports.
AB  - The results of a series of eight individual case reports in which protriptyline,
      an activating tricyclic antidepressant, was used as a 'stimulant' medication are
      presented. For some patients with head injury, traditional stimulants, such as
      methylphenidate, or dopaminergic stimulants, such as levodopa-carbidopa,
      amantadine, or bromocriptine, may be partially or totally ineffective or not
      tolerated. Protriptyline can be a very effective alternative and, for some
      patients, may be the most effective stimulant tried. In low to moderate doses,
      protriptyline should be considered for trials as an activating/stimulant
      medication in patients with head injury.

PMID- 8358410
TI  - Post-traumatic haemorrhage in corpus callosum: a case study of disconnection
      syndrome.
AB  - This paper reports the case of a 16-year-old man who had sustained a traumatic
      head injury. Neuroradiological examinations showed haemorrhagic lesion in corpus
      callosum. The patient initially demonstrated several symptoms of disconnection
      syndrome; however, these clinical signs later resolved in subtle dysfunctions
      that could be evidenced only by statistical analyses of performances to specific
      tests. It is thus suggested that comparable cases may be undetected by standard
      examination procedures.

PMID- 8358411
TI  - Repatriation Community Programs, Part I: A collaborative model of service
      delivery.
AB  - The Repatriation Community Programs pilot project was funded by the Ontario
      Ministry of Health in 1990. Its mandate is to facilitate the return of brain
      injured individuals from US rehabilitation facilities to their home communities
      in Ontario. Most Ontario residents receiving rehabilitation in the US fall into
      one of two 'hard to serve' groups: (1) those with severe behavioural
      difficulties; and (2) those at various levels of post-comatose unawareness whose
      families are unwilling to accept chronic care 'maintenance'. The pilot programme
      has been charged with demonstrating the feasibility of community-based care for
      severely brain-injured individuals and their families, as well as developing a
      model of service delivery and interagency collaboration which will expedite
      province-wide implementation of similar programmes. This paper describes the
      collaborative model developed over the first 2 years of the project. Issues
      leading to this model are identified and elements of the model are discussed.

PMID- 8358412
TI  - Extracorporeal shock wave lithotripsy in patient with cardiac pacemaker in an
      abdominal location: case report and review of the literature.
AB  - A 75-year-old man with complete heart block and a ventricular demand pacemaker
      with the generator in a left upper-quadrant subcutaneous pouch underwent
      extracorporeal shock wave lithotripsy (SWL) for a 2-cm proximal right ureteral
      calculus, receiving 2000 shocks at 24 kV. There was no damage or malfunction of
      the pacemaker, and the Dornier HM3 lithotripter had no difficulty sensing all
      paced ventricular complexes. The patient had excellent fragmentation of his
      calculus. Extracorporeal shock wave lithotripsy may be performed safely on
      patients with pacemakers directly in the path of the shock waves at maximal
      kilovoltage when appropriate peri-SWL guidelines are followed. Specifically, the
      treatment should be approved by a cardiologist knowledgeable about the patient
      and the pacemaker, and a cardiologist should be nearby with the equipment
      necessary to deal with any problems. Dual-chamber pacemakers should be
      reprogrammed to the single-chamber mode, and single-chamber rate-responsive
      devices should have the activity mode programmed off. Patients with the latter
      type of pacemaker implanted in the abdomen should not have SWL if the device will
      be close to F2.

PMID- 8358413
TI  - Absence of activation of proteolytic enzymes by extracorporeal shock waves.
AB  - The mechanism of tissue damage by extracorporeal shock wave lithotripsy has not
      been clarified, but proteolytic enzymes are known to play an important role in
      tissue breakdown in response to other types of injury. Screening tests for
      activation of the proteolytic enzymes kallikrein, plasmin, trypsins 1 and 2, and
      granulocyte elastase therefore were performed for 4 to 5 hours in 14 dogs after
      unilateral treatment with 1500 or 2000 extracorporeal shock waves under
      anesthesia and vigorous hydration. We also studied the activity of the proenzymes
      prekallikrein, plasminogen, and prothrombin and three plasma protease inhibitors
      (kallikrein inhibitor, antiplasmin, and antithrombin III). Blood from both renal
      veins (treated and control kidneys) and the aorta and tissue samples of the
      injured renal parenchyma and corresponding areas of the control kidneys revealed
      no proteolytic enzyme activation by the shock waves and no decline in the
      activities of proenzymes and enzymes inhibitors. Significant proteolysis does not
      seem to play a part in the tissue injury induced by extracorporeal shock wave
      lithotripsy.

PMID- 8358414
TI  - Compliance with use of the Hydrate 1 system by patients with treated
      urolithiasis.
AB  - Adequate hydration, leading to decreased urine osmolality and increased
      solubility of urinary constituents, is the cornerstone of urolithiasis
      prevention. Hydrate 1 is a system designed to allow patients to monitor urine
      osmolality by a simple colorimetric method, thereby adjusting their fluid intake.
      In 10 patients treated surgically for stone disease, the device worked well when
      used, guiding patients to increase intake appropriately. However, compliance was
      sporadic, determined principally by occupational or lifestyle constraints. Use of
      this system may have a place in that subset of patients with recurrent stone
      disease who have difficulty maintaining adequate urine volume.

PMID- 8358415
TI  - Lasertripsy of ureteral calculi using pulsed-dye laser with automatic shut-off
      after tissue contact.
AB  - Since June 1991, 54 patients with ureteral calculi (13 upper, 18 middle, and 23
      distal) have been treated in our department using a flashlamp-pumped tunable-dye
      (rhodamine 6G) laser with a wavelength of 594 nm with an energy at the distal
      fiber tip between 30 and 120 mJ. The fiber core diameters were 200 and 300
      microns. By spectral analysis of the reflected light, immediate shut-off of the
      laser was obtained after tissue contact. In average, 1599 impulses at a mean
      energy of 76.4 mJ were applied. In 32 cases (59%), complete disintegration was
      achieved. In 22 cases (41%), partial disintegration was noted, leading to
      retrograde mobilization of the fragments followed by SWL in 16 patients.
      Ureteroscopic extraction of fragments was performed in six patients. All patients
      were rendered stone free after 6 weeks. Because of the ureteroscopic
      manipulation, mucosal lesions were found in five patients, but no trauma
      attributable to the action of the laser was seen. In 42 patients, a double-J
      stent was placed after the procedure. Lasertripsy using a pulsed-dye laser with
      automatic shut-off after tissue contact is a safe and effective approach that
      offers a new aspect in the noninvasive treatment of recalcitrant ureteral calculi
      in our department.

PMID- 8358416
TI  - Outcomes of non-self-expandable metal prostheses in strictured human ureter:
      suggestions for future developments.
AB  - The success of metal stents in the urethra led us to implant flexible metal
      stents unilaterally in the ureter in four patients. Radiographic and endoscopic
      controls during follow-up showed an obstruction in three cases. We describe the
      different aspects of these unfavorable outcomes and propose changes to be made in
      metal stents for use in the upper urinary tract.

PMID- 8358417
TI  - Effect of balloon dilation of ureter on upper tract dynamics and ureteral wall
      morphology.
AB  - Sixteen male Yucatan minipigs underwent balloon dilation of the right
      ureterovesical junction (UVJ) and lower ureter to twice its normal caliber. With
      the bladder open, bilateral upper tract dynamics measurements under different
      perfusion rates (0.5, 2, and 4 ml/min) were recorded predilation, immediately
      after dilation, and 1, 2, 3, 4, and 6 weeks after dilation. Immediate and late
      antegrade nephrostograms, suprapubic cystograms, and right antegrade
      nephrostograms (oblique view) were taken. In the chronic experiment, no
      difference in renal pelvic pressure (Ppvs) was detectable between the control and
      dilated sides immediately after dilation. Only at 4 ml/min was there a
      statistically significant increase in the Ppvs of the dilated ureter 1 week after
      dilation when compared with the controls. At 2 weeks, this obstructive change had
      disappeared. At 3, 4, and 6 weeks, Ppvs of the dilated ureter declined
      progressively in comparison with the control side, but the difference was not
      statistically significant. At 6 weeks, Ppvs of the dilated ureter decreased
      significantly compared with predilation readings only at 4 ml/min. Immediate
      antegrade radiologic evaluation revealed that 69% of the experimental animals had
      no extravasation, while 31% showed variable degrees of extravasation, which
      disappeared completely on late antegrade nephrostograms (6 weeks). Grade 2 reflux
      occurred in 33% of the experimental animals at 1 week and had disappeared at 6
      weeks. Histologic examinations at 1, 2, and 3 weeks revealed a nonhomogeneous
      pattern of ureteral damage, ranging from total rupture to much less dramatic
      injury.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358418
TI  - Intrarenal access with the flexible ureteropyeloscope: effects of active and
      passive tip deflection.
AB  - In flexible ureteroscopy, active deflection of the tip of the endoscope is
      essential to reach the lateral and inferior infundibula. Two other features may
      affect endoscope function: one- or two-way deflection and the presence of a
      secondary, passively deflectable, segment. In our 7-year experience with five
      different endoscopes, attempts to examine the intrarenal collecting system were
      successful in 205 of 225 patients (92%). The success rate was lowest with a
      prototype endoscope, which did not have a secondary deflecting segment. There was
      no significant difference between those instruments with single- or two-way
      deflection that possessed secondary deflection. Endoscopes with secondary
      deflection were most successful in entering the lower pole, and this feature was
      necessary to reach the entire collecting system in 51% of the patients. Most of
      the failures of access were in attempts to reach the lower infundibulum. There
      was some trend toward greater success with the smaller instruments (8.5F).

PMID- 8358419
TI  - Endoscopic repair of the completely disrupted urethra.
AB  - Posterior urethral disruption or obliteration is most often the result of pelvic
      trauma. We describe a modified endoscopic technique used to reestablish urethral
      continuity in five patients with a minimum 2-year follow-up. This technique
      involved cold-knife incision of the scar without dilation followed by short-term
      catheterization. The advantages of endoscopic reestablishment of urethral
      continuity include short hospitalization, limited blood loss, no external
      incision, briefer operating time compared with open urethroplasty, and a stable
      patent urethra.

PMID- 8358420
TI  - Extraperitoneal endosurgical lymphadenectomy with insufflation in the staging of
      bladder and prostate cancer.
AB  - A new technique of endosurgical pelvic lymph node dissection was performed for
      the staging of 10 prostate and 8 bladder cancers. The technique, involving an
      exclusive extraperitoneal space development with CO2 insufflation, is described
      in detail. Using the standard endosurgical (laparoscopic) equipment, we performed
      a complete bilateral ilio-obturator lymph node dissection in 15 patients (83%).
      In the remaining three patients, because of technical difficulties, only
      unilateral dissection was performed. The average operating time was 84 minutes.
      Morbidity was low (one instance of sepsis). Prospective assessment of CO2
      homeostasis showed that arterial CO2 pressure (PaCO2) increased significantly but
      could be controlled by increasing minute ventilation output. Our results show
      that perioperative assessment of end-tidal CO2 partial pressure is necessary and
      sufficient for the adaptation of minute ventilation output. Two patients with
      prostate cancer had positive nodes. No intraoperative or postoperative morbidity
      related to the procedure was observed in patients submitted to radical surgery.
      Extraperitoneal endosurgical pelvic lymphadenectomy with CO2 insufflation is a
      rapid, safe, and effective method in the staging of urologic pelvic malignancies
      and represents an alternative to traditional open surgery as well as to
      conventional transperitoneal laparoscopic lymphadenectomy.

PMID- 8358421
TI  - Inhibition of peritoneal tumor-cell implantation: model for laparoscopic cancer
      surgery.
AB  - A serious concern in applying laparoscopic surgery to malignancies is the
      possibility of tumor spillage and seeding. We developed a model of peritoneal
      tumor implantation using a murine bladder tumor cell line, MBT-2. Anesthetized
      C3H male mice underwent mock laparoscopy with or without peritoneal disruption
      and instillation of tumor cells via a 16-gauge angiocatheter, and the effect of
      heparin and the pentapeptide Gly-Arg-Gly-Asp-Ser (GRGDS) on tumor cell adherence
      and growth was evaluated. Animals were divided into six groups: Group 1 = tumor
      cells only; Group 2 = peritoneal disruption + tumor cells; Group 3 = heparin +
      tumor cells; Group 4 = peritoneal disruption + heparin + tumor cells; Group 5 =
      GRGDS + tumor cells; and Group 6 = peritoneal disruption + GRGDS + tumor cells.
      In all animals, a greater tumor burden was noted at the sites of peritoneal
      disruption. Moreover, 50% and 63% of animals in Groups 1 and 2 developed tumors
      compared with 17% and 31% of those in Groups 3 and 4, respectively. There was
      significantly more tumor at the sites of peritoneal disruption in the "tumor
      only" groups than in those that received heparin (mean tumor volume 32.32 mm3 in
      Group 2 v 2.77 mm3 in Group 4; p < 0.05). The GRGDS-treated groups showed a trend
      toward decreased number and size of tumors compared with the tumor only groups,
      although the differences were not statistically significant. These findings imply
      that prophylactic irrigation with substances that decrease cell adherence may
      prevent tumor implantation after accidental intraoperative tumor spillage.

PMID- 8358422
TI  - Laparoscopic retroperitoneal lymphadenectomy in the pig: initial report.
AB  - The value of retroperitoneal lymphadenectomy in the management of nonseminomatous
      testicular tumors is still a matter of controversy. Lymphadenectomy doubtlessly
      has great advantages but is somewhat down-graded by the considerable associated
      morbidity. Our experimental study in six pigs has shown that retroperitoneal
      lymphadenectomy by means of laparoscopic techniques is feasible. Clinical trials
      will follow. Should they prove successful, the role of retroperitoneal
      lymphadenectomy in the management of testicular tumors has to be reassessed.

PMID- 8358423
TI  - Prostatic tissue destruction by high-intensity focused ultrasound:
      experimentation on canine prostate.
AB  - High-intensity focused ultrasound (HIFU) has been used transrectally to induce
      intraprostatic coagulation necrosis lesion in the canine prostate. The device
      combines a firing system (power amplifier and therapy transducer) and a
      localization system (ultrasound scanner). Thirty-seven dogs have been treated
      with ultrasound intensity ranging from 720 W/cm2 to 2300 W/cm2 and shot durations
      ranging from 1 to 4 seconds. The threshold for focal ultrasonic lesions was
      determined to be 1000 W/cm2 with a 1-second shot duration. Intraprostatic lesions
      were obtained without any damage to the rectal wall. These lesions were
      homogeneous coagulation necroses and progressed first to an inflammatory fibrosis
      and then to sclerosis with cavity formation. Intraprostatic lesions also occurred
      with a combination of moderate acoustic intensity (720 W/cm2) and longer shot
      duration (4 seconds). The temperature reached at the focal point of the
      transducer was 85 degrees C. The study confirms the possibility of creating
      irreversible lesions in the prostatic tissue through the rectal wall. The
      destruction of localized prostatic cancer seems to be possible in the near future
      using HIFU delivered by the transrectal route.

PMID- 8358424
TI  - Diagnosing the heart of the problem.

PMID- 8358425
TI  - Are linkage studies boring?

PMID- 8358426
TI  - Therapies that make sense.

PMID- 8358427
TI  - No linkage to chromosome 14 in Swedish Alzheimer's disease families.

PMID- 8358428
TI  - Nonsense mutations and diminished mRNA levels.

PMID- 8358429
TI  - Expansion of an unstable trinucleotide CAG repeat in spinocerebellar ataxia type
      1.
AB  - Spinocerebellar ataxia type 1 (SCA1) is an autosomal dominant disorder
      characterized by neurodegeneration of the cerebellum, spinal cord and brainstem.
      A 1.2-Megabase stretch of DNA from the short arm of chromosome 6 containing the
      SCA1 locus was isolated in a yeast artificial chromosome contig and subcloned
      into cosmids. A highly polymorphic CAG repeat was identified in this region and
      was found to be unstable and expanded in individuals with SCA1. There is a direct
      correlation between the size of the (CAG)n repeat expansion and the age-of-onset
      of SCA1, with larger alleles occurring in juvenile cases. We also show that the
      repeat is present in a 10 kilobase mRNA transcript. SCA1 is therefore the fifth
      genetic disorder to display a mutational mechanism involving an unstable
      trinucleotide repeat.

PMID- 8358430
TI  - Effect of the myotonic dystrophy (DM) mutation on mRNA levels of the DM gene.
AB  - Myotonic dystrophy (DM) results from the amplification of an unstable CTG repeat
      in the 3' untranslated region of a transcript encoding a putative
      serine/threonine kinase. We have analysed the amplification of the repeat and the
      steady state levels of the DM kinase (DMK) mRNA in tissues and cell lines from
      normal and congenital DM individuals. Southern blot analysis of DNA samples from
      a severely affected neonate shows somatic heterogeneity of the repeat in all
      tissues studied. RNA analyses on these tissues show a marked increase in DMK
      steady state mRNA levels. We demonstrate that the mutant DMK allele is expressed
      regardless of the number of CTG repeats and that the increase in DMK mRNA levels
      is due to elevated mutant mRNA levels. We postulate that elevated DMK levels
      explains the dominant inheritance pattern of DM.

PMID- 8358431
TI  - Cloning of human, mouse and fission yeast recombination genes homologous to RAD51
      and recA.
AB  - Rad51, of Saccharomyces cerevisiae, is a homologue of recA of Escherichia coli
      and plays crucial roles in both mitotic and meiotic recombination and in repair
      of double-strand breaks of DNA. We have cloned genes from human, mouse and
      fission yeast that are homologous to rad51. The 339 amino acid proteins predicted
      for the two mammalian genes are almost identical and are highly homologous (83%)
      with the yeast proteins. The mouse gene is transcribed at a high level in thymus,
      spleen, testis and ovary and at a lower level in brain and other tissues. The
      rad51 homologues fail to complement the DNA repair defect of rad51 mutants of S.
      cerevisiae. The mouse gene is located in the F1 region of chromosome 2 and the
      human gene maps to chromosome 15.

PMID- 8358432
TI  - Human and murine FMR-1: alternative splicing and translational initiation
      downstream of the CGG-repeat.
AB  - Fragile X syndrome is associated with massive expansion of a CGG trinucleotide
      repeat within the FMR-1 gene and transcriptional silencing of the gene due to
      abnormal methylation. Partial cDNA sequence of the human FMR-1 has been reported.
      We report here the isolation and characterization of cDNA clones encoding the
      murine homologue, fmr-1, which exhibit marked sequence identity with the human
      gene, including the conservation of the CGG repeat. A conserved ATG downstream of
      the CGG repeat in human and mouse and an in-frame stop codon in other human 5'
      cDNA sequences demarcate the FMR-1 coding region and confine the CGG repeat to
      the 5' untranslated region. We also present evidence for alternative splicing of
      the FMR-1 gene in mouse and human brain and show that one of these splicing
      events alters the FMR-1 reading frame, predicting isoforms with novel carboxy
      termini.

PMID- 8358433
TI  - Telomere capture stabilizes chromosome breakage.
AB  - Terminal deletions are found frequently in both malignancies and clinically
      recognizable deletion syndromes in man. Little is known, particularly in cancer,
      of the specific mechanisms which lead to the generation of deleted chromosomes or
      the process by which these broken chromosomes are stabilized. We demonstrate that
      several examples of apparent terminal deletions are, in fact, subtelomeric
      translocations which were not detectable using conventional cytogenetics. The
      unexpectedly high frequency of this phenomenon and the diversity of partner
      chromosomes involved in the subtelomeric translocations is consistent with a
      model in which telomere capture can stabilize chromosome breakage in man.

PMID- 8358435
TI  - Functional equivalence of human X- and Y-encoded isoforms of ribosomal protein S4
      consistent with a role in Turner syndrome.
AB  - Several genes are found on both the human X and Y chromosomes in regions that do
      not recombine during male meiosis. In each case, nucleotide sequence analysis
      suggests that these X-Y gene pairs encode similar but nonidentical proteins. Here
      we show that the human Y- and X-encoded ribosomal proteins, RPS4Y and RPS4X, are
      interchangeable and provide an essential function: either protein rescued a
      mutant hamster cell line that was otherwise incapable of growth at modestly
      elevated temperatures. These findings are consistent with the hypothesis that
      RPS4 deficiency has a role in Turner syndrome, a complex human phenotype
      associated with monosomy X.

PMID- 8358434
TI  - 3,400 new expressed sequence tags identify diversity of transcripts in human
      brain.
AB  - We present the results of the partial sequencing of over 3,400 expressed sequence
      tags (ESTs) from human brain cDNA clones, which increases the number of distinct
      genes expressed in the brain, that are represented by ESTs, to about 6,000. By
      choosing clones in an unbiased manner, it is possible to construct a profile of
      the transcriptional activity of the brain at different stages. Proteins that
      comprise the cytoskeleton are the most abundant; however, a large variety of
      regulatory proteins are also seen. About half of the ESTs predicted to contain a
      protein-coding region have no matches in the public peptide databases and may
      represent new gene families.

PMID- 8358436
TI  - A high resolution deletion map of human chromosome Xp22.
AB  - We have developed a 32-interval deletion panel for human chromosome Xp22 spanning
      about 30 megabases of genomic DNA. DNA samples from 50 patients with chromosomal
      rearrangements involving Xp22 were tested with 60 markers using a polymerase
      chain reaction strategy. The ensuing deletion map allowed us to confirm and
      refine the order of previously isolated and newly developed markers. Our mapping
      panel will provide the framework for mapping new sequences, for orienting
      chromosome walks in the region and for projects aimed at isolating genes
      responsible for diseases mapping to Xp22.

PMID- 8358437
TI  - Heterozygous missense mutation in the rhodopsin gene as a cause of congenital
      stationary night blindness.
AB  - A number of mutations in the rhodopsin gene have been shown to cause both
      dominant and recessive retinitis pigmentosa. Here we describe another phenotype
      associated with a defect in this gene. We discovered a patient with congenital
      stationary night blindness who carries the missense mutation Ala292Glu. When
      coupled with 11-cis-retinal in vitro, Ala292Glu rhodopsin is able to activate
      transducin in a light-dependent manner like wild-type rhodopsin. However, without
      a chromophore, Ala292Glu opsin anomalously activates transducin. We speculate
      that the rod dysfunction in this patient is due to an abnormal, continuous
      activation of transducin by mutant opsin molecules in photoreceptor outer
      segments.

PMID- 8358438
TI  - Chromosomal assignment of the second locus for autosomal dominant cerebellar
      ataxia (SCA2) to chromosome 12q23-24.1.
AB  - The autosomal dominant cerebellar ataxias (ADCA) are a group of neurodegenerative
      disorders characterized by onset with gait ataxia, dysarthria, dysmetria and
      dysdiadochokinesia. We have demonstrated previously genetic heterogeneity within
      these disorders by excluding the disease locus from the documented
      spinocerebellar ataxia locus (SCA1) on chromosome 6p in a large Cuban founder
      population. We now report the assignment of a second locus for ADCA (SCA2) to
      chromosome 12q23-24.1 following linkage analyses carried out for the Cuban
      pedigrees, with probable flanking markers D12S58 and phospholipase A2.
      Investigation of linkage to the interval containing SCA2 for seven French ADCA
      families, previously excluded from linkage to SCA1, provides preliminary data
      suggesting the existence of a third ADCA locus (SCA3).

PMID- 8358439
TI  - The gene for Machado-Joseph disease maps to human chromosome 14q.
AB  - Machado-Joseph disease (MJD) is an autosomal dominant, multisystem
      neurodegenerative disorder involving predominantly cerebellar, pyramidal,
      extrapyramidal, motor neuron and oculomotor systems. Although it was first
      reported in families of Portuguese-Azorean descent, MJD has also been described
      in non-Azorean families from various countries, being one of the most common
      hereditary spinocerebellar degenerations. With the use of highly polymorphic
      microsatellite DNA polymorphisms, we have assigned the gene for MJD to the long
      arm of chromosome 14 (14q24.3-q32) by genetic linkage to microsatellite loci
      D14S55 and D14S48 (multipoint lod score Zmax = 9.719).

PMID- 8358441
TI  - Mapping of a novel gene for familial hypertrophic cardiomyopathy to chromosome
      11.
AB  - Familial hypertrophic cardiomyopathy (FHC) is a cardiac disorder transmitted as
      an autosomal dominant trait. FHC has been shown to be genetically heterogeneous
      with less than 50% of published pedigrees being associated with mutations in the
      beta myosin heavy chain (beta-MHC) gene on chromosome 14q11-q12. A second locus
      has recently been reported on chromosome 1. We examined the segregation of
      microsatellite markers in a French pedigree for which the disease is not linked
      to beta-MHC gene. We found significant linkage of the disease locus to several
      (CA)n repeats located on chromosome 11 (lod scores between +3.3 and +4.98). The
      data suggest the localization of the novel FHC gene in a region spanning 17
      centiMorgans.

PMID- 8358440
TI  - Susceptibility to insulin dependent diabetes mellitus maps to a 4.1 kb segment of
      DNA spanning the insulin gene and associated VNTR.
AB  - Recent studies have demonstrated that a locus at 11p15.5 confers susceptibility
      to insulin dependent diabetes mellitus (IDDM). This locus has been shown to lie
      within a 19 kb region. We present a detailed sequence comparison of the
      predominant haplotypes found in this region in a population of French Caucasian
      IDDM patients and controls. Identification of polymorphisms both associated and
      unassociated with IDDM has allowed us to define further the region of association
      to 4.1 kb. Ten polymorphisms within this region are in strong linkage
      disequilibrium with each other and extend across the insulin gene locus and the
      variable number tandem repeat (VNTR) situated immediately 5' to the insulin gene.
      These represent a set of candidate disease polymorphisms one or more of which may
      account for the susceptibility to IDDM.

PMID- 8358443
TI  - [Hormonal treatments of normo-gonadotrophic oligoasthenospermia].

PMID- 8358442
TI  - Identification of a common mutation in the carnitine palmitoyltransferase II gene
      in familial recurrent myoglobinuria patients.
AB  - Carnitine palmitoyltransferase (CPT) II deficiency is the most common inherited
      disorder of lipid metabolism affecting skeletal muscle. We have identified a
      missense mutation (Ser113Leu) in one patient with the classical muscular
      symptomatology. Transfection experiments in COS cells demonstrate that the
      mutation drastically depresses the catalytic activity of CPT II. The mutation
      results in normal synthesis but a markedly reduced steady-state level of the
      protein, indicating decreased stability of mutant CPT II. The Ser113Leu mutation
      is the most frequent cause of CPT II deficiency. The mutation can be detected
      easily by restriction analysis enabling molecular diagnosis of most patients and
      identification of heterozygous carriers.

PMID- 8358444
TI  - [Use of GnRh analogues in the treatment of female sterility].

PMID- 8358445
TI  - [Ultrasonic mammography].

PMID- 8358446
TI  - [What to do--what not to do with hirsutism].

PMID- 8358448
TI  - [Cancer of the ovary and the treatment of infertility. Analysis of the article by
      Whittemore et al].
AB  - Whittemore and al. recently published a general paper concerning the risk factors
      of ovarian cancer, combining the data from 12 epidemiological studies realised
      from 1979 to 1988. Three of these studies allowed to analyze the role of
      infertility treatments which were associated to an increased risk (odds ratio =
      2.8), specially in nulligravid women (OR = 27.0). However potential bias could
      not be rejected, and information on drugs was too scanty, so that no definite
      conclusion could be drawn, even if the results were in accordance with the main
      physicopathogenical theories. In conclusion, it appears necessary to undertake a
      large epidemiological study, and, in the same time, even if patients must be
      reassured, to recommend attention to the doctors when prescribing infertility
      treatments.

PMID- 8358447
TI  - [Contraception and endometriosis].
AB  - Contraception in women with endometriosis is unusual. In case of mild
      asymptomatic endometriosis all contraceptive methods may be used except
      predominant estrogenic action pills. In case of severe endometriosis if score is
      upon 70 or adhesion score upon 50 the patients are generally infertile.
      Contraception is not necessary. If scores are lower, medical treatment of
      endometriosis insure the contraception during the first six months. Afterwards an
      hydroxyprogesterone derivative pill such as cyproterone acetate, or a norpregnan
      derivative pill, or a combined estrogen progestogen pill, with predominant
      progestogen action (norgestrienon), or a monophasic pill containing
      norethisteron, or in case of metabolic diseases a pill containing gestoden, must
      be prescribed three out of four weeks. In case of adenomyosis, vaginal
      contraception is better. Perhaps in the next future, the new progestogen
      sterilant will be the best.

PMID- 8358449
TI  - [Microfertilization techniques: con].
AB  - The actually used microfertilization procedures are exposed according to
      potential indications: flagellar immotility, previous unexplained failure of IVF,
      and oligo-asthenoteratozoospermia. Results of two prospective randomized studies
      are presented in case of severe asthenozoospermia associated with at least one
      previous failure of IVF. Evaluation of fertilization rates confirms that ZD does
      not improve IVF prognosis whereas SUZI could be used to enhance IVF results.
      Authors focused on major methodological criticisms raising about most of
      published series, on relatively low evolutive pregnancy rate (5.7%) and on the
      need of randomized prospective studies for judge real interest of assisted
      fertilization.

PMID- 8358450
TI  - [Pro clomiphene].
AB  - Thanks to CC an important number of endocrine sterility has been cured. The
      antiestrogenic effect of CC has been accused to promote perturbations of cervical
      mucus secretion and endometrial receptivity. The different technics to assure
      correction of negative side effects while promoting optimal activity of
      clomiphene will be discussed in terms of modern evaluation methods.

PMID- 8358451
TI  - [Sperm and HIV].
AB  - Screening and prevention are two major weapons in the fight against AIDS.
      Procreation of couples where the spouse is seropositive poses a serious ethical
      social and epidemiological problem. We have consequently established a list of
      the current biological data concerning HIV in the sperm at the level of non
      germinal cells, seminal plasma and spermatozoa and of the clinical data on the
      transmission of the virus during sexual intercourse and insemination. Finally, we
      have presented the results of the research on predictable factors of the
      infectiousness of sperm. After this analysis, we consider the possibilities open
      to the medical corps: dissuasion, ovulation monitoring, insemination with the
      husband sperm, IVF and insemination with hope to be able to participate in the
      debate which must lead to a clear concerted and coherent position on the part of
      the medical corps, at least on a national level.

PMID- 8358452
TI  - [Fertility tests (hamster, electronic microscopy): are they useful?].
AB  - Tests of sperm function are often considered to be able to predict the in vivo or
      in vitro fertility of a given patient although they only assess part of the
      process of sperm fertilizing ability. It appears from the literature, that the
      sperm penetration assay (SPA) which investigates the sperm fusiogenic and nuclear
      functions cannot accurately predict the in vivo fertility and there is still much
      debate on the reliability of its correlation with in vitro fertilization (IVF)
      principally in cases of severe sperm deficiency. With the development of new
      techniques of assisted fertilization, by-passing the zona pellucida, a test of
      sperm fusion, hetero or homospecific as well, could be interesting. Considering
      sperm ultrastructure and beyond some specific morphological alterations of the
      whole sperm population that can be responsible for the infertility, such studies
      were not able, as yet, to reveal significative differences between semen fertile
      in vitro or not.

PMID- 8358453
TI  - [Chronicle of functional pain: chronic pelvic pains].
AB  - Chronic pelvic pains are one of the most frequent complaints in our daily
      gynecological practice, motivating at least a quarter of our consultants. As it
      usually puts the practitioner ill at ease in a difficult situation, we will try
      to understand the meaning of those particular pains, thus defined: a duration
      outlasting 6 months and the absence or the ineffective suppression of any organic
      -somatic--substratum. But every alleged pain is real and true, and we must work
      on that. To validate such suffering, to accept such repetitive complaints, can
      also be a therapeutic medical approach, even if it is less gratifying for the
      gynecologist, and certainly less customary.

PMID- 8358454
TI  - [University of Quebec at Montreal. Psychosexuality of childhood and adolescence:
      trends in research].
AB  - This paper reviews the literature on child and adolescent psychosexuality. It
      intends to identify the major trends in contemporary research in the field of
      psychosexual development. Reviewing first, the theories of the child and
      adolescent development, in exploring the psychosexuality dimension, it shows
      afterward that in the actual state of research two thematics are privileged in
      empirical literature: "gender" and "sexual and contraceptive attitudes-values
      behaviours". These thema are mainly studied in the descriptive correlation
      researches which focus on gender identity, gender roles, gender differences in
      one part and on initiation to first sexual relationships, its predictors and
      consequences on the other part. In a whole, these data are factual rather than
      developmental in nature. These one identifies the facts inherent to development
      but they rarely shows the interaction between these facts nor their evolution in
      the courses of time. This literature review does not cover all the interests
      touched by the searchers in the field nor it pretend to fully examine the
      research content exposed in this paper. It limits itself to identify the major
      trends in the contemporary research and to offer some indication for the future.

PMID- 8358455
TI  - [Prostatic utricle, a rare but potentially curable cause of male sterility].
AB  - This case report describes a patient presenting a cyst of the prostatic utricule
      that was detected during assessment for sterility and removed surgically. A
      review of the pertinent literature is proposed. Azoospermia or severe
      oligospermia associated with a low ejaculation volume are the main
      manifestations. Transrectal ultrasonography is the diagnostic examination of
      choice. In most cases incision of the mouth of the utricule promptly abolishes
      sterility and enables fertilization.

PMID- 8358456
TI  - [Respective roles of thecal and granulosa cells in the morphogenesis of the
      corpus luteum].
AB  - Studies on human ovary embryogenesis and adult post-ovulatory surgically resected
      ovaries allowed the authors to propose a new conception on the genesis of corpus
      luteum: large luteal cells would be derived from theca interna cells and small
      luteal cells would come from externa theca cells. So there would be a structural
      unity of luteal tissue which might explain steroidogenesis potential of these two
      types of cells, derived both from the same ovarian stroma. On the other hand if
      granulosa cells played an important function in bio-conversion of androgens to
      oestradiol by aromatase activity before ovulation, their role is over after the
      expulsion of the oocyte out of the follicle; derived from primitive sex cords of
      coelomic mesothelium origin, granulosa cells act to support and surround the
      oocyte; they disappeared at the disappearance of the oocyte from the follicle.

PMID- 8358457
TI  - Interesting times: managed critical care.

PMID- 8358458
TI  - Determining AACN's research priorities for the 90s.
AB  - The American Association of Critical-Care Nurses completed a three-phased process
      of priority identification for critical care nursing research. In phase 1, a 78
      item survey was generated following a comprehensive review of potential research
      topics. In phase 2, approximately 1000 critical care nurses rated each item on
      the survey for importance to critical care nursing. Based on these results, the
      AACN Research Committee formulated a clinical and a nonclinical (contextual) list
      of research topics. Each list contained 25 topics. In phase 3, topics were given
      final rankings at a 1-day Consensus Conference on Research Priorities. Both
      Likert-type and magnitude estimation scaling were used to determine priority
      ranking of items on each list. As a result, both clinical and contextual research
      priorities were established for AACN.

PMID- 8358460
TI  - Pilot study: validating staff nurses' observations of sleep and wake states among
      critically ill patients, using polysomnography.
AB  - BACKGROUND: Effective management of sleep pattern disturbance begins with
      accurate assessment of the patient's sleep and wake states. OBJECTIVE: The
      purpose of this study was to validate staff nurses' observations of sleep and
      wake states among critically ill adult patients, using polysomnography. SAMPLE
      AND SETTING: The sample consisted of 21 adult patients with multisystem diagnoses
      in a 10-bed medical intensive care unit in a 540-bed acute care teaching
      hospital. METHOD: Each staff nurse caregiver observed a single patient for the
      entire data collection period of 4 hours, with a total of 15 nurses participating
      in the study. A total of 340 observations were made, with the possibility of 17
      observations per patient. Nursing observations were made every 15 minutes on each
      patient and compared to the actual patient state as measured by polysomnography.
      RESULTS: Nurses' assessments were correct 81.9% of the time. CONCLUSIONS: There
      is some basis for using staff nurses as observers of sleep and wake states.
      Increased credence can be placed on nursing assessments and diagnosis of sleep
      pattern disturbance, resulting in more timely and effective management of the
      problem.

PMID- 8358459
TI  - Effects of patient-controlled analgesia on postoperative anxiety in elderly men.
AB  - OBJECTIVE: To determine whether the use of patient-controlled analgesia vs
      intramuscular injections improves postoperative psychological parameters,
      particularly anxiety. DESIGN: Randomized, controlled trial of patient-controlled
      analgesia vs as-needed intramuscular morphine with pre- and postoperative
      assessments of pain, mental status, narcotic use, anxiety and mood states.
      SETTING: General surgical wards and surgical intensive care unit at a Veterans
      Administration hospital. PATIENTS: Eighty-three elderly, chronically ill males
      undergoing major elective surgery. INTERVENTION: Subjects randomized to receive
      postoperative patient-controlled analgesia vs as-needed intramuscular morphine.
      Pre- and postoperative assessments of State-Trait Anxiety Inventory, McGill
      Dartmouth Part IV and Short Portable Mental Status Questionnaire. Pain (using
      linear analog scale), sedation score and narcotic use assessed every 4 hours for
      72 hours. RESULTS: No differences were found in state anxiety or self-perceived
      mood states. Postoperative state anxiety was found to relate most closely to
      preoperative anxiety and postoperative complications, rather than method of
      analgesia or severity of pain. However, patient-controlled analgesia subjects had
      significantly improved analgesia and increased satisfaction. CONCLUSION: The use
      of patient-controlled analgesia does not significantly alter the measured
      psychological parameters, compared with intramuscular injections. Improved
      analgesia is the result of pharmacologic effects, independent of psychological
      factors.

PMID- 8358461
TI  - Room-temperature thermodilution cardiac output: proximal injectate lumen vs
      proximal infusion lumen.
AB  - OBJECTIVE: To assess the accuracy of room-temperature thermodilution cardiac
      output measurements from the venous infusion port. DESIGN: Central venous port
      cardiac output measurements were compared with venous infusion port measurements
      in 48 right-heart catheters. INTERVENTION: Three 10-mL injections of 5% dextrose
      in water were made through each port. The order of port injection was random.
      RESULTS: The cardiac outputs were 5.8 +/- 1.8 L/min from both ports, with no
      difference between ports (paired t test). CONCLUSION: Room-temperature
      thermodilution cardiac output determinations from the venous infusion port can be
      used in place of central venous port cardiac outputs if the central venous port
      becomes nonfunctional.

PMID- 8358462
TI  - Liver transplantation for acute hepatic failure: a review of clinical experience
      and management.
AB  - OBJECTIVE: The purpose of this review was to examine and describe the clinical
      experience and outcomes of liver transplantation in humans for acute fulminant
      hepatic failure. DATA SOURCES: A review of the literature since 1980 using
      Medline was done to identify clinical reports including case study reports. STUDY
      SELECTION: Clinical reports were included if they stated the number of patients
      in a given time frame who were evaluated and/or received a transplant for acute
      hepatic failure and any other outcome data such as the number of those who
      recovered without a transplant and who died in the operative period. Twenty-two
      reports were identified that met the selection criteria. Data were reported
      inconsistently. No ex post facto reports that examined factors relevant to
      clinical outcomes were identified. CONCLUSIONS: Acute hepatic failure is
      considered an acceptable indication for liver transplantation based on the
      opinions expressed by the leading experts in the field as currently reported in
      the literature and at professional meetings. Data is limited, however, on
      outcomes and factors contributing to successful outcomes.

PMID- 8358463
TI  - Common infections in heart transplant patients.
AB  - Infection is the primary cause of morbidity and mortality following cardiac
      transplantation because of the strict immunosuppressive regimens patients follow.
      In the immediate postoperative phase, patients are more susceptible to infection
      because of interruption of their external barriers to infection. Cardiac
      transplant recipients are most likely to succumb to infections caused by
      cytomegalovirus, Epstein-Barr virus and bacterial organisms, especially
      staphylococcus. Fungal, protozoal and herpes simplex infections are also
      frequently troublesome to the transplant recipient. Critical care clinicians can
      control the incidence of infection in the cardiac transplant population by
      initiating measures to maintain external barriers, monitoring the patient for
      early signs of infection, and instituting appropriate isolation techniques.

PMID- 8358464
TI  - Case study: heart transplantation--increased incidence of acute rejection in
      female recipients.
AB  - Although the precise link between the increased incidence of allograft rejection
      in female heart transplant recipients remains uncertain, various gender-specific
      characteristics may predispose women to earlier rejection episodes. Critical care
      practitioners must be cognizant of the underlying immunologic factors that
      indicate higher risk in these recipients. Until the ideal treatment for cardiac
      rejection is discovered, identifying pertinent immunologic factors, attending to
      subtle symptoms, obtaining serial endomyocardial biopsies and initiating prompt,
      additional aggressive immunosuppressive protocols remain paramount in rendering
      quality patient care. Research must continue to elicit more specific tissue
      typing antigens and more selective immunosuppressive agents that will ultimately
      result in prolonged survival of all heart transplant recipients.

PMID- 8358466
TI  - A case report of postpneumonectomy syndrome.

PMID- 8358465
TI  - A preliminary investigation of opinions and behaviors regarding advance
      directives for medical care.
AB  - BACKGROUND: Advance directives are a means of promoting patient autonomy in end
      of-life decisions but are used infrequently. A recent federal law requires
      healthcare organizations to provide information to patients about advance
      directives. This study explored attitudes and behaviors related to the use of
      advance directives in three areas: familiarity with advance directives, reasons
      for completing or not completing advance directives and preferences for receiving
      information about advance directives. METHODS: A questionnaire was administered
      by personal interview to a nonrandomized convenience sample of 46 inpatients and
      50 outpatients at a large, tertiary care, urban academic medical center in the
      summer of 1991. RESULTS: Most respondents (77%) had heard of either the living
      will or durable power of attorney for healthcare, but only 52% correctly
      understood the purpose of these documents. Twenty-nine percent of the sample had
      executed an advance directive. Those who had advance directives were older and
      considered themselves less healthy than did those without advance directives.
      Unfamiliarity with advance directives and procrastination were cited most often
      as reasons for not having an advance directive. Most subjects (65%) had spoken
      with someone, usually a family member or close friend, about preferences for
      treatment during a critical illness. Although they had rarely discussed advance
      directives, 83% anticipated that they would be comfortable doing so with a
      physician or a nurse. CONCLUSIONS: Advance directives are used infrequently to
      document treatment preferences. The success of programs to promote greater use of
      advance directives depends on a clearer understanding of the factors that
      influence both decision and action to execute an advance directive. Patients
      claim to be comfortable in discussing the topic and prefer that such discussions
      occur in the outpatient setting.

PMID- 8358467
TI  - PTCA in elderly patients: hospital events.
AB  - BACKGROUND: Medical treatment of the elderly is changing to include the
      aggressive management of coronary artery disease with percutaneous transluminal
      coronary angioplasty. OBJECTIVE: The purpose of this study was to review major
      hospital events of patients aged 70 years or more, who underwent a first
      percutaneous transluminal coronary angioplasty. METHODS: A retrospective medical
      record review was done of 246 consecutive patients of 70 years or more, from
      January 1985 to December 1988, at a tertiary care community hospital. Adverse
      events and the factors that influenced outcome were identified. RESULTS: Of 246
      patients (age range, 70-85 years, mean = 73.6), 19 died, 4 had a cerebral
      vascular accident, 11 had a transfusion and 11 underwent coronary artery bypass
      grafting. Sixteen patients had acute vessel closure and 8 died. Twenty-five
      patients had one event and 21 patients had more than one. DISCUSSION: The event
      rate after percutaneous transluminal coronary angioplasty in the elderly is high.
      CONCLUSIONS: Knowledge of the factors that influence adverse events (diagnostic
      category, success of procedure, degree of coronary artery disease and age) will
      assist the critical care team to plan and implement appropriate care.

PMID- 8358468
TI  - Survey of the degree to which critical care nurses are performing current
      procedural terminology-coded services.

PMID- 8358469
TI  - An open door policy in ICU.

PMID- 8358470
TI  - Regulations and critical care.

PMID- 8358471
TI  - Nontraditional nursing education programs.

PMID- 8358472
TI  - Doing the thing right: assumptions and assessment in hemodynamic monitoring.

PMID- 8358473
TI  - Indirect blood pressure measurement: a need to reassess.
AB  - BACKGROUND: Indirect blood pressure measurement is the assessment tool used most
      frequently in epidemiological studies and hypertension management in the
      population at large. OBJECTIVE: To review indirect blood pressure measurement
      within the context of nursing practice. RESULTS: Nurses are not following
      recommended American Heart Association measurement guidelines. CONCLUSION: A
      national program of certification in indirect blood pressure measurement, similar
      to that of basic and advanced cardiac life support, is needed. An initial
      approach to evaluating present practice is also suggested.

PMID- 8358474
TI  - ST segment monitoring for coronary artery reocclusion following thrombolytic
      therapy and coronary angioplasty: identification of optimal bedside monitoring
      leads.
AB  - BACKGROUND: Bedside ST segment monitors analyze only one precordial lead and one,
      two or three limb leads. The precordial lead V1 (or V6 if V1 is not feasible) has
      been recommended for bedside monitoring because of its value in diagnosing
      cardiac rhythms with a wide QRS complex. Thus, the remaining lead choices for ST
      monitoring are limited to the six limb leads. PURPOSE: To determine which of the
      limb leads in conjunction with V1 or V6 provides the greatest sensitivity for
      myocardial ischemia, a study was undertaken. METHOD: A total of 30 vessel-unique
      ischemic episodes were analyzed prospectively using continuous 12-lead
      electrocardiographic recordings in patients with acute myocardial infarction (n =
      2) and patients undergoing coronary angioplasty (n = 25). RESULTS: Ischemic
      changes were evident in all cases using the full 12-lead electrocardiogram. Right
      coronary artery-related ischemia was detected in all cases using a single-lead
      III or aVF. In the group as a whole, the best combinations were: V1 + aVF, V1 +
      III, V6 + III, and V6 + aVF. Two patients developed sudden coronary artery
      reocclusion in the cardiac care unit after successful angioplasty. In both, leads
      identified in the cardiac catheterization laboratory as sensitive for recording
      ischemia were excellent choices for detection of reocclusion in the cardiac care
      unit. CONCLUSIONS: 12-lead electrocardiogram recordings during coronary
      angioplasty balloon inflation provide excellent guidance for postprocedure lead
      selection decisions. The most valuable limb leads for detecting ischemia due to
      abrupt artery closure are leads III and aVF, either of which is more sensitive
      than the routinely monitored lead II. The precordial leads valuable for
      arrhythmia monitoring, V1 and V6, are seldom sensitive in detecting ischemia in
      these patients.

PMID- 8358475
TI  - Chest tube stripping in pediatric oncology patients: an experimental study.
AB  - BACKGROUND: Stripping of chest tubes to promote drainage of the thorax of
      postthoracotomy patients has been routine practice, based on tradition. Recent
      published findings indicate that significant negative pressures are generated in
      the tube during stripping that could cause pain, bleeding and possible damage to
      the patient's lung tissue. OBJECTIVE: To determine whether pediatric oncology
      patients whose chest tubes were not stripped would differ in frequency of pain,
      fever or lung complications from patients who underwent routine tube stripping.
      METHODS: Data were collected at multiple points during the first 72-hour
      postoperative period from 16 patients assigned to the stripped or unstripped
      groups. Pain was measured by the Faces Pain Scale and the Visual Analogue Scale;
      temperature, by electronic thermometer; and lung complications, by stethoscope
      and radiographs. Both groups, which were comparable for age, primary diagnosis
      and prior history of lung problems, received identical supportive nursing and
      medical care, with the physicians blind to group assignment. RESULTS: The two
      groups did not differ significantly in frequency of pain, incidence of fever,
      breath sounds or radiographic findings across measurement points. A strong
      correlation was found between the pain scores using the two instruments.
      DISCUSSION: Patients whose tubes were not stripped did not have an increased risk
      of infection or lung complications. Study findings indicated that stripping did
      not increase the frequency of pain. CONCLUSIONS: Stripping of chest tubes as a
      routine postoperative measure is questioned.

PMID- 8358476
TI  - Consenting to DNR: critical care nurses' interactions with patients and family
      members.
AB  - OBJECTIVE: To investigate the process of consenting to do-not-resuscitate status
      from the perspective of critical care nurses who have been involved with patients
      and/or family members during their decision. METHOD: A network sample of 22
      critical care nurses, with at least 1 year's experience in a critical care unit
      and self-reported multiple experiences with the do-not-resuscitate consent
      process, participated in the study. Semistructured, formal interviews were used
      to collect data. All interviews were tape recorded and transcribed verbatim. The
      grounded theory method was used to collect and analyze data. RESULTS: The
      analysis revealed a core category: consenting to do-not-resuscitate status.
      Integrated into the process were intervening conditions that further explained
      the process: the meaning of "do not resuscitate," the importance of time/timing
      in the process, the nurse's role and conflict issues that arose during the
      process of consenting to do-not-resuscitate status. CONCLUSIONS: The theoretical
      model developed in this study provides a framework to describe the role of
      critical care nurses in the do-not-resuscitate process. In addition, a
      description of the categories provides information for nurses, especially novice
      nurses, to consider when caring for patients and families who are in the process
      of making decisions concerning resuscitation.

PMID- 8358477
TI  - Organ donation: comparison of nurses' participation in two states.
AB  - BACKGROUND: The number of organs available for transplantation in the United
      States is insufficient, and the donor rate in New Jersey is particularly low.
      OBJECTIVES: To explore reasons nurses do or do not refer organ donors and to
      identify factors that contribute to differences in referral rates in New Jersey
      and Pennsylvania. METHODS: Registered nurses (N = 976) in 57 nongovernmental
      acute care hospitals, primarily in emergency departments and intensive care
      units, completed a questionnaire that focused on their knowledge and
      participation in the organ procurement process. RESULTS: Two-thirds of the
      subjects said they had participated in organ procurement. Pennsylvania nurses had
      a significantly higher involvement rate than New Jersey nurses. Pennsylvania
      nurses were also slightly more knowledgeable about the process. A higher
      proportion of nurses in both states who attended continuing education programs
      participated. CONCLUSIONS: Nurses need more inservice education regarding
      policies and procedures for organ donation.

PMID- 8358478
TI  - Effects of lung hyperinflation and presence of positive end-expiratory pressure
      on arterial and tissue oxygenation during endotracheal suctioning.
AB  - PURPOSE: To explore the effects of endotracheal suctioning on mixed venous oxygen
      tension and other measures of arterial and tissue oxygenation, to determine if
      these would be clinically useful outcome measures of endotracheal suctioning.
      BACKGROUND: Measuring arterial oxygenation only as an outcome of endotracheal
      suctioning can be misleading in that it may appear adequate in the presence of
      marked decreases in mixed venous oxygen tension, a good indicator of the adequacy
      of tissue oxygenation. METHODS: Eighteen instrumented and oleic acid-injured
      animal models of acute respiratory failure undergoing closed-system endotracheal
      suctioning were studied according to a 2 x 2 factorial design to measure the
      effects of oxygen inflations at tidal volume or 135% of tidal volume either in
      the presence or absence of positive end-expiratory pressure. RESULTS: Using
      multivariate analysis of variance for repeated measures, protocol by time effects
      for mixed venous oxygen tension, arterial oxygen saturation, arterial oxygen
      tension, oxygen delivery and oxygen extraction ratio were statistically
      significant. Changes in mixed venous oxygen tension and arterial oxygen
      saturation were parallel. CONCLUSIONS: Continuous measurement of mixed venous
      oxygen tension allows the calculation of oxygen delivery and oxygen extraction
      ratio, which provide a better estimation of the effects of endotracheal
      suctioning on tissue oxygenation than arterial oxygen tension alone.

PMID- 8358480
TI  - The indirect patient care effect of a unit-based clinical nurse specialist on
      preventable pulmonary complications.
AB  - PURPOSE: To examine the indirect effect of a unit-based expert nurse on the
      incidence of preventable pulmonary complications, which were defined as
      malpositioned endotracheal tube and inadvertent extubation. DESIGN: A
      nonequivalent control group/separate samples pretest/posttest design was used to
      test differences in the incidence of preventable pulmonary complications before
      and after a 6-month intervention by a unit-based expert nurse in the experimental
      unit. Retrospective medical record audits were used to collect data on all
      consecutive admissions to the experimental and control units in March and April
      of years 1 and 2. RESULTS: Estimated risk ratios demonstrated a significant
      reduction in preventable pulmonary complications in the experimental unit after
      the test, even though the acuity was significantly higher in posttest patients.
      It was concluded that indirect patient care by a unit-based clinical nurse
      specialist can reduce the incidence of preventable pulmonary complications.

PMID- 8358479
TI  - The effect of saline lavage prior to suctioning.
AB  - OBJECTIVE: To determine the effect on oxygen saturation of instilling a saline
      bolus into artificial airways prior to suctioning, as measured by pulse oximeter.
      DESIGN: Quasi-experimental, single-case, counterbalanced design. SETTING: The
      surgical, medical and coronary intensive care units of a federal, teaching
      medical center. SUBJECTS: Subjects were 40 men, more than 40 years old, in need
      of intensive care nursing and mechanical ventilation. INTERVENTIONS: Subjects
      were suctioned as needed for 24 hours. A 5-mL saline bolus was instilled every
      other time the subject was suctioned. Outcome measurements were done immediately
      before and after suctioning and at 1-minute intervals for 5 minutes after
      suctioning. MAIN OUTCOME MEASURES: Noninvasive oxygen saturation values. RESULTS:
      The instillation of a saline bolus was found to have an adverse effect on oxygen
      saturation that worsened over time. Significant changes in oxygen saturation as a
      result of saline bolus instillation were found at 2,3,4 and 5 minutes after
      instillation. CONCLUSIONS: These results indicate that instilling saline prior to
      suctioning has an adverse effect on oxygen saturation. These results support the
      recommendation that the practice of instilling saline prior to suctioning should
      be abandoned as a routine procedure. More study is needed to investigate whether
      a specific group of patients may actually benefit from this procedure.

PMID- 8358481
TI  - Visit preferences of middle-aged vs older critically ill patients.
AB  - OBJECTIVE: To differentiate between middle-aged and older adults' visiting
      preferences in critical care settings. DESIGN: Patients' preferences for
      visiting, perceptions of illness severity and extent of fatigue associated with
      visiting and an objective measurement of illness severity while in critical care
      were surveyed within 3 days after transfer from the critical care unit. SETTING:
      Interviews occurred on the transitional care units with patients who transferred
      from either the coronary care or surgical intensive care units in a large
      Northeast teaching hospital. PATIENTS: Fifty-three middle-aged (35 through 65
      years) and 46 older (over 65 years) patients were surveyed (N = 99). RESULTS:
      Both middle-aged and older patients consistently wanted to limit the number of
      visitors to two or three persons per visit. Compared with middle-aged patients, a
      greater proportion of older patients preferred to limit visits to once a day and
      wanted the visit length to be unlimited. A greater proportion of older coronary
      care unit patients preferred to limit visits to two times a day than older
      surgical unit patients. CONCLUSIONS: Middle-aged and older patients differed in
      their preferences for visits, with sufficient variation in responses to warrant
      tailoring visits to the unique preferences of patients based on age and clinical
      setting.

PMID- 8358482
TI  - "I want to die, I think": a case study in clinical ethics and determination of
      truth.

PMID- 8358483
TI  - The importance of magnesium in cardiovascular disease.

PMID- 8358484
TI  - Intelligent monitoring and control of dynamic physiological systems.

PMID- 8358485
TI  - Model-based diagnosis in intensive care monitoring: the YAQ approach.
AB  - YAQ is an ontology for model-based reasoning in physiologic domains. YAQ is based
      on a hybrid algebra of qualitative and numerical values, and is designed to
      benefit from the rich and ever-changing nature of information available in a
      critical care monitoring environment. The focus of the project is on diagnosis of
      clinical conditions, prediction of the effects of therapy, and therapy management
      assistance. Two models of diagnosis are implemented in YAQ: diagnosis based on
      associations, and model-based diagnosis. The ontology is applied to the domain of
      ventilator management in infants with respiratory distress syndrome (RDS). The
      article describes the diagnostic capabilities of YAQ, illustrates these concepts
      on examples taken from actual patient records, and reports the results of an
      evaluation of the diagnostic performance on the RDS/assisted ventilation domain
      model.

PMID- 8358486
TI  - Guaranteeing real-time response with limited resources.
AB  - Unanticipated problems detected by patient-monitoring systems may sometimes
      require real-time response in order to provide high-quality care and avoid
      catastrophic outcomes. In this paper, we present an approach for guaranteeing a
      response to such events by a monitoring agent even in situations where we have
      limited problem-solving resources. We show that an action-based hierarchy can
      accomplish this goal. We also analyze the performance of this hierarchy under
      varying resource availability and discuss decision-theoretic approaches to enable
      us to best structure such a hierarchy. We also describe an implementation of
      these ideas, called ReAct, in the BB1 architecture. All the ideas are illustrated
      with examples from the surgical intensive care unit (SICU).

PMID- 8358487
TI  - The design and implementation of a ventilator-management advisor.
AB  - VentPlan is an implementation of the architecture developed by the qualitative
      quantitative (QQ) research group for combining qualitative and quantitative
      computation in a ventilator-management advisor (VMA). VentPlan calculates
      recommended settings for four controls of a ventilator by evaluating the
      predicted effects of alternative ventilator settings. A belief network converts
      clinical diagnoses to distributions on physiologic parameters. A mathematical
      modeling module applies a patient-specific mathematical model of cardiopulmonary
      physiology to predict the effects of alternative ventilator settings. A decision
      theoretic plan evaluator ranks the predicted effects of alternative ventilator
      settings according to a multiattribute-value model that specifies physician
      preferences for ventilator treatments. Our architecture allows VentPlan to
      interpret quantitative observations in light of the clinical context (such as the
      clinical diagnosis). We report a retrospective study of the ventilator-setting
      changes encountered in postoperative patients in a surgical intensive-care unit
      (ICU). We conclude that the QQ architecture allows VentPlan to apply a patient
      specific physiologic model to calculate ventilator settings that are optimal with
      respect to a decision-theoretic value model describing physician preferences for
      setting the ventilator.

PMID- 8358488
TI  - Physiological applications of consistency-based diagnosis.
AB  - This research attempts to span the gap between the AI in medicine (AIM) and
      consistency-based diagnosis (CBD) communities by applying CBD to physiology. The
      highly-regulated nature of physiological systems challenges standard CBD
      algorithms, which are not tailored for complex dynamic systems. Extensions of CBD
      to dynamic domains have relied upon complete quantitative dynamic simulation for
      behavior prediction. However, dynamic simulations, particularly by continuous
      systems, tend to inundate key CBD processes (such as truth maintenance and
      information-theoretic testing) with a deluge of temporal information. To combat
      this problem, we separate static from dynamic analysis so that CBD performs
      static diagnosis at a selected set of time slices. Knowledge of the qualitative
      behavior of physiological regulators is then used to link static intra-slice
      diagnoses into a complete dynamic account of the progression of a physiological
      condition. This provides a simpler approach to CBD of dynamic systems while
      adding a new capability to CBD: the detection of dynamic faults (i.e. those that
      do not necessarily persist throughout diagnosis). This paper describes (a) a few
      of the problems underlying CBD extensions to dynamic systems, (b) our hybrid
      static-dynamic, qualitative-quantitative approach, (c) our implemented IDUN
      system, (d) IDUN's diagnosis of volume-loading hypertension, (e) the
      generalization of IDUN's modeling perspective to the compartmental ontology, and
      (f) IDUN's use of compartmental models to diagnose acidosis.

PMID- 8358489
TI  - European research efforts in medical knowledge-based systems.
AB  - This article describes the major projects going on in Europe in the field of
      Artificial Intelligence in Medicine. The important role of the Commission of the
      European Communities in providing the needed resources is stressed throughout the
      paper. Particular attention is given to the methodological and technological
      issues addressed by the European research teams, since the results which these
      teams accomplish are fundamental for a more extensive diffusion of knowledge
      based systems in real medical settings. The variety of medical problems tackled
      shows that there is no field of medicine where the potential of advanced
      informatics technologies has not yet been assessed.

PMID- 8358490
TI  - Exploring the relationship between rationality and bounded rationality in medical
      knowledge-based systems.
AB  - If our goal in Artificial Intelligence in Medicine (AIM) is to engineer systems
      health-care providers will both use and, in the process, improve their
      performance, we must concentrate on the development of causal theories of
      knowledge and problem solving. One broad direction in pursuing this goal is
      understanding the relationships between existing models of rationality and
      bounded rationality for similar tasks. Models of rationality refer to those
      approaches in which the optimal properties of the models are deductively
      provable, i.e. in which the processing is rational. Representative models of
      rationality used in AIM are deductive logical models, statistical models such as
      Bayesian inference models, and decision-analytic models. Models of bounded
      rationality are those which do not guarantee such optimal properties nor yield to
      deductive correctness proofs. These models have their roots in cognitive
      psychology. In this article we show how explicating the relationship between
      models of rationality and bounded rationality might be done in the case of
      abductive tasks in medicine. This is done by positioning these modeling
      approaches within the same framework (an abstract computational model) and
      interpreting in this context both computational complexity results concerning the
      nature of the task and empirical results studies of human problem-solving
      behavior.

PMID- 8358491
TI  - Neural computation in medicine.
AB  - During the last decade there has been a great revival of interest in neural
      modelling. Powerful new computational methods have resulted from work in this
      area and are being applied to an increasing range of medical problems. This paper
      briefly explains the nature of a neural model and then reviews work in neural
      computation involving problems in medical informatics (e.g. expert systems) and
      modelling of psychiatric and neurological phenomena. The state of the art is
      assessed, and speculation about future developments is given.

PMID- 8358492
TI  - On the soundness and safety of expert systems.
AB  - The problems of developing sound and safe expert systems are discussed, with
      particular reference to medicine. The concepts, notations, methods, results and
      technologies which have emerged from the study of mathematical logic as a
      computational paradigm offer many benefits for improving the quality of expert
      systems. Logic programming offers a better discipline for design, specification
      and implementation than ad hoc development methodologies. When logic programming
      is combined with software engineering methods, such as a software development
      life-cycle, the probability of routinely developing large-scale yet efficient and
      sound applications will be increased. However, although soundness is a necessary
      property of any technology it is not sufficient for assuring safety. Established
      methods for improved software safety are discussed, and a number of approaches to
      improving the safety of medical expert systems is identified. The possibility of
      introducing an appropriately extended life-cycle, and the potential benefits of a
      formal theory of safety are discussed.

PMID- 8358493
TI  - Artificial intelligence in medicine: state-of-the-art and future prospects.

PMID- 8358494
TI  - The adolescence of AI in medicine: will the field come of age in the '90s?
AB  - Artificial intelligence in medicine (AIM) has reached a period of adolescence in
      which interactions with the outside world are not only natural but mandatory.
      Although the basic research topics in AIM may be those of artificial
      intelligence, the applied issues touch more generally on the broad field of
      medical informatics. To the extent that AIM research is driven by performance
      goals for biomedicine, AIM is simply one component within a wide range of
      research and development activities. Furthermore, an adequate appraisal of AIM
      research requires an understanding of the research motivations, the complexity of
      the problems, and a suitable definition of the criteria for judging the field's
      success. Effective fielding of AIM systems will be dependent on the development
      of integrated environments for communication and computing that allow merging of
      knowledge-based tools with other patient data-management and information
      retrieval applications. The creation of this kind of infrastructure will require
      vision and resources from leaders who realize that the practice of medicine is
      inherently an information-management task and that biomedicine must make the same
      kind of coordinated commitment to computing technologies as have other segments
      of our society in which the importance of information management is well
      understood.

PMID- 8358495
TI  - Graphical knowledge acquisition for medical diagnostic expert systems.
AB  - Like many textbook authors use text systems for writing their books, expert
      system authors should have easy to use knowledge acquisition systems for entering
      and testing their knowledge bases by themselves without much help from 'knowledge
      engineers'. In this paper, we report on a graphical knowledge acquisition tool
      (CLASSIKA) based on an expert system shell for heuristic classification (MED2)
      and designed for direct use by domain experts. We demonstrate how the system has
      been used for building a rather large expert system for diagnosing rheumatology
      diseases which is now being tested in clinical use.

PMID- 8358496
TI  - Medical decision making based on inductive learning method.
AB  - Medical decision making based on inductive learning has been studied in order to
      collect experience necessary for practical use of such methods in clinical and
      epidemiological work. The decision trees have been constructed by using the
      modified Quinlan's approach based on choosing relevant attributes according to
      their informativity. An inductive learning software tool, ASSISTANT Professional,
      has been used for experimenting. The variability in results has been studied
      under varying learning conditions. Two sets of data have been chosen for learning
      experiments: from a study on rheumatoid factors in patients with rheumatoid
      arthritis, and from an epidemiological investigation of aging. The results of
      this study indicate the necessity to determine inductive learning parameters for
      each particular problem. The pruning procedure is always recommended as it
      eliminates redundant elements in the tree. In problems with greater number of
      attributes, however, pruning itself is not guaranteeing satisfactory solutions.
      Interventions like the change of the minimal weight threshold might improve the
      situation. If these precautions are met, the method of inductive learning seems
      to be a useful guide in practical clinical and epidemiological decisions.

PMID- 8358497
TI  - Automatic knowledge base refinement: learning from examples and deep knowledge in
      rheumatology.
AB  - MESICAR is a second generation expert system which contains very general
      descriptions of rheumatological disorders in the primary medical care field. With
      the help of a detailed hierarchical description of the human anatomy the system
      is able to support diagnostic decisions. The paper describes how machine learning
      techniques are used to automatically construct more specific disease descriptions
      for common, frequently occurring cases. The system MESICAR-LEARN implements a
      learning method which integrates analytical and empirical learning techniques.
      Cases diagnosed by MESICAR form the training examples, and MESICAR's knowledge
      base is used as domain theory. The learned concepts are integrated into a
      hierarchy of disease descriptions. They support efficient and fast reasoning on
      common cases in addition to the general diagnostic support afforded by MESICAR's
      deep knowledge.

PMID- 8358498
TI  - Consistency enforcement in medical knowledge base construction.
AB  - Some aspects of knowledge base creation can be partially or completely automated,
      resulting in higher quality and smaller effort. Computer assistance is
      particularly valuable in ensuring the internal consistency of a knowledge base.
      The article describes several techniques for consistency enforcement in QMR-KAT,
      an interactive knowledge base editor for the INTERNIST-I/QMR medical knowledge
      base. Two strategies that improve consistency are applicable to a wide range of
      situations. The first strategy prevents simple (but common) inconsistencies. The
      second strategy reveals facts that are potentially (but not necessarily)
      inconsistent with known data, and may require further evaluation. Both strategies
      use the contents of the existing knowledge base in the evaluation of new facts.

PMID- 8358499
TI  - Inferential knowledge acquisition.
AB  - This paper describes the approach we are pursuing for modeling inferential
      processes in knowledge-based systems. It is aimed at overcoming the lack of
      generality affecting many of the systems described in the literature. This mainly
      happens since the problem-solving method adopted by those systems is too closely
      tied to the particular domain problem over which the method itself has been
      modeled. We also describe a system called M-KAT (Medical Knowledge Acquisition
      Tool) which is useful in simplifying the process of acquiring inferential
      knowledge. M-KAT relies on an epistemological model of medical reasoning which
      represents a generalization of most of the problem-solving methods adopted in
      medical knowledge-based systems. The metarules formalism has been adopted as a
      mean for representing inferential knowledge and making its acquisition easier,
      thus allowing the computational implementation of the epistemological model of
      medical reasoning.

PMID- 8358500
TI  - Specification of models in large expert systems based on causal probabilistic
      networks.
AB  - Problems involved in the specification of large expert systems are discussed. In
      the specification of causal probabilistic networks conditional probability tables
      for all nodes have to be provided. These conditional probability tables can often
      be described by models that specify the nature of interaction between nodes.
      Various types of models are described and a program that handles such models is
      presented. Large causal probabilistic networks often contain several copies of
      identical tables or structures. A header facility that provides common
      definitions of such repeated elements is proposed. This facility makes
      specifications much shorter and easier to construct and maintain.

PMID- 8358501
TI  - Calbindin D-28k and monoamine oxidase A immunoreactive neurons in the nucleus
      basalis of Meynert in senile dementia of the Alzheimer type and Parkinson's
      disease.
AB  - In this study, calbindin D-28k (CaBP), monoamine oxidase A (MAO A) and nerve
      growth factor receptor (NGFr) immunoreactivities were investigated in the nucleus
      basalis of Meynert (NbM) in patients with senile dementia of the Alzheimer type
      (SDAT), with Parkinson's disease (PD) with or without dementia, and in controls.
      Immunocytochemistry using specific antibodies in differing serial sections was
      employed, and cell counts and NbM nuclear volume measurements were made. Most of
      the large multipolar NbM neurons showed CaBP immunoreactivity in the cytoplasm of
      their somata, dendrites and axons. In adjacent, NGFr-reacted sections, the large
      NbM neurons were also found to be intensely immunoreactive for NGFr on their
      cellular surfaces. In addition, a subpopulation of large NbM neurons and glial
      cells were found to be immunoreactive for MAO A. The number of CaBP
      immunoreactive (CaBP-i) neurons was decreased by an average of 55% in the 6 SDAT
      patients, 70% in the 2 nondemented PD patients and 40% in the 1 demented PD
      patient. The volume calculated for the compact part of the NbM formed by the CaBP
      i neuronal somata decreased by an average of 47% in SDAT. On the other hand,
      measurements in the volume of NGFr-i neurons (including the dendritic
      arborization) showed an average decrease of 25% in SDAT patients compared to
      controls. Although all SDAT and PD patients showed a decrease of CaBP-i neurons
      in the NbM, a loss of MAO-A-i NbM neurons was found only in those patients with
      dementia. Therefore, the relative proportions of MAO-A-i to CaBP-i neurons were
      increased in the nondemented PD patients (14.2 and 19.6%) when compared with
      those in the demented PD patient (2.2%) and with the SDAT patients (0.3-5.6%).
      These data indicate that a balanced presence of MAO-A-i cholinergic, large NbM
      neurons may be necessary for the proper maintenance of cognitive function.
      Functionally this may be translated to mean that dementing changes may cause a
      decrease from the normal amount of MAO A enzyme activity. This suggests that
      therapeutic strategies based upon correction of MAO-A activities by MAO-A
      inhibitors may be important to ameliorating some of the loss in cholinergic
      function in dementias of SDAT and PD.

PMID- 8358502
TI  - The spatial patterns of plaques and tangles in Alzheimer's disease do not support
      the 'cascade hypothesis'.
AB  - In Alzheimer's disease (AD), the 'Cascade hypothesis' proposes that the formation
      of paired helical filaments (PHF) may be casually linked to the deposition of
      beta/A4 protein. Hence, there should be a close spatial relationship between
      senile plaques and cellular neurofibrillary tangles in a local region of the
      brain. In tissue from 6 AD patients, plaques and tangles occurred in clusters and
      individual clusters were often regularly spaced along the cortical strip.
      However, the clusters of plaques and tangles were in phase in only 4/32 cortical
      tissues examined. Hence, the data were not consistent with the 'Cascade
      hypothesis' that beta/A4 and PHF are directly linked in AD.

PMID- 8358503
TI  - Brain damage caused by ischemia: pathophysiological and pharmacological aspects.
AB  - The distribution of brain cell injury after ischemic challenge is remarkable
      because only discrete brain areas are damaged, whereas other structures exhibit a
      very high resistance (selective neuronal death). The calcium hypothesis, one of
      the hypotheses that has been formulated to explain this selective vulnerability,
      postulates that an increase in excitatory amino acid release and the large
      calcium influx during ischemia leads to insufficient energy production and to
      stimulation of lipases, proteases, and endonucleases. This paper reviews the
      experimental data concerning the relationship between cerebral blood flow,
      glucose consumption and hippocampal morphological damage. The neuroprotective
      effects of some drugs against ischemic damage have also been discussed.

PMID- 8358504
TI  - Oral tetrahydroaminoacridine treatment of Alzheimer's disease evaluated
      clinically and by regional cerebral blood flow and EEG.
AB  - Neurochemical evidence indicates that cognitive impairment in dementia of
      Alzheimer type (DAT) is related to degeneration of cholinergic neurons in the
      brain. A pharmacological approach is treatment with a cholinesterase inhibitor
      such as tetrahydroaminoacridine (THA). THA treatment of 17 patients with DAT was
      studied with a double-blind crossover design with three types of treatment, THA +
      lecithin, THA + placebo and placebo + placebo. Each treatment period was 6 weeks
      with wash out periods of 2 weeks. The treatment was evaluated with clinical
      ratings, psychometric testing, EEG and regional cerebral blood flow (rCBF)
      measurements. No significant clinical differences between treatment periods were
      found in the total sample, but marked individual differences were observed. The
      patients were subdivided into three outcome groups based on four clinical
      measures: 6 patients improved (responders), 5 patients were mainly unchanged, and
      6 patients showed further deterioration during the trial period of 26 weeks.
      Pretreatment rCBF in responders differed significantly from that of the
      deteriorated patients. EEG showed more high frequency activity among responders.
      Hepatotoxic side effects were observed in several cases. Three subjects showed
      marked increases of liver enzymes, with normalization following dose reduction.
      The majority of patients who improved or remained unchanged during the study
      chose to continue THA treatment in an open trial.

PMID- 8358505
TI  - Multichannel EEG frequency analysis and somatosensory-evoked potentials in
      patients with different types of organic dementia.
AB  - Thirty-five patients with organic dementia were investigated with multichannel
      FFT analysis of EEG. In 21 of them, somatosensory-evoked potentials (SEPs) with
      stimulation of the median nerves were also recorded. Based on clinical and
      psychometric data and regional cerebral blood flow measurements, the patients
      were subdivided into Alzheimer-type dementia (DAT) of moderate (n = 10) and
      severe (n = 11) degree, multi-infarct dementia (MID) (n = 7), and frontotemporal
      degeneration (FTD) (n = 7). The FTD patients showed mild EEG abnormality and the
      MID patients showed increases of low frequency activity in combination with a
      well-preserved posterior dominant activity. The DAT patients showed the most
      pronounced abnormalities with deterioration of the posterior activity combined
      with a large increase of low frequency activity. The SEPs of the DAT group showed
      an amplitude enhancement of the parietal response components. The FTD group
      showed only a moderate delay of the precentral N30 component. The MID group
      showed individually varying abnormalities, including a delay of the primary
      cortical response. It is concluded that the different distributions of pathology
      in the different organic dementia disorders are reflected in the quantified EEG
      and SEPs as studied with multichannel technique.

PMID- 8358506
TI  - Increased sweat sodium concentration in patients with Alzheimer's disease.
AB  - Sweat sodium concentration was estimated with pilocarpine iontophoresis in 15
      women with Alzheimer's disease (AD) and 29 healthy control women. The age ranged
      from 76 to 96 years with a mean age of 85 years in both groups. The mean sodium
      concentration of 91 +/- 41 mmol/l (n = 11) in the Alzheimer patients was
      significantly higher than in the control group (62 +/- 29 mmol/l, n = 27, p =
      0.0011). 27% of AD patients and 7% of the control women did not respond to
      stimulation. The impaired sweating in AD patients make them more vulnerable to
      heat stress. Further studies are needed to reveal whether the neurophysiological
      mechanism involved is located in the hypothalamus in cortical projections to the
      hypothalamus or in postganglionic sympathetic fibers.

PMID- 8358507
TI  - Psychometric discrimination of tetrahydroaminoacridine responders in Alzheimer
      patients.
AB  - Fourteen patients with probable Alzheimer's disease (AD) participated in an open
      tetrahydroaminoacridine (THA) treatment trial. Before initiation of THA
      treatment, a brief battery of neuropsychological tests was performed by an
      experienced neuropsychologist. The tests were repeated 120 min after a single
      dose of 50 mg THA had been administered perorally. Thereafter, the patients had a
      4-week active treatment with THA 100 mg/day. After the treatment period, eight
      patients were defined as responders (increase of Mini-Mental State Examination
      score > or = 3) and six patients as nonresponders to the treatment. The
      responders showed significant improvement on Digit Span, Trail Making B, and on
      both Clock Setting and Clock Recognition tests after 50 mg of THA. The results
      suggest that in this subgroup of AD patients augmentation of the brain
      cholinergic systems mainly led to improvement of attentional and frontal-lobe
      rather than mnemonic functions.

PMID- 8358508
TI  - Clinical course and CSF amyloid beta protein precursor having the site of
      application of the protease inhibitor (APPI) levels in patients with dementia of
      the Alzheimer type.

PMID- 8358509
TI  - Is impaired recall in dementia of the Alzheimer type a consequence of a
      contextual retrieval deficit?
AB  - Eighty-eight patients with mild to moderate dementia of the Alzheimer type were
      tested in a word list and a spatial pattern recall task. With increasing degree
      of dementia severity we found a decline in the initial recall scores while
      learning curves over five consecutive trials remained normal in the mildly
      demented patients. Furthermore, there was a loss of the primacy effect in the
      word list task in our moderately demented patients. These findings are consistent
      with the pattern that have been reported after medial temporal lobe dysfunction.
      The data are discussed in the framework of cognitive dual process theories of
      memory as indicators of a contextual retrieval deficit.

PMID- 8358510
TI  - Long-term effects of bilateral frontal lobe lesions from neuropsychiatric and
      neuroradiological aspects.
AB  - Long-term effects of bilateral prefrontal lesions were studied in 14 lobotomized
      schizophrenic patients who were operated in the fifties. CT scans revealed cystic
      bilateral frontal lesions in almost every patient and cortical atrophy was seen
      in 5 patients. The prefrontal syndrome was severe in 1 patient, marked in 1
      patient, mild in 9 patients and absent in 3 patients. Primitive reflexes could be
      elicited in 2 patients, 3 patients suffered from epileptic seizures, and 8 from
      minor motor defects. Four patients committed a homicide in the period after the
      operation, which indicates that the frequency of committing homicidal acts had
      doubled when compared with the situation before the operation. The incidence of
      homicides after lobotomy is extremely high considering that all patients except 1
      were kept under continuous observation in hospitals.

PMID- 8358511
TI  - Delirium in the elderly: relationship of clinical symptoms to outcome.
AB  - Twenty-eight elderly patients meeting the DSM-III-R criteria for delirium were
      evaluated using the Delirium Rating Scale (DRS) in order to examine the relation
      between the clinical symptoms of delirium and its outcome. Patients whose
      delirious episode improved within 1 week had a significantly lower DRS score at
      the time of psychiatric consultation than patients whose delirium lasted more
      than 1 week. Neither the difference between the mean ages nor the sex
      distribution in the two groups was statistically significant. The present study
      suggests that the DRS is a valuable instrument for predicting the clinical
      outcome of delirium.

PMID- 8358512
TI  - Telephone-Assessed Mental State.
AB  - In 30 patients with Alzheimer's disease (AD), we compared performance on a brief
      Telephone-Assessed Mental State (TAMS) examination with performance on standard
      cognitive instruments administered face to face. TAMS scores correlated strongly
      with scores on both the Mini Mental State Examination (rho = 0.81) and the
      Alzheimer's Disease Assessment Scale (rho = -0.80).

PMID- 8358513
TI  - MRI findings in an individual at risk for familial Alzheimer's disease.

PMID- 8358514
TI  - Distribution of iron in the basal ganglia and neocortex in postmortem tissue in
      Parkinson's disease and Alzheimer's disease.
AB  - Post-mortem tissue was obtained from subjects with Parkinson's disease (PD),
      Alzheimer's disease (AD) and age-matched controls. Iron levels were measured from
      various sites of the basal ganglia and neocortex using atomic absorption
      spectrophotometry. The results indicate that iron levels are increased in the
      substantia nigra and the lateral segment of the globus pallidus of parkinsonian
      tissue. In contrast, the medial segment of the globus pallidus shows reduced iron
      levels in AD when compared to age-matched controls. No significant alterations of
      iron concentration were detected in AD in any region. These results are discussed
      in terms of the role of iron in the basal ganglia, mechanisms of abnormal
      deposition and possible neurotoxicity in PD.

PMID- 8358515
TI  - Quantitative assessment of the synaptophysin immuno-reactivity of the cortical
      neuropil in various neurodegenerative disorders with dementia.
AB  - It has remained a matter of debate until now whether amyloid and tangle pathology
      may be regarded as the main causes of the dementia in Alzheimer's disease (AD) or
      only as markers of the disease. In the present study we examined the
      synaptophysin immunoreactivity of the cortical neuropil as a measure of its
      synapse density, in 17 cases of AD, 1 case with a 10-month episode of dementia
      and cortical amyloid deposition, 5 cases of Huntington's disease (HD) with
      dementia, 11 cases of parkinsonism (PD), 5 with dementia (PD-D) and 16 controls.
      The immunoreactivity was assessed in two layers (molecular, pyramidal) of three
      regions (frontal, occipital, hippocampus) by means of automated black-and-white
      image analysis. In AD we found a rather diffuse reduction of the cortical
      synaptophysin expression of up to 26.5% (mean 11%) of the controls. No
      correlation was found between synaptophysin expressivity and age either in AD or
      in the controls. Univariate analyses revealed only a very weak negative
      correlation between the density of beta A4-immunoreactive cortical plaques and
      the intensity of the synaptophysin staining, while in a multivariate analysis the
      plaque density did not show any impact on the latter. In HD a reduction of the
      synaptophysin immunoreactivity of the cortical neuropil was also found (mean
      10.4%), with a predominance in the pyramidal layer of the neocortex. The same was
      true for PD (5.3%) and PD-D (8.2%). Our results support the view that loss of
      synapses in the cortical neuropil may be a significant factor for the development
      of organic dementia, while the amyloid pathology in AD is more likely a marker of
      the disease.

PMID- 8358516
TI  - Rare neuropil threads in amyotrophic lateral sclerosis and parkinsonism-dementia
      on Guam and in the Kii Peninsula of Japan.
AB  - Using three different silver impregnation methods and antisera against
      microtubule-associated protein-tau (MAP-tau) and amyloid beta/A4 protein, we
      demonstrated abundant neurofibrillary tangles (NFTs), rare senile plaques,
      absence of amyloid angiopathy and rare MAP-tau- and silver-positive neuropil
      threads in the hippocampus of patients with amyotrophic lateral sclerosis (ALS)
      and parkinsonism-dementia (PD) on Guam and in the Kii Peninsula of Japan. In
      contrast, abundant neuropil threads, NFTs, senile plaques with associated
      dystrophic neurites and amyloid angiopathy were confirmed in Alzheimer disease
      patients. These observations indicate that there may be important factor(s)
      responsible for the difference in the deposition and distribution of amyloid
      beta/A4 protein and MAP-tau between Pacific ALS and PD and Alzheimer disease.

PMID- 8358517
TI  - Assessment of depression in Alzheimer's disease: symptoms, syndrome, and computed
      tomography findings.
AB  - The Hamilton Rating Scale for Depression (HAM-D) and DSM-III-R criteria were
      simultaneously employed to assess the prevalence of depression in 26 outpatients
      with dementia of the Alzheimer type and 26 age-matched normal control subjects.
      Both assessment methods evidenced a higher frequency of depression during the
      severe stages of Alzheimer's disease. Among the Alzheimer patients, the
      prevalence rate of depression produced by the HAM-D (38%) was higher than the
      rate produced by DSM-III-R criteria (23%). Such a difference was due to the
      weight given by the HAM-D to the vegetative symptoms reported by the Alzheimer
      patients with more severe dementia. In a subgroup of 14 Alzheimer patients who
      underwent computed tomography, the volumetric measurement of CSF spaces did not
      reveal any difference between the depressed and nondepressed patients. On the
      basis of these results, the clinical problems related to the assessment of
      depression in Alzheimer's disease are discussed.

PMID- 8358518
TI  - Pattern of cerebral metabolic interactions in a subject with isolated amnesia at
      risk for Alzheimer's disease: a longitudinal evaluation.
AB  - A pattern of reduced cerebral metabolic rate for glucose (rCMRglc) has been shown
      by positron emission tomography (PET) in patients with dementia of the Alzheimer
      type. To verify if a similar rCMRglc pattern is present in subjects 'at risk' for
      Alzheimer's disease (AD), we used high-resolution PET to longitudinally study a
      subject with isolated memory impairment and a family history for autosomal
      dominant AD. Initial rCMRglc data did not reveal any consistent abnormality as
      compared to a group of sex- and age-matched healthy controls. However, 1 year
      later, a follow-up evaluation did reveal reduced parietal rCMRglc values
      coinciding with a worsening of cognitive impairment, which suggested that
      standard analyses of resting rCMRglc data may not be useful in the early
      diagnosis of AD. In contrast, when a previously determined discriminant function
      for distinguishing controls from AD patients was applied, the subject was
      correctly identified as an AD patient on both PET scans.

PMID- 8358519
TI  - Social support in labor--a selective review.
AB  - Support during labor has been offered by a variety of different people, including
      fathers, professional medical staff, trained labor coaches and monitrices,
      untrained lay supporters and family and friends. A comparison of the various
      findings shows that support given by trained or lay untrained female supporters,
      who are not necessarily known to the laboring woman, yields the most extensive,
      methodologically sound, and consistently positive effects on obstetric and
      psychosocial outcomes. Although trained labor coaches have been shown to exert a
      positive effect on outcome, the results of doula support are the most impressive
      when both methodology and outcome effects are considered. Studies of father
      support have yielded contradictory findings, although women do appear to value
      their presence in most studies. Family and friends have not been shown to
      influence outcomes. Support from professional medical staff is rare, but when
      given, has, in some cases, had a positive effect. These findings are important
      for the field, since the use of lay supporters constitutes a low-cost preventive
      intervention. The inclusion of lay supportive women is also consistent with
      traditional practices in most countries in the world.

PMID- 8358520
TI  - The potential value of a short self-completion questionnaire for the assessment
      of habitual physical activity in pregnancy.
AB  - The aim of this methodological study was to validate a newly designed self
      completion questionnaire assessing various dimensions of physical activity among
      100 pregnant women in Bristol, UK. For this purpose different measures obtained
      by self-completion questionnaire were compared with those simultaneously obtained
      by two established assessment methods for physical exertion. Based on the
      findings it was suggested that the self-completion questionnaire be slightly
      modified by adding questions pertaining to household activities and deleting
      questions which proved to be conceptually meaningless. It is concluded that in
      future studies this strategy will facilitate the understanding of the complex
      relationship between way of life and pregnancy outcome.

PMID- 8358521
TI  - The relationship between sex role and emotional functioning in patients
      undergoing assisted conception.
AB  - It is suggested that infertility may be distressing because it results in an
      inability to fulfil traditional roles and thus those individuals who adhere to
      traditional sex roles may be more distressed by the experience of infertility. In
      order to examine the relationship between sex role and emotional well-being in
      infertility patients, 58 women attending a clinic for assisted conception
      procedures and 31 of their male partners completed questionnaires assessing sex
      role type (i.e. masculine, feminine, androgynous or undifferentiated) and
      emotional, marital and sexual functioning. Women with a traditional feminine sex
      role type were more anxious than those with a masculine sex-role type but there
      were no differences in depression or marital or sexual functioning. Men with an
      undifferentiated sex-role type were more anxious and depressed than those with
      other sex-role types. The findings are discussed in terms of the relationship
      between sex role and infertility, previous research into sex differences in
      distress amongst infertility patients, and the problems associated with measuring
      distress.

PMID- 8358522
TI  - Premenstrual symptoms and dysmenorrhea in relation to emotional distress factors
      in adolescents.
AB  - The extent to which premenstrual symptoms occur when they are distinguished from
      primary dysmenorrhea and the relationship of premenstrual symptoms to other
      emotional distress in adolescents is not well understood. This pilot
      investigation examined relationships between premenstrual symptoms, dysmenorrhea
      and emotional distress factors in a sample of 165 females, ages 15-19 years.
      Premenstrual symptoms were correlated with dysmenorrhea (r = 0.54, p < 0.0001).
      Subjects with premenstrual symptoms had significantly more emotional distress
      than the normal group as assessed by the Symptom Checklist (SCL-90), an objective
      self-report questionnaire. In contrast, dysmenorrhea had no relationship with the
      SCL factors and no interaction with premenstrual symptoms in relation to
      emotional distress. The SCL scores significantly decreased from baseline (2 years
      earlier) in the normal group but not in the premenstrual symptom group. The data
      show that premenstrual symptoms were associated with other emotional distress
      factors in adolescents while dysmenorrhea was not. A further prospective,
      longitudinal study of menstrually-related symptoms in adolescents is needed to
      learn about the development of these premenstrual symptoms that may be related to
      the premenstrual syndrome seen clinically in the later reproductive years.

PMID- 8358523
TI  - Changes in sexual behavior following radiation therapy for cervical cancer.
AB  - Twenty-one women with cervical cancer Types I and II, treated by radiation were
      evaluated by comparing periods before cancer and after therapy in order to
      identify changes in sexual behavior; if so, whether they attributed the changes
      to therapy, or whether other factors were associated with being sexually
      dysfunctional or non-dysfunctional. Data were obtained through administration of
      a sexual behavior questionnaire, personal interviews and review of medical
      records. Statistically significant changes were found: decreased frequency of
      masturbation and intercourse, decreased frequency of orgasm through non-coital
      sexual activities, less satisfaction with sex, and less enjoyment of intercourse.
      The majority believed that changes were due to radiation therapy and reflected
      decreased feelings of self-esteem, sex desirability and attractiveness. Most of
      the women believed that cancer could be transmitted through intercourse. Women
      who did not follow advice regarding use of vaginal dilators and did not resume
      their pre-illness level of sex were more likely to develop physical and sexual
      changes. The subjects' need for sexual counselling concerning the effect of the
      illness and treatment on relationships with partners was strongly evident.
      Suggestions for preventing undesirable physical and psychological changes, and
      guidelines for counselling are provided.

PMID- 8358524
TI  - Evolution of maternal mood state and of the auditory and olfactory perception of
      their newborn: preliminary data.
AB  - The auditory and olfactory discrimination ability of mothers, in relation to
      stimuli from their newborn infants, was concomitantly measured in a sample of 12
      mother-newborn dyads during the 1st week after the child's birth. Both types of
      discrimination ability had a parallel evolution from one day to the next. The
      performances continued to increase from day to day, except on the 4th and 7th
      days. These 2 days corresponded to times when the mothers were more depressed.
      Half of the mothers were more skilled in one sensorial skill than the other.

PMID- 8358525
TI  - Comparative prospective study of the psychological development of children born
      by in vitro fertilization and their mothers.
AB  - A comparative prospective survey of psychomotor development and mother-infant
      bonding was conducted on 33 children born after in vitro fertilization and two
      control groups composed of: a group of children born to infertile women who
      underwent ovulation induction treatment but with no medically assisted
      procreation; and a group of children born by natural procreation, with no medical
      intervention. No major disorders were observed. In the postpartum, the minor
      mother-infant relational problems seemed to be more frequent in the in vitro
      fertilization and infertility groups but with no statistical differences. At 9
      months, the factors related to sleep disturbances in the child and maternal
      depressive syndromes seemed to be more frequent in the in vitro fertilization and
      infertility groups than in the controls. At 18 months these minor disturbances
      decreased and there were fewer differences across the three groups. This trend
      was confirmed at 3 years.

PMID- 8358526
TI  - The climacteric and well-being.
AB  - The climacteric is accompanied by many changes in life, which may give cause to a
      variety of complaints. Thus, it may be difficult to discern to what extent the
      climacteric is related to well-being. The association between menopausal status
      and well-being was determined in a population of 2729 women aged 45-60 years. A
      self-administered questionnaire was filled out and returned by 1947 women
      (response 71.3%). Well-being was measured by the Inventory of Subjective Health
      (ISH) and the three subscales of the Sickness Impact Profile (SIP): social
      functioning; emotions, feelings and sensations; and intellectual functioning. The
      relationship between menopausal status and well-being was estimated using linear
      regression analysis, while adjusting for age and other potential confounding
      variables, including body mass index, smoking behavior, education, work outside
      the home, parity, way of cohabitation, difference in age with the partner and
      partner's employment. The results show that early perimenopausal women report a
      lower level of well-being as compared to premenopausal women on all three SIP
      scales. Early postmenopausal women report a lower level of well-being on the SIP
      emotions, feelings and sensations. Intermediate postmenopausal women have a lower
      level of well-being on the ISH only. Finally, late postmenopausal women have a
      lower level of well-being on the SIP social functioning and SIP emotions,
      feelings and sensations. We tentatively conclude that the influence of the
      climacteric on well-being independent of confounders is primarily found in
      behavioral functioning in the daily life of a woman.

PMID- 8358527
TI  - Psychological aspects of genital human papillomavirus infection: a preliminary
      report.
AB  - Genital human papillomavirus (HPV) infection can lead to self-inflicted blame and
      hypochondriac fears as well as to problems with sexuality. The aim of this study
      was to assess the psychological and psychodynamic aspects of patients with
      widespread genital HPV infection entering into a clinical trial in which they
      were randomly assigned to three treatment groups: CO2 laser ablation,
      intramuscular interferon-alpha, CO2 laser ablation plus intramuscular interferon
      alpha. Fifty-one patients were studied. Patients were asked to take a series of
      questionnaires which included a self-rating questionnaire for gathering
      information on sexuality, emotional relationship with the partner and social
      life. A visual analog scale was used to rate intensity of pain during sexual
      intercourse. Each patient went also through an in-depth interview with a clinical
      psychologist and filled out two personality tests to measure depression (CDQ =
      IPAT depression test) and anxiety (ASQ = IPAT anxiety test). Results indicated a
      high percentage of sexual impairments after therapy (28 cases), presence of fear
      of cancer (14 cases) and worsenings in the emotional relationship with the
      partner. No difference was found among groups of treatment.

PMID- 8358528
TI  - Maternal-fetal attachment during pregnancy following in vitro fertilization.
AB  - The aim of the study was to examine the degree of anxiety experienced by pregnant
      women who had conceived by in vitro fertilization (IVF), as well as their
      attitudes towards the pregnancy and the strength of their attachment to the
      fetus. Fifteen women who had conceived by IVF were compared with 20 women who had
      conceived without assistance. Each woman was administered the State-Trait Anxiety
      Inventory, the Childbearing Attitudes Questionnaire and the Maternal-Fetal
      Attachment Scale. While the two groups of expectant mothers did not differ on
      these measures, a clear relationship was found for all of the women combined
      between general attitudes towards childbearing and attachment to the fetus,
      showing that women who are less positive about pregnancy, childbirth and
      childcare show weaker attachment to their unborn child.

PMID- 8358529
TI  - Neuropsychiatric aspects of Sydenham's chorea: a case report.
AB  - A case report of a 21-year-old girl developing Sydenham's chorea in pregnancy
      following a probable streptococcal A infection is reported. Associated
      neuropsychiatric aspects are discussed. Awareness of this condition is encouraged
      to prevent possible misdiagnosis.

PMID- 8358530
TI  - Is premenstrual syndrome an endocrine disorder?
AB  - To both patients and physicians it seems natural to attribute adverse
      premenstrual phenomena to cyclic fluctuations of hormones produced by the ovary.
      This seems so plausible that, although the endocrine mechanism that causes
      premenstrual syndrome remains unknown, the condition itself is often treated with
      hormonal substances. Psychosocial factors are thus considered to be of only
      secondary importance. They may play a role as a contributing factor, to the
      'real' cause of premenstrual syndrome they are not an essential ingredient. The
      aim of this review article is to examine how strong the evidence is for the
      possible existence of an endocrine factor as the causative agent in premenstrual
      syndrome. Using an epidemiological approach we conclude that the continuing
      search for the responsible mechanism that causes premenstrual syndrome may very
      well be an endocrine 'Holy Grail'. Human behavior cannot be understood within a
      single (hormonal) frame of reference. Cyclical ovarian activity is only one of
      the etiological factors in premenstrual syndrome. Unravelling the pathogenesis of
      premenstrual syndrome requires a multidisciplinary approach.

PMID- 8358531
TI  - Peripheral endotoxin induces hypothalamic immunoreactive interleukin-1 beta in
      the rat.
AB  - Interleukin-1 (IL-1) is a polypeptide produced by a variety of cells and
      contributes to the general host response to inflammation. It displays a wide
      spectrum of inflammatory, metabolic, physiological, haematopoietic and
      immunological activities. Brain cells, including neurones, microglia, endothelial
      cells and astrocytes can all produce IL-1 beta in response to various
      physiological and pathological stimuli. In this report we show that peripherally
      administered endotoxin stimulates the appearance of immunoreactive IL-1 beta (IL
      1 beta) in the rat hypothalamus as measured by an ultrasensitive, highly specific
      enzyme amplified immunometric assay for rat IL-1 beta.

PMID- 8358532
TI  - Mg2+ and caffeine-induced intracellular Ca2+ release in human vascular
      endothelial cells.
AB  - Interaction of ionized magnesium ([Mg2+]o) and caffeine in regulation of
      intracellular free calcium concentration ([Ca2+]i) in human aortic endothelial
      cells was studied using fura-2 and digital imaging microscopy. In 1.2 mM [Mg2+]o,
      basal [Ca2+]i was 73.7 +/- 22.4 nM, with a heterogeneous distribution within the
      cells. No significant changes of basal [Ca2+]i were found either when cells were
      treated with 10 mM caffeine or when [Mg2+]o was lowered from 1.2 mM to 0.3 mM.
      However, a combined superfusion of the cells with 0.3 mM [Mg2+]o and 10 mM
      caffeine resulted in a significant elevation of [Ca2+]i to 382.8 +/- 57.1 nM,
      probably by release of Ca2+ from internal stores, which was attenuated by NiCl2
      (1 mM). These results suggest that a Ca(2+)-induced Ca2+ release mechanism is
      involved in regulation of [Ca2+]i in endothelial cells, which may be either
      regulated or modulated by Mg2+.

PMID- 8358533
TI  - Differential effects of cocaine and cocaethylene on intracellular Ca2+ and
      myocardial contraction in cardiac myocytes.
AB  - 1. Isolated cardiac myocytes of the ferret were used to investigate the influence
      of cocaine and cocaethylene on the intracellular Ca2+ transient indicated by the
      indo-1 405/480 nm ratio signal, and peak cell shortening. 2. Both cocaine and
      cocaethylene produced significant decreases in peak intracellular Ca2+ and peak
      cell shortening in a dose-dependent manner. Of interest, (1) the minimally
      effective dose of cocaethylene was ten fold lower (10(-8)M versus 10(-7)M) than
      that of cocaine; (2) the log EC50 of cocaethylene was -5.99 +/- 0.13 (1.0 x 10(
      6) M), which was about ten fold lower than that of cocaine (-5.02 +/- 0.11, 9.6 x
      10(-6) M); and (3) 1 x 10(-4)M cocaethylene decreased the contraction amplitude
      by 71 +/- 7%, while the same concentration of cocaine decreased the amplitude
      only by 55 +/- 5%, indicating that cocaethylene is more potent than cocaine. 3.
      The negative inotropic effects of either cocaine or cocaethylene could be
      overcome by noradrenaline (approximately 5 microM) or calcium. 4. In contrast to
      cocaine, cocaethylene shifted the peak [Ca2+]i-peak shortening relationship
      downward, indicating that cocaethylene decreased myofilament Ca(2+)
      responsiveness. 5. These data indicate that both cocaine and cocaethylene act
      directly on cardiac myocytes to produce a negative inotropic effect that is due
      to decreased Ca2+ availability. In contrast to cocaine, cocaethylene produces
      more potent inhibition by an additional action to decrease myofilament Ca(2+)
      responsiveness.

PMID- 8358534
TI  - High-affinity uptake of noradrenaline in postsynaptic neurones.
AB  - 1. Neurotransmitters released from nerve endings are inactivated by re-uptake
      into the presynaptic nerve terminals and possibly into neighbouring glial cells.
      While analysing the functional properties of alpha 1-adrenoceptors in the
      hypothalamus, we observed a high-affinity uptake process for noradrenaline in
      postsynaptic peptidergic neurones. 2. In primary hypothalamic cell cultures and
      in a hypothalamic neuronal cell line, [3H]-prazosin bound with high affinity and
      was displaced by unlabelled prazosin in concentrations of 10(-10) to 10(-7) M.
      However, at concentrations of unlabelled prazosin above 10(-7) M, there was a
      paradoxical increase in apparent [3H]-prazosin binding. 3. Methoxamine, an alpha
      1-adrenoceptor ligand that is not subject to significant neuronal uptake,
      displaced [3H]-prazosin but did not cause the paradoxical increase in the
      apparent binding of [3H]-prazosin. Cooling the cells to 4 degrees C reduced the
      total amount of prazosin associated with the cells; under these conditions,
      methoxamine almost completely inhibited [3H]-prazosin binding to the cells. 4. In
      the presence of desipramine (DMI), unlabelled prazosin displaced [3H]-prazosin as
      before, but no paradoxical increase in apparent binding was seen above 10(-7) M.
      5. The paradoxical increase of [3H]-prazosin binding was not observed in membrane
      preparations of hypothalamic neurones. These findings indicated that the
      paradoxical increase in apparent [3H]-prazosin binding was due to a cellular
      uptake process that becomes evident at high concentrations of the ligand. 6. DMI
      (10(-5) M) had no effect on the specific binding of [3H]-prazosin. The presence
      of alpha1-adrenoceptors was confirmed by binding of [125]-HEAT, but [3H]-idazoxan
      (an alpha2- ligand) did not bind to the cells.7. The uptake of prazosin obeyed
      the Michaelis-Menten model, with similar Km and Vmax values in both types of
      cultures.8. Noradrenaline was taken up with high affinity by both types of
      cultures. (+/-)-[3H]-noradrenaline uptake was reduced by DMI and by excluding
      sodium from the medium, indicating that this process has some of the properties
      of uptake 1. (+/-)-[3H]-noradrenaline uptake in the cell line was unaffected by
      testosterone.9. The measured uptake of (-)-noradrenaline in the cell line was
      considerably increased by blockade of catechol-omicron-methyl-transferase and
      monoamine oxidase, suggesting that (-)-noradrenaline is metabolized to lipophilic
      products that escape across the plasma membrane.10. Studies in rats, in which the
      noradrenaline isomer 6-hydroxydopamine was used, suggested that the post synaptic
      uptake process is operative in hypothalamic CRH and vasopressin neurones in
      vivo.11. The Km for (-)-noradrenaline was within the range for the high affinity
      uptake, process in noradrenergic neurones. Uptake takes place in concentrations
      at which noradrenaline activates alpha1-adrenoceptors.Removal of noradrenaline
      from the vicinity of the receptors may prevent desensitization,thus maintaining
      the responsiveness of postsynaptic neurones to the actions of the
      neurotransmitter.

PMID- 8358535
TI  - Effects of potassium channel openers and their antagonists on rat locus coeruleus
      neurones.
AB  - 1. Intracellular recordings were obtained from a pontine slice preparation of the
      rat brain containing the locus coeruleus (LC). Two openers of ATP-sensitive
      potassium (K(ATP)) channels, RO 31-6930 (10 microM) and cromakalim (100 microM)
      decreased the spontaneous discharge of action potentials without altering their
      amplitude or duration. Neither compound changed the resting membrane potential.
      2. Of two K(ATP) channel blockers, tolbutamide (300 microM) increased the firing
      rate, while glibenclamide (3 microM) only tended to do so. In addition, both
      compounds antagonized the effect of RO 31-6930 (10 microM). Neither glibenclamide
      (3 microM) nor tolbutamide (300 microM) altered the resting membrane potential.
      3. Tetrodotoxin (0.5 microM) depressed the firing, but did not influence the
      inhibitory action of RO 31-6930 (10 microM). The excitatory amino acid
      antagonist, kynurenic acid (500 microM), did not change the spontaneous discharge
      of action potentials. 4. Small shifts (2-4 mV) of the membrane potential by hyper
      or depolarizing current injections markedly decreased and increased the firing
      rate, respectively. 5. Noradrenaline (100 microM) hyperpolarized the cells and
      decreased their input resistance. This effect was not antagonized by
      glibenclamide (3 microM) or tolbutamide (300 microM). Ba2+ (2 mM), a blocker of
      both ATP-sensitive and inwardly rectifying potassium channels, abolished the
      effects of RO 31-6930 (10 microM) and noradrenaline (100 microM). 6. These data
      suggest that K(ATP) channels are present on the noradrenergic LC neurones, but
      are not coupled to alpha 2-adrenoceptors.

PMID- 8358536
TI  - Inhibition by the adenosine analogue, (R-)-N6-phenylisopropyladenosine, of kainic
      acid neurotoxicity in rat hippocampus after systemic administration.
AB  - 1. Binding of the peripheral benzodiazepine receptor ligand, [3H]-PK 11195, to
      rat hippocampal membranes has been used to quantify the reactive gliosis
      resulting from neuronal death induced by intraperitoneally administered kainic
      acid. 2. Intraperitoneal administration of kainic acid (10 mg kg-1) caused a 350
      500% increase in [3H]-PK 11195 binding measured in rat hippocampal P2 membranes 7
      days later. Co-treatment with the adenosine derivative R-phenylisopropyladenosine
      (R-PIA) (100, 25 or 10 micrograms kg-1, i.p.) abolished this elevation. The
      protective action of R-PIA could itself be abolished by co-treatment with 8
      phenyltheophylline (1 mg kg-1). 3. Body temperatures were recorded in the
      antagonist experiments and no significant changes were recorded, suggesting that
      the protective action of R-PIA was not mediated by hypothermia. 4. Since systemic
      kainic acid-induced neurotoxicity has been claimed as a good model of neuronal
      death in temporal lobe epilepsy, the results suggest that the systemic
      administration of purines in low doses may provide protection against certain
      neurodegenerative insults.

PMID- 8358538
TI  - Novel regulation of muscarinic receptors and their coupling with G proteins in
      smooth muscle: transient resensitization during desensitizing process.
AB  - 1. Muscarinic stimulation of the smooth muscle of guinea-pig taenia caeci was
      produced with 10(-4) M carbachol for 15 s, 30 s, 1 min, 2 min and 30 min, and the
      time course of developing desensitization was studied by measuring the muscle
      contractility and the binding characteristics of muscarinic receptors. 2. The
      contractile response to carbachol was analyzed using dose-response curves. The
      response to 10(-7) M carbachol was reduced by treatment for 15 s with 10(-4) M
      carbachol (fast desensitization), but recovered partially after 30 s treatment
      and completely after 1 min treatment (resensitization). Contractility was reduced
      again after 2 min and 30 min treatment (re-desensitization). 3. The affinity of
      carbachol for muscarinic receptors was changed by the carbachol treatment in a
      manner similar to the contractility. Thus, the affinity was reduced at 15 s,
      restored slightly at 30 s and completely at 1 and 2 min, and was reduced again at
      30 min. 4. 5'-Guanylylimidodiphosphate (GppNHp), a non-hydrolysable analogue of
      guanosine triphosphate (GTP) reduced the affinity of muscarinic receptors for
      carbachol via guanine nucleotide-binding regulatory proteins (G proteins). A
      similar effect was observed in tissues desensitized by 15 s carbachol treatment.
      This effect disappeared after 30 s, recovered completely after 1 and 2 min, and
      disappeared again after 30 min carbachol treatment. 5. Neither the dissociation
      constant (Kd value) nor the maximal binding (Bmax) of [3H]-quinuclidinyl
      benzilate ([3H]-QNB) to muscarinic receptors were changed by the carbachol
      treatment. 6. These results indicate that the whole process of desensitization,
      resensitization and re-desensitization are related to changes in the binding
      ability of muscarinic receptors, in their coupling with G proteins and in the
      post-receptor steps of the signal transduction. We emphasize that the
      desensitizing process involves an early transient phase of resensitization that
      could be caused by restoration of both the affinity of carbachol for muscarinic
      receptors and their coupling with G proteins. This novel resensitization
      mechanism may have some physiological significance for cellular homoeostasis by
      modulating cellular responsiveness transiently or even in an oscillatory manner
      during the process of desensitization.

PMID- 8358537
TI  - Mechanisms of vasodilatation in pregnancy: studies of the role of prostaglandins
      and nitric-oxide in changes of vascular reactivity in the in situ blood perfused
      mesentery of pregnant rats.
AB  - 1. To examine the possible mechanisms of the vasodilatation and blunted pressor
      responses in late pregnancy, we have studied vascular reactivity of the in situ
      blood perfused mesenteric resistance vessels of 18-20 day pregnant Wistar-Kyoto
      rats (WKY). 2. Intra-arterial mean blood pressure (MBP) was lower in pregnant
      rats than in nonpregnant controls. There was no significant difference in basal
      mesenteric perfusion pressure (BPP) between groups. 3. Vascular reactivity to
      electrical stimulation (ES) or intra-arterial noradrenaline (NA), angiotensin II
      (AII) and arginine vasopressin (AVP) was decreased in the preparations from
      pregnant rats compared to that from nonpregnant controls. Noradrenaline spillover
      into mesenteric venous blood following ES was similar in pregnant and nonpregnant
      animals. 4. Indomethacin (5 mg kg-1, i.v.), an inhibitor of cyclo-oxygenase,
      induced significant increases in reactivity to ES in both pregnant and
      nonpregnant groups while potentiating the responses to NA and AII in nonpregnant
      animals only and having no effect on AVP-induced contractions in the preparations
      from either pregnant or nonpregnant animals. 5. NG-nitro-L-arginine (L-NOARG) (5
      mg kg-1, i.v.), an inhibitor of nitric-oxide synthase, increased MBP and BPP in
      both pregnant and nonpregnant animals, but the difference in MBP between groups
      was still evident. 6. L-NOARG enhanced mesenteric vascular responses to ES, NA
      and AII in both pregnant and nonpregnant groups. Only the difference in NA
      responses between groups was abolished after pretreatment with L-NOARG. 7. These
      data show that vasoconstrictor responses to a variety of agonists are decreased
      in the in situ blood-perfused mesenteric resistance vessels of pregnant rats.
      Increase in endothelial-dependent nitric oxide generation could contribute to the
      vasodilatation seen in pregnancy but other mechanisms might also be involved.
      Cyclo-oxygenase products are not responsible for any decreased contractile
      responses in this preparation.

PMID- 8358539
TI  - The superficial buffer barrier in venous smooth muscle: sarcoplasmic reticulum
      refilling and unloading.
AB  - 1. The interaction of Ca2+ transport in the plasmalemma and the sarcoplasmic
      reticulum (SR) was investigated in smooth muscle of the rabbit inferior vena
      cava. We tested the possibility of direct refilling of the SR with extracellular
      Ca2+ and of the existence of a vectorial Ca2+ extrusion pathway from the SR lumen
      to the extracellular space suggested by earlier results. 2. After depletion with
      caffeine the SR was loaded with Ca2+ to increasing levels by incubation in a high
      potassium 1.5 mM Ca2+ solution and a 10 mM Ca2+ zero Na+ solution, respectively.
      Thapsigargin, 2 microM, (a specific SR Ca(2+)-ATPase blocker) completely blocked
      refilling of the SR in either of the above solutions, indicating that the SR
      Ca(2+)-ATPase is essential for this process. 3. Three different agents, caffeine,
      ryanodine and thapsigargin, which inhibit Ca2+ accumulation by the SR, increased
      the steady state intracellular Ca2+ concentration in the rabbit inferior vena
      cava. 4. Measurements of Mn2+ induced quenching of the intracellular fura-2
      signal during pharmacological manipulation of the SR content showed that these
      three agents did not stimulate divalent cation entry. 5. On the other hand,
      stimulation with noradrenaline caused a marked increase in Mn2+ influx, which was
      blocked by 2 mM Ni2+. Mn2+ entry stimulated by high K+ solution was blocked by 1
      microM diltiazem. 6. We conclude that the SR refilling has to be mediated by the
      SR Ca(2+)-ATPase. Inhibition of Ca2+ accumulation by the SR causes an increase in
      the steady state intracellular Ca2+ concentration. This observation cannot be
      explained by an increase in Ca2+ influx into the smooth muscle cells of the
      rabbit inferior vena cava. Alternatively these results suggest the existence of a
      continuous vectorial release of Ca2+ from the SR lumen to the extracellular
      space.

PMID- 8358540
TI  - Desensitization of histamine H1 receptor-mediated inositol phosphate production
      in HeLa cells.
AB  - 1. Histamine stimulated the accumulation of total [3H]-inositol phosphates (IPn)
      in control HeLa cells with an EC50 of 3.7 +/- 0.7 microM in the presence of 10 mM
      LiCl. The maximum response to histamine after 15 min incubation was 43 +/- 5%
      over basal accumulation and occurred at a concentration of 1 mM histamine. 2. The
      histamine-induced IPn production in HeLa cells was confirmed as H1 receptor
      mediated, since the H1 antagonist mepyramine (10(-6) M) inhibited the histamine
      response (10(-4) M) by 83 +/- 7%, whereas the H2 antagonist, ranitidine (10(-4)
      M), and H3 antagonist, thioperamide (10(-6) M), were ineffective. 3. Histamine
      (10(-4) M) pretreatment of HeLa cells for 30 min desensitized the subsequent
      histamine-induced IPn accumulation. The desensitized cells accumulated IPn in
      response to histamine with an EC50 of 1.7 +/- 0.7 microM after 15 min incubation.
      The maximum histamine-induced IPn accumulation at 10(-4) M was 19 +/- 5% over
      basal and was significantly lower (P < 0.03) than the maximum response in control
      cells. 4. The desensitization of histamine-induced IPn accumulation was time
      dependent and, at a desensitizing histamine concentration of 10(-4) M, the half
      maximal attenuation occurred after approximately 9 min and maximum
      desensitization was achieved by 15-20 min. The desensitization of the IPn
      accumulation was a reversible phenomenon and full recovery of the response
      occurred 150 min after the removal of the desensitizing histamine-containing
      medium. The half-time for the recovery of the histamine-induced response was
      estimated at 120 min. 5. Bradykinin stimulated IPn, accumulation in HeLa cells,
      and the ECm in control cells of 1.9 +/- 0.2 nM was not significantly different
      from the EC50 value from histamine-pretreated cells of 1.6 +/- 0.9 nM. The
      bradykinin response at 1 microM was 194 +/- 48% over basal IPn accumulation in
      control cells and this value was significantly different (P <0.04) from the 1
      microM bradykinin-induced IPn accumulation in histamine pretreated HeLa cells of
      143 +/- 38% over basal.6. NaF stimulated IP,, accumulation in control HeLa cells
      in a dose-related manner, with the maximum effect occurring at 15-20 mM. The EC50
      value for NaF-stimulated IPn accumulation in control cells was 10.5 +/- 1.1 mm
      and the maximum response was 136 +/- 41% over basal after 20 min incubation. In
      histamine desensitized HeLa cells the EC50 value for NaF was 12.3 +/- 0.4 mM
      after 20 min stimulation,which was not significantly different from the value
      obtained in control cells. The maximum NaF stimulated IPn formation in
      desensitized cells of 68 +/- 23% over basal occurred at 15 -20 mM and was
      significantly lower (P<0.01) than that obtained in control cells.7. We show here
      that the acute histamine pretreatment of HeLa cells results in the
      desensitization of histamine H1 receptor-mediated IPn production. The
      desensitization was not restricted to the H1 receptor-mediated signal
      transduction pathway, but also includes both the bradykinin- and NaF mediated
      responses, supporting a heterologous desensitization mechanism. Our results are
      consistent with the site of attenuation being at or distal to the G-protein and
      the underlying mechanism being a slowed time-course for the production of
      inositol phosphates.

PMID- 8358541
TI  - Modulation of vasodilatation to levcromakalim by hypoxia and EDRF in the rabbit
      isolated ear: a comparison with pinacidil, sodium nitroprusside and verapamil.
AB  - 1. We have used an isolated buffer-perfused preparation of the rabbit ear to
      investigate the effects of hypoxia and inhibition of endothelium-derived relaxing
      factor (EDRF) synthesis on the vasodilator responses to the potassium channel
      opener, levcromakalim (the active (-)-enantiomer of cromakalim). The results
      obtained with levcromakalim have been compared with those for pinacidil, sodium
      nitroprusside and verapamil. 2. Levcromakalim relaxed preconstricted preparations
      with an EC50 = 343 +/- 41 nM and Rmax = 80.3 +/- 6.4%. Under hypoxic conditions
      the concentration-response curve was significantly (P < 0.01) shifted to the left
      with an EC50 = 118 +/- 16 nM and Rmax = 89.9 +/- 2.7%. Hypoxia did not influence
      relaxation to either pinacidil, sodium nitroprusside or verapamil. 3. Inhibition
      of EDRF synthesis with 100 microM NG-nitro-L-arginine methyl ester (L-NAME) also
      significantly (P < 0.001) increased the vasodilator potency of levcromakalim
      (EC50 = 56 +/- 5 nM), and caused a similar shift in the concentration-response
      curve to sodium nitroprusside. It did not influence vasodilation to either
      verapamil or pinacidil. The potentiation of vasodilator responses to
      levcromakalim by L-NAME was reversed by an excess of L-arginine. 4. Impairment of
      oxidative phosphorylation with 400 nM carbonyl cyanide m-chlorophenylhydrazone
      significantly (P < 0.05) increased the potency of levcromakalim (EC50 = 120 +/-
      20 nM) but did not influence vasodilation to pinacidil or endothelium-dependent
      relaxations to acetylcholine. 5. Vasodilatation to levcromakalim was augmented
      both by hypoxia and by inhibition of EDRF activity. Since impairment of oxidative
      phosphorylation increased the potency of levcromakalim but did not alter EDRF
      activity then the mechanism responsible for hypoxic facilitation of responses to
      levcromakalim is likely to be due to reduced ATP levels in hypoxic smooth muscle
      cells rather than a change in EDRF activity. These results suggest that
      levcromakalim may selectively dilate both hypoxic vessels and vessels with
      impaired EDRF activity. The results also point to important differences in the
      pharmacology of levcromakalim and pinacidil.

PMID- 8358542
TI  - Interaction between the effects of 5-hydroxytryptamine and adrenaline on the
      growth of platelet thrombi in the coronary artery of the anaesthetized dog.
AB  - 1. The interaction between adrenaline and 5-hydroxytryptamine (5-HT) has been
      quantitated on the rate of thrombus formation, in the stenosed coronary artery
      with damaged endothelium of the anaesthetized dog. 2. Changes in the plasma
      concentration of adrenaline were produced by varying the rate of an intravenous
      infusion of adrenaline and in the effects of 5-HT, by intravenous injections of
      the selective 5-HT2 receptor antagonist, ICI 170809. 3. Increases in the plasma
      concentration of adrenaline, which did not cause significant changes in blood
      pressure and heart rate, increased the rate of thrombus formation. 4. Antagonism
      of the 5-HT2 receptor by ICI 170809, in the absence of an infusion of adrenaline,
      abolished thrombus formation (mean ED50 0.41 microgram kg-1, i.v.). 5. The
      effects of adrenaline were non-competitively antagonized by ICI 170809; maximum
      effects were obtained in the dose-range 50-200 micrograms kg-1, i.v., when the
      mean dose-ratio increase in adrenaline required to restore equivalent rates of
      thrombus formation was 39 fold. 6. These results are consistent with a synergism
      between adrenaline and 5-HT and emphasize the importance of both on thrombus
      formation.

PMID- 8358543
TI  - A2-purinoceptor-mediated relaxation in the guinea-pig coronary vasculature: a
      role for nitric oxide.
AB  - 1. The Langendorff heart preparation was used to investigate the mechanism of
      action of the endothelium-dependent vasodilatation evoked by adenosine and its
      analogues in the guinea-pig coronary vasculature. 2. The relative order of
      potency of adenosine and its analogues in causing a reduction in perfusion
      pressure was D-5'-(N-ethylcarboxamide)adenosine (NECA) = 2-[p-(2
      carboxyethyl)phenylethylamino]-5'-N- ethylcarboxamidoadenosine (CGS 21680)> R-N6
      (2-phenylisopropyl)adenosine (R-PIA) = adenosine = 2-chloroadenosine (2-CA) > S
      N6-(2-phenylisopropyl)adenosine (S-PIA) = N6-cyclopentyl-adenosine (CPA); thus
      suggesting the presence of A2-purinoceptors in this preparation. 3. 8-(p
      Sulphophenyl)theophylline (8-PSPT; 3 x 10(-5) M) significantly reduced both the
      maximum amplitude and area of the vasodilatation produced in response to
      adenosine (5 x 10(-10) -5 x 10(-8) mol) without having any effect on the response
      to the P2-purinoceptor agonist, 2-methylthioATP. The relaxation induced by
      adenosine (5 x 10(-12) -5 x 10(-8) mol) was unaffected by the selective A1
      purinoceptor antagonist 1,3-dipropyl-8-cyclopentylxanthine (DPCPX; 10(-8) M).
      This antagonist profile suggests that only A2-purinoceptors are present in the
      guinea-pig coronary vasculature. 4. The areas of the vasodilator response to
      adenosine (5 x 10(-10) -5 x 10(-7 mol), NECA (5 x 10(-12) -5 x 10(-7) mol) and
      CGS 21680 (5 x 10(-12) -5 x 10(-10) mol) were significantly reduced by NG-nitro-L
      arginine methyl ester (L-NAME; 3 x 10(-5) M). The amplitude of the responses to
      low concentrations of adenosine (5 x 10-10-5 x 10-9mol), NECA (5 x 1011 mol) and
      CGS 21680 (5 x 1011-5 x 10-9mol)were significantly reduced by L-NAME (3 x 10-5
      M).5. L-Arginine (1.5 x 10-3 M) significantly reversed the inhibition, by L-NAME
      (3 x 10-5 M), of the relaxant response to adenosine (5 x 10-8 mol), NECA (5 x I0-
      mol) and CGS 21680 (5 x 10-11 mol).6. Indomethacin (10-6 M) did not inhibit the
      response to adenosine, except at low doses (5 x 10-11-5 x 10-10 mol).7. It is
      concluded that in the guinea-pig coronary vasculature, while a major part of the
      vasodilator action of adenosine is probably directly via A2-receptors on the
      smooth muscle, activation of a subpopulation of A2-purinoceptors on endothelial
      cells by adenosine and its analogues induces relaxation via production of nitric
      oxide; prostanoids appear to play a minimal role in the relaxation induced by
      adenosine as in most other preparations.

PMID- 8358544
TI  - Release of nitric oxide from glyceryl trinitrate by captopril but not
      enalaprilat: in vitro and in vivo studies.
AB  - 1. The hypotensive effects of glyceryl trinitrate (GTN, 0.5 mg kg-1) but not of 3
      morpholino-sydnonimine (SIN-1, 0.125 mg kg-1) in anaesthetized rats were
      attenuated following a seven day (using a q.i.d. dosing schedule) oral treatment
      with isosorbide-5-mononitrate (IS-5-MN; 5 mg kg-1) indicative of the induction of
      tolerance to GTN but not to SIN-1. The hypotensive effects of GTN did not decline
      when the sulphydryl (SH) containing angiotensin converting enzyme inhibitor (ACE
      1), captopril (CPT, 5 mg kg-1) or the structurally unrelated SH-containing, N
      acetylcysteine (NAC, 10 mg kg-1) but not the non-SH-containing ACE-I, enalaprilat
      (ENA, 5 mg kg-1) were given together with IS-5-MN for the seven days treatment.
      2. The attenuated hypotensive effects of GTN (0.5 mg kg-1) in rats treated with
      IS-5-MN were also restored when CPT (1 mg kg-1) or NAC (2.5 mg kg-1) but not ENA
      (1 mg kg-1) was administered intraperitoneally (i.p.) 30 min before GTN.
      Furthermore, in control rats, CPT or NAC but not ENA given i.p. 30 min before
      GTN, potentiated its haemodynamic effects. These effects were blocked by
      methylene blue (10 mg kg-1). At the same doses, CPT or NAC did not affect the
      hypotensive effects of SIN-1. 3. The reduced ability of cultured tolerant smooth
      muscle cells (SMC, 24 x 103 cells) or endothelial cells(EC, 40 x 103 cells) to
      potentiate the anti-platelet effects of GTN (44 microM) was restored by CPT or
      NAC but not by ENA or glutathione (all at 0.5 mM). Potentiation of the anti
      platelet effects of tolerant SMC or EC by CPT or NAC was abolished by co
      incubation with oxyhaemoglobin (Oxy-Hb, 10 microM)indicative of nitric oxide (NO)
      formation.4. When GTN (150-2400 microM) was incubated with CPT, NAC or
      glutathione but not ENA (all at 0.1 mM) for 30 min in Krebs buffer at 37 degrees
      C a concentration-dependent increase in nitrite (NO2-)formation was observed. 5.
      The antiplatelet effects of GTN (5.5-352 microM) were potentiated by co
      incubation with CPT or NAC but not with ENA or glutathione (all at 0.5 mM). The
      concentration of GTN required to inhibit platelet aggregation by 50% (IC50) was
      110 +/- 2 microM for GTN alone, 14 +/- 2 microM for GTN in the presence of NAC
      and 30 +/- 2 microM for GTN in the presence of CPT. The potentiation of the
      effects of GTN by CPT or NAC was inhibited by co-incubation with Oxy-Hb (10
      microM). By themselves, CPT or NAC did not inhibit platelet aggregation.6. The
      ability of CPT to restore (a) the haemodynamic effects of GTN in tolerant rats
      and (b) the reduced capacity of tolerant SMC or EC to potentiate the anti
      platelet effects of GTN is not related to its ACE inhibitory activity.7. CPT also
      potentiated the hypotensive effects of GTN in non-tolerant rats, and in vitro CPT
      released NO from GTN in the absence of a GTN to NO converting cell, so that it is
      unlikely that reversal of tolerance by CPT is due to the replenishment of
      intracellular thiols. Rather it can be explained by the ability of CPT to release
      NO from GTN in the extracellular space. This extracellular formation of NO from
      GTN by CPT would then compensate for the impaired enzymic biotransformation of
      GTN to NO that develops during tolerance as was originally proposed for NAC.

PMID- 8358545
TI  - Effects of prolonged application of isoprenaline on intracellular free magnesium
      concentration in isolated heart of rat.
AB  - 1. The effect of prolonged application of isoprenaline on intracellular free-Mg2+
      concentration ([Mg2+]i) was examined by use of 31P-nuclear magnetic resonance
      (31P-n.m.r.) in rat isolated hearts. Left ventricular pressure (LVP) was
      simultaneously measured. 2. [Mg2+]i was estimated from the separation of the
      alpha- and beta-ATP peaks, using the dissociation constant of MgATP 38 microM
      (established previously). In normal (phosphate-free, Krebs-Henseleit) solution,
      [Mg2+]i was approximately 0.4 mM. 3. When isoprenaline was applied for 100 min, a
      transient increase in [Mg2+]i was observed during the initial 25 min, whilst
      concentrations of ATP ([ATP]) and phosphocreatine ([PCr]) decreased and [Pi]
      correspondingly increased. During the subsequent 75 min of isoprenaline
      application, [Mg2+]i decreased below its resting levels. Washout of isoprenaline
      restored [Mg2+]i and [PCr], but [ATP] remained low. These changes elicited by
      isoprenaline were not observed in the presence of propranolol, a typical alpha
      adrenoceptor blocker. 4. Isoprenaline increased both LVP and heart rate. The
      increased LVP and heart rate slowly returned to lower values during prolonged
      application of isoprenaline, but remained higher than those before application.
      5. The transient rise in [Mg2+]i elicited by isoprenaline could be attributed to
      the decrease in [ATP] resulting in a release of Mg2+. The subsequent decrease in
      [Mg2+]i during the prolonged applications suggests that beta-adrenoceptor
      stimulation itself facilitates Mg(2+)-extruding mechanism(s).

PMID- 8358546
TI  - Blockade by glibenclamide of the flow-evoked endothelial release of ATP that
      contributes to vasodilatation in the pulmonary vascular bed of the rat.
AB  - 1. The effect of step augmentation of flow rate on the level of adenosine -5'
      triphosphate (ATP) measured in the Krebs perfusate was investigated, and the
      effect of glibenclamide on the release of ATP was tested in the rat pulmonary
      vascular bed. 2. For flow rates between 10.38 +/- 1.18 and 28.88 +/- 2.08 ml min
      1 (n = 8) 1 microM suramin, a P2-purinoceptor antagonist, significantly (P <
      0.05) increased vascular resistance under conditions of step augmentation of flow
      rate. This suggests that endogenous ATP released during increases in flow rate
      dilates pulmonary vessels. 3. In response to a step augmentation in flow rate
      from 9.13 +/- 0.97 to 18.3 +/- 1.69 ml min-1 (n = 4) ATP levels were up to 23
      fold higher (P < 0.05) for 15 s, and gradually dropped to a level of about half
      the initial rise. Once the ATP levels had stabilized, another step augmentation
      of flow rate to 27.00 +/- 3.49 ml min-1 was able to evoke a corresponding
      increase of ATP release. The ability of the vascular bed to respond with
      increased ATP release after the initial ATP responses had tapered, demonstrates
      that the drop in ATP levels after the initial rise is not due to depletion of
      ATP. Furthermore, the maximal ATP response directly precedes the vasodilatation
      observed following each jump in perfusion pressure produced with each step
      increase in flow rate. 4. In response to two 3 fold step augmentations of flow
      rate (8.41-27.29 ml min-1) spaced 30 min apart there were two increases in the
      level of ATP which were not significantly different from each other.However,
      perfusion with 1 microM glibenclamide between the first and the second step
      augmentation of flow rate (8.08-24.67 ml min-1) significantly (P<0.05; n = 6)
      blocked the increase in ATP release. This suggests that the release of
      intracellular ATP is mediated by glibenclamide-sensitive K+ channels.5. A
      concentration of 1 microM glibenclamide perfused for 30 min was without effect on
      vascular pressure at constant flow. However, under conditions where flow was
      augmented in a stepwise manner (between 11.50 and 36.45 ml min-1) perfusing with
      1 microM glibenclamide increased vascular resistance (P <0.10).6. It is concluded
      that flow-induced ATP release is mediated by a glibenclamide-sensitive K+
      channel,and that the release of ATP from endothelial cells probably functions to
      vasodilate the pulmonary vascular bed of the rat.

PMID- 8358548
TI  - Reciprocal interaction of 5-hydroxytryptamine and cholecystokinin in the control
      of feeding patterns in rats.
AB  - 1. The effect of the CCKA receptor antagonist, devazepide (100 mg kg-1) on meal
      parameters during the initial phase of the dark period was studied in free
      feeding rats by use of a procedure for continuously monitoring feeding patterns.
      2. In a second experiment, the effect of devazepide on the reduction in meal
      parameters induced by the 5-hydroxytryptamine (5-HT) releaser and uptake
      inhibitor, (+)-fenfluramine (1.5 mg kg-1) in 4 h food-deprived rats was examined.
      3. The hypophagic effect of an intraperitoneal injection of cholecystokinin (CCK
      8, 4 micrograms kg-1) was studied in rats treated with the 5-HT receptor
      antagonist, metergoline (1 and 2 mg kg-1). 4. Devazepide increased the size of
      the first meal in free-feeding, but not in 4 h food-deprived rats and partially
      antagonized the effect of (+)-fenfluramine on the size and duration of the first
      meal. The reduction in eating rate induced by (+)-fenfluramine was not modified
      by devazepide. No changes in (+)-fenfluramine or (+)-norfenfluramine levels were
      found in the brain of rats treated with devazepide. 5. The effect of CCK-8 on
      meal size was completely antagonized by 2 mg kg-1 metergoline. A significant
      interaction was also found between 2 mg kg-1 metergoline and CCK-8 as regards
      their effect on the inter-meal interval. 6. The results suggest a reciprocal
      interaction between 5-HT and CCK-8 in enhancing the satiating effect of food in
      rats.

PMID- 8358547
TI  - Induction of endothelium-dependent relaxation in the rat aorta by IRL 1620, a
      novel and selective agonist at the endothelin ETB receptor.
AB  - 1. The effects of a novel and selective agonist at the endothelin ETB receptor,
      IRL 1620 (Suc-[Glu9, Ala11,15] endothelin-1 (8-21)), were examined in the
      isolated aorta of the rat. 2. IRL 1620 (1-300 nM) changed neither the resting
      tone nor the cytosolic Ca2+ level ([Ca2+]i) of the aorta without endothelium. In
      the presence of endothelium, however, IRL 1620 increased endothelial [Ca2+]i with
      little effect on the muscle tone. In the absence of external Ca2+, IRL 1620 still
      induced a transient increase in endothelial [Ca2+]i. 3. Noradrenaline (100 nM)
      increased both muscle [Ca2+]i and tension. IRL 1620 (1-300 nM) relaxed the muscle
      with an increase in endothelial [Ca2+]i only in the presence of endothelium. An
      inhibitor of nitric oxide synthase, 100 microM NG-monomethyl-L-arginine,
      inhibited the relaxant effect of IRL 1620 but not the increase in endothelial
      [Ca2+]i. 4. In resting and noradrenaline-stimulated aorta, the effects of IRL
      1620 were inhibited by a selective antagonist of the ETB receptor, IRL 1038 (0.3
      3 microM), although a selective antagonist of the ETA receptor, BQ-123 (3
      microM), was ineffective. Verapamil (10 microM) did not alter the effects of IRL
      1620. 5. A muscarinic receptor agonist, carbachol (1 microM), also induced
      endothelium-dependent relaxation with an increase in endothelial [Ca2+]i.
      However, the effects of carbachol were not inhibited by the ETB antagonist, IRL
      1038 (3 microM). 6. These results suggest that IRL 1620 is a selective agonist at
      the ETB receptor which increases endothelial [Ca2+]i by releasing Ca2+ from
      storage sites and by opening non-L type Ca2+ channels,activates nitric oxide
      synthase, releases nitric oxide, and relaxes vascular smooth muscle.

PMID- 8358549
TI  - Investigations of the dual contractile/relaxant properties showed by antioquine
      in rat aorta.
AB  - 1. In the present study we assessed the activity of antioquine, a
      bisbenzyltetrahydroisoquinoline alkaloid isolated from Pseudoxandra sclerocarpa,
      by examining its effects on the contractile activity of rat isolated aorta,
      specific binding of [3H]-(+)-cis-diltiazem, [3H]-nitrendipine and [3H]-prazosin
      to cerebral cortical membranes and the different molecular forms of cyclic
      nucleotide phosphodiesterases (PDE) isolated from bovine aorta. 2. Contractions
      in rat aorta induced by high concentrations of KCl (80 mM) and noradrenaline (1
      microM) were inhibited by antioquine in a concentration-dependent manner (0.1
      microM- 300 microM). The alkaloid appeared more potent against KCl-induced
      contractions. This inhibitory effect was observed at both 37 degrees C and 25
      degrees C. 3. Paradoxically, at the highest concentration tested (300 microM)
      antioquine induced a contractile response of similar magnitude in the presence
      and absence of extracellular calcium, at 37 degrees C. This activity was greatly
      attenuated at 25 degrees C. Antioquine-induced contractions were not inhibited by
      prazosin (0.1 microM), nifedipine (1 microM) or diltiazem (100 microM). On the
      contrary, prazosin and nifedipine slightly increased the contractions in the
      presence of extracellular calcium. Papaverine (100 microM) partially inhibited
      the contractile response to antioquine both in the presence and absence of
      extracellular calcium. 4. At 25 degrees C, in Ca(2+)-free solution, antioquine
      (300 microM) did not modify the contractile response (phasic and tonic) evoked by
      noradrenaline, but increased the phasic contraction induced by caffeine. At 37
      degrees C, the contraction elicited by antioquine made it impossible to observe
      the noradrenaline-induced one. 5. Antioquine showed affinity for the [3H]
      prazosin binding site and for the [3H]-(+)-cis-diltiazembinding site of the Ca2+
      channel receptor complex, but had no effect at the dihydropyridine binding site
      in rat cerebral cortex.6. Antioquine weakly inhibited some PDE forms isolated
      from bovine aorta: a CaM-PDE (PDE I)which preferentially hydrolyzes cyclic GMP
      and is activated by calmodulin, and a rolipram-sensitive cyclic AMP-PDE (PDE IV)
      which hydrolyzed cyclic AMP. Antioquine did not exert any inhibitory effect on
      the other forms of PDE, a cyclic GMP selective form (PDE V) and a low Km cyclic
      AMP-PDEthat is inhibited by cyclic GMP (CGI-PDE, PDE III).7. The present work
      provides evidence that antioquine has properties both as a calcium entry
      blocker(possibly through the benzothiazepine recognition site in the calcium
      channel) and as a contractile agent.Its mechanism of action as a contractile
      agent is not related to Ca2+-entry and is hypothetically similar to that of
      calyculin-A or okadaic acid. The possible involvement of a-adrenoceptors in this
      paradoxical effect cannot be excluded. The rigidity of the molecule provides an
      interesting model for analyzing this contractile mechanism and the intracellular
      processes involved.

PMID- 8358550
TI  - Activation by calcium alone of chloride secretion in T84 epithelial cells.
AB  - 1. The goal of this study was to determine if an increase in cytoplasmic calcium
      concentration ([Ca2+]i), in the absence of additional second messengers derived
      from membrane phospholipid turnover, is a sufficient signal to induce chloride
      secretion across monolayers of the human colonic epithelial line, T84. 2.
      Thapsigargin was used to increase [Ca2+]i by inhibiting the endomembrane Ca(2+)
      ATPase. [Ca2+]i was monitored in monolayers by fura-2 fluorescence spectroscopy,
      chloride secretion by measuring changes in short circuit current (Isc) in
      modified Ussing chambers, and inositol phosphates were measured by radio-h.p.l.c.
      of extracts of cells prelabelled with [3H]-inositol. 3. Thapsigargin increased
      [Ca2+]i and Isc in parallel, without increasing any inositol phosphates. The
      effect of thapsigargin on Isc was abolished by the intracellular calcium
      chelator, bis-(o-aminophenoxy)-ethane-N,N,N',N"-tetraacetic acid (BAPTA). 4.
      Increasing [Ca2+]i with thapsigargin did not prevent a subsequent calcium
      response to carbachol or histamine if extracellular calcium was available. In the
      absence of extracellular calcium, only one such release of calcium to hormonal
      stimulation occurred when cells were pretreated with thapsigargin, and a second
      response to either carbachol histamine was essentially abolished. 5. Addition of
      carbachol or histamine to thapsigargin-treated cells mounted in Ussing chambers
      caused a transient further increase in Isc followed by termination of the
      response, even though [Ca2+]i continued to rise. 6. We conclude that an elevation
      in [Ca2+]i is a sufficient signal to induce chloride secretion in T84 cells.
      Rather than being required to stimulate secretory responses, additional second
      messengers induced by hormonal secretagogues (such as inositol phosphates) may in
      fact serve to limit the secretory response.

PMID- 8358551
TI  - On the high affinity binding site for [3H]-1,3-dipropyl-8-cyclopentylxanthine in
      frog brain membranes.
AB  - 1. Radioligand binding properties of the adenosine receptor ligands, [3H]-1,3
      dipropyl-8-cyclopentylxanthine ([3H]-DPCPX), and [3H]-R-phenylisopropyladenosine
      ([3H]-R-PIA) were investigated in frog brain membranes. 2. The specific binding
      of the adenosine antagonist, [3H]-DPCPX to frog brain membranes showed one
      binding site with Kd and Bmax values of 43.8 nM and 0.238 +/- 0.016 pmol mg-1
      protein, respectively. Guanosine 5'-triphosphate (GTP, 100 microM) decreased to
      72 +/- 7% and Mg2+ (8 mM) increased to 121 +/- 3% [3H]-DPCPX (40 nM) binding to
      frog brain membranes. 3. [3H]-DPCPX saturation binding experiments performed in
      the presence of Mg2+ (8 mM), or in the presence of GTP showed that Mg2+ ions
      decreased the Kd value of [3H]-DPCPX to 14 nM, and GTP increased this value to
      65.6 nM. Bmax values were not significantly (P > 0.05) modified (0.261 +/- 0.018
      pmol mg-1 protein, with Mg2+, and 0.266 +/- 0.026 pmol mg-1 protein, in presence
      of GTP) by the presence of Mg2+ or GTP. 4. The specific binding of [3H]-R-PIA (15
      nM) was decreased to 37 +/- 6% by GTP (100 microM) and increased to 123 +/- 4% by
      Mg2+ (8 mM). [3H]-R-PIA saturation binding experiments performed in the presence
      of Mg2+ (8 mM) showed one binding site with Kd and Bmax values of 0.9 nM and
      0.229 +/- 0.008 pmol mg-1 of protein, respectively. 5. The concentration
      inhibition curves of adenosine agonists and antagonists versus [3H]-DPCPX binding
      showed the following order of potencies: CPA> R-PIA~ NECA> S-PIA> > CGS 21680,
      for the agonists, and XAC ~-DPCPX> > XCC> PACPX, for the antagonists.6. The
      present results suggest that the adenosine binding site in the frog brain
      membranes is G-protein coupled, but that the antagonist affinities and the
      pharmacological profile is different from the Al or A2 adenosine receptors.

PMID- 8358552
TI  - Roles of prostacyclin, EDRF and active oxygens in leukocyte-dependent platelet
      adhesion to endothelial cells induced by platelet-activating factor in vitro.
AB  - 1. The mechanism of polymorphonuclear leukocyte (PMN)-dependent platelet adhesion
      to cultured endothelial cells induced by platelet-activating factor (PAF) was
      investigated to determine whether PMNs release or generate any factor(s) capable
      of inducing platelet adhesion, and the roles of prostacyclin and endothelium
      derived relaxing factor (EDRF). 2. Cell-free supernatants, sonicates or rapid
      filtrates of PAF-stimulated PMN suspensions did not induce platelet adhesion to
      endothelial cells, but the PMN sonicates induced platelet adhesion when
      endothelial cells were pretreated with both aspirin and NG-nitro-L-arginine (L
      NOARG). Its microphotograph showed that mainly platelet aggregates adhered to the
      endothelial cell surface. 3. Platelet adhesion induced by the PMN sonicates to
      aspirin- and L-NOARG-pretreated endothelial cells was dose-dependently prevented
      by OP-41483 (1-100 nM), and slightly by L-arginine (1 mM). The inhibition of
      platelet adhesion by OP-41483 and L-arginine was potentiated by their
      combination. 4. WEB 2170 (3 microM), a PAF antagonist, inhibited platelet
      adhesion induced by the PMN sonicates. However, PAF alone did not induce
      significant platelet adhesion to aspirin- and L-NOARG-treated endothelial cells.
      5. Platelet adhesion induced by the PMN sonicates was not suppressed by AA-861
      and indomethacin. However, both superoxide dismutase and catalase significantly
      inhibited platelet adhesion, and, in combination, their inhibitory effect was
      synergistically potentiated. Mannitol had no effect. It was also significantly
      inhibited by alpha 1-antitrypsin, whereas chymostatin and elastatinal had no
      effect. 6. PAF-induced platelet adhesion to endothelial cells in the presence of
      intact PMNs was not suppressed by indomethacin and AA-861, or by protease
      inhibitors. SOD alone, and in combination with catalase, caused a slight but
      significant inhibition, while catalase and mannitol by themselves had no
      effect.7. PMN-induced platelet adhesion was slightly inhibited by OP-41483 (100
      nM). L-Arginine (1 mM)alone had no effect, but slightly potentiated the effect of
      OP-41483. This platelet adhesion was not accompanied by suppression of
      prostacyclin synthesis.8. The results with the PMN sonicates show that
      prostacyclin, EDRF and active oxygens are important modulators of intercellular
      interactions between platelets and endothelial cells. These results further
      suggest that the mechanism of intact PMN-dependent platelet adhesion is primarily
      through platelet endothelial cell interactions in which leukocyte-derived active
      oxygens play a role, but does not involve platelet-platelet interactions
      inhibitable by prostacyclin.

PMID- 8358553
TI  - Mediation of endothelin-1-induced inhibition of platelet aggregation via the ETB
      receptor.
AB  - 1. The effects of FR139317 (ETA antagonist) or PD145065 (non-selective ETA/ETB
      antagonist) on endothelin-1 (ET-1)-induced changes in blood pressure and
      inhibition of ex vivo platelet aggregation were investigated in the anaesthetized
      rabbit. 2. ET-1 (1 nmol kg-1, i.a. bolus) caused a sustained increase in mean
      arterial pressure (MAP) (peak increase 47 +/- 5 mmHg, n = 8). Intravenous
      infusion of FR139317 at 0.2 (n = 4) or 0.6 mg kg-1 min-1 (n = 4) inhibited the ET
      1 pressor response by 83 or 89%, respectively. Infusion of PD145065 at 0.2 (n =
      4) or 0.6 mg kg-1 min-1 (n = 4) inhibited the ET-1-induced increase in MAP by 79
      or 75%, respectively. 3. The transient depressor response (-16 +/- 3 mmHg) which
      preceded the rise in blood pressure induced by ET-1 (1 nmol kg-1, i.a., n = 8)
      was enhanced by an intravenous infusion of FR139317 (0.6 mg kg-1 min-1) to -35 +/
      5 mmHg (P < 0.05, n = 4). This enhancement was abolished by indomethacin (5 mg
      kg-1, i.v.) pretreatment (-17 +/- 1 mmHg, n = 4). PD145065 (0.2 mg kg-1 min-1,
      i.v.) attenuated the ET-1-induced fall in blood pressure to -9 +/- 1 mmHg (n =
      4), while a higher dose of this antagonist (0.6 mg kg-1 min-1, i.v.) completely
      abolished the ET-1-mediated depressor response. 4. ET-1 (1 nmol kg-1, n = 8)
      inhibited ex vivo platelet aggregation by 96% at 5 min after injection of the
      peptide. FR139317 (0.2 or 0.6 mg kg-1 min-1, i.v.) or PD145065 (0.2mg kg-1 min-1,
      i.v.) did not affect the inhibition of ex vivo platelet aggregation in response
      to ET-1. In contrast, intravenous infusion of PD145065 (0.6 mg kg-1 min-1)
      abolished the anti-aggregatory effects of ET-1.5. Thus, FR139317 inhibits the
      pressor, but not the depressor actions of ET-1 and has no effect on the ET-l
      induced inhibition of ex vivo platelet aggregation. In contrast, PD145065
      antagonizes the pressor and depressor responses to ET-1 and abolishes the anti
      aggregatory effects of the peptide.6. These results strongly suggest that ET-1
      induced vasoconstriction in the anaesthetized rabbit is primarily mediated via
      the ETA receptor while the depressor and antiaggregatory actions of ET-1 are due
      to activation of the ETB receptor.

PMID- 8358554
TI  - Action of alpha-dendrotoxin on K+ currents in nerve terminal regions of axons in
      rat olfactory cortex.
AB  - 1. In the rat olfactory cortex, unmyelinated axons give rise to synapses en
      passant. This tissue was used to study the pharmacology of axonal K(+)-currents.
      Responses were measured from a group of these axons as unclamped field currents,
      with a polarizable suction electrode. 2. A single stimulus to the axons elicited
      a tetrodotoxin-sensitive Na(+)-dependent transient K(+)-currents were revealed by
      positive polarization of the suction electrode and were manifest as a negative
      current following the Na(+)-component. 3. In the presence of tetraethylammonium
      (TEA, 5 mM) and Cd2+ (100 microM), the K(+)-component was depressed by 3,4
      diaminopyridine (3,4-DAP; 1 to 20 microM; IC50 2.0 +/- 0.4 microM). alpha
      Dendrotoxin (DTX; 15-1500 nM) also attenuated the aminopyridine-sensitive
      component (IC50 93 +/- 4 nM). At the highest DTX concentration, depression of the
      K(+)-current was incomplete, the residual K+ current being reduced by 3,4-DAP
      (0.1 to 5 microM). 4. These results indicate the presence of two aminopyridine
      sensitive K+ currents in this preparation distinguished by their susceptibility
      to DTX.

PMID- 8358555
TI  - Differential localization of endothelin ETA and ETB binding sites in human
      placenta.
AB  - 1. The localization and differential distribution of endothelin (ET) receptor
      subtypes (ETA and ETB) was investigated in sections of human placenta by use of
      quantitative in vitro autoradiography and receptor selective ligands. 2.
      Specific, high density [125I]-ET-1 binding sites were localized to the decidua
      and foetal membranes as well as to arteries and veins in the chorionic plate and
      throughout the villous tree. Moderate to low density binding was found in the
      extravillous and villous trophoblast respectively. 3. [125I]-ET-1 binding sites
      exhibited a rank order of inhibition by unlabelled peptide sequences (ET-1 > ET-3
      > [Ala3,11,18Nle7]-ET-1 > BQ123 > or = sarafotoxin 6c). However, in contrast to
      the monophasic inhibition curve of ET-1, the other sequences produced a
      significantly better fit to a two component inhibition curve suggesting the
      presence of a heterogeneous population of ET binding sites. 4. ETA and ETB
      receptors were distinguished by competitive inhibition of [125]-ET-1 binding with
      increasing concentrations of unlabelled ET-3, [Ala3,11,18Nle7]-ET-1, sarafotoxin
      6c and BQ123 and by incubating sections with the ETB agonist, [125I]-BQ3020. ET
      receptor subtypes exhibited a differential distribution in the placenta. ETA type
      binding sites predominated (approximately 80% of the total) on veins and arteries
      in the chorionic plate. Veins in stem villi, blood vessels in distal regions of
      the villous tree and decidual cells displayed a high density (approximately 60
      70% of the total) of the ETB receptor subtype. 5. No difference was detected in
      either the relative density of [125I]-ET-1 binding sites or the proportion of ETA
      to ETB sites in placentae from pregnancies complicated by pre-eclampsia compared
      with normal term controls.6. ET may have a local autocrine or paracrine role in
      the placenta, acting via specific receptors to influence foetoplacental blood
      flow and other aspects of placental function.

PMID- 8358556
TI  - A comparison of the effects of polyarginine and stimulated eosinophils on the
      responsiveness of the bovine isovolumic bronchial segment preparation.
AB  - 1. The bovine isovolumic bronchial segment preparation has been used to study the
      sensitivity and responsiveness of bronchial smooth muscle after various
      manipulations. 2. Addition of acetylcholine (ACh) to the lumen of the segments
      elicited an increase in intraluminal pressure as a result of contraction of the
      airway smooth muscle. However, the increases in intraluminal pressure were
      greater when the ACh was added to the adventitial surface of the preparation. 3.
      Addition of polyarginine to the bronchial lumen for 60-120 min resulted in an
      increased magnitude of response and greater than 100 fold increase in sensitivity
      to ACh administered into the lumen. Depolarizations induced by KCl were similarly
      enhanced when the solution was added into the lumen. In contrast, the sensitivity
      and responsiveness to ACh or K(+)-induced depolarization administered
      adventitially was unchanged. 4. The mechanical disruption of the epithelium
      produced a 32 fold increase in sensitivity to ACh introduced via the lumen,
      whereas the sensitivity to ACh added adventitially remained unaltered. 5.
      Addition of polyarginine to the adventitial bathing medium resulted in no change
      in the responsiveness or sensitivity to ACh, irrespective of whether the ACh was
      given intraluminally or adventitially. 6. Histological examination revealed that
      polyarginine caused extensive disordering of the normal architecture of the
      bronchial epithelium. Taken together with the unaltered responsiveness to
      adventitial ACh (i.e. lack of change in intrinsic muscle sensitivity) these
      observations suggest that the effect of polyarginine was most likely due to
      disruption of a diffusion barrier. 7. In contrast to the effects of polyarginine,
      the only effect of stimulated eosinophils was to produce a small diminution in
      the responsiveness to ACh that had been added adventitially.

PMID- 8358557
TI  - Hoe 694, a new Na+/H+ exchange inhibitor and its effects in cardiac ischaemia.
AB  - 1. The benzoylguanidine derivative Hoe 694 ((3-methylsulphonyl-4- piperidino
      benzoyl) guanidine methanesulphonate) was characterized as an inhibitor of Na+/H+
      exchange in rabbit erythrocytes, rat platelets and bovine endothelial cells. The
      potency of the compound was slightly lower or comparable to ethylisopropyl
      amiloride (EIPA). 2. To investigate a possible cardioprotective role of the
      Na+/H+ exchange inhibitor Hoe 694, rat isolated working hearts were subjected to
      ischaemia and reperfusion. In these experiments all untreated hearts suffered
      ventricular fibrillation on reperfusion. Addition of 10(-7) M Hoe 694 to the
      perfusate almost abolished reperfusion arrhythmias in the rat isolated working
      hearts. 3. Hoe 694 reduced the release of lactate dehydrogenase (LDH) and
      creatine kinase (CK), which are indicators of cellular damage during ischaemia,
      into the venous effluent of the hearts by 60% and 54%, respectively. 4. The
      tissue content of glycogen at the end of the experiments was increased by 60% and
      the high energy phosphates ATP and creatine phosphate were increased by 240% and
      270% respectively in the treated hearts as compared to control hearts. 5.
      Antiischaemic effects of the Na+/H+ exchange inhibitor, Hoe 694, were
      investigated in a second experiment in anaesthetized rats undergoing coronary
      artery ligation. In these animals, pretreatment with Hoe 694 caused a dose
      dependent reduction of ventricular premature beats and ventricular tachycardia as
      well as a complete suppression of ventricular fibrillation down to doses of 0.1
      mg kg-1, i.v. Blood pressure and heart rate remained unchanged. 6. We conclude
      that the new Na+/H+ exchange inhibitor, Hoe 694, shows cardioprotective and
      antiarrhythmic effects in ischaemia and reperfusion in rat isolated hearts and in
      anaesthetized rats. In view of the role which Na+/H+ exchange seems to play in
      the pathophysiology of cardiac ischaemia these effects could probably be
      attributed to Na+/H+ exchange inhibition.

PMID- 8358558
TI  - Kinetic study of the tubular dopamine outward transporter in the rat and dog
      kidney.
AB  - 1. The present study has determined the kinetic characteristics of the outflow of
      dopamine of renal origin in slices of rat and dog renal cortex loaded with
      exogenous L-dihydroxyphenylalanine (L-DOPA 5 to 5000 microM). 2. In both dog and
      rat renal tissues the production of dopamine was found to be dependent on the
      concentration of L-DOPA used and reached its maximum at 2500 microM L-DOPA. The
      decarboxylation of L-DOPA in rat cortical slices (16.4 +/- 2.6 to 1479.2 +/- 85.2
      nmol g-1) was 6 fold that in the dog (2.2 +/- 0.4 to 252.1 +/- 21.2 nmol g-1). In
      the rat kidney a large amount (approximately 50%) of the dopamine (5.2 +/- 0.6 to
      743.4 +/- 58.3 nmol g-1) was found to escape into the incubation medium, whereas
      in dog renal slices the amount of newly-formed dopamine escaping into the
      incubation medium (0.7 +/- 0.2 to 46.5 +/- 9.3 nmol g-1) was less than 25% of the
      total amount of the amine formed. 3. The application of the Michaelis-Menten
      equation to the net transport of newly-formed dopamine has allowed the
      identification of a saturable (carrier-mediated transfer) and a non-saturable
      component (diffusion). The Vmax (nmol g-1 15 min-1) and Km (nM) values for the
      saturable component were, respectively, 340 +/- 41 and 396 +/- 45 in the rat
      kidney and 112 +/- 16 and 319 +/- 35 in the dog kidney. In both rat and dog renal
      tissues, the magnitude of the non-saturable component was found to be of minor
      importance up to a concentration of 250 nmol g-1 of dopamine to be transported.
      At high concentrations of the amine (greater then 250 nmol g-1), only attainable
      in rat kidney slices, most of the dopamine was found to leave the compartment
      where the synthesis did occur through a non-saturable transport system.4. In
      conclusion, the results presented here show that the outflow of newly-formed
      dopamine in both dog and rat kidney slices loaded with exogenous L-DOPA follows
      Michaelis-Menten kinetics with a saturable component and a non-saturable one, the
      latter assuming particular importance only at higher concentrations of the amine.

PMID- 8358559
TI  - The antiarrhythmic effects of the nucleoside transporter inhibitor, R75231, in
      anaesthetized pigs.
AB  - 1. The effect of R75231, an inhibitor of purine nucleoside transport, were
      examined on ischaemic arrhythmias in anaesthetized pigs. 2. In closed chest pigs
      (n = 4), R75231 exerted a moderate dose-dependent decrease in mean arterial blood
      pressure (from 97 +/- 4 mmHg to 95 +/- 4, 90 +/- 1 and 83 +/- 2 mmHg at 25, 50
      and 100 micrograms kg-1 respectively) and produced a dose-related shift to the
      left of the blood pressure dose-response curve to intravenous bolus doses of
      adenosine. The degree of inhibition of adenosine uptake by R75231, assessed ex
      vivo in erythrocyte suspensions, was 43 +/- 5%, 64 +/- 13 and 114 +/- 15% at
      doses of 25, 50 and 100 micrograms kg-1 respectively. 3. In open chest pigs,
      intravenous injection of R75231 (50 micrograms kg-1; n = 6 and 100 micrograms kg
      1; n = 10) induced a dose-related decrease in both systolic and diastolic
      arterial blood pressure which was more marked than in closed-chest pigs (mean
      pressure 86 +/- 4 to 70 +/- 2 mmHg and 88 +/- 6 to 60 +/- 6 mmHg with 50 and 100
      micrograms kg-1 respectively), without affecting heart rate or myocardial
      contractility. Coronary artery occlusion in these pigs caused a secondary
      decrease in blood pressure. This was not observed in controls (n = 10). The lower
      dose of R75231 did not exert any antifibrillatory effects, whereas the higher
      dose significantly reduced the incidence of ventricular fibrillation, from 80% in
      control pigs to 30%. Neither dose modified the incidence of ventricular
      tachycardia (33% and 40% with 50 and 100 microg kg-1 respectively, compared to
      30% in controls) or had any effect on the total number of ventricular ectopic
      beats (85 +/- 47 and 130 +/- 31 vs 110 +/- 19 in controls). R75231, at a dose of
      100 microg kg-1, also attenuated the ischaemia-induced shortening of QRS
      interval, but neither dose modified the ST-segment depression seen following
      occlusion.4. These results show that the nucleoside transport inhibitor, R75231,
      exerts an antifibrillatory effect ina model of severe myocardial ischaemia in a
      dose which completely inhibits adenosine uptake ex vivo.However, while this agent
      has minimal haemodynamic effects in closed chest animals, the reduction in blood
      pressure induced by R75231 in open-chest pigs cannot be excluded as a possible
      contributory mechanism of the antiarrhythmic effects of this drug.

PMID- 8358560
TI  - 5-HT1B receptors mediate potent contractile responses to 5-HT in rat caudal
      artery.
AB  - 5-Hydroxytryptamine (5-HT) evoked potent contractile responses in
      phenoxybenzamine-treated ring segments of rat caudal artery, partially contracted
      with U46619. Responses were mimicked by 5-HT1-selective agonists with the potency
      order: RU24969 > 5-carboxamidotryptamine > 5-HT = CP-93,129 >> sumatriptan. 8
      Hydroxy-N,N-dipropylaminotetralin was virtually inactive. Responses were
      unaffected by spiperone (0.1 microM) and mesulergine (1.0 microM), but were
      antagonized competitively by (+/-)-cyanopindolol affording agonist-independent
      pKB estimates of 8.4 to 8.9. The pharmacological profile of this receptor is
      consistent with that of the 5-HT1B subtype. Since the 5-HT1B receptor is the
      rodent homologue of the 5-HT1D beta subtype, it might be anticipated that 5-HT1D
      beta receptors will be found to mediate vasoconstrictor responses in non-rodent
      species.

PMID- 8358561
TI  - Oestradiol inhibits smooth muscle cell proliferation of pig coronary artery.
AB  - 1. The effect of oestradiol 17 beta on vascular smooth muscle proliferation was
      examined in segments of the pig left anterior descending coronary artery (LAD).
      It was established by cytochemical techniques that out-growth from the segments
      was composed of vascular smooth muscle cells. 2. [3H]-thymidine uptake by pig LAD
      segments was used as an index of vascular smooth muscle cell proliferation.
      Nitroprusside and forskolin significantly inhibited [3H]-thymidine uptake and
      were used as positive controls. 3. Oestradiol 17 beta (180-360 nM) inhibited
      thymidine uptake by pig LAD segments (P < 0.05). The inhibition was observed only
      in the absence of phenol red, which is a weak oestrogen receptor agonist. The
      anti-oestrogens tamoxifen and its more potent metabolite 4-hydroxytamoxifen, both
      of which are partial oestrogen receptor agonists, also significantly inhibited
      thymidine uptake. However, pretreatment with either tamoxifen or 4
      hydroxytamoxifen did not significantly block oestradiol 17 beta-induced
      inhibition of thymidine uptake. 4. The LAD segments bound [3H]-oestradiol 17 beta
      in a time-dependent manner and about 20 to 30% was displaced by an excess of
      unlabelled oestradiol 17 beta. Autoradiography showed [3H]-oestradiol 17 beta was
      evenly distributed in the cytosol and nuclei of cells in the three layers of the
      vessel wall. 5. The data suggest that oestradiol 17 beta inhibits smooth muscle
      cell proliferation in porcine LAD segments, possibly through an oestrogen
      receptor mechanism. This in vitro effect suggests an in vivo role for oestradiol
      17 beta in directly protecting coronary arteries against myointimal proliferation
      in premenopausal women.

PMID- 8358562
TI  - Development of a radioligand binding assay for 5-HT4 receptors in guinea-pig and
      rat brain.
AB  - 1. The 5-HT4 receptor antagonist, GR113808, has been radiolabelled to a high
      specific activity with tritium. 2. Characterization of specific [3H]-GR113808
      binding in homogenates of guinea-pig striatum and hippocampus revealed a single
      site of high affinity (Kd values 0.20 and 0.13 nM respectively). 3. [3H]-GR113808
      binding was reversible and displayed rapid kinetics such that association and
      dissociation were complete within 3 min. 4. Specific [3H]-GR113808 binding was
      potently and stereoselectively inhibited by agonists and antagonists acting at
      the 5-HT4 receptor but not by compounds selective for other 5-HT receptors or
      other neurotransmitter receptors. 5. Autoradiographic analysis revealed a
      discrete localization in both guinea-pig and rat brain with high concentrations
      of binding in brain areas such as the striatum, substantia nigra and olfactory
      tubercle. 6. [3H]-GR113808 binding to homogenates of guinea-pig striatum meets
      the criteria for labelling of the 5-HT4 receptor and, as such, represents the
      first characterization of this receptor in a radioligand binding assay.

PMID- 8358563
TI  - Vasorelaxant mechanism of KRN2391 and nicorandil in porcine coronary arteries of
      different sizes.
AB  - 1. The relaxant mechanisms of action of KRN2391, a novel vasodilator, and
      nicorandil on epimyocardial coronary artery (2.5- 3.0 mm outer diameter) and mid
      myocardial coronary artery (0.8-1.0 mm outer diameter) were investigated in
      porcine isolated coronary arteries. In addition, the vasorelaxant responses of
      KRN2391 and nicorandil were compared with those of nitroglycerin and cromakalim,
      a K+ channel opener, in epi- and mid-myocardial coronary arteries. 2.
      Nitroglycerin showed a more potent relaxant effect on epi-myocardial coronary
      arteries than on mid-myocardial coronary arteries, whereas cromakalim produced
      greater relaxation responses in mid-myocardial coronary arteries. There was no
      difference between epi- and mid-myocardial coronary arteries in terms of the
      relaxant effect of KRN2391 and nicorandil. 3. Relaxation induced by KRN2391 in
      epi- and mid-myocardial coronary arteries was inhibited by oxyhaemoglobin, a
      pharmacological antagonist of nitrovasodilators, and glibenclamide, a
      pharmacological antagonist of K+ channel opening drugs. However, the inhibitory
      effect of glibenclamide on KRN2391-induced relaxation was greater in mid
      myocardial coronary artery than in epi-myocardial coronary artery. 4. Relaxation
      induced by nicorandil was inhibited by oxyhaemoglobin alone in epi-myocardial
      coronary arteries and by both oxyhaemoglobin and glibenclamide in mid-myocardial
      coronary arteries. 5. In epi- and mid-myocardial coronary arteries, relaxation
      induced by cromakalim was inhibited by glibenclamide but not by oxyhaemoglobin,
      whereas relaxation induced by nitroglycerin was inhibited by oxyhaemoglobin but
      not by glibenclamide. 6. These results suggest that KRN2391 and nicorandil
      exhibit a dual mechanism of action acting partly as a nitrate and partly as a K+
      channel opener. The mechanism of action of these drugs depend on the segment of
      coronary artery studied. Furthermore, the dual mechanism of action of KRN2391 and
      nicorandil seems to contribute to the equipotent relaxant effect between epi- and
      mid-myocardial coronary arteries.

PMID- 8358564
TI  - Cellular mechanism of the positive inotropic effect of hydralazine in mammalian
      myocardium.
AB  - 1. The purpose of this study was to elucidate the cellular mechanism of the
      positive inotropic effect of hydralazine, a vasodilator widely used for afterload
      reduction in patients with heart failure that has also been reported to have
      positive inotropic effects on the heart. After isolation, right ventricular
      papillary muscles from the ferret were maintained in bicarbonate-buffered salt
      solution (30 degrees C). A concentration-response relationship was obtained for
      hydralazine (10(-6) to 10(-3) M). In order to mimic different levels of
      catecholamine release found in heart failure, we utilized two methods of
      stimulation: (a) threshold punctate pulses and (b) suprathreshold punctate
      stimulation with voltage approximately 10% above threshold. 2. In a first group
      of muscles (n = 16), a maximally effective concentration of hydralazine (10(-3)
      M) increased peak isometric tension by 39 +/- 9% (P < 0.05). Doses lower than 10(
      5) M had no significant effect. The bioluminescent Ca2+ indicator, aequorin, was
      loaded into a subset of these muscles (n = 7). A significant increase in peak
      light (i.e., intracellular Ca2+) developed, concurrently with an increase in peak
      tension (38 +/- 5% to 66 +/- 8%). This inotropic response was associated with a
      decrease in time to peak tension (ms), 221 +/- 7 to 186 +/- 5 (P < 0.05), and
      time to peak light, 65 +/- 4 to 52 +/- 2 (P < 0.05). These effects were markedly
      attenuated by pretreatment with autonomic blocking agents. 3. In a second group
      of muscles (n = 12), histamine was used to stimulate cyclic AMP production in the
      presence of propranolol. Hydralazine (3 x 10-4 M) led to a shift in the pD2 (i.e.
      the negative log of the concentration of histamine producing 50% of the maximal
      response) from 6.1 +/- 0.1 to 5.9 +/- 0.1(P <0.05), thus increasing the
      sensitivity of the muscles to histamine. Hydralazine also increased maximum
      tension from 160 +/- 77% to 195 +/- 57% (P <0.05) above baseline. Thus,
      hydralazine altered the potency and efficacy of histamine despite the presence of
      beta-adrenoceptor blockade.4. A third group of muscles were chemically skinned to
      examine the effects of hydralazine on myofilament Ca2+ responsiveness.
      Pretreatment of ferret papillary muscles with hydralazine (10-3 M)before skinning
      did not shift the force-pCa curve after skinning (n = 16). However, hydralazine
      added to previously skinned fibres desensitized the myofilaments, as indicated by
      a rightward shift of the force-pCa curve (n = 12). Maximum tension development
      was not changed.5. The pharmacological effects of hydralazine are characteristic
      of inotropic drugs that act mainly via cyclic AMP; however, the increase in peak
      tension demonstrated with histamine in the presence of hydralazine also suggests
      an effect on cyclic AMP-independent second messenger pathways. These data are
      consistent with reports that large doses of hydralazine may increase cellular
      levels of cyclic AMP, as well as other second messengers, by direct cardiac and
      indirect neuronal mechanisms.

PMID- 8358565
TI  - Effect of nafamostat mesilate on Na+ and K+ transport properties in the rabbit
      cortical collecting duct.
AB  - 1. To determine the mechanism(s) of hyperkalemia caused by nafamostat mesilate
      (NM), a serine-protease inhibitor, we investigated the effects of the drug on Na+
      and K+ transport properties of the collecting duct (CD) cell in the isolated and
      perfused cortical collecting duct from rabbit kidneys. 2. NM at 10(-4) M in the
      lumen, hyperpolarized the apical membrane in parallel with increases in
      transepithelial resistance (RT) and fractional apical membrane resistance (fRA).
      3. These effects were completely inhibited by pretreatment with 50 microM luminal
      amiloride, whereas they were not affected by luminal addition of 2 mM Ba2+. 4. NM
      at 10(-4) M in the bath slightly but significantly depolarized the basolateral
      membrane without any changes in RT or fRA, although NM at 10(-5) M in the bath
      had no effect on the electrical parameters. 5. It is concluded that NM mainly
      acts on the apical membrane of the CD cell and inhibits the amiloride-sensitive
      Na+ conductance in the apical membrane.

PMID- 8358566
TI  - Functional characterization of three adenosine receptor types.
AB  - 1. The purpose of the present study was to classify adenosine receptors into A1
      and A2 subtypes in a wide range of isolated tissues and cell types (rat
      adipocytes and atria, guinea-pig ileum and atria (A1); guinea-pig aorta, dog
      coronary artery and human platelets and neutrophils (A2)) using the R- and S
      diastereoisomers of N-phenylisopropyladenosine (PIA), N-cyclopentyladenosine
      (CPA), the novel compound, N-[(1S,trans)-2-hydroxycyclopentyl]adenosine
      (GR79236), N-[(2-methylphenyl)methyl]adenosine (metrifudil), 2
      (phenylamino)adenosine (CV1808), and 2[[2-[4-(2-carboxyethyl)phenyl]ethyl]amino]
      N- ethylcarboxamidoadenosine (CGS21680); N-ethylcarboxamidoadenosine (NECA) was
      used as a standard. 2. Results obtained in all tissue preparations previously
      reported to contain A1-receptors could be described by a single rank order of
      agonist potency: CPA > or = GR79236, R-PIA > or = NECA >> S-PAI > or = metrifudil
      > or = CV1808, CGS21680. 3. In contrast, two distinct rank orders of agonist
      potency were observed in preparations previously reported to contain A2
      receptors. In dog coronary artery, human neutrophils and platelets the rank order
      of potency was: CV1808, CGS21680 > or = NECA > R-PIA > or = metrifudil > or = CPA
      > GR79236 S-PIA. However, in guinea-pig aorta the rank order was: NECA >
      metrifudil > R-PIA, CPA > CV1808, GR79236 > or = S-PIA, CGS21680. 4. The results
      of this study are consistent with the existence of three types of adenosine
      receptor: A1-and two subtypes of A2-receptor. The receptor present in dog
      coronary artery, human platelets and neutrophils, probably corresponds to the A2a
      subtype, whilst that present in the guinea-pig aorta may be of the A2b subtype.

PMID- 8358567
TI  - Intracellular cross-talk between receptors coupled to phospholipase C via
      pertussis toxin-sensitive and insensitive G-proteins in DDT1MF-2 cells.
AB  - 1. The effect on intracellular free calcium concentration ([Ca2+]i) of
      simultaneous activation of receptors coupled to phospholipase C via pertussis
      toxin (PTX)-sensitive and -insensitive G-proteins has been investigated in the
      hamster vas deferens smooth muscle cell line, DDT1MF-2. 2. In fura-2-loaded
      DDT1MF-2 cells, activation of adenosine A1-receptors (which are linked to PTX
      sensitive G-proteins) with a maximal concentration of N6-cyclopentyladenosine
      (CPA; 300 nM) increased [Ca2+]i from 121 +/- 5 nM to 254 +/- 20 nM (n = 8). These
      experiments were performed in the presence of extracellular Ca2+. Stimulation of
      histamine H1-receptors (which are linked to PTX-insensitive G-proteins) with a
      low concentration of histamine (1 microM) increased [Ca2+]i from 128 +/- 8 nM to
      150 +/- 13 nM (n = 8). When combined, CPA (300 nM) and histamine (1 microM)
      synergistically raised [Ca2+]i from 134 +/- 6 nM to 607 +/- 61 nM (n = 8). 3.
      Removal of extracellular Ca2+ (experiments performed in Ca(2+)-free buffer
      containing 0.1 mM EGTA) had no effect on the synergistic interaction between CPA
      (300 nM) and histamine (1 microM). 4. The addition of maximal concentrations of
      CPA (300 nM) and histamine (100 microM) resulted in a rise in [Ca2+]i which was
      additive when compared to the Ca2+ responses obtained with the two agonists
      alone. Low (30 nM) and subthreshold (3 nM) concentrations of CPA did not alter
      the Ca2+ response elicited by maximal concentrations of histamine (100 microM).
      5. Subthreshold concentrations of CPA (3 nM) and low concentrations of histamine
      (1 microM) elicited synergistic rises in [Ca2+]i. 6 Synergistic Ca2+ responses
      were not observed between histamine Hl- and ATP-receptors when cells were
      simultaneously stimulated with either 1 microM or 10 microM of each agonist.7
      These data suggest that adenosine A1-receptors linked to PTX-sensitive G
      protein(s) and histamine H14-receptors linked to PTX-insensitive G-proteins
      interact synergistically to raise [Ca2+]i. In contrast,activation of ATP
      receptors which are linked to PTX-insensitive G-protein(s) do not interact
      synergically with histamine H1-receptors.

PMID- 8358568
TI  - Pharmacology of a cloned potassium channel from mouse brain (MK-1) expressed in
      CHO cells: effects of blockers and an 'inactivation peptide'.
AB  - 1. Chinese hamster ovary cells (CHO), maintained in cell culture, were stably
      transfected with DNA for the MK-1 voltage-activated potassium channel, previously
      cloned from a mouse brain library. 2. Voltage-activated currents were recorded by
      the whole cell patch clamp method. In CHO cells transfected with the vector only,
      there were no significant outward voltage activated currents. However, large
      outward voltage-activated potassium currents were always observed in those cells
      which had been transfected with the vector containing the DNA encoding for MK-1.
      3. These potassium currents activated from -40 mV, and reversed at the potassium
      equilibrium potential. The half-maximal conductance of MK-1 was at -10 mV and had
      a slope factor of 11 mV when fitted with a Boltzmann function. There was only
      very slight (< 10%) inactivation of MK-1 even at very large positive voltages. 4.
      MK-1 was reversibly blocked by: 4-aminopyridine (4-AP, 0.1-4 mM), Toxin I 10-100
      nM), mast cell degranulating peptide (1 microM), tetraethylammonium (TEA, 4-10
      mM), tedisamil (100 microM), quinine (100 microM) and ciclazindol (100 microM);
      all applied to the outside of the cell from a 'U tube' rapid perfusion system. 4
      AP may block closed as well as open MK-1 potassium channels. 5. A synthetic 20
      amino acid peptide derived from the N-terminus sequence of the Shaker B potassium
      channel (the 'inactivation peptide') produced dramatic inactivation of MK-1 when
      applied to the inside, but not the outside of the cell. Reducing peptide
      concentration or 'degrading' the peptide produced less inactivation. 6. The block
      of MK-1 by the synthetic inactivation peptide was quite different in time
      dependence from block by internal TEA (0.4-4 mM), which probably blocks much more
      quickly but less potently than the peptide.

PMID- 8358569
TI  - Differential effects of BQ-123 against endothelin-1 and endothelin-3 on the rat
      vas deferens: evidence for an atypical endothelin receptor.
AB  - 1. Endothelin-1 and endothelin-3 enhanced concentration-dependently the rat vas
      deferens twitch response to electrical stimulation, endothelin-1 being three
      times more potent. Sarafotoxin S6c was at least 200 times less active than
      endothelin-1. 2. The response to endothelin was antagonized in a competitive
      manner by the supposedly selective ETA receptor antagonist, BQ-123 (pA2:7.0 +/-
      0.1). In contrast, the endothelin-1 concentration-response curve was only shifted
      two fold in the presence of 10 microM BQ-123, while no effect was observed at 1
      microM. 3. This evidence suggests the rat vas deferens contains an endothelin
      receptor not conforming to the ETA/ETB receptor subtype classification so far
      proposed.

PMID- 8358570
TI  - Protective effects of ranolazine in guinea-pig hearts during low-flow ischaemia
      and their association with increases in active pyruvate dehydrogenase.
AB  - 1. In isolated Langendorff-perfused, electrically-paced, hearts of guinea-pigs,
      global low-flow-ischaemia (LFI; at 0.7 ml min-1) resulted in marked increases in
      the rates of release of lactate, lactate dehydrogenase (LDH) and creatine kinase
      (CK) over a 30 min period. At the end of the LFI period, tissue ATP content was
      significantly reduced from a control value of 11.8 +/- 0.8 (5) to 5.6 +/- 0.8 (5)
      mumol g-1 dry weight. 2. The presence of ranolazine [(+/-)-N-(2,6-dimethyl
      phenyl)-4[2-hydroxy-3-(2-methoxy-phenoxyl)- propyl] - l-piperazine acetamide
      dihydro-chloride; RS-43285-193] at 10 microM, from 20 min prior to and during
      LFI, resulted in significant reductions in the release of lactate, LDH and CK
      during the ischaemic period and a significant preservation of tissue ATP (9.0 +/-
      1.1 (6) mumol g-1 dry wt.). Ranolazine did not prevent the reductions in creatine
      phosphate or glycogen observed in LFI, nor did it have any significant effects on
      any contractile parameters before or during the LFI period. 3. Neither ranolazine
      nor LFI affected the total amounts of tissue pyruvate dehydrogenase (PDH)
      activity; however, the significant reduction in the amount of active, non
      phosphorylated PDH caused by LFI (from 88.2 +/- 5.5 to 44.2 +/- 3.2% of total
      activity) was partially but significantly prevented by ranolazine (67.2 +/-
      6.8%). This effect of ranolazine on PDH may be part of the mechanism whereby the
      compound reduces lactate release and preserves tissue ATP during ischaemia.

PMID- 8358571
TI  - Binding of angiotensin antagonists to rat liver and brain membranes measured ex
      vivo.
AB  - 1. The effects of the angiotensin antagonists GR117289, losartan and Sar1Ala8
      angiotensin II on the ex vivo binding of [125I]-Sar1Ile8-angiotensin II to rat
      liver and cortex/hippocampus (Cx/H) membranes have been investigated. 2. GR117289
      (0.1-30 mg kg-1, s.c., 2 h pretreatment) caused a dose-dependent reduction in
      [125I]-Sar1Ile8-angiotensin II binding to both liver and cortex/hippocampus
      membranes. 3. Administration of a submaximal dose of GR117289 (1 mg kg-1, s.c.)
      indicated that the peak inhibition of binding in the liver occurred within 0.5 h,
      whereas the peak inhibition of binding in the Cx/H occurred 2 h after drug
      treatment. 4. The effect of GR117289 was long lasting. Binding was still reduced
      in the Cx/H 48 h after drug treatment (10 mg kg-1, s.c.) but had returned to
      normal 72 h after drug treatment. In the liver binding was still reduced 72 h
      after treatment with the same dose. 5. Losartan (1-30 mg kg-1, s.c.) was
      equipotent with GR117289 in its ability to reduce liver binding, but was less
      effective at inhibiting binding to central receptors. 6. The non-peptide
      antagonist Sar1Ala8-angiotensin II (3 and 10 mg kg-1) reduced binding in the
      liver but not in the Cx/H membranes. 7. These results suggest that, unlike the
      peptide antagonist Sar1Ala8-angiotensin II, the non-peptide angiotensin
      antagonists, GR117289 and losartan, are able to cross the blood brain barrier and
      occupy central angiotensin II receptors.

PMID- 8358572
TI  - Effects of rolipram and siguazodan on the human isolated bronchus and their
      interaction with isoprenaline and sodium nitroprusside.
AB  - 1 The effects of the selective inhibitors of cyclic AMP phosphodiesterase type IV
      (rolipram) and type III (siguazodan) and their interactions with isoprenaline and
      sodium nitroprusside have been studied in the human isolated bronchus. 2 On
      bronchi under resting tone rolipram was, in terms of potency (pD2 = 7.77 +/-
      0.14, n = 8), very similar to isoprenaline (pD2 = 7.31 +/- 0.12, n = 12) and
      salbutamol (pD2 = 7.12 +/- 0.17, n = 10) and approximately 10 fold more potent
      than siguazodan (pD2 = 6.80 +/- 0.12, n = 6). In terms of efficacy (Emax,
      expressed as percentage of maximal effect induced by theophylline 3 mM), both
      rolipram and siguazodan were less efficient (Emax = 74 +/- 6.7%, n = 8 and 66 +/-
      7.5%, n = 6, respectively) than isoprenaline (Emax = 98 +/- 0.4%, n = 12) and
      salbutamol (Emax = 83 +/- 2.4%, n = 10). 3 During precontraction induced by
      methacholine (3 x 10(-7) M) or acetylcholine (10(-3) M), concentration-response
      curves to rolipram and siguazodan were shifted to the right and maximal effects
      reduced. Rolipram was more potent than siguazodan and, in terms of efficacy, it
      was less active. 4. Rolipram 10(-8) and 10(-7) M but not siguazodan potentiated
      the effects of isoprenaline as shown by the shift to the left of the
      concentration-response curve to isoprenaline. Sodium nitroprusside-induced
      relaxation was not modified by either drug. 5. These results show that rolipram
      is a potent relaxant of the human isolated bronchus, potentiating the effects of
      beta-adrenoceptor stimulation and suggest that, as previously demonstrated in
      other species(guinea-pig, cow) (Tomkinson et al., 1993), there may be a
      connection between the beta2-adrenoceptor subtype, which predominate in human
      airway smooth muscle, and the cyclic AMP phosphodiesterase type IV.

PMID- 8358573
TI  - Endothelin receptors mediating contraction in goat cerebral arteries.
AB  - 1. The aim of the present study was to identify the subtype of receptor mediating
      contraction to endothelin-1 and sarafotoxin S6b in goat isolated middle cerebral
      arteries. 2. Endothelin-1, endothelin-2 and endothelin-3 contracted cerebral
      arteries in a concentration-dependent manner. Although the three peptides were
      full agonists, the order of potency was endothelin-1 = endothelin-2 > endothelin
      3, with a relative potency of endothelin-1 and endothelin-2 versus endothelin-3
      of approximately 280. Sarafotoxin S6b induced concentration-dependent
      contractions with lower potency than endothelin-1/endothelin-2, higher potency
      than endothelin-3 and a higher maximum response than the three endothelins. 3.
      The selective ETA-receptor antagonist, BQ-123, did not induce changes in either
      the resting tension or in the active tone developed by depolarization. In
      contrast, BQ-123 produced concentration-dependent relaxations of endothelin-1
      precontracted cerebral arteries, and to a greater extent of sarafotoxin S6b
      precontracted arteries. 4. Concentration-response curves to endothelin-1 and
      sarafotoxin S6b were competitively antagonized by BQ-123 (pA2 of 7.43 +/- 0.12
      and 8.41 +/- 0.09, respectively). In contrast, BQ-123 had no effect on 5
      hydroxytryptamine-elicited contractions even at 10(-6) M. 5. It is concluded that
      both the order of potency of endothelin isopeptides and the antagonism of BQ-123
      point to the existence of ETA receptors mediating vasoconstriction to endothelin
      1 and sarafotoxin S6b in the goat middle cerebral artery. The different
      antagonistic potency of BQ-123 against endothelin-I and sarafotoxin S6b suggests
      the existence of subtypes of ETA receptors.

PMID- 8358574
TI  - Hypercholesterolaemia severely impairs EDRF-dependent collateral perfusion
      following acute arterial occlusion in rabbit isolated ear.
AB  - 1. We have used a rabbit isolated buffer-perfused ear as a model of acute
      arterial occlusion to investigate the effects of dietary-induced
      hypercholesterolaemia on EDRF-dependent collateral perfusion. The effects of
      hypercholesterolaemia on endothelium-dependent relaxations to acetylcholine were
      also investigated in the unligated isolated buffer-perfused ear of the rabbit. 2.
      In rabbits receiving a high cholesterol diet (1%) for 4 weeks, blood cholesterol
      levels were significantly (P < 0.001) increased (26.0 +/- 3.6 vs. 2.6 +/- 0.6
      mmol l-1), EDRF-dependent collateral perfusion was similar to that in age-matched
      controls for the first 15 min after occlusion but then decreased and was
      significantly (P < 0.01) less than control during the maintenance phase of
      collateral perfusion. 3. Cholesterol feeding for 8 weeks (blood cholesterol =
      56.2 +/- 3.8 vs. 1.3 +/- 0.1 mmol l-1) was associated with almost complete
      impairment of collateral perfusion, an effect previously observed following
      inhibition of EDRF synthesis. 4. Endothelium-dependent relaxations to
      acetylcholine in isolated perfused ears were impaired in the rabbits fed the diet
      for 8 weeks but not those fed for 4 weeks. In the 8 week group, the maximum
      relaxation of tone was 32.6 +/- 11.6% and was significantly (P < 0.01) less than
      that in the controls (77.9 +/- 5.7%). 5. We conclude that EDRF-dependent
      collateral perfusion is severely impaired in hypercholesterolaemia and that the
      level of impairment is related to the duration of feeding.

PMID- 8358575
TI  - Non-adrenergic, non-cholinergic neural activation in guinea-pig bronchi: powerful
      and frequency-dependent stabilizing effect on tone.
AB  - 1. We examined non-adrenergic, non-cholinergic (NANC) stimulation for its
      stabilizing effect on bronchial smooth-muscle tone with respect to its regulatory
      power and the effect of variations in neural impulse frequency. 2. The guinea-pig
      isolated main bronchus (n = 4-12) was pretreated with indomethacin (10 microM)
      and incubated with atropine (1 microM) and guanethidine (10 microM). Electrical
      field stimulation (EFS: 1200 mA, 0.5 ms, 240 s) was applied at various levels of
      tone prior to EFS: first without tone, then at a moderate tone induced by
      histamine (0.3 microM) and, finally, at a high tone induced by histamine (6
      microM). Three different stimulation frequencies (1, 3 or 10 Hz) were used in
      order to produce moderate to near-maximum contractile and relaxant NANC neural
      responses. Both the contractile and the relaxant NANC responses were tetrodotoxin
      sensitive in the guinea-pig isolated main bronchus (3 Hz). 3. Without tone prior
      to EFS, NANC activation (1, 3 or 10 Hz) induced a pronounced contractile
      response. At a moderate level of tone prior to EFS, NANC activation induced a
      less pronounced contractile response. At the highest level of tone prior to EFS,
      NANC activation induced a relaxant response. All these NANC responses adjusted
      the tone towards a similar level and this 'stabilization level' was 56(6)% at 1
      Hz, 65(3)% at 3 Hz and 56(5)% at 10 Hz, expressed as a percentage of the maximum
      histamine-induced (0.1 mM) tone in each airway preparation. 4. There was a
      difference of approximately 90% of maximum between the highest and the lowest
      tone level prior to NANC activation. This difference was reduced by the
      converging contractile and relaxantNANC responses and the magnitude of this
      'convergence effect' was 40(8)% at 1 Hz, 72(4)% at 3 Hz and 90(2)% at 10 Hz.5.
      These findings indicate that NANC neural activation stabilizes bronchial smooth
      muscle tone via a contraction when the tone is low prior to activation and via a
      relaxation when the tone is high prior to activation. The NANC stabilizing effect
      on tone appears to be powerful and its magnitude can be controlled by the neural
      impulse frequency. The level of tone towards which the NANC responses converge
      does not appear to be markedly altered by variations in the impulse frequency.
      Our findings are consistent with a regulatory role for NANC responses in the
      control of bronchial smooth-muscle tone.

PMID- 8358576
TI  - Antiarrhythmic drugs, clofilium and cibenzoline are potent inhibitors of
      glibenclamide-sensitive K+ currents in Xenopus oocytes.
AB  - 1. The novel K+ channel opener, Y-26763 induced outward K+ currents in voltage
      clamped follicle-enclosed Xenopus oocytes in a concentration-dependent manner
      with an EC50 value of 58 microM. 2. The Y-26763-induced K+ current was completely
      and reversibly blocked by glibenclamide (an ATP-sensitive K+ channel blocker) in
      a concentration-dependent manner (IC50 140 nM). Effects of several antiarrhythmic
      drugs on Y-26763-induced glibenclamide-sensitive K+ currents were investigated.
      3. (+/-)-Cibenzoline, RS-2135, pirmenol, lorcainide and KW-3407 (class I
      antiarrhythmic drugs, Na+ channel blockers) suppressed Y-26763 responses in a
      concentration-dependent manner with IC50 values (in microM) of 6.6, 54, 68, 71
      and 370, respectively. 4. Clofilium, E-4031, MS-551 and bretylium (class III
      antiarrhythmic drugs which increase the action potential duration) also
      suppressed Y-26763 responses concentration-dependently, IC50 values (in microM)
      were 3.3, 660, 980 and > or = 2000, respectively. N-acetylprocainamide (class III
      antiarrhythmic drug) scarcely suppressed Y-26763 responses. 5. The glibenclamide
      sensitive K+ currents elicited by KRN2391 were also suppressed by all these
      antiarrhythmic drugs. 6. The antiarrhythmic drugs, clofilium and (+/-)
      cibenzoline block glibenclamide-sensitive K+ channels in Xenopus oocytes at
      concentrations comparable to their therapeutic plasma levels.

PMID- 8358577
TI  - Enhancement by endothelin-1 of microvascular permeability via the activation of
      ETA receptors.
AB  - 1. The objective of the present experiments was to assess the involvement of
      endothelin-A (ETA) receptors in mediating the effects of endothelin-1 on
      microvascular permeability in conscious rats. 2. Bolus injection of endothelin-1
      (0.1 and 1 nmol kg-1, i.v.) resulted in a dose-dependent prolonged pressor effect
      preceded by a transient depressor response. These changes were accompanied by a
      dose-dependent loss of plasma volume. Endothelin-1 (1 nmol kg-1) enhanced the
      vascular permeability of the upper and lower bronchi, kidney, stomach, duodenum
      and spleen (up to 270%) as measured by the extravasation of Evans blue dye. 3.
      Pretreatment of the animals with the selective ETA receptor antagonist, BQ-123 (1
      mg kg-1, i.v.) significantly blunted the pressor response to endothelin-1 without
      affecting the depressor response. BQ-123 inhibited by 87% the endothelin-1 (1
      nmol kg-1)-induced plasma volume loss. BQ-123 markedly attenuated protein
      extravasation elicited by endothelin-1 in the upper and lower bronchi and kidney,
      whereas it completely inhibited the permeability effect of endothelin-1 in the
      stomach and duodenum. BQ-123 by itself had no significant effect on the
      parameters studied. 4. The endothelin-1 analogue, [Trp(For)21]-endothelin-1, in
      which Trp21 is formylated, was as potent a pressor agent as endothelin-1, but had
      no depressor action. Bolus injection of [Trp(For)21]-endothelin-1 (0.1 and 1 nmol
      kg-1, i.v.) evoked similar plasma volume losses to those observed following
      administration of equimolar doses of endothelin-1. Furthermore, 1 nmol kg-1
      [Trp(For)21]-endothelin-l evoked increases in protein extravasation similar to
      endothelin-l, 1 nmol kg-1.5. The present findings suggest that endothelin- 1
      enhances microvascular permeability, in part, via the activation of ETA
      receptors.

PMID- 8358578
TI  - Influence of exercise adherence level on modifiable coronary heart disease risk
      factors and functional-fitness levels in middle-aged men.
AB  - The study investigated the potential health benefits of two levels of short-term
      exercise intervention, compared with non-intervention, on selected modifiable
      coronary heart disease (CHD) risk factors and functional fitness states in middle
      aged men. All subjects underwent medical screening and signed informed consent
      before carrying out a standardized graded treadmill walk which required exercise
      up to 85% of age-predicted maximal heart rate. The results of the test were used
      together with musculoskeletal fitness assessments, for the prescription of a
      personalized exercise programme lasting 14 weeks. In all, 55 subjects were
      classified by adherence into high (HA, n = 20), low (LA, n = 19), or non
      adherence (NA, n = 16) groups according to the degree of documented participation
      in the programme based on standard criteria (American College of Sports Medicine
      1978, 1990). In addition, the respective groups of subjects were classified
      according to other modifiable and non-modifiable CHD risk factors and compared by
      self-reported levels of activity and sport involvement as well as perceived body
      weight classification. The results indicated that there were more comprehensive
      improvements in functional fitness including significant gains in aerobic
      endurance capacity, muscular endurance and flexibility in the HA group compared
      with the LA and NA groups. However, there was little or no change in the
      modifiable CHD risk factors in any of the respective groups, although
      anthropometric indices of weight, body mass index (BMI), skinfolds and waist:hips
      ratio tended to decrease in the HA and LA groups but increased marginally in the
      NA group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358579
TI  - Evaluation of the Colin STBP-680 at rest and during exercise: an automated blood
      pressure monitor using R-wave gating.
AB  - The application of automated blood pressure measurement during exercise has been
      limited by inaccuracies introduced by the effects of accompanying motion and
      noise. We evaluated a newly developed automated blood pressure monitor for
      measuring exercise blood pressure (Colin STBP-680; Colin, San Antonio, Texas,
      USA). The STBP-680 uses acoustic transduction with the assistance of the
      electrocardiogram R-wave to trigger the sampling period for blood pressure
      measurement. The automated monitor readings were compared with simultaneous
      technician mercury sphygmomanometric readings in the same arm. Blood pressure was
      measured in 18 men at rest and during exercise at 40% VO2 peak, (low intensity),
      70% VO2 peak (moderate intensity) and VO2 peak (high intensity) on the cycle
      ergometer. Mean(s.d.) systolic blood pressure difference between the automated
      monitor and mercury manometer readings at rest and during exercise at low,
      moderate and high work intensities were 3(0) mmHg, 3(2) mmHg, 1(1) mmHg, and
      0(11) mmHg respectively (analysis of variance; P > 0.05). Resting diastolic blood
      pressure obtained with the STBP-680 was similar to the mercury manometer readings
      (78(10) versus 81(7) mmHg (P > 0.05). Exercise diastolic pressure at the low
      level of work intensity was almost identical between the automated monitor and
      mercury manometer readings (64(8) versus 65(10) mmHg (not significant)).
      Diastolic blood pressure readings between the STBP-680 and mercury manometer
      showed a greater difference at the moderate and high workloads (11 mmHg and 9
      mmHg, respectively), but this difference was not significant (P > 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8358580
TI  - Effectiveness of functional ankle taping for judo athletes: a comparison between
      judo bandaging and taping.
AB  - This study was conducted to compare the effectiveness of the traditional method
      of ankle bandaging and the new method of ankle taping for judo athletes in Japan,
      and to introduce a functionally effective taping method for judo players. Four
      university judo athletes with ankle instability were selected to undertake
      radiography of the ankles before and after exercise, with bandaging at one time
      and taping at the other. Talar tilt (TT) angles were measured in order to compare
      the ankle-supporting effects. The results showed that the old ankle bandaging
      method had no role in eliminating the talar tilt during judo practice. In
      contrast, the new taping method was more effective in eliminating the talar tilt
      and supporting the involved ankles both mechanically and functionally.

PMID- 8358581
TI  - Audit of knee injuries seen in a sports medicine clinic.
AB  - In order to assess the management of knee injuries in a sports medicine clinic,
      an audit was performed of all new patients who attended the clinic over a 12
      month period. Of the 167 new patients seen, 76 (46%) had sustained knee injuries.
      Of these, 43 (57%) were treated in the sports medicine clinic and 33 (43%) were
      referred for arthroscopic assessment. The maximum waiting time from the time of
      referral was 3 weeks, with 85% of patients seen within 1 week and 92% within 2
      weeks. Arthroscopy was performed on 28 (85%) of the 33 patients referred, and the
      positive correlation between the sports clinic diagnosis and the arthroscopic
      diagnosis was 64%. Of the 33 patients referred for arthroscopy, 28 (85%) had
      sustained acute knee injuries while five (15%) had been treated at other
      hospitals before referral to the sports medicine clinic. A National Health
      Service sports medicine clinic is an effective means of treating knee injuries,
      provided that access to arthroscopy is readily available.

PMID- 8358582
TI  - Spinal injuries in sports in the UK.
AB  - An analysis was made of 150 rugby, trampolining, gymnastics and horse-riding
      injuries between 1952 and 1985, resulting in severe spinal injury. The individual
      analyses of the separate sports had been published previously. There are common
      factors to all these sports. Of those injured 121 had cervical injuries often as
      a result of participation in sport by young impetuous people, and causes
      included: inadequate supervision; motivation to attempt tasks beyond their
      abilities; a mismatch between the abilities of the performer and the task
      attempted.

PMID- 8358583
TI  - Surgical treatment of dislocations of the acromioclavicular joint in the athlete.
AB  - The treatment of the sports related dislocation of the acromioclavicular joint
      remains controversial. This study was carried out to determine whether or not a
      combined surgical procedure consisting of repair and polydioxanone (PDS)-cord
      augmentation of the coracoclavicular ligaments, fixation of the acromioclavicular
      joint with a single Kirschner wire as well as the repair of the acromioclavicular
      ligament permitted return to athletic activity. Athletes were examined with
      regard to their range of motion, pain and their ability to return to the
      performance level achieved before the injury. During the period 1986-1989, 21
      athletes were treated. Follow-up averaged 22 months. Return of athletes to
      previous performance level was related to their original degree of activity. Two
      recreational once-a-week athletes did not return to this level, 19 patients,
      including five competitive athletes, continued their previous activities. There
      was no correlation between coracoclavicular ossification or post-traumatic
      arthritis and a good or excellent result. We recommend the operative treatment of
      acromioclavicular separations in athletes.

PMID- 8358584
TI  - Shoulder tendinitis and osteoarthrosis of the acromioclavicular joint and their
      relation to sports.
AB  - A sample of 207 men from the construction industry was studied using an
      epidemiological technique of cross-sectional design to investigate if sport
      activities involving the arms increase the risk of developing shoulder tendinitis
      or osteoarthrosis of the acromioclavicular joint. The relative risk for shoulder
      tendinitis was estimated to be 9.5 on the right side, and 4.9 on the left side
      for a lifetime of sport activity exceeding 8399 h. Subjects who reported both
      extremely high physical load from work and from sports had an estimated relative
      risk for signs of shoulder tendinitis of 5.9 on the right side and 10.4 on the
      left side. High sport activity yielded relative risks of 4.6 on the right side
      and 2.8 on the left side for osteoarthrosis of the acromioclavicular joint. The
      combination of high activity in sports and high exposure to load lifted during
      work yielded relative risks for osteoarthrosis of the acromioclavicular joint of
      12.5 on the right side and 6.7 on the left side. There seems to be an increased
      risk for shoulder tendinitis and acromioclavicular osteoarthrosis for subjects
      who have been extremely active in sports, and an even higher risk for those who
      have been extremely active in sports and also report a high exposure to load
      lifted during work.

PMID- 8358585
TI  - Patient assessment of treatment following knee injury.
AB  - A survey of 100 sports-injured cases was carried out to elicit patients' personal
      assessment of their treatment and to investigate the utility of a typical
      database system for recording and analysis. The cases were limited to knee
      injuries, with a high proportion arising from football of various types and
      interesting light was thrown on several possible contributory factors.

PMID- 8358587
TI  - Clenbuterol: a medal in tablet form?

PMID- 8358586
TI  - American football injuries in Finland.
AB  - American football is currently played in 14 European countries. It is a contact
      sport where injuries are inevitable. In this study, injuries causing more than
      one week of absence from game or practise were registered during the 1991
      preseason and season. A total of 112 injuries was reported among 684 players.
      Knees were most vulnerable to injury (28.6%) followed by ankle injuries (16.7%).
      Operations were performed on 28 (25%) of the injured players. Catastrophic
      injuries can occur in this sport, but none has happened in Finland during the 12
      years for which the sport has been practised. The skill level was not a
      contributing factor. The frequency of injuries and their profile closely resemble
      those in US-based studies so it is suggested that the precautions and preventive
      measures recommended in the USA should be applied and followed in Europe.

PMID- 8358588
TI  - Hong Kong Sports Institute: sports medicine and science from theory to practice.

PMID- 8358589
TI  - Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

PMID- 8358590
TI  - Arthrography and arthrotomy of the knee in sports injuries.
AB  - A total of 266 patients with injuries to the knee sustained during sports
      activities were managed by arthroscopy and/or arthrotomy. All of them received
      systemic examination and a standard battery of knee stability tests. Fifty-three
      were examined by arthrography and all underwent arthrotomy for surgical
      correction of the lesion diagnosed by both clinical examination and arthrography.
      Our study showed that clinical examination could give an accurate clinical
      diagnosis in 88.35% of cases and arthrography in 76.89%. No complication from
      arthrography was found. Injury occurred most commonly between 21 and 30 years of
      age and was more common to the right knee than the left. The sport in which most
      injuries occurred was football.

PMID- 8358591
TI  - Closed extensor tendon rupture and distal radial fracture with use of a gymnast's
      wrist support.
AB  - We report a case of delayed closed rupture of the tendon of extensor indicis
      proprius in a skeletally immature individual. This occurred following a minor
      greenstick fracture during use of a gymnast's wrist-finger support. To our
      knowledge this unusual complication has not been described previously.

PMID- 8358593
TI  - Speech perception and brain laterality: the effect of ear advantage on auditory
      event-related potentials.
AB  - Dichotic listening has been used for assessing asymmetries in processing auditory
      stimuli. It is known that there is better recognition of dichotic stimuli in the
      right ear with verbal stimuli (right ear advantage, REA) by the majority of the
      subjects. We were interested in the psychophysiological correlates of ear
      advantage as it is manifested in event-related potentials (ERP). We compared ERPs
      to monaural and dichotic syllables in stable REA and LEA subjects. The most
      consistent finding was that REA subjects show larger positive ERP deflections
      over the left hemisphere (maximal at T5) and LEA subjects over the right
      hemisphere (maximal at T6) both at the latency range of 320-340 msec. Thus, brain
      event-related potentials support the contention that the REA and LEA reflect
      differential activation of the left and right hemispheres, respectively.

PMID- 8358592
TI  - Sports medicine: some ethical issues.
AB  - The ethical aspects of sports medicine have hitherto received little scrutiny, in
      contrast to its legal implications, which have recently been subject to much
      greater discussion. However, the differences that are apparent between sports
      medicine and 'mainstream' areas of clinical practice can shed new light on a
      number of the central issues within health-care ethics. By means of hypothetical
      case studies, this paper seeks to examine some of these issues within a sports
      medicine context. Specific attention will be paid to the concepts of autonomy and
      paternalism, issues to do with truthfulness, and the question of conflicting
      professional loyalties. It is suggested that the ethics of sports medicine
      warrant further and more detailed examination.

PMID- 8358594
TI  - Automatic access to lexical semantics in aphasia: evidence from semantic and
      associative priming.
AB  - We report the auditory lexical decision performance of four patients, all of whom
      are clinically diagnosed as Broca's aphasics. In a task that separates
      associative from semantic priming, all four patients show significant priming
      effects and no interaction with type of relatedness. We find no evidence to
      support some of the current accounts of these patients' linguistic difficulties
      in terms of an impairment in automatic processing routines. Instead, we argue
      that automatic access to lexical semantics is intact.

PMID- 8358595
TI  - Intraword timing relations in Thai after unilateral brain damage.
AB  - The present study examined temporal characteristics of monosyllabic, bisyallabic,
      and trisyllabic words in Thai to evaluate timing control at the word level in
      brain-damaged patients. Subjects included young and old normal adults, right
      hemisphere patients, and left hemisphere nonfluent and fluent aphasic patients.
      Utterances were produced at a conversational speaking rate. Results indicated
      that, on an absolute or relative measurement scale, magnitude of the shortening
      effect on nonfinal syllables in polysyllabic words was significantly smaller in
      left nonfluent aphasics than in other groups. In trisyllabic words, duration of
      the penultimate syllable for left fluent aphasics was also significantly longer
      than that of normals. Left nonfluent and fluent aphasics were significantly more
      variable than other speakers in their production of bisyllabic and trisyllabic
      words. Findings are discussed in relation to issues pertaining to the nature of
      timing deficits in nonfluent and fluent aphasic patients.

PMID- 8358596
TI  - Diazepam therapy of verbal auditory agnosia.
AB  - A 7-year-old girl suffered from a gradual loss of her ability to understand
      speech. But she had normal hearing and understood various environmental sounds.
      Brain computerized axial tomography showed normal, but electroencephalogram
      revealed spike and wave activity from temporal leads, especially on the left
      side. She was diagnosed as having verbal auditory agnosia. The treatment
      consisted of diazepam therapy. One year after the onset, her impaired auditory
      comprehension dramatically improved with the use of diazepam. The dichotic
      listening test revealed a left ear advantage for both environmental sounds and
      spoken words. The results seemed to suggest that in this patient the right
      hemisphere might be functioning as a speech center instead of the left one.

PMID- 8358597
TI  - Impairments of lexical-semantic processing in aphasia: evidence from the
      processing of lexical ambiguities.
AB  - Broca's and Wernicke's aphasics performed speeded lexical decisions on the third
      member of auditorily presented triplets consisting of two word primes followed by
      either a word or a nonword. In three of the four priming conditions, the second
      prime was a homonym with two unrelated meanings. The relation of the first prime
      and the target with the two meanings of the homonym was manipulated in the
      different priming conditions. The two readings of the ambiguous words either
      shared their grammatical form class (noun-noun ambiguities) or not (noun-verb
      ambiguities). The silent intervals between the members of the triplets were
      varied between 100, 500, and 1250 msec. Priming at the shortest interval is
      mainly attributed to automatic lexical processing, and priming at the longest
      interval is mainly due to forms of controlled lexical processing. For both
      Broca's and Wernicke's aphasics overall priming effects were obtained at ISIs of
      100 and 500 msec, but not at an ISI of 1250 msec. This pattern of results is
      consistent with the view that both types of aphasics can automatically access the
      semantic lexicon, but might be impaired in integrating lexical-semantic
      information into the context. Broca's aphasics showed a specific impairment in
      selecting the contextually appropriate reading of noun-verb ambiguities, which is
      suggested to result from a failure either in the on-line morphological parsing of
      complex word forms into a stem and an inflection or in the on-line exploitation
      of the syntactic implications of the inflectional suffix. In a final experiment
      patients were asked to explicitly judge the semantic relations between a subset
      of the primes that were used in the lexical decision study. Wernicke's aphasics
      performed worse than both Broca's aphasics and normal controls, indicating a
      specific impairment for these patients in consciously operating on automatically
      accessed lexical-semantic information.

PMID- 8358598
TI  - Anomia for facial expressions: neuropsychological mechanisms and anatomical
      correlates.
AB  - We report a patient with a selective impairment in naming and pointing to
      emotional facial expressions following a circumscribed lesion of the right
      temporal lobe. Detailed investigation of this patient's deficit revealed that the
      neuropsychological mechanism underlying his anomia for facial expressions is best
      understood as a category-specific bidirectional visual-verbal disconnection
      between intact visual semantic and verbal semantic representations for facial
      emotions. Magnetic resonance imaging findings from this case and from another
      patient previously described with this unique syndrome (Rapcsak, Kaszniak, &
      Rubens, 1989), together with the results of cortical electrical stimulation
      studies and microelectrode recordings of cortical neuronal activity in epileptic
      patients, provide converging evidence that the inferotemporal visual association
      cortex of the right middle temporal gyrus plays an important functional role in
      the verbal labeling of emotional facial expressions. The implications of these
      findings for cognitive and neural models of facial affect processing are
      discussed.

PMID- 8358600
TI  - An investigation of attention allocation deficits in aphasia.
AB  - Nine aphasic and 18 normal adults participated in a dual task with components of
      phoneme monitoring and semantic judgment. Subjects listened to lists of recorded
      spoken words and were required to detect semantic and phonetic targets. Two
      within-subject variables were manipulated: the probability of target occurrence
      for each dual-task component (.2, .5, and .8) and the explicitness of instruction
      (explicit vs. implicit). Only in the explicit condition were subjects told about
      the probability structure and given the attention allocation strategy congruent
      with that structure. Reaction times were recorded on-line for analysis by an IBM
      AT. The results showed that normal subjects' overall latencies in detecting
      phonetic targets decreased as the target occurrence probability increased in both
      implicit and explicit instruction conditions. The detection latencies for
      semantic targets showed a similar probability effect but only in the explicit
      condition. By contrast, the aphasic subjects did not show the probability effect
      in any condition, although they performed above the chance level on both semantic
      and phonetic tasks. The presence of the probability effects for the normal
      subjects indicated that an efficient attention allocation mechanism was operating
      so as to optimize the performance level. On the other hand, the absence of
      probability effects for the aphasic subjects suggests that their attention
      control system might be inefficient so that task-demand cues (probability and
      attention allocation instruction) were not utilized properly.

PMID- 8358599
TI  - Memory impairment and executive control in individuals with stroke-induced
      aphasia.
AB  - The purpose of this study was to examine memory abilities of aphasic individuals
      in relation to site of neurological lesion. Fourteen individuals with stroke
      induced aphasia (7 with anterior lesions; 7 with posterior lesions) and 14
      demographically matched control subjects were given selected tests of short-term
      memory (STM) and long-term memory (LTM). Stroke patients were impaired relative
      to control subjects on tests of verbal memory, with greater impairment of LTM
      associated with anterior lesions and greater impairment of STM associated with
      posterior lesions. Verbal memory performance did not correlate highly with
      language ability, and did not appear to be simply a consequence of language
      impairment. Executive control deficits were postulated as explanatory of the LTM
      impairment associated with anterior lesions.

PMID- 8358601
TI  - Blunting of the neurotensin mRNA response to haloperidol in the striatum of aging
      rats: possible relationship to decline in dopamine D2 receptor expression.
AB  - Neuroleptic drugs such as haloperidol (H) induce a rapid increase in
      neurotensin/neuromedin N (NT/N) gene expression in the dorsolateral striatum
      (DLSt) and nucleus accumbens (NA) in young adult rats. This effect may be
      mediated by post-receptor effectors that are activated by dopamine D2 receptor
      antagonism. The regional pattern of induction of neurotensin gene expression
      correlates with the side effect profile of particular neuroleptics. As motor side
      effects of H differ in aged animals, we hypothesized that the regional expression
      of the neurotensin gene may differ between young and old animals. We administered
      H or saline acutely to 3, 14, and 25 month-old Fischer 344 rats, followed by in
      situ hybridization and quantitative autoradiography for NT/N mRNA. There was a
      significant age effect on the H-induced NT/N mRNA response in the DLSt, but not
      the NA, of older animals. In addition to the blunted NT/N mRNA response,
      significant decreases in D2 receptor mRNA were observed in the lateral striatum
      of another group of young, middle-aged, and aged rats. Age-related blunting of
      the NT/N mRNA response to H in the DLSt may be due in part to a decrease in D2
      receptors in this structure.

PMID- 8358602
TI  - Intracerebroventricular administration of corticotropin-releasing factor induces
      c-fos mRNA expression in brain regions related to stress responses: comparison
      with pattern of c-fos mRNA induction after stress.
AB  - Centrally administered corticotropin-releasing factor (CRF) produces a number of
      physiological and behavioral changes akin to those elicited by exposure to acute
      stress. However, the specific brain site of action responsible for the centrally
      activating property of CRF has not been precisely determined. In this study, we
      used in situ hybridization histochemistry for c-fos mRNA to map potential
      neuronal structures activated after intracerebroventricular (i.c.v.) injection of
      CRF and compared the distribution of c-fos mRNA with that after stress. Wistar
      male rats were sacrificed 30, 60, 120 and 180 min after the i.c.v. injection of 1
      microgram ovine CRF or vehicle alone. Another group of rats was exposed to
      immobilization stress for 60 min or electrical foot-shock stress (1.5 mA, 1-s
      duration, 30 x) for 15 min and sacrificed before and 30, 60, 120 and 180 min
      after the beginning of stress. Centrally administered CRF rapidly (30-60 min)
      induced c-fos mRNA expression in most of the areas that showed hybridization
      signals for c-fos after stress: the limbic structures, including the piriform
      cortex, cingulate cortex, the lateral septal nucleus, the hippocampus, the
      anterior corticomedial and the medial amygdaloid nuclei, the hypothalamic nuclei,
      such as the paraventricular nucleus, the supraoptic nucleus (SO) and the
      dorsomedial nucleus (DMD), and some brainstem nuclei like the pontine nucleus,
      the locus ceruleus (LC) and Barrington's nucleus. The granular layer of the
      cerebellum, some thalamic nuclei and the habenula also showed hybridization
      signals after i.c.v. injection of CRF and stress. However, c-fos induction in the
      bed nucleus of the stria terminalis, the central nucleus of the amygdala (CeA)
      and the nucleus tractus solitarius (SOL) was seen only after i.c.v.
      administration of CRF; in the septo-hypothalamic nucleus and the superior olive,
      however, c-fos mRNA expression was observed only after stress. There were no
      differences in the pattern of c-fos mRNA expression between the two stress
      paradigms. In contrast, i.c.v. injection of saline-induced expression of c-fos
      mRNA in the piriform cortex, neocortex, cingulate cortex and the amygdala was
      much less than that seen after i.c.v.-administered CRF as evident in the
      intensity of the signals. These results suggest that CRF produces c-fos mRNA
      expression in the brain areas related to stress response, and that CRF may induce
      behavioral and neuroendocrine responses through activating these brain
      structures, such as the limbic system and the hypothalamic nuclei.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8358604
TI  - Olfactory sensitivity of rats with transection of the lateral olfactory tract.
AB  - Rats with discrete transection of the lateral olfactory tract (LOT) were tested
      using operant conditioning and psychophysical methods for their amyl acetate
      intensity difference threshold and absolute detection threshold. Experimental
      rats performed as well as controls on the easiest problems of both threshold
      series but their intensity difference threshold was approximately 2.5 times as
      high as controls and their absolute detection threshold was approximately 2.25
      orders of magnitude higher than controls. The deficit in sensitivity in both
      tests was related to the frontal level at which the tract was cut; rats with the
      most rostral transection had the greatest increase in threshold. The absolute
      detection threshold of rats with transection of the LOT was increased to that of
      normal human subjects tested with the same apparatus.

PMID- 8358603
TI  - Neurobehavioral changes produced in rats by prenatal exposure to carbon monoxide.
AB  - Wistar female rats were exposed to relatively mild concentrations of carbon
      monoxide (75 and 150 ppm) from day 0 to day 20 of pregnancy. The results show
      that prenatal exposure to CO (150 ppm) produced a significant reduction in the
      minimum frequency of ultrasonic calls emitted by rat pups removed from their
      nest. Moreover, a significant decrease in the responsiveness (rate of calling) to
      a challenge dose of diazepam (0.25 mg/kg) was found in male pups exposed to CO
      (150 ppm) during gestation. Prenatal CO (75 and 150 ppm) did not significantly
      affect locomotor activity or D-amphetamine-induced hyperactivity in both 14- and
      21-day-old animals. Furthermore, adult male rats exposed to this chemical (150
      ppm) during gestation exhibited significant alterations in the acquisition of an
      active avoidance task. CO-induced learning disruption does not seem to be linked
      to changes in the emotionality of animals. These findings suggest that
      gestational exposure to CO induces in rat offspring both short- and long-term
      behavioral changes characterized by altered ontogeny of emotional responsiveness
      to environmental challenges and by learning impairment.

PMID- 8358605
TI  - NMDA glutamatergic receptors, labelled with [3H]MK-801, in brain samples from
      drug-free depressed suicides.
AB  - Glutamate receptors of the NMDA-subtype were quantitated by binding of
      [3H]dizocilpine maleate (MK-801) in nine brain regions from 22 suicide victims
      (20-60 yr), with a firm retrospective diagnosis of depression, who had not
      recently received antidepressant drugs, and 20 age- and sex-matched controls.
      [3H]MK-801-binding did not differ between suicides and controls in any region
      studied. Suicides who died violently did not differ from non-violent suicides and
      controls. A significative negative correlation was found between age and NMDA
      receptor-binding in the frontal cortex of suicide victims, but not in controls.
      This preliminary study provides little evidence for an important role of NMDA
      binding sites in the pathophysiology of depression.

PMID- 8358606
TI  - Influence of GABA on neurons of the gustatory zone of the rat nucleus of the
      solitary tract.
AB  - The role of gamma-aminobutyric acid (GABA) as an inhibitory neurotransmitter in
      the rostral, gustatory zone of the nucleus of the solitary tract (rNST) was
      examined using whole cell recordings in brain slices of the adult rat medulla.
      Superfusion of GABA resulted in a concentration-dependent reduction in input
      resistance in 68% of the neurons in rNST. The change in input resistance was
      often accompanied by membrane hyperpolarization. The effect of GABA was a direct
      action on the postsynaptic membrane since it could be elicited when synaptic
      transmission was blocked by tetrodotoxin or in a low Ca2+ and high Mg2+ perfusing
      solution. The mean reversal potential of the GABA effect was about -60 mV,
      determined by applying GABA at different holding potentials, or from the
      intersection of current-voltage curves measured in control saline and saline
      containing GABA. When neurons were separated into groups based on intrinsic
      membrane properties, some neurons in each group responded to GABA. Superfusion of
      the slices with either the GABAA agonist, muscimol, or the GABAB agonist,
      baclofen, caused a decrease in input resistance accompanied by membrane
      hyperpolarization. The GABAA antagonist bicuculline either totally or partially
      blocked the neuronal response to GABA and blocked the response to muscimol but
      did not antagonize responses to baclofen. Superfusion of the GABAB antagonist
      phaclofen depressed the membrane responses to GABA. The use of the GABAA and
      GABAB agonists and antagonists demonstrates that some neurons in rNST have both
      GABAA and GABAB receptors. Since most rNST neurons studied respond to GABA,
      inhibition probably plays a major role in sensory processing by the rNST.

PMID- 8358607
TI  - Mesencephalic microinjections of neurotensin-(1-13) and its C-terminal fragment,
      neurotensin-(8-13), potentiate brain stimulation reward.
AB  - Using the curve shift method, we assessed the effects of ventromedial
      mesencephalic tegmental (VMT) microinjections of an equimolar concentration of
      neurotensin-(1-13) (NT-(1-13)) and of its C-terminal fragment, neurotensin-(8-13)
      (NT-(8-13)), on operant responding for rewarding electrical stimulation of the
      caudal mesencephalic central gray. The effects of NT-(1-13) and NT-(8-13) on
      brain stimulation reward (BSR) were also compared to those of systemically
      administered quinpirole (0.1 and 0.2 mg/kg, s.c.), a direct dopamine agonist, and
      GBR-12909 (10 and 20 mg/kg, i.p.), a selective dopamine uptake blocker. At the
      concentration injected, NT-(8-13) was as effective as NT-(1-13) at facilitating
      BSR, producing significant leftward shifts of the function relating the rate of
      responding to the stimulation frequency (R/F function); neither form of the
      peptide was effective when injected in regions dorsal to the VMT. Similarly, GBR
      12909 produced a parallel leftward shift of the R/F function, but, unlike NT-(1
      13), also significantly increased the asymptotic rates of responding. In
      contrast, the high dose of quinpirole produced non-parallel leftward shifts of
      the R/F function and suppressed the asymptote. The similarity between the effects
      of neurotensin and GBR-12909 on one hand, and the differences between those of
      neurotensin and quinpirole on the other, suggest that activation VMT neurotensin
      receptors potentiate BSR by enhancing increases in dopamine neurotransmission
      that are contingent upon operant responding or rewarding brain stimulation, or
      both.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358608
TI  - Polyamines modulate the neurotoxic effects of NMDA in vivo.
AB  - The ability of polyamines to alter NMDA-induced neurotoxicity in neonatal rats
      was examined to determine whether polyamines modulate NMDA receptor activity in
      vivo. Unilateral injections of NMDA and/or polyamines were made into the striatum
      of 7-day-old rats. After 5 days, the brains were removed and 20 microns thick
      coronal sections were cut and stained with Cresyl violet. A computer-based image
      analysis system was used to densitometrically measure the cross-sectional area of
      intact tissue in the control and injected hemispheres. Administration of NMDA (5
      40 nmol) produced a dose-dependent tissue damage that ranged from 7 to 52% of the
      area of the uninjected hemisphere. The polyamine agonist spermine (10-500 nmol)
      dose-dependently exacerbated the toxicity of a 15 nmol dose of NMDA, increasing
      the size of the lesion by up to 50%. Administration of spermine alone produced
      dose-dependent tissue damage that ranged from 9 to 52%. The damage produced by
      both NMDA and spermine could be completely inhibited by co-administration of the
      NMDA antagonist MK-801. The polyamine inverse agonist 1,10-diaminodecane (DA-10,
      50-400 nmol) inhibited the damage produced by NMDA in a dose-dependent manner,
      with a maximal inhibition of 50%. Administration of DA-10 alone produced limited
      damage at doses above 100 nmol. The weak partial agonist diethylenetriamine had
      no effect by itself or on NMDA-induced toxicity at the doses tested. These
      results indicate that polyamines can modulate the activity of NMDA receptors in
      vivo and suggest that polyamines or related compounds may have important
      therapeutic potential as neuroprotective agents.

PMID- 8358609
TI  - Kindling antagonism: mapping of susceptible sites.
AB  - Previous research has shown that concurrent alternating stimulation of paired
      limbic sites culminates in kindling of generalized seizures from 1 (dominant)
      site, whereas the other (suppressed) site supports only focal or partial
      seizures. This phenomenon has been referred to as kindling antagonism, and it has
      been proposed that antagonism reflects an arrest of kindling, which is therefore
      viewed as a non-continuous stepwise process. We have attempted to replicate these
      important observations in adult rats stimulated in various combinations of
      forebrain sites. Kindling antagonism was displayed by rats stimulated in the
      amygdala and the septal area, in the bilateral amygdala, the septal area and the
      splenium of the corpus callosum, and the amygdala and the cingulate cortex. We
      also found that antagonism between the amygdala and septal area as well as
      electrographic and behavioral correlates of alternating stimulation were
      sensitive to the hemispheric relation of the electrodes and to the order in which
      the sites received initial stimulations. That is, rats that carried ipsilateral
      amygdaloid and septal electrodes were less likely to display antagonism when the
      amygdala was the first site stimulated. On the other hand, we failed to obtain
      antagonism from rats stimulated in other limbic pairs (e.g. entorhinal cortex and
      septal areas.

PMID- 8358610
TI  - Mechanical hyperalgesia in streptozotocin-diabetic rats is not sympathetically
      maintained.
AB  - It has been suggested that the mechanism underlying the pain that occurs in
      patients with diabetic neuropathy may be similar to that mediating
      sympathetically maintained pain (SMP), such as occurs in patients with reflex
      sympathetic dystrophy. To evaluate this suggestion we have examined a model of
      diabetes mellitus, the streptozotocin-diabetic (STZ-D) rat, for features
      characteristic of SMP. We demonstrate that the decrease in nociceptive threshold
      observed in the STZ-D rat is not attenuated by chemical sympathectomy nor
      exacerbated by intradermal injection of norepinephrine (NE). In addition, the NE
      content is markedly decreased in the skin of the STZ-D rat. These results suggest
      that altered nociceptive thresholds associated with diabetic neuropathy are not
      sympathetically maintained.

PMID- 8358611
TI  - Neuronal loss in the human claustrum following ulegyria.
AB  - The claustrum is a large subcortical structure that in animals possesses
      extensive connections with almost all regions of the cerebral cortex. Because
      there are no data that support the presence of claustrocortical connections in
      human brain, the main aims of the present study were to confirm the existence of
      these connections in the human brain. Five control brains and nine brains with
      bilateral and large ulegyria were studied. Severe neuronal loss in the anterior
      part of the claustrum was observed after pathological lesions that involved the
      frontal cortex. Pathological changes localized in the parietal and occipital
      cortices caused neuronal loss in the central and posterior part of the human
      claustrum. These findings suggest that the human claustrum is dependent on the
      neocortex and that, as in animals, it possesses extensive connections with the
      cerebral cortex that are topographically organized. The anterior part of the
      claustrum is connected with the frontal cortex, and the central and posterior
      parts with the parietal and occipital cortices.

PMID- 8358612
TI  - Abdominal vagal afferents excite A1 area neurons antidromically activated from
      the region of the supraoptic nucleus in the rabbit.
AB  - We made extracellular recordings from 113 spontaneously active neurons in the A1
      area, after identifying the cells by antidromically activating them from the
      region of the supraoptic nucleus in urethane-anesthetized rabbits. We tested the
      response of these neurons to inputs from abdominal vagal, renal and somatic
      nerves. Electrical stimulation of the abdominal vagus nerve activated 64/85
      neurons tested (75%), and had no effect on the remaining 25%. Latency was 195 +/-
      25 ms, (conduction velocity 0.7 m/s). Stimulation of renal afferents had no
      effect on the discharge rate of 4 neurons tested. Stimulation of branches of the
      sciatic nerve inhibited 7/17 A1 area neurons tested, excited 4 and had no effect
      on 6 neurons. Stimulation of the central ear nerve inhibited 4/17 neurons tested,
      excited 6 and had no effect on 7 neurons. Gastric distension had no effect on
      20/24 neurons tested. Lightly touching the animals back and legs had no effect on
      the discharge of 45/49 neurons tested. Similarly, painful stimuli failed to
      affect 44/49 neurons tested. Our results indicate that A1 area neurons, with
      projections to the region of the supraoptic nucleus, receive excitatory inputs
      from the abdominal vagus nerve. The visceral information transmitted to A1 cells
      by these abdominal vagal afferents is not yet determined, but acute gastric
      distention does not appear to be a physiological stimulus. A1 area neurons seem
      not to be involved in transmitting somatic information to the hypothalamus.

PMID- 8358613
TI  - In Aplysia sensory neurons, the neuropeptide SCPB and serotonin differ in
      efficacy both in modulating cellular properties and in activating adenylyl
      cyclase: implications for mechanisms underlying presynaptic facilitation.
AB  - The facilitatory transmitters serotonin (5-HT) and the molluscan neuropeptides
      SCPA and SCPB both activate adenylyl cyclase in Aplysia mechanosensory neurons
      and produce multiple modulatory effects that contribute to increasing transmitter
      release from these cells. This enhancement of transmitter release from sensory
      neurons contributes to increased behavioral response during sensitization and
      classical conditioning in Aplysia. Recently, specific examples of modulation in
      these sensory neurons have been described that are more effectively initiated by
      5-HT than by the SCPs. For example, in the present study, 5-HT produces 55%
      greater broadening of the normal sensory neuron action potential than did SCPB.
      These differences in the modulatory actions of the facilitatory transmitters have
      been interpreted as suggesting that 5-HT produces its modulatory effects at least
      partly via a cAMP-independent mechanism. However, we have found that the two
      types of facilitatory transmitters are not equally effective in activating
      adenylyl cyclase. In both whole CNS membranes and sensory neuron membranes, SCPB
      was less effective than 5-HT in stimulating adenylyl cyclase activity measured in
      steady state assays. Because electrophysiological experiments suggested that the
      response to the SCPs desensitizes rapidly, we further compared cyclase
      stimulation in perfused membrane assays that enable continuous monitoring of
      cyclase activity; however we observed that 5-HT was also more effective than SCPB
      in stimulating cyclase at the onset of transmitter exposure. We discuss the
      possibility that lower peak stimulation of cyclase by SCPB and a faster rate of
      desensitization could account for some of the differences between the SCPs and 5
      HT in modulating sensory neurons.

PMID- 8358614
TI  - Separate neural pathways respond to different noxious stimuli affecting
      respiratory pump frequency in Aplysia fasciata.
AB  - Neural circuits responsible for both conditioned and unconditioned respiratory
      pumping to three stimuli modulating respiratory pumping were examined. The
      stimuli used were: (i) reduction of pH; (ii) increase and (iii) decrease in
      seawater concentration. Ablation of the osphradium, but not of the rhinophores,
      abolished responses to all 3 stimuli. Cutting the pleural-abdominal connectives
      led to a decrease in responses to lowered pH, but did not affect responses to
      changes in seawater concentration. Further lesions showed that integrity of the
      cerebral-pleural ganglion is needed for animals to respond to a decrease in pH.
      Thus, neural circuitry entirely within the abdominal ganglion and the periphery
      innervated by the ganglion is sufficient for mediating responses to changes in
      seawater concentration, while the cerebral ganglion is needed to respond to
      lowered pH. Different transmitter mechanisms are also used by pathways responding
      to changes in seawater concentration and to decreased pH: 5,7-dihydroxytryptamine
      in concentrations which cause depletion of serotonin blocked the response to
      lowered pH, but not to altered seawater concentrations.

PMID- 8358615
TI  - Demonstration of a human urinary trypsin inhibitor (urinastatin)-like substance
      in the murine brain.
AB  - A human urinary trypsin inhibitor (urinastatin)-like immunoreactive substance
      with trypsin-inhibitory activities was found in the murine brain. Regional levels
      of this urinastatin (UT)-like substance in the brain were within 5 ng/mg protein
      and were expressed in a descending order as follows: cerebral cortex not equal to
      hippocampus > hypothalamus > mesencephalon not equal to corpus striatum >>
      medulla oblongata > cerebellum. Mechanical lesioning of the cerebral cortex or
      hippocampus with a needle induced a rapid and intense appearance of a UT-like
      immunoreactive substance in the neuronal cells of injured sites. Conditioned fear
      stress induction incited a reversible increase in the level of UT-like
      immunoreactive substance in the hippocampus. These results suggest that the UT
      like immunoreactive substance is produced by neurons in response to brain injury
      and fear-stress stimuli.

PMID- 8358616
TI  - Heterogeneous distribution of D1, D2 and D5 receptor mRNAs in monkey striatum.
AB  - The primate striatum has a compartmental organization reflected both in the
      topography of its afferent projections and in the segregation of its
      morphologically similar but neurochemically distinct efferent neurons. Discretely
      projecting mesostriatal neurons release dopamine (DA) which modulates the
      responses of striatal neurons to other afferent inputs. Multiple DA receptor
      (DAR) subtypes have been cloned and characterized and mapping their cellular
      expression is crucial for understanding the influence of DA on striatal function.
      We report the distribution of mRNAs for D1, D2 and D5 DAR subtypes (D2R, D2R and
      D5R) in the striatum of cynomolgus monkeys (Macaca fascicularis) studied by in
      situ hybridization histochemistry (ISH) using monkey-specific cRNA probes.
      Adjacent sections were stained for calbindin immunoreactivity to distinguish
      striosomal and matrix compartments for comparison with the patterns obtained with
      ISH. In the caudate nucleus, D1R mRNA was concentrated in calbindin-poor
      striosomes where dense grain clusters were seen overlying the majority of medium
      sized neurons (diameter approximately 15 microns). D1R mRNA localization was
      relatively homogeneous in the putamen. By contrast, the distributions of D2R and
      D5R mRNAs showed no clear preference for the striosomal or matrix compartments of
      either caudate nucleus or putamen. In the ventral striatum (nucleus accumbens,
      olfactory tubercle and ventral portions of caudate nucleus and putamen),
      expression of D1R and D2R mRNA was sparse relative to dorsal striatum, while D5R
      mRNA expression was roughly equal in ventral and dorsal striatum. Circumscribed
      zones of hybridization associated with islands of tightly packed small cells
      occurred with all three DAR mRNA subtypes in the ventral striatum.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8358617
TI  - Suppression of visual responses of neurons in inferior temporal cortex of the
      awake macaque by addition of a second stimulus.
AB  - The responses of neurons, in inferior temporal cortex of the awake macaque, to
      single stimuli and pairs of stimuli were examined. The responses of most neurons
      were weaker to pairs of stimuli than to the best single stimulus of that pair
      presented alone. This 'suppression by a second stimulus' did not appear to be
      stimulus-selective and the suppression was greater when the second stimulus
      appeared in receptive field locations that exhibited weaker responses. This
      phenomenon suggests competitive interactions between IT neurons that may be
      involved in visual attention or learning or both.

PMID- 8358618
TI  - Cocaine neurotoxicity and altered neuropeptide Y immunoreactivity in the rat
      hippocampus; a silver degeneration and immunocytochemical study.
AB  - Neuroanatomical methods were used to determine if cocaine irreversibly injures
      neurons. Despite acute and chronic high-dose treatments for months that produced
      stereotyped behavior and seizures, and the use of a sensitive silver impregnation
      method, we were unable to find any evidence of neuronal damage anywhere in the
      brain. Since expression of the inducible 72 kDa heat shock protein (HSP72) is a
      sensitive indicator of potentially toxic neuronal stress, we next determined if
      cocaine evoked HSP72 expression. Even high doses of cocaine that evoked seizures
      did not induce HSP72 immunoreactivity anywhere within the brain, whereas kainic
      acid produced widespread HSP72 immunoreactivity and irreversible injury. Having
      failed to find indications of frank neurotoxicity, we examined peptide and
      protein cell marker immunoreactivities in search of cocaine-induced changes.
      Although cocaine treatment had no obvious effects on the patterns of hippocampal
      calbindin-D28K, somatostatin-, tyrosine hydroxylase- and parvalbumin
      immunoreactivities, cocaine reliably altered neuropeptide Y-like immunoreactivity
      (NPY-LI). Most notably, NPY-LI was expressed in hippocampal dentate granule cells
      and pyriform cortical neurons, which do not normally express it. Conversely, we
      noted decreased NPY-LI in dentate hilar neurons that normally do express it.
      Since both changes in NPY-LI were seen only in cocaine-treated rats that
      exhibited seizures, the role of seizure activity per se in producing the NPY
      changes was addressed in normal rats by electrical stimulation of the perforant
      path. Like cocaine, perforant path stimulation for as little as 15min evoked NPY
      LI in granule cells but did not replicate the cocaine-induced decrease in hilar
      cell NPY-LI. These results suggest that cocaine does not irreversibly injure
      neurons in the rat, even at doses that induce seizures. However, cocaine produces
      long-lasting changes in NPY expression that are of unknown functional
      significance. Our inability to demonstrate cocaine-induced neuronal damage in
      rats should in no way be taken as evidence of its safety in humans.

PMID- 8358619
TI  - Task constraints on foot movement and the incidence of compensatory stepping
      following perturbation of upright stance.
AB  - Our understanding of the postural control responses in the event of external
      perturbation has focused almost exclusively on the early automatic adjustments.
      The present study addresses another postural reaction that is functionally
      important: compensatory stepping. The purpose was to identify the relative
      importance by comparing the prevalence of compensatory stepping with and without
      instructions constraining the subjects' responses. Subjects stood on two force
      plates which were mounted on a "moveable" platform. Their posture was perturbed
      by the translation of the platform either forward or backward at various
      accelerations. Following a practice period, seven subjects each performed under
      two different tasks: "constrained" (keep feet in place) and "unconstrained" (no
      specific instructions given). The primary focus of the analysis was on responses
      to forward platform translations. Analysis revealed that the frequency of
      stepping tended to be higher in "unconstrained", as opposed to "constrained",
      tasks. The frequency of stepping was also related to the interaction between the
      tasks and the order in which they were given. Specifically, subjects stepped most
      frequently when they received the "unconstrained" task first. The frequency of
      stepping also increased as the magnitude of the platform acceleration increased.
      Time of onset of stepping, as defined from the force plate measures, began as
      early as 160 ms in one subject and averaged 250 ms across all subjects. These
      relatively fast response times suggest that step initiation often occurs well
      before the limits of stability are reached. A novel and unexpected finding was
      the identification of a third response type, intermediate to stepping and
      (bilaterally symmetrical) non-stepping responses.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8358620
TI  - Separation of different interictal discharge patterns in acute experimentally
      induced epileptic foci of the rat in vivo.
AB  - Epileptic discharge patterns in an acute experimental model of epilepsy were
      analyzed. Epileptic foci were induced by epicortical application of penicillin on
      the rat motor cortex in vivo. Patterns with regular 1/s discharges, patterns with
      irregular discharges of about 0.5/s as well as compound patterns comprising
      discharges with intervals of about 300 ms could be differentiated by means of
      interval histograms and autocorrelation functions. These patterns occurred in an
      ordered sequence indicating that the different rhythms are activated by a
      progressive enlargement of the focus and duration of focal activity. The
      experiments suggest that different interictal discharge patterns can occur within
      the same brain regions and are not specific for a certain etiology; instead they
      seem to represent 'resonance' frequencies characteristic for the brain tissue
      which are disclosed under pathophysiological conditions.

PMID- 8358621
TI  - Medial diencephalic sites involved in calcitonin-induced hyperthermia and
      analgesia.
AB  - Calcitonin is a peptide hormone which can act centrally to decrease food intake
      and locomotor activity, and increase body temperature and nociceptive thresholds.
      In a previous study we showed that the brain sites involved in the food intake
      and locomotion decreases were mostly the paraventricular nucleus, the
      perifornical area and the preoptic area above the optic chiasma. We now study the
      diencephalic sites involved in calcitonin-induced increases in body temperature
      and nociceptive thresholds. Salmon calcitonin (15 ng in 0.3 microliters) was
      injected in several diencephalic sites, and the effects on body temperature and
      nociceptive thresholds compared with a saline injection. The results show that
      the sensitive sites are the dorsomedial nucleus of the hypothalamus, the preoptic
      area and the centromedial nucleus of the thalamus, and not the paraventricular
      nucleus and adjacent perifornical area. Therefore, different kinds of central
      effects of calcitonin can be differentiated on an anatomical basis.

PMID- 8358622
TI  - Neonatal glutamate can destroy the hippocampal CA1 structure and impair
      discrimination learning in rats.
AB  - Neonatal Wistar rats were subcutaneously injected with 0.1, 1, or 2 mg/g b.wt. of
      monosodium glutamate (MSG) at 1, 3, 5, 7, and 9 days after birth. The animals
      were observed for degeneration of pyramidal cells in the hippocampus. The
      histological change disappeared when the animals were concurrently injected with
      glutamate diethyl ester (GDEE), an antagonist of the glutamate receptor. When
      light-dark discrimination learning was carried out at 10 weeks old, the correct
      response in the acquisition period was impaired in the animals given 1 and 2 mg/g
      of neonatal MSG. Their retention scores were also impaired in comparison with the
      control animal. The behavioral impairment recovered with pre-treatment with GDEE.
      No significant changes were observed in the concentrations of transmitter
      substances, including amino acids and monoamines. These results suggest that
      neonatal MSG destroys the hippocampus and impairs acquisition and retention of
      discrimination learning through the mechanism of glutamate receptors.

PMID- 8358623
TI  - Alterations of corticotropin-releasing factor-like immunoreactivity in different
      brain regions after acute cocaine administration in rats.
AB  - Corticotropin-releasing factor (CRF) may mediate some of the neuroendocrine and
      behavioral responses to cocaine. In this study, the distribution of CRF-like
      immunoreactivity (CRF-LI) was determined in the hypothalamus and in several
      extrahypothalamic brain regions after acute cocaine administration in handled
      rats. CRF-LI decreased dose-dependently with cocaine administration in the
      hypothalamus and in the basal-forebrain structures. A small dose of cocaine (7.5
      mg/kg) decreased CRF-LI in the hippocampus and in the frontal cortex. A
      significant, selective, dose-dependent increase in CRF-LI was found in the
      amygdala after cocaine injection. None of the investigated doses of cocaine
      altered CRF-LI in the striatum. These results suggest that acute cocaine
      administration alters brain CRF systems to contribute behavioral and
      neuroendocrine responses to cocaine.

PMID- 8358625
TI  - Simultaneous demonstration of Fos-like immunoreactivity and 2-deoxy-glucose
      uptake in the inferior colliculus of the mouse.
AB  - Fos-like immunoreactivity and 2-deoxy-glucose uptake can be visualized in
      adjacent sections of the same brain by applying a modified cytochemical reaction
      protocol. This study demonstrates that the two methods correspond to each other
      in mapping the tonotopic organization of the inferior colliculus.

PMID- 8358624
TI  - A68 is a component of paired helical filaments of Gerstmann-Straussler-Scheinker
      disease, Indiana kindred.
AB  - Gerstmann-Straussler-Scheinker disease in the Indiana kindred is pathologically
      characterized by prion protein amyloid deposits and neurofibrillary tangles (NFT)
      with paired helical filaments (PHF). Using antibodies to various domains of the
      tau molecule, we investigated the composition of PHF in this family by
      immunocytochemistry and immunoblot analysis. The results indicate that A68 is a
      component of NFT in this family as it is in Alzheimer's disease, and suggest that
      post-translational modifications of tau leading to formation of A68 are not
      unique to Alzheimer's disease.

PMID- 8358626
TI  - Immunocytochemical identification of photoreceptor populations in the tree shrew
      retina.
AB  - The presence and retinal distributions of short-wavelength-sensitive cones, long
      wavelength-sensitive cones, and rods were assessed in the retina of the tree
      shrew Tupaia belangeri using visual pigment antibodies OS-2, COS-1 and anti
      rhodopsin, respectively. Results demonstrated a clear immunocytochemical
      differentiation of the three photoreceptor types with each showing regional
      variation in density across the retina.

PMID- 8358627
TI  - A geometrical description of horizontal cell networks in the turtle retina.
AB  - Networks of physiologically identified H2 horizontal cells in the turtle retina
      were labeled by intracellular injection of Neurobiotin. We obtained a
      quantitative description of the neighbourhood relations in the dye-coupled cell
      mosaics by using the somata as centers for the Voronoi-Delaunay construction.
      Computational models simulating the experimental data are presented.

PMID- 8358628
TI  - The variation in safety factor with myelinated axon diameter: experiments with
      low sodium perfusion.
AB  - Theoretical considerations suggest that myelinated axons of a small diameter (and
      therefore with a low conduction velocity) also have a low safety factor. That
      these axons, many of which are involved in the mediation of pain, may fail first
      when action potential conduction is inhibited may explain the analgesic
      properties of local anesthetics. We have tested this hypothesis by perfusing frog
      myelinated axons with a low concentration of sodium ions and monitoring the
      reduction in conduction velocity, and the tendency to conduction failure. It was
      found that axons conducting action potentials at below 10 m/s are affected to the
      greatest extent by low sodium perfusion, indicating that slow conducting axons do
      have a low safety factor and confirming the earlier theoretical prediction.

PMID- 8358630
TI  - Responses of rat striatal neurons during performance of a lever-release version
      of the conditioned avoidance response task.
AB  - Neural activity was recorded from 218 sites in the striatum (caudate-putamen and
      nucleus accumbens) of rats trained on a lever-release version of the conditioned
      avoidance response (CAR) task, in which an auditory signal elicits a short
      latency, forelimb withdrawal. > 80% of these recording sites showed task-related
      activity, including neurons that responded to the auditory stimulus (signal
      related cells), the lever-release (response-related cells), or both of these
      events (signal/response-related cells). Histological analysis revealed a
      predominance of signal-related neurons in medial striatum, whereas lateral
      recording sites mainly showed response-related activity. Haloperidol (0.1 mg/kg
      s.c.), a widely used neuroleptic that impairs CAR performance, significantly
      attenuated task-related neural activity without altering the latency of the
      neural response or spontaneous firing rate. Collectively, these results, which
      demonstrate the usefulness of the lever-release CAR paradigm for assessing
      striatal function, suggest that the sensory and motor aspects of the CAR task are
      processed by different striatal regions. Moreover, haloperidol appears to disrupt
      the striatal processing of both sensory and motor information.

PMID- 8358629
TI  - Serotonin 5-HT3 receptors in schizophrenia: a postmortem study of the amygdala.
AB  - Alterations in density of some serotonin receptor sites (5-HT1A receptors, 5-HT2
      receptors and 5-HT uptake sites) have been reported in postmortem studies of
      brain obtained from subjects with schizophrenia, suggesting a disturbance in
      serotonergic transmission in schizophrenia. The purpose of the present study is
      to investigate [3H]-LY278584 binding to serotonin 5-HT3 receptors in postmortem
      samples of amygdala from schizophrenic and matched control subjects. As all of
      the schizophrenic patients but none of the controls had been treated with
      neuroleptics, we first investigated in rodents the effects of short-term and long
      term haloperidol administration on limbic 5-HT3 receptors, and we found no
      effects. No differences in the maximum number of 5-HT3 binding sites (Bmax) or
      equilibrium dissociation constant (Kd) between schizophrenics and controls were
      found in amygdala. This study does not support the presence of an alteration of 5
      HT3 receptors in amygdala in schizophrenic patients.

PMID- 8358631
TI  - Blockade of morphine-induced analgesia and tolerance in mice by MK-801.
AB  - The effect of MK-801 on morphine-induced analgesia, tolerance and opioid binding
      sites was examined in mice. In analgesia studies, mice received either naloxone
      or MK-801. Controls were injected with saline. Mice were then injected with
      morphine 10 or 30 min following naloxone or MK-801, respectively, and tested for
      analgesia (tail flick assay) 45 min later. Pretreatment with naloxone or MK-801
      blocked morphine-induced analgesia. In tolerance studies, mice were pretreated
      with either saline or MK-801. Thirty minutes later, mice were injected with
      either saline or morphine (acutely or chronically) and tested for analgesia 24 h
      later. Pretreatment with MK-801 partially or completely blocked the development
      of acute and chronic tolerance, respectively. In binding studies, MK-801
      displaced [3H]naloxone poorly compared to naloxone or morphine. Together, these
      data suggest a role for NMDA receptors in morphine-induced analgesia and
      tolerance. The poor inhibition of the [3H]naloxone binding sites by MK-801
      supports the possibility that MK-801 might not act directly on the opioid
      receptors, but rather, inhibits morphine-induced analgesia and tolerance by some
      other mechanisms.

PMID- 8358634
TI  - Ultrastructural changes of osteoclasts on hen medullary bone during the egg
      laying cycle.
AB  - 1. The ultrastructure of osteoclasts on hen medullary bone during the egg-laying
      cycle was observed by electron microscopy. 2. At 0 to 6 h after oviposition,
      osteoclasts lacking ruffled borders were attached to the bone via the clear zone
      and appeared to have ceased bone resorption. Small vacuoles were scattered
      throughout this cytoplasm. 3. At 9 to 21 h after oviposition, most of the
      osteoclasts had ruffled borders and appeared to be resorbing bone. The ruffled
      borders at 15 h were well developed, whereas at 9, 18 and 21 h they were poorly
      developed or showed similarities in structure to the clear zone. The small
      vacuoles were concentrated under the ruffled borders at 9 h and then decreased.
      4. These results demonstrate cyclic changes in osteoclasts during the egg-laying
      cycle, indicate that ruffled borders form at the beginning of bone resorption and
      suggest that they are derived from the clear zone and the small vacuoles. The
      results also indicate that the ruffled borders fuse into the clear zone and
      disappear at the completion of bone resorption.

PMID- 8358633
TI  - Incidence and classification of early embryonic mortality in broiler breeder
      chickens.
AB  - 1. Unusually high early embryonic mortality (EEM) was observed in hatching eggs
      from broiler compared with white or brown table-egg breeders in Atlantic Canada.
      Broiler breeder EEM in Atlantic Canada was twice the EEM in broiler breeders from
      other areas of North America. 2. Comparisons of holding temperatures (18 and 30
      degrees C) for 24 h after egg collection, in combination with a storage time of 0
      or 7 d at 18 degrees C prior to incubation, were made using the criteria: embryo
      development (stage), and size at 0, 3, 6 and 9 d incubation, EEM, late embryonic
      mortality (LEM) and hatchability (HAT). 3. Stage of development of embryos, at 0
      d incubation, was highest for eggs held for 24 h at 30 degrees C and stored for 7
      d. Embryo stage, weight and length at 3, 6 and 9 d incubation were positively
      correlated. 4. Hatchability of fertile eggs was lowest (66.5%) for eggs held for
      24 h at 30 degrees C and stored for 7 d and highest (87.2%) for eggs held for 24
      h at 18 degrees C and stored for 0 d. Holding temperature and storage time
      significantly influenced EEM and LEM. 5. EEM classification differed for strain
      of breeder. In broiler breeders the majority of the EEM was at a relatively late
      stage of development (exhibiting an obvious blood ring with a visible embryo). In
      comparison, EEM from table egg breeders was distributed equally among three
      categories.

PMID- 8358632
TI  - Identification of a 34 kDa protein specific to synaptic vesicles.
AB  - In this study, we used synaptic vesicles purified from the electric organ of
      marine electric rays to search for novel molecules which have important functions
      in synaptic transmission. Proteins that copurified with synaptic vesicles were
      used to immunize rats, and the resulting antisera were then used to further
      characterize the vesicle proteins. One of the antisera recognizes a protein of 34
      kDa, p34, that has several characteristics which suggest it is a synaptic vesicle
      specific protein: (1) it copurifies exclusively with the synaptic vesicle peak
      during permeation chromatography on a controlled pore glass beads column, (2) it
      can be immunoprecipitated with intact synaptic vesicles and (3) it is
      specifically localized to the nervous system. The results suggest that p34 is a
      synaptic vesicle specific protein with a widespread distribution in the nervous
      system.

PMID- 8358635
TI  - Effects of the sex-linked dwarf gene (dw) on skeletal muscle cellularity in
      broiler chickens.
AB  - 1. The number and size of muscle fibres and the DNA concentration in m.
      pectoralis superficialis of normal (Dw+/-) and dwarf (dw/-) White Plymouth Rock
      females were investigated at the ages of 9 and 52 weeks. 2. Live weight and total
      meat was reduced by 37.4 and 42.8% in dw/- as compared with Dw+/- females at the
      age of 9 weeks. The suppressive effect of the dwarf allele on the weight of m.
      pectoralis superficialis was 40.6% (67.8 v. 40.3 g in Dw+/- and dw/- genotypes).
      This reduction in weight was accompanied by a similar decrease of DNA content
      (28.8 v. 17.1 mg, i.e. 40.6%), a decrease in number of muscle fibres (829 x 10(3)
      v. 654 x 10(3), i.e. 21.2%) and fibre diameter (30.80 v. 28.95 microns, i.e.
      6.0%). In mature hens, the differences between genotypes Dw+/- and dw/- were
      slightly smaller. 3. The different relationships between the muscle growth traits
      studied are discussed.

PMID- 8358636
TI  - The relationship between yolk cholesterol and total lipid concentration
      throughout the first year of egg production in the domestic fowl.
AB  - 1. Variation of egg yolk cholesterol and total lipid concentration (mg/g wet
      yolk) throughout the first year of egg production for the domestic fowl is
      described. 2. Yolk cholesterol concentration decreases between 20 and 30 weeks of
      age, and then remains constant until 70 weeks of age. Yolk total lipid
      concentration increases to a maximum at 40 weeks of age before decreasing to its
      original value at 60 and 70 weeks of age. 3. Bird means for yolk cholesterol and
      total lipid concentration are negatively related at 20 weeks of age, and
      essentially independent for the remainder of the first year of egg production. 4.
      Variation for yolk cholesterol concentration between 30 and 70 weeks of age
      appears to be a consequence of differences in the proportion of cholesterol to
      other lipid components. 5. Uptake of plasma lipoproteins characteristic of the
      immature bird is likely to be responsible for the high yolk cholesterol
      concentration at 20 weeks of age.

PMID- 8358637
TI  - Microbiological survey of five poultry processing plants in the UK.
AB  - 1. Neck skin samples were taken from chickens and turkeys at all the main stages
      of processing to monitor changes in total viable count (TVC) and counts of
      coliforms and pseudomonads. 2. Processing reduced TVC by up to 100-fold.
      Geometric mean counts after packaging were log10 4.4 to 5.3 CFU/g whilst
      corresponding counts of coliforms were 2.7 to 3.8 CFU/g. 3. Increases in mean TVC
      or coliforms as a result of either defeathering or evisceration did not exceed
      0.6 log. 4. Pseudomonads represented only a minor fraction of the initial
      microflora of the bird and were often reduced by scalding to a figure which could
      not be detected by direct plating of samples; however, subsequent contamination
      resulted in means between log10 2.9 and 4.0 CFU/g for packaged carcases. 5.
      Although Staphylococcus aureus was readily isolated from defeathering equipment,
      mean counts from defeathered carcases were always below log10 3.0 CFU/g.

PMID- 8358638
TI  - Toxicity of raw limabeans (Phaseolus lunatus L.) and limabean fractions for
      growing chicks.
AB  - 1. In a 4-week feeding trial, raw limabeans Phaseolus lunatus and extracted
      limabean fractions were tested as dietary ingredients in broiler starter diets.
      During the study, parameters such as body weight, lengths of intestinal sections
      as well as weights and histopathology of some organs (liver, kidney, heart,
      adrenals, spleen, brain, pancreas and small intestine) were investigated. 2. With
      the exception of broiler chicks fed on the diet containing soaked/boiled
      limabeans, growth was severely hindered in chicks fed on diets containing raw
      limabeans and limabean fractions. 3. Significant treatment differences in lengths
      of some intestinal sections were observed. The relative weights of the liver and
      spleen decreased, and the weights of the kidney, adrenals, small intestine and
      caecum increased in birds fed on diets containing raw limabeans and fractions
      containing high concentrations of anti-nutritional factors, whereas there was no
      difference in the weights of these organs in soaked/boiled limabean diet-fed
      birds. 4. The inclusion of raw limabeans, base-soluble protein, acid-soluble
      protein, defatted limabean and ether extracted meal in the diets for growing
      chickens was shown to produce serious histopathological changes within the
      livers, kidneys, pancreases, spleen and lungs.

PMID- 8358639
TI  - Comparative growth and development of the digestive organs and of some enzymes in
      broiler and egg type chicks after hatching.
AB  - 1. Body weight, the weight of digestive organs and activities of some digestive
      enzymes were determined from hatching to 14 d of age in meat- and egg-type
      chickens. 2. Relative daily food intake and growth rate were much higher in meat-
      than in egg-type chickens. Relative daily food intake peaked at 30% of body
      weight at 3 d of age in meat-type, and at 20% of body weight at 6 d of age in egg
      type chickens and then decreased gradually. The corresponding values for growth
      rate were 20 and 14%. 3. Allometric growth of the small intestine, intestinal
      contents and liver was greater in meat-type chickens, but the growth of the
      pancreas attained a higher value in the egg-type birds. Diminution of the
      vitelline residue was similar in the two breeds. 4. Pancreatic digestive enzyme
      activities were similar between stocks, but activities in the small intestinal
      contents were lower in meat-type chickens. 5. The secretion of digestive enzymes
      in the newly-hatched meat-type chicken could be a limiting factor in digestion
      and, consequently, in food intake and growth.

PMID- 8358640
TI  - Precocious puberty in tamoxifen-treated cockerels: hypothalamic gonadotrophin
      releasing hormone-I and plasma luteinising hormone, prolactin, growth hormone and
      testosterone.
AB  - 1. The administration of the anti-oestrogen, tamoxifen (TAM) to juvenile chicks
      results in precocious puberty. In the present study the effects of TAM
      administration (1 mg/kg body weight on alternate days from 12 d of age) on
      testicular function, hypothalamic chicken gonadotropin-releasing hormone (cGn-RH
      I), plasma luteinising hormone (LH), growth hormone (GH), prolactin (PRL) and
      testosterone were studied in juvenile White Leghorn cockerels. 2. The increase in
      hypothalamic GnRH-I content which occurs during sexual development was advanced
      in TAM-treated birds, in association with precocious testicular development, an
      early rise of plasma testosterone content and enhanced comb growth. 3. Plasma LH
      concentrations behaved similarly and were higher in the TAM-treated than in
      control birds, during most of the experimental period. Plasma PRL concentration,
      which is high at hatching, decreased more quickly in TAM-treated than in control
      birds; plasma GH values were not consistently affected by TAM treatment. 4. Both
      the growth and the involution of the bursa of Fabricius in the TAM-treated
      cockerels preceded that in the control chicks. 5. It is concluded that TAM
      treatment induces precocious puberty in the cockerel by blocking the negative
      feedback action of aromatised testicular androgens on the hypothalamus.

PMID- 8358641
TI  - Effect of acute heat exposure on triglyceride transfer to the preovulatory
      follicles of the laying fowl (Gallus domesticus).
AB  - 1. The effect of acute heat exposure on triglyceride (TG) transfer to
      preovulatory follicles was studied in the laying fowl. 2. Heat exposure of laying
      fowl resulted in a 1.1 degree C rise in body temperature, a 10-fold increase in
      respiration frequency and mild hypocapnia and hypoxaemia. 3. Plasma and
      follicular tissue TG concentrations were not significantly affected by heat
      exposure, but plasma TG specific radioactivity decreased significantly and was
      negatively correlated with body temperature. 4. The transfer rate of TG to the
      preovulatory follicles was not affected significantly by hyperthermia. 5. We
      conclude that nutrient supply to the developing follicles is not compromised in
      acutely heat-exposed laying fowl.

PMID- 8358642
TI  - Susceptibility of two commercial single comb White Leghorn strains to calcium
      induced urolithiasis: efficacy of dietary supplementation with DL-methionine and
      ammonium sulphate.
AB  - 1. Susceptibility to calcium-induced urolithiasis was assessed in pullets of two
      commercial SCWL strains (A and B) reared together from 5 to 18 weeks of age on
      diets containing 10 g/kg calcium (normal calcium: NC) or 35 g/kg calcium (high
      calcium: HC). 2. Kidney damage was not observed in pullets reared on NC diets.
      For pullets fed on HC diets, strain A developed significantly greater kidney
      asymmetry, a higher incidence of gross kidney damage and a higher incidence of
      uroliths than strain B. 3. Supplementing the HC diet with 6 g/kg DL-methionine
      significantly reduced the incidence of calcium-induced gross kidney damage and
      urolith formation in both strains. Ammonium sulphate (5.3 g/kg) was significantly
      more effective than DL-methionine in reducing calcium-induced kidney damage. 4.
      Neither DL-methionine nor ammonium sulphate caused a measurable metabolic
      acidosis. Neither supplement consistently affected water consumption or manure
      moisture.

PMID- 8358643
TI  - Defective Down syndrome in chicks is not caused by riboflavin deficiency in
      breeders.
AB  - 1. Riboflavin-deficient practical and semi-purified diets were fed to broiler
      breeder hens. 2. Yolk and albumen riboflavin concentrations were depressed by the
      deficient diets and cases of curled toes were seen in the chicks. 3. The few
      instances of defective down did not resemble cases seen in field outbreaks of a
      condition involving depressed hatchability and a defective down syndrome. 4. It
      is concluded from observations in this experiment and in the field outbreaks that
      there is a condition in breeding chickens causing depressed hatchability and
      defective down that is not attributable to riboflavin deficiency.

PMID- 8358644
TI  - Application of epidemiologic principles and methods to investigating and
      controlling equine infectious diseases.
AB  - Epidemiology is a tool much like any other diagnostic tool that the practitioner
      uses as an aid in the complete physical examination of the group of animals. It
      can be used to generate a specific differential diagnosis list. Epidemiology is
      especially useful to design a disease control and prevention program by helping
      to elucidate the key determinants of disease occurrence.

PMID- 8358645
TI  - Equine influenza.
AB  - Influenza continues to be one of the most important diseases of horses despite
      the availability and widespread use of equine influenza vaccines for almost 30
      years. In recent years, infection with the influenza A/equine/2 subtype has
      become endemic in the equine populations of North America, Europe, and
      Scandinavia. Continued antigenic drift of field virus has compromised the
      efficacy of vaccines, most of which contain antigens prepared from influenza
      viruses isolated more than 10 years ago. This article reviews the history,
      virology, epidemiology, pathogenesis, immunology, clinical presentation,
      diagnosis, treatment, control, and prevention of influenza in horses and
      emphasizes recent developments in diagnostic methods and vaccine technology.

PMID- 8358646
TI  - Rotaviral diarrhea.
AB  - Rotavirus poses a challenge each foaling season to farm managers and
      veterinarians in intensive horse breeding areas throughout the world. By
      understanding the epidemiology of the disease as well as characteristics of the
      virus, veterinarians can make sound recommendations on prevention and control of
      outbreaks. Even when effective prophylactic products are developed, farm
      management practices, including quarantine, disinfection, and hygiene, will
      always need to be in force to prevent any contagious disease outbreak.

PMID- 8358647
TI  - Equine rabies.
AB  - With the continued increase in the number of wildlife rabies cases reported
      across the United States and Canada, this disease will remain a threat to the
      horse as the potential for exposure to infected wildlife and other domestic
      animals is likely to also increase. Because there are no rapid, definitive
      antemortem diagnostic tests, the tentative diagnosis is based upon the variable
      and sometimes nonspecific clinical signs. Although the CSF analysis may be
      helpful in some cases, it may not be abnormal. Nor is collection of the specimen
      always practical in the field situation. The FAT on neural tissue remains the
      most accurate diagnostic test; therefore, the diagnosis of rabies can be
      definitively made only at necropsy. Vaccination of horses with the inactivated
      rabies vaccines is thought to be safe and effective and may be advised for horses
      in endemic areas. Practitioners should consult with state or provincial
      authorities regarding the need for vaccination in their area. Veterinary
      technicians, veterinarians, and other animal health workers should be vaccinated
      against rabies.

PMID- 8358648
TI  - African horse sickness.
AB  - AHS is a noncontagious vector-borne disease of Equidae caused by Orbiviruses.
      Species susceptibility in decreasing order is horses, mules, donkeys, and zebras.
      The main vectors of AHS are culicoides. The disease is endemic in sub-Saharan
      Africa, but epizootics have occurred outside of this area on several occasions.
      The most recent outbreaks outside of the endemic area were in Spain, Morocco, and
      Portugal between 1987 and 1990. AHS causes mortality up to 95% and is classically
      divided into four clinical forms: the pulmonary, cardiac, mixed, and horse fever
      forms. Pathologic changes are subcutaneous and intermuscular edema and lung
      edema. The most consistent clinical signs include fever, nonpurulent
      conjunctivitis, and increased respiratory rate. Prevention and control measures
      include quarantines, control of insects, and vaccination. There is no treatment
      for AHS. Neurotropic strains of AHSV may cause retinitis and encephalitis in
      humans.

PMID- 8358649
TI  - Strangles.
AB  - The etiology, epizootiology, pathogenesis, and clinical presentation of strangles
      are described. Streptococcus equi, the causative organism, is highly host-adapted
      to Equidae and shows no antigenic variation. Protective immunity apparently is
      mediated by a combination of serum opsonic and nasopharyngeal mucosal humoral
      responses. Vaccines based on M protein or inactivated bacterial suspensions may
      reduce the clinical attack rate by 50%, a level of protection much lower than
      that produced during recovery from strangles.

PMID- 8358650
TI  - Rhodococcus equi.
AB  - This article summarizes recent advances in understanding of the epidemiology,
      pathogenesis, clinical and laboratory diagnosis, immunology, treatment, and
      control of Rhodococcus equi infections in foals. Our understanding of these
      aspects currently is sufficient to ensure control of this problem on affected
      farms and in infected foals. More information, however, is needed on factors
      predisposing foals to R. equi pneumonia, in particular, the nature of the
      naturally occurring cellular immunodeficiency in foals of 2 to 4 months of age,
      which also predisposes them to severe respiratory infection with certain other
      intracellular pathogens. In addition, the relative importance of R. equi
      pneumonia in the context of other causes of lower respiratory tract infection of
      foals needs to be defined.

PMID- 8358651
TI  - Salmonellosis.
AB  - Salmonellosis is the most common infectious cause of diarrhea or colitis in
      horses. It can be associated with high fatality rates in patients with
      compromised host defenses. The increasing incidence of infection and
      antimicrobial resistance present a challenge for the practicing veterinarians.
      The epidemiology and pathogenesis of salmonellosis are reviewed. Diagnosis,
      treatment, and control of disease are discussed.

PMID- 8358652
TI  - Potomac horse fever.
AB  - E. risticii, the cause of classic Potomac horse fever, is now known to produce
      two disease syndromes: EEC and EEA. The pathogen appears to commonly infect
      horses based on seroepidemiologic studies; however, the method of transmission
      remains unknown. The most common clinical disease is EEC, commonly called Potomac
      horse fever, which presents a wide spectrum of clinical signs. Diagnosis is
      currently dependent on serology, which frequently does not lead to a definitive
      diagnosis and at best results in a retrospective diagnosis. A new diagnostic
      approach, polymerase chain reaction, may offer a rapid and accurate diagnostic
      test but is yet to be proven. Antimicrobials found to be highly effective in
      treating EEC include intravenous oxytetracycline and the oral combination of
      erythromycin and rifampin. Without an understanding of the mode of transmission,
      prevention of EEC will remain impossible. Although two commercial bacterins are
      available, vaccination does not result in complete protection. EEA is a recently
      recognized clinical syndrome caused by E. risticii. After recovery from EEC,
      pregnant mares may abort. Based on histologic examination, the aborted fetus
      appears to be a victim of an ehrlichial colitis as well as placentitis. The
      effect of antimicrobials and vaccination on the occurrence of EEA has yet to be
      investigated.

PMID- 8358653
TI  - Clostridia-associated enterocolitis in adult horses and foals.
AB  - A review of the literature describing clostridia-associated enterocolitis is
      presented. The bacteria, their toxins, and possible factors that interact to
      contribute to the pathogenesis of enterocolitis are described. Clinical signs
      associated with clostridia-associated enterocolitis, methods of diagnosis,
      treatments, and preventive strategies are discussed.

PMID- 8358654
TI  - Equine ehrlichiosis.
AB  - Equine ehrlichiosis is a seasonal disease of horses first reported in 1969.
      Clinical signs in horses include high fever, depression, partial hypophagia,
      anorexia, limb edema, petechiation, icterus, ataxia, and reluctance to move.
      Hematologic changes include leukopenia, thrombocytopenia, icterus, anemia, and
      inclusion bodies, principally in neutrophils and occasionally in eosinophils.
      Diagnosis is made by clinical signs and observing characteristic morulae in a
      blood smear with standard Wright's stain. Mortality is low unless secondary
      infection develops or injury occurs as a result of incoordination. Treatment with
      tetracycline produces prompt defervescence of fever and gradual improvement of
      clinical signs.

PMID- 8358655
TI  - Lyme disease (Lyme borreliosis) in horses.
AB  - This article reviews epizootiology, public health considerations, antibody
      testing, and molecular biology of Lyme borreliosis. Correlation of clinical signs
      with titer response is discussed.

PMID- 8358656
TI  - Leptospirosis.
AB  - Equine clinical leptospirosis has been primarily related to uveitis and the often
      recurrent sequelae of ocular changes. Reports of equine hepatic and renal
      involvement are sporadic. More recently, serovar bratislava has been identified
      as a host-adapted serovar in the horse. More significantly, reports of equine
      abortion and stillbirth have become more frequent in the literature. This is more
      than likely a result of improved diagnostic techniques, not of increased
      prevalence of disease. In addition to abortion, equine neonatal disease is
      becoming more frequently recognized in association with leptospira infection.
      Whether leptospiral infection results in abortion or diseased foals may depend
      upon the stage of gestation when the mare is exposed and host immune status.
      Antibiotic of choice for treatment of equine leptospirosis remains speculative,
      as specific equine studies have not been performed. Extrapolation from other
      species suggests that the use of streptomycin remains a good choice of therapy
      for the chronic shedding state and may be used in combination with other
      antimicrobials for treatment of acute disease. Penicillin or potentiated
      penicillins and tetracycline at appropriate to high end dosages are logical
      choices for the treatment of acute leptospirosis.

PMID- 8358657
TI  - The nursing practice corner.

PMID- 8358659
TI  - I offer the public the fruit of my pains.

PMID- 8358658
TI  - On-the-job exposure to HIV: reducing RNs' risk (continuing education credit).

PMID- 8358660
TI  - Lack of risk of HIV transmission.

PMID- 8358661
TI  - The do's and don'ts of marketing.
AB  - Marketing is a tough area for most dentists. They either reject it altogether (an
      attitude that is bound to go the way of the dinosaurs because of sheer economics)
      or they accept its role in principal but aren't sure about the choreography for
      the marketing moves. What's important for dentists who embrace marketing is that
      their actions are well thought out, planned and executed. Because the fallout
      from inappropriate or ineffectual marketing can be bottomless. The idea (a
      variation of that old adage) is to please most of the people most of the time, as
      in the cited rose example above. (Yes, Abby sided with the wife.)

PMID- 8358662
TI  - Meeting the needs of women in dentistry.

PMID- 8358663
TI  - Access and isolation problem solving in endodontics: anterior teeth.
AB  - Through a pictorial presentation of case studies, this paper examines the
      versatility of alternative methods of retention as a means of improving the
      overall access to the endodontically-involved tooth. Successful endodontics is
      the result of precise biomechanical instrumentation involving procedural
      manipulations that depend on a complete and unobstructed approach to the working
      field. This pictorial essay is aimed principally at clinicians who would
      ordinarily reject rubber dam isolation in those cases where the clinical
      pretreatment conditions are anything but ideal.

PMID- 8358664
TI  - Prosol-chlorhexidine irrigation reduces the incidence of bacteremia during
      ultrasonic scaling with the Cavi-Med: a pilot investigation.
AB  - The purpose of this pilot investigation was to determine whether the incidence of
      bacteremia following subgingival ultrasonic scaling and root planing could be
      reduced by the use, pre- and intraoperatively, of an irrigant containing 0.12 per
      cent chlorhexidine (CHX); Prosol. Individuals having evidence of significant
      periodontal disease (minimum of seven sites per quadrant 4.0 mm and bleeding on
      probing) were entered into this study. By use of a random number table, patients
      were assigned to either the experimental or control groups. The procedures, as
      described below, were carried out in a double blind fashion so that neither the
      investigator nor the patient was aware of whether Prosol or placebo was being
      used. The placebo solution was flavored to make it indistinguishable from Prosol.
      Patients were first anesthetized. Their gingival crevices were then irrigated
      using the Cavi-Med ultrasonic scaler. At this point, the ultrasonic action was
      not activated. Ten minutes later, ultrasonic scaling and root planing with the
      Cavi-Med unit were begun with a continuous flow of either the placebo or control
      solutions. Blood samples were taken preoperatively, while postoperative samples
      were taken one minute after completing the scaling of each quadrant and then 10
      minutes after scaling the second quadrant. Routine aerobic and anaerobic
      bacterial culture methods were used to identify viable blood-borne bacteria. The
      results show that there was no difference in the distribution or presentation of
      periodontal disease between the experimental and control quadrants.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8358665
TI  - [Mouth diseases in a prehistoric agricultural population of northeastern North
      America].
AB  - There is no longer any question that the consumption of refined sugar is a factor
      in the development of dental caries. In fact, researchers now believe that the
      production of refined sugar and, particularly, its great availability and use in
      post-industrial populations has led to a virtual revolution in both the food
      industry and buccopathology. Clinical and epidemiological studies on the
      relationship between caries and sugar consumption have been conducted for more
      than 40 years, and the harmful effects of sugar consumption on the development of
      dental caries are now well known. Some authors have also demonstrated a
      historical relationship between caries and sugar over the last three centuries.
      Another food revolution that had an equally great impact on oral health occurred
      with the introduction of agriculture. This innovation is discussed from both a
      technical and food perspective. Agriculture modified the diet of ancient
      populations by providing new foods that were rich in carbohydrates and by
      introducing new cooking methods (food was now often boiled instead of being
      roasted). These two factors alone contributed to an increased rate of dental
      caries, but at the same time reduced the abrasion of occlusal surfaces and dental
      crowns. This paper documents the relationship between dental caries, occlusal
      abrasion, fractures and periodontal disorders, as well as the agriculture
      practises of an Amerindian population that lived between 1000 and 1500 A.D. in
      parts of what are now New York State, Quebec and Ontario. The author's findings
      confirm those of many other researchers who have investigated agricultural
      populations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358666
TI  - The questionable relationship between HIV and AIDS.

PMID- 8358667
TI  - Computerized occlusal analysis.

PMID- 8358668
TI  - A two-part energy burden imposed by growth of Enterobacter cloacae and
      Escherichia coli in sodium dodecyl sulfate.
AB  - Enterobacter cloacae, like most enteric bacteria, can grow in the presence of 10%
      sodium dodecyl sulfate (SDS). The bacteria tolerate the detergent and do not
      metabolize it. In a defined glucose-salts medium the growth rate remained
      unchanged (G = 55 min) as the detergent concentration was increased from 0 to 10%
      SDS. However, growth in SDS exhibited a two-part energy dependence. In part 1,
      the SDS-grown cells underwent rapid lysis when they ran out of energy. Cells that
      had entered stationary phase owing to carbon limitation lysed, while those that
      had entered owing to nitrogen or phosphorus limitation did not. We attribute part
      1 of the energy dependence to SDS as a detergent. In part 2, the cells grown in 5
      or 10% SDS exhibited longer lag periods, potassium accumulation, decreased cell
      yields, and higher oxygen consumption. The higher oxygen consumption occurred
      during both exponential phase and nitrogen-limited stationary phase. However, the
      decreased cell yield and higher oxygen consumption of SDS-grown cells were
      mimicked by cells grown in equivalent concentrations of sucrose or polyethylene
      glycol. We attribute part 2 of the energy dependence to SDS as a solute. Finally,
      with regard to the as yet unidentified bacterial osmotic stress detector, we used
      the micelle-forming nature of SDS to conclude that the detector was responding to
      turgor pressure-water activity rather than to osmolarity itself.

PMID- 8358669
TI  - Biodegradation of cycloalkane carboxylic acids in oil sand tailings.
AB  - The biodegradation of both an n-alkane and several carboxylated cycloalkanes was
      examined within tailings produced by the extraction of bitumen from the Athabasca
      oil sands. The carboxylated cycloalkanes examined were structurally similar to
      naphthenic acids that have been associated with the acute toxicity of oil sand
      tailings. The biodegradation potential of naphthenic acids was estimated by
      determining the biodegradation of both the carboxylated cycloalkanes and
      hexadecane in oil sand tailings. Carboxylated cycloalkanes were biodegraded
      within oil sand tailings, although compounds with methyl substitutions on the
      cycloalkane ring were more resistant to microbial degradation. Microbial activity
      against hexadecane and certain carboxylated cycloalkanes was found to be nitrogen
      and phosphorus limited.

PMID- 8358670
TI  - Host range and transfer efficiency of incompatibility group HI plasmids.
AB  - HI plasmids are distinguished by their thermosensitive mode of conjugation
      (transfer efficiency is optimal at 22-30 degrees C) and their capacity to encode
      multiple antibiotic resistance. These traits have implicated HI plasmids as
      potential vectors in the dissemination of antibiotic resistance among pathogenic
      and indigenous bacterial species in water and soil environments. We compared the
      transfer efficiency of HI plasmids with that of plasmids from 13 other
      incompatibility groups at 37, 24, and 14 degrees C in intragenic conjugations
      between laboratory strains of Escherichia coli K-12 under in vitro conditions.
      Only the HI plasmids and a representative plasmid from incompatibility groups M,
      N, P alpha, T, and W were observed to be transmissible at 14 degrees C. These
      plasmids, along with HI plasmids and the related HII representative, were tested
      for their host range and transfer proficiency to Enterobacteria species and some
      other Gram-negative organisms of environmental significance at 24 and 14 degrees
      C. Notable differences in the host range of HI plasmids compared with plasmid
      representatives from the other enterobacterial groups were not evident at 24
      degrees C. At 14 degrees C, R478 (HI2) displayed the broadest host range and
      transfer proficiency among the test plasmids. The ability of several plasmid
      groups, including HI, to transfer at 14-24 degrees C to Vibrio cholerae non 01,
      Salmonella typhi, and the fish pathogens Aeromonas salmonicida, Vibrio
      anguillarum, and Yersinia ruckeri needs to be corroborated by in situ studies.

PMID- 8358671
TI  - Factors affecting PCB degradation by an implanted bacterial strain in soil
      microcosms.
AB  - Pseudomonas testosteroni B-356 was able to degrade approximately 50% of the
      Aroclor 1242 mixture in shaken culture. The aims of the present study were to
      evaluate the capabilities of this bacterial strain to degrade PCBs in soil
      microcosms and to identify some of the factors likely to favor the degradative
      performance of the implanted bacteria. The presence of biphenyl as cosubstrate
      was the most important factor affecting PCB degradation in soil. However, because
      biphenyl was rapidly depleted in soil microcosms, repeated addition of small
      amounts of biphenyl to maintain a constant level of the cosubstrate allowed the
      achievement of a higher degree of degradation of the tetrachlorinated components
      of Aroclor 1242 than was achieved with a single addition at the time of
      inoculation. Degradation of di- and tri-chlorinated PCB congeners was less
      affected by repeated addition of biphenyl because these congeners were degraded
      very fast and complete degradation was achieved before biphenyl was depleted in
      the soil. Biodegradation was also related to bioavailability of the substrate. We
      observed that the proportion of each congener degraded was higher in the
      microcosms receiving both the producer of the surface-active agent, Alcaligenes
      faecalis B-556, and strain B-356. Under the best conditions (presence of a
      constant level of biphenyl and of strain B-556) P. testosteroni B-356 was able to
      degrade approximately 30% of the Aroclor 1242 added to soil microcosms; some
      other factors reducing the PCB degradation capabilities of the implanted bacteria
      are also discussed.

PMID- 8358672
TI  - Genetic mapping of bfmA mutation causing fatty acid deficiency in Bacillus
      subtilis.
AB  - Bacillus subtilis strain 626, defective in the bfmA gene, is a derivative
      derivatives of B. subtilis strain 168 and requires branched short-chain
      carboxylic acids for growth. Branched-chain 2-keto acid decarboxylase activity
      and fatty acid synthesis in B. subtilis strain 626 were 14 and 7%, respectively,
      of their levels in strain 626-2R, a spontaneously reverted strain. These results
      indicate that the bfmA mutation is in either the branched-chain 2-keto acid
      decarboxylase gene itself or its controlling gene. Thus, primer synthesis from
      the 2-keto acid substrate in strain 626 is defective, causing a deficiency in
      fatty acid synthesis. A bfmA mutation was transferred to a suitable genetic
      background and analysed. The bfmA strain, CAC1, was competent and motile, and
      required 50 microM CaCl2 or 5 microM FeCl3 for growth on glucose minimal agar
      plates. The bfmA gene was mapped between glyC (320 degrees) and ctrA (325
      degrees) and estimated to be at 320 degrees by protoplast fusion and PBS1 phage
      transduction.

PMID- 8358673
TI  - Comparative study of the body surface electrocardiogram in double-muscled and
      conventional calves.
AB  - The purpose of this work was to study electrocardiographic features of double
      muscled beef cattle. Electrocardiograms were recorded on one to six occasions
      from each of a group of 18 conventional calves of the Friesian breed and 29
      double-muscled calves of the Belgian White and Blue breed. Ages of the calves at
      the times of examination ranged from eight to 348 days. The Holmes semi
      orthogonal lead system was used. The waves and interval durations and the
      tridimensional P, QRS, and T modal vector orientation and amplitude were
      calculated. The magnitude of the cardiac vectors was significantly lower and the
      ventricular waves and QT interval duration significantly shorter in the double
      muscled than in the conventional calves. The P modal vector pointed significantly
      less downwards and the QRS modal vector pointed significantly more forwards and
      less up- and rightwards in the Belgian White and Blue, than in the Friesian
      group. Most of the observed differences might be a consequence of the bodily, and
      more specifically the thoracic, conformation of the former calves. However, the
      lower cardiac vector magnitude and shorter wave and interval durations might also
      reflect lower cardiac mass in the double-muscled subjects.

PMID- 8358674
TI  - Characterization of Escherichia coli isolated from cases of avian colibacillosis.
AB  - Forty-four western Canadian isolates of Escherichia coli associated with
      colibacillosis of turkeys and chickens were examined for serotype, antibiotic
      resistance, and production of aerobactin. The isolates belonged to fourteen O
      serogroups, with 39% of the strains being non-typeable. A high frequency of
      resistance to tetracycline, kanamycin, neomycin, cephalothin, streptomycin and
      erythromycin was observed. Most isolates produced aerobactin. Ten E. coli
      belonging to serogroups O1, O2 and O78 were also examined for pili production,
      hemagglutination, serum sensitivity, production of iron-regulated outer membrane
      proteins (IROMPS), and virulence. All isolates examined produced pili, exhibited
      mannose-sensitive hemagglutination of avian red blood cells and produced IROMPS
      under iron-restricted growth conditions. The five isolates of serogroup O1 and O2
      were resistant to killing by turkey serum and were highly virulent. Only two of
      the five isolates of serogroup O78 were serum resistant. No correlation between
      serum resistance and virulence was observed in serogroup O78.

PMID- 8358676
TI  - Lack of effect of recombinant bovine interferon alpha I1 in the treatment of
      experimentally-induced bovine warts.
AB  - Fifteen four-month old calves were inoculated, on five scarified sites on each
      side of the neck, with a suspension of ground wart tissue from a steer naturally
      infected with bovine papilloma virus 1. Warts started to appear about one month
      postinfection and were measurable in ten calves two months postinfection, when
      the trial started. After stratification on the size of the warts, all fifteen
      calves were allocated randomly to one of the following treatment groups: twice
      weekly intramuscular injections of 5 mg recombinant bovine interferon alpha I1
      (rBoIFN alpha I1), weekly injection of 5 mg of rBoIFN alpha I1 or placebo, for
      three weeks. The biggest wart on each calf at the beginning of the trial was
      measured and photographs of all warts were taken weekly for five weeks. An
      analysis of covariance on the log of the volumes of warts during the five weeks
      of the trial showed a significant difference between groups (p = 0.026). Warts in
      treated groups tended to grow faster than in the placebo group.

PMID- 8358675
TI  - The (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium) colorimetric assay for
      the quantitation of Actinobacillus pleuropneumoniae cytotoxin.
AB  - Using swine neutrophils as target cells, two MTT (3-(4,5-dimethylthiazol-2-yl)
      2,5-diphenyltetrazolium) colorimetric assay systems, one with and one without
      phorbol 12-myristate 13-acetate (PMA) stimulation were established for the
      quantitation of Actinobacillus pleuropneumoniae cytotoxin. The MTT assays were
      optimized for the number of neutrophils, incubation time, and PMA concentration
      by a series of experiments. The optimal conditions were 25 x 10(4) cells/well
      incubated for four hours for the assay system without PMA stimulation, and 12.5 x
      10(4) cells/well incubated for two hours for the assay system with PMA
      stimulation. One culture supernatant of a toxigenic Pasteurella multocida strain
      and five A. pleuropneumoniae cytotoxin preparations produced from three A.
      pleuropneumoniae strains were used to test assay reproducibility. Results showed
      both assays were reproducible with a coefficient of variation ranging from 7.8 to
      18% for the assay system without PMA stimulation and from 10.7 to 18.2% for the
      assay system with PMA stimulation. The PMA-stimulated assay had 40 to 60-fold
      higher sensitivity than the nonstimulated MTT assay. The MTT assay also was
      applied to the measurement of neutralizing antibody titers against A.
      pleuropneumoniae cytotoxin.

PMID- 8358677
TI  - The predictive value of pelvimetry in beef cattle.
AB  - To elucidate reasons for failure of pelvimetry to predict dystocia, we collected
      data from 1146 heifers and 210 cows in five beef cow herds in Saskatchewan. We
      assessed the reliability of pelvic area measurements, the generalizability of
      findings, various modifications of the technique, and the statistical association
      between pelvic area measurements and dystocia. The repeatability (kappa) of
      pelvic area measurements between and within veterinarians for the Rice and
      Krautmann pelvimeters were low to moderate, indicating pelvic area measurements
      were imprecise. The positive predictive values and sensitivities of pelvic area
      measurements were consistently poor across herds, years of study, breeds of
      heifers, times of measurement, various pelvic area cut-off points, and sires.
      Various modifications of the technique, including pelvic area/calf birth weight
      ratios, pelvic area/heifer weight ratios, and Ko's calving prediction equation
      were also poor on-farm tests for predicting dystocia. Although the mean pelvic
      area in heifers with dystocia was smaller than those without dystocia, there was
      a large overlap in the distribution of their measurements. Far too many heifers
      with a small pelvic area had no dystocia (false positives) and far too many
      heifers with a large pelvic area had dystocia (false negatives) for pelvimetry to
      be useful. We conclude there is little evidence to justify the continued use of
      pelvimetry as an on-farm test to reduce dystocia in beef cattle.

PMID- 8358679
TI  - Chlamydia psittaci infection and associated infertility in sheep.
AB  - Nineteen ewes were injected subcutaneously with the agent of enzootic ovine
      abortion, Chlamydia psittaci serovar 1, at 50 days gestation. Placental and fetal
      tissues were examined at 15 days postinfection and thereafter at ten day
      intervals. Placental infection was detected at 15 days postinfection. Only
      postinoculation sera collected from postinfected ewes contained antibodies
      reactive to C. psittaci. Five (26%) chlamydial infected ewes experienced
      inapparent fetal loss before day 105 of gestation. This finding is significant
      since C. psittaci infection in sheep is commonly associated with abortion and not
      infertility.

PMID- 8358678
TI  - Characterization of Salmonella enteritidis strains.
AB  - A study was conducted to characterize 318 Salmonella enteritidis strains that
      were mainly isolated from poultry and their environment in Canada. Biotype,
      phagetype (PT), plasmid profile (PP), hybridization with a plasmid-derived
      virulence sequence probe, antibiotic resistance, outer membrane proteins (OMPs),
      and lipopolysaccharide (LPS) profiles were determined. Relationships of these
      properties to one another, and their diagnostic and pathogenic significance were
      assessed. Biotyping indicated that failure to ferment rhamnose was sometimes
      useful as a marker for epidemiologically related strains. Phagetyping was the
      most effective method for subdividing S. enteritidis; it distinguished 12 PTs.
      Phagetype 13 was occasionally associated with septicemia and mortality in
      chickens. The strains belonged to 15 PPs. A 36 megadalton (MDa) plasmid was found
      in 97% of the strains. Only the 36 MDa plasmid hybridized with the probe.
      Seventeen percent of the strains were drug resistant; all strains were sensitive
      to ciprofloxacin. Thirty-five of 36 strains possessed the same OMP profile, and
      36 of 41 strains contained smooth LPS.

PMID- 8358680
TI  - Actinobacillus pleuropneumoniae culture supernatants interfere with killing of
      Pasteurella multocida by swine pulmonary alveolar macrophages.
AB  - The effect of Actinobacillus pleuropneumoniae culture supernatant on swine
      pulmonary alveolar macrophage (PAM) functions was studied. The A.
      pleuropneumoniae culture supernatant was toxic to PAMs when tested by MTT (3-(4,5
      dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and lactate dehydrogenase
      (LDH) release assays. Biological activity of the supernatant was ascribed to
      cytotoxins. Both the LDH and MTT assays were used for measurement of crude A.
      pleuropneumoniae cytotoxin concentration with good reproducibility. A preparation
      containing 6,800 toxic units/mL (determined by MTT assay) was used for subsequent
      experiments. The objective was to study the effect of crude cytotoxin on the
      ability of swine PAMs to kill Pasteurella multocida. Phagocytosis of opsonized P.
      multocida type A by PAMs was not efficient. Only 8% of incubated organisms were
      ingested by noncytotoxin-treated PAMs after 30 min phagocytosis. The bactericidal
      effect of noncytotoxin-treated PAMs only last for 60 min, after which, the rate
      of growth of surviving P. multocida exceeded the rate of bacterial killing by
      PAMs. Complete elimination of P. multocida by PAMs was not observed in this
      study. A total loss of ability to kill P. multocida by PAMs was seen when the
      PAMs were pretreated with a high concentration (340 toxic units/mL) of A.
      pleuropneumoniae cytotoxin. If the PAMs were pretreated with a low concentration
      (3.4 toxic units/mL) of cytotoxin, a significant reduction in the killing of P.
      multocida was still observed. The reductions in phagocytosis, phagosome-lysosome
      fusion (demonstrated using yeast particles of Candida albicans), and oxidative
      burst (demonstrated by nitro blue tetrazolium reduction (NBT) assay) may have
      contributed to the impaired killing of P. multocida by PAMs.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8358681
TI  - Effects of Pasteurella haemolytica culture supernate on bovine tracheal smooth
      muscle.
AB  - Pasteurella haemolytica leukotoxin is a ruminant specific leukotoxin that has
      been implicated in the pathogenesis of shipping fever in cattle. The present
      study was undertaken to determine the effect of this toxin on bovine airway
      smooth muscle. In vitro, the addition of culture supernate containing leukotoxin
      to bovine tracheal smooth muscle resulted in contraction of 55% of the muscle
      strips tested. Maximum responses were reached rapidly during cumulative additions
      of this material. In 95% of the muscle strips that responded, maximum responses
      were obtained after the addition of one or two cumulative doses. Repeated
      additions of culture supernate resulted in decreased responsiveness. Since
      responsiveness to other agonists was not affected, these results suggest the
      development of a condition similar to tachyphylaxis. The contractions were
      inhibited by antihistamines. Diphenhydramine, at a concentration of 10(-6) M
      (dose-ratio 7), and mepyramine, at a concentration of 2 x 10(-7) M (dose-ratio
      56), blocked the contractions by 84% and 100% respectively. In addition, the
      contractions were blocked by the muscarinic antagonist atropine, but this
      inhibition was much weaker (46%) and was present at high concentrations only.
      Inhibition of the contractions by H1 receptor antagonists suggests that the
      contractions are mediated via H1 receptors. Since the dose-response relationship
      is not typical of a drug-receptor interaction, it appears unlikely that the
      leukotoxin is a direct agonist of H1 receptors. It is proposed that an indirect
      mechanism of action involving the release of histamine by tissue mast cells is
      responsible for the leukotoxin-induced contractions.

PMID- 8358683
TI  - Influence of low dietary iron and iron overload on urethan-induced lung tumors in
      mice.
AB  - Weanling male CD-1 mice were fed low iron (7 ppm), control (120 ppm) and iron
      loaded diets (3000 or 5000 ppm) for 19 weeks. After seven weeks, the mice
      received 1.5 mg urethan/g ip, and tumor development was evaluated 12 weeks later.
      The low iron diet increased the incidence of lung adenomas by 86%. The iron
      loaded diets did not influence adenoma development. Tumor size was unaffected by
      iron status (p = 0.297). These results indicate that low iron body status
      promotes tumor development and are inconsistent with the hypothesis that excess
      iron promotes cancer growth and that low iron protects against tumor growth.

PMID- 8358682
TI  - Detection of Actinobacillus pleuropneumoniae in the porcine upper respiratory
      tract as a complement to serological tests.
AB  - Attempts were made to isolate Actinobacillus pleuropneumoniae from the nasal
      cavities and tonsils of 442 healthy pigs from 15 herds. Samples were streaked
      onto different media formulations. Serum samples were assayed for antibodies to
      A. pleuropneumoniae by enzyme-linked immunosorbent assay and complement fixation
      test. Actinobacillus pleuropneumoniae was isolated from the nasal cavities only
      in 24 pigs, from tonsils only in 90 pigs, and from both the nasal cavities and
      the tonsils in 11 pigs. A PPLO medium supplemented with lincomycin, bacitracin
      and crystal violet allowed recovery of A. pleuropneumoniae from more animals than
      a tryptic soy agar medium from both sites. Incubation of plates in an enriched
      CO2 atmosphere did not affect the recovery rate. Actinobacillus pleuropneumoniae
      belonging to serotypes 1, 2, 3, 5a, 5b, 7, 8, 10 and 12 were isolated, and, in
      several herds, more than one serotype were recovered. Serotypes of A.
      pleuropneumoniae were isolated from nine herds which were found seronegative to
      these. The isolation of A. pleuropneumoniae from the upper respiratory tract can
      be useful for detection of carrier pigs and complements serological screening.

PMID- 8358684
TI  - Response of heifer mammary gland macrophages and neutrophils to interferon-gamma
      stimulation in vitro.
AB  - The phagocytic and killing abilities of heifer mammary gland macrophages (M phi)
      and neutrophils were evaluated after exposure to recombinant bovine interferon
      gamma (rBoIFN-gamma) stimulation in vitro. Macrophages or neutrophils were
      cultured for 2 h with 0, 10(2), 10(4) and 10(5) units rBoIFN-gamma/mL.
      Phagocytosis assays were performed by incubation with Staphylococcus aureus at a
      leukocyte:bacteria ratio of 1:10. After 45 min, cells were stained with acridine
      orange and phagocytic and killing abilities were determined. Although rBoIFN
      gamma had no effect on M phi phagocytic activity, neutrophil phagocytic activity
      after incubation in 10(4) units rBoIFN-gamma (41.62%) was significantly higher
      than 0 (25.24%) or 10(2) units rBoIFN-gamma (24.73%). Neutrophil and M Phi
      killing abilities were not affected by any dose of rBoIFN-gamma. Results
      suggested that rBoIFN-gamma promoted neutrophil phagocytic activity, but did not
      affect neutrophil killing or overall M phi function in vitro.

PMID- 8358685
TI  - Injuries and public health in Canada.

PMID- 8358686
TI  - A pilot study of farm accidental injuries in Aberdeen, Saskatchewan.

PMID- 8358687
TI  - Home injuries to children.
AB  - To describe the circumstances around childhood injuries in the home, information
      on home injuries to children was collected in the emergency room of a pediatric
      trauma centre as part of an injury surveillance program. During a one-year
      period, data on 1,538 patients (age < or = 18 years) injured at home were
      recorded. An inverse s-shape association of home injuries with age was observed.
      Falls were the leading cause (51%); other children were struck by objects (18%)
      or sustained cutting/piercing injuries (9%). Age was positively associated with
      the likelihood of being struck by objects, cutting/piercing, and overexertion,
      but negatively associated with falls. Playing was the most common activity at
      time of injury. The peak time of injuries tended to be the early evening. Because
      most injuries occurred in an environment that seemed safe to parents, reduction
      in home injuries may require identification of potential hazards in the context
      of the stages of children's psychological and motor development.

PMID- 8358688
TI  - Childhood gunshot injuries in the Ottawa area.
AB  - To determine the incidence of non-fatal firearm injuries in the Ottawa area, we
      retrospectively reviewed the charts of all children admitted to the Children's
      Hospital of Eastern Ontario for firearm injuries in the last 15 years. The
      Children's Hospital is the only pediatric tertiary care care centre in the
      Eastern Ontario and Western Quebec areas, serving a child population of 600,000.
      Eighteen children were admitted to our hospital for firearm injuries during this
      period; six suffered long-term disabilities. The low number of non-fatal firearm
      injuries at our institution reflects national trends in the incidence of fatal
      firearm injuries in Canadian children and adolescents.

PMID- 8358689
TI  - Parental attitudes toward legislation for helmet use by child cyclists.
AB  - A random-digit dialing telephone survey was conducted in the second half of 1991
      to examine parental attitudes toward legislation of helmet use by child cyclists.
      The surveyed population were 703 parents of at least one child aged 5-17 years
      who owned a bicycle and lived within Metropolitan Toronto. Five hundred sixty
      eight (80.8%) responding parents were in favour of the suggested legislation, 81
      (11.5%) were against, and 54 (7.7%) had no opinion on the issue. The 95%
      confidence interval for the support rate was 78.9-83.7%. Although there was some
      variation in the level of support, at least two thirds of the respondents in
      every subgroup, except parents with teenaged children (aged 15-17 years), were in
      favour of the legislation. Legislation requiring bicycle helmet use by all
      children has strong support from the public. Additional surveys should be
      directed at public attitudes to legislation of helmet use by adults.

PMID- 8358690
TI  - [Profile of aged traffic victims on the road to Sherbrooke (Quebec)].
AB  - This article draws a portrait of the victims, 65 years of age and over, of road
      accidents in a mid-size Quebec town. By examining four variables--age, sex,
      condition of the victims and the type of road users--we measured the magnitude
      and severity of road accident injuries in senior citizens, and identified those
      road users most at risk. Results indicate that, in the city of Sherbrooke as
      elsewhere in Quebec, road accident injuries are increasing slowly but constantly
      in this age group. Analysis of the severity of injuries and of the category of
      road users, shows that senior citizens have a high degree of vulnerability and
      are over-represented in statistics dealing with pedestrians who are victims of
      accidents. We discuss these results and their impact on public health.

PMID- 8358691
TI  - Cooperation and collaboration between a public health unit and midsized private
      industry in health promotion programming: the Polymer Heart Health Program
      experience.
AB  - In 1990, Cobequid Health Unit was approached by Polymer International, a plastics
      manufacturer, and planning began for a worksite cardiovascular risk factor
      screening and follow-up program. In 1991, 302 Polymer employees (89.1%)
      participated in a screening. Follow-up included smoking cessation programs,
      fitness opportunities, dietary counselling, and physician referral for further
      investigation of blood pressure and cholesterol levels. Policy and environmental
      changes include heart healthy foods at the cafeteria, development of non-smoking
      policy, and coverage under the corporate group insurance plan for dietary
      counselling. This process demonstrates the potential for public health and
      private industry to collaborate in preventive efforts and the principles required
      for success.

PMID- 8358692
TI  - Hypertension follow-up survey Laval, Quebec, 1988.
AB  - In 1988, a follow-up study of a group of hypertensives (n = 278), identified two
      years earlier in a prevalence survey (1986), was conducted. Blood pressure (BP)
      levels, treatment and control status and medical follow-up were assessed.
      Subjects were classified as either known hypertensives or newly identified
      hypertensives. There was a moderate increase in blood pressure control over the
      two-year period in known hypertensives. Approximately half of newly identified
      hypertensives remained untreated, uncontrolled; half became ex-hypertensives. One
      third of the ex-hypertensives, however, still had high-normal diastolic readings
      (85-89 mm Hg). Newly identified hypertensives reported less frequent medical
      visits and fewer non-pharmacological recommendations from their physicians than
      known hypertensives. The study suggests that follow-up and counselling on
      modifiable risk factors in borderline and mild hypertensives might not be up to
      recent Canadian and American guidelines.

PMID- 8358694
TI  - [Knowledge and attitude to sexually transmitted diseases and condoms in students
      and undergraduate students].
AB  - Since sexually transmitted diseases (STDs) are a serious health problem among
      youth, proper understanding of knowledge about STDs, beliefs about condom use and
      associated factors are public health necessities. A self-administered
      questionnaire was sent to 2,920 randomly selected students and was returned by
      59.3% of the sample. We observed a lack of knowledge in one third of students,
      negative beliefs on condom use for at least 20% of students and a low perceived
      risk to contract STDs. With multivariate analyses, we observed that male
      students, youths between 18-21 years of age and those who didn't have any sexual
      partner since their admission to the university should be the target of
      intervention programs.

PMID- 8358693
TI  - Calgary's needle exchange program: profile of injection drug users.
AB  - This report provides a baseline description of a sample of injection drug users
      who are clients of a needle exchange program in Calgary, Alberta. The results of
      the study suggest a relatively older, predominantly male clientele who reported
      heavy and sustained use of drugs, particularly cocaine. Despite a high level of
      awareness of the basic modes of HIV transmission, many respondents still engaged
      in high risk injection practices and/or sexual practices. In addition, self
      perception of risk was much lower than reported behaviour would indicate. Three
      percent of the sample were HIV+ at the time of the interview. In addition to
      providing a baseline for further evaluation, the results of this study can be
      used by program planners to target interventions more effectively.

PMID- 8358695
TI  - [Utilization of qualitative and quantitative methods to study the attitudes and
      beliefs related to AIDS in a Montreal population of Haitian origin].
AB  - To determine attitudes and beliefs related to AIDS among the population of
      metropolitan Montreal of Haitian origin, we conducted serial cross-sectional
      surveys between 1987 and 1990 among a random sample of 777 men and women aged 15
      to 39. Data on perceived risk of AIDS and attitudes towards HIV testing were
      collected in home settings using a combination of face-to-face structured
      interviews and a self-administered questionnaire. Multivariate analysis was
      conducted to determine predictors of attitudes towards people with HIV. The fear
      of being infected with HIV is great in this population. The social representation
      of illness in this community is very much influenced by religious beliefs. Scores
      for the five-item scale suggest only moderately favourable attitudes towards
      persons with HIV compared to Montrealers in general. Attitudes towards persons
      with AIDS were positively associated with years of schooling and a higher
      perceived risk of getting infected (p < or = 0.01).

PMID- 8358696
TI  - Concentrations of organochlorine pesticides in the adipose tissue of British
      Columbia residents.
AB  - Adipose tissue from a sample of 41 British Columbians was analyzed for a number
      of organochlorine pesticides. Pesticide concentrations were very low. Persistent
      fat-soluble compounds like DDT were found at the highest concentrations, whereas
      compounds that either quickly metabolize to other forms or are readily excreted
      were found at low levels or not detected. Data on age, sex, area of residence,
      occupation, diet and weight were obtained by interview. Increasing age was
      related to increasing levels of several of the persistent pesticides. Although
      there were insufficient data for statistical analysis, two individuals with
      potential occupational exposures had much higher levels of the pesticides than
      other subjects. Although population-based surveys of these organochlorine
      pesticides in human tissue may have little value, further study may be warranted
      for groups known to have had high exposures (e.g. occupationally exposed).

PMID- 8358697
TI  - Indicators for a sustainable society.
AB  - This study presents a set of 20 indicators that could be suitable for monitoring
      the progress of our society on the path to sustainable development. Based on the
      concept of a sustainable society, which explicitly links the four aspects of
      health, social equity, economy and environment, these indicators are meant for
      large administrative areas, and use mostly already available data. The approach
      is global and symbolic in order to be able to facilitate the integration of the
      four aspects in the public's mind. It is information for action that could be
      used in a systematic way for presentation to the general public and to decision
      makers, in the manner of everyday economic or weather indicators.

PMID- 8358698
TI  - The accuracy of ascertaining vital status in a historical cohort study of
      synthetic textiles workers using computerized record linkage to the Canadian
      Mortality Data Base.
AB  - Vital status of a cohort of 10,211 Quebec, synthetic textiles workers was
      ascertained through a probabilistic record linkage to the Canadian Mortality Data
      Base (CMDB); 5,033 of these workers were also traced using other sources. There
      was agreement in the vital status of all but 60 of the subjects traced jointly
      through the CMDB and the alternate sources. 41 subjects were declared 'deceased'
      from the CMDB but 'alive' from the alternate sources; it is likely that these
      subjects were indeed deceased. 19 subjects, declared 'deceased' with a fair
      degree of certainty from the alternate sources, were not identified from the
      computer search of the CMDB; 17 were found manually on the microfiche death
      records and two died outside of Canada. The probability of identifying deceased
      and living subjects from the CMDB was therefore estimated to be 98.2% (95%
      confidence interval: 97.5-98.7%) and about 100%, respectively. Estimates of cost
      are also presented, and it is concluded that use of the CMDB is the method of
      choice for tracing moderate to large cohorts.

PMID- 8358699
TI  - Leukemia and residential exposure to radon.

PMID- 8358700
TI  - Preconceptional folate and neural tube defects: time for rethinking.

PMID- 8358701
TI  - Children fathered by previous partners: a risk factor for violence against women.

PMID- 8358702
TI  - Concerning the link between tobacco smoking and impaired mental functioning.

PMID- 8358703
TI  - Q fever.
AB  - Q fever is an acute febrile illness first described in 1935 and now seen in many
      parts of the world. Human infection follows exposure to animals, especially
      domestic livestock. Recent outbreaks in metropolitan areas have implicated cats
      as the carrier of disease to humans. The etiologic agent, Coxiella burnetti,
      belongs to the family Rickettsiaceae, although it has distinct genetic
      characteristics and modes of transmission. Most recent attention has been focused
      on a number of large outbreaks of Q fever associated with medical research
      involving pregnant sheep. Although most infections are self-limited, some
      patients require prolonged treatment. Recent vaccines have had encouraging
      success in the prevention of disease in individuals at high risk of exposure.

PMID- 8358704
TI  - Delta hepatitis: molecular biology and clinical and epidemiological features.
AB  - Hepatitis delta virus, discovered in 1977, requires the help of hepatitis B virus
      to replicate in hepatocytes and is an important cause of acute, fulminant, and
      chronic liver disease in many regions of the world. Because of the helper
      function of hepatitis delta virus, infection with it occurs either as a
      coinfection with hepatitis B or as a superinfection of a carrier of hepatitis B
      surface antigen. Although the mechanisms of transmission are similar to those of
      hepatitis B virus, the patterns of transmission of delta virus vary widely around
      the world. In regions of the world in which hepatitis delta virus infection is
      not endemic, the disease is confined to groups at high risk of acquiring
      hepatitis B infection and high-risk hepatitis B carriers. Because of the
      propensity of this viral infection to cause fulminant as well as chronic liver
      disease, continued incursion of hepatitis delta virus into areas of the world
      where persistent hepatitis B infection is endemic will have serious implications.
      Prevention depends on the widespread use of hepatitis B vaccine. This review
      focuses on the molecular biology and the clinical and epidemiologic features of
      this important viral infection.

PMID- 8358708
TI  - Increased mannose 6-phosphate/insulin-like growth factor II receptor and
      transforming growth factor beta 1 levels during monoterpene-induced regression of
      mammary tumors.
AB  - The monoterpenes represent a potentially new class of breast cancer therapeutic
      agents. We have shown that d-limonene induces the regression of advanced rat
      mammary adenocarcinomas. These regressing tumors have an increased cellular
      concentration of both the mannose-6-phosphate/insulin-like growth factor II
      receptors and transforming growth factor beta 1. The terpene-induced regression
      of mammary tumors may result in part from the mitoinhibitory and differentiation
      properties of active transforming growth factor beta 1. Furthermore, the
      activation of transforming growth factor beta 1 in these tumors is likely to be
      facilitated by the increased concentration of the mannose-6-phosphate/insulin
      like growth factor II receptors in the mammary tumor cells. Tumors not responding
      to terpene therapy lacked a rise in the mannose-6-phosphate/insulin-like growth
      factor II receptor level which may relate to the fact that this gene is
      hemizygous due to maternal imprinting.

PMID- 8358709
TI  - Heterogeneity in MLL/AF-4 fusion messenger RNA detected by the polymerase chain
      reaction in t(4;11) acute leukemia.
AB  - We have designed a single polymerase chain reaction (PCR) primer pair that
      detects the MLL/AF-4 fusion mRNA encoded by the derivative 11 chromosome from
      t(4;11)(q21;q23) leukemia cells using the reverse transcriptase PCR technique.
      PCR amplification was possible in seven of seven cells studied. Sequencing of the
      amplified products showed three different breakpoints on 11q23 and three on 4q21,
      resulting in six unique fusion sequences. All fusion sequences maintained an open
      reading frame. The areas of the MLL and AF-4 genes that are conserved in all
      derivative 11 fusion RNAs and therefore likely to contribute to the function of
      the oncogenic fusion protein are centromeric regions of MLL through exon 6
      (retaining the AT hook motif) and telomeric regions of AF-4 beginning at codon
      491 (containing nuclear localization and GTP-binding motifs). A single primer
      pair was able to detect the derivative 11 fusion transcript in seven of seven
      cases of t(4;11) acute leukemia tested. Given the variability shown in specific
      fusion sequences, studies correlating differential exon usage with clinical
      parameters will require different fusion-specific oligonucleotides or PCR primer
      pairs.

PMID- 8358705
TI  - Leishmaniases of the New World: current concepts and implications for future
      research.
AB  - Recent epidemiologic studies indicate that leishmaniasis in the Americas is far
      more abundant and of greater public health importance than was previously
      recognized. The disease in the New World is caused by a number of different
      parasite species that are capable of producing a wide variety of clinical
      manifestations. The outcome of leishmanial infection in humans is largely
      dependent on the immune responsiveness of the host and the virulence of the
      infecting parasite strain. This article reviews current concepts of the clinical
      forms, immunology, pathology, laboratory diagnosis, and treatment of the disease
      as well as aspects of its epidemiology and control. Recommendations for future
      research on the disease and its control are made.

PMID- 8358710
TI  - Association of putative origins of replication with the nuclear matrix in normal
      human fibroblasts.
AB  - Several metabolic processes, such as DNA organization and replication,
      transcription, and RNA processing are closely associated with the nuclear matrix.
      Nuclear matrix attachment regions are nucleotide sequences holding DNA tightly
      complexed with the nuclear scaffold and are resistant to extractions with
      detergents and high salt solutions. The role of matrix attachment regions in DNA
      replication has not been completely clarified, but they have been identified in
      close association with origins of replication in mammalian cells. We isolated
      nuclear matrix-associated DNA from normal human fibroblasts synchronized to
      different phases of the cell cycle and cloned compatible fragments into pUC19. We
      tested the homology of a fraction of the available clones to DNA replicated at
      the beginning of the S phase in human fibroblasts. We confirmed that nuclear
      matrix-associated DNA isolated from cells in G0 and G1 phases of the cell cycle
      contains sequences that are among the earliest replicated regions in the human
      genome. This finding supports the hypothesis that matrix attachment regions in
      human DNA are located in close proximity to origins of DNA replication.

PMID- 8358711
TI  - Transplacental carcinogenicity of cisplatin: initiation of skin tumors and
      induction of other preneoplastic and neoplastic lesions in SENCAR mice.
AB  - cis-Dichlorodiammineplatinum (cis-DDP), an anticancer agent sometimes used in
      pregnant women for the treatment of malignant ovarian and uterine tumors, was
      tested for transplacental carcinogenic and/or tumor-initiating effects in SENCAR
      mice. Pregnant mice were given a single i.p. injection of either cis-DDP (7.5
      mg/kg body weight) in 2.5% NaCl or the same weight-adjusted volume of NaCl (5
      ml/kg body weight) on day 17 of gestation. Offspring were delivered and raised by
      their natural mothers until weaning at 3 weeks of age. Starting at week 4,
      offspring in experimental groups received topical applications of 2 micrograms 12
      O-tetradecanoylphorbol-13-acetate (TPA) in acetone twice a week for 20 weeks
      while those in control groups received only acetone (0.2 ml/application) for the
      same duration. The experiment was terminated at 25 weeks of age. A high incidence
      (18 of 37; 48.7%) of papillomas was observed in offspring exposed
      transplacentally to cis-DDP and postnatally to TPA, while only 10% (4 of 40) of
      offspring exposed to TPA alone developed such tumors (P < 0.0002). Although no
      skin tumors were observed without TPA promotion, transplacental administration of
      cis-DDP resulted in development of thymic lymphomas, lung tumors, and
      proliferative kidney lesions in offspring. These results provide the first
      evidence that cis-DDP can initiate and/or induce preneoplastic and neoplastic
      lesions in multiple tissues transplacentally.

PMID- 8358712
TI  - Alternatively spliced glucocorticoid receptor messenger RNAs in glucocorticoid
      resistant human multiple myeloma cells.
AB  - Glucocorticoids are highly effective chemotherapeutic agents used in the
      treatment of hematological malignancies including multiple myeloma. However, the
      clinical usefulness of this class of drugs is limited by the problem of
      resistance. In the following study, we have isolated two alternatively spliced
      transcripts of the glucocorticoid receptor from a complementary DNA library
      generated from the glucocorticoid-resistant myeloma cell line MM.1Re. In each of
      the clones, specific exons of the hormone binding domain are precisely deleted.
      Our data implicate alternate splicing as a mechanism by which a cell generates
      different receptor isoforms and as a consequence evades the effects of hormone.

PMID- 8358706
TI  - Clostridium difficile: clinical disease and diagnosis.
AB  - Clostridium difficile is an opportunistic pathogen that causes a spectrum of
      disease ranging from antibiotic-associated diarrhea to pseudomembranous colitis.
      Although the disease was first described in 1893, the etiologic agent was not
      isolated and identified until 1978. Since clinical and pathological features of
      C. difficile-associated disease are not easily distinguished from those of other
      gastrointestinal diseases, including ulcerative colitis, chronic inflammatory
      bowel disease, and Crohn's disease, diagnostic methods have relied on either
      isolation and identification of the microorganism or direct detection of
      bacterial antigens or toxins in stool specimens. The current review focuses on
      the sensitivity, specificity, and practical use of several diagnostic tests,
      including methods for culture of the etiologic agent, cellular cytotoxicity
      assays, latex agglutination tests, enzyme immunoassay systems,
      counterimmunoelectrophoresis, fluorescent-antibody assays, and polymerase chain
      reactions.

PMID- 8358714
TI  - Repair of O6-methylguanine and O4-methylthymidine in F344 rat liver following
      treatment with 1,2-dimethylhydrazine and O6-benzylguanine.
AB  - Concentrations of O6-methylguanine, O4-methylthymidine, and N-7-methylguanine
      were measured in the livers of Fischer 344 rats following treatment with 1,2
      dimethylhydrazine (20 mg/kg, s.c.) alone or in combination with the O6
      alkylguanine transferase inhibitor O6-benzylguanine (100 mg/kg, i.p., daily).
      Animals were sacrificed at 12, 24, 36, or 48 h following 1,2-dimethylhydrazine
      exposure. Direct measurement of alkyltransferase demonstrated that daily
      treatment with O6-benzylguanine completely eliminated detectable alkyltransferase
      activity in the livers of treated rats. Adducts in liver DNA were quantitated by
      high performance liquid chromatography separation followed by fluorescence
      detection, UV absorbance, and/or specific radioimmunological assays. In animals
      exposed to 1,2-dimethylhydrazine alone O6-methylguanine concentrations declined
      rapidly, whereas animals exposed to both O6-benzylguanine and 1,2
      dimethylhydrazine showed less removal of O6-methylguanine, with significant
      differences between the two populations appearing at 36 and 48 h. O4
      Methylthymidine removal also differed significantly between the two groups, with
      O6-benzylguanine-treated animals exhibiting higher concentrations of adducts at
      36 and 48 h. O6-Benzylguanine treatment had no effect on the removal of N-7
      methylguanine. These results show that the rate of disappearance of both O6
      methylguanine and O4-methylthymidine is slower following alkyltransferase
      depletion, suggesting that mammalian alkyltransferase is involved in the removal
      of O4-methylthymidine lesions as well as O6-methylguanine lesions.

PMID- 8358713
TI  - Radiation-induced transforming growth factor beta and subsequent extracellular
      matrix reorganization in murine mammary gland.
AB  - Little is known about radiation-induced protein expression in vivo nor has the
      relationship between early molecular events and subsequent tissue repair,
      fibrosis, or carcinogenesis been fully appraised. In this study, expression of
      proteins involved in tissue remodeling was examined in mammary gland immediately
      and shortly after ionizing radiation exposure. Using indirect immunofluorescence,
      selected antigens were followed as a function of time after 0, 5, or 10 Gy of
      whole body gamma-radiation in the mammary gland of adult female BALB/c mice.
      Rapid induction of transforming growth factor beta (TGF beta) immunoreactivity
      was observed at 1 h post radiation. Extracellular and intracellular TGF beta
      increased in the periepithelial stromal sheath as evidenced by immunoreactivity
      with antibodies CC(1-30) and LC(1-30), respectively. Furthermore, both
      extracellular and intracellular TGF beta were unexpectedly expressed in the
      previously negative adipose stroma. Elevated expression persisted for 7 days
      after irradiation. Thus an early response to radiation exposure is the induction
      of TGF beta, which mediates myriad events during tissue repair, growth, and
      extracellular matrix production. The distribution of extracellular matrix
      proteins was examined as a function of time post radiation exposure. Collagen III
      immunoreactivity decreased in the periepithelial stroma at day 1. In contrast, at
      day 3 collagen III was newly evident in the adipose stroma, and periepithelial
      collagen III had increased in both abundance and intensity. By day 7 collagen III
      expression in the adipose stroma had resolved but was enhanced in the
      periepithelial stroma. Over this same period stromal collagen I immunoreactivity
      surrounding the epithelium became diffuse and possibly diminished. Fibronectin,
      laminin, and collagen IV localization were unchanged over the time course. I
      postulate that radiation-induced TGF beta may mediate the remodeling of the
      stromal extracellular matrix in the irradiated mammary gland.

PMID- 8358715
TI  - Chemopreventive effects of dietary D,L-alpha-difluoromethylornithine, an
      ornithine decarboxylase inhibitor, on initiation and postinitiation stages of
      diethylnitrosamine-induced rat hepatocarcinogenesis.
AB  - The modifying effects of dietary administration of D,L-alpha
      difluoromethylornithine (DFMO) during initiation or postinitiation phase on the
      hepatocarcinogenesis initiated by diethylnitrosamine (DEN) were investigated in
      male F344 rats. A total of 129 animals were divided into seven groups. Groups 1-5
      were given the drinking water containing 40 ppm DEN for 5 weeks, starting at 7
      weeks of age. Groups 2 and 3 were fed the diets mixed with 500 and 1000 ppm DFMO,
      respectively, for 7 weeks, starting at 6 weeks of age. Groups 4 and 5 were given
      the diets containing 500 and 1000 ppm DFMO, respectively, starting 1 week after
      DEN exposure and maintained on these diets until the end of the study (Week 32).
      Rats in group 6 were fed the DFMO diet (1000 ppm) alone during the experiment.
      Group 7 served as an untreated control. At the end of the study, the incidences
      of liver cell foci (resistant iron accumulation or positive for glutathione S
      transferase placental form) and hepatocellular neoplasms along with polyamine
      levels in the liver were measured. Also, morphometric analysis of silver-stained
      nucleolar organizer regions proteins as cell proliferation activity in liver
      cells was performed. The mean incidences and areas of foci in rats given DEN and
      DFMO in groups 2-5 were significantly lower than those of group 1 (P < 0.01). The
      frequencies of liver cell tumors in group 3 (50%), 4 (24%), and 5 (45%) were
      significantly reduced compared to that of group 1 (100%) (P < 0.01). The
      multiplicities of neoplasms in group 2 (1.15/rat), 3 (0.65/rat), 4 (0.35/rat),
      and 5 (0.95/rat) were significantly smaller than that of group 1 (3.34/rat) (P <
      0.001). Although the polyamine levels of liver tissues among the groups showed no
      clear differences among the groups, the number and area of silver-stained
      nucleolar organizer regions proteins/nucleus in rats given DEN and DFMO (groups 2
      5) were significantly lower than those of group 1. These results indicate that
      the feeding of DFMO during the initiation or postinitiation stage clearly
      inhibited DEN-induced rat hepatocarcinogenesis and that such inhibition may be
      due to alteration in cell proliferation activity caused by DFMO.

PMID- 8358716
TI  - Chemoprevention of colon carcinogenesis by the natural product of a simple
      phenolic compound protocatechuic acid: suppressing effects on tumor development
      and biomarkers expression of colon tumorigenesis.
AB  - Our previous study has shown that dietary administration of protocatechuic acid
      (PCA) acts as potential chemopreventive agent in inhibiting diethylnitrosamine
      induced liver carcinogenesis in male F344 rats. The present study was designed to
      determine the modifying effect of PCA on azoxymethane (AOM)-induced colon
      carcinogenesis in male F344 rats and the effect on intermediate biomarkers, i.e.,
      colonic mucosal ornithine decarboxylase activity and colonic epithelial
      proliferation, which can be used as effective predictors of colon cancer. Staring
      at 6 weeks of age, groups of animals were fed the basal diet and experimental
      diet containing PCA at dose levels of 250, 500, and 1000 ppm. At 7 weeks of age,
      all animals except the PCA alone group (1000 ppm) and untreated controls were
      given s.c. injections of AOM at a dose level of 15 mg/kg body weight/week for 3
      weeks. PCA at 3 doses was fed during the initiation phase (before 1 week, during,
      and after 1 week of AOM exposure) or postinitiation phase (for 28 weeks starting
      1 week after the last injection of AOM). All animals were then killed at 32 weeks
      after the start and colonic tumor incidence and multiplicity were determined.
      Animals intended for cell proliferation study were given injections of
      bromodeoxyuridine/5-fluoro-2'-deoxyuridine (1 ml/100 g body weight) 1 h prior to
      be killing. The rate of colonic cell proliferation in the distal portion was
      assessed by immunohistochemistry using antibromodeoxyuridine and by counting
      silver-stained nucleolar organizer regions protein. The colonic mucosal ornithine
      decarboxylase activity was also measured at the termination. The results indicate
      that dietary PCA administration at 500 and 1000 ppm during the initiation or
      postinitiation phase significantly inhibited intestinal carcinogenesis induced by
      AOM as revealed by the reduction of tumor incidence and multiplicity. The data
      also demonstrate that PCA at 500 ppm and 1000 ppm significantly inhibited
      bromodeoxyuridine labeling index and also silver-stained nucleolar organizer
      regions protein number at three doses when animals were fed PCA at the initiation
      or postinitiation stage. Also, feeding of PCA at 1000 ppm during the initiation
      and postinitiation phase exerted a pronounced inhibitory effect on the colonic
      ornithine decarboxylase levels. PCA feeding did not cause any toxicity. These
      results demonstrate that PCA is a possible new chemopreventive agent for colon
      carcinogenesis through the suppression of manifestation of intermediate
      biomarkers induced by AOM, although the precise mechanisms of PCA-induced
      inhibition during the initiation and postinitiation phases remain to be
      elucidated.

PMID- 8358717
TI  - Inhibitory effect of Bifidobacterium longum on colon, mammary, and liver
      carcinogenesis induced by 2-amino-3-methylimidazo[4,5-f]quinoline, a food
      mutagen.
AB  - The inhibitory effect of lyophilized cultures of Bifidobacterium longum on 2
      amino-3-methylimidazo[4,5-f]quinoline (IQ)-induced carcinogenesis was
      investigated in male and female F344 rats. Beginning at 5 weeks of age, male and
      female rats were divided into various experimental groups and fed one of the high
      fat, semipurified diets containing 0 and 0.5% lyophilized cultures of B. longum
      with or without 125 ppm IQ in the diet. All animals were continued on this
      regimen until the termination of the study. All animals were necropsied during
      the 58th week. The results indicated that dietary B. longum significantly
      inhibited the IQ-induced incidence (percentage of animals with tumors) of colon
      (100% inhibition) and liver (80% inhibition) tumors and multiplicity
      (tumors/animal) of colon, liver, and small intestinal tumors in male rats. In
      female rats, dietary supplementation of Bifidobacterium cultures also suppressed
      the IQ-induced mammary carcinogenesis to 50% and liver carcinogenesis to 27% of
      those observed in animals fed the control diet, but the differences did not reach
      a statistical significance at P < 0.05; however, the mammary tumor multiplicity
      (tumors/animal) was significantly (P < 0.05) inhibited in female rats fed the
      diet containing Bifidobacterium cultures. These findings suggest that
      Bifidobacterium supplements in the diet inhibit IQ-induced colon and liver tumors
      and to a lesser extent mammary tumors in F344 rats.

PMID- 8358718
TI  - Two-year carcinogenicity study of tamoxifen in Alderley Park Wistar-derived rats.
AB  - Tamoxifen, a nonsteroidal antiestrogen used widely in the treatment of breast
      cancer, was tested in a conventional 2-year carcinogenicity bioassay in rats, a
      species in which tamoxifen acts variably as a partial agonist and antagonist on
      different target tissues. Groups of 51 males and 52 females were given 5, 20, and
      35 mg/kg of tamoxifen/day by gastric intubation in 0.5% hydroxypropyl
      methylcellulose at 5 ml/kg dose volume. There were 102 male and 104 female
      controls dosed with vehicle alone. Growth rate and food consumption were reduced
      in all treated groups. The major finding was a dose-related increase in the
      incidence of hepatocellular tumors which were first observed after 31 weeks of
      treatment in the top dose group. The majority of the neoplasms were
      hepatocellular carcinomas showing a well differentiated trabecular pattern. Some
      tumors were glandular in type. Mortality was increased in the 20 and 35 mg/kg
      dose groups compared with controls as a result of these tumors. By contrast,
      survival was greater than controls in rats given 5 mg/kg tamoxifen despite the
      presence of hepatocellular tumors due to a reduction in the number of pituitary
      tumors in females and less chronic renal disease in males. The mechanism of
      hepatic tumor induction by tamoxifen in rats is unclear. In view of the lack of
      genotoxic activity in conventional genotoxicity studies and lack of similar
      effect in mice or in humans, the findings may relate to a particular
      constellation of effects in rats. All other drug-induced changes in this study
      were nonneoplastic in nature and most appeared to be the result of hormonal
      perturbation since they were confined to endocrine organs or have been seen
      previously in rats treated for long periods with tamoxifen.

PMID- 8358719
TI  - Stimulation of growth of azaserine-induced putative preneoplastic lesions in rat
      pancreas is mediated specifically by way of cholecystokinin-A receptors.
AB  - Cholecystokinin (CCK) has been shown to stimulate the growth of both normal
      pancreas and azaserine-induced putative preneoplastic pancreatic lesions in the
      rat. The present study was performed to determine whether these effects are
      mediated by way of CCK-A receptors, CCK-B receptors, or both. Sixteen-day-old
      male Lewis rats were given i.p. injections of azaserine at 30 mg/kg body weight.
      Starting on day 21, rats were given s.c. injections, 5 days/week for 16
      consecutive weeks, of either (a) CCK octapeptide (nonselective CCK agonist) (2.50
      micrograms/kg body weight, n = 17), (b) tert-butyloxycarbonyl-Trp-Lys(epsilon-N-2
      methylphenylaminocarbonyl++ +)-Asp- (N-methyl)-Phe-NH2 (highly selective CCK-A
      agonist) (1.84 micrograms/kg body weight, n = 18), (c) [(2R,3S)-beta-MePhe28,N
      MeNle31]CCK26-33 (highly selective CCK-B agonist) (2.40 micrograms/kg body
      weight, n = 18), or (d) normal saline solution (control, n = 17). Rats were
      subsequently sacrificed, pancreatic weights were determined, and quantitative
      morphometric analysis of atypical acinar cell foci and nodules was performed.
      Both CCK octapeptide and the selective CCK-A agonist tert-butyloxycarbonyl-Trp
      Lys(epsilon-N-2- methylphenylaminocarbonyl)-Asp-(N-methyl)-Phe-NH2 stimulated
      pancreatic growth and the development of acidophilic atypical acinar cell foci
      and nodules. Furthermore, the effect produced by the selective CCK-A agonist tert
      butyloxycarbonyl-Trp-Lys(epsilon-N-2- methylphenylaminocarbonyl)-Asp-(N-methyl)
      Phe-NH2 was greater than that produced by CCK octapeptide. In contrast, the
      selective CCK-B agonist [(2R,3S)-beta-MePhe28,N-MeNle31]CCK26-33 had no effect.
      These findings suggest that the growth of putative preneoplastic lesions
      (acidophilic atypical acinar cell foci and nodules) in the rat pancreas during
      the early stages of azaserine-induced pancreatic carcinogenesis is mediated
      specifically by way of CCK-A receptors.

PMID- 8358720
TI  - Phase I trial of a 90-minute infusion of the fusion toxin DAB486IL-2 in
      hematological cancers.
AB  - DAB486IL-2, a recombinant fusion toxin in which the native receptor binding
      domain of diphtheria toxin has been replaced with interleukin-2 (IL-2), has
      displayed significant activity in patients with chemotherapy refractory
      hematological cancers. To further investigate the safety and antitumor effect of
      this agent, we conducted a single arm, dose escalation study of a 90-min infusion
      of DAB486IL-2 daily for 5 days. Patients with cancers of a histology previously
      reported to express the p55 component of the IL-2 receptor and who could not
      receive potentially more effective therapy were eligible for enrollment. Fifteen
      men and 8 women with a median age of 49 years were given a total of 51 courses of
      DAB486IL-2. The maximum tolerated dose was 0.3 mg/kg/day defined by renal
      insufficiency associated with hemolysis and thrombocytopenia. The clearance of
      DAB486IL-2 from serum fit a one-compartment model with a half-life of 11.5 +/-
      4.3 (SD) min at the 0.2-mg/kg dose. Two patients sustained a partial response and
      4 patients had tumor reduction not qualifying for an objective response. No
      tumors that were negative for expression of the p55 subunit of the receptor
      responded to DAB486IL-2 treatment. Reduction in size occurred in 2 tumors in
      which p55 expression was unknown and 4 patients with tumors that were known to be
      p55 positive. Dosing determined by specific activity rather than mass also
      appeared to be an important determinant of response. This study suggests that the
      presence of p55 expression on tumor cells is necessary, but alone may not be
      sufficient to achieve a tumor response. The correlation of additional variables
      such as specific activity of DAB486IL-2 and tumor expression of the p75 subunit
      of the IL-2 receptor and receptor function will also require further study.

PMID- 8358707
TI  - The Mycobacterium avium complex.
AB  - Mycobacterium avium complex (MAC) disease emerged early in the epidemic of AIDS
      as one of the common opportunistic infections afflicting human immunodeficiency
      virus-infected patients. However, only over the past few years has a consensus
      developed about its significance to the morbidity and mortality of AIDS. M. avium
      was well known to mycobacteriologists decades before AIDS, and the MAC was known
      to cause disease, albeit uncommon, in humans and animals. The early interest in
      the MAC provided a basis for an explosion of studies over the past 10 years
      largely in response to the role of the MAC in AIDS opportunistic infection.
      Molecular techniques have been applied to the epidemiology of MAC disease as well
      as to a better understanding of the genetics of antimicrobial resistance. The
      interaction of the MAC with the immune system is complex, and putative MAC
      virulence factors appear to have a direct effect on the components of cellular
      immunity, including the regulation of cytokine expression and function. There now
      is compelling evidence that disseminated MAC disease in humans contributes to
      both a decrease in the quality of life and survival. Disseminated disease most
      commonly develops late in the course of AIDS as the CD4 cells are depleted below
      a critical threshold, but new therapies for prophylaxis and treatment offer
      considerable promise. These new therapeutic modalities are likely to be useful in
      the treatment of other forms of MAC disease in patients without AIDS. The
      laboratory diagnosis of MAC disease has focused on the detection of mycobacteria
      in the blood and tissues, and although the existing methods are largely adequate,
      there is need for improvement. Indeed, the successful treatment of MAC disease
      clearly will require an early and rapid detection of the MAC in clinical
      specimens long before the establishment of the characteristic overwhelming
      infection of bone marrow, liver, spleen, and other tissue. Also, a standard
      method of susceptibility testing is of increasing interest and importance as new
      effective antimicrobial agents are identified and evaluated. Antimicrobial
      resistance has already emerged as an important problem, and methods for
      circumventing resistance that use combination therapies are now being studied.

PMID- 8358721
TI  - Control of HLA-DR antigen expression by gamma-interferon: separate signal
      transduction mechanisms in malignant and nonmalignant human thyroid cells.
AB  - Three intracellular signal transduction pathways have been found to be utilized
      by gamma-interferon (IFN-gamma) in the induction of HLA-DR in several cell types,
      mainly monocytes/macrophages and B-cells: the protein kinase A (PKA); Ca(2+)
      calmodulin; and protein kinase C (PKC) pathways. In this study, we investigated
      the role of these pathways in IFN-gamma-induced HLA-DR expression in normal and
      neoplastic human thyroid cells. The PKA pathway seemed to inhibit both neoplastic
      and normal IFN-gamma-induced HLA-DR expression; addition of thyroid-stimulating
      hormone to normal thyroid cells, as well as 8-bromo cyclic AMP and forskolin to
      normal and neoplastic cells, reduced the amount of IFN-gamma-induced HLA-DR.
      Moreover, H-8, a PKA inhibitor, enhanced such IFN-gamma-induced HLA-DR
      expression. The calcium-calmodulin pathway does not seem to play a role in IFN
      gamma-induced HLA-DR expression in normal and neoplastic thyrocytes, since the Ca
      ionophore A23187, EGTA, and the calmodulin antagonist, W-7, neither induced HLA
      DR nor showed any effect on HLA-DR expression induced by IFN-gamma. Alone,
      phorbol 12-myristate 13-acetate, a PKC activator, did not induce HLA-DR on
      thyroid cells. However, its addition to neoplastic cells together with IFN-gamma
      caused a synergistic elevation of the expressed HLA-DR, whereas it significantly
      inhibited IFN-gamma-induced HLA-DR in normal thyrocytes. TPA had to be added
      before or together with IFN-gamma for optimal function. If added more than 6 h
      after IFN-gamma, TPA was not effective. An inactive TPA analogue did not affect
      HLA-DR induction, while an active analogue mimicked TPA. Staurosporine, a PKC
      inhibitor, reduced the TPA enhancing effect in neoplastic thyrocytes and
      cancelled TPA inhibition in normal cells. Moreover, when added to IFN-gamma
      without TPA in normal thyroid cells, staurosporine increased 3- to 4-fold the
      amount of HLA-DR. Thus, in normal thyroid cells the PKC pathway is activated by
      IFN-gamma and inhibits HLA-DR expression. In neoplastic thyrocytes, although IFN
      gamma does not induce HLA-DR via PKC, this pathway augments HLA-DR expression.

PMID- 8358722
TI  - Interaction of a polyamine analogue, 1,19-bis-(ethylamino)-5,10,15-
      triazanonadecane (BE-4-4-4-4), with DNA and effect on growth, survival, and
      polyamine levels in seven human brain tumor cell lines.
AB  - Computer graphics modeling and physicochemical studies of spermine-DNA
      interactions, as well as experiments in cell culture, indicate that a polyamine
      analogue with strong affinity for nucleic acids but poor ability to condense and
      aggregate DNA in vitro should act as an antiproliferative agent if it can enter
      cells. On the basis of our studies of polyamine-DNA interactions, we designed a
      pentamine, 1,19-bis(ethylamino)-5,10,15- triazanonadecane (BE-4-4-4-4), that had
      these characteristics. Measurement of melting temperature and ultraviolet light
      scattering studies show that the affinity of this analogue for calf-thymus DNA is
      about 4 times higher than that of spermine, whereas its ability to aggregate DNA
      is slightly poorer than that of spermine. Studies in U-87 MG, U-251 MG, SF-126,
      SF-188, SF-763, SF-767, and DAOY human brain tumor cells in tissue culture showed
      that treatment for more than 96 h with concentrations of 5 microM BE-4-4-4-4 or
      greater inhibited growth; decreased levels of putrescine, spermidine, and
      spermine; and decreased colony-forming ability in all cell lines. The
      cytotoxicity of the analogue varied among cell lines; DAOY and SF-767 were the
      most sensitive and the most resistant lines, respectively. In SF-763 cells,
      growth inhibition by BE-4-4-4-4 could be partially reversed by the addition of
      putrescine, spermidine, or spermine 1 day after BE-4-4-4-4 addition, but in U-251
      MG cells, growth inhibition was reversed only by spermine and not by other
      polyamines. When any of the naturally occurring polyamines was added
      simultaneously with BE-4-4-4-4, growth inhibition was completely blocked. The
      data suggest that a threshold intracellular concentration of BE-4-4-4-4 is needed
      to manifest the growth-inhibitory and cytotoxic effects. In most cell lines, once
      that threshold level is reached, the growth-inhibitory and cytotoxic properties
      of the analogue are manifest irrespective of cellular polyamine levels. Further
      increases in the BE-4-4-4-4 concentration or incubation time reduce the
      intracellular polyamine levels but do not significantly increase growth
      inhibition. In U-87 MG and DAOY cells, however, prolonged incubation with higher
      concentrations of BE-4-4-4-4 causes additional growth inhibition along with
      depletion of intracellular polyamines.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8358723
TI  - Site-specific prodrug activation by antibody-beta-lactamase conjugates:
      regression and long-term growth inhibition of human colon carcinoma xenograft
      models.
AB  - Antibody-directed catalysis (ADC) is a two-step method for the delivery of
      chemotherapeutic agents in which enzyme-antibody conjugate, prelocalized to
      antigen-bearing tumor cells, catalyzes the site-specific conversion of prodrug to
      drug. An ADC system consisting of F(ab')-beta-lactamase conjugates and a
      cephalosporin derivative of the oncolytic agent 4-desacetylvinblastine-3
      carboxhydrazide was investigated. The ability of the system to mediate antitumor
      activity was compared with that of free drug given alone and with covalent drug
      antibody conjugates in LS174T and T380 colon carcinoma xenografts in nude mice.
      Efficacy increased from moderate tumor growth inhibition by using free 4
      desacetylvinblastine-3-carboxhydrazide to tumor regression and long-term
      stabilization with the ADC system. Labile covalent drug-antibody conjugates
      prepared from the same antibodies were less effective than ADC and required much
      higher antibody doses. The antigens KS1/4, carcinoembryonic antigen, and tumor
      associated glycoprotein-72, TAG-72, present on the model cell lines, were chosen
      to investigate the effect of differences in subcellular location and expression
      heterogeneity on the efficacy of ADC delivery. Response was equivalent with the
      three tumor antigens. Hence, heterogeneous expression and membrane shedding of
      carcinoembryonic antigen and TAG-72, did not diminish the suitability of these
      antigens as targets for ADC therapy. In contrast, drug-antibody conjugate
      efficacy was more sensitive to subcellular location and heterogeneity. Thus, ADC
      is a highly effective form of immunochemotherapy in preclinical models, with
      applicability toward a variety of antigen targets.

PMID- 8358724
TI  - Arrest of human lung tumor xenograft growth in severe combined immunodeficient
      mice using doxorubicin encapsulated in sterically stabilized liposomes.
AB  - Incorporation of polyethylene glycol-derivatized phospholipids into liposomes
      results in carriers that can enhance the therapeutic efficacy of encapsulated
      drugs by imparting the ability to evade the reticuloendothelial system and remain
      in the circulation for prolonged periods. In this study, doxorubicin encapsulated
      in these sterically stabilized liposomes (S-DOX) is shown to completely arrest
      the growth of human lung tumor xenografts in severe combined immunodeficient
      (scid) mice. Doxorubicin administered at equivalent doses as free drug or
      encapsulated into conventional liposomes was ineffective at completely arresting
      the growth of this human tumor, although a decrease in tumor growth rate compared
      to untreated controls was observed. Scid mice were found to be significantly more
      susceptible to the toxic effects of doxorubicin than were immunocompetent C.B-17
      control mice, a characteristic that is likely to result from the deficit in DNA
      repair mechanisms previously identified in scid mice. However, doxorubicin
      toxicity in scid mice could be minimized while maintaining the antitumor activity
      of doxorubicin encapsulated in sterically stabilized liposomes by administering
      the drug in multiple weekly injections at low doses. This report provides the
      first evidence that antitumor drugs delivered in sterically stabilized liposomes
      are more effective at arresting the growth of human tumors than are conventional
      delivery systems. In addition, the scid mouse is presented as a viable model in
      which to study novel chemotherapeutic approaches to the treatment of human
      cancer.

PMID- 8358725
TI  - Neuroblastoma sensitivity to growth inhibition by deferrioxamine: evidence for a
      block in G1 phase of the cell cycle.
AB  - Iron (Fe) is known to be necessary for cellular proliferation. Previous studies
      have suggested that neuroblastoma cells appear to be relatively sensitive to
      growth inhibition by a specific Fe chelator, deferrioxamine (DFO), in vitro.
      Also, DFO has been recently used for the treatment of neuroblastoma patients. In
      this paper we demonstrate that neuroblastoma cell proliferation in vitro is
      extremely sensitive to inhibition by DFO as compared to another cell line with
      almost identical growth kinetics. Neuroblastoma cells treated with DFO adapt
      appropriately to Fe chelation as measured by marked upregulation of transferrin
      receptor mRNA, increased functional transferrin receptor, and decreased cellular
      ferritin concentration. Further studies that quantitated cellular incorporation
      of 59Fe from added transferrin-59Fe in the presence of DFO indicated that
      neuroblastoma cells were more sensitive to inhibition of Fe incorporation by the
      chelator as compared to the other cell line. Neuroblastoma cells treated with DFO
      showed a consistent arrest in the G1 phase of the cell cycle. For cells taken
      from the "resting" state this block occurred before the vast majority of cells
      had entered S or G2-M phases of the cell cycle. Further evidence that
      neuroblastoma cells were arrested before the G1-S interface was provided when
      cells inhibited by DFO and released into aphidicolin exhibit arrest at the G1-S
      interface, whereas release from aphidicolin into DFO resulted in entry into S
      phase. Also, DFO-treated cells exhibited a decrease in both p34cdc2
      immunoreactive protein as well as kinase activity. The results of these latter
      studies strongly indicate evidence for a Fe requirement for malignant cell
      proliferation before the onset of DNA synthesis. Our results also provide a basis
      for further studies that will better define a therapeutic approach to patients
      with neuroblastoma utilizing DFO treatment.

PMID- 8358726
TI  - Specific proteolytic cleavage of poly(ADP-ribose) polymerase: an early marker of
      chemotherapy-induced apoptosis.
AB  - Apoptosis is a morphologically and biochemically distinct form of cell death that
      occurs under a variety of physiological and pathological conditions. In the
      present study, the proteolytic cleavage of poly(ADP-ribose) polymerase (pADPRp)
      during the course of chemotherapy-induced apoptosis was examined. Treatment of HL
      60 human leukemia cells with the topoisomerase II-directed anticancer agent
      etoposide resulted in morphological changes characteristic of apoptosis.
      Endonucleolytic degradation of DNA to generate nucleosomal fragments occurred
      simultaneously. Western blotting with epitope-specific monoclonal and polyclonal
      antibodies revealed that these characteristic apoptotic changes were accompanied
      by early, quantitative cleavage of the M(r) 116,000 pADPRp polypeptide to an M(r)
      approximately 25,000 fragment containing the amino-terminal DNA-binding domain of
      pADPRp and an M(r) approximately 85,000 fragment containing the automodification
      and catalytic domains. Activity blotting revealed that the M(r) approximately
      85,000 fragment retained basal pADPRp activity but was not activated by exogenous
      nicked DNA. Similar cleavage of pADPRp was observed after exposure of HL-60 cells
      to a variety of chemotherapeutic agents including cis
      diaminedichloroplatinum(II), colcemid, 1-beta-D-arabinofuranosylcytosine, and
      methotrexate; to gamma-irradiation; or to the protein synthesis inhibitors
      puromycin or cycloheximide. Similar changes were observed in MDA-MB-468 human
      breast cancer cells treated with trifluorothymidine or 5-fluoro-2'-deoxyuridine
      and in gamma-irradiated or glucocorticoid-treated rat thymocytes undergoing
      apoptosis. Treatment with several compounds (tosyl-L-lysine chloromethyl ketone,
      tosyl-L-phenylalanine chloromethyl ketone, N-ethylmaleimide, iodoacetamide)
      prevented both the proteolytic cleavage of pADPRp and the internucleosomal
      fragmentation of DNA. The results suggest that proteolytic cleavage of pADPRp, in
      addition to being an early marker of chemotherapy-induced apoptosis, might
      reflect more widespread proteolysis that is a critical biochemical event early
      during the process of physiological cell death.

PMID- 8358727
TI  - In vitro and in vivo effect of doxorubicin combined with liposome-encapsulated
      muramyl tripeptide on canine monocyte activation.
AB  - Chemotherapeutic agents have been shown to enhance the antitumor activity of
      biological response modifiers and cytokines in rodents and humans. The purpose of
      this study was 2-fold: (a) to determine whether doxorubicin (DOX) would enhance
      or interfere with the effect of muramyl dipeptide and lipopolysaccharide on
      canine monocyte activation as measured by an in vitro WEHI-164 cell cytotoxicity
      assay; and (b) to evaluate the in vivo effect of DOX alone and combined with
      liposome-encapsulated muramyl tripeptide-phosphatidylethanolamine (L-MTP-PE) on
      monocyte activation and serum tumor necrosis factor activity. The in vitro
      results showed that increasing concentrations of DOX for either 1 or 24 h
      incubation did not directly enhance or inhibit spontaneous or activated monocyte
      supernatant-mediated cytotoxicity. The in vivo study showed that monocyte
      supernatant-mediated cytotoxicity was increased on day 3 and significantly
      elevated on day 7 (P = 0.016) post-DOX (30 mg/m2, single injection)
      administration. When DOX was given in combination with L-MTP-PE (2 mg/m2, twice
      weekly for 3 weeks), monocyte-mediated cytotoxicity was enhanced on days 3
      through 10 with a significant increase on day 10 (P < 0.001). In vivo monocyte
      supernatant-mediated cytotoxicity was significantly elevated in dogs receiving L
      MTP-PE alone at 2 h after day 0, 7, and 14 treatment, and this response was
      further enhanced by DOX. Serum tumor necrosis factor activity at 2 h post-L-MTP
      PE was enhanced and sustained for a longer period of time in dogs that also
      received DOX. We conclude that DOX administered with L-MTP-PE will enhance canine
      monocyte activation induced by DOX or L-MTP-PE alone, and suggest that DOX may be
      combined with L-MTP-PE early in the treatment of cancer patients.

PMID- 8358728
TI  - Unusual oxygen concentration dependence of toxicity of SR-4233, a hypoxic cell
      toxin.
AB  - Toxicity from drugs activated by bioreductive metabolism has been suggested as a
      means to eliminate the treatment resistance caused by hypoxic tumor cells. In
      general, drugs have been selected to maximize the hypoxic cytotoxicity ratio
      [exposure (drug concentration x time) in air:exposure in nitrogen] to cause equal
      toxicity. On this basis, two recently developed drugs have very similar
      characteristics; an aziridine derivative of misonidazole (RSU1069) and a
      benzotriazine di-N-oxide (SR4233). The oxygen dependence of the toxic response
      has not previously been characterized. This report shows that the toxicity from
      SR4233 extends over a much greater range of oxygen concentrations than does that
      of RSU1069. Furthermore, unlike all previous drugs studied, the toxicity of
      SR4233 does not level off at high oxygen concentrations, but continues to
      decrease as the oxygen concentration increases. For 1 mM oxygen (the solubility
      of oxygen in medium at 37 degrees C equilibrated with 100% oxygen and water
      vapor) the toxicity from SR4233 is at least 2000-fold less than that for hypoxia.
      Modeling the effect of oxygen on combined radiation and toxicity shows that
      radiation plus SR4233 should be much more effective in eliminating hypoxic cells
      than radiation plus RSU1069. The unusual oxygen dependence of toxicity by SR4233
      may indicate a unique biochemical activation process.

PMID- 8358729
TI  - Amphibolic drug combinations: the design of selective antimetabolite protocols
      based upon the kinetic properties of multienzyme systems.
AB  - Computer simulation of a simple biochemical pathway containing a divergent branch
      has been used to study the interaction of two inhibitors that straddle the branch
      point. The combined effects of the two sequentially acting inhibitors could be
      synergistic, additive, or antagonistic, depending upon the regulation of the
      pathway. Factors that influenced the interaction included relative Vmax and Km
      values for the competing enzymes, the sink capacity of the system (i.e., the
      capacity of the system for eliminating the shared intermediate in relation to its
      capacity for producing it), the competitive or noncompetitive nature of the
      second inhibitor, and the presence or absence of feedback in the system. In
      certain cases, a two-fold change in the Vmax value of one of the competing
      enzymes was sufficient to change the interaction from synergistic to
      antagonistic. The existence of such drug combinations (which this article terms
      amphibolic combinations) means that it is possible in principle to identify
      binary drug combinations that will be synergistic against a tumor cell but
      antagonistic against normal cells. Identification of amphibolic drug combinations
      should be a means of designing more selective chemotherapy.

PMID- 8358730
TI  - Killing of skin-derived tumor cells by mouse dendritic epidermal T-cells.
AB  - Dendritic epidermal T-cells (DETC) are a unique population of T-cells that reside
      normally in mouse epidermis and express a gamma delta T-cell receptor. We have
      reported previously that DETC acquire in culture the capacity to lyse the YAC-1
      lymphoma, a conventional target for natural killer cells. The aim of the present
      study was to characterize this cytotoxic potential, using a spectrum of skin
      derived mouse tumors. Cytotoxicity was measured by a 51Cr release assay and by
      the visual assessment of target cell lysis. Long-term DETC lines, established
      from CBA, AKR, and BALB/c mice by mitogenic stimulation and repeated feeding with
      interleukin 2 (5 units/ml), were used as effectors. Skin-derived tumor targets
      included 5 melanoma lines and the transformed keratinocyte line Pam 212. Each
      DETC line lysed skin-derived tumors as well as YAC-1 targets effectively in the
      18-h 51Cr release assay, and target lysis occurred in a non-major
      histocompatibility complex-restricted manner. By contrast, freshly isolated
      spleen cells lysed YAC-1 but not skin tumor targets. Moreover, confluent
      monolayers of melanoma or Pam 212 targets were disrupted completely by added DETC
      lines but not by spleen cells. The cytolytic activity of DETC appeared to be
      specific for tumor cells, since normal mouse keratinocyte monolayers remained
      intact under the same conditions. Finally, DETC freshly isolated from skin failed
      to exhibit significant cytotoxicity but acquired this capacity 10-14 days after
      mitogenic stimulation and feeding with interleukin 2 (5 units/ml). We conclude
      that DETC possess the potential to recognize, bind, and lyse tumor cells that
      originate in skin.

PMID- 8358731
TI  - Tumor-specific lysis of human renal cell carcinomas by tumor-infiltrating
      lymphocytes: modulation of recognition through retroviral transduction of tumor
      cells with interleukin 2 complementary DNA and exogenous alpha interferon
      treatment.
AB  - Two cytotoxic effector cell populations were isolated from a patient with renal
      cell carcinoma. The tumor-infiltrating lymphocytes comprised a population of
      highly specific, major histocompatibility complex-restricted, cytotoxic T
      lymphocytes (CTL). An autologous non-major histocompatibility complex-restricted
      lymphokine-activated killer (LAK) cell population was generated by culturing the
      peripheral blood lymphocytes with high doses of recombinant interleukin 2 (rIL
      2). The capacity of these two effector cell types to lyse cytokine-modulated
      autologous tumor cells was compared in vitro. A complementary DNA for rIL-2 was
      introduced into the tumor cells by retroviral transduction, and tumor cells
      secreting low doses of rIL-2 were isolated. The CTL recognition of these tumor
      cells was enhanced, compared to unmodified tumor cells, whereas LAK cell
      recognition was unchanged or slightly reduced. Pretreatment of tumor cells with
      exogenous alpha interferon led to an up-regulation of some major
      histocompatibility complex class I molecules and to slightly better recognition
      by the CTL; little effect on LAK cell recognition was observed. CTL were found to
      be 50-150-fold more effective than LAK cells in lysing autologous tumor cell
      lines or clones modulated with both rIL-2 and alpha interferon. The assessment of
      a patient's cytotoxic immune capacity directed against genetically modified
      autologous tumor cells in vitro provides important insight for cytokine-mediated
      gene therapy of cancer.

PMID- 8358732
TI  - Genotypic characterization of prostatic carcinomas: a combined cytogenetic, flow
      cytometry, and in situ DNA hybridization study.
AB  - Cytogenetic studies were performed on 36 biopsies obtained from 26 primary
      prostatic adenocarcinomas. Following histopathological characterization of
      control sections, the biopsies were investigated using metaphase cytogenetics,
      DNA flow cytometry, and fluorescence in situ DNA hybridization. In 12 specimens,
      no carcinoma was found in control sections by histopathological means. In 24
      carcinoma biopsies clonal aberrations were detected in 15 specimens. Tetraploidy
      as sole aberration was detected in five specimens. Loss of the Y chromosome was
      seen in eight samples. Only one tumor revealed structural abnormalities. Eight
      samples were found to be normal (46,XY). Remarkably, nonclonal chromosome
      aberrations, particularly marked chromosome loss, were frequently detected in
      prostatic carcinomas and premalignant lesions (prostatic intraepithelial
      neoplasia). In the series of biopsies investigated by means of cytogenetics and
      flow cytometry, biopsies with aneuploid DNA content were found to be
      cytogenetically normal. Conversely, the cytogenetically aberrant clones were
      found to be of diploid DNA content. Evidence of focal intratumoral heterogeneity
      was revealed by cytogenetics, flow cytometry, and in situ hybridization.

PMID- 8358733
TI  - Transforming growth factor-beta 1 induces transforming growth factor-alpha
      promoter activity and transforming growth factor-alpha secretion in the human
      colon adenocarcinoma cell line FET.
AB  - FET cells are well differentiated human adenocarcinoma cells whose growth is
      partially inhibited (50-60%) by transforming growth factor-beta 1 (TGF-beta 1).
      In exponentially growing cultures, TGF-beta 1 induces the expression of
      transforming growth factor-alpha (TGF-alpha) by 3-fold. To determine whether this
      induction is the result of increased TGF-alpha promoter activity, FET cells were
      transiently transfected with a plasmid containing 2816 base pairs of the 5'
      flanking region of the TGF-alpha gene linked to luciferase. Transfected FET cells
      treated with growth-inhibitory concentrations of TGF-beta 1 (10 ng/ml) showed up
      to a 10-fold increase in luciferase activity. The increase in luciferase activity
      was dose dependent through the normal physiological range of TGF-beta 1 (0.5-20
      ng/ml), saturating at 10 ng/ml. This effect was also TGF-alpha promoter specific,
      inasmuch as the Rous sarcoma virus long terminal repeat used as a control
      remained relatively insensitive to the effects of TGF-beta 1. By using
      progressively smaller portions of the TGF-alpha promoter region, the TGF-beta 1
      responsive element was mapped between base pairs -77 and -201 of the 5'-flanking
      region. TGF-beta 1 treatment also affected epidermal growth factor receptor
      levels. FET cells treated with TGF-beta 1 (10 ng/ml) for 48 h showed a 20%
      decrease in the number of epidermal growth factor receptors and a 2-fold increase
      in the number of high affinity epidermal growth factor receptors on their
      surface. These results indicate that TGF-beta 1 acts as a positive regulator of
      TGF-alpha transcription, and they suggest a possible mechanism by which these
      cells circumvent the growth-inhibitory effects of TGF-beta 1.

PMID- 8358734
TI  - Mutation of the p53 gene in neuroblastoma and its relationship with N-myc
      amplification.
AB  - Mutation of the p53 tumor suppressor gene frequently occurs in a variety of
      tumors including lung, breast, gastrointestinal, and brain, as well as lymphomas
      leukemias. Neuroblastoma, one of the most common solid tumors in childhood, often
      has amplification of the N-myc gene. We examined for mutations of the p53 tumor
      suppressor gene by single-strand conformational polymorphism using polymerase
      chain reaction products and direct sequencing method in neuroblastoma; in
      addition, we assessed the relationship between p53 mutation and N-myc gene
      amplification in the disease. Of 86 DNA samples from patients with neuroblastoma,
      two mutations (2%) were found in the coding region of the p53 gene. Each mutation
      caused a substitution of amino acid residues. One mutation was located in exon 5,
      and another was in exon 6. N-myc gene was amplified in 26% of the samples. No p53
      mutations were found in neuroblastoma samples with N-myc amplification. In the
      two individuals, p53 mutations appeared as their disease became more progressive.
      The neurofibromatosis 1 (NF1) gene is frequently abnormal in another neural
      disorder, neurofibromatosis type 1; in addition, a potential mutational hot spot
      of NF1 at lysine at codon 1423 has been identified in several types of tumors.
      Using single-strand conformational polymorphism, we were unable to detect an
      abnormality in this region of NF1 in 50 samples of neuroblastoma. The data
      suggest that p53 mutations occasionally are associated with progression of
      neuroblastomas, and tumorigenetic influences of mutant p53 may differ from those
      of N-myc.

PMID- 8358735
TI  - Cloning and expression of mutant glucocorticoid receptors from glucocorticoid
      sensitive and -resistant human leukemic cells.
AB  - The molecular basis for the receptorless (r-) and activation-labile (act1)
      phenotypes of glucocorticoid-resistant mutants isolated from glucocorticoid
      sensitive human leukemic CEM-C7 cells was determined. Clones isolated from a
      complementary DNA library prepared from r- ICR27TK.3 cells, in which one
      glucocorticoid receptor (GR) gene has been deleted, contained a single adenosine
      to thymidine transversion in the third position of codon 753, resulting in the
      substitution of phenylalanine for leucine. This mutant gene (GR753F) had only 13%
      of the trans-activating activity of the normal gene and produced a M(r) 92,000
      receptor protein with the same r- phenotype seen in ICR27TK.3 cells. Analysis of
      complementary DNA clones isolated from a library prepared from parental
      glucocorticoid-sensitive 6TG1.1 cells showed that these cells express both a
      normal GR gene (GR+) and the GR753F gene. Thus, their genotype is GR+/GR753F.
      Analysis of clones isolated from a complementary DNA library prepared from
      glucocorticoid-resistant activation-labile 3R7. 6TG.4 cells revealed the presence
      of the GR753F gene and a second mutant gene (GR421Y) containing a guanosine to
      adenosine transition in the second position of codon 421, resulting in the
      replacement of the first cysteine of the proximal zinc finger of the DNA-binding
      domain by tyrosine. This mutant had no trans-activating activity but normal
      ligand-binding characteristics. Thus, the genotype of act1 3R7.6TG.4 cells is
      GR421Y/GR753F. Consequently, the sequence-specific DNA-binding activity of
      receptors in act1 cells is attributable to the GR753F gene, while the ligand
      binding activity seen in intact cells is attributable to the GR421Y gene. These
      results provide a direct explanation for the r- and act1 phenotypes of
      glucocorticoid-resistant cells and demonstrate that glucocorticoid-sensitive
      cells derived from CEM-C7 cells contain a heterogeneous population of normal and
      mutant receptors.

PMID- 8358736
TI  - Role of chromosome 9 in human bladder cancer.
AB  - The tumors of 20 patients with multifocal primary transitional cell carcinoma of
      the bladder or lymph node metastases were examined for molecular genetic defects
      which we have previously found to be present in > 50% of invasive tumors. These
      included loss of heterozygosity (LOH) of chromosome 9, which occurs in
      superficial as well as invasive bladder tumors, and LOH of chromosome 17p and p53
      mutations, which are commonly found only in invasive tumors. Analysis of multiple
      or recurrent primary tumors in 7 patients for these markers was generally
      consistent with recently published data that the tumors are monoclonal in origin
      and that p53 mutations occur as a late event in the generation of invasive
      bladder cancers. Comparison of the primary tumors and metastases to regional
      lymph nodes in 14 patients demonstrated a complete concordance between the
      molecular genetic defects present, showing that LOH of chromosomes 9 and 17p and
      p53 mutations occurred in the primary tumors before metastasis. Because of the
      importance of chromosome 9 in bladder cancer, we mapped the location of a
      putative tumor suppressor gene by restriction fragment length polymorphism
      analysis of 123 cases obtained in this and earlier studies. Most of the tumors
      showed LOH for more than one marker on chromosome 9. Results of mapping of 4
      tumors with partial deletion of chromosome 9 suggests that the tumor suppressor
      gene is located between 9p12 and 9q34.1.

PMID- 8358737
TI  - Differential growth factor production, secretion, and response by high and low
      metastatic variants of B16BL6 melanoma.
AB  - Low levels of tyrosine and phenylalanine alter the metastatic phenotype of B16BL6
      murine melanoma. In this study, we investigated expression and secretion of
      fibroblast growth factor-like (FGF-like) and transforming growth factor beta-like
      (TGF beta-like) molecules as well as the biological effect of basic FGF (bFGF)
      and TGF beta 1 on high (NDP) and low (LTP) metastatic variants of B16BL6
      melanoma. Both NDP and LTP cells expressed bFGF-like and TGF beta-like
      polypeptides as detected by Western blot analysis. An M(r) 29,000 bFGF-like form
      eluted from heparin-Sepharose by 0.6 M NaCl was found in extracts of both NDP and
      LTP cells. Elution at 0.6 M NaCl suggested that this M(r) 29,000 form might be
      more closely related to FGF-5 than to bFGF. In addition, cell extracts of LTP,
      but not NDP cells, contained an M(r) 47,000 monomeric bFGF-like form that was not
      retained on heparin-Sepharose. Three major specific immunoreactive forms of M(r)
      44,000, 36,000, and 29,000 were present in conditioned medium from NDP cells. The
      M(r) 29,000 form present in the conditioned medium of NDP cells was retained on
      heparin-Sepharose. Only the M(r) 44,000 and 36,000 FGF-like molecules were
      detected in conditioned medium from LTP cells, and they were also not retained on
      heparin-Sepharose. Anti-TGF beta antibody that recognized both TGF beta 1 and TGF
      beta 2 detected 3 different TGF beta-like forms (M(r) 25,000, 23,000 and 22,000)
      in NDP and LTP cell extracts. Conditioned medium from NDP cells contained an M(r)
      38,000 form of TGF beta; however, no immunoreactive forms were found in
      conditioned medium from LTP cells. Thus, the NDP-LTP differences in this melanoma
      system were primarily in growth factor secretion, not expression. The effect of
      exogenous bFGF and TGF beta 1 on proliferation of LTP and NDP cells was
      determined by [methyl-3H]thymidine uptake. bFGF stimulated proliferation of NDP
      cells; whereas, LTP cells exhibited no increase in proliferation. Both NDP and
      LTP cells responded to TGF beta 1. Proliferation of NDP cells was inhibited more
      by this growth factor than was proliferation of LTP cells. When NDP and LTP cells
      were incubated with 5 ng/ml TGF beta 1 and various amounts of bFGF, the effect of
      TGF beta 1 was masked. Antibody depletion of bFGF-like molecules from NDP
      conditioned medium resulted in the decreased proliferation of NDP cells but not
      LTP cells. Depletion of TGF beta-like molecules resulted in increased
      proliferation of LTP cells but did not affect NDP cells.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8358738
TI  - Identification of a new interferon-alpha-inducible gene (p27) on human chromosome
      14q32 and its expression in breast carcinoma.
AB  - A new complementary DNA, p27, has been cloned and sequenced from estradiol
      treated MCF7 human breast carcinoma cells. It encodes a putative highly
      hydrophobic protein of 122 amino acids which has a 33% overall sequence
      similarity to the product of the 6-16 gene (R. L. Friedman, S. P. Manly, M.
      McMahon, I. M. Kerr, and G. R. Stark, Cell, 38: 745-755, 1984), which is
      transcriptionally induced by interferons of the alpha/beta type. We demonstrate
      here that the p27 gene, which is located in band q32 of human chromosome 14, is
      also induced by interferon-alpha in human cell lines of different origin and that
      expression is independent of the presence of estradiol receptor in the cells.
      High levels of p27 RNA were found in vivo in approximately 50% of primary human
      breast carcinomas (21 were tested by Northern blotting). In situ hybridization to
      some of the p27-overexpressing tumors showed that the p27 RNA is localized in
      cancer cells and sometimes also in fibroblastic cells of tumor stroma. p27 RNA
      levels in the tumors did not correlate with the presence of estrogen receptor or
      with the expression of the estrogen-induced pS2 gene. Further studies are now
      necessary to elucidate the cause of p27 gene overexpression in breast carcinoma
      and in particular to determine whether it corresponds to chromosomal
      rearrangements in the 14q32 region and/or to induction by interferons of the
      alpha/beta type.

PMID- 8358739
TI  - Interleukin 1 alpha acts as an autocrine growth stimulator for human gastric
      carcinoma cells.
AB  - The expression and effect of interleukin 1 alpha (IL-1 alpha) were examined in
      human gastric carcinoma cell lines to determine if IL-1 alpha acts as a growth
      stimulator for these cells. Six of 8 gastric carcinoma cell lines expressed IL-1
      alpha mRNA at various levels. Among them, TMK-1 and MKN-7 cells secreted IL-1
      alpha into the culture fluid, in an especially large amount by MKN-7 cells.
      Scatchard plot analysis of IL-1 alpha binding revealed that TMK-1 cells had only
      one type of high-affinity receptors, whereas MKN-7 cells had high- and low
      affinity receptors. Cell growth and DNA synthesis of TMK-1 and MKN-7 cells were
      stimulated by IL-1 alpha, and those of MKN-7 were inhibited by addition of anti
      IL-1 alpha antibody or IL-1 receptor antagonist. The expression of IL-1 alpha
      mRNA by these cell lines was induced by either IL-1 alpha, epidermal growth
      factor, or transforming growth factor alpha. On the other hand, IL-1 alpha
      increased the mRNA expression for transforming growth factor alpha and epidermal
      growth factor receptor. These findings indicate that IL-1 alpha is an autocrine
      growth stimulator for gastric carcinoma cells and the interaction with epidermal
      growth factor/transforming growth factor alpha/receptor system should be involved
      in the growth modulation by IL-1 alpha.

PMID- 8358740
TI  - Differentiation therapy of cancer: laboratory and clinical investigations.

PMID- 8358741
TI  - Structural studies of the antigenic polysaccharide of Eubacterium saburreum,
      strain T19.
AB  - The antigenic polysaccharide produced by Eubacterium saburreum, strain T19,
      contains unusual sugars, including D-glycero-D-galacto-heptose (Hep) and D-fucose
      (D-Fuc). A repeating unit of the polysaccharide is composed of a linear chain of
      D-glycero-D-galacto-heptopyranosyl tetrasaccharide as its backbone structure,
      i.e., -[-->6)-beta-Hep p-(1-->3)-beta-Hep p-(1-]2-->, and a D-fucofuranosyl
      disaccharide as a branched group, i.e., alpha-D-Fuc f-(1-->2)-alpha-D-Fuc f-(1-
      >, which is linked to O-4 of one (1--6)-linked D-glycero-D-galacto-heptopyranosyl
      residue. The polysaccharide also contains O-acetyl groups.

PMID- 8358742
TI  - Proton and carbon NMR chemical-shift assignments for [beta-D-Fru f-(2-->1)]3
      (2<==>1)-alpha-D-Glc p (nystose) and [beta-D-Fru f-(2-->1)]4-(2<==>1)-alpha-D-Glc
      p (1,1,1-kestopentaose) from two-dimensional NMR spectral measurements.
AB  - The proton chemical-shift assignment of nystose (1) [beta-D-fructofuranosyl-(2-
      >1)-beta-D-fructofuranosyl-(2-->1)-beta-D- fructofuranosyl-(2<==>1)-alpha-D
      glucopyranoside], was determined by using two-dimensional (2D) NMR spectral
      methods, and corrections of, and additions to the previous 13C chemical-shift
      assignments were made. The 1H peak of H-1 of the D-glucosyl group was determined
      by its chemical shift. Signals from fructose-1 were distinguished by the
      observation of long-range C-H coupling between H-1 of the D-glucosyl group and C
      2 of fructose-1. The distinction between fructose-2 and fructose-3 was made by
      the different 1JCH coupling patterns between C-1 and H-1. Assignments of 13C and
      1H chemical shifts of the related dp 5 compound, beta-D-fructofuranosyl-(2-->1)
      beta-D-fructofuranosyl-(2-->1)-beta-D- fructofuranosyl-(2-->1)-beta-D
      fructofuranosyl-(2<==>1)-alpha-D-glucopyr anoside (1,1,1-kestopentaose, 2) are
      also reported here with comparisons of its spectral data with the data from 1
      kestose, nystose and inulin. Based on differences in 13C chemical shifts, it
      appears that the chemical environment of inulin is not attained in nystose, and
      only partially attained in 1,1,1-kestopentaose.

PMID- 8358743
TI  - NMR studies of oligosaccharides derived from hyaluronate: complete assignment of
      1H and 13C NMR spectra of aqueous di- and tetra-saccharides, and comparison of
      chemical shifts for oligosaccharides of increasing degree of polymerisation.
AB  - A series of oligosaccharides was prepared from hyaluronate by depolymerisation
      with bovine testicular hyaluronidase. Complete assignment of the 1H and 13C NMR
      spectra was obtained for the disaccharide, the tetrasaccharide, and the NaBH4
      treated tetrasaccharide, by using various 1D and 2D NMR methods. The 1H
      assignments for the tetrasaccharide differ from the incomplete data reported
      recently (ref. 11). The 13C NMR spectra of the aqueous di-, tetra-, hexa-, and
      octa-saccharides of this series show that all resonances, apart from those
      subject to obvious end effects, have chemical shifts comparable to those of the
      corresponding resonances of hyaluronate in D2O. The observed 13C chemical shifts
      suggests that cooperative intramolecular hydrogen bonds probably play a minor
      role in determining the conformation of hyaluronate in water.

PMID- 8358744
TI  - A polysaccharide produced by a mucoid strain of Moraxella nonliquefaciens with a
      2-acetamido-2-deoxy-5-O-(3-deoxy-beta-D-manno-octulopyranosyl)-beta-D-
      galactopyranosyl repeating unit.
AB  - A capsular polysaccharide, isolated from the mucoid Moraxella nonliquefaciens
      strain 3828/60, has been investigated by component analyses, periodate oxidation,
      methylation analyses, mass spectrometry, 1H and 13C NMR spectroscopy, and
      hydrolysis to give a disaccharide that was isolated and characterised. The
      results showed that the polysaccharide has the repeating unit-->3)-beta-D-
      GalpNAc-(1-->5)-beta-Kdo p-(2-->, with approximately 40% of O-8 of Kdo being
      acetylated.

PMID- 8358745
TI  - Chemical synthesis and kinetic characterization of UDP-2-deoxy-D-lyxo-hexose("UDP
      2-deoxy-D-galactose"), a donor-substrate for beta-(1-->4)-D
      galactosyltransferase.
AB  - Bovine beta-(1-->4)-galactosyltransferase (GalT) transfers galactose from UDP
      galactose to beta-D-GlcpNAc-terminating oligosaccharides to produce N
      acetyllactosamine sequences. We report here the chemical synthesis, structural
      characterization and enzymatic evaluation of the very labile UDP-2-deoxy-D-lyxo
      hexose ("UDP-2-deoxy-galactose," 2) as an alternate donor for GalT. Donor 2 had
      kinetic parameters, including a Km value of 51 microM, almost identical to those
      for the natural substrate UDP-galactose when beta-D-GlcpNAc-O(CH2)8COOMe was used
      as the acceptor. The product of the enzymatic transfer was isolated and confirmed
      to have the expected 2'-deoxy-N-acetyllactosamine sequence.

PMID- 8358746
TI  - Synthesis and characterization of two 1,2,3,6,2',3',4',6'-octa-O-benzoyl- beta-D
      hexapyranosyl-(1-->4)beta-D-allopyranoses.

PMID- 8358747
TI  - Isolation and purification of trehalose 6-mono- and 6,6'-di-corynomycolates from
      Corynebacterium matruchotii. Structural characterization by 1H NMR.

PMID- 8358748
TI  - Isolation and structural analysis of the tetrasaccharide 3-deoxy-5-O-[3-O- (3-O
      alpha-D-glucopyranosyl-L-glycero-alpha-D-manno-heptopyranosyl)-L-g lycero- alpha
      D-manno-heptopyranosyl]-D-manno-octulosonic acid from the core region of the
      lipopolysaccharide of Salmonella minnesota strain R5 (rough mutant chemotype RcP
      ).

PMID- 8358749
TI  - Conformational analysis of methyl beta-cellobioside by ROESY NMR spectroscopy and
      MD simulations in combination with the CROSREL method.
AB  - Methyl beta-cellobioside has been studied extensively by molecular dynamics (MD)
      simulations in water and by ROESY NMR spectroscopy in order to establish its
      solution structure. The MD simulations were started with four significantly
      different minimal energy conformations. The MD trajectories were analysed with
      respect to interproton distances and mobility, in order to find models for
      application in the analysis of NMR data. The ROESY spectra were analysed by using
      the CROSREL method, which allows quantitative analysis of ROESY spectra through
      correction for the offset dependence and incorporation of HOHAHA transfer
      estimates. These results were compared with data obtained from an initial rate
      analysis of the ROESY data and with the MD data. It is concluded that methyl beta
      cellobioside in aqueous solution is in the same extended conformation that is
      also found in the solid state.

PMID- 8358750
TI  - Synthesis of p-trifluoroacetamidophenyl 6-deoxy-2-O-(3-O-[2-O-methyl-3-O- (2-O
      methyl-alpha-D-rhamnopyranosyl)-alpha-L-fucopyranosyl]-alpha-L- rhamnopyranosyl)
      alpha-L-talopyranoside: a spacer armed tetrasaccharide glycopeptidolipid antigen
      of Mycobacterium avium serovar 20.
AB  - The synthesis of the title tetrasaccharide glycoside 38 is reported. p
      Nitrophenyl endo-3,4-O-benzylidene-6-deoxy-alpha-L-talopyranoside (4), 3-O-acetyl
      2,4-di-O-benzyl-alpha-L-rhamnopyranosyl trichloroacetimidate (7), methyl 3-O
      acetyl-4-O-benzyl-2-O-methyl-1-thio-beta-L-fucopyranoside (15), 3-O-acetyl-4-O
      benzyl-2-O-methyl-alpha-L-fucopyranosyl bromide (16), and ethyl 3-O-acetyl-4-O
      benzyl-2-O-methyl-1-thio-alpha-D-rhamnopyranoside (33) were prepared as
      intermediates. Compound 4 was glycosylated with imidate 7 as well as with methyl
      3-O-acetyl-2,4-di-O-benzyl-1-thio-alpha-L-rhamnopyranoside (9), affording the
      same disaccharide derivative 8. Deacetylation of 8 gave crystalline 17.
      Condensation of 17 with both fucosyl donors 15 and 16 yielded the same
      trisaccharide derivative 18 stereoselectively. Compound 18 was also prepared by
      the coupling of 4 with disaccharide glycosyl donor 20. After deacetylation of 18
      (-->34), methyl triflate-promoted glycosylation with compound 33 resulted in
      tetrasaccharide 35. Conversion of the p-nitrophenyl group of 35 into the p
      trifluoroacetamidophenyl group (-->36) and removal of the protecting groups gave
      the title tetrasaccharide glycoside 38.

PMID- 8358751
TI  - Synthesis of the laminara-oligosaccharide methyl beta-glycosides of dp 3-8.
AB  - Ethyl 2,3,4,6-tetra-O-acetyl-1-thio-alpha-D-glucopyranoside has been prepared in
      a good yield by anomerization of the corresponding beta-thioglucoside with
      tin(IV) chloride and transformed, in three steps, into ethyl 2-O-benzoyl-4,6-O
      benzylidene-1-thio-alpha-D-glucopyranoside (18). Chloroacetylation of 18,
      followed by treatment of the product with chlorine gave crystalline 2-O-benzoyl
      4,6-O-benzylidene-3-O-chloroacetyl-beta-D-glucopyranosyl chloride (20). This was
      coupled with methanol in the presence of silver carbonate-silver perchlorate and
      the product was O-dechloroacetylated to afford methyl 2-O-benzoyl-4,6-O
      benzylidene-beta-D-glucopyranoside (22). Silver triflate-promoted glucosylation
      of 18 with 20 gave a beta-(1-->3)-linked disaccharide derivative, reaction of
      which with chlorine yielded crystalline O-(2-O-benzoyl-4,6-O-benzylidene-3-O
      chloroacetyl-beta-D-glucopyranosyl) - (1-->3)-2-O-benzoyl-4,6-O-benzylidene-beta
      D-glucopyranosyl chloride (24). Likewise, condensation of 22 with 20 gave a beta
      (1-->3)-linked disaccharide glycoside, which was partially deprotected to give
      methyl O-(2-O-benzoyl-4,6-O-benzylidene-beta-D-glucopyranosyl)-(1-->3)-2-O-benz
      oyl- 4,6-O-benzylidene-beta-D-glucopyranoside (26). The methyl beta-glycosides of
      a homologous series of (1-->3)-linked beta-D-gluco-oligosaccharides from the tri-
      to the octa-saccharide have been synthesized in a blockwise manner by using 22
      and 26 as the glycosyl acceptors, 24 as the disaccharide donor, and silver
      triflate as the promoter.

PMID- 8358752
TI  - Interpretation of dextransucrase inhibition at high sucrose concentrations.
AB  - When acceptor reactions were carried out at high sucrose concentrations (> or =
      200 mM), dextran synthesis was inhibited and the acceptor reactions were
      increased. A model, based on the known mechanisms of dextran synthesis and
      acceptor reactions, is proposed to explain the inhibition of dextran synthesis
      and the increase in the acceptor products at high sucrose concentrations.
      According to the model, sucrose binds to a third, low-affinity binding site,
      allosterically changing the conformation of the active site so that dextran
      cannot be formed but acceptor products can be formed.

PMID- 8358753
TI  - Salivary gland calculi: diagnostic imaging and surgical management.

PMID- 8358754
TI  - Dental office record keeping and its impact on anticipated litigation.

PMID- 8358755
TI  - Guided tissue regeneration in the treatment of localized juvenile periodontitis-
      a multi-disciplinary approach in improving anterior esthetics: a case report.

PMID- 8358756
TI  - X-radiation: potential risks and dose-reduction mechanisms.

PMID- 8358757
TI  - Child abuse and neglect: the dental profession's responsibility.

PMID- 8358758
TI  - Dr. Kisai Takayama--the Samurai who founded Japan's first modern dental school.

PMID- 8358759
TI  - Removable partial denture design with a splint bar and precision attachments.

PMID- 8358760
TI  - Microbial assessments and periodontal diagnosis.

PMID- 8358762
TI  - [Transesophageal echocardiography in adults with congenital heart defects].
AB  - The authors give an account of their experience with transesophageal
      echocardiography (TEE) in 61 adult patients with congenital heart disease. The
      main indications for examination in this group of patients were: confirmation of
      an atrial septal defect, unsatisfactory visualization, in particular in complex
      defects, evaluation of the results of surgical correction, detailed valvular
      morphology, in particular of the mitral and aortic valve, search for the source
      of embolization, suspected aneurysm of the aorta. A high diagnostic yield of TEE
      was obtained in: defects of the atrial septum, or other pathological conditions
      affecting the atrium, defects of the atrioventricular septum (AV), pathology of
      the AV valves, in particular the mitral one, pathology of the aortic valve and
      the efflux tract of the left ventricle, aortic arch and its descendent part,
      transposition of the large arteries or other complex defects, incl. conditions
      following surgical correction. A small diagnostic contribution of TEE was
      obtained when visualizing defects of the ventricular septum, pulmonary valves and
      the efflux tract of the right ventricle and the distal portions of the ascendant
      aorta.

PMID- 8358761
TI  - [Congenital heart defects in pregnancy].
AB  - The authors investigated a group of 95 pregnant women with congenital heart
      disease. In two induced abortion was indicated fur cardiac reason (major left-to
      right shunt in ASD II and in a patient with a non-corrected TOF with a
      significant right-to-left shunt). In the remainder the course of pregnancy was
      not complicated. From the total number of 132 deliveries only six were by
      Caesarean section, five times on obstetric grounds. One infant died, delivery
      during the 29th week by Caesarean section on account of premature escape of
      amniotic fluid--mother with a history of radial correction of TOF. Other relevant
      data are summarized in a table. In the conclusion the authors summarize basic
      provisions indicated in pregnant women with congenital heart disease.

PMID- 8358763
TI  - [Basic indicators of energy metabolism in patients with rheumatoid arthritis
      evaluated by indirect calorimetry].
AB  - The objective of the investigation was to examine basic parameters of the energy
      metabolism (energy expenditure at rest (REE), the respiratory quotient (RQ) and
      evaluate their relationship with age, basic parameters of the activity of the
      disease, serum positivity, basal therapy and corticoid therapy in patients with
      rheumatoid arthritis. The investigation comprised 26 patients with rheumatoid
      arthritis selected at random, incl. 12 serum positive ones. The mean age af the
      patients was 62.2 +/- 11.0 years, BMI 26.65 +/- 4.35, the mean duration of the
      disease was 11.8 +/- 9.9 years (range 1-36 years). A total of 12 patients had
      basal therapy, 12 patients took glucocorticoids regularly. The examination
      comprised a record of the case-history, clinical examination (Thompson's
      articular index), REE was evaluated by indirect calorimetry. The assessed REE
      value was compared with the expected value calculated according to Harris
      Benedict's empirical formula (BMR) and expressed in per cent of the calculated
      value (REE%). The respiratory quotient (RQ) was calculated from the assessed CO2
      and O2 consumption. The authors found a close correlation between REE and REE% (r
      = 0.606, p < 0.01) but no correlation between BMR and REE% (r = 0.115). The above
      parameters did not differ in serum positive and serum negative patients with RA
      treated with corticoids and those without corticotherapy, only in patients with
      basal therapy there are statistically significantly higher REE values (6456.7 +/-
      790.5 kJ/24 h vs. 5396.4 +/- 826.7 kJ/24 h, p < 0.01) and REE% (110.6% +/- 99.2%,
      p < 0.05), as compared with subjects without basal therapy.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8358764
TI  - [Can the cardiologist implant pacemakers without a surgeon?].
AB  - The authors evaluate the results of activities of the cardiostimulation centre
      during a two-year period: 1991-1992 with special attention to the incidence of
      surgical complications. As in the authors' department are implanted by
      cardiologists without the assistance of a surgeon, the authors compared the
      frequency of surgical complications with data from departments where
      implantations are made by a cardiologists and a surgeon. During the investigation
      period a total of 315 operations were performed, incl. 229 primary implantations.
      Early surgical complications developed in two subjects (0.63%). Late surgical
      complications occurred in 22 patients (6.98%). The total was thus 24
      complications, i.e. 7.58% of all operations. These results are comparable with
      the percentage of complications reported in our literature and literature
      published in other countries. Permanent cardiac pacing is a routine operation
      which can be implemented by a well trained cardiologist without a surgeon,
      without a negative impact on the patient. The authors conclude that under new
      economic conditions this approach makes the implantation cheaper and simpler from
      the technical aspect.

PMID- 8358765
TI  - [The effect of omeprazole on healing of duodenal ulcers, Helicobacter pylori and
      gastritis].
AB  - Losec (omeprazole) Astra Co. is a blocker of the proton pump of the parietal
      cell. It inhibits basal and stimulated HCl secretion. It is used for treatment of
      gastroduodenal ulcers, reflux oesophagitis and Zollinger Ellison's syndrome. In a
      group of 17 patients with duodenal ulcers the authors investigated the effect of
      omeprazole on (1) healing of duodenal ulcers and bulbitis after 2-4 weeks of
      therapy, (2) elimination of Helicobacter pylori in the antrum, (3) chronic antral
      gastritis. Ad 1. After two weeks of treatment the authors found that 5 of 17
      chronic duodenal ulcers were healed in the remainder substantial regression was
      found. Four-week treatment led to healing of 16 from a total of 17 ulcers (P <
      0.001), i. e. 94%. In subjects with ulcers and bulbitis (12 patients) the ulcer
      healed in 11 instances, in 7 patients residual bulbitis persisted. Ad 2. H.
      pylori was detected before treatment in 16 of 17 patients, after treatment only
      in 5 (P < 0.001). Ad 3. Chronic gastritis was recorded before treatment in all
      patients. Treatment reduced its activity and the presence of H. pylori.

PMID- 8358766
TI  - [Thrombosis of the inferior vena cava--an unusual cause of a chronic septic
      condition in a female patient with type 1 diabetes mellitus].
AB  - The authors describe the accidental detection of a clinically not very marked
      thrombosis of the vena cava inferior in a 29-year-old female diabetic which was
      the cause of permanent bacteriaemia and the source of embolization of the lungs.
      The patient was delivered of an infant six years previously by Caesarean section,
      subsequently complicated by a paranephritic abscess on the right which called for
      surgical treatment. Since then the patient suffered from frequent dermal
      infections and was dyspnoic. Because of deterioration of polyneuropathic
      complaints of the lower extremities resulting from diabetes the patient was
      admitted to the authors' clinic. Sonographic examination of the abdominal cavity
      aroused urgent suspicion of a thrombus in the vena cava inferior, as confirmed by
      subsequent cavography and computed tomography. The patient was treated for
      prolonged periods with anticoagulants and antibiotics. During the subsequent
      check-up examination after four months marked diminution of the thrombus was
      recorded and improvement of the patient's general condition.

PMID- 8358768
TI  - [Ethnopharmacology and alternative medicine].

PMID- 8358767
TI  - [6 "non-natural", yet most natural conditions necessary for health].
AB  - The medieval preventive medical scheme which persisted up to the period of
      Enlightenment, called the "Six Things Non-natural and Necessary", comprised six
      items whose influence on the health of the individual is not inborn (not
      determined by innateness), but no one can avoid facing them in his life (hence,
      they are "necessary"); however, they may be tackled in ways either promoting or
      impairing health (viz.: air, food, exercise, sleep, emotions, cleansing and
      sexuality). The taxative list of "Six Things" is normalized in book Six of
      Hippocratic "Epidemics"; later, the topos was furthered by Galen, John of
      Alexandria (and other Alexandrinian authors) and Hunain ibn Ishaq. At least nine
      authors in Bohemia, Moravia and Slovakia divulged the "Six Non-natural Necessary
      Things" from the 15th to the end of the 18th century. Due to the re-evaluation of
      "naturalness" on the break from Enlightenment to Romantism, the concept of "non
      natural" conditions of health was abandoned; during the period of analytical
      medicine relevant questions were side-tracked; only the "re-synthetical" medicine
      (in the second half of the 20th c.) restored the original intuitive scheme of
      "Six Non-natural and Necessary" conditions of health in the new form of the "risk
      factors of health relevant behaviour".

PMID- 8358769
TI  - Current bibliography of cell calcium prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 8358770
TI  - Monitoring of intracellular free calcium in perfused rat liver.
AB  - Fluorescent calcium indicators have been widely used to assess cytoplasmic
      calcium concentration in cells. To examine the role of calcium ions on different
      physiological functions (e.g. in case of liver; bile secretion, glucose
      metabolism, etc.) there is a need for whole organ studies. We have developed a
      technique to estimate intracellular free calcium changes in perfused rat liver.
      Krebs-Henseleit perfused livers were loaded with 7 microM or 35 microM Indo-1/AM.
      An area 3 mm in diameter and approximately 300 microns in depth was illuminated
      at 340 nm. Fluorescence was monitored with photomultiplier tubes at 3 wavelengths
      (400 nm for Ca-bound dye, 504 nm for free dye and 464 nm for NADH). The viability
      of liver preparations was assessed by measurement of the concentrations of
      lactate dehydrogenase and alanine aminotransferase in the effluent. Loading of
      the livers with 7 microM Indo-1/AM via the portal vein resulted in a 5-fold
      increase of fluorescence at 400 nm. However the dye 'leaked' out of the liver
      with a half-time of 18 min. Probenecid (a specific anion carrier blocker)
      inhibited loss of dye in a dose dependent fashion (2.5-10 mM). Transient calcium
      elevations were observed in response to vasopressin (5-50 nM) at physiological
      levels, ethanol (0.3-0.8 M) and the calcium ionophore, ionomycin. Certain
      limitations were apparent with this approach: (1) it was necessary to use an
      anion carrier blocker to maintain a relatively steady dye concentration; (2)
      endogenous NADH fluorescence interfered with the calcium signal; and (3) absolute
      values of calcium concentration could not be determined.

PMID- 8358771
TI  - Critical evaluation of cytosolic calcium determination in resting muscle fibres
      from normal and dystrophic (mdx) mice.
AB  - The fluorescent probe Fura-2/AM was used to determine cytosolic free calcium
      concentration in soleus muscle and in isolated flexor digitorum brevis fibres.
      This required a precise calibration; therefore, each calibration parameter was
      studied in situ. The influence of the dye concentration on calcium measurements
      was also examined. This precise calibration technique was used to compare
      absolute free calcium concentration in resting preparations from dystrophic (mdx)
      and control (C57) mice. We showed that the behavior of the dye was not similar in
      C57 and in mdx muscles. For this reason, we did not confirm the previous results
      that cytosolic free calcium concentration is increased in mdx muscles.

PMID- 8358772
TI  - Sphingosine mobilizes intracellular calcium in human neutrophils.
AB  - The effect of sphingosine on the cytosolic free Ca2+ concentrations, [Ca2+]i, of
      human neutrophils was re-examined using Fura-2 loaded cells. We found that
      sphingosine induced a dose-dependent elevation of [Ca2+]i. At sphingosine
      concentrations > or = 10 microM, the rise in [Ca2+]i was biphasic; an initial
      phase increasing basal [Ca2+]i by 100% was succeeded by a second phase which
      raised [Ca2+]i to several microM. The enhanced signal was sustained and slowly
      approached the Fmax of Fura-2 over 10 min. Although cytotoxicity assays indicate
      that Fura-2 leakage contributed to the rise in fluorescence, EGTA, surprisingly,
      had no effect on the time course of this response. The explanation was that EGTA
      blocked Fura-2 leakage from and trypan blue uptake by neutrophils. Thus, in the
      presence of EGTA, biphasic increases in the fluorescent signal can be attributed
      mainly to release of intracellular Ca2+. Mn2+ quenching studies confirmed that
      sphingosine mobilized Ca2+ in two distinct phases and promoted the influx of
      Mn2+. Mn2+ entry, however, was not matched by substantial Ca2+ influx.
      Sphingosine elevation of [Ca2+]i was insensitive to pertussis toxin treatment of
      neutrophils and was not correlated with (1,4,5)IP3 formation. Studies with semi
      permeabilized cells show that sphingosine, up to 80 microM, neither mobilized
      Ca2+ significantly nor inhibited active Ca2+ sequestration.
      Sphingosylphosphorylcholine induced a small but dose-dependent release of Ca2+.
      We hypothesize that a metabolite of sphingosine may release Ca2+ directly in
      intact neutrophils.

PMID- 8358773
TI  - An inwardly rectifying K+ channel in human adenomatous parathyroid cells.
AB  - The ion channel populations of cells prepared from human adenomatous parathyroid
      glands have been investigated using standard patch-clamp techniques with pipettes
      containing isotonic K(+)-rich solutions. The principal channel type observed was
      an inwardly rectifying K+ channel of 35 pS conductance. In addition, we have
      frequently observed a lower conductance (12 pS) K+ channel that appeared to
      conduct current in both directions. In addition to these K+ channels, we have
      observed non-selective cation channels and possibly CI- channels. Although we
      have observed occasional current transitions that might have arisen from a large
      conductance K+ channel similar to that observed in rat and bovine parathyroid
      cells, we have not been able positively to identify such a channel in human
      parathyroid cells, either in cell-attached or in excised inside-out patches.

PMID- 8358774
TI  - Placebo-controlled clinical trials with ergotamine in the acute treatment of
      migraine.
AB  - Although oral ergotamine alone or in combination with caffeine is widely used for
      the acute treatment of migraine, there is little evidence that it is
      significantly more effective than placebo. There are no placebo-controlled data
      to support the use of aerosol or suppository formulations. In addition, the
      recommended doses of ergotamine cannot be justified. Each formulation of
      ergotamine now should be tested in clinical studies performed according to the
      IHS criteria for trial design and in migraine patients fulfilling the diagnostic
      criteria of the IHS. Until these clinical data are available, no clear
      recommendations can be given for the use of ergotamine in the acute treatment of
      migraine.

PMID- 8358775
TI  - Episodic cluster headache from a textbook of 1745: van Swieten's classic
      description.
AB  - The first description of cluster headache is usually attributed to authors who
      published between 1867 and 1939, but lately several researchers have found
      accounts dating back to the 18th or even the 17th century which are incomplete or
      do not account for cluster headache in the strict sense. However, Gerhard van
      Swieten gave a full description of a case of episodic cluster headache meeting
      the IHS criteria in 1745, in his textbook of clinical medicine, the mainstream
      textbook of Continental medicine in those years, since van Swieten was the
      founder of the then leading medical centre, the Vienna School. That the case was
      found again only in 1992 is due to the circumstance that it was published in
      Latin. It is presented here in an English translation facing the original Latin
      text.

PMID- 8358776
TI  - Exteroceptive suppression periods in jaw-closing muscles. Variability and
      relation to experimental pain and sustained muscle contraction.
AB  - The duration of the late exteroceptive suppression period (ES2) of temporal
      muscle EMG activity has been reported to be reduced in patients suffering from
      chronic tension-type headache. Methods of recording and analysing ES2 have varied
      between centers and reproducibility of results within subjects, although
      insufficiently studied, has generally been poor. ES2 was investigated in 30
      healthy subjects, using a computerized technique of recording, rectifying and
      averaging the EMG signals. Hour to hour and week to week variations of ES2
      durations were calculated, and the influence of pain during a cold pressor test
      and of sustained muscle contraction on ES2 durations was investigated. The intra
      individual variation of ES2 durations was 16.0% from hour to hour and 20.7% from
      week to week. The inter-individual variation was 36.7%. The present method for
      analysis of ES2 periods proved to be reliable, as the intra-observer variation
      was 4.2% and the inter-observer variation 4.6%. ES2 periods were significantly
      shorter on the first compared to the second day of examination (p = 0.006) and
      during experimental pain (p = 0.0005). We recommend the use of the computerized
      average technique in future studies and caution against the dependence of results
      upon factors such as conditioning and pain.

PMID- 8358777
TI  - Basilar migraine with electroencephalographic findings of occipital spike-wave
      complexes: a long-term study in seven children.
AB  - Basilar migraine is characterized by headache preceded by prodromal symptoms and
      signs of posterior cerebral circulation dysfunction. Few studies have focused on
      EEG findings in this condition or on the prognosis of occipital spike-wave
      complexes observed in either migraine or epilepsy. We now report a long-term
      follow-up (8-16 years) in seven children affected by basilar migraine who had EEG
      findings of occipital spike-wave complexes. Basilar migraine resolved and the EEG
      became normal in all subjects during the observation period, as did migraine with
      aura and seizures which developed in some of the patients after basilar migraine
      attacks ceased.

PMID- 8358778
TI  - Effect of biofeedback treatment on sympathetic function in common migraine and
      tension-type headache.
AB  - Behavioral therapies such as biofeedback are commonly used to treat migraine and
      tension headache. Controlling sympathetic activity is effective for controlling
      the pain in both disturbances. A group of 26 common migraine patients and a group
      of 14 tension headache patients were treated by electromyographic biofeedback
      (EMG-BFB); blood samples were collected during the treatment (1st session; pre
      and post 10th session) and plasma catecholamines and cortisol measured to
      determine basal levels and changes induced by the behavioral therapy. The
      clinical efficacy of BFB treatment for tension headache and common migraine was
      confirmed. The basal values of the plasma stress indices were significantly
      different between the two groups, but did not change during treatment. The lack
      of correlation between the clinical improvement and the biological indices
      monitored indicates the need for further studies with standardized protocols in
      order to probe the mechanism of action of these effective behavioral therapies.

PMID- 8358779
TI  - Relief of cluster-tic syndrome by the combination of lithium and carbamazepine.
AB  - This paper presents a further case of cluster-tic syndrome. Cluster headache and
      trigeminal neuralgia have coexisted in our patient for 18 years. Carbamazepine
      has selectively relieved the tic douloureux, while lithium has completely
      controlled the cluster headache. Our case shows again that the simultaneous
      occurrence of cluster headache and trigeminal neuralgia seems to be more than
      coincidental.

PMID- 8358780
TI  - Headache resembling tension-type headache as the single manifestation of Lyme
      neuroborreliosis.
AB  - We present two patients with monosymptomatic headache resembling chronic tension
      type headache as the first manifestation of Lyme neuroborreliosis. The headache
      developed over a few days in both cases and lasted for three months in the first
      case and for two and a half years in the second case before the diagnosis of Lyme
      neuroborreliosis was made. Neuroimaging and many laboratory investigations did
      not lead to the diagnosis, which was only established after lumbar puncture. The
      CSF in both cases showed high protein, lymphocytic pleocytosis and Borrelia
      burgdorferi-specific intrathecal antibody synthesis. The headache disappeared
      completely after treatment with penicillin G. In patients suffering from daily
      headaches which have developed subacutely, Lyme neuroborreliosis should be
      considered even in the absence of signs of meningeal irritation. A lumbar
      puncture should be performed more often than is presently customary and the CSF
      should be examined for pleocytosis as well as Borrelia burgdorferi-specific
      intrathecal antibody synthesis.

PMID- 8358781
TI  - Intracranial hypertension and migraine.
AB  - We describe the case report of a migraineur who developed daily postural headache
      due to benign intracranial hypertension. The CSF pressure was elevated despite
      the lack of papilledema on clinical examination. This case emphasizes that
      intracranial hypertension without papilledema must be in the differential
      diagnosis of the so-called "migraine transformation" headache. Accordingly, CSF
      analysis, including CSF pressure measurement, should be part of the diagnostic
      evaluation of "migraine transformation" headache.

PMID- 8358782
TI  - The forgotten lumbar puncture.
AB  - Lumbar puncture is crucial in two distinct clinical situations in the diagnosis
      of the headache patient. The first is the patient who is suspected of having a
      symptomatic headache; the second is the patient with a chronic intractable or
      atypical headache disorder. This review discusses the usefulness of the lumbar
      puncture in the diagnosis of headache secondary to subarachnoid hemorrhage,
      meningitis, and intracranial hypotension and hypertension. The value of lumbar
      puncture in the presence of a normal CT/MRI scan is discussed.

PMID- 8358783
TI  - Migraine epidemiology.

PMID- 8358784
TI  - Endothelin in migraine.

PMID- 8358785
TI  - Post-endarterectomy headache.

PMID- 8358786
TI  - Does vasopressin serve a vasomotor adaptive function in migraine?

PMID- 8358787
TI  - Nuclear shuttling: the default pathway for nuclear proteins?

PMID- 8358788
TI  - Alternative readings of the genetic code.

PMID- 8358789
TI  - bcl-x, a bcl-2-related gene that functions as a dominant regulator of apoptotic
      cell death.
AB  - We report the isolation of bcl-x, a bcl-2-related gene that can function as a bcl
      2-independent regulator of programmed cell death (apoptosis). Alternative
      splicing results in two distinct bcl-x mRNAs. The protein product of the larger
      mRNA, bcl-xL, is similar in size and predicted structure to Bcl-2. When stably
      transfected into an IL-3-dependent cell line, bcl-xL inhibits cell death upon
      growth factor withdrawal at least as well as bcl-2. Surprisingly, the second mRNA
      species, bcl-xS, encodes a protein that inhibits the ability of bcl-2 to enhance
      the survival of growth factor-deprived cells. In vivo, bcl-xS mRNA is expressed
      at high levels in cells that undergo a high rate of turnover, such as developing
      lymphocytes. In contrast, bcl-xL is found in tissues containing long-lived
      postmitotic cells, such as adult brain. Together these data suggest that bcl-x
      plays an important role in both positive and negative regulation of programmed
      cell death.

PMID- 8358790
TI  - Bcl-2 heterodimerizes in vivo with a conserved homolog, Bax, that accelerates
      programmed cell death.
AB  - Bcl-2 protein is able to repress a number of apoptotic death programs. To
      investigate the mechanism of Bcl-2's effect, we examined whether Bcl-2 interacted
      with other proteins. We identified an associated 21 kd protein partner, Bax, that
      has extensive amino acid homology with Bcl-2, focused within highly conserved
      domains I and II. Bax is encoded by six exons and demonstrates a complex pattern
      of alternative RNA splicing that predicts a 21 kd membrane (alpha) and two forms
      of cytosolic protein (beta and gamma). Bax homodimerizes and forms heterodimers
      with Bcl-2 in vivo. Overexpressed Bax accelerates apoptotic death induced by
      cytokine deprivation in an IL-3-dependent cell line. Overexpressed Bax also
      counters the death repressor activity of Bcl-2. These data suggest a model in
      which the ratio of Bcl-2 to Bax determines survival or death following an
      apoptotic stimulus.

PMID- 8358791
TI  - Skeletal muscles of mice deficient in muscle creatine kinase lack burst activity.
AB  - To understand the physiological role of the creatine kinase-phosphocreatine (CK
      PCr) system in muscle bioenergetics, a null mutation of the muscle CK (M-CK) gene
      was introduced into the germline of mice. Mutant mice show no alterations in
      absolute muscle force, but lack the ability to perform burst activity. Their fast
      twitch fibers have an increased intermyofibrillar mitochondrial volume and an
      increased glycogenolytic/glycolytic potential. PCr and ATP levels are normal in
      resting M-CK-deficient muscles, but rates of high energy phosphate exchange
      between PCr and ATP are at least 20-fold reduced. Strikingly, PCr levels decline
      normally during muscle exercise, suggesting that M-CK-mediated conversion is not
      the only route for PCr utilization in active muscle.

PMID- 8358792
TI  - A kinase-independent function of Lck in potentiating antigen-specific T cell
      activation.
AB  - The lymphocyte-specific cytoplasmic protein-tyrosine kinase p56lck (Lck) is
      essential for T cell development and activation. Its association with the co
      receptor molecules, CD4 and CD8, is required for potentiation of antigen-specific
      signals through the T cell antigen receptor. To study the mechanism of action of
      Lck, hybrid molecules consisting of the extracellular and transmembrane domains
      of CD4 fused to Lck or other Src family kinases were analyzed in an antigen
      specific, CD4-dependent T cell hybridoma. Surprisingly, a chimera with a deletion
      of the Lck kinase domain was more active than the full-length protein. In
      contrast, point mutations in residues required for SH2 or kinase function
      resulted in moderately decreased activity, while a combination of these mutations
      rendered the chimera largely inactive. Different domains of CD4-associated Lck
      therefore have distinct functions that can independently contribute to T cell
      activation.

PMID- 8358793
TI  - Sigma F, the first compartment-specific transcription factor of B. subtilis, is
      regulated by an anti-sigma factor that is also a protein kinase.
AB  - The establishment of compartment-specific transcription in sporulating cells of
      B. subtilis is governed at the level of the activity of transcription factor
      sigma F. Genetic experiments have suggested that SpoIIAA and SpoIIAB, the other
      products of the sigma F operon, are involved in regulating sigma F activity. This
      activity is inhibited in the predivisional cell but specifically released from
      inhibition in the prespore about 1.5 hr after sporulation is induced. We now show
      that purified SpoIIAB inhibits transcription directed by sigma F in vitro. We
      note that the amino acid sequence of SpoIIAB shows some similarity to a group of
      bacterial histidine protein kinases, and we find that SpoIIAB is indeed a protein
      kinase that phosphorylates SpoIIAA on a serine residue. We suggest that this
      phosphorylation is responsible for the compartment-specific release of sigma F
      activity, perhaps through the formation of a tight complex between SpoIIAB and
      phosphorylated SpoIIAA.

PMID- 8358794
TI  - A transmembrane protein with a cdc2+/CDC28-related kinase activity is required
      for signaling from the ER to the nucleus.
AB  - In eukaryotic cells, the accumulation of unfolded proteins in the endoplasmic
      reticulum (ER) triggers a signaling pathway from the ER to the nucleus. Several
      yeast mutants defective in this pathway map to the ERN1 gene, which protects
      cells from lethal consequences of stress by signaling for increased expression of
      BiP and other ER proteins. ERN1 encodes a 1115 amino acid transmembrane protein
      (Ern1p) whose glycosylated N-terminal portion is located inside microsomes and
      whose cytoplasmic C-terminal portion carries an essential protein kinase
      activity. We postulate that Ern1p is the proximal sensor of events in the ER and
      that binding of ligand causes transduction of information across the ER membrane,
      leading to activation of a specific set of transcription factors.

PMID- 8358796
TI  - Riding the wave of the future.

PMID- 8358795
TI  - Sex determination gene TASSELSEED2 of maize encodes a short-chain alcohol
      dehydrogenase required for stage-specific floral organ abortion.
AB  - Maize produces separate unisexual flowers through programmed abortion of
      preformed organ primordia. In the male inflorescence (tassel), stamen primordia
      develop to sexual maturity, while gynoecia (pistil primordia) are aborted. In
      tasselseed2 (ts2) mutant plants, floral structures in the tassel adopt a female
      developmental program. Here we report the transposon tagging and cloning of the
      TS2 gene, which plays a late but pivotal role in determining the sexual fate of
      floral meristems. Shortly before abortion of the gynoecium, Ts2 mRNA is expressed
      subepidermally in that primordium. Phenotypic instability of the Activator (Ac)
      induced allele ts2-m1 indicates that late restoration of TS2 action in somatic
      tissues, which is correlated with Ac excision, reactivates the male developmental
      program. The predicted amino acid sequence of the Ts2 protein shows significant
      similarity to short-chain alcohol dehydrogenases, particularly hydroxysteroid
      dehydrogenases.

PMID- 8358797
TI  - Communication is the key.

PMID- 8358798
TI  - Hospital admittance, operating room technique and discharge of the dental
      patient.

PMID- 8358799
TI  - Investing for the established practice.

PMID- 8358801
TI  - The spousal aspects of retirement.

PMID- 8358800
TI  - Marketing for today's dentist.

PMID- 8358802
TI  - What do a leech and a handpiece have in common?

PMID- 8358803
TI  - Temporomandibular joint osteoarthrosis: clinical and radiographic characteristics
      30 years after nonsurgical treatment: a preliminary report.
AB  - Thirty years after being treated nonsurgically for osteoarthrosis and internal
      derangement, 14 women and seven men were re-examined clinically and
      radiographically. The results of this examination were compared with those
      recorded before and after treatment 30 years ago, and with those of a matched
      control group. The number and degree of subjective and objective signs and
      symptoms decreased, and was comparable to that of the controls. However, the
      patients reported significantly more pain and difficulty on opening the mouth
      wide. This was reflected in the radiographically assessed joint mobility, which
      increased significantly over the years, but was still significantly less than
      that of the controls. The occurrence and extent of radiographically visible
      osteoarthrotic alterations increased over the years, and differed significantly
      from those of the controls. Therefore, the authors conclude that few symptoms and
      clinical signs of osteoarthrosis are found many years after treatment, although
      radiographic alterations may be extensive.

PMID- 8358804
TI  - Myofascial pain dysfunction: treatments used by ADA members.
AB  - A survey of 10,000 members of the American Dental Association was conducted in
      order to identify the most commonly used treatments for myofascial pain
      dysfunction (MPD). A questionnaire was used in which MPD was defined, all
      treatments (including referral) were listed, and a percentage-of-use estimate for
      each treatment was requested. Results from 2,544 questionnaires showed that the
      most commonly used treatments are: flat plane splints with anterior/canine
      guidance or posterior group function, occlusal equilibration, thermal packs,
      relaxation/stress management training, diet counseling, and medications with anti
      inflammatory (nonopioid) analgesic and muscle relaxant properties. The results
      also showed considerable variation in the ways common treatments are performed. A
      call is issued for systematic and careful research on the outcomes of these and
      other treatments and their major variations.

PMID- 8358805
TI  - Head and cervical spine postures in complete denture wearers.
AB  - Signs and symptoms in the stomatognathic system and head and cervical spine
      postures were evaluated in 10 edentulous patients prior to renewal of their
      dentures, as well as immediately and six months after insertion of new dentures.
      Natural head posture was recorded using the fluid-level method and measured from
      the roentgen cephalograms. It was shown that the variables duration of
      edentulousness and free-way space displayed positive correlations with the
      dysfunction symptoms. In addition, the patients who needed oral rehabilitation
      the most, who received the greatest reduction in their free-way space, were seen
      to have raised their heads more than average. There was also an inverse
      correlation between the reduction of clinical dysfunction index score and
      cervical spine postures.

PMID- 8358806
TI  - Headache and facial pain-the role of the paranasal sinuses: a literature review.
AB  - Long neglected as a clinical entity, sinus headache has become a common complaint
      of patients with facial pain. Although pain is associated with some sinus
      disease, many experts feel the magnitude and instances of sinus headache have
      been exaggerated to the public. Birt stated that "otolaryngologists see scores of
      patients with vague discomfort in the forehead, between the eyes, and across the
      nose and cheeks." Patients invariably ascribe their symptoms to sinus disease,
      and are later surprised to discover that they are not infected. In fact, chronic
      sinusitis is not particularly common, and many headache patients with autonomic
      features will probably have muscle tension headaches or migraines. Most authors
      feel that acute or chronic headache processes are not a result of overt paranasal
      sinus disease. However, the clinician is obliged to consider the possibility in
      differential diagnosis. This paper will present the anatomic, neurologic,
      physiologic, and pathologic aspects of paranasal sinus disease and its
      conceivable relationship to headache and facial pain.

PMID- 8358807
TI  - The effects of dental condition on hand strength and maximum bite force.
AB  - Piezoelectric force transducer and hand dynamometer were used for measuring the
      maximum bite force and hand grasp force on 2034 primary, middle, and high school
      students. Dental condition and body weight and height were also observed to
      relate to the force measurements. It was discovered that both forces increased
      relative to the increase of age, body weight, and body height. Boys had stronger
      bite force than girls at all age groups, while the grasp force of boys became
      significantly stronger only after the age of 13. Students who had dentition with
      decay and missing teeth tended to have weaker bite force, while hand force was
      not influenced. Bite force does not seem parallel to hand strength and is,
      instead, related to dental condition.

PMID- 8358809
TI  - A system for the study of jaw movements.
AB  - This paper describes a system to record incisal and condylar movements. It
      consists of two Charge Coupled Device (CCD) cameras that detect the position of
      markers fixed to the face, real-time hardware to recognize the markers and
      software for three-dimensional reconstruction of condylar and mandibular
      movements. The subject sat upright in front of the cameras and was asked to
      perform jaw movements. The position of the markers was recorded and the
      coordinates were fed into the computer and converted to three-dimensional
      kinematic data by a mathematical algorithm implemented on an AT IBM personal
      computer. Dedicated software calculated the head movements and the mandibular
      movements separately and performed a three-dimensional mathematical
      reconstruction of the movements of the condylar points and the interincisive
      point, using the geometrical rules of a rigid body. This pilot study describes
      the pattern from opening, closing, protrusive, and lateral movements as obtained
      from healthy subjects with good dentition.

PMID- 8358808
TI  - A clinical observation: a relationship of occlusal contacts to distal
      musculature.
AB  - Dentists treating craniomandibular dysfunction frequently encounter pain and
      dysfunction in seemingly unrelated distal areas of the body. This is a study
      using manual palpation to demonstrate a change in distal muscle pain response
      caused by altering an apparent noxious tooth contact. Forty-four (n = 44)
      patients with a defined muscle involvement were selected for this study. After
      isolating one tooth and the single contact that influenced the muscles under
      observation, one or two slight alterations were made to the contact to redirect
      the occlusal force in all but the four control subjects. Thirty-eight (n = 38)
      patients showed marked relief in tenderness to palpation following minute tooth
      alteration in the muscles being observed. Two (n = 2) showed slight improvement.
      No significant change in pain to palpation was noted in the control group (n =
      4). The results suggest that altering an apparent noxious occlusal contact has a
      direct influence on muscles in other parts of the body.

PMID- 8358810
TI  - Pressurized infusion of sodium hyaluronate for closed lock of the
      temporomandibular joint. Part I: A case study.
AB  - Patients with temporomandibular joint disorders (TMD) report a myriad of problems
      including headaches, facial pain, limited mouth opening capacity, and clicking
      and/or grating sounds from the temporomandibular joints. Although conservative
      therapy with an occlusal splint can bring relief for many of these patients, a
      small number of subjects must be treated by means of surgical procedures. Direct
      injections of either air or fluids (saline, local anesthetic, corticosteroid,
      hyaluronate) into the superior and/or inferior temporomandibular joint (TMJ)
      cavities have gained popularity. The injection of a local anesthetic and
      hyaluronic acid can provide relief for patients with persistent, painful
      nontranslatory closed-lock conditions of the TMJs. As documented through
      objective electronic and computer-enhanced measurements, this case report
      describes the effect of sodium hyaluronate on a closed lock condition of the TMJ.
      This case report explains the methodology employed for a larger group of closed
      lock patients treated and monitored for over one year. The results of that larger
      group will be reported at a later time after long-term efficacy is confirmed.

PMID- 8358812
TI  - Scuba diving and TMD.

PMID- 8358811
TI  - A clinical study of temporomandibular joint (TMJ) vibrations in TMJ dysfunction
      patients.
AB  - Using electrovibratography (EVG), the vibrations of 309 temporomandibular joints
      (TMJs) from 213 patients with clinical symptoms of temporomandibular joint
      dysfunction (TMD) were compared to TMJ arthrography. Of 309 imaged joints, 221
      had an internal derangement (ID) and 88 were arthrographically normal (NID).
      Among the parameters derived from the power spectrum function of joint vibration,
      the total power density from 0 to 600 Hz (I(T)), the peak power density I(max)),
      and the power density at each 50 Hz frequency range (I(f)), each of these was
      significantly greater in ID than in NID patients. The frequency range that
      included (I(max) and the frequency range containing 50%, 75%, and 90% of I(T) was
      significantly lower in ID than in NID patients. The diagnostic sensitivity and
      specificity of a patient's perception of TMJ sounds were 43% and 80%,
      respectively, while those for a doctor's perception were 54% and 72%. When using
      I(T) as a parameter, the sensitivity and specificity of the EVG were 75% and 77%,
      respectively. By using these parameters of TMJ vibration energy analysis, a
      separation may be made between patients with normal joint anatomy and internal
      derangement.

PMID- 8358813
TI  - Capsulitis of the temporomandibular joint.

PMID- 8358814
TI  - History taking of the facial pain patient with the assistance of a comprehensive
      questionnaire.

PMID- 8358815
TI  - Asd-homothallism of Saccharomyces cerevisiae: identification of asd1-1 as an
      allele of sir4 and detection of alpha-specific suppressors of it.
AB  - Asd-homothallism of Saccharomyces cerevisiae involves a life cycle characterized
      by a non-mating phenotype and endomitotic diploidization. The former trait is
      determined by a single mutation, asd1-1. This mutation was mapped between hom2
      and lys4 on the right arm of chromosome IV and was complemented by the cloned
      SIR4 gene. Therefore, we conclude that asd1-1 is an allele of sir4-11 and renamed
      it sir4-11. Endomitotic diploidization of asd-homothallism is caused by the
      collaboration of three to four mutations including sir4-11. In the course of this
      study, we detected alpha-specific suppressors of sir4-11.

PMID- 8358816
TI  - Major chromosomal length polymorphisms are evident after meiosis in the
      phytopathogenic fungus Leptosphaeria maculans.
AB  - Chromosomal DNA of Australian field-isolates of the phytopathogenic ascomycete
      Leptosphaeria maculans was resolved by pulsed-field gel electrophoresis. All
      isolates examined had highly variable karyotypes. Ascospores (sexual spores)
      derived from single pseudothecia (sexual fruiting bodies) isolated from Brassica
      napus (oilseed rape) stubble were analyzed. In two tetrads four distinct
      karyotypes were observed, with only one chromosomal DNA band in common to all the
      members of each tetrad. Although isolates had highly variable karyotypes, two
      overall patterns were present. In one pattern there were at least 12 chromosomal
      DNA bands, the largest being greater than 2.2 Mb in size; in the other there were
      more than 15 chromosomal DNA bands, the largest being about 2.0 Mb. The
      chromosomal DNA preparations included mitochondrial DNA which migrated as a
      diffuse band between 0.10 and 0.15 Mb in size, and DNA molecules of 8 and 9 kb in
      size.

PMID- 8358818
TI  - Symmetrical transcription in the tRNA region of the mitochondrial genome of
      Saccharomyces cerevisiae.
AB  - The occurrence of discrete transcripts originating from the non-coding strand of
      the yeast mitochondrial genome is described. The region under investigation is
      localized in the large tRNA gene cluster between the LSU ribosomal RNA and OXI 1
      genes. The transcripts originating from the non-coding strand were detected in a
      wild-type strain and in a rho- mutant. Their size range includes transcripts of
      about 2000 nucleotides able to accommodate more than one "anti-tRNA". In some
      cases their extremities can be mapped near highly-conserved nonanucleotides that
      could function as origins of transcription. The involvement of the tRNA
      processing machinery in the cleavage of these transcripts is also hypothesized.

PMID- 8358817
TI  - A nucleotide sequence involved in replicative transformation of a filamentous
      fungus.
AB  - Replicative plasmids generated through in-vivo recombination have been identified
      among transformants of the fungus Pleurotus ostreatus. In addition to sequences
      from a standard selection vector (pAN7-1), these recombinant plasmids contain
      recombined sequences of chromosomal origin conferring replicative potential upon
      the vector. One such recombined sequence, an 1148-bp insert into plasmid pP01,
      has been characterized. This sequence has been analyzed for secondary structural
      features as well as for consensus sites affiliated with origins of replication
      (ori) in other eukaryotic systems. The 1148-bp insert lacks an ORF and does not
      contain an acceptable match to the commonly identified 11-bp ars consensus
      sequence (A/TTTTATA/GTTTA/T) for autonomous replication in the yeast
      Saccharomyces cerevisiae. The analysis, however, revealed a cluster of three
      hairpin-loop-forming subsequences with individual delta G25 degrees C free energy
      values of -7.6, -6.4 and -5.2 kcal mol-1. Also found were two 7-bp analogues to
      centromere-affiliated sequences recognized in other fungi, as well as several
      putative gyrase recognition sites comparable to the 9-bp S. cerevisiae/E. coli
      gyrase-binding consensus sequence. Sequences comparable to the ori of the yeast 2
      microns plasmid or to various sequences associated with ori of yeast/fungal
      mitochondrial DNAs (mtDNA) were not present in the 1148-bp insert. Replication of
      pP01 appears rather to involve a replication of chromosomal derivation devoid of
      an ars-type consensus.

PMID- 8358819
TI  - Characterization of a second nuclear gene, AEP1, required for expression of the
      mitochondrial OLI1 gene in Saccharomyces cerevisiae.
AB  - Due to mutation in a single nuclear locus, AEP1, the temperature-conditional pet
      mutant ts1860 of Saccharomyces cerevisiae fails to synthesize mitochondrial ATP
      synthase subunit 9 at the restrictive temperature of 36 degrees C. The presence
      at this temperature of near-normal levels of the cognate oli1 mRNA in mutant
      ts1860 indicates that, as previously shown, the product of the AEP1 gene is
      required for translation of the mitochondrial oli1 transcript. In this study the
      AEP1 gene has been cloned from a wild-type yeast genomic library by genetic
      complementation of a temperature-conditional aep1 strain at the restrictive
      temperature. A 2,330-bp genomic fragment which restores subunit 9 synthesis in
      aep1 mutant strains was characterized. This fragment encoded five open reading
      frames: the longest of these, at 1,554 nucleotides, was identified as the AEP1
      gene, since disruption of this reading frame generated a non-conditional pet
      strain unable to synthesize subunit 9. The predicted product of AEP1 is a basic,
      hydrophilic protein of 59,571 Da which possesses a putative mitochondrial address
      sequence. Hybridization studies with AEP1-specific probes indicate that the gene
      is located on chromosome XIII and produces several poly(A)+ transcripts ranging
      in size from 0.9 to 2.7 kb. None of the identified reading frames share
      significant homologies with entries of several data bases.

PMID- 8358820
TI  - Molecular cloning and analysis of the nuclear gene MRP-L6 coding for a putative
      mitochondrial ribosomal protein from Saccharomyces cerevisiae.
AB  - The Saccharomyces cerevisiae nuclear gene MRP-L6 was cloned by complementation of
      the respiratory-deficient mutant pet-ts 2523 with a library of wild-type yeast
      genomic DNA. The isolated gene was part of a 3.8-kb sequenced DNA fragment
      containing, in addition to MRP-L6, two unassigned reading frames, ORF1 and ORF2.
      MRP-L6 codes for a basic protein of 205 amino acids and a molecular mass of 22.8
      kDa. The protein exhibits significant sequence similarity to the ribosomal
      protein L6 of bacteria and chloroplasts. Unlike the corresponding bacterial
      proteins, however, the MRP-L6 protein (MRP-L6p) contains at its N-terminus a 16
      amino-acid leader sequence exhibiting the known characteristics of mitochondrial
      import signals. Disruption of MRP-L6 leads to the phenotype of a mitochondrial
      translation-defective, rho-negative yeast mutant. The results are consistent with
      MRP-L6p representing an essential component of yeast mitochondrial ribosomes.
      Expression of MRP-L6 was examined, under conditions of glucose repression and
      derepression, in wild-type cells and in a series of catabolite repression
      defective yeast mutants. In most cases, a distinct though small influence of the
      carbon source on the expression of an MRP-L6/lacZ reported construct was
      observed.

PMID- 8358821
TI  - The cytoplasmic male-sterility (CMS) determinant of common bean is widespread in
      Phaseolus coccineus L. and Phaseolus vulgaris L.
AB  - To identify regions of the mitochondrial genome that potentially could specify
      cytoplasmic male sterility (CMS) in Phaseolus coccineus (including P.
      polyanthus), and to define differences amongst P. coccineus lines, mitochondrial
      (mt)DNA restriction patterns and Southern blots of total DNA from sterile and
      fertile lines were analysed. By restriction endonuclease mapping we isolated a
      region which was specific to CMS lines flanking an F1-ATPase alpha-subunit (atpA)
      gene. DNA sequence analysis of this region showed 99.9% homology to the region
      previously isolated from P. vulgaris CMS Sprite. A high frequency of plants
      carrying the CMS-fragment was observed in a wild Phaseolus population, perhaps
      explaining the occurrence of inter- and intra-specific gene flow observed in the
      autogamous species P. vulgaris.

PMID- 8358822
TI  - Characterization of the radish mitochondrial orfB locus: possible relationship
      with male sterility in Ogura radish.
AB  - The orfB locus of the normal (fertile) and Ogura (male-sterile) radish
      mitochondrial genomes has been characterized in order to determine if this
      region, which has previously been correlated with cytoplasmic male sterility
      (CMS) in Brassica napus cybrids (Bonhomme et al. 1991; Temple et al. 1992), could
      also be involved in radish CMS. In normal radish, orfB is expressed as a 600
      nucleotide (nt) transcript. In Ogura radish, orfB is present as the second gene
      of a 1200-nt transcript that also contains a 138-codon open reading frame
      (orf138). Sequences showing similarity to orf138 are present in normal radish,
      but are not expressed.

PMID- 8358823
TI  - The sugar beet mitochondrial gene for the ATPase alpha-subunit: sequence,
      transcription and rearrangements in cytoplasmic male-sterile plants.
AB  - We have characterized the mitochondrial atpA (the alpha subunit of F1-ATPase)
      gene from male-fertile cytoplasm (cv TK81-0) of sugar beet. The gene is 1518-bp
      long and encodes a polypeptide of 506 amino acids. The atpA mRNA sequence is
      modified by three C-to-U RNA editing events, all of which alter the encoded
      protein sequences. In order to examine the genome organization of the atpA locus
      in cytoplasmic male-sterile (CMS) sugar beet, atpA-containing clones were
      isolated from Owen CMS (TK81-MS) and a different source of CMS [I-12CMS(2)]
      cytoplasm respectively. The sequences of the atpA coding region from TK81-MS and
      I-12CMS(2) are identical to each other and to the corresponding TK81-0 sequence.
      However, the TK81-0 and TK81-MS loci diverge completely 47 bp upstream of the
      initiation codon, resulting in different 5' transcript termini for the two genes.
      On the other hand, the point of divergence between the TK81-0 and I-12CMS(2) atpA
      genes was found to occur after 393 bp 3' to the TAA stop codon. Our results also
      show the 3'-flanking sequences of I-12CMS(2) atpA to be present elsewhere in the
      mitochondrial genomes of TK81-0, TK81-MS and I-12CMS(2), suggesting the possible
      involvement of these repeated DNA elements in the sequence rearrangements.

PMID- 8358825
TI  - Detection of gene-disruption events in Aspergillus transformants by polymerase
      chain reaction direct from conidiospores.
AB  - We describe a rapid method for the identification of gene disruption events after
      DNA-mediated transformation of Aspergillus fumigatus. This involves a polymerase
      chain reaction in which the target DNA is added in the form of intact
      conidiospores. Using one primer specific to the plasmid DNA and a second primer
      specific to the target gene on the chromosome, it is possible to identify gene
      disruption events among the more common ectopic integrations approximately 4 h
      after sporulating transformants appear on selective medium.

PMID- 8358826
TI  - Reorientation of the distal region in linkage group IIR of fission yeast.
AB  - The genetic map of the fission yeast Schizosaccharomyces pombe has been revised
      in the distal region of chromosome arm IIR. The spo4 locus, hitherto considered
      the outermost marker, has been moved to an intermediate position. As a result,
      and in accordance with recent physical mapping data, the order of the entire
      distal subgroup of some 12 genetic markers is reversed relative to previously
      published gene maps.

PMID- 8358824
TI  - A large deletion in the plastid DNA of the holoparasitic flowering plant Cuscuta
      reflexa concerning two ribosomal proteins (rpl2, rpl23), one transfer RNA (trnI)
      and an ORF 2280 homologue.
AB  - We have determined the nucleotide sequence of a 5.3-kb region of the plastid DNA
      (ptDNA) from the heterotrophic holoparasitic plant Cuscuta reflexa. The cloned
      area contains genes for the D1-protein (32-kDa protein; psbA), tRNA(His) (trnH),
      ORF 740 (homologous to ORF 2280 from Nicotiana tabacum), ORF 77 (homologous to
      ORF 70), tRNA(Leu) (trnL) and a hypothetical ORF 55 which has no homology to any
      known gene among higher plants. This 5.3-kb area is colinear with a 12.4-kb
      region of tobacco ptDNA and has therefore undergone several deletions totalling
      7.1 kb. Most of the missing nucleotides belong to one large deletion in the ptDNA
      of C. reflexa of approximately 6.5 kb. This deletion involves two ribosomal
      protein genes, rpl2 and rpl23, as well as the transfer RNA for Isoleucin (trnI)
      and a region encoding 1540 amino-acid residues of an ORF 2280 homologue, as
      compared to tobacco chloroplast DNA. This is remarkable since the remaining
      genes, especially the psbA gene, are highly conserved in C. reflexa. Furthermore,
      we found that the expression of the psbA gene is in the same range as in the
      autotrophic Ipomoea purpurea which belongs to the same family as Cuscuta
      (Convolvulaceae). Here we hypothesize a total loss of rpl2 and rpl23 in the
      entire genome of C. reflexa. The phylogenetic position of, and the evolutionary
      change of ptDNA from, Cuscuta are discussed.

PMID- 8358827
TI  - High efficiency transformation of Kluyveromyces marxianus by a replicative
      plasmid.
AB  - Kluyveromyces marxianus can be transformed with an efficiency of 10(5)
      transformants/microgram of DNA by a replicative plasmid using electroporation. In
      order to obtain this efficiency, we isolated ura- mutants cells which can be
      complemented by the URA3 gene from Saccharomyces cerevisiae. The URA3 gene and
      KARS2, a replicative origin from Kluyveromyces lactis which functions in K.
      marxianus, were ligated together in a plasmid which can be used as a vector to
      transform this strain.

PMID- 8358828
TI  - The glycerol kinase (GUT1) gene of Saccharomyces cerevisiae: cloning and
      characterization.
AB  - The GUT1 gene of Saccharomyces cerevisiae, encoding glycerol kinase, was cloned
      and sequenced. The cloned genomic DNA fragment contains an open reading frame
      potentially coding for a protein of 709 amino acids with homology to bacterial
      glycerol kinases (40.8% identity over 502 amino acids, and 42.1% identity over
      496 amino acids, in comparison to the smaller E. coli and B. subtilis enzymes).
      Disruption of GUT1 showed that the gene is required for growth on glycerol, but
      not on glucose or ethanol media. No glycerol kinase activity was detected in the
      disruption mutant. According to enzyme activity and transcript analysis,
      synthesis of glycerol kinase is repressed by glucose, and derepression is ADR1
      dependent.

PMID- 8358829
TI  - Expression of the Klebsiella pneumoniae pullulanase-encoding gene in
      Saccharomyces cerevisiae.
AB  - A 3800-base pair (bp) DNA fragment encoding the mature pullulanase from
      Klebsiella pneumoniae was inserted between two different yeast expression
      secretion cassettes and an yeast gene terminator. These cassettes were cloned
      into an yeast centromeric plasmid YCplacIII and transformed into laboratory
      strains of Saccharomyces cerevisiae. Transcription initiation signals were
      derived from the mating pheromone alpha-factor (MF alpha 1p) and alcohol
      dehydrogenase (ADC1p) gene promoters. Secretion of pullulanase was directed by
      the leader sequence of the yeast mating pheromone alpha-factor (MF alpha 1s).
      Transcription termination was effected by the yeast tryptophan synthase gene
      terminator (TRP5T). Southernblot analysis confirmed the presence of pulA in
      transformed yeasts and Northern-blot analysis revealed the presence of PUL1 mRNA.
      A pullulan agarose assay indicated the extracellular production of biologically
      active pullulanase by S. cerevisiae.

PMID- 8358830
TI  - Cloning and expression of Hormoconis resinae glucoamylase P cDNA in Saccharomyces
      cerevisiae.
AB  - A cDNA coding for glucoamylase P of Hormoconis resinae was cloned using a
      synthetic oligonucleotide probe coding for a peptide fragment of the purified
      enzyme and polyclonal anti-glucoamylase antibodies. Nucleotide-sequence analysis
      revealed an open reading frame of 1848 base pairs coding for a protein of 616
      amino-acid residues. Comparison with other fungal glucoamylase amino-acid
      sequences showed homologies of 37-48%. The glucoamylase cDNA, when introduced
      into Saccharomyces cerevisiae under the control of the yeast ADC1 promoter,
      directed the secretion of active glucoamylase P into the growth medium.

PMID- 8358831
TI  - Polyploidy in the haplontic yeast Schizosaccharomyces pombe: construction and
      analysis of strains.
AB  - The fission yeast Schizosaccharomyces pombe has a haplontic life cycle in which
      the diplophase is confined to the zygote. Through the use of one- and two-step
      protoplast fusions we show that the ploidy can be increased up to pentaploid. The
      polyploid fusion products are rather unstable and segregate cells of lower
      ploidies by gradual loss of chromosomes during mitotic divisions. The polyploid
      cells conjugate normally but are prone to arrest at various stages of meiosis (1
      , 2- and 3-spored asci, binucleate spores) and/or produce inviable, most probably
      aneuploid, spores. Marker segregation in the complete tetrads indicates the
      multiple association of homologous chromosomes. In tetra- and penta-ploid
      meiosis, multispored (6- to 7-spored) asci are also produced, probably by
      postmeiotic division of the nuclei.

PMID- 8358832
TI  - Cloning of an Aspergillus niger invertase gene by expression in Trichoderma
      reesei.
AB  - The filamentous fungus Aspergillus niger produces two glycosylated forms of the
      sucrose-hydrolysing enzyme, invertase. In contrast, some Trichoderma species lack
      invertase and are unable to utilise sucrose as a sole carbon source. Using an A.
      niger genomic library constructed in a cosmid vector containing the ura5 gene of
      Podospora anserina as a selectable marker, and the T. reesei ura5- strain as a
      sucrose-minus recipient strain, an A. niger invertase gene (suc1) has been cloned
      by a sib selection procedure. PAGE and enzyme analysis confirmed that
      transformants had acquired invertase activity. The cloned gene contained DNA
      sequences which were complementary to the amino-acid sequences of tryptic
      peptides found in invertase purified from A. niger. The suc1 invertase gene can
      be used as a dominant selectable marker for the transformation of Trichoderma
      strains.

PMID- 8358833
TI  - Purification and characterisation of an Aspergillus niger invertase and its DNA
      sequence.
AB  - A secreted invertase was purified 23-fold by ultrafiltration, ion-exchange, and
      gel filtration chromatography from the culture supernatant of 18 h sucrose-grown
      cultures of Aspergillus niger. The purified enzyme hydrolysed sucrose and
      raffinose but there was no detectable hydrolysis of inulin, melezitose or PNPG.
      Invertase activity was optimal at pH 5.5 and 50 degrees C. The molecular mass of
      reduced invertase was 115 kDa, as determined by SDS gel electrophoresis. The
      native molecular weight of between 225 kDa and 250 kDa, estimated by
      electrophoresis under non-denaturing conditions, suggests that the protein is a
      dimer of identical subunits. The suc1 gene encoding this protein was completely
      sequenced. The translated sequence yields a protein of 566 amino acids with a
      calculated molecular mass of 61 kDa, suggesting that carbohydrates represent
      about 50% of the mass of the protein.

PMID- 8358834
TI  - uvsI mutants defective in UV mutagenesis define a fourth epistatic group of uvs
      genes in Aspergillus.
AB  - Three UV-sensitive mutations of A. nidulans, uvsI, uvsJ and uvsA, were tested for
      epistatic relationships with members of the previously established groups, here
      called the "UvsF", "UvsC", and "UvsB" groups. uvsI mutants are defective for
      spontaneous and induced reversion of certain point mutations and differ also for
      other properties from previously analyzed uvs types. They are very sensitive to
      the killing effects of UV-light and 4-NQO (4-nitro-quinoline-N-oxide) but not to
      MMS (methylmethane sulfonate). When double- and single-mutant uvs strains were
      compared for sensitivity to these three agents, synergistic or additive effects
      were found for uvsI with all members of the three groups. The uvsI gene may
      therefore represent a fourth epistatic group, possibly involved in mutagenic
      repair. On the other hand, uvsJ was clearly epistatic with members of the UvsF
      group and fitted well into this group also by phenotype. The uvsA gene was
      tentatively assigned to the UvsC group. uvsA showed epistatic interactions with
      uvsC in all tests, and like UvsC-group mutants is UV-sensitive mainly in dividing
      cells. However, the uvsA mutation does not cause the defects in recombination and
      UV mutagenesis typical for this group.

PMID- 8358838
TI  - [Promotion, encouragement and support of breast feeding].

PMID- 8358836
TI  - Physical characteristics of the genome of the phytopathogenic fungus Puccinia
      graminis.
AB  - The physical characteristics of the genome of Puccinia graminis f. sp. tritici,
      the wheat stem rust fungus, were determined by reassociation kinetics. The
      results indicate that the haploid genome contains 67 Mb and consists of three
      classes of DNA sequences: (1) 64% unique; (2) 30% repetitive; and (3) 4%
      foldback. The repetitive sequences have a total complexity of 390 kb and are
      repeated an average of 52 times. The base composition was 45.3% G+C based on an
      analysis of the DNA melting temperature. The average amount of DNA per
      ungerminated urediniospore by diphenylamine assay, corrected for losses during
      extraction, was 435 fg. This was three times the expected value (147 fg) for
      dikaryotic spores with nuclei in the G1 phase of the cell cycle, an indication
      that the spores were in G2.

PMID- 8358839
TI  - [History of the Baby-Friendly Hospital Initiative in Czechoslovakia].

PMID- 8358837
TI  - Secretion of a Cryptococcus albidus xylanase in Pichia stipitis resulting in a
      xylan fermenting transformant.
AB  - A fragment of cDNA containing the xylanase gene (XLN) of Cryptococcus albidus was
      inserted into the vector pJHS which contains the selectable marker his3. To
      permit expression of the XLN gene, the xylose reductase promoter XYL1 from Pichia
      stipitis was introduced in front of the XLN gene. P. stipitis PJH53, a histidine
      dependent strain, transformed with this plasmid produced an active extracellular
      xylanase. The enzyme secreted by P. stipitis had an apparent molecular mass of 50
      kDa, which was slightly greater than that of the native 48-kDa xylanase produced
      by C. albidus. The expression of the XLN gene in P. stipitis allowed it to use
      xylan as a carbon source and to ferment xylan directly to ethanol under anaerobic
      conditions.

PMID- 8358835
TI  - Molecular structure of the SWA2 gene encoding an AMY1-related alpha-amylase from
      Schwanniomyces occidentalis.
AB  - A 2.1-kb DNA fragment containing the SWA2 gene determining an alpha-amylase from
      Schwanniomyces occidentalis has been sequenced. It contains an open reading frame
      of 1521 bp which has the potential to encode a 507 amino-acid protein of M(r)
      55966. Its deduced amino-acid sequence shows significant similarities to the
      sequence of other studied alpha-amylases. These similarities identify a consensus
      sequence, F(LIV)(ED)NHD, which is shared in addition by most maltases, invertases
      and glucoamylases.

PMID- 8358840
TI  - [The present status of the International Marketing Code for breast milk
      substitutes in Czechoslovakia].

PMID- 8358842
TI  - [Immunologic properties of milk and the importance of breast feeding in neonatal
      immunity].

PMID- 8358841
TI  - [Anatomy of the mammary gland and the physiology of breast feeding].

PMID- 8358843
TI  - [The spectrum of fatty acids during lactation].

PMID- 8358844
TI  - [Promotion of breast feeding 1982-1992].

PMID- 8358845
TI  - [Promotion and encouragement of breast feeding in Slovakia].

PMID- 8358846
TI  - [Breast feeding in southern Moravia].

PMID- 8358847
TI  - [Observations by a psychologist on the situation in various maternity and
      neonatal departments in Prague].

PMID- 8358848
TI  - Ten steps toward successful breast-feeding and the building blocks of the Baby
      Friendly Hospital Initiative (BFHI).

PMID- 8358849
TI  - Current status of the code of marketing of breastmilk substitutes.

PMID- 8358850
TI  - [Why the Baby-Friendly Hospital Initiative?].

PMID- 8358852
TI  - Inhibition of the autoxidation of linoleic acid by phenylpropanoid glycosides
      from Pedicularis in micelles.
AB  - The activities of six phenylpropanoid glycosides as chain-breaking antioxidants
      have been studied for the autoxidation of linoleic acid in cetyl
      trimethylammonium bromide (CTAB) micelles at 37 degrees C. Verbascoside,
      isoverbascoside, echinacoside and pedicularioside A, which possess four phenolic
      hydroxyl groups, exhibited antioxidant activities, while cistanoside D possessing
      only two phenolic hydroxyl groups and permethyl verbascoside without phenolic
      hydroxyl group did not suppress the oxidation appreciably. The ratio of rate
      constants for inhibition and propagation kinh/kp and stoichiometric factor n were
      determined.

PMID- 8358851
TI  - Simultaneous measurements of conjugated dienes and free malondialdehyde, used as
      a micromethod for the evaluation of lipid peroxidation in rat hepatocyte
      cultures.
AB  - Membrane lipid peroxidation in rat hepatocyte cultures was induced by a 5-h
      incubation with either ethanol (50 mM) or the chelate iron-nitrilotriacetic acid
      (Fe-NTA) (100 microM). To test the oxidative stress, two indices were measured
      simultaneously on the same sample: extracellular free malondialdehyde (MDA)
      measured by HPLC with a size exclusion column, and conjugated dienes (CD)
      determined by second derivative spectroscopy. With ethanol, both CD and MDA gave
      nearly the same values of lipid peroxidation, about 135% of the control value.
      With Fe-NTA, both indices indicated a higher lipid peroxidation, but the MDA and
      CD values were different. Iron lipid peroxidation evaluated by free MDA and CD
      was, 290 and 230%, respectively, of the control. This discrepancy could be
      ascribed to an increased decomposition of hydroperoxides by iron. In addition,
      the ratio of cis,trans and trans,trans conjugated dienes, which reflects the
      cellular redox status, remained unchanged after 5 h of lipid peroxidation induced
      either by ethanol or iron.

PMID- 8358853
TI  - Effect of N-acylethanolamines with different acyl-chains on DPPC multilamellar
      liposomes.
AB  - The influence of N-acylethanolamines with different acyl-chains on the physico
      chemical state of neutral phospholipids was investigated using dipalmitoyl
      phosphatidylcholine (DPPC) multilamellar liposomes. The thermal dependence of
      steady state fluorescence anisotropy of 1,6-diphenyl-1,3,5-hexatriene (DPH) and
      its charged derivative 1-(4-trimethylaminophenyl)-6-phenyl-1,3,5-hexatriene (TMA
      DPH) was recorded. The N-acylethanolamines modified the DPPC phase transition
      temperature and broadened the transition temperature range in different ways
      depending on the N-acylethanolamines acyl chain characteristics. Our data suggest
      that the N-acylethanolamine acyl chain length and unsaturation play an important
      role in the interaction of these compounds with model membranes. The results show
      that long-chain-N-acylethanolamines interact largely with DPPC model membranes
      while a similar effect is not observed for the short ones.

PMID- 8358854
TI  - Chromatographic and mass spectrometric characterization of 3-O-benzoyl methyl
      ester derivatives of mycolic acid fractions from Corynebacterium
      pseudotuberculosis, C. diphtheriae and Rhodococcus rhodochrous.
AB  - A benzoyl group was attached to the 3-hydroxyl group of the methyl ester
      derivative of corynomycolic acid fraction isolated from Corynebacterium
      pseudotuberculosis. The infrared spectrum of the 3-O-benzoylated compound
      displayed a series of characteristic absorptions found at 1110, 1267 and 1603 cm
      1 that confirmed the presence of a monosubstituted phenyl grouping. The 1H-NMR
      spectrum showed peaks representing protons of the aromatic ring at 7.4 ppm and
      8.0 ppm. The UV spectrum revealed two absorption maxima: at 190 and 228 nm. The
      mass spectrum of the 3-O-benzoylated material exhibited the following peaks: (1)
      a prominent peak at m/z 105 of the benzoyl group that constituted the base peak;
      (2) peaks of methyl esters representing the alpha-hydrocarbon side chain plus
      carbon atoms C1 and C2 of the mycolic acid molecule; and (3) peaks of molecular
      ion minus benzoic acid and/or molecular ion minus benzoxyl group. When subjected
      to liquid chromatography (LC) on an octadecylsilane-silica gel column the 3-O
      benzoylated methyl ester derivatives of the corynomycolic acid fraction were
      separated into their constituent homologous fractions corresponding to
      underivatized corynomycolic acids with the chain length C30, C32 and C34.
      Reversed phase HPLC of saturated and monounsaturated species of 3-O-benzoylated
      derivatives of the mycolic acid fraction from C. diphtheriae and Rhodococcus
      rhodochrous led to the separation of the corresponding homologous fractions. Mass
      spectrometry by electron impact mode identified both series of the homologous
      materials differing in mass by 28 units.

PMID- 8358855
TI  - The role of T cells in myosin-induced autoimmune myocarditis.

PMID- 8358856
TI  - T cells in cardiac myosin-induced myocarditis.
AB  - Autoimmune myocarditis induced by immunization with cardiac myosin can be seen as
      a virus-free system to analyze the immunopathological mechanisms of certain forms
      of postinfectious heart disease. Immunodepletion studies have shown that in A.SW
      mice myosin-induced myocarditis is mediated by both CD4+ and CD8+ cells. The CD4+
      subset is at least required for the induction of the autoimmune response, whereas
      the CD8+ subset seems to play a key role in mediating the myocardial injury. In
      addition, we found a bias concerning the TCR repertoire, because T cells within
      the inflammatory heart infiltrate almost exclusively use V beta 8 elements.
      Furthermore, recent serologic and immunohistologic studies indirectly suggest
      that the cardiac myocyte is not the target for the anti-myosin response. Rather,
      the primary target might consist in dendritic cells presenting myosin epitopes
      even under normal conditions.

PMID- 8358857
TI  - Interstitial connective tissue matrix alterations in acute murine Chagas'
      disease.

PMID- 8358858
TI  - A clinicopathologic description of myocarditis.

PMID- 8358859
TI  - Vascular HLA-DR expression correlates with pathologic changes suggestive of
      ischemia in idiopathic dilated cardiomyopathy.

PMID- 8358860
TI  - Immunologic dialogue between cardiac myocytes, endothelial cells, and mononuclear
      cells.

PMID- 8358861
TI  - Mechanisms of action of cyclosporine: considerations for the treatment of
      autoimmune diseases.

PMID- 8358863
TI  - Modulation of mouse preimplantation development by epidermal growth factor
      receptor antibodies, antisense RNA, and deoxyoligonucleotides.
AB  - Two-cell mouse preimplantation embryos were cultured for 48 h in four different
      reagents to modulate epidermal growth factor (EGF) receptor function. These were
      rabbit polyclonal and mouse monoclonal antibodies to EGF receptor, EGF receptor
      antisense RNA, and EGF receptor antisense deoxyoligonucleotides. Embryos were
      scored for two endpoints: onset of cavitation as a measure of trophectoderm
      differentiation and mean embryo cell number as a measure of cell proliferation.
      The consistent observations were that cavitation was significantly accelerated by
      antibodies and delayed by antisense RNA and antisense deoxyoligonucleotides. None
      of these reagents exerted a significant effect on mean embryo cell number, with
      one exception, the polyclonal antibody. Our interpretation of these observations
      is that the antibody binding facilitated cavitation by mimicking natural ligand
      receptor binding and inducing the signal transduction cascade that is typical for
      the EGF receptor. In the case of antisense RNA or deoxyoligonucleotide, we
      propose that they delayed onset of cavitation by interfering with EGF receptor
      production. We hypothesize that during this period of development, EGF receptor
      is concerned predominantly with the regulation of differentiation more than with
      cell proliferation.

PMID- 8358862
TI  - Immunopathogenesis of HIV-1-associated cardiomyopathy.

PMID- 8358864
TI  - The Xenopus platelet-derived growth factor alpha receptor: cDNA cloning and
      demonstration that mesoderm induction establishes the lineage-specific pattern of
      ligand and receptor gene expression.
AB  - We have cloned the Xenopus PDGF alpha receptor cDNA and have used this clone,
      along with cDNA encoding PDGF A, to examine their expression pattern in Xenopus
      embryos and to determine the factors responsible for lineage specificity.
      Recombinant Xenopus alpha receptor expressed in COS cells exhibits PDGF-A
      dependent tyrosine kinase activity. We find that receptor mRNA is present in
      cultured marginal zone tissue explants and in animal cap tissue induced to form
      mesoderm either by grafting to vegetal tissue or by treatment with recombinant
      activin A. In contrast, PDGF A mRNA is expressed in cultured, untreated animal
      cap tissue and is suppressed by mesoderm induction. These results suggest that
      ectodermally produced PDGF A may act on the mesoderm during gastrulation and that
      mesoderm induction establishes the tissue pattern of ligand and receptor
      expression.

PMID- 8358865
TI  - Possible autocrine/paracrine actions of insulin-like growth factors during
      embryonic development: expression and action of IGFs in undifferentiated P19
      cells.
AB  - The insulin-like growth factors I and II (IGF I and II) and their cell surface
      receptors are expressed in the mammalian embryo and may function as autocrine or
      paracrine growth factors during early development. P19 embryonic carcinoma cells,
      derived from a 7.5 day mouse embryo, were used as a model for a functional study
      of the IGF system in post-implantation embryogenesis. Undifferentiated P19 cells
      synthesized IGF I and II, the type I and II IGF receptors, and IGF binding
      proteins (IGF BP2, IGF BP3, and IGF BP4). P19 cells showed an increase in
      thymidine incorporation of 150% of control with a 4 hour incubation of IGF I (10
      ng/ml) or IGF II (100 ng/ml) and an increase in cell viability compared to
      control cells during 24 hours of serum starvation. In both experiments IGF I was
      more potent than IGF II. Endogenous concentrations of IGF I and II in conditioned
      media were low compared to the doses of exogenous IGFs required for biologic
      effect, but nonetheless contributed significantly to baseline DNA synthesis, as
      demonstrated by inhibition of IGF actions with specific antibodies. Cell surface
      associated IGF BPs bound more radiolabeled IGF than IGF receptors, as determined
      by binding studies and affinity cross-linking. IGF I and IGF II appeared to
      regulate production of IGF BP2, suggesting that the IGFs may regulate their own
      actions by altering the abundance of their binding proteins.

PMID- 8358866
TI  - Transforming growth factor-beta in the early mouse embryo: implications for the
      regulation of muscle formation and implantation.
AB  - In a search for functions of transforming growth factor-beta during early
      embryonic development we used two different experimental approaches. In the first
      we made use of embryonic stem (ES) cells. ES cells in culture differentiate to
      derivatives of all three germ layers and mimic some aspects of organogenesis when
      grown as aggregates in suspension to form embryoid bodies. Differentiation
      proceeds further when the embryoid bodies attach to suitable substrates. Muscle
      and neuronal cells are among the most readily identified cell types then formed.
      We examined the effect of all-trans retinoic acid (RA) and members of the
      transforming growth factor-beta family (TGF-beta 1, TGF-beta 2) under these
      conditions in an assay where single aggregates formed in hanging microdrops in
      medium supplemented with serum depleted of lipophilic substances which would
      include retinoids. Endoderm-like cells formed under all conditions tested. RA at
      concentrations of 10(-8) M and 10(-7) M induced the formation of neurons but in
      the absence of RA or at concentrations up to 10(-9) M, neurons were not observed.
      Instead, beating muscle formed in about one-third of the plated aggregates; this
      was greatly reduced when RA concentrations increased above 10(-9) M.
      Immunofluorescent staining for muscle specific myosin showed that two muscle cell
      types could be distinguished: elongated, non-contractile myoblasts and
      mononucleate flat cells. The mononucleate flat cells appeared to correspond with
      rhythmically contracting muscle. The number of non-contractile myoblasts
      increased 3-fold over controls in the presence of 10(-9) M RA. TGF-beta s
      increased the number of contractile and non-contractile muscle cells by a factor
      3 to 7 over controls, depending on the TGF-beta isoform added and the muscle cell
      type formed. TGF-beta 2 also invariably increased the rate at which contracting
      muscle cells were first observed in replated aggregates. The stimulatory effect
      of TGF-beta s on the formation of mononucleate flat cells was completely
      abrogated by RA at 10(-9) M while the number of myoblasts under similar
      conditions was unchanged. These data suggest that a complex interplay between
      retinoids and TGF-beta isoforms may be involved in regulation of differentiation
      in early myogenesis. In the second approach, neutralizing polyclonal rabbit
      antibodies specific for TGF-beta 2 were injected into the cavity of mouse
      blastocysts 3.5 days post coitum (pc). After 1 day in culture, embryos were
      transferred to pseudopregnant females. The number of decidua, embryos and
      resorptions were counted at day 8.5-9.5 pc.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8358867
TI  - Rapid induction and clearance of TGF beta 1 is an early response to wounding in
      the mouse embryo.
AB  - The TGF beta family of growth factors has been implicated as playing a
      significant role in many aspects of embryonic morphogenesis, and also as a
      mediator of adult tissue repair processes. Unlike the situation in the adult,
      tissue repair in the embryo does not result in scarring, and it has been
      suggested that this might be due, in part, to reduced levels of growth factors,
      particularly TGF beta, at the wound site. We have examined the expression
      patterns of TGF beta genes following wounding of limb bud lesions in cultured
      E11.5 mouse embryos. The timetable of wound closure was investigated by standard
      light and electron microscopy from the time of wounding until the lesion had re
      epithelialised 24 hours later. The expression of transcripts for each of the
      three TGF beta genes was examined at various time points during the healing
      process using radioactive in situ hybridisation to tissue sections and wholemount
      non-radioactive in situ hybridisation to embryo pieces. Within 1 to 3 hours of
      wounding, transcripts encoding TGF beta 1 were rapidly induced within the
      epithelial cells of the wound margin, particularly those cells at the ventral
      aspect of the wound. By 3 to 6 hours post-wounding, TGF beta 1 transcripts were
      detectable in the mesenchyme of the wound bed. No TGF beta 3 induction was
      observed, and possible TGF beta 2 induction was largely obscured by endogenous
      expression associated with pre-cartilage mesenchymal condensation.
      Immunocytochemical analysis of tissue sections of the wound demonstrated a rapid
      induction of TGF beta 1 protein within 1 hour post-wounding, but also a
      subsequent rapid clearance of the protein from the wound site such that, by 18
      hours post-wounding, TGF beta 1 levels had returned to near background. These
      data are discussed in terms of the molecular mechanisms underlying embryonic
      wound healing and the significance of the results to an understanding of scarring
      following adult tissue repair.

PMID- 8358868
TI  - Site of action of imprinted genes revealed by phenotypic analysis of
      parthenogenetic embryos.
AB  - The phenotypes of early post-implantation parthenogenetic embryos were examined.
      The spectrum of phenotypes suggested that three stages are adversely affected by
      imprinting--implantation, pregastrulation, and postgastrulation. Survival of
      parthenogenetic embryos past these developmental blocks can be improved but not
      completely overcome by experimental asynchrony. These results suggest that
      imprinting may be "leaky" at early stages.

PMID- 8358869
TI  - Focal segmental glomerulosclerosis (FSG) 20 years later. From toddler to grown
      up.
AB  - In 1981, we reported the outcome of 25 children with FSG after a follow-up of 10
      years. In 1991, all the living patients were reevaluated. Ten patients are now in
      sustained remission. Four patients still present heavy proteinuria with a normal
      glomerular filtration rate, four required dialysis and seven patients have died.
      The renal survival curve has stabilized at 56%. These data show an overall
      outcome slightly more favourable than we had initially reported in 1981. The
      difference probably stems from our referral system which enables us to see the
      patients at an earlier stage of their disease. The percentage of deaths is
      important. Among the various clinical or histological factors of predictive
      prognostic value only the degree of interstitial damage has reached statistical
      significance (p < 0.02).

PMID- 8358870
TI  - Urinary levels of IL-6 in patients with active lupus nephritis.
AB  - Using the IL-6 dependent hybridoma, MH60.BSF2, we measured urinary levels of
      interleukin 6 (IL-6) in 29 patients with active lupus nephritis. We detected IL-6
      activity in the urine of 24 (83%) of 29 patients before the initiation of
      therapy. The median value of urinary IL-6 levels in patients with a histologic
      diagnosis of WHO class IV on renal biopsy was significantly higher than that in
      patients with other classes (p < 0.01). After treatment, urinary levels of IL-6
      decreased significantly (p < 0.001). These data suggest that urinary levels of IL
      6 may be a valuable tool for monitoring the progression of lupus nephritis.

PMID- 8358871
TI  - An association between ANCA positive renal disease and malignancy.
AB  - The detection of anti-neutrophil cytoplasmic antibodies (ANCA) is now a routine
      part of the evaluation of patients clinically suspected of suffering from small
      vessel vasculitis. The factor(s) that trigger the development of these
      autoantibodies and their role in the pathogenesis of vasculitis is still unclear.
      We describe four patients who presented to us since June 1990. All patients had
      positive ANCA serology and had clinical evidence of vasculitis. In all patients
      soon after the establishment of ANCA positivity, a carcinoma of either the
      respiratory or urinary tracts was diagnosed. We suggest that in some cases of
      ANCA-associated vasculitis, malignant disease may be a trigger for either the
      generation of these autoantibodies, or the development of vasculitis.

PMID- 8358872
TI  - Tubular proteinuria in steroid sensitive multi-relapsing nephrotic syndrome.
AB  - The urinary excretion of N-acetyl-beta-D-glucosaminidase (UNAG) and retinol
      binding protein (URBP) was studied in 65 children with steroid sensitive
      multirelapsing nephrotic syndrome (MRNS): 28 on cyclosporin A (CyA) therapy, 22
      on prednisolone (P), 15 off-treatment and in 32 normal children to assess renal
      tubular damage or dysfunction. The urinary protein excretion was expressed in
      relation to that of creatinine (UNAG/UC in mumol pnp/h/mmol; URBP/UC in
      microgram/mmol). There was a weak but significantly negative correlation between
      age and both, UNAG/UC (r = -0.38, p < 0.01) and URBP/UC (r = -0.50, p < 0.05) in
      normal children, but not in nephrotics. In normals and in patients off steroids
      an association between these two proteins was found (r = 0.38, p < 0.05; r =
      0.56, p < 0.05 respectively). Geometric mean UNAG/UC was significantly higher in
      nephrotics on CyA therapy (26.5 +/- 4.0), and on P (37.0 +/- 7.9) as well as in
      those off-treatment (16.3 +/- 3.1) compared to normal children (9.3 +/- 3.4).
      There was a further increase in those with raised urinary albumin: creatinine
      ratio (UA/UC) (> 0.1 mg/mg). URBP/UC was not increased in any of the groups of
      children with MRNS. Raised NAG in urine may therefore indicate active nephrotic
      syndrome rather than being due to the drug therapy.

PMID- 8358873
TI  - Effect of age and gender on kidney function in renal transplant donors: a
      prospective study.
AB  - We evaluated the long-term residual renal function in 64 living related kidney
      donors. Our main objective was to identify baseline factors, including gender and
      age, that could predict renal impairment after nephrectomy. Forty-four (69%) of
      the 64 donors were women. The mean +/- SEM age of those studied was 36 +/- 1.3
      years and their mean +/- SEM duration of follow-up was 62 +/- 4.9 months (range,
      6 to 174). Overall mean serum creatinine concentration after kidney donation was
      increased compared to baseline values (1.13 mg/dl vs 0.92 mg/dl, respectively, p
      < 0.001). At the last follow-up visit, post-nephrectomy mean glomerular
      filtration rate (GFR) values, adjusted for body surface area, age at donation,
      baseline serum creatinine and duration of follow-up, measured by 99mTc-DTPA were
      significantly lower in women than in men (72.11 ml/min vs 87.17 ml/min,
      respectively, p = 0.02). At follow-up, mean effective renal plasma flow, adjusted
      for the same variables, measured by 131I-hippuran was also significantly lower in
      women compared to men (318.07 ml/min vs 400.82 ml/min, respectively, p < 0.01).
      Eleven of twelve patients with post-nephrectomy GFR values less than 60 ml/min
      were women. Following nephrectomy, serum creatinine concentration increased
      significantly as a function of greater age at donation in women but not in men.
      Similarly, in women but not in men, follow-up GFR measurements decreased
      significantly as a function of age after adjusting for baseline serum creatinine
      and duration of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358874
TI  - Clinical significance of vesicoureteral reflux after kidney transplantation.
AB  - In this study 103 out of our 125 CsA-treated patients who received between
      January 1985 and December 1989 a first cadaver kidney transplant that functioned
      for at least one year were studied with voiding cystography (VC) for
      vesicoureteral reflux (VUR). All patients had an external uretero-neo-cystostomy.
      VUR occurred in 89 (86.4%) patients. Patients were grouped according to VUR:
      absence of VUR (group 0), VUR grade I-II (group 1-2), and VUR grade III (group
      3). The 3 groups were comparable for male/female ratio, cause of renal failure,
      cause of donor death, recipient and dialytic age, immunosuppressive therapy,
      follow-up, time of VC performance after transplantation. At 6 months and 1, 2, 3,
      4, and 5 years after transplantation graft function, number of rejection
      episodes, and number of urinary tract infections (UTIs) were similar in the 3
      groups. In groups 1-2 and 3 hypertension was more frequent than in group 0 and
      occurred even after the 6th month (whereas this did not happen in group 0), but
      the differences between the 3 groups were not significant. However, when only the
      13 patients who were followed for 5 years were considered, the prevalence of
      hypertension after 5 years was significantly higher in groups 1-2 and 3 (both
      100.0%) than in group 0 (33.3%) (chi-square = 7.88; p < 0.02). Finally, 4.5% of
      patients with VUR and no patients without VUR had septic episodes linked to UTIs,
      but the difference was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8358875
TI  - Plasticizers induced mononuclear cells interleukin 1 production: implications
      with peritoneal sclerosis.

PMID- 8358876
TI  - Central venous hemodialysis catheter related superior vena cava syndrome.

PMID- 8358877
TI  - Effects of indomethacin misoprostol on GFR.

PMID- 8358878
TI  - Heart failure: drug therapy in the nineties and beyond.
AB  - The lesson learned from recent advances in the understanding of congestive heart
      failure is that it is too complex a process to be managed in a simple fashion. At
      present, incremental improvement such as that provided by ACE inhibitors, and now
      possibly by new agents such as flosequinan, are what we have to offer our
      patients, short of transplantation, to control symptoms and increase exercise
      tolerance. No one knows what the future holds for these patients, but one can
      hope that the current therapy and those drugs being studied in clinical trials
      will provide agents that will continue to reduce the morbidity and mortality
      associated with current therapies. However, only so much can be done with drugs
      in the failing heart, and research must continue in the area of cardiac
      transplantation as well as in the area of totally implantable ventricular assist
      devices.

PMID- 8358879
TI  - Sarcoidosis of the heart.
AB  - Myocardial involvement in sarcoidosis occurs in about 27% of patients. Clinical
      manifestations include ventricular arrhythmias, conduction abnormalities, and
      sudden death. Diagnosis requires clinical suspicion and may be supported by
      electrocardiography, echocardiography, thallium imaging, gallium-67 scanning, and
      myocardial biopsy. Steroids seem to be beneficial in the treatment of myocardial
      sarcoidosis. Those who do not respond to medical treatment may benefit from
      cardiac transplantation.

PMID- 8358880
TI  - Low-dose dobutamine stress test for the evaluation of cardiac function using
      ultrafast computed tomography.
AB  - High dose-dobutamine (DOB) has been previously used as a pharmacological stress
      test to evaluate wall motion abnormalities. As a result, recent stress
      echocardiography with low-dose DOB has been reported to be valuable for
      investigating stunned myocardium after thrombolysis. However, echocardiography
      requires an operator's skill and experience to evaluate wall motion abnormalities
      which are subjectively determined by the observer. In contrast, ultrafast
      computed tomography (UFCT) does not necessarily require extreme technical skill
      and experience. To evaluate the feasibility of stress UFCT with low-dose DOB, we
      scanned 10 normal subjects along the short-axis by 8-slice-multicine mode. After
      scanning at rest for baseline, we scanned during the administration of 4 and 8
      micrograms/kg/min of DOB, respectively, for 5 min. Ejection fraction,
      contraction, and thickening were higher during 8 micrograms/kg/min of DOB than
      during 4 micrograms/kg/min of DOB and baseline, while the above values were
      higher during 4 micrograms/kg/min of DOB than during baseline (p < 0.01). It was
      possible to detect changes of cardiac function and wall motion due to low-dose
      DOB by UFCT. We therefore conclude that UFCT is a reliable modality for
      evaluating cardiac function and wall motion for low-dose DOB stress test because
      of its excellent spatial and contrast resolution.

PMID- 8358881
TI  - Exertional hemodynamics in women with chest pain--an aortic Doppler ultrasound
      study.
AB  - Aortic ultrasound Doppler recordings of stroke volume, maximal flow velocity, and
      acceleration can be used to assess central hemodynamic effects of exercise in
      coronary artery disease (CAD) and left ventricular dysfunction. We wanted to
      evaluate the time course and amplitude of changes in aortic Doppler ultrasound
      parameters in women during supine exercise and the potential diagnostic value of
      a submaximal supine exercise test. For this purpose, 18 women who had undergone
      coronary angiography because of incapacitating chest pain (10 with significant
      coronary stenoses and previous myocardial infarction, 8 without stenoses or
      infarction) were compared with 10 healthy controls. Pathological
      electrocardiographic (ECG) ST-segment depression during supine exercise was
      common in all groups. In the control group, a significant increase of stroke
      volume (10%), maximal aortic flow velocity (27%), and acceleration (43%) occurred
      at low load during exercise. Women with CAD showed no increase and a lower
      cardiac output during exercise, indicating left ventricular dysfunction. Women
      with syndrome X resembled the controls but had a higher maximal flow velocity at
      rest, which may indicate hyperdynamic circulation. We conclude that a test up to
      40% of seated maximal load is valuable and often sufficient when assessing the
      hemodynamic effects of supine exercise by Doppler ultrasound in terms of stroke
      volume, maximal flow velocity, and acceleration. By characterizing left
      ventricular function in groups of female patients where false-positive stress ECG
      reactions are common, Doppler ultrasound may contribute to the understanding and
      clinical management of women with chest pain.

PMID- 8358883
TI  - Ventricular arrhythmias late after myocardial infarction are related to
      hypomagnesemia and magnesium loss: preliminary trial of corrective therapy.
AB  - It has been well established that in acute myocardial infarction (MI) many
      patients display low serum magnesium (Mg). This is associated with complex
      ventricular arrhythmias. The question arises whether predischarge arrhythmias
      occurring late after MI might also be related to Mg imbalance. In 118 patients
      subjected to heart rhythm 24 h Holter monitoring in the second or third week
      after MI, we investigated (1) the relationship between serum Mg, urinary Mg loss,
      and ventricular arrhythmias, and (2) the effect of Mg supplementation on heart
      rhythm disturbances. In patients with undisturbed rhythm or monomorphic
      ventricular ectopic beats (VEB) (Lown 0-2; n = 84), mean serum Mg level (mg% +/-
      SD) was 1.83 +/- 0.21, whereas in patients with multifocal VEB, pairs, or
      nonsustained ventricular tachycardia (VT) (Lown 3-4; n = 34) serum Mg was
      decreased to 1.68 +/- 0.27 (p < 0.01). Serum Mg normal range in our laboratory is
      1.7-2.6 mg%. The lowest serum Mg reaching 1.55 +/- 0.27 was found in nonsustained
      VT (Lown 4 b) subgroup (n = 14). Urinary Mg loss measured in 81 patients was more
      pronounced in those with Lown 3-4 arrhythmias (n = 26) than with Lown 0-2 (n =
      55). The daily values were 73 +/- 22 and 54.4 +/- 26 mg, respectively (p <
      0.001). Thirteen patients with complex arrhythmias and low serum Mg received Mg
      supplementation (MgSO4, 8 g in 500 ml 5% glucose intravenously during 24 h). This
      resulted in restoration of almost undisturbed rhythm in 10 subjects.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8358882
TI  - Safety of transvenous right ventricular endomyocardial biopsy guided by two
      dimensional echocardiography.
AB  - A total of 231 endomyocardial biopsy procedures performed in 74 consecutive
      patients were evaluated to compare the incidence and nature of complications in
      procedures guided by fluoroscopy versus those guided by echocardiography. Sixty
      biopsy procedures were guided by fluoroscopy and 171 by two-dimensional
      echocardiography. The right interventricular septum was the target site for
      biopsy sampling in all patients. Clinical signs of myocardial perforation
      occurred during one (1.7%) procedure guided by fluoroscopy versus two (1.2%)
      procedures guided by echocardiography. Two cases of interventricular septal
      perforation were visualized during the echo-guided procedures. The biopsy
      specimens were judged to be inadequate for diagnosis in 2.2% of the biopsy
      procedures, all of which were guided by fluoroscopy. The number of samples
      obtained during a procedure guided by fluoroscopy was lower (mean 2.3 +/- 1.6)
      (mean +/- 1 SD) than that taken during a procedure guided by echocardiography
      (mean 4.0 +/- 1.2). Epicardial or pericardial tissue was present in 5.8% of the
      samples obtained under fluoroscopic guidance, versus 0.7% of the samples obtained
      using echocardiography (p = 0.0003). It is concluded that although
      echocardiography seems to provide more accurate and safer guidance for the
      positioning of the bioptome toward the septum, the presence of epicardium or
      pericardium in 0.7% of the samples indicates that inadvertent sampling from the
      right ventricular free wall cannot be avoided.

PMID- 8358884
TI  - Determinants of immediate and follow-up results of pulmonary balloon
      valvuloplasty.
AB  - The data of 93 patients (age 11.4 +/- 9.4 years, range 8 months-56 years) who
      underwent pulmonary balloon valvuloplasty (PBV) for valvular pulmonic stenosis
      (PS) in our institution are reviewed. The patients were classified into three
      groups: Group I (34 patients) had a right ventricular (RV) to aortic systolic
      pressure ratio of < 1, Group II (39 patients) had suprasystemic RV systolic
      pressures, and Group III (20 patients) included patients with elevated mean right
      atrial (RA) pressures irrespective of the RV systolic pressures. The percentage
      drop in immediate postdilatation peak systolic gradients (PSG) and the follow-up
      PSG were similar in the three groups and were not influenced by any predilatation
      patient characteristics. A balloon-annulus ratio < 1 predicted a poorer follow-up
      outcome. Nine patients, eight of Group III and one of Group II, experienced
      difficult procedures requiring sequential use of progressively larger balloon
      catheters. Eleven patients, six of Group II and five of Group III, experienced
      procedure-related events (hypotension, bradycardia/asystole, hypoxia, apnea,
      tachyarrhythmias, and seizures) and one patient (Group II) died. Although changes
      in immediate and follow-up gradients after PBV are not influenced by the severity
      of PS, difficult procedures and procedure-related events are particularly common
      in patients with severe PS and elevated RA pressures. A cautious and planned
      approach is therefore indicated in these patients.

PMID- 8358885
TI  - Lone atrial fibrillation and anticoagulant therapy.
AB  - Assessment of risk of thromboembolism and potential benefit of prophylaxis with
      long-term anticoagulant therapy in lone atrial fibrillation is hampered by a lack
      of consensus regarding definition of lone atrial fibrillation. In general,
      patients less than 60 years of age with normal left ventricular function and left
      atrial size have a low risk of thromboembolic events and are unlikely to gain any
      significant benefit with anticoagulants; however, patients older than 60 years
      with impaired left ventricular function, enlarged left atrium, and/or associated
      conditions such as hypertension have an increased risk of thromboembolism and
      would benefit from long-term anticoagulant therapy. Decisions regarding
      anticoagulant usage would be simplified by using a scoring system containing
      clinical and investigational variables.

PMID- 8358886
TI  - Anatomy, histology, and pathology of the cardiac conduction system--Part IV.
AB  - Metastatic tumor involvement of the heart as a basis for the genesis of various
      cardiac arrhythmias is reviewed. The morphologic basis of pre-excitation
      syndromes and right ventricular dysplasia are also reviewed.

PMID- 8358887
TI  - Hypothyroid cardiac tamponade presenting with severe systemic hypertension.
AB  - Hemodynamic data are presented which not only depict typical tamponade
      physiology, but demonstrate that hypotension may not necessarily be present with
      slow accumulation of pericardial fluid in myxedema patients. This case is unique
      in that severe hypertension, as part of the presentation of hypothyroid
      tamponade, has never been reported.

PMID- 8358888
TI  - Stress-induced polymorphous ventricular tachyarrhythmias in two brothers: unusual
      pattern of inheritance in the long QT syndrome.
AB  - Two brothers, 10 and 9 years old, are reported who were treated for years with
      antiepileptic drugs until the cardiac origin of their syncopal attacks was
      discovered. Our findings are consistent with the diagnosis of long QT syndrome,
      although no other family members are affected and only intermittent and mostly
      borderline QT prolongation could be found. Diagnostic difficulties and genetic
      implications are discussed.

PMID- 8358889
TI  - Harold Nathan Segall (1897-1990).

PMID- 8358890
TI  - The differential effects of FSH and LH on the human ovary.
AB  - The basic foundation for normal puberty and adult reproductive function is
      established during fetal life with the adequate development of the hypothalamus,
      pituitary and gonads. Further maturation and differentiation of the hypothalamic
      pituitary-gonadal axis continues throughout childhood, puberty, adult life and
      senescence. Pituitary FSH and LH play a central role in the cascade of events in
      the hypothalamic-pituitary-gonadal axis by mediating between the brain and
      hypothalamus on one hand and the end-organ, the ovary, on the other. Absent or
      low pituitary secretion of FSH and LH, as occurs in hypothalamic/pituitary
      hypogonadism, leads in women to anovulation, amenorrhoea and absent ovarian
      follicular development. The ability of gonadotrophins to modulate ovarian
      function depends on their rate of synthesis by the pituitary gonadotrophs, on
      their circulating concentrations (which vary throughout life and throughout the
      menstrual cycle), on the relative abundance of the multiple forms of
      gonadotrophins that have varying biological activity, on the presence of their
      receptors on the different cell types of the ovary, on the intracellular
      adenylate cyclase enzyme that causes the production of cAMP, and on the extra-
      and intragonadal factors that are able to modulate the effects of gonadotrophins
      in the ovary. Recent clinical and basic research with recombinant gonadotrophins,
      molecular biological studies on the localization, function and regulation of the
      long sought after gonadotrophin receptors, as well as research on the interaction
      between gonadotrophins and local intragonadal factors have widened our knowledge
      about the function and role of FSH and LH in the ovary and have provided new
      insights into previously unanswered questions of ovarian physiology and
      pathophysiology and will provide the basis for the design of new treatment
      strategies to overcome ovulatory gonadotrophin-dependent dysfunction in the
      future.

PMID- 8358891
TI  - The significance of elevated FSH for reproductive function.
AB  - 1. Women aged 40 or more with favourable hormone profiles can do well in assisted
      reproduction, while women of any age with basal FSH levels greater than 20
      IU/litre will be poor responders to ovarian stimulation. 2. Basal FSH is an
      important predictor of ovarian reserve--levels over 25 IU/litre are rarely
      associated with ongoing pregnancy, and the best chance for pregnancy is an FSH
      between 10 and 20 IU/litre. 3. A basal E2 over about 50 pg/ml predicts poor
      ovarian reserve. 4. Age remains an important factor even when the FSH and E2
      levels are known. 5. Optimal prediction involves simultaneous consideration of
      age, FSH, LH and E2. 6. Provocative tests of ovarian reserve are probably
      superior but are not as simple as static tests. 7. Defined risks of multiple
      pregnancy can be controlled by adjusting the number of pre-embryos transferred
      according to age and FSH levels. 8. Cases of otherwise unexplained infertility
      may be uncovered by evaluating basal FSH and E2 levels.

PMID- 8358892
TI  - The FSH threshold concept in clinical ovulation induction.

PMID- 8358893
TI  - The step-down principle in gonadotrophin treatment and the role of GnRH
      analogues.
AB  - This chapter has focused on the step-down principle for gonadotrophin induction
      of ovulation in women suffering from clomiphene-resistant anovulation. The
      physiological rationale of this approach has been highlighted. Under normal
      conditions, FHS levels surpassing the FSH threshold initiate gonadotrophin
      dependent growth of a cohort of follicles (this process is referred to as
      'recruitment'). Due to negative feedback actions, the FSH levels decrease and FSH
      is above the threshold for only a limited number of days (the 'FSH window').
      Around the mid-follicular phase, selection of a dominant follicle takes place; in
      addition to relatively low serum FSH concentrations, intraovarian regulation
      appears to be important for this process. In the conventional step-up or low dose
      step-up protocols for gonadotrophin induction of ovulation, administered doses
      are kept constant once an 'adequate' ovarian response is observed, resulting in
      high FSH serum levels in the late follicular phase and a broad FSH window. This
      contradicts normal circumstances and may give rise to unintended interference
      with the selection process by continuously stimulating follicles to enter the
      growing pool. This may result in multiple follicle development which, in turn,
      may be related to higher rates of multiple pregnancies and ovarian
      hyperstimulation. Potential mechanisms underlying arrested follicle maturation in
      PCOS are also discussed since they appear to be of relevance for the induction of
      ovulation. Disturbed selection can be overcome in the majority of cases by
      elevating the serum FSH concentrations through the administration of exogenous
      gonadotrophins to surpass the elevated FSH threshold in these patients. Data
      obtained by our group so far suggest that in PCOS patients treated with
      gonadotrophins in a step-down fashion, follicles continue to mature and can be
      stimulated to ovulation. Moreover, the number of functionally active medium-sized
      follicles seems to be reduced. If monofollicular development is observed in these
      patients, growth rates and oestrogen serum levels are indistinguishable from
      unstimulated normal development of the dominant follicle. In our initial series
      of over 200 cycles of gonadotrophin treatment according to the step-down
      principle in clomiphene-resistant anovulatory patients, 84% of cycles were
      ovulatory and pregnancy was achieved in 18% of the cycles (giving a cumulative
      pregnancy rate of 51%). Moreover, the overall complication rate appears to be
      low. The potential advantages and critical points of adjuvant treatment with GnRH
      analogues is also discussed. It has been clearly demonstrated that premature
      luteinization can be prevented effectively. Various other potential advantages of
      cotreatment seems to justify adjuvant medication with GnRH agonists.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8358894
TI  - Clomiphene citrate: the case for a monoisomeric preparation.

PMID- 8358895
TI  - Ovulation induction in gonadotrophin-resistant women.
AB  - The patient who has gonadotrophin-resistant ovaries and who requires ovulation
      induction or superovulation for IVF presents a serious problem. The diagnosis is
      usually made in the first treatment cycle which is either abandoned due to a
      failure of response, requires inordinately high doses of gonadotrophins to induce
      a response or fails to induce satisfactory oestradiol levels and/or follicular
      development. This situation is often associated with advanced maternal age and
      high day 3 concentrations of FSH. The possible treatment strategies that we have
      described seem to offer only a partial solution to specific subgroups of poor
      responders. These include protocols of clomiphene/hMG, mini-dose GnRH agonist
      regimens, and cotreatment with GH, each of which may be found to be effective in
      individual cases. Taking into account today's increasing demand for pregnancy in
      older aged women, more research is needed to evolve more efficient solutions for
      this difficult problem.

PMID- 8358896
TI  - The luteinized unruptured follicle syndrome.

PMID- 8358897
TI  - Ovulation induction for luteal phase defects and luteal phase defects after
      ovulation induction.

PMID- 8358898
TI  - Surgical options in polycystic ovary syndrome patients who do not respond to
      medical ovulation induction.
AB  - Women with PCOS often present with anovulatory infertility. In these women,
      attempts at ovulation induction should be initiated with clomiphene citrate.
      However, 10 to 15% of women will not ovulate in response to clomiphene citrate,
      and in those who do, half will not conceive. Ovulation induction in these
      patients may involve the administration of hMG or pure FSH, with or without prior
      pituitary desensitization by GnRH agonists. However, gonadotrophin therapy is
      expensive, requires extensive monitoring, is not available at all centres and is
      associated with a significant incidence of ovarian hyperstimulation syndrome,
      multiple pregnancy and pregnancy loss. Furthermore, the chance of conception is
      limited to the treatment cycle. For women who fail to respond to clomiphene
      citrate therapy, and for whom gonadotrophin therapy is unsuccessful or
      unavailable, surgical therapy should be considered. There is a very limited role,
      if any, for OWR in the treatment of anovulation due to PCOS. Although effective
      in inducing ovulation in approximately 80% of women, with pregnancy rates
      approximating 60%, OWR requires major surgery and is associated with significant
      adhesion formation. Newer, less invasive techniques are emerging for the
      anovulatory woman who fails medical management. These include laparoscopic
      ovarian cautery and laparoscopic ovarian laser vaporization. These surgical
      techniques can be performed as outpatient procedures and may be combined with a
      diagnostic laparoscopy. Knowledge of the long-term effects of these techniques is
      still limited, but results appear promising, with spontaneous ovulation being
      initiated in 70 to 90% of women. Of the patients who remain anovulatory or oligo
      ovulatory after these procedures, most will have been rendered sensitive to
      clomiphene citrate. Conception rates approximate 60%. The mechanism of action
      remains uncertain, but is likely to involve alteration of the intraovarian
      steroid environment and, in turn, the feedback to the hypothalamic-pituitary
      axis. The overall result is normalization of gonadotrophin drive and follicular
      microenvironment, allowing follicular recruitment and development to proceed to
      ovulation. Future clinical studies with long-term follow-up will be required to
      determine relapse rate and fecundity rates following these procedures. The risk
      of postoperative adhesion formation and the role of second-look laparoscopy in
      the prevention of this undesirable complication remains uncertain. Until more
      complete, long-term information is known, caution must be exercised and complete
      information provided to the patient with respect to the possible adverse affects.

PMID- 8358899
TI  - Complications of ovulation induction.
AB  - Induction of ovulation has its own risks. Since this treatment is elective the
      physician should be convinced that it is really indicated for the specific
      patient. Multiple pregnancies still occur in 4 to 15% in in vivo treatment and in
      15 to 20% in assisted reproduction. Abortions occur in 20% of the pregnancies
      achieved. These numbers demonstrate the complexity of induction of ovulation. In
      recent years the average age of the treated patient has increased, but it is too
      early to see whether this influences the frequency of complications. The
      physician should be aware of the possible complications and should remain in
      contact with the patients at risk after completion of the treatment. The patient
      should be well informed about the possible complications before starting
      treatment. At the end of the treatment she should be able to recognize any
      clinical warning signs of OHSS and inform her physician, in order to be treated
      appropriately. Further studies of the pathogenesis of OHSS in the future will
      hopefully lead to more specific treatments or even prevention of this phenomenon.
      The increasing experience in selective fetal reduction seems to be a practical
      solution to high rank multifetal gestation, preventing extreme prematurity and
      its sequelae.

PMID- 8358900
TI  - Ovulation, ovulation induction and ovarian carcinoma.

PMID- 8358901
TI  - Results of nonoperative management of full-thickness tears of the rotator cuff.
AB  - The results of nonoperative management of 53 patients with full-thickness tears
      of the rotator cuff proven by arthroscopic examination was as follows. Patients
      were treated with nonsteroidal antiinflammatory medication, stretching,
      strengthening, and occasional steroid injections. Average age at presentation was
      62.2 years. Patients were evaluated at an average of 7.6 years. Forty patients
      were male, and the dominant limb was involved in 40 cases. Thirty-four patients
      were reviewed by questionnaire and physical examination, whereas 19 patients were
      evaluated by telephone interview only. In 40 patients, the onset of symptoms was
      associated with an injury. In 12 patients, workmen's compensation was involved.
      At follow-up evaluation, the 34 shoulders that were available for examination
      were evaluated for pain, range of motion, strength, and function. Thirty-nine of
      the 53 patients (74%) assessed subjectively had only slight or no shoulder
      discomfort. Of the 28 shoulders presenting within three months of injury, 24
      (86%) were rated as satisfactory at the time of latest evaluation. Of the 16
      patients who initially had had shoulder pain for over 6 months, only nine (56%)
      were rated as satisfactory. Most patients showed improvement with regard to their
      ability to perform activities of daily living. Average active total elevation was
      149 degrees compared with 121 degrees at initial presentation. Thirty-two of the
      34 patients examined (94%) had evidence of weakness on muscle testing and 19
      (56%) had demonstrable muscle atrophy.

PMID- 8358902
TI  - Acromioclavicular joint cyst associated with rotator cuff tear. A report of three
      cases.
AB  - Acromioclavicular joint cyst (AJC) is a rare condition, usually occurring in the
      presence of a wide communication between glenohumeral and acromioclavicular
      joints in patients with a massive rotator cuff tear. In the presence of AJC,
      accurate evaluation of the status of the rotator cuff should always be made.
      Removal of the cyst only must be avoided because the condition tends to recur if
      the cuff tear is not repaired. When the tear is so large that it cannot be
      repaired, excision of the cyst should be associated with a resection of the
      lateral end of the clavicle.

PMID- 8358903
TI  - A prospective randomized study of a collar versus a collarless femoral
      prosthesis.
AB  - A prospective, randomized study of 44 collared versus 40 collarless cemented HD-2
      total hip arthroplasties (THAs) was performed in 84 patients. Seventy patients
      were examined at an average of 4.6 years after surgery. Five hips have required,
      or are scheduled to have, revision arthroplasty: two with collared prostheses and
      three with collarless prostheses. Good collar contact with the proximal medial
      femur was achieved in 47% of the collared prostheses. No patient with good
      contact has required or is scheduled to have revision hip surgery. Radiolucent
      lines were greater in both frequency and width in Gruen Zones 2 and 7 in patients
      with a collarless prosthesis. Loss of endosteal height of the femoral neck was
      3.5 mm in patients with collarless prostheses and 1.7 mm in patients with
      collared prostheses. Loss in height of the femoral neck was 2.6 mm in patients
      with collared prostheses with poor bone contact and 0.7 mm in patients with
      collared prostheses with good bone contact. The mean preoperative and
      postoperative Harris hip scores for the collarless group and for the collared
      group were not statistically different. There were no statistically significant
      differences in acetabular position, the incidence of acetabular radiolucent
      lines, or femoral subsidence between patients treated with collared or collarless
      prostheses. This study demonstrates that it is possible to stress the proximal
      medial portion of the femur with a collared prosthesis. Furthermore, a
      significant increase is identified in both the frequency and width of radiolucent
      lines in patients with collarless prostheses in Zones 2 and 7.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8358904
TI  - The uncemented Gerard bipolar double-cup arthroplasty of the hip. A five- to 11
      year follow-up study.
AB  - Between 1978 and 1984, 183 hips in 154 patients with the uncemented Gerard double
      cup arthroplasty were resurfaced. The clinical and radiographic results of the
      106 original arthroplasties were reviewed after a median follow-up period of 98
      months. Although many of these patients had clinically improved immediately, the
      Harris Hip score decreased significantly in most hips in subsequent years. No
      correlation was found between the clinical score and radiographic complications.
      Major revision surgery with removal of the double cup was performed in 54 of 183
      patients, making the cumulative success rate after 132 months only 48%. Survival
      was significantly greater in patients younger than 50 years of age and in
      patients with a low body weight (Quetelet index less than 25). This high failure
      rate eliminates the Gerard double-cup arthroplasty, except possibly for the
      patient with a destructive inflammatory arthropathy for whom there are no other
      surgical alternatives.

PMID- 8358905
TI  - Survivorship analysis of cemented high modulus total hip arthroplasty.
AB  - Ninety-four high-modulus total hip arthroplasties (THAs) were performed from 1977
      to 1982 using the Computer Assist Design (CAD) and HD-2 prostheses. Eighty-six
      hips were followed for an average of 6.7 years. The cement gun was used
      throughout the study period, and distal bone or cement plug use was begun in
      1979. The results of these arthroplasties were evaluated retrospectively using
      both survivorship analysis and observed success rates. Using a standard hip
      rating system, 19 hips were rated as excellent, 44 as good, 15 as fair, and 11 as
      poor. Failure was defined as definitely visible radiographic migration of either
      component, or reoperation for revision of one or both components. There was no
      significant difference between the HD-2 and CAD prostheses. There were five hips
      revised for aseptic loosening and revision was advised in an additional three
      hips. One hip with late sepsis required removal of both components. The five- and
      ten-year survivorships of the acetabular components were 97% +/- 3 and 58% +/-
      17, respectively. Those of the femoral components were 93% +/- 5 and 78% +/- 13,
      respectively. For the components combined, the survivorship at five years was 91%
      +/- 6 but only 50% +/- 17 at ten years. Survivorship analysis provided a
      different and more realistic appraisal of the long-term results of the
      arthroplasties in this series than did the observed success rates. The
      contemporary cement techniques of the late 1970s and early 1980s may not be
      sufficient for the long-term survival of high-modulus THAs. Additional techniques
      may be necessary for improved long-term survival.

PMID- 8358906
TI  - Total hip arthroplasty in sickle cell hemoglobinopathy.
AB  - Twenty-two arthroplasties were performed in 14 patients with sickle cell
      hemoglobinopathy (SCH). There were 15 primary and seven revision procedures; none
      were lost to follow-up evaluation. In the primary arthroplasty group, there were
      two deaths in patients whose implants were functioning well. The remaining 13
      hips had a mean follow-up period of 4.8 years. Failure occurred in five of these
      13 hips (38%), four due to aseptic acetabular loosening and one due to sepsis. In
      the revision arthroplasty group, at a mean follow-up period of 5.3 years, failure
      occurred in three hips (43%), one due to acetabular loosening, one due to femoral
      loosening, and one due to sepsis. Perioperative complication rates were high in
      both groups. Femoral intramedullary sclerosis and bone altered by marrow
      hyperplasia were associated with intraoperative technical difficulties as well as
      problems with achieving long-term component fixation. Though total hip
      arthroplasty provides the most reliable measure of effective treatment in SCH, it
      carries a high risk of complications and failure.

PMID- 8358907
TI  - Total hip arthroplasty in beta-thalassemia. Case report and review of the
      literature.
AB  - A 60-year-old man with beta-thalassemia intermedia and degenerative joint disease
      was successfully treated by total hip arthroplasty. The operation was complicated
      by severe bleeding associated with marked bone marrow hyperplasia. Despite
      autologous cell salvage, massive homologous transfusion was required. Special
      orthopaedic and perioperative complications stem from beta-thalassemia syndromes.
      Management may be complicated by anemia, medullary hyperplasia, organ dysfunction
      associated with iron overload, and susceptibility to infection. The orthopaedic
      manifestations of beta-thalassemia may be mitigated by chronic transfusions.

PMID- 8358908
TI  - Chevron osteotomy and single wire reattachment of the greater trochanter in
      primary and revision total hip arthroplasty.
AB  - Even at a medical center where hip arthroplasty is performed routinely without
      trochanteric osteotomy, selected arthroplasties still require greater
      trochanteric osteotomy. A technique of greater trochanteric biplane osteotomy and
      reattachment with one wire is described. The technique provides maximum stability
      with a minimum of internal fixation and it can be performed quickly. The
      postoperative rehabilitation protocol is the same as that used in hip
      arthroplasty patients without trochanteric osteotomy. Results with a minimum two
      year follow-up period disclosed osseous union in 98% of 53 primary arthroplasties
      and 97% of 74 revision hip arthroplasties. Problems related to the greater
      trochanter necessitated reoperation in only two patients: one for reattachment of
      a migrated trochanter and one for trochanteric wire removal.

PMID- 8358909
TI  - Extensile triradiate approach for complex acetabular reconstruction in total hip
      arthroplasty.
AB  - The triradiate approach as described by Mears has been used for open reduction of
      complex dual-column acetabular fractures. Mears extended the anterior limb of
      this incision to the symphysis pubis by the ilioinguinal approach. From a
      consecutive series of 43 total hip revisions, this approach was used successfully
      in seven cases in which extensile exposure was necessary to revise complicated
      acetabular reconstructions for arthroplasty. The approach was used also to
      perform complex acetabular reconstruction after en bloc tumor resection. Three
      patients had severe intrapelvic component protrusio and anterior column
      deficiency where close proximity of the prosthesis and femoral neurovascular
      bundle were detected before surgery. Massive allograft and pelvic reconstructions
      were used to span large anterior column defects and to stabilize pelvic
      dehiscence. Complications included one hip dislocation and one posterior flap tip
      necrosis. Follow-up ranged from six to 34 months. No graft failure has been
      noted.

PMID- 8358910
TI  - Pelvic reconstruction/total hip arthroplasty for metastatic acetabular
      insufficiency.
AB  - Four cases of pathologic periacetabular insufficiency/fracture in patients with
      extensive neoplastic metastatic involvement of the hemipelvis were treated by
      pelvic reconstruction with hemipelvis pin reinforcement with total hip
      arthroplasty (THA). Reconstruction was reserved for patients with limited other
      bony or visceral metastases, and had extreme narcotic-dependent pain and
      debilitation, or failed prior management, but had reasonable life/activity
      expectancy. Tumor palliation and hemipelvis reconstruction was obtained by
      ilioinguinal (pelvic) and posterolateral (hip) incisions. Iliac crest exposure
      allowed iliacus elevation, debulking of any intrapelvic soft-tissue mass, and
      exposure of the medial acetabulum. Rows of threaded Steinman pins were
      selectively passed from iliac crest (ilioinguinal incision) to superior and
      medial acetabular deficiencies (hip incision) in guided antegrade fashion. A
      reinforced polymethylmethacrylate (PMMA) acetabular reconstruction was then
      created, with PMMA incorporating medial and superior pins, an anti-protrusio
      ring, and a standard cemented acetabular component. A long-stem cemented femoral
      component was placed for proximal femoral metastasis prophylaxis. Postoperative
      rehabilitation (mean hospitalization, 12.7 days) was as for cemented THA. Mean
      survival was 15 months with integrity of the hip construct maintained throughout.
      All four patients progressed to independent ambulation with walking aids and were
      gratified that they had elected surgical treatment with reconstruction.

PMID- 8358911
TI  - Ununited femoral neck fractures by open reduction and vascularized iliac bone
      graft.
AB  - Neglected femoral neck fractures are frequently complicated with nonunion and
      avascular necrosis of the femoral head. The treatment is especially difficult in
      young adults because arthroplasty is not indicated. Five cases of neglected
      femoral neck fractures in young patients were treated by open reduction and
      internal fixation with pins. The defect of the femoral neck was filled with a
      block of vascularized iliac bone graft. After at least two years, the fractures
      were healed without avascular necrosis of the femoral head. The leg-length
      discrepancy was corrected in all but one case. The pedicled iliac graft provided
      a viable bone graft, which maintained the viability of the head and hastened
      fracture healing.

PMID- 8358912
TI  - Intertrochanteric fractures of the femur in rheumatoid arthritis patients.
AB  - In a series of 33 intertrochanteric femoral fractures in patients suffering from
      classic rheumatoid arthritis (RA), the typical patient was about 70 years of age,
      osteopenic, and severely affected by longstanding polyarticular RA of joints
      other than the hip. Prefracture involvement of the hip joint (other than
      osteopenia) was apparent radiographically in only 9.1% of patients. There was a
      higher rate of avascular necrosis (9.7%) and nonunion (6.5%) than expected in the
      nonrheumatoid general population. There was also a high rate of secondary
      displacement. Of three patients with avascular necrosis, two had had
      corticosteroid treatment.

PMID- 8358913
TI  - Walking ability after internal fixation of trochanteric hip fractures with Ender
      nails or sliding screw plate. A comparative study of gait.
AB  - The influence of several clinical and radiographic parameters on the functional
      outcome of 92 patients with trochanteric hip fractures treated at random with
      either Ender nails or a sliding screw plate (SSP) was prospectively investigated.
      Apart from other clinical variables such as pain, the use of walking aids, and
      walking distance, the walking ability of patients was assessed by gait analysis
      performed on an electronic walkway. The parameters investigated were the maximal
      vertical force (MVF) and single-limb support phase (SLS). Independent of the type
      of fixation, no differences were observed between stable and unstable fractures
      in any of the parameters analyzed six months after surgery. In fractures treated
      with Ender nails, the use of walking aids and MVF were influenced by a
      satisfactory fracture reduction. Walking distance was the sole factor correlated
      with the status of fracture healing. In fractures treated with SSP, the pain was
      the only clinical variable significantly influenced by the outcome of fracture
      healing. In trochanteric fractures treated with Ender nails, the quality of
      fracture reduction was the most valuable predictor of patients' recovery of
      walking ability.

PMID- 8358914
TI  - Avascular necrosis of the femoral head as sequela of fracture of the greater
      trochanter. A case report and review of the literature.
AB  - After a fall from a tree, a 12-year-old boy sustained a fracture of the greater
      trochanter and was subsequently treated by open reduction. Twenty months after
      surgery, the hip developed to a flexion contracture, limb-length discrepancy, a
      collapsed, irregular-shaped femoral head with sclerotic areas, and a metaphyseal
      cyst. A growing child with avascular necrosis of the femoral head after fracture
      of the greater trochanter seems not to have been reported in the English language
      literature.

PMID- 8358915
TI  - Classification in slipped capital femoral epiphysis. Sonographic assessment of
      stability and remodeling.
AB  - In a prospective study of 26 hips in 21 patients with slipped capital femoral
      epiphyses (SCFEs), serial sonography was more sensitive than radiography in
      showing epiphyseal displacement and reduction. Reductions were associated with
      grossly visible hip joint effusions. The initial slips were reduced by treatment
      in seven of 11 hips with effusion. The 15 hips without effusion were unreduced.
      After stabilization and pinning, the effusion did not recur in any case.
      Sonography is sensitive and free from projectional errors in the assessment of
      metaphyseal remodeling. If any remodeling is present, the SCFE is at least three
      weeks in duration. A new classification into acute, acute-on-chronic, and chronic
      SCFEs is proposed, based on the objective sonographic data. Joint effusion
      represents physeal instability or recent progression, and remodeling is a sign of
      chronicity. An acute SCFE is characterized by effusion, whereas a slip without
      effusion but with remodeling is designated as chronic. An acute-on-chronic SCFE
      is associated with both effusion and remodeling. Joint effusion suggests that
      SCFEs should be operatively fixed and that displacement may diminish with
      traction or intraoperative positioning of the hip.

PMID- 8358916
TI  - Long-term results of valgus osteotomy for congenital coxa vara.
AB  - Twenty hips (12 patients) with congenital coxa vara, treated with valgus
      subtrochanteric osteotomy, were reviewed retrospectively. The average
      Hilgenreiner-epiphyseal (HE) and head-shaft (HS) angles at the initial evaluation
      were 66 degrees and 96 degrees, respectively. The average postoperative follow-up
      time was 20 years. Five of the 12 hips with trochanteric overgrowth had abductor
      weakness. A postoperative HE angle of 35 degrees or less and a HS angle of 130
      degrees or more was correlated with consistently satisfactory results.

PMID- 8358917
TI  - Sensitivity of manual palpation in testing the neonatal hip.
AB  - Developmental dysplasia of the hip (DDH) is a term used to describe a group of
      disorders of the neonatal hip in which the head of the femur is unstable or
      incongruous in relation to the acetabulum. Early detection and treatment of the
      condition generally results in normal development, whereas late diagnosis has
      poor success. In Northern Ireland, despite all neonates being manually examined
      for hip disorders by a medical officer before hospital discharge, there is an
      unacceptable late diagnostic rate of almost 50% of all cases. To help reduce the
      number of late presentations, vibration arthrometry, a noninvasive form of
      screening for DDH, has been used to record hip vibration events during clinical
      testing. In a comparative study, 300 infants were examined by nurses and medical
      officers to establish the sensitivity of manual palpation to neonatal hip
      vibrations detected by the objective detection system. Experienced research
      nurses detected 86% of the signals; doctors in training detected less than 10%.
      This suggests that objective, noninvasive screening by vibration arthrometry
      would detect a higher proportion of vibration events in neonates during the early
      stages of DDH. More time should be invested in training medical officers and
      others involved in DDH screening.

PMID- 8358918
TI  - Nine-year follow-up results of two methods of MacIntosh anterior cruciate
      ligament reconstructions.
AB  - Forty-seven MacIntosh anterior cruciate reconstructions using iliotibial band
      were performed in patients with chronic instability symptoms and positive pivot
      shift jerk. In 22 knees, a lateral substitution technique alone was used. In 25
      knees, the technique was supplemented with an intraarticular component. After an
      average of follow-up of nine years, 62% of knees had an excellent or good Lysholm
      score; 83% of patients remained active in sports. Subjectively, there was no
      deterioration of stability with time, and no return of the jerk on pivot shift
      testing, although a slide persisted in one third of the patients. The addition of
      an intraarticular component did not alter the subjective result. Objectively, the
      trend was toward improvement in functioning. The lateral tenodesis was the major
      determinant in the improvement of subjective stability and control of pivot shift
      jerk.

PMID- 8358919
TI  - Gait analysis study on patients with varus osteoarthrosis of the knee.
AB  - Biomechanical changes that occur after high tibial osteotomy (HTO) was
      investigated in 30 patients with osteoarthrosis (OA) of the knee and 11 age
      matched normal subjects. Of the 37 knees with varus OA evaluated, 21 were
      analyzed before and after surgery (average follow-up evaluation, two years). The
      mean age of the patient group was 58.2 years. Clinical assessment was based on
      the Hospital for Special Surgery (HSS) knee scoring system. Full-length weight
      bearing radiograms were taken for the measurement of the mechanical axis of the
      lower limb. Results from clinical assessment showed that 90% of the patients had
      good or excellent postoperative clinical results, as opposed to 9.5% before
      surgery. An overall improvement in the gait parameters was evident in the group
      evaluated after surgery, although control levels were not attained. Further
      analysis based on moments about the knee showed that 57% of the surgically
      treated knees with good or excellent clinical results had abnormal load
      distribution. This may lead to deterioration in the future, and further surgery
      may be required. The abnormal loading was also reflected in the ground-reaction
      force vector diagram. Therefore, the force vector diagram can be used as a quick
      screening method to detect abnormal joint loading.

PMID- 8358920
TI  - Experimental studies of osteopetrosis in laboratory animals.
AB  - Osteopetrosis is a metabolic bone disease characterized by a systemic increase in
      skeletal mass. It results from a defect in the production or function of
      osteoclasts and is inherited in nine genetically distinct osteopetrotic animal
      mutations and man. Studies of these mutations have revealed that osteopetrosis is
      a complex, heterogeneous disorder in its expression, etiology, and response to
      treatment by bone marrow transplantation or by hormone/growth factor therapy.
      These animal mutations have been valuable tools for probing the pathogenesis and
      treatment of osteopetrosis, and information obtained from these studies has been
      used clinically for the treatment of humans with osteopetrosis. In addition,
      studies of these mutations have contributed significantly to understanding normal
      bone cell biology, including the origin of the osteoclast and the significance of
      colony-stimulating factor-1 in osteoclast development. The resistance of some of
      these mutations to cure by stem cell transplantation and hormone therapy, coupled
      with similar observations and experiences in the human condition, indicates that
      these animal mutations will continue to serve important roles in the development
      of alternative therapies to treat resistant forms of the disease. These studies
      are bound to improve the understanding of normal bone biology by providing
      additional insights into the regulation of osteoclasts by osteoblasts and their
      products or by other elements of the skeletal microenvironment.

PMID- 8358921
TI  - Early weight bearing of lateral tibial plateau fractures.
AB  - From 1975 to 1984, 134 consecutive lateral tibial plateau fractures were treated
      as part of this prospective study. Eighty-six fractures (64%) were followed until
      union, with an average follow-up period of 22.7 months. The two aims of this
      study were: First, to analyze the results of operative and nonoperative therapy
      in each fracture type, and second, to evaluate the effect of early weight bearing
      in a cast brace in both types of treatment. All lateral tibial plateau fractures
      with greater than 5 mm depression or displacement were treated operatively. Forty
      four patients were treated operatively and 42 patients nonoperatively. All
      patients were treated with early range of motion and weight bearing in a cast
      brace. Fractures were initially classified using Hohl's classification system.
      Overall, 95% of the patients with Type I, II, or V fractures had satisfactory
      results, as opposed to only 70% of patients with Type III fractures. Of the Type
      III fractures, 83% treated operatively had satisfactory results compared with 53%
      treated nonoperatively. Moreover, early weight bearing did not produce further
      depression greater than 2 mm.

PMID- 8358922
TI  - Knee arthrodesis using combined intramedullary rod and plate fixation.
AB  - Intramedullary arthrodesis of the knee is a satisfactory method for treating
      difficult salvage cases of infected arthroplasty, bone loss, and severe
      osteoporosis. In eight cases, a medial compression plate was routinely used for
      complete fixation. Union occurred in all cases, including two proximal tibial
      segmental allografts. Five previously infected cases were healed at follow-up
      examination (average, six to 44 months). Complications included proximal rod
      prominence, partial peroneal nerve palsy, recurrent sepsis in one case, and
      tibial shaft perforation on nail insertion. Seven of the eight patients used some
      form of walking aid for extended ambulation. Leg length was generally 1.5-2.5 cm
      shorter than the opposite limb.

PMID- 8358923
TI  - Arthroscopic treatment of anterior cruciate ligament avulsion.
AB  - A new technique is described for arthroscopic reduction and internal fixation
      (ARIF) of avulsion fractures involving the insertion of the anterior cruciate
      ligament (ACL). Conventional methods of treatment of ACL avulsion in adults may
      lead to suboptimal results owing to stiffness from either prolonged
      immobilization or the morbidity of arthrotomy. Contemporary techniques of
      arthroscopic reduction and percutaneous pinning do not achieve rigid fixation and
      thus still require cast immobilization. The placement of cannulated screws
      through the anteromedial arthroscopic portal provides rigid fixation while
      avoiding arthrotomy, allowing early mobilization and return to activity. The
      possibility of interstitial damage to the ACL and implications regarding
      tensioning of the ligament are considered A typical case illustrates ARIF of ACL
      avulsion. The technique minimizes morbidity and optimizes function.

PMID- 8358924
TI  - Unicompartmental arthroplasty for osteonecrosis of the knee joint.
AB  - A review of 34 knees with osteonecrosis of the medial femoral condyle treated by
      unicompartmental arthroplasty is presented, with a minimum of two years' follow
      up time and an average of five-and-one-half years. Excellent or good results were
      obtained in 89% of the patients. Of the four failures reported, two were caused
      by the development of osteonecrosis of the lateral compartment. Two other
      patients had persistent pain with no apparent cause. Unicompartmental
      arthroplasty is acceptable treatment of osteonecrosis of the knee joint because
      of the rapid recovery from the operation, the low morbidity rate, and the
      preservation of the cruciate ligaments, the patella, and the opposite
      compartment, which results in better function and motion than a high tibial
      osteotomy or a total knee arthroplasty.

PMID- 8358925
TI  - The Maquet procedure in the treatment of patellofemoral osteoarthrosis. Long-term
      results.
AB  - Long-term results are reported for 35 knees with patellofemoral osteoarthrosis
      treated by Maquet procedure. Eighty percent were rated very good or good, and 20%
      fair or poor. The poor results are attributed to errors in the diagnosis or to
      inadequate surgical technique. The Maquet procedure thus provides good results
      for painful knees with patellofemoral osteoarthrosis. A tibial tubercle elevation
      of at least 2 cm is necessary to decrease joint pressure sufficiently.

PMID- 8358926
TI  - Alveolar soft-part sarcoma. A report of ten cases.
AB  - The clinical and pathologic features of ten cases of alveolar soft-part sarcoma
      (ASPS) were observed in subjects aged ten to 49 years. Eight were male and two
      were female. The lesion involved the thigh in six cases and the adjacent bone in
      three. All lesions were retrospectively classified as high risk (Stage II or III
      of Enneking's staging system), and distant metastasis to lung or bone was noted
      at initial presentation in four patients. Three patients died with distant
      metastases at a mean time of three years seven months after diagnosis. The mean
      interval from initial presentation to detection of distant metastasis was nine
      months; and the mean interval from detection of metastasis to death was three
      years two months. Ultrastructural studies demonstrated typical organoid
      arrangement of the neoplastic cells surrounded by a basement membrane with close
      attachment of individual cells to the basal lamina. No local recurrence, even in
      cases with inadequate tumor control, and the tendency for distant metastasis
      demonstrated in the current series, reemphasized that management of metastasis is
      most important in the treatment of ASPS.

PMID- 8358927
TI  - Massive osteolysis.
AB  - Massive osteolysis is rare, peculiar, and enigmatic. The clinical, radiographic,
      and histologic features were reviewed in 11 cases. The patients were generally
      young (mean age, 20.7 years), and males outnumbered females. More than half the
      patients had involvement of either the femur or the ribs alone or including the
      vertebrae. On the basis of radiographic studies, the disease process is capable
      of originating either in bone or adjacent soft tissues. Histologically, the
      authors were unable to identify pathognomonic features. Other than excision of
      all involved tissue, surgical treatment was generally ineffective. Radiation
      therapy may be successful in eradicating the disease in selected cases.

PMID- 8358928
TI  - Enchondroma in a patient with fibrodysplasia ossificans progressiva.
AB  - Fibrodysplasia ossificans progressiva (FOP) is a rare heritable disorder
      characterized by progressive heterotopic endochondral bone formation arising in
      ligament, tendon, and the fibrous connective tissue of skeletal muscle. The
      disorder is almost invariably associated with skeletal malformations of the
      endochondral anlage of the feet. A 25-year-old woman with FOP had a
      histopathologically documented phalangeal enchondroma. This common neoplasm of
      cartilage and bone seems not to have been previously reported in FOP; it may
      represent a coincidental occurrence, but in the context of the patient's genetic
      disorder, an enchondroma may represent an unusual and variable expression of the
      disease.

PMID- 8358929
TI  - Chondrosarcoma treated by reimplantation of resected bone after autoclaving and
      supplementation with allogeneic bone matrix. A case report.
AB  - An extensive intramedullary lesion of the femur was diagnosed as a Grade I
      chondrosarcoma in 1986. At definitive surgery, four fifths of the femoral
      diaphysis were resected, autoclaved, and reimplanted. The reconstruction, after
      stabilization with AO plates, was supplemented with allogeneic bone matrix to
      induce new bone formation. No autografts were used. Despite subsequent infection
      and sequestration of the autoclaved tumorous segment, the reconstructed area was
      gradually enveloped by new bone. Three years after primary surgery, the infection
      persisted. The AO-plated and autoclaved sequestered bone was excised. Six years
      after the operation, the patient walks bearing full weight and works full time.
      There are no signs of tumor recurrence.

PMID- 8358930
TI  - Total sacrectomy for a giant sacral schwannoma. A case report.
AB  - Giant sacral schwannomas (GSS) are extremely rare. Complete resection of benign
      but neurologically devastating tumors has been recommended. A 48-year-old man
      with GSS had a tumor so large that a total sacrectomy was necessary. A special
      method of lumbar iliac fixation was devised. Two years and nine months after
      surgery, the patient was free of pain and ambulating with bilateral orthoses.

PMID- 8358931
TI  - Multiple myeloma in a 25-year-old woman.
AB  - A 25-year-old woman with acute knee pain and a lytic area in the proximal femur
      was diagnosed as having multiple myeloma (MM). This case is one of only eight in
      patients younger than aged 30 years to meet modern diagnostic criteria for MM.
      Failure to consider MM in young individuals precludes early diagnosis and
      valuable time for treatment.

PMID- 8358932
TI  - Pfeiffer's syndrome family tree. Review of the literature.
AB  - Pfeiffer's syndrome is an autosomal dominant disorder characterized by
      craniofacial abnormalities and distal extremity abnormalities. This case study
      reviews four generations of a family with craniofacial abnormalities, multiple
      simple syndactylies, and delta phalanges of bilateral great toes and thumbs
      inherited in an autosomal dominant fashion.

PMID- 8358934
TI  - Coronal-plane transcondylar fracture of the humerus in a child.
AB  - A coronal plane fracture of the distal humerus in a child is an uncommon
      fracture, with the most familiar example being a capitellar fracture. An unusual
      coronal fracture of the entire distal humeral articular surface (capitellum and
      trochlea) occurred in a three-year-old boy. This fracture pattern has been
      described in adults but is believed to be previously unreported in children. This
      Salter-Harris Type IV fracture was initially misdiagnosed as a lateral humeral
      condyle fracture. Three years after treatment with open reduction and pin
      fixation, the distal humerus shows no evidence of growth disturbance.

PMID- 8358933
TI  - Triple arthrodesis using internal fixation in treatment of adult foot disorders.
AB  - Forty adult patients with 44 fused feet were evaluated at an average of 4.9 years
      after triple arthrodesis. The average age of the patients at operation was 41
      years. All operations were performed by a specific technique using rigid internal
      fixation with screws. Outcome was graded using the clinical criteria of
      Hallgrimsson as modified by Angus and Cowell. Function was evaluated according to
      modified Arthritis Impact Measurement Scales (AIMS). Radiographic evaluation
      included measurement of lateral talocalcaneal angle, lateral talometatarsal
      angle, and anteroposterior (AP) talometatarsal angle on standing or simulated
      weight-bearing radiographs. Thirty-four feet had good results, six had fair
      results, and there were four failures. The average patient could function
      painlessly on flat surfaces in nonstrenuous activities and had only occasional
      mild pain with more vigorous activities. In roentgenographic parameters, there
      was an average improvement of 17 degrees in the lateral talometatarsal angle, 11
      degrees improvement in the lateral talocalcaneal angle, and an improvement of 18
      degrees in the AP talometatarsal angle. There were two pseudarthroses, no
      recurrences, and two unsatisfactory corrections. When carefully done, triple
      arthrodesis can restore an adult patient with a disabling foot disorder to normal
      function and minimal pain.

PMID- 8358935
TI  - Transverse divergent dislocation of the elbow in a child. A case report.
AB  - The transverse divergent dislocation of the elbow in the child is a rare
      occurrence. In a ten-year-old boy, divergent dislocation was associated with a
      fracture of the coronoid process and of the radial epiphysis. After a closed
      reduction and plaster immobilization, full function of the elbow was recovered
      within nine months.

PMID- 8358936
TI  - Synthetic posterior cruciate ligament reconstruction and below-knee prosthesis
      use in Ehlers-Danlos syndrome.
AB  - Ehlers-Danlos syndrome (EDS) has been associated with irreparable arterial
      disruption, spontaneous and traumatic, necessitating amputation. Recurrent and
      chronic joint dislocation is a common component. Because of the very thin,
      hypermobile skin and "tissue paper scars," these patients would be expected to be
      poor candidates for the use of lower extremity prostheses. A review of the
      literature failed to show any reports of lower extremity prosthesis use in EDS
      patients or of recurrent and chronic joint dislocation treated by synthetic
      ligament reconstruction. The case of a 21-year-old woman is an example of both.

PMID- 8358937
TI  - Two patterns of calcification in primary (physeal) and secondary (epiphyseal)
      growth cartilage.
AB  - It is generally stated that the process of cartilage calcification and
      ossification is the same in the physeal (primary growth center) and epiphyseal
      (secondary growth center) growth plates. Reexamination of osteophyte growth led
      to the proposal that these growth plates differ. This proposition was tested by
      examining rabbit and human material from both sites before and after maceration;
      both tissue preparations were processed for light microscopy, and the macerated
      tissues were also studied by scanning electron microscopy (SEM). The physis
      showed the well-recognized, longitudinal calcified tubal structures in which
      capillaries make direct contact with and resorb the nonmineralized, transverse
      septal cartilage. In the epiphysis, the transverse septal cartilage was also
      mineralized, producing a continuous calcified sheet, perforated only by a limited
      number of channels and susceptible only to osteoclastic removal. This variation
      in mineral distribution modifies the way in which the primary spongiosa is formed
      during growth.

PMID- 8358938
TI  - Delayed implantation of demineralized bone powder after local irradiation in
      rats.
AB  - Previous studies have shown that osteoinduction is inhibited when demineralized
      bone powder (DBP) is implanted within 48 hours of local irradiation (i.e., when
      the acute effects of radiation injury are present). This study sought to
      determine whether normal osteoinduction can proceed if the implantation of DBP is
      delayed until 21 days postirradiation. At 21 days, the acute effects of radiation
      injury are likely to have subsided, but the long-term effects have not yet
      appeared. Twenty-eight-day-old rats were administered a radiation dose of either
      7 or 20 Gy over a localized area of one thigh. The contralateral, nonirradiated
      thigh served as a control. Demineralized bone powder was subcutaneously implanted
      21 days later. Subcutaneous pellets were retrieved at various intervals
      thereafter (up to Day 45) and were histologically graded for evidence of
      osteoinduction. No difference in osteoinduction was detected at any time interval
      in pellets from the 7-Gy-treated sites, compared with controls. Pellets from the
      20-Gy-treated sites, however, demonstrated significantly a lower osteoinductive
      response at each interval. These latter pellets showed small scattered areas of
      osteoinduction and reduced formation of marrow elements. Thus, although
      osteoinduction proceeds normally when the implantation of DBP is delayed for 21
      days after irradiation with 7 Gy, this is not the case when 20 Gy are
      administered. Given the absence of gross impairment of tissue vascularity in
      irradiated sites, it is possible that inhibition of osteoinduction after higher
      doses of radiation results from permanent damage to mesenchymal precursor cells.

PMID- 8358939
TI  - Polylactic acid-polyethylene glycol block copolymer. A new biodegradable
      synthetic carrier for bone morphogenetic protein.
AB  - A new biodegradable polymer, a polylactic acid-polyethylene glycol (PLA-PEG)
      block copolymer, proved to be an effective and suitable carrier for bone
      morphogenetic protein (BMP). Composites of semipurified BMP and PLA-PEG
      consisting of a PLA segment with a molecular weight (MW) of 650 d and a PEG
      segment with a MW of 200 d (PLA-PEG 650-200) were implanted under the fasciae of
      the dorsal muscles of mice. Three weeks after implantation, the PLA-PEG 650
      200/BMP composites were completely absorbed and replaced by newly induced bone
      with hematopoietic marrow. The composites induced twice as much bone as
      composites of BMP and a 650-d PLA homopolymer. Results indicate that of all the
      biodegradable synthetic polymers the authors have tested, PLA-PEG 650-200 is the
      most suitable and effective BMP carrier. Composites of PLA-PEG 650-200/BMP and
      hydroxyapatite powder (HAP) also induced ectopic bone formation. Because PLA-PEG
      650-200/BMP is viscous and semiliquid and PLA-PEG 650-200/BMP/HAP is doughy and
      plastic, the former can be used as an injectable osteoinductive material and the
      latter as a plastic mold.

PMID- 8358940
TI  - Osteopetrosis. Current clinical considerations.
AB  - Osteopetrosis is an inherited skeletal condition characterized by increased bone
      radiodensity. There are three clinical groups: infantile-malignant autosomal
      recessive, fatal within the first few years of life (in the absence of effective
      therapy); intermediate autosomal recessive, appears during the first decade of
      life but does not follow a malignant course; and autosomal dominant, with full
      life expectancy but many orthopaedic problems. The infantile variant shows a
      myelophthisic anemia, granulocytopenia, and thrombocytopenia, and patients
      eventually die from infection or bleeding or both. Neurologic sequelae include
      cranial nerve compression (optic nerve, blindness; auditory nerve, deafness;
      facial nerve, paresis), hydrocephalus, convulsions, and mental retardation.
      Radiographs show uniform bone density without corticomedulary demarcation,
      broadened metaphyses, "bone within a bone" or endobone phenomena (tarsals,
      carpals, phalanges, vertebra, ilium), and thickened growth plates if there is
      superimposed rickets. Transverse pathologic fractures occur, often followed by
      massive periosteal bone formation. Computed tomographic scans, magnetic resonance
      imaging, and bone scans provide specific information. Iliac crest bone biopsy is
      valuable to quantitate osteoclast and marrow changes by light and electron
      microscopy. Medical treatments involve high-dose calcitriol to stimulate
      osteoclast differentiation and bone marrow transplantation to provide monocytic
      osteoclast precursors. Orthopaedic problems in the intermediate and autosomal
      dominant forms include increased fractures, coxa vara, long-bone bowing, hip and
      knee degenerative arthritis, and mandibular and long-bone osteomyelitis. Cranial
      nerve compression also occurs. Osteotomy, plating, intramedullary rodding, and
      joint arthroplasty can be done, but are difficult because of bone hardness.

PMID- 8358941
TI  - Gene cloning and expression of a bone morphogenetic protein derived from a murine
      osteosarcoma.
AB  - Based on information from partial amino acid sequences of a protein with bone
      inducing activity that was purified from a murine osteosarcoma (Dunn type), a
      cDNA library of the sarcoma was screened to clone a gene complementary to the
      protein. The cloned cDNA was amplified and transfected into Chinese hamster
      ovarian (CHO) cells for expression. When the protein produced by the transfected
      cell line was implanted in combination with pure carrier collagen into allogeneic
      mice, ectopic ossicles consistently developed at implanted sites within two
      weeks. The nucleotide sequence of the cDNA and its deduced amino acid sequence
      were homologous to those of human bone morphogenetic protein-4 (also BMP-2B). In
      addition, the cDNA and deduced amino acid sequences were identical to those
      proposed for murine BMP-4 derived from the normal murine fetus. It is postulated
      that the cloned cDNA encodes the protein responsible for bone formation induced
      by implantation of devitalized Dunn-type osteosarcoma tissue or cells. The
      protein product was identified as murine BMP-4, a member of the TGF-beta gene
      family.

PMID- 8358942
TI  - Establishment of a cell line from a human giant cell tumor of bone.
AB  - A cell line (CG-1) was established from a specimen of a 21-year-old woman with
      giant cell tumor of bone. Inverted-phase microscopic analysis showed that the
      cultured cells were spindle-shaped in appearance. Multinucleated giant cells and
      macrophagelike round cells characterizing the histology of giant cell tumor of
      bone were not found. It is believed that the spindle-shaped cells were the
      neoplastic element of this tumor, because they were cultured more than 40
      passages over the course of one year and subsequent cytogenetic analysis with a G
      band technique showed constant loss of chromosomes 14 and 19. The cell line was
      found to produce several cytokines: M-CSF, IFN-gamma and TNF-alpha, as
      demonstrated by Western blotting analysis. These cytokines are known to show
      chemotactic, differentiation-inducing, and activating effects on macrophages.
      Because it has been recently reported in the literature that there are many
      infiltrated macrophages in giant cell tumor of bone, and because multinucleated
      giant cells are formed by fusion of macrophages, the newly established cell line
      may prove a useful system in studying the nature of giant cell tumor of bone.

PMID- 8358943
TI  - Characteristics of metal and ceramic total hip bearing surfaces and their effect
      on long-term ultra high molecular weight polyethylene wear.
AB  - The micromechanics of ultra high molecular weight polyethylene (UHMWPE) wear in
      total hip replacement are very complex. Polyethylene wear from the metal head and
      debris formation are two common types of wear. There are additional wear-related
      processes occurring at the metal-bearing surfaces that are not well-known,
      however. This study outlines these processes, including (1) surface wettability
      changes, (2) oxidative wear of metal surfaces, (3) microabrasion of metal
      surfaces from oxide film damage, and (4) surface abrasion from three-body
      polymethylmethacrylate and bone debris. These processes can contribute to metal
      ion release and a gradual increase in the roughness of the metal surfaces. This
      can lead to increased long-term UHMWPE wear. Of the metal alloys currently used
      in total hip replacements, Co-Cr-Mo alloy is significantly more resistant to
      roughening processes. Hard, stable, oxide: ceramic surfaces articulating against
      UHMWPE are essentially immune to these surface-roughening processes, however. In
      addition, they provide a more wettable surface, further minimizing polyethylene
      wear relative to metal surfaces. By analyzing metal release rates from metal
      polyethylene wear tests, it is shown here that Co-Cr-Mo is gradually removed at a
      rate of about 0.1 micron per year (10(6) cycles), whereas 316L stainless steel is
      removed on the order of 0.2 microns per year and Ti-6Al-4V on the order of 1
      micron per year. The wear rate of Co-Cr-Mo articulating against itself is
      reported to be still greater, at about 2-4 microns per year after an initial wear
      in period. Because metal is gradually removed with articulation time, surface
      hardening methods such as nitrogen ion implantation can be expected to provide
      only temporary resistance to these metal removal and surface-roughening
      processes. Hard, stable ceramic surfaces such as Al2O3 and ZrO2, however, can be
      expected to maintain their initial surface finish and thus minimize UHMWPE wear
      in the long term.

PMID- 8358944
TI  - Quadriceps/anterior cruciate graft interaction. An in vitro study of joint
      kinematics and anterior cruciate ligament graft tension.
AB  - The Oxford Rig, a device that simulates active knee extension during stance, was
      used to study the effects of quadriceps force on AP tibial displacement and axial
      tibial rotation in vitro. Human anatomic specimen knees were tested with the
      anterior cruciate ligament (ACL) intact, sectioned, and reconstructed. Patellar
      tendon grafts used in the ACL-reconstructed state were attached distally to a
      load cell, allowing direct measurement of graft tension. Both ACL status and
      quadriceps force had significant effects on anterior tibial displacement, limits
      of AP displacement, axial tibial rotation, and graft tension, as shown by
      analysis of variance. Anterior cruciate ligament sectioning led to anterior
      tibial displacement in the absence of quadriceps force, whereas ACL
      reconstruction led to posterior tibial displacement. In the ACL-intact,
      quadriceps-stabilized state, anterior displacement of the tibia was observed
      between 95 degrees flexion and full extension, with a maximum displacement (3.5
      +/- 0.2 mm) between 30 degrees and 45 degrees flexion. After ACL sectioning,
      anterior tibial displacement resulting from quadriceps force was accentuated
      relative to the intact state by as much as 4.5 mm +/- 0.9 mm at 20 degrees and 25
      degrees flexion. Anterior tibial displacement in the ACL-intact and reconstructed
      specimens was similar when quadriceps force was present. In the quadriceps
      stabilized state, graft tension increased between 5 degrees and 80 degrees
      flexion. The maximum increase in graft tension due to quadriceps force was at 35
      degrees flexion.

PMID- 8358945
TI  - Bone resorption restored in osteopetrotic mice by transplants of normal bone
      marrow and spleen cells. 1975.

PMID- 8358946
TI  - Autosomal dominant osteopetrosis.
AB  - Autosomal dominant osteopetrosis is radiographically characterized by universal
      osteosclerosis, primarily involving the axial skeleton, and by symmetrical
      affections of the long bones without modeling defects. Based on standard
      radiographs, it is possible to describe two different subtypes with different
      clinical, biochemical, and histologic manifestations. Type I is radiographically
      characterized by pronounced osteosclerosis of the cranial vault, whereas Type II
      has end-plate thickening of the vertebrae (Rugger-Jersey spine) and endobones in
      the pelvis. Both types are strictly family related and seen in childhood.
      Combined radiogrammetric, biochemical, and histologic investigations indicate
      states of defective bone resorption, whereas bone formation seems to be normal in
      both types of patients. Patients with autosomal dominant osteopetrosis are often
      asymptomatic, and the diagnosis may be reached by chance. However, by systematic
      investigations, nearly all patients have manifestations related to the disorder.
      Symptoms are progressive with age, and correlated with osteosclerosis. The
      fracture frequency is increased in Type II patients, and normal in Type I, where
      biomechanical investigations have shown normal, or even increased trabecular bone
      strength. Treatment has been symptomatic. A rational treatment consists of
      stimulation of bone resorption, in combination with inhibition of bone formation
      if possible.

PMID- 8358947
TI  - Carbonic anhydrase II deficiency.
AB  - Carbonic anhydrase (CA) isoenzyme II deficiency--formerly called the syndrome of
      osteopetrosis with renal tubular acidosis and cerebral calcification--is an
      autosomal recessive "inborn error of metabolism" that has disclosed important
      insight concerning osteoclast function. Nearly 50 cases have been described,
      predominantly from the Middle East and Mediterranean region. It is discovered
      late in infancy or early in childhood through developmental delay, short stature,
      fracture, weakness, cranial nerve compression, dental malocclusion, and/or mental
      subnormality. Typical radiographic features of osteopetrosis are present, and
      histopathologic study of the iliac crest reveals unresorbed calcified primary
      spongiosa. The radiographic findings are unusual, however, in that cerebral
      calcification appears by early childhood and the osteosclerosis and skeletal
      modeling defects may gradually resolve by adulthood. Patients are usually not
      anemic. A hyperchloremic metabolic acidosis, sometimes with hypokalemia, is
      caused by renal tubular acidosis that may be a proximal, distal, or combined
      type. Several different mutations within the CA II gene have been identified.
      There is no established medical therapy, and the long-term outcome remains to be
      characterized. Prenatal diagnosis has not been reported. Delineation of CA II
      deficiency establishes an important role in humans for CA II. The pathogenesis of
      the mental subnormality and cerebral calcification is poorly understood; however,
      CA II deficiency provides significant insight concerning CA II in renal
      regulation of acid/base homeostasis and osteoclast-mediated bone resorption.

PMID- 8358948
TI  - Bone densitometry observations of osteopetrosis in response to bone marrow
      transplantation.
AB  - Spinal bone density was measured in eight patients with osteopetrosis to assess
      the natural history of the disease and to monitor the response to therapy.
      Quantitative computed tomographic scans of the lumbar vertebra were obtained in
      seven patients, and dual photon absorptiometric scans were obtained when the
      technique became available. Six children were afflicted with the infantile
      malignant recessive condition and two with the less severe dominant condition. In
      all cases, bone densitometry values ranged from four to five times higher than
      the mean for normal age and gender-matched controls. In four children with
      recessive osteopetrosis, quantitative computed tomographic and dual photon
      absorptiometric scans showed an excellent correlation (R = 0.93) between the
      methods. Quantitative computed tomographic values ranged from 597 to 730 mg/cm3
      (mean = 655 mg/cm3) in children with osteopetrorickets and from 901 to 1000
      mg/cm3 (mean = 980 mg/cm3) in the same children when the rickets was cured. In
      two children treated with bone marrow transplantation, bone densitometry values
      returned to normal within three years. Bone densitometry provides a safe and
      noninvasive method for observing the natural history and therapeutic response of
      the osteopetrotic syndromes.

PMID- 8358949
TI  - Osteopetrosis. The pharmaco-physiologic basis of therapy.
AB  - Medical treatments of osteopetrosis have attempted to improve hematologic
      function, reduce the osteosclerotic condition, and/or improve immune function.
      Prednisone therapy has improved hematologic function in some patients, but has
      not resulted in a reduction in bone mass. Calcium deficient diets have limited
      further sclerosis in some patients. High-dose calcitriol and parathormone
      infusions have stimulated osteoclastic activity. In some patients, high-dose
      calcitriol has resulted in clinical improvement. Newer treatments, such as
      interferon gamma and macrophage colony stimulating factor, may alter the
      osteoclastic and immune defects by stimulating cellular formation and function.
      These therapies, alone or in combination, ameliorate but do not cure the
      osteopetrotic condition.

PMID- 8358950
TI  - Intradural recurrence with chondrosarcoma of the spine. A case report and review
      of the literature.
AB  - Known for its resistance to chemotherapy and radiation therapy, chondrosarcoma
      remains largely a surgically managed tumor predisposed to local recurrence and
      late distant metastasis. A 42-year-old man with known thoracic chondrosarcoma
      developed progressive low back pain, lower extremity weakness, and urinary
      incontinence. Magnetic resonance imaging and computed tomographic myelography
      demonstrated multiple filling defects throughout the lumbosacral region. Surgical
      excision of these lesions disclosed intradural, extramedullary drop metastases of
      the chondrosarcoma. The spread of neoplasms within the dural space is uncommon,
      accounting for less than 5% of spinal metastases, and has not previously been
      reported for chondrosarcoma.

PMID- 8358951
TI  - Anatomic relationships in the shoulder impingement syndrome.
AB  - Impingement syndrome of the shoulder may be produced by compression of the
      subacromial structures against the coracoacromial arch. The anterior tip of the
      acromion, the coracoacromial ligament, and the coracoid process have been
      implicated as sources of impingement. Anatomic specimens were examined to
      determine the anatomic sites on the coracoacromial arch that result in
      compression of the subacromial structures during specific shoulder motions that
      are known to produce impingement pain. The relationships of the supraspinatus
      tendon, the biceps tendon, and the greater tuberosity of the humerus with the
      coracoacromial arch were demonstrated through various arcs of shoulder motion in
      autopsy subjects. Biceps tendon impingement occurred predominantly against the
      lateral free edge of the coracoacromial ligament. Impingement of the
      supraspinatus tendon and greater tuberosity was demonstrated primarily against
      the acromial end of the coracoacromial ligament and the anterior tip of the
      acromion during arcs of flexion and internal rotation. The coracoacromial
      ligament was stretched by the greater tuberosity passing beneath it. This may
      explain the formation of traction osteophytes on the anterior acromion in
      patients with chronic impingement symptoms.

PMID- 8358953
TI  - Pathophysiology of perinatal asphyxia.
AB  - Following a severe asphyxial episode many cells can recover metabolically, and a
      cascade of processes are triggered in which intervention, even some hours later,
      can allow rescue of some cells that would otherwise die. A number of principles,
      however, needs to be carefully considered before extrapolating from animal to
      human trials. In particular, the effects on long-term outcome and on those who
      are compromised by intrauterine growth retardation need to be determined. It is
      critical to be able to identify rapidly those infants in terms of nature and
      severity of injury who are most likely to benefit from treatment. The dimension
      of time and phase of injury or recovery are key factors to effective
      intervention. Novel continuous cerebral function monitoring techniques such as
      those based on real-time spectral analysis of the EEG activity, cortical
      impedance monitoring, and near-infrared spectroscopy have considerable potential
      for determining the severity and pathophysiologic phase of injury on line.

PMID- 8358952
TI  - The definition of acute perinatal asphyxia.
AB  - Perinatal asphyxia remains a concern for physicians, patients, and attorneys. The
      history of concern for this condition is reviewed, and efforts in neonatal
      perinatal medicine to identify at risk patients and prevent serious sequelae are
      discussed. A definition consistent with the American Academy of Pediatrics
      American College of Obstetrics and Gynecology Guidelines for Perinatal Care,
      requiring multiple biochemical and clinical indices for asphyxia, is given.

PMID- 8358954
TI  - Birth asphyxia and the neonatal brain: what do we know and when do we know it?
AB  - In this article, the authors examine whether indicators commonly used to
      recognized birth asphyxia are specific to asphyxial states, and whether these
      allow recognition of a severity of asphyxia sufficient to pose a risk of
      irreversible brain injury. Characteristics recognizable within the first hours
      after birth are focused on because these characteristics will be of most use in
      clinical decisions regarding use of potential new therapies for asphyxia.

PMID- 8358955
TI  - Nuclear magnetic resonance imaging and spectroscopy following asphyxia.
AB  - Nuclear magnetic resonance imaging and spectroscopy have added significant new
      information about the newborn brain during and following asphyxia. NMR imaging
      has permitted sequential in vivo analysis of CNS maturation in the perinatal
      period that is superior in anatomic resolution, and especially in the
      characterization of myelination, to either cranial ultrasound or radiographic
      computed tomography. As a result, the accurate detection and recognition of the
      brain lesions associated with hypoxic-ischemic encephalopathy is now possible,
      including PVL, cerebral infarction, intraparenchymal and intraventricular
      hemorrhage, and delayed myelination. This has improved our understanding of the
      associated potential risk for abnormal neuro-developmental outcome with specific
      lesions. NMR spectroscopy has provided a metabolic window into the biochemical
      events during and following asphyxia. 31P MRS captures the phosphorous
      metabolites as levels rise and fall and shift in relation to each other to
      maintain cellular energy homeostasis in the face of oxygen depletion. Meanwhile,
      proton NMR spectroscopy promises to sustain the metabolic purview beyond the
      immediate cellular response to asphyxia to the chronic adaptation phase.
      Appropriately applied, this noninvasive technology may yet enable us to identify
      brain injury that is reversible in sufficient time to intervene and to diagnose
      accurately what is irreversible for timely prognostication. Furthermore, the
      integration of clinical imaging and spectroscopy capabilities is both feasible
      and desirable; information provided by each being mutually complementary. Imaging
      could improve spectroscopy interpretation by identifying the observed tissue,
      whereas MRS should clarify diagnosis of anatomic lesions detected by MRI.
      Advances in spatial resolution and speed of data acquisition may soon make
      integrated MRI/MRS a clinical reality.

PMID- 8358956
TI  - Near-infrared spectroscopy in asphyxial brain injury.
AB  - Near-infrared spectroscopy is capable of providing noninvasive quantification of
      several important indices of cerebral hemodynamics, including cerebral blood
      flow, cerebral blood volume, and its response to changing arterial carbon dioxide
      tension. Preliminary results in term infants following acute perinatal asphyxia
      suggest that cerebral blood flow and volume are elevated, and the normal control
      mechanisms are abolished. These hemodynamic disturbances occur prior to the later
      development of secondary energy failure with its poor prognosis and may allow
      valuable prognostic information to be obtained in the first hours after birth.

PMID- 8358957
TI  - Brain sonography, computed tomography, and single-photon emission computed
      tomography in term neonates with perinatal asphyxia.
AB  - The clinical diagnosis of hypoxic-ischemic brain injury in neonates can be
      supported by radiologic studies including cranial sonography, computed tomography
      (CT), single-photon emission computed tomography (SPECT), magnetic resonance
      imaging, and positron emission tomography. The role of cranial sonography, CT,
      and SPECT in term neonates with perinatal asphyxia is reviewed in this article.

PMID- 8358958
TI  - Positron emission tomography scanning: applications in newborns.
AB  - Positron emission tomography (PET) is an imaging technique that allows local
      chemical and physiologic functions in various body organs to be measured. Studies
      of local cerebral glucose metabolism in infants and children using PET have
      provided important information on human brain functional development and
      plasticity. In the neonate, PET studies have provided important clues into the
      pathophysiology of hypoxic-ischemic injury. Patterns of cerebral glucose
      utilization in various clinical subtypes of cerebral palsy associated with
      perinatal brain injury are discussed and contrasted to metabolic patterns seen in
      cerebral palsy without clear etiology. Expanding PET technology provides a new
      approach that holds great promise in the diagnosis and management of brain
      disorders affecting the neonate.

PMID- 8358959
TI  - Perinatal asphyxia: effects of biologic and environmental risks.
AB  - The literature on biologic risks, such as asphyxia, and later outcome contains
      many confounding issues. Earlier data may not be applicable today because of high
      mortality rates and significant changes in medical practice. Data from a more
      contemporary cohort indicate an association between arrays of biologic variables
      and outcome, although early developmental/behavioral measures are more
      predictive. Some variables had a 'sleeper effect,' which did not surface until 36
      months. Suggestions for better delineation of relationships between nonoptimal
      risk variables and outcome are provided.

PMID- 8358960
TI  - Visual-evoked potentials in neonates following asphyxia.
AB  - Visual evoked potentials (VEPs) are easily recorded in the neonatal intensive
      care setting using light-emitting diode goggles as the flash stimulus. They are
      sensitive measures of CNS integrity and are altered or abolished by hypoxia.
      Prognosis in newborns with birth asphyxia or hypoxia is difficult to predict;
      however, the VEPs have been shown to be very helpful. Absent VEPs carry a poor
      prognosis; persistently abnormal, i.e., beyond 1 week, also predict abnormal
      outcome. Normal VEPs by 1 week have an accuracy rate around 90% for normal
      outcome.

PMID- 8358961
TI  - Somatosensory-evoked potentials in term neonates with postasphyxial
      encephalopathy.
AB  - This article reviews the use of median nerve somatosensory-evoked potentials in
      full-term neonates with postasphyxial encephalopathy. The predictive value of
      this technique with regard to neurodevelopmental outcome is compared with that of
      clinical assessment and cranial ultrasonography.

PMID- 8358962
TI  - Recent advances in the genetics of heritable breast cancer.

PMID- 8358963
TI  - Expression of the pS2 peptide in normal human glandular endometrium during the
      menstrual cycle: a possible function.

PMID- 8358964
TI  - HLA-DPA1 and HLA-DPB1 in rheumatoid arthritis and its subsets.
AB  - The aim of this study was to examine the relationship between HLA-DP and
      susceptibility to articular and extra-articular features (Felty's syndrome and
      vasculitis) of rheumatoid arthritis (RA). The possible association of DP types
      with severity of articular disease was also analysed. No statistically
      significant associations were observed between HLA-DP alleles and articular or
      extra-articular features of RA, or to the severity of the arthritis when p was
      corrected for the number of alleles tested.

PMID- 8358965
TI  - An assessment of the clinical usefulness of two serum markers, CA15 3 and HMFG 2
      in localized and metastatic breast cancer.
AB  - CA 15 3 is a circulating glycoprotein defined by two monoclonal antibodies (115 D
      8 and DF 3) with good specificity for breast cancer. Tumour-associated antigens
      have been detected by the monoclonal antibody HMFG 2 using a low pH ELISA method.
      We compare the values obtained using these two assays in patients with localized
      and metastatic breast cancer. CA 15 3 and HMFG 2 levels were measured in 61
      patients, 24 localized and 37 metastatic, evaluated by standard biochemical and
      radiological testing. Of the patients with metastatic disease 78.4 per cent had
      an elevated CA 15 3 level whereas only 8.3 per cent of patients with localized
      disease had an elevated level (chi 2 = 28.2 p = 0.001); 29.8 per cent of patients
      with metastatic disease had elevated HMFG 2 levels while among those with
      localized disease 16.7 per cent had elevated levels (chi 2 = 0.57 p = NS). We
      conclude that only CA 15 3 is a useful marker in advanced disease.

PMID- 8358966
TI  - Economic credentialing: can physicians and hospitals find common ground?

PMID- 8358967
TI  - Colorado Society of Internal Medicine. Survey of Colorado's internists completed.

PMID- 8358968
TI  - People-to-People (thoracic and cardiovascular surgeons) visit Viet Nam and
      Southeast Asia.

PMID- 8358969
TI  - Confidential medical care important to adolescents.

PMID- 8358970
TI  - Vertical integration: what is it and what does it mean for physicians?

PMID- 8358971
TI  - Thyroid disorders in patients with progressive systemic sclerosis: a review.

PMID- 8358972
TI  - Histopathology of the vessels of the femoral heads in specimens of osteonecrosis,
      osteoarthritis and algodystrophy.
AB  - The authors studied by light microscopy the vessels of the femoral head and neck
      in 38 well preserved specimens from core biopsy. There were 17 cases of
      osteonecrosis (ON), 11 cases of osteoarthrosis (OA) and 10 cases of reflex
      sympathetic dystrophy, so called algodystrophy (AD). Mean age of the patients was
      respectively 44, 45 and 42 years. The sex ratio, M/F, was respectively 12/5, 6/5
      and 9/1. Types of staining used were hematoxylin-eosin, Masson Trichrome, P.A.S.
      and Verhoeff. In counting, thick-walled and thin-walled vessels were
      distinguished. There was a significant reduction in the number of the thick- and
      thin-walled vessels, in the ON group, by comparison with the OA and AD groups. An
      increased number of thin-walled vessels in the AD group were also observed.
      Morphological study showed an abnormal frequency of fibrosis of the media in the
      arteries of the ON group, i.e. arteriosclerosis. These data were compared with
      the few other histopathological studies previously published. The authors
      recommend further studies in order to precise their frequency and their
      significance.

PMID- 8358973
TI  - Electrophoretic separation of alkaline phosphatase isoenzymes in synovial fluid
      and serum from patients with rheumatoid arthritis.
AB  - The alkaline phosphatase enzyme in both serum and synovial fluid from 28 cases of
      rheumatoid arthritis and from the serum of 30 controls was measured. The enzyme
      was further studied by separating its isoenzymes to clarify their origin in both
      synovial fluid and serum of 10 patients with elevated level of the enzyme in
      their sera. The level of the enzyme in serum was elevated in 37% of patients
      confirming previous reports on that point. The most abundant isoenzyme in the
      synovial fluid (66.9%) was found to be bone in origin while in serum the most
      abundant isoenzyme was found to be hepatic (60.5%). This may be responsible for
      increased bone turn-over in rheumatoid joints whether in formation or resorption.

PMID- 8358975
TI  - Validity of echographic evaluation of cartilage in gonarthrosis. Preliminary
      report.
AB  - We studied an echographic technique by which precise reproducible measurements of
      articular cartilage thickness of the knee is possible. Two groups of individuals
      were studied: a group of 18 patients with gonarthrosis and a control group of 10
      normal individuals. The group of 18 patients with gonarthrosis was studied by
      ultrasound (US) before knee prosthesis surgery. The cartilage thickness was
      measured within the weight-bearing area. US re-evaluation and histological
      measurements were made on the pathological specimen following the operation.
      Results of pre- and post-operative US data were compared with histological data.
      A good correlation between these measurements was found [P(t) > 10%]. In order to
      have comparative reference values of the articular cartilage within the weight
      bearing area of the femoral trochlea a group of 10 control subjects was also
      studied with US as above. We found that the articular cartilage thickness of the
      femoral trochlea in the weight-bearing area has a mean of 2.2 +/- 0.3 mm for the
      lateral condyle and 2.3 +/- 0.2 mm for the medial condyle. The intra-observer and
      inter-observer difference in measurements was evaluated with Student's t-test.
      Our data demonstrate that US measurements of articular cartilage thickness of
      femoral condyles is a sensitive and reproducible technique which permits early
      diagnosis and management of knee arthropathy as well as quantification of
      cartilage damage.

PMID- 8358974
TI  - Proprioceptive sensibility in women with normal and osteoarthritic knee joints.
AB  - The objective of this study was to quantify the effect of degenerative joint
      change on the proprioceptive acuity of women with osteoarthritis (OA) of the
      knee. Middle-aged women with OA of the knee, age-matched healthy women, and
      younger healthy women were studied. Tests examined the ability of subjects to
      correctly reproduce knee angles in weightbearing and non-weightbearing
      situations. The knee angles were photographed and measured in degrees. The
      absolute error (AE) of each matching test was calculated and the mean AE of two
      tests was used as the criterion variable in a three-way analysis of variance
      (ANOVA). The relationship between the reproduction error and the osteoarthritic
      subjects' self-paced walking speed was also examined. Under both test conditions
      the AE of the osteoarthritic subjects was greater than that of the healthy
      subjects (p < .05). There was, however, no significant relationship between the
      AE measurements of the patients and their walking speed. These data indicate that
      while women with OA may have poorer proprioception than healthy controls, this
      impairment may not affect their walking ability.

PMID- 8358976
TI  - Effect of zopiclone on sleep quality, morning stiffness, widespread tenderness
      and pain and general discomfort in primary fibromyalgia patients. A double-blind
      randomized trial.
AB  - Thirty-three patients fulfilling the diagnostic criteria for primary fibromyalgia
      completed an eight-week double-blind treatment trial with the drug zopiclone. Of
      outcome measures studied a score expressing subjective sleep quality showed
      improvement in more than ninety percent of zopiclone patients at 4 weeks and
      nearly eighty percent at 8 weeks, but similar improvement was also reported by
      more than sixty percent of the patients on placebo. Patient self-assessment of a
      treatment effect also showed an advantage for zopiclone, with most patients in
      the placebo group considering their state as unchanged at 8 weeks. According to
      examiner assessment, however, half the patients in both groups showed improvement
      at 8 weeks. For other assessment variables, e.g. dolorimeter assessment of
      widespread tenderness, visual analogue scales and pain drawings for pain and
      other subjective feelings of discomfort, the effects of zopiclone treatment were
      at the same level as those of placebo.

PMID- 8358977
TI  - Skeletal manifestations of moderate phosphate diabetes.
AB  - Six patients, with vertebral osteoporosis and reflex sympathetic algodystrophy
      syndrome of the lower limbs, due to moderate diabetes, are presented.
      Osteoporosis was documented by low CT scan bone density and moderate decrease of
      bone trabecular volume. Histomorphometric studies found a mild increase of
      resorption areas. All patients had unremarkable serum phosphorus level (mean:
      0.91 +/- 0.13) but increase of urinary phosphorus excretion was documented by
      phosphate clearance higher than 20ml/mm, phosphate tubular reabsorption lower
      than 80% and TmPo4/GFR lower than 0.8mmol/l. Phosphate clearance and phosphate
      tubular reabsorption are studied in two control groups. Mild phosphate diabetes,
      of unknown incidence and prevalence (need for prospective studies) may be the
      vector of osteoporosis, vertebral and peripheral. The diagnosis of PD requires
      determination of phosphate clearance, phosphate tubular reabsorption, TmPo4/GFR
      and these tests may be useful in the diagnostic work up of bone demineralization
      disorders. We thought that osteoporosis could be the result of progressive
      dissolution of bone apatite crystals necessary to maintain normal or sub-normal
      blood phosphate level in spite of the phosphate diabetes.

PMID- 8358978
TI  - Rheumatoid arthritis as a cause of cardiac compression. Favourable long-term
      outcome of pericardiectomy.
AB  - In order to clarify the significance of rheumatoid arthritis (RA) as a cause of
      cardiac compression, we scrutinized pericardiectomy files of 47 patients over a
      ten-year period at two university hospitals in Finland. Five patients with RA
      were found. All the patients with RA were men with seropositive disease and
      subcutaneous rheumatoid nodules. Two of the patients had pulmonary fibrosis, one
      had cutaneous vasculitis and three had had rheumatoid pleurisy. There was a mean
      delay of 10 months from the first cardiac symptom to the diagnosis of cardiac
      compression, the most common misdiagnosis being primarily a liver disease. On the
      basis of clinical and operative data, four out of the five patients had
      constrictive pericarditis and one had an effusive-constrictive form of the
      disease. The histopathological findings in all cases were consistent with chronic
      fibrosing pericarditis. A follow-up of seven to seventeen years of four patients
      has not revealed any signs of recurrent pericardial disease. Our results
      demonstrate that RA is an important aetiological factor for cardiac compression.
      The long-term outcome of this manifestation seems to be good after
      pericardiectomy.

PMID- 8358979
TI  - Increased soluble IL-2 receptor in serum of patients with systemic lupus
      erythematosus.
AB  - We estimated the concentration of soluble IL-2R (sIL-2R) in the serum of patients
      with systemic lupus erythematosus (SLE) and examined the relationship between the
      serum levels of sIL-2R and clinical features or laboratory data. We found that
      elevated levels of sIL-2R were present in the serum of SLE patients with discoid
      rash, and sIL-2R concentrations were correlated with the soluble CD4 and soluble
      CD8 concentrations but not with classical serological marker, anti-DNA antibody
      or complement titer.

PMID- 8358980
TI  - Better effect of methotrexate on C-reactive protein during daily compared to
      weekly treatment in rheumatoid arthritis.
AB  - Treatment with methotrexate (MTX) is well established in rheumatoid arthritis
      (RA), but dosing remains arbitrary as studies on the effect of different dosing
      schedules are lacking. In a randomised crossover design of 20 patients with RA,
      the effect of low (2.5mg) oral daily doses of MTX (15 mg weekly) was compared to
      intermittent weekly dosing (15 mg). C-reactive protein (CRP) values were lower
      and more stable on daily dosing compared to the significant (p < 0.05) changes in
      CRP observed during treatment with the same weekly dose. It may be postulated
      that nonresponders or patients with dose-dependent side effects may have clinical
      advantage from daily MTX dosing if hepatotoxicity and other side effects are not
      increased.

PMID- 8358981
TI  - Echocardiographic findings in patients with primary Sjogren's syndrome.
AB  - Cardiac involvement in 27 consecutive patients fulfilling the criteria for
      primary Sjogren's syndrome was evaluated using echo-doppler-cardiography. A
      clinical physical examination showed that the heart was normal in all patients.
      Nine (33%) had signs of present or previous pericarditis with effusion and/or
      fibrin deposition, four of them had chest symptoms. The pericarditis patients
      were slightly older, had significantly shorter disease duration, had
      significantly increased levels of orosomucoid and haptoglobin, and were
      significantly more often antinuclear-antibody positive than those without
      pericarditis. Of the echocardiographic measurements, the left ventricular
      systolic dimension was significantly smaller and the fractional shortening of the
      left ventricle significantly higher in the pericarditis patients. However, four
      of the nine pericarditis patients had localized hypokinesia of the left
      ventricle, all with unspecific ECG changes, while only one without pericarditis
      showed this symptom. No patient had low voltage, ST-T elevation or conduction
      abnormalities. Mitral valvular thickening was found in one patient and age
      related sclerosis of the aortic cusps appeared in some.

PMID- 8358982
TI  - Liver involvement in giant cell arteritis.
AB  - Giant cell arteritis is a vasculitis which usually affects large and medium-sized
      vessels in patients over 50 years old. The liver is one of the internal organs
      which can be involved in this systemic disease. During the last 15 years, 56
      patients with giant cell arteritis were seen in our hospital. In 12 patients
      disturbed liver function test were found. In the majority of cases the
      disturbance was of cholestatic type and resolved completely with steroid
      treatment. The association of temporal arteritis with disturbed liver function
      tests is discussed, with a review of the recent literature.

PMID- 8358983
TI  - Intestinal absorption in patients with rheumatoid arthritis treated with
      methotrexate.
AB  - Twelve patients with rheumatoid arthritis treated for at least 12 months with
      methotrexate and 11 matched rheumatoid arthritis controls underwent a standard d
      xylose absorption test. No patients had any pre-existing clinical of biochemical
      evidence of malabsorption. No significant difference was observed in the 1 hour
      plasma d-xylose estimation between methotrexate treated patients and controls.
      The 2 to 5 hour urinary excretion ratio, however, was significantly lower in the
      methotrexate-treated group compared with controls indicating a minor degree of
      malabsorption. Six of the methotrexate treated patients and 5 of the controls
      underwent endoscopic duodenal biopsy but neither group demonstrated any
      significant histological changes. In conclusion, methotrexate therapy in patients
      with rheumatoid arthritis produces mild intestinal malabsorption.

PMID- 8358984
TI  - Free plasma concentrations of piroxicam in patients with osteoarthritis: relation
      to age, sex and efficacy.
AB  - Steady state piroxicam plasma samples from 85 patients suffering from
      osteoarthritis of the hip and/or the knee, and treated with piroxicam 20 mg daily
      for at least four weeks, were obtained. Twenty-seven of these patients had a
      newly diagnosed osteoarthritis and had not been treated with a nonsteroidal
      antiinflammatory drug (NSAID) previously. The plasma samples were subjected to
      equilibrium dialysis, analyzed by HPLC and total and free drug concentrations
      measured and unbound fractions were calculated. In the 27 newly diagnosed
      patients with free piroxicam concentrations ranging from 0.004 to 0.117
      micrograms/ml, there was no correlation between free concentration and change in
      any of the clinical response variables from pretrial to week 4. In the total
      patient population free concentrations were 0.057 +/- 0.038 micrograms/ml (mean
      +/- standard deviation). Females had a 79% higher free concentration than males
      (p < 0.0002) and there was a statistically significant (p < 0.01) increase of
      free concentration with increasing age in females. The unbound fraction was 0.87%
      +/- 0.36% (mean +/- SD). There was no difference in unbound fraction between the
      sexes, nor could we detect any change with increasing age.

PMID- 8358985
TI  - Plasma concentration of human atrial natriuretic hormone in patients with
      connective tissue diseases.
AB  - Atrial natriuretic peptide (ANP), a peptide released from the cardiac atria,
      compensates blood volume expansion by its diuretic, natriuretic and vasoactive
      properties. We measured human plasma ANP(hANP) levels in patients with systemic
      lupus erythematosus (SLE), rheumatoid arthritis (RA) and progressive systemic
      sclerosis (PSS) and found that their values were higher than those of healthy
      controls. In SLE patients, hANP levels correlated with serum creatinine
      concentration and the patients with proteinuria showed high levels of hANP.
      Administration of large amount of corticosteroid as a remission induction of the
      patients with SLE caused high levels of hANP. In patients with PSS, %FEV1 showed
      strong inverse correlations between hANP levels, and the patients with an
      enlarged second curvature of the heart had high levels of hANP. In patients with
      RA, no significant correlation was found between hANP levels and clinical
      variables including patients' age.

PMID- 8358986
TI  - Lumbar bone mineral density in anorexia nervosa.
AB  - We studied lumbar bone mineral densities (BMD) using a dual photon absorptiometer
      in 18 women with anorexia nervosa (AN). Results were compared with data from a
      control group of 36 healthy women. We found significantly reduced mean bone
      densities as compared with control group (0.814 +/- 0.072 g/cm2 hydroxy-apatite
      equivalent vs 1.011 +/- 0.023; p < 0.01). Only one patient developed vertebral
      compression fracture. BMD was negatively correlated with duration of amenorrhoea
      (r = -0.68; p < 0.01) but not significantly with duration of AN. We found no
      correlation between BMD and estradiol blood levels, age of onset, body mass index
      and daily calorie intake. The correlation between BMD and duration of amenorrhoea
      may indicate that long standing estrogen deficiency is a major factor in the
      osteoporosis (OP) observed in AN.

PMID- 8358987
TI  - Increased levels of urinary collagen crosslinks in females with rheumatoid
      arthritis.
AB  - Bone loss is a feature of RA, but the exact mechanisms involved are not clear.
      The collagen crosslinks deoxypyridinoline (DPYR) and pyridinoline (PYR) are
      specific indices of 'mature' collagen breakdown and reflect increased bone
      turnover. The aims of the study were to examine crosslink levels in RA and their
      association with disease activity and the effect of steroids. Urinary crosslinks
      corrected for creatinine were measured on morning fasting samples by HPLC in 70
      postmenopausal women with rheumatoid arthritis (RA) aged 45-65 and compared with
      169 postmenopausal healthy age-matched controls from the population. Mean levels
      of PYR were significantly higher in RA cases than in controls (52.4 versus 37.5
      nmols/mmolCr) although mean levels of DPYR did not differ significantly. A weak
      correlation was found with ESR and PYR (r = 0.35) but not with other markers of
      disease activity. Thirteen of the RA cases were current steroid users and their
      levels of DPYR and PYR even with low doses, were significantly elevated above
      those of non-users, ex-users and controls. The finding of raised urinary PYR but
      not the bone specific DPYR in nonsteroid using RA cases suggests that the
      increased collagen breakdown does not primarily come from bone but from other
      sources such as cartilage and synovium. The large increases in collagen excretion
      in low dose steroid users, may reflect the higher risk of osteoporosis in this
      group.

PMID- 8358988
TI  - The value of specific antibody detection and culture in the diagnosis of reactive
      arthritis.
AB  - Joint inflammation, predominantly of the lower limbs, occurring some weeks after
      urogenital or gastrointestinal infection is classified as reactive arthritis
      (ReA) but there is no general agreement on diagnostic criteria, especially if the
      preceding infections are asymptomatic. The same is true for Lyme disease (LD)
      which is caused by Borrelia burgdorferi (BB). Determination of antibody titre or
      culture of urethral swabs and stools are often used as diagnostic tools. We
      examined 4 groups of patients: one with undifferentiated arthritis (Group I, n =
      55), one with well-defined rheumatic diseases other than ReA (n = 43, Group II),
      one group without joint disease (n = 50, Group III) and one with ReA or LD (n =
      7). Specific antibacterial antibody titres in serum were measured in all
      patients; stool and urethral cultures were performed in all groups except the
      last. A calculation of positive predictive value (PPV) was done for each test.
      Evidence of present or previous infection with the microbes Chlamydia trachomatis
      (CT), Mycoplasma urethritidis (MU), Yersinia enterocolitica (YE) and BB were
      found in all groups. In Group I, Group II and Group III respectively, positive
      serological results were found for CT IgA (20%, 31%, 16%) and IgG (49%, 51%,
      34%), YE (7%, 6%, 0%) and BB (17%, 2%, 10%). Positive cultures were found in
      Group I and Group II respectively for CT (28%, 29%) and MU (14%, 17%). Therefore
      no test had a significant positive predictive value for ReA in the general
      population and even in the rheumatology clinic the PPV for most tests was low. We
      conclude that these methods are of little value in the diagnosis of reactive
      arthritis when the preceding infection is asymptomatic.

PMID- 8358989
TI  - Sneddon's syndrome and phospholipid antibodies.
AB  - We present a case of Sneddon's syndrome with high titers of antiphospholipid
      antibodies (APLA), in which the leading symptom was an incapacitating memory
      defect. MRI revealed vasculitic lesions of the central nervous system (CNS).
      Therefore immunosuppressive therapy was started with steroids and
      cyclophosphamide pulses. The transient beneficial effects of such a therapy will
      be discussed.

PMID- 8358990
TI  - A case of Sjogren's syndrome complicating immune-mediated aplastic anaemia.
AB  - A 78-year-old Japanese woman with Sjogren's syndrome complicating immune-mediated
      aplastic anaemia is described. A diagnosis of aplastic anaemia was made from
      severe pancytopenia with hypoplastic marrow. Laboratory studies suggested an
      association of bone marrow suppressive T-lymphocytes with the pathogenesis of
      aplastic anaemia. Following the administration of mepithiostan and prednisolone,
      pancytopenia improved gradually. Two years after the onset of aplastic anaemia,
      Raynaud's phenomenon developed and examinations revealed the existence of
      keratoconjunctivitis sicca and anti-SSA/Ro and anti-SSB/La antibodies.

PMID- 8358991
TI  - Astasia-abasia revealing a primary Sjogren's syndrome.
AB  - A 63-year-old woman presented with mild arthralgias and inability to stand and
      walk without other significant neuropsychiatric abnormality. Neurological
      explorations showed intrathecal oligoclonal immunoglobulin production in CSF and
      numerous bright foci at brain MRI. A primary Sjogren's syndrome was concomitantly
      evidenced and was thought to be the cause of the astasia-abasia symptom by
      multiple brain involvement. Patient's condition gradually improved with
      hydroxychloroquine and corticosteroid therapy. Central nervous system involvement
      by primary Sjogren's syndrome is discussed.

PMID- 8358992
TI  - Ankylosing spondylitis in two Zairian brothers.
AB  - Ankylosing spondylitis has never been described in Zaire and is considered to be
      rare in black African populations. We report two cases observed in the University
      Hospital of Kinshasa. The two patients are brothers. The diagnosis is based on
      anaemnestic, clinical and radiological findings. We therefore demonstrate the
      existence of this disease in Zaire and presume that other similar cases may be
      diagnosed.

PMID- 8358993
TI  - Seronegative spondyloarthropathy associated with megarectum.
AB  - In this report we describe a case of a 19-year-old man with a two-year history of
      polyarthritis affecting the lower limbs and dactylitis of the toes. His clinical
      picture fulfilled the new European diagnostic criteria for spondyloarthropathies.
      Systemic examination revealed a big mass in the left iliac fossa that was found
      to be due to an acquired functional megacolon. Complete remission of the joint
      involvement was obtained by treating the bowel disease.

PMID- 8358994
TI  - Chronic destructive monoarthritis of the wrist in patients with anti-SSA/Ro
      antibodies: report of two cases.
AB  - Among 340 patients with rheumatic diseases, two cases of chronic destructive
      monoarthritis of the wrist with anti-SSA/Ro antibodies and rheumatoid factor,
      were observed for over three years. It is not clear whether these cases represent
      a specific subset of rheumatoid arthritis (RA) or whether they may progress to
      diffuse symmetrical destructive polyarthritis typical of RA. Long-term follow-up
      studies including analysis of autoantibodies will be needed to clarify the
      characteristics and course of chronic monoarthritis.

PMID- 8358995
TI  - A case of scurvy presenting with cutaneous and articular signs.
AB  - This report is on a patient, who presented purpura and hemarthrosis in a context
      of vitamin C deficiency. This case gives us the opportunity to discuss the
      differential diagnosis, the clinical features, the pathogenicity and the
      treatment of this rare condition.

PMID- 8358996
TI  - Paraneoplastic Raynaud's phenomenon.
AB  - A testicular tumour could be diagnosed by the occurrence of a Raynaud's
      phenomenon complicated by severe digital arteritis. The arteritis rapidly
      regressed under prostacyclin therapy. Such vascular manifestations are frequent
      in testicular carcinoma, but they usually develop after chemotherapy. To our
      knowledge, this is the first case where they preceded the diagnosis and specific
      treatment of a tumour of the testis.

PMID- 8358997
TI  - Is the benign joint hypermobility syndrome benign?

PMID- 8358998
TI  - Fatal outcome of low-dose methotrexate therapy in rheumatoid arthritis.

PMID- 8358999
TI  - Interleukin-2 production in early rheumatoid arthritis.

PMID- 8359000
TI  - Epidemiologic typing of multiply drug-resistant Pseudomonas aeruginosa isolated
      from an outbreak in an intensive care unit.
AB  - From June to August 1991, there was an outbreak of Pseudomonas aeruginosa
      infections in an intensive care unit in a general hospital in Sao Paulo, Brazil.
      We obtained 14 isolates from 14 patients, 11 from tracheal aspirate, and 3 from
      surgical wound exudates. These strains were typed by serotyping, pyocin typing,
      and pulsed-field electrophoresis (CHEF) of chromosomal DNA (chrDNA), and the
      different typing methods were analyzed. These three methods demonstrated seven
      identical strains. We also performed an extensive antibiogram (33 drugs) in all
      14 isolates. The incidence of resistance to aminoglycosides, extended-spectrum
      beta-lactams, and quinolones was very high among the seven identical isolates;
      however, the antibiogram profile differed significantly among the isolates. Our
      results suggest that a unique strain caused several cross-transmitted infections
      during this period of time, and the emergence of antimicrobial resistance has
      been occurring before and after the establishment of the epidemic strain by
      selective drug use. The chrDNA fingerprinting proved to be versatile and precise
      for epidemiologic investigations of P. aeruginosa infections.

PMID- 8359001
TI  - Clinical assessment of anaerobic isolates from blood cultures.
AB  - Patients at two tertiary-care medical centers were evaluated to determine the
      clinical significance of anaerobic isolates from their blood specimens and to
      identify whether aerobic and/or anaerobic conditions were necessary for the
      detection of Streptococcus pneumoniae isolates. Significant anaerobes were
      isolated from only 0.1% and 0.4% of all blood cultures collected. The majority of
      patients with significant anaerobes had clinical conditions in which anaerobes
      are known to cause infections. Of the S. pneumoniae organisms, 83% were isolated
      only from the aerobic bottles of a blood culture set. These data lend support to
      the recommendations for the selective ordering of anaerobic blood cultures
      without compromising the isolation of S. pneumoniae.

PMID- 8359002
TI  - Identification of clinical isolates of nondiphtherial Corynebacterium species and
      their antibiotic susceptibility patterns.
AB  - Starting in 1982, our laboratory has performed species identification of
      coryneform bacteria isolated from blood cultures, intravenous (i.v.) catheter
      tips and sites, urines with high colony counts, and other potentially significant
      cultures, using predefined criteria. Of 283 isolates identified, Corynebacterium
      jeikeium was the most common (47%), followed by CDC group G2 (12%) and C.
      minutissimum (8%). Blood cultures and i.v. catheter-related sources were the most
      frequent sources (58% of total). Certain species or groups, like CDC group G2,
      were most frequently isolated from blood or i.v. catheter sites. CDC group G2
      showed a progression to greater multiple antibiotic resistance during this 9-year
      period. Occasional multiresistant strains of other species were also encountered.
      By in vitro testing, we note vancomycin remains the most active agent against
      corynebacterialike organisms, and is the most reliable antibiotic to use while
      awaiting susceptibility testing results.

PMID- 8359003
TI  - Application of a leukocyte and nitrite urine test strip to the management of
      children with neurogenic bladder.
AB  - A urine leukocyte count of > or = 50/mm3 together with a bacterial count of > or
      = 10(5) colony-forming units (CFUs) per milliliter was used to define significant
      infection in 160 children with neurogenic bladder and evaluate the leukocyte and
      nitrite components of the Chemstrip 9 test. A Chemstrip 9 leukocyte reading of <
      or = 25 together with a negative nitrite reaction occurred in 99 children and had
      a sensitivity of 83.5% and a negative predictive value for infection of 97.0%. A
      Chemstrip 9 reading of > or = 500 leukocytes together with a positive nitrite
      reaction occurred in 18 children and had a sensitivity of 40% with a 100%
      positive predictive value for infection. Other combinations of Chemstrip 9
      leukocyte and nitrite reactions were unhelpful or of uncertain value. Selection
      of up to three specimens from each patient increased the number of samples to 360
      and provided general confirmation of the above conclusions. Nitrofurantoin may
      reduce the sensitivity of the nitrite strip reaction.

PMID- 8359004
TI  - Posthysterectomy wound infection. A review.
AB  - We reviewed the microorganisms isolated from gynecologic surgery wounds showing
      signs of infection, from January to December 1990. A total of 88 samples of
      abdominal wall exudates from as many patients who had undergone abdominal
      hysterectomy were studied. In 54 women (61.3%), cultures were positive and, in 26
      specimens (48.1%), mixed aerobic-anaerobic flora were isolated. In 28 cases
      (51.9%), a single microorganism was isolated, the most frequent being
      Staphylococcus aureus, followed by Mycoplasma hominis and Escherichia coli.
      Mycoplasma hominis was unexpectedly frequent, appearing in five women with wall
      abscess and fever.

PMID- 8359005
TI  - In vitro antimicrobial activity of tioconazole and its concentrations in vaginal
      fluids following topical (vagistat-1 6.5%) application.
AB  - In vitro assays demonstrated that clinical yeasts were significantly more
      inhibited by tioconazole (MIC50, < or = 0.5 microgram/ml) than by fluconazole
      (MIC50, 8 micrograms/ml). Tioconazole also exhibited high potency against most
      molds (Alterneria spp. and Acremonium spp.). All Candida tropicalis isolates had
      MICs of 8 micrograms/ml, four-fold greater than any other Candida spp. Generally
      Gram-negative bacteria were less susceptible to tioconazole. Moraxella
      catarrhalis (MIC90, 2 micrograms/ml) was the most susceptible Gram-negative
      species. Staphylococci and enterococci were the most susceptible to tioconazole
      Gram-positive species (MIC50s, 1-8 micrograms/ml). Bacterial species associated
      with vaginosis. [Gardnerella vaginalis (MIC90, 16 micrograms/ml), Mobiluncus spp.
      (MIC90, 16 micrograms/ml) and Prevotella biviadisiens (MIC90, 64 micrograms/ml)]
      were inhibited by tioconazole. Isolates of Lactobacillus spp. were most resistant
      (MIC90, > or = 256 micrograms/ml) to tioconazole. Vaginal fluid levels of
      tioconazole (mean, 91.4 micrograms/ml) persisted above the MIC90 levels (1-64
      micrograms/ml) for most fungal and bacterial pathogens for 72 h in 19 evaluable
      female human subjects receiving 300 mg tioconazole in an intravaginal ointment.

PMID- 8359006
TI  - Sensitivity of surveillance cultures for the detection of methicillin-resistant
      Staphylococcus aureus in a nursing-home-care unit.
AB  - This study compared the sensitivity of nasal culture alone versus multiple-site
      cultures and single versus duplicate sampling for the detection of methicillin
      resistant Staphylococcus aureus (MRSA)-colonized individuals in a nursing-home
      population. Repeat culture of 68 specimens collected from 35 colonized subjects
      yielded identical results for 57 specimens, (84%), and 89% of the colonized
      residents (31 of 35) were identified by the first culture of multiple sites. A
      single nares culture detected 27 (77%) of 35 (first screen) and 29 (83%) of 35
      (second screen) residents colonized with MRSA at any site. The most cost
      effective screening would consist of a nasal culture only or combined with a
      gastrostomy tube site, if applicable. To identify all colonized individuals,
      however, it would be necessary to culture more than one specimen from multiple
      sites on each resident.

PMID- 8359007
TI  - An enzyme immunoassay for the direct detection of adenovirus in clinical
      specimens.
AB  - A total of 414 clinical samples were tested by an enzyme immunoassay (EIA) for
      direct detection of adenovirus as well as cultured in Graham 293, A549, and human
      diploid foreskin fibroblast cells. Adenovirus was detected in 69 (16.7%) of 414
      clinical specimens. The EIA detected adenovirus in 51 (12.3%) of 414 specimens;
      two were EIA positive only. Adenovirus was isolated from 67 (16.2%) of 414
      specimens; 18 were culture positive only. Compared with viral isolation, EIA had
      a sensitivity of 73.4% and a specificity of 99.4%, with a positive predictive
      value of 96% and a negative predictive value of 95%.

PMID- 8359008
TI  - In vitro susceptibility test practices with Haemophilus influenzae among College
      of American Pathologists survey participants in the United States.
AB  - Questionnaire results from 5233 clinical microbiology laboratories participating
      in the College of American Pathologists (CAP) survey program in the United States
      were used to establish current standards of practice with respect to in vitro
      susceptibility testing of Haemophilus influenzae. The results of this CAP survey
      indicated that the recently developed National Committee for Clinical Laboratory
      Standards (NCCLS) guidelines for H. influenzae susceptibility tests have been
      widely adopted, particularly with regard to the medium used to perform
      susceptibility tests. Haemophilus test medium (HTM) is now the most commonly used
      medium and there exists a general level of satisfaction (approximately 80%) with
      medium performance. Specific methodologic recommendations of the NCCLS, however,
      are often not being followed, for example, length and atmosphere of incubation
      and means of preparing inocula. beta-Lactamase assays constitute a very commonly
      employed means of assessing ampicillin activity. Among susceptibility test
      methods, disk diffusion (82.2%) is much more commonly used compared with broth
      microdilution (17.8%) procedures. Data are provided regarding the most commonly
      tested antimicrobials as well as some of the problems encounted when using
      current NCCLS methods for susceptibility tests with H. influenzae. Finally, the
      CAP survey questionnaire revealed that many laboratories have applied HTM to
      susceptibility tests with other fastidious bacteria such as pathogenic Neisseria
      sp., streptococci, and Moraxella catarrhalis.

PMID- 8359009
TI  - Evaluation of disk susceptibility testing of fosfomycin tromethamine.
AB  - Fosfomycin tromethamine is an orally administered fosfomycin that may be used for
      single-dose therapy of uncomplicated urinary tract infections. At breakpoint
      concentrations [< or = 128 micrograms/ml plus 25 micrograms/ml glucose-6
      phosphate (G-6-P)], fosfomycin tromethamine inhibited > 90% of the 350 bacterial
      isolates tested. When testing Escherichia coli, Klebsiella spp., and Enterobacter
      spp., we note that the performance of fosfomycin disks improved when G-6-P was
      added to the disks. The interpretive error rates were minimized when 200
      micrograms fosfomycin disks were supplemented with either 50 or 100 micrograms G
      6-P. Using < or = 128 and > or = 256 micrograms/ml as the susceptible and
      resistant MIC breakpoints, respectively, the regression-analysis-derived disk
      diffusion zone diameter breakpoints for the 200-micrograms fosfomycin disk
      supplemented with 50 micrograms of G-6-P are as follows: susceptible, > or = 16
      mm; intermediate, 13-15 mm; and resistant, < or = 12 mm.

PMID- 8359010
TI  - Comparison of vidas Clostridium difficile toxin-A assay and premier C. difficile
      toxin-A assay to cytotoxin-B tissue culture assay for the detection of toxins of
      C. difficile.
AB  - Damage to the intestinal mucosa by Clostridium difficile (CD) is toxin mediated.
      Two enzyme immunoassays (EIAs) for toxin-A detection, the automated Vitek
      immunodiagnostic assay system CDA (Vidas CDA), and the Premier toxin A (Premier)
      were tested for their ability to detect toxin A in 301 stool samples and compared
      with an in-house tissue culture assay for toxin B (TCA). Of these 301 samples, 49
      were TCA positive and 252 were TCA negative. Agreement between Vidas CDA and TCA
      on the initial run was 85% (255 of 301) and increased to 94% (278 of 296) when
      discordant samples were retested from available frozen specimens. Corresponding
      levels of agreement for Premier were 91% (272 of 301) and 98% (284 of 288),
      respectively. If tissue culture positivity at any titer was used as the sole
      criterion for positivity of the specimen, agreement with positive TCA before and
      after repeat testing was 57% (26 of 49) and 74% (34 of 46) for Vidas CDA and 65%
      (32 of 49) and 95% (36 of 38) for Premier. Agreement with negative TCA titers was
      good: 90% for Vidas CDA and 95% for Premier, and 98% for Vidas CDA and 99% for
      Premier after repeat testing. Predictive values positive and negative after
      repeat testing were, respectively, 88% and 96% for Vidas CDA, and 95% and 99% for
      Premier. Results for the automated and manual EIA methods for detection of C.
      difficile toxin A were obtained in 2.5 h as compared with 36-48 h for tissue
      culture.

PMID- 8359011
TI  - A comparison of the in vitro postantibiotic effect of meropenem and imipenem
      versus selected enterobacteriaceae and other pathogens.
AB  - The in vitro postantibiotic effect (PAE) of meropenem (Merrem or SM-7338) and
      imipenem was determined by using 12 strains of clinically important pathogens. A
      PAE of > or = 1/2 h duration was observed more frequently with strains tested
      against meropenem than with imipenem.

PMID- 8359012
TI  - In vitro antimicrobial activity of CP-99433 compared with other fluoroquinolones.
AB  - CP-99433 is a new C-7 diazabicyclofluoroquinolone with a broad spectrum of
      activity that includes Enterobacteriaceae, Gram-positive cocci, and nonenteric
      Gram-negative bacilli. Potent activity was demonstrated against Pseudomonas
      aeruginosa [minimum inhibitory concentration (MIC90, 0.5 microgram/ml),
      Xanthomonas maltophilia (MIC90, 1 microgram/ml), and all Streptococcus species
      (MIC90s, 0.25-1 microgram/ml). Only CP-99433 was active against Enterococcus
      faecium (MIC50, 2 micrograms/ml). CP-99433 also demonstrated activity against
      several ciprofloxacin-resistant staphylococci. Additional studies of CP-99433
      activity appear indicated.

PMID- 8359013
TI  - The biological basis of ethanol tolerance in Drosophila.

PMID- 8359014
TI  - Muscle actin genes in insects.

PMID- 8359015
TI  - Changes in ketone body utilization by chick liver, duodenal mucosa and kidney
      during embryonic and postnatal development.
AB  - 1. Lipid synthesis from acetoacetate and 3-hydroxybutyrate in chick kidney and
      duodenal mucosa showed a clear decrease between 15 and 19 days of the embryonic
      phase, followed by an increase at hatching and a new decrease during the first
      neonatal period. The hepatic synthesis of lipids presented a different profile: a
      peak at 19-day-old embryo and a new increase during postnatal development. 2.
      These changes would be related to those in 3-hydroxybutyrate concentration in
      chick plasma throughout the perinatal period. 3. Phospholipids were the main kind
      of lipid formed in the three tissues. An appreciable percentage of radioactivity
      was also recovered as free cholesterol, especially during the embryonic phase.
      Triglycerides were also formed from acetoacetate in a high proportion in liver
      from neonatal animals. 4. Chick kidney showed the maximal ability to incorporate
      both precursors into amino acids. The peak obtained around hatching time would be
      related to the availability of the substrates. 5. Ketone body oxidation to CO2
      was also maximal in kidney. In this tissue, a drastic decrease was observed
      during the final embryonic period, followed by a strong increase at day 1 after
      hatching and a new decrease at 4 days.

PMID- 8359016
TI  - PCR amplification of partial mRNA sequences encoding the alpha- and beta-globin
      chains of the bivalve mollusc Anadara trapezia: correction of the C-terminal
      amino acid sequence of the alpha-chain.
AB  - 1. PCR was carried out on cDNA which had been synthesized from poly(A)+ RNA
      extracted from A. trapezia red blood cells. 2. A 348 bp product encoding the C
      terminal region of the alpha-globin chain and another product encoding a portion
      of the beta-globin chain were isolated. 3. The C-terminal alpha-chain sequence,
      encoded by the cDNA, differs from the previously published sequence and these
      changes improve the alignment of this chain with the other globin chains of this
      organism.

PMID- 8359017
TI  - Fatty acid and lipid composition in vitro and in vivo of rat epidermis.
AB  - 1. Fatty acid and lipid compositions of cultured rat keratinocytes were compared
      with those of intact epidermis prepared from newborn and adult rats. 2. The
      uniqueness of the lipid profile of cultured cell manifested itself in the
      accumulation of a novel lipid which co-migrated with monoalkyldiacylglyceride on
      thin-layer chromatography. 3. Concentration of the branched-chain fatty acid was
      specifically high in the cholesterol ester fraction of the intact cell, and was
      decreased by cultivation under submerged conditions.

PMID- 8359018
TI  - Protein synthesis in ovine muscle and skin: sequential measurements with three
      different amino acids based on the large-dose procedure.
AB  - 1. Protein synthesis has been determined in biopsies from ovine skin and muscle
      by sequential use of three [13C] amino acids, valine leucine and phenylalanine,
      as large-dose injections. 2. Leucine and phenylalanine increased plasma insulin
      concentrations within 40 min of injection. 3. All three amino acids decreased the
      plasma concentrations of other amino acids. 4. Intracellular free amino acids in
      muscle decreased while those in skin increased. 5. The fractional rates of
      protein synthesis were similar, regardless of which amino acid was used, although
      the rates for muscle were significantly less than for skin (2.1 vs 11.0%/day, P <
      0.001).

PMID- 8359019
TI  - Temporal synthesis of cuticle proteins during larval development in Glossina
      morsitans.
AB  - 1. Larval development in Glossina species occurs in utero with the mature third
      instar larva being deposited after a developmental period of 7 days. 2. In this
      study, the patterns of cuticular protein synthesis during larval development were
      analysed by two-dimensional gel electrophoresis. 3. From the results, four types
      of cuticle proteins were identified: those specific to larval, pupal and adult
      cuticles, and others common to all the stages. 4. Few cuticular proteins were
      synthesized between the first and second larval instars. By the third larval
      instar (two days before larviposition), a large number of proteins (Mr < or = 30
      kDa) were induced. These proteins persisted up to the brown pupal stage and
      showed a rapid decline thereafter. Most of the proteins with molecular weights Mr
      < or = 30 kDa were undetectable at apolysis (5 days after larviposition). 5. By
      day 15 of the pupal stage, the number of cuticle proteins was very small. The
      protein profile during the pupal stages remained relatively constant. This was
      probably due to the fact that the pupal cuticle does not provide any protection
      since it is itself enclosed at all times within the protective puparium.

PMID- 8359020
TI  - Transthyretin expression evolved more recently in liver than in brain.
AB  - 1. Transthyretin was found to be synthesized and secreted by choroid plexus from
      rats, echidnas, and lizards, but not toads. 2. Transthyretin was observed in
      blood from placental mammals, birds, and marsupials, but not reptiles and
      monotremes. 3. The obtained data suggest that transthyretin synthesis by the
      liver evolved independently in the lineage leading to the placental mammals and
      marsupials and in that leading to the birds. 4. It is proposed that transthyretin
      gene expression in mammalian liver appeared about 200 million years later than
      its first occurrence in the choroid plexus of the stem reptiles.

PMID- 8359021
TI  - Occurrence of a furin-like prohormone processing enzyme in Aplysia neuroendocrine
      bag cells.
AB  - 1. Strong evidence is accumulating that the endoproteases which process
      prohormones at dibasic residue cleavage sites are members of a subtilisin-related
      class of proteases. 2. Using the polymerase chain reaction (PCR), we have
      isolated and characterized an Aplysia californica neuroendocrine bag cell cDNA
      product (270 base pairs) that encodes a sequence which is highly homologous to
      the subtilisin-related class of processing proteases that includes yeast Kex2,
      human/mouse/Drosophila furin, human PC2, and mouse PC1/PC3 and PC2. 3. The
      characterized cDNA PCR product showed the highest degree of residue identity with
      the furin-related group of proteins (human/mouse furin 71%; Drosophila furin
      63%). 4. These results establish that Aplysia contain a subtilisin-like gene and
      suggest that the expression of this gene may play a role in processing Aplysia
      precursor proteins in the bag cells and likely also in the exocrine atrial gland.
      5. Furthermore, the Aplysia nucleotide sequence results, together with available
      sequence information from human, mouse, and Drosophila furins, provide reasonable
      evidence that the furin-like enzymes may represent a separate subclass of the
      subtilisin-like processing enzymes.

PMID- 8359022
TI  - Characterization of a partial cDNA clone encoding porcine skeletal muscle titin:
      comparison with rabbit and mouse skeletal muscle titin sequences.
AB  - 1. A cDNA fragment encoding 571 amino acid residues of porcine skeletal muscle
      titin was isolated from total RNA using RNA-PCR. 2. The porcine titin clone
      hybridized to a large RNA species (> 23 kb) in rabbit cardiac muscle, rabbit
      skeletal muscle and porcine skeletal muscle. 3. The porcine skeletal muscle titin
      clone encoded two types of 100-residue motifs and its amino acid sequence was 96%
      and 93% identical to the corresponding sequence of rabbit and mouse skeletal
      muscle titin, respectively. These results suggest that the titin sequence is
      highly conserved among mammalian species.

PMID- 8359023
TI  - Immunological and charge properties of GFAP in lower vertebrates.
AB  - 1. An antiserum specific for bovine GFAP was employed in a comparative study of
      this protein in several species of bony fish and in an anuran species. 2. The
      immunological properties of this protein are conserved in a remarkable way in all
      the species examined. 3. Analysis of trout and bovine GFAP by two-dimensional gel
      electrophoresis indicated that the charge properties of this protein have
      remained quite constant from fish to mammals.

PMID- 8359024
TI  - Glycogen phosphorylase activity in the liver of the frog Rana esculenta.
AB  - 1. Phosphorylase activity has been assayed in liver extracts of the frog, Rana
      esculenta, during the winter period. In native conditions, most of the
      phosphorylase is present as AMP-independent activity and shows properties similar
      to those of the a form of the liver enzyme from other vertebrates. 2. It is
      suggested that regulation of phosphorylase activity is through interconversion
      between a and b forms operated by endogenous phosphorylase kinase and
      phosphatase. 3. Kinetic studies show hyperbolic saturation curves for glycogen
      with apparent Km of 2.91 mM and 9.67 mM for a and b forms, respectively. 4. A
      hyperbolic saturation curve is also observed for glucose 1-P in the case of
      phosphorylase a, with an apparent Km of 3.95 mM, whereas a sigmoidal kinetic is
      shown by the b form for the same substrate; from Hill plots an S0.5 of 24.2 mM
      was derived. 5. Hyperbolic responses were observed in the case of AMP, and Ka of
      70 microM and 0.31 mM were calculated for phosphorylase a and b, respectively.

PMID- 8359025
TI  - Thermal gradients in the eyes of lid-sutured chicks.
AB  - Thermal gradients were measured from the cornea to the posterior pole in the eyes
      of 11 chicks, six of which had the lids of one eye sutured three weeks
      previously. A comparison was made between eyes that were chronically closed by
      lid-suture (while still sutured shut) and two types of control eyes: (a) treated
      controls, which were the non-sutured, contralateral eyes of the lid-sutured
      chicks and (b) untreated controls, which were the eyes of a different group of
      chicks in which neither eye had been sutured. The results indicated that
      transient closing of the eyes of normal, untreated chicks (untreated controls)
      elevated the ocular temperature by about 1.5 degrees C at the cornea; the extent
      of thermal elevation diminished as the thermoprobe was advanced towards the
      posterior pole. In contrast, when the transiently closed eyes in untreated
      control chicks were compared with the chronically closed eyes of the lid-sutured
      chicks, the lid-sutured eyes were cooler by 2 degrees - 2.5 degrees. When the
      sutured lids were opened, however, the eyes were isothermal with the untreated
      control eyes. Moreover, the eyes of lid-sutured chicks were isothermal with their
      contralateral, non-sutured, control eyes (treated control), whether in the opened
      or closed state. A comparison of the untreated control eyes and the treated
      control eyes revealed no differences (except at the cornea) when the eyes were
      opened; but when the eyes were closed, the treated control eyes were 2 degrees -
      3 degrees cooler than the untreated control eyes.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8359026
TI  - The effect of caffeine on the accommodative response/accommodative stimulus
      function and on the response AC/A ratio.
AB  - Using a phoro-accommodometer, accommodation and convergence responses were
      measured for 17 experimental subjects before and after they ingested 200 mg
      caffeine. For 16 control subjects accommodation and convergence responses were
      determined at two test sessions separated by 45 min. For the experimental group,
      the accommodative response/accommodative stimulus (Ar/As) slope increased 0.05
      D/D after ingestion of caffeine, and the response AC/A ratio decreased 3.05
      delta/D. The y-intercept of the convergence response/accommodative response
      increased by 3.7 delta in the experimental group. These changes were
      statistically significant. For the control group, the differences in Ar/As slope,
      response AC/A ratio, and convergence response/accommodative response y-intercept
      between first and second test sessions were not statistically significant.

PMID- 8359027
TI  - Soft drugs 15: mydriatic activity and transcorneal penetration of phenylsuccinic
      soft analogs of methscopolamine as short acting mydriatics.
AB  - Soft drug analogs of methscopolamine (4 a-c) were tested for mydriatic activity
      in rabbits' eyes. After unilateral administration of equieffective doses, the
      AUC24hrs and the mydriatic recovery times were found to be significantly lower
      with the soft drugs compared to methscopolamine. At equieffective doses, the
      AUC24hrs for soft drugs ranged from 22.4% to 60% of that of methscopolamine.
      Significant dilation of the untreated eye was observed with methscopolamine but
      not with the soft drugs after unilateral administration. Soft drug 4a exhibited
      only 10.4% of the AUC6hrs (untreated eye) of that of methscopolamine. Shorter
      durations of mydriatic action combined with potentially reduced systemic side
      effects make these compounds candidates for further study. In vitro rabbit
      transcorneal penetration of soft analog 4a was found to be significantly higher
      than methscopolamine.

PMID- 8359028
TI  - Evolution of morphologic changes after intravitreous injection of gentamicin.
AB  - Gentamicin shows retinal toxicity in rabbits, monkeys, and humans, but its
      mechanism of toxicity is not understood. Pig eyes, which are anatomically similar
      to human eyes, were examined with ophthalmoscopy, fluorescein angiography, and
      light and electron microscopy at time points ranging from 3 to 72 hours after
      intravitreous injection of 3 mg of gentamicin or vehicle to observe the sequence
      of toxicity-related changes that occur in the retina. The first ophthalmoscopic
      changes were retinal hemorrhages at 3 hours, followed by retinal whitening and
      thickening and vascular nonperfusion detected by fluorescein angiography 48 hours
      after injection. Vacuolization in the nerve fiber layer and perivascular swelling
      were seen at 6 hours, and subsequently, extended deeper into the retina. Vascular
      endothelial cells, photoreceptors, and the retinal pigment epithelium appeared to
      be spared from the toxic effects of gentamicin. At 48 and 72 hours after
      injection, numerous large and small retinal vessels showed congestion and
      leukocyte margination. These changes could not be prevented by increasing the pH
      of gentamicin to 7.2. These data suggest that gentamicin toxicity is not simply a
      pH-related phenomenon, that the primary targets of gentamicin toxicity are
      neurons and glia of the inner retina, and that retinal infarction occurs
      secondarily, possibly due to leukocytic plugging.

PMID- 8359029
TI  - Separation and characteristics of glycoproteins in tears which inhibit coating
      and precipitation of protein.
AB  - Using a modified turbidimetric assay to determine the protein concentration in
      human tears by precipitation with trichloroacetic acid (TCA) we found lower
      protein concentrations if compared with other methods for protein determination.
      This implies that a factor in human tears is able to inhibit the precipitation of
      protein by TCA. Earlier a coating inhibitory factor in human tears was described
      which is able to prevent coating of a polyacrylate surface by proteins using a
      ELISA methodology. Because of the similarity in its behaviour towards protein we
      investigated whether the same factor could be responsible for both inhibitory
      effects. A pool of human tears was separated into various fractions using HPLC
      whereafter inhibitory activity in the turbidimetric and the coating assay could
      be found in the same fractions. Characterization of the inhibitory factor was
      performed by minigel-electrophoresis (SDS-PAGE), after which blotting and
      staining with a lectin (Jacalin) revealed two subunits of a glycoprotein with a
      molecular weight of 30 and 70 kD. The inhibitory factor also could be isolated if
      human tears were incubated for 30 min at 100 degrees C whereafter precipitated
      protein was removed by centrifugation. Inhibitory activity could be detected in
      the supernatant and an identical glycoprotein profile could be produced after
      staining with lectin (Jacalin). The results of this study suggest that a soluble
      glycoprotein serves as a coating and precipitation inhibitor in tears and may
      play an important role in the protein to protein interaction on the surface of
      the eye.

PMID- 8359030
TI  - In vitro inhibition of collagen formation by 2,4-pyridine dicarboxylate and
      minoxidil in rabbit corneal fibroblasts.
AB  - Two anti-fibrotic agents were evaluated in vitro for potential application in
      trabeculectomy. The rate of collagen formation by cultured rabbit corneal
      fibroblasts was determined by [3H]proline uptake and hydroxylation assay.
      Incubation of fibroblasts, for 96 hours, with 16 mM 2,4-pyridine dicarboxylic
      acid (2,4-PDCA), a competitive inhibitor of prolyl 4-hydroxylase, decreased
      [3H]OH-proline formation from control by 28.2 +/- 3.9%; (average +/- S.E.M),
      whereas 10 mM minoxidil, an antihypertensive pyrimidine oxide and a lysyl
      hydroxylase inhibitor, induced a decrease of 17.3 +/- 4.5%. Incubating
      fibroblasts with a mixture of the two inhibitors, 16 mM 2,4-PDCA and 10 mM
      minoxidil, resulted in a further decrease in [3H]proline incorporation of 40.7 +/
      5.1%. After 96 hours of incubation with the inhibitors, rabbit corneal
      fibroblast growth was decreased from control by 17.2 +/- 4.2% and 10.5 +/- 4.5%
      for 16 mM 2,4-PDCA and 10 mM minoxidil, respectively. These effects were dose
      dependent. The results suggest that both 2,4-PDCA and minoxidil have an
      inhibitory effect on collagen formation and may be useful in delaying surgical
      wound healing.

PMID- 8359031
TI  - Fluorescein angiography as a means of assessing retinal vascular pathology in
      oxygen-exposed newborn rats.
AB  - Recently a new technique was reported in which examination of the retina of
      oxygen reared newborn rats was made using indirect fluorescence microscopy
      (Invest. Ophthal. Vis. Sci. 31:810). We have now improved this technique and
      systematically employed it as a means of studying oxygen-induced retinopathy in
      the newborn rat as an animal model for retinopathy of prematurity (ROP).
      Immediately after birth, litters of pigmented rats were exposed to an elevated
      oxygen atmosphere that varied in a cyclic fashion between 40% and 80% every 12
      hours for 14 days. Rats raised simultaneously in room air served as controls. At
      the end of the treatment period, rats were deeply anesthetized, their pupils
      dilated, and 100 microliters of 3% sodium fluorescein was administered via tail
      venipuncture. After angiography, rats were awakened and returned to their mothers
      in room air for future assessment. Angiography was performed again at 4, 7, 38 or
      56 days after oxygen treatment. Our results suggest that retinal pathology in the
      rat model parallels that of the human infant with ROP with respect to loss of
      patent retinal blood vessels in oxygen and subsequent abnormal vasoproliferation
      upon return to room air. Angiograms performed on room air-raised control rats at
      14 days of age demonstrated our ability to resolve the smallest retinal
      capillaries. Angiograms conducted at the same age in oxygen-exposed rats revealed
      extensive areas of retinal non-perfusion and substantial arterio-venous shunting
      between adjacent primary vessels. If rats were maintained in room air for 4 or 7
      days following oxygen exposure, a variety of pathologic signs became obvious
      including: 1) tortuosity of primary vessels mimicking human "plus disease", 2)
      frequent abnormal budding of tertiary vessels and capillaries, 3) retinal
      fluorescein leaks indicative of hemorrhages and 4) abnormal capillary tufts not
      evident at the time of removal from oxygen. By 38 and 56 days post-exposure, all
      four of these phenomena were still observed. Many of these pathologic phenomena
      could not have been observed with conventional methods currently used for retinal
      vascular assessment in small animals.

PMID- 8359032
TI  - Keratoconus corneas: increased gelatinolytic activity appears after modification
      of inhibitors.
AB  - We examined the metalloproteinase activity from normal and keratoconus corneal
      extracts. No differences were detected in the total amount of the
      metalloproteinase or its physical form of activation. However, there was a
      significant elevation in enzymatic activity in the keratoconus extracts after
      chemical modification of inhibitory elements. This suggests either a difference
      in the enzymatic capabilities of keratoconus corneas or, as suggested previously,
      a decrease in the amount of TIMP (tissue inhibitor of metalloproteinase) present
      in the tissue.

PMID- 8359033
TI  - Radiology of maxillofacial trauma.
AB  - There has been a rising incidence of maxillofacial injuries during the past
      decade as a result of an increasing number of assaults and motor vehicle
      accidents. The maxillofacial region is one of the most complex areas of the human
      body, and the radiographic imaging of this region becomes even more difficult in
      traumatized patients because of their clinical condition and their inability to
      cooperate. Imaging modalities used in the evaluation of the traumatized
      maxillofacial region include conventional (plain) films, tomography, panoramic
      radiography, computed tomography, three-dimensional computed tomography,
      DentaScan, and magnetic resonance imaging. Each modality is discussed with regard
      to technique, advantages, and disadvantages. Plain films and computed tomography,
      the modalities that are used most in evaluating maxillofacial structures, are
      discussed in more detail. The normal anatomy and radiologic features are
      presented for both of these modalities. Radiographic evaluation of maxillofacial
      injury begins with a knowledge of the direct and indirect radiographic signs of
      injury seen on most imaging modalities. Computed tomography also has allowed a
      method of classifying facial fractures that is based on the involvement of the
      facial buttresses or struts. Three horizontal, two coronal, and five sagittal
      oriented struts are described. Limited fractures are differentiated from
      transfacial fractures by the lack of involvement of the pterygoid plates in the
      limited fractures. Limited fractures also can be subclassified as solitary
      (fracture of a single strut) or complex (fractures of multiple struts). A portion
      of the orbit is involved in almost every form of facial fracture; therefore,
      evaluation of facial injuries should always include the orbital structures.
      Although both can occur simultaneously, orbital injuries can be divided into soft
      tissue and bony vault injuries. Similar to midface fractures, orbital fractures
      also can be classified as solitary (fracture involves a single wall) or complex
      (fracture involves more than one wall or a part of a midface fracture). Computed
      tomography is of great value in evaluating both forms of injury. Magnetic
      resonance imaging is becoming increasingly important in the evaluation of orbital
      soft tissue injuries. Classification of midface injuries includes the solitary
      strut fractures and the complex strut fractures. Solitary strut fractures include
      fractures of the nasal arch, zygomatic arch, and isolated sinus wall fractures.
      Complex strut fractures include the nasal complex fractures, zygomatic (tripod)
      and zygomaticomaxillary fractures, transfacial fractures (LeFort fractures), and
      facial smash fractures. Each fracture type and its radiographic appearance are
      discussed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8359034
TI  - Special issue: A festschrift for Martin W. Donner, M.D.

PMID- 8359035
TI  - Dysphagia diagnostics and Donner: experiences in the decade of change.
AB  - Martin Donner's influence in the area of dysphagia diagnostics has spanned
      several decades and has provided an impetus for the evolution of advanced
      dysphagia diagnostics. This article presents an historical perspective of the
      development of ultrasound imaging and the variety of other imaging procedures to
      evaluate swallowing. The future of image processing for dysphagia is firmly set.

PMID- 8359036
TI  - The probability of correctly predicting subglottic penetration from clinical
      observations.
AB  - It is difficult to predict from clinical signs and symptoms which patients suffer
      from subglottic penetration of foods. Most investigators attempting to predict
      aspiration have used small numbers of patients and relatively unsophisticated
      statistical techniques. In this study, we utilized 249 patients to examine the
      predictive value of several clinical factors thought to be suggestive of
      subglottic penetration with discriminant analysis. Using this approach we were
      able to correctly predict about 2/3 of both those who aspirate and those who do
      not aspirate. This is better than others have reported but still inadequate for
      clinical purposes.

PMID- 8359037
TI  - Speech-language pathology and dysphagia: a brief historical perspective.
AB  - In the past decade, speech-language pathologists have taken a leading role in the
      management of services for patients with oropharyngeal dysphagia. This article
      presents the historical perspective of this role, the rationale for assuming the
      responsibility, and suggests directions for continued involvement.

PMID- 8359038
TI  - The search for the central swallowing pathway: the quest for clarity.
AB  - As the work of Dr. Martin Donner has brought a clarity to understanding
      swallowing, so has the work of various neuroscientists, including that of a Nobel
      Laureate, in providing us with a better comprehension of this complex motor
      pattern. Understanding the neural control of swallowing has been a process that
      has occurred during this century in which several investigators, primarily from
      Europe, Japan, Canada, and the United States, have brought their perspectives in
      applying particular techniques to decipher how the central and peripheral nervous
      system control swallowing. Swallowing represents a complex muscular response of
      the oral, pharyngeal, and esophageal regions which are integrated to provide an
      effective functional pattern that prepares and transports food while
      simultaneously protecting the airway. This adaptation of the upper
      gastrointestinal tract in mammals has been extensively studied peripherally by
      two methods: recording from the peripheral nerves and muscles, and stimulating
      peripheral nerves and their receptive fields that can induce the pharyngeal and
      esophageal phases of swallowing. The study of the peripheral nervous system has
      provided insight into the sensory receptive fields that evoke or facilitate
      swallowing, and has established the first serious evidence of the all-or-none
      sequential contraction pattern of the oropharyngeal and esophageal muscles. It
      has been these electromyographic studies of the muscles that has established much
      of the criteria for evaluating the central swallowing pathway. Five techniques
      have been applied to the central nervous system to study swallowing and include
      lesioning or destroying discrete regions to determine how swallowing is impaired
      or modified, electrically stimulating the central neural tissue to determine the
      type of effects on swallowing, recording from the central neural tissue with
      macro- and microelectrodes to ascertain when neurons respond in timing to the
      peripheral muscle activity during swallowing, applying pharmacological agents
      through micropipettes which could mimic or inhibit potential transmitters, and
      using immunochemical techniques to tag specific chemicals that could be
      transmitters used by the neurons in the central swallowing pathway. These various
      techniques have provided insight into how the central swallowing pathway is
      organized but the details of the central control are still in the process of
      being defined and will require as much effort this next century as has been
      previously developed over the past 90 years.

PMID- 8359039
TI  - The role of the cerebral cortex in swallowing.
AB  - This paper reviews clinical, neuroanatomical, and neurophysiological studies that
      have implicated the cerebral cortex in the initiation and/or regulation of
      swallowing as well as related functions such as mastication. Cortical dysfunction
      has been reported to result in a variety of swallowing impairments. Furthermore,
      swallowing can be evoked and/or modulated by stimulation applied to restricted
      regions of the cortex. Neuroanatomical investigations and single neuron recording
      studies also provide some insights into the cortical structures, pathways, and
      mechanisms that may mediate deglutition.

PMID- 8359040
TI  - A protocol for the videofluorographic swallowing study.
AB  - This paper presents a detailed protocol for performing the videofluorographic
      swallowing study (VFSS), and describes how it evolved from its antecedents. The
      objectives of the VFSS are both diagnostic and therapeutic. Preparing for the
      VFSS is described, including the equipment, food preparation, and a brief
      discussion of the clinical evaluation. The detailed description of the VFSS
      procedure covers the position of the patient, the foods presented, the views
      obtained, modifications of feeding and swallowing that are commonly employed, the
      standardized set of observations, and reporting the results. Criteria for
      deviating from the protocol or aborting the study are presented. The VFSS does
      not necessarily end when a patient aspirates. Indeed, the complete evaluation of
      aspiration, and the effects of maneuvers designed to reduce it, is a major
      purpose of the VFSS. Modifications of feeding and swallowing are tested
      empirically during the study. The modifications include therapeutic and
      compensatory techniques that may improve the safety and efficiency of swallowing.
      A rationale for deciding which modifications to test in a given patient is
      discussed. The protocol has been used successfully in more than 350 patients. It
      has improved the efficiency and quality of our videofluorographic examinations.

PMID- 8359041
TI  - The evaluation of pediatric feeding abnormalities.
AB  - An appreciation of normal age-related feeding behavior is a prerequisite for the
      study of pediatric feeding disorders. When faced with a child with dysphagia, the
      diagnostic evaluation including history, physical and developmental exam, and
      feeding observation, followed by appropriate diagnostic tests forms the basis for
      understanding the underlying pathophysiology and the anticipated developmental
      progression. It makes possible the formulation and implementation of an optimal
      treatment strategy, which can be monitored for results and modified when needed.
      Four case examples are provided.

PMID- 8359042
TI  - The functions of saliva.
AB  - Oral health is determined to a considerable extent by our ability to produce
      saliva. Not only must adequate amounts be produced, but a large number of
      specific proteins also must be secreted for the mouth to function properly. This
      brief review is directed at describing (1) how saliva is secreted, (2) the
      consequences of decreased salivary function, (3) the components necessary for
      oral homeostasis, and (4) the common causes of salivary hypofunction.

PMID- 8359043
TI  - Oropharyngeal swallowing after stroke in the left basal ganglion/internal
      capsule.
AB  - One of the foci of Martin Donner's work was the neural control of swallowing.
      This present investigation continues that work by examining oropharyngeal
      swallowing in 8 patients identified with a single, small, left-basal
      ganglion/internal capsule infarction and 8 age-matched normal subjects. Stroke
      patients were assessed with a bedside clinical and radiographic swallowing
      assessment, and normal subjects received only the radiographic study. Results
      revealed disagreement between the bedside and radiographic assessments in one of
      the 8 stroke patients. Stroke and normal subjects differed significantly on some
      swallow measures on various bolus viscosities, but behaved the same as normal
      subjects on a number of measures. Differences in swallowing in the stroke
      subjects were not enough to prevent them from eating orally. The significant
      differences seen in the basal ganglia/internal capsule stroke subjects may result
      from damage to the sensorimotor pathways between the cortex and brainstem. These
      differences emphasize the importance of cortical input to the brainstem
      swallowing center in maintaining the systematic modulations characteristic of
      normal swallowing physiology.

PMID- 8359044
TI  - Clinically probable brainstem stroke presenting primarily as dysphagia and
      nonvisualized by MRI.
AB  - Ten patients with clinically probable brainstem stroke presenting primarily as
      acute dysphagia but without visible brainstem abnormality by MRI are described.
      The patients were evaluated with neurologic examinations,
      cinepharyngoesophagography, and brain MRI studies. Each patient solely or
      predominately experienced sudden pharyngeal dysphagia, and additional symptoms or
      signs other than dysphonia or dysarthria were scarce. Small vessel disease or
      cardiac embolism were the apparent causes of what appear to have been very
      discrete brainstem strokes in these patients. Acute pharyngeal dysphagia can be
      the sole or primary manifestation of brainstem stroke. A negative MRI study
      should not preclude consideration of this diagnosis, if brainstem stroke is
      otherwise clinically probable.

PMID- 8359045
TI  - Pharyngeal constrictor paresis: an indicator of neurologic disease?
AB  - Pharyngeal constrictor paresis (PHCP) is sometimes found in videoradiography of
      the swallowing act in patients complaining of dysphagia. Ten patients with PHCP
      and 10 dysphagic, age- and sex-matched controls with normal videoradiography were
      neurologically evaluated and examined with magnetic resonance imaging (MRI) of
      the brain and brainstem in order to learn the pathogenetic process behind PHCP.
      The study revealed 8 PHCP patients and 1 dysphagic control with abnormal clinical
      neurological findings such as myopathy, cerebrovascular disease, or
      extrapyramidal disease. The neurological examination revealed considerable
      information of prognostic and therapeutic value in PHCP patients. The MRI was
      abnormal in 7 PHCP patients and 4 dysphagic controls. However, the findings in
      MRI were nonspecific but the examination was found to be valuable in selected
      cases. It is concluded that PHCP is an indicator of neurological disease and
      accordingly, such patients should be examined by a neurologist to establish the
      cause of the disease.

PMID- 8359046
TI  - Cricopharyngeal function and dysfunction.
AB  - The cricopharyngeus is a narrow band of muscle strategically placed between the
      pharynx and esophagus. Its normal function is vital to the efficient transfer of
      foodstuffs to the esophagus. Cine- and videoradiography are the major methods of
      studying the pharyngo-esophageal segment. More recently, refinements in
      manometric methods have complemented radiology, and have enabled us to achieve a
      better understanding of cricopharyngeal function in health and disease. Such an
      understanding of the physical forces necessary for normal bolus transfer, and the
      recognition of abnormal patterns of pharyngeal and cricopharyngeal motility, will
      hopefully lead us to a more rational approach to therapy in patients with
      pharyngeal dysphagia.

PMID- 8359047
TI  - The role of cricopharyngeus muscle in pharyngoesophageal disorders.
AB  - The cricopharyngeus muscle is generally thought to be responsible for the high
      pressure zone of the pharyngoesophageal (upper esophageal) sphincter. In this
      review we critically examined the evidence for the role of the cricopharyngeus
      muscle in the manometric pharyngoesophageal sphincter. The available studies show
      disparities between the anatomic location of the cricopharyngeus muscle and the
      manometric high pressure zone of the pharyngoesophageal sphincter. The
      cricopharyngeus muscle seems to correspond to the distal 1/3 of the sphincteric
      high pressure zone and the peak high pressure zone appears to be located proximal
      to the cricopharyngeus muscle. The discrepancy between the upper high pressure
      zone and the anatomic cricopharyngeus is important in understanding the role of
      the cricopharyngeus muscle in the pathophysiology and treatment of clinical
      disorders of the pharyngoesophageal sphincter.

PMID- 8359048
TI  - Volume accommodation during swallowing.
AB  - Bolus volume is an important modifier of the biomechanical events of the
      oropharyngeal swallow. The biomechanical events comprising a swallow can be
      divided into events associated with the reconfiguration of the pharynx into a
      swallow pathway and events associated with bolus transport from the oropharynx
      into the esophagus. Volume modification is achieved differently for the events of
      reconfiguration and propulsion. In the case of reconfiguration, a longer time is
      allocated to the process, as exemplified by sustained laryngeal elevation and
      hyoid excursion during larger volume swallows. On the other hand, in the case of
      bolus expulsion, volume accommodation is accomplished within the same period of
      time by utilizing increased vigor of expulsion. The result of deglutitive volume
      accommodation is a remarkably different fluoroscopic appearance of a small vs. a
      large volume swallow. The larger volume swallow seemingly takes longer and
      results in much more vigorous bolus expulsion than a small volume. However, this
      is more related to the bolus than the swallow.

PMID- 8359049
TI  - Dysphagia and expiratory air flow.
AB  - Expiratory air flow preserves the freedom of the upper airway from foodway
      contamination in patients with dysphagia. Valving the tracheostomy cannula, "quad
      coughing," the Heimlich maneuver, the "supraglottic swallow," and coupling to a
      ventilator each has a place among the measures used for treating aspiration.

PMID- 8359050
TI  - Modern solid state computerized manometry of the pharyngoesophageal segment.
AB  - There has been renewed interest in the use of manometry of the pharyngoesophageal
      segment in the investigation of pharyngeal dysphagia. Advances in technology have
      alleviated previous difficulties presented by factors such as the rapid response
      rate of the striated muscle and asymmetry of the upper esophageal sphincter.
      Close attention to technique can overcome difficulties with movement artifacts
      encountered during deglutition. Manometry is being used to study normal swallow
      function and the effects of physiologic changes. There are also increasing
      numbers of reports in the literature of manometric studies in patients with
      oropharyngeal dysphagia. This technique provides information on pressure changes
      and augments that information obtained from a barium swallow.

PMID- 8359053
TI  - [Reimbursement for elective procedures based on the health care restructuring
      legislation].

PMID- 8359052
TI  - Malignancy-induced secondary achalasia.
AB  - Secondary achalasia refers to the development of clinical, radiographic, and
      manometric findings of achalasia as a result of (i.e., secondary to) another
      underlying disorder. A variety of malignancies have been associated with
      secondary achalasia. Adenocarcinoma of the esophagogastric junction accounts for
      the majority of cases of malignancy-induced achalasia, however, noncontiguous
      tumors may also cause this disorder. Although rare, malignancy-induced achalasia
      will occasionally be encountered by gastroenterologists and gastrointestinal
      radiologists who see patients with dysphagia and/or achalasia. Since treatment is
      aimed at the underlying neoplasm, it is important to recognize this disorder.
      Three clinical features suggest the possibility of malignancy as a cause of
      achalasia: 1) short duration of dysphagia (< 1 year); 2) significant weight loss
      (> 15 pounds); and 3) age > 55 years. The presence of any of these should at
      least raise a suspicion of malignancy. Diagnosis may not be evident on routine
      esophagrams and endoscopy, and requires clinical suspicion for further evaluation
      with thoraco-abdominal CT scanning and endoscopic ultrasonography.

PMID- 8359051
TI  - Barrett's esophagus: pathogenesis, epidemiology, functional abnormalities,
      malignant degeneration, and surgical management.
AB  - Barrett's esophagus (i.e. columnar epithelial metaplasia in the distal esophagus)
      is an acquired condition that in most patients results from chronic
      gastroesophageal reflux. It is a disorder of the white male in the Western world
      with a prevalence of about 1/400 population. Due to the decreased sensitivity of
      the columnar epithelium to symptoms, Barrett's esophagus remains undiagnosed in
      the majority of patients. Gastroesophageal reflux disease in patients with
      Barrett's esophagus has a more severe character and is more frequently associated
      with complications as compared with reflux patients without columnar mucosa. This
      appears to be due to a combination of a mechanically defective lower esophageal
      sphincter, inefficient esophageal clearance function, and gastric acid
      hypersecretion. Excessive reflux of alkaline duodenal contents may be responsible
      for the development of complications (i.e., stricture, ulcer, and dysplasia).
      Therapy of benign Barrett's esophagus is directed towards treatment of the
      underlying reflux disease. Barrett's esophagus is associated with a 30- to 125
      fold increased risk for adenocarcinoma of the esophagus. The reasons for the
      dramatic rise in the incidence of esophageal adenocarcinoma, which occurred
      during the past years, are unknown. High grade dysplasia in a patient with
      columnar mucosa is an ominous sign for malignant degeneration. Whether an
      esophagectomy should be performed in patients with high grade dysplasia remains
      controversial. Complete resection of the tumor and its lymphatic drainage is the
      procedure of choice in all patients with a resectable carcinoma who are fit for
      surgery. In patients with tumors located in the distal esophagus, this can be
      achieved by a transhiatal en-bloc esophagectomy and proximal gastrectomy. Early
      adenocarcinoma can be cured by this approach. The value of multimodality therapy
      in patients with advanced tumors needs to be shown in randomized prospective
      trials.

PMID- 8359054
TI  - [Classification and grading of soft tissue tumors].

PMID- 8359055
TI  - [Preoperative chemotherapy in treatment of soft tissue sarcoma].

PMID- 8359056
TI  - [Surgical therapy and prognosis of soft tissue sarcoma].

PMID- 8359057
TI  - [Soft tissue sarcoma: isolated hyperthermic extremity perfusion. Technique and
      indications].

PMID- 8359058
TI  - [Soft tissue tumors: indications and results of hyperthermia].

PMID- 8359059
TI  - [Value of sonography in diagnosis of uncertain lesions of the abdominal wall and
      inguinal region].
AB  - In a prospective trial we investigated the value of ultrasound in 134 patients
      with clinical doubtful findings of the abdominal wall and inguinal region.
      Ultrasound diagnosis was made by predefined criteria. In 105 patients a definite
      diagnosis was made by means of operative findings, CT, NMR, or puncture. In 40
      patients a hernia was found. The sensitivity of ultrasound was 85%, the specifity
      93.8%, the positive predictive value as 89.5% and the negative predictive value
      was 91%. Separating the findings to localisation of the hernia results in highest
      sensitivity for epigastric hernia (100%) and lowest for crural hernia (72.7%).
      The specifity for all hernias was more than 96%. Liquid tumors (hematom, serom,
      abscess) could be differentiated from solid tumors (lymphom, metastatic nodule,
      lipom). The most frequent course of wrong diagnosis was mixing the different
      liquid or solid tumors among themselves because of similar sonomorphologic
      properties. The sensitivity for hematom, serom, abscess, lymphom and metastatic
      nodule was 87.5%, 100%, 66.6%, 77% and 85.7% respectively. The corresponding
      specifity was 97.8%, 97.8%, 100%, 96.7% and 98%. Ultrasound was found to be of
      value for the diagnosis of clinical indeterminal findings of the abdominal wall
      and inguinal region.

PMID- 8359060
TI  - [Value of image analysis DNA cytometry in cancer of Vater's ampulla].
AB  - In 27 patients who underwent partial duodenopancreatectomy due to cancer of the
      ampulla of Vater, in addition to the TNM classification and usual morphologic
      criteria, the paraffin-embedded material underwent deparaffinization, was
      rehydrated, and was mechanically and enzymatically processed into a single-cell
      solution. For evaluating the DNA histogram this was analyzed with the help of
      automatic single cell cytophotometric study. At the time of DNA analysis the
      histomorphological data and the survival time of the patients were not known. In
      the univariate analysis the 5-year survival rate of patients with diploid or
      hypotriploid tumors (n = 12) was 69% of patients with diclonal (diploid-triploid
      n = 7, triploid-tetraploid n = 1) tumors was 62.5% and no patient with a triploid
      or hypertriploid tumor (n = 7) survived 5 years. No association could be found
      between the known prognostic criteria and the DNA content. The multivariate
      analysis shows that beside the lymph node status, the DNA content of tumor cells
      had a strong and independent influence on the prognosis in cancer of the ampulla
      of Vater.

PMID- 8359061
TI  - [Lack of effectiveness of alternative non-surgical treatment procedures of
      Dupuytren contracture].
AB  - In the early stage of the disease a group of patients was treated with
      radiotherapy, later another group with injections of superoxid-dismutase. The
      results of follow-up examinations 7 years after radiotherapy and 3 years after
      treatment with superoxid-dismutase respectively do not differ clearly from
      spontaneous course of Dupuytren's contracture grade one. At present we cannot
      recommend an alternative treatment for early stage Dupuytren's contracture.

PMID- 8359063
TI  - [Monstrous Buschke-Loewenstein tumor (condylomata acuminata gigantea) with
      transition to invasive squamous epithelial cancer].
AB  - The case of a 34-year-old female is reported, who has suffered from recurring
      condylomata acuminata of the anogenital region since she was 16. In the further
      course of the disease multiple Buschke-Loewenstein tumors developed, and finally
      an invasively growing, highly differentiated, keratinizing squamous cell
      carcinoma. The course of the disease was complicated by severe septicemia. In the
      framework of multimodal therapy, laser resection was the preferred method of
      surgical intervention. A systemic or local interferon treatment has only a
      prophylactic character in this stage of the disease.

PMID- 8359062
TI  - [Dorsolateral approach to the left subphrenic area, to the bursa omentalis and to
      the cauda pancreatis].
AB  - We are reporting on a dorsolateral access left to the bursa omentalis and to the
      left subphrenium carried out in order to relieve infectious processes in this
      region. The access has proved a success above all in the later postoperative
      period, e.g. when the protecting conglutinations towards ventral isolate the
      process from the abdominal cavity. At the lying patient this access allows the
      drainage of the exsudation over the deepest point. The results of 23 surgical
      interventions are being demonstrated with references to possible complications
      caused by the intervention.

PMID- 8359064
TI  - [Recurrent lung embolisms in aneurysm of the popliteal vein].
AB  - Report about a rare case of pulmonary embolism caused by a clinically unsuspected
      aneurysm of the popliteal vein. The aneurysm was suitable for local venous
      reconstruction. The diagnosis and the treatment are discussed.

PMID- 8359065
TI  - [Limited surgery of breast cancer].

PMID- 8359066
TI  - U.S. householder survey of functional gastrointestinal disorders. Prevalence,
      sociodemography, and health impact.
AB  - Our objective was to obtain national data of the estimated prevalence,
      sociodemographic relationships, and health impact of persons with functional
      gastrointestinal disorders. We surveyed a stratified probability random sample of
      U.S. householders selected from a data base of a national market firm (National
      Family Opinion, Inc.). Questions were asked about bowel symptoms,
      sociodemographic associations, work absenteeism, and physician visits. The
      sampling frame was constructed to be demographically similar to the U.S.
      householder population based on geographic region, age of householder, population
      density, household income, and household size. Of 8250 mailings, 5430 were
      returned suitable for analysis (66% response). The survey assessed the prevalence
      of 20 functional gastrointestinal syndromes based on fulfillment of multinational
      diagnostic (Rome) criteria. Additional variables studied included: demographic
      status, work absenteeism, health care use, employment status, family income,
      geographic area of residence, population density, and number of persons in
      household. For this sample, 69% reported having at least one of 20 functional
      gastrointestinal syndromes in the previous three months. The symptoms were
      attributed to four major anatomic regions: esophageal (42%), gastroduodenal
      (26%), bowel (44%), and anorectal (26%), with considerable overlap. Females
      reported greater frequencies of globus, functional dysphagia, irritable bowel
      syndrome, functional constipation, functional abdominal pain, functional biliary
      pain and dyschezia; males reported greater frequencies of aerophagia and
      functional bloating. Symptom reporting, except for incontinence, declines with
      age, and low income is associated with greater symptom reporting. The rate of
      work/school absenteeism and physician visits is increased for those having a
      functional gastrointestinal disorder. Furthermore, the greatest rates are
      associated with those having gross fecal incontinence and certain more painful
      functional gastrointestinal disorders such as chronic abdominal pain, biliary
      pain, functional dyspepsia and IBS. Preliminary information on the prevalence,
      socio-demographic features and health impact is provided for persons who fulfill
      diagnostic criteria for functional gastrointestinal disorders.

PMID- 8359067
TI  - Irritable bowel-type symptoms in HMO examinees. Prevalence, demographics, and
      clinical correlates.
AB  - A study of irritable bowel-type symptoms in 1264 health examinees using a self
      administered questionnaire and psychological tests revealed they are common
      throughout adulthood. Of affected subjects 68% were female, and those with the
      more severe type (> or = 3 Manning criteria) were predominantly female (80%).
      Fewer Asians than other racial/ethnic groups had these symptoms.
      Nongastrointestinal symptoms, physician visits, incontinence, laxative use, a
      stress effect on bowel pattern and abdominal pain, abdominal surgery,
      hysterectomy, childhood abuse, use of mind-altering drugs, depression, and
      anxiety were correlated with irritable bowel-type symptoms. Regression analysis
      found some of the clinical correlates were independent markers for irritable
      bowel-type symptoms and that sexual abuse was related to nongastrointestinal
      symptoms and abdominal surgery independent of irritable bowel-type symptoms. More
      severe irritable bowel-type symptoms were especially associated with
      nongastrointestinal symptoms, stress effects, sexual abuse, use of sedatives and
      oral narcotics, and a past alcohol problem. There are important demographic and
      clinical correlates with irritable bowel-type symptoms.

PMID- 8359068
TI  - Terminal ileal mucosal mast cells in irritable bowel syndrome.
AB  - Terminal ileal biopsies were prospectively obtained and stained specifically for
      mast cells in 20 patients with irritable bowel syndrome (IBS) and 15 controls.
      The number of terminal ileal mast cells per high powered field (MC/HPF) (mean +/-
      SEM) was 23.3 +/- 3.1 for IBS and 6.8 +/- 1.1 for controls (P = 0.0001). The
      diarrhea IBS subgroup had the greatest number of MC/HPF. No correlation was found
      between terminal ileal mucosal mast cell counts (MMCC) and the number of Manning
      criteria present or the functional bowel disease score (r = 0.06 and r = -0.31,
      respectively). We conclude that terminal ileal MMCC are significantly elevated in
      a majority of patients with IBS. The mast cell may be responsible for the altered
      visceral perception found in the gastrointestinal tract in patients with IBS. The
      poor correlation of the MMCC to the clinical features of IBS may be the result of
      the dynamic state of the mast cell.

PMID- 8359069
TI  - Oral contraceptive use and cigarette smoking in Crohn's disease.
AB  - Previous studies have consistently found strong positive associations between
      smoking and Crohn's disease. The association between oral contraceptive use and
      Crohn's disease remains, however, controversial. In order to analyze whether
      smoking and oral contraceptive use are independent risk factors, a case-control
      study was performed. In 90 women with Crohn's disease and 90 community controls
      information was assessed about their smoking habits and their use of oral
      contraceptives. Smoking and oral contraceptive use were associated with one
      another. After adjusting for oral contraceptive use, the relative risk for
      smokers compared with nonsmokers was 3.0 (1.3-6.8). After controlling for
      smoking, the relative risk estimates for oral contraceptive use were for no use,
      1-3 years, and > 3 years of use 1.0, 2.5 (1.0-6.6), and 4.3 (1.3-14.4),
      respectively. When oral contraceptive use was stratified by smoking habits, the
      data show that oral contraceptives only increased the risk for Crohn's disease in
      nonsmokers. From the lack of increase in risk for combined exposure, it is
      concluded that both factors might act through a common mechanism.

PMID- 8359070
TI  - Indium scanning in assessment of acute Crohn's disease. A prospective study of
      sensitivity and correlation with severity of mucosal damage.
AB  - The aim of this study was to determine whether the sensitivity of indium-111
      (111In) scanning in the assessment of the activity and extent of Crohn's disease
      correlates with the severity of intestinal lesions as measured by the newly
      validated Crohn's disease endoscopic index of severity (CDEIS). Nineteen patients
      with active (CDAI > 200) colonic (N = 11) or ileocolonic (N = 8) Crohn's disease
      were assessed by colonoscopy and indium scanning. The intestine was divided into
      five segments in both studies (rectum, sigmoid and left colon, transverse colon,
      right colon, and ileum). Seventy of the 86 intestinal segments seen at
      colonoscopy presented macroscopic lesions of Crohn's disease. On third-hour
      scintigrams 111In uptake was observed in 52 segments, 51 of which were found to
      be abnormal at colonoscopy. Predictive positive and negative values of scanning
      with respect to disease extent assessment were equal to 98% and 44%,
      respectively. Complete agreement between endoscopic and scintigraphic findings
      was observed in only six of the 19 patients (32%). Segmental endoscopic indexes
      of severity (SEIS) were significantly (P < 0.001) lower in false negative (7.9 +/
      4.2) (mean +/- SD) than in true positive (18.0 +/- 9.7) segments as defined by
      scintigraphy. SEIS values above which 111In uptake was constantly observed did
      not differ in the different disease locations. When compared macroscopically
      abnormal intestinal segments according to their 111In uptake grade, the
      corresponding mean SEIS values increased significantly as the grade increased.
      Scintigraphic activity, as assessed by the fall in splenic activity, was equal to
      23 +/- 11% (N = 19).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359071
TI  - Small intestinal mucosa changes, including epithelial cell proliferative
      activity, of children receiving total parenteral nutrition (TPN).
AB  - We examined the small intestinal histology disaccharidase activities as well as
      the incorporation of [3H]thymidine into DNA of biopsies maintained in organ
      culture from seven children (ages 9 months to 5 years) receiving total parenteral
      nutrition (TPN). Three children suffered from inflammatory bowel disease and
      received TPN for one month (short term). Four required long-term TPN (> 9 months)
      for short-bowel syndrome. DNA was extracted from the samples following serial
      precipitation with perchloric acid. Results were compared to those from 22 age
      matched children investigated for abdominal pain or chronic diarrhea. Short-term
      TPN resulted in slightly lower lactase, sucrase, and palatinase activities that
      were not statistically different from controls. Long-term TPN resulted in focal
      mild villus atrophy and a decrease in disaccharidase activity in two patients.
      Biopsies from long-term TPN patients incorporated less thymidine compared to
      those of controls (P < 0.001) when data was expressed per total biopsy (3.6 +/-
      1.1 vs. 8.4 +/- 1.1 fmol) or per milligram of tissue (1.0 +/- 0.12 vs 2.7 +/- 0.7
      fmol). The above data are in general agreement with the hypoplastic effect of TPN
      in animals. However, in children, much longer periods of TPN are required to
      realize the changes.

PMID- 8359072
TI  - Multiple vitamin status in Crohn's disease. Correlation with disease activity.
AB  - We measured serum, blood, or red cell concentrations of various vitamins in 24
      patients with Crohn's disease who had been free from any nutritional treatment,
      and compared them with those in 24 healthy controls. Twelve of the patients were
      affected in the small bowel only, two in the large bowel only, and the remaining
      10 in both the small and large bowel. The fat-soluble vitamins A and E were
      significantly decreased in patients with Crohn's disease compared to controls.
      Among the water-soluble vitamins, vitamins B1, B2 and B6 and folic acid were more
      depleted in patients with Crohn's disease than in the controls, whereas vitamins
      B12 and C, nicotinic acid, and biotin were not different between the two groups,
      and pantothenic acid was increased in patients with Crohn's disease. In addition,
      vitamin B2 and nicotinic acid showed a negative correlation with the Crohn's
      disease activity index. These findings suggest that there is a variety of vitamin
      deficiencies in Crohn's disease prior to treatment and also that concentrations
      of some vitamins, such as vitamin B2 and nicotinic acid, may reflect the severity
      of the disease.

PMID- 8359073
TI  - Nonsteroidal antiinflammatory drugs and lower gastrointestinal bleeding.
AB  - To define the association of the ingestion of nonsteroidal anti-inflammatory
      drugs (NSAIDs), including aspirin (ASA), and lower gastrointestinal bleeding
      (GIB) a retrospective, case-controlled study was undertaken of 188 patients
      admitted to three community hospitals in three cities with a diagnosis of lower
      GIB. Information was obtained about NSAID usage among these patients, and the
      data were compared with an age- and sex-matched control group of 185 patients
      admitted with a nongastrointestinal diagnosis, derived from a daily admission
      list. At the time of admission, in the New Jersey group, NSAID consumption was
      present in 26 of 90 (29%) patients with lower GIB compared with 16 of 90 (18%) of
      controls (P < 0.05, odds ratio 1.88, 95% CI 1.2-3.1) whereas, in the South
      Carolina group 34 of 98 (35%) were taking NSAID compared with 18 of 95 (19%) of
      controls (P < 0.01, odds ratio 2.27, 95% CI 1.2-4.4). These data indicate that
      there is a significantly increased rate of NSAID ingestion in patients admitted
      with lower GIB, implying that NSAID may unmask bleeding from a variety of lower
      gastrointestinal lesions.

PMID- 8359074
TI  - Effect of oral cyclosporin on renal function in Crohn's disease.
AB  - Twenty-one patients with Crohn's disease were followed prospectively for 24 weeks
      to examine the effect of a low-dose cyclosporin regime on renal function (initial
      dose 5 mg/kg reduced by 1 mg/kg every two months to a maintenance of 2 mg/kg).
      Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were
      measured by radioisotope clearance at 0, 6 and 24 weeks. GFR and ERPF fell
      significantly (mean GFR at baseline: 120.9 ml/min/1.73 m2; at six weeks: 100.9
      ml/min/1.73 m2; mean ERPF at baseline: 497.3 ml/min/1.73 m2; at six weeks: 398.5
      ml/min/1.73 m2). Following dose reduction, the ERPF remained lower than baseline
      (mean 408.6 ml/min/1.73 m2), and there was a trend towards the GFR remaining low
      (mean 111.8 ml/min/1.73 m2). Serum creatinine rose significantly (median
      pretreatment 72 mumol/liter; median at four weeks 86 mumol/liter) but returned to
      baseline after dose reduction. Plasma cyclosporin levels and serum creatinine did
      not help predict the extent of changes in renal function. At low doses,
      cyclosporin causes changes in renal hemodynamics that may not be reversed by dose
      reduction.

PMID- 8359075
TI  - PMN-elastase in assessment of patients with inflammatory bowel disease.
AB  - PMN-elastase is a proteinase released by activated neutrophils. PMN-elastase was
      determined in two independent populations with inflammatory bowel disease. In an
      unselected population of 70 consecutive patients with Crohn's disease and 24
      patients with ulcerative colitis with different degrees of disease activity
      plasma PMN-elastase levels were statistically significantly higher in patients
      with active than in patients with inactive disease [Crohn's disease: 80.5 +/-
      33.2 ng/ml vs 60.1 +/- 24.6 ng/ml (mean +/- SD), P = 0.0017; ulcerative colitis:
      98.2 +/- 54.9 ng/ml vs 59.2 +/- 16.8 ng/ml, P = 0.026]. PMN-elastase levels in
      feces were also higher in patients with active Crohn's disease (23.6 +/- 15.3
      ng/g vs 13.6 +/- 12.5 ng/g, P = 0.0021) and active ulcerative colitis (46.5 +/-
      60.5 ng/g vs 20.2 +/- 25.0 ng/g, P = 0.46), but the difference reached
      significance only in Crohn's disease. Correlation of disease activity and PMN
      elastase in individual patients showed a statistically significant correlation
      between plasma and fecal elastase concentrations and disease activity in
      ulcerative colitis (plasma: r = 0.72, P < 0.001; feces: r = 0.57, P = 0.002). In
      patients with Crohn's disease only plasma levels of PMN-elastase (r = 0.423, P <
      0.001) but not fecal elastase concentrations (r = 0.0083, P = 0.485) correlated
      significantly with disease activity. Plasma PMN-elastase correlated weakly with
      fecal PMN-elastase levels in Crohn's disease (r = 0.431, P < 0.01) and in
      ulcerative colitis (r = 0.515, P = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359077
TI  - Intestinal permeability to [51Cr]EDTA in infectious diarrhea.
AB  - Orally administered [51Cr]EDTA was used to measure intestinal permeability in
      subjects with infectious diarrhea and in those without gastrointestinal
      complaints. [51Cr]EDTA was given to 87 subjects: 63 controls (32 normal controls,
      and 31 disease controls), and 24 patients with infectious diarrhea. Approximately
      100 microCi of [51Cr]EDTA was given orally after an overnight fast. Urine was
      collected for the following 24 hr. Intestinal permeability to [51Cr]EDTA in both
      normal volunteers and in patients with a variety of diseases not associated with
      intestinal injury was low and results were in a relatively narrow range. Mean 24
      hr urinary excretion of [51Cr]EDTA, calculated as a percent of the administered
      dose, in controls was 1.6% (0.2-3.5%). Patients with infectious diarrhea
      associated with invasive pathogens and/or intestinal inflammation had increased
      excretion of [51Cr]EDTA (mean 6.1%, P < 0.0001), with elevated excretions in 75%.
      These results demonstrate that intestinal infections must be considered as
      possible causes for increased intestinal permeability as assessed by the
      [51Cr]EDTA test.

PMID- 8359076
TI  - Effect of alpha-methylnorepinephrine, an alpha 2-adrenergic agonist, on jejunal
      absorption in neurally intact conscious dog.
AB  - Although alpha 2-adrenergic agonists stimulate absorption in the mammalian small
      and large intestine in vitro, the possibility of central neural effects have
      confounded interpretation of in vivo studies. Our aim was to assess the effects
      of intravenous administration of alpha-methylnorepinephrine (MNE), an alpha 2
      adrenergic agonist that does not cross the blood-brain barrier, on net jejunal
      absorption of water and electrolytes in the neurally intact, conscious dog.
      Absorption from a 30-cm proximal jejunal segment was studied using a triple-lumen
      perfusion technique in seven dogs. A warmed, isosmolar, balanced electrolyte
      solution containing [14C]polyethylene glycol was infused at 5 ml/min. Net jejunal
      fluxes of water and electrolytes were determined before, during, and after a 1.5
      hr infusion of MNE (900 nmol/kg/hr). MNE increased net jejunal water absorption
      (from 12.9 +/- 1.8 to 22.5 +/- 1.5 microliters/cm/min, P < 0.05). Peripheral
      alpha 2-adrenergic receptors mediate a net proabsorptive response in the neurally
      intact canine jejunum in vivo independent of direct central neural effects.

PMID- 8359078
TI  - Insulin, IGF-1, and IGF-2 receptors in rat small intestine following massive
      small bowel resection. Analysis by binding, flow cytometry, and
      immunohistochemistry.
AB  - This study was undertaken to correlate changes in insulin, IGF-1, and IGF-2
      receptors in enterocytes both during the phase of active hyperplasia (protocol 1)
      and the phase of initiation of hyperplasia (protocol 2) induced by 60% proximal
      jejunoileal resection in rats. Hormone binding to purified receptor preparations,
      indirect immunofluorescence analysis by flow cytometry, and immunohistochemistry
      were used to identify receptor changes. Insulin and IGF-2 receptor binding were
      increased in the intestine two days after surgery and prior to increased cell
      mass. The number of cells expressing insulin and IGF-1 receptors increased two-
      and three-fold between 12 and 36 hr after resection, whereas IGF-2 receptors were
      maintained throughout the 48-hr period. A significant increase in immunoreactive
      IGF-2 receptors in both the villus and crypt regions of the jejunum and ileum was
      observed 12 hr after resection, and this increase was maintained in the crypt
      region of the jejunum through 48 hr. Therefore, insulin and IGF-2 receptors
      appear to be important in the initiation of cellular hyperplasia following
      resection.

PMID- 8359079
TI  - One-day therapy for treatment of Helicobacter pylori infection.
AB  - The present study evaluated the effect of a one-day high-dose combined therapy on
      Helicobacter pylori infection. Thirty-two consecutive patients (suffering from
      either peptic ulcer or nonulcer dyspepsia) with Helicobacter pylori infection
      received omeprazole (40 mg) + bismuth subcitrate (240 mg x 4) + amoxicillin
      suspension (2000 mg x 4) + metronidazole (500 mg x 4), for only one day.
      Endoscopy, histology, culture, and susceptibility studies were done at entry and
      30 and 90 days after the treatment day. Successful eradication was obtained in
      23/32 (72%) patients and gastritis had resolved in 95% of these. Side effects
      were induced by the treatment in 6/32 (19%) patients, but these were all self
      limiting, short-lasting, and did not require any specific treatment. Development
      of bacterial resistance to metronidazole occurred in 6/9 (67%) non-eradicated
      patients. These data suggest that one-day treatment with high doses of
      amoxicillin, metronidazole, bismuth, and omeprazole represents an effective,
      safe, and inexpensive therapeutic approach for the treatment of H. pylori
      infection.

PMID- 8359080
TI  - Bismuth subsalicylate suppression of Helicobacter pylori in nonulcer dyspepsia: a
      double-blind placebo-controlled trial.
AB  - Gastritis caused by Helicobacter pylori (HP) is common in patients with nonulcer
      dyspepsia (NUD), but an etiologic relationship between the histologic lesion and
      clinical symptoms is unproven. HP is inhibited by bismuth subsalicylate (BSS), a
      traditional remedy for dyspeptic complaints. The aim of this study was to assess
      the short- and long-term effects of BSS on HP, gastritis, and symptoms in
      patients with NUD. One hundred twenty-six patients with NUD who were shown to be
      infected with H. pylori (HP+) were enrolled. There was a two-week placebo run-in
      period to eliminate placebo responders. Fifty patients remained symptomatic and
      were randomly assigned to therapy with either BSS liquid or a matching placebo.
      EGD, biopsy, and clinical evaluations were performed at entry, at week 5 (end of
      therapy), at week 9 (four weeks after therapy), or at time of symptomatic
      relapse. Twenty-seven patients received placebo and 23 patients received BSS. BSS
      suppressed H. pylori in 15/23 patients (65%) and eradicated it in one patient,
      whereas the placebo had no effect on H. pylori. Gastritis improved during therapy
      with BSS but relapsed by week 9. There was no significant change in level of
      dyspeptic symptoms during or after treatment, although one month after the end of
      treatment, the patients in the BSS group consistently had lower symptom scores
      and fewer symptomatic days for all symptoms measured. The study confirms that BSS
      given for three weeks suppresses but does not usually eradicate H. pylori. Such
      short-term suppression of H. pylori heals gastritis but does not result in
      clinical improvement.

PMID- 8359081
TI  - Asymptomatic H. pylori infection impairs pH inhibition of gastrin and acid
      secretion during second hour of peptone meal stimulation.
AB  - H. pylori infection is associated with acid-peptic disease, although its role in
      the pathogenesis is unclear. The purpose of this study was to determine if
      chronic infection in asymptomatic subjects impairs the inhibition of meal
      stimulated gastrin and acid secretion that is observed normally at low
      intragastric pH. Presence of infection was determined by both C-14 urea breath
      test and serology. Acid secretion was measured under basal conditions and in
      response to peptone meal stimulation and pentagastrin. Plasma gastrin
      concentrations were determined by radioimmunoassay under basal conditions and
      during peptone meal stimulation. Intragastric titration with 1% peptone during
      the first hour, and 8% peptone during the second hour, was performed at both pH
      7.0 and 2.5 on different days to compare the inhibition of gastrin and acid
      secretion. Compared to noninfected subjects, asymptomatic individuals infected
      with H. pylori had significantly increased: (1) basal gastrin values (P < 0.005);
      (2) 8% peptone-stimulated gastrin responses at both pH 7.0 and 2.5 (P < 0.05);
      and (3) 8% peptone-stimulated acid output at pH 2.5 (P = 0.01). During the second
      hour of peptone-stimulation, subjects infected with H. pylori had significantly
      decreased inhibition of gastrin (52% vs 95%) (P = 0.002) and acid (30% vs 81%) (P
      = 0.01) secretion from pH 7.0 to 2.5. Thus, chronic infection with H. pylori
      results in impaired inhibition of gastrin and acid secretion at low intragastric
      pH during the second hour of peptone meal stimulation. These defects may be
      unrelated to the pathogenesis of acid-peptic disease, since they occur in
      asymptomatic subjects infected with H. pylori.

PMID- 8359082
TI  - Helicobacter pylori infection, ABO blood group, and effect of misoprostol on
      gastroduodenal mucosa in NSAID-treated patients with rheumatoid arthritis.
AB  - Our aim was to investigate the effect of misoprostol on NSAID-induced
      gastroduodenal mucosal damage in patients with rheumatoid arthritis. The study
      included 40 patients, and it was designed as a double-blind, placebo-controlled
      trial. Misoprostol significantly reduced the gastroduodenal mucosal lesions found
      at endoscopy (P < 0.05) and prevented the development of ulcers. The cumulative
      incidence of ulcers at four weeks was 5% in the placebo group and 0% in the
      misoprostol group. The basal and pentagastrin-stimulated acid output as evaluated
      after 23 days of treatment with misoprostol was not significantly affected. Forty
      one percent of the patients had signs of current Helicobacter pylori infection,
      33% had positive serology only, and 26% had no evidence of infection. Most of the
      patients with current infection belonged to blood group O (P < 0.05). Misoprostol
      treatment did not affect the occurrence of Helicobacter pylori or the rheumatic
      disease activity. It is concluded that the protective actions of misoprostol on
      the gastroduodenal mucosa of NSAID-treated patients are largely mediated by
      mechanisms other than inhibition of acid secretion. The relationship among active
      Helicobacter pylori infection, blood group O, and peptic ulcer may be helpful to
      identify a subpopulation of patients taking NSAIDs at risk of developing peptic
      ulcers.

PMID- 8359083
TI  - Production of chemoattractant by Helicobacter pylori.
AB  - Helicobacter pylori is present in the antral region of the stomach in a majority
      of patients with gastritis type B. The specific mechanism whereby the organism
      participates in the development of disease remains uncertain. Since the organism
      is not invasive, we postulate that H. pylori produces a chemoattractant that
      recruits inflammatory cells to the antral region of the stomach. H. pylori was
      grown under microaerophilic conditions at 37 degrees C for 72 hr in Brucella
      broth containing 1% fetal bovine serum. Culture supernates were harvested after
      removal of organisms by centrifugation and filtration. The putative
      chemoattractant in culture supernates as well as that which might be present
      endogenously in the growth medium (negative control) was assayed against human
      neutrophils (PMN) in modified Boyden blind-well chambers using 3.0-microns
      membranes. We found that H. pylori supernates are chemotactic and showed up to
      130% activity when compared to the positive chemoattractant control (zymosan
      activated serum, a source of C5a). Minimal activity was observed with virgin
      growth medium. The chemoattractant activity is proportional to the number of
      colony forming units (CFU) of H. pylori. Preliminary characterization of the
      activity shows that the chemoattractant is stable in a boiling water bath for 15
      min, activity is lost within 1 hr in acid or alkali, and the chemotactic factor
      has an approximate molecular weight of 8500 daltons. The factor has no amino
      sugar and is negative for the lipid A portion of lipopolysaccharide.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8359084
TI  - ESWL and oral dissolution therapy. What factors influence results?
AB  - With the aim of identifying the criteria that have a decisive influence on the
      success of treatment of gallstones with ESWL and oral dissolution therapy, we
      investigated, in 117 patients, the stone-free rate as a function of sex, age,
      weight quotient, number of stones, total stone volume, and gallbladder function.
      The following inclusion criteria were applied: (1) the Munich criteria, (2) a
      follow-up period of at least 12 months, or (3) freedom from stones irrespective
      of the duration of the period of follow-up. Although, owing to the small number
      of cases involved, no significantly differing results were seen in the parameters
      investigated, clear tendencies were indeed observed. While age, sex, and weight
      quotient appear to have no influence on the stone-free rate, the number of
      stones, total stone volume, and gallbladder function do appear to have an effect
      on the results of treatment. Patients with solitary stones not more than 20 mm in
      diameter, and patients with a small total stone volume and good gallbladder
      function would appear to have the best chance of becoming stone-free within a
      short period of time, irrespective of age, sex, or girth.

PMID- 8359085
TI  - Effect of extracorporeal shock wave lithotripsy and ursodeoxycholic acid on
      gallbladder motility.
AB  - Extracorporeal shock wave lithotripsy and dissolution agents are useful
      nonsurgical therapies for gallstones. Their effect on gallbladder emptying is
      unclear. We evaluated emptying by ultrasonography before and after lithotripsy in
      50 patients on ursodeoxycholic acid or placebo and in nine controls. At baseline,
      patients had normal (68.8 +/- 3.2%) or delayed emptying (14.5 +/- 3.3%). In a
      subset of 24 patients, lithotripsy increased fasting volume (26.6 +/- 3.0 to 43.8
      +/- 5.0 ml, P < 0.005), postprandial volume (11.3 +/- 3.1 ml to 22.9 +/- 3.0 ml,
      P < 0.05), and decreased ejection fraction (70.0 +/- 4.1% to 42.7 +/- 6.0%, P <
      0.0005). There was an inverse linear correlation between power and ejection
      fraction, r = -0.43, P < 0.005. Ursodeoxycholic acid increased fasting (23.3 +/-
      2.2 ml to 36.7 +/- 4.6 ml, P < 0.005) and postprandial volume (11.1 +/- 1.8 to
      17.6 +/- 2.5, P < 0.005). Treatment with ursodeoxycholic acid resulted in a
      greater decrease in fragment size compared to placebo after lithotripsy in
      patients with fragment size greater than 6 mm. In conclusion, both lithotripsy
      and ursodeoxycholic acid have an effect on gallbladder emptying.

PMID- 8359086
TI  - Cholescintigraphic study of effect of somatostatin analog, octreotide, on bile
      secretion and gallbladder emptying in normal subjects.
AB  - The objective of the study was to investigate the effects of a single intravenous
      injection of the somatostatin analog octreotide on hepatic bile secretion and
      gallbladder emptying with a quantitative scintigraphic technique. Twelve healthy
      volunteers received, in a double-blind randomized fashion, either octreotide, 100
      micrograms intravenously, or placebo. Ten minutes later, [99mTc]PBIDA was
      administered intravenously (50 microCi/kg) (time = 0) followed, 60 min later, by
      the ingestion of a standardized fatty meal. In the liver area, the relative
      decrease per minute of tracer activity from the time of maximal activity to 60
      min was significantly lower in the octreotide group (P = 0.02). In the
      gallbladder area, after the fatty meal, the ratio of tracer activity at 60 and 90
      min (A90/A60) was significantly (P = 0.01) higher in the octreotide group. Our
      study demonstrates that octreotide slows down liver release of the
      radiopharmaceutical, probably reflecting decreased bile secretion, and inhibits
      postprandial gallbladder contraction.

PMID- 8359087
TI  - Treatment of dextran sulfate sodium-induced murine colitis by intracolonic
      cyclosporin.
AB  - The use of oral and intravenous cyclosporin represents a significant advance in
      the therapy of refractory inflammatory bowel diseases (IBD). However, oral
      administration of cyclosporin is fraught with improper delivery of cyclosporin to
      the colon for its topical action. Because of unpredictable metabolism by
      cytochrome P-450 IIIA, the targeted blood level for systemic effect is not
      reached at low doses. Furthermore, the doses that have been used for therapy of
      IBD have been shown to induce several adverse side effects. Thus, an alternate
      method of delivering cyclosporin to the colon is desirable. In this study, the
      effect of intracolonically administered cyclosporin was tested for its efficacy
      to heal mucosal erosions in dextran sulfate sodium (DSS)-induced colitis in mice.
      Both acute and chronic colitis was induced by feeding female Swiss-Webster mice
      with 5% DSS (30,000-40,000 mol wt) for five or seven days, respectively. Therapy
      was advocated prophylactically, prophylaxis plus therapy and therapeutically
      during the acute and chronic phase of the disease and therapeutically during the
      chronic phase of the disease. Intracolonic cyclosporin given prophylactically
      showed adverse effects by increasing the damage to the colonic mucosa. However,
      intracolonic cyclosporin given therapeutically in 2.5, 5, and 10 mg/kg after the
      induction of colitis resulted in dramatic responses in terms of reducing the
      disease activity and histologic scores, corroborated by complete histological
      resolution compared to oral cyclosporin given at identical doses. Intracolonic
      cyclosporin (5 mg/kg) was also very effective in reducing the chronic
      inflammation. The results of this study highlight the application of this animal
      model for therapeutic research. Furthermore, cyclosporin administered as an enema
      provides a new stratagem for the therapy of IBD because of its rapid onset of
      action at very low doses without the risk inherent in oral or systemic
      administration.

PMID- 8359089
TI  - Intractable neurological Wilson's disease treated with orthotopic liver
      transplantation.

PMID- 8359090
TI  - Recurrent fulminant hepatic failure in an HB carrier after intensive
      chemotherapy.

PMID- 8359091
TI  - Cholestatic hepatitis following flutamide.

PMID- 8359088
TI  - Intestinal epithelial function: the case for immunophysiological regulation.
      Implications for disease (2).
AB  - Substantial amounts of data have been reported showing a role for
      immunomodulation of epithelial function (particularly ion secretion and
      permeability) using animal models of anaphylactic reactions. In part one of this
      review we outlined the main immune cell types and mediators/cytokines that are
      currently known to influence epithelial physiology either directly, or indirectly
      via an intermediate cell type. Here we will expand on the significance of these
      studies and show how antigenic activation of the mucosal immune system can evoke
      changes in epithelial function that may be beneficial to the host by mediating
      loss/inactivation of the antigen. However, a continued and inappropriate immune
      stimulation can lead to pathophysiological reactions and disease. Thus, we will
      present data on immune regulation of epithelial function with direct
      applicability to understanding the mechanism underlying human intestinal
      inflammatory and secretory disease. Finally, we highlight key strategic points in
      the cascade of immune events that can control epithelial function and thus may be
      of relevance in the formulation of new therapeutic approaches to intestinal
      inflammation.

PMID- 8359092
TI  - Obesity, diabetes, and hyperlipidemia in a central Australian aboriginal
      community with a long history of acculturation.
AB  - OBJECTIVE: To determine the age- and sex-specific prevalence of diabetes and to
      examine associations between related anthropometric and metabolic abnormalities
      in an Aboriginal community in central Australia with a long history of
      acculturation. RESEARCH DESIGN AND METHODS: We used a cross-sectional survey of
      353 adults > 15 yr of age (87% response rate) and measured the following
      parameters: weight, height, circumferences of waist and hips; glucose, insulin,
      cholesterol, triglyceride, and high-density lipoprotein cholesterol in fasting
      plasma; and plasma glucose and insulin 2 h after 75 g oral glucose. RESULTS: The
      prevalence of diabetes was 29.6% in survey participants > 35 yr of age and 5.3%
      in those < 35 yr of age. Impaired glucose tolerance also occurred with higher
      frequency in those > 35 yr of age (14.8 vs. 4.7%). Of those > 35 yr of age, 75%
      of the women and 51% of the men were overweight or obese, with a body mass index
      > or = 25 kg/m2. A large insulin response to oral glucose was evident, with the
      upper tertile of the 2-h insulin response six times higher than the lower tertile
      (113 +/- 43 vs. 19 +/- 8 mU/L). Hyperinsulinemia showed a strong, positive
      association with impaired glucose tolerance, body mass index, waist-to-hip ratio,
      cholesterol, and triglyceride levels and a negative association with high-density
      lipoprotein cholesterol levels. Cholesterol levels were on average 0.5 mM higher
      in men than in women. Deteriorations in carbohydrate and lipid metabolism
      occurred before 40 yr of age: diabetes, body mass index, waist-to-hip ratio, and
      fasting triglycerides and cholesterol concentrations peaked and high-density
      lipoprotein cholesterol concentrations reached their nadir at the end of the
      fourth decade. CONCLUSIONS: These data suggest that any intervention programs
      developed to prevent or reduce diabetes prevalence in this population should be
      targeted at adolescents and young adults.

PMID- 8359093
TI  - Evidence for a role for insulin and growth hormone in overnight regulation of 3
      hydroxybutyrate in normal and diabetic adolescents.
AB  - OBJECTIVE: To determine the relative effects of growth hormone and insulin on
      ketogenesis during puberty. RESEARCH DESIGN AND METHODS: We studied overnight
      changes in plasma ketones--3-hydroxybutyrate and acetoacetate--in 35 normal and
      26 IDDM adolescents at different stages of puberty. The diabetic adolescents
      either were on their normal insulin regimen or were studied during an overnight
      euglycemic clamp with or without suppression of endogenous growth hormone
      release. RESULTS: Total ketone body and 3-hydroxybutyrate concentrations in the
      normal adolescents rose significantly from 2000 (29 +/- 5 microM), reaching a
      peak at 0200 (103 +/- 16 microM, P < 0.001 vs. 2000). After a brief fall, a
      further rise occurred before breakfast. Fasting 3-hydroxybutyrate concentrations
      showed a negative correlation with fasting insulin levels (r = -0.46, P = 0.005)
      and decreased with advancing puberty, while insulin concentrations increased. In
      the diabetic patients on their usual insulin regimen, free insulin levels waned
      overnight, and an exaggerated rise in ketones was observed before breakfast.
      During the euglycemic clamp studies, ketone levels were higher than normal
      throughout the night. Mean overnight growth hormone and free insulin levels also
      were higher than in the normal control subjects. The addition of the
      anticholinergic drug pirenzepine reduced growth hormone secretion and obliterated
      the early-night peak of 3-hydroxybutyrate. CONCLUSIONS: We conclude that the
      early-night peak of ketone concentrations is related to growth hormone release,
      whereas the fasting levels are largely determined by insulin concentration.
      Inadequate insulin delivery in the presence of the high growth hormone
      concentrations characteristic of diabetic adolescents could lead to rapid
      decompensation and ketoacidosis.

PMID- 8359094
TI  - Vascular dysfunction detected by a simplified venous occlusion test in NIDDM
      patients.
AB  - OBJECTIVE: To elucidate the relationship between angiopathies and vascular
      function evaluated by a simplified venous occlusion test in patients with NIDDM.
      RESEARCH DESIGN AND METHODS: The serum concentration of FDP was measured before
      and 5 min after venous occlusion in 23 NIDDM patients, 11 patients with
      cerebrovascular accident, and 10 age-matched healthy control subjects. RESULTS:
      The increment of serum FDP level after venous occlusion was significantly less in
      patients with NIDDM (60.6 +/- 33.5 to 81.5 +/- 49.6 ng/ml) and in those with
      cerebrovascular accident (101.4 +/- 51.5 to 116.2 +/- 47.2 ng/ml) than in control
      subjects (79.9 +/- 41.0 to 148.8 +/- 65.4 ng/ml). The increment of serum FDP
      after venous occlusion in NIDDM patients with macroangiopathy was significantly
      lower than that in those without macroangiopathy. CONCLUSION: The responsiveness
      of fibrinolytic activity to venous occlusion was significantly less in NIDDM
      patients with macroangiopathy, as in patients with cerebrovascular accident,
      compared with that in healthy control subjects.

PMID- 8359096
TI  - Effective treatment of insulin-induced edema using ephedrine.
AB  - OBJECTIVE: To control insulin-induced edema in a patient with poorly controlled
      IDDM. RESEARCH DESIGN AND METHODS: A 31-yr-old woman with a 14-yr history of
      poorly controlled IDDM first developed peripheral edema 3 yr after diagnosis of
      IDDM; the edema worsened whenever insulin dosage was increased. In August 1991,
      severe edema developed after treatment of ketoacidosis, with body weight
      increasing from 46 to 61 kg. No evidence of cardiac dysfunction or autonomic
      neuropathy existed, and serum albumin was consistently normal. RESULTS: Treatment
      with 15 mg of ephedrine every 8 h produced a prompt diuresis, with body weight
      falling by 4 kg in 48 h and by 12 kg within 1 wk. CONCLUSIONS: Ephedrine may be
      an effective treatment for insulin-induced edema and may be preferable to the use
      of diuretics in such patients.

PMID- 8359095
TI  - Prevalence of cardiovascular and renal complications in older adults with normal
      or impaired glucose tolerance or NIDDM. A population-based study.
AB  - OBJECTIVE: To determine the prevalence of CVD and renal disease by glucose
      tolerance status in a population-based study. RESEARCH DESIGN AND METHODS: The
      study consisted of 991 men and 1243 women, aged 50-89 yr, living in the upper
      middle class community of Rancho Bernardo, CA. All participants received a
      standard OGTT between 1984 and 1987. RESULTS: A total of 159 men and 158 women
      had NIDDM, whereas 237 men and 348 women had IGT. Age-adjusted prevalence of
      complications generally was highest in those who were previously diagnosed with
      NIDDM. A significant correlation was observed between increases in the prevalence
      of complications and increases in glucose intolerance for microproteinuria,
      macroproteinuria, and myocardial infarction (borderline), as well as for stroke
      and claudication in men and myocardial infarction and stroke in women. In men
      with IGT or NIDDM, the age-adjusted prevalence of proteinuria and CVD was highest
      when other complications were present whereas in women such a prevalence was
      highest when other complications were absent. In men with diabetes,
      microproteinuria was associated with duration of disease. CONCLUSIONS: Prevalent
      CVD and renal disease were increased in adults with NIDDM and elevated in adults
      with IGT compared to those with normal glucose tolerance. The prevalence of
      complications in NIDDM subjects in this population-based study was substantially
      lower than that reported for clinic-based diabetic populations.

PMID- 8359097
TI  - Association between fish intake and coronary heart disease mortality. Differences
      in normoglycemic and glucose intolerant elderly subjects.
AB  - OBJECTIVE: To compare the association of habitual fish intake with 17-yr
      mortality of coronary heart disease between normoglycemic and glucose intolerant
      elderly subjects. RESEARCH DESIGN AND METHODS: In 1971, 272 men and women, 64-87
      yr of age, were examined in a general practice in the town of Rotterdam, The
      Netherlands. Glucose intolerance (impaired glucose tolerance or diabetes
      mellitus) was observed in 83 subjects, and 189 subjects were found to be
      normoglycemic and free of clinically diagnosed diabetes mellitus. Information on
      usual dietary intake was obtained using the cross-check dietary history method.
      RESULTS: Fish consumption was found in 58.7% of the normoglycemic population and
      in 62.4% of the glucose intolerant population. Among normoglycemic subjects, the
      age- and sex-adjusted 17-yr mortality for coronary heart disease was 10.9/1000
      person-yr for those who ate fish and 25.1/1000 person-yr for those who did not.
      For the glucose intolerant population, the rates were 20.6/1000 and 31.2/1000
      person-yr, respectively. Adjusted for age, sex, body mass index, smoking, alcohol
      use, intake of energy, polyunsaturated fat, and carbohydrates, the risk ratio for
      normoglycemic population was 0.34 (95% confidence interval: 0.16-0.72). For
      glucose intolerant subjects, an adjusted risk ratio of 0.80 (95% confidence
      interval: 0.31-2.05) was observed. CONCLUSIONS: These results suggest that in a
      glucose intolerant population the possible protective effect of fish intake on
      coronary heart disease may be smaller than in normoglycemic subjects.

PMID- 8359099
TI  - Carbohydrate and dietary management of individuals with insulin-requiring
      diabetes.

PMID- 8359098
TI  - Metabolic and hemodynamic effects of metformin and glibenclamide in normotensive
      NIDDM patients.
AB  - OBJECTIVE: To compare the metabolic and hemodynamic effects of metformin and
      glibenclamide in normotensive NIDDM patients. RESEARCH DESIGN AND METHODS: After
      a 2-wk run-in period on dietary treatment alone, 12 Chinese normotensive patients
      with uncomplicated NIDDM were randomized to receive either metformin, or
      glibenclamide for 4 wk before being crossed-over to the alternative treatment for
      an additional 4 wk. Metabolic and hemodynamic index, including cardiac output
      estimation by impedance cardiography, were measured at baseline and at the end of
      each treatment period. RESULTS: Body mass index was reduced more with metformin
      than with glibenclamide, although glycemic control was similar with both drugs.
      Plasma total cholesterol concentration fell more with metformin (mean difference 
      0.65 mM, 95% confidence interval -0.96 to -0.32) than glibenclamide (mean
      difference -0.20 mM, 95% confidence interval -0.54-0.12) (P < 0.05). Compared
      with baseline values, erect diastolic blood pressure was reduced more by
      metformin (12.9% [95% confidence interval -21.5 to -4.4%]) than glibenclamide (
      6.8% [95% confidence interval -14.9 to 1.2%]) (P < 0.001). The relative changes
      in the systemic vascular resistance index also differed between the two
      treatments (glibenclamide, 6.2 [-4.3 to 16.6%]; metformin, -1.2 [95% confidence
      interval -8.8-6.4%]) (P < 0.05)]. CONCLUSIONS: In normotensive NIDDM patients,
      treatment with metformin was associated with greater reductions in body weight,
      plasma total cholesterol concentration, and erect diastolic blood pressure,
      whereas the systemic vascular resistance index increased after treatment with
      glibenclamide. These findings merit long-term investigation.

PMID- 8359100
TI  - Finding the right fit for meal planning.

PMID- 8359101
TI  - Should the bee suck honey or lard? That is the question.

PMID- 8359102
TI  - Extensor plantar response in diabetic neuropathy.

PMID- 8359103
TI  - Hunger--a common symptom of hypoglycemia.

PMID- 8359104
TI  - What is a significant change in the level of HbA1c?

PMID- 8359105
TI  - Acute insulin response to glucose and glucagon in subjects at risk of developing
      type I diabetes.
AB  - OBJECTIVE: To determine if knowledge of characteristics of insulin response to
      various secretagogues during the preclinical phase of type I diabetes may
      facilitate the diagnosis of subjects at risk. RESEARCH DESIGN AND METHODS: A test
      consisting of sequential intravenous challenge with glucose (0.3 g/kg) and
      glucagon (1 mg, 10 min after the end of glucose injection) was performed on 171
      ICA- relatives of type I diabetic patients, 18 ICA+ relatives of type I diabetic
      patients, and 5 transiently hyperglycemic subjects. Acute response to glucose was
      expressed as the sum of plasma insulin at 2 and 5 min and response to glucagon as
      the increase in plasma insulin after 10 min. RESULTS: Responses below the lower
      95% confidence interval in the ICA- population (40 and 43 microU/ml for glucose
      and glucagon, respectively) were considered abnormal. The two values were
      correlated (r = 0.62). Abnormalities coexisted in 2.3% of the ICA- group, 11% of
      the ICA+ group, and 100% of the transiently hyperglycemic group. All the
      relatives who subsequently developed diabetes or hyperglycemic subjects who
      required insulin exhibited combined abnormalities. Some ICA- and ICA+ relatives
      were tested repeatedly over a follow-up period of 1.5-4 yr. Although the
      intraindividual coefficient of variation for the two responses was high (28 and
      30%), values tended to run parallel in both ICA+ and ICA- relatives. In 2
      patients monitored for 2 and 4 yr before diabetes developed, both responses
      declined at the same rate. In terms of prediction of diabetes, sensitivity of
      combined abnormalities was high (100%). But compared with the intravenous glucose
      tolerance test, improvement of specificity by the double challenge was not
      statistically significant. CONCLUSIONS: Both insulin responses to glucose and
      glucagon are related. They depend on the secretory capacity of beta-cells and
      simultaneously become abnormal in the prediabetic phase.

PMID- 8359106
TI  - Stability over time of modern diagnostic criteria for type II diabetes.
AB  - OBJECTIVE: To examine the long-term stability of the World Health Organization
      criteria for diabetes in the 8-yr follow-up of the San Antonio Heart Study. A
      problem with older criteria for diagnosing diabetes was that many individuals
      classified as having borderline or chemical diabetes reverted to nondiabetic
      status on follow-up. Few studies have addressed this issue among diabetic
      patients who meet the more stringent, modern National Diabetes Data Group or
      World Health Organization criteria. RESEARCH DESIGN AND METHODS: We studied 98
      Mexican-American and 44 non-Hispanic white type II diabetic patients 8 yr after
      they were diagnosed according to World Health Organization criteria in a
      population-based epidemiological survey. Patients were classified as follows:
      whether they were on pharmacological treatment for diabetes at baseline, or, if
      not, whether they had a prior diagnosis of diabetes at the time of their baseline
      survey visit or were newly diagnosed. RESULTS: Of the 142 patients who met the
      study criteria for type II diabetes at baseline and whose status at follow-up was
      known, 20 (14.1%; 95% confidence interval 9.0-20.5%) no longer met criteria at
      follow-up 8 yr later. All but 2 of those who reverted to nondiabetic status were
      from the newly diagnosed group. Two of 20 had lost more than 5.0 kg over the 8 yr
      and an additional 5 had lost 2.5-5.0 kg. The 20 patients who reverted to
      nondiabetic status lacked many of the associated anthropometric, physiological,
      and metabolic findings of diabetes such as obesity, unfavorable body fat
      distribution, and dyslipidemia. Moreover, only one had proteinuria, and none had
      any grade of diabetic retinopathy at baseline. CONCLUSIONS: Epidemiological
      surveys that rely on a single oral glucose tolerance test to determine the
      prevalence of type II diabetes may overestimate prevalence by as much as 16% (95%
      confidence interval 10.5-23.6%) (142/122 = 1.16). The actual overestimate could
      well be less because some patients who truly have diabetes at baseline may be in
      remission at follow-up as a result of significant weight loss. Despite these
      difficulties, the modern National Diabetes Data Group and World Health
      Organization criteria are more stable than earlier criteria.

PMID- 8359107
TI  - Seven years of remission in a type I diabetic patient.
AB  - OBJECTIVE: To analyze factors contributing to a long-term remission in a patient
      with type I diabetes. RESEARCH DESIGN AND METHODS: The patient was treated with
      cyclosporin for 16 mo after a short duration of symptoms. During the 7-yr follow
      up, we tracked his glycemic control, oral glucose tolerance, insulin sensitivity,
      endogenous insulin secretion, and beta-cell immunology. The results are compared
      with those of matched diabetic patients and healthy control subjects. RESULTS:
      Insulin therapy was discontinued after 5 wk. Thereafter the patient had normal
      fasting and home blood glucose concentrations and near-normal HbA1c without
      insulin therapy for 7 yr. During this period, he maintained islet cell
      antibodies, although his basal and glucagon-stimulated C-peptide concentrations
      were normal. He participated in active physical training and had an insulin
      sensitivity higher than in sedentary control subjects or trained diabetic
      patients and equal to that in healthy athletes. His oral glucose tolerance
      decreased gradually and became diabetic during the last 3 yr. CONCLUSIONS: In
      this patient, an early start of cyclosporin therapy probably contributed to the
      maintenance of endogenous insulin secretion, and insulin sensitivity was high
      because of physical training. Consequently, the patient was able to maintain
      normoglycemia without exogenous insulin therapy for 7 yr.

PMID- 8359108
TI  - A prospective population-based study of microalbuminuria as a predictor of
      mortality in NIDDM.
AB  - OBJECTIVE: To assess prospectively the relationship between microalbuminuria and
      mortality in a geographically defined population of NIDDM patients and to
      determine the relative importance of microalbuminuria as a risk factor for
      mortality. RESEARCH DESIGN AND METHODS: A survey of known diabetes undertaken in
      1982 identified a cohort of 249 NIDDM patients. Follow-up information was
      available for 246 patients who contributed 1498 person-yr exposure and were
      followed up for a mean period of 6.1 yr. The median age of the cohort at entry
      was 68 yr (range 28-89 yr), and the median duration of diabetes was 7 yr (range 1
      41 yr). At baseline, a clinical examination was performed and a random daytime
      urine specimen was obtained for measurement of urinary albumin concentration.
      RESULTS: UAC results were available for 236 patients: 45 (19%) patients had a UAC
      > 15- < 40 mg/L; 36 (15%) had a UAC 40-200 mg/L; 10 (4%) had a UAC > 200 mg/L;
      and 145 (61%) had a normal UAC < or = 15 mg/L. During the follow-up period, 93
      patients died. All-causes mortality, expressed as standardized mortality ratio
      (SMR = 149) and coronary heart disease mortality (CHD SMR = 166) were
      significantly increased. This excess mortality was significant in women (all
      causes SMR = 194, CHD SMR = 234) but not in men (all-causes SMR = 118, CHD SMR =
      128). On univariate analysis, systolic blood pressure was the only significant
      association with albumin concentration (P = 0.0002). An age-stratified log-rank
      test was conducted to determine the effect of potential explanatory variables on
      survival. Survival distributions were significantly different for known duration
      of diabetes (P = 0.045), intermittent claudication (P = 0.012), severity of
      retinopathy, lens opacity (P < 0.001) and UAC (P = 0.013) and diastolic blood
      pressure approached significance (P = 0.051). After adjusting for the effects of
      these potentially confounding variables identified by the log-rank analysis,
      significant predictors of early mortality on multivariate survival analysis were
      age, UAC of 40-200 mg/L (relative risk = 2.2, 95% confidence interval 1.3-3.7),
      more severe retinopathy (relative risk = 3.4, 95% confidence interval 1.9-6.0),
      and lens opacity (relative risk = 2.4, 95% confidence interval 1.6-3.8).
      CONCLUSIONS: The findings from this population-based cohort confirm the
      predictive power of microalbuminuria as a risk factor for mortality in NIDDM. In
      contrast to prospective studies of conventional cardiovascular risk factors in
      NIDDM, consistent evidence indicates that microalbuminuria is an independent
      predictor of excess mortality regardless of the collection procedure used.

PMID- 8359109
TI  - Restenosis after coronary angioplasty.
AB  - Coronary angioplasty is used to treat coronary disease in many patients.
      Indications for angioplasty have expanded since it was first performed, mainly as
      a result of improvement in equipment and techniques. One problem with coronary
      angioplasty is the phenomenon of renarrowing of the treated coronary lesion, a
      process called restenosis. The events that constitute restenosis appear to be a
      universal response to the arterial wall injury of angioplasty. They are currently
      characterized as follows: platelet adhesion and aggregation on the damaged
      endothelium and within deep splits into the tunica media; release of platelet
      derived growth factors; inflammation of the mechanically injured medial zone;
      transformation of smooth muscle cells of the tunica media after their activation
      by several of the growth-promoting substances; migration and proliferation of
      transformed smooth muscle cells, with secretion of copious amounts of
      extracellular matrix material; and, finally, termination of the growth process
      with regrowth of endothelium over the injured area. A decade of research work has
      helped identify clinical correlates of restenosis after coronary angioplasty
      procedures. This work is hindered by lack of a uniform angiographic definition of
      restenosis. In addition, much of the information has come from small studies,
      with incomplete follow-up and retrospective orientation. Nevertheless, some data
      are available. Patient-related correlates include male gender, unstable angina,
      diabetes, and continued smoking after angioplasty. Lesion-related correlates
      include multilesional and multivessel procedures, higher postangioplasty residual
      stenosis, proximal vessel location, location in the left anterior descending
      artery, location in a vein graft, long lesions, and total occlusions. The only
      consistent procedure-related correlate has been incorrect sizing of the
      angioplasty balloon to the treated artery. For the purposes of individual patient
      care, clinical correlates are not helpful. No group of variables has been found
      to be associated with complete freedom from restenosis, and no group is
      completely predictive of restenosis. All patients undergoing angioplasty
      procedures require some follow-up through subsequent months and years. Symptom
      status and the results of noninvasive studies have been investigated for purposes
      of follow-up. Symptoms are virtually useless by themselves for predicting
      restenosis or its absence. When symptom status is combined with exercise thallium
      201 scintigraphy performed 4 to 6 months after an angioplasty procedure, the two
      factors are less than ideal but have a negative predictive value of more than
      90%. This means that more than 90% of patients who have neither symptoms nor
      evidence of ischemia by thallium 201 scintigraphy will not have angiographic
      restenosis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8359110
TI  - [The diagnosis and differential diagnosis of Crohn's disease and ulcerative
      colitis by hydrocolonic sonography].
AB  - As part of a prospective study the value of hydrocolonic sonography in the
      diagnosis and differential diagnosis of Crohn's disease (CD) and ulcerative
      colitis (UC) was assessed and compared with that of coloscopy as standard
      reference. Of 440 patients who were examined, 41 (23 men, 18 women; mean age 25
      +/- 6 years) had CD and 36 (20 men, 16 women; mean age 32 +/- 8 years) had UC. CD
      and UC were correctly diagnosed by hydrocolonic sonography in 39 and 33 cases,
      respectively (sensitivity 95 and 91%, specificity 100 and 99%, respectively).
      Among healthy subjects five layers of variable echo density were demonstrated in
      the intestinal wall, while in all those with CD the wall was clearly thickened
      and in 36 of them the wall structure was also abnormal. In 16 patients the wall
      structure was homogeneous without evidence of layers and in 20, layers 1-3 were
      not demonstrable and layers 4 and 5 only rudimentary. In contrast, the 33
      patients with UC diagnosed by hydrocolonic sonography had only slight thickening
      of the intestinal wall and all layers were present in 30 of them. CD and UC were
      correctly distinguished in 91%. Hydrocolonic sonography makes it possible to
      demonstrate in detail the structural changes in the intestinal wall in CD and UC
      so that the two conditions can be distinguished.

PMID- 8359111
TI  - [An increase in cardiopulmonary exercise tolerance after the embolization of a
      pulmonary arteriovenous fistula].
AB  - A 21-year-old woman suffering from increasing dyspnoea on intense physical
      exercise, was found to have a congenital right-sided arteriovenous pulmonary
      fistula. This was successfully and without complication embolized using a
      percutaneously introduced Gianturco wire coil. All symptoms disappeared after
      this procedure. Definite improvement in physical performance, in comparison with
      pre-embolization values, was documented by spiroergometry as early as two days
      later (oxygen uptake 1855 vs. 1459 ml/min; anaerobic threshold 920 vs. 790
      ml/min; oxygen-pulse 10.6 vs. 8.0 ml/beat; oxygen partial pressure 77.5 vs. 67.6
      mmHg; alveolar arterial oxygen difference 33 vs. 44 mm Hg). Further constant
      subjective and objective improvement in physical performance was demonstrated 3
      months after embolization. This case confirms that embolization of a pulmonary
      arteriovenous fistula can rapidly achieve lasting improvement in exercise
      performance.

PMID- 8359112
TI  - [The diagnostic value of shoulder arthroscopy].

PMID- 8359113
TI  - [The diagnosis and therapy of immunologically mediated polyneuropathies].

PMID- 8359114
TI  - [The right of the chief physician to inspect his personal file. The judgement of
      the Federal Labor Court of 8 April 1992].

PMID- 8359115
TI  - [Hilus amputation].

PMID- 8359117
TI  - [The transmission of myeloid leukemia by preserved blood].

PMID- 8359116
TI  - [Thrombosis recurrence in pregnancy].

PMID- 8359118
TI  - [The treatment of Candida peritonitis during peritoneal dialysis].

PMID- 8359119
TI  - [Gallbladder poly].

PMID- 8359120
TI  - [The therapy of Lyme borreliosis].

PMID- 8359121
TI  - [The "important physician"].

PMID- 8359122
TI  - [Complications following ambulatory liver biopsy].

PMID- 8359123
TI  - Retirement plan investment strategies for fiftysomething investors.

PMID- 8359124
TI  - Discrimination: individual rights vs. mandated behavior.

PMID- 8359125
TI  - Potentials recorded from neck and supraclavicular fossa during a rapid voluntary
      contraction of the triceps brachii muscle.
AB  - Two experiments were performed in order to study whether it is possible to record
      potentials related to the voluntary movement from electrodes placed on the skin
      overlying the spinous process of the 2nd and 6th cervical vertebrae and at Erb's
      point ipsilateral to the movement. In the first series of experiments (Experiment
      I) the subject initiated spontaneously an arm movement accompanying a contraction
      of the right triceps brachii muscle. Rapid extension of the right 5 fingers was
      also performed self paced. Recordings of the potentials were referential to the
      left knee. The morphology of the potentials from the neck and Erb's point did not
      differ among time constants, between experimental days, among subjects and
      between the arm movement and the finger movement. A negative deflection of the
      cervical potential started preceding the onset of the electromyogram (EMG). This
      negativity was followed by a positive deflection after the EMG onset. The
      positive potential was followed by a negative deflection during the rising phase
      of the EMG. In the second series of experiments the subject performed both
      reaction and self-paced arm movements. The prime mover was the same as the
      agonist in Experiment I. Morphology of the potentials recorded with monopolar and
      bipolar derivations did not differ between the differently initiated movements
      and among the subjects. The morphology of the potentials from the neck and Erb's
      point was the same as the morphology of the potentials recorded in Experiment I.
      The present results indicate that it is possible to record the potentials related
      to the voluntary movement from neck and supraclavicular fossa.

PMID- 8359126
TI  - Usefulness of motor evoked potentials in compressive myelopathy.
AB  - Motor Evoked Potentials elicited by transcranial magnetic stimulation were
      recorded from 1 degree Dorsal Interosseus for the upper limbs and from Extensor
      Digitorum Brevis for the lower limbs in 42 subjects with compressive myelopathy
      (36 in the cervical region and 6 in the dorsal region), radiologically defined by
      Nuclear Magnetic Resonance (NMR) imaging, with no clinical and radiological signs
      of radiculopathy. Central motor conduction abnormalities in the cortex-C8 and
      cortex-L5 tract were compared with clinical signs of motor impairment and with
      NMR findings. The subjects with medullar hyperintensity of NMR signal at the
      compression site level, showed a central conduction time (C.C.T.) prolongation in
      at least one side in the 70% of cases in the cortex-C8 tract and in the 95% of
      cases in the cortex-L5 tract, while in the cases with no compression site
      alterations of signal, C.C.T. abnormalities were observed only in 25% in the
      cortex-C8 tract and in 42% in the cortex-L5 tract. In 12 subjects (10 with
      cervical compression and 2 with dorsal compression) we compared Motor Evoked
      Potentials before, two weeks and two months after surgical decompression. The
      C.C.T. cortex-C8 and cortex-L5 improved at least in one side in 11 out of the 12
      subjects, showing a good correlation with clinical recovery. In the examined
      patients we found a latency reduction statistically significant between the first
      and second investigation, with a trend to stabilization in the following
      controls.

PMID- 8359127
TI  - Recruitment patterns in the cervical paraspinal muscles during cervical forward
      flexion: evidence of cervical flexion-relaxation.
AB  - The phenomenon of lumbar paraspinal flexion-relaxation has been well established
      and its clinical significance to low back pain has been demonstrated. Conversely,
      cervical paraspinal flexion-relaxation has not been consistently observed. This
      may be attributable to the inappropriate use of trunk flexion motion used to
      observe the phenomenon in previous studies. This investigation reports on the
      observance of cervical flexion-relaxation when flexion is limited to the cervical
      spine. Results demonstrate the observance of cervical flexion-relaxation in ten
      of ten asymptomatic subjects when flexion is limited to the cervical region in
      the seated orthograde position.

PMID- 8359128
TI  - Electromyography of walking in obese children.
AB  - The electromyographic activity of six lower extremity muscles during three speeds
      of walking was examined in fourteen (14) (10 obese and 4 normal weight) pre
      pubertal children aged 8.5-10.5 years. Ensemble average EMG patterns of six lower
      extremity muscles at three speeds of walking were compared in obese pre-pubertal
      and normal weight children. The pattern of EMG activity and phasic
      characteristics did not change appreciably across the three speeds of walking for
      either group. The lack of significant change in EMG amplitude with altered speed
      of walking was contrary to the results of previous studies. Studies involving
      different weight groups and analyses that involve walking over greater distances
      are required to provide an alternative data base to normal weight children.

PMID- 8359129
TI  - Similarity in shape, timing and amplitude of H- and T-reflex potentials
      concurrently recorded along the broad skin area over soleus muscle.
AB  - Variations in shape, timing and amplitude of both mono- and bipolarly measured H-
      and T-reflex potentials can be influenced to a great extent by the muscle
      architecture and the peculiarities of the extracellular potential field. The
      "best point" for bipolar measurements, where the amplitude of the bipolar H- and
      T-potentials is maximal, occurred for the various subjects at a distance of 3.0
      to 5.0 cm below the insertion of the gastrocnemii on the Achilles tendon. In
      contrast, the corresponding "best point" for monopolar H- and T-potentials is
      located 5.0 to 9.0 cm below the gastrocnemii insertion. The shape, total duration
      and timing of H- and T-potentials, concurrently measured at the various points
      along soleus muscle are similar. When the amplitude of the monopolar H- and T
      potentials are levelled at the "best point" for monopolar measurements, the
      changes in the amplitude of both sets of potentials, monopolarly and bipolarly
      measured along soleus muscle, are identical. These results imply similar efferent
      outputs for both H- and T-reflexes, i.e. recruitment of motoneurons of comparable
      size.

PMID- 8359130
TI  - Impaired activation pattern in antagonistic elbow muscles of patients with
      spastic hemiparesis: contribution to movement disorder.
AB  - Surface electromyographic "EMG" activity in biceps brachii (agonist muscle) and
      triceps brachii (antagonist muscle) as well as the discharge behaviour of motor
      units "MUs" (needle recording) in biceps brachii muscle were recorded during slow
      (0.33 Hz) and fast (0.66 Hz) voluntary elbow flexion movements (auditory matching
      task) in fifty patients with spastic hemiplegia. In the spastic limbs, a long
      lasting, small amplitude tonic co-contraction of antagonist muscles was seen
      during slow flexions (SF) in 29 cases. This effect was strongest during the fast
      elbow flexion movements (FF). In 33 patients a triphasic pattern of muscle
      activation was observed on the unaffected side but not on the spastic side. The
      amplitude of the agonist surface EMG was significantly reduced and the amplitudes
      of the MU potentials recruited during maximal effort were generally smaller on
      the spastic side compared to the unaffected side. The agonist-antagonist
      activation pattern was analysed with respect to three clinically identifiable
      functional recovery stages of voluntary movements in the spastic limbs, namely
      synergistic, isolated and useful movements. The MU amplitudes and the amplitude
      of the surface EMG activity in the agonist muscle recorded during FF movements
      became significantly larger whereas the amplitude of the antagonist tonic
      activity became smaller with increasing functional recovery of the limb. It is
      concluded that impaired recruitment of type II motor units in the agonist muscles
      and the inability to selectively activate the agonist muscle contribute to the
      deficit in motor performance in spastic paresis.

PMID- 8359131
TI  - Functional anatomy of the hand.
AB  - The emphasis of this review is on anatomy as related to function of the hand. We
      have described all aspects of functional anatomy from the skin to the skeletal
      framework. This article provides a concise overview of the hand and intricacies.

PMID- 8359132
TI  - Evaluation of the injured hand.
AB  - Hand disorders are common emergency department problems. They may be associated
      with long-term disability and significant financial impact for the patient and
      society. In many areas of clinical medicine, highly technical diagnostic and
      therapeutic modalities have taken center stage. In contrast, an accurate history
      and carefully performed physical examination of the hand retains a central and
      pivotal role in hand evaluation and treatment.

PMID- 8359133
TI  - Hand infections.
AB  - Special approaches are required for management of infected wounds involving the
      hand. Care must be taken to consider involvement of joint, bone, and tendon, or
      tendon sheath as well as deep fascial spaces. The hand is also prone to
      infections with unusual microbiology that can result from animal and human bites
      as well as soil, plant, and water exposures. The special anatomic and
      microbiologic considerations are critical for selection of proper surgical and
      medical therapy to preserve function of this vital structure.

PMID- 8359134
TI  - Flexor tendon injuries of the hand.
AB  - Flexor tendon injuries can be problematic injuries from the time of occurrence
      until the patient returns to full and complete recovery. There are many
      misadventures that can occur along the way. The emergency physician must be
      keenly aware of the anatomy involved, and a careful history and physical
      examination must be performed. The diagnosis may be obvious or subtle, and the
      emergency physician must methodically search for the unsuspected injury. An
      appropriate referral should be initiated soon after an injury is determined. The
      hand surgeon has many considerations and obstacles in flexor tendon repairs, but
      good to excellent results can be expected in up to 80% of patients if the
      emergency physician and the hand surgeon work together to ensure an optimal
      patient outcome.

PMID- 8359135
TI  - Extensor tendon injuries of the hand.
AB  - Extensor tendon injuries are often initially evaluated and diagnosed in the
      Emergency Department. These injuries may be painfully obvious or frightfully
      subtle, but if the emergency physician has a firm understanding of the anatomy
      involved and he or she embarks on a careful and complete history and physical
      examination, the diagnosis should be made. There are various considerations in
      the ultimate treatment and outcome for the patient, and the patient's best
      interests are served when the emergency physician provides the initial
      appropriate treatment and proper disposition.

PMID- 8359136
TI  - Nerve injuries in the hand.
AB  - Nerve injuries of the hand are an important problem for the emergency physician
      because most are diagnosed in the emergency setting. Successful diagnosis and
      treatment are critical if the injured patient is to regain full hand function.
      Emergency department management relies on the knowledge of hand and forearm
      functional anatomy and techniques for diagnosing loss of nerve function. Once a
      nerve injury has been diagnosed, issues such as primary versus secondary repair
      must be discussed with the hand surgeon. The hand surgeon must consider whether
      to pursue an epineurial or fascicular repair and must use additional techniques
      for diagnosing return of nervous function. Lack of nerve regeneration, chronic
      paresthesias, neuromas, and sympathetic dystrophy can complicate the successful
      return of hand nerve function after injury.

PMID- 8359137
TI  - Metacarpal and phalangeal fractures.
AB  - Metacarpal and phalangeal fractures are common presenting injuries in many
      emergency departments. The emergency physician should become skilled at properly
      evaluating and initiating appropriate management and follow-up for these injuries
      when they occur. Failure to properly do so may result in permanent disability.

PMID- 8359138
TI  - Wrist fractures.
AB  - The various types of wrist fractures are described. Keeping in mind the anatomy
      and biomechanics of the wrist assists in the detection of these injuries. The
      clinical and radiographic findings are discussed and the various associated
      injuries that may go undiscovered without maintaining a high index of suspicion.

PMID- 8359139
TI  - Ligamentous wrist injuries.
AB  - The wrist is one of the most complex joints of the body. Wrist injuries are quite
      common, yet improper diagnosis of ligamentous injuries as simply 'sprains' often
      occurs. Understanding the functional anatomy and mechanics of the wrist is
      extremely important in appreciating the spectrum of injuries that occur there. A
      review of the analysis and detection of potential injuries is provided.

PMID- 8359140
TI  - Amputations and replantations.
AB  - Essential aspects of emergency department assessment and initial treatment of
      patients with traumatic amputations are outlined. Pitfalls of early treatment and
      indications for replantation are discussed. The dogmatic approach is avoided.

PMID- 8359141
TI  - Fingertip and nail bed injuries.
AB  - Nail bed and fingertip injuries are commonly seen in the Emergency Department.
      Each of these injuries must be evaluated carefully not only for the acute
      situation but for the possible long-term effects. Nail bed injuries must be
      appropriately diagnosed and treated initially because a secondary repair is often
      unsatisfactory. Fingertip injuries must provide the patient with a sensitive
      fingertip with sufficient length for effective use of the finger. The initial
      care and treatment are vital for the best patient outcome.

PMID- 8359142
TI  - Special injuries of the hand.
AB  - Unique injuries resulting from high-pressure injection, wringer washers,
      cornpickers, and snowblowers are presented. Epidemiology, pathophysiology,
      clinical presentation, and management are reviewed. These injuries commonly
      require surgical intervention. Prompt recognition and treatment can greatly
      influence prognosis.

PMID- 8359143
TI  - Acute joint injuries of the hand.
AB  - The joints of the hand are stabilized by articular contours, tough ligamentous
      structures, and dynamically by a system of flexor and extensor tendons.
      Disruption of a joint seriously reduces the ability of the hand to function
      properly. The history and especially a detailed description of the mechanism of
      injury is invaluable information for the diagnosis and for the ability to
      anticipate complications. Radiographic evaluation is required for virtually all
      potential injuries. Multiple views and especially a true lateral view of the
      digit, when appropriate, are usually sufficient. The clinical examination
      includes the evaluation of (1) deformity, (2) swelling, (3) tendon and
      neurovascular status, (4) tests for stability, and (5) active and gentle passive
      range of motion. The most important aspect of treatment is the ability to
      distinguish between injuries that require surgery and those that can be splinted
      and referred for follow-up. In general a near full range of active motion
      indicates joint congruity, and the injury can be treated by splinting and
      referral to a hand surgeon.

PMID- 8359144
TI  - Emergency department treatment of hand burns.
AB  - The hand burn, although small, can cause significant loss for the patient.
      Therefore, decisive attention to preserve the skin and the function of the
      fingers is required. This article reviews assessment of burn injuries, types of
      burn injuries, and treatment. Pain management information is provided along with
      recommended antibiotic regimens. Criteria on admission versus outpatient
      treatment, which is particularly relevant for the emergency physician, is also
      presented.

PMID- 8359145
TI  - Conformational properties of the -35 region of the trp promoter in solution:
      comparison of the wild-type sequence with an AT transversion.
AB  - The majority of the 1H NMR resonances of the protons in a tetradecamer containing
      the -35 region of the trp promoter d(GCTGTTGACAATTA): d(TAATTGTCAACAGC) and in
      the TA transversion have been assigned. The conformational properties of the
      nucleotides have been determined and compared in the two duplexes. Analysis of
      spin-spin coupling and NOEs shows that all sugar puckers are in the south domain
      (i.e. near C2' endo) and the glycosidic torsion angles are anti (chi
      approximately 110 degrees). The NMR data are consistent with the duplex being in
      the B family of conformations. Significant differences in chemical shifts between
      the two molecules were observed only for nearest neighbours to the transversion
      site, suggesting the absence of long range conformational effects. This was
      confirmed by the similarity of coupling constants and NOEs. Other properties are
      also not greatly affected at positions more than two base pairs from the mutation
      site. These results are consistent with the hypothesis that unconstrained
      oligonucleotides are highly flexible, and can readily accommodate significant
      perturbations of the local structure, such as a transversion.

PMID- 8359146
TI  - Structure of clathrin-coated vesicles from small-angle scattering experiments.
AB  - Previously published small-angle neutron and X-ray scattering data from coated
      vesicles, reassembled coats, and stripped vesicles have been analyzed in terms of
      one common model. The neutron data sets include contrast variation measurements
      at three different D2O solvent concentrations. The model used for interpreting
      the data has spherical symmetry and explicitly takes into account polydispersity,
      which is described by a Gaussian distribution. A constant thickness of the
      clathrin coats is assumed. The fitting of the model shows that the coated
      vesicles consist of a low-density outer protein shell (clathrin) and a central
      protein shell (accessory polypeptides and receptors) of approximately six times
      higher density. For the X-ray scattering and neutron contrast variation data, the
      polydispersity of the samples is of the order of 90 A (full-width-at-half-maximum
      value) and the average outer radius is approximately 400 A. The inner high
      density shell has inner and outer radii of 115 and 190 A, respectively. A
      simultaneous fit to the three neutron contrast variation data sets identifies the
      lipid membrane with a thickness of 40 A and an outer radius of 196 A. Thus, the
      membrane and the high-density protein shell overlap in space, which shows that
      the lipid membrane contains protein. The molecular mass of the average particle
      is 27 x 10(6) Da. The coated vesicles consist, on average, of approximately 85%
      protein and 15% lipids. About 40% of the protein mass is situated in the central
      high-density shell, which gives a large amount of protein in the lipid membrane.
      The densities of the central shell and the lipid membrane show that the hydration
      is small in the central region. A comparison of the total mass, the mass
      distribution, and the structure of the average-size particles with the barrel
      structure shows that the accessory polypeptides are incorporated in the lipid
      membrane. The results from the neutron data for the reassembled coats show that
      the structure of these particles is very similar to the structure of the native
      coats. The main difference is a higher density of the central protein shell,
      which shows that the membrane is replaced by protein in the reassembled coats.

PMID- 8359147
TI  - The existence of non-axisymmetric bilayer vesicle shapes predicted by the bilayer
      couple model.
AB  - The existence of non-axisymmetric shapes with minimal bending energy is proved by
      means of a mathematical model. A parametric model is used; the shapes considered
      have an elliptical top view whilst their front view contour is described using
      Cassini ovals. Taking into account the bilayer couple model, the minimization of
      the membrane bending energy is performed at a constant membrane area A, a
      constant enclosed volume V and a constant difference between the two membrane
      leaflet areas delta A. It is shown that for certain sets of A, V and delta A the
      non-axisymmetric shapes calculated with the use of the parametric model have
      lower energy than the corresponding axisymmetric shapes obtained by the exact
      solution of the general variational problem. As an exact solution of the general
      variational problem for non-axisymmetric shapes would yield even lower energy,
      this indicates the existence of non-axisymmetric shapes with minimal bending
      energy in a region of the V/delta A phase diagram.

PMID- 8359151
TI  - Micronucleus test and erythropoiesis: effect of cobalt on the induction of
      micronuclei by mutagens.
AB  - The micronucleus test is used widely as an in vivo short-term assay for potential
      carcinogens. In the present study, results of the micronucleus test were affected
      by cobalt dichloride pretreatment. Cobalt dichloride was used to induce
      erythropoietin, a growth factor for erythropoiesis. The increase in mutagen
      induced micronucleus response following cobalt pretreatment, therefore, may have
      been due to a change in the rate of erythropoiesis. The greatest interaction
      between cobalt pretreatment and mutagen treatment for the induction of
      micronucleated polychromatic erythrocytes (MPCE) occurred when mice were injected
      with 1,1-dimethylhydrazine (DMH) 12-24 hr after pretreatment with cobalt
      dichloride and killed 30 hr later. Increased sensitivity of the micronucleus test
      was attributable to the administration of mutagen during the differentiation and
      multiplication of erythroblast, which is presumed to have been accelerated by
      pretreatment with cobalt dichloride. An increased induction of MPCE in the bone
      marrow by two chemicals--benzo(a)pyrene, 2-naphthylamine--was also observed
      following pretreatment with cobalt dichloride.

PMID- 8359152
TI  - Investigation of aneuploidy induction in mouse oocytes following exposure to
      vinblastine-sulfate, pyrimethamine, diethylstilbestrol diphosphate, or chloral
      hydrate.
AB  - The various causative and mechanistic phenomena associated with aneuploidy
      induction require considerable investigation to better understand the etiology of
      chromosome missegregation. We investigated the potential of vinblastine sulfate,
      pyrimethamine, diethylstilbestrol diphosphate, and chloral hydrate to induce
      numerical and structural chromosome changes in female mouse germ cells.
      Superovulated ICR mice were administered the compounds either by intraperitoneal
      injection or oral gavage, and oocytes were collected and processed for
      cytogenetic analysis 17 hr later. Vinblastine sulfate, administered i.p., induced
      a significant increase in the frequency of ovulated MI oocytes and of hyperploid
      MII oocytes compared to controls, but did not increase the frequency of
      structural aberrations. Pyrimethamine, diethylstilbestrol diphosphate, and
      chloral hydrate did not increase the frequency of numerical or structural
      chromosome changes in female mouse germ cells.

PMID- 8359153
TI  - Genotoxic activity detected in soils from a hazardous waste site by the Ames test
      and an SOS colorimetric test.
AB  - Ten soil samples from a hazardous waste site were compared for their genotoxic
      activity by the Ames test (Salmonella reverse mutation assay) and a modified SOS
      colorimetric test. Polynuclear aromatic hydrocarbons known to produce frameshift
      mutations were found in high levels in the soils. Salmonella typhimurium TA98,
      sensitive to frameshift mutations, was selected as the Ames tester strain.
      Escherichia coli K12 PQ37 (sulA::lacZ) was the SOS tester strain. Organic
      extracts were prepared from the soil samples by Soxhlet extraction. One set of
      the soil samples was extracted with methylene chloride and a second set with
      cyclohexane. Two criteria from reproducible dose-related increases in response to
      the soil were used to compare the positive responses: 1) the concentrations
      required for doubling responses and 2) a minimum concentration required to
      produce statistically significant increases from background controls. Analysis of
      variance indicated that with S9 mix, Ames and SOS results were similar for the
      same soils and solvent extractions. However, without S9 mix, the SOS test was
      significantly more sensitive than the Ames test to the genotoxins extracted from
      the soils. Both the Ames and SOS tests detected lower concentrations of
      genotoxins in methylene chloride than in cyclohexane extracts. The simplicity of
      the method, reduction in expenses, and results within 1 working day all
      contribute to the advantages of the SOS test.

PMID- 8359154
TI  - Chemico/biological investigation of contaminated sediment from the Hamilton
      Harbour area of western Lake Ontario.
AB  - Highly contaminated sediment from the Hamilton Harbour area of western Lake
      Ontario was examined using a bioassay-directed fractionation methodology. A
      sediment sample was extracted using a Soxhlet apparatus and the resulting extract
      was fractionated into compound classes using an alumina clean-up step and high
      performance liquid chromatographic techniques. The resulting fractions were
      subjected to bioassays using TA98- and TA100-like strains modified by the
      inclusion of genes for the activating enzymes nitroreductase and O-acetyl
      transferase. The majority of the mutagenic activity displayed by the sample
      extract was found to be present in the fraction containing the polycyclic
      aromatic hydrocarbons (PAH). Extracts of the PAH-containing fraction displayed
      dramatically higher responses with the TA100 type strains with metabolic
      activation. Further separation of the PAH-containing fraction showed the majority
      of the biological activity coeluted with PAH having molecular masses of 276, 278,
      and 302 amu.

PMID- 8359155
TI  - Molecular analysis of hypoxanthine phosphoribosyl transferase mutants induced by
      glycidyl 1-naphthyl ether in mouse spleen cells in vivo.
AB  - Treatment of C57BL/6J mice with an epoxide, glycidyl 1-naphthyl ether (GNE),
      resulted in an average of a 3.4-fold increase in frequency of 6-thioguanine
      resistant mutants of mouse spleen T-lymphocytes. In similar experiments with the
      epoxide trichloropropylene oxide, no increase in mutant frequency was found. To
      determine the kind and location of mutations in the coding region of the
      hypoxanthine phosphoribosyl transferase (HPRT) gene, 26 GNE-induced mutants and
      17 spontaneous mutants were analyzed by direct sequencing of polymerase chain
      reaction amplified cDNA. Among the GNE-induced mutants, HPRT cDNA was present in
      22, while that from 4 could not be detected. Among the spontaneous mutants, HPRT
      cDNA was present in 15 and absent in 2. Among GNE-induced mutants, base
      substitution in HPRT occurred in 15 of 22 mutants analyzed. Nine of 15 base
      substitutions involved TA base pairs, primarily TA-->CG transitions. Base
      substitutions were found throughout exons 3-7 but 46% of substitutions were
      located in exon 3 and one frameshift mutation involving a GC base pair in exon 3
      was also observed. Among the spontaneous mutants, base substitutions of HPRT
      occurred in 7 of 15 mutants analyzed with 6 of 7 base substitutions involving a
      TA base pair and another 2 of the 15 mutants showed a 4 base pair deletion. The
      base substitution spectrum in GNE-induced mutants was different from that of the
      spontaneous mutants.

PMID- 8359156
TI  - AMESFIT: a microcomputer program for fitting linear-exponential dose-response
      models in the Ames Salmonella assay.
AB  - The Ames Salmonella/microsome assay remains the most widely used microbial test
      for genotoxicity. In this article, we describe a microcomputer program developed
      to fit a linear-exponential dose-response model to Ames assay data for
      established mutagens. The model includes a linear term to describe the mutagenic
      effects of the test agent at low to moderate doses and an exponential attenuation
      factor to accommodate downturns at high doses due to cytotoxicity. Quasi
      likelihood methods are used to obtain estimates of the unknown model parameters,
      thereby avoiding the need to fully specify the distribution of the experimental
      data. This method of estimation also allows for extra-Poisson variation that is
      characteristic of counts of mutant colonies of bacteria observed in the Ames
      assay. The particular linear-exponential model used here was developed for use in
      the analysis of a recent large-scale collaborative trial using the Ames assay
      sponsored by the International Programme on Chemical Safety. The use of our
      program is illustrated using sample data sets taken from that collaborative
      study.

PMID- 8359157
TI  - Dose-dependent genotoxic effects of styrene on human blood lymphocytes and the
      relationship to its oxidative and metabolic effects.
AB  - Although the genotoxic potential of styrene is known, very limited information is
      available regarding its dose-dependent genotoxic response to human blood
      lymphocytes and how such response correlates with different metabolic events in
      whole blood lymphocytes. The present study was therefore carried out to study
      such a relationship using in vitro human blood lymphocytes from healthy
      volunteers. To study genotoxic response to styrene, sister chromatid exchanges
      (SCEs), cell cycle, and cell survival were analyzed. Lymphocytes were cultured
      for 72 hr in the presence of different concentrations of styrene (0-1,000
      microM). Twenty-four hr before harvest, BrdU (5 micrograms/ml) was added to
      assess the increase in SCEs and cell cycle delay. Both the SCE frequency and the
      cell cycle length were increased linearly with increasing concentrations of
      styrene up to 200 microM, without addition of any exogenous metabolizing system.
      Above 200 microM, no further increase in genotoxic response occurred. The range
      of concentrations (10-200 microM) at which increase of cell cycle length due to
      styrene was observed did not impair the viability of the cells, suggesting that
      such cell cycle delay is a genotoxic-related event and not caused by
      cytotoxicity. In vitro metabolic transformation of styrene in whole-blood
      lymphocyte cultures without the presence of any exogenous metabolic activation
      system showed the formation of a reactive intermediate, styrene 7,8-oxide, to be
      capacity-limited, as verified from a nonlinear increase in the formation of
      styrene glycol. The value of such metabolic parameter reached a plateau above 200
      microM styrene. The same phenomenon of saturation has also been observed with
      regard to other metabolic effects due to styrene in whole blood lymphocytes in
      culture, such as dose-dependent increase in lipid peroxidation and depletion of
      blood lymphocyte glutathione. Based on the relationship between the formation of
      different metabolic events and the genotoxicity of styrene, it may be possible
      that the genotoxic properties of styrene in human blood lymphocytes may be
      mediated initially not only by the formation of the presumably reactive styrene
      7,8-oxide, but also by that of a reactive oxygen species as well. However, the
      present data are not sufficient enough to definitely identify the role of
      reactive oxygen species in such toxicity and therefore it warrants further study.

PMID- 8359158
TI  - In vitro and in vivo assays of isopropanol for mutagenicity.
AB  - To assess the mutagenic potential of isopropanol, an in vitro Chinese hamster
      ovary (CHO) cell/HGPRT gene mutation assay and a bone marrow micronucleus study
      in mice were conducted. In the CHO/HGPRT assay, concentration levels ranged from
      0.5 to 5.0 mg/ml. No elevated mutant frequencies attributable to treatment were
      observed in the test under either activated or non-activated conditions. In the
      micronucleus assay, mice were injected intraperitoneally (IP) with either 350,
      1,173, or 2,500 mg/kg of isopropanol at constant volumes of 10 ml/kg. No
      increased incidence of micronuclei was observed in bone marrow polychromatic
      erythrocytes (PCEs) harvested at 24, 48, or 72 hr post-dosing. In both assays,
      negative and positive control mutant frequencies were within historical control
      ranges. These results, in conjunction with previously published data, clearly
      demonstrate that isopropanol is not a mutagen.

PMID- 8359159
TI  - Increasing problems in the therapy of enterococcal infections.

PMID- 8359160
TI  - One year follow-up study to assess the prevalence and incidence of Lyme
      borreliosis among Dutch forestry workers.
AB  - A one-year serological and clinical follow-up study was conducted to assess the
      prevalence and incidence of asymptomatic and symptomatic infection with Borrelia
      burgdorferi among 151 Dutch forestry workers. The prevalence of antibodies to
      Borrelia burgdorferi among the forestry workers and among office employees as
      control group was compared. Antibodies to Borrelia burgdorferi were detected by
      enzyme immunoassay. Forestry workers were examined physically at the start of the
      study. Clinical follow-up of forestry workers whose first blood sample was
      positive and of persons showing seroconversion was done by telephone interview.
      If Lyme borreliosis was suspected, clinical and laboratory data were obtained.
      The seroprevalence was significantly higher among forestry workers (28%) than
      among controls (5%). Of 127 forestry workers who were examined, 7 (18%) of the 39
      seropositive persons but none of the seronegative persons had a history of Lyme
      borreliosis. None of 32 asymptomatic seropositive forestry workers had developed
      Lyme borreliosis one year later. The incidence of infection with Borrelia
      burgdorferi as demonstrated by seroconversion among 95 initially seronegative
      forestry workers was 5%. None of them had Lyme borreliosis. Infection with
      Borrelia burgdorferi among forestry workers is frequent but seems to take a
      benign course.

PMID- 8359162
TI  - Multicentre evaluation of a biphasic culture system for recovery of mycobacteria
      from clinical specimens.
AB  - A new biphasic system (MB Check, Roche) for isolation of mycobacteria from
      clinical specimens was evaluated by eight different microbiological laboratories
      in comparison with methods routinely used in the respective laboratories.
      Altogether 1125 clinical specimens were processed; pretreatment, if performed,
      was by a variety of methods. Mycobacteria were recovered from 167 specimens with
      the biphasic system and 165 specimens with the other methods. The average time
      required for isolation of Mycobacterium tuberculosis was 22.6 days with the
      biphasic system and 24.7 days with egg-based media; for other mycobacterial
      species it was 23.5 versus 20.8 days. The inclusion of a chocolate agar section
      in the biphasic system facilitated the early detection of contaminants, while the
      NAP-containing section appeared unable to differentiate Mycobacterium
      tuberculosis from other mycobacterial species. The biphasic system, which enables
      recovery of mycobacteria in small laboratories without specialized equipment, is
      more practical than conventional methods and at least as sensitive.

PMID- 8359161
TI  - Comparison of seven commercial kits for detection of antibodies to Borrelia
      burgdorferi.
AB  - Five enzyme immunoassay (EIA) and two Western blot (WB) commercial kits were
      compared for their ability to detect antibodies to Borrelia burgdorferi. The
      panel of 53 test sera consisted of 25 sera positive for antibodies to Borrelia
      burgdorferi, 15 sera negative for such antibodies, 5 sera reactive in serologic
      tests for syphilis, and 8 sera containing antinuclear antibodies and/or
      rheumatoid factor. The rate of agreement with reference results was 93%, 90%, 90%
      and 88% for EIA kits from Diamedix, Cambridge Biotech, Mardx and Sigma
      respectively. The sensitivity and specificity was 84% and 100% respectively for
      Cambridge Biotech, 76% and 94% for Diamedix, 68% and 83% for Mardx, and 68% and
      83% for Sigma. The three confirmatory tests, Cambridge Biotech WB, General
      Biometrics P39 EIA and Mardx WB, demonstrated 75%, 60% and 63% agreement
      respectively. The sensitivity and specificity was 52% and 100% respectively for
      Cambridge Biotech WB, 24% and 100% for General Biometrics P39 EIA, and 44% and
      100% for Mardx WB. The results demonstrate the variable performance of commercial
      serologic kits for detection of antibodies to Borrelia burgdorferi. WB appears to
      be a better confirmatory test than the single protein EIA.

PMID- 8359163
TI  - Immunoglobulin G antibodies to Pseudomonas aeruginosa lipopolysaccharides and
      exotoxin A in patients with cystic fibrosis or bacteremia.
AB  - IgG antibodies to nine Pseudomonas aeruginosa lipopolysaccharides (LPS) and
      exotoxin A in sera from 11 patients with bacteremia and 51 patients with cystic
      fibrosis (CF) were analyzed. The methods used were enzyme immunoassay (EIA) and
      immunoblotting. Nine of the 11 bacteremic patients were infected with strains
      expressing an LPS serotype identical to one of the test antigens. In sera from
      six of these nine patients, antibody homologous to the serotype of the infecting
      strain was observed. An antibody response to heterologous Pseudomonas aeruginosa
      LPS antigens was observed in nine patients. Eight of the bacteremic patients
      mounted an antibody response to exotoxin A. Thirty-five CF patients chronically
      colonized with Pseudomonas aeruginosa possessed significantly higher levels of
      antibody to all of the test antigens than 16 patients with intermittent or no
      colonization (p < 0.001). For exotoxin A and serotype 3 the sensitivity was 91%
      and 94%, and the specificity 94% and 88% respectively. When the results for
      exotoxin A and serotype 3 were combined, the sensitivity was 91% while the
      specificity was 81%. The pronounced antibody response to heterologous LPS
      antigens, as measured by the EIA and immunoblot, suggests expression of a common
      antigen determinant. A simplified serological assay utilizing exotoxin A and
      serotype 3 as test antigens may be useful for detecting Pseudomonas aeruginosa
      infections in patients with CF and chronic colonization and in bacteremic
      patients from whom cultures are not available.

PMID- 8359164
TI  - Detection of Chlamydia trachomatis in urine from men with urethritis.
AB  - The performance of a commercial EIA (Chlamydiazyme) for detection of Chlamydia
      trachomatis in urine specimens was compared with that of culture of urethral
      samples from men with urethritis. The incidence of chlamydial infection on the
      basis of culture results was 34% (56/167). The sensitivity, specificity, positive
      and negative predictive values for the EIA were 55% (31/56), 98% (109/111), 94%
      (31/33) and 81% (109/134), respectively, compared with culture. Although this EIA
      has a high specificity, the low sensitivity makes it valueless as a clinical tool
      for demonstrating chlamydial antigen in urine from men with urethritis.

PMID- 8359165
TI  - Meropenem versus imipenem/cilastatin in the treatment of intraabdominal
      infections requiring surgery.
AB  - In a prospective randomized study meropenem was compared with imipenem/cilastatin
      in the treatment of 62 patients with intraabdominal infections requiring surgery.
      The patients were suffering from diffuse or local peritonitis of moderate
      severity complicating in most cases gangrenous appendicitis, stomach perforation
      or gallbladder disease. There were 30 patients in the meropenem group and 32
      patients in the imipenem/cilastatin group. Both antibiotic regimens were given
      intravenously at a dosage of 1 g every 8 h for a mean duration of 7.7 days in the
      meropenem group versus 8.6 days in the imipenem/cilastatin group. Fifty-nine
      aerobic strains and 15 anaerobic strains were isolated from cultures of pus taken
      intraoperatively, the meropenem MICs ranging from < or = 0.25 to 2 micrograms/ml.
      At follow-up at least one month after treatment the outcome was considered
      successful in all of 27 evaluable patients given meropenem and in all of 29
      evaluable patients given imipenem/cilastatin. Both antibiotic regimens were well
      tolerated.

PMID- 8359166
TI  - Adherence of Corynebacterium urealyticum (CDC group D2) and Corynebacterium
      jeikeium to intravascular and urinary catheters.
AB  - The ability of Corynebacterium urealyticum, Corynebacterium jeikeium and other
      control strains to adhere to two intravascular catheters (polyvinyl chloride and
      Teflon) and one urinary catheter (Teflon-coated rubber) was studied. Results
      demonstrated that the Corynebacterium species adhered to all catheter materials
      in greater numbers than a control strain of Micrococcus luteus (p < 0.001). There
      was not a clear difference in the ability of the strains of Corynebacterium
      jeikeium and Corynebacterium urealyticum to adhere to the catheters tested, so
      that differences other than this property could explain their different
      pathogenicity for humans.

PMID- 8359167
TI  - Infection caused by the nonfermentative gram-negative bacillus CDC group IV c-2:
      case report and literature review.
AB  - A 10-year-old girl with acute lymphocytic leukemia developed nosocomial
      septicemia caused by the gram-negative bacterium CDC group IV c-2. Recovery of
      the patient followed appropriate treatment with ceftriaxone, to which the
      organism was susceptible in vitro. Four other reported cases of infection caused
      by this organism are reviewed.

PMID- 8359169
TI  - Detection of toxigenic Clostridium difficile in fecal samples by colony blot
      hybridization.
AB  - A hybridization assay for detection of toxigenic Clostridium difficile in fecal
      samples was developed and compared with the classical tissue culture cytotoxicity
      assay. A DNA fragment probe specific for the toxin B gene of Clostridium
      difficile was synthesized by the polymerase chain reaction and labelled with
      digoxigenin. Fecal samples were cultured for 24 hours, replica-plated and
      hybridized with the probe. The hybridization assay had a sensitivity of 100%,
      specificity of 96.7%, positive predictive value of 86.7% and negative predictive
      value of 100% compared with the cytotoxicity assay.

PMID- 8359168
TI  - Use of the polymerase chain reaction to detect Bordetella pertussis in patients
      with mild or atypical symptoms of infection.
AB  - Nasopharyngeal aspirates and nasopharyngeal swabs from 177 children exhibiting
      mild to severe clinical symptoms of whooping cough were tested by the polymerase
      chain reaction (PCR) and culture for the presence of Bordetella pertussis. In the
      PCR analysis amplifications of samples prepared with and without DNA extraction
      were compared. In 26% of samples prepared without DNA extraction, the PCR was
      found to be inhibited, whereas no inhibition was detected after DNA extraction.
      Twelve percent (21/177) of the samples were positive in both culture and the PCR,
      and an additional 49% (87/177) of the samples were positive exclusively in the
      PCR. Thirty-eight percent (8/21) of culture-positive patients and 63% (55/87) of
      the patients in whom infection was detected only by PCR had mild or atypical
      clinical symptoms. Of these groups 26% (5/19) and 50% (39/78), respectively, had
      been fully vaccinated with three or more doses of diphtheria, tetanus and
      pertussis vaccine.

PMID- 8359170
TI  - Analysis of antibiotic resistance determinants in Proteus penneri.
AB  - The plasmid profiles of 65 strains of Proteus penneri were analyzed to determine
      whether resistance was determined chromosomally or by plasmids. Only seven
      strains harboured one to three plasmids, although these strains exhibited
      resistance to a wide range of antibiotics. Markers for ampicillin and
      tetracycline resistance could be transferred to Escherichia coli by
      transformation. Plasmids carried resistance to chloramphenicol in two strains and
      resistance to sulfonamides in one strain. The result showed that resistance is
      determined chromosomally rather than by plasmids, however the possibility that
      these bacteria may acquire resistance plasmids which change their antibiotic
      susceptibility pattern cannot be excluded.

PMID- 8359171
TI  - Ampicillin-sulbactam susceptibility testing criteria.
AB  - In vitro studies in five different medical centers documented the susceptibility
      of 2,440 consecutive isolates of the Enterobacteriaceae against ampicillin
      sulbactam disks of different potencies. For determination of MICs, both 2:1 or
      1:1 ratios were used as long as the concentrations of sulbactam at the
      breakpoints remained the same, i.e. MIC < or = 16/8.0 micrograms/ml or < or =
      8.0/8.0 micrograms/ml for the susceptible category. Disks containing 10
      micrograms of ampicillin and 10 micrograms of sulbactam are still to be preferred
      with interpretive criteria of > or = 15 mm for susceptible and < or = 11 mm for
      resistant (MIC > or = 64/32 micrograms/ml or > or = 32/32 micrograms/ml). The
      reliability of the disk test actually diminished when the amount of sulbactam in
      the disk was increased.

PMID- 8359173
TI  - Pulmonary toxoplasmosis in immunocompromised patients.

PMID- 8359172
TI  - Vibrio alginolyticus wound infection after exposure to sea water in an air crash.

PMID- 8359174
TI  - Sensitivity to mupirocin of staphylococci isolated from colonized or infected
      patients in Germany.

PMID- 8359175
TI  - Group C meningococcal meningitis presenting as acute pericarditis.

PMID- 8359176
TI  - Systolic time intervals in clinical pharmacology.

PMID- 8359177
TI  - Renal effects of atrial natriuretic peptide during dopa-decarboxylase inhibition
      in patients with essential hypertension.
AB  - To assess whether intrarenal dopamine synthesis could contribute to the renal
      response to ANP in essential hypertension, the effects of alpha-human ANP
      infusion (50 ng.min-1.kg-1 b.w. for 30 min) on the urinary excretion of dopamine
      and sodium, urine flow rate and arterial pressure were evaluated in 7 patients
      with mild-moderate essential hypertension before (control period) and during DOPA
      decarboxylase inhibition with carbidopa (carbidopa period). In the control
      period, urinary dopamine excretion was 400 pg.min-1 in baseline conditions and
      340 pg.min-1 during ANP infusion. Carbidopa significantly decreased urinary
      dopamine excretion both before (210 pg.min-1) and during ANP (99 pg.min-1). In
      contrast, carbidopa did not affect sodium excretion (control from 184 to 460 mu
      Eq.min-1; carbidopa period from 140 to 390 mu Eq.min-1) or urine flow rate
      (control from 5.35 to 11.21 ml.min-1; carbidopa period from 4.29 to 11.54 ml.min
      1). Arterial pressure fell significantly during ANP infusion in both periods, and
      no significant difference was observed between the two study days, i.e. in the
      absence of and during carbidopa administration. We conclude that DOPA
      decarboxylase inhibition does not influence the diuretic and natriuretic response
      to alpha-human ANP infusion in patients with essential hypertension.

PMID- 8359178
TI  - The effect of different dosage schedules of cisapride on gastric emptying in
      idiopathic gastroparesis.
AB  - The aim of this study was to determine the optimal dosage regimen of cisapride
      for the treatment of idiopathic gastroparesis. We studied 17 patients with
      documented idiopathic gastroparesis in a three-way, cross-over, double-blind
      study with three 4-day treatment periods separated by at least 3 days without
      treatment. In each period, the patients were preloaded with cisapride (10 mg tid)
      for three days. On the fourth day (the test day) they took either 10 mg or 20 mg
      before breakfast and placebo before lunch (1 x 10 mg), (1 x 20 mg), or 10 mg
      before breakfast and 10 mg before lunch (2 x 10 mg). The medications were taken
      30 min before meals. Gastric emptying of solids (99mTc-sulphur colloid) was
      measured at lunch time under basal conditions and during each treatment period.
      Plasma concentrations of cisapride were determined before the breakfast dose,
      before the lunch dose, and at 1, 2, 3, 4 and 5 h after. The greatest acceleration
      in gastric emptying occurred with the 2 x 10 mg regimen. Although the single
      morning dose of 20 mg also significantly accelerated gastric emptying (P = 0.05),
      the reduction was not as substantial. Plasma concentrations of cisapride were
      significantly higher after 2 x 10 mg than after 1 x 20 mg or 1 x 10 mg. There was
      a significant relation between cisapride plasma concentrations and changes in
      gastric emptying. Peak concentrations of cisapride greater than 60 ng.ml-1 were
      invariably associated with acceleration of gastric emptying. We conclude that
      cisapride 10 mg tid before meals is the optimal dose for the treatment of
      idiopathic gastroparesis.

PMID- 8359179
TI  - Effect of quinidine on the interconversion kinetics between haloperidol and
      reduced haloperidol in humans: implications for the involvement of cytochrome
      P450IID6.
AB  - Haloperidol (HAL) is a potent butyrophenone antipsychotic agent which is
      reversibly metabolized to reduced haloperidol (RHAL). In order to determine if
      this reversible metabolic pathway is linked to the debrisoquine 4-hydroxylase
      isozyme of cytochrome P-450 (P450IID6). HAL (5 mg) or RHAL (5 mg) was orally
      administered to healthy male volunteers in a randomized crossover design both
      with and without a prior (1 h) oral dose of quinidine (250 mg bisulfate), a
      potent inhibitor of this isozyme. Thirteen volunteers, 11 extensive metabolizers,
      2 poor metabolizers, completed all four phases of the study. Plasma samples
      harvested over seven days were analysed for HAL and RHAL. An expression for the
      apparent fractional availability of metabolite from the parent compound given
      (Fapppm) was derived and was used to determine whether HAL or RHAL is the
      preferred metabolite, and whether quinidine co-administration alters Fapp for
      either compound. The AUC (0-t) for both HAL and RHAL were significantly greater
      following the administration of either compound with quinidine compared with AUC
      (0-t) values obtained in the absence of quinidine. The maximum plasma
      concentration (Cmax) of the administered compound was also greater following the
      administration of quinidine. Quinidine had no effect on the half-lives of the
      administered compounds. The Fapp for HAL and RHAL were not significantly affected
      by the administration of quinidine, indicating that the interconversion of HAL
      and RHAl is not linked to P450IID6. The Fapp of RHAL after administration of HAL
      was significantly greater than the Fapp of HAL after RHAL administration,
      indicating that RHAL is the preferred metabolic form. This difference was not
      affected by quinidine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359180
TI  - Chlorpromazine in human scalp hair as an index of dosage history: comparison with
      simultaneously measured haloperidol.
AB  - The concentration of chlorpromazine (CPZ) in hair was measured to demonstrate its
      value as an index of individual dosage history and compliance. An animal study
      using pigmented rats was conducted to confirm the dose-dependent accumulation of
      CPZ in hair. The concentration of CPZ in hair, newly regrown on a denuded area of
      the back after the administration of CPZ for 3 weeks, was 4.6, 8.5 and 16.6 ng.mg
      1 hair after daily doses of 1.25, 2.5 and 5 mg.kg-1.day-1, respectively,
      significantly correlated with the daily dose. The concentration of CPZ in black
      hairs collected from 23 Japanese patients, who had been taking CPZ in fixed daily
      doses (30-300 mg/day), ranged from 1.6 to 27.5 ng.mg-1, and was significantly
      correlated both with the daily dose and with the trough plasma concentration at
      steady state. Several strands of hair collected from each of 5 patients, whose
      doses of CPZ had been changed within several months before sampling, were cut
      into 1-cm pieces successively from the scalp end and the concentration of CPZ in
      each piece was measured. With the assumption of a hair growth rate of 1 cm per
      month, the individual history of CPZ doses in all patients could be deduced from
      the distribution of CPZ along the hair shaft. In 5 patients with grizzled hair
      the concentration of CPZ in white hairs was much lower (< 10%) than in black
      hairs, suggesting that the strong affinity of CPZ for hair melanin may explain
      the accumulation of CPZ in black hair.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359181
TI  - Polymorphic 2-hydroxylation of desipramine. A population and family study.
AB  - We have studied desipramine hydroxylation capacity, determined as the metabolic
      ratio of desipramine to 2-hydroxydesipramine in the urine after a single oral
      dose of 10 mg of desipramine, in 340 Swedish Caucasians, including the members of
      45 two-generation families. Desipramine metabolic ratios were bimodally
      distributed among 237 unrelated subjects and 8% were poor metabolizers. There was
      a strong correlation between the metabolic ratios for desipramine and
      debrisoquine in 337 subjects phenotyped with both drugs and there was no
      dissociation between their capacities to hydroxylate desipramine and
      debrisoquine. Complex segregation analysis in the 45 families gave evidence for a
      major locus with incomplete recessivity (d = 0.14) controlling the 2
      hydroxylation of desipramine. Similar results were obtained in segregation
      analysis for debrisoquine. There was evidence for linkage between the CYP2D6 gene
      and the gene regulating the hydroxylation of desipramine and debrisoquine. This
      study has provided unequivocal evidence that the capacity to 2-hydroxylate
      desipramine is polymorphic and under similar genetic control to the hydroxylation
      of debrisoquine.

PMID- 8359182
TI  - Comparison of the effects of two different galenical preparations of glyceryl
      trinitrate on pulmonary artery pressure and on the finger pulse curve.
AB  - The time course and the magnitude of the effect of glyceryl trinitrate (GTN) on
      central venous (pulmonary artery diastolic pressure-PAPd) and peripheral arterial
      (a/b-ratio of the finger pulse wave) haemodynamics were compared in a randomized
      double-blind cross-over study in 12 patients suffering from congestive heart
      failure (NYHA II-III) with elevated PAPd at rest (> or = 15 mmHg). The data were
      obtained in a bioavailability study of two sprays of glyceryl trinitrate, which
      differed in their galenical characteristics and in the dose of GTN (0.4 mg vs.
      0.8 mg). Following sublingual administration of each spray, PAPd, a/b-ratio and
      the plasma concentrations of GTN and its metabolites were measured up to 30 min.
      The relative bioavailability of GTN of the test preparation was estimated to be
      157%, 161% and 147%, when calculated from the plasma concentration-time data or
      the integrated effect of GTN on a/b-ratio or PAPd, respectively. The mean time
      courses of the decrease in PAPd and the increase in the a/b-ratio of the finger
      pulse curve were mirror images. Thus, there was a strong correlation between the
      mean values of PAPd and a/b-ratio following the administration of glyceryl
      trinitrate. Since the slope of the relationship differed considerably between the
      patients, the magnitude of effect of GTN on PAPd in the individual patient could
      not be predicted from the changes in a/b-ratio.

PMID- 8359183
TI  - Lack of effect of long-term amlodipine on insulin sensitivity and plasma insulin
      in obese patients with essential hypertension.
AB  - To evaluate the effects of long-term treatment antihypertensive with the
      dihydropyridine calcium antagonist amlodipine on insulin sensitivity, plasma
      insulin, and lipoprotein metabolism in obese hypertensive patients. We measured
      the insulin sensitivity index (SI), determined by the Minimal Model Method of
      Bergman, fasting plasma insulin and glucose concentrations, serum total
      triglyceride and lipoprotein cholesterol fractions, and blood pressure in 20
      obese, non-diabetic patients with essential hypertension before and after 6 weeks
      of placebo and again after 6 months of amlodipine. Ten patients [mean body mass
      index (BMI) 30.2 kg.m-2] had been on prior treatment with a thiazide diuretic in
      low dosage and/or a beta-adrenoceptor blocker (group A), and 10 matched patients
      [BMI 31.8 kg.m-2] had been previously untreated (group B). Amlodipine was started
      in a dose of 5 mg and was increased to 10 mg once daily in 14 patients who were
      hypertensive after 8 weeks on the lower dosage. At entry (before placebo), SI was
      slightly but not significantly lower in group A than B [2.7 vs. 3.6 x 10(-4)
      ml.microU-4.min-1]; fasting plasma insulin was 13.6 vs. 12.9 microU.ml-1. After 6
      weeks on placebo, S1 averaged 3.7 in group A and 4.4 x 10(-4) microU.ml-1.min-1
      in group B; fasting plasma insulin was 14.6 vs. 15.1 microU.ml-1, and glucose 5.5
      vs. 5.5 mmol.l-1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359184
TI  - Pharmacokinetics and pharmacodynamics of benazepril hydrochloride in patients
      with major proteinuria.
AB  - We have investigated whether the pharmacokinetics and pharmacodynamics of the ACE
      inhibitor benazepril hydrochloride are altered with proteinuria by studying 8
      patients with major proteinuria of different causes who were given a single dose
      of 10 mg p.o. The maximum plasma concentration of benazepril was found between
      0.5 and 2 h after dosing (median 1 h). Its elimination was almost complete within
      6 h. Peak plasma levels of benazeprilat, the active metabolite of benazepril,
      were observed between 1 and 6 h (median 2.5 h). The elimination of benazeprilat
      from plasma was biphasic, with mean initial and terminal half-lives of 3.0 and
      17.3 h, respectively. On average, the pharmacokinetic parameters of benazepril
      and benazeprilat in the patients did not differ from those in a historical
      control group of healthy volunteers, but intersubject variability in the AUC and
      half-lives of benazeprilat was greater in the patients. Plasma ACE was completely
      inhibited from 1.5 to 6 h after dosing, and at 48 h the mean inhibition was still
      42%. Plasma renin showed substantial intersubject variation. Mean supine blood
      pressure (systolic/diastolic) was reduced from baseline by a maximum of 18/13 mm
      Hg at 6 h. Proteinuria was diminished after benazepril in 7 patients. In
      conclusion, the results of this study suggest that proteinuria in the nephrotic
      range does not require a change in benazepril dosage.

PMID- 8359185
TI  - Absolute bioavailability of an aqueous solution of 1-deamino-8-D-arginine
      vasopressin from different regions of the gastrointestinal tract in man.
AB  - The absolute bioavailability of an aqueous solution of 1-deamino-8-D-arginine
      vasopressin (dDAVP) from different regions of the gastrointestinal (GI) tract
      (stomach, duodenum, jejunum, ileum, colon, rectum) has been studied in 6 healthy,
      male volunteers aged 24 to 35 years, followed for 12 h after each drug
      administration. For i.v. administration the subjects received 4 micrograms dDAVP.
      For intestinal administration 400 micrograms dDAVP was directly applied to six
      distinct sites in the GI tract via two or four channel tubes with or without a
      distal occlusive balloon. Biological effects were assessed and plasma and urinary
      levels of dDAVP were measured using a specific, sensitive RIA. Urine osmolality
      remained elevated and diuresis decreased for 12 h following dDAVP administration
      irrespective of the site of application. After i.v. administration, the half-life
      of elimination of dDAVP was 60.0 min, plasma clearance 1.7 ml.min-1.kg-1, amount
      excreted in urine 2.0 micrograms and renal clearance was 0.8 ml.min-1.kg-1. The
      mean bioavailability (f) after gastric application was 0.19% (range 0.02-0.35%).
      f was 0.24% after duodenal application (range 0.04-0.62%), 0.19% after jejunal
      (range 0.01-0.41%), 0.03% after distal ileal (range 0.01-0.08%), 0.04% after
      proximal colonic (range 0.01-0.12%) and 0.04% after rectal (0.01-0.10%)
      application. The bioavailability was significantly higher in the three upper GI
      regions in comparison to the three lower regions. The bioavailability of dDAVP
      after gastric, duodenal and jejunal application was similar to that after
      swallowing a tablet in a previous study. Absorption from the ileum was lower than
      expected and no preferential site of absorption was found.

PMID- 8359186
TI  - Evaluation of the effect of thymoxamine solution 0.5% on mydriasis induced by
      ibopamine solution 1%.
AB  - The effects of thymoxamine 0.5% solution and of a placebo solution (mannitol) on
      the mydriasis induced by ibopamine 1% solution were evaluated in 8 healthy
      volunteers and 12 patients with eye diseases. One drop of ibopamine was instilled
      into each eye and 30 min later 1 drop of thymoxamine was instilled into one eye
      and 1 drop of placebo into the contralateral eye. Pupillary diameter was measured
      before and 30 min after the instillation of ibopamine, immediately before the
      treatment with thymoxamine and placebo and 30, 60 and 90 min after the
      instillation of thymoxamine or of placebo. Within 30 min of treatment, ibopamine
      had produced a statistically and clinically significant mydriatic effect. In eyes
      treated with thymoxamine, prompt reversal of mydriasis was observed, the baseline
      diameter being observed within 60 min. No difference in the time-course of the
      mydriatic effect was detected between healthy subjects and patients. The
      pupillary response to thymoxamine was not influenced by the colour of the iris.
      The tolerability of ibopamine and of thymoxamine was good. No local or systemic
      adverse events were seen or reported.

PMID- 8359187
TI  - Plasma protein binding of the enantiomers of hydroxychloroquine and metabolites.
AB  - The in vitro binding of the enantiomers of hydroxychloroquine and its three major
      metabolites in pooled plasma obtained from four healthy volunteers and the
      binding of the enantiomers of hydroxychloroquine to purified plasma proteins has
      been investigated. The plasma protein binding of hydroxychloroquine was found to
      be stereoselective. The (S)-enantiomer of hydroxychloroquine was 64% bound in
      plasma, while (R)-hydroxychloroquine was 37% bound. Fifty% of (S)
      hydroxychloroquine was bound to a 40 g.l-1 solution of human serum albumin, while
      only 29% of the (R)-enantiomer was bound. The enantioselectivity of
      hydroxychloroquine binding was reversed in a 0.7 g.l-1 solution of alpha 1-acid
      glycoprotein with (R)-hydroxychloroquine being bound to a greater extent than its
      optical antipode (41% versus 29%). The enantiomers of the metabolites of
      hydroxychloroquine were bound to a similar extent to plasma and purified plasma
      proteins. Binding of hydroxychloroquine to plasma and purified proteins was found
      to be linear over the racemic concentration range of 50 to 1000 ng.ml-1 and
      hydroxychloroquine metabolite binding to plasma was linear over the range 25 to
      500 ng.ml-1.

PMID- 8359188
TI  - Enalapril related changes in the fibrinolytic system in survivors of myocardial
      infarction.
AB  - Disturbances of the fibrinolytic system have been associated with cardiovascular
      disease and its risk factors. In the present study the effects of an ACE
      inhibitor (enalapril) and a placebo on the fibrinolytic system have been
      compared. Eighty one survivors of acute myocardial infarction were randomised to
      treatment with enalapril or placebo. The mass concentrations and activity of
      tissue plasminogen activator (tPA) and plasminogen activator inhibitor (PAI-1) in
      plasma were measured three months after the infarction. The enalapril group had a
      significantly lower level of tPA antigen compared to the placebo-treated group
      (9.2 and 10.6 respectively). There was no difference between the two groups in
      any of the other fibrinolytic variables. We conclude that survivors of myocardial
      infarction treated with enalapril have a significantly lower concentration of tPA
      antigen than those treated with placebo. This may have a prognostic implication,
      as lower plasma concentrations of tPA antigen have been associated with better
      prognosis in patients with established coronary heart disease.

PMID- 8359189
TI  - The effect of age on diurnal variation in the pharmacokinetics of propranolol in
      hypertensive subjects.
AB  - There is diurnal variation in the absorption rate of propranolol in younger
      subjects. This study was undertaken to examine the effect of age on the
      chronopharmacokinetics of propranolol. We gave 20 mg of propranolol orally to 13
      younger and 11 older hypertensive subjects at 09.00 h (day study) or 21.00 h
      (night study) in a cross-over design. Plasma concentrations of propranolol and
      its metabolites, 4-hydroxypropranolol and naphthoxylactic acid, were determined
      just before and at 0.5, 1, 1.5, 2, 3, 4, 6, 12, and 24 h after dosage. In the
      younger subjects the absorption rate constant (ka) of propranolol and its maximum
      plasma concentration (Cmax) were significantly higher and the time to maximum
      concentration (tmax) was significantly shorter in the day than at night. There
      were similar time-variant changes in Cmax and tmax for 4-hydroxypropranolol and
      naphthoxylactic acid. In contrast, there were no time-variant changes in ka, Cmax
      and tmax of propranolol and its metabolites in the older subjects. These results
      suggest that propranolol is absorbed more rapidly after morning dosing than after
      night-time dosing in younger but not in older subjects. Based on these findings,
      we speculate that the time-variance in the absorption rate or first-pass
      elimination, or both, of propranolol diminish with age.

PMID- 8359190
TI  - Pharmacokinetics and beta-blocking effects of transdermal timolol.
AB  - The pharmacokinetic profiles of transdermal timolol 6 and 24 mg (as 5 and 20% w/v
      patches) was studied in four healthy young volunteers. To assess its
      bioavailability, the pharmacokinetics of an IV infusion of timolol maleate 5 mg
      was also determined in the same subjects. When the 20% (w/v) timolol patch was
      applied, the mean bioavailability was 74.4%. Plasma timolol concentrations were
      below the detection limit when a 5% patch was applied to the same skin area in
      all four subjects, except for one in whom the bioavailability was 23.6%. Weak
      erythema developed at the application site in all of the volunteers after
      application of the 20% (w/v) patch. However, erythema did not develop in any
      volunteer when the 5% patch was applied. The beta-blocking effect was determined
      by exercise testing. Similar plasma levels generated similar changes in exercise
      induced heart rate after the transdermal and intravenous administration of
      timolol.

PMID- 8359191
TI  - Pharmacokinetics of nocloprost in human volunteers and its relation to dose.
AB  - The pharmacokinetics and absolute bioavailability of nocloprost, a synthetic PGE2
      analogue with cytoprotective properties, was investigated in human volunteers as
      a function of the dose. Ten young male volunteers received nocloprost 5
      micrograms i.v. and 100, 200 and 400 micrograms p.o. in random order at weekly
      intervals. Serum nocloprost levels were monitored for up to 12 h after each dose,
      using a specific, validated assay. After nocloprost 5 micrograms i.v. the highest
      serum level of 373 pg.ml-1 was found in the first sample 5 min after injection,
      and the subsequent decline showed one or two phases, with half-lives of 4 and 49
      min. The AUC was 89 pg.h.ml-1, the total plasma clearance was 13.2 ml.min-1.kg-1,
      and the volume of distribution at steady state was 0.16 l.kg-1. After oral
      administration the maximum serum level and AUC increased in proportion to the
      dose. tmax showed a wide scatter, with an average value of about 30 min
      independent of the dose. Although not detectable in every subject, post maximum
      serum levels declined biphasically, with half-lives of ca 10 and 35-40 min. The
      absolute bioavailability after oral administration averaged about 2% and was
      independent of the dose.

PMID- 8359192
TI  - Absorption of zidovudine in patients with diarrhoea.
AB  - Many patients with AIDS have gastrointestinal complaints, including the major
      clinical disorder of chronic diarrhoea. The pharmacokinetics of zidovudine was
      studied in 9 male patients with HIV infection and diarrhoea to establish whether
      drug absorption was impaired in them. The peak plasma concentration and AUC after
      a single oral dose of 200 mg, were the same as those reported in 6 healthy male
      volunteers (3.1 vs 4.0 mumol.l-1 and 7.2 vs 5.2 mumol.h.l-1, respectively). Since
      the bioavailability of zidovudine is not particularly impaired, oral zidovudine
      therapy can be maintained in patients with diarrhoea.

PMID- 8359193
TI  - Pharmacokinetics of exogenous adenosine in man after infusion.
AB  - The plasma kinetics of adenosine was investigated in healthy volunteers after a 1
      minute infusion of 2.5, 5 and 10 mg (38.79 and 148 micrograms.kg-1 respectively)
      and after infusion of 200 micrograms.kg-1 in 10 min followed by 400 micrograms.kg
      1 in 10 min. As the dose in the 1 min infusion study was increased the mean CL of
      adenosine decreased (10.7, 4.70 and 4.14 l.min-1, respectively), its mean half
      life increased (0.91, 1.24 and 1.86 min, respectively), and the mean volume of
      distribution did not show any clear trend (8-13 l). After the 20 minute infusion
      the plasma level of adenosine reached a peak value comparable to that observed
      after infusion of 5 mg in 1 min (about 0.5 micrograms.ml-1), but the mean
      clearance and half-life were significantly different (12.1 l.min-1 and 0.63 min
      respectively). In all the subjects the plasma concentration of adenosine had
      returned to the baseline value in 5-15 min after the end of the infusion.

PMID- 8359194
TI  - Cefotiam during continuous haemofiltration.

PMID- 8359195
TI  - Cisplatin, an antineoplastic drug, inhibits catecholamine secretion from bovine
      adrenal chromaffin cells.
AB  - Long-term pretreatment (12-120 h) of cultured bovine adrenal chromaffin cells
      with cis-diamminedichloroplatinum (cisplatin, Pt(NH3)2Cl2) (33 microM), an
      antineoplastic drug, resulted in a decrease in the secretion of catecholamines
      from the cells stimulated by acetylcholine. Acetylcholine-induced 45Ca2+ influx
      into the cells was also reduced in the cells pretreated with cisplatin for 48 h.
      The concentration-response curves (3-66 microM) for cisplatin inhibition of the
      secretion and 45Ca2+ influx were quite similar. Pretreatment of cells with 33
      microM Pt4+ or carboplatin, an analog of cisplatin, for 48 h also led to a
      decrease in acetylcholine-evoked secretion, but not with 33 microM Pt2+ or other
      metals (Au+, Au3+, Ni2+, Os3+, Pd2+, Ir3+, and Ir4+) that have properties similar
      to Pt4+. These results strongly suggest that in bovine adrenal chromaffin cells,
      cisplatin (3-66 microM) inhibits catecholamine secretion by the suppression of
      the Ca2+ influx into the cells evoked by acetylcholine and that the inhibitory
      effect of cisplatin is attributable to the tetravalent platinum ion in its
      molecule.

PMID- 8359196
TI  - Effect of age on vascular content of calcitonin gene-related peptide and
      mesenteric vasodilator nerve activity in the rat.
AB  - Effects of age on sensory nerve vasodilator activity and vascular calcitonin gene
      related peptide (CGRP) levels were investigated in Fischer 344 rats, aged 6, 20
      and 27 months. Increases in pressure to transmural nerve stimulation (TNS) of the
      isolated perfused mesentery were greater at 27 months compared to 6 or 20 at
      frequencies of 4 and 8 Hz. With guanethidine to block adrenergic nerves and
      methoxamine to increase smooth muscle tone, TNS-induced vasodilation of the
      perfused mesentery decreased with age, reaching statistical significance at a
      frequency of 4 Hz and 27 months. There were no significant differences with age
      in concentration-response curves to CGRP in the perfused mesentery, except for
      the oldest rats at low concentrations of CGRP which showed increased
      vasodilation. Levels of CGRP-like immunoreactivity (CGRP-LI) in mesenteric and
      femoral arteries at 27 months were significantly less compared with 6 and 20
      months; in the renal artery CGRP-LI was significantly decreased by 20 months.
      This study suggests that decreased sensory nerve function in aging animals may
      contribute to age-related alterations in circulatory hemodynamics.

PMID- 8359197
TI  - Recombinant interleukin-5 induces in vivo airway hyperresponsiveness to histamine
      in guinea pigs.
AB  - Interleukin-5-producing CV-1 cells were encapsulated in alginate and injected
      i.p. in guinea pigs (4 x 10(6)/animal). These cells produced approximately 8 ng
      interleukin-5 per 4 x 10(6) cells per day. Airway hyperresponsiveness to
      histamine in vivo was observed 3 and 7 days after administration. The increase in
      lung resistance after intravenous administration of histamine to guinea pigs was
      significantly potentiated, by approximately 70 to 90% in interleukin-5-treated
      animals. In animals treated with antibody to interleukin-5, the administration of
      interleukin-5-producing CV-1 cells did not induce hyperresponsiveness. The
      percentage of eosinophils in broncho-alveolar lavage fluid was increased by 100%
      at 7 days but not at 3 days after administration of interleukin-5-producing CV-1
      cells. Antibody to interleukin-5 prevented the broncho-alveolar lavage
      eosinophilia at 7 days after interleukin-5 administration. It can be concluded
      that interleukin-5 induces broncho-alveolar lavage eosinophilia and airway
      hyperresponsiveness and that these phenomena do not occur simultaneously. These
      data suggest a role for interleukin-5 in the development of airway
      hyperresponsiveness in bronchial asthma.

PMID- 8359198
TI  - Electrical kindling of rats treated discontinuously or continuously with
      haloperidol.
AB  - Intermittent as opposed to continuous treatment of rats with haloperidol resulted
      in a long-lasting potentiation of oral activity. To examine if this behavioural
      sensitization to discontinuous neuroleptic treatment facilitates seizure
      development in electrical kindling, rats treated either intermittently or
      continuously with haloperidol for 15 weeks were kindled in the nucleus amygdala.
      Development of kindled seizures was significantly faster in the intermittently
      treated group (P < 0.01) than in controls or continuously treated rats.
      Furthermore, discontinuously treated animals displayed electroencephalographic
      afterdischarges in the substantia nigra from the beginning of treatment. The
      findings of cross-sensitivity between electrical amygdala kindling and
      pharmacological sensitization and of early appearance of epileptiform nigral
      activity have implications for the pathogenesis of both conditions. We suggest
      that depressed gamma-aminobutyric acid activity in substantia nigra could be a
      common mechanism.

PMID- 8359199
TI  - Effects of repeated administration of propentofylline on memory impairment
      produced by basal forebrain lesion in rats.
AB  - The effects of repeated propentofylline administration on impairments of learning
      and memory in rats with basal forebrain lesions were investigated in several
      behavioral tasks (water maze, habituation and passive avoidance tasks). Rats were
      subjected to all the tasks in sequence. Basal forebrain lesions produced by
      bilateral injections of ibotenic acid (approximately 6 micrograms on each side)
      severely impaired performance in water maze, habituation and passive avoidance
      tasks. Repeated administration of propentofylline (10 and 25 mg/kg per day for 14
      days, p.o.) improved the deficits of performance in a water maze task, even when
      administration began one week after the basal forebrain lesions were produced.
      The impaired performance in habituation and passive avoidance tasks was also
      markedly ameliorated after repeated administration (24 and 26 days) of
      propentofylline. The rats with basal forebrain lesions exhibited a significant
      decrease in choline acetyltransferase activity in the cortex. Propentofylline
      significantly increased hippocampal choline acetyltransferase activity in basal
      forebrain-lesioned rats compared with that in vehicle-treated basal forebrain
      lesioned rats. However, cortical choline acetyltransferase activity in basal
      forebrain-lesioned animals was not affected by repeated propentofylline
      administration. These results indicate that repeated administration of this agent
      ameliorated the impaired performance of basal forebrain-lesioned rats in part by
      increasing hippocampal choline acetyltransferase activity. Propentofylline might
      be useful for the treatment of amnesia and dementia.

PMID- 8359200
TI  - Pharmacological properties of ATP-sensitive K+ channels in mammalian skeletal
      muscle cells.
AB  - The patch-clamp technique (single-channel recordings) was used to study the
      effects of glibenclamide and some channel openers on the KATP channel in mouse
      skeletal muscle. In outside/out membrane patches, glibenclamide reversibly
      inhibited KATP channel activity in a dose-dependent manner with an apparent Ki of
      190 nM. In inside/out membrane patches, RP 61419 increased KATP channel activity
      both in the absence and in the presence of internal ATP while other K+ channel
      openers such as nicorandil and cromakalim required the presence of internal ATP
      to evoke channel activation. The half-maximal activity effect for cromakalim,
      with 0.5 mM ATP at the cytoplasmic face, was observed at about 220 microM.
      Pinacidil was unable to activate the KATP channel in the absence of internal ATP
      and could even reduce channel opening in situations where activity was high in
      the control. In the presence of internal Mg2+, activation by pinacidil occurred
      when ATP or low and weakly activating concentrations of ADP were present at the
      cytoplasmic side. Pinacidil activation could also be observed in the presence of
      ATP or ADP when Mg2+ was absent from the internal solution. The mechanism of
      action of pinacidil is discussed in terms of interactions between the different
      nucleotide regulatory sites and the K+ channel opener binding site of the KATP
      channel. Half-maximum activation of the KATP channel in the presence of 0.5 mM
      ATP at the cytoplasmic face was observed at 125 microM pinacidil.

PMID- 8359201
TI  - Bradykinin is less potent in causing airway microvascular leakage in immature
      than in adult guinea-pigs. Role of neutral endopeptidase.
AB  - To study the effect of maturation on bradykinin-induced airflow obstruction and
      airway microvascular leakage, we measured changes in both lung resistance (RL)
      and extravasation of Evans Blue dye in anaesthetized immature (aged 12 +/- 1
      days) and adult guinea-pigs (aged 77 +/- 2 days). After measurement of RL after
      i.v. administration of bradykinin (2.5, 5 and 10 nmol/kg) or vehicle (0.9% NaCl),
      dye extravasation in the lower airways was examined in the same animal.
      Bradykinin did not cause a significant increase in RL in immature airways,
      whereas even 2.5 nmol/kg induced a significant elevation in adult airways.
      Bradykinin-induced extravasation of Evans Blue dye was greater in adult than in
      immature animals. Phosphoramidon (2.5 mg/kg), a neutral endopeptidase inhibitor,
      did not abolish the age-related difference in the amount of dye extravasated,
      suggesting that mechanisms other than changes in neutral endopeptidase activity
      may be responsible for the lower potency of bradykinin in inducing airway
      microvascular leakage in immature airways.

PMID- 8359202
TI  - Involvement of vasoactive intestinal polypeptide in gastric reflex relaxation.
AB  - We have previously presented evidence for a non-adrenergic, vagally mediated
      colono-gastric inhibitory reflex induced by distension of the colon. We also
      found that pain stimulation by putting pressure on a testicle induced a
      pronounced gastric relaxation mediated by both adrenergic and vagal non
      adrenergic fibres in anesthetized rats. Previous in vitro studies by other
      workers have strongly indicated that vasoactive intestinal polypeptide (VIP) is a
      neural mediator of gastric relaxation. The aim of the present in vivo study was
      to investigate, in anesthetized rats, whether VIP is involved in the gastric
      reflex relaxation induced by colonic distension and pain stimulation. A
      volumetric method was used to monitor changes in gastric volume. Gastric reflex
      relaxation following colonic distension was significantly and markedly inhibited
      by VIP antiserum as compared to the control relaxation before administration of
      the antiserum. Non-immunized control serum did not significantly influence
      gastric relaxation caused by colonic distension. Pain-induced gastric relaxation
      was moderately but significantly reduced after the administration of VIP
      antiserum but not after control serum. The selective beta 2-adrenoceptor agonist,
      salbutamol, induced a pronounced gastric relaxation of the same magnitude before
      and after the administration of VIP antiserum. VIP antiserum changed the pattern
      of gastric motility by inducing a specific type of gastric contraction appearing
      spontaneously or in response to colonic distension. A close intra-arterial
      injection of VIP induced gastric relaxation and inhibition of phasic gastric
      contractions. The present results in the rat suggest that VIP or a VIP-like
      peptide is involved in gastric reflex relaxation induced by colonic distension
      and pain stimulation.

PMID- 8359204
TI  - Effect of 5-hydroxytryptamine on glossopharyngeal afferent nerve activity in
      anesthetized rats.
AB  - Excitatory responses to 5-hydroxytryptamine (5-HT) were recorded from the whole
      glossopharyngeal afferent nerve in anesthetized rats, using an
      electrophysiological technique. Bolus intravenous injection of 5-HT (6.25-50
      micrograms/kg) evoked a dose-dependent excitation of glossopharyngeal afferent
      nerve activity with a rapid onset and lasting a few seconds. This response was
      blocked by a selective 5-HT3 receptor antagonist, YM060 (10 micrograms/kg i.v.).
      A 5-HT3 receptor agonist, 2-methyl-5-HT (6.25-50 micrograms/kg), also produced a
      rapid and dose-dependent excitation of this nerve activity, and YM060 (10
      micrograms/kg i.v.) caused an inhibition of this effect. In contrast, efferent
      glossopharyngeal nerve activity was not altered by 5-HT even at a high dose (50
      micrograms/kg). These results suggest that exogenous 5-HT may elicit excitation
      of the glossopharyngeal afferent nerve, and that this effect might be mediated
      via the 5-HT3 receptors on the nerve endings.

PMID- 8359203
TI  - Effects of serotonin and the 5-HT2/1C receptor agonist DOI on neurons of the
      cerebellar dentate/interpositus nuclei: possible involvement of a GABAergic
      interneuron.
AB  - The present study was designed to examine the effects of iontophoretically
      applied serotonin (5-HT) on neurons of the cerebellar dentate/interpositus nuclei
      in an in vitro slice preparation and to determine if the 5-HT2/1C receptor
      subtype could be responsible for mediating any effects noted with 5-HT. 5-HT and
      the 5-HT2/1C-selective agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane
      hydrochloride (DOI) were iontophoretically applied alone and during superfusion
      of the 5-HT2/1C-selective antagonist, ritanserin. 5-HT and DOI elicited either
      inhibition or excitation of the spontaneous activity of dentate/interpositus
      neurons. An inhibitory response was induced by both compounds in the majority of
      cells responding. Ritanserin significantly attenuated the inhibitory response
      elicited by both 5-HT and DOI. In addition, the inhibitory response to DOI was
      significantly attenuated by the gamma-aminobutyric acid (GABA) antagonists,
      bicuculline and picrotoxin. Our results suggest that the 5-HT2/1C receptor
      subtype may be partially responsible for mediating 5-HT-induced inhibition of
      dentate/interpositus neurons, possibly via activation of GABAergic interneurons.

PMID- 8359205
TI  - NMDA receptor antagonists inhibit catalepsy induced by either dopamine D1 or D2
      receptor antagonists.
AB  - In the present study, we investigated the ability of NMDA receptor antagonists to
      inhibit catalepsy induced by haloperidol, or SCH23390 and clebopride, selective
      dopamine D1 and D2 receptor antagonists respectively. Catalepsy was measured by
      recording the time the animal remained with its forepaws placed over a rod 6 cm
      above the bench. Pretreatment with either the non-competitive NMDA receptor
      antagonist, MK-801 (0.25-0.5 mg/kg i.p.) or the competitive antagonist, LY274614
      (10-20 mg/kg i.p.) reduced the cataleptic response produced by haloperidol (10
      mg/kg), SCH23390 (2.5-10 mg/kp i.p.) or clebopride (5-20 mg/kg i.p.). This
      demonstrates that NMDA receptor antagonists will reduce both dopamine D1 and D2
      receptor antagonist-induced catalepsy. Muscle relaxant doses of chlordiazepoxide
      (10 mg/kg i.p.) failed to reduce the catalepsy induced by haloperidol, suggesting
      that the anticataleptic effect of the NMDA receptor antagonists was not due to a
      non-specific action. These results support the hypothesis that NMDA receptor
      antagonists may have beneficial effects in disorders involving reduced
      dopaminergic function, such as Parkinson's disease.

PMID- 8359206
TI  - p-chlorophenylalanine-reversible reduction of sigma binding sites by chronic
      imipramine treatment in rat brain.
AB  - Repeated treatment with imipramine (10 mg/kg intraperitoneally (i.p.), once daily
      for 14 days) caused a decrease in the Bmax, without affecting the Kd, of [3H]DTG
      (1,3-di-o-tolylguanidine) binding to the haloperidol-sensitive sigma sites in the
      striatum, hippocampus and cerebral cortex of the rat. A similar reduction was
      observed after chronic administration of a selective serotonin uptake inhibitor,
      fluoxetine (10 mg/kg i.p., twice daily for 14 days), but not of a selective
      norepinephrine uptake inhibitor, desipramine (10 mg/kg i.p., once daily for 14
      days). Neither a single injection of imipramine (10 mg/kg i.p.) nor addition of
      imipramine or fluoxetine into the binding assay medium mimicked the changes in
      the maximal binding of brain sigma sites induced by chronic treatment with these
      drugs. Finally, depletion of brain serotonin by means of repeated administration
      of p-chlorophenylalanine, which produces inhibition of the amine synthesis,
      blocked the ability of repeated imipramine treatment to reduce the maximal number
      of [3H]DTG binding sites in the striatum and hippocampus. The present results
      suggest that cerebral serotonergic transmission may play a role in the regulation
      of cerebral sigma binding sites in the rat.

PMID- 8359207
TI  - Trifluoperazine inhibition of insulin-induced increase in skeletal muscle glucose
      uptake.
AB  - The ability of trifluoperazine, a calmodulin blocker, to prevent increases in
      skeletal muscle glucose uptake induced by insulin was tested. Insulin
      significantly increased glucose uptake by the rat hindlimb and trifluoperazine
      (10(-6) M) completely inhibited this increase. We conclude that calmodulin is a
      factor involved in the regulation of insulin-mediated glucose transport in muscle
      cells.

PMID- 8359208
TI  - Antiproliferative effect of esculetin on vascular smooth muscle cells: possible
      roles of signal transduction pathways.
AB  - The effect of esculetin, a coumarin derivative with lipoxygenase inhibitor
      activity, on the proliferation response of cultured rabbit vascular smooth muscle
      cells was studied. Proliferation response was determined by the uptake of
      tritiated thymidine. Esculetin (10(-5)-10(-4) M) dose dependently inhibited the
      enhanced proliferation stimulated by 5% fetal calf serum. The structure-activity
      relationship of esculetin and eight other coumarin derivatives indicates that two
      adjacent phenolic hydroxyl groups at the C-6 and C-7 positions in the coumarin
      skeleton are necessary for the potent antiproliferative effect. The
      antiproliferative effects of other lipoxygenase inhibitors, 5,8,11,14
      eicosatetraynoic acid (ETYA) and ketoconazole, were comparable to the effect of
      esculetin. However, esculetin exhibited the greatest maximal suppression. The
      enhanced releases of 12-hydroxyeicosatetraenoic acid (12-HETE), prostaglandin E2
      and 6-keto-prostaglandin F1 alpha in the culture medium of smooth muscle cells
      stimulated by 5% fetal calf serum were significantly reduced by esculetin.
      Furthermore, the fetal calf serum-stimulated protein tyrosine kinase activity was
      reduced by esculetin (10(-5)-10(-4) M) in a dose-dependent manner. In contrast,
      the protein kinase C activity stimulated by phorbol-12-myristate-13-acetate was
      not affected by esculetin (10(-6)-10(-4) M). These results suggest that the
      antiproliferative effect of esculetin on vascular smooth muscle cells may be
      partly mediated through inhibition of protein tyrosine kinase and modulated by
      inhibition of lipoxygenase.

PMID- 8359209
TI  - Enhanced stress-induced dopamine release in the prefrontal cortex of amphetamine
      sensitized rats.
AB  - This study examined the extent to which chronic d-amphetamine administration
      sensitizes animals to some behavioral and neurochemical effects of foot shock
      stress. Rats received daily injections of saline for 14 days or d-amphetamine (2
      mg/kg 7 days and 4 mg/kg 7 days). After a 7 day drug abstinent period,
      extracellular dopamine, 3,4-dihydroxyphenylacetic acid and homovanillic acid
      concentrations were measured in the medial prefrontal cortex using in vivo
      microdialysis in freely moving rats. The behavioral responses to mild foot shock
      stress were enhanced in the d-amphetamine-pretreated subjects. Concomitant with
      this behavioral sensitization, d-amphetamine-pretreated subjects showed greater
      stress-induced increases in extracellular dopamine in the medial prefrontal
      cortex than in controls. d-Amphetamine (2 mg/kg)-induced stereotyped behavior was
      also enhanced in the amphetamine-pretreated animals compared to controls;
      however, d-amphetamine-induced increases in extracellular dopamine in the medial
      prefrontal cortex were not enhanced in the amphetamine-pretreated group. These
      results suggest that the mesocortical dopaminergic system is involved in cross
      sensitization between d-amphetamine and stress, but not in d-amphetamine-induced
      behavioral sensitization.

PMID- 8359210
TI  - Endothelin mechanisms in altered thyroid states in the rat.
AB  - Endothelin (ET) and its receptor characteristics were studied in hyper- and hypo
      thyroid states in the rats. Hyperthyroidism was induced by daily administration
      of thyroxine (0.1 mg/kg i.p.) for 8 weeks, while hypothyrodism was induced by
      daily administration of methimazole (10 mg/kg i.p.) for 8 weeks. The chronic
      administration of thyroxine to rats decreased their rate of gain of body weight,
      increased serum T3 and T4 concentration, blood pressure and heart rate. The
      chronic administration of methimazole decreased the rate of gain of body weight,
      serum T3 and T4 concentration, blood pressure and heart rate as compared to
      vehicle-treated control. Plasma ET-1 levels were found to be similar in control
      and methimazole-treated rats, while the levels were found to be significantly (P
      < 0.002) increased in thyroxine-treated rats as compared to control rats. Binding
      studies showed that [125I]ET-1 bound to a single, high affinity binding site in
      the cerebral cortex, hypothalamus and pituitary. The density (Bmax) and the
      affinity (Kd) of [125I]ET-1 binding in the cerebral cortex and hypothalamus were
      found to be similar in control, methimazole- and thyroxine-treated rats. The
      pituitary of thyroxine-treated rats showed a decrease in the binding (34.3%
      decrease in the density) of [125I]ET-1 as compared to control rats. No difference
      was observed in the binding of [125I]ET-1 to pituitary membranes from control and
      methimazole-treated rats. Competition studies showed that the IC50 and Ki values
      of ET-3 for [125]ET-1 binding were about 8 to 11 times higher than ET-1 in
      cerebral cortex, hypothalamus and pituitary.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359211
TI  - Relationship between scaffold-attached regions, sequences replicating
      autonomously in yeast, and a chromosomal replication origin in the Drosophila
      rDNA.
AB  - The potential relationship between anchorage of Drosophila rDNA to a nuclear
      substructure and replication mechanisms was studied. First, two scaffold-attached
      regions (SARs) were identified, in the internally transcribed spacer and in the
      region spanning both the intergenic spacer (IGS) and the externally transcribed
      spacer (ETS), respectively. These SARs define two possible loops containing the
      sequence coding for the 18S rRNA and part of that coding for the 28S rRNA,
      respectively. They also bind yeast scaffolds. Then, the presence of sequences
      able to promote extrachromosomal replication in yeast (ARSs) was tested. The
      identified ARSs comap with SARs. The tight relationship between SARs and ARSs was
      further investigated in the IGS-ETS region which contains a chromosomal
      replication origin. The topological correlation observed between SARs, ARSs, and
      a chromosomal replication origin suggests the physical association of the
      replication origin to the nuclear substructure.

PMID- 8359212
TI  - Contact inhibition of cell spreading: a mechanism for the maintenance of thyroid
      cell aggregation in vitro.
AB  - When freshly isolated porcine thyroid cells are stimulated with thyrotropin (TSH)
      they organize to form functional follicles in conventional substrate-adherent
      culture. Cell aggregation is essential for follicular reorganization and is
      likely to be influenced by the balance between cell-cell adhesion (promoting
      aggregation) and cell-substrate adhesion (favoring spreading and monolayer
      formation). Recently we observed that TSH potentiated cell-cell adhesion and in
      the present study we have sought evidence that TSH might also regulate cell
      substrate adhesion. Two parameters of cell-substrate adhesion, namely, cell
      attachment to collagen and cell spreading upon collagen, were measured using
      preparations of isolated single cells and of multicellular aggregates. TSH had no
      effect upon the attachment or spreading of single cells, but inhibited aggregate
      spreading without affecting aggregate attachment. The possibility that cell-cell
      contact modulated the response to TSH in aggregates, but not in single cells, was
      confirmed using a cell-free membrane preparation which inhibited the spreading of
      single cells but not their rate of attachment. Moreover, TSH potentiated the
      inhibitory effect of membranes on the spreading of single cells. Heparin also
      specifically inhibited the spreading of both single cells and cell aggregates,
      suggesting that a heparin-sensitive adhesive mechanism might be recruited as
      thyroid cells spread. We conclude that thyroid cell-substrate adhesion is
      regulated by a synergistic interaction between cell-cell contact and TSH which
      preferentially inhibited cell spreading but not attachment. Such contact
      dependent inhibition of cell spreading is predicted to preserve cell aggregates
      and hence contribute to the maintenance of thyroid follicular differentiation in
      vitro.

PMID- 8359213
TI  - Most nuclear proteins are imported by a single pathway.
AB  - Using kinetic competition analysis, we show that the import of most Xenopus
      oocyte nuclear proteins is directed by a single family of nuclear localization
      signals (NLS). The transport of microinjected [35S]methionine-labeled nuclear
      proteins into oocyte nuclei was challenged with saturating concentrations of SV40
      large T-antigen NLS peptide-BSA (P(Lys)-BSA) and was assessed by SDS-acrylamide
      gel electrophoresis and fluorography. P(Lys)-BSA was effective at competing the
      import of virtually all larger polypeptides but had a less marked effect on the
      mediated import of many smaller polypeptides. Wheat germ agglutinin, an inhibitor
      of nuclear pore complex function, enhanced the competitive effects of P(Lys)-BSA
      on the import of both large and small polypeptides. These data indicate that most
      35S-labeled Xenopus oocyte nuclear proteins, including nucleoplasmin, contain
      NLSs that are functionally related to the T-antigen NLS and probably employ the
      same cytosolic NLS receptor(s).

PMID- 8359214
TI  - Mechanisms of flagellar excision. I. The role of intracellular acidification.
AB  - It has previously been shown that exposure of Chlamydomonas to low pH induces the
      cells to shed their flagella. In the present paper we report that a 30-s
      treatment with 20 mM acetic, carbonic, formic, or benzoic acid at pH 4.0 will
      induce flagellar excision. In contrast, 20 mM concentrations of the stronger
      aspartic, phosphoric, citric, and tartaric acids (pH 4) do not induce excision.
      Further, the excision efficacy of acetate is a function of the concentration of
      protonated acetate. Thus, excision correlates with the presence of a protonated,
      membrane-permeant species of acid. Relative to acetate, the more permeant
      benzoate induces excision at a much lower concentration of protonated acid. We
      conclude that a flux of acid into the cell is the signal for excision. Previous
      work has shown that detergent-permeabilized cells excise their flagella in
      response to calcium but not in response to low pH. This suggests that the
      acidification of intact cells triggers excision by stimulating an increase in
      intracellular calcium. We have previously reported that the source of this
      calcium might be IP3-sensitive. In our model for the mechanism of pH-induced
      flagellar excision, a flux of acid into the cell activates phospholipase C,
      leading to IP3 production, the activation of an IP3-gated calcium channel
      (located on either an intracellular or surface membrane), and an increase in
      cytosolic calcium, which is the trigger of flagellar excision.

PMID- 8359215
TI  - Phenotypic and cell cycle analysis of human peripheral blood mononuclear cells
      activated with interleukin-2 and/or OKT3.
AB  - The poor clinical response rates of cancer patients following immunotherapy with
      interleukin-2 (IL-2) and other cytokines has prompted attempts to enhance the
      response rate by using combinations of biological response modifiers. Peripheral
      blood mononuclear cells (PBMC) respond to interleukin-2 and mediate non-MHC
      restricted cytotoxicity and cell proliferation. The addition of anti-human CD3
      monoclonal antibody OKT3 has been reported to increase cytotoxicity by increasing
      the number of cells generated in response to the two stimuli; however, our
      results could not confirm this finding. In the present study we have investigated
      the proliferative capacity of individual populations of PBMC responding to IL-2
      and OKT3 compared to either stimulus alone, in order to identify possible reasons
      for the failure of OKT3 to generate enhanced cytotoxic responses. PBMC were
      stained with monoclonal antibodies to surface antigens and propidium iodide in
      order to determine the phenotype of populations of PBMC progressing through the
      cell cycle. OKT3 alone caused an increase in PBMC progressing through the cell
      cycle, and addition of recombinant human IL-2 (rhIL-2) sustained this response. A
      higher percentage of CD56- or CD16-positive cells responded to the rhIL-2 alone,
      but the addition of OKT3 lowered the percentage of this phenotype and increased
      the number of CD3-positive T cells, which additionally demonstrated an increased
      CD25 expression. Comparison of the phenotypes progressing through the cell cycle
      in response to OKT3 plus rhIL-2 or rhIL-2 alone showed that a higher percentage
      of all populations responded to OKT3 plus rhIL-2, compared to IL-2 alone. Using
      flow cytometric cell sorting, those populations of cells with cytolytic activity
      were identified. Using flow cytometry, it was also possible to show minority cell
      populations (i.e., those representing less than 5% of the total number of cells)
      responding to individual stimuli and entering the cell cycle. This technique
      therefore offers distinct advantages over conventional proliferation assays.

PMID- 8359216
TI  - Binding and activation of plasminogen at the surface of human keratinocytes.
AB  - Plasmin is thought to be involved in the pericellular proteolysis of the human
      epidermis under physiological and pathological conditions. Plasmin is provided by
      activation of the proenzyme plasminogen. We have explored in vitro whether
      plasminogen is bound and activated at the keratinocyte surface, a possible
      mechanism for providing plasmin in the pericellular space. Plasminogen and
      plasmin could be eluted from the surface of keratinocytes grown in serum
      containing medium. When plasminogen was added to cultured keratinocytes it was
      activated by cell-associated urokinase-type plasminogen activator. The activation
      required plasminogen binding to the cell surface. Plasminogen binding by
      keratinocytes was saturable and proceeded in a time- and concentration-dependent
      manner. Surface-bound plasmin was rapidly displaced from the surface into the
      culture supernatant. When compared to plasmin in solution surface-bound plasmin
      was relatively protected from interaction with the specific inhibitor alpha 2
      antiplasmin. Addition of exogenous plasmin or plasmin generation by the
      keratinocyte-associated plasminogen activators was ensued by the detachment of
      adherent keratinocytes in culture. Along the same line, plasmin counteracted
      keratinocyte adhesion to fibrin-coated but not to collagen-coated culture plates.
      The findings indicate that plasmin may be generated in the pericellular space of
      keratinocytes and may interfere with the adhesion to particular extracellular
      substrates.

PMID- 8359217
TI  - S-100 protein in rat brown adipose tissue under different functional conditions:
      a morphological, immunocytochemical, and immunochemical study.
AB  - The brown adipose tissue (BAT) is responsible for nonshivering thermogenesis,
      exhibiting changes in cell morphology related to the functional conditions. In
      stimulated BAT (neonatal period, cold acclimation) the large majority of
      adipocytes become multilocular and active, while in inactive BAT (warm
      acclimation) most cells are pauci- or unilocular and inactive, very similar to
      white adipocytes. It is well known that white adipocytes are sites of
      concentration of S-100, a calcium-binding protein originally isolated from the
      nervous system and later detected also in nonneural cell types, whereas data on
      the possible presence of this protein in BAT are lacking. The present study used
      morphological, immunocytochemical, and immunochemical methods to investigate the
      presence of S-100 protein in BAT under different functional conditions. We found
      that S-100 was present in both stimulated and inactive BAT and that is was
      expressed in significantly higher quantities in the latter than in the former.
      The multilocular cells were always negative (in both active and inactive tissue),
      whereas the pauci- and unilocular cells were always S-100-positive under both
      functional conditions. These data suggest that only pauci- and unilocular brown
      adipocytes express S-100 protein, thus manifesting a possible relationship
      between S-100 and cell morphology.

PMID- 8359218
TI  - Induced endocytosis in human fibroblasts by electrical fields.
AB  - Electroporation creates transient pores through which exogenous molecules can
      gain access to the cell cytoplasm. However, the electrical events associated with
      this phenomenon may perturb membrane-dependent events such as endocytosis. To
      measure the effect of electroporation on endocytosis, suspensions of human
      gingival fibroblasts were subjected to 5-ms electrical discharges, allowed to
      recover for variable periods of time, incubated with fluorescent probes, and then
      analyzed by flow cytometry. Incubation of electroporated fibroblasts with FITC
      conjugated bovine serum albumin (BSA) to label moities on cell membranes
      nonspecifically demonstrated a time-dependent increase of internalized probe for
      up to 90 min after electroporation. Pretreatment incubation of cells with
      cytochalasin D abrogated the increased internalization of FITC-BSA due to
      electroporation. Compared to controls, fluorescence signals due to
      internalization of surface glycoproteins with FITC-concanavalin A were 43% higher
      after electroporation and treatment with endoglycosidase F or H to reduce probe
      associated with surface membrane. Confocal microscopy confirmed intracellular
      labeling and reduction of membrane-associated probe by the enzyme. Assessment of
      nonspecific FITC-Con A labeling of cells by pretreatment with alpha-methyl D
      mannoside showed that labeling was largely (92%) specific. Compared to controls,
      electroporation induced a 60% increase of internalization of lucifer yellow, a
      fluid-phase endocytosis marker. Dual fluorescence labeling of membrane
      phosopholipids by FITC and TRITC-DHPE demonstrated an increased acidification
      after electroporation that was time dependent, indicating that electroporation
      induced more rapid entry of membrane lipid into endosomal compartments. These
      data demonstrate that the electrical fields used in electroporation of
      fibroblasts cause an actin-dependent increase in the internalization of all
      membrane components examined and an increased rate of probe entry in to
      acidifying compartments.

PMID- 8359219
TI  - Differential patterns of expression of three C/EBP isoforms, HNF-1, and HNF-4
      after partial hepatectomy in rats.
AB  - Regenerating liver provides a system for studying the mechanisms controlling
      regulated proliferation of differentiated hepatocytes. A set of transcription
      factors termed hepatocyte nuclear factors (HNF-1, -3, -4) and CCAAT/enhancer
      binding protein (C/EBP) isoforms are known to regulate several genes
      predominantly expressed in the liver. To assess whether these factors might be
      involved in the hepatocyte proliferation program, we have studied the expression
      of the three C/EBP isoforms C/EBP alpha, C/EBP beta, and C/EBP delta and the two
      hepatocyte-enriched transcription factors, HNF-1 and HNF-4, in rat liver at
      various time points after partial hepatectomy and sham operations using
      transcriptional "run-on" assays and Northern blot and Western blot experiments.
      We report here that partial hepatectomy in rats leads to dramatic changes in the
      pattern of expression of some of these genes. The three C/EBP isoforms are
      differentially regulated in response to partial hepatectomy and are likely to
      play different roles in determining the proliferation/differentiation state of
      hepatocytes. In particular, C/EBP alpha expression is rapidly down-regulated,
      whereas C/EBP delta is induced. C/EBP beta expression is also increased, although
      an increase is also observed after sham operation. The drastic decrease in C/EBP
      alpha under these conditions of active DNA synthesis and rapid cell proliferation
      further supports the concept of a potential incompatibility between high C/EBP
      alpha protein levels and cell proliferation. The patterns of transcriptional
      rates of HNF-1 and HNF-4 during the different stages of the regenerative process
      are similar. However, HNF-1 steady-state mRNA and protein levels are
      significantly changed while HNF-4 remains virtually unaffected, indicating that
      post-transcriptional mechanisms are also involved in the regulation of HNF-1 gene
      expression.

PMID- 8359220
TI  - Senescence stimulates U937-endothelial cell interactions.
AB  - Progressive pathophysiologic modifications of endothelial cells are associated
      with aging. In vitro, endothelial cell senescence is accompanied by the failure
      to proliferate as well as by perturbations in gene expression. Here we show that
      (i) senescence enhances monoblastoid U937 cell adhesion to the endothelial
      monolayer; (ii) the enhanced interaction between senescent endothelial cells and
      U937 cells is mediated, at least in part, by the overexpression of ICAM-1; and
      (iii) LPS and interleukin 1 alpha, but not tumor necrosis factor alpha, are
      unable to stimulate the adhesion of U937 to senescent endothelial cells. Since
      monocyte adhesion to the endothelium is an early event in atherosclerosis, the
      altered adhesive properties observed in senescent cells could give insights into
      the formation of atherosclerotic lesions.

PMID- 8359221
TI  - Nonisotopic ultrastructural mapping of transcription sites within the nucleolus.
AB  - A nonradioactive ultrastructural method based on the incorporation of 5
      bromouridine-5'-triphosphate into the RNA of streptolysin O-permeabilized
      cultured HeLa cells is described and used for the visualization of rRNA
      transcription sites. Even though the method provides much better resolution than
      ultrastructural autoradiography, the results obtained do not allow the assignment
      of rRNA transcription to a single nucleolar structural component. We locate the
      rRNA transcription sites at the border region of fibrillar centers with dense
      fibrillar components. In addition, the method represents a convenient tool for
      the in situ immunodetection of extranucleolar RNA synthesis.

PMID- 8359222
TI  - Uvomorulin, LAMP-1, and laminin are substrates for cell surface beta-1,4
      galactosyltransferase on F9 embryonal carcinoma cells: comparisons between wild
      type and mutant 5.51 att- cells.
AB  - Intercellular adhesions in F9 embryonal carcinoma cells are primarily dependent
      upon two types of cell adhesion molecules: uvomorulin (Um or E-cadherin), which
      facilitates intercellular adhesion by homophilic binding, and cell surface beta
      1,4-galactosyltransferase (GalTase), which binds terminal N-acetylglucosamine
      residues on consociate glycoprotein substrates on adjacent cell surfaces. The
      variant F9 cell line, 5.51 att-, undergoes initial cell aggregation, but fails to
      form the mature intercellular adhesions characteristic of wild-type F9 cells. The
      5.51 att- cells show reduced Um expression; however, previous studies have shown
      that reduced levels of Um are not responsible for the att- mutant phenotype.
      Therefore, in this study we determined whether the att- mutant phenotype was the
      result of altered expression of surface GalTase or of its consociate glycoprotein
      substrates. Surface GalTase was found to be expressed normally on 5.51 att-
      cells. Furthermore, the initial intercellular adhesions characteristic of
      reaggregating 5.51 att- cells were dependent upon surface GalTase, since anti
      GalTase antibodies inhibited 5.51 intercellular adhesion. Preliminary studies
      showed that the interaction of surface GalTase with its consociate glycoprotein
      substrates was abnormal on 5.51 att- cells. To define the biochemical basis for
      this observation, specific glycoprotein substrates for cell surface GalTase were
      identified and their expression and utilization were compared between wild-type
      and 5.51 att- cells. In wild-type cells, uvomorulin (Um), lysosome-associated
      membrane protein-1 (LAMP-1), and laminin (Lm) were shown to be substrates for
      cell surface GalTase, suggesting that they may participate in GalTase-specific
      adhesions. Moreover, the interaction between GalTase and these glycoproteins
      exhibited characteristic changes during retinoic acid-induced F9 cell
      differentiation. In contrast to that seen on wild-type cells, surface GalTase
      interaction with Um, LAMP-1, and Lm was atypical on 5.51 att- cells, resulting,
      in part, from increased synthesis of oligosaccharide substrates for surface
      GalTase, as determined by size exclusion and lectin affinity chromatography. N
      Acetylglucosaminyltransferase activity was elevated in 5.51 att- cells and likely
      responsible for the increased expression of GalTase oligosaccharide substrates.
      These results suggest that mutant 5.51 att- cells are able to maintain residual
      intercellular adhesions because of increased expression of oligosaccharide
      substrates for cell surface GalTase. The impact of aberrant GalTase-specific
      adhesions on the ability of 5.51 att- cells to form mature intercellular
      adhesions and to differentiate in response to retinoic acid is discussed.

PMID- 8359223
TI  - DNA fragmentation and cytolysis in U937 cells treated with diphtheria toxin or
      other inhibitors of protein synthesis.
AB  - We treated the human monoblastoid cell line, U937, with various cytotoxic
      proteins or drugs that specifically inhibit protein synthesis and monitored the
      cells for degradation of chromosomal DNA and other changes. In cells treated with
      diphtheria toxin (DT), Pseudomonas aeruginosa exotoxin A, ricin toxin, and abrin
      toxin the chromosomal DNA was degraded into oligonucleosome-sized fragments, the
      chromatin became condensed, and the cell nuclei fragmented. All of these changes
      are characteristic of cells undergoing apoptosis, or programmed cell death.
      Various drugs, including puromycin, cycloheximide, emetine, and anisomycin
      produced similar changes. An enzymically attenuated mutant of DT, DT-E148S,
      produced effects identical to those produced by the native toxin, except that a
      higher concentration of toxin was required, corresponding to the reduction in ADP
      ribosylation activity. In all cases, DNA degradation and other changes were
      observed only after the rate of protein synthesis was reduced to low levels,
      approximately 10% or less of normal levels. These results imply that inhibition
      of protein synthesis in U937 cells induces apoptosis, regardless of the mechanism
      of action of the inhibitor. Differences in the kinetics of induction of apoptosis
      by the various inhibitors may reflect secondary effects on other aspects of
      cellular physiology.

PMID- 8359224
TI  - Ca2+ and Zn2+ dependence of DNA synthesis in untransformed and in Ha-ras(val-12)
      expressing NIH 3T3 cells.
AB  - The role of Ca2+ and Zn2+ in the initiation of DNA synthesis in NIH 3T3
      fibroblasts and c-Ha-ras(val-12) oncoprotein-expressing (NIH 3T3) cells has been
      studied. Entrapment of the Ca2+ chelator, BAPTA (30 microM), into the cells
      totally blocked a serum-induced rise in cytosolic free Ca2+ ([Ca2+]i) as
      determined with fura-2. Serum starvation for 24 h considerably reduced DNA
      synthesis in control NIH 3T3 fibroblasts. BAPTA treatment reduced serum-induced
      DNA synthesis and totally inhibited platelet-derived growth factor-induced DNA
      synthesis in these cells. DNA synthesis of the c-Ha-ras(val-12)-expressing
      fibroblasts was little affected by serum starvation and unaffected by entrapment
      of BAPTA into the cells. Intracellular Zn2+ was measured using the fluorescent
      probe TSQ in intact cells. As determined using image analysis the TSQ
      fluorescence was distributed throughout the cytoplasm and concentrated around the
      nucleus. The permeable Zn2+ chelator, TPEN, at a concentration of 10 microM,
      caused a maximal reduction in TSQ-available Zn2+. This concentration of TPEN
      totally blocked DNA synthesis both in control and c-Ha-ras(val-12)-expressing
      fibroblasts. Upon addition of 11 microM Zn2+ DNA synthesis was restored even
      after TPEN addition. [3H]Thymidine incorporation itself was also sensitive to
      TPEN treatment. The results suggest that c-Ha-ras(val-12)-induced proliferation
      is independent of changes in [Ca2+]i. A specific role of Zn2+ in c-Ha-ras-induced
      proliferation is unlikely since ras-expressing and control cells reacted
      similarly to Zn2+ deprivation. There seems to be a constant requirement for the
      presence of Zn2+ in cell proliferation.

PMID- 8359225
TI  - Protein kinase C-mediated inhibition of vascular smooth muscle cell
      proliferation: the isoforms that may mediate G1/S inhibition.
AB  - The role of protein kinase C (PKC) in the regulation of vascular smooth muscle
      cell proliferation was studied using not only phorbol ester but also
      diacylglycerol, with regard to the molecular species of PKC. Phorbol 12,13
      dibutyrate (PDBu) and 1,2-dioctanoylglycerol (DOG) both potently inhibited serum
      stimulated DNA synthesis and cell population doubling. The PDBu effect on DNA
      synthesis was maximal when applied at late G1. Neither PDBu nor DOG inhibited DNA
      synthesis in cells incubated with phorbol 12-myristate 13-acetate (PMA) for 24 h,
      which down-regulates PKC. Moreover, long exposure to PMA shortened the G1 period
      and the cell population doubling time. Therefore, a PKC isoform(s) that can be
      activated by phorbol ester and down-regulated by long exposure to PMA should be
      involved in the G1/S inhibition. A PKC enzyme assay of the soluble proteins
      extracted from late G1 cells and fractionated by anion exchange and
      hydroxylapatite chromatography showed that the activity eluting with PKC-alpha
      predominated, whereas that eluting with PKC-zeta was detectable. The former was
      dependent on Ca2+ and phorbol ester but the latter was not. PKC-zeta appeared to
      be expressed as two subspecies of M(r) 70 and 80 kDa. In cells incubated with PMA
      for 24 h, the activity eluting with PKC-alpha was completely abolished, whereas
      the significant activity eluting with PKC-zeta (70 kDa) remained. On the other
      hand, a relatively low, Ca(2+)-independent activity eluted with PKC-epsilon from
      the particulate fraction. This was reduced by long exposure to PMA, although not
      completely. Therefore, PKC-alpha and -epsilon may be the most probable mediators
      of the G1/S inhibition.

PMID- 8359226
TI  - Erythropoietin as a mitogen for fetal liver stromal cells which support
      erythropoiesis.
AB  - Fetal liver stromal cells established from 13-day-old embryos support
      erythropoiesis in vitro in combination with erythropoietin (Epo). Epo stimulated
      growth of these stromal cells in a dose-dependent manner and mRNA for Epo
      receptor was detected. These results suggest the possible involvement of Epo in
      the generation of the fetal erythropoietic microenvironment during development.

PMID- 8359227
TI  - The close relationship between DNA replication and the selection of
      differentiation lineages of human erythroleukemia cell lines K562, HEL, and TF1
      into either erythroid or megakaryocytic lineages.
AB  - The selection of differentiation lineages into either erythroid or megakaryocytic
      series was analyzed with human erythroleukemia cell lines K562, HEL, and cytokine
      dependent TF1. A tumor promoter, TPA, induced a megakaryocyte marker,
      glycoprotein IIb/IIIa (GP IIb/IIIa) or IIIa (GP IIIa), but suppressed erythroid
      differentiation. On the other hand, aphidicolin, which is a potent inhibitor of
      DNA replication, inhibited GP IIb/IIIa or IIIa expression, but induced the
      expression of erythroid phenotypes. These phenomena were observed in all
      erythroleukemia cell lines tested. The bromodeoxyuridine labeling experiments
      indicated that de novo DNA synthesis was completely suppressed by aphidicolin
      treatment but was well preserved in TPA-treated cells. Among these three cell
      lines, erythropoietin (EPO) treatment induced erythroid differentiation of TF1
      cells, which was dependent on GM-CSF or IL-3. In this case, EPO functioned as the
      survival factor and mild stimulator for cell proliferation as well as the inducer
      of erythroid differentiation. However, when either GM-CSF or IL-3 was depleted
      from the culture medium, TF1 ceased cell growth; concomitantly, hemoglobin
      positive cells appeared, which is consistent with the results obtained with
      aphidicolin. The incubation of K562 cells for 48 h with either TPA or aphidicolin
      induced the irreversible commitment of cells to megakaryocytic and erythroid
      lineages, respectively. Our results using three different erythroleukemia cell
      lines suggest that a possible linkage between the DNA replication system and the
      selection of a differentiation lineage is the common feature of human
      erythroleukemia cell lines, and that these culture systems provide a suitable
      model for the analysis of the signal transduction system for differentiation
      lineage selection.

PMID- 8359228
TI  - Genes coding for basement membrane glycoproteins laminin, nidogen, and collagen
      IV are differentially expressed in the nervous system and by epithelial,
      endothelial, and mesenchymal cells of the mouse embryo.
AB  - The pattern of laminin A, B1, B2, nidogen, and collagen alpha 1 (IV) gene
      expression in the 12.5-day mouse embryo was determined by in situ hybridization.
      Laminin B1, B2, and collagen alpha 1 (IV) mRNAs were present in many epithelial
      and mesenchymal compartments. Laminin A mRNA had a more restricted distribution,
      being present in cells closely associated with basement membranes and also in the
      ependymal layer of the neural tube. Nidogen was not produced by any epithelium,
      but was abundant in mesenchymal and endothelial cells. These results demonstrate
      that mesenchymal cells contribute significantly to basement membrane production,
      and that many cells not associated with typical basement membranes produced high
      levels of mRNAs coding for basement membrane components. Very few cell types
      produced all five gene products, and some tissues preferentially expressed only
      one or two of the five genes. This study shows that basement membranes at the
      epithelial-mesenchymal interface in the majority of mouse embryonic tissues are
      assembled from components derived from both cell types, and that heterogeneous
      matrix structures containing different laminin subunits and/or nidogen are likely
      to be present in the central nervous system and other tissues of the midgestation
      mouse embryo.

PMID- 8359229
TI  - Parathyroid hormone-related protein production by normal human keratinocytes in
      vitro.
AB  - The role of parathyroid hormone-related protein (PTHrP) and its regulation in
      normal epidermal physiology is not currently known. Recent evidence suggests that
      PTHrP production may be related to the degree of differentiation of keratinocytes
      in vitro. This investigation characterized the production of PTHrP by normal
      human foreskin keratinocytes (NHFK) during both spontaneously occurring and
      induced differentiation in vitro. PTHrP production in keratinocyte serum-free
      conditioned medium was determined using an N-terminal radioimmunoassay for human
      PTHrP (1-36). Agents known to stimulate (calcium, 1,25-dihydroxyvitamin D3) or
      inhibit (transforming growth factor-beta) keratinocyte differentiation were
      examined for their ability to alter production of PTHrP. Measurements of cell
      number and involucrin content of the cultures were made to confirm the effects of
      these agents on keratinocyte growth and differentiation. The production of PTHrP
      in control cultures (under low calcium conditions, 0.08 mM) was decreased and
      involucrin content increased (P < 0.01) after the cells became confluent. The
      addition of 1 mM calcium to keratinocyte medium increased cell number and
      involucrin content of the cultures (P < 0.05) but inhibited production of PTHrP
      (P < 0.01). The 1,25-dihydroxyvitamin D3 (10 nM) had no significant effect on
      cell number or PTHrP production, but increased involucrin content (P < 0.05).
      Transforming growth factor-beta (5 ng/ml) decreased both cell number (P < 0.05)
      and involucrin content (P < 0.01), but significantly stimulated PTHrP production
      (P < 0.01). These data indicate that the production of PTHrP by NHFK is inhibited
      with the onset of both spontaneously occurring and calcium-induced
      differentiation in vitro, while transforming growth factor-beta inhibited
      differentiation and upregulated PTHrP production in normal human keratinocytes.

PMID- 8359230
TI  - Phenomenology.

PMID- 8359231
TI  - Why are some references more equal than others?

PMID- 8359232
TI  - Cure of osteopetrosis in op/op mice by bone grinding and good food?

PMID- 8359233
TI  - Posttranscriptional regulation of colony-stimulating factor-1 (CSF-1) and CSF-1
      receptor gene expression during inhibition of phorbol-ester-induced monocytic
      differentiation by dexamethasone and cyclosporin A: potential involvement of a
      destabilizing protein.
AB  - Colony stimulating factor-1 (CSF-1) and its receptor (encoded by the c-fms proto
      oncogene) have long been recognized as playing an important role in monocytic
      differentiation. However, the regulation of expression of the CSF-1 and c-fms
      genes during inhibition of monocytic differentiation has not been fully
      characterized. The present studies demonstrate that dexamethasone (dex) and
      cyclosporin A (CsA) resulted in inhibition of 12-O-tetradecanoylphorbol-13
      acetate (TPA)-induced monocytic differentiation of HL60 cells, as well as TPA
      induction of c-fms and CSF-1 transcripts. These agents also blocked TPA-induced
      adherence, alpha-naphthyl acetate esterase staining, and the development of a
      more differentiated morphology. Nuclear run-off analyses revealed no effect of
      either of these agents on transcription of either c-fms or CSF-1 genes in TPA
      treated HL60 cells. Measurements of c-fms transcript half-life confirmed post
      transcriptional regulation of c-fms transcript levels after the addition of dex
      or CsA to TPA, both of which resulted in a decrease in c-fms mRNA half-life.
      Others have suggested that TPA results in the stabilization of c-fms mRNA in HL60
      cells through induction of a labile mRNA stabilizing protein. We observed,
      however, that the inhibition of protein synthesis by cycloheximide (CH) in this
      setting of early monocytic differentiation increased both c-fms and CSF-1 steady
      state transcript levels. While CH had no effect on the transcription of c-fms and
      CSF-1 genes in TPA/dex- or TPA/CsA-treated HL60 cells, c-fms mRNA was stabilized
      after the addition of CH to TPA/dex-treated cells. Taken together, our results
      suggest the existence of a labile mRNA regulatory protein or proteins, whose
      actions include destabilization of both c-fms and CSF-1 transcripts after
      inhibition of TPA-induced monocytic differentiation by dex or CsA.

PMID- 8359234
TI  - Expression of membrane-bound burst-promoting activity is mediated by allogeneic
      effector cells.
AB  - To investigate whether "self" and "non-self" recognition processes are involved
      in murine erythropoiesis, the expression of membrane-bound burst-promoting
      activity (mBPA) was determined for B lymphocytes purified from spleens of CF-1,
      C57 BL/6J, B6021-7115, and CAF-1J mice using syngeneic and allogeneic bone marrow
      cultures. Addition of B lymphocyte conditioned medium (LCM), shed membrane
      derived vesicles, or intact plasma membranes prepared from syngeneic murine cells
      stimulated erythroid burst-forming unit (BFU-E) proliferation by two- to three
      fold above control levels. BFU-E proliferation was increased by six- to eight
      fold, however, when LCM, shed membrane vesicles, or plasma membranes purified
      from allogenic B lymphocytes were used as sources of growth-stimulatory activity.
      Bioactivity was immunoprecipitated from detergent extracts of membranes purified
      from both allogeneic and syngeneic lymphocytes with a monoclonal antibody that
      specifically recognizes mBPA, suggesting that the factors expressed by these
      cells share antigenic determinants. The results indicate that allogeneic effector
      cells are a more potent source of mBPA-like molecules than are syngeneic cells,
      suggesting that immune mechanisms may be involved in inducing erythroid growth
      factor expression at the B cell surface.

PMID- 8359235
TI  - Modified celluloses for erythrocyte deformability fractionation.
AB  - Cellulose columns have been used to separate erythrocytes into deformability
      classes, but recoveries have been variable and incomplete. Columns of modified
      cellulose (propylaminocarbonylmethyl cellulose [PAC] and butylisourea cellulose
      [BIC]) were effective in increasing the recovery of both normal and sickle cells
      applied to the columns, with reasonable yields of rigid cells in the late
      fractions. In particular, sickle cells were recovered in 95% yield, and late
      eluting cells had a sharply reduced deformability index.

PMID- 8359236
TI  - Development and application of a sensitive radioimmunoassay for human granulocyte
      macrophage colony-stimulating factor able to measure normal concentrations in
      blood.
AB  - A radioimmunoassay (RIA) for human granulocyte-macrophage colony-stimulating
      factor (GM-CSf) was developed based on antibodies from rabbits immunized with
      glycosylated recombinant human (rh) GM-CSF. The antibodies are specific for human
      GM-CSF and do not crossreact with other human hematopoietic growth factors or
      mouse GM-CSF. The antibodies also react with nonglycosylated rhGM-CSF, so E. coli
      derived rhGM-CSF can be assayed as well. The RIA has a measuring range of about
      10 to 200 pg/mL. Normal blood was found to contain 13 to 24 pg/mL (95% limits)
      with a mean of 18.5 pg/mL (n = 34). Monoclonal antibodies against GM-CSF could
      remove GM-CSF from normal human serum, thus ensuring that the GM-CSF measured in
      serum is real and does not represent nonspecific reactivity with our polyclonal
      rabbit antibodies. While previously published methods have been unable to measure
      GM-CSF in human serum under normal conditions, our more sensitive RIA does
      confirm the presence of small amounts of GM-CSF in serum or plasma and can
      therefore be used to detect fluctuations of GM-CSF in health and in disease.

PMID- 8359237
TI  - Induction by interleukin-7 of lymphokine-activated killer activity in lymphocytes
      from autologous and syngeneic marrow transplant recipients before and after
      systemic interleukin-2 therapy.
AB  - Therapy with recombinant lymphokines after autologous bone marrow transplantation
      (ABMT) is being explored as a way to prevent relapse. Lymphokine therapy may
      exert an antitumor effect through a variety of mechanisms, including the
      induction of lymphokine-activated killer (LAK) cell cytotoxicity. We tested the
      ability of interleukin-7 (IL-7) to induce LAK cytotoxicity in peripheral blood
      mononuclear cells (PBMC) from healthy subjects and from patients early after
      ABMT. LAK activity was defined as lysis of Daudi by PBMC after incubation with IL
      7 at 10 to 100 ng/mL or IL-2 at 1000 U/mL. PBMC from four healthy subjects were
      cultured with either IL-7 or IL-2. IL-7 induced LAK activity in two of the four,
      whereas IL-2 induced LAK activity in all four. The median percent lysis (effector
      to-target ratio [E:T] 40:1) with IL-7 (23%) was lower than with IL-2 (67%). PBMC
      were obtained from 15 patients 27 to 84 days after autologous (n = 13) or
      syngeneic (n = 2) bone marrow transplantation (BMT) and tested for IL-7-induced
      LAK activity. Eleven exhibited significant activity (10% to 77% lysis at E:T
      40:1). In contrast to the results in PBMC from normal subjects, in PBMC from ABMT
      patients IL-7 induced LAK activity of a magnitude similar to that induced by IL
      2. Studies were also performed on PBMC from eight patients who had received IL-2
      after ABMT (3.0 x 10(6) U/m2/d) for 4 days by continuous intravenous (IV)
      infusion. In seven of the eight patients, IL-7 induced significant LAK activity,
      which was higher than that seen in PBMC from ABMT patients who had not received
      IL-2. Thus, IL-7 reproducibly induced significant LAK activity in cells obtained
      early after autologous or syngeneic BMT. Indeed, such LAK activity was comparable
      quantitatively to that induced by IL-2. Finally, IL-7 induced an even greater LAK
      activity in vitro in PBMC obtained after ABMT and preactivated in vivo by IL-2
      therapy. The results suggest that IL-7 may have a potential immunotherapeutic
      role, alone or with IL-2, after ABMT.

PMID- 8359238
TI  - Interpretation of high-resolution current source density profiles: a simulation
      of sublaminar contributions to the visual evoked potential.
AB  - Current source density (CSD) analysis provides an index of the location,
      direction, and density of transmembrane currents that arise with synchronous
      activation of neural tissue and that generate an evoked potential profile in the
      extracellular medium. In neocortex and other laminated structures, a simplified,
      one-dimensional CSD analysis can be computed by differentiation of voltages
      sampled at discrete points in a linear array. One-dimensional CSD analysis is a
      practical and accurate method for defining both regional activity patterns and
      neural generators of surface-recorded evoked and event-related potentials. In
      computing the CSD, common practices of differentiating across spatial grids of
      200 microns or more and use of spatial smoothing routines help to reduce noise,
      but severely limit the spatial resolution available to the analysis. High
      resolution CSD procedures (i.e., 3 point differentiation using a spatial grid of
      100 microns or less) are more suited to identification of processes within
      individual cortical laminae or sublaminae, but can magnify the contributions of
      computational artifacts. Despite the inclusion of independent indices of cellular
      activity (e.g., multiunit activity), both high- and low-resolution analyses may
      indicate current source and sink configurations for which there is more than one
      plausible physiological interpretation. In the present study we examined the
      resolving capacity and pitfalls of common CSD procedures using simulated
      ensembles of current dipoles. These were positioned and oriented to model the
      depolarization of lamina 4C stellate cells and thalamocortical afferents in
      macaque striate cortex. Empirically, the surface N40 appears in association with
      a CSD configuration which includes current sinks within the thalamorecipient
      (stellate) subdivisions of lamina 4C and a large current source extending
      considerably below 4C. Dipole ensemble contributions to the CSD profile were
      computed and compared to physiological data from this region. Small asymmetries
      in activation of model stellate laminae were sufficient to produce substantial
      open field contributions. However, the best fit with empirical CSD profile was
      found when the simulation included contributions from thalamocortical axons,
      along with both open and closed field contributions from dual stellate cell
      sublaminae. High-resolution CSD profiles were shown to be interpretable when
      computational artifacts characteristic of closed and open fields were identified
      using a series of differentiation grids.

PMID- 8359239
TI  - The temporary inactivation of the red nucleus affects performance of both
      conditioned and unconditioned nictitating membrane responses in the rabbit.
AB  - These experiments are part of a series of studies examining the role of the red
      nucleus in the performance of the conditioned and unconditioned nictitating
      membrane reflexes in the rabbit. Specifically, the experiments test the
      hypothesis that the temporary inactivation of the red nucleus selectively affects
      the performance of the conditioned reflex. The experiments were designed to
      assess the effects of lidocaine and control saline microinjections on conditioned
      as well as unconditioned responses in both paired and unpaired trials. Rabbits
      were chronically implanted with cannulae through which small injecting tubes were
      passed stereotaxically to the red nucleus. The animals were conditioned using a
      delay paradigm in which a 1 kHz tone and an air puff applied to the cornea were
      used as the unconditioned and conditioned stimulus, respectively. Once
      conditioned, the effects of either lidocaine or saline injection were evaluated
      while alternating paired trials with unpaired trials in which only the air puff
      was applied. The principal finding of this study was that the amplitudes of both
      the conditioned and unconditioned responses were reduced following lidocaine
      injection into the red nucleus. The effect on the unconditioned response
      amplitude could not be ascribed to any interaction between the conditioned and
      unconditioned responses, since it also was present in the unpaired trials. The
      reduction in amplitude of the conditioned and unconditioned responses was shown
      to be correlated with changes in other characteristics of the same responses. The
      data suggest that the red nucleus contributes to the performance of both the
      conditioned and unconditioned nictitating membrane reflexes and consequently is
      not likely to be involved only in pathways responsible for mediating and/or
      storing the engram for the conditioned reflex.

PMID- 8359240
TI  - A pertussis toxin-sensitive G protein mediates inhibition by morphine of
      spontaneous electrical activity of oxytocin neurones in anaesthetized rats.
AB  - We investigated the effects of intracerebroventricular (i.c.v.) pertussis toxin
      upon the sensitivity of supraoptic oxytocin neurones to intravenous morphine (1
      5000 micrograms/kg) in urethane-anaesthetized rats. The maximal inhibitory
      capacity of morphine was diminished by prior administration of pertussis toxin.
      Some cells were tested with both morphine and with the kappa-opioid agonist
      U50,488 (1-5000 micrograms/kg): U50,488-induced inhibition of firing rate was
      apparently unimpaired by pertussis toxin pre-treatment. The opioid inhibition of
      firing rate seen in the absence of and after pertussis toxin pre-treatment was
      naloxone-reversible. Thus a pertussis toxin-sensitive G protein may mediate the
      inhibitory action of morphine upon supraoptic putative oxytocin neurones or
      inputs to them.

PMID- 8359241
TI  - The effect of muscimol micro-injections into the fastigial nucleus on the
      optokinetic response and the vestibulo-ocular reflex in the alert monkey.
AB  - Eye movements of four macaque monkeys were investigated after unilateral micro
      injections of the GABA agonist muscimol (1 microgram in 1 microliter NaCl) into
      the caudal fastigial nucleus, i.e. the fastigial oculomotor region. Spontaneous
      eye movements in the dark and in the light were tested, as well as those evoked
      by vestibular stimulation in the dark (sinusoidal: 0.1-0.2 Hz, +/- 40-100 deg/s,
      velocity trapezoid acceleration 40 deg/s2, constant velocity 120 deg/s),
      optokinetic stimulation (sinusoidal: 0.1-0.2 Hz, +/- 40-100 deg/s, constant
      velocity 60-100 deg/s), and visual-vestibular conflict stimulation. With these
      stimuli, smooth pursuit mechanisms (fast build-up of optokinetic slow phase
      velocity), the vestibulo-ocular reflex (VOR) and the velocity storage mechanism
      were investigated. Muscimol injections consistently led to specific eye movement
      changes which were maximal 30-60 min after the injection and lasted 4-6 h. The
      fast initial rise of OKN slow phase velocity to the contralateral side decreased
      by 45% (range 24%-82%) of its pre-injection value, while it was virtually
      unaltered on the ipsilateral side (average decrease of 1%, range from a decrease
      of 20% to an increase of 32%). For conflict ramp stimulation, the suppression of
      vestibular nystagmus was less (decrease of 50%, range 12-82%) towards the
      contralateral side while it remained unchanged on the ipsilateral side. The VOR
      in the dark and the velocity storage mechanism were not altered. For the latter,
      the slow build-up of optokinetic nystagmus velocity, the optokinetic
      afternystagmus (OKAN) and the time constant of decay for the vestibular nystagmus
      were evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359242
TI  - Experimentally induced laminar necrosis, status verrucosus, focal cortical
      dysplasia reminiscent of microgyria, and porencephaly in the rat.
AB  - Different types of cortical malformation were produced, following focal cortical
      freezing, electrocoagulation, focal cortical aspiration or gentle brushing of
      uncovered meninges, in newborn or 1- to 3-day-old rats. Malformations included
      laminar necrosis of the cerebral cortex, status verrucosus, focal cortical
      dysplasia reminiscent of microgyria, and porencephaly. Similar procedures from
      postnatal day 4 onwards, at a time when a reactive astrogliosis is possible,
      produced cavitating infarcts and tissue scars. Cytoarchitectonic studies revealed
      an abnormal distribution of different types of pyramidal and non-pyramidal
      neurons in these malformations. These indicated three subtypes of focal cortical
      dysplasia, which probably depend on different pathogenic mechanisms.
      Autoradiographic studies with [3H] methylthymidine showed normal positioning of
      late-generated neuroblasts in the cerebral cortex, thus suggesting preserved
      migration. The present experimentally induced cortical malformations are useful
      models of similar cortical abnormalities in humans.

PMID- 8359243
TI  - Priming stimulation facilitates Hebb-type plasticity in the Schaffer collateral
      commissural pathways of the mouse hippocampus.
AB  - Hebb-type plastic changes of synaptic transmission were analyzed in the Schaffer
      collateral-commissural pathways (SC) of the mouse hippocampal slice. Low
      frequency (0.05-0.1 Hz) SC stimulation (S2) was paired with intracellular
      depolarization (100-200 ms; 2-3 nA) of CA1 pyramidal. Postpairing facilitation of
      synaptic responses in picrotoxin-free medium occurred only when S2 was "primed"
      with neurons the preceding shock (S1) administered through the same electrode 200
      ms before S2. Priming-determined disinhibition in local circuitry is supposed to
      be responsible for this phenomenon.

PMID- 8359244
TI  - Effect of optic nerve stimulation on neurons in pericruciate cortex of cats.
AB  - The distribution of optic chiasm input to different types of neurons in
      pericruciate cortex of cats agreed with previous work using light flashes. Neuron
      response times served to differentiate the input pathways to pericruciate cortex,
      and the types of neurons they influence. Input from the optic chiasm arrived in
      three distinct surges: the first via the superior colliculus, the second via an
      unidentified pathway, and the third via the visual cortex. A fourth, diffuse
      surge arrived in the postcruciate cortex via some unidentified pathway.
      Stimulation of the contralateral side of the optic chiasm had a weaker effect
      than stimulation of the ipsilateral side; it evoked activity at a higher
      threshold, with fewer spikes per response, and at a longer latency. The
      difference in response latency between the two sides was largest on neurons
      responding to the first surge, decreasing in later surges, and being least on
      those neurons responding to the last surge. About 2.3% of the postcruciate and
      15% of the precruciate neurons responded only to optic chiasm stimulation; they
      were isolated in the granular layers, and their responses could not be influenced
      by prior cutaneous input. It is suggested that much of the visual input to
      pericruciate cortex serves to modulate on-going cortical output and, thereby, the
      behavior of the animal.

PMID- 8359245
TI  - Characteristics of target-reaching in cats. I. Individual differences and intra
      individual constancy.
AB  - Trajectory formation of unrestrained forelimb target-reaching was investigated in
      six cats. A Selspot-like recording system was used for three-dimensional
      recording of the position of the wrist every 3 ms with the aid of two cameras
      detecting infrared light emitted from diodes taped to the wrist. These
      measurements allowed reconstruction of movement paths in the horizontal and
      sagittal planes and velocity profiles in the direction of the cartesian x, y and
      z co-ordinates. Horizontal movement paths were smoothly curved, segmented or
      almost linear. Sagittal movement paths were sigmoid. The net velocity profile was
      usually bell-shaped with longer deceleration than acceleration, but for some slow
      movements the velocity profile had a plateau. When the net velocity profile was
      bell-shaped, the averaged sagittal movement paths and normalized x (protraction)
      and z (lifting) velocity profiles were virtually superimposable for fast and slow
      movements: thus, movement speed was changed by parallel scaling of protraction
      and lifting. Comparison of movement paths and velocity profiles amongst the
      different cats revealed considerable differences. The x profile was unimodal in
      one cat and double peaked in five cats: the second component was pronounced in
      two cats and small in the other three. The z profile was unimodal and, except for
      one cat, it had later onset and summit than the first component of the x profile.
      In contrast to the interindividual differences, there was a high degree of
      intraindividual constancy over 6-12 months. It is postulated that the
      interindividual variability depends on chance differences established early
      during learning of the task and that the imprinted pattern remains, resulting in
      intra-individual constancy.

PMID- 8359246
TI  - Characteristics of target-reaching in cats. II. Reaching to targets at different
      locations.
AB  - Trajectory formation of unrestrained forelimb target-reaching was investigated in
      relation to the effect of a change in target location. Sagittal displacement of
      the target (6 cm in each direction) gave a selective change of velocity in the x
      direction (protraction) with an increase or decrease at larger and shorter
      distances, respectively. In the case of a double-peaked x velocity profile, the
      change was mainly with respect to the first major component. The shape of the y
      (sideways) and of the z (lifting) velocity profiles were both almost unchanged,
      but the onset of the movement in the z direction changed with the x distance.
      Vertical displacement (4 cm up or 5 cm down) gave increased velocity in the z
      direction (lifting) when the target was above the normal mid-position and
      decreased velocity when the target was lower. The velocity was changed with
      constant rate of rise, so that the rise time increased when the target was
      elevated and shortened when the target was lowered (pulse width control policy).
      The change in the z velocity was not selective. In cats with a double-peaked x
      velocity profile, the second component decreased when the target was elevated and
      increased when it was lowered. With excessive lowering of the target (14 cm
      down), the first x velocity component was very much reduced in amplitude so that
      protraction depended mainly on the second x velocity component. In the cat with a
      unimodal x velocity profile, a second component appeared in the x and net
      velocity profiles when the target was excessively lowered.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8359247
TI  - The inhibitory effect of the ventrolateral periaqueductal grey matter on neurones
      in the rostral ventrolateral medulla involves a relay in the medullary raphe
      nuclei.
AB  - Experiments were carried out in urethane-anaesthetised rats to determine whether
      the inhibition of neurones in the rostral ventrolateral medulla (RVLM) induced by
      stimulation in the ventrolateral periaqueductal grey matter (PAG), is mediated
      via a relay in the medullary raphe nuclei. Electrical stimulation in the
      ventrolateral part of the PAG (20-ms trains, 7 pulses, 5-100 microA) inhibited
      ongoing activity of neurones in the RVLM for periods of 10-120 ms (mean 43.6 ms).
      The duration of the inhibition was reduced by 51.1% after microinjection of GABA
      (40-160 nmol in volumes of 200-400 nl, 9/12 sites), but not 165 mM NaCl (8/8
      sites) in nucleus raphe magnus (NRM) and the rostral half of nucleus raphe
      obscurus (NRO). In a further series of experiments, activation of neuronal
      perikarya at 17 sites in NRM or NRO by microinjection of d,l-homocysteic acid (5
      40 nmol in volumes of 50-400 nl) inhibited ongoing activity of 9 out of 14
      neurones in the RVLM, the other 5 being excited. We suggest that the inhibitory
      effect on neurones in the RVLM, which can be evoked by stimulation in the
      ventrolateral PAG, is mediated indirectly by activation of an inhibitory
      projection to the RVLM from NRM and the rostral half of NRO.

PMID- 8359248
TI  - Gait-related motor patterns and hindlimb kinetics for the cat trot and gallop.
AB  - To assess speed- and gait-related changes in semitendinosus (ST) activity, EMG
      was recorded from three cats during treadmill locomotion. Selected step cycles
      were filmed, and hip and knee joint kinematics were synchronized with EMG
      records. Swing-phase kinetics for trot and gallop steps at 2.25 m/s were compared
      for gait-related differences. Also, swing kinetics for different gallop forms
      were compared. With few exceptions, ST-EMG was characterized by two bursts for
      each step cycle; the first preceded paw off (STpo), and the second preceded paw
      contact (STpc). The two-burst pattern for the walk was defined by a high
      amplitude STpo burst and a brief, low-amplitude STpc burst; at the slowest walk
      speeds, the STpc burst was occasionally absent. For the trot, the STpo burst was
      biphasic, with a brief pause just after paw off. With increasing walk-trot
      speeds, the duration of both bursts (STpo, STpc) remained relatively constant,
      but recruitment increased. Also, the onset latency of the STpo burst shifted, and
      a greater proportion of the burst was coincident with knee flexion during early
      swing. At the trot-gallop transition, there was an abrupt change in the two-burst
      pattern, and galloping was characterized by a high-amplitude STpc burst and a
      brief, low-amplitude STpo burst. At the fastest gallop speeds, the STpo burst was
      often absent, and the reduction in or elimination of the burst was associated
      with a unique pattern of swing phase kinetics at the knee. Knee flexion during
      the gallop swing was sustained by two inertial torques related to hip linear
      acceleration (HLA) and leg angular acceleration (LAA); correspondingly, muscle
      contraction was unnecessary. Conversely, knee flexion at the onset of the trot
      swing relied on a flexor muscle torque at the knee acting with an inertial flexor
      torque (LAA). Rotatory and transverse gallops at 4.0 m/s had similar swing phase
      kinetics and ST-EMG. Gait-related changes in ST-EMG, particularly at the trot
      gallop transition, are not congruent with neural models assuming that details of
      the ST motor pattern are produced by a spinal CPG. We suggest that motor patterns
      programmed by the spinal CPG are modulated by input from supraspinal centers
      and/or motion-related feedback from the hindlimbs to provide appropriate gait
      specific activation of the ST.

PMID- 8359250
TI  - Task-related behaviour of motor units in the human temporalis muscle.
AB  - Muscle activity patterns in some complex human jaw muscles appear to be task
      sensitive. However, it is presently uncertain how changes in motor task affect
      motor unit (MU) behaviour in the human temporalis muscle. In this study, activity
      was recorded from 40 MUs in the anterior region of the muscle. The lowest
      sustainable firing frequency (LSFF) was reached by slow increases and decreases
      in firing rate, then firing was maintained at the lowest possible rate without
      significant pauses. An array of consecutive interspike intervals (ISI) were
      sampled digitally and used to measure the LSFF for each task associated with the
      MU. In a controlled paradigm, MU reflex inhibition was measured during the
      performance of different tasks. Single electrical pulses of non-noxious intensity
      were delivered to the gingiva near the maxillary canine tooth. During continuous
      MU firing at a controlled firing frequency of 10 Hz, series of pulses were
      delivered with increasing delays, after preselected spikes. The MUs fired
      continuously during the performance of 1-4 postural and tooth-contact tasks.
      There were significant differences in LSFFs between tasks in those MUs associated
      with multiple tasks. In the reflex study, all MUs were inhibited, but the
      magnitude of the inhibition was highly task dependent. Thus, both LSFF and reflex
      inhibition of temporalis MUs appear to vary with the motor task and are sensitive
      to the position of the jaw and the direction and location of tooth contact along
      the tooth row. This behaviour most likely reflects task-related changes in output
      from orofacial and muscle afferents.

PMID- 8359249
TI  - Parallels between properties of high-threshold mechanoreceptors of the goat oral
      mucosa and human pain report.
AB  - In the following experiments, we examined parallels between properties of A-delta
      high-threshold mechanoreceptors (HTMs; mechanonociceptors, MN, and intense
      pressure receptors, IPR) innervating the goat mucosa and human mucosal pain
      report. As suggested in previous studies, activation thresholds of afferents
      which are generally considered to be mechanical nociceptors are far below
      mechanical pain thresholds. It was determined that classification of nociceptors
      by frequency thresholds, i.e., the pressure at which HTMs maintained a minimum
      frequency (97 g/mm2 and 117 g/mm2 for IPRs and MNs respectively) brings afferent
      reactivity into alignment with perceptual events. The range of reactivity of the
      nociceptor pool paralleled pain report from "faint-weak" (142 g/mm2) to "strong
      intense" (277 g/mm2). It is suggested that coding of intense mechanical pain from
      compressive forces is likely to arise from both individual afferents, whose
      reactivity spanned the range, and from recruitment of afferent populations with
      progressively higher thresholds.

PMID- 8359252
TI  - Neural activity in the caudate nucleus of monkeys during spatial sequencing.
AB  - Single cell activity was recorded from the monkey caudate nucleus. The animal had
      to execute motor and oculomotor sequences based on memorized information. In each
      trial, the monkey had to remember the order of illumination of three fixed
      spatial targets. After a delay, the animal had to press the targets in the same
      sequence. The "task-related" cells were activated by onset of the targets and on
      execution of saccades or arm movements. In a majority of cells, activation did
      not depend only on the retinal position of the stimuli or on the spatial
      parameters of gaze and arm movements, but was contingent on the particular
      sequence in which the targets were illuminated or the movements were performed.

PMID- 8359251
TI  - A perceptual analysis of viscosity.
AB  - The perception of viscosity was studied using the contralateral limb-matching
      procedure in which subjects adjusted the viscosity of a motor connected to the
      wrist of one (matching) arm until it was perceived to be the same as that of the
      motor attached to the other (reference) arm. Two servo-controlled electromagnetic
      linear motors with computer-controlled viscosity were used to present viscosities
      ranging in amplitude from 2 to 1024 N.s/m to 11 subjects. Ten different
      viscosities were matched by subjects, and there were ten repetitions of each
      stimulus amplitude. The psychophysical function relating the reference to
      matching viscosity was linear (99% variance accounted for), and the accuracy with
      which the viscosities were matched (slope of 0.88) paralleled that reported
      previously for force, limb position and stiffness. The Weber fraction for
      viscosity was 0.34, which is 50% larger than that measured for stiffness and over
      twice that reported for force. An analysis of the movements and forces generated
      to perceive the reference viscosity revealed that subjects did not vary the
      amplitude of the movements and typically made very small excursions of the
      forearm, but that both the velocity of the movements and force changed
      significantly as a function of the reference viscosity. These findings were
      interpreted as indicating that the human proprioceptive system is capable of
      integrating information regarding force and movement velocity so as to perceive
      the viscosity of a mechanical system connected to the limbs, but that its
      sensitivity to changes in viscosity is much less than would be predicted from its
      capacity to detect variations in muscle force and limb movement.

PMID- 8359253
TI  - In vivo tracing of pathways and spatio-temporal activity patterns in rat visual
      cortex using voltage sensitive dyes.
AB  - We monitored optical signals from cortex stained with a voltage sensitive dye to
      study activity evoked by intracortical electrical stimulation. The objectives
      were to study the spatial and temporal spread of activity from intrinsic
      connections near the stimulating electrode and to develop a new technique to
      study extrinsic projections from striate cortex to extrastriate target areas.
      Various measures were made of the time course of the optical signal (latency,
      rise time, decay time, temporal summation, facilitation versus depression, and
      presence or absence of a slow undershoot); in general, these measures were found
      to vary significantly across different response positions, different experiments,
      and even different runs within the same experiment. The spatial distribution of
      responses near the stimulating electrode in striate cortex was usually elliptical
      and was most often elongated along the anterior-posterior axis, with a typical
      size (full width at 75% max) of 1.3 mm (anterior-posterior axis) by 0.75 mm
      (medio-lateral axis). In some cases, complex spatio-temporal patterns were
      observed, in which the position of the maximum optical signal shifted with time
      or split into multiple peaks. In eight experiments, a response focus was found in
      extrastriate cortex at an expected location within the lateromedial area (LM).
      The response focus in LM was typically about half the size of that in striate
      cortex. In some experiments we observed additional focal responses in the
      anterolateral visual area (AL). The extrastriate responses showed a significant
      delay (3-10 ms) in onset and time to peak relative to the striate response. The
      validity of this technique for determining extrinsic projections was tested in
      two types of experiments. In the first, stimulation from two electrodes in
      striate cortex generated response foci consistent with the known topographic
      organization of area LM. In the second, the optically measured response focus was
      shown to correlate with the histologically reconstructed projection of a chemical
      tracer injected near the site of stimulation. We discuss the chain of
      neurophysiological events that occur during and after focal electrical
      stimulation and how they relate to the observed optical signal. We conclude that
      direct passive responses were a small component of our signal, that the component
      due to action potentials in directly stimulated neurons should have occurred in
      the first 1-2 ms post stimulus and is small compared to the peak signal, and that
      overall our signals were probably dominated by a combination of asynchronously
      occurring action potentials and excitatory and inhibitory synaptic
      potentials.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8359254
TI  - Morphology of visual callosal neurons with different locations, contralateral
      targets or patterns of development.
AB  - In kittens, callosally projecting neurons were labeled by retrograde transport of
      FITC- (fluorescein isothiocyanate)- and TRITC- (tetramethylrhodamine
      isothiocyanate)-conjugated latex microspheres injected in two different visual
      areas (17, 17/18, 19, or postero-medial lateral suprasylvian; PMLS) at postnatal
      day 3. At postnatal day 57 more than 1200 labeled neurons in visual cortical
      areas were intracellularly injected with 3% lucifer yellow (LY) in perfusion
      fixed slices of the contralateral hemisphere. The distribution of labeled neurons
      was charted, and LY-filled neurons were classified on the basis of their area and
      layer of location, and dendritic pattern. The dendritic arbors of 120 neurons
      were computer reconstructed. For the basal dendrites of supragranular pyramidal
      neurons a statistical analysis of number of nodes, internodal and terminal
      segment lengths, and total dendritic length was run relative to the area of
      location and axonal projection. Connections were stronger between homotopic than
      between heterotopic areas. Overall tangential and laminar distributions depended
      on the area injected. Qualitative morphological differences were found among
      callosally projecting neurons, related to the area of location, not to that of
      projection. In all projections from areas 17 and 18, pyramidal and spinous
      stellate neurons were found in supragranular layers. In contrast, spinous
      stellate neurons lacked in projections from area 19, 21a, PMLS and postero
      lateral lateral suprasylvian (PLLS). In all areas, the infragranular neurons
      showed heterogeneous typology, but in PMLS no fusiform cells were found.
      Quantitative analysis of basal dendrites did not reveal significant differences
      in total dendritic length, terminal, or intermediate segment length among neurons
      in area 17 or 18, and this was related to whether they projected to contralateral
      areas 17-18 or PMLS. All injections produced exuberant labeling in area 17. No
      differences could be found between neurons in area 17 (with transient axons
      through the corpus callosum) and neurons near the 17/18 border (which maintain
      projections to the corpus callosum). In conclusion, morphology of callosally
      projecting neurons seems to relate more to intrinsic specificities in the
      cellular composition of each area than to the area of contralateral axonal
      projection or the fate of callosal axons.

PMID- 8359255
TI  - Binocular interaction and disparity coding in area 19 of visual cortex in normal
      and split-chiasm cats.
AB  - Binocular disparity, resulting from the projection of a three-dimensional object
      on the two spatially separated retinae, constitutes one of the principal cues for
      stereoscopic perception. The binocularity of cells in one hemisphere stems from
      two sources: (1) the ganglion cells in the homonymous temporal and nasal
      hemiretinae and (2) the contralateral hemisphere via the corpus callosum (CC).
      The objectives of this study were, on one hand, to determine whether disparity
      sensitive cells are present in a "higher order" area, namely area 19 of the
      visual cortex, of the cat and, on the other hand, to ascertain whether the CC
      contributes to the formation of these cells. As in areas 17-18, two types of
      disparity-sensitive neurons were found: one type, showing maximal interactive
      effects around zero disparity, responded with strong excitation or inhibition
      when the stimuli presented independently to the two eyes were in register. These
      neurons are presumed to signal stimuli situated about the fixation plane. The
      other type, also made up of two subtypes of opposed valencies, gave maximum
      responses at one set of disparities and inhibitory responses to the other set.
      These are presumed to signal stimuli situated in front of or behind the fixation
      plane. Unlike areas 17-18, however, disparity-sensitive cells in area 19 of the
      normal cat were less finely tuned and their proportion was lower. In the split
      chiasm animal, very few cells were sensitive to disparity. These results, when
      coupled with behavioral data obtained with destriate animals, indicate that (1)
      area 19 is probably less involved in the analysis of disparity information than
      area 17, (2) the disparity-sensitive neurons that are sensitive to disparity are
      not involved in the resolution of very fine three-dimensional spatial detail, and
      (3) the CC only determines a limited number of these cells in the absence of
      normal binocular input.

PMID- 8359256
TI  - Differential effects of local inactivation within motor cortex and red nucleus on
      performance of an elbow task in the cat.
AB  - This study examined changes in the performance of a single-joint, elbow task
      produced by reversible inactivation of local regions within the proximal forelimb
      representation in area 4 gamma of motor cortex (MCx) and the red nucleus (RN) of
      the cat. Inactivation was carried out by microinjecting lidocaine, gamma
      aminobutyric acid, or muscimol into sites where microstimulation evoked
      contraction of elbow muscles. Reaction time, amplitude, and speed (velocity or
      dF/dt) of position and force responses elicited during inactivation were compared
      to control values obtained immediately prior to inactivation. In addition, we
      assessed qualitatively the effects of inactivation on reaching, placing
      reactions, and proprioceptive responses to imposed limb displacement. In the
      single-joint task, injections in MCx did not increase reaction time (simple or
      choice) and produced modest and inconsistent reductions in response amplitude
      (mean -8%) and speed (mean -19%). In contrast, injections of the same amounts of
      inactivating agents in the forelimb representation of RN consistently increased
      reaction time (34.4%), and increased the reaction time coefficient of variability
      (32%). There were small reductions in response amplitude (-4%) and speed (-10%)
      which were less than those produced by MCx inactivation. During reaching,
      however, these same injections in MCx and RN produced a substantial loss of
      accuracy. For MCx, this was due, in part, to systematic hypometria: for RN,
      inaccuracy resulted from increased variability in paw paths. Placing reactions
      and corrective responses to imposed limb displacements were also depressed by the
      cortical and rubral injections. Our results suggest that the forelimb
      representation in RN plays a role in the initiation of the single-joint, elbow
      tracking response examined here. The RN may mediate cerebellar regulation of
      response timing, a function that is likely to be important for interjoint
      coordination. Although neurons in the forelimb representations of MCx may
      contribute to force generation in single-joint movements, their contribution to
      multijoint control appears to be more important and is examined in the subsequent
      report (Martin and Ghez 1993).

PMID- 8359257
TI  - Differential impairments in reaching and grasping produced by local inactivation
      within the forelimb representation of the motor cortex in the cat.
AB  - This study analyzed changes in the performance of a reaching task and its
      adaptive modification produced by reversible inactivation of three sites within
      the forelimb representation of the motor cortex (MCx, area 4 gamma) in five cats
      by microinjections of muscimol. Two sites were located in the lateral MCx,
      rostral (RL-MCx) and caudal (CL-MCx) to the end of the cruciate sulcus, where
      intracortical microstimulation (ICMS) produced contraction of the most distal
      muscles. The third site was located more medially, in the anterior sigmoid gyrus
      (RM-MCx) where ICMS primarily produced contraction of more proximal muscles. The
      task required the animals to reach into a horizontal target well, located in
      front of them at one of three possible heights, to grasp and retrieve a small
      piece of food. The height of the reach was primarily achieved by elbow flexion.
      Grasping consisted primarily of digit flexion, and food retrieval consisted of
      forearm supination and shoulder extension. In some blocks of trials, an obstacle
      was placed in the path of the limb to assess the animal's ability to adaptively
      adjust the kinematic characteristics of their response trajectory. In normal
      animals, contact with the bar on the first trial triggered a corrective response
      at short latency that allowed the paw to circumvent the bar. On all subsequent
      trials, the trajectory was adapted to prevent contact with the obstacle, with a
      safety margin of about 1 cm. Inactivation at all sites produced a slowing of
      movement, a protracted and extended forelimb posture, and increased variability
      of initial limb position. In addition, inactivation of RL-MCx immediately
      produced systematic reaching errors, consisting of hypermetric movements, as well
      as impaired grasping and food retrieval. The degree of hypermetria was similar
      for all target heights and was not associated with alterations in trajectory
      control. During inactivation, animals did not compensate for the hypermetria by
      reducing paw path elevation, suggesting a defect in kinematic planning or in
      adaptive control. This was confirmed by finding that trajectory adaptation to
      avoid bar contact was impaired during RL-MCx inactivation. The short latency
      corrective response, triggered by contact of the limb with the obstacle was,
      however, preserved. Inactivation of CL-MCx did not impair aiming, grasping, or
      adaptation immediately after injection. However, impairments occurred after about
      1 h postinjection, and at that time mimicked the effects of RL-MCx
      inactivation.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8359258
TI  - Changes induced in the representation of auditory space in the superior
      colliculus by rearing ferrets with binocular eyelid suture.
AB  - There have been conflicting reports concerning the importance of visual
      experience in the development of auditory localization mechanisms. We have
      examined the representation of auditory space in the superior colliculus of adult
      ferrets that were visually deprived by binocular eyelid suture from postnatal
      days 25-28, prior to natural eye opening, until the time of recording. This
      procedure attenuated the transmission of light by a factor of a least 20-25 and
      blurred the image so that, as long as the eyelids were still fused, the responses
      of visual units in the superficial layers of the superior colliculus were labile
      and very poorly tuned. After the eyelids were opened, the representation of the
      visual field in these layers appeared to be normal. Acoustically responsive units
      were, as usual, almost exclusively restricted to the deeper layers of the
      superior colliculus. However, unlike normal animals, where responses occurring
      only at stimulus onset predominate, most of these units exhibited sustained or
      multi-peaked discharge patterns. The degree of spatial tuning of individual units
      recorded from the normal and deprived groups of animals was not significantly
      different in either azimuth or elevation. Normally orientated maps of both sound
      azimuth and elevation were also found in the visually deprived ferrets. However,
      abnormalities were present in the topography and precision of these
      representations and consequently in their alignment with the overlying visual
      map. In particular, an increase was observed in the proportion of auditory units
      with spatially ambiguous receptive fields, in which the maximum response occurred
      at two distinct locations. These results indicate that patterned visual
      experience is not required for establishing at least a crude map of auditory
      space in the superior colliculus, but suggest that it may play a role in refining
      this representation during development.

PMID- 8359259
TI  - Effects of prolonged weightlessness on horizontal and vertical optokinetic
      nystagmus and optokinetic after-nystagmus in humans.
AB  - Horizontal and vertical optokinetic nystagmus (OKN) and optokinetic after
      nystagmus (OKAN) provided by a partial-field, binocular optokinetic stimulator
      were recorded in one astronaut before, during, and after a 25-day space flight. A
      ground-based study was performed on six control subjects. During the flight
      experiment, performed on flight days 5, 18, 19, and 21, the subject either had
      their feet attached to the deck or was free-floating. Vertical OKN gain only
      slightly increased in weightlessness compared with ground data, but the center of
      interest (CI) during vertical OKN, evaluated by the eye position in the saggital
      plane at the end of the fast phases relative to the straight-ahead direction, was
      found to be significantly changed during long-term exposure to weightlessness.
      The horizontal CI showed very little change in-flight, but the gain was
      increased. The time constant for the astronaut was small for vertical OKAN, but
      there was an increase in slow-phase velocity (SPV) by the end of the flight,
      which returned to normal postflight. These results partly confirm the data
      obtained during head-tilt studies on the ground and are in accordance with the
      hypothesis of a gravity-dependent control of vertical gaze direction during
      orientation reflexes.

PMID- 8359260
TI  - Human gaze shifts in which head and eyes are not initially aligned.
AB  - Most studies of rapid orienting gaze shifts generated by combined eye and head
      movements have focused on an experimental condition in which gaze displacements
      are started with the subject's eyes in the normal straight-ahead position in the
      orbit. Such an experimental approach does not permit a clear identification of
      the input signal to the head motor system, because target offset angle is the
      same for both the eye and head. We have studied gaze shifts in human subjects
      which began with the visual axis straight ahead relative to the body (i.e., gaze
      or line of sight aligned with body sagittal plane) and with head offset from
      straight ahead at various angular positions. In our experimental conditions, the
      amplitude of head movement during a gaze shift was nearly equal to the angular
      distance between the target position and the starting head position (target-re
      head), even though subjects were not specifically instructed to move their heads.
      This observation contrasts with other published reports in the literature showing
      considerable variability amongst subjects in the amplitude of head rotation
      within a given task and between tasks. The difference may be related to the
      initial conditions which required subjects to align the eye and head on specific
      starting targets, since others have shown that requiring head alignment enhances
      head displacement. The amplitude of the saccadic eye movement was not determined
      by either the target's position relative to the starting eye or head positions.
      The value that best described the eye movement amplitude was the eye position in
      the orbit at the end of the saccade.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359261
TI  - Coordination between the transport and the grasp components during prehension
      movements.
AB  - In this study, the possible influence of the transport on the grasp component of
      prehension movements was investigated. The first phase of the transport
      (acceleration phase) and of the grasp (finger aperture phase) kinematics were
      studied under conditions of visual and non-visual object presentation (prehension
      experiment). In the non-visual condition, object size was estimated by haptics
      and object position was estimated by proprioception. Eight subjects were required
      to reach and grasp three objects of different size located at two distances. An
      additional experiment (matching experiment) was carried out to control the
      scaling of object size in two conditions. The results showed that in the matching
      experiment size estimation for large objects was similar in the two conditions,
      whereas small stimuli were underestimated in the haptic condition. In the
      prehension experiment, maximal finger aperture and velocity of finger aperture
      were greater in the non-visual than in the visual condition, and the difference
      was greater for small than for large stimuli. Moreover, in both conditions,
      finger opening was larger for prehension movements directed to the far than to
      the near objects, but only for smaller stimuli. Hand trajectory variability
      increased in the non-visual condition and with the distance, whereas finger
      opening variability was only affected by the non-visual condition. For smaller
      stimuli, increased finger opening with distance was positively correlated with
      the increase in wrist variability in the visual condition, but not in the non
      visual condition. Furthermore, increased finger opening between visual and non
      visual conditions was correlated with the increase in wrist variability, for
      smaller objects at the near object location.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359262
TI  - Role of the cerebellum in visuomotor coordination. I. Delayed eye and arm
      initiation in patients with mild cerebellar ataxia.
AB  - The initiation of coupled eye and arm movements was studied in six patients with
      mild cerebellar dysfunction and in six age-matched control subjects. The
      experimental paradigm consisted of 40 deg step-tracking elbow movements made
      under different feedback conditions. During tracking with the eyes only, saccadic
      latencies in patients were within normal limits. When patients were required to
      make coordinated eye and arm movements, however, eye movement onset was
      significantly delayed. In addition, removal of visual information about arm
      versus target position had a pronounced differential effect on movement
      latencies. When the target was extinguished for 3 s immediately following a step
      change in target position, both eye and arm onset times were further prolonged
      compared to movements made to continuously visible targets. When visual
      information concerning arm position was removed, onset times were reduced. Eye
      and arm latencies in control subjects were unaffected by changes in visual
      feedback. The results of this study clearly demonstrate that, in contrast to
      earlier reports of normal saccadic latencies associated with cerebellar
      dysfunction, initiation of both eye and arm movements is prolonged during
      coordinated visuomotor tracking thus supporting a coordinative role for the
      cerebellum during oculo-manual tracking tasks.

PMID- 8359263
TI  - On the origin of the postexcitatory inhibition seen after transcranial magnetic
      brain stimulation in awake human subjects.
AB  - Non-invasive transcranial magnetic stimulation (TMS) of motor cortex induces
      motor evoked potentials in contralateral muscles which are thought to be
      conducted by the corticospinal tract. Furthermore, inhibitory actions can be
      elicited by TMS which appear directly after the motor evoked potential
      (postexcitatory inhibition, PI) and can be visualized by blockade of tonic
      voluntary EMG activity. It was the aim of the present study to answer the
      questions of whether this inhibitory action is mainly of cortical or of spinal
      origin, which brain area generates this inhibition, and whether the duration of
      PI differs between proximal and distal muscles. Experiments were performed on a
      total of 34 healthy volunteers. Brain stimuli were delivered with a Novametrix
      Magstim 200HP with a maximum output of 2.0 T, and stimulation was performed
      during tonic voluntary activation of the muscle under study. Stimulation strength
      was 1.5 times threshold level. Duration of PI was defined as the time from the
      onset of the motor evoked potential to the reoccurrence of the EMG background
      activity. PI was found more pronounced in distal hand muscles than in proximal
      arm and leg muscles. The largest PI values were observed when the primary motor
      cortex was stimulated. To test the excitability of the spinal motoneurones during
      PI, cortical double stimulation at various intervals was performed and the soleus
      H-reflex was evoked at different intervals after cortical stimulation. Neither
      test revealed a decrease in the excitability of the spinal motoneurones during
      PI. These findings imply that spinal segmental inhibitory action cannot account
      for PI and that, most probably, inhibitory actions within the motor cortex play a
      major role in the genesis of PI.

PMID- 8359264
TI  - Principles for learning single-joint movements. I. Enhanced performance by
      practice.
AB  - This study investigated changes in myoelectric and mechanical variables for
      movements made "as fast as possible" as a function of practice in the context of
      the dual-strategy hypothesis of motor control (Gottlieb et al. 1989b). Five male
      subjects made 1400 rapid elbow flexion movements in ten blocks of 20 trials over
      seven experimental sessions. Improved performance was defined as increased peak
      movement velocity, decreased peak velocity variability, increased acceleration
      and deceleration, a proportionately greater increase in peak deceleration than
      peak acceleration, and greater consistency in terminal location. The changes
      observed over experimental sessions were very similar to (but larger and more
      consistent than) those seen for the first experimental session, with the partial
      exception of the timing of the antagonist electromyogram (EMG). In general, the
      increases in the values of the measured mechanical variables covary with
      myoelectric measures in the same way as when subjects are asked to intentionally
      change speed in accordance with the rules of the speed-sensitive strategy (Corcos
      et al. 1989). However, there are differences between subjects in the extent to
      which speed changes can be attributable to the agonist muscle, the antagonist
      muscle, or in the timing between the muscles. In one of the five subjects, the
      latency of the antagonist EMG decreased over blocks on the 1st day but increased
      over experimental sessions and was consequently activated proportionately later
      in the movement. This suggests that extended practice can give at least some
      subjects flexibility in modifying the motor programs that underlie movement.

PMID- 8359266
TI  - Compensation for mechanically unstable loading in voluntary wrist movement.
AB  - In order to study the roles of muscle mechanics and reflex feedback in
      stabilizing movement, experiments were conducted in which healthy human subjects
      performed targeted wrist movements under conditions where the damping of the
      wrist was reduced with a load having the property of negative viscosity. If the
      movement speed and negative viscosity. If the movement speed and negative
      viscosity were sufficiently high, the wrist oscillated for several hundred
      milliseconds about the final target position. Subjects increased the activation
      of both wrist flexor and extensor muscles to increase joint stiffness to damp the
      oscillations. With practice, both the tendency to oscillate and the level of
      muscle activation were reduced. A small bias torque in either direction, added to
      the negative viscosity, enhanced the oscillations as well as the amount of flexor
      and extensor muscle activation during the stabilization phase of fast movements.
      The tendency for the wrist to oscillate was also seen during slow movements where
      the oscillations were superimposed upon the voluntary movement. We suggest that
      this reduction in mechanical stability is primarily of reflex origin. As wrist
      stiffness increases, the natural frequency of the wrist also increases, which in
      turn produces an increase in the phase lag of the torque generated by the
      myotatic reflex with respect to wrist angular velocity, effectively reducing
      damping. The oscillation frequency was often close to a critical frequency for
      stability at which torque, due to the myotatic reflex, lagged angular velocity by
      180 degrees (6-7.5 Hz). Nevertheless, subjects were able to damp these
      oscillations, probably because the torque due to intrinsic muscle stiffness (in
      phase with position and hence lagging velocity by only 90 degrees) dominated the
      torque contribution of the myotatic reflex. Increasing stiffness with declining
      oscillation amplitude may also have contributed significantly to damping.

PMID- 8359265
TI  - Principles for learning single-joint movements. II. Generalizing a learned
      behavior.
AB  - The previous paper in this series showed that changes both within and between
      experimental sessions can be understood in the framework of the dual-strategy
      hypothesis of motor control, with a modification sometimes required for the
      timing of the antagonist muscle. The present paper extends these findings by
      determining how practicing movements at one distance generalizes to changes in
      performance at other distances. Five subjects made elbow flexion movements over
      five different distances (pretest). They then performed 1400 movements (seven
      sessions of ten blocks of 20 trials) at only one of those distances. The subjects
      then repeated the flexion movements over the five different distances (posttest).
      On the posttest, subjects decreased their average movement time by 20 ms. In
      addition, their movements became less variable. The electromyographic pattern of
      the faster movements was characterized by a more rapidly rising electromyogram,
      for three of the subjects, and an antagonist latency that decreased.

PMID- 8359267
TI  - Effects of cortical stimulation on reciprocal inhibition in humans.
AB  - We attempted to demonstrate convergence onto human spinal Ia inhibitory
      interneurons from Ia afferents and from fast conducting corticospinal axons.
      Stimulation of the common peroneal nerve at or below the threshold of the alpha
      motoneuron axons resulted in inhibition of the soleus H-reflex, attributed to
      reciprocal inhibition. Magnetic stimulation over the contralateral motor cortex
      resulted in complex modulations of the soleus H-reflex, including a short latency
      inhibition. To test for convergence, the two stimuli were given together so that
      the two inhibitions coincided. When each stimulus alone produced clear
      inhibition, the inhibition produced by both stimuli was less than expected,
      implying an interaction between the two volleys, for example, occlusion occurring
      in interneurons or motoneurons. When the H-reflex was relatively unaffected by
      one or other conditioning volley, the inhibition produced by the combined
      stimulation was greater than expected, as might be expected with convergence onto
      a common pool of interneurons.

PMID- 8359268
TI  - Introduction. Melatonin and the light-dark zeitgeber in vertebrates,
      invertebrates and unicellular organisms.

PMID- 8359269
TI  - Presence in and effects of pineal indoleamines at very low level of phylogeny.
AB  - The unicellular organism Tetrahymena contains serotonin and is able to take up
      the hormone from its milieu. The serotonin content of the cell changes as a
      function of the presence of foreign exogenous hormones. This indicates a possible
      role of serotonin as a chemical mediator. Exogenous serotonin stimulates the RNA
      synthesis of Tetrahymena, and it was the only one among the hormones studied
      which kept the RNA level durably high. Serotonin stimulates phagocytosis and
      growth of Tetrahymena, and its precursors also stimulate growth. Serotonin can
      imprint Tetrahymena, and as a consequence of this the effect of the hormone
      increases in the case of further encounters. Treatment with serotonin-related
      molecules soon after imprinting can reduce the effect of imprinting. Melatonin
      can contract the pigment cells of Planaria; however, its precursors serotonin and
      tryptamine can do this more intensely. Both melatonin and serotonin can influence
      the regeneration of Planaria, with effects which differ when different phenomena
      are studied. Evolutionary theories are discussed.

PMID- 8359271
TI  - Structures and molecules involved in generation and regulation of biological
      rhythms in vertebrates and invertebrates.
AB  - Melatonin from the retina and the pineal gland functions in neuroendocrine
      hierarchies. Photoreceptors--eyes and extraretinal--detect light. Oscillators-
      pineal and suprachiasmatic nuclei--act as pacemakers. Driven neuroendocrine
      rhythms carry temporal hormone signals throughout the body. Light controls
      melatonin: light sets the phase of the melatonin rhythm and determines the
      duration of melatonin synthesis. By these means, circadian rhythms (e.g., in
      locomotor activity and body temperature) and seasonal rhythms (e.g., in
      reproduction) are controlled.

PMID- 8359270
TI  - Calmodulin mediates melatonin cytoskeletal effects.
AB  - In this article, we review the data concerning melatonin interactions with
      calmodulin. The kinetics of melatonin-calmodulin binding suggest that the hormone
      modulates cell activity through intracellular binding to the protein at
      physiological concentration ranges. Melatonin interaction with calmodulin may
      allow the hormone to modulate rhythmically many cellular functions. Melatonin's
      effect on tubulin polymerization, and cytoskeletal changes in MDCK and N1E-115
      cells cultured with melatonin, suggest that at low concentrations (10(-9) M)
      cytoskeletal effects are mediated by its antagonism to Ca2+-calmodulin. At higher
      concentrations (10(-5)M) non-specific binding of melatonin to tubulin occurs thus
      overcoming the specific melatonin antagonism to Ca2+-calmodulin. Since the
      structures of melatonin and calmodulin are phylogenetically well preserved,
      calmodulin-melatonin interaction probably represents a major mechanism for
      regulation and synchronization of cell physiology.

PMID- 8359272
TI  - The contribution of extrapineal sites of melatonin synthesis to circulating
      melatonin levels in higher vertebrates.
AB  - While the production of melatonin in higher vertebrates occurs in other organs
      and tissues besides the pineal, the contribution of extrapineal sites of
      melatonin synthesis such as the retina, the Harderian glands and the gut to
      circulating melatonin levels is still a matter of debate. The amount of melatonin
      found in the gastrointestinal tract is much higher than in any other organ
      including the pineal and the gut appears to make a significant contribution to
      circulating melatonin at least under certain conditions. The gut has been
      identified to be the major source of the elevated plasma concentrations of
      melatonin seen after tryptophan administration and of the changes of circulating
      melatonin level induced by the feeding regimen. Whereas the circadian and
      circannual fluctuations of the concentration of melatonin in the blood seem to be
      triggered by changes of the photoenvironment and its effect of pineal melatonin
      formation, basal daytime melatonin levels and the extent of their elevation at
      nighttime appear to be additionally controlled by nutritional factors, such as
      the amount and the composition of ingested food and therefore availability of
      tryptophan as a rate-limiting precursor of melatonin formation by the
      enterochromaffin cells of the gastrointestinal tract.

PMID- 8359274
TI  - Melatonin decreases the amplitude of the b-wave of the human electroretinogram.
AB  - In a double-blind placebo crossover study of 13 healthy volunteers, the pineal
      hormone melatonin (10 mg) was given at 4 pm, and the electroretinogram measured
      under conditions of dark and light adaptation. A significant diminution of b-wave
      amplitude was found under both photopic (delta = 5.4 microV, p < 0.05) and
      scotopic conditions (delta = 7.4 microV, p < 0.01). These data indicate that
      melatonin may transduce the dark signal at the level of the retina as well as the
      pineal. Acute administration of melatonin decreases sensitivity to light.

PMID- 8359275
TI  - Partition coefficients of drugs in bilayer lipid membranes.
AB  - The oil/water partition coefficient of drugs is widely accepted as a key
      parameter in drug design. The coefficients are usually determined using a bulk
      octanol phase to represent the lipid. The physiologically and pharmacologically
      relevant structure is, of course, the bilayer lipid membrane, but until now there
      has been no convenient means of measuring the partition coefficients of small
      molecules into a single bilayer. This paper demonstrates that the partition
      coefficient may be calculated from the change in membrane refractive index which
      occurs when a drug molecule partitions into the membrane. The refractive index is
      determined by an integrated-optics technique ideally suited to an ultra-thin
      structure such as a lipid bilayer.

PMID- 8359273
TI  - Clinical aspects of the melatonin action: impact of development, aging, and
      puberty, involvement of melatonin in psychiatric disease and importance of
      neuroimmunoendocrine interactions.
AB  - During the last decade we have learned much on physiological changes in the
      secretion of the pineal hormone melatonin (MLT) in man. Reportedly, there is
      little or no MLT secreted before age 3 months. Then MLT production commences,
      becomes circadian, and reaches highest nocturnal levels at the age of 1-3 years.
      During all of childhood nocturnal peak levels drop progressively by 80% until
      adult levels are reached. This alteration appears to be the consequence of
      increasing body size in face of constant MLT production during childhood. The
      biological significance of this MLT alteration is presently unknown. Because of
      conceptual considerations, major depressive syndrome (MDS) and seasonal affective
      disorder (SAD) have been in the focus of pineal research for several years.
      Although in these disorders alterations in MLT levels could not be substantiated,
      light therapy, a consequence of this research, was discovered as an effective
      treatment for SAD and perhaps for MDS. In addition, there is some recent evidence
      for low MLT levels in schizophrenia. Finally, the potential effect of MLT in
      neuroimmunoendocrine interactions is presently explored. Reportedly, in vitro
      studies and animal experiments give evidence for a modulatory role of MLT in the
      immune response. However, the exact way of this possible action of MLT remains to
      be clarified. Clinical studies are too scant for a meaningful estimation of MLT's
      involvement in human neuroimmunoendocrine interactions.

PMID- 8359276
TI  - Role of 1,25-dihydroxyvitamin D3 in the generation of the acute-phase response in
      rats with talc-induced granulomatosis.
AB  - Subcutaneous injection of nonspecific irritants such as magnesium silicate (talc)
      provokes granulomatous inflammation in the rat. Part of the acute phase response
      (APR) in these animals is the loss of trabecular bone at sites distant from the
      site of inflammation. To assess the possible involvement of vitamin D in the bone
      loss, we studied the development of the acute phase response in vitamin D
      deprived rats. The serum APR provoked by subcutaneous inflammation in rachitic
      rats consisted of hypozincemia, hypercupremia, increased alkaline phosphatase
      activity and adrenocorticotropic hormone (ACTH) concentration, and was similar to
      that in control animals except for the absence of hypoferremia. Control rats with
      talc-induced subcutaneous inflammation also had splenomegaly and decreased total
      and mononuclear peripheral blood cell counts, while subcutaneous inflammation did
      not induce spleen changes in rachitic rats. Subcutaneous inflammation induced the
      loss of trabecular bone and decreased the osteoblastic cell count in tibial
      metaphyses in control animals. Rachitic rats had abundant osteoid on trabecular
      surfaces, and the number of osteoblasts and osteoclasts was comparable to that of
      the controls. Subcutaneous inflammation did not affect any of the bone parameters
      in rachitic rats. These results indicate that vitamin D plays an important role
      in the generation of the acute phase response during inflammation, particularly
      in the induction of spleen and bone cell changes. The discrepancy of the blood on
      one hand and bone and spleen indices of the APR on the other, indicate that they
      may be divergent pathways in the generation of the inflammatory response, some of
      which may be dependent on vitamin D.

PMID- 8359277
TI  - Protein aggregation as primary and characteristic cell reaction to various
      stresses.
AB  - Ehrlich carcinoma and EL-4 thymoma ascites cells were subjected in vitro to heat
      shock, ATP depletion, oxidative stress, Ca2+ overloading and iodoacetamide
      treatment. After the transient stresses, Triton (X-100)insoluble (TIS) fractions
      were isolated from the cells and analysed by electrophoresis and immunoblotting.
      All stresses used caused rapid aggregation of cell proteins. This was manifested
      in a significant rise in protein content in the TIS fractions. The protein
      increase was mostly due to an increase in the insolubility of actin, 57 kDa
      protein of intermediate filaments, 70 kDa heat shock protein (HSP 70), and some
      specific proteins whose insolubilization was a characteristic sign for each type
      of cell injury. Different survival rates in the cell lines after either stress
      correlated well with differences in their TIS protein accretion. Possible
      mechanisms for stress-induced protein aggregation and its relationship with cell
      viability are suggested.

PMID- 8359278
TI  - The width of excision of cutaneous melanoma.

PMID- 8359279
TI  - Mucosal malignant melanoma of head and neck: forty-eight cases treated at
      Istituto Nazionale Tumori of Milan.
AB  - A series of 48 cases of malignant mucosal melanomas treated at the Milan Cancer
      Institute from 1975 to 1990 is retrospectively reviewed. There were 34 males and
      14 females, and their ages ranged from 21 to 79 years (mean, 58). The site of
      origin of the tumor was the nasal cavity in 26 cases, the oral cavity in 15,
      larynx in two, lip mucosa in two, pharynx in two and upper esophagus in one. At
      presentation, the neoplasm was limited to the primary site in 60.4% of the
      patients. Most patients (34) were treated with surgery alone. Nine were treated
      with surgery combined with chemo- and/or radiotherapy and five with radiotherapy
      combined with chemotherapy and/or immunotherapy. Only when surgery was part of
      the treatment (42 of 48 cases) the patients were rendered disease free, but no
      further relapse of disease was documented in only five of these patients. The
      observed 2- and 5-year survival rate of the entire group was 45% and 21%,
      respectively. The 4-year disease-free survival rate was 7%. The median interval
      between therapy and the first relapse was 8.5 months (range, 1-66). In 44% of the
      patients the first recurrence of the tumor was at the primary site.

PMID- 8359280
TI  - Mandible reconstruction with metallic endoprosthesis following Commando's
      operation for advanced head and neck cancer. Personal experience.
AB  - Invasion of the mandible is found in 22% to 29% of advanced (Stage III-IV) head
      and neck cancers; only an aggressive surgical technique, such as Commando's
      operation with subsequent reconstruction of tissue defects, can give a chance of
      cure to these patients. The reconstruction is feasible both by means of
      microsurgical free-tissue transfers or with alloplastic materials and
      myocutaneous flaps. Between 1982 and 1991, 34 patients in Stage III (n = 6;
      17.7%) and IV (n = 28; 82.3%) head and neck cancers underwent Commando's
      operation with different types of reconstruction in 30 patients: pectoralis
      myocutaneous flap (n = 9), osteo-myocutaneous flap with the underlying segment of
      the fifth rib (n = 2), myocutaneous flap plus prosthesis (n = 17), or prosthesis
      alone (n = 2). Two different prostheses were implanted: the linear A-O mandibular
      reconstruction plate (n = 13), and the Dumbach titanium cage (n = 6). In the
      group of patients in which the linear A-O mandibular reconstruction plate was
      used there were four cases of prosthesis dislodgement and major exposure and one
      case of prosthesis breakage while in patients who were given the Dumbach titanium
      cage there were four cases of major exposure. Prosthesis removal was required in
      five and two patients with linear A-O and Dumbach titanium cage prosthesis,
      respectively. Median survival was 14 months with 28% five-year survival. In our
      experience, metallic prostheses with a shape and arrangement that allow a
      distribution of traction forces on a wider surface, with screws drilled in
      nonaligned points of the mandible, seem to be more reliable as they reduce the
      risk of dislodgement and breakage.

PMID- 8359281
TI  - Modified use of gate flap for the reconstruction of the lower lip.
AB  - Surgical excision of advanced lower lip carcinomas with adequate safety margins,
      in some cases, causes defects as large as three-fourths of the width of the lip
      or total lip defects. This paper describes a modification of nasolabial 'gate
      flap' for reconstruction of extensive defects of the lower lip. Splitting the
      flap into skin and mucosal flaps provides the surgeon more skin on the inferior
      aspect of the reconstruction where he needs skin without any mucosa and more
      mucosa on the superior aspect of the reconstruction where he needs mucosa for
      reconstruction of the vermilion and lower labial sulcus. Four patients with total
      lower lip defects have been treated with this technique. The results were quite
      satisfactory both functionally and cosmetically.

PMID- 8359282
TI  - Surgical intervention for complications caused by late radiation damage of the
      small bowel: a retrospective analysis.
AB  - We studied the records of 46 patients who had been operated on between 1974 and
      1990 in The Netherlands Cancer Institute because of complications due to late
      radiation damage of the small bowel. Data were collected on preoperative history,
      surgical intervention, postoperative complications and survival. By means of
      Cox's proportional hazards regression analysis we sought to identify factors that
      contribute to complication-risk and survival. The following factors led to an
      increase in complication-risk: hypoalbuminemia, more than one laparotomy prior to
      irradiation and a short interval (< 12 months) between irradiation and surgical
      intervention. The following factors related to a poorer survival: incomplete
      resection of the primary tumor and a short interval (< 12 months) between
      irradiation and surgical intervention. The type of surgical intervention did not
      have cumulative prognostic value in relation to complication-risk or survival. As
      patients undergoing resections differed considerably from patients undergoing
      bypass-procedures, no conclusions could be drawn about the superiority of one
      technique over the other. We think that both types of intervention have their own
      field of indication.

PMID- 8359283
TI  - Early vulval cancer: the place of conservative management.
AB  - There is a trend towards conservative surgery for early vulval cancer, which is
      increasingly being diagnosed in younger women. In this series there were 21
      patients who had lesions which had invaded to a depth of 3 mm or less. Nine
      patients were treated by wide local excision without any form of lymphadenectomy,
      and eight patients had wide local excision with ipsilateral groin dissection. In
      the remaining four patients, radical surgery was carried out, consisting of
      radical vulvectomy and bilateral lymphadenectomy. None of the 12 patients who had
      some form of lymphadenectomy was shown to have nodal involvement. None of the
      patients suffered from local recurrence or recurrence in the groin nodes. No
      patient died from vulval cancer, and all but one of the patients are still alive
      with a mean follow-up period of 54.8 months. Though there is as yet no universal
      agreement on the criteria for early vulval cancer, with superficial invasion
      there is a place for individualized treatment, when patients will benefit from
      less than radical surgery.

PMID- 8359284
TI  - Oestrogen and progesterone receptor estimation by enzyme-immunoassay on tissues
      removed before and after a modified radical mastectomy.
AB  - To investigate the possibility of receptor degradation due to devascularization
      of the tumour during mastectomy, oestrogen and progesterone receptors (ER and
      PgR) were measured by an enzyme-immunoassay (EIA) in 59 cases of primary breast
      cancer on samples taken before and after performing a modified radical
      mastectomy. Pre- and post-mastectomy samples from the same patient were analysed
      simultaneously in the same assay run. There was 86.4% and 93.2% agreement
      respectively in ER and PgR status between samples removed before and after
      surgery. When actual values were analysed, the post-mastectomy values were higher
      or lower than pre-mastectomy values with similar frequency. These random
      variations could be attributed to heterogeneous distribution of receptors within
      a tumour. The overall correlation between pre- and post-mastectomy values was
      excellent (ER: r = 0.810, P < 0.001; PgR: r = 0.706, P < 0.001).
      Devascularization of the tumour during surgery does not seem to affect the
      integrity of the epitopes recognized by monoclonal antibodies against ER and PgR
      to any significant extent.

PMID- 8359285
TI  - Is immediate postmastectomy reconstruction safe in the long-term?
AB  - A prospective case-control study of 81 patients has been carried out over 10
      years comparing mastectomy with immediate reconstruction to mastectomy alone. The
      patients were matched for age (within 5 years), TNM stage, pathologic nodal
      status and operative procedure. After complete 10-year follow-up we have failed
      to demonstrate any long term difference in tumour behaviour. We conclude that
      immediate reconstruction is widely applicable and technically feasible without
      any long term effect on the development of local recurrence or metastatic
      disease.

PMID- 8359286
TI  - Right ventricular metastasis from choriocarcinoma: report of a rare case and
      review of the literature.
AB  - A previously healthy gravida developed chest pain and progressive dyspnea several
      months after delivery. A right ventricular mass rising from the septum and
      floating through the pulmonary valve was detected, with multiple lung nodules.
      With the suspicion of a primary sarcoma of the heart, she was referred for
      cardiac surgery. Microscopic observation of the cardiac neoplasm revealed
      malignant trophoblast. There was no evidence of disease in the uterus and adnexa.
      Combination chemotherapy with EMA-CO schedule was instituted because of the high
      risk score. A complete recovery was achieved after 20 weeks of treatment and the
      patient is free of disease 4 years after the end of chemotherapy and is now
      pregnant again.

PMID- 8359287
TI  - Inflammatory pseudotumour of the liver.
AB  - Inflammatory pseudotumours of the liver are uncommon, usually mistaken for
      malignant lesions and resected. This report describes the presentation of an
      inflammatory pseudotumour of the liver in a 28-year-old male which was
      demonstrated on C.T. scanning and diagnosed by percutaneous needle biopsy. This
      case was treated conservatively and spontaneously resolved within four months,
      emphasising the need to consider this lesion in the differential diagnosis of an
      intrahepatic mass.

PMID- 8359288
TI  - TNM system.

PMID- 8359289
TI  - Surgery for carotid stenosis: the quest for the ideal technique.

PMID- 8359291
TI  - Defective cerebrovascular autoregulation after carotid endarterectomy.
AB  - Correction of high grade carotid artery stenosis may result in cerebral
      hyperperfusion because of defective vascular autoregulation. Thus, transcranial
      Doppler was used to determine mean arterial flow velocity (Vmean) of the middle
      cerebral artery in 95 patients before and after carotid endarterectomy. Attention
      was focused on postoperative episodes of ipsilateral headache and hypertension.
      Symptoms of cerebral hyperperfusion lasted for 3 (1.5-5) h (median and range) in
      nine patients, and for 12 (8-14) days in nine other patients. Of these later
      patients, two developed seizures on the 5th and 6th postoperative day,
      respectively. The mean pressure difference across the stenosis was 31 (0-63) mmHg
      in the symptomatic group (n = 18) as opposed to only 10 (0-60) mmHg in the
      asymptomatic group (n = 77) (p < 0.01). In the 18 patients with headache after
      surgery, ipsilateral Vmean increased to 177 (130-332)% of the preoperative value
      (p < 0.0001), while the contralateral Vmean remained unchanged. After blood
      pressure was reduced in symptomatic patients with labetalol, ipsilateral Vmean
      decreased from 92 (69-124) to 56 (32-93) cm s-1 (p < 0.0001) as systemic arterial
      pressure decreased from 101 (80-128) to 88 (60-103) mmHg, with no change in
      contralateral Vmean. Normalisation of Vmean via reduction of arterial pressure
      ended episodes of headache and seizure in symptomatic patients. Thus, in patients
      who developed post-endarterectomy hyperperfusion, these findings clearly
      demonstrated that ipsilateral middle cerebral artery mean flow velocity was
      pressure dependent. This substantiates the hypothesis of defective autoregulation
      in the ipsilateral hemisphere after carotid endarterectomy, and in turn
      demonstrates an immediate cessation of symptoms with reduction of arterial
      pressure even in normotensive patients.

PMID- 8359290
TI  - Anticoagulants, antiaggregants or nothing following carotid endarterectomy?
AB  - Carotid endarterectomy (TEA) has proven to be beneficial for symptomatic
      patients. Anticoagulation (AC) and antiplatelet therapy (ASA) have been shown to
      prolong life following vascular surgery in patients with occlusive arterial
      disease (PAOD). To determine whether ASA or AC prolong life after TEA,
      retrospective analysis was undertaken, since cerebral haemorrhage is associated
      with the use of both drugs, especially AC. Between 1979-1986, 328 patients with
      stenotic lesions of the carotid bifurcation were operated upon electively.
      Patient survival and causes of death were the primary end points of the analysis.
      Recent data were obtained from the Austrian Central Bureau of Statistics.
      Cumulative survival rates were calculated by Kaplan-Meier estimation and
      differences determined by Breslow and Mantel tests. 36 patients were on AC, 157
      on ASA and 135 remained without medication (0-group). Since the common risk
      factors in PAOD were unevenly distributed between groups, a stepwise Cox
      regression model was applied which revealed age (p < 0.01), cardiac pathology (p
      < 0.01) and diabetes (p < 0.05) as relevant for survival. Therefore, ASA patients
      and 0-group patients were selected and matched, employing the aforementioned
      prognostic criteria, and compared to the patients on long-term AC for various
      indications (vein bypass surgery, myocardial infarction, pulmonary embolism; i.e.
      data-matching). The median postoperative survival was 7.72 years for ASA and 8.48
      years for AC, compared to 6.07 years for the 0-group (p = 0.0095 Breslow, p =
      0.477 Mantel). There was no significant difference between AC and ASA treated
      patients. Irrespective of medication, the causes of death were well balanced, and
      no higher incidence of intracerebral haemorrhage was detected.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8359292
TI  - Can recurrent stenosis after carotid endarterectomy be prevented by low-dose
      acetylsalicylic acid? A double-blind, randomised and placebo-controlled study.
AB  - Recurrent stenosis (> 50%) after carotid endarterectomy is reported with a
      frequency ranging from 7-20%. 232 patients undergoing carotid endarterectomy were
      randomised to low-dose acetylsalicylic acid (ASA, 75 mg daily) or placebo
      (identical tablets). The treatment was started the day before surgery and
      continued for 6 months. All patients were followed clinically for 1 year. Doppler
      examination was performed preoperatively (n = 230) and postoperatively (n = 228)
      and at follow-up at 2 (n = 220) and at 6 months (n = 174) after surgery. The
      degree of stenosis was estimated from the maximum Doppler frequency shift in the
      internal carotid artery. Recurrent stenosis of 30% or more was detected in 85 of
      the 220 patients (38.6%) at 2 months, and at 6 months in 73 of the 174 examined
      patients (42.0%). Stenosis > 50% was seen in 16 patients (9.2%) and occlusion was
      found in four patients (1.8%) at 6 months. No difference between the low-dose ASA
      treated group (n = 112) compared to the placebo group (n = 108) was seen
      regarding recurrent stenosis. Women had an increased risk of recurrent stenosis
      (p < 0.001), whereas other factors such as age, hyperlipidaemia, diabetes and
      smoking were not associated with increased risk. Importantly, the number of
      neurological events did not differ between those with or without restenosis.
      Therefore, the indications for surgery of asymptomatic recurrent stenosis are
      questionable. The progress of arteriosclerosis in the contralateral carotid
      artery did not differ between the treatment groups.

PMID- 8359293
TI  - Chronic obstructive pulmonary disease and abdominal aortic aneurysms.
AB  - In a prospective study during the period January-May 1992, 362 consecutive out
      patients above 65 years of age, attending the pulmonary department for chronic
      obstructive airways disease (COPD), were ultrasonographically screened for an
      aneurysm of the abdominal aorta (AAA). Data from pulmonary function tests
      together with history of cardiac disease, diabetes mellitus, hypertension,
      hypercholesterolaemia, peripheral arterial obstructive disease, smoking and
      corticosteroid medication were collected. 30/282 men and 6/80 women with COPD had
      an AAA > or = 30 mm in diameter, which equals a prevalence of 9.9% (95%
      confidence limits: 6.8-13.0%). COPD patients with severe emphysema, having a
      decreased forced expiratory volume/vital capacity ratio (FEV/VC) of < 55%, have a
      significantly higher prevalence of aortic dilatation or AAA compared to COPD
      patients with mild or moderate decreased FEV/VC (chi-squared test: p < 0.05,
      alpha = 0.05). In the group of patients with AAA, significantly more smokers were
      seen compared to the group with normal and dilated aortas (chi-squared test: p <
      0.05).

PMID- 8359294
TI  - Hyperhomocysteinemia in patients operated for lower extremity ischaemia below the
      age of 50--effect of smoking and extent of disease.
AB  - Moderate hyperhomocysteinemia may be a risk factor for atherosclerotic peripheral
      vascular disease (PVD). In order to develop PVD at an early age risk factors are
      more strongly expressed and hyperhomocysteinemia may be one such factor.
      Homocysteine is derived from methionine and is metabolised by cystathionine
      synthase to cystathionine or remethylated to methionine. Cystathionine-synthase
      activity is dependent on vitamin B6 while the remethylation of homocysteine is
      dependent on vitamin B12 and folate. The present study analyses homocysteine in
      patients operated on for lower extremity ischaemia before the age of 50.
      Homocysteine before and after loading with methionine, vitamin B6, B12 and folate
      were measured at follow-up. The patients were compared to age- and sex-matched
      controls. Significantly more patients than controls had hyperhomocysteinemia,
      16/58 vs. 4/65, defined as fasting total homocysteine above 18.6 mumol/l. Loading
      with methionine did not further discriminate between patients and controls.
      Smoking patients had higher levels of homocysteine than non-smoking patients or
      smoking and non-smoking controls. Smoking patients also had lower levels of
      vitamin B6. When comparing patients with suprainguinal, infrainguinal and
      multilevel disease the highest homocysteine levels were seen in the latter group.
      Also, in this group smoking patients had higher homocysteine levels. Multivariate
      analysis revealed that homocysteine was associated with low levels of vitamin
      B12, folate and smoking. Smoking therefore seems to be connected to increased
      homocysteine levels in patients with early development of atherosclerosis, partly
      explained by decreased levels of B6, B12 and folate.

PMID- 8359295
TI  - The Gloucestershire Aneurysm Screening Programme: the first 2 years' experience.
AB  - 5337 men aged 65 were invited for ultrasound examination of the abdominal aorta
      between September 1990 and October 1992 as part of a General Practice based
      aneurysm screening programme covering the County of Gloucestershire. 4232 (79%)
      attended. 3877 (91.6%) had aortic diameters equal to or less than 2.5 cm. 302
      (7.1%) had aortic diameters in the range 2.6-3.9 cm and 53 (1.3%) had a diameter
      of 4.0 cm or greater. Mean aortic diameter was 2.04 cm (S.D. 0.50 cm). The
      practicalities, costs and benefits of a community based aneurysm screening
      programme are discussed.

PMID- 8359296
TI  - Patency and morphology of fibrous polyurethane vascular prostheses implanted in
      the femoral artery of dogs after seeding with subcultivated endothelial cells.
AB  - A cell culture line was established from enzymatically-derived canine jugular
      endothelial cells and further cultured. Whenever sufficient cells were present,
      fibrous polyurethane vascular prostheses, impregnated with gelatin and coated
      with fibronectin, were seeded with 4.8 x 10(5)/cm2 cells, sufficient to establish
      a confluent monolayer, and implanted in the femoral arteries of 16 dogs. A non
      seeded prosthesis on the contralateral side served as control. Eight dogs
      received antiplatelet aggregation medication: 250 mg aspirin together with 25 mg
      dipyridamole, orally three times daily, starting 2 weeks prior to the
      implantation operation and continued for the duration of the experiment. Results
      show that in the non-medicated dogs all control prostheses become occluded within
      3 weeks after implantation, whereas five out of eight seeded prostheses remained
      patent. In the medicated group, two out of eight control prostheses occluded and
      all seeded prostheses remained patent. Scanning and light microscopy revealed
      that seeded prostheses were completely lined with endothelial cells (Factor VIII
      positive stain) week 3 (n = 3) and 12 (n = 3) after implantation, while
      endothelialisation in control prostheses had advanced only 5 mm into the
      prostheses in 12 weeks. Two dogs of each group were included in long-term patency
      studies. We conclude that prostheses seeded with a confluent monolayer of
      endothelial cells result in superior patency rates for both medicated and non
      medicated dogs. No immunological reaction against the (allogeneic) seeded
      endothelial cells were noted.

PMID- 8359297
TI  - Distal vein graft reconstruction for isolated tibioperoneal vessel occlusive
      disease in diabetics with critical foot ischaemia--does it work?
AB  - Since 1986, 75 distal vein bypass procedures have been performed in 72 diabetics
      with isolated tibioperoneal vessel occlusive disease for limb salvage. Fifty-six
      grafts were anastomosed proximally to the below-knee popliteal artery and 19 to
      the anterior tibial artery. Autologous vein was used in all patients. One patient
      died within the first postoperative month. Of the occluded grafts, only two which
      failed during hospitalisation were salvaged. In six patients progressive plantar
      gangrene necessitated below-knee amputation in spite of graft patency. Using life
      table analysis, primary and secondary patency rates were 84 and 86% at 1 year and
      71 and 76% at 5 years. One- and five-year limb salvage rates were 81 and 72%,
      respectively. Distal vein graft reconstruction for limb threatening ischaemia
      produces excellent patency rates and contributes significantly to limb salvage in
      these patients.

PMID- 8359298
TI  - Lower limb ischaemia in primary antiphospholipid syndrome.
AB  - Primary antiphospholipid syndrome (PAPS) is an autoimmune disorder manifested by
      recurrent thrombosis in the venous and arterial system. We report a group of
      seven patients with lower limb ischaemia associated with PAPS. Four were male
      patients and three were females, with a mean age of 37 years. All had a previous
      deep vein thrombosis and the majority, five out of seven, had a prior
      cerebrovascular accident (CVA). Prolonged activated thromboplastin time was
      demonstrated in all our patients and PAPS was established by positive
      thromboplastin titration index, circulating anticoagulant index and increased
      anticardiolipin levels. Symptoms included claudication in three, rest pain in
      four and gangrene in five patients. Angiography demonstrated thrombosis of
      various segments of the arterial tree including: aorta, iliac, femoral and
      popliteal arteries. Two patients were treated conservatively and one by
      percutaneous transluminal angioplasty (PTA) of the distal aorta. A total of
      eleven vascular surgical procedures were performed in four patients resulting in
      early postoperative thrombosis (2h-30 days) in 10 cases. Only one graft remained
      patent, when full heparinisation (1000 units/h) was used perioperatively. We
      conclude that PAPS patients are at high risk for graft thrombosis and should only
      be operated upon on full anticoagulation, starting at operation and proceeding
      indefinitely.

PMID- 8359299
TI  - Chronic critical leg ischaemia must be redefined.
AB  - The Second European Consensus Document on Chronic Critical Leg Ischaemia defines
      critical limb ischaemia in non-diabetic patients as rest pain or tissue necrosis
      (ulceration or gangrene) with an ankle systolic pressure (ASP) of less than or
      equal to 50 mmHg, or a toe pressure of less than or equal to 30 mmHg. The aim of
      this study was to investigate whether this definition is able to predict the
      outcome of patients with severe lower limb ischaemia and thus to determine the
      relevance of the definition in clinical practice. We have analysed 148 severely
      ischaemic limbs in 133 non-diabetic patients who presented with rest pain, tissue
      necrosis or a combination of these symptoms. Fifty-one percent of these limbs
      fulfilled the current definition with an ASP < or = 50 mmHg; 49% had an ASP > 50
      mmHg and were thus not defined as critically ischaemic according to the current
      definition. We have compared actuarial limb salvage and mortality rates in
      patients with an ASP < or = 50 mmHg to those patients with an ASP > 50 mmHg. The
      1 year limb salvage and mortality rates for ischaemic limbs fulfilling the
      European Consensus Document criteria were 78.7 and 36.7% respectively, compared
      to rates of 73.9 and 17.3% in patients who were not defined as critically
      ischaemic under the current definition. There were no significant differences
      between 1 year limb salvage or mortality rates between the two patients groups (p
      = 0.843, 0.078, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359301
TI  - Prevalence of symptomatic leg ischaemia in a Swedish community--an
      epidemiological study.
AB  - The prevalence of symptomatic leg ischaemia (SLI) was studied using a
      standardised postal questionnaire and by measuring ankle systolic blood pressure
      among those with leg pain. All individuals, aged 50-89 years, of both sexes (n =
      2748) in a community of 7524 inhabitants were included. The overall questionnaire
      response rate was 92%, of whom 441 (17%) reported any form of leg pain. Ankle
      systolic blood pressure (ASBP) was measured in 353 (80%) of those. Ankle/brachial
      index (ABI) < or = 0.8 was chosen as the criterion for verified SLI. One hundred
      and seven (30%) had a verified SLI (ABI < or = 0.8). Hospital records could be
      reviewed in 83% of the non-responders, and revealed corresponding distributions
      of risk factors among the non-responders and the questionnaire-responders. Risk
      factor frequencies among ASBP-examined and not examined individuals were also
      comparable. The overall prevalence of SLI in the age 50-89 years was 4.1%,
      ranging from 1.5% in the age decade of 50-59 years, to maximum 7.1% in the decade
      70-79 years. A slight but not significant male predominance was recorded, except
      for the age decade 70-79 years. The prevalence of SLI in the whole community
      population was approximately 2000/100,000 of which 5% were possible candidates
      for vascular intervention.

PMID- 8359300
TI  - How much heparin? A simple in vitro test.
AB  - A simple in vitro test to calculate the dose of heparin required to achieve
      optimal in vivo anticoagulation during surgery has been assessed in 15 patients
      who subsequently underwent vascular surgery. Heparin was added to four aliquots
      of patients blood in vitro to give five solutions with heparin concentrations
      ranging from 0-0.8 units/ml of plasma. The activated partial thromboblastic times
      (APTT) of each of these samples was then measured and the natural log (ln) of the
      APTT calculated. The natural log of the APTT in vitro was then plotted against
      the in vitro heparin concentration. From this linear correlation the
      concentration of heparin required to achieve an APTT 2.5 times the normal in
      vitro (Hc) for the 15 different patients was calculated and ranged from 0.4-0.75
      units/ml (median 0.47). Based on an estimate of the plasma volume (PV), the bolus
      dose of heparin given intravenously to each patient to produce an equivalent
      anticoagulant response in vivo was calculated (Hc x PB). Heparin boli
      administered ranged from 1000-2000 units (median 1500). The mean in vivo APTT
      achieved was 77% of the predicted value (range 62%-123%). Such an estimation of
      an in vivo response, by means of an in vitro test, should help to more accurately
      predict the effects of heparin in vivo and individualise anticoagulation dosage.

PMID- 8359302
TI  - The choice of strategy in the treatment of intermittent claudication--a decision
      tree approach.
AB  - OBJECTIVES: to compare possible outcomes of the non-operative treatment for
      intermittent claudication with that of surgery. DESIGN: decision tree approach
      using published and vascular registry data. The valuation of clinical outcomes
      was estimated by index weights using the Rosser index and the Quality of Well
      Being scale. SETTING: routine health care in Sweden. MATERIALS: published data on
      224 non-operatively treated claudicants and data from 805 claudicants treated
      with surgery or angioplasty from the Swedvasc registry. No diabetics were
      included. Chief outcome measure: expected utility value at one year after
      decision on treatment given the clinical data and the estimated health status
      valuations. MAIN RESULTS: it was possible to identify a success rate for surgery
      above which it was the better alternative. However, depending on which of two
      health indices that was used, and if reconstruction was supra- or infrainguinal,
      this threshold value varied from 0-81%. CONCLUSIONS: reliable measures of the
      value of outcomes have to be developed and, in addition, long-term data on
      outcome and costs in routine care have to be collected before a comprehensive
      economic assessment based on the decision tree approach can be made to support
      decisions on treatment for intermittent claudication.

PMID- 8359303
TI  - A prospective study of the natural history of femoropopliteal artery stenosis
      using duplex ultrasound.
AB  - A foreknowledge of impending femoral artery occlusion might allow prevention of a
      deterioration in ischaemia by percutaneous transluminal angioplasty (PTA) in the
      preocclusive stage. A window of opportunity exists before a femoral stenosis
      progresses to occlusion and its treatment by PTA becomes more difficult, riskier
      and associated with lower patency. The size of this window is unknown. This is
      the first report of a study of the natural history of femoral stenoses using
      Duplex ultrasound. The aims of the study were to determine in patients with
      symptomatic peripheral arterial disease: (1) the incidence of progression from
      stenosis to occlusion; (2) the change in severity of stenosis over time; and (3)
      the relationship between severity of stenosis and progression to occlusion. The
      velocity ratio (VR) of 43 femoral artery stenoses in 38 patients was measured by
      Duplex ultrasound. The examination was repeated after a median of 28 (range 5-76)
      weeks. Nine/43 (21%) stenoses progressed to occlusion within a median of 13
      weeks. Little overall change in VR was demonstrable if occlusion did not occur.
      Only stenoses with a VR > 3 progressed to occlusion in the study period. The data
      suggest that severe stenoses progress more rapidly than moderate, with a
      relatively brief window of opportunity. If PTA is to be undertaken, stenoses with
      a VR greater than 3 should be treated with minimum delay.

PMID- 8359304
TI  - Quality of life following lower limb amputation for peripheral arterial disease.
AB  - Lower limb amputations for peripheral arterial disease are performed
      predominantly on an elderly population with poor social support and concomitant
      medical problems. The effect of amputations on the quality of life of this
      population has not been properly assessed. The quality of life of 149 amputees
      from one hospital was evaluated using the Nottingham Health Profile and compared
      to that of a control group matched for age and sex. One hundred and thirty (87%)
      amputees and 115 (77%) controls responded to the questionnaire. Amputees reported
      significantly more problems with mobility, social isolation, lethargy, pain,
      sleep and emotional disturbance than controls (p < 0.001). However, mobility was
      the only significant independent factor after matched logistic regression
      analysis (p < 0.001). The differences in social isolation and emotional distress
      lost their significance after adjustment for mobility. The overall quality of
      life following lower limb amputation for peripheral arterial disease is poor, but
      much of this is secondary to restricted mobility. Rehabilitation following
      amputation should therefore focus on attempts to improve mobility.

PMID- 8359305
TI  - A simple technique for thrombectomy of a reversed saphenous vein arterial bypass
      graft.

PMID- 8359306
TI  - A new posterior approach for an extra-anatomical arterial bypass for lower
      extremity revascularisation (gluteopopliteal bypass).

PMID- 8359307
TI  - The basilic vein as an in situ bypass for occlusion of the brachial artery.
AB  - The use of the basilic vein as an in situ bypass in upper extremity
      revascularisation has not as yet been reported. Two patients with an occlusion of
      the brachial artery and disabling arm claudication in whom the basilic vein was a
      suitable vascular conduit are discussed.

PMID- 8359308
TI  - Basilic vein in situ bypass for chronic post-traumatic ischaemia of the arm.

PMID- 8359309
TI  - Penetrating missile embolisation.
AB  - The present case report is that of a 13-year-old boy, who was admitted to the
      Emergency Unit at the American University of Beirut Medical Center (AUBMC), with
      a bullet injury to the right upper quadrant with no exist. Chest X-ray and KUB
      failed to reveal the bullet and there was no evidence of haemo- or pneumothorax.
      X-ray of both thighs showed the bullet at the level of the right groin. The
      bullet penetrated the liver, diaphragm and pericardium. It entered through the
      left ventricle and embolised through the arterial circulation to the right
      superficial femoral artery. Included in this report is a review and analysis of
      patients with missile embolisation, who were treated at the AUBMC over the last
      10 years.

PMID- 8359310
TI  - Upper limb venous gangrene, a lethal condition.
AB  - Venous gangrene of the upper extremity is rare. It was the mode of presentation
      in a 41-year-old woman who died 10 days later of heart failure due to acute
      myocardial infarction. There is evidence from this and previous publications that
      patients with this condition tend to have characteristics in common. Most have
      either advanced malignant disease or seriously impaired myocardial function and
      venous gangrene usually occurs as a pre-terminal event. Treatment should be
      directed primarily at the underlying illness but there may be a case for early
      amputation if permitted by the general condition of the patient.

PMID- 8359311
TI  - Workshop on the scientific evaluation of the safety factor for the acceptable
      daily intake (ADI): editorial summary.

PMID- 8359312
TI  - Data-derived safety factors for the evaluation of food additives and
      environmental contaminants.
AB  - A safety factor of 100-fold is commonly applied to animal data to derive the
      acceptable daily intake (ADI) of food additives; other factors have been used in
      some cases and higher values are used more frequently for determining the
      tolerable daily intake (TDI) of environmental chemicals. The 100-fold factor is
      considered to represent the product of a 10-fold factor to allow for species
      differences between the test animal and humans and a 10-fold factor to allow for
      inter-individual differences. A scheme is proposed whereby data relevant to the
      safety assessment of a compound, e.g. species differences in toxicokinetics, can
      contribute quantitatively to the safety factor and therefore to the ADI or TDI.
      For this to be possible, it is necessary to subdivide each of the 10-fold factors
      into two separate factors to allow for differences in toxicokinetics and
      toxicodynamics. For any compound, data on one particular aspect may be used to
      derive a specific data-derived factor for that aspect. The overall safety factor
      will then be calculated as the product of the known data-derived factor(s) and
      default values for the remaining unknown factors. In this way the derivation of
      the safety factor would be clearly defined and the potential impact of additional
      data on other aspects identified. Additional safety factors (over and above the
      100-fold or overall data-derived factor) are also proposed to allow for the
      nature or severity of the toxicity and the adequacy of the database. These
      factors are consistent with previous evaluations and will allow the logical
      derivation of factors greater than either 100 or the appropriate data-derived
      factor. These additional factors will be of greatest value in the derivation of
      safety factors for the calculation of the TDIs of environmental contaminants but
      may also be applied if necessary to the safety assessment of food additives. In
      such cases the rationale and logic for a safety factor in excess of 100 will be
      clearly defined.

PMID- 8359313
TI  - Scientific evaluation of the safety factor for the acceptable daily intake (ADI).
      Case study: butylated hydroxyanisole (BHA).
AB  - The principles of 'data-derived safety factors' are applied to toxicological and
      biochemical information on butylated hydroxyanisole (BHA). The calculated safety
      factor for an ADI is, by this method, comparable to the existing internationally
      recognized safety evaluations. Relevance for humans of forestomach tumours in
      rodents is discussed. The method provides a basis for organizing data in a way
      that permits an explicit assessment of its relevance.

PMID- 8359314
TI  - Hazard assessment of lead.
AB  - Exposure to lead (Pb) continues to be a source of concern for the US Food and
      Drug Administration and other United States federal regulatory agencies. Blood
      lead levels as low as 10 micrograms/dl have been associated with impaired
      neurobehavioural and cognitive development and electrophysiological deficits in
      children and reduced gestational age and birth weight in infants. Blood lead
      levels of 10 micrograms Pb/dl are also of concern in pregnant women because of
      exposure to the fetus. Blood lead levels of 30 micrograms Pb/dl have been
      associated with elevated blood pressure and other adverse effects in adults.
      Thus, the values of 10 and 30 micrograms Pb/dl represent lowest-observed-effects
      levels for developing and adult populations, respectively. The ingestion levels
      that result in these blood levels of concern were estimated to be 60 micrograms
      Pb/day for children ages 6 years or younger, 150 micrograms Pb/day for children
      aged 7 years or older, 250 micrograms Pb/day for pregnant women and 750
      micrograms Pb/day for adults. Provisional total tolerable intake levels for lead
      were derived from these blood lead levels for each group by applying the Renwick
      approach to obtain a tolerable exposure level.

PMID- 8359315
TI  - A data-derived safety (uncertainty) factor for the intense sweetener, saccharin.
AB  - An increased incidence of bladder cancer is found when male rats are fed high
      dietary concentrations of sodium saccharin (3% or more) from birth. This toxicity
      has been used as the basis for the development of a data-derived safety factor.
      Such an effect would attract an extra factor (10-fold) for nature of toxicity and
      in the absence of other data would result in a high overall safety factor.
      However the extensive mechanistic database on sodium saccharin allows an
      assessment of the potential relevance of the effect for humans. In addition the
      effect is only seen under specific conditions in rats, i.e. largely with the
      sodium salt and with a commercial rat diet. The effect is not related to the
      concentration of saccharin in the rat urine or bladder so that toxicokinetic
      considerations are simplified. The extensive animal database allows the
      determination of data-derived factors for inter-species differences in both
      toxicokinetics and toxicodynamics. Based on this analysis an overall safety
      factor of 50 (which includes the factor of 10 for severity of effect) would
      appear appropriate at the present time. This factor, and the ADI which would
      result from its application, are consistent with the absence of an association
      between the consumption of artificial sweeteners and bladder cancer in humans.

PMID- 8359316
TI  - The evaluation of data-derived safety factors for bis(tri-n-butyltin)oxide.
AB  - In this report the evaluation of a safety factor is assessed, according to the
      decision tree suggested by Renwick (1991a,b), to determine a Tolerable Daily
      Intake (TDI) value for the environmental contaminant bis(tri-n-butyltin)oxide
      (TBTO). Based on available literature the nature of the most sensitive parameter
      of TBTO-toxicity was perceived to be on lymphoid organs and lymphoid function.
      Subsequently, safety factors were derived in relation to published data on inter
      species and inter-individual differences in both kinetics and dynamics of TBTO.
      Lack of information on human data concerning the nature of toxicity as well as
      kinetics and dynamics of TBTO finally resulted in a safety factor of 100. A TDI
      of 5 or 0.25 mg/kg bw per day was assessed based on reductions of lymphoid organ
      weights (thymus) or lymphoid function (resistance to T. spiralis), respectively.
      In addition, based on available data in rodents on kinetics and dynamics of TBTO,
      it is suggested that a combined TDI value for both tri- and dibutyltin compounds
      might have to be considered.

PMID- 8359318
TI  - Why some new ideas fail.

PMID- 8359319
TI  - Trusted employee stole more than cash.

PMID- 8359317
TI  - Scientific evaluation of the data-derived safety factors for the acceptable daily
      intake. Case study: diethylhexylphthalate.
AB  - Diethylhexylphthalate causes peroxisome proliferation and is hepatocarcinogenic
      in rodents; it also displays reproductive and developmental toxicity in a variety
      of mammalian and non-mammalian species. These manifestations of toxicity have
      each been separately evaluated for the development of a data-derived safety
      factor and Tolerable Daily Intake (TDI). Using hepatocarcinogenicity as the
      pivotal study, the nature of toxicity factor of 10 is applicable and there are no
      adequate studies demonstrating a No-Observed-Adverse-Effect Level (NOAEL). If
      studies of less statistical sensitivity are used to derive the NOAEL and a factor
      of 0.1 is used for the relative sensitivity to humans of peroxisome proliferation
      (assuming this is linked mechanistically to carcinogenesis), a TDI of 1 mg/kg bw
      is obtained. The data-derived safety factor using peroxisomal proliferation as
      the pivotal end-point is 6.25, since the factor from trans-species toxicodynamics
      is 0.01, and the TDI derived from the NOAEL for peroxisome proliferation is thus
      8 mg/kg bw. If teratogenicity is used as the pivotal study, the nature of
      toxicity attracts a factor of 10 and all the other aspects take default values
      because of the limited availability of relevant toxicodynamic and toxicokinetic
      data. The TDI derived from the NOAEL for teratogenicity is then 0.04 mg/kg bw and
      this confirms teratogenicity as the limiting aspect of toxicity defining the TDI.
      It also identifies the fact that appropriate toxicokinetic and toxicodynamic data
      related to the pregnant animal and fetus would facilitate a re-evaluation of the
      safety factor and TDI by replacing the current default values by data-derived
      values.

PMID- 8359320
TI  - Maximize your financing program.

PMID- 8359321
TI  - Overcoming some common situations, common barriers.

PMID- 8359322
TI  - Expanding to meet practice growth.

PMID- 8359323
TI  - Sounding board for complaints.

PMID- 8359324
TI  - Where there's a will, should there be a trust?

PMID- 8359325
TI  - OSHA: bad business or new opportunity?

PMID- 8359326
TI  - Marketing excellence with quality provisional restorations.

PMID- 8359327
TI  - Impression excellence through precise gingival retraction.

PMID- 8359329
TI  - The clinical assistant's role in the new-patient examination.

PMID- 8359328
TI  - Monitoring "the vital signs" of masticatory system health--a simplified screening
      for TM problems.

PMID- 8359330
TI  - Productivity in endodontics.

PMID- 8359331
TI  - Regulations needed for implantology.

PMID- 8359332
TI  - A playful, active practice setting.

PMID- 8359334
TI  - Push without shove.

PMID- 8359333
TI  - The keys to a successful practice.

PMID- 8359335
TI  - Sealants: an underused service.

PMID- 8359336
TI  - Realizing the dream.

PMID- 8359337
TI  - Coping with increasing regulations.

PMID- 8359338
TI  - Taking a risk.

PMID- 8359339
TI  - Increasing practice quality and productivity through high-retention, low-wear
      sealants.

PMID- 8359341
TI  - Esthetic excellence with implant abutments.

PMID- 8359340
TI  - Esthetic excellence with the single-tooth implant.

PMID- 8359342
TI  - Peri-implantitis versus periodontitis.

PMID- 8359343
TI  - Retrobulbar histology and immunohistochemistry in endocrine ophthalmopathy.

PMID- 8359344
TI  - Graves' hyperthyroidism and endocrine ophthalmopathy--one or two closely related
      diseases?

PMID- 8359346
TI  - Autoimmune endocrine ophthalmopathy--the ophthalmologist's view.

PMID- 8359345
TI  - Immunogenetics of endocrine ophthalmopathy and Graves' disease.

PMID- 8359347
TI  - Immunosuppression in endocrine ophthalmopathy: why and when?

PMID- 8359348
TI  - Orbital radiotherapy in the treatment of endocrine ophthalmopathy: when and why?

PMID- 8359349
TI  - Orbital decompression for endocrine ophthalmopathy: the endonasal approach.

PMID- 8359350
TI  - T cell reactivity in endocrine ophthalmopathy.

PMID- 8359351
TI  - Biological activity of antibodies circulating in endocrine ophthalmopathy.

PMID- 8359352
TI  - Elevated anti-alpha-galactosyl antibody titres. A marker of progression in
      endocrine ophthalmopathy and in auto-immune thyroid disorders?

PMID- 8359353
TI  - Orbital connective tissue in endocrine ophthalmopathy.

PMID- 8359354
TI  - Urinary and plasma glycosaminoglycans in endocrine ophthalmopathy.

PMID- 8359355
TI  - Adipose tissue in endocrine ophthalmopathy.

PMID- 8359356
TI  - Nature and significance of eye muscle autoantigens in endocrine ophthalmopathy.

PMID- 8359357
TI  - Eye muscle cells in endocrine ophthalmopathy.

PMID- 8359358
TI  - Mouse monoclonal antibodies to human and bovine xanthine oxidase (XO).

PMID- 8359359
TI  - Antibodies to xanthine oxidase (XO) in human males and females.

PMID- 8359360
TI  - Sensitive enzyme linked immunosorbent assay (ELISA) for xanthine oxidase.

PMID- 8359361
TI  - The effects of high monounsaturated and polyunsaturated fat diets on vascular
      endothelium and the coagulation system in non-insulin dependent diabetes mellitus
      -related to changes in lipid peroxidation?

PMID- 8359362
TI  - Doctoral studies at a British university and at a Pakistani university: a
      comparison.

PMID- 8359363
TI  - The effects of tetrahexylammonium chloride on calcium mobilization from
      cerebellar microsomes.

PMID- 8359364
TI  - Effects of allethrin on the thermotropic properties of phospholipid vesicles.

PMID- 8359365
TI  - Molecular forms of acetylcholinesterase in microsomal membranes of normal and
      dystrophic muscle.

PMID- 8359366
TI  - Control of insulin secretion by imidazolines in rat pancreatic islets.

PMID- 8359367
TI  - L-trans-pyrrolidine-2,4-dicarboxylic acid (L-transPDC) has properties consistent
      with that of a competitive substrate for the plasma membrane glutamate
      transporter.

PMID- 8359368
TI  - WAY 100252 inhibits evoked [3H]GABA release when tested against a number of
      release-inducing stimuli.

PMID- 8359369
TI  - The role of His394 in the binding of substituted benzamides to the rat D2
      dopamine receptor.

PMID- 8359370
TI  - Overexpression of the D2 dopamine receptor in insect cells using the baculovirus
      system.

PMID- 8359371
TI  - Pharmacological characterization of the human serotonin 5-HT-1A receptor
      expressed in CHO cells using the ergot alkaloids lisuride.

PMID- 8359372
TI  - Expression of the rat D2 dopamine receptor in the yeast Saccharomyces cerevisiae.

PMID- 8359374
TI  - Localisation of agonist stimulated CMP-phosphatidate accumulation in single
      mammalian neurones.

PMID- 8359373
TI  - Neocortical neuronal polarity: targeting of a foreign protein linked to a
      glycosyl-phosphatidylinositol (GPI) anchor in postmitotic neurons and polarized
      distribution of a marker of the trans-Golgi network (TGN 38).

PMID- 8359375
TI  - An isoform of the cGMP-gated retinal photoreceptor channel gene expressed in the
      sinoatrial node (pacemaker) region of rabbit heart.

PMID- 8359376
TI  - Nuclear associated casein kinase II expression in rat ventral prostate.

PMID- 8359377
TI  - Diabetes-related changes in sialic acid content of leucocytes: an assay-dependent
      artefact?

PMID- 8359378
TI  - Beta-cell responses in the offspring of non-insulin dependent diabetics after a
      test meal.

PMID- 8359379
TI  - Homologous sequences in fibrillar collagens may be proteoglycan binding sites.

PMID- 8359380
TI  - The role of glycogenin in glycogen synthesis and non-insulin dependent diabetes
      mellitus.

PMID- 8359381
TI  - Intracellular events in the assembly and secretion of apolipoprotein B in rat
      liver.

PMID- 8359382
TI  - Topography of apolipoprotein B in subcellular fractions from rabbit liver.

PMID- 8359383
TI  - Apolipoprotein (a) in rabbit blood and liver.

PMID- 8359384
TI  - Serum factors that regulate phagocytosis of liposomes by Kupffer cells.

PMID- 8359385
TI  - Phosphorylation of apoproteins in VLDL and LDL by protein kinases in vitro.

PMID- 8359386
TI  - Valinomycin pretreatment induced LDL receptor activity in cultured human cells.

PMID- 8359387
TI  - Direct visualization of lipid vesicle changes on addition of filamin.

PMID- 8359388
TI  - Comparison of the purification of lipoprotein lipase from various rat tissues.

PMID- 8359389
TI  - Glucose dependent insulinotropic polypeptide and glucagon-like peptide-1(7
      36)amide: effects on lipoprotein lipase activity.

PMID- 8359390
TI  - Measurement of postprandial apolipoprotein B-48 using a novel specific antibody.

PMID- 8359391
TI  - The use of retinyl palmitate to measure clearance of chylomicrons and chylomicron
      remnants following meals of different fatty acid compositions.

PMID- 8359392
TI  - Evidence for a regulatory link between hepatic lipase secretion and intra
      hepatocyte cholesterol.

PMID- 8359393
TI  - Conformational changes in oxidized LDL using X-ray and neutron solution
      scattering techniques.

PMID- 8359394
TI  - The effects of native and oxidised low density lipoproteins on platelet
      activation.

PMID- 8359395
TI  - Altered interactions between lipogenesis and glycogenesis in liver during
      fructose feeding.

PMID- 8359396
TI  - Cardiac lipoprotein lipase activities in relation to glucose utilization during
      progressive starvation.

PMID- 8359397
TI  - Factors contributing to the hypertriacylglycerolaemia of late pregnancy.

PMID- 8359399
TI  - Adipose tissue site specificity of lipoprotein lipase mRNA expression in rats fed
      diets containing different fatty acid compositions.

PMID- 8359398
TI  - Effects of niacin on biliary lipid output in the rat.

PMID- 8359400
TI  - Reverse cholesterol transport from the perfused spleen in the presence or absence
      of a perfused liver.

PMID- 8359401
TI  - Plasma VLDL cholesterol and egg cholesterol are resistant to change in the laying
      hen.

PMID- 8359402
TI  - Cholesterol feeding increases serum VLDL and hepatic phosphatidate
      phospohydrolase in hamsters.

PMID- 8359403
TI  - Depot specific effects of insulin and isoproterenol on porcine adipose tissue
      metabolism.

PMID- 8359404
TI  - LDL binding to hepatocytes isolated from hamsters fed different dietary fatty
      acids.

PMID- 8359405
TI  - A lipophilic protein inhibitor of neutral cholesteryl ester hydrolase: effects of
      treatment with female sex hormones.

PMID- 8359406
TI  - Assessment of particle size of very low density lipoproteins by morphometry.

PMID- 8359407
TI  - Very low density lipoprotein apo beta 100--comparison of several methods for
      protein assay.

PMID- 8359408
TI  - The effect of dietary casein and soyprotein on cholesterol metabolism in
      hamsters.

PMID- 8359409
TI  - Control of lipoprotein lipase activity by isoproterenol.

PMID- 8359410
TI  - In vitro testing of a glyoxalase I inhibitor.

PMID- 8359411
TI  - Modification of the glyoxalase system in clinical diabetes mellitus.

PMID- 8359412
TI  - Inhibition of human leukaemia 60 cell growth by diethyl esterification of the
      glyoxalase II inhibitor S-p-nitrobenzoxycarbonylglutathione in vitro.

PMID- 8359413
TI  - The potentiation of GTP-dependent assembly of microtubules by S-D
      lactoylglutathione.

PMID- 8359414
TI  - The effect of S-D-lactoylglutathione on the movement of neutrophils.

PMID- 8359415
TI  - Modification of the glyoxalase system in streptozotocin-induced diabetic rats and
      the effect of the aldose reductase inhibitor Statil.

PMID- 8359416
TI  - Formation of methylglyoxal and D-lactate in human red blood cells in vitro.

PMID- 8359417
TI  - The assay of S-D-lactoylglutathione in biological systems.

PMID- 8359418
TI  - Inhibition of growth of human leukaemia 60 cells by S-2-hydroxyacylglutathione
      derivatives.

PMID- 8359419
TI  - Mechanism of the inhibition of growth of human leukaemia 60 cells by S-D
      lactoylglutathione.

PMID- 8359420
TI  - Glyoxalase activity in human tumour cell lines in vitro.

PMID- 8359421
TI  - Inhibition of proliferation of human leukaemia 60 cells by methylglyoxal in
      vitro.

PMID- 8359422
TI  - The hydrolysis of S-D-lactoylglutathione.

PMID- 8359424
TI  - Simple chromatographic methods for the purification of human red blood cell
      glyoxalase I and glyoxalase II to homogeneity.

PMID- 8359423
TI  - Binding of methylglyoxal to albumin and formation of fluorescent adducts.
      Inhibition by arginine, N-alpha-acetylarginine and aminoguanidine.

PMID- 8359425
TI  - Population genetics of human glyoxalases and the development of diabetic
      complications.

PMID- 8359426
TI  - In situ kinetics of yeast glyoxalase I.

PMID- 8359427
TI  - Oxygen effects on yeast glyoxalase system.

PMID- 8359428
TI  - Structural characterisation of human caeruloplasmin in solution by FTIR
      spectroscopy.

PMID- 8359429
TI  - Quantitative analysis of defects of mitochondrial oxidation during recovery from
      exercise.

PMID- 8359430
TI  - Control of intracellular concentrations of 'bioenergetic' metabolites in skeletal
      muscle.

PMID- 8359431
TI  - Theoretical aspects of transient disturbances of cellular [Pi] and organic
      phosphates.

PMID- 8359432
TI  - Skeletal muscle Pi transport in vitro.

PMID- 8359433
TI  - Transarcolemmal Pi movement in perfused rat heart: a 31-P NMR spectroscopic
      study.

PMID- 8359434
TI  - Use of olive cultures to evaluate triacylglycerol synthesis.

PMID- 8359435
TI  - Influence of alterations in environmental CO2 and temperature on wheat grain
      lipids.

PMID- 8359436
TI  - Differential sensitivity of lipid metabolism in monocotyledons to grass-specific
      herbicides.

PMID- 8359438
TI  - Further studies on Plasmodium falciparum glycoproteins: characterization of 195
      kDa glycoprotein.

PMID- 8359437
TI  - The inhibition of fatty acid elongation by a thiocarbamate herbicide and its
      sulphoxide.

PMID- 8359439
TI  - Further studies on cervical glycoproteins: isolation and characterization of
      oligosaccharides from follicular phase cervical glycoproteins of bonnet monkey.

PMID- 8359440
TI  - Thymidylate synthase in normal and cancer tissues.

PMID- 8359441
TI  - Partial purification of ribose 1-phosphate dependent "ADP forming" activity in
      rat liver.

PMID- 8359442
TI  - Purine nucleotide catabolism in rat liver.

PMID- 8359443
TI  - Estradiol and phospholipid metabolism in the rat.

PMID- 8359444
TI  - Purine nucleotide content of lymphocytes subpopulations.

PMID- 8359445
TI  - Protein kinase C alpha is the isoform responsible for inhibition of histamine H2
      receptor mediated stimulation of adenylate cyclase in the human gastric cancer
      cell line HGT-1.

PMID- 8359446
TI  - Short term effects of interleukin-1 beta on insulin secretion and cyclic
      nucleotide levels in rat islets of Langerhans cultured with arginine and arginine
      analogues.

PMID- 8359447
TI  - The solubility of Coomassie blue protein-dye complexes.

PMID- 8359448
TI  - SDS-PAGE of cat parotid salivary proteins.

PMID- 8359449
TI  - Effects of atropine upon the secretion of rate parotid salivary proteins.

PMID- 8359450
TI  - A monoclonal antibody which recognizes rabbit CD11a and which inhibits homotypic
      T cell aggregation.

PMID- 8359451
TI  - Isolation and characterization of a novel family of G protein-coupled receptors.

PMID- 8359452
TI  - Solubilisation and molecular characterisation of the P2X purinoceptor.

PMID- 8359453
TI  - Gene expression and control of enzymes for synthesis of magnesium protoporphyrin
      monomethyl ester in Rhodobacter sphaeroides.

PMID- 8359454
TI  - The cloning and overexpression of E. coli acyl carrier protein (ACP).

PMID- 8359455
TI  - Mucosal surface ferricyanide reductase in mouse duodenum.

PMID- 8359456
TI  - Cytosolic aconitase activity in mouse small intestine: iron dependence.

PMID- 8359457
TI  - Degradation of human and rat surfactant apoprotein by neutrophil elastase and
      cathepsin G.

PMID- 8359458
TI  - Alpha-1-proteinase inhibitor activity can be compromised by the choice of assay
      conditions.

PMID- 8359459
TI  - The antigenicity of elastin-derived peptides obtained from atherosclerotic human
      aorta.

PMID- 8359460
TI  - Immunospecificity of soluble elastin peptides: determination by ELISA assay.

PMID- 8359461
TI  - The effect of arginine on glycolysis by Streptococcus mutans and Actinomyces
      viscosus.

PMID- 8359462
TI  - Analysis of enterotoxin synthesis in a Vibrio cholerae strain lacking DsbA, a
      periplasmic enzyme involved in disulphide bond formation.

PMID- 8359463
TI  - A new method for the purification of the B subunit (EtxB) of Escherichia coli
      heat-labile enterotoxin.

PMID- 8359464
TI  - Monosaccharide composition of haptoglobin purified from alcoholic cirrhotic and
      control sera determined by HPAE.

PMID- 8359465
TI  - New substrate-derived thiol-specific time-dependent inhibitors for the
      characterisation of the coupling of binding site interactions with catalytic site
      chemistry in the cysteine proteinases.

PMID- 8359467
TI  - The kinetically influential ionizations of chymopapain M.

PMID- 8359466
TI  - Ficin: a cysteine proteinase with binding site-catalytic site signalling
      characteristics intermediate between those of papain and actinidin.

PMID- 8359468
TI  - Nature of the leak induced in erythrocyte membranes by Kanagawa Haemolysin.

PMID- 8359469
TI  - Effect of a milk fat globule membrane fraction on cultured mouse mammary cells.

PMID- 8359470
TI  - Free radical damage in Down's syndrome brain.

PMID- 8359471
TI  - Catalytic RNA: structure and mechanism.

PMID- 8359472
TI  - Lipid sorting--measurement and interpretation.

PMID- 8359473
TI  - Biosynthesis of sphingomyelin and its delivery to the surface of baby hamster
      kidney (BHK) cells.

PMID- 8359474
TI  - Properties and intracellular localization of phosphatidylinositol transfer
      protein in Swiss mouse 3T3 cells.

PMID- 8359475
TI  - Mechanism and function of changes in membrane-phospholipid asymmetry in platelets
      and erythrocytes.

PMID- 8359476
TI  - Biocompatible surfaces based upon the phospholipid asymmetry of biomembranes.

PMID- 8359477
TI  - Two-phase partitioning applied to changes in phospholipid asymmetry.
AB  - In summary aqueous two-phase polymer partition is a useful addition to the range
      of techniques available for determining lipid asymmetry in model and in
      biological membrane systems. The methodology is straightforward, the experimental
      requirements simple and the materials used inexpensive. We have demonstrated its
      usefulness in several model membrane systems rendered asymmetric by the
      establishment of a membrane potential across the lipid bilayer and in monitoring
      Ca(2+)-induced asymmetry in human erythrocytes.

PMID- 8359478
TI  - Structure and energetics of phospholipid and diacylglycerol assemblies relative
      to membrane fusion.

PMID- 8359479
TI  - Asymmetry in trans-bilayer lateral pressure may drive expansion of the secretion
      fusion pore.

PMID- 8359480
TI  - How lipid asymmetry can make vesicles fusion-competent by inhibition of the
      thermal undulations.

PMID- 8359481
TI  - Loss of phospholipid asymmetry in cell fusion.

PMID- 8359482
TI  - Diacylglycerol in the exocytosis of the mammalian sperm acrosome.

PMID- 8359483
TI  - Protein kinase C, membrane fusion and platelet granule secretion.

PMID- 8359484
TI  - Molecular studies on chemotactic receptors.

PMID- 8359485
TI  - Identification of a protein capable of causing fusion of endosome and lysosome
      membranes.

PMID- 8359487
TI  - Structural analysis of the variation in the major outer membrane proteins of
      Neisseria meningitidis and related species.

PMID- 8359486
TI  - Sequence-specific anti-peptide antibodies that recognize different subunits of
      the high-affinity IgE receptor.

PMID- 8359488
TI  - Characterization of amino-acid transport in pig erythrocytes.

PMID- 8359489
TI  - GLUT 1: identification of exofacial lysine-residues.

PMID- 8359490
TI  - Dynamics of lipid peroxidation and its inhibition by antioxidants.

PMID- 8359491
TI  - Cerebral ischaemia, free radicals and antioxidant protection.

PMID- 8359492
TI  - High-dose systemic iron chelation attenuates reperfusion injury.

PMID- 8359493
TI  - Composition and organization of the NADPH oxidase of phagocytes and other cells.

PMID- 8359494
TI  - Protein modification by oxidants and the role of proteolytic enzymes.

PMID- 8359496
TI  - Peroxynitrite and atherosclerosis.

PMID- 8359495
TI  - Mitochondrial calcium handling and oxidative stress.

PMID- 8359497
TI  - Antioxidant drugs and the inhibition of low-density lipoprotein oxidation.

PMID- 8359499
TI  - Oxidative stress and its control: a pathogenetic role in inflammatory joint
      disease.

PMID- 8359498
TI  - Free radicals and mitochondrial dysfunction in Parkinson's disease.
AB  - The precise relationship of the complex I deficiency in PD to the dopaminergic
      cell death and aetiology of this disorder is as yet unknown. However, evidence is
      accruing that this mitochondrial defect may play a central role in the cascade of
      events that terminates in nigral neuronal loss. Further work needs to be carried
      out to determine the molecular mechanisms that underlie the complex I deficiency
      as these may provide important indicators to the ultimate cause of PD. This may
      involve a genetic abnormality of complex I that may convey a susceptibility to
      developing PD. Alternatively, exogenous or endogenous toxic agents may target
      nigral complex I along pathways similar to those recognized for MPTP. A
      combination of a genetic predisposition in addition to an environmental
      precipitant has gained substantial support as an explanation for the cause of PD.

PMID- 8359500
TI  - Review of General Medical Council proposals on undergraduate medical education.

PMID- 8359501
TI  - Contribution of basic medical science to a new medical curriculum.

PMID- 8359502
TI  - Teaching versus learning.

PMID- 8359503
TI  - Two revolutions and the scientific culture.

PMID- 8359504
TI  - Identification of cytosolic protein regulators of exocytosis.

PMID- 8359505
TI  - Hippocampal nicotinic autoreceptors modulate acetylcholine release.

PMID- 8359506
TI  - Probing the atomic interactions between proteins and carbohydrates.

PMID- 8359507
TI  - Oligosaccharides and recognition--a 'shape' problem probed by n.m.r. and
      molecular modelling.

PMID- 8359508
TI  - The conformational effects of N-linked glycosylation.

PMID- 8359509
TI  - Recognition of complex carbohydrates by Ca(2+)-dependent animal lectins.

PMID- 8359510
TI  - Sweet and shapely: ligands for animal lectins.

PMID- 8359511
TI  - Structure/function relationships in the collectins (mammalian lectins containing
      collagen-like regions).

PMID- 8359512
TI  - Recognition of complex carbohydrates by the macrophage mannose receptor.

PMID- 8359513
TI  - The role of mannose-binding protein in host defence.

PMID- 8359514
TI  - Heparan sulphate: functional role as a modulator of fibroblast growth factor
      activity.

PMID- 8359515
TI  - Apolipoproteins E and C-III have opposing roles in the clearance of lipoprotein
      remnants in transgenic mice.

PMID- 8359516
TI  - The assembly and secretion of apoB-100-containing lipoproteins.

PMID- 8359517
TI  - Synthesis and secretion of apolipoprotein A-I.

PMID- 8359518
TI  - Genetic influences on lipoprotein(a) concentration.

PMID- 8359519
TI  - Lipoprotein metabolism in lipase deficient states: studies in primary and
      secondary hyperlipidaemia.

PMID- 8359521
TI  - Regulation of lipoprotein lipase.

PMID- 8359520
TI  - Phenotypic variation of mutations in the human lipoprotein-lipase gene.
AB  - We have described a large number of different mutations in the LPL gene that
      result in completely catalytically defective LPL protein. More recently exonic
      polymorphisms in the LPL gene have been described that do not result in the
      catalytic activity of LPL being significantly impaired. Furthermore we have
      recently described a patient who is homozygous for a mutation in the LPL gene in
      a conserved region of exon 5 that results only in partial residual activity and a
      very mild clinical phenotype. This may suggest that the frequency of mutations in
      the LPL gene is greater than has been previously recognized. Recognition and
      selection of patients for analysis was based on the phenotype of
      chylomicronaemia. However, the existence of the Ser172-Cys mutation in the LPL
      gene that results in only moderate hypertriglyceridaemia in the absence of
      environmental factors might suggest that mutations in this gene are more frequent
      and could be seen in patients with a milder clinical phenotype. The clue to
      detecting these changes in the LPL gene might be to investigate patients who
      present with chylomicronaemia due to different environmental triggers while, in
      the absence of these environmental factors, they have only moderate
      hypertriglyceridaemia.

PMID- 8359522
TI  - Catalytic and molecular properties of glyoxalase I.

PMID- 8359523
TI  - Glyoxalase I in micro-organisms: molecular characteristics, genetics and
      biochemical regulation.

PMID- 8359524
TI  - Glyoxalase II: molecular characteristics, kinetics and mechanism.
AB  - The mechanism that has been proposed for glyoxalase II [36] is summarized in
      Figure 3. It involves direct nucleophilic attack of an active-site histidine on
      the thiol ester substrate to form an acyl-imidazole intermediate which then
      rapidly hydrolyses. This is consistent with the known susceptibility of thiol
      esters to aminolysis and with the lability of acyl-imidazoles [47].

PMID- 8359525
TI  - The glyoxalase system in higher plants: regulation in growth and differentiation.

PMID- 8359526
TI  - Modification of the glyoxalase system in disease processes and prospects for
      therapeutic strategies.

PMID- 8359527
TI  - Inhibitors of glyoxalase I: design, synthesis, inhibitory characteristics and
      biological evaluation.

PMID- 8359528
TI  - Structural relationships between glyoxalase I and membrane transport proteins.

PMID- 8359529
TI  - Inhibitors and inhibition studies of mammalian glyoxalase II activity.

PMID- 8359530
TI  - Mechanism for the formation of methylglyoxal from triosephosphates.

PMID- 8359531
TI  - Fourier transform infrared spectroscopic studies on human transferrin receptor.

PMID- 8359532
TI  - Inhibition of aminophospholipid translocation in red cell vesicles.

PMID- 8359533
TI  - Hydrophilic and hydrophobic surface map analysis of bacteriorhodopsin.

PMID- 8359534
TI  - Effect of heat on 1,2-diacylglycerol and triacylglycerol levels in WRK-1 and CHO
      cells.

PMID- 8359535
TI  - Interaction of myosin with charged membranes is affected by ATP.

PMID- 8359536
TI  - The structure of a polypeptide corresponding to the pore region of the voltage
      gated potassium channel.

PMID- 8359537
TI  - Conformation of the Pf1 coat protein in the phage and in a lipid membrane.

PMID- 8359538
TI  - Binding-independent fluorescence enhancement of MC 540 in erythrocytes with
      decreased phospholipid asymmetry.

PMID- 8359539
TI  - Maintenance of GSH content in primary astrocyte cultures under oxidative stress
      conditions.

PMID- 8359540
TI  - Diphenylisobenzofuran (DPBF) follows the dynamics of ROO. to RO. and C-centered
      radicals in microsomal membranes.

PMID- 8359541
TI  - Detection of radicals in oxidised lipoproteins.

PMID- 8359542
TI  - The effect of lipid hydroperoxides on the copper dependent oxidation of low
      density lipoprotein.

PMID- 8359543
TI  - Short and long term modulation of oxidant induced ATP depletion--implications for
      effective treatment.

PMID- 8359544
TI  - Effect of folates and folate antagonists on lipid peroxidation.

PMID- 8359545
TI  - Alterations in the antioxidant defense of peripheral nervous tissue following
      acute ethanol administration.

PMID- 8359546
TI  - Metal-catalysed oxidation and post-Amadori reactions of serum albumin and other
      model proteins.

PMID- 8359547
TI  - Erythrocyte-induced oxidation of low density lipoproteins: control by antioxidant
      nutrients.

PMID- 8359548
TI  - A new method for measuring antioxidant activity.

PMID- 8359549
TI  - Novel hydroxamates and myocardial reperfusion injury.

PMID- 8359550
TI  - The role of bound lipid and transition metal in the formation of fluorescent
      advanced glycation endproducts by human serum albumin.

PMID- 8359552
TI  - Purification of xanthine oxidase from human heart.

PMID- 8359551
TI  - Effect of oxidants on vascular smooth muscle proliferation.

PMID- 8359553
TI  - Effect of short-term administration of dexamethasone on canine antral gastrin
      gene expression.
AB  - The acute effect of corticosteroids on the release and biosynthesis of gastrin
      still remains unclear. We report the effect of short-term administration of
      dexamethasone on the antral gastrin gene expression and gastrin levels in 6 dogs,
      which were treated with dexamethasone (1.5 mg/kg, i.m. daily) for 3 days. One day
      after treatment, gastrin mRNA levels increased (152 +/- 14%), but serum and
      tissue gastrin showed no significant changes. With 2 and 3 days of dexamethasone
      treatment, gastrin mRNA (2 days: 163 +/- 28%, 3 days: 170 +/- 22%), serum gastrin
      (2 days: from 94 +/- 12 to 168 +/- 23 pg/ml, 3 days: to 180 +/- 16 pg/ml) and
      tissue gastrin concentration (2 days: from 480 +/- 32 to 664 +/- 31 pg/mg tissue
      protein, 3 days: to 708 +/- 45 pg/mg tissue protein) significantly increased.
      However, gastrin mRNA levels were not increased even after 1 day culture of
      canine antral tissue with dexamethasone in vitro. These findings suggest that
      short-term administration of corticosteroid may increase the canine gastrin gene
      expression in vivo by an unknown pathway.

PMID- 8359554
TI  - Effect of short-term administration of omeprazole on serum gastrin and
      pepsinogens in antrectomized patients.
AB  - Omeprazole, a potent and long-acting inhibitor of gastric acid secretion, is
      known to increase both serum gastrin and pepsinogen A and C levels in unoperated
      subjects. It has been suggested that the rise in serum pepsinogens is mediated by
      the omeprazole-induced increase in serum gastrin. This study was undertaken to
      determine the role of gastrin in hyper-pepsinogenemia induced by antisecretory
      therapy. We have studied the effect of a 5-day course of 40 mg of omeprazole
      daily on fasting serum gastrin and pepsinogen A and C levels in 14 patients with
      an antrectomy and a Billroth I anastomosis (n = 8) or a Billroth II anastomosis
      (n = 6). In antrectomized patients omeprazole failed to induce any increase in
      basal serum gastrin. On the other hand, omeprazole increased significantly serum
      pepsinogen A levels in both Billroth I and II patients, while the rise in serum
      pepsinogen C level was significant in Billroth I, but just failed to reach
      statistical significance in Billroth II patients. We conclude that the
      stimulation of serum pepsinogens A and C by a short-term treatment with
      omeprazole is not mediated by increases in serum gastrin. This study further
      shows that omeprazole stimulates gastrin release only from the antrum and not
      from extra-antral sources.

PMID- 8359555
TI  - Long-term outcome of acute pancreatitis: a prospective study with 118 patients.
AB  - 118 patients who had recovered from acute pancreatitis underwent endoscopic
      retrograde pancreatography (ERCP) during a long-term follow-up (mean 4.4 years,
      range 1-17) to investigate the frequency and features of residual ductal lesions.
      Oedematous and necrohaemorrhagic pancreatitis occurred in 35 and in 83 patients,
      respectively. The aetiology was biliary (39 patients), alcoholic (32), biliary
      alcoholic (18) and miscellaneous (29). After oedematous pancreatitis, ERCP was
      normal in 31, showed obstructive pancreatitis in 2 and a slight localized and
      smooth stricture of the main duct in 2 patients. After necrotizing pancreatitis,
      29 patients showed ductal changes without features of chronic pancreatitis, 7
      obstructive, 3 chronic calcifying pancreatitis and 44 normal pictures. In 17
      patients submitted to two or three ERCPs during a mean 10-year follow-up, the
      ductal appearance was unchanged in 12, worsened in 3, and improved in 2 patients.
      The aetiology of pancreatitis and frequency of recurrences was similar in
      patients with or without scarring lesions. We conclude that residual ductal
      lesions are common after acute necrotizing pancreatitis.

PMID- 8359556
TI  - Natural course in 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 long-term observation of > 10
      years, and severe exocrine/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
      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- 8359557
TI  - Role of endothelin and platelet-activating factor in indomethacin-induced gastric
      mucosal injury in rats.
AB  - The current study was designed to investigate the role of two potent vasoactive
      substances, endothelin (ET) and platelet-activating factor (PAF), in the
      pathogenesis of indomethacin-induced gastric lesions in rats. Treatment with anti
      ET antibody before indomethacin administration resulted in a significant decline
      in the total length of the lesions as determined by gross evaluation. In
      contrast, CV-6209, a specific PAF antagonist, had no effect on the total length
      of the lesions. The results strongly suggest the incorporation of endogenous ET
      in the mechanism of gastric damage after indomethacin administration.

PMID- 8359558
TI  - Congestive gastropathy versus chronic gastritis: a comparison of some
      pathophysiological aspects.
AB  - In order to investigate some pathophysiological aspects of the two diseases, 15
      patients with congestive gastropathy and 15 with chronic gastritis have been
      studied and compared with 15 healthy controls. Gastric blood flow as determined
      during endoscopy by means of laser Doppler flowmetry was found to be
      significantly increased (p < 0.001) in congestive gastropathy, whereas a
      significant reduction (p < 0.001) was noted in chronic gastritis. On the other
      hand, Helicobacter pylori was detected in 80% of cases in chronic gastritis,
      while the prevalence of the microorganism in congestive gastritis was similar to
      that in healthy controls. It is concluded that chronic gastritis and congestive
      gastropathy are related to different pathogenetic factors and require different
      therapeutic approaches.

PMID- 8359559
TI  - Luminal release of hyaluronan (hyaluronic acid) in intestinal ischemia in the
      rat.
AB  - Hyaluronan (HA) is a glycosaminoglycan, the water-binding properties of which are
      suggested to be pivotal for an optimal hydration of tissues. The lamina propria
      of the intestinal villi is characterized by a high concentration of HA. Increased
      amounts of HA are observed in the intestinal lumen in patients with Crohn's
      disease. We have evaluated whether epithelial denudation as such is sufficient to
      increase the concentration of HA in the lumen of the small intestine. Epithelial
      damage was accomplished by reversible ischemia-reperfusion injury to the rat
      ileum and the concentration of HA was determined in luminal perfusate. The
      perfusate concentration of HA was increased from 26 +/- 8 micrograms/l before
      ischemia, to 68 +/- 13 and 41 +/- 12 micrograms/l 0-30 and 30-60 min after a 60
      min period of subtotal ischemia without venous stasis (p < 0.05). In sham
      operated animals, in contrast, the perfusate concentration of HA was virtually
      unchanged (31 +/- 18, 13 +/- 3 and 10 +/- 1 microgram/l, respectively). Specific
      staining for HA on sections revealed loss of HA from the villus tips after
      ischemia. The results show that epithelial denudation results in loss of HA from
      the villus interstitium to the intestinal lumen.

PMID- 8359560
TI  - Gastric and colorectal cancer in patients attending mission hospitals in rural
      areas of South-east Asia.
AB  - 25 missionaries working in Taiwan, Thailand, Indonesia and the Philippines
      completed questionnaires regarding their clinical practice during the year 1980.
      Data were collected on the numbers of both gastric and colorectal cancers
      diagnosed. More than 90,000 out-patients were reviewed, and over 25,000 in
      patients treated. In total, 76 gastric and 118 colorectal carcinomas were seen.
      Surgery and radiology were available at 88% of hospitals, but histology at only
      53%. In both Indonesia and the Philippines, the relative risk of developing
      colorectal compared with gastric cancer was 3.3 (95% confidence limits 1.8-6.2
      and 1.4-8.5, respectively). In Thailand and Taiwan, these tumours occurred with
      similar frequencies. Thailand, Indonesia and the Philippines had similar numbers
      of gastric neoplasms, but Taiwan a significantly higher number than the other
      countries (z > or = 4.4, p < 0.0001). Thailand had lower numbers of colorectal
      tumours than the Philippines, (z = 2.2, p < 0.05), Taiwan (z = 3.4, p < 0.001)
      and Indonesia (p = 5.0, p < 0.0001). Local dietary factors probably play an
      important role in the development of these tumours.

PMID- 8359561
TI  - High risk of coeliac disease in Punjabis. Epidemiological study in the south
      Asian and European populations of Leicestershire.
AB  - The purpose of this study was to measure the incidence of coeliac disease in
      different ethnic communities and investigate the hypothesis that the incidence is
      decreasing in most European countries and the role incomplete retrieval of data
      may play. In a retrospective study of histologically confirmed cases of coeliac
      disease between 1975 and 1989 in the City of Leicester, 106 patients with coeliac
      disease were identified. Of these 86 were European and 20 Asian. The overall
      incidence of coeliac disease in Europeans was 2.5/10(5)/year (95% CI 2-3.2), in
      Gujaratis 0.9/10(5)/year (95% CI 0.4-1.8), and in Punjabis 6.9 (95% CI 3.2-12.3).
      These differences were independent of religious belief. The relative risk to
      Punjabis compared with Europeans is 2.9 (95% CI 1.5-5.3; chi 2 = 12.5, p < 0.01)
      and to Gujaratis 8.1 (95% CI 3-22.4; chi 2 = 25; p < 0.001). Gujaratis were at
      0.4 risk of Europeans (90% CI 0.2-0.8; chi 2 = 6.7; p < 0.01). The incidence in
      the urban populations of Leicester was 6/10(5)/year (95% CI 1.3-1.9) which was
      significantly lower than the 3.2/10(5)/year (95% CI 2.7-3.8; chi 2 = 5.6; p <
      0.001) in surrounding rural areas. This study shows that the incidence of coeliac
      disease in Punjabis (Sikhs, Hindus and Muslims) is 8 times higher than in
      Gujaratis (Hindus and Muslims) and 4 times higher than in Europeans in Leicester.

PMID- 8359562
TI  - Epidemiological characteristics of inflammatory bowel disease in Bologna, Italy-
      incidence and risk factors.
AB  - Recently, in Bologna, an inflammatory bowel disease incidence of 7.7/10(5)/year
      has been calculated, about one third of that reported in Northern Europe,
      confirming the existence of a 'North-South gradient'. A first peak of incidence
      was observed at 20-29 years of age and a second peak at 60-69 years of age for
      ulcerative colitis (UC) alone. A prevalence of UC males, mainly after the 7th
      decade, and of Crohn's disease (CD) females in the first peak was found. A
      greater frequency of ex-smokers in UC, with a relative risk (RR) significantly
      higher in males for all age groups (RR = 6.1; p < 0.01) and of smokers in CD with
      a RR significantly higher in 20- to 29-year-old females (RR = 11.6; p < 0.05) was
      observed. A different pattern for the two diseases exists: male ex-smokers and
      young female smokers are at risk of developing UC and CD, respectively.

PMID- 8359563
TI  - Proceedings Sandostatin, State of the Art. International symposium. Monte Carlo,
      1991.

PMID- 8359564
TI  - Proceedings of the discussion: 'Tolerability and safety of Sandostatin'.

PMID- 8359565
TI  - Sandostatin therapy of acute oesophageal variceal bleeding.
AB  - This communication deals with the emergency control of variceal bleeding rather
      than the prevention of rebleeding. The current main options of oesophageal
      tamponade, emergency sclerotherapy and drug therapy are discussed, with
      particular reference to the use of somatostatin. Sandostatin (Sandoz, Basel), a
      synthetic long-acting somatostatin analogue, was found to reduce transhepatic
      venous gradient by 30% with no effect on systemic haemodynamics in a study of 16
      stable cirrhotic patients. In a trial comparing intravenous infusion of
      Sandostatin (SMS) to oesophageal tamponade (OT) in active variceal bleeding, 18
      of 20 bleeds in the SMS group and 19 of 20 bleeds in the OT group were controlled
      at 4 h. Ten in the SMS group and 14 in the OT group had no further bleeding
      during the 48-hour study period. Thus SMS may be useful in the temporary control
      of active variceal bleeding.

PMID- 8359566
TI  - Perioperative use of octreotide in gastrointestinal surgery.
AB  - The evolution of gastrointestinal endocrinology has led to the design and
      application of analogs of gut peptides to treat disease. Octreotide, a long
      acting analog of the inhibitory peptide somatostatin, has proven useful in the
      management of disorders such as carcinoid syndrome and secretory diarrhea due to
      VIPoma. More recent experience suggests a role for this peptide in the management
      of certain complications of gastrointestinal surgery. Prophylactic use of
      octreotide appears warranted in the prevention of carcinoid crisis in selected
      patients with carcinoid syndrome undergoing invasive procedures, and in the
      prevention of complications in selected patients undergoing pancreatic surgery.
      Evidence from placebo-controlled trials supports a role for octreotide in the
      management of dumping symptoms in severely affected patients, at least in the
      short term. Octreotide appears to serve a useful adjunctive role in controlling
      output from postoperative gastrointestinal fistulae and may hasten closure,
      particularly in pancreatic fistulae. Selected patients with ileostomy diarrhea
      and short bowel syndrome benefit from octreotide treatment, but the long-term
      value of the peptide in controlling stool output is less clear. Rare patients
      with other forms of postoperative secretory diarrhea have been successfully
      treated with octreotide. Finally, animal and early human experience suggests that
      octreotide may have a role as an adjunctive treatment of partial small bowel
      obstruction. In most of these conditions, the available data is sparse and
      further controlled trials are warranted.

PMID- 8359567
TI  - Treatment of gastrointestinal fistulas with Sandostatin.
AB  - Pharmacological treatment of patients with enterocutaneous fistulas aims at
      reducing output, increasing the chance of spontaneous closure and reducing the
      time of fistula closure. Our initial experience with octreotide suggests that
      this drug effectively reduces output of established enterocutaneous fistulas when
      compared with a placebo in patients on parenteral nutrition. Output reduction was
      independent of the basal output. Likewise, this somatostatin analogue was shown
      to accelerate fistula closure in a series of 27 patients treated with the drug
      after having received parenteral nutrition for a mean of 25 days. When compared
      with a historical series, the rate of spontaneous fistula closure was not
      modified by octreotide.

PMID- 8359568
TI  - Octreotide in dumping and short bowel syndromes.
AB  - Octreotide inhibits intestinal motility and reduces gastrointestinal secretions.
      These actions have led to its evaluation in two postsurgical conditions: dumping
      syndrome and short bowel syndrome. Octreotide substantially reduces symptoms of
      early and late dumping and prevents the associated phenomena including the
      increase in packed cell volume considered to be indicative of reduced plasma
      volume. Its therapeutic benefit probably relates both to slowing of gastric
      emptying and small bowel transit and inhibition of the release of putative
      mediators (peptide hormones) of the vasomotor symptoms. Octreotide also reduces
      intestinal efflux in some patients with the short bowel syndrome. This can lead
      to a reduction in the volume of intravenous fluid requirements but does not allow
      an intravenous fluid-dependent patient to change back to an oral regimen. The
      major mechanism of octreotide's therapeutic effect in this situation may be its
      ability to reduce endogenous gastric acid secretion.

PMID- 8359569
TI  - Treatment of pancreatic ascites and external pancreatic fistulas with a long
      acting somatostatin analogue (Sandostatin).
AB  - Prior to the advent of somatostatin conservative therapy for pancreatic fistulas,
      treatment included intravenous nutritional therapy with nothing per mouth and
      therapeutic agents to diminish pancreatic secretions. None of these modalities
      were uniformly successful. A prospective study to evaluate the efficacy of a long
      acting somatostatin analogue (Sandostatin) was carried out. 18 patients-10 with
      pancreatic ascites and 8 with external pancreatic fistulas-were treated. The
      ascites resolved in 9 of 10 patients in a mean period of 22 days (+/- 3 days).
      The external fistulas were all high output fistulas and resolved in 7 of 8
      patients. Mean period for closure was 23 days. There were no side effects
      associated with Sandostatin. Sandostatin has made a major impact on the
      conservative treatment of pancreatic ascites and is an important adjunct to the
      management of external pancreatic fistulas. It is emphasised however that surgery
      may be required for the underlying pancreatic disease. In this regard close
      surveillance of these patients is necessary.

PMID- 8359570
TI  - Potential indications for octreotide in gastroenterology: summary of workshop.
AB  - The potential therapeutic applications of somatostatin and octreotide in
      gastroenterology involve gut neuro-endocrine tumours, bleeding varices, bleeding
      peptic ulcers, gastro-intestinal fistulae, pancreatic fistulae, dumping syndrome,
      pancreatic pseudocysts, short bowel syndrome, acute pancreatitis, AIDS-related
      diarrhoea, intestinal subacute obstruction, idiopathic 'diarrhoea', irritable
      bowel syndrome and GIT tumours. Octreotide has a longer duration of action than
      somatostatin and can be administered by subcutaneous injection, thus making it
      suitable for long-term administration. Many of the potential gastro-intestinal
      indications require long-term administration and thus octreotide would be the
      agent of choice.

PMID- 8359571
TI  - Somatostatin analogue therapy in functioning neuroendocrine gut tumors.
AB  - The purpose of the workshop was to critically evaluate the use of octreotide in
      the management of important surgical and gastroenterological conditions. The
      topics covered included: (1) management of functioning gut neuroendocrine tumors,
      (2) new approaches to localize these tumors, (3) the place of octreotide in the
      treatment of variceal bleedings, and (4) the use of octreotide in postoperative
      conditions. Octreotide therapy has been shown to be effective in the carcinoid
      syndrome, in which symptom control is achieved in 85% of patients, and reduction
      in 5-HIAA in 60%. Although tumor regression is rarely seen, prolongation of
      survival probably occurs. Control of diarrhea has been achieved in 84% of
      patients with VIPoma treated with octreotide. Similarly, octreotide has been
      found to provide effective control of the necrolytic, migratory dermatitis seen
      in glucagonoma. By contrast, insulinomas are more resistant to somatostatin
      agonist therapy. In the Zollinger-Ellison syndrome, octreotide is effective in
      alleviating symptoms and in reducing serum gastrin levels. However, its use in
      this syndrome has been superceded by omeprazole. Radioiodine-labelled octreotide
      has been very effective in in vivo imaging of neuroendocrine tumors in the
      abdomen, and is now considered the best available technique for localizing these
      tumors preoperatively. Intraoperative localization with a hand-held gamma camera
      is being developed. There is an exciting future possibility to use the technique
      to deliver therapy to tumors. Octreotide therapy has been shown to be at least as
      effective as and without the adverse hemodynamic effects of Pitressin in control
      of variceal hemorrhage. It should be regarded as one of several modalities of
      therapy in the condition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359572
TI  - Gastroenteropancreatic endocrine tumours: effect of Sandostatin on tumour growth.
      The German Sandostatin Study Group.
AB  - One hundred and fifteen gastroenteropancreatic (GEP) patients with malignant
      endocrine tumours entered a prospective multicentre trial (12 patients with
      gastrinoma, 53 with carcinoid syndrome, 45 with nonfunctioning tumours and 5 with
      other endocrine GEP tumours) to determine the efficacy of 200 micrograms
      Sandostatin t.i.d. in the control of tumour growth. This interim report describes
      the results in 85 patients. Thirty-four patients died, 14 before and 20 after the
      first follow-up investigation, indicating a 'negative' selection of patients
      included in the trial and suggesting that Sandostatin is unable to prevent
      disease progression when it is far advanced. In the evaluation of 68 patients
      followed up for at least 3 months, partial regression was observed in 4.4%,
      stable disease in 50% and tumour progression in 45%. An initially favourable
      response occurred frequently, however, it was followed by a decrease in response,
      from 54.4% at 3 months to 38% at 12 months, for the whole group of patients.
      Proven inhibition of tumour growth was mirrored by suppression of serum and urine
      hormone parameters. It is concluded that Sandostatin exerts a beneficial effect
      on tumour growth in patients with metastatic endocrine GEP tumours. This
      beneficial effect decreases with time and is as yet unpredictable in the
      individual patient.

PMID- 8359573
TI  - 111In-octreotide scintigraphy in oncology.
AB  - Various tumors of neuroendocrine origin that have amine precursor and
      decarboxylation (APUD) characteristics can be visualized in vivo after
      intravenous injection of the somatostatin analogue [123I-Tyr3]-octreotide.
      However, the relatively short effective half-life of this compound and the high
      background of radioactivity in the abdomen are drawbacks in its application.
      Therefore, an 111In-coupled somatostatin analogue ([111In-DTPA-D-Phe1]
      octreotide) was developed. This analogue is excreted mainly via the kidneys, 90%
      of the dose being present in the urine 24 h after injection. Using 111In
      octreotide scintigraphy, 7 out of 7 gastrinomas, 4 out of 7 insulinomas, 1 out of
      1 glucagonoma, 3 out of 3 unclassified apudomas, but none out of 18 exocrine
      pancreatic carcinomas were visualized. Also, 19 out of 19 carcinoids, 15 out of
      15 glomus tumors, 8 out of 12 medullary thyroid carcinomas, 6 out of 6 small cell
      lung carcinomas, 4 out of 4 growth hormone-producing and 6 out of 9 clinically
      nonfunctioning pituitary adenomas were visualized. Apart from APUD-cell-derived
      tumors, 111In-octreotide scintigraphy was also successfully applied to visualize
      breast cancer, lymphomas and granulomas. In 39 out of 50 patients with breast
      carcinoma, 10 out of 11 patients with non-Hodgkin lymphomas, 3 out of 3 patients
      with Hodgkin's disease, and 8 out of 8 patients with sarcoidosis, tumor sites
      accumulated radioactivity during octreotide scintigraphy. In a considerable
      number of patients with carcinoids and glomus tumors, but also in patients with
      granulomas and lymphomas, 111In-octreotide scintigraphy revealed more tumor sites
      than did conventional imaging techniques.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359574
TI  - Use of radiolabeled somatostatin analogs in the identification and treatment of
      somatostatin receptor-bearing tumors.
AB  - Radiolabeled somatostatin analogs are potentially of considerable value in both
      the localization and treatment of somatostatin receptor-bearing tumors. Whole
      body 123I-labeled Tyr3-octreotide scintigraphy is capable of detecting and
      localizing primary tumors and metastatic disease that may not be detectable by
      other methods. Although it is possible that this technique may be applicable to a
      wide variety of neoplasms, 123I-Tyr3-octreotide scans appear particularly useful
      for imaging various gut neuroendocrine tumors, meningiomas, and paragangliomas.
      This primarily reflects the level of expression of somatostatin receptors by
      these lesions. In addition to whole body scintigraphy, intraoperative
      localization by receptor identification utilizing a hand-held gamma detector
      probe may prove to be an effective means of identifying spread and
      micrometastasis of somatostatin receptor-bearing tumors. Aside from
      identification and topographic localization of disease, the detection of an 123I
      Tyr3-octreotide labeled tumor may be utilized as in vivo assay for the presence
      of somatostatin receptors. Such observations may prove useful in predicting the
      susceptibility of an individual tumor to octreotide therapy. Additionally, it may
      prove possible to deliver a therapeutic dose of radiation to receptor-bearing
      tumors by the administration of specific radiolabeled somatostatin analogs.

PMID- 8359575
TI  - Preclinical studies on the anticancer activity of the somatostatin analog
      octreotide (SMS 201-995).
AB  - The antiproliferative effect of somatostatin-14 and its analog octreotide on in
      vitro pancreatic and breast tumor cells has led to the suggestion that octreotide
      may have further oncological indications in addition to gastroenteropancreatic
      tumors. To extend these in vitro observations, we evaluated the effect of
      octreotide in rodent models of pancreatic and breast tumors. Octreotide of 5 or
      50 micrograms b.i.d. in nude mice bearing solid MiaPaCa pancreatic tumors
      (subline 21) or ZR-75-1 breast tumors induced significant inhibition of tumor
      growth from week 2 until the end of treatment at week 5. After 5 weeks the mean
      volume of ZR-75-1 tumors in animals treated with the 50-micrograms regimen was
      48% that of control. Autoradiographic studies showed a high percentage (71%) of
      ZR-75-1 tumors to be somatostatin receptor-positive. In addition, the growth of
      ZR-75-1 cells in vitro was significantly inhibited by octreotide. The drug was
      also tested in a second breast cancer model, DMBA-induced mammary tumors in rats,
      and continuous administration of 10 micrograms/kg/h over 6 weeks led to an
      approximately 50% reduction in the number of tumors arising in the rat mammary
      gland. These data suggest that pancreatic and breast cancer may be among the
      malignant diseases clinically susceptible to octreotide.

PMID- 8359576
TI  - In vivo and in vitro increased pancreatic beta-cell sensitivity to glucose in
      normal rats submitted to a 48-h hyperglycaemic period.
AB  - We investigated the importance of the level and the duration of glucose
      stimulation on the in vivo and in vitro insulin response to glucose in normal
      rats previously submitted to hyperglycaemia. Rats were made hyperglycaemic by a
      48-h glucose infusion. Glucose-induced insulin secretion was investigated in vivo
      by a 20-min hyperglycaemic clamp and in vitro by the isolated perfused pancreas
      technique, 3 h after the end of the in vivo glucose infusion. In glucose-infused
      rats, as compared to controls, in vivo incremental plasma insulin values above
      baseline integrated over the 20-min hyperglycaemic clamp (delta I) were five
      times higher during 8 mmol/l glucose clamp, only two times higher in 11 mmol/l
      glucose clamp and no different in 16.5 mmol/l. Compared to the controls, in vitro
      incremental plasma insulin concentration above baseline integrated over a 20-min
      period (delta I) in glucose-infused rats was 16 times higher in response to 2.8
      mmol/l glucose, two times higher in response to 5.5 mmol/l, similar in response
      to 8.3 mmol/l and significantly lower in response to 16.5 mmol/l. In conclusion,
      our data suggest that a 48-h hyperglycaemic period results in an increased
      response of the pancreatic beta cell to low glucose. The response is immediately
      maximal and can not be increased with higher glucose concentrations. This
      situation could explain the apparent minimal effect of high concentrations on in
      vitro insulin secretion in previously hyperglycaemic rats and may provide
      insights into the sequence of events leading to the impairment of beta-cell
      function in Type 2 (non-insulin-dependent) diabetes mellitus.

PMID- 8359577
TI  - Osmotically-induced nerve taurine depletion and the compatible osmolyte
      hypothesis in experimental diabetic neuropathy in the rat.
AB  - Diabetic neuropathy results from progressive nerve fibre damage with blunted
      nerve regeneration and repair and may be complicated by nerve hyperexcitability
      resulting in pain. The naturally occurring amino acid taurine functions as an
      osmolyte, inhibitory neurotransmitter, and modulator of pain perception. It is
      also known to have neurotrophic actions. The compatible osmolyte hypothesis
      proposes that levels of intracellular organic osmolytes including taurine and myo
      inositol, respond co-ordinately in response to changes in intracellular sorbitol
      or external osmolality to maintain the intracellular milieu. We hypothesize that
      glucose-induced sorbitol accumulation in diabetes mellitus will result in taurine
      depletion in peripheral nerve which may potentially impair nerve regeneration and
      precipitate neuronal hyperexcitability and pain. This study explored the
      relationships of taurine, myo-inositol and sorbitol in the rat nerve and their
      effects on nerve conduction velocity. Osmolyte levels and nerve conduction
      velocity were determined in sciatic nerve from non-diabetic and streptozotocin
      induced diabetic rats, with or without dietary taurine or myo-inositol
      supplementation. Taurine levels decreased by 31% (p < 0.01) and myo-inositol
      decreased by 37% (p < 0.05) in diabetic nerve as sorbitol accumulated. Taurine
      supplementation of diabetic animals did not affect nerve conduction velocity but
      further reduced nerve myo-inositol levels. Prevention of sorbitol accumulation
      with the aldose reductase inhibitor sorbinil increased nerve taurine levels by
      22% (p < 0.05) when compared with untreated diabetic animals. Thus, we have
      demonstrated an interdependence of organic osmolytes within the nerve. Abnormal
      accumulation of one osmolyte results in reciprocal depletion of others. Diabetic
      neuropathy may be an example of maladaptive osmoregulation, nerve damage and
      instability being aggravated by taurine depletion.

PMID- 8359578
TI  - Medial arterial calcification in the feet of diabetic patients and matched non
      diabetic control subjects.
AB  - The prevalence and distribution of medial arterial calcification was assessed in
      the feet of four subject groups; 54 neuropathic diabetic patients with previous
      foot ulceration (U), median age 60.5 (50.5-67 interquartile range) years,
      duration of diabetes 19.5 (9.9-29.9) years; 40 neuropathic diabetic patients
      without a foot ulcer history (N), age 68 (62-73) years, duration of diabetes 14.0
      (8.0-28.0) years; 43 non-neuropathic diabetic patients (NN), age 60.5 (52-68.5)
      years, duration of diabetes 14.0 (8.0-28.0) years and 50 non-diabetic control
      subjects, age 62.5 (53.7-70) years. A single radiologist graded medial arterial
      calcification as absent, mild or severe, at the ankle, hind-foot, mid-foot,
      metatarsals and toes on standardised plain lateral and antero-posterior foot
      radiographs taken by a single radiographer. Diabetes history, vibration
      perception threshold, ankle systolic pressure and serum creatinine were also
      assessed. Medial arterial calcification was significantly greater (total score 18
      [3-31]) in neuropathic diabetic patients with previous ulceration (U vs N p <
      0.01, U vs NN p < 0.001). Non-neuropathic diabetic patients did not have
      significantly higher arterial calcification scores than age-matched non-diabetic
      control subjects. Medial arterial calcification correlated with vibration
      perception threshold (r = 0.35), duration of diabetes (r = 0.32) and serum
      creatinine (r = 0.41), (all p < 0.01). Logistic regression models showed
      vibration perception and duration of diabetes to predict the probability of any
      calcification. Serum creatinine level was added to predict severe
      calcification.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359579
TI  - Glucose-induced changes in renal haemodynamics in proteinuric type 1 (insulin
      dependent) diabetic patients: inhibition by acetylsalicilic acid infusion.
AB  - The effect of hyperglycaemia on renal function in diabetic nephropathy remains
      poorly understood. We investigated the renal haemodynamic response to an acute
      plasma glucose rise from sustained euglycaemia to sustained hyperglycaemia in
      eight persistently proteinuric Type 1 (insulin-dependent) diabetic patients.
      Studies were performed in a double-blind cross-over manner after i.v. injection
      of 450 mg lysine acetylsalicilate (equivalent to 250 mg acetylsalicilic acid) or
      equal volume of 0.9% NaCl (isotonic saline). In the isotonic saline experiments
      hyperglycaemia produced a significant rise, by approximately 35%, in glomerular
      filtration rate in all patients from 41.5 +/- 5.2 to 55 +/- 6 ml.min-1.1.73 m-2
      (p < 0.005) and an increase in sodium paraminohippurate clearance from 178 +/-
      22.7 to 220 +/- 20.0 ml.min-1.1.73 m-2 (p < 0.05). These changes took place
      within the first 30 min of glucose infusion and were maintained for a 90 min
      hyperglycaemic period. Filtration fraction did not change significantly. Infusion
      of lysine acetylsalicilate lowered baseline glomerular filtration rate (isotonic
      saline vs lysine acetylsalicilate 41.5 +/- 5.2 vs 30.0 +/- 5.7 ml.min-1.1.73 m-2;
      p < 0.05) and significantly blunted the rise in glomerular filtration rate during
      hyperglycaemia (glomerular filtration rate increment: saline vs lysine
      acetylsalicilate: 13.6 +/- 2.8 vs 5.3 +/- 1.8 ml.min-1.1.73 m-2; p < 0.005). The
      effects on renal plasma flow were similarly blunted. In five additional patients,
      time- and volume-controlled isotonic saline experiments during sustained
      euglycaemia showed no significant changes in glomerular filtration rate and
      sodium paraminohippurate clearance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359580
TI  - Altered pattern of insulin receptor isotypes in skeletal muscle membranes of type
      2 (non-insulin-dependent) diabetic subjects.
AB  - The human insulin receptor exists in two isoforms (HIR-A alpha-subunit 719 amino
      acids and HIR-B alpha-subunit 731 amino acids) which are generated by alternative
      splicing of a small exon and display distinct patterns of tissue-specific
      expression. Using the polymerase chain reaction we have recently shown that
      skeletal muscle of non-diabetic individuals contains predominantly mRNA encoding
      HIR-A while in skeletal muscle derived from subjects with Type 2 (non-insulin
      dependent) diabetes mellitus similar amounts of each mRNA are expressed. We used
      a polyclonal antibody which discriminates between HIR-A and HIR-B to assess the
      isoform expression at the protein level. The antibody showed clearly distinct
      displacement of insulin binding in skeletal muscle membranes of non-diabetic
      subjects compared to Type 2 diabetic subjects (displacement of specific 125I
      insulin binding: 13 non-diabetic subjects 70.0% +/- 14.34, 12 Type 2 diabetic
      subjects 32.6% +/- 17.45). A control antibody which does not discriminate between
      both isoforms showed similar displacement of 125I-insulin in membranes of non
      diabetic and Type 2 diabetic subjects. These data suggest that the altered
      expression of receptor isotype mRNA in the skeletal muscle of Type 2 diabetic
      subjects leads to an altered receptor isoform pattern in the plasma membrane.
      While skeletal muscle membranes of non-diabetic subjects contain predominantly
      HIR-A, membranes of Type 2 diabetic subjects show an increased level of HIR-B in
      addition to HIR-A.

PMID- 8359581
TI  - Positive association in the absence of linkage suggests a minor role for the
      glucokinase gene in the pathogenesis of type 2 (non-insulin-dependent) diabetes
      mellitus amongst south Indians.
AB  - Mutations of the glucokinase gene have been implicated in the development of
      glucose intolerance in pedigrees with maturity-onset diabetes of the young.
      However, the contribution of the glucokinase gene to the aetiology of common Type
      2 (non-insulin-dependent) diabetes mellitus is uncertain. We have studied the
      role of the glucokinase gene in the pathogenesis of Type 2 diabetes in South
      Indians, using both population-association and linkage methodology. A pair of CA
      repeat sequences (GCK(3') and GCK(5')) straddling the glucokinase gene were
      employed as markers, each subject being typed using the polymerase chain reaction
      and polyacrylamide gel electrophoresis. Comparisons of allele frequencies at
      these markers were made between 168 Type 2 diabetic subjects and 70 racially
      matched control subjects. No differences in allele frequencies were apparent at
      the GCK(5') marker; however, there were significant differences in allele
      frequencies at the GCK(3') marker between the Type 2 diabetic subjects and
      control subjects (chi 2 = 11.6, df = 3, p = 0.009) with an increase of the z
      allele (78.0% vs 66.4%) and a decrease of the z + 2 allele (13.7% vs 25.0%)
      amongst the diabetic subjects. Linkage between glucose intolerance and the
      glucokinase gene was studied in 53 nuclear pedigrees under a variety of genetic
      models. Linkage was excluded (lod score < -2) at a recombination fraction of zero
      under five of the ten models used and highly unlikely (-2 < lod score < -1) under
      the others. The combination of positive association and negative linkage suggests
      that glucokinase acts as a minor gene influencing the development of Type 2
      diabetes within this population.

PMID- 8359582
TI  - Insulin resistance, hypertension and microalbuminuria in patients with type 2
      (non-insulin-dependent) diabetes mellitus.
AB  - We examined the impact of hypertension and microalbuminuria on insulin
      sensitivity in patients with Type 2 (non-insulin-dependent) diabetes mellitus
      using the euglycaemic insulin clamp technique in 52 Type 2 diabetic patients and
      in 19 healthy control subjects. Twenty-five diabetic patients had hypertension
      and 19 had microalbuminuria. Hypertension per se was associated with a 27%
      reduction in the rate of total glucose metabolism and a 40% reduction in the rate
      of non-oxidative glucose metabolism compared with normotensive Type 2 diabetic
      patients (both p < 0.001). Glucose metabolism was also impaired in normotensive
      microalbuminuric patients compared with normotensive normoalbuminuric patients
      (29.4 +/- 2.2 vs 40.5 +/- 2.8 mumol.kg lean body mass-1.min-1; p = 0.012),
      primarily due to a reduction in non-oxidative glucose metabolism (12.7 +/- 2.9 vs
      21.1 +/- 2.6 mumol.kg lean body mass-1.min-1; p = 0.06). In a factorial ANOVA
      design, however, only hypertension (p = 0.008) and the combination of
      hypertension and microalbuminuria (p = 0.030) were significantly associated with
      the rate of glucose metabolism. The highest triglyceride and lowest HDL
      cholesterol concentrations were observed in Type 2 diabetic patients with both
      hypertension and microalbuminuria. Of note, glucose metabolism was
      indistinguishable from that in control subjects in Type 2 diabetic patients
      without hypertension and microalbuminuria (40.5 +/- 2.8 vs 44.4 +/- 2.8 mumol.kg
      lean body mass-1.min-1). We conclude that insulin resistance in Type 2 diabetes
      is predominantly associated with either hypertension or microalbuminuria or with
      both.

PMID- 8359583
TI  - Increased microvascular fluid permeability in young type 1 (insulin-dependent)
      diabetic patients.
AB  - Microvascular fluid permeability was assessed by determination of the capillary
      filtration coefficient in the forearm of ten young Type 1 (insulin-dependent)
      diabetic patients with a short duration of diabetes, satisfactory glycaemic
      control and minimal evidence of microangiopathy, and ten age- and sex-matched
      control subjects. A strain gauge plethysmographic method with a computer based
      logging and analysis system was used. This enabled differentiation between the
      volume filling and fluid filtration components of the response to venous pressure
      elevation. The median capillary filtration coefficient was found to be
      significantly higher in the young diabetic patients in comparison with control
      subjects (9.2 x 10(-3) ml.min-1.100 g tissue-1.mmHg-1 vs 3.8 x 10(-3) ml.min
      1.100 g tissue-1.mmHg-1, p < 0.001). There were no significant correlations
      between capillary filtration coefficient and either plasma glucose concentration,
      haemoglobin A1c or duration of diabetes. As there is no evidence from other
      studies to support an increase in capillary surface area in the forearms of young
      Type 1 diabetic patients, these results may reflect a primary change in
      microvascular fluid permeability.

PMID- 8359584
TI  - A glucose monitoring system for on line estimation in man of blood glucose
      concentration using a miniaturized glucose sensor implanted in the subcutaneous
      tissue and a wearable control unit.
AB  - We have developed a miniaturized glucose sensor which has been shown previously
      to function adequately when implanted in the subcutaneous tissue of rats and
      dogs. Following a glucose load, the sensor output increases, making it possible
      to calculate a sensitivity coefficient to glucose in vivo, and an extrapolated
      background current in the absence of glucose. These parameters are used for
      estimating at any time the apparent subcutaneous glucose concentration from the
      current. In the previous studies, this calibration was performed a posteriori, on
      the basis of the retrospective analysis of the changes in blood glucose and in
      the current generated by the sensor. However, for clinical application of the
      system, an on line estimation of glucose concentration would be necessary. Thus,
      this study was undertaken in order to assess the possibility of calibrating the
      sensor in real time, using a novel calibration procedure and a monitoring unit
      which was specifically designed for this purpose. This electronic device is able
      to measure, to filter and to store the current. During an oral glucose challenge,
      when a stable current is reached, it is possible to feed the unit with two
      different values of blood glucose and their corresponding times. The unit
      calculates the in vivo parameters, transforms every single value of current into
      an estimation of the glucose concentration, and then displays this estimation. In
      this study, 11 sensors were investigated of which two did not respond to glucose.
      In the other nine trials, the volunteers were asked to record every 30 s what
      appeared on the display during the secondary decrease in blood glucose.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8359586
TI  - Nicotinamide and insulin secretion in normal subjects.
AB  - Nicotinamide has been given both before and after clinical onset of Type 1
      (insulin-dependent) diabetes mellitus in an attempt to prolong beta-cell
      survival. Nicotinic acid, structurally similar to nicotinamide, induces insulin
      resistance and increases insulin secretion in healthy individuals. It is not
      known if nicotinamide has similar effects. Since insulin secretion, as measured
      by the acute insulin response to intravenous glucose, is used to predict diabetes
      and to monitor therapy, the effects of nicotinamide must be established before
      trials in individuals at high risk of progression to Type 1 diabetes can be
      interpreted. Intravenous tolerance tests were performed according to the ICARUS
      standard protocol in 10 healthy, adult subjects (age 32 +/- 5.7 years) before and
      after 14 days of treatment with nicotinamide 25 mg.kg-1.day-1. The acute insulin
      response after nicotinamide did not differ from the control study, whether
      measured as the incremental 0-10 min insulin area (278 +/- 142 vs 298 +/- 130
      mU.l-1.10 min-1) or as the 1 +/- 3 min insulin level (78 +/- 39 vs 81 +/- 44
      mU/l). The late insulin response was equally unaffected, as were basal insulin
      (5.2 +/- 1.6 vs 5.6 +/- 2.1 mU/l) and glucose (5.0 +/- 0.4 vs 4.9 +/- 0.2 mmol/l)
      levels and glucose disposal rates (1.98 +/- 0.88 vs 2.04 +/- 0.68%/min).
      Nicotinamide does not affect insulin secretion and glucose kinetics in normal
      subjects, confirming its suitability for trials designed to delay or prevent the
      onset of Type 1 diabetes.

PMID- 8359585
TI  - The Maillard protein cross-link pentosidine in urine from diabetic patients.
AB  - The Maillard protein cross-link pentosidine is a fluorescent condensation product
      of lysine, arginine and ribose. It accumulates in human tissues with age, and the
      accumulation process is accelerated in the tissues of diabetic patients. Using SP
      Sephadex C-25 in the pretreatment for HPLC, we examined levels of pentosidine in
      urine without hydrolysis (free form) and levels of pentosidine in urine after
      hydrolysis (total forms), from 23 diabetic patients and 21 control subjects. The
      mean percentages of the values of free form per total forms (+/- SD) were 89 +/-
      15% in diabetic patients, 88 +/- 16% in control subjects and 89 +/- 15% in total
      populations of diabetic patients and control subjects. There was a significant
      correlation between the values of free form and total forms in diabetic patients
      (r = 0.983, p = 0.0001), in control subjects (r = 0.820, p < 0.02) and in total
      populations of diabetic patients and control subjects (r = 0.951, p = 0.0001).
      The mean level of pentosidine per mol creatinine (+/- SD) was significantly
      elevated in urine from diabetic patients as compared to the level in control
      subjects (8.8 +/- 4.3 mumol/mol creatinine vs 4.2 +/- 1.4 mumol/mol creatinine, p
      = 0.0001 in free form; 10.1 +/- 5.3 mumol/mol creatinine vs 4.7 +/- 1.4 mumol/mol
      creatinine, p = 0.0001 in total forms). These results demonstrate that urinary
      pentosidine, especially in free form, could be a useful marker for the assessment
      of diabetes and diabetic complications.

PMID- 8359587
TI  - The effects of recombinant insulin-like growth factor I administration on growth
      hormone levels and insulin requirements in adolescents with type 1 (insulin
      dependent) diabetes mellitus.
AB  - Type 1 (insulin-dependent) diabetes mellitus in adolescence is associated with
      reduced levels of insulin-like growth factor I, elevated growth hormone
      concentrations and insulin resistance. In order to determine whether restoring
      insulin-like growth factor I levels to normal might lead to a reduction in growth
      hormone levels and insulin requirements, we undertook a double-blind placebo
      controlled study of a single s.c. dose of recombinant insulin-like growth factor
      I (40 micrograms/kg body weight) in nine late pubertal subjects with Type 1
      diabetes. After administration of placebo or insulin-like growth factor I at
      18.00 hours, a variable rate insulin infusion was used to maintain euglycaemia
      overnight. Plasma insulin-like growth factor I, growth hormone, free insulin, and
      intermediate metabolite concentrations were monitored throughout the study.
      Recombinant insulin-like growth factor I led to a rise in plasma concentrations
      which reached a peak at 5.5 h (413.1 +/- 28.2 ng/ml, mean +/- SEM). Mean growth
      hormone levels between 20.00 and 08.00 hours were significantly reduced after
      recombinant insulin-like growth factor I (19.4 +/- 4.0 compared with 33.6 +/- 5.8
      mU/l; p = 0.01), as were the insulin requirements for euglycaemia (0.25 +/- 0.02
      compared with 0.31 +/- 0.04 mU.kg-1.min-1; p = 0.03). Plasma free insulin levels
      were lower after recombinant insulin-like growth factor I administration (31.9 +/
      2.7 compared with 67.9 +/- 16.0 mU/l; p = 0.001) but no significant differences
      in ketone or lactate levels were detected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359588
TI  - Early insulitis and the islet vascular system.

PMID- 8359589
TI  - Follow-up of anti-beta-lactoglobulin antibodies in children with type 1 (insulin
      dependent) diabetes mellitus.

PMID- 8359590
TI  - Persisting antibodies to glutamic acid decarboxylase in type 1 (insulin
      dependent) diabetes mellitus are not associated with neuropathy.

PMID- 8359591
TI  - Characterization and expression analysis of the murine rck gene: a protein kinase
      with a potential function in sensory cells.
AB  - We have characterized a murine protein kinase gene, rck, which was identified by
      crosshybridization with sequences from the v-ros tyrosine kinase gene under
      conditions of reduced stringency. cDNA analysis indicated that rck encodes a
      putative protein kinase related to the cdc2 subclass of the gene family and that
      the gene is identical to mak identified previously in the rat. An extensive
      expression analysis in the mouse performed by a combination of in situ
      hybridization and RNase protection revealed a novel and restricted pattern of
      expression: rck transcripts are found in two cell types involved in sensory
      transduction, photoreceptors and olfactory receptors as well as in epithelia of
      the respiratory tract and choroid plexus. Specific transcripts are also found in
      pre- and postmeiotic male germ cells. We suggest therefore that rck participates
      in signalling pathways important in a distinct set of cells, remarkably among
      them cells involved in sensory signal transduction.

PMID- 8359592
TI  - 'Spontaneous' transformation as aberrant epigenesis.
AB  - The NIH 3T3 line of cells has particular advantages for studying the dynamics of
      change in cellular phenotype in response to environmental conditions. Similar to
      stem cell growth during development, the cell line changes its phenotype under
      growth constraints that elicit differentiation or, alternatively, it maintains
      its original state over many replication cycles when grown without constraint.
      Unlike many cell types which respond by undergoing terminal differentiation, the
      NIH 3T3 cells continue to multiply indefinitely following an induced alteration
      in phenotype; the heritability of this change may thus be analyzed under
      stringent conditions of cell culture. During the course of over two years of
      frequent passage at low density in high calf serum (CS) concentration, a new
      subline developed which exhibited a consistent capacity to respond quickly and
      pervasively to growth constraints with an increase in saturation density,
      development of transformed foci in confluent cultures and altered appearance of
      isolated colonies. A retrospective study was undertaken, with cells from
      cryopreserved samples, of the course of changes in responsiveness of the cells to
      growth constraint leading up to the highly responsive state. Three stages were
      discerned, the first with an initially high capacity of a small fraction of cells
      to produce diffuse foci, but with a rapid decline in this capacity with frequent
      low density passages; the second stage, extending over more than 200 passages, of
      refractoriness to transformation; and the third stage (which probably arose by
      mutation) in which there is a consistent transformation-related response by the
      entire population to growth constraint, a response which has remained relatively
      constant over some 100 passages. A striking and novel feature of the third stage
      is seen on cloning the cells. Almost all the colonies obtained by cloning cells
      from post-confluent, growth-inhibited cultures are distinctly different in
      morphology from those obtained by cloning cells from the frequent low density
      passages. The pervasiveness of this morphological change among the clones is
      unmistakable evidence for a heritable adaptive response to growth constraint by
      most if not all of the cells in the population. The population-wide response of
      the cells of the third stage offers the opportunity for a rigorous, quantitative
      analysis of the nature of this type of persistent cellular change. Although cells
      of the third stage may be of mutational origin, their pervasive heritable
      response once the variant population is established supports the concept of
      progressive state selection which postulates that transformation can arise by the
      continuous fluctuation of growth states within cells, accompanied by the
      progressive selection of those states best suited to function under the selecting
      constraint. Relevance of the concept to the process of differentiation under
      growth constraint is considered.

PMID- 8359593
TI  - NGF retards apoptosis in chick embryo bursal cell in vitro.
AB  - Recent studies have demonstrated that the action of nerve growth factor (NGF) is
      not restricted to neuronal cells but also affects cells of the immune system. In
      a previous work on the effect of NGF on the chick embryo bursa of Fabricius both
      in vivo and in vitro, we observed that NGF prolongs bursal cell survival in
      vitro. In the present study we report that the increase of viable cells in NGF
      treated cultures is not due to a proliferative effect of NGF on bursal cells but
      to a reduction of cell mortality. The morphological analysis revealed that bursal
      cells in cultures die by apoptosis, which was also shown by the typical pattern
      of DNA fragmentation, a hallmark of this cell death process. It is concluded that
      NGF, with an action similar to that described in sympathetic neurons and PC12,
      could retard bursal cell death by influencing apoptosis.

PMID- 8359594
TI  - Expression from the proximal promoter of the carbonic anhydrase 1 gene as a
      marker for differentiation in colon epithelia.
AB  - Carbonic anhydrase 1 (CA1) catalyses the reversible hydration of CO2 and is
      important for cellular diffusion of CO2, ion transport and pH regulation. The
      gene encoding CA1 (CA1) has two promoters. In adult colon epithelia the proximal
      promoter determines high levels of expression and the distal erythroid promoter
      is repressed. RNA in situ hybridisation shows that CA1 mRNA is abundant in
      differentiating cells of the colonic crypt as they migrate to the luminal
      surface, but is not present at the base of the crypts and levels are low on the
      luminal surface. It is likely that CA1 gene expression in these cells is
      regulated by differential transcription and/or mRNA stability. In contrast CA1
      protein is localised predominantly on the luminal surface. Since CA1 mRNA and
      protein do not exactly co-localise it can be inferred that CA1 expression is also
      subject to post-transcriptional control. CA1 mRNA is significantly reduced in
      colon carcinoma and in adenomas from familial adenomatous polyposis patients.
      Loss of CA1 expression is associated with the disappearance of differentiated
      epithelial cells. Out of twelve colon carcinoma cell lines three, LIM1215,
      LIM1899 and HT115, expressed CA1 and nine did not. This variation in expression
      may also be associated with cell type differentiation.

PMID- 8359596
TI  - The editorial business.

PMID- 8359597
TI  - Electronic publishing.

PMID- 8359595
TI  - The human gene encoding cytokeratin 20 and its expression during fetal
      development and in gastrointestinal carcinomas.
AB  - The differentiation of the predominant cell types of the mucosal epithelium of
      the mammalian gastrointestinal tract is characterized by increasing amounts of an
      intermediate-sized filament (IF) protein designated cytokeratin (CK) 20 which is
      a major cellular protein of mature enterocytes and goblet cells. Here we report
      the isolation of the human gene encoding CK 20, its complete nucleotide sequence
      and the amino acid sequence deduced therefrom that identifies this polypeptide
      (mol. wt. 48553) as a member of the type I-CK subfamily. Remarkable, however, is
      the comparably great sequence divergence of CK 20 from all other known type I
      CKs, with only 58% identical amino acids in the conserved alpha-helical 'rod'
      domain of CK 20 and, e.g. CK 14. Using riboprobes corresponding to exon 6 of the
      gene in Northern blot and ribonuclease protection assays, we show that the
      approximately 1.75 kb mRNA encoding CK 20 is specifically produced in cells of
      the intestinal and gastric mucosa, including tumors and cell lines derived
      therefrom. The appearance of CK 20-positive cells in human embryonic and fetal
      development and in adult tissues has been studied using immunohistochemistry with
      CK 20-specific antibodies. CK 20 synthesis has first been recognized at embryonic
      week 8 in individual 'converted' simple epithelial cells of the developing
      intestinal mucosa. In later fetal stages, CK 20 synthesis extends over most
      goblet cells and a variable number of villus enterocytes. The distribution of CK
      20-positive cells in the developing gastric and intestinal mucosa is similar to-
      but not identical with--the pattern in the adult intestine in which all
      enterocytes and goblet cells as well as certain 'low-differentiated' columnar
      cells contain CK 20, whereas the neuroendocrine ('enterochromaffin') and Paneth
      cells are negative. In gastrointestinal carcinomas similarly examined, CK 20 has
      been detected in almost all cases (50/52) of colorectal adenocarcinomas,
      including all grades of differentiation and malignancy and also metastatic
      tumors, whereas CK 20 immunostaining in gastric carcinomas has been found less
      consistent and more heterogeneous. The possible biological meaning of the
      specific expression of the CK 20 gene in certain cells of the gastrointestinal
      tract and carcinomas derived therefrom and the regulatory mechanisms involved in
      the integration of the protein in the IF cytoskeleton are discussed.

PMID- 8359598
TI  - A study of the referral decision in general practice.
AB  - The applicability of published models of the referral decision in general
      practice was investigated by asking general practitioners (GPs) to record data on
      consultations during which referral to a consultant's outpatient clinic was
      considered, whether this resulted in referral or not. The GPs were then
      interviewed about their decisions with particular reference to patient factors,
      clinical factors, their perception of the risk involved, consultant factors and
      time factors. The doctors varied in the weight that they gave to the patient's
      wishes, and also in their selection and interpretation of diagnostic data. Risk
      to the patient was rarely a major consideration; neither was risk to the doctor's
      self-esteem. There was virtually no evidence of conflict arising during the
      decision-making process, and doctors on the whole, did not feel pressed for time.
      This was, however, a self-selected sample of highly motivated general
      practitioners. It is suggested that the assumptions on which the conflict model
      of decision-making is based do not apply to the majority of referral decisions in
      general practice.

PMID- 8359599
TI  - Non-attendance at outpatient clinics: is it related to the referral process?
AB  - Non-attendance at outpatient clinics is a complex problem and previous studies
      have concentrated on hospital-related factors. It has been suggested that non
      attendance might be related to the referral process, including the selection of
      patients for referral and the quality of communication between GP and patient.
      These issues are examined in a study of 1492 patients given first-time
      appointments at ENT and gastroenterology clinics. Non-attendance rates were 26
      and 20% respectively. Non-attendance was not related to the nature, severity or
      duration of the patients' presenting problems at the time of referral or to their
      perception of the need for referral. Resolution of symptoms did not appear to be
      a major reason for non-attendance. Patients were significantly less likely to
      attend if they had been unable or only partly able to discuss their health
      problem with their general practitioner. Those who had requested referral were
      equally likely to default.

PMID- 8359600
TI  - The influence of a desk-top analyser on the number of laboratory tests used in
      daily general practice. A randomized controlled trial.
AB  - This study evaluated the influence of a desk-top analyser, used in general
      practice, on the mean number of blood tests per contact, prescribed or analysed
      by general practitioners. A randomized controlled trial was used. The mean number
      of blood tests per contact requested by two groups of GPs, before and after the
      introduction of a Reflotron in the intervention group was compared. Practitioners
      were assigned to the control group or to the intervention group by stratified
      randomization. Flemish GPs, known by the Flemish Institute of General Practice as
      interested in research were enrolled into the study. There were two registration
      periods of 8 weeks each. The weekly number of doctor-patient contacts and all
      requested or performed blood tests for each patient were registered. During the
      second period the members of the intervention group were asked to use the
      Reflotron, following their own judgement, and to register the total number of
      tests per contact, performed with it, on a special form. In the Reflotron group
      there was a slight increase in the median of the relative differences between the
      intervention and the base-line period (3%). In the control group the median of
      the relative differences decreased (-7%). The difference between both groups was
      not statistically significant (P = 0.17). In both groups the size and direction
      of the relative differences of the individual practices were very different. No
      statistically significant differences were found in any of the subgroups.

PMID- 8359601
TI  - Dry chemistry instruments in primary care. I. Operating conditions and financial
      considerations.
AB  - The objectives of this study were to describe the operating conditions of dry
      chemistry instruments in primary care, as well as to elucidate financial aspects
      in general practice fee-for-service settings. We used questionnaires mailed to
      all users of the two most used dry chemistry instruments in Norway, as well as to
      a 14% random sample of Norwegian GPs. The overall response rate was 79%. The mean
      number of dry chemistry analyses varied considerably between individual users,
      but in general a substantial number of analyses were carried out. Even though
      most analyses on the instruments' repertoire were available in all user groups, a
      total of 13 additional constituents were suggested to be included in the
      repertoire. In occupational health care most results were ready when the client
      was present; this was not the case in general practice. The instruments were more
      profitable when more constituents were analysed per sample, although
      profitability varied substantially in the period studied (1986-1989). A discrete
      time history event analysis revealed that net profit earned, lower instrument
      price, available information about the technology and being in solo practice
      significantly influenced the decision to buy an instrument in fee-for-service
      practices.

PMID- 8359602
TI  - Dry chemistry instruments in primary care. II. Comparison of users with non
      users.
AB  - One way of studying the impact of dry chemistry desk-top instruments in primary
      care is by comparing users and non-users of this technology with respect to
      practice setting and changes in everyday practice, as well as to elucidate
      reasons for not implementing this technology. We therefore mailed a similar
      questionnaire to all users of the most-used dry chemistry instruments in Norway
      (n = 298) and to a 14% random sample of general practitioners (n = 381), and a
      40% random sample of doctors in occupational health care units (n = 181). The
      response rate was 77-79% and 200 users and 281 non-users could be included. In
      general practice, more users were solo practitioners and more users had a cell
      counter in the office laboratory; fewer occupational health care users kept
      computerized records. Users reported improvement in diagnosis and treatment and
      claimed that patient satisfaction had improved. In general, an increase in the
      number of tests was estimated. Non-users were more pessimistic with regard to
      improvements in office laboratory service, and stated perceived problems
      regarding cost, workload and analytical quality as well as good service from the
      hospital laboratory as reasons for not implementing such instruments in their
      practice.

PMID- 8359603
TI  - Coronary heart disease prevention: the role of the general practitioner.
AB  - The objectives of the study were to identify the level of general practitioner
      (GP) involvement in activities aimed at coronary heart disease prevention and to
      explain variations in involvement. These questions were explored through a postal
      survey of a random sample (n = 1696) of GPs in England of whom 64% completed
      questionnaires. Ninety-four per cent of GPs reported that they were involved in
      risk factor assessment in the consultation although these assessments most
      commonly involved blood pressure testing and identification of smoking. Ninety
      one per cent of practices were reported by the GP to have a lifestyle risk
      assessment clinic where there was more evidence of systematic risk assessment.
      These clinics were usually run by a practice nurse as were lifestyle risk factor
      management clinics although GPs were more involved in hypertension and
      cholesterol clinics. Positive attitudes to prevention and training in health
      promotion were associated with higher GP involvement, and higher practice
      involvement was associated primarily with the number of practice nurses employed.
      The implication of these findings are discussed.

PMID- 8359604
TI  - Socio-economic factors, health care consumption and rating of abdominal symptom
      severity. A report from the abdominal symptom study.
AB  - A study of the abdominal/gastrointestinal symptom panorama in relation to socio
      economic factors and health care consumption in the general population was
      performed in Osthammar, Sweden. A postal questionnaire was sent to a
      representative sample of the adult population (n = 1260). The response rate was
      87%. The responders with symptoms (52.1%) subjectively rated their illness on
      visual analogue scales. All responders were classified as asymptomatic or having
      'minor' or 'major' abdominal symptoms. Those having dyspepsia, reflux or
      irritable bowel syndrome were also ranked as 'minors' or 'majors'. The proportion
      of subjects with abdominal/gastrointestinal complaints decreased with age, mainly
      due to a decrease of 'major' symptoms. Also, the proportion of complainers
      increased among the more educated. Those on sick leave and students had more and
      worse symptoms than the others, despite the former seldom stating abdominal
      discomfort as the main reason for sick listing. Fifty-five per cent of all
      persons reporting abdominal/gastrointestinal symptoms had at some time consulted
      a doctor because of such complaints, the proportion increasing with severity, as
      did drug consumption and the rate of previous abdominal operations, with
      appendectomy as an exception. The results show that it is possible to rank the
      illness along a severity dimension among persons with abdominal/gastrointestinal
      complaints in epidemiological research.

PMID- 8359605
TI  - Family practice in Cuba: evolution into the 1990s.
AB  - A group of practising physicians, family practice academicians and medical
      students visited Cuba in 1991. The purpose of this visit was to assess the
      current status of the discipline of family medicine in the country. Numerous
      interviews were conducted with practising family physicians, Cuban medical
      physicians in other medical specialties, the medical school faculty, patients and
      officials from the Ministry of Public Health. A summary of the content of these
      interviews constitutes the following paper. The authors conclude that the Cubans
      have developed a medical care system that has its basis in family practice, and
      provides a model which could be emulated not only in less developed, but also in
      more developed countries.

PMID- 8359607
TI  - Implementation of the national cervical cancer screening in general practice and
      feasibility of a general practice-based call system: the GP's opinion.
AB  - Thus far, the response to the nationwide screening programme for cervical cancer
      in The Netherlands, which was started in 1989, has been disappointing. One way to
      improve response is to involve general practitioners in the call system. A postal
      survey was conducted to review the implementation of the current screening
      programme in general practice and to examine the willingness of general
      practitioners to participate in a general practice-based call system. The
      response rate to the survey was 90%. The general practitioners were dissatisfied
      with follow-up, cost and time spent and compliance of women. Of all respondents
      60% had already set up a call system within the practice or were willing to do
      so; another 31% were willing to participate in a regionally organized practice
      based call system. On the basis of the results of this study a centralized
      general practice-based call system is recommended. The next step is to study the
      applicability of this system in a pilot programme.

PMID- 8359606
TI  - Diabetes and its long-term complications in general practice: a survey in a well
      defined population.
AB  - The aim of this study was to assess the prevalence of long-term complications in
      all patients with non-insulin-dependent diabetes mellitus, who were known to
      their general practitioners (GPs). During one year 19 GPs in the area of
      Hoogeveen in the Netherlands examined their non-insulin-dependent (NIDDM)
      patients, including those under specialist's care. A detailed protocol was used;
      the GPs were trained in the diagnostic procedures. Complications were either
      already known from the records or newly discovered during screening. In a
      population of 41,940 14.5/1000 patients with diabetes were identified: 12/1000
      NIDDM and 2.5/1000 insulin-dependent diabetes mellitus (IDDM). Of the 509 NIDDM
      patients, 387 (76%) could be screened for late complications. Signs and symptoms
      of late complications were found in many patients: retinopathy (14%), nephropathy
      (57%), neuropathy (68%) and macroangiopathy (53%). The prevalence of serious
      complications was: proliferative retino- and maculopathy (3.3%); diabetic foot
      (2.6%); renal failure (2.5%). The systemic screening revealed a high number of
      previously unknown cases. It is concluded that many patients with NIDDM develop
      signs and symptoms of late complications. Most cases are identified by systemic
      screening only. More long-term studies of the prognosis of late complications in
      NIDDM are needed.

PMID- 8359608
TI  - SFAT-AM: short family therapy in ambulatory medicine. Treatment approach in 10-15
      minute encounters.
AB  - The question of the possibilities latent within an appointment lasting on average
      only 10-15 minutes, under the pressures of a heavy workload in a public clinic,
      has occupied the authors for three years. SFAT-AM: Short Family Therapy in
      Ambulatory Medicine, has been developed with aim of offering solutions to this
      question. The theoretical background is taken from family medicine with a
      biopsychosocial (b.p.s.) systems approach. The authors formulated series of basic
      doctor-patient encounters which last on average 10-15 minutes. The basic
      encounter is a kind of didactic checklist model which presents to the doctor
      possibilities latent within. Emphasis is placed on the art of treatment and the
      meeting itself as therapeutic. During the meeting, patient's satisfaction,
      psychosocial information and the doctor's inner voice help the participants
      adjust to each other and move from stage to stage. The approach also relates to
      the possibility of joint work together with colleagues or with members of
      different teams in the clinic. The doctor makes use of communication techniques
      and reaches a b.p.s. diagnosis which will be the basis for suggesting a
      treatment. The presented model was tried by the authors and by trainees as part
      of a specialization course in family medicine. The trainees received between 20
      and 70 academic hours of instruction. From the doctors' report it can be seen
      that SFAT-AM can be used in a primary clinic. Future research should give more
      specific answers to questions about the model's desirability, cost-efficiency,
      and job satisfaction. (Doctors will be referred to in the male gender throughout
      the article).

PMID- 8359609
TI  - Stories from the sealed rooms: patient interviews during the Gulf war.
AB  - The mass deployment of gas masks to an entire population, which occurred in
      Israel prior to the Persian Gulf crisis and their use in early 1991, were
      phenomena without precedent. In addition to the historical significance, there
      were considerable health and psychological ramifications. This research examines
      the experiences of the Israeli public during the Gulf war using a qualitative
      methodological approach, narrative analysis. Interviews of a convenience sample
      of 60 patients attending primary care clinics were audio-recorded by three family
      physicians using an open-ended interview guide. Encounters took place at sites
      located in the north, south and centre of the country during the period of Iraqi
      missile attacks. Patients' stories were analysed using a multistep narrative
      analysis protocol. Seventy per cent of subjects reported deleterious health
      effects related to the missile attacks or civil defence measures, mainly
      psychological and neurological complaints, sleep disorders, gastrointestinal and
      respiratory symptoms. Recurrent themes and metaphors in the narratives most often
      focused on the difference of this war to others, the central involvement of the
      family, concern for children and identification and connection to the nation. The
      Scud missile attacks combined with the civil defence measures had significant
      impact on the population, as manifested in subjects' stories, symptoms, symbols
      and behaviour. Narrative analysis provided an efficient method to capture the
      rich texture of patients' experiences.

PMID- 8359610
TI  - Why do mothers consult when their children cough?
AB  - Mothers' beliefs and evaluations of their child's illness were studied in a group
      of 30 mothers who had consulted a general practitioner because of a cough. Data
      were collected by tape-recorded semi-structured interviews conducted in their own
      homes. A major concern for mothers was their fear that their child was going to
      die, usually because of choking on phlegm or vomit, but also through an asthma
      attack or cot death. Mothers were also worried that their child would develop
      long-term chest damage. Particularly important in mothers' assessments were their
      experience of disturbed sleep because of worries about their child dying at night
      and their belief that the cough was 'on the chest' which gave rise to worries
      about dying through choking on phlegm and long-term chest damage. Antibiotics
      were commonly believed to be required to break up phlegm which might cause the
      long-term damage or the choking and death.

PMID- 8359611
TI  - The patient's family history: a key to the physician's understanding of patients'
      fears.
AB  - Patients often feel considerably worried by conditions that appear to be
      biomedically mild to their physicians. Their reaction may be linked to personal
      experience from cases of severe disease in their family history. In this
      qualitative study, 30 primary health care patients were interviewed about their
      definition of their present problem, their fears and associations with their
      family history. For several patients, the discrepancy between objective signs and
      fears was linked to cases in their family. Death or threats to life, especially
      when occurring prematurely, appeared to be significant. The same was true for
      actual or threatening disability in family members. A condition perceived to have
      been overlooked also seemed to be important for some patients. These findings may
      be used to understand patients' rationale for seeking care. The subject should be
      the theme for further investigation.

PMID- 8359612
TI  - Shared understanding of the qualitative research process. Guidelines for the
      medical researcher.
AB  - The qualitative research process is presented and discussed as a model,
      emphasizing matters frequently experienced as unfamiliar by the medical
      researcher. This model represents a prescriptive methodology, implying underlying
      values on construction of scientific knowledge where shared understanding-
      intersubjectivity--is considered as essential. Various stages of the research
      process are demonstrated, drawing attention to matters that influence analysis
      and the paths to knowledge, especially preconceptions and theoretical frames of
      reference. Principles and procedures related to analysis of qualitative data, as
      decontextualizing and recontextualizing, are explained. The structure of this
      model, accentuating the researcher's responsibility to give access to all levels
      of the research process, underlies all kinds of scientific inquiry. Such
      principles should probably more often be explicitly questioned and accounted for
      in all sorts of medical research.

PMID- 8359613
TI  - Factors affecting general practitioners' recruitment of patients into a
      prospective study.
AB  - Many research projects depend on general practitioners (GPs) to recruit patients
      into the study. As part of a study of patients' experiences of treatment for
      menorrhagia, completeness of recruitment and the extent of bias introduced by
      failure to recruit was assessed. Only 129 (41%) of 315 GPs who had agreed to
      recruit patients actually did so. A review of notes in six practices revealed
      that only 40 (20.4%) of 196 eligible patients had been recruited. There was some
      evidence that the recruited patients had more severe symptoms than those not
      recruited. There was no difference in recruitment rates between male and female
      doctors, but those who had received a practice visit from a member of the
      research team recruited more patients. A survey of participating GPs revealed
      that forgetfulness and time pressures were the main factors inhibiting
      recruitment.

PMID- 8359614
TI  - Measuring functional status in a population survey. The Dartmouth COOP functional
      health assessment charts/WONCA used in an epidemiological study.
AB  - In a population study, a random sample of 398 persons from 20 to 72 years
      answered the six item version of the Dartmouth COOP functional health assessment
      charts/WONCA. The results according to age and sex are presented. The charts have
      been developed primarily for use in clinical settings. In a cross-sectional study
      in a normal population, the instrument seems feasible in use and it
      differentiates between the sexes and age groups.

PMID- 8359615
TI  - Influencing diagnostic and preventive performance in ambulatory care by feedback
      and reminders. A review.
AB  - The number of good quality studies on the effect of feedback and reminders on
      diagnostic and preventive activities in ambulant practice is still low. The
      interventions and procedures studied differ widely, and the reporting of the
      results is insufficiently precise. This makes comparison difficult and
      quantitative pooling impossible. Nevertheless, the literature supports the
      contention that feedback reduces the use of diagnostic tests and the costs
      thereby engendered. It also discloses a positive effect of feedback on the
      adherence of medical practice to guidelines or standards. In this respect, the
      effect of reminders seems to exceed that of classical methods of feedback. There
      is still a need for research on the effect of feedback, reminders and other
      instruments for quality assurance on various aspects of medical performance in
      different settings.

PMID- 8359616
TI  - Conference report: teaching old docs new tricks: research dissemination and
      professional behavioural change.

PMID- 8359617
TI  - Selections from current literature: psychiatric disorders in primary care.
AB  - Although each paper reviewed for this article examined different populations,
      used differing measures to detect psychiatric problems and differing criteria to
      diagnose psychiatric illness, the results consistently demonstrate the high
      prevalence of psychiatric illness in the community and in primary care. Twenty
      five per cent of all attenders, 52% of high utilizers and 46% of illness
      initiation visits in primary care have a diagnosable psychiatric illness.
      Depression and anxiety appear to be the most frequently encountered psychiatric
      problems in primary care patients. Also consistent in the three primary care
      based reports is the finding that primary care physicians under-diagnose
      psychiatric illness in their patients. Reasons for this appear to include: (i)
      the relatively short duration of primary care visits (though against this is the
      frequency of visits-particularly among high utilizers), (ii) the presentation of
      somatic symptomatology by patients, (iii) the shortcomings of current diagnostic
      categories when applied to primary care patients, (iv) the frequency of
      relatively mild and subthreshold conditions in primary care patients, and (v) the
      lack of evidence demonstrating beneficial treatment outcomes for primary care
      psychiatric disorders and the related difficulty of extrapolating treatment
      results from hospital and referral based trails to primary care patients. Despite
      these difficulties, family physicians need to be watchful to detect psychiatric
      illnesses in those patients most likely to benefit from treatment. The finding of
      Broadhead et al. indicating that persons with symptoms of depressed mood are at
      increased risk for development of major depression over the subsequent 12 months
      is of interest to family physicians. More frequent follow-up of this group may be
      indicated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359618
TI  - Alpha-interferon 2b in the treatment of chronic hepatitis C: interim report of
      the first multicentre Australian trial.
AB  - Interferon has been shown to be effective in the treatment of chronic hepatitis C
      but the optimal treatment regime has not yet been defined. Studies using 3
      million units (MU) of interferon thrice weekly (tiw) for 6 months have shown
      normalization of serum alanine aminotransferase (ALT) in about 50% of patients,
      but relapse occurs in at least 50% of responders after interferon is stopped. The
      aims of this study were to determine whether 5 MU of interferon tiw produces a
      higher response rate than 3 MU tiw and to examine if the higher dose results in
      more sustained remissions. In addition, factors that are associated with a more
      or less favourable response to interferon treatment were sought. Overall, 65% of
      patients responded and no advantage of the higher dose therapy was found, either
      in terms of response or relapse rate after treatment. The presence of cirrhosis
      on the pre-treatment liver biopsy was associated with a poor response rate to
      interferon and a trend towards a higher relapse rate. Risk factor for acquisition
      of disease was also related to likelihood of response but not relapse. We
      conclude that two thirds of Australian patients with chronic hepatitis C
      initially respond to interferon treatment. Positive predictors of response are
      intravenous drug use as a risk factor and histologically less severe liver
      disease. Relapse occurs in two thirds of all responders.

PMID- 8359619
TI  - Long-term therapeutic efficacy of interferon for patients with chronic hepatitis
      C.
AB  - Interferon is being used for therapy of chronic hepatitis C, but its long-term
      results have not been reported. We studied 65 patients with this disease who were
      monitored for at least 2 years after completion of the therapy. Almost all
      patients who had responded to therapy at 6 months after the end of therapy had
      normal levels of alanine aminotransferase (ALT) when evaluated later. The level
      of ALT became normal for the first time in some patients more than 6 months after
      therapy ended. The level of ALT in many of the patients without HCV RNA had
      become normal 6 months after the end of the therapy. One of three schedules was
      employed: three times weekly long-term; daily for two weeks and none for two
      weeks in a cycle; and daily for several weeks; 57%, 29%, and 17% of the patients
      on these schedules came to have normal ALT levels. Patients without HCV RNA at
      six months after completion of therapy tended to have higher responses in terms
      an increased level of 2',5'-oligoadenylate synthetase of mononuclear cells in
      vitro before therapy began. However, therapy three times per week was effective
      even for some patients judged not responsive to IFN by this test. The results
      showed that IFN therapy was effective for chronic hepatitis C when judged by long
      term results.

PMID- 8359620
TI  - Autoimmunity during alpha-interferon therapy for chronic hepatitis C.
AB  - One hundred twenty-five patients with chronic hepatitis C were treated with
      natural IFN alpha or recombinant IFN alpha-2a, daily doses of 3 MU or 9 MU,
      respectively. IFNs were given 6 times a week for the first 2 weeks followed by
      thrice weekly administration for 12 weeks or more. ANA, TMA, AMA and anti-DNA
      antibody newly developed in 8, 1, 2 and 1 patient, respectively. Furthermore, we
      encountered some cases in which underlying autoimmune disorders were thought to
      be exacerbated by IFNs. It is important to pay sufficient attention to the
      development of autoimmune diseases in IFN therapy for chronic hepatitis C.

PMID- 8359621
TI  - PGE2 protects isolated cells against injury through multiple mechanisms.
AB  - In order to clarify how PGE2 regulates gastric mucosal integrity, we examined the
      effects of PGE2 on ethanol-caused injury of isolated gastric chief cells,
      cultured gastric mucous cells from guinea pigs and Balb/c 3T3 fibroblasts.
      Pretreatment of these cells with PGE2 reduced ethanol-caused injury of the cells.
      Furthermore, pretreatment of gastric mucous cells with indomethacin enhanced
      ethanol-caused injury, suggesting that endogenous PGE2 may be involved in the
      cell protection. PGE2 stimulated an increase in diacylglycerol (DG) accumulation
      in chief cells and treatment of chief cells with synthetic DG reduced the injury
      of the cells. However, DG accumulation was not observed in gastric mucous cells
      treated with PGE2. Therefore PGE2 may protect the cells from injury through a
      variety of mechanisms. In addition, PGE2 enhanced the survival of the quiescent
      fibroblasts cultured in the absence of serum, while PGE2 had no survival
      enhancing effect on gastric mucous cells. These results suggest that the
      mechanism by which PGE2 preserves the cell viability may depend on not only cell
      types used but also how the cells are injured.

PMID- 8359623
TI  - Alteration of gastric microcirculation in ulcer healing and recurrence:
      significance of autonomic nervous regeneration and mesenchymal cell.

PMID- 8359622
TI  - Prospect of the treatment of human gastric ulcers with orally administered
      epidermal growth factor.

PMID- 8359624
TI  - Epidemiology and genetics of peptic ulcer.
AB  - At the turn of the century, duodenal ulcer rose from rarity to affect 10% of
      males in their life time, subsequently declining in some countries such as UK,
      levelling off in others such as Germany, and continuing to increase in still
      others such as Hong Kong. The annual incidence per 1000 population varies from
      about 1 in Japan to 1.5 in Norway, 1.8 in USA and 2.7 in Scotland, and the
      frequency also varies within many individual countries, such as Australia, China
      and India, and among races such as a higher prevalence among whites than blacks
      in USA and among Chinese than Javanese in Indonesia. Ulcer frequency is higher in
      winter months, and this appears universal, being true in cold as well as in warm
      countries. Most places report a rise of ulcer rates among the elderly in recent
      decades. The male to female ratio also varies geographically, for example from
      1:1 in USA to 18:1 in India, and with time such as moving from 2:1 to 1:1 in the
      last two decades in USA, and the duodenal ulcer to gastric ulcer ratio varies
      widely from place to place, for example from 0.8 in Japan to 19:1 in Africa and
      32:1 in India. Placebo healing rates also differ geographically, ranging from 5%
      in Philippines to 78% in Mexico. These epidemiological data can only be explained
      by the presence of multiple aetiological factors, including analgesics, society
      stress, cigarette smoking, Helicobacter pylori, dietary factors, and genetic
      factors. Three lines of evidence support a genetic role: family studies, twin
      studies and blood group studies. Family aggregation occurs more commonly in
      patients with early-onset (< 30 yr) of symptoms. Blood group O prevalence is more
      associated with late-onset of symptoms. Other genetic markers include nonsecretor
      status, HLA antigens, phenylthiocarbamide taste sensitivity, and alpha-1
      antitrypsin. Genetic syndromes such as MEN I also support a genetic role and give
      insight into pathogenetic mechanisms. The best physiological marker is still
      hyperpepsinogenemia I, which is transmitted by autosomal dominance, despite
      recent report of lower serum pepsinogen 1 after healing of Helicobacter pylori
      associated gastritis.

PMID- 8359625
TI  - The role of Helicobacter pylori in peptic ulcer disease.
AB  - The linking of relapse of duodenal as well as gastric ulcers with Helicobacter
      pylori (H. pylori) has been a considerable advance in managing patients with
      peptic ulcer disease. However, pathogenetic role of H. pylori in peptic ulcer
      still remains unclear. The aim of this study was to assess the relationship
      between H. pylori infection and inflammatory cell infiltration in gastric mucosa
      in peptic ulcer disease. Sixty-four patients with endoscopically proven gastric
      ulcer and 26 patients with duodenal ulcer were evaluated by prospective study.
      Biopsy specimens were taken from the ulcer margin, corpus and antrum. Eradication
      of H. pylori was attempted by concomitant administration of amoxycillin 500 mg,
      metronidazole 250 mg and bismuth subnitrate 1 g twice daily for 2 weeks. H.
      pylori positive rates in clinical stages of gastric and duodenal ulcer showed
      almost the same values of more than 90%. The prevalence of H. pylori at the
      antrum and corpus was almost the same as that between gastric and duodenal ulcer
      patients, whereas a dramatic difference in the positive rates at the ulcer margin
      was observed between gastric and duodenal ulcer patients (83.9% and 35.0%,
      respectively). The prevalence of polymorphonuclear (PMN) cell infiltration at the
      ulcer margin was still high even at the scarring stage of gastric and duodenal
      ulcer with positive H. pylori, whereas a dramatic decrease of PMN cell
      infiltration was observed at the ulcer margin after successful eradication of H.
      pylori. These results suggest that H. pylori may play an important role in the
      pathogenesis of gastric and duodenal ulcer by inducing inflammatory cells such as
      PMN cells in gastric mocosa.

PMID- 8359626
TI  - Histological patterns of prolonged hepatitis C infection.
AB  - Liver biopsies from 63 patients with hepatitis C virus (HCV) infection have been
      studied. 31 were asymptomatic and had been detected by a variety of screening
      programs, and most of the other 32 had complained of vague symptoms only. In 57
      patients a confident estimate of the duration of infection was able to be made
      (ranging from 12 months to over 38 years) and 73% of these had been infected for
      over 5 years. The most common histological pattern observed was a low-grade
      panacinar hepatitis. This affected 74.6% of all biopsies, and 43% of this group
      had been infected for over 10 years. Severe chronic active hepatitis and/or
      cirrhosis occurred in only 8% of the whole series, and in 16.7% of those infected
      for over 10 years. This incidence of serious sequelae in chronic HCV infection is
      much lower than previously reported, probably reflecting the methods of patient
      selection, and may represent more accurately the natural history of the disease
      in this community. The occurrence of a number of characteristic histological
      features (lymphoid follicles and aggregates, steatosis, Kupffer cell prominence,
      and apoptotic or acidophilic bodies) was confirmed, the constellation of which is
      highly suggestive of HCV infection. It is suggested that apoptosis may play an
      important role in the perpetuation of HCV as a chronic infection.

PMID- 8359627
TI  - Ethics in the aging population: a gastroenterologist's perspectives.

PMID- 8359628
TI  - Current ethical problems in Japan.

PMID- 8359629
TI  - Liver transplantation: the Danish experience.

PMID- 8359630
TI  - Liver transplantation: the Australian experience.

PMID- 8359631
TI  - Current status of liver transplantation (LT) in France and specificities of
      French ethical attitudes concerning LT.
AB  - The authors report first on the current status of liver transplantation in France
      and underline its exponential development. The main indications for this
      procedure are outlined for adults as well as for children. The modalities of
      distribution of livers harvested by strictly controlled university teams are also
      briefly described. The specificities of French ethical attitudes towards liver
      transplantation are discussed. They concern the donor, the recipient and the
      society. Legal dispositions stipulating the presumed consent of the donor and
      accrediting the notion of "cerebral death" have eased the development of liver
      transplantation in France. Despite these measures shortage in liver available for
      grafts results in still too large waiting list and fosters nation-wide campaign
      to encourage organ donation. There is, in France, a strong consensus for a strict
      sticking to the absolute principles of gratuity of organ donation and non
      marketing of excised organs available for graft. As stated recently by Thomas
      Starzl, liver transplantation has become the second most commonly performed solid
      organ transplant after kidney transplant. In the latin Europe, the idea of organ
      transplantation is in the mind of people for a long time as illustrated from
      paintings or carvings that can still be seen in several roman catholic churches
      of the Middle Age. Although, liver transplantation in man developed only after
      the pioneer work of Thomas Starzl in Pittsburg, it is fair to recall that Alexis
      Carrel (1908, Noble Prize), from France, opened the way to organ transplantation
      by performing in animals the first vascular sutures and organ auto- or
      homografts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359632
TI  - Education in medical ethics.
AB  - Since ethics is an integral part of practice of medicine, its study should
      parallel that of study of medicine. It should proceed in an orderly fashion from
      undergraduate into postgraduate study, starting with an understanding of
      principal moral values governing medical ethics. It should subsequently develop
      awareness of frequent existence of ethical issues and dilemmas, help develop the
      capacity for resolution of these issues through ethical reasoning, and acquire
      understanding of the function of institutional bodies concerned with ethics.
      Clinical real life situations and case studies should be extensively used as an
      educational tool. The exact design of the curriculum may vary to reflect the
      medical curriculum of a particular institution, but common objectives to all
      systems must be to achieve familiarity with moral values underlying the practice
      of medicine and with methodology of ethical reasoning. Some form of examination
      and evaluation of the course should be a standard feature of all teaching
      programs of medical ethics.

PMID- 8359633
TI  - Liver transplantation in Italy and the scarcity of donors: causative factors and
      ethical considerations.
AB  - We analyze the current state of liver transplantation (OLTx) in Italy that in the
      last few years had reached approximately 150 OLTx per year for a population of 58
      millions of inhabitants. The need for OLTx in Italy is high and mainly due to the
      incidence of post-hepatitis and post-alcoholic liver cirrhosis, which are the
      prevalent indication for OLTx. On the contrary the availability of donor organs
      in Italy is very low as compared with other European countries, and as a
      consequence the gap between need and performed OLTx is widening. The reasons for
      poor donations are multifactorial among which; lack of organization, insufficient
      ICU care beds, poor knowledge of health personnel. General attitudes of the
      society and brain death concepts are also involved as a recent survey has
      demonstrated. Under certain circumstances the patient who cannot be transplanted
      on time in Italy is allowed to seek for care abroad under the local government
      economical assistance. Finally some ethical considerations and the proposal for
      better education of both population and health care providers are advocated.

PMID- 8359634
TI  - Orthotopic liver transplantation in Canada.

PMID- 8359635
TI  - Ethical issues and liver transplantation in the United States of America.

PMID- 8359636
TI  - Promotion of ethics in gastroenterology. Joint meeting of the members of the
      Japanese Society of Gastroenterology and the World Organization of
      Gastroenterology.

PMID- 8359637
TI  - Gastrointestinal hormones: past, present, and future.

PMID- 8359638
TI  - Anal dysplasia in homosexual men: role of anoscopy and biopsy.
AB  - BACKGROUND: Both anal squamous cell cancer and human papilloma virus (HPV) are
      increased in homosexual men. This study evaluates histology of internal anal
      abnormalities in a high-risk population of human immunodeficiency virus (HIV)
      seropositive and seronegative homosexual men. METHODS: Ninety men with
      abnormalities of the internal anal canal (referred from a cross-sectional study
      of 512 homosexual men) were evaluated by anoscopy, anal cytology, and directed
      biopsy. CD4 cell counts from blood and HPV types from anal tissue were also
      obtained. RESULTS: Seventy-eight (86%) men had HPV-associated abnormalities:
      discrete warts in 39 (43%), a wart ring in 23 (26%), and flat white epithelium in
      18 (20%). Dysplasia was detected by cytology in 36% and by biopsy in 92% (27%
      high grade). High-grade dysplasia was equally common in HIV-seropositive and 
      seronegative men. The morphology of anal lesions did not predict the presence of
      dysplasia. Both high- and low-risk HPV types were common in many of the biopsy
      specimens. CONCLUSIONS: Anal dysplasia is common in biopsy specimens from
      homosexual men with visible HPV-associated internal anal abnormalities. Natural
      history studies are needed to determine the clinical significance of anal
      dysplasia, rates of progression to cancer, and the role of screening and therapy.

PMID- 8359639
TI  - Simultaneous assessment of liquid emptying and proximal gastric tone in humans.
AB  - BACKGROUND: Barostat is the only technique that allows assessment of gastric tone
      in humans. Our aim was to simultaneously assess gastric emptying and relaxation
      in response to a liquid meal. METHODS: Gastric tone was monitored using an
      electronic barostat in six healthy subjects after three liquid meals (200 mL, 400
      mL, 600 mL, 1 kcal/mL). Scintigraphic imaging was obtained by using double
      isotopic labeling (technetium 99m for liquid of the 200 mL meal and xenon 133 for
      air into the barostat). RESULTS: Profound gastric relaxation was detected in
      every subject. The duration of proximal gastric relaxation increased with meal
      size. The proximal stomach remained relaxed through the duration of gastric
      emptying. Gastric tone returned to the fasting values simultaneously with
      completion of liquid emptying. Repeated measures after the 200-mL meal showed
      that amplitude (i.e., maximal volume change) and duration of relaxations were
      reproducible. However, the presence of the bag slightly accelerated gastric
      emptying and modified the intragastric distribution of the meal. CONCLUSIONS: The
      barostat is a sensitive and reproducible technique to measure gastric relaxation
      following liquid meals in humans. The results also suggest that the role of
      gastric tone as the driving force of gastric emptying of liquids has been
      overestimated.

PMID- 8359640
TI  - Growth failure in children with inflammatory bowel disease: a prospective study.
AB  - BACKGROUND: Growth failure frequently complicates the clinical course of
      inflammatory bowel disease (IBD) in children. This study was designed to
      investigate the role of disease activity versus steroid therapy on growth
      faltering in this disorder. METHODS: We studied growth failure and its
      relationship to disease activity and steroid therapy in 69 children who have IBD
      by prospectively monitoring height for a maximum of 3 years. Disease activity and
      steroid use were recorded at entry into the study. RESULTS: The prevalence of
      growth failure was 24%, 23%, and 39% by height velocity, Z score, and height-for
      age criteria, respectively; deficits were equally prevalent regardless of the
      stage of pubertal development. A delay in linear growth persisted throughout
      puberty and was not reversed after surgery. Patients who had Crohn's disease were
      twice as likely to have growth abnormalities than patients who had ulcerative
      colitis. We detected significant negative associations between linear growth and
      disease activity but not steroid therapy. CONCLUSIONS: In a unique group of
      children, growth failure is an early, "prepatterned" manifestation of IBD. The
      inflammatory process, rather than steroid use, has a predominant influence on the
      development of growth faltering.

PMID- 8359641
TI  - Inhibition of glucose absorption by phlorizin affects intestinal functions in
      rats.
AB  - BACKGROUND: To investigate the mechanism of regulation of intestinal
      disaccharidase activity and glucose absorption, the effect of dietary intake of
      phlorizin, a potent and specific inhibitor of intestinal glucose transport, on
      intestinal disaccharidase activity and Na(+)-dependent glucose transporter was
      examined in rats. METHODS: Jejunal disaccharidase activity and the number of
      Na(+)-dependent glucose transporters were determined in rats maintained on a low
      starch diet, a high-starch diet, or low-starch diets containing various amounts
      of phlorizin (0.1%-0.9% wt/wt). RESULTS: Jejunal disaccharidase activity
      increased in a dose- and time-dependent manner. Stimulation of jejunal
      disaccharidase activity only occurred when phlorizin was added to starch
      containing diets, not when it was added to a carbohydrate-free diet. Addition of
      the same amount of phloretin and glucose (constituents of phlorizin), to the diet
      failed to increase disaccharidase activity. The maximum binding of phlorizin to
      brush border membrane vesicles was increased in the rats fed phlorizin, whereas
      the dissociation constant remained unchanged, suggesting an increase of glucose
      transporter expression. CONCLUSIONS: Dietary phlorizin increased the jejunal
      disaccharidase activity and Na(+)-dependent glucose transporter expression. The
      trigger for these changes may have been due to an increased luminal glucose
      content.

PMID- 8359642
TI  - Surface staining on the villus of lactase protein and lactase activity in adult
      type hypolactasia.
AB  - BACKGROUND: We have shown in previous studies the presence of a patchy pattern of
      lactase protein expression in the proximal jejunum of hypolactasic humans, adult
      rabbits, and rats. The present study investigated the mechanisms underlying the
      heterogeneous expression of lactase on the villus. METHODS: Proximal jejunal
      tissue from 18 adult humans and 12 adult rabbits was examined using
      enzymocytochemical and surface-staining techniques for lactase protein and
      activity. RESULTS: In the proximal jejunum of hypolactasic humans and adult
      rabbits, lactase activity is patchily distributed on the villus enterocytes. In
      humans, the patches of lactase-positive enterocytes are randomly distributed on
      the villus, whereas in rabbits, vertical, continuous sheets of positive
      enterocytes arise from the base of the villus. CONCLUSIONS: The presence of
      enterocytes without lactase activity is one of the mechanisms causing adult-type
      hypolactasia in the proximal jejunum of humans and mammals. The patchy pattern of
      lactase in rabbits suggests a clonal origin with heterogeneity of the cells
      arising from the crypts. In hypolactasic humans, the enterocyte heterogeneity
      occurs as a consequence of mechanisms that do not have a clonal origin.

PMID- 8359644
TI  - Fat-induced ileal brake in humans: a dose-dependent phenomenon correlated to the
      plasma levels of peptide YY.
AB  - BACKGROUND: Upper gastrointestinal motility is regulated by the presence of
      nutrients in the distal gut. The present study evaluated whether lipid-induced
      ileal brake on gastric emptying (1) can be elicited by low fat concentrations;
      (2) is a dose-dependent phenomenon; and (3) is related to gastrointestinal
      peptide release. METHODS: Seven patients were studied in the defunctionalized
      stage of total colectomy, on three separate occasions. On each study day,
      patients ate a meal labeled in the solid component; 30 minutes later, one of the
      following solutions was randomly infused into the ileal pouch: 0.9% saline, 2%
      oleic acid, and 20% oleic acid. Plasma concentrations of peptide YY (PYY),
      enteroglucagon, neurotensin, and motilin were measured. RESULTS: Both oleic acid
      solutions slowed gastric emptying compared with saline (P < 0.001), the effect
      being dose dependent (P < 0.001). Ileal infusions did not modify neurotensin and
      enteroglucagon levels but induced a dose-dependent increase of PYY (P < 0.01) and
      a borderline decrease of motilin (P = 0.05) levels. Slower rates of gastric
      emptying were related to increased plasma concentrations of PYY (r = 0.615; P <
      0.05). CONCLUSIONS: This study shows that (1) the ileal brake on gastric emptying
      can be evoked by low doses of lipids in the distal ileum; (2) the delay of
      gastric emptying is related to the release of PYY; and (3) both phenomena are
      dose dependent.

PMID- 8359643
TI  - Bicarbonate-stimulated [14C]butyrate uptake in basolateral membrane vesicles of
      rat distal colon.
AB  - BACKGROUND: The mechanism of short-chain fatty acid (SCFA) absorption by the
      colon is not known. The aim of these experiments was to identify the transport
      mechanisms present in the basolateral membrane to develop an overall model of
      colonic SCFA absorption. METHODS: These studies determined the uptake of
      [14C]butyrate (used as a model SCFA) by basolateral membrane vesicles prepared
      from rat distal colonic mucosa. RESULTS: Significantly higher [14C]butyrate
      uptake under an acidic environment (extravesicular pH [pHo] = intravesicular pH
      [pHi] = 5.5) than that under alkaline environment (pHo = pHi = 7.5) indicates the
      presence of nonionic diffusion. In the absence of a pH gradient (pHo/pHi =
      7.5/7.5), outward gradients of bicarbonate significantly stimulated [14C]butyrate
      uptake. Additional presence of a pH gradient (pHo/pHi = 6.0/7.5) further enhanced
      the bicarbonate gradient-stimulated [14C]butyrate uptake that was not inhibited
      by voltage clamping but was inhibited substantially by an anion exchange
      inhibitor 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS) (82%). Both
      increasing extravesicular butyrate concentration and intravesicular bicarbonate
      concentration saturated bicarbonate/pH gradient-stimulated [14C]butyrate uptake
      with an apparent Michaelis constant (Km) for butyrate of 6.9 mmol/L and an
      apparent Km for bicarbonate of 27.4 mmol/L. CONCLUSIONS: Butyrate uptake by
      basolateral membrane vesicles represents both nonionic diffusion and a carrier
      mediated SCFA-bicarbonate exchange process that differs from the SCFA-bicarbonate
      exchange recently identified in apical membrane vesicles. Thus, two distinct
      carrier-mediated anion exchange processes located in apical and basolateral
      membranes mediate transcellular SCFA transport in colonocytes.

PMID- 8359645
TI  - Effect of crural myotomy on the incidence and mechanism of gastroesophageal
      reflux in cats.
AB  - BACKGROUND: Esophagogastric junction (EGJ) pressure is the major barrier to
      gastroesophageal reflux. Recent studies suggest that contraction of the crural
      diaphragm increases esophagogastric junction pressure. Whether this increase in
      EGJ pressure is important in the prevention of gastroesophageal reflux is not
      known. Our aim in this study was to determine the effects of crural myotomy on
      the occurrence of gastroesophageal reflux. METHODS: The spontaneous and stress
      gastroesophageal reflux before and after a surgical crural myotomy in four cats
      was studied. Spontaneous gastroesophageal reflux was recorded in the awake cats
      through a pH probe, placed via an esophagostomy, for periods of 12-24 hours.
      Stress reflux was studied during periods of airway obstruction and abdominal
      compression in anesthetized animals using the technique of simultaneous
      esophageal manometry and pH monitoring. RESULTS: There was a significant increase
      in the frequency of spontaneous acid reflux after crural myotomy. In anesthetized
      animals, there was an increase in the EGJ pressure during airway obstruction,
      which was abolished by a crural myotomy. Abdominal compression caused a reflex
      contraction at the EGJ that was not affected by crural myotomy. The crural
      myotomy resulted in a significant increase in the frequency of acid reflux during
      airway obstruction but not during abdominal compression. CONCLUSIONS: It is
      concluded that the crural diaphragm is important in the prevention of
      gastroesophageal reflux and its dysfunction leads to an increased incidence of
      gastroesophageal reflux.

PMID- 8359646
TI  - Duodenal pH dips as an index of transpyloric flow in conscious dogs.
AB  - BACKGROUND: To determine if duodenal pH fluctuations might be used as a valuable
      index of the occurrence of gastric chyme ejection, the transpyloric flow and pH
      in the duodenal bulb were monitored simultaneously in six dogs. METHODS:
      Transpyloric flow, monitored by a chronically implanted electromagnetic
      flowmeter, was represented by individual pulses of flow. Relations between the
      volume of these flow pulses and changes in duodenal pH were assessed both
      postprandially and during the increased gastric outflow that followed gastric
      loading of buffered saline solutions at pH 2 and 4. RESULTS: During fasting and
      gastric loading with buffered saline at pH 2, no consistent relationship between
      flow pulses and duodenal pH fluctuations was evident. After instillation of
      buffer solution at pH 4 and postprandially, the magnitude of duodenal pH
      fluctuations became proportional to the stroke volume of the flow pulses. The
      removal of bile from the proximal duodenum decreased the relationship.
      CONCLUSIONS: It is concluded that duodenal pH measured at 2 cm from the pylorus
      might be used postprandially as an index of the transpyloric flow rate of chyme.

PMID- 8359647
TI  - Anti-immunoglobulin E-stimulated ion transport in human large and small
      intestine.
AB  - BACKGROUND: Mast-cell regulation of intestinal ion transport, previously shown in
      animals and cultured cells, was examined in surgically resected human bowel in
      this study. METHODS: Changes in short-circuit current (Isc) in response to rabbit
      anti-human immunoglobulin (Ig) E or control serum, histamine, and electrical
      stimulation were measured in muscle-stripped, noninflamed segments of intestine
      mounted in Ussing chambers. Chloride-free buffer, pyrilamine, piroxicam, sodium
      cromoglycate, and tetrodotoxin were examined for their effect on Isc responses to
      these stimuli. RESULTS: Within 1-2 minutes of adding anti-IgE serum, a specific
      monophasic rise in Isc (peaking at 7-10 minutes) was observed in large and small
      intestine. This response was reduced approximately 80% in chloride-free buffer
      and inhibited by the histamine1-receptor antagonist, pyrilamine, and the cyclo
      oxygenase inhibitor, piroxicam, implicating histamine and prostaglandins as
      mediators of the ion transport changes. The mast-cell stabilizer, sodium
      cromoglycate, reduced anti-IgE responses in the small, but not large, intestine.
      Approximately 50% inhibition of anti-IgE responses in colon by the neurotoxin,
      tetrodotoxin, indicated that nerves were involved. CONCLUSIONS: These results
      suggest that activation of mast cells releases mediators that stimulate
      intestinal ion transport through direct epithelial action and via nerves. This
      study provides important evidence that immunoregulation of intestinal ion
      transport does occur in humans.

PMID- 8359648
TI  - 5-hydroxytryptamine-3 receptors are involved in the initiation of gastric phase-3
      motor activity in humans.
AB  - BACKGROUND: 5-hydroxytryptamine-3 (5-HT3) receptor antagonists inhibit gastric
      phase-3 motor activity in the dog. This study examined the role of 5-HT3
      receptors in the generation of gastric phase 3 of the migrating motor complex in
      humans. METHODS: Interdigestive motor activity was recorded manometrically in 16
      subjects before and after administration of ondansetron, a selective 5-HT3
      receptor antagonist. Plasma motilin values were also assayed in 7 individuals.
      The incidence of gastric activity fronts before and after ondansetron was
      compared with a control group that had not received ondansetron. The ability of
      erythromycin to induce a gastric activity front in the presence of ondansetron
      was also evaluated in 7 subjects. RESULTS: The incidence of gastric activity
      fronts was 69% before ondansetron vs. 19% after ondansetron. In contrast, in the
      control group there was no significant change in the incidence of gastric
      activity fronts over time. Activity fronts preceding ondansetron were associated
      with motilin peaks while activity fronts after ondansetron were not. Despite the
      previous administration of ondansetron, erythromycin induced gastric activity
      fronts in 89% of cases. CONCLUSIONS: Selective antagonism of 5-HT3 receptors
      suppresses the gastric component of phase-3 motor activity and simultaneously
      suppresses plasma motilin peaks. The results suggest that the suppression of
      gastric activity fronts is achieved via the suppression of plasma motilin peaks
      because in the presence of ondansetron a motilin agonist like erythromycin
      restores the gastric phase 3.

PMID- 8359649
TI  - Functional constipation and outlet delay: a population-based study.
AB  - BACKGROUND: Chronic constipation may result from many mechanisms including
      colonic inertia or rectosigmoid outlet delay, but risk factors for constipation
      in the community are poorly defined. The prevalence of and predictors for
      symptoms consistent with functional constipation and outlet delay were estimated.
      METHODS: An age- and gender-stratified random sample of 1,021 residents of
      Olmsted County, MN, aged 30-64 years, was mailed a valid self-report
      questionnaire; 835 responded (82%). These respondents were mailed a second
      questionnaire 12-20 months later that gathered data on symptoms compatible with
      functional constipation and outlet delay; 690 responded (83%). RESULTS: Self
      reported constipation did not reliably identify functional constipation or outlet
      delay. The overall age- and gender-adjusted prevalences (per 100) of functional
      constipation and outlet delay were 19.2 (95% confidence interval [CI], 16.1-22.3)
      and 11.0 (95% CI, 8.7-13.3), respectively. Outlet delay but not functional
      constipation was more frequent in women. After adjusting for age, gender, and
      other symptoms, an increased usage of aspirin was associated with functional
      constipation but not outlet delay. CONCLUSIONS: In apparently healthy middle-aged
      persons, approximately 1 in 5 have symptoms compatible with functional
      constipation, and 1 in 10 may experience outlet delay, but these groups
      correspond poorly with self-reported constipation.

PMID- 8359650
TI  - The motor response to intestinal resection: motor activity in the canine small
      intestine following distal resection.
AB  - BACKGROUND: The mucosal response to intestinal resection has been extensively
      studied; little is known of the motor response. Our aim was to evaluate motility
      in the intestinal remnant following distal resection. METHODS: Motor activity,
      duodenocecal transit, nutrition, and absorption were studied over a 3-month
      period in control animals (n = 9) and in groups of dogs who had undergone 25% (n
      = 6), 50% (n = 5), and 75% (n = 5) distal resection. RESULTS: Diarrhea and
      steatorrhea developed in each resection group, and the 75% group alone developed
      true short bowel syndrome. Resection did not affect migrating motor complex
      frequency or periodicity; phase 1 duration was shorter in the 75% group (control
      vs. 75%: 22 +/- 4 vs. 6 +/- 2 minutes, P < 0.03). The most striking motor effect
      was the development of prominent cluster activity in the distal part of the
      remnant in 25% and 50% resection animals and throughout the remaining intestine
      in the 75% group. Duodenocecal transit slowed during the study period from 13 +/-
      1 to 20 +/- 2 minutes in the 50% and from 10 +/- 2 to 14 +/- 2 minutes in the 75%
      group (P < 0.05). CONCLUSIONS: The initial motor response to major resections of
      the distal small intestine is dominated by the development of abnormal patterns.
      This motor disruption may contribute to the symptomatology and clinical features
      of the short bowel syndrome.

PMID- 8359651
TI  - Flow cytometry and Zollinger-Ellison syndrome: relationship to clinical course.
AB  - BACKGROUND: With successful means of controlling gastric acid secretion in
      patients with Zollinger-Ellison syndrome, the gastrinoma itself is becoming the
      major determinant of long-term survival. No methods have yet been described to
      predict which tumors will have more malignant courses thereby indicating which
      patients should undergo aggressive surgery or antitumor therapy. Because DNA
      analysis, using flow cytometry, has proved helpful in this regard in other
      tumors, the current study was designed to evaluate its utility in gastrinoma
      patients. METHODS: Flow cytometry was performed on 81 paraffin-embedded
      gastrinoma specimens from 59 patients. Results were compared with preoperative
      patient characteristics, findings at surgery, and postoperative follow up.
      RESULTS: Tumors were diploid in 54% of patients, near diploid in 15%, pure
      tetraploid in 0%, nontetraploid aneuploid in 25%, and multiple stem line
      aneuploid in 5%. All patients with multiple stem line aneuploid tumors had wide
      spread metastases whereas all patients with nontetraploid aneuploid tumors had
      localized or regional disease. Median S phase percentage was 3.6. S phase
      percentages were higher in patients with widespread metastatic disease than in
      patients with localized or regional disease. Disease extent also correlated
      closely with fasting serum gastrin level. After removing this variable with
      logistic regression analysis, the significant correlation between disease extent
      and DNA analysis persisted. CONCLUSIONS: DNA analysis of gastrinoma tissue
      specimens correlates independently with the extent of disease and may be useful
      in planning therapeutic strategies for patients with Zollinger-Ellison syndrome.

PMID- 8359652
TI  - The significance of carbonic anhydrase expression in human colorectal cancer.
AB  - BACKGROUND: Carbonic anhydrase isoenzymes I and II are present in normal
      colorectal mucosa. This study aimed to determine if carbonic anhydrase is present
      in colorectal cancer and what is its potential clinical significance. METHODS:
      The messenger RNA (mRNA) and protein expression of carbonic anhydrase isoenzyme I
      were analyzed in fresh specimens of colorectal adenocarcinoma by Northern and
      Western blots, respectively. The immunohistochemical expression was subsequently
      studied in a larger number of formalin-fixed surgical specimens. RESULTS: All of
      30 normal colon samples had a strong RNA hybridization signal. Only 4 of 39
      paired colorectal cancer and none of 9 normal liver samples had detectable levels
      of carbonic anhydrase mRNA. Isoenzyme I protein expression showed similar
      results. In a separate group of patients, immunohistochemical studies showed that
      16 of 96 colorectal tumors had positive staining cells. All positive tumors were
      well or moderately differentiated carcinomas (P < 0.05). When analyzed
      retrospectively, immunoreactive cases were more likely to be in a group with a
      good outcome (P < 0.01) and to lack vascular invasion (P < 0.01) than negative
      cases. CONCLUSIONS: The majority of colorectal cancers do not express carbonic
      anhydrase isoenzyme I. The presence of any isoenzyme I-positive immunoreactive
      cancer cells may be associated with a more favorable outcome in colorectal
      cancer.

PMID- 8359653
TI  - Sucrase-isomaltase gene expression in Barrett's esophagus and adenocarcinoma.
AB  - BACKGROUND: Specialized Barrett's esophageal mucosa, characterized by incomplete
      intestinal metaplasia of the esophageal mucosa, is associated with the
      development of adenocarcinoma. Although the intestinal disaccharidase sucrase
      isomaltase (SI) has been shown in incomplete intestinal metaplasia of the
      stomach, it is commonly believed that Barrett's mucosa does not express SI based
      on the lack of enzymatic activity. This study was undertaken to determine whether
      the SI gene is expressed in Barrett's epithelium and its associated
      adenocarcinoma at the level of messenger RNA (mRNA) and protein. METHODS: Reverse
      transcription polymerase chain reaction was used to determine the presence of SI
      mRNA in Barrett's esophagus and esophageal adenocarcinomas. Cellular localization
      of SI protein was determined by immunohistochemistry. RESULTS: SI mRNA was
      identified in 76% of Barrett's epithelium and 82% of esophageal adenocarcinomas.
      The transcriptional initiation site for SI in these tissues was identical to that
      of the small intestine. Immunohistochemical localization showed that SI was
      directed to the apical membrane in Barrett's epithelium in contrast to a more
      diffuse cytoplasmic pattern in esophageal adenocarcinomas. CONCLUSIONS: Columnar
      cells of specialized Barrett's epithelium express SI and are, therefore,
      phenotypically similar to those in incomplete intestinal metaplasia of the
      stomach with respect to intestinal gene expression.

PMID- 8359654
TI  - Hepatic encephalopathy in rats with thioacetamide-induced acute liver failure is
      not mediated by endogenous benzodiazepines.
AB  - BACKGROUND: To distinguish whether the improvement of hepatic encephalopathy by
      benzodiazepine receptor antagonists is mediated by their antagonistic or their
      inverse agonistic properties, the neurobehavioral effects of a variety of
      benzodiazepine receptor ligands in rats with thioacetamide-induced acute liver
      failure were tested. METHODS: The neural inhibitory effect of the benzodiazepine
      agonist flunitrazepam and its reversibility by the "pure" antagonist Ro 14-7437
      were examined in thioacetamide-treated rats and controls. The effects of Ro 14
      7437, of the partial inverse agonist Ro 15-4513, and the inverse agonist DMCM in
      rats with hepatic encephalopathy grade II/III were tested. Encephalopathic rats
      were pretreated with Ro 14-7437 or vehicle and then injected with Ro 15-4513.
      RESULTS: Thioacetamide-treated rats were more sensitive to flunitrazepam than
      controls. In both groups, its effect was completely antagonized with Ro 14-7437.
      Encephalopathy was significantly improved by Ro 15-4513, although Ro 14-7437 and
      vehicle had no effect. DMCM worsened the condition of encephalopathic rats but
      had no effect in controls. Pretreatment with Ro 14-7437 abolished the beneficial
      effects of Ro 15-4513. CONCLUSIONS: In rats with thioacetamide-induced liver
      failure, endogenous benzodiazepines do not precipitate hepatic encephalopathy.
      The amelioration of hepatic encephalopathy is mediated by benzodiazepine receptor
      ligands with both antagonistic and inverse agonistic properties.

PMID- 8359655
TI  - Secretion and contribution to lipolysis of gastric and pancreatic lipases during
      a test meal in humans.
AB  - BACKGROUND: The aim of this study was to quantitatively evaluate the relative
      contributions to in vivo lipolysis of gastric and pancreatic lipases. METHODS:
      Gastric and pancreatic lipase secretions were measured, and their respective
      levels were determined in duodenal fluid during the digestion of a liquid test
      meal in healthy volunteers. Gastric lipase activity was clearly distinguished
      from that of pancreatic lipase by using both a specific enzymatic assay and an
      enzyme-linked immunosorbent assay. Lipolysis products were monitored throughout
      the digestion period. RESULTS: On a weight basis, the ratio of pancreatic lipase
      to gastric lipase total secretory outputs was found to be around four after 3
      hours of digestion. The level of gastric hydrolysis was calculated to be 10% +/-
      1% of the acyl chains released from the meal triglycerides. Gastric lipase
      remained active in the duodenum where it might still hydrolyze 7.5% of the
      triglyceride acyl chains. CONCLUSIONS: Globally during the whole digestion
      period, gastric lipase might hydrolyze 17.5% of the triglyceride acyl chains. In
      other words, gastric lipase might hydrolyze 1 acyl chain of 4, which need to be
      hydrolyzed for a complete intestinal absorption of monoglycerides and free fatty
      acids resulting from the degradation of two triglyceride molecules.

PMID- 8359656
TI  - Bile acid-dependent vesicular transport of lysosomal enzymes into bile in the
      rat.
AB  - BACKGROUND: Bile acids may stimulate the movement of hepatocyte vesicles and
      enhance their fusion with the biliary canaliculus. The present study examined the
      effects of various bile acids on the exocytosis of the contents of hepatocyte
      lysosomes into the biliary canaliculus. METHODS: The effects of various bile
      acids on hepatocyte lysosome movement and on exocytosis of the contents of
      hepatocyte lysosomes into the biliary canaliculus were determined from the
      distribution of fluorescein isothiocyanate-dextran--labeled lysosomes in
      hepatocyte couplets and by quantitating biliary lysosomal enzyme output in rats.
      RESULTS: Hydrophobic as well as hydrophilic and nonmicellar bile acids were found
      to stimulate to a similar degree the output of lysosomal enzymes into bile,
      indicating that bile acid-induced change of canalicular or lysosomal membrane
      fluidity is not responsible for enhanced exocytosis. The taurocholate-dependent
      increase in lysosomal enzyme excretion was completely blocked by either
      microtubule or microfilament inhibition, suggesting that these subcellular
      structures are involved in bile acid-dependent vesicular transport. Fluorescent
      microscopy studies showed that taurocholate causes a microtubule-dependent
      translocation of lysosomes towards the canaliculus in hepatocyte couplets, which
      occurred at the same time as increased output of lysosomal enzymes into bile.
      CONCLUSIONS: The results suggest that bile acids modulate vesicle traffic towards
      the canaliculus by a mechanism unrelated to bile acid interaction with the
      vesicle membrane.

PMID- 8359657
TI  - Fibrosing cholestatic hepatitis in a transplant recipient with hepatitis B virus
      precore mutant.
AB  - A patient with hepatitis B virus (HBV) precore mutant (seropositive for hepatitis
      B surface antigen [HBsAg], anti-hepatitis B e antigen [HBeAg], and HBV DNA) who
      underwent orthotopic liver transplantation for end-stage liver disease is
      described. Sequencing of the HBV precore region of the pretransplant serum sample
      confirmed the presence of the precore stop-codon mutant (G-->A mutation in codon
      1896) only. The patient received HBV immunoglobulin prophylaxis for 6 months but
      HBV recurred thereafter with a mild hepatitic flare, and he remained seropositive
      for HBsAg, anti-HBe, and HBV DNA. The initial hepatitic illness resolved in 3
      months. The patient remained well for another 16 months before presenting with
      fibrosing cholestatic hepatitis (FCH). During his entire initial hepatitic flare,
      quiescent period, and final FCH phase, he remained seropositive for HBsAg, anti
      HBe, and HBV DNA. Moreover, sequencing of the serum HBV DNA in final FCH phase
      showed the presence of the identical HBV precore mutant. Immunohistochemical
      staining showed extensive expression of HBsAg/pre-S1, pre-S2, and hepatitis B
      core antigen, but HBeAg was scarcely detectable. This case illustrates that (1)
      recurrence of HBV precore mutant infection can occur in liver; (2) it can give
      rise to FCH; and (3) hepatic accumulation of HBeAg is not essential for the
      development of FCH.

PMID- 8359658
TI  - Abdominal radiotherapy is a cause for chronic pancreatitis.
AB  - We report a series of five patients with nonalcoholic chronic pancreatitis who
      underwent abdominal radiotherapy for Hodgkin's disease (n = 4) or seminoma (n =
      1) at doses ranging from 3600 to 4050 rads, 6 to 20 years (median, 7 years)
      before the onset of pancreatitis. Patients were in complete remission for their
      malignant disease. Other causes of chronic pancreatitis were excluded. The
      manifestations of chronic pancreatitis (median follow-up after the diagnosis of
      pancreatitis, 5 years) were pancreatic pain (n = 5), acute pancreatitis (n = 3),
      pseudocysts (n = 3), common bile duct stenosis (n = 2), duodenal stenosis (n =
      1), splenic vein obstruction (n = 1), diabetes mellitus (n = 4), steatorrhea (n =
      4), and pancreatic calcifications (n = 1). Other abdominal radiation injuries
      were severe chronic ulcer of the genu superius (n = 1), stenosis at the junction
      of the right and left hepatic ducts (n = 1), and splenic and left renal atrophy
      (n = 1). In one patient, pathological examination of the pancreas showed signs of
      chronic pancreatitis, severe fibrous endarteritis, and lack of inflammation.
      Abdominal radiotherapy should be added to the list of causes of chronic
      pancreatitis. We suggest that the physiopathology of postradiotherapy chronic
      pancreatitis is a vascular process.

PMID- 8359659
TI  - HLA susceptibility genes in celiac disease: genetic mapping and role in
      pathogenesis.
AB  - The overrepresentation of particular HLA alleles in patients with celiac disease
      was first noted two decades ago. Several lines of evidence obtained during the
      last years strongly suggest that a particular HLA-DQ heterodimer, encoded by the
      DQA1*0501 and DQB1*0201 genes in cis or trans configuration, confers the primary
      disease susceptibility. This paper reviews the evidence behind this concept and
      discusses how this particular DQ molecule may be involved in the pathogenesis.

PMID- 8359660
TI  - Intestinal lactase: what defines the decline?

PMID- 8359661
TI  - Neuroimmune regulation of human intestinal transport.

PMID- 8359662
TI  - Hiatal hernia and gastroesophageal reflux: another attempt to resolve the
      controversy.

PMID- 8359663
TI  - ANCAs aweigh in colitis.

PMID- 8359664
TI  - Dietary risk factors and colorectal polyps: apparently gender does make a
      difference.

PMID- 8359665
TI  - Feedback regulation of intracellular calcium release.

PMID- 8359666
TI  - Reversal of hypersplenism after liver transplantation.

PMID- 8359667
TI  - Deoxycholic acid metabolism in patients with adenomas.

PMID- 8359668
TI  - Role for thalidomide in primary biliary cirrhosis treatment?

PMID- 8359669
TI  - Gut permeability and disease severity in acute pancreatitis.

PMID- 8359670
TI  - Prostaglandin E2 effects on duodenal electrical conductance.

PMID- 8359671
TI  - Cloning and nucleotide sequence analysis of the Candida albicans enolase gene.
AB  - The complete nucleotide sequence of the coding region as well as the flanking non
      coding region of Candida albicans enolase gene was determined. A continuous open
      reading frame of 1323 nucleotides with no introns was identified. The deduced
      amino acid sequence showed 87% similarity to the enolases from the yeast
      Saccharomyces cerevisiae. The two isoforms of enolase are encoded by two non
      tandemly arrayed genes in S. cerevisiae. However, DNA hybridisation analysis
      indicates that in C. albicans enolase is encoded by a single gene. The position
      of the transcription start site, putative TATA box and polyadenylation signal of
      the C. albicans enolase gene have been identified. The location of these
      sequences are similar to those of the S. cerevisiae enolase genes.

PMID- 8359672
TI  - Unique genetic arrangement in the dnaA region of the Borrelia burgdorferi linear
      chromosome: nucleotide sequence of the dnaA gene.
AB  - The complete nucleotide sequence of the Borrelia burgdorferi dnaA gene (encoding
      the initiator protein of chromosome replication) and its flanking regions was
      determined. The putative DnaA polypeptide exhibited 29-42% identity with those of
      other eubacteria. The gene order in the dnaA region at the centre of the B.
      burgdorferi linear chromosome is rnpA-rpmH-dnaN-dnaA-gyrB-gyrA in contrast to the
      consensus eubacterial order of rnpA-rpmH-dnaA-dnaN-recF-gyrB, suggesting a
      rearrangement during the evolution of the Borrelia chromosome. We did not detect
      the multiple 9-nucleotide repeats known as DnaA boxes, which characterise origin
      of replications, in the dnaA-gyrB and dnaA-dnaN intergenic regions. In addition
      B. burgdorferi DnaA protein differs considerably from those of other eubacteria
      in a normally highly conserved region at the C-terminus of the polypeptide which
      may be involved in DNA binding.

PMID- 8359673
TI  - Agr-related sequences in Staphylococcus lugdunensis.
AB  - Sequences related to the Staphylococcus aureus accessory gene regulator (agr)
      were demonstrated in S. lugdunensis by Southern blot analysis of 13 strains and
      sequencing of the S. lugdunensis agr-like locus (agr-sl). Northern blot analysis
      of cellular RNA revealed the presence of a transcript having homology with the
      agr-P3 transcript (RNAIII) for three of the six strains tested. The three strains
      containing this transcript produce a hemolysin with phenotypic properties similar
      to that of S. aureus delta-hemolysin. Nevertheless, unlike agr-P3 from S. aureus,
      agr-sl does not encode any potential peptide homologous to S. aureus delta
      hemolysin, suggesting that the hemolytic activity detected in S. lugdunensis is
      encoded elsewhere and may be controlled by agr-sl.

PMID- 8359674
TI  - Phototaxis genes on linkage group V in Dictyostelium discoideum.
AB  - During the course of mapping and complementation analysis of phototaxis (pho)
      mutations in Dictyostelium discoideum we have assigned to linkage group V three
      mutant pho alleles belonging to complementation groups phoG and phoK. These are
      the first genetic markers with an easily recognizable phenotype to be found on
      this linkage group.

PMID- 8359675
TI  - Identification of the mcrC gene product in Methanococcus vannielii.
AB  - The polypeptide encoded by the mcrC gene has been identified in Methanococcus
      vannielii by immunoblotting using rabbit antibodies raised against the product of
      a lacZ-mcrC gene fusion synthesized and purified from Escherichia coli. The mcrC
      gene product (gpmcrC) was located in both the supernatant and pellet fractions
      after centrifugation of Mc. vannielii cell extracts for 2 h at 100,000 x g. When
      anaerobic reducing conditions were maintained during purification, gpmcrC co
      sedimented through sucrose gradients to the same position as molecules of the
      methyl coenzyme M reductase holoenzyme (approx. 300 kDa). This co-sedimentation
      was lost under aerobic, nonreducing conditions.

PMID- 8359676
TI  - Construction of genetically marked Vibrio cholerae O1 vaccine strains.
AB  - Attenuated Vibrio cholerae O1 vaccine strains lacking the gene encoding the A
      subunit of cholera toxin have proven efficacious in preventing experimental
      cholera. As these strains move from closed, contained testing environments to
      large-scale field trials, a readily assayable phenotypic trait to distinguish a
      vaccine strain from wild-type V. cholerae O1 is desirable. We have constructed
      three derivatives of the attenuated V. cholerae strain CVD 103 which carry a
      mercury resistance or urease marker in the hlyA gene. CVD 103-HgR was constructed
      using a protracted marker-exchange procedure; this strain was found to have
      somewhat lowered colonisation efficiency in infant mice in comparison to its
      parent strain, CVD 103. The insertion of the resistance marker was repeated using
      a suicide vector system; CVD 103-HgR2 was found to colonise infant mice as
      efficiently as CVD 103. Strain CVD 103-UR, in which sequences encoding urease
      were inserted using a suicide vector, also colonised infant mice as well as CVD
      103. The genetically marked strains CVD 103-HgR, CVD 103-HgR2 and CVD 103-UR form
      the basis for a generation of defined oral vaccines that may give single-dose,
      long-lasting protection to populations at risk from cholera.

PMID- 8359677
TI  - A transformant of Aspergillus fumigatus deficient in the antigenic cytotoxin
      ASPFI.
AB  - The aspfI gene encoding a ribonucleotoxin, a putative virulence factor of
      Aspergillus fumigatus, was inactivated by gene disruption. Gene replacement
      through homologous recombination by the disrupted allele tagged by the hygromycin
      B resistance marker was performed by transformation of a pathogenic strain. One
      transformant with the disrupted aspfI gene failed to produce the ASPFI protein
      and was shown to be pathogenic for mice. We concluded that this ribotoxin is not
      a main factor in the colonization of the lung tissues by A. fumigatus.

PMID- 8359679
TI  - A kinetic study on the regeneration of Candida albicans protoplasts in the
      presence of cell wall synthesis inhibitors.
AB  - Aculeacin A and papulacandin B block cell wall regeneration in Candida albicans
      protoplasts at an intermediate step in which the protoplasts have not yet
      synthesized the rigid structure of the cell wall and are therefore still
      osmotically sensitive. In the presence of the antibiotics, total synthesis of
      glucan is not significantly lowered with respect to control cells, although most
      of it appears either in the culture medium or in the regenerating wall as alkali
      soluble glucan. Thus, it is proposed that echinocandins (such as aculeacin A) and
      papulacandins may not inhibit glucan synthesis per se but instead inhibit its
      incorporation into the supramolecular organization of the cell wall.

PMID- 8359678
TI  - Structural features of a polygalacturonase gene cloned from Aspergillus oryzae
      KBN616.
AB  - A genomic gene encoding a polygalacturonase from Aspergillus oryzae, used in soy
      sauce production, was cloned and sequenced. The structural gene comprises 1227 bp
      coding for 363 amino acids with a putative prepropeptide of 28 amino acids and
      the open reading frame is disrupted by two short introns of 57 bp and 81 bp. The
      deduced amino acid sequence of the mature protein showed 63, 63, 63 and 64%
      homology with those of Aspergillus niger polygalacturonase I, Aspergillus niger
      polygalacturonase II, Aspergillus tubingensis polygalacturonase II and
      Cochliobolus carbonum polygalacturonase, respectively. There is, however, little
      homology among fungal, plant and bacterial polygalacturonases.

PMID- 8359680
TI  - Prevalence of a Vibrio cholerae 18-kDa antigen in vibrios.
AB  - An 18-kDa protein that occurs in Vibrio cholerae has been described as an in vivo
      and low-iron regulated outer membrane antigen. Monoclonal antibodies which
      recognized this antigen were protective as passive vaccines in the infant rabbit
      model of cholera disease. In this study, those monoclonal antibodies were used in
      three immunological assays for surveillance of various bacteria for the 18-kDa
      antigen. ELISA, and Western blot assays gave variable results with bacteria or
      outer membrane preparations. The biodot assay was the most sensitive test,
      detecting the 18-kDa antigen in 29 of 29 V. cholerae strains, independent of
      biotype or serotype. A few other Gram-negative bacteria and V. parahaemolyticus
      reacted weakly with our antibodies and antiserum.

PMID- 8359681
TI  - Expression of the exoglucanase gene in yeast and hyphal forms of Candida
      albicans.
AB  - The gene for the beta-(1,3) exoglucanase of Candida albicans was used as a probe
      to detect transcripts of related genes in C. albicans and in several other
      Candida species. A single homologous transcript was detected in all of the
      species tested. Expression of the exoglucanase gene in C. albicans was found to
      be coincident with the onset of growth and the levels of the transcript were
      proportional to the growth rate. Comparable levels of the transcript were
      produced during yeast and hyphal forms of growth.

PMID- 8359682
TI  - Nucleotide sequence analysis and heterologous expression of the Erysipelothrix
      rhusiopathiae dnaJ gene.
AB  - DNA sequence analysis of chromosomal DNA from the Gram-positive facultative
      intracellular pathogen, Erysipelothrix rhusiopathiae has identified a dnaJ heat
      shock gene homolog. A 1109-bp open reading frame encoding dnaJ is located
      immediately 3' to the E. rhusiopathiae dnaK gene. The deduced DnaJ amino acid
      sequence exhibits the modular structure of other members of the DnaJ protein
      class including a glycine-rich region and the repeating consensus sequence
      CXXCXGXGX. Heterologous expression of the dnaJ sequence in Escherichia coli
      resulted in accumulation of a unique 38.9-kDa protein with an isoelectric point
      of 8.0. Deletion analysis of the dnaJ gene was used to confirm that the
      overproduced protein was encoded by the dnaJ sequence.

PMID- 8359683
TI  - Comparison of barley malt alpha-amylase isozymes 1 and 2: construction of cDNA
      hybrids by in vivo recombination and their expression in yeast.
AB  - Germinating barley produces two alpha-amylase isozymes, AMY1 and AMY2, having 80%
      amino acid (aa) sequence identity and differing with respect to a number of
      functional properties. Recombinant AMY1 (re-AMY1) and AMY2 (re-AMY2) are produced
      in yeast, but whereas all re-AMY1 is secreted, re-AMY2 accumulates within the
      cell and only traces are secreted. Expression of AMY1::AMY2 hybrid cDNAs may
      provide a means of understanding the difference in secretion efficiency between
      the two isozymes. Here, the efficient homologous recombination system of the
      yeast, Saccharomyces cerevisiae, was used to generate hybrids of barley AMY with
      the N-terminal portion derived from AMY1, including the signal peptide (SP), and
      the C-terminal portion from AMY2. Hybrid cDNAs were thus generated that encode
      either the SP alone, or the SP followed by the N-terminal 21, 26, 53, 67 or 90 aa
      from AMY1 and the complementary C-terminal sequences from AMY2. Larger amounts of
      re-AMY are secreted by hybrids containing, in addition to the SP, 53 or more aa
      of AMY1. In contrast, only traces of re-AMY are secreted for hybrids having 26 or
      fewer aa of AMY1. In this case, re-AMY hybrid accumulates intracellularly.
      Transformants secreting hybrid enzymes also accumulated some re-AMY within the
      cell. The AMY1 SP, therefore, does not ensure re-AMY2 secretion and a certain
      portion of the N-terminal sequence of AMY1 is required for secretion of a re
      AMY1::AMY2 hybrid.

PMID- 8359684
TI  - Isolation and characterization of the chicken cystatin-encoding gene: mapping
      transcription start point and polyadenylation sites.
AB  - A 6.9-kb fragment containing coding sequences for chicken egg white cystatin
      (CsnEW) was isolated from a chicken genomic library using the CsnEW cDNA as a
      probe. The gene is approximately 2.4 kb in length; it contains three exons, two
      introns and two polyadenylation signals. The exon-intron arrangement corresponds
      exactly with those of other members of the Csn superfamily. The sequence of the
      5' flanking region contains two SP1-binding sites and a high G+C content
      suggestive of a housekeeping gene. All tissues studied express CsnEW mRNA;
      Northern analysis showed that CsnEW mRNA levels are most abundant in lung and
      least abundant in liver and spleen. Mapping of the 3' end of the CsnEW mRNA
      isolated from brain tissue resolved two CsnEW mRNA species. The larger transcript
      resulting from the use of the second polyadenylation signal was more abundant
      than the smaller transcript. Determination of the transcription start point (tsp)
      of CsnEW mRNA by primer extension and RNase protection assays showed that CsnEW
      mRNA from a number of chicken tissues was approximately 40-50 nucleotides shorter
      than that predicted from the CsnEW cDNA isolated from chicken oviduct.

PMID- 8359685
TI  - Structure determination and evolution of the chicken cDNA and gene encoding
      prepropancreatic polypeptide.
AB  - We have previously demonstrated that the C-terminal regions of the rat and human
      pancreatic polypeptide (PPP) precursors exhibit a high degree of divergence,
      whereas the N-terminal regions are highly conserved. This blend of structural
      conservation and divergence in the precursors appears to be caused by splice
      junction sliding and translational frameshift in the 3'-region of the PPP gene
      [Yonekura et al., J. Biol. Chem. 263 (1988) 2990-2997]. In the present study, we
      determined the nucleotide (nt) sequences of the chicken PPP (cPPP) cDNA and gene,
      and compared them with those of the mammals. In cPPP, the C-terminal region of
      the precursor is quite heterologous with respect to the rat (rPPP) and human
      (hPPP) precursors, and this heterogeneity is accentuated by the large deletion in
      exon 3 of cPPP. Furthermore, mutational accumulation during evolution caused the
      structural organization of the 3'-region of cPPP to change; cPPP is terminated in
      exon 3, whereas rPPP and hPPP are terminated in exon 4. Thus, our previous
      observation regarding the possibility of 'mosaic evolution' [Yamamoto et al., J.
      Biol. Chem. 261 (1986) 6156-6159] of PPP has been extended and confirmed by this
      study. Available evidence suggests that 'mosaic evolution' is a phenomenon unique
      to PPP, and not to the genes encoding the other members of the PPP family,
      neuropeptide-Y and peptide-YY.

PMID- 8359686
TI  - Isolation and characterization of the genes encoding mouse and human type-5 acid
      phosphatase.
AB  - The gene (mT5AP) encoding murine type-5 acid phosphatase has been isolated and
      completely sequenced while the gene (hT5AP) encoding human T5AP has been partly
      sequenced. The murine gene spans 4 kb and contains five exons. Exon 1 is
      completely non-coding and exon 2 starts with the initiation codon in both mT5AP
      and hT5AP. The positions of the intron/exon boundaries are completely conserved
      between mT5AP and hT5AP, but are distinct from the gene encoding the related
      porcine protein, uteroferrin (Utf). There is strong homology at both the
      nucleotide (nt) and amino acid (aa) levels between the inferred mouse cDNA and
      the sequences of rat T5AP and hT5AP, and pig Utf. The mT5AP and hT5AP genes were
      found to have multiple transcription start points (tsp) by primer extension
      analysis, consistent with the absence of a consensus TATA box. The sequences for
      the 5'-flanking regions of mT5AP and hT5AP were determined to -1.6 and -1.0 kb,
      respectively, relative to the tsp. A 2-kb segment of the mT5AP 5' flanking region
      linked to a luciferase-encoding reporter gene (Luc) was sufficient to direct
      tissue-specific transcription in the mouse macrophage cell line, RAW264.
      Significant sequence similarity between the mT5AP and hT5AP promoters is
      restricted to the most proximal 200 bp, which also resembles the porcine Utf
      gene, and a 300-bp segment 700 bp upstream. A progesterone-response element is
      present only in the mouse promoter and the estrogen- and iron-response elements
      described previously in the pig gene are absent from both the mouse and human
      genes. These differences may result in distinctive regulation of T5AP and Utf
      expression.

PMID- 8359687
TI  - Sequence of a cDNA encoding the beta 4 subunit of murine integrin.
AB  - A cDNA coding for the beta 4 subunit of murine integrin (m beta 4) has been
      cloned and sequenced using mRNA from a murine lung carcinoma as the template. The
      5' sequence contains two AUG codons, the second of which initiates synthesis of
      the mature protein. The cDNA sequence has an open reading frame coding for 1748
      amino acids (aa), including a signal peptide, cysteine-rich region, serine- and
      threonine-rich region, transmembrane domain, and a cytoplasmic domain of over
      1000 aa. Overall, the deduced m beta 4 aa sequence has 88% identity with the
      human beta 4 subunit (h beta 4) sequence deduced from the sequence of placental
      mRNA. Reverse transcriptase-polymerase chain reaction using primers flanking
      splice sites for two variant forms of h beta 4 transcripts provided evidence for
      alternate splicing of RNA in the murine spleen and to a lesser extent in the
      skin, uterus, and thymus but was found at only one of the two alternative sites.
      Five potential glycosylation sites present in the extracellular domain of h beta
      4 are conserved in m beta 4. One tyrosine in the terminal region of the
      cytoplasmic domain (position 1600) is conserved between m beta 4 and h beta 4 and
      has the consensus sequence for tyrosine phosphorylation. Finally, a genomic
      restriction map of m beta 4 shows that the gene is about 40 kb in length. No
      restriction-fragment length polymorphisms were detected between BALB/c liver and
      BALB/c lung carcinoma DNA.

PMID- 8359689
TI  - Partial characterization of a novel 'GGA' factor which binds to the osteonectin
      promoter in bovine bone cells.
AB  - Osteonectin (On)/SPARC (secreted protein, acidic and rich in cysteine) is a
      highly conserved extracellular matrix protein found in bone and other tissues
      throughout vertebrate evolution. In previous studies, approximately 500 bp of DNA
      5' to the transcription start point (tsp) and a part of exon 1, including
      homopurine (Rn)/homopyrimidine (Yn)-rich sequences (the 'GGA box' and its
      complements), was demonstrated to be important in upregulation of On gene
      expression in a cell-specific manner. The purpose of this study was to decipher
      the transcriptional regulation of On through its cis- and trans-acting elements.
      DNase I footprinting analysis indicated protein binding which may be related to
      the transcriptional factors, AP2, SP1 and a novel 'GGA' factor which binds to the
      3' end of the promoter (-286 to +43 to the tsp). Comparisons of footprinting
      between nuclear extracts of bone (On-expressing) cells and Madin and Darby bovine
      kidney (MDBK) (nonexpressing) cells indicate that 'GGA' factor binding to a
      purine GGGGA/GGA-rich sequence is cell-type specific and therefore may be
      involved in the cell-specific expression of this gene. From ultraviolet (UV)
      crosslinking experiments, this 'GGA' factor was demonstrated to be a single 40
      kDa protein.

PMID- 8359688
TI  - Transcriptional regulation of the gene encoding cholesterol 7 alpha-hydroxylase
      in the rat.
AB  - The cytochrome P450 enzyme, cholesterol 7 alpha-hydroxylase (CYP7A), catalyses
      the first and rate-limiting step in the conversion of cholesterol to bile acids.
      Expression of the CYP7A gene is under complex physiological control, encompassing
      amongst others a feedback down-regulation by bile acids. Using the CYP7A cDNA of
      the rat as a probe, we isolated a rat genomic clone containing the 5' part of the
      gene, including approximately 3.6 kb of upstream sequences. Sequence analysis
      revealed the presence of several putative regulatory elements. Transient
      expression analyses of transfected primary hepatocytes demonstrated that the
      major transcription-activating region is located in the proximal 145 nucleotide
      (nt). Upon addition of taurocholate to the culture, a significant reduction of
      the transcriptional activity was observed, suggesting the presence of a bile acid
      responsive element in the proximal region of the CYP7A promoter. In addition,
      evidence was obtained for the presence of a thyroxine-responsive site further
      upstream. After addition of taurocholate, steady-state CYP7A mRNA levels, as
      judged by Northern analysis of hepatocyte RNA, are eightfold reduced. On the
      other hand, the transcriptional activity of CYP7A, as shown both in CAT assays
      and run-on experiments, revealed only a threefold decrease. These experiments
      suggest that both transcriptional control and regulation of CYP7A mRNA stability
      play an important part in the feedback regulation of CYP7A activity in the rat.

PMID- 8359690
TI  - An engineered PGK promoter and lac operator-repressor system for the regulation
      of gene expression in mammalian cells.
AB  - Previous reports have demonstrated that the Escherichia coli lac repressor can
      operate effectively in mammalian cells to repress expression of genes driven by
      modified viral or metallothionein (MT) promoters. We have developed a more
      general expression system using the promoter from the PGK1 gene (encoding murine
      3-phosphoglycerate kinase) which is widely expressed in almost all cell types,
      including early embryonic and ES (embryonic stem) cells. Firstly, we engineered
      the lac repressor to include a nuclear localisation signal and placed it under
      control of the PGK1 promoter. Efficient nuclear localisation of the repressor was
      demonstrated by mobility-shift assays and immunofluorescence detection. For the
      target vectors, we modified the wild-type (wt) PGK1 promoter to include lac
      operator (lacO) sites for binding of the lac repressor and compared a number of
      different lacO positions and arrangements based on proximity to the native start
      points for transcription (tsp) and translation. In the absence of repressor, we
      observed reduced expression of the neo reporter gene for some placements of the
      lacO, but wt expression for placements near the tsp. When both target and
      repressor were present in the cells, we observed that the expression of neo could
      be strongly suppressed and reversibly regulated by induction with IPTG. In
      particular, for a promoter which contained two spaced lacO replacing native
      sequence around the major tsp, we observed 90-95% repression by the lac repressor
      for the neo reporter gene and up to 98% repression for the cat reporter gene.
      Efficient derepression by IPTG was observed in both cases.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8359691
TI  - The Aspergillus niger carbon catabolite repressor encoding gene, creA.
AB  - In order to undertake a comparative analysis of carbon catabolite repression in
      two Aspergillus species, the creA gene has been isolated from A. niger by cross
      hybridization, using the cloned A. nidulans gene. The A. niger gene has been
      shown to be functional in A. nidulans by heterologous complementation of the
      creA204 mutation of A. nidulans. Overall, the genes show 90% sequence similarity
      (82% identity) at the amino acid (aa) level. There were some striking
      similarities between the aa sequences encoded by the two fungal creA genes and
      two genes involved in carbon catabolite repression in Saccharomyces cerevisiae.
      The zinc-finger regions showed 96% similarity (84% identity) with the zinc-finger
      region of the MIG1 gene of S. cerevisiae. The CREA protein contains a stretch of
      42 aa that is identical in A. niger and A. nidulans, and these show 81%
      similarity (33% identity) with a region of the S. cerevisiae RGR1 gene.

PMID- 8359692
TI  - The 59-kDa polypeptide constituent of 8-10-nm cytoplasmic filaments in Neurospora
      crassa is a pyruvate decarboxylase.
AB  - The fungus Neurospora crassa harbors large amounts of cytoplasmic filaments which
      are homopolymers of a 59-kDa polypeptide (P59Nc). We have used molecular cloning,
      sequencing and enzyme activity measurement strategies to demonstrate that these
      filaments are made of pyruvate decarboxylase (PDC, EC 4.1.1.1), which is the key
      enzyme in the glycolytic-fermentative pathway of ethanol production in fungi, and
      in certain plants and bacteria. Immunofluorescence analyses of 8-10-nm filaments,
      as well as quantitative Northern blot studies of P59Nc mRNA and measurements of
      PDC activity, showed that the presence and abundance of PDC filaments depends on
      the metabolic growth conditions of the cells. These findings may be of relevance
      to the biology of ethanol production by fungi, and may shed light on the nature
      and variable presence of filament bundles described in fungal cells.

PMID- 8359693
TI  - Functional domains of the transcriptional activator NUC-1 in Neurospora crassa.
AB  - The NUC-1 regulatory protein directly controls the transcription of these genes
      and how the activity enzymes in Neurospora crassa. To understand how NUC-1
      regulates the transcription of these genes and how the activity of NUC-1 is
      modulated by other regulatory proteins, two putative functional domains of NUC-1
      were analysed: the DNA-binding domain and the regulatory domain. The DNA-binding
      activity of NUC-1 has not been directly demonstrated; however, results of
      deletion analysis, sequence analysis of the nuc-1 mutant alleles, and strong
      sequence similarity with the Saccharomyces cerevisiae PHO4 protein strongly
      suggest that the basic helix-loop-helix motif of NUC-1 forms a DNA-binding
      domain. Deletion and mutant analyses revealed that 39 amino acid (aa) residues
      (aa 463 to 501), or fewer, of NUC-1 are interacting with the negative regulatory
      factor(s), the PREG and/or PGOV proteins.

PMID- 8359694
TI  - Characterization of the pyruvate kinase-encoding gene (pki1) of Trichoderma
      reesei.
AB  - The pyruvate kinase-encoding gene (pki1) from Trichoderma reesei was isolated by
      hybridization to the corresponding Aspergillus nidulans pkiA gene. The 1614-bp
      nucleotide (nt) sequence of the cloned gene codes for a 538-amino-acid protein.
      The coding sequence contains a single intron of 246 nt at a position identical to
      that of intron E in the A. nidulans gene. The PKI protein shows extensive
      homology to the PKIs of A. nidulans and A. niger (67%) and Saccharomyces
      cerevisiae (59%). The 5' non-coding sequence contains a number of motifs typical
      for yeast glycolytic genes, but so far only rarely found in filamentous fungi.

PMID- 8359695
TI  - Functional analysis of chicken vimentin distal promoter regions in cultured lens
      cells.
AB  - Synthesis of the cytoskeletal intermediate filament protein vimentin (Vim) in the
      lens is unexpected due to the mesenchymal preference of Vim-encoding gene (Vim)
      expression and the epithelial origin of the lens. Previous studies indicated that
      chicken Vim gene expression in cultured lens cells is regulated by both positive-
      and negative-acting sequence elements within the first -767 nucleotides (nt) of
      its promoter. Here, we demonstrate the existence of additional upstream chicken
      Vim promoter elements which function in transfected lens cells. Sequences within
      the nt -1360/-1156 region repressed promoter activity in transfected lens cells
      to levels lower than that observed for the previously defined more proximal
      repressor elements. The -1612/-1360 region activated promoter activity to levels
      similar to those observed for the strongest previously defined proximal promoter.
      The nt sequence analysis of the upstream promoter region revealed the presence of
      multiple consensus repressor and activator transcription-factor-binding sites.
      Several of these sites have been implicated for lens expression of enzyme
      crystallin-encoding genes (cry), suggesting that Vim expression may share
      features with the cry genes for recruitment and high-level expression in the
      lens.

PMID- 8359696
TI  - Transcription factor IID probes localize a single gene to the proximal region of
      mouse chromosome 17.
AB  - We have used a 5' fragment of the gene GTF2D, which encodes human transcription
      factor IID, and Chinese hamster-mouse somatic cell hybrids to map the murine
      homologue, Gtf2d, to a single locus on mouse chromosome 17 (Chr 17). Linkage
      analysis of progeny from an interspecific backcross localized the gene near the
      marker D17Leh66 in the proximal region of Chr 17.

PMID- 8359697
TI  - Sequence analysis of mouse cDNAs encoding ribosomal proteins L12 and L18.
AB  - Mouse cDNAs encoding ribosomal proteins (r-proteins), L12 and L18, were isolated
      and their sequences determined. The L12 cDNA was found to contain 639 bp,
      including a coding sequence of 498 nucleotides (nt), 5' (78 nt) and 3' (45 nt)
      untranslated regions (UTRs), and a poly(A) tail of 18 nt. The L18 cDNA was shown
      to consist of 648 bp, including a coding sequence of 567 nt, 5' (26 nt) and 3'
      (39 nt) UTRs, and a poly(A) tail of 16 nt. The nt sequences of the protein-coding
      region from the mouse L12 and L18 cDNAs were found to exhibit 96% and 92%
      identity, respectively, with those of the rat. With the use of mouse L12 and L18
      cDNA probes, multiple (at least 10) copies of the L12 and L18 gene families were
      shown to be present in the mouse and rat genomes. However, there was no sequence
      heterogeneity detected among seven L18 cDNA clones, indicating that only one copy
      of the L18 gene-related sequences is functional, and the other copies are
      presumably nonfunctional pseudogenes. The complete amino acid (aa) sequences of
      the mouse r-proteins, L12 and L18, were deduced from the nt sequences of their
      cDNA clones. L12 has 165 aa and a M(r) of 17,790, while L18 has 188 aa and a M(r)
      of 21,570. The aa sequences of the mouse r-proteins, L12 and L18, exhibit 98% and
      94% identity, respectively, to those of rat.

PMID- 8359698
TI  - cDNA cloning and mRNA expression of calponin and SM22 in rat aorta smooth muscle
      cells.
AB  - We cloned and sequenced cDNAs encoding calponin (Calp) and SM22 (smooth muscle
      specific 22-kDa protein) from rat aorta (RaA) smooth muscle (Smu) cells. The 1504
      bp calp cDNA contains a single open reading frame (ORF) which encodes 297 amino
      acids (aa) (M(r) 33,342). The 1186-bp SM22 cDNA contains a single ORF which
      encodes 201 aa (M(r) 22,601). There were 43% identical aa in a 181-aa overlap
      between RaA Calp and SM22. Especially for the C-terminal region of SM22 and for
      the first repeat motif of Calp, 70% identity was observed. Northern blot analysis
      revealed that the calp and SM22 mRNAs were expressed in RaA Smu, but not in rat
      cardiac and skeletal muscles. SM22 mRNA was much more abundant than calp mRNA in
      RaA (3- to 4-fold). The expression levels of the calp and SM22 mRNAs in RaA
      showed a significant increase for 5 to 15 week old rats (1.5- to 3-fold) with
      vascular development and blood pressure elevation. No significant differences
      were observed in the expression of the RaA calp and SM22 mRNAs between
      normotensive (Wistar Kyoto) and spontaneously hypertensive rats (SHR).

PMID- 8359699
TI  - Cloning and sequencing of the cDNA encoding a mouse IL-2 receptor gamma.
AB  - A mouse cDNA encoding an interleukin-2 receptor gamma (mIL-2R gamma) was cloned.
      The primary amino acid sequence deduced from the nucleotide sequence exhibits 70%
      overall similarity with human IL-2R gamma and, in particular, the predicted
      cytoplasmic region shows a higher degree of similarity (about 84.7%).

PMID- 8359701
TI  - [Profile of Prof. emeritus M.C. Alfonso Alvarez Bravo].

PMID- 8359700
TI  - Sequence of a cDNA encoding dog insulin-like growth factor I.
AB  - Polymerase chain reaction amplification of a cDNA derived from dog left
      ventricular myocardium, using primers specific for rat insulin-like growth factor
      I (IGFI), exons 3 and 6, yielded the dog clone, IGFI5.1. This clone includes the
      signal peptide sequence, the entire coding sequence for mature dog IGFI and the C
      terminal extension sequence. By analogy with the organization of the rat and
      human IGFI genes which encode two extension peptides, we have termed this cDNA,
      dog IGFIa. The deduced amino acid sequence of mature dog IGFI is identical to
      that of human IGFI.

PMID- 8359702
TI  - [Assisted reproduction. Alternatives].
AB  - From the first publications about fertilization in vitro (FIVTE) Patrick Steptoe
      and Robert Edwards, added several knowledges and new concepts in modern
      Gynecology, so starting a new era of Reproductive Medicine, so ideating a series
      of programs and methodologies to emulate the physiological ovarian cycle; with
      this concept Ricardo Asch carries the transference of gametes to tubes and
      calling this procedure GIFT. These methodologies with a high technology have been
      called Assisted Reproduction, which is reviewed in this paper.

PMID- 8359703
TI  - [Vaginal intraepithelial carcinoma. Diagnosis and management].
AB  - At the Colposcopy Clinic, Hospital "Luis Castelazo Ayala", from January 1990 to
      May, 1991, 24 cases of vaginal intraepithelial neoplasia, were diagnosed. The
      average age of the patients was 54.2 years. Twenty had antecedents of previous
      hysterectomy; seven (29%) with benign pathology, and twelve (50%) with malignant
      pathology. Only four patients (17%) presented with symptomatology. In all the
      cases it was suspected by abnormal cytology. Colposcopy was done, as well as
      directed biopsy, finding that the pointillism and white epithelium, were the most
      frequent findings, with localization mainly in the vaginal cupule and vaginal
      upper third. Histopathological correlation showed NIVa I in three cases (13%)
      NIVa II in six cases (25%), and NIVa III in 15 (62%). Treatment was done with
      cryotherapy in 10 patients; with 5-fluorouracil in eight; cryotherapy plus 5
      fluorouracil in three; radiotherapy in two, and it was not done in one. It was
      found persistent lesion in two cases treated with cryotherapy, and in one case
      with radiotherapy; there was a complication in one case after cryotherapy
      (retrovaginal fistula). Vaginal cytology should be done in every patient after
      hysterectomy, by benign or malignant pathology. In NIVa the colposcopic study is
      mandatory for the adequate diagnosis. 5-Fluorouracil showed to be an adequate
      treatment.

PMID- 8359704
TI  - [Seven-year experience with microsurgery].
AB  - From 700 laparoscopies performed, in 600 of them (85.7%) the tuboperitoneal
      factor was altered. Surgery included: termino-terminal plastia 70 cases (36%), (3
      patients had previous plastia); adhensiolysis 62 (31%), salpingostomy 48 (24%),
      neoimplantation 10 (5%), and mixed surgery 9 (4%). After surgery, desertion was
      present in 78 patients. Of the 121 remaining, 34 (28.1%) had primary sterility
      and 87 (71.9%) secondary sterility. 74 patients (61.2%) obtained pregnancy, 62
      (83.8%) reached term, seven were abortions of first trimester (9.5%) and were
      five ectopic pregnancies (6.7%). The interval between surgery and pregnancy
      achievement was 1 to 48 months, 12.8 months average. We emphasize the 47 patients
      analysis who didn't has pregnancy, through: remark time after surgery,
      histerosalpingography, new laparoscopy and reevaluation of sterility factors; the
      results were: 19 cases (40.5%) have a 5 to 60 months time after surgery, 19.5
      months average, 18 (38.3%) had new tubary obstruction, three (6.4%) with
      endometriosis treatment, three (6.4%) have tuberculosis genital treatment, two
      (4.2%) with falling again endocrine-ovarian factor, and two (4.2%) with masculine
      relapse. A decease was present because anesthetic complication. We underline
      selection surgery criterion and a strictly evaluation, such as an antiadhesion
      pre, trans and postoperative regime, ligamentopexya of rounds ligaments and a
      conscious education of the patients in their strictly pursuit.

PMID- 8359705
TI  - [Effect of L-arginine and polyamines on sperm motility].
AB  - The biochemical and physiological relevance of L-arginine is described in the
      male reproductive system. This amino acid has been used successfully in the
      treatment of some reproductive diseases. L-arginine is the precursor in the
      synthesis of putrescine, spermidine and spermine. It has been suggested that
      these polyamines have important role as initiators in the spermatic motility
      processes. Some practical uses for L-arginine are proposed.

PMID- 8359706
TI  - [Perforation of the large intestine caused by a type 7 medicated copper IUD].
AB  - A case of large bowel perforation at sigmoides level, secondary to application of
      a "medicated" intrauterine contraceptive device (IUD), Copper-7, is presented.
      This variety of IUD translocated to peritoneal cavity may provoke peritoneal or
      omental adhesions, volvulus, uterocutaneous fistula and bowel perforation, which
      involves a significant morbidity. The diagnosis is often delayed and difficult to
      establish, but, once knowing the exact location of ectopic IUD, it is justified
      the immediate removal from the peritoneal cavity by either laparoscopy or
      laparotomy with the utilization of prophylactic antimicrobials for colon
      preparation before elective surgery.

PMID- 8359707
TI  - Visualization of iron in cultured macrophages: a cytochemical light and electron
      microscopic study using autometallography.
AB  - The objective of this study was to develop a sensitive cytochemical method for
      the visualization of iron, both at light microscopical (LM) and at electron
      microscopical (EM) levels, in glutaraldehyde-fixed cultured cells with reasonable
      morphological preservation. The method is based on autometallography (also called
      the sulfide silver method or the Timm technique). Gold, silver, and various metal
      sulfides have previously been shown to act as catalysts for cellular silver
      deposition from a physical developer (autometallography). In our modification of
      this cytochemistry, a high pH is used during the initial sulfidation step to
      guarantee adequate levels of sulfide ions to generate enough Fe(II or III)
      sulfide. Since this procedure may cause severe cellular distortion, we initially
      stabilize the cultured cells by a glutaraldehyde fixation. We have compared our
      new high pH, high S2- LM and EM variety of autometallography with other
      modifications of this technique that have previously been used for LM and EM
      demonstration of easily sulfidated heavy metals, such as zinc. Cultured mouse
      macrophages were examined for the localization of reactive metals following
      endocytosis of ferritin or inorganic Fe(III) iron. Ag-precipitates, presumed to
      indicate the presence of iron, were predominantly found within secondary
      lysosomes of the acidic vacuolar apparatus. The relation of the Ag-precipitates
      to iron was proven by the fact that iron-exposed cells showed a much reduced
      amount of silver precipitates after subsequent exposure to deferoxamine a potent
      iron chelator. Moreover, control macrophages neither exposed to iron nor to
      ferritin showed only a low normal lysosomal content--and a few extralysosomal
      sites--of reactive substances, believed to be iron.

PMID- 8359708
TI  - Effects of reactive oxygen species on arachidonic acid metabolism in rabbit
      platelets.
AB  - Rabbit platelets were exposed to a reactive oxygen species (ROS) generating
      system (xanthine plus xanthine oxidase) to explore the effect of ROS on the
      formation of 12-hydroxy-5,8,10,14-eicosatetraenoic acid (12-HETE), thromboxane
      (TX) B2, and 12-hydroxy-5,8,10-heptadecatrienoic acid (HHT) from exogenous
      arachidonic acid. Xanthine plus xanthine oxidase suppressed the production of 12
      HETE, TXB2, and HHT by 65-69%. This effect was reversed by addition of catalase
      to the ROS generating system but not by superoxide dismutase, mannitol, or
      dimethylsulfoxide, indicating that H2O2 is the responsible metabolite. These
      results suggest that H2O2 plays an important role in the regulation of platelet
      cyclo-oxygenase and lipoxygenase activities.

PMID- 8359709
TI  - Inhibition of lipoxygenase and cyclooxygenase augments cardiac injury by H2O2.
AB  - The role of arachidonic acid metabolites in the cardiac effects of toxic oxygen
      metabolites (TOM) was investigated in buffer-perfused rat hearts (Langendorff
      model). Hydrogen peroxide (H2O2, 200 microM) was given for 10 min to generate
      TOM, followed by 30 min recovery. H2O2 reduced left ventricular developed
      pressure (LVDP), increased left ventricular end-diastolic pressure (LVEDP), and
      increased coronary flow (CF). The hydroxyl radical scavenger thiourea inhibited
      the H2O2-induced effects. Perfusion with three lipoxygenase inhibitors, AA861,
      BWA4C, and diethylcarbamazine, in addition to H2O2, augmented the decrease of
      LVDP and the increase of LVEDP induced by H2O2. The cyclooxygenase inhibitor
      indomethacin had the same effects. The H2O2-induced increase in CF was not
      influenced by diethylcarbamazine, but inhibited by all other drugs. Control
      perfusion with drugs alone did not influence cardiac function. In conclusion,
      inhibition of lipoxygenase and cyclooxygenase augmented the depression of cardiac
      function induced by TOM. Leukotrienes and prostanoids appear to be protective
      against H2O2-induced cardiac injury.

PMID- 8359710
TI  - Ferrous-iron-induced oxidation in chicken liver slices as measured by hemichrome
      formation and thiobarbituric acid-reactive substances: effects of dietary vitamin
      E and beta-carotene.
AB  - Hemichrome formation in chicken liver slices was determined by employing a Heme
      Protein Spectra Analysis Program (HPSAP) on the visible spectrum of the liver
      tissue. Relative hemichrome formation (RHF) in liver tissue exposed to ferrous
      iron for 1 h at 37 degrees C could be predicted according to the general
      catalytic equation RHF = k.[Fe2+]/(Ap + [Fe2+]), with k = 132 +/- 30, where the
      factor Ap represents the additive antioxidative potential in the liver tissue.
      RHF in Fe2+ exposed liver slices incubated at 37 degrees C for 1 h correlated
      significantly with formation of thiobarbituric acid-reactive substances (TBARS)
      (r = .77, P < .0001). RHF was found to decrease significantly with increasing
      vitamin E concentration in liver tissue exposed to ferrous iron (1 h, 37 degrees
      C). However, the influence of beta-carotene on RHF in ferrous-iron exposed liver
      slices (1 h, 37 degrees C) was less evident, as the concentration of Fe2+ was
      found to be decisive for whether beta-carotene acted as an antioxidant or a
      prooxidant under the conditions in question. Results in the liver slice model
      system regarding the effect of vitamin E and beta-carotene on iron overload were
      supported in a subsequent in vivo iron injection experiment with chicks. These
      observations indicate that RHF is a sensitive marker for ferrous-iron-induced
      oxidative damage in the present tissue slice system.

PMID- 8359711
TI  - Increased generation of reactive oxygen species in embryos cultured in vitro.
AB  - Previous studies have suggested that oxygen toxicity is closely related to the
      developmental blockage of embryos cultured in vitro. In this study, to obtain an
      actual proof of the increase in production of reactive oxygen species within
      embryos, we have measured the level of H2O2 in individual embryos using a
      fluorimetric method. Mouse (ICR) pronuclear stage embryos from the oviducts were
      cultured for a specified time under various conditions in a medium to which 2',7'
      dichlorodihydrofluorescin diacetate was added. After washing the embryos, the
      fluorescence emissions of the H2O2-dependent oxidative product in embryos were
      measured. The fluorescent emissions were lowest in embryos cultured under 5% O2
      and highest under 40% O2 (5% < 20% < 40%), just the inverse of the culture
      efficacy. The fluorescence emmissions of embryos cultured in Ham's F-10, which
      contains hypoxanthine and transition metals such as Cu and Fe, were higher than
      those cultured in BWW and alpha MEM, which do not contain these components (alpha
      MEM < BWW < Ham's F-10; again this is the inverse of the culture efficacy). The
      fluorescence emissions of embryos increased with the time of the exposure to
      visible light. L-cysteine and thioredoxin, both of which have been shown to
      promote embryo development, decreased the fluorescence emissions of embryos. All
      of these results would provide direct evidence for the hypothesis that oxygen
      radicals are involved in the developmental blockage.

PMID- 8359712
TI  - Current status of antioxidant therapy.
AB  - There is evidence that free radical damage contributes to the aetiology of many
      chronic health problems such as emphysema, cardiovascular and inflammatory
      diseases, cataracts, and cancer. In this review we are not concerned with tissue
      damage in vivo induced directly by radicals from exogenous sources, such as air
      pollutants and tobacco smoke, high-pressure oxygen, irradiation, or through the
      metabolism of certain solvents, drugs, and pesticides. Rather, we address some of
      the disease states associated with increased oxidative stress from endogenous
      sources and the possible therapeutic advantage of the antioxidant treatment. This
      raises the question of the antioxidant status of individuals and its role in
      protection against amplification of certain disease processes. We have chosen to
      concentrate mainly on coronary heart disease, reperfusion injury, and organ
      storage for transplantation.

PMID- 8359713
TI  - Alterations in free radical scavenging mechanisms following blood-brain barrier
      disruption.
AB  - It has been reported earlier that rat microvessels which constitute the blood
      brain barrier (BBB) are rich in free radical scavenging enzymes. In the present
      investigation, BBB of rat was disrupted by intravenous infusion of the hypertonic
      saline and changes in enzymes--namely, superoxide dismutase (SOD), catalase
      (CAT), glutathione peroxidase (GPx), and glutathione reductase (GR)--were
      evaluated in the brain microvessels at 30 min after the intravenous
      administration of hypertonic saline, being the time of peak effect. There was a
      significant increase in the activities of CAT (40%), GPx (26%), and SOD (16%)
      over the control values. In addition, within 90 min BBB was found to be
      reestablished and the levels of enzymes reverted to normal. Malondialdehyde (MDA)
      levels and activity of lactate dehydrogenase (LDH) remained unaltered during and
      following disruption, suggesting that there was no change in the membrane lipid
      environment. Similarly, there was no cell lysis. The results suggest that the
      disruption of BBB following hypertonic saline administration might be due to an
      increase in the generation of free radicals in the brain microvessels.

PMID- 8359714
TI  - [Promotion program for breast feeding in Poland. II. Analysis of the breast
      feeding situation in Poland].
AB  - Assessment of breast-feeding situation in Poland was based on three kinds of
      nation-wide surveys conducted in 1988: newborn feeding and breast feeding
      routines in maternity wards epidemiology of breast-feeding and other feeding
      methods in first six months of infant life KAP study among MCH professionals The
      major findings of the surveys were: conflicting with lactation maternity wards
      routines especially: very initiation of breast-feeding, administration of liquids
      and formulas, rigid feeding schedule, separation of newborns from the mothers too
      early supplantation of breast-feeding lack of current breast-feeding knowledge
      among MCH professionals.

PMID- 8359715
TI  - [Accuracy of pretherapeutic diagnosis of early invasive cervical carcinoma].
AB  - In 114 women treated at the First Department of Gynecology Medical Academy in
      Cracow, between the years 1967-1985 there was compared the agreement of the
      histological examination of a colposcopy directed biopsy specimen with the
      histological examination of the operative specimen in cervical carcinoma with
      early invasion. In 103 cases (90.4%) histological examination of a guided biopsy
      specimen of early invasive carcinoma confirmed the results of the operative
      specimen. In 1 case the operative specimen confirmed severe dysplasia as in the
      guided biopsy specimen early invasive carcinoma. In 10 cases the guided biopsy
      specimen confirmed CIN 3 (6 cases severe dysplasia and 4 cases ca in situ), the
      results of operative specimen confirmed early invasive carcinoma. In 5 out the
      above 10 cases, the results were altered due to a 3-8 mouth delay of surgery. The
      divergence regards to the remaining 5 cases (4.4%). This high agreement of
      histological examination of a colposcopy guided biopsy specimen and operative
      specimen shows a significant accurate meaning of colposcopy in confirming early
      lesions of cervical carcinoma.

PMID- 8359716
TI  - [Removal of melanocytic nevi as a prophylaxis and early recognition of cutaneous
      and mucous malignant melanoma].
AB  - In article 1240 melanocytic nevi were described in which 26 melanomas were found.
      The authors present necessity of early removal (excision) of dysplastic
      melanocytic nevi, pigmented lesions with high risk of malignant transformation,
      giant congenital melanocytic nevi before adolescence and nevi which are irritated
      constantly. Particularly dysplastic nevi and pigmented lesions with high risk
      often contain melanoma "in situ" or invasive melanoma. Such a procedure early
      done, prevents developing of tumor and makes possible early recognition of
      melanoma but the procedure depends on a conscience of patients, members of their
      families, nurses and doctors.

PMID- 8359717
TI  - [Use of nalador for pregnancy termination in the second trimester].
AB  - The efficacy of Nalador in the induction of second trimester pregnancy
      termination in 23 pregnant women was assessed. The most frequent indications for
      pregnancy termination were: severe CNS malformations, chromosome aberrations,
      hydatidiform mole and missed abortion. In all treated cases Nalador was
      effective. There was no correlation between a total dose of Nalador needed for
      pregnancy termination and gestational age. The total dose of drug was not
      correlated with the indication to pregnancy termination. The important side
      effects were not observed. Neither in red and white blood cell patterns nor in
      blood clotting significant changes were found. The genital tract and uterine
      injury were not observed (in one case Nalador was administered to the patient who
      underwent caesarean section in the past). It has been concluded, that Nalador is
      effective, safe and free of side effects for the induction of the second
      trimester pregnancy termination.

PMID- 8359718
TI  - [Selected indices in perinatal evaluation of the newborn with respiratory
      disturbances. I. Usefulness in differential diagnosis].
AB  - There are several maternal and fetal factors, which may influence the development
      of respiratory disturbances in the newborn. Certain, indices of perinatal
      evaluation (delivery route, gestational age, birth weight, maturity degree, sex
      and Apgar score) in two groups of patients were compared. The first group
      compressed 36 newborns with Hyaline Membrane Disease (HMD), the second called
      aspiration--pneumonia (AP) group-44 newborns with other kinds of respiratory
      disturbances: 18 with pneumonia, 12 with fetal liquid aspiration syndrome, 8 with
      meconium aspiration syndromes and 6 with transient tachypnea. The diagnosis of
      each kind of respiratory disorder was based on the criteria of Hjalmarson. In
      both groups high percentage of newborn babies born by cesarean section (higher in
      AP group) was found. Hence the conclusion that the decision to perform this
      procedure should consider the risk of neonatal pulmonary complications. In the
      HMD group lower gestational age was found and in the AP group more babies were
      born with intrauterine dystrophy. In both groups prevalence of the male sex and
      low Apgar score was found.

PMID- 8359719
TI  - [Selected indices in perinatal evaluation of the newborn with respiratory
      disturbances. II. Prognostic value].
AB  - Respiratory disturbances are the most frequent causes of life-threatening
      situations in the newborn. In this paper evaluation indices of the newborn were
      compared in 2 groups of patients. The first comprised 36 babies with Hyaline
      Membrane Disease (HMD) with good or fatal outcome, in the second 44 newborns with
      Aspiration-Pneumonia (AP) syndromes were included. Prognostic value of following
      indices was considered: delivery route, gestational age, birth weight, maturity
      degree, sex and Apgar score. Bad prognostic value of low birth weight was found
      in the HMD group and low Apgar score and intrauterine dystrophy in the AP group.
      Mortality was similar in children delivered vaginally and by cesarean section in
      both groups of patients.

PMID- 8359720
TI  - [Breast dysplasia in women].
AB  - The current knowledge concerning the fibrocystic disease of the breast is
      presented in this work. The authors outlined the theoretical principles of the
      problem and the most important diagnostic methods as well as the prophylaxis and
      prognostic in the fibrocystic disease of the breast.

PMID- 8359721
TI  - [Risk factors in breast cancer].
AB  - This assay analyses the risk factors which have great importance in breast cancer
      pathogenesis. Having excluded the group of higher risk in women's population we
      can early detect this disease and treat it as well. It may extremely improve the
      results of breast cancer treatment.

PMID- 8359722
TI  - [Occult cervical cancer developing after diagnostic-therapeutic conization of CIN
      3].
AB  - A case of the so called occult cervical cancer which developed 2 years after the
      conisation performed in a 45-year old woman on account of CIN 3 has been
      described. Cancer was detected in the operative specimen of the removed uterus.
      Hysterectomy was performed on account of the progressive form of the myomas. The
      multiple colposcopy and cytological follow-up examination after conisation was
      always negative, just as the histological examination of the tissue specimen of
      the cervical canal. The hypothetical course of the development of the cancer has
      been discussed. In connection with the above findings a modification of the
      conisation technique, especially in older women, is suggested.

PMID- 8359723
TI  - [Simultaneous ectopic and intrauterine pregnancy].
AB  - The case simultaneous intrauterine and ectopic pregnancy was presented. The
      patient was admitted to the clinic, because of abdominal pain and vaginal
      bleeding. The curettage was performed and the trophoblastic tissue was removed.
      Five days later she was operated because of the rupture of the tube caused by
      ectopic pregnancy. The diagnosis was confirmed by histopathological examination.

PMID- 8359724
TI  - [Climacteric in the male--reality of fiction?].

PMID- 8359725
TI  - [A case of pregnancy with polycystic kidneys].
AB  - The authors described a course of pregnancy and delivery of pregnant women who
      was admitted to the hospital in the third trimester with symptoms of sepsis in
      course of the pyelonephritis. Signs of a kidney insufficiency and pulmonary
      oedema were observed. During hospitalization ultrasound examination showed
      polycystic kidneys.

PMID- 8359726
TI  - [Twin pregnancy with intrauterine death of one fetus].
AB  - A case of twin pregnancy with congenital malformations and intrauterine death of
      one fetus in the 27th week of pregnancy has been discussed. The pregnancy was
      continued with special care of the mother and the alive fetus. During all stay of
      the pregnant in the clinic no coagulation disturbances were observed. In the 33rd
      week of pregnancy spontaneous labour occurred, which was conducted by vaginal
      delivery. Simultaneously a macerated dead fetus and an alive premature newborn
      were born. The alive one was charged home in good condition in the 38th day of
      staying in the Neonatal Ward.

PMID- 8359727
TI  - [Promotional program for breast feeding in Poland. III. Proposed organizational
      implementation].
AB  - On the basis of the experience and data gained during breast-feeding situation
      assessment process (see Part II) the major activities of the breast-feeding
      promotion programme were identified as follows: 1. Training of health workers
      which aims the revision and change of practices in health services responsible
      for mother and child care. 2. Education of population about advantages of breast
      milk and breast-feeding management. The detailed project of the implementation of
      the programme on the national scale was presented.

PMID- 8359728
TI  - [Evolution of a method for breech deliveries during 1946-1990 in material from
      the 1st Obstetric Clinic of the Medical Academy in Wroclaw].
AB  - The analysis of 2191 breech deliveries in the 1st Obstetrics Clinic of Medical
      Academy in Wroclaw shows that there was a steady increase in the percentage of
      cesarean sections (from 0.8% in 1946-1955 to 59.6% in 1986-1990) and a decrease
      in the number of vaginal deliveries, especially manual procedures. The neonates
      born from cesarean section were generally in better condition than the ones born
      through vaginal delivery. There were also considerably fewer cases of trauma and
      perinatal mortality than in the natural delivery group. The greatest trauma and
      stillbirth rate has been observed in neonates after total extraction and in
      premature deliveries.

PMID- 8359729
TI  - [Value of vascular resistance in fetal circulation during normal pregnancy].
AB  - The aim of the study is to estimate the values of resistance index (RI) in the
      arteries of the fetus using color doppler ultrasound. Measurements have been made
      in aorta, umbilical and medial cerebral artery of the fetus and in arcuate artery
      of the pregnant women. 50 women have been examined every 4 weeks and another 50
      every 6 weeks during normal pregnancy. Resistance index has been calculated based
      on analyses of flow waves configuration in all of the mentioned arteries.
      Likeness between curves obtained in women examined every 4 and 6 weeks in
      obvious. The examination of mean RI values shows that vascular resistance in
      descending aorta remains constant during the vascular resistance in descending
      aorta remains constant during the all the period. In arcuate artery vascular
      resistance falls down until 22 week of pregnancy and then settles on constant
      level. RI of umbilical artery decreases during pregnancy and in median cerebral
      artery reaches its peak in 32/34 week of pregnancy.

PMID- 8359730
TI  - [Evaluation of surfactant administration in neonates with respiratory distress
      syndrome. III. The role of intra-uterine stimulation on lung maturity].
AB  - Prenatal corticosteroids and exogenous surfactant therapy independently reduce
      the adds of neonatal death by about 40%. It is not clear however if babies who
      develop RDS despite prenatal corticosteroid therapy behave differently when later
      given exogenous surfactant. This paper presents an evaluation of the outcome of
      babies treated with Curosurf (a porcine surfactant) for RDS depending upon
      whether they received prenatal corticosteroids (16 babies) or not (11 babies).
      Although not randomised these two groups of babies appear to be similar in
      respect of gestational age. However, lower mortality was found in the group
      treated with prenatal corticosteroids (12.5% vs. 27.2%).

PMID- 8359731
TI  - [Evaluation of ovulation induction in infertile women who are underweight].
AB  - The induction of ovulation in 74 underweight normally menstruated sterile women
      were analyzed with regard to the body mass index (BMI). The underweight patients
      presented 10.5% of the treated anovulatory women among them 4.8% presented
      serious weight loss. The concentration of serum gonadotropins and estradiol just
      before treatment did not allow to anticipate the results of therapy. The
      interesting observation concerned the cases with low concentration of serum FSH
      and LH which was more frequently found in nonresponding patients. The ovulatory
      ratio was not high and was comparable in all groups but pregnancy ratio in the
      responders was 1.5 times higher in slightly underweight patients. Among the
      nonresponders more than half of them demonstrated follicular growth confirmed by
      USC, serum estradiol and mucus viscosity.

PMID- 8359732
TI  - [Diagnostic value of mucin-like associated antigen (MCA) in neoplasms of the
      mammary gland].
AB  - The aim of the present study was to evaluate the diagnostic value of the new
      tumour marker MCA in serum from women with breast cancer. Relationship between
      presence MCA in serum and cER, cPgR, nER, nPgR in aqueous extracts from cancer
      tissues was subject of our investigation, too. Immunoenzymatic method (Roche)
      which employed monoclonal antibody MAb b-12 was used for determination of MCA in
      serum 49 operable patients (preoperative determination). In a group of 26 cancer
      patients MCA and cER, cPgR, nER, nPgR were tested simultaneously. Steroid hormone
      receptors were measured by immunoenzymatic method (Abbott). Mean concentration of
      MCA in women with breast cancer (n = 36) was higher as compared with control (n =
      21, p < 0.001). When 6.86 U/ml was took as mean level of MCA in control group it
      was found that 46% women with benign tumours, 64% with carcinoma ductal and 62%
      with carcinoma lobular have had concentrations of MCA below this value. Also it
      was found that differences between mean levels of MCA and cER, cPgR, nER, nPgR
      were statistical significance only in women with carcinoma ductal. On the basis
      of our own investigations we can suggest that MCA has limited value in the
      diagnosis of breast cancer.

PMID- 8359733
TI  - [Psycho-gynecologic reflections].

PMID- 8359734
TI  - [KOMPOR--Computer system for perinatal surveillance. I. System description].
AB  - The computer system of perinatal surveillance--KOMPOR-build by OBREAM-TEMED in
      Zabrze is described. This system enable to collect the personal data of patients,
      obstetrical anamnesis as well as very precise analysis "on line" of
      cardiotocographic records.

PMID- 8359735
TI  - [Unsaturated fatty acids of trans isomers in plasma of pregnant women and birth
      weight].
AB  - Trans unsaturated fatty acid originated from synthetic technology. Human
      consumption of trans isomers of unsaturated fatty acids increased markedly. The
      induction of growth failure was observed in animals when trans fatty acids were
      supplied. We studied whether or not there are indications of untoward effects of
      trans fatty acids in premature infants. Trans fatty acids were in higher
      concentrations in plasma of 23 women in pre-term delivery compared with 21 women
      delivering in normal term. Trans fatty acids in plasma were also inversely
      correlated to birth weight and with gestational age. These data indicate a
      impairment of intrauterine growth by trans isomer of unsaturated fatty acids.

PMID- 8359736
TI  - [Increased activity of aminotransferases (ALAT, AspAT) in pregnant women
      threatened with immature and premature delivery treated with fenoterol].
AB  - 2330 pregnant women were admitted to the 2nd Department of Pregnancy Pathology at
      the Polish Mother's Memorial Hospital (PMMH) in Lodz, Poland, during the period
      from 28th March, 1989 to 30th June, 1991. Out of the group 1055 pregnancies were
      treated because of the risk of premature delivery (45.28%). In five (5) cases a
      significant rise of ALAT and AspAT aminotransferase activity occurred during
      fenoterol therapy. Laboratory tests excluded infectious etiology in the rise of
      the enzymes in question (no markers typical for HBV, HAV infection). Toxic injury
      of hepatic cells being suspected, fenoterol therapy was withdrawn, followed by a
      decrease of aminotransferases activity to normal values in those five (5) cases.
      No increase in the activity of ALAT and AspAT occurred in further follow up of
      the pregnant women in pregnancy and in puerperium. Since no other hepatotoxic
      factors appeared, it may be assumed that a chronic administration of fenoterol
      can cause transient injuries of hepatic cells. For this reason all pregnant women
      treated with betamimetics require examinations of the liver.

PMID- 8359737
TI  - [Ultrasonographic evaluation of fetal weight in normal, single fetus pregnancies
      in the population of Wroclaw].
AB  - The aim of this paper was the analysis of the clinical usefulness of the nomogram
      presented by Hansmann for the fetal weight prediction in normal, single fetus
      pregnancies of Wroclaw population. The authors proved, that in the group of 36
      pregnant women the least difference between fetal weight evaluated before birth
      and the birth weight of newborn was noted in the group of babies with birth
      weight 2000-4000 g. In the group with birth weight below 2000 g and over 4000 g
      respectively, the twice to octuple evaluation error is expected.

PMID- 8359738
TI  - [Ultrasonographic evaluation of growth in twin pregnancies in the population of
      Wroclaw. I].
AB  - Authors have ultrasonographically evaluated and analysed appropriate parameters
      determining fetal growth in bigeminal pregnancies in the population of Wroclaw.
      The following parameters were taking in consideration: biparietal head dimension
      (BPD), transversal chest dimension (THD) and thigh bone length (FL). After the
      comparative analysis of the average BPD, THD, and FL values in fetuses from 28
      40th single fetus and bigeminal pregnancies authors revealed, that BPD and TDH
      values were significantly smaller in twins that single fetuses. No correlation
      was found in FL values in both groups. In the aim to obtain more accurate
      evaluation of intrauterine growth in twins. Authors proposed an application of
      special ultrasonographic BPD and THD parameters net-works, different from those
      applicable for primiparous pregnancies.

PMID- 8359739
TI  - [Ultrasonic evaluation of fetal growth of twins in the Wroclaw population. II.
      Proposed percentile curves of ultrasonographic parameters].
AB  - Authors analyzed and evaluated biparietal head dimension (BPD), transversal chest
      dimension (THD) and femur length (FL) measured in the fetuses from 28 to 40th
      week in bigeminal pregnancies on the material of Wroclaw population. Obtained
      results were presented as percentile curves of each parameter in succeeding weeks
      of pregnancy. In the face of findings in the 1st part of work (statistically
      lower parameters BPD and THD in twins in confrontation with fetuses in single
      fetus pregnancies and lack of correlations between FL dimensions), authors are of
      opinion that, for accurate evaluation of twins growth in examined population, in
      the period from 28 to 40 weeks of pregnancy, the application of
      ultrasonographical parameters net-work of BPD and THD parameters in necessary.
      Moreover, the authors are considering that the presented percentile BPD and THD
      curves may make a graphic image of twins intrauterine growth in the evaluated
      population.

PMID- 8359740
TI  - [Doppler flow evaluation of atrio-ventricular valve blood flow in the fetal heart
      during the second half of normal pregnancy].
AB  - 39 normal fetal heart examinations were evaluated since 20 week of gestation to
      term, and Doppler blood flow was analysed for mitral and tricuspid valves. The
      measurements were done always in good 4 chamber view and qualitative and
      quantitative analysis were performed, in terms of describing E and A waves and
      maximal velocity against gestational age. In all of the cases between 20 and 34
      weeks of gestation there were type E < A Doppler waveform, and since 35 week of
      gestation there was also type E = A. There were only 2 cases with type E > A,
      both near term. This Doppler waveform may depends on maturity of the fetal
      myocardium. The maximal velocity for the atrio-ventricular valves did not
      correlated with gestational age. The average max value for mitral valve was 43 +/
      10 cm/s and for tricuspid valve 50 +/- 11 cm/s (p < 0.01).

PMID- 8359741
TI  - [Diagnostic and therapeutic procedures in preinvasive disease of the cervix and
      cervical cancer in pregnancy].
AB  - 154 pregnant women with dysplasia and cervical carcinoma of the uterus treated in
      the Institute in years 1953-1990 underwent investigation. We notice that only 50
      pathologies were diagnosed in I trimester of pregnancy and 85% constituted
      precancerous and early forms of carcinoma of the uterine cervix. Authors
      presented the model of management and care of pregnancy, labour and puerperium in
      these patients. Due to this procedure we obtained 90% compatibility of
      preliminary and final diagnosis.

PMID- 8359742
TI  - [Micro-glandular hyperplasia of the cervix canal mucosa].
AB  - During the period of 1981-1990 2109 diagnostic-therapeutical curettages of the
      cervical canal and uterus were performed in the Department of Gynecology and
      Oncology of Medical Academy in Krakow. In histological examinations of scrapings
      17 cases (0.8%) of micro-glandular hyperplasia limited to cervical canal have
      been found. In 14 out of analysed cases curettage have been performed due to
      metrorrhagia. There were 12 cases of myomatous uterine among them. Two cases were
      colposcopically suspected of CIN. One woman exhibited a cervical polyps. A
      connection between micro-glandular hyperplasia and pregnancy and particularly
      with oral contraception observed in other studies has not been determined. None
      of the 17 patients were pregnant. They took neither contraceptive pills nor were
      treated by female hormones. 15 out of examined patients had an estrogenic
      reaction in cytological evaluation. Decidual transformation of the uterine cervix
      has not been colposcopically found in any case. Coexistence of micro-glandular
      hyperplasia and severe dysplasia were revealed in two patients suspected
      cytologically and colposcopically of CIN. In one case micro-glandular hyperplasia
      parallel to squamous carcinoma of the cervix has been stated.

PMID- 8359743
TI  - [Survival, complications and quality of life in patients with breast cancer after
      ovariectomy and hormonal therapy].
AB  - Seventy one women with breast cancer in clinical stage IIIa were treated by
      chemotherapy and radical operation on the basis five features, namely: survivals,
      relapses, metastases, quality of life, and post-therapy complications. The two
      treatment methods were compared. The dependence between survivals and time
      elapsed between breast surgery and ovariectomy was evaluated. Women treated by
      ovariectomy suffer from; menopause symptoms, osteoporosis, blood coagulation
      distortions more after than women treated by hormonotherapy. Tamoxifen therapy
      increases the rate of breast cancer relapses and probably it is the cause of
      breast cancer metastases into liver. Women who underwent hormonal castration are
      professionally active more after them women treated by ovariectomy. Time elapsed
      between breast surgery and ovariectomy does not affect survivals in stage IIIa.
      In stage IIIb however, performing later ovariectomy prolongs survivals.

PMID- 8359744
TI  - [Triploidy as a cause of failure in human reproduction].
AB  - Triploidy is a frequent chromosomal abnormality found in 12% of all spontaneous
      first trimester abortions. Triploidy can result from various mechanisms: failure
      of segregation during meiosis I or II leads to the formation of gametes with an
      extra haploid set of chromosomes or abnormally fertilization by two spermatozoa.
      The authors presents physiological mechanism which prevent polyspermic
      fertilization, the morphological pictures of triploid early embryos. After
      implantation of triploid embryos partial embryonal hydatidiform moles develops.
      Now the possibility of the prevention and treatment of triploid in humans are
      very limited.

PMID- 8359745
TI  - [Microstructure of placenta and activity of some respiratory enzymes --in
      pregnancy with treated and untreated fetal intrauterine hypotrophy syndrome].
AB  - The cases of fetal intrauterine hypotrophy syndrome were subjected to rest,
      dietetic and pharmacological treatment which included intravenous infusions of
      low molecular Dekstrane, intramuscular injections of Synacthen-Depot, Sadamine
      and Partusisten. The clear improvement of selected parameters of placenta
      efficiency during the management was observed. It included: mean increase of
      blood serum oxytocinase activity about 2.1 U, mean increase of quantity of
      estrogens excreted in 24-hour urine about 4.1 mg/24 hours, mean decrease of term
      stabile alkaline phosphatase activity in blood serum about 16 U. The comparison
      of the state of hypotrophic newborns found in the group with hypotrophy treated
      during the course of pregnancy with the group of untreated hypotrophy permits to
      conclude: statistically significant more rarefied occurrence of newborns of low
      values according to Apgar scale, hypoglycemia, acidosis, anemia as well as
      respiratory distress syndrome and five-fold diminished perinatal mortality. It
      was demonstrated a clear correlation between many parameters of structure and
      activity of oxygenizing enzymes of placentae existed between the group with
      treated and untreated hypotrophy.

PMID- 8359746
TI  - [Pregnancy and labor in the patient with arteriovenous congenital fistula].
AB  - The paper presents a case of uncomplicated pregnancy in 26-years old primipara
      suffering from congenital arteriovenous fistula. The clinical picture of disease
      was manifested by presence of vaso-dilatations in lower and upper limbs and in
      the vulva, because of which the pregnancy was terminated by cesarean section.
      Puerperal and postoperative outcome was uncomplicated. In the puerperal period
      heparin and large-spectrum antibiotic therapy was administered. No cardiovascular
      or thromboembolic complications were observed. Authors are of opinion, that in
      face of menace, the pregnancy and labour in the women presenting arterio-vascular
      fistula have to be considered as situation of high obstetrical risk.

PMID- 8359747
TI  - The seventh key to facial beauty and TMJ health: proper condylar position. Part
      3.
AB  - This is the eleventh article in a series of articles on orthodontic diagnosis.
      Only a proper diagnosis can lead to the correct treatment for an individual
      patient--leading to a balanced profile, a beautiful smile, and a healthy TMJ.
      This article is to document the first phase of TMJ treatment in patients who are
      being treated for TMJ Dysfunction related to posterior and/or superior TMJ
      displacement, and the change in the mandibular position and dental relationships
      that almost always occurs with proper treatment. The illusion of a posterior
      openbite "supposedly created" by the splint has led to much misunderstanding and
      unhappiness with both patients and family dentists. The real "cause" of this
      posterior openbite and treatment procedures to correct it will be discussed.

PMID- 8359748
TI  - Achieving excellence in TMJ, functional orthopedics, and case finishing. Part II.
      Locating position of the mandible.

PMID- 8359749
TI  - Mandibular whiplash. Part II. An extension flexion injury of the
      temporomandibular joints.
AB  - The single most common contributing factor in the onset of TMJ disorders is
      cranio cervical trauma. This is strongly supported by the referred literature and
      a wide range of clinical experience. Trauma is also one of the most frequently
      overlooked factors when developing an occlusion related treatment plan. Failure
      to take into account a previous injury that has caused permanent damage to the
      TMJs could prove to be very embarrassing. If the symptoms are in remission at the
      initiation of occlusal therapy, a tense situation can arise if an old injury
      becomes acute during treatment and the patient mistakenly assumes that the
      occlusal therapy was the proximate cause of the flare up in symptoms.
      Pretreatment screening for TMJ injuries is extremely important and can have
      substantial impact on the final therapeutic course.

PMID- 8359751
TI  - [Relevance of psychotherapy methods for gynecology].

PMID- 8359750
TI  - The bicuspid buildup ... an alternative in Phase II treatment of craniomandibular
      dysfunction. Part II.

PMID- 8359752
TI  - [Female orgasm. Disorders of orgasm and treatment possibilities].

PMID- 8359754
TI  - [Erotic aspects of the physician-patient relationship in gynecology].

PMID- 8359753
TI  - [Male orgasm. Disorders of orgasm and treatment possibilities].

PMID- 8359755
TI  - [The relevance of love in gynecology].

PMID- 8359756
TI  - [Woman and death--medicine and modern aspects. A medical historical essay].

PMID- 8359757
TI  - [Emotions of the physician in sterility consultation].

PMID- 8359758
TI  - [The psychosomatic unit of the gynecology clinic].

PMID- 8359759
TI  - [Antepartum CTG: anemia and parvovirus 19 infection].

PMID- 8359761
TI  - [Apoptosis: biological and clinical significance. Italian Society of Experimental
      Hematology, Florence, 18 March 1993. Abstracts].

PMID- 8359760
TI  - [Diabetes mellitus and nephrotic syndrome in pregnancy].

PMID- 8359762
TI  - [Long-term culture of bone marrow cells: biological aspects and clinical
      applications. Italian Society of Experimental Hematology. Florence, 18 March
      1993. Abstracts].

PMID- 8359763
TI  - First metatarsal head-shaft angle: a method of determination.
AB  - The distal metatarsal angle (DMAA) is a measurement of the relationship between
      the longitudinal axis of the first metatarsal and the articular surface of the
      metatarsal head. We measured the DMAA on radiographs with and without markers on
      the articular edges and compared them with measurements of the anatomic
      specimens. Based on the studies, the significance of the radiographic
      measurements to the actual DMAA and the normal distribution of the measurement
      were determined.

PMID- 8359764
TI  - Peroneus longus tendon sling in revision surgery for congenital vertical talus: a
      new surgical technique.
AB  - When faced with revision surgery for recurrent congenital vertical talus
      deformity, the tibialis anterior tendon may be deficient or absent as a result of
      the initial procedure. This tendon cannot then be used as a dynamic sling to
      dorsiflex the talar neck. We present two cases in which the peroneus longus
      tendon was transferred dorsally into the talar neck as an alternative to an
      absent tibialis anterior tendon. Excellent corrections were achieved and
      maintained. The use of this tendon has not been described previously in surgery
      for this condition.

PMID- 8359765
TI  - A treatment algorithm for neuropathic (Charcot) midfoot deformity.
AB  - Forty-nine feet in 47 patients with midfoot neuropathic foot deformity were
      referred for care to a comprehensive foot salvage clinic and followed for an
      average of 3.6 years. Twenty-three initially presented without open ulcers. Two
      underwent elective Syme's ankle disarticulation amputation, and the others were
      kept ambulatory with a combination of periods of nonweightbearing cast
      immobilization, accommodative extra-depth shoes with custom orthotics, and ankle
      foot orthoses. Twenty-six of the feet initially presented for care with open
      ulcers and/or chronic osteomyelitis. Twenty-two of these patients underwent 32
      surgical procedures. Sixteen underwent debridement of the infected bone and
      surrounding soft tissues. Excision of large, nonaccommodative boney prominence,
      termed exostectomy, was performed in eight. Partial excision of the deformed
      midfoot combined with boney stabilization and attempted arthrodesis, termed
      partial tarsectomy, were performed in seven. All surgical patients were managed
      postoperatively with long-term custom accommodative bracing. Follow-up at an
      average of 3.6 years revealed that all but one of the patients remained
      ambulatory. Six walk with accommodative shoe gear and persistent stable chronic
      open ulcers. None required below-knee amputation. Five amputations were
      performed, three at the Syme's ankle disarticulation level, one at the Chopart's
      hind-foot level, and one at the mid-foot level.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359766
TI  - Morphometric analysis of the plantar plate apparatus of the first
      metatarsophalangeal joint.
AB  - Reliable and reproducible radiographic assessment of plantar plate integrity of
      the great toe is possible with standard radiographic techniques. Normal values in
      100 pairs of feet (200 feet) are defined for comparison of one foot to the other
      and absolute values emerge if comparison is not possible. Bipartite sesamoids
      occurred in 13.5% of 200 feet with a 37% bilaterality.

PMID- 8359767
TI  - Digital nerves of the foot: anatomic variations and implications regarding the
      pathogenesis of interdigital neuroma.
AB  - Seventy-one cadaveric feet were dissected, with attention to communicating
      branches of the digital nerves, the diameters of the digital nerves, the distance
      between the metatarsal heads, and the presence or absence of interdigital
      neuromas. A communicating branch was absent in 52 feet (73.2%) and present in 19
      specimens (26.8%). The communication was from the fourth to the third web space
      common digital nerve (i.e., from the lateral to the medial plantar nerve) in 11
      specimens. A reverse communication, from the third to the fourth web space common
      digital nerve (i.e., from the medial to the lateral plantar nerve), was present
      in eight specimens. Neuromas were identified in the second web space in 26
      specimens and in the third web space in 32 feet. The common digital nerve to the
      third web space was not thicker in feet with a contribution from the fourth to
      the third web space nerve. Additionally, the incidence of third web space neuroma
      in feet with this type of communication was not significantly greater than in
      those feet without an internervous communication. However, the intermetatarsal
      head distances and the ratios of the intermetatarsal head distance to the digital
      nerve diameter in web spaces 2 and 3 were significantly smaller in comparison to
      spaces 1 and 4 (P < .05). The morphometric data lend support to theories that
      explain the propensity for neuroma formation in both the second and third web
      spaces on a mechanical basis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359768
TI  - Differences in ankle joint complex range of motion as a function of age.
AB  - The purpose of this study was to determine whether gender- and age-related
      differences in ankle joint complex (AJC) range of motion (ROM) exist in children
      (range 9-13 years), adolescents (14-16 years), and young adults (17-20 years),
      and to compare these data with those published for older subjects (21-79 years)
      using the same protocol. A total of 120 subjects (58 males and 62 females)
      ranging in age from 9 to 20 years were tested for AJC ROM using a specifically
      designed 6 degrees of freedom fixture. All measurements were made with respect to
      a laboratory coordinate system, and represented assessment of active AJC ROM.
      Angular displacements for plantarflexion, dorsiflexion, inversion, eversion,
      abduction, and adduction were digitally recorded and compared. AJC ROMs of
      females aged 9 to 20 years were generally greater than those for males about all
      three orthogonal axes. Within each gender, there was a consistent trend for AJC
      ROM to decrease from a maximum at 14 to 16 or 17 to 20 years to a minimum after
      age 60 years. The average decrement was greater for females than for males. This
      study provided evidence to support the contention that age-related and gender
      differences in AJC ROM do exist. The possibility of minimizing the decline in AJC
      ROM with age requires further investigation.

PMID- 8359769
TI  - Ankle arthrodesis placement of cannulated screws.

PMID- 8359770
TI  - Talar neck fractures.
AB  - Talar neck fractures represent a serious injury, and a review of the literature
      reveals the controversies surrounding the treatment options. In spite of the
      differences, there are many aspects of management where little disagreement
      exists. Anatomic reduction is the goal in situations where a primary salvage
      procedure is not performed. If closed treatment is chosen, careful follow-up is
      necessary to prevent unrecognized displacement as swelling subsides in the cast.
      Weight-bearing should be delayed until radiographic signs of fracture healing are
      obvious. There is a growing tendency toward open reduction and internal
      stabilization of talar neck fractures. Results suggest improved maintenance of
      reduction, decreased time to union, and a better end result. Prior to attempting
      any type of salvage procedure, careful assessment of both the tibiotalar and
      subtalar complex is necessary. The incidence of poor results following a talar
      neck fracture is disappointingly high. Additional studies of the pathoanatomy and
      biomechanics may improve our understanding. Controlled prospective clinical
      series will help clarify the advantages of specific treatment approaches and lead
      to better clinical results.

PMID- 8359771
TI  - Defining how the prescription footwear association and the board for
      certification in pedorthics can help the medical profession.
AB  - Dorland's Medical Dictionary defines pedorthics as the art concerned with the
      design, manufacture, fit, and modification of shoes and related foot appliances
      as prescribed for the amelioration of painful or disabling conditions of the foot
      and limb.

PMID- 8359772
TI  - [Worldwide foundation for AIDS research and prevention is organized].

PMID- 8359773
TI  - [Variants of chronic polyarthritis with late disease onset. More benign or
      malignant course in the elderly?].

PMID- 8359774
TI  - [Conservative therapy of low back pain. Part 1: Immobilization].
AB  - The most common treatment for low back pain is bedrest, the purpose of which is
      to minimize pain caused by movement. Randomized studies have shown that this form
      of treatment is of use only over the short term. Whenever possible, the patient
      should be mobilized again after only 2 days. Long-term immobilization has a
      number of disadvantages. Lumbar corsets may be considered a form of partial
      immobilization, and are usually not recommended for unspecific back pain. As
      initial treatment of acute back pain, short term bedrest with proper positioning
      of the sufferer, possibly in combination with drug treatment can be employed.

PMID- 8359775
TI  - [Duplex sonography of dialysis shunts. Noninvasive evaluation of the
      arteriovenous fistula in dialysis patients].
AB  - Duplex sonography permits non-invasive evaluation of both the anatomy and
      function (flow volume) of the AV-fistula in patients on hemodialysis in a single
      session. It should be the first imaging procedure to be applied when access to
      the circulation presents a problem. Comparisons with angiography and surgical
      reports confirm the adequate sensitivity and specificity of the procedure.
      Diagnostic problems may occur with ambiguous vascular anatomy, stenoses affecting
      the anastomosis or central veins. Duplex sonography makes the establishment of
      the indication for angiography or therapy much more accurate.

PMID- 8359776
TI  - [Dying in the hospital. Medical and psychological aspects].
AB  - For a variety of reasons, the process of dying is taking place ever more
      frequently in the institution hospital. Apart from the fact that the problem of
      death continues to be a taboo subject, this is leading to medico-somatic and
      psychological problems for both the dying person and the so-called "helper". To
      enable the latter to deal with this existential challenge, he or she must undergo
      adequate preparation.

PMID- 8359777
TI  - [Weight reduction with alternative diets. Principles, philosophy, side effects,
      outcome. Part 2. Alternative diets B].

PMID- 8359778
TI  - [Autologous blood and concentrates or donor blood and fresh frozen plasma? On the
      path of medical decision lurk legal pitfalls (2)].

PMID- 8359779
TI  - [Surgical treatment of stroke--the recent trend and problems].

PMID- 8359780
TI  - Preparation of three troponin components from puffer skeletal muscle.
AB  - The Ca(2+)-regulatory proteins, i. e., troponin C, I and T, were prepared from
      puffer skeletal muscle. The SDS-gel electrophoretic study indicated that the
      molecular weights of troponin C, I and T were 18, 20 and 30k daltons,
      respectively. The Ca(2+)-sensitivity of the ATPase activity of the puffer
      myofibrils was abolished by the removal of troponin C by the CDTA-treatment and
      then restored by the reconstitution with puffer skeletal troponin C. The
      treatment with excess troponin T of either puffer or rabbit skeletal muscle at
      slightly acidic condition resulted in the removal of troponins C and I from the
      puffer myofibrils. The reconstituted puffer troponin C-I-T gave the Ca(2+)
      sensitivity to the ATPase activity of puffer desensitized myofibrils in the
      presence tropomyosin.

PMID- 8359781
TI  - Effect of substitution of troponin C on the ATPase of bullfrog skeletal
      myofibrils with troponin C from various muscles.

PMID- 8359782
TI  - [An autopsy case of severe portal hypertensive gastropathy associated with a
      large shunt from superior mesenteric to left renal vein in a patient with
      alcoholic liver cirrhosis].
AB  - We report an autopsy case of severe portal hypertensive gastropathy with a large
      shunt from the superior mesenteric to left renal vein in a patient with alcoholic
      liver cirrhosis. A 60-year-old man with alcoholic cirrhosis was admitted for
      tarry stool and ascites. Endoscopic finding revealed multiple red spots and
      hemorrhagic gastritis at prepylorus of the stomach. Angiography showed a large
      shunt vessel originating from the superior mesenteric to left renal vein. He died
      of hepatic failure and DIC following frequent gastrointestinal bleeding. At
      autopsy, the stomach showed marked congestion of the capillary vessels in the
      tunica propria mucosa. This finding showed that the gastropathy resulted in the
      congestion of the gastric veins connecting with the large shunt vessel.

PMID- 8359783
TI  - Diabetes mellitus-associated glycogen storage hepatomegaly: report of a case and
      review of the Japanese literature.
AB  - A huge hepatomegaly was seen in a 30-yr-old female diabetic who was treated with
      high dose of insulin for her uncontrollable food ingestion. The liver function at
      the peak of the hepatic enlargement showed a moderate increase of transaminases,
      alkaline phosphatase, and gamma-glutamyl transpeptidase. The histology of the
      enlarged liver revealed PAS-positive granules in enlarged hepatocytes, indicating
      the presence of massive glycogen storage. On admission, she was maintained under
      a calorie-restricted diet and received approximately 15 to 20 units per day of
      insulin supplement. At one month after admission, a marked shrinkage of her
      enlarged liver and restoration of normal liver function were observed
      concomitantly with the return of fair control of her blood sugar levels. One year
      later, she had an episode of diabetic ketoacidosis which subsequently was treated
      with a continuous low-dose infusion of insulin; however, she showed neither
      hepatomegaly nor liver dysfunction during this episode. There have been 20 cases
      reported of Japanese diabetics with marked hepatomegaly, in whom the vigorous
      treatment of diabetic ketoacidosis with insulin seemed to be a trigger of the
      enlarged liver. This has occurred mostly in patients with insulin-dependent
      diabetes mellitus. We present a case of non-insulin-dependent diabetes mellitus
      with glycogen storage hepatomegaly, presumably due to excessive insulin
      supplements. This suggests that glycogen storage hepatomegaly in diabetics may
      not be only due to an acute restoration from diabetic ketoacidosis, but may also
      be due to an overinsulinization in an attempt to maintain a euglycemic condition
      in spite of excess food intake.

PMID- 8359784
TI  - Study design for final height determination in Turner syndrome: pros and cons.
AB  - Early studies on the use of human growth hormone (hGH) for the treatment of
      Turner syndrome are reviewed and attention is drawn to the higher dose used
      compared with the doses for growth hormone deficiency (GHD). Patients with Turner
      syndrome responded less consistently than GHD patients to hGH. The prediction of
      final height in Turner syndrome from bone age is uncertain - long-term trials are
      essential to resolve final height questions. The pros and cons of randomized
      placebo-controlled trials, randomized nontreatment-controlled trials and
      historical controlled trials are compared, and it is concluded that in the USA, a
      randomized placebo-controlled trial is the most appropriate study design. The
      ethical considerations of such a long-term trial, in terms of risk vs. benefit,
      and the need for a placebo-treated group are also discussed.

PMID- 8359785
TI  - Dose-dependent effect of growth hormone therapy on glucose metabolism in subjects
      with Turner syndrome. The German Lilly Ullrich-Turner Syndrome Study Group.
AB  - Recombinant human growth hormone (GH) is effective in promoting growth velocity
      in subjects with Turner syndrome. As higher doses are used for this indication
      than for substitution therapy in GH deficiency, the long-term effects of GH
      therapy on carbohydrate metabolism represent a safety issue; this is particularly
      important in Turner syndrome, in which there is an increased prevalence of
      impaired glucose tolerance. So far, GH therapy has been given to patients with
      Turner syndrome for up to 7 years without any significant changes having been
      reported in glycosylated haemoglobin (HbA1c) values, unstimulated and stimulated
      oral glucose tolerance test (OGTT) blood glucose and serum insulin
      concentrations. These findings may, however, be influenced by other variables,
      such as study design, number of subjects or standardization methods applied.
      Results of an ongoing trial in the FRG, from which 2 years' data on glucose
      metabolism (as assessed by serial OGTTs) of 72 patients with Turner syndrome are
      available, indicate that glucose homoeostasis is maintained at the expense of an
      increase in insulin secretion, which is time- and dose-dependent. Although these
      changes may be fully reversible on withdrawal of GH. therapy, accurate control of
      glucose metabolism both during and after GH. treatment is advocated.

PMID- 8359786
TI  - Results of long-term therapy with growth hormone in two dose regimens in Turner
      syndrome. Dutch Growth Hormone Working Group.
AB  - Girls with Turner syndrome were divided according to age (group A 6-12 years, and
      group B 12-19 years) and human growth hormone (GH) dose regimen (A1 and B1, three
      injections/week; A2 and B2, six injections/week). All groups responded to GH, 24
      IU/m2/week, with an increase in height velocity, though in the older girls, the
      response was comparatively poor. Therefore, the dose regimens in groups B1 and B2
      were increased to 36 IU/m2/week given as six injections in both groups. This
      change resulted in an increase in height velocity only in group B1. During the
      first 2 years only, the height velocity was greater in group A2 than group A1.
      The conclusion is that a regimen of six injections/week is more effective than
      one of three injections/week in terms of initial height gain and change in
      predicted adult height. In girls with Turner syndrome aged over 16 years, GH
      therapy has no significant effect.

PMID- 8359787
TI  - Growth hormone treatment in Turner syndrome: results of a multicentre study in
      Japan. The Committee for the Treatment of Turner Syndrome.
AB  - Patients with Turner syndrome were treated with recombinant human growth hormone
      (GH) for 3 years. Sixty-eight patients received GH, 0.5 IU/kg/week, while 93
      received GH, 1.0 IU/kg/week, by daily subcutaneous injection. Both treatment
      groups showed a statistically significant increase in growth during treatment.
      However, the higher dose increased height velocity to a significantly greater
      extent during the first and second year of treatment. The projected adult height
      was exceeded by 52 of 71 patients over the age of 14 years. Plasma insulin-like
      growth factor 1 levels were elevated and no remarkable advances in bone age were
      observed. There were no other significant changes in physical or laboratory
      parameters. No glucose intolerance was observed. These results indicate that GH
      treatment is useful for accelerating growth velocity in patients with Turner
      syndrome. However, further study will be required to find the most appropriate
      dose.

PMID- 8359788
TI  - Safety and efficacy of human growth hormone treatment in girls with Turner
      syndrome.
AB  - Six major adverse medical events (AMEs) and 44 minor AMEs were recorded in 6 and
      23 patients, respectively, during human growth hormone (GH) treatment of Turner
      syndrome, equivalent to 118 treatment years. During the first year of GH
      treatment, there was no change in the SD score (SDS) for systolic or diastolic
      blood pressure. In a subgroup of 20 patients, there was no change in
      psychological tests, oral glucose tolerance, glycosylated haemoglobin or serum
      triglycerides over the first year of GH treatment. The mean total serum
      cholesterol level fell over this period. The low incidence of adverse medical
      problems during GH treatment complemented its efficacy. Height velocity in the
      first year was 7.7 +/- 1.8 cm/year (mean +/- SD) and was correlated with maternal
      height SDS, though not with paternal height SDS. Some 36% of first-year height
      velocity SDS could be predicted by the dose of GH and maternal height SDS.

PMID- 8359789
TI  - Long-term effect of human growth hormone therapy on the prevalence of
      autoantibodies in Turner syndrome. The Dutch Growth Hormone Working Group.
AB  - Abnormalities of immune status, particularly a high prevalence (about 50%) of
      thyroid autoantibodies, have been reported before in Turner syndrome. Results are
      conflicting as regards other abnormalities of immune function. Growth hormone
      (GH) has immunomodulatory effects, but results of its effects on GH-deficient
      children are inconsistent. In this study, 42 girls with Turner syndrome, aged 7.3
      19 years, are investigated before, during and after 4 years of human GH therapy.
      Girls over 12 years old also received ethinyl oestradiol. The prevalence of
      antithyroid antibodies was 16.7% initially, 35.3% after 24-45 months and 48%
      after 4 years of therapy though, as there was no control group, it was difficult
      to conclude that GH was enhancing their appearance. Hypothyroidism was extremely
      uncommon, and the growth response was no different in those who had the
      antibodies from those who had not. There were no dramatic increases in prevalence
      of any of the other antibodies investigated, though the prevalence of parietal
      cell antibodies was higher than expected.

PMID- 8359790
TI  - Psychosocial effects of two years of human growth hormone treatment in Turner
      syndrome. The Dutch Working Group: Psychologists and Growth Hormone.
AB  - Thirty-eight girls with Turner syndrome were treated for 2 years with human
      growth hormone. Both parents and patients carried out assessments of the effects
      of treatment on various aspects of psychosocial functioning. The children used
      the Piers-Harris Self-Concept Scale and the Social Anxiety Scale for children,
      while parents were interviewed and filled in the Child Behavior Checklist. Both
      parents and children used the Therapy Evaluation Scale and the Silhouette
      Apperception Technique. Teachers completed the Teacher Rating Form. Results
      showed no significant changes with treatment in self-concept or social anxiety,
      or in behavioural problems, though immature behaviour was less common after the
      treatment period. Therapy was evaluated positively, and improvements were
      apparent in both social and emotional functioning; about a quarter of the
      patients became more independent, happier and more involved in social
      interactions. Unrealistic perceptions of present height and expectations of
      future height were expressed by a large proportion of both children and parents.

PMID- 8359791
TI  - Psychological aspects of the Canadian randomized controlled trial of human growth
      hormone and low-dose ethinyl oestradiol in children with Turner syndrome. The
      Canadian Growth Hormone Advisory Group.
AB  - Preliminary results are presented after 2 years of the Canadian long-term
      multicentre study on the impact of hormone therapy on the final height, sexual
      development and psychological status of girls with Turner syndrome. Girls
      entering the study were randomized either to be treated with recombinant human
      growth hormone or to act as controls. Both groups received oestrogen replacement
      therapy in the same dose and format at the age of 13 years. However, for the
      purposes of the psychological study at this time, children receiving oestrogen
      were excluded from analysis. Girls treated with GH for a period of 2 years showed
      a significant increase in growth rate, which declined with continued treatment,
      while the growth rate in the control group remained constant throughout. There
      was a correlation between the higher growth rate and the girls' perceptions of
      themselves as more intelligent, more attractive, having more friends, greater
      popularity and experiencing less teasing than the untreated group. Growth rate
      was not correlated with family or school functioning.

PMID- 8359792
TI  - Neurocognitive function and brain imaging in Turner syndrome--preliminary
      results.
AB  - Girls with Turner syndrome were investigated in order to determine the anatomical
      differences in their brains compared with those of normal age-matched female
      controls, and to relate these differences to deficits in neurocognitive function
      with a view to understanding the abnormal brain development in Turner syndrome.
      During the 2-year study period, it is planned to evaluate 50 girls with Turner
      syndrome and 50 age-matched controls. A wide range of authentic neurocognitive
      tests will be applied to establish the neurocognitive profile, and brain anatomy
      will be studied by magnetic resonance imaging (MRI). Ten patients with Turner
      syndrome have been evaluated by neurocognitive testing to date, and 8 girls with
      Turner syndrome and 13 controls have had MRI scans performed. There is
      preliminary evidence of both specific and generalized processes affecting brain
      development and cognitive function in Turner syndrome. The evidence of a role for
      sex hormones in socio-behavioural and cognitive abilities in Turner syndrome is
      discussed.

PMID- 8359795
TI  - Development of human peribiliary capillary plexus: a lectin-histochemical and
      immunohistochemical study.
AB  - We investigated the development of human intrahepatic peribiliary capillary
      plexus by lectin-histochemistry and immunohistochemistry, using 40 fetal livers
      of various gestational ages, 52 postnatal livers of various ages, and 10 adult
      livers. In the earliest developmental stage of intrahepatic bile ducts ("the
      stage of ductal plate"), no vasculatures were found around the ductal plate, but
      progenitor vascular cells positive for von Willebrand factor, Ulex europaeus
      agglutinin I and succinylated wheat germ agglutinin appeared in the mesenchyme of
      the portal tracts. In "the stage of biliary cell migration into the mesenchyme,"
      the progenitor vascular cells transformed into capillaries positive for von
      Willebrand factor, Ulex europaeus agglutinin I, and succinylated wheat germ
      agglutinin. In "the stage of bile duct formation," capillaries began to surround
      the bile ducts (immature peribiliary capillary plexus). The capillaries of the
      immature peribiliary capillary plexus proliferated and formed premature
      peribiliary capillary plexus around 40 wk of gestation in large bile ducts and
      around 6 wk after birth in small bile ducts. The former was composed of inner and
      outer layers, whereas the latter consisted of scattered capillaries without layer
      formation. The premature peribiliary capillary plexus continued to proliferate in
      the postnatal life and reached an adult and mature state around 15 yr. These data
      suggest that endothelial cells of capillaries of peribiliary capillary plexus
      derive from mesenchyme at the earliest stage of bile duct development and that
      the development and maturation of peribiliary capillary plexus progress parallel
      to those of the intrahepatic bile ducts.

PMID- 8359793
TI  - Propranolol compared with propranolol plus isosorbide dinitrate in portal
      hypertensive patients: long-term hemodynamic and renal effects.
AB  - The long-term hemodynamic and renal effects of propranolol were compared with
      those of propranolol plus isosorbide dinitrate in 44 portal-hypertensive
      alcoholic cirrhotic patients. Eight control patients, 8 patients receiving
      propranolol and 14 patients receiving propranolol plus isosorbide dinitrate were
      hemodynamically evaluated. Renal function was studied in a fourth group of 14
      patients receiving propranolol plus isosorbide dinitrate. Portal pressure
      decreased more (p < 0.05) with combined therapy (-21.6%, from 19.5 +/- 4.8 to
      15.4 +/- 4.3 mm Hg) than with propranolol alone (-12.5%, from 19.9 +/- 1.2 to
      17.4 +/- 1.8 mm Hg). Serum urea and creatinine levels, plasma sodium
      concentration, urine volume and urinary sodium excretion showed nonsignificant
      changes in all groups studied. Combined therapy induced a significant (p < 0.05)
      decrease in plasma renin activity (from 4.42 +/- 4.7 to 1.59 +/- 1.9 ng/ml/hr)
      and nonsignificant reductions in plasma aldosterone concentration and creatinine
      clearance. None of the eight patients with ascites or history of ascites not
      receiving isosorbide dinitrate showed evidence of impairment in renal sodium
      metabolism during the study period. In contrast, 8 of the 14 patients (57%) with
      ascites or history of ascites receiving isosorbide dinitrate showed impairment in
      renal sodium metabolism (p < 0.01), as reflected by the development or worsening
      of ascites and the need of higher diuretic requirements. Long-term combined
      administration of propranolol plus isosorbide dinitrate is superior to
      propranolol alone in the pharmacological treatment of portal
      hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359796
TI  - Visualization of the uptake and processing of oxidized low-density lipoproteins
      in human and rat liver.
AB  - The interaction of oxidized human low-density lipoproteins with human and rat
      liver was analyzed by light and electron microscopy. At the light microscopic
      level oxidized low-density lipoprotein was visualized by the fluorescent dye 1,1'
      dioctadecyl 3,3,3',3' tetramethyl indocarbocyanine perchlorate, whereas at the
      electron microscopic level, an indirect immunolabeling procedure was used that
      detected the apoprotein B of the oxidized low-density lipoprotein. In rats,
      oxidized low-density lipoprotein was administered intravenously, and uptake by
      human liver was studied by perfusion of tissue blocks. Both in human and in rat
      liver, fluorescently labeled oxidized low-density lipoprotein was mainly found to
      become concentrated in Kupffer cells and, to a lesser extent, in endothelial
      cells. In both species the cell association of fluorescently labeled oxidized low
      density lipoprotein could be inhibited by preadministration of polyinosinic acid,
      indicating a scavenger receptor-mediated process. At the electron microscopic
      level, oxidized low-density lipoprotein was found to bind mainly to areas of the
      plasma membrane of the Kupffer cells without clathrin coating, although binding
      to coated regions was also noticed. Internalization of the ligand occurred
      through coated vesicle formation and through membrane folding of interacting
      lamellipodia and wormlike structures. No indication for phagocytosis of
      aggregated oxidized low-density lipoprotein particles was noticed. After
      internalization, the immunoreactive oxidized low-density lipoprotein was detected
      in relatively electron-lucent endosomes and, subsequently, in lysosomes.
      Endothelial cells internalized oxidized low-density lipoprotein solely through
      coated pits, after which the particles were transferred through endosomes into
      lysosomes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359794
TI  - Secretion of soluble chemotactic factors, including interleukin-6: a mechanism
      for the recruitment of CD8-positive T lymphocytes to human liver allografts
      during rejection.
AB  - In 35 patients receiving first liver transplants we assessed the chemotactic
      responsiveness of peripheral blood lymphocytes to bile, the subset composition of
      the responding population and the ability of peripheral blood lymphocytes to
      produce chemotactic factors. In 13 patients in whom acute rejection developed,
      lymphocyte chemotaxis in vitro was significantly greater in bile sampled 1 or 2
      days after transplantation and before episodes of acute rejection than in bile
      sampled when rejection was clinically apparent or after steroid therapy during
      stable graft function. The chemotactic factors present showed preferential
      activity for CD8-positive T cells. Bile sampled during the same posttransplant
      periods from 11 patients who did not exhibit rejection showed significantly less
      chemotactic activity. In vitro cultured peripheral blood lymphocytes from
      patients in whom rejection developed produced lymphocyte chemotactic factors that
      induced a similar pattern of chemotactic responsiveness with preferential
      activity for CD8-positive T cells. Separate culture of purified CD4-positive and
      CD8-positive T cells obtained from patients in whom rejection developed showed
      that CD4-positive cells produced the factor(s). Analysis of the subset responses
      of normal peripheral blood lymphocytes to a variety of chemotactic cytokines
      showed interleukin-6 to have specificity similar to that observed with
      chemotactic bile, mixed peripheral blood lymphocyte culture supernatants and
      supernatants of CD4-positive T cells. Chemotactic activity was reduced by 45% to
      90% in five chemotactic bile samples and three peripheral blood lymphocyte
      culture supernatants by treatment with affinity purified interleukin-6 monoclonal
      antibody.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359797
TI  - Distribution of B lymphocytes in nonsuppurative cholangitis in primary biliary
      cirrhosis.
AB  - Primary biliary cirrhosis is characterized by the immune-mediated, nonsuppurative
      destruction of intrahepatic small bile ducts, with significant T-cell
      involvement. To date, B cells in livers of primary biliary cirrhosis patients
      have been ignored in immunopathological evaluations of nonsuppurative
      cholangitis. This study aimed to correlate the distribution of activated T and B
      cells with the histopathology of nonsuppurative cholangitis in primary biliary
      cirrhosis, with emphasis on B cell infiltration. The distribution of activated T
      and B cells and the histopathology in primary biliary cirrhosis were
      heterogeneous in bile ducts showing nonsuppurative cholangitis; they were also
      heterogeneous in various parts of a given bile duct. Although activated T cells
      were significantly involved in the occurrence of nonsuppurative cholangitis, B
      cell-predominant reaction or cholangitis and B-cell infiltration into the biliary
      epithelial layer were also prominent in some nonsuppurative cholangitis. Many
      bile ducts with nonsuppurative cholangitis of various histological types showed
      intermixed activated T- and B-cell infiltration. These findings indicate that
      immune mechanism(s) involving B cells and, probably, humoral immunity are at work
      in the occurrence of nonsuppurative cholangitis and the destruction of bile ducts
      in primary biliary cirrhosis. Cell-to-cell interactions of activated T and B
      cells should therefore be evaluated in livers of patients with primary biliary
      cirrhosis.

PMID- 8359798
TI  - Increased plasma interleukin-8 concentrations in alcoholic hepatitis.
AB  - Patients with alcoholic hepatitis often have hepatic polymorphonuclear leukocyte
      infiltration and neutrophilia. Interleukin-8 is a cytokine that stimulates
      neutrophil chemotaxis and release of lysosomal enzymes. It is made by several
      types of cells, including fibroblasts, Kupffer cells and hepatocytes. In this
      study, serial plasma interleukin-8 concentrations were measured with enzyme
      linked immunosorbent assay in 40 consecutive patients with moderate-to-severe
      alcoholic hepatitis over a 6-mo period. Two control groups included 10 patients
      without clinically important liver disease admitted for treatment of alcohol
      dependence and 12 healthy male volunteers. The mean plasma interleukin-8 level on
      admission was markedly increased: 695 +/- 146 pg/ml in the alcoholic hepatitis
      patients. The alcohol-dependent control group and the normal volunteer controls
      had mean interleukin-8 concentrations of 106 +/- 28 pg/ml and 10 +/- 5 pg/ml,
      respectively. Initially increased interleukin-8 levels in alcoholic hepatitis
      patients decreased to a mean of 182 +/- 42 pg/ml over the first month; levels had
      decreased further to 124 +/- 79 pg/ml after 6 mo. Increased interleukin-8
      concentrations in patients with alcoholic hepatitis suggest a role for
      interleukin-8 in the neutrophilia and hepatic polymorphonuclear leukocyte
      infiltration of alcoholic hepatitis.

PMID- 8359799
TI  - Spatial and temporal patterns of gene expression for the proteoglycans biglycan
      and decorin and for transforming growth factor-beta 1 revealed by in situ
      hybridization during experimentally induced liver fibrosis in the rat.
AB  - Expression of the proteoglycans biglycan and decorin and of transforming growth
      factor-beta 1 at various stages of liver fibrosis induced experimentally in rats
      by oral administration of thioacetamide was examined. Using in situ hybridization
      combined with immunocytochemical staining for cell-type characteristic markers,
      we demonstrate spatial and temporal expression patterns specific for each of the
      genes. Biglycan gene expression levels coincided tightly with the activity and
      extent of fibrosis, fat-storing cells and their transformed form, the
      myofibroblast-like cells, being the major contributors. Decorin messenger RNA was
      detectable only after the transition to the chronic inflammatory stage in
      nonparenchymal cells of periportal fields and, transiently, in the forming septa.
      In the cirrhotic stage, expression was detected solely in periportal fields with
      enhanced bile duct proliferation. Transforming growth factor-beta 1 expression
      was undetectable in normal liver. During the subacute inflammatory stage, a
      hepatocyte subpopulation expressing low levels of transforming growth factor-beta
      1 occurred at the limiting plate. With the progression of fibrosis, transforming
      growth factor-beta 1 expression levels increased considerably but remained
      restricted to the mesenchymal cells of the fibrotic septa.

PMID- 8359800
TI  - Effect of chronic iron overload on procollagen gene expression.
AB  - The pathogenesis of hepatic fibrosis and cirrhosis in genetic hemochromatosis may
      involve a direct effect of excess iron on collagen synthesis in the liver. To
      investigate this theory, we measured procollagen messenger RNA levels (types I,
      III and IV) in the livers of rats in which we produced chronic parenchymal iron
      overload by feeding them dietary carbonyl iron (2.5%, wt/wt) for up to 18 mo.
      This feeding resulted in predominantly parenchymal iron deposition in a
      periportal distribution similar to that seen in genetic hemochromatosis.
      Increased amounts of collagen fibrils were observed in iron-loaded livers on
      electron microscopy; all iron-loaded livers showed some periportal fibrosis.
      Although very high hepatic iron concentrations (range = 340 to 1,100 mumol/gm dry
      wt) were achieved in the carbonyl iron-loaded rats, we saw no consistent
      difference between steady-state messenger RNA levels for procollagens types I,
      III and IV in control and iron-loaded livers examined at five different time
      points up to 18 mo. Messenger RNA levels of the cytokine transforming growth
      factor-beta 1, which has been implicated as having a role in the production of
      extracellular matrix proteins, were also measured. No significant differences
      were observed between iron-loaded and control livers. These results suggest that
      excess parenchymal iron does not have a direct effect on the expression of the
      procollagens or transforming growth factor-beta 1 genes in iron-loaded livers and
      that factors other than, or in addition to, iron are necessary for fibrosis to
      occur.

PMID- 8359801
TI  - Liver carcinogenesis associated with feeding of ethionine in a choline-free diet:
      evidence against a role of oval cells in the emergence of hepatocellular
      carcinoma.
AB  - In an attempt to clarify the role of oval cells in the emergence of
      hepatocellular carcinoma, we fed rats a choline-free diet containing 0%, 0.05% or
      0.1% ethionine. The incidence and nature of premalignant and malignant hepatic
      lesions were then related to the degree of oval cell proliferation. Intake of
      choline-free diet alone for up to 12 mo was associated with minimal oval cell
      proliferation; cholangiofibrosis, hepatocellular nodules and hepatocellular
      carcinoma were observed in 55%, 23% and 14% of the animals, respectively. When
      rats were given the choline-free diet with 0.05% ethionine, proliferation of oval
      cells was more pronounced; after a 6- to 12 mo feeding period, cholangiofibrosis
      (57%) was again observed. However, hepatocellular nodules (91%) and
      hepatocellular carcinoma (74%) were the most common lesions seen with this
      feeding regimen. Finally, rats fed the choline-free diet with 0.1% ethionine had
      massive oval cell proliferation and progressive loss of parenchymal liver tissue.
      Most of these animals died before they had consumed the choline-free diet with
      0.1% ethionine for 12 mo. Rats in this group (96%) exhibited large and numerous
      cholangiofibrotic lesions, but hepatocellular nodules and carcinoma were not
      detected. In all animals of each experimental group, hyperplastic bile duct cells
      in areas of cholangiofibrosis and oval cells were positive for cytokeratin 19, an
      intermediate filament protein present only in bile duct cells in normal liver.
      Hepatocellular nodules and hepatocellular carcinoma were invariably negative for
      cytokeratin 19. We interpret these findings to suggest that oval cells are not
      involved in the histogenesis of hepatocellular carcinoma.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8359802
TI  - Ethinyl estradiol decreases acidification of rat liver endocytic vesicles.
AB  - Treatment with ethinyl estradiol is known to impair bile formation, bile acid
      transport and Na,K-ATPase activity, to alter receptor-mediated endocytosis and
      transcytosis of IgA and asialoorosomucoid and to affect membrane lipid
      composition and fluidity. Because appropriate sorting and trafficking of
      asialoorosomucoid requires adequate acidification of endocytic vesicles by a
      lipid-sensitive electrogenic proton pump, we examined the effects of 5 days of
      treatment with ethinyl estradiol (5 mg/kg body wt, subcutaneously) on
      acidification of early endosomes prepared from male rat livers. Littermate
      control animals received equal volumes of the solvent propylene glycol.
      Pretreatment with ethinyl estradiol reduced ATP-dependent initial rates of
      endosome acidification by 11% to 25% when measured in potassium medium containing
      0 to 140 mmol/L chloride; these differences were significant at four of six
      chloride concentrations tested. The proton pumps of ethinyl estradiol and
      propylene glycol endosomes exhibited similar Michaelis-Menten constants for MgATP
      (Michaelis-Menten constant of 63 and 66 mumol/L in the absence of chloride and
      101 and 126 mumol/L in the presence of chloride, respectively). Acidification of
      ethinyl estradiol and propylene glycol endosomes changed in the same manner when
      various cations or anions were substituted for potassium gluconate, although the
      effects of ethinyl estradiol were less marked in the absence of K+. Kinetics of
      inhibition for ethinyl estradiol and propylene glycol endosomes were similar for
      the proton pump inhibitors N-ethylmaleimide (50% inhibitory concentrations of
      13.5 and 18.1 mumol/L), dicyclohexylcarbodiimide (50% inhibitory concentrations
      of 206 and 216 mumol/L) and bafilomycin A (50% inhibitory concentrations of 11
      and 6 nmol/L). Although initial rates of acidification were slower in ethinyl
      estradiol endosomes, ATP-dependent steady-state vesicle interior pH was the same
      as that of propylene glycol endosomes over a range of chloride concentrations;
      this appeared to be due mainly to a trend toward decreased proton leak rates in
      ethinyl estradiol endosomes. Overall, ethinyl estradiol treatment modestly
      decreased initial rates of acidification and vesicle proton leakage, perhaps
      because of changes in endosome lipid composition; differences in the number,
      density or activation state of proton pumps; or differences in endosome geometry.
      Because the decrease in acidification rates was small, the effects of estrogen on
      the efficiency of uncoupling of endocytosed ligands such as asialoorosomucoid
      from their receptors in early endosomes; thus the rates of sorting and
      distribution of ligands remain unclear.

PMID- 8359803
TI  - Role of prostacyclin in hemodynamic alterations in conscious rats with
      extrahepatic or intrahepatic portal hypertension.
AB  - Although prostaglandins are thought to be involved in the hyperdynamic
      circulation of portal hypertension, the role of this substance has not been
      elucidated. Dose-response curves, the hemodynamic effects of prostacyclin (20
      micrograms/kg) and its inhibitor indomethacin and measurements of plasma and
      urinary levels of 6-keto-prostaglandin F1 alpha were compared in three groups of
      six rats each: normal, with portal vein stenosis and with secondary biliary
      cirrhosis. Plasma and urinary levels of 6-keto-prostaglandin F1 alpha were higher
      in rats with portal vein stenosis and cirrhotic rats than in normal rats. Dose
      response curves showed similar maximal decreases in arterial pressure in the
      three groups, whereas the maximal increase in portal pressure was less marked in
      cirrhotic rats than in normal rats and rats with portal vein stenosis. In normal
      rats, prostacyclin increased cardiac output by 21% and portal pressure by 41%.
      Similar increases were observed in rats with portal vein stenosis. In contrast,
      prostacyclin did not affect cardiac output and portal pressure in cirrhotic rats.
      Indomethacin induced a more marked vasoconstrictive effect in normal rats than in
      cirrhotic rats. This study shows that prostacyclin plays a role in the
      hemodynamic alterations in portal hypertension. Moreover, the hyporeactivity
      observed in cirrhotic rats suggests that prostacyclin plays a major role in the
      circulatory changes of portal hypertension due to chronic liver disease.

PMID- 8359804
TI  - Involvement of nitric oxide and prostaglandins in gastric mucosal hyperemia of
      portal-hypertensive anesthetized rats.
AB  - This study investigates the effects of inhibition of nitric oxide synthesis by NG
      nitro-L-arginine methyl ester (L-NAME), the inhibition of prostaglandin synthesis
      with indomethacin and the combined effects on gastric mucosal hyperemia of
      ketamine-anesthetized rats with portal hypertension induced by partial portal
      vein ligation. The hydrogen gas-clearance technique was used for measurement of
      gastric mucosal blood flow. Blood pressure increased with L-NAME administration
      in a similar manner in portal-hypertensive and sham-operated rats. Low doses of L
      NAME (1 and 3 mg/kg, intravenously) caused a significant and dose-dependent
      reduction in gastric mucosal blood flow in portal-hypertensive rats but had no
      effect on sham-operated animals. With a higher dose of L-NAME (13 mg/kg,
      intravenously), a significant decrease in gastric mucosal blood flow was observed
      in both portal-hypertensive and sham-operated rats. Indomethacin pretreatment (5
      mg/kg, subcutaneously) caused a significant decrease in basal gastric mucosal
      blood flow of portal-hypertensive rats but did not modify this parameter in sham
      operated animals. In sham-operated rats pretreated with indomethacin, the lower
      dose of L-NAME (3 mg/kg) did not significantly modify basal gastric mucosal blood
      flow. Likewise, pretreatment with indomethacin in sham-operated rats did not
      augment the significant reduction in gastric mucosal blood flow produced by the
      higher dose of L-NAME. In portal-hypertensive rats the significant dose-dependent
      reduction in gastric mucosal blood flow induced by L-NAME (3 and 13 mg/kg) was
      not significantly altered by pretreatment with indomethacin.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8359805
TI  - Role of platelets in hepatic allograft preservation injury in the rat.
AB  - Cold preservation of liver allografts injuries hepatic sinusoidal lining cells.
      This injury is exacerbated on reperfusion, in part because of adhesion of
      leukocytes. Platelets also adhere to activated endothelial surfaces. In this
      study we examined the role of platelets in preservation injury. Our specific aim
      was to determine whether the degree of platelet adhesion on reperfusion of
      preserved rat livers was related to duration of cold or warm ischemia and whether
      platelet adhesion resulted in injury to allografts. We also examined the effect
      of prior activation of platelets on adhesion and injury. Rat livers were
      preserved at 1 degree C for different time periods in University of Wisconsin
      solution and then reperfused for 3 hr on the isolated perfused rat liver system
      with Krebs-Henseleit solution to which unactivated isolated rat platelets were
      added. Other livers were rewarmed before reperfusion or reperfused with activated
      platelets. Platelets were lost from the circulation in all studies; the
      percentage reduction of circulating platelets was dependent on the length of
      preservation. The initial platelet concentration did not affect the rate of
      reduction of platelets in the circuit. Rewarming before reperfusion increased
      platelet adherence, and prior activation also increased adherence. With electron
      microscopy we determined that platelets adhered in small aggregates to
      endothelial cells or endothelial cell remnants. Adherent platelets appeared more
      activated and contained fewer granules than did unperfused platelets. Liver
      injury as measured by release of transaminases into perfusate was worsened by
      longer periods of cold preservation and by addition of rewarming to the protocol.
      The presence of platelets under these circumstances aggravated injury. Prior
      activation of platelets also increased the extent of injury. These studies show
      that platelets have an important role in cold preservation-reperfusion injury.

PMID- 8359806
TI  - Effect of ethanol on rat fetal hepatocytes: studies on cell replication, lipid
      peroxidation and glutathione.
AB  - Studies have shown that ethanol at moderate concentrations inhibits epidermal
      growth factor-dependent replication of fetal rat hepatocytes in culture. This may
      account for the growth/development impairment associated with fetal alcohol
      syndrome and decreased liver regeneration in alcoholic liver disease. In this
      study, we further define the mechanism(s) of the negative impact of ethanol on
      fetal rat hepatocytes and provide evidence that ethanol-induced injury to these
      cells is associated with membrane damage caused by lipid peroxidation, altered
      cell glutathione homeostasis and deranged mitochondrial structure and function.
      Exposure of fetal rat hepatocyte replication to ethanol (2 mg/ml) promptly
      resulted in blockade of replication, as indicated by a 40% reduction in DNA
      synthesis (p < 0.05). Assessment of cell injury on the basis of lactate
      dehydrogenase and ALT leakage indicated a statistically significant but not
      appreciable effect, whereas 51Cr leakage was more substantially increased (p <
      0.05). Within 6 hr of ethanol exposure, superoxide radical levels increased more
      than twofold (p < 0.05). We noted a 56% increase in levels of diene conjugates, a
      131% increase in malonaldehyde concentration and a 66% increase in fluorescent
      products of lipid peroxidation (all p < 0.05). Glutathione levels were decreased
      to 47% below control values (p < 0.05). Electron microscopic studies illustrated
      a slight disruption of mitochondrial structure (enlargement of mitochondria and
      dilation of cristae). This disruption was accompanied by mitochondrial swelling
      (increased permeability), altered mitochondrial membrane potential (a 16%
      decrease in rhodamine uptake), a 28% decrease in succinate dehydrogenase activity
      and a 30% decrease in cellular ATP level (p < 0.05). Pretreatment of fetal rat
      hepatocytes with 0.1 mmol/L N-acetylcysteine or S-adenosylmethionine for 24 hr
      prevented the ethanol-induced reduction of ATP and glutathione levels,
      essentially restored cell replication, ameliorated 51Cr leakage and decreased
      malonaldehyde and diene conjugate levels to 41% to 65% and 25% above control
      values, respectively. Pretreatment with 0.1 mmol/L vitamin E fully normalized
      malonaldehyde and diene conjugate levels and 51Cr leakage but failed to improve
      ATP levels or to increase significantly cell replication and glutathione levels.
      Concomitant administration of glutathione precursors with ethanol, rather than
      pretreatment, did not alter the impaired cell replication. Thus our data
      underscore the importance of cellular glutathione and ATP in preventing ethanol
      induced decreases in fetal cell replication and suggest that alleviation of
      cellular lipid peroxidation alone is not sufficient to prevent this abnormality
      in fetal rat hepatocyte function.

PMID- 8359808
TI  - Budget trends and issues affecting biomedical research: a perspective from the
      National Institute of Diabetes and Digestive and Kidney Diseases.

PMID- 8359807
TI  - Role of newly synthesized cholesterol or its metabolites on the regulation of
      bile acid biosynthesis after short-term biliary diversion in the rat.
AB  - Cholesterol 7 alpha-hydroxylase, the rate-limiting enzyme in the bile acid
      biosynthetic pathway, is thought to be regulated by hydrophobic bile acids
      through negative feedback control. The role of cholesterol in the regulation of
      cholesterol 7 alpha-hydroxylase is more controversial, in part because of
      incomplete understanding of the relationship between the pathways of cholesterol
      synthesis and degradation. The main objective of this study was to define the
      interaction between these two pathways in an experimental model in which the
      supply of newly synthesized cholesterol was interrupted by sustained infusion of
      mevinolin (lovastatin), an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A
      reductase (HMG-CoA reductase) or accelerated by a continuous infusion of
      mevalonate, a cholesterol precursor. The study was carried out in rats subjected
      to short-term bile fistula. In one set of experiments, rats were treated
      postoperatively with mevinolin (5 mg/kg loading dose followed by 2 mg/kg/hr
      infusion), mevalonate (180 mumol/hr infusion) or both for up to 96 hr. In a
      separate set of experiments, rats were infused intraduodenally with taurocholate
      (36 mumol/100 gm/hr for up to 96 hr). We determined cholesterol 7 alpha
      hydroxylase- and HMG-CoA reductase specific activities at those time intervals,
      whereas bile acid synthesis rates were determined throughout the study. Compared
      with rats not subjected to surgery, rats with short-term biliary diversion had
      increases in cholesterol 7 alpha-hydroxylase activity of 259% and 827% at 48 and
      96 hr, respectively. The increase in bile acid biosynthesis was less pronounced.
      Continuous infusion of mevinolin completely prevented increases in cholesterol 7
      alpha-hydroxylase specific activity and bile acid biosynthesis at both time
      intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359809
TI  - Amino acid transport and glutathione homeostasis: what is the mechanism for
      cysteine uptake from bile?

PMID- 8359810
TI  - Urinary copper excretion after penicillamine challenge in children with prolonged
      hepatitis A infection.

PMID- 8359811
TI  - Association between heterozygous alpha 1-antitrypsin deficiency and genetic
      hemochromatosis.

PMID- 8359812
TI  - Risk of ovarian cancer and genetic relationship to other cancers in families.
AB  - The risk of ovarian and other cancers was assessed in first-degree relatives of
      patients with ovarian cancer from an analysis of 391 pedigrees. Overall there was
      a significant increase in the risk of ovarian cancer (4.5-fold; p < 0.001). The
      risks were 14.2- (p < 0.001), 5.2- (p < 0.001) and 3.7-fold (p < 0.001) for
      relatives of patients diagnosed before 45, between 45 and 54 and after the age of
      55, respectively. There was no significant increase in the risk of cancers of the
      uterus, stomach, lung, colorectum or prostate. There was, however, an overall
      increase in the risk of breast cancer (1.3-fold; p < 0.05). The risk was highest
      for those relatives of patients diagnosed with ovarian cancer before the age of
      55 (2.2-fold; p < 0.01). These results support the role of genetic factors in the
      aetiology of ovarian cancer and provide further evidence for the existence of a
      breast-ovarian family cancer syndrome, which may result from the pleiotropic
      effects of the same gene in some families.

PMID- 8359813
TI  - Absence of the atypical mitochondrial aldehyde dehydrogenase (ALDH2) isozyme in
      Saskatchewan Cree Indians.
AB  - Three methods were employed to assess whether human volunteers (Caucasian, Asian
      or Cree Indian) possessed the typical or atypical mitochondrial aldehyde
      dehydrogenase (ALDH2) isozyme. These methods were: (1) questioning individuals
      about facial flushing responses following alcohol consumption; (2) application of
      the ethanol skin patch test, and (3) direct analysis using isoelectric focusing
      and activity staining of ALDH activity in hair root samples. The results from the
      three methods were in good agreement and revealed that only the typical ALDH2
      isozyme was expressed in Saskatchewan Cree Indians. In agreement with previous
      reports, the typical ALDH2 was expressed in the Caucasian group of subjects,
      while both the typical and atypical forms were expressed in the Asian subjects.

PMID- 8359814
TI  - Serum protein polymorphisms (GC, TF, and PI subtypes) in the Basque population of
      Alava.
AB  - Group-specific component (GC), transferrin (TF) and alpha-1-antitrypsin (PI)
      polymorphisms have been studied in the Basque population of Alava. The following
      gene frequencies were found: GC*1S = 0.525, GC*1F = 0.109, GC*2 = 0.366; TF*C1 =
      0.793, TFC*2 = 0.171, TF*C3 = 0.032, TF*B = 0.003; PI*M1 = 0.611, PI*M2 = 0.164,
      PI*M3 = 0.101, PI*M4 = 0.019, PI*S = 0.101, PI*T = 0.003, PI*Z = 0.002. These
      results show that there is heterogeneity within the Basque population. In
      comparison with other populations from the Iberian Peninsula, the Basques from
      Alava show significant differences only for the PI system.

PMID- 8359816
TI  - Haptoglobin types in Chinese ethnic groups.
AB  - The distribution of haptoglobin (HP) types was examined in six different Chinese
      ethnic groups. The gene frequencies were compared among these groups and to those
      reported in other Chinese Han populations. The effects of sex and age on the
      distribution of HP types are also discussed.

PMID- 8359815
TI  - Genetic variation around the collagen IV 1a gene locus and proliferative
      retinopathy in type 2 diabetes mellitus.
AB  - The development of proliferative retinopathy in type 2 diabetes mellitus may be
      under genetic control. A well-documented pathological change in the fundal
      capillaries of patients with diabetic retinopathy is basement membrane
      thickening, with an increased amount of collagen IV protein. Variation at the
      collagen 1a IV gene therefore may explain familial susceptibility to this
      complication. It has been previously reported that genetic variation at the
      collagen 1a locus, as shown by allelic association with a HindIII restriction
      site, predisposes to diabetic nephropathy where basement membrane thickening is
      also prevalent. In order to test the hypothesis that the collagen 1a IV gene
      locus is important in the development of diabetic retinopathy, a population
      association study was performed comparing allele frequencies of the HindIII RFLP
      in diabetic patients with retinopathy and controls. No statistically significant
      differences were found between allele frequencies or genotypes in the two groups.
      The future use of similar studies in diabetic retinopathy is discussed.

PMID- 8359817
TI  - SHIN, a low frequency red cell antigen, found in two Japanese blood donors.
AB  - A low frequency red cell antigen, SHIN, was detected in two Japanese blood
      donors. Red cells of the first propositus reacted, in pretransfusion tests, with
      the serum of a previously untransfused male patient. The second propositus was
      disclosed when anti-SHIN was used to screen red cells from 3,000 random blood
      donors in Tokyo: a frequency of 0.03% in this population. Family studies showed
      SHIN to be inherited as an autosomal dominant character and not to be part of the
      MNS, FY, JK or P1 blood group systems. Anti-SHIN is not a common antibody in
      normal sera but was found in about 10% of multispecific sera used in
      investigation of low frequency antigens.

PMID- 8359818
TI  - Haptoglobin subtypes in two Spanish Pyrenean populations.
AB  - Haptoglobin subtypes have been determined in two population samples, one of them
      from the Pyrenean Valley of Pallars Sobira in the province of Lerida and other
      from the Garrotxa region, province of Gerona. The obtained frequencies have been
      compared with other Pyrenean and European populations. Our results contrast with
      the absence of HP*2FF in the north-eastern district of the Pyrenees and suggest a
      more extensive distribution of this allele in European populations.

PMID- 8359819
TI  - Genetic affinities of Buryat populations and other Mongoloids of Siberia.
AB  - Variation at ten polymorphic loci (ABO, RH, PGD, ACP, PGM1, GLO1, ESD, ADA, GC,
      TF) was studied in a sample of 326 Buryat newborns from Ulan-Ude. The genetic
      relationships between Buryat and other Mongoloids from Central and Northern Asia
      were assessed; close similarity was found between the Buryat, Mongol, Yakut,
      Chulym and Kyzyl populations.

PMID- 8359820
TI  - Multipoint mapping under genetic interference.
AB  - Genetic chiasma interference occurs when one crossover influences the probability
      of another crossover occurring nearby. While interference is known to occur in
      humans, it is typically ignored when computing multipoint likelihoods for genetic
      mapping. This biologically unsound assumption of no interference facilitates the
      calculation of the likelihoods at the expense of reduced power to accurately
      construct a genetic map. We have developed a computer program that calculates
      multipoint likelihoods of three-generation nuclear families while taking
      interference into account. In our program, interference is modelled by using a
      map function to convert genetic distances into recombination fractions. We can
      determine which of several map functions best fits the data by comparing the
      multipoint likelihoods of the data under each map function. Since the
      distribution of the difference between likelihoods is unknown, we use a
      simulation approach to determine the statistical significance of our results.
      When our program is applied to six loci, D10S34, D10S19, D10S16, D10S14, D10S4,
      and D10S20, from the CEPH consortium map of chromosome 10, we find significant
      evidence in favor of positive interference as modelled by the Sturt map function.

PMID- 8359821
TI  - Successful technique for the selective production of monoclonal antibodies
      against a major allergenic component in timothy pollen extract.
AB  - Monoclonal antibodies (MAbs) were selectively raised against a major allergenic
      component of 38 kD in timothy grass pollen (Phleum pratense). We used a special
      prefractionating technique to isolate the 38 kD allergen, because immunizations
      with crude pollen extract had resulted in a wide variety of antibodies against
      other determinants, and cross-reactions between different-sized proteins
      occurred. Pollen extract was separated by Western blotting. Strips of the
      nitrocellulose membrane containing the allergen were excised, dispersed into
      allergen bearing particles, and used for immunization of BALB/c mice. Five MAbs
      were obtained that reacted with the 38 kD allergen. Four of these antibodies (BF
      1, DC 9, EB 4, GE 2) exclusively detected the 38 kD protein, while one MAb (EB 6)
      additionally bound to a 32 kD allergen. Epitope mapping with the 3 IgG 1
      antibodies (BF 1, EB 6, DC 9) was performed by ELISA inhibition tests using the
      purified 38 kD component. The antibodies did not interfere with each other. This
      confirms that they bind to different sites of the 38 kD molecule. Only a weak
      inhibitory effect of the MAbs on the binding of patient's IgE was determined, we
      suppose that the MAbs do not bind to IgE reactive epitopes. For standardization
      and further characterization of the 38 kD protein by peptide mapping the MAbs
      will be useful tools.

PMID- 8359822
TI  - Bispecific monoclonal antibodies to human interleukin 2 and horseradish
      peroxidase.
AB  - Hybrid hybridomas (tetradomas), producing bispecific monoclonal antibodies
      (bmabs) binding to both interleukin 2 and horseradish peroxidase were obtained by
      fusing IL 2-specific and HRP-specific hybridomas. Parental hybridomas were
      labelled prior to the fusion with fluorescein isothiocyanate and
      tetramethylrhodamine isothiocyanate. Bifluorescent (tetradoma) cells were sorted
      out using fluorescence activated cell sorter. Two clones, designated D8C1/G and
      H7C11/H were shown to secrete bmabs over at least 6 months growth in culture.
      Bmabs have been purified from mouse ascites by ammonium sulfate precipitation and
      affinity chromatography on immobilized peptide, modelling corresponding IL 2
      epitope. The purity of antibodies obtained was characterized by capillary
      electrophoresis. The possibility of using these antibody preparations in rIL 2
      analysis was evaluated in two types of EIA: direct and competitive solid-phase
      EIA. Both assays had similar sensitivity of about 1.5-4 ng IL 2 per ml.

PMID- 8359823
TI  - Production of stable rabbit-mouse heterohybridomas: characterization of a rabbit
      monoclonal antibody recognizing a 180 kDa human lymphocyte membrane antigen.
AB  - Polyclonal rabbit antihuman thymocyte globulin (RATG) remains a key component of
      immunosuppressive strategies in transplantation. The human thymus immunization
      regimen that produces highly immunosuppressive RATG induces unique antibody
      specificities in the rabbit. Rabbit monoclonal antibodies (RAb MAbs) to human T
      cell antigens would be of value in the effort to investigate and reproduce the
      multiple specificities of RATG. We have fused mouse Sp2/0 cells with splenocytes
      from rabbits immunized with human thymus and have identified 52 rabbit-mouse
      heterohybridomas which secrete RAb MAbs directed against human lymphocyte surface
      antigens. The technical aspects of hybridoma isolation, stabilization and
      characterization are presented. Analysis by flow cytometry, preabsorption and
      immunoprecipitation suggests that RAb MAb 1A8 IgG may recognize LFA-1, one of the
      principal lymphocyte surface antigens recognized by RATG. The 1A8 antigen is 180
      kDa and is expressed by 80-90% human PBL and thymocytes. LFA-1 and the 1A8
      antigen exhibit 100% co-expression in two-color FACS analysis using four
      different murine anti-LFA-1 MAbs. 1A8 markedly inhibits the mitogenic response of
      lymphocytes to PHA, as do murine anti-LFA-1 MAbs. A combination of rabbit
      antilymphocyte MAbs may potentially reproduce the multiple specificities found in
      polyclonal RATG and lead to the production of a superior immunosuppressive
      clinical agent.

PMID- 8359824
TI  - A rapid, simple method for calculating equilibrium constants and antibody site
      concentrations from dilution curves alone.
AB  - A rapid new practical method for calculating both the antibody-antigen
      equilibrium constant and the antibody concentration from antibody dilution curve
      data alone is described. This method is faster than the inhibition curve method
      for evaluating a humoral immune response. It is particularly suitable for
      monitoring the immune response of an immunization program. The response is
      assessed as an immunization index, Abi*Ka. This index is more exact than the
      antibody titer obtained from dilution curves and independent of the specific
      activity of the labelled molecule and total activity used in the assay. The
      method was used to monitor the production of a monoclonal antibody to the
      sulphide peptide leucotriene including immunization, cloning and purification.

PMID- 8359825
TI  - Selection of monoclonal antibodies that bind and inhibit tissue-type plasminogen
      activator.
AB  - Three monoclonal antibodies raised against tissue-type plasminogen activator (t
      PA) were selected for their ability to inhibit solid-phase bound t-PA. Each
      monoclonal antibody blocked the release of p-nitroaniline from H-D-Ile-Pro-Arg
      pNA (S-2288). The first antibody 1D2 was a gamma 2b, kappa with KD = 8 x 10(-9)
      M, the second antibody 2B9 was a gamma 1, kappa with KD = 2 x 10(-9) M, and the
      third antibody 5A9 was a gamma 1,kappa with KD = 4 x 10(-10) M. In solution-phase
      format each antibody blocked the conversion of plasminogen to plasmin as judged
      by a plasmin assay and also inhibited t-PA-mediated lysis of plasma fibrin clot
      in plasma. The binding of each 125I-radiolabeled antibody to t-PA was inhibited
      by any one of the three antibodies, suggesting that they recognized a common
      epitope on t-PA which was absent on unfolded t-PA. We concluded these antibodies
      bind near t-PA active site since PPACK treatment lowered binding of two
      antibodies. We believe solid-phase chromogenic substrate assay may be a useful
      way to screen for antibodies directed against the active site of proteases.

PMID- 8359826
TI  - An immunofluorescent stain for Helicobacter pylori.
AB  - We prepared a murine monoclonal antibody that recognized the Helicobacter pylori
      urease. Monoclonal antibody, U2, reacted with purified native urease in enzyme
      linked immunosorbent assay but it did not react in Western immunoblot analysis.
      Urease was immunoprecipitated with U2 bound to Staphylococcus aureus protein A,
      followed by elution and visualization by sodium dodecyl-sulfate polyacrylamide
      gel electrophoresis. The species and strain specificity of U2 were determined by
      biodot reaction with H. pylori, H. mustelae, Campylobacter spp., and other gram
      negative bacteria. Monoclonal antibody, U2, was used for an indirect
      immunofluorescent stain of formalin fixed gastric biopsies from patients with H.
      pylori gastritis. The immunofluorescent stain showed spiral and coccoid forms of
      H. pylori within the gastric mucosa. U2 was specific for H. pylori and did not
      react with other tested bacteria. These findings suggest that antibody U2 might
      be of diagnostic value for specific immunofluorescence detection of H. pylori.

PMID- 8359827
TI  - The use of a novel immune complex to isolate neutralizing antibodies to basic
      fibroblast growth factor.
AB  - This paper describes the use of a novel immune complex (IC) to generate
      neutralizing monoclonal antibodies to basic fibroblast growth factor. The IC uses
      a non-neutralizing monoclonal antibody bound to Protein A, itself coated on a
      solid support, to capture the antigen. Presumably, the capture antibody binds to
      a region of the antigen distal from the neutralizing site. Animals, immunized
      with the IC, develop a neutralizing titer and hybridomas producing neutralizing
      antibodies to basic FGF were obtained. This method can be used to generate
      neutralizing monoclonals to highly conserved growth factors whenever the antigen
      can be captured at a site distal to the neutralizing eptiopes.

PMID- 8359828
TI  - Androgenic regulation of glycolytic and HMP pathway in epididymis and vas
      deferens of rhesus monkey.
AB  - The androgenic regulation of the eleven enzymes of glycolytic pathway and two key
      enzymes of HMP pathway was studied in the initial segment, caput, corpus and
      cauda regions of the epididymis and in the vas deferens of rhesus monkey. The
      specific activities of enzymes were expressed as units of activity per mg DNA.
      Results in control animals indicate a marked difference in energy metabolism of
      epididymis and vas deferens. However, the epididymal duct itself did not show
      much regional variation in enzyme activities along its length. All the enzymes of
      the two pathways studied showed significant reduction after castration, the
      regulatory enzymes being affected more severely. On treatment with exogenous
      dihydrotestosterone, most of these enzymes showed stimulation in castrated
      monkeys, but none of them could be restored to normal level. The stimulation of
      these enzymes on treatment with exogenous dihydrotestosterone varied along the
      epididymal duct itself being maximum in the initial segment and minimum in the
      cauda region. The changes in the vas deferens were less marked as compared to the
      epididymis following castration and androgen replacement.

PMID- 8359829
TI  - Potentiation of radiation effects in plateau phase human glioma cells by
      combination of metabolic inhibitors.
AB  - Effects of glycolytic inhibitor 2-deoxy-D-glucose (2-DG) on radiation damage were
      studied in a human glioma cell line (BMG-1), grown to confluence in monolayer.
      After irradiation (60Co-gamma-rays, 2 Gy) and incubation with low concentrations
      of 2-DG (0.5, 1.25 mM; 2-DG/glucose = 0.1, 0.25; 2 hr), in the absence or
      presence of respiratory inhibitor KCN (0.5-2 mM), cells were trypsinized and
      plated to assay radiation induced cytogenetic damage (micronuclei formation). The
      observations made were: (1) 2-DG and/or KCN treatments did not induce damage in
      unirradiated cells. (2) Either of these treatments did not increase radiation
      induced micronuclei formation. (3) Presence of 2-DG along with KCN (1,2 mM)
      significantly enhanced the radiation induced micronuclei formation. (4)
      Preliminary experiments by macrocolony assay showed that radiation induced cell
      death was also significantly increased by the combined treatment. These
      observations suggest that presence of clinically feasible, low concentrations of
      2-DG (2-DG/glucose < 0.5) for short intervals of time after radiation could
      increase radiation damage in non-cycling, hypoxic tumour cells with impaired
      oxidative and increased glycolytic energy metabolism.

PMID- 8359830
TI  - Anticholestatic effect of picroliv, active hepatoprotective principle of
      Picrorhiza kurrooa, against carbon tetrachloride induced cholestasis.
AB  - Picroliv showed a dose (3-12 mg/kg, po for 7 days) dependent choleretic activity
      as evidenced by increase in bile flow and its contents (bile salts and bile
      acids). Significant anticholestatic activity was also observed against carbon
      tetrachloride induced cholestasis in conscious rat, anaesthetized guinea pig and
      cat. Picroliv was more active than the known hepatoprotective drug silymarin.

PMID- 8359832
TI  - Testosterone and lipid peroxide metabolism in orchidectomised rats.
AB  - The effect of testosterone on lipid peroxides and antiperoxidative enzymes in
      normal and orchidectomised animals has been studied. Orchidectomy results in
      increased lipid peroxidation in the heart, while administration of testosterone
      to the animals reverses this to a certain extent. On the other hand the
      administration of testosterone to normal rats results in increased lipid
      peroxidation in the liver and heart.

PMID- 8359831
TI  - Cholesterol side-chain cleavage by immobilized cells of Rhodococcus equi DSM 89
      133.
AB  - Side-chain cleavage of sterol and extracellular cholesterol oxidase activity were
      investigated using viable cells of R. equi DSM 89-133 immobilized in
      polyacrylamide gel. In batch culture, immobilized cells were active in side-chain
      cleavage of cholesterol for more than 30 days. Free or immobilized cells were
      incapable of side-chain cleavage in the absence of 2,2' dipyridyl; cholesterol
      oxidase was, however, produced in both the cases. Maximal activity of the
      immobilized cells was 60 to 70% of the free cells.

PMID- 8359833
TI  - Effect of leaf extract of Aegle marmelose in diabetic rats.
AB  - Alloxan induced animal model was used to evaluate the potential antidiabetic
      effect of A. marmelose leaf extract. The diabetic animals were given insulin
      injection and another group A. marmelose leaf extract orally. It maintained the
      weight of the animals near to the control rats but a significant decrease in
      weight was noted in diabetic animals without any treatment. The blood glucose
      level in treated animals were near to that of control ones. Also a significantly
      increased glucose tolerance was observed in animals orally given the leaf extract
      prior to the experiment. A significant decrease in liver glycogen (1.24 +/- .07
      g/100 g of wet tissue) was observed in diabetic rats which was brought to almost
      the normal level (1.84 +/- .14 g/100 g) with leaf extract treatment. Blood urea
      and serum cholesterol increased (62.66 +/- 3.50 and 192.67 +/- 13.64 mg/dl)
      significantly in alloxan diabetic rats. The leaf extract treatment decreased the
      blood urea and serum cholesterol (37.83 +/- 3.97 and 99.20 +/- 8.43 mg/dl) to
      that of control ones. A similar effect was seen with insulin treatment. The
      results indicate that the active principle in A. marmelose leaf extract has
      similar hypoglycaemic activity to insulin treatment.

PMID- 8359834
TI  - Effects of gestational undernutrition, stress and diazepam treatment on spatial
      discrimination learning and retention in young rats.
AB  - Effects of prenatal undernutrition, stress and diazepam treatment on learning
      acquisition, and subsequent retention of a spatial discrimination task was
      assessed in the offsprings. Undernutrition of the dams was induced by restricting
      food intake to half, throughout the period of gestation, whereas footshock stress
      and diazepam (0.5 mg/kg, ip) treatment was given from day 13 to 20 of gestation,
      this being the critical period for neural development in this species. The pups
      born were subjected to spatial discrimination learning, and retention of the
      learning acquisition after an interval of one week, in a single unit black/white
      T-maze, at 8-9 weeks of age. The results indicate that prenatal undernutrition
      induces significant learning and retention deficits in the offspring, whereas the
      effect of prenatal stress was limited to only deficit in learning acquisition.
      Prenatally administered diazepam induced significant deficits in learning
      acquisition and subsequent retention of the discrimination task in pups culled
      from normally nourished dams. However, offsprings from diazepam administered
      undernourished dams exhibited less marked cognitive deficits, which may be
      attributable to the altered emotional reactivity of pups born to undernourished
      mothers. Prenatally administered diazepam also induced differential effects in
      stressed and non-stressed dam offsprings, though the effects were statistically
      insignificant. The results suggest that prenatal insults, in the form of
      undernourishment, stress and anxiolytic drugs, leave a lasting imprint on
      cognitive behaviour of the offspring. The final effect on this behaviour may be
      determined by the co-existence of these prenatal factors, particularly at a time
      when the foetus is vulnerable because of neural development and differentiation.

PMID- 8359835
TI  - Comparative efficacy of exogenous acetylcholinesterase administration on soman
      and dichlorvos toxicity in rats.
AB  - Cholinesterase (ChE) activity in the blood serum of rats was elevated to 15, 25,
      and 45 times by the sc administration of 1000, 2000 and 3000 electric eel
      acetylcholinesterase (AChE) units respectively. Apparently no ill-effect to
      animals was observed. The maximal activity of the enzyme occurred in 90 min after
      its administration and was directly proportional to the administered dose. The
      increase activity of ChE in the serum on the exogenous administration of AChE
      persisted for 18 hr. The exogenously raised serum ChE, protected rats against
      lethal dose of dichlorvos, but not against lethal dose of soman. The possible
      mechanism of differential response in discussed.

PMID- 8359837
TI  - Reproductive toxicity of vincristine in male rats.
AB  - Gross morphological and gravimetric changes were observed in the male
      reproductive system of sexually mature rats as well as rats in pubertal
      transition, given a continuous treatment of vincristine at dose levels of 10/20
      and 5/10 micrograms respectively per day, for 15 days. The treatment resulted in
      a drastic regression of entire male reproductive system, suggesting that
      vincristine would cause male reproductive toxicity.

PMID- 8359836
TI  - Methyl parathion induced alterations in GABAergic system during critical stage of
      central nervous system development in albino rat pups.
AB  - Sublethal doses of methyl parathion (o, o-dimethyl-o-nitrophenyl thiophosphate)
      injected intraperitoneally to 7th day old developing albino rat pups induced
      alterations in the inhibitory GABAergic system of CNS. A substantial simulation
      of the inhibitory system was noticed. A profound increase was found in the level
      of the inhibitory transmitter, GABA on methyl parathion injection. An increase in
      the activity levels of the enzymes glutamic acid decarboxylase and 4
      aminobutyrate-2-oxoglutarate-amino transferase in the cortex, brain stem and
      spinal cord of the CNS was found. It is observed that methyl parathion causes
      potentiation of the inhibitory transmission (GABAergic system) in the wake of
      inducing suppression of cholinergic system in CNS of developing rat pups.

PMID- 8359838
TI  - Embryo transfer in rabbits.
AB  - Surgical method of embryo collection and embryo transfer was used in rabbit. PMSG
      was used for superovulation. Out of the 41 embryos collected from 6 donors, 30
      embryos were transferred in 7 recipients. Out of 7 embryo transferred recipients,
      2 kidded giving birth to 7 kids.

PMID- 8359839
TI  - Antifertility activity of Ailanthus excelsa Linn. in female albino rats.
AB  - Alcoholic extract of leaf and stem bark of A. excelsa at a dose of 250 mg
      equivalent of plant material/kg body weight, exhibited remarkably high anti
      implantation and early abortifacient activities. The results are in agreement
      with the traditional use of this plant as a abortifacient by the Irula women of
      the Nilgiri district.

PMID- 8359840
TI  - Prolactin suppression during pre and post-implantation periods on rat uterine
      glucosamine synthase activity.
AB  - Administration of bromocriptine (Bc), an ergot derivative having dopamine
      receptor agonist activity, to rats on day 1-5 of pregnancy prevented implantation
      of blastocysts and significantly suppressed uterine glucosamine 6-phosphate
      synthase activity. There was no effect on implantation or the enzyme activity
      when Bc was injected on day 7 or later of pregnancy. Injection of prolactin
      following Bc partially restored the enzyme activity and increased number of
      implantation sites. These results indicate that suppression of prolactin on day 1
      to 5 of pregnancy causes failure of implantation. Bc on day 9 or later had no
      effect possibly due to the availability of placental LH/hCG to support the luteal
      cells.

PMID- 8359841
TI  - Prostaglandin biosynthesis inhibitory activity of some indian-1 acids in relation
      to their anti-inflammatory activity and ulcerogenic potency.
AB  - Continuation of our work towards development of some newer non-steroidal anti
      inflammatory agents led us to some substituted indian-1-acids with low
      ulcerogenic liability. Prostaglandin biosynthesis inhibitory activity of these
      indian acids and their acid dissociation constants were evaluated in view of
      their activity profile.

PMID- 8359842
TI  - Inhibition of albumin denaturation and anti-inflammatory activity of acetamido
      [(phenyl-4'-yl)-oxymethyl)]2-(p-substituted phenylamino)-1,2,4-triazoles and 
      1,3,4-thiadiazoles.
AB  - Acetamido [(phenyl-4'-yl)-oxymethyl)]-2-(p-substituted-phenylamino)-1,2,4-tr
      iazoles (4a-4d) and 1,3,4-thiadiazoles (5a-5d) inhibited the thermal denaturation
      of bovine serum albumin. As protein denaturation is implicated in inflammation,
      some compounds which showed good inhibition of denaturation were tested in vivo
      for anti-inflammatory activity by carrageenan induced edema in the rat paw.
      Although there was no complete correlation, compounds which showed good
      inhibition of denaturation also showed significant anti-inflammatory activity.

PMID- 8359843
TI  - Lung injury by furanoterpenoids isolated from Fusarium solani infected sweet
      potato, Ipomea batatas.
AB  - Intraperitoneal administration (1 mg/kg body/wt./day for 21 days) of crude
      extract of furanoterpenoids, isolated from F. solani damaged I. batatas caused
      pulmonary oedema in albino rats. The elevated broncho alveolar lavage (BAL)
      angiotensin converting enzyme (ACE), lactate dehydrogenase (LDH) and protein
      levels indicated lung damage. The estimation of pulmonary extracellular
      surfactant phospholipids showed an alteration in various phospholipid fractions.

PMID- 8359844
TI  - Correlation between antiamoebic IgG and autoreactive anti-IgG in amoebic liver
      abscess cases.
AB  - IgG isolated and purified from a healthy human serum through Sephadex G-200 and
      protein A CL 4B sepharose chromatography was used for detection of its own
      antibodies and correlated with the antiamoebic antibody titres in amoebic liver
      abscess cases. The mean titres with standard deviation of the self reactive
      antibodies to serum IgG both ALA cases and healthy controls show a highly
      significant difference, and antiamoebic antibody titres (IgG) are very much
      correlated with the autoreactive anti IgG titres in amoebic liver abscess cases.
      This correlation suggests that as antiamoebic IgG levels reach to its maximum,
      autoreactive anti IgG are produced to switch off antiamoebic anti IgG production
      in amoebic liver abscess cases.

PMID- 8359845
TI  - Effect of thyroxine, prolactin and adrenalin on the gravid ovaries of the frog
      Rana cyanophlyctis (Schn.).
AB  - The effects of thyroxine, prolactin and adrenalin on the gravid ovaries of R.
      cyanophlyctis were studied during late prebreeding period when vitellogenic
      growth of oocytes is complete or near completion. Specified doses of hormones
      were injected (ip) six days a week for one month. They were fed guppies ad
      libitum daily 6 days a week. Administration of 2 or 5 micrograms eltroxine
      (synthetic thyroxine) had no effect on ovaries or oviducts. Whereas, higher doses
      8, 12 and 16 micrograms thyroxine caused significant (P < 0.05) decrease in the
      per cent weight of ovaries and oviducts. The mean diameter of the largest oocyte
      was also reduced significantly compared to the controls. There was an increase in
      the atresia of vitellogenic oocytes. Treatment with 100 micrograms prolactin also
      caused reduction in the per cent weight of ovaries and oviducts. However, mean
      diameter of the largest oocyte did not change significantly. Follicular atresia
      increased only moderately. Injection of 180 micrograms adrenalin bitartrate
      caused drastic decrease (P < 0.05) in the per cent weight of ovaries and oviducts
      and mean diameter of the largest oocyte. Many yolky follicles became atretic. The
      findings suggest that increase in the levels of thyroxine (beyond a certain
      limit), prolactin and adrenalin around the breeding period decrease the fecundity
      of the frog by inducing atresia of yolky oocytes. We conclude that the above
      hormones in excess quantities act as negative modifiers of ovarian activity in R.
      cyanophlyctis.

PMID- 8359846
TI  - Effect of (d-Ala6) LHRH on hypophyseal gonadotrophs and ovary of adult frog, Rana
      tigrina (Daud.) during post-breeding regression phase.
AB  - Effects of synthetic luteinizing hormone-releasing hormone (LHRH, 1.5 micrograms)
      agonist on pituitary and ovary were studied in R. tigrina during November, the
      post-breeding regression phase. Injections (ip) were given 6 days a week for 30
      days and frogs were sacrificed on day 31. Pituitary sections were stained with AB
      PAS-OG. The staining intensity, cytoplasmic granulation and cell, nuclear and
      cytoplasmic areas of hypophyseal gonadotrophs (B2 cells) increased (P < 0.05)
      following LHRH administration. In controls, the B2 cells were small and faintly
      stained. LHRH treatment significantly increased ovarian weight over controls due
      to recruitment of medium sized second growth phase oocytes (MSGP) from the first
      growth phase (FGP) oocytes. Nearly 50% of oocytes from the FGP oocyte pool were
      recruited to SGP. Control frog ovaries lacked SGP oocytes. The results
      demonstrate that both ovary and pituitary of R. tigrina remain responsive to
      gonadotrophic and GnRH stimulation respectively during the post breeding
      regression phase.

PMID- 8359847
TI  - Modulation in activity of some epididymal glycosidases by prolactin.
AB  - Activity of glycosidases in the epididymis was influenced by several factors
      originating in the testis. Activities of all the three glycosidases studied viz.,
      beta-glucosidase, beta-galactosidase and alpha-mannosidase were found to be
      significantly lower in the epididymis of orchidectomized animals than in sham
      operated rats. However, an enhanced activity of epididymal beta-galactosidase and
      alpha-mannosidase was noticed in prolactin treated orchidectomized rats compared
      to orchidectomized rats given vehicle alone. On the other hand, activity of these
      two enzymes in bromocriptine treated orchidectomized rats was even lower than
      that found in orchidectomized rats given vehicle. Neither prolactin nor
      bromocriptine treatment had any significant influence on the epididymal beta
      glucosidase. The results suggest a selective but definite action of prolactin on
      epididymal glycosidases.

PMID- 8359848
TI  - Photoperiodism in Japanese quail (Coturnix coturnix japonica) with special
      reference to relative refractoriness.
AB  - Cloacal gland (an androgen dependent sex accessory) of Japanese quail exhibits
      full breeding condition as long as these were maintained under long days (LD
      16:8). When shifted to short daylength (LD 6:18), scotosensitivity (cloacal gland
      regression) was observed up to 5 weeks, followed by scotorefractoriness (cloacal
      gland development). There was a regression in cloacal gland volume of the birds
      when shifted to intermediate daylength (LD 13.5:10.5 and 13:11) after 12 weeks of
      exposure to long days (relative refractoriness) but no regression when shifted to
      relatively short days (< 14 hr) after 3 weeks of exposure to long daylength.
      Birds maintained under constant short photoperiod (LD 6:18) exhibited cyclicity.
      Shift experiments (quail reared and maintained under continuous light; LL, were
      shifted to LD 16:8, 13:11 and 8:16, similarly quail maintained under LD 16:8 were
      shifted to rest three photoperiods and so on) made to compare the cloacal gland
      responses indicated that if the difference between two photoperiods (previous and
      shifted one) was more the percentage of difference in cloacal gland response was
      also high. Short daylength (LD 8:16) was always gonadoinhibitory for the quail
      previously exposed to any daylength (13L, 16L or 24L) and 16L and 24L were always
      stimulatory for the quail previously exposed to other daylength (8L, 13L, 16L).
      But, when the birds were shifted to 13L, photoresponses cannot be generalized and
      it depends on the photoperiod to which quail were exposed previously (i.e.
      photoperiodic history).

PMID- 8359849
TI  - Reverse single radial immunodiffusion for estimation of titre of anti IgG
      antibody.
AB  - Reverse Single Radial Immunodiffusion (SRID) for estimating titre of anti IgG
      antisera is reported. Unlike the conventional radial immunodiffusion, the antigen
      (IgG) is held immobile in the gel while the antibody (Anti IgG) diffuses radially
      from the well (7 microliters) and the diameter of the resulting
      immuneprecipitates after immunodiffusion at 4 degrees C for 24 hr, represents a
      linear correlation with the antibody titre. The procedure was standardised by an
      extensive trial and error employing different concentrations of human IgG in the
      gel (60-240 micrograms) against varying dilutions of the standard antibody
      (titre: 3.8 mg/ml). The best results were obtained at 80 micrograms of IgG in the
      gel. The locally raised rabbit anti IgG antisera displayed a distinctive titre
      pattern under optimised conditions. Technical reproducibility, high-sensitivity
      threshold (0.25 mg/ml), simultaneous visual scrutiny of several antibody batches
      at a glance and ability to assess the shelf life of the stored antisera are its
      distinct assets.

PMID- 8359850
TI  - Protective effect of BR-16A (Mentat), a herbal preparation on alcohol abstinence
      induced anxiety and convulsions.
AB  - Chronic administration of ethanol (2-5 g/kg, po) on days 1 to 6 and its
      withdrawal produced anxiogenic reaction in mice and rats as assessed on the
      elevated plus-maze. Daily administration of BR-16A (100 mg/kg) prior to ethanol
      intoxication for 6 days prevented withdrawal induced anxiety in both rats and
      mice. However, acute administration of a single dose of BR-16A, to animals
      withdrawn from ethanol, i.e. on the 7th day, showed significant anxiogenic
      response. Ethanol withdrawal also sensitized the convulsogenic reaction to
      pentylenetetrazole (PTZ). A non-convulsive dose (40 or 60 mg/kg) of PTZ produced
      full blown convulsions and increased mortality in ethanol withdrawn rats and
      mice, respectively. Both acute and chronic administration of BR-16A (100 mg/kg)
      exhibited significant protection against ethanol withdrawal-induced reduction in
      PTZ threshold in rats and mice. The results suggest the usefulness of this safe
      herbal psychotropic preparation in the management of ethanol withdrawal
      reactions.

PMID- 8359851
TI  - Effect of histaminergic drugs on tail melanophores of tadpole, Bufo
      melanostictus.
AB  - The H1 and H2 receptor agonist histamine caused a powerful aggregation of B.
      melanostictus tail melanophores, which was completely blocked by metiamide, a
      specific H2 receptor antagonist, while mepyramine an H1 receptor blocker
      partially blocked the aggregating response. The strong melanin aggregating effect
      of 4-methyl histamine a specific H2 receptor agonist and its complete blockade by
      metiamide further supports the conclusion that there exists a dominant population
      of H2 type of histamine receptors along with sparse population of H1 receptor on
      the tail melanophores of the toad, which mediate centripetal movement of melanin
      granules within the pigment cells leading to blanching of the animal.

PMID- 8359852
TI  - Inhibition of lipid peroxidation by piperine during experimental inflammation in
      rats.
AB  - Carrageenin induced rat paw oedema shows a direct co-relationship with liver
      lipid peroxidation and not with kidney or brain. Pretreatment with piperine or
      oxyphenylbutazone reduced the liver lipid peroxidation, acid phosphatase and
      oedema induced by carrageenin. However, no such co-relationship was observed with
      treatment of these anti-inflammatory agents in control animals. It is, therefore,
      suggested that the inhibition of these liver enzymes is non specific in nature.

PMID- 8359853
TI  - Systemic and gastrointestinal candidiasis of infant mice as model for antifungal
      therapy.
AB  - Systemic and gastrointestinal infection was established in infant (15-19 days
      old) mice after oral-intragastric challenge with Candida albicans. All survivors
      retained high levels of organisms in the liver, kidney, spleen, stomach and
      intestine up to the 24th post infection day. These animals with persistent
      infections were used to study the efficacy of short term antifungal therapy. Drug
      treatment was initiated on 13th day for a two week period, treatment with
      fluconazole was compared with amphotericin B, and 5 fluorocytosine. The results
      suggest that fluconazole is a useful drug in the treatment of gastrointestinal
      candidiasis.

PMID- 8359854
TI  - Role of lipid peroxides, glutathione and antiperoxidative enzymes in alcohol and
      drug toxicity.
AB  - Ethanol administration to rats for 30 days and 90 days followed by paracetamol
      administration resulted in liver injury indicated by the significant increase in
      the serum GOT and GPT levels. The ethanol treatment to rats and the
      administration of paracetamol to the normal and alcoholic rats also caused a
      significant increase in the activity of serum acid and alkaline phosphatase. The
      hepatotoxicity of ethanol and paracetamol were indicated by the histological
      alterations in this study. The content of lipid peroxidation products
      malondialdehyde, hydroperoxides and conjugated dienes were increased in the
      liver, heart, kidney and brain of the acute and chronic ethanol treated and
      paracetamol treated rats. The activities of the antiperoxidative enzymes-SOD and
      catalase decreased in the ethanol and paracetamol treated rats. The changes in
      the activities of the antiperoxidative enzymes in alcoholism and drug toxicity
      suggests increased peroxidation, increased synthesis of ecosonoids and increased
      damage to the tissues. The glutathione levels were decreased in the rats
      administered ethanol for 30 days, while the glutathione levels increased in the
      90 days ethanol treated rats. The paracetamol treatment caused a decrease in the
      glutathione levels in the normals and the ethanol treated rats.

PMID- 8359855
TI  - Oviposition site preference in four species of Drosophila.
AB  - Oviposition site preference which is an important aspect of nonsexual behaviour
      of adult females was studied in four species of Drosophila, viz. D. ananassae, D.
      bipectinata, D. malerkotliana and D. biarmipes. The number of eggs laid by
      females in food vials was counted for 20 days. In each species, eggs were counted
      in both central and peripheral areas of culture medium. Eggs were also separated
      into two groups: deposited on the surface of food medium and inserted into the
      surface of culture medium. Greater proportion of eggs was oviposited in
      peripheral area of food medium and were inserted into the surface of the medium
      by females of all the four species. However, there are interspecies variations
      with respect to oviposition site preference. Further, these species show
      variation with respect to total fecundity. D. ananassae lays maximum number of
      eggs whereas D. biarmipes shows lowest rate of fecundity.

PMID- 8359856
TI  - Hypoglycaemic activity of arecoline in betel nut Areca catechu L.

PMID- 8359857
TI  - Recognition of Entamoeba histolytica in liver abscess cases through their
      specific antiamoebic antibodies.

PMID- 8359858
TI  - Penicillin decreases streptococcal hydrophobicity and streptococcal adherence to
      human pharyngeal cells.

PMID- 8359859
TI  - Control of citrinin caused nephrotoxicosis through aqueous leaf extract of Vitis
      vinifera L., mercurious corrossivus and cortisone.

PMID- 8359860
TI  - Geographic distribution of I-R and P-M systems of hybrid dysgenesis in Indian
      populations of Drosophila melanogaster.

PMID- 8359861
TI  - Vitamin E as a radioprotector of bursa of Fabricius in chicks.

PMID- 8359862
TI  - Denervation and exercise effects on cholesterol content of chick pectoralis and
      gastrocnemii muscles.

PMID- 8359864
TI  - Induction of experimental autoimmune myasthenia gravis with acetylcholine
      receptors using a nonionic block copolymer as adjuvant.
AB  - To induce autoimmune diseases in animals, the auto-antigen has to be emulsified
      in adjuvants (e.g., complete Freund's adjuvant) containing microbial products
      such as Mycobacterium tuberculosis. But these powerful immunoadjuvants are not
      without undesirable immune response to the microbial proteins and induction of
      adjuvant arthritis, which could interfere with the antigen specific autoimmune
      response to be tested. This study was performed to evaluate the requirement of
      microbial products in the induction of experimental autoimmune diseases, and to
      identify an adjuvant without unwanted immune responses. C57BL/6 mice were
      inoculated with Torpedo acetylcholine receptors (T-AChR) emulsified in Titermax
      (TM), an adjuvant containing nonionic block copolymer and no microbial products,
      and evaluated for experimental autoimmune myasthenia gravis (EAMG)
      susceptibility. Mice immunized with T-AChR in TM demonstrated characteristic
      myasthenic muscle weakness with electrophysiological defect, elevated serum anti
      AChR antibodies, and muscle AChR loss. None of the mice that received TM alone
      had muscle weakness, serum anti-AChR antibodies or muscle AChR loss. The data
      imply that microbial products are not critical in the induction of autoimmune
      diseases like myasthenia gravis in mice. Further, nonionic block copolymer could
      be an ideal adjuvant in the induction of autoimmune diseases in animals.

PMID- 8359863
TI  - Effects of various anti-T cell receptor antibodies on the development of type II
      collagen-induced arthritis in mice.
AB  - Recent genetic studies of David and coworkers suggest that subsets of T cells
      utilizing specific V beta TcR genes may play important roles in the
      susceptibility to collagen-induced arthritis (CIA). Hence, in vivo depletion of
      such T cell subsets may significantly affect the development of CIA. To address
      this possibility, we first examined the effects of in vivo treatments with
      various monoclonal antibodies (mAbs) that are specific for particular TcR V beta
      families on the induction of CIA. Results presented in this study demonstrated
      that treatments with either anti-V beta 6, anti-V beta 8 or anti-V beta 11 did
      not suppress the development of arthritis in collagen-immunized mice. While
      combined treatments with these V beta specific mAbs which resulted in the in vivo
      elimination of V beta 6+, V beta 8+ and V beta 11+ T cells were not very
      effective in preventing the onset of CIA, the severity of the arthritic disease
      was somewhat reduced in animals that had received the triad of anti-V beta mAbs.
      By contrast, depletion of T cells expressing the alpha beta receptors by in vivo
      treatments with a pan anti-alpha beta mAb significantly decreased the incidence
      of CIA. Therefore, although an effect on the development of CIA was achieved by
      in vivo treatments with a mAb that detects all alpha beta + T cells, the
      elimination of only a few subsets of T cells which included the V beta 6+, V beta
      8+, and V beta 11+ cells did not profoundly alter the incidence of CIA.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8359866
TI  - Irreversible suppression of CD8 expression in CD4-CD8+ thymocytes upon in vitro
      stimulation.
AB  - CD8 (Ly-2) expression was suppressed in purified murine CD4-CD8+ thymocytes at
      the mRNA level upon continuous stimulation with PMA and ionomycin in the presence
      of rIL-2. The level of CD8 expression on CD4-CD8+ thymocytes was reduced
      gradually during the culture and a majority of them turned into CD4-CD8- cells
      after 48 hr. This suppression was not transient, since CD8 expression was not
      recovered on these cells in additional 48 hr of culture without PMA and
      ionomycin. The suppression was dependent on the concentrations of PMA and
      ionomycin, and inhibited by adding an immunosuppressant, CsA to the culture.
      Treatment with either PMA or ionomycin alone did not induce suppression of CD8.
      Crosslinking of CD3-epsilon chains also induced suppression of CD8 for a part of
      CD4-CD8+ thymocytes. Interestingly, CD8 expression was hardly suppressed in CD4
      CD8+ peripheral T lymphocytes, suggesting that the mechanisms of suppression of
      CD8 is developmentally regulated. We propose that the suppression of CD8
      expression at CD4-CD8+ stage involves an additional mechanism of negative
      selection of thymic T cells.

PMID- 8359865
TI  - Inhibitory effect of lipopolysaccharide-stimulated P388D1 macrophage-like cells
      on plasmacytoma cells.
AB  - Culture supernatants of lipopolysaccharide-stimulated P388D1 macrophage-like
      tumor cells showed a growth inhibitory effect on plasmacytoma MOPC-315, MPC-11
      and myeloma FO cells, but had no effect on J558 plasmacytoma cells. Based on the
      results of trypan blue staining and a 51Cr release assay, the supernatant had
      both cytotoxic and cytostatic activity for MOPC-315 plasmacytoma cells. The
      inhibitory activity was trypsin-sensitive, heat-stable at 100 degrees C for 20
      min., but sensitive to 2-mercaptoethanol and cystein HCl. At least 6 hrs of
      exposure period were required for the P388D1 culture supernatant to show an
      inhibitory effect on plasmacytoma cells. Since the inhibitory activity could not
      be blocked by protease inhibitor or neutralized by antibodies to mouse IL-1 beta,
      IL-6 and TNF-alpha, the inhibitory factor(s) was distinct from the defined
      cytotoxic factors. After partial purification with DEAE-Sephacel and Sephacryl S
      300 chromatography, four major active peaks with the molecular mass of 874-KDa
      (near the void volume), 112-KDa, 45-KDa and 18-KDa were obtained.

PMID- 8359867
TI  - In recognition of an implant pioneer: Professor Dr. Andre Schroeder.

PMID- 8359868
TI  - Is osteoporosis a risk factor for osseointegration of dental implants?
AB  - The success of osseointegration depends in part on the state of the host bed.
      Concerns have therefore been raised about osteoporosis, a condition believed to
      be associated with a decrease in bone quality and quantity. However, the
      orthopedic literature indicates that osteoporotic fractures heal readily and that
      the level of bone mass and estimates of the parameters associated with bone
      remodeling present considerable overlap between patients with osteoporosis and
      control subjects. It also appears that osteoporosis, as diagnosed at one
      particular site of the skeleton, is not necessarily seen at another distant site.
      Although the prevalence of osteoporosis increases among the elderly and after
      menopause, the results of this study indicate that implant failure rate is not
      correlated with age and sex. A review of the literature and of results of a
      series of patients treated does not provide a compelling theoretical or practical
      basis to expect osteoporosis to be a risk factor for osseointegrated dental
      implants.

PMID- 8359869
TI  - Repositioning the inferior alveolar nerve for placement of endosseous implants:
      technical note.
AB  - Placement of implants in the posterior mandible is limited by the height of bone
      between the alveolar crest and the inferior alveolar canal. This paper discusses
      a surgical technique to reposition and protect the neurovascular bundle so that
      endosseous implants may be placed. A rectangular window is cut in the cortical
      bone posterior to the mental foramen. The mental foramen is not violated and the
      mental nerve is not relieved peripherally into the soft tissue. Cancellous bone
      is removed from the window and the canal is uncovered. A vessel loop placed
      around the bundle repositions and protects the nerve laterally. After implant
      placement, the bundle is replaced within the cortical window and the
      mucoperiosteal flap is sutured. Avoiding manipulation of the terminal branches of
      the inferior alveolar nerve reduces the risk of permanent nerve damage.

PMID- 8359870
TI  - Treatment planning and placement of implants in the posterior maxillae: report of
      732 consecutive Nobelpharma implants.
AB  - One to nine Nobelpharma osseointegrated implants were placed in the posterior
      maxillae of 213 consecutive partially edentulous patients. Reconstruction was
      completed with a ceramic fixed partial denture with follow-up of 5 to 70 months
      (mean 30.3 months) after loading. Thirty-four implants in 29 patients failed;
      eight were replaced and one of these failed. Thus, the overall failure rate was
      4.8% (35/732). The failure rate in type IV bone was only slightly higher than
      that in types II and III bone (5.5% versus 4.6%). The failure rate in the entire
      molar area was 5.3% compared with 4.5% in the premolar area (P = NS), and the
      failure rate of 7-mm implants was 9.5% compared with 3.8% for implants of all
      other lengths (P = .01).

PMID- 8359871
TI  - Osseointegrated dental implants with ball attachments supporting overdentures in
      patients with mandibular alveolar ridge atrophy.
AB  - Branemark dental implants with ball attachments supporting overdentures were used
      as alternative treatment to combined lingual-vestibuloplasty with free split
      thickness skin graft and removable dentures in 25 consecutive patients with
      mandibular alveolar ridge atrophy. Ninety-three fixtures were placed. Ball
      attachments were mounted on the fixtures, and implant-supported overdentures were
      inserted 3 to 4 months after fixture placement. The observation period after
      implant activation and prosthesis insertion varied from 12 to 27 months with a
      median observation period of 18 months. The overall success rate of individual
      implants was 97% (90/93). The prosthesis function rate was 100% (25/25). The 1
      year success rate of individual implants was 98% (91/93) with a prosthesis
      function rate of 100% (25/25). No persistent surgical or prosthodontic
      complications were observed. Preliminary results indicate that osseointegrated
      Branemark dental implants with ball attachments supporting overdentures can be a
      successful alternative to combined lingual-vestibuloplasty with free split
      thickness skin graft and removal dentures in patients with denture problems
      related to mandibular alveolar ridge atrophy.

PMID- 8359872
TI  - Treatment of the severely resorbed maxillae with bone graft and titanium
      implants: histologic review of autopsy specimens.
AB  - One of a series of patients with extremely resorbed maxillae treated with bone
      grafts from the hip in combination with Branemark self-tapping fixtures died in a
      car accident 4 months after implant surgery. Autopsy specimens from this patient
      were analyzed to evaluate the amount and extent of "osseointegration" after 4
      months of healing. Histologic examination revealed that minimal bone was in
      direct contact with the titanium and the general pattern was that of soft tissue
      screw anchorage. There were no signs of sequestering of the transplanted bone.
      The connection between the nasal cavity and the sinus mucosa with respect to the
      transplants seemed to be without adverse reactions. The superior part of the
      transplant did show signs of newly formed bone. The grafted specimens showed
      indications of delayed bone response compared to the nongrafted situation. All
      implants were clinically stable as studied postmortem.

PMID- 8359873
TI  - Qualitative mechanoperception of natural teeth and endosseous implants.
AB  - The responses of 100 patients to load on Tubingen ceramic implants and natural
      teeth were analyzed to learn about the facets of qualitative mechanoperception.
      This approach revealed four factors of mechanoperception: dullness, intensity,
      localization, and persistence. Dullness, localization, and persistence were
      discriminated between teeth and implants. Intensity perception, however, depended
      on load only.

PMID- 8359874
TI  - Biomechanical considerations of prosthodontic therapy: the urgency of research
      into alveolar bone responses.
AB  - The prognosis of natural and implant abutments depends in part on the
      complementary and/or antagonistic biomechanic and calcium homeostatic functions
      of the adjacent alveolar bone. Whereas bone morphology is determined by peak
      strains, strain rates, and strain distributions, infrequent error strains on
      abutments have a greater impact on the adjacent alveolar bone than those
      generated during "normal" activity. Alveolar responses depend on the immediate
      prevailing systemic and local demands, although unexpected abutment failures will
      continue until such influences have been investigated further.

PMID- 8359875
TI  - The effect of crestal versus mucobuccal incisions on the success rate of implant
      osseointegration.
AB  - A retrospective analysis compared the success rate of osseointegration of
      Nobelpharma implants at stage 2 surgery. The implants had been placed using
      either a mucobuccal fold incision or a crestal incision. A total of 386 implants
      was placed in 92 patients; 265 implants were placed in 60 patients using a
      mucobuccal fold incision, with a success rate of 98.8%, and 121 implants were
      placed in 32 patients using a crestal incision, with a success rate of 98.3%.
      Implants can be placed using either a mucobuccal fold incision or a crestal
      incision to achieve predictable success.

PMID- 8359876
TI  - Anatomic consideration for preventive implantation.
AB  - The aim of preventive implant therapy is to prevent or delay loss of alveolar
      ridge bone mass. For use in an anatomic study of 60 mandibles, resorption of the
      alveolar ridge was classified into four preventive stages: (1) after extraction
      of teeth; (2) after initial resorption; (3) when the ridge has atrophied to a
      knife-edge shape; and (4) when only basal bone remains. Implantation in stage 3
      necessitates removal of the knife-edge ridge to create space for cylindrical
      implants. Therefore, implantation in stage 2 is advocated to prevent the
      development of stage 3. The aim of implantation in stage 4 is to prevent total
      loss of function of the atrophic mandible.

PMID- 8359877
TI  - Craniofacial osseointegration: the Canadian experience.
AB  - A survey was undertaken to determine the number of centers in Canada with an
      active involvement in extraoral osseointegration. It was found that six centers
      had placed 222 implants in 91 patients in Canada. The individual implant success
      rates for the Canadian experience were compared with the published Swedish and
      United States' experience. The Canadian experience is combined with the Swedish
      and United States' experience to provide retrospective multinational multicenter
      data. The data given should be viewed as providing trends only and not as
      definitive expectations of predictable success rates. The success rates are
      considered likely to change with time as the number of patients treated increases
      and the duration of follow-up is extended. The mastoid region in nonradiated
      patients is considered to provide a high degree of predictable individual implant
      success. The success rates in radiated patients yield far lower success rates,
      which vary with anatomic location. The criteria for success in using craniofacial
      implants need to be defined and should reflect the differences between extraoral
      and intraoral implants.

PMID- 8359878
TI  - Use of the final denture base for the intermaxillary registration in an implant
      supported overdenture: technical note.
AB  - A method of implant-retained overdenture treatment based on the early use of the
      final denture base during registration of the maxillomandibular jaw relation is
      described. Using this stable denture base, an accurate recording of jaw relation
      and an adequate try-in procedure are facilitated without displacement of the
      base, especially in the situation of an unfavorable flat edentulous mandibular
      residual ridge.

PMID- 8359879
TI  - Distal extension removable partial dentures supported by implants and residual
      teeth: considerations and case reports.
AB  - The traditional treatment for an edentulous maxilla opposed by a partially
      edentulous mandible with a complete denture and a distal extension removable
      partial denture is fundamentally inadequate. Continuing resorption of alveolar
      bone under the denture base of the removable partial denture causes changes in
      the occlusal plane. Consequently, overloading of the anterior maxillary region
      occurs, usually leading to increased bone resorption in the anterior maxillary
      ridge. Placement of implants beneath the distal extension denture base of the
      removable partial denture can result in a stable and durable occlusion. Two
      patients in whom the use of implants combined with a cast metal removable partial
      denture provided occlusal stability and improved functional comfort are
      presented.

PMID- 8359880
TI  - CyaC-mediated activation is important not only for toxic but also for protective
      activities of Bordetella pertussis adenylate cyclase-hemolysin.
AB  - Bordetella pertussis adenylate cyclase-hemolysin (AC-Hly), encoded by the cyaA
      gene, belongs to the RTX family of toxins with extensive glycine-rich repeats in
      the carboxy-terminal portion. AC-Hly possesses both adenylate cyclase toxic and
      hemolytic activities that depend on a posttranslational modification mediated by
      the product of the cyaC gene. An improved system for AC-Hly synthesis and
      activation in Escherichia coli was developed. The results show that with purified
      AC-Hly (i) increased expression of the cyaC gene leads to a higher proportion of
      activated AC-Hly, (ii) the increase in protective activity of the activated
      recombinant AC-Hly correlates with the increase in its invasive and hemolytic
      activities, and (iii) the activated recombinant AC-Hly, but not the nonactivated
      recombinant AC-Hly, is a protective antigen against B. pertussis infection in a
      murine respiratory model. This suggests that possibly an immunodominant epitope
      required for protective activity is linked to the CyaC-mediated modification.
      Surprisingly, the protective and hemolytic activities of activated recombinant AC
      Hly were lower than those of AC-Hly produced by B. pertussis, while its invasive
      activity was higher. This indicates that the modification of AC-Hly in B.
      pertussis and that in E. coli may differ.

PMID- 8359881
TI  - An OspB mutant of Borrelia burgdorferi has reduced invasiveness in vitro and
      reduced infectivity in vivo.
AB  - Most Borrelia burgdorferi strains have two major surface proteins, OspA and OspB.
      In the present study, we selected from a clonal population of infectious B.
      burgdorferi an OspB escape mutant, identified the genetic basis for this
      phenotype, and evaluated its functional activities. Selection with the anti-OspB
      antibody H614 was performed in vitro in medium and extended in vivo in scid mice.
      Mutants with a truncated OspB protein were selected at a frequency of 1 x 10(-5)
      to 3 x 10(-5). After no major rearrangements in DNA were detected, sequence
      analysis of the mutant's ospAB locus revealed a single base change in the
      consensus ribosomal binding sequence for ospB and a single nucleotide deletion in
      the ospB gene itself. The effect of these mutations was reduced expression of a
      truncated OspB protein. When functional abilities of the wild type and mutant
      were compared, the mutant had a threefold-lower capacity to penetrate a human
      endothelium umbilical vein cell monolayer. Infectivity of wild-type and mutant
      cells for scid mice was evaluated by culturing different organs, and the median
      infectious dose was calculated. The inoculum of mutant cells for infecting the
      mice was 30- to 300-fold higher than that of wild-type cells. This study shows
      that reduced size and expression of OspB are associated with lowered virulence of
      B. burgdorferi. Selection of mutants that to some degree remain infectious is one
      approach to defining the role of different surface proteins in the pathogenesis
      of Lyme disease.

PMID- 8359882
TI  - Unexpectedly high levels of some presumably protective secretory immunoglobulin A
      antibodies to dental plaque bacteria in salivas of both caries-resistant and
      caries-susceptible subjects.
AB  - The role of salivary antibodies in protection against cariogenic bacteria is
      actually a matter of debate. Correlation between caries experience and naturally
      occurring antibodies was extensively investigated. Comparison of salivary
      antibodies from 21 caries-resistant and 22 caries-susceptible subjects was
      carried out by using a new quantitative method. Secretory immunoglobulin A (S
      IgA) antibodies to Streptococcus sobrinus and Streptococcus sanguis cells were
      detected in all salivas and at similar levels in both groups. When assayed with
      two major antigens from S. sobrinus, i.e., protein antigen I/II and cell wall
      carbohydrates, only specific activities of antibodies to the protein component
      were increased (P < 0.01), but this occurred unexpectedly in the caries
      susceptible group. Western blot (immunoblot) analysis with the culture
      supernatant and cell wall proteins from S. sobrinus showed the same antibody
      specificity in both groups. No selective increase of the protease-resistant S
      IgA2 subclass was found, and avidities of antibodies to both antigen I/II and
      cell wall carbohydrates were similar. Our results demonstrate that naturally
      induced S-IgA antibodies against S. sanguis, S. sobrinus, and the major antigens
      of the latter are not sufficient to inhibit caries development.

PMID- 8359883
TI  - Toxic effects of tetanus toxin on GG2EE macrophages: prevention of gamma
      interferon-mediated upregulation of lysozyme-specific mRNA levels.
AB  - By using a nonneuronal cell system, evidence has previously been provided that
      tetanus toxin (TT) intoxication occurs in macrophages, impairing their secretory
      activity as well as their antitumoral activity. In particular, both secreted and
      total lysozyme (LZM) activities are reduced by TT treatment, provided that GG2EE
      macrophages have been preexposed to gamma interferon (IFN-gamma). In an attempt
      to provide insight into the molecular mechanisms underlying this phenomenon, we
      focused our attention on the levels of LZM-specific transcripts. GG2EE
      macrophages preexposed to IFN-gamma exhibited augmented levels of LZM-specific
      mRNA. Such an effect was detected 1 h after removal of IFN-gamma, peaked at 3 h,
      and gradually decreased with time in culture. Exposure of IFN-gamma-pretreated
      GG2EE macrophages to TT resulted in the prevention of the IFN-gamma-mediated
      upregulation of LZM mRNA levels. The phenomenon was mediated by the holotoxin (>
      or = 1 micrograms/ml) and abrogated by preexposure of the macrophages to the C
      fragment of TT. Protein kinase C (PKC) and Ca(2+)-calmodulin-dependent PK were
      likely involved in the IFN-gamma-mediated upregulation of LZM mRNA levels and
      biological activity, as assessed by PK inhibitors. Furthermore, PK inhibitors
      mimicked TT in impairing LZM activity of GG2EE macrophages, thus suggesting that
      impairment of PKC and/or the Ca(2+)-calmodulin-dependent PK pathway(s) may be one
      of the events involved in TT intoxication of macrophages.

PMID- 8359884
TI  - Stimulation of DNA synthesis in osteoblast-like MC3T3-E1 cells by Bordetella
      bronchiseptica dermonecrotic toxin.
AB  - We investigated the effects of Bordetella bronchiseptica dermonecrotic toxin on
      DNA synthesis in MC3T3-E1 cells. The rate of [methyl-3H]thymidine incorporation
      increased in the toxin-treated cells more than 24 h after addition of the toxin
      under the serum-starved conditions. This effect was dependent on the toxin
      concentration ranging from 0.3 to 3 ng/ml and was eliminated by aphidicolin and
      hydroxyurea, inhibitors for DNA replication. In the toxin-treated culture, the
      number of cells did not increase but polynucleated cells appeared and their
      number increased to ca. 50% of the total number of cells 6 days after the toxin
      addition. From these results, we concluded that the toxin stimulates DNA
      replication in MC3T3-E1 cells without cell proliferation.

PMID- 8359885
TI  - OmpC is involved in invasion of epithelial cells by Shigella flexneri.
AB  - Osmoregulation of the Shigella flexneri ompC gene and the role of OmpC in
      Shigella virulence have been investigated. OmpC was highly expressed when
      bacteria were grown in medium of either low or high osmolarity. This constitutive
      expression is in contrast with the regulation observed in Escherichia coli, in
      which the expression of OmpC is repressed at low osmolarity and induced at high
      osmolarity. In addition, the Shigella ompC gene was barely expressed by a delta
      ompB (delta ompR and delta envZ) mutant. We described in a previous report that
      such a mutant was severely impaired in virulence both in vitro and in vivo.
      Starting from this observation, and in order to assess which gene(s) regulated by
      ompR and envZ are involved in virulence, we constructed an S. flexneri delta ompC
      mutant. Three S. flexneri mutants, ompF'-lacZ, delta ompC, and delta ompB, were
      compared for virulence. The ompF'lacZ mutant behaved like the S. flexneri
      serotype 5 wild-type strain M90T in all in vitro and in vivo virulence tests. On
      the contrary, the delta ompB and delta ompC strains were considerably impaired in
      their virulence phenotypes. The ability of these two mutants to spread from cell
      to cell and to kill epithelial cells was severely affected. Consequently delta
      ompC, as previously described for delta ompB, was unable to elicit a positive
      Sereny test. The delta ompB mutant was restored to virulence by introducing a
      recombinant multicopy plasmid carrying the cloned E. coli ompC gene, indicating
      that a functional OmpC protein was necessary and sufficient to restore virulence
      to this mutant of S. flexneri.

PMID- 8359886
TI  - Involvement of the stage-specific 82-kilodalton adhesion molecule of Trypanosoma
      cruzi metacyclic trypomastigotes in host cell invasion.
AB  - This study provides several pieces of evidence indicating that 3F6-Ag, identified
      by monoclonal antibody (MAb) 3F6 as a stage-specific glycoprotein of
      approximately 82 kDa on the surface of metacyclic trypomastigotes of different
      Trypanosoma cruzi strains, promotes the entry of parasites into host cells
      through a ligand-receptor type interaction. First, invasion of Vero cells by
      metacyclic trypomastigotes of both CL and Tulahuen strains was significantly
      inhibited by MAb 3F6 or its Fab fragments. Second, purified 3F6-Ag bound to Vero
      cells in a dose-dependent and saturable fashion. Third, soluble 3F6-Ag reduced
      the infection of Vero cells by metacyclic forms of CL and Tulahuen strains by 90
      to 97 and 50%, respectively. Unrelated proteins, as well as extracellular matrix
      components, such as heparan sulfate and collagen, had no effect. Our studies also
      show that in the Tulahuen strain, 10D8-Ag, a 35/50-kDa glycoprotein identified by
      MAb 10D8, participates in target cell invasion, confirming previous observations,
      but the variant form of 10D8-Ag expressed by highly invasive CL strain metacyclic
      trypomastigotes appears to be irrelevant. Overall, our results indicate that the
      surface components of T. cruzi metacyclic trypomastigotes involved in the process
      of host cell penetration are developmentally regulated molecules, such as 3F6-Ag
      and 10D8-Ag, that have no counterpart in blood- or tissue culture-derived
      trypomastigotes.

PMID- 8359887
TI  - The Mycobacterium leprae antigen 85 complex gene family: identification of the
      genes for the 85A, 85C, and related MPT51 proteins.
AB  - The genes for two novel members (designated 85A and 85C) of the Mycobacterium
      leprae antigen 85 complex family of proteins and the gene for the closely related
      M. leprae MPT51 protein were isolated. The complete DNA sequence of the M. leprae
      85C gene and partial sequences of the 85A and MPT51 genes are presented. As in M.
      tuberculosis, the M. leprae 85A, 85C, and previously identified 85B component
      genes are not closely linked on the genome. However, the MPT51 genes of both
      species localize close to the respective 85A component genes. Like the 85B
      component, the M. leprae 85A-MPT51 and 85C antigens are recognized by T cells
      from healthy contacts and leprosy patients.

PMID- 8359888
TI  - Cloning and characterization of ECE1, a gene expressed in association with cell
      elongation of the dimorphic pathogen Candida albicans.
AB  - The gene ECE1 (extent of cell elongation 1) was isolated by differential
      hybridization screening of a Candida albicans cDNA library by using probes
      derived from populations of yeast cells or hyphae. Expression of this gene was
      not detected when C. albicans grew as a budding yeast cell but was observed
      within 30 min after cells had been induced to form hyphae. In all strains tested,
      regardless of the induction signal, ECE1 expression correlated with the extent of
      cell elongation. The genomic version of ECE1 was cloned and sequenced. The
      deduced 271-amino-acid polypeptide consisted of eight tandem repeats of a
      degenerate 34-amino-acid sequence which contained no discernible homology with
      other known sequences. An ECE1 null mutant displayed no morphological
      alterations, which demonstrated that ECE1 is not essential for cell elongation or
      hypha formation despite the strict morphological association of its expression.

PMID- 8359889
TI  - Role of complement component C1q in phagocytosis of Listeria monocytogenes by
      murine macrophage-like cell lines.
AB  - Listeria monocytogenes is a facultative intracellular pathogen of a great variety
      of cells. Among them, macrophages constitute the major effector cells of
      listerial immunity during the course of an infection. Although the molecular
      bases of L. monocytogenes attachment and entry to phagocytes are not completely
      understood, it has been demonstrated that C3b significantly increases L.
      monocytogenes uptake by macrophages via complement receptor type 3. The first
      component of complement, C1q, is present in organic fluids at a relatively high
      concentration, and C1q receptor sites in macrophages are also abundant. In the
      present report, results of studies on the role of C1q in the internalization and
      infectivity of L. monocytogenes by macrophages are presented. L. monocytogenes
      uptake is enhanced by prior treatment of bacteria with normal sera. Heated serum
      or C1q-deficient serum abrogates this enhancement. Purified C1q specifically
      restored uptake. This effect was blocked by the addition of F(ab')2 anti-C1q
      antibody but not by an irrelevant matched antibody. Direct binding of C1q to L.
      monocytogenes was specific, saturable, and dose dependent with both fluorescent
      and radiolabeled C1q. N-Acetyl-D-alanyl-L-isoglutamine, diaminopimelic acid, and
      L-rhamnose caused a significant dose-dependent inhibition of C1q binding to
      bacteria, suggesting that these molecules, at least, are involved in the
      attachment of C1q to L. monocytogenes cell wall. When C1q binding structures on
      macrophage-like cells were blocked with saturating concentrations of C1q, the
      uptake of C1q-opsonized bacteria was less than in untreated cells. These
      experiments demonstrate that, in addition to other reported mechanisms, L.
      monocytogenes binds C1q, which mediates enhanced uptake by macrophages through
      C1q binding structures.

PMID- 8359890
TI  - Synthesis, characterization, and clinical evaluation of conjugate vaccines
      composed of the O-specific polysaccharides of Shigella dysenteriae type 1,
      Shigella flexneri type 2a, and Shigella sonnei (Plesiomonas shigelloides) bound
      to bacterial toxoids.
AB  - The theoretic basis for developing conjugate vaccines, to induce immunoglobulin G
      (IgG) lipopolysaccharide (LPS) antibodies for the prevention of shigellosis, has
      been described (J. B. Robbins, C.-Y. Chu, and R. Schneerson, Clin. Infect. Dis.
      15:346-361, 1992). The O-specific polysaccharides (O-SPs) of Shigella dysenteriae
      type 1, S. flexneri type 2a, and S. sonnei were covalently bound to carrier
      proteins. Alone, the O-SPs were not immunogenic in mice. Conjugates of these O
      SPs, injected into young outbred mice subcutaneously as saline solutions
      containing 2.5 micrograms of saccharide, elicited serum IgG and IgM antibodies
      with booster responses; adsorption onto alum enhanced their immunogenicity.
      Injection of 25 micrograms of these conjugates into adult volunteers elicited
      mild local reactions only. Each conjugate induced a significant rise of the
      geometric mean serum IgG, IgM, and IgA LPS antibody levels. A second injection 6
      weeks later did not elicit booster responses, and adsorption of the conjugates
      onto alum did not enhance their immunogenicity. Conjugate-induced levels of IgA,
      but not IgG or IgM, declined to preimmunization levels at day 56. The levels of
      postimmunization antibodies of the three immunoglobulin classes were similar to
      or higher than those of recruits in the Israel Defense Force following
      shigellosis caused by S. flexneri type 2a or S. sonnei. These data provide the
      basis for evaluating these conjugates to prevent shigellosis.

PMID- 8359891
TI  - Structural analysis of the Actinobacillus pleuropneumoniae-RTX-toxin I (ApxI)
      operon.
AB  - Actinobacillus pleuropneumoniae-RTX-toxin I (ApxI), an important virulence
      factor, is secreted by serotypes 1, 5, 9, 10, and 11 of A. pleuropneumoniae.
      However, sequences homologous to the secretion genes apxIBD of the ApxI operon
      are present in all 12 serotypes except serotype 3. The purpose of this study was
      to determine and compare the structures of the ApxI operons of the 12 A.
      pleuropneumoniae serotypes. We focused on the nucleotide sequence comparison of
      the ApxI-coding genes, the structures of the ApxI operons, and the transcription
      of the ApxI operons. We determined the nucleotide sequences of the toxin-encoding
      apxICA genes of serotype 9 and found that the gene for the structural toxin,
      apxIA, was almost identical to the apxIA gene of serotype 1. The toxin-encoding
      genes of the other serotypes are also similar for the main part; nevertheless,
      two variants were identified, one in serotypes 1, 9, and 11 and one in serotypes
      5 and 10. The two apxIA variants differ mainly within the distal 110 nucleotides.
      Structural analysis demonstrated that intact ApxI operons, consisting of the four
      contiguous genes apxICABD, are present in serotypes 1, 5, 9, 10, and 11. ApxI
      operons with a major deletion in the apxICA genes are present in serotypes 2, 4,
      6, 7, 8, and 12. Serotype 3 does not contain ApxI operon sequences. We found that
      all ApxI operons are transcriptionally active despite the partial deletion of the
      operon in some serotypes. The implications of these data for the expression and
      secretion of ApxI and the other Apx-toxins, ApxII and ApxIII, as well as for the
      development of a subunit vaccine against A. pleuropneumoniae will be discussed.

PMID- 8359892
TI  - Association of type II immunoglobulin G-binding protein expression and survival
      of group A streptococci in human blood.
AB  - Expression of immunoglobulin G (IgG)-binding proteins on group A streptococcus
      strain 64 was monitored on bacteria subjected to sequential passage in human
      blood. After approximately 10 cycles through human blood, strain 64 demonstrated
      enhanced levels of IgG-binding protein, including the expression of a type IIa
      binding molecule with an M(r) of approximately 47,000 present only at very low
      levels on the parent isolate. Changes in the expression of IgG-binding proteins
      after passage in human blood were similar to those observed when the same
      organism was passaged sequentially intraperitoneally in mice. Strain 64, passaged
      in human blood 23 times, was found to be more virulent than the parent isolate
      when used to infect mice either intraperitoneally or in a skin air sac. These
      findings suggest that the expression of IgG-binding proteins may be a common
      response of group A organisms to pressures exerted by distinct host defense
      mechanisms.

PMID- 8359893
TI  - Inactivation of the streptococcal erythrogenic toxin B gene (speB) in
      Streptococcus pyogenes.
AB  - Streptococcal proteinase precursor (SPP) is a zymogen secreted by Streptococcus
      pyogenes that becomes activated to a cysteine proteinase. SPP has been shown to
      be immunologically identical to streptococcal erythrogenic toxin B (SPE B), and
      sequence comparison has shown a high degree of homology between the two proteins.
      In this study, we have constructed a speB mutant strain of S. pyogenes by
      insertional inactivation. An internal fragment of the cloned speB gene in plasmid
      pCR1000 was replaced with an erythromycin resistance determinant, and the
      recombinant plasmid was introduced into strain NZ131 by electrotransformation.
      Following the selection of erythromycin-resistant clones, Southern hybridization
      experiments confirmed the presence of the recombinant plasmid containing the erm
      gene in the chromosome of the resistant strains. Analysis of extracellular
      proteins produced by the wild-type and speB mutant strains by Ouchterlony
      immunodiffusion and isoelectric focusing revealed the presence of SPE B in the
      wild-type strain but not the speB mutant. Additionally, SPP, which has an
      isoelectric focusing pattern similar to that of SPE B and reacts with SPE B
      antiserum, was not detected among the extracellular proteins of the speB mutant
      strain. Proteinase activity as assayed by two different methods was present in
      the extracellular proteins produced by the wild-type strain, but the speB mutant
      strain had no extracellular proteinase activity. The mutant strain had a growth
      rate similar to that of the wild-type strain and produced normal levels of other
      extracellular products, suggesting that proteinase was not essential for
      viability as previously suggested. Our data are consistent with the view that a
      single gene (speB) produces a single protein that has been identified and/or
      assayed as either SPE B or SPP.

PMID- 8359894
TI  - Gamma interferon response in secondary Leishmania major infection: role of CD8+ T
      cells.
AB  - CD8+ T cells have been shown to contribute to the rapid resolution of secondary
      lesions developing in immune mice challenged with Leishmania major. In the
      present study, we assessed directly the participation of specific CD8+ T cells in
      the memory response induced in immune mice by reinfection. Lymphocyte populations
      from reinfected immune mice exhibit marked secondary gamma interferon (IFN-gamma)
      responses. The participation of IFN-gamma-producing CD8+ T cells in the memory
      response elicited by secondary infectious challenge was demonstrated in both
      genetically resistant immune CBA mice and genetically susceptible immune BALB/c
      mice that were rendered resistant by administration of anti-CD4 monoclonal
      antibody in the early phase of the primary infection. The protective function of
      CD8+ T cells in experimental murine cutaneous leishmaniasis might thus be
      explained in part by their ability to secrete IFN-gamma. In this context, the
      neutralization of IFN-gamma at the time of reinfection reduced the Leishmania
      specific delayed-type hypersensitivity response, showing that this cytokine is
      involved in the recall of immunological memory to L. major in vivo.

PMID- 8359895
TI  - Analysis of cytokine mRNA expression in Listeria-resistant C57BL/6 and Listeria
      susceptible A/J mice during Listeria monocytogenes infection.
AB  - This laboratory previously reported that mRNA expression for many cytokines, as
      determined by reverse transcription-polymerase chain reaction analysis, is
      induced rapidly in the spleen during murine listeriosis. In the present study,
      the patterns of cytokine mRNA expression in spleens and livers of Listeria
      resistant C57BL/6 and Listeria-susceptible A/J mice were compared. In addition,
      in situ hybridization was performed to evaluate the distributions of cytokine
      mRNA-expressing cells in these tissues. Listeria-resistant C57BL/6 mice
      demonstrated greater expression of gamma interferon (IFN-gamma) and granulocyte
      macrophage colony-stimulating factor (GM-CSF) mRNAs in the spleen than Listeria
      susceptible A/J mice. Greater numbers of cells expressing IFN-gamma and GM-CSF
      mRNAs were observed by in situ hybridization in the spleens of C57BL/6 mice than
      in those of A/J mice. C57BL/6 and A/J mice did not differ in their expression of
      IFN-gamma mRNA in the liver. Nor did C57BL/6 and A/J mice differ in their
      expression of tumor necrosis factor alpha, interleukin-1 alpha (IL-1 alpha), IL
      2, IL-4, or IL-6 mRNA in the liver or spleen, as determined by reverse
      transcription-polymerase chain reaction and in situ hybridization. These results
      indicate that the greater resistance of C57BL/6 mice to Listeria monocytogenes
      infection is associated with greater expression of IFN-gamma and GM-CSF mRNAs in
      the spleen and GM-CSF mRNA in the liver.

PMID- 8359896
TI  - Intracytoplasmic growth and virulence of Listeria monocytogenes auxotrophic
      mutants.
AB  - The intracellular growth of several auxotrophic mutants of Listeria monocytogenes
      was examined in cell culture, and virulence was evaluated in mice by intravenous
      injection of log-phase bacteria. L. monocytogenes transposon insertion mutants
      requiring either uracil, phenylalanine, glycine, proline, or nicotinic acid for
      growth were fully virulent and grew similarly to the parental strain as shown by
      their growth rates in cell culture. Those requiring all three aromatic amino
      acids (phenylalanine, tryptophan, and tyrosine) or adenine were 1.5 log10 less
      virulent than the wild type. A threonine auxotroph, which showed enhanced growth
      in the presence of threonine-containing peptides as compared with that in the
      presence of free threonine, was approximately 1 log10 less virulent than the wild
      type. When host cells were deprived of specific amino acids required by both the
      host cell and L. monocytogenes, the bacteria continued to grow intracellularly.
      These studies suggest that the cytoplasm of eucaryotic cells behaves like rich
      medium, facilitating the growth of an intracellular bacterial pathogen with
      complex growth requirements. In addition, results related to amino acid
      deprivation during intracellular growth and specific extracellular growth
      requirements of a threonine auxotroph suggest that L. monocytogenes may utilize
      intracellular peptides as a source of amino acids.

PMID- 8359897
TI  - Interaction of group B streptococcal opacity variants with the host defense
      system.
AB  - Group B streptococci (GBS) demonstrate high-frequency phase variation of colony
      opacity. Colony opacity is a function of chain length, with opaque colonies
      consisting of GBS that form longer chains. Because opaque variants do not grow on
      standard streptococcal media, the role of opacity variation in GBS infection has
      not been studied. We have isolated stable variants from type III GBS that are
      either transparent (variants 1.2 and 1.3) or opaque (variants 1.1 and 1.5). In
      this study, we evaluated the interactions of these variants with different
      components of the host immune system both in vitro and in vivo. Opaque GBS were
      less immunogenic than transparent GBS. Opaque GBS were more susceptible to
      killing by polymorphonuclear neutrophils (PMNs) and could induce a
      chemiluminescent response of PMNs in the absence of antibody (Ab) or complement.
      Transparent GBS did not induce neutrophil chemiluminescence in the absence of Ab
      and complement. However, in the presence of Ab and complement, transparent GBS
      induced a stronger chemiluminescent response than did opaque GBS. Scanning
      electron micrographs of PMNs and GBS demonstrated differences in the attachment
      and engulfment of the different variants by the PMNs as well as different effects
      of the GBS on the PMNs themselves. Interactions with complement were affected by
      GBS opacity as well, with opaque variant 1.1 initiating complement activation in
      the absence of any Ab. The virulence of the GBS opacity variants was studied in
      vivo by inoculation of graded numbers of GBS into newborn mice. Transparent
      variants 1.2 and 1.3 were most virulent, with variant 1.1 intermediate and
      variant 1.5 minimally virulent. However, in mixed infections, variant 1.5 greatly
      enhanced the virulence of small numbers of transparent GBS. These results
      indicate that the opacity status of GBS can influence the interaction between the
      GBS and the host immune system.

PMID- 8359898
TI  - Natural killer cells do not play a dominant role in CD4+ subset differentiation
      in Candida albicans-infected mice.
AB  - The effects of in vivo administration of monoclonal antibodies against NK-1.1
      bearing cells on the early production of gamma interferon (IFN-gamma) in vitro
      and development of Th1-associated immunity were studied in mice infected with a
      live vaccine strain of Candida albicans. At 1 and 4 days postinfection, natural
      killer (NK) cell-enriched fractions from the spleens of antibody-treated mice
      displayed a dramatic reduction in 5E6+ lymphocytes and negligible anti-YAC-1
      cytotoxic activity in vitro. Nevertheless, the frequency of IFN-gamma-producing
      cells in those fractions was reduced by less than half, on average, by anti-NK
      1.1 treatment in vivo. In addition, the antibody-treated and infected mice
      demonstrated unchanged T helper cell responses, as measured by yeast-specific
      footpad reactions, resistance to reinfection, occurrence of antibodies of
      different isotypes, and production in vitro of interleukin-2 (IL-2), IFN-gamma,
      IL-4, and IL-10 by CD4+ cells. Therefore, although NK cells may contribute to
      early IFN-gamma production in Candida-vaccinated mice, these cells apparently do
      not play a dominant role in the qualitative development of yeast-specific T
      helper responses.

PMID- 8359899
TI  - Implication of phagosome-lysosome fusion in restriction of Mycobacterium avium
      growth in bone marrow macrophages from genetically resistant mice.
AB  - The ability of the host to resist infection to a variety of intracellular
      pathogens, including mycobacteria, is strongly dependent upon the expression of
      the Bcg gene. Mouse strains which express the resistance phenotype (Bcgr)
      restrict bacterial growth, whereas susceptible strains (Bcgs) allow bacterial
      growth. Expression of the Bcg allele is known to influence the priming of host
      macrophages (M phi s) for bactericidal function. In the present work, bone marrow
      derived M phi s from congenic BALB/c (Bcgs) and C.D2 (BALB/c.Bcgr) mice were
      infected with the virulent strain Mycobacterium avium TMC 724 to define the
      mechanism involved in growth restriction of M. avium. By combining CFU
      measurements and ultrastructural analyses, we show that growth of this bacterium
      is restricted in marrow M phi s from resistant mice. Using acid phosphatase as a
      lysosomal marker, we provide evidence that the hydrolytic activity of M phi s, as
      measured by the capacity of lysosomes to fuse with and transfer active hydrolytic
      enzymes to phagosomes in which M. avium resides, is an expression of the Bcg gene
      and that this phenomenon is a key antibacterial activity responsible for growth
      restriction of M. avium: (i) the percentage of phagosome-lysosome fusions was
      twice as high in Bcgr M phi s as in Bcgs M phi s, and (ii) the percentage of
      intact viable bacteria residing in acid phosphatase-negative phagosomes was twice
      as low in Bcgr M phi s as in the Bcgs counterparts. These differences are not due
      to a lower activity of the enzyme in Bcgr M phi s. The mechanism by which the Bcg
      gene exerts control over the phagolysosomal fusion is discussed.

PMID- 8359900
TI  - Acquired immunity in experimental murine aspergillosis is mediated by
      macrophages.
AB  - A number of studies have substantiated the pivotal role of innate defense
      mechanisms in protection against invasive aspergillosis. However, experiments
      demonstrating increased resistance to lethal intravenous (i.v.) infection with
      Aspergillus fumigatus conidia in cortisone-treated or untreated mice preinfected
      with a sublethal dose of conidia and protection of turkeys inoculated
      subcutaneously with a killed A. fumigatus germling vaccine against subsequent
      aerosol challenge led us to speculate that acquired immunity may also contribute
      to host defense against Aspergillus infection. Five-week-old male BALB/c mice
      were inoculated i.v. with 1.0 x 10(4) viable conidia or saline and challenged
      i.v. with 1.0 x 10(6) conidia after 7, 15, or 21 days. No protection against
      challenge was found after 7 days. However, significant and reproducible
      protection was observed after 15 and 21 days. Mortality was reduced from 90% in
      control mice to 53% in preinfected mice 40 days after challenge (P = 0.0002).
      Increased survival was correlated with decreased content of chitin in lungs,
      liver, and kidneys 4 and 7 days after challenge (P < 0.05). Mice were again
      inoculated with 1.0 x 10(4) conidia or saline, and after 21 days, 1.0 x 10(8) or
      2.0 x 10(8) splenocytes were transferred to naive syngeneic recipients; 2.0 x
      10(8) immune splenocytes conferred significant protection (P = 0.0001) against
      i.v. challenge with 1.0 x 10(6) conidia, and mortality decreased from 83 to 48%
      40 days after challenge. Transfer of immune serum offered no protection despite
      the presence of antibody against a hyphal homogenate of A. fumigatus, which was
      absent in the sera of control mice. Protection by immune splenocytes was
      maintained after selective depletion of T cells but was abolished after removal
      of plastic-adherent splenocytes. Adherent cells were characterized as macrophages
      by using morphological criteria, nonspecific esterase, and MAC-1 monoclonal
      antibody. Production of hydrogen peroxide by peritoneal and splenic macrophages
      from preinfected mice was the same as and lower than, respectively, that from
      uninfected controls. However, phagocytosis of conidia by peritoneal or splenic
      macrophages from mice preinfected i.v. or intratracheally was significantly
      increased after 2 and 3 h of coculture compared with that from uninfected
      animals, whereas in vitro killing of conidia by splenic macrophages was
      unaltered. Peritoneal or splenic macrophages from control or preinfected mice
      failed to kill hyphae in vitro. Killing of hyphae by polymorphonuclear leukocytes
      was not significantly different between mice preinfected i.v. and uninfected
      controls. Taken together, the results indicate that acquired immunity mediated by
      activated macrophages can be demonstrated in experimental murine
      aspergillosis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8359902
TI  - Role of the Streptococcus mutans gtf genes in caries induction in the specific
      pathogen-free rat model.
AB  - The role of each of the Streptococcus mutans gtf genes coding for glucan
      synthesis in cariogenesis was evaluated by using strain UA130 in the specific
      pathogen-free (SPF) rat model system. Mutants defective in either or both of the
      genes required for insoluble glucan synthesis, the gtfB and gtfC genes, exhibited
      markedly reduced levels of smooth-surface carious lesions relative to that of the
      parental organism. Likewise, the mutant defective in the gtfD gene coding for the
      glucosyltransferase-S enzyme synthesizing water-soluble glucans also produced
      significantly fewer smooth-surface lesions than strain UA130. None of these
      mutations markedly altered the rate of sulcal caries induction relative to that
      of the parental organism. In addition, a mutant of strain UA130 defective in the
      gtfA gene was reexamined in the SPF rat model. In contrast to previous results
      from a gnotobiotic rat system, these mutants also induced significantly fewer
      smooth-surface carious lesions compared with that by strain UA130. These results
      suggest that all four genes are important for smooth-surface caries formation.
      Furthermore, these results are discussed relative to the differences in the diets
      utilized in the SPF and gnotobiotic rat model systems for assessing the virulence
      factors of S. mutans.

PMID- 8359901
TI  - Characterization of Ehrlichia risticii binding, internalization, and
      proliferation in host cells by flow cytometry.
AB  - The binding, internalization, and proliferation of Ehrlichia risticii in P388D1
      cells and equine polymorphonuclear (PMN) leukocytes were studied by
      immunofluorescent staining and flow cytometric analysis. The binding of
      ehrlichiae to P388D1 cells at 4 degrees C was dose dependent, and the antigens of
      bound organisms were susceptible to pronase treatment. Additionally, the binding
      of ehrlichiae to P388D1 cells was diminished when either P388D1 cells or
      ehrlichiae were treated with 1% paraformaldehyde for 30 min or 0.25% trypsin for
      15 min. These results indicate that the ehrlichial ligand and host cell receptor
      are likely surface proteins. Following incubation at 37 degrees C, bound E.
      risticii and/or its antigens were removed with pronase and indirect
      immunofluorescent staining in the presence of saponin was used to examine
      intracellular ehrlichiae. Our results indicate that E. risticii was internalized
      into P388D1 cells within 3 h and proliferated by 48 h of incubation. The
      microfilament-disrupting agent cytochalasin D and the transglutaminase inhibitor
      monodansylcadaverine were used to differentiate between phagocytosis (sensitive
      to cytochalasin) and receptor-mediated endocytosis (sensitive to
      monodansylcadaverine) of E. risticii by P388D1 cells. In concentrations that
      produced distinctive morphological changes and inhibited phagocytosis of
      polystyrene latex beads, cytochalasin D did not suppress the infectivity of E.
      risticii. Binding, internalization, or proliferation of E. risticii was not
      affected by cytochalasin D. However, monodansylcadaverine inhibited infection of
      E. risticii in a dose-dependent manner. The agent did not affect the attachment
      of ehrlichiae to host cells, but it did suppress internalization and
      proliferation. These results suggest that E. risticii is internalized by receptor
      mediated endocytosis and that productive infection by E. risticii does not depend
      on phagocytosis by the P388D1 cells. Although E. risticii did not bind to the
      surface of equine PMN leukocytes at 4 degrees C, organisms were taken up by this
      cell at 37 degrees C. E. risticii, however, failed to survive in equine PMN
      leukocytes.

PMID- 8359903
TI  - Effect of endothelial cells on phagocyte-mediated anticryptococcal activity.
AB  - The anticryptococcal activity of peripheral blood polymorphonuclear leukocytes
      (PMN) and monocytes was compared on plastic versus human umbilical vein
      endothelial cell surfaces. Various amounts of PMN and monocytes were incubated on
      plastic or endothelial surfaces and then challenged for 18 h with Cryptococcus
      neoformans. Both phagocyte populations exhibited significantly more
      anticryptococcal activity on an endothelial cell monolayer than on plastic.
      Prestimulating the endothelial cell monolayer with interleukin-1 augmented the
      antifungal activity of PMN but not that of monocytes. In the absence of
      phagocytes, endothelial cells lacked activity. Blocking antibodies directed
      against endothelial adhesion molecules ICAM-1 and ELAM-1 did not affect PMN
      mediated inhibition of fungal growth. Recombinant interleukin-1 and interleukin-8
      (two cytokines secreted by endothelial cells) activated neutrophils for modestly
      enhanced antifungal activity. However, supernatants derived from endothelial
      cells, as well as neutralizing antibodies directed against the endothelial cell
      derived cytokines interleukin-8 and granulocyte-macrophage colony-stimulating
      factor failed to augment PMN antifungal activity. PMN viability after 18 h was
      diminished on plastic compared with endothelial surfaces. While the percentages
      of C. neoformans bound to neutrophils were similar on both surfaces, the patterns
      of binding were markedly different: on endothelial (but not plastic) surfaces,
      most cryptococci were surrounded by greater than five PMN. Thus, phagocyte
      mediated inhibition of cryptococcal growth is enhanced on endothelial monolayers
      compared with plastic surfaces, possibly as a result of differences in phagocyte
      viability and patterns of binding. Bolstering the activity of circulating
      phagocytes by stimulating endothelial cells may be of relevance in the treatment
      of patients with or at risk for cryptococcemia.

PMID- 8359904
TI  - Virulence of enterohemorrhagic Escherichia coli O91:H21 clinical isolates in an
      orally infected mouse model.
AB  - Escherichia coli K-12 strains producing high levels of Shiga-like toxin type II
      (SLT-II) but not SLT-I were previously shown to be virulent in an orally
      infected, streptomycin-treated mouse model. In this investigation, we tested the
      virulence of several SLT-II-producing enterohemorrhagic E. coli (EHEC) isolates
      from patients with hemorrhagic colitis or hemolytic uremic syndrome. All of the
      strains tested were able to colonize the mouse intestine. However, only two
      strains were consistently virulent for mice: O91:H21 strain B2F1 (Strr), which
      was previously shown to carry two copies of slt-II-related toxins, and O91:H21
      strain H414-36/89 (Strr), which was found in this study to contain three genes
      from the slt-II group. The oral 50% lethal doses of strains B2F1 (Strr) and H414
      36/89 (Strr) when fed to streptomycin-treated mice were less than 10 bacteria.
      Histological sections from moribund mice fed the O91:H21 strains demonstrated
      extensive renal tubular necrosis; however, hematological results were not
      consistent with a diagnosis of hemolytic uremic syndrome. The central role of SLT
      in the virulence of the O91:H21 EHEC strains was supported by the finding that
      streptomycin-treated mice preinoculated with monoclonal antibody specific for SLT
      II survived oral challenge with either B2F1 (Strr) or H414-36/89 (Strr). The
      basis for the variation in virulence among the SLT-II-producing EHEC strains
      tested was not determined. However, a correlation between the capacity of an EHEC
      strain to grow in small intestinal mucus and lethality in the streptomycin
      treated mice was observed.

PMID- 8359905
TI  - Borrelia burgdorferi outer surface lipoproteins OspA and OspB possess B-cell
      mitogenic and cytokine-stimulatory properties.
AB  - Sonicated Borrelia burgdorferi was previously reported to possess both B-cell
      mitogenic and interleukin-6 (IL-6) stimulatory activities. In this report, two
      outer surface lipoproteins, OspA and OspB, were purified from B. burgdorferi and
      assessed for the presence of these functions. OspA was purified from two strains,
      an OspB-deficient variant of HB19 and N40, while OspB was purified from the N40
      strain. All lipoprotein preparations were free of endotoxin contamination, and
      polymyxin B failed to inhibit responses, indicating that media contamination was
      not contributing to biological assays. All three preparations were able to
      stimulate proliferation of mononuclear cells from naive C3H/HeJ and BALB/c mice.
      Depletion experiments indicated that the responding cells were B lymphocytes and
      not T lymphocytes. Purified OspA and OspB stimulated immunoglobulin M production
      by splenocyte cultures from naive mice, a property also previously attributed to
      sonicated B. burgdorferi. OspA and OspB also stimulated the production of IL-6
      and tumor necrosis factor alpha by bone marrow-derived macrophages from BALB/c
      and C3H/HeJ mice. Cytokine production was enhanced by the presence of gamma
      interferon in the cultures, indicating that the magnitude of responses to these
      lipoproteins may be modulated by cytokines in the microenvironment of infected
      tissues. Human endothelial cells produced IL-6 when incubated with OspA and OspB,
      indicating that non-hematopoietic lineage cells can respond to the lipoproteins.
      Purified OspA and OspB had approximately equal activity, with responses detected
      in the range of 10 ng of lipoprotein per ml to 1 microgram of lipoprotein per ml.
      Comparison with published dose responses for lipoproteins purified from
      Escherichia coli indicates that OspA and OspB purified from B. burgdorferi are
      much more potent. The high potency of the B. burgdorferi lipoproteins and the
      ability of the spirochete to invade tissues and persist argue that they could be
      important in the localized events contributing to the pathology of Lyme disease.

PMID- 8359906
TI  - Aeromonas salmonicida grown in vivo.
AB  - The virulent fish pathogen Aeromonas salmonicida was rapidly killed in vivo when
      restricted inside a diffusion chamber implanted intraperitoneally in rainbow
      trout. After a period of regrowth, the survivors had acquired resistance to host
      mediated bacteriolysis, phagocytosis, and oxidative killing, properties which
      were subsequently lost by growth in vitro. Resistance to bacteriolysis and
      phagocytosis was associated with a newly acquired capsular layer revealed by
      acidic polysaccharide staining and electron microscopy. This capsular layer
      shielded the underlying, regular surface array (S-layer) from immunogold labeling
      with a primary antibody to the S-layer protein. Resistance to oxidative killing
      was mediated by a mechanism not associated with the presence of the capsular
      layer. An attenuated vaccine strain of A. salmonicida grown in vivo failed to
      express the capsular layer. Consequently, the in vivo-grown cells of this
      attenuated strain remained as sensitive to bacteriolysis, and as avidly adherent
      to macrophages, as the in vitro-grown cells. The importance of these new
      virulence determinants and their relation to the known virulence factors of A.
      salmonicida are discussed.

PMID- 8359907
TI  - A broadly cross-protective monoclonal antibody binding to Escherichia coli and
      Salmonella lipopolysaccharides.
AB  - During the last decade, episodes of sepsis have increased and Escherichia coli
      has remained the most frequent clinical isolate. Lipopolysaccharides (LPS;
      endotoxin) are the major toxic and antigenic components of gram-negative bacteria
      and qualify as targets for therapeutic interventions. Molecules that neutralize
      the toxic effects of LPS are actively investigated. In this paper, we describe a
      murine monoclonal antibody (MAb; WN1 222-5), broadly cross-reactive and cross
      protective for smooth (S)-form and rough (R)-form LPS. As shown in enzyme-linked
      immunosorbent assay and the passive hemolysis assay, WN1 222-5 binds to the five
      known E. coli core chemotypes, to Salmonella core, and to S-form LPS having these
      core structures. In immunoblots, it is shown to react with both the
      nonsubstituted core LPS and with LPS carrying O-side chains, indicating the
      exposure of the epitope in both S-form and R-form LPS. This MAb of the
      immunoglobulin G2a class is not lipid A reactive but binds to E. coli J5, an RcP+
      mutant which carries an inner core structure common to many members of the family
      Enterobacteriaceae. Phosphate groups present in the inner core contribute to the
      epitope but are not essential for the binding of WN1 222-5 to complete core LPS.
      Cross-reactivity for clinical bacterial isolates is broad. WN1 222-5 binds to all
      E. coli clinical isolates tested so far (79 blood isolates, 80 urinary isolates,
      and 21 fecal isolates) and to some Citrobacter, Enterobacter, and Klebsiella
      isolates. This pattern of reactivity indicates that its binding epitope is
      widespread among members of the Enterobacteriaceae. WN1 222-5 exhibits
      biologically relevant activities. In vitro, it inhibits the Limulus amoebocyte
      lysate assay activity of S-form and R-form LPS in a dose-dependent manner and it
      neutralizes the LPS-induced release of clinically relevant monokines (interleukin
      6 and tumor necrosis factor). In vivo, WN1 222-5 blocks endotoxin-induced
      pyrogenicity in rabbits and lethality in galactosamine-sensitized mice. The
      discovery of WN1 222-5 settles the long-lasting controversy over the existence of
      anti-core LPS MAbs with both cross-reactive and cross-protective activity,
      opening new possibilities for the immunotherapy of sepsis caused by gram-negative
      bacteria.

PMID- 8359908
TI  - Inhibition of lipopolysaccharide-associated endotoxin activities in vitro and in
      vivo by the human anti-lipid A monoclonal antibody SdJ5-1.17.15.
AB  - The present study evaluated the effect of a novel anti-lipid A monoclonal
      antibody, termed SdJ5, on the in vitro production of tumor necrosis factor alpha
      (TNF-alpha) and interleukin-1 beta by endotoxin- or lipopolysaccharide (LPS)
      challenged human peripheral blood mononuclear cells (hPBMC). In addition, the
      present study determined whether SdJ5 could neutralize the in vivo toxicity of
      LPS. SdJ5, at a concentration equal to or greater than 3 micrograms/ml,
      specifically inhibited TNF-alpha and interleukin-1 beta production by hPBMC
      stimulated with every type of LPS and lipid A assessed. SdJ5 also showed a
      significantly greater inhibition of cytokine production than a nonrelevant human
      immunoglobulin M myeloma control. The SdJ5-mediated inhibition of TNF-alpha
      production was rapid, as the simultaneous addition of the SdJ5 and LPS still
      resulted in a marked decrease in hPBMC cytokine synthesis. The ability of SdJ5 to
      neutralize in vivo toxicity was also determined by using LPS from four different
      strains of gram-negative bacteria. LPS, when preincubated with SdJ5, resulted in
      a significant decrease in the 24-h mortality rate compared with that for the
      control. These studies show that the anti-lipid A monoclonal antibody SdJ5 can
      modulate LPS-induced cytokine production in vitro and increase the survival rate
      of rats challenged with lethal doses of LPS.

PMID- 8359909
TI  - The accessory gene regulator (agr) controls Staphylococcus aureus virulence in a
      murine arthritis model.
AB  - We have studied the role of the accessory gene regulator (agr) of Staphylococcus
      aureus as a virulence determinant in the pathogenesis of septic arthritis. At
      least 15 genes coding for potential virulence factors in Staphylococcus aureus
      are regulated by a putative multicomponent signal transduction system encoded by
      the agr/hld locus. agr and hld mutants show a decreased synthesis of
      extracellular toxins and enzymes, such as alpha-, beta-, and delta-hemolysin,
      leucocidin, lipase, hyaluronate lyase, and proteases, and at the same time an
      increased synthesis of coagulase and protein A as compared with the wild-type
      counterpart. We have used a recently described murine model of S. aureus-induced
      arthritis to study the virulence of S. aureus 8325-4 and two agr/hld mutants
      derived from it. Sixty percent of the mice injected with the wild-type strain
      developed arthritis, whereas agrA and hld mutants displayed joint involvement in
      only 10 and 30%, respectively. In addition, 40% of the mice inoculated with the
      wild-type strain displayed an erosive arthropathy; such changes were not
      detectable at all in mice inoculated with the agrA mutant. Serum levels of
      interleukin-6, a potent B-cell differentiation factor, were significantly higher
      (P < 0.001) in the mice inoculated with the wild-type strain than in those
      inoculated with the agrA mutant counterpart. Overall, our results suggest that
      the agr system of S. aureus is an important virulence determinant in the
      induction and progression of septic arthritis in mice.

PMID- 8359910
TI  - Shiga toxin-associated hemolytic uremic syndrome: interleukin-1 beta enhancement
      of Shiga toxin cytotoxicity toward human vascular endothelial cells in vitro.
AB  - Development of hemolytic uremic syndrome (HUS) after infection by Shigella
      dysenteriae 1 or enterohemorrhagic Escherichia coli has been associated with the
      production of Shiga toxins (verotoxins). The putative target of Shiga toxins in
      HUS is the renal microvascular endothelium. This report shows that preincubation
      of human umbilical vein endothelial cells (HUVEC) with interleukin-1 beta (IL-1
      beta) enhances the cytotoxic potency of Shiga toxin toward HUVEC. A preincubation
      of HUVEC with IL-1 beta is required for sensitization of HUVEC to Shiga toxin.
      Sensitization of HUVEC to Shiga toxin is IL-1 beta dose dependent. Development of
      the IL-1 beta response is time dependent, beginning within 2 h of IL-1 beta
      preincubation and increasing over the next 24 h. That these responses were due to
      IL-1 beta was demonstrated by heat inactivation of IL-1 beta, by neutralization
      of IL-1 beta by specific antibody, and by the ability of an IL-1 beta receptor
      antagonist to inhibit the effect of IL-1 beta. Shiga toxin-related inhibition of
      HUVEC protein synthesis preceded loss of cell viability. IL-1 beta incubation
      with HUVEC induced the receptor for Shiga toxin, globotriaosylceramide.
      Lipopolysaccharide included during IL-1 beta preincubation with HUVEC increased
      sensitivity to Shiga toxin in an additive manner. We conclude that IL-1 beta may
      induce Shiga toxin sensitivity in endothelial cells and contribute to the
      development of HUS.

PMID- 8359911
TI  - Specific adherence of Borrelia burgdorferi extracellular vesicles to human
      endothelial cells in culture.
AB  - Borrelia burgdorferi produces extracellular vesicles which contain some of the
      outer surface proteins of the bacterium (e.g., OspA and OspB). Borrelial
      vesicles, isolated by differential centrifugation and filtration, were tested for
      the ability to bind to cultured human umbilical vein endothelial (HUVE) cells in
      culture. The recently described lipoprotein OspD was expressed on vesicles.
      Vesicles exhibited differential expression of OspB and OspD in a relationship
      with passage number and medium serum supplement type, respectively. Qualitative
      immunoblotting analyses demonstrated dose-dependent, passage number-dependent
      adsorption of vesicles by HUVE cells. This adsorption was demonstrated to be
      dependent upon a borrelial component of the vesicle and not due to the presence
      of minor contamination with intact spirochetes. Quantitative experiments
      examining inhibition of B. burgdorferi-HUVE association as a function of prior
      vesicle-HUVE association demonstrated dependence upon (i) a borrelial
      component(s) in the vesicle, (ii) low passage number, and (iii) vesicle protein
      concentration. However, vesicle pretreatment of the HUVE cell monolayer was not
      requisite for this inhibition. Vesicles from highly passaged borrelias were
      noninhibitory for B. burgdorferi-HUVE cell association, regardless of the serum
      used to supplement the medium. The use of vesicles as a tool for studying B.
      burgdorferi pathogenesis and/or physiology is proposed.

PMID- 8359912
TI  - Comparison of gamma interferon, tumor necrosis factor, and direct cell contact in
      activation of antimycobacterial defense in murine macrophages.
AB  - We compared the abilities of gamma interferon (IFN-gamma), tumor necrosis factor
      alpha (TNF-alpha), and sensitized murine lymph node lymphocytes to activate
      syngeneic murine peritoneal macrophages to inhibit the growth of intracellular
      Mycobacterium bovis BCG in vitro. IFN-gamma could activate antimycobacterial
      defense only when added to macrophage cultures prior to their infection with BCG.
      TNF-alpha was without any effect. In contrast, BCG-sensitized lymphocytes could
      induce antimycobacterial defenses when added after macrophages had been infected
      with BCG. The cell-mediated effect required direct contact between effector
      lymphocytes and the targets (BCG-infected macrophages), as revealed in studies in
      which these cell populations were separated by a semipermeable membrane.
      Cyclosporin A, which inhibits the production of relevant macrophage-activating
      lymphokines, did not abrogate the ability of sensitized lymphocytes to activate
      antimycobacterial effects in infected macrophages. Furthermore, only BCG
      sensitized lymphocytes, and not Listeria-sensitized lymphocytes, could activate
      the antimycobacterial effects. These lymphocytes were not cytotoxic to the
      infected macrophages. The presence of anti-TNF-alpha antibody in cocultures
      reduced the antimicrobial effects. We propose that the activation of
      antimycobacterial defense in macrophages can occur by direct physical contact
      with sensitized lymphocytes. This process may be due to lymphocyte membrane
      associated TNF-alpha, as we previously demonstrated in our studies of
      antileishmanial defense.

PMID- 8359913
TI  - Cellular internalization in the absence of invasin expression is promoted by the
      Yersinia pseudotuberculosis yadA product.
AB  - The Yersinia pseudotuberculosis invasin protein is able to promote bacterial
      penetration into mammalian cells. Insertion mutations that eliminate production
      of this protein show residual internalization that is dependent on the presence
      of the Yersinia virulence plasmid. An enrichment procedure was used to isolate
      molecular clones containing regions of the virulence plasmid that confer this low
      level uptake on Y. pseudotuberculosis inv mutants. All of the Y.
      pseudotuberculosis strains isolated from this procedure harbored plasmids
      containing a region encompassing the yadA gene, which encodes a previously
      identified adhesin associated with attachment to extracellular matrix proteins.
      All of the mutations isolated that affected internalization of one of the strains
      that survived the enrichment disrupted the yadA open reading frame. Furthermore,
      a strain that contained yadA sequences and no other region of the virulence
      plasmid was able to promote internalization of a Y. pseudotuberculosis inv
      mutant. Consistent with these results, an intact virulence plasmid containing an
      insertion mutation in yadA was as defective as a plasmid-cured strain at
      promoting uptake of Y. pseudotuberculosis inv mutants. These results indicate
      that the product of the yadA gene is responsible for the plasmid-dependent entry
      observed in Y. pseudotuberculosis inv mutants.

PMID- 8359914
TI  - Purification and partial characterization of a product from Yersinia
      pseudotuberculosis with the ability to activate human T cells.
AB  - We tried to purify a substance exhibiting mitogenicity for human peripheral blood
      lymphocytes from Yersinia pseudotuberculosis isolated from patients with Y.
      pseudotuberculosis infection manifesting acute and systemic clinical symptoms.
      The supernatant of a suspension of the bacteria disrupted by sonication was
      serially chromatographed on DEAE-Sepharose fast-flow, Sephacryl S-100 HR, and TSK
      gel G2000SW high-pressure liquid chromatography columns. Sodium dodecyl sulfate
      polyacrylamide gel electrophoresis analysis revealed that the purified
      mitogenically active substance migrated as a single band corresponding to a
      molecular mass of 21 kDa. We designated the purified substance Y.
      pseudotuberculosis-derived mitogen (YPM). YPM stimulated human peripheral T cells
      to proliferate and produce interleukin-2 at 0.1 ng/ml or more. YPM-induced T-cell
      activation required the expression of HLA class II molecules on accessory cells.

PMID- 8359915
TI  - Immunogenicity of the Plasmodium falciparum serine repeat antigen (p126)
      expressed by vaccinia virus.
AB  - cDNA encoding the serine repeat antigen (SERA) (also called p126) of Plasmodium
      falciparum has been isolated from the FCR3 strain and inserted into a recombinant
      vaccinia virus designated vP870. Expression analysis of vP870-infected Vero cells
      by immunoprecipitation has demonstrated several intracellular forms of SERA and a
      single secreted SERA peptide. Endoglycosidase digestion of these
      immunoprecipitated SERA peptides indicated that the intracellular SERA peptides
      contain simple, high-mannose N-linked oligosaccharides and that the secreted SERA
      peptide contains complex N-linked oligosaccharides. Pulse-chase experiments
      indicate that the multiple intracellular SERA peptides in infected Vero cells
      represent a trafficking pathway whereby the smallest SERA peptide is converted
      into larger peptides by co- and posttranslational modifications, including
      glycosylation, and eventually secreted from the cell with complex N-linked
      oligosaccharides. To study the immunogenicity of vaccinia virus-expressed SERA,
      rabbits were immunized with vP870 and their sera were analyzed for reactivity
      with authentic, parasite-derived SERA protein. The anti-vP870 rabbit sera reacted
      with P. falciparum-infected erythrocytes by immunofluorescence analysis,
      recognized authentic SERA from schizonts by both immunoprecipitation and Western
      blot (immunoblot) analyses, and recognized proteolytically processed fragments of
      SERA secreted into the culture medium by Western blot analysis. These results
      indicate that when expressed by vaccinia virus, SERA is glycosylated and secreted
      from infected cells and that in immunized rabbits, vaccinia virus-expressed SERA
      can stimulate a humoral immune response against SERA derived from blood-stage
      parasites.

PMID- 8359916
TI  - Expression of the Pasteurella haemolytica leukotoxin is inhibited by a locus that
      encodes an ATP-binding cassette homolog.
AB  - Multicopy and single-copy chromosomal fusions between the Pasteurella haemolytica
      leukotoxin regulatory region and the Escherichia coli beta-galactosidase gene
      have been constructed. These fusions were used as reporters to identify and
      isolate regulators of leukotoxin expression from a P. haemolytica cosmid library.
      A cosmid clone, which inhibited leukotoxin expression from multicopy and single
      copy protein fusions, was isolated and found to contain the complete leukotoxin
      gene cluster plus additional upstream sequences. The locus responsible for
      inhibition of expression from leukotoxin-beta-galactosidase fusions was mapped
      within these upstream sequences, by transposon mutagenesis with Tn5, and its DNA
      sequence was determined. The inhibitory activity was found to be associated with
      a predicted 440-amino-acid reading frame (lapA) that lies within a four-gene
      arginine transport locus. LapA is predicted to be the nucleotide-binding
      component of this transport system and shares homology with the Clp family of
      proteases.

PMID- 8359917
TI  - Impaired mucosal antibody response to cholera toxin in vitamin A-deficient rats
      immunized with oral cholera vaccine.
AB  - To investigate the importance of vitamin A in the ability to respond to oral
      antigen administration, rats were fed a vitamin A-free diet. The animals were
      immunized perorally three times with a mixture of cholera toxin (CT) and a
      commercial cholera vaccine. The total immunoglobulin A (IgA) concentration as
      well as the specific IgA anti-CT antibody levels in serum and bile was
      significantly lower in the vitamin A-deficient animals than in the paired fed
      controls (animals that were fed a normal commercial diet in an amount equal to
      the amount the deficient animals consumed), while the levels of total and
      specific anti-CT IgG were not affected to the same extent by the vitamin A
      deficiency. The number of IgA anti-CT antibody-producing cells in the mesenteric
      lymph nodes after immunization was also significantly lower in the vitamin A
      deficient rats than in the control rats. Supplementation of the diet with retinyl
      palmitate restored the ability to mount an IgA antibody response to the antigen,
      since the level of specific IgA anti-CT antibodies in relation to the total IgA
      concentration was as high in the vitamin A-supplemented group as in the paired
      fed control group. Restricted diet intake by itself did not affect the ability to
      respond adequately to the antigen since there was no difference in IgA anti-CT
      antibody level between paired fed rats and those being fed ad libitum. Assessment
      of transforming growth factor beta in cell cultures revealed no difference
      between vitamin A-deficient and paired fed animals. In summary, vitamin A
      deficiency resulted in a decreased number of IgA-producing cells, decreased IgA
      production, and a reduced ability to respond with IgA antibodies to the oral
      cholera vaccine.

PMID- 8359918
TI  - Molecular genetic analysis of beta-toxin of Clostridium perfringens reveals
      sequence homology with alpha-toxin, gamma-toxin, and leukocidin of Staphylococcus
      aureus.
AB  - Oligonucleotide probes designed on the basis of the N-terminal sequence of
      Clostridium perfringens beta-toxin were used to isolate the encoding gene (cpb).
      The nucleotide sequence of cpb was determined, and on the basis of DNA
      hybridization experiments it was shown that the gene is found only in type B and
      C strains of C. perfringens. The deduced amino acid sequence of the beta-toxin
      revealed homology with the alpha-toxin, gamma-toxin, and leukocidin of
      Staphylococcus aureus. The beta-toxin purified from C. perfringens appeared to
      exist in monomeric and multimeric forms. Recombinant beta-toxin, produced in
      Escherichia coli, appeared to be mainly in the multimeric form.

PMID- 8359919
TI  - Tumor necrosis factor alpha (TNF-alpha) production in mice immunized with
      Escherichia coli: correlation with mortality after lethal challenge and
      production of a native inhibitor of TNF-alpha activity.
AB  - The kinetics of tumor necrosis factor alpha (TNF-alpha) production, the
      correlation between cytokine levels and mortality rates after lethal challenge,
      and the production of a native inhibitor of TNF-alpha activity was investigated
      in mice immunized with formalin-killed Escherichia coli. Groups of mice were
      injected for 8 weeks with either untreated bacteria or bacteria treated with 0.5
      MIC of aztreonam and subsequently challenged with 100 50% lethal doses of viable
      E. coli. Mice receiving saline only (controls) died within 24 h. The mortality of
      mice immunized with aztreonam-treated E. coli was significantly lower than that
      of mice immunized with untreated E. coli. There were no measurable levels of TNF
      alpha in sera obtained from control mice during the entire period of
      immunization. TNF-alpha levels ranging from 90 to 306 U/ml were measured 90 min
      after each vaccination in sera obtained from mice immunized with untreated E.
      coli. Sera from mice immunized with antibiotic-treated E. coli showed lower TNF
      alpha levels, ranging from 40 to 128 U/ml. TNF-alpha levels measured 90 min after
      lethal challenge correlated with the mortality rate observed in each group (r =
      0.95). The cytotoxic activity of recombinant murine TNF-alpha was inhibited by
      the sera from immunized mice but not by the sera from controls. The inhibition
      was drastically reduced by preincubation of the sera with staphylococcal protein
      A. In immunoblot experiments, class G immunoglobulins reacting with recombinant
      murine TNF-alpha were observed in the sera of immunized mice. These data confirm
      the correlation existing between TNF-alpha levels and mortality and suggest that
      native inhibitors may play a role in the regulation of the biological function of
      the cytokine.

PMID- 8359920
TI  - Adoptive transfer of immunity to oral challenge with virulent salmonellae in
      innately susceptible BALB/c mice requires both immune serum and T cells.
AB  - The mechanisms of immunity to salmonellae conferred by immunization with live
      vaccines were studied by adoptive transfer using the mouse-virulent strain
      Salmonella typhimurium C5 and innately susceptible BALB/c (ltys) mice. This
      organism cannot establish a sublethal infection in naive BALB/c mice. Animals
      immunized 2 to 3 months earlier with the S. typhimurium SL3261 aroA live vaccine
      were used as donors of serum, spleen cells, and mesenteric lymph node cells for
      naive recipients which were challenged orally with the virulent C5 strain.
      Simultaneous transfer of both immune serum and immune cells was necessary for
      protection. Simultaneously depleting the donors of CD4+ and CD8+ T cells by
      administration of antisera in vivo prior to cell harvesting showed that T cells
      were necessary for protection. The results demonstrate that both antibody and T
      cells are required for recall of immunity to oral challenge with virulent
      salmonellae in innately susceptible mice and suggest that the ability to elicit
      opsonizing antibody in addition to cell-mediated immunity is important for
      optimal protection induced by salmonella vaccines.

PMID- 8359921
TI  - Fibroblast-stimulating factor 1, a novel lymphokine produced in schistosomal egg
      granulomas, stimulates liver fat-storing cells in vitro.
AB  - We report that the novel lymphokine fibroblast-stimulating factor 1, produced
      within hepatic schistosomal egg granulomas, stimulates liver fat-storing cells
      (FSC) in vitro to proliferate and express fibronectin genes. Because FSC are
      critical in hepatic fibrogenesis generally, we propose that in vivo stimulation
      of FSC by fibroblast-stimulating factor 1 may be an important step in
      schistosomal liver fibrosis.

PMID- 8359922
TI  - Clostridium difficile toxin A elicits Ca(2+)-independent cytotoxic effects in
      cultured normal rat intestinal crypt cells.
AB  - In rat intestinal crypt cells, Clostridium difficile toxin A induces (i) early
      cytoskeletal alterations involving the whole population and (ii) late effects in
      30 to 40% of the cells, consisting mainly of surface blebbing and nuclear
      fragmentation. All these effects were Ca2+ independent and were not abolished by
      protein synthesis inhibitors.

PMID- 8359923
TI  - Safety, immunogenicity, and excretion pattern of single-dose live oral cholera
      vaccine CVD 103-HgR in Peruvian adults of high and low socioeconomic levels.
AB  - Groups of 122 Peruvian adults of low socioeconomic level (SEL) and 125 of high
      SEL received a randomly allocated 5 x 10(9)- or 5 x 10(8)-CFU dose of CVD 103-HgR
      live oral cholera vaccine or a placebo. The vaccine was well tolerated.
      Vibriocidal seroconversions occurred in 78% of high-SEL and 72% of low-SEL
      subjects who ingested the high dose and in 78 and 49%, respectively, of those who
      received the low dose.

PMID- 8359924
TI  - Similar proportions of immunoglobulin A1 (IgA1) protease-producing streptococci
      in initial dental plaque of selectively IgA-deficient and normal individuals.
AB  - By comparing the initial colonization of cleaned teeth in immunoglobulin A (IgA)
      deficient, IgM-compensating individuals with that in normal individuals, no
      significant difference in the proportion of IgA1 protease-producing streptococci
      was found. Thus, as one of several bacterial means of immune evasion, the ability
      to cleave secretory IgA1 does not appear essential to the successful adherence of
      oral streptococci.

PMID- 8359925
TI  - Actin accumulation at sites of attachment of indigenous apathogenic segmented
      filamentous bacteria to mouse ileal epithelial cells.
AB  - Selective attachment of indigenous, apathogenic, segmented filamentous bacteria
      to follicle-associated epithelia of terminal ileal Peyer's patches involves both
      the specialized M cells and normal enterocytes. A striking, highly localized
      cytoplasmic accumulation of polymerized actin, which resembles that associated
      with adherence of enteropathogenic Escherichia coli to cultured epithelial cells,
      occurs at attachment sites of segmented filamentous bacteria. The epithelial
      response to the attachment of microorganisms may thus involve mechanisms which
      are the same for diverse microorganisms.

PMID- 8359926
TI  - Immunological properties of ribosomal proteins from Mycobacterium bovis BCG.
AB  - Two proteins with molecular mass 65 kDa, a heat shock protein, and an S1-like
      protein were found in a 30S ribosomal subunit from Mycobacterium bovis BCG. The
      17-kDa protein in the 30S subunit was homologous to alpha-crystallin heat shock
      protein, and the 16-kDa protein in the 50S subunit was homologous to the L7/L12
      protein. The latter provoked a strong delayed-type hypersensitivity reaction in
      the sensitized guinea pigs. The GroES-like protein (12 kDa) loosely associated
      with ribosomes.

PMID- 8359927
TI  - Interleukin-7 enhances antimicrobial activity against Leishmania major in murine
      macrophages.
AB  - Recently, it has been shown that interleukin-7 (IL-7) is able to induce secretion
      of cytokines and tumoricidal activity by human monocytes. This study shows that
      treatment of murine macrophages infected with Leishmania major with IL-7 without
      any other stimulus reduced the percentage of infected cells, as well as the
      parasite burden per cell, in a dose-dependent manner to a limited degree (45%
      reduction of the number of amastigotes per 100 macrophages). Simultaneous
      treatment of macrophages with gamma interferon and IL-7 led to nearly complete (>
      99%) elimination of amastigotes. Addition of anti-tumor necrosis factor alpha or
      N omega-monomethyl-L-arginine acetate reversed the leishmanicidal effects of IL
      7, and production of nitric oxide was induced in the presence of IL-7.

PMID- 8359928
TI  - Staphylococcus-mediated T-cell activation and spontaneous natural killer cell
      activity in the absence of major histocompatibility complex class II molecules.
AB  - We used major histocompatibility complex class II antigen-deficient transgenic
      mice to show that in vitro natural killer cell cytotoxicity and T-cell activation
      by staphylococcal exotoxins (superantigens) are not dependent upon the presence
      of major histocompatibility complex class II molecules. T cells can be activated
      by exotoxins in the presence of exogenously added interleukin 1 or 2 or in the
      presence of specific antibody without exogenously added cytokines.

PMID- 8359929
TI  - Molecular cloning and sequence of the gene for outer membrane protein P5 of
      Haemophilus influenzae.
AB  - The gene for outer membrane protein P5 of Haemophilus influenzae was identified
      by immunological screening of a genomic lambda EMBL3 library of the serotype b
      strain 1613. The gene was subcloned, and plasmid clones expressing P5 were
      identified by immunologic screening. The gene for outer membrane protein P5 was
      sequenced. The mature protein has a molecular weight of 35,628. The protein is
      50% identical and 65% similar to the OmpA protein of Escherichia coli.

PMID- 8359930
TI  - Vasectomy and health revisited.

PMID- 8359931
TI  - Effect of chronic alcoholism on semen--studies on lipid profiles.
AB  - The effect of chronic alcoholism on various seminal parameters (sperm
      concentration, rate of forward motility, percentage of abnormal spermatozoa,
      lipid profiles of seminal plasma and spermatozoa) was studied together with the
      serum levels of testosterone and oestradiol. In chronic alcoholics there was a
      marked reduction in sperm concentration and in the rate of their forward
      motility, and increase in the number of spermatozoa with morphological
      abnormalities when compared to age-matched normal fertile subjects. Serum levels
      of testosterone were decreased while oestradiol levels were increased in chronic
      alcoholic men. Studies of lipid profiles showed a marked decrease in the total
      phospholipid concentration in spermatozoa, primarily in sphingomyelin,
      phosphatidyl choline and ethanolamine fractions. The cholesterol:phospholipid
      ratio in spermatozoa was increased in alcoholics. In the seminal plasma of
      chronic alcoholics, there was a decrease in total lipid, in glyceride glycerol
      and in free and esterified cholesterol. Of the phospholipid classes,
      sphingomyelin and phosphatidyl ethanolamine showed a significant reduction. In
      general, the present study provides evidence for the adverse effects of chronic
      alcoholism on serum hormones, sperm count, morphology, motility and seminal lipid
      profiles. These may be responsible for the fertility disorders common in chronic
      alcoholics.

PMID- 8359932
TI  - Reactive oxygen species in semen of infertile patients: levels of superoxide
      dismutase- and catalase-like activities in seminal plasma and spermatozoa.
AB  - Reactive oxygen species (ROS) can be detected in the semen of 40% of infertile
      men, whereas none is detected in semen from normal men. The ROS detected in semen
      are a reflection of the imbalance between ROS production and degradation. The aim
      of the present study was to determine whether a lowered scavenging capacity or an
      increased production of ROS was responsible for the ROS detected in semen samples
      from infertile men. Two activities were investigated: (1) catalase-like activity,
      which is responsible for the degradation of H2O2 and (2) superoxide dismutase
      like (SOD-like) activity which is responsible for the degradation of .O2-.
      Catalase-like and SOD-like activities were found in whole seminal plasma, in
      dialyzed seminal plasma (> 12 kD), in an ultrafiltrate of seminal plasma (< 5 kD)
      and in spermatozoa. There was no significant difference in the SOD-like
      activities measured in spermatozoa, or in seminal plasma (whole or fractionated)
      from samples that did or did not produce ROS. SOD-like activity originated mostly
      from the high molecular weight components of seminal plasma. However, the
      catalase-like activity of whole seminal plasma and of spermatozoa was
      significantly greater (P = 0.01) in those samples that produced ROS as compared
      to those that did not. The catalase-like activity in dialyzed seminal plasma, and
      an ultrafiltrate of seminal plasma from semen samples that did or did not produce
      ROS were not statistically different. The catalase-like activity of the seminal
      plasma originated equally from high and low molecular weight components.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8359933
TI  - Seminal leucocyte subpopulations and sperm function in fertile and infertile
      Chinese men.
AB  - The level of seminal leucocytes and the prevalence of leucocytospermia was
      determined in a group of fertile and infertile southern Chinese men in Hong Kong.
      Sixteen normal fertile semen donors and 49 men with male factor infertility were
      studied prospectively. None had antisperm antibodies and past or present evidence
      of genital tract infection. Seminal leucocytes and their subsets were analysed
      using monoclonal antibodies and an immunocytochemical alkaline phosphatase-anti
      alkaline phosphatase conjugate technique. Seminal leucocytes were detectable in
      94% and 86% of the fertile and infertile men respectively, with the predominant
      subset being granulocytes. Leucocytospermia (> 1 x 10(6) leucocytes/ml) was found
      in only one of the 49 (2%) infertile men without clinical evidence of genito
      urinary infection. Inverse correlations were observed between (1) the percentage
      of spermatozoa with normal morphology and the number of T-helper/inducer cells,
      (2) the linearity of sperm movement and the number of T-lymphocytes. In
      conclusion, the level of seminal leucocytes and the prevalence of
      leucocytospermia is low in infertile Chinese subjects. The effect of seminal
      leucocytes on sperm function in these subjects needs further evaluation.

PMID- 8359934
TI  - Diurnal variations in scrotal temperature of normal men and patients with
      varicocele before and after treatment.
AB  - Scrotal temperature was monitored using a portable data recorder for periods of
      24 h in six normal volunteers and 48 infertile patients with unilateral
      varicocele while subjects pursued their regular daily activities. Temperatures
      during sleep (TS) were generally higher than daytime values (TD), probably as a
      consequence of thermal insulation in bed. These diurnal variations were found to
      be less pronounced in the infertile patients than in volunteers (TS - TD = 0.29
      degrees C +/- 0.06 degrees C vs 0.88 degrees C +/- 0.12 degrees C; P < 0.01).
      Moreover, scrotal temperatures at night of patients and volunteers were
      indistinguishable statistically, but were different during daytime hours. After
      successful ligation or embolization of the spermatic-vein in 16 patients, no
      change in scrotal temperature was observed. Although sperm counts were higher
      after treatment, this difference was not significant (67.4 +/- 17.2 x 10(6) vs
      105.8 +/- 25.5 x 10(6); P > 0.05). The data support the view that varicocele
      related damage to the testis results from a lack of adequate cooling, and that
      treatment does not normalize the temperature pattern.

PMID- 8359935
TI  - Plasminogen activator activity and fertilizing ability of human spermatozoa.
AB  - Mature spermatozoa contain a number of proteases that are supposed to contribute
      to their fertilizing ability. The present study was directed at plasminogen
      activator (PA), a protease that belongs to the group of serine proteases and
      converts the zymogen plasminogen to the active broad-spectrum protease plasmin.
      To investigate the possible role of PA in the fertilization process, we have
      measured sperm-bound PA activity in 63 patients included in an in-vitro
      fertilization (IVF) programme and assessed their relationship to standard semen
      parameters and the rate of fertilization. PA activity was correlated
      significantly with the sperm count, as well as with sperm motility and
      morphology. Using logistic regression analysis, specific PA (pmol pNA 10(-6)
      cells min-2) was found to significantly influence the probability of
      fertilization. Other significantly predictive factors were motility and the
      percentage of spermatozoa with normal morphology. The sperm concentration (10(6)
      cells ml-1) did not significantly affect the outcome of IVF. We suggest that
      sperm-bound PA is involved in the fertilization process and may represent a
      potential indicator of sperm fertilizing capacity.

PMID- 8359936
TI  - The detection of antisperm antibodies in serum: a comparison of the tray
      agglutination test, indirect immunobead test and indirect SpermCheck assay.
AB  - Testing for antisperm antibodies (ASAs) is an important part of the work-up of
      the sub-fertile couple, yet there is little consensus regarding the most
      appropriate methods. The SpermCheck assay (GSC; Bio-Rad Laboratories Inc.,
      Diagnostics Division, Hercules, CA, U.S.A.) is supplied with wash buffer,
      controls and bead reagent which detects all three major classes of ASAs (IgA, IgG
      and IgM) in a single test. This study compared results on a bank of samples using
      the tray agglutination test (TAT), immunobead test (IBT), GSC and a modified
      SpermCheck assay to detect a single isotype in each test (SISC). The IBT and SISC
      showed excellent correlation, with 127/141 (90.1%) tests agreeing. There was an
      apparent lack of sensitivity to IgM with GSC as 8/15 (53.3%) samples testing
      positive with IBT and 7/15 (46.7%) testing positive with SISC were negative with
      GSC. Of the 24 IBT-negatives, seven (29.2%) were positive for TAT, indicating a
      high incidence of non-immunological agglutination, though this decreased as the
      TAT titre increased. The proportion of samples testing positive for IBT increased
      with TAT titre: 3/20 (15.0%) for TAT-negative samples, 6/10 (60.0%) for low
      titres and 21/24 (87.5%) for high titres. This was also observed when comparing
      the GSC with TAT. The TAT therefore appears useful as a first-line screen, whilst
      the inability of the GSC to adequately detect IgM limits its use as an indirect
      test. Both the IBT and SISC can be used to further investigate the type and class
      of ASA present.

PMID- 8359937
TI  - Immunohistochemical localization of calmodulin in the testes of patients with
      idiopathic male infertility.
AB  - The localization of calmodulin in testes of patients with idiopathic male
      infertility was studied using the indirect immunoperoxidase method. Specimens
      were obtained by testicular biopsy from 55 patients. They were divided into 26
      cases of hypospermatogenesis, 11 cases of maturation arrest (8 of primary
      spermatocyte arrest and 3 of spermatid arrest) and 18 cases of Sertoli cell-only
      syndrome. Regardless of the type of testicular pathology, the types of
      immunoreactive cell and the intensities of staining were the same as those in the
      normal testis. That is, staining for calmodulin was first found to be positive in
      early pachytene primary spermatocytes. It became intense in late pachytene
      primary spermatocytes and round spermatids. By contrast, elongated spermatids and
      spermatozoa were not stained. Sertoli cells were stained slightly or not at all.
      A calmodulin-staining index (CaM-S index) was defined as the proportion of
      primary spermatocytes that were stained intensely for calmodulin relative to the
      total number of primary spermatocytes. The indices for the testes of men with
      complete spermatocyte maturation arrest were significantly lower than those for
      the testes of normal controls and of men with hypospermatogenesis. Degenerating
      late pachytene spermatocytes observed in the testes of men with spermatocyte
      arrest showed low calmodulin-specific immunoreactivity. Such a decrease in
      numbers of normal late pachytene spermatocytes might be responsible for the low
      CaM-S index in cases of complete spermatocyte arrest.

PMID- 8359938
TI  - Is testosterone essential for maintenance of normal morphology in immature rat
      Leydig cells?
AB  - Selective deprivation of gonadotrophins in prepubertal rats by administration of
      a GnRH antagonist (Ac-D2Nal1, D4ClPhe2, DTrp3, DArg6, DA1a10-GnRH; GnRH code: 103
      289-10, National Institutes of Health, USA) for 3 weeks, initiated at 20-22 days
      of age, induced morphological changes in the Leydig cells, including thickening
      and indentation of the nuclear margin, pyknosis and elongation of the nuclei.
      Mean nuclear diameter was reduced to 22% of that in the controls. Under the
      electron microscope the cells exhibited reduced volume of the nucleus and
      cytoplasm and the plasma membrane was irregular. This abnormal appearance of the
      Leydig cells improved marginally in 20-30% of the Leydig cells and their mean
      nuclear diameter increased to 39% of the control level after FSH supplementation
      (20 micrograms ovine FSH/day). Normal morphological integrity of the Leydig cells
      consisting of round or oval nuclei, a smooth nuclear and cellular margin and the
      original mean nuclear diameter was restored completely when testosterone (30
      micrograms/day) was administered to GnRH antagonist-treated rats, with or without
      simultaneous administration of FSH; in these rats testosterone levels in blood
      were also restored to normal. These findings indicate that testosterone may be
      important for the maintenance of normal Leydig cell morphology in the rat.

PMID- 8359939
TI  - Arachidonic acid metabolites as intratesticular factors controlling androgen
      production.
AB  - The effect of inhibitors and products of arachidonic acid metabolism on rat
      testicular steroidogenesis has been investigated. In the presence of indomethacin
      (inhibitor of cyclooxygenase) and nordihydroguaiaretic acid (NDGA) (inhibitor of
      lipoxygenase), the activity of 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD)
      and 17 beta-hydroxysteroid dehydrogenase (17 beta-HSD) were both inhibited. The
      LH-stimulated increase in secretion of testosterone and progesterone was also
      inhibited by indomethacin and NDGA. On the other hand, vitamin E (antioxidant and
      inhibitor of lipoxygenase), stimulated the activity of both 3 beta-HSD and 17
      beta-HSD and enhanced LH-stimulated androgen production. The metabolites of
      lipoxygenase (15-HPETE, 15-HETE, 5-HPETE and 5-HETE) and cyclooxygenase (PGF2
      alpha) pathways stimulated 3 beta-HSD and 17 beta-HSD activity and enhanced the
      secretion of progesterone and testosterone. It is concluded that arachidonic acid
      metabolites are intratesticular factors which can regulate LH-stimulated
      testicular steroidogenesis.

PMID- 8359940
TI  - Alterations in testicular function after endotoxin injection in the boar.
AB  - Twelve mature boars were injected intravenously with endotoxin from Salmonella
      typhimurium. Blood plasma was analysed for 15-ketodihydro-PGF2 alpha, LH and
      testosterone. The boars were castrated at various times after endotoxin
      administration and the testes examined by light and electron microscopy. The
      levels of 15-ketodihydro-PGF2 alpha and LH rose immediately after endotoxin
      injection followed by an increase in testosterone levels, and in five boars a
      second increase in LH levels was observed. Morphological examination of the
      testes revealed infiltration of polymorphonuclear neutrophils (PMN) into the
      testicular interstitium. The Leydig and myoid cells showed morphological changes.
      Alterations were also present in the seminiferous epithelium among Sertoli cells,
      spermatocytes and spermatids. The results indicate that endotoxins can exert a
      negative effect on testicular function in the boar. Except for the initial
      increase in LH levels, which is not clearly understood, the hormonal changes are
      thought to be mediated by alterations in Leydig cell function. The alterations
      further support previous findings in the boar, and indicate that there is short
      term, moderate damage to the seminiferous epithelium following endotoxin
      injection.

PMID- 8359941
TI  - Naturalistic observation of adolescent tobacco use.
AB  - A naturalistic observation study of adolescent tobacco use was conducted to
      corroborate previous studies which used self-report questionnaire or structured
      interview methods to study this problem behavior. Several findings converged with
      previous accounts of adolescent tobacco use. For example, most use occurred in
      small groups. However, other findings diverged somewhat from previous research in
      that an unexpectedly low number of offers of tobacco was observed, nonusers were
      present in smoking groups, and solitary smoking was common. These data suggest
      that direct, normative social pressure to use tobacco may not be as frequent as
      more subtle informational social influence, at least in high school adolescent
      tobacco use groups.

PMID- 8359942
TI  - The link between identity and crime for the heroin addict in methadone treatment.
AB  - In this paper we examine the relationship between identity and involvement in
      crime for the heroin addict enrolled in methadone treatment. We hypothesize that
      crime during treatment is related to the maintenance of an identity appropriate
      to the role of the active street hustler. Data derive from interviews with
      addicts in methadone treatment in the New York City area. The major finding is
      that addicts in methadone treatment who had street-oriented identities were more
      likely than those with model patient-based identities to be involved in crime,
      particularly property crime. The limitations and implications of this research
      are discussed.

PMID- 8359943
TI  - Alcoholics initial expectancies of and attitudes toward treatment.
AB  - In one study, 100 poor inner-city alcoholics were asked about their expectancies
      of the counselor's behavior in an initial interview. The majority expected a
      medically oriented, supportive, active interviewer who asked them about emotional
      issues. Eighty percent reported a disconfirmation of at least one expectancy
      postinterview. In a second study, patient's receptivity to treatment was
      assessed. That sample was found to accept the need for treatment and to have
      confidence in the counseling process as well as to be moderately tolerant of the
      stigma of being alcoholic and interpersonally open. Neither the degree of
      expectancy disconfirmation or receptivity to treatment predicted patient's
      subsequent clinic attendance in this patient sample.

PMID- 8359944
TI  - Potential use of mass media to reach urban intravenous drug users with AIDS
      prevention messages.
AB  - To access the potential of using the mass media to reach urban intravenous drug
      users (IVDUs) with AIDS prevention messages, we: 1) questioned 353 participants
      in a Baltimore IVDU cohort study on their media use and sources of AIDS
      information, 2) analyzed data on Baltimore AIDS public service announcement (PSA)
      airings during a 3-month period, and 3) discussed with media executives their
      willingness to air a variety of potential AIDS messages. Forty-seven percent of
      all respondents reported that they learned the most about AIDS from television.
      Participants watched television a median of 28 hours/week; 52% of IVDUs listened
      to ratio > or = 12 hours/week. Eight hundred eleven AIDS television PSAs were
      aired; 37% of PSAs were placed on news programs; 53% of respondents watched news
      programs. Acceptability of hypothetical prevention messages (e.g., on sexual
      abstinence, condom use, or safer drug use practices) varied with media reach
      (national vs local) and type (television vs radio). We conclude that media could
      reach IVDUs with AIDS prevention messages. Television could be used to direct
      IVDUs to local prevention programs and provide safe/safer sex messages. Explicit
      and detailed AIDS prevention messages would be acceptable to some local radio
      stations.

PMID- 8359945
TI  - The influence of parent, sibling, and peer modeling and attitudes on adolescent
      use of alcohol.
AB  - This 1-year prospective study of 173 families with two or more children examines
      the influence of parent, sibling, and peer modeling (i.e., use) and attitudes on
      adolescent use of alcohol. Independent questionnaire data were obtained from the
      adolescent, father, mother, and sibling(s). Structural equation modeling methods
      were employed to examine these relationships. Parent attitude toward youth
      alcohol use and parent modeling of alcohol use were strongly related to change in
      adolescent alcohol use, suggesting that parents can influence the future use of
      alcohol by their children. Peer and sibling modeling and peer attitudes also
      influenced adolescent alcohol use.

PMID- 8359946
TI  - Reasons for drinking alcohol: their relationship to psychosocial variables and
      alcohol consumption.
AB  - The present investigation was designed to gain a better understanding of the
      psychosocial factors that predict reasons for drinking alcohol and how these
      drinking motives differentially relate to alcohol consumption. Four distinct
      reasons for drinking alcohol scales were established through factor analysis:
      drink to cope, drink to be sociable, drink to enhance social confidence, and
      drink for enjoyment. Multiple regression analyses showed that 1) each reason for
      drinking was predicted by a somewhat different set of demographic and
      psychosocial variables, and 2) the reasons for drinking, in turn, differentially
      predicted multiple indicators of quantity and frequency of alcohol consumption.
      Theoretical implications of the study results and suggestions for future research
      are discussed.

PMID- 8359947
TI  - Problem severity and symptomatology among substance misusers: differences between
      African-Americans and Caucasians.
AB  - Using data collected on 348 patients presenting to a hospital-based substance
      misuse treatment program, the present study compares psychiatric symptomatology
      and severity of substance misuse among African-American and Caucasian alcohol and
      drug misusers. African-Americans had a higher overall severity of substance
      misuse and reported using more substances than Caucasians. African-Americans also
      had higher levels of somatization, interpersonal problems, depression, hostility,
      obsessive/compulsive behavior, phobia, paranoia, and psychoticism than
      Caucasians. African-Americans exhibited higher levels of psychosocial stress and
      lower levels of global functioning than did Caucasians. The implications of the
      findings are discussed.

PMID- 8359948
TI  - Attitudes of registered nurses toward alcoholic patients in a general hospital
      population.
AB  - The Marcus Alcoholism Questionnaire was administered to 66 registered nurses at a
      community hospital to ascertain their attitudes regarding alcoholic patients in a
      general hospital population. This was done to provide documentation on what
      nurses attitudes actually are as opposed to making an assumption about what they
      should be because of the high visibility of the problem of alcoholism. The author
      reports the results of the study and then contrasts them with information about
      registered nurses attitudes toward alcoholic patients at a university hospital.
      The article concludes with insight into contributing factors for the differences.

PMID- 8359949
TI  - Health surveillance in Europe: lessons from EUROCAT and Chernobyl.

PMID- 8359950
TI  - Completeness of cancer registration in Limburg, The Netherlands.
AB  - The completeness of cancer registration in the IKL (Integraal Kankercentrum
      Limburg) cancer registry, Limburg, the Netherlands, was evaluated for the years
      1988-1990 by means of the independent case ascertainment method. This study was
      performed in co-operation with the Registration Network of Family Practices
      (RNFP) of the University of Limburg. The RNFP is a centralized database used by
      general practitioners (GP), containing their patients' background variables and
      diagnoses. The contents of the two databases were compared using computerized
      record linkage. If the information from both databases differed, this was
      verified using the source forms of the cancer registry and the GP involved. By
      combining the information from both registries in this way it was determined
      which malignancies should have been registered by the cancer registry. The IKL
      cancer registry had recorded 307 of the 319 eligible malignancies (96.2%). Five
      of the 12 missed registrations could be attributed to systematic shortcomings in
      the notification procedures. The estimated completeness for all malignancies of
      the IKL cancer registry is comparable with the results from cancer registries
      outside the Netherlands which have been established for longer.

PMID- 8359951
TI  - Mortality patterns and trends for lung cancer and other tobacco-related cancers
      in the Americas, 1955-1989.
AB  - Mortality from cancers of the oral cavity and pharynx, oesphagus, larynx and lung
      between 1955 and 1989 has been analysed for USA, Canada and 14 countries in Latin
      America. Among males, Uruguay, Cuba, Argentina and Puerto Rico have the highest
      rates for all sites, and Peru, Ecuador, Dominican Republic, Mexico and Colombia
      have the lowest rates. Among females, Cuba, Colombia and Puerto Rico rank high
      for all sites, and Mexico, Paraguay, Ecuador and Peru rank low. For both sexes,
      lung cancer mortality rates from the US and Canada are high, whereas rates from
      other sites are intermediate. An increasing trend in lung cancer mortality over
      time is shown in all countries except Cuba (no changes), Argentina, Paraguay and
      Peru (decreasing trend). In Latin America, the tobacco-related lung cancer
      epidemic is in its early phase among males, and very early phase among females.

PMID- 8359952
TI  - Marital stability and cancer of the uterine cervix: changing patterns in post-war
      Britain.
AB  - This study investigates the extent to which the distinctive cross-sectional
      marital status picture of risk for cancer of the uterine cervix (single, married,
      widowed, divorced in ascending order of risk) has persisted in post-war Britain.
      Incidence and mortality due to invasive cervical cancer amongst single women now
      exceeds that of the married, and for both has become much closer to that of the
      widowed and divorced. A dramatic increase in carcinoma in situ in Scotland, seen
      particularly in the single since 1982, must partly reflect changes in screening
      and diagnostic classification, but is also consistent with the later occurrence
      of the sexual revolution in Scotland. Overall in Britain, the distribution of
      screening and hysterectomy cannot account for the present day pattern of the
      disease. Available data on patterns of smoking and oral contraceptive use are
      broadly consistent with a role for them in determining the current disease
      pattern associated with marital status but their possible involvement cannot be
      disentangled from the more likely effect of changing levels of sexual activity
      increasing the risk of sexually transmitted disease. As marital status becomes a
      less important social indicator of sexual behaviour, it has also become a much
      less reliable marker of cervical cancer risk.

PMID- 8359953
TI  - Do chart reviews and interviews provide the same information about breast and
      cervical cancer screening?
AB  - The National Cancer Institute of the United States has set a goal for the year
      2000 that 80-90% of eligible women should have a Pap smear every 3 years and that
      80% of women aged 50-70 should receive an annual breast examination and
      mammogram. Very few studies have examined how we might best measure our progress
      towards this goal. Specifically, should we employ interview data or data derived
      from medical records? To respond to this question, data were gathered at two
      different public health clinics in poor areas of Chicago using both techniques.
      The interviews estimated significantly higher proportions of women receiving Pap
      smears, breast examinations, and mammograms in the previous 12-month interval
      than were estimated from randomly selected medical records. A review of the
      literature suggests the same pattern exists when other studies using these two
      data gathering processes are compared. We are thus left with a serious problem,
      one that must be resolved before we will be able to fully assess our progress in
      increasing breast and cervical cancer screening.

PMID- 8359954
TI  - Coffee, tobacco and alcohol as risk factors for cancer and adenoma of the large
      intestine.
AB  - Our aim was to estimate the association between smoking history, alcohol and
      tobacco smoking and tumours of the large intestine. Associations were studied at
      an early stage of colorectal cancer in order to avoid bias in the information. In
      order to estimate the link between adenoma and cancer the exposures were analysed
      separately for cancer and adenoma patients. The study was conducted as a case
      control study within a randomized trial for colorectal cancer among males and
      females aged 45-74 years. Cases initially included all individuals with a
      positive Haemoccult-II test in three screens and an age- and sex-matched
      reference group was selected from the test negatives. Subsequent colonoscopy
      defined the final case group, which consisted of 49 colorectal cancer patients,
      171 with adenoma and 177 test positives with no diagnosis or with non-adenomatous
      polyps or haemorrhoids. Controls were 362 age- and sex-matched test negatives.
      Data were collected by blind telephone interviewing before the first clinical
      examinations of test positives. Smoking history, coffee or alcohol intake were
      not statistically significantly associated with colorectal cancer. For adenomas,
      the odds ratios (OR) were between 2.0 and 2.7 in all smoking categories. For
      smokers with > 40 years duration OR = 2.7 (95% confidence interval (Cl): 1.6
      4.7). Coffee consumption showed a clear protective effect. Consumers of 4-7 cups
      per day had an OR of 0.5 (95% Cl: 0.3-0.8) and heavy consumers of > or = 8 cups
      had an OR of 0.3 (95% Cl: 0.1-0.6). Neither tea nor alcohol consumption was
      related to adenoma risks.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359955
TI  - Occupational risks of bladder cancer in France: a multicentre case-control study.
AB  - The relationships between occupational risk factors in France and bladder cancer
      were assessed from a hospital-based case-control study conducted between 1984 and
      1987 in five regions representing various industries, including mining, textile
      manufacture, metallurgy and the production of rubber and chemicals. The study
      concerned 765 cases (658 men and 107 women) and the same number of controls. Odds
      ratios (OR) adjusted for matching variables (age, place of residence and
      hospital), and tobacco smoking were estimated by unconditional logistic
      regression. A significantly increased risk of bladder cancer was observed among
      men employed in coal mining (OR = 2.42; 95% confidence interval (Cl) : 1.25-4.67)
      and the chemicals industry (OR = 2.36; 95% Cl : 1.23-4.53). Aircraft and ship's
      officers (OR = 11.8; 95% Cl : 1.46-95.7), managers (OR = 1.64; 95% Cl : 1.11
      2.43) and street vendors (OR = 3.60; 95% Cl : 1.15-11.3) also had an increased
      risk. Among women, employment in the clothing industry was associated with a high
      OR (= 3.21; 95% Cl : 1.34-7.71). Assessment of individual exposures by a panel of
      industrial hygiene experts showed that significantly more cases than controls had
      been exposed to the following substances: chlorinated solvents (OR = 1.86; 95% Cl
      : 1.19-2.90), industrial oils and greases (OR = 1.44; 95% Cl : 1.10-1.89),
      welding fumes (OR = 1.40; 95% Cl : 0.98-2.01), coal dust (OR = 1.71; 95% Cl :
      1.02-2.89) and metallic oxide dust (OR = 2.99; 95% Cl : 1.12-8.01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8359956
TI  - Tumours of the brain and presence of antibodies to Toxoplasma gondii.
AB  - The possible association between prior infection with the protozoan Toxoplasma
      gondii and development of brain tumours was investigated as part of two
      Australian population-based case-control studies of adult brain tumours. One
      study, based in Adelaide, South Australia, collected blood from 73 subjects with
      glioma, 53 subjects with meningioma and 348 controls. The other study, based in
      Melbourne, Victoria, collected blood from 44 subjects with glioma and 67
      controls. All tumours had been verified histologically. IgG antibodies to T.
      gondii were measured using Enzyme Linked Immunosorbent Assay (ELISA) techniques.
      In both the centre-specific and combined analyses, there was no difference
      between subjects with glioma and controls in the prevalence of antibody test
      positivity (35% test-positive in glioma versus 33% in controls, age-, sex- and
      centre-adjusted odds ratio (OR) = 1.00, 95% confidence interval (CI): 0.64-1.56).
      In the Adelaide study, there was a statistically significant increased risk of
      meningioma associated with antibody test-positivity (47% test-positive in
      meningioma versus 31% in controls, P = 0.02, adjusted OR = 2.09, 95% CI: 1.14
      3.83). Our results do not support the hypothesis that antibody positivity to T.
      gondii is a risk factor for glioma, but suggest that it might be associated with
      meningioma.

PMID- 8359957
TI  - The association of education with coronary heart disease mortality in the USSR
      Lipid Research Clinics Study.
AB  - There is a strong inverse association between educational attainment and coronary
      heart disease (CHD) mortality in men in the USSR Lipid Research Clinics (LRC)
      Study. Less educated men were characterized by higher mean blood pressure, high
      density lipoprotein cholesterol (HDL-C), cigarettes smoked and by lower mean low
      density lipoprotein cholesterol (LDL-C) and body mass index (BMI). With respect
      to nutritional variables, less educated men were characterized by higher mean
      energy per kg body weight and alcohol intake and by lower mean intake of fat,
      saturated, mono- and polyunsaturated fatty acids, cholesterol, sucrose, and other
      sugars. The Keys score closely predicted the differences in plasma cholesterol
      among the educational groups in the randomly selected sample. In men without CHD
      at entry, the age and clinic-adjusted relative risk for CHD mortality was 2.4 for
      the least educated compared with the most educated group; on adjusting for
      systolic blood pressure, HDL-C, LDL-C, BMI, alcohol intake and number of
      cigarettes, the relative risk was reduced to 1.9. These data indicate that only
      22% of the twofold excess of CHD mortality associated with low education was
      statistically attributable to the major risk factors. The failure to explain more
      of the education-CHD mortality gradient in the USSR LRC cohort was similar to
      observations from cohort studies in Great Britain and the US. Other correlates of
      low education must be explored to explain the association.

PMID- 8359958
TI  - Community-based intervention: the Coronary Risk Factor Study (CORIS).
AB  - The Coronary Risk Factor Study (CORIS) examined the feasibility and effectiveness
      of a multifactorial community intervention programme to reduce coronary heart
      disease (CHD) risk factor levels. Three Afrikaner communities were surveyed
      before and after a 4-year intervention in two of the communities, the third
      serving as a control (C). Intervention was primarily by small mass media (low
      intensity intervention, LII) or by small mass media plus interpersonal
      intervention to high-risk individuals (high-intensity intervention, HII). After
      allowing for change in C, significant net reductions in blood pressure, smoking,
      and risk score were obtained in LII and HII alike. Though the total cholesterol
      (TC) fell by 10-12%, there was no net reduction in favour of the intervention
      communities. However, LII and HII resulted in significant increases in high
      density lipoprotein cholesterol (HDL-C) levels and HDL-C/TC ratios in comparison
      to C. Overall, the LII community fared almost as well as the HII community, and
      high-risk individuals did not show a greater change in risk factors than others.
      We conclude that community-based intervention works, and that in these particular
      communities a media-based health education programme was more cost-effective than
      one which adds a greater degree of interpersonal intervention.

PMID- 8359959
TI  - Snoring, sleep apnoea and cardiovascular risk factors: the MONICA II Study.
AB  - The objective of this study was to evaluate the cardiovascular risk profile in
      self-reported snorers and sleep apnoeics in an adult representatively-selected
      population. A total of 1504 males and females, aged 30, 40, 50 and 60 years were
      included. The following were measured: snoring, alcohol and tobacco consumption
      by questionnaire, blood pressure, serum high density lipoprotein (HDL) and total
      cholesterol. Nocturnal respiration was determined in 748 participants.
      Respiratory distress index (RDI) was defined as the number of apnoea and
      hypopnoea lasting longer than 10 seconds per hour sleep. Habitual snoring was
      reported by 19.1% (9.2-24.2%, aged 30-60 years) of males and 7.9% (3.8-11.7%, age
      30-60 years) of females. An RDI > or = 5 was found in 10.9% (7.1-18.3%, age 30-60
      years) of males and in 6.3% (5.3-7.6%, age 30-60 years) of females. The following
      factors were associated with snoring: age (P < 0.02), sex (P < 0.001), body mass
      index (BMI) (P < 0.0001), alcohol (P < 0.05) and tobacco (P < 0.01) consumption.
      An RDI > or = 5 was associated with sex (P < 0.001), age (P < 0.05), BMI (P <
      0.0001), tobacco (P < 0.02) and alcohol (P < 0.05) consumption. Self-reported
      snores showed higher systolic (P < 0.001) and diastolic (P < 0.001) blood
      pressure and total cholesterol (P < 0.001) and a lower HDL (P < 0.001). The
      participants with RDI > or = 5 showed higher systolic and diastolic blood
      pressure (P < 0.001) and total cholesterol (P < 0.001).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8359960
TI  - Excess mortality for the unmarried in rural Bangladesh.
AB  - Prospective data from the Matlab surveillance area in rural Bangladesh, 1974
      1982, were used in this study to show that divorced and never-married adults
      (aged 15-44 years) had significantly higher mortality than their currently
      married peers with differences in disability status accounting for some of this
      excess risk. Widowed individuals on the other hand had no excess mortality
      relative to the currently married. A certain proportion of the sharp reduction in
      mortality associated with remarriage after divorce for men could be attributed to
      differences in disability between the remarried group and those who remained
      divorced. Household economic status indicators could account for little of the
      excess mortality of divorced and never-married individuals relative to their
      married counterparts. These findings provide support for the hypothesis that a
      certain proportion of mortality differentials by marital status in this
      population can be attributed to selection into marriage and remarriage on the
      basis of underlying disability status. The evidence for the protective effect of
      increased economic status associated with the currently married state is less
      convincing.

PMID- 8359961
TI  - Patterns of infant mortality from Armenian parish records: a study from 10
      countries of the diaspora, 1737-1982.
AB  - Using parish records from 10 different countries with small Armenian communities,
      this study compared patterns of infant mortality in these countries over a period
      of 245 years. Deaths registered as aged < or = 1 year were used to estimate the
      numerator for the infant mortality rates (IMR) while the denominator was
      estimated from births in the same year based on baptisms in the appropriate
      registers. To check on the validity of using the baptisms as the denominator for
      the IMR, records of infant deaths were linked with the baptismal records. Thus,
      from a sample of 273 infant deaths 78.4% had a baptismal record in the registers
      of the same church in which the death was recorded. Of the deaths 60% had a
      recorded cause of death. Over the past 245 years, IMR have fallen substantially
      in all parishes. However, there were notable exceptions to this general pattern
      of declining IMR over time. For example, the IMR was tripled in Palestine during
      the decade of the First World War, possibly as a result of the influx of refugees
      deported from Turkey. A study of the seasonal occurrence of the deaths revealed
      peaking of deaths between May and August, a pattern influenced by the relative
      importance of gastroenteritis as a cause of death during the summer months in
      Egypt where the majority of these infant deaths were recorded. A review of the
      most important causes of death helped identify an outbreak of undetermined cause
      in Belgrade in 1737 and an outbreak of dysentery deaths in Alexandria, Egypt, in
      1909.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359962
TI  - Consanguinity as a determinant of reproductive behaviour and mortality in
      Pakistan.
AB  - To determine the prevalence of consanguineous marriages and estimate the effects
      of consanguinity on reproductive behaviour and mortality, household and hospital
      based surveys were conducted in 11 cities in the Pakistan province of Punjab
      between 1979 and 1985. The 9520 women interviewed reported 44,474 pregnancies,
      with data collected on maternal and paternal ages at marriage,
      abortions/miscarriages, stillbirths and deaths in the first month, at 2-12 months
      and 2-8/10 years. Six categories of consanguineous marriage were included: double
      first cousin, first cousin, first cousin once removed/double second cousin,
      second cousin, bradari (brotherhood) and non-consanguineous. Marriages contracted
      between spouses related as second cousins or closer accounted for 50.3% of the
      total, equivalent to an average coefficient of kinship (alpha = sigma piFi) of
      0.0280. Unions between close biological relatives were characterized by younger
      maternal and paternal ages at marriage and reduced spousal age difference, but a
      longer time to first delivery. Overall, they exhibited greater fertility than non
      consanguineous couples. Antenatal and postnatal mortality were assessed by
      consanguinity and age interval. Consanguinity-associated deaths were consistently
      higher in the neonatal, infant and childhood periods. The consequences of these
      outcomes on the health of the present and future generations is assessed.

PMID- 8359963
TI  - Trends in amenable mortality in New Zealand 1968-1987.
AB  - Trends in amenable mortality rates for Maori and non-Maori New Zealanders were
      analysed and compared using regression models. The contribution of medical
      services to the decline in mortality rates was estimated. Mortality from causes
      amenable to medical intervention declined at a greater rate than non-amenable
      mortality for both groups. The proportion of the decline in mortality
      attributable to improvement in the impact of medical services was greater for non
      Maori than for Maori, especially for females. Maori to non-Maori mortality ratios
      were greater for amenable than for non-amenable causes, indicating a systematic
      differential between the two groups in the impact of medical services. There was
      only a small improvement over the 20 years in the excess of amenable mortality
      suffered by Maori. The results have implications for the provision of medical
      services to Maori people.

PMID- 8359964
TI  - Effect of age, birth cohort and period of death on Italian liver cirrhosis
      mortality, 1972-1986.
AB  - Liver cirrhosis is one of the main causes of death in Mediterranean countries. A
      trend towards a global reduction in the mortality rate has been recently
      reported. In order to clarify better this trend and in an attempt to hypothesize
      the future pattern of mortality, we analysed data from 254,834 Italian subjects
      aged 30-79 who died from liver cirrhosis during the period 1972-1986. We used a
      log-linear Poisson model to examine the effects of age, calendar period of death
      and birth cohort. Our data confirm that both in the population as a whole and
      after stratification for three geographical areas (Northern, Central and Southern
      Italy) the mortality rate is decreasing. The age-effect analysis showed an
      exponentially rising effect in the Southern population, in accordance with the
      viral aetiology of cirrhosis, whereas an increased effect followed by a decreased
      effect was observed in the Northern and Central population, suggesting the
      alcoholic aetiology for the disease. The results from the birth-cohort effect
      suggested that in the Northern and Central populations mortality should continue
      to decrease over the next decade, possibly due to the implementation of better
      prevention programmes for cirrhotics and to decreased alcohol consumption in
      Italy. In the Southern population, however, mortality is still rising and this
      will probably continue for the next decade, as the generations born between 1940
      and 1950 who are at high risk of carrying chronic hepatitis B virus infection,
      reach the age of higher risk of death from liver cirrhosis.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8359965
TI  - Pedal cycling fatalities in northern Sweden.
AB  - The aim of the study was to elucidate the crash and injury mechanisms in bicycle
      fatalities in the northern half of Sweden. All available autopsy protocols,
      hospital records and police reports were scrutinized. In 11 years, 146 bicyclists
      were fatally injured. The majority of the victims were males (66%) and the median
      age was 60 years. Most of the crashes (81%) occurred from May through October,
      during weekdays (84%), and during daylight (86%). Almost all victims (88%) died
      in a motor vehicle collision, in 21% with a truck. None was wearing a helmet.
      Poor hearing and cerebral arterosclerosis were probable risk factors among the
      elderly. Of the victims tested, 10% were under the influence of alcohol, half of
      whom were involved in single-bicycle crashes. In an additional five cases, the
      motor vehicle driver was impaired by alcohol. All injuries were due to blunt
      trauma and 69% of the victims died from head injuries. In 91% of all cases, there
      was an Abbreviated Injury Scale (AIS) score of the head region of > or = 3. The
      results indicate that separation of bicyclists from motor vehicle traffic by
      separate cycling tracks and protection of the head by a helmet would be
      beneficial.

PMID- 8359967
TI  - Risks for premature rupture of amniotic membranes.
AB  - The objective of this study was to test the hypothesis that diverse risk
      variables including infections during the index pregnancy independently increase
      the risk of preterm premature rupture of amniotic membranes (PROM) and preterm
      delivery without PROM. A case-control design was used to study women 15-45 years
      old who had preterm PROM, full-term PROM or preterm without PROM and were singly
      matched by age race and parity to controls who delivered full-term infants. The
      odds for preterm PROM was 6.0 times that of controls among women with intra
      amniotic infection, 3.7 times among those with urinary tract and 7.6 times among
      women with gonorrhoea infections after controlling for the effects of exposure to
      cigarette smoke, having previous preterm and full-term PROM deliveries and
      antepartum bleeding that independently increased the odds. The odds for preterm
      births without PROM was 4.8 times that of controls among women with a previous
      preterm PROM birth, was significantly increased among those exposed to cigarette
      smoke or having antepartum bleeding, but not among those exposed to chlamydia
      infection. Even after adjusting for concomitant risk factors, women with preterm
      PROM births were more likely than their matched controls to have had infections.

PMID- 8359966
TI  - Risk factors for preterm delivery in Burkina Faso (west Africa).
AB  - The environmental and socioeconomic risk factors for preterm delivery were
      assessed in a West African urban population (Bobo-Dioulasso, Burkina Faso). The
      study population were 102 cases of preterm delivery matched with 102 controls
      obtained from 4124 sequential deliveries which occurred between May and October
      1989 in the three maternity centres in the city. The univariate analysis
      identified the risk factors as age (< 20 years), primiparity, marital status
      (single), low frequency of antenatal visits, death of a previous child and level
      of education of the mother. The following risk factors identified by multivariate
      analysis (logistic regression) are consistent with those identified in previous
      studies: youth of the mother, primiparity (P = 0.01) and death of a previous
      child (P < 0.05). On the other hand, in this study, the level of education of the
      parent was identified as an independent risk factor (P < 0.001). This finding
      could be used to determine a target population for prevention programmes.

PMID- 8359969
TI  - Development and validation of a food frequency questionnaire in Spain.
AB  - To create a suitable instrument to estimate intakes of total calories, protein,
      carbohydrate, fats (saturated, mono and polyunsaturated), alcohol, cholesterol,
      fibre, vitamin A and vitamin C in epidemiological studies conducted in Spain, a
      food frequency questionnaire was developed and tested. In particular, the
      questionnaire was designed to be used in a large population-based case-control
      study of dietary factors in relation to breast and colorectal cancer among women
      from different Spanish regions. After identifying the most important food sources
      of the relevant nutrients in the study population, the final version of the
      questionnaire asked about consumption of 118 food items. Its reproducibility and
      validity were tested among 147 Spanish women aged 18-74 years. These subjects
      were asked to complete the questionnaire before and after completing four 4-day
      food records. The records were obtained at 3-month intervals designed to
      represent daily and seasonal changes (between 1990 and 1991). Using the
      information available from standard Spanish food composition tables, an ad hoc
      computer program was created to translate food consumption into nutrient intake.
      The reproducibility of the questionnaire was assessed by means of estimating
      correlations between nutrient scores measured with the same instrument twice,
      with a period of 1 year between estimates. Pearson correlation coefficients
      ranged from 0.51 for saturated fat to 0.88 for alcohol. In the validity study,
      correlation coefficients between diet records and the first and second
      questionnaires ranged between r = 0.20 for vitamin A and r = 0.88 for
      alcohol.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359968
TI  - An outbreak of pellagra related to changes in dietary niacin among Mozambican
      refugees in Malawi.
AB  - Between February and October 1990, 18,276 cases of pellagra dermatitis (due to
      niacin deficiency) were reported among 285,942 Mozambican refugees in Malawi.
      Overall, 6.3% of the refugee population developed pellagra and the attack rate
      was 7.8 times higher among women than men. This outbreak followed a 5-month
      cessation of groundnut distribution (the major source of niacin) to refugees. A
      matched-pair case-control study confirmed the protective role of the daily
      consumption of groundnuts (Odds Ratio [OR] = 0.08), as well as the independent
      role of garden ownership (OR = 0.34), and home maize milling (OR = 0.3).
      Recommended corrective action included early case finding and treatment,
      distribution of niacin tablets, prompt identification of groundnut supply on the
      world market, fortification with niacin of the food ration and diversification of
      the food basket through access to local markets.

PMID- 8359970
TI  - Short-term and long-term reproducibility of dietary history interview data.
AB  - This study gives results for comparisons between dietary history interviews
      repeated at short-term (4-8 months) and long-term (4-7 years) intervals in
      conjunction with the Finnish Mobile Clinic Health Examination Survey. Interviews
      surveying the whole range of consumable foods over the preceding year were
      completed in 1967-1976. Short-term study was accomplished among 93 adults, and
      long-term study among 1844 adults. Comparisons were made for intakes of 32 food
      groups and 32 nutrient indices. In the short term, the intraclass correlation
      coefficients for nutrient indices ranged from 0.16 to 0.80, with 90% of values
      higher than 0.5. The corresponding figures for repeated measurements at long-term
      interval were generally poorer, being in the range 0.12-0.60, with 45% of values
      > 0.5. When studied in population subgroups, long-term agreement in dietary data
      was not found to be affected by sex, age, body mass index or smoking status, but
      it may be reduced among heavier drinkers (> or = 20 g alcohol per day). The
      intraclass correlation coefficients for separate nutrients tended to be higher
      than those for different food groups. In conclusion, we suggest that the
      reproducibility of the dietary history method used was acceptable, and that the
      dietary patterns of examinees were sufficiently stable to be compatible with the
      needs of epidemiological follow-up studies.

PMID- 8359971
TI  - Incidence of HIV-1 infection among adults in the Kagera region of Tanzania.
AB  - The results of a population-based follow-up study are presented. The baseline
      study which started in August 1987, was carried out to determine the prevalence
      of human immunodeficiency virus (HIV-1) infection in the Kagera region of
      Tanzania. A multistage cluster sampling technique was adopted in the selection of
      the study population. In the follow-up survey which started in June 1988, members
      of the same study population were revisited and studied in order to determine the
      incidence of HIV-1 infection among those who were HIV seronegative in the initial
      survey. HIV serology was conducted by using enzyme-linked immunosorbent assay and
      all positive sera were confirmed by the Western blot technique. A total
      population of 1316 adults aged 15-54 years was studied, constituting an average
      follow-up response rate of 69% in the rural areas and of 59% in the urban area.
      The overall incidence of HIV-1 infection among the adult population sample was
      13.7 per 1000 person-years at risk with the highest incidence in the urban zone
      (47.5 per 1000 person-years at risk) and the lowest incidence in one of the three
      rural zones (4.9 per 1000 person-years at risk). The age-specific annual
      incidence was highest in the age group 25-34 years for males and in the age group
      15-24 for females. From these results it was estimated that the number of newly
      infected adults in the region each year is about 8200 with a range between 5400
      and 11,000 corresponding to the 95% confidence limits on the overall
      incidence.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8359972
TI  - Determinants of HIV-1 infection in intravenous drug users in Valencia, Spain,
      1987-1991.
AB  - From 1987 through 1991, 2687 intravenous drug users recruited at three AIDS
      information centres in the Region of Valencia (Spain) were interviewed about drug
      use and sexual behaviour and subsequently tested for HIV-1 antibody. The overall
      seroprevalence was high, 50% (95% confidence interval [CI]: 41.8-51.9%). There
      were no differences by gender, but HIV-1 infection was related to older age and
      city of residence. After adjustment by means of logistic regression age (odds
      ratio [OR] = 1.80), sharing of injection equipment (OR = 2.16), duration of
      addiction (OR = 6.59) and prostitution (OR = 1.77) were significantly associated
      with HIV-1 prevalence. High educational level was inversely related to HIV-1
      status (OR = 0.43) and a decreasing trend of prevalence with time was observed.

PMID- 8359973
TI  - Acceptability of the tuberculosis service: scale development.
AB  - Health workers require reliable, easily administered and scored measures to
      evaluate acceptability of a health service. A 13-item attitude scale was
      developed to determine acceptability of the tuberculosis (TB) service. The
      objectives of this study were to: ascertain reliability (internal consistency) of
      the scale and confirm, through factor analysis, that acceptability of the TB
      service was based on cognitive and affective reactions. The sample comprised 487
      black adult interviewees (67 TB patients on ambulatory therapy and 420 non-TB
      community members) from two urban townships in the Transvaal, South Africa. The
      reliability coefficient revealed a high level of internal consistency for the
      scale (r = 0.84). A principal components analysis, with orthogonal and oblique
      rotations, was conducted. Two factors accounted for 45.4% of the variance. The
      highest loadings on Factor I involved an empathic dimension (friendly, helpful,
      encouraging and communicative). Factor II tended to focus on the organizational
      elements of the system, such as availability, consistency of information, length
      of waiting time and maintenance of contact. It was concluded that this scale was
      a reliable, easily administered and scored measure of acceptability, with
      underlying affective and cognitive components.

PMID- 8359974
TI  - A clinical prediction rule for American cutaneous leishmaniasis in Colombia.
AB  - Neither parasitological nor molecular diagnosis of leishmaniasis is widely
      available in clinical settings where American cutaneous leishmaniasis (ACL) is
      endemic. Therefore four clinical prediction rules for ACL were developed which
      incorporated physical examination findings (clinical rule), physical examination
      and leishmanin skin test (LST) (clinical-LST rule), physical examination and
      historical information (clinical-historical rule), or physical examination,
      historical information and LST (clinical-historical-LST rule). One hundred
      parasitologically diagnosed ACL cases and 38 cases of chronic skin lesions of
      other aetiologies comprised the derivation set. The validation set consisted of
      124 ACL cases and 35 patients with lesions of other aetiologies. Components of
      each rule were selected by bivariate analysis, then step-wise logistic
      regression. Sensitivity, specificity and efficiency were calculated for each
      score threshold; the threshold achieving greatest efficiency was selected for
      each rule. When these rules were applied to the validity set the sensitivity,
      specificity and efficiency were respectively: clinical 93%, 31%, 79%; clinical
      LST 90%, 73%, 85.9%; clinical-historical 97%, 51%, 87%; clinical-historical-LST
      92%, 70%, 87%. Inclusion of LST skin test consistently improved the specificity
      of the rules. Should a given clinical setting warrant optimizing either
      sensitivity or specificity alone, the rule thresholds can be adjusted. These and
      other prediction rules, once evaluated in other settings, should be incorporated
      into leishmaniasis control programmes.

PMID- 8359975
TI  - Ascertainment corrected rates: applications of capture-recapture methods.
AB  - Accurate rates, though fundamental to epidemiology, are often very difficult to
      obtain. Incidence, prevalence, and mortality rates have traditionally been
      established through either passive reporting surveillance systems, through active
      surveillance systems, or by a combination of the two methods. Typically, when
      researchers employ these approaches they do not formally evaluate or correct for
      the degree of underascertainment. Undercount of cases is a potent determinant of
      rates which we cannot continue to ignore. We believe all rates should be adjusted
      for underascertainment in order to achieve a truer picture of the risk and risk
      factors of disease. Here, we present a procedure to ascertainment correct rates
      based upon well established capture-recapture methods.

PMID- 8359976
TI  - HIV and AIDS indexed by MEDLINE.

PMID- 8359977
TI  - Intention-to-treat analyses in clinical trials and cohort studies.

PMID- 8359978
TI  - Reduced transport of adenosine in erythrocytes from patients with beta
      thalassaemia.
AB  - The transport of adenosine into blood from beta-thalassaemia subjects was
      measured to provide a background to the relationship between resistance of
      malaria infection and beta-thalassaemia. Adenosine transport was significantly
      reduced in the abnormal cells in the blood samples. As adenosine is one of the
      major purines salvaged by P. falciparum malaria, we suggest that the resistance
      to malaria in beta-thalassaemia subjects may be due to a nutrient deficiency in
      the abnormal red cells.

PMID- 8359979
TI  - Differential secretion of acetylcholinesterase and proteases during the
      development of Heligmosomoides polygyrus.
AB  - The development of the gastrointestinal nematode Heligmosomoides polygyrus was
      studied in the mouse. Levels of production of acetylcholinesterase and proteases
      were measured in excretory/secretory products of various stages of the parasite.
      The production of acetylcholinesterase was found to be maximal between days 4 and
      6 post-infection, corresponding to the fourth larval stage of the parasite's life
      cycle. Analysis of proteolytic activity revealed both quantitative and
      qualitative differences between the stages. Quantitative examination showed a
      maximal concentration of proteolytic enzymes in the early third larval stage
      (L3). Qualitative analysis revealed L3-associated molecules at 96, 15 and 8 kDa,
      L4-associated molecules at 58 and 33 kDa and adult-associated molecules at 116,
      102, 39 and 25 kDa. A number appeared to be shared by all stages (18, 16 and 13
      kDa), whilst others (76 and 42 kDa) appeared to be associated with the late
      L4/early adult parasite. The biological and immunological implications of
      variation in the production of proteases and acetylcholinesterase during the
      development of H. polygyrus are discussed.

PMID- 8359980
TI  - Anthelmintic effects of cyclosporin A on protoscoleces and secondary hydatid
      cysts of Echinococcus granulosus in the mouse.
AB  - Cyclosporin A (CsA), employed primarily as an immunosuppressant during the
      management of organ and graft transplants, exhibits anthelmintic properties.
      However, its efficacy against tapeworm infections in laboratory models is
      variable. A preliminary investigation has been undertaken to assess the action of
      CsA on the establishment and growth of protoscoleces and secondary hydatid cysts
      of ovine Echinococcus granulosus in mice. Administration of CsA in five
      consecutive daily doses, beginning 2 days prior to infection, resulted in
      significant reduction in cyst establishment (measured in terms of cyst masses,
      cyst numbers and cyst wet weights), when mice were autopsied 20 weeks post
      infection. None of these parameters were significantly reduced when the drug was
      administered 18 weeks post-infection, although wet weight decreased by 42%.
      Ultrastructural examination of the germinal membrane and laminated layer of late
      treated E. granulosus revealed abnormalities in all cysts studied whereas control
      and early-treated hydatids were normal. A case is made for the consideration of a
      clinical use for CsA for post-operative control of secondary hydatidosis and its
      efficacy against hydatid cysts is discussed.

PMID- 8359981
TI  - Comparative pharmacokinetic behaviour of albendazole in sheep and goats.
AB  - Albendazole (ABZ) containing a trace of [14C]-ABZ was administered intraruminally
      at 4.75 mg kg-1 to Merino sheep and Angora goats and the pharmacokinetic
      behaviour of ABZ and its metabolites in plasma nd abomasal fluid compared. The
      systemic availability (area under the curve, AUC) for total [14C]-labelled
      metabolites was significantly lower in goats than in sheep. This was largely
      attributable to the disposition of ABZ sulphoxide (ABZ.SO) which had a
      significantly lower maximum concentration (Cmax) in goats (0.94 +/- 0.04
      micrograms ml-1) than in sheep (1.41 +/- 0.24 micrograms ml-1). The AUC of [14C]
      in abomasal fluid was similar in goats and sheep, with approximately 35 and 45%
      of the dose passing the pylorus in the two species, respectively. ABZ, ABZ.SO and
      ABZ sulphone (ABZ.SO2) were present in the abomasal fluid of both species but
      between-species differences were only evident with ABZ.SO which had a lower Cmax
      in goats compared with sheep. The relative proportions of the [14C] dose excreted
      in urine and faeces were similar between species. It is suggested that ABZ may be
      sequestered to a greater extent in the liver of goats than of sheep which would
      result in lower concentrations of ABZ.SO in plasma and abomasal fluid. This
      behaviour might be compensated for by administering ABZ to goats at a
      proportionally higher dose rate.

PMID- 8359982
TI  - Cellular and chemical mediators of type 1 hypersensitivity in calves infected
      with Ostertagia ostertagi: mast cells and eosinophils.
AB  - Abomasal mucosal mast cell and eosinophil accumulation was morphometrically
      evaluated in 26 Holstein steers after natural or experimental infection with
      Ostertagia ostertagi. Results showed that following infection, accumulation of
      mast cells and eosinophils in abomasal tissue was dependent on infection pattern.
      Eosinophilia was greater in steers with type 1 ostertagiosis, while mastocytes
      was more pronounced in steers with type 2 ostertagiosis.

PMID- 8359983
TI  - Cellular and chemical mediators of type 1 hypersensitivity in calves infected
      with Ostertagia ostertagi: histamine, prostaglandin D2, prostaglandin E2 and
      leukotriene C4.
AB  - Plasma histamine, prostaglandin E2 (PG) D2, PGE2, and leukotriene (LT) C4 levels
      were determined in 26 Holstein steers before and after natural or experimental
      infection with Ostertagia ostertagi. Post-infection abomasal lymph was also
      assayed for PGD2, PGE2, and LTC4. Histamine determinations were performed on
      abomasal tissue from three locations. Results showed that: (1) tissue histamine
      levels increased in steers with type 2 ostertagiosis, (2) lymphatic PGD2 and PGE2
      levels were increased, probably as a result of macrophage activity, (3) lymphatic
      LTC4 levels increased in steers with type 1 ostertagiosis, and were correlated
      with tissue eosinophilia, and (4) plasma levels of PGD2, PGE2, LTC4 and histamine
      were not useful for predicting worm burdens. These findings suggest a functional
      role for eosinophils and mast cells in the pathophysiology of ostertagiosis,
      through mediation of a type 1 hypersensitivity reaction.

PMID- 8359984
TI  - Cercariae and metacercariae of Stephanostomum cloacum (Trematoda:
      Acanthocolpidae).
AB  - Cercariae and metacercariae of the acanthocolpid trematode, Stephanostomum
      cloacum (Srivastava, 1938) are described and illustrated, based on material
      collected from Chilka Lake, a brackish water lagoon. Natural infections with the
      cercariae were found in the snail, Nassarius orissaensis and with the
      metacercariae in the bivalve, Modiolus undulatus. Cercariae are distomate,
      ophthalmoxiphidiocercous, and possess a small stylet, simple tail, four pairs of
      penetration glands arranged in two groups and a large granular excretory bladder.
      Development of the cercaria into the metacercaria was followed in M. undulatus
      under laboratory conditions. Infections with adults of S. cloacum were identified
      in the fish Triacanthus biaculeatus, found in the lake.

PMID- 8359985
TI  - Serum-independent and serum-dependent cytoadherence in the interaction of
      Entamoeba histolytica with mammalian target cells.
AB  - Entamoeba histolytica kills target cells only on direct contact, suggesting that
      trophozoite-mediated cytolysis is initiated by the contact between trophozoites
      and target cells. We have shown that adherence between E. histolytica and target
      cells (polymorphonuclear granulocytes, erythrocytes, Chinese hamster ovary cells,
      human colon carcinoma cells) was inhibited by specific carbohydrates, and
      adherence between E. histolytica and polymorphonuclear granulocytes (PMN) was
      enhanced by preincubation of the trophozoites with serum. Inhibition of adherence
      clearly paralleled inhibition of cytolysis and phagocytosis of target cells.
      Cytolysis of PMN, however, was not increased by preincubation of the trophozoites
      with serum. These results suggest that the effector functions of trophozoites are
      only dependent on carbohydrate-specific adherence mechanisms mediated by the
      amoebic Gal/GalNAc-binding lectin. E. histolytica trophozoites themselves can be
      killed by PMN, depending on the virulence of the trophozoites. PMN could not kill
      E. histolytica trophozoites more effectively when the adherence was enhanced by
      preincubation of the trophozoites with serum or when adherence was only mediated
      by serum-dependent mechanisms.

PMID- 8359986
TI  - In vitro activity of paraherquamide against the free-living stages of Haemonchus
      contortus, Trichostrongylus colubriformis and Ostertagia circumcincta.
AB  - Paraherquamide, an oxindole alkaloid recently reported to have potent nematocidal
      activity, was shown to have a marked inhibitory effect on the motility of the
      free-living larval stages of H. contortus, T. colubriformis and O. circumcincta.
      The effect of paraherquamide on larval motility could be distinguished from that
      caused by levamisole and the avermectins. After 72 h exposure, the concentration
      of paraherquamide required to inhibit the motility of 50% of L3 larvae present
      was 0.033, 0.058 and 2.7 micrograms ml-1 for O. circumcincta, T. colubriformis
      and H. contortus, respectively. Ivermectin (IVM)-resistant isolates of H.
      contortus were significantly more sensitive to the paralytic effects of
      paraherquamide than IVM-susceptible isolates of this species. Paraherquamide had
      no effect on the time for development from the egg to the L3 larval stage of H.
      contortus, T. colubriformis and O. circumcincta.

PMID- 8359987
TI  - The diagnostic antigen encoded by gene fragment Dv3-14: a major sperm protein of
      Dictyocaulus viviparus.
AB  - The Dv3-14 gene fragment of Dictyocaulus viviparus is 471 bp, of which about 90%
      is translated. The calculated molecular mass of the translation product is 15.5
      kDa. DNA sequence homologies were found with major sperm proteins (MSPs) from
      Ascaris suum, Caenorhabditis elegans and Onchocerca volvulus. Within a segment of
      62 amino acids the predicted amino acid sequence of Dv3-14 shows 84% homology
      with an A. suum MSP and 84% homology with a C. elegans MSP. Computer analysis of
      the protein sequence identified three segments of immunodominant antigenic sites
      as putative candidates for synthetic peptide antigens. Immunoblotting analysis of
      the translated product showed that it is adult stage specific, water soluble and
      not membrane bound and can be demonstrated in the supernatant fluids of cultures
      from adult worms kept in cell culture medium. The results suggest that the
      protein encoded by Dv3-14 is a MSP of D. viviparus.

PMID- 8359988
TI  - Comparative histopathology of Longicollum (Acanthocephala: Pomphorhynchidae)
      infection in the alimentary tract and spleen of Acanthopagrus australis (Pisces:
      Sparidae).
AB  - The pomphorhynchid acanthocephalan Longicollum alemniscus infected the rectum of
      16 and the intestine of five of 628 Acanthopagrus australis from Moreton Bay,
      Queensland. The neck and proboscis penetrated the entire gut wall and were
      surrounded by a layer of compact, rounded fibroblasts inside a layer of elongated
      fibroblasts and scattered connective tissue fibres. These layers extended across
      the entire gut wall and into the capsule that enclosed the proboscis outside of
      the gut. A similar parasite occurred extraintestinally in three fish; the
      proboscis of one penetrated into the spleen. The spleen was shrunken, with the
      proboscis and anterior part of the neck enclosed in a capsule of proliferated
      connective tissue and cellular elements similar to that in the response to
      infection of the gut wall.

PMID- 8359989
TI  - The toxicity of antifolates in Babesia bovis.
AB  - A variety of anti-folate compounds have been tested for their ability to inhibit
      the growth of Babesia bovis as measured by the incorporation of [3H]hypoxanthine
      into the parasite's nucleic acids. Inhibitors of folate synthesis (including 7
      methylguanosine and several sulpha drugs) were without effect but several
      structural analogues of folate were toxic. The most potent folate analogues were
      the lipophilic compounds piritrexim and trimetrexate, each causing 50% inhibition
      of [3H]hypoxanthine incorporation (IC50) at a concentration of 2.9 nM; other
      classical anti-folates such as pyrimethamine, methotrexate and trimethoprim were
      at least 100-fold less effective with IC50 values of 1.2, 0.29 and 0.50 microM,
      respectively. From these results we conclude that B. bovis does not synthesize
      folate de novo under cell culture conditions. However, the toxic effects of
      piritrexim and trimetrexate suggest that dihydrofolate reductase (DHFR) activity
      is essential for the parasite, most probably because of the role of this enzyme
      in the synthesis of thymidine nucleotides via thymidylate synthase.

PMID- 8359990
TI  - Analysis of the results obtained using a technic of experimental primary
      infestation with Fasciola hepatica in the rat.
AB  - In this work, we analyzed the results obtained using a technic of infestation
      with Fasciola hepatica in the rat. The infestations were carried out with 30
      metacercariae in a gelatin capsule. The humoral immune response, measured by
      ELISA, and the liver necroses, spleen size, number and length of the flukes
      recovered at necropsy were followed during the course of four experimental
      primary infestations. The results showed that the magnitude of the parasitic
      burden did not correlate with the humoral immune response of the rat. The study
      of the liver necroses, spleen size, fluke length and antibody titres showed that
      the use of 30 metacercariae in a capsule as a technic of infestation in the rat
      ensured the homogeneity of the parasite development and the humoral immune
      response of the host.

PMID- 8359991
TI  - Female-specific genomic PCR sequences from Schistosoma mansoni as probes for
      hybridization histochemistry.
AB  - Rapid methods for sexing single larval or egg stages of schistosomes have been
      difficult to establish. Such methods would be of value for assessing changes in
      sex ratios at different stages of the life cycle and studying diseases processes
      of schistosomiasis. We describe the use of hybridization histochemistry for
      identification of female eggs of Schistosoma mansoni in sections of infected
      mouse liver using a highly repetitive genomic DNA sequence generated by the
      polymerase chain reaction with primers spanning a known female-specific sequence
      (W1) of S. mansoni. In an initial study, approximately half of the eggs in each
      liver section from mice infected for 50 days labelled heavily with this probe.
      Further studies will evaluate the sensitivity and specificity of the probe on
      clonal populations (either male or female) or larvae in host tissue.

PMID- 8359992
TI  - An outbreak of haemonchosis associated with anthelmintic resistance in sheep.
AB  - An outbreak of haemonchosis associated with anthelmintic resistance was recorded
      in a flock of 150 crossbred lambs. Closantel and ivermectin were 100% effective
      against Haemonchus contortus while fenbendazole and morantel reduced faecal egg
      counts by 87 and 29%, respectively. Levamisole showed an efficacy of 95%. At
      double the recommended dose (10 mg kg-1), fenbendazole had an efficacy of 99%
      against H. contortus infection. This appears to be the first report of an
      outbreak of haemonchosis associated with fenbendazole and morantel resistance in
      a strain of H. contortus in sheep.

PMID- 8359993
TI  - New host record for the entodiniomorphid ciliate, Troglodytella abrassarti, from
      siamangs (Hylobates syndactylus).
AB  - Examination of faecal samples from several diarrhoeic siamangs Hylobates
      syndactylus (Anthropoidea: Hylobatidae) revealed the presence of numerous
      entodiniomorphid ciliates whose morphological and ultrastructural characteristics
      were consistent with those of Troglodytella abrassarti previously recorded from
      chimpanzees, orangutans and gorillas (Anthropoidea: Pongidae).

PMID- 8359994
TI  - Species-specific PCR for the parasitic nematodes Haemonchus contortus and
      Trichostrongylus colubriformis.
AB  - Reliable species determination of gastrointestinal nematode parasites from sheep
      is usually carried out on third-stage larvae (L3) by visual differentiation. The
      culturing of L3 takes about 1 week so a reliable method that could use eggs for
      the determination would accelerate the procedure. We developed a polymerase chain
      reaction (PCR), using very small amounts of parasite DNA and an oligonucleotide
      set according to parts of the DNA sequence of a beta-tubulin gene from Haemonchus
      contortus, that can discriminate H. contortus DNA and Trichostrongylus
      colubriformis DNA from each other and from several other sheep nematode
      parasites. This method can be used for every stage of the parasite, including
      eggs. For the first time a PCR method is reported to discriminate between sheep
      nematode parasites.

PMID- 8359995
TI  - Comparison of the second internal transcribed spacer (ribosomal DNA) from
      populations and species of Fasciolidae (Digenea).
AB  - The nucleotide sequence of the 3' end of the second internal transcribed spacer
      region (ITS2) was determined for four isolates of Fasciola hepatica, two isolates
      of Fasciola gigantica, one isolate of Fascioloides magna and one isolate of
      Fasciola sp. from Japan. Intraspecific sequence divergence was negligible.
      Sequence divergence between F. hepatica and F. gigantica was 2.8% and between
      Fasciola hepatica and Fascioloides magna was 13.2%. The sequence of Fasciola sp.
      from Japan matched closely that of F. gigantica. This study demonstrates
      variability in nucleotide sequence within the ITS2 region which allows
      discrimination between species of Fasciolidae.

PMID- 8359996
TI  - Experience with doxorubicin-bound polyisohexylcyanoacrylate nanoparticles on
      murine alveolar echinococcosis of the liver.
AB  - The parasiticidal properties of doxorubicin against the metacestode of
      Echinococcus multilocularis were investigated after binding of that drug to
      polyisohexylcyanoacrylate nanoparticles, a colloidal biodegradable drug carrier.
      A reduction of the hepatic parasite development and a reduced viability of the
      metacestode were observed in mice injected with 5 mg kg-1 body weight-1, but 7.5
      mg kg-1 body weight-1 did not appear more efficient. Free doxorubicin or unbound
      nanoparticles had no antiparasitic activity.

PMID- 8359997
TI  - Psychiatric manifestations of olivo-ponto-cerebellar atrophy and treatment with
      clozapine.
AB  - Patients with multiple system atrophy, a neurodegenerative disease entity, have a
      high incidence of associated mental disturbances such as a mood disorder with or
      without psychotic features. Treatment of the psychiatric symptoms, without
      compromising neurological status, is often complicated and unsuccessful. This
      article describes a patient with olivo-ponto-cerebellar atrophy and treatment
      resistant psychotic depression whose psychiatric symptoms were successfully
      treated with clozapine without aggravating the neurological disabilities.

PMID- 8359998
TI  - Psychologic distress during menopause: associations across the reproductive life
      cycle.
AB  - OBJECTIVE: To determine if women with high psychologic distress attending a
      menopause clinic report more previous psychiatric disorders (especially
      depression), or psychologic distress associated with oral contraceptive use and
      reproductive cycle events than women with low psychologic distress attending the
      clinic. METHOD: Consecutive women attending a university hospital menopause
      clinic were administered the Brief Symptom Inventory (BSI). Women with high
      psychologic distress (who met case severity on the BSI general severity index)
      were compared to a similar number of the lowest scoring clinic women on their
      reports of previous psychiatric diagnoses and treatment, and depression or
      distress related to oral contraceptive use, the premenstrual period, or
      associated with pregnancy. RESULTS: The forty-four women with high psychologic
      distress were significantly more likely than the forty-two menopause clinic
      patients with low psychologic distress to report a past psychiatric diagnosis
      (usually depression) (p = 0.001), requiring anti-depressant treatment (p =
      0.002), oral contraceptive dysphoria (p = 0.004), dysphoric premenstrual syndrome
      (p = 0.000), postnatal blues (p = 0.02) and postpartum depression (p = 0.004).
      CONCLUSIONS: Although the halo effect of current distress or retrospective
      reporting may have biased these results, the similarity of ratings in the two
      groups on physical symptoms in menopause and psychologic symptoms during
      pregnancy makes this less likely. These findings corroborate other recent studies
      showing that women who suffer from affective disorders following one reproductive
      event are more vulnerable to recurrences associated with others. Clinicians
      should inquire about possible relationships between previous depression or
      psychologic distress and reproductive cycle events as it may help predict women
      who are vulnerable to affective disorders and psychological distress at these
      critical times.

PMID- 8359999
TI  - Body image in chronic illness--a reconceptualization.
AB  - OBJECTIVE: Was to construct a classification system of the body image
      specifically relevant to patient experience of chronic physical disorder. METHOD:
      To review both previous writings on body image and also data on psychosocial
      factors relevant to a variety of chronic illnesses. From this were derived four
      component parts of body image: comfort, competence, appearance and
      predictability. These are discussed in general and disease-specific terms.
      RESULTS: Using this format, a classification system is offered. This is intended
      to be simple enough for routine clinical use and yet to offer some insight into
      body experience. An example is given. CONCLUSION: Separating out the aspects of
      body image relevant to physical illness provides a clinically useful
      classification system. Further work is needed to determine its applicability as a
      research tool.

PMID- 8360000
TI  - New perspectives on Type A behavior: a psychiatric point of view.
AB  - OBJECTIVE: To propose an answer to Medicine's confusion about what Type A
      Behavior is. METHOD: To critically review early writings about Type A as well as
      current literature with a focus on five key articles which are frequently
      mentioned in medical and lay literature as containing relevant data undermining
      the Type A hypothesis. These five are critically evaluated for their definition
      of Type A, method of diagnosing Type A, nature of the cohort studied, and logic
      of their conclusions. RESULTS: There is a failure in the literature to
      distinguish between Axis I symptoms and Axis II personality traits; the same
      term, Type A, being applied to quite different phenomena. CONCLUSIONS: Type A
      should be defined as a Axis II Personality Disorder, and a new term, Stress
      Disorder (or Hostility Disorder) to the Axis I symptoms. This opens up endless
      possibilities in Medicine for Stress Disorder research, since Medicine can
      rightly argue that the research is to better treat the Stress Disorder disease,
      that precedes Coronary Artery disease.

PMID- 8360001
TI  - Self-reported compliance with diabetes self-management during pregnancy.
AB  - OBJECTIVE: The current study examined regimen compliance in pregnant women with
      pre-existing (overt) diabetes across multiple self-care tasks at three times
      during the pregnancy: mid-second, early third, and late third trimesters. METHOD:
      Forty-nine pregnant women with Type I (68%) or Type II (32%) diabetes completed
      measures to assess compliance with the diabetic regimen, major and minor life
      stressors, and social support for the diabetic regimen. RESULTS: Pregnant women
      with overt diabetes generally reported being compliant with their self-care
      regimen. There were, however, notable differences in reported compliance levels
      across different regimen tasks. Specifically, 74 to 79 percent of women reported
      being always compliant with dietary recommendations compared to 86 to 88 percent
      for insulin administration, 85 to 89 percent in managing insulin reactions, and
      94 to 96 percent for glucose testing. Furthermore, stress in the form of major
      and minor life events and regimen-related social support were significantly
      related to self-reported compliance with dietary recommendations. There was no
      relationship between compliance and blood glucose levels. CONCLUSIONS: These
      findings suggest that psychiatric consultants focus on ways to increase social
      support as one means of improving compliance in pregnant women with diabetes.

PMID- 8360002
TI  - How big was the effect?

PMID- 8360003
TI  - Psychosocial factors and recurrent genital herpes: a review of prediction and
      psychiatric treatment studies.
AB  - OBJECTIVE: The purpose of this review was to evaluate the evidence which supports
      the association between psychosocial factors and genital herpes simplex virus
      recurrences (HSV), as well as to examine the biological and psychological
      treatments for disease. METHOD: Forty-five studies were reviewed from the years
      1928 to 1991. Studies were identified via computerized biographic literature
      search of Psychological Abstracts and Medline. Additional studies were located by
      inspection of key article reference sections. Studies were included in the review
      if the sample consisted of recurrent genital herpes sufferers and the design was
      either correlational or experimental. Cases studies were reviewed if they
      described HSV psychiatric treatment and provided outcome information. RESULTS:
      Psychosocial variables are important elements in the prediction, maintenance, and
      management of recurrent genital herpes. Furthermore, the effectiveness of
      psychological treatment regimes may be explained via psychoimmunological theory.
      CONCLUSIONS: Psychosocial treatment should be considered as adjunctive therapy
      for biological treatment of recurrent HSV infections. Future research should
      address primary prevention of genital herpes and other sexually transmitted
      diseases, including HIV infections.

PMID- 8360004
TI  - Guided tissue regeneration and endosseous dental implants.
AB  - This paper presents an evaluation of the use of the principles of guided tissue
      regeneration to correct the osseous defects associated with the placement of
      dental implants. The biologic rationale for the use of supplemental materials,
      such as decalcified freeze-dried bone allograft, is discussed. The results of
      this investigation suggest that the use of a physical barrier in combination with
      a bone allograft can produce successful results in 97% of the defects treated.

PMID- 8360005
TI  - Autogenous tooth transplantation: a reevaluation.
AB  - This paper discusses whether autogenous tooth transplantation can survive as an
      option in the future dental armamentaria. Clinically, successful transplants must
      show a radiolucent space between the roots and surrounding bone. There must be no
      evidence of ankylosis, no permanent root resorption, and no inflammation.
      Histologically, the criterion of success is a normal and functional periodontal
      ligament between the root surfaces of transplants and the bone or gingival
      connective tissues. Case reports are presented to illustrate replantation or
      transplantation of teeth. Possible donor teeth are those with the proper amount
      of viable periodontal ligament, single-rooted teeth, third molars, and
      malpositioned or impacted teeth. The transplantation procedure involves
      extraction of the donor tooth, measurement of the root form and amount of
      periodontal ligament, preservation of donor tooth, preparation of recipient
      socket, positioning of donor tooth, suturing, and temporary splinting.

PMID- 8360006
TI  - Gingival response to subgingival placement of monolithic tetracycline-impregnated
      fibers: microscopic observations.
AB  - This study examines and characterizes the soft tissue wall of periodontal pockets
      after a 10-day in vivo exposure to monolithic tetracycline-impregnated fibers,
      with and without root planing. Four teeth from each of eight patients were
      randomly assigned to (1) nontreatment (controls), (2) treatment by root planing
      only, (3) treatment by tetracycline fiber only, or (4) treatment by scaling and
      root planing and tetracycline fibers. Ten days after initial therapy, all teeth
      were extracted with associated soft tissue pocket walls intact. Three specimens
      were obtained from each tooth for examination by scanning microscopy, energy
      dispersive spectroscopy, and light microscopy. Results indicated that use of
      tetracycline-impregnated fibers over a 10-day period did not adversely affect the
      epithelial lining and had no significant effect on the density or character of
      the inflammatory response present in adjacent soft tissue and confirmed the
      antimicrobial effects of the fibers.

PMID- 8360007
TI  - Guided tissue regeneration without a stage 2 surgical procedure.
AB  - In the two cases described, the problems of insufficient bone and insufficient
      soft tissue in the edentulous ridge were addressed concurrently. Freeze-dried
      demineralized bone was used to fill the osseous defect. Freeze-dried fascia lata
      was used to prevent epithelial migration into the defect, act as a barrier, and
      eliminate a second surgery for membrane removal. This regeneration procedure can
      provide increased alveolar bone for better implant placement and esthetics.

PMID- 8360008
TI  - The strip gingival autograft technique.
AB  - In keeping with the concept of rapid epithelialization of close wound edges, the
      strip technique was developed to maximize the area of gingival grafting with less
      trauma to the donor site or the recipient site. An incision is made and a partial
      thickness flap is reflected so that stable periosteum is left. The apical mucosal
      border of the recipient site is sutured to the periosteum. Donor tissues are
      obtained in 2-mm-wide strips, transferred to the recipient site, and sutured. Dry
      foil and surgical packing are used to stabilize and protect the site during
      healing. The donor site is rapidly epithelialized (within 10 days) and produces
      minimal patient discomfort.

PMID- 8360009
TI  - The effect of citric acid application on periodontally involved root surfaces.
      II. An in vitro scanning electron microscopic study.
AB  - The in vitro effect of citric acid application on periodontally involved root
      surfaces was investigated using scanning electron microscopy. Teeth were selected
      following specific criteria. The specimens were prepared for observation, and the
      features of the root surface were studied. The results demonstrated that a 3
      minute application of citric acid (pH = 1.0) to the root surface after scaling
      and root planing demineralized the outer root surface, opened the dentinal
      tubules, and exposed collagen fibers. Scaling and root planing alone left the
      surface with a smear layer, scattered islands of cementum, and no collagen fibers
      or exposed dentinal tubules.

PMID- 8360010
TI  - Histogenesis of the avian retina in reaggregation culture: from dissociated cells
      to laminar neuronal networks.

PMID- 8360011
TI  - Plasticity and differentiation of retinal precursor cells.

PMID- 8360013
TI  - Growth factor-induced retinal regeneration in vivo.
AB  - It is apparent from a number of studies that the RPE has a remarkable ability to
      regenerate neural retina. While retinal regeneration from the RPE has not been
      reported in adult vertebrates, with the exception of the newt, there is evidence
      that many vertebrate species have the ability to regenerate a new neural retina
      during the early development. Studies of retinal regeneration in the chicken
      embryo have provided some insight into the requirements for this process. Recent
      investigations using copolymer implants as an intraocular delivery system for
      growth factors have demonstrated that the state of differentiation of RPE cells
      in the stage 22-24 chicken embryo can be altered in vivo by specific growth
      factors, aFGF and bFGF. These results raise the distinct possibility that
      variations in the local production of FGFs and their receptors in the eye during
      development may, in part, regulate the pathway of differentiation of RPE and
      neural retina precursors. Further research on the role of FGFs and their
      receptors in retinal development and regeneration will not only contribute to our
      understanding of how the differentiated state is achieved and maintained but may
      provide a foundation for future attempts to develop methods of treatment for
      various degenerative and proliferative diseases of the eye.

PMID- 8360012
TI  - Genetics, development, and malignancy of melanocytes.

PMID- 8360014
TI  - Cytokine production by retinal pigmented epithelial cells.

PMID- 8360015
TI  - Biological clocks in the retina: cellular mechanisms of biological timekeeping.

PMID- 8360016
TI  - Type IV collagen, laminin, and fibronectin promote the adhesion and migration of
      rabbit lens epithelial cells in vitro.
AB  - PURPOSE: To assess the ability of basement membrane and extracellular matrix
      proteins to promote rabbit lens epithelial cell adhesion and migration, which may
      play a role in the development of secondary cataract. METHODS: Rabbit lens
      epithelial cells were isolated and grown in tissue culture for use in
      standardized assays to study adhesion and migration of rabbit lens epithelial
      cells in response to type IV collagen, laminin, fibronectin, and ovalbumin.
      RESULTS: Under these conditions, the adhesion of rabbit lens epithelial cells to
      surfaces coated with varying concentrations of type IV collagen, laminin, and
      fibronectin was shown to be dependent on concentration. Rabbit lens epithelial
      cells did not adhere to ovalbumin-coated surfaces at any concentration tested.
      Type IV collagen promotes maximal in vitro adhesion of rabbit lens epithelial
      cells at lower coating concentrations in comparison to laminin and fibronectin.
      In cell migration experiments, fibronectin promoted maximal migration at lower
      concentrations in comparison with laminin and type IV collagen. This was shown
      both in haptotaxis experiments (the migration of cells to surfaces coated with
      protein) and in chemotaxis experiments (the migration of cells to attractants in
      solution). Lens epithelial cells did not migrate in response to ovalbumin under
      the conditions of this study. CONCLUSION: The results of these studies indicate
      that adhesion and migration of lens epithelial cells occurs in response to the
      lens capsule proteins type IV collagen and laminin and in response to
      fibronectin, a protein found in the lens during embryologic development. Because
      fibronectin plays a role in the embryologic development of the lens but is not
      normally present in the adult lens, the possible introduction of fibronectin into
      the eye after surgery may play a critical role in the posterior migration of lens
      epithelial cells and the development of posterior capsular opacification or
      secondary cataract.

PMID- 8360017
TI  - Calcium regulation in tissue-cultured human and bovine lens epithelial cells.
AB  - PURPOSE: To study calcium regulatory mechanisms in lens cells with particular
      reference to the relative contributions from the calcium adenosine triphosphatase
      of plasma and endoplasmic reticulum membranes, respectively. METHODS: The calcium
      sensitive fluorescent dye, Fura 2, was incorporated into tissue-cultured human
      and bovine epithelial cells and internal calcium was calibrated using the
      ionomycin (1 microM) method. The dynamics of calcium release from the endoplasmic
      reticulum were also studied in digitonin-permeabilized bovine cells. RESULTS:
      Tissue-cultured bovine and human lens cells have very similar resting calcium
      levels (235 +/- 22 nM and 216 +/- 12 nM, respectively). Thapsigargin caused an
      increase in cytoplasmic calcium both in the presence and absence of external
      calcium, but the calmodulin antagonist W7 only initiated an increase in the
      presence of external Ca2+. The effects of thapsigargin and W7 were additive.
      Exposing lens cells to Na(+)-free perfusing solutions caused a transient increase
      in internal Ca2+. Bovine lens cells permeabilized by digitonin-released Ca2+ when
      exposed to inositol (1,4,5) triphosphate and the effect was maximal at 1 microM.
      CONCLUSIONS: Lens cytoplasmic calcium is controlled by calcium adenosine
      triphosphatases at the plasma and endoplasmic reticulum membranes. The former is
      inhibited by W7 and insensitive to thapsigargin whereas the latter is inhibited
      by thapsigargin, but insensitive to W7. The lens endoplasmic reticulum store is
      also controlled by an inositol (1,4,5) trisphosphate calcium-release mechanism.
      Na+/Ca2+ exchange plays a relatively minor role in calcium regulation, at least
      at resting calcium levels.

PMID- 8360018
TI  - Enzyme activities in human lens epithelium of age-related cataract.
AB  - PURPOSE: To investigate associations between enzyme activity of glutathione
      reductase (GR) with and without added flavin adenine dinucleotide (FAD),
      glutathione peroxidase (GPX), and 6-phosphogluconic dehydrogenase (6PGDH) in the
      lens epithelium collected at surgery, and some nutritional and biochemical
      variables determined in the same individuals during the Italian-American Case
      Control Study of age-related cataract. METHODS: One hundred eighty-three
      epithelium capsule samples were collected from 174 patients undergoing surgery.
      Data on enzyme activity were obtained from 52 samples for 6-PGDH and from 53
      samples for GR and for GPX. The Lens Opacity Classification System II was used to
      classify and grade cataracts. RESULTS: No correlation was found between enzyme
      activity in lens epithelium and the same enzymatic activity in erythrocytes (with
      the exception of a negative correlation between lens and erythrocyte 6PGDH
      activity), or the type and severity of cataract. No correlation was found between
      lens GPX activity and plasma selenium and between lens GR activation coefficient
      (GRAC) and riboflavin intake. Lens GR with added FAD and lens GRAC were
      significantly correlated to plasma vitamin E level. Lens GRAC was positively
      correlated to a nutritional vitamin index. CONCLUSIONS: Present data stress the
      difficulty in verifying the assumption that biochemical indices collected on
      plasma and on erythrocyte actually reflect the status of these factors in the
      lens itself.

PMID- 8360019
TI  - Effects of oxygen and carbon dioxide on human retinal circulation.
AB  - PURPOSE: Carbogen, a gas mixture of 95% O2 and 5% CO2, is given to patients with
      retinal artery obstruction in an attempt to improve retinal oxygenation. The
      purpose of this study was to compare the effects of carbogen and 100% O2
      breathing on retinal blood flow. METHODS: On two separate occasions, 12 normal,
      healthy volunteers breathed air and then either 100% O2 or carbogen while laser
      Doppler velocimetry measurements and monochromatic fundus photographs were taken.
      Retinal vessel diameter, maximum velocity of red blood cells, and volumetric
      blood flow rate were determined in a main temporal vein. RESULTS: Both 100% O2
      and carbogen caused significant average reductions in vessel diameter (14.1% and
      10.6%, respectively), maximum red blood cell velocity (42.1% and 27.3%,
      respectively), and blood flow (56.4% and 42.2%, respectively). The average
      vasoconstriction of the large retinal veins caused by carbogen was not
      significantly smaller than that caused by 100% O2. The average reductions in
      maximum red blood cell velocity and blood flow caused by carbogen were
      significantly smaller than those caused by 100% O2 (P < .001 and P < .01,
      respectively). CONCLUSIONS: In normal subjects, inhalation of carbogen leads to
      less reduction in blood flow than inhalation of 100% O2, presumably by reducing
      the vasoconstriction of small arterioles induced by elevated oxygen levels.

PMID- 8360020
TI  - An elevated hematogenous photosensitizer in the preterm neonate.
AB  - PURPOSE: Human blood contains low levels of protoporphyrin IX (PP IX), a
      photoactive compound that produces reactive oxygen species when exposed to light.
      It has been proposed that photoactivation of PP IX and subsequent generation of
      potentially tissue-damaging reactive oxygen may be a mechanism of retinal injury
      in retinopathy of prematurity (ROP). The purpose of this study is to determine an
      association between blood PP IX level and infant birth-weight and gestational
      age. METHODS: Erythrocyte PP IX levels were measured from the umbilical cord
      blood of 31 neonates, both full term and preterm. Birthweights and gestational
      ages were recorded. RESULTS: PP IX levels in infants weighing < 1000 grams (n =
      7) average 200 micrograms/dl, which is significantly higher than PP IX levels in
      infants weighing > 1000 grams (125 micrograms/dl, n = 24; P < 0.02). CONCLUSION:
      Elevated PP IX levels may place preterm neonates at increased risk for
      photosensitizing retinal injury.

PMID- 8360021
TI  - Retinal vessel circulation patterns visualized from a sequence of computer
      aligned angiograms.
AB  - PURPOSE: To present a computer method that can be used to combine the images from
      a sequence of fluorescein angiograms of the retinal microcirculation so that a
      composite image can be generated and a color image illustrating circulation at
      all points in the vascular network can be computed. This should enable more
      accurate comparison of retinal vascular occlusions that occur during
      cardiopulmonary bypass surgery. METHODS: Photographic negatives of the macular
      region from two angiographic sequences, one taken before surgery and the other
      taken just before the end of bypass, were digitized, background shade corrected,
      and registered. Composite images were generated as minimum projection images and
      the filling images generated from parameters of a smooth curve fit to the filling
      data at every point. RESULTS: The composite images showed a filling pattern that
      more accurately reflected the maximum fluorescence at every point than any single
      image. The images generated from the filling data provide a new way to visualize
      and quantify changes in the retinal circulation. CONCLUSIONS: The technique
      demonstrates that problems arising from selection of a single frame from a
      filling sequence can be overcome by combining images. The technique used to
      generate the color-coded filling image should prove useful for any image sequence
      in which differential filling is of interest.

PMID- 8360022
TI  - Immunologic cross-reactivity in the pathogenesis of ocular onchocerciasis.
AB  - PURPOSE: Onchocerca volvulus, a filarial worm, is a major cause of infectious
      blindness and inflammatory eye disease. An autoimmune cause for ocular
      onchocerciasis has been suggested since the identification of a recombinant
      antigen of O. volvulus that shows immunologic cross-reactivity with a host ocular
      component of 44,000 M(r). The aim of this study was to establish the distribution
      of the cross-reactive antigens in both host tissues and the parasite, and to
      determine if significant autoantibody responses to the host antigen could be
      detected in infected persons. METHODS: The tissue and organ distribution of the
      44,000 M(r) antigen was determined by immunocytochemistry and Western blot
      analysis. Human autoantibody responses to the ocular antigen were demonstrated by
      Western blot analysis using sera collected from persons with onchocerciasis, with
      and without posterior segment pathology, Bancroftian filariasis, and Europeans
      with no filarial infection. RESULTS: The tissue distribution of the 44,000 M(r)
      antigen correlates with the sites of pathology in onchocerciasis and antibody
      reactivity against this antigen could be detected in all persons with
      onchocerciasis and posterior segment pathology. The antigen is also recognized by
      sera from persons with Bancroftian filariasis, but not from normal persons.
      CONCLUSIONS: A role is proposed for immunologic cross-reactivity in the
      pathogenesis of onchocerciasis and it is suggested that intraocular presentation
      of the cross-reactive parasite antigen by microfilariae is essential for the
      development of disease.

PMID- 8360023
TI  - The paradoxical effect of tumor necrosis factor alpha (TNF-alpha) in endotoxin
      induced uveitis.
AB  - PURPOSE: To investigate the role of TNF-alpha in endotoxin-induced uveitis (EIU)
      in mice. METHODS: To neutralize TNF-alpha activity, mice were pretreated with
      either repeated injections of this cytokine or a single injection of antibody
      against it. The mice were then injected intraperitoneally with 500 micrograms
      endotoxin, to induce lethal septic shock, or into the footpad with 200 micrograms
      to induce EIU. RESULTS: Although both pretreatments conferred protection against
      the systemic toxic effects of LPS, TNF-resistant mice and mice treated with anti
      TNF-alpha antibody demonstrated an exacerbation of EIU when compared to control
      animals. CONCLUSIONS: Unlike its apparent participation in the systemic effect of
      endotoxin, TNF-alpha is not directly involved in the pathogenesis of EIU and may
      even protect against the inflammatory processes of this disease.

PMID- 8360024
TI  - Rods and cones contain antigenically distinctive S-antigens.
AB  - PURPOSE: S-antigen (48 kDa protein or arrestin) is known to be present in rod
      photoreceptors. Its localization in cones is less clear with several conflicting
      reports among various species examined. METHODS: This study employed three
      different anti-S-antigen antibodies (a48K, a polyclonal antiserum and two
      monoclonal antibodies, MAb A9-C6 and MAb 5c6.47) and examined their localization
      in rods and cones of human and cat retinas. To identify the respective cone
      types, an enzyme histochemical technique for carbonic anhydrase (CA) was employed
      to distinguish blue cones (CA-negative) from red or green cones (CA-positive). S
      antigen localization was then examined by immunocytochemical staining of adjacent
      sections. RESULTS: In human retinas, a similar labeling pattern was seen with
      both a48K and MAb A9-C6, i.e., the rods and blue-sensitive cones were strongly
      positive, whereas the red- or green-sensitive cones showed little
      immunoreactivity. All human photoreceptors showed reactivity to MAb 5c6.47. In
      the cat retina, only CA-positive cones could be found. As in the human retina,
      both rods and cones of the cat were positive for MAb 5c6.47. A difference from
      the labeling pattern in human retina was noted for the other S-antigen
      antibodies; a48K labeled rods and all of the cones, whereas MAb A9-C6 reacted
      strongly with the rods but showed no cone staining. CONCLUSIONS: These results
      suggest that both rods and cones contain S-antigen but that they are
      antigenically distinctive.

PMID- 8360025
TI  - Anterior chamber-associated immune deviation elicited via primate eyes.
AB  - PURPOSE: To determine whether injection of a soluble antigen, ovalbumin (OVA),
      into the anterior chamber of cynomolgus monkey eyes would impair the ability of
      these animals to subsequently develop delayed hypersensitivity when confronted by
      this antigen in immunogenic form. METHODS: OVA or phosphate-buffered saline was
      injected into the anterior chamber of adult cynomolgus monkeys that were
      subsequently immunized with OVA in adjuvant and then skin challenged for delayed
      hypersensitivity with OVA. RESULTS: Recipients of intracameral OVA proved unable
      to acquire antigen-specific delayed hypersensitivity when they received an
      immunogenic regimen of OVA in adjuvant. Since the flow of aqueous humor through
      the uveoscleral pathway of primate eyes can be promoted by topical treatment with
      PGF2 alpha isopropylester, a preliminary experiment is described in which
      induction of anterior chamber-associated immune deviation by OVA was prevented
      when the antigen was first introduced into monkey eyes treated with PGF2 alpha
      isopropylester. CONCLUSIONS: Monkeys resemble rodents in displaying anterior
      chamber associated immune deviation (impaired ability to acquire antigen-specific
      delayed hypersensitivity) when they first encounter an antigen via the anterior
      chamber. The findings suggest that the cellular and molecular mechanisms of
      immune privilege, recently described in rodents, may apply to immune responses to
      intraocular antigens and pathogens in primates, including humans. Primate eyes
      offer an opportunity to explore the mechanisms of anterior chamber-associated
      immune deviation using pharmacologic agents that modify the aqueous outflow
      tracts.

PMID- 8360026
TI  - Quantitative analysis of iris translucency in Fuchs' heterochromic cyclitis.
AB  - PURPOSE: To measure intraocular stray light and to quantify translucency of the
      iris and the surrounding ocular wall in both eyes of patients with Fuchs'
      heterochromic cyclitis; to investigate whether differences in paired eyes could
      be measured in patients without heterochromia or with a minimal degree of iris
      atrophy. METHODS: Intraocular stray light was measured by means of the direct
      compensation technique. A modification of this technique was used to quantify
      translucency of the iris and the surrounding ocular wall. RESULTS: Intraocular
      stray light proved to be significantly higher in all patients with Fuchs'
      heterochromic cyclitis (both eyes) than in normal control subjects. Translucency
      of the iris and the ocular wall around it were increased in the patients with
      Fuchs' heterochromic cyclitis, including patients without heterochromia or with a
      minimal degree of iris atrophy. CONCLUSIONS: Quantitative analysis of
      translucency was used to determine iris depigmentation in vivo in patients with
      Fuchs' heterochromic cyclitis. This technique showed that the process of atrophy
      and depigmentation in patients with Fuchs' heterochromic cyclitis is probably not
      restricted to the iris, but also occurs in the surrounding ocular wall. More
      studies, including other uveitis groups, are necessary to investigate if this
      technique can be used as a diagnostic tool in Fuchs' heterochromic cyclitis.

PMID- 8360027
TI  - Nuclear muscarinic acetylcholine receptors in corneal cells from rabbit.
AB  - PURPOSE: Previous studies have indicated that muscarinic acetylcholine receptors
      (mAChR) may be present in an unexpected, unique location and play a singular role
      in cellular growth regulation of rabbit corneal epithelium that may be of general
      physiologic significance if found in other cells. The purpose of this study was
      to examine rabbit corneas and corneal cells in culture to determine mAChR
      location and tissue distribution. METHODS: Using [3H]-propylbenzilylcholine
      mustard ([3H]PrBChM), which binds covalently to the active site of mAChR, rabbit
      corneal cross-sections, cultured corneal keratocytes, epithelial and endothelial
      cells, as well as nuclei isolated from these cultured corneal cells were labeled,
      stained, and autoradiographed. Nuclei labeled with [3H]PrBChM were further
      analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. RESULTS:
      Direct visual confirmation of the localization of mAChRs was obtained. MAChR were
      found in epithelial and endothelial layers of fresh-frozen corneal cross
      sections, in cultured rabbit epithelial and endothelial cells, and on isolated
      rabbit epithelial and endothelial cell nuclei. mAChR were not detectable in
      keratocytes with these techniques. When [3H]PrBChM-labeled nuclei from cultured
      corneal cells were analyzed by sodium dodecyl sulfate polyacrylamide gel
      electrophoresis, epithelial and endothelial samples showed specific mAChR
      binding, whereas binding to keratocyte nuclei was not detectable. CONCLUSIONS: As
      a result of these findings, a revised hypothesis is suggested for the locations
      and possible functions of mAChR in regulation of growth in corneal and other
      cells.

PMID- 8360028
TI  - Interlamellar cohesive strength in the vertical meridian of human eye bank
      corneas.
AB  - PURPOSE: Previously, human corneal stromal interlamellar cohesive strength in the
      horizontal meridian was shown to be twice as strong peripherally as centrally
      (approximately 2.90 x 10(-1) versus 1.40 x 10(-1) N/mm). In the current study,
      stromal samples excised from the vertical meridian were studied to determine if
      meridional differences also exist. Precise knowledge about corneal stromal
      structure is warranted, because anisotropy can influence postoperative healing
      strength and corneal shape. METHODS: Limbus-to-limbus stromal strips with a
      constant 2.2-mm width were obtained from the vertical meridians of 52 eyebank
      corneas (8 single, 22 pairs). Cohesive strength was recorded as samples were
      split at a constant 1.6 mm/s at 50% stromal depth. RESULTS: The mean cohesive
      strength in the inferior periphery was found to be only two thirds the strength
      observed in the nasal or temporal periphery (1.96 x 10(-1) N/mm versus
      approximately 2.94 x 10(-1) N/mm @ 5 mm). The mean cohesive strength in the
      inferior periphery was also significantly less than the strength of the superior
      periphery (1.85 x 10(-1) N/mm +/- 8.83 x 10(-3) SEM versus 2.34 x 10(-1) +/- 1.37
      x 10(-2) @ 4 mm from the central cornea; P = 0.0027). Unlike the samples from the
      horizontal meridian, which could be described by a profile symmetric about the
      central cornea, force profiles for the vertical data could be characterized with
      distinct, classifiable patterns that were generally asymmetric. Fellow corneas
      from a single donor tended to have strength profiles belonging to the same class
      (P = 0.035; chi-square), although some paired eyes exhibited profiles from
      distinctly different classes. CONCLUSIONS: These data strongly support the
      concept of an anisotropic collagen macrostructure that is more complex than
      previously believed. This inherent structural anisotropy may become a significant
      determinant of corneal shape during ectatic disease and some forms of
      keratorefractive surgery.

PMID- 8360029
TI  - Egocenter location in children with strabismus: in the median plane and unchanged
      by surgery.
AB  - PURPOSE: Previous studies have shown that there are spatial localization shifts
      after horizontal strabismus surgery when a patient performs an open-loop pointing
      task. After monocular enucleation, an adult will also show a shift in the
      pointing response. Other studies have shown that in children who underwent
      enucleation, the egocenter location shifts toward the remaining eye. Is the
      pointing shift after surgery in children with strabismus the result of a shift in
      egocenter location? METHODS: Using a modified Roelofs' method for measuring the
      egocenter, eight children were tested before and after horizontal strabismus
      surgery to see if there were any shifts in egocenter location. One control group
      consisted of six children undergoing surgery for correction of vertical
      strabismus in which the horizontal muscles would be unaltered. RESULTS:
      Presurgery measurements of egocenter location in the people with strabismus were
      the same as those found in the other control group of 12 normal children.
      Postsurgical measurements of eye position showed horizontal rotations of 14.5
      degrees for the horizontal group and 2.4 degrees for the vertical group.
      Egocenter measurements showed no postoperative shift for either strabismus group.
      CONCLUSIONS: Thus, the pointing shift seen in the previous studies is not from a
      shifting egocenter location but from a change in the registered position of the
      eye in the orbit.

PMID- 8360030
TI  - Objective concurrent measures of open-loop accommodation and vergence under
      photopic conditions.
AB  - PURPOSE: To investigate the relationship between photopic open-loop accommodation
      and vergence and the effect of mental effort on these positions. METHODS: Twenty
      subjects (11 men and 9 women) viewed monocularly a photopic (25 cdm-2), high
      contrast (90%) Maltese cross-target for 3 minutes, through a 0.5-mm pinhole
      drilled into an infrared filter. Accommodation was measured objectively at 1
      second intervals using a Canon Autoref R-1 infrared optometer, and vergence was
      recorded continuously and objectively using a differential infrared eye tracking
      system. RESULTS: Under passive viewing conditions there was a significant
      correlation between photopic open-loop accommodation and vergence (R = 0.671, P =
      0.0012); for the majority of subjects the imposition of mental effort shifted the
      passive levels of both open-loop accommodation and vergence, but these shifts
      were unsystematic and uncorrelated (R = 0.259, P = 0.270). The active open-loop
      positions of accommodation and vergence were also found to be correlated (R =
      0.692, P = 0.0007). CONCLUSIONS: The influence of proximal stimuli can explain
      the correlations identified between photopic open-loop positions of accommodation
      and vergence. The uncorrelated responses of the accommodation and vergence
      systems to mental effort are likely to reflect interactions between various
      spatiotopic stimuli including mental effort and perceived proximity.

PMID- 8360031
TI  - Visual stabilization of posture in retinitis pigmentosa and in artificially
      restricted visual fields.
AB  - PURPOSE: To investigate the relationship between retinitis pigmentosa (RP)
      progression and the visual contribution to posture stabilization; to examine the
      extent to which visual-field diameter affects the visual contribution to posture
      stabilization. METHODS: Posture information was recorded in 35 subjects with well
      characterized RP and in 20 subjects with normal vision. Data were collected as
      each subject stood in a dark environment and as each subject viewed a stationary
      visual display. In both conditions, somatosensory feedback was concurrently
      altered. Data were also collected on 10 additional subjects with normal vision
      wearing field-restricting goggles (visual-field diameters ranged from 26.5 down
      to 6 degrees). RESULTS: RP progression is accompanied by a steady decrease of the
      visual stabilization of posture, from normal values at the onset of the disease
      to the absence of visual stabilization and, eventually, to visual destabilization
      of posture. Decreasing visual field diameter in the subject with normal vision
      resulted in a linear decrease of the visual stabilization of posture. However,
      subjects with RP with comparable visual-field loss showed significantly lower
      visual stabilization than normal subjects with artificially restricted fields.
      Moreover, subjects with normal vision with restricted visual fields as small as 6
      degrees failed to show visual destabilization of posture. CONCLUSIONS: Most
      likely, the additional reduction in the visual stabilization of posture shown in
      subjects with RP, as well as the visual destabilizing effect manifest in the late
      stages of RP, is caused by anomalous processing of visual information in the
      remaining visual field.

PMID- 8360032
TI  - Mechanisms mediating visual detection in static perimetry.
AB  - PURPOSE: The usual stimuli in static perimetry are white-light luminance
      increments. However, the specific visual detection mechanisms involved in
      perimetry are unknown because all classes of neural mechanisms are sensitive to
      spectrally broadband stimuli. The objective of this study was to determine the
      relative sensitivities of nonopponent and opponent detecting mechanisms under
      standard perimetry test conditions. METHODS: Using trained rhesus monkey
      subjects, the relative sensitivities of the vision mechanisms for the detection
      of perimetry test stimuli were determined through psychophysical measurements of
      spectral sensitivity at each of the test field locations of the C24-2 threshold
      program on the Humphrey Field Analyzer (Allergan Humphrey, San Leandro, CA). The
      spectral sensitivity functions were analyzed by a three-channel model that
      incorporated independent short-wavelength-sensitive, nonopponent (luminance), and
      opponent (chromatic) spectral sensitivity mechanisms. RESULTS: The visual
      detection mechanisms for perimetry thresholds varied as a function of the size
      and wavelength of the test field. With the perimeter's standard stimulus
      (Goldmann Size III) and bowl illumination (31.5 asb), the presence of a short
      wavelength-sensitive mechanism was clearly evident at all field locations, but
      its relative sensitivity systematically declined with eccentricity. Under these
      conditions, the sensitivities of the opponent and nonopponent mechanisms were
      approximately equal at most field locations. With a larger stimulus (Goldmann
      Size V), however, the contribution of the opponent spectral sensitivity mechanism
      was more apparent over most of the central field and the alterations of
      sensitivity with eccentricity were less pronounced. In contrast, a small test
      field (Goldmann Size II) appeared to bias detection toward nonopponent
      mechanisms. CONCLUSION: The results of these investigations indicate that
      detection thresholds during perimetry can be effectively biased toward different
      photopic, visual processing channels through the appropriate selection of size
      and wavelength of the test stimulus.

PMID- 8360033
TI  - Migraine headache and its association with open-angle glaucoma: the Beaver Dam
      Eye Study.
AB  - PURPOSE: To investigate the relationship of a history of migraine headache to
      open-angle glaucoma. METHODS: In an epidemiologic study of age-related eye
      disease, subjects were asked if they had migraine headaches. The diagnosis of
      glaucoma was based on visual field, intraocular pressure, cup/disc ratio, and
      history. RESULTS: Those younger than 65 years were significantly more likely to
      report a history of migraine (P = 0.001) as were women (P < 0.001). There was no
      difference in the frequency of open-angle glaucoma between those with and those
      without migraine headache (P = 0.87). Multivariate analyses did not alter the
      conclusion. CONCLUSION: In this population-based study there is no evidence of a
      relationship between open-angle glaucoma and migraine headache.

PMID- 8360034
TI  - Chronic desquamative gingivitis.

PMID- 8360035
TI  - Advertising for professional services: what the rules say.

PMID- 8360036
TI  - Management of respiratory infections in the elderly.

PMID- 8360037
TI  - Medical management of ulcerative colitis.

PMID- 8360038
TI  - The management of gastric ulcers in general practice.

PMID- 8360039
TI  - Ankylosing spondylitis. A comparison of clinical and radiographic features in men
      and women.
AB  - The clinical and radiographic features of 83 patients with a diagnosis of
      Ankylosing Spondylitis conforming to Rome criteria were reviewed. There was 64
      males and 19 females attending for a mean duration of 13 and 11 years. Females
      presented with more peripheral arthritis (X2 = 3.15464, DF = 1, P < .05 (one
      sided) and more asymptomatic sacroiliitis (X2 = 6.70172; DF = 1, P < .01 (two
      sided)). Spinal involvement occurred with a similar frequency in men and women,
      no increase in cervical spine involvement in women was identified. Four males and
      one female of 83 patients, developed radiographically proven spinal fusion. One
      male patient developed upper lobe pulmonary fibrosis, one male patient developed
      the cauda equina syndrome, one male patient required a total hip replacement. No
      statistically significant difference in the rate of complications in men and
      women was identified.

PMID- 8360040
TI  - Hospital initiated prescribing in the General Medical Services scheme.
AB  - Twenty-seven general practitioners associated with the Department of Community
      Health and General Practice, TCD, agreed to record details of the drugs
      prescribed on 30 consecutive GMS prescriptions. Doctors were asked to indicate
      whether the items they were prescribing were initiated by themselves or by a
      hospital doctor and whether they agreed with the latter items in terms of their
      clinical appropriateness and cost. Information on 1,471 prescribed items was
      obtained from a total of 754 prescriptions. General practitioners initiated 63%
      of these items, hospital doctors 35% and in 2% the person responsible was
      unknown. Hospital initiated items accounted for 44.5% of total ingredient costs
      compared with 54% in general practice. General practitioners agreed with most of
      the hospital initiated items in terms of their clinical appropriateness and cost.
      Given the extent of hospital initiated GMS prescribing in this study there is a
      clear need to differentiate between those items originating in hospital and those
      in general practice for accountability purposes.

PMID- 8360041
TI  - Alcohol use in post-primary school children.
AB  - The prevalence of alcohol use of Irish post-primary schoolchildren has been
      reported on numerous occasions over the past five years. A study of drinking
      patterns in 294 schoolchildren aged 14 to 17 from single sex and mixed sex
      schools is presented. The age at first drink for boys was 11.7 years, and for
      girls 12.3 years. Eighty percent of boys had ever drank compared to 66% of girls.
      59% of boys were regular drinkers compared to 54% of girls. Both these parameters
      were equal for boys from single sex and mixed schools but girls from mixed sex
      schools had a higher prevalence of drinking than girls from single sex schools.
      Beer was by far the favourite drink of boys whereas wine was the favourite drink
      of girls. Girls were more likely to drink at home than boys. The results of the
      present study will be compared with other recent prevalence studies of teenage
      alcohol use in Ireland. Many findings are similar but the separate analysis of
      single and mixed sex schools is new.

PMID- 8360042
TI  - Sexual behaviour and knowledge of normal children as perceived by their parents.
AB  - This study set out to examine sexual behaviour and knowledge of normal children
      as perceived by their parents. The study was carried out in two settings; a)
      general practice and b) an acute paediatric admission ward. Families where there
      was a history or suspicion of child abuse or neglect were excluded. The parents
      (62 mothers and 22 fathers) of 84 children aged three to twelve years, from a
      variety of social backgrounds, were interviewed. The majority of parents saw
      mothers as the main and most important source of information on sexual matters
      for their children. Parents believed that their children were able to talk freely
      to them about sexual matters, and most had discussed general information about
      reproductive matters without going into detail with their children. Parents
      perceived their children as having little interest in the genitalia of others,
      except during nappy changing or bathing of preschool siblings. Few parents were
      aware that their children masturbated although many mentioned "nervous fiddling"
      with genitals by male children. More explicit sexual behaviour among children,
      such as simulated intercourse, were distinctly unusual. The parents of 14% of
      boys and 44% of girls were unaware of what word (correct or slang) their child
      used to describe their own genitalia. The results of this study suggest that
      explicit sexual activities or preoccupations that come to adult attention are
      distinctly unusual in normal children. While parents can talk in a general way
      with their children about reproductive matters, specific details about sexual
      behaviour tend not to be discussed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360043
TI  - Prevalence of asthma in Galway city school children.
AB  - To determine the prevalence of asthma in the past 12 months in nine year old
      Galway school children, a questionnaire on respiratory symptoms was distributed
      to children for completion by parents and returned to the school. We issued 896
      questionnaires and 832 (426 boys and 406 girls) were returned completed. The
      overall response was 93%. The prevalence of wheeze in the past 12 months was
      16.1%. A history of wheeze was more common in boys than in Girls. (19.7% Vs
      12.3%). Overall, 67% of those reporting wheeze also reported a history of
      diagnosed asthma and 74% had used a bronchodilator. 60% reported a history of
      exercise induced wheezing and 67% had nocturnal cough. 28% were taking
      prophylactic medication. The current prevalence of asthma in Galway city school
      children is high. There is an increased willingness to diagnose and treat asthma
      in this community.

PMID- 8360044
TI  - Prevalence of hepatitis A IgG in Irish international travellers.
AB  - The authors have studied the sero-conversion levels of Irish international
      travellers over the past 6 years with regard to Hepatitis A IgG levels. The rate
      of sero-conversion is significantly associated with patient age (x2 = 77.8, df =
      1, p < 0.0001). There was no significant difference in the antibody levels
      between males and females. The results show that a large proportion of younger
      people travelling to developing countries are unprotected against Hepatitis A.
      Also approximately 30% of travellers over the age of 40 years have not
      seroconverted from previous exposure and therefore remain at risk. The mortality
      associated with Hepatitis A is in high risk groups. Therefore vaccination should
      be considered.

PMID- 8360045
TI  - Invasive group A streptococcal infections of children.

PMID- 8360046
TI  - Plantar responses in infancy.

PMID- 8360047
TI  - Carcinoma of the tonsillar region: a multivariate analysis of 243 patients
      treated with radical radiotherapy.
AB  - Between October 1964 and June 1990, 243 patients with squamous cell carcinoma of
      the tonsillar region were treated with continuous-course radical radiotherapy at
      the University of Florida. All patients had a minimum 2-year follow-up. Patients
      were staged according to the AJCC system; stage IV was stratified into two
      subsets: favorable, IVA (T1-T3 or N2A-N3A); and unfavorable, IVB (T4 or N3B). The
      initial and ultimate local control rates (including surgical salvage) according
      to T stage were as follows: T1, 87% and 100%, T2, 79% and 92%; T3, 71% and 76%;
      and T4, 44% and 48%. Multivariate analysis demonstrated that anterior extension
      of the primary tumor (p = .0001) and T stage (p = .014) were the most significant
      parameters affecting local control after radiotherapy. For T4 lesions, twice
      daily irradiation significantly improved local control (p = .04). The 5-year
      absolute and cause-specific survival rates as a function of modified AJCC stage
      were as follows: I, 37% and 100%; II, 55% and 90%; III, 55% and 85%; IVA, 35% and
      60%; and IVB, 23% and 38%. The probability of a severe complication was 3% for
      the entire group of patients.

PMID- 8360048
TI  - Cartilage-shaving procedure for the control of tracheal cartilage invasion by
      thyroid carcinoma.
AB  - This study was carried out to ascertain whether the cartilage-shaving procedure
      is appropriate to control thyroid carcinoma with tracheal cartilage invasion. Of
      432 thyroid carcinoma patients treated between 1979 and 1988, 16 had tracheal
      cartilage invasion only. This patient population was made up of 3 men and 13
      women, with a mean age of 55.8 years. Fourteen were diagnosed histologically as
      having papillary carcinoma and the remaining two as having follicular carcinoma.
      Cartilage shaving was the primary treatment in all the patients, and subsequent
      radioactive iodine (131I) or external-beam radiotherapy was administered to
      control any possible residual disease. Lifelong thyroid hormone replacement was
      instituted in all patients, and the follow-up period averaged 70.7 months. Only
      four of the 16 patients remained disease free; the disease was not controlled in
      the other 12, and seven of this latter group eventually died of their disease. We
      feel that a more extensive resection procedure than cartilage shaving should be
      considered, even in patients with superficial tracheal invasion, to increase the
      disease-free survival rate.

PMID- 8360049
TI  - Salvage surgery of cervical recurrences after neck dissection or radiotherapy.
AB  - A series of 113 patients operated on in the period 1980-1989 for a neck
      recurrence from a head and neck cancer was studied. All patients had no other
      evidence of disease. The male/female ratio was 93/20, and the median age was 58
      years (range 28-87). Previous treatment consisted of surgery (SG) +/-
      radiotherapy (RT) in 81 patients (SG group) and only RT in 32 (RT group): 59
      cases presented a relapse in the treated neck and 54 in the contralateral side.
      All but one contralateral recurrences were in the SG group. Ten patients were
      lost to follow-up. The observed 5-year survival rate of the whole series was
      29.2% (95% confidence interval, 0%-38%). Considering patients with ipsilateral
      recurrences, the 5-year disease-free survival rate was 38.7% (95% c.i., 28.7%
      48.7%) and 27% (95% c.i., 18%-36%) for the SG and the RT group, respectively. The
      5-year disease-free survival rate after SG for contralateral recurrences was
      38.8% (95% c.i., 23.8%-53.8%). Dimension and mobility of the neck nodes were the
      only demonstrable prognostic factors.

PMID- 8360051
TI  - Base of tongue carcinoma: patterns of failure and predictors of recurrence after
      surgery alone.
AB  - Between January 1971 and December 1986, 55 patients with squamous cell carcinoma
      of the tongue base underwent complete surgical resection with curative intent. No
      preoperative or postoperative adjuvant therapy was administered. The study group
      consisted of 41 men and 14 women (median age 61 years). All patients were
      followed until death (39 patients) or for a median of 9.4 years. Local control at
      5 years was 74%. No predictors of local recurrence were discovered. Control in
      the dissected neck at 5 years was 68%. Control of cancer above the clavicles at 5
      years was 48%. Distant metastases developed in 14% of the patients by 5 years.
      Cause-specific survival at 5 years was 65%. A Cox multivariate regression
      analysis revealed that pathologic N stage was the only significant independent
      predictor of recurrence in the dissected neck, recurrence above the clavicles,
      and cause-specific survival. The 5-year overall survival was 55%. Surgical
      mortality was 4%.

PMID- 8360050
TI  - Pretreatment neck node biopsy, distant metastases, and survival in nasopharyngeal
      carcinoma.
AB  - Pretreatment neck node biopsy had been performed on 50 of 422 patients who had
      cervical node metastases from nasopharyngeal carcinoma when initially seen.
      Multivariate analysis using the Cox proportional hazards model shows that
      pretreatment node biopsy is not a significant determinant of distant metastases,
      survival, or recurrence in the neck. Results of similar studies are reviewed and
      the role of pretreatment node biopsy in nasopharyngeal carcinoma discussed.

PMID- 8360052
TI  - Treatment of stage I and II oral tongue cancer.
AB  - We reviewed 156 previously untreated patients with squamous cell carcinoma of the
      oral tongue staged T1 and T2 to determine the incidence of nodal metastasis, and
      if elective neck dissection affected local/regional control or survival. Patients
      were divided into two nonrandomized groups: group 1, intraoral glossectomy only
      (102 patients); and group 2, intraoral glossectomy plus neck dissection (54
      patients). Analysis revealed no significant differences for tumor location,
      histologic differentiation, status of margins, or clinical appearance; however,
      perineural invasion significantly adversely affected survival and local/regional
      control. In group 1 patients, 16.5% subsequently developed cervical metastasis,
      and 20.4% of patients in group 2 had occult nodal disease. The survival and
      local/regional control for group 1 patients subsequently developing nodes was 33%
      and 50%, respectively. The survival and local/regional control for group 2
      patients with occult metastasis was 55% and 91%, respectively. We believe
      elective neck dissection is indicated for early staged oral tongue cancer.

PMID- 8360053
TI  - Carcinomas of the lacrimal drainage system.
AB  - Primary carcinomas of the lacrimal drainage system are rare. These malignant
      neoplasms typically present as noncompressible, nontender masses with low-grade
      dacyrocystitis and/or unilateral epiphora. Lymph node metastasis may occur late
      in the disease course. Complete surgical resection is the best treatment choice;
      extensive procedures such as orbital exenteration and maxillectomy may be
      necessary for complete tumor extirpation. Further adjunctive radiotherapy may
      improve local control. We present two cases of carcinoma of the lacrimal drainage
      system, including one locally controlled tumor with apparent lymph node
      metastasis that occurred 21 years after primary treatment. A review of the
      histopathology and literature concerning carcinomas of the lacrimal drainage
      system is presented.

PMID- 8360054
TI  - Radical radiotherapy for T4 carcinoma of the skin of the head and neck: a
      multivariate analysis.
AB  - Sixty-seven patients with 68 stage T4 carcinomas of the skin of the head and neck
      were treated with radical radiotherapy at the University of Florida between
      October 1964 and November 1989. Thirty-three lesions were previously untreated
      and 35 were recurrent. Twenty-nine lesions were squamous cell carcinomas, 37 were
      basal cell carcinomas, and 2 were basosquamous carcinomas. Minimum follow-up was
      2 years. The 5-year local control, local control including surgical salvage, and
      cause-specific survival probabilities were 53%, 74%, and 75%, respectively. Local
      control rates with radiotherapy alone were poorer in patients with recurrent
      lesions (41% vs. 67%, p = .07) or bone involvement (40% vs. 62%, p = .08).
      Results were analyzed by multivariate methods using local control, local control
      with surgical salvage, and cause-specific survival as endpoints. The parameters
      analyzed were histology; size of primary lesion; previous treatment (previously
      untreated vs. recurrent); involvement of bone, nerve, or cartilage; and skeletal
      muscle invasion. Three important prognostic factors were identified, each
      predictive of poorer ultimate local control and cause-specific survival rates:
      (a) bone involvement (p < .01); (b) recurrent lesions (p < .01); and (c) nerve
      involvement (p < .02). Radiotherapy alone can control advanced carcinomas of the
      skin of the head and neck, although lesions that have recurred after prior
      treatment and those with involvement of bone or nerve are associated with a lower
      likelihood of cure.

PMID- 8360057
TI  - Dynamic radiographic imaging following total laryngectomy.
AB  - Cinepharyngoesophograms of the pharynx were obtained in 51 patients after total
      laryngectomy for squamous cell carcinoma. The radiological findings were
      correlated with operative reports and follow-up findings in 47 patients.
      Postoperative anatomic changes were well-demonstrated radiographically. A
      spectrum of radiographic findings were observed and included narrowing at the
      superior surgical closure site in 52% and pseudodiverticula in 47% of all
      patients. Cricopharyngeal prominence was observed in 15%, fistulae in 10%, and
      pharyngeal pouches in 6% of all cases. Increased retropharyngeal soft tissue
      thickness was not found to be indicative of tumor recurrence. We conclude that
      cineradiography is a useful method for demonstrating both functional and
      structural changes following laryngectomy for carcinoma.

PMID- 8360055
TI  - Recovery of postoperative swallowing in patients undergoing partial laryngectomy.
AB  - This study assessed the achievement of postoperative swallowing in patients
      undergoing partial laryngectomy surgery. Oropharyngeal swallow efficiency was
      used to predict time to achievement of outcome. Fifty-five patients were followed
      for up to 1 year in two hemilaryngectomy and four supraglottic laryngectomy
      groups. Within 10 days of healing, a videofluoroscopic evaluation enabled the
      measurement of swallowing efficiency. Times to achievement of oral intake,
      removal of feeding tube, preoperative diet, and normal swallow were analyzed
      using actuarial curves. Patients with hemilaryngectomies achieved swallowing
      rehabilitation sooner than patients with nonextended supraglottic laryngectomies
      (p < .05) who, in turn, achieved swallowing function sooner than did patients
      undergoing supraglottic laryngectomies with tongue base resection (p < .05).
      Median time to attainment of preoperative diet in these three groups was 28 days,
      91 days, and > 335 days, respectively. Higher early postoperative oropharyngeal
      swallow efficiency was related to earlier achievement of oral food intake and of
      preoperative diet (p < .05). Results show that the time course for swallowing
      rehabilitation covers an extended postoperative period. In some surgical groups,
      functional swallowing and eating may be achieved within 3 months of surgery while
      for other types, significant impairment remains up to 9 months postoperatively
      Early radiographic assessments of swallowing function are useful in predicting
      the time to swallow recovery. Recovery of swallowing ability may be delayed in
      patients who have not achieved oral intake before radiotherapy is started.

PMID- 8360056
TI  - Value of fine-needle aspiration in the diagnosis of Hurthle cell neoplasms.
AB  - The cytologic and histologic slides on all patients with a diagnosis of Hurthle
      cell tumor at Mount Sinai Hospital during the last 12 years were reviewed. There
      were 67 Hurthle cell tumors of which 15 (22%) were malignant. Four carcinomas
      (27%) occurred in a background of thyroiditis. Forty-three patients with Hurthle
      cell tumors had undergone preoperative fine-needle aspiration, of which 31 had
      satisfactory aspirates. For Hurthle cell neoplasia, fine-needle aspiration
      cytology had a sensitivity of 83.8% (26 of 31) and positive predictive value of
      93% (26 of 28), provided that the aspirate was of adequate cellularity. All 3
      cases predicted as Hurthle cell carcinoma on the basis of cellular and nuclear
      atypia were correctly predicted, but 3 carcinomas composed of bland cells were
      incorrectly predicted as adenomas. We conclude that aspiration cytology can
      differentiate nonneoplastic from neoplastic Hurthle cell lesions with high
      accuracy, but that the differentiation between benign and malignant lesions is
      less reliable.

PMID- 8360058
TI  - Hurthle cell adenoma arising in a thyroglossal duct cyst.
AB  - A 18-year-old black woman was initially seen with a 1-year history of a slowly
      enlarging midline neck mass. On physical examination this was consistent with a
      thyroglossal duct cyst. Histologic examination following a Sistrunk procedure
      revealed a Hurthle cell adenoma arising in a thyroglossal duct cyst. This is the
      second reported case of a Hurthle cell adenoma arising in a thyroglossal duct
      cyst. Neoplasms of thyroglossal duct cysts are reviewed.

PMID- 8360059
TI  - Seven-year follow-up of vanishing bone disease in a 14-year-old girl.
AB  - A review of the literature revealed 91 cases of massive osteolysis since the
      first report by Jackson in 1838, including 31 in the maxillofacial region meeting
      the Heffez criteria. In seven cases, early irradiation was performed, after which
      no further progression of bone lysis was observed. The young female patient
      reported here has been followed up clinically and radiologically for 7 years
      after radiotherapy, during which time she has remained stable, with no
      progression of the osteolysis. Our experience with this patient appears to
      confirm that early radiotherapy with a dose of 30-40 Gy prevents further
      progression of the disease and can even lead to recalcification. On this basis,
      and provided the patient remains symptom-free, reconstructive surgery appears a
      viable treatment option.

PMID- 8360060
TI  - Metastatic thyroid cancer.

PMID- 8360061
TI  - Answering critical care nursing questions by interfacing nursing research
      training, career development, and research with biologic and molecular science.
AB  - Critical care nursing practice encompasses physiologic as well as psychosocial
      responses of individuals to acute and chronic health care problems. Before
      solving integrative nursing problems, pathophysiologic information based on state
      of-the-science biotechnology is needed. More critical care nurse researchers need
      to answer clinical questions with biologic and molecular science information,
      measurements, and techniques. The purpose of this article is to describe research
      training, career development, and research opportunities to facilitate the
      interface of critical care nursing research with the biologic and molecular
      sciences.

PMID- 8360062
TI  - Depression in patients with COPD.
AB  - Patients with chronic obstructive pulmonary disease (COPD) can have an
      accompanying depression that interferes with nursing management and reduces
      patients' quality of life. Nurses need to understand more about that depression,
      how depression can be manifested and measured in older adults, and how depression
      in those with COPD differs from that seen in other chronic diseases. Self-report
      questionnaires can be used to identify depression initially and determine the
      need for further assessment. The DSM III-R criteria is recommended for those who
      wish to use a clinical evaluation tool. Treatment for the depression seen in COPD
      can include pharmacologic therapy and life changes, as well as individual and
      family therapies.

PMID- 8360064
TI  - Left bundle branch block-type conduction due to acceleration-dependent aberrancy.

PMID- 8360063
TI  - Alternatives for cardiac rehabilitation patients unable to return to a hospital
      based program.
AB  - OBJECTIVE: To determine the effectiveness of a home exercise program using
      transtelephonic exercise monitoring (TEM). DESIGN: Prospective, two-group
      experimental, random assignment. SETTING: Urban centered hospital and surrounding
      community. SUBJECTS: Twenty cardiac rehabilitation patients entering a Phase II
      cardiac rehabilitation program. OUTCOME MEASURES: Maximal oxygen consumption,
      blood pressure, pressure-rate product, workload. INTERVENTION: Twenty male
      cardiac patients were randomly enrolled in either a 12-week home- or hospital
      based exercise program. Maximal exercise tolerance tests were conducted, before
      and after exercise intervention, on a computer-driven bicycle ergometer. Subjects
      trained 3 days per week for 12 weeks on a bicycle ergometer for a maximum of 35
      minutes at 75% of maximum heart rate reserve or functional capacity. RESULTS:
      Posttraining results showed significant improvement in cardiac function for both
      groups. Two patients in the TEM group developed new arrhythmias while exercising
      that required medication changes; however, no medical emergencies arose in either
      exercise group. Independent Student t test showed no significant difference
      between groups before or after training. CONCLUSIONS: We conclude that TEM is an
      effective alternative for the rehabilitation of patients who are unable to return
      to a hospital-based program.

PMID- 8360065
TI  - A comparison of the recovery period for women and men after an acute myocardial
      infarction.
AB  - OBJECTIVES: To compare return to work, participation in cardiac rehabilitation,
      and sexual activity in women and men recovering from acute myocardial infarction
      (AMI). DESIGN: A descriptive survey design was used. Descriptive statistics and
      chi square analysis were used to compare differences between women and men after
      an AMI. SETTING: The survey was mailed to the subject's home. SUBJECTS: A
      purposive sample of 20 women and 42 men. RESULTS: Comparing women with men, there
      were significant differences in the following activities with women evidencing
      higher percentages in responsibility for household duties before AMI, and
      cooking, washing dishes, reading, bed making, laundry, dusting and sweeping
      within 4 weeks after AMI. For those subjects who were sexually active before AMI,
      all resumed sexual activities after an average of 8 weeks. Women reported a
      decrease in frequency, less satisfactory relationship, and more reports of chest
      pain during sexual activity. Subjects reported that nurses gave little or no
      counseling concerning resumption of household activities, return to work issues,
      and sexual activity. Women received less counseling than men after AMI.
      CONCLUSIONS: The findings are not generalizable to the population at large;
      however, the study indicates a need to investigate further the recovery period
      for women who experience AMI.

PMID- 8360066
TI  - A pilot study of pain, analgesia use, and pulmonary function after colectomy with
      or without a preoperative bolus of epidural morphine.
AB  - OBJECTIVE: To determine whether patients who received a preoperative bolus of
      epidural morphine plus postoperative parenteral analgesia had less pain and
      better pulmonary function over the first 2 days after a colectomy than patients
      who received postoperative parenteral analgesia alone. DESIGN: Repeated measures,
      quasi-experimental, random assignment. SETTING: Northeastern general hospital.
      SUBJECTS: Thirteen patients were randomized to receive parenteral with (n = 6) or
      without (n = 7) epidural analgesia. OUTCOME MEASURES: Indicators of pain
      (intensity of pain and pain-related distress, intensity of words used to describe
      pain, intramuscular-equivalent amount of morphine administered, duration from
      start of surgery to first request for analgesia) and pulmonary function (forced
      expiratory volume in one second  FEV1], forced vital capacity [FVC], inspiratory
      capacity [IC], peripheral oxygen saturation [SaO2] values). MEASUREMENT:
      Indicators of pain and pulmonary function were obtained the day before surgery,
      approximately 6 hours after surgery, and the first two mornings after surgery.
      RESULTS: Six hours after surgery, patients in the epidural group had less pain (p
      = 0.0177) and related distress (p = 0.0303) and greater FVC (p = 0.0303) and FEV1
      (p = 0.0025) than patients in the no-epidural group. On the first postoperative
      morning, patients in the epidural group had less distress related to pain (p =
      0.0350) but similar respiratory rates and spirometry values. Inspiratory capacity
      was not statistically different but was always larger in the epidural group. Of
      patients who breathed room air, SaO2 was higher in the epidural group over the
      first two postoperative days (p = 0.0286 each occasion). Patients in the epidural
      group received their first on-demand analgesic an average of 30 hours after the
      start of surgery compared with 6 hours for patients in the no-epidural group (p =
      0.0022). There were no significant differences in the total number of words used
      to describe the type of pain, and both groups described the pain with fewer words
      than expected on the first and second mornings after surgery. CONCLUSIONS:
      Results should be confirmed through study of a larger sample with the hypothesis
      that pain relief, selected aspects of pulmonary function, and peripheral
      oxygenation may be superior for patients who receive a preoperative bolus of
      epidural analgesia for abdominal surgery.

PMID- 8360067
TI  - Oxygen transport variables in the identification and treatment of tissue hypoxia.
AB  - Critically ill patients have greater than normal oxygen demands because of
      enhanced energy requirements placed on them by the stress of acute illness, blood
      and fluid loss, surgery, wound healing, and hospitalization. Early recognition of
      major alterations in oxygen transport variables, oxygen delivery, oxygen
      consumption, and the oxygen extraction ratio, by the critical care team assists
      in the prevention and treatment of tissue hypoxia in seriously ill and injured
      patients. Supranormal levels of oxygen delivery are required to meet these
      increased oxygen demands, to prevent tissue hypoxia, and to correct tissue oxygen
      debt. The critical care team should promptly determine the patient's oxygen
      transport variables on admission to the intensive care unit to provide a starting
      point for patient resuscitation. When deviations from supranormal values of
      oxygen transport variables in these patients are identified, specific
      interventions that improve oxygen delivery to peripheral tissues should be
      implemented and evaluated for their effectiveness in normalizing the oxygen
      extraction ratio. When serial measurements of oxygen delivery, oxygen
      consumption, and the oxygen extraction ratio follow each therapeutic intervention
      that is directed at increasing oxygen delivery, the survival rate of critically
      ill patients is significantly improved.

PMID- 8360068
TI  - Comparison of two methods of measuring gastric pH.
AB  - OBJECTIVE: To assess the agreement between two methods of measuring gastric pH in
      critically ill patients (multiple band litmus paper-tested aspirations versus a
      meter-read probe located in the tip of a nasogastric tube) and to compare nurse
      satisfaction with both methods of measuring pH. DESIGN: Prospective,
      correlational, nonprobability sample. SETTING: Mid-Atlantic, semirural Veterans
      Affairs Medical Center. SUBJECTS: 39 male, surgical, critical care patients, who
      were nasogastrically intubated in the operating room and received nothing by
      mouth. NURSES: Twenty-seven registered nurses on the medical-surgical intensive
      care staff. OUTCOME MEASURES: Differences in pH units as determined by two
      methods of measurement and nurse satisfaction scores. INSTRUMENTATION: Litmus
      paper-tested aspirations versus a meter-read probe located in the tip of the
      nasogastric tube, measured every 2 hours for 48 hours. A nurse satisfaction
      assessment form for both measurement methods at entry, 6 months, and 12 months.
      RESULTS: All measures of association, Pearson's r (0.79), the concordance
      coefficient (0.74), and eta (0.88), were high. The concordance coefficient
      measures indicated sufficient agreement between the two methods at the initial
      and 24 hour measurement times (Cb) = 0.97, 0.97, and 0.94), but not at 48 hours.
      The meter method indicated prophylaxis was needed when the paper did not, more
      often than did the paper method (9.3% vs 5.2%). A significant difference between
      methods was found only at the last reading at 48 hours (z = -2.24, p < .0249).
      MANOVA revealed that nurses' preference for the meter method was significant (F =
      139.48, df = 1.18) and increased over time (F = 4.77, df = 2,36). CONCLUSIONS:
      The gastric probe method of measuring pH is an accurate substitution up to 48
      hours for the litmus-paper aspiration method in the postoperative patient who is
      receiving nothing by mouth. Nurses prefer the gastric probe method of measuring
      pH over the litmus-paper method because they judge it to be safer, faster, and
      more accurate.

PMID- 8360069
TI  - Emergency department patients' perception of nurse caring behaviors.
AB  - OBJECTIVE: To identify which behaviors performed by emergency department nurses
      were perceived by patients as important indicators of caring. DESIGN:
      Descriptive. SETTING: Two private urban emergency departments. SUBJECTS:
      Ambulatory patients treated in the emergency department and interviewed by
      telephone within 30 days of discharge. The resulting sample consisted of a total
      of 288 interviews including 81 patients in the emergent group, 99 in the urgent
      group, and 108 in the nonurgent group. Of the 288 patients, 49% were male and 51%
      were female. OUTCOME MEASURES: Individual and composite measures of perceptions
      of nurse caring behaviors as measured with the Caring Behaviors Assessment,
      satisfaction with care, and patients' evaluation of their medical condition.
      RESULTS: Patients in all triage categories were found to assign the greatest
      importance to the technical nursing behaviors as indicators of nurse caring.
      Polychotomous logistic regression indicated that, although subscale differences
      occurred, they did not account for substantial differences among triage
      categories. Kruskall-Wallis one way ANOVA revealed no significant differences
      between triage levels and ratings of level of personal concern. Chi-square
      analysis indicated that patients in the emergent group identified fewer caring
      behaviors that the nurse must perform to demonstrate caring compared with
      patients in the nonurgent group. CONCLUSIONS: Patients experience nurse caring
      behavior most consistently from the technical aspects of nursing care.

PMID- 8360071
TI  - Hepatitis. Part I. Enterically transmitted viral hepatitis: etiology,
      epidemiology, and prevention.

PMID- 8360070
TI  - Nosocomial tuberculosis in the AIDS era with an emphasis on multidrug-resistant
      disease.

PMID- 8360072
TI  - Mycoplasma pneumoniae induced thrombocytopenia.

PMID- 8360073
TI  - Process of foregoing life-sustaining treatment in a university hospital: an
      empirical study. (Faber-Langendoen K, Bartels DM. Crit Care Med 1992;20[5]:570
      7).

PMID- 8360074
TI  - Myocardial infarction and cerebral hemorrhage.

PMID- 8360075
TI  - Chromosomal localization and regulation of the longevity determinant genes in a
      selected strain of Drosophila melanogaster.
AB  - A controlled chromosome substitution experiment was performed on a strain (NDC-L)
      selected for long life to determine if the genes responsible for the extended
      longevity phenotype could be localized to any particular chromosome(s). All 27
      different possible combinations of the three major chromosomes of Drosophila
      melanogaster were constructed and longevities were determined on 3875 individual
      animals of both sexes and analysed. The results are statistically significant and
      demonstrate that mean longevity is specified primarily by recessive genes on the
      third chromosome (c3). The extended longevity phenotype (ELP) is only expressed
      in those lines which are homozygous for the NDC-L type c3. Loci on the first (c1)
      and second (c2) chromosomes interact, both positively (c1) and negatively (c2),
      respectively, such that c1 represses c2 which in turn represses c3. The ELP is
      fully expressed in the mutual presence and mutual absence of c1 and c2. The
      significance of these results is discussed in the context of broader categories
      of molecular genetic mechanisms suggested previously to be involved in the
      modulation of longevity in Drosophila.

PMID- 8360076
TI  - Larval regulation of adult longevity in a genetically-selected long-lived strain
      of Drosophila.
AB  - Our previous work has shown that the major genes involved in the expression of
      the extended-longevity phenotype are located on the third chromosome.
      Furthermore, their expression is negatively and positively influenced by
      chromosomes 2 and 1, respectively. In this report we show that the expression of
      the extended-longevity phenotype is dependent on the larval environment. A
      controlled chromosome substitution experiment was carried out using a strain
      selected for long life (L) and its parent (R) strain. Twenty different
      combinations of the three major chromosomes were conducted and their longevities
      were determined under both high (HD) and low (LD) larval density conditions. The
      extended-longevity phenotype was only expressed under HD conditions. The
      chromosome interactions were not apparent under LD conditions. Density-shift
      experiments delineate a critical period for expression of the extended-longevity
      phenotype, extending from 60 h after egg laying (AEL) to 96 h AEL, during which
      the developing animal must be exposed to HD conditions if the extended-longevity
      phenotype is to be expressed. The change from HD to LD conditions is accompanied
      by statistically significant increases in body weight. The possible role of a
      dietary restriction phenomenon is examined and the implications of these findings
      discussed. It is now apparent, however, that the extended-longevity phenotype in
      Drosophila is a developmental genetic process.

PMID- 8360077
TI  - Regulatory aspects of esterase 6 activity variation in sibling Drosophila
      species.
AB  - Esterase 6 in Drosophila melanogaster, Drosophila simulans and Drosophila
      mauritiana is produced in several life stages and diverse tissues, but the major
      pulse of expression is in the sperm ejaculatory duct of adult males. Comparison
      of EST6 activity levels among several lines of D. melanogaster, D. simulans and
      D. mauritiana reveals two major quantitative differences among the species.
      First, newly eclosed females of both D. simulans and D. mauritiana show
      significantly higher EST6 activity than those of D. melanogaster. Secondly, 5-day
      old adult D. simulans have significantly higher activities than D. mauritiana in
      both sexes and significantly higher activity than D. melanogaster in males. The
      genetic bases of the differences between D. melanogaster and the other species
      are investigated through germ line transfer of the D. simulans and D. mauritiana
      Est-6 genes plus 1.2 kb of 5' and 0.2 kb of their 3' flanking sequences into D.
      melanogaster. The newly eclosed female activities of the transformants resemble
      those of the two donor species, suggesting that the interspecific differences in
      this aspect of expression are due to cis-inherited factors contained within the
      transferred DNA. In contrast, the 5-day adult activity of the D. simulans
      transgene resembles the recipient species, D. melanogaster, suggesting that the
      difference between D. simulans and D. melanogaster in this aspect of expression
      is due to trans-acting factors. We also find that third instar larval activities
      of the D. simulans transgene and 5-day male activities of the D. mauritiana
      transgene are lower than those of either parental species, suggesting that not
      all the promoter elements relevant to these aspects of expression are included in
      the transferred DNA.

PMID- 8360078
TI  - Correlation between the individual heterozygosity of parents and their offspring.
AB  - Specific formulations are derived for the correlation between the heterozygosity
      of a randomly mating parent and its offspring for a diallelic locus, and for the
      correlation when multiple loci are considered. The expected correlation is
      maximal, approaching r = 0.50, when allelic frequencies are highly asymmetric,
      and it is zero when the allelic frequencies are equal to 0.50. Parent-offspring
      correlations, up to a maximum of 0.50 for diallelic loci, indicate that levels of
      heterozygosity can respond to selection. Multilocus allozyme data from limber
      pine, Pinus flexilis, and from horses of standardbred and thoroughbred breeds are
      used to demonstrate correlations between a parent and its offspring. The Spearman
      rank correlation between the heterozygosity of a limber pine and the mean
      heterozygosity of her offspring is r = 0.45. Correlations in the horses range
      from r = 0.16 to 0.32.

PMID- 8360079
TI  - Intracellular localization of parvovirus B19 nucleic acid at the ultrastructural
      level by in situ hybridization with digoxigenin-labelled probes.
AB  - Conditions suitable for immunogold detection of digoxigenin-labelled DNA probes
      hybridized to parvovirus B19-infected erythroid cells embedded in Lowicryl K4M
      and LR White acrylic resins were established at the electron microscope level.
      The protocol was initially optimized using a positive control probe for whole
      human DNA which produced signal over the heterochromatin of all nucleated cells.
      In cultures harvested 2 days postinfection, B19 nucleic acid was detected mainly
      within the centrinuclear region of erythroid cells exhibiting characteristic
      margination of the chromatin. The B19 hybridization signal was largely unaffected
      by denaturation and was resistant to RNase digestion but sensitive to DNase
      digestion, indicating that it was mainly single-stranded B19 DNA. Relatively few
      gold particles were found over crystalline arrays of viral capsids, consistent
      with the observation that they are composed of mainly 'empty' capsids. B19
      nucleic acid was detected in apparent transit from nucleus to cytoplasm through
      pores in the nuclear membrane. While the sensitivity of this system is limited by
      the fact that hybridization occurs only at the surface of the section, it is a
      rapid and specific means of localizing viral nucleic acids with a high degree of
      resolution.

PMID- 8360080
TI  - The von Kossa reaction for calcium deposits: silver lactate staining increases
      sensitivity and reduces background.
AB  - The classical von Kossa method has been modified: the high silver nitrate
      concentration in the original was replaced by 0.05% silver lactate with
      hydroquinone remaining the reducing agent of choice. The present modification
      stained calcification nodules with a sensitivity comparable to the original von
      Kossa reaction, but resulted in a reduced background staining in cultured
      osteoblasts. The method works well also with plastic- or paraffin-embedded tissue
      sections.

PMID- 8360081
TI  - Ultrastructural localization of lectin-binding sites in different basement
      membranes.
AB  - In the present work we localized binding sites for the lectins WGA, RCA I, con A
      and SBA at the ultrastructural levels in morphologically different basement
      membranes. These different basement membranes included (a) thin ones, for
      example, tubular basement membrane of the mouse kidney which separates epithelial
      cell layers from mesenchymal cells and glomerular basement membrane which
      separates epithelial cells from other epithelial cells, (b) thick multilayered
      ones, for example. Reichert's membrane which is built up during the embryonic
      development of rodents and as an example of a pathologically thickened basement
      membrane, the basement membrane of the Engelbreth-Holm-Swarm (EHS) sarcoma. We
      were able to show that, in contrast to the thick multilayered basement membranes,
      the thin ones showed a strong positive SBA-binding pattern. Thick basement
      membranes otherwise revealed very strong labelling with the lectins WGA and RCA
      I. Our findings lead us to conclude that thin and thick basement membranes differ
      markedly in the quality and quantity of the carbohydrates which they contain.

PMID- 8360083
TI  - Steel-jaw leghold trap.

PMID- 8360082
TI  - Animal research.

PMID- 8360084
TI  - BST product labels--still FDA's call.

PMID- 8360086
TI  - Looking in on the pet food industry.

PMID- 8360085
TI  - Veterinary medical degree enrollment, 1992-1993.

PMID- 8360088
TI  - Comparison of french-pezzar and Malecot catheters for percutaneously placed
      gastrostomy tubes in cats.
AB  - Gastrostomy tubes were placed percutaneously in 28 cats by use of an endoscope.
      French-pezzar mushroom-tip catheters were used for 14 of the procedures, and
      Malecot catheters were used for the remainder. Inner flanges were not used in
      gastrostomy tube placement. The french-pezzar catheters remained in place and
      functional for 2 weeks in all 14 cats. The Malecot catheters remained in place
      and functional for 2 weeks in 4 cats. Malecot catheters pulled out in 10 cats,
      and 2 of these cats died or were euthanatized because of complications. The
      gastrostomy tubes were removed in 18 cats 2 weeks after placement by applying
      gentle, steady traction and removing the entire catheter or by cutting the tube
      flush with the skin and leaving the catheter tip in the cat's stomach. Neither
      method of removal was associated with problems.

PMID- 8360087
TI  - Effect of trimethoprim/sulfamethoxazole on thyroid function in dogs with
      pyoderma.
AB  - The effect of trimethoprim/sulfamethoxazole (T/SMX, 30 mg/kg, PO, q 12 h for 6
      weeks) on thyroid function was evaluated in 21 dogs with pyoderma and normal
      baseline serum thyroxine concentrations. The population mean serum thyroxine
      concentration, but not the population mean serum triiodothyronine concentration,
      was significantly decreased at the end of treatment. After 6 weeks of treatment,
      the response in 3 dogs to thyrotropin administration was substantially reduced.
      Radionuclide thyroid imaging of 2 dogs after T/SMX treatment revealed higher-than
      normal thyroid technetium 99m pertechnetate uptake, suggestive of an interference
      with iodide metabolism. Use of T/SMX may cause hypothyroidism, and inadequate
      thyroid function may be incorrectly diagnosed in dogs treated with this
      antimicrobial.

PMID- 8360089
TI  - Effects of a high-density intramammary device on mammary glands, production, and
      reproductive performance in dairy cows.
AB  - A clinical field trial was undertaken to determine the influence of an
      intramammary device (IMD) on environmental mastitis and production. On 4 central
      California dairies, 200 Holstein first-lactation cows were randomly assigned to 2
      groups. Cows in the treatment group were fitted with an IMD, and cows in the
      control group were not. The incidence of clinical mastitis for the 2 groups was
      determined during the study period. Bacteriologic monitoring at intervals over 2
      lactations (lactation 2 and through 60 days of lactation 3) was used to determine
      the incidence of subclinical infection. In addition, data were collected to
      determine whether the groups differed in milk production, butterfat production,
      post-milking and test-day somatic cell counts, and reproductive efficiency. Total
      milk production and butterfat production over the 2 lactation periods did not
      vary significantly between the groups. Also, the groups did not differ in calving
      to-conception interval, duration of lactation, calving interval, and calving-to
      first service interval. Cows with IMD were significantly less likely to develop
      clinical mastitis (5% vs 13%) than control cows. The IMD did not appear to affect
      subclinical infection rates (minor pathogens only) except at day 300 of lactation
      2 and at day 10 of lactation 3, when prevalence was greater in the cows with IMD.
      The minor pathogens were predominately (80%) coagulase-negative staphylococci. It
      was unusual to have coagulase-negative staphylococci in the same quarter at 2
      consecutive samplings, prompting the speculation that during lactation, the
      duration of coagulase-negative staphylococci infection is short (resolves without
      intervention).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360090
TI  - Comparison of enzyme-labeled immunosorbent assay and particle concentration
      fluorescence immunoassay with standard serologic methods and bacteriologic
      culture for detection of Brucella sp-infected cows in herds with brucellosis.
AB  - Bacteriologic culture of udder secretions and card, rivanol, and complement
      fixation tests for detection of brucellosis were performed on samples from 828
      cows vaccinated with strain 19 in herds with brucellosis. An ELISA and a particle
      concentration fluorescence immunoassay were performed on sera from 560 and 569
      cows, respectively. A field strain of Brucella abortus or strain 19 was isolated
      from 278 cows. The ELISA and the card test had high sensitivity, but low
      specificity. Data suggested that there is no advantage to using primary binding
      assays rather than the simple buffered antigen agglutination procedures to detect
      cows infected with a field strain of B abortus.

PMID- 8360091
TI  - Ultrasonographic appearance of ruptured peroneus tertius in a horse.
AB  - Ultrasonography was a valuable diagnostic tool for examination of a ruptured
      peroneus tertius in a horse, because it allowed visualization of the extent of
      the injury and evaluation of healing prior to return of the horse to athletic
      activity.

PMID- 8360093
TI  - Hypertrophic osteopathy associated with Mycobacterium fortuitum pneumonia in a
      dog.
AB  - Mycobacterium fortuitum was isolated from the lung of a dog that had new
      periosteal bone formation consistent with hypertrophic osteopathy. Fever, weight
      loss, and bilateral hind limb lameness were the initial clinical signs. The tarsi
      were swollen and a pain response was elicited on palpation of the hind limb.
      Radiography revealed periosteal new bone formation on the metatarsi, femurs, and
      ischii. Thoracic radiography revealed pulmonary mass lesions in the right middle
      and left caudal lung lobes. After right middle and left caudal lung lobectomy, M
      fortuitum was isolated from the excised tissues. Amoxicillin
      trihydrate/clavulanic acid and amikacin were administered, on the basis of
      susceptibility test results.

PMID- 8360092
TI  - Sialadenitis associated with periorbital disease in a dog.
AB  - Submucosal sialadenitis was diagnosed on histologic examination of a biopsy
      specimen from a palatine swelling associated with acute, unilateral periorbital
      disease in a dog. Sialadenitis may have been the cause of periorbital disease or
      may have been part of a generalized inflammatory condition affecting the
      periorbital tissues. Corticosteroids were immediately effective in eliminating
      signs of periorbital disease and sialadenitis. A 3-month corticosteroid treatment
      was used because the sialadenitis and periorbital disease were immune-mediated.
      This dog has been free of recurring signs for more than 3 years.

PMID- 8360094
TI  - Proventriculotomy in ostriches: 18 cases (1990-1992).
AB  - Over a 3-year period, proventriculotomy was performed on 18 ostriches to relieve
      impaction of the proventriculus. Diagnosis was confirmed by abdominal palpation,
      abdominal radiography, and in some cases, exploratory proventriculotomy. In
      addition to proventriculotomy, an esophagotomy was performed in 5 birds that were
      debilitated to allow force-feeding during the postoperative period. The median
      age of ostriches treated surgically for proventricular impaction was 7.5 months
      (range, 3 months to 18 years). Impactions consisted of sand, rocks, or gravel in
      combination with grass, leaves, wood, or other fibrous materials. In 7 birds,
      small pieces of wire or nails were also removed from the proventriculus. In 1
      bird, a large metal punch was removed via the proventriculotomy. Six ostriches
      died at the hospital in the immediate postoperative period. Four of these died
      within 24 hours of surgery. All 4 birds were emaciated and in a severely weakened
      condition at admission, and they continued to deteriorate after surgery. One bird
      died 8 days after surgery as a result of complications associated with a septic
      joint unrelated to the proventriculotomy procedure. Another bird was euthanatized
      6 days after surgery because its condition failed to improve and the owners did
      not want to pursue further treatment because of expense. Follow-up information
      was obtained for 12 surviving ostriches 1 week to 29 months (median, 5.5 months)
      after they were discharged from the hospital. Four of the 12 birds died within 30
      days of discharge from the hospital. The remaining 8 birds (44%) were alive at
      follow-up evaluation (median, 10.5 months after surgery; range, 5 to 29
      months).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360095
TI  - Scintigraphic evaluation of fractures of the distal phalanx in horses: 27 cases
      (1979-1988).
AB  - Retrospective radiographic and scintigraphic analyses were performed on 27
      fractures of the distal phalanx in 25 horses. Location of 99mtechnetium methylene
      diphosphonate (99mTc-MDP) uptake was compared with fracture line location as seen
      on radiography. Intensity (intense, moderate, mild) and pattern (focal, diffuse)
      of 99mTc-MDP uptake was recorded and compared with duration of fracture. Nine
      horses were monitored during convalescence by obtaining additional scintigraphic
      views 3 to 68 months after injury. Palmar scintigraphic views had evidence of
      focal areas of increased 99mTc-MDP uptake that corresponded to fracture line
      location as seen on radiography. Lateral scintigraphic views had evidence of
      diffuse increased uptake. There was a significant (P < 0.01) association between
      duration of fracture and intensity of uptake, with fractures < 3 months in
      duration more likely to have intense focal uptake. All fractures < 10 days in
      duration had intense focal uptake. As fracture age increased, 99mTc-MDP uptake
      became less intense and more diffuse. Three fractures not evident on radiography
      had evidence of 99mTc-MDP uptake on scintigraphy. Stall rest resulted in
      decreased 99mTc-MDP uptake in 6 of 9 horses, but increased uptake was still
      visible in all horses between 4 and 25 months after injury. The only
      scintigraphic view without evidence of increased uptake was that obtained from a
      horse reexamined 68 months after injury.

PMID- 8360096
TI  - What is your diagnosis? Multiple, irregular, diffuse intraluminal masses in the
      urinary bladder.

PMID- 8360097
TI  - Tetrafibricin, a novel fibrinogen receptor antagonist. I. Taxonomy, fermentation,
      isolation, characterization and biological activities.
AB  - Tetrafibricin is a novel fibrinogen receptor antagonist produced by Streptomyces
      neyagawaensis NR0577. It was isolated from the culture broth by Diaion HP-21
      adsorption, MeOH extraction, MCI GEL CHP-20P column chromatography, preparative
      HPLC and Toyopearl HW-40 SF column chromatography. The physico-chemical
      properties of tetrafibricin indicated that the structure of tetrafibricin is
      different from the known peptide fibrinogen receptor antagonists and closely
      related to the polyene macrolide antibiotics. Tetrafibricin strongly inhibited
      the binding of fibrinogen to its receptors with an IC50 of 46 nM. It also
      inhibited ADP-, collagen-, and thrombin-induced aggregation of human platelets
      with IC50s of 5.6, 11.0 and 7.6 microM, respectively.

PMID- 8360098
TI  - Tetrafibricin, a novel fibrinogen receptor antagonist. II. Structural
      elucidation.
AB  - The structure of tetrafibricin, a novel and potent fibrinogen receptor antagonist
      isolated from the culture broth of Streptomyces neyagawaensis NR0577, was
      determined. Tetrafibricin has a unique structure containing primary amine,
      conjugated tetraenoic acid, and polyhydroxy functionalities that is
      biosynthetically related to the polyene macrolide antibiotics.

PMID- 8360099
TI  - R1128 substances, novel non-steroidal estrogen-receptor antagonists produced by a
      Streptomyces. I. Taxonomy, fermentation, isolation and biological properties.
AB  - New non-steroidal estrogen-receptor antagonists, R1128 A, B, C and D, were
      isolated from the cultured broth of Streptomyces sp. No. 1128 by solvent
      extraction, silica gel chromatography, reverse phase chromatography and
      preparative HPLC. These compounds inhibited estrogen binding to its receptor. The
      IC50 values of R1128 A, B, C and D for partially purified rat uterine cytosol
      receptor were 1.1 x 10(-7) M, 1.2 x 10(-7) M, 2.6 x 10(-7) M and 2.7 x 10(-7) M,
      respectively.

PMID- 8360100
TI  - R1128 substances, novel non-steroidal estrogen-receptor antagonists produced by a
      Streptomyces. II. Physico-chemical properties and structure determination.
AB  - R1128 A, B, C and D, new non-steroidal estrogen-receptor antagonists, were
      isolated from the cultured broth of Streptomyces sp. No. 1128. Their structures
      were elucidated to be 1,3,6-trihydroxy-8-alkylanthraquinones on the basis of
      their physico-chemical properties and spectroscopic data.

PMID- 8360101
TI  - R1128 substances, novel non-steroidal estrogen-receptor antagonists produced by a
      Streptomyces. III. Pharmacological properties and antitumor activities.
AB  - R1128 B (1,3,6-trihydroxy-8-n-butylanthraquinone), a new antibiotic produced by
      Streptomyces sp. No. 1128, inhibited estrogen binding to its receptor. The IC50
      value of R1128 B for partially purified rat uterine cytosol receptor was 1.2 x
      10(-7) M. However, the IC50 value of R1128 B against androgen-receptor binding
      was about 50-fold greater than that against estrogen-receptor binding. R1128 B
      was a competitive inhibitor against estrogen-receptor binding. R1128 B inhibited
      the growth of estrogen-responsive human mammary adenocarcinoma MCF-7 cells in
      soft agar. This inhibition, however, was reversed when estradiol was added to the
      culture medium. R1128 B showed antitumor activities against MCF-7 both
      xenografted to nude mice and implanted in subrenal capsule of mice (SRC assay).
      The potency of R1128 B was about 8-fold lower than that of tamoxifen both in
      vitro and in vivo.

PMID- 8360102
TI  - Vicenistatin, a novel 20-membered macrocyclic lactam antitumor antibiotic.
AB  - A new antitumor antibiotic vicenistatin was isolated from the culture broth of
      Streptomyces sp. HC34. The structure of vicenistatin was elucidated by NMR
      spectral analysis. Vicenistatin exhibited antitumor activity against human colon
      carcinoma Co-3 in the xenograft model.

PMID- 8360103
TI  - Eupenifeldin, a novel cytotoxic bistropolone from Eupenicillium brefeldianum.
AB  - Eupenifeldin was isolated from cultures of Eupenicillium brefeldianum ATCC 74184
      by extraction and crystallization. The compound was identified as a pentacyclic
      bistropolone on the basis of spectral data and its complete structure was
      established by single-crystal X-ray analysis. The compound is cytotoxic against
      the HCT-116 cell line and has in vivo antitumor activity in the P388 leukemia
      model.

PMID- 8360104
TI  - UK-1, a novel cytotoxic metabolite from Streptomyces sp. 517-02. I. Taxonomy,
      fermentation, isolation, physico-chemical and biological properties.
AB  - A new benzoxazole, UK-1, was isolated from the mycelial cake of an actinomycete
      strain 517-02. Based on morphological, cultural and physiological
      characteristics, strain 517-02 was seemed to be a close relative of Streptomyces
      morookaense. UK-1 showed potent cytotoxic activity against B16, HeLa and P388
      cells and did not show any antimicrobial activity.

PMID- 8360105
TI  - UK-1, a novel cytotoxic metabolite from Streptomyces sp. 517-02. II. Structural
      elucidation.
AB  - The structure of UK-1 isolated from the mycelium of Streptomyces sp. 517-02 was
      elucidated to be a novel benzoxazole dimmer derivative (1) on the basis of
      spectroscopic methods.

PMID- 8360106
TI  - Antifungal macrocyclic polylactones from Penicillium verruculosum.
AB  - Three macrocyclic polylactones have been isolated from Penicillium verruculosum.
      Two were found to be novel and the third to be identical with NG-012(1). Their
      structures were elucidated by spectroscopic and chemical methods. A full
      assignment of 1H- and 13C-resonances in acetone-d6 are given for all three
      compounds. The compounds show antifungal activity.

PMID- 8360107
TI  - A novel macrolactam-disaccharide antifungal antibiotic. Taxonomy, fermentation,
      isolation, physico-chemical properties, structure elucidation and biological
      activity.
AB  - A novel natural product (1), with antifungal activity was isolated from the
      culture broth of an actinomadurae. The active compound was separated from broth
      by n-butanol extraction and purified by silica gel and multicoil counter current
      chromatography. Physico-chemical data suggested the structure of this compound to
      be a novel macrolactam disaccharide related to Sch 38518 (3). The structure was
      determined by spectroscopic studies on the acetate derivative. It was active
      against Candida spp. (MIC's, 4 approximately 64 micrograms/ml) but less than the
      monosaccharide, Sch 38518 (MIC's, 1 approximately 16 micrograms/ml).

PMID- 8360108
TI  - Isolation of trehalamine, the aglycon of trehazolin, from microbial broths and
      characterization of trehazolin related compounds.
AB  - Trehalamine, (3aR,4R,5S,6S,6aS)-2-amino-4-(hydroxymethyl)-3a,5,6,6a- tetrahydro
      4H-cyclo-pent[d]oxazole-4,5,6-triol (1) and D-glucose were obtained by acid
      hydrolysis of trehazolin (3), a trehalase inhibitor produced by actinomycetes.
      More vigorous hydrolytic treatment of trehazolin afforded an aminocyclitol,
      (1R,2S,3R,4S,5R)-5-amino-1- (hydroxymethyl)cyclopentane-1,2,3,4-tetraol (2).
      Trehalamine, the aglycon of trehazolin, was also found in the culture broths of
      two trehazolin producing strains, Micromonospora sp. SANK 62390 and Amycolatopsis
      sp. SANK 60791. These trehazolin related compounds trehalamine (1) and 2 were
      poor inhibitors of trehalase (1; IC50 1.8 x 10(-4) M, 2; > 5.0 x 10(-4) M). On
      the other hand they inhibited more potently rat intestinal sucrase (1; IC50 6.8 x
      10(-5) M) and sweet almond beta-glucosidase (2; IC50 5.6 x 10(-6) M) than
      trehazolin.

PMID- 8360109
TI  - Germicidin, an autoregulative germination inhibitor of Streptomyces
      viridochromogenes NRRL B-1551.
AB  - During germination spores of Streptomyces viridochromogenes NRRL B-1551 excrete a
      compound, germicidin, which has an inhibitory effect on the germination of its
      own arthrospores at a concentration as low as 200 pM (40 pg/ml). At higher
      concentrations germicidin inhibits porcine Na+/K(+)-activated ATPase and retards
      the germination of the cress Lepidium sativum. Germicidin is the first known
      autoregulative inhibitor of spore germination in the genus Streptomyces and was
      isolated from the supernatant of germinated spores, but also from the supernatant
      of the submerged culture. Spectroscopic analysis and derivatization reactions
      revealed germicidin to be 6-(2-butyl)-3-ethyl-4-hydroxy-2-pyrone (C11H16O3).
      Crude isolates of germicidin from the supernatant of submerged culture, but not
      from the spores, contained a second, structurally very similar compound
      (C10H14O3), in which in contrast to germicidin a 2-propyl instead of the 2-butyl
      chain was bound to C-6 and which did not show any activity in the germination and
      ATPase assay. The germination assay was evaluated as a new screening model for
      specifically active compounds.

PMID- 8360110
TI  - PC-766B, a new macrolide antibiotic produced by Nocardia brasiliensis. II.
      Isolation, physico-chemical properties and structure elucidation.
AB  - A new macrolide antibiotic, PC-766B, was isolated from the cells of Nocardia
      brasiliensis SC-4710 by acetone extraction, and purified by gel filtration,
      silica gel chromatography, HPLC and TLC. The structure of PC-766B was determined
      by NMR spectral analysis to be a new class of the hygrolidin family antibiotics.
      PC-766B had a 16-membered macrocyclic lactone ring, a 6-membered hemiketal ring
      and a 2-deoxy-D-rhamnose moiety. DL-alpha-Tocopherol, known as an antioxidant
      agent, significantly improved the stability of PC-766B and prevented the
      decomposition of PC-766B during the storage of the antibiotic.

PMID- 8360111
TI  - Delaminomycins, novel extracellular matrix receptor antagonist. IV. Structure
      activity relationships of delaminomycins and derivatives.
AB  - Delaminomycins A, B, C and their derivatives were prepared and investigated
      biological activities of them. Among these compounds, spiro compounds (A2, B2 and
      C2) showed stronger inhibitory activity than natural products (A1, B1 and C1) on
      B16 melanoma cells adhesion assay and Con A-induced proliferation of murine
      splenic lymphocytes assay. In MLCR and antimicrobial assay, however, A1, B1 and
      C1 showed more potent inhibitory activity than spiro compounds (A2, B2 and C2).
      On the other hand, as to C-5' substituents of pyrrolidine ring, the order of
      inhibitory activity was R = OH > R = OCH3 > R = H on Con A-induced proliferation
      of murine splenic lymphocytes assay. In MLCR and antimicrobial assay, however,
      the order of inhibitory activities were R = H > R = OCH3 > R = OH. Inhibitory
      activities of A4 which was lacked pyrrolidine ring were reduced on B16 melanoma
      cells adhesion assay and on cytotoxicity against tumor cells in vitro in
      comparison with those of A1.

PMID- 8360112
TI  - Chemical modification of erythromycins. XII. A facile synthesis of clarithromycin
      (6-O-methylerythromycin A) via 2'-silylethers of erythromycin A derivatives.

PMID- 8360113
TI  - Pyripyropenes, highly potent inhibitors of acyl-CoA:cholesterol acyltransferase
      produced by Aspergillus fumigatus.

PMID- 8360114
TI  - Chrysosporin, a new inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase
      produced by Chrysosporium pannorum.

PMID- 8360115
TI  - A novel producer of the antibiotic kirromycin belonging to the genus
      Actinoplanes.

PMID- 8360116
TI  - Synthesis of diolmycin analogs and their anticoccidial activities.

PMID- 8360117
TI  - The detection by a disc diffusion technique of inducible beta-lactamase in
      Yersinia enterocolitica.

PMID- 8360118
TI  - The effect of increased agar concentration in susceptibility testing media on
      MICs of antimicrobials for gram-negative bacilli.

PMID- 8360119
TI  - In-vitro activity of imipenem and amikacin combinations against resistant
      Pseudomonas aeruginosa.

PMID- 8360120
TI  - Effect of probenecid on cefazolin serum concentrations.

PMID- 8360121
TI  - Early diagnosis of systemic candidal infection.

PMID- 8360122
TI  - Selective decontamination of the digestive tract and its role in antimicrobial
      prophylaxis.
AB  - Selective decontamination of the digestive tract (SDD) is an established form of
      infection prevention which relies upon local antibiotic action to afford
      suppression of potential pathogens while preserving 'colonization resistance'
      (CR). However, CR has never been shown conclusively to play a decisive role in
      either achieving or maintaining effective prophylaxis in patients and by
      employing absorbable antimicrobials or parenteral antibiotics, prophylaxis is
      actually achieved by both local and systemic action. The role of prophylaxis in
      neutropenic patients is also far from clear since morbidity and mortality remain
      the same whether or not prophylactic antibacterials are given and most patients
      still require empirical therapy for fever. In addition, the Gram-positive cocci,
      rather than Gram-negative bacilli presently predominate as pathogens. There is
      also an increasing trend towards including fungal and viral infection as targets
      for prophylaxis. Moreover, current anti-infective strategies are more akin to
      'pre-emptive therapy' (PET) since the antimicrobials are available systemically
      and given at optimum therapeutic doses and there is little to distinguish
      treatment given to prevent colonization from progressing to infection from that
      used to arrest incipient infection or effect a cure of established infection. In
      contrast, SDD as originally conceived may well prove cost-effective for the
      prevention of infection in intensive care although neither the optimum regimen
      nor the patient group who would gain most benefit have been defined. None the
      less, by affording protection against Gram-negative sepsis, both SDD and PET
      would reduce the pressure on the clinicians to treat empirically and shift the
      emphasis once more on appropriate investigations which would involve the
      microbiologist more directly and immediately in patient care. Any savings from
      lowering the drug usage could then be diverted to improving diagnosis and
      providing the regular monitoring that is essential to the success of both PET and
      SDD.

PMID- 8360123
TI  - Mutator plasmid in a nalidixic acid-resistant strain of Shigella dysenteriae type
      1.
AB  - A clinical isolate of Shigella dysenteriae from Kashmir, resistant to seven
      antibacterial agents including nalidixic acid, carried four plasmids, only one of
      which was transferable by conjugation. This plasmid, designated pYD1, conferred
      trimethoprim resistance and increased the frequency of mutation to nalidixic acid
      resistance in recipient strains. Thus, although nalidixic acid resistance was not
      carried on a transferable plasmid, the presence of pYD1 increased the frequency
      at which the strain mutated to nalidixic acid resistance.

PMID- 8360124
TI  - The use of a DNA probe and PCR to examine the distribution of the aac(6')-Ic gene
      in Serratia marcescens and other gram-negative bacteria.
AB  - A nucleotide probe for the chromosomal aminoglycoside 6' acetyltransferase gene
      (aac(6')-Ic) of Serratia marcescens was used in non-radioactive dot-blot
      hybridization experiments with 186 strains belonging to ten different species of
      Serratia. The gene was only detected in strains of S. marcescens (all strains
      tested), and positive hybridization was seen irrespective of whether or not
      strains were kanamycin-resistant. An additional 180 strains belonging to 28 Gram
      negative bacterial species other than in the genus Serratia did not hybridize
      with the probe. A rapid PCR test for the aac(6')-Ic gene was developed and used
      to confirm that the aac(6')-Ic gene is only found in S. marcescens. Southern
      hybridization analysis of S. marcescens chromosomal DNA demonstrated that the
      gene was usually located on a PvuII fragment with a putative isoleucine tRNA-2
      gene, but polymorphisms with respect to the size of this fragment were observed.

PMID- 8360125
TI  - Accumulation and killing kinetics of fifteen quinolones for Escherichia coli,
      Staphylococcus aureus and Pseudomonas aeruginosa.
AB  - The accumulation of fifteen quinolone antimicrobial agents (nalidixic acid, eight
      mono-fluorinated agents, three di-fluorinated agents and three tri-fluorinated
      agents) by Escherichia coli KL16, Staphylococcus aureus NCTC 8532 and Pseudomonas
      aeruginosa NCTC 10662 was studied. The concentration of quinolones accumulated
      varied with the quinolone and the bacterial species, and was not affected by the
      number of fluorine atoms on the quinolone nucleus. There was also no direct
      relationship between the hydrophobicity or the molecular size of each drug and
      accumulation or activity. The killing of the three strains by the fifteen
      quinolones at a concentration of 10 mg/L was determined in broth and phosphate
      buffer to mimic the conditions of the accumulation assay. The bactericidal
      activity varied with the agent and the strain, and usually reflected the in-vitro
      activity of the drug. Despite most agents causing a decrease in the viable count
      of the three strains there was no detectable effect on the pattern of
      accumulation of the quinolones.

PMID- 8360126
TI  - Studies on the postantibiotic effect and the postantibiotic sub-MIC effect of
      meropenem.
AB  - The postantibiotic effect (PAE), the postantibiotic sub-MIC effect (PA SME) and
      the sub-MIC effect (SME) of a new carbapenem, meropenem, were determined for
      different strains of Escherichia coli and Pseudomonas aeruginosa. A PAE was
      induced by 10 x MIC of meropenem for 2 h. After induction, the antibiotic was
      eliminated by washing and dilution. The strains in the postantibiotic exposure
      phase and the controls were then exposed to no antibiotic or to different sub
      MICs concentrations (0.1-0.6 x MIC) of meropenem. The growth curves were followed
      for 24 h with viable counts and/or measured by continuous monitoring of optical
      density in a BioScreen C apparatus. Zero or very low values for the PAE were seen
      in the strains studied. However, a long PA SME and SME were seen for P.
      aeruginosa when determined by both methods, which at 0.3 x MIC gave comparable
      results. At lower concentrations the PA SMEs measured with BioScreen C were
      shorter, probably due to differences in the definition between the two methods.
      The BioScreen C method was less laborious than viable counting. However, one
      disadvantage of the BioScreen C method was that manual viable counting still had
      to be used to determine bacterial killing. No PA SME or SME against E. coli was
      observed, and the increased sensitivity of P. aeruginosa to sub-MICs of
      carbapenems remains unexplained.

PMID- 8360127
TI  - Influence of methylprednisolone on the intracellular antimicrobial activity of
      erythromycin and clindamycin against Legionella pneumophila.
AB  - We have investigated the effect of methylprednisolone on the intracellular
      activity of erythromycin and clindamycin in vitro. An assay system was developed
      for the determination of intracellular activity of antibiotics against Legionella
      pneumophila using guinea pig resident alveolar macrophages. Erythromycin at a
      concentration of 0.625 mg/L (5 x MIC) and clindamycin at a concentration of 8
      mg/L (MIC) inhibited the growth of a single strain of L. pneumophila in
      macrophages, whilst ceftizoxime at a concentration of 0.625 mg/L (5 x MIC) did
      not. Methylprednisolone at therapeutic concentrations did not affect the
      intracellular antibacterial activity of either erythromycin or clindamycin
      against L. pneumophila. We found no direct effect of methylprednisolone on the
      intracellular antibacterial activity of either erythromycin or clindamycin.

PMID- 8360128
TI  - Treatment of familial staphylococcal infection--comparison of mupirocin nasal
      ointment and chlorhexidine/neomycin (Naseptin) cream in eradication of nasal
      carriage.
AB  - Twenty-six families with recurrent staphylococcal infections were treated with
      either mupirocin nasal ointment (group M) or chlorhexidine neomycin (Naseptin)
      cream (group N) to the anterior nares, each combined with chlorhexidine soap for
      washing and chlorhexidine powder applied to other possible carriage sites.
      Patients receiving mupirocin following failure with chlorhexidine/neomycin (group
      M/N) were also treated. Treatment was given for seven days to 99 patients, 32
      index (infected) patients and 67 family members. Follow-up swabs were collected
      by a study nurse 8, 14, 28, and 91 days after starting treatment. The carriage of
      Staphylococcus aureus in the anterior nares was 67%, in the axillae 22%, in the
      groin 23%, and perianal 19%. The carriage rates in the index patients was higher
      than family members, in all sites. The eradication of S. aureus from the nasal
      carriage site after therapy at 8 days was 95% in group M, 85% in group M/N and
      61% in group N. Recolonization during the follow-up period was much less in those
      treated with mupirocin: 57% of patients in group M and 42% in group M/N were not
      carriers at 91 days, whereas 89% of patients group N were again colonized.
      Assessment clinically and in terms of prevention of further infective lesions
      showed that there was a higher response to mupirocin than to
      chlorhexidine/neomycin. Mupirocin nasal is a successful therapy for removing
      nasal carriage of S. aureus and has a prolonged effect on recolonization.

PMID- 8360129
TI  - Emergence of antibiotic resistance amongst Pseudomonas aeruginosa isolates from
      patients with cystic fibrosis.
AB  - We investigated the emergence of resistance to 15 anti-pseudomonal antibiotics
      amongst Pseudomonas aeruginosa isolates from 34 chronically colonized patients
      with cystic fibrosis by comparing the susceptibilities of strains isolated before
      1987 and after 1989 from the same patients. Strains obtained after 1989 from a
      further 19 patients who were newly colonized served as controls. The 34 pairs of
      isolates demonstrated a marked increase in resistance which could not be
      accounted for by a general increase in resistance during the intervening years
      since the susceptibility patterns of strains isolated before 1987 were similar to
      those of strains isolated from patients in the control group. There was a strong
      correlation between this increase in resistance and both the frequency of
      admissions to and the number of days spent in hospital. Cluster analysis of the
      changes in susceptibility for individual antibiotics revealed four distinct
      patterns of resistance: the fluoroquinolones, with the exception of ofloxacin;
      the aminoglycosides; the ureidopenicillins and aztreonam; and the cephalosporins,
      carbapenems, carboxypenicillins and ofloxacin. We conclude that the long-term
      administration of anti-pseudomonal antibiotics to patients who are chronically
      colonized with P. aeruginosa is associated with the development of resistance.

PMID- 8360130
TI  - Monotherapy in serious hospital-acquired infections: a clinical trial of
      ceftazidime versus imipenem/cilastatin. European Study Group.
AB  - The clinical and bacteriological efficacy and safety of the antibiotics
      ceftazidime or imipenem/cilastatin in seriously ill patients with nosocomial
      infections were compared in a prospective, open, evaluator-blind, multicentre
      comparative trial. The study was performed in 26 European centres, the majority
      being intensive care units. Subjects were randomized to receive either
      ceftazidime 2 g bid or imipenem cilastatin 0.5 g qid given for at least five days
      after stratification for pneumonia, septicaemia or urinary tract infection (UTI).
      Three hundred and ninety-three patients with serious nosocomial infections (254
      with pneumonia; 91 with septicaemia and 48 UTI were treated between February 1988
      and January 1990 and their clinical and bacteriological response to antibiotic
      treatment assessed. There were no significant differences between ceftazidime and
      imipenem/cilastatin in clinical efficacy. The failure rates in evaluable patients
      were 22 and 26% in pneumonia, 23 and 19% in septicaemia and 0 and 5% respectively
      in those with UTI. Overall there was no significant difference between the two
      antibiotics for bacteriological response in the three infection strata. However,
      in patients with pneumonia ceftazidime was significantly more effective than
      imipenem/cilastatin in clearing patients of Pseudomonas spp.: 3/17 and 11/19
      patients respectively had persistent growth of Pseudomonas spp. post-treatment (P
      = 0.004), and in one ceftazidime failure resistance emerged compared to six
      imipenem/cilastatin failures in which resistance emerged. Few drug-related
      adverse events were recorded in either treatment group. Monotherapy with either
      ceftazidime (2 g bid) or imipenem/cilastatin (0.5 g qid) is safe and effective
      and could be considered as an alternative to combination therapy for the
      treatment of serious hospital-acquired infections.

PMID- 8360131
TI  - Once- versus twice-daily amikacin regimen: efficacy and safety in systemic gram
      negative infections. Scandinavian Amikacin Once Daily Study Group.
AB  - Three hundred and sixteen patients with serious infections verified or suspected
      to be of Gram-negative aetiology were treated in an open, randomized, comparative
      multicentre study with amikacin 15 mg/kg/day given either as a single dose or in
      two divided doses at 12 h intervals. Two hundred patients were evaluated for
      efficacy and all 316 for safety. The efficacy of both dosage regimens was very
      good with a satisfactory clinical response in 90% of the patients. There were no
      significant differences between the two regimens regarding efficacy and safety.
      This was also confirmed in an analysis according to the principle of 'intention
      to-treat' including all randomized patients. In 218 patients additional therapy,
      most commonly with piperacillin or ampicillin, was considered necessary. The mean
      peak serum concentration of amikacin was 40.9 mg/L in the once-daily group, which
      is 10 x MIC for most Gram-negative bacteria, compared to 24.4 mg/L in the twice
      daily group, which is 6 x MIC. Mean trough serum concentrations after 24 h were
      1.8 mg/L in the once-daily group and 3.1 mg/L after 12 h in the twice-daily
      group. These serum concentrations were often close to or just below the MICs of
      the isolated pathogens. Drug related adverse reactions were seen in 40 (13%) of
      the patients. Among the adverse reactions with possible or probable relation to
      amikacin were 20 nephrotoxic events, nine in the once-daily group and 11 in the
      twice-daily group. A multivariate analysis of selective causative factors and
      nephrotoxic events gave a low correlation for once- vs twice-daily amikacin
      therapy. Five ototoxic events were observed, three in the once-daily group and
      two in the twice-daily group. One patient in the once-daily group experienced
      nausea in connection with amikacin infusions.

PMID- 8360132
TI  - Loracarbef versus doxycycline in the treatment of acute bacterial maxillary
      sinusitis. Scandinavian Study Group.
AB  - In a double-blind, multicentre study, 662 patients with acute maxillary sinusitis
      were randomly assigned to receive either loracarbef 400 mg bd (332 patients) or
      doxycycline, 200 mg for the first dose followed by 100 mg od, (330 patients) for
      ten days. One hundred and sixty-eight patients in the loracarbef group and 164 in
      the doxycycline group were evaluable for efficacy. Streptococcus pneumoniae
      and/or Haemophilus influenzae were isolated from approximately 75% of patients.
      The clinical response rate (cure or improvement) was significantly higher for
      patients receiving loracarbef (98.2%) than for those who received doxycycline
      (92.2%). There was no significant difference between the two groups with respect
      to bacteriological outcome, although more of the pre-treatment isolates were
      resistant to doxycycline (35 strains) than to loracarbef (five strains). Adverse
      events related to the gastrointestinal tract occurred in 11.7% and 10.6% of
      loracarbef- and doxycycline-treated patients respectively; therapy was terminated
      prematurely in ten patients in the loracarbef group and in nine in the
      doxycycline group. The results indicate that loracarbef is effective and safe
      treatment for acute maxillary sinusitis.

PMID- 8360133
TI  - Clarithromycin versus cefaclor for the treatment of mild-to-moderate acute
      bacterial bronchitis.
AB  - Four hundred and eight outpatients with the clinical signs and symptoms of mild
      to-moderate acute bronchitis of bacterial aetiology were enrolled in a
      multicentre, double-blind, randomized clinical trial comparing the efficacy and
      safety of clarithromycin and cefaclor, both administered orally. Two hundred and
      seven patients received clarithromycin 250 mg bd and 201 patients received
      cefaclor 500 mg tds for a maximum of seven days. Clinical and bacteriological
      evaluations were performed before treatment was initiated, during the course of
      treatment, and within 72 h of completing therapy; all adverse events were
      recorded. Two hundred and three patients in the clarithromycin group and 195 in
      the cefaclor group were evaluable for clinical response and 129 and 124 patients
      in the clarithromycin and cefaclor groups, respectively, were evaluable for
      bacteriological response. The clinical response rates three to five days after
      starting treatment and at the post-treatment assessment were 97% (193/199) and
      99.5% (202/203), respectively, for the clarithromycin group and 97.4% (187/192)
      and 97.9% (191/195), respectively, for the cefaclor group. The bacteriological
      cure rates were 94.6% (122/129) for the clarithromycin group and 90.3% (112/124)
      for the cefaclor group. None of the differences between the groups was
      statistically significant. Adverse events, which were generally mild and
      predominantly related to the gastrointestinal tract, were reported by 5.8% of
      clarithromycin-treated patients and 10.4% of cefaclor-treated patients. Adverse
      reactions caused one patient in the clarithromycin group and three in the
      cefaclor group to discontinue treatment prematurely. The results of this study
      indicate that clarithromycin and cefaclor are comparable with respect to efficacy
      and safety when used as treatment for patients with mild-to-moderate acute
      bacterial bronchitis.

PMID- 8360135
TI  - The management of infections and antibiotic therapy: a European survey.
AB  - A survey was undertaken in the five largest European countries in 1990/91 to
      measure the incidence of infectious diseases and record their antibiotic
      treatment, and usage as prophylaxis in acute general hospitals with over 300
      beds. A representative sample of between 1234 and 1954 patient records were
      received for each country, with each participating clinician providing eight to
      ten records. Data were projected up to national totals. There were similarities
      between the patients across the countries, 50% of patients received surgery at
      some time in their hospital stay and in 45% the first antibiotic usage was as
      prophylaxis. In one fifth of the 55% treated for an infection, that infection was
      hospital acquired, but these 20% of patients accounted for 30% of total days in
      hospital for patients treated for infection. Infections of the lower respiratory
      tract, urinary tract and abdomen accounted for 75% of all infection cases. In 85%
      of infection cases, initial treatment was empirical. Overall, no culture and
      sensitivity data were reported by the end of treatment in over 50% of patients,
      with appreciable variation between the countries. In the UK, 60% of in-patient
      treatment was with oral antibiotics; in Italy, over 80% was injectable with over
      half that intramuscular. Germany had the highest rate of intravenous
      administration at nearly 60% of treatment days. Combination usage was highest,
      with over 30% of patient treatment days, in France and Spain, but Germany and
      Italy had the lowest usage at 21% and 16%. Mean duration of administration of
      antibiotics was shortest in the UK, eight days for infection and four days for
      prophylaxis, with France the longest at 12 days for infection, and Italy for
      prophyalxis at over five days. The UK had the highest rate of discharge on
      antibiotic treatment at over 30% of patients. Initial therapy was effective in
      about 90% of patients, but the UK, with the shortest durations and the greatest
      use of older antibiotics often as monotherapy and administered orally, had the
      highest rate of initial failure (> 10%) of both treatment of infection and
      prophylaxis. The result of initial failure was a significant prolongation of both
      hospital stay and antibiotic treatment. The 10% of initial treatment failures
      accounted for 15% of antibiotic usage in the UK. In France initial treatment
      failures were treated for twice the length of those in whom the initial therapy
      was successful.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8360136
TI  - Ovarian dysgerminoma: a therapeutic challenge.
AB  - Dysgerminoma remains a rare but quite interesting tumor. Over the last 40 years,
      the prognosis has markedly improved with a 5 year survival increasing from around
      30% to more than 80%. Precise diagnosis and adequate staging are mandatory to
      define the best treatment approach aiming to cure the woman, while preserving her
      quality of life (ovarian function and fertility).

PMID- 8360134
TI  - Randomized comparison of oral fluconazole versus oral polyenes for the prevention
      of fungal infection in patients at risk of neutropenia. Multicentre Study Group.
AB  - An open, randomized study was performed at 18 European centres to compare the
      efficacy, safety and tolerance of oral fluconazole with oral polyenes for the
      prophylaxis of fungal colonization and infection in adults at high risk of
      developing neutropenia. Five hundred and thirty-six hospitalized patients with
      malignant disease, about to receive chemotherapy, radiotherapy, or bone marrow
      transplantation, and who were already neutropenic or were expected to develop
      neutropenia were included in the study. Before therapy or transplantation,
      patients commenced either oral fluconazole therapy (50 mg/day as a single dose)
      or oral polyenes therapy (amphotericin B 2 g/day and/or nystatin 4 x 10(6)
      units/day in four or more divided doses), for a mean of 29.3 days and 31.3 days,
      respectively. After baseline clinical and mycological testing, patients were re
      evaluated at least weekly during prophylaxis, at the end of prophylaxis and two
      to six weeks later to identify proven or suspected fungal infection and to
      determine rates of colonization with fungi. Fungal infection was diagnosed in 41
      of 511 evaluable patients, 10 (3.9%) of 256 in the fluconazole group and 31
      (12.2%) of 255 in the polyene group (P = 0.001). This total included four
      patients (1.6%) in the fluconazole group who developed oropharyngeal candidiasis
      compared with 22 (8.6%) in the polyene group (P < 0.001). Systemic infections
      comprised 6 (2.3%) in the fluconazole group and 9 (3.5%) in the polyene group (P
      = not significant), and included three Candida krusei infections in each group.
      Parenteral amphotericin B therapy was given empirically for persistent fevers in
      an additional 62 (24.2%) patients receiving fluconazole and 59 (23.1%) receiving
      polyenes (P = not significant). Colonization with fungi was generally similar in
      each treatment group, although an increased proportion of patients receiving
      fluconazole developed colonization of the faeces (P < 0.01). Adverse reactions,
      possibly related to treatment, were recorded in 15 (5.6%) of 269 patients in the
      fluconazole group and 14 (5.2%) of 267 in the polyene group; these necessitated
      discontinuation of therapy in seven patients in each group. Once-a-day
      fluconazole was therefore more effective than oral polyenes for the prevention of
      oropharyngeal fungal infection and as effective for the prevention of infections
      at other sites in patients with neutropenia.

PMID- 8360137
TI  - Epidemiology and clinical aspects of testis tumors.

PMID- 8360138
TI  - Experience with high dose chemotherapy and autologous bone marrow transplantation
      in testicular cancer.
AB  - Carboplatin based HDCT followed by ABMT produces reasonable response rates (40
      60%) and some durable remissions in patients with advanced and cisplatin
      resistant testicular cancer. Patients eligible for such an approach are those
      with primary refractory or recurrent disease and low probability for salvage by
      conventional dose regimens. The use of recombinant human growth factors and
      peripheral stem cell transplantation will probably reduce the toxicity and
      mortality of HDCT.

PMID- 8360139
TI  - Rat intestinal fatty acid binding protein. A model system for analyzing the
      forces that can bind fatty acids to proteins.

PMID- 8360140
TI  - Peptidomimetic inhibitors of Ras farnesylation and function in whole cells.
AB  - The ras protooncogene is involved in regulation of cell growth. Mutations that
      activate the protein result in uncontrolled cell growth. Ras undergoes a series
      of posttranslational processing events, the first of which, farnesylation, is
      crucial for the function of the protein. Inhibitors of the farnesyltransferase
      enzyme are therefore potential candidates for the development of anticancer
      drugs. Tetrapeptides have been reported to be good inhibitors of this enzyme in
      vitro. We have synthesized analogs of the tetrapeptide Cys-Val-Phe-Met by
      replacement of the amino-terminal amide bonds. One inhibitor, B581, is permeable
      to the cell membrane. In the cell, it inhibits processing of two farnesylated
      proteins, H-ras and lamin A, but it does not inhibit processing of a
      geranylgeranylated protein, Rap 1A. Microinjection of B581 into frog oocytes
      inhibits maturation induced by activated, farnesylated H-ras but not maturation
      induced by activated, geranylgeranylated H-ras or by progesterone. These results
      demonstrate that this peptide mimic inhibits farnesylation selectively in the
      cell. The inhibition of farnesylation results in inhibition of H-ras function.

PMID- 8360141
TI  - Identification of a small GTP-binding protein, Rab25, expressed in the
      gastrointestinal mucosa, kidney, and lung.
AB  - Small GTP-binding proteins have been implicated in the regulation of many dynamic
      cellular processes. The carboxyl termini of parietal cell small GTP-binding
      proteins were cloned using a 3'-rapid amplification of cDNA ends (RACE) technique
      with a degenerate oligonucleotide primer based on the WDTAGQE consensus GTP
      binding sequence. Six out of 53 clones demonstrated a novel Rab sequence, now
      designated Rab25. The complete sequence was obtained using 3'-RACE and revealed a
      deduced amino acid sequence having 63% identity with Rab11. The deduced amino
      acid sequence demonstrated a carboxyl-terminal CCQNI and also a novel GTP-binding
      site sequence of WDTAGLE. Nevertheless, recombinant Rab25 was able to bind GTP on
      blot. A major 1.2 kilobase Rab25 message was detected throughout the
      gastrointestinal mucosa and in lung and kidney tissue. No message was detected in
      brain, heart, liver, or skeletal muscle. In gastric tissue, Rab25 was absent in
      the bowel wall; among mucosal cells, it was highly enriched in parietal cells
      compared to chief cells. Rab25 mRNA was also detected in several colon carcinoma
      lines including LIM1215 and HT-29. The results indicate that Rab25 represents a
      novel member of the Rab family with an epithelial distribution.

PMID- 8360142
TI  - Cleavage of cellubrevin by tetanus toxin does not affect fusion of early
      endosomes.
AB  - Tetanus toxin is a potent inhibitor of neurotransmitter release, which acts as an
      intracellular metalloendoprotease that selectively cleaves synaptobrevin, a major
      membrane protein of synaptic vesicles. Recently, synaptobrevin has been found to
      form an ATP-dependent complex with N-ethylmaleimide-sensitive fusion protein
      (NSF) and soluble NSF attachment protein, which are known to function in endosome
      fusion. Furthermore, a highly homologous isoform of synaptobrevin, named
      cellubrevin, was identified that is expressed in virtually all tissues in the
      endocytic pathway and is cleaved by tetanus toxin light chain in vitro,
      suggesting that cellubrevin may have a general function in intracellular fusion
      events. In the present study, we have analyzed whether cleavage of cellubrevin by
      tetanus toxin influences the ATP-dependent, N-ethylmaleimide-sensitive fusion of
      early endosomes in vitro. Our results show that endosome fusion is not affected
      by tetanus toxin although cellubrevin is almost completely proteolyzed,
      suggesting that the function of NSF in endosome fusion does not involve
      cellubrevin.

PMID- 8360143
TI  - The role of phosphorylation in activation of the alpha 6A beta 1 laminin
      receptor.
AB  - The phorbol ester phorbol 12-myristate 13-acetate (PMA) induces phosphorylation
      of serine residues in the cytoplasmic domain of the alpha 6A integrin subunit, as
      well as activation of the alpha 6A beta 1 laminin receptor. We examined whether
      phosphorylation correlates with the induction of high affinity binding of laminin
      by the alpha 6A beta 1 receptor. Two potential phosphorylation sites for protein
      kinase C, serine 1041 and serine 1048, are present in the cytoplasmic domain of
      the alpha 6A subunit. We introduced point mutations into the alpha 6A cDNA,
      replacing either one or both of the serine residues with alanine. Wild-type and
      mutant alpha 6A cDNAs were transfected into K562 cells. All alpha 6A subunit
      mutants were expressed at levels similar to those of wild-type alpha 6A and
      formed heterodimers with endogenous beta 1. Analysis of the phosphorylation state
      of wild-type and mutant alpha 6A subunits in resting K562 cells and after
      treatment with PMA showed that serine 1041, but not serine 1048, is the target
      residue of PMA-induced phosphorylation. Cells expressing alpha 6A mutant subunits
      or wild-type alpha 6A transfectants all bound laminin in the presence, but not in
      the absence of PMA; however, the extent of binding differed. Cells transfected
      with alpha 6A containing the serine to alanine mutation showed a 2-3-fold higher
      binding to laminin than cells transfected with alpha 6A containing serine 1041.
      The results indicate that phosphorylation of the alpha 6A cytoplasmic domain is
      not required for the induction of high affinity of the alpha 6A beta 1 receptor
      by PMA, and suggest that, in contrast, it may reduce the affinity of this
      integrin for ligand.

PMID- 8360144
TI  - Cell cycle-dependent suppressive effect of histone H1 on mitosis-specific H3
      phosphorylation.
AB  - To analyze the mechanism by which histone H3 phosphorylation occurs specifically
      during mitosis, the effect of H1 on mitosis-specific H3 phosphorylation (Ser-10)
      was investigated in nucleosomes. H1 interaction with H1-depleted nucleosomes
      suppressed H3 phosphorylation including Ser-10 by approximately 50%. However, H1
      interaction with DNA-free histone octamers failed to suppress H3 phosphorylation.
      The extent of suppression of H3 phosphorylation in nucleosomes with H1 prepared
      from synchronized HeLa cells was cell cycle-dependent. Binding with a highly
      phosphorylated mitotic H1 produced the least suppression of H3 phosphorylation,
      whereas binding with a lower H1 phosphorylation from G1 phase resulted in the
      greatest suppression. The results suggest that 1) mitotic H3 phosphorylation is
      suppressed with a lower level of H1 phosphorylation during interphase and 2)
      highly phosphorylated H1 during mitosis partially releases the suppression of
      mitotic H3 phosphorylation.

PMID- 8360146
TI  - Direct energization of bile acid transport into plant vacuoles.
AB  - Bile acids were shown to be transported into barley mesophyll vacuoles. Uptake of
      the cholate conjugates taurocholate and glycocholate is strictly ATP-dependent.
      Uptake of taurocholate is a saturable process (Km = 40 microM) and is inhibited
      by vanadate but not by bafilomycin, a specific inhibitor of the vacuolar H(+)
      ATPase. Together with the observation that the non-hydrolyzable ATP analog AMPPNP
      (5'-adenylyl beta,gamma-imidodiphosphate) does not stimulate, but rather
      inhibits, the ATP-dependent uptake of taurocholate, and that a 3-fold
      accumulation of the bile acid is observed in the presence of bafilomycin, these
      results suggest that taurocholate is transported into the vacuole by a primary
      active process as is the case for its canalicular secretion in rat liver
      (Nishida, T., Gatmaitan, Z., Che, M., and Arias, I. M. (1991) Proc. Natl. Acad.
      Sci. U. S. A. 88, 6590-6594). Taurocholate uptake is inhibited by other bile
      acids and is slightly stimulated by glutathione S-conjugates. The different
      responses of the glutathione S-conjugate (Martinoia, E., Grill, E., Tommasini,
      R., Kreuz, K., and Amrhein, N. (1993) Nature 364, 247-249) and the taurocholate
      transporters, respectively, to substrates, oligomycin, GTP, and UTP suggest the
      presence of at least two ATPases specifically involved in the transport of
      conjugates across the tonoplast. As cholate and its conjugates have so far not
      been reported to occur in plants, the physiological function of the novel
      transport ATPase described here is presently unknown.

PMID- 8360145
TI  - Germline manipulation of glucose homeostasis via alteration of glucose
      transporter levels in skeletal muscle.
AB  - Transgenic mice were constructed that overexpress the human Glut1 glucose
      transporter in skeletal muscle. Transcription of the human Glut1 cDNA was driven
      by the rat myosin light chain 2 promoter. Soleus and quadriceps muscles from
      transgenic mice expressed increased levels of Glut1 protein relative to muscles
      obtained from nontransgenic littermates, but there was no difference in the level
      of Glut4 protein between the two groups. Skeletal muscles isolated from the
      transgenic animals exhibited 3-4-fold increases in basal glucose uptake relative
      to muscles obtained from nontransgenic littermates. Muscles isolated from
      nontransgenic littermates exhibited 2-3-fold increases in glucose transport after
      incubation in the presence of insulin, but no insulin-stimulated increase in
      transport was observed in the muscles of transgenic mice. Plasma glucose levels
      were reduced by 18 and 30%, respectively, in fed and fasted transgenic mice
      relative to their nontransgenic siblings, but insulin and glucagon levels were
      not significantly different between the two groups. Glucose disposal following an
      oral glucose load was markedly enhanced in the transgenic animals, and plasma
      lactate and beta-OH-butyrate levels were elevated in both fed and fasted
      transgenic mice. These data strongly support the hypothesis that glucose
      transport plays a key role in whole body glucose homeostasis. They also
      demonstrate that the level of a glucose transporter in skeletal muscle can
      significantly influence the blood glucose set point and alter the levels of other
      fuel metabolites in the blood.

PMID- 8360147
TI  - The structure of Leishmania major amastigote lipophosphoglycan.
AB  - Intracellular amastigotes of Leishmania major produce 6 x 10(4) copies/cell of a
      lipophosphoglycan (LPG) that is structurally distinct from the LPG produced by
      the extracellular promastigote form of L. major, Leishmania donovani, and
      Leishmania mexicana (reviewed by McConville, M. J. (1991) Cell Biol. Int. Rep.
      15, 779-798). L. major amastigote LPG is composed of a lysoalkyl
      phosphatidylinositol lipid anchor that links via a diphosphorylated
      hexasaccharide core to a phosphoglycan (6-100 kDa). The structures of the anchor,
      the core, and the phosphoglycan were determined by monosaccharide and linkage
      analysis, fast atom bombardment-mass spectrometry, one-dimensional 1H NMR
      spectroscopy, and exoglycosidase microsequencing. The lipid anchor contains
      predominantly 1-O-alkylglycerols with 24:0 and 22:0 alkyl chains. The lipids are
      linked via a glycerol-myo-inositol-PO4 to a core glycan with the structure -PO4
      6)Gal(alpha 1-)Gal(alpha 1-) Galf(beta 1-)[Glc(alpha 1-PO4-)]Man(alpha 1
      )Man(alpha 1-)GlcN(alpha 1-). The chromatographic characteristics of the core
      glycan suggest that the saccharide components are linked similarly in amastigote
      and promastigote LPG. The phosphoglycan attached to the core consists of -PO4
      6)Gal(beta 1-4)Man(alpha 1- repeats units which are either unsubstituted (70%) or
      substituted (30%) at the 3-position of the Gal residues with oligosaccharide side
      chains containing primarily Gal and some Glc. Thirteen different types of side
      chains were identified with the structures [Gal(beta 1-3)]x, where x = 1-11, or
      Glc(1-3)Glc(1-3), or Glc(1-3)Gal(beta 1-3), where glucose is probably in the beta
      configuration. All monosaccharides in the phosphoglycan domain are in the
      pyranose configuration. The average number of repeat units per molecule is 36.
      The nonreducing terminus of the phosphoglycan chains probably terminates
      predominantly in the neutral disaccharide Gal(beta 1-4)Man(alpha 1-. Comparison
      of the structure of L. major amastigote LPG to L. major promastigote procyclic
      and metacyclic LPG forms (McConville, M. J., Turco, S. J., Furguson, M. A. J.,
      and Sacks, D. L. (1992) Embo J. 11, 3593-3600) indicates that this molecule is
      developmentally modified throughout the different stages of the parasites' life
      cycle.

PMID- 8360148
TI  - Ligand-specific dimerization of the extracellular domain of the bovine growth
      hormone receptor.
AB  - The bovine growth hormone (bGH) receptor and its extracellular domain (bGHBP)
      bind two protein hormones with high affinity; bGH and bovine placental lactogen
      (bPL). However, each of these hormones bind with a different stoichiometry. bGH
      binds to the bGHBP in a 1:2 ratio while bPL binds in a 1:1 ratio. Scatchard
      analysis of saturation binding yields similar apparent dissociation constants
      (Kd) for bGH and bPL of 1.4 x 10(-11) M and 3.0 x 10(-11) M, respectively, for
      the membrane receptor and 6.8 x 10(-11) M and 4.2 x 10(-11) M, respectively, for
      bGHBP. In competition experiments using either liver membranes or bGHBP, bGH is 2
      3-fold more effective than bPL in competing for 125I-bGH-binding sites. In
      similar experiments using 125I-bPL, bPL is 50-fold more effective than bGH in
      competing for binding sites. A rat monoclonal antibody raised against bGHBP
      competes effectively for 125I-bGH-binding sites, but not for 125I-bPL-binding
      sites. Since bPL cannot dimerize the bGHBP and yet it acts in part as a somatogen
      in vivo, homodimerization of the growth hormone receptor is apparently not
      essential for some biological responses signaled through this receptor.

PMID- 8360149
TI  - Identification of a transcript that is down-regulated in senescent human
      fibroblasts. Cloning, sequence analysis, and regulation of the human L7 ribosomal
      protein gene.
AB  - Normal eukaryotic cells divide only a limited number of times before
      proliferation ceases due to cellular senescence. We previously reported that a
      constitutively expressed, non-cell cycle-regulated transcript of unknown identity
      declines severalfold when human fibroblasts become senescent. We show here, from
      the sequence of cDNA and genomic clones, that this transcript encodes L7, a
      structural protein of the large ribosomal subunit. The human L7 protein shares >
      90% amino acid identity with the mouse and rat L7 proteins but is shorter than
      either rodent protein due to fewer basic repetitive motifs at the amino terminus.
      The position of the first intron is conserved between the mouse and human genes.
      The L7 mRNA was abundant, stable (t1/2 > 10 h), and polyadenylated in
      presenescent and senescent human fibroblasts; however, steady state mRNA levels
      were 5-10-fold lower in senescent cells, whether derived from fetal lung or
      neonatal foreskin. Quiescent and senescent cells synthesized protein at similar
      rates, yet only senescent cultures showed a decline in L7 mRNA. The mRNAs
      encoding five other ribosomal proteins (L5, P1, S3, S6, and S10) behaved
      similarly. The results suggest that the senescence-associated decline in L7 and
      other ribosomal protein mRNAs is unrelated to growth state or protein synthetic
      rate per se and support the view that senescence and quiescence are dissimilar
      states.

PMID- 8360150
TI  - Utilization of conformational flexibility in enzyme action-linkage between
      binding, isomerization, and catalysis.
AB  - An intimate relationship between protein conformational changes and catalysis has
      often been suggested. The present study employs ligand-induced ultraviolet
      difference spectra and kinetic parameters determined for Escherichia coli
      ornithine transcarbamoylase and its site-specific mutants to evaluate the linkage
      between binding, isomerization, and reaction rate. For the wild-type enzyme, the
      lead substrate carbamoyl phosphate introduces a large difference absorbance in
      the enzyme upon binding (delta epsilon max approximately 1,800 M-1 cm-1; Miller,
      A. W., and Kuo, L. C. (1990) J. Biol. Chem. 265, 15023-15027). The spectrum is
      the same in lineshape as that produced by the bisubstrate analog N
      (phosphonacetyl)-L-ornithine and is 80% as intense. Both substrate and analog
      cause gross protein conformational rearrangements as evident by swift and severe
      cracking of enzyme crystals in their presence. For the mutants, the difference
      spectra actuated by the substrate are the same in lineshape as that of the wild
      type but vary in intensity. A wide range of substrate affinity and steady-state
      kinetic constants are also observed for the mutants. When the binding energy of
      carbamoyl phosphate and the activation energy for transcarbamoylation are
      calculated for the wild-type and mutant enzymes, they are found to be inversely
      correlated to the intensity of protein difference absorbance elicited by the lead
      substrate. Together with analyses of steady-state kinetic parameters derived for
      various plausible reaction schemes, the experimental data suggest that carbamoyl
      phosphate induces the committed isomerization in ornithine transcarbamoylase for
      transition state binding. Our results provide a unique demonstration that an
      induced-fit isomerization, triggered by binding, either controls or contributes
      significantly to the rate of an enzyme-catalyzed reaction.

PMID- 8360151
TI  - The oxidation of blood plasma and low density lipoprotein components by
      chemically generated singlet oxygen.
AB  - Human blood plasma and freshly isolated LDL were exposed to singlet oxygen (1O2)
      by thermal decomposition of synthetic endoperoxides. Exposure of blood plasma to
      20 mM water-soluble 1O2 generator resulted in the depletion of ascorbate (100%),
      urate (75%), ubiquinol-10 (65%), protein thiols (50%), and bilirubin (25%),
      whereas under these conditions the levels of alpha-tocopherol, beta-carotene, and
      lycopene remained unchanged. The following rates of depletion were obtained by
      kinetic analysis (moles depleted per 100 mol of 1O2 consumed): protein thiols
      (5), urate (5), ascorbate (4), bilirubin (1), and ubiquinol-10 (0.008). In
      contrast, the rates of depletion using the lipid-soluble 1O2 generator were
      faster for bilirubin (13-fold), protein thiols (9-fold), ubiquinol-10 (8-fold),
      and ascorbate (5-fold), and slower for urate (2-fold). The formation of lipid
      hydroperoxides, including mostly cholesteryl linoleate hydroperoxide, was
      observed in 1O2-treated plasma (0.007-0.009 mol/100 mol 1O2) and LDL solutions
      (0.086 mol/100 mol 1O2). Based on competition kinetics, we estimate that 98% of
      1O2 generated in the aqueous phase of plasma is quenched by components in this
      phase, mostly by plasma protein (63%; 6% by protein thiols), urate (9%; 5% by
      chemical quenching), and bilirubin (5%; 1% by chemical quenching). Ascorbate and
      ubiquinol-10 do not contribute to 1O2 quenching in plasma, and their oxidation is
      probably mediated secondary species. The remaining 1O2 generated in plasma (2%)
      diffuses into lipoprotein leading to the formation of lipid hydroperoxides with
      an efficiency of about 100-fold greater than that compared to aqueous generated
      1O2. The principal 1O2 quenchers in LDL include apoB (42%), lycopene and beta
      carotene (40%), and alpha-tocopherol (17%). The importance of carotenoids in the
      quenching of 1O2 in lipoprotein suggest that the beneficial effects of these
      compounds in health may in part be due to the elimination of this species in
      biology and medicine.

PMID- 8360152
TI  - Affinity radiolabeling identifies peptides and amino acids associated with
      substrate binding in human placental 3 beta-hydroxy-delta(5)-steroid
      dehydrogenase.
AB  - Purified human placental 3 beta-hydroxy-delta(5)-steroid dehydrogenase (3 beta
      HSD) was affinity radiolabeled by 2 alpha-bromo[2'-14C]acetoxyprogesterone (2
      alpha-BAP) in the presence or absence of 3 beta-HSD substrate, pregnenolone. The
      substrate steroid substantially protects 3 beta-HSD activity from inactivation by
      2 alpha-BAP. Tryptic peptides of unprotected and substrate-protected
      radioalkylated enzyme were purified by high pressure liquid chromatography. The
      amino acid sequence of each radiolabeled peptide was determined and localized
      within the cDNA-derived primary structure of the enzyme. According to the percent
      total radioactivity associated with each of four radiolabeled peaks separated by
      high pressure liquid chromatography, two peptides were protected by substrate
      from affinity radioalkylation by 2 alpha-BAP. The first,
      251GQFYYISDDTPHQSYDNLNYTLSK274, was produced by tryptic cleavage at Arg-250 and
      Lys-274 (the Arg-250 peptide) and contained radiolabeled His262. The second,
      176NGGTLYTCALR186, was produced by tryptic cleavage at Lys-175 and Arg-186 (the
      Lys-175 peptide) and contained radiolabeled Cys183. Based on amino acid analysis
      to quantitate radioactivity incorporated per nmol of peptide, substrate steroid
      decreased the radiolabeling of His262 in the Arg-250 peptide by 3.6-fold and
      decreased the radiolabeling of Cys183 in the Lys-175 peptide by 3.7-fold. Three
      minor radiolabeled peptides (the NH2-terminal, Arg-71, and Arg-196 tryptic
      peptides) were also identified in the primary structure, but pregnenolone did not
      diminish their affinity radioalkylation. These observations indicate that the Arg
      250 and Lys-175 peptides are involved in substrate binding and suggest that
      His262 and Cys183 are in close proximity in the three-dimensional structure of
      the enzyme.

PMID- 8360153
TI  - Binding of cerebrosides and sulfatides to saposins A-D.
AB  - Saposins are a family of four small glycoproteins, all of which are derived from
      prosaposin, and are involved in the lysosomal hydrolysis of various
      sphingolipids. Results from this investigation demonstrate that saposins A-D bind
      to galactosyl- and glucosylceramide. The binding was highly dependent on the
      solution pH; maximum binding of glucosylceramide to all saposins occurred at pH
      7. Maximum binding of galactosylceramide to saposins B and D occurred at a more
      basic pH (8.5). The binding of glucosylceramide to saposins was significantly
      inhibited by Mg2+, Ca2+, or Zn2+. Although maximum binding of sulfatide to
      saposins A, C, and D occurred at acidic pH, the binding to saposin B was maximum
      at pH 8.5. Saposin A also bound sphingomyelin or phosphatidylcholine at neutral
      pH. No significant binding was evident between these lipids and saposins B-D at
      any pH value. The existence of saposin-lipid complexes was further confirmed in
      selected samples by gel filtration, isoelectric focusing, and a TLC binding
      assay. We have also shown that galactosylceramide bound to saposins A-D was
      efficiently transported to a rat brain microsomal fraction. This result suggests
      that saposins and possibly their precursor, prosaposin, may be involved in
      membrane biogenesis such as the assembly of myelin and plasma membranes.

PMID- 8360155
TI  - Characterization of the ATP-dependent binding of wheat germ protein synthesis
      initiation factors eIF-(iso)4F and eIF-4A to mRNA.
AB  - The ATP-dependent binding of wheat germ protein synthesis initiation factors eIF
      (iso)4F and eIF-4A to an oligoribonucleotide has been investigated by direct
      fluorescence titration techniques. In addition, the effect of ATP on the
      interaction between another cap-binding initiation factor, eIF-4F, and eIF-4A was
      studied using the same methods. Comparison of the equilibrium association
      constants (K(eq)) indicate that 1) hydrolyzable ATP affects the affinity of eIF
      (iso)4F for eIF-4A, regardless of whether or not mRNA was previously bound to the
      eIF-(iso)4F; in contrast, ATP had no effect on the eIF
      (iso)4F/oligoribonucleotide interaction; 2) in the presence of ATP, the binding
      of the binary eIF-(iso)4F.eIF-4A complex to the oligoribonucleotide is of similar
      affinity as the binding of the oligoribonucleotide to the eIF-(iso)4F alone; the
      stoichiometry of this ternary eIF-(iso)4F.eIF-4A.mRNA complex was found to be
      1:1:1; and 3) a similar ATP effect is observed for the eIF-4F/eIF-4A interaction
      as for the eIF-(iso)4F.eIF-4A complex.

PMID- 8360154
TI  - Inhibition of neutrophil NADPH oxidase assembly by a myristoylated
      pseudosubstrate of protein kinase C.
AB  - To further define the role played by protein kinase C (PKC) in the activation of
      the neutrophil NADPH oxidase, we have utilized a pseudosubstrate of PKC which was
      myristoylated at the N terminus. In electropermeabilized neutrophils, the
      myristoylated pseudosubstrate Phe-Ala-Arg-Lys-Gly-Ala-Leu-Arg-Gln (myr-psi PKC)
      inhibited PMA-induced protein phosphorylations and activation of the NADPH
      oxidase, induced either by PMA or by the receptor agonist formyl-methionyl-leucyl
      phenylalanine. Both the pseudosubstrate lacking the N-terminal myristate (psi
      PKC) and a myristoylated control peptide (Phe-Ala-Glu-Asp-Gly-Ala-Leu-Glu-Gln,
      myr-CP) were without effect on these responses. The myristoylated pseudosubstrate
      was also tested in a cell-free system, in which NADPH oxidase activation can be
      achieved by addition of SDS and guanosine 5'-3-O-(thio)triphosphate in a
      staurosporine-insensitive manner. Myr-psi PKC, but not psi PKC or myr-CP, proved
      to be a potent inhibitor of NADPH oxidase activity in the cell-free system,
      indicating that the inhibition observed in permeabilized neutrophils may have
      been caused by an effect other than PKC inhibition. In the presence of myr-psi
      PKC, translocation in the cell-free system of the cytosolic oxidase components
      p47-phox and p67-phox to the plasma membrane was inhibited. From these results we
      conclude that myristoylation profoundly increases the ability of pseudosubstrates
      of PKC to inhibit not only PKC-mediated phosphorylations, but also NADPH oxidase
      activation. The latter effect, however, is most probably not related to PKC
      inhibition but may indicate a critical role of the membrane surface charge in the
      translocation of the cytosolic oxidase components p47-phox and p67-phox.

PMID- 8360156
TI  - NADPH-sulfite reductase from Escherichia coli. A flavin reductase participating
      in the generation of the free radical of ribonucleotide reductase.
AB  - Protein R2, the small subunit of ribonucleotide reductase of Escherichia coli,
      contains an essential free radical localized to tyrosine 122 of its polypeptide
      chain. When this radical is scavenged by hydroxyurea, the enzyme is transformed
      into an inactive form, metR2. E. coli contains a NAD(P)H:flavin oxidoreductase,
      named Fre, absolutely required for the regeneration of the radical and the
      activation of metR2 into R2. Consequently, an E. coli mutant strain lacking an
      active fre gene is more sensitive to hydroxyurea during growth, demonstrating the
      physiological protective function of Fre from the loss of the radical. However,
      this gene is not essential, and we found that E. coli contains a second tyrosyl
      radical generating activity, also residing in a flavin reductase. The enzyme has
      been purified 200-fold to homogeneity and found to be identical to sulfite
      reductase. Pure sulfite reductase has the ability to catalyze the reduction of
      free riboflavin, FMN, or FAD by NADPH and thus, as Fre, to transfer electrons to
      the iron center of metR2, a key step during the activation reaction.

PMID- 8360157
TI  - The ATP-binding cassette (ABC) transporter for maltose/maltodextrins of
      Salmonella typhimurium. Characterization of the ATPase activity associated with
      the purified MalK subunit.
AB  - The ATPase activity associated with the purified MalK subunit of the maltose
      transport complex of Salmonella typhimurium, a bacterial ATP-Binding Cassette
      (ABC) transporter (Walter, C., Honer zu Bentrup, K., and Schneider, E. (1992) J.
      Biol. Chem. 267, 8863-8869), was characterized in detail. The analysis of the
      kinetics of ATP hydrolysis yielded a Km value of 70 +/- 4 microM and a Vmax of
      1.3 +/- 0.3 mumol/min/mg of protein. Both GTP and CTP also served as substrates.
      While MalK exhibited nearly the same affinity for GTP as for ATP, the Michaelis
      constant for CTP as a substrate was much higher. ATP hydrolysis was strongly
      dependent on the presence of Mg2+ ions. Mn2+ at low concentrations, but neither
      Ca2+ nor Zn2+ partially substituted for Mg2+. The ATPase activity was optimal at
      slightly alkaline pH and was stimulated in the presence of both glycerol (7.5%)
      and dimethyl sulfoxide (Me2SO) (5%). ADP and the non-cleavable substrate analog
      ATP gamma S (adenosine 5'-O-(3-thiotriphosphate)) were identified as competitive
      inhibitors. The MalK-ATPase was resistant to specific inhibitors of F-, P-, and V
      type ATPases, such as dicyclohexylcarbodiimide, azide, vanadate, or bafilomycin
      A1. In contrast, micromolar concentrations of the sulfhydryl reagent N
      ethylmaleimide strongly inhibited the enzymatic activity. This inhibition was
      blocked in the presence of ATP. These results suggest that the intrinsic ATPase
      activity of purified MalK can be clearly distinguished from other ATP-hydrolyzing
      enzymes, e.g. ion-translocating ATPases.

PMID- 8360158
TI  - Cloning and characterization of a 23-kDa stress-induced mouse peritoneal
      macrophage protein.
AB  - Exposure of mouse peritoneal macrophages to oxidative and sulfhydryl-reactive
      agents in vitro enhances synthesis of a few cellular proteins that may be
      important in a self-defense system. A cDNA encoding a novel stress-inducible
      protein, designated MSP23 (macrophage 23-kDa stress protein), was cloned from a
      cDNA library of the macrophages by differential screening. A 1.0-kilobase mRNA
      transcript hybridized with the MSP23 cDNA gradually increased in macrophages upon
      culture in vitro. Treatment with diethylmaleate or glucose/glucose oxidase, which
      generates H2O2, markedly enhanced the induction of the transcript after several
      hours. Cadmium chloride and sodium arsenite also induced the transcript. An
      antiserum raised against recombinant MSP23 reacted with the 23-kDa stress
      inducible protein of the macrophages. The amounts of 23-kDa protein in the cells
      rapidly increased during culture with diethylmaleate. The mRNA was detected in
      various tissues, and it was especially high in content in the liver. A search of
      databases revealed that six proteins of various species from bacteria to the
      mouse have a sequence homology to MSP23. One of the proteins is the C22 component
      of alkyl hydroperoxide reductase, which is induced by hydrogen peroxide in
      Salmonella typhimurium.

PMID- 8360159
TI  - Determination of the intrinsic Michaelis constant of immobilized alpha
      chymotrypsin.
AB  - The Michaelis constant of alpha-chymotrypsin, immobilized on a glutaraldehyde
      activated silicate support, for N-glutaryl-L-phenylalanine-p-nitroanilide was
      determined and was found to be identical with that of the enzyme in solution. The
      influence of intraparticular diffusion was taken into account by immobilizing
      different amounts of enzyme, thus changing the magnitude of diffusional
      constraints and extrapolating apparent Michaelis constants, determined for each
      amount of immobilized enzyme, to zero diffusional constraints. The possible
      effect of the immobilized enzyme distribution inside the porous matrix was
      investigated through numerical simulations.

PMID- 8360160
TI  - Calcium responses elicited by nucleotides in macrophages. Interaction between two
      receptor subtypes.
AB  - The responses elicited by ATP and UTP in macrophages (measured by
      microfluorescence and in patch-clamp) present marked differences. The release of
      Ca2+ from intracellular stores induced by ATP is due to the activation of P2U
      receptors. These receptors can be activated by ATP4- and by MgATP2-, with
      apparent K0.5 values of 0.65 and 6.5 microM, respectively. The release of Ca2+
      due to activation of P2U receptors by either ATP or UTP is followed by the
      opening of ionic channels leading to an influx of Ca2+. A second pathway for Ca2+
      influx results from the opening of P2Z receptor channels triggered by adenosine
      5'-O(1-thiotriphosphate) or ATP but not by UTP. The form of ATP that activates
      P2Z receptors is ATP4- (with a K0.5 of 0.5 microM). In voltage-clamped cells, the
      inward current activated by ATP4- is transient, partly because it inactivates and
      partly because it is rapidly masked by the development of a quinine-sensitive
      Ca(2+)-dependent K+ current. In current-clamp, macrophages stimulated by UTP
      remain normally polarized, whereas ATP depolarizes them. This P2Z-mediated
      depolarization results in an inhibition of the influx of Ca2+, which explains
      part of the difference between the time courses of the Ca2+ responses elicited by
      ATP and UTP.

PMID- 8360161
TI  - The pattern of agonist-evoked cytosolic Ca2+ oscillations depends on the resting
      intracellular Ca2+ concentration.
AB  - The agonists acetylcholine (ACh) and cholecystokinin (CCK) have been shown to
      evoke markedly different patterns of cytosolic Ca2+ oscillations in the same
      isolated pancreatic acinar cells. ACh induces high frequency sinusoidal
      oscillations (spiking) associated with activation of Ca2+ influx. CCK evokes
      longer lasting discrete transients separated by long intervals, and these low
      frequency transients persist for many minutes in the absence of extracellular
      Ca2+. Using digital imaging of fura-2 fluorescence, we have now monitored the
      free cytoplasmic Ca2+ concentration ([Ca2+]i) simultaneously in many individual
      cells from the same population. In the resting condition [Ca2+]i ranged from
      about 50 to 300 nM. When the resting [Ca2+]i was below 150 nM, ACh (50-100 nM)
      invariably evoked typical high frequency spiking. In the majority of cells which
      had a resting [Ca2+]i higher than 150 nM, ACh also evoked low frequency
      transients. Although initiated by ACh, these transients displayed the temporal
      and functional characteristics of the CCK-evoked transients. Removal of
      extracellular Ca2+ for a few minutes had no effect on this type of oscillation,
      whereas such a procedure reversibly abolished the ACh-evoked high frequency
      response. For the response evoked by 10-30 pM Ca2+ signal amplitude and the
      resting [Ca2+]i. Because the Ca2+ signal amplitude and the resting [Ca2+]i.
      Because CCK could never induce high frequency spiking there is some receptor
      specificity in dictating the time course of Ca2+ oscillations, but the resting
      [Ca2+]i is a major determinant of the Ca2+ signal pattern.

PMID- 8360162
TI  - Surfactant protein A-binding proteins. Characterization and structures.
AB  - An alveolar cell membrane protein acts as a surfactant protein A (SP-A) receptor;
      it binds SP-A and regulates surfactant secretion. We identified such alveolar
      cell membrane SP-A-binding proteins using anti-idiotype antibodies directed
      against the surfactant protein binding region of anti-surfactant antibodies.
      These monoclonal anti-idiotype antibodies, A2C and A2R, also recognize an
      alveolar cell membrane protein of approximately 30 kDa. A pulmonary protein of
      approximately 30 kDa binds SP-A. Unique cDNAs encoding this protein were
      identified in human (4.1-kilobase) and porcine (1.8-kilobase) lung expression
      libraries. Coding regions of these cDNAs cross-hybridize with each other under
      stringent conditions. Both cDNAs encode similar approximately 32-kDa proteins
      that bind SP-A. The human and porcine SP-A recognition (SPAR) proteins resemble
      each other, as well as other cell membrane receptors. Their projected structures
      are consistent with cell membrane receptors. Recombinant human and porcine SPAR
      proteins bind SP-A as well as the two anti-idiotype antibodies just as do native
      lung proteins of approximately 30 kDa. SPAR transcripts are expressed primarily
      in lung. The cellular distribution of these transcripts, as determined by in situ
      hybridization, is similar to that of SPAR protein, as determined by
      immunohistochemistry; both are found in cells consistent with type II
      pneumocytes. SPAR-producing cells resemble the alveolar cells expressing SP-B and
      SP-C transcripts in appearance, location, and distribution. Therefore, cDNAs for
      pulmonary SP-A-binding proteins from two disparate species have been isolated and
      sequenced, and the recombinant proteins they encode bind the same ligand. Further
      structural, functional, and genetic studies of these proteins may help explain
      how pulmonary surfactant secretion is regulated.

PMID- 8360163
TI  - Placement of dinitrophenyl-modified ribosomal proteins in totally reconstituted
      Escherichia coli 30 S subunits. Localization of proteins S6, S13, S16, and S18 by
      immune electron microscopy.
AB  - Purified Escherichia coli ribosomal proteins S6, S13, S16, and S18 were
      dinitrophenylated at their amino termini and/or at one or more internal lysine
      residues. Each dinitrophenyl protein was then separately incorporated into
      reconstituted small ribosomal subunits. Modified proteins were localized on the
      30 S subunit surface by electron microscopy of reconstituted subunits complexed
      with antibodies to dinitrophenol (DNP). DNP protein S13 was placed on the subunit
      head above the platform and on the surface that faces the large subunit. DNP-S18
      was localized to the subunit platform below the tip and in a region associated
      with binding to 50 S subunits. DNP proteins S6 and S16 were both localized near
      the junction of the subunit body and platform; DNP-S6 was available to antibody
      in 70 S ribosomes and was placed on the cytoplasm-facing side of the subunit in
      an area that overlaps the platform and body of the particle. DNP-S16 in 70 S
      ribosomes was not bound by antibody. It was localized to the 30 S body near its
      junction with the platform and on the surface facing the 50 S particle. The
      results complement and clarify data obtained using other approaches.

PMID- 8360164
TI  - Mutational study of Streptomyces tyrosinase trans-activator MelC1. MelC1 is
      likely a chaperone for apotyrosinase.
AB  - The melanin operon (melC) of Streptomyces antibioticus contains two genes, melC1
      and melC2 (apotyrosinase). Our previous studies indicated that MelC1 forms a
      transient binary complex with the downstream apotyrosinase MelC2 to facilitate
      the incorporation of copper ion and the secretion of tyrosinase. In this study,
      we investigated the role of histidine residues in the function of MelC1 by
      examining a series of substitution or deletion mutants. Of eight mutants only the
      substitution of His-117 with Asp in the mutant M-117D rendered the complete
      abolishment of the intracellular tyrosinase activity in both Streptomyces and
      Escherichia coli. Replacement of His-102 by Leu in the mutant M-102L also caused
      a 64-70% reduction of tyrosinase activity in Streptomyces and E. coli. These two
      mutations also affected the secretion of both MelC1 and MelC2 proteins. In vitro
      copper activation of the purified MelC1.MelC2 binary complex from these two
      mutants regained only 20-30% tyrosinase activity of the wild type. Biochemical
      characterization of the tyrosinases from these two mutants revealed that they
      were different in several aspects. The intracellular tyrosinase activity in M
      117D, but not in M-102L, could be partially reactivated by copper ion or by the
      cell extract containing MelC1. The copper content and the specific activity of
      the tyrosinase purified from the culture supernatant from M-117D were only 40% of
      those in wild type and M-102L. Additionally, fast protein liquid chromatography
      analysis indicated that in these two mutants the copper activation process was
      defective, very likely due to the incompetent MelC1.MelC2 binary complex formed:
      reduced association in M-117D and elevated association in M-102L. Furthermore,
      the conformation of MelC2 in the binary complex or in the mature enzyme form in
      wild type could be differentiated by the proteinase K digestion pattern, and so
      did the conformation of MelC2 found in those of M-102L, but not in M-117D mutant.
      Taken together, our results demonstrate that MelC1 is indispensable in the
      incorporation of copper ion into MelC2 apotyrosinase via a transient, competent
      binary complex formation, during which a conformational transition of MelC2 has
      occurred. This strongly suggests that MelC1 is a chaperone for the apotyrosinase
      MelC2.

PMID- 8360165
TI  - PEB1, the major cell-binding factor of Campylobacter jejuni, is a homolog of the
      binding component in gram-negative nutrient transport systems.
AB  - The protein PEB1 (28 kDa) is a common antigen and a major cell adherence molecule
      of Campylobacter jejuni and Campylobacter coli. We created a bank of chromosomal
      DNA fragments of C. jejuni strain 81-176 using lambda gt11. Screening this bank
      in Escherichia coli Y1090 cells with antibody raised against purified PEB1
      enabled us to isolate and to purify a clone with a 2.6-kilobase insert expressing
      an immunoreactive protein of 28 kDa. DNA sequencing revealed that the insert
      contains three complete and two partial open reading frames (ORFs), designated 5'
      to 3' as ORFs A-E. The peb1A gene (ORF D) contains 780 bases encoding a 259
      residue polypeptide having a calculated molecular mass of 28,181 Da. The peptide
      sequence starting at residue 27 matches that determined from aminoterminal
      sequencing of mature PEB1 from C. jejuni. The first 26 residues contain typical
      signal peptidase I and II cleavage sites. The deduced amino acid composition and
      pI of the recombinant mature protein are similar to those determined for purified
      PEB1. Gene bank searches indicated significant overall homology of peb1A and ORF
      C with operons for amino acid transport systems in other Gram-negative organisms.
      peb1A is homologous to the binding components of systems such as glnH (27.8%) and
      hisJ (28.9%), whereas ORF C has nearly 50% identity to glnQ and hisP. Thus, PEB1
      could be involved both in binding to intestinal cells and in amino acid
      transport.

PMID- 8360166
TI  - The amino-terminal 29 amino acids of cytochrome P450 2C1 are sufficient for
      retention in the endoplasmic reticulum.
AB  - Cytochromes P450 are inserted into and anchored to the endoplasmic reticulum (ER)
      membrane by a hydrophobic signal sequence at the NH2 terminus. To determine
      whether the NH2-terminal sequence might also have an ER retention function, the
      NH2-terminal 29 amino acids of cytochrome P450 2C1, with and without an
      additional 29 amino acids containing an N-glycosylation site, were fused either
      to a soluble cytoplasmic protein, Escherichia coli beta-galactosidase, or to a
      secreted protein, E. coli alkaline phosphatase, and the hybrid proteins were
      expressed in COS1 cells. Subcellular fractionation indicated that both the beta
      galactosidase and alkaline phosphatase hybrid proteins cosedimented with marker
      enzymes for ER membranes, and localization by immunofluorescent staining was
      consistent with an ER location. Hybrid proteins with the NH2-terminal
      glycosylation site were glycosylated in COS1 cells, and the carbohydrate moiety
      was sensitive to endoglycosidase H digestion, providing further evidence that the
      proteins were retained in the ER. In vitro studies of membrane insertion of the
      alkaline phosphatase hybrid indicated that fusion to alkaline phosphatase hybrid
      indicated that fusion to alkaline phosphatase did not alter the topological
      properties of the cytochrome P450 NH2-terminal sequence. In addition, alkaline
      phosphatase fused to the extracellular and transmembrane domains of epidermal
      growth factor receptor was transported to the plasma membrane in COS1 cells,
      which establishes that alkaline phosphatase as a cytoplasmic domain does not
      prevent transport from the ER. These observations indicate that the large
      cytoplasmic domain of cytochrome P450 is not required for retention in the ER and
      suggest that a specific sequence or structure within the NH2-terminal 29 amino
      acids functions as an ER retention signal.

PMID- 8360167
TI  - Induction of arachidonate 12-lipoxygenase mRNA by epidermal growth factor in A431
      cells.
AB  - 12(S)-Hydroxyeicosatetraenoic acid is biosynthesized from arachidonic acid by the
      microsomal fraction of human epidermoid carcinoma A431 cells, and the microsomal
      12-lipoxygenase activity is enhanced by about 2-fold by epidermal growth factor
      (EGF) with a 10-h lag period (Chang, W.C., Ning, C.C., Lin, M.T., and Huang, J.D.
      (1992) J. Biol. Chem. 267, 3657-3666). The microsomal 12-lipoxygenase in A431
      cells was only 3% active with linoleic acid as compared with arachidonic acid.
      The enzyme was immunoprecipitated by a monoclonal antibody against human platelet
      12-lipoxygenase but not by that against porcine leukocyte enzyme. A 3.1-kilobase
      mRNA was detected in A431 cells by Northern blot analyses using cDNA probe of
      human platelet 12-lipoxygenase. EGF could increase the 12-lipoxygenase mRNA level
      by about 2-fold with a lag period of 10 h, which was well parallel with the
      increase in the enzyme activity. The induction of the 12-lipoxygenase mRNA by EGF
      was completely blocked by 35 microM cycloheximide, if present in culture medium
      during EGF treatment, indicating that a de novo protein biosynthesis was
      essential for EGF-induced 12-lipoxygenase mRNA expression. Our data provide the
      first evidence for the inducibility of human 12-lipoxygenase gene expression by a
      growth factor.

PMID- 8360168
TI  - Differential expression of transmembrane proteoglycans in vascular smooth muscle
      cells.
AB  - Rat aortic vascular smooth muscle (VSM) cells synthesize the transmembrane
      proteoglycan syndecan (Cizmeci-Smith, G., Asundi, V., Stahl, R. C., Teichman, L.
      J., Chernousov, M., Cowan, K., and Carey, D. J. (1992) J. Biol. Chem. 267, 15729
      15736). The present work demonstrated that VSM cells synthesize the related
      transmembrane proteoglycan fibroglycan and that increased expression of these two
      proteoglycans is stimulated under different conditions. Fibroglycan synthesis by
      cultured rat aortic VSM cells was demonstrated by Northern blot analysis with a
      rat fibroglycan cDNA probe and immunoblot analysis with anti-rat fibroglycan
      antibodies. Effects of growth factors and vasoactive substances on syndecan and
      fibroglycan expression were examined by Northern blot analysis. Syndecan mRNA
      levels increased in response to stimulation of VSM cells with serum, platelet
      derived growth factor, or angiotensin II. VSM cells stimulated with platelet
      derived growth factor contained more syndecan core protein and processed syndecan
      than control cells. Fibroglycan mRNA levels either decreased or remained
      unchanged in response to these agents. Fibroglycan mRNA levels increased
      following transforming growth factor-beta stimulation, while syndecan mRNA levels
      decreased. Other agents, including basic fibroblast growth factor, endothelin,
      and carbacyclin did not alter the expression of either proteoglycan. Syndecan and
      fibroglycan mRNA levels also varied as a function of cell density. These data
      demonstrate that syndecan and fibroglycan expression are regulated differently in
      VSM cells and lend support to the hypothesis that these proteoglycans carry out
      distinct physiological functions.

PMID- 8360169
TI  - Purification and characterization of bovine brain platelet-activating factor
      acetylhydrolase.
AB  - Platelet-activating factor (PAF) acetylhydrolase, which removes the acetyl moiety
      at the sn-2 position, has been found in plasma and tissue cytosol. PAF
      acetylhydrolase in bovine brain cytosol was chromatographically separated into
      three distinct fractions, all of which exhibited pH optima in the neutral to mild
      alkaline region and were unaffected by EDTA. We have purified the major fraction
      of the enzyme to near homogeneity. The purified enzyme had a molecular mass of
      about 100 kDa, as estimated by gel filtration chromatography, and gave three
      distinct bands of 45, 30, and 29 kDa, respectively, on sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. These polypeptides exclusively co-migrated
      with the activity throughout the purification steps. These data suggest that this
      set of polypeptides corresponds to the subunits of bovine brain PAF
      acetylhydrolase. Diisopropyl fluorophosphate completely inhibited the activity at
      0.1 mM. [3H]Diisopropyl fluorophosphate labeled only the 29-kDa polypeptide,
      suggesting that this polypeptide possesses an active serine residue(s). The
      purified enzyme displayed similar activity against PAF and oxidatively modified
      phosphatidylcholine, but did not hydrolyze phosphatidylcholine or
      phosphatidylethanolamine with two long chain acyl groups. Thus, the intracellular
      PAF acetylhydrolase is likely to be a new member of the calcium-independent
      phospholipases A2 in mammalian tissues.

PMID- 8360170
TI  - Characterization of two different glycosylated domains from the insoluble mucin
      complex of rat small intestine.
AB  - The highly glycosylated domains of rat small intestinal mucins were isolated
      after reduction and trypsin digestion and separated into two populations (A and
      B) by gel chromatography. The molecular mass values were 650 and 335 kDa,
      respectively, and the relative yields suggest that the two glycopeptides occur in
      equimolar proportions. Electron microscopy revealed linear structures with weight
      average lengths of 230 nm (A) and 110 nm (B) corresponding to a mass/unit length
      of about 3 kDa/nm. The protein cores (17-19%) contain large amounts of threonine
      (over 40%), serine (17-24%), and proline (18-19%). Carbohydrate and sulfate
      account for approximately 80 and 0.5%, respectively, and gas chromatography-mass
      spectrometry showed that the patterns of neutral and sialic acid-containing
      glycans are very similar in the two glycopeptides. Both contain a significant
      amount (7-10 mol %) of single GalNAc residues, the average oligosaccharide is
      about 4 sugar residues long, and the largest species observed are
      heptasaccharides. The major neutral and sialic acid-containing oligosaccharides
      are Fuc1-2Gal1-3GalNAcol and GlcNAc1-6(NeuGc2-Gal1-3)GalNAcol, respectively.
      Sialic acid is present as both N-acetyl- and N-glycoloyl-neuraminic acid.
      Repeated extractions of the tissue with guanidinium chloride left approximately
      80% of the mucus glycoproteins as an insoluble glycoprotein complex whereas
      exposure to dithiothreitol or high speed homogenization accomplished complete
      solubilization. The "subunits" obtained after reduction with dithiothreitol are
      larger than glycopeptides A and B, and fragments corresponding in size to the
      latter are obtained after cleavage with trypsin. Most of the mucins from rat
      small intestine thus occurs as an insoluble glycoprotein complex composed of
      subunits joined with disulfide bonds. The subunits contain two highly
      glycosylated regions with different lengths substituted with very similar
      oligosaccharides.

PMID- 8360171
TI  - Molecular cloning of the gene for bilirubin oxidase from Myrothecium verrucaria
      and its expression in yeast.
AB  - Myrothecium verrucaria bilirubin oxidase (EC 1.3.3.5) is an enzyme catalyzing the
      oxidation of bilirubin to biliverdin and other substrates. We have purified
      bilirubin oxidase from the medium of M. verrucaria and determined its partial
      amino acid sequence and isolated cDNA fragment amplified by polymerase chain
      reaction using oligonucleotide primers designed on the basis of the partial amino
      acid sequence. The gene for bilirubin oxidase has been cloned from a genomic
      library using the cDNA fragment as a probe. The gene encodes a precursor of
      bilirubin oxidase consisting of 572 amino acid residues, which comprises the
      prepro-region of 38 amino acid residues and the mature enzyme of 534 amino acid
      residues containing one cysteine. Five introns were found within the coding
      region. Sequence comparison of bilirubin oxidase with other blue copper proteins
      (laccase, ascorbate oxidase, human ceruloplasmin, plastocyanin, and azurin)
      revealed the presence of four domains corresponding to potential copper ligands.
      We have expressed this bilirubin oxidase gene in Saccharomyces cerevisiae under
      the repressible acid phosphatase promotor and found an active recombinant
      bilirubin oxidase, establishing the functional identity of the gene.

PMID- 8360172
TI  - Evidence that the transcription factor USF is a component of the human beta
      globin locus control region heteromeric protein complex.
AB  - The human locus control region (LCR) consists of four DNase I hypersensitive
      sites upstream of the epsilon-globin gene and is intimately involved in globin
      gene transcription. We have used DNase I footprinting with K562 erythroleukemia
      cell extracts to identify protein components of the minimal LCR element,
      hypersensitive site 2. Six major regions of protection were observed, and the
      occupation of two regions (sites II and V) was strongly temperature-dependent.
      Fractionation of K562 nuclear proteins revealed a single major protein that bound
      tightly to site II. An E-box was necessary for high affinity binding to DNA. We
      used antibodies and recombinant USF protein to prove that the helix-loop-helix
      transcription factor USF is the only detectable component in K562 cells that
      binds to this site. Despite significant differences between site II and a
      canonical USF-binding site, the USF binding affinity was comparable for the two
      sites. In both cases the interaction with the E-box of either wild-type USF or a
      approximately 15-kDa minimal USF DNA binding polypeptide displays an unusual
      positive temperature dependence, consistent with the observed footprinting
      behavior. The results show that a relatively ubiquitous factor, not confined to
      erythroid cells, is an important part of the complex of proteins bound at
      hypersensitive site 2 of the LCR in K562 cells.

PMID- 8360173
TI  - Characterization of high and low molecular weight forms of amphiregulin that
      differ in glycosylation and peptide core length. Evidence that the NH2-terminal
      region is not critical for bioactivity.
AB  - Human amphiregulin (AR) is a polypeptide growth regulator which acts by binding
      to and activating the epidermal growth factor (EGF) receptor tyrosine kinase. AR
      consists of an EGF-like domain and an NH2-terminal extension which contains
      potential glycosylation sites and nuclear localization signals. Two high
      molecular weight species which had molecular masses of approximately 16.5 kDa
      (HMW-AR1 and HMW-AR2) and a approximately 9.5-kDa low molecular weight form (LMW
      AR) were isolated from the conditioned medium of phorbol 12-myristate 13-acetate
      treated MCF-7 human breast carcinoma cells by sequential heparin affinity,
      immunoaffinity, and reverse phase-high performance liquid chromatography. HMW-AR1
      and HMW-AR2 were found to possess complex or hybrid type N-linked oligosaccharide
      structures that contained sialic acid. Additionally, HMW-AR1 and HMW-AR2
      contained the disaccharide, Gal beta(1-->3)GalNAc, linked to Ser/Thr residues. No
      carbohydrate moieties were detected in LMW-AR. Mapping of the peptide cores of
      these molecules using antipeptide antibodies revealed that HMW-AR1 and HMW-AR2
      were intact molecules, whereas LMW-AR contained the EGF-like domain, but
      possessed a truncated NH2-terminal extension. LMW-AR, HMW-AR1, and HMW-AR2 were
      all found to be potent stimulators of DNA synthesis in MCF-10A human mammary
      epithelial cells. These results suggest that the NH2-terminal region of the AR
      molecule is not critical to the ability of AR to activate the EGF receptor
      tyrosine kinase.

PMID- 8360174
TI  - Yeast bZip proteins mediate pleiotropic drug and metal resistance.
AB  - Saccharomyces cerevisiae contains a group of transcription factors related to
      mammalian c-Jun. This yeast Jun-family of proteins consists of GCN4, a regulator
      of genes involved in amino acid biosynthesis, and yAP-1, a factor conferring
      pleiotropic drug resistance when overexpressed. In the work described here, we
      show that a third member of the yeast Jun-family exists. This protein has been
      designated CAD1 and provides resistance to cadmium when present on a high-copy
      plasmid. CAD1 and yAP-1 are related in their amino-terminal DNA binding domains
      and can recognize the same DNA target site in vitro. Overproduction of CAD1 leads
      to transcriptional activation of an artificial reporter gene in delta yap1 cells.
      High level production of either CAD1 or yAP-1 causes cells to acquire a
      pleiotropic drug-resistant phenotype and to be able to tolerate normally toxic
      levels of iron chelators and zinc. Surprisingly, disruption of the CAD1 gene has
      no effect on the normal cellular resistance to cadmium but delta yap1 mutants are
      hypersensitive to this cytotoxic metal. The cadmium hypersensitivity of the delta
      yap1 mutant described here indicates that one major role of YAP1 in the yeast
      cell is to mediate resistance to this metal.

PMID- 8360175
TI  - Specific uptake of retinol-binding protein by variant F9 cell lines.
AB  - Serum retinol-binding protein (RBP) specifically binds to and is internalized by
      F9 embryonal carcinoma cells. Monolayers of F9 cells were differentiated into a
      primitive endoderm stage by addition of retinoic acid. Fluorescein-derivatized or
      radiolabeled RBP associated with F9 cell monolayers at 37 degrees C in a time-
      and concentration-dependent manner. Competition by simultaneous incubation with
      excess unlabeled RBP indicated that this association was specific and saturable;
      the apparent dissociation constant was 200-300 nM using either tracer. At 37
      degrees C, over 80% of the cell-associated RBP was internalized, and only a small
      fraction was bound to the cell surface; fluorescence microscopy indicated that
      internalized RBP was in small vesicles within the cytoplasm. Internalized RBP was
      subsequently degraded and released from the cell in an acid-soluble form.
      Parental F9 cells were heterogeneous in their ability to associate with RBP.
      Random subcloning identified natural variant F9 cell lines which did, or did not,
      express this biological activity upon retinoic acid-induced differentiation. The
      clonal nature of the capacity for RBP uptake suggests that this specific
      internalization is a heritable trait. Together, these observations provide strong
      evidence that RBP uptake occurs by a receptor-mediated process in F9 cells. The
      cycle of RBP internalization and degradation by F9 cells bearing specific RBP
      receptors may provide a regulable mechanism for the cellular accumulation of
      serum retinol.

PMID- 8360177
TI  - Purification, characterization, and cellular localization of the 100-kDa human
      placental GTPase-activating protein.
AB  - Human placenta contains, in addition to the ubiquitous p120-GTPase-activating
      protein (GAP), another isoform of 100 kDa, which is specific to this organ. We
      have established a method for purifying this placental p100-GAP to near
      homogeneity. The purified p100-GAP allowed the preparation of polyclonal and
      monoclonal anti Ras-GAP antibodies. Two monoclonal antibodies were selected for a
      two-site enzyme immunoassay. This simple and accurate assay in turn facilitated
      the detection of the GAPs during purification. The purified p100-GAP has a
      specific activity identical to and catalytic properties similar to those of
      native p120-GAP. Sequence analysis of p100-GAP revealed almost total identity to
      the known corresponding sequences predicted by the cDNA. The purified p100-GAP
      kept its activity for 1 year when stored at -80 degrees C. Our immunometric assay
      showed GAP to be present in human placental extracts at the exceptional abundance
      of about 0.1% of the total protein content. Quantitative assays showed p100-GAP
      to be up to 10 times more abundant than p120-GAP. Use of our antibodies allowed
      the specific localization of placental GAPs to cytotrophoblasts and in the
      syncytiotrophoblast barrier. Hence p100-GAP is shown to be found only in
      trophoblasts. The large quantity of p100-GAP in trophoblasts suggests that it may
      play a regulatory role in the proliferation or the differentiation of this cell
      type.

PMID- 8360176
TI  - Purification, characterization, and biosynthesis of margatoxin, a component of
      Centruroides margaritatus venom that selectively inhibits voltage-dependent
      potassium channels.
AB  - A novel peptidyl inhibitor of K+ channels has been purified to homogeneity from
      venom of the new world scorpion Centruroides margaritatus. The primary structure
      of this 39-amino-acid peptide, which we term margatoxin (MgTX), was determined by
      amino acid compositional analysis and peptide sequencing. Margatoxin potently
      inhibits binding of radiolabeled charybdotoxin (ChTX) to voltage-activated
      channels in brain synaptic plasma membranes. Like ChTX, MgTX blocks the n-type
      current of human T-lymphocytes (Kv1.3 channel), but compared to ChTX, is 20-fold
      more potent (half-block at approximately 50 pM), has a slower dissociation rate,
      and has no effect on calcium-activated channels. To demonstrate that these
      characteristics are due solely to the purified toxin, recombinant MgTX was
      expressed in Escherichia coli as part of a fusion protein. After cleavage and
      folding, purified recombinant MgTX displayed the same properties as native
      peptide. Replacement of the COOH-terminal histidine residue of MgTX with
      asparagine resulted in a peptide with a 10-fold reduction in potency. This was
      due to a faster apparent dissociation rate, suggesting that the COOH-terminal
      amino acid may play an important role in the binding of MgTX to the Kv1.3
      channel. MgTX displays significant sequence homology with previously identified
      K+ channel inhibitors (e.g. ChTX, iberiotoxin, noxiustoxin, and kaliotoxin).
      However, given its potency and unique selectivity, MgTX represents an especially
      useful tool with which to study the physiologic role of Kv1.3 channels.

PMID- 8360179
TI  - Myristoylation of hippocalcin is linked to its calcium-dependent membrane
      association properties.
AB  - Hippocalcin, a recently identified Ca(2+)-binding protein of the recoverin family
      exclusively expressed in the hippocampus, has a primary structure containing
      three putative Ca(2+)-binding sites (EF-hands) and a possible NH2-terminal
      myristoylation site. 45Ca blots demonstrated that every three EF-hand domains,
      expressed as fusion proteins in Escherichia coli, bind Ca2+, indicating that
      hippocalcin binds 3 mol of Ca2+/mol of protein. To determine whether hippocalcin
      is myristoylated, hippocalcin mRNA was translated in vitro in the presence of
      [3H]myristic acid. 3H label was resistant to hydroxylamine treatment, and
      replacement of NH2-terminal glycine with alanine prevented 3H label
      incorporation, indicating that in vitro translated hippocalcin covalently bound
      [3H]myristic acid at the NH2-terminal glycine. In vitro translated hippocalcin is
      quantitatively myristoylated, as evidenced by an electrophoretic mobility shift
      of [35S]methionine-labeled protein on two-dimensional gels. Native hippocalcin
      comigrated precisely with the in vitro translated hippocalcin on two-dimensional
      gels, suggesting that native hippocalcin is myristoylated. Native and in vitro
      translated hippocalcins, but not non-myristoylated mutagenic (Gly1-Ala1)
      hippocalcin, displayed Ca(2+)-dependent membrane association, indicating that
      myristoylation participates in its Ca(2+)-dependent membrane association
      properties. In vitro translated hippocalcin bound to phospholipid vesicles
      somewhat, however, phospholipid association was insufficient for its membrane
      association properties, suggesting that the NH2-terminal myristoyl moiety on
      hippocalcin interacts with lipid bilayers and facilitates interaction with other
      membrane proteins.

PMID- 8360178
TI  - Purification of the major histocompatibility complex class I transcription factor
      H2TF1. The full-length product of the nfkb2 gene.
AB  - H2TF1 is a ubiquitous major histocompatibility complex (MHC) class I-specific
      transcription factor, which binds to the palindromic kappa B enhancer site
      upstream of MHC class I genes. Here we report that H2TF1 consists of a
      polypeptide with relative molecular mass 110,000, that corresponds to the
      predicted 100-kDa product (NF-kappa B2 p100) encoded by the candidate proto
      oncogene nfkb2 (lyt-10). H2TF1 was purified by a novel affinity chromatography
      method and identified as the NF-kappa B2 p100 polypeptide by peptide sequencing
      as well as by reactivity with a specific antiserum. Purified H2TF1 binds the MHC
      kappa B site with high affinity (KD = 3 x 10(-11) M), in contrast with previous
      reports that NF-kappa B2 p100 did not bind DNA.

PMID- 8360181
TI  - The extracellular matrix proteins laminin and fibronectin contain binding domains
      for human plasminogen and tissue plasminogen activator.
AB  - This study describes the binding of plasminogen and tissue-type plasminogen
      activator (t-PA) to the extracellular matrix proteins fibronectin and laminin.
      Plasminogen bound specifically and saturably to both fibronectin and laminin
      immobilized on microtiter wells, with Kd(app) values of 115 and 18 nM,
      respectively. Limited proteolysis by endoproteinase V8 coupled with ligand
      blotting analysis showed that both plasminogen and t-PA preferentially bind to a
      55-kDa fibronectin fragment and a 38-kDa laminin fragment. Amino acid sequence
      analysis demonstrated that the 5-kDa fragment originates with the fibronectin
      amino terminus whereas the laminin fragment was derived from the carboxyl
      terminal globular domain of the laminin A chain. Ligand blotting experiments
      using isolated plasminogen domains were also used to identify distinct regions of
      the plasminogen molecule involved in fibronectin and laminin binding. Solution
      phase fibronectin binding to immobilized plasminogen was mediated primarily via
      lysine binding site-dependent interactions with plasminogen kringles 1-4. Lysine
      binding site-dependent binding of soluble laminin to immobilized plasminogen
      kringles 1-5 as well as an additional lysine binding site-independent interaction
      between mini-plasminogen and the 38-kDa laminin A chain fragment were also
      observed. These studies demonstrate binding of plasminogen and tissue-type
      plasminogen activator to specific regions of the extracellular matrix
      glycoproteins laminin and fibronectin and provide further insight into the
      mechanism of regulation of plasminogen activation by components of the
      extracellular matrix.

PMID- 8360180
TI  - The PSI-K subunit of photosystem I from barley (Hordeum vulgare L.). Evidence for
      a gene duplication of an ancestral PSI-G/K gene.
AB  - Photosystem I of barley contains a polypeptide with an apparent molecular mass of
      7 kDa when isolated using the detergent n-decyl-beta-D-maltopyranoside. The 7-kDa
      polypeptide is lost from the PS I complex isolated using Triton X-100. The 7-kDa
      polypeptide and a corresponding full-length cDNA clone have been isolated. Based
      on high sequence similarity to an N-terminal sequence of PSI-K from spinach and
      to the deduced amino acid sequence of Psak from Chlamydomonas reinhardtii the 7
      kDa barley polypeptide is identified as PSI-K. The cDNA clone encodes a precursor
      polypeptide of 131 amino acid residues with a calculated molecular mass of 13,726
      Da. The transit peptide shows characteristics of polypeptides imported into the
      chloroplast. PSI-K has two hydrophobic regions predicted to be membrane-spanning
      alpha-helices. In vitro expressed prePSI-K polypeptide was imported into intact
      chloroplasts, whereas an in vitro expressed prePSI-K lacking 7 amino acid
      residues (Met-Ala-Ser-Gln-Leu-Ser-Ala) at the N-terminal end of the transit
      peptide failed to be imported. The mRNA encoding PSI-K increases during
      illumination. PsaK is located in a single locus in the genome. PSI-K has
      significant similarity to PSI-G. When comparing the barley PSI-K and PSI-G with
      the reported PSI-K sequence from Synechococcus vulcanus, the degree of similarity
      is equal, suggesting that an ancestral gene has been duplicated in a chloroplast
      progenitor but not in a cyanobacterial.

PMID- 8360182
TI  - Modulation of tissue plasminogen activator-catalyzed plasminogen activation by
      synthetic peptides derived from the amino-terminal heparin binding domain of
      fibronectin.
AB  - Fibronectin is a multidomain adhesive glycoprotein found in plasma, interstitial
      connective tissue, and basement membrane. Diverse biological activities have been
      associated with the fibronectin molecule including cell adhesion, cell migration,
      wound healing, hemostasis, and oncogenic transformation. Binding sites for
      heparin, fibrin, gelatin/collagen, and cells have been localized to various
      structural domains of the molecule. In addition, fibronectin also binds both
      plasminogen and tissue plasminogen activator (t-PA) via a 55-kDa amino-terminal
      fragment (Moser, T.L., Enghild, J.J., Pizzo, S.V., and Stack, M.S. (1993) J.
      Biol. Chem. 268, 18917-18923). Although intact fibronectin does not enhance the
      rate of t-PA-catalyzed plasminogen activation, a mixture of proteolytically
      degraded fibronectin fragments stimulates the activation reaction, resulting in
      an 11-fold increase in the kcat/Km. Based on these observations, we have
      synthesized a variety of peptides derived from the plasminogen/t-PA binding
      region of fibronectin and determined the effect of these peptides on the initial
      rate kinetics of plasminogen activation by t-PA as well as on plasmin and t-PA
      amidolytic activity. Here we report that a specific octapeptide, SRNRCNDQ-NH2,
      consisting of residues 196-203 of the fibronectin molecule is a potent stimulator
      of t-PA-catalyzed plasminogen activation, resulting in a 15-fold increase in the
      kcat/Km of the activation reaction.

PMID- 8360183
TI  - Characterization of the bifunctional cytochrome c reductase-processing peptidase
      complex from potato mitochondria.
AB  - In potato, cytochrome c reductase, a protein complex of the respiratory chain,
      exhibits processing activity toward mitochondrial precursor proteins. One of the
      two cooperating components of the processing peptidase was shown to be identical
      with subunit III of the complex. Here we report that two additional proteins of
      the complex (subunit I and II) share 40-50% sequence identity with the processing
      enhancing protein, the other component of the processing enzyme from fungi and
      mammals. Thus the composition and structure of the complex integrated processing
      peptidase seems to be different from its fungal and mammalian counterparts.
      Cytochrome c reductase from potato is extraordinarily stable, and separation of
      subunit III from the complex leads to aggregation of the remaining subcomplex and
      irreversible loss of processing activity. Expression of the three high molecular
      weight subunits of the complex allowed purification of each individual protein.
      Neither the individual subunits nor their combinations are active in in vitro
      processing assays suggesting that they may need the structural support of the
      complex for activity. In contrast to mitochondrial processing peptidases from
      other organisms, the purified potato enzyme is active in the presence of high
      salt (above 1 M NaCl) and works efficiently without addition of metal ions. These
      data indicate that potato cytochrome c reductase is a bifunctional protein
      complex with unique features. Possibly, there is a more general evolutionary
      relationship between cytochrome c reductases and mitochondrial processing
      peptidases than hitherto assumed.

PMID- 8360184
TI  - Purification, cloning, and expression of a bovine UDP-GalNAc: polypeptide N
      acetyl-galactosaminyltransferase.
AB  - Partial amino acid sequence was obtained from UDP-GalNAc:polypeptide N
      acetylgalactosaminyltransferase (polypeptide GalNAc transferase) purified from
      bovine colostrum. Oligonucleotide primers designed from these sequences were used
      to amplify and clone a polypeptide GalNAc transferase cDNA from bovine placental
      mRNA. The cDNA encodes an open reading frame, which is 519 amino acids in length
      and contains the predicted N-terminal and internal amino acid sequence derived
      from three Lys-C peptides obtained from the purified protein. There was no
      sequence homology with the UDP-GalNAc: Fuc alpha 1,2Gal alpha 1,3GalNAc
      transferase. To verify the authenticity of the clone, the cDNA was cloned in
      frame with an insulin secretion sequence and was expressed transiently in COS-7
      cells. Polypeptide GalNAc transferase activity was detected in the culture
      medium; no activity was detected in the media of mock-transfected cells. Previous
      studies have shown that the polypeptide GalNAc transferase from bovine colostrum
      glycosylates threonine residues more efficiently than serine residues in the same
      peptide context (O'Connell, B. C., Hagen, F. K., and Tabak, L. A. (1992) J. Biol.
      Chem. 267, 25010-25018). We found that the cloned polypeptide GalNAc transferase
      glycosylates the threonine-containing peptide, PPDAATAAPLR, at a 58-fold greater
      rate than the serine-containing homologue, PPDAASAAPLR. The ratio of the in vitro
      threonine and serine glycosylation rate is identical for the cloned placental and
      purified colostral enzymes. It is not known if the preference for threonine over
      serine is merely context-dependent on the specific amino acids that flank the
      glycosylation site or if there are discrete threonine- and serine-specific
      isoforms of this transferase. Alternatively, there may be additional factors
      required to enhance the glycosylation of serine residues in vivo.

PMID- 8360186
TI  - Purification and properties of NADPH-dependent tylosin reductase from
      Streptomyces fradiae.
AB  - A reductase of Streptomyces fradiae was speculated to catalyze reduction of
      tylosin to relomycin, an industrially undesirable product. The activity of
      tylosin reductase was closely related to bacterial growth, suggesting involvement
      of the enzyme in a primary metabolism. The reductase activity was improved
      significantly in vivo and in vitro. The enzyme was also partially stabilized in
      vitro. Using a simple five-step chromatographic procedure, the reductase was
      purified 480-fold to apparent homogeneity. The purified reductase had a molecular
      mass of 270 kDa and consisted of two different subunits of 26 and 7 kDa at 1:1
      ratio. The enzyme exhibited an absorption maximum at 405 nm and was inhibited by
      exogenous FAD or FMN, indicating a flavin as its prosthetic group. Tylosin
      reductase was optimally active at pH 7.0-7.2 and 40 degrees C with NADPH as a
      preferred electron donor. The Km of the enzyme for tylosin was 1.4 mM and that
      for NADPH was 0.15 mM. The Vmax for the enzymatic reaction was 917 mumol of
      tylosin formed/min/mg protein. The enzymatic conversion of tylosin to relomycin
      was coupled to that of NADPH to NADP+ at a stoichiometric ratio of 1:1. Tylosin
      reductase showed a broad substrate specificity toward all macrolide aldehydes (as
      normal and shunt metabolites of tylosin biosynthesis) tested. Thus, the enzyme
      may have a physiological role of macrolide detoxification for the bacterium.

PMID- 8360185
TI  - Protease nexin-1, a thrombin inhibitor, is regulated by interleukin-1 and
      dexamethasone in normal human fibroblasts.
AB  - Thrombin participates in several regulatory events following injury as a result
      of its effects on blood coagulation and cell migration, proliferation, and
      differentiation. Protease nexin-1 (PN-1) is a potent thrombin inhibitor in the
      extracellular environment. Since injury-related factors are known to regulate the
      synthesis and secretion of PN-1, the inhibitor may serve to modulate the actions
      of thrombin during injury. Here we report the molecular mechanisms that underlie
      this regulation. In normal human fibroblasts, interleukin-1 (IL-1) beta
      stimulated the synthesis and secretion of PN-1. The stimulation correlated with
      an increase in steady-state levels of PN-1 mRNA. Treatment of cells with both
      cycloheximide and IL-1 reduced the levels of PN-1 mRNA. Nuclear run-on assays
      indicated that IL-1 modestly increased the rate of PN-1 transcription. However,
      experiments with actinomycin D demonstrated that IL-1 significantly increased the
      half-life of the PN-1 mRNA. In contrast, dexamethasone (DXM) repressed the
      synthesis and secretion of PN-1 from fibroblasts. This effect correlated with a
      decrease in PN-1 mRNA. A sustained decrease in PN-1 mRNA was also seen when cells
      were treated with cycloheximide and DXM. In nuclear run-on assays, DXM functioned
      as a transcriptional repressor of PN-1 synthesis. Treatment of cells with
      actinomycin D showed that DXM did not affect mRNA stability. Thus, our
      experiments demonstrate that IL-1 and DXM, which function biologically in
      different fashions, regulate the synthesis of PN-1 by separate molecular
      mechanisms. While DXM directly regulates PN-1 at the level of transcription, IL-1
      in the presence of ongoing protein synthesis regulates PN-1 production
      predominantly in a post-transcriptional fashion by increasing the half-life of
      the PN-1 mRNA.

PMID- 8360187
TI  - Steroid requirement for androgen receptor dimerization and DNA binding.
      Modulation by intramolecular interactions between the NH2-terminal and steroid
      binding domains.
AB  - Infection of Spodoptera frugiperda Sf9 insect cells with recombinant human
      androgen receptor (AR) baculovirus results in expression of a 118-kDa
      phosphoprotein that displays high affinity androgen binding and androgen
      dependent targeting to the nucleus. Using the DNA mobility shift assay, specific
      in vitro binding of full-length AR to androgen response element DNA (ARE)
      requires intracellular hormone exposure. The ability of a variety of steroids to
      induce ARE binding paralleled their transcriptional potential. Certain
      antihormones, cyproterone acetate and RU486, promote ARE binding, but a pure
      antiandrogen, hydroxyflutamide, inhibits AR binding to ARE DNA. AR dimerization
      requires incubation of recombinant baculovirus-infected insect cells with
      androgen, but only when one or both components of the dimer contain the NH2
      terminal domain. Based on the intensities of ARE binding and lack of binding to
      an ARE half-site, it appears that, unlike the glucocorticoid receptor, AR binds
      DNA primarily as a dimer. Thus, full-length baculovirus-expressed AR requires
      intracellular hormone exposure for dimerization and ARE binding to overcome
      inhibition imposed by the AR NH2-terminal domain. Antihormones with agonist
      activity promote dimerization and ARE binding, while a pure antiandrogen blocks
      AR DNA binding. It is concluded that intramolecular interactions between the NH2
      terminal and steroid-binding domains are regulated by the specificity of hormone
      binding and modulate receptor dimerization and DNA binding.

PMID- 8360188
TI  - A new isoform of the laminin receptor integrin alpha 7 beta 1 is developmentally
      regulated in skeletal muscle.
AB  - Within the integrin family, there are two groups of receptors that bind laminin.
      One of these groups comprises the heterodimers alpha 3 beta 1, alpha 6 beta 1,
      and alpha 7 beta 1, all of which bind the E8 fragment of laminin, and whose alpha
      subunits show significant homology at the amino acid sequence level. alpha 3 and
      alpha 6 exist as isoforms with distinct cytoplasmic domains (termed A and B),
      suggesting that they may couple laminin adhesion to distinct cellular responses.
      We report the identification of a new alpha 7 mRNA which encodes an alpha 7
      protein isoform with an alternative cytoplasmic domain. Based on homology with
      alpha 3 and alpha 6 isoforms, this new isoform is classified as alpha 7A and the
      previously published one as alpha 7B. This result extends the similarity between
      alpha 3, alpha 6, and alpha 7 laminin receptor subunits and suggests a common
      ancestral gene. The alpha 7 beta 1 laminin receptor was proposed to be involved
      in myogenic differentiation. However, alpha 7 isoforms were not investigated in
      that context. We detected the alpha 7B isoform mRNA in all tissues and cell types
      tested, including myocardial and skeletal muscle. In contrast, the alpha 7A
      isoform was detectable exclusively in skeletal muscle, not in myocardial muscle
      or cells or any other tissues or cell lines tested. Furthermore, the
      differentiating skeletal muscle cell line C2C12 expressed only alpha 7B at the
      replicating myoblast stage and acquired alpha 7A expression upon induction of
      differentiation and fusion. Splicing of alpha 7B mRNA in C2C12 occurred shortly
      after myogenin expression and could be an indicator of progression through the
      program of skeletal muscle differentiation.

PMID- 8360189
TI  - Functional characterization of the alternatively spliced, placental human growth
      hormone receptor.
AB  - The human growth hormone family of peptide hormones is encoded by five genes,
      pituitary growth hormone (hGH-N), and four placentally expressed genes, growth
      hormone variant (hGH-V), chorionic somatomammotropin A and B (hCS-A, hCS-B), and
      prolactin (hPrl). As part of an effort to define the local effects of the
      placentally expressed members of the GH/Prl family of hormones on the placenta,
      we have identified an isoform (hGHRd3) of the growth hormone receptor expressed
      in the placental villi. hGHRd3 mRNA differs from the liver GHR mRNA by the
      deletion of a 66-base pair segment encoding exon 3. In this study we show that
      hGHRd3 mRNA encodes a stable and functional receptor. hGHRd3 mRNA is efficiently
      translated and processed in a rabbit reticulocyte lysate translation system as
      well as in an in vivo Xenopus laevis oocyte expression system. In Xenopus oocytes
      hGHRd3 is stably integrated into the cell membrane and binds and internalizes
      ligand as efficiently as hGHR. hGHRd3 binds all three of the placentally
      expressed members of the GH/Prl gene family (hGH-V, hCS, and Prl) as well as both
      the 22 and 20 kDa isoforms of the pituitary hGH-N. The results of the present
      study strongly support the expression of a functional hGHRd3 isoreceptor in the
      placenta which may serve in autocrine, paracrine, and/or endocrine activation.

PMID- 8360190
TI  - Peculiar spectroscopic and kinetic properties of Cys-47 in human placental
      glutathione transferase. Evidence for an atypical thiolate ion pair near the
      active site.
AB  - Cys-47, the most reactive cysteine in the homodimeric glutathione transferase (EC
      2.5.1.18) from human placenta (class Pi), displays peculiar acid base and
      spectroscopic properties. The thiolate form of this residue is characterized by a
      sharp UV absorption spectrum centered at 229 nm with an epsilon = 7,500 M-1 cm-1.
      The dependence of the apparent extinction coefficient on pH indicates that the
      sulfhydryl group of Cys-47 has a pKa value of 4.2. Moreover the dependence of the
      reactivity of Cys-47 toward bromopyruvate and iodoacetamide with pH resembles
      that found for the functional sulfhydryls of thiol proteases, which have very low
      pKa values and exist mainly as a mercaptide-imidazole ion pair. The apparent pKa
      value for Cys-47, calculated by this kinetic approach, is in good agreement with
      that determined spectroscopically. X-ray crystallographic data indicate that the
      protonated amino group of Lys-54, 4.9 A from the sulfur atom, is probably
      involved in the deprotonation of Cys-47. Calculation of the electrostatic
      potential on the sulfur atom of Cys-47 gives a theoretical pKa value of 3.5 for
      the sulfhydryl group. The simulated neutralization of Lys-54 shifts the pKa value
      of Cys-47 to a normal value of 9.5. These findings suggest that at physiological
      pH values, Cys-47 exists as the thiolate ion stabilized by an ion pair formation
      with the protonated amino group of Lys-54, and this probably accounts for its
      high reactivity.

PMID- 8360191
TI  - Structure of the alpha subunit of F1-ATPase probed by limited proteolysis.
AB  - The structure of the isolated alpha subunit of F1-ATPase from the thermophilic
      Bacillus strain PS3 was probed using limited proteolysis by four different
      proteases, and the following results were obtained. 1) Distribution of 21
      protease-cleaved sites is similar to that of the beta subunit of F1-ATPase
      (Tozawa, K., Odaka, M., Date, T., and Yoshida, M. (1992) J. Biol. Chem. 267,
      16484-16490), thus providing experimental evidence for similar folding topology
      of the two subunits, and the locations of 11 water-exposed loop regions in the
      tertiary structure are predicted. 2) Most proteolytic peptides remain associated
      to maintain the gross structure of the alpha subunit and can reassociate each
      other after denaturing urea treatment. 3) However, the carboxyl-terminal peptides
      comprising approximately 80 residues (C1 peptides) are released from other
      peptide(s) during proteolysis, and those comprising approximately 105 residues
      (C2 peptides) are released during native polyacrylamide gel electrophoresis after
      proteolysis. 4) Inclusion of Mg-ATP in the native electrophoretic system prevents
      the release of the C2 peptide. Addition of Mg-ATP to the proteolysis mixtures
      results in an increase of the C2 peptide population and a decrease of the C1
      peptide population. Thus, Mg-ATP induces a conformational change at the regions
      of C1 and C2 peptides of the alpha subunit. 5) Except for the trypsin-treated
      one, protease-treated alpha subunits are reconstitutable with the native beta
      subunit into the form of alpha 3 beta 3 complexes, which show significantly
      higher ATPase activities than the intact alpha 3 beta 3 complex. This activation
      is attributable to the cleavage of a peptide bond that produces C2 peptides. The
      carboxyl-terminal region of the alpha subunit is likely to be involved in the
      regulation of ATPase activity in F1-ATPase.

PMID- 8360192
TI  - Alteration of the structural properties of starch components by the lack of an
      isoform of starch branching enzyme in rice seeds.
AB  - This study describes the effect of starch-synthesizing enzymes on biosynthesis of
      storage starch in rice amylose-extender mutants, which contain branched D-glucans
      with abnormal structures. Western blot analysis indicated that two out of five
      amylose-extender mutant lines lacked an isoform of starch branching enzyme,
      termed RBE3, although the levels of granule-bound starch synthase and a major
      form of branching enzyme, RBE1, were normal in these two mutants. Proteins
      corresponding to the 87-kDa RBE3 molecule were present in the three other amylose
      extender mutants as well as in the wild type. However, the level of branching
      enzyme activity significantly decreased in all amylose-extender mutants,
      suggesting that the 87-kDa proteins in these three mutants are inactive forms of
      RBE3. Therefore, we conclude that formation of the abnormal branched glucans in
      the amylose-extender mutant of rice is due to the lack of the RBE3 activity. The
      cDNA clones encoding RBE3 have been identified from a normal rice seed cDNA
      library in lambda gt11, using a synthetic oligonucleotide as a probe. The deduced
      amino acid sequence of RBE3 indicates that this protein is initially synthesized
      as a precursor of 825 amino acids, including a 65-residue transit peptide at the
      NH2 terminus. The sequences of the catalytic regions in amylolytic enzymes are
      highly conserved in the sequence of RBE3. Thus, the branching enzyme isoform
      belongs to a family of the amylolytic enzymes. RBE3 also shares a noticeable
      degree of sequence identity with RBE1, especially at the central portion of the
      protein molecule. However, RBE3 possesses an approximately 70-residue extra
      sequence at the NH2 terminus and lacks a COOH-terminal sequence of almost 50
      residues as compared with RBE1. The structural differences at both termini may
      explain the distinct role in starch synthesis for RBE1 and RBE3.

PMID- 8360193
TI  - The glucose transporter GluT4 and secretory carrier membrane proteins (SCAMPs)
      colocalize in rat adipocytes and partially segregate during insulin stimulation.
AB  - Secretory carrier membrane proteins (SCAMPs) mark the recycling system for the
      insulin-responsive glucose transporter, GluT4, in rat adipocytes. Anti-GluT4 and
      anti-SCAMP antibodies each immunoadsorbed vesicles containing both antigens from
      a low density microsomal fraction that is enriched in both antigens. The
      immunoadsorbed vesicles also contain VAMPs (synaptobrevins), synaptic vesicle
      membrane proteins. All three antigens were colocalized in low density microsomal
      vesicles from both basal and insulin-stimulated adipocytes. The SCAMPs have the
      same electrophoretic mobility as a major polypeptides detected in GluT4 vesicles.
      During insulin stimulation, 40% each of GluT4 and VAMPs redistribute from low
      density microsomes to the plasma membrane fraction; however, < 10% of the SCAMPs
      redistribute. Immunocytochemical staining of adipose tissue shows almost complete
      coincidence of SCAMPs and GluT4 in the basal state and extensive redistribution
      of both antigens to the cell periphery during insulin stimulation. Segregation of
      antigens during stimulation is not as distinct as observed by fractionation,
      although there are regions at the cell border where the SCAMPs appear more
      concentrated than GluT4. These data suggest that during insulin stimulation, in
      contrast to the behaviour of GluT4, SCAMPs remain tightly associated with the
      recycling system.

PMID- 8360194
TI  - Polyamine and polyamine analog regulation of spermidine/spermine N1
      acetyltransferase in MALME-3M human melanoma cells.
AB  - In MALME-3M human melanoma cells the polyamine analog N1,N12-bis(ethyl)spermine
      (BESPM) suppresses the key polyamine biosynthetic enzymes, ornithine and S
      adenosylmethionine decarboxylase, and increases the polyamine catabolizing
      enzyme, spermidine/spermine N1-acetyl-transferase (SSAT) by more than 200-fold.
      In the present study increases in SSAT activity in MALME-3M cells treated with 10
      microM BESPM were found to be accompanied by a substantial (up to 45-fold)
      accumulation of SSAT mRNA. By Northern blot analysis three RNA transcripts were
      found to hybridize with the coding region of human SSAT cDNA: a minor high
      molecular weight (approximately 3.5 kilobases) species designated form A and two
      lower molecular weight species designated forms B and C (approximately 1.5 and
      approximately 1.3 kilobases, respectively). Form A increased uniformly during
      BESPM treatment and was most obvious in nuclear RNA preparations. On the basis of
      size similarity to the transcribing region of the gene and hybridization with the
      coding region of SSAT cDNA and its prevalence in nuclear mRNA preparations, form
      A is thought to represent precursor SSAT RNA. Form C is present in control cells
      and increases steadily during treatment, whereas form B increases transiently
      during early treatment (1-3 h). By RNase H digestion assay, form B was found to
      have a 200-base pair longer poly(A) tract and as such may represent a precursor
      to form C. Accumulation of SSAT mRNA was found to be a result of increased gene
      transcription and stabilization of SSAT mRNA. Nuclear run-on studies indicated a
      2-4-fold increase in the transcription rate of the SSAT gene. As indicated by
      actinomycin D studies, the SSAT mRNA half-life increased with BESPM treatment
      from 17 to 64 h. The natural polyamine, spermine, also increased SSAT mRNA (5.5
      fold at 24 h) and behaved similarly to BESPM in inducing the appearance of the
      same three transcript forms. The polyamine was much less effective than the
      analog at increasing enzyme activity. Lowering intracellular polyamine pools with
      inhibitors of biosynthesis decreased basal SSAT mRNA levels by at least 70%
      indicating, that the gene can be down-regulated as well as up-regulated by
      polyamines. These findings indicate that SSAT represents a unique example of gene
      expression being positively influenced at the RNA level by polyamines and their
      analogs.

PMID- 8360195
TI  - Cloning and characterization of an endothelin-3 specific receptor (ETC receptor)
      from Xenopus laevis dermal melanophores.
AB  - We report here the presence of a receptor specific for endothelin-3 (termed ETc
      receptor or ETcR) on Xenopus laevis dermal melanophores. Activation of ETcR
      causes the dispersion of the pigment granules within the melanophores. The EC50
      for ET-3 to induce the pigment dispersion is 24 +/- 7 nM, compared to greater
      than 10 microM for both ET-1 and -2. This effect desensitizes in a manner that is
      dependent on both time and the concentration of ET-3 used to stimulate the cells.
      A cDNA encoding for ETcR was isolated by a polymerase chain reaction-mediated DNA
      amplification strategy using degenerate oligonucleotides prepared based on
      conserved regions of other known G-protein-coupled receptor sequences and by the
      subsequent screening of a frog melanophore cDNA library. The cloned cDNA consists
      of 2,240 nucleotides, with an open reading frame coding for 444 amino acids
      containing an initial 20-amino acid signal sequence. The predicted mature peptide
      consists of 424 amino acids with a heptahelical structure common to the G-protein
      coupled receptor surperfamily. Its deduced amino acid sequence is 47 and 52%
      identical to ETA and ETB receptors, respectively, while ETA and ETB are 48%
      identical to each other. Expression of cDNA in HeLa cells, which do not contain
      endothelin receptors, enables the cells to specifically bind [125I]ET-3.
      Competition binding experiments performed on HeLa cells transiently expressing
      pETc show that the apparent Ki values for ET-3 and ET-1 to displace [125I]ET-3
      are 45.5 +/- 16 and 114 +/- 22 nM, respectively.

PMID- 8360196
TI  - Serine 1002 is a site of in vivo and in vitro phosphorylation of the epidermal
      growth factor receptor.
AB  - We have shown previously that treatment of A431 cells with epidermal growth
      factor (EGF) induces desensitization of the EGF receptor. We now show that this
      desensitization is associated with an increase in the phosphorylation of the
      receptor on Ser-1002. Using a synthetic peptide corresponding to the sequence
      surrounding Ser-1002, p34cdc2 was identified as a kinase capable of
      phosphorylating this serine residue. Purified Xenopus p34cdc2 was found to
      phosphorylate the synthetic peptide on the serine residue corresponding to Ser
      1002. This kinase also phosphorylated purified EGF receptor in vitro on Ser-1002.
      Phosphorylation of the EGF receptor by p34cdc2 was associated with a decrease in
      its tyrosine protein kinase activity. These data indicate that the EGF receptor
      may be a target for phosphorylation by a cyclin-dependent kinase in vivo and
      imply that receptor function may be regulated in a cell cycle-dependent fashion.

PMID- 8360197
TI  - Localization of "non-extractable" acetylcholinesterase to the vertebrate
      neuromuscular junction.
AB  - Asymmetric forms of acetylcholinesterase (AChE) are thought to be the predominant
      forms of this enzyme at vertebrate neuromuscular junctions where they attach to
      the synaptic basal lamina via a collagen-like tail. High salt and heparin
      containing buffers are capable of solubilizing asymmetric AChE molecules from
      skeletal muscle; however, detachment of AChE specifically from synaptic basal
      lamina using these procedures has not been demonstrated. To determine whether
      AChE can be solubilized from mature neuromuscular junctions, adult quail muscle
      fibers were extracted with buffered detergent solutions containing either 0.05 M
      NaCl, 1 m NaCl, 0.5-2 mg/ml heparin, 8 M urea, or 4 m guanidine HCl, and the
      remaining AChE molecules were localized by indirect immunofluorescence. Analysis
      of extracted AChE oligomeric forms showed that low salt buffers containing
      heparin and high salt buffers were capable of solubilizing substantial amounts of
      catalytically active collagen-tailed AChE, whereas none of these buffers were
      capable of detaching AChE from synaptic basal lamina. In contrast, digestion with
      purified collagenase detached asymmetric forms from the non-extractable fraction
      and removed the AChE from the neuromuscular junctions. Parallel experiments using
      rat gastrocnemius muscle and enzyme histochemistry to detect AChE gave similar
      results. These studies indicate that the junctional AChE molecules are firmly
      attached to the extracellular matrix and that all the conventional extraction
      buffers used to solubilize the asymmetric collagen-tailed forms of AChE are
      incapable of detaching this enzyme from the synaptic basal lamina.

PMID- 8360198
TI  - The blood compatibility catastrophe.

PMID- 8360199
TI  - Organoapatites: materials for artificial bone. II. Hardening reactions and
      properties.
AB  - This article reports on chemical reactions and the properties they generated in
      artificial bone materials termed "organoapatites." These materials are
      synthesized using methodology we reported in the previous article of this series.
      Two different processes were studied here for the transition from organoapatite
      particles to implants suitable for the restoration of the skeletal system. One
      process involved the hardening of powder compacts by beams of blue light derived
      from a lamp or a laser and the other involved pressure-induced interdiffusion of
      polymers. In both cases, the hardening reaction involved the formation of a
      polyion complex between two polyelectrolytes. In the photo-induced reaction an
      anionic electrolyte polymerizes to form the coulombic network and in the pressure
      induced one, pressure forms the complex by interdiffusion of two polyions. Model
      reactions were studied using various polycations. Based on these results the
      organoapatite selected for the study was that containing dispersed poly(L-lysine)
      and sodium acrylate as the anionic monomer. The organomineral particles can be
      pressed at room temperature into objects of great physical integrity and
      hydrolytic stability relative to anorganic controls. The remarkable fact about
      these objects is that intimate molecular dispersion of only 2-3% by weight
      organic material provides integrity to the mineral network in an aqueous medium
      and also doubles its tensile strength. This integrity is essentially nonexistent
      in "anorganic" samples prepared by the same methodology used in organoapatite
      synthesis. The improvement in properties was most effectively produced by
      molecular bridges formed by photopolymerization. The photopolymerization leads to
      the "hardening" of pellets prepared by pressing of organoapatite powders. The
      reaction was found to be more facile in the microstructure of the organomineral,
      and it is potentially useful in the surgical application of organoapatites as
      artificial bone.

PMID- 8360200
TI  - Organoapatites: materials for artificial bone. III. Biological testing.
AB  - This article reports on the in vivo testing of new artificial bone materials we
      have termed "organoapatites." These materials consist of mineral networks in
      which organic polymers are intimately dispersed by nucleation and growth of
      apatite crystals from a mother liquor containing the organic substances.
      Organoapatites were tested as implants in adult canine cortical bone for periods
      in the range from 12-35 weeks and fluorochromes were used in the model to
      investigate the kinetics of bone growth or repair. The analysis of histological
      samples was carried out using histomorphometric methods as well as fluorescence
      microscopy. Results showed excellent apposition of poly(amino acid)
      organoapatites with mineralized bone and fibrous encapsulation when a synthetic
      polyelectrolyte was the only organic component. This observation suggests that
      the molecularly dispersed organic dopant amounting to only 2-3% by weight of the
      microstructure can play a critical role in the tissue response to the implant.
      Relative to apatite controls, organoapatites were also found to have greater
      resistance to fragmentation in vivo and those containing amino acid units
      revealed interfacial bioerosion accompanied by regeneration of mineralized
      tissue. Design of organoapatite compositions and microstructures may therefore be
      useful in achieving the specific rate of biological response which is clinically
      desired.

PMID- 8360201
TI  - Collagen fibers as a temporary scaffold for replacement of ACL in goats.
AB  - ACL substitutes made of braided or plied purified collagen fibers and cross
      linked with hexamethylenediisocyanate were implanted into a total of 14 adult
      goats to achieve resorption within 8 to 10 months. Two types of collagen fiber
      prostheses differing in degree of collagen purification were tested. The implants
      were harvested 2 to 11 months postimplantation, tested for mechanical strength,
      and evaluated by morphological methods. In the first group (n = 5), the less
      purified and less cross-linked collagen fiber ACL implant induced fast connective
      tissue ingrowth. At 6 months postimplantation, 40 to 60% of the collagen implant
      was resorbed. No studies on breaking strength were done in this group. In the
      second group, highly purified and more crosslinked ACL implants were less
      infiltrated by cells and were resorbed only by 10 to 20%. Still, the breaking
      strength was decreased to 10% of the original implant strength. In the second
      group, the fixation of the ACL implant in the bone tunnel with a bone wedge was
      insufficient (n = 6); however, additional fixation with metal screws was
      successful (n = 3). We conclude that cross-linked collagen fibers alone cannot be
      used as a safe ACL substitute as they quickly lose mechanical strength despite
      limited biodegradation.

PMID- 8360202
TI  - Variations between Biomer lots. 2: The effect of differences between lots on in
      vitro enzymatic and oxidative degradation of a commercial polyurethane.
AB  - In vitro degradation of two lots of Biomer, a commercial poly(ether urethane
      urea), has been investigated in order to understand possible mechanisms for in
      vivo degradation. Two lots of Biomer, BSUA001 and BSP067, were used in the study.
      Lot BSUA001 contained a poly(diisopropylaminoethyl-methacrylate), an ultraviolet
      stabilizing additive. This additive was absent in lot BSP067. Samples of each lot
      were exposed to two hydrolytic enzymes, papain and leucine aminopeptidase, and to
      hydrogen peroxide for 24 h. The extent of degradation was assessed using high
      pressure gel permeation chromatography and x-ray photoelectron spectroscopy
      (XPS). Statistically significant changes in the molecular-weight distribution
      occurred in lot BSP067 for all three treatments. Only the hydrogen peroxide
      treatment resulted in statistically significant changes in the molecular weight
      of lot BSUA001. XPS data for samples of lot BSUA001 that had been treated with
      hydrogen peroxide revealed the formation of nitroso groups and protonated amines
      at the surface. The data suggest that surface chemistry is important for enzyme
      catalyzed degradation, while permeability is important for degradation by
      hydrogen peroxide.

PMID- 8360203
TI  - Platelet deposition onto polymeric surfaces during shunting.
AB  - In an attempt to develop blood-contacting tubes that can be applied for short
      term uses with a reduced heparin concentration or, ideally, without
      heparinization, we evaluated the blood compatibility of polymeric materials with
      a rabbit ex vivo shunt model. The shunt tubes employed were made of silicone,
      plasticized poly(vinyl chloride) (PVC), and segmented poly(ether urethane) (PU).
      In addition, two kinds of surface-modified tube were used: poly(vinyl alcohol)
      (PVA)-coated PVC and poly(dimethylacrylamide) (PDMAA)-grafted PU. The ex vivo
      shunt results correlated well with protein adsorption and platelet adhesion in
      vitro. The following order for the extent of platelet deposition was given,
      irrespective of the blood-contacting duration: PDMAA-grafted PU < PVA-coated PVC
      < PU < silicone, PVC. It is likely that many platelet aggregates detached from
      the PVA-coated PVC surface. For PDMAA-grafted PU, no trace of detachment of
      aggregates could be detected on any of the SEM photographs. The number and
      morphology of blood cells adhered onto the tube surfaces during ex vivo shunting
      were dependent on the kind of polymer surfaces, the blood exposure time, and the
      flow rate of blood.

PMID- 8360204
TI  - Degradation of medical-grade polyurethane elastomers: the effect of hydrogen
      peroxide in vitro.
AB  - Treatment of Pellethane 2363-80A--a medical-grade poly(tetramethylene oxide)
      based polyurethane elastomer--with 25% (w/w) hydrogen peroxide at 100 degrees C
      for times ranging from 24 h to 336 h led to significant decreases in ultimate
      tensile properties and decreases in molecular weight, both at the surface and in
      the bulk. IR spectral changes were similar to those observed after degradation in
      vivo. Differential scanning calorimetry showed that hydrogen-peroxide-induced
      degradation was associated with greater order in the hard domain and greater
      mobility in the soft domain. Studies conducted with low-molecular-weight model
      compounds for the hard and soft segments confirmed that methylene groups adjacent
      to oxygen were susceptible toward oxidation. The extent of degradation of a
      series of commercial polyurethanes on treatment with hydrogen peroxide (25%, 24
      h, 100 degrees C) correlated well with their reported susceptibility to
      environmental stress cracking in vivo.

PMID- 8360205
TI  - Interaction of heparin with polyallylamine-immobilized surfaces.
AB  - A new method to bind ionically and remove heparin from solution and dilute serum
      is described. Utilizing cellulose diacetate (CA) as the polymer substrate, a
      cationic polymer chain--poly(allylamine)-PALA--was immobilized directly onto the
      CA surface and onto the surface using poly(ethylene glycol) (PEG) spacer groups.
      The ionic interaction between the anionic heparin molecule and the cationic PALA
      polymer is specific and effective to remove heparin from the bulk solution. The
      binding properties of heparin onto the PALA and PEG-PALA surfaces were examined.
      The effects of PEG spacers on heparin binding onto the PALA-immobilized surface
      were investigated by varying the Mw of PEG spacers. PALA (Mw 8500)-immobilized
      surfaces exhibited enhanced heparin binding. The maximum heparin binding was
      observed in the region of PEG Mw 2000-4000. For the high-molecular-weight PALA
      (Mw 50,000)-immobilized surfaces, heparin binding was independent of the
      molecular weight of PEG. PEG spacers were also evaluated for their ability to
      prevent or decrease protein (albumin) adsorption. It was observed that at high
      albumin concentrations, the adsorption of proteins decreased with increasing
      chain length of PEG, up to Mw 3400. These observations suggest that low-molecular
      weight PALA (Mw 8500)-immobilized CA surfaces with PEG spacers (Mw 3400) may
      provide increased heparin binding capacity and decreased protein adsorption.

PMID- 8360206
TI  - Protein adsorption to poly(ether urethane ureas) modified with acrylate and
      methacrylate polymer and copolymer additives.
AB  - To understand better blood interactions with poly(ether urethane urea) (PEUU)
      materials, a radioimmunoassay and whole or diluted human plasma were used to
      characterize the presence of fibrinogen, immunoglobulin G, factor VIII/von
      Willebrand factor, Hageman factor (factor XII), and albumin on a PEUU formulation
      and on PEUU formulations modified with the amphiphilic additive Methacrol 2138F
      (co[diisopropylaminoethyl methacrylate (DIPAM)/decyl methacrylate] [3/1]), or
      with hydrophobic acrylate or methacrylate polymer or copolymer additives. The
      protein adsorption assay showed that PEUU films loaded or coated with Methacrol
      2138F (Methacrol) or homopoly-DIPAM (h-DIPAM) adsorbed significantly lower
      amounts of the studied proteins than did either the base PEUU formulations or the
      PEUUs loaded with the more hydrophobic acrylate or methacrylate polymer
      additives. Experiments with Methacrol-loaded PEUUs, where the loading of
      Methacrol was varied from 0.25 wt% to 20.0 wt%, showed that the adsorption of
      each of the characterized proteins did not vary significantly throughout the
      Methacrol loading range, and that all Methacrol-loaded PEUU formulations adsorbed
      significantly lower amounts of the studied proteins than did the unloaded PEUU.
      Phase separation within the additive loaded PEUUs was characterized by scanning
      electron microscopy (SEM). The solubility parameters of the additives, as well as
      of the base PEUU, were calculated and used to interpret differences in phase
      separation of the additive modified PEUUs. The analysis showed that additives of
      lower solubility parameter phase-separated into fewer large microdroplets within
      the PEUU matrix. SEM analysis also showed that additive microdroplets were not
      present on the air side surface of loaded PEUUs. To explain the differences in
      protein adsorption to the air side of additive loaded PEUUs when compared to the
      base PEUU, it was assumed that the additives near this region of the solvent
      swollen PEUU matrix may have migrated to, at, or near the PEUU-air interface
      during film formation, creating an additive enriched PEUU surface region. Once at
      this surface region, it was suggested that dynamic surface reorientation in
      response to an aqueous medium ensured that the additives were able significantly
      to influence protein adsorption behavior only if they interacted with aqueous
      media more favorably than the PEUU.

PMID- 8360207
TI  - Extracellular matrix analogs as carriers for growth factors: in vitro fibroblast
      behavior.
AB  - Repair of connective tissue involves interactions between growth factors (GFs)
      and extracellular matrix (ECM) molecules. On the other hand, biological
      biomaterials could be used to carry and deliver GFs to stimulate wound healing.
      In the present study, fibroblasts were cultivated in a serum-free culture medium
      onto collagen (type I), hyaluronic acid, chondroitin sulfate, fibronectin, or
      fibrin. FGF, EGF, or PDGF was incorporated within those substrates. Using immuno-
      and radiolabeling assays, the distribution of GFs within the ECM analogs was
      relatively uniform and GFs retained in substrates were dependent on the
      substrates. Fibroblast replication was determined by the incorporation of [3H]
      thymidine and compared to control groups. On collagen or chondroitin sulfate, the
      incorporation of GFs did not significantly improve cell proliferation. On
      hyaluronic acid, the incorporation of FGF and PDGF enhanced cell replication at
      48 h. The incorporation of PDGF in fibronectin enhanced cell replication. On
      fibrin, the incorporation of PDGF, EGF, and FGF significantly enhanced cell
      replication. However, cell replication on FGF-incorporated fibrin was higher by
      48 h than that on fibrin in the presence of FGF-supplemented culture medium.
      Fibrin sustains the biological activity of GFs, FGF in particular, and can be a
      carrier for GF that stimulates cell replication.

PMID- 8360208
TI  - Bending properties and transformation temperatures of heat treated Ni-Ti alloy
      wire for orthodontic appliances.
AB  - The effect of heat treatment temperature on bending properties and transformation
      temperatures of a Ni-Ti alloy wire, 1.0 mm in diameter, was investigated so that
      superelasticity could be used in orthodontic appliances needing shape memory
      processes. The heat treatment process was at 713 K for 1.8 ks and between 673 K
      and 813 K for 1.8 ks. A three-point bending test and differential scanning
      calorimetry were performed. The transformation temperatures of the wires were
      lowered with increasing heat treatment temperature. The reverse transformation
      finishing temperature was below the body temperature with the treatment above 753
      K. Residual deflection of the Ni-Ti wire after bending was small with the
      secondary heat treatment above 733 K. The load in the unloading process was less
      changeable and increased with the treatment temperature between 733-813 K.
      Secondary heat treatment in this range was suitable for using superelasticity in
      expansion arch appliances.

PMID- 8360209
TI  - Effect of crosslinking agent content, monomer functionality, and repeat unit
      chemistry on properties of unfilled resins.
AB  - Seven mechanical/physical properties were used to evaluate 10 unfilled resins:
      eight aromatic dimethacrylates and two urethane dimethacrylates. Physical
      property tests included compressive strength, Young's modulus in compression,
      uniaxial tensile strength, intrinsic yield point, toothbrush abrasion, Knoop
      hardness, and water sorption. Controlled changes were made in the following four
      material parameters: amount of crosslinking diluent present in the uncured
      monomer, functionality of the monomer, repeat unit chemistry of the monomer
      (urethane vs. aromatic structure) and mode of activation (chemical vs. visible
      light). Polymers containing a high concentration of crosslinking agent (50 wt%)
      were found to be tougher and to possess lower hardness than materials containing
      lesser amounts of crosslinking agent. This was attributed to the flexible nature
      of the triethylene glycol dimethacrylate crosslinking molecule. Exposure to water
      plasticized the highly crosslinked materials to the degree that the yield point
      and elastic modulus were effectively lowered. Most of the tested properties were
      unaffected by differences in functionality except resistance to toothbrush
      abrasion, which was enhanced for polymers derived from high functionality
      monomers. The urethane-based polymers sorbed substantially more water than the
      aromatic-based materials, which presumably resulted in lower values for surface
      hardness. However, the urethane resins were very tough, and excellent resistance
      to toothbrush abrasion was observed. Property differences caused by differences
      in activation mode were small, although the visible light materials did sorb more
      water.

PMID- 8360210
TI  - Fluoroalkylethyl silane coating as a moisture barrier for dental ceramics.
AB  - The performance of dental ceramics is reduced in wet environments due to stress
      corrosion limiting restoration lifetime. As analysis suggests that fracture is
      typically initiated from the internal surface, placement of a thin coating before
      a restoration is cemented to place may prevent fracture if it acts as a moisture
      barrier. Of coatings we tested, a fluoroalkylethyl silane (du Pont MPD-7680)
      showed promise. This study aimed to test a range of concentrations on glass and
      to determine any strength improvement on dental ceramics. Glass slides (n = 8-9)
      were indented (29-N load) stored 24 h, etched, coated with 100, 50, and 25%
      fluorosilane in isopropyl alcohol, and air-cured for 24 h. The slides were
      fractured on a biaxial fixture in water at 0.5 mm/min and maximum stresses
      calculated. Uncoated controls were tested in water and liquid N2 to determine the
      inert strength without stress-corrosion. Results showed increasing mean strength
      from uncoated (53.6 MPa) to 100% (68.0 MPa) which compared to the 80.4 MPa inert
      strength. ANOVA showed P < .05. Subsequently the experiment was repeated on discs
      of three dental ceramics (n = 7-10): feldspathic (Ceramco), glass-ceramic (Dicor
      MGC), high-leucite (Optec) with the 100% solution only. Mean strength was
      significantly (P < .01) enhanced in the feldspathic (56.2 MPa, untreated, 70.7
      MPa, treated) but not the high-leucite (83.1, 83.0) or the glass-ceramic (283.9,
      271.4). Fluoroalkylethyl silane coating reduced stress-corrosion in glass and
      feldspathic porcelain. It may be a practical approach to reducing fracture of
      ceramic restorations.

PMID- 8360211
TI  - New ideas in biomaterials science--a path to engineered biomaterials.
AB  - Our existing biomaterials, although demonstrating generally satisfactory clinical
      performance, were developed based upon a trial-and-error optimization approach
      rather than being engineered to produce the desired interfacial reaction. Most
      biomaterials exhibit a nonspecific biological reaction, with sluggish kinetics
      and a broad spectrum of active processes simultaneously occurring. This article
      describes materials science nanotechnology, and molecular biology techniques that
      may permit the synthesis of precisely engineered surfaces. Such surfaces might
      demonstrate rapid, precise reactions with proteins and cells. This opens the
      question, "what type of specific surface bioreactions do we want?" New thoughts
      on biocompatibility are presented that may be helpful in the design of specific
      surfaces yielding precise, defined biological responses.

PMID- 8360212
TI  - Behavior of primary bone cells on characterized polystyrene surfaces.
AB  - Primary bone cells, isolated from the periosteally stripped calvariae of neonate
      rats, were cultured on 60Co gamma-irradiation-sterilized bacteriologic-grade
      polystyrene that had been either surface treated with concentrated sulfuric acid
      or received further gamma-irradiation treatments facilitated cell colonization of
      the polystyrene compared to those surfaces not treated in the laboratory. x-Ray
      photoelectron spectroscopy (XPS) showed that the two treatments introduced
      different chemical groups onto the polymer surface and that cell adhesion was
      related to gamma-irradiation in a dose-dependent manner. These results show that
      simple biologic assays, such as cell colonization, are not able to distinguish
      between differences in surface chemistry demonstrated by such a routinely
      employed surface analysis technique. Thus, there is a need to develop more
      sensitive biologic assays that provide functional information of a precision that
      can be correlated with subtle changes in substratum surface chemistry. Further,
      we argue that because cells isolated by tissue digestion using proteolytic
      enzymes respond more readily to changes in the surface chemistry of the
      substratum they colonize, compared to explanted cells; biologic assays designed
      for biomaterials testing must take into account changes effected in cell adhesion
      behavior by isolation procedures.

PMID- 8360213
TI  - In vivo evaluation of protein adsorption to sterically stabilised colloidal
      carriers.
AB  - A diffusion chamber implanted intraperitoneally in the rabbit was employed as an
      in vivo model to evaluate the interaction of peritoneal proteins with block
      copolymer (poloxamer and poloxamine)-coated polystyrene microspheres (PS). Using
      a desorption technique followed by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, six proteins of 94, 86, 66, 53, 40, and 20 kDa were desorbed
      from the carrier systems after incubation with peritoneal fluid in vitro. The 40-
      and 20-kDa proteins dominated the protein profile. A similar pattern was observed
      when proteins were desorbed from PS microspheres removed after 24-h implantation
      in chambers in the peritoneal cavity, although the protein profile was dominated
      by the 94- and 53-kDa proteins. In general, coating of PS with block copolymers
      reduced the amount of protein bound to the microspheres in vitro and in vivo but
      did not change the types of proteins bound.

PMID- 8360214
TI  - Porous collagen sponge for esophageal replacement.
AB  - A new artificial esophagus with a bilayered structure made of porous collagen
      sponge and silicone was studied. The concept of this study was not to replace an
      esophageal defect permanently with prosthesis but to promote tissue regeneration
      by collagen. Five centimeters of cervical esophagus were replaced by this
      artificial esophagus in 19 adult mongrel dogs. Two weeks after implantation, the
      collagen sponge was replaced by autologous tissue and regeneration of the
      "neoesophagus" was observed in all animals. The inner surface of the neoesophagus
      was covered with mature mucosal epithelium similar to the intact esophagus 4-5
      weeks after implantation. The replacement site was not complicated by infection,
      anastomotic leakage, or exuberant granulation tissue development on the luminal
      surface. In a long-term survival study, animals showed moderate-grade stenosis
      but could take normal feed orally and with no clinical problems observed.

PMID- 8360215
TI  - Biocompatibility testing of restorative materials influencing dentin and pulp.
AB  - A comparative study was carried out using 27 healthy human bicuspids that had
      been extracted for orthodontic reasons from adolescents 11-14 years old. A
      microphotometrical analysis of buccal and lingual odontoblast layer thickness was
      performed using the SAMBA 2000 system and the results were submitted to
      statistical comparison. The buccal odontoblast layer (BOL) was found to be
      thicker than the lingual odontoblast layer (LOL). These results were independent
      of age, sex, and tooth position in the dental arch. Moreover, a strong
      relationship existed between the layer thicknesses as linear function on a
      logarithmic scale. Standards for the evaluation of pulp-dentin biocompatibility
      are based essentially upon qualitative or semiquantitative histological criteria.
      A method of quantitative evaluation based upon microphotometrical measurements of
      the thickness of the buccal odontoblast layer, considered variable, and the
      lingual odontoblast layer, considered stable, was applied to coronal filling
      materials that had previously been tested by a classic method. Seventy bicuspids
      extracted from adolescents 11-14 years of age whose class-V cavities had been
      filled in situ with one of four restorative materials, and whole residual dentin
      thickness was less than 750 microns, were divided into two groups: an
      intermediate-term group (A) and a long-term group (B); both groups were
      subdivided into four experimental series as a function of test materials. A
      microphotometrical analysis was carried out using an automatic scanning system
      (SAMBA 2000) for the quantification of buccal and lingual odontoblast layer
      thicknesses. The results confirmed that due to the stability of the LOL thickness
      it may legitimately be used as reference in the study of the analogous BOL
      thickness.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360216
TI  - Gentamicin sulfate attachment and release from anodized Ti-6A1-4V orthopedic
      materials.
AB  - A novel method has been developed to attach, retain, and release antibiotics from
      titanium based materials. This technique consists of forming porous surface
      coatings by anodizing and using the surface chemical properties of the oxide
      coatings to attach antibiotics. Coatings with pores in the size range 0.1-0.5
      micron have been formed in acid solutions. The attachment and retainment of
      gentamicin sulfate, a cationic antibiotic, to the coatings has been investigated
      using microbiological methods. In vitro test results have shown that the duration
      of antimicrobial activity on the surface of anodized materials is dependent on
      the porosity and isoelectric point of the coatings. Using microporous oxide
      coatings formed in phosphoric acid solutions, it has been found that
      antimicrobial activity could be retained for more than 2 weeks.

PMID- 8360217
TI  - Cell growth on immobilized cell growth factor. 6. Enhancement of fibroblast cell
      growth by immobilized insulin and/or fibronectin.
AB  - A cell growth factor protein (insulin) and/or a cell-adhesion protein
      (fibronectin) were immobilized on surface-hydrolyzed poly(methyl methacrylate)
      membranes. The growth of mouse fibroblast cells STO was accelerated by the
      immobilized insulin. This acceleration was enhanced by introduction of spacer
      arms. Coimmobilization of insulin and fibronectin was very effective for the
      acceleration of cell growth.

PMID- 8360218
TI  - Cell growth on immobilized cell growth factor. 9. Covalent immobilization of
      insulin, transferrin, and collagen to enhance growth of bovine endothelial cells.
AB  - Bovine endothelial cells were cultivated on the surface of polyurethane membranes
      or tubes immobilized with insulin, transferrin, and/or collagen, and growth was
      measured. For the purpose of immobilization, amino groups were introduced on the
      membranes or tubes by glow-discharge treatment in the presence of ammonia gas.
      The proteins were coupled to the amino groups on the surfaces by using dimethyl
      suberimidate (DMS) or water-soluble carbodiimide (WSC). Growth of bovine
      endothelial cells was higher on immobilized insulin or transferrin using DMS than
      that using WSC. The cell growth was higher on immobilized insulin or transferrin
      than on free insulin or transferrin, respectively. Though immobilized collagen
      did not affect the cell growth, coimmobilization with insulin or transferrin
      brought about greater acceleration of cell growth. In addition, the immobilized
      collagen was indispensible to maintain the endothelial cells on the material
      surface for a long time. The endothelial cells grown in the polyurethane tubes,
      on which insulin and collagen are coimmobilized, kept a normal cobblestone-like
      appearance and maintained the ability to secrete prostacyclin for 9 months.

PMID- 8360219
TI  - Selective neuronal cell attachment to a covalently patterned monoamine on
      fluorinated ethylene propylene films.
AB  - The patterned covalent surface addition of a monoamine to fluorinated ethylene
      propylene films (FEP) controls both cellular attachment and differentiation in
      defined media conditions. A radio frequency glow discharge (RFGD) process was
      used to replace FEP surface fluorine atoms with hydroxyl groups. The primary
      amine was then covalently attached by polymerizing aminopropyl-triethoxysilane
      (APTES) via the hydroxyl functionalities. The selective attachment of cells to
      the APTES regions was determined to be dependent upon the initial adsorption of
      albumin to the patterned FEP membrane. Albumin was determined to enhance cellular
      attachment to the APTES regions and prevent attachment to the unmodified FEP
      areas for both an NB2a neuroblastoma cell line and primary rat endothelial cells.
      If albumin were not preadsorbed onto the membrane, selective attachment to the
      modified regions would not occur. Radiolabeling albumin with 125I demonstrated
      the preference of albumin for adsorption onto the monoamine surface where the
      cells preferentially attached. Both hydrophobic and ionic forces contributed to
      the adsorption process. Although selective cellular attachment to the patterned
      APTES regions could be achieved by albumin preadsorption to the surface, the
      neuroblastoma cells did not significantly differentiate unless additional serum
      components were supplemented to the media.

PMID- 8360220
TI  - Dissolution, leaching, and Al2O3 enrichment at the surface of bioactive glasses
      studied by solution analysis.
AB  - Five glass compositions in or near the bioactive region in the system SiO2-Na2O
      CaO-P2O5-Al2O3-B2O3 were studied in vitro by immersion in Tris buffer. The Si
      concentration can be taken as a measure of the amount of dissolved glass, whereas
      the Na concentration can be used to estimate the thickness of the Si-rich (Si
      gel) layer. Upon immersing a bioactive glass into Tris buffer, a surface layer of
      a few micrometer thickness is dissolved during the first 8 h. During the first
      few hours of immersion, the rate of dissolution of the glass network is equal to
      or exceeds that of the growth of the Si-rich layer. If the glass contains Al2O3,
      most of the aluminum that would be released due to dissolution of the silica
      network is enriched in the Si-rich surface layer that forms due to leaching.
      Al2O3 is not only bonded by the Si gel but also interferes with formation of
      calcium phosphate.

PMID- 8360221
TI  - Neocartilage after artificial cartilage repair in the rabbit: histology and
      proteoglycan fragments in joint fluid.
AB  - Repair of full-thickness cartilage defects of the rabbit medial femoral condyle
      with artificial plugs and periosteal grafts was followed for 1 year. The
      morphological characteristics of the neocartilage after repair and the
      concentration of proteoglycan fragments in the joint fluid (CPFF) were evaluated.
      The CPFF showed only a weak correlation to the histological score of the
      neocartilage. Normal cartilage and subchondral bone did not develop with any of
      the repair alternatives. With a Dacron plug, neocartilage formation appeared
      earlier than with natural repair and was better than with periosteal grafting.
      Increased CPFFs were found in all specimens with repair at 3 months, probably
      reflecting the remaining effect of surgery. At 6 months, the CPFFs had normalized
      to control values. At 1 year, the CPFFs were again similar to those at the 3
      month evaluation. This was paralleled by a degeneration of the neocartilage. We
      conclude that Dacron plugs could serve as a scaffold for neocartilage formation.
      The CPFF reflected surgical trauma and late degeneration of neocartilage but did
      not indicate minor differences in quality between cartilage repair techniques,
      probably because of the limited size of the grafted defect.

PMID- 8360222
TI  - Kinetics of cell proliferation as a function of vascular graft material.
AB  - Bioresorbable vascular grafts constructed for polyglactin 910 (PG910) and
      polydioxanone (PDS) and nonresorbable Dacron were interposed into the infrarenal
      abdominal aortas of New Zealand White rabbits. The prosthesis/tissue complexes
      were harvested after 2, 3, 4, 12, and 52 weeks. Seventeen, 9, and 1 h prior to
      sacrifice, animals received tritiated thymidine (0.5 mCi/kg/dose). All specimens
      were studied grossly and by light and transmission electron microscopy. Mitotic
      indices (MI's) were determined by autoradiography for inner capsule
      myofibroblasts at the proximal, mid, and distal segments of each prosthesis.
      There were no aortic-related deaths. All grafts were patent with no aneurysmal
      dilatation. At 4 weeks, PG910 resorption was evidenced by macrophage
      phagocytosis, less so in PDS while Dacron remained intact. At 12 weeks, the PG910
      was completely resorbed while PDS resorption continued. The latter was completely
      resorbed by 52 weeks. There was no significant difference in MI's between
      proximal, mid, and distal regions for each graft type. The mitotic index
      paralleled the rate of prosthetic resorption in both PG910 and PDS groups, as
      high as 28.34 +/- 23.21 in the former 3 weeks after implantation and
      significantly higher at 4 weeks (7.58 +/- 2.02 and 7.50 +/- 2.66, respectively)
      than at 52 weeks (0.72 +/- 0.98 and 1.00 +/- 0.22, respectively) in both groups.
      The mitotic index in the Dacron group never surpassed 1.22 +/- 0.90. We conclude
      that higher levels of early cell proliferation in bioresorbable grafts closely
      parallel the kinetics of prosthetic resorption.

PMID- 8360223
TI  - Use of polyphosphazenes for skeletal tissue regeneration.
AB  - The hydrolytically unstable polyphosphazenes, poly [(imidazolyl) (methylphenoxy)
      phosphazenes] and poly [ethyl glycinato) (methylphenoxy) phosphazenes], were
      studied as potential polymeric supports for cells in tissue regeneration. For
      bone repair, their specific function would be to support osteoblast growth,
      forming a bone-polymer matrix. MC3T3-E1 cells (an osteogenic cell line) were
      seeded onto polymer matrices and cell adhesion and growth as well as polymer
      degradation were examined. Both imidazolyl- and ethyl glycinato-substituted
      polyphosphazenes supported the growth of MC3T3-E1 cells. An increase in the
      content of the imidazolyl side group resulted in a reduction in cell attachment
      and growth on the polymer surface and an increase in the rate of degradation of
      the polymer. In contrast, substitution with the ethyl glycinato group favored
      increased cell adhesion and growth and also an increase in the rate of
      degradation of the polymers. Thus, the polyphosphazenes represent a system
      whereby cell growth and degradation can be modulated by varying the nature of the
      hydrolytically unstable side chain. This in vitro evaluation suggests that the
      polyphosphazenes may be suitable candidate biomaterials for the construction of a
      cell-polymer matrix for tissue regeneration.

PMID- 8360224
TI  - Factors influencing infant mortality in Vietnam.
AB  - Selected determinants of overall infant mortality in Vietnam were examined using
      data from the 1988 Vietnam Demographic and Health Survey, and factors underlying
      neonatal and post-neonatal mortality were also compared. Effects of community
      development characteristics, including health care, were studied by logistic
      regression analysis in a subsample of rural children from the 1990 Vietnam
      Accessibility of Contraceptives Survey. Infant neonatal and post-neonatal
      mortality rates showed comparable distributions by birth order, maternal age,
      pregnancy intervals, mother's education and urban-rural residence. Rates were
      highest among first order births, births after an interval of less than 12
      months, births to illiterate mothers and to those aged under 21 or over 35 years
      of age. Logistic regression analysis showed that the most significant predictor
      of infant mortality was residence in a province where overall infant mortality
      was over 40 per 1000 live births. In the rural subsample, availability of public
      transport was the most persistent community development predictor of infant
      mortality. Reasons for the low infant mortality rates in Vietnam compared to
      countries with similar levels of economic development are discussed.

PMID- 8360225
TI  - Selected determinants of fertility in Vietnam: age at marriage, marriage to first
      birth interval and age at first birth.
AB  - Data from the 4172 women aged 15-49 interviewed in the 1988 Vietnamese
      Demographic and Health Survey were used to examine age at marriage, marriage to
      first birth intervals and age at first birth. Differences between urban and rural
      areas, northern and southern provinces and by education of the women were
      analysed. The majority of the women had their first birth before age 20, but
      women with secondary education had a significantly higher age at first birth than
      those with little or no education, and women from the north had a significantly
      higher age at first birth than women from the south. Rural women and those with
      little or no education married at significantly younger ages than urban women and
      those with secondary education; these education effects were confirmed in a rural
      subsample of women. Women from rural areas and from the north had significantly
      shorter marriage to first birth intervals than urban women and those from the
      south, but there were no significant effects related to education.

PMID- 8360226
TI  - Socioeconomic and environmental determinants of child survival in Bangladesh.
AB  - Differentials in child survival in Bangladesh have been examined using a number
      of socioeconomic and environmental factors on data from the 1989 Bangladesh
      Fertility Survey. Multivariate analysis reveals that both wife's and husband's
      education and household electricity show a significant positive association with
      child survival. The respondent's working status exerts a significant negative
      influence. Wife's education has a greater influence on child survival in
      Bangladesh than that of husband's education.

PMID- 8360227
TI  - Influence of son preference on the contraceptive use and fertility of Sri Lankan
      women.
AB  - The effect of moderate son preference on family size is analysed using data from
      the 1982 Sri Lanka Contraceptive Prevalence Survey whose respondents were
      followed-up in the 1985 Sri Lanka Contraceptive Survey. Reported reproductive
      intentions on desire for additional children were not always reflected in overall
      contraceptive use. Complicating factors were the use of modern and traditional
      methods and the role of induced abortion. Longitudinal observations of the 1982
      85 period relating women's individual reproductive behaviour to their intentions
      show no consistent behavioural difference between those with and without sons.
      However, at any given parity, the proportion reporting at least one additional
      child born during the intersurvey period was higher among those women who
      intended to have at least one additional child than among those who wanted to
      stop childbearing. This analysis suggests that son preference finds expression
      more through reproductive intentions than through actual fertility behaviour in
      the follow-up period.

PMID- 8360228
TI  - Availability of marriage partners in England and Wales: a comparison of three
      measures.
AB  - Measures of partner availability introduced by Goldman, Westoff & Hammerslough
      (1984) and by Veevers (1988) are described and a new measure of partner
      availability, the Iterated Availability Ratio, is introduced. The three measures
      are applied to 1981 Census data for England and Wales and their abilities to
      predict regional variations in age-specific marriage rates are compared.

PMID- 8360229
TI  - Effects of biosocial variables on changes in nutritional status of rural
      Bangladeshi children, pre- and post-monsoon flooding.
AB  - This study examined the effects of biosocial variables on changes in nutritional
      status of rural Bangladeshi children, aged less than 2 years, pre- and post-1987
      monsoon flooding. Nutritional status was measured by weight for age: variables
      included were age, sex, sickness during 2 weeks preceding the survey, intake of
      vitamin A capsules, socioeconomic status of household, and mother's education. A
      multivariate logistic regression analysis revealed an adverse effect of flood on
      nutrition and the effect was dependent on sex of child and intake of vitamin A.
      After the flood the proportion of severely malnourished children was
      significantly greater among those who had not taken vitamin A. For boys the
      proportion with severe malnutrition increased after the flood and the increase
      was greater than for girls; however, boys always had a lower risk of severe
      malnutrition than girls.

PMID- 8360230
TI  - Survival in the perinatal period: a prospective analysis.
AB  - A prospective study of 3080 Filipino mothers and non-twin births in 33
      communities is used to study the determinants of mortality in week 1 postpartum.
      The results show significant nonlinear birth weight effects and the importance of
      environmental contamination, particularly for infants born by traditional methods
      at home, and several other intermediate and underlying determinants of perinatal
      mortality. The pathways through which important sociodemographic factors affect
      perinatal mortality are also presented.

PMID- 8360231
TI  - Paediatric care and immunisation among Jordanian children.
AB  - This paper investigates the behavioural aspects of health care use for Jordanian
      children from birth to 3 years using data from a national survey. Statistical
      analyses indicate differences in the determinants of the use of paediatric care
      and immunisation: whereas immunisation coverage was already good in 1983 (and has
      improved subsequently), paediatric care is used for fewer than half of the
      children under 1 year of age. Socioeconomic and demographic characteristics of
      the population, especially female education, and maternal health care use, are
      important determinants of these patterns of child health care. The absence of
      differences in paediatric care and immunisation by sex of the child are
      discussed.

PMID- 8360232
TI  - Regional mortality differences in Britain, 1931-87: a two dimensional analysis.
AB  - In a recent analysis, Illsley, Le Grand & Mullings argued that, over the years
      1931-87, regional inequalities in mortality in Britain effectively disappeared
      for most age groups. The present study reanalyses their data, breaking regional
      life tables down into their two major components, the level of survivorship, and
      the shape of the mortality curve. It is shown that whereas there has been a
      consistent decline in regional inequalities in the level of mortality, there has
      not been a comparable convergence in the shape of the mortality curves. These
      shape differences, implying premature adult mortality, are now the major source
      of variation among the regions.

PMID- 8360233
TI  - Reaction times and intelligence: a comparison of Chinese-American and Anglo
      American children.
AB  - Chinese-American and Anglo-American school children were compared on a nonverbal
      test of intelligence (Raven's Progressive Matrices) and on twelve chronometric
      variables which measure the speed with which basic information processes (e.g.
      stimulus apprehension, decision, and discrimination) can be carried out. All of
      these tasks are correlated with psychometric intelligence. The two groups
      differed significantly on most of the variables, but the differences appear to be
      multidimensional and are not simply due to a group difference in psychometric
      intelligence, equivalent to about 5 IQ points in favour of the Chinese-Americans.
      The results are compared with those of Lynn and his colleagues on Bristish,
      Japanese, and Hong Kong children, and both consistencies and inconsistencies are
      found.

PMID- 8360234
TI  - Teenage sexual activity in Zambia: the need for a sex education policy.
AB  - Data from a study of teenage sexual activity among secondary school girls show
      the need for a sex education policy as a first step in controlling teenage
      fertility in Zambia. A large proportion of teenage females enter into close
      relationships with males at young ages and a high proportion of young females
      have engaged in sexual intercourse. Most of these sexually active females do not
      use family planning methods even though a large proportion of them have heard of
      modern methods. The teenagers receive very little sex education from their
      parents and a modern institutional sex education programme is needed.

PMID- 8360235
TI  - Infant and child mortality in rural Egypt. A comment.

PMID- 8360236
TI  - A simple, effective system for assessing viability in split-thickness skin with
      the use of oxygen consumption.
AB  - To address the recognized need for better viability-assessment techniques in the
      banking of allograft skin, we have developed a simple, effective, and easily
      constructed system for measuring the aerobic activity in small skin samples. The
      system consists of a microcomputer interfaced to a Clark-type polarographic
      oxygen electrode to measure oxygen concentrations in discs (5 mm diameter) of
      split-thickness skin. The system allows simultaneous data acquisition and an on
      screen display of oxygen readings on a linear or logarithmic scale. The computer
      program quantifies the rate of oxygen consumption by calculating a linear
      regression of oxygen measurements between 100 and 600 seconds. Data are stored in
      a standard format for easy transfer to commercial software packages for further
      analysis. The kinetics of oxygen consumption by porcine split-thickness skin
      stored at 4 degrees C for up to 21 days was assessed with this technique and
      showed a gradual decline in rate as function of storage time, reaching 50%
      recovery after 6 days. This assay is a simple and inexpensive method to establish
      and perform, thus making it suitable as a routine assay for use in the banking of
      skin and other tissues.

PMID- 8360237
TI  - A review of the biophysical basis for the clinical application of electric fields
      in soft-tissue repair.
AB  - Interest in the role of electrical interactions as epigenetic regulators of wound
      healing had its beginnings nearly 40 years ago. Because the mechanisms of action
      are not understood (which obviates rational therapy), the empiric application of
      fields to wounds has produced mixed results. However, taken collectively,
      clinical trials have demonstrated some beneficial effects. Tests on soft tissues
      of animals have shown that electric stimulation can influence the rate of wound
      healing and scar strength. Natural epithelial-derived sodium currents have been
      discovered in the wounds of invertebrates and mammals. It is theorized that these
      currents may be a normal controlling factor in wound healing. Therefore,
      perturbation of these signals is important to understand. The purpose of this
      review is to put into proper perspective the biophysical, physiological, and
      clinical data pertaining to use of electricity to control wound healing, with the
      goal of minimizing much of the prevailing confusion.

PMID- 8360238
TI  - Relationship between extent of burn injury and magnitude of microbial
      translocation from the intestine.
AB  - The gut can be a source of sepsis after thermal injury. In the present study the
      relationship between the extent of burn injury and magnitude of bacterial
      translocation was investigated. Mice underwent 0%, 10%, 20%, 30%, or 50% total
      body surface area full-thickness burn and simultaneous gavage with 1 x 10(10) 14C
      labeled Escherichia coli. mesenteric lymph nodes, liver, spleen, peritoneal
      fluid, and burn wound were excised 4 hours after burn injury. Residual
      radioactivity and bacterial colony counts were measured, and percentages of
      viable organisms were calculated. Results showed that the rate of translocation
      of 14C E. coli increased proportionally with the burn size, reaching a maximum at
      30%. The cutaneous eschar collected a remarkable amount of labeled bacteria,
      suggesting enteric microflora as a possible source of contamination of the burn
      wound via endogenous routes. The percentage of viable organisms in the tissues
      demonstrated that the ability of mesenteric lymph nodes, liver, and eschar to
      clear translocated bacteria was directly affected by the severity of the burn
      injury.

PMID- 8360239
TI  - A systematic approach to flap selection for the axillary burn contracture.
AB  - Any soft-tissue deficiency about the axilla unfortunately may readily be
      translated into a functional limitation of the upper extremity that should be
      addressed in a simple yet expeditious fashion. Commonly a sequela of burn
      injuries, significant skin destruction in kind must be restored. Whatever the
      etiology of major deformities, the vital axillary structures and preservation of
      shoulder range of motion may best be accomplished by resurfacing with the use of
      vascularized tissues taken from sources adjacent to the defect. If this is the
      case, the efficacious application of these local muscle or fascial flaps mandates
      a realization that such choices are finite in number. A schema for a reasonable
      flap selection process has been devised based on the relative severity and
      anatomic location of the axillary burn scar contracture.

PMID- 8360240
TI  - Evaluation of the Unna Boot for lower-extremity autograft burn wounds excoriated
      by pruritus in pediatric patients.
AB  - Six pediatric patients with lower-extremity excoriated autografts secondary to
      pruritus were treated randomly. Group 1 was treated with application of an Unna
      Boot that was changed every 7 days; Group 2 was treated with conventional
      dressing and antihistamines. Average time for complete wound closure was similar
      in the two groups: 32 days for group 1 versus 36 days for group 2. Treatment of
      group 1 cost $19.80/wk compared with $30.90/wk for treatment of group 2. The time
      for dressing change was 15 min/wk for group 1 and 3.5 hr/wk for group 2. The
      parents in group 1 gave their children better scores when asked about appetite,
      sleep, and play patterns.

PMID- 8360241
TI  - Anal stenosis with megarectum: an unusual complication of a perineal burn.
AB  - A case of a 3-year-old boy with anal stricture and megarectum is described.
      Overflow incontinence and soiling were corrected by local flaps and skin graft
      and were maintained by frequent dilatations after downward traction of the whole
      anus was performed. The options of immediate and late treatment of such burns and
      the colostomy procedure are discussed.

PMID- 8360242
TI  - Release of the first web space with the "goalpost" procedure in pediatric burns.
AB  - First web-space contractures commonly occur in dorsal and palmar hand burns. Both
      abduction and extension limitations develop as a result of reduction in thumb
      motion. Optimal treatment of first web-space contractures should treat both
      abduction and extension deformities and should minimize the need for reoperation
      in growing children. Many techniques exist to manage web-space contractures. This
      article describes a long rectangular flap release ("goalpost" procedure) used to
      treat first web deformities in pediatric patients with burns. During the period
      1987 through 1989, 31 first web-space releases were performed in 23 patients
      (mean age 9.2 years). The operations were performed a mean of 50 months after
      burn injury. No wound complications occurred and no patient required repeat
      operation in the follow-up period. Range of motion in abduction and extension was
      increased a mean of 10 degrees. The goalpost procedure is a highly acceptable
      alternative to standard web-space releases and offers advantages in its ability
      to treat both abduction and extension contractures.

PMID- 8360243
TI  - Fibrin glue: its use for skin grafting of contaminated burn wounds in areas
      difficult to immobilize.
AB  - A human fibrin glue was used in patients with burns for fixation of skin grafts
      on slightly infected wounds in the axillas, perineum, and the gluteal folds.
      These areas had been left open after previous skin transplantations. There was
      stable and safe adhesion and little inflammatory reaction between the graft and
      the recipient area, resulting in favorable conditions for graft incorporation. By
      using the glue the last wounds in our patients healed earlier, and the patients'
      general condition improved.

PMID- 8360244
TI  - Omiderm as an initial burn dressing.

PMID- 8360245
TI  - Reasons for the selection of burn-scar-support suppliers by burn centers in the
      United States: a survey.
AB  - Several companies currently market anti-burn-scar pressure garments to burn
      centers. Because of the numerous available choices, decisions about the reasons
      for selecting a garment are often confusing to those who are responsible for
      ordering the supports. This study was conducted to assist in decision making
      about garment selection by determining the relative importance of various factors
      in selecting brands of anti-burn-scar supports. A survey questionnaire was sent
      to 101 randomly selected burn centers in the United States, asking about the
      reasons for their choice of pressure-support suppliers. Sixty-two survey (61%)
      respondents indicated factors used in selection of a manufacturer. The factors
      included ease of accessibility for orders (97%), ease of measurement methods
      (90%), reliability of fit with the first garment ordered (90%), ability to
      fashion either a nonstandard support (77%) or special options into a garment
      (76%), provision of measurement materials (65%), and costs of the support (63%).
      Availability of standard garment options (50%) and/or choice of colors (31%) were
      listed less frequently. Twenty-four burn centers (39%) use only one company for
      orders, whereas 20 (31%) use two, 9 (15%) use three, and 9 (15%) use four
      different suppliers. Industry responses to these findings were gathered and
      presented as well. The results of this survey would indicate that burn staff have
      viable options of pressure-garment suppliers to assist them in responding to the
      scar-control needs of their patients.

PMID- 8360246
TI  - Development of a computerized registry for the patient with burns: Part II.

PMID- 8360247
TI  - Hardiness, stress, and burnout among intensive care nurses.
AB  - The purposes of this study were to determine whether hardiness is a predictor of
      burnout and whether it can buffer the effect of stress on burnout. Thirty-one
      registered nurses who work in intensive care units completed the Hardiness test,
      the Nursing Stress scale, and the Tedium scale. Descriptive statistics,
      correlational statistics, t tests, analysis of variance, and hierarchical
      multiple regressions were used to analyze the data. Results indicated that
      hardiness and burnout had a significant inverse relationship (r = 0.66). Stress
      and the stress-hardiness interaction term accounted for 29% of the variance in
      burnout scores. This study found hardiness to be a predictor of burnout and a
      buffer in the stress-burnout relationship. Furthermore, the relationship between
      hardiness and stress was found to be stronger than that between stress and
      burnout. Further study is needed to verify that hardiness is a stress mediator in
      nursing and to determine how to best promote hardiness in nurses.

PMID- 8360248
TI  - Burns caused by flambe foods.
AB  - From 1978 to 1990, five patients were admitted to the hospital for treatment of
      burns that were sustained during the preparation of flambe foods in restaurants.
      Three patients were patrons, and two were waiters. The average body surface area
      involved was 14% (range 10% to 18%). The average area of full-thickness burn was
      3% (0% to 10%). All patrons required long-term psychologic support and were
      involved with lengthy and expensive litigation proceedings. The two waiters lost
      a total of 5 months from work. Although these injuries are quite rare, it is
      hoped that they can be totally prevented by adherence to certain safety
      guidelines.

PMID- 8360249
TI  - Tasks of bereavement for burn center staffs.
AB  - Considerable research and theoretic work is reviewed to identify the major tasks
      of the grieving process. These tasks are diffusing the emotional energy of loss,
      reknitting the social fabric, and forming a new relationship with the deceased. A
      narrative approach to understanding human experiences is outlined, and specific
      application is given to the grieving process. Through the use of a narrative
      report of the death of twins in a hospital burn unit, the tasks of grieving are
      applied to professionals who work with patients with burns. Finally, practical
      suggestions for help with the tasks of grieving in a burn center are offered.

PMID- 8360250
TI  - Therapeutic abortion in a severely burned woman.

PMID- 8360251
TI  - The die is cast: telling patients they are going to die.

PMID- 8360252
TI  - Human branding in college fraternities: round-up time at "animal house".

PMID- 8360253
TI  - Packaging zinc, fibrinogen, and factor XIII in platelet alpha-granules.
AB  - Zinc(II) accumulated by platelets has profound effects on platelet activity. This
      study is focused on the distribution of Zn(II) between human platelet subcellular
      compartments. After incubation with 86Rb+ and platelet lysis, the organelles were
      separated by sucrose density gradient centrifugation. Fibrinogen served as a
      marker for alpha-granules. 86Rb+ and factor XIII served as markers for the
      cytoplasmic fractions. Zn(II) was found to be distributed between the cytoplasm
      and the alpha-granules, with variations between different individual units. The
      total platelet Zn concentration and its relative subcellular distribution were
      dependent on its extracellular level. Incubation of platelets with 100 microM
      Zn(II) resulted in a twofold increase of its level in the cytoplasm and by one
      order of magnitude in the alpha-granules. In addition to the anticipated factor
      XIII activity in the cytoplasmic pool fraction, we found thrombin-inducible
      factor XIII activity within the alpha-granules. Immunoblotting confirmed the
      presence of both the a and b subunits of plasma factor XIII (a2b2 form) in the
      alpha-granules. As fibrinogen is not synthesized in the platelet, we propose that
      by virtue of their mutual binding, fibrinogen, Zn(II) and plasma factor XIII-a2b2
      are simultaneously taken up into the alpha-granules by endocytosis, presumably
      through the vehicle of the GPIIb/IIIa fibrinogen receptor. A rationale for co
      packaging these components within the alpha-granules is that Zn(II) inhibits
      factor XIII activity and thereby prevents the premature cross-linking of the
      concentrated fibrinogen prior to platelet activation and secretion. By contrast,
      cytoplasmic Zn(II) may increase platelet responsiveness to agonists due to its
      interaction with cytoplasmic modulators of platelet activity.

PMID- 8360254
TI  - Comparative analysis of mitogenic and morphogenic effects of HGF and EGF on rat
      and human hepatocytes maintained in collagen gels.
AB  - Hepatocytes maintained in collagen gels remain differentiated for prolonged
      periods of time compared to cells maintained on conventional cultures. Previous
      studies with other culture systems in which chemical supplements or substratum
      modifications enhanced hepatocyte differentiation showed that in all of these
      systems hepatocytes do not respond to mitogens. In this study it is shown that
      hepatocytes maintained between two layers of collagen gels respond to mitogens
      HGF (also known as scatter factor (HGF/SF)) and epidermal growth factor (EGF).
      Cell density did not affect the responsiveness to mitogens as in conventional
      cultures. In addition both mitogens (HGF more pronounced) induce characteristic
      morphogenic changes in which hepatocytes form processes and join in formation of
      cords. Hepatocytes respond to mitogens for up to 6 days in culture at which point
      they become refractory to further mitogenic stimulation. This occurs despite
      electron microscopic evidence that these cells are fully viable when they become
      refractory to mitogenesis. The refractory state is not modified by substitution
      of one growth factor for the other or by addition of growth factors at different
      times. Hepatocytes in the refractory state become again responsive to mitogens
      when the collagen gels are dispersed by collagenase and the cells are replated on
      conventional substrates.

PMID- 8360255
TI  - Effect of floating a gel matrix on mucin release in cultured airway epithelial
      cells.
AB  - Confluent cultures of primary hamster tracheal surface epithelial (HTSE) cells
      grown on a thick collagen gel are highly enriched with secretory cells and
      constitutively release mucins. In the present experiment, we examined the
      possible effect of mechanical strain of cultured HTSE cells on the release of
      mucin. The mechanical strain of cells was accomplished by several methods: 1) by
      floating the gel from the culture dish by rimming; 2) by treatment with EGTA
      which interrupts intercellular tight junctions; 3) by treatment with collagenase
      which disrupts the cell-matrix adhesion; and 4) by mechanically flexing the
      collagen gel matrix. All these conditions caused increases of mucin release
      without damage on the plasma membrane. We conclude that a number of mechanical
      strains which might alter cell shape can stimulate mucin release from cultured
      HTSE cells. Such a mechanism might be operative in the physiological regulation
      of airway goblet cell mucin secretion where mechanical strains may be induced on
      epithelial cells by underlying smooth muscles.

PMID- 8360256
TI  - Activation of protein kinase C inhibits human keratinocyte migration.
AB  - The involvement of protein kinase C (PKC) in epidermal growth factor (EGF)
      induced human keratinocyte migration was studied with the phagokinetic assay. It
      was concluded that PKC activation does not mediate, but rather inhibits, EGF
      induced keratinocyte migration. The following experimental observations support
      these conclusions: 1) The PKC inhibitor H-7 did not inhibit EGF-induced migration
      but instead led to a modest enhancement. 2) PKC activators such as phorbol-12
      myristate-13-acetate (PMA), phorbol-12,13-dibutyrate (PDBu), and 1,2-dioctanoly
      sn-glycerol inhibited migration, but biologically inactive 4 alpha-PMA had no
      effect. 3) PMA did not inhibit keratinocyte attachment and spreading but blocked
      migration almost immediately after addition. 4) Migration of PKC-depleted cells,
      which were produced by prolonged treatment with PDBu, was enhanced similarly to
      normal cells by EGF. 5) PKC-depleted cells were not susceptible to the inhibitory
      effects of phorbol esters on migration. Additional experiments, in which cells
      were preactivated with EGF, suggested that PKC inhibits the EGF effect at a post
      receptor level. The inhibitory effect of PKC on keratinocyte migration was not
      restricted to EGF-induced migration; PKC activation also inhibited keratinocyte
      migration induced by bovine pituitary extract, insulin, insulin-like growth
      factor-1, and keratinocyte growth factor.

PMID- 8360257
TI  - Expression of transforming growth factor alpha antisense mRNA inhibits the
      estrogen-induced production of TGF alpha and estrogen-induced proliferation of
      estrogen-responsive human breast cancer cells.
AB  - To ascertain if 17 beta-estradiol (E2)-induced proliferation could be attenuated
      by blocking the expression of endogenous transforming growth factor alpha (TGF
      alpha), estrogen receptor (ER)-positive, estrogen-responsive MCF-7 or ZR-75-1
      cells and ER-negative, estrogen-nonresponsive MDA-MB-468 or HS-578T cells were
      infected with a recombinant amphotropic, replication-defective retroviral
      expression vector containing a 435 base pair (bp) Apa1-Eco R1 coding fragment of
      the human TGF alpha cDNA oriented in the 3' to 5' direction and under the
      transcriptional control of an internal heavy metal-inducible mouse
      metallothionein (MT-1) promoter and containing the neomycin (neo) resistance
      gene. E2-stimulated expression of endogenous TGF alpha mRNA was inhibited by 4-5
      fold, and the production of TGF alpha protein was inhibited by 50-80% when M-1
      mass-infected MCF-7 or MZ-1 mass-infected ZR-75-1 cells were treated with 0.75-1
      microM CdCl2, whereas in comparably treated parental MCF-7 or ZR-75-1 cells there
      was no significant effect upon these parameters. E2-stimulated anchorage
      dependent growth (ADG) and anchorage-independent growth (AIG) of the M-1 or MZ-1
      cells was inhibited by 60-90% following CdCl2 treatment. In contrast, neither the
      ADG nor AIG of the parental noninfected MCF-7 or ZR-75-1 cells that were
      maintained in the absence or presence of E2 was affected by comparable
      concentrations of CdCl2. The ADG and AIG of TGF alpha antisense MD-1 mass
      infected MDA-MB-468 cells that express high levels of endogenous TGF alpha mRNA
      were also inhibited by 1 microM CdCl2, whereas the ADG and AIG of MH-1 mass
      infected HS-578T cells, a TGF alpha-negative cell line, were unaffected by CdCl2
      treatment. These results suggest that TGF alpha may be one important autocrine
      intermediary in regulating estrogen-induced cell proliferation.

PMID- 8360258
TI  - Importance of cell aggregation for expression of liver functions and regeneration
      demonstrated with primary cultured hepatocytes.
AB  - Adult rat hepatocytes aggregated to form floating multicellular spheroids when
      cultured in Primaria dishes, which have a positively charged surface, in serum
      free Williams' medium E (WE) supplemented with insulin and epidermal growth
      factor (EGF). These hormones were essential for maintenance of the spheroids,
      whereas the size of the spheroids depended on the inoculum cell density. The
      spheroids retained in vivo levels of expressions of albumin and glucokinase and
      synthesized scarcely any DNA even in the presence of insulin and EGF. On transfer
      to type I collagen-coated dishes, the spheroids gradually disaggregated and the
      cells formed monolayers, in which the expressions of albumin and glucokinase were
      suppressed and DNA synthesis and hexokinase activity were increased. DNA
      synthesis of hepatocytes in monolayer culture was maximal 24 hr after transfer of
      the spheroids, approximately 80% of the hepatocyte nuclei were labelled with
      bromodeoxyuridine during culture for 48 hr, and the mitotic index was
      approximately 70% after 60 hr. These results suggest that, in spheroids,
      hepatocytes remained in the G0 phase, but that when they formed monolayers, they
      progressed to the G1 phase and proceeded through the cell cycle in the presence
      of insulin and EGF. This work shows that the cell cycle of hepatocytes in culture
      can be manipulated by providing conditions for quiescence as spheroids or growth
      as monolayers and that the shape of hepatocytes is important for regulating their
      growth and liver-specific functions.

PMID- 8360259
TI  - Thrombin receptor activating peptides induce Ca2+ mobilization, barrier
      dysfunction, prostaglandin synthesis, and platelet-derived growth factor mRNA
      expression in cultured endothelium.
AB  - Endothelial cell activation by thrombin is a key event in wound healing,
      inflammation, and hemostasis. To better define thrombin-endothelial cell
      interactions we synthesized several peptides of varying length corresponding to
      the initial 14 amino acid sequence of the cloned human platelet thrombin receptor
      after cleavage at an arginine41 site (R/SFLLRNPNDKYEPF). Thrombin receptor
      activating peptides (TRAPs) as short as 5 amino acids induced significant levels
      of PGI2 synthesis and expression of PDGF mRNA in human endothelium and produced
      dose-dependent cellular contraction and permeability of confluent human umbilical
      vein and bovine pulmonary artery endothelial monolayers. To explore whether TRAPs
      utilized similar signal transducing pathways as alpha-thrombin to accomplish
      endothelial cell activation, phospholipase C production of the Ca2+ secretagogue
      IP3 was measured and detected 10 seconds after either TRAP 7 or alpha-thrombin.
      Furthermore, TRAPs ranging from 5-14 residues induced significant dose-dependent
      increases in Fura-2 fluorescence indicative of Ca2+(1) mobilization. These
      results indicate that thrombin-mediated proteolytic cleavage of the human and
      bovine thrombin receptor initiates stimulus/coupling responses such phospholipase
      C activation, Ca2+ mobilization, and protein kinase C activation. The functional
      consequence of this cellular activation via the cleaved receptor is enhanced
      cellular contraction, barrier dysfunction, PGI2 synthesis, and expression of PDGF
      mRNA.

PMID- 8360260
TI  - Contributions of K+, Na+, and Cl- to the membrane potential of intact hamster
      vascular endothelial cells.
AB  - The transmembrane potential (Vm) of vascular endothelial cells (EC) is an
      important property that may be involved in intra- and intercellular signal
      transduction for various vascular functions. In this study, Vm of intact aortic
      and vena caval EC from hamsters were measured using conventional microelectrodes.
      Vascular strips with the luminal surface upwards were suffused in a tissue
      chamber with Krebs solution in physiological conditions. The resting Vm of aortic
      and vena caval EC was found to be -40 +/- 1 mV (n = 55) and -43 +/- 1 mV (n =
      15), respectively. The Vm recordings were confirmed to have originated from EC by
      scanning and transmission electron microscopy combined with the comparison of
      electrical recordings between normal and endothelium-denuded aortic strips. The
      input resistance varied from 10-240 M omega, which implied the presence of
      electrical coupling between vascular EC. Elevating the K+ level in the suffusate
      from 4.7 mM to 50 and 100 mM depolarized aortic EC by 19% and 29% and vena caval
      EC by 18% and 29%, respectively. These low percentages indicated a relatively
      small contribution of [K+] to the resting Vm of vascular EC. A positive
      correlation (r > 0.69) between the resting Vm and the magnitude of depolarization
      by the high [K+]o may be related to the involvement of voltage-dependent K+
      channels. The hyperpolarization caused by lowering both [Na+]o and [Cl-]o
      suggested the disengagement of some electrogenic transport systems in the
      membrane, such as a Na(+)-K(+)-Cl- cotransporter. The transference number
      (t(ion)), as an index of membrane conductance for specific ions, was calculated
      for K+ (15-20%), Na+ (16%), and Cl- (9-15%), demonstrating that both Na+ and Cl-
      as well as K+ contribute to the overall resting Vm. Our study documented some
      basic electrophysiology of the vascular EC when both structural and functional
      properties of the cell were maintained, thus furthering the understanding of the
      essential role of endothelial cells in mediating vascular functions.

PMID- 8360261
TI  - Amiloride-dependent transport is the main mechanism implicated in sodium influx
      regulation in rat mast cells.
AB  - Mast cell sodium regulation is a largely unknown field. In our effort to study
      the mechanisms by which mast cells regulate sodium levels, we have examined the
      effect of amiloride and ouabain on 22Na entry in rat mast cells in isotonic and
      hypertonic conditions. Ouabain (0.5 mM) enhances sodium uptake by 32% in isotonic
      conditions. Hypertonicity increases by 400% the uptake of sodium through an
      amiloride (1 mM) dependent mechanism. Ouabain has no appreciable effect on the
      entry of 22Na in hypertonic conditions.

PMID- 8360262
TI  - Apotransferrin stimulation of thyroid hormone dependent rat pituitary tumor cell
      growth in serum-free chemically defined medium: role of FE(III) chelation.
AB  - Triiodothyronine (T3) dependent growth of GH1 rat pituitary tumor cells in serum
      free defined culture requires apotransferrin (apoTf) (Sirbasku et al.: Mol. Cell.
      Endocrinol., 77:C47-C55, 1991). Diferric transferrin (2Fe.Tf) also is necessary
      as an iron source (Eby et al.: Anal. Biochem., 203:317-325, 1992). Further, T3
      dependence is prevented by soluble Fe(III) addition to the medium (Sato et al.:
      In Vitro Cell. Dev. Biol., 27A:599-602, 1991). While our data suggested that
      apoTf caused growth by chelation of Fe(III), direct evidence was required. We
      used urea polyacrylamide gel electrophoresis along with autoradiography and
      Western immunoblotting to measure the Fe(III) content of growing GH1 cell
      cultures and identify the apoTf, mono-metal transferrins and 2Fe.Tf present. We
      found that apoTf per se did not cause growth but instead chelated inhibitory
      levels of Fe(III). In fact, apoTf need not be present at all provided that
      Fe(III) is reduced to < or = 0.6 microM. In addition, other protein and non
      protein Fe(III) chelators were shown to be as effective as apoTf. Here, we report
      that pituitary cells are completely inhibited by > or = 1.2 microM Fe(III), which
      are concentrations which might be expected in many culture media and usually are
      not thought to influence growth. The high sensitivity of pituitary cells to
      Fe(III) suggests further study to determine what cellular functions are affected
      and how they interfere with thyroid hormone dependence.

PMID- 8360263
TI  - An N-cadherin-like protein contributes to solute barrier maintenance in cultured
      endothelium.
AB  - We investigated the role of cadherins in the solute barrier maintained by
      endothelial cells in vitro. Cell-column chromatographic measurement of
      endothelial barrier showed that reducing normal extracellular calcium from 1.2 to
      0.12 mM increased endothelial permeability to 250% of baseline after 20 min.
      Restoring normal calcium restored the barrier within 15 min which remained stable
      for at least 60 min. We used sulfo-NHS-biotin and anti-cadherin antibodies to
      characterize endothelial proteins with possible roles in the maintenance of
      endothelial barrier. The non-specific probe sulfo-NHS-biotin identified at least
      ten endothelial cell surface proteins, with greatest labelling occurring at
      molecular weights of 125 and 145 kD. Six proteins, including the 125 and 145 kD
      proteins, associated with the cytoskeleton. Western blotting for the presence of
      classical cadherins containing the conserved cytoplasmic sequence
      CDPTAPPYDSLLVFDYEG detected two bands at 145 and 125 kD which associated with the
      cytoskeleton. Western blotting with an antibody, which recognizes
      FHLRAHAVDINGNQV, an extracellular homotypic binding region of N-cadherin, detects
      three bands. Of these three, one protein had a molecular weight of 125 kD and was
      associated with the cytoskeleton. Immunofluorescence with both N-cadherin and
      anti-peptide 1 antibodies found staining at endothelial cell borders. The utility
      of a newly developed cell-column calcium switch assay was tested by verifying the
      functional role of the previously described epithelial cadherin, uvomorulin, in
      epithelial barrier. We then applied this method to endothelial cell columns and
      found the N-cadherin antibody interfered with the reforming of interendothelial
      junctions. These results suggest that, as in epithelial cells, cadherins in
      bovine endothelial cells have a functional role in forming the calcium sensitive
      endothelial junction and may play an important role in the formation of normal
      barrier.

PMID- 8360264
TI  - Heat shock protein is a unique marker of growth arrest during macrophage
      differentiation of HL-60 cells.
AB  - Prior to morphologic and functional maturation, terminally differentiating
      hematopoietic cells first exit the cell cycle and undergo growth arrest.
      Relatively little is known about which molecules regulate differentiation-induced
      growth arrest. In the present report, we sought to determine whether the
      mammalian low molecular weight heat shock protein (hsp28) was a candidate growth
      regulatory molecule during human hematopoiesis. To this end, hsp28 protein
      expression was examined during phorbol ester (PMA)-induced macrophage
      differentiation of the human HL-60 promyelocytic leukemic cell line. Whereas
      hsp28 was constitutively expressed at relatively low levels in an
      unphosphorylated state, hsp28 was rapidly phosphorylated within 4 hr following
      PMA-induced differentiation, preceding increased hsp28 protein levels at 24-48 h.
      In contrast to other differentiative agents, hsp28 steady state mRNA and protein
      were regulated concordantly in response to macrophage differentiation. More
      importantly, these changes were transient, and occurred concomitant with the down
      regulation of cellular proliferation and the onset of G1 phase cell cycle arrest.
      In total, these observations implicate hsp28 as an intermediary in the
      myelomonocytic differentiative pathway of promyelocytic leukemic cells, and will
      shed light on the events regulating this process.

PMID- 8360265
TI  - Characterization of system L and system y+ amino acid transport activity in
      cultured vascular smooth muscle cells.
AB  - The uptake of L-leucine and L-lysine into vascular smooth muscle cells cultured
      from the aortas of rats has been investigated. Both amino acids are taken up by
      saturable systems that are independent of the presence of a Na+ gradient and can
      be stimulated in trans by neutral bulky amino acids for leucine and cationic
      amino acids for lysine. Leucine uptake is inhibited competitively in cis by
      several neutral amino acids, whereas lysine uptake is inhibited strongly by other
      cationic amino acids but also significantly by neutral amino acids such as
      leucine. The leucine inhibition is noncompetitive. Cells preloaded with leucine
      and lysine could also export these amino acids and the rate of efflux was
      stimulated by the presence of appropriate amino acids in trans. These data are
      all consistent with leucine being transported largely if not entirely by System L
      and lysine by the System y+ transporter.

PMID- 8360266
TI  - A novel member of the dynamin family of GTP-binding proteins is expressed
      specifically in the testis.
AB  - Dynamin is a member of a new GTPase family, which includes the mouse Mx protein,
      the yeast VPS1 and the Drosophila shibire gene product. A high homology with the
      shibire product suggests a role for dynamin in the endocytotic process, but it is
      expressed only in mature neurons. We identified two additional dynamin-like
      proteins in rats, by using the polymerase chain reaction with degenerate primers
      corresponding to the GTP-binding areas conserved between dynamin and VPS1. The
      full coding sequence of one of them, dynamin-2, revealed that it has 848 amino
      acids and has great similarity with brain dynamin and the shibire product.
      Northern blot analysis and in situ hybridization revealed its expression to be
      specific to the seminiferous tubules in the testis. Dynamin-2 (testis type
      dynamin) was expressed in germ-cell-depleted testis as well, indicating its
      expression in Sertoli cells. Our data imply that a number of dynamin family
      proteins, which are products of distinct genes, may play different roles specific
      to each cell type in the same rat.

PMID- 8360267
TI  - Inhibition of transcription blocks cell cycle progression of NIH3T3 fibroblasts
      specifically in G1.
AB  - We have analysed the role of RNA polymerase II-dependent transcription in cell
      cycle progression. Time-lapse video recording and cytogenetic analysis were used
      to determine the sensitivity of NIH3T3 cells to the RNA polymerase II inhibitor
      alpha-amanitin at different stages of the cell cycle. Our results show that alpha
      amanitin blocks cells specifically in G1, irrespective of the concentration
      within the range of 3 to 30 micrograms/ml. This indicates that transcription in
      G1 is required to overcome a restriction point located in this phase of the cell
      cycle. In agreement with this conclusion is the requirement for an uninhibited
      protein synthesis during G1 progression. In addition, the insensitivity of S
      phase cells to RNA polymerase II inhibition suggests that the transcription of
      genes thought to be normally induced during S/G2 is not required for the
      completion of an ongoing cell cycle. S/G2 progression was however clearly
      dependent on protein synthesis. This suggests that cells exposed to alpha
      amanitin are able to complete their cell cycle because sufficiently high levels
      of mRNA are present in S/G2 due to basal level transcription, or are left from
      preceding cell cycles. It is therefore unlikely that transcriptional regulation
      in S or G2 plays a crucial role in the control of cell cycle progression in
      NIH3T3 cells.

PMID- 8360268
TI  - Deregulation of cyclins D1 and E and suppression of cdk2 and cdk4 in senescent
      human fibroblasts.
AB  - The state of cellular senescence is characterised by an irreversible arrest in
      the G1 phase of the cell cycle. It has previously been shown that three cell
      cycle genes, cyclin A, cyclin B and cdc2, are not expressed in senescent human
      fibroblasts. All three gene products have functions after S-phase entry, so that
      their suppression cannot explain the irreversible G1 arrest. Here, we report that
      the abundance of transcripts from two other cell cycle genes, cdk2 and cdk4,
      thought to act during G1-->S progression, is significantly diminished in
      senescent cells of the diploid human fibroblast line WI-38. Surprisingly, two
      other cyclins, D1 and E, behave in a completely different way, in that their
      expression is elevated in senescent cells, especially under conditions of serum
      starvation. Both the synthesis and the steady-state level of cyclin D1 protein
      were also found to be markedly higher in senescent cells (3- to 6-fold). Cyclins
      D1 and E are thus the first genes shown to be overexpressed or deregulated in
      senescent cells. It is tempting to speculate that this deregulation may be due to
      the absence, in senescent cells, of a regulatory loop that would normally control
      their expression. This is supported by our finding that cyclin E-associated
      kinase activity in senescent cells is reduced approx. 14-fold. Our data also
      suggest that the deregulated expression of cyclin D1 and E is not sufficient to
      drive senescent cells into DNA replication.

PMID- 8360269
TI  - gamma-Tubulin participates in the formation of the midbody during cytokinesis in
      mammalian cells.
AB  - Animal cells undergoing cytokinesis form an inter-cellular bridge containing two
      bundles of microtubules interdigitated at their plus ends, which constitute the
      midbody. Polyclonal antibodies raised against three specific amino acid sequences
      of gamma-tubulin (EEFATEGGDRKDV, NIIQGEADPTDVHKSL and EYHAATRPDYISWGTQEQ)
      specifically stained the centrosome in interphase, the spindle poles in all
      stages of mitosis, and the extremities of the midbody in mammalian cells
      (Potorous, human, Chinese hamster, mouse). This staining was prevented by the
      corresponding peptides, by Xenopus gamma-tubulin, but was not modified by
      purified alpha beta-tubulin heterodimer. An identical staining was obtained with
      affinity-purified antibodies against the carboxyl-terminal amino acid sequence of
      human gamma-tubulin. No gamma-tubulin could be detected in the interzone during
      anaphase and early telophase. Material containing gamma-tubulin first appeared in
      the two daughter cells on each side of the division plane in late telophase, and
      accumulated transiently at the minus ends of the two microtubule bundles
      constituting the midbody for one hour after metaphase. Micro-injection of gamma
      tubulin antibodies into anaphase cells prevented the subsequent formation of the
      microtubule bundles between the two daughter cells. In contrast with previous
      views, these observations suggest that the microtubules constituting the midbody
      may be nucleated on special microtubule organizing centres, active during late
      telophase only, and assembled on each side of the dividing plane between the
      daughter cells.

PMID- 8360270
TI  - gamma-Tubulin is present in acentriolar MTOCs during early mouse development.
AB  - gamma-Tubulin, a recently discovered member of the tubulin superfamily, is a peri
      centriolar component considered to be essential for microtubule nucleation. Mouse
      oocytes and early embryos lack centrioles until the blastocyst stage. Thus, early
      mouse embryos allowed us to study the location of gamma-tubulin in animal cells
      in the absence of centrioles. For this, we used an antiserum directed against a
      specific peptide of the gamma-tubulin sequence, which is conserved among species.
      This serum has been characterised both in PtK2 and mouse cells. We found that it
      specifically-stained the spindle poles and the cytoplasmic microtubule organizing
      centers in metaphase II oocytes and the spindle poles in mitosis during the
      cleavage stages. In contrast, no interphase staining could be detected during
      cleavage. Since the overall level of gamma-tubulin did not decrease during
      interphase, as shown by immunoblotting experiments, this absence of staining
      during interphase is probably due to a cytoplasmic dispersion of gamma-tubulin. A
      single dot-like interphase reactivity appeared at the 32-cell stage. In parallel,
      electron microscopy studies allowed us to detect centrioles for the first time at
      the 64-cell stage. The possible roles of gamma-tubulin in microtubule nucleation
      and in centrosome maturation are discussed.

PMID- 8360271
TI  - Stress-relaxation of fibroblasts in collagen matrices triggers ectocytosis of
      plasma membrane vesicles containing actin, annexins II and VI, and beta 1
      integrin receptors.
AB  - To learn about the effects of tension on fibroblast function, we have been
      studying initial cellular responses to stress-relaxation. Human foreskin
      fibroblasts were cultured in anchored collagen matrices for 2 days, during which
      time mechanical stress developed. Subsequently, the matrices were dislodged;
      thereby allowing stress to dissipate. Within 5 min after initiating stress
      relaxation, fibroblasts retracted their pseudopodia. At this time, we observed
      the disappearance of cellular stress fibers and the formation of actin clusters
      along the cell margins. The actin was found to be located inside 200 nm diameter
      vesicles that were budding from the cell surface. Vesicles isolated from the
      matrix after stress-relaxation contained prominent 24 kDa, 36 kDa (doublet), 45
      kDa, and 135 kDa polypeptides. The 45 kDa polypeptide was the major component in
      the Triton-insoluble vesicle fraction and appeared to be actin. The 36 kDa
      (doublet) polypeptide, which was found predominantly in the Triton-soluble
      vesicle fraction, was identified as annexin II. Vesicles also contained annexin
      VI and beta 1 integrin receptors but not tubulin, vimentin, vinculin or annexin
      I. The results suggest that stress-relaxation of fibroblasts induces a novel
      ectocytotic process involving transient budding of intact, plasma membrane
      vesicles from the cell cortex. On the basis of their morphological and
      biochemical features, these vesicles may be analogous to the 'matrix vesicles'
      released by chondrocytes and could play a role in extracellular matrix remodeling
      after wound contraction.

PMID- 8360272
TI  - Expression of integrin receptors and their role in adhesion, spreading and
      migration of normal human melanocytes.
AB  - Integrin receptors of human melanocytes in vivo and of melanocytes isolated and
      cultured from in vitro reconstituted normal human epidermis were investigated.
      Melanocytes were studied by high-resolution immunocytochemistry of in situ
      epidermis and were found to expose only the integrin subunits alpha 3, alpha 6,
      alpha v and beta 1 on their plasma membrane surface. Instead, cultured normal
      melanocytes expressed alpha 3 beta 1, alpha 5 beta 1, alpha 6 beta 1 and alpha v
      beta 3, which were immunoprecipitated from both metabolically and surface-labeled
      cells. Beta 1 integrins were diffused on the adhesion surface, while alpha v beta
      3 was clustered in focal contacts both in control cells and upon dendrite
      induction with phorbol 12-myristate 13-acetate (PMA). The functional roles of
      integrins were studied in vitro by cell adhesion, spreading and migration assays.
      The sum of the data indicated that, in normal human melanocytes: (i) adhesion to
      defined substrata is mainly mediated by specific beta 1 integrins; (ii) spreading
      is mainly modulated by alpha v beta 3; (iii) the beta 1 and beta 3 heterodimers
      cooperate in regulating migration. The in vitro expression of two integrins
      (alpha v beta 3 and alpha 5 beta 1) that are not exposed in situ, and their role
      in the spreading and migratory properties of melanocytes, strongly suggest that
      they are involved in regenerating a normally pigmented epidermis during wound
      healing by controlling melanocyte spreading and migration over a provisional
      matrix. Tumor promoters, such as PMA, selectively increased the expression of
      alpha 3 beta 1. We suggest that this integrin might be involved in melanocyte
      migration on the newly formed basement membrane during wound healing as well as
      in intercellular recognition of adjacent keratinocytes.

PMID- 8360273
TI  - 5-Bromo-2-deoxyuridine regulates invasiveness and expression of integrins and
      matrix-degrading proteinases in a differentiated hamster melanoma cell.
AB  - Cell interactions with the extracellular matrix play a critical role in
      regulating complex processes such as terminal differentiation and tumor
      progression. In these studies we describe a melanoma cell system that should be
      useful in addressing the regulation of cell-matrix interactions and the roles
      they play in regulating differentiation and cell invasiveness. CS (suspension)-1
      melanoma cells are relatively well differentiated: they are melanotic, responsive
      to melanocyte-stimulating hormone, and express TA99, a melanosome membrane
      differentiation marker. Their repertoire of integrin receptors for extracellular
      matrix ligands is limited; in particular, they lack receptors for vitronectin,
      accounting for the observation that they are nonadherent when cultured in the
      presence of serum. CS-1 cells are noninvasive as well, and express low levels of
      both metalloproteinases and activated plasminogen activators. Treatment of these
      cells with melanocyte-stimulating hormone causes them to increase melanin
      production and assume an arborized phenotype, suggesting that it promotes their
      further differentiation. In contrast, treatment of CS-1 with the thymidine analog
      5-bromodeoxyuridine, converts them to a highly invasive cell population (termed
      BCS-1) that loses its differentiated properties and responsiveness to melanocyte
      stimulating hormone, acquires a broad integrin repertoire (including vitronectin
      receptors), and expresses elevated levels of metalloproteinases and activated
      urokinase. From these observations and findings of others on BrdU treatment of
      other developmental lineages, we hypothesize that BrdU both suppresses
      differentiation and promotes invasiveness of CS-1 cells. The demonstrated
      manipulability of CS-1 cells should make them extremely useful for studying the
      regulation of both terminal differentiation and tumor progression in the
      melanocyte lineage.

PMID- 8360274
TI  - Growth cone guidance and neuron morphology on micropatterned laminin surfaces.
AB  - Neurite growth cones detect and respond to guidance cues in their local
      environment that determine stereotyped pathways during development and
      regeneration. Micropatterns of laminin (which was found to adsorb preferentially
      to photolithographically defined hydrophobic areas of micropatterns) were here
      used to model adhesive pathways that might influence neurite extension. The
      responses of growth cones were determined by the degree of guidance of neurite
      extension and also by examining growth cone morphology. These parameters were
      found to be strongly dependent on the geometry of the patterned laminin, and on
      neuron type. Decreasing the spacing of multiple parallel tracks of laminin
      alternating with non-adhesive tracks, resulted in decreased guidance of chick
      embryo brain neurons. Single isolated 2 microns tracks strongly guided neurite
      extension whereas 2 microns tracks forming a 4 microns period multiple parallel
      pattern did not. Growth cones appear to be capable of bridging the narrow non
      adhesive tracks, rendering them insensitive to the smaller period multiple
      parallel adhesive patterns. These observations suggest that growth cones would be
      unresponsive to the multiple adhesive cues such as would be presented by oriented
      extracellular matrix or certain axon fascicle structures, but could be guided by
      isolated adhesive tracks. Growth cone morphology became progressively simpler on
      progressively narrower single tracks. On narrow period multiple parallel tracks
      (which did not guide neurite extension) growth cones spanned a number of
      adhesive/non-adhesive tracks, and their morphology suggests that lamellipodial
      advance may be independent of the substratum by using filopodia as a scaffold. In
      addition to acting as guidance cues, laminin micropatterns also appeared to
      influence the production of primary neurites and their subsequent branching. On
      planar substrata, dorsal root ganglion neurons were multipolar, with highly
      branched neurite outgrowth whereas, on 25 microns tracks, neurite branching was
      reduced or absent, and neuron morphology was typically bipolar. These
      observations indicate the precision with which growth cone advance may be
      controlled by substrata and suggest a role for patterned adhesiveness in neuronal
      morphological differentiation, but also highlight some of the limitations of
      growth cone sensitivity to substratum cues.

PMID- 8360275
TI  - Moesin, like ezrin, colocalizes with actin in the cortical cytoskeleton in
      cultured cells, but its expression is more variable.
AB  - The band 4.1 superfamily of proteins show approx. 30% sequence identity in their
      amino-terminal region to the membrane binding domain of erythrocyte band 4.1.
      Within this superfamily are three members, ezrin, radixin and moesin, that show
      approx. 75% overall sequence identity. A comparison of the domain structure and
      intracellular localization of ezrin and moesin in cultured cells is reported
      here. Limited proteolytic digestion of ezrin or moesin yields a relatively stable
      32 kDa domain derived from the amino-terminal region that is homologous to the
      protease-resistant membrane binding domain of erythrocyte band 4.1. The remaining
      regions of the two proteins give rise to very different fragments, suggesting
      that the secondary/tertiary structures of the two proteins are different in these
      regions. We have generated polyclonal antibodies that discriminate between ezrin
      and moesin, and do not react with radixin. All cultured cell lines investigated
      contain ezrin, whereas moesin is variably expressed. Cells that contain both
      ezrin and moesin show a very similar pattern: both proteins are enriched and
      colocalize with actin in cell surface structures. Ezrin is also detected in the
      cytoplasm. In cells with few or no surface structures, both proteins show a
      patchy distribution in regions of the cell that contain fine networks of actin
      filaments. No staining of focal contacts or adherens junctions was observed.
      These results, together with those of others, lead to the conclusion that, of the
      members of this protein family, only radixin is an authentic component of
      adherens junctions and focal contacts. Ezrin and moesin are both found in cell
      surface structures after treatment of human A431 cells with epidermal growth
      factor, and ezrin, but not moesin, becomes phosphorylated on tyrosine. This study
      shows that ezrin and moesin have a similar subcellular distribution in cultured
      cells, yet are distinguishable in their expression, structure and ability to
      serve as a kinase substrate.

PMID- 8360276
TI  - Changing spatial patterns of DNA replication in the noise-damaged chick cochlea.
AB  - The purpose of the present study was to examine the spatio-temporal pattern of
      cell proliferation in the chick cochlea in response to the sensory hair cell loss
      induced by a 1.5 kHz pure tone at 120 dB SPL (1 dB = 20 muPa) for 48 h. DNA
      replication was evaluated with the bromodeoxyuridine (BrdU) pulse-fix technique.
      One group of birds was given multiple injections of BrdU (50 mg/kg) over a period
      of 8 h at various starting times during or after the exposure. Afterwards, their
      cochleas were removed and processed as whole mounts for BrdU
      immunohistochemistry. The cochleas of a second group of acoustically traumatized
      chicks were evaluated by scanning electron microscopy in order to determine the
      spatio-temporal pattern of hair cell loss. Hair cell loss was first observed 12 h
      after the start of the exposure and DNA replication started near the inferior
      edge of the hair cell lesion 24-32 h after the start of the exposure, i.e. 12-20
      h after the first sign of hair cell loss. The site of hair cell loss and DNA
      replication shifted toward the superior edge of the basilar papilla as the
      exposure continued. The rate of DNA replication accelerated and reached its peak
      near the end of the 48 h exposure. The estimated latency of cell proliferation
      after hair cell loss was faster and the duration of DNA replication shorter than
      that observed in other sensory systems. The spatio-temporal pattern of DNA
      replication follows the spatio-temporal gradient of hair cell loss, suggesting
      that cell proliferation is triggered by hair cell loss itself rather than by
      intrinsic positional cues or gradients.

PMID- 8360277
TI  - The Drosophila melanogaster dodecasatellite sequence is closely linked to the
      centromere and can form connections between sister chromatids during mitosis.
AB  - We have used fluorescence in situ hybridisation to wild-type and rearranged
      mitotic chromosomes to map the Drosophila melanogaster dodecasatellite sequence.
      It is located at a unique site, within the pericentric heterochromatin of the
      right arm of the third chromosome, closely linked to the primary constriction. In
      polytene chromosomes, dodecasatellite is found as one or a few dots in the
      central region of the chromocentre. In untreated diploid cells, dodecasatellite
      sequences are found as one or two dots throughout the cell cycle. This
      distribution can be altered in a cell cycle-dependent manner in two ways.
      Firstly, in interphase cells, hypotonic shock promotes the decondensation of the
      genomic region containing this satellite, resulting in a string-like structure.
      Secondly, some of the precociously separated sister chromatids produced by
      colchicine treatment show dodecasatellite within the intervening space connecting
      the main dodecasatellite signals of each chromatid. The distribution of
      dodecasatellite seems to be rather constant between individuals of the same
      species, as indicated by the lack of any detectable variations in its pattern
      amongst individuals from six geographically distant strains of D. melanogaster.
      On the other hand, the distribution of dodecasatellite shows a remarkable degree
      of variation amongst closely related species of the melanogaster subgroup ranging
      from a non-detectable signal in Drosophila yakuba and Drosophila teissieri, to
      staining in the X, second and third chromososomes of Drosophila mauritiana.

PMID- 8360278
TI  - Interphotoreceptor retinoid-binding protein (IRBP), a major 124 kDa glycoprotein
      in the interphotoreceptor matrix of Xenopus laevis. Characterization, molecular
      cloning and biosynthesis.
AB  - We have demonstrated that the neural retina of Xenopus laevis secretes into the
      extracellular matrix surrounding the inner and outer segments of its
      photoreceptors a glycoprotein containing hydrophobic domains conserved in
      mammalian interphotoreceptor retinoid-binding proteins (IRBPs). The soluble
      extract of the interphotoreceptor matrix contains a 124 kDa protein that cross
      reacts with anti-bovine IRBP immunoglobulins. In vitro [3H]fucose incorporation
      studies combined with in vivo light and electron microscopic autoradiographic
      analysis, showed that the IRBP-like glycoprotein is synthesized by the neural
      retina and secreted into the interphotoreceptor matrix. A 1.2 kb Xenopus IRBP
      cDNA was isolated by screening a stage 42 (swimming tadpole) lambda Zap II
      library with a human IRBP cDNA under low-stringency conditions. The cDNA
      hybridizes with a 4.2 kb mRNA in adult Xenopus neural retina, tadpole heads as
      well as a less-abundant mRNA of the same size in brain. During development, IRBP
      and opsin mRNA expression correlates with photoreceptor differentiation. The
      translated amino acid sequence of the Xenopus IRBP clone has an overall 70%
      identity with the fourth repeat of the human protein. Sequence alignment with the
      four repeats of human IRBP showed three highly conserved regions, rich in
      hydrophobic residues. This focal conservation predicts domains important to the
      protein's function, which presumably is to facilitate the exchange of 11-cis
      retinal and all-trans retinol between the pigment epithelium and photoreceptors,
      and to the transport of fatty acids through the hydrophilic interphotoreceptor
      matrix.

PMID- 8360279
TI  - Characterization of a putative Drosophila GTP-binding protein.
AB  - We generated a set of monoclonal antibodies raised against Drosophila antigen
      eluted from a lectin affinity column. One antibody, mAb 13D5 recognizes an
      antigen found in the most dorsal regions of the ventral midline of Drosophila
      embryos at stages prior to and during axonogenesis. 13D5 recognizes cells dorsal
      to the ectoderm in the extended germ band beginning approximately 7 hours after
      fertilization and in the peripheral nervous system (PNS) at about 13 hours. In
      addition, 24-hour-old cultures of isolated embryonic neuroblasts possess a number
      of cells that express the 13D5 antigen and are not recognized by horseradish
      peroxidase antisera. These cells extend ramified processes with multiple growth
      cone-like structures or large individual processes with a broad growth cone
      structure. 13D5 immunoprecipitates a single band with an apparent molecular mass
      of 58 kDa and isolated a 1.9 kb EcoRI fragment from the lambda gt11 expression
      libraries. In situ hybridization to staged embryos using the digoxygenin-labeled
      probe reveals a pattern of expression in cells just lateral to the dorsal-most
      regions (mesectoderm) of the ventral midline in 8- to 9-hour embryos. In situ
      hybridization to cultured cells derived from whole embryos reveals several cell
      types with differing morphologies that express transcript recognized by the
      digoxygenin-labeled probe. These cells may possess either broad processes
      containing detectable transcript, or long thin processes with no detectable
      transcript. Northern analysis reveals a 2.1 kb RNA transcript detectable in all
      embryonic stages. Nucleotide sequence obtained from the 1.9 kb insert reveals
      homology with the GTP-binding regions of two signal recognition particle
      receptors (SNRP) isolated from canine and human tissues.

PMID- 8360280
TI  - Measurement of regional cerebral blood flow with positron emission tomography: a
      comparison of [15O]water to [11C]butanol with distributed-parameter and
      compartmental models.
AB  - To further our understanding of the best way to measure regional CBF with
      positron emission tomography (PET), we directly compared two candidate tracers
      ([15O]water and [11C]butanol, administered intravenously) and two popular
      implementations of the one-compartment (1C) model: the autoradiographic
      implementation representing a single PET measurement of tissue radioactivity over
      1 min and a dynamic implementation representing a sequence of measurements of
      tissue radioactivity over 200 s. We also examined the feasibility of implementing
      a more realistic, and thus more complex, distributed-parameter (DP) model by
      assigning fixed values for all of its parameters other than CBF and tracer volume
      of distribution (Vd), a requirement imposed by the low temporal resolution and
      statistical quality of PET data. The studies were performed in three normal adult
      human subjects during paired rest and visual stimulation. In each subject seven
      regions of interest (ROIs) were selected, one of which was the primary visual
      cortex. The corresponding ROI were anatomically equivalent in the three subjects.
      Regional CBF, Vd, tracer arrival delay, and dispersion were estimated for the
      dynamic data curves. A total of 252 parameter sets were estimated. With
      [11C]butanol both implementations of the 1C model provided similar results (r =
      0.97). Flows estimated using the 1C models were lower (p < 0.01) with [15O]water
      than with [11C]butanol. In comparison with the 1C model, the constrained version
      of the DP used in these studies performed inadequately, overestimating high flow
      and underestimating low flow with both tracers, possibly as the result of the
      necessity of assigning fixed values for all of its parameters other than CBF and
      Vd.

PMID- 8360281
TI  - Reproducibility of resting cerebral blood flow measurements with H2(15)O positron
      emission tomography in humans.
AB  - Two consecutive measurements of resting CBF were carried out in normal volunteers
      (n = 25) using H2(15)O positron emission tomography. Absolute whole-brain blood
      flow (WBBF; ml 100 g-1 min-1, mean +/- SD) for the first (40.3 +/- 6.4) and
      second (39.3 +/- 6.5) measurements was not significantly different (mean %
      difference 2.3 +/- 8.7). Analysis of regions of interest showed no significant
      differences in absolute regional CBF (rCBF) and normalized (rCBF/WBBF) rCBF. Left
      right differences were also not significant. These data demonstrate the
      reproducibility of resting CBF measurements in normal humans.

PMID- 8360282
TI  - Imaging ischemic tissue at risk of infarction during stroke.
AB  - Autoradiograms obtained after middle cerebral artery occlusion (MCAO) in
      spontaneously hypertensive rats show that the 99mTc complex of a 2-nitroimidazole
      derivatized propylene amine oxime (BMS-181321) is selectively retained in acutely
      ischemic brain before disruption of the blood-brain barrier (BBB), but not in the
      ischemic infarct. BMS-181321 is therefore a marker of ischemic tissue at risk of
      infarction and its uptake, unlike that of x-ray and magnetic resonance contrast
      agents, does not require disruption of the BBB. In keeping with this conclusion,
      we have found that the single-pass cerebral extraction fraction of BMS-181321 is
      0.67 at normal rat whole-brain blood flow. Sequential single-photon emission
      computed tomographic images obtained from cats after MCAO show that the initial
      distribution of BMS-181321 approximates regional CBF and that selective retention
      subsequently produces a positive image within the ischemic territory. BMS-181321
      is the first Tc complex able to indicate not only ischemia, but also ischemic
      tissue at risk of infarction. Use of this novel Tc complex to monitor biochemical
      events during ischemia may contribute to the clinical management of acute stroke.

PMID- 8360284
TI  - Acceleration of HSP70 and HSC70 heat shock gene expression following transient
      ischemia in the preconditioned gerbil hippocampus.
AB  - To evaluate the mechanism of tolerance to ischemia, inductions of heat shock
      protein (HSP) 70 and heat shock cognate protein (HSC) 70 mRNAs in gerbil
      hippocampus were compared with in situ hybridization between cases of a single
      3.5-min period of forebrain ischemia and a 3.5-min period of ischemia 2 days
      after 2-min pretreatment with ischemia. Immunohistochemistry for HSP70 protein
      and morphological studies were also performed in the same brains up to 7 days
      after the reperfusion. Following a single 3.5-min period of ischemia, HSP70 and
      HSC70 mRNAs were induced in all hippocampal cells. However, the hippocampal CA1
      cells produced only a minimum of HSP70 protein, and the cells were almost lost by
      7 days. Following 3.5 min of ischemia after 2-min pretreatment, large populations
      of the CA1 cells survived at 7 days. The peak time of the HSP70 and HSC70 mRNA
      induction shifted to an earlier period of reperfusion in all hippocampal cells as
      compared with the case of a single episode of ischemia. The peak of HSP70 and
      HSC70 mRNA induction shifted from 1 day to 3 h in the CA1 cells. The CA1 cells
      produced strongly immunoreactive HSP70 from 3 hr to 2 days. These results suggest
      that pretreatment with an initial period of ischemia (for 2 min) accelerated
      HSP70 and HSC70 gene expression at the transcriptional level, ameliorated the
      translational disturbance of HSP70 mRNA to protein, and saved the CA1 cells from
      subsequent lethal ischemia (for 3.5 min). These changes of heat shock gene
      expression might play important roles in the acquisition of ischemic tolerance of
      hippocampal CA1 neurons.

PMID- 8360283
TI  - Local cerebral blood flow measured by xenon-enhanced CT during cryogenic brain
      edema and intracranial hypertension in monkeys.
AB  - We developed a closed-skull model of freeze injury-induced brain edema, a model
      classically thought to produce vasogenic edema, and observed the natural course
      of changes in edema and blood flow using xenon-enhanced computed tomography (CT)
      in five rhesus monkeys before and for up to 6 h post insult. Intracranial
      pressure (ICP) gradually rose throughout the duration of the experiment. CT scans
      and CBF images permitted direct observation of the evolution of the lesion and
      revealed early ischemia in the periphery of the injury zone that progressed over
      time in association with edema. Frequency histogram analysis of local CBF (ICBF)
      demonstrated subtle but potentially important changes in distribution of ICBF
      between and within hemispheres at various times post insult. Changes in ICBF
      distribution were phasic and dissociated from increases in ICP in the latter
      stages of injury. The Xe/CT CBF method can be used to evaluate the effects of
      injury and therapy on CBF in this and other models of acute brain injury.

PMID- 8360285
TI  - Biphasic striatal acetylcholine release during and after transient cerebral
      ischemia in gerbils.
AB  - Acetylcholine (ACh) release into the extracellular space was measured by HPLC
      with electrochemical detection after in vivo intracerebral microdialysis in the
      striatum of gerbils subjected to 15 min of bilateral carotid artery occlusion
      followed by 5 h of recirculation. Tissue ACh and choline (Ch) contents were also
      determined during ischemia and after 5, 30, 60, and 120 min of reflow. Fifteen
      minutes of ischemia led to a significant transient increase in extracellular ACh
      concentration (threefold after 7.5 min of ischemia) concomitant with a reduced
      endogenous ACh level (-62%) and increased tissue Ch content (ninefold).
      Recirculation significantly reduced the ACh release during the early period of
      reflow (-50% vs. basal level), followed by a significant increase in ACh release
      between 1 and 3 h of reflow (45-55% vs. basal level) and subsequent
      normalization. Simultaneously, a "rebound" of tissue ACh level occurred in the
      early period of reflow (fourfold vs. ischemic value), followed by gradual
      normalization after 2 h of reperfusion, whereas a rapid decrease in tissue Ch
      levels was found after 30 min of reflow. These findings represent the first
      demonstration of a biphasic release of ACh during ischemia and reperfusion, as
      assessed by intracerebral microdialysis in gerbils.

PMID- 8360286
TI  - Hypothermia attenuates the loss of hippocampal microtubule-associated protein 2
      (MAP2) following traumatic brain injury.
AB  - Traumatic brain injury (TBI) produces a tissue-specific decrease in protein
      levels of microtubule-associated protein 2 (MAP2), an important cross-linking
      component of the neuronal cytoskeleton. Because moderate brain hypothermia (30
      degrees C) reduces certain neurobehavioral deficits produced by TBI, we examined
      the efficacy of moderate hypothermia (30 degrees C) in reversing the TBI-induced
      loss of MAP2 protein. Naive, sham-injured, and moderate (2.1 atm) fluid
      percussion-injured rats were assessed for MAP2 protein content 3 h post injury
      using quantitative immunoreactivity measurements. Parallel groups of sham-injured
      and fluid percussion-injured animals were maintained in moderate hypothermia (30
      degrees C), as measured by temporalis muscle temperature, for MAP2 quantitation 3
      h post injury. No difference in MAP2 levels was observed between naive and sham
      injured normothermic animals. Hypothermia alone had no effect on soluble MAP2
      levels in sham-injured animals compared with normothermic sham-injured controls
      (88.0 +/- 7.3%; p > 0.10). Fluid percussion injury dramatically reduced MAP2
      levels in the normothermic group (44.3 +/- 5.9%; p < 0.0005) compared with
      normothermic sham-injured controls. No significant reduction of MAP2 was seen in
      the hypothermic injured group (95.2 +/- 4.6%; compared with hypothermic sham
      injured controls, p > 0.20). Although it is premature to infer any causal link,
      the data suggest that the attenuation of injury-induced MAP2 loss by hypothermia
      may contribute to its overall neuroprotective action.

PMID- 8360287
TI  - Secobarbital attenuates excitotoxicity but potentiates oxygen-glucose deprivation
      neuronal injury in cortical cell culture.
AB  - We examined the effects of secobarbital and other sedative-hypnotic barbiturates
      on the neuronal death induced by exposure to excitatory amino acids or
      deprivation of oxygen or glucose in mouse cortical cell cultures. N-Methyl-D
      aspartate (NMDA), alpha-amino-3-hydroxy-5-methyl-4- isoxazolepropionate, and
      kainate toxicities were attenuated in a concentration-dependent fashion by high
      concentrations of secobarbital or thiopental. Antagonism of NMDA toxicity was not
      overcome by increasing NMDA concentration and not mimicked by gamma
      aminobutyrate. Despite these antiexcitotoxic actions, secobarbital exacerbated
      the neuronal death induced by deprivation of either glucose alone or oxygen and
      glucose together; death induced by oxygen deprivation alone was little affected.
      Thiopental and methohexital also increased oxygen-glucose deprivation injury. A
      possible explanation for this injury potentiation was provided by the observation
      that secobarbital enhanced the cellular ATP depletion induced by combined oxygen
      glucose deprivation. Deleterious effects on ATP production may counterbalance the
      protective effects of barbiturates under some conditions.

PMID- 8360288
TI  - Recovery of mitochondrial and plasma membrane function following hypoglycemic
      coma: coupling of ATP synthesis, K+ transport, and changes in extra- and
      intracellular pH.
AB  - The primary objective of the present study was to evaluate the recovery of plasma
      and mitochondrial membrane functions after 30 min of hypoglycemic coma and to
      establish whether a lingering accumulation of free fatty acids (FFAs) delays the
      recovery. A secondary objective was to study whether production of metabolic
      acids following glucose infusion leads to a fall in intracellular pH (pHi).
      Phosphocreatine, creatine, ATP, ADP, and AMP, as well as glycogen, glucose,
      lactate, pyruvate, and FFAs of rat brain cortex and caudoputamen were measured,
      and "free" ADP was calculated from the creatine kinase equilibrium. Extracellular
      pH (pHe) and K+ concentration (K+e) were measured with ion-sensitive
      microelectrodes, and pHi was derived by the CO2 method. Glucose injection was
      followed by resumption of oxidative phosphorylation within approximately 2 min
      and by an equally rapid restoration of normal K+e levels. These functions
      recovered although tissue FFAs remained elevated for at least 7-8 min. Tissue
      lactate content increased only moderately and production of metabolic acids did
      not lead to intracellular acidosis. After 15 min of recovery, pHi was moderately
      increased, although pHe fell toward 7.0. It is speculated that the dissociation
      between intra- and extra-cellular pH is compatible with an up-regulation of an
      Na+/H+ antiporter, e.g., by phosphorylation.

PMID- 8360289
TI  - Regulation of intracellular pH in single rat cortical neurons in vitro: a
      microspectrofluorometric study.
AB  - Intracellular pH (pHi) and the mechanisms of pHi regulation in cultured rat
      cortical neurons were studied with microspectrofluorometry and the pH-sensitive
      fluorophore 2',7'-bis(carboxyethyl)-5,6-carboxyfluorescein. Steady-state pHi was
      7.00 +/- 0.17 (mean +/- SD) and 7.09 +/- 0.14 in nominally HCO3(-)-free and HCO3(
      )-containing solutions, respectively, and was dependent on extracellular Na+ and
      Cl-. Following an acid transient, induced by an NH1 prepulse or an increase in
      CO2 tension, pHi decreased and then rapidly returned to baseline, with an average
      net acid extrusion rate of 2.6 and 2.8 mmol/L/min, in nominally HCO3(-)-free and
      HCO3(-)-containing solutions, respectively. The recovery was completely blocked
      by removal of extracellular Na+ and was partially inhibited by amiloride or 5-N
      methyl-N-isobutylamiloride. In most cells pHi recovery was completely blocked in
      the presence of harmaline. The recovery of pHi was not influenced by addition of
      4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS) or removal of Cl-. The
      rapid regulation of pHi seen following a transient alkalinization was not
      inhibited by amiloride or by removal of extracellular Na+, but was partially
      inhibited by DIDS and by removal of extracellular Cl-. The results are compatible
      with the presence of at least two different pHi-regulating mechanisms: an acid
      extruding Na+/H+ antiporter, possibly consisting of different subtypes, and a
      passive Cl-/HCO3- exchanger, mediating loss of HCO3- from the cell.

PMID- 8360290
TI  - An electron microscopic immunogold analysis of developmental up-regulation of the
      blood-brain barrier GLUT1 glucose transporter.
AB  - Electron microscopy was used to quantitate blood-brain barrier (BBB) glucose
      transporters in newborn, 14-day-old suckling, 28-day-old weanling, and adult
      rabbits. A rabbit polyclonal antiserum to a synthetic peptide encoding the 13 C
      terminal amino acids of the human erythrocyte glucose transporter (GLUT1) was
      labeled with 10-nm gold particle-secondary antibody conjugates and localized
      immunoreactive GLUT1 molecules in rabbit brain capillary endothelia. Three
      distinct populations of brain capillary profiles were identified in newborn
      rabbits: prepatent capillary buds, partially patent capillaries with highly
      amplified luminal membranes, and patent capillaries. Immunogold analyses
      indicated that the GLUT1 transporter abundance positively correlated with
      capillary developmental status. The mean number of gold particles per capillary
      profile increased at each developmental age examined, suggesting that
      developmental up-regulation of the BBB glucose transporter occurred in rabbits.
      GLUT1 immunoreactivity was three- to fourfold greater on the abluminal than
      luminal capillary membranes among all ages examined. Changes in the proportions
      of GLUT1 transporter were also seen, and possible reasons for the postnatal
      decrease in the percentage of cytoplasmic GLUT1 transporter are discussed. The
      numbers of cytoplasmic and membrane-associated immunogold particles increased
      with age. We conclude that regulatory modulations of BB glucose transport may be
      characterized by increases in BBB glucose transporter density with age and state
      of development. In addition, modulation of glucose transporter activity may be
      reflected by minor postnatal shifts of GLUT1 from cytoplasmic to membrane
      compartments, which can be demonstrated with quantitative immunogold electron
      microscopy.

PMID- 8360291
TI  - Tetrahydroaminoacridine and physostigmine increase cerebral glucose utilization
      in specific cortical and subcortical regions in the rat.
AB  - The effects of the anticholinesterases tetrahydroaminoacridine (THA) and
      physostigmine on local cerebral glucose utilization (LCGU) were studied in the
      conscious rat, using the autoradiographic [14C]deoxyglucose technique. THA (5
      mg/kg i.p.) increased LCGU significantly in 8 of the 43 regions studied. A higher
      dose of THA (10 mg/kg) produced a metabolic activation in 19 of the 43 regions.
      LCGU increased in cortical areas (including parietal and temporal cortices), the
      septohippocampal system, the thalamus, the lateral habenula, the basolateral
      amygdala, the superior colliculus, and the substantia nigra. Scopolamine (4 mg/kg
      i.p.) reversed the THA-induced LCGU increase. Physostigmine (0.2 and 0.5 mg/kg)
      increased LCGU in 15 and 22 regions, respectively. The average magnitude of the
      change induced by 0.5 mg/kg of physostigmine was similar to that observed after
      THA at 10 mg/kg, but the topography of the effects was somewhat different.
      Physostigmine increased LCGU in the preoptic magnocellular area, the brainstem,
      and the cerebellum but not in the parietal cortex. The effects in the
      septohippocampal system were smaller than those induced by THA. The regional
      topography of the LCGU increase overlapped the distribution of the M2 muscarinic
      receptors and that of acetylcholinesterase activity. These data suggest that the
      major effects of THA and physostigmine on LCGU result from their
      anticholinesterase action.

PMID- 8360292
TI  - Perivascular microapplication of endothelin-1: a new model of focal cerebral
      ischaemia in the rat.
AB  - In the present study, we describe the effects of perivascular microapplication of
      the potent vasoconstrictor peptide endothelin-1 (ET-1; (120 pmol in 3
      microliters), delivered via a guide cannula stereotaxically positioned above the
      left cerebral artery (MCA) of the conscious male Sprague-Dawley rat. Ten minutes
      after the administration of Et-1, mean arterial blood pressure had increased by
      20% and profound reductions in local cerebral blood flow (up to 93%) were
      observed within those brain areas supplied by the MCA. In addition, significant
      increases in local cerebral blood flow were observed within the globus pallidus
      (100%), substantia nigra pars reticulata (48%), ventrolateral thalamus (65%), and
      dorsal hippocampus (74%) ipsilateral to the insult. Twenty-four hours following
      the insult, the pattern of ischaemic damage was similar to that reported
      previously following permanent occlusion of the rat MCA. It is suggested that
      perivascular microapplication of Et-1 may provide a useful model for the study of
      the functional disturbances associated with focal cerebral ischaemia in the
      conscious rat.

PMID- 8360293
TI  - A model of brain arteriolar oxygen and carbon dioxide transport during anemia.
AB  - Existing experimental and theoretical evidence suggests that precapillary
      diffusion of O2 and CO2 occurs between arterioles and tissue under normal
      physiologic conditions. However, limited information is available on arteriolar
      gas transport during anemia. With use of a mathematical model of an arteriolar
      network in brain tissue, anemic hematocrits of 35, 25, and 15% were modeled to
      determine the effect of anemia on the exchange, the change in the equilibrium
      tissue O2 and CO2 tensions, and the increase in blood flow needed to restore
      tissue oxygenation. We found that the blood PO2 exiting the network fell from 66
      mm Hg normally to 48 mm Hg during the severest anemia. Concurrently, the
      equilibrium tissue O2 tensions dropped from 44 to 23 mm Hg. For CO2 the exit
      blood PCO2 was 58 mm Hg for a 15% hematocrit, an increase of 4 mm Hg from the
      normal value, and equilibrium tissue PCO2 increased from 56 to 61 mm Hg. Blood
      flow increases from normal values necessary to offset the effects of the
      decreased O2 delivery to the tissue were 26, 86, and 222%, respectively, for
      hematocrits of 35, 25, and 15%. We compared our model results with recent
      experimental studies that have suggested that the amount of O2 diffusion is much
      higher than predicted values. We found that these experimental O2 gradients are
      three to four times larger than theoretical.

PMID- 8360295
TI  - Dynamic high-resolution MR imaging of brain deoxygenation during transient anoxia
      in the anesthetized rat.
AB  - Transient alterations in brain oxygenation during 60-s periods of anoxia were
      visualized at high spatial resolution (voxel size < or = 0.15 microliter) with
      the use of serial long echo time FLASH (fast low-angle shot) magnetic resonance
      images (measuring time > or = 6 s) of halothane-anesthetized rats in vivo.
      Difference images from normoxia and anoxia exploit the signal decrease associated
      with increased levels of paramagnetic deoxyhemoglobin in the arterial and venous
      blood pool. Insights into the spatial heterogeneity of oxygen deprivation are
      complemented by physiologic information from the time course of pertinent signal
      changes in different regions of the brain.

PMID- 8360294
TI  - Striatal 18F-dopa uptake: absence of an aging effect.
AB  - L-[18F]6-Fluoro-DOPA (L-[18F]6-fluoro-3,4-dihydroxyphenylalanine; FDOPA) has been
      used with quantitative positron emission tomography (PET) to assess presynaptic
      nigrostriatal dopaminergic function in life. The relationship of estimated
      kinetic rate constants for striatal FDOPA uptake [Ki(FDOPA)] to the normal aging
      process has been the subject of conflicting reports. Resolution of this issue has
      been hampered by methodological differences in previous FDOPA/PET investigations.
      We studied 19 healthy normal subjects (aged 27-77 years) and measured striatal Ki
      (FDOPA) according to each of the earlier methods. While significant correlations
      (p < 0.005) existed between Ki(FDOPA) values estimated by the various techniques,
      none correlated with normal aging. We conclude that normal striatal Ki(FDOPA)
      values estimated using quantitative FDOPA/PET are uncorrelated with the aging
      process.

PMID- 8360296
TI  - Changes in insulin-like growth factor 1 receptor density after transient cerebral
      ischemia in the rat. Lack of protection against ischemic brain damage following
      injection of insulin-like growth factor 1.
AB  - Binding of 125I-insulin-like growth factor-1 (125I-IGF-1) to rat brain slices was
      studied after 15 min of two-vessel occlusion ischemia and 1 h to 4 days of
      recirculation. Ligand binding in the hippocampus increased at 6 h post ischemia
      in the CA1 and CA3 regions and the dentate gyrus, suggesting that the IGF-1
      receptors were up-regulated, while no change was seen in neocortex and striatum.
      Intracerebroventricular injections of IGF-1 (2 micrograms) prior to and after
      transient cerebral ischemia did not reduce neuronal damage. The increased up
      regulation on IGF-1 receptors and the absence of neuroprotection by IGF-1 suggest
      that the intracellular signal transduction chain activated by the IGF-1 receptor
      may be interrupted.

PMID- 8360297
TI  - Chromatographic techniques used to determine benz[c]acridines in environmental
      samples.
AB  - Benz[c]acridine and many of its related compounds have been shown to exhibit
      carcinogenic activity. Unfortunately, these compounds are continually being found
      in many natural and environmental samples in widely divergent geographical
      locations. A review of chromatographic methods for mainly benz[c]acridine and its
      analogues is presented.

PMID- 8360298
TI  - Detection of airborne cocaine and heroin by high-throughput liquid-absorption
      preconcentration and liquid chromatography-electrochemical detection.
AB  - A high-throughput liquid-absorption preconcentrator (HTLAP) for rapid and/or
      ultrasensitive detection and analysis of trace contaminants samples air at a rate
      of 600-700 l/min and collects analytes from vapors or aerosols at an efficiency
      of 40-60% into a small volume of liquid absorbent dripping at a rate of 0.1-2
      ml/min. These features combine to reduce the lower detection limit (LDL) of
      available analytical instrumentation by a factor of > 1000 and/or to permit
      faster sampling and far more rapid on-site air monitoring than were previously
      practicable. LDLs of ca. 1:10(13) (v/v) of alkaloids have been achieved with LC
      and electrochemical detection. The HTLAP is directly adaptable to most liquid
      phase analyzers. The small rate of liquid collection is also compatible with
      available interfaces to mass spectrometers. Moreover, the HTLAP permits detection
      and quantitation of polar or highly reactive compounds that cannot be readily
      analyzed by conventional preconcentration and GC.

PMID- 8360299
TI  - Pollutants in drinking water and waste water.
AB  - Extracts of drinking water and effluents from municipal and industrial sewage
      treatment plants were analysed by gas chromatography-mass spectrometry and by
      high-performance liquid chromatography combined with ultraviolet and/or mass
      spectrometric detection. After column chromatography or flow-injection analysis
      bypassing the analytical column, ionization was performed by a thermospray
      interface. Identification of the pollutants was carried out by tandem mass
      spectrometry, generating daughter-ion spectra by collision-induced dissociation.
      Most pollutants in drinking water and in the effluents of waste water treatment
      plants are surface-active compounds of anthropogenic origin or their biochemical
      degradation products. Difficulties encountered during separation, detection and
      identification are presented and discussed and techniques for solving these
      problems are proposed.

PMID- 8360300
TI  - Comparison of the abundance of the fecal sterol coprostanol and fecal bacterial
      groups in inner-shelf waters and sediments near Sydney, Australia.
AB  - Concurrent measurement of the sewage tracer coprostanol and fecal indicator
      bacteria were made for water and sediments collected in January 1992 from coastal
      waters off Sydney, Australia. The coprostanol results were compared with data
      from an earlier survey conducted in 1989 before the commisioning of Sydney's
      deepwater ocean outfalls in 1990 and 1991. Good correlations were observed for
      both water and sediment samples between coprostanol and the two fecal indicator
      organisms, fecal coliforms and Clostridium perfringens spores, thereby validating
      the use of coprostanol as a sewage signature in this environment. For sediments,
      most inner-shelf sites (1-10 km offshore) showed an increase in the concentration
      of coprostanol between the two surveys. The areas of highest concentration have
      been shifted further off-shore, to zones adjacent to the diffusers.

PMID- 8360301
TI  - Solid-phase extraction followed by high-performance liquid chromatographic
      analysis for monitoring herbicides in drinking water.
AB  - A multiresidue analytical method based on C18 solid-phase extraction and one-run
      HPLC determination has been developed for the analysis of eleven acidic, neutral
      and weak basic herbicides in drinking water. A 1-1 sample of water was
      preconcentrated by passage through a 500-mg C18 solid phase extraction column.
      The retained compounds were eluted from the column with 1 ml of methanol. After
      concentration of the extract the pesticides were separated and quantified by
      reversed-phase HPLC with UV detection. Bentazone, 2,4-D, MCPA, fluazifop-acid,
      metoxuron, monolinuron, metobromuron, diuron, linuron, atrazine and simazine were
      determined simultaneously in a single run on a C18 HPLC column. Reanalyses of the
      sample extracts on a second cyano column were used to confirm the identity of the
      neutral and basic compounds. The limit of determination, defined as four times
      the baseline noise, varied between 0.01 microgram/l and 0.1 microgram/l depending
      on the compound, the detection sensitivity of the instrument and the type of HPLC
      column used.

PMID- 8360302
TI  - Chromatographic methods in the determination of herbicide residues in crops, food
      and environmental samples.
AB  - The state of the art of chromatographic methods used in the determination of
      herbicide residues in crops, food and environmental samples is reviewed. The main
      structural groups of herbicides, i.e., triazines, phenyl- and sulphonylureas,
      carbamates, uracils and phenoxyalkanoic and arylphenoxypropanoic acids, and
      important degradation products (dealkylated triazines, substituted anilines,
      chlorophenols) are considered. Advantages and drawbacks of gas (GC), liquid (LC)
      and thin-layer chromatography in this type of analysis are discussed. The
      characteristics of a modern chromatographic method for the determination of
      herbicide residues are summarized and trends in the development and combination
      of current GC and LC methods discussed.

PMID- 8360303
TI  - High-performance liquid chromatographic analysis of carbofuran residues in
      tomatoes grown in hydroponics.
AB  - Tomato plants grown in hydroponics were irrigated three times on alternate days
      with nutrient solutions fortified with carbofuran at levels of 36, 111 and 222 mg
      1-1, and carbofuran residues were analysed in tomato fruits. Residues were found
      to be below the maximum residue level set up by Codex Alimentarius Mundi (0.1 mg
      kg-1) 6, 11 and 18 days after the third irrigation with nutrient solutions
      fortified with carbofuran. Consequently, the withholding period of 60 days may be
      reduced to allow continuous harvest of tomatoes under the conditions used in this
      experiment.

PMID- 8360304
TI  - Application of solid-phase partition cartridges in the determination of fungicide
      residues in vegetable samples.
AB  - Disposable, ready-to-use cartridges filled with a macroporous diatomaceous
      material are used to extract in a single step fungicide residues with
      dichloromethane from aqueous acetone extracts of vegetables. This procedure takes
      the place of some functions (such as separating funnel partition, drying over
      anhydrous sodium sulphate and clean-up) usually performed by separate steps in
      classical schemes. Fourteen fungicides (dichloran, vinclozolin, chlorthalonil,
      triadimefon, dichlofluanide, procymidone, hexaconazole, captan, folpet,
      ditalimfos, iprodione, captafol, pyrazophos and fenarimol) were determined using
      the described procedure with recoveries between 83 and 107% at spiking levels
      ranging for the different compounds from 0.04 to 0.40 mg/kg. Crops subjected to
      the described procedure included lettuce, strawberry, apple, yellow pepper and
      peach, and gave extracts containing a mass of co-extractives between 5 and 30 mg.
      Compared with classical schemes, the described procedure is simple, less labour
      intensive, allows parallel handling of several extracts and does not require
      preparation and maintenance of equipment. Troublesome emulsions such as those
      frequently observed in separating funnel partitioning do not occur.

PMID- 8360305
TI  - Liquid chromatographic analysis of antibacterial drug residues in food products
      of animal origin.
AB  - This paper reviews recent developments in the liquid chromatographic (LC) methods
      of analysis for the residues of antibiotics (aminoglycosides, chloramphenicol,
      sulfonamides, tetracyclines, macrolides, beta-lactams, etc.) in food products of
      animal origin. The review also covers clean-up procedures, such as,
      ultrafiltration, liquid-liquid partition, solid-phase extraction, immunoaffinity,
      and matrix solid-phase dispersion, for use as extraction, deproteination, and
      concentration steps. The LC methods offer considerable potential for rapid
      automated analysis, and some may be used as direct screening for residues in meat
      and milk.

PMID- 8360306
TI  - Organic micropollutants in Swiss sewage sludge.
AB  - Sludges from sixteen municipal and eleven industrial Swiss sewage treatment
      plants were analysed for adsorbable organic compounds (AOX), chlorinated
      pesticides, polychlorinated biphenyls and polycyclic aromatic hydrocarbons.
      Except for the AOX values, which were significantly higher (p < 0.05) in
      industrial sludges, there was no significant difference between industrial and
      municipal sludges. The AOX values did not correlate with any of the measured
      pollutants. The methods employed (capillary GC-MS and GC-electron-capture
      detection) proved to be suitable for monitoring organic micropollutants in
      industrial and municipal sewage sludges.

PMID- 8360307
TI  - Chromatographic determination of volatile solvents and their metabolites in urine
      for monitoring occupational exposure.
AB  - The determination of volatile solvents and their metabolites in biological
      materials such as expired air, blood or urine allows the estimation of the degree
      of exposure of these chemicals. Chromatographic methods are now universally
      employed for this purpose and numerous analytical procedures are available for
      the determination of the most commonly used volatile solvents and their
      metabolites in urine. GC methods appear well adapted to the determination of the
      parent volatile solvents in blood and urine and may be used for the determination
      of their urinary metabolites, but these methods often require several
      prechromatographic steps. However, HPLC is becoming a powerful tool for the
      accurate and easy determination of urinary metabolites of volatile solvents,
      considering its decisive advantages for routine monitoring. Further, recent
      developments in HPLC could widen the usefulness of this method for most complex
      analytical problems that could be encountered during this measurement. However,
      despite the relative neglect of planar chromatography in this area of concern and
      considering the great interest in methods that could permit the simultaneous
      assay of numerous samples often required by routine monitoring, new approach
      using improved methods such as overpressured TLC could be very fruitful in the
      future.

PMID- 8360308
TI  - Environmental analysis of polychlorinated terphenyls: distribution in shellfish
      from the Ebro Delta (Mediterranean).
AB  - Polychlorinated terphenyls (PCTs) have characteristics almost identical with
      those of polychlorinated biphenyls (PCBs) and have been used for analogous
      applications, but only sporadic reports of the occurrence of PCTs in the
      environment have been published. High-resolution gas chromatography with electron
      capture detection (HRGC-ECD) and mass spectrometric detection in the selected ion
      monitoring mode was used to analyse samples for PCTs. The homologue distribution
      of Aroclor 5432, 5460, Leromoll 141 and the PCTs in samples of shellfish from the
      Ebro Delta (Catalonia, Spain) was established, taking into account the
      contribution of the [M-Cl2]+ fragments. Quantification was achieved by HRGC-ECD.
      Concentrations were between 790 and 3 ng/g (dry mass).

PMID- 8360309
TI  - Rapid isolation of polychlorinated biphenyls from milk by a combination of
      supercritical-fluid extraction and supercritical-fluid chromatography.
AB  - The extraction and isolation of polychlorinated biphenyls (PCBs) from sample
      matrices such as freeze-dried milk is a lengthy and expensive process that
      conventionally requires the isolation of microgram amounts of PCBs from large
      volumes of flammable organic solvents used in the extraction and chromatographic
      stages. Supercritical-fluid extraction (SFE) and chromatography (SFC) using
      carbon dioxide has been investigated as a replacement procedure using a Simplex
      optimisation approach to optimise the working conditions. The SFE conditions
      required to extract PCBs and milk fat from freeze-dried milk were investigated,
      and it was found that although extraction was rapid (10 min), the conditions
      required were identical so that there was no separation of PCBs and fat. However,
      SFC conditions have been developed that permit the resolution of PCBs from milk
      fat in 15 min. Thus, a combination of SFE and SFC have the potential to replace
      the existing methods of extraction and isolation with procedures that are
      quicker, cheaper, and avoid the use of flammable organic solvents.

PMID- 8360310
TI  - Determination of paraquat in rat brain by high-performance liquid chromatography.
AB  - The applications of a method based on ion-pair solid-phase extraction and
      reversed-phase HPLC are reported. The method was used to measure paraquat
      concentrations in discrete brain areas at different times after its systemic
      administration in rats. In addition, the method was employed in the determination
      of paraquat levels in whole-brain samples from rats of various ages systemically
      treated with several doses of the herbicide.

PMID- 8360311
TI  - Study of polychlorinated dibenzodioxins and furans from municipal waste
      incinerator emissions in The Netherlands: analytical methods and levels in the
      environment and human food chain.
AB  - An overview is given of the methods that have been used in the study of
      polychlorodibenzo-p-dioxins and polychlorodibenzofurans in agriculture and the
      human food chain in a national survey and monitoring programme, including
      sampling strategies, sampling in the field and clean-up and analysis in various
      biological and environmental samples by high-resolution gas chromatography-high
      resolution mass spectrometry. The quality of data was evaluated as a result of
      internal quality control protocols and participation in interlaboratory
      comparison studies. Statistical analysis techniques and modelling were applied in
      order to compare and relate congener profiles in various matrices and to evaluate
      levels found in field studies for their use for regulatory purposes.

PMID- 8360312
TI  - Detection of human T-cell lymphotropic virus type 1 infection by the polymerase
      chain reaction using dried blood specimens on filter papers.
AB  - A simple method for detection of proviral DNA sequences of human T-cell
      lymphotropic virus type 1 (HTLV-1) was developed using dried blood specimens on
      filter papers. The whole blood was blotted onto the Guthrie paper. After the
      blood has dried, the blotted paper was punched out into small discs. The discs
      were then boiled to prepare the template for PCR (filter paper-PCR method). The
      filter paper-PCR method detected even a single HTLV-1-infected cell in three
      discs. The sensitivity of the filter paper-PCR method was equivalent to that of
      the method in which DNA was extracted with phenol and used as the template for
      PCR (DNA extraction-PCR method). In addition, DNA in the blotted filter paper was
      still utilizable as the template after the storage at 25 degrees C for at least 7
      wk. A total of 53 clinical specimens from 30 seropositive and 23 seronegative
      individuals who were screened by particle agglutination (PA) test were analysed
      for HTLV-1 DNA by both PCR methods. Of 30 PA-positive specimens, 28 were also
      positive for HTLV-1 antibody by Western blot (WB) analysis, but two were
      indeterminate. The twenty eight WB-positive and one of the two indeterminate
      specimens were positive for HTLV-1 proviral DNA by both PCR methods. Of 23 PA
      negative specimens, 22 were negative for HTLV-1 proviral DNA by both PCR methods.
      However, one PA-negative specimen was positive by both PCR methods. This patient
      was a 16-mth-old infant who was born to an HTLV-1 carrier mother and fed
      thereafter without her breast milk. In comparison to DNA extraction-PCR method,
      the sensitivity and specificity of the filter paper-PCR method was 100%,
      respectively.

PMID- 8360313
TI  - Specific detection of anti-HBc antibodies with an enzyme immunoassay using
      recombinant HBcAg and monoclonal antibodies.
AB  - An enzyme immunoassay for the detection of total anti-HBc antibodies in undiluted
      serum samples was developed. This assay utilizes an anti-HBc monoclonal antibody
      and a recombinant HBc antigen. The results of the clinical validation are now
      reported. A total of 1,301 sera were tested using both the Recombinant TOTAL HBc
      Ab EIA and a reference assay. The specificity was evaluated on a panel of 573
      normal human sera and human sera from subjects with pathological findings
      unrelated to a hepatitis B virus infection. The sensitivity was studied on a
      total of 455 sera from HBV infected patients at different stages of infection.
      The final results indicate 99.8% sensitivity and 99.8% specificity. In addition,
      273 sera with either isolated anti-HBc antibodies or with anti-HCV antibodies
      were tested. The agreement between the Recombinant and the reference assay for
      these two populations, 96.6 and 90.1%, respectively, is discussed.

PMID- 8360314
TI  - Concentration of fish enveloped viruses from large volumes of water.
AB  - The validity of several concentration procedures for the detection of fish
      enveloped viruses present in large volumes of water was determined. Viral
      haemorrhagic septicaemia virus (VHSV) was used to evaluate adsorption/elution to
      positively-charged MK filter cartridges for the concentration of enveloped
      viruses. For fresh water, the efficiency of the procedure ranged from 12 to 100%,
      with a mean recovery of 57%. In seawater samples, the recoveries varied from 15
      to 100%, with a mean recovery of 59%. The same virus was used in methods such as
      organic flocculation and ammonium sulphate flocculation with very poor recoveries
      of infectious virus, caused by the inactivation of VHSV in both procedures.
      Concentration of seawater samples from tanks housing sea bass or gilthead
      affected by viral erythrocytic infection and lymphocystis, respectively, were
      carried out. In both cases, the viruses responsible for the outbreaks were
      detected by electron microscopy in the concentrated water samples.

PMID- 8360315
TI  - Immuno disc assay for screening duck hepatitis B surface antigen in serum, liver
      tissue and cultured hepatocytes.
AB  - An immuno disc assay (IDA) for semi-quantitative analysis of the surface antigen
      (DHBsAg) of duck hepatitis B virus (DHBV) is described. Unpurified antigen
      preparations were adsorbed onto punched-out nitrocellulose membrane discs. Rabbit
      antiserum raised against serum-derived gradient-purified DHBsAg was used for
      detecting the antigen. Cross-reacting antibodies in the rabbit antiserum were
      removed using normal duck serum and normal duck hepatocytes. The sensitivity of
      the IDA was compared with that of the Western blot analysis and was observed to
      be of the same order, but differed slightly for DHBsAg in liver and sera. In
      contrast to Western blot analysis, antigen specificity for the IDA included the S
      protein. Immunodetection was carried out in microtitre plates, but the procedure
      was accelerated by attaching the antigen-adsorbed discs to an adhesive plate
      sealer. The IDA was exemplified for measuring DHBsAg in duck serum, duck liver
      homogenates and viral protein synthesis in cultures of DHBV-infected hepatocytes.

PMID- 8360316
TI  - Rapid production of full-length, infectious geminivirus clones by abutting primer
      PCR (AbP-PCR).
AB  - The application of the polymerase chain reaction (PCR) method of DNA
      amplification for the isolation of full-length, infectious clones of
      geminiviruses is described. Non-overlapping, abutting 20-mer oligonucleotide
      primers were used to produce a linear product from the circular geminivirus
      genomic template. Clones of African cassava mosaic virus (ACMV) DNA A, obtained
      by this method, were infectious following mechanical inoculation (in the presence
      of ACMV DNA B) onto Nicotiana benthamiana. Normal ACMV symptoms resulted and
      typical geminate viral particles were detected by electron microscopy. The use of
      PCR for the detection and production of full-length, infectious geminivirus
      clones is discussed.

PMID- 8360317
TI  - Improved specificity of testing methods for filovirus antibodies.
AB  - An epizootic among monkeys imported into the United States created an immediate
      need for detection of antibodies to filoviruses. Thousands of samples were
      submitted to the Centers for Disease Control and Prevention for testing. Problems
      of sensitivity and specificity existed in the methods available for these assays.
      The experiments described in this report resulted in improved methods for the
      detection of antibodies to filoviruses, both for indirect fluorescent antibody
      assays (IFA) by standardizing methods and the Western blot (WB) by minimizing
      antigen load and by incorporating skim milk in diluents.

PMID- 8360318
TI  - Incorporation of microinjected biotin-labelled actin into nascent myofibrils of
      cardiac myocytes: an immunoelectron microscopic study.
AB  - Incorporation of microinjected biotin-labelled actin into nascent myofibrils of
      cultured cardiac muscle cells was investigated by immunogold electron microscopy.
      At the proximal parts of myofibrils, gold labelling was first found (at about 4
      min after injection) around the A-band level. This observation suggests that
      polymerization of actin or the addition of newly-formed actin filaments occurs
      preferentially in association with myosin filaments to increase the myofibrillar
      girth. The distal terminals of developing myofibrils were also labelled at about
      4 min after injection. This rapid incorporation of actin subunits at the
      myofibrillar ends suggests the continued reorganization and/or de novo formation
      of myofibrils at these positions. Along the extending direction of the
      myofibrillar terminals, gold particles were arranged in rows on the inner surface
      of the sarcolemma. These rows of particles continued to become longer with
      incubation. It appears that actin subunits are added at the membrane-associated
      ends of pre-existing actin filaments to increase the length of myofibrils.

PMID- 8360319
TI  - The complex Young's modulus of skeletal muscle fibre segments in the high
      frequency range determined from tension transients.
AB  - Stiffness measurements of muscle fibres are often based on application of a
      length change at one end of the muscle fibre and recording of the following
      tension change at the other end. In this study a method is developed to determine
      in the high frequency range (up to 40 kHz) the complex Young's modulus of
      skeletal muscle fibre as a function of frequency from the tension transient,
      following a rapid stepwise length change completed within 40 microseconds. For
      this purpose both a new mechanical moving part of the displacement generating
      system and a force transducer with a high natural frequency (70 kHz) had to be
      developed. In addition to stiffness measurements of a silk fibre to test the
      displacement generating system and the method of analysis, stiffness of skeletal
      muscle fibres in relaxed and rigor state have been measured. The complex Young's
      moduli of relaxed muscle fibres as well as muscle fibres in rigor state are
      frequency dependent. In both cases the complex Young's modulus increases smoothly
      with increasing frequency over a range of 250 Hz up to 40 kHz. The phase angles
      of the responses remained almost constant at a value of 0.3 radians for a fibre
      in rigor and 0.6 radians for a relaxed fibre. This leads to the conclusion that
      for muscle fibres in rigor state the recovery in the tension response to a step
      length change shows a continuous distribution of relaxation times rather than a
      few discrete ones. Results of our stiffness measurements are compared with
      results obtained from current viscoelastic models used to describe stiffness of
      muscle fibre in this frequency range.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360320
TI  - Two-dimensional time-resolved X-ray diffraction studies of live isometrically
      contracting frog sartorius muscle.
AB  - Results were obtained from contracting frog muscles by collecting high quality
      time-resolved, two-dimensional, X-ray diffraction patterns at the British
      Synchrotron Radiation Source (SERC, Daresbury, Laboratory). The structural
      transitions associated with isometric tension generation were recorded under
      conditions in which the three-dimensional order characteristic of the rest state
      is either present or absent. In both cases, new layer lines appear during tension
      generation, subsequent to changes from activation events in the thin filaments.
      Compared with the 'decorated' actin layer lines of the rigor state, the spacings
      of the new layer lines are similar whereas their intensities differ
      substantially. We conclude that in contracting muscle an actomyosin complex is
      formed whose structure is not like that in rigor, although it is possible that
      the interacting sites are the same. Transition from rest to plateau of tension is
      accompanied by approximately 1.6% increase in the axial spacing of the myosin
      layer lines. This is explained as arising from axial disposition of the
      interacting myosin heads in the actomyosin complex. Model calculations are
      presented which support this view. We argue that in a situation where an
      actomyosin complex is formed during contraction, one cannot describe the
      diffraction features as being either thick or thin filament based. Accordingly,
      the layer lines seen during tension generation are referred to as actomyosin
      layer lines. It is shown that these layer lines can be indexed as submultiples of
      a minimum axial repeat of approximately 218.7 nm. After lattice disorder effects
      are taken into account, the intensity increases on the 15th and 21st AM layer
      lines at spacings of approximately 14.58 and 10.4 nm respectively, show the same
      time course as tension rise. However, the time course of the intensity increase
      of the other actomyosin layer lines and of the spacing change (which is the same
      for both phenomena) shows a substantial lead over tension rise. These findings
      suggest that the actomyosin complex formed prior to tension rise is a non-tension
      generating state and that this is followed by a transition of the complex to a
      tension-generating state. The intensity increase in the 15th actomyosin layer
      line, which parallels tension rise, can be accounted for assuming that in the
      tension-generating state the attached heads adopt (axially) a more perpendicular
      orientation with respect to the muscle axis than is seen at rest or in the non
      tension-generating state. This suggests the existence of at least two
      structurally distinct interacting myosin head conformations.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 8360321
TI  - Models of the mechanism for crossbridge attachment in smooth muscle.
AB  - The mechanism responsible for formation of attached, dephosphorylated
      crossbridges (latchbridges) in smooth muscle is controversial. Myosin light chain
      phosphorylation may be obligatory for crossbridge attachment; if this were the
      case, latchbridges would arise solely by dephosphorylation of attached,
      phosphorylated crossbridges. Alternatively, the presence of attached crossbridges
      could induce cooperative activation by allowing dephosphorylated crossbridges to
      attach to the thin filament. We evaluated whether four-state models based on
      dephosphorylation and/or cooperativity-regulated attachment could quantitatively
      predict smooth muscle contractile behaviour. Five quantitative models for
      transitions between crossbridge states were developed. Mechanisms for latchbridge
      formation included: (1) dephosphorylation, (2) cooperativity-regulated attachment
      dependent only on attached, phosphorylated crossbridges, (3) cooperativity
      regulated attachment dependent on all attached crossbridges, (4)
      dephosphorylation and cooperativity-regulated attachment dependent only on
      attached, phosphorylated crossbridges, and (5) dephosphorylation and
      cooperativity-regulated attachment dependent on all attached crossbridges. All
      five models approximated the time course of contraction and the dependence of
      steady-state stress on myosin phosphorylation in the swine carotid artery. In the
      two models that had cooperative attachment regulated by all attached
      crossbridges, small increases in the rate constant for cooperativity-regulated
      attachment resulted in positive feedback and irreversible contraction. We suggest
      that a number of four-state crossbridge models can predict contractile behaviour
      in arterial smooth muscle. Potentially, latchbridges could be formed by both
      dephosphorylation and cooperativity-regulated attachment. If cooperativity
      regulated latchbridge attachment does exist in smooth muscle, we suggest that it
      should be dependent only on the number of phosphorylated crossbridges rather than
      all attached crossbridges.

PMID- 8360322
TI  - Mechanical response to photolytic ATP pulses of skinned muscle fibres pre
      activated with a small pulse of ATP.
AB  - (1) Skinned fibres from rat psoas muscle were placed in oil and activated at 10
      degrees C by pulse photolysis of caged ATP. From the force and stiffness
      transients on small ATP pulses, we estimated the concentration and rate of ATP
      hydrolysis of the crossbridges in the fibres. They were 0.14 mM and 0.16 mMs-1,
      respectively, and thus the turnover rate was 1.1 s-1. (2) To examine the
      mechanical properties of the physiological ADP-bound crossbridges, we took a
      double-pulse protocol: the skinned fibre was first activated with a conditioning
      ATP pulse (0.2-0.5 mM). Several (3-5) seconds later, when almost all the ATP
      should have been hydrolysed into ADP+P(i), we applied another ATP pulse (0.2-1
      mM) to test the fibre. (3) An analysis of the transients on the test pulses
      indicated that the conditioning pulse slowed the rate of crossbridge detachment.
      The time course of force development was thus expected to be also delayed, but
      was not. (4) We suggested that the rigor crossbridge might differ from the
      nucleotide-free intermediate in the physiological reaction cycle.

PMID- 8360324
TI  - Abstracts of the 1992 Annual Meeting on Muscle and Cell Motility Physiology.
      Tokyo, 18-19 December 1992.

PMID- 8360323
TI  - Partial titin cDNA sequence isolated from rabbit cardiac muscle RNA.
AB  - Two regions of the rabbit cardiac titin cDNA were amplified from rabbit cardiac
      muscle total RNA using primers based on rabbit skeletal muscle titin (connectin)
      cDNAs. These 1.7 kb and 1.5 kb RNA-PCR products were based on the 3' regions of
      the skeletal muscle titin clones CE12 and MS2, respectively. The cDNA sequence of
      the 1.7 kb product was extended an additional 1.5 kb by a novel 3' extension
      technique which used random primers in RNA-PCR. The cardiac titin cDNAs were 99%
      identical in nucleotide sequence to their skeletal muscle counterparts and
      predicted two types of 100-residue repeats. Southern blot analysis suggested that
      both cardiac and skeletal titin are encoded by the same gene. PCR amplification
      of human genomic DNA with titin specific primers indicated that there is strong
      sequence similarity between rabbit and human titin sequences. The successful
      amplification of a 907 basepair region from human genomic DNA suggested that
      titin contains large exons which span multiple motif borders. This may be
      particularly advantageous in the processing of such a large RNA transcript.

PMID- 8360325
TI  - Gangliosides and bacterial toxins in Guillain-Barre syndrome.
AB  - Autoimmune factors are strongly favoured as mediating Guillain-Barre syndrome
      (GBS); however, the precise mechanisms by which this occurs remain unknown.
      Microbial infections in a susceptible host resulting in an idiosyncratic immune
      response which cross-reacts with nerve constituents still remains the most
      plausible working hypothesis on which much current research is based.
      Considerable recent evidence indicates that this humoral immune response is at
      least in part directed to gangliosides. Interestingly, many bacterial toxins,
      including botulinum and tetanus neurotoxins, also bind to gangliosides and induce
      diseases with some similarities to GBS. This article discusses the evidence in
      favour of a pathogenic role for anti-ganglioside antibodies in GBS in the context
      of our knowledge of the biology of gangliosides and the factors that determine
      their immunogenicity.

PMID- 8360326
TI  - Interferon beta decreases T cell activation and interferon gamma production in
      multiple sclerosis.
AB  - Interferons (IFN) are biological molecules with anti-viral, anti-proliferative
      and immunomodulatory actions. There is evidence that IFN-gamma increases the
      frequency of exacerbations of multiple sclerosis (MS) whereas IFN-beta may reduce
      their frequency. Here we present evidence that IFN-beta significantly decreases
      concanavalin A (Con A)-induced proliferation of peripheral blood mononuclear
      cells (PBMC) of MS patients and healthy individuals. Similar results were
      obtained when PBMC were activated through the T cell receptor (TcR) by anti-CD3
      monoclonal antibody or independently of it by phorbol ester and Ca2+ ionophore.
      These effects of IFN-beta were also noted when IFN-gamma and IFN-beta were added
      together. Furthermore, IFN-beta decreased proliferation when added to cells that
      were already pre-activated. Activated CD4+ and CD8+ T cells were downregulated to
      approximately the same extent. Analysis of cytokine production showed that IFN
      gamma production by Con A activated PBMC was increased in MS when compared to
      controls. IFN-beta significantly decreased IFN-gamma production in MS patients
      and control individuals. Con A activated cultures treated with IFN-beta showed
      decreased IL2R expression and accumulation of IL2. These results show that IFN
      beta decreases T cell activation and IFN-gamma production in vitro, effects that
      may be beneficial in MS.

PMID- 8360327
TI  - Investigation of a synthetic peptide as immunogen for a variant epidermal growth
      factor receptor associated with gliomas.
AB  - We have previously demonstrated antibody production to a glioma-associated
      variant form of the human epidermal growth factor receptor in rabbits that had
      received a synthetic peptide mimicking the unique primary structure of the
      variant protein as immunogen. We report here the response of mice, rabbits,
      goats, and macaques immunized by various protocols to this peptide. Titers to
      both peptide- and cell-elaborated variant receptor were measured, and the
      capacity to recognize the variant receptor in human tumor samples was determined.
      Within the range of species and strains investigated, we demonstrated a variable
      species-associated response to the peptide (rabbits > mice > goats > rats >
      macaques). Rabbits and a single goat produced specific, high titer antibody
      activity to the variant receptor protein following immunization with peptide
      alone. Murine titers to the parent protein were not appreciable following peptide
      immunization alone; additional immunization with variant receptor as expressed on
      cell membranes was used to boost this response.

PMID- 8360328
TI  - Trans-blood-brain-barrier albumin leakage and comparisons of intrathecal IgG
      synthesis calculations in multiple sclerosis patients. Multiple Sclerosis Study
      Group, Alpha Interferon Study Group, and Azathioprine Study Group.
AB  - We compared four equations for estimating intrathecal IgG synthesis (Tibbling and
      Link IgG index (T/L), Schuller and Sagar (S/S), Reiber and Felgenhauer (R/F), and
      Tourtellotte (T) equations) using data from chronic progressive MS patients. For
      normal albumin leakage (AL) (< 75 mg/day-intact BBB), T (r = 0.15) and R/F (r =
      0.10) showed comparable positive correlations with trans-BBB AL, T/L (r = -0.10)
      was negative and S/S was uncorrelated (r = 0.05). For abnormal AL (> or = 75
      mg/day), the R/F (r = -0.24), S/S (r = -0.37) and the T/L (r = -0.22) equations
      overcorrected, whereas the T (r = 0.07) equation values did not correlate with
      AL. The albumin index and trans-BBB albumin leakage rate formulae gave
      essentially identical estimates of BBB leakage (r = 0.99, P = 0.0001). We
      conclude that in chronic progressive MS patients the R/F, T/L and S/S formulae
      overcompensate for large abnormal T-BBB albumin leakage rates. The T formula
      corrected best for IgG transudate at high AL rate values in MS.

PMID- 8360329
TI  - Magnetic resonance imaging investigation of blood-brain barrier damage in
      adoptive transfer experimental autoimmune encephalomyelitis.
AB  - Recent advances in fast magnetic resonance imaging (MRI) techniques have allowed
      quantification of parameters such as T1 relaxation time, which can be modified by
      changes in the water content of a tissue. We have used this new method to study
      the evolution of blood-brain barrier (BBB) changes after adoptive transfer of MBP
      specific (AT-EAE) and ovalbumin-specific T cell lines in Lewis rats. Measurable
      changes in T1 relaxation time suggesting widespread increase in BBB permeability
      were found, starting on day 3 post inoculation (p.i.), in the midbrain and
      brainstem of AT-EAE rats. In addition, we noted a significant decrease in T1
      relaxation time before injection of a paramagnetic agent, in the cisternal
      cerebrospinal fluid (CSF) of diseased animals, starting on day 5 p.i. In vitro
      measurement of T1 in CSF containing various concentrations of albumin, IgM and
      glucose showed that, at physiological concentrations, a T1 decrease is mainly
      associated with an increase in albumin concentration. A moderate increase in BBB
      and blood-CSF barrier permeability was found as early as 4-8 h p.i., in rats
      injected with MBP-specific as in animals injected with ovalbumin-specific T cell
      lines, suggesting a non-specific mechanism. Experimental MRI may become a
      powerful tool to sequentially analyse changes in barrier dynamics, for example
      following pharmacological intervention.

PMID- 8360330
TI  - On classification of post-mortem multiple sclerosis plaques for neuroscientists.
AB  - Plaque classification is proposed based on observation of 348 plaques from 52
      post-mortem multiple sclerosis (MS) cases. Four plaque types, ranging from
      'earliest lesion' to 'inactive', are described according to immunological
      activation and degree of demyelination, seen by expression of the Major
      Histocompatibility Complex (MHC) Class II molecule, HLA-DR, and by Oil Red O
      staining, respectively. 40% of the plaques were inactive. This result highlights
      the need for a description of plaque activity for studies of the etiopathogenesis
      of MS; that is, the earliest and/or the most active plaques should contain the
      causative agent whereas the burnt out plaques should not.

PMID- 8360331
TI  - Trafficking of activated cytotoxic T lymphocytes into the central nervous system:
      use of a transgenic model.
AB  - We have used cell or tissue-specific promoters to express lymphocytic
      choriomeningitis virus (LCMV) proteins in selected cells in independent lines of
      transgenic mice. Upon adoptive transfers into these mice, MHC-restricted LCMV
      specific cytotoxic T lymphocytes homed specifically to either the choroid plexus
      (SV40 promoter) or beta cells of the islets of Langerhans (rat insulin promoter).
      The availability of promoters specific for neurons, oligodendrocytes and
      astrocytes makes this approach compelling for evaluating T cell trafficking into
      the CNS and for analyzing antigen presentation in vivo in the CNS.

PMID- 8360332
TI  - Minor myelin proteins can be major targets for peripheral blood T cells from both
      multiple sclerosis patients and healthy subjects.
AB  - T cell recognition of myelin is likely to play a role in the pathogenesis of
      multiple sclerosis. Predominant protein components of myelin, myelin basic
      protein (MBP) and proteolipid protein (PLP), have been considered as possibly
      relevant autoantigens, especially since both proteins are encephalitogenic in
      various laboratory animals. It has remained unclear, however, to what extent the
      numerous minor proteins contained in myelin may serve as targets for human T cell
      responses to myelin. In this study, the abilities of several minor myelin
      proteins to trigger proliferative responses of human peripheral blood T cells
      were compared to that of MBP. By using a water soluble collection of myelin
      proteins as an antigen, including MBP as the major component, short-term T cell
      lines were generated. Proliferative responses were determined against the various
      proteins after their fractionation by HPLC. Short-term T cell lines from both
      multiple sclerosis patients and healthy control subjects displayed significant
      responses to several minor myelin proteins but failed to respond to MBP. Only the
      use of purified MBP as trigger antigen allowed the selective expansion of MBP
      specific T cell lines. These findings indicate that minor myelin proteins may act
      as relevant targets for autoreactive human T cells.

PMID- 8360333
TI  - Differential effect of interleukin-1 beta on Ia expression in astrocytes and
      microglia.
AB  - In an earlier study we demonstrated the inhibitory effect of interleukin-1 beta
      (IL-1 beta) on human leukocyte antigens (HLA) class II enhancement by interferon
      gamma (IFN-gamma) in a human glioblastoma multiforme cell line. In this study we
      have examined the effect of IL-1 beta on IFN-gamma induced major
      histocompatibility complex (MHC) class II (Ia) in primary cultures of newborn
      murine astrocytes and microglial cells. Astrocytes expressed very low levels of
      Ia molecules under basal culture conditions but these molecules could be induced
      with IFN-gamma. IL-1 beta in doses ranging from 1 to 100 units/ml inhibited the
      level of IFN-gamma induced Ia expression on astrocytes, and this inhibition was
      dose-dependent (mean maximum inhibition of 53 +/- 5% in number of positive cells
      and 53 +/- 2.6% in mean fluorescence intensity in four separate experiments). IL
      1 beta treatment had no effect on MHC class I induction by IFN-gamma in the
      astrocytes. In contrast, microglial cells expressed Ia molecules under basal
      culture conditions, and this expression was enhanced by IFN-gamma treatment. Both
      basal and IFN-gamma induced Ia expression on microglia were resistant to IL-1
      beta treatment in doses ranging from 1 to 100 units/ml. These results indicate
      that Ia expression is differentially regulated on astrocytes and microglial cells
      and that IL-1 beta may have an important immune regulatory function in the
      central nervous system.

PMID- 8360334
TI  - Orthodontist of the year.

PMID- 8360335
TI  - Dr. Lysle E. Johnston, Jr., on orthodontics and the scientific method, an
      interview by Dr. White.

PMID- 8360336
TI  - Bond strengths and fracture modes of three orthodontic adhesives.

PMID- 8360338
TI  - Predictable indirect bonding.

PMID- 8360337
TI  - Use of mutual protective agreement after a heart attack.

PMID- 8360339
TI  - Bringing an ectopic lower canine into the arch.

PMID- 8360340
TI  - Double ball clasp for plate and splint appliances.

PMID- 8360341
TI  - A computer in the hand.

PMID- 8360342
TI  - Orthodontic office design: applications of glass block.

PMID- 8360343
TI  - Sealing palatal expansion screws with light-cured adhesive.

PMID- 8360345
TI  - Macintosh program for submitting TMD insurance claims.

PMID- 8360344
TI  - Comparison of three dry-heat convection sterilizers.

PMID- 8360346
TI  - Teamwork, quality, and competitive advantage: the Deming philosophy in
      orthodontics.

PMID- 8360347
TI  - Rubber dam isolation of the working field in orthodontics.

PMID- 8360348
TI  - Tooth extrusion with a removable appliance.

PMID- 8360349
TI  - Comparative three-dimensional analysis of CT-scans of the calvaria and cranial
      base in Apert and Crouzon syndromes.
AB  - The purpose of this study is to describe and analyze Apert and Crouzon skulls
      from three-dimensional (3-D) reconstructions of CT-scans. 12 Apert patients and
      19 with Crouzon syndrome were included in the study. The age range was 0 to 23
      years. All CT-scannings were carried out according to the same protocol with a
      slice thickness of 2 or 4 mm and 3-D reconstructions of the craniofacial region
      included midsagittal and horizontal cuts. A number of qualitative characteristics
      of the calvaria and cranial base were recorded and the cranial base angle was
      measured on the 3-D models. Our results showed that Apert and Crouzon syndromes
      are very different in cranial development and their dysmorphology is highly age
      dependent. We suggest that cartilage abnormalities, especially in the anterior
      cranial base, play a primary role in cranial development in the Apert syndrome
      from very early intrauterine life. Several cranial anomalies observed
      postnatally, however, are caused by the resultant dysmorphic and compensatory
      growth and are probably compounded by early cranial deformation. The primary
      abnormality in Crouzon syndrome appears to be premature fusion of sutures and
      synchondroses. Based on the findings at birth and early infancy it would seem
      that such fusions occur relatively late in fetal life. The adult cranial form in
      Crouzon's patients is explainable by resultant dysmorphic and compensatory growth
      changes. Very early release of the coronal suture areas with advancement of the
      frontal bone is advocated in both syndromes but for somewhat different
      reasons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360350
TI  - Median cleft of the lower lip, mandible and manubrium. A case report.
AB  - There is a wide variation in the severity of median clefts of the lower lip and
      mandible. We report a severe case demonstrating clefts of the lower lip and
      mandible together with lack of supporting structures in the neck and upper
      sternum. Since a case with a cleft of the manubrium sterni is very rare, the
      literature is reviewed and discussed.

PMID- 8360351
TI  - Fibrin sealing and histometrical changes in conventionally sutured microvascular
      anastomoses.
AB  - Reports from the literature demonstrated an early occlusive thrombosis rate of
      microvascular anastomoses of up to 25%. In order to reduce free flap failure due
      to kinking and pressure in the region of the anastomosis, fibrin sealing of
      microvascular anastomosis was recommended in previous studies. However, it is
      well accepted that haemostasis is activated by vascular wall injuries (lesions of
      the endothelial layer). For that reason, a fast re-endothelialisation of the
      inner surface of the anastomosis is thought to reduce early occlusive thrombosis
      and, subsequent, free flap failure. To clarify whether application of fibrin
      adhesives exert any effect on microvascular anastomoses, we constructed 84
      anastomoses in rat arteries applying sealant or non-sealant in randomized order.
      At certain time intervals, arteries operated on were removed and histologically
      analyzed. Early complete endothelial regeneration, 4 days after surgery, was
      observed in the unsealed anastomosis group, whereas sealed anastomosis showed a
      complete re-endothelialisation only after 7 days. These observations may be
      explained by a reduced multiplication rate and migration speed (0.3 mm/day) of
      endothelial cells during the first 3 days (unsealed anastomosis: 0.63 mm/day). In
      addition, in sealed anastomoses a higher incidence of media necrosis was found
      (60.7% vs 49.3% in the unsealed group). These histological changes were confirmed
      by scanning and transmission electron microscopy.

PMID- 8360352
TI  - The mandibular body bone (MBB) graft: an alternative source of membranous bone.
AB  - The use of mandibular body bone (MBB) as an alternative source of membranous bone
      graft is described. The MBB technique is a simple, safe and rapid method of
      obtaining cortical bone for grafting. Furthermore MBB is membranous bone, which
      has been reported to be more dimensionally stable after grafting than is
      endochondral bone. The donor site is more readily accessible than is that for
      cranial bone, the other source of membranous bone. Two 1.5 x 3 cm rectangular
      grafts are generally available. We recommend the use of MBB in situations where
      the technique provides sufficient bone.

PMID- 8360353
TI  - Solitary plasmacytoma of the mandible. Case report and review of the literature.
AB  - A case of solitary plasmacytoma of the mandible is presented. Review of the
      literature disclosed the following characteristics regarding the clinical course
      and prognosis. The patients ages ranged from 34 to 76 years, with a mean of 53
      years; there was a marked preponderance of males. The site of predilection was
      the posterior portion of the mandible. The common symptom was a non-painful
      swelling of the mandible of long duration, and radiological features were non
      specific. Monoclonal immunoglobulin was initially detected in 42% of the
      evaluated patients. The majority of patients were treated with radiation therapy
      with a mean dose of 48Gy with or without surgery. The period of follow-up ranged
      from 4 months to 12 years, and 17% of the patients progressed to multiple myeloma
      within 1 year.

PMID- 8360354
TI  - Morphological study of the parotid lymph nodes.
AB  - The surgical resection of metastatic lesions of the parotid gland is
      controversial. The present anatomical study has been carried out to determine
      whether or not lymph nodes are present in the deep lobe of the gland and to
      assess their number in different age groups. We found a substantial number of
      lymph nodes in the deep lobe of the parotid gland independently of the subject's
      age. It can be concluded that from a strictly morphological point of view,
      superficial parotidectomy does not appear adequate when radical neck dissection
      including the parotid gland is to be done.

PMID- 8360355
TI  - The treatment of mandibular fractures in children.
AB  - 92 children with mandibular fracture were treated at our hospital between 1980
      and 1989. Distribution and treatment of the fractures focus on a new
      classification based upon the stage of the dentition, site of the fracture and
      displacement of the tooth-bearing part of the mandible. The treatment rationale
      includes intermaxillary fixation by specially designed mini-arch bars with
      acrylic resin stiffening in cases with undisplaced fractures in the early stages
      of the dentition. With the help of this technique, invasive procedures for
      fracture immobilization become less common. The indication for miniplate
      osteosynthesis is limited to displaced or multiple fractures of the tooth-bearing
      part of the mandible. The combination of miniplates and monomaxillary splinting
      with mini-arch bars allows a shorter duration of intermaxillary fixation and
      hence early functional treatment of additional condylar fractures. Correctly
      applied miniplates neither injure the tooth germs nor lead to growth disturbances
      of the mandible. The classification and treatment of mandibular fractures in
      children are discussed.

PMID- 8360356
TI  - The split rib bundle graft in mandibular reconstruction by M. el Sheikh--Vol. 20
      (1992) 326-332.

PMID- 8360357
TI  - Evaluating diagnostic tests in dentistry.

PMID- 8360358
TI  - Characterization of Actinomyces with genomic DNA fingerprints and rRNA gene
      probes.
AB  - Cellular DNA from 25 Actinomyces naeslundii and Actinomyces viscosus strains
      belonging to the 7 taxonomic clusters of Fillery et al. (1978) and several
      unclustered strains was obtained by enzymatic and N-lauroylsarcosine/guanidine
      isothiocyanate treatment of whole cells, followed by extraction of the nucleic
      acid. The DNA samples were digested with restriction endonucleases BamHI or
      PvuII, and agarose gel electrophoresis was used to obtain DNA fingerprints. The
      DNA fragments were subjected to Southern blot hybridization with a digoxigenin
      labeled cDNA probe transcribed from Escherichia coli 16S and 23S rRNA. The
      patterns of bands from genomic (DNA fingerprints) and rDNA fingerprints
      (ribotypes) were used for comparison between the taxonomic cluster strains and
      strains within clusters. Representative strains from each taxonomic cluster
      provided different BamHI DNA fingerprints and ribotype patterns with 3 to 9
      distinct bands. Some strains within a cluster showed identical ribotype patterns
      with both endonucleases (A. naeslundii B120 and A. naeslundii B102 from cluster
      3), while others showed the same pattern with BamHI but a different pattern with
      PvuII (A. naeslundii ATCC 12104 and 398A from cluster 5). A viscosus ATCC 15987
      (cluster 7) and its parent strain T6 yielded identical fingerprint and ribotype
      patterns. The genomic diversity revealed by DNA fingerprinting and ribotyping
      demonstrates that these techniques, which do not require phenotypic expression,
      are suited for study of the oral ecology of the Actinomyces, and for
      epidemiological tracking of specific Actinomyces strains associated with caries
      lesions and sites of periodontal destruction.

PMID- 8360359
TI  - In vitro demineralization by strains of Actinomyces viscosus and Streptococcus
      sobrinus of sound and demineralized root surfaces.
AB  - Root sections were inoculated with one of two strains of Actinomyces viscosus or
      a strain of Streptococcus sobrinus and then incubated for 9 days in Trypticase
      soy broth (TSB) containing 0.25% glucose or TSB supplemented with 0.25% sucrose
      (TSB+S). Lesion progression was measured from microradiographs. One section from
      each group was examined with a transmission electron microscope. Lesion
      progression was associated with a fall in the pH of the medium. However, lesion
      progression was not correlated with the mean 48-hour pH of the medium. In both
      TSB and TSB + S, lesion progression with A. viscosus was significantly greater
      than in the S. sobrinus group. However, the mean 48-hour pH value in TSB + S was
      lower than that in the S. sobrinus group. Plaque formation in TSB was,
      subjectively, least in the S. sobrinus group. Examination of transmission
      electron micrographs revealed bacteria penetrating the surfaces of the sections
      and extending into the lesion in the A. viscosus groups but not in the S.
      sobrinus group. This in vitro bacterial plaque model of root caries may be
      suitable for investigations of the bacterial etiology of root-surface caries and
      the virulence factors associated with pathogenicity.

PMID- 8360360
TI  - Protective effect of topically applied fluoride in relation to fluoride
      sensitivity of mutans streptococci.
AB  - The aim of the present in vitro experiments was to determine whether the
      protection of enamel by topically applied fluoride against demineralization by
      bacterial acids would depend on the fluoride sensitivity of the bacteria. Glucose
      agarose gel suspensions of fluoride-sensitive and fluoride-resistant mutans
      streptococci were placed on bovine enamel specimens with different amounts of
      fluoride. One group of specimens was untreated, a second group had been
      pretreated with a F-lacquer, and a third group had been pretreated with the F
      lacquer and rinsed subsequently with a KOH-solution, to remove deposited CaF2.
      After 22-hour incubations at 37 degrees C, the amounts of calcium and lactate and
      the pH of the agarose gels were determined. This procedure was repeated on three
      consecutive days. Two parent S. mutans strains, one parent S. sobrinus strain,
      and five fluoride-resistant derivatives were tested. Both pretreatments gave a
      significant protection to the enamel specimens. For the S. mutans strains, the
      degree of protection did not depend on the fluoride sensitivity of the strains.
      For the S. sobrinus strains, the results suggested a reduced protection against
      demineralization by the fluoride-resistant derivatives. Only from the second
      group of enamel specimens was enough fluoride released for inhibition of
      bacterial metabolism. Presumably, it was released by the dissolution of CaF2. It
      is concluded that a possible adaptation of mutans streptococci in dental plaque
      to frequent exposures to fluoride will not necessarily decrease the caries
      preventive effects caused by topically applied fluoride agents.

PMID- 8360361
TI  - The isolation and characterization of milleri group streptococci from dental
      periapical abscesses.
AB  - Reports of the isolation of streptococci from dental abscesses have shown an
      association of the "S. milleri" group with such lesions. There has been
      considerable confusion regarding the taxonomy of these organisms, but the milleri
      group has recently been reclassified into three distinct species: Streptococcus
      anginosus, Streptococcus constellatus, and Streptococcus intermedius. In this
      study, 45 samples from dental periapical abscesses were examined. Milleri group
      streptococci were isolated from 16 patients (37%), 15 being identified as S.
      anginosus and one as S. intermedius. In one patient, S. anginosus was isolated in
      pure culture, and it would appear that this is the predominant species of milleri
      group streptococci associated with periapical abscesses.

PMID- 8360362
TI  - Long-term effects of Meridol and chlorhexidine mouthrinses on plaque, gingivitis,
      staining, and bacterial vitality.
AB  - The aim of the present study was to compare the effect on plaque growth and
      gingival response of Meridol, an amine/stannous fluoride solution, during a three
      month investigation, with those of a placebo preparation as a negative control
      and a chlorhexidine solution as a positive control, in a double-blind study.
      After having their teeth professionally cleaned, 36 volunteers continued their
      usual oral hygiene for a period of two weeks. Their teeth were then polished
      again (month 0) after which they rinsed twice daily (morning and evening) with
      one of the three mouthrinses in addition to their habitual toothcleaning. After
      three months of rinsing, plaque indices remained lowest in the chlorhexidine
      group, although the subjects using Meridol had indices significantly lower than
      those of individuals rinsing with the placebo solution. The gingival index scores
      in the Meridol group were higher than in the chlorhexidine group and lower than
      in the placebo group. The plaque vitality scores showed a bactericidal effect in
      vivo with chlorhexidine and Meridol during the entire experiment. The use of
      Meridol resulted in more toothstaining than with the placebo, but significantly
      less than with chlorhexidine. This study demonstrated that Meridol reduced plaque
      accumulation, retarded gingivitis development, possessed a definite bactericidal
      action, and produced only slight toothstaining.

PMID- 8360363
TI  - Recovery of the jaw-opening reflex after lesions of the lingual nerve in the rat.
AB  - In three groups of rats, lesions were produced in the right lingual nerves near
      the base of the tongue; the three types of injury inflicted (cryogenic, crush,
      and stretch) are reputed to spare the epineurium but produce different degrees of
      intraneural damage. In regular assessments of recovery, an electrical stimulus
      (sufficient to elicit the jaw-opening reflex) was applied to either side of the
      tongue in turn; the amplitude of the reflex was measured as the isometric force
      of jaw opening. The size of the reflex response to stimulation of the injured
      side was followed up to 4 months post-lesion, with the response elicited from the
      control side used as the reference level. The reflex was absent when the
      experimental side was stimulated immediately after creation of a lesion; the
      first sign of reflex recovery was found at about 15 days post-operative.
      Subsequently, in 84% of the animals, the reflex activity elicited from the
      experimental side increased until it exceeded that elicited from the reference
      side; this relative hyperreflexia started 1-4 months post-lesion and had a highly
      variable duration. There was no difference in the incidence, latency, or duration
      of the hyperreflexia following any of the three types of lesion. The
      hyperreflexia found in this study is not readily explained by existing hypotheses
      of the mechanisms underlying post-lesion hyperesthesia or central neuronal
      hyperexcitability.

PMID- 8360364
TI  - Spatial and gender-dependent variations in perioral pinprick sensitivity.
AB  - Twenty-eight right-handed young adults participated in a sensory testing
      experiment to evaluate pinprick sensitivity at ten spatially matched sites on the
      right and left sides of the face. Stimuli were provided by a sharp-pointed dental
      explorer on which a rubber eraser had been positioned to minimize variations in
      the extent to which the skin was indented. Sharpness was defined as the magnitude
      at which abrupt, localized pricking/stinging sensations were evoked. A magnitude
      matching procedure was used to reduce among-subject variability in the data.
      Specifically, each estimate of sharpness was adjusted (i.e., divided) by the
      subject's mean estimate of the brightness of a visual stimulus. Prior to data
      collection, subjects were carefully instructed on the use of a common numerical
      scale for assignment of values of sharpness and brightness. Repeated-measures
      analysis of variance of the adjusted estimates of sharpness revealed a non
      significant effect of gender (p > 0.4), a highly significant effect of side (p <
      0.0001), and a highly significant effect of test site (p < 0.0001). Pinprick
      percepts were sharper on the left side of the face than on the right. Moreover,
      the vermilion of the upper lip exhibited the greatest sensitivity to pinprick;
      the vermilion of the lower lip exhibited the least sensitivity. These results
      suggest that use of a patient's sensitivity to pinprick during clinical
      neurosensory examination must be undertaken in an informed manner. A conclusion
      of pathological alteration in sensation can be made only after consideration of
      the normal spatial variations in the percept of sharpness.

PMID- 8360365
TI  - The reinnervation of healing extraction sockets in the ferret.
AB  - The objective of this study was to describe the pattern of healing of pulpal and
      periodontal nerve fibers following tooth extraction. The mandibular canine teeth
      were, under general anesthesia, removed from one side of nine young ferrets. One
      week (two animals), one month (four animals), and three months (three animals)
      later, again under general anesthesia, the animals were perfused with fixative.
      The mandibles were decalcified, paraffin-embedded, and serially sectioned. Sample
      sections were stained with hematoxylin and eosin, the remainder with a silver
      stain for nerves. Serial reconstructions were made of the innervation in control
      teeth and in the extraction sockets. A grid sampling technique was used for the
      estimation of the innervation density in different regions at various levels in
      the healing socket. One week after extraction, although osteoid material was
      beginning to fill the socket, the pattern of innervation remained similar to that
      of controls in being restricted to the former location of the periodontal
      ligament and being densest in the apical third of the socket. One month after
      extraction, the innervation consisted of many fine axons or small bundles
      distributed throughout the healing osteoid tissue though still most dense in the
      periphery of the socket. The overall innervation density increased between one
      week and one month post-extraction. At three months, as the margins of the socket
      were becoming obscured, the innervation consisted largely of one or two organized
      nerve trunks running from the apical to the coronal aspect in either the central
      or lateral aspects of the socket. At no time was there evidence of neuroma
      formation.

PMID- 8360366
TI  - Differences in composition of cell-attachment sialoproteins between dentin and
      bone.
AB  - Matrices of dentin and bone were compared with respect to the content of cell
      attachment sialoproteins. The levels of two sialoproteins, osteopontin (OPN) and
      bone sialoprotein (BSP), were determined in dentin and bone by immunochemical
      procedures. Polyclonal antibodies against bovine BSP and an antibody against the
      amino-terminal decapeptide of rat OPN were used. The relative levels of OPN and
      BSP in dentin were less than one-tenth of the levels in bone. The differences
      between dentin and bone levels of OPN and BSP were thus larger than those for
      osteonectin or bone Gla protein in the two tissues. The scarcity of the cell
      attachment proteins in dentin may reflect the metabolic inactivity of dentin.

PMID- 8360367
TI  - Development of the human submandibular salivary gland.
AB  - The development and morphogenetic timetable of the submandibular gland was
      studied in 37 human embryos and human fetuses. The medial paralingual groove
      constituted the anlage of the submandibular gland: Its anterior three-quarters
      gave rise to Wharton's duct, and its posterior quarter to the submandibular gland
      proper. The sublingual process of the submandibular gland originated from a
      lateral ectodermal bud of the anlage of the submandibular gland, in the posterior
      quarter of the medial paralingual groove.

PMID- 8360368
TI  - Nucleolar organizer regions as markers of incipient cellular alterations in
      squamous epithelium.
AB  - Transcriptionally active nucleolar organizer regions identified by silver
      staining (AgNOR) vary in number with cellular activity and/or malignant
      transformation and have been used as a diagnostic tool. A morphometric study of
      AgNORs was performed in an experimental model of irradiated squamous epithelium
      (Wistar rat sole skin) 4, 8, and 14 hours and 1, 2, 5, and 7 days post
      irradiation with 50 Gy of x-rays. A statistically significant and progressive
      rise in AgNOR average volume of up to 238% and reduction in AgNOR number/nucleus
      of up to 40% were detected as a function of post-irradiation time. A
      statistically significant 46% increase in AgNOR volume was detected as early as 8
      h post-irradiation, when no histological changes were observable in routine
      preparations. These results suggest that AgNORs may be useful as a quantitative
      marker of incipient changes in cellular activity and caution against the
      indiscriminate use of AgNORs in the follow-up of lesions which may have been
      exposed to radiotherapy. Furthermore, this study suggests the possibility of
      using AgNORs as a sensitive biological dosimeter in cases of uncontrolled
      exposure to radiation.

PMID- 8360369
TI  - Coping with oral surgery by self-efficacy enhancement and perceptions of control.
AB  - Recent work has suggested that patients' coping could be improved in stressful
      dental situations if perceptions of self-efficacy and control could be enhanced.
      To test this hypothesis, 70 first-time third-molar extraction patients were
      randomly assigned to one of four surgery preparation conditions: standard
      preparation, oral premedication, relaxation, and a relaxation+efficacy-enhancing
      feed-back condition in which subjects were given false galvanic skin response
      (GSR) biofeedback leading them to believe that they were highly skilled at
      relaxing. Analyses indicated that: (1) all treatments were seen as equally
      credible (controlling for placebo effects); (2) a priori contrasts showed that
      both the relaxation-only treatment and the relaxation+efficacy-enhancement
      treatment were superior to the premedication and standard preparations in raising
      coping self-efficacy; (3) regardless of treatment condition, increase in reported
      coping self-efficacy was significantly correlated with pre-operative anxiety,
      with self-reported peri-operative distress, and with behavioral ratings of peri
      operative distress; and (4) the relaxation treatments resulted in lower pre
      operative anxiety than the other interventions, and linear contrasts showed
      significant trends in which the relaxation+efficacy-enhancing condition was
      superior to the relaxation-only condition, which was in turn superior to the
      medication condition and the standard preparation in reducing both pre-operative
      anxiety and behavioral ratings of peri-operative distress. It was concluded that
      thoughts related to self-confidence and control can be manipulated, and that
      these thoughts can in part determine how well a person copes in stressful dental
      situations.

PMID- 8360370
TI  - Analysis of debond rates of resin-bonded prostheses.
AB  - Debonding rates of 164 resin-bonded prostheses (RBP) placed from 1974 to 1985
      were examined at recall. The yearly debond rates were calculated, the cumulative
      probability of failure was determined for the debonded RBPs, and Weibull
      distribution parameters were determined. For perforated prostheses, there was a
      high initial debond rate, followed by slowly decreasing rates for about 5 years.
      Increasing rates after 5 years indicated the beginning of wear-out. The Weibull
      parameters for the wear-out period of the perforated prostheses were:
      characteristic life = 128 (SE = 2) months, modulus = 1.27 (0.06), and threshold
      parameter = 0. Data were available for etched frameworks for 6 years and showed
      decreasing debond rates during this time. The characteristic life of the etched
      bridges was 318 (84) months. The cumulative failure data were also modeled with a
      cubic polynomial distribution that resulted in a U-shaped hazard function.

PMID- 8360371
TI  - Mechanical performance of a dental composite: probabilistic failure prediction.
AB  - In clinical situations, the mechanical performances of dental structures--for
      example, composite restorations--depend on many factors. Most of them have a
      probabilistic character. Because composites are brittle materials, their strength
      should also be considered as a probabilistic quantity. For successful prediction
      of mechanical failure of structures consisting of these materials, a
      probabilistic approach is indispensable, and a suitable definition of equivalent
      stress must be introduced. An equivalent stress facilitates the transfer of
      strength data of laboratory specimens to situations where the stress state is
      much more complicated. The tensile and compressive strengths of composites differ
      considerably. Of two equivalent stress definitions that potentially describe this
      experimental fact (the Drucker-Prager and the Modified von Mises equivalent
      stress), the predictive capacity was investigated for a microfine composite. In a
      probabilistic approach to failure, use of the Drucker-Prager equivalent stress
      appeared to be superior, because the average failure load of notched beams was
      predicted with an error smaller than 8%.

PMID- 8360372
TI  - Release of fluoride and other elements from light-cured glass ionomers in neutral
      and acidic conditions.
AB  - The purpose of this study was to measure the release of fluoride, sodium,
      silicon, calcium, strontium, and aluminum from light-cured glass ionomers. The
      materials tested were: (1) Baseline VLC thick mix; (2) Baseline VLC thin mix; (3)
      Fuji Lining LC; (4) Vitrebond; and (5) XR-Ionomer. A conventional glass ionomer,
      Ketac-FilAplicap, and a silver-reinforced glass ionomer, Ketac-Silver, were used
      as controls. Each test specimen was first stored for 16 days in de-ionized water,
      followed by a further 16 days in 0.01 mol/L lactic acid (pH 4.0); both solutions
      were replaced at predetermined intervals. After that, the specimens were immersed
      for up to 122 days in de-ionized water. During the immersion, light-cured glass
      ionomers showed considerable variation in the release of fluoride and other
      elements. In lactic acid, all cements eluted the matrix-forming cations, aluminum
      and calcium or strontium. This suggests that light-cured materials are as equally
      susceptible to erosion as are chemically cured glass ionomers. During the
      immersion, some of the light-cured materials showed a considerable weight gain.

PMID- 8360373
TI  - The balance between quality and quantity.

PMID- 8360374
TI  - Perceptions of dental fluorosis.
AB  - Mild dental fluorosis has long been accepted as a side-effect of water
      fluoridation and, more recently, has been recognized as a consequence of the use
      of other fluoride-based caries-preventive strategies. Traditionally, dental
      health professionals have not seen this as being of public health importance, but
      members of the public have not been asked their opinion. The purpose of the
      present study was to gather the opinions of lay groups concerning the appearance
      of the teeth of children with various degrees of fluorosis. Twenty-eight
      children, born in 1978, who had earlier participated in a study of fluorosis in
      Perth (Western Australia), allowed 110 observers to look at their upper central
      incisors under good viewing conditions. Fluorosis in these teeth ranged from TF
      score 0 (no fluorosis) to TF score 3. The observers were university students,
      parents, public servants, or dentists. They responded to statement items about
      the appearance of the teeth. The results, based on just over 3000 responses,
      showed that lay and dental observers could distinguish between different
      fluorosis levels. In response to a statement that the teeth appeared pleasing, a
      large majority agreed when the TF score was 0, but agreement declined as the TF
      score increased; when the TF score was 3, most people disagreed. Similarly,
      observers felt that the appearance would increasingly embarrass the child as the
      TF score increased. Observers, except the dentists, tended to feel that higher TF
      scores indicated neglect on the part of the child.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8360375
TI  - Operatory ventilation and scavenger evacuation rate influence on ambient nitrous
      oxide levels.
AB  - Investigations have shown that greater than Federally-recommended levels of
      ambient nitrous oxide often exist in the dental workplace. The purposes of this
      investigation were to examine the influences of (1) operatory ventilation rate
      and (2) scavenger evacuation rate on ambient nitrous oxide concentrations within
      a closed dental operatory. This laboratory investigation utilized a scavenging
      nasal mask assembly (Porter/Brown) to deliver 40% nitrous oxide in oxygen, at a
      total flow rate of 5 L/min, to a mannequin positioned supinely in a dental chair.
      Eight experimental groups were assigned based on combinations of operatory air
      exchange rates (0, 5, 10, or 15 room air changes per hour) and scavenger
      evacuation rates (18.8 L/min and 21.4 L/min). Ambient nitrous oxide levels were
      monitored at four locations (0, 15.3, 30.7, and 61.4 cm) from the nasal mask by
      means of an infrared spectrophotometer (Miran 1B). The operatory air exchange
      rate was measured with a flow hood (Short Ridge) and manipulated to one of the
      desired ventilation rates. Time-weighted average (TWA) concentrations of ambient
      nitrous oxide (ppm) were continuously recorded at 15-second intervals with a
      microprocessor (DL332F Datalogger) connected directly to a microcomputer. The
      results demonstrated that significantly reduced (p < 0.05) ambient nitrous oxide
      levels were achieved with increasing room air exchange rates and the high
      scavenger evacuation rate. It was concluded that operatory ventilation and
      scavenger evacuation rates were significant control measures available for
      reduction of ambient nitrous oxide to Federally recommended levels.

PMID- 8360376
TI  - Influence of carbonate on sintering of apatites.
AB  - Sintering of carbonate apatite, prepared at 100 degrees C and pH 9.0 for 3 days,
      was studied by thermal analysis, x-ray diffraction, and infrared spectroscopy.
      The sintering temperature, at which the linear thermal shrinkage of isostatically
      compacted specimens increased sharply, decreased in proportion to the amount of
      carbonate initially present in the apatite. For example, specimens with over 8
      wt% carbonate could be sintered at a temperature (650 degrees C) which was nearly
      400 degrees C lower than that needed for sintering a specimen with no carbonate.
      Amounts of carbonate lost at the end of sintering, estimated chemically and by
      infra-red spectroscopy, were approximately equal to sample weight losses
      estimated thermogravimetrically.

PMID- 8360377
TI  - Crystallographic morphology of heterogeneous fluoridated carbonate apatites.
AB  - Carbonate-containing fluoridated apatites were synthesized with two different
      modes of fluoride incorporation: by supplying F-free solution initially, followed
      by a F-containing solution; and with the order of supply of these solutions
      reversed. Both of these heterogeneously synthesized fluoridated CO3 apatites
      showed typical apatitic x-ray diffraction patterns; and both had similar total
      fluoride contents (0.87 +/- 0.07 and 0.94 +/- 0.03 mmol/g, respectively), i.e.,
      half of the maximum fluoride content of fluorapatite. However, they differed
      considerably in their crystallographic properties. The 300 reflection peaks of
      both apatites were split, and their patterns were slightly different. In the
      former, SEM observation revealed capsule-like crystals with a rounded hexagonal
      shape. However, the latter had many small crystals, similar to those of
      homogeneous CO3 apatite, adhering to the larger hexagonal crystals, which were
      also similar to homogeneous fluorCO3 apatite. Wavelength-dispersive spectroscopy
      attached to the SEM showed a higher fluoride intensity in the former spectrum
      than the latter. These results suggest that two different types of heterogeneous
      fluoridated CO3 apatites were formed, CO3 apatite covered with fluorCO3 apatite,
      and fluorCO3 apatite covered with CO3 apatite. The simple two-step supply system
      used in this study is helpful for the study of complicated heterogeneous
      formation of apatites.

PMID- 8360378
TI  - Analysis of the "shear" bond strength of pretreated aged composites used in some
      indirect bonding techniques.
AB  - Investigations of the repair of composites have shown that bond strengths can be
      significantly reduced at an interface involving an aged composite. Brackets
      placed by some indirect bonding techniques also have an interface involving an
      aged composite. This study investigated some of the properties of sealant
      composite interfaces and parameters affecting these properties independent of
      other regions and interfaces found in the total enamel-sealant-composite-bracket
      system using a shear bond-strength test and fractographic analysis. The effects
      of various pretreatments of 7-day-old composite surfaces on the bond strength and
      contact angle of a mixed sealant on these pretreated surfaces were determined.
      Fractured specimens with adhesive failure closest to the point of force
      application had low bond strengths (17.62 MPa), which could be correlated with
      surface pretreatment. Preliminary tests showed that acetone pretreatment produced
      the most consistently strong interfaces with the fewest adhesive failures of this
      type. Specimens with adhesive failure only in other regions had higher bond
      strengths (23.41 MPa), which showed no dependence on pretreatment. There was no
      statistical relationship between contact angle and bond strength. The data
      coupled with fracture path analysis suggest that: first, the critical region for
      fracture analysis is that part of the adhesive interface which is closest to the
      point of force application; second, failure during some dental shear bond
      strength tests probably occurs as a consequence of tensile stress induced by a
      bending moment rather than by shear stress; and third, specifying bond strength
      as breaking load/area may be incorrect.

PMID- 8360379
TI  - Acute toxicological effects of ingested tooth whiteners in female rats.
AB  - Tooth whiteners are considered as cosmetic agents to be used for bleaching teeth.
      Since tooth whitener may be swallowed during the whitening procedure, studies
      were conducted to determine whether ingestion of tooth whitener containing
      carbamide peroxide resulted in toxic effects. Adult female rats were used, and
      vaginal smears were examined daily to determine whether the animals were
      ovulating. Following an overnight fast, a single bolus of a commercial tooth
      whitener (5 g of tooth whitener/kg fasting body weight) was administered by
      gavage. Control rats received de-ionized water. After 2 h, mean respirations per
      min of animals receiving the tooth whitener Quik Start (contains 35% carbamide
      peroxide) decreased from 169 to 55, and body temperature decreased from 38.4 to
      34 degrees C. Other distress signs included: labored breathing, loss of righting
      reflex, partial eye closure, bloody urine, and incontinence. Three of 22 animals
      (3/22) died within 48 h, of gastric hemorrhaging. Eight/10 rats stopped
      ovulating. At necropsy 2 weeks post-dosing, 10/19 animals had grossly bloated
      stomachs, and mucosal necrosis was observed histologically in 3. Animals
      receiving White & Brite or Nu-Smile (containing 10 or 15% carbamide peroxide,
      respectively) exhibited similar but milder symptoms. The data indicate that
      ingestion of large doses of commercial preparations of tooth whiteners may be
      acutely toxic, sometimes fatal, to female laboratory rats.

PMID- 8360380
TI  - The effect of fluoride application on fluoride release and the antibacterial
      action of glass ionomers.
AB  - The aim of this study was to investigate whether the release of fluoride and the
      antimicrobial effect of freshly mixed glass ionomers could be prolonged by
      application of fluoride on aged material. Test slabs of freshly mixed and aged
      (14 d in water) conventional and silver glass ionomer (Ketac-Fil and Ketac
      Silver, Espe, Seefeld, Germany) and composite (Silux Plus, 3M, St. Paul, MN) were
      fitted into the bottom of a test tube. A layer of S. mutans Ingbritt cells was
      centrifuged onto the test slabs, and the samples were incubated for 20 h in 1.7%
      sucrose solution. After the incubation, pH, F, and Ca contents of the fluid
      phase, and F, Mg, P, and K contents of the cells were determined. The aged glass
      ionomer samples were then covered with toothpaste (0.1% F) or with fluoride gel
      (1.25% F), and the composite samples with fluoride gel. After being thoroughly
      rinsed, S. mutans cells were incubated on the samples as above. The pH fall was
      significantly inhibited by freshly mixed glass ionomers, and there were changes
      in cellular cation and phosphorus contents. Large amounts of fluoride were found
      in the fluid and cells. For old glass ionomers, no inhibitory effect on pH fall
      could be seen. Fluoride release had decreased to a low level.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8360381
TI  - The effect of the electrode potential on the release of mercury from dental
      amalgam.
AB  - The effect of the electrode potential on the rate of mercury dissolution from the
      matrix phase (gamma 1) of dental amalgam was investigated. Specimens of the Ag-Hg
      phase, with and without dissolved tin, were exposed to synthetic saliva and
      maintained at various potentials by means of a potentiostat. The amount of
      dissolved mercury was determined after 24 h by cold-vapor Atomic Absorption
      Spectrophotometry. Anodic polarization curves for the gamma 1 specimens and pure
      silver and mercury were also recorded. The results for the Ag-Hg phase showed a
      potential-independent dissolution rate between -0.6 and -0.1 V (SCE), followed by
      a sharp increase. Mercury dissolution from the Ag-Hg-Sn phase was much slower
      than from the tin-free gamma 1 phase, and potential-independent to +0.05 V (SCE);
      a sharp increase in mercury dissolution was observed at +0.1 V (SCE). The anodic
      polarization curves for the Ag-Hg-Sn phase indicated passivity between -0.67 V
      and +0.1 V (SCE), but no clear passivation for the Ag-Hg specimen, silver, or
      mercury. The results show that in the potential-independent region, mercury
      dissolved in the atomic form from both the tin-free and tin-containing gamma 1
      phase. The increase in dissolution in the upper range of potentials was
      tentatively attributed to selective anodic dissolution of silver and an onset of
      electrochemical dissolution. The results indicate that the rate of mercury
      release from the gamma 1 phase of dental amalgam was not affected by potential
      changes due to alloying or galvanic contacts unless the potential exceeded some
      critical value.

PMID- 8360382
TI  - The level of mercury in human dental plaque and interaction in vitro between
      biofilms of Streptococcus mutans and dental amalgam.
AB  - Mercury levels (micrograms/mg dry weight) in dental plaque from amalgam and
      enamel surfaces in human subjects with amalgam restorations were (range, mean,
      SD) 0.5-1.31, 0.72, 0.34 and 0.01-0.54, 0.2, 0.19, respectively. The levels of
      mercury in plaque from amalgam surfaces were significantly higher than those from
      plaque on enamel (p < 0.001). No mercury was detected in plaque from subjects
      without amalgam restorations. The mean level of mercury in a 24-hour collection
      of plaque was 2 micrograms (median, 1.8 micrograms), an amount close to those
      calculated by other workers (1.2-1.7 micrograms) for the amount of mercury
      liberated in the mouth from amalgam restorations in 24 h. Freshly prepared
      amalgam liberated relatively large amounts of mercury into culture broth in the
      first 24 h of exposure; subsequently, the levels declined except in the presence
      of Streptococcus mutans. In vitro, biofilms of Streptococcus mutans facilitated
      the release of mercury from freshly prepared amalgam, in what appeared to be a
      cyclical fashion. Amalgam aged for two years did not release mercury, even when
      supporting the growth of an S. mutans biofilm. The resistance of aged amalgam was
      attributed to the presence of a passive tarnish layer. The mercury released by
      the biofilm had an effect on the composition of the biofilm. The biofilms on
      fresh amalgam had significantly lower levels of carbohydrate (p < 0.001-p < 0.01)
      and protein (p < 0.001-p < 0.02) than did biofilms on aged amalgam and on control
      stainless steel wires.

PMID- 8360383
TI  - A quantitative enzyme histochemical analysis of the distribution of alkaline
      phosphatase activity in the periodontal ligament of the rat incisor.
AB  - The spatial distribution of alkaline phosphatase (ALP) activity was examined in
      the periodontal ligament of the continuously growing rat incisor. With the
      indoxyl-tetrazolium salt method, enzyme activity was demonstrated in
      undecalcified cryosections, and the amount of reaction product was quantified.
      ALP activity appeared to be distributed heterogeneously. Its highest activity was
      found in the bone-related compartment of the ligament. In the tooth-related
      compartment and the supracrestal extension of the ligament, enzyme activity was
      significantly lower, but still higher than in the lamina propria of the gingiva.
      In the part of the ligament bordering the cementum, highest activity was found in
      the apical region just occlusal to Hertwig's epithelial root sheath, where
      formation of acellular cementum begins. From there toward the incisal edge, the
      activity of the enzyme gradually decreased. It is suggested that differences
      among the various parts of the periodontal ligament are related to local
      variations in phosphate metabolism and cementum deposition.

PMID- 8360384
TI  - Effect of centrifugal force on growth of mouse osteoblastic MC3T3-E1 cells in
      vitro.
AB  - The effect of biomechanical force on growth of skeletal tissue was studied in
      monolayer cultures of mouse osteoblastic MC3T3-E1 cells which were centrifuged at
      320 g for 15 min to 72 h in a CO2 incubator. Centrifugation of the cells for 30
      min in low concentrations (0.3 or 1%) of fetal bovine serum (FBS) caused a two
      fold increase of [3H]thymidine incorporation at 20 h from the start of
      centrifugation. However, centrifugation under 10% FBS caused no increase in
      [3H]thymidine incorporation into DNA. Under 0.3% FBS, [3H]thymidine incorporation
      increased in a manner dependent on the period of centrifugation and reached a
      maximum when the cells were centrifuged for 3 h. Stimulation of DNA synthesis by
      centrifugation was abolished in the presence of H-7, an inhibitor of protein
      kinase C. Moreover, conditioned medium collected from the centrifuged cultures
      increased [3H]thymidine incorporation by two-fold over the basal when added to a
      quiescent culture of MC3T3-E1 cells. These results suggest that centrifugal force
      stimulates growth of osteoblastic cells through autocrine secretion of some
      diffusible growth-promoting activity. On the other hand, centrifugation of the
      cells inhibited induction by FBS of alkaline phosphatase activity and calcium
      uptake, two indices of the differentiated phenotype of osteoblasts.

PMID- 8360385
TI  - Increased condylar growth after experimental relocation of the glenoid fossa.
AB  - Attempts to increase mandibular growth by the stimulation of condylar
      proliferative activity, either experimentally or with functional appliances in
      humans, have led to controversial results. The aim of this study was to measure
      changes in proliferative activity in the mandibular condyle after steady
      experimental posterior relocation of the glenoid fossa in the rabbit without
      actively interfering with normal masticatory action. The method differed from
      most previous experimental procedures, which force the mandible anteriorly to
      stimulate functional appliance therapy. Twelve 5-day-old rabbits underwent gluing
      of the interparietal, temporoparietal, and lambdoidal sutures. Three experimental
      and three control rabbits were injected with tritiated thymidine at 10, 15, 20,
      and 30 days and were killed after 2 h for histological and autoradiographic
      examination. The total number of labeled cells in the prechondroblastic layer was
      higher in the experimental group, the difference being greatest in the 20-day-old
      rabbits. The highest proliferative activity in the experimental group was found
      in the area immediately posterior to the articular contact surface. There was a
      tendency for the cartilage layers to be thicker in the experimental group,
      especially in the extreme anterior segments of the condyle.

PMID- 8360386
TI  - Steroid-resistant asthma.
AB  - The treatment of patients with asthma that is resistant to corticosteroids
      represents a therapeutic challenge, because corticosteroids are the most potent
      and potentially effective medications for severe asthma. Recent investigations
      have identified several functional defects in mononuclear cells and T lymphocytes
      isolated from patients with corticosteroid-resistant asthma, including
      abnormalities in proliferation, activation, and cytokine production. The
      development of medications with immunomodulatory effects on specific cellular
      functions represents an exciting step for more efficacious treatment for such
      patients.

PMID- 8360387
TI  - Bioequivalence of metered-dose inhaled medications.

PMID- 8360388
TI  - A prospective assessment of the remote practice of allergy: comparison of the
      diagnosis of allergic disease and the recommendations for allergen immunotherapy
      by board-certified allergists and a laboratory performing in vitro assays.

PMID- 8360389
TI  - The low prevalence of occupational asthma and antibody-dependent sensitization to
      diphenylmethane diisocyanate in a plant engineered for minimal exposure to
      diisocyanates.
AB  - BACKGROUND: Diisocyanate chemicals are leading causes of occupational asthma
      (OA). METHODS: We conducted a cross-sectional study of 243 workers exposed to
      diphenylmethane diisocyanate (MDI) in a urethane mold plant that had been
      designed to minimize MDI exposure (levels were maintained below 0.005 ppm and
      were continuously monitored). All participants were screened by questionnaire and
      tests for serum antibodies to MDI-human serum albumin (HSA). On the basis of
      questionnaire responses, diagnoses were derived that included OA; non-OA; work
      related and non-work-related rhinitis; and lower respiratory irritant responses.
      Serial peak expiratory flow rate studies were performed for 2 weeks in 43 workers
      with and in 23 workers without lower respiratory symptoms. RESULTS: Results of
      serial peak expiratory flow rate studies were abnormal in 3 (33%) of 9 workers
      with OA, in 2 (50%) of 4 with non-OA, and in 2 (9%) of 23 case control subjects.
      A significant association was found between peak flow rate variability and a
      questionnaire asthma diagnosis (chi 2 p < 0.002). Physicians confirmed three
      cases of OA, one of which occurred in a control worker who was free of symptoms.
      In all three cases asthma symptoms remitted after the worker left the workplace.
      Serum specific IgE and IgG levels were elevated in 2 of 243 workers, one of whom
      was prick test positive to MDI-HSA and had had cutaneous anaphylaxis after MDI
      exposure. CONCLUSIONS: On the basis of these cases, specific work activities
      associated with exposure to MDI were identified and corrective measures were
      instituted. Strict control and monitoring of ambient MDI exposure was associated
      with a low prevalence of specific sensitization to MDI and a lower than expected
      prevalence of OA.

PMID- 8360390
TI  - Relationships among numbers of bronchoalveolar lavage cells expressing messenger
      ribonucleic acid for cytokines, asthma symptoms, and airway methacholine
      responsiveness in atopic asthma.
AB  - BACKGROUND: We recently demonstrated that T lymphocytes in bronchoalveolar lavage
      (BAL) fluid from atopic asthmatic patients were activated and expressed increased
      cytokine messenger ribonucleic acid (mRNA) for "TH2-type" cytokines, particularly
      IL-4 and IL-5, when compared with those in normal control subjects. This pattern
      of cytokines may determine the nature of the cellular infiltrate in the bronchial
      mucosa in asthma and hence the bronchial hyperresponsive (BHR) and symptoms that
      characterize this condition. METHODS: To examine the association between these
      cytokines and clinical measures of asthma severity we have extended our studies
      of BAL cells from subjects with atopic asthma. Numbers of BAL cells with positive
      in situ hybridization signals for IL-2, IL-3, IL-4, IL-5, granulocyte macrophage
      colony-stimulating factor (GM-CSF), and interferon-gamma were counted on
      cytocentrifuge preparations. Results were compared between patients with
      symptomatic (n = 19) and asymptomatic asthma (n = 10), and associations were
      sought with airway methacholine responsiveness, resting airway caliber, and
      asthma symptom scores. RESULTS: There were increased proportions of cells
      positive for IL-3 (p < 0.05), IL-4 (p < 0.005), IL-5 (p < 0.005), and GM-CSF (p <
      0.005) mRNA in BAL fluid from patients with symptomatic asthma when compared with
      that from subjects free of symptoms, but no difference between the groups in
      numbers of cells expressing IL-2 and interferon-gamma mRNA. There were
      significant associations among numbers of cells expressing mRNA for IL-4, IL-5,
      and GM-CSF, and airflow restriction, BHR, and Aas asthma score. CONCLUSIONS:
      These findings support the hypothesis that cytokines contribute to airway events
      that determine asthma symptoms and BHR.

PMID- 8360391
TI  - Effect of anthelmintic treatment on the allergic reactivity of children in a
      tropical slum.
AB  - It is well known that helminthic infection can cause a polyclonal stimulation of
      the synthesis of IgE, which is dependent on interleukin-4 (IL-4) production, and
      it has been suggested that this can modulate the expression of allergic
      reactivity in tropical populations. We evaluated the effect of regular
      anthelmintic treatment, for a period of 22 months, on certain aspects of the
      allergic reactivity of children in a slum area of Caracas, Venezuela, where
      helminths are endemic. The treatment (Oxantel-Pyrantel; Quantrel) effectively
      eliminated intestinal helminthic infection and resulted in a significant decrease
      in the initially elevated total serum IgE levels. IL-4 was detectable in the
      serum, and a significant reduction in IL-4 was also observed after treatment. In
      contrast, both the immediate-hypersensitivity skin-test reactivity and serum
      levels of specific IgE antibody against environmental allergens were markedly
      increased in the treated children. In a group of children who were also evaluated
      in the same slum, but who declined treatment, a substantial increase in
      helminthic infection occurred, which was related to an acute deterioration of the
      socioeconomic conditions of Venezuela over the course of our study period. This
      was paralleled by a considerable increase in total IgE levels in these children
      and a decrease in the skin-test reactivities and specific IgE levels. The
      application of Prausnitz-Kustner passive transfer tests and analysis of specific
      IgE antibody levels indicated that the polyclonal stimulation of IgE synthesis by
      helminthic parasites results in mast cell Fc epsilon receptor saturation and
      suppression of specific IgE antibody synthesis. This inhibition of allergic
      reactivity is reversible by anthelmintic treatment.

PMID- 8360392
TI  - Bronchial epithelial cells of patients with asthma release chemoattractant
      factors for T lymphocytes.
AB  - BACKGROUND: T lymphocytes may orchestrate the inflammatory response in atopic
      asthma, but the mechanisms that promote T-cell accumulation in asthmatic airways
      are still unclear. In this study, we tested the hypothesis that bronchial
      epithelial cells of patients with atopic asthma release chemoattractant factors
      for T lymphocytes. METHODS: Sixteen patients with atopic asthma and eight healthy
      control subjects were selected for this study. Bronchial epithelial cells were
      isolated from biopsy specimens obtained by means of bronchoscopy and cultured for
      48 hours in serum- and hormone-free medium, with or without 10(-6) mol/L
      histamine. RESULTS: Only the supernatants of cells from donors with asthma showed
      chemotactic activity for T lymphocytes, and this was significantly increased (p <
      0.025) by exposure to histamine. Chemotactic activity was in part mediated by
      interleukin-8 (IL-8), because an antibody against human IL-8 significantly
      reduced it (p < 0.05) and the cell supernatants contained appreciable amounts of
      immunoreactive IL-8 (0.89 +/- 0.39 ng/ml). Both the residual chemotactic activity
      of unstimulated epithelial cells and the increased activity caused by histamine
      were mediated by a single protease-sensitive substance with an apparent molecular
      weight of 56,000 d and an estimated isoelectric point of 8.8 to 9.1. The
      partially purified chemoattractant specifically enhanced the migration of CD4+ T
      lymphocytes, and its activity was inhibited by the univalent Fab fragment of a
      monoclonal antibody against CD4. CONCLUSION: These results extend our previous
      observations, indicating an important effector role of bronchial epithelium in
      asthma.

PMID- 8360393
TI  - Airway allergy to trimellitic anhydride in guinea pigs: different time courses of
      IgG1 titer and airway responses to allergen challenge.
AB  - BACKGROUND: Trimellitic anhydride (TMA) is a low molecular weight chemical that
      may cause occupational asthma in human beings. The objectives of this study were
      to determine the time course of immune and airway responses to TMA in guinea pigs
      and to relate the immunologic response to the immediate responses in lung
      resistance (RL) and plasma exudation induced by allergen challenge. METHODS: We
      studied the effects of time course after sensitization on airway response to TMA
      in guinea pigs actively sensitized to free TMA, given by intradermal injection
      (0.1 ml of 0.3% TMA in corn oil). During weeks 1, 2, 3, 5, and 8 after
      sensitization, anesthetized animals were challenged with TMA conjugated to guinea
      pig serum albumin (TMA-GPSA), instilled via the airway route. Nonsensitized
      animals were challenged with the same amount of conjugate 4 weeks after
      intradermal injection of corn oil only. In the same animal, we measured both RL
      to monitor airflow obstruction and extravasation of Evans blue dye (20 mg/kg) to
      quantify airway plasma exudation. RESULTS: Instillation of TMA-GPSA (0.5%; 50
      microliters) into the tracheal lumen caused a significant increase in RL,
      reaching a maximum at 2.5 minutes after the instillation in the 1-week group (9.0
      +/- 5.9 cm H2O/ml/sec) and between 5 and 6 minutes in the 2-, 3-, 5-, and 8-week
      groups (9.4 +/- 4.8, 12.7 +/- 5.5, 3.7 +/- 1.1, and 1.7 +/- 0.2 cm H2O/ml/sec,
      respectively). The maximal increase in RL after the challenge in nonsensitized
      animals was 0.39 +/- 0.05 cm H2O/ml/sec. TMA-GPSA also produced significant
      extravasation of Evans blue dye at all airway levels in the sensitized groups,
      and the amount of dye in the peripheral airways was significantly greater than
      that in the trachea. Furthermore, the level of Evans blue dye in airway tissue
      increased with the time after sensitization, up to the latest time point tested
      (8 weeks). Specific IgG1 antibodies to TMA-GPSA demonstrated by ELISA were
      detected in all animals in the 3-, 5-, and 8-week groups, with maximal levels 5
      weeks after sensitization. Specific IgG1 titers to TMA-GPSA significantly
      correlated with the level of Evans blue dye induced by challenge with TMA-GPSA
      but not with the increase in RL. CONCLUSIONS: Intradermal sensitization to free
      TMA induces specific airway allergy for a long period after sensitization.
      Specific IgG1 antibodies to allergen may influence allergen-induced plasma
      exudation rather than the airflow obstruction in this animal model of TMA-induced
      asthma.

PMID- 8360395
TI  - Pulmonary eosinophils express HLA-DR in chronic eosinophilic pneumonia.
AB  - BACKGROUND: Chronic eosinophilic pneumonia is a rare idiopathic disorder. role
      the eosinophil plays in the pathogenesis of this disease is unknown. The recent
      finding that nature eosinophils can express the class II major histocompatibility
      complex molecule HLA-DR suggests an immunologic role, perhaps through antigen
      presentation. The purpose of this research was to determine whether lung-derived
      eosinophils exhibit in vivo expression of HLA-DR. METHODS: Eosinophils were
      obtained simultaneously from bronchoalveolar lavage and peripheral blood from a
      59-year-old woman with asthma and chronic eosinophilic pneumonia. Eosinophil
      enriched aliquots of peripheral blood were cocultured with human lung fibroblasts
      (with or without additional granulocyte-macrophage colony-stimulating factor).
      The percentage of cells expressing HLA-DR was quantitated by flow cytometric
      analysis. RESULTS: Eosinophils derived from bronchoalveolar lavage displayed in
      vivo expression of HLA-DR (86%) in contrast to those from peripheral blood (7%),
      suggesting compartmentalization of eosinophil activation within the lung.
      Peripheral blood eosinophils retained the capacity for HLA-DR expression when
      coincubated with lung fibroblasts (83%) with augmentation by granulocyte
      macrophage colony-stimulating factor (93%). CONCLUSION: These data demonstrate
      that lung eosinophil HLA-DR expression occurs in vivo; it may contribute to the
      pathogenesis of inflammatory lung injury.

PMID- 8360394
TI  - A magnetic resonance imaging evaluation of histamine-mediated allergic response
      in the guinea pig nasopharynx.
AB  - BACKGROUND: Magnetic resonance imaging (MRI) is a powerful technique for
      visualizing tissues with a high water content. In this study we used MRI to
      evaluate the effect of antigen and mediators of allergic responses on the
      nasopharyngeal airway of guinea pigs. METHODS AND RESULTS: Longitudinal
      relaxation time-weighted transverse images of the nasopharyngeal airway revealed
      a clearly defined airway lumen and mucosa. Topical administration of ovalbumin
      (0.00006% to 0.06%) to the nasopharyngeal airway of sensitized guinea pigs caused
      a concentration-dependent reduction (34% +/- 1%, maximum) in airway luminal
      volume and a corresponding increase (28% +/- 3%, maximum) in the volume of the
      airway mucosa. These effects were duplicated by histamine (10(-5) to 10(-3)
      mol/L), but not by methacholine (10(-3) mol/L). The antigen-induced changes in
      airway and mucosal volumes were dose-dependently inhibited by the H1-antagonist
      loratadine (0.3 to 3 mg/kg, administered orally). On the other hand, topical
      administration of a decongestant drug, oxymetazoline (250 micrograms per guinea
      pig), had no effect on the response to antigen. CONCLUSIONS: These results
      indicate that MRI is a useful technique to measure allergic responses in the
      airways and identify that histamine is an important mediator of the obstruction
      that occurs in the nasopharyngeal airway of guinea pigs after antigen challenge.

PMID- 8360396
TI  - Effect of a topical corticosteroid on airway hyperresponsiveness and eosinophilic
      inflammation induced by trimellitic anhydride exposure in sensitized guinea pigs.
AB  - BACKGROUND: Topical corticosteroids are effective in the treatment of asthma by
      improving bronchial hyperresponsiveness and reducing airway inflammation.
      METHODS: We assessed the effect of a nebulized corticosteroid, budesonide, on
      airway hyperresponsiveness and inflammatory response provoked by inhalation of
      trimellitic anhydride (TMA) dust, a known cause of occupational asthma in human
      beings, in guinea pigs sensitized to the free hapten. Male Dunkin-Hartley guinea
      pigs (n = 24) were injected intradermally with 0.1 ml of 0.3% TMA in corn oil,
      followed by exposure 21 to 28 days later to five consecutive doses of budesonide
      aerosol (0.5 mg/ml) or saline solution, administered for 10 minutes every 12
      hours. They were then exposed (noses only) to TMA dust (8 mg/m3) or air for 1
      hour (four groups, n = 6 in each). Airway responsiveness to acetylcholine,
      defined as the concentration needed to cause a 200% increase in lung resistance
      (PC200), was measured 8 hours later. RESULTS: In saline-treated guinea pigs
      exposed to TMA, mean PC200 was 0.094 mmol/L (geometric SEM, 1.4 mmol/L) compared
      with 0.31 mmol/L (geometric SEM, 1.3 mmol/L, p < 0.05) in those guinea pigs
      pretreated with budesonide. In sham-exposed sensitized guinea pigs, PC200 was
      0.35 mmol/L (geometric SEM, 1.2 mmol/L), which was not significantly different
      from the budesonide-treated group (0.36 mmol/L; geometric SEM, 1.3 mmol/L). There
      was a significant increase in the number of eosinophils in the subepithelium of
      guinea pigs further exposed to TMA dust (71.5 +/- 6.8 cells/unit area [mean +/-
      SEM]) compared with those exposed to air (22.7 +/- 6.7, p < 0.01). Budesonide did
      not inhibit the number of subepithelial eosinophils of guinea pigs exposed to TMA
      dust (54.0 +/- 3.7 cells/unit area) or in those exposed to air (24.3 +/- 6.7
      cells/unit area) and did not affect the increase in eosinophils found in
      bronchoalveolar fluid. CONCLUSIONS: Budesonide significantly inhibited the
      increase in airway responsiveness but not the eosinophilic inflammation induced
      by exposure to TMA dust in sensitized guinea pigs.

PMID- 8360397
TI  - Estimation of nasal epithelial lining fluid using urea as a marker.
AB  - BACKGROUND: The luminal surface of respiratory mucous membranes is lined with an
      epithelial lining fluid (ELF) layer. Previous attempts to determine ELF volumes
      in airways have used dyes or freely diffusible molecules such as urea, yet have
      not led to a universally accepted method. The nasal mucous membrane provides an
      accessible area to examine whether urea is an appropriate marker of respiratory
      ELF volume. METHODS AND RESULTS: Collection of undiluted nasal secretions after
      either glandular stimulation or induction of vascular permeability confirmed that
      plasma urea and nasal urea concentrations are equivalent. Baseline ELF volume was
      calculated as 800 microliters/nostril. The calculated molar concentrations of
      urea in ELF did not vary with either methacholine or histamine challenge.
      CONCLUSIONS: These data indicate the plasma, interstitial, glandular, and ELF
      urea concentrations are equivalent and, therefore, that urea is a useful marker
      of ELF volume in the nasal mucosa.

PMID- 8360398
TI  - Immunologic studies of the mechanisms of occupational asthma caused by western
      red cedar.
AB  - BACKGROUND: Occupational asthma caused by western red cedar (Thuja plicata) is a
      common problem in sawmill industries. The objective of this study was to examine
      the cellular and immunologic mechanisms of western red cedar asthma (WRCA) more
      closely. METHODS: Bronchial biopsy specimens, bronchoalveolar lavage (BAL) mast
      cells and peripheral blood basophils from patients with WRCA, patients with
      atopic asthma, and nonatopic control subjects were challenged in vitro with
      plicatic acid (PA), PA-human serum albumin conjugate (PA-HSA), grass pollen, or
      calcium ionophore. RESULTS: PA (100 micrograms/ml) released histamine from the
      basophils of 9 of 11 patients with WRCA, 1 of 7 patients with atopic asthma, and
      2 of 7 normal subjects. PA triggered histamine release from 10 of 11 bronchial
      biopsy specimens and 8 of 8 BAL samples from patients with WRCA. Interestingly,
      PA released histamine from BAL cells and bronchial biopsy specimens from 3 of 7
      normal subjects but in none of the patients with atopic asthma. PA-HSA-induced
      histamine release from basophils and biopsy specimens was confined to patients
      with WRCA. PA-specific IgE was not detectable in serum from most patients with
      WRCA, and their serum did not transfer PA sensitivity to human lung fragments or
      lactate-stripped basophils. After pretreatment with anti-IgE in the absence of
      calcium, basophils from 14 subjects with WRCA still responded to PA (mean 64% to
      67% of pretreatment response), whereas responses to grass pollen or anti-IgE were
      abolished. CONCLUSIONS: This study confirms that PA releases histamine from
      bronchial mast cells of most patients with WRCA but not from those of patients
      with atopic asthma. The PA response of some normal subjects suggests that PA may
      have both specific and nonspecific actions on mast cells and basophils, whereas
      the serologic studies indicate histamine release in WRCA cannot simply be
      attributed to PA-specific IgE.

PMID- 8360399
TI  - Duration and magnitude of action of 50 and 100 micrograms of inhaled salmeterol
      in protecting against bronchoconstriction induced by hyperventilation of dry cold
      air in subjects with asthma.

PMID- 8360400
TI  - Papain-induced allergic rhinoconjunctivitis in a cosmetologist.

PMID- 8360401
TI  - Eosinophilia in early-stage human immunodeficiency virus infection.

PMID- 8360402
TI  - Correction regarding an adverse reaction to the recombinant hepatitis B vaccine.

PMID- 8360403
TI  - Putting osteoporosis in perspective.
AB  - Osteoporosis is characterized by a reduction in bone mineral density (BMD).
      Dietary patterns that encourage adequate calcium intake are essential to maximal
      development and later maintenance of bone mass. The majority of white women are
      at risk for osteoporosis-related fractures, especially in the wrist, spine, and
      hip. The degree of fracture risk at a specific bone site is best assessed by
      measuring BMD with single- or x-ray-photon absorptiometry. BMD in adults of any
      age is quite variable. Numerous diet and lifestyle factors influence BMD and, in
      turn, fracture risk. Sufficient evidence exists for a relationship between BMD
      and diet, particularly calcium and vitamin D; amenorrhea; body weight;
      alcoholism; smoking; and physical inactivity. Less convincing evidence exists for
      a relationship with dietary protein, dietary phosphorus, and caffeine intake. To
      minimize fracture risk, young women should have regular menses, consume a
      nutritionally adequate diet (according to the principles of the Food Guide
      Pyramid), perform regular physical activity, only consume a moderate intake of
      alcohol (if any), and not smoke. Postmenopausal women should follow those same
      guidelines and should seriously consider estrogen replacement therapy. Elderly
      persons especially should ensure adequate calcium and vitamin D nutriture.
      Currently, osteoporosis is the rule, rather than the exception, in old age for
      many white women. Dietitians can help reduce the prevalence of this disorder.

PMID- 8360404
TI  - The role of weight management in the health of women.
AB  - Weight management plays a central role in preventing many diseases that affect
      women. Lifelong hormonal, psychological, and environmental influences on women
      elicit a set of behavioral and biological responses distinctive from men that
      place them at increased risk for overall weight concerns, weight gain, and
      obesity. Limitations of current treatment call for increased research to improve
      our understanding and guide efforts in this important aspect of women's health.
      Research needs to be conducted to define realistic and obtainable weight goals
      and to design educational strategies to promote health and self-esteem. Research
      in the field of weight management should be directed to understanding gender
      differences, etiologies, and effective treatments.

PMID- 8360405
TI  - Women's health care: changing concepts.

PMID- 8360406
TI  - Identifying predictive variables for long-term weight change after participation
      in a weight loss program.
AB  - OBJECTIVE AND DESIGN: To determine if there was an association between weight
      change and 31 independent variables among obese persons 2 years after a weight
      loss program. Data were obtained from subjects' records and from questionnaires
      administered at enrollment and after a 2-year follow-up. SETTING: The 8-week
      weight control program was taught by registered dietitians and developed by the
      staff at the Sid Richardson Institute for Preventive Medicine, Houston, Tex.
      SUBJECTS/SAMPLES: Of the 1,460 subjects who attended at least one of eight
      classes, 509 subjects (123 men and 386 women) responded to the mailed follow-up
      questionnaire. MAIN OUTCOME MEASURES: Associations between weight change and the
      31 independent variables were assessed. Heights and weights were measured by the
      dietitians during treatment. Two-year follow-up weights were self-reported.
      STATISTICAL ANALYSES PERFORMED: Analysis of variance was used for 16 of the
      independent variables. For the remaining variables we performed a test of the
      null hypothesis that the correlation coefficient was 0 based on the test of the
      regression coefficient between the independent and dependent variable. A stepwise
      regression process was used to determine the best combination of variables
      predictive of weight change. RESULTS: Of the 31 independent variables, 16 were
      significantly predictive of weight change. The adjusted R2 for the entire group
      of 16 variables was .379. Thus, 37.9% of the variance was explained by the joint
      efforts of the 16 variables. Eight variables with an adjusted R2 of .371
      (accounting for 37.1% of the variance) were most important: feeling in control of
      eating habits, percentage over ideal body weight at enrollment, percentage of
      weight lost during the 8-week treatment, frequency of weight measurement,
      increase in physical activity, frequency of eating in response to emotions,
      number of pounds gained before subject resumed diet, and occupation.
      APPLICATION/CONCLUSION: The predictive variables for weight change may be useful
      to professionals who treat obese clients and may improve success rates of long
      term weight loss.

PMID- 8360407
TI  - Metabolic and anthropometric changes in female weight cyclers and controls over a
      1-year period.
AB  - OBJECTIVE: Women who diet to lose weight often regain the weight over time, and
      the cycle repeats itself. The objective of this study was to identify a group of
      female weight cyclers and to match them with a control group who had never
      consciously tried to lose weight. For 1 year, weight patterns, eating habits,
      metabolic parameters, and body composition were assessed to determine whether
      there was a relationship between weight cycling and these variables. DESIGN:
      Measurements were done at baseline and at 6 and 12 months. Changes in weight,
      diet, and exercise were monitored throughout the year. SETTING: All testing was
      done at a university physiology laboratory. SUBJECTS/SAMPLES: Nine weight cyclers
      with a notable history of dieting and food restriction were recruited.
      Subsequently, nine control subjects were selected and matched for age, height,
      weight, lean body mass, and exercise habits. MAIN OUTCOME MEASURE: The
      observational study included measures of 3-day diet records, skinfold and girth,
      serum glucose, insulin and triiodothyronine, and resting energy expenditure.
      STATISTICAL ANALYSES PERFORMED: The main variables were analyzed using a 2 x 3
      (diet group x time) analysis of variance with repeated measures on the time
      factor. Comparison of the means was done by Tukey post hoc test. RESULTS: A 7
      point satisfaction scale indicated that the weight cyclers were dissatisfied with
      their weight compared with the noncyclers (P = .03). Otherwise, there were no
      differences between groups in dietary intakes or the physiologic variables.
      APPLICATIONS/CONCLUSIONS: In the parameters measured, a history of weight cycling
      did not affect the metabolic profiles of the weight cyclers compared with the
      noncyclers.

PMID- 8360408
TI  - Resting energy expenditure in the obese: a cross-validation and comparison of
      prediction equations.
AB  - OBJECTIVE: To examine the accuracy and precision of 12 equations or tables for
      predicting resting metabolic rate (RMR) in obese persons. DESIGN: Observational
      (correlational) study. SETTING: Obesity Research Center, St Luke's/Roosevelt
      Hospital, New York, NY. SUBJECTS/SAMPLES: One hundred twenty-six (73 women, 53
      men) healthy, obese subjects recruited through the Obesity Research Center's
      Weight Control Unit. MEASURES: RMR by indirect calorimetry. Weight and height
      were measured to the nearest 0.1 kg and to the nearest 1 cm. STATISTICAL ANALYSES
      PERFORMED: Bivariate regression of predicted RMR on measured RMR; paired t tests
      for the difference between means of predicted RMR and measured RMR. RESULTS: Of
      the 12 prediction equations, 6 had intercepts or slopes that were significantly
      different from 0 and 1, respectively. With two exceptions, the equations
      accounted for between 56% and 63% of the variance in measured RMR. The Robertson
      and Reid (1952) equation and the Fleisch (1951) equation performed best with our
      obese sample. APPLICATIONS/CONCLUSIONS: The Robertson and Reid (1952) and the
      Fleisch (1951) equations are recommended for clinical use with obese patients.

PMID- 8360409
TI  - Predictors of body satisfaction in college women.

PMID- 8360410
TI  - Eating disorders: the changing role of nutrition intervention with anorexic and
      bulimic patients during psychiatric hospitalization.

PMID- 8360411
TI  - Assessment of differences between compliers and noncompliers in outpatient
      research diet studies.

PMID- 8360413
TI  - Cancer patients need referrals to dietitians.

PMID- 8360412
TI  - Health care reform--where ADA stands.
AB  - Few issues have galvanized the American public as dramatically as health care
      reform. Virtually everyone agrees that health care costs, quality, and
      accessibility require close examination and a prescription for change. Not
      everyone, however, agrees on the exact nature of this change. It is extremely
      important that we awaken the public and our policy makers to the vital role
      nutrition plays in the health care system. ADA is dedicated to this effort. Stay
      tuned as the health care reform plan unfolds. This effort is likely to be long
      term and will require your commitment, dedication, and energy to make nutrition
      services in health care reform a reality.

PMID- 8360414
TI  - Body temperature in persons with anorexia nervosa.

PMID- 8360415
TI  - Forces for research.

PMID- 8360416
TI  - ADA's nutrition & health campaign for women.

PMID- 8360418
TI  - The American Dietetic Association 76th Annual Meeting and Exhibition. Anaheim,
      California, October 25-28, 1993. Abstracts.

PMID- 8360417
TI  - Role of nutrition in the prevention and treatment of coronary heart disease in
      women.
AB  - Coronary heart disease (CHD) is the major cause of death in women. Because the
      manifestation of CHD differs in women and men (men are more likely to have acute
      CHD and women are more likely to have chronic CHD), it is imperative to explore
      the unique aspects of CHD in women. In addition, there is a critical need to
      increase our understanding of the effect of CHD risk factor modification on
      coronary morbidity and mortality in women. Several major CHD risk factors in
      women, such as elevated blood lipids and lipoproteins, body weight, and,
      frequently, hypertension, are beneficially responsive to nutrition intervention.
      Approximately 27% of all women and 50% of women aged 55 to 74 years are
      candidates for dietary intervention. The fact that women respond positively to
      dietary intervention has been well established by researchers. Studies are needed
      to determine the efficacy of risk factor modification achieved by dietary and
      other hygienic approaches as well as by other more rigorous therapies (eg, drugs
      and surgery) on the primary and secondary prevention of CHD in women. Finally, it
      will be important to understand the effects of gender, menopausal status, and age
      on dietary responsiveness. We must gain a better understanding of these issues so
      that we may significantly reduce the incidence of CHD in women.

PMID- 8360419
TI  - [Diurnal vision and mesopic vision in patients with monofocal and diffractive
      bifocal implants. A prospective and comparative study].
AB  - In a prospective study we implanted 34 monofocal posterior chamber lenses and 34
      diffractive bifocal posterior chamber lenses. The corrected distance acuity of
      both groups with comparable age showed no significant difference. To compare
      functional results of both groups under mesopic conditions we examined all
      patients with the Mesoptometer II. We determined the visual acuity under field
      luminance of 1.0 cd/m2 and contrast thresholds under field luminance of 0.1
      cd/m2. The results-of patients with diffractive bifocal posterior chamber lenses
      were significantly reduced compared with patients with monofocal posterior
      chamber lenses.

PMID- 8360420
TI  - [Epidemiological data on primary open-angle glaucoma and treatment in the
      department of Marne].
AB  - A descriptive cross-sectional epidemiological survey of primary open-angle
      glaucoma (POAG) was carried out in the department of Marne, France, between
      October 1990 and May 1991. The aim of the study was to obtain socio-medico
      demographic data on glaucoma patients who were treated for a period of one year
      or more. Fifty per cent of the ophthalmologists in the department of Marne
      participated in the study by having their patients complete an anonymous
      questionnaire at home. Eighty-five per cent of the 407 patients replied. This
      response rate to the investigation did not vary significantly (p > 0.90) with
      respect to the ophthalmologist. However, forgetting to distribute the
      questionnaires to the patients was variable from one physician to the other. The
      prevalence of POAG cases undergoing treatment was between 0.15 and 0.36% for the
      whole population; between 0.37 and 0.89% for patients over the age of 40 years;
      0.67 and 1.67% after the age of 60. The same number of women and men are
      affected, but the risk is 1.33 times greater for men after the age of 60. The
      geographical distribution of the patients is identical to that of the general
      population. Sixty-two per cent of the patients take other drugs as well and this
      proportion increases with age (p < 0.0001); 24% of the subjects have hypertension
      and 10.6% are diabetic. Half of the patients have received anti-glaucoma therapy
      for 6 years or less; 94% take beta-blockers, 18% take miotics and 12% use
      adrenergic drugs. More women instil their eyedrops on their own (79% vs 57%; p <
      0.0001). Ten per cent of patients have had glaucoma operations and this
      proportion increases with age (p < 0.03). The frequency of laser treatment is
      20%. Glaucoma patients seem to be faithful to their ophthalmologist as 65% of
      them go to the same one for follow-up. Our study shows that this type of
      investigation is well received by the patients.

PMID- 8360421
TI  - [Therapeutic observance and life of patients with primary open-angle glaucoma.
      Apropos of 341 cases in the department of Marne].
AB  - Patient compliance with treatment is an important factor in chronic diseases such
      as primary open-angle glaucoma (POAG). Among the 404 glaucoma patients included
      in our study in the department of Marne (France), 341 patients responded by
      completing an anonymous questionnaire at home in which the psychological effect
      of the illness, their knowledge about it, compliance with treatment and their
      relationships with the physician were explored. Sixty-eight per cent of these
      patients confirmed strict compliance with the treatment prescribed; this rate
      does not vary with respect to either the ophthalmologist (p = 0.57), or the
      duration of treatment (p = 0.42). Half of the remaining patients only alter the
      hours of their treatment and 6% forget to instill the eyedrops on certain days.
      According to our survey, the principal causes of poor compliance are
      forgetfulness, time constraints with other duties, poor doctor-patient
      relationship and lack of sufficient knowledge about the disease and its
      treatment. The majority of patients (59%) are minimally disturbed by the
      treatment; 2/3 of the subjects do not feel any change in their moral whereas 15%
      are more depressed or weakened since the time the illness was discovered. Fifty
      six per cent of them observed little or no change in their vision; 32% believe to
      have a moderate or considerable repercussion and 6% claim a very severe visual
      deterioration. Generally, patients appear to have a positive attitude towards
      their illness and do not try to deny it. Thirty-eight per cent of them consider
      it as a handicap which they can overcome and 42% have either no particular
      opinion or take it as a minor event.

PMID- 8360422
TI  - [HERETAIN: a computer-assisted diagnosis system for hereditary retinal
      syndromes].
AB  - The diagnosis of hereditary retinal syndromes may be difficult for a physician
      because of their number and variability. A computer assisted diagnosis of these
      syndromes can be useful in such cases. We used an identification software (XPER)
      for this purpose. The data base contains more than 67,000 elementary data that
      enable us to define 115 hereditary retinal syndromes. The knowledge is not
      represented by description of typical cases or diagnostic procedure rules but by
      structured description of syndromes defined by the group of experts. This CAI
      software is characterised by specific optimising procedures, deductive algorithms
      and dissimilarities calculus and enables very fast diagnoses by limiting the
      number of complementary analyses and thus the cost of this research. This system
      is extensible and justifies all its conclusions, its user-friendly data
      representation makes it accessible for any physician even if he does not master
      computers. The selected pathology field seems very suitable to developing a
      computer assisted diagnosis system: many low frequency syndromes, meaningful
      precise diagnosis for genetic and professional counseling, therapeutic
      expectations due to progress in molecular genetics. According to the authors,
      HERETAIN is one of the largest computer assisted decision support systems in
      ophthalmology.

PMID- 8360424
TI  - [Current status of treatment of pterygium].
AB  - After reviewing the various etio-pathogenic hypotheses for pterygium in which the
      discontinuity of the lacrymal film at the corneo-limbic junction appears to play
      an essential role, the authors discuss the current therapeutic choices. The value
      and place of lamellar keratoplasty overlapping the limbus are discussed.

PMID- 8360423
TI  - [Etiologies and risk factors of endophthalmitis].
AB  - Endophthalmitis is a serious disease with multiple aetiologies. Its development
      seems to be dependent upon various risk factors. Among 99 cases of
      endophthalmitis, 79% were secondary to intraocular surgery especially cataract
      surgery and perforating ocular trauma. To identify risk factors of post-cataract
      surgery endophthalmitis, we performed a case-control study: 55 cases and 269
      controls were used. Five risk factors were identified: duration of the operative
      procedure longer than 60 min, suture dehiscence, persistence of lens mass,
      traumatic cataract and left eye operated. The importance of prevention of
      endophthalmitis by avoiding such risk factors is raised.

PMID- 8360425
TI  - [Development of bilateral Kayser-Fleischer rings in a patient operated on by
      radial keratotomies].

PMID- 8360426
TI  - [Combined operation of trabeculectomy, cataract extraction and implantation of an
      artificial lens in the posterior chamber].

PMID- 8360427
TI  - [Elongation of the levator palpebrae superioris in palpebral retraction in
      Basedow's disease].

PMID- 8360428
TI  - [Invasive carcinoma of the conjunctivo-corneal limbus. Apropos of a case].
AB  - The limbus is an elective site of epithelial malignancies, mostly represented by
      precarcinomatous lesions. An 83-year-old female patient was operated for an
      exophytic tumor of the limbus. Histological examination showed an invasive
      squamous carcinoma. As the excision was not complete, complementary radiation
      therapy (45 Gy) was applied with a good short-term result. This case report
      emphasizes the value of early diagnosis and treatment of limbal tumors at the
      stage of precancerous lesions.

PMID- 8360429
TI  - [Treatment of recurrent erosion of the cornea].

PMID- 8360430
TI  - [Abortions of immunologic origin. A trial of etiologic classifications and
      therapeutic consequences].
AB  - Repeated unintentional abortions are an agonizing problems for many couples. When
      the cause is unexplained an immunological reason is often invoked. There have
      been many theories, but none have been able to be proven. Progress in immunology
      makes it possible to predict that these mechanisms will become better understood.
      At the present time the most recent work presented by the authors underlines the
      fact that there are probably several different immunological mechanisms causing
      abortion. When the mechanisms can be identified using current techniques, it may
      be possible to suggest the treatment suited to each one of these situations and
      to abandon empirical treatment as is at present used in these repeated abortions.

PMID- 8360431
TI  - [Local and long-term systemic risks of silicone breast implants].
AB  - A woman of 59 years of age, who had bilateral breast implants, 20 years earlier,
      presented with both breasts hard, inflamed and ulcerated, which suggested
      bilateral siliconomas. Bilateral mastectomy was carried out in two stages because
      she developed disseminated intravascular coagulation during the first operation.

PMID- 8360432
TI  - [The unexpected occurrence of spontaneous pregnancy during hormone replacement
      therapy for premature menopause].
AB  - Ovarian failure may be an irreversible consequence of cancer treatment for
      premenopausal woman. The diagnosis must be do of repeated gonadotropins and
      estrogen levels. A case of pregnancy is reported in a 26-year-old woman with
      iatrogenic menopause since eleven years and receiving estrogen/progesterone
      replacement therapy. The patient's age at the time of therapy, the amount of
      radiation that the ovaries received and the dose of the antineoplastic agent(s)
      are the critical factors for determine future ovarian functioning.

PMID- 8360433
TI  - [Active forces of urinary continence and urethral fatigability. Application to
      stress urinary incontinence in women].
AB  - Eighteen women who had urinary stress incontinence were studied to find the
      existence of urethral fatigue on effort by using a sphincterometric technique.
      Urethral pressure measurements at rest as compared with after six heavy coughs
      showed a mean lowering of the urethral pressure of 40% (range 24.5%-90%) in 10
      women. Spectral analysis of the electromyographic trace of the striated urethral
      sphincter at rest and then after coughing confirms that the striated muscle and
      the periurethral tissues are involved with a marked quantitative lessening of
      electric sphincter activity. The clinical, physiopathological, prognostic and
      therapeutic consequences of this new concept are discussed, together with their
      relationship to other active forces involved in continence.

PMID- 8360434
TI  - [Robert's uterus with menstrual retention in the blind cavity].
AB  - Robert's uterus or asymmetric septate uterus is a rare malformation. It presents
      with two cavities, one of which is blind. The authors report an original case:
      the blind cavity, on the right side of the septum, contained retained secretions.
      The embryologic and physiopathologic mechanism of this anomaly still are to be
      discussed.

PMID- 8360435
TI  - [Intraperitoneal chemo-hyperthermia in the treatment of peritoneal carcinomatosis
      of ovarian origin. Initial cases, physiopathologic data].
AB  - The authors report the first results using intraperitoneal hyperthermic
      chemotherapy with mitomycin C or cisplatinum with protective hypothermia up to 32
      degrees C in four cases of peritoneal carcinomatosis secondary to cancer of the
      ovary which was resistant to conventional treatment. They were stage III and IV
      in the FIGO classification. There were no post-operative complications. Two
      patients are still alive 4 and 6 months after intraperitoneal hyper-chemotherapy.
      Hypothermia has its own action of destroying tumour cells and potentiates the
      effects of chemotherapy. We have, following the work of the japanese, devised a
      therapeutic regime combining chemotherapy and intraperitoneal hyperthermia.

PMID- 8360436
TI  - [The association of dermatopolymyositis and cancer of the ovary].
AB  - Different aspects of the relationship between dermatopolymyositis and cancer of
      the ovary are emphasised here. A clinical case support these aspects. In the
      incidence of cancer of the ovary it is remarkable that there is often a
      relationship between the two conditions. Usually the diagnosis of the
      dermatopolymyositis comes before the cancer is discovered. This means that
      decisions have to be taken as to how far investigations for the cancer should be
      carried out when dermatopolymyositis has been diagnosed.

PMID- 8360437
TI  - [Pheochromocytoma of the broad ligament].
AB  - The authors report a rare case where a pheochromocytoma which was not in the
      adrenal gland occurred in the broad ligament. A review of the literature resulted
      in only three published cases being found. When the symptomatology suggests that
      there may be a pheochromocytoma in the body one has to research where it is sited
      and one has to think of such a possibility if a tumour in the broad ligament is
      found during an operation, so that the risks of operating on these tumours can be
      lessened.

PMID- 8360438
TI  - [To be born or not to be. Epidemiologic, judicial and psychological aspects].
AB  - The requisites for filling up birth certificates in France (> or = 180 days of
      pregnancy and vitality at the registration of birth) are different from the
      criteria recommended by the World Health Organisation (WHO) (at least 500 g) for
      national statistics. The number of stillborn babies and neonatal deaths known
      from two different sources in the Nord-Pas de Calais Region in 1988-1989 have
      been compared ie: the vital statistics published by INSEE and the data of a
      survey carried out in hospitals according to the WHO criteria. Among the 808
      known perinatal deaths in the survey, 305 (37.7%) were ignored or were not
      classified in the same categories by the registration services for vital
      statistics. 230 children including 29 born alive had not been registered and 75
      children born alive had been registered as still born. The disparity in these
      definitions between INSEE and the WHO has serious consequences: the perinatal
      mortality measured by INSEE is underestimated by 28%, in comparison with
      mortality registered according to the WHO criteria. The 180 day threshold of
      viability reduces the social rights of employed women and makes it more difficult
      for them to have the money they spent on medical care refunded. Finally, as it is
      impossible to find a trace of these children who were not legally registered
      since they were under the threshold of viability, the mourning response of
      parents to perinatal deaths is all the more difficult. Current evolution in the
      threshold of viability observed in maternity units, makes it necessary to change
      the criteria which are applied for the legal registration of births.

PMID- 8360439
TI  - [Anti-Tja (PP1Pk) isoimmunization. A case, a review of the literature].
AB  - AIM: A review of the literature concerning the very rare anti-PP1Pk
      isoimmunisation with a personal case. CLINICAL MATERIAL: Anti-PP1k antibody gives
      rise to the high risk of abortion in the first and the second trimester (in a
      different series the risk is 50-70%). A 19-year-old patient who had this antibody
      was helped by a plasmaphoresis repeatedly between the 6th and the 25th week of
      pregnancy. Cordocentesis was carried out to estimate fetal haemoglobin from the
      25th week onwards. A set caesarean section was carried out at 36 weeks because of
      intrauterine growth retardation and the development of fetal anaemia. DISCUSSION:
      The authors suggest research based on the known immunohaematological factors
      concerned with this isoimmunisation and on the main treatments available
      (plasmaphoresis, cordocentesis, and delivery at a set time). CONCLUSION: Until
      now there have been very few cases and only four similar cases to ours have been
      reported in the literature. That is why it is so difficult to suggest a well
      defined strategy for treating these patients.

PMID- 8360440
TI  - [The use of sulprostone (Nalador) in the evacuation of uterine contents. Apropos
      of 32 cases at the Department of Gynecology, University Hospital Center, Nimes,
      over 2 years (a retrospective study)].
AB  - We have studied the use of sulprostone in evacuating uterine contents in 32
      patients, the majority of whom were in the second trimester of their pregnancies.
      There are three ways to administer the drug (continuous intravenous, intermittent
      intravenous, and intramuscular); the best results were obtained when the drug was
      administered continuously intravenously. It was well tolerated, the use of
      Nalbuphine reducing pain. There were few side effects. The use of this product is
      discussed in connection with a few of the cases as well as the possible
      alternative treatments in difficult cases.

PMID- 8360442
TI  - [Swallowing of an amniotic string by a fetus at term].
AB  - Amniotic band syndrome is a rare pathology which involves a group of fetal
      malformations due to the formation of bands between the fetus and the
      extraembryonic derivatives. These fetal malformations are extremely variable and
      their type depends upon the period of gestation during which the bands develop.
      In rare cases, these bands could strangulate the umbilical cord vessel and lead
      to fetal death. The authors report an exceptional case fo swallowing of the
      amniotic band by a fetus at term and fetal death due to strangulation of the
      umbilical cord vessels by amniotic band.

PMID- 8360441
TI  - [Gestational age and fetal lung maturity].
AB  - In order to assess the lung maturity of the fetus, a biochemical analysis using
      two reliable, simple and rapid methods (FLM-TDX Abbott and determination of
      phosphatidylglycerol (PG) have been carried out on 166 amniotic fluids taken by
      amniocentesis. The patients were particularly pregnant women presenting disorders
      such as diabetes (n = 41), premature rupture of the membranes (n = 30),
      hypertension (n = 20), intra uterine growth retardation (n = 13) and gemellar
      pregnancies (n = 27). The lung maturity of the fetus has been considered as
      mature (no risk of any hyaline membrane disease: HMD) when the phospholipid rate
      is higher than 50 mg/g albumin (FLM-TDX Abbott), associated or not with the
      presence of PG (PG positive). The latter phospholipid was present only in women
      whose pregnancy was about 35 weeks. Besides, our results show a very large
      disparity of the phospholipid rates (FLM-TDX) in the amniotic samples for an
      identical gestational age. Values from 9 to 124 for pregnancies with term of 31
      weeks, and from 21 to higher than 160 for those of 38 weeks. In infants born not
      later than 48 hours after the amniotic punction (n = 30), four of them presented
      an HMD. The FLM-TDX values were less than 30 for three cases and equal to 52 for
      the fourth. The term of these newborns was 37 weeks or more for three of them,
      and 31 weeks for the last one. Our study confirm that the TDX-FLM Abbott is
      useful to assess the fetal lung maturity and does not correlate with the
      gestational age.

PMID- 8360443
TI  - [Term birth of a twin after the rupture of the uterine horn at 15 weeks
      gestational age].
AB  - Having treated a case which resulted in the delivery at term of an intrauterine
      twin when the other twin had been lost after the rupture of a uterine cornu which
      itself followed a salpingectomy without removal of the interstitial portion of
      the tube brings the authors to discuss the physiopathology and the symptomatology
      of such cases. They also discuss the value of resecting the interstitial portion
      of the tube and what management should be when there is a live intrauterine
      pregnancy.

PMID- 8360444
TI  - [Cloacal dysgenesis and vaginal delivery].
AB  - The failure of urorectal septum to form and divide the cloaca into rectum
      dorsally, and urogenital sinus ventrally, results in a cloacal dysgenesis. It is
      an extremely rare anatomic malformation of the genito-urinary tract and
      alimentary tract. A case of pregnancy and vaginal delivery in a patient with
      cloacal dysgenesis type II and previous heart operation is presented. Both mother
      and newborn were in good condition. The way of treatment of such patients is
      discussed.

PMID- 8360446
TI  - [Infectious endocarditis of gyneco-obstetric origin. Apropos of 15 cases].
AB  - With the object of analyzing current characteristics of post-partum and post
      abortum infective endocarditis (IE), authors carried out a retrospective study of
      15 cases between september 1985 and may 1992. Mean age was 22.2 +/- 4.0 years.
      Origin of sepsis was delivery (1 case), abortion (14 cases). There was no
      underlying cardiac lesion in 9 cases, rheumatic heart disease in 6 cases.
      Infecting organisms were Staphylococcus aureus (n = 6), streptococcus D (n = 3),
      Clostridium perfringens (n = 2). There were 10 acute and 5 subacute IE, 7 right
      sided, 7 left-sided, and 1 right and left-sided IE. Vegetations were determined
      by transthoracic echocardiography in 12 cases (80%). The main complications were
      heart failure (15 cases), and pulmonary or arterial embolism (7 cases). Lethality
      was 53.3% and was not different in tricuspid acute IE and left-sided IE.
      Treatment was the more difficult as cardiac surgery is expensive or even
      inaccessible. Accordingly, prevention is primordial. It consist of antibiotic
      prophylaxis and fight against illicit abortion.

PMID- 8360445
TI  - [Complete and complicated tears of the perineum in spite of preventive incision.
      A study of the risk factors and the short-term consequences].
AB  - A retrospective study of case controls was carried out by postal enquiry to find
      out the risk factors for complete complicated tears (DCC) of the perineum
      occurring after prophylactic episiotomy. There were 33 such cases of DCC out of
      8,039 vaginal deliveries which means 0.41% in the University Centre in Grenoble
      in the years 1985-1986-1987. A control group of 66 cases was paired according to
      parity and episiotomy. The risk factors were identified as large fetal weight,
      instrumental deliveries, mid-line episiotomy or perineotomy. The questionnaires
      could be analysed for faults after delivery in 26 cases and 52 controls (response
      rate of 90%). The sole significant problem of the cases was perineal and rectal
      pain lasting more than a month longer than in the control cases. There was no
      greater dyspareunia, stress incontinence with urine, nor anal incontinence which
      contradicts previous reports in the literature. The authors conclude there are no
      serious complications of DCC following perineotomy providing repair is carried
      out very carefully. The patients in this group show that is was acceptable
      because no more in this group than in the controls were frightened of a repeat
      pregnancy.

PMID- 8360447
TI  - [Ectopic abdominal pregnancy. 2 cases treated by laparoscopic surgery].

PMID- 8360448
TI  - [For sterilization is still illegal but insured].

PMID- 8360449
TI  - [The autonomy of the practice of ultrasonography confirmed by the Court of
      Appeals (decision of 5 April 1993)].

PMID- 8360450
TI  - A century of failure: health care reform in America.
AB  - To understand fully the persistent failure of the United States to enact national
      health insurance requires an appreciation not only of the role of government and
      the dynamics of politics but of underlying social realities. One consideration,
      which dates back to the Great Depression, is the absence of the middle class from
      a coalition in favor of such a policy. This absence reflects both the constricted
      vision of the middle class and the spirited campaigns of groups like Blue Cross
      to make certain that middle-class needs were met in order to reduce pressure for
      government intervention. Another critical social feature is the special
      entrepreneurial character of the American medical profession. Physicians saw
      themselves as small businessmen and, as such, shared and promoted a suspicion of
      governmental intervention. All the while, Americans justified the absence of a
      national program in terms of the ethos of voluntarism, which had a sufficient
      base in reality for the posture to be maintained without great embarrassment. In
      fact, the rhetoric that surrounded the enactment of Medicare reinforced these
      views, making it appear that, the elderly aside, all was well with the provision
      of medical services in the country. Even as national health insurance assumes a
      new prominence on the political agenda, it remains unclear whether these several
      considerations will allow for the enactment of sweeping changes.

PMID- 8360452
TI  - Black America: from community health care to crisis medicine.
AB  - This study traces the major policy shifts in medical care that have affected
      disadvantaged African-Americans and the response of this community's medical
      leadership to these changes. Since World War II policy has passed through three
      major phases. The first--engagement--ran from the mid-1960s through the mid
      1970s. During this phase a community health policy orientation prevailed as
      national government targeted resources to health care programs for needy blacks
      and other poor Americans. From the late 1970s to the mid-1980s the period of
      submersion occurred: black community health professionals and political leaders
      experienced a new-found inclusion in health policy debate, but, at the same time,
      broader policy-making circles in government and health care reduced medical
      resources for the inner-city poor. Finally, in the third phase--crisis
      recognition--a network developed of community health advocates who seek to
      reorient the health system so that it addresses needs within urban American's
      "New Ghettos."

PMID- 8360451
TI  - The struggle for the soul of health insurance.
AB  - The politics of American health insurance is a struggle over which vision of
      distributive justice should govern: the solidarity principle or the logic of
      actuarial fairness. Actuarial fairness is central to American private health
      insurance. It is both an antiredistributive ideology and a method of organizing
      mutual aid by fragmenting communities into ever-smaller, more homogeneous groups,
      leading ultimately to the destruction of mutual aid. This fragmentation is
      accomplished by fostering in people a sense of their differences and their
      responsibility for themselves, rather than their commonalities and
      interdependence. Actuarial fairness developed as a business strategy for gaining
      market share. Medical underwriting, which is far more extensive than commonly
      known, is the information technology used for implementing actuarial fairness.
      Despite significant changes in the political context of health insurance which
      are leading toward restraints on underwriting, the logic of actuarial fairness is
      so deeply embedded in the structure of competitive markets in insurance and so
      deeply consonant with social divisions in American society that eradicating it
      will take more than any current reform proposals contemplate.

PMID- 8360453
TI  - Dogmatic slumbers: American business and health policy.
AB  - For more than a decade students of health policy have predicted a revolution
      waged by corporate purchasers of health care who would rise in demand of public
      policy cures for increasing and burdensome health care costs. This forecast has
      been largely disappointed, however, as the business sector has remained oddly
      diffident in its demands for health policy reform. There are three reasons for
      business's reticence--the economic stakes of the corporate sector in health
      reform are uncertain, organizational encumbrances hamper business activism in
      this arena, and ideological convictions make business wary of governmental
      solutions. Although business is sometimes said to manipulate the policy process
      for its own material ends, in the health sphere the most likely road to reform
      may reverse this image: a newly activist federal government may have to mobilize
      business support for reforms that advance both corporate interests and larger
      social goals.

PMID- 8360454
TI  - Together again: business, government, and the quest for cost control.
AB  - Corporate America leads the pack in the collective anxiety attack over health
      care costs. But will the business community add its considerable political power
      to the movement for national health reform? Conventional wisdom suggests not:
      businessmen seldom rally for collective concerns, have traditionally been biased
      against government action, and have diverse interests. This article guardedly
      offers grounds for greater optimism about corporate participation, arguing that
      the proper institutional context can help businessmen to see their preferences as
      consistent with health reform. Business groups have already proven critical to
      the issue development stage, where a dedicated group of corporate health
      reformists were key to getting reform on the national agenda. Business may also
      respond to strong leadership from President Clinton and assist in the legislation
      of national health reform. Yet the price of this corporate support is a decidedly
      conservative slant to the proposed legislation.

PMID- 8360455
TI  - Political influence in the 1990s: from iron triangles to policy networks.
AB  - To assess the prospects of comprehensive health care reform during the Clinton
      administration, we must examine the changes that have occurred in the political
      and structural contexts in which reform is debated. The political context
      includes the status of the health care system itself as well as public attitudes
      and voting patterns associated with health care reform; it may be friendlier now
      to reform than it has been in any previous period, but it cannot on its own
      produce policy change. The structural context, the representational community of
      organized interests and government institutions, is the means by which politics
      is either thwarted or translated into action. Changes in these organized
      interests and in Congress have transformed the health care reform policy
      community from an "iron triangle" dominated by an antireform alliance of
      medicine, insurance, and business to a more loosely bound policy network in which
      a reform coalition may now be able to prevail, especially under the direction of
      an activist president like Bill Clinton. I consider three hypotheses: The first
      claims that, despite the apparent structural changes, the core power
      relationships will remain the same as in the past, and the antireform alliance
      either will continue to block policy change or will push through a reform program
      that protects its constituent interests. According to the second, the structural
      changes produce an atomization of power, making coalition building in support of
      reform impossible. The third and most plausible hypothesis proposes that the
      structural changes, in combination with the shift in politics and Clinton's
      election, have generated new opportunities for fundamental reform.

PMID- 8360456
TI  - The courts, health care reform, and the reconstruction of American social
      legislation.
AB  - Because of budgetary and other political pressures, American health care reform
      (and other social reform) legislation is often not enforced, or is implemented in
      ways that undermine its egalitarian goals. About 25 years ago the federal courts
      began to try to reduce this gap between statutory promise and policy reality by
      interpreting federal funding laws as creating rights for their ultimate
      beneficiaries, including low-income patients and the providers who serve them.
      This major innovation in the concept of legal rights was confirmed by hundreds of
      judicial decisions and accepted by Congress itself. Over the past few years,
      however, a new Supreme Court, led by Chief Justice William Rehnquist, has issued
      opinions denying that such rights exist and vastly increasing agency power to
      reduce important statutory provisions to virtually meaningless formalities. Thus,
      at the very moment that national health care reform is prominent on the political
      agenda, the federal courts are abandoning a rights-enforcing role that may be
      critical for the reform's success. This article explains the struggle around the
      courts' rights-enforcing role, defends the role, and suggests ways that it can be
      maintained even if the courts themselves are not currently in a good position to
      fulfill it.

PMID- 8360457
TI  - The American states and Canada: a comparative analysis of health care spending.
AB  - Most comparisons of the relative effectiveness of cost containment in the
      Canadian and U.S. health systems trace Canada's greater success to its single
      payer approach. However, these studies ignore the substantial variation that
      exists in hospital and personal health care spending among both the American
      states and the provinces and territories of Canada. Four American states have
      adopted all-payer hospital rate setting; one other uses competitive bidding. All
      five show rates of growth in per capita hospital spending comparable to (and in
      some cases, lower than) the Canadian jurisdictions. Hospital spending, as a
      percentage of state gross domestic product (GDP), declined or remained constant
      in four of the five states. In four out of the five, growth in per capita
      spending on personal care, as a percentage of GDP, remained or fell below the
      national average. By contrast, in Canada, per capita spending on both hospitals
      and personal health care increased as a percentage of GDP in ten out of eleven
      jurisdictions. In each of the U.S. states, government played a central role in
      structuring the terms of payment and thus strengthened the hand of purchasers
      over providers. This strategy, rather than specifically a single-payer or
      universal health insurance approach, seems to be the key to limiting the growth
      in health costs to the growth in state or national income.

PMID- 8360458
TI  - Regulatory regimes and state cost containment programs.

PMID- 8360459
TI  - States and the health care crisis.

PMID- 8360460
TI  - Disinfection of medical waste.

PMID- 8360461
TI  - Biological indicators for a liquid chemical sterilizer: a solution to the
      instrument reprocessing problem?

PMID- 8360462
TI  - Nosocomial infections in neutropenic cancer patients.
AB  - OBJECTIVE: Identification of overall and site-specific rates of nosocomial
      infection in neutropenic patients with cancer and associated pathogens. DESIGN:
      Cumulative continuous prospective surveillance over a 42-month period. Criteria
      and definitions of infection in neutropenic patients (absolute neutrophil counts
      < 1,000/mm3) were developed, and surveillance was carried out by a certified
      infection control nurse and a senior oncology research fellow. SETTING: A cancer
      research center with two designated oncology nursing units. PATIENTS: Neutropenic
      patients with hematological and solid malignancies undergoing high-dose
      chemotherapy with and without autologous bone marrow transplantation. All
      patients admitted to both of the units during the study period were surveyed.
      Those who developed neutropenia are included in this report. RESULTS: A total of
      444 nosocomial infections were identified in 920 neutropenic patients during
      9,582 days of neutropenia for an overall rate of 48.3 per 100 neutropenic
      patients, or 46.3 per 1,000 days at risk. The rate of bloodstream infection per
      100 neutropenic patients was 13.5 (gram-positive, 9.2; gram-negative, 4.8; and
      Candida 1.2). Other site-specific rates were: urinary tract, 5.7; respiratory
      tract, 5.5; thrush, 6.6; skin, 3.4; and gastrointestinal tract, 3.4. Among 392
      pathogens identified, there were 137 (35%) gram-positive cocci, 105 (27%) gram
      negative rods, 70 (18%) Candida, 37 (9%) gram-positive rods, 22 (6%) viruses, and
      15 (4%) Aspergillus. CONCLUSIONS: The rate of both overall and site-specific
      nosocomial infections in neutropenic patients is high. Neutropenia is a
      significant intrinsic risk factor that should be addressed in surveillance
      programs. Infection control and infectious diseases practitioners may need to
      modify techniques for surveillance, control, and management of infection in this
      population.

PMID- 8360463
TI  - Methicillin-resistant Staphylococcus aureus in a nursing home and affiliated
      hospital: a four-year perspective.
AB  - OBJECTIVES: To determine the effect of a methicillin-resistant Staphylococcus
      aureus (MRSA) outbreak in a nursing home on the subsequent MRSA caseload in a
      closely affiliated hospital. DESIGN: Observational and descriptive; routine and
      special MRSA surveillance data for nursing home and hospital were reviewed for a
      four-year period (1988 to 1991) as were records regarding patient transfers from
      nursing home to hospital. SETTING: The 120-bed nursing home care unit (NHCU) and
      the geographically separate 434-bed acute care facility (hospital) of the
      Portland Veterans' Affairs Medical Center (PVAMC). PATIENTS: Veterans
      hospitalized in the acute care division of NHCU. RESULTS: Following the
      introduction of MRSA into the NHCU in December 1987, it quickly disseminated. Two
      to 32 newly colonized or infected patients were recognized in each quarter of the
      study period. Facility-wide prevalence surveys on two occasions disclosed MRSA
      colonization rates of 34% and 10%. During the study period, 15 to 54 (mean: 37.6)
      patients were transferred each quarter from the NHCU to the hospital of the
      PVAMC. The number of MRSA cases transferred ranged from 0 to 16 per quarter
      (mean: 5.4). During the same period, the total number of MRSA cases in the
      hospital increased, rising from 7 cases in 1987 to 16 in 1988, 48 in 1989, 34 in
      1990, and 35 in 1991. The percentage of hospital MRSA cases accounted for by NHCU
      transfers was 0% in 1988, 38% in 1989, 12% in 1990, and 11% in 1991. CONCLUSIONS:
      Despite the steady flow of patients between the NHCU and the hospital, the MRSA
      outbreak in the NHCU was associated with only a modest increase in the MRSA
      caseload at the affiliated hospital.

PMID- 8360464
TI  - Choices: a brief review of economic analysis.

PMID- 8360465
TI  - Practicing emporiatrics: basic sources of information on travel medicine.
AB  - Travel medicine is an exciting and rewarding field. This article has provided an
      overview of basic sources of information. The interested clinician will find many
      other sources of information on special topics or on travelers with special
      medical conditions.

PMID- 8360466
TI  - New AIDS research institute opens in San Francisco.

PMID- 8360467
TI  - NIH opens first trial of HIV vaccines in children.

PMID- 8360468
TI  - Court rules on patient's right to file suit for fear of contracting HIV from
      surgeon.

PMID- 8360469
TI  - Selective expression of Ly-6G on myeloid lineage cells in mouse bone marrow. RB6
      8C5 mAb to granulocyte-differentiation antigen (Gr-1) detects members of the Ly-6
      family.
AB  - Mouse Ly-6 proteins are characterized by lineage-restricted patterns of
      expression on lymphoid cells. A mAb (1A8) was produced to Ly-6G, a newly
      described member of the Ly-6 locus. Based on selective reactivity to cloned Ly-6
      gene products expressed in EL4J cells, 1A8 was determined to be specific for Ly
      6G. Furthermore, mAb to other Ly-6 specificities did not bind to Ly-6G
      transfected EL4J cells, indicating that Ly-6G is distinct from other
      serologically defined Ly-6 specificities. FACS analysis using 1A8 demonstrated
      that Ly-6G was expressed in bone marrow but not substantially on other lymphoid
      tissues, including activated T and B cells. In the bone marrow, Ly-6G expression
      was primarily restricted to the cells with more forward angle light scatter,
      which are mostly granulocytes. The RB6-8C5 mAb, previously described to detect a
      myeloid-restricted Ag (Gr-1) on more differentiated granulocytes, also reacted
      with Ly-6G- and Ly-6C-transfected EL4J cells. Both 1A8 and RB6-8C5 selectively
      precipitate a M(r) 21 to 25 kDa, glycosylphosphatidylinositol-anchored protein.
      Collectively, these data indicate that the Gr-1 Ag is a member of the Ly-6 family
      and further link expression of individual Ly-6 genes with distinct lineages in
      mouse bone marrow cells.

PMID- 8360470
TI  - Alterations in lymphopoiesis after hematopoietic reconstitution with IL-7 virus
      infected bone marrow.
AB  - Murine bone marrow was infected with a helper-free recombinant retrovirus
      expressing the mIL-7 gene and used to reconstitute lethally irradiated hosts.
      Twenty-three percent of mIL-7 retrovirus-infected recipients became moribund
      within 4-16 wk posttransplant with splenomegaly and hyperplastic lymph nodes,
      elevated white blood cell counts, plus other noticeable abnormalities including,
      in one animal, lymphocytic ascites. FACS analysis of hematopoietic tissue in
      diseased mice revealed marked alterations in T cell subsets of spleen and lymph
      nodes. These differences in extrathymic tissues compared with control animals
      included increases in CD4(-)-CD8+ lymphocytes and most strikingly the appearance
      of large numbers of an unusual CD4(+)-CD8+ T cell population with other
      characteristics of immature thymocytes (CD3lo-Thy1(+)-HSAhi). 3H-thymidine
      incorporation assays performed on extrathymic lymphocytes from a lymph node or
      ascites of two affected mice showed high levels of proliferation in the absence
      of either CD3 cross linking or exogenous IL-7 stimulation. Interestingly, in
      contrast to the effects noted on peripheral lymphoid tissues, no alteration in
      thymic size was noted and the proportion of CD4(+)-CD8+ cells was generally
      decreased with corresponding increases in CD4+ or CD8+ or CD4(-)-CD8- cells.
      These results provide further evidence of the involvement of IL-7 in the
      development and proliferation of early T cells in vivo and point to the
      possibility of IL-7 involvement in extrathymic expansion of a primitive class of
      T cells, the functional nature of which remains to be elucidated.

PMID- 8360471
TI  - Glycopeptides bind MHC molecules and elicit specific T cell responses.
AB  - Carbohydrates are T cell independent antigens because they do not bind to MHC
      molecules. However, glycopeptides might potentially bind to MHC molecules via
      their peptide component for presentation to T cells. We have conjugated the
      disaccharide galabiose [Gal alpha (1-4)Gal beta] to the amino terminus of a T
      cell peptide determinant from hen egg-white lysozyme [HEL(52-61)]. The resulting
      glycopeptide (Gal2-52-61) and a nonglycosylated analogue containing tyrosine and
      glutamic acid at the amino-terminus (YE-52-61) bound equally well to purified I
      Ak. T cell hybridomas were produced after immunization with Gal2-52-61. Many of
      the T cell hybridomas were glycopeptide-specific and responded to Gal2-52-61 but
      not to nonglycosylated synthetic peptides or to HEL presented by APC, indicating
      that the carbohydrate moiety influenced T cell recognition. Recognition was lost
      with the amino terminal attachment of the disaccharide to a peptide six amino
      acids longer at the amino terminus than HEL(52-61). Recognition also was lost
      with peptides containing only a single galactosyl residue or with galabiose bound
      to a different I-Ak binding peptide. T cells directed to Gal2-52-61 recognized
      glycopeptides having significant variation in the disaccharide structure, such as
      HEL(52-61) glycopeptides carrying lactose, cellobiose, or hepta-o-acetylated
      galabiose. Peptide residues were important features of the T cell epitope; Ala
      substitutions of two critical T cell contact residues of HEL(52-61) (Tyr53 and
      Leu56) abrogated T cell reactivity to the glycopeptides without affecting binding
      to I-Ak. In conclusion, we propose that these T cells recognize a peptide
      conformation specific to glycopeptide-I-Ak complexes and that this recognition
      does not involve specific interaction between the carbohydrate moiety and the T
      cell receptor.

PMID- 8360472
TI  - Cytotoxic T cell responses to minor H-43 alloantigens in H-43a and H-43b mice.
      Distinctive MHC class I restriction specificity and clonal inactivation are
      inherent properties of the H-43 system.
AB  - Our previous studies demonstrated that CTL responses to the newly identified
      minor H-43a and H-43b alloantigens induced in H-43b and H-43a responder mice,
      respectively, utilized the same H-2Kb (Kb) MHC class I restriction element,
      whereas many allelic class I products were not utilized. Also, a single i.v.
      injection of H-43b recipient mice with spleen cells (SC) from H-43 congenic mice
      induced specific and lasting CTL tolerance to H-43a rather than priming. We have
      produced a H-43b C3H.AU mouse strain (H-2p), which we regard as H-43 congenic to
      the C3H.NB (H-2p, H-43a) strain. Using this strain we demonstrate that Kp and/or
      Dp alleles can serve as class 1 restricting elements in the CTL responses to H
      43a and H-43b alloantigens. Injection of H-43a recipient mice with antigenic H
      43b SC from the paired H-43 congenic abrogated the anti-H-43b CTL response,
      irrespective of MHC class I specificity, i.e., in the contexts of Kb and of Kp
      and/or Dp elements. A corresponding result was obtained upon injection of H-43b
      recipient mice with congenic H-43a SC. The tolerance-inducing capacity of H-43a
      congenic SC was so strong that injection of these cells into H-43b responders
      that had previously received immunogenic H-43a SC completely blocked the
      previously activated Kb-restricted memory CTL activity specific for the H-43a
      alloantigen.

PMID- 8360473
TI  - Pattern of potassium channel expression in proliferating B lymphocytes depends
      upon the mode of activation.
AB  - Ionic channel expression is highly regulated during mitogenesis. But it is not
      clear whether these regulations only follow intrinsic programs during the course
      of the cell cycle or if they also depend upon the external factors used to
      promote cell activation. B lymphocytes express two classes of potassium channels
      and can be stimulated to enter the cell cycle by distinct pathways. Thus, we have
      analyzed, with the patch-clamp technique, if the expression of channels varies
      when the cells are activated by different signals that lead to cell
      proliferation. We found that stimulation through Ag receptors increases the
      expression of calcium- and voltage-activated potassium channels, whereas a
      bacterial mitogen, LPS, only enhances the expression of the latter. Moreover,
      channel expression can still be modified in proliferating cells because
      stimulation of LPS-activated cells through Ag receptors induces rapid expression
      of calcium-activated channels. The use of inhibitors of mRNA synthesis revealed
      that this process depends upon gene transcription. Thus, differential induction
      of the expression of potassium channels is not only linked to the entry into the
      cell cycle but depends also on pathways of stimulation.

PMID- 8360475
TI  - Low concentrations of Gm allotypic subsets G3 mg and G1 mf in homozygotes and
      heterozygotes.
AB  - Serum concentrations of IgG3, IgG1, and of the Gm allotypic subsets of these two
      isotypes were measured in adult homozygotes and heterozygotes. Alleles G3 mb and
      G3 mst of the IgG3 locus, and alleles G1 ma and G1 max of the IgG1 locus were
      found to associate with a high concentration of the allotypic product. Alleles G3
      mg (IgG3) and G1 mf (IgG1) were associated with a low concentration of the
      product. This was true regardless of the haplotype; for example, allele G3 mb was
      associated with a high concentration of the product in all haplotypes f;n+;b f;n
      ;b and fa;n+;b. One dose of allele G3 mg was associated with a characteristic
      mean concentration of the product (g-type IgG3). This rule was valid regardless
      of the other allele of the subject, thus, heterozygotes and G3 mg/g homozygotes
      had mean concentrations of 0.10 and 0.20 g/liter, respectively, of g-type IgG3.
      Products of the IgG1 alleles were also simply additive: one dose of allele G1
      ma(x) or G1 mf was associated with mean concentrations of 3.63 and 2.84 g/liter,
      respectively, and two doses with twice these amounts. Only allele G3 mb did not
      completely follow this rule. We also studied the serum concentrations and the
      allotype distribution of 41 IgG1 and 31 IgG3 myeloma proteins. The results
      suggested that the allotype-associated differences in serum concentrations are
      caused by different numbers of B cells producing allotypic subsets of IgG1 or
      IgG3, not by different rates of synthesis per B cell.

PMID- 8360474
TI  - Properdin, a positive regulator of complement activation, is expressed in human T
      cell lines and peripheral blood T cells.
AB  - Properdin plays an important regulatory role in the activation of the complement
      system. Here we report the biosynthesis of properdin in four different human T
      cell lines and in T cells purified from peripheral blood. Cell sorting
      experiments, in conjunction with Northern blotting, showed that both CD4- and CD8
      bearing populations of T cells have the potential to synthesize properdin. The
      functional activity of properdin secreted from these T cell lines was determined
      in a hemolytic assay. In view of the numerous ways in which complement activation
      may influence cellular immune response, the present results indicate, for the
      first time, a possible interaction between the complement and the T cell system.

PMID- 8360476
TI  - Expression of the Bcl-2 protein in murine and human thymocytes and in peripheral
      T lymphocytes.
AB  - Bcl-2, a proto-oncogene that can block apoptosis, was found to be expressed
      throughout the thymic medulla, but in only scattered cells in the thymic cortex.
      In order to determine the precise distribution of Bcl-2 protein during thymocyte
      development, we utilized mAb specific for either mouse or human Bcl-2. Thymocyte
      subpopulations were assessed using three-color flow cytometry and a saponin
      permeabilization method. Staining of adult mouse and human thymocytes was
      comparable, with 20 to 35% of cells expressing Bcl-2. Bcl-2 was expressed in
      nearly all CD4+ and CD8+, and CD3hi cells, but in only 5 to 10% of CD4+8+ cells.
      The CD4-8- population was more variable, with 25 to 40% of human cells and 65 to
      80% of murine cells expressing Bcl-2. In sorted adult murine CD4-8- cells, the
      very immature Pgp-1+/IL-2R alpha- subset had a high percentage of Bcl-2+ cells.
      Bcl-2 expression was also examined during murine fetal development. At fetal day
      15.5 to 16.5, 60 to 70% of total thymocytes expressed Bcl-2. By fetal day 17.5,
      overall Bcl-2 expression fell to adult levels of 20 to 30%. Bcl-2 was present in
      peripheral T cells from lymph node, spleen, and peripheral blood at uniformly
      high levels. In vitro stimulation with anti-CD3 or anti-TCR antibodies increased
      Bcl-2 expression in total thymocyte cultures, but could not induce Bcl-2
      expression in CD4+8+ cells, even with the addition of a variety of cytokines.
      These data suggest that early double negative thymocytes express Bcl-2 but lose
      Bcl-2 with differentiation to the double positive stage. Thymocytes regain Bcl-2
      during selection to a single positive state and retain Bcl-2 in the periphery.

PMID- 8360477
TI  - Involvement of IL-6 signal transducer gp130 in IL-11-mediated signal
      transduction.
AB  - IL-11 is a novel cytokine with a variety of biofunctions which overlap with those
      of IL-6. We have previously identified IL-11 specific binding protein which is
      distinct from that of IL-6 in a number of cell lines. The similarities in
      biofunctions and differences in ligand binding proteins between IL-11 and IL-6
      prompted us to investigate whether IL-11 shares common signal transduction
      mechanisms with IL-6. We have examined early signals triggered by IL-11 or IL-6
      in a multifactor-dependent human erythroleukemic cell line, TF-1. The results
      showed that IL-11 and IL-6 can both stimulate cell proliferation, induce similar
      pattern of protein tyrosine phosphorylation, and activate the same proto-oncogene
      (junB) expression in TF-1 cells. These findings imply that IL-11 and IL-6 share
      similar early signaling events with the possibility of using the same signal
      transducer, gp130. We next tested whether IL-11 induced signaling can be
      inhibited by anti-gp130 antibodies which blocked IL-6-mediated functions. It was
      observed that anti-gp130 antibodies abolished cell proliferation, protein
      tyrosine phosphorylation, and junB gene expression elicited by IL-11 or IL-6 in
      TF-1 cells. The same antibodies, however, had no effect on granulocyte-macrophage
      colony stimulating factor or erythropoietin-induced TF-1 cell proliferation.
      Finally, anti-IL-6R antibody inhibited the ability of IL-6, but not IL-11, to
      transduce early signals in TF-1 cells. These results demonstrate that IL-11 and
      IL-6 utilize different ligand binding proteins, but share common signal
      transducer, gp130, in TF-1 cells.

PMID- 8360478
TI  - Nonimmune macromolecular complexes of Ig in human gut lumen. Probable enhancement
      of antibody functions.
AB  - Protein Fv, a human sialoprotein recently described in the stools of patients
      suffering from liver diseases, binds the variable domain of H chains without
      impairing Ag binding. Normal subjects are shown here to secrete protein Fv under
      a hidden form, saturated with luminal Ig. In feces, the nonimmune complexes are
      essentially of 1800 and 800 kDa M(r); they contain protein Fv molecules bound
      with F(ab')2 fragments produced by cleavage of Secretory IgA during colonic
      transit. The 800-kDa complexes correspond to 6 molecules of F(ab')2 fragments
      bound to a sole protein Fv dimer. This was established by comparison with an in
      vitro-made complex having a valency of 6. Investigation of the role of protein Fv
      shows that in vitro addition of this free molecule to antivirus or to anti
      Salmonella typhi antibodies allows or augments agglutination of the corresponding
      pathogens. This property is of major interest for secretory antibodies because it
      favors their role in Ag conveyance in the mucus stream. It seems therefore that
      protein Fv is a novel key factor of the immune defense in gut.

PMID- 8360479
TI  - Characteristics of endogenous peptides eluted from the class I MHC molecule HLA
      B7 determined by mass spectrometry and computer modeling.
AB  - Microcapillary HPLC electrospray ionization tandem mass spectrometry was used to
      sequence 15 peptides eluted from HLA-B7. Sequence alignment implicated four
      peptide positions in specific interactions with the class I molecule, and their
      importance was confirmed using synthetic peptides. Because no crystal structure
      for HLA-B7 was available, computer-assisted modeling was used to understand novel
      aspects of peptide binding specificity and to accurately predict the effect of
      defined changes in peptide structure. The results demonstrate that mass
      spectrometric sequencing coupled with computer-assisted modeling can be used in
      the absence of a crystal structure to make accurate predictions concerning
      requirements for peptide binding to class I molecules. These techniques may be
      valuable to predict or engineer T cell epitopes.

PMID- 8360480
TI  - Coordinate silencing of myeloma-specific genes in myeloma x T lymphoma hybrids.
AB  - It has been well-established that Ig genes are transcriptionally silenced when Ig
      producing myeloma lines are fused to non-B cells. In the present study, we
      analyzed the expression of several other myeloma-specific genes in fusions of
      myelomas with the T lymphoma, BW5147. Seven of the eight genes analyzed behaved
      coordinately with the Ig loci; they were silent in most myeloma x T hybrids but
      active in the rare hybrid that retained Ig gene expression. Cloned IgH genes
      introduced into the two types of hybrids behaved as their endogenous
      counterparts. The coordinate behavior of these several genes in the panel of
      "exceptional" and "extinguished" hybrids suggests a central and bimodal switch
      for alternately activating and de-activating the genetic program of the Ig
      secreting plasmacyte. The switch between an active and an inactive
      transcriptional state involves, at some level, a change in the methylation status
      of the IgH genes. Methylation and transcriptional activity were inversely
      correlated. In Ig-extinguished hybrids the myeloma-derived locus was methylated
      de novo, whereas in the rare Ig-expressing hybrid, the T cell-derived locus was
      demethylated de novo.

PMID- 8360481
TI  - The soluble pool of beta 2-microglobulin free HLA class I alpha-chains.
      Qualitative and quantitative characterization.
AB  - Previous studies have demonstrated that HLA class I heterodimers are present in
      plasma and cell culture supernatants. They can be precipitated by mAb the binding
      of which is dependent on the proper association of the polymorphic alpha-chain
      with beta 2-microglobulin (beta 2-m). The molecular mass of the alpha-chain
      ranges from 45 to 35 kDa with a number of intermediate products. We report on the
      identification of 35-kDa soluble beta 2-m free HLA class I H chains
      immunoprecipitated by mAb LA45 from cell culture media of activated B and T
      cells. Furthermore, a peptide-based competitive immunosorbent assay was
      established to determine the amounts of soluble HLA class I alpha-chains. By
      means of this assay, we formally proved the specificity of mAb LA45 for a linear
      epitope on HLA class I H chains centered on residues arginine-asparagine at
      positions 62 and 63 of the alpha 1-domain. PHA or rIL-2 were identified as
      efficient stimuli for PBMC leading to the generation of soluble beta 2-m free HLA
      class I H chains. Testing of cell lines representing distinct stages of
      hematopoietic differentiation demonstrated a significant correlation between cell
      surface expression of beta 2-m free HLA class I H chains and amounts of soluble
      LA45 reactive molecules. However, three of six human T lymphotropic virus type I
      transfected cell lines, although expressing beta 2-m free H chains, do not
      generate soluble molecules. Finally, human sera were found to contain
      considerable amounts of beta 2-m free HLA class I H chains. The average amount of
      these molecules in sera of individuals with one positive LA45 allele was
      determined to be 46.9 +/- 38.6 nM/liter.

PMID- 8360482
TI  - Humanization of an antibody directed against IgE.
AB  - IgE antibodies bind to specific high-affinity receptors on mast cells, leading to
      mast cell degranulation and release of mediators, such as histamine, which
      produce symptoms associated with allergy. Hence, anti-IgE antibodies that block
      binding of IgE to its high-affinity receptor are of potential therapeutic value
      in the treatment of allergy. These antibodies must also not bind to IgE once it
      is bound to the receptor because this would trigger histamine release. This study
      describes the humanization of a murine antibody, MaE11, with these
      characteristics. Variants of the humanized antibody were evaluated to probe the
      importance of framework residues on antibody binding and to determine which
      charged residues in the CDR interacted with IgE. We found that only five changes
      in human framework residues were required to provide for binding comparable to
      that of the original murine antibody.

PMID- 8360483
TI  - Extraembryonic expression of the human MHC class I gene HLA-G in transgenic mice.
      Evidence for a positive regulatory region located 1 kilobase 5' to the start site
      of transcription.
AB  - Trophoblast, the only fetal tissue in direct contact with maternal cells, fails
      to express the polymorphic HLA class I molecules HLA-A and -B, but does express
      the nonpolymorphic class I molecule HLA-G. It is thought that HLA-G may provide
      some of the functions of a class I molecule without stimulating maternal immune
      rejection of the fetal semiallograft. As a first step in identifying the cis
      acting DNA regulatory elements involved in the control of class I expression by
      extraembryonic tissue, several types of transgenic mice were produced. Two HLA-G
      genomic fragments were used, 5.7 and 6.0 kb in length. These included the entire
      HLA-G coding region, 1 kb of 3' flanking sequence, and 1.2 or 1.4 kb of 5'
      flanking sequence, respectively. A hybrid transgene, HLA-A2/G, was produced by
      replacing the 5' flanking sequence, first exon, and early first intron of HLA-G
      with the corresponding elements of HLA-A. Comparison of transgene mRNA expression
      patterns seen in HLA-A2/G and HLA-G transgenic mice suggests that 5' flanking
      sequences are largely responsible for the differing patterns of expression
      typical of the classical class I and HLA-G genes. Studies comparing the
      extraembryonic HLA-G expression levels of founder embryos transgenic for either
      the 5.7- or 6.0-kb HLA-G transgene showed that the 6.0-kb transgene directed HLA
      G expression far more efficiently than did the 5.7-kb HLA-G transgene, producing
      extraembryonic HLA-G mRNA levels similar to those seen in human extraembryonic
      tissues. The results of these studies suggest that the 250-bp fragment present at
      the extreme 5' end of the 6.0-kb HLA-G transgene and absent from the 5.7-kb HLA-G
      transgene contains an important positive regulatory element. This 250-bp fragment
      lies further upstream than any of the previously documented class I regulatory
      regions and may function as a locus control region.

PMID- 8360484
TI  - Regulation of TL antigen expression. Analysis of the T18d promoter region and
      responses to IFN-gamma.
AB  - Type I (alpha/beta) and type II (gamma) IFN enhance MHC class I gene expression
      through an IFN-responsive element (IRE) present in the 5' flanking region of the
      class I-a genes. Comparison of the 5' sequences between classical class I-a genes
      and T region class I-b genes reveals little homology except for presence of a
      potential IRE. We have found that cell surface expression of thymus leukemia Ag
      (TL) was up-regulated by IFN-gamma to a greater extent than H-2K,D in all TL+ T
      cell lines tested. In contrast, IFN-alpha/beta, which significantly increased H
      2K and H-2D Ag expression, had only minor effects on TL expression. Resting
      peripheral T cells, which were considered to be TL- from previous studies, were
      found to express TL at a low level as determined by flow cytometry,
      immunoprecipitation, as well as polymerase chain reaction; the level of
      expression also could be elevated by IFN-gamma. To examine the control of TL gene
      transcription and its regulation by IFN-gamma, varying lengths of the T18d 5'
      flanking region were analyzed in chloramphenicol acetyl transferase assays. By
      deletion analysis, promoter activity and IFN-gamma responsiveness were localized
      to an 86-bp fragment that contains the IRE. Both responses were localized further
      to a 32-bp fragment that contained the IRE at its 3' end. RNase protection assays
      revealed two major transcription initiation sites, one immediately 5' of the IRE
      and another approximately 60 bp downstream. Furthermore, polymerase chain
      reaction analysis of mRNA from resting T cells, thymocytes, and T cell tumor
      lines confirmed the RNase protection data. Thus, transcription of T18d initiates
      much further upstream than the classical class I genes, can utilize an unusual
      promoter element, and can be elevated by IFN-gamma.

PMID- 8360485
TI  - IL-8 produced by human malignant melanoma cells in vitro is an essential
      autocrine growth factor.
AB  - Normal melanocytes require a number of exogenous growth factors in contrast to
      most metastatic malignant melanomas. This investigation demonstrates that
      endogenously produced human IL-8 can act as an important growth factor for human
      melanoma cells. In the present study, six out of eight human melanoma cell lines
      tested secrete IL-8 protein into the culture supernatant. In two of these IL-8
      secreting melanoma cell lines, SK-MEL 13 and SK-MEL 23, we have determined the IL
      8 requirement for their proliferative capacity. These melanoma cell lines
      produced significant amounts of bioactive IL-8 as measured by the ELISA
      technique. Secretion of human IL-8 was inducible by IL-1 and by PMA. Human IL-8
      specific mRNA was already detected in unstimulated melanoma cells. In addition,
      human IL-8-R mRNA could be detected for the first time in human melanoma cells.
      Exposure of the two melanoma cell lines in vitro to antisense oligonucleotides
      targeted against two different sites of human IL-8 mRNA-inhibited cell
      proliferation, colony formation in soft agar, and secretion of IL-8 protein into
      culture supernatant in a dose dependent fashion. Effects were reversible either
      by removal of the oligomers or by addition of exogenous IL-8 protein. In
      contrast, exposure to IL-8 sense probes or oligonucleotides in sense or antisense
      orientation specific for IL-7, TGF-alpha, TGF-beta, and MGSA had no such effect.
      A monospecific immune serum and two IL-8-specific mAb were also capable of
      inhibiting melanoma cell proliferation in the same manner. These results provide
      strong evidence for an autocrine IL-8 synthesis and for an IL-8-dependent
      proliferation in a subgroup of human melanomas. Furthermore, they suggest that IL
      8 may play a role not only in immunomodulation but also in melanoma progression
      and metastatic spread.

PMID- 8360486
TI  - Analysis of human skin mast cell proteins by two-dimensional gel electrophoresis.
      Identification of tryptase as a sialylated glycoprotein.
AB  - Proteins of mast cells purified from human foreskin were separated by 2-D
      polyacrylamide gel electrophoresis using either nonequilibrium pH gradient
      electrophoresis or isoelectric focusing in the first dimension and SDS-PAGE in
      the second dimension. Silver staining showed that a major feature of skin mast
      cell 2-D protein maps was a variety of relatively abundant proteins in the m.w.
      range of 29 to 37 kDa and covering a broad pH range from 5.0 to 8.5. Tryptase was
      identified on Western blots of 2-D-separated proteins by its binding of mAb and
      of 3H-diisopropylfluorophosphate. The precise distribution of tryptase varied
      among individuals but this protein generally occupied a continuum of molecular
      weights between 28 and 37 kDa and ranged in isoelectric point between 5.0 and
      6.5. Tryptase was one of a number of mast cell proteins that bound the lectin
      concanavalin A as well as lectins specific for sialic acid, demonstrating that
      this enzyme is a sialylated glycoprotein. The diffuse m.w. distribution of skin
      mast cell tryptase (31 to 36 kDa) observed after SDS-PAGE was reduced to a single
      band of 30 kDa after treatment with protein-N-glycosidase F to remove asparagine
      linked oligosaccharides. This finding suggests that intrinsic m.w. heterogeneity
      of tryptase in skin mast cells is largely a result of the addition of variable
      amounts of oligosaccharide to the tryptase polypeptide.

PMID- 8360487
TI  - IL-2 up-regulates but IFN-gamma suppresses IL-8 expression in human monocytes.
AB  - IL-2 has pleiotropic properties and is a potent activator of monocytic functions.
      Since monocytes are an important source of the chemoattractant cytokine IL-8, we
      studied the effects of IL-2 on the expression of IL-8 in human monocytes. IL-8
      mRNA expression was detectable in resting human monocytes. Treatment of monocytes
      with IL-2 increased IL-8 mRNA expression by a protein synthesis-independent
      process. The augmentation of IL-8 mRNA by IL-2 was associated with an increase in
      IL-8 secretion. The expression of IL-8 mRNA was not a nonspecific response to any
      stimulus of monocyte activation. In fact, IFN-gamma, which is also a potent
      monocyte activator, not only failed to induce IL-8 expression but inhibited the
      stimulation of IL-8 by IL-2. Nuclear run-on experiments demonstrated that both
      the enhancement of IL-8 mRNA expression and its down-regulation by IFN-gamma
      occurred at the transcriptional level. These results show for the first time that
      in fresh human monocytes, IL-8 expression is differentially regulated by IL-2 and
      IFN-gamma and suggest that the interactions among IL-2, IL-8, and IFN-gamma may
      be important for the development and control of the inflammatory response.

PMID- 8360488
TI  - Transcriptional down-regulation of tumor necrosis factor-alpha gene expression by
      a synthetic peptide homologous to retroviral envelope protein.
AB  - We have previously shown that a synthetic peptide (CKS-17) homologous to
      retroviral envelope protein suppresses the accumulation of superantigen
      staphylococcal enterotoxin-induced TNF-alpha mRNA in human PBMC and in highly
      purified human monocytes. The present study was designed to examine the
      underlying mechanism(s) by which CKS-17 down-regulates the TNF-alpha mRNA
      expression using a human acute monocytic leukemia cell line THP-1 stimulated with
      the superantigen staphylococcal enterotoxin E. A cyclooxygenase inhibitor
      indomethacin does not reverse the inhibition of TNF-alpha mRNA expression by CKS
      17, suggesting that prostaglandins are not responsible for the suppressive action
      of CKS-17. The inhibitory effect of CKS-17 is, however, significantly blocked by
      a protein synthesis inhibitor cycloheximide, indicating that CKS-17 requires de
      novo protein synthesis to induce the suppressive activity. The mRNA stability
      assays using actinomycin D show that CKS-17 does not decrease the TNF-alpha mRNA
      stability. Nuclear run-on transcription assays further reveal that CKS-17
      suppresses the TNF-alpha mRNA transcription rate. Taken together, these results
      suggest that the synthetic retroviral peptide CKS-17 down-regulates TNF-alpha
      mRNA expression through inhibition of transcriptional activation of the TNF-alpha
      gene, which requires de novo synthesis of a transcriptional repressor protein(s).

PMID- 8360489
TI  - Particle opsonization and lung macrophage cytokine response. In vitro and in vivo
      analysis.
AB  - Inhaled inert particles and organisms cause a spectrum of pulmonary responses,
      ranging from minimal changes to marked acute inflammation. During ingestion and
      clearance of such particles, alveolar macrophages (AM) can initiate pulmonary
      inflammation by production of TNF and neutrophil chemoattractant cytokines. We
      tested the role of opsonization in determining the AM response to ingestion of
      inert particles in vitro and in vivo. As measures of AM activation after
      phagocytosis in vitro, we measured release of TNF and mRNA expression for the
      platelet-factor 4 family neutrophil chemoattractants, KC and macrophage
      inflammatory protein-2 (MIP-2). Using albumin-coated fluorescent latex particle
      as phagocytic targets, we found a marked release of TNF by AM ingesting particles
      opsonized with antialbumin IgG, although uptake of similar numbers of unopsonized
      particles caused little or no release (e.g., 4648 +/- 1147 pg/ml, opsonized beads
      vs 576 +/- 205 unopsonized, 10:1 particle:cell ratio, n = 4, mean +/- SD). Flow
      cytometry confirmed equal uptake of the two particle types. Northern analysis of
      AM mRNA showed marked induction of KC and MIP-2 mRNA after ingestion of opsonized
      particles only. Instillation of opsonized particles into hamster lungs caused a
      marked neutrophil influx, although unopsonized particles did not. TNF was
      elevated in lavage fluid after instillation of opsonized particles, but not after
      unopsonized beads (92.7 +/- 136 pg/ml opsonized, n = 7 vs 1.3 +/- 3.6
      unopsonized, n = 6). KC and MIP-2 mRNA were induced in lavaged cells after
      instillation of opsonized but not after unopsonized particles or vehicle control.
      The nature of particle interaction with the AM surface during phagocytosis
      determines the subsequent AM response. Although many unopsonized inert particles
      are ingested with minimal AM activation, specific opsonization of pathogens or
      non-specific adsorption of Ig onto other particles may activate AM and lead to
      pulmonary inflammation.

PMID- 8360490
TI  - Effects of subunit mutation on the localization to coated pits and
      internalization of cross-linked IgE-receptor complexes.
AB  - IgE receptors of mast cells, Fc epsilon RI, localize to coated pits and
      internalize after cross-linking. We investigated whether any one of the
      receptor's four distinctive cytoplasmic domains regulates these phenomena. COS
      cells, which lack Fc epsilon RI entirely, and P815 mouse mastocytoma cells that
      lack the alpha and beta subunits of the tetrameric Fc epsilon RI (alpha beta
      gamma 2), were transfected with wild-type, incomplete, or variant Fc epsilon RI.
      IgE-receptor complexes were observed by electron microscopy. Before cross-linking
      with anti-IgE gold particles, receptors were not preferentially localized to
      coated pits, which occupy approximately 1% of the cell surface. After cross
      linking, up to 10 to 20% of the wild-type and most other receptor variants were
      in coated pits in transfected P815 cells at any one time. beta-less variants
      localized normally but, surprisingly, receptors containing a variant beta subunit
      showed reduced localization. "Receptors" consisting simply of the lipid-anchored
      ectodomains of the human alpha subunit failed to localize to coated pits. In
      general, cross-linked receptors that localized to coated pits were progressively
      internalized, whereas receptors that failed to accumulate in coated pits were
      not. We conclude that no single cytoplasmic domain of the Fc epsilon RI uniquely
      controls its ligand-induced localization to coated pits and internalization.

PMID- 8360491
TI  - Human mononuclear phagocytes express adenosine A1 receptors. A novel mechanism
      for differential regulation of Fc gamma receptor function.
AB  - Using monoclonal anti-adenosine A1 receptor antibodies that bind the A1 receptor
      ligand binding site, we demonstrate that A1 receptors are expressed on cultured
      monocytes and rheumatoid synovial fluid mononuclear phagocytes. This finding is
      associated with the acquisition of reactivity with selective adenosine A1
      receptor agonists and is temporally coordinated with the induction of adenosine
      A2 receptors on cultured monocytes. In a rapid, concentration-dependent fashion,
      these two distinct adenosine receptors modulate Fc gamma receptor-mediated
      phagocytosis, a response critical to the pathogenesis of immune complex diseases.
      Occupancy of A1 receptors by N6-cyclopentyladenosine (an A1-specific adenosine
      analogue) or mAb AA1 (an anti-A1 mAb) results in a potent stimulation that is
      blocked by adenosine receptor antagonists. This A1 receptor-induced enhancement
      of Fc gamma receptor-mediated phagocytosis is a consequence of preferential
      augmentation of Fc gamma RI function, suggesting distinct mechanisms for receptor
      effector coupling of Fc gamma receptor families. In contrast, ligation of A2
      receptors by A2-specific agonists decreases Fc gamma receptor-mediated
      phagocytosis in cultured monocytes. The opposing effects of adenosine A1 and A2
      receptors allow for a concentration-dependent feed-back loop that responds more
      rapidly than effects elicited by other endogenous modulators. Low concentrations
      of adenosine are proinflammatory providing enhanced Fc gamma receptor function
      via A1 receptors, whereas higher concentrations that can occur with tissue damage
      are anti-inflammatory providing inhibition via A2 receptors. This rapid and
      potent modulation of Fc gamma receptor-mediated function suggests that adenosine
      is an important local regulator of the inflammatory response.

PMID- 8360492
TI  - Synergism between human monocyte chemotactic and activating factor and bacterial
      products for activation of tumoricidal properties in murine macrophages.
AB  - Chemotactic factors regulate the recruitment of monocytes-macrophages to
      inflammatory sites and neoplastic tissues. The purpose of this study was to
      determine whether MCAF also influences the activation of C3H/HeN macrophages to
      become tumoricidal. Several metastatic and nonmetastatic clones of the K-1735
      murine melanoma cells syngeneic to C3H/HeN mice were transfected with expression
      vectors containing the human MCAF gene or control DNA. Tumor cells producing high
      levels of MCAF were significantly lysed by macrophages treated with LPS, whereas
      parental or control transfected cells were not. Control-activated macrophages
      incubated with both IFN-gamma and LPS lysed all the melanoma cells regardless of
      MCAF production. Pretreatment of macrophages with MCAF significantly enhanced
      their response to low concentrations of LPS, muramyl tripeptide, and a synthetic
      bacterial LPP, as measured by lysis of murine melanoma cells. These data suggest
      that in addition to being a chemotactic factor, MCAF can prime macrophages to
      respond to endotoxins and other bacterial products and therefore may regulate
      several levels of macrophage-tumor interactions in situ.

PMID- 8360493
TI  - Conversion of vitamin D3 binding protein (group-specific component) to a
      macrophage activating factor by the stepwise action of beta-galactosidase of B
      cells and sialidase of T cells.
AB  - Highly conserved DBP (human DBP is known as Gc) of serum alpha 2-globulin
      fraction can be converted to a potent macrophage activating factor by stepwise
      modification of Gc glycoprotein with beta-galactosidase of B cells and sialidase
      of T cells. These glycosidases, beta-galactosidase and sialidase, are membrane
      bound and not soluble in culture medium. Thus, consecutive contact of Gc protein
      with B cells and T cells, presumably via specific receptors, is required for
      conversion of Gc glycoprotein to the macrophage activating factor. The essential
      role of T cell sialidase in macrophage activation was confirmed by the finding
      that peritoneal nonadherent cells of SM/J mouse, whose T cells are deficient in
      sialidase activity, were unable to convert Gc protein to the macrophage
      activating factor and thus did not activate macrophages. Treatment with sialidase
      of a conditioned medium of lipid metabolite-treated SM/J mouse nonadherent cells
      efficiently generated the macrophage activating factor. When Gc protein was first
      treated with soluble or immobilized sialidase and used in a medium for 2 h
      cultivation of lipid metabolite-treated SM/J mouse nonadherent cells or BALB/c
      mouse B cells, the resultant conditioned media contained a large amount of the
      macrophage activating factor. These results support the hypothesis that Gc
      protein carries a dibranched trisaccharide with galactose and sialic acid
      termini.

PMID- 8360494
TI  - Differential expression of H-2K and H-2D in the central nervous system of mice
      infected with Theiler's virus.
AB  - A model of demyelination induced by Theiler's murine encephalomyelitis virus
      (TMEV) was used to study differential regulation of class I MHC gene products in
      the brain and spinal cord of resistant (B10) and susceptible (B10.Q and B10.RBQ)
      mice. Allelic polymorphisms in the H-2D region, but not the H-2K region, play a
      primary role in determining susceptibility to late demyelinating disease.
      However, even though significant structural diversity distinguishes class I
      alleles, there are no discernible K or D-specific patterns of structural
      diversity within the peptide binding domains of these glycoproteins. Our
      hypothesis was that D region association of susceptibility to demyelination was
      related to differences in the expression of the K and D Ag in the central nervous
      system (CNS) after TMEV infection. Using allele-specific mAb and an
      immunoperoxidase technique, we demonstrated transient but equivalent increases in
      K and D Ag expression in the brain and spinal cord of resistant mice beginning 7
      days after TMEV infection, which returned to baseline by 90 days. However, when
      genetically susceptible animals were examined, a significantly greater increase
      in D expression relative to K expression was seen in the brain and spinal cord at
      all post-infection observation periods. Immunosuppression of genetically
      resistant animals before TMEV infection, which results in viral persistence, was
      accompanied by equivalent increases in both the K and D Ag. Depletion of CD8+ T
      cells, but not CD4+ T cells, in susceptible mice ablated class I expression in
      the CNS in response to TMEV infection, implying that CD8+ cells contribute to the
      differential regulation of K and D Ag in the CNS. These findings are consistent
      with the hypothesis that differences in gene regulation may account for different
      roles of the K and D loci play in determining resistance and susceptibility to
      TMEV-induced demyelinating disease.

PMID- 8360495
TI  - High affinity, thyroid-specific human autoantibodies displayed on the surface of
      filamentous phage use V genes similar to other autoantibodies.
AB  - Autoantibodies to thyroid peroxidase (TPO) are characteristic of thyroid
      inflammation in autoimmune thyroid disease. We have used the phage display, H and
      L chain combinatorial cDNA library approach to clone, from thyroid-infiltrating B
      cells, six new human Fab autoantibodies with high affinities (approximately 10(
      10) M) for TPO. This library, in the pComb3 vector, was screened with viable,
      stably transfected Chinese hamster ovary cells expressing human TPO on their
      surface. The H and L chain genes in the six TPO-specific Fab were similar, but
      not identical, to those encoding Fab previously isolated from the same library by
      screening bacteriophage plaques in the Immunozap vector with purified TPO. The
      TPO-specific VK genes isolated with the phage display system are closer to
      germline than those obtained with Immunozap. Essentially all the V kappa isolated
      with pComb3 were 99 or 100% homologous with the germ-line genes KL012 and A3 that
      also code for low affinity systemic autoantibodies. There are two important
      implications of the study. First, the phage display system can be used with
      impure Ag to generate high affinity autoantibodies. This finding opens the way to
      cloning autoantibodies against other autoantigens, not previously possible with
      the bacteriophage lambda approach because of the lack of purified Ag. Second,
      germ-line L chain genes can code for very high affinity antibodies.

PMID- 8360497
TI  - Induction of antibodies to a kappa V region by gene immunization.
AB  - Direct gene transfer into muscle can lead to sustained gene expression at the
      injected sites. Here we tested the ability of in vivo gene transfection to
      immunize mice against an isolated human IgV region. The Humkv325 germline kappa L
      chain V gene encodes the kappa L chain in V regions of several human IgM
      autoantibodies and is used frequently in chronic lymphocytic leukemia. This gene
      was inserted into a mammalian expression vector, pREP7, to produce pREVk3. Mice
      injected i.m. with pREVk3 produced antibodies against the V region of Glo, a
      human monoclonal IgM paraprotein whose kappa L chain is encoded by Humkv325. Co
      injection of an expression vector encoding IL-2 enhanced anti-Glo antibody
      production fivefold and induced a localized delayed hypersensitivity reaction.
      Antibody production also was induced when vectors encoding Humkv325 and IL-2 were
      injected s.c. These experiments demonstrate that gene immunization vectors can
      stimulate immune responses to antibody V region determinants.

PMID- 8360498
TI  - Nomenclature for T-cell receptor (TCR) gene segments of the immune system. WHO
      IUIS Nomenclature Sub-Committee on TCR Designation.
AB  - The recommended procedures and criteria for T-cell receptor (TCR) designations
      are described. The officially adopted designations are for the TCR A, B, D and G
      loci and for V, D, J and C segments.

PMID- 8360496
TI  - Macrophage inflammatory protein-1 alpha expression in interstitial lung disease.
AB  - Mononuclear phagocyte (M phi) recruitment and activation is a hallmark of a
      number of chronic inflammatory diseases of the lung, including sarcoidosis and
      idiopathic pulmonary fibrosis (IPF). We hypothesized that macrophage inflammatory
      protein-1 (MIP-1 alpha), a peptide with leukocyte activating and chemotactic
      properties, may play an important role in mediating many of the cellular changes
      that occur in sarcoidosis and IPF. In initial experiments, we demonstrated that
      human rMIP-1 alpha exerted chemotactic activities toward both polymorphonuclear
      leukocytes and monocytes, and these activities were inhibited by treatment with
      rabbit anti-human MIP-1 alpha antiserum. In support of the potential role of MIP
      1 alpha in interstitial lung disease, we detected MIP-1 alpha in the
      bronchoalveolar lavage fluid of 22/23 patients with sarcoidosis (mean 443 +/- 76
      pg/ml) and 9/9 patients with IPF (mean 427 +/- 81 pg/ml), whereas detectable MIP
      1 alpha was found in only 1/7 healthy subjects (mean 64 +/- 64 pg/ml). In
      addition, we found a 2.5- and 1.8-fold increase in monocyte chemotactic activity
      in BALF obtained from patients with sarcoidosis and IPF respectively, as compared
      to healthy subjects, and this monocyte chemotactic activity, but not neutrophil
      chemotactic activity, was reduced by approximately 22% when bronchoalveolar
      lavage fluid from sarcoidosis and IPF patients were preincubated with rabbit
      antihuman MIP-1 alpha antibodies. To determine the cellular source(s) of MIP-1
      alpha within the lung, we performed immunohistochemical analysis of
      bronchoalveolar lavage cell pellets, transbronchial biopsies, and open lung
      biopsies obtained from patients with IPF and sarcoidosis. Substantial expression
      of cell-associated MIP-1 alpha was detected in M phi, including both alveolar AM
      phi and interstitial M phi. In addition, interstitial fibroblasts within biopsies
      obtained from sarcoid and IPF patients also expressed immunoreactive MIP-1 alpha.
      Minimal to no detectable MIP-1 alpha was expressed in alveolar M phi from healthy
      subjects or interstitial cells in lung biopsy specimens obtained from patients
      undergoing thoracotomy for malignancy. Furthermore, pulmonary fibroblasts
      isolated from patients with IPF produced greater amounts of MIP-1 alpha after
      challenge with IL-1 beta than did similarly treated pulmonary fibroblasts
      recovered from patients without fibrotic lung disease. Our findings suggest that
      MIP-1 alpha is expressed in increased amounts within the airspace and
      interstitium of patients with sarcoidosis and IPF, and that this cytokine may be
      an important mediator of both M phi activation and recruitment that characterize
      these disease states.

PMID- 8360499
TI  - Microtiter plate assay for measuring the anticomplementary activity of
      immunoglobulins.
AB  - An anticomplementary activity (ACA) assay on a microtiter plate combined with a
      computer-controlled plate reader and computerized calculation of the assay result
      is described. The assay is a simplified version of existing ones and can be used
      to assay immunoglobulins at low protein concentrations. The method detects the
      consumption of 0.13 CH50U, corresponding to anticomplementary activity of 7.5
      CH50U/g protein. The assay has a coefficient of variation of 20.4%.

PMID- 8360500
TI  - Purification of murine Kupffer cells by centrifugal elutriation.
AB  - Procedures to reproducibly obtain pure preparations of murine Kupffer cells are
      described. Pure Kupffer cell preparations obtained following collagenase
      digestion, metrizamide separation and centrifugal elutriation remained viable and
      maintained their phagocytic functions for at least 4-5 days in vitro.
      Furthermore, we determined the feasibility of extracting RNA from Kupffer cells
      obtained immediately following elutriation and after 2 and 4 days of culture in
      vitro. These RNA extracts were used to determine the level of cytokine gene
      expression in Kupffer cells.

PMID- 8360501
TI  - Problems and pitfalls with measurement of antibody affinity using solid phase
      binding in the ELISA.
AB  - Current methods of estimation of antibody affinity constants using ELISA assume
      homogeneous binding of antibody to the solid phase, despite many reports in the
      literature that this is not true. I have derived theoretical antibody binding
      curves for solid phase antigen assuming homogeneous antibody binding. I have
      compared these curves with a set of experimental binding curves of monoclonal
      antibodies to the serum protein fibronectin. The results conclusively show that
      while some monoclonal antibodies behave as predicted by theory, others show
      departures from homogeneous binding which can be explained by various surface
      effects. I have discussed how these surface effects can cause errors in estimates
      of either liquid phase or solid phase affinities using the ELISA, and have
      demonstrated the limitations of methods of affinity ranking.

PMID- 8360503
TI  - Enzyme release assay of human NK cell activity using beta-galactosidase
      expressing K562 target cell line.
AB  - In the present report, we established a K562 cell line useful for an enzyme
      release assay of human natural killer (NK) activity. Human myelogenous leukemia
      cell line, K562, was transfected with a plasmid carrying Escherichia coli beta
      galactosidase (beta-gal) gene. A colony that permanently expresses the enzyme
      activity was isolated, and designated K562/Zneo. Incubation of K562/Zneo cells (1
      x 10(4)) with nonadherent human peripheral blood lymphocytes (PBL) resulted in
      the release of beta-gal activity depending on the incubation time and the number
      of effector cells. Released beta-gal activity was assayed sensitively by using 4
      methylumbelliferyl-beta-D-galactoside, a fluorescent substrate. The cytolytic
      activity of PBL was augmented significantly when the cells were preincubated with
      interleukin-2 for 20 h. This enzyme release assay showed a comparable sensitivity
      to that of 51Cr release assay. Thus, K562/Zneo cell line is thought to be useful
      for the nonradioactive assay of human NK and lymphokine-activated killer
      activities.

PMID- 8360502
TI  - A modified enzyme-linked immunosorbent assay for measuring type-specific anti
      pneumococcal capsular polysaccharide antibodies.
AB  - We have developed an ELISA for antibody determination, superior to others
      hitherto described, in which optimal coating is achieved using phenylated
      pneumococcal capsular polysaccharides as coating antigen. The specificity of the
      assay is ensured by complete inhibition of antibodies against the species
      specific pneumococcal antigen, C-polysaccharide (C-Ps). The method is sensitive,
      specific, reproducible, fast and easy to work with and can be used for both
      immunoglobulin class and subclass antibody determinations.

PMID- 8360504
TI  - Flow cytometric analysis of cellular DNA content. An alternative approach for the
      identification and quantitation of xenogeneic cells engrafted in SCID mice.

PMID- 8360505
TI  - On the purification of IgG from egg yolk.

PMID- 8360506
TI  - A new method for determining anti-B cell antibodies and their specificity using
      flow cytometry.
AB  - We describe a new flow cytometric B cell crossmatch method with improved
      sensitivity and specificity. It is based on the coating of B cell surface
      immunoglobulins with an unconjugated polyvalent anti-human immunoglobulin
      antibody. The method also provides a means for determining the specificity of
      anti-B cell antibodies and, potentially, for anti-HLA class II antibody
      specificity differentiation (DR, DQ or DP) in a binding inhibition test using
      mouse monoclonal antibodies directed against human HLA class II antigens.

PMID- 8360507
TI  - Direct double antibody sandwich immunoassay for Pseudomonas aeruginosa elastase.
AB  - A direct sandwich enzyme immunoassay was developed in order to quantify
      Pseudomonas aeruginosa elastase. As a solid phase the wells of a microtitre plate
      were coated with specific IgG and horseradish peroxidase labelled IgG was used as
      the second antibody. The detection limit of the assay was 0.26 ng/ml and a good
      agreement was found with elastolytic activity determined using elastin-Congo red.
      This assay was simple, specific, sensitive and reproducible, and permits the
      determination of low levels of elastase.

PMID- 8360508
TI  - Purification of antibodies using protein L-binding framework structures in the
      light chain variable domain.
AB  - Protein L from the bacterial species Peptostreptococcus magnus binds specifically
      to the variable domain of Ig light chains, without interfering with the antigen
      binding site. In this work a genetically engineered fragment of protein L,
      including four of the repeated Ig-binding repeat units, was employed for the
      purification of Ig from various sources. Thus, IgG, IgM, and IgA were purified
      from human and mouse serum in a single step using protein L-Sepharose affinity
      chromatography. Moreover, human and mouse monoclonal IgG, IgM, and IgA, and human
      IgG Fab fragments, as well as a mouse/human chimeric recombinant antibody, could
      be purified from cultures of hybridoma cells or antibody-producing bacterial
      cells, with protein L-Sepharose. This was also the case with a humanized mouse
      antibody, in which mouse hypervariable antigen-binding regions had been
      introduced into a protein L-binding kappa subtype III human IgG. These
      experiments demonstrate that it is possible to engineer antibodies and antibody
      fragments (Fab, Fv) with protein L-binding framework regions, which can then be
      utilized in a protein L-based purification protocol.

PMID- 8360509
TI  - A novel, sensitive bioassay for transforming growth factor beta.
AB  - We have developed a simple, sensitive bioassay for transforming growth factors
      beta 1 and beta 2 (TGF-beta 1 and TGF-beta 2) based on the ability of these
      cytokines to inhibit the interleukin-5 induced proliferation of the
      erythroleukaemia cell line, TF-1. This assay is rapid, reproducible and sensitive
      to less than 500 fg/ml of TGF-beta 1, and 5-10 pg/ml TGF-beta 2. The assay is 100
      1000-fold less sensitive to other inhibitory molecules such as interferon-beta,
      interferon-gamma and TNF-alpha. The assay can be made specific for TGF-beta 1 or
      TGF-beta 2 by including specific neutralising antibodies for TGF-beta 1 or TGF
      beta 2. The assay can recognise all the readily available recombinant molecular
      species of these molecules as well as the natural proteins produced from human
      and bovine platelets and detects TGF-beta in serum samples.

PMID- 8360510
TI  - 51Cr-labeled human hepatocytes as target cells for cytotoxicity mediated by
      freshly isolated liver-infiltrating lymphocytes.
AB  - Previous studies on lymphocyte cytotoxicity against autologous human hepatocytes
      had been studied using Terasaki plates, in which dead hepatocytes after
      incubation with lymphocytes were counted visually. No studies with 51Cr-labeled
      human hepatocytes as targets have been reported, although it can give us more
      objective results. In the present study, we established procedures for labeling
      human hepatocytes with 51Cr and for measuring cytotoxicity of freshly isolated
      liver-infiltrating lymphocytes (LIL) against 51Cr-labeled human autologous
      hepatocytes. Hepatocytes were isolated from diseased and 'normal' liver tissues,
      cultured overnight, and labeled with 51Cr 'in situ' in the wells of 96-well round
      bottom plates. Human hepatocytes isolated from either 'normal' or diseased liver
      tissues labeled well with 51Cr, and mean spontaneous 51Cr release was less than
      15% in the presence of 5% fetal bovine serum or human AB serum. Freshly isolated
      LIL obtained from chronic viral hepatitis but not from other liver diseases
      showed cytotoxicity against 51Cr-labeled autologous hepatocytes in 4 h 51Cr
      release assays, and the percent specific lysis was linearly related to the E:T
      cell ratio. LIL from viral hepatitis were able to mediate natural killer (NK)
      activity against K562 targets, lymphokine-activated killer-like activity against
      Daudi cells, and lectin-dependent cellular cytotoxicity. Two-color flow cytometry
      analysis showed that these LIL contained both CD3+ T cells and CD3-CD56+ NK
      cells. This is the first report which examined the cytotoxicity of liver
      infiltrating lymphocytes against 51Cr-labeled human hepatocytes, and it will be
      useful in assessing local immune response against autologous hepatocytes in
      chronic liver diseases.

PMID- 8360511
TI  - Application of the ILISPOT-IDIP system for the enumeration of different sizes of
      IgA spot forming cells in the murine small and large intestine.
AB  - The immunofluorescence-linked immunospot (ILISPOT) assay associated with the
      immunofluorescence digital image processing (IDIP) system was originally
      developed in our laboratory to allow enumeration of immunoglobulin (Ig)
      producing, spot forming cells (SFC) in a more objective and quantitative manner.
      In this study, the ILISPOT-IDIP system was further advanced in order to analyze
      different sizes of SFC (e.g., IgA producing cells) including large (L), medium
      (M), and small (S) cells which correspond to high (> 2.4 pg), medium (1.2-2.4 pg)
      and low (< 1.2 pg) IgA secreting cells by the adaptation of real time image
      processor and intensified video camera system. When the ILISPOT-IDIP system was
      used to characterize the frequency of IgA secreting cells among mononuclear cells
      isolated from different parts of the murine gastrointestinal (GI) tract including
      the small (upper, middle and lower sections) and large (colon and rectum)
      intestine, the small intestine contained higher numbers of IgA SFC (approximately
      8.4 x 10(5) SFC/10(6) cells) when compared with large intestine (approximately
      1.3 x 10(5) SFC/10(6) cells). Among the 3 areas of small intestine, the upper
      (approximately 3.7 x 10(5) SFC/10(6) cells) and middle (approximately 2.4 x 10(5)
      SFC/10(6) cells) parts had higher numbers of IgA SFC when compared to the lower
      small (approximately 2.3 x 10(5) SFC/10(6) cells) intestine. When these IgA
      producing cells in different parts of the intestine were classified into three
      groups according to the size of individual spots, the upper and middle intestine
      contained higher frequencies of large (approximately 20%) and medium
      (approximately 20%) SFC which corresponded to high and medium IgA secretors in
      comparison to the lower small (approximately 9%) and large (approximately 6%)
      intestine. In contrast, the lower small and large intestine were dominated by
      small SFC since approximately 85% of IgA producing cells were categorized as low
      secretors. Using the advanced ILISPOT-IDIP system, a unique distribution of
      different sizes (or secretion rates) of IgA producing SFC was elucidated in the
      different regions of the mouse small and large intestine.

PMID- 8360512
TI  - Specificity and sensitivity of polymerase chain reaction (PCR) in comparison with
      other methods for the detection of mycoplasma contamination in cell lines.
AB  - The polymerase chain reaction (PCR) amplification was used for the detection of
      mycoplasma contamination in 42 continuous cell lines. Using the microbiological
      cultivation on agar as the reference method, 29 cell lines were regarded as
      positive and 13 cell lines as negative. The double-step PCR analysis employed
      nested primers that anneal to gene sequences coding for the evolutionarily
      conserved 16 S rRNA of some 25 different mycoplasma species (including the ones
      most commonly found in cell cultures). In terms of the positivity or negativity
      of mycoplasma infection the results were identical for the agar assay and PCR
      amplification. All positive cell lines displayed distinct, unequivocal,
      objectively discernible bands on agarose gels while the non-infected specimens
      showed no DNA amplification. A simultaneously performed comparison with four
      other commonly used detection methods (DNA-RNA hybridization in solution, DAPI
      DNA fluorescence staining, immunostaining with a monoclonal antibody and an
      ELISA) showed that PCR produced significantly less false-negative or false
      positive results than all the other methods. Furthermore, in dilution
      experiments, PCR correctly detected the infecting mycoplasmas at the lowest level
      of 1/10(4) whereas the other assays were less sensitive. It is concluded that
      double-step PCR employing nested primers is superior to other mycoplasma
      detection methods in many respects: simplicity and speed, high specificity and
      extreme sensitivity, objectivity and accuracy.

PMID- 8360513
TI  - The expression of an adhesion-related protein by clam hemocytes.
AB  - Molluscs have circulating cells in the hemolymph which are both adherent and
      phagocytic. Mya arenaria, the soft-shell clam, is particularly interesting
      because it develops a leukemia detected first in the hemolymph and, as the
      disease progresses, in solid tissue. We have previously described a leukemia
      specific protein (Miosky et al., 1989) identified by murine monoclonal antibodies
      generated to pure populations of leukemia cells. In the following work, a
      monoclonal antibody was generated to normal hemocytes of Mya. The antibody,
      designated 2A4, was evaluated by ELISA, immunocytochemistry, Western blotting,
      and flow cytometry. The 2A4 antigen was detected on 87% normal adherent cells.
      However, 2A4 was lost as leukemia cells proliferated. The mature leukemia cell,
      which is nonadherent, neither expresses 2A4 nor can 2A4 be detected in the
      leukemia cell lystate. Western blot analyses reveal that 2A4 reacts with a 130
      kDa protein. Our data suggest that p130 may be involved in the regulation of cell
      adhesion.

PMID- 8360514
TI  - Use of synthetic peptides to probe functional domains of a Bacillus thuringiensis
      toxin.
AB  - Two 10-residue peptides exhibiting sequence homology to CryIA(a) toxin were
      chemically synthesized. One corresponds to a segment from residues 48-57 (peptide
      A) and is common to all CryIA toxins and the second corresponds to a segment from
      residues 348-357 (peptide B) and is specific to the CryIA(a) toxin. Antibodies
      were raised in rabbits against both peptides. Antipeptide A did not protect
      either Bombyx mori or Choristoneura fumiferana larvae against CryIA(a) toxin.
      However, antipeptide B offered significant protection to B. mori and somewhat
      less protection to C. fumiferana larvae. Neither antiserum interfered with the
      binding of CryIA(a) toxin to brush border membrane vesicles of either insect. The
      results suggest that the segment from residues 348-357 in CryIA(a) toxin is
      important for expression of toxicity in both insects but not for binding.

PMID- 8360515
TI  - [Detection and identification of HBV DNA and DNA subtypes of HBs-antigen by the
      use of the polymerase chain reaction and non-radioactive probes].
AB  - A technique of nested polymerase chain reaction (PCR) and hybridization with non
      radioactive probes was developed for the detection and identification of HBV DNA
      and HBs-subtypes in very small volumes of human sera. Four oligonucleotide
      primers (20 mer) complementary to DNA sequences in the S region of HBV and probes
      (18 or 20 mer) conjugated to alkaline phosphatase were used for the present PCR
      assay. The results of the PCR assay coincide with those of enzyme immunoassay
      (EIA) in 14 HBe-positive and 59 HBe-negative samples with 98.6% of specificity.
      The HBV subtypes adr and adw were identified using an 18-mer DNA probe in 30
      samples with an accuracy of 100%. Further, the DNA subtypes were clearly
      demonstrated in 3 samples where HBs-antigen was undetectable. These results
      indicate that amplification of HBV DNAs by PCR and their detection with non
      radioactive probes is a reliable tool for diagnosis of HBV infection in clinical
      laboratories.

PMID- 8360517
TI  - Capnocytophaga sputigena bacteremia associated with acute leukemia.
AB  - During a three-year period, Capnocytophaga sputigena bacteremia occurred in three
      patients with acute leukemia receiving induction therapy on a hematology ward.
      Oral pathology such as periodontitis or severe mucositis was considered to be the
      most likely source of bacteremia. All three blood culture isolates were
      identified as that species by deoxyribonucleic acid (DNA) homology studies.
      Because of the phenotypical similarity of Capnocytophaga species, it is difficult
      to differentiate them by conventional bacteriological methods. All three isolates
      were susceptible to antibiotics active against most anaerobes. However,
      production of beta-lactamase was found in two isolates, one of which proved
      resistant to both piperacillin and ceftazidime. Therefore, the empiric use of
      imipenem or clindamycin may be justified in febrile granulocytopenic patients
      with cancer who develop significant oral lesions.

PMID- 8360516
TI  - [In vitro and clinical studies of MRSA infections in compromised hosts].
AB  - From January to December 1991, 47 clinical cases in when methicillin-resistant
      Staphylococcus aureus (MRSA) strains were isolate were investigated at our
      internal medicine ward. The MRSA infection rate was 57.4% (27/47). The mortality
      due to MRSA bacteremia was 75.0% (9/12) and that due to MRSA pneumonia was 57.1%
      (4/7). We think that MRSA infections must be treated by multiple antibiotics. At
      out institution, most of the patients were given a combination therapy of
      imipenem + fosfomycin or imipenemt + mynocycline. Although in vitro the MICs of
      imipenem did not show excellent activity against MRSA strains, in vivo these
      combination therapy including imipenem showed excellent activity against MRSA
      infections. We think that this result was due to the additive effect of the two
      drug combination. We determined the MICs of single antibiotics against MRSA
      strains. Most of the MRSA strains were sensitive to minocycline and arbekacin.
      All MRSA strains were sensitive to vancomycin we think that vancomycin is a
      highly useful drug to combat MRSA infection.

PMID- 8360518
TI  - [Effect of the passage and storage of strains, and inoculum size on the change of
      zone pattern types and sizes produced by protease of methicillin resistant
      Staphylococcus aureus].
AB  - Protease produced by Staphylococcus aureus precipitates digests of casein in
      standard methods caseinate agar (SMCA) plate, and the various sizes of A to E
      precipitation types were produced depending on strains of inoculated
      Staphylococcus aureus, as previously reported. To evaluate these phenomena for
      epidemiological use, we investigated the effects of bacterial passage, storage
      and dosage on zonal pattern and the size of precipitation rings. Methicillin
      resistant Staphylococcus aureus (MRSA) was found to produce variable types and
      sizes of precipitation rings depending upon the inoculated strains. After 5, 30
      and 50 passages in heart infusion broth (HIB), each of the strains randomly
      selected from MRSA strains showed that the precipitation pattern of A to E
      produced the same types and sizes of precipitation rings. The storage effects
      were assessed by comparing those strains in different storage time. The strain
      stored for 1 and 3 years at room temperature in HIB contained 0.8% agar produced
      the same pattern of precipitation rings at that of the freshly isolated one.
      Finally, the dosage of inoculated bacteria was examined. Overnight broth (HIB)
      cultures of MRSA were directly inoculated in SMCA plates, and were found to
      produce almost the same size of precipitation rings (reproducible within 3 mm).
      These findings indicated that protease digestion on SMCA plate provides a rapid,
      sensitive, and specific assay that can supplement the currently available
      modalities for typing of MRSA strains.

PMID- 8360519
TI  - [Etiology of pediatric inpatients with pneumonia].
AB  - The etiology of acute pneumonia was studied in 596 pediatric inpatients at Chiba
      Municipal Kaihin Hospital between January 1990 and December 1991. A pathogen was
      identified in 389 (64.4%) episodes of pneumonia. Evidence of bacterial infection
      was present in 167 (28.8%) episodes, viral infection in 178 (29.9%) and
      Mycoplasma pneumoniae infection in 89 (14.9%). The major bacterial pathogens were
      H. influenzae 117 (19.6%), S. pneumoniae 51 (8.6%), M (B). catarrhalis 24 (4.0%).
      RS virus was the most common respiratory virus. The peak age of the patients was
      7 months to 2 years old. For bacterial pneumonia, the highest rates occurred in
      infants. Mycoplasma pneumonia produced the highest rates in school-age children.
      Mycoplasma pneumonia was prevalent at two distinct times, the first emerging in
      the spring of 1990 and emerging again in the autumn of 1991. RS virus and
      influenza virus epidemics occur during the winter. Most of the parainfluenza
      virus have been observed during the early summer season.

PMID- 8360520
TI  - Bacterial flora detected of the uterine endometrial cavity of diabetic patients
      with myoma uteri.
AB  - Patients with diabetes frequently suffer from various postoperative
      complications, especially infection. Diabetic patients also have a high incidence
      of uterine endometrial cancer. The nature of the intrauterine bacterial flora may
      be related to both infection and carcinogenesis. Therefore, identification of the
      intrauterine bacterial flora in diabetic patients may be useful. Bacteria were
      detected in the uterine endometrial cavity of 100% of ten diabetic patients with
      myoma uteri. However, among 20 non-diabetic control patients with myoma uteri,
      only three 15% harbored bacteria. Members of the Enterobacteriaceae (Escherichia
      coli, Proteus spp., Enterobacter cloacae, and Klebsiella pneumoniae) were the
      predominant bacteria. We speculate that bacterial products contribute to
      carcinogenesis, as has been proposed for colon carcinoma. Antimicrobial agents
      active against Enterobacteriaceae should be used to prevent postoperative
      infections in gynecologic procedures in diabetic patients.

PMID- 8360521
TI  - Macrophages in the urine in acute bacterial cystitis.
AB  - In the previous study in this series of studies concerning the role of
      macrophages in urinary tract infection, we attempted to detect macrophages in the
      urine of acute bacterial cystitis patients by nonspecific esterase staining of
      urinary sediment, however none of the leukocytes stained, probably because of
      cell damage caused by the urine and by centrifugation. In the present study,
      detection of macrophages in urine was again attempted, this time by prompt
      transfer of urinary leukocytes to culture medium after minimum centrifugation, 1
      hr culture in a glass bottom chamber and non-specific staining of leukocytes
      adhering to glass. Macrophages in urine were detected by this method, and they
      comprised 5.9% of the adherent leukocytes, although macrophage spreading, which
      implies macrophage activation and is often seen in the early stage of
      nonbacterial prostatitis, was hardly ever observed. The percentages of adherent
      leukocytes were not correlated with urine osmolarity, probably because the effect
      of urine was minimized by prompt transfer of urinary leukocytes to culture medium
      after the urine samples had been collected. There have been quite few studies
      involving culture of urinary leukocytes in the past. Our simple techniques, such
      as prompt transfer of urinary leukocytes to culture medium after centrifuging
      with minimum gravity and for a minimum period of time, appear to be useful in the
      study of urinary leukocytes using other cells which appear in urinary tract
      infection, as well as cytokines and antibiotics, to clarify cellular mechanisms
      of defenses in urinary tract infection.

PMID- 8360522
TI  - [Study of bacterial flora in the stomach and the upper and lower respiratory
      tracts--the mechanism of lower respiratory tract infection].
AB  - To evaluate the mechanism of lower respiratory tract infection in the hospital,
      gastric juice, throat secretions, secretions in tracheal cannulae or tubes and
      aspirated sputum were cultured simultaneously in seven patients with tracheostomy
      and seven patients with tracheal intubation. Thirty-six strains of bacteria were
      isolated from gastric juice and only 22.2% of them were the same bacteria as
      those in the throat secretions. This suggested that there was little correlation
      between gastric and oropharyngeal flora. The bacteria isolated from throat
      secretions and aspirated sputum showed 38.5% coincidence in tracheostomized
      patients and 80% coincidence in intubated patients. In addition, the rate of
      agreement was 33.3% in tracheostomized patients and 88.9% in intubated patients
      between throat secretions and tracheal cannulae or tubes. These findings
      suggested that the correlation of bacterial flora between the upper and lower
      respiratory tracts was high in intubated patients and low in tracheostomized
      patients. Identical bacteria in the stomach and the upper and lower respiratory
      tracts (which may cause nosocomial infection) were isolated in only four of the
      14 patients. It has been suggested that bacterial flora in the lower respiratory
      tract are transmitted from the stomach to the oropharynx and then cause lower
      respiratory tract infection in hospital. However, our study suggested that this
      was not a common pathogenic mechanism.

PMID- 8360523
TI  - [Clinical study of patients with deep-seated fungal infection associated with
      hematological diseases].
AB  - An assessment has been made regarding usefulness of measuring beta-D-glucan (beta
      glucan) as fungal serodiagnosis in 50 cases of fungal infection with
      hematological diseases. Further, an assessment has been made regarding relation
      between hematological findings and therapeutic effect by administering
      miconazole, an antifungal agent (MCZ: Florid, clinically to the subjects.
      Positivity of beta-glucan (beta-glucan > or = 10 pg/ml) was observed in 54.5%
      (24/44), and the effective rate of MCZ in the positive cases was 75.0% (18/24).
      In the cases in whom fungus was detected, beta-glucan-positive rate was 50.0%
      (8/16), and MCZ-effective rate in beta-glucan-positive cases was 62.5% (5/8). The
      total effective rate of MCZ was 80% (40/50). Side effects were observed in 3
      cases, but continual administration of MCZ was possible in all of the 3 cases. By
      the assessment regarding the relation between hematological findings and
      therapeutic effect of MCZ, it was found that the effective rates in the cases who
      underwent a transition with neutrophil and lymphocyte counts less than
      500/microliters during the period of MCZ administration were 64.7% (11/17) and
      50% (5/10), respectively, and large effects were observed in the cases who
      underwent a transition with the neutrophil and lymphocyte counts more than
      500/microliters was 86.7% (19/22) and 91.7% (22/24), respectively. These results
      suggested that lymphocytes rather than neutrophils had an important role in the
      morbidity of fungal infection. It was noteworthy that MCZ was effective for the
      treatment of deep seated mycosis and significant effective rate was obtained in
      the group of patients who had neutrophils and lymphocytes less than
      500/microliters.

PMID- 8360524
TI  - [A case of brain abscess due to Streptococcus sanguis in association with
      multiple pulmonary arteriovenous fistulas].
AB  - A case is reported here of brain abscess due to Streptococcus sanguis in
      association with multiple pulmonary arteriovenous fistulas. A 19-year-old male
      who had been diagnosed in 1988 as pulmonary arteriovenous fistulas was admitted
      to our hospital for repeated epistaxis, headache, and vomiting. A brain abscess
      which was diagnosed using various roentogenologic examinations, worsened despite
      conservative therapy. Additional surgical drainage was performed; S. sanguis was
      isolated from the drainage fluid. After drainage, clinical symptoms gradually
      improved with no subsequent neurological deficits. We have formulated the
      following hypothesis regarding the mechanism of abscess formation in this case:
      S. sanguis invaded from a ruptured nasomucosal vein, forming a septic emboli in
      the blood flow, which passed through a pulmonary arteriovenous shunt and led to
      the formation of a brain abscess which established a metastatic presence in the
      cerebral tissue.

PMID- 8360525
TI  - [Assessment of left ventricular contraction with LV Emax during cardiopulmonary
      bypass in patients with open heart surgery].
AB  - There are few reports on the assessment of left ventricular contraction during
      cardiopulmonary bypass (CPB) in open heart surgery. LV Emax is thought to be a
      load-independent index of left ventricular function. We used a left ventricular
      conductance catheter to measure LV Emax from "non-working beating heart" during
      CPB in 16 patients who underwent open heart surgery. During CPB, at 45 minutes
      after aortic declamping, changes of heart rate with atrial pacing (120/min) did
      not change LV Emax, but after intravenous dobutamine administration (DOB, 10
      micrograms/kg/min) LV Emax increased by 26% (p < 0.01). DOB increased LV Emax in
      14 of 16 patients during CPB. These 14 patients were weaned from CPB without
      difficulty. But in 2 other patients DOB didn't increase LV Emax during CPB. In
      order to be weaned from CPB, the two patients needed epinephrine and intraaortic
      balloon pumping. We concluded that change of LV Emax made by intravenous
      administration of dobutamine is one of useful indexes to assess left ventricular
      contractility during cardiopulmonary bypass.

PMID- 8360527
TI  - [Local resection of pulmonary lesions by Nd-YAG laser without suturing].
AB  - Local excision of 67 pulmonary lesions in 5 patients was performed with the Nd
      YAG laser. There were 2 women and 3 men with an average age of 68 years. The
      patients consisted of three cases of metastatic lung cancer (65 lesions), one
      hamartoma (One lesion) and one organized pneumonitis (one lesion). The lesion was
      first enucleated by a contact method using an Nd-YAG laser scalpel, then the
      crater of the resected lesion in the normal lung tissue was coagulated with a
      defocused laser beam. The craters of 52 of the 67 resected lesions which were
      shallow seated in the lung were left open, but the other 15 resected lesions were
      closed with sutures. Total blood loss was less than 100 ml. There was no bleeding
      or air leakage (30 cm water pressure) during the post operative days in 4 of the
      5 patients, but one patients (one lesion) had to be treated by bronchoscopic
      endobronchial embolization against a persistent air leak. This lesion was 2.5 cm
      in diameter and 4 cm deep in the lung on CT. The other lesions were also measured
      by CT. The tumor size was 1.4 +/- 0.7 cm and the depth was 2.4 +/- 1.0 cm. The Nd
      YAG laser is very suitable for local resection of peripheral lung lesions without
      suturing.

PMID- 8360526
TI  - [Risk factors and therapeutic methods for sternal wound infection following
      cardiac surgery].
AB  - In a study of 1040 patients undergoing cardiac surgery at The Osaka Medical
      College Hospital from 1984 through 1991, we analyzed the correlation between a
      variety of preoperative and operative parameters and the risk of postoperative
      sternal wound infection, as well as the efficacy of various therapeutic method
      for this condition. Sternal infection or mediastinitis developed after cardiac
      surgery in 31 patients (3.0%). As the risk factors for wound infections, age,
      diabetes mellitus, reexploration, duration of cardiopulmonary bypass and use of
      bilateral internal thoracic artery grafting were listed. Application of pectoral
      muscle flaps significantly led to shorten a duration between diagnosis of
      infection and hospital discharge, and increased survival rate, than the other
      treating methods such as debridement or irrigation. We conclude that bilateral
      internal thoracic artery grafts should not be used in the cases with diabetes,
      and closure with pectoral muscle flaps is effective for sternal infection and
      mediastinitis.

PMID- 8360528
TI  - [Pathological assessments of allografts after heart transplantation using a dog
      model--allograft vasculopathy].
AB  - The pathological findings of allografts after heart transplantation were assessed
      in long-term period using a dog model. Eight orthotopic heart transplantations
      were performed with cross-circulation method using a dog. Two dogs survived over
      1 year after heart transplantation. One dog died due to cardiac rejection, and
      the another dog died due to infection at 14 months and 16 months after the
      transplantation, respectively. The coronary artery morphologic features were
      assessed in the allografts. The pathological findings showed fibrous intimal
      thickening with infiltration of lymphocytes and macrophages. And it was diffusely
      distributed to each area of transplanted heart. The stenosis of coronary lumen
      was significantly seen in middle size of coronary arteries which was from 100
      microns to 50 microns. The characteristics of these findings in comparison with
      arteriosclerosis change were 1) rapid progression, 2) diffuse fibrous intimal
      thickening, 3) preserved internal elastic lamia. These findings might be
      important for treating this complication.

PMID- 8360529
TI  - [Late results and problems after atrial switch operation].
AB  - Between 1970 and June 1992, 137 consecutive patients with transposition of the
      great arteries and double outlet right ventricle underwent an atrial switch
      operation at the Heart Institute of Japan. They included 74 patients with a
      Senning operation (Group I) and 63 patients with a Mustard operation (Group II).
      Ages at operation ranged from 1 month to 15 years (average 25.7 months) and
      follow-up period in 114 operative survivors ranged from 1 month to 22 years
      (average 6.8 years in the Senning group, 10.9 years in the Mustard group). Twelve
      year actuarial survival rate was 90.1% in Group I and 64.1% in Group II, and 22
      year actuarial survival rate was 64.1% in Group II. There were 6 and 13 late
      deaths in group I and group II, respectively. Sudden Death occurred in 7 patients
      in the late postoperative period presumably due to arrhythmias, although there
      were no symptoms and signs of arrhythmias in 4 of the 7 patients. Five other
      patients died from cardiac failure in the late postoperative period. Ninety-two
      percent of group I and seventy-one percent of group II maintained normal sinus
      rhythm evaluated by the electrocardiogram and Holter's electrocardiogram in the
      late postoperative period. Mean PQ interval in the late postoperative period was
      0.14 +/- 0.03 seconds in group I and 0.17 +/- 0.03 seconds in group II; Group II
      had a higher incidence of arrhythmias than group I.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8360530
TI  - [Pathologic changes at the coronary artery-bypass graft anastomosis--an
      immunocytochemical study].
AB  - We have performed immunocytochemical investigations on proliferative tissues
      observed in anastomotic sites of the saphenous vein aortocoronary bypass grafts
      to the coronary arteries. Nine anastomotic sites were obtained from 5 necropsy
      patients who had died after bypass grafting. Interval between the operation and
      death in these patients varied from 5 days to 9 months. The anastomotic sites
      were fixed in methanol-Carnoy's fixative, and embedded in paraffin. Six
      monoclonal antibodies specific for muscle cell actin (HHF35), smooth muscle cell
      actin (CGA7), vimentin, desmin, macrophages (HAM56) and endothelial cells were
      used for the immunocytochemical study. Of the 9 anastomotic sites, 4 were totally
      occluded, while the remaining 5 were patent. The occluded sites were
      characterized by a presence of fresh or organized thrombus. Immunocytochemically,
      the latter was composed of macrophages, smooth muscle cells and
      neovascularization. In contrast, a patent site at 5 days after grafting showed an
      early stage of intimal proliferation composed of macrophages and spindle-shaped
      cells. Two patent sites at 33 days after grafting revealed a distinct intimal
      thickening consisting almost entirely of smooth muscle cells. At this stage,
      smooth muscle cells at a deeper intima were stained positive with both HHF35 and
      CGA7, whereas the cells at the luminal site were stained positive with HHF35 but
      negative with CGA7. In older lesion at 9 months after grafting, almost all smooth
      muscle cells within intimal thickening showed positive with HHF35 and CGA7.
      Moreover, these smooth muscle cells were stained positive with vimentin but were
      negative with desmin, irrespective of the lesion's age.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8360531
TI  - [Peritoneal dialysis following open heart surgery in children].
AB  - From 1982 to 1991, 13 (3.9%) of 336 children who underwent open heart surgery
      required peritoneal dialysis postoperatively, including 5 with transposition of
      the great arteries, 4 with tetralogy of Fallot, 2 with ventricular septal defect,
      1 each with atrioventricular canal defects and total anomalous pulmonary venous
      connection. Patients ages ranged from 12 days to 4 years (mean, 1 year and 4
      months). The infusion catheter was directed toward diaphragm from the right lower
      quadrant, and the drainage catheter was placed in the pelvis from the left upper
      quadrant. Dialysis solution was instilled and drained simultaneously. Seven
      children (54%) recovered renal function, with six (46%) longterm survivors.
      Differences between patients who did and did not recovered renal function (Group
      A and Group B respectively) were examined. No significant intergroup difference
      existed in age or weight. PD was initiated significantly sooner in Group B (1.2
      +/- 0.8 days) than in Group A (3.2 +/- 1.9 days) (p < 0.05). The negative fluid
      balance was 88.0 +/- 31 mL/kg/day in Group A and 78.4 +/- 25.0 mL/kd/day (NS).
      BUN and serum creatinine concentrations were slightly elevated in both group, but
      were not significant different. Patients in Group A were dialyzed from 3 days to
      21 days (mean 9.9 +/- 6.4 days), and patients in Group B were dialyzed from 1 day
      to 14 days (mean 5.3 +/- 5.2 days) (NS). The central venous pressure (CVP) in
      Group A decreased while blood pressure (BP) and renal perfusion pressure (RPP)
      increased following initiation of PD. CVP increased in Group B, while BP and RPP
      decreased. All patients died of low cardiac output syndrome.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8360532
TI  - [Effectiveness of continuous retrograde cerebral perfusion for surgical treatment
      of aneurysms of the aortic arch--comparison with antegrade cerebral perfusion].
AB  - Several methods have been used for an adjunct to perform operation of aortic arch
      aneurysms. However, their results were often not so reasonable. Recently
      retrograde cerebral perfusion was reported as a new adjunctive method. In our
      institute, for the past 6 and a half years from May 1985 to April 1992, 50
      patients underwent reconstruction of the transverse aortic arch by using two
      methods of artificial cerebral perfusion. One method is continuous antegrade
      cerebral perfusion (ACP, for 32 patients), and the other is continuous retrograde
      cerebral perfusion (RCP, for 18 patients), each technique was combined with deep
      hypothermia (18-20 degrees C) and low flow perfusion (10-30 ml/kg/min) to lower
      half body performed from femoral artery. In our RCP circuit, an additional pump
      was used for cerebral perfusion to superior vena cava, but the circuit was much
      simpler than the circuit in ACP. We compared the two methods (ACP versus RCP) as
      regards to the following items and the results were showed in parentheses;
      hospital death (8/32, 25%: 2/18, 11%), respiratory complication (8.27, 30%: 3/18,
      17%), neurological complication (7/29, 24%: 1/18, 5.5%), duration of
      extracorporeal circulation (306.8 +/- 74.5 min: 260.4 +/- 60.0 min), periods of
      pre-ECC in the operation (160.3 +/- 69.2 min: 117.7 +/- 35.3 min), duration of
      cerebral perfusion (113.6 +/- 45.4 min: 74.1 30.5 min) and amount of bleeding
      (3424 +/- 2881 ml: 1802 +/- 1291 ml). RCP has superior advantages in all of those
      in comparison with ACP. These results suggest that RCP is a useful adjunctive
      method for reconstruction of aortic arch with a low operative risk.

PMID- 8360533
TI  - [Aortic valve replacement for narrow aortic ostium, supraannular insertion at
      noncoronary sinus with Bjrk-Shiley valve].
AB  - Fifteen patients with small aortic annuli underwent aortic valve replacement
      either isolated or combined with other procedures. All patients had aortic valve
      replacement with Bjork-Shiley prosthesis larger than the aortic annulus. The
      prosthesis was sutured in a supraannular position in the area corresponding to
      the noncoronary sinus. There was no hospital and late death. In the long term
      follow up, 21 mm prosthetic gradients by doppler method ranged from 17 to 43
      (29.9 +/- 7.3) mmHg in patients with supraannular aortic valve replacement and
      from 20 to 45 (27.4 +/- 7.1) mmHg in patients with standard aortic valve
      replacement, which showed statistically no significant difference. Because this
      technique allows the insertion of prosthetic valves one sizes larger than the
      size of aortic annulus, it will produce stable hemodynamic result. As a
      consequence, those procedure such as transannular patch reconstruction will be
      avoided.

PMID- 8360534
TI  - [Cell viability assessment of cold-preserved (4 degrees C) and cryopreserved (
      196 degrees C) allograft valves by flowcytometric analysis].
AB  - We introduced cryopreservation technique to store the allograft valve and
      subsequently commenced the use of the cryopreserved aortic allograft valve for
      aortic valve replacement. For the clinical use of the allograft valve, it is
      essential to evaluate the cell viability. We assessed cell viability of the
      allograft valve by flowcytometry (FCM), using a fluorescein diacetate (FDA)
      propidium iodide (PI) stain. Pulmonary allograft valves were harvested from the
      cadavers with a consent. Of the 9 valves collected and sterilized in 4 degrees C
      antibiotic solution for 48 hours, 4 valves were stored under refrigeration (cold
      preserved), and the remaining 5 valves were cryopreserved. The warm ischemic time
      from cardiac death to valve preservation was 7.3 +/- 5.4 hours. The cold
      preserved valves were stored at 4 degrees C in the nutrient medium (TC-199, calf
      serum and HEPES buffer). The cryopreserved valves were frozen by a programmable
      freezer to -80 degrees C in the same nutrient medium containing 10%
      dimethylsulfoxide (DMSO), and subsequently stored in liquid nitrogen (-196
      degrees C). We assessed the cell viability of the allograft valve leaflet, before
      storage and at 2 weeks, 1 month and 2 months after the storage. Suspensions of
      the valve leaflet fibroblasts were double-stained with FDA (1 micrograms/ml) and
      PI (1 microgram/ml) for flowcytometric analysis of the viable cells (cells
      showing a chromatic response to FDA but no response to PI). In the cold-preserved
      group, percentage of the viable cell was 90.3 +/- 3.6% before storage, 62.0 +/-
      3.0% after 1 month of storage, and 50.3 +/- 3.7% after 2 months of
      storage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360536
TI  - [Study on prevention of paraplegia during occlusion blockade of the thoracic
      aorta--examination of the evoked potential in the motor nerve induced by
      stimulation of the motor area of cerebral cortex].
AB  - In an attempt to trace the motor neurons in the descending tract of the motor
      system of the spinal cord and anterior horn, we have succeeded in inducing a
      potential in the peripheral motor nerve (evoked motor nerve action potential:
      EMNAP) by stimulating the motor area of the cerebral cortex in dogs, we have
      examined the characteristics of this potential. Besides the EMNAP, we have
      induced the conventional somatosensory evoked potential (SSEP) and evoked spinal
      cord potential (ESCP) during spinal ischemia. These are compared with each other,
      with theoretical predictions and with pathological findings. EMNAP possessed a
      biphasic negative potential (N1, N2) and subsequent multiphasic potential (N3+n)
      during the latency 10-18 msec. The stimulation threshold of EMNAP in the lower
      limbs was the lowest near the longitudinal fissure in the anterior part of the
      cerebral crucial groove. The amplitude of N2 and N3+n of EMNAP decreased under
      the condition of frequent stimulation. N2 and N3+n did not disappear after the
      dorsal root was severed. When the three potentials of EMNAP, SSEP, and ESCP were
      simultaneously induced, the left subclavian artery was occluded, the descending
      aorta was partially occluded immediately under the bifurcation of this artery,
      and the pressure of the partially occluded periphery was gradually reduced, EMNAP
      alone disappeared at 45.2 +/- 6.2 mmHg. Although ESCP and SSEP did not disappear
      even when partial occluding was continued for 90 minutes under this condition,
      histopathological findings obtained by formalin perfusion fixation showed
      ischemic disorder of the anterior horn cells when compared with the normal group
      fixed in the same way. EMNAP was considered to be induced through the alpha
      motoneuron in the anterior horn of the spinal cord, and disappeared under the
      critical ischemia in which ESCP and SSEP do not disappear. Disorder of the
      anterior horn cells were also observed histopathologically. Direct monitoring of
      the alpha-motoneuron in the anterior horn, which is most susceptible to
      disorders, seems appropriate as a method for preventing paraplegia. EMNAP may be
      useful for monitoring motor function of the spinal cord not only during chest
      surgery but also for other types of diagnosis and treatment.

PMID- 8360535
TI  - [Surgical treatment of type A aortic dissection combined with aortic root
      lesions].
AB  - From January 1980 to December 1992, 36 patients with type A aortic dissection
      were operated on at the St. Marianna University Hospital. Hospital mortality and
      10-year survival rate in 26 patients (Group I and II) undergoing replacement of
      the ascending aorta with or without hemi-arch resection (including one case of
      aortic wrapping for the closing dissection) were 19.2% and 88.0%, respectively.
      Among the patients having aortic root destructions due to acute aortic dissection
      or preexisting annuloaortic ectasia (Group III), 8 patients underwent aortic root
      reconstruction with a valved conduit and 2 patients supra-coronary aortic
      resection and graft replacement with concomitant coronary artery bypass grafting
      with 20.0% of hospital mortality and 55.6% of 10-year cumulative survival rate.
      Modified Bentall operation using Carrel patch method seems to be preferable to
      avoid postoperative complications for the case with intimal tear extending to the
      aortic sinuses, ruptured outer layer of the aortic root or preexisting AAE. If
      the disrupted coronary artery is concerned, coronary artery bypass grafting is
      mandatory. In the case of replacement of the ascending aorta for the dissection
      extending to the aortic sinuses, complete obliteration of the proximal false
      lumen must be required to avoid uncontrollable bleeding and compromised coronary
      blood flow.

PMID- 8360537
TI  - [Quantitative assessment of fibroblast viability in cryopreserved aortic valve
      allografts].
AB  - The purpose of this study is to clarify whether serum (fetal bovine serum or
      human serum) is necessary or not for cryopreservation of aortic valve allografts.
      The protective effects of fetal bovine serum compared with human serum were
      evaluated by means of quantitative assessment of fibroblast viability. Porcine
      aortic valves were excised and rinsed immediately after death, followed by
      treatment with low concentration antibiotics. Valves were gradually frozen at a
      control-rate of -1 degree C/min and then stored in liquid nitrogen vapor-phase.
      The samples were classified into three groups by nutrient medium as follows.
      Group A (n = 5); Dulbecco's Modified Eagle Medium (DMEM), Group B (n = 5); DMEM
      containing 10% fetal bovine serum, Group C (n = 5); DMEM containing 20% human
      serum. At 1 week, 1 month, and 3 months after initiation of storage, the valves
      were thawed rapidly and examined for fibroblast viability, which was assessed
      quantitatively by means of autoradiography with tritiated proline. After 1 week
      storage, the fibroblast viability rate reduced from 98% to 80.7% in group A,
      79.4% in group B and 79.2% in group C respectively, but there were no significant
      differences among three groups. The viability rate decreased with the passage of
      time, and remained around 72% in all groups after 3 months storage. The
      histological examination did not show any changes in the structure of the valves
      in all samples up to 3 months of storage. The results demonstrate that the
      fibroblasts are still viable after 3 months storage by cryopreservation. The
      addition of fetal bovine serum or human serum does not improve fibroblast
      viability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360538
TI  - [Experimental study on the hydrodynamic performance of "valved pericardial
      roll"].
AB  - Optimal configuration and hydrodynamic performance of "Valved Pericardial Roll
      (VPR)" as an external conduit was studied using a mock circulatory system which
      was able to simulate a right cardiac function of infants. Results were as
      follows: 1) Cardiac output produced by VPR was consistently higher than that by
      non valved pericardial roll. This result showed the hemodynamic effectiveness of
      VPR at early stage of operation. 2) Cardiac output by VPR tended to decreased as
      an elevation of afterload and/or an increment of pulse rate. This result
      exhibited that VPR had a comparable performance to the Ionescu-Sihley pericardial
      valve, a satisfactory performance of which was recognized clinically. 3) The
      optimal configuration related to the length of valve leaflet (LVL) were obtained
      from the simulation data. VPR with two leaflets produced the best performance
      when each LVL was design to be 95% of the roll diameter. Among the VPR with three
      leaflets, the best LVL was 85%. Thus far, VPR which was developed based on the
      above fundamental studies, indicated satisfactory performance as compared to the
      conventional surgical treatment.

PMID- 8360540
TI  - [A case report of aortic valve and VSD Dacron patch infective endocarditis after
      VSD patch closure 15 years ago].
AB  - A 39-year-old man who had undergone the patch closure of the VSD 15 years ago,
      was admitted with a diagnosis of infective endocarditis due to Alcaligenes
      Xylosoxidans. Echocardiography revealed vegetation of the aortic valve and a high
      echoic lesion on the ventricular septum. Surgical findings showed vegetation of
      the aortic valve and a subannular type mycotic aneurysm. In the aneurysm, the
      infected pledget used in a previous surgery was found. After debridement, direct
      closure of the aneurysm, aortic valve replacement (AVR) using a #25 SJM
      prosthetic valve, and mitral annuloplasty were performed. Two months later, fever
      developed. The patient was diagnosed with prosthetic valve endocarditis and a
      second surgery was performed. The prosthetic valve was clear, but an infected
      Dacron patch used for VSD closure 15 years earlier was found. Debridement, patch
      closure of the ventricular septum, and re-AVR were performed. The post-operative
      course was uneventful. This is thought to be a rare case, because infection
      extended from the aortic valve to the VSD type II Dacron patch, and remained to
      the VSD type II Dacron patch.

PMID- 8360539
TI  - [Efficacy of myocardial preservation using GIK solution for prolonged ischemic
      heart].
AB  - The efficacy of myocardial preservation using GIK solution combined with
      continuous cold blood perfusion was assessed in patients with prolonged ischemia.
      Fifteen patients receiving more than 4 hours' ischemia were divided into two
      groups. In Group A, seven patients were associated with severe aortic
      regurgitation and showed increased left ventricular volume of more than 60 mm in
      LVDd and 45 mm in LVDs. In Group B, eight patients had a normal left ventricular
      volume of less than 60 mm in LVDd and 45 mm in LVDs echocardiographically. There
      was no significant difference in ischemic time, or preoperative hemodynamic
      parameters between the two groups. The postoperative cardiac index was 2.93 +/-
      0.87 in Group A and 4.3 +/- 0.8 in Group B (p < 0.01). The postoperative
      shortening fraction was 0.17 +/- 0.01 in Group A, 0.43 +/- 0.12 in Group B (p <
      0.01). These parameters significantly deteriorated in Group A compared to Group
      B. Released enzymes (GOT, CK-MB) were significantly increased in Group A with
      prolonged ischemic time. In conclusion, postoperative cardiac function after 4
      hours' ischemia using GIK solution deteriorated in the patients with a dilated
      heart due to aortic regurgitation.

PMID- 8360541
TI  - [Reexpansion pulmonary edema after removal of a huge localized mesothelioma].
AB  - A 70-year-old female with hypoglycemia was admitted to our hospital for
      progressive dyspnea. In chest X-ray film, a mass occupied two thirds of the left
      hemi-thorax followed by the right shift of the mediastinum. Thoracotomy revealed
      that a huge tumor grew from the left upper lobe and the diaphragm without
      invasion. The resected tumor was 2550 g in weight. Histological diagnosis was
      benign fibrous mesothelioma. A large amount of expectoration started soon after
      the resection of the tumor. Measurement of protein in tracheal fluid and serum
      revealed that the event resulted from the reexpansion of the left lung after the
      huge mass removal. The patient recovered from pulmonary edema followed by steroid
      administration and respiratory management. We consider that it is useful to
      measure the protein in tracheal fluid and serum for diagnosis of reexpansion
      pulmonary edema.

PMID- 8360542
TI  - [A case of thymoma associated with hypogammaglobulinemia].
AB  - In this paper, we report a case of thymoma associated with hypogammaglobulinemia,
      a relatively rare disorder. The case involved a 79-year-old man, who was told,
      following the diagnosis of an upper respiratory tract infection, that he had a
      tumor shadow in the anterior mediastinum. A preoperative examination revealed
      hypogammaglobulinemia. An extended thymectomy was performed. The tumor that was
      removed was found to be a noninvasive spindle cell thymoma. After three years of
      postoperative treatment, no tumor recurrence was observed. The
      hypogammaglobulinemia, however, did not improve, and the subject suffered from
      repeated occurrences of pneumonia.

PMID- 8360543
TI  - [A case of left atrial myxoma with acute myocardial infarction--emergency
      coronary artery bypass grafting and removal of left atrial myxoma].
AB  - A 68-year-old woman had clinical signs of an acute myocardial infarction.
      Echocardiography revealed a tumor in the left atrium. Coronary angiography
      demonstrated total occlusion at RCA#1. On emergency operation a left atrial
      myxoma was removed and aortocoronary saphenous vein graft to the right coronary
      artery was performed. The operative correction of coronary arterial obstruction
      due to cardiac myxoma or thrombus is rare.

PMID- 8360544
TI  - [A case report of redo Fontan operation].
AB  - A 21-year-old man, who had undergone Fontan operation for tricuspid atresia type
      1b using 21 mm Hancock valved conduit 15 years ago, had right sided heart failure
      when his heart rhythm turned to atrial fibrillation. On cardiac catheterization,
      pressure data revealed that trans valved conduit pressure gradient reached to 5.2
      mmHg. Chest CT and right atrial angiography showed right atrial wall thrombus.
      Right upper lobe perfusion defect was detected by lung perfusion scintigraphy.
      Then he was recommended redo Fontan operation. He underwent resection of stenosed
      valved conduit, right atrial thrombectomy and reconstruction of new route between
      right atrium and pulmonary artery with bovine pericardium. He tolerated well that
      operation and now 3 months passed, he resumed fairly vigorous physical activity.

PMID- 8360545
TI  - [Acute aortic dissection due to cross-clamp injury during coronary artery bypass
      grafting--a report of successfully repaired case].
AB  - A case with successfully repaired acute aortic dissection due to cross-clamp
      injury during coronary bypass surgery was reported. A 54-year-old man had usual
      coronary artery bypass surgery by using 3 saphenous vein grafts (4 distal
      anastomosis). Immediately after the completion of cardiopulmonary bypass, acute
      aortic dissection, which was caused by aortic cross-clamp, was noted.
      Cardiopulmonary bypass was resumed and the injured ascending aorta was replaced
      with prosthetic graft under profound hypothermia and circulatory arrest. An
      "Island flap" of the ascending aorta (3 x 4 cm in diameter), containing 3
      proximal anastomotic positions of vein grafts, was excised from the aortic wall,
      and was re-implanted into the frontal wall of the aortic prosthesis. The patient
      well tolerated the operative procedure, and fully recovered from the serious
      condition after 6 days of IABP support and 11 days of inotropic support. He is
      doing quite well one year after the surgery. This case is believed to be the
      first reported one of such reconstructive method for acute aortic dissection
      during the coronary bypass surgery.

PMID- 8360546
TI  - [A case of simultaneous association of an early esophageal carcinoma and an early
      gastric carcinoma with radical operation].
AB  - We encountered a case of simultaneous association of an intraepithelial
      esophageal carcinoma and an intramucosal gastric carcinoma with radical
      operation. Up to present, only four cases including this report had been printed
      in Japan. A 67-year-old with chronic cholecystitis was pointed out the esophageal
      lesion (O-IIa) in the Im area by FGS after it had demonstrated the gastric lesion
      (early I) at the posterior wall of the prepyrolus. We performed subtotal
      esophagectomy, total gastrectomy, pyroloplasty with esophagoileostomy through the
      retrosternal tunnel and lymph nodes dissection (R2). On gross inspection, there
      was no obvious lesion in the esophagus. Microscopic examination revealed no
      invasion of cancerous cells to lymph nodes, lymph ducts, and vessels. The patient
      followed post operative respiratory disorders which not lung edema but
      atelectasis caused because perioperative measurement of Extra Vascular Lung Water
      Index (EVLWI) was stable within normal values.

PMID- 8360547
TI  - [A case report of the preoperative diagnosis of thoracoabdominal aortic aneurysm
      by three-dimensional CT angiography].
AB  - A sixty-year-old woman with the thoracoabdominal aortic aneurysm (7 cm in the
      diameter) was evaluated by the newly developed three-dimensional CT angiography.
      The thoracoabdominal aortic aneurysm was scanned by spiral CT and three
      dimensional images were generated preoperatively. The three-dimensional
      structures of the thoracoabdominal aorta with the aneurysm, the celiac trunk and
      the superior mesenteric artery were clearly visualized by this method. The
      thoracoabdominal aorta was replaced by the graft with the reconstruction of
      celiac trunk. The post-operative course was uneventful. The preoperative
      diagnosis of thoracoabdominal aortic aneurysm by this method was very useful in
      the determination of operative procedure in this case. Three-dimensional CT
      angiography may be the useful method in the preoperative diagnosis of the aortic
      surgery.

PMID- 8360548
TI  - [A case of treatment of the Paget-Schroetter syndrome with PTA and Gianturco'
      expandable metallic stent].
AB  - We report a effective management of the Paget-Schroetter syndrome. A 23-year-old
      man was seen with a complaint of arm swelling and venous engorgement of the left
      arm. A first-rib resection was performed through a infraclavicular approach with
      removal of compressive elements including scalenus anterior and subclavius
      muscles. He became asymptomatic. But 2 months later, recurrent symptoms developed
      and venograms demonstrated the presence of restenosis of the subclavian vein with
      extensive collaterals. To relieve symptoms a percutaneous transluminal
      angioplasty (PTA) and a insertion and placement of the Gianturco's expandable
      metallic stents was carried out for the remaining stenosis of the subclavicular
      vein and a residual compression. Venograms, 7 months after operation, showed
      widely the patent subclavian vein. Trans-infraclavicular approach allowed
      exposure of the stenotic or obstructed segments of the subclavian vein. The PTA
      and stenting, especially after removal of compressive elements or during chronic
      phase, was a very useful and effective procedure for the treatment of the Paget
      Schroetter syndrome.

PMID- 8360549
TI  - [A case of partial anomalous pulmonary venous connection to the high superior
      vena cava with intact atrial septum].
AB  - A 16-year-old female with partial anomalous pulmonary venous connection to the
      high superior vena cava underwent a successful correction using only autologous
      pericardium. Right upper pulmonary venous blood returned to the left atrium via
      the superior vena cava and the constructed atrial septal defect. The right atrium
      received blood from the brachiocephalic vein through the conduit. The azygos vein
      was not identified. Post-operative examination revealed that there were no
      pressure gradients across the superior vena cava and the conduit. She was
      discharged from the hospital on the 14th post-operative day.

PMID- 8360550
TI  - [A successful case of emergency coronary artery bypass grafting for a patient
      with cardiopulmonary arrest on arrival at our hospital due to acute myocardial
      infarction].
AB  - A successful case of emergency coronary artery bypass grafting for a 62-year-old
      man with cardiopulmonary arrest due to acute myocardial infarction was reported.
      He developed cardiopulmonary arrest 4 minutes before arrival at Critical care and
      Emergency Department of our hospital. The ECG of the patient showed ventricular
      fibrillation. He was resuscitated successfully 26 minutes after cardiopulmonary
      arrest. Emergency coronary angiography revealed that LAD just proximal was
      totally occluded and LCx just proximal was 90% stenosed. As he was still in the
      state of shock after resuscitation, emergency CABG was performed to LAD and LCx
      using saphenous vein grafts. The post operative course was uneventful. The
      patient has resumed a normal and active life-style as a deput principal of a high
      school one year after operation.

PMID- 8360551
TI  - [Application of cryopreserved allograft to aortic root replacement for valve
      detachment case due to aortitis].
AB  - A 54-year-old male who had received an aortic valve replacement with SJM 23 about
      3 years before suffered from an acute cardiac failure because of the valve
      detachment. From his clinical course, it was diagnosed that the aortic valve
      insufficiency was complicated by an aortitis. We operated on him by an aortic
      root replacement using a cryopreserved allograft which we prepared. A donor of
      the allograft was 35-year-old male, died of a subarachnoidal hemorrhage. We
      harvested his aortic root at an autopsy and dipped it into a nutrition medium
      with 10% dimethylsulfoxide. Within 10 hours from his death, we froze the tissue
      using a program freezer and stored it in a liquid nitrogen for 7 months. After
      thawing it in 37 degrees C water quickly, we rinsed the graft and used for the
      operation. The cell viability of the graft was confirmed by a tissue culture.
      Indication of the allograft valve to an aortitis case is still controversial. We
      think the allograft is recommendable to valve detachment case due to aortitis,
      because the softness of the graft decreases a compliance mismatch between the
      graft and the patient's annulus, which may prevent redetachment. Although we felt
      concern about redetachment of the conduit due to the weakness of the patient's
      aortic annulus, no complication regarding the allograft happened at all as yet.

PMID- 8360552
TI  - [Solitary fibrous tumor (SFT) of the thymic area--a case report].
AB  - A 52-year-old man was referred to our hospital with a large anterior mediastinal
      tumor on chest X-ray. A preoperative CT scan revealed the large tumor in front of
      the ascending aorta. We failed aspiration biopsies for several times because of
      scant tumor cells. This tumor was totally removed with a small part of the
      pericardium through median sternotomy after preoperative radiation therapy
      consisting of a total dose of 25 Gy. There was no metastasis to regional lymph
      nodes nor dissemination in the anterior mediastinum. The tumor was encapsulated,
      9 x 12 cm in size, 270 g in weight with necrotic region induced by preoperative
      radiation therapy. We made the diagnosis of solitary fibrous tumor of the thymic
      area by pathological examination and immunohistochemical study. SFT most
      frequently arises in the pleura and is less frequently observed in the
      pericardium and peritoneum. But SFT of the mediastinum has been rarely reported
      in the world and this is the second case in Japan.

PMID- 8360553
TI  - [Concept and etiological mechanism of cor pulmonale].

PMID- 8360554
TI  - [Clinical condition and physiopathology of patients with cor pulmonale].

PMID- 8360555
TI  - [Physiopathology and diagnosis of hypoxic pulmonary vasoconstriction].

PMID- 8360556
TI  - [Diagnosis of cor pulmonale by hematologic tests, thoracic radiography and ECG].

PMID- 8360557
TI  - [Diagnosis of cor pulmonale by radioisotope angiography].

PMID- 8360558
TI  - [Diagnosis of cor pulmonale by echocardiography].

PMID- 8360559
TI  - [Diagnosis of cor pulmonale by heart catheterization].

PMID- 8360560
TI  - [Epidemiology and prognosis of cor pulmonale].

PMID- 8360561
TI  - [Drug therapy of cor pulmonale].

PMID- 8360562
TI  - [Oxygen therapy of cor pulmonale].

PMID- 8360563
TI  - [Guidance of life for patients with cor pulmonale].

PMID- 8360564
TI  - [Surgical treatment of cor pulmonale].

PMID- 8360565
TI  - [Left ventricular function in patients with cor pulmonale].

PMID- 8360566
TI  - [Pulmonary thromboembolism and IgE].

PMID- 8360567
TI  - [Adult respiratory distress syndrome and cell adhesion molecules].

PMID- 8360569
TI  - [Pulmonary hemodynamics following pneumonectomy].

PMID- 8360568
TI  - [Obstructive sleep apnea syndrome and right heart function].

PMID- 8360570
TI  - [Physiopathology of pulmonary circulatory disorders. Discussion].

PMID- 8360571
TI  - [A case of acute kidney failure complicated with rhabdomyolysis in alcoholics].

PMID- 8360572
TI  - [A case of primary idiopathic hypothyroidism showing macro-CPK type 1].

PMID- 8360573
TI  - [A male case of primary biliary liver cirrhosis found in the course of
      psoriasis].

PMID- 8360574
TI  - [A case of Addison's disease associated with hypogonadotropic hypogonadism].

PMID- 8360575
TI  - [A case of Dejerine-Sottas disease with central nervous system involvement].

PMID- 8360576
TI  - [Pulmonary intravascular macrophages].

PMID- 8360577
TI  - [Insulin and insulin receptor disorders].

PMID- 8360578
TI  - Antibody production in the baculovirus expression system.
AB  - The proven ability of insect cells to produce murine and human antibodies renders
      the baculovirus system amenable to the synthesis of both naturally occurring
      antibodies and designed mutants. Study of these antibodies should provide a basis
      for rational antibody design useful in human therapy.

PMID- 8360579
TI  - Oligonucleotide-directed mutagenesis of antibody combining sites.
AB  - We review here our attempts to achieve a better understanding of the structure-
      function relationship of antibody combining sites, and to gain insights into the
      engineering of antibodies with desired specificity and affinity. We have focused
      on a model system--antibodies to the hapten p-azophenylarsonate (Ars) derived
      from A/J mice. Oligonucleotide-directed mutagenesis was used to alter the
      sequence of the variable region genes of such anti-Ars antibodies. Mutant
      antibodies were generated in hybridoma cells following transfection of the
      altered genes, and the effects of the primary structure changes on antibody
      specificity, affinity, and idiotypic expression were assessed. These studies
      suggest that an antibody combining site with basic specificity for an antigen
      could be created by introducing a set of a few amino acid residues in the
      complementarity determining regions, and that the affinity of such a site could
      be improved one substitution at a time in a sequential manner.

PMID- 8360580
TI  - Increased antibody affinity and specificity by codon-based mutagenesis.

PMID- 8360581
TI  - Characterization and applications of antibodies produced in plants.
AB  - Of the variety of compounds expressed in transgenic plants, antibodies offer
      probably the widest range of applications. The antibodies appear to possess all
      of the functional characteristics of antibody derived from hybridoma cells,
      although further study will be required to determine the effect of the difference
      in heavy chain glycosylation. More work will also be directed toward the
      assembly, accumulation, stability and secretion of plant antibodies. The effect
      of the signal sequence on the expression and assembly of antibodies has been
      shown and further methods of optimizing transgenic protein accumulation in plants
      almost certainly exist. Plant antibody technology is still in its infancy.
      However, it offers enormous potential in "mix-and-match" antibody engineering,
      and the construction of multimeric immunoglobulin complexes may be feasible
      relatively easily, for the first time. Furthermore, as there is an enduring
      interest in using antibodies for therapeutic purposes, agricultural production
      and distribution offers a means of obtaining large quantities of antibodies at a
      relatively low cost.

PMID- 8360582
TI  - Combinatorial libraries.
AB  - Combinatorial antibody libraries, in which PCR amplified immunoglobulin light and
      heavy chain DNA are randomly recombined irrespective of their pairing in vivo
      into a vector and subsequently expressed in E. coli, have quickly become a very
      productive tool to generate monoclonal antibodies from various species. It has
      been drastically improved by utilizing phage display technologies in the
      selection process of specific antibodies. A brief summary of current techniques,
      critical published experiments showing the versatility of these systems with
      emphasis on human antibodies and discussions on chain preference, affinity
      maturation and the advent of semisynthetic and non-immune libraries will be
      presented.

PMID- 8360583
TI  - Chimeric antibodies.

PMID- 8360584
TI  - Hybrid antibodies.
AB  - One of the major advantages of genetic engineering is the ability to produce
      novel, hybrid antibodies. Hybrid antibodies can be assembled using fragments from
      different antibodies with the objective of assembling novel combinations of
      antibody-related effector functions. To efficiently achieve this goal it is
      necessary to have a precise understanding of the structure-function relationships
      within the antibody molecule. Secondly, it is possible to produce hybrids of
      antibodies with non-immunoglobulin proteins thereby achieving unique combination
      of functional properties. In this case it is necessary to consider both the
      desired functional properties and the means of assembling the protein components
      so as to maintain these properties. In all cases it is necessary to have the
      cloned gene segments, appropriate vectors and expression systems.

PMID- 8360585
TI  - Bispecific antibodies in lymphoma.

PMID- 8360586
TI  - Medical applications of single-chain antibodies.
AB  - A single-chain antibody or single-chain Fv (sFv) incorporates the complete
      antibody binding site in a single polypeptide chain of minimal size, with an
      approximate molecular weight of 26,000. In antibodies, the antigen combining site
      is part of the Fv region, which is composed of the VH and VL variable domains on
      separate heavy and light chains. Efforts over nearly two decades have indicated
      that Fv fragments can only rarely be prepared from IgG and IgA antibodies by
      proteolytic dissection. Beginning in 1988, single-chain analogues of Fv fragments
      and their fusion proteins have been reliably generated by antibody engineering
      methods. The first step involves obtaining the genes encoding VH and VL domains
      with desired binding properties; these V genes may be isolated from a specific
      hybridoma cell line, selected from a combinatorial V-gene library, or made by V
      gene synthesis. The single-chain Fv is formed by connecting the component V genes
      with an oligonucleotide that encodes an appropriately designed linker peptide,
      such as (Gly4-Ser)3. The linker bridges the C-terminus of the first V region and
      N-terminus of the second, ordered as either VH-linker-VL or VL-linker-VH. In
      principle, the sFv binding site can faithfully replicate both the affinity and
      specificity of its parent antibody combining site, as demonstrated in our model
      studies with the 26-10 anti-digoxin sFv. Furthermore, the sFv remains stable at
      low concentrations that promote VH and VL dissociation from the Fv heterodimer,
      resulting in loss of Fv binding. Intravenously administered sFv proteins exhibit
      accelerated biodistribution and exceptionally fast clearance compared to IgG or
      Fab. These pharmacokinetic properties allow rapid imaging by sFv, which therefore
      may be labeled with a short-lived isotope such as Tc-99m. Expression of a single
      gene product from fused sFv and effector genes facilitates immunotargeting of the
      effector protein, as shown for single-chain Fv toxin fusion proteins.

PMID- 8360587
TI  - Recent developments in catalytic antibodies.

PMID- 8360588
TI  - Humanized antibodies: enhancing therapeutic utility through antibody engineering.
AB  - The promise of antibody therapeutics has been greatly expanded by the development
      of monoclonal antibody technology and more recently antibody humanization. By
      transferring the mouse antibody binding site into a human antibody gene, we can
      engineer a "human antibody" which retains the specificity and biological effects
      of the original mouse antibody but has the potential to be nonimmunogenic in
      humans. Additionally, antibody effector functions can be improved through
      manipulation of the antibody constant region genes. We have produced a humanized
      version of OKT3 with human IgG4 and kappa constant regions. This antibody retains
      all of the in vitro characteristics of murine OKT3 including induction of
      cytokine release and T cell activation markers. Humanized OKT3 has an affinity of
      1.4 x 10(9) M-1 relative to a 1.2 x 10(9) M-1 affinity of murine OKT3.
      Substitution of a glutamic acid for leucine at residue 235 in the antibody
      constant region abrogates FcR I binding and causes a marked reduction of T cell
      activation. The humanized FcR mutant of OKT3 has potential to be an improved
      therapeutic for transplantation and may have applications in autoimmune disease
      treatment.

PMID- 8360589
TI  - Chimeric T cell receptor-immunoglobulin molecules: function and applications.
AB  - The antigen-specific receptors on T and B cells are related by sequence
      similarities, mechanisms for the generation of diversity, and a common protein
      domain structure. In contrast, the form of antigen recognition for T- and B-cell
      antigen receptors is entirely different. Whereas the B cell antigen receptor,
      i.e., membrane-bound immunoglobulin (Ig), has the potential to recognize a vast
      diversity of chemical determinants, the T cell antigen receptor (TCR) invariably
      recognizes oligomeric peptides bound to major histocompatibility complex
      molecules. A question is whether the variable domains of the TCR and Ig are
      similar in structure, and if so, can they be substituted one for the other.
      Recent experiments show that, in some combinations, the variable region of Ig can
      substitute for the variable region of a TCR, and convey, to a reactive T
      lymphocyte, the antigen specificity of an Ig molecule. This type of receptor
      engineering may have interesting applications in disease therapy.

PMID- 8360590
TI  - Effects of in vitro exposure to arachidonic acid on TNF-alpha production by
      murine peritoneal macrophages.
AB  - Modifying the fatty acid composition of macrophages through diet can
      significantly alter some of their functions, such as tumoricidal capacity and
      tumor necrosis factor alpha (TNF-alpha) production. The mechanism of that
      modification, however, is unknown. In this report, we provide evidence that fatty
      acids added to macrophages in culture can significantly alter macrophage TNF
      alpha production. For example when inflammatory macrophages were incubated with
      various doses of arachidonic acid [20:4(n-6)] during activation with
      lipopolysaccharide (LPS), we observed a dose-dependent decrease in the level of
      bioactive TNF-alpha with complete inhibition at 2-5 microM. This inhibition was
      specific for 20:4(n-6) because in vitro treatment with other fatty acids, such as
      eicosapentaenoic [20:5(n-3)] or docosahexaenoic [22:6(n-3)] acids, had
      differential effects. The inhibitory action of 20:4(n-6) did not involve toxicity
      because cell viability was not affected and in vitro interferon-gamma and
      lipopolysaccharide (LPS) activation of macrophages for killing of P815 tumor
      targets was not altered. Inhibition by 20:4(n-6) occurred posttranscriptionally,
      and could be reversed when macrophages were treated with indomethacin during
      activation. Arachidonic acid treatment also significantly increased the
      production of immunoreactive prostaglandin E2 (PGE2) by LPS-treated and untreated
      macrophages. These results suggest that in vitro treatment of macrophages with
      20:4(n-6) may inhibit TNF-alpha production through an alteration in the levels of
      PGE2 at a posttranscriptional level. These results provide evidence that some
      dietary fats may affect macrophage activity through modification of eicosanoid
      synthesis.

PMID- 8360591
TI  - Calcium-binding myeloid protein (P8,14) is phosphorylated in fMet-Leu-Phe
      stimulated neutrophils.
AB  - In this report, we show that the p14 subunit of calcium-binding myeloid protein
      complex (p8,14) is phosphorylated in human neutrophils stimulated with either
      fMet-Leu-Phe, phorbol myristate acetate, or a calcium ionophore. Trifluoperazine,
      a calmodulin antagonist, caused hyperphosphorylation of p14 in intact resting
      neutrophils. Preincubation of resting cells with 10-20 nM calyculin A, a potent
      protein phosphatase inhibitor, also caused enhanced labeling of p14, which was
      further progressively increased on stimulation with fMLP. Thus, the
      phosphorylation level of p14 in resting as well as in stimulated neutrophils
      appears to be controlled by an active protein phosphatase. The phosphorylation of
      p14 by a chemoattractant and by a phorbol ester is a novel finding supporting the
      current belief that p8,14 myeloid protein may play an important role in the
      metabolism of myeloid cells.

PMID- 8360592
TI  - Retinoic acid inhibits interleukin-1-induced cytokine synthesis in human
      monocytes.
AB  - Retinoids are pluripotent morphogens whose effects on gene expression are
      mediated through specific intracellular receptors. They have certain anti
      inflammatory effects in vivo, the basis of which is not clearly understood. To
      characterize mechanisms involved with potential anti-inflammatory actions of
      retinoids, we studied the effects of retinoic acid (RA) on cytokine production in
      human peripheral blood monocytes. RA differentially modulated the expression of
      interleukin-1 beta (IL-1 beta), IL-6, and IL-8 mRNAs depending on the inducing
      stimulus. While phorbol myristate acetate-induced IL-1 beta and IL-8 mRNA
      expression was increased by RA (IL-6 could not be induced by this pathway in
      monocytes), IL-1 beta-induced expression of IL-1 beta and IL-8 was markedly
      reduced and IL-6 gene expression was almost completely suppressed.
      Lipopolysaccharide (LPS)-induced cytokine synthesis was only slightly reduced and
      this required a longer preincubation (> 72 h) of monocytes with RA. IL-1-induced
      de novo synthesis of IL-6 protein and secretion of biologically active IL-6 were
      also inhibited by RA. The inhibition pattern of RA was different from that of
      dexamethasone, which inhibited both IL-1 and LPS effects. In summary, our data
      show that RA regulates monocyte cytokine expression selectively in response to
      the particular stimuli. Inhibition of IL-1 beta-induced cytokine expression
      provides a mechanism that can explain some of the anti-inflammatory effects of
      RA.

PMID- 8360593
TI  - Suppressive effect of interleukin-4 on the differentiation of M1 and HL60 myeloid
      leukemic cells.
AB  - The effect of interleukin-4 (IL-4) on the proliferation and differentiation of
      myeloid leukemic cell lines was studied in vitro. A culture of murine myeloid
      cell line, M1, with lipopolysaccharide (LPS) from Escherichia coli, induced
      differentiation into macrophages that expressed Fc receptors and phagocytic
      activity. IL-4 did not induce the differentiation of M1 cells but inhibited the
      differentiation of M1 cells induced with LPS. On the other hand, LPS arrested the
      proliferation of M1 cells. IL-4 had no effect on the proliferation of M1 cells
      but restored the LPS-induced arrest of the proliferation of M1 cells. IL-1, IL-6
      and tumor necrosis factor alpha (TNF-alpha) also induced the differentiation of
      M1 cells into macrophages and arrested proliferation. IL-4 suppressed the IL-1-,
      IL-6-, and TNF-induced differentiation of M1 cells and restored the arrested
      proliferation with IL-1, IL-6, and TNF. Similar results were obtained with human
      myeloid cell line HL60. These results suggest that IL-4 has a suppressive effect
      on the differentiation of myeloid cells into macrophages.

PMID- 8360594
TI  - Fibrosarcoma-induced increase in macrophage tumor necrosis factor alpha synthesis
      suppresses T cell responses.
AB  - Tumors down-regulate T cell responses partly by increasing macrophage (m phi)
      production of the suppressive molecule prostaglandin E2 (PGE2). Because tumor
      growth increases m phi tumor necrosis factor alpha (TNF-alpha) production and TNF
      alpha stimulates m phi PGE2 synthesis, we examined the contribution of TNF-alpha
      to fibrosarcoma-induced m phi-mediated suppression of alloreactive CD4+ T cell
      proliferation. We showed that tumor-bearing host (TBH) m phi s express high
      levels of TNF-alpha mRNA, which leads to increased lipopolysaccharide-induced TNF
      alpha production. Tumor cells were directly involved in m phi TNF-alpha synthesis
      because fibrosarcoma cells induced normal host (NH) m phi s to produce TNF-alpha.
      Addition of TBH m phi s to allogeneic mixed lymphocyte reaction (MLR) cultures
      suppressed CD4+ T cell proliferation more than NH m phi s. The neutralization of
      endogenous TNF-alpha activity with anti-TNF-alpha antibody (Ab) treatment
      reversed TBH, but not NH, m phi-mediated suppression. Conversely, exogenous TNF
      alpha increased NH or TBH m phi-mediated suppression but stimulated T cell
      proliferation without m phi s. Kinetic treatment of MLR cultures with anti-TNF
      alpha Ab or TNF-alpha showed that TNF-alpha production and activity occurred at
      the beginning of T cell proliferation. When arachidonic acid metabolite synthesis
      was inhibited, TNF-alpha-induced suppression was blocked in NH m phi-containing
      cultures and completely reversed in TBH m phi-containing cultures. A PGE2
      specific enzyme-linked immunosorbent assay showed that TNF-alpha addition
      increased PGE2 production in NH m phi-containing cultures to that of TBH m phi
      containing cultures. Exogenous PGE2 did not affect the TNF-alpha enhancement of T
      cell proliferation without m phi s. Therefore, suppression induced by TNF-alpha
      was caused by increased m phi PGE2 production and not by TNF-alpha in concert
      with PGE2. Even though TNF-alpha is known to enhance lymphocyte proliferation, we
      show that in the presence of m phi s, the main TNF-alpha producers, TNF-alpha
      suppresses T cell proliferation. Perhaps increased TNF-alpha production during
      pathological states, such as cancer, triggers the initial stages of suppression.

PMID- 8360595
TI  - Suppression of human IgE antibody forming cell responses by IL-6.
AB  - To study the effects of cytokines on human IgE antibody forming cells (AFCs), log
      phase U266 myeloma cells (3 x 10(3)/ml), which secrete immunoglobulin E (IgE),
      were cultured for 0-24 h with and without cytokine or with or without antibodies
      against various cytokines. The numbers of IgE AFCs were determined in ELISPOT
      assay. We found that interleukin-6 (IL-6) suppressed (to 95%) whereas anti-IL-6
      increased (to 148%) the numbers of IgE AFCs and that both worked in a dose
      dependent fashion. IL-4 and interferon-gamma (IFN-gamma) also suppressed IgE AFC
      responses in a dose-dependent fashion. However, antibodies to these cytokines had
      no effect. In contrast, IFN-alpha increased (to fourfold) the numbers of IgE AFCs
      in a dose-dependent fashion. The data are the first to show a suppressive effect
      of IL-6 on human IgE responses and may also suggest a role for IL-6 in the
      treatment of atopic disease.

PMID- 8360597
TI  - Apical third instrumentation of curved canals with K-type and canal master
      instruments.
AB  - Forty acrylic blocks with curved canals were divided into two groups of 20 each.
      One group had canals with 30-degree curvature and the other with 45-degree
      curvature. Each group was divided into two subgroups of 10 blocks each. One
      subgroup was instrumented with precurved Kerr files and the other was
      instrumented with Canal Master hand instruments. The efficiency of the two
      instruments for preparing the apical third of curved canals was compared. In
      plastic blocks, Canal Master caused less transportation and was more suitable for
      instrumenting the canals.

PMID- 8360596
TI  - Movement of resin cement components through acid-treated dentin during crown
      cementation in vitro.
AB  - This study examined the hypothesis that components of crown cements may be forced
      through acid-treated dentin during cementation. Freshly extracted, human third
      molar teeth were prepared to accept full crowns. Roots were removed to allow
      irrigation of the pulp chamber with saline before, during, and after crown
      placement with resin dentin bond and resin composite cement. Saline samples were
      collected and analyzed by high performance liquid chromatography to identify and
      quantify resin components arriving in the pulp space. Two components of the bond
      cement system used were identified in the pulp space samples immediately after
      crown cementation. These were 2-hydroxyethylmethacrylate and 2,2-bis[4-(2-hydroxy
      3-methacryloxypropoxy)phenyl]propane. The amounts of these components in the pulp
      space decreased when the bonding agent was cured prior to crown placement. The
      results of this study supported the hypothesis that crown cementing components
      may flow through acid-treated dentin during crown cementation.

PMID- 8360598
TI  - Smear layer removal with different concentrations of EDTA-ethylenediamine
      mixtures.
AB  - The purpose of this study was to observe the effectiveness of EDTA and
      ethylenediamine mixtures in removing the smear layer from prepared root canal
      walls following instrumentation. Thirty-five freshly extracted, single-rooted
      maxillary anterior teeth were used. After the preparation of access cavities and
      establishing the working length, the apical foramen of each canal was sealed with
      casting wax. All canals were then sequentially enlarged with K-type files to size
      50. The sample was divided into seven groups of five teeth. The teeth in the
      control group were irrigated with saline solution. The specimens in the other
      groups were irrigated with 10 and 20 ml of three different EDTA-ethylenediamine
      mixtures. A scanning electron microscopic evaluation of the canal walls following
      irrigation showed that the superficial layer was totally removed and the openings
      of the dentinal tubules were patent. Only at the coronal third of the teeth in
      group 4 and the apical thirds in groups 2 and 4 was a moderate smear layer
      observed. The most favorable results were obtained with groups 5, 6, and 7. The
      results show that the smear layer can be totally removed by using 10 ml of a four
      to-three by volume mixture of EDTA and ethylenediamine for irrigation of
      instrumented root canals.

PMID- 8360599
TI  - Effects of the XeCl excimer laser on Streptococcus mutans.
AB  - The effect of XeCl excimer laser irradiation on the growth of Streptococcus
      mutans in liquid media and on agar plates was studied. Bacterial suspensions of
      S. mutans were placed in 96 wells of well culture plates. The contents of 72
      wells (three experimental groups of 24 wells each) were lased for different time
      durations (2, 4, and 8 s). The remaining 24 wells were left unlased to be used as
      controls. Samples were withdrawn from all wells and examined for surviving
      bacteria. In addition, blood agar plates were inoculated with S. mutans and were
      lased with different energy densities (fluences). Zones of bacterial inhibition
      were measured. Analysis of variance test was used to determine statistical
      differences. The bactericidal effect of the laser applications was directly
      related to the amount of radiation time. Laser irradiation for 4 and 8 s resulted
      in bactericidal effect that was statistically significant compared with no
      treatment or to 2-s exposure. The effect of different energy levels was studied
      by irradiating inoculated blood agar plates. The zones of inhibition produced by
      higher energy levels (0.5 J/cm2, 0.7 J/cm2, and 1.0 J/cm2) were larger in
      comparison to the lowest fluence used (0.1 J/cm2). Application of the laser to
      the surface of the agar plates produced an indentation with a surrounding halo.
      The indentations and the zones of inhibition were more pronounced as the fluences
      increased. Based on our results it appears that the XeCl 308-nm excimer laser can
      kill S. mutans. This effect should be tested on other bacteria commonly present
      infected root canals.

PMID- 8360600
TI  - Computerized analysis of the instrumentation of the root canal system.
AB  - A method is proposed for a three-dimensional visualization of the root canal
      system before and after the cleaning and shaping procedure to analyze the
      relationships of the root canal walls. The first part of the study provided cross
      sections of the root perpendicular to the root canal. A system for remounting the
      sections of the root before and after instrumentation was set up. Micrographs of
      the sections were transferred to a graphics computer which rebuilt and elaborated
      the sections, providing a three-dimensional model of the root with the image of
      the root canal system before and after instrumentation. This experimental
      computerized model enables sections of all kinds to be produced, with great
      possibilities for measurement and analysis.

PMID- 8360601
TI  - Effect of various types of sodium perborate on the pH of bleaching agents.
AB  - Time-dependent changes in the pH value of various types of sodium perborate
      solutions used as bleaching agents were evaluated. Sodium perborate-monohydrate
      (MH), sodium perborate-trihydrate (TRH), and sodium perborate-tetrahydrate are
      available. Each perborate was mixed with 10%, 15%, or 30% fresh hydrogen peroxide
      or with bidistilled water in a powder to liquid ratio of 2 g:1 ml, respectively.
      The pH values were recorded at baseline and after 1h, 1 day, 3 days, and 7 days,
      respectively. At baseline the pH values of MH, TRH, and tetrahydrate in
      conjunction with 30% H2O2 were 8.7, 7.0, and 7.5, respectively. The pH increased
      significantly with decreasing concentrations of H2O2. For TRH, MH, and
      tetrahydrate mixed with bidistilled water more alkaline values were measured at
      baseline and after 1 h. Due to solidification of the samples, the pH could not be
      determined for MH starting day 1 and for TRH starting day 3. In conclusion, the
      pH of bleaching pastes depends on the content of water of crystallization in
      sodium perborate, H2O2 concentration, and time of measurement. The bulk of the
      mixtures recorded reached alkaline pH values of 10 to 11. It is recommended that
      the pH of the mixture being used be checked to avoid potential postbleaching root
      resorption.

PMID- 8360602
TI  - Accuracy of an electronic apex locator: a clinical evaluation in maxillary
      molars.
AB  - Identifying the point of apical termination in endodontic therapy is of
      indisputable importance. In this study, the accuracy of an electronic apex
      locator was clinically evaluated in 26 maxillary molar teeth, and comparisons
      were made to the radiographic and direct anatomical measurements of tooth length.
      The results indicated that a higher percentage of acceptable measurements were
      obtained by the radiographic method as compared with the electronic method (88.5%
      to 73.1%). Additionally, inaccurate electronic estimates were long in every
      instance. The results of this study do not support the replacement of radiographs
      with electronic devices in endodontic therapy.

PMID- 8360603
TI  - Prevention of apical periodontal ligament pain: a preliminary report of 100 vital
      pulp cases.
AB  - A preliminary study was conducted in a private practice office to determine the
      incidence of postoperative pain in 100 vital pulp cases. An ophthalmic
      dexamethasone-neomycin solution was introduced within the root canal during the
      complete cleaning and shaping procedure with the purpose of premedicating and
      preventing apical periodontal ligament inflammation and pain. The postoperative
      pain outcome was compared between cases premedicated with intracanal
      dexamethasone-neomycin solution alone and in combination with an oral
      administration of Mesulide. Moderate pain was reported in 10 cases and tooth
      sensitivity in 13. The clinical results indicated no report of severe pain.

PMID- 8360604
TI  - A two-rooted mandibular incisor.
AB  - A case report is presented demonstrating a two-rooted mandibular incisor. Because
      of prosthetic considerations, endodontic therapy was not performed and the tooth
      was extracted. However, this case reinforces the importance of proper
      radiographic techniques and interpretation in detecting radicular anomalies.

PMID- 8360605
TI  - Pulp obliteration: a histological study.
AB  - Pulp obliteration is a very rare occurrence that is most frequently caused by
      trauma. A 58-yr-old female patient had a generalized pulp obliteration that
      involved all maxillary and mandibular teeth. One tooth was extracted due to an
      extensive carious lesion and it was processed by a cutting-grinding technique. It
      was possible to observe the complete obliteration of the pulp chamber, which was
      filled in part by reparative dentin and in part by a calcified tissue with a
      concentric layers structure with no tubular pattern. The root canals were almost
      completely obliterated by an amorphous calcified material.

PMID- 8360606
TI  - The flare-up index: a quantitative method to describe the phenomenon.
AB  - Acute exacerbation of symptoms during the inter-appointment time interval of
      endodontic treatment is a well-known complication. The phenomenon is termed
      "flare-up" by most researchers and clinicians, although the exact definition of
      it differs from one author to another, making it difficult to compare the results
      of the studies. The suggested flare-up index may be the way to build a common
      language that will enable the dental community to measure and study more of this
      phenomenon.

PMID- 8360607
TI  - Assessing the evidential value of DNA profiles matching without using the
      assumption of independent loci.
AB  - DNA profiling allows determination of the alleles at multiple loci on an
      individual's genome. The frequencies of these alleles are then estimated from a
      sample drawn from the population. If the occurrences of alleles at different loci
      are independent, the frequencies may be multiplied together to give an estimate
      of the probability of DNA from a randomly-chosen member of the population
      matching the DNA in question. However, there is doubt as to whether the
      assumption of independence can be justified. This paper discusses a method of
      calculating the probability of a match that does not require the assumption of
      independence. A suitable set of criteria is also derived that offer an objective
      approach to the determination of a match from two DNA samples.

PMID- 8360608
TI  - Differentiation of alpha-amylase from various sources: an approach using
      selective inhibitors.
AB  - A radial diffusion assay in an agarose/starch gel utilizing crude kidney bean
      extract and a commercially prepared alpha-amylase inhibitor isolated from wheat
      seeds was developed and assessed to determine its ability to differentiate alpha
      amylase from various sources. Kidney bean extract was found to have a greater
      inhibitory effect on AMY2, while the wheat lectin inhibitor was found to have a
      greater inhibitory effect on AMY1. Neither inhibitor was found to have any effect
      on commercially prepared bacterial alpha-amylase extract in both liquid
      preparations and dried stains. Mixtures of varying concentrations of pancreatic
      and salivary extracts also gave interpretable results. Additionally, dried stains
      prepared from human body fluids having high levels of AMY2 were differentiated
      from dried stains prepared from human body fluids containing high levels of AMY1.

PMID- 8360609
TI  - Salmonella reference collection B (SARB): strains of 37 serovars of subspecies I.
AB  - A reference collection of 72 strains representing 37 serovars of Salmonella
      subspecies I has been established for use in research on genetic and phenotypic
      variation in natural populations. Included are isolates of the host-adapted
      serovars S. choleraesuis, S. dublin, S. gallinarum, S. paratyphi A, S. paratyphi
      B, S. paratyphi C, S. pullorum, S. sendai, S. typhi and S. typhisuis, as well as
      strains of S. enteritidis, S. typhimurium, and other commonly recovered serovars
      with broad host ranges. The isolates were characterized by enzyme electrophoresis
      for allelic variation in 25 chromosomal genes and represent 71 distinctive
      multilocus genotypes (electrophoretic types or ETs). Genetic relationships among
      the ETs are indicated in an evolutionary tree constructed by the neighbour
      joining method from a matrix of Nei's standard genetic distance.

PMID- 8360610
TI  - Colonization of chicks by motility mutants of Campylobacter jejuni demonstrates
      the importance of flagellin A expression.
AB  - Campylobacter jejuni strain 81116 contains two flagellin genes, flaA and flaB.
      Wild-type (WT) bacteria express flaA only, but flaB can be expressed under
      certain conditions. We have determined the importance of flagella for
      colonization of the avian caecum, which appears to be the natural environment for
      these bacteria. Mutants in which flaA or flaB, or both had been inactivated, and
      motility variants, were investigated. Flagella are not a requisite for
      colonization, but mutants lacking both flagellin genes colonized less efficiently
      than WT. Inactivation of the flaB gene, which had no effect on bacterial
      motility, enhanced chicken caecal colonization 1000-fold compared to WT. A
      variant (SF-1) with flagella composed of flagellin A, but with poor motility,
      also colonized better than WT. Conversely, mutants with an inactivated flaA gene
      colonized 100- to 1000-fold less efficiently than WT, regardless of their
      motility conferred by truncated or full-length flagellin B flagella. These
      results suggest that the presence of flagellin A, rather than motility, is
      essential for optimal bacterial colonization of chicken caeca.

PMID- 8360611
TI  - Purification and characterization of the extracellular aspartyl proteinase of
      Candida albicans: removal of extraneous proteins and cell wall mannoprotein and
      evidence for lack of glycosylation.
AB  - Aspartyl proteinase (AP) is an extracellular enzyme of Candida albicans
      implicated as a pathogenic factor. Previous reports on the purification and
      characterization of AP suggested that a single DEAE-Sephadex chromatographic step
      was sufficient for the removal of extraneous proteins and that the final product
      was glycosylated. We purified AP using a chromatographic series consisting of
      DEAE-Sephadex A25, Sephadex G75 and rechromatography on DEAE-Sephadex A25. Use of
      DEAE-Sephadex alone did not remove extraneous proteins and removed little
      contaminating mannoprotein (MP). The addition of a Sephadex G75 column to the
      purification scheme removed the majority of contaminating MP and proteins. The
      final DEAE-Sephadex A25 chromatographic step resulted in (a) removal of
      detectable extraneous proteins, (b) removal of immunologically detectable MP by
      dot blot and Western blot enzyme immunoassay, (c) loss of periodic acid-silver
      stain positivity, and (d) a high AP yield (1295 U l-1) and specific activity
      (1749 U mg-1). We conclude that a single DEAE-Sephadex A25 purification step is
      insufficient to remove extraneous proteins and MP, which could interfere with the
      production of AP-specific antibodies and the dissection of moieties responsible
      for immune reactivity. Reports of periodic acid-Schiff or anthrone positivity of
      AP preparations may reflect the presence of extraneous MP, which can be removed
      by the chromatographic series we describe.

PMID- 8360612
TI  - Induction of extracellular proteinase in Candida albicans.
AB  - Pulse-chase experiments indicated that the extracellular proteinase (EPR) of
      Candida albicans originates as a 45 kDa precursor protein which is processed to a
      43 kDa protein prior to secretion. Secretion was routinely stimulated in EPR
      induction medium which contains bovine serum albumin (BSA) and glucose. Although
      EPR was not induced without glucose as a carbon source, EPR secretion was induced
      without the addition of BSA or other nitrogen sources. Furthermore, it was shown
      that EPR production was not induced at pH > 6.0, irrespective of the presence of
      a nitrogen source. This suggests that medium pH may act directly upon EPR
      induction, and not as a secondary effect of the nitrogen supply from EPR-mediated
      protein digestion, which exhibited a pH optimum of around pH 3.5. When germ tube
      induced cells were transferred to EPR induction medium, EPR was not induced.
      Thus, EPR production and germ tube formation may not be induced by the same
      conditions. We speculate that EPR production and germ tube formation do not co
      operate in the invasive process but play different and separate roles.

PMID- 8360613
TI  - Multiple chromosomal and phenotypic changes in spontaneous mutants of Candida
      albicans.
AB  - Previous studies have revealed the occurrence of multiple chromosomal alterations
      among spontaneous colony form mutants and clinical isolates of Candida albicans.
      In this report we show that such karyotype alterations are also seen in
      spontaneous and induced non-germinative mutants of the fungus. To determine if
      phenotypic changes other than colony form and microscopic morphology accompanied
      the rearrangements of the electrophoretic karyotype, we studied the following
      characteristics of the non-germinative and some of the colony form mutants:
      formation of pseudohyphae, chlamydospore production, germ tube formation, colony
      morphology, auxotrophy, growth at various temperatures, and colony morphology and
      pigment formation on selected media (bismuth sulphite and Phloxine B). We
      established that phenotypic and karyotypic variability among spontaneous, non
      germinative mutants was no different than such variability among spontaneous
      colony form mutants. Thus, non-germination may represent another phenotypic
      consequence of genomic instability in C. albicans. The variability in different
      phenotypic attributes that occurred amongst the mutants was not associated with
      any given karyotype. Moreover, neither the low nor the high phenotypic
      variabilities observed were explained by the relatively high number of
      alterations in a limited number of chromosomes.

PMID- 8360615
TI  - Transcriptional regulation of an endoglucanase and a cellodextrinase gene in
      Ruminococcus flavefaciens FD-1.
AB  - A gene which encodes a 35 kDa protein with both carboxymethylcellulase and
      xylanase activity was cloned from Ruminococcus flavefaciens FD-1 and the
      nucleotide sequence determined. The FD-1 gene, celE, and the celA gene, which
      encodes a cellodextrinase, were used as probes to analyse transcription in R.
      flavefaciens grown under different conditions. Transcription of both genes was
      induced when cellulose was added to cells growing in cellobiose. This induction
      continued after cellulose depletion and after cell division had ceased.
      Transcription of both genes was also induced by cellotriose, although the effect
      was not as pronounced as induction by cellulose and was greater for the celA gene
      than for the celE gene.

PMID- 8360614
TI  - Identification of two laccase genes in the cultivated mushroom Agaricus bisporus.
AB  - A cDNA library was constructed in lambda gt11 using mRNA from 11-d-old mycelium
      of Agaricus bisporus. Three clones containing laccase sequence were identified
      using an affinity-purified anti-laccase antibody. From one of these clones, a 333
      bp sequence was used to identify further cDNA clones (including one which is
      close to full length) and a genomic clone. The coding sequences found were of two
      similar but not identical versions with differences at 36 out of 520 residues of
      deduced amino acid sequence. The laccase genes each encode a sequence expressed
      as a 2.3 kb mRNA, specifying a 520 residue polypeptide including a 19 amino acid
      residue signal peptide that is absent from the N terminus of the mature
      (extracellular) protein. The coding sequence of lcc1 is interrupted by 14 short
      introns. The lcc1 and lcc2 genes are not allelic as they do not segregate in
      uninucleate spores derived from a four-spored basidium. Comparison of the deduced
      amino acid sequences with that of the other fungal laccases that have been
      cloned, and with the very similar ascorbate oxidases from higher plants shows
      that whilst some sequence is absolutely conserved at and around the amino acid
      residues involved in copper binding, the overall sequence similarities are low.

PMID- 8360616
TI  - Cloning, sequencing and biochemical characterization of xylose isomerase from
      Thermoanaerobacterium saccharolyticum strain B6A-RI.
AB  - The xylose isomerase gene from Thermoanaerobacterium saccharolyticum strain B6A
      RI was cloned by complementation using Escherichia coli xyl-5 mutant strain
      HB101. One positive clone was detected and the recombinant plasmid, pZX16, was
      isolated. The clone contained the vector pUC18 and an insert fragment of 4.5 kb.
      The cloned xylose isomerase gene (xylA) was expressed constitutively in E. coli.
      The gene contained one open reading frame (ORF) of 1317 bp, which corresponds to
      439 amino acid residues. The molecular mass of the gene product was calculated to
      be 50474 Da from the deduced amino acid sequence. A putative promoter region
      (Pribnow box), TATAATATATAAT, which repeated twice at the -10 region in E. coli,
      was found 25 bp upstream of the ribosomal binding site. The deduced amino acid
      sequence of T. saccharolyticum strain B6A-RI xylose isomerase exhibited very high
      homology to those from Thermoanaerobacterium thermosulfurigenes 4B (formerly
      Clostridium thermosulfurogenes 4B) and Thermoanaerobacter ethanolicus 39E
      (formerly Clostridium thermohydrosulfuricum 39E). Codon usage in xynA, xynB and
      xylA showed a clear propensity for AT-containing isocodons. The native molecular
      mass of the purified recombinant thermostable xylose isomerase was 200 kDa, and
      the enzyme was a tetramer comprised of identical subunits. The apparent
      temperature and pH optima for activity of the cloned xylose isomerase were 80
      degrees C and 7.0 to 7.5, respectively.

PMID- 8360617
TI  - Genetic organization, sequence and biochemical characterization of recombinant
      beta-xylosidase from Thermoanaerobacterium saccharolyticum strain B6A-RI.
AB  - Endoxylanase (xynA) and beta-xylosidase (xynB) genes from Thermoanerobacterium
      saccharolyticum were subcloned from a cosmid clone (pXDM1) to generate pXPH3. The
      nucleotide sequence of a PstI-HindIII fragment in pXPH3 that contained xynB
      revealed an open reading frame (ORF) of 1500 bp encoding a 55 kDa protein.
      Another open reading frame (ORF1) of unknown function was found 21 bp downstream
      from the first stop codon of xynB. xynB, ORF1 and xynA had the same direction of
      transcription. xynB from T. saccharolyticum strain B6A-RI exhibited 45% amino
      acid similarity, with 18% amino acid identity to xynA of T. saccharolyticum
      strain B6A-RI, and 61% similarity and 37% identity with the beta-xylosidase gene
      from Caldocellum saccharolyticum. Recombinant beta-xylosidase was purified from
      E. coli (pXPH3) cells. The enzyme was a monomer with a molecular mass of 55 kDa.
      The specific activity and pH and temperature optima for hydrolysis of p
      nitrophenyl-beta-D-xylopyranoside (pNPX) were 5.53 U mg-1, 5.5 and 70 degrees C,
      respectively. The beta-xylosidase was stable at 65 degrees C, but lost activity
      at 85 degrees C. The purified enzyme had hydrolytic activity towards xylopentose,
      xylotriose, xylobiose and pNPX, but had no activity toward xylan.

PMID- 8360618
TI  - beta-Lactamase of Lysobacter enzymogenes: cloning, characterization and
      expression of the gene and comparison of the enzyme to other lactamases.
AB  - The gene for the periplasmic beta-lactamase of Lysobacter enzymogenes was
      isolated as part of a 1017 bp EcoRI fragment and the nucleotide sequence of the
      gene was determined. It has a G+C content of 71.5% and encodes a 27 amino acid
      signal sequence and the mature beta-lactamase of 276 amino acids which has a mass
      of 29,146 Da. The enzyme appears to be unique to L. enzymogenes but its amino
      acid sequence shows a high degree of homology with the amino acid sequences of
      the lactamase from Citrobacter diversus and other Class A beta-lactamases. The
      beta-lactamase gene of L. enzymogenes was expressed in Escherichia coli using
      pUC118 as the vector. The production of active beta-lactamase was highest after
      the active growth phase of the expression host and reached levels which were
      about three times higher than those obtained with L. enzymogenes.

PMID- 8360619
TI  - Processing and secretion by Escherichia coli of a recombinant form of the
      immunogenic protein MPB70 of Mycobacterium bovis.
AB  - The gene encoding an immunodominant secreted antigen, MPB70, of Mycobacterium
      bovis was cloned into the plasmid vector pBluescript II KS+ along with its native
      ribosome-binding site. In this construct translation of the protein in
      Escherichia coli was from the native AUG initiation codon and was directed by the
      mycobacterial ribosome-binding site. Two different molecular mass forms (26 kDa
      and 22 kDa) of MPB70 were observed in whole-cell pellets of recombinant E. coli.
      The difference in size indicates cleavage of the signal peptide of MPB70 by an
      endopeptidase of E. coli. MPB70 was secreted into the periplasm of recombinant E.
      coli, where the 22 kDa form of the protein was predominant. The culture filtrate
      contained only the 22 kDa form of the protein, which was soluble. The passage of
      MPB70 from the periplasm into the growth medium was found to be due, at least in
      part, to non-specific leakage of periplasmic proteins across the outer membrane
      associated with the expression of recombinant MPB70.

PMID- 8360620
TI  - Sensitivity of naturally occurring coliphages to type I and type II restriction
      and modification.
AB  - Protection against lethal infections by bacteriophage may seem the most likely
      role of restriction-modification (R-M) systems in bacteria and the reason for
      their evolution. There are, however, phenomena which question this phage-mediated
      selection hypothesis for the maintenance of extant R-M systems. Most prominent
      among these are the mechanisms phage have to avoid or otherwise limit the effects
      of the restriction endonucleases produced by their host bacteria. To evaluate the
      importance of these antirestriction mechanisms in Escherichia coli, we have
      examined the sensitivity of coliphage from natural and laboratory sources to a
      series of type I and II R-M systems. The results of our study indicate that, in
      vivo, restriction endonucleases have no effect on a substantial fraction of
      naturally occurring coliphage. The absence of restriction sites appears to be the
      most common reason why these phage are unaffected by type II restriction
      endonucleases, but other antirestriction mechanisms also operate. On the other
      hand, the frequency of naturally occurring coliphage sensitive to restriction
      appears sufficiently great for phage-mediated selection to be a viable hypothesis
      for the maintenance of R-M in E. coli and its accessory elements.

PMID- 8360621
TI  - Alterations in the cellular envelope of spontaneous IIIManL-defective mutants of
      Streptococcus salivarius.
AB  - In Streptococcus salivarius, the phosphoenolpyruvate: mannose phosphotransferase
      system (PTSMan) transports and concomitantly phosphorylates mannose, glucose,
      fructose and 2-deoxyglucose. PTSMan consists of a membrane Enzyme II and two
      forms of Enzyme III (IIIMan) having molecular masses of 38.9 kDa (IIIManH) and
      35.2 kDa (IIIManL) respectively. We have previously reported the isolation of
      spontaneous mutants lacking IIIManL, and showed that they exhibited abnormal
      growth when cultured in mixtures of sugars containing glucose. The mutants also
      synthesize several cytoplasmic glucose-repressible proteins during growth on
      glucose and some of them constitutively express a fructose PTS which is induced
      by fructose in the parental strain. We have now investigated the properties and
      composition of the cellular envelope of three S. salivarius IIIManL-defective
      mutants (strains A37, B31 and G29) after growth on glucose. The mutants have
      altered sensitivity to various toxic compounds that interfere with cell-envelope
      functions. The mutants also exhibited altered membrane-protein profiles when
      analysed by two-dimensional PAGE and modified total lipid and phosphorus contents
      and lipid/protein ratio. In one mutant (strain G29), the proportion of the
      phospholipids separated by TLC was different from the parental strain. Electron
      microscopy indicated that one mutant (strain A37) possessed more fimbriae than
      the parental strain. The results suggested that these IIIManL-defective mutants
      were affected in a global regulatory gene controlling several cellular or
      physiological functions, many of these being related to the cellular envelope.

PMID- 8360622
TI  - Involvement of the accessory gene regulator (agr) in expression of type 5
      capsular polysaccharide by Staphylococcus aureus.
AB  - The effect of an agr mutation on expression of type 5 capsular polysaccharide
      (CP) by Staphylococcus aureus Newman was investigated in different complex and
      synthetic media. CP expression by the agr mutant was strongly reduced in certain
      media but slightly in others, indicating that CP synthesis is positively
      controlled by agr. CP expression occurred in the post-exponential growth phase in
      both wild-type and mutant strains, suggesting that other regulatory systems could
      act in conjunction with agr.

PMID- 8360623
TI  - Oxygen inhibition of nitrogenase activity in Klebsiella pneumoniae.
AB  - A purpose-built oxystat has been used to study reversible inhibition of
      nitrogenase by O2 in the facultative anaerobe Klebsiella pneumoniae. C2H2
      reducing activity in samples from either an anaerobic glucose-limited or an O2
      limited diazotrophic chemostat culture was completely inhibited by exposure to a
      dissolved O2 concentration (DOC) of 1.5 microM or above. Subsequently, under
      anaerobic conditions, C2H2-reducing activity returned in the absence of de novo
      protein synthesis. The amount of activity returning never reached 100% of the
      initial anaerobic activity before O2 treatment. The degree of reversibility was
      inversely proportional to the log of DOC during exposure and was decreased by
      increasing the time of exposure to O2 (about 60% reversibility occurred after a
      20 min exposure to 6 microM-O2). The failure to obtain complete recovery of
      activity was apparently not due to inactivation of the very O2-sensitive pyruvate
      flavodoxin oxidoreductase (nifJ product) which provides electrons for nitrogenase
      activity in vivo. Samples from the O2-limited culture behaved similarly to those
      limited by glucose. Thus, 'training' of the organism to use O2 during growth does
      not influence the tolerance of nitrogenase to O2. Since the behaviour towards O2
      reported here for K. pneumoniae differs from that known to occur in Azotobacter,
      the mechanism of protection of nitrogenase from O2 damage may differ in these
      organisms.

PMID- 8360624
TI  - The role of lipoic acid in product formation by Enterococcus faecalis NCTC 775
      and reconstitution in vivo and in vitro of the pyruvate dehydrogenase complex.
AB  - The role of the pyruvate dehydrogenase complex (PDC) in the formation of
      different fermentation products by Enterococcus faecalis was studied. This
      organism was grown on a semi-defined medium under various conditions in the
      presence or absence of lipoic acid, an essential cofactor of the enzyme complex.
      When grown on a medium without added lipoic acid, a very low activity, both in
      vivo and in vitro, of the PDC was observed. When pyruvate served as the energy
      source, lipoic acid was found to be essential for growth under anaerobic
      conditions at low culture pH values. The presence of lipoic acid in the culture
      medium had a marked effect on the production of acetoin: in the presence of
      lipoic acid, acetoin was produced only when the intracellular pyruvate
      concentration was relatively high, whereas in the absence of lipoic acid, acetoin
      was a common product. Under potassium-limited conditions, lactate was the main
      product and culture pH significantly affected the bacterial dry weight. After
      instantaneous addition of lipoic acid to a glucose+pyruvate-limited chemostat
      culture, an immediate activation of the PDC took place as deduced from the change
      in fermentation pattern. Reconstitution of the PDC by the addition of lipoic acid
      was also possible in cell-free extracts, although pre-incubation with ATP and
      lipoic acid for 90 min was necessary for maximal activation. The effects of an
      active PDC on product formation and the physiological role of the complex under
      anaerobic growth conditions are discussed.

PMID- 8360625
TI  - Microbial transformation of nitroaromatic compounds under anaerobic conditions.
AB  - The transformation of several mono- and dinitroaromatic compounds (tested at 50
      200 microM) by methanogenic bacteria, sulphate-reducing bacteria and clostridia
      was studied. Some of the nitroaromatics tested were transformed chemically by 1.5
      mM quantities of culture media reducing agents, like cysteine or sulphide. This
      abiotic reduction occurred at the o-nitro-groups preferentially. Nitrophenols, p
      nitroaniline and p-nitrobenzoic acid were completely transformed biologically
      into the corresponding amino derivatives. The nitroaromatics were transformed by
      all of the bacterial strains tested. While growing cells of sulphate-reducing
      bacteria and Clostridium spp. carried out nitroreduction, methanogen cells lysed
      in the presence of nitroaromatics. Nevertheless these culture suspensions
      converted nitroaromatics to the corresponding amino derivatives. This was also
      confirmed by crude cell extracts of methanogenic bacteria. The rate of
      nitroreduction by sulphate-reducing bacteria depended on the electron donors
      supplied and the cell density, with molecular hydrogen being the most effective
      donor of reducing equivalents. The toxicity of p-nitrophenol to some of the
      organisms tested depended on the concentration of the nitroaromatic compound and
      the type of organism.

PMID- 8360627
TI  - Partial purification and properties of carminomycin 4-O-methyltransferase from
      Streptomyces sp. strain C5.
AB  - A methyltransferase that acts on carminomycin and 13-dihydrocarminomycin, and
      that is postulated to be the terminal enzyme in the daunomycin biosynthesis
      pathway, was purified to near-homogeneity from the daunomycin- and baumycin
      producing Streptomyces sp. strain C5. The enzyme was obtained in approximately 5%
      yield with a purification of 114-fold in specific activity over the sample
      precipitated with 30-50% ammonium sulphate. Polyacrylamide gel electrophoresis
      under denaturing conditions indicated a subunit M(r) of about 41,000. The enzyme
      was shown by gel filtration chromatography to have an M(r) of approximately
      166,000, suggesting that it is a homotetramer. Kinetic analysis indicated an
      affinity for S-adenosyl-L-methionine typical of antibiotic methyltransferases;
      the enzyme had a slightly higher affinity for carminomycin than for 13
      dihydrocarminomycin. The reaction product from methylation of carminomycin was
      confirmed by chromatography and mass spectral analysis to be daunomycin. The
      purified enzyme did not catalyse methylation of the aglycones carminomycinone or
      13-dihydrocarminomycinone. S-Adenosyl-L-homocysteine inhibited the
      methyltransferase, whereas homocysteine, adenosine, adenine, epsilon
      rhodomycinone, daunomycin, and daunomycinone showed little or no inhibitory
      activity.

PMID- 8360626
TI  - Relationships amongst some bacterial and yeast lactate and mandelate
      dehydrogenases.
AB  - Five yeast strains were isolated by enrichment culture on the basis of their
      ability to grow on mandelate and two of these strains were identified as
      Rhodotorula glutinis. In addition, a range of yeasts from culture collections was
      screened for growth on mandelate. The results suggest that mandelate utilization
      is a widespread but not universal characteristic within the genus Rhodotorula.
      Several of the yeasts contained an inducible NAD-dependent D(-)-mandelate
      dehydrogenase and an inducible dye-linked (presumably flavoprotein) L(+)
      mandelate dehydrogenase. All the D(-)-mandelate dehydrogenases from the yeasts
      showed immunological cross-reactivity with each other (as judged by both
      immunoinhibition and immunoblotting), as did all the yeast L(+)-mandelate
      dehydrogenases that were tested. Determination of N-terminal amino acid sequences
      of several bacterial and yeast lactate and mandelate dehydrogenases, together
      with the evidence from the immunological studies, confirmed and extended previous
      proposals that there are several major groups of such dehydrogenases: FMN
      dependent, membrane-bound L(+)-lactate and L(+)-mandelate dehydrogenases (M(r) =
      approx. 44,000) in bacteria, mitochondrial flavocytochrome b2 L(+)-lactate and
      L(+)-mandelate dehydrogenases (M(r) = approx. 59,000) in yeasts, FAD-dependent,
      membrane-bound D(-)-lactate and D(-)-mandelate dehydrogenases in bacteria, and
      soluble NAD-dependent D(-)-mandelate dehydrogenases in both bacteria and yeasts.

PMID- 8360628
TI  - Inhibition of phosphatidylcholine and chitin biosynthesis in Pyricularia oryzae,
      Botrytis fabae and Fusarium graminearum by edifenphos.
AB  - Colony growth of the fungi Pyricularia oryzae, Botrytis fabae and Fusarium
      graminearum was reduced by 50% (ED50) by edifenphos concentrations of 7, 25 and
      190 microM respectively; the phosphatidylcholine (PC) content of biomass of P.
      oryzae, B. fabae, and F. graminearum harvested from fungicide-containing-cultures
      was reduced by 50% by 6, 95 and 350 microM-edifenphos respectively. By contrast,
      the activities of membrane-bound chitin synthase preparations isolated from the
      three fungi were approximately equally sensitive to edifenphos. A direct
      relationship was observed between PC contents of biomass grown in the presence of
      ediphenphos and in vivo rates of chitin synthesis (biomass incubated with
      [3H]GlcNAc in the absence of fungicide). Membrane-bound chitin synthase
      preparations from P. oryzae grown in medium containing 3 or 6 microM-edifenphos
      had, at the same fungicide concentration, a lower rate of in vivo chitin
      synthesis than preparations isolated from biomass grown in the absence of
      edifenphos. Membrane-bound chitin synthase preparations from P. oryzae grown in
      the presence and absence of 6 microM-edifenphos had the same Km values for the
      substrate (UDP-[14C]GlcNAc) but different Vmax values. The results suggest that
      chitin synthesis is inhibited directly by non-competitive inhibition of chitin
      synthase activity, and indirectly following inhibition of PC biosynthesis. P.
      oryzae is very sensitive to edifenphos because inhibition of PC biosynthesis
      occurs at very low fungicide concentrations, and therefore in this fungus
      inhibition of PC biosynthesis probably represents the primary mode of action of
      the fungicide.

PMID- 8360629
TI  - Purification and characterization of a serine proteinase from senescent
      sporophores of the commercial mushroom Agaricus bisporus.
AB  - A proteinase has been purified from the stipes of senescent sporophores of the
      mushroom Agaricus bisporus. The proteinase was inhibited by PMSF. It has a broad
      pH optimum, 6.5-11.5, and a narrow substrate specificity, requiring both a
      hydrophobic amino acid in the P1 position and a minimum peptide chain length. The
      apparent molecular mass of the proteinase was 27 kDa when determined by SDS-PAGE
      and 14.1 kDa when measured by gel filtration. The isoelectric point of the
      proteinase was 9.0. Polyclonal antibodies have been raised to the proteinase. The
      proteinase from A. bisporus has similar properties to, and 60% N-terminal
      sequence identity with, proteinase K from the fungus Tritirachium album.

PMID- 8360630
TI  - Distribution of anaerobic fungi in the digestive tract of cattle and their
      survival in faeces.
AB  - A most probable numbers procedure was used to enumerate populations of anaerobic
      fungi in the digesta and faeces of cattle. Anaerobic fungi were isolated from the
      rumen, omasum, abomasum, small intestine, caecum, large intestine and faeces. By
      determining the amount of digesta in each organ of the digestive tract, it was
      possible to estimate the total population of anaerobic fungi in cattle and make
      comparisons between populations in different organs. In addition to enumerating
      anaerobic fungi in freshly collected samples, they were quantified in digesta and
      faeces which had been dried at ambient temperature and stored in air for up to 9
      months. These experiments showed that a higher proportion of the anaerobic fungi
      present in the hindgut and faeces were able to withstand desiccation than those
      present within the gastric and pre-gastric organs. Our results support the
      hypothesis that the life cycle of anaerobic fungi consists of three stages; the
      motile zoospore, the vegetative thallus and an aero-tolerant survival stage (cyst
      or resistant zoosporangium).

PMID- 8360631
TI  - Changes in levels of anti-dengue virus IgG subclasses in patients with disease of
      varying severity.
AB  - Extensive complement activation precedes onset of shock in dengue patients and
      complement "split products" C3a and C5a could be responsible, directly or
      indirectly, for the increased vascular permeability and disseminated
      intravascular coagulation which characterises dengue haemorrhagic fever (DHF)
      dengue shock syndrome (DSS). As IgG subclasses vary in their capacity to activate
      the classical complement pathway after combining with antigen, we have used an
      indirect enzyme linked immunosorbent assay (ELISA) to assess levels of IgG1-4
      against each dengue serotype in acute and convalescent sera from patients with
      disease of varying severity. Acute phase sera from patients with dengue
      haemorrhagic fever (DHF) or dengue shock syndrome (DSS) contained higher levels
      of anti-dengue antibodies of the IgG1, complement fixing, subclass than similar
      sera from dengue fever (DF) patients. Conversely, acute phase sera from DHF and
      DSS patients contained lower levels of anti-dengue antibodies of the poor
      complement activating IgG2 subclass than acute phase sera from DF patients. No
      significant differences were detected between the levels of anti-dengue IgG3 and
      IgG4 antibody in acute phase sera from DF, DHF, and DSS patients. With the
      exception of levels of anti-dengue IgG2 antibody from DHF patients which were
      lower than those from DF and DSS patients, levels of anti-dengue IgG1, IgG2,
      IgG3, and IgG4 were similar in convalescent sera from all patients. These results
      provide a possible explanation for the activation of the serum complement system
      which precedes onset of shock in severe dengue infections.

PMID- 8360632
TI  - Antibody responses of children to the C-terminal peptide of the SH protein of
      respiratory syncytial virus and the immunological characterization of this
      protein.
AB  - The SH protein of RSV, a small integrated hydrophobic membrane protein, consists
      of 64 amino acid residues in the polypeptide of subgroup A and 65 amino acid
      residues in the polypeptide of subgroup B. We synthesized five peptides,
      representing the SH protein of each RSV subgroup comprised of the following amino
      acid residues: 2-16, 12-26, 35-49, 45-60, and for subgroup A, 51-64 and for
      subgroup B, 51-65. Peptides 2-16 and 51-64/65 represented the N-terminal and C
      terminal ends of the protein, respectively. In RIPA, under reducing conditions
      with mercaptoethanol, hyperimmune guinea pig (GP) serum against C-terminal
      peptide of the two subgroups precipitated the homologous 7.5 kDa and 21-30 kDa SH
      proteins. Under nonreducing conditions, the GP antipeptide sera precipitated all
      three SH proteins, suggesting that the 13-15 kDa protein exists as a dimer. The
      subgroup A 7.5 and 13-15 kDa proteins had apparent molecular weights about 1-2
      kDa higher than the corresponding subgroup B proteins. The C-terminal peptides of
      subgroups A and B were used to characterize the immune response of 11 children,
      age 1 month to 1 year, with presumed primary RSV infection. Three of 4 children
      with subgroup A infection and 4 of 7 children with subgroup B infection developed
      homologous 4-fold rises in antibody to C-terminal peptide (aa 51-64/65) during
      convalescence. Except for one child with subgroup A and one child with subgroup B
      infection, the other 5 children developed heterologous rises also.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8360633
TI  - Aetiology of acute sporadic non-A, non-B viral hepatitis in India.
AB  - Non-A, non-B (NANB) hepatitis viruses are now classified as hepatitis E
      (enterically transmitted) and hepatitis C (parenterally transmitted). India
      experiences a large number of epidemics of the enteric disease every year. In
      addition, about 70% of the sporadic cases among adults are also due to NANB
      hepatitis. With the availability of an immunoblot assay for the detection of anti
      HEV-IgM and the polymerase chain reaction (PCR) for the detection of HCV-RNA,
      serum samples from epidemic and sporadic NANB patients were screened for these
      markers. We found that a large number of cases from the epidemics were HEV,
      though a few remained undiagnosed, while of the sporadic cases only a few could
      be diagnosed as HCV or HEV; a large proportion remained undiagnosed.

PMID- 8360634
TI  - Paramyxoviruses and Paget's disease.
AB  - Using the technique of in situ hybridisation, we extended our initial studies of
      the occurrence of canine distemper and measles virus in Paget's disease. Bone
      samples from untreated patients and patients treated with 3-amino
      hydroxypropylidene 1,1 bisphosphonate pamidronate (APD) were examined for canine
      distemper nucleocapsid (CDV-N), measles nucleocapsid (MV-N), respiratory
      syncytial virus fusion (RSV-F), and simian virus 5 haemoglutinin-neuraminidase
      (SV5-HN) sequences using 35S-labelled sense and antisense riboprobes. Only CDV-N
      mRNA was detected in osteoclasts, osteoblasts, and mononuclear cells. In
      untreated Paget's patients, 63.5% were found to have CDV sequences residing in
      bone cells, and 48.2% of those undergoing APD treatment were still found to have
      the viral sequences. RSV-F mRNA was only found in one patient. None of the other
      paramyxoviruses tested were detected. This study shows that CDV can infect a
      human host and may be an aetiological agent of Paget's disease of bone.

PMID- 8360635
TI  - Hepatitis B and hepatitis C among institutionalized psychiatric patients in
      Taiwan.
AB  - To investigate the seroprevalence of hepatitis B surface antigen (HBsAg) and
      antibodies to hepatitis C virus (anti-HCV) in a psychiatric institution in
      Taiwan, where hepatitis B virus (HBV) is hyperendemic, a total of 780 patients
      with psychiatric disorders were studied. Enzyme-linked immunosorbent assays
      (ELISA) were used for testing HBsAg and anti-HCV. The prevalence of HBsAg was
      higher than that of anti-HCV among these patients (18.1% vs. 6.8%, P < 0.0001).
      The HBsAg carrier rate in these patients was consistent with that of the general
      population, with a trend for HBsAg carrier rate to be lower in the aged and in
      females. In contrast, the prevalence of anti-HCV was higher in these patients
      than in general population. Anti-HCV positivity was found more frequently in
      patients who had received blood transfusion previously (24% vs. 6.4%, P < 0.05).
      The majority (92%) of patients with positive anti-HCV did not have a history of
      apparent parenteral exposure. The prevalence of anti-HCV increased significantly
      with duration of the psychiatric disorder. The prevalence of anti-HCV also tended
      to increase with duration of hospitalization but without reaching statistical
      significance. These findings suggest that these institutionalized psychiatric
      patients contract hepatitis B, as does the general population in Taiwan, and they
      should be considered as a specific risk group for hepatitis C infection.

PMID- 8360636
TI  - Is the course of perinatal hepatitis B virus infection influenced by genetic
      heterogeneity of the virus?
AB  - We studied the relations between genetic heterogeneity of pre-C region of
      hepatitis B virus (HBV) DNA and outcome of HBV infection in 5 infants with
      perinatal infection, 3 born to anti-hepatitis B e antigen (HBeAg), and 2 to HBeAg
      positive mothers. HBV infection developed in the babies at 3-4 months of age, but
      it resolved with seroconversion to anti-HBs in infants born to anti-HBe positive
      mothers, while the infection became chronic in the 2 babies born to HBeAg
      positive mothers. HBV-DNA extracted from the first hepatitis B surface antigen
      (HBsAg) positive serum sample of each baby was amplified and directly sequenced
      for the pre-core region. HBV-DNA sequences from 3 babies born to anti-HBe
      positive mothers showed at position 1896 the contemporary presence of 2
      nucleotides (G+A), indicating a mixture of wild-type and "e minus" variant HBV.
      These findings suggest a possible co-transmission of the 2 viruses from anti-HBe
      positive mothers to newborns. HBV-DNA from babies born to HBeAg positive mothers
      showed wild-type sequences only. The results of this study suggest that the
      outcome of HBV infection in newborns depends not only on the host's
      immunocompetence and on viremia level in maternal blood, but also on
      heterogeneity of HBV. Transmission of mixed HBV populations appears associated
      with an early immunoelimination of the virus, while infection with wild-type HBV
      alone contributes to induction of chronicity.

PMID- 8360637
TI  - Response of hemophilic patients to poliovirus vaccination: correlation with HIV
      serology and with immunological parameters.
AB  - Hemophilic patients may present immunological dysfunctions resulting from either
      human immunodeficiency virus (HIV) infection, or other factors like impure factor
      VIII concentrate and other viral infections. We evaluated prospectively the
      serologic response to polio vaccination of Israeli hemophilic patients who were
      vaccinated during an outbreak of poliomyelitis. Eighty-two hemophilic patients,
      43 seronegative and 39 seropositive for human immunodeficiency virus (HIV), were
      vaccinated with enhanced inactivated poliovirus (eIPV). Titers of antibodies for
      poliovirus types 1-3 were determined before and 4 weeks after immunization. T
      helper and suppressor lymphocytes (T4 and T8), B and T lymphocyte mitogenic
      response, and natural killer cells were tested and correlated with the response
      to vaccination. Both groups responded to vaccination with increased titers of
      antibodies to the three viral types, 4 weeks after immunization. HIV-seronegative
      patients, however, exhibited higher titers than the HIV-seropositive group. The
      same pattern was found when 21 patients were tested 1 year after the exposure to
      eIPV. HIV seropositive patients were grouped according to their T4 count (between
      16/microliter and 500/microliter). There was no statistically significant
      difference in the response of these different groups to vaccination. No
      correlation was found between the response to vaccination and other immune
      parameters. These results suggest that asymptomatic HIV-seropositive hemophilic
      patients respond well to eIPV, irrespective of their T4 count.

PMID- 8360638
TI  - Psychiatric comorbidity and treatment seeking. Sources of selection bias in the
      study of clinical populations.
AB  - Population studies have shown that the co-occurrence of psychiatric disorders
      increases the likelihood of treatment seeking. This leads to a biased estimation
      of the prevalence of comorbidity in clinical samples, and this overestimation can
      be attributed to two different sources of selection bias. Using data from a
      population survey of psychiatric disorders, in which 3258 residents of Edmonton,
      Alberta, Canada, were interviewed with the Diagnostic Interview Schedule, we
      assessed the extent of each of these two mechanisms. The first source of
      selection bias is the mathematical bias known as Berkson's bias and arises from
      the fact that an individual affected with two psychiatric disorders can seek
      treatment for either one or the other of these disorders. The second source of
      selection bias is clinical and results from the changed probability of seeking a
      treatment for a specific disorder because of the existence of a comorbid
      disorder.

PMID- 8360639
TI  - A comprehensive review of cyclothymic disorder.
AB  - Chronic affective disorders have generated much interest during the past decade
      due to increasing recognition of their clinical importance and because of
      controversy about their appropriate classification and treatment. The purpose of
      this paper was to review cyclothymic disorder. This review will include
      historical concepts, clinical phenomenology, family history, biological studies,
      and treatment of cyclothymia. In addition, the relationship of cyclothymia to
      other psychiatric disorders, such as bipolar, dysthymic, and personality
      disorders, is examined. The results suggest that some forms of cyclothymia are
      strongly associated with bipolar disorder, but that the condition is clinically
      heterogeneous. The problems of existing research in this area and future
      directions for research are also discussed.

PMID- 8360640
TI  - Perception of facial emotion in schizophrenic and right brain-damaged patients.
AB  - Deficits in the perception of facial emotion have been demonstrated in patients
      with right-sided brain damage (RBD) and schizophrenia (SZ). Furthermore, recent
      speculations have implicated right-hemisphere dysfunction in Type II
      schizophrenics, especially those with a preponderance of "negative symptoms" and
      flat affect. The performance of SZ, RBD, and normal control subjects was compared
      on measures assessing facial emotional perception. Both identification and
      discrimination paradigms were used, with positive/pleasant and
      negative/unpleasant emotions. To examine the effects of visuospatial and facial
      processing on facial emotion tasks, the Visual Matrices Test and the Benton
      Facial Recognition Test were administered. On both facial emotion tests, SZ and
      RBD patients were significantly impaired relative to normal subjects, but not
      different from each other. The SZ and RBD patients were also impaired on the
      matrices and facial recognition tests. When the effects of the matrices and
      neutral face recognition tests were statistically controlled, significant group
      differences remained for the identification task but not for the discrimination
      task. Thus, methodologies are presented for the neuropsychological study of
      facial emotional perception, and some support is provided for the notion that
      negative-symptom schizophrenia is associated with right hemisphere dysfunction.

PMID- 8360641
TI  - Treatment response of borderline inpatients. A growth curve analysis.
AB  - This study examined the course of 40 hospitalized female borderline personality
      disorder patients over 25 weeks of inpatient treatment. Course was measured
      through weekly administration of the SCL-90-R. Level of identity and
      interpersonal problems, hypothesized by Kernberg to be at the center of the
      borderline patient's pathology, were found to be powerful predictors of treatment
      course. Patients with the most severe identity and interpersonal problems
      reported more symptoms throughout treatment and increasing symptom levels over
      time. This was very different from patients with the lowest level of identity and
      interpersonal problems, who reported fewer symptoms overall and decreasing
      symptoms over time.

PMID- 8360642
TI  - Perinatal substance abusers. Psychological and social characteristics.
AB  - Forty perinatal substance abusers were administered multiple psychosocial,
      addiction, and psychological measures before beginning treatment. Results
      indicate that these patients are limited intellectually, educationally,
      financially, and emotionally. Psychiatric comorbidity was high, with 45% having
      non-substance abuse axis I diagnoses and 75% having confirmed (by two or more
      tests) axis II pathology. The most frequently identified axis I disorders were
      depression and anxiety. The most frequently detected personality disorders were
      antisocial, borderline, paranoid, and dependent. The average IQ was 87 (low
      average range) and nearly one third of the sample were found to be somewhat
      impaired intellectually. These data suggest that treatment programs must take
      psychological characteristics into account if they are going to succeed in
      helping these women achieve and maintain abstinence.

PMID- 8360643
TI  - Long-term outcome of treated schizophrenia in a Nigerian cohort. Retrospective
      analysis of 7-year follow-ups.
AB  - Consecutive case records of 142 patients (55 males and 87 females) who fulfilled
      stringent criteria for schizophrenia, and attended the psychiatric facilities at
      the Ibadan teaching hospital for at least 7 consecutive years were studied in
      detail in order to determine outcome in a period of follow-up that ranged from 7
      to 26 years (mean +/- SD, 13.3 +/- 4.6 years). A unique history of stability of
      staff and research record keeping, as well as the fact that relatives frequently
      accompany patients to hospital, enhanced the reliability and validity of
      documents. Using outcome criteria that included the presence of positive and
      negative symptoms of schizophrenia and social adjustment in the past 12 months,
      it was found that 72 (50.7%) patients were in the good outcome group, while 34
      (23.9%) and 36 (25.4%) had moderate and poor outcome, respectively. The social
      and clinical characteristics of the patients were similar to those of
      participants in World Health Organization prospective studies in this country.
      Whereas there was a nonsignificant trend for more females to be without psychotic
      symptoms, the males performed significantly better in social adjustment outcome
      measures. In contrast with reports from the Western world, patients with acute
      onset and episodic course were a common feature of the cohort. The results
      support previous reports indicating fairly good outcome of schizophrenia in
      developing countries.

PMID- 8360644
TI  - Delusional mania: what is a mood-incongruent psychotic feature?

PMID- 8360645
TI  - Lithium neurotoxicity at therapeutic levels in an AIDS patient.

PMID- 8360646
TI  - Abuse potential of carbamazepine.

PMID- 8360647
TI  - A putaminal lesion in an adolescent with obsessive-compulsive disorder and
      atypical anorexia nervosa.

PMID- 8360648
TI  - War and posttraumatic stress disorder: the question of social context.

PMID- 8360649
TI  - How to run a brain bank.

PMID- 8360650
TI  - The need of a consensus for brain banking.

PMID- 8360651
TI  - A brain bank in a neuropathology laboratory (with some emphasis on diagnostic
      criteria).
AB  - The Brain Bank of La Salpetriere Hospital (Paris) is implanted in a
      neuropathology laboratory. It is multipurpose, prospective, and "free of charge"
      for the users. Protocols are prospectively established, in collaboration with the
      neuroscientists. One of our major difficulties in the collection of cases
      concerns presently the controls: the neurological status of patients coming from
      Neurology departments has usually been correctly assessed but those patients are
      bad controls. The normality of the neurological status of patients dying in other
      departments is difficult to assess retrospectively. A general autopsy is
      performed in each case. Several systematic sampling and fixation procedures are
      currently in use; their pros and cons are discussed. The main safety problem we
      are confronted with is the risk of HIV and Jakob-Creutzfeldt transmission. We try
      to standardize our diagnostic procedures; criteria used in Alzheimer's disease,
      Parkinson's disease, Huntington's chorea are briefly reviewed. We plan, in the
      future, to standardize our procedures for control cases. The Brain Bank has had a
      very positive impact on the way this neuropathology laboratory works: it
      introduced new techniques; on the other hand, the adequate processing and
      diagnosis of the samples was, in many aspects, simplified by the collaboration
      with the neuropathology department. The demand for human brain samples is
      steadily increasing in Neuroscience, for at least 2 reasons: 1. some diseases are
      specifically human and lack adequate animal models (Alzheimer's disease,
      multisystem atrophy), or animal models may appear irrelevant in some aspects
      (multiple sclerosis) or finally, results obtained in animal models may have to be
      confronted with human pathology (AIDS ...) 2. many aspects of human neuroanatomy
      can not be extrapolated from animal data There are many ways of organizing a
      brain bank and no golden standard (Swaab et al., 1989): the neuroscientist
      himself may collect the samples in a given pathology or the neuropathologists may
      modify their practice to provide adequate samples to the neuroscientists. When
      the neuroscientist himself collects his own samples, he obviously proceeds more
      rapidly. However, he is confronted with the difficult problem of the controls,
      which require both a clinical follow-up and a pathological check up of the
      tissues, both of which may be difficult to obtain in a research unit. In our
      opinion, the neuropathologists are the natural "brain bankers": they are indeed
      naturally "rich", their job being precisely to collect human samples, in
      connection with the clinicians.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8360652
TI  - Brain banks and research in neurochemistry.
AB  - The increasing demand to brain banks for specimens that are properly prepared for
      research in neurochemistry has stimulated interest in the drawing up of suitable
      protocols. The purpose of this chapter is twofold: (1) to describe the various
      strategies that are currently applied in different brain banks and (2) to point
      out the main neurochemical requirements in order to reach a consensus with the
      brain bank about the more suitable protocol in each case. In recent years, some
      brain banks have acquired the necessary equipment and now have access to
      neurochemical expertise. Their experience will be very helpful in defining the
      new procedures to be used at each stage of brain tissue banking and will permit
      the development of research projects in this discipline.

PMID- 8360653
TI  - Brain banking for immunocytochemistry and autoradiography.
AB  - The aim of a human brain bank is to establish groups of matched brains (normal
      control versus pathological groups) for studying human diseases of the nervous
      system. This bank is obtained by means of autopsy performed with a very short
      post-mortem delay and from clinically and neuropathologically well-documented
      patients. According to research protocols, two types of brain tissue storage are
      performed: fixed tissue or frozen tissue. Brain dissection procedures are
      performed according to precise anatomical boundaries of each brain region. This
      paper will center on the questions raised by brain banking in relation to
      histological and immunocytochemical studies and to biochemistry and
      autoradiography of binding sites. The lack of neuroanatomical data of the human
      brain leads us to compare anatomical results obtained in animals to that of the
      human. Moreover, it is clear that human brains present numerous interindividual
      differences (Kopp et al., 1977; Jack et al., 1989). Therefore, investigations of
      the human brain should be made on a large series of brains indicating the
      necessity of a well-documented brain bank of tissue from normal controls and
      patients.

PMID- 8360654
TI  - The Netherlands brain bank--a clinico-pathological link in aging and dementia
      research.
AB  - The number of sophisticated neurobiological techniques which can be applied on
      human brain has rapidly increased and causes an increased demand for post-mortem
      human brain tissue for research purposes. Brain banks, which collect post-mortem
      tissue from patients who suffered from neurological and psychiatric disorders,
      have become an important link between clinicians, scientists and
      neuropathologists involved in aging and dementia research. Due to the large
      variability of the material, there are many drawbacks in the use of post-mortem
      brains. Therefore, collecting human brain tissue for research should include
      matching for several factors, both ante-mortem and post-mortem. Some of the most
      important ante-mortem factors include age, sex, agonal state, seasonal
      alterations, circadian variation and clock time of death. The post-mortem factors
      which should be matched for include the post-mortem delay, fixation and storage
      time and lateralization. The material and data on aging and dementia, collected
      by the Netherlands Brain Bank in the past six years will serve in the present
      paper to illustrate the wide variety of potentialities and pitfalls in the use of
      post-mortem human brain tissue. Brain Bank organizations for various neurological
      diseases form at present an important clinico-pathological link in aging and
      dementia research and the availability of post-mortem human brain tissue makes it
      possible to investigate those diseases for which no animal model is available. In
      order to provide research groups with post-mortem brain tissue from Alzheimer's
      disease (AD) patients and controls, a brain bank was established by the end of
      1985 in The Netherlands Institute for Brain Research. This brain bank is based
      upon research projects submitted in advance, specifying a variety of requirements
      such as: total number of brains needed, kind of fixation, agonal state, post
      mortem delay, exact anatomical boundaries of the brain region, kind of fixation
      and other treatment requirements of the tissue. This Brain Bank has got two
      unique features: 1. Human brain tissue is obtained by means of rapid autopsies
      with a very short post-mortem delay, ranging between 2-4 hour. 2. Fresh brain
      dissection procedure is used, which is a difficult regime to establish, requiring
      qualified staff at inconvenient times. This dissection procedure is necessary for
      the immediate use of fresh tissue and advantageous in increasing the range of
      morphological, neurochemical, immunocytochemical, metabolic and other procedures
      which can be applied to tissues fixed in a different way or rapidly frozen brain
      tissue free of freezing artifacts.

PMID- 8360655
TI  - Organization and research applications of the U.K. Multiple Sclerosis Society
      Tissue Bank.
AB  - The Multiple Sclerosis Society Tissue Bank contains post-mortem central nervous
      system tissue from over 100 clinically and neuropathologically well-documented
      multiple sclerosis (MS) cases, and from normal control subjects. This bank is a
      resource centre which provides histologically screened snap-frozen material for
      immunological, neurochemical and nucleic acid studies in our own and other MS
      laboratories in Europe and the USA. In addition to immunopathological studies,
      Tissue Bank material has been used to investigate changes in CNS-specific
      proteins and lipids in MS plaques and responses of oligodendrocytes and
      astrocytes to the inflammatory demyelinating process. MS lesions detected in
      unfixed post-mortem brain and spinal cord by magnetic resonance imaging
      techniques prior to dissection have been characterized histologically and
      biochemically. A computer database on Tissue Bank post-mortem cases has been
      established to link clinical, pathological and scientific aspects of MS research.

PMID- 8360656
TI  - Parkinson's Disease Society Brain Bank, London: overview and research.
AB  - The UK Parkinson's Disease Society Brain Bank receives tissue from patients with
      Parkinson's disease and a variety of different movement disorders. Half of the
      brain is used for full neuropathological examination prior to allocation for
      specific research projects. Clinical misdiagnosis occurs in a significant
      proportion of cases and clinico-pathological correlation provides valuable
      information for disease recognition. With the expanding number of other
      specialist brain banks there is a need for agreement on diagnostic criteria.
      Furthermore, awareness of different methods of tissue handling is essential.

PMID- 8360657
TI  - The development of a brain bank.
AB  - The methods used in developing a brain bank are described. The techniques for
      encouraging brain donation and the precautions to be used when dealing with
      medical examiner cases are outlined. Simplifying the donation process by the
      pathologist in order to gain his cooperation is essential. The importance of
      keeping an open telephone link available at all hours of the day and night and
      the need to solicit the donating families' cooperation in seeking clinical
      records is emphasized. Detailed neuropathological examination of every brain is
      essential for diagnostic purposes. Recent techniques to improve the qualify of
      postmortem brain tissue for molecular genetic studies are described.

PMID- 8360658
TI  - Pathological assessment of movement disorders: requirements for documentation in
      brain banks.
AB  - The general methodological requirements and principal morphologic hallmarks for
      the post mortem assessment of the major types of movement disorders are
      critically reviewed. These data may enable Brain Banks to classify movement
      disorders according to current clinicopathological diagnostic criteria.
      Comprehensive clinical assessment and accurate neuropathological examination
      using adequate methods are required for collection of and research on tissues
      from patients with movement disorders.

PMID- 8360659
TI  - Parkinson's Disease Brain Bank in Paris: an evolutive bank responding to the
      exigencies of new neurochemical methodologies.
AB  - The purpose of a brain bank is to collect specimens in order to investigate human
      brain and pathologies of the central nervous system. The organization of the
      brain bank in Paris, devoted to the study of Parkinson's disease, is described,
      with it's evolutions with years, to respond to the exigencies of the new
      neurochemical methodologies.

PMID- 8360660
TI  - The interest of the neurological tissue preservation for the investigation of
      sudden infant death syndrome.
AB  - Sudden infant death syndrome (SIDS) is the main cause of post-natal infant
      mortality in developed countries with an incidence rate ranging from 1.5 to
      2:1000 live births. Brainstem dysfunction of circuits which control respiration
      and cardiovascular stability may be involved in SIDS. Combined neuropathological
      and biochemical studies could elucidate some of these aspects. The relationships
      of these deaths to medico-legal problems could explain the scarce availability of
      these tissues. The need for a central SIDS tissue bank is emphasized and a
      protocol for the collection of CNS tissue is proposed. A detailed
      neuropathological study using this protocol allowed us to recognize pathological
      features in the CNS of 9 SIDS cases. Some features were related to the maturation
      of CNS, and others to possible infections. Gliosis was a common finding in most
      cases. The present state of SIDS investigation and results are also discussed.

PMID- 8360661
TI  - Amyotrophic lateral sclerosis brain banking: a proposal to standardize protocols
      and neuropathological diagnostic criteria.
AB  - Motorneurons which are primarily affected in ALS cannot be sampled during life.
      Morphological, biochemical, ultrastructural and molecular investigations can be
      only performed on post-mortem material. No animal model reproduce adequately ALS.
      All these features and the low ALS incidence and the absence of definite clusters
      stress the need for brain banking in Europe. We present the protocol which is
      followed in our centers. The clinical information is supplied by neurologists in
      order to provide clinical data necessary for an accurate interpretation of
      pathological features. Initial symptomathology, duration and type of ALS, cause
      of death and a simple disability scale shortly before death are included. CNS
      relevant samples stained with H-E, luxol fast blue, the Marchi impregnation
      technique and immunostained with ubiquitin, are used for diagnosis. Samples for
      Golgi impregnation and immunohistochemistry are also obtained and the remaining
      tissue is frozen. Classical criteria for pathological diagnosis include:
      neurogenic changes in muscles, loss of motorneurons and degeneration of
      corticospinal tracts. We propose new diagnostic criteria based only on CNS
      examination. Muscle tissue is not always available and other classical criteria
      could be absent in rapid evolution or early death cases. Our criteria includes:
      a) Major criteria: loss or degeneration (chromatolysis, basophilia or
      neuronophagia) of motorneurons in brainstem and/or spinal cord, degeneration of
      corticospinal tracts. b) Minor criteria: axonal spheroids, Bunina bodies,
      ubiquitin-immunoreactives bodies. Criteria necessary for the pathological
      diagnosis are discussed and the need to quantify neuronal loss in relation to age
      matched controls is stressed.

PMID- 8360662
TI  - Changes in the myelinated axons of femoral nerve in amyotrophic lateral
      sclerosis.
AB  - Myelinated fibres in femoral nerves removed from amyotrophic lateral sclerosis
      (ALS) cases at post mortem were compared with age matched controls. A technique
      for processing whole transverse sections of the nerves for osmication and
      subsequent morphometric analysis is described. Although areas depleted in
      myelinated fibres were seen in the nerves from the ALS group, no statistically
      significant difference was shown due to wide variations in the controls. However,
      the ALS nerves showed a degree of disruption in the myelin which was not apparent
      in the controls. The most obvious effect was widespread "wrinkling" of the myelin
      in both large and small fibres from the ALS nerves. This phenomenon is the
      initial stage of a process which eventually results in uneven myelin thickness
      and nodal swellings and finally myelin ovoids and balls. We illustrate the steps
      in the progression of this degeneration with teased nerve studies and electron
      microscopy and propose that there are qualitative changes in the myelin of
      peripheral nerve in ALS. It seems likely that these are secondary effects
      resulting from axonal degeneration caused by deterioration and loss of anterior
      horn cells in the spinal cord.

PMID- 8360663
TI  - How to run a brain bank: potentials and pitfalls in the use of human post-mortem
      brain material in research.
AB  - Brain banks for neurological diseases serve as a link between the clinician, the
      neuropathologist and the basic scientist who require brain tissue samples from
      patients who have undergone a thorough clinical investigation and whose brains
      have been subjected to detailed neuropathological analysis. In order to provide
      research groups with post-mortem brain tissue from patients who show clinical
      signs of dementia such as Alzheimer's disease (AD), senile dementia of Alzheimer
      type (SDAT), vascular dementia including multi-infarct dementia (MID) and mixed
      dementia, a brain bank was established at Huddinge University Hospital at the end
      of 1988. The brain bank provides either rapidly or slowly frozen tissue samples,
      tissue samples fixed in formalin (short/long fixation time), cerebrospinal fluid
      (CSF), and blood samples. Average postmortem times are from 3-47 hours. The
      information available on the cases includes the clinical diagnosis, the premortem
      clinical investigation with behavioral observations, psychometric and
      neuropsychological test data, premortem medication, cause of death, agonal state,
      pH in brain and CSF, and the general anatomic and neuropathologic assessments
      leading to the final diagnosis.

PMID- 8360664
TI  - How to run a brain bank. A report from the Austro-German brain bank.
AB  - The sophisticated analysis of and growing information on the human brain requires
      that acquisition, dissection, storage and distribution of rare material are
      managed in a professional way. In this publication we present the concept and
      practice of our brain bank. Both brain tissue and information are handled by
      standardized procedures and flow in parallel from pathology to neuropathology and
      neurochemistry. Data concerning brain material are updated with clinical
      information gained by standardized procedures.

PMID- 8360665
TI  - Human neuro-specimen banking 1961-1992. The National Neurological Research
      Specimen Bank (a donor program of pre- and post-mortem tissues and cerebrospinal
      fluid/blood; and a collection of cryopreserved human neurological specimens for
      neuroscientists).
AB  - The National Neurological Research Specimen Bank (The Bank) was established in
      1961 to provide a vital service to neuroscientists. Our purpose is to support
      medical research which seeks the etiopathogenesis for devastating neurological
      disorders with no known cause, treatment or precise animal model. It serves as a
      bridge between the neurology clinician who diagnoses and cares for patients with
      incurable disease and the basic scientist who has need for specimens to find
      their etiopathogenesis. In the long run this service should advance neurologic
      diagnoses and serve as the basis for designing treatment. The Bank has grown to
      be the largest, most diverse neurological specimen bank of its kind in the world.
      It is a type of "tissue bank" where donor members "will" their central nervous
      system tissues to science. Then we collect, photograph, seal in air tight bags,
      quick freeze, cryogenically store and distribute on request the donated tissue to
      research scientists around the world. All tissue diagnoses are confirmed by
      clinical records and neuropathologic examination; further histology is conducted
      on request. In addition to brain and spinal cord tissues, the Bank has samples of
      other tissues. There are also samples of pre- and post-mortem CSF and sera from
      normal individuals and patients with various neurological disorders, especially
      serial specimens on multiple sclerosis patients and HIV-1 seropositive and at
      risk individuals. This paper outlines the global operations of our human brain
      bank, based on protocols developed and used by the authors. These operations
      include donor solicitation, tissue acquisition and documentation, tissue
      processing and storage, specimen dissemination to users, outcome assessment of
      banking, quality control, cost of our operation, table of organization and the
      future.

PMID- 8360666
TI  - How to run a "brain bank"? Clinical and institutional requirements for "brain
      banking".
AB  - "Brain Banking" or prospective sampling of tissues relevant to the study of
      neurological disease is a complex task which needs organization at various levels
      of operation such as the establishment of a donor system, recruitment of clinical
      assessment centres, establishment of standardized assessment protocols, the
      inauguration of logistic structures for brain removal and transport to the bank,
      proper storage of patient data and tissues, histological verification of the
      disease and availability of tissue and clinical data to researchers. This effort
      certainly promises to bear fruit since there is a striking lack of precise
      prospective studies into etiology and pathogenesis in most neurological diseases
      especially in the field of the neurodegenerative diseases.

PMID- 8360667
TI  - The contemporary AIDS database and brain bank--lessons from the past.
AB  - This paper addresses the issues in establishing a contemporary AIDS Brain Bank
      with a Database. It draws comparisons from the past when a similar approach was
      made towards the understanding of mental illness and its treatment. The aim of
      the Brain Bank is to provide a comprehensive range of neuropathologically
      characterised tissues from the nervous system to researchers and scientists as a
      resource for research. The aim of the Database is to provide the up-to-date
      clinical and pathological information relating to the material supplied by the
      Brain Bank. The paper describes the mechanics of establishing the Database, the
      importance of efficiency as well as discussing the sensitive issues that need to
      be addressed when designing and AIDS Database and Brain Bank.

PMID- 8360668
TI  - Brain banks and non nervous tissues.
AB  - Nervous system diseases may not be confined to neural tissue, but also affect
      other organs. These organs could be involved indirectly or could be
      simultaneously affected by the same pathological process. A brain bank (BB)
      should also guarantee the storage of specific organs primarily or secondary
      affected other than nervous system. Tissues from patients with primary nervous
      system diseases without or with unknown systemic involvement should also be
      stored. Samples stored will be identified and registered in a BB database for an
      accurate distribution and utilization of the material. To guarantee the best
      quality of the material stored, several techniques for the collection and
      preservation (cryopreservation, chemical fixation and microwave irradiation) and
      tissue management are described.

PMID- 8360669
TI  - Biliverdin reductase is heat resistant and coexpressed with constitutive and heat
      shock forms of heme oxygenase in brain.
AB  - Two heme oxygenase (HO) isozymes--HO-1, which is a heat shock protein (HSP32),
      and HO-2--catalyze the isomer-specific production of biliverdin IX alpha and
      carbon monoxide. The latter has the potential of functioning as a
      neurotransmitter, whereas the reduced form of biliverdin, bilirubin, has potent
      antioxidant activity. Formation of bilirubin is catalyzed by biliverdin reductase
      (BVR). The reductase is a unique enzyme in being dual pyridine nucleotide and
      dual pH dependent. Here, we show that the reductase is resistant to thermal
      stress at both the protein and message level. We further demonstrate that the
      reductase is coexpressed in cells that display HO-1 and/or HO-2 under normal
      conditions, as well as in regions and cell types that have the potential to
      express heat shock-inducible HO-1 protein. Exposure of male rats to 42 degrees C
      for 20 min did not decrease brain BVR activity, but caused a slight increase in
      NADPH- and NADH-dependent activities at 1 and 6 h following hyperthermia. High
      levels of the approximately 1.5-kb BVR mRNA were detected in control brain; it
      too displayed thermal tolerance. Similarly, the pattern of multiplicity of net
      charge variants of the enzyme purified from brain of heat-shocked rats did not
      differ from the control pattern. Immunochemical localization of BVR protein in
      normal brain correlated well with the presence of HO-1 and/or HO-2 throughout the
      forebrain, diencephalon, cerebellum, and brainstem regions. There were select
      neuronal and nonneuronal cells in the substantia nigra and cerebellum that did
      express the reductase under normal conditions, wherein no HO isozymes could be
      detected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360670
TI  - Nerve growth factor stimulates the production of inositol 1,3,4- and 1,4,5
      trisphosphate and inositol 1,3,4,5-tetrakisphosphate in PC12 cells.
AB  - In PC12 cells, preincubated with [3H]inositol, nerve growth factor (NGF)
      stimulated an approximately 100% increase in the levels of [3H]inositol 1,3,4
      trisphosphate ([3H]-Ins(1,3,4)P3], [3H]inositol 1,4,5-trisphosphate
      ([3H]Ins(1,4,5)P3], and [3H]inositol 1,3,4,5-tetrakisphosphate
      ([3H]Ins(1,3,4,5)P4] as early as 5-15 s after addition of NGF. This NGF-mediated
      response was apparent only when the cells had been cultured in the absence of
      fetal bovine serum (FBS). PC12 cells cultured in FBS-containing medium did not
      display NGF-mediated increases in [3H]Ins(1,3,4)P3, [3H]Ins(1,4,5)P3, and
      [3H]Ins(1,3,4,5)P4 levels. Using cells cultured in the absence of FBS, epidermal
      growth factor (EGF) and fibroblast growth factor also stimulated production of
      [3H]Ins(1,3,4)P3, [3H]Ins(1,4,5)P3, and [3H]Ins(1,3,4,5)P4. Lavendustin A, a
      tyrosine kinase inhibitor, inhibited both the EGF- and NGF-stimulated increases
      in the levels of these tritiated inositol phosphates. These results suggest that
      NGF stimulates the production of Ins(1,3,4)P3, Ins(1,4,5)P3, and Ins(1,3,4,5)P4
      and that this response is dependent on tyrosine kinase activity. Furthermore,
      although the production of Ins(1,3,4)P3, Ins(1,4,5)P3, and Ins(1,3,4,5)P4 may be
      a common response to factors stimulating neuronal differentiation, it is not
      sufficient for stimulation of neuronal differentiation.

PMID- 8360671
TI  - Muscarine receptors regulating electrically evoked release of acetylcholine in
      hippocampus are linked to pertussis toxin-sensitive G proteins but not to
      adenylate cyclase.
AB  - [3H]Acetylcholine release elicited with 360 pulses/3 Hz from slices of rabbit
      hippocampus is facilitated in the presence of the muscarine (M) receptor
      antagonist atropine (indicating the existence of autoinhibition) and diminished
      by the M receptor agonists carbachol and oxotremorine. N-Ethylmaleimide (30
      microM) and pertussis toxin (8 micrograms/ml) counteracted antagonist-induced
      facilitation and agonist-induced inhibition of release, suggesting that a
      pertussis toxin-sensitive GTP-binding protein is involved in the chain of events
      mediating activation of M receptors to inhibition of release. Neither 8-bromo
      cyclic AMP (300 microM), a membrane analogue of cyclic AMP, nor rolipram (10
      microM), a phosphodiesterase inhibitor, affected electrically evoked release of
      [3H]acetylcholine. They also did not influence the oxotremorine-induced
      inhibition of transmitter release. In conclusion, no evidence was found for the
      assumption that activation of M autoreceptors is linked to inhibition of
      adenylate cyclase.

PMID- 8360672
TI  - Homologous desensitization of serotonin 5-HT2 receptor-stimulated intracellular
      calcium mobilization in C6BU-1 glioma cells via a mechanism involving a
      calmodulin pathway.
AB  - Serotonin 5-HT2 receptor-mediated intracellular Ca2+ mobilization was
      investigated in rat glioma C6BU-1 cells. The receptors became desensitized after
      previous exposure to 5-HT in a time- and concentration-dependent manner. The
      desensitization of 5-HT2 receptor-mediated intracellular signaling appeared to be
      homologous because previous exposure to 5-HT did not alter the response to other
      transmitters such as thrombin or isoproterenol and because previous exposure to
      thrombin or isoproterenol did not diminish the response to 5-HT. The
      desensitization induced by pretreatment with 5-HT was potently prevented by the
      naphthalenesulfonamide derivative W-7, a calmodulin antagonist, when it was
      cosupplied with 5-HT. Furthermore, the preventive effect of W-7 was greater than
      that of W-5, a weak analogue of W-7, and than that of H-7, a nonselective
      inhibitor of protein kinases. These results suggest that 5-HT2 receptor-mediated
      Ca2+ mobilization can be desensitized homologously after prolonged exposure to 5
      HT in a calmodulin-dependent manner in rat glioma C6BU-1 cells.

PMID- 8360673
TI  - Effect of an n-3 fatty acid-deficient diet on the adenosine-dependent melatonin
      release in cultured rat pineal.
AB  - We studied the effect of a diet deficient in n-3 fatty acids on the adenosine
      dependent melatonin release from cultured rat pineal gland after stimulation by
      5'-N-ethylcarboxamidoadenosine (NECA), an A2 adenosine agonist. Experiments were
      conducted with 2-month-old rats raised on semipurified diets containing either
      peanut oil (n-3 deficients) or peanut plus rapeseed oil (controls). The
      proportion of docosahexaenoic acid (22:6 n-3) in the pineal total lipid fraction
      and in phosphatidylcholine and phosphatidylethanolamine was significantly
      decreased in n-3-deficient rats. This was compensated for partially by an
      increase in 22:4 n-6 and 22:5 n-6 levels. The activity of the cultured rat
      pineal, in terms of cyclic AMP content and N-acetylserotonin and melatonin
      release in the medium, was lower after stimulation by 10(-5) mol/L NECA in the
      group fed peanut oil than in the group fed peanut plus rapeseed oil. The
      increased ratio of n-6/n-3 fatty acids in pineal total lipids and the major
      glycerophospholipids (phosphatidylcholine and phosphatidylethanolamine) may have
      an important influence on the rat pineal responses. The results are discussed in
      the context of changes in membrane-bound proteins, including enzymes and/or
      receptors involved in the rat pineal gland function.

PMID- 8360674
TI  - High and low molecular weight tau proteins are differentially expressed from a
      single gene.
AB  - Both high and low molecular weight (HMW and LMW) tau proteins are expressed in
      the immature and adult mouse spinal cord. Northern blot analysis, performed with
      probes complementary to domains common and uncommon to the LMW and HMW entities,
      suggested that HMW tau proteins found in the immature mouse spinal cord are not
      translated from the single transcript of 6 kb expressed at these stages, but are
      transported within this nervous structure by axons arising in the periphery. In
      contrast, another minor transcript of 8 kb was detected in the adult mouse spinal
      cord by a HMW tau specific probe, suggesting that a small fraction of the HMW tau
      forms present in adulthood are translated within mouse spinal cord neurons. LMW
      spinal cord tau forms are encoded by mRNAs of 6 kb that contain three and four
      homologous repeats at immature and mature stages, respectively, whereas adult HMW
      entities contain four repeats. PCR analysis performed with mouse genomic DNA also
      showed that the nonhomologous region specific for HMW tau is a single exon.
      Southern blot and gene mapping showed that the same gene, located on the murine
      chromosome 11, encodes all the LMW and HMW tau variants. All these tau forms,
      therefore, are produced by an alternative splicing mechanism that is neuron
      specific and developmentally regulated.

PMID- 8360675
TI  - Molecular cloning of two additional members of the neural visinin-like Ca(2+)
      binding protein gene family.
AB  - We have isolated a rat cDNA clone encoding a neural visinin-like Ca(2+)-binding
      protein (NVP), which we designate NVP-1. To identify additional molecular forms
      of NVP, a rat brain cDNA library was screened for their presence using an NVP-1
      cDNA probe under low-stringency hybridization conditions. Two types of cDNA
      clones encoding structurally related proteins, designated NVP-2 and NVP-3, have
      been isolated. The deduced amino acid sequences of NVP-2 and NVP-3 are 89.0% and
      68.6% identical to that of NVP-1, respectively, and contain consensus sequences
      for EF-hand Ca(2+)-binding sites. Northern blot analysis shows that NVP-1, NVP-2,
      and NVP-3 mRNAs are most highly expressed in brain and are differentially
      expressed in various regions of rat brain. These results suggest that NVP-2 and
      NVP-3 are additional members of the NVP gene family.

PMID- 8360676
TI  - Basic fibroblast growth factor-induced increase in zif/268 and c-fos mRNA levels
      is Ca2+ dependent in primary cultures of hippocampal neurons.
AB  - Basic fibroblast growth factor (bFGF) is present in the developing rat brain and
      has been shown to provide critical trophic support for hippocampal neurons in
      culture. The influence of bFGF on the expression of mRNAs encoding the
      transcription factors zif/268 and c-fos was studied in primary cultures of
      hippocampal neurons (derived from rat embryos) using reverse transcription
      coupled PCR. In these cultures grown for 3 days in the absence of serum, bFGF
      causes a dramatic and transient increase in the levels of zif/268 and c-fos,
      within 15 and 30 min, respectively. A similar induction of these two early genes
      occurs following activation of protein kinase C (PKC). The bFGF-induced
      activation persists after PKC desensitization but is inhibited by chelation of
      intracellular Ca2+. These results suggest that in primary cultures of hippocampal
      neurons, bFGF induces the expression of immediate early genes through a pathway
      that requires Ca2+ mobilization.

PMID- 8360677
TI  - Identification and characterization of endothelin receptor subtype B in rat
      retina.
AB  - The presence of immunoreactive (IR) endothelin (ET)-1 and ET-1 receptors in rat
      retina has been studied by radioimmunoassay and receptor assay, respectively. The
      specific binding of 125I-ET-1 to rat retinal particulate preparations was
      saturable. Apparent equilibrium conditions were established within 120-140 min.
      Scatchard analysis of binding data indicated a single class of high-affinity
      binding sites with a KD of 35 +/- 11 pM and a Bmax of 168 +/- 60 fmol/mg of
      protein. 125I-ET-1 binding to retinal particulate preparations was not inhibited
      by 1 microM concentrations of somatostatin, atrial natriuretic factor, brain
      natriuretic peptide, thyroid-stimulating hormone, growth hormone, or insulin. The
      three endothelin isoforms, ET-1, -2, and -3, had similar affinity for the
      receptor. Cross-linking of 125I-ET-1 to retinal particulate preparations with
      disuccinimidyl suberate resulted in the labeling of two bands with apparent
      molecular masses of 52 and 34 kDa. We have established a highly sensitive and
      specific radioimmunoassay for ET-1. The concentration of IR-ET-1 in rat retina
      was 35 +/- 10 fmol/g wet weight. The demonstration of specific high-affinity ETB
      receptors and the presence of IR-ET-1 suggest that the peptide may act as a
      neurotransmitter or neuromodulator in the retina.

PMID- 8360678
TI  - Subunit association and glycosylation of acetylcholinesterase from monkey brain.
AB  - Cercopithecus monkey brain acetylcholinesterase (AChE; EC 3.1.1.7) consists of
      about 15% hydrophilic, salt-soluble enzyme and 83% amphiphilic, detergent-soluble
      enzyme. Sucrose density gradient centrifugation showed that hydrophilic, salt
      soluble AChE was composed of about 85% tetramer (10.3S) and 15% monomer (3.3S).
      In amphiphilic, detergent-soluble AChE, 85% tetramer (9.7S), 10% dimer (5.7S),
      and 5% monomer (3.2S) were seen. The enzyme is N-glycosylated, and no O-linked
      carbohydrate could be detected. Use of two monoclonal antibodies, one directed
      against the catalytic subunit and the other against the hydrophobic anchor, gave
      new insights into the subunit assembly of brain AChE. It is shown that in
      tetrameric AChE, not all of the subunits are disulfide-bonded and that two
      populations of tetramers exist, one carrying one and the other carrying two
      hydrophobic anchors.

PMID- 8360680
TI  - Inhibition of succinate dehydrogenase by malonic acid produces an "excitotoxic"
      lesion in rat striatum.
AB  - Excitotoxicity and defects in neuronal energy metabolism have both been
      implicated in the pathogenesis of neurodegenerative disease. These two mechanisms
      may be linked through the NMDA receptor, activation of which is dependent on
      neuronal membrane potential. Because the ability to maintain membrane potential
      is dependent on neuronal energy metabolism, bioenergetic defects may affect NMDA
      receptor-mediated excitotoxicity. We now report that reversible inhibition of
      succinate dehydrogenase (SDH), an enzyme central to both the tricarboxylic acid
      cycle and the electron transport chain, produces an "excitotoxic" lesion in rat
      striatum that can be blocked by the NMDA antagonist MK-801. Male Sprague-Dawley
      rats received intrastriatal stereotaxic injections of the SDH inhibitor malonic
      acid (1 or 2 mumol) in combination with intraperitoneal injections of vehicle or
      MK-801 (5 mg/kg) 30 min before and 210 min after malonic acid. Animals were
      killed 72 h after surgery, and brains were processed for histology, cytochrome
      oxidase activity, and [3H]MK-801 and [3H]AMPA autoradiography. The higher dose of
      malonic acid (2 mumol) produced large lesions that were markedly attenuated by
      treatment with MK-801 (28.1 +/- 3.6 vs. 4.7 +/- 2.6 mm3; p < 0.001). [3H]MK-801
      and [3H]AMPA binding were reduced in the lesions by 60 and 63%, respectively. One
      micromole of malonic acid produced smaller lesions that were almost completely
      blocked by MK-801 treatment (9.6 +/- 1.3 vs. 0.06 +/- 0.04 mm3; p < 0.0001). The
      toxic effects of malonic acid were due specifically to inhibition of SDH inasmuch
      as coinjection of a threefold excess of succinate with the malonic acid blocked
      the striatal lesions (p < 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360679
TI  - Neurofilament proteins are synthesized in nerve endings from squid brain.
AB  - It is generally believed that the proteins of the nerve endings are synthesized
      on perikaryal polysomes and are eventually delivered to the presynaptic domain by
      axoplasmic flow. At variance with this view, we have reported previously that a
      synaptosomal fraction from squid brain actively synthesizes proteins whose
      electrophoretic profile differs substantially from that of the proteins made in
      nerve cell bodies, axons, or glial cells, i.e., by the possible contaminants of
      the synaptosomal fraction. Using western analyses and immunoabsorption methods,
      we report now that (a) the translation products of the squid synaptosomal
      fraction include neurofilament (NF) proteins and (b) the electrophoretic pattern
      of the synaptosomal newly synthesized NF proteins is drastically different from
      that of the NF proteins synthesized by nerve cell bodies. The latter results
      exclude the possibility that NF proteins synthesized by the synaptosomal fraction
      originate in fragments of nerve cell bodies possibly contaminating the
      synaptosomal fraction. They rather indicate that in squid brain, nerve terminals
      synthesize NF proteins.

PMID- 8360681
TI  - Chronic ethanol reduces immunologically detectable Gq alpha/11 alpha in NG108-15
      cells.
AB  - Recent work has shown that chronic ethanol treatment inhibits receptor-stimulated
      phosphoinositide hydrolysis in NG108-15 cells and that ethanol exerts this effect
      primarily at the level of the guanine-nucleotide binding protein (G protein).
      Here we investigated the effects of ethanol exposure on the expression of Gq
      alpha/11 alpha, two highly homologous G protein alpha-subunits that have been
      implicated as regulators of phosphoinositidase C. Addition of ethanol (10-200 mM)
      to the culture medium for 48 h caused a concentration-dependent decrease in the
      immunologically detectable levels of Gq alpha/11 alpha. A small (approximately
      15%) reduction in Gq alpha/11 alpha was observed after only 6 h of exposure to
      200 mM ethanol, but membrane levels were reduced by 31% at 48 h. The ethanol
      induced loss of Gq alpha/11 alpha was apparently independent of factors present
      in the foetal calf serum component of the culture medium. These results suggests
      that the decrease in receptor-mediated phosphoinositide hydrolysis following
      chronic ethanol treatment of NG108-15 cells may be mediated in part by a
      reduction in the membrane levels of Gq alpha/11 alpha.

PMID- 8360682
TI  - Aluminum, iron, and zinc ions promote aggregation of physiological concentrations
      of beta-amyloid peptide.
AB  - A major pathological feature of Alzheimer's disease (AD) is the presence of a
      high density of amyloid plaques in the brain tissue of patients. The plaques are
      predominantly composed of human beta-amyloid peptide beta A4, a 40-mer whose
      neurotoxicity is related to its aggregation. Certain metals have been proposed as
      risk factors for AD, but the mechanism by which the metals may exert their
      effects is unclear. Radioiodinated human beta A4 has been used to assess the
      effects of various metals on the aggregation of the peptide in dilute solution
      (10(-10) M). In physiological buffers, 10(-3) M calcium, cobalt, copper,
      manganese, magnesium, sodium, or potassium had no effect on the rate of beta A4
      aggregation. In sharp contrast, aluminum, iron, and zinc under the same
      conditions strongly promoted aggregation (rate enhancement of 100-1,000-fold).
      The aggregation of beta A4 induced by aluminum and iron is distinguishable from
      that induced by zinc in terms of rate, extent, pH and temperature dependence.
      These results suggest that high concentrations of certain metals may play a role
      in the pathogenesis of AD by promoting aggregation of beta A4.

PMID- 8360683
TI  - Tau in paired helical filaments is functionally distinct from fetal tau: assembly
      incompetence of paired helical filament-tau.
AB  - tau in paired helical filaments (PHF-tau) and fetal tau share several
      phosphorylated epitopes, as revealed by several phosphorylation-dependent PHF
      monoclonals. We have asked whether there is any difference between the two
      molecules in tubulin assembly-promoting activity and found that PHF-tau is almost
      assembly incompetent, whereas fetal tau is low in this activity but still
      assembly competent. This indicates that despite substantial similarities in
      immunoreactivities, PHF-tau and fetal tau are quite distinct from each other in
      function.

PMID- 8360684
TI  - Evolving concepts about the role of acidosis in ischemic neuropathology.
AB  - Cerebral ischemia is one of the most common neurological insults. Many
      pathological events are undoubtedly triggered by ischemia, but only recently has
      it become accepted that ischemic cell injury arises from a complex interaction
      between multiple biochemical cascades. Tissue acidosis is a well established
      feature of ischemic brain tissue, but its role in ischemic neuropathology is
      still not fully understood. Within the last few years, new evidence has
      challenged the historically negative view of acidosis and suggests that it may
      play more of a beneficial role than previously thought. This review reintroduces
      the concept of acidosis to ischemic brain injury and presents some new
      perspectives on its neuroprotective potential.

PMID- 8360685
TI  - Antibodies raised against synthetic peptides react with choline acetyltransferase
      in various immunoassays and in immunohistochemistry.
AB  - Antisera were raised in rabbits against five synthetic peptides. These peptides
      have been identified as potentially antigenic epitopes from the sequence of
      porcine choline acetyltransferase (ChAT) using primary and secondary structure
      analysis. All five antisera recognized immunoaffinity-purified antigen from
      porcine brain in an ELISA and on western blots. Four antisera recognized ChAT on
      dot blots, and another four antisera reacted with native and degraded enzyme in a
      sandwich ELISA using monoclonal antibodies as the capture antibody. One peptide
      antiserum was of similar avidity in this sandwich ELISA as a polyclonal antibody
      raised against immunoaffinity-purified ChAT. The same antiserum reacted with the
      enzyme from human placenta in an ELISA and on western and dot blots and
      recognized ChAT in rat, primate, and human neurons. Thus, a single peptide (amino
      acids 168-189) provides the means for easy, reliable, and reproducible generation
      of antibodies against ChAT suitable for replacing conventional polyclonal and
      monoclonal antibodies.

PMID- 8360686
TI  - Detection of intracellular free Na+ concentration of synaptosomes by a
      fluorescent indicator, Na(+)-binding benzofuran isophthalate: the effect of
      veratridine, ouabain, and alpha-latrotoxin.
AB  - A novel fluorescent Na+ indicator, Na(+)-binding benzofuran isophthalate (SBFI),
      was used to follow changes in the intracellular free Na+ concentration ([Na+]i)
      of synaptosomes. The dye, when loaded into synaptosomes in the form of its
      acetoxymethyl ester, was responsive to changes of [Na+]. Calibration was made
      using the 340/380 nm excitation ratio when the cytoplasmic Na+ concentration was
      equilibrated with different concentrations of extracellular Na+ in the presence
      of 2 microM gramicidin D. The basal value of [Na+]i in synaptosomes in the
      presence of 140 mM extracellular Na+ was found to be 10.9 +/- 1.8 mM.
      Veratridine, which opens potential-dependent Na+ channels, caused a sudden
      increase in [Na+]i in a concentration-dependent manner (1-20 microM), whereas the
      effect of ouabain (20 and 50 microM), the inhibitor of the plasma membrane
      Na+,K(+)-ATPase, was more gradual. The rise in the fluorescence intensity upon
      addition of veratridine was prevented completely by 2 microM tetrodotoxin. alpha
      Latrotoxin, the black widow spider toxin, caused an increase in the fluorescence
      intensity, which became evident 1 min after the addition of the toxin. The rate
      of increase was proportional to the concentration of the toxin (0.19-1.5 nM).
      This report confirms our earlier finding demonstrating a Na(+)-dependent
      component in the action of alpha-latrotoxin, and shows that changes in [Na+]i in
      synaptosomes can be followed by SBFI.

PMID- 8360687
TI  - Cytochalasin modulation of nicotinic cholinergic receptor expression and
      muscarinic receptor function in human TE671/RD cells: a possible functional role
      of the cytoskeleton.
AB  - Previous studies have shown that cells of the TE671/RD human clonal line express
      muscle-type nicotinic acetylcholine receptors (nAChR) and m3-type muscarinic
      acetylcholine receptors (mAChR) whose numbers and function are regulated by
      agonist treatment and second messenger modulation. Here we show that cytochalasin
      treatment, which causes disruption of actin networks, induces marked changes in
      the numbers and distribution of nAChR, but not mAChR. Moreover, whereas
      cytochalasin treatment fails to alter nAChR function significantly, it acutely
      potentiates mAChR-mediated phosphoinositide hydrolysis. Treatment of TE671/RD
      cells with different cytochalasin analogues (rank order efficacy at 5
      micrograms/ml is H > J = B = C = D > A = E) produces a two- to fourfold increase
      in numbers of membrane-bound nAChR (Bmax in units of specific 125I-labeled alpha
      bungarotoxin binding per milligram of membrane protein). nAChR up-regulation is
      evident after 1-2 days of cytochalasin B exposure, is maximal after 3-6 days of
      drug treatment, and is dominated by an approximately 10-fold increase (per cell)
      in an intracellular nAChR pool. Cytochalasin-induced nAChR up-regulation is
      similar in magnitude to, but not additive with, up-regulation of nAChR following
      chronic exposure to nicotine or phorbol ester. Northern blot analysis shows a
      four- to five-fold coordinate increase in levels of mRNA that encode nAChR alpha,
      beta, gamma, or delta subunits in cytochalasin-treated cells, suggesting that
      nAChR up-regulation has a possible transcriptional basis. Studies done using a
      86Rb+ efflux assay indicate that cytochalasin treatment has no significant effect
      on nAChR function. By contrast, cytochalasin treatment has no effect on the
      numbers of mAChR as assessed by binding studies with the radioantagonist 3H
      labeled quinuclidinyl benzilate, but it induces marked enhancement of carbachol
      stimulated, but not basal, phosphoinositide hydrolysis. These studies suggest
      that presumed modulation by cytochalasin treatment of cytoskeletal microfilament
      integrity can differentially influence expression and function of mAChR (a
      prototype of the metabotropic receptor superfamily) and nAChR (a prototype of the
      ligand-gated ion-channel superfamily). The results also suggest possible new
      roles for the cytoskeleton in regulation of membrane receptor expression,
      function, and cross talk.

PMID- 8360688
TI  - Heterogeneity of the high molecular weight tau proteins in N115 neuroblastoma
      cells.
AB  - The sequence of a high molecular weight (HMW) tau cDNA cloned from a
      neuroblastoma N115 library contains, in addition to the C- and N-terminal and
      middle regions present in the low molecular weight mouse brain tau proteins, a
      711-bp nonhomologous domain (exon 4a) and a region of 198 bp corresponding to
      exon 6 of the tau gene. Protein immunoblot analysis, performed with antibodies
      specific either for a sequence present in the N-terminal region of all the tau
      variants or for exon 4a revealed several bands suggesting that more than one tau
      form is expressed in this cell line. Northern blot experiments performed with a
      number of cDNA probes spanning domains common and uncommon to low molecular
      weight and HMW tau allowed the identification of four tau transcripts differing
      in the size of their coding and noncoding regions. All these transcripts contain
      the sequence encoded by exon 6, but two of them lack exon 4a. As shown by RNase
      protection assays, the N-terminal region of these transcripts is also variable
      and contains either exon 1, or exons 1 and 2, or exons 1-3. Yet all these HMW tau
      forms contain four homologous repeats in their C-terminal domain both in the
      differentiated and nondifferentiated cells, i.e., have adult characteristics. In
      conclusion, the data reported in this article demonstrate that several HMW tau
      variants are expressed in neuroblastoma N115 cells and that the transition
      between immature to mature tau forms occurring during brain development is not
      required for neurite outgrowth during morphological differentiation of this cell
      line.

PMID- 8360689
TI  - Effects of chronic basic fibroblast growth factor administration to rats with
      partial fimbrial transections on presynaptic cholinergic parameters and
      muscarinic receptors in the hippocampus: comparison with nerve growth factor.
AB  - The present study compares the effects of chronic administration of basic
      fibroblast growth factor (bFGF) and nerve growth factor (NGF) on various
      hippocampal cholinergic parameters in rats with partial unilateral fimbrial
      transections. Lesions resulted in marked reductions of several presynaptic
      cholinergic parameters: choline acetyltransferase (ChAT) activity (by 50%), [3H]
      acetylcholine ([3H]ACh) synthesis (by 59%), basal and veratridine (1 microM)
      evoked [3H]ACh release (by 44 and 57%, respectively), and [3H]vesamicol binding
      site densities (by 35%). In addition, [3H]AF-DX 116/muscarinic M2 binding site
      densities were also modestly decreased (by 23%). In contrast,
      [3H]pirenzepine/muscarinic M1 and [3H]AF-DX 384/muscarinic M2/M4 binding site
      densities were not altered by the lesions, nor were they affected by any of the
      treatments. Intracerebroventricular administration of bFGF (10 ng, every other
      day, for 21 days) partially prevented the lesion-induced deficit in hippocampal
      ChAT activity, an effect that was not markedly different from that measured in
      the NGF-treated (1 microgram, intracerebroventricularly, every other day, for 21
      days) rats. In rats treated with a combination of bFGF and NGF, ChAT activity was
      not different from that in rats treated with the individual factors alone. In
      contrast, the lesion-induced deficits in the other cholinergic parameters were
      not attenuated by bFGF treatment, although they were at least partially prevented
      by NGF administration. To determine whether higher concentrations of bFGF are
      necessary to affect cholinergic parameters other than hippocampal ChAT activity,
      rats were treated with 1 microgram (every other day, 21 days) of the growth
      factor. In this group of rats, detrimental effects of bFGF, manifested by an
      increased death rate (46%), and marked reductions in body weight of the
      survivors, were observed. In addition, this concentration of bFGF appeared to
      exacerbate the lesion-induced reduction in [3H]ACh synthesis by hippocampal
      slices; [3H]ACh synthesis in lesioned hippocampi represented 36 and 52% of that
      in contralateral unlesioned hippocampi for the bFGF-treated and control groups,
      respectively. In conclusion, although bFGF administration attenuates the deficit
      in hippocampal ChAT activity induced by partial fimbrial transections, this does
      not appear to translate into enhanced functional capacity of the cholinergic
      terminals. This is clearly in contrast to NGF, which enhances not only
      hippocampal ChAT activity, but also other parameters indicative of increased
      function in the cholinergic terminals.

PMID- 8360690
TI  - Nonenzymatic conversion of 3,4-dihydroxyphenylalanine to 2,4,5
      trihydroxyphenylalanine and 2,4,5-trihydroxyphenylalanine quinone in
      physiological solutions.
AB  - 2,4,5-Trihydroxyphenylalanine (TOPA) oxidizes in solution to form a quinone
      derivative that is a non-N-methyl-D-aspartate agonist and neurotoxin. Although
      pathways have been postulated for the formation of both TOPA and TOPA quinone
      from closely related catecholamines, the generation of these compounds has not
      been conclusively demonstrated by analytical techniques. Reverse-phase HPLC with
      a dual electrode coulometric detector was used to analyze TOPA containing
      solutions in an effort to rigorously characterize the behavior of this substance
      under physiological conditions. Electrode potential, buffer system, and methanol
      concentration were varied to obtain optimal conditions to selectively detect and
      quantify TOPA and TOPA quinone from closely related catecholamines. TOPA was
      shown to rapidly autoxidize to TOPA quinone by a process dependent on pH. TOPA
      was the dominant species at acidic pHs (below 5-6), whereas TOPA quinone was
      dominant at physiological pHs. This conversion was reversible upon acidification.
      In addition, we found that 3,4-dihydroxyphenylalanine can autoxidize to form both
      TOPA and TOPA quinone under physiological conditions. This partial conversion
      (0.5%) is time dependent and can be substantially decreased (0.2%) in acidic
      conditions (pH < or = 3). These results suggest that some of the excitatory and
      excitotoxic properties that some investigators have attributed to DOPA may
      actually be due to its conversion to TOPA and TOPA quinone.

PMID- 8360691
TI  - The presence of (+)-S-adenosyl-L-methionine in the rat brain and its lack of
      effect on phenylethanolamine N-methyltransferase activity.
AB  - (+)-S-Adenosyl-L-methionine [(+)-SAM] was isolated from rat brain and was
      quantified by HPLC followed by UV spectrophotometric measurements and by 1H-NMR.
      Its estimated ratio in brain is 3% of total SAM. Because of its commercial
      unavailability, (+)-SAM was also prepared from chemically synthesized SAM by
      separation of the two diastereoisomers on a preparative reverse-phase Nucleosil
      C8 column. The (+) diastereoisomer thus obtained was then assayed in vitro both
      as an inhibitor and a substrate of phenylethanolamine N-methyltransferase.
      Enzymatic activity was measured by HPLC analysis. It was shown that (+)-SAM has
      no effect on phenylethanolamine N-methyltransferase activity; therefore, it is
      unlikely that (+)-SAM plays any possible role in regulation of adrenaline
      synthesis in the brain.

PMID- 8360692
TI  - Microdialysis of melatonin in the rat pineal gland: methodology and
      pharmacological applications.
AB  - The present study describes the development of a new technique to measure
      melatonin contents in the pineal gland of freely moving rats, by means of on-line
      microdialysis. The transcerebral cannula was modified, and a sensitive assay of
      melatonin, using HPLC with fluorimetric detection, was set up. With this system
      it is possible to monitor the melatonin levels on-line in the pineal gland during
      day- and nighttime. The nightly increase in melatonin release was recorded.
      Tetrodotoxin had an inhibitory effect on nighttime levels, whereas even high
      concentrations did not alter the daytime level. From this we conclude that
      neuronal activity is necessary to synthesize melatonin and that during daytime no
      net neuronal activity is present. Melatonin levels could be greatly enhanced by
      systemic administration of the beta-agonist isoprenaline (ISO). Also, local
      infusion of ISO or 8-bromoadenosine 3',5'-cyclic monophosphate, an analogue of
      the second messenger cyclic AMP, resulted in increased melatonin levels,
      demonstrating the presence of beta-adrenergic receptors, coupled to a cyclic AMP
      based second messenger system, on the pineal gland. Injection of phenylephrine
      had no effect on daytime levels. Only when administered during ISO-induced
      stimulation of melatonin release did it enhance this stimulated release. This
      proved the regulatory role of alpha 1-receptors on pinealocytes. The method
      presented is of special interest for investigating the innervation of the pineal
      gland and the biochemical processes that regulate the biosynthesis of melatonin.
      Also, for studies on the diurnal rhythms of melatonin release and factors that
      influence these rhythms in freely moving animals, this model will be of great
      value.

PMID- 8360693
TI  - ATP-sensitive potassium channels and local energy demands in the rat hippocampus:
      an in vivo study.
AB  - Microdialysis coupled with an enzyme-based flow injection analysis was used to
      monitor brain extracellular lactate and glucose in the freely moving rat. Glucose
      levels reflect the balance between supply from the blood and local utilisation,
      and lactate efflux indicates the degree of local nonoxidative glucose metabolism.
      Local application of tolbutamide, a blocker of the ATP-sensitive potassium
      channel, decreased extracellular glucose and lactate levels in the hippocampus
      but not in the striatum. The increase in glucose and lactate levels following
      mild behavioural stimulation was also reduced by tolbutamide in the hippocampus.
      Similar effects on both basal and stimulated lactate levels were obtained with
      local application of 10 mM glucose. These results indicate that ATP-sensitive
      potassium channels are active under physiological conditions in the hippocampus
      and that the effects of tolbutamide can be mimicked by physiological glucose
      levels.

PMID- 8360694
TI  - Age-related changes in the ceramide composition of the major gangliosides present
      in rat brain subcellular fractions enriched in plasma membranes of neuronal and
      myelin origin.
AB  - Age-related changes of the ceramide composition of gangliosides were studied in
      the synaptosomal and myelin fractions from rat brain, carrying plasma membranes
      of neuronal and glial origin, respectively. The five major gangliosides (GM1,
      GD1a, GD1b, GT1b, and GQ1b) present in these fractions were separated and
      quantitated by normal-phase HPLC. Each ganglioside was then fractionated by
      reverse-phase HPLC into the molecular species carrying a single long-chain base
      (LCB). The largely preponderant LCBs in the synaptosomal and myelin fractions
      were the C18:1 and C20:1. The content of C20:1 LCB, generally low at 1 month,
      increased with age in all analyzed gangliosides and in all subcellular fractions
      and was greater in the "b series" than in the "a series" gangliosides.
      Remarkably, GM1 was the only ganglioside where the proportion of LCB 20:1 was
      higher in the synaptosomal fraction than in the myelin fraction. The fatty acid
      composition of the C18:1 or C20:1 LCB species of the different gangliosides in
      the synaptosomal and myelin fractions did not undergo appreciable changes with
      age. Stearic acid was largely predominant in all the gangliosides of the
      synaptosomal fraction, more in the C18:1 than in the C20:1 LCB species (80-90%
      vs. 60-70%). The gangliosides of the myelin fraction were characterized by a
      lower content of 18:0 and a much higher content of 16:0 and 18:1 fatty acids than
      those of the synaptosomal fraction. Thus, the ceramide composition is different
      in the gangliosides of neuronal and myelin origin and appears to be subjected to
      an age-related control.

PMID- 8360695
TI  - A tau fragment containing a repetitive sequence induces bundling of actin
      filaments.
AB  - Much indirect evidence suggests that the interconnections of actin microfilaments
      with the microtubule system are mediated by microtubule-associated proteins
      (MAPs). In this study we provide new data to support the interaction of a
      specific tubulin-binding domain on tau with actin in vitro. In actin
      polymerization assays, the synthetic peptide VRSKIGSTENLKHQPGGG, corresponding to
      the first repetitive sequence of tau protein, increased turbidity at 320 nm in a
      dose-dependent fashion. A salient feature of the tau peptide-induced assembly
      process is the formation of a large amount of actin filament bundles, as revealed
      by electron microscopic analysis. An increase in the tau peptide concentration
      resulted in a proportional increase in the bundling of actin filaments. It is
      interesting that a gradual decrease of pH within the range 7.6-4.7 resulted in a
      higher effect of tau peptide in promoting bundles of actin filaments. A similar
      pH-dependent effect was observed for tau protein-induced bundling. An analysis of
      the mechanisms that operate in the peptide induction of actin filament bundles
      suggests the involvement of electrostatic forces, because the neutralization of
      epsilon-aminolysyl residues by selective carbamoylation resulted in a complete
      loss of the peptide induction of actin bundles. The data suggest that a tau
      repetitive sequence (also found in MAP-2 and MAP-4) containing a common tubulin
      binding motif may constitute a functional domain on tau for the dynamics of the
      interconnections between actin filaments and microtubules.

PMID- 8360696
TI  - The balance between tau protein's microtubule growth and nucleation activities:
      implications for the formation of axonal microtubules.
AB  - The microtubule-associated protein tau is found primarily in neuronal tissues and
      is highly enriched in the axon. It promotes microtubule assembly in vitro and
      stabilizes microtubules in cells. To study how tau protein might be involved in
      the unique features of axonal microtubules, we have analyzed the effect of E.
      coli-synthesized tau protein using an in vitro centrosome-mediated microtubule
      regrowth assay over a wide range of tau/tubulin ratios. We report that
      microtubule assembly promoted by tau protein exhibits characteristic changes
      dependent on the tau/tubulin ratio. Above a threshold level, nucleation of new
      microtubules is favored over growth of existing ones. tau isoform variation does
      not change this phase transition in microtubule assembly. We discuss how tau
      might participate in the elaboration of axonal morphology based on our results
      and present evidence that the phase transition from microtubule growth to
      nucleation is critical for axonal development.

PMID- 8360697
TI  - The neuropathology of temporal lobe epilepsy.
AB  - Complex partial epilepsy arising in the temporal lobe has been associated with
      several types of pathologic lesions including Ammon's horn sclerosis,
      malformations, neoplasms, and inflammatory scars from infarcts or infection.
      These lesions are usually situated at various sites in the medial temporal lobe,
      so that one of the enigmas of attempting to understand the pathogenesis of TLE
      pertains to the clinical manifestation of a single epileptic disorder which is
      associated with dissimilar lesions at dissimilar sites. Recent demonstrations of
      an alteration in temporal lobe anatomy, i.e. malformations of the normal
      circuitry of the temporal lobe and foci of microdysgenesis, have given rise to
      the hypothesis that insults which occur during a critical period of brain
      development could alter the connections within the hippocampus and predispose it
      to increased excitability and seizurogenesis. Such a hypothesis forces us to
      reconsider TLE in reference to risk factors which may act as "teratogens" and
      produce these malformations. These malformations may range from a subtle
      alteration in the neurotransmitters of the dentate gyrus to large areas of
      cortical dysplasia or the hamartomatous neoplasms seen in TLE. A reevaluation of
      the neuroanatomical disruptions created by the various lesions may allow us to
      define a minimal optimal surgical resection for each lesion; or, the definitions
      of neurotransmitter deficits may lead to alternative pharmacologic therapies. As
      neuropathologists we have the exciting opportunity to participate in the
      definition of the neuropathology of temporal lobe epilepsy.

PMID- 8360698
TI  - Renaut bodies contain elastic fiber components.
AB  - Renaut bodies (RB) are fusiform endoneurial structures preferentially found at
      sites of nerve entrapment, often occupying more than 30% of the cross-sectional
      area of a nerve fascicle. Their composition and significance, however, are still
      incompletely understood. In this study, further evidence for the link between the
      appearance of RB and nerve entrapment is presented. Reanaut bodies were already
      found at the age of 1 year in the median nerve at the level of the wrist, i.e. in
      the carpal tunnel, a possible site of entrapment. Here, their number increased
      with age. Renaut bodies were absent, however, in fetal nerves at this site. Many
      of the cells in RB resembled perineurial cells or pericytes. They were stained
      with antibodies against vimentin and epithelial membrane antigen and were
      partially covered by a basal lamina reactive with antibodies against collagen IV,
      laminin, and s-laminin. Focally accumulated filaments and bundles of 30-40 nm
      collagen fibrils were major extracellular components of RB. The diameter of the
      filaments (8-12 nm) corresponded to the size of the microfibril, i.e. the
      oxytalan component of elastic fibers. Renaut bodies were intensely stained with
      antibodies against these microfibrils and several types of collagen
      glycoproteins. On the basis of these results, we conclude that RB are composed of
      cells that show perineurial differentiation. These cells produce an extracellular
      matrix highly enriched in elastic fiber components.

PMID- 8360699
TI  - Spatial distribution of nerve injury after occlusion of individual major vessels
      in rat sciatic nerves.
AB  - In an attempt to better understand the spatial distribution of ischemic injury
      secondary to occlusion of major arteries, we measured nerve blood flow (NBF) and
      studied morphologic changes at various levels distal to the ligature site.
      Arterial ligation of the femoral, internal iliac, or superior gluteal artery was
      preceded and followed by measurement of NBF using laser Doppler flowmetry which
      helped identify "watershed areas" and guided the sampling process as nerves were
      examined pathologically and areas of injury were identified. Femoral artery
      ligation produced the most severe ischemia, focally reducing NBF by 80% in the
      tibial nerve at a level just below the knee. Within these ischemic nerve segments
      there were degenerative changes of nerve fibers seen mainly in the subperineurial
      region. Ligation of the internal iliac artery caused an approximately 60%
      reduction in NBF at the upper and mid-thigh levels of the sciatic nerve which
      resulted only in endoneurial edema in tissue taken at this level. Following
      superior gluteal artery ligation. NBF was reduced by only 20% at the pelvic level
      of the sciatic nerve and there was neither endoneurial edema nor fiber
      abnormalities. This study demonstrates the watershed pattern of ischemic injury
      associated with single vessel ligation by correlating neuropathologic change with
      quantitative measures of local nerve blood flow. The data further support the
      concept that mild levels of ischemia cause endoneurial edema, while moderate
      levels of ischemia produce demyelination and severe ischemia produces Wallerian
      degeneration.

PMID- 8360701
TI  - Histologic assessment of the age of recent brain infarcts in man.
AB  - In order to design a dating system based on the microscopic picture of brain
      infarcts of recent onset, we performed the histological examination of 31
      infarcts covering the first 4 weeks of evolution in 30 autopsy cases. The date of
      the cerebral vascular accident was clinically established in every case. There
      were 13 men and 17 women with a mean age of 65 years. Hemorrhagic infarcts were
      found in 15 cases and anemic infarcts in 16 cases. Based on the histological
      features four periods were identified: the first period, from day 1 through day
      4, was characterized by the predominance of eosinophilic neurons and necrotic
      oligodendrocytes; the second period, from day 5 through day 7, differed from the
      first by the appearance of macrophages and of newly formed blood vessels; the
      third period, from day 8 through day 14, showed neuronal ghosts, macrophages,
      astrocytic proliferation, gemistocytes, and absence of neutrophils; and in the
      fourth period, from day 15 through day 27, there were no eosinophilic neurons,
      and neither necrotic oligodendrocytes nor myelin in the central portion of the
      infarct were identified. By assessing the histological features and accurately
      correlating the findings with the corresponding clinical data, we have been able
      to describe four distinct microscopic patterns of the first month of evolution of
      brain infarcts. The present findings may be considered useful morphological clues
      to better characterize the early evolutional phase of brain infarcts in humans.

PMID- 8360700
TI  - Brain structures selectively targeted by canine distemper virus in a mouse model
      infection.
AB  - Paramyxoviruses such as measles virus or canine distemper virus are etiological
      agents for acute and chronic encephalitis (measles inclusion body encephalitis,
      subacute sclerosing panencephalitis and chronic distemper encephalitis or old dog
      encephalitis). The mechanisms by which viral injury leads to neurological
      diseases have not yet been fully elucidated. We have developed an experimental
      model in mice in order to analyze the spatial and temporal distribution of canine
      distemper virus in the central nervous system. Cerebral target structures for
      viral replication were examined for the presence of viral material (proteins and
      mRNA) during the two stages of the biphasic disease. During the acute stage of
      infection all target areas could be identified by day 6 with a similar anatomical
      distribution in all the animals examined, which were either intracranially or
      intracerebroventricularly infected. Viral mRNA and proteins were selectively
      localized in certain brain structures such as the thalamus, hypothalamus,
      substantia nigra (pars compacta), locus ceruleus and raphe nuclei (dorsalis and
      centralis), and limbic system (hippocampus, septum, entorhinal and cingulate
      cortex, amygdala). The virus was apparently unable to replicate in cerebellum,
      striatum, a large part of cortex, or endothelial cells. During the subacute
      disease, viral material was no longer detectable except in a few structures such
      as hypothalamus up to 4-6 weeks after inoculation. After this time, all target
      structures were devoid of any labeling in spite of the occurrence of pathology
      (obesity, paralysis) during this viral quiescent phase. These results suggest
      that after the initial viral exposure, expression of viral genes in defined
      structures might disrupt central homeostasis and finally may lead to neurological
      or neuroendocrine diseases, even in the absence of the hallmarks of the virus.

PMID- 8360702
TI  - Effects of psychosine (galactosylsphingosine) on the survival and the fine
      structure of cultured Schwann cells.
AB  - The cytotoxicity of psychosine (galactosylsphingosine) for cultured rat Schwann
      cells was studied by maintaining them in medium containing 1, 10, 50, 75 and 100
      microM psychosine for 24, 48 and 72 hours (h). When incubated in 50-100 microM
      concentrations of psychosine for 24 h, 52-99% of cultured Schwann cells did not
      survive. Lower concentrations (1-10 microM) did not significantly reduce Schwann
      cell numbers for the first 24 h. However, only 43-69% of cultured Schwann cells
      survived in these low concentrations for 48 h, and substantially fewer remained
      after 72 h of incubation. During incubations in psychosine, bipolar processes of
      Schwann cells retracted; the resulting oval and rounded Schwann cells still were
      S-100 positive. When these Schwann cells were transferred into normal medium,
      their processes elongated quickly. When examined with the electron microscope,
      the cytoplasm of Schwann cells incubated in psychosine contained numerous
      membranous inclusions and fewer mitochondria, some of which were swollen. There
      also were fewer profiles of granular endoplasmic reticulum and some had widely
      dilated cisternae. These results suggest that 1) exogenous psychosine in
      concentrations of 1 microM and greater is cytotoxic for cultured rat Schwann
      cells; 2) psychosine has reversible toxic effects and its turnover is rapid; and
      3) psychosine produces membranous inclusions and abnormalities in the
      mitochondria and granular endoplasmic reticulum of cultured Schwann cells. Our
      findings support the hypothesis that the accumulation of psychosine in human and
      murine globoid cell leukodystrophy is toxic for Schwann cells, produces changes
      in their capacity to maintain myelin, and leads to Schwann cell dysfunction.

PMID- 8360703
TI  - Surgical pathology of temporal lobe epilepsy. Experience with 216 cases.
AB  - The surgical treatment of chronic epilepsies is increasing rapidly. Here we
      report the histopathologic findings in 216 consecutive surgical specimens of
      patients with chronic pharmacoresistant temporal lobe epilepsy. In 75 cases
      (34.7%) there were tumors, all but two of which were of low histopathological
      grade (WHO grade I or II). The most common tumors were gangliogliomas (34 cases),
      pilocytic astrocytomas (17 cases), oligodendrogliomas (9 cases), fibrillary
      astrocytomas (6 cases), and dysembryoplastic neuroepithelial tumors (6 cases).
      There were 51 cases with non-neoplastic focal lesions and an additional 13 cases
      with tumors and non-neoplastic focal lesions within the same specimen. The most
      frequent non-neoplastic focal lesions were microscopic glioneuronal hamartias (32
      cases), glioneuronal hamartomas (7 cases), and vascular malformations (13 cases).
      The hippocampal formation was structurally well preserved in 71 specimens. In 51
      of these (71.8%) there was Ammon's horn sclerosis. Presurgical placement of depth
      electrodes was invariably associated with circumscribed defects of the brain
      parenchyma. The implantation of subdural electrodes was sometimes followed by
      chronic inflammatory changes of the leptomeninges. Our findings indicate that in
      the majority of patients with medically intractable temporal lobe epilepsy there
      are significant histopathologic findings, many of which are only rarely
      encountered otherwise.

PMID- 8360704
TI  - Differential expression of retinal proteins in a pineal parenchymal tumor.
AB  - The pineal gland and retina share histogenetic features that reflect a similar
      neurosensory/photosensory ontogeny. Pineal parenchymal tumors demonstrate a
      highly variable and incomplete photosensory differentiation evidenced by specific
      cytoarchitectural features and the expression of photosensory retinal S-Antigen
      (S-Ag). Despite these neuro-ontogenetic parallels, pineal parenchymal tumors have
      not been well studied for the neuroretinal phenotypes that accompany normal
      neuroretinal development. The investigation of photoreceptor gene expression may
      provide an important insight into the histogenesis of pineal parenchymal
      neoplasms. In this study, a pineal parenchymal tumor of the "mixed
      pineoblastoma/pineocytoma" type was examined for the expression of several
      photoreceptor, glial and neuronal proteins including: interphotoreceptor retinoid
      binding protein (IRBP), rod opsin, cone opsin, S-Ag and cellular retinaldehyde
      binding protein (CRA1BP). The detection of IRBP and its mRNA, the earliest
      photoreceptor-associated protein expressed during retinal development,
      corroborated the rudimentary photosensory differentiation of this tumor which had
      limited cytoarchitectural evidence for pineal differentiation. The analysis of
      IRBP expression may facilitate the diagnostic recognition of primitive pineal
      neoplasms and further define the neuroretinal differentiation which occurs in
      pineal parenchymal tumors.

PMID- 8360705
TI  - Ependymal abnormalities in lissencephaly/pachygyria.
AB  - The ependyma was examined in eight children with neuroblast migratory disorders
      of diverse origin: three cases of lissencephaly type 1 with severe to mild
      degrees of agyria/pachygyria, four cases of lissencephaly type 2 in Fukuyama
      muscular dystrophy and the Walker-Warburg syndrome, and one case of
      hemimegalencephalic pachygyria. Morphological and immunohistochemical
      abnormalities of the ependyma were strikingly similar in all. Discontinuities
      were disproportionate to the degree of ventriculomegaly. In some regions, the
      ependyma remained a pseudostratified columnar epithelium, though basal processes
      were absent. The poles of the horns of the lateral ventricles were replaced by
      extensive heterotopic ependymal rosettes. Rosettes and rows of ependyma also were
      in other subventricular sites. Subependymal nodules of large astrocytes and their
      processes bulged into the ventricular lumen after infancy. Ependymal cells did
      not express glial fibrillary acidic protein, but showed persistent expression of
      S-100 protein, cytokeratin CK-904 and sometimes vimentin long after these
      proteins normally disappear. An abnormal ependyma in lissencephaly/pachygyria may
      contribute to disturbances in neuronogenesis, guidance of axonal projections and
      neuroblast migrations; it may be a primary factor in pathogenesis.

PMID- 8360706
TI  - Experimental lovastatin myopathy.
AB  - Lovastatin (LS) is a potent HMG-CoA inhibitor used in the treatment of
      hypercholesterolemia. In humans it can cause a severe, necrotizing myopathy with
      myoglobinuria and renal failure. To investigate the pathogenesis of LS-induced
      myopathy we studied the effects of LS on rat skeletal muscle. Lewis rats were
      gavage-fed 1 mg/g body weight/day of LS. Control rats received
      carboxymethylcellulose-based suspension by gavage. Gastrocnemius and soleus, fast
      and slow twitch muscles respectively, were studied by light and electron
      microscopy. By day 10 LS-treated rats became severely weak. Gastrocnemius was
      severely affected with degeneration of membranous organelles and microvacuole
      formation, but soleus was spared. Eventually, 20-50% of the gastrocnemius but
      none of the soleus fibers became necrotic. Non-necrotic fibers showed no
      increases of acid phosphatase, indicating that autophagy was not excited. We
      conclude that LS causes muscle injury by inducing degeneration of membranous
      organelles, and fast twitch muscle fibers are selectively vulnerable to LS
      myopathy.

PMID- 8360707
TI  - Responses of human glioblastoma cells to human natural tumor necrosis factor
      alpha: susceptibility, mechanism of resistance and cytokine production studies.
AB  - Responses and susceptibility of 14 human glioblastoma cell lines to human natural
      tumor necrosis factor-alpha (TNF) were studied in vitro. Susceptibility of
      glioblastoma cells to TNF varied in experimental conditions applied. Most of
      glioblastoma cell lines were resistant to cytotoxic activity of TNF in a MTT
      assay at concentrations below 16 U/ml for 72 h exposure. However, TNF at higher
      dose, in prolonged exposure and against low density of target cells was
      antiproliferative for certain glioblastoma cultures. TNF exposure at 10 U/ml for
      48 h suppressed DNA synthesis in 9 of 14 glioblastoma cultures, but increased in
      3 cultures. In addition, colony forming assay showed anti-clonogenic activity of
      TNF in 5 of 6 glioblastoma cell lines tested. In spite of their low
      susceptibility to TNF, glioblastoma cells well responded to TNF stimulation at
      low dose (10 U/ml) for a short period in the absence of cell damage. Productions
      of Interleukin-6 (IL-6), IL-8-like activity, granulocyte-macrophage colony
      stimulating factor (GM-CSF), prostaglandin E2 (PGE2) and manganous superoxide
      dismutase (Mn-SOD) were enhanced or induced by the low-dose TNF stimulation. Mn
      SOD, a protein protective against oxidative cell damage, was well induced in time
      and dose-dependent manner, however did not correlate with TNF resistance.
      Whereas the levels of PGE2 in TNF-susceptible cell lines, H-4 and SF-188, were
      higher than those of other lines. In conclusion, most of glioblastoma cells are
      resistant to TNF cytotoxic effects, but highly responsive to TNF stimulation. Its
      effect on glioblastoma cells appears to modulate cell differentiation rather than
      to kill the cells.

PMID- 8360708
TI  - (14C-methyl)-L-methionine uptake in rat brain tumors before and after treatment
      with the protein synthesis inhibitor cycloheximide.
AB  - Autoradiographic study of (14C-methyl)-L-methionine with brain tumor bearing rats
      aimed at an elucidation of the mechanism of tracer accumulation in the protein
      synthesis of tumor. Twice as much tracer accumulated in the tumors compared as in
      the contralateral gray matter (nontumor region) at 90 min post intravenous
      injection. The protein-bound fraction of the tumors, expressed as acid-insoluble
      fraction (AIF), was 1.7 +/- 0.6 (mean +/- standard deviation, n = 6),
      significantly higher than that (0.8 +/- 0.2) of the nontumor region (p < 0.05 by
      the Mann-Whitney test). The tumor AIF comprised 82.3 +/- 9.2% of the total amount
      of the tracers accumulated in the tumors. The protein synthesis inhibitor
      cycloheximide reduced the tracer uptake and the AIF of the tumors to an almost
      same level as the nontumor region. These findings indicate that metabolic
      acceleration of protein synthesis may be a main reason for the high accumulation
      of (14C-methyl)-L-methionine in tumor.

PMID- 8360709
TI  - Treatment of spinal epidural neuroblastoma xenografts in rats using anti-GD2
      monoclonal antibody 3F8.
AB  - Epidural neuroblastoma xenografts in nude rats causing paraparesis were treated
      with intravenous injection of an anti-GD2 monoclonal antibody 3F8. Metastatic or
      primary epidural tumors in humans cause rapid neurologic compromise. Treatment is
      often unsatisfactory. An animal model was established to study antibody targeted
      therapy of epidural tumor. Human neuroblastoma was xenotransplanted into the
      thoracic epidural space of nude rats. When paraparesis developed, animals were
      treated intravenously with an anti-GD2 monoclonal antibody, 3F8, either alone or
      radiolabeled with 131Iodine. Improvement in neurologic function occurred in 2 of
      20 (10%) animals receiving no treatment or control antibody, 14 of 17 (82%)
      animals receiving 3F8 alone and all 9 animals receiving 131I-3F8 (p < 0.0001 for
      3F8 or 131I-3F8 vs. control). Six animals treated with 3F8 alone recovered normal
      neurologic function and remained well until sacrifice 10 days later. Four animals
      treated with 3F8 alone had no tumor evident on pathologic examination. The
      percent injected dose of 131I-3F8/g tumor in 5 samples ranged from 0.73% to 3.8%.
      These observations demonstrate that neoplastic epidural compression of the spinal
      cord in the rat can be treated successfully with intravenous unmodified
      monoclonal antibody and that signs of neurologic dysfunction can be reversed. The
      potential of this approach in treating patients with epidural tumors and other
      neoplasms, especially those that are not sensitive to chemotherapy or
      radiotherapy, deserves to be explored.

PMID- 8360710
TI  - Intracranial myxopapillary ependymoma: case report.
AB  - The authors report an unusual case of a myxopapillary ependymoma arising from the
      lateral ventricle. The patient, a 37-year-old woman, developed recurrent symptoms
      including scotomata, disorientation, and headache during two successive
      pregnancies before the definitive diagnosis. The causes of this ependymoma
      variant and its relationship to pregnancy are discussed.

PMID- 8360711
TI  - Comparison between BCNU and procarbazine chemotherapy for treatment of gliomas.
AB  - We compared sequential single-agent BCNU and procarbazine (PCB) chemotherapy in
      31 patients with gliomas [grade IV (10), grade III (15), grade II (6)]. Patients
      had failed surgical biopsy +/- resection and radiation therapy. All patients were
      treated initially with BCNU 150-300 mg/m2 by intra-arterial or intravenous route
      every 6 weeks. After CT evidence of tumor progression, all patients received PCB
      150 mg/m2/day for 28 days every 8 weeks. Patient responses to BCNU were CR (0),
      PR (7), SD (12), progression (12), and to PCB CR (2), PR (9), SD (6), and
      progression (14). Kaplan-Meier estimates of median time to failure for all
      patients were shorter for BCNU, 5.0 months (range 1.5-20), than for PCB, 6.0
      months (range 2-50+). There was a statistically significant difference (Mantel
      Cox test, p = 0.02) in the distribution of time to disease progression between
      the two drugs, especially for grade III tumors (p = 0.02). The cumulative
      proportion of patients without disease progression at 6 months was 26% while on
      BCNU, compared to 48% while on PCB; at 12 months the cumulative proportions were
      3% for BCNU compared to 35% for PCB. Although there was no formal washout period
      between administration of the two drugs, no carryover effect was evident. These
      data provide further evidence that PCB has significant activity against malignant
      glioma and may, in fact, be more effective than BCNU.

PMID- 8360712
TI  - Delayed neurotoxicity of intraventricular interleukin-2: a case report.
AB  - A case is reported of a 40 year old woman treated with intraventricular IL-2 for
      leptomeningeal disease who developed progressive cognitive dysfunction. This
      deterioration started 3 months post-treatment and worsened over the ensuing 4
      years. MRI revealed white matter abnormalities that were not present on the
      pretreatment scan. Although free of disease, the patient has a subcortical
      dementia and is unable to work. The potential for progressive brain injury and
      subsequent disability related to intraventricular IL-2 therapy is discussed.

PMID- 8360713
TI  - Methotrexate induced brain necrosis and severe leukoencephalopathy due to
      disconnection of an Ommaya device.
AB  - A 63-year old woman with breast carcinoma developed leucoencephalopathy and local
      brain necrosis after intraparenchymal infusion of methotrexate. This iatrogenic
      condition was caused by drain disconnection of the Ommaya device (bore hole
      type). The diagnosis of this rare complication of an Ommaya device was based on
      multiplanar MR-imaging. The case is discussed with regard to the complications of
      intraventricular chemotherapy by means of an Ommaya reservoir.

PMID- 8360714
TI  - Primary diffuse leptomeningeal gliomatosis (PDLG): a neoplastic cause of chronic
      meningitis.
AB  - Cancerous 'chronic meningitis' may be related to subarachnoid space involvement
      by solid tumors, hematologic malignancies or rarely intraparenchymatous gliomas.
      Primary leptomeningeal gliomatosis is a rare condition that is attributed to
      malignant transformation of heterotopic neuroglial tissue. We discuss the
      clinical and biological features of a patient who died with the diffuse form of
      primary leptomeningeal gliomatosis (PDLG). A literature search shows that a one
      to two months long non-specific prodromal phase followed by a fluctuating
      neurologic downhill course is suggestive of this disease. Cerebro-spinal fluid
      (CSF) cytology has been diagnostic in only 1 of 8 reported cases. Recent
      technical progress, including the use of GFAP (glial fibrillary acidic protein)
      directed antibody, may enhance the sensitivity of CSF cytologies. Diagnosis may
      require repeated cerebral biopsies, because the hemispheric lesions are often
      separated by normal tissue. PDLG must be added to the large differential
      diagnosis of 'chronic meningitis'.

PMID- 8360715
TI  - Motor cortical activity during voluntary gait modifications in the cat. I. Cells
      related to the forelimbs.
AB  - 1. The discharge patterns of 91 identified pyramidal tract neurons (PTNs),
      located within the forelimb region of area 4 of the cat motor cortex, were
      recorded during the voluntary modifications of gait needed to step over obstacles
      attached to a moving treadmill belt. Recordings were made simultaneously from
      flexor and extensor muscles acting around the shoulder, elbow, wrist, and digits
      of the forelimb contralateral to the recording site. 2. Analysis of the changes
      in electromyographic (EMG) activity during the gait modification showed increases
      in the activity of most flexor muscles of the shoulder and elbow, as well as in
      the wrist and digit dorsiflexors, when the contralateral forelimb was the first
      to pass over the obstacle. This period of augmented activity could be subdivided
      into two parts: one associated with the initial flexion of the limb that was
      needed to bring it above and over the obstacle (phase I), and the second
      associated with increased wrist dorsiflexor muscle activity before foot contact
      (phase II). 3. The discharge frequency of a total of 57/91 (63%) of the recorded
      PTNs was significantly increased during the gait modification when the limb
      contralateral to the recording site was the first to step over the obstacle; six
      of these neurons also showed a significant decrease in their discharge in a
      different part of the step cycle. In a further 21/91 (23%) neurons, discharge
      frequency was only decreased, whereas the remaining 13/91 (14%) PTNs showed
      similar patterns of activity both during control walking and during the gait
      modifications. 4. Most of those neurons (47/57) in which significant increases in
      firing frequency were observed, discharged maximally during the period of
      increased activity of the physiological flexor muscles. Twenty-three of these
      cells (23/47) discharged maximally in phase I, and 12 (12/47) in phase II. A
      third population of PTNS (12/47) started to increase their discharge in the
      stance phase of the step cycle immediately preceding the modified cycle. Seven
      (7/57) PTNs increased their discharge during the stance phase of the modified
      cycle, and the remaining three could not be classified as being preferentially
      related to any one part of the step cycle. 5. The frequency modulation of 41/57
      PTNs was less when the leg contralateral to the recording site was the second to
      encounter the obstacle. In many neurons there was also an appreciable change in
      the time in the step cycle that peak discharge occurred. These changes in
      amplitude and timing paralleled the changes observed in the temporal
      relationships of the muscles.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8360716
TI  - Thermal and pain sensations evoked by microstimulation in the area of human
      ventrocaudal nucleus.
AB  - 1. We have studied the sensations evoked by threshold microstimulation (TMS) in
      the area of the human principal sensory nucleus of the thalamus [ventralis
      caudalis (Vc)] in patients (n = 11) undergoing stereotactic surgery for the
      treatment of movement disorders and pain. Preoperatively, patients were trained
      to describe somatic sensory stimuli using a standard list of descriptors. This
      same list was used to describe sensations evoked intraoperatively by thalamic
      microstimulation. Stimulation sites (n = 216) were defined by location within the
      area where the majority of cells had a reproducible response to innocuous
      cutaneous stimulation (core region) or in the cellular area posterior and
      inferior to the core region (posteroinferior region). 2. TMS-evoked sensations
      were categorized as paresthetic if the descriptors "tingle," "vibration," or
      "electric current" were chosen by the patient to describe the sensation and as
      thermal/pain if the descriptors "cool," "warm," "warm and cool," or "pain" were
      chosen. Thermal/pain sensations were evoked by stimulation in 82% (9/11) of
      patients and at 19% of sites studied. These results suggest that thalamic
      microstimulation can evoke thermal/pain sensations reproducibly across patients.
      3. Thermal/pain sensations were evoked more frequently by stimulation at sites in
      the posteroinferior region (30%) than by stimulation at sites in the core region
      (5%). Nonpainful thermal sensations composed the majority of thermal/pain
      sensations evoked by stimulation in both the core (80%) and posteroinferior
      regions (86%). Sites where stimulation evoked pain and nonpainful cool sensations
      were found anterior to the area where nonpainful warm sensations were evoked.
      Thermal/pain sensations were evoked at sites located medially near the border
      between the core and posteroinferior regions. 4. Radiologic techniques were used
      to determine the presumed nuclear location of stimulation sites. Thermal/pain
      sensations were evoked less frequently by stimulation in the part of Vc included
      in the core region than by stimulation in any of the following: the part of Vc
      included in the posteroinferior region, ventralis caudalis portae nucleus,
      ventralis caudalis parvocellularis nucleus, or the white matter underlying the
      ventral nuclear group. 5. The location of the sensation evoked by stimulation
      [projected field (PF)] varied widely in size. PFs were categorized as large if
      they involved more than one part of the body (e.g., face and arm) or if they
      crossed at least one joint proximal to the metacarpophalangeal joint or to the
      metatarsophalangeal joint. PFs were more frequently large at sites where
      thermal/pain sensations were evoked by TMS (33%) than at those where paresthesia
      were evoked (6%).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8360717
TI  - Motor cortical activity during drawing movements: population representation
      during sinusoid tracing.
AB  - 1. Monkeys were trained to trace sinusoids with their index fingers on a planar
      surface. During this task, both the direction and speed of movement varied
      continuously. Activity of individual units in the precentral gyrus contralateral
      to the moving arm was recorded as the task was performed. These cells responded
      to passive movement of the shoulder and/or elbow. The relation between discharge
      rate and movement direction for these individual cells could be described with a
      cosine tuning function. 2. Data recorded as the sinusoid was traced were divided
      into 100 bins as each cell was studied during the experiment. In each bin, the
      activity of a particular cell was represented by a vector. The vector ("cell
      vector") pointed in the direction of finger movement that corresponded to the
      highest rate of neuronal discharge. This direction, referred to as the preferred
      direction, corresponded to the peak of the cosine tuning function. The direction
      of the vector was constant between bins, but the magnitude of this cell's vector
      was a function of the instantaneous discharge rate. 3. This cell vector is a
      hypothetical contribution of a single cell to the population response comprised
      of 554 similarly derived vectors from different cells. The population response
      was represented as the vector that resulted from forming the sum of the vector
      contributions from the individual cells. A separate calculation was made for each
      bin, resulting in 100 population vectors for each sinusoid. 4. Within a given
      time series of population vectors, their lengths and directions varied in a
      consistent relation to the tangential velocity of the drawing movement.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8360718
TI  - Neuronal activity in the second somatosensory cortex of monkeys (Macaca mulatta)
      during active touch of gratings.
AB  - 1. In penetrations made into the upper bank of the lateral sulcus in two monkeys
      (Macaca mulatta), cells were isolated from the second somatosensory cortex (SII).
      During single-cell recordings, animals performed an active touch task in which
      they rubbed their fingertips over pairs of gratings differing in groove width and
      indicated which was the smoother surface. Hand motion and downward applied force
      were measured and recorded during these strokes. 2. In this survey, 151
      penetrations provided observations on 352 cells that responded to passive
      stimulation of the digits or during performance of the active touch task.
      Consistent with previous reports, receptive fields (RFs) in SII were large, often
      multi-digit, and frequently included a portion or all of the hand and
      occasionally the arm. Modality was determined for 92 of 127 fully characterized
      cells, and included 70 cutaneous, 5 deep, 11 Pacinian corpuscle, and 6 joint
      cells. Characteristic of SII, modality could not be defined in 35 cells that were
      unresponsive to passive stimulation or whose responses varied widely over time.
      3. Response properties of a subgroup of 79 cells in SII resembled those
      previously studied in the primary somatosensory cortex (SI) and ventroposterior
      lateral nucleus of the thalamus (VPL) using identical procedures. Correlation
      analysis revealed that 29 of these cells, like a portion of cells in SI,
      responded to changes in groove width independent of force or velocity. This
      selectivity could be considered a form of feature specificity. 4. In contrast to
      SI and VPL, transient responses to the fingertips contacting small elevated metal
      bars, which demarcated the beginning, middle, and end of strokes across the
      gratings, were seen in a majority of SII cells (109/127). During contact with
      bars, 89 cells displayed excitatory responses and 20 cells showed suppressed
      activity. Twelve cells, which responded to bars in isolation from gratings,
      provided a possible example of increased stimulus selectivity. 5. Passive
      stimulation failed to activate 16 cells that responded, in some cases
      differentially to gratings or force, during the task. Responses of nine other
      cells demonstrated task-dependent modulation in the form of response reduction or
      enhancement during selected portions of the stroke. In these same cells, response
      changes did not occur under comparable stimulus conditions in other portions of
      the stroke that differed only in behavioral context. These types of selective
      response modulations, not noted in our previous studies of VPL or SI, suggest
      that mechanisms regulating sensory inputs may affect SII.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8360719
TI  - Effects of bilateral and unilateral ablation of auditory cortex in cats on the
      unconditioned head orienting response to acoustic stimuli.
AB  - 1. Reflexive head orienting responses (ORs) elicited by bursts of wide-band noise
      were investigated in cats after bilateral or unilateral ablation of the auditory
      cortex, and the cats' performance was compared with that of control cats. The OR
      was used as an indication of ability to orient toward the azimuthal direction of
      a source of sound. 2. To adequately test this ability, a unique combination of
      stimulus duration and position of the sound source was selected on each trial.
      Stimulus durations (0.1, 0.3, and 1.5 s) were selected so that the offset of a
      burst of noise occurred before, during, or after an OR. The stimuli were produced
      from speakers positioned approximately at the interaural horizontal plane within
      each quadrant of a cat's auditory field. The ORs were recorded on moving film and
      analyzed quantitatively. 3. In the control cats, the trajectory of the OR was
      characterized by a saccadic profile (rapid steplike movement, monophasic
      velocity, and biphasic acceleration). The accuracy of the OR varied directly with
      stimulus duration, suggesting that the response was modified by auditory feedback
      produced by a head movement during the stimulus. Corrective responses executed
      during long-duration (1.5 s) stimuli reduced residual mean error to < 7 degrees
      in each of the control animals. The mean error in orientation was smaller for
      sources located in the frontal sound field than for sources located behind the
      coronal plane the head (> 90 degrees). When brief (0.1 s) stimuli were presented
      behind the head, the cats confused back with front directions on most of the
      trials. 4. Compared with performance in the control cats, bilateral destruction
      of the auditory geniculocortical system severely impaired a cat's ability to
      orient consistently and accurately toward a source of sound. Latencies to the
      onset of ORs were increased, the magnitudes of ORs were reduced, average error in
      orienting to a sound source was larger under every stimulus duration-source
      position combination, relatively few corrective responses were executed, and
      residual mean error was significantly elevated (bilateral = 28.1 degrees; control
      = 3.1 degrees). Several animals with bilateral lesions also made vertical errors
      in orienting to azimuthal sources of sound. 5. However, in the bilateral lesion
      group, ORs were initiated in the correct right or left direction; and, rather
      than eliminating accurate responses altogether, the lesions reduced the
      probability of their occurrence. Furthermore, the saccadic profile of the
      response was preserved, providing evidence that the motor control system for the
      OR was not perturbed by the bilateral lesions.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8360720
TI  - Covert orienting of attention in macaques. I. Effects of behavioral context.
AB  - 1. A task was used by Posner (1980) to measure shifts of attention that occurred
      covertly, in the absence of an eye movement or other orienting response. This
      paradigm was used here to assess the nature of covert attentional orienting in
      monkeys to develop an animal model for neurophysiological studies. Shifts of
      attention were measurable in monkeys and were consistent across a variety of
      experimental conditions. 2. The paradigm required that monkeys fixate and release
      a bar at the appearance of a target, which was preceded by a cue. Reaction times
      to targets that followed peripheral cues at the same location (validly cued) were
      significantly faster than those that followed cues in the opposite visual field
      (invalidly cued). This difference was defined as the validity effect, which as in
      humans, is used as the measure of a covert attentional shift. 3. When the
      proportion of validly to invalidly cued targets was decreased, no change was seen
      in the validity effect of the monkeys. This is in contrast to humans, for whom
      the ratio of validly to invalidly cued targets affected the magnitude of the
      validity effect. When 80% of the targets were preceded by cues at the same
      location, the validity effect was greatest. The effect was reversed when the
      proportions were reversed. From this result, it is concluded that cognitive
      processes can affect covert orienting to peripheral cues in humans, whereas in
      trained monkeys, performance was automatic. 4. To test whether cognitive
      influences on attention could be demonstrated in the monkey, an animal was taught
      to use symbolic, foveal signals to covertly direct attention. The magnitude of
      this validity effect was greater than that obtained with peripheral cues. 5. The
      effects of motivational and perceptual processes were tested. Although overall
      reaction times could be modified, the facilitating effects of the cues persisted.
      This constancy across motivational and perceptual levels supports the notion that
      the monkeys were performing the task in an automatic way, under the exogenous
      control of peripheral cues. 6. Most visual cuing has been tested with visual
      landmarks at the locations of cues and targets. These monkeys were trained with
      such landmarks, and when tested without them, the attentional effect of the cues
      was nearly abolished. These data suggest that local visual features can be
      important for covert orienting. 7. To determine the spatial extent of the effect
      of the cue, monkeys and humans were tested with four cue-target distances (0-60
      degrees).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8360721
TI  - Effects of selective attention on spatial form processing in monkey primary and
      secondary somatosensory cortex.
AB  - 1. The effects of selective attention were studied in SI and SII cortex of a
      rhesus monkey trained to perform two tasks, a tactile discrimination task and a
      visual detection task. In the tactile task, a letter was displayed on a video
      screen in front of the monkey and the animal was rewarded for responding when the
      raised letter (6.0 mm letter height) scanning across its finger (15 mm/s) matched
      the letter on the screen. In the visual task, three illuminated squares were
      displayed on the screen, and the animal was rewarded for detecting when one of
      the squares dimmed. The neural responses evoked by the raised letters were
      recorded continuously while the animal's focus of attention was switched back and
      forth between the two tasks. 2. Significant differences between the discharge
      rates evoked by raised letters in the two tasks were observed in approximately
      50% of neurons in SI cortex and 80% of neurons in SII cortex. The effects in SII
      cortex were divided between increased (58%) and decreased (22%) rates. In SI
      cortex only increased rates were observed. 3. The attentional effects were
      expressed not only as changes in overall neuronal activity but also as
      modifications of the form of the responses evoked by the letters. 4. Whether
      attentional effects were observed depended upon the behavioral relevance of
      individual letters. During brief periods in the tactile task when a behavioral
      response could not yield a reward (time-out and reward periods) the neuronal
      responses were not significantly different from the responses evoked by the same
      letters during the visual task.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360722
TI  - Medical therapeutic strategy of acute cerebral ischaemia in adults.

PMID- 8360723
TI  - Contribution of computerized tomography to the diagnosis of acute cerebral
      ischaemia.

PMID- 8360724
TI  - Magnetic resonance imaging in acute cerebral ischaemia.
AB  - The frequency of cerebral vascular accidents justifies a rapid evaluation of the
      patients to distinguish between ischaemia and haematoma. In acute cerebral
      ischaemia, data from the literature show that magnetic resonance imaging is
      sensitive early (4th to 6th hours) and anatomically efficient (posterior fossa,
      brain stem) although it lacks specificity, being based on water movements alone.
      The most difficult differential diagnosis in the acute phase is bleeding, and in
      that phase early computerized tomography images are easier to interpret.

PMID- 8360725
TI  - Epidemiology of stroke.

PMID- 8360726
TI  - Posterior subscapular approach to the brachial plexus. Report of 102 patients.
AB  - A 15-year operative experience with 105 posterior subscapular approaches to the
      brachial plexus in 102 patients is presented. The procedure is indicated in
      carefully selected cases, especially where the proximal portions of lower spinal
      nerves are involved. Its main advantage is proximal exposure of the plexus spinal
      nerves, particularly at an intraforaminal level. The indications in this series
      were thoracic outlet syndrome (TOS) in 51 carefully selected procedures, brachial
      plexus tumor involving proximal roots in 22 patients, post-irradiation brachial
      plexopathy in 14 cases, and proximal traumatic brachial plexus palsy in 18
      patients. Thoracic outlet syndrome associated with neurological loss, recurrent
      TOS after a prior operation, or proximal brachial plexus surgical lesions
      involving the spinal nerve(s), especially at an intraforaminal level, can be
      approached advantageously by such a posterior subscapular approach. The technique
      should also be considered when prior operation, trauma, or irradiation to the
      neck or anterior chest wall make a posterior exploration of the plexus easier
      than an anterior one. Anterior exposure of the plexus is the preferable approach
      for the majority of lesions needing an operation, but the posterior subscapular
      procedure can be useful in well-selected cases.

PMID- 8360727
TI  - Centrocentral anastomosis of the proximal nerve stump in the treatment of painful
      amputation neuromas of major nerves.
AB  - The term "centrocentral anastomosis" is used to describe the end-to-end
      connection across interposed nerve grafts between paired fascicular groups of the
      proximal stump of a severed nerve. In 22 patients harboring a painful terminal
      neuroma following amputation of a lower limb (20 neuromas on the sciatic nerve
      and two on the peroneal nerve), a centrocentral anastomosis was performed on the
      end of the sectioned nerve to treat pain that had not improved with conventional
      conservative treatment. Follow-up review at 1 year revealed that the typical
      neuroma pain had disappeared in all cases, although sporadic diffuse pain
      persisted in four. Where previous phantom sensation was present, no change was
      observed. The results presented here are consistent with laboratory findings
      demonstrating the absence of neuroma formation after centrocentral anastomosis.
      Therefore, this technique is recommended for the treatment of painful amputation
      neuroma.

PMID- 8360728
TI  - Short-segment compression instrumentation for selected thoracic and lumbar spine
      fractures: the short-rod/two-claw technique.
AB  - The short-rod/two-claw (SRTC) technique of spine instrumentation was recently
      introduced for the treatment of thoracic and lumbar spine fractures. The use of
      this technique in 10 patients harboring wedge compression or burst fractures of
      the thoracic or lumbar spine is described. Of three patients treated with the
      construct placed in a distraction mode, the average follow-up loss of angle (the
      difference between the immediate postoperative and follow-up midsagittal angle as
      measured on x-ray films) was 18.3 degrees. Of the seven patients in whom the
      instrumentation was placed in a compression mode, the average observed loss of
      angle at follow-up examination was 1.6 degrees. Two patients had a preoperative
      scoliotic deformity at the fracture site, and both deformities were exaggerated
      by the placement of the SRTC technique in compression. Although no patient
      experienced an adverse outcome and all achieved a solid fusion, the application
      of the SRTC technique of universal spine instrumentation in distraction was
      associated with an exaggerated loss of angle. Loss of angle and deformity
      exaggeration are not desirable and are preventable by strict patient selection
      and by applying the construct in a compression mode. It is emphasized that few
      patients are candidates for this form of instrumentation. When applicable,
      however, the advantages of decreased pain and stiffness and the elimination of
      the need for instrumentation removal make the SRTC and related short-segment
      techniques desirable alternatives to traditional methods of spinal fixation.

PMID- 8360729
TI  - Magnetic resonance imaging documentation of coexistent traumatic locked facets of
      the cervical spine and disc herniation.
AB  - The coexistence of traumatic locked facets of the cervical spine and a herniated
      disc is not well described. The authors present a series of patients with
      traumatic locked facets who demonstrated a high incidence of associated disc
      herniation documented on magnetic resonance (MR) imaging. Thirteen patients with
      either unilateral (four cases) of bilateral (nine cases) locked facets of the
      cervical spine were analyzed retrospectively. Immediate closed reduction using
      traction and/or manipulation was attempted in the first nine cases treated and
      was successful in only three; however, the procedure was abandoned in three cases
      due to deterioration in the patient's clinical status. In the subsequent four
      patients, an MR image was obtained prior to attempts at closed reduction. All
      patients underwent MR imaging of the cervical spine. Of eight consecutive cases
      treated at the University of Michigan, frank disc herniation with fragmented disc
      in the canal was found in five while pathological disc bulging was found in the
      other three. All five cases contributed by other institutions had concurrent disc
      herniation. This series illustrates the importance of using MR imaging to
      document the presence of a herniated disc during the initial evaluation of a
      patient with traumatic locked facets of the cervical spine and prior to attempted
      reduction of the locked facets. Experience indicates that closed reduction of
      facet dislocation associated with disc rupture may result in increased spinal
      cord compression and neurological deficit. If a herniated disc is discovered,
      anterior discectomy and fusion would be favored as the initial therapy over
      attempts at closed reduction or operative posterior reduction.

PMID- 8360730
TI  - Reflex variability in selective dorsal rhizotomy.
AB  - The variability of reflex responses during selective dorsal rhizotomy was studied
      in eight children between the ages of 3 and 7 years. For a given dorsal root or
      rootlet, the electrical reflex threshold and response varied considerably when
      observed over several minutes. Changes in electrode pressure, mechanical
      dissection of the root, and reflex spatial facilitation were all found to
      contribute to the variability. Even when electrode pressure was held constant,
      intrinsic spinal cord reflex variability substantially weakened the
      predictability of the intraoperative selection method used during this surgery.

PMID- 8360731
TI  - The use of moderate therapeutic hypothermia for patients with severe head
      injuries: a preliminary report.
AB  - Animal research suggests that moderate therapeutic hypothermia may improve
      outcome after a severe head injury, but its efficacy has not been established in
      humans. The authors randomly assigned 40 consecutively treated patients with a
      severe closed head injury (Glasgow Coma Scale score 3 to 7) to either a
      hypothermia or a normothermia group. Using cooling blankets and cold saline
      gastric lavage, patients in the hypothermia group were cooled to 32 degrees to 33
      degrees C (brain temperature) within a mean of 10 hours after injury, maintained
      at that temperature for 24 hours, and rewarmed to 37 degrees to 38 degrees C over
      12 hours. Patients in the normothermia group were maintained at 37 degrees to 38
      degrees C during this time. Deep-brain temperatures were monitored directly and
      used for all temperature determinations. Intracranial pressure (ICP), cerebral
      blood flow (CBF), and cerebral metabolic rate for oxygen (CMRO2) were measured
      serially for all patients. Hypothermia significantly reduced ICP (40%) and CBF
      (26%) during the cooling period, and neither parameter showed a significant
      rebound increase after patients were rewarmed. Compared to the normothermia
      group, the mean CMRO2 in the hypothermia group was lower during cooling and
      higher 5 days after injury. Three months after injury, 12 of the 20 patients in
      the hypothermia group had moderate, mild, or no disabilities; eight of the 20
      patients in the normothermia group had improved to the same degree. Both groups
      had a similar incidence of systemic complications, including cardiac arrhythmias,
      coagulopathies, and pulmonary complications. It is concluded that therapeutic
      moderate hypothermia is safe and has sustained favorable effects on acute
      derangements of cerebral physiology and metabolism caused by severe closed head
      injury. The trend toward better outcome with hypothermia may indicate that its
      beneficial physiological and metabolic effects limit secondary brain injury.

PMID- 8360732
TI  - Effect of mild hypothermia on uncontrollable intracranial hypertension after
      severe head injury.
AB  - Recent experimental studies have demonstrated that mild hypothermia at about 34
      degrees C can be effective in the control of intracranial hypertension. A
      randomized controlled study of mild hypothermia was carried out in 33 severely
      head-injured patients. All patients fulfilled the following criteria: 1)
      persistent intracranial pressure (ICP) greater than 20 mm Hg despite fluid
      restriction, hyperventilation, and high-dose barbiturate therapy; 2) an ICP lower
      than the mean arterial blood pressure; and 3) a Glasgow Coma Scale score of 8 or
      less. The patients were divided into two groups: one received mild hypothermia
      (16 patients) and one served as a control group (17 patients). Mild hypothermia
      significantly reduced the ICP and increased the cerebral perfusion pressure.
      Eight patients (50%) in the hypothermia group and three (18%) in the control
      group survived (p < 0.05), while five (31%) in the hypothermia group and 12 (71%)
      in the control group died of uncontrollable intracranial hypertension (p < 0.05).
      In five patients in the hypothermia group, cerebral blood flow was measured by
      the hydrogen clearance method and arteriojugular venous oxygen difference was
      evaluated before and during mild hypothermia. Mild hypothermia significantly
      decreased the cerebral blood flow, arteriojugular venous oxygen difference, and
      cerebral metabolic rate of oxygen (p < 0.01). The results of this preliminary
      investigation suggest that mild hypothermia is a safe and effective method to
      control traumatic intracranial hypertension and to improve mortality and
      morbidity rates.

PMID- 8360733
TI  - A clinical study of the relationship of timing to outcome of surgery for ruptured
      cerebral aneurysms. A retrospective analysis of 1622 cases.
AB  - Between 1980 and 1987, 1622 patients with angiographically verified ruptured
      cerebral aneurysms were admitted within 7 days after subarachnoid hemorrhage. A
      retrospective analysis evaluated both the timing of surgery in operative patients
      and the status of nonsurgical patients. The patients' clinical grade according to
      the Hunt and Hess classification was assessed at admission, and a comparative
      analysis of outcome was carried out for each grade in relation to time of
      surgery: those operated on from Day 0 to 3 and those undergoing surgery on Day 4
      or later. Among nonsurgical cases, fatal rebleeding occurred in 105 cases and
      fatal vasospasm in 69 cases. These nonsurgical cases were divided into one of two
      groups, either an early- or a late-management group, and the outcome of each
      group was analyzed by clinical grade. The mortality rates in the early-surgery
      groups were higher than in the late-surgery groups, especially in Grade V, in
      which the rate was significantly different. However, with the 174 nonsurgical
      patients included in these management results, marked differences in mortality
      rates disappeared except in Grade V, which failed to show statistical
      significance. A higher rate of good recovery among Grade III patients receiving
      early surgery shifted significantly in the early-management group. The results
      suggest that the timing of surgery in clinical Grade I or II patients is not a
      major factor; however, early surgery appears to be beneficial in Grade III and IV
      patients. The incidence of rebleeding in the early- and late-management groups
      was 2.7% and 9.5%, respectively.

PMID- 8360734
TI  - Anterior communicating artery collateral flow protection against ischemic change
      during carotid endarterectomy.
AB  - The purpose of this study was to determine whether preoperative angiographic
      patterns of collateral cerebral blood flow correlate with protection against
      intraoperative electroencephalographic (EEG) evidence of cerebral ischemia caused
      by carotid artery cross-clamping during carotid endarterectomy. Previous studies
      have shown that contralateral carotid artery occlusion and intracranial stenoses
      are associated with cerebral ischemia during carotid endarterectomy; however, the
      angiographic collateral flow patterns associated with cerebral ischemia have not
      been identified. This paper reports a retrospective study of 67 patients who
      underwent two- to four-vessel cerebral angiography followed by carotid
      endarterectomy with 16-channel EEG monitoring. The angiograms were reviewed for
      extracranial occlusive disease and collateral flow patterns, and the EEG
      recordings were analyzed for ischemic changes during carotid artery cross
      clamping. Statistical analysis was by Fisher's exact test. Cross-filling of the
      anterior and middle cerebral arteries from the contralateral carotid artery
      through the anterior communicating artery correlated with a decreased incidence
      of EEG ischemic changes. Only 21% of patients with this collateral flow pattern
      showed ischemic changes compared to 50% of patients without this pattern (p <
      0.03). Three angiographic findings occurring in combination on the side
      contralateral to surgery correlated with EEG ischemia: 1) occlusion of the
      contralateral internal carotid artery (five of seven or 71%, p < 0.03); 2)
      collateral flow from the external carotid circulation to the internal carotid
      circulation via the ophthalmic artery; and 3) collateral flow from the posterior
      circulation to the contralateral anterior circulation via the posterior
      communicating artery. The data presented here corroborate the correlation between
      contralateral carotid artery occlusion and cerebral ischemia during carotid
      endarterectomy. They also demonstrate that cross-filling of the anterior and
      middle cerebral arteries by the contralateral carotid artery protects against
      such ischemia. This collateral flow may serve as an indicator of tolerance to
      carotid artery cross-clamping.

PMID- 8360735
TI  - Evaluation of pressure changes in feeding arteries during embolization of
      intracerebral arteriovenous malformations.
AB  - The pressure in 47 arteries feeding 21 arteriovenous malformations (AVM's) was
      investigated during transarterial embolization using a Tracker-18 microcatheter.
      On average, systolic pressure increased by 22 mm Hg. In AVM's with single or few
      feeders, embolization was usually achieved well; in contrast, giant AVM's with
      multiple feeders and a large arteriovenous shunt were poorly embolized. However,
      large AVM's with well-demarcated components may be reduced by embolization to an
      appropriate size for surgery or stereotactic radiation therapy. It was found that
      the feeding artery pressure increased significantly more in well-embolized than
      in poorly embolized cases. Measurements of the feeding artery pressure clarified
      the hemodynamics of AVM's and facilitated more successful embolization.

PMID- 8360736
TI  - Percutaneous lateral cervical cordotomy: target localization with water-soluble
      contrast medium.
AB  - Water-soluble intrathecal contrast material was used for radiographic
      identification of the cord target in 13 patients undergoing percutaneous lateral
      cervical cordotomy. Adequate visualization of the dentate ligament, considered
      essential for successful placement of the electrode, was achieved in seven cases.
      In the remaining six patients, four with suboptimal definition and two with
      nonvisualization of the ligament, an additional injection of contrast medium
      using a modified coaxial needle system outlined the entire thickness of the
      cervical cord. This technique improved needle-tip positioning in relation to the
      cord and resulted in successful surgery in all six patients.

PMID- 8360737
TI  - Intraoperative identification of motor areas of the rhomboid fossa using direct
      stimulation.
AB  - Intraoperative electrical identification of motor areas within the floor of the
      fourth ventricle was successfully carried out in a series of 10 patients with
      intrinsic pontine lesions and lesions infiltrating the brain stem. Direct
      electrical stimulation was used to identify the facial colliculus and the
      hypoglossal triangle before the brain stem was entered. Multichannel
      electromyographic recordings documented selective stimulation effects. The
      surgical approach to the brain stem was varied according to the electrical
      localization of these structures. During removal of the lesion, functional
      integrity was monitored by intermittent stimulation. In lesions infiltrating the
      floor of the fourth ventricle, stimulation facilitated complete removal.
      Permanent postoperative morbidity of facial or hypoglossal nerve dysfunction was
      not observed. Mapping of the floor of the fourth ventricle identifies important
      surface structures and offers a safe corridor through intact nervous structures
      during surgery of brain-stem lesions. Reliable identification is particularly
      important in mass lesions with displacement of normal topographical anatomy.

PMID- 8360738
TI  - Urinary epidermal growth factor in patients with gliomas: significance of the
      factor as a glial tumor marker.
AB  - Epidermal growth factor (EGF) content in urine from patients with glial tumors
      was examined by radioimmunoassay techniques with labeled human EGF and its rabbit
      EGF polyclonal antibody. There was no cross-reaction with transforming growth
      factor-alpha, which has a common receptor with EGF. Forty glial tumors were
      divided into three groups according to the clinical stage: Samples from Group A
      patients were obtained before therapy and/or after biopsy; in these patients a
      large volume of tumor was apparent on computerized tomography (CT). Group B
      samples were obtained after gross total removal of the tumor and/or chemo- and
      radiation therapy; these patients showed a small volume of residual tumor on CT.
      Samples from Group C patients were obtained after gross tumor total removal
      and/or chemo- and radiation therapy; no tumor was detected on CT scans in these
      patients. Urinary EGF levels in Group A samples were statistically significantly
      higher than in samples from healthy individuals (p < 0.001), Group B patients (p
      < 0.10), and Group C patients (p < 0.02). In addition, high-grade glial tumors in
      Group A cases showed a significantly higher level of urinary EGF than low-grade
      tumors in Group A patients (p < 0.05), or patients with meningioma (p < 0.02),
      metastatic brain tumor (p < 0.05), and cerebral infarction (p < 0.001).
      Longitudinal changes of urinary EGF levels in glioma patients mostly synchronized
      with the clinical course and therapeutic interventions. Therefore, urinary EGF,
      as a glial tumor marker, may be of practical value for diagnosing a malignant
      glioma and evaluating for the efficacy of chemo- and radiation therapy.

PMID- 8360739
TI  - A comparison of the protective effect of dexamethasone to other potential
      prophylactic agents in a neonatal rat model of cerebral hypoxia-ischemia.
AB  - It has recently been reported that pretreatment with a single dose of
      dexamethasone (0.1 mg/kg) 24 hours before hypoxia in 7-day-old rat pups is
      protective against an hypoxic-ischemic insult (unilateral carotid artery
      occlusion followed by 3 hours of hypoxia in 8% O2). The authors now examine
      whether pretreatment 6 hours before insult is equally effective and compare other
      agents potentially suitable for prophylaxis in neonatal hypoxia-ischemia,
      including the calcium antagonists flunarizine (30 mg/kg pretreatment), nimodipine
      (0.5 mg/kg pretreatment), and the 21-aminosteroid U-74389F (10 mg/kg pre- and
      posttreatment). For each active agent, there was also a vehicle-treated control
      group. Comparison of the mean area of ipsilateral infarction on brain coronal
      sections showed that there was no statistically significant difference between
      the various control groups (mean area of infarction 66% +/- 4%). Pretreatment
      with dexamethasone 6 hours prior to hypoxia offered complete protection with no
      infarction. A beneficial effect was seen following pretreatment with flunarizine
      (mean area of infarction 33.6% +/- 7.8%), although this degree of damage was
      still significantly different from that seen with dexamethasone pretreatment.
      Pretreatment with nimodipine or U-74389F offered no protection (mean area of
      infarction 77.5% +/- 4% and 59% +/- 10%, respectively). Unlike findings in adult
      animals and clinical studies, the current studies show that dexamethasone may
      have a role in the treatment of neonatal hypoxia-ischemia and deserves
      reappraisal.

PMID- 8360740
TI  - Traumatic brain injury, hemorrhagic shock, and fluid resuscitation: effects on
      intracranial pressure and brain compliance.
AB  - Intracranial hypertension following traumatic brain injury is associated with
      considerable morbidity and mortality. Hemorrhagic hypovolemia commonly coexists
      with head injury in this population of patients. Therapy directed at correcting
      hypovolemic shock includes vigorous volume expansion with crystalloid solutions.
      It is hypothesized that, following traumatic brain injury, cerebrovascular
      dysfunction results in rapid loss of brain compliance, resulting in increased
      sensitivity to cerebrovascular venous pressure. Increased central venous pressure
      (CVP) occurring with vigorous crystalloid resuscitation may therefore contribute
      to the loss of brain compliance and the development of intracranial hypertension.
      The authors tested this hypothesis in miniature swine subjected to traumatic
      brain injury, hemorrhage, and resuscitation. Elevated CVP following resuscitation
      from hemorrhage to a high CVP significantly worsened intracranial hypertension in
      animals with concurrent traumatic brain injury, as compared to animals subjected
      to traumatic brain injury alone (mean +/- standard error of the mean: 33.0 +/-
      2.0 vs. 20.0 +/- 2.0 mm Hg, p < 0.05) or to animals subjected to the combination
      of traumatic brain injury, hemorrhage, and resuscitation to a low CVP (33.0 +/-
      2.0 vs. 24.0 +/- 2.0 mm Hg, p < 0.05). These data support the hypothesis that
      reduction in brain compliance can occur secondary to elevation of CVP following
      resuscitation from hemorrhagic shock. This may worsen intracranial hypertension
      in patients with traumatic brain injury and hemorrhagic shock.

PMID- 8360741
TI  - Clival chordoma associated with pathological laughter. Case report.
AB  - The case of a 40-year-old man with a clival chordoma who presented with symptoms
      of pathological laughter and left sixth cranial nerve paresis is reported.
      Laughing and talking during sleep were noted on polygraphic and videotape
      recordings of nocturnal sleep. Selective disorganization of sleep was observed,
      with laughing facial expressions and a lack of muscular atonia. The tumor
      developed in the prepontine cistern, compressing the pontomesencephalic
      structures backward and involving the upper clivus and the left cavernous sinus.
      No recurrence of laughter attacks were noted after total removal of the tumor.
      The sleep patterns observed were similar to those of experimental animals with
      lesions of the peri-alpha locus ceruleus. The importance of uncontrolled laughter
      as a sign of a ventral brain-stem mass is emphasized.

PMID- 8360742
TI  - Spontaneous thrombosis of posterior cerebral artery aneurysm with angiographic
      reappearance. Case report.
AB  - The case is presented of a 23-year-old man suffering ischemic brain infarction
      from spontaneous thrombosis of a left posterior cerebral artery P1-P2 junction
      aneurysm. Vasospasm and/or partial parent vessel occlusion were documented by
      magnetic resonance (MR) imaging and angiography. Repeat cerebral angiography and
      MR imaging 3 months later revealed patency of the posterior cerebral artery and
      luminal filling of a 1-cm fusiform aneurysm, which was successfully trapped at
      surgery.

PMID- 8360743
TI  - Supraclinoid internal carotid artery fenestration with an associated aneurysm.
      Case report.
AB  - The case of an aneurysm occurring at the site of fenestration of the supraclinoid
      portion of the left internal carotid artery (ICA) is reported. A 37-year-old
      woman presenting with subarachnoid hemorrhage was found to have bilateral ICA
      aneurysms at the level of the posterior communicating arteries (PCoA's). The
      patient underwent right-sided craniotomy with uneventful clipping of the right
      PCoA aneurysm, and attempted clip placement on the contralateral left ICA
      aneurysm. The follow-up angiogram revealed a residual dome on the left ICA
      aneurysm, which was noted to originate at the proximal end of a fenestration of
      the left supraclinoid ICA. This represents the third reported case of
      fenestration of the intracranial ICA associated with an aneurysm. Intracranial
      artery fenestrations and their embryological origins are also reviewed.

PMID- 8360744
TI  - Spinal epidural leiomyoma occurring in an HIV-infected man. Case report.
AB  - A case of spinal epidural leiomyoma is reported in a 52-year-old man infected
      with the human immunodeficiency virus (HIV). The tumor arose in the epidural
      region at the T-3 vertebral level, and the patient presented with radicular pain
      in the right T-3 dermatome. While soft-tissue tumors such as Kaposi's sarcoma and
      lymphomas have been well documented in association with HIV infection, this is
      the first reported case of primary spinal leiomyoma. Isolated cases of leiomyomas
      and leiomyosarcomas in unusual locations have been reported, notably in pediatric
      HIV-positive patients, perhaps indicating a causal relationship. This case may
      represent further evidence of such an association.

PMID- 8360745
TI  - Spinal cord infarction associated with primary antiphospholipid syndrome in a
      young child. Case report.
AB  - Antiphospholipid antibodies have been reported to occur in ischemic stroke
      patients, but there have been no previous reports linking these antibodies to
      spinal cord infarction. A case of spinal cord infarction associated with primary
      antiphospholipid syndrome in a 6-year-old boy is reported. Magnetic resonance
      imaging clearly demonstrated marked swelling of the thoracolumbar spinal cord
      with gadolinium-diethylenetriamine pentaacetic acid enhancement at an acute
      stage, followed later by cord atrophy. Serological study disclosed positive lupus
      anticoagulant and immunoglobulin G anticardiolipin antibody. It is suggested that
      the role of antiphospholipid antibodies as an etiological factor for spinal cord
      ischemia should be recognized among causes that might have been categorized as
      either spontaneous spinal cord infarction or myelitis.

PMID- 8360746
TI  - Hemodynamic activity associated with a paraganglioma of the cauda equina. Case
      report.
AB  - A 53-year-old man presented with a paraganglioma of the cauda equina that caused
      significant hemodynamic instability during removal. The clinical implications of
      this phenomenon are discussed.

PMID- 8360747
TI  - Pigmented villonodular synovitis of the spine. Case report.
AB  - Pigmented villonodular synovitis commonly occurs in synovial joints of the
      appendicular skeleton, but rarely affects the synovial joints of the spine. It
      has both neoplastic and benign features, and the etiology is thought to be
      posttraumatic. The case of a young man presenting with paraparesis and a large
      thoracic lesion is reported.

PMID- 8360748
TI  - Cosmetic mastoidectomy for the combined supra/infratentorial transtemporal
      approach. Technical note.
AB  - The authors describe a cosmetic mastoidectomy technique for use when performing a
      combined supra/infratentorial craniotomy and transtemporal exposure. The
      technique involves a single temporal suboccipital bone flap and cosmetic
      mastoidectomy, removing the outer table of bone for later replacement.
      Replacement of the outer table of mastoid bone enables tamponade of a fat graft
      against the dura to reduce the risk of postoperative cerebrospinal fluid leaks.
      The technique has been performed in eight patients treated for petroclival
      meningiomas with excellent cosmetic results.

PMID- 8360749
TI  - A new brain retractor. Technical note.
AB  - A new brain retractor is presented that can be applied easily and safely from any
      direction. It is particularly useful in the evacuation of intracerebral
      hematomas.

PMID- 8360750
TI  - The Vanderbilt University neurosurgical heritage.
AB  - The Vanderbilt University Hospital heritage was influenced by the excellence of
      the Johns Hopkins era--by Osler, Halsted, Cushing, Brooks, and many others. Upon
      this strong origin, the neurosurgery department was built by Cobb Pilcher and
      perpetuated by William F. Meacham.

PMID- 8360751
TI  - Cerebral hemicorticectomy for epilepsy.

PMID- 8360752
TI  - Magnetic resonance imaging surveillance.

PMID- 8360753
TI  - Doppler ultrasound prediction of delayed ischemia.

PMID- 8360754
TI  - Assuring institutional control of private duty personnel.

PMID- 8360755
TI  - Mothers who use nurse midwives have shorter hospital stays and fewer cesarean
      sections and episiotomies.

PMID- 8360756
TI  - Outcome evaluation: frustration or fertile field?

PMID- 8360757
TI  - The head nurse role in redesign.
AB  - As administrators review how best to meet patient's needs and redesign patient
      care givers' job content, as well as introduce multiskilled workers to the
      patient care unit, the head nurse role must be reviewed and revamped at the same
      time. The author describes the experiences of two different institutions in
      overloading the head nurses with reporting relationships that they were ill
      equipped to supervise. The solution in both institutions was the same, and
      emphasizes the need for interactive planning for these complex and interdependent
      models.

PMID- 8360758
TI  - The chief nurse officer as a board member: representation and compensation.

PMID- 8360759
TI  - Accounting for contributions. An update.

PMID- 8360760
TI  - A competency achievement orientation program. Professional development of the
      home health nurse.
AB  - One of the vital components to the assurance of quality nursing care is a
      comprehensive orientation program. The concept of a competency achievement
      program facilitates the development of independent practice and judgment skills
      on the part of today's home healthcare nurse. The authors discuss one agency's
      program to meet the needs of newly employed registered nurses.

PMID- 8360761
TI  - Developmental levels of interdisciplinary collaborative practice committees.
AB  - Establishing interdisciplinary collaborative practice committees has and will be
      a prime strategy in healthcare. Evaluating the functioning, progress, and
      outcomes of these committees is important. Defining a mechanism to evaluate
      interdisciplinary collaborative practice committees should be beneficial. The
      author presents an easy evaluation tool that can determine the level and
      functioning of interdisciplinary collaborative practice committees.

PMID- 8360762
TI  - Experiences, events, people. Do they influence the leadership style of nurse
      executives?
AB  - Nurse executives play a key role in healthcare organizations. This study asked
      nurse executives whether there were particular experiences, events, or persons
      that influenced their leadership style. The answers to this question provide
      guidance for nurses who aspire to this role. Nurse administrators, leaders, and
      educators are in pivotal positions to influence the development of leadership in
      others.

PMID- 8360764
TI  - Unique AIDS treatment facility.

PMID- 8360763
TI  - Sustaining work redesign innovations through shared governance.
AB  - Organizational change, in the form of work redesign, is widespread in hospitals
      across the country. How can the resulting patient-focused care models be
      sustained when "sustaining" means continuously changing and improving? The
      authors describe one hospital's use of a multidisciplinary shared governance
      system to provide the structure and process support for the innovative changes
      initiated by work redesign.

PMID- 8360765
TI  - Strategic planning. A practical approach.
AB  - A successful organization, whether a corporation or a department within that
      corporation, will, in most instances, have a plan, a blueprint for action, that
      establishes goals and a direction for the future. The author outlines initial and
      subsequent efforts of the department of nursing at a large military medical
      center to establish an annual strategic planning conference and to develop,
      implement, and maintain a department of nursing strategic plan.

PMID- 8360766
TI  - Research or quality improvement?. Making the decision.
AB  - Deciding if a project is one of research or quality improvement is a dilemma
      frequently faced by nursing administrators. Guidelines have been established to
      help administrators and practitioners overcome this dilemma and, at the same
      time, consider the rights and responsibilities of the patient, the hospital, and
      the investigator.

PMID- 8360767
TI  - A cost-benefit analysis of shared governance.
AB  - Shared governance is one of several strategies promoted by and to nurse
      executives as critical to retention of professional nurses and important in
      maintaining quality of care. Thus far, few studies have examined the various
      financial aspects of this type of decision-making structure. This article
      identifies a framework for cost analysis and reports the cost-benefit
      relationship of implementing a shared governance model over a 5-year period.

PMID- 8360768
TI  - Nurse staff planning under conditions of a nursing shortage.
AB  - The shortage of qualified nurses presents some important managerial challenges
      for the hospital administrator. Nurse work force management has often been
      described as a three-phase planning and control process consisting of staffing,
      scheduling, and allocation. In this research study, the authors present a
      research methodology for improving the staffing phase of the process.
      Specifically, a nurse staffing model was developed as a means of improving the
      nurse staffing process for a 700-bed, nonprofit hospital.

PMID- 8360770
TI  - Alphabetical list of consultants and consulting firms.

PMID- 8360769
TI  - The effective use of consultants.
AB  - Successful consultation between nurse administrators and management consultants
      requires developing a good working relationship and effectively managing the
      consultation process. The authors describe a four-phase consultation process from
      the perspective of both the manager and the consultant, identifying the critical
      steps and behaviors at each phase that promote a successful consultation.

PMID- 8360771
TI  - Minding the gap.

PMID- 8360772
TI  - Corticosterone enhances the zinc and interleukin-6-mediated induction of
      metallothionein in cultured rat hepatocytes.
AB  - The regulation of metallothionein induction in cultured rat hepatocytes was
      investigated with Zn, hormones, cytokines and either the synthetic
      glucocorticoid, dexamethasone, or the endogenous rat glucocorticoid,
      corticosterone. A concentration-dependent increase was seen with Zn (two- to
      fivefold increase in 24 h, Zn 10-50 mumol/L). Dexamethasone at 1 mumol/L
      increased metallothionein synthesis by fourfold that of the controls. Maximal
      metallothionein concentrations of 17-fold the control value were seen with 50
      mumol/L Zn and 1 mumol/L dexamethasone. Interleukin-6 (1 x 10(5) U/L) alone did
      not induce metallothionein but increased it 35-65% with Zn+dexamethasone. Like
      dexamethasone, corticosterone had a dose dependent effect on metallothionein and
      synergy with Zn and Zn+interleukin-6. Dexamethasone was approximately 100 times
      more potent than corticosterone at 10-100 mumol/L. Physiological concentrations
      of corticosterone (1 mumol/L) when added alone, with Zn (10 mumol/L), and with
      Zn+interleukin-6 resulted in inductions of 2.2, 5.0 and 7.4-fold above the
      control cultures. Glucagon (1 mumol/L) had no independent effect but increased
      metallothionein by 31% and 33% with Zn(10 mumol/L)+dexamethasone (1 mumol/L) and
      Zn-dexamethasone+interleukin-6, respectively. There was no accumulation of
      metallothionein with interleukin-1 beta, tumor necrosis factor alpha or
      interferon gamma (1 x 10(5) U/L) alone, but interleukin-1 beta and tumor necrosis
      factor alpha enhanced the response obtained with Zn+dexamethasone with and
      without interleukin-6. Insulin (100 U/L) alone, caused metallothionein
      accumulation and further enhanced the response seen with
      Zn+dexamethasone+interleukin-6+glucagon. No additional enhancement was seen with
      interleukin 1 beta+tumor necrosis factor alpha+interferon. The results
      demonstrate that concentrations of corticosterone in rats with experimental
      inflammation facilitate metallothionein induction with Zn and interleukin
      6.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360773
TI  - Preweaning diet affects bile lipid composition and bile acid kinetics in infant
      baboons.
AB  - We tested, with 14-wk-old baboons before weaning, the hypothesis that bile acid
      metabolism is differentially affected by breast feeding or by feeding formulas
      with a high polyunsaturated:saturated fatty acid ratio or with a low ratio,
      similar to that of breast milk. Bile lipid content, bile acid pool size,
      fractional turnover rate, synthetic rate and conjugate composition were measured
      in a single bile sample 9 d after an injection on d 1 of a mixture of [14C]cholic
      and [14C]chenodeoxycholic acids and an injection of a mixture of [3H]cholic acid
      and [3H]chenodeoxycholic acid on d 8. The principal biliary bile acid was
      chenodeoxycholic acid. The only difference in chenodeoxycholic acid metabolism
      among the infant diet groups was a lower chenodeoxycholic acid synthetic rate in
      baboons fed the low polyunsaturated:saturated formula compared with those fed the
      high polyunsaturated:saturated formula or breast-fed. Cholic acid metabolism was
      significantly affected by infant diet: breast-fed infants had a smaller cholic
      acid pool size, lower cholic acid percentage of total bile acids, higher cholic
      acid glycine:taurine conjugate ratio and larger cholic acid fractional turnover
      rate than formula-fed animals. The polyunsaturated:saturated fatty acid ratio in
      the formulas did not significantly affect these variables. These results show
      that differences in bile acid metabolism between breast- and formula-fed infant
      baboons are limited principally to cholic acid. These differences likely are due
      to factors other than fatty acid saturation.

PMID- 8360774
TI  - Selenium deficiency suppresses the S-glutathiolation of carbonic anhydrase III in
      rat hepatocytes under oxidative stress.
AB  - To examine the modification of reactive sulfhydryls of carbonic anhydrase III (CA
      III), hepatocytes were prepared by collagenase perfusion from Se deficient and Se
      adequate male Sprague-Dawley rats. After 24 h in culture, hepatocytes were
      treated for 15-30 min with one of two oxidative stressors, t-butyl hydroperoxide
      (t-BuOOH) or menadione. Modification of CA III was measured by isoelectric
      focusing/immunoblotting. Formation of glutathione disulfide (GSSG) during
      oxidative stress was markedly less in hepatocytes of Se-deficient rats than in
      those of Se-adequate rats. During treatment with t-BuOOH, GSSG formation in
      hepatocytes from Se-adequate rats reached a maximum at 3 min, and then GSSG was
      gradually reduced to glutathione. After menadione treatment, intracellular GSSG
      irreversibly increased in hepatocytes of Se-adequate rats but not in those of Se
      deficient rats. A modification of CA III that was reversible by dithiothreitol
      treatment concurred with the formation of GSSG during treatment with either t
      BuOOH or menadione. Although modification of CA III occurred in hepatocytes from
      Se-deficient rats, the extent of modification was significantly less than in Se
      adequacy, and the modification was less reversible by dithiothreitol than in
      hepatocytes from Se-adequate rats. Selenium deficiency may be useful in examining
      the importance of modification of specific proteins subjected to oxidative
      stress.

PMID- 8360775
TI  - N-(4-hydroxyphenyl)retinamide (fenretinide) induces retinol-binding protein
      secretion from liver and accumulation in the kidneys in rats.
AB  - The chemopreventive retinoid N-(4-hydroxyphenyl)retinamide (HPR) depresses serum
      retinol and retinol-binding protein (RBP) concentrations. To study long-term
      effects of HPR on serum proteins, rats were fed a control diet or a diet
      containing HPR (737 mumol/kg diet) for 14 d. Serum retinol and RBP of HPR-treated
      rats decreased to 42 and 41%, respectively, of initial concentrations.
      Transthyretin, albumin and transferrin did not differ between treatments.
      Previous studies found that HPR decreased secretion of the retinol-RBP complex
      into plasma. To investigate acute effects of HPR on RBP metabolism, vitamin A
      deficient rats were injected with HPR (51 mumol/kg body wt), retinol (0.52
      mumol/rat) or Tween carrier only. Liver RBP concentrations in HPR- and retinol
      treated rats were 45 and 18%, respectively, of concentrations in Tween-treated
      rats, indicating rapid RBP secretion. Tween- and HPR-treated rats maintained
      relatively constant serum RBP concentrations, whereas retinol-replete rats had 12
      fold higher serum RBP after 150 min. Rats treated with HPR and rats treated with
      retinol had 29- and eightfold higher kidney RBP concentrations, respectively,
      than Tween-treated rats, indicating rapid clearance of RBP from plasma. We
      conclude that HPR affects RBP metabolism by inducing secretion of liver RBP into
      the bloodstream and rapid RBP accumulation in the kidney.

PMID- 8360776
TI  - Dietary chromium supplementation with or without somatotropin treatment alters
      serum hormones and metabolites in growing pigs without affecting growth
      performance.
AB  - Twenty-four castrated male pigs were used in a 2 x 2 treatment array to determine
      the main effects of and interactions between dietary chromium supplementation and
      pituitary porcine somatotropin (ppST) administration on growth performance and
      serum hormone and metabolite concentrations. The treatments were 1) control
      (basal diet); 2) chromium (basal diet+300 micrograms/kg diet added trivalent
      chromium as chromium picolinate); 3) ppST (100 micrograms/(kg body wt.d); and 4)
      chromium+ppST. Treatments were administered when pigs weighed between 30 and 60
      kg. Blood was collected when pigs weighted 45 and 60 kg. All pigs treated with
      ppST exhibited improvements in growth performance (P < 0.05). Pigs given chromium
      showed no improvements in growth rate, feed efficiency or composition of gain.
      Measurements at 60 kg body weight revealed that ppST increased the
      cholesterol:HDL cholesterol ratio (P < 0.05). Chromium lowered serum insulin and
      glucose concentrations relative to controls (P < 0.05) and normalized the
      increase in glucose and insulin resulting from ppST treatment. No ppST x chromium
      interactions were noted, suggesting these changes in glucose and insulin
      metabolism are exerted through different mechanisms. These results indicate that
      chromium does not affect growth performance of young growing pigs. Chromium does
      normalize altered hormone and metabolite concentrations resulting from ppST
      treatment.

PMID- 8360778
TI  - Medium-chain fatty acid oxidation in colostrum-deprived newborn piglets:
      stimulative effect of L-carnitine supplementation.
AB  - To investigate the role of L-carnitine in medium-chain fatty acid (MCFA, fatty
      acids with 6-12 carbons) metabolism, 16 newborn pigs were fitted with umbilical
      arterial catheters. Pigs were placed in respiration chambers, and [1-14C]MCFA
      were infused for 9-12 h providing energy equivalent to 50-175% of the animals'
      metabolic rate. After 5-7 h (carnitine-free infusion period) of MCFA infusion, a
      primed (12.5, 25 or 50 mumol) co-infusion of L-carnitine [5, 10 or 20
      mumol/(h.kg0.75), respectively] was started and maintained for 4-5 h (carnitine
      infusion period). The fatty acid oxidation rate (MCFA-derived CO2/total CO2 x
      100) was calculated based on the specific radioactivity of expired CO2 (measured
      per 20-min interval) and the specific radioactivity of the MCFA infused. A single
      pool exponential curve was fitted to the fatty acid oxidation rate of the
      carnitine-free infusion period and was extrapolated to the carnitine infusion
      period. For each piglet, the average difference between fatty acid oxidation rate
      during the carnitine infusion period and the extrapolated curve was calculated
      and tested for significance using a t test. Under steady state conditions, MCFA
      oxidation accounted for 40% of MCFA infused. Carnitine, independent of the level,
      increased the fatty acid oxidation rate by as much as 20% if the energy provided
      as MCFA exceeded 50% of the metabolic needs of the pig (P < 0.01), and the
      response above 50% was proportional to the relative rate of fatty acid infusion
      (increase in fatty acid oxidation rate = -3.9 + 0.07 x infusion rate,
      r0.76).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360777
TI  - Alpha-keto and alpha-hydroxy branched-chain acid interrelationships in normal
      humans.
AB  - Plasma concentrations of the branched-chain amino acids leucine, isoleucine and
      valine, and those of leucine's and isoleucine's transamination products alpha
      ketoisocaproic acid (KICA) and alpha-keto-beta-methylvaleric acid (KMVA),
      respectively, are known to increase after a protein meal or during extended
      fasting, but little or no increase in the concentration of valine's
      transamination product, alpha-ketoisovaleric acid (KIVA), has been observed under
      these conditions. To determine whether this could be explained by the conversion
      of KIVA to its alpha-hydroxy analogue, we measured the plasma concentrations of
      KICA, KMVA and KIVA, as well as their alpha-hydroxy analogues [alpha
      hydroxyisocaproic acid (HICA), alpha-hydroxy-beta-methylvaleric acid (HMVA) and
      alpha-hydroxyisovaleric acid (HIVA)], in normal volunteers immediately after a
      protein meal or during a 60-h fast. We also determined the oxidoreduction
      equilibrium constants for HIVA/KIVA and HICA/KICA and their extent of plasma
      protein binding. In subjects in the postabsorptive state, the plasma
      concentrations of KICA and KMVA were 100 times those of HICA and HMVA, whereas
      that of KIVA was only twice that of HIVA. Shortly after a protein meal, KICA and
      KMVA concentrations increased significantly by 30 and 60%, respectively, whereas
      that of KIVA decreased by 25% (P < 0.05). HICA, HMVA and HIVA concentrations did
      not change. During prolonged fasting the plasma concentrations of all six
      metabolites increased gradually. The high plasma keto/hydroxy acid ratios were
      not related to their K(eq), which favored alpha-hydroxy analogue formation. The
      reduction of the branched-chain alpha-keto acids to their alpha-hydroxy analogues
      seems to take place too slowly to attain thermodynamic equilibrium.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8360779
TI  - Time after feeding and dietary arginine deficiency alter splanchnic and hepatic
      amino acid flux in rats.
AB  - The effect of an arginine-deficient diet containing 3.4% glutamate on net flux of
      amino acids across the portal-drained viscera and liver was studied in rats at 0,
      1 or 2 h after a meal and compared with that in arginine-fed controls. Net portal
      drained viscera flux for most amino acids was greater in the fed state compared
      with the postabsorptive state except for glycine and cystine, which did not
      change, and methionine, which declined. Net amino acid recovery in portal blood 2
      h after feeding compared with amounts consumed was highest for alanine (17.3%);
      recovery of other amino acids ranged from 5.6 to 15.3%. No net portal-drained
      viscera recovery of consumed cystine was observed. For the branched-chain and
      aromatic amino acids, methionine, threonine, histidine and lysine, net hepatic
      uptake was nearly equal to net portal-drained viscera absorption (range 77-127%
      of portal-drained viscera flux). Correlation coefficients between net hepatic and
      portal-drained viscera fluxes for leucine, valine, isoleucine, methionine and
      phenylalanine were 0.84 to 0.93. Postabsorptive hepatic extraction for most amino
      acids was zero, but after a meal, ranged from 13.3 to 22.9% for the branched
      chain and aromatic amino acids. Net hepatic production of ornithine and proline
      occurred in arginine-fed control rats. This value was near zero for ornithine in
      rats fed the arginine-deficient diet. Models of interorgan amino acid metabolism
      in the food-deprived and fed state are presented.

PMID- 8360780
TI  - Normal circulating triiodothyronine concentrations are maintained despite severe
      hypothyroidism in growing pigs fed rapeseed presscake meal.
AB  - Experiments were designed to study effects of dietary rapeseed presscake meal on
      the thyroid and on the liver 5'-monodeiodinase activity in growing pigs. Animals
      were fed rapeseed presscake meal (15% in the ration) of 0-varieties (containing
      relatively high amounts of glucosinolates and goitrin) or a control diet (soybean
      meal instead of rapeseed presscake meal) without or with thyroxine added to feed.
      Food intake and average daily gain were comparable because pigs were pair-fed.
      Serum thiocyanate concentration was significantly greater in pigs fed rapeseed
      presscake meal. Pigs fed rapeseed presscake meal developed hypothyroidism. Serum
      free thyroxine concentrations in rapeseed presscake meal-fed pigs were
      significantly lower than in controls, normal in thyroxine-supplemented pigs fed
      rapeseed presscake meal and significantly above normal in thyroxine-supplemented
      controls. Serum free triiodothyronine concentrations were not significantly
      influenced by rapeseed presscake meal feeding or thyroxine supplementation. Liver
      weight and total DNA content in pigs fed rapeseed presscake meal were higher than
      in controls but were not significantly affected by thyroxine feeding. Hepatic 5'
      monodeiodinase activity on a protein basis was lower in pigs fed rapeseed
      presscake meal and was not normalized by thyroxine supplementation. However, in
      whole liver, because of greater liver mass, 5'-monodeiodinase activity in pigs
      fed rapeseed presscake meal was similar to that in controls. The data indicate
      that serum free triiodothyronine concentrations in pigs fed rapeseed presscake
      meal could be maintained in the physiological range, probably because of enhanced
      triiodothyronine secretion and sufficient extrathyroidal thyroxine to
      triiodothyronine conversion.

PMID- 8360781
TI  - Lower food intake is a primary cause of reduced growth rate in growing pigs fed
      rapeseed presscake meal.
AB  - Rapeseed presscake meal (15% in the ration) of 0-varieties or a control diet
      (soybean meal instead of rapeseed presscake meal) was fed without or with
      thyroxine for 9-10 wk to growing pigs. Pigs fed rapeseed presscake meal developed
      hyperplastic goiter. Blood serum free thyroxine concentrations in rapeseed
      presscake meal-fed pigs were depressed, normal in thyroxine-supplemented pigs fed
      rapeseed presscake meal and above normal in thyroxine-supplemented controls, but
      serum free triiodothyronine concentrations were comparable in all groups. Feed
      intake and average daily gain were reduced in pigs fed rapeseed presscake meal,
      independent of oral thyroxine intake. However, in an additional experiment, in
      which food intake was comparable because pigs were pair-fed, average daily gain
      was similar. The data indicate that reduced growth performance of rapeseed
      presscake meal-fed pigs was primarily the consequence of decreased feed intake
      and that hypothyroidism was of lesser importance.

PMID- 8360782
TI  - Threshold for glucose-stimulated insulin secretion in pancreatic islets of
      genetically obese (ob/ob) mice is abnormally low.
AB  - Pancreatic islets were isolated from 8-9-wk-old female genetically obese (ob/ob)
      and lean mice to determine the glucose threshold for insulin secretion, and to
      examine effects of acetylcholine on insulin secretion. Only equal-sized islets
      from ob/ob and lean mice were incubated to eliminate confounding effects of
      phenotypic differences in islet size. Even after this adjustment, islets from
      ob/ob mice still hypersecreted insulin in response to 20 mmol/L glucose. The
      threshold for glucose-induced insulin secretion determined by perifusing islets
      with a linear glucose gradient averaged 1.9 +/- 0.1 mmol/L glucose in fed ob/ob
      mice and 3.1 +/- 0.1 mmol/L glucose in ob/ob mice after 24 h of food deprivation.
      These low thresholds indicate that islets from ob/ob mice are constantly
      stimulated by glucose. Islets from lean mice exhibited considerably higher
      thresholds (4.8 +/- 0.1 and 7.1 +/- 0.1 mmol/L glucose in fed and 24-h food
      deprived lean mice, respectively). Rates of insulin secretion per each unit
      (mmol/L) increase in glucose above threshold concentrations were unaffected by
      phenotype or feeding state. Addition of acetylcholine to the perifusing buffer
      further lowered the threshold for insulin secretion to 0.5 mmol/L glucose in
      pancreatic islets from ob/ob mice and also doubled the rate of increase in
      insulin secretion at glucose concentrations above the threshold. The combination
      of the very low threshold for glucose-induced insulin secretion and the
      exaggerated insulin secretory response to acetylcholine in pancreatic islets of
      ob/ob mice are likely critical factors in the hyperinsulinemia of these mice.

PMID- 8360783
TI  - A multi-element isotopic tracer assessment of true fractional absorption of
      minerals from formula with additives of calcium, phosphorus, zinc, copper and
      iron in young piglets.
AB  - True fractional absorption of minerals was measured to determine the
      bioavailability of Zn, Fe, Mn and Se from liquid formulas fortified with stepwise
      additions of Ca and P (as Ca glycerophosphate and carbonate, Ca*P), and Zn, Cu
      and Fe (as sulfate salts). Growth, deposition of tracers in organs and bone
      mineral content of femurs as assessed by single photon absorptiometry were
      measured. Four-day-old piglets (n = 36) were randomly assigned to groups fed a
      basal diet or additions of Ca*P (Ca = 25, P = 18 g/kg dry diet), Ca*P+Zn (Zn =
      0.04 g/kg), Ca*P+Zn+Cu (Cu = 0.007 g/kg) or Ca*P+Zn+Cu+Fe (Fe = 0.008 g/kg). Oral
      and intravenous administration of extrinsic isotopes of 59Fe, 54Mn, 65Zn, 75Se
      and 47Ca was followed by fecal monitoring for 15 d and true absorption calculated
      after accounting for endogenous excretion. Addition of Ca*P+Zn reduced Zn
      absorption (P < 0.05) and Ca*P+Zn+Cu reduced Fe absorption (P < 0.01), but Mn and
      Se absorptions were not altered. Uptake of only Zn tracer into heart was
      significantly different (P < 0.05) among diet groups. Weight gain and linear
      growth were similar in all groups. Addition of Ca*P produced higher bone mineral
      density, but its effect on Zn absorption warrants further investigation.

PMID- 8360784
TI  - The dietary requirement of young rainbow trout (Oncorhynchus mykiss) for folic
      acid.
AB  - We sought to determine the dietary folic acid requirement of young rainbow trout
      using growth indices supported by measurements of tissue folate concentrations.
      The investigation was conducted with purified diets that had, by assay, basal
      folic acid levels of 0.08 and 0.16 mg/kg in the first and second, respectively,
      of two experiments. Each experiment was started with fry (initial mean weight,
      1.4 and 2.8 g/fish in Experiments 1 and 2, respectively) and was conducted at a
      water temperature of 15 degrees C. Experiment 1 lasted 18 wk and Experiment 2
      lasted 16 wk. Recovery tests (of 8 wk duration, performed on fish fed the
      unsupplemented diet) and pair-feeding showed that the unsupplemented diet led to
      a folate-specific deficiency condition in which the main hematological
      abnormality was the appearance of misshapen nuclei in a small proportion (2.3%)
      of erythrocytes. Dietary requirements were shown not to exceed 0.3 and 0.6 mg
      folic acid/kg (17 and 33 micrograms/MJ digestible energy) for optimizing survival
      and growth indices, respectively. We conclude that the dietary folate requirement
      of the trout is comparable to that of other vertebrates for the purpose of
      achieving maximal weight gain.

PMID- 8360785
TI  - Comments on the paper by Garwin et al. (1992)

PMID- 8360786
TI  - Comments on the paper by Garwin et al. (1992)

PMID- 8360787
TI  - Comment by A. H. Merrill, associate editor.

PMID- 8360788
TI  - Dietary factors influencing calcium and bone metabolism: introduction.

PMID- 8360789
TI  - Caffeine, urinary calcium, calcium metabolism and bone.
AB  - Oral doses of caffeine increase the urinary excretion of calcium, magnesium,
      sodium and chloride for at least 3 h after consumption. The hypercalciuric effect
      can be blocked by adenosine receptor agonists. The effect is proportional to dose
      per lean body mass and no adaptation to the urinary losses occurs with continuing
      consumption of caffeine. Uncompensated losses of calcium would be a risk factor
      for development of osteoporosis. Risks of osteoporosis due to caffeine
      consumption are reviewed. Comparison of data from epidemiological surveys and
      animal and human studies suggests that for younger adult women consuming adequate
      calcium, moderate caffeine intakes may have little or no deleterious effects.
      Increased urinary and intestinal losses may be compensated for by increased
      intestinal calcium absorption. However older women do not seem to compensate
      adequately to maintain their former calcium balance, especially when calcium
      intakes are below recommendations.

PMID- 8360790
TI  - The nature and significance of the relationship between urinary sodium and
      urinary calcium in women.
AB  - Orally or parenterally administered sodium is known to increase urinary calcium
      in experimental animals and humans, and there is well-documented correlation
      between urinary sodium and calcium in 24-h urine collections from normal subjects
      and renal stone formers. The correlation between urinary sodium and calcium is
      generally sodium driven, i.e., it is the sodium load that influences urinary
      calcium rather than vice versa, but the converse may also occur, as after an oral
      calcium load or in hypercalcemia. When sodium is the determinant, 100 mmol of
      sodium takes out approximately 1 mmol of calcium in the urine. When calcium load
      is the determinant, each millimole of calcium appearing in the urine is
      associated with an extra 10-20 mmol of sodium. Sodium-dependent calcium loss may
      continue indefinitely, but calcium-dependent natriuresis is self-limiting. There
      is a significant correlation between calcium and sodium in fasting urine from
      both pre- and postmenopausal women, but there is more calcium relative to sodium
      in postmenopausal women than in premenopausal women. In postmenopausal but not
      premenopausal women, urinary hydroxyproline is also related to obligatory sodium
      and calcium output, and restriction of salt intake lowers not only urinary sodium
      but also calcium and hydroxyproline. There is not only an increase in obligatory
      calcium excretion at the menopause, but also an increase in the fasting urinary
      sodium, which in turn accounts for some of the increase in calcium output. This
      rise in fasting urinary sodium represents a delay in sodium excretion that may
      have a significant effect on calcium homeostasis.

PMID- 8360791
TI  - Potassium causes calcium retention in healthy adults.
AB  - The administration of 60 mmol/d of KHCO3 to healthy adults reduced urinary
      calcium excretion by 0.9 mmol/d and caused calcium balance to become equivalently
      more positive. Other studies showed that 90 mmol/d of KHCO3 reduced both daily
      and fasting urinary calcium excretion rates, whereas deprivation of either KCl or
      KHCO3, using synthetic diets, was accompanied by increased daily and fasting
      urinary calcium excretion rates. A significant inverse relationship between the
      changes in urinary calcium and the changes in urinary potassium was observed:
      delta urinary Ca (mmol/d) = 0.29-0.015 delta urinary K (mmol/d); r = -0.65.
      Correlative evaluation of additional data suggested that the fall in urinary
      calcium during potassium administration may be related to the natriuretic effects
      of potassium, resulting in ECF-volume contraction or to potassium-induced
      phosphate retention and suppression of calcitriol synthesis, or to both
      mechanisms.

PMID- 8360792
TI  - Dietary phosphorus, calcium metabolism and bone.
AB  - Many American women consume diets high in phosphorus and low in calcium. Concern
      about this dietary pattern stems from studies that show high phosphorus, low
      calcium intake causes secondary hyperparathyroidism and bone loss in several
      animal models. Recent studies in young adults have shown that a high phosphorus,
      moderately low calcium intake results in mild secondary hyperparathyroidism that
      persisted over 4 wk. However, plasma concentrations of the active form of vitamin
      D did not change in these subjects, despite stimulatory changes in parathyroid
      hormone and serum ionized calcium. Studies in normal adult men have shown that
      dietary phosphorus at levels within the observed normal range of intake can
      finely regulate the renal production and serum concentration of 1,25
      dihydroxycholecalciferol. Thus, prolonged high phosphorus intake may impair the
      usual homeostatic mechanisms that are evoked when dietary calcium is limited. The
      current dietary patterns of high phosphorus, low calcium consumption result in
      persistent changes in the calcium regulating hormones that are not conductive to
      optimizing peak bone mass or slowing the rate of bone loss.

PMID- 8360793
TI  - California grapples with hygiene demands for independent provider
      status/diagnosis.

PMID- 8360794
TI  - Antibodies to Sm, RNP and SSB detected by solid-phase ELISAs using recombinant
      antigens: a comparison study with counter immunoelectrophoresis and
      immunoblotting.
AB  - Sera from 64 patients with systemic lupus erythematosus (SLE) were tested for the
      presence of anti-Sm, anti-RNP, and anti-SSB antibodies using commercially
      available solid-phase enzyme-linked immunosorbent assays (ELISAs) and recombinant
      nuclear proteins as substrates. The results were compared to those obtained with
      counterimmunoelectrophoresis (CIE) and immunoblotting (IBT) using a rabbit thymus
      extract (RTE) as the substrate. The ELISAs detected antibodies to Sm, RNP, and
      SSB in, respectively, 25%, 36%, and 15% of the SLE sera. Neither IBT
      positive/ELISA-negative nor CIE-positive/ELISA-negative sera were found,
      regardless of the specificity considered, suggesting that ELISAs using
      recombinant nuclear antigens are highly sensitive. Discrepancies were observed
      between the results obtained with these different techniques. In addition to sera
      positive by both IBT and ELISA but negative by CIE, a substantial number of sera
      had ELISA-detectable anti-Sm, anti-RNP, and anti-SSB antibodies which failed to
      react with the corresponding polypeptides by IBT. The reasons for ELISA/IBT
      discrepancies were explored; however, no single explanation was found. Instead, a
      higher sensitivity of the ELISA to detect antibodies directed against certain
      polypeptides, the possible inability of IBT using RTE as the substrate to detect
      antibodies reacting with conformational antigenic determinants, and false
      positive reactions in the ELISAs were suggested. Thus, it is still advisable to
      perform both IBT and ELISAs simultaneously in well-defined autoimmune diseases to
      further analyze the potential advantages of ELISAs using recombinant antigens.

PMID- 8360795
TI  - Application of checkerboard immunoblotting (CBIB) to the detection of anti-viral
      IgG in human serum.
AB  - In the present study, we have begun to investigate the possibility of using
      checkerboard immunoblotting (CBIB) as a semi-quantitative screening tool for
      detecting human serum IgG against specific viral antigens. The viral antigens
      studied were Epstein-Barr, herpes simplex I and II, cytomegalovirus, varicella
      zoster, rubella, rubeola, and mumps. Western immunoblotting experiments using
      these partially purified preparations demonstrated that there were apparently no
      interactions between IgG from non-immune sera and the respective viral antigen
      preparations. The CBIB assay was evaluated using sera of known positive or
      negative immune status for the viral antigens. There was excellent agreement
      between the results of CBIB and the results of alternative methods for evaluating
      immune status: all discrepancies (1/18 sera for mumps, 3/18 sera for rubeola, and
      1/28 sera for rubella) involved sera with borderline results, either by CBIB or
      by the alternative method. Therefore, although further work is required to define
      the method in terms of sensitivity and clinical specificity, and to refine
      positive/negative cutpoint criteria for certain antigen components, our
      preliminary experience suggests that CBIB has considerable potential in the
      efficient and inexpensive screening of sera for the presence of IgG against a
      panel of viral antigens, so as to identify subjects at risk for infection.

PMID- 8360796
TI  - Production of hydrogen peroxide by neutrophilic polymorphonuclear leukocytes in
      patients with diabetic nephropathy.
AB  - The production of hydrogen peroxide (H2O2) by neutrophilic polymorphonuclear
      leukocytes (PMN) after stimulation with phorbol myristate acetate (PMA), n-formyl
      l-methionyl-l-leucyl-l-phenylalanine (FMLP), aggregated human IgG, or
      Staphylococcus aureus was determined in 36 patients with non-insulin dependent
      diabetes mellitus (NIDDM). H2O2 production by PMN after stimulation was measured
      using flow cytometry. Thirty-six patients with NIDDM were divided into four
      stages as follows: 1) stage I: non-microalbuminuric stage; 2) stage II:
      microalbuminuric stage; 3) stage III: proteinuric stage without impairment of
      renal function; and 4) stage IV: proteinuric stage with impairment of renal
      function. H2O2 production after PMA stimulation in all stages of NIDDM patients
      was higher than that in healthy controls. This increase of H2O2 production by PMN
      was particularly observed in stage IV of NIDDM patients after stimulation.
      Furthermore, H2O2 production in patients in stage IV was higher than that in
      patients with non-diabetic disease with impairment of renal function. It appears
      that reactive oxygen species produced by PMN after stimulation under some
      conditions may play an important role in the progression of diabetic nephropathy.

PMID- 8360797
TI  - Specificity of an immunochemical reagent for quantifying the isoforms of creatine
      kinase-MB.
AB  - Fractionation of the creatine kinase-MB isoforms is promising for use in
      diagnosing acute myocardial infarction and for monitoring myocardial perfusion
      status after thrombolytic therapy. An immunochemical reagent intended for use in
      fractionating the MB1 and MB2 isoforms of creatine kinase-MB was examined before
      and after immunoextraction, qualitatively by visually examining electrophoresis
      separation of various MB1 and MB2 mixtures, and quantitatively by comparing the
      observed and predicted enzymatic activity of various MB1 and MB2 mixtures.
      Qualitatively the reagent showed greater reactivity for MB1 than for MB2, as
      demonstrated by a marked decrease in the MB1 electrophoretic region following
      immunoextraction. Quantitatively, the reagent consistently eliminated about 75%
      of MB1 activity; however, the assay also eliminated about 40% of MB2 activity
      from isoform mixtures. Although the performance of the immunochemical reagent was
      not ideal, the greater reactivity for MB1 may have clinical use.

PMID- 8360798
TI  - Improved measurement of anti-thyroglobulin IgG in urine of patients with
      autoimmune thyroid diseases by sensitive enzyme immunoassay (immune complex
      transfer enzyme immunoassay.
AB  - Previously, antithyroglobulin IgG was assayed in dialyzed urine from patients
      with autoimmune thyroid diseases by a sensitive enzyme immunoassay (immune
      complex transfer enzyme immunoassay), and most of the assay results were useful
      as a diagnostic aid for autoimmune thyroid diseases. However, dialysis of urine
      was laborious and time-consuming, and some results were less reliable due to low
      levels of anti-thyroglobulin IgG in urine. This paper describes some improvements
      of the assay. Useful assay results could be obtained for most of urine samples
      without dialysis, although some interfering substance(s) was suggested to be
      present in some urine samples before dialysis. Accurate assay results with no
      interference could be obtained after gel filtration by only two min
      centrifugation in place of dialysis. More reliable assay results for urine
      samples containing low levels of antithyroglobulin IgG were obtained after
      concentration using a molecular sieve.

PMID- 8360799
TI  - Immunocytodiagnosis of solid tumors employing panels of monoclonal antibodies.

PMID- 8360800
TI  - Correlation between human sperm hypo-osmotic swelling test and other semen
      parameters.
AB  - Ninety semen samples from male patients were studied. They were classified into 4
      different groups; normospermic fertile, oligospermia, asthenospermia, and
      oligoasthenospermia. In addition to routine semen analysis, the hypo-osmotic
      swelling test was done for all these samples, measuring total protein and
      specific gravity. A significant positive correlation was observed between percent
      sperm swelling and its motility, its total protein, and specific gravity. Also a
      significant negative correlation was noticed between percent sperm swelling and
      its count. Although there were overlapping ranges, different groups showed
      significant relations of percent sperm swelling among themselves. It is
      postulated that the sperm quality and not its quantity is the cornerstone of the
      hypo-osmotic test and that the physico-chemical properties of the sperm
      influences its swelling.

PMID- 8360801
TI  - Meeting of the Parenteral Society.

PMID- 8360802
TI  - ISO 9000. Policy implications for FDA. Taking the pulse of increasing global use
      of the ISO series of uniform quality standards by FDA regulated industries.

PMID- 8360803
TI  - Thermal mechanical analysis of frozen solutions of mannitol and some related
      stereoisomers: evidence of expansion during warming and correlation with vial
      breakage during lyophilization.
AB  - The mechanical properties of frozen mannitol, L-iditol, dulcitol, and sorbitol
      solutions were measured as a function of temperature during warming (after
      freezing) using a thermal mechanical analyzer (TMA). The mannitol sample first
      underwent a contractive phase starting at 30 degrees C and ending at -25 degrees
      C. This was followed by an initially rapid, then less rapid expansive phase which
      continued until melting occurred. These events provide direct evidence that
      mannitol solutions undergo an expansion during warming after "fast" freezing and
      also corroborate the vial breakage observed when mannitol solutions are frozen
      and thawed or freeze-dried in glass vials. Of the other stereoisomers studied,
      only dulcitol had an expansive phase although at a slower rate than mannitol. Its
      solution was found to cause vial breakage also but only at fill volumes higher
      than mannitol fill volumes. TMA is a useful technique for studying dimensional
      changes in the frozen state, with important implications for solving vial
      breakage problems in freeze-drying.

PMID- 8360804
TI  - IV fluidmakers: preparation of sterile water for injection in a field setting.
AB  - Two approaches have been investigated for generating USP sterile, pyrogen-free
      water for injection (WFI) from potable water in the field. The first approach
      utilizes reverse osmosis (RO), ion exchange, a solid matrix filter containing
      activated carbon and zeta adsorbent, a final 0.2 microns pore size sterilizing
      filter and a device for transferring the WFI to an IV bag; prototype systems
      based on three different hand-operated RO units weigh 1.5-3.5 kg and are capable
      of producing WFI at rates of 1-10 L/hr. Parenteral solutions were made by adding
      WFI to an IV bag containing concentrated Ringer's lactate. The second approach,
      still in the breadboard stage, is similar but utilizes a larger ion exchange
      column in place of the RO unit and a multiport distribution head to fill a set of
      18 1-L IV bags. This system, considered to be disposable, is capable of
      generating water of WFI quality at a fill rate of 0.5 L/min from a pressurized
      source.

PMID- 8360805
TI  - Particle size reduction of emulsions by formulation design. I: Effect of
      polyhydroxy alcohols.
AB  - The objective of this study was to characterize the effect on particle size and
      stability of oil-in-water emulsion formulations caused by the addition of
      polyhydroxy alcohols. Stable soybean oil and hexadecane emulsions were prepared
      containing increasing amounts of propylene glycol (PG) and glycerol (GLY). A
      nonionic emulsifier system consisting of Tween 80 and Span 80 was used to achieve
      optimal stability. Particle size was found to decrease as the level of PG or GLY
      increased. A three-fold particle size reduction was obtained at a PG level of 40%
      w/w and at a GLY level of 70% w/w. The particle size of soybean oil emulsions
      decreased from about 4.8 microns to about 1.7 microns. The particle size of
      hexadecane emulsions decreased from about 2.7 microns to less than 1 micron. The
      increase in emulsion viscosity was found to be proportional to the amount of
      polyhydroxy alcohols added to the formulation. The particle size and creaming
      stability of the emulsions were found to improve with increasing PG or GLY
      concentration.

PMID- 8360806
TI  - Stability of cefazolin sodium and metronidazole at 8 degrees C for use as an i.v.
      admixture.
AB  - The stability of cefazolin 1 g in metronidazole 500 mg/100 mL at 8 degrees C was
      studied for use as an IV admixture. The commercially available injection of
      cefazolin sodium 1 g vial was diluted to 5 mL with 0.9% sodium chloride injection
      and added to metronidazole 500 mg/100 mL. Following dilution of 2 mL to 100 mL
      with water, 1-mL aliquots were transferred to glass vials, refrigerated at 8
      degrees, and assayed for cefazolin and metronidazole concentration at 0, 1, 2, 4,
      8, 12, 24, 36, 48, and 72 hours after preparation. The concentration of cefazolin
      and metronidazole was determined by a stability-indicating high-performance
      liquid chromatographic method. The range of concentration was determined to be
      within 5% of the 0-hour mean concentration. Over the 72-hour period, the mean
      concentration of cefazolin at all assay times was within 98.4 to 101.0% of the
      initial concentration. The mean concentration of metronidazole at each assay time
      was 96.9 to 104.9% of the initial concentration. Cefazolin sodium 10 mg/mL and
      metronidazole 5 mg/mL, prepared by adding reconstituted cefazolin to a glass
      bottle of metronidazole ready-to-use solution, were stable for 72 hours when
      stored at 8 degrees C.

PMID- 8360807
TI  - Comparative terminal sterilization.
AB  - Thermal processing of product in its final container to achieve product safety
      has been a major process operation of the pharmaceutical and food industries for
      many years. The original batch type autoclave (retort) is still in prevalent use
      today. However, high volume continuous and semi-continuous methods are also
      utilized, primarily in the food industry. Each different terminal sterilization
      method and load type requires assurance of process adequacy. This paper examines
      some of the types of moist heat terminal sterilizers in both the pharmaceutical
      and food industries and compares their features.

PMID- 8360808
TI  - The validation life cycle.
AB  - The Validation Life Cycle is an implementation mechanism which can assist
      pharmaceutical (and other types of medical product) manufacturers in the
      organization and execution of validation activities. A considerable body of work
      exists which identifies how to validate processes of various type and
      description. Unfortunately, there is a paucity of information on how to organize
      these individual validation activities into a cohesive whole. This paper
      describes a suggested means for achieving an organization's validation goals in a
      rational and effective fashion. To best understand the advantages of a life cycle
      for validation, a recap of the history of validation in the U.S. pharmaceutical
      industry is useful.

PMID- 8360809
TI  - Histoplasma capsulatum and V beta a mice: cellular immune responses and
      susceptibility patterns.
AB  - Certain strains of mice, designated V beta a, have a deletion of the gene
      segments encoding the beta chain of the T-cell receptor variable region. These
      mice do not express 40 to 50% of the T-cell receptor V beta chains. In this
      study, we examined the influence of this deletion on susceptibility to
      Histoplasma capsulatum. In addition, H. capsulatum-injected V beta a mice were
      tested for their capacity to generate T-cell dependent responses to H. capsulatum
      antigens. Susceptibility profiles of V beta a mice, SWR/J (H-2q), SJL/J (H-2s)
      and C57L-(H-2b), were compared to V beta b strains, C57BL/6 (H-2b) and DBA/l (H
      2q), following intravenous (IV) injection of sublethal and lethal inocula of H.
      capsulatum yeast cells. One week after injection of 6 x 10(5) yeast cells, the
      spleens of SWR/J, SJL/J and C57L mice contained 5- to 7-fold fewer colony forming
      units (CFU) than spleens of C57BL/6 mice. Approximately 50% fewer CFU of H.
      capsulatum were recovered from the spleens of DBA/l mice compared to those from
      C57BL/6 animals. Subsequently, groups of mice were challenged IV with either 1.5
      x 10(7) or 7.5 x 10(6) yeast cells and observed for 30 days. Survival of
      SWR/J,SJL/J, C57L and DBA/l mice was significantly prolonged compared to C57BL/6
      mice. V beta a and DBA/l mice injected with viable H. capsulatum yeast cells
      mounted a delayed-type hypersensitivity response to an extract from the cell wall
      and cell membrane of yeast cells and to HIS-62, a purified antigen derived
      therefrom.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8360811
TI  - An improved culture medium for detecting live yeast phase cells of
      Paracoccidioides brasiliensis.
AB  - The plating efficiency of standard mycological media such as brain heart infusion
      (BHI) agar is poor for Paracoccidioides brasiliensis. We prepared a water-extract
      of yeast phase cells of P. brasiliensis and examined it for growth-enhancing
      activity for the fungus. The water-extract, when added to BHI agar to a
      concentration of 5%, improved the plating efficiency of the medium for the fungus
      to some extent, but the degree of improvement was considerably varied among P.
      brasiliensis isolates. By contrast, when the water-extract was added in
      combination with horse serum (4%), the plating efficiency was highly improved (to
      94-99%) for all the P. brasiliensis isolates employed. The growth-enhancing
      factor(s) in the water-extract was heat-stable and heating at 120 degrees C for
      15 min had little, if any, effect on growth-enhancing activity.

PMID- 8360810
TI  - Differential binding of acapsulate and encapsulated strains of Cryptococcus
      neoformans to human neutrophils.
AB  - Investigations into mechanisms of binding of encapsulated and acapsulate strains
      of Cryptococcus neoformans by human neutrophils were performed, using a monolayer
      assay. The two strains bound to neutrophils by different mechanisms although both
      had an absolute requirement for opsonization with complement components in normal
      human serum for binding to occur. Neutrophil binding of encapsulated yeasts
      required conformational changes in actin yet did not appear to lead to
      phagocytosis of the organism. A maximum of 12 acapsulate cells bound per
      neutrophil compared with only four encapsulated yeasts. Cytochalasin D treatment
      reduced the maximum numbers able to bind per neutrophil by 50%. The encapsulated
      cryptococci appeared to compete with each other for binding to neutrophils
      whereas the acapsulate yeast cells bound to neutrophils in an approximately
      Poisson distribution, suggesting independent binding. Binding of acapsulate
      cryptococci did not require actin filaments and appeared to trigger phagocytosis.
      Thus, the capsule of C. neoformans appeared to inhibit binding and
      internalization by neutrophils.

PMID- 8360812
TI  - Efficacy evaluation of a novel submicron amphotericin B emulsion in murine
      candidiasis.
AB  - A submicron amphotericin B (AmB) sterile emulsion with a mean droplet size of
      approximately 100 nm was prepared. The emulsion was stable at 4 degrees C over a
      period of 4 months. The acute toxicity results showed that the maximum tolerated
      dose of the AmB emulsion was 2.0 mg kg-1 as compared to 0.5 mg kg-1 for a
      commercial deoxycholate suspension, Fungizone. Efficacy evaluations of submicron
      AmB emulsion compared to Fungizone were performed in a murine candidiasis model
      using either a single or a multiple daily dose administration of 0.4 mg kg-1.
      Survival (100%) was observed up to 15-18 days post-infection in mice treated with
      AmB emulsion or Fungizone, while all control non-treated animals had died after 9
      days in both single and multi-treatment experiments. Survival (50%) was obtained
      after 35 days in the single treatment, and 40 days in the multi-treatment,
      experiment with AmB emulsion, while treatment with Fungizone gave 50% survival
      after 15 and 20 days, respectively. The overall results indicate that in murine
      candidiasis, treatment with AmB submicron emulsion was more effective than
      Fungizone, suggesting a potential therapeutic application.

PMID- 8360813
TI  - Qualitative and quantitative differences in recognition patterns of Candida
      albicans protein and polysaccharide antigens by human sera.
AB  - Cytoplasmic and cell wall proteins and glycoproteins extracted from Candida
      albicans germ tubes were screened by Western blotting for their ability to
      differentiate between the serological responses of patients with candidosis and
      healthy individuals. Molecules of 114, 74 and 65 kDa were not recognized by any
      sera. Qualitative differences were observed for responses to proteins and
      glycoproteins from 29 to 60 kDa. Conversely, only quantitative differences were
      found to high molecular mass glycoproteins. Their recognition by control sera was
      invariably associated with reactivity against a 14-18 kDa antigen. However,
      despite a high level of antibodies against high molecular mass mannoproteins,
      some patients sera failed to react with the 14-18 kDa antigen, or lost this
      reactivity during the course of the disease.

PMID- 8360814
TI  - Identification of Candida albicans cell wall antigens lost during subculture in
      synthetic media.
AB  - A high variability in reactivity was observed when Candida albicans strains
      freshly isolated from both patients with candidiasis and asymptomatic carriers
      were tested against different human sera. The highest reactivity was observed in
      C. albicans strains isolated from blood cultures. This high reactivity was
      observed when the isolates were tested against sera from patients with Candida
      oesophagitis, patients with vulvovaginal candidiasis, or asymptomatic carriers
      but not against sera from blood donors. The antigenic reactivity of the strongly
      reactive strains, but not that of the weakly reactive strains, decreased during
      subculture in synthetic media. Five major components of an apparent molecular
      mass of > 200, 67-70, 49-52, 33-35 and 29-31 kDa were observed in alpha
      mannosidase extracts from C. albicans strains from both blood cultures (Group I)
      and patients with Candida oesophagitis (Group II) subcultured in synthetic media
      for different times. Changes in staining intensity through the different
      subcultures were observed for some bands. Group I strains showed a decrease in
      staining intensity for bands of > 200 and 67-70 kDa, an increase for bands of 33
      35 and 29-31 kDa, but no changes were observed for the band of 49-52 kDa. Group
      II strains showed opposite changes in banding intensity. A decrease in staining
      intensity was observed for the proteins of 33-35 and 29-31 kDa, an increase for
      the protein of 49-52 kDa, and no change in intensity was observed for the band of
      67-70 kDa. A component of > 200 kDa showed an irregular expression through the
      subcultures. The main antigen present in extracts from the first subculture of
      isolates from Group I and II had a molecular mass of 67-70 kDa. It could be
      related to the P antigens since it disappeared following subculture of the
      strains in synthetic media.

PMID- 8360815
TI  - Sch 39304, a new antifungal agent: oral and topical treatment of vaginal and
      superficial infections.
AB  - Sch 39304 is a new broad spectrum triazole antifungal agent that is active,
      orally and topically, against superficial Trichophyton mentagrophytes and vaginal
      Candida albicans infections. Sch 39304 was compared to fluconazole (FLZ) in a T.
      mentagrophytes infection model in guinea pigs. Following topical administration,
      Sch 39304 (0.125%, twice daily, 10 days), was 5-8-fold more effective than FLZ,
      based on culture and lesion score results. Following oral administration, Sch
      39304 (2.5 mg kg-1, once daily, 10 days) produced a dramatic reduction in lesion
      scores and was 20-fold more active than FLZ; however, due to the length of time
      it takes for the drugs to reach the infected area of the skin and eradicate the
      infections, most animals remained culture positive with both drugs. Sch 39304 was
      also compared with FLZ in a vaginal C. albicans infection in hamsters. Following
      oral administration (4 days), Sch 39304 (1.6 mg kg-1), cured all hamsters and was
      4-fold more active than FLZ. In addition, Sch 39304 as a single oral dose (10 mg
      kg-1) also cured all hamsters. When treatment was intravaginal (8 days), Sch
      39304 was again more active than FLZ (2-fold), and also micronazole (8-fold),
      with 100% of the hamsters cured at concentrations as low at 0.025%.

PMID- 8360816
TI  - Placental involvement in paracoccidioidomycosis.
AB  - A case of juvenile-type paracoccidioidomycosis in a pregnant woman is reported.
      The disease pre-dated pregnancy and antifungal treatment was being administered
      when she became pregnant. A premature male infant was delivered with no evidence
      of infection. Microscopic examination of the placenta showed numerous
      Paracoccidioides brasiliensis yeast forms in the intervillous space, enmeshed in
      a macrophagic-phagocytic reaction, with damage of the trophoblastic layer.
      Placental transfer of specific P. brasiliensis antibodies was demonstrated.

PMID- 8360817
TI  - Fluconazole in patients at risk from invasive aspergillosis.
AB  - We report on four cases of aspergillosis which developed during therapy with
      fluconazole in patients who were immunosuppressed or granulocytopenic.
      Fluconazole may obscure the onset of aspergillosis. We feel that it should
      neither be given prophylactically nor for fever of unknown origin in patients who
      are at high risk of contracting aspergillosis.

PMID- 8360819
TI  - Pharmaceutics and drug delivery aspects of heme and porphyrin therapy.
AB  - The importance of porphyrins and metalloporphyrins as therapeutic drugs has
      increased significantly over the last decade. This review highlights some of the
      challenges faced by pharmaceutical scientists in formulating these drugs into
      stable, effective, and safe dosage forms. Most activity in the clinic has focused
      on three areas: photodynamic therapy of cancer (e.g., hematoporphyrin
      derivatives), porphyrias and hematological diseases (e.g., heme), and various
      forms of jaundice (e.g., tin porphyrins). The biodistribution, stability,
      aggregation, toxicology, and analytical methodology of porphyrin drugs are all
      important considerations in the pharmaceutical development of porphyrin drugs.
      The utility of delivery systems such as liposomes hold promise of increasing the
      therapeutic potential of these drugs. Future prospects for therapeutic
      applications of porphyrin drugs are also discussed.

PMID- 8360818
TI  - Transdermal iontophoretic peptide delivery: in vitro and in vivo studies with
      luteinizing hormone releasing hormone.
AB  - Protein and peptide drugs are not orally active. Their large molecular size and
      charged character make them poor candidates for passive transdermal delivery.
      With an applied electromotive force, these drugs can be forced through the skin
      to be absorbed by the systemic circulation. The present study investigates the
      transdermal iontophoretic delivery of a peptide hormone in an in vitro model
      system, the isolated perfused porcine skin flap, as well as in vivo. It is shown
      that with knowledge of the systemic disposition of the drug, transdermal fluxes
      can be utilized to accurately predict in vivo serum concentrations. It is also
      shown that the iontophoretically delivered hormone retains both its immunologic
      and biologic activity.

PMID- 8360820
TI  - Percutaneous absorption: a single-layer model.
AB  - In vitro percutaneous permeation of betamethasone 17-valerate through excised
      human skin was studied. Pressure-sensitive silicone adhesive containing
      betamethasone 17-valerate in suspension was used as a vehicle. Steady-state flux
      through the split-thickness skin was similar to that through the isolated
      epidermis. However, the lag-time and half-life after removal of the vehicle were
      longer for the split-thickness skin than from epidermis. At steady state, 37% of
      the drug in the split-thickness skin was partitioned in dermis. When the kinetic
      parameters of a simple single-layer model are defined to specify the permeability
      coefficient and the drug amount in skin at steady state, this model can predict
      the longer half-life observed for the split-thickness skin sample compared with
      that for epidermis. The difference between the observed and theoretical values of
      the half-life after removal of the vehicle was within 23%. On the other hand, the
      lag-time had a large variation and the simple diffusion model failed to be
      predictive. A single-layer model described by two or three kinetic parameters may
      be able to describe percutaneous permeation kinetics even when the processes
      after the compound permeation through stratum corneum are not negligible.
      However, it is stressed that none of the kinetic parameters inherent in this
      simple model directly represents one of the single physicochemical parameters,
      such as diffusion and partition coefficients and path length of each skin layer.

PMID- 8360822
TI  - Effects of protein binding on the isomerization of ceftibuten.
AB  - Isomerization of ceftibuten to trans-ceftibuten, a less active isomer of
      ceftibuten, was observed in human serum in vitro. Investigation of the
      isomerization mechanism in the serum clarified that albumin accelerated the
      isomerization. The isomerization rate constant correlated significantly with the
      percent of binding to albumin, suggesting the binding of ceftibuten to albumin
      might be the driving force for the isomerization under in vitro conditions. This
      isomerization was also observed in clinical studies in humans. Results of
      physiological model analysis indicate that the isomerization catalyzed by albumin
      contributes significantly to the overall isomerization in the human body
      following oral administration.

PMID- 8360821
TI  - Reaction-frequencymetric method: a new analytical technique for determination of
      submicromolar concentration levels of vitamin C.
AB  - A new analytical technique for the assay of pharmaceutical substances at low
      concentration levels has been proposed and applied to the determination of
      vitamin C as an example of its application. It is based on the chemical reaction
      of vitamin C with iodine in a sodium citrate-hydrochloric acid medium, followed
      by measurement of the frequency change of a silver-plated piezoelectric quartz
      crystal. The frequency change is proportional to the vitamin C concentration from
      2 x 10(-7) to 4 x 10(-6) M. The method was applied to the assay of vitamin C in
      pharmaceutical preparations.

PMID- 8360823
TI  - Molecular organization of liquid n-octanol: an X-ray diffraction analysis.
AB  - We recorded X-ray diffraction patterns from n-octane, n-octanol, and fully
      hydrated n-octanol. These patterns were analyzed using a modified version of the
      Percus-Yevick hard-sphere theory for liquids. A model is presented for the
      molecular organization of n-octanol that accurately predicts the observed
      diffraction patterns. The octanol molecules are associated in aggregates, with
      their hydroxyl groups forming roughly spherical clusters and their hydrocarbon
      chains pointing outwards, almost fully extended. When n-octanol is hydrated, the
      overall organization does not change greatly, but water molecules coordinate the
      hydroxyl groups in the clusters. Estimates are made for the maximum number of
      octanol molecules in the aggregates.

PMID- 8360824
TI  - A specific radioimmunoassay for the measurement of gadoteridol, a contrast agent
      for magnetic resonance imaging in biological fluids.
AB  - Gadoteridol, a nonionic gadolinium chelate, is currently being evaluated for
      contrast-enhanced magnetic resonance imaging. A radioimmunoassay (RIA) has been
      developed for the measurement of gadoteridol in biological fluids. The RIA has a
      range of 0 to 25 micrograms/mL and has the sensitivity to detect 0.05
      microgram/mL of gadoteridol. Satisfactory zero binding and sensitivity were
      obtained after an overnight incubation at 4 degrees C. Separation of the antibody
      bound and free radiolabel was achieved with 12.5% polyethylene glycol. A
      quantitative recovery of the exogenous analyte was obtained at all concentrations
      of gadoteridol tested. Linearity in both serum and urine was satisfactory.
      Intraassay coefficients of variation were 6.4 and 2.8% for the low and medium
      controls, respectively. Interassay coefficients of variation were 5.4, 3.8, and
      12.2% for the low, medium, and high controls, respectively. Cross reactivities of
      the ligand 5 and the calcium salt 6 were 37 and 29%, respectively. Clinical
      samples from the ascending dosage studies were analyzed by the gadoteridol RIA.
      The results obtained from the serum specimens demonstrated an excellent linear
      proportionality between drug concentration in blood and administered dosage of
      gadoteridol. Cumulative urinary excretion data showed that 94% of the drug was
      excreted in the urine within 24 h.

PMID- 8360825
TI  - Displacement of thiopental from human serum albumin by associated drugs.
AB  - Displacement of thiopental from its binding sites to 4% human serum albumin
      solution was studied in vitro. Experimental conditions were selected to reproduce
      a physiological situation. Associations were studied according to the therapeutic
      conditions of use of the substances (drug and protein concentrations). The
      unbound fraction of thiopental was obtained by equilibrium dialysis at 37 degrees
      C and pH 7.4. Eleven drugs were associated with thiopental in 50 combinations of
      drugs and molar ratios. Bromhexine, citocoline, dextromoramide, dexamethasone,
      and methotrimeprazine had no effect on thiopental binding. The unbound fraction
      of thiopental significantly increased with cefamandole, cefazolin, diazepam,
      desmethyldiazepam, furosemide, and fentanyl. At usual therapeutic drug
      concentrations, the unbound fraction increase was < 5%. Higher values, however
      still < 10%, were found with associated drugs that were added at maximal
      concentrations observed in therapy. The displacement of thiopental from its
      albumin binding by drugs that are normally associated with the treatment of
      intracranial hypertension does not modify the pharmacokinetic parameters or
      pharmacological effect of thiopental.

PMID- 8360826
TI  - Formation and characterization of cyclosporine-loaded nanoparticles.
AB  - The commercially available formulations of cyclosporine (cyclosporin A, CyA) are
      associated with acute hemodynamic changes that result in high nephrotoxicity.
      Among colloidal vectors, nanoparticles (NPs) are receiving much attention as
      potential drug carriers that would avoid the therapeutic risks of conventional
      formulations. Two different mechanisms for obtaining polymeric NPs loaded with
      CyA were studied with regard to their preparation and physicochemical
      characterization. Isobutyl-2-cyanoacrylate monomer (IBCA) was polymerized,
      whereas poly-E-caprolactone (PCL, a preformed polymer) was precipitated; both
      reactions took place in an aqueous medium containing Pluronic F-68
      (polyoxypropylene polyoxyethylene block copolymer) as a surface active agent. The
      encapsulation efficiencies were 78.49 +/- 5.87 and 84.85 +/- 5.02%, respectively,
      and they remained stable over a wide range of drug concentrations. The polymeric
      NP had average sizes of 81 +/- 25 and 95 +/- 25 nm for poly-IBCA and PCL,
      respectively, as confirmed by photon correlation spectroscopy. Poly-IBCA NPs were
      built from oligomers with molecular weights of 157 to 2644 that joined to form a
      polymeric nanomatrix. In vitro activity of the drug and the carrier was tested by
      inhibition of lymphocyte proliferation induced by Concanavalin A. Drug-loaded PCL
      NPs and free CyA inhibited lymphocyte proliferation by 91.40 and 86.19%,
      respectively. However, drug-free NPs also exhibited statistically significant (p
      < 0.05) immunosuppressive activity.

PMID- 8360827
TI  - Ion-pair reversed-phase liquid chromatographic identification and quantitation of
      papaverine congeners.
AB  - A reversed-phase ion-pair high-performance liquid chromatographic separation was
      developed for identification and quantitation of papaverine drug congeners,
      namely papaverine (1), moxaverine (2), drotaverine (3), and ethaverine (4)
      hydrochlorides. A synthetic reference mixture of the four congeners in the range
      1-4 micrograms showed good separation. With a reference standard (codeine
      phosphate), the relative retention times to codeine were 1.356, 1.984, 2.46, and
      2.91 (mean of six) for 1, 2, 3, and 4, respectively. Good linearity was obtained
      in the quantitation of 1 and 2 in the range 1-2 micrograms [correlation
      coefficient (r), 0.9978 and 0.9997, respectively] and 3 and 4 in the range 2-4
      micrograms, (r, 0.9998 and 0.9991, respectively). Analysis of some commercial
      dosage forms containing one of these congeners showed good recovery with
      sufficient accuracy and precision. The method was sensitive and permitted the use
      of small sample sizes or unit doses.

PMID- 8360828
TI  - Toxin-targeted design for anticancer therapy. I: Synthesis and biological
      evaluation of new thioimidate heterobifunctional reagents.
AB  - In an effort to obtain a more potent and specific immunotoxin for cancer therapy,
      we designed a series of heterobifunctional linkers characterized by a thioimidate
      group linked to a S-acetyl thiol (4, 5) or substituted aryldithio group (6-10).
      These ligands were synthesized by a Pinner-type process from the corresponding
      nitrile derivatives obtained by thiol-disulphide exchange reaction, reaction with
      substituted benzene-sulphenyl chloride, or other known procedures. To check the
      reagent of choice for immunoconjugate preparation, we studied thioldisulphide
      exchange kinetics between the intermediate nitrile derivatives and cysteine.
      Among the tested aryldithio derivatives (6-10), we selected ethyl 3-(4
      carboxamido-phenyldithio)propionthioimidate (CDPT, 9) for further studies. By
      analyzing the rate of incorporation of the linkers 4, 5, and 9 in a model
      immunoglobulin G protein, we found similar results with CDPT 9 and ethyl S-acetyl
      3-mercaptopropionthioimidate ester hydrochloride (AMPT, 5) because both reagents
      showed a linear correlation between the number of introduced thiol groups and
      factors such as time and protein and reagent concentrations. Comparison of the
      two acetylthio-derivative ligands 4 and 5 showed that AMPT 5 was more stable
      toward deacetylation than ethyl S-acetyl 2-mercaptopropionthioimidate ester
      hydrochloride (AMAT, 4). By comparing the kinetic and biological parameters of
      seven new thioimidate linkers, we found that two of these (CDPT and AMPT) could
      be superior ligands for protein-protein conjugation. They offer advantages over
      the commercially available compounds, such as minimal perturbation of the protein
      structure, controlled reactivity, and good stability.

PMID- 8360830
TI  - Extraction and analysis by high-performance liquid chromatography of antibiotics
      in a drug delivery system for farmed fish.
AB  - Simple assays for extraction and determination of the concentrations of the
      antibiotics oxytetracycline, oxolinic acid, and flumequine in a drug dosage form
      for farmed fish are described. HPLC with UV detection was used in the analyses.
      The recovery of all three drugs was approximately 100%, and the precision varied
      from 0.5-3.0%. The methods are applicable to the production control, quality
      control, and stability control of the products.

PMID- 8360829
TI  - Antiserotoninergic activity of 2-aminoethylbenzocyclanones in rat aorta:
      structure-activity relationships.
AB  - The antiserotoninergic activity at the serotonin receptor subtype 2 (5-HT2) of
      seven new 2-aminoethylbenzocyclanones was determined with respect to serotonin
      induced contractions in rat aorta and compared with that of ketanserine (pA2 =
      8.87). Competitive antagonism was observed in six compounds (6.72 < or = pA2 < or
      = 8.12). Three-dimensional structures and molecular electrostatic potential
      distributions of ketanserine and 2-aminoethylbenzocyclanones were analyzed.
      Several molecular features correlated with the rank of antiserotoninergic
      activity. In the case of the cyclanone fragment, the rank of activity was
      associated with the degree of planarity of the bicyclic system. The steric and
      electrostatic effects due to the loss of planarity were analyzed. In the case of
      the amino moiety, activity was associated with a particular spatial pattern
      defined by the amino nitrogen, the aromatic system, and molecular electrostatic
      potential minima generated by the oxygen atom.

PMID- 8360831
TI  - Quantitative structure-activity relationships for substituted aminotetralin
      analogues. II: Inhibition of dopamine uptake.
AB  - Quantitative structure-activity relationships of 44 substituted aminotetralin
      analogues with regard to dopamine (DA) uptake inhibitory potency are examined in
      this study. Lipophilic substituents at R3 and hydrophilic substituents at R6
      and/or R9 positions, as well as the overall lipophilicity of the molecule
      contribute toward increasing the inhibitory potency. Unlike with norepinephrine
      uptake inhibition, little effects are seen from the nitrogen substituent. Among
      the ring substituents examined, an hydroxy group at the R6 position increases the
      DA uptake inhibitory potency, whereas a methoxy group at the R7 position
      decreases it. A comparative quantitative structure-activity relationship study
      shows that a bromine at the R6 position and/or hydrogen at the R9 position make
      the compound a better norepinephrine uptake inhibitor than a DA uptake inhibitor,
      whereas hydrogen at the R6 and/or a substituent larger than a propyl group at the
      R2 position make the compound a more potent DA uptake inhibitor.

PMID- 8360833
TI  - An interactive program for pharmacokinetic modeling.
AB  - A computer program, PharmK, was developed for pharmacokinetic modeling of
      experimental data. The program was written in C computer language based on the
      high-level user-interface Macintosh operating system. The intention was to
      provide a user-friendly tool for users of Macintosh computers. An interactive
      algorithm based on the exponential stripping method is used for the initial
      parameter estimation. Nonlinear pharmacokinetic model fitting is based on the
      maximum likelihood estimation method and is performed by the Levenberg-Marquardt
      method based on chi 2 criterion. Several methods are available to aid the
      evaluation of the fitting results. Pharmacokinetic data sets have been examined
      with the PharmK program, and the results are comparable with those obtained with
      other programs that are currently available for IBM PC-compatible and other types
      of computers.

PMID- 8360832
TI  - A multi-organ, axially distributed model of capillary permeability for a magnetic
      resonance imaging contrast agent.
AB  - Capillary permeability was resolved from uptake data for eight rat organs with
      gadoteridol, which is a stable, well-tolerated, nonionic, highly water soluble,
      gadolinium-containing, magnetic resonance imaging contrast agent. The
      extracellular kinetics were elucidated with an axially distributed, plasma
      interstitial fluid model and measured plasma flow, organ plasma volume, and
      interstitial fluid volume. The molecular and biological properties of gadoteridol
      and this kinetic model provide magnetic resonance imaging with a tool to begin
      measuring physiologic processes.

PMID- 8360834
TI  - Synthesis of potential metabolites of ethyl (E)-4-[2-(3,4-dihydro-4,4-dimethyl-2H
      1-benzopyran-6-yl)-1-propenyl] benzoate.
AB  - Potential metabolites of ethyl (E)-4-[2-(3,4-dihydro-4,4-dimethyl-2H-1-benzopyran
      6-yl)-1-propenyl] benzoate were synthesized. The new compounds include ethyl 3
      [3,4-dihydro-4,4-dimethyl-2H-1-benzopyran-6-yl]crotonate, 3-[3,4-dihydro-4,4
      dimethyl-1H-1-benzopyran-6-yl]crotonic acid, 3,4-dihydro-4,4-dimethyl-2H-1
      benzopyran-6-carboxylic acid, 4-[3,4-dihydro-4,4-dimethyl-2H-1-benzopyran-6
      yl]delta 2-butenolide, ethyl (E)-4-[3,4-dihydro-4,4-dimethyl-2H-1-benzopyran-6
      yl)-3-hydroxy-1- propenyl]benzoate, ethyl (E)-4-[2-(3,4-dihydro-4,4-dimethyl-2H-1
      benzopyran-6-yl)-2-propenal] benzoate, and ethyl (E)-4-[2-(3,4-dihydro-4,4
      dimethyl-2H-1-benzopyran-6-yl)-2-propenoic+ ++ acid]benzoate. Stereospecific
      oxidizing reagents and/or conditions were developed for these sensitive systems
      and include the use of SeO2, Clorox bleach, activated MnO2, and NaClO2 in the
      presence of resorcinol as a chlorine scavenger.

PMID- 8360835
TI  - Population pharmacodynamic modeling of drug-induced anemia.

PMID- 8360836
TI  - Effect of electrolytes on oxygen solubility in aqueous systems.

PMID- 8360837
TI  - Skin penetration enhancement of triprolidine base by propylene glycol.

PMID- 8360838
TI  - Polylactide-polyglycolide delivery system for physostigmine.

PMID- 8360839
TI  - Simulation studies on ethanol metabolism in different human populations with a
      physiological pharmacokinetic model.
AB  - A physiological pharmacokinetic model of ethanol metabolism was used to simulate
      ethanol metabolism in standard, fasted, human males of the white American, white
      European, black American, and Japanese populations. Gastric ethanol metabolism
      accounted for only 0.24% of the dose in the several populations. In contrast,
      hepatic first-pass ethanol metabolism accounted for 3.7-4.2% of the dose. Ethanol
      elimination by the lung and kidney accounted for 1.3-1.7% of the dose in the
      several populations. The black American population had a significantly higher
      maximum blood ethanol concentration and area under the blood ethanol
      concentration versus time curve than the other populations studied when either a
      single dose or multiple doses of ethanol were ingested. These increases were due
      to the presence of a considerable amount of the beta 3 beta 3-alcohol
      dehydrogenase (ADH) isoenzyme, with a Michaelis constant of 34 mM in the black
      American population. The Japanese population, which has a relatively high
      proportion of the beta 2 beta 2-ADH isozyme, metabolized ethanol somewhat more
      rapidly than the other populations, as previously noted.

PMID- 8360840
TI  - Pharmacokinetics of the anticancer agent sulofenur in mice, rats, monkeys, and
      dogs.
AB  - The absorption and pharmacokinetics of sulofenur [N-(indan-5-sulfonyl)-N'-(4
      chlorophenyl)urea, LY186641] and its major metabolites were examined in mice,
      rats, monkeys, and dogs. The compound is a diarylsulfonylurea currently being
      evaluated as an oncolytic agent in phase I and II trials. In all species,
      sulofenur was well absorbed after an oral dose, but over a prolonged period, and
      sulofenur exhibited a fairly long half-life of elimination from plasma. These
      values ranged from 6 h in rats up to 30, 110, and 200 h in mice, monkeys, and
      dogs, respectively, at doses (240-1000 mg/m2) within the range of those used in
      clinical trials. Experiments describing the high degree of binding of sulofenur
      to plasma proteins (consistently > 99%) help to explain these relatively long
      half-lives. There is, however, a large difference between these plasma half-lives
      in the species studied. Sulofenur was previously found to be extensively
      metabolized to products that are excreted primarily into the urine. In this
      study, its major metabolites, which are found mainly in the urine, were also
      minor components of the drug-related material (< 10% of the sulofenur
      concentrations) in the plasma of rats treated with sulofenur. The absorption,
      binding characteristics, and elimination of these major metabolites after their
      administration to rats were also compared with sulofenur.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8360841
TI  - Kinetics and mechanisms of peptide aggregation. I: Aggregation of a
      cholecystokinin analogue.
AB  - Aggregation kinetics for a tetrapeptide analogue of cholecystokinin (A-71623)
      have been studied by quasi-elastic light scattering. Aggregation kinetics were
      quantitated with a kinetic model, described herein, which was modified for quasi
      elastic light scattering data. The model predicts that the average molecular
      weight of peptide aggregates increases in a linear fashion with time. Data
      generated for A-71623 were consistent with the model presented under conditions
      of varied ethanol concentration at a fixed peptide concentration, as well as
      varied A-71623 concentration at fixed ethanol concentration. Although not the
      primary thrust of this study, experimental design permitted some understanding of
      the effect of environmental changes on the apparent aggregation kinetics of A
      71623. These studies suggest A-71623 aggregation may be partially mediated by
      hydrophobic bonding.

PMID- 8360842
TI  - Pharmacokinetics and metabolic interconversion of intravenous 4-amino-5-chloro-2
      [(methylsulfinyl)ethoxy]-N-[2-(diethylamino)ethyl] benzamide and its sulfide and
      sulfone metabolites in rats.
AB  - The pharmacokinetics of a new 5-hydroxytryptamine (5HT3) receptor antagonist, 4
      amino-5-chloro-2-[(methylsulfinyl)ethoxy]-N-[2-(diethylamino)ethyl] benzamide (ML
      1035, 1), and its sulfone and sulfide metabolites were examined in 12 rats. Each
      of these compounds (25.4 mumol/kg) was administered to rats intravenously. Their
      plasma concentrations were measured by high-performance liquid chromatography.
      These plasma data revealed that 1, a sulfoxide, underwent interconversion with
      its sulfide metabolite. However, no interconversion was observed between 1 and
      its sulfone metabolite. Examination of mean times and additional properties of
      the 1/sulfide metabolite system revealed that total exposure times of 1 and the
      sulfide metabolite were moderately and weakly, respectively, influenced by the
      metabolic interconversion process. However, the tissue distribution process
      strongly influenced the total exposure times of both compounds. The disposition
      of the sulfone metabolite of 1 was also strongly influenced by the tissue
      distribution process. In addition, < 3% of the intravenous dose of 1 or the
      sulfide was available to the general circulation as the sulfone metabolite.

PMID- 8360844
TI  - Application of a system analysis approach to population pharmacokinetics and
      pharmacodynamics of nicardipine hydrochloride in healthy males.
AB  - Nicardipine hydrochloride, a dihydropyridine calcium channel blocker, possesses
      antihypertensive and arterial vasodilator properties. A system analysis approach,
      which makes fewer structural assumptions than compartmental methods, is presented
      for determining the pharmacokinetics and pharmacodynamics of nicardipine
      hydrochloride in healthy males following a discontinuous infusion at four dose
      levels. The results indicate that the average total body clearance of nicardipine
      is 0.920 L/h/kg and the volume of distribution is 0.275 L/kg. Nicardipine
      hydrochloride has a mean residence time in the body of 1.27 h, of which 0.324 h
      were spent in the systemic circulation and the remainder in the periphery. The
      determined pharmacokinetic model was linked to a pharmacodynamic model that
      allowed the change in the mean arterial blood pressure and heart rate to be
      described and predicted. A population pharmacokinetic-pharmacodynamic model was
      derived and the predictive power of the proposed model was assessed with a cross
      validation technique that employs a relative predictive quotient for comparing
      the predictions to the fitted model. The results indicate that the proposed model
      describes the pharmacodynamics of nicardipine in healthy males and has good
      predictive ability when tested with a cross-validation procedure.

PMID- 8360843
TI  - Toxin-targeted design for anticancer therapy. II: Preparation and biological
      comparison of different chemically linked gelonin-antibody conjugates.
AB  - To obtain more potent immunotoxins for anticancer therapy a gelonin-AR3 antibody
      immunoconjugate was prepared with different new linkers and coupling procedures.
      The gelonin was derivatized with the heterobifunctional thioimidate linkers ethyl
      acetyl-3-mercaptopropionthioimidate (AMPT) and 3-(4
      carboxamidophenyldithio)propionthioimidate (CDPT), and with the succinimidyl type
      reagents N-succinimidyl-3-(4-carboxamidophenyldithio)propionate (SCDP) and N
      succinimidyl-S-acetyl thiolacetate (SATA). The biological activity of gelonin
      modified with different linkers (AMPT, CDPT, SCDP, SATA) was determined by a
      rabbit reticulocyte assay. We found that AMPT was the molecule of choice to
      derivatize the toxin, confirming the preferability of thioimidate linkers. The
      monoclonal antibody Mab was derivatized with CDPT and SCDP. Then the following
      immunoconjugates were prepared with different procedures: Mab-CDPT with gelonin
      AMPT; Mab-CDPT with gelonin-CDPT; Mab-SCDP with gelonin-SATA. To verify whether
      selection of the most suitable coupling procedure could affect the antitumoral
      activity of the gelonin-AR3 immunoconjugate, the three immunotoxins were tested
      on target HT-29 human colon carcinoma cells versus nontarget MeWo cells. The
      gelonin immunoconjugate linked via the AMPT-CDPT thioimidate reagents showed
      highest antitumoral activity as well as best selectivity for the target cells.

PMID- 8360845
TI  - A rapid method for the measurement of cholesterol thermodynamic activity in bile
      salt-lecithin-cholesterol solutions.
AB  - Earlier work from this laboratory suggested that the cholesterol (Ch)
      thermodynamic activity is a more meaningful measure of the degree of Ch
      supersaturation in human bile than the widely known cholesterol saturation index.
      An early version of a method for determining thermodynamic activity based on Ch
      uptake from bile salt (BS)-lecithin (LE) solutions into silicone polymer
      particles, but requiring 12-24 h for reaching equilibrium, was considered
      unsatisfactory because Ch nucleation and crystal formation frequently occurred
      within a few hours. The aim of the present work was to develop a method that
      would reduce equilibration times to the order of 1 h. Changing the thickness of
      the silicone film alone did not result in the desired reduction of equilibration
      times and it was soon deduced that the uptake of Ch by the silicone film from the
      BS-LE solution was a surface-controlled transport process involving the transport
      of Ch by negatively charged BS and BS-LE micelles at the interface. Three
      different approaches were tried to modify the silicone film to make its surface
      positively charged, thereby reducing and/or eliminating the presumed electrical
      repulsion barrier for the interfacial transport of Ch. The film was treated with
      different concentrations of aminopropyl methyl-dimethylsiloxane (AMDS) in
      cyclohexane, octadecyldimethyl-[3-(trimethoxysilyl)-propyl] ammonium chloride
      (ODTOP) in methanol, and octadecylamine solution in ethanol. Films treated with 1
      1.5% ODTOP and 5-10% AMDS reduced the Ch equilibration times for model BS-LE
      solutions to < 1 h.

PMID- 8360846
TI  - Nutrient-induced changes in the permeability of the rat jejunal mucosa.
AB  - We examined the site of action of nutrients that enhance mucosal permeability by
      use of D-glucose as an archetype of nutrients of this class. We tested the
      hypothesis that D-glucose enhances mucosal permeability by either acting outside
      the intestinal lumen after absorption or acting inside the intestinal lumen to
      cause mediator release from either endocrine or nerve tissue. The rate of
      absorption of L-[14C]glucose, a passively absorbed molecule, from the lumen was
      used as an index of the permeability of the mucosa of a perfused segment. L
      Glucose was absorbed more rapidly in the presence of D-glucose than in the
      presence of an equimolar concentration of mannitol. However, the permeability of
      the jejunal mucosa was unaffected by elevated blood glucose levels during
      intravenous infusion of D-glucose. The mucosal permeability was also unaffected
      by exposure of an adjacent segment to D-glucose, a result suggesting that D
      glucose does not alter mucosal permeability by inducing the release of a blood
      borne mediator from enteroendocrine cells. Finally, the effect of D-glucose on
      mucosal permeability could not be blocked by hexamethonium or tetrodotoxin, a
      result suggesting that the intestinal nerves do not mediate this phenomenon.
      Lidocaine significantly increased the rate of L-glucose absorption when D-glucose
      was present in the lumen but had no effect on L-glucose absorption under basal
      conditions. Our findings indicate that D-glucose must be in contact with the
      apical membranes of enterocytes to alter mucosal permeability. This suggestion is
      consistent with the hypothesis that the modulation of mucosal permeability
      results from the activation of sodium-dependent cotransport systems.

PMID- 8360847
TI  - Pharmacokinetics of (Me)Arg-Lys-Pro-Trp-tert-Leu-Leu-OEt and (Me)Arg-Lys-Pro-Trp
      tert-Leu-Leu administered intravenously to beagle dogs.
AB  - The pharmacokinetics of two analogues (NT-1 and NT-2) of the smallest active
      fragment of neurotensin were investigated in beagle dogs after intravenous (iv)
      administration at the doses of 0.1 and 0.5 mg/kg for NT-1 and of 0.25 and 0.5
      mg/kg for NT-2. After iv administration of these two drugs, the plasma levels
      decreased with time with a biexponential pattern, and linear kinetic behavior was
      observed. The pharmacokinetic parameters (mean +/- standard error of mean) after
      iv administration of NT-1 at 0.1 mg/kg were as follows: the half-life of the
      distribution phase (t1/2 alpha) was 0.29 +/- 0.11 h, the half-life of the
      terminal phase (t1/2 beta) was 1.99 +/- 0.41 h, total plasma clearance (CL) was
      33.2 +/- 6.3 mL/h/kg, steady-state volume of distribution (Vdss) was 57.1 +/- 2.8
      mL/kg, and mean residence time (MRT) was 2.20 +/- 0.55 h. The t1/2 alpha, t1/2
      beta, CL, Vdss, and MRT values after iv administration of NT-2 at 0.25 mg/kg were
      0.11 +/- 0.02 h, 0.58 +/- 0.04 h, 257.3 +/- 17.2 mL/h/kg, 180.3 +/- 4.6 mL/kg,
      and 0.71 +/- 0.04 h, respectively. After iv administration of NT-1, NT-2 was
      detected in the plasma. It was confirmed from this result that NT-1 was
      metabolically hydrolyzed to NT-2 in the body of beagle dog.

PMID- 8360848
TI  - Solvent dependence of optical rotation of (S)-N-[1-(2-fluorophenyl)- 3,4,6,7
      tetrahydro-4-oxo-pyrrolo[3,2,1-jk][1,4]benzodiazepine-3-yl]- 1H-indole-2
      carboxamide.
AB  - A new cholecystokinin-A antagonist, (S)-N-[1-(2-fluorophenyl)- 3,4,6,7-tetrahydro
      4-oxo-pyrrolo[3,2,1-jk][1,4]benzodiazepine-3-yl]- 1H-indole-2-carboxamide
      (FR120480; 1), is a chiral compound that shows considerable solvent dependence of
      its optical rotation. Not only the absolute values, but also the signs (+ or -)
      for this compound change in various solvents. The optical rotation of 1
      inherently correlated to the electron donating property characterized by donor
      number of the solvent. The 1H NMR study implied that hydrogen bonds were formed
      between electron donor groups of the solvents and the NH groups of indole and
      amide of 1. In accordance with the NMR results, X-ray crystallography of the
      tetrahydrofuran solvate of 1 showed that hydrogen bond formation occurred between
      the oxygen atom of tetrahydrofuran and the amide group of 1.

PMID- 8360849
TI  - Use of hydroxypropyl methylcellulose acetate succinate in an enteric polymer
      matrix to design controlled-release tablets of amoxicillin trihydrate.
AB  - A controlled-release table of amoxicillin trihydrate was developed by use of a
      matrix formulation based on the enteric polymer hydroxypropyl methylcellulose
      acetate succinate (HPMCAS). Sustained drug release was shown by in vitro
      dissolution testing; the polymer could suppress drug release in the presence of
      gastric pH but could enhance drug release in the presence of small intestinal pH,
      compared with compacts of pure drug. Grinding or physical mixing of the drug with
      the polymer, an alteration in normal compaction pressure, or a substitution of
      other enteric polymers did not markedly affect drug release from compacts.
      Physicochemical testing of samples confirmed that the method of mixing did not
      alter powder morphology. An ethanolic granulation procedure was used in the
      production of final tablets (21 x 10 mm) containing amoxicillin (750 mg), HPMCAS,
      anhydrous directly compressible lactose, and lubricants. These large tablets
      showed a promising sustained-release effect in vitro when a variable-pH-shift
      dissolution procedure was used. However, single-dose studies with a panel of
      fasting subjects showed that the tablets had a relative bioavailability of only
      64.4%. Other pharmacokinetic parameters confirmed a lack of therapeutic advantage
      of these tablets over an equivalent dose of conventional capsules.

PMID- 8360850
TI  - Mechanism of phosphate adsorption to a three-dimensional structure of boehmite in
      the presence of bovine serum albumin.
AB  - A new microcrystalline boehmite (tentatively named PT-A) was synthesized as an
      efficient phosphate adsorbent to replace aluminum hydroxide gel. The
      characteristic structure of PT-A was examined by nitrogen adsorption/desorption,
      X-ray diffraction, deviation microscopy, and scanning electron microscopy to
      establish a pore structural model of PT-A. With this model structure, the details
      of the mechanism of interaction between PT-A and phosphate in the presence of
      bovine serum albumin (BSA) are discussed. PT-A is a spherical particle with a
      diameter of approximately 100 microns and a porous surface structure, and its
      inside is packed with boehmite microcrystals (crystallite size, 2 nm). PT-A has
      three types of pores in its structure: a micropore with a narrow size
      distribution, a mesopore with a broad size-distribution, and a macropore (radii
      of pores are 0.7, 1-20, and approximately 300 nm, respectively). When phosphate
      was incubated with PT-A in human gastric and intestinal juices or in an aqueous
      solution containing BSA, the amounts of phosphate adsorbed by PT-A were not
      affected by the presence of proteins. The nitrogen adsorption/desorption
      isotherms and energy dispersive X-ray analyses demonstrated that phosphate could
      diffuse to the smaller tunnels freely even if the external surface of PT-A was
      covered with BSA. It was also demonstrated that the main site of adsorption for
      phosphate was in micropores of PT-A, whereas BSA was adsorbed only to the
      external surface and none entered inside smaller tunnels consisting of micro- and
      mesopores.

PMID- 8360851
TI  - Multiple-layer, direct-compression, controlled-release system: in vitro and in
      vivo evaluation.
AB  - A new approach to achieve controlled drug delivery is demonstrated for a triple
      layer tablet, which simultaneously combines the principles of diffusion and
      dissolution. Heckel's equation was used to characterize the compression behavior
      of formulation components. A balanced proportion of each component and a model
      drug (theophylline) were selected to avoid lamination after ejection and ensure
      coherent compaction. In vitro release profiles over a period of 10 h in different
      dissolution media and hydrodynamic conditions were similar and resulted in an n
      value of 0.786, signifying anomalous release kinetics. The n value is calculated
      from a curve fit to the empirical equation: Mt/Minfinity = Ktn, where Mt and
      Minfinity denote the amount of drug released at time t and at infinite time,
      respectively, K denotes the proportionality constant, and n characterizes the
      type of release mechanism operative during the dissolution process. In vivo study
      in human subjects after administration of the experimental triple-layer system
      exhibited a steady rise in plasma concentration up to 7 h. The actual amount of
      drug absorbed by the body was calculated by the Wagner-Nelson technique, and a
      linear relationship was observed between the percentage absorbed in vivo and the
      percentage dissolved in vitro. The proposed triple-layer model appears to provide
      good correlation between in vitro and in vivo results with maximum flexibility
      with respect of dose, duration range, and ease of production.

PMID- 8360852
TI  - Antibacterial organophosphorus compounds: phosphoranilidohydrazones of 5-nitro-2
      furaldehyde.
AB  - A series of phosphoranilidohydrazones of 5-nitro-2-furaldehyde was synthesized
      and evaluated for antibacterial activity. The series was prepared to examine the
      applicability of phosphoramidic hydrazones as carriers for the antibacterial
      nitrofuran moiety. Designed as analogues of nitrofurantoin, members of the series
      were chosen according to the Topliss approach to analogue design. The title
      compounds were devoid of gram-negative activity but possessed moderate
      antistaphylococcal activity. The most potent members of the series were
      equipotent with nitrofurantoin against Staphylococcus aureus. The relationship
      between structure and antistaphylococcal activity is discussed.

PMID- 8360853
TI  - Phase diagram of (R)- and (S)-4-hydroxy-2-pyrrolidone mixtures: a new case of a
      conglomerate-forming system.
AB  - The phase diagram of (R)- and (S)-4-hydroxy-2-pyrrolidone presents a conglomerate
      in the racemic mixture. The enthalpy of melting extrapolated by the Schroder-van
      Laar-Le Chatelier equation [change in enthalpy (delta H) = 28410 J/mol; melting
      temperature (TA) = 429.9 K; solidus temperature (Ts) = 395.4 K] and the value
      determined by differential scanning calorimetry (delta H = 28494 J/mol; TA =
      429.6 K; Ts = 394.6 K) are in excellent agreement. The experimental entropy of
      the mixing of enantiomers is 5.69 J/mol.K. The conglomerate nature of the racemic
      mixture was confirmed by X-ray and IR spectroscopy. The presence of solvates was
      also observed.

PMID- 8360854
TI  - Estimation of variance for AUC in animal studies.

PMID- 8360855
TI  - A method for continuous pH regulation of dissolution medium in stirred vessels.

PMID- 8360856
TI  - Adenylate cyclase-the more membrane associated, the less radiosensitive.
AB  - A dose dependent but not parallel decreases were observed both in SH content and
      catalytic activity of "free" catalytic subunit after irradiation (0-3200 Gy),
      while SH groups of membrane-associated adenylate cyclase were insensitive (under
      3200 Gy). An initial "radioactivation" of membrane-associated enzyme was found
      under 800 Gy, then an inhibition above 1600 Gy. The SH alkylating agent, N
      ethylmaleimide resulted in a complete inactivation, both of membrane associated
      form of adenylate cyclase and "free" catalytic subunit with similar inactivation
      profiles. These data indicate that in the radiosensitivity or "radioprotection"
      of adenylate cyclase, its membrane association/integration might play a more
      important role than the SH groups themselves.

PMID- 8360857
TI  - A shuttle vector system for studying ionizing radiation-induced mutagenesis in
      mammalian cells.
AB  - A shuttle vector system was developed to quantitate and analyze ionizing
      radiation-induced mutation in mammalian host cells, COS-1 and CV-1. The shuttle
      vector pSV2-lacY, which was constructed to detect both point mutations and
      deletions, was irradiated in vitro with 60Co gamma rays before introduction into
      unirradiated host cells. The plasmid was then isolated and reintroduced into
      HB101 (lacY-) bacterial host cells for identification of mutated lacY marker
      genes. Gamma-irradiation produced a decrease of the survival (recovery) and an
      increase of mutation of the shuttle vector. The mutated shuttle vector molecules
      were examined for structural changes by means of restriction endonuclease
      digestion and agarose gel electrophoresis. A dose dependent increase was observed
      in the percentages of gross alteration events of total mutations in mammalian
      host. This system will be useful for studies of ionizing radiation-induced
      mutagenesis.

PMID- 8360858
TI  - Transfer of 239Pu to mouse fetoplacental tissues.
AB  - Cross-placental transfer of 239Pu from the mother to fetus was studied in C3H
      mice. The activity of 239Pu in the conceptus was measured 24 hrs after the
      intravenous injection of 239Pu citrate on days 10.5 to 16.5 of gestation. More
      239Pu was transferred to the conceptus when the plutonium was administered in the
      later stages of gestation; 0.12% of the injected dose per conceptus on day 10.5
      and 1.3% on day 16.5. In all the gestational stages examined, the yolk sac and
      decidua contained more than 89% of the total activity distributed in the
      conceptus. The concentration of 239Pu in the yolk sac was about two orders of
      magnitude greater than that in the fetus. The 239Pu concentration in the maternal
      liver decreased with the gestational stage. In the early gestational stages the
      concentration in the maternal liver was greater than that in the yolk sac; but,
      this relationship was reversed in the later stages.

PMID- 8360859
TI  - X-irradiation-induced emesis in Suncus murinus.
AB  - X-irradiation-induced emesis was investigated in Suncus murinus, a house musk
      shrew. Whole body X-irradiation caused emesis, and the calculated ED50 value that
      induced emesis in 50% of animals was 429 cGy. At the irradiation dose of 800 cGy
      all the animals vomited 10.0 +/- 2.4 times with a latency of 20.0 +/- 2.9 min.
      The emetogenic effect of X-irradiation was dependent on the part of the body
      exposed. Abdominal X-irradiation at 1000 cGy caused emesis in all animals
      studied, whereas the same dose to the head had no emetogenic effect. We
      investigated several prophylactic methods against X-irradiation-induced emesis.
      Surgical vagotomy completely inhibited the emesis induced by 800 cGy X
      irradiation. Emesis was also prevented by the subcutaneous administration of
      tropisetron (ICS 205-930, a selective serotonergic 5-HT3 receptor antagonist)
      with an ID50 value of 29 micrograms/kg. These results suggest that (1) suncus is
      a useful experimental animal for the study of radiation-induced emesis and the
      development of prophylactic drugs, (2) serotonin plays an important role in X
      irradiation-induced emesis, and (3) X-irradiation-induced emesis is very similar
      to that caused by cancer chemotherapeutic agents.

PMID- 8360860
TI  - Effect of gamma-irradiation on the uptake and digestion of 125I-labeled bovine
      serum albumin by rat visceral yolk sac cultured in vitro.
AB  - The effect of gamma-irradiation on a major nutritional function of the yolk sac
      (the uptake and digestion of macromolecular materials) was studied in rat
      visceral yolk sacs cultured in vitro being used 125I-labeled bovine serum albumin
      (RISA) as the tracer protein. The uptake of RISA (per g wet weight) by rat yolk
      sacs irradiated with doses of 5-80 Gy was essentially the same as that in the
      unirradiated control yolk sacs. There were no significant differences in yolk sac
      uptake of RISA with respect to the radiation doses or to culture period up to 18
      hours after irradiation. External gamma-irradiation with 10-80 Gy does also had
      no effect on the extracellular release of 125I from yolk sacs which had been
      taken it up as RISA. The ratios of the activity in ultrafiltrates of the medium
      to the total activity in the medium were slightly higher at doses of 40 and 80
      Gy.

PMID- 8360861
TI  - [Significance of ultrasonographic aspects of hydatid cyst of the liver. Apropos
      of a case studied before and after liver injury].

PMID- 8360862
TI  - [Ascariasis of the common bile duct. An ultrasonographic case in Yemen].
AB  - A case of a biliary ascariasis associated with a cystic bile duct lithiasis
      observed in the French Medical Mission of the Republic of Yemen is reported.
      Ascaris biliary migration, method of diagnosis, complications and treatment are
      reviewed.

PMID- 8360863
TI  - [Percutaneous treatment of liver abscess. Apropos of 34 cases].
AB  - The authors report on a retrospective series of 37 liver abscesses treated via
      the percutaneous route in 34 patients, in order to assess the efficacy of this
      method. One or more aspiration punctures were undertaken in 24 patients (70.6%),
      while percutaneous drainage was performed in 10 patients (29.4%). In 27 cases
      (79.5%), this percutaneous treatment resulted in a cure. Further surgical
      drainage, carried out in 7 patients (20.5%) was only required in 3 cases, twice
      due to the inefficacy of percutaneous drainage and once in the presence of three
      liver abscesses containing particularly thick pus. Ultrasonographic monitoring
      demonstrated a return to normal in 66.6% of cases, the persistence of a slight
      residual collection in 26.6% patients and one relapse, two months after
      percutaneous drainage. Two complications inherent to the percutaneous treatment
      were noted: a pneumothorax and a case of septicemia, both of which had a
      favourable outcome.

PMID- 8360864
TI  - [Primary carcinoid tumor of the pancreas. X-ray computed tomographic and echo
      endoscopic aspects].
AB  - Primary carcinoid tumors of the pancreas are exceedingly rare, only few cases
      have been reported in the literature. We present a case of primary carcinoid
      tumor of the pancreas occurring on chronic pancreatitis. The CT, as well as
      endosonographic features are described. Those two techniques might contribute to
      an early preoperative diagnosis which is important since carcinoid tumors have a
      better prognosis than the common pancreatic adenocarcinoma.

PMID- 8360865
TI  - [Cystic dilatation of the seminal vesicle associated with renal agenesis.
      Contribution of different types of imaging].
AB  - The authors report a case of cystic disease of the seminal vesicle associated
      with renal agenesis. This young patient presented only with cystitis.
      Developmental malformation of the mesonephric duct is the cause of this uncommon
      abnormality. The value of modern imaging (IVU, US, CT, MRI) is related.

PMID- 8360866
TI  - [Normal and pathologic imaging of the pituitary stalk].
AB  - Study of the pituitary stalk pathology about six demonstrative cases. This
      illustrative cases are described after review of literature, anatomy and imaging
      modalities. CT and MRI are very sensitive technics but not very specific.

PMID- 8360868
TI  - [Radiology in Cambodia].

PMID- 8360867
TI  - [Cauda equina syndrome disclosing adenocarcinoma of the ethmoid].
AB  - Cauda equina metastases have been exceptionally described in sinusal neoplasms.
      MRI with gadolinium injection show up the primitive lesion and its neurologic
      extension. We report a case of cauda equina syndrome in which, only MRI, had show
      up intradural metastases and localised the ethmoid sinus carcinoma.

PMID- 8360869
TI  - [In Uruguay, the Leborgne family].

PMID- 8360870
TI  - Anticonvulsant activities of some arylsemicarbazones displaying potent oral
      activity in the maximal electroshock screen in rats accompanied by high
      protection indices.
AB  - Various semicarbazones derived from aryl aldehydes, phenylalkyl aldehydes, and
      phenylalkyl ketones as well as some related compounds were evaluated for
      anticonvulsant activity. Most of the compounds displayed anticonvulsant activity
      in the maximal electroshock (MES) and subcutaneous pentylenetetrazole (scPTZ)
      screens accompanied by neurotoxicity when given to mice by the intraperitoneal
      route. However quantitative data revealed protection indices (TD50/ED50) of less
      than 4 in general. Oral administration of the compounds to rats led to excellent
      potency in the MES screen accompanied by high protection indices while virtually
      no activity in the scPTZ test was displayed. These observations support the
      theory that one large hydrophobic group (in this case the aryl ring) and two
      electron donor atoms (present in the semicarbazono group) are requirements for
      protection in the MES screen. In general, the semicarbazones had rapid onsets of
      action, and one of the ways in which these compounds displayed their
      anticonvulsant activity is likely to be interaction with chloride channels.
      Empirical and semiempirical conformational calculations indicated that certain
      molecular fragments and hydrophobicity of these molecules affect bioactivity.

PMID- 8360871
TI  - Nonpeptide angiotensin II receptor antagonists. 2. Design, synthesis, and
      structure-activity relationships of 2-alkyl-4-(1H-pyrrol-1-yl)-1H-imidazole
      derivatives: profile of 2-propyl-1-[[2'-(1H-tetrazol-5-yl)-[1,1' -biphenyl]-4-yl]
      methyl]-4-[2-(trifluoroacetyl)-1H-pyrrol-1-yl]-1H- imidazole-5-carboxylic acid
      (CI-996).
AB  - A novel series of nonpeptide angiotensin II (AII) receptor antagonists containing
      a 1H-pyrrol-1-yl moiety at the 4-position of the imidazole have been developed.
      The pyrrole group occupies the same lipophilic pocket at the receptor as the
      chloro group in DuP 753 (68) and EXP 3174 (69) and the pentafluoro group in DuP
      532 (70), respectively. The impetus for its selection came from bioisosteric
      considerations based on hydrophobic and electronic substituent constants. An
      extensive study of the structure-activity relationships revealed several highly
      potent AII receptor antagonists. An acyl substitution at the 2-position of the
      pyrrole ring improved activity, most notably in the in vivo rat model. In
      addition, the 2-substituted pyrrole compounds improved chemical stability toward
      extremely facile decarboxylation reaction associated with unsubstituted pyrrole
      analogues, thus facilitating development of these agents. The IC50's of 18, 20,
      and 42 (< 1 nM) were better than the reference compounds 69 and 70, respectively.
      These compounds were selective AII antagonists that compete at the AT1 receptor
      and showed no affinity at the AT2 receptor at concentrations up to 10 microM.
      Upon intravenous administration in a normotensive rat model, compound 18
      inhibited the AII-induced responses with ED50 of 6 micrograms/kg per min. In a
      renal hypertensive rat model, the antihypertensive potency of compound 18, at a
      dose of 10 mg/kg, was very similar to those 68 and 69, respectively. Compound 18
      demonstrated a dose-related (3-30 mg/kg) decrease in blood pressure that was
      sustained for greater than 24 h. On the basis of its profile, compound 18,
      designated as CI-996, has been selected for in-depth studies. The design,
      synthesis, in vitro, and in vivo structure-activity relationships are described.

PMID- 8360872
TI  - Benzoquinazoline inhibitors of thymidylate synthase: enzyme inhibitory activity
      and cytotoxicity of some 3-amino- and 3-methylbenzo[f]quinazolin-1(2H)-ones.
AB  - The synthesis and thymidylate synthase (TS) inhibitory activity of a series of
      simple benzo[f]-quinazolin-1(2H)-ones are described. Fully aromatic 3-amino
      compounds with compact lipophilic substituents in the 9-position were found to
      have I50 values as low as 20 nM on the isolated enzyme, and represent the first
      examples of potent, folate-based TS inhibitors that completely lack any
      structural feature corresponding to the (p-aminobenzoyl)glutamate moiety of the
      cofactor. A number of the compounds also showed moderate growth inhibitory
      activity against a human colon adenocarcinoma cell line (SW480), with IC50 values
      as low as 2 microM.

PMID- 8360873
TI  - Synthesis and structure-activity studies of a series of spirooxazolidine-2,4
      diones: 4-oxa analogues of the muscarinic agonist 2-ethyl-8-methyl-2,8
      diazaspiro[4.5]decane-1,3-dione.
AB  - A series of spirooxazolidine-2,4-dione derivatives related to the putative M1
      agonist 2-ethyl-8-methyl-2,8-diazaspiro[4.5]decane-1,3-dione (RS86; 1) were
      synthesized. The compounds were evaluated as cholinergic agents in in vitro
      binding assays and in in vivo pharmacological tests including antiamnesic effects
      using scopolamine-treated mice, hypothermia, and salivation in mice. Four
      compounds (5a,c,f and 17a) exhibited affinity for cortical M1 receptors and
      reversed scopolamine-induced impairment of mouse passive avoidance tasks, as did
      1. Among these compounds, only 5a exhibited M1-receptor stimulating activity in
      pithed rats. Structural requirements for muscarinic activity in this series of
      spirooxazolidine-2,4-dione derivatives were as strict as those reported for
      spirosuccinimide derivatives including 1. The antiamnesic dose of 3-ethyl-8
      methyl-1-oxa-3,8-diazaspiro[4.5]decane-2,4-dione (5a) was 2 orders of magnitude
      lower than the doses inducing hypothermia and salivation, in contrast to 1 for
      which the former dose was only 5-10-fold lower than the latter. These results
      suggest that the 8-azaspiro[4.5]decane skeleton represents a useful template for
      designing new muscarinic agonists as antidementia drugs.

PMID- 8360874
TI  - Potent HIV protease inhibitors: the development of tetrahydrofuranylglycines as
      novel P2-ligands and pyrazine amides as P3-ligands.
AB  - A series of protease inhibitors bearing constrained unnatural amino acids at the
      P2-position and novel heterocycles at the P3-position of compound 1 (Ro 31-8959)
      were synthesized, and their in vitro enzyme inhibitory and antiviral activities
      were evaluated. Replacement of P2-asparagine of compound 1 with (2S,3'R)
      tetrahydrofuranylglycine resulted in improvement in enzyme inhibitory as well as
      antiviral potencies (compound 23). Interestingly, incorporation of (2S,3'S)
      tetrahydrofuranylglycine at the P2-position proved to be less effective. The
      resulting compound 24 was 100-fold less potent than the 2S,3R-isomer (compound
      23). This stereochemical preference indicated a hydrogen-bonding interaction
      between the tetrahydrofuranyl oxygen and the residues of the S2-region of the
      enzyme active site. Furthermore, replacement of P3-quinolinoyl ligand of 1 with
      various novel heterocycles resulted in potent inhibitors of HIV proteases. Of
      particular interest, compound 2 with (2S,3'R)-tetrahydrofuranylglycine at P2 and
      pyrazine derivative at P3 is one of the most potent inhibitors of HIV-1 (IC50
      value 0.07 nM) and HIV-2 (IC50 value 0.18 nM) proteases. Another important result
      in this series is the identification of compound 27 in which the P2-P3-amide
      carbonyl has been removed. The resulting compound 27 has exhibited improvement in
      antiviral potency while retaining the enzyme inhibitory potency similar to
      compound 1.

PMID- 8360875
TI  - Synthesis and evaluation of conformationally restricted N-[2-(3,4
      dichlorophenyl)ethyl]-N-methyl-2-(1-pyrrolidinyl)ethylamines at sigma receptors.
      2. Piperazines, bicyclic amines, bridged bicyclic amines, and miscellaneous
      compounds.
AB  - As a continuation of our earlier study (J. Med. Chem. 1992, 35, 4334-4343) we
      conformationally restricted the sigma-receptor ligand 2-(1-pyrrolidinyl)-N-[2
      (3,4-dichlorophenyl)ethyl]-N-methylethylamine (1) by incorporating it into a
      series of homologous piperazines 3-9 and homopiperazines 10 and 11,
      diazabicyclononanes and decanes, bridgehead bicyclooctanes and nonanes as well as
      other miscellaneous compounds. sigma-Receptor binding affinities were obtained
      using [3H](+)-pentazocine in guinea pig brain membrane sigma 1 sites. The studies
      suggest that the nitrogen lone pair orientation found in the piperazines affords
      the strongest binding interaction. Other nitrogen lone pair orientations or
      compounds representing unlikely staggered conformations of 1 [ as in 4-[2-(3,4
      dichlorophenyl)ethyl]-1,4-diazabicyclo[3.2.2]nonane (16)] show very weak sigma
      interaction. Comparison of the binding data of different N-substituted homologues
      of 1 with those of the 1-[2-(3,4-dichlorophenyl)ethyl]-4-alkylpiperazines
      suggests that the two nitrogen atoms of 1 are working in opposition to one
      another in terms of their sensitivity to steric bulk. The high binding affinity
      of the 1,4-diazabicyclo[4.3.0]nonanes 12 suggests that these may approximate the
      methyl and pyrrolidine ring conformations found in 1 when it is bound to the
      sigma receptor. Compound 12 exhibited a 4-fold enantioselectivity favoring (+)
      12. The synthesis of 6,7-dichloro-2-[[2-(1-pyrrolidinyl)ethyl]amino]tetralin (19)
      and its desmethyl derivative 20 permitted constraint of the 3,4-dichlorophenyl
      and N-methyl moieties of 1 into a gauche orientation. The binding data suggests
      that this conformation in 1 favors strong binding interaction at sigma-receptors.
      sigma-Receptor Ki's ranged from 0.55 nM for 1-[2-(3,4-dichlorophenyl)ethyl]-4-n
      butylpiperazine (7) to 654 nM for 16. Overall comparison of the results indicate
      that 1 is subject to considerable conformational freedom and suggests that the
      sigma receptor is not subject to rigid stereochemical restraints with 1. These
      results add to our earlier study where we restrained 1 using simple monocyclic
      heterocycles.

PMID- 8360876
TI  - A novel constrained reduced-amide inhibitor of HIV-1 protease derived from the
      sequential incorporation of gamma-turn mimetics into a model substrate.
AB  - C7 mimetics, designed to lock three amino acid residues of a peptide chain into a
      gamma-turn conformation, were introduced sequentially between the P3 to P2'
      positions of a model HIV-1 protease substrate I (resulting in compounds II-IV) to
      probe its conformational requirements in binding to HIV-1 protease. Of these,
      compound IIIa with the C7 mimetic replacing Asn-Tyr-Pro, corresponding to the P2
      through P1' positions of substrate, was found to be an inhibitor with a Ki of 147
      microM. Reduction of the amide bond in the C7 mimetic of IIIa resulted in a novel
      constrained reduced-amide mimetic VIa with a Ki of 430 nM. This corresponds to
      over a 300-fold improvement in inhibitory activity over the original C7 mimetic.
      The inhibitory activity of mimetic VIa was in addition found to be 44-fold better
      than a similar linear reduced-amide containing inhibitor V. The synthesis of
      these mimetics are described.

PMID- 8360877
TI  - Synthesis and anaerobic activity of novel 1-carba-1-dethiacephalosporins.
AB  - The synthesis and biological evaluation of novel 1-carba-1-dethiacephalosporins
      exhibiting activity against anaerobic pathogens are described. The nitrothiazole
      substituent was determined to be crucial to maintaining this activity. The
      pharmacokinetic parameters and initial toxicological profile of the lead compound
      are discussed.

PMID- 8360878
TI  - Quinoxaline N-oxide containing potent angiotensin II receptor antagonists:
      synthesis, biological properties, and structure-activity relationships.
AB  - A series of novel quinoxaline heterocycle containing angiotensin II receptor
      antagonist analogs were prepared. This heterocycle was coupled to the biphenyl
      moiety via an oxygen atom linker instead of a carbon atom. Many of these analogs
      exhibit very potent activity and long duration of effect. Interestingly, the N
      oxide quinoxaline analog was more potent than the nonoxidized quinoxaline as in
      the comparison of compounds 5 vs 30. In order to improve oral activity, the
      carboxylic acid function of these compounds was converted to the double ester.
      This change did result in an improvement in oral activity as represented by
      compound 44.

PMID- 8360879
TI  - Nonpeptide angiotensin II receptor antagonists. Synthesis and biological activity
      of potential prodrugs of benzimidazole-7-carboxylic acids.
AB  - In order to improve the oral bioavailability (BA) of 2-butyl-1-[[2'-(1H-tetrazol
      5-yl)biphenyl-4-yl]methyl]-1H-benzimid azole - 7-carboxylic acid (3: CV-11194)
      and 2-ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4- yl]methyl]-1H-benzimidazole-7
      carboxylic acid (4: CV-11974), novel angiotensin II (AII) receptor antagonists,
      chemical modification to yield prodrugs has been examined. After selective
      tritylation of the tetrazole rings in 3 and 4, treatment of N-tritylated
      benzimidazole-7-carboxylic acids (6, 7) with a variety of alkyl halides, followed
      by deprotection with hydrochloric acid, afforded esters of 3 and 4. Mainly 1
      (acyloxy)alkyl esters and 1-[(alkoxycarbonyl)oxy]alkyl esters, double ester
      derivatives, were synthesized. Their inhibitory effect on AII-induced pressor
      response in rats and oral BA were investigated. (Pivaloyloxy)methyl and (+/-)-1
      [[(cyclohexyloxy)-carbonyl]oxy]ethyl esters of 3 and 4 showed marked increases in
      oral bioavailability which significantly potentiated the inhibitory effect of the
      parent compounds on AII-induced pressor response. Among them, (+/-)-1
      [[(cyclohexyloxy)carbonyl]oxy]ethyl 2- ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4
      yl]methyl]-1H-benzimida zole- 7-carboxylate (10s, TCV-116) was selected as a
      candidate for clinical evaluation.

PMID- 8360880
TI  - Characterization of the interaction between human alpha-thrombin and methyl 3-(2
      methyl-1-oxopropoxy)[1]benzothieno[3,2-b]furan-2-carboxylate (LY806303) using
      electrospray mass spectrometry and tandem mass spectrometry.
AB  - Electrospray ionization mass spectrometry (ESI-MS) and tandem mass spectrometry
      (MS/MS) have been used for the first time to study the interaction of human alpha
      thrombin with methyl 3-(2-methyl-1-oxopropoxy)[1]benzothieno[3,2-b]furan-2-carbox
      ylate (LY806303; 1), a potent and selective inhibitor whose mechanism of action
      was never fully defined. Using ESI-MS, it is shown that inhibitor 1 covalently
      modifies human alpha-thrombin as evidenced by a shift in the molecular weight of
      the native protein by 72 Da, which is consistent with isobutyrylation (C4H7O; 71
      Da) of the enzyme at a single site. Tryptic digestion of the modified protein and
      tandem mass spectral analysis of isolated peptide fragments indicate that
      compound 1 acylates Ser-205 of the heavy chain of alpha-thrombin. Ser-205, along
      with His-43 and Asp-99 make up the catalytic triad within the active site of
      thrombin.

PMID- 8360881
TI  - Analogues of capsaicin with agonist activity as novel analgesic agents; structure
      activity studies. 1. The aromatic "A-region".
AB  - A series of analogues of capsaicin, the pungent principle of chilli peppers, was
      synthesized and tested in assays for capsaicin-like agonism in vitro. The results
      of these assays were compared with activities in an acute nociceptive model and a
      correlation was observed which established that the results of these in vitro
      assays were predictive of analgesia. Using a modular approach the structure
      activity profile of specific regions of capsaicin congeners was established using
      an in vitro assay measuring 45Ca2+ uptake into neonatal rat dorsal root ganglia
      neurones. Substituted benzylnonanamides 2a-z and N-octyl-substituted
      phenylacetamides 4a-v were made to test the requirements for activity in the
      aromatic "A-region" of the molecule. Compounds with the natural substitution
      pattern (2b and 4c) and the corresponding catechols (2i and 4g) were the most
      potent, although the catechols were less potent in vivo. Other substitution
      patterns have reduced activity. These results have established stringent
      structural requirements for capsaicin-like activity in this part of the molecule.

PMID- 8360882
TI  - Analogues of capsaicin with agonist activity as novel analgesic agents; structure
      activity studies. 2. The amide bond "B-region".
AB  - A series of compounds incorporating replacements for the amide bond "B-region"
      moiety of capsaicin have been synthesized, including vanillylamides and esters,
      homovanillic acid amides and esters, ureas, and thioureas. These have been tested
      in an in vitro assay for agonism (45Ca2+ influx into dorsal root ganglia
      neurones), which is predictive of analgesic activity, to investigate the
      requirements in this region of capsaicin for activity. N-(4-Hydroxy-3
      methoxybenzyl)-N'-octylthiourea (14a) emerged as the most potent analogue (EC50 =
      0.06 microM). An operational model based on multiple hydrogen-bonding
      interactions is proposed to explain the structure-activity profile observed. In
      combination with studies on the other regions of the capsaicin molecule these
      results describe a picture of the molecular interactions of capsaicin with its
      putative receptor.

PMID- 8360883
TI  - Analogues of capsaicin with agonist activity as novel analgesic agents; structure
      activity studies. 3. The hydrophobic side-chain "C-region".
AB  - Structural variants of the hydrophobic side chain ("C region") of the capsaicin
      molecule have been incorporated into a series of vanillylamides and
      vanillylthioureas. These compounds have been tested in an in vitro assay for
      agonism (45Ca2+ influx into dorsal root ganglia neurones), previously shown to be
      predictive of analgesic activity. The results of this study have established the
      requirement for a hydrophobic substituent of limited size (molar refractivity,
      MR, < 55) in order to obtain high potency. Combination of the information gained
      here about the "C-region" of the capsaicin molecule with the studies described in
      the preceding two papers provides a rational basis for the design of compounds of
      increased potency.

PMID- 8360884
TI  - Three-dimensional quantitative structure-activity relationship of angiotesin
      converting enzyme and thermolysin inhibitors. II. A comparison of CoMFA models
      incorporating molecular orbital fields and desolvation free energies based on
      active-analog and complementary-receptor-field alignment rules.
AB  - The utility of comparative molecular field analysis (CoMFA), a three-dimensional
      Quantitative Structure-Activity Relationship (3-D QSAR) paradigm, as a tool to
      aid in the development of predictive models has been previously addressed
      (Depriest, S.D. et al., J. Am. Chem. Soc. 1993, in press). Although predictive
      correlations were obtained for angiotensin-converting and thermolysin inhibitors,
      certain inadequacies of the CoMFA technique were noted. Primarily, CoMFA steric
      and electrostatic fields alone do not fully characterize the zinc-ligand
      interaction. Previously, this was partially rectified by the inclusion of
      indicator variables into the QSAR table to designate the class of zinc-binding
      ligand. Recent advances in molecular modeling technology have allowed us to
      further address this limitation of the preceding study. Using molecular orbital
      fields derived from semiempirical calculations as additional descriptors in the
      QSAR table, predictive correlations were produced based on CoMFA and molecular
      orbital fields alone--indicator variables no longer being necessary. Arbitrary
      information concerning the alignment of molecules under study within the active
      site introduces ambiguities into the CoMFA study. Crystallographic information
      detailing the binding mode of several thermolysin enzyme inhibitors has
      previously been used as a guide for the alignment of additional, noncrystallized,
      inhibitors. However, this process was complicated by the lack of parameters for
      zinc in the molecular mechanical force field. Therefore, zinc-ligand interactions
      were ignored during the standard minimization procedure. The use of field-fit
      minimization using complementary receptor fields as templates is presented as a
      possible solution to the problem. Predictive correlations were obtained from
      analyses based on this method of molecular alignment. The availability of
      crystallographic data for thermolysin enzyme-inhibitor complexes allowed for an
      alternate definition of the CoMFA region. Herein, promising results from analyses
      using actual receptor active-site atom probe atoms are presented.

PMID- 8360885
TI  - Synthesis of new 11 beta-substituted spirolactone derivatives. Relationship with
      affinity for mineralocorticoid and glucocorticoid receptors.
AB  - Various steroidal 17-spirolactones substituted in the 11 beta-position were
      synthesized to study the relationship between the nature of the 11 beta-arm and
      their affinity for cytosolic mineralocorticoid (MR) and glucocorticoid (GR)
      receptors prepared from adrenalectomized rabbit kidney or liver. One of them, the
      11 beta-allenyl-3-oxo-19-nor-17-pregna-4,9-diene-21,17- carbolactone derivative,
      exhibited the same affinity for MR as aldosterone and a 5-fold higher affinity
      than mespirenone. Its affinity for GR was found to be relatively low. As
      suggested by molecular modeling, the marked differences in mineralocorticoid
      receptor binding affinity could be related to the structural features induced by
      this 11 beta-allenic substituent.

PMID- 8360886
TI  - A mechanism-based inactivation study of neutral endopeptidase 24.11.
AB  - The mechanism-based inactivation of human neutral endopeptidase 24.11 (NEP) was
      studied with N-[(R)-2-benzyl-5-cyano-4-oxopentanoyl]-L-phenylalanine (1) and its
      peptidic analogue, N(-)[N-(cyanoacetyl)-L-phenylalanyl]-L-phenylalanine (2).
      While both these active-site-directed molecules inactivate NEP, the related
      angiotensin-converting enzyme (ACE) is only inactivated by compound 2 [Ghosh et
      al. J. Med. Chem. 1992, 35, 4175-4179]. The selectivity in inactivation was
      addressed further by a comparative study of the interaction of compounds 1 and 2
      with five other zinc proteases. The selective inactivation of NEP observed with
      the ketomethylene compound 1 suggests that the active site of NEP is less
      discriminating in its requirements for binding such substrate analogues as
      compared to ACE, a characteristic that may be exploited for designing specific
      mechanism-based inactivators for NEP. It is proposed that the inactivation is a
      result of NEP-catalyzed formation of ketenimine intermediates, which are
      subsequently trapped by an active-site nucleophile.

PMID- 8360887
TI  - Synthesis and kappa-opioid antagonist selectivity of a norbinaltorphimine
      congener. Identification of the address moiety required for kappa-antagonist
      activity.
AB  - Compound 2, which represents a structurally simplified congener of
      norbinaltorphimine 1a, was synthesized in order to evaluate the role of its
      second basic nitrogen in conferring kappa-opioid receptor antagonist selectivity.
      Congener 2 was found to be at least twice as selective as 1a as a kappa
      antagonist, while its N-carbobenzoxy derivative (3) was inactive at kappa
      receptors. This study establishes the importance of the second basic nitrogen of
      1a for kappa-receptor recognition. It is proposed that this basic group mimics
      the guanidinium moiety of Arg7, which may be the key kappa-address component of
      dynorphin.

PMID- 8360888
TI  - Application of a conformationally restricted Phe-Leu dipeptide mimetic to the
      design of a combined inhibitor of angiotensin I-converting enzyme and neutral
      endopeptidase 24.11.

PMID- 8360889
TI  - Egg surface ultrastructure of eight New World phlebotomine sand fly species
      (Diptera: Psychodidae).
AB  - The ultrastructure of the egg chorionic sculpturing of eight neotropical and fly
      species (Lutzomyia townsendi (Ortiz, 1959), L. youngi Feliciangeli & Murillo,
      1987, L. spinicrassa Osorno, Morales, Osorno, & Hoyos, 1969, L. evansi Nunez
      Tovar 1924, L. lichyi, Floch & Abonnenc, 1950, L. trinidadensis Newstead, 1922,
      L. venezuelensis Floch & Abonnenc, 1948, and L. olmeca bicolor, Fairchild &
      Theodor, 1971) was studied using scanning electron microscopy (SEM). A new
      pattern, ellipses bound by fine longitudinal ridges, was observed in L.
      venezuelensis. Moreover, the chorionic ultrastructure was useful for separating
      three isomorphic species (L. townsendi, L. youngi, and L. spinicrassa), of which
      L. youngi and L. spinicrassa are sympatric in some endemic foci of Tachira State,
      Venezuela.

PMID- 8360890
TI  - Hypersensitivity of horses in British Columbia to extracts of native and exotic
      species of Culicoides (Diptera: Ceratopogonidae).
AB  - Six horses from British Columbia severely affected by Culicoides
      hypersensitivity, a seasonal dermatitis caused by the bites of Culicoides spp.,
      were inoculated intradermally with extracts of six species or forms of Culicoides
      from British Columbia, United States, and Israel. Two native and four exotic
      species were thought to cause the disease in their own geographical area. The
      horses developed large welts within 20 min after injection of any of the six
      extracts, indicating an immediate (type I) reaction. The skin reactions caused by
      each extract peaked at or after 24 h, indicating an additional delayed (type IV)
      reaction. These reactions confirm that the reactions to the extracts were
      allergic in nature. The horses were physically irritated by each extract and
      developed transverse ridges in the injection area similar to those seen in
      natural cases of the disease, again indicating an allergic reaction. Previous
      studies showed that control horses injected with Culicoides extract showed only a
      small, short-term reaction, with no delayed component, no irritation, and no
      transverse ridge development, further indicating that the observed reactions were
      allergic in nature. The affected horses reacted to all extracts of Culicoides,
      despite the fact that they had not been previously exposed to most of the
      species, indicating that the allergen(s) was present in all the extracts tested.

PMID- 8360891
TI  - Anopheline mosquito (Diptera: Culicidae) ecology in relation to malaria
      transmission in the inner and outer terai of Nepal, 1987-1989.
AB  - The ecology of Anopheles mosquitoes in relation to malaria transmission was
      studied at sprayed and unsprayed villages and two unsprayed cattle sheds in the
      inner terai of Sindhuli District, Central Region, and at two unsprayed villages
      and one cattle shed in Kanchanpur, Far Western Region of Nepal, from August 1987
      to August 1989. Anopheles maculatus was the most abundant of 26 anopheline
      species collected in Sindhuli District; however, An. fluviatilis was collected
      most frequently at human bait and was infected most frequently with malaria
      sporozoites. Residual house spray controlled the indoor resting abundance of the
      endophilic resting species and protected the population from malaria during
      midsummer, but had less effect on exophilic resting species and those abundant
      after and before spray application during the fall and spring, respectively.
      Malaria at the unsprayed village was detected predominantly in adults of both
      sexes, perhaps because young children retired early and frequently slept indoors
      under bed nets during the early evening period of elevated anopheline host
      seeking activity. Malaria transmission was verified by the collection of
      sporozoite infected An. fluviatilis and An. maculatus during spring at cattle
      sheds in the forested Churia Hills and during the summer monsoon season within
      the unsprayed village. An. culicifacies was the most abundant of 12 anopheline
      species collected in Kanchanpur District. Few females of all species were
      collected at human bait positioned in or out of houses or had human positive
      blood meals; none were infected with sporozoites. Malaria incidence was higher in
      the study village positioned along the forest-rice field ecotone than in the
      cleared rice growing area.

PMID- 8360892
TI  - Biosynthesis of serine proteases in Lutzomyia anthophora (Diptera: Psychodidae).
AB  - Changes in the biosynthesis of serine proteases in adult Lutzomyia anthophora
      Addis were followed and compared with the larval and pupal stages. More
      chymotrypsinlike than trypsinlike enzyme was synthesized by 2-d-old and 3-d-old
      sugar-fed females and females that were fed blood 72 h earlier. A small increase
      in the amount of chymotrypsinlike enzyme occurred within the first 48 h after
      blood feeding, whereas trypsinlike enzyme activity increased rapidly after the
      blood meal and peaked at 72 h. [1,3-3H]DIP trypsinlike and chymotrypsinlike
      derivatives of sugar-fed and blood-fed females were compared using polyacrylamide
      gel electrophoresis.

PMID- 8360893
TI  - Bionomics of Anopheles quadrimaculatus and Culex erraticus (Diptera: Culicidae)
      in the Falls Lake basin, North Carolina: seasonal changes in abundance and
      gonotrophic status, and host-feeding patterns.
AB  - Larval and adult Anopheles quadrimaculatus Say (sensu lato) and Culex erraticus
      (Dyar & Knab) were collected at Falls of the Neuse Lake (Falls Lake) in North
      Carolina from May 1985 to December 1986. Adult mosquitoes were aspirated weekly
      from shelters in woodlands adjacent to larval sampling sites. An. quadrimaculatus
      and Cx. erraticus comprised > 95% of the total number of mosquitoes collected.
      An. quadrimaculatus adults exhibited vernal and autumnal peaks of abundance
      during both years. Cx. erraticus adults exhibited several peaks of abundance in
      summer and early fall of both years. An. quadrimaculatus initiated blood feeding
      in May and April 1985 and 1986, respectively. Only unfed females were found in
      late fall and winter. Cx. erraticus initiated blood feeding earlier than An.
      quadrimaculatus. In 1985, approximately 25% of the females in the first
      collection in May contained a blood meal, whereas in 1986, approximately 10% of
      the females in the first collection in April were blood fed. Females of both
      species ceased blood feeding in late fall. Larvae were sampled on a weekly basis
      from lake edge, flood plain, and creek edge habitats. Generally, An.
      quadrimaculatus larvae were most abundant in lake edge and flood plain habitats,
      whereas Cx. erraticus larvae were most abundant in the creek edge habitat. The
      population dynamics of An. quadrimaculatus were associated with seasonal changes
      in the level of Falls Lake. In 1985 and 1986, the level of Falls Lake gradually
      declined from May to mid-August until heavy rainfall caused a 1-m rise in lake
      level. Populations of An. quadrimaculatus larvae and adults increased
      significantly following the rise in the level of Falls Lake. In contrast, the
      abundance of larval and adult Cx. erraticus decreased with rising lake levels in
      late August. Water level management should be an effective method for controlling
      populations of An. quadrimaculatus but not for Cx. erraticus. Blood-fed
      mosquitoes were tested to identify bloodmeal hosts using both capillary
      precipitin and enzyme-linked immunosorbent assays. An. quadrimaculatus (n = 941)
      predominantly (99%) fed on mammals, principally white-tailed deer and horses. Cx.
      erraticus (n = 348) exhibited an opportunistic host-feeding pattern; blood meals
      were taken from mammalian (49%), reptile or amphibian (20%), and avian (31%)
      hosts.

PMID- 8360894
TI  - Life cycle of Leishmania major (Kinetoplastida: Trypanosomatidae) in the
      neotropical sand fly Lutzomyia longipalpis (Diptera: Psychodidae).
AB  - The development of Leishmania major Yakimoff & Schokhor in the New World sand fly
      Lutzomyia longipalpis (Lutz & Neiva) was examined by light and electron
      microscopy. In this unnatural host, parasites differentiated into 10 typical
      morphological forms, multiplied at three sites, migrated anteriorly and
      established in the foregut, and attached to gut surfaces. In the blood meal,
      amastigotes divided and transformed into two successive dividing, stumpy
      promastigote stages. Elongate nectomonad promastigotes developed from stumpy
      forms and subsequently rounded up in some flies into paramastigotes and
      opisthomastigotes. Differentiation into round opisthomastigotes and the apparent
      fusion of paramastigotes in the blood meal were novel observations in this study.
      Three nectomonad promastigotes--elongate, short, and metacyclic--were free
      swimming in the midgut lumen. Elongate nectomonad promastigotes were highly
      oriented in the midgut, with their flagella embedded between the epithelial
      microvilli. Short haptomonad promastigotes were the predominant form attached to
      the intima of the stomodeal valve, whereas pear-shaped haptomonad promastigotes
      and paramastigotes colonized surfaces of the esophagus and pharynx. Peripylarian
      attachment of promastigotes and paramastigotes in the pylorus, ileum, and colon
      was noted in 21% of flies, suggesting that suprapylarian leishmanias have not
      lost the ability to colonize the hindgut. L. longipalpis was a successful
      biological host for L. major, allowing complete development of the parasite.

PMID- 8360895
TI  - Antibody responses of BALB/c mice to salivary antigens of hematophagous black
      flies (Diptera: Simuliidae).
AB  - The humoral antibody responses to salivary antigens of Simulium vittatum
      Zetterstedt were investigated in a BALB/c mouse laboratory model. Production of
      antisera was stimulated by intraperitoneal immunization with salivary gland
      extract or by feeding flies directly on depilated mice. Antibody responses in
      these two groups of mice were compared by western blotting, thus characterizing
      "true" salivary immunogens present in salivary gland extract. Immunized mice
      developed IgG, IgM, and IgE antibodies which recognized several salivary gland
      components, ranging in molecular weight between 26 and 67 kDa. Sera from bitten
      mice recognized fewer antigens, indicating that some components of the salivary
      gland extract were poorly immunogenic or absent from the saliva secreted during
      blood feeding. Antisera raised against S. vittatum also were used to identify
      cross-reactive immunogens and allergens in salivary gland extracts from other New
      World simuliids (Simulium argus Williston, S. metallicum Bellardi, and S.
      ochraceum Walker). SDS-PAGE protein profiles indicated a high degree of
      similarity between salivary gland extract of S. vittatum and S. argus, and
      several cross-reacting antigens were identified by western blotting. In contrast,
      protein profiles of S. ochraceum and S. metallicum differed from the former
      species, both qualitatively and quantitatively. Antisera demonstrated a low
      degree of cross-reactivity against salivary gland extract of S. ochraceum,
      whereas no cross-reactivity was detected against S. metallicum. These
      observations were confirmed using a monoclonal antibody raised against S.
      vittatum salivary gland extract (designated SVSG.1.F10), which showed cross
      reactivity against S. argus but failed to recognize salivary gland components of
      either S. ochraceum or S. metallicum.

PMID- 8360896
TI  - Description of the immature stages of Ixodes (Pholeoixodes) baergi (Acari:
      Ixodidae), a parasite of cliff swallows in the United States.
AB  - The larva and nymph of Ixodes (Pholeoixodes) baergi Cooley & Kohls are described
      for the first time. This tick has been collected only in the United States on
      cliff swallows, Hirundo pyrrhonota, in their nests, or in adjacent habitats. To
      date, it has been reported from Arkansas, Colorado, Illinois, Oklahoma, and
      Texas. Brief notes on the synchronization of the life cycle of I. baergi with
      that of its host are included.

PMID- 8360897
TI  - Relative importance of bird species as hosts for immature Ixodes dammini (Acari:
      Ixodidae) in a suburban residential landscape of southern New York State.
AB  - Abundance of birds and their tick parasites were estimated in a residential
      community located in Westchester County, NY, where Lyme disease is endemic. In
      total, 36 bird species (416 captures) were collected, of which 25 species (69%)
      were parasitized by ticks. Ixodes dammini Spielman, Clifford, Piesman & Corwin
      composed 96.4% of the 1,067 ticks found on birds. The bird species most heavily
      parasitized was house wren, Troglodytes aedon Vieillot (11.1 Ixodes dammini per
      bird). Relative density estimates of birds, using fixed circle radius counts,
      revealed dominance by the American robin, Turdus migratorius L. (29.3%), followed
      by the common grackle, Quiscalus quiscula (L.) (9.3%). Bird density estimates
      were combined with tick abundance data to calculate an importance value for each
      bird species as a host for immature I. dammini. The American robin was most
      important, accounting for 72.7% of all larval I dammini found on birds, followed
      by the common grackle (8.2%) and the house wren (5.9%). Both the American robin
      and house wren are reservoir competent for the Lyme disease spirochete Borrelia
      burgdorferi Johnson, Schmid, Hyde, Steigerwalt & Brenner and therefore may
      contribute to the risk of Lyme disease for humans. During August when larvae were
      most prevalent, 39% of the American robins and 70% of the common grackles were
      observed on lawns. These species are probable contributors to nymphal I. dammini
      populations found on lawns.

PMID- 8360898
TI  - Removal of attached nymphs and adults of Ixodes ricinus (Acari: Ixodidae).
AB  - Chemical and mechanical methods of removing Ixodes ricinus (L.) attached to the
      skin of pigs and sheep were tested experimentally. Three frequently advocated
      chemical treatments (gasoline, fingernail polish, and methylated spirit) failed
      to induce self-detachment of the ticks within 30 min. Also, the success of the
      subsequent mechanical removal was not influenced by chemical treatment. Two
      methods of mechanical removal of the ticks also were compared: (1) pulling
      straight out with a blunt forceps and (2) rotation of the tick around its body
      axis, using a "Tick Solution" forceps (Instruments of Sweden, Stamford, CT).
      Pulling frequently resulted in the complete removal of the tick, but fragments of
      the mouthparts that remained in the skin were often quite large. In contrast, if
      the tick was removed by rotation without pulling, the tip of the hypostome
      usually broke off and remained in the skin, but this portion was generally quite
      small.

PMID- 8360899
TI  - Replacement times, storage, and vertebrate host source of blood for in vitro
      feeding of Haematobia irritans (Diptera: Muscidae) adults.
AB  - Studies were conducted to determine optimum replacement intervals, storage times,
      and vertebrate source of blood used to feed Haematobia irritans (L.) adults in
      vitro. Feeding success was measured by the total number of larvae produced per
      female during 10-d experimental periods which combined adult female survival, egg
      production, and egg hatch. The number of larvae per female was reduced
      significantly when blood replacement intervals were increased from 24 to 48 h;
      however, blood replacement intervals could be increased to 48 h without affecting
      larval production if the blood was agitated continuously. Maximum larval
      production was obtained when adult flies fed on whole, citrated bovine blood that
      had been stored at 3 degrees C for 2 wk; however, there was no difference in the
      number of larvae produced per female when adults were fed blood stored at -20
      degrees C for 2-52 wk. Significantly more larvae were produced when adults fed on
      citrated porcine blood than bovine or ovine blood.

PMID- 8360900
TI  - Spatial and temporal patterns of Ixodes scapularis (Acari: Ixodidae) in
      southeastern Connecticut.
AB  - The spatial distribution and abundance of host-seeking Ixodes scapularis Say
      (formerly I. dammini) were studied in 10 residential sites in woodlands during
      1989-1991. In total, 7,385 larval, 2,202 nymphal, 164 female, and 248 male I.
      scapularis were collected in Old Lyme, Lyme, East Haddam, and Chester, CT. The
      majority of host-seeking I. scapularis larvae (84.2%) and nymphs (73.5%) were
      collected within the woodland plots, whereas a large proportion of the adults
      were recovered from lawn (36.4%) and transitional areas between lawns and forest
      (20.9%). The majority (71.1% of 1,244) of all stages of I. scapularis on the lawn
      were recovered within 1 m of the lawn edge, particularly along woods and stone
      walls. In contrast, most of the I. scapularis (60.0% of 3,065) collected in the
      woods were > 3 m from any defined edge and ticks were recovered throughout the
      forested plots. The abundance of nymphs on the lawns (1.0-29.4 nymphs per ha per
      sample) and in the woods (17.3-271.5 nymphs per ha per sample) varied
      significantly among the 10 residences during June and July. The average rate of
      infection by Borrelia burgdorferi, the causal agent of Lyme disease, in the
      nymphs was 14.2, 14.1, and 15.5% for 1989, 1990, and 1991, respectively. The
      abundance of I. scapularis nymphs in the forest was significantly higher in June
      1991, than in 1989 or 1990. The risk of exposure to infected nymphs of I.
      scapularis varied spatially with the landscape and individual residence, and
      temporally.

PMID- 8360901
TI  - Mutation in the pla gene of Yersinia pestis alters the course of the plague
      bacillus-flea (Siphonaptera: Ceratophyllidae) interaction.
AB  - Yersinia pestis possesses a unique gene (pla) encoding coagulase and fibrinolysin
      which is implicated in the transmission of plague by fleas. This gene is encoded
      on the highly conserved but poorly characterized 'pesticin' plasmid pKYP1. The
      role of the pKYP1-encoded gene, pla, in plague transmission was addressed by
      feeding fleas on blood containing avirulent Y. pestis strain EV76-6 and three
      derivatives of this strain (K10-2, K10-3, and K10-5) carrying Tn801 insertions in
      pKYP1. One of these mutant strains, K10-5, contains an insertion within the pla
      gene that eliminates both coagulase and fibrinolysin activities, whereas strains
      K10-3 and K10-2 retain both pla-associated phenotypes. After feeding, it was
      found that flea mortality at 4 d after infection associated with strain K10-5
      (26%) was significantly lower than the mortality observed with other strains (53
      64%). These results suggest that expression of the pla gene product may
      contribute to the deleterious effects of plague bacilli on fleas that have been
      associated with flea blockage and plague transmission. This increased mortality
      is not caused simply by an increased bacterial load in fleas containing pla+
      bacteria because fleas ingesting pla+ strains contained no more bacteria by flea
      blot hybridization analysis than did those that ingested the pla- strain K10-5.
      It is anticipated that further work in this area will clarify the mechanism by
      which pla acts and will reveal additional genetic loci in the plague bacillus
      which are required for transmission by fleas.

PMID- 8360902
TI  - Detection of Anaplasma marginale (Rickettsiales: Anaplasmataceae) in hemolymph of
      Dermacentor andersoni (Acari: Ixodidae) with the polymerase chain reaction.
AB  - The polymerase chain reaction (PCR) was used to detect Anaplasma marginale in
      hemolymph collected from live Dermacentor andersoni Stiles ticks. Hemolymph was
      collected from severed legs of male and female ticks exposed to A. marginale as
      either nymphs or adults. Heat treatment was found to be the optimum method of
      hemolymph preparation for PCR. Hemolymph samples were collected and pooled from
      adult ticks exposed as nymphs on days 0-10 of feeding on a susceptible calf. For
      male and female ticks exposed as adults, samples were collected as ticks fed 7 d
      on an infected calf, while being held 9 d between feedings, and during a second
      feeding of 10 d (or to repletion) when they transmitted the parasite. Hemolymph
      samples were collected from uninfected ticks at the same times to serve as
      controls. Anaplasma marginale DNA was amplified with primers BAP-2 (5'
      GTATGGCACGTAGTCTTGGGATCA-3') and AL34S (5'-CAGCAGCAGCAAGACCTTCA-3'), which flank
      a 409-bp fragment of the A. marginale Florida isolate msp1 beta gene. Infected
      tick hemolymph was PCR-positive for A. marginale at all collection times,
      including unfed adults infected as nymphs and previously unexposed adults that
      fed on infected calves for only 1 d. The PCR-based assay of tick hemolymph proved
      to be a sensitive method for identification of infected ticks, potentially
      without killing them; it would be well suited for identification of laboratory-
      or field-infected ticks that could then be used for further studies. The primers
      used in this assay were also found specific when tested with species of 18
      different genera, and universal for 7 A. marginale isolates from diverse
      geographical areas of the United States.

PMID- 8360903
TI  - Detection of Anaplasma marginale (Rickettsiales: Anaplasmataceae) in secretagogue
      induced oral secretions of Dermacentor andersoni (Acari: Ixodidae) with the
      polymerase chain reaction.
AB  - The polymerase chain reaction (PCR) was used to detect Anaplasma marginale in
      secretagogue-induced oral secretions of male and female Dermacentor andersoni
      Stiles exposed as nymphs or adults by feeding on infected calves. A 409-bp DNA
      fragment derived from the A. marginale (Florida isolate) msp1 beta gene was
      amplified with oligonucleotide primers BAP-2 (5'-GTATGGCACGTAGTCTTGGGATCA-3') and
      AL34S (5'-CAGCAGCAGCAAGACCTTCA-3'). The target DNA was amplified in oral
      secretions of female ticks exposed to A. marginale as adults and stimulated to
      secrete by injection of dopamine. Conversely, A. marginale was detected in saliva
      from prefed female ticks exposed as nymphs only after stimulation with a
      combination of dopamine, gamma-aminobutyric acid, pilocarpine, and theophylline.
      Saliva from ticks exposed as nymphs and stimulated with ergot alkaloids did not
      contain the A. marginale target DNA. Saliva collected after 11 d of feeding from
      dopamine-stimulated male ticks contained A. marginale DNA. The results indicate
      that A. marginale is present in tick saliva and suggest that the parasite can be
      transmitted to cattle via saliva of feeding ixodid ticks. The variable appearance
      of A. marginale in saliva, regardless of the method used to induce salivation,
      suggests that transmission of A. marginale may be affected by the physiological
      state of the tick.

PMID- 8360904
TI  - Extension of the range of Dermacentor variabilis (Acari: Ixodidae) in
      Pennsylvania.
AB  - The American dog tick, Dermacentor variabilis (Say), until recently was recorded
      only from the southeastern and southwestern counties of Pennsylvania. Since 1968,
      this species has expanded its range and is reported from 63 of Pennsylvania's 67
      counties. This range extension is a matter of concern to the medical community
      and to physicians throughout Pennsylvania, particularly those with practices in
      areas where this tick was previously unknown and who may not be familiar with the
      symptoms of Rocky Mountain spotted fever.

PMID- 8360905
TI  - Association of ticks (Acari: Ixodoidea) with rodent burrows in northern Senegal.
AB  - Four species of ticks were retrieved from burrows of 64 multimammate rats,
      Mastomys erythroleucus (Temminck), 55-gerbils, Taterillus gracilis (Thomas) or T.
      pygargus (Cuvier), 13 Nile rats, Arvicanthis niloticus (DeMarest), and five
      Geoffroy's ground squirrels, Xerus erythropus (Geoffroy) from May 1987 through
      August 1988 at two study sites in northern Senegal. Ornithodoros sonrai Sautet &
      Witkowski were recovered from 95% (74/78) of burrows near Bandia and 6% (4/66) of
      burrows near Yonofere. Eight Hyalomma truncatum Koch, four Rhipicephalus guilhoni
      Morel & Vassiliades, and one R. sulcatus Neumann were recovered from 144 rodent
      burrows (nine tick-positive burrows) from both locations. No seasonal trend of
      tick abundance or activity was noted, nor was any pattern of burrow preference by
      ticks detected. Rodent burrows in either location appeared to be little used by
      ixodid ticks.

PMID- 8360906
TI  - Habitat overflow, a source of larval mortality for Aedes sierrensis (Diptera:
      Culicidae).
AB  - In laboratory and field tests, larvae of the western tree hole mosquito, Aedes
      sierrensis (Ludlow), were flushed by rainfall from both glass containers and
      natural tree holes. After 7 d and an accumulated rainfall of 7.9 cm (3.1 in),
      between 0 and 327 Ae. sierrensis immatures were recovered in collection devices
      placed below four natural tree holes. Habitat overflow affected all larval stages
      and may be an important, but overlooked, density-independent source of larval
      mortality for mosquitoes developing in some water-filled containers.

PMID- 8360907
TI  - Assimilation rates of different particulate foods for Simulium verecundum
      (Diptera: Simuliidae).
AB  - Particulate food assimilation rates for larvae of Simulium verecundum Stone &
      Jamnback were studied using three radiolabelled particulate foods: Navicula
      pelliculosa Breb. ex Kutz.) Hilse (a diatom), Scenedesmus quadricauda (Turp.)
      Breb. (a green alga), and field-collected, size-fractionated (< 3.0 microns)
      heterotrophic bacterioplankton. Assimilation was determined by radiolabelling the
      microorganisms followed by a 5-h laboratory feeding of each food to fifth- to
      seventh-instar S. verecundum. The bacterioplankton provided the highest
      assimilation efficiency (27.8%). N. pelliculosa produced higher assimilation
      efficiency estimates (19.5%) than did S. quadricauda (4.0%). The relationship
      between black fly abundance and the availability of quickly assimilated food is
      discussed.

PMID- 8360908
TI  - Influence of low temperature (-30 degrees C) on the different stages of the human
      allergy mite Dermatophagoides pteronyssinus (Acari: Epidermoptidae).
AB  - Effects of low temperature (-30 degrees C) on the different life stages of
      Dermatophagoides pteronyssinus (Trouessart) were studied. Humid cold air at -30
      degrees C killed all stages of mites except eggs after 10 min; after 35 min
      exposure, 20% of the eggs hatched after the incubation period. Dry, cold air at 
      30 degrees C killed 40% of all stages of mites except eggs after 4 min and 100%
      after 5 min; all eggs died after 1 min exposure.

PMID- 8360909
TI  - Seasonal variation in the capacity of the bank vole to infect larval ticks
      (Acari: Ixodidae) with the Lyme disease spirochete, Borrelia burgdorferi.
AB  - Seasonal variation in the capacity of bank voles, Clethrionomys glareolus
      (Schreber), to infect larval Ixodes ricinus (L.) ticks with Borrelia burgdorferi
      Johnson, Schmid, Hyde, Steigerwalt & Brenner was examined from May through
      October 1991 at Bogesund, near Stockholm in south-central Sweden. Although larval
      infestations of bank voles were greatest in June and July, nearly 70% of all
      larval ticks infected with spirochetes by bank voles at this site became infected
      during August and September. Seasonality of infectivity was related to the degree
      of earlier nymphal infestation on voles as well as to the age composition of the
      vole population. These factors may influence the infectivity of other rodent
      reservoirs of B. burgdorferi, both in Europe and North America. Moreover, in
      determining the reservoir potential of tick hosts, a host population's
      spirochetal infectivity should be determined for the entire period of larval
      infestation rather than just during the period of peak larval infestation.

PMID- 8360910
TI  - Adult emergence patterns in Musca autumnalis (Diptera: Muscidae).
AB  - Adult emergence patterns were investigated in four lines of face flies, Musca
      autumnalis De Geer, in a 16:8 (L:D) h photoperiod and corresponding 30:25 degrees
      C thermo-period. Most emergence occurred in a specific time interval ("emergence
      gate") that began at 2000 hours and continued until 1200 hours. A cohort of
      puparia completed emergence in two or three consecutive emergence gates. The four
      lines showed different median times and rates of emergence. Laboratory rearing
      seemed to select progeny of earlier median times and faster rates of emergence.
      F1 progeny of the two lines showed patterns of emergence intermediate between
      those of the parents. Female flies tended to eclose earlier than males in all
      lines.

PMID- 8360911
TI  - Egg yolk and bacteria growth medium for Musca domestica (Diptera: Muscidae).
AB  - Six preparations of egg yolk media inoculated with Escherichia coli (Migula) were
      evaluated as an in vitro growth system for immature house flies, Musca domestica
      L. Larval development, based on pupation and eclosion success, was normal on all
      media supplemented with E. coli, but few larvae survived without bacteria (4%).
      Pupation (72%) and eclosion (63%) were significantly higher on egg yolk media
      without mannitol than on media with mannitol or on blood agar controls.

PMID- 8360912
TI  - Ecological studies of Ixodes scapularis (Acari: Ixodidae) in central Mississippi:
      lateral movement of adult ticks.
AB  - Lateral movement by adult Ixodes scapularis Say was measured by two mark-release
      recapture studies in which ticks were collected by flagging, marked with tiny
      drops of model paint, released at predetermined spots within the study site, and
      subsequently recaptured during weekly sampling by flagging. In the first mark
      release-recapture experiment, 10/23 ticks were recaptured; all but 3 (2 collected
      at 3 m and 1 at 1 m) were collected at the release point. In the second
      experiment, 43/82 ticks were recaptured and all but 1 (which was collected 1 m
      from the release point) were collected within 0.5 m of their release point.
      Results of this study indicate that lateral movement by questing adult I.
      scapularis is minimal.

PMID- 8360913
TI  - Can flies stand in for humans?

PMID- 8360914
TI  - Methylated cytosine at Dcm (CCATGG) sites in Escherichia coli: possible function
      and evolutionary implications.
AB  - The frequency and distribution of methylated cytosine (5-MeC) at CCATGG (Dcm
      sites) in 49 E. coli DNA loci (207,530 bp) were determined. Principal
      observations of this analysis were: (1) Dcm frequency was higher than expected
      from random occurrence but lower than calculated with Markov chain analysis; (2)
      CCTGG sites were found more frequently in coding than in noncoding regions, while
      the opposite was true for CCAGG sites; (3) Dcm site distribution does not exhibit
      any identifiably regular pattern on the chromosome; (4) Dcm sites at oriC are
      probably not important for accurate initiation of DNA replication; (5) 5-MeC in
      codons was more frequently found in first than in second and third positions; (6)
      there are probably few genes in which the mutation rate is determined mainly by
      DNA methylation. It is proposed that the function of Dcm methylase is to protect
      chromosomal DNA from restriction-enzyme EcoRII. The Dcm methylation contribution
      to determine frequency of oligonucleotides, mutation rate, and recombination
      level, and thus evolution of the E. coli genome, could be interpreted as a
      consequence of the acquisition of this methylation.

PMID- 8360915
TI  - The higher fungus Protomyces inouyei has two group I introns in the 18S rRNA
      gene.
AB  - The nucleotide sequence of the small-subunit rRNA (18S rRNA) coding gene in the
      higher fungus Protomyces inouyei contains two group I introns. This is the first
      report of two group I introns in the 18S rRNA coding region. Based on the
      comparison of the two introns of Protomyces inouyei with those of the green alga
      Ankistrodesmus stipitatus, and the other two higher fungi Pneumocystis carinii
      and Ustilago maydis, the Protomyces introns are group I introns containing the
      highly conserved sequence elements P, Q, R, and S. Intron A of Protomyces inouyei
      is located in the same position as in Pneumocystis carinii while intron B shares
      the location with that in Ustilago maydis. The phylogenetic relationships
      strongly support horizontal transfer of these group I introns.

PMID- 8360916
TI  - Sequences related to the ox pancreatic ribonuclease coding region in the genomic
      DNA of mammalian species.
AB  - Mammalian pancreatic ribonucleases form a family of homologous proteins that has
      been extensively investigated. The primary structures of these enzymes were used
      to derive phylogenetic trees. These analyses indicate that the presence of three
      strictly homologous enzymes in the bovine species (the pancreatic, seminal, and
      cerebral ribonucleases) is due to gene duplication events which occurred during
      the evolution of ancestral ruminants. In this paper we present evidence that
      confirms this finding and that suggests an overall structural conservation of the
      putative ribonuclease genes in ruminant species. We could also demonstrate that
      the sequences related to ox ribonuclease coding regions present in genomic DNA of
      the giraffe species are the orthologues of the bovine genes encoding the three
      ribonucleases mentioned above.

PMID- 8360917
TI  - Transcribed heteroplasmic repeated sequences in the porcine mitochondrial DNA D
      loop region.
AB  - The mitochondrial D-loop region of the pig, Sus scrofa, was found to be several
      hundred base pairs larger than the corresponding region in cow, a related
      artiodactyl species, primarily because of an insertion containing the tandemly
      repeated sequence CGTGCGTACA. Porcine mitochondrial DNA from the tissue of a
      single animal exhibits a large population of length polymorphs, each member of
      which may have as few as 14 or as many as 29 of these repeat units. This
      intracellular variability may be due to the repeated and self-complementary
      properties of this sequence, which would favor mispairing and lead to replication
      slippage. The repeat domain is unusual in that symmetry properties suggest it may
      assume alternative conformations including cruciforms and left-handed (Z) DNA. It
      also appears to be the longest known, naturally occurring, alternating purine
      pyrimidine sequence. In order to understand the functional significance of this
      heteroplasmic domain that potentially disrupts a key regulatory region in the
      mitochondrial genome, RNA and DNA mapping studies were conducted which located
      this region between the H-strand replication origin and the putative L-strand
      transcriptional start site. H-strand RNA analysis demonstrated that this
      heteroplasmic region is transcribed and, therefore, that priming for H-strand DNA
      replication in mitochondria is independent of the primer RNA length or secondary
      structure.

PMID- 8360918
TI  - Heterogeneity in the concerted evolution process of a tandem satellite array in
      meadow mice (Microtus).
AB  - The evolutionary history of a 160-bp tandem satellite array, originally described
      from Microtus chrotorrhinus and called MSAT-160, was examined in related species
      of arvicolid rodents by sequence analyses, quantitative dot blotting, and
      Southern blotting. Results indicate that MSAT-160 is present in 12 of the 20
      species and subspecies of Microtus assayed, but not in species belonging to any
      of the eight other genera examined. DNA from each species containing MSAT-160 was
      digested with 12 restriction endonucleases and restriction patterns were obtained
      reflecting the variable extent of homogenization of any given variant in
      different species. For example, with MboI digestion, M. chrotorrhinus produced a
      type A ladder pattern where most monomers contain the restriction site, M.
      ochrogaster generated a type B pattern where most monomers lack the site, and M.
      agrestis yielded a pattern intermediate between the A and B types. Further, dot
      blotting revealed copy-number differences between species. These findings
      indicate that changes in the periodic structure and amount of satellite DNA have
      occurred since these species last shared a common ancestor. In addition, various
      species-specific patterns were documented, illustrating that mechanisms other
      than genome-wide homogenization, such as stochastic mutation, out-of-register
      crossing over, deletion, and random amplification also play a role in structuring
      tandem arrays. Stochastic mutation and homogenization rates in satellite DNA,
      levels of species diversity, and magnitudes of chromosomal divergence differ
      significantly in Microtus, Mus and Ctenomys, the three rodent lineages examined.

PMID- 8360919
TI  - Origin of glutaminyl-tRNA synthetase: an example of palimpsest?
AB  - Sequence data and evolutionary arguments suggest that a similarity may exist
      between the C-terminal end of glutaminyl-tRNA synthetase (GlnRS) and the
      catalytic domain of glutamine amidotransferases (GATs). If true, this would seem
      to imply that the amidation reaction of the Glut-tRNA(Gln) complex was the
      evolutionary precursor of the direct tRNA(Gln) aminoacylation pathway. Since the
      C-terminal end of GlnRS does not now have an important functional role, it can be
      concluded that this sequence contains vestiges that lead us to believe that it
      represents a palimpsest. This sequence still conserves the remains of the
      evolutionary transition: amidation reaction-->aminoacylation reaction. This may
      be important in deciding which mechanism gave origin to the genetic code
      organization. These observations, together with results obtained by Gatti and
      Tzagoloff [J. Mol. Biol. (1991) 218:557-568], lead to the hypothesis that the
      class I aminoacyl-tRNA synthetases (ARSs) may be homologous to the GATs of the
      trpG subfamily, while the class II ARSs may be homologous to the GATs of the purF
      subfamily. Overall, this seems to point to the existence of an intimate
      evolutionary link between the proteins involved in the primitive metabolism and
      aminoacyl-tRNA synthetases.

PMID- 8360920
TI  - Close phylogenetic relationship between Vestimentifera (tube worms) and Annelida
      revealed by the amino acid sequence of elongation factor-1 alpha.
AB  - To clarify the phylogenetic position of Vestimentifera (tube worms), 346-bp
      fragments of the elongation factor-1 alpha (EF-1 alpha) gene (939-1286 according
      to the numbering of the human gene) of a vestimentiferan, Lamellibrachia sp., a
      sternaspid polychaete, Sternaspis scutata, an earthworm, Pheretima sp., and a
      gastropod, Alviniconcha hessleri, were sequenced. From the amino acid sequences
      of these EF-1 alpha, and those of two other vertebrates and two arthropods,
      phylogenetic relationships were deduced by the maximum likelihood (ML) method, by
      which the phylogenetic tree can be inferred without assuming constancy of the
      molecular evolutionary rate. For the ML tree and all of seven alternative trees,
      whose log-likelihoods could not be discriminated from that of the ML tree by the
      criterion of the standard error, the vestimentiferan, the polychaete, and the
      oligochaete formed a clade, excluding the arthropods and the gastropod as
      outgroups. This result is convincing evidence that Vestimentifera are protostomes
      that are closely related to Annelida. The ML tree suggests that Vestimentifera
      are more closely related to Polychaeta than to Oligochaeta, though the data were
      not sufficient to discriminate these three groups at a significant level. From
      recent evidence such as morphological characteristics and molecular information,
      it may safely be said that vestimentiferans should be included in the Annelida
      provided this phylum contains polychaetes and oligochaetes.

PMID- 8360921
TI  - Molecular evolutionary analysis based on the amino acid sequence of catalase.
AB  - Heme-containing catalase sequences from 20 different organisms representing
      prokaryotes, fungi, animals, and plants have been compiled for phylogenetic
      reconstruction. Phylogenies based on distance and parsimony analysis show that
      fungal and animal catalases can be derived from one ancestor, whereas bacterial
      catalases fail to form a monophyletic group. Plant catalases appear to form a
      second class of catalases that arose independently from a possible prokaryotic
      ancestor.

PMID- 8360922
TI  - Man's place in Hominoidea revealed by mitochondrial DNA genealogy.

PMID- 8360923
TI  - Clinical chemoprevention: developing a cancer prevention strategy.

PMID- 8360924
TI  - Dietary supplements reduce cancer deaths in China.

PMID- 8360925
TI  - European tamoxifen studies moving ahead.

PMID- 8360926
TI  - NCI expert panel issues summary report on excise tax on cigarettes.

PMID- 8360927
TI  - Regulatory approval and technological advances raise hopes for photodynamic
      therapy.

PMID- 8360928
TI  - Man's best friend may be companion in cancer research.

PMID- 8360929
TI  - Efficacy and cost-effectiveness of cancer treatment: rational allocation of
      resources based on decision analysis.

PMID- 8360930
TI  - Natural killer cells and bone marrow transplantation.
AB  - Bone marrow transplantation is currently used in the treatment of a variety of
      neoplastic and nonneoplastic diseases. However, significant obstacles still limit
      the efficacy of this procedure. These include the occurrence of graft-versus-host
      disease, the failure of the marrow to engraft, the susceptibility of patients to
      opportunistic infections during the period of immunodeficiency after
      transplantation before full recovery of immune function, and finally, the
      recurrence of the cancer. Natural killer (NK) cells are lymphoid cells
      responsible for mediating a variety of immunologic and homeostatic functions.
      Initially described almost 20 years ago, the full range of functions carried out
      by these enigmatic cells continues to unfold. NK cells may be both beneficial and
      deleterious in bone marrow transplantation, depending on their genotype and
      activation status. Resting host-derived NK cells appear capable of mediating
      resistance to both autologous and allogeneic bone marrow cell grafts. At the
      other end of the spectrum, the transfer of activated NK cells of donor type
      appears to produce multiple beneficial effects during both syngeneic and
      allogeneic bone marrow transplantation. Here, we review and attempt to reconcile
      the literature concerning the basic biology of NK cells and their effects on
      hematopoiesis, both in vitro and in vivo. We also discuss the current issues in
      bone marrow transplantation and the potential role NK cells may play in
      determining the outcome of the marrow graft, the occurrence of graft-versus-host
      disease, and the generation of a graft-versus-tumor response when bone marrow
      transplantation is used for the treatment of cancer.

PMID- 8360932
TI  - Nutrition intervention trials in Linxian, China: multiple vitamin/mineral
      supplementation, cancer incidence, and disease-specific mortality among adults
      with esophageal dysplasia.
AB  - BACKGROUND: A number of vitamins and minerals have been shown to influence
      carcinogenesis in experimental animals. In humans, epidemiologic evidence
      suggests that intake of fruits and vegetables may reduce risk of esophageal and
      other cancers. Vitamins and minerals in these foods may contribute to the reduced
      cancer risk. The people of Linxian, China, have persistently low intake of
      multiple nutrients and exhibit one of the world's highest rates of
      esophageal/gastric cardia cancer, with an exceptionally high risk of esophageal
      dysplasia. PURPOSE: To determine whether supplementation with multiple vitamins
      and minerals may reduce esophageal/gastric cardia cancer among persons with
      esophageal dysplasia, we conducted a 6-year prospective intervention trial in
      Linxian. METHODS: Mortality and cancer incidence were ascertained from May 1985
      through May 1991 for 3318 persons with cytologic evidence of esophageal dysplasia
      who were randomly assigned to receive, throughout that period, daily
      supplementation with 14 vitamins and 12 minerals or placebo. Doses were typically
      two to three times U.S. Recommended Daily Allowances. Compliance was assessed by
      counting unused pills monthly for all trial participants and by assaying nutrient
      levels in blood collected from samples of individuals randomly selected without
      replacement every 3 months throughout the trial. Cancers were identified through
      routine surveillance and by special cytology and endoscopy screenings after 2 1/2
      years and 6 years. RESULTS: A total of 324 deaths occurred during the 6-year
      intervention period; 167 occurred in the control (placebo) group and 157 occurred
      in the supplement group. Cancer was the leading cause of death (54% of all
      deaths); 18% were due to cerebrovascular diseases and 29% to other causes.
      Cumulative esophageal/gastric cardia death rates were 8% lower (relative risk
      [RR] = 0.92; 95% confidence interval [CI] = 0.67-1.28) among individuals
      receiving supplements rather than placebo, a nonsignificant (P > .10) difference.
      Risk of total mortality was 7% lower (RR = 0.93; 95% CI = 0.75-1.16; P > .10),
      total cancer 4% lower (RR = 0.96; 95% CI = 0.71-1.29; P > .10), cerebrovascular
      disease 38% lower (RR = 0.62; 95% CI = 0.37-1.06; P = .08), and other diseases
      12% higher (RR = 1.12; 95% CI = 0.74-1.69; P > .10) among the treated group.
      Cumulative cancer incidence rates were nearly the same in the two groups.
      CONCLUSIONS: No substantial short-term beneficial effect on incidence or
      mortality for this type of cancer occurred following daily supplementation with
      multiple vitamins and minerals among adults with precancerous lesions of the
      esophagus. IMPLICATIONS: Although no statistically significant short-term
      benefits were observed, longer follow-up should be more informative about the
      effectiveness of this 6-year supplementation on cancer and other diseases among
      individuals with esophageal dysplasia.

PMID- 8360931
TI  - Nutrition intervention trials in Linxian, China: supplementation with specific
      vitamin/mineral combinations, cancer incidence, and disease-specific mortality in
      the general population.
AB  - BACKGROUND: Epidemiologic evidence indicates that diets high in fruits and
      vegetables are associated with a reduced risk of several cancers, including
      cancers of the esophagus and stomach. Vitamins and minerals in these foods may
      contribute to the reduced cancer risk. The people of Linxian County, China, have
      one of the world's highest rates of esophageal/gastric cardia cancer and a
      persistently low intake of several micronutrients. PURPOSE: We sought to
      determine if dietary supplementation with specific vitamins and minerals can
      lower mortality from or incidence of cancer as well as mortality from other
      diseases in Linxian. METHODS: Individuals of ages 40-69 were recruited in 1985
      from four Linxian communes. Mortality and cancer incidence during March 1986-May
      1991 were ascertained for 29,584 adults who received daily vitamin and mineral
      supplementation throughout this period. The subjects were randomly assigned to
      intervention groups according to a one-half replicate of a 2(4) factorial
      experimental design. This design enabled testing for the effects of four
      combinations of nutrients: (A) retinol and zinc; (B) riboflavin and niacin; (C)
      vitamin C and molybdenum; and (D) beta carotene, vitamin E, and selenium. Doses
      ranged from one to two times U.S. Recommended Daily Allowances. RESULTS: A total
      of 2127 deaths occurred among trial participants during the intervention period.
      Cancer was the leading cause of death, with 32% of all deaths due to esophageal
      or stomach cancer, followed by cerebrovascular disease (25%). Significantly (P =
      .03) lower total mortality (relative risk [RR] = 0.91; 95% confidence interval
      [CI] = 0.84-0.99) occurred among those receiving supplementation with beta
      carotene, vitamin E, and selenium. The reduction was mainly due to lower cancer
      rates (RR = 0.87; 95% CI = 0.75-1.00), especially stomach cancer (RR = 0.79; 95%
      CI = 0.64-0.99), with the reduced risk beginning to arise about 1-2 years after
      the start of supplementation with these vitamins and minerals. No significant
      effects on mortality rates from all causes were found for supplementation with
      retinol and zinc, riboflavin and niacin, or vitamin C and molybdenum. Patterns of
      cancer incidence, on the basis of 1298 cases, generally resembled those for
      cancer mortality. CONCLUSIONS: The findings indicate that vitamin and mineral
      supplementation of the diet of Linxian adults, particularly with the combination
      of beta carotene, vitamin E, and selenium, may effect a reduction in cancer risk
      in this population. IMPLICATIONS: The results on their own are not definitive,
      but the promising findings should stimulate further research to clarify the
      potential benefits of micronutrient supplements.

PMID- 8360933
TI  - Radiopharmaceutical therapy of 5T33 murine myeloma by sequential treatment with
      samarium-153 ethylenediaminetetramethylene phosphonate, melphalan, and bone
      marrow transplantation.
AB  - BACKGROUND: Total-body irradiation, followed by hematopoietic system rescue by
      bone marrow transplantation (BMT), has been found to improve the response of
      patients with multiple myeloma to treatment with melphalan. The problems of
      nonhematopoietic toxicity from whole-body irradiation might be circumvented by
      using a bone-seeking radiopharmaceutical, such as samarium-153
      ethylenediaminetetramethylene phosphonate (153Sm-EDTMP), to ablate the bone
      marrow. PURPOSE: A mouse model system for multiple myeloma was used to evaluate
      the potential therapeutic efficacy of sequential therapy with 153Sm-EDTMP,
      melphalan, and BMT. METHODS: Female C57BL/KaLwRij mice were inoculated with 8 x
      10(5) 5T33 murine myeloma cells. Treatment protocols were begun 3 or 10 days
      later, when the myeloma was either confined to bone marrow or disseminated in
      liver, spleen, and lymph nodes, simulating human multiple myeloma. 153Sm, a
      potent beta particle-emitting radioisotope of short half-life (46.7 hours), was
      linked to the bone-seeking chelate EDTMP. Animals in the first treatment group
      were each given 22.5 MBq 153Sm-EDTMP via the jugular vein (day 3 or 10), followed
      by 18.5 mg/kg melphalan (maximum tolerated dose) given intraperitoneally 5 days
      later (day 8 or 15) and syngeneic BMT another 2 days later (day 10 or 17).
      Survival in groups of six to 10 animals for each time series was compared with
      that in mice left untreated (control cohort), in mice treated with 153Sm-EDTMP
      alone (day 3 or 10), or in mice treated with melphalan alone (day 8 or 15). The
      hematopoietic systems of animals in the latter two treatment groups recovered
      full function, obviating the necessity of BMT. The end point was onset of
      paraparesis, at which time the animals were immediately killed by carbon dioxide
      asphyxiation. RESULTS: Median survival in untreated control animals was 23 days
      in those with localized disease and 24 days in those with disseminated myeloma.
      Treatment with 153Sm-EDTMP alone improved survival to a median of 29 days when
      commenced on day 3 and 30 days when begun on day 10. Melphalan treatment alone
      improved the median survival to 31 days for animals with localized myeloma and 34
      days in animals with disseminated disease. Additional improvement in survival to
      a median of 42 days was achieved in animals treated 3 days after tumor
      inoculation with sequential 153Sm-EDTMP, melphalan, and BMT; median survival was
      40 days using this regimen in animals with disseminated myeloma. CONCLUSIONS:
      Animals in all three treatment protocols survived longer than those left
      untreated after inoculation with myeloma cells (P < .001). Sequential treatment
      with 153Sm-EDTMP, melphalan, and BMT was significantly more effective than single
      agent treatment (P < .01). No evidence of radiotoxicity was detected in
      nonhematopoietic organs. IMPLICATIONS: The survival advantage conferred by our
      sequential treatment protocol suggests its potential clinical usefulness in the
      treatment of multiple myeloma and other hematologic malignancies in humans.

PMID- 8360934
TI  - Spectrum of mutation and frequency of allelic deletion of the p53 gene in ovarian
      cancer.
AB  - BACKGROUND: The p53 gene encodes a nuclear phosphoprotein present in low levels
      in normal human cells. The wild-type form of this protein functions to restrain
      inappropriate cellular proliferation. Approximately one half of human epithelial
      ovarian cancers have mutations in the p53 gene and overexpress the mutant protein
      product. Deletion of one allele of the p53 gene also frequently occurs in these
      cancers. PURPOSE: We sought to define the spectrum of mutations in the p53 gene
      in epithelial ovarian cancer with respect to both the specific codons involved
      and the type of mutations observed. We also examined the frequency of allelic
      deletion of the p53 gene in cancers containing p53 gene mutations. METHODS:
      Tissue samples from the epithelial ovarian cancers of 62 patients were obtained
      during initial laparotomy. Histologic examination was done to ensure that the
      experimental samples used in this study contained more than 75% cancer cells.
      Total RNA was extracted from these samples and separately from matched control
      noncancerous regions of the surgical specimen or white blood cells. The purified
      RNAs were reverse transcribed to generate cDNA copies of exons 4-10 of the p53
      gene. Two rounds of polymerase chain reaction (PCR) were conducted to produce
      enough template for DNA sequence analysis of the regions of interest within the
      p53 gene. Dideoxy sequencing of at least two independent productions of each
      amplified DNA template was done to confirm the validity of the mutations found.
      Allelic deletions were identified by PCR and gel electrophoretic techniques to
      examine three polymorphisms within the p53 gene in cancer-normal DNA pairs.
      RESULTS: We identified 45 mutations in exons 5-8 of the p53 gene, where mutations
      frequently have been found in other cancer types. An additional mutation was
      identified in exon 4. Overall, 72% of the mutations were transitions, 24%
      transversions, and 4% microdeletions. Allelic deletion of the other p53 allele
      was seen in 67% of ovarian cancers in which a p53 mutation was present. Germ-line
      p53 mutations were not found in any patients whose cancers had p53 mutations.
      CONCLUSIONS AND IMPLICATIONS: Like p53 mutations in other types of human cancers,
      those in epithelial ovarian cancers are diverse and occur frequently in exons 5
      8. The predominance of transition mutations suggests that p53 mutations in
      ovarian cancer arise because of spontaneous errors in DNA synthesis and repair
      rather than the direct interaction of carcinogens with DNA. These molecular data
      are consistent with data from epidemiologic studies that have failed to
      demonstrate a convincing relationship between exposure to environmental
      carcinogens and the development of ovarian cancer.

PMID- 8360935
TI  - Suramin toxicity and efficacy in agnogenic myeloid metaplasia.

PMID- 8360936
TI  - Re: Oral cavity cancer in non-users of tobacco.

PMID- 8360937
TI  - Re: Oral contraceptives and breast cancer.

PMID- 8360938
TI  - Exposure of rats to hyperoxia: alteration of lavagate parameters and macrophage
      function.
AB  - Exposure of rats to hyperoxia (100% oxygen for 64 h) resulted in striking
      alterations in the properties of samples obtained by bronchoalveolar lavage. The
      yield of neutrophils, lymphocytes, and red blood cells was increased, while the
      number of harvested alveolar macrophages decreased. The acellular lavage fluid
      level of protein was elevated, indicating lung damage. However, acellular
      phospholipid levels were unchanged. The ability of alveolar macrophages to
      produce reactive forms of oxygen in response to zymosan was significantly
      decreased by oxygen exposure. This impaired function was not fully explained by a
      decrease in viability of these phagocytes. In contrast, stimulant-induced
      chemiluminescence was elevated after hyperoxia. This rise was not due to a change
      in cellular antioxidant levels or to a discernible increase in arachidonic acid
      metabolites. However, it was associated with increased cellular lipid
      peroxidation.

PMID- 8360939
TI  - Role of purified IgG1 in pulmonary hypersensitivity responses of the guinea pig.
AB  - Guinea pigs have been used extensively to model pulmonary hypersensitivity
      responses. Although guinea pigs produce mainly immunoglobulin G1 (IgG1)
      antibodies and humans produce IgE, both immunoglobulin classes have been shown to
      be regulated similarly. We used an established guinea pig model to examine the
      role of IgG1 in immediate- and late-onset pulmonary hypersensitivity responses.
      IgG1 was purified from the serum of ovalbumin-immunized animals and shown to be
      free of IgE. It was transferred into naive recipients in doses quantified on the
      basis of its biological activity as measured in the passive cutaneous anaphylaxis
      (PCA) assay. Inhalation challenge of recipient animals 24 h later with an
      ovalbumin aerosol produced immediate-onset airway constrictive responses, with
      response dependent upon the quantity of antibody passively administered. None of
      the recipient animals displayed a late-phase response previously shown to be
      characterized by increased breathing frequency, airflow limitation during
      exhalation, and mild fever. However, pulmonary eosinophilia, measured at 24 h
      postinhalation challenge, was detected with the severity of the eosinophilia
      dependent upon the quantity of IgG1 administered. The results indicated that
      immediate-, but not late-onset, responses were associated with IgG1 antibody.
      Occurrence of late-onset pulmonary eosinophilia indicated that eosinophilic
      inflammation, a recognized characteristic of hypersensitivity responses, was
      related to antigen-specific IgG1 antibody.

PMID- 8360940
TI  - Groundwater pesticides: interactive effects of low concentrations of carbamates
      aldicarb and methomyl and the triazine metribuzin on thyroxine and somatotropin
      levels in white rats.
AB  - Using full-factorial design experiments for three variables at two levels each
      and center replicates, we examined the effects of common agricultural carbamate
      insecticides, aldicarb and methomyl, and a triazine herbicide, metribuzin, on
      hormone levels in Sprague-Dawley rats. Fifty-four female rats were sampled at 2
      and 6 wk during a 6-wk exposure to individual chemicals or to combinations of
      them. Some main effects and interaction effects were significant. For example,
      rats treated with the herbicide (metribuzin) were hyperthyroid. The interactions
      of all three chemicals also significantly increased thyroxine levels. One year
      later, we repeated these experiments for 16 wk using 54 male rats; the results
      were very similar. Metribuzin alone significantly increased thyroxine throughout
      the second study (at 7, 13, and 16 wk). Somatotropin levels were significantly
      altered after 13 wk of exposure. The same concentrations and mixtures of these
      three pesticides have now been shown to be implicated in learning impairment and
      other neurological functions, immune parameter changes, and endocrine changes.
      These findings support the concept of the interconnectedness of the nervous,
      endocrine, and immune systems and raise the likelihood of impacts on all three
      systems if one is shown to be affected. Development, growth, and reproduction all
      depend on the proper function of these three systems. These results strongly
      suggest the need to reassess currently allowed "safe" levels of chemicals based
      on adult dosages that are accepted in ground-water and in our food supplies.

PMID- 8360941
TI  - Correlation between tissue and plasma concentrations of oxytetracycline in veal
      calves.
AB  - Mercer et al. (1977) proposed a three-phase experimental design to establish
      withdrawal times, based on plasma pharmacokinetics. This approach was the premise
      of a study in which plasma pharmacokinetics and tissue depletion data of
      oxytetracycline after intramuscular administration were correlated. Correlations
      between estimated and measured concentrations were shown to be significant for
      kidney tissue (r = .9236, p < .001), liver tissue (r = .9302, p < .01) as well as
      for muscle tissue (r = .9045, p < .001). The data presented support the
      pharmacokinetic approach as proposed by Mercer et al. (1977) and demonstrate that
      tissue elimination rates correlate highly with elimination rates in plasma.
      Although generalizations must be applied with caution, this article shows that
      when certain criteria are fulfilled, plasma pharmacokinetics can reliably predict
      tissue withdrawal times.

PMID- 8360942
TI  - Porphyrin profiles in the nestling European starling (Sturnus vulgaris): a
      potential biomarker of field contaminant exposure.
AB  - Porphyrin patterns in avian and mammalian tissues and/or excreta have been
      proposed as qualitative and quantitative biomarkers of exposure to
      polyhalogenated hydrocarbons, heavy metals, and other environmental contaminants.
      However, no widely distributed terrestrial species has been characterized as a
      suitable model in which to assess porphyrin profiles in the evaluation of
      environmental contaminant exposure. The European starling, whose nests can be
      readily established and manipulated on contaminated sites, has many qualities
      that accommodate controlled field research and that suggest its suitability for
      such assessments. In the present studies, we measured the total and individual
      porphyrin concentrations in liver, kidney, and fecal-urate excreta of nestling
      starlings from a noncontaminated field site from day of hatch through d 17 of the
      nestling period. Total as well as individual 8-, 7-, 6-, 5-, 4-, and 2-carboxyl
      porphyrin concentrations in liver, kidney, and fecal-urate excreta were readily
      detectable by high-performance liquid chromatography (HPLC) spectrofluorometric
      techniques and displayed tissue-specific patterns throughout the developmental
      period. Liver and fecal-urate porphyrin patterns were established by d 4
      subsequent to hatch and remained constant through d 17 of development, whereas
      renal porphyrin profiles were constant throughout the entire developmental
      period. In controlled field studies, nestling starlings were treated with either
      HgCl2 or hexachlorobenzene (HCB), and tissue and excreta porphyrins were
      extracted and evaluated. The findings suggest that the nestling starling may
      serve as a suitable model species in which to monitor the effects of field
      contaminant exposure to wildlife based on chemical-induced changes in tissue or
      excreta porphyrin levels.

PMID- 8360943
TI  - Comparative cytotoxic responses of cultured avian and rodent aortic smooth muscle
      cells to allylamine.
AB  - The present studies were designed to compare the acute cytotoxic responses of
      cultured avian and rodent aortic smooth muscle cells (SMCs) to allylamine (AAM),
      a selective vascular toxin. SMCs were isolated from male Japanese quail or
      Sprague-Dawley rats and established in culture by standard procedures. Cellular
      glutathione (GSH) content and lactate dehydrogenase (LDH) leakage were used as
      indices of cytotoxicity. Exposure of avian and rodent SMCs in primary culture to
      AAM (0.2-200 microM) for 4 h was associated with a significant reduction in
      cellular GSH and enzyme leakage in cultures of both cell types. Increased
      exposure time to 24 h further depleted cellular GSH levels and enhanced the
      leakage of LDH in primary cultures of avian SMCs. In contrast, enhanced LDH
      leakage occurred without further GSH depletion in primary cultures of rodent SMCs
      upon exposure to AAM for 24 h. Removal of serum did not modulate the cytotoxic
      response profile of primary cultures of avian SMCs treated with 200 microM AAM,
      but was associated with marked elevation in cellular GSH levels and significant
      LDH leakage in rodent SMC cultures. The cytotoxic responses to 0.2-200 microM AAM
      in secondary cultures of avian SMCs were comparable to those observed in primary
      culture. In contrast, AAM-induced enzyme leakage did not consistently correlate
      with changes in GSH content in subcultured rodent SMCs. Challenge with 200 microM
      acrolein (ACR) for 4 h reduced the GSH content in avian, but not rodent,
      subcultures of SMCs. However, significant LDH leakage occurred in subcultures of
      both cell types upon exposure to ACR. Although hydrogen peroxide (H2O2) did not
      modulate GSH levels in avian or rodent cultures, leakage of LDH was observed in
      rat SMCs challenged with 200 microM H2O2. Removal of serum did not alter the
      cytotoxic responses of avian subcultures to 200 microM AAM for 24 h, but fully
      prevented cytotoxicity in rodent subcultures. These data suggest that potentially
      significant variations in the sequence of events leading to injury may exist
      between quail and rat aortic SMCs. These differences may contribute to the
      enhanced avian susceptibility to AAM-induced aortic injury in vivo.

PMID- 8360944
TI  - Intrarenal distribution of inorganic mercury and albumin after coadministration.
AB  - The renal disposition and the intrarenal distribution of albumin and mercury were
      studied simultaneously in rats co-injected with a 0.5-mumol/kg dose of albumin
      and a 0.25-mumol/kg dose of inorganic mercury at 2, 5, 30, and 180 min after
      injection. These studies were carried out to test the hypothesis that one of the
      mechanisms involved in the renal tubular uptake of inorganic mercury is
      cotransport with albumin. By the end of the first 2 min after injection, the
      ratio of inorganic mercury to albumin in the renal cortex and outer stripe of the
      outer medulla was approximately 2.6 and 1.6, respectively. Both the cortex and
      outer stripe contain segments of the proximal tubule, and it is these segments
      that have been shown to be principally involved in the renal tubular uptake of
      both albumin and inorganic mercury. The ratio increased slightly in these two
      zones after 5 and 20 min after injection. These data demonstrate that there is a
      relatively close relationship in the renal content of inorganic mercury and
      albumin during the early minutes after coinjection of inorganic mercury and
      albumin. However, the ratios are significantly greater than the ratio of
      inorganic mercury to albumin in the injection solution, which was 0.5. After 180
      min following co-injection, the ratio increased to about 38 in the cortex and 15
      in the outer stripe. This increase in the ratio is probably related to the
      metabolism of albumin. Based on the ratios of inorganic mercury to albumin in the
      renal cortex and outer stripe of the outer medulla, it appears that some proximal
      tubular uptake of inorganic mercury occurs by mechanisms other than endocytotic
      cotransport of inorganic mercury with albumin. However, since the ratios were
      small during the early times after injection, cotransport of inorganic mercury
      with albumin cannot be excluded as one of the mechanisms involved in the proximal
      tubular uptake of inorganic mercury.

PMID- 8360945
TI  - Prednisolone enhances myogenesis and dystrophin-related protein in skeletal
      muscle cell cultures from mdx mouse.
AB  - The differentiation of skeletal muscle cells from mdx mice which lack dystrophin
      expression was examined after glucocorticoid treatment, namely alpha
      methylprednisolone (PDN). Primary skeletal muscle cell cultures were established
      from newborn mdx, congenic C57BL/10, and allogenic BALB/C mice. We show that PDN
      promotes the myogenesis of both mdx- and control mice-derived cultures as
      determined by 1) the number of myotubes, 2) acetylcholine receptors, and 3)
      dystrophin and dystrophin-related protein levels. These results support the
      hypothesis that PDN could enhance the myogenesis of satellite cells and increase
      dystrophin-related protein expression in DMD treated patients.

PMID- 8360946
TI  - Evidence for activation of astrocytes via reactive microglial cells following
      hypoglossal nerve transection.
AB  - Following peripheral nerve injury, resident microglial cells proliferate and
      astrocytes undergo hypertrophy, as evidenced, e.g., by an increase in the levels
      of glial fibrillary acidic protein (GFAP). In a previous study we have shown that
      infusion of cytosine arabinoside (ARA-C) into the rat brain blocks the axotomy
      induced proliferation of microglial cells. This experimental approach has been
      used in the present study in order to explore the issue of whether the reactive
      microglial cells are mediators of the increased GFAP expression in the
      hypoglossal nucleus of the rat following axotomy. Quantitative analysis of
      sections processed for immunocytochemistry or in situ hybridization demonstrated
      a marked increase in GFAP-like immunoreactivity and GFAP-mRNA, respectively, in
      the ipsilateral hypoglossal nucleus 4 and 7 days after axotomy in control
      experiments. These increases failed to occur in axotomized animals treated with
      ARA-C. Therefore, our data are compatible with the hypothesis that activation of
      astrocytes following axotomy as measured by increased expression of GFAP and its
      mRNA is induced secondarily to the microglial response.

PMID- 8360947
TI  - Identification of a collagen potentiated neurite promoting factor isolated from
      C6 glioma cells.
AB  - The C6 glial cell line has been used as a model cell system for the investigation
      of new glial produced neurotrophic and neurotropic molecules. By using the C6
      cell line grown in a defined medium on collagen, this laboratory has isolated a
      distinct neurite promoting factor (NPF) that is potentiated by the presence of
      collagen (CPNPF). We have observed that C6 cells cultured in a defined medium on
      collagen (rat type-I) slowed their growth rate and expressed an astrocytic- or
      oligodendrocytic-like morphology. CPNPF, at this state of purity, appears to be a
      distinct NPF which induces neurite outgrowth (neurites of 1 or more somal
      diameters) in PC12 cells. These neurite promotion effects, however, appear to
      support the neuron morphology for only a short period (4 days) of time without
      the presence of neurotrophic factor (NTF). The neurite promoting activity is
      ineffective in inducing neurite outgrowth using mouse neuroblastoma cells (neuro
      2a). CPNPF appears to be a heat stable protein whose activity does not depend on
      the presence of intact collagen, heparin sulfate proteoglycan (HSPG), or
      chondroitin sulfate proteoglycan (CSPG). Exposure to dissociative conditions
      results in a loss of neurite promoting activity. CPNPF is not a glycoprotein that
      contains an accessible alpha-D-mannopyranosyl, alpha-D-glucopyranosyl, or a
      sterically related residue (hydroxyl groups in the C-3,4, and 5 positions).
      Although these residues are not present on all glycoproteins, it does indicate
      that CPNPF is most likely not a glycoprotein. CPNPF activity is not blocked by
      neutralizing antibodies directed toward NGF, beta-FGF, IL-1 beta, IL-6, TGF-beta
      2, TGF-beta 1.2, TGF-beta 3, TGF-beta 5, or EGF. CPNPF appears to either be
      oligomeric protein or a complex of proteins. On the basis of indirect evidence,
      it does not appear to be glial derived protease nexin-I. The alteration in
      morphology of the C6 glial cell line by serum-free conditions in the presence of
      collagen may have induced the production of a potentially new NPF not seen by
      previous investigators.

PMID- 8360948
TI  - Vesicular transport of myelin proteolipid and cerebroside sulfates to the myelin
      membrane.
AB  - The possibility that cerebroside sulfates and myelin proteolipid (PLP) could be
      simultaneously located in transport vesicles destined to be assembled in myelin
      was investigated in the brain of 20 day old rats. The brain was homogenized and
      fractionated according to Burkart et al. (J Biol Chem 257:3151-3156, 1982) to
      obtain a microsomal fraction that was further subfractionated in a linear sucrose
      density gradient following the procedure of Siegrist et al. (J Neurochem 33:497
      504, 1979) to obtain a vesicular fraction which has been shown to transport
      cerebroside sulfates (Burkart et al., as above). This fraction was associated
      with acid hydrolase activity and had a lipid composition different from that of
      myelin and microsomal fractions. Studied by slab gel electrophoresis, dot blot,
      and Western blot analysis, using a highly specific anti-PLP antibody, it was
      found to contain myelin PLP. In view of previous findings of several laboratories
      including our own, the presence of myelin proteolipid in a vesicular fraction
      which is related to the transport of cerebroside sulfates gives further support
      to the hypothesis that the delivery of both constituents to the myelin membrane
      could be associated.

PMID- 8360949
TI  - Changes of amino acid and monoamine levels after neonatal 6-hydroxydopamine
      denervation in rat basal ganglia, substantia nigra, and Raphe nuclei.
AB  - The effects of a neonatal dopaminergic deafferentation with the neurotoxin 6
      hydroxydopamine (6-OHDA) on endogenous tissue levels of catecholamines,
      indoleamines, and amino acids were investigated in discrete rat brain regions.
      After producing the lesion at postnatal day 3 by intraventricular injections of 6
      OHDA, with a desipramine pretreatment to protect noradrenaline neurons, the
      animals were kept for 3 months. Their brains were dissected to obtain samples of
      neostriatum, Globus pallidus, Substantia nigra, and Raphe nuclei, which were then
      analyzed by high-performance liquid chromatography, coupled either to
      electrochemical detection for aromatic monoamines, or to post-column ninhydrin
      derivatization with spectrophotometry for amino acids. The neonatal 6-OHDA
      treatment depleted dopamine (DA) levels in neostriatum, Globus pallidus, and
      Substantia nigra, but in Raphe nuclei DA was increased. The main metabolites of
      DA were also decreased in neostriatum, Globus pallidus, and Substantia nigra but
      remained unchanged in Raphe nuclei. Serotonin (5-HT) and its metabolite 5-hydroxy
      indole-3-acetic acid increased in neostriatum and Raphe nuclei; in Substantia
      nigra there was a slight increase in 5-HT only. The 6-OHDA lesion caused
      heterogeneous alterations in amino acid contents, which varied according to the
      region. In the neostriatum there were increases of gamma-aminobutyric acid
      (GABA), aspartic acid, and glycine. In the Globus pallidus taurine, GABA,
      glutamic acid, glutamine, aspartic acid, serine, and alanine were elevated. In
      the Substantia nigra only increases in taurine, GABA, glutamic acid, and
      glutamine could be documented. This study shows important changes in amino acid
      levels and in some of their ratios, occurring in different anatomical
      subdivisions of the basal ganglia and related brainstem nuclei following a
      neonatal treatment with 6-OHDA. The results thus demonstrate major biochemical
      modifications in amino acids in the aftermath of a DA denervation and/or a 5-HT
      hyperinnervation during an early developmental period.

PMID- 8360950
TI  - Pentylenetetrazol seizures increase pro-nerve growth factor-like immunoreactivity
      in the reticular thalamic nucleus and nerve growth factor mRNA in the dentate
      gyrus.
AB  - Neurotrophins may have a neuroprotective role and are probably involved in the
      control of axonal sprouting and synaptic plasticity. An antibody raised against a
      pro-sequence of nerve growth factor (NGF) was tested. In control undisturbed
      rats, a strong immunoreactivity was detected in scattered cells in and around the
      pyramidal and granule cell layer of the hippocampus and a moderate labeling was
      found in the reticular thalamic nucleus. In situ hybridization showed specific
      expression of NGF mRNA in a similar population of scattered cells in the
      hippocampal formation but not in the reticular thalamic nucleus. Acute epileptic
      seizures, induced by a convulsive dose of 50 mg/kg pentylenetetrazol (PTZ),
      strongly increased NGF mRNA in neurons of the granular layer of the dentate gyrus
      3 hr but not 6 hr after the injection. No change in pro-NGF-like immunoreactivity
      was observed in the hippocampus or reticular thalamic nucleus after acute
      seizures. Chemical kindling was induced by daily injections of subconvulsive
      doses (30 mg/kg) of PTZ for 4 weeks. This treatment significantly increased pro
      NGF-like immunoreactivity in the reticular thalamic nucleus but did not affect
      NGF mRNA. These data strengthen a role for the reticular thalamic nucleus and NGF
      in PTZ kindling.

PMID- 8360951
TI  - Expression of heterologous proteins in cultured rat hippocampal neurons using the
      Semliki Forest virus vector.
AB  - The Semliki Forest virus expression vector (Liljestrom and Garoff: Bio/Technology
      9:1356-1361, 1991) was tested in cultured rat hippocampal neurons using two Madin
      Darby canine kidney (MDCK) cell membrane-associated proteins as reporters: rab8,
      a small GTPase involved in post-Golgi vesicle transport, and VIP21, an integral
      membrane protein of caveolae, trans-Golgi network, and post-Golgi vesicles.
      Expression of the c-myc epitope-tagged proteins was visualized by
      immunofluorescence microscopy. The proteins were first detected in neurons after
      3-4 hr infection by the recombinant viruses. The infection efficiency on neurons
      was high: after 6 hr infection at a multiplicity of one, 50-60% of the cells
      expressed the reporter proteins. The neurons tolerated the infection well up to 8
      hr. Their polarized organization was not disturbed, as judged from morphology and
      from distribution of the dendritic MAP2 and axonal synaptophysin marker proteins.
      The Semliki Forest virus vector thus seems suitable for short-term expression of
      proteins in cultured neurons.

PMID- 8360953
TI  - NMA seeks prescription to end violence.

PMID- 8360952
TI  - A piece of my mind. The learning curve.

PMID- 8360954
TI  - Report: health care reform must affirm 'right'.

PMID- 8360955
TI  - New partnership pursues research on biosensors.

PMID- 8360957
TI  - From the Centers for Disease Control and Prevention. Tuberculosis among pregnant
      women--New York City, 1985-1992.

PMID- 8360956
TI  - From the Food and Drug Administration.

PMID- 8360958
TI  - From the Centers for Disease Control and Prevention. Emergency department
      response to domestic violence--California, 1992.

PMID- 8360959
TI  - From the Centers for Disease Control and Prevention. Jin bu huan toxicity in
      children--Colorado, 1993.

PMID- 8360960
TI  - Digital rectal examination screening for prostate cancer.

PMID- 8360961
TI  - Digital rectal examination screening for prostate cancer.

PMID- 8360963
TI  - Hysterectomy, HMOs, and appropriateness.

PMID- 8360962
TI  - Drug interactions: the death pen.

PMID- 8360964
TI  - Abdominal aortic aneurysm: preoperative evaluation.

PMID- 8360965
TI  - Old times: nasty, brutish, and short--but at least no injected pharmaceuticals.

PMID- 8360966
TI  - Teaching interviewing and interpersonal skills.

PMID- 8360967
TI  - Continuing climb in rates of esophageal adenocarcinoma: an update.

PMID- 8360968
TI  - Recurrent epidemics caused by a single strain of erythromycin-resistant
      Staphylococcus aureus. The importance of molecular epidemiology.
AB  - OBJECTIVE--To compare the accuracy of clinical epidemiologic findings with
      results of molecular epidemiologic analysis in identifying the source of
      recurrent epidemics of erythromycin-resistant Staphylococcus aureus (ERSA)
      infections in a well-baby nursery. DESIGN--Epidemic investigations with
      retrospective and prospective microbiological surveillance. Staphylococcus aureus
      isolates were evaluated by plasmid analysis and genotyping. SETTING--A well-baby
      nursery in a 700-bed university teaching hospital with approximately 250
      deliveries per month. PATIENTS--Newborn infants who developed ERSA infections
      during 1990 and 1991. INTERVENTION--Traditional infection control measures,
      including cohorting of infected infants and hand washing, were implemented.
      Personnel were cultured for nasal carriage of S aureus during both epidemics.
      Employees carrying ERSA were removed from the nursery and treated with mupirocin.
      RESULTS--In the first epidemic, 15 infants were infected with ERSA. A nursing
      assistant who cared for most of the infants was found to be a carrier of ERSA.
      She was removed from the nursery and the epidemic resolved. Fifteen months after
      the first epidemic ended, an epidemic that involved 11 infants began. The
      attending physician had a facial furuncle and was found to be a carrier of ERSA.
      The physician was treated and the epidemic resolved. Plasmid and genotyping
      showed the ERSA organisms from both epidemics were the same. The employee
      implicated in the first epidemic did not have the epidemic strain, but the
      physician who attended during both epidemics did. CONCLUSIONS--Traditional
      epidemic investigations may lead to false conclusions that can only be recognized
      with molecular epidemiologic techniques. For these techniques to be useful in the
      control of outbreaks, plasmid analysis and/or genotyping must be readily
      available.

PMID- 8360969
TI  - Comparison of survival probabilities for dialysis patients vs cadaveric renal
      transplant recipients.
AB  - OBJECTIVE: To compare mortality risk among cadaveric renal transplant recipients
      vs transplant candidates on dialysis in the cyclosporine era. SETTING: Patient
      mortality risk was analyzed by treatment modality for a completed statewide
      patient population. PATIENTS: All Michigan residents younger than age 65 years
      who started endstage renal disease (ESRD) therapy between January 1, 1984, and
      December 31, 1989, were included. Patients were followed up from ESRD onset (n =
      5020), to wait-listing for renal transplant (n = 1569), to receiving a cadaveric
      first transplant (n = 799), and to December 31, 1989. MAIN OUTCOME MEASURE:
      Mortality rates. RESULTS: Using a time-dependent variable based on the waiting
      time from date of wait-listing to transplantation and adjusting for age, sex,
      race, and primary cause of ESRD, the relative risk (RR) of dying was increased
      early after transplantation and then decreased to a beneficial long-term effect,
      given survival to 365 days after transplantation (RR, 0.36; P < .001). This lower
      long-term risk was most pronounced (RR, 0.25) among diabetic transplant
      recipients compared with diabetic wait-listed dialysis patients (P < .001) and
      not observed among patients with glomerulonephritis as cause of ESRD (P > .05).
      Overall, the estimated times from transplantation to equal mortality risk was 117
      +/- 28 days and to equal cumulative mortality was 325 +/- 91 days. CONCLUSIONS:
      The overall mortality risk following renal transplantation was initially
      increased, but there was a long-term survival benefit compared with similar
      patients on dialysis. These analyses allow improved description of comparative
      mortality risks for dialysis and transplant patients and allow advising patients
      regarding comparative survival outcomes.

PMID- 8360970
TI  - Racial equity in renal transplantation. The disparate impact of HLA-based
      allocation.

PMID- 8360971
TI  - Holes in the Jackson Hole approach to health care reform.

PMID- 8360973
TI  - Climbing 'the learning curve'. New technologies, emerging obligations.

PMID- 8360972
TI  - Molecular epidemiology and its clinical application.

PMID- 8360974
TI  - Seronegative Lyme disease.

PMID- 8360975
TI  - Metallic taste.

PMID- 8360976
TI  - Cholecystokinin-enhanced cholescintigraphy in the diagnosis of gallbladder
      disease.

PMID- 8360977
TI  - [Activities of antibiotics against methicillin-resistant Staphylococcus aureus
      with particular reference to synergetic effect between ticarcillin and fosfomycin
      on penicillinase non-producing methicillin-resistant S. aureus].
AB  - We tested susceptibilities of 46 strains of clinical isolates of methicillin
      resistant Staphylococcus aureus (MRSA) to arbekacin (ABK), tobramycin (TOB),
      ticarcillin (TIPC), clavulanic acid/ticarcillin (CVA/TIPC) and fosfomycin (FOM).
      Twelve strains had penicillinase activity. Most strains were resistant to TOB,
      TIPC, FOM and CVA/TIPC, but ABK inhibited 80% of the 46 MRSA strains at a
      concentration of 1.56 microgram/ml. The combination of ABK and FOM was
      indifferent. Synergism was observed, however, between FOM and TIPC against 79% of
      penicillinase non-producing MRSA. This synergism may mean that FOM inhibits the
      production of penicillin-binding protein 2' in some strains of penicillinase non
      producing MRSA.

PMID- 8360978
TI  - [Antimicrobial activity of clarithromycin and its effect on bacterial adherence
      to medical material].
AB  - Antimicrobial activity of clarithromycin (CAM) in comparison with other 6
      macrolides was determined against 419 recent clinical isolates including
      Streptococci, Enterococci, Staphylococci, Moraxella, Haemophilus and Bacteroides
      strains. MICs80's of CAM against Streptococcus pneumoniae, Streptococcus pyogenes
      and Streptococcus agalactiae were 0.78, 0.10 and 0.10 microgram/ml, respectively.
      MICs80's against Moraxella catarrhalis and Haemophilus influenzae were 0.05 and
      1.56 micrograms/ml, respectively. Laboratory-induced resistance to CAM in strains
      of S. pneumoniae, Enterococcus faecalis or methicillin-sensitive Staphylococcus
      epidermidis occurred in stepwise fashion and at a very low rate. Adherence to
      silicon filter of strains of Pseudomonas aeruginosa or S. epidermidis was
      strongly repressed by the addition of sub-MIC of CAM or other macrolides.
      Although tosufloxacin (TFLX) alone had no bactericidal activity against the
      sessile cells of P. aeruginosa strains tested, TFLX showed synergistic
      bactericidal activity when combined with sub-MICs of CAM or erythromycin.

PMID- 8360979
TI  - [Usefulness of (1-->3)-beta-D-glucan measurement for diagnosis of deep mycosis].
AB  - The number of deep mycosis has been increasing because of increases in
      immunocompromised hosts and in fungal colonization associated with increasing use
      of broad-spectrum antibacterial antibiotics. Based on these phenomenon, a simple
      test method for an early diagnosis of deep mycosis is urgently desired. We
      therefore investigated the usefulness of assaying a fungal cell component, (1-
      >3)-beta-D-glucan (beta-glucan). The amount of beta-glucan was obtained from the
      difference between the amounts determined using Toxicolor and Endospecy, and the
      serum levels of more than 10 pg/ml were considered positive signs for beta
      glucan. The following results were obtained: We found that beta-glucan was
      positive in 75% of the patients who had been definitely diagnosed to have
      mycosis, and in 58.3% of the patients strongly suspected of mycosis. The numbers
      of beta-glucan positive patients' in these 2 groups of patients were
      significantly different from that in those without mycosis (14.7%, P < 0.05).
      Thus a usefulness of beta-glucan measurement for the diagnosis of mycosis was
      demonstrated. However, beta-glucan was sometimes negative even in patients with
      fungemia at an early phase of the disease and turned positive several days later.
      Even in a patient with definite lung mycosis, who had a latent circumscribed
      lesion (afebrile and CRP-negative), beta-glucan was also negative. From these
      findings, one should be aware that the beta-glucan test produces false negatives
      even in patients with definite mycosis and that the test should be repeated
      during the course of the disease.

PMID- 8360980
TI  - [Antimicrobial activities of cefminox against recent clinical isolates].
AB  - Against main clinical isolates at our center in 1990 to 1992, the minimum
      inhibitory concentrations (MICs) of cefminox (CMNX) and some other comparable
      cephems were determined. The results are summarized as follows. 1. As to the
      strains resistant to cephems including CMNX, annual increases were observed for
      Streptococcus pneumoniae among Gram-positive bacteria and Proteus vulgaris among
      Gram-negative bacteria. Moreover, cephem-resistant strains of Escherichia coli
      were constantly isolated, and there were signs indicating that cephem-resistant
      strains would increase among strains of Klebsiella pneumoniae. 2. The annual
      increases in cephem-resistant strains of S. pneumoniae and P. vulgaris may
      respectively reflect the recent increases in the incidence of benzylpenicillin
      (PCG)-insensitive strains of S. pneumoniae (PISP) and multi-drug resistant
      strains including oxime type cephems and new quinolones introduced into clinical
      use in the latter half of the 1980s. 3. Concerning antimicrobial activities of
      CMNX against recent clinical isolates, the same problems as described above will
      remain. However, these tendencies have been observed only with regard to MIC90.
      No remarkable changes have been noted for MIC50 or MIC80 at this time.

PMID- 8360981
TI  - [A nationwide survey of antimicrobial susceptibilities of clinical isolates to
      antibiotics in Japan (1988-1990)].
AB  - This study was conducted to investigate susceptibilities of clinical isolates to
      antibacterial agents at 149 hospitals throughout Japan from September to December
      in both 1989 and 1990. In this study, identifications and susceptibility testings
      were carried out at each hospital laboratory. The susceptibility testings were
      performed according to the disk diffusion method recommended by NCCLS.
      Staphylococcus aureus and coagulase-negative staphylococci showed high or
      moderate resistance rates to beta-lactam antibiotics, but Streptococcus pyogenes
      and Streptococcus pneumoniae were highly susceptible to them. Enterococcus
      faecalis was susceptible to imipenem (IPM) and piperacillin but resistant to beta
      lactam antibiotics and aminoglycosides. Haemophilus influenzae, Escherichia coli,
      Klebsiella pneumoniae and Proteus mirabilis were susceptible to beta-lactam drugs
      and aminoglycosides. Enterobacter cloacae, Serratia marcescens, Proteus vulgaris,
      Morganella morganii and Pseudomonas aeruginosa had a good susceptibility to IPM
      and aminoglycosides. Bacteroides fragilis was highly susceptible to IPM. IPM had
      strong antibacterial activity to many species of clinical isolates, including
      strains which were resistant to commonly used antibiotics.

PMID- 8360983
TI  - In vitro antimicrobial activities of lactoferrin, its concomitant use with
      cefpodoxime proxetil and clinical effect of cefpodoxime proxetil.
AB  - As one of the biodefense mechanisms, lactoferrin (LFN) in the secreta of female
      genital organ may be an interesting biological material in view of its
      antimicrobial activity. In the present study, we investigated antimicrobial
      activities of LFN and its combination with cefpodoxime proxetil (CPDX-PR), we
      also as evaluated clinical effect of CPDX-PR. The following results were
      obtained. 1. Antimicrobial activities of LFN were tested against 15 strains of 10
      species of bacteria, and potent activities against Staphylococcus aureus 209P,
      Escherichia coli, Klebsiella pneumoniae and Proteus spp. were found. 2. In a
      concomitant use of LFN with CPDX-PR (a checkerboard method), synergistic actions
      were observed against S. aureus 209P, E. coli STf, K. pneumoniae 602 and
      Pseudomonas aeruginosa 1046, and additive actions against E. coli NIHJ and
      Providencia rettgeri 1603. In 3 strains, the MICs of CPDX-PR in the presence of
      LFN were reduced to < 1/64. 3. In the evaluation of clinical effect of CPDX-PR,
      efficacy rates were 53/57 (92.9%) in a patient group with infections. The
      incidence of adverse reaction was 0/57.

PMID- 8360982
TI  - [Therapeutic efficacy of cefodizime in combination with aminoglycosides against
      systemic infections caused by Pseudomonas aeruginosa in immunocompromised tumour
      bearing mice].
AB  - In vivo synergistic effects of cefodizime (CDZM) were investigated in combination
      with aminoglycosides (AGs), sisomicin (SISO) or dibekacin (DKB) against
      Pseudomonas aeruginosa in immunocompromised tumour bearing mice. Fractional
      effective dose (FED) indices showed that either synergistic or additive effects
      were observed between CDZM and AGs. The synergistic intraperitoneal bactericidal
      effect of CDZM in combination with SISO or DKB was also observed in
      immunocompromised tumour bearing mice. The post antibiotic effect (PAE) of AGs
      was prolonged by the addition of CDZM. Moreover, the strong synergistic
      bactericidal effects of CDZM and AGs against P. aeruginosa were observed in the
      presence of immunocompromised tumour bearing murine polymorphonuclear leukocytes
      (PMN). These results suggest that the strong therapeutic efficacy of CDZM in
      combination with AGs was caused by synergistic bactericidal effect of CDZM and
      AGs in the presence of PMN.

PMID- 8360984
TI  - [An evaluation of a therapy with antibacterial and antifungal agents infections
      with hematological disorders].
AB  - The primary objective of this study is to confirm the efficacy and safety of
      combination therapy with antibacterial and antifungal drugs for patients with
      hematological disorders complicated with infections of unknown causative
      organisms. The subjects consisted of 55 patients with hematological disorders, 28
      males and 27 females, ranging from 1 to 78 years of age, with an average age of
      34 years. The breakdown of the patients by disease was: 41 leukemias, 10
      malignant lymphomas, 3 myelodysplastic syndromes and an aplastic anemia. All
      patients were treated with sulbactam/cefoperazone (SBT/CPZ) and aminoglycoside
      (AG) plus fluconazole (FLCZ) as an empiric therapy. Overall efficacy rate was
      54.5% for all the patients: 57.7% for patients with suspected sepsis and 0% for
      those with pneumonia from which unknown organisms were detected. The efficacy
      rate was 59.4% for patient who had been previously treated with other antibiotics
      and 47.8% for those who had not previously been treated. The above results
      suggested that this combination therapy might be effective for severe infections
      of unknown causative organisms associated with hematological disorders.

PMID- 8360985
TI  - [GPI-anchored proteins and paroxysmal nocturnal hemoglobinuria].

PMID- 8360986
TI  - [Treatment of aplastic anemia with antithymocyte globulin, Lymphoser Berna].
AB  - Twenty-four patients with aplastic anemia (19 severe: 5 moderate) were treated
      with combined immunosuppression consisting of antithymocyte globulin (ATG:
      Lymphoser Berna, Swiss Serum and Vaccine Institute Berne) and high-dose
      methylprednisolone. Danazol or meptiostane was administered concurrently for at
      least 3 months. Three batches of ATG were used, two were not absorbed with
      thrombocytes and one was absorbed with thrombocytes for the prevention of
      thrombocytopenia. Nine of 20 evaluable patient (45%) had sustained improvement in
      hematopoiesis within 3 months of treatment. Nine of 14 patients (64%) showed a
      response to ATG without thrombocyte absorption, on the other hand, none of 6
      patients responded to ATG with thrombocyte absorption. By life table analysis,
      the 3 year probability of survival was 81 +/- 27% after the combined
      immunosuppressive therapy. These results indicated that ATG therapy was very
      effective in Japanese patients with aplastic anemia.

PMID- 8360987
TI  - [Estimation of megakaryothrombopoiesis by mean platelet volume in leukemia
      patients during the course of chemotherapy and patients undergoing bone marrow
      transplantation].
AB  - The mean platelet volume (MPV) was measured in 14 patients with acute leukemia
      during the course of chemotherapy for remission induction and 21 patients
      undergoing bone marrow transplantation, in order to assess its usefulness as an
      indicator for megakaryothrombopoiesis at bone marrow suppression and recovery. In
      patients with acute leukemia, the MPV fell from 9.7 +/- 0.8 fl to 9.2 +/- 0.4 fl
      during the myelosuppression, and then it rose transiently to 10.2 +/- 0.5 fl and
      fell to 9.3 +/- 0.5 fl during recovery of platelet count. Similarly, in patients
      undergoing bone marrow transplantation, the MPV elevation was followed by the
      recovery of platelet count. Thus, when engraftment was defined as this MPV
      elevation, engraftment was confirmed significantly earlier by MPV (19.9 +/- 5.8
      days) than by platelet count (24.8 +/- 6.7 days). MPV should be a useful
      indicator for engraftment or recovery from marrow aplasia in cases of acute
      leukemia and those of bone marrow transplantation.

PMID- 8360988
TI  - [Chronic myelomonocytic leukemia and esophageal cancer developed in a renal
      allograft recipient].
AB  - A 46-year-old man treated with azathioprine (100-150 mg/day) and prednisolone
      (10mg/day) for 14 years after allogeneic renal transplantation, was admitted to
      our hospital in December, 1988 for the evaluation of leukocytosis. His leukocyte
      count was 32,700/microliters with 38% monocytes and 2% blasts. Chromosomal
      analysis of the bone marrow revealed 45, XY, -7. He was diagnosed as chronic
      myelomonocytic leukemia (CMML), and treated with low-dose Ara-C. Two months
      later, he progressed to overt acute leukemia, and he complained of difficulty in
      swallowing. Endoscopic examination revealed esophageal cancer. The patient died
      of respiratory failure on April 18, 1989. This case suggests that
      immunosuppressive agents might play an important role on the pathogenesis of CMML
      and esophageal cancer.

PMID- 8360989
TI  - [Plasma exchange failures in two patients with thrombotic thrombocytopenic
      purpura].
AB  - We treated two patients with thrombotic thrombocytopenic purpura (TTP) with
      multiple plasma exchanges for a short period. Following 6 plasma exchanges during
      11 days in patient 1 and the 8 exchanges during 13 days in patient 2,
      consciousness disturbance and thrombocytopenia improved with a decrease in serum
      lactate dehydrogenase (LDH) levels in both patients. However, thrombocytopenia
      rapidly progressed with a rise of serum LDH levels after a few days from
      cessation of the treatment. They received a few rounds of plasma exchange without
      beneficial effects and eventually died of massive hemorrhage. The clinical course
      of these patients indicates that some patients with TTP are refractory to
      repeated plasma exchanges for a short period. It seems important to determine the
      target point in blood chemistry values such as the LDH level for plasma exchange
      at which the treatment could be discontinued without causing relapse of TTP.

PMID- 8360990
TI  - [A case of Evans' syndrome in which CD4+CD45RA+ cells markedly decreased in its
      active phase].
AB  - A 38-year-old man was admitted to our hospital because of exertional dyspnea in
      February, 1990. The patient had already been diagnosed as having autoimmune
      hemolytic anemia (AIHA) in February, 1982 and treated with prednisolone (PSL)
      until January, 1988. The laboratory examination confirmed the relapse of AIHA
      (IgG-warm type) and additionally disclosed the marked decrease of
      CD4+CD45RA+/CD4+ ratio in peripheral blood lymphocytes. Thereupon, the patient
      was treated again with PSL and entered the remission in one month.
      Simultaneously, CD4+CD45RA+/CD4+ ratio also increased to the normal level.
      Afterwards, the remission had been maintained for about six months with a small
      dose of PSL. However, in September, 1990, the hemolysis relapsed with marked
      thrombocytopenia and decreased CD4+CD45RA+ ratio. Then the diagnosis was
      corrected to Evans' syndrome because PAIgG was highly elevated together with
      positive Coombs' test. Although danazol and azathioprine were administered in
      addition to PSL, the disease remained in active phase. Thus, splenectomy was
      carried out in March, 1992. Consequently, the patient entered the remission that
      has been maintained over six months. CD4+CD45RA+/CD4+ ratio was also normalized.
      These results suggest that CD4+CD45RA+ cells may play an important role in the
      pathogenesis of AIHA or Evans' syndrome.

PMID- 8360991
TI  - [Mediastinal widening simulating relapse in a case of Hodgkin's disease].
AB  - The appearance of a mediastinal mass in a patient with Hodgkin's disease in
      remission frequently indicates recurrence. However, benign processes such as
      rebound hyperplasia of the thymus gland should be included in the differential
      diagnosis. The authors present a case in which an anterior mediastinal mass was
      revealed by a routine chest radiograph 3 months after completion of combined
      modality treatment with low-dose radiation and MOPP chemotherapy for cervical
      Hodgkin's disease, stage I, nodular sclerosis. As the patient was clinically well
      with no other laboratory evidence of disease, recurrence was considered unlikely.
      Benign thymic enlargement was strongly suspected on the basis of striking
      resolution of the mediastinal mass after treatment with a short course of oral
      prednisolone. Thymic rebound in our case occurred coincidentally with the
      restoration of normal immune functions after removal of the stress imposed by
      antineoplastic treatment. The patient has remained free of disease recurrence for
      more than 20 months after cessation of therapy. Awareness of the possible benign
      etiology of a mediastinal mass may avert a diagnostic surgical exploration and
      also unnecessary adjuvant therapy.

PMID- 8360992
TI  - [Effectiveness of dapsone on refractory immune thrombocytopenia in a patient with
      systemic lupus erythematosus associated with sarcoidosis].
AB  - A 57-year-old man was admitted with massive nasal bleeding and blurred vision in
      January, 1991. Laboratory examination showed a prominent decrease of platelet
      number (1,000/microliters) and a marked elevation of PAIgG (4,025 ng/10(7)
      cells). Serological test revealed positive antinuclear factor, low concentration
      of C3 and C4, high level of immune complex and polyclonal hypergammaglobulinemia.
      The patient had uveitis and bilateral hilar lymphadenopathy with a high level of
      serum lysozyme and negative PPD skin test. The diagnosis of SLE complicated with
      thrombocytopenia and sarcoidosis was made. In spite of the various trials of
      treatment, such as oral prednisolone (PSL), methyl-PSL pulse therapy, plasma
      exchange, high-dose intravenous gammaglobulin, cyclophosphamide, azathioprine,
      vincristine, colchicine, cyclosporine-A, mizoribine, danazol, ascorbic acid and
      interferon alpha 2b, the platelet number could not be raised enough to keep more
      than 10,000/microliters, though the level of PAIgG decreased to 200 ng/10(7)
      cells. Finally, the administration of 75 mg/day of dapsone brought about a
      significant rise in platelet number within 2 weeks. The maximum number of 6.2 x
      10(4)/microliters was obtained after 2 months. Then the patient stopped himself
      to take the drug, but the platelet number remained around 4-5 x
      10(4)/microliters. Same dose of the drug was again prescribed to confirm the
      effect of dapsone. The platelet number increased to 7.9 x 10(4)/microliters in 2
      weeks, and gradually returned to 5 x 10(4)/microliters after cessation of the
      drug. Thus being certainly effective against thrombocytopenia, dapsone should be
      considered as one of the therapeutic choice for refractory autoimmune
      thrombocytopenia.

PMID- 8360993
TI  - [Distribution of cofactor-dependent anti-cardiolipin antibodies in collagen
      diseases].
AB  - Cofactor-dependent IgG anti-cardiolipin antibodies (ACA) were examined in sera
      from various connective tissue diseases by ELISA using purified human beta 2
      glycoprotein I. The frequency and titer of cofactor-dependent IgG ACA were higher
      in patients with SLE than in those with other diseases, such as RA, SSc, PM/DM,
      overlap syndrome, and MCTD. The predictive value for SLE was 95%. However, all of
      the ACA were not cofactor-dependent in SLE patients. These results indicated that
      cofactor-dependent IgG ACA were specific for SLE patients, but the epitopes of
      ACA were heterogenous, depending on various clinical manifestations.

PMID- 8360994
TI  - [A case of primary non-Hodgkin lymphoma of the adrenal gland presenting with
      Addison's disease].
AB  - A 69-year-old male was admitted to our hospital complaining of skin pigmentation.
      Masses in bilateral adrenal glands were noted on computed tomography. An
      exploratory laparotomy revealed malignant lymphoma confined to the bilateral
      adrenal glands. Histological diagnosis was diffuse mixed-cell type, B-cell
      lymphoma. Laboratory tests disclosed an elevated ACTH level and decreased urinary
      17KS and 170HCS secretion. Based on hypofunction of adrenal glands and skin
      pigmentation, the patient was diagnosed as having Addison's disease. After
      complete remission with combination chemotherapy, adrenal function recovered
      normal and pigmentation disappeared, Addison's disease is an extremely rare
      complication of primary malignant lymphoma of the adrenal gland.

PMID- 8360995
TI  - [Various endocrine syndromes of the thyroid gland].

PMID- 8360996
TI  - [Various endocrine syndromes of the adrenal gland].

PMID- 8360997
TI  - [Various endocrine syndromes of male sex function].

PMID- 8360998
TI  - [Various endocrine syndromes of female sex function].

PMID- 8360999
TI  - [Various endocrine syndromes of sex differentiation and growth].

PMID- 8361001
TI  - [Endocrine syndrome].

PMID- 8361000
TI  - [Various endocrine syndromes of the brain and pituitary gland].

PMID- 8361002
TI  - [Carcinogenesis and oncogenes].

PMID- 8361003
TI  - [Evaluation of AgNORs in lung cancer].

PMID- 8361004
TI  - [AgNORs in prostatic and thyroid cancer cells].

PMID- 8361005
TI  - [Anti-endometrial cancer monoclonal antibody "MSN-1" and its application to EmC
      EIA method].

PMID- 8361006
TI  - [Cytoskeleton].

PMID- 8361007
TI  - [Genetic alterations in gastric cancer with special reference to the histological
      type].

PMID- 8361008
TI  - [Tumor suppressor gene and cytodiagnosis--p53 expression in urinary cytology].

PMID- 8361009
TI  - [Flow & image cytometry and clinical applications in cancer diagnosis].

PMID- 8361010
TI  - [Flow cytometric DNA analysis of renal cell carcinoma and its relationship to
      tumor grading, tumor stage and prognosis].

PMID- 8361011
TI  - [Application of molecular technology for cytologic study].

PMID- 8361012
TI  - [General remarks of methods for analyzing proliferative characteristics of the
      cells].

PMID- 8361013
TI  - [Advances in diagnostic procedures for detection of pheochromocytoma].
AB  - Pheochromocytoma arises from chromaffin tissue, usually in the adrenal medulla,
      and is a cause of curable hypertension. In most cases, clinical acumen alone is
      not sufficient to diagnose pheochromocytoma. Therefore, the diagnosis of this
      disorder has become almost totally dependent on laboratory test results. The most
      widely used biochemical procedures for detection of pheochromocytoma are
      measurements of urinary catecholamines or their metabolites, such as
      vanillylmandelic acid (VMA) or total metanephrine (MN). Traditional
      spectrophotometric and fluorometric methods for urinary catecholamines and their
      metabolites are being replaced by highly sensitive and selective chromatographic
      methods. Plasma noradrenaline and adrenaline measurements are of additional
      diagnostic value in determining recent catecholamine release and response to
      clonidine suppression. For either urine or plasma measurements, appropriate
      patient preparation, sample collection and method validation along with an
      understanding of the variable pattern of catecholamine secretion and metabolism
      in pheochromocytoma are essential. Localization of tumors is important for the
      surgeon and is accomplished by CT scan, 131I-metaiodobenzylguanidine scintiscans
      or abdominal aortography.

PMID- 8361014
TI  - [Pituitary system with special reference to pituitary antibodies].
AB  - Amino et al. postulated a postpartum autoimmune thyroid syndrome and Sugiura et
      al. established an assay for detecting antibodies to anterior pituitary cell
      surface membrane (PCSA) by immunofluorescent methods. Using this technique, we
      attempted to determine the prevalence of PCSA before and after delivery. Studies
      were conducted with 16 pregnant women without any apparent diseases. Serial
      measurements of PCSA from the sera of each woman before and after delivery were
      performed by immunofluorescent methods using AtT-20 cells (mouse ACTH secreting
      cells) and GH3 cells (rat prolactin and GH secreting cells). Antibodies to AtT-20
      cells were detected in 5 of 16 pregnant women at 36 weeks (31.3%), while those to
      GH3 cells were detected in 3 cases (18.8%). Following delivery, positive
      antibodies were observed in 12 women (75.0%) at 1 month, 15(93.7%) at 3 months
      and 13 (81.3%) at 6 months. A similar result also was obtained with GH3 cells. It
      is possible that some of the patients with positive antibodies have functional
      abnormalities of the anterior pituitary. The results obtained suggest the
      presence of postpartum autoimmune endocrine syndrome at the anterior pituitary
      level.

PMID- 8361015
TI  - [Gastrointestinal hormones: recent developments].
AB  - Progress in gastrointestinal hormone research has increased our knowledge in
      peptide hormone biochemistry and gastrointestinal physiology considerably.
      However, this knowledge has not yet helped our understanding of common
      gastrointestinal diseases. More specific and reliable methods are needed to prove
      or to exclude the participation of gastrointestinal peptides in the pathogenesis
      of gastrointestinal diseases. Peptide hormones are potentially useful as
      diagnostic and therapeutic modalities in the practice of gastroenterology.

PMID- 8361016
TI  - [Dynamic changes in polymorphonuclear cell elastase-alpha 1 protease inhibitor
      complex, a stress marker, in various pulmonary diseases].
AB  - Polymorphonuclear cell elastase-alpha 1 protease inhibitor complex (PMN elastase
      alpha 1 PI complex), which increased in peripheral venous blood during many
      inflammatory diseases, showed significant transpulmonary difference (ie. mixed
      venous blood < arterial blood, p < 0.05) in patients with pulmonary disorders (N
      = 64) but not in those with nonpulmonary disorders (N = 15). Further, PMN
      elastase-alpha 1 PI complex exhibited higher values in arterial blood than in
      peripheral venous blood (p < 0.01). Taken together, this evidence suggests
      intrapulmonary production of PMN elastase-alpha 1 PI complex and suggests
      potential lung damage due to released PMN elastase. Increased and sustained
      elevated levels of PMN elastase-alpha 1 PI complex in acute respiratory failure
      with/without adult respiratory distress syndrome showed resistance to intensive
      medication suggesting that PMN elastase may be a good prognostic marker.

PMID- 8361017
TI  - [Bronchial provocation test in bronchial asthma].
AB  - Methacholine provocation test, bronchial reversibility test, aspirin inhalation
      test, and cough provocation test have been performed at our institute to examine
      pathophysiology and to diagnose bronchial diseases. Bronchial responsiveness to
      methacholine correlated to baseline pulmonary functions, especially to %
      predicted value of forced expiratory volume in 1 second (%FEV1) in asthma and
      sinobronchial syndrome. Bronchial reversibility was greater with beta 2-agonists
      than with muscarinic antagonists in asthma while it was less with beta 2-agonists
      than with muscarinic antagonists in sinobronchial syndrome. Our protocol for
      aspirin inhalation test consists of a screening test and threshold measurement
      test and is useful for diagnosis of analgesics-induced asthma. Capsaicin
      provocation test to measure airway cough receptor sensitivity is used to diagnose
      chronic cough.

PMID- 8361018
TI  - [Analysis of platelet-activating factor and its effect on the lung].
AB  - One of the lipid mediators, platelet-activating factor (PAF), is reported to be
      involved in a variety of biological phenomena including not only harmful
      reactions such as allergy or inflammation, but also physiological phenomena like
      nerve cell differentiation, sperm mobilization, ovulation, implantation,
      parturition etc. We reviewed the methods of detecting PAF in biological fluids
      and the effects of PAF on fetal lung maturation and pulmonary diseases. Fetal
      lung has a capacity to produce PAF and this autacoid is involved in glycogen
      breakdown to furnish both glycerol backbone, such as dihydroxyacetone phosphate
      and glycerol-3-phosphate, and the fatty acids utilized to synthesize pulmonary
      surfactant. PAF also enhances secretion of pulmonary surfactant. However, PAF
      causes eosinophil recruitment to the lung, activation of eosinophil and
      neutrophil, bronchoconstriction, and lung edema, and increases bronchial
      hyperreactivity. All are characteristics of the pathophysiology of bronchial
      asthma. We examined PAF acetylhydrolase activity in plasma from patients with
      bronchial asthma, and found the activity was significantly lower in severe cases
      than that in mild or moderate cases. Ketotifen had no effect on this enzymatic
      activity. Evaluating PAF acetylhydrolase activity may help determine the severity
      of bronchial asthma. PAF is also involved in chronic lung disorders of newborns,
      such as bronchopulmonary dysplasia. We treated a 3-month-old child with frequent
      pulmonary problems who was made a diagnosis of bronchopulmonary dysplasia during
      neonatal period. After administration of Ketotifen for one and a half months, his
      clinical symptoms improved dramatically.

PMID- 8361019
TI  - [Usefulness anti-PPD antibody in the medical practice of tuberculosis].
AB  - The decline rate of tuberculosis has decreased recently in Japan. One of the
      problems is the tendency of increasing doctor's delay in the diagnosis of
      tuberculosis. One of measures against this problem is to develop a new laboratory
      diagnostic method. We studied anti-PPD (Purified Protein Derivative of
      tuberculin) antibody in serum, pleural effusion, and bronchoalveolar lavage fluid
      (BAL), and found its clinical usefulness in the medical practice of tuberculosis.
      Firstly the methods of enzyme linked immunosorbent assay (ELISA) for the antibody
      to PPD were examined. The expression of antibody titer in optical density was
      found to be the most accurate and most simple method, and was applied in this
      study. IgG, IgM and IgA antibody to PPD were measured in serum, BAL and pleural
      effusion obtained from 122 patients with pulmonary tuberculosis, 54 patients with
      tuberculous pleurisy, 39 patients with lung cancer, 39 patients with malignant
      pleurisy, 37 patients with pneumonia, 26 patients with chronic bronchitis, 51
      patients with sarcoidosis, or 49 control subjects. Serum level of IgG, IgM, and
      IgA antibody to PPD was elevated in tuberculosis compared with those in other
      diseases or control subjects. The difference was most distinctive in IgG
      antibody. Serum IgG antibody was higher in chronic case than in acute case and
      IgM antibody was higher in acute case than in chronic case. IgG, IgM and IgA
      antibody in pleural effusion was elevated in tuberculous pleurisy compared with
      those in malignant pleurisy. IgG antibody was higher in chronic tuberculous
      pleurisy than in acute tuberculous pleurisy and IgM antibody was higher in acute
      pleurisy than in chronic one.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361020
TI  - [Usefulness of BAL in understanding of pulmonary diseases].
AB  - Since the introduction of bronchoalveolar lavage (BAL) by Reynolds, et al. in
      1974, direct examination of cells from interest sites in the lung has generated
      great progress in our understanding of pulmonary diseases. In the present study,
      BAL and the clinical usefulness of BAL in diagnosing and treating pulmonary
      diseases were described. In addition, recent research using BAL to elucidate the
      fundamental mechanism of pulmonary granulomatous disorders was also described.

PMID- 8361021
TI  - [Detection of drug resistant-genes in cisplatin-resistant colon carcinoma cells
      by RT-PCR assay. II].
AB  - The c-fos, c-Ha-ras and c-myc oncogenes have been proposed to play an important
      role in DNA synthesis. Expression of c-fos, c-Ha-ras and c-myc genes were
      compared with the human colon carcinoma cell line HCT8S cells and a subline that
      was 4.5 resistant to cis-diamminedichloro-platinum (cisplatin). Resistant cells
      (HCT8DDP) exhibited a 4.0, 2.8 and 1.1 fold in mRNA for these genes when compared
      with the parent cells by Northern blotting analysis, respectively. The reverse
      transcription (RT)-PCR method has been demonstrated to quantify a sequence of
      these oncogenes. This method allowed the detection of gene expression from
      minimal cells. Thus RT-PCR assay could be an effective device in th early
      detection of oncogenes to cisplatin-resistance.

PMID- 8361022
TI  - [Detection of human parvovirus B19 DNA using PCR and serological test using ELISA
      for diagnosis of infection].
AB  - The development of a polymerase chain reaction (PCR) method for detection of
      human parvovirus B19 DNA and serological test of clinical specimens using ELISA
      is described. Of 43 serum (or plasma) samples, 29 were found to be positive for
      B19 DNA using the PCR, anti-IgM was detected in 16 specimens and anti-IgG in 25.
      In all specimens confirmed to contain B19-specific IgM, the presence of B19 DNA
      was demonstrated. Furthermore, B19 DNA was demonstrated in a patient with B19
      infection for a longer period of time than was anti-IgM. In addition, we discuss
      the diagnosis of B19 infection using anti-IgG, in the acute stage and
      convalescent stage. In fetal infection, the PCR method provides sufficient
      detection of B19 DNA in cord blood, amniotic fluid, ascitic fluid, and fetal
      pericardial effusion and pleural effusion.

PMID- 8361023
TI  - [Development of an enzymatic fluorescence method for detecting of cholesterols in
      circulating monocyte].
AB  - Since the infiltration of macrophage/monocyte into the arterial intima would be
      the first and most important step to developing the atherosclerosis, it is
      important to analyze the lipid composition not only in the circulating blood but
      also in the cell. We developed the high sensitive enzymatic assay method of total
      and free cholesterol and employed this assay to the measurement of monocyte
      cholesterol ester. Diabetic patients had high total cholesterol and cholesterol
      ester of monocyte. The elevated monocyte cholesterol ester was related to the LDL
      cholesterol and Lp(a) concentrations in the plasma.

PMID- 8361024
TI  - [Evaluation of an enzyme-linked immunosorbent assay for the determination of
      prothrombin fragment F1.2 (Dade Prothrombin Fragment F1.2 ELISA: Baxter
      Diagnostics Inc., U.S.A.) using micro-titer plate].
AB  - Prothrombin fragment F1.2 (F1.2) is a new molecular marker indicating
      acceleration of blood coagulation. We evaluated a new assay of F1.2 measurement
      using a micro-titer plate (Dade Prothrombin Fragment F1.2 ELISA: Baxter
      Diagnostics Inc., U.S.A.). The assay obtained satisfactory results in intra-assay
      reproducibility test, inter-assay reproducibility test, dilution linearity test
      and in vitro recovery test. Normal values of plasma F1.2 were 0.16 +/- 0.09
      nmol/l (mean +/- SD) in 108 healthy individuals. Differences in the levels
      between the sexes were not significant. In patients with DIC (n = 22), plasma
      F1.2 levels were significantly higher than in normal healthy individuals and were
      correlated with the levels of thrombin-antithrombin III complex. These findings
      suggest that this F1.2 assay using a micro-titer plate is clinically useful for
      the evaluation of the therapeutic effect and diagnosis of hypercoagulable states
      like DIC.

PMID- 8361025
TI  - [Studies on the fragments of FDP in 3 non-DIC patients with increased FDP levels
      in the sera].
AB  - We previously studied fibrinolysis and fibrinogenolysis by analyzing fragments of
      fibrin/fibrinogen degradation products (FDP) employing sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and immunoblotting. In this report, we
      characterized the fragments of FDP in three patients with increased serum FDP,
      that were caused by various diseases. In the patient suffering from tuberculous
      constrictive pericarditis (case 1), the most part of the FDP fragments were DD
      and D. In the patient suffering from infection in addition to liver cirrhosis
      (case 2), the most part of the FDP fragments were high molecular weight (HMW) and
      D. In case 1 and 2, serum FDP levels were increased in parallel with the
      elevations of CRP levels. Although DD and HMW fragments were remarkably increased
      in case 1 and 2 with our immunoblotting analysis, DD levels assayed with LPIA
      system were much lower than FDP levels. The reason this discrepancy was explained
      by the observation that affinities of the monoclonal antibody used in LPIA system
      with DD and HMW fragment were markedly lower than that to DD-E fragment. In the
      patient suffering from deep vein thrombosis probably caused by steroid therapy of
      nephrotic syndrome (case 3), the most part of detected FDP fragments were DD and
      HMW in the period when APTT was shorter than normal, whereas D was mainly
      observed in the period when APTT was normal. In case 3, FDP and DD levels were
      increased in parallel with the shortening of APTT. In these non-DIC patients,
      increased serum FDP levels were induced by the presence of ascites and/or pleural
      effusion plus infection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361026
TI  - [Clinical preventive medicine in cancer diagnosis--proposal for a new cancer
      diagnostic system in an aging society].
AB  - To enroll a large percentage of the cancer high-risk group and to simultaneously
      screen for various kinds of cancer, a modified combination assay of tumor markers
      and risk factors in serum was devised. A pilot study using 5 tumor markers, AFP,
      CEA, CA19-9, CA125, Dupan-2, as well as 3 risk factors of pepsinogen, PGI, PGII,
      PGI/II, showed 87.0% sensitivity and 58.8% specificity in 54 patients with
      various cancers and 163 healthy subjects. Eighty percent of stage I or II cases
      were detected except for one stage I case of right lung cancer and one stage II
      case of oral cavity cancer. Field work is now under way to detect various cancers
      among approximately 1000 inhabitants above 50 years of age in a particular town
      using 11 tumor markers and 3 risk factors. One hundred fifty three of 967 cases
      (male 372, female 595) showed various abnormal values and some were examined
      further as higher risk cases to detect particular cancers suspected from the
      results of the modified combination assay. At present, 5 PAP positive cases were
      referred to urological clinic for examination and 3 were confirmed histologically
      as prostatic cancer. This corresponds to approximately a 0.8% of detection rate
      which is more than 40 times the prostatic cancer mortality. Other kinds of cancer
      are still under investigation at various specified clinics. If cancer is not
      detected in these higher risk cases, they will be followed year to year. Further,
      the most suspicious cases will be examined at a chromosome or DNA level.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8361027
TI  - [Borderline values of laboratory data in patients with hyperlipidemia].
AB  - In Japanese, serum cholesterol levels have been increasing. This seems to be due
      to changes in life style, mainly the increase in dietary fat. Epidemiologic
      studies in the United States and Europe have shown that patients with
      hypercholesterolemia have a high risk of ischemic heart disease. Some guidelines
      for the management of hyperlipidemia have been developed in the United States,
      Europe, and Japan. The National Cholesterol Education Program (NECP) in the
      United States divides serum cholesterol level into three grades (desirable: below
      200 mg/dl, borderline: between 200 mg/dl and 240 mg/dl, hypercholesterolemia:
      over 240 mg/dl). Borderline serum cholesterol is also a risk, especially in
      people complicated by other risk factor(s). As most borderline serum cholesterol
      seems to be due to polygenic hypercholesterolemia, an attempt to change the diet
      should be the first recommendation for treatment.

PMID- 8361028
TI  - [Borderline hypertension].
AB  - According to WHO criteria in 1978, borderline hypertension is defined as systolic
      blood pressure between 140 and 159 mmHg and/or diastolic blood pressure between
      90 and 94 mmHg. Compared with direct intravascular pressure measurement, values
      obtained by the conventional cuff method were 2 mmHg lower in systolic pressure
      and 2 mmHg higher in diastolic pressure. The precision of the cuff method was
      approximately +/- 4 mmHg in both systolic and diastolic pressures. In 20 patients
      with mild hypertension, arterial pressure fluctuated with respiration within
      ranges from 6 to 32 mmHg in systole and from 3 to 14 mmHg in diastole. From these
      results, repetitive blood pressure measurements are recommended for the diagnosis
      of borderline hypertension. Borderline hypertension is the most sensitive
      predictor of definite hypertension in the future. Long term follow up should be
      stressed.

PMID- 8361029
TI  - [The boundary levels of laboratory data in autoimmune diseases].
AB  - The clinical significance of rheumatoid factor, antinuclear antibody, anti
      thyroid antibody, CH50 and serologic tests for syphilis (STS) in boundary levels
      were investigated. The boundary levels were tentatively determined as: RF 5-20
      U/ml, ANA 20-40X, anti-thyroid antibody 100-400X and CH50 25-30 U/ml. In STS,
      cases with biological false positive reaction were examined. In ninety percent of
      patients with positive anti-thyroid antibody, thyroid antibody, thyroid diseases
      were demonstrated. However, various disorders were involved at the boundary
      levels of rheumatoid factor, antinuclear antibody, CH50 and serologic tests for
      syphilis. To assess the boundary levels of these serological data, it seems
      important to observe serial data and other clinical and laboratory findings.

PMID- 8361030
TI  - [An evaluation of tumor markers and risk factors in mass screening for various
      cancers].
AB  - The borderline values of tumor markers and the clarification of risk factors for
      cancer are problems to be solved in the development of mass screening tests for
      various cancers. A tiny abnormality may be overlooked in an evaluation based upon
      traditional reference standards obtained by surveying healthy subjects. Both
      negative and positive values are required in mass screening for various cancers.
      That is, cut-off values should minimize the incidence of false negatives and
      false positives in the screening test. A modified combination assay using tumor
      markers and risk factors was used to screen 967 healthy subjects over age 50 for
      nonspecific cancers and the results were analyzed. Positive rates based on
      ordinary cut-off values for each tumor marker were about 6 to 7% in CEA, CA19-9
      and BFP, 2.7% in SPAN-1, 1.3% in PAP, and less than 1% in AFP, SCC, CA125 and NCC
      -ST-439. For pepsinogen, a risk factor of various cancers especially in the
      digestive tract, the cut-off value was determined as the mean-SD in 967 healthy
      subjects over 50 years old. That is, the cut-of value for pepsinogen I was 18.7
      ng/ml. A lower value was found in 149 subjects (15.4%). The cut-off value for
      pepsinogen II was 7.4 ng/ml and a lower value was found in 227 subjects (23.5%).
      The cut-off value for the pepsinogen I/II ratio was 1.2 and 108 subjects showed
      lower values (11.2%). Positive cases were referred to specialists in various
      fields to detect the specific suspected cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361031
TI  - [Detection of carbohydrate antigens of malignant cells in sputum with panel of
      monoclonal antibodies].
AB  - Serum tumor markers are useful for post-operative follow up, however, they are
      not necessarily useful for early stage diagnosis. Because the lesion is so small
      that it is unable to detect a tiny amount of their molecules in serum. If we
      could detect those antigens directly in cells from cytological specimens, it
      would provide a new diagnostic method for early stage cancers. The expression of
      carbohydrate antigens were examined with panel of specific anti-carbohydrate
      monoclonal antibodies (MAbs) on cytological specimens of sputum. In total, 146
      sputa were collected in Sacomano's solution; 69 malignant cases (35 squamous cell
      carcinomas, 13 adenocarcinomas and 21 other primary lung cancers), 19 benign
      cases (pneumonia and bronchitis) and 58 borderline-malignancy cases which were
      defined by the standard of Japan Society of Lung Cancer. After removing mucus,
      the cells were stained with Vector's ABC method. Evaluation was performed by
      counting positively-stained cells among benign or atypical cells. As we examined
      previously in lung cancer tissue sections, there was statistical significance of
      frequency of positive stain between malignant and benign cases especially in MAbs
      AH6, THK2, SH1 and SNH3. Borderline malignancy gave intermediate value which
      means certain number of cells with cancerous biochemical character are mixed in
      the borderline specimens. In most cases, cell membrane was positively stained and
      sometimes, cytoplasm. Although the high sensitivity was observed in AH6 and SNH3,
      their specificity was lower than that of SH1, and visa versa. Those results
      indicate that the combination of anti-carbohydrate MAbs is useful for cytological
      diagnosis of lung cancer.

PMID- 8361032
TI  - [Magnet-supported chemiluminescent detection for amplified mecA gene of
      methicillin-resistant Staphylococcus aureus].
AB  - A method of chemiluminescent detection for mecA gene of methicillin-resistant S.
      aureus amplified by polymerase chain reaction, was developed. The senseprimer was
      biotinylated at 5'-end, and an oligonucleotide probe, complementary to the
      senseprimer, was labeled with acridinium ester at 5'-end. Template DNA was
      obtained from colonies of S. aureus cultured on blood agar. Polymerase chain
      reaction product was hybridized with the probe and was separated using
      streptavidin-coated magnetic microparticles in magnetic field. The pellet was
      washed by decantations, and was measured for chemiluminescence in an automatic
      luminescence reader. For reference, drug sensitivity and presence of mecA gene
      were tested by dilution method and electrophoresis of polymerase chain reaction
      product, respectively, for each colony studied. Results showed that methicillin
      resistant S. aureus (n = 44) and methicillin-susceptible S. aureus (n = 19) can
      be successfully differentiated by chemiluminescence measurement. This method is
      specific, rapid, and suitable for handling a large number of samples.

PMID- 8361033
TI  - [Intestinal flora of inpatients and isolation frequency of methicillin-resistant
      Staphylococcus aureus].
AB  - The authors compared intestinal flora from 30 healthy volunteers and 128
      inpatients. E. coli, B. fragilis, and Bifidobacterium were each detected in the
      stools of healthy subjects at a frequency of more than 90%, while the incidences
      of such flora were low in the stools of inpatients: A significant difference was
      observed between the two groups. E. faecium, P. aeruginosa, Methicillin-resistant
      Staphylococcus aureus (MRSA), C. difficile, and Candida were detected at high
      frequencies in the stools of inpatients, as compared with healthy subjects. This
      finding is attributed to the administration of antimicrobial agents. It is also
      considered that microbial interaction in maintaining the balance among normal
      intestinal flora had been lost in patients from whom MRSA and/or C. difficile was
      isolated. The decrease or elimination of bacterial species antagonistic to such
      resistant strains must be guarded against, because this can lead to weakening of
      the defence mechanism against intestinal infection.

PMID- 8361034
TI  - [Serum superoxide dismutase (SOD) activity in diabetes mellitus].
AB  - The serum superoxide dismutase (s-SOD) activities in patients with diabetes
      mellitus (DM) were assayed in order to evaluate its usefulness for monitoring of
      DM and also evaluate the relation between s-SOD activities and microangiopathies
      (nephropathy, neuropathy and retinopathy). As results followings were obtained;
      1) s-SOD activities in DM patients were significantly higher than those in
      healthy controls (12.56 +/- 7.73 vs 10.51 +/- 1.69, p < 0.01). 2) There was no
      relations between s-SOD activities and FBS-, fructosamine- and HbA1-levels,
      respectively. 3) Among DM patients s-SOD activities were significantly higher in
      patients with microangiopathy than those in patients without microangiopathy
      (14.18 +/- 11.00 vs 11.24 +/- 3.13, p < 0.01). 4) Among DM patients with
      microangiopathy higher s-SOD activities tended to be observed in patients with
      triopathy such as nephropathy, neuropathy and retinopathy than in those with one
      or two microangiopathic complications. 5) Among DM patients with nephropathy the
      correlation was present between s-SOD activities and levels of creatinine. These
      results suggest that the assay of s-SOD activity is not useful for the monitoring
      of DM, however, it is suggested that the high s-SOD activity reflects the
      microangiopathic complications, particularly nephropathy.

PMID- 8361035
TI  - [Rapid alteration in serum lipoprotein profile after bile drainage in a patient
      with acute bile duct obstruction: contribution of cholestasis to cholesteryl
      ester-dominant ApoE-rich HDL accumulation].
AB  - Remarkably increased cholesteryl ester-dominant apoE-rich HDL with alpha 2
      mobility, similar to the apoE-rich HDL observed in primary biliary cirrhosis, was
      found in a patient with acute bile duct obstruction due to common bile duct
      carcinoma. Bile drainage rapidly lowered her serum apoE-rich HDL from 34.1 to 6.1
      mg/dl and from 96 to 10 mg/dl in terms of apoE (control; 2.6 +/- 1.5 mg/dl, n =
      38) and of cholesterol (control; 6.7 +/- 2.3 mg/dl, n = 38), respectively.
      Disturbance in hepatic lipoprotein clearance due to the presence of cholestasis
      without severe liver damage is a possible cause of accumulation of cholesteryl
      ester-dominant apoE-rich HDL. Hence, plasma cholesteryl ester-dominant apoE-rich
      HDL level is supposed to be a good indicator of hepatic lipoprotein clearance.
      The measurement of this lipoprotein and the analysis of its lipid composition, by
      our convenient method, would be useful for the diagnosis of cholestasis and for
      the evaluation of hepatic function in cholestatic patients.

PMID- 8361036
TI  - [Evaluation of serum protein fractions using nonlinear least squares method].
AB  - We developed a method to evaluate the contents of serum protein fractions using
      nonlinear least squares approach. Parameters that determined the distributions of
      fractions of a densitogram were estimated assuming that each fraction obeys
      Gaussian distribution. One hundred test results of patients and one hundred and
      fourteen simulated patterns were analyzed with the proposed method and the
      traditional method. For patient data, the traditional method tended to give
      higher values in beta-globulin fraction and lower values in alpha 2-globulin and
      gamma-globulin fractions compared with our method. For the simulated data, the
      traditional method also tended to give higher values in beta-globulin fraction
      and lower values in gamma-globulin fraction, whereas our method gave the correct
      values.

PMID- 8361038
TI  - [Roles of pathology laboratories on medical care service and quality assessment
      system for pathological diagnosis].
AB  - In practical medicine, pathologists provide highly specialized medical
      information (pathological diagnosis) to clinicians. Pathological diagnosis
      includes histopathology, cytology, intraoperative consultation (rapid diagnosis
      by frozen section) and autopsy service. In particular, histopathological
      diagnosis of biopsy specimens, nearly always gives a qualitative diagnosis to
      unknown pathological process, in other words, a final diagnosis. In addition,
      pathological diagnosis contributes to supporting medical audit. Thus it is quite
      important that to establish the quality assessment system for pathological
      diagnosis which is hard to be judged with the value.

PMID- 8361037
TI  - [Immunohistopathological analysis of estrogen receptors in human meningioma].
AB  - We studied immunohistochemically estrogen receptors (ER) in 25 meningiomas
      removed from 20 patients using formalin-paraffin sections. Estrogen and
      progesterone receptors were studies in three case of meningiomas using frozen
      sections, also. Only two cases show positive reactions for estrogen receptor
      using formalin-paraffin sections. No correlation was found between estrogen
      receptor state and histological type, or biological behavior except for sex.
      Frozen sections failed to show the positive reaction for estrogen or progesterone
      receptors at all. The data suggest that estrogen receptors are detected in a few
      of the case with meningioma. Immunohistochemical analysis for estrogen receptor
      do not offer the useful informations in histopathological diagnosis or estimation
      of biological behaviors for meningioma on routine laboratory works.

PMID- 8361039
TI  - [Newly developed method by the use of factor Y assay for the detection of the
      lupus anticoagulant].
AB  - A New method for the detection of lupus anticoagulant was developed. Plasma
      factor V activities using tissue thromboplastin (simplastin auto-SA) and partial
      thromboplastin (platelin excel LS-LS) were measured simultaneously. Furthermore,
      the ratio of the two activities was calculated (SA/LS ratio) as a marker of lupus
      anticoagulant. The normal range of SA/LS ratio was 0.79-1.39 (mean +/- 3SD). The
      high SA/LS ratios were detected in all of 15 patients with positive lupus
      anticoagulant, in 3 (5.8%) of 52 SLE patients with normal activated partial
      thromboplastin time, in 2 (28.7%) of 7 patients with hemophilia, in 1 (33.3%) of
      3 patients with factor VIII inhibitor and in 4 (3.3%) of 122 patients with
      various diseases, respectively. All of 15 patients with liver dysfunction, 54
      patients under warfarin treatment and 8 patients under heparin treatment had
      normal SA/LS ratio.

PMID- 8361040
TI  - [Studies on the fragments of FDP in 3 patients with DIC associated with acute
      promyelocytic leukemia].
AB  - We previously reported a study on fibrinolysis and fibrinogenolysis that analyzed
      fragments of fibrin/fibrinogen degradation products (FDP) using sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis and immunoblotting. In this report, we
      characterized the fragments of FDP in three patients with disseminated
      intravascular coagulation (DIC) associating with acute promyelocytic leukemia
      (APL). D, Y, DD, DY/X and high molecular weight fragments were observed in sera
      of all the patients obtained at the onset of APL. These results showed that
      various degrees of fibrinogenolysis, concomitant with fibrinolysis, was occurring
      in APL patients presenting DIC. However, changes in the patterns of the FDP
      fragments during anticoagulation therapy were apparently different among three
      patients. Namely, fibrinogenolysis was dominant in case 1, while fibrinolysis was
      dominant in case 2. Interestingly, fibrinogenolysis and fibrinolysis were almost
      equivalent from the onset to the end of DIC in case 3. In case 3, FDP and FDP-D
      dimer were remarkably elevated about two months before the onset of APL, although
      their elevation was not complicated with DIC but with bone marrow necrosis. At
      that time, serum LDH levels and plasma polymorphonuclear elastase (PMN-Ela) were
      increased presumably due to the release of these enzymes from necrotic bone
      marrow, and the levels of CRP and plasma fibrinogen were increased probably due
      to an infectious complication. In non-DIC period of case 3, FDP and FDP-D dimer
      were spontaneously decreased without reduction of PMN-Ela levels, after three
      weeks of chemotherapy for microbial agents. Taken together, characteristics of
      FDP fragments were unique to each case of APL-DIC, probably because many factors
      differently affected the degradation of fibrin and/or fibrinogen.

PMID- 8361041
TI  - [Final goal and problems in clinical chemistry examination measured by advanced
      analytical instruments].
AB  - In the field of clinical chemistry of Japan, the automation of analytical
      instruments first appeared in the 1960's with the rapid developments in
      electronics industry. After a series of improvements and modifications in the
      past thirty years, these analytical instruments became excellent with
      multifunctions. From the results of these developments, it is now well recognized
      that automated analytical instruments are indispensable to manage the modern
      clinical Laboratory. On the other hand, these automated analytical instruments
      uncovered the various problems which had been hitherto undetected when the
      manually-operated instruments were used. For instances, the variation of
      commercially available standard solutions due to the lack of government control
      causes the different values obtained in institutions. In addition, there are many
      problems such as a shortage of medical technologists, a complication to handle
      the sampling and an increased labor costs. Furthermore, the inadequacies in
      maintenance activities cause the frequent erroneous reports of laboratory
      findings in spite of the latest and efficient analytical instruments equipped.
      Thus, the working process in clinical laboratory must be systematized to create
      the rapidity and the effectiveness. In the present report, we review the
      developmental history of automation system for analytical instruments, discuss
      the problems to create the effective clinical laboratory and explore the ways to
      deal with these emerging issues for the automation technology in clinical
      laboratory.

PMID- 8361042
TI  - [Immunoassay].
AB  - Since the advent of radioimmunoassay in 1959, the immunoassay technology has
      developed enormously as a very sensitive assay system suitable for wide range of
      analytes of clinical interest. Current popularity of the noncompetitive principle
      is attributable to its higher sensitivity, wide dynamic range and shorter
      incubation time. Recent innovation includes time-resolved fluorescent immunoassay
      designed to eliminate non-specific fluorescence, amplified enzyme-linked
      immunoassay and enhanced chemiluminescent immunoassay for ultra-sensitivity,
      particle counting immunoassay with a high resolution power, simultaneous
      measurement of multiple analytes, and easy-to-perform multilayer film
      immunoassays. Despite these advances in the technology, there remain various
      assay problems such as lack of standardization in reagents, a large
      interlaboratory variations despite the use of same assay kits, non-linear results
      in diluted samples and so-called prozone phenomenon.

PMID- 8361043
TI  - [Blood coagulation-fibrinolysis tests by a biochemical method].
AB  - Blood coagulation-fibrinolysis factors are conventionally measured using
      fibrinogen or fibrin as a natural substrate. With recent advances in the
      technology to biochemically separate and purify, individual coagulation
      fibrinolysis factors were isolated and purified, and their biochemical
      properties, function, and primary structure were clarified. Measurement
      techniques for blood coagulation-fibrinolysis factors were also developed. At
      present, enzyme activity for each factor is measured by the synthetic substrate
      method, on the other hand trace proteins and complex proteins are measured using
      monoclonal antibody. We present an outline of blood coagulation-fibrinolysis
      factors and synthetic substrates, and describe the characteristics of the
      synthetic substrate method using measurement of plasma tissue factor and protein
      C activity as examples.

PMID- 8361044
TI  - [Evaluation and problems of ultracentrifugal technique for separation and
      analysis of serum lipoproteins: comparison with other analytical methods].
AB  - An ultracentrifugal technique for separating and analyzing serum lipoproteins was
      evaluated in comparison with analyses by electrophoresis using agarose-gel and
      polyacrylamide-gel. In general, the percent of pre beta- and beta-lipoproteins in
      electrophoresis was estimated higher than the percent of VLDL and LDL in
      ultracentrifugal method, while the percentage of alpha-lipoprotein in the former
      was estimated lower than that of HDL in the latter. In cases with abnormal
      lipoproteinemias, various discrepancies arose between the methods. For examples,
      pre beta- and beta-lipoproteins were estimated too high by the analyses with
      electrophoresis. The cholesterol content in HDL decreases in hypertriglyceridemia
      accompanied by an increase in triglyceride content. Therefore, when HDL
      cholesterol is determined by a polyanion method to assess the net HDL
      concentration in such cases, it is estimated to be low. Such errors are not only
      found in the determination of HDL cholesterol, but also in apoproteins in liver
      cirrhosis, because the composition of HDL apoprotein is markedly altered. Since
      the heterogeneity of lipoproteins separated by ultracentrifugation is
      characteristic in hereditary disorders of lipoproteins such as LCAT deficiency,
      the centrifugal technique is essential for lipoprotein analysis in such
      disorders. The disadvantages in ultracentrifugation are cross-contaminations
      among fractions, and removals of lipids and apoproteins from lipoprotein
      particles. Apo A-I and E proteins, and phospholipids were removed from the
      particles more rapidly than other components. From the results of repeated
      ultracentrifugation of HDL, 3% of apo A-I was estimated to be lost from the HDL
      during the centrifuge procedure.

PMID- 8361045
TI  - [Usefulness of admission biochemical tests for general medical patients].
AB  - To evaluate the diagnostic utility of admission biochemical tests in the
      "Essential Laboratory Tests" proposed by the Japan Society of Clinical Pathology,
      we examined performance, abnormality and undetected abnormality in the tests of
      250 randomly selected new patients admitted to the internal medicine wards of a
      prefectural general hospital during a year period. Each admission biochemical
      test was performed in 63% to 93% of the patients, and abnormal rates were
      obtained in 13% to 53% of each type of test performed. It is noteworthy that 37%
      of the patients were positive for HCV antibody and 32% had elevated blood glucose
      levels. In 28 of 250 patients, clinical diagnoses were supplemented or changed
      because of abnormal test results. However, in 15 cases, significant test results
      were overlooked. To promote appropriate action by the attending physician, we
      presented interpretative laboratory reports. Clinical usefulness of the reports
      was also evaluated. During the past four years, 100 interpretative biochemical
      test reports were accumulated. Diagnoses and treatments were supplemented or
      changed in 36 cases and 26 cases, respectively, because of the reports. In
      conclusion, effective and appropriate use of biochemical tests is promoted by
      interpretative reports.

PMID- 8361046
TI  - [Laboratory tests in primary care medicine: pre-clinical, ambulatory screening
      test system on the basis of the patient's chief complaints in the initial
      diagnosis making].
AB  - We have explored the efficacious laboratory test system to be performed before
      the first medical contact with a physician on the basis of the patient's chief
      complaints and their abnormalities of the "essential laboratory tests" advocated
      by the Japan Society of Clinical Pathology by analyzing 2,625 complaints from
      2,175 new patients visited the outpatient unit of Comprehensive Medicine,
      National Defense Medical College. The patients with complaints such as general
      fatigue, fever of unknown origin or reno-urinary symptoms showed higher
      abnormalities of these diagnostic tests than those in 750 patients performed
      these tests irrespective of the patient's chief complaints. However, complaints
      originated from neurological, gastro-intestinal, cardiovascular or respiratory
      diseases were not associated with abnormalities of these laboratory tests in the
      patients as compared to those in 750 patients mentioned above. These results
      indicate that (1) clinical usefulness of the "essential laboratory tests" are
      variable depending on the patients chief complaints and these tests are
      recommended for the patients with complaints such as general fatigue, fever of
      unknown origin or reno-urinary symptoms as pre-clinical ambulatory screening
      tests before history taking and physical examination to enable to make accurate
      initial diagnosis and subsequent efficacious medical approach and (2) test items
      should be selected depending on the patient's chief complaints.

PMID- 8361047
TI  - [Detection of methicillin-resistant Staphylococcus aureus by in vitro enzymatic
      amplification of mecA and femA genes].
AB  - In the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection,
      rapid detection of MRSA is extremely important. The mecA gene codes the new drug
      resistant polypeptides called penicillin-binding protein 2a (PBP2a) or 2'(PBP2'),
      which mediates the clinically relevant resistance to all beta-lactam antibiotics.
      This gene could be beneficial in the detection of MRSA using the polymerase chain
      reaction (PCR). However, the identical mecA gene has been found in both coagulase
      positive and coagulase-negative Staphylococcus with the appropriate methicillin
      resistant phenotype. The second gene related to the expression of methicillin
      resistance has been called femA. In this study, we amplified both mecA and femA
      genes by PCR in 97 strains and 32 clinical specimens. The mecA gene was positive
      in all 63(100%) MRSA strains and 2(6%) of the 34 methicillin-sensitive
      Staphylococcus aureus (MSSA) strains. Two strains with the methicillin-sensitive
      phenotype and the mecA gene resulted in methicillin-resistance when cultured on
      an agar plate containing 4.5% NaCl. The mecA gene was also present in all
      10(100%) coagulase-negative Staphylococcus strains with the methicillin-resistant
      phenotype. The femA gene was positive in all 97(100%) MRSA and MSSA strains. On
      the other hand, the femA gene was absent from coagulase -negative Staphylococcus
      strains with the methicillin-resistant phenotype. Although the mechanism by which
      the product of femA gene influences the expression of methicillin-resistance is
      unknown, the gene appears to be restricted only in coagulase-positive
      Staphylococcus, regardless of methicillin-resistance. In conclusion, in vitro
      enzymatic amplification of both mecA and femA genes would lead to rapid and
      definite diagnosis of the MRSA infection.

PMID- 8361048
TI  - [Detection of alterations of dihydrofolate reductase gene in folate-resistant
      leukemia cells by in vitro enzymatic amplification].
AB  - Three methods for analyzing the products of polymerase chain reaction were
      applied to detect complex alterations of dihydrofolate reductase (DHFR) gene, in
      order to assess their value in detection of folate-resistance in leukemia cells.
      A single point mutation in the second position of codon 31, a T-to-C transition,
      in trimetrexate (TMQ) resistant MOLT-3/TMQ200 cells was detected by either allele
      specific oligonucleotide hybridization or restriction pattern of the PCR product.
      These two analyses allowed us to detect not only the presence of the mutation,
      but also the amplification of the mutated gene in TMQ-methotrexate (MTX) doubly
      resistant MOLT-3/TMQ200-MTX500 cells. The base change was confirmed by direct
      sequencing method of the PCR product. Using these analyses of the PCR product,
      the complex alterations of DHFR gene are to be examined in leukemic patient
      cells.

PMID- 8361049
TI  - [Urinary-plasmin alpha 2 plasmin inhibitor complex (PIC) in patients with
      diabetic nephropathy].
AB  - The levels of urinary PIC and FDP were studied in 86 diabetics. Urinary PIC or
      FDP were detected only in patients representing more than (++) urinary protein,
      suggesting that urinary PIC is not useful for diagnosis of early stage of
      diabetic nephropathy. On the other hand, positive rate of urinary PIC was much
      higher than that of chronic nephritis not due to diabetes mellitus. Plasma levels
      of PIC were elevated above normal range in all patients with advanced diabetic
      nephropathy tested. These results suggest that urinary PIC might be derived from
      circulating blood and reflect the level of systemic fibrinolytic activities in
      diabetics.

PMID- 8361050
TI  - [Iron deficient erythropoiesis in the young females--analysis by Percoll
      discontinuous density gradient].
AB  - To observe changes in erythropoiesis in iron deficient subjects, we fractioned
      red cells by discontinuous density gradient using Percoll. Blood samples were
      taken from 57 young females of 19-21 years old without abnormal history or
      abnormal biochemical profiles except anemia or iron deficiency. 6 layers gradient
      were made and 7 fractions (F1 to F7, from the top to the bottom) were obtained.
      In the lightness fraction (F3 in nonanemic subjects), reticulocytes were
      concentrated. From patterns of Hemoglobin A1c concentrations of the fractions, it
      was inferred that red cells with heavier density were older in ages. In cases
      with iron deficiency or resulting anemia, low density fraction(s) increased in
      percentage, with relative decrease in that of higher density fractions, as a
      result of impairment in hemoglobin production. Subjects in whom the lowest
      density fraction (F3) was less than 5% were regarded to be normal in terms of
      erythropoiesis, because the fractional pattern was comparable to that of the
      normal adult males. Among 57 females examined, 24 (52.6%) showed iron deficient
      erythropoiesis and 6 (10.5%) were iron deficiency anemia (hemoglobin < 120 g/l).
      The density gradient fractionation of the red cells was proved to be useful in
      analyzing abnormal erythropoiesis.

PMID- 8361051
TI  - [Present status of computerization in routine pathology work in Japan: a
      questionnaire survey and its analysis].
AB  - A total of 71.7% of the institutions surveyed were using computers, and most of
      the institutions not using computers were considering their introduction. Large
      computers were being used by 36% of the institutions and personal computers (PCs)
      by 61%. With regard to software, 88% of the large computers had been programmed
      by professionals, while 76% of the PCs were using commercially available
      software. The wide difference between the software used by the two types of
      computer makes it advisable to discuss them separately. The details on the
      patients at the stage of specimen registration was received on-line in 57% of
      institutions using large computers but in only 5.7% of those using PCs. Coding
      had been implemented in 47% of institutions using large computers and in 16% of
      those using PCs. The rate of use for case reference was 55% for large computers
      and 44% for PCs. References using a register as well as codes and letter data
      were also observed. It is considered that a wide-ranging method of reference will
      probably lead to better ideas than a scrupulous method. In the present survey,
      59% of institutions using large computers and 35% of those using PCs replied that
      system improvements were troublesome. The only way to ensure the privacy of
      patients and the protection of pathological data is to enhance awareness among
      medical doctors and paramedical personnel. It is hoped that some organization
      will lead the way in collecting computer information on pathology duties and make
      this available free of charge.

PMID- 8361052
TI  - [Echocardiographic study in adult patients with Down's syndrome].
AB  - In Down's syndrome (DS) mental retardation accompanying chromosomal abnormalities
      is seen, and the incidence of associated congenital heart abnormalities is also
      known to recent years, the accelerated aging and premature senility associated
      with DS have attracted attention. In the present study, we examined cardiac
      lesions using echocardiography in a group of asymptomatic adult DS subjects
      discussed the relation between these lesions and premature aging. The subjects
      comprised 28 adult DS patients ranging in age from 20 to 46 years (mean +/- SD,
      30.8 +/- 8.9 years) residing in 8 institutions in Fukui prefecture. The presence
      of DS was confirmed in all cases by chromosomal examination, which revealed 21
      trisomy in 25 and mosaic type in three. Of indices of left heart function, the
      end diastolic volume index (EDVI) and end systolic volume index (ESVI) showed
      significantly reduced values, whereas indices of systolic function such as the
      ejection fraction (EF) and mean velocity of circumferential fiber shortening
      (mean Vcf) showed significantly elevated values. The results of early diastolic
      left ventricular function, which has been noted to be related to aging, did not
      show any significant difference as determined by observation of mitral valve
      dynamics. On the other hand, morphologically, mitral valve prolapse (MVP) was
      found significantly more frequently in the DS group (17.9%) as compared to a
      normal control group. Also, valvular calcification (14.3%) and aortic valve
      regurgitation (AR, 11%) were both frequently noted. Whether signs such as
      valvular calcification are findings related to accelerated aging will require
      further study.

PMID- 8361053
TI  - [The correlation between changes in EEG and eye movement (EOG) accompanied by
      lowered arousal level].
AB  - We investigated the correlation between the components of spontaneous eye
      movement (EOG) and EEG in six healthy individuals. The study was conducted in
      three periods; from the resting to drowsy stage, from the drowsy to spontaneous
      awakening stage, and in the forced waking stage. EEG, as registered from bipolar
      electrodes attached between the left parietal region (P3) and the left occipital
      region (O1), was monitored continuously by the FFT method with a segment of 12.8
      seconds. Rapid eye movement and slow eye movement were observed simultaneously.
      In conclusion, even when the arousal level varies considerably, there is a close
      correlation between frequency of rapid eye movement and EEG patterns of 10.16
      integral of 10.94 Hz & 17.97 integral of 19.53 Hz (simple correlation p < 0.01).
      Additionally, during the forced waking period (after stage 2), delta and theta
      bands increased in cases along with sleepiness. Even if the depth of sleep was
      the same, one's mood upon awakening was determined by the frequency of slow waves
      before awakening.

PMID- 8361054
TI  - [Effect of substrate and diluent for factor VIII activity in highly purified
      factor VIII concentrate and patient plasma infused factor VIII concentrate].
AB  - We studied the difference between congenital factor VIII deficient plasma and
      factor VIII immuno-depleted plasma on the effect of pre-dilution for factor VIII
      activity determined by the one-stage assay. When standard curves of one-stage
      assay for factor VIII: C by GEORGE KING factor VIII deficient plasma (frozen at 
      80 degrees C), BEHRING factor VIII deficient plasma (lyophilized), DADE factor
      VIII depleted plasma (lyophilized, von Willebrand factor antigen 0.2 U/ml) and
      DADE factor VIII depleted plasma (lyophilized, von Willebrand factor antigen 1.0
      U/ml) were compared, the difference between the clotting times for 100% and 6.25%
      of activity in each reagent were 39.5, 29.5, 25.0, 23.0 seconds respectively.
      Potency values in concentrates without albumin or von Willebrand factor showed a
      discrepancy between pre-dilution in Owren-Koller buffer and pre-dilution in
      factor VIII deficient plasma. Potencies of those products pre-diluted in Owren
      Koller buffer were 40-60% lower than potencies pre-diluted in factor VIII
      deficient plasma. These results showed substrate and pre-diluent must be chosen
      carefully for the accurate assay of factor VIII activity in vitro for the highly
      purified factor VIII concentrates.

PMID- 8361055
TI  - [The effects of exogenous and endogenous dopamine on the gastric microcirculation
      and their action sites in rat stomach].
AB  - The effect of exogenous and endogenous dopamine on the gastric microcirculation
      and their action sites on stomach were investigated by laser Doppler flowmetry,
      histochemistry, electron microscopy and radioautography. The effects of graded
      doses of dopamine on the gastric mucosal blood flow were different from those on
      the systemic blood flow, implying that there may exist a dopaminergic control of
      gastric mucosal blood flow independent from the systemic circulation. By
      histochemical observations of the horseradish peroxidase (HRP) infused
      preparations, HRP was found to be distributed mainly to the arterioles and
      venules at the base of the gastric mucosa with a high dose of dopamine which may
      contributed to open the arterio-venular shunt either at the base of mucosa or in
      the submucosa. Pretreatment with monoamine oxidase inhibitor and/or 6
      hydroxydopamine caused changes in the levels of endogenous catecholamine
      (dopamine, noradrenaline and adrenaline) in the stomach wall. An imbalanced
      catecholamine in the stomach wall, particularly an increase in DA, decreased
      gastric mucosal blood flow. Radioautographic studies revealed that D1-receptors
      are located mainly on the arterioles in the lower part of the mucosa and
      submucosa, while D2-receptors are located mainly on the muscularis mucosae and on
      the collecting venules. Tyrosine hydroxylase (TH) positive nerve fibers possibly
      corresponding to the dopaminergic fiber were evident in the vicinity to the
      arterioles, venules, and muscularis mucosae. Some TH-positive fibers were
      extended to the true capillaries in the mucosa. Dopamine beta-hydroxylase
      positive fibers were noted near the arterioles and venules both in the submucosa
      and the lower portion of mucosal layer. Based on the above results, the
      dopaminergic mechanisms are considered to be involved in the regulation of the
      gastric mucosal microcirculation through the dopaminergic nerves.

PMID- 8361056
TI  - [Changes in gastric mucosal glycosidases and thiobarbituric acid reactants
      induced by burn stress in obstructive jaundice rats].
AB  - To elucidate the pathogenesis of acute gastric mucosal lesion (AGML), burn stress
      was loaded in rats with and without obstructive jaundice. The activation of
      gastric mucosal glycosidases (beta-N-acetyl-D-glucosaminidase (NAG), beta
      glucuronidase (BG)), which were released into the cytoplasm as a results of
      instability of the lysosomal membrane, was studied biochemically, enzymatically
      and histochemically after burn stress with and without obstructive jaundice. The
      latent enzyme activity calculated by NAG or BG, which represented the stability
      of lysosomal membrane, was lowest at 2-3 hour after burn stress in both groups.
      In other words, the degree of activation of the glycosidases was highest at 2-3
      hour after burn stress. The latent enzyme activity calculated by NAG decreased
      significantly (p < 0.05) at 1 hour after burn stress in obstructive jaundice
      group compared with the non-obstructive jaundice group. The staining of NAG
      before burn stress was observed in mucus neck cell and surface epithelial cell in
      granular shape and it was observed diffusely after burn stress, especially in
      obstructive jaundice group. The changes in staining of BG was similar to NAG.
      Before activation of glycosidases, the thiobarbituric acid reactants, which are
      considered products of lipid peroxidation, increased promptly at 30 min after
      burn stress in both groups. Ulcer index increased gradually after burn stress and
      the significance was found between in the obstructive jaundice group and in non
      obstructive jaundice group at 3 hour after burn stress. It's concluded that
      obstructive jaundice accelerated the fragility of lysosomal membrane after burn
      stress and these change were considered to be the reasons of frequent occurrence
      of AGML.

PMID- 8361057
TI  - [Newly developed ultrasonic micro-probe (15MHz), basic and clinical study for
      gastrointestinal lesions].
AB  - The authors evaluated a new device the ultrasonic micro-probe (2.4mm in the outer
      diameter, radial scanning system, 15MHz, Toshiba Co.) from both its basic and
      clinical aspects using resected gastric specimens and clinical subjects. The
      ultrasonic resolution of this new ultrasound imaging catheter was demonstrated to
      be best the probe-object distance was 1.0-3.0mm and angle of inclination was 0
      20. On clinical use of the probe, the above-mentioned basic evaluation is
      important to achieve high resolution ultrasonic image. For attenuation of
      ultrasound due to the high-frequency (15MHz), the main subjects of this probe for
      evaluation of gastrointestinal tract are small lesions of mucosal-submucosal
      layers. Because of its small caliber (2.4mm), the micro-probe can be passed
      through the biopsy channel of common used endoscope, and permits the intra
      luminal ultrasound examination at routine endoscopy, if necessary. This new
      device the ultrasonic micro-probe will develop the ability of endoscopic
      ultrasound in diagnosing gastrointestinal disorders.

PMID- 8361058
TI  - [Development of colonic lesions caused by occlusion of paracolic marginal artery
      and/or vein--an experimental study using the model of ischemic colitis].
AB  - Paracolic marginal artery and/or vein of rabbit descending colon were ligated at
      two points with a distance of 3cm each other. The animals were sacrificed 1, 4
      and 7 days after the operative procedure. The colonic segment including the
      vessel-ligated region was removed and studied macroscopically and
      microscopically. The impairment of arterial blood supply was more responsible for
      the development of colonic lesions. Especially, ulcerative lesions occurred only
      in artery-ligated and both of artery and vein-ligated groups. All the lesions
      occurred in the vein-ligated group were those showing only edema. Three types of
      mucosal folds with different etiology appeared in the vessel-ligated region of
      the colon, i. e., longitudinal and transverse folds and those converging to the
      ulcerative lesion. The morphological features of colonic lesions changed
      gradually. In the artery-ligated group, a variety of lesions including multiple
      ulcers and petechiae appeared with a longer lapse of time.

PMID- 8361059
TI  - [Detection of obscure fistulas complicated with Crohn's disease by indocyanine
      green].
AB  - When treating patients with Crohn's disease (CD), external or internal fistulas
      connected to the intestine were encountered, and these were often difficult to
      diagnose correctly. In order to diagnose such fine fistulas, we modified a method
      of using indocyanine green (ICG) administration to the gut lumen. The subjects of
      this study comprised nine patients with CD who had an obscure fistula which could
      not be demonstrated by barium study, fistulography, or by urological or
      gynecological examinations. If the administrated ICG was detected by various ways
      from an external fistula or from the neighboring organs, a fistulous connection
      was thought to be evident. Following oral administration in nine patients,
      colonic fistulas became evident in seven and by ICG enema in three patients,
      colonic fistulas became evident in all three. In addition, since the fistulous
      connection was ameliorated following nutritional therapy, it would appear that
      ICG administration is a useful marker of such therapy for this condition. ICG
      administration was therefore thought to be a useful method of detecting obscure
      fistulas connected to the intestine.

PMID- 8361060
TI  - [A study of osteopenia in liver cirrhosis by dual energy X-ray absorptiometry
      (DXA)].
AB  - We studied osteopenia in patients with liver cirrhosis by dual energy X-ray
      absorptiometry (DXA). Total body bone mineral density showed a positive
      correlation with the lumbar spine bone mineral density, and % age matched total
      body bone mineral density under 90% was defined as osteopenia. The incidence of
      osteopenia in 54 patients with liver cirrhosis was 20.4%. Since this osteopenia
      had no relationship to the general risk factors for osteoporosis, it was
      suggested that it is a complication specific to liver cirrhosis. Because the
      level of serum total bilirubin and the activity of serum total alkaline
      phosphatase in the group with osteopenia were usually higher than those in the
      group without osteopenia, it was suggested that osteopenia in liver cirrhosis
      might be related to hepatic dysfunction.

PMID- 8361061
TI  - [Gastroduodenal Crohn's disease: report of a case and review of Japanese
      literatures].

PMID- 8361062
TI  - [A case of surreptitious laxative abuse diagnosed by high performance liquid
      chromatography].

PMID- 8361063
TI  - [Acute hepatic failure after complete remission of the hematopoietic malignancy].

PMID- 8361064
TI  - [The relationship between aortic pulse wave velocity and atherogenic index in
      centenarians].
AB  - It is considered that the atherogenic index (AI), calculated from cholesterol
      fraction levels, is biochemically acceptable but cannot completely express the
      degree of physiological development of individual arteriosclerotic changes in
      extremely elderly persons. The purpose of this study is to search for another
      form of the atherosclerotic index which is more reliable in terms of
      physiological aspects, and to clarify the relationship between aortic pulse wave
      velocity (PWV) and AI in centenarians. We have measured the PWV in 40 healthy
      centenarians (7 males and 33 females; age 100 to 105, average age 101.1) and 92
      ordinary elderly people (45 males and 47 females; age 70 to 89, average age 75.8)
      in Okinawa, Japan. The conventional AI was calculated by the Fridewald Method. A
      statistically significant difference in the AI value was observed between
      centenarians (1.91), and controls (2.59, p < 0.0001). Higher levels of PWV in
      centenarians (10.15 m/sec), were recognized than in the controls (8.45 m/sec, p <
      0.0001). However, no significant correlations were noticed between PWV and AI in
      centenarians (r = 0.0049) and in controls (r = 0.094). These results suggested
      that pathological findings in centenarians are produced mainly by physiological
      fibrotic changes of the arterial wall instead of pathological atherosclerotic
      changes.

PMID- 8361066
TI  - [Three cases of acquired megacolon in the elderly].
AB  - As the number of the elderly in society increase, cases of abnormal bowel habit
      in the aged have also increased. This report describes 3 cases of acquired
      megacolon in the elderly. Case 1, a 71-year-old female, complained of
      constipation and developed megacolon after an attack of cerebral infarction. Case
      2, a 82-year-old male, developed megacolon while receiving psychoactive
      medication. Case 3, a 69-year-old male who complained of constipation for a long
      time and rapidly developed megacolon was diagnosed as idiopathic megacolon.

PMID- 8361065
TI  - [The importance of the host nutritional and immune status on the prognosis of
      urinary tract infection in the elderly].
AB  - This study was performed to evaluate the role of the nutritional and immune
      status on the prognosis of urinary tract infections (UTI) in the elderly. 192
      patients among the 790 inpatients were diagnosed as UTI. Age-related increase in
      the prevalence of UTI was accompanied with poor prognosis in the patients with
      hypoalbuminemia (< 2.6 g/dl) and lymphocytopenia (< 700/mm3). To study the
      immunologic basis for susceptibility to UTI in the aged further, we compared the
      T-cell functions between outpatients without serious disease and inpatients with
      chronic UTI. The absolute numbers of lymphocyte, OKT3 (pan T-cell marker), OKT4
      (Helper/Inducer marker) and Interleukin (IL)-2 as well as serum albumin
      concentration were decreased in the patients with UTI. A prospective study was
      done to confirm that these nutritional and immunological changes become risk
      factors in the prognosis of UTI with long-term and low-dose chemotherapy. In the
      patients continued with bacteriuria (Non-responders, n = 6), serum albumin
      concentration and IL-2 production were significantly lower than the patients who
      became free from bacteriuria (Responders, n = 7). These results suggest that poor
      nutrition-related immune dysfunction contributes to the vulnerability of elderly
      patients to UTI and becomes risks for he prognosis of UTI.

PMID- 8361067
TI  - [Two cases of Werner's syndrome treated with penetrating keratoplasty].
AB  - Cataract is one of the typical ocular manifestations of Werner's syndrome. In
      contrast to cataract in normal elderly persons, cataract in patients with
      Werner's syndrome is known to be associated with degenerative corneal changes
      after cataract surgery. Among the corneal changes bullous keratopathy occurs in
      almost 100% of patients with Werner's syndrome after cataract surgery. Although
      penetrating keratoplasty appears to be the best treatment for bullous
      keratopathy, there have been few reports on bullous keratopathy in patients with
      Werner's syndrome. Here we report two patients with Werner's syndrome who
      underwent penetrating keratoplasty for the treatment of bullous keratopathy. In
      both cases, visual acuity was improved, suggesting that penetrating keratoplasty
      is a recommendable treatment for bullous keratopathy in patients with Werner's
      syndrome.

PMID- 8361068
TI  - [Non-Hodgkin's lymphoma with pulmonary involvement and various immunological
      abnormalities in an elderly patient].
AB  - A 85-year-old female was admitted with general fatigue and chest discomfort in
      July 1991. Her chest X-ray film showed several pulmonary nodules in the bilateral
      lung fields without hilar lymphadenopathy. Metastatic lung cancer was suspected,
      but primary cancer was not detected in spite of cancer screening. Hemoglobin was
      8.7 g/dl. The patient also had various immunological abnormalities including
      increased serum cold agglutinin titer, decreased serum complement, positive anti
      nuclear antigen and IgM-kappa monoclonal gammopathy detected by
      immunoelectrophoresis. She was diagnosed as having autoimmune hemolytic anemia
      with cold agglutinin disease and M-protein. With the administration of
      corticosteroids, hemolytic anemia improved temporarily, but the patient died of
      hemorrhagic gastritis. At autopsy, a lung tumor was detected in the left upper
      lobe, mainly without hilar lymphadenopathy. The autopsy specimens showed Non
      Hodgkin's lymphoma (diffuse medium-sized cell type), differentiated from
      macroglobulinemia by immunohistochemical studies. In elderly patients, with
      various immunological abnormalities, B-cell lymphoproliferative disorders such as
      malignant lymphoma should be suspected.

PMID- 8361069
TI  - [Age difference in appearance of synaptophysin positive substance of rat
      hippocampus--immunohistochemical study].

PMID- 8361070
TI  - [Rehabilitation for the elderly with hip fracture. From onset to terminal stage].

PMID- 8361071
TI  - [Energy metabolism and nutrition in the elderly].

PMID- 8361072
TI  - [Energy requirements for frail elderly females].
AB  - About half the residents living in nursing homes and homes for the elderly show
      activity factor values less than 0.25 in daily living. However, the current
      Recommended Dietary Allowances (RDA) have been intended to apply to self
      supporting and healthy elderly persons rather than bedridden elderly persons.
      Accordingly, current RDA tables do not indicate energy requirements for frail
      elderly people who show less values than 0.25 in activity factor. Consequently,
      in most institutions for the elderly, an adequate dietary energy supply for
      residents has been calculated on the basis of "level I (light)" in levels of
      physical activities. In this study, we measured the daily energy expenditures of
      78 frail elderly females (age; 79.9 +/- 7.1 yrs) living in nursing homes and
      homes for the elderly. From these results, energy requirements for frail elderly
      females corresponding with 0.00 to 0.25 of the activity factor were provisionally
      estimated as to be 21 to 31 kcal/kg BW.

PMID- 8361073
TI  - [Aging, basal metabolic rate, and nutrition].
AB  - Age is one of the most important factor of changes in energy metabolism. The
      basal metabolic rate decreases almost linearly with age. Skeletal musculature is
      a fundamental organ that consumes the largest part of energy in the normal human
      body. The total volume of skeletal muscle can be estimated by 24-hours creatinine
      excretion. The volume of skeletal musculature decreases and the percentage of fat
      tissue increases with age. It is shown that the decrease in muscle mass relative
      to total body may be wholly responsible for the age-related decreases in basal
      metabolic rate. Energy consumption by physical activity also decreases with
      atrophic changes of skeletal muscle. Thus, energy requirement in the elderly
      decreases. With decrease of energy intake, intake of essential nutrients also
      decreases. If energy intake, on the other hand, exceeds individual energy needs,
      fat accumulates in the body. Body fat tends to accumulate in the abdomen in the
      elderly. Fat tissue in the abdominal cavity is connected directly with the liver
      through portal vein. Accumulation of abdominal fat causes disturbance in glucose
      and lipid metabolism. It is shown that glucose tolerance decreases with age.
      Although age contributes independently to the deterioration in glucose tolerance,
      the decrease in glucose tolerance may be partly prevented through changes of life
      style variables, energy metabolism is essential for the physiological functions.
      It may also be possible to delay the aging process of various physiological
      functions by change of dietary habits, stopping smoking, and physical activity.

PMID- 8361074
TI  - [Physical fitness and energy metabolism of the elderly].
AB  - It is generally accepted that decreased lean body mass (LBM) with aging is
      responsible for decline in basal metabolism (BMR) of the elderly. However,
      multiple regression analysis of BMR and related factors for middle- to older-aged
      subjects showed that decline in BMR with aging could not be explained only by
      decrease in LBM. Basal heat production rates per essential body mass (EBM) and
      per fat tissue mass (FTM) by sex and by age class were estimated using the
      regression analysis proposed by Chirifu. It was found that the basal heat
      production per EBM decreased with aging, indicating that both decreases in active
      tissue mass and BMR per unit of active tissue mass were involved in reduced BMR
      for the elderly. A 15-week aerobic exercise training course prescribed for mildly
      obese middle- to older-aged women improved their fitness level and body
      composition, i.e., decrease in FTM with increase in EBM. The basal heat
      production rate per EBM increased by 21%. These results suggest that aerobic
      exercise training is effective for improving the metabolism of active tissue in
      the middle-aged and the elderly. Although there was a wide inter-individual
      variation in BMR in the elderly over 70 years of age, the BMR tended to increase
      depending on the level of daily activity. In conclusion, physical exercise and an
      active daily life are important for decelerating the decrease in BMR for the
      elderly through maintaining active tissue mass and its basal metabolism.

PMID- 8361075
TI  - [Relation of habitual exercise to basal metabolic rate and energy expenditure
      during exercise in older people].
AB  - The relation between habitual exercise and the basal metabolic rate, energy
      expenditure during exercise (lactic threshold and maximal oxygen uptake) was
      examined in 291 older people. Metabolic rate was highest in old players of
      gatebowl (a form of croquet) (male; 23.3 +/- 2.3, female; 22.7 +/- 3.0
      kcal/kg/day), higher in old untrained people (male; 21.9 +/- 2.5, female; 20.8 +/
      2.4 kcal/kg/day), and lower in old people in a home for the aged (male; 20.6 +/-
      3.5, female; 20.8 +/- 3.7 kcal/kg/day). Energy expenditure while walking at a
      speed of less than 100 m/min was similar in trained and untrained old people aged
      60-69 years. However, lactic threshold was higher in trained (30.2 +/- 4.8
      ml/kg/min) than in untrained (20.9 +/- 2.8 ml/kg/min) females aged 60-69 years.
      Maximal oxygen uptake was higher in trained (male; 50.4 +/- 4.1, female; 36.6 +/-
      3.9) than in untrained (male; 30.9 +/- 3.7, female; 26.8 +/- 2.8) old people aged
      60-69 years. It was suggested that a higher basal metabolic rate, lactic
      threshold and maximal oxygen uptake resulted in higher daily physical activity
      and larger daily energy consumption in trained old people.

PMID- 8361076
TI  - [Nutritional assessment and nutritional support therapy in elderly patients].
AB  - In order to study nutritional assessment and nutritional support therapy for
      elderly patients, we conducted energy supply therapy on 15 elderly (aged over 75)
      patients disabled with diseases such as cerebrovascular disease, pneumonia and
      heart failure. After recovery from acute phase, they were divided into 3 groups,
      and assigned to 3 different energy supply methods for 2 weeks: Six (3 males, 3
      females) could take hospital diet, but only could absorb about 50% of the energy,
      amounting only 1,000 to 1,400 kcal/day. Additional 246 kcal was given by
      peripheral parental nutrition (PPN). Five (2 males, 3 females) were unable to
      take nutrition orally. Therefore, they were given high caloric nutrients by total
      parental nutrition (TPN), giving (1,222 kcal daily for a week), then 1,666 kcal
      for another week. Four (1 male, 3 females) also could not take meals orally, and
      had to be nourished by enteral nutrition (EN) with a nutrient preparation of
      1,120 kcal for one week, then with 1,600 kcal for another week. In all 3 groups,
      the indices of rapid turnover proteins (pre-albumin, retinol binding protein and
      transferrin), choline esterase and vitamin A significantly elevated after 2 weeks
      of therapy, though the increase of pre-albumin and RBP in TPN group was slightly
      below the significant level. The increase in rapid turnover proteins and choline
      esterase was greater in the order of EN, TPN and PPN. Vitamin C, on the other
      hand, decreased significantly with treatment in all the groups, while vitamin E
      remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361078
TI  - [Factors for weight loss in patients with senile dementia].
AB  - The authors investigated causes for weight loss in inpatients with senile
      dementia, who could take diets. The 81 patients (80 +/- 8.3 years of mean age +/-
      S.D., 22 males and 59 females) included 48 cases of senile dementia of Alzheimer
      type (SDAT) and 25 cases of multi-infarct dementia (MID). Controls consisted of
      77 non-demented patients (82 +/- 9.1 years, 29 males and 48 females) who were
      admitted because of cerebrovascular or cardiopulmonary diseases. Demented
      patients showed an average of -1.8 +/- 8.5% weight change per year, while that of
      non-demented patients was +4.4 +/- 6.3%, resulting in a significant difference
      between them (p < 0.0001). Between demented males and females, there was no
      significant difference. In male, SDAT cases showed more weight loss than MID
      cases (-5.0 +/- 5.1% vs +3.3 +/- 4.2%, P = 0.003), although in females there was
      no significant difference between SDAT and MID. Even when patients with a
      wandering tendency or complications were excluded, results essentially did not
      change. In demented patients, weight change did not correlated with age, amount
      of dietary intake, length of hospital stay or serum albumin level. However, it
      correlated with body weight (r = 0.26, P = 0.014), ADL index (GBS-A) (r = 0.22, P
      = 0.04), and with Mini-Mental State Examination score (r = 0.23, P = 0.048). In
      multiple regression analysis, the most powerful explanatory variable in demented
      males was the index for cerebral atrophy. These results confirmed previous
      studies reporting that reduced dietary intake, complications or hyperactivity do
      not fully explain weight loss in demented patients.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8361077
TI  - [Hyperinsulinemia and hypertension in an elderly Japanese population--the
      Hisayama Study].
AB  - Hyperinsulinemia has been closely associated with hypertension in several
      epidemiological studies, but little is known about this condition in the elderly.
      The authors studied the relationship between serum insulin and blood pressure
      levels, and the prevalence of hypertension according to insulin levels in the
      elderly in a Japanese rural community, Hisayama. In 1988, 75 g oral glucose
      tolerance test was performed on 426 male and 567 female Hisayama residents aged
      60 to 79 years. Fasting and 2 hr serum insulin values were measured by
      radioimmunoassay. In the subjects, excluding those receiving antihypertensive
      drugs, the sum of fasting and 2 hr postload insulin (sigma IRI) significantly
      correlated with systolic (r = 0.15 and 0.25 for males and females, respectively)
      and diastolic blood pressure (r = 0.20, 0.16). In multiple regression analyses,
      the correlation with systolic blood pressure remained significant in females
      after controlling for age, body mass index, alcohol intake, smoking habits, serum
      total cholesterol, HDL-cholesterol, triglycerides, and fasting plasma glucose. In
      contrast, sigma IRI did not remain as an independent variable relevant to blood
      pressure among males. The age-adjusted prevalence rates of hypertension (> or =
      160/95 mmHg or receiving drug treatment) significantly increased with increasing
      quartiles of sigma IRI in females. The prevalence of hypertension which was not
      treated with drugs also increased significantly with increasing sigma IRI in
      females. However, no significant association was observed in males. In
      conclusion, the present study suggests that hyperinsulinemia can be related to
      hypertension in the female elderly in the general population of Japan.

PMID- 8361079
TI  - [Age-related changes in intracranial artery velocity measured by transcranial
      Doppler sonography in normotensive, hypertensive and diabetic patients].
AB  - We measured mean blood flow velocity (MFV) and Fourier pulsatility index (PI) of
      the M1 portion of the middle cerebral artery (MCA) by transcranial Doppler
      mapping technique (2 MHz, Trans-scan, EME Co., Ltd.). The correlations between
      these parameters and arteriosclerotic risk factors such as aging, hypertension
      and diabetes mellitus were examined. Healthy volunteers as well as patients
      suffering from hypertension and diabetes mellitus were studied. A total of 59
      persons (85 MCAs) consisting of 30 males (mean age 54.4, 24-81 years) and 29
      females (mean age 54.8, 20-75 years) were enrolled in this study. Some
      hypertensive or diabetic subjects had previous cerebrovascular disease, therefore
      cases who had only minor stroke or asymptomatic infarction without significant
      lesions in carotid artery system were included. After excluding brain embolism,
      these subjects were divided into three groups as normotensive/non diabetic group
      (NT/non DM), hypertensive group (HT) and diabetic group (DM). In each group, MFV
      decreased with aging, being more evident in the HT and DM groups than in the
      NT/non DM group. Fourier PI also showed a significant increase with aging, and
      the correlation was stronger than that between MFV and age. Moreover, these
      trends of age-Fourier PI relationship were more highly significant in HT and DM
      groups than NT/non DM group. In cases with HT or DM, age-related arterial changes
      appeared to be more severe than in those without. Fourier PI seemed valuable for
      detecting arterial lesions with aging, HT and DM.

PMID- 8361080
TI  - [Analysis by two-dimensional electrophoresis of the cause of myocardial
      dysfunction in aging rat hearts].
AB  - The severity and frequency of atherosclerosis, diabetes, and ischemic heart
      disease, which affect cardiac function, increase with aging. Although there are
      many reports about hemodynamic and histopathological studies about aging hearts,
      there are very few studies on changes in structural proteins in aging hearts. We
      investigated the contractile proteins of the left ventricles in rats aged 6, 12
      and 125 weeks using two-dimensional electrophoresis. There were no difference in
      structural proteins in heart between 6-week and 12-week-old rats. The contents of
      myosin heavy chain, myosin light chain 2, actin, troponin-I in 125-week-old rats
      decreased compared with those of 12-week-old rats. Myosin heavy chain, which is
      one component of myosin, interacts with actin and changes chemical energy to
      mechanical energy. Therefore its decrease leads to a decline in myocardial
      contractility. These results seem to indicate one of the most important changes
      in the aging rat heart, as well as impairment in relaxation by the increase of
      interstitial fibrosis and decline of Ca uptake by sarcoplasmic reticulum.

PMID- 8361081
TI  - [The effect on age for the relationship between hypertension and glucose
      intolerance].
AB  - Recently, high frequencies of glucose intolerance and insulin resistance have
      been reported in patients with hypertension. However, both blood pressure and
      glucose tolerance are influenced by age. To investigate the effect of age on the
      interaction between blood pressure and glucose tolerance, we analyzed blood
      pressure and glucose tolerance in otherwise healthy subjects (n = 576) who
      underwent an oral glucose tolerance test and blood pressure measurement as a part
      of a healthy care program. The prevalence of DM and IGT were significantly higher
      in the hypertensive group than in the normotensive group. When the subjects were
      divided into three groups according to their age (less than 50 years old, between
      50 and 60 years old and more than 60 years old), the prevalence of glucose
      intolerance (DM or IGT) was significantly higher in the hypertensive group than
      in the normotensive group in subjects under 50 years old, but not in subjects
      between 50 and 60 years old or over 60 years old. In the subjects classified as
      having normal glucose tolerance, the incremental area of glucose under the curve
      of 75g-OGTT was significantly higher in the hypertensive group than in the
      normotensive group. These data suggest that hypertension is associated with
      glucose intolerance in Japanese population and that age significantly affects
      this interaction.

PMID- 8361082
TI  - [Two elderly cases of megacolon associated with cerebral infarction and diabetes
      mellitus].
AB  - The authors experienced two elderly patients of megacolon associated with
      cerebral infarction and diabetes mellitus. The first patient was a 66-year-old
      female who was admitted to our hospital for rehabilitation with a complaint of
      knee pain. She had suffered from diabetes mellitus since she was 30 years old and
      multiple cerebral infarction since age 62. Two months after admission, she had an
      episode of abdominal distension and obstructive symptoms. The roentgenograms of
      her abdomen showed diffuse dilatation of the colon. The second patient was a 78
      year-old female admitted to our hospital with complaints of abdominal pain,
      distension of the abdomen and vomiting. Her abdomen was severely distended and
      plain roentgenograms of the abdomen, X-ray studies of the colon with the aid of
      contrast medium and CT scan of the abdomen showed striking dilatation of the
      colon. Megacolon may be congenital or acquired, and in acquired forms the
      conditions are secondary to organic diseases, smooth muscle atrophy, metabolic
      and neurological diseases, ulcerative colitis or psychogenic origin (idiopathic).
      The two patients in this series were suffered from cerebral infarction and
      diabetes mellitus. The mechanisms of megacolon seen in these two patients are not
      known, but involvement of the visceral autonomic innervation is presumed. Some
      elderly patients have chronic constipation, and dilatation of the colon may not
      be uncommon due to underlying diseases or drugs. Therefore, when examining
      elderly patients, careful attention should be paid to their bowel movement.

PMID- 8361084
TI  - [Immune reaction, inflammation and sclerosis].

PMID- 8361083
TI  - Angiotensin II receptors: cloning, structure, function and regulation.

PMID- 8361085
TI  - [Dialysis therapy--1992].

PMID- 8361086
TI  - [Renal transplantation--1992].

PMID- 8361087
TI  - [Nutrition and renal disease].

PMID- 8361088
TI  - [The role of the kidney in essential hypertension].

PMID- 8361090
TI  - [Pregnancy induced hypertension and renal changes].

PMID- 8361089
TI  - [The histopathology of tubulo-interstitial nephritis].

PMID- 8361091
TI  - [Mesangial cells and growth factors].

PMID- 8361092
TI  - [Clinical and basic studies on immunosuppressive agents in renal disease].

PMID- 8361093
TI  - [Studies in Walter-electrolyte metabolism on the basis of molecular biology].

PMID- 8361094
TI  - [Gene expression for extracellular matrix components and growth factors in
      DBA/2FG-pcy mice with polycystic kidney disease].

PMID- 8361095
TI  - [The experimental models of glomerulonephritis--the present status and the
      prospect for the future].

PMID- 8361096
TI  - [Recent advances in the research on the acute renal failure--pathophysiological
      aspect].

PMID- 8361097
TI  - [Surgical treatment of elderly patients with primary lung cancer].
AB  - Fourteen patients with lung cancer over the age of 70 years had the standard
      operation with mediastinal lymph node dissection. Their postoperative
      complications and prognoses were compared with those of 47 patients under the age
      of 70 years with the same operation. The propriety of the standard operation with
      mediastinal lymph node dissection for lung cancer in elderly patients was
      studied. A program of respiratory training was arranged preoperatively for the
      patients. Preoperative complications was more common in elderly than in younger
      patients, but postoperative complications were less frequent. The prognosis in
      elderly patients was also satisfactory. We conclude that the standard operation
      with mediastinal lymph node dissection for lung cancer can be performed as well
      in elderly as in younger patients.

PMID- 8361098
TI  - [A role of valvuloplasty in surgical treatment of isolated tricuspid
      regurgitation].
AB  - Seven surgical cases of isolated tricuspid regurgitation were reviewed. From
      pathological point of view, the patients were classified into three groups. Two
      were due to abnormalities of subvalvular system, four to annular dilatation and
      one to anomalous leaflet. Among four cases of annular dilatation, two were
      diagnosed as dilated cardiomyopathy. In one, it was very rare myopathy confined
      to right ventricle. Three cases, two subvalvular and one leaflet abnormalities,
      underwent valvuloplasty which included chordal reconstruction using Gore-Tex
      suture. Among annular dilatation group, three underwent valve replacement (two
      with mechanical valve and one with bioprosthetic valve), while fourth underwent
      annuloplasty. When We look at 89 surgical patients with secondary tricuspid
      regurgitation, thrombosed mechanical valve was seen in two cases, one of them
      necessitating re-valve replacement. On the other hand, late results of tricuspid
      annuloplasty with Carpentier-Edwards ring was excellent without re-operation.
      Although isolated tricuspid regurgitation has very complicated pathological
      features, we now think it very important to manage to repair regurgitant
      tricuspid valve utilizing all available techniques including redundant valve
      tissue resection, chordal reconstruction, and annuloplasty, thus avoiding valve
      replacement especially with mechanical valve.

PMID- 8361099
TI  - [Tracheobronchial injury: clinical analysis of 17 consecutive cases].
AB  - Consecutive 17 tracheobronchial injury caused by blunt chest trauma were
      reviewed. 14 patients were injured by traffic accidents, 2 by fall from the high,
      and one by accident during play in the house. 16 were male and one was female.
      Patient's age range from 4 to 60 years (average 25). Site of tracheobronchial
      injuries were scattered and there were not found risky area. Several problem to
      rescue tracheobronchial injuries are discussed. To maintain the ventilation in
      the patient of carinal injury, it is supposed that jet ventilation may be a
      possible method. For the infant victims, it is difficult to evaluate the injury
      using bronchofiberscopy. It is recommended that repair of tracheobronchial injury
      may be undergone as soon as the general condition becomes enough for anesthesia.
      On a technical aspect, stay suture should be put at the healthy site because
      those injuries are larger than expected before operation. For the victims with
      cerebral injury or shock, respirator is necessary for ventilatory management. In
      those cases adequate sedation and muscle relaxation should be applied.

PMID- 8361100
TI  - [Disadvantages of "Gelseal graft" as a vascular prosthesis].
AB  - In clinical use, the Gelseal Triaxial graft have been shown to have several
      problems, such as pyrexia, pleural effusion and seroma formation around the
      graft. To investigate the cause of these complications, we examined mechanical
      and biological properties of the graft. The water permeability was found to be 0
      ml at 120 mmHg in an in vitro study. Scanning electron microscopical observation
      revealed that gelatin in the graft wall was not uniform and easily detached from
      the luminal surface. The amount of impregnated gelatin in the graft was found to
      be 6.73 mg/cm2. In addition, this graft contained 297 and 73 pg endotoxin in
      extract/g of graft wt at 25 degrees C 72 hrs as assessed by Toxicolor and
      Endospecy pyrogen tests, respectively. The grafts were implanted in the
      descending aorta of 8 dogs for 2 weeks in an animal study. Three out of 8 animals
      died of graft occlusion. Both macroscopic and microscopic evaluations of the
      explants from 5 dogs showed that neither fibroblasts nor capillary blood vessels
      had infiltrated in some area of the graft wall. Serous fluid was found to be
      retained between the graft and the surrounding host tissue in three cases. These
      results indicated that the Gelseal graft was easy to implant due to zero
      porosity, but the coated gelatin was not clean and gelatin was easily detachable.
      Hence, the graft would be prone to some complications such as pyrexia, immune
      response, thromboembolism, seroma, and pleural effusion. One must be aware of the
      potential disadvantages of the Gelseal grafts before using it in patients.

PMID- 8361101
TI  - [Newly-developed catheter for cardio-renal assist during intraaortic balloon
      counterpulsation].
AB  - A new catheter was developed for the cardio-renal assist during intra-aortic
      balloon counterpulsation. The catheter consists of both a large balloon of
      conventional IAB (TMP balloon) located at the distal end of the catheter and an
      additional small balloon 10 cm distant from the large balloon with common lumen
      and single shaft. Experimental study was carried out in the mock circulatory
      system simulating the descending aorta employing a conventional IAB catheter as a
      control. It was demonstrated that the flow in the mid portion between both
      balloons could be increased maximally by as much as 28% of that of the control
      under the continuous flow and 214% under the pulsatile flow. The double balloon
      catheter was considered to improve the renal perfusion as well as the coronary
      perfusion.

PMID- 8361102
TI  - [A successful insertion of the prosthetic valve in supraannular position
      concomitant with pericardial enlargement of the aortic root in a child: a case
      report].
AB  - A 4-year-old boy admitted to our hospital due to congestive heart failure one
      year after the intracardiac repair of tetralogy of Fallot. Echocardiography and
      cineangiography revealed severe aortic regurgitation. The aortic valve
      replacement was performed with a prosthesis larger than the aortic annulus.
      Operative findings showed that the cause of aortic regurgitation was infective
      endocarditis. The aortic root was enlarged with pericardial patch and a 21 mm St.
      Jude Medical valve prosthesis was inserted in supraannular position. This
      technique was very useful for insertion of a prosthetic valve one or two sizes
      larger than the aortic annulus without risk of distorting the mitral valve or
      left ventricular function.

PMID- 8361103
TI  - [Transcranial Doppler monitor in the case of selective cerebral perfusion].
AB  - Six patients underwent ascending aorta and aortic arch replacement for aneurysmal
      disease between 1991.12-1992.2 using the cardiopulmonary bypass technique with
      selective cerebral perfusion from right axillary artery. For four patients,
      intraoperative transcranial Doppler monitorings of left MCA flow velocity were
      done. We added left carotid artery perfusion for 5 patients because of old age;
      1, intraoperative finding of anisocoria; 1 and low left MCA flow velocity on the
      TCD monitor; 3. After the addition of left side perfusion, the left MCA flow
      velocity on the TCD monitor recovered to normal level in the 3 patients. TCD
      reflected the cerebral perfusion state every minutes and seemed to be very useful
      monitor in selective cerebral perfusion. It also suggested that unilateral
      cerebral perfusion does not supply enough blood flow in contralateral side of
      brain in many cases. To another patient who also underwent aortic arch
      replacement, we examined preoperatively left MCA flow velocity on the TCD monitor
      under left carotid artery compression. This "carotid artery compression test" was
      thought to suggest the degree of right to left intracranial collateral blood flow
      via Willis's circle. TCD image, when the left carotid artery was clamped, was
      compared with the result of preoperative "carotid artery compression test". But
      we can't evaluate the results quantitatively now.

PMID- 8361104
TI  - [Surgical treatment of endocardial cushion defect in 3 elderly patients].
AB  - We performed surgical treatment for partial endocardial cushion defect in 3
      patients over fifty year old. Case 1 was a 55-year-old-male with TR of grade II.
      Case 2 was a 59-year-old-female with TR and MR, and was repaired mitral cleft by
      a mattress suture. She needed infusion of dopamine (over 5 micrograms/kg/min) for
      6 days and therapy of mediastinitis postoperatively. Case 3 was 56-year-old-male
      without atrioventricular valve regurgitation. Preoperative left ventricular
      volume was small in all patients, therefore perioperative circulatory control,
      mainly water balance, and respiratory control were importance. All patients
      survived, and both decreasing of CTR and improvement of NYHA classification were
      recognized in all three patients. In conclusion the operation for ECD in even
      elder patients was effective, but intensive care needed perioperatively.

PMID- 8361105
TI  - [Solitary papilloma of the lung: a case report].
AB  - A case of solitary papilloma of pulmonary parenchyma is presented. The patient
      was a 47-year-old woman admitted our clinic because of a mass shadow on routine
      chest films. The operation was performed without definitive diagnosis of the
      tumor. Intraoperative frozen specimen revealed to be either papilloma or squamous
      cell carcinoma. So right upper and middle lobectomies with mediastinal lymph
      nodes dissection were performed. When a definite diagnosis cannot be proved to be
      papilloma even at surgery, treatment as a lung cancer should be performed.
      Solitary benign papilloma like this case is very rare. According to the
      literature, this case seems to be the first Japanese case of solitary papilloma
      in pulmonary parenchyma.

PMID- 8361106
TI  - [A case of hypertrophic obstructive cardiomyopathy using intraoperative trans
      esophageal echocardiography].
AB  - A 45-year-old man underwent trans-aortic myectomy for hypertrophic obstructive
      cardiomyopathy (HOCM). Although two mounds of hypertrophic septal muscle were
      resected, Brockenbrough phenomena proved unsatisfactory myectomy. Intraoperative
      trans-esophageal echocardiogram (TEE) revealed a residual mound at the apical
      septum. After the additional myectomy, Brockenbrough phenomena was disappeared.
      Intraoperative TEE is an useful supplement in the operation of transaortic
      myectomy for HOCM.

PMID- 8361107
TI  - [A case of primary cardiac hemangiosarcoma].
AB  - A case of primary hemangiosarcoma of right atrium was reported. The patient was
      43 years old female. She had the symptoms of tamponade due to massive bloody
      pericardial effusion. Echocardiography, computed tomography, NMR imaging and
      angiography revealed the precise delineation and extension of tumor, and also
      allowed diagnosis of hemangiosarcoma. Extirpation of tumor was performed under
      the cardiopulmonary bypass. The patient was died 3 months later after the
      operation for liver metastasis. The bloody pericardial effusion seems to be an
      important symptom of the primary malignant cardiac tumor, and early and precise
      diagnosis may allow successful operation and long survival of the patients.

PMID- 8361108
TI  - [Urgent mitral valve replacement for acute mitral regurgitation due to ruptured
      chordae tendineae in systemic lupus erythematousus].
AB  - We reported a successful surgical treatment of mitral regurgitation (MR) due to
      ruptured chordae tendineae in a 44-year-old man with systemic lupus erythematosus
      (SLE) who had received the steroid therapy. He had signs of acute congestive
      heart failure with severe pulmonary hypertension due to MR, and underwent urgent
      mitral valve replacement. The postoperative course was uneventful. When replacing
      valve in SLE, a careful manipulation should be taken because of friability of
      cardiovascular tissue. Patients are usually administered steroid agents, and the
      agents ought to be discontinued in perioperative period, but it seems to be
      better to resume as soon as possible. We conclude that the surgical treatment for
      valvular diseases should be considered, even in the patient with SLE.

PMID- 8361109
TI  - [A case of coronary artery bypass grafting for single coronary artery complicated
      by angina pectoris].
AB  - A case of coronary artery bypass grafting (CABG) for single coronary artery
      complicated by angina pectoris (AP) was reported. The patient was a 74-year-old
      male, complained of anginal discomforts. His single coronary artery originated in
      left coronary sinus, bifurcated to the left anterior descending artery (LAD) and
      the circumflex artery (CX), and then, an abnormal communicating branch, passing
      in front of the right ventricular outflow, was branched from the proximal region
      of LAD; it showed a route corresponding to the proximal region of the right
      coronary artery (RCA). The distal region of RCA and the posterior descending
      artery were angiographed in continuity from CX. Other findings included 75%
      stenosis at LAD-#6 and 90%-stenosis at CX-#13. Using two saphenous vein grafts,
      CABG operation was carried out on those regions at LAD-#7 and distal CX
      corresponding to #3 normally. Postoperatively, anginal discomforts disappeared,
      and favorable results were obtained.

PMID- 8361110
TI  - [Successful operation for isolated cardiac rhabdomyoma of the right atrium].
AB  - A 12-year-old girl has experienced palpitation and dizziness, and presented
      atrial flutter with maximal heart rate of 220/min. Two-dimensional echocardiogram
      and chest MRI revealed a mass attached to the inter-atrial septum. Complete
      excision of the tumor including the atrial septum was performed without damage to
      tricuspid valve. The interatrial septal defect was closed primarily. Histology of
      the tumor was compatible with cardiac rhabdomyoma. Sinus rhythm was present and
      no tachycardia occurred in the postoperative period. On the literature, only one
      case of isolated cardiac rhabdomyoma developing in the atrium was reported and
      this is considered as the oldest operative case in Japan.

PMID- 8361112
TI  - [A case of chondrosarcoma of the thoracic vertebra].
AB  - A case of chondrosarcoma of the thoracic vertebra in a 47-year-old female is
      described. Chest X-ray, CT and MRI disclosed an abnormal mass lesion in the
      posterior mediastinum. The lesion was surgically removed through right
      thoracotomy. The operative findings revealed that the lesion, hard and measuring
      6.5 x 4.5 x 4.5 cm in diameter, was originated from the 7th and 8th thoracic
      vertebra. The lesion was histopathologically diagnosed chondrosarcoma. The
      chondrosarcoma arising from the thoracic vertebra is very rare, and only 10 cases
      have hitherto been reported in the Japanese literature.

PMID- 8361111
TI  - [A case report of graft replacement of the ascending and transverse aorta without
      homologous red blood cell transfusion].
AB  - A 28-year-old man of DeBakey type I dissecting aneurysm was received graft
      replacement of the ascending and transverse aorta under the deep hypothermic
      circulatory arrest and continuous retrograde cerebral perfusion for cerebral
      protection during circulatory arrest. From 3 weeks before operation, autologous
      blood was collected from the patient with the intravenous administration of a
      recombinant human erythropoietin (rHuEPO) and was subsequently used in the
      operation. As result, the graft replacement of the ascending and transverse aorta
      was performed without homologous red blood cell transfusion and postoperative
      neurological complications. We believe autologous blood transfusion with rHuEPO
      and circulatory arrest with CRCP contributes operations of aortic aneurysms
      without homologous blood transfusion.

PMID- 8361113
TI  - [A case of intrathoracic colon perforation due to adult Bochdalek hernia].
AB  - The patient, a 70-year-old man, diagnosed as having left pneumothorax and
      hydrothorax, was admitted and had a thoracic drain inserted. The evacuation of
      stool was noted from 3 days after insertion. With the abscess in the left
      thoracic cavity shown on emergency CT, a diagnosis of perforation of the
      digestive tract in the left thoracic cavity was made and emergency operation was
      performed. On the basis of the intraoperative findings, the case was diagnosed as
      adult Bochdalek hernia with intrathoracic colon perforation, and repair of hernia
      and colostomy were done by laparotomy and thoracotomy. However, the patient died
      of DIC and sepsis 5 days after operation. Two cases of adult Bochdalek hernia
      complicated with spontaneous pneumothorax have hitherto been report. However,
      there has been no reported case which had adult Bochdalek hernia complicated with
      pneumothorax considered due to intrathoracic colon perforation as in this case.
      So this case was considered very rare and worthy of reporting.

PMID- 8361114
TI  - [Squamous papillomatosis of the left main bronchus and trachea: a case report].
AB  - A 49-year-old female complaining of dyspnea at exercise was admitted.
      Bronchoscopic examination revealed that the left main bronchus was almost
      obstructed by a tumor. A sleeve resection of the left main bronchus was
      performed. Histological examination confirmed that the tumor was squamous
      papilloma. After one year and eight months, bronchofiber examination disclosed
      papilloma in the trachea. Therefore, papilloma was treated with endoscopic
      methods, including Nd-YAG laser. The patient has survived for 11 years since
      first treatment.

PMID- 8361115
TI  - [Retreatment of pulmonary tuberculosis--duration of chemotherapy].
AB  - Although standard chemotherapy for initial treatment of pulmonary tuberculosis
      has been established, regimens for retreatment of tuberculosis have not yet been
      established. One hundred fifty nine retreatment pulmonary tuberculosis cases
      admitted to Fukujuji Hospital were retrospectively analyzed. Regardless of the
      age at the start of retreatment, majority of cases were treated previously
      between 1955 and 1960. Bacillary negative conversion rate, duration of
      chemotherapy, follow-up period and bacteriological relapse rate were compared
      according to resistance against isoniazid and/or rifampicin. Sixty four cases
      were sensitive to both INH and RFP. For this group the average duration of
      chemotherapy was 14.6 months, mean follow up period was 47.3 months and relapse
      rate was 3.1%. This rate was similar to that of initial treatment cases. Sixty
      one (94%), were treated with more than two sensitive drugs containing INH and
      RFP. The 22 INH-resistant and RFP-susceptible cases were treated for 18.6 months
      and followed up for 55.2 months. The relapse rate of this group was 13.6%.
      Thirteen cases were treated with more than 2 sensitive drugs containing RFP.
      Eleven cases were resistant to both INH and RFP. Five of them were surgically
      operated of which 3 cases were converted to negative and among the nonsurgical
      cases in this group only one remained sputum positive. All of these retreatment
      regimens did not contain pyrazinamide and ofloxacin. Although bacillary positive
      rate of INH and RFP susceptible cases was 13.0% at 6 months after treatment and
      5.3% at 12 months after treatment, that of INH resistant and RFP susceptible
      cases were 25.0% and 12.5%, respectively. A certain rule of retreatment could be
      obtained from the result of this study.

PMID- 8361116
TI  - [Clinical studies on lung disease caused by atypical mycobacteria in our hospital
      -especially in relation to drug susceptibility].
AB  - From 1987 to 1991, 27 patients were diagnosed as atypical mycobacteriosis in our
      hospital. Some strains of M. avium complex were found to be M. avium and M.
      intracellulare by means of a DNA probe test. 1. Total cases consisted of 14 males
      (the average age was 66.7 years) and 13 females (65.7 years). 2. M. avium complex
      was observed in 24 patients (9 cases of M. avium and 5 cases of M.
      intracellulare): M. kansasii and M. chelonae were found in 2 patients and 1
      patient, respectively. 3. The findings of sputum cultures became negative three
      months after the chemotherapy treatment in 3 out of 25 patients. Two male
      patients were operated on and cured. Three patients died, and all of them had
      respiratory infections. 4. To determine the susceptibility of mycobacteria
      strains isolated from patients to various antimicrobial agents, an investigation
      was carried out. There were 88 strains of M. tuberculosis, 52 strains of M. avium
      complex (23 strains of M. avium and 17 strains of M. intracellulare), 3 strains
      of M. kansasii, 2 strains of M. gordonae and 2 strains of M. chelonae. 5. Strains
      of M. tuberculosis, M. kansasii and M. gordonae were susceptible to various
      antituberculous agents and ciprofloxacin. Strains of M. chelonae were susceptible
      to ciprofloxacin, and one strain was susceptible to streptomycin and ethionamide.
      6. The M. avium strains were more susceptible to cycloserine and ciprofloxacin
      than were the M. intracellulare strains. Conversely, the M. intracellulare
      strains were more susceptible to ethambutol than were the M. avium strains.

PMID- 8361117
TI  - [A survey of the initial course of tuberculosis chemotherapy under compulsory
      hospitalization on the basis of the revised Tuberculosis Prevention Law--report
      of the 32nd C series of controlled trials of chemotherapy--Cooperative Study Unit
      of Chemotherapy of Tuberculosis of the National Sanatoria in Japan].
AB  - We studied 2247 patients with pulmonary tuberculosis who were hospitalized for
      the initial course of chemotherapy under the provision of the revised
      Tuberculosis Prevention Law issued by Japanese Ministry of Welfare. The results
      were as follows. 1) There were more males than females with a ratio of 2.6: 1. 2)
      There were two peaks in their ages, 20s and 60s. 3) The average admission periods
      were 5.2 +/- 2.7 months for men and 5.1 +/- 2.8 months for women. 4) The average
      compulsory admission periods were 6.8 +/- 2.5 months for men and 6.4 +/- 2.3
      months for women, so that the actual admission periods were shorter in the
      majority of the patients. 5) The sputum cultures were converted negative in three
      months in about 80 percent of the patients who were smear and/or culture positive
      on admission. 6) The appearance rate of INH-resistant and RFP-resistant strains
      were 2% and 1.4% respectively. 7) Most of the death from tuberculosis was
      observed in the early stages of admission. 8) With regards to the cost, there
      seemed to be no difference whether treated under the new or the old provisions.
      9) The newly approved extension of the admission periods for those who had
      complications such as diabetes mellitus or pneumoconiosis and those who had INH
      and/or RFP positive bacilli seemed to be appropriate.

PMID- 8361118
TI  - [A case of oral tuberculosis suspected malignancy].
AB  - Oral tuberculosis with pulmonary tuberculosis is very rare in Japan. A 45-year
      old man admitted to our hospital because of spontaneous teeth extraction and pain
      in oral cavity for the past 3 months. The painful granulation in palate and
      fistel of 7th tooth root defect in right upper gum were observed. The diagnosis
      of oral tuberculosis was made by the histological examination of biopsy material
      and positive smear test for M. tuberculosis in surface of granulation. Chest X
      ray showed multicavitary lesions in bilateral upper lobs and spread shadows in
      bilateral lower lung fields. He was treated with chemotherapy (INH, RFP, SM and
      EB) and with tube feeding. Five month's chemotherapy was needed to achieve cured
      granulation and negative smear test for M. tuberculosis in sputum. He was
      discharged 10 months after admission.

PMID- 8361119
TI  - Proceedings of the Priscilla Kincaid-Smith Festschrift. Melbourne, Australia,
      November 5-8, 1991.

PMID- 8361120
TI  - A specific glomerular lesion of the graft: allograft glomerulopathy.
AB  - During the period from January 1973 to December 1970, 774 renal transplantations
      in 698 children have been performed in our Renal Unit. A total of 540 grafts have
      been examined both by light and immunofluorescence microscopy at least once.
      Recurrent glomerulonephritis was diagnosed in 62 grafts, de novo
      glomerulonephritis in 68 and allograft glomerulopathy (AGP) in 38. AGP was
      defined as a lesion affecting all glomeruli and characterized by widespread
      reduplication of the GBM with widening of the subendothelial space and
      interposition of mesangial matrix and without significant deposits by
      immunofluorescence. The aim of the current study is to describe the natural
      history of AGP and to delinate its clinical significance. At time of biopsy, an
      increase in serum creatinine was present in 30 patients associated with a
      proteinuria > or = 1 g/day in 21. During the post-transplantation course,
      proteinuria was present in 29 patients and associated with a nephrotic syndrome
      in 10 of them. With a mean follow-up of eight years seven months, two patients
      died, 23 lost their grafts and 13 have a functioning graft. The lesions of AGP
      recurred in three of the nine children who received a second graft. Thirteen of
      the 33 patients in whom earlier biopsies were performed showed a different
      pattern of involvement characterized by a prominent swelling of active
      endothelial and mesangial cells and a hypercellularity related to the presence of
      mononuclear cells both in the lumens and in the mesangial areas.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8361121
TI  - Future directions in transplantation: xenotransplantation.
AB  - Xenotransplantation would overcome the worldwide shortage of organs for
      transplantation. However, xenotransplantation using primate organs is
      unpracticable, and xenotransplantation between phylogenetically disparate species
      results in hyperacute rejection. This fulminant form of rejection is mediated by
      both naturally occurring xeno-antibodies and by direct activation of the
      alternative pathway of complement. The precise specificities of the xeno
      antibodies are incompletely understood and better characterization of these
      antibodies and their target antigens is needed to allow the development of
      therapeutic maneuvers, such as immunoadsorption of the relevant antibodies. The
      direct activation of the alternative pathway of complement by xenogeneic tissue
      is due, at least in part, to the lack of appropriate (human) membrane bound
      regulators of complement on the xenogeneic cells. These regulatory molecules,
      called homologous restriction factors, are species specific, and act to favor
      inactivation of the complement cascade if the complement is of the same species.
      Human homologous restriction factors are capable of protecting xenogeneic cells
      from lysis mediated by human complement. The study of cell-mediated rejection in
      xenotransplantation has been largely overshadowed by hyperacute rejection.
      Resolution of the barriers to xenotransplantation will benefit the ever growing
      number of patients awaiting transplantation.

PMID- 8361122
TI  - Deficiency and depletion of complement in the pathogenesis of nephritis and
      vasculitis.

PMID- 8361123
TI  - Pathogenesis of glomerulonephritis.
AB  - This review summarizes current understanding of the mechanisms which mediate
      immune glomerular injury in glomerulonephritis. Non-inflammatory lesions
      resembling minimal change disease and membranous nephropathy, respectively, are
      induced by non-complement fixing antibodies to glomerular epithelial cell (GEC)
      membrane antigens (minimal change disease) and GEC membrane insertion of the C5b
      9 membrane attack complex of complement (membranous nephropathy). The cellular
      mechanisms of these effects are unclear but may involve GEC activation and
      release of local mediators, such as proteases or oxidants, or GEC detachment from
      underlying basement membrane. Inflammatory types of glomerular lesions are
      mediated by circulating inflammatory cells (neutrophils, platelets, macrophages)
      or by resident glomerular cells (mesangial cells) or both. Neutrophil-mediated
      injury involves local release of GBM degrading proteases or GBM halogenation
      induced by the interaction of neutrophil-derived myeloperoxidase with H2O2 and a
      halide. Neutrophil induced glomerular injury is augmented by platelets. Recent
      evidence establishes that mesangial cell proliferation in glomerulonephritis is
      mediated by complement and platelets. Mesangial cell proliferation is accompanied
      by increased expression of PDGF and PDGF receptor proteins and the genes for
      these proteins resulting in an autocrine mechanism of cell proliferation.
      Mesangial cell proliferation is also accompanied by increased release of neutral
      proteinase in sites of basement membrane damage. Mesangial cell proliferation
      precedes up-regulation of genes for extracellular matrix components in several
      models and may be important in the pathogenesis of glomerulosclerosis.

PMID- 8361124
TI  - The contributions of Priscilla Kincaid-Smith to the study of glomerulonephritis:
      a personal view.

PMID- 8361125
TI  - Role of leukocyte-endothelial cell adhesion molecules in renal inflammation: in
      vitro and in vivo studies.
AB  - An increasing body of evidence suggests that endothelial cells as well as
      parenchymal cells within the kidney express multiple cytokine-inducible leukocyte
      adhesion molecules. This paper reviews evidence from our own laboratory as well
      as others on the in vitro induction and function of adhesion molecules in the
      kidney. We review current data from the literature on the possible role of
      endothelial cell adhesion molecules in mediating leukocyte infiltration and renal
      injury in experimental and human transplant rejection and glomerulonephritis.
      These early studies suggest that leukocyte-endothelial adhesive interactions
      result in a complex cascade of biological and pathological processes leading to
      renal injury. Further analysis of such interactions in the kidney will elucidate
      their specific roles.

PMID- 8361126
TI  - The glomerular peripolar cell.
AB  - The PPC is a distinctive granulated epithelial cell at the vascular pole of the
      glomerulus. It is present in a wide range of animal species. It is especially
      prominent in sheep, particularly the newborn lamb. To date, it has been shown
      that its granules contain albumin, immunoglobulins, neuron-specific enolase and
      transthyretin. It does not appear to contain renin. The function of the PPC
      awaits clarification. It has been postulated that it may play a role in the
      synthesis and secretion of factors involved in modulating renal tubular function.

PMID- 8361127
TI  - Localization and properties of angiotensin II receptors in rat kidney.

PMID- 8361128
TI  - Renal gene expression.
AB  - The advent of cloned DNA probes has revolutionized the study of cells and tissues
      via the technique of hybridization histochemistry. Because of the intrinsic
      specificity of the probes the application of the technique to functionally
      complex and morphologically diverse tissue like the kidney has been especially
      rewarding. The technology has been advanced enormously by the parallel
      development of synthesized DNA or oligonucleotides. A specific synthetic probe
      can be manufactured in a day, purified, labeled and used to determine in which
      cells a particular gene of interest is being expressed ("switched on"). The
      applications of this technology are particularly opposite in the renal field.
      They can provide unique insights into normal physiological processes and will
      provide new diagnostic approaches of unparalleled specificity. Some specific
      examples have been chosen over a wide range of institute programs to highlight
      the potential value of the technique of hybridization histochemistry and to
      emphasize its potential for studying renal physiology and pathology.

PMID- 8361129
TI  - Contributions of Priscilla Kincaid-Smith to hypertension.

PMID- 8361130
TI  - Hypertension and the kidney.
AB  - From our perspective, Priscilla Kincaid-Smith's major achievement in the field of
      hypertension relates to the pathogenesis of vascular lesions. Our own studies of
      the hypertension of renal parenchymal disease have suggested a role for
      impairment of the cortisol-cortisone shuttle and decreased activity of the enzyme
      complex 11-beta-hydroxy-steroid dehydrogenase. We have defined the renal
      functional consequences of steroid-induced hypertension and shown that the rise
      in blood pressure produced by steroids with predominant glucocorticoid activity
      is not dependent on volume shifts or sodium status, although the magnitude of the
      rise is modulated by dietary sodium content. We have shown that normal pregnant
      women adapt readily to extremes of sodium intake while women with pre-eclampsia
      retain sodium, and have shown enhanced capillary permeability. Recent studies
      have defined an abnormal aldosterone:renin ratio, dopaminergic inhibition of
      aldosterone, elevations of plasma atrial natriuretic peptide and reduced urinary
      prostacyclin:thromboxane ratios in women with pre-eclampsia.

PMID- 8361131
TI  - Intrarenal renin-angiotensin system in renal physiology and pathophysiology.
AB  - It has now been demonstrated by several techniques that all components of the
      renin-angiotensin system reside within the kidney. It is likely that angiotensin
      II is formed within interstitial renal tissue, as well as intracellularly, and
      acts locally in an autocrine, paracrine or intracrine manner. It has been
      difficult to dissect the different renal physiological roles of circulating
      angiotensin II as opposed to intrarenal generated angiotensin II. Angiotensin
      converting enzyme (ACE) inhibitors have played an important role in helping
      distinguish the effects of intrarenal angiotensin. Apart from hemodynamic actions
      and effects on glomerular filtration rate and renal tubular function, the
      intrarenal renin angiotensin system probably plays an important role as a
      regulator of renal sympathetic activity, modifies mesangial cell function, acts
      as a renal growth promoter, maintains endothelial cell function, and may be an
      important inflammatory mediator in the kidney. The renoprotective action of ACE
      inhibitors in reducing proteinuria and in slowing the fall in glomerular
      filtration rate in experimental and human renal disease may involve any of the
      above mechanisms. However, a prerequisite for the renoprotective action of ACE
      inhibitors is reduction of systemic blood pressure.

PMID- 8361132
TI  - Aspects of renal disease and pregnancy.

PMID- 8361133
TI  - Drug treatment of hypertension.
AB  - Over the last 40 years effective drug treatment of hypertension has become
      available. Newer classes of drugs offer efficacy with simplicity of dosing
      regimen and good patient acceptability. However, there is increasing interest in
      the long-term benefits of treatment, particularly influences on total mortality
      and morbidity and mortality from coronary artery disease and its complications.
      Established treatments with diuretics and beta blockers do reduce stroke risk but
      have less than predicted effects on coronary heart disease. While there is
      experimental evidence and clinical pointers that ACE inhibitors and calcium
      antagonists may influence atherosclerosis in the long-term, there is as yet no
      objective clinical confirmation. The aim of treatment in the 1990s is to control
      blood pressure (and other risk factors) in the short-term with a view to
      improving long-term outcome. Many clinicians have modified step-care approaches
      to individualize drug treatment using one or two agents, selected from older and
      newer classes, which on clinical grounds are most appropriate in the individual
      patient. Factors determining choice are race, other risk factors and associated
      diseases.

PMID- 8361134
TI  - Chronic tubulo-interstitial nephritis: the contributions of Priscilla Kincaid
      Smith.

PMID- 8361135
TI  - Clinical management of autosomal dominant polycystic kidney disease.
AB  - Autosomal dominant polycystic kidney disease (ADPKD) is a common systemic genetic
      disease which comprises 8 to 10% of patients treated by dialysis and
      transplantation. Breakthroughs in molecular genetics and cell biology have led to
      new insights into cyst formation and growth. Until the specific genetic defects
      are identified, the management of this disorder will necessarily be empiric. This
      paper discusses current management strategies in ADPKD focusing on hypertension,
      hematuria, pain and infection. Special considerations for management of end-stage
      renal failure in patients with ADPKD are also reviewed.

PMID- 8361137
TI  - Analgesic nephropathy in the 1990s--an Australian perspective.
AB  - Analgesic nephropathy or analgesic abuse-associated analgesic nephropathy (AA
      AAN) is a disease of the twentieth century. The emergence of AA-AAN was due to
      aggressive marketing of analgesics and the susceptibility of individuals with
      addictive personalities to analgesic abuse. Analgesic abuse resulted in major
      morbidity and mortality from renal disease and renal failure, premature
      atherogenesis with cardiovascular diseases, and the other aspects of the
      analgesic syndrome; these conditions have had heavy demands upon health budgets.
      Legislative restriction of analgesic sales in Australia has resulted in a decline
      in analgesic abuse and end-stage renal failure from AA-AAN. There have also been
      changes in the analgesic syndrome. However, the long-term risks of transitional
      cell carcinoma of the uroepithelium remain as a legacy of analgesic abuse and AA
      AAN. Nonsteroidal anti-inflammatory drug-associated analgesic nephropathy (NSAID
      AAN) has emerged as a distinct clinical syndrome, and may become a significant
      health problem in view of the widespread use and misuse of NSAIDs.

PMID- 8361136
TI  - Vesico-ureteric reflux and reflux nephropathy.

PMID- 8361138
TI  - Microscopic urinalysis in glomerulonephritis.

PMID- 8361139
TI  - Lithium nephrotoxicity.
AB  - After nearly two decades of concern and controversy surrounding the long-term
      effects of lithium on the kidney, the fact that lithium is capable of causing a
      major disturbance in water balance, manifest as polyuria and secondary
      polydipsia, remains undisputed. A decreased urinary concentrating ability
      (nephrogenic diabetes insipidus) with a disturbed responsiveness of the distal
      nephron to the action of ADH (vasopressin) is demonstrable, and the symptoms are
      largely reversible on cessation of lithium or reduction of the dose. An acute
      histological lesion of the distal nephron, corresponding to the site of lithium
      inhibition of the action of ADH, and consisting of epithelial cellular swelling
      and glycogen deposition, also appears to be readily reversible. Of greater
      concern is the development of a progressive impairment of urinary concentrating
      ability in patients on long-term maintenance therapy--especially those with a
      history of acute lithium toxicity and those additionally treated with
      neuroleptics. This functional lesion is not always reversible, and the underlying
      renal histology is a chronic focal interstitial nephropathy. Interestingly, some
      psychiatric patients never exposed to lithium have demonstrated similar renal
      histology. There is very little evidence that stable maintenance lithium therapy,
      without episodes of acute intoxication, is associated with a reduction of
      glomerular filtration rate. Episodes of acute lithium intoxication are largely
      predictable, and therefore avoidable, provided appropriate precautions are taken.
      Patients with polyuria and impaired urinary concentrating ability are at
      increased risk of acute lithium toxicity because of excessive renal losses of
      fluid, and these symptoms should be treated in the first instance with dosage
      reduction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361140
TI  - Renal transplantation: contributions of Priscilla Kincaid-Smith.

PMID- 8361141
TI  - [Sinobronchial syndrome--a meaningful diagnosis?].
AB  - The term sinobronchial syndrome is often used, but there is no generally accepted
      definition. Due to the functional and clinical unity of the whole respiratory
      tract infectious and allergic irritations lead to homogeneous reactions of the
      bronchi and the paranasal sinuses. On the other hand there are hints that a
      disease in one region can cause problems in the other or reinforce it. Probably
      bronchi and sinuses can also become infected simultaneously from the pharynx. In
      chronic cases sinusitis and bronchitis are often only symptoms masking an
      underlying disease that requires differentiated diagnostics and treatment, e.g.
      cystic fibrosis, primary ciliary dyskinesia, and immunological defects.

PMID- 8361142
TI  - [Follow-up and prognosis of pyelonephritis in infancy].
AB  - 128 infants between 1 and 18 months, 80 girls and 48 boys suffering from their
      first pyelonephritis (PN), were investigated and followed up over 2.9 +/- 2.2
      years (mean +/- SD). 20 children showed urinary tract obstructions. In 49 of 108
      cases (45%) with nonobstructive PN a vesico-uretero-renal reflux (VUR) was found
      and surgically corrected in 13 cases. In 36 patients (52 renal units) the VUR
      disappeared in most cases under medical management within 3 years. Recurrences of
      urinary tract infections (UTI) were found in the same frequency in children with
      and without reflux (28%), but those with VUR showed significantly more PN. 22 of
      108 patients with nonobstructive PN (20%) developed renal scars, 39% of children
      with reflux (mostly VUR III. or IV. degree), 5% of those without reflux. In more
      than half of these cases renal scars were found already after the first PN. We
      conclude that a reduction of the risk of renal damage and an improvement of the
      prognosis can achieved by the following measures: 1. early detection of
      obstruction by pre- or postnatal sonographic screening, 2. early and exact
      diagnosis of PN and antibiotic therapy without delay. PN has to be excluded in
      all infants with unclear fever. 3. In all infants with PN a voiding cystography
      should be performed. In children with VUR, long-term chemoprophylaxis is
      necessary to avoid recurrence of PN.

PMID- 8361143
TI  - [Hirschsprung disease. Discussion of a disease picture also relevant to
      neonatology].
AB  - The clinical disease pattern of an "acute abdomen" is by no means rare in newborn
      and very young infants and always signals an emergency situation. Besides
      inflammatory causes, congenital anomalies are among the most prominent reasons
      responsible for this condition. The example of 3 own patients serves to
      illustrate the disease pattern of Hirschsprung's disease, which is discussed with
      special reference to neonatology.

PMID- 8361144
TI  - [Correlation between glycemia control and lipid metabolism parameters in children
      with diabetes mellitus].
AB  - Screening for hypercholesterolaemia and hypertriglyceridaemia should be
      considered in children with diabetes mellitus. Studies on different serum lipids
      in children with Type I diabetes have shown different results. Hyperglycaemia is
      the primary abnormality of diabetes. It is logical to consider elevated blood
      glucose as a possible risk factor in the development of macrovascular disease.
      Although associations between hyperglycaemia and diabetic complications have been
      repeatedly shown for microvascular disease, such an association is weaker for
      macrovascular disease. We report on the results of estimations of different serum
      lipids in 78 children with diabetes mellitus. These results are compared with
      those of assessment of the quality of glycaemic control. The results show an
      association between the quality of glycaemic control and the height of
      triglycerid concentrations. There were no associations between the quality of
      glycaemic control and LDL- and HDL-cholesterol. Cholesterol showed only a weak
      association to glycaemic control. In nearly all patients HDL-cholesterol was
      estimated to be in the upper normal range. The results are discussed in respect
      of possible risks for the development of macrovascular disease.

PMID- 8361145
TI  - [Treatment of ocular toxoplasmosis. Part 2: Therapeutic approaches].
AB  - Retinochorioditis is the most common complication of ocular toxoplasmosis and
      also the most dangerous one in respect of central visual acuity. New treatment
      concepts are increasingly replacing the therapy that had become established since
      the fifties and that had been based on pyrimethamine and sulphadiazine. The new
      concepts entail fewer complications and are better accepted by the patients.
      However, prospective randomised studies that are based on severe criteria could
      not prove for any of the employed treatment courses that it promotes healing of
      retinochorioditis or prevents relapses. However, if central visual acuity is
      endangered, drug therapy should nevertheless be initiated. In babies and in
      persons with immunodeficiency treatment must be in accordance with the overall
      pattern of symptoms.

PMID- 8361146
TI  - [A further case with Baller-Gerold syndrome (craniosynostosis--radial aplasia
      syndrome)--overview and new viewpoints on a rare syndrome].
AB  - The Baller-Gerold syndrome is a rare malformation syndrome with craniosynostosis.
      A radial defect is the main feature of this combination besides the premature
      craniosynostosis. The entity and the etiology of this inherited trait was often
      discussed in recent years. This syndrome is further characterised and presented
      as a distinct entity with the reported new case. Parents of such a child should
      be aware of the 25% recurrence risk in subsequent siblings because of an
      autosomal recessive mode of inheritance.

PMID- 8361147
TI  - [Preventive vaccinations 10 years after treatment of undifferentiated malignant
      blastoma?].

PMID- 8361148
TI  - [Increased risk of invasive bacterial infections after preventive mumps-measles
      rubella vaccination?].

PMID- 8361149
TI  - [The physician as expert witness. Aspects of an ambivalent role exemplified by
      expert testimony for legal health insurance].
AB  - This article provides a broad survey of the difficulties confronting the
      physician in his role as a specialist in the Health Insurance Medical Service,
      assessing claims relating to the state medical insurance system. These problems
      can be divided into the three following categories. Firstly, problems on a
      personal level relating to the interaction of the different people involved,
      albeit within the given institutional framework. Secondly, problems involving
      matters of principle in reconciling diagnosis, the patient's subjective
      assessment of his condition and legal criteria. Thirdly, problems arising from
      the pressure created by socio-cultural developments which influence both the
      patient and the specialist physician in his assessment.

PMID- 8361150
TI  - Volume profiles obtained by a conductimetric method.
AB  - One problem faced by intracardiac conductance volumetry is the non-uniform
      distribution of the injected current. Salo, in 1989, proposed a method to correct
      this undesirable effect. The objective here is to test Salo's method in known
      volumes of simple geometry by obtaining volume profiles. A plastic rod with 15
      metallic rings simulated the conductance catheter. Five sections were used for
      the resistance measurements employing the upper electrode as fixed current source
      and the lowest one as the shifting source. This is part of Salo's procedure. The
      source-to-section distance was measured from the moving source to the section
      (linear definition) or using the equivalent distance concept (Salo's).
      Thereafter, each sectional resistance set of values was plotted as a function of
      the inverse of the source-to-section distance (either definition) elevated to an
      empirical exponent k to obtain the corrected sectional resistance by
      extrapolation back to zero of the regression line, i.e., a value produced by a
      source theoretically placed at infinity. In addition, a mathematical analysis was
      attempted, searching for an optimum k based on minimum volume error. The best
      volume profiles for two cylinders and a frustum were obtained with k = 2 using
      the linear definition of distance (errors of -3.49%, -1.25% and -3.65%,
      respectively). Moreover, the frustum angle was determined within 0.4 degrees
      (2.7%) of the real value. The theoretical analysis led to an inverse logarithmic
      relationship between the exponent k and the source-to-section distance.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8361151
TI  - Microcomputer-based system for automatic analysis of M-mode echocardiograms.
AB  - A microcomputer-based system has been developed for automatically analysing M
      mode echocardiograms. This system can be used on images directly transferred from
      an echograph to the microcomputer. To obviate the major disadvantage of
      echocardiography, its poor signal-to-noise (S/N) level, the system conducts,
      first, an image restoration based on the quasi-periodicity of cardiac cycles,
      then border extraction is performed, using methods based on template matching
      using dynamic cardiac information present in the echocardiograms.

PMID- 8361152
TI  - Changes in oscillometric pulse amplitude envelope with cuff size: implications
      for blood pressure measurement criteria and cuff size selection.
AB  - Oscillometric blood pressures are derived from the amplitude envelope of
      oscillometric pulses generated in an occlusive cuff during cuff inflation or
      deflation; one factor which will affect the characteristics of these pulses is
      the size of the cuff bladder. Because limiting values are stipulated in
      recommendations and standards for bladder sizes, there is a wide variety of
      acceptable cuff sizes for any particular application. An experimental and
      theoretical study was undertaken to show the dependence of oscillometric blood
      pressures on bladder size. Actual cuff-arm compliance data were obtained from two
      subjects for two cuffs of different bladder size. Theoretical analysis was then
      applied to the data to predict the effects of different bladder sizes on the
      characteristics of the pulses. The results show that cuff-arm compliance and
      bladder size interact to affect the pulse amplitude and hence oscillometric blood
      pressure determination. These results suggest that blood pressures obtained using
      the oscillometric method may vary depending on cuff size, and in particular that
      replacement cuffs for oscillometric non-invasive blood pressure monitors should
      be chosen carefully.

PMID- 8361153
TI  - Dynamic model of the bronchial tree.
AB  - We present a distributed model of the bronchial tree which simulates the global
      dynamic characteristics of the lung. Local mechanical characteristics of each
      airway are represented by RCL circuits and parameters of the electrical
      components are determined from local physiological data. The bronchi geometry is
      described by Weibel's symmetric model, the flow in each airway is assumed laminar
      and mixing effects at the bifurcations are neglected; the transpulmonary pressure
      is assumed to be sinusoidal. In simulations of quiet breathing the resistance to
      airflow is found to be dominant, the flow amplitude decreasing as breathing
      frequency increases, but remaining almost constant in all the generations.
      Simulations of ventilation through obstructed lungs show frequency dependence of
      the dynamic characteristics in very compliant lungs. The global resistance to
      airflow and the dynamic compliance of the bronchi decrease as the forced
      oscillation frequency increases in a pattern similar to in vivo measurements in
      diseased lungs. This may be an outcome of the RCL properties of the network
      rather than due to uneven distribution of mechanical properties of the lung.

PMID- 8361155
TI  - Novel monochromatic optical density meter.
AB  - A novel monochromatic optical density meter is described for use with
      radiographic films. The principles of the instrument are outlined together with a
      brief description of the construction of a prototype model. The calibration of
      the meter shows high accuracy (r = 0.9999) in the optical density range 0-1.5 OD
      when compared to standard neutral density filters.

PMID- 8361154
TI  - A three-dimensional anatomical model of the human patello-femoral joint, for the
      determination of patello-femoral motions and contact characteristics.
AB  - The object of this study is to develop a three-dimensional mathematical model of
      the patello-femoral joint, which is modelled as two rigid bodies representing a
      moving patella and a fixed femur. Two-point contact was assumed between the femur
      and patella at the medial and lateral sides and in the analysis, the femoral and
      patellar articular surfaces were mathematically represented using Coons' bicubic
      surface patches. Model equations include six equilibrium equations and eleven
      constraints: six contact conditions, four geometric compatibility conditions, and
      the condition of a rigid patellar ligament; the model required the solution of a
      system of 17 nonlinear equations in 17 unknowns, its response describing the six
      degrees-of-freedom patellar motions and the forces acting on the patella.
      Patellar motions are described by six motion parameters representing the
      translations and rotations of the patella with respect to the femur. The forces
      acting on the patella include the medial and lateral component of patello-femoral
      contact and the patellar ligament force, all of which were represented as ratios
      to the quadriceps tendon force. The model response also includes the locations of
      the medial and lateral contact points on the femur and the patella. A graphical
      display of its response was produced in order to visualize better the motion of
      the components of the extensor mechanism. Model calculations show good agreement
      with experimental results available from the literature. The patella was found to
      move distally and posteriorly on the femoral condyles as the knee was flexed from
      full extension. Results indicate that the relative orientation of the patellar
      ligament with respect to the patella remains unchanged during this motion. The
      model also predicts a patellar flexion which always lagged knee flexion. Our
      calculations show that as the angle of knee flexion increased, the lateral
      contact point moved distally on the femur without moving significantly either
      medially or laterally. The medial contact point also moved distally on the femur
      but moved medially from full extension to about 40 degrees of knee flexion, then
      laterally as the knee flexion angle increased. The lateral contact point on the
      patella did not change significantly in the medial and lateral direction as the
      knee was flexed; however, this point moved proximally toward the basis of the
      patella with knee flexion. The medial contact point also moved proximally on the
      patella with knee flexion, and in a similar manner the medial contact point on
      the patella moved distally with flexion from full extension to about 40 degrees
      of flexion.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8361156
TI  - Stress analysis of endosseous implants using the Boundary Integral Equation (BIE)
      method.
AB  - The Boundary Integral Equation (BIE) method for modelling mathematically an
      endosseous implant within its bony surroundings is described in this study. The
      results are compared to those calculated by Finite Element Analysis (FEA), and
      the following conclusions drawn: both FEA and BIE are able to provide stress
      analyses of the dental implant situation and give similar numerical values of
      stresses and strains at the implant-bone interfaces. The BIE method does not
      produce a pictorial representation of the calculated stresses in the form of
      stress contours, as this is not applicable to boundary investigations. It is
      easier to alter the outline of the implant with line elements than with solid
      elements; therefore slight alterations in the outline form of an implant are easy
      to investigate with regard to their resultant interfacial stress levels. The BIE
      method is simpler to use than FEA, but little software is commercially available.
      The aim of the study was to determine whether future developments in this field
      could be useful in the stress analysis of endosseous implants.

PMID- 8361157
TI  - Stresses at the meniscofemoral joint: elastostatic investigations on the
      applicability of interface elements.
AB  - Stress distributions at the meniscofemoral joint were analysed and the
      applicability of nonlinear interface elements in a finite element model (FEM)
      were tested. Centred and 70% off-centre load cases with a complete, a partially
      removed or a totally removed medial meniscus were evaluated in two dimensions.
      Interface width was assumed to increase linearly from almost zero to 1 mm at the
      inner and outer border of the femoral condyles. Maximum interface forces were
      found at the centre of the condyles, decreasing to zero at the peripherical and
      intercondylar femoral border. Simulation data concerning a removed medial
      meniscus or medial 70% off-centre load with complete meniscus indicated higher
      medial contact forces in the first case. A decrease in the elastic modulus of the
      articular surface tissues caused two small force transfer peaks (femoral centre
      and intercondylar border), which were strongly influenced by the predefined gap
      width.

PMID- 8361158
TI  - Repeatability of subject/bed interface pressure measurements.
AB  - The repeatability of a technique for measuring interface pressures has been
      assessed. Pressure was measured using a Talley SA500 Pressure Evaluator under six
      anatomical sites (occiput, scapula, elbow, sacrum, buttock, and heel) of six
      healthy subjects lying supine on a Clinifloat mattress (trademark, SSI). For each
      site of each subject, four repeat readings were taken per day on four separate
      days. Mean pressures varied significantly between subjects (p < 0.02), though
      differences in mean pressures between sites were greater. Pressure was not
      significantly related to subject mass. The overall repeatability of the technique
      was +/- 0.77 kPa (+/- 5.8 mm Hg) which was much smaller than the range of
      pressures found under different sites (2.72 kPa or 20.4 mm Hg at the sacrum to
      9.00 kPa or 67.5 mm Hg at the heel). Repeatability varied from site to site, from
      +/- 0.47 kPa (+/- 3.5 mm Hg) at the buttocks to +/- 1.20 kPa (+/- 9.0 mm Hg) at
      the heel. Measurements were found to vary significantly more between days than
      between repeats on the same day (p < 0.02).

PMID- 8361159
TI  - Computer-controlled portable stimulator for paraplegic patients.
AB  - A six-channel lightweight, portable and computer-controlled stimulator for the
      functional activation of paraplegic patients is described. To enable programming
      of the various functions, the stimulator was designed to work in a remote-control
      mode hosted by an IBM PC or compatible computer, in addition to its normally used
      local mode. The stimulus parameters, including current intensity, stimulus
      frequency and pulse width, are individually adjustable and programmable for each
      channel. The power source is 12 V 500 m Ah-1, from 10 rechargeable nickel cadmium
      batteries, with a run time of 1.5 h for a load of 200 mA in four channels.
      Various training programmes for the activation of paraplegics in the sitting,
      standing and walking positions are described. The final design of the stimulator
      is based on experience gained from 25 patients, treated and evaluated during the
      course of development. Ongoing work including clinical, biomechanical and
      physiological studies is carried out to evaluate performance of the activated
      patients and to optimize stimulation.

PMID- 8361160
TI  - Quantification of soft-tissue imbalance in condylar knee arthroplasty.
AB  - Soft-tissue balance has been debated in recent publications in connection with
      the long-term survival of the 'condylar-type' knee prostheses. Present methods of
      assessment have all assumed that the soft tissues around the knee are inelastic
      strings. The authors have developed two instruments to quantify soft-tissue
      imbalance, at the time of the operation, with the assumption that the soft
      tissues are viscoelastic structures. These two soft-tissue balancing devices were
      consequently used on 121 patients undergoing condylar knee arthroplasties at the
      Derbyshire Royal Infirmary and Bretby Hall Orthopaedic Hospital. The first
      instrument consisted of two flat plates separated by four standard compression
      springs and provided a qualitative measure of imbalance assuming that the soft
      tissues were viscoelastic. It was used on 55 patients before being replaced by
      the quantitative measure of the second instrument. The authors have redefined
      soft-tissue imbalance, to take into account the viscoelastic nature of the soft
      tissues, as the resultant trapezoidal geometry of the knee after the bony cuts
      have been made and when the knee is tensed by equal forces both medially and
      laterally. The second balancer eliminates the requirement to quantify the
      individual tensions in the medial and lateral structures by introducing to the
      system a low-friction, central pivot in the coronal plane. Once the pivot is
      situated at the centre of the knee, an equilibrium position is achieved where the
      clockwise and counter-clockwise moments are equal. The tensions exerted by soft
      tissues can be assumed to be equal and opposite as their moment arms are the
      same.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361161
TI  - Accuracy of interface pressure measurement systems.
AB  - Interface pressure measurement is needed to assess beds designed to prevent
      pressure sores, so it is therefore important to establish the accuracy of
      interface pressure measuring systems. In this study, the Talley SA500 pressure
      evaluator (with 28 mm and 100 mm sensor pads), the DIPE (with 100 mm sensor pad),
      and a water-filled bladder system (with 0.1 ml and 0.3 ml water) were assessed.
      Measurement errors were evaluated using a loading system with pressures up to 7.4
      kPa (55 mm Hg) in steps of 0.9 kPa (6.9 mm Hg). All systems tested over-measured
      interface pressure, the error being approximately linearly proportional to the
      loading pressure. The repeatability for a given system was approximately
      constant. The mean error (+/- SD) (%) and repeatability (kPa) for the systems
      were: 28 mm Talley 12 +/- 1%, +/- 0.07 kPa; 100 mm Talley 15 +/- 1%, +/- 0.07
      kPa; DIPE 27 +/- 3%, +/- 0.12 kPa; 0.1 ml water bladder 17 +/- 1%, +/- 0.13 kPa;
      0.3 ml water bladder 26 +/- 3%, +/- 0.07 kPa. Different interfaces affected
      accuracy markedly, and repeatability was affected when an inhomogeneous interface
      was used. The study shows that the errors associated with interface pressure
      measurement systems can be substantial, and can vary from one system to another.

PMID- 8361162
TI  - Sustained slow sinus rhythm entrained by retrograde atrial impulses.
AB  - Sustained slow sinus rhythm due to a returning cycle after a premature atrial P
      wave is described. It seems possible to consider a model of the forced vibration
      in a spring-mass system or resonant electric circuit of an alternating current
      series element containing resistance R, inductance L, and capacitance C as a
      quantitative approach to describing the slow sinus rhythm. The differential
      equation expressing cardiac resonant oscillation has for the case R = 500 omega
      the form 178 (d2X/dt2) + 500(dX/dt) + 5600X = 4490 cos 3.57t, where X is 100q,
      where q is the capacitor charge. By solving the equation of this special case, we
      obtained an effective voltage and current of 0.84 V and 1.68 mA, respectively.
      Determination of cardiac electrical activity by this method was considered to be
      useful, and may have practical applications in solving problems of nearly linear
      resonance in vital phenomena. This is the first paper on applying a linear second
      order differential equation to describing a frequency response modelling of slow
      sinus rhythm due to entrainment by the retrograde atrial impulses.

PMID- 8361163
TI  - Bombesin-stimulated acetylcholine release from myenteric plexus neurons.
AB  - The ability of bombesin to stimulate acetylcholine release from guinea pig
      myenteric plexus neurons was studied using a primary neuronal culture system.
      Bombesin caused dose-dependent increases in [3H]-acetylcholine (ACh) release from
      guinea pig myenteric plexus neurons. ACh release in response to 0.5 mM bombesin
      (160 +/- 12% of control) was blocked by exposure to a calcium-free medium (116 +/
      13%) by nifedipine (101 +/- 11%) and by omega conotoxin (107 +/- 10%). Bombesin
      stimulated ACh release was inhibited the protein kinase C inhibitor, H7, but was
      not affected by inhibitors of the cAMP signaling pathway. Interactions with
      inhibitory neuropeptides was implied by sensitivity of bombesin-stimulated ACh
      release to neuropeptide Y and galanin. The findings suggest that bombesin
      activation of protein kinase C in myenteric neurons results in increased
      acetylcholine release.

PMID- 8361164
TI  - Endotoxin increases hepatic glutamine transport activity.
AB  - Glutamine uptake by the liver is accelerated during endotoxemia, but little is
      known regarding the influence of sepsis on the plasma membrane transport systems
      catalyzing hepatic glutamine uptake. We hypothesized that this augmented uptake
      was due to an increase in hepatocyte plasma membrane transport activity. We
      investigated the activities of the Na(+)-dependent transport System N (transports
      glutamine into the hepatocyte) and the Na(+)-independent System n (transports
      glutamine out of the cell) in hepatocyte plasma membrane vesicles (HPMVs)
      prepared from livers of rats treated with Escherichia coli endotoxin (LPS) in
      vivo. HPMVs were prepared by differential centrifugation and the transport of
      [3H]glutamine was assayed by a rapid mixing/filtration technique in the presence
      and absence of sodium. Vesicle integrity and functionality were confirmed by
      enzyme marker enrichments and classic "overshoots" in the presence of sodium.
      Carrier-mediated Na(+)-independent glutamine transport activity was not altered
      by LPS administration. In contrast, endotoxemia resulted in a time- and dose
      dependent two- to threefold increase in Na(+)-dependent glutamine transport
      activity in HPMVs secondary to an increase in the transport Vmax, consistent with
      the appearance of increased numbers of corresponding transporter proteins in the
      hepatocyte plasma membrane. The Km (affinity for glutamine) of the System N
      transporter was not affected by LPS treatment. Maximal increases in transport
      were observed 4 hr after exposure to endotoxin. System N transport activity
      returned to basal levels by 12 hr. This increase in transport activity represents
      an important mechanism regulating the accelerated hepatic glutamine uptake that
      occurs during severe infection.

PMID- 8361165
TI  - Lanthanide "blockade" of antigen-presenting cells suppresses lymphocyte
      proliferation by inducing nitric oxide synthesis.
AB  - Introduction of antigen into the portal venous circulation can induce a state of
      antigen-specific tolerance. Reversal of this phenomenon by the administration of
      gadolinium chloride (GD) before portal venous inoculation with antigen has been
      thought to result from the inhibition of macrophage phagocytosis by GD, thereby
      permitting passage of antigen through the hepatic sinusoids into the systemic
      circulation where sensitization can occur. We recently demonstrated that i.v. GD
      also greatly enhances the ability of the hepatic macrophage, or Kupffer cell
      (KC), to suppress lymphocyte proliferation in vitro. In this study, lymphocytes
      from ovalbumin (OVA)-immunized Lewis rats were cocultured with OVA plus KC or
      adherent splenocytes from syngeneic rats injected i.v. with GD or saline. Whereas
      small numbers of either hepatic or splenic untreated macrophages enhanced
      lymphocyte proliferation, both macrophage populations treated with GD were
      markedly inhibitory. Neither the presence of lymph node macrophages nor of normal
      KC was able to prevent the effect of GD-treated KC indicating a mechanism of
      active suppression rather than defective macrophage antigen uptake, processing,
      and presentation. While cyclooxygenase inhibition had no effect, the addition of
      inhibitors of nitric oxide synthase, i.e., aminoguanidine and NG-methyl-L
      arginine, fully reversed the suppression of proliferation by GD-treated
      macrophages. Nitrite, but not PGE2, levels correlated with the degree of
      inhibition by the GD-treated macrophages. The suppression of lymphocyte
      proliferation and elevated supernatant nitrite levels associated with the
      presence of GD-treated macrophages were reversed when the macrophages were
      preincubated with EDTA indicating that GD's effect was directly on macrophages
      and due to its persistence in cultured cells. The findings of this study suggest
      that GD's in vivo prevention of portal venous tolerance may be due to enhanced
      nitric oxide synthesis whose effect on lymphocytes could be to inhibit adhesion
      or replication in the hepatic sinusoid.

PMID- 8361166
TI  - Inhibition of sarcoplasmic reticulum calcium release reduces myocardial stunning.
AB  - Recent findings indicate that ischemia/reperfusion (IR) is associated with
      phospholipase C (PLC)-induced inositol 1,4,5-triphosphate production, as well as
      abnormal sarcoplasmic reticulum (SR) Ca2+ release. Therefore, we hypothesized
      that increased SR Ca2+ release may contribute to Ca2+ overload and myocardial
      stunning. Neomycin (NEO) was used to inhibit PLC, and sodium dantrolene (DAN) was
      used to inhibit myocardial SR Ca2+ release. The purposes of this study were (1)
      to determine if PLC inhibition would reduce IR-induced ventricular dysfunction,
      (2) to examine ventricular function during inhibition of SR Ca2+ release prior to
      ischemia, and (3) to examine the influence of SR Ca2+ release inhibition on post
      IR ventricular function. Left ventricular developed pressure (DP) and +/- dP/dt
      of isolated crystalloid perfused rat heart (Langendorff apparatus) paced at 350
      bpm were compared before and after global IR (38 degrees C, 20 min I, 40 min R)
      to assess functional recovery. PLC was inhibited with NEO (10 microM x 5 min
      prior to ischemia), and SR Ca2+ release was retarded with DAN (12.5 microM) in
      0.05% DMSO (vehicle) infused for 3 min via the aortic cannula 13 min prior to
      ischemia. No effect on DP was observed during NEO or DAN infusion. NEO and DAN
      pretreatment each improved recovery of DP (% recovery +/- SEM) following IR:
      control, 46.5 +/- 5.1%; NEO + IR, 71.0 +/- 6.3%,* vehicle + IR, 44.4 +/- 2.9%;
      DAN + IR, 71.0 +/- 4.7%, *, # (*P < 0.05 vs control IR, #P < 0.05 vs vehicle +
      IR, ANOVA, Scheffe F test, n = 5 all groups). We conclude that SR Ca2+ release
      during IR contributes to myocardial stunning.

PMID- 8361167
TI  - In vivo hepatocyte transduction with retrovirus during in-flow occlusion.
AB  - Gene therapy research would be facilitated by a technically simple procedure for
      transducing hepatocytes in vivo. Previously reported methods have employed
      partial hepatectomy followed 24 hr later by asanguineous perfusion of the
      regenerating liver with retrovirus. We have developed a simpler method of in vivo
      transduction in which we deliver an intraportal bolus of retrovirus to the
      regenerating rodent liver during a brief period of hepatic in-flow occlusion. On
      Day 0, adult male Sprague-Dawley rats (N = 19) underwent 70% hepatectomy to
      induce hepatocyte replication. On Day 1, retroviral supernatant was harvested
      from an amphotropic retroviral packaging cell line that packaged an LNL6-derived
      vector containing the cytomegalovirus promoter driving expression of the
      Escherichia coli beta-galactosidase (beta gal) gene. Twenty-four hours after
      partial hepatectomy, experimental rats (N = 17) received 6 x 10(5) colony-forming
      units of retrovirus by intraportal injection during a 3-min occlusion of the
      hepatic artery and portal vein. Control rats (N = 2) received intraportal medium
      (without retrovirus), also during in-flow occlusion. The procedure required 20-25
      min, and the survival rate was 84%. Cryostat sections were prepared from liver
      biopsies obtained on Post-transduction Days 8 and 15 and stained with 5-bromo-4
      chloro-3-indolyl- beta-D-galactopyranoside to detect beta gal expression. Light
      microscopic examination of Day 8 sections from surviving experimental rats (N =
      14) revealed 0.10-1.00% blue (i.e., transduced) hepatocytes per low power field,
      while sections from control rats (N = 2) exhibited no blue cells. Day 15 sections
      from experimental rats revealed a somewhat lower frequency of hepatocytes
      expressing beta gal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361168
TI  - Regulation of macrophage TNF alpha, IL-1 beta, and Ia (I-A alpha) mRNA expression
      during peritonitis is site dependent.
AB  - Failure of the immune system to successfully prevent organ failure after injury
      or infection may be associated with a shift in macrophage function from antigen
      recognition and presentation to overexpression of inflammatory cytokines.
      Regulation may be due to changes in macrophage gene expression. Levels of mRNA
      for tumor necrosis factor alpha (TNF alpha), interleukin-1 beta (IL-1 beta), and
      the Ia subunit, I-A alpha, in peritoneal macrophages, liver, spleen, kidney, and
      lung were measured following cecal ligation and puncture (CLP) in Swiss Webster
      mice. Northern blot analysis was performed using 32P-labeled mouse cDNA probes.
      Peritoneal macrophage TNF alpha and IL-1 beta mRNA expression increased 2.5- and
      2-fold, respectively, by 6 hr after CLP and remained elevated at 24 hr.
      Peritoneal macrophage I-A alpha mRNA levels decreased 8-fold by 24 hr after CLP.
      I-A alpha mRNA expression in liver, spleen, kidney, and lung decreased following
      CLP, with a return toward normal levels by 8 days in all tissues except spleen.
      IL-1 beta and TNF alpha mRNA were barely detectable in liver and kidney. IL-1
      beta mRNA tended to increase over time in lung and spleen, whereas TNF alpha mRNA
      in these tissues did not vary greatly after CLP. Muramyl dipeptide or
      monophosphoryl lipid A pretreatment of animals prior to CLP was ineffective in
      altering the expression of TNF alpha and I-A alpha mRNA. We conclude that
      peritonitis is associated with an early increase in peritoneal macrophage TNF
      alpha and IL-1 beta mRNA levels and a sharp decline in macrophage I-A alpha
      mRNA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361169
TI  - Hypertension accelerates the growth of experimental aortic aneurysms.
AB  - Hypertension has long been suspected to increase the growth rate of abdominal
      aortic aneurysms (AAA), but there is little experimental evidence to support this
      hypothesis. Using an established model, aneurysms were induced in normotensive
      Wistar-Kyoto (WKY) rats and in a unique strain of genetically hypertensive Wistar
      Kyoto (WKHT) rats by perfusing an isolated segment of the infrarenal aorta with
      elastase (n = 14, each group). Aortic diameter was measured with a micrometer and
      systolic blood pressure (sBP) determined by tail plethysmography. Rats were
      killed at 7 or 14 days, aneurysm diameter was measured, and aneurysms were
      examined histologically. Systolic blood pressure was significantly higher in WKHT
      rats (164 +/- 15 mm Hg) compared to WKY animals (119 +/- 7 mm Hg, P < 0.001).
      Initial aortic size was 1.10 +/- 0.02 mm in the two groups. Aneurysms in the
      hypertensive animals were significantly larger at Day 7 (WKY, 2.31 +/- 0.09 mm;
      WKHT, 2.54 +/- 0.22 mm; P = 0.02) and Day 14 (WKY, 2.36 +/- 0.25; WKHT, 3.45 +/-
      0.89; P = 0.001). Overall, the mean AAA growth rate of the WKYHT group was nearly
      twice that of the WKY group: 0.13 +/- 0.09 mm/day vs 0.07 +/- 0.03 mm/day, (P =
      0.004). Growth rates were also positively correlated with sBP (r = 0.82, P <
      0.0001). Both groups showed elastic lamellar disruption and inflammatory cell
      infiltration within the wall of the aorta. As demonstrated in this experimental
      model, hypertension does indeed increase the rate of growth of AAA.

PMID- 8361170
TI  - Allograft rejection by T cell receptor transgenic mice.
AB  - We have used a line of T cell receptor (TcR) transgenic mice, in which a
      significant portion of CD8+ T cells expresses a TcR that is specific for the
      minor histocompatibility antigen H-Y presented by the H-2Db Class I molecule, to
      examine the immune response to H-Y-incompatible skin or pancreatic islet
      allografts. Our results indicate that, in contrast to the conclusions of previous
      reports, pancreatic islet endocrine cells are invulnerable or only weakly
      vulnerable to an H-Y-directed immune response. An even more unexpected finding
      was that unlike normal female mice of the C57BL/6 background which consistently
      reject male skin within a few weeks, TcR transgene+ littermates reject male skin
      only infrequently. Our results are consistent with the conclusion that the
      inability of H-Y TcR females to reject male skin is due to a deficiency of cells
      with male-specific helper activity. Long-term acceptance of male grafts by H-Y
      TcR females leads to a state of T cell hyporesponsiveness to male skin grafts. In
      addition, T cells harvested from long-term skin acceptors were hyporesponsive to
      in vitro stimulation by a clonotype-specific monoclonal antibody. Transgenic mice
      with TcRs having antigenic specificity for defined transplantation antigens
      provide a unique model for study of the allograft response.

PMID- 8361171
TI  - Hypercholesterolemia and experimental vein grafts: accelerated development of
      intimal hyperplasia and an increase in abnormal vasomotor function.
AB  - Hypercholesterolemia is an important risk factor for the development of
      atherosclerosis. Late vein graft failure has been attributed to a combination of
      both intimal hyperplasia and atherosclerosis. This study examines the effect of
      hypercholesterolemia on the early morphology and vasomotor function of
      experimental vein grafts. Forty New Zealand White rabbits received either a 1%
      cholesterol diet (n = 24; HC) or a standard diet (n = 16; CON) for 4 weeks before
      operation and thereafter until harvest. All animals underwent a reversed vein
      common carotid artery bypass. The vein grafts and contralateral veins were
      harvested at 2 and 4 weeks after operation in both groups for either histological
      and morphometric analysis (n = 8 for each group) or for in vitro isometric
      tension studies using serotonin (5-HT), norepinephrine (NE), bradykinin (BK), and
      endothelin-1 (ET) and following NE precontraction, relaxation in response to
      acetylcholine (ACh) and sodium nitroprusside (SNP). Serum cholesterol levels were
      measured after 4, 6, and 8 weeks of the cholesterol diet. Serum cholesterol
      concentrations were 20 to 30 times higher than controls in the
      hypercholesterolemic animals at all times. The intimal area of the grafts in the
      HC group increased by twofold at 2 weeks and threefold at 4 weeks compared to
      corresponding controls. In contrast to the CON vein grafts, the intima of the
      vein grafts from HC consisted mainly of lipid-laden smooth muscle cells with
      scattered interspersed macrophages and occasional lipid plaques between the
      intima and the media. Medial areas were similar in all grafts. HC grafts became
      progressively more sensitive to 5-HT at 2 and 4 weeks. A supersensitivity to NE
      and BK developed at 4 weeks in HC grafts. There was no change in sensitivity to
      ET. While no graft relaxed to ACh, HC grafts contracted at low doses. All grafts
      responded to SNP in a dose-dependent manner. In contrast to CON veins, HC veins
      demonstrated an increase in sensitivity to NE and a contractile response to 5-HT
      (at 4 weeks only). HC veins did not relax in a dose-dependent manner in response
      to ACh. No changes in the morphology of HC veins were noted. HC produces changes
      in the structure and associated vasomotor abnormalities of vein grafts. Closely
      related functional changes also occur in contralateral veins. HC appears to
      induce intrinsic changes in smooth muscle cells which are linked to a greater
      proliferative and abnormal vasomotor capability. Clinically, applications of
      vigorous anti-HC regimens perioperatively may be beneficial in maintaining
      patency over the longer term.

PMID- 8361172
TI  - Effect of anti-lipid A monoclonal antibody (E5) on microcirculatory function
      during lipopolysaccharide shock.
AB  - Early septic shock is characterized by fever, increased cardiac output, decreased
      systemic vascular resistance, and dilation of higher-order arterioles in
      peripheral tissues, such as skeletal muscle. We used a rat model of low-dose
      lipopolysaccharide (LPS) "septic" shock to investigate the potential benefit of
      an anti-lipid A monoclonal antibody preparation (E5) on macro- and
      microcirculatory function. Twenty-five male Sprague-Dawley rats were anesthetized
      and instrumented for measurement of arterial pressure (AP), heart rate (HR), and
      cardiac output (CO). The left cremaster muscle of each rat was prepared for in
      vivo video microscopic examination of changes in third-order arteriolar (A3)
      diameter and erythrocyte velocity. Rats were randomly assigned to two groups:
      Group I (n = 13) received E5 vehicle and 200 micrograms/kg Escherichia coli LPS;
      Group II (n = 12) received 2 mg/kg E5 iv prior to LPS administration. All
      variables were recorded at 15-min intervals for 30 min prior to and 150 min
      following LPS. Microcirculatory recordings were restricted to those rats where
      arteriolar diameters were 20-40 microns and vessels displayed obvious vasomotion
      (n = 7/group). Infusion of LPS caused no significant change in AP, an increase in
      CO by 105 min, an increase in HR by 75 min, an increase in diameter by 75 min,
      and a decrease in velocity by 165 min (P < 0.01). Pretreatment with E5 inhibited
      the A3 vasodilation but did not affect the macrocirculatory changes. These data
      suggest a potential therapeutic role for E5 in ameliorating LPS-induced changes
      in skeletal muscle microcirculation.

PMID- 8361173
TI  - Blockade of prostaglandin products augments macrophage and neutrophil tumor
      necrosis factor synthesis in burn injury.
AB  - Cyclooxygenase products are believed to be a major regulator of host tumor
      necrosis factor-alpha (TNF-alpha) production in response to trauma and sepsis. To
      study this relationship, Lewis rats underwent a 30% burn or sham burn. Dimethyl
      prostaglandin E (dPGE, 50 micrograms/kg), ibuprofen (IFU, 2 mg/kg), or saline was
      administered twice daily. Rats were sacrificed at Day 7 to obtain Kupffer cells,
      peritoneal macrophages, splenic macrophages, and neutrophils. For in vivo
      studies, 10(6) cells from each group were cultured with 10 micrograms of
      lipopolysaccharide (LPS). For in vitro studies, cells from the burn and sham
      groups were cultured with LPS and dPGE (10 micrograms/ml), IBU (10
      micrograms/ml), or saline. The supernatants were harvested after 2, 6, and 24 hr
      of culture and assayed for TNF-alpha (mu/ml) by L929 cytolysis. Burn injury
      resulted in a significant increase in Kupffer cell and neutrophil TNF-alpha
      production compared to the sham group (P < 0.001, ANOVA). The administration of
      IBU to burned animals led to a pronounced elevation of TNF-alpha production by
      Kupffer cells, peritoneal macrophages, and neutrophils compared to vehicle
      treated burned animals (P < 0.001, ANOVA). With in vitro studies, IBU increased
      Kupffer cell, peritoneal macrophage, and neutrophil TNF-alpha release by 213,
      327, and 198%, respectively (P < 0.05, ANOVA). dPGE caused a marked decrease in
      Kupffer cell and peritoneal macrophage TNF-alpha synthesis by 50 and 43%,
      respectively (P < 0.01, ANOVA). In conclusion, prostaglandins are critical for
      down regulating TNF-alpha production. Clinical use of cyclooxygenase inhibitors
      may result in adverse outcomes due to the excessive TNF-alpha production.

PMID- 8361174
TI  - Prolongation of small bowel allografts after intrathymic injection of donor
      alloantigen and ALS.
AB  - The increasing success of clinical small bowel transplantation in recent years
      has been due largely to improved nonspecific immunosuppression of the recipient,
      which carries significant morbidity. The induction of donor-specific tolerance
      would eliminate the risk of long-term immunosuppression while ensuring graft
      function and survival. We have demonstrated that the intrathymic injection of
      donor splenocytes with the simultaneous intraperitoneal administration of rabbit
      anti-rat lymphocyte serum results in indefinite donor-specific cardiac allograft
      survival in > 85% of recipients. In this study, we further examined the effect of
      this tolerance induction protocol on the more immunogenic small bowel allograft.
      Male Buffalo (RT1b) rats were exposed to donor alloantigen by an intrathymic
      injection of 25 x 10(6) MHC mismatched unfractionated Lewis (RT1(1)) splenocytes.
      The Buffalo recipients were given 1 ml of rabbit anti-rat lymphocyte serum intra
      peritoneally at the time of the donor antigen injection and 21 days later
      underwent a heterotopic 15-cm Lewis small bowel transplant. Pretransplant
      intrathymic Lewis alloantigen and anti-rat lymphocyte serum treatment prolonged
      Lewis small bowel survival by approximately 2.5 times (mean survival time = 18.0
      vs 7.0 days for controls, P < 0.05). These small bowel allografts demonstrated
      pericryptic T cell infiltrates, areas of cryptic necrosis, and a dense submucosal
      lymphocytic infiltrate, all consistent with acute resection. In contrast to our
      studies achieving donor-specific cardiac allograft survival, this protocol did
      not result in indefinite intestinal allograft survival. No Buffalo recipients
      developed evidence of graft-versus-host disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361175
TI  - Endothelial cell dysfunction occurs after hemorrhage in nonheparinized but not in
      preheparinized models.
AB  - Although hemorrhage produces alterations in hemodynamics and cellular functions,
      it is not known whether endothelial cell function is depressed under such
      conditions and, if so, whether preheparinization has any protective effect on
      this function. To study this, rats (with or without heparinization prior to
      hemorrhage, 1 U/g body wt) were bled to and maintained at a mean arterial
      pressure of 40 mm Hg until 40% of maximal bleedout volume was returned in the
      form of lactated Ringer's solution (LR). The rats were then resuscitated with
      four times the volume of maximal bleedout in the form of LR. At 1.5 hr
      postresuscitation, the thoracic aorta was removed, cut into approximately 2.5-mm
      rings, and placed in organ chambers. Norepinephrine (2 x 10(-7) M) was applied to
      achieve near-maximal contraction, and dose responses for an endothelium-dependent
      vasodilator, acetylcholine, were determined. Hypoxia-induced contraction (an
      endothelium-dependent process) was also carried out using 95% N2:5% CO2. The
      results indicate that endothelium-dependent relaxation and contraction were
      markedly depressed following hemorrhage and resuscitation in nonheparinized, but
      not in preheparinized models. However, there was no significant difference in the
      relaxation induced by an endothelium-independent vasodilator, nitroglycerin,
      irrespective of heparinization. Thus, endothelial cell dysfunction (i.e., the
      depressed capacity of aortic endothelium to maximally release endothelium-derived
      relaxing and contracting factors) occurs after hemorrhage in nonheparinized, but
      not in preheparinized animals. Since trauma victims are not heparinized before
      the injury and since preheparinization protects endothelial cell function,
      pharmacologic agents to restore the depressed cellular function should be tested
      only in nonheparinized models of hemorrhage and resuscitation.

PMID- 8361176
TI  - Serum D(-)-lactate levels as a predictor of acute intestinal ischemia in a rat
      model.
AB  - Currently there exists no reliable serum marker for the early diagnosis of acute
      mesenteric ischemia. We investigated D(-)-lactate as a marker of acute mesenteric
      ischemia in a rat model. D(-)-Lactate is a byproduct of bacterial metabolism; it
      is neither produced nor metabolized by mammalian cells. In an ischemic segment of
      bowel the resident microflora rapidly proliferate and soon overgrow the affected
      intestinal segment. Additionally, the mucosal barrier of the gut begins to break
      down. Under these conditions we hypothesize that D(-)-lactate should cross the
      mucosal barrier in large quantities. To determine if this rapid bacterial
      proliferation and mucosal leakage produces D(-)-lactate concentrations in
      quantities sufficient to elevate peripheral blood levels, two models of acute
      intestinal ischemia and one model of simple obstruction were developed in rats.
      The three models included: strangulation obstruction of terminal ileum, superior
      mesenteric artery ligation, and simple intestinal obstruction of the ileum.
      Controls were divided into two groups: sham-operated controls and unoperated
      controls. Serum samples were collected via an internal jugular catheter at 5 min,
      2 hr, and 4 hr after surgery. These samples were then assayed for D(-)-lactate
      using an enzymatic-spectrophotometric assay. Data was analyzed by repeated
      measures analysis of variance and where applicable the Student t test was used to
      determine statistical significance. We found statistically significant elevations
      in D(-)-lactate concentrations as early as t = 5 min in the strangulation
      obstruction model and SMA ligation model compared to unoperated
      controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361177
TI  - Escherichia coli bacteremia exacerbates cyclosporine-induced renal
      vasoconstriction.
AB  - The clinical observation that cyclosporine (CSA) nephrotoxicity is particularly
      severe in patients during and following bacterial infections has recently been
      made. Transplant recipients develop a marked deterioration of graft function
      following Escherichia coli bacteremia secondary to urinary tract infection. CSA
      causes intrarenal vasoconstriction which may account for its nephrotoxicity. We
      therefore undertook a study using the split hydronephrotic kidney model to
      investigate the direct in vivo effects of CSA and E. coli bacteremia on the renal
      microcirculation. Hydronephrotic kidneys in Sprague-Dawley rats were suspended in
      an environmentally controlled tissue bath. Interlobular arterial (ILA) and
      afferent (AFF) and efferent (EFF) arteriolar diameters were measured by in vivo
      videomicroscopy and red cell velocity by Doppler velocimetry. Topical
      administration of CSA to the kidney in the tissue bath caused a 23 +/- 1%
      constriction of the ILA and a 67 +/- 5% reduction in blood flow. AFF and EFF
      arterioles were also constricted by 21 +/- 3 and 16 +/- 2%, respectively. The
      intravenous infusion of live E. coli was also followed by decreases in ILA
      diameters and flow (38 +/- 4 and 68 +/- 4%) and AFF diameters (22 +/- 5%) while
      EFF diameters were unchanged. The infusion of E. coli following addition of CSA
      to the tissue bath resulted in a dramatically increased constriction of ILA (49
      +/- 4%) and AFF (31 +/- 2%) vessels and almost abolished ILA flow (90 +/- 2%). We
      conclude that in this model, E. coli bacteremia exacerbates CSA-induced
      preglomerular vasoconstriction and suggests a scientific basis for the severe
      renal dysfunction noted in transplant recipients during bacterial infection.

PMID- 8361178
TI  - Reduced ileal taurocholate absorption with total parenteral nutrition.
AB  - Total parenteral nutrition is associated with decreased primary bile acid output.
      This may result from reduced synthesis or decreased absorption of primary bile
      acids in the enterohepatic circulation. Ileal atrophy occurs with total
      parenteral nutrition, and we postulated that absorption of primary bile acids is
      reduced. Ileal absorption of taurocholate was investigated in miniswine on total
      parenteral nutrition and this was compared to orally fed animals. Following
      cholecystectomy and bile duct cannulation, 20 cm, of ileum was perfused with
      taurocholate. Since miniswine have no significant endogenous taurocholate
      secretion, the measured taurocholate output reflected ileal absorption. To
      examine uptake and secretion of taurocholate by the liver, pigs on total
      parenteral nutrition and controls were infused with intravenous taurocholate (0.5
      to 2.5 mumole/kg/min), and bile acid output was determined. Baseline bile acid
      output was decreased in animals on total parenteral nutrition, yet the response
      to intravenous taurocholate was similar to controls. When taurocholate was
      perfused in the ileum, taurocholate output was markedly different. Taurocholate
      output (pmole/cm ileum/min) at the taurocholate perfusate concentrations of 3 and
      20 mM was, respectively, 65 +/- 14 and 183 +/- 63 for controls and 18 +/- 3 and
      63 +/- 17 for miniswine on total parenteral nutrition. The latter group's output
      was significantly lower, at P < 0.05. Both groups of pigs had equal increases in
      bile acid output with intravenous infusion of taurocholate, suggesting normal
      hepatic uptake and secretion. Ileal perfusion with taurocholate, however,
      resulted in decreased taurocholate output with total parenteral nutrition due to
      decreased ileal absorption of bile acids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361179
TI  - Pulmonary vascular disease and operative indications in complete atrioventricular
      canal defect in early infancy.
AB  - Pulmonary vascular disease was morphometrically analyzed in 67 patients (mean
      age, 19 months) with isolated complete atrioventricular canal defect. Complete
      obstruction of the small pulmonary arterial lumen resulting from acute fibrous
      proliferation and atrophy of the peripheral arterial media, which were considered
      absolute operative contraindications, were characteristic in six patients with
      Down's syndrome. Morphometric analysis of medial thickness revealed that thinning
      of the media of the small pulmonary arteries is generally observed at around 6
      months of age in patients with complete atrioventricular canal defect and that
      the media in patients who have complete atrioventricular canal defect and Down's
      syndrome was thinner than that in such patients without Down's syndrome. These
      results suggest that thinning of the media as a result of two factors--Down's
      syndrome and aging--facilitates the rapid occurrence of fibrous intimal
      proliferation. Therefore intracardiac repair is desirable within 6 months of
      life, before medial thinning, in patients with complete atrioventricular canal
      defect and Down's syndrome. Excluding patients with absolute operative
      contraindications, the scores of the index of pulmonary vascular disease in
      operative survivors were below 2.0 and death occurred when scores were more than
      2.2. The pulmonary vascular resistances measured in room air and by the oxygen
      inhalation and tolazoline tests in patients with operative contraindications were
      more than 7.3, 3.8, and 6.6 units.m2, respectively. We thus conclude that lung
      biopsy should be undertaken for patients in whom pulmonary vascular resistance is
      beyond these values to determine the appropriateness of surgical intervention.

PMID- 8361180
TI  - Contractility of the human internal mammary artery at the distal section
      increases toward the end. Emphasis on not using the end of the internal mammary
      artery for grafting.
AB  - The distal section of the internal mammary artery (3 to 4 cm proximal to the
      bifurcation) is often used for coronary grafting. This part of the artery is more
      pharmacologically responsive to vasoconstrictor agents than is its midsection.
      The present study was designed to test the hypothesis that the reactivity of the
      distal section of the internal mammary artery is inversely correlated to the
      diameter of the artery. The distal section of the human internal mammary artery
      was collected from aorta-coronary bypass grafts and studied in organ baths at a
      length of 3 mm. At the optimal point of the length-tension curves determined by a
      computer-iterative fitting technique, the diameter at 100 mm Hg, the maximal
      contraction forces and effective concentration causing 50% of the maximal
      response to vasoconstrictor agents U46619, potassium chloride, alpha-adrenoceptor
      agonists norepinephrine, methoxamine, and phenylephrine were recorded or
      calculated. The maximal relaxation and 50% response to glyceryl trinitrate in
      phenylephrine-precontracted internal mammary artery segments were also
      calculated. The contraction force was standardized by the circumference (grams
      per millimeter). Regression analysis between contraction force and diameter
      revealed that the contraction force induced by U46619 and potassium chloride was
      inversely correlated to diameter (r2 = 0.2, p < 0.05 in U46619-induced
      contraction and r2 = 0.2, p < 0.01 in potassium chloride-induced contraction).
      The contraction force induced by norepinephrine also had a trend inversely
      correlated to diameter (r2 = 0.2, p = 0.07). Glyceryl trinitrate-induced
      relaxation was not correlated to diameter. This study demonstrated that the
      contractility of the distal section of the internal mammary artery is inversely
      correlated to the diameter; that is, the smaller the diameter, the greater the
      tendency for spasm to develop. This suggests that trimming off the distal end of
      the internal mammary artery as much as possible may be the best way to prevent
      graft spasm and that superior results of left internal mammary artery grafted to
      the left anterior descending artery or the use of a "free graft" may be related
      to the shorter length (distal end is trimmed off) and less contractility of the
      graft.

PMID- 8361181
TI  - In vitro comparison of bileaflet aortic heart valve prostheses. St. Jude Medical,
      CarboMedics, modified Edwards-Duromedics, and Sorin-Bicarbon valves.
AB  - The hydrodynamic performance of four currently used bileaflet heart valve
      prostheses (St. Jude Medical, CarboMedics, modified Edwards-Duromedics, and Sorin
      Bicarbon) with a nominal tissue anulus diameter of 27 mm were measured in the
      aortic position. All experiments were performed in nonpulsatile flow and in an
      electrohydraulic, computer-controlled pulse duplicator simulating the left side
      of the human circulatory system. Testing conditions were set at cardiac outputs
      of 3.0, 4.5, 6.5, and 8.0 L/min at a constant heart rate of 70 beats/min. The
      Sorin-Bicarbon valve had the lowest pressure difference with regard to
      nonpulsatile (mean 5.4 mm Hg at 30 L/min) and pulsatile (mean 2.2 mm Hg at 8
      L/min) flow, followed by the St. Jude Medical, CarboMedics, and modified Edwards
      Duromedics valves. The leakage volumes under static and pulsatile flow conditions
      were lowest for the modified Edwards-Duromedics and Sorin-Bicarbon valves. The
      energy loss in pulsatile flow was lowest for the Sorin-Bicarbon valve, mainly
      because its systolic, closure, and leakage energy losses were low. Systolic
      sequential velocity profiles showed the most even flow distribution pattern for
      the St. Jude Medical and Sorin-Bicarbon valves. These findings correspond with
      lower overall Reynolds shear stress levels for the St. Jude Medical and the Sorin
      Bicarbon valves than for the modified Edwards-Duromedics and CarboMedics valves.

PMID- 8361182
TI  - Early open mitral commissurotomy: long-term results.
AB  - It has frequently been suggested that early mitral commissurotomy could improve
      long-term results in patients with severe mitral stenosis. However, the real
      advantages of this procedure have yet to be demonstrated. To evaluate this
      hypothesis, we retrospectively studied 397 patients who underwent operation for
      mitral stenosis in our unit between 1978 and 1988. Forty of these patients (group
      I) fulfilled the criteria for early mitral commissurotomy: being young (average
      age 33 years), being asymptomatic or showing few symptoms, and being in sinus
      rhythm. The remaining 357 patients who underwent operation during the same period
      of time served as control (group II). Mitral valve replacement (p < 0.05) and
      associated tricuspid annuloplasty (p < 0.05) occurred less frequently in patients
      from group I than it did in patients from group II. Survival after 11 years for
      patients with early mitral commissurotomy was 100%, 90% of whom were in
      functional class I, were in sinus rhythm, and were receiving no medication
      whatsoever. Ninety-six percent of these patients were free of complications after
      11 years, compared with 73% of patients in group II (p < 0.05). In our opinion,
      these results support the use of early mitral commissurotomy for young patients
      in sinus rhythm, who are symptom free, who are and who have a mitral valve area
      is 1.3 cm2 or less.

PMID- 8361183
TI  - Replacement of the thoracic aorta with collagen-impregnated woven Dacron grafts.
      Early results.
AB  - We used the collagen-impregnated woven double-velour Dacron graft in 120 patients
      undergoing 122 aortic reconstructions. Seventy-nine aortic root, ascending, or
      arch replacements were performed during cardiopulmonary bypass with or without
      circulatory arrest; 53 of the 79 were for acute aortic dissection. In addition,
      three infants and one child underwent repair of truncus arteriosus. There were no
      deaths caused by hemorrhage or bleeding-related complications. For aortic root
      replacement, the impervious nature of the collagen-impregnated woven double
      velour Dacron graft allowed elimination of wrap-around techniques. Eight deaths
      occurred as a result of multisystem organ failure, which followed late diagnosis
      of type A dissection. Two patients underwent reoperation for late complications
      of type A dissection. Thirty-nine patients underwent treatment for disease of the
      descending aorta; eight of these patients underwent a central cannulation
      technique with profound hypothermic cardiopulmonary bypass. The other 31
      underwent repair with aortic crossclamping without bypass. Four of these patients
      died: two as a result of multisystem organ failure, one as a result of
      uncontrolled bleeding from the native dissected aorta, and one as a result of
      intestinal necrosis. Follow-up studies for 2 months to 5 years revealed three
      late deaths caused by the rupture of a persistent aneurysmal false lumen after
      type A dissection. The intraoperative advantages of the collagen-impregnated
      woven double velour Dacron graft represent an important advance in vascular graft
      technology. Its handling and suturing characteristics are excellent, and the
      graft is completely impervious in its originally manufactured state. Needle holes
      self-seal rapidly. Medium-term follow-up by clinical, angiographic, computed
      tomographic, and magnetic resonance imaging techniques showed no late graft
      complications--specifically, no dilatation or thrombus formation.

PMID- 8361184
TI  - Lining of viable and nonviable allogeneic and xenogeneic cardiovascular tissue
      with cultured adult human venous endothelium.
AB  - With the aim of creating a confluent endothelial lining of cultured adult human
      saphenous vein endothelial cells on cardiovascular bioprosthetic tissues in
      vitro, we performed seeding on deendothelialized segments of viable or
      devitalized (in deionized water) human vein, porcine aorta, and bioprosthetic
      tissues preserved in glutaraldehyde. After being seeded, specimens were kept for
      7 days under culture conditions. On glutaraldehyde-preserved tissue, seeding was
      performed after 3 weeks of elution of glutaraldehyde. Evaluation was performed
      with hematoxylin-eosin staining, immunohistochemical staining of von Willebrand's
      factor and of collagen IV-related antigens, and scanning and transmission
      electron microscopy. The origin of the cells as derived from culture was verified
      by vital staining with a carbocyanine dye. Evaluation revealed a confluent lining
      of cultured human saphenous vein endothelial cells similar to native endothelium
      on both viable and nonviable human and porcine tissues. Collagen IV-related
      immunoreactivity was demonstrated close to the endothelial cells, corresponding
      to a de novo-formed basement membrane. Organelles and a basement membrane were
      demonstrated by transmission electron microscopy. The human saphenous vein
      endothelial cells seeded on glutaraldehyde-preserved tissues showed initial
      adherence but rounded up and detached on the second day of culture, probably
      because of residual glutaraldehyde. This study demonstrates that the native
      endothelium of allogenic or xenogeneic viable and nonviable vascular tissue may
      be replaced by cultured endothelium in vitro. The structural similarities with a
      native endothelium suggest that in vitro endothelialization with cultured
      autologous endothelial cells may be used to improve performance of cardiovascular
      bioprostheses.

PMID- 8361185
TI  - Clinical significance of weight difference between donor and recipient in heart
      transplantation.
AB  - A standard and important criterion for donor acceptance is to match the donor's
      body weight to within 20% of the recipient's body weight. However, to meet the
      increasing demand of patients who need heart transplantation, frequently a heart
      that is below the standard criteria for donation is accepted. Of the 200
      consecutive patients who underwent heart transplantation at the University of
      Arizona, 27 patients received a heart from a smaller donor with a weight
      difference of more than 30% (range 30% to 46%). The early mortality and late
      survival of these 27 patients were not different when compared with those of the
      patients who received transplants from donors with a weight difference of less
      than 30%. The probability of freedom from rejection and infection and
      postoperative ejection fraction were also similar between the two groups.
      Therefore, we believe that the widely accepted donor-recipient weight-match
      criterion of 20% can be safely extended.

PMID- 8361186
TI  - Aspects of lung transplantation that contribute to increased severity of
      pneumonia. An experimental study.
AB  - In lung or heart-lung transplant recipients, complications as a result of
      pulmonary infections continue to be the most frequent causes of morbidity and
      mortality. This study was undertaken to identify the contributions of (1)
      thoracotomy, (2) interruption of lymphatic vessels and bronchial arteries, (3)
      transplant procedure, (4) drug-induced immunosuppression, and (5) graft
      allogenicity to the increased risk of pneumonia in lung transplantation. Lewis
      rats were inoculated with 10(5) colony-forming units of Legionella pneumophila
      serogroup 1 by direct instillation into the trachea after one of the following: a
      general anesthetic with no operation; a left thoracotomy; a left thoracotomy with
      pulmonary hilar stripping; an isogeneic orthotopic left lung transplant with or
      without immunosuppression; or an allogeneic transplant with immunosuppression
      with Brown-Norway rats as donors. Immunosuppression was induced with an
      intramuscular injection of cyclosporine (25 mg/kg of body weight) from the
      inoculation day to day 3. All rats were killed on day 6, and severity of
      infection was determined by quantitative culture of Legionella organisms in the
      lungs and spleen, titer of Legionella urinary antigen, differential cell count in
      bronchoalveolar lavage fluid, body weight loss, and gross inspection of the lung.
      Significant increases in lung Legionella concentration occurred as a result of
      the addition of pulmonary hilar stripping (from 10(5.13 +/- 0.34) in the
      thoracotomy group to 10(5.66 +/- 0.25) in the thoracotomy with hilar stripping
      group, p = 0.013) and the addition of immunosuppression (from 10(5.47 +/- 0.47)
      in the isogeneic transplant group to 10(6.94 +/- 0.52) in the isogeneic
      transplant with immunosuppression group, p = 0.00016). Thoracotomy, transplant
      procedures, and allogenicity itself resulted in no significant increases. The
      results for all other indicators paralleled those for lung culture. We conclude
      that the combination of drug-induced immunosuppression with lung denervation and
      interruption of lymphatic vessels and bronchial arteries results in the early
      development and increased severity of pneumonia in lung transplantation.

PMID- 8361187
TI  - Myosin light chain efflux after heart transplantation in infants and children and
      its correlation with ischemic preservation time.
AB  - Serum levels of cardiac myosin light chain 1 after heart transplantation were
      studied in 24 infants and children who underwent heart transplantation between
      June 1990 and April 1991. The ages of the patients ranged from 4 days to 6 years
      7 months (mean, 9.9 months), and their body weights ranged from 2.2 to 20 kg
      (mean, 5.6 kg). The ages of the donors ranged from 2 days to 8 years, 7 months
      (mean, 26.6 months), and their body weights ranged from 2.5 to 26 kg (mean, 11.4
      kg). The donor heart ischemic time ranged from 90 minutes to 482 minutes (mean,
      279 minutes). Peak myosin levels after heart transplantation showed significant
      correlation with the duration of graft ischemia (p < 0.01) and with diastolic
      cardiac function in the first posttransplant week (p < 0.05). Peak myosin levels
      did not correlate with systolic cardiac function, age of the donor, or age of the
      recipient. Myosin levels of the 15 patients with graft ischemic times exceeding 4
      hours averaged 6.30 +/- 3.50 ng/ml. These levels were significantly higher than
      those of patients with graft ischemia lasting less than 4 hours (2.60 +/- 1.20
      ng/ml; p < 0.01). Both of the values are higher than previously reported values
      of normal controls but lower than previously reported values of patients with
      myocardial infarction. Preservation techniques used for this series of transplant
      operations provided good clinical protection of the donor heart for up to 8
      hours, although release of the cardiac myosin light chain fragment correlated
      with duration of graft ischemia. Cardiac myosin levels appeared to be a good
      indicator of heart graft damage during ischemic preservation. It remains to be
      determined at what level of myosin release (and, hence, at what duration of graft
      ischemia) irreversible myocardial damage, which might result in permanent
      functional compromise, occurs.

PMID- 8361188
TI  - Early experience with sequential bilateral lung transplantation.
AB  - We performed 20 sequential bilateral lung transplantation in 19 consecutive
      patients from April 1990 to May 1992. Perioperative mortality was low (2
      patients). One-year actuarial survival was 70%. All survivors had normal blood
      oxygen tension (82 mm Hg, mean) while breathing room air and continuing
      improvement of pulmonary function. Bronchial dehiscence did not occur. Stents
      were implanted in 7 patients to control bronchial stenosis. Aggressive treatment
      of graft rejection has been effective in preventing obliterative bronchiolitis.

PMID- 8361189
TI  - Complement activation during extracorporeal circulation. In vitro comparison of
      Duraflo II heparin-coated and uncoated oxygenator circuits.
AB  - The degree of complement activation during cardiopulmonary bypass is considered a
      valuable parameter of biocompatibility of the extracorporeal circuit. In an in
      vitro setting with a heart-lung machine primed with fresh whole blood and saline
      solution, the C3 activation products C3b, iC3b, and C3c and the terminal
      complement complex were measured in double-antibody enzyme immunosorbent assays.
      No differences were found between seven sets treated with Duraflo II heparin
      coating and seven uncoated sets after 2 hours of circulation. C3 activation
      products (expressed as median and 95% confidence intervals) increased from 4.5 AU
      (2.8 to 12.3 AU) to 16.5 AU (10.0 to 19.4 AU) in the uncoated sets (p = 0.02) and
      from 4.6 AU (2.2 to 5.8 AU) to 19.3 AU (3.5 to 27.1 AU) in the coated sets (p =
      0.02). Terminal complement complex increased from 5.7 AU (2.7 to 11.3 AU) to 13.6
      AU (8.2 to 17.8 AU) in the uncoated sets (p = 0.02) and from 7.9 AU (4.6 to 11.4
      AU) to 17.3 AU (9.4 to 35.1 AU) in the coated sets (p = 0.02). A significant drop
      in thrombocyte levels was observed in both coated and uncoated sets. In a
      supplementary series, the sterilization process did not influence the results.
      Although Duraflo II heparin coating is considered highly effective in preventing
      coagulation, it did not prevent complement activation in the present in vitro
      study. We hypothesize that the mode by which the heparin molecule is bound to the
      surface may be essential to obtain effects on both coagulation and complement
      system.

PMID- 8361190
TI  - Increased plasma levels of endothelin-1 after cardiopulmonary bypass in patients
      with pulmonary hypertension and congenital heart disease.
AB  - The plasma level of the potent vasoconstrictor endothelin-1 was measured in
      children who underwent cardiac operations. Forty-five patients were divided into
      two groups, those with a high pulmonary blood flow (HF group; n = 23) and those
      with a normal or low flow (NF group; n = 22). Seven blood samples were taken:
      immediately before cardiopulmonary bypass, immediately after removing the aortic
      cross-clamps, immediately after discontinuing bypass, and at 20 minutes and 3, 6,
      and 24 hours after termination of bypass. The plasma levels of endothelin-1 were
      similar in both groups before bypass. From the time the aortic crossclamps were
      removed, the plasma endothelin-1 levels in both groups increased significantly,
      to reach a peak level at 3 to 6 hours. The increase was significantly greater in
      the HF than in the NF group, and the maximum values in the two groups were 12.6
      +/- 1.1 and 9.6 +/- 0.8 fmol/ml, respectively (mean +/- standard error of the
      mean, p < 0.05). The value 20 minutes after bypass showed a positive correlation
      with the mean pulmonary arterial pressure measured at the preoperative cardiac
      catheterization study (r = 0.41, p < 0.05). In addition, a significant positive
      correlation was obtained between endothelin-1 3 hours after bypass and the
      maximum pulmonary/systemic arterial pressure ratio during the first 12 hours
      after operation (r = 0.86, p < 0.05). These results suggest that cardiopulmonary
      bypass is associated with an immediate postoperative increase in circulating
      endothelin and that patients who had a high pulmonary blood flow before the
      operation are particularly vulnerable, bypass having a more injurious effect on a
      lung with preexisting endothelial dysfunction. A high level of circulating
      endothelin may predispose to pulmonary vascular lability and pulmonary
      hypertensive crises in the postoperative period.

PMID- 8361191
TI  - Altered pulmonary microvascular reactivity after total cardiopulmonary bypass.
AB  - Pulmonary vascular resistance is frequently elevated after cardiac operations in
      which cardiopulmonary bypass is used. In our study of the possible contribution
      of altered pulmonary microvascular reactivity to this condition, sheep were
      heparinized, cannulated via the aorta and right atrium, and placed on total
      cardiopulmonary bypass. After 90 minutes of total cardiopulmonary bypass and
      pulmonary arterial occlusion, the sheep were removed from cardiopulmonary bypass,
      and their lungs were perfused normally for 60 minutes. Noninstrumented animals
      were used as controls. To evaluate the effect of 90 minutes of extracorporeal
      circulation without reduced pulmonary perfusion, we studied additional sheep
      after they underwent right heart bypass with a pump-oxygenator. Pulmonary
      microarterial vessels (130 to 230 microns in diameter) from each group were
      examined in vitro in a pressurized (20 mm Hg), no-flow state with video
      microscopic imaging and electronic dimension analysis. After preconstriction of
      vessels with the thromboxane A2 analog U46619 by 30% to 40% of the baseline
      diameter, vasoactive drugs were applied extraluminally. Serotonin caused control
      microvessels to dilate. In the presence of the nitric oxide synthetase inhibitor
      NG-methyl-L-arginine, this was converted to a significant contractile response.
      Acetylcholine alone had minimal effect on control vessels. However, in the
      presence of the cyclooxygenase inhibitor indomethacin, acetylcholine caused a
      significant relaxation response. After total cardiopulmonary bypass and pulmonary
      reperfusion, pulmonary microvessels contracted significantly when exposed to
      acetylcholine and serotonin, compared with respective control responses. Both
      these contractile responses were inhibited in the presence of indomethacin.
      Endothelium-independent responses to sodium nitroprusside and U46619 and dilation
      responses to adenosine were not altered after cardiopulmonary bypass.
      Extracorporeal circulation with continued pulmonary arterial perfusion (right
      heart bypass group) had no effect on microvascular responses. In conclusion,
      total cardiopulmonary bypass with associated reduced pulmonary perfusion causes
      significant alterations of endothelium-dependent pulmonary microvascular
      responses because of the increased release of a constrictor prostanoid substance
      and possibly because of reduced release of endothelium-derived relaxing factor.

PMID- 8361193
TI  - Role of amino acids and enhancement cardioplegia in routine myocardial
      protection. Experimental results.
AB  - The purpose of this study was to determine the effects of the addition of amino
      acids to blood cardioplegic solution and the value of terminal cardioplegia
      enhancement techniques in routine myocardial protection. Forty-five open-chest
      adult dogs were instrumented with sonomicrometry crystals to measure left
      ventricular long axis, midequatorial short axis, and wall thickness. The aorta
      was clamped for 120 minutes of cardiopulmonary bypass. Animals were randomly
      separated into four myocardial protection groups: (1) blood cardioplegic solution
      with amino acids and no terminal cardioplegia (n = 12); (2) blood cardioplegic
      solution with amino acids and warm amino acid terminal cardioplegia (n = 11); (3)
      blood cardioplegic solution with amino acids and cold amino acid terminal
      cardioplegia (n = 12); and (4) blood cardioplegic solution plus cold terminal
      cardioplegia (no amino acids, n = 10). Data for preload recruitable stroke work
      were obtained by inflow occlusion before bypass (baseline) and at 30 and 60
      minutes after reperfusion and analyzed for changes in x-intercept and slope. A
      significant rightward shift in x-intercept did not occur in any group. When
      cardiac function was expressed as a percentage of baseline preload recruitable
      stroke work slope, improved functional recovery was seen at both 30 and 60
      minutes in groups 2 (88.6% and 91.8%), 3 (85.8% and 86.9%), and 4 (88.6% and
      92.6%) compared with group 1 (77.3% and 79.2%, p < 0.05). No significant
      difference was found in the degree of functional recovery among groups 2, 3, and
      4. These results suggest that for myocardial protection of 2 hours in nonischemic
      hearts, a terminal dose of blood cardioplegic solution before unclamping is
      beneficial, but this positive effect is independent of amino acid supplementation
      and temperature.

PMID- 8361192
TI  - Blockade of cyclosporine-induced vasoconstriction by the calcium channel blocker
      diltiazem in dogs.
AB  - The calcium channel blocker diltiazem has been shown to reduce cyclosporine
      toxicity both in clinical and in experimental studies. To determine the effect of
      diltiazem administration on cyclosporine vasoconstriction and on renal release of
      endothelin, we administered cyclosporine in models of renal and hind limb
      autoperfusion in the dog. Infusion of cyclosporine in the hind limb (20 mg)
      during diltiazem perfusion caused an average increase of 6 +/- 2 mm Hg in hind
      limb perfusion pressure compared with 17 +/- 2 mm Hg before diltiazem, a
      significant difference (p < 0.05). Similarly, injections of cyclosporine (10 mg)
      in the kidney during diltiazem infusion caused an average increase of 26 +/- 4 mm
      Hg in renal perfusion pressure compared with 83 +/- 13 mm Hg before diltiazem
      infusion, a significant decrease in the renal vascular response (p < 0.05). On
      the other hand, sodium nitroprusside did not change the renal vasoconstriction to
      cyclosporine, which suggests a specific effect of diltiazem. Serum levels of
      endothelin in renal venous blood increased from 0.5 +/- 0.4 pg/ml to 3.8 +/- 0.6
      pg/ml with cyclosporine, despite diltiazem infusion. Therefore, although the
      calcium channel blocker diltiazem effectively decreases cyclosporine-induced
      renal and hind limb vasoconstriction, it does not act by preventing endothelin
      release induced by cyclosporine stimulation.

PMID- 8361194
TI  - Cardioplegic effect of University of Wisconsin solution on hypothermic ischemia
      of rat myocardium assessed by mitochondrial oxidative phosphorylation.
AB  - The effectiveness of the University of Wisconsin solution and the Collins' M
      solution for preservation of rat hearts was compared by examining histologic
      appearance, tissue water content, and mitochondrial respiratory functions after
      prolonged hypothermic storage and subsequent heterotopic transplantation.
      Survival of transplanted hearts after 5 days of reperfusion was markedly lowered
      by storage in Collins' M solution for 15 hours. Hearts stored in University of
      Wisconsin solution for 10 hours showed no increase in myocardial necrosis after 5
      days of reperfusion, whereas hearts stored in University of Wisconsin solution
      for 15 hours and Collins' M solution for 10 and 15 hours showed a significant
      increase in tissue necrosis. University of Wisconsin solution reduced tissue
      swelling during hypothermic storage, whereas Collins' M solution did not cause
      such reduction. The yield of mitochondrial protein after reperfusion was
      significantly decreased by storage in either solution, especially after 15 hours
      in Collins' M solution. Mitochondrial oxidative phosphorylation was significantly
      inhibited by storage, especially by storage in Collins' M solution and subsequent
      reperfusion. These results indicate that myocardial injury, after prolonged
      ischemia and reperfusion, results in a decrease in functionally and structurally
      intact mitochondria that is dependent on preservation conditions. University of
      Wisconsin solution protects isolated hearts against ischemia and reperfusion
      injury possibly by preventing cellular and mitochondrial deterioration.

PMID- 8361195
TI  - Duration of asystolic reperfusion and reperfusate electrolyte composition
      influence postcardioplegia ventricular fibrillation.
AB  - The conditions of postcardioplegia reperfusion that influence cardiac
      electrophysiologic recovery have not yet been fully elucidated. Studies of
      postcardioplegia electrophysiologic recovery and reperfusion-induced arrhythmias,
      particularly reperfusion-induced ventricular fibrillation, are useful for
      improving our understanding of reperfusion injury since reperfusion-induced
      arrhythmias are sensitive indicators for reperfusion injury. The purpose of this
      study was to determine the effects of asystolic reperfusion and reperfusate
      electrolyte composition on postcardioplegia electrophysiologic recovery of the
      heart. The hypothesis tested is that the duration of asystolic reperfusion
      produced by a hyperkalemic reperfusate is a primary determinant for the return of
      cardiac electrical activity without reperfusion-induced ventricular fibrillation
      and that reperfusion with a hypocalcemic-hyperkalemic solution further reduces
      the prevalence of reperfusion-induced ventricular fibrillation by limiting
      myocyte calcium exposure during initial postischemic recovery. Fifty-six pigs
      were supported by cardiopulmonary bypass and subjected to identical conditions of
      hypothermic cardioplegic arrest. Reperfusion was initiated with unmodified pump
      blood, a hypocalcemic-normokalemic cardioplegic solution, a hyperkalemic
      normocalcemic cardioplegic solution, or a hyperkalemic-hypocalcemic cardioplegic
      solution. The hyperkalemic-normocalcemic solution was administered at a dose of
      500 ml/m2 or 1500 ml/m2. The hyperkalemic-hypocalcemic and hypocalcemic
      normokalemic solutions were given only at a dose of 500 ml/m2. All cardioplegic
      reperfusion solutions were followed by infusion of unmodified pump blood for the
      remainder of the 15-minute period of controlled reperfusion. Reperfusion-induced
      ventricular fibrillation was less prevalent in the high-dose hyperkalemic
      solution group (4/12) than in the low-dose hyperkalemic solution (9/10) or
      unmodified pump blood (12/12) groups (p < 0.05). The transmyocardial lactate
      gradient at the time of initial postreperfusion electrical activity was positive
      (0.21 +/- 0.04 mmol/L) in the high-dose hyperkalemic group and negative (-0.05 +/
      0.09 mmol/L) in the low-dose hyperkalemic group (p < 0.05). Fibrillation was
      less prevalent in the hypocalcemic-hyperkalemic group (8/12) than in the other
      groups reperfused with cardioplegic solution at a dose of 500 ml/m2 (hypocalcemic
      normokalemic, 10/10; hyperkalemic-normocalcemic, 9/10) or in the group reperfused
      with unmodified pump blood (12/12) (p < 0.05, hypocalcemic-hyperkalemic group
      versus other reperfusate groups). Reperfusion-induced ventricular fibrillation is
      an indicator of reperfusion injury, and in this study the conditions of
      reperfusion influenced the prevalence of reperfusion-induced ventricular
      fibrillation. Recovery of aerobic metabolism during hyperkalemia-induced
      asystolic reperfusion was associated with a lower prevalence of reperfusion
      induced ventricular fibrillation. Combining hypocalcemia with hyperkalemia
      decreased the prevalence of reperfusion-induced ventricular fibrillation.

PMID- 8361196
TI  - Multivariate analysis of risk factors for thrombus formation in University of
      Tokyo ventricular assist device.
AB  - Of 77 University of Tokyo ventricular assist devices used in a total of 70
      patients at 21 institutions, 13 pumps were found to have macroscopic thrombus
      formations. Because 19 devices that were used for less than 24 hours showed no
      thrombus deposition, they were considered not to have been sufficiently exposed
      to the thrombogenic environment for macroscopic thrombus deposition and were
      removed from the subsequent multivariate study. A total of eight potential risk
      factors were assessed in relation to thrombosis. Prevalences of thrombus
      formation were compared between two groups with or without each of the risk
      factors. In a univariate analysis, the following categoric variables were
      demonstrated to be significantly associated with complications, in descending
      order of significance: use of gabexate mesilate (protease inhibitor) as an
      anticoagulant (p = 0.005), normal platelet count (p = 0.010), duration of support
      (p = 0.038), leukocytosis (p = 0.042), and minimum pumping flow (p = 0.042). Use
      of heparin and the consequent increase in activated clotting time showed no
      relationship. Multivariate discriminant analysis, which was done to identify risk
      factors rejecting cross correlation between each variable, demonstrated platelet
      count (p = 0.006), use of gabexate mesilate (p = 0.007), and minimum flow (p =
      0.008) to have significant and independent risks. These results indicate the
      importance of maintaining pumping flow above a certain minimum level, addition of
      antiplatelet drugs to the antithrombogenic regimen, and nonuse of gabexate
      mesitate.

PMID- 8361197
TI  - Influence of hydrogen ion concentration versus carbon dioxide tension on
      pulmonary vascular resistance after cardiac operation.
AB  - Disturbances of respiratory acid-base status are common in patients supported
      with mechanical ventilation of the lungs after cardiac operations. This study was
      conducted with two protocols. The purpose was to determine whether respiratory
      acid-base status influences pulmonary vascular resistance in adults after cardiac
      operations and whether the influence is mediated by hydrogen ion concentration or
      carbon dioxide tension. Patients were studied while under general anesthesia
      immediately after aorta-coronary bypass. In the first protocol, with seven
      patients, arterial carbon dioxide tension was manipulated by the addition of 5%
      carbon dioxide to the breathing circuit. Pulmonary vascular resistance index was
      determined as arterial carbon dioxide tension rose from 30 mm Hg to 50 mm Hg and
      back to 30 mm Hg. In the second protocol, with 10 different patients, hydrogen
      ion concentration was manipulated by the addition of 0.2N hydrochloric acid,
      sodium bicarbonate, or both as arterial carbon dioxide tension was held constant.
      We used analysis of variance for statistical data. The results of the first
      protocol showed that pulmonary vascular resistance index rose by 44% (p < 0.05)
      as arterial carbon dioxide tension rose from 30 to 50 mm Hg. The results of the
      second protocol showed that changes in pulmonary vascular resistance index were
      parallel to changes in hydrogen ion concentration as arterial carbon dioxide
      tension was held constant (p < 0.05). These data demonstrate that respiratory
      acid-base status is an important determinant of pulmonary vascular resistance in
      the adult after cardiac operations. Furthermore, these data suggest the effect is
      mediated by hydrogen ion concentration, not carbon dioxide tension.

PMID- 8361198
TI  - Endobronchial metastasis.
AB  - Endobronchial metastases from nonpulmonary neoplasms are rare. Since 1971, we
      have treated 23 patients with endobronchial metastases, the findings for which
      form the basis of this article. Many types of primary tumors are capable of
      endobronchial metastases, although breast, colon, and renal carcinomas
      predominate. The mean time from the diagnosis of the primary carcinoma to the
      diagnosis of endobronchial metastases was 59.9 months. Bronchoscopic results were
      diagnostic in all cases. Although the mean time for the appearance of
      endobronchial metastases is almost 5 years, on examination the majority of
      patients will have symptomatic extrabronchial metastatic disease, the quality of
      their survival will often be poor, and their survival time will be limited (12.5
      months). Surgical resection should be confined to patients with localized
      disease.

PMID- 8361199
TI  - Chemotherapy and operation for invasive thymoma.
AB  - Sixteen patients with invasive thymoma (stage III and stage IVA) were treated
      with chemotherapy and then operation. All tumors were considered nonresectable
      after first staging, and patients were treated with the following chemotherapy in
      4-day courses, administered intravenously: cisplatin (50 mg/m2) and doxorubicin
      (40 mg/m2) on day 1, vincristine (0.6 mg/m2) on day 3, and cyclophosphamide (700
      mg/m2) on day 4. The courses were repeated every 3 weeks, and toxic effects were
      well tolerated. Seven patients (43%) had a complete remission, and nine patients
      (57%) had a partial remission, with an overall complete remission plus partial
      remission rate of 100%. After chemotherapy all patients underwent operation. We
      performed 12 sternotomies and four posterolateral thoracotomies. At operation 11
      patients had radical resection and five had partial resection. We administered
      radiotherapy in 11 patients who had histologically demonstrated tumor after
      operation. In five patients, the specimen showed only fibrosis; these patients
      received three cycles of chemotherapy but not radiotherapy. Median survival was
      66 months with a 3-year survival of 70%. We believe that neoadjuvant chemotherapy
      with surgical intervention is justified for advanced invasive thymoma; a longer
      follow-up and a larger number of patients will determine the impact of this
      treatment on long-term survival.

PMID- 8361200
TI  - Techniques for localization of pulmonary nodules for thoracoscopic resection.
AB  - Significant advances in surgical equipment, video monitoring, and endoscopic
      surgical techniques have expanded the role of thoracoscopy to include pulmonary
      resection. One limitation of the thoracoscopic technique is the loss of manual
      palpation to identify the nodule that is either too small or too deep beneath the
      pleural surface. We describe the techniques used in 300 thoracoscopic pulmonary
      resections that have aided in identification of pulmonary nodules. These
      techniques include careful preoperative assessment of the computed tomogram,
      preoperative injection of methylene blue, or a needle localizing system to
      identify the nodule. Intraoperative techniques include instrument palpation,
      digital palpation, and intraoperative ultrasonography. It should be possible to
      identify the majority of pulmonary nodules at the time of thoracoscopy with these
      localizing techniques. All nodules were successfully identified in our last 200
      thoracoscopic resections.

PMID- 8361201
TI  - Thoracoscopic mediastinal lymph node sampling: useful for mediastinal lymph node
      stations inaccessible by cervical mediastinoscopy.
AB  - Cervical mediastinoscopy is useful for the diagnosis of paratracheal lymph node
      metastasis from bronchogenic carcinoma. Access to adenopathy in the
      aorticopulmonary window, anterior mediastinal, periazygos, and subcarinal lymph
      nodes is difficult with this technique. Operative visibility in these locations
      through anterior mediastinotomy, the Chamberlain procedure, is limited. We have
      used thoracoscopic mediastinal exploration in 40 patients with computed
      tomographic scan evidence of enlarged aorticopulmonary window (n = 30) or
      enlarged right periazygos or subcarinal lymph nodes (n = 10). This procedure was
      used primarily as an adjunct to cervical mediastinoscopy in the staging of
      bronchogenic carcinoma. Adjunctive thoracoscopic nodal sampling was 100%
      sensitive and 100% specific in diagnosing the mediastinal adenopathy. It did not
      significantly delay thoracotomy in cases of benign adenopathy. Visibility of the
      ipsilateral pleural space and mediastinum was excellent. Thoracoscopic
      exploration with mediastinal nodal sampling is a valuable diagnostic adjunct for
      assessment of adenopathy inaccessible to cervical mediastinoscopy and can
      overcome many of the limitations of anterior mediastinotomy.

PMID- 8361202
TI  - Invited letter concerning: what is the best therapeutic strategy for mitral
      stenosis?

PMID- 8361203
TI  - Interpretation of data on the use of 5'-nucleotidase inhibition to preserve the
      cardioplegically arrested rabbit heart.

PMID- 8361204
TI  - Anomalous origin of the left coronary artery from the pulmonary artery in older
      adults.

PMID- 8361205
TI  - Endothelium-dependent relaxation and interaction between indomethacin and L-NG
      monomethylarginine in coronary bypass grafts.

PMID- 8361206
TI  - Invited letter concerning: cytokines and mechanisms of capillary leakage after
      cardiopulmonary bypass.

PMID- 8361207
TI  - Invited letter concerning: experience with 205 procedures of transcatheter
      closure of ductus arteriosus in 182 patients, with special reference to residual
      shunts and long-term follow-up (J Thorac Cardiovasc Surg 1992;104:1721-7)

PMID- 8361208
TI  - A new technique to simplify the Fontan procedure after a previous bidirectional
      Glenn shunt.

PMID- 8361209
TI  - Modulation of cell proliferation and cytokine production in AML by recombinant
      interleukin-1 receptor antagonist.
AB  - In Acute Myelogenous Leukemia (AML), Interleukin 1 (IL-1) might sustain autocrine
      and paracrine loops of leukemic growth. An IL-1 inhibitor has been recently
      purified and cloned. This molecule binds to the IL-1 receptors but has no IL-1
      like activity fulfilling the characteristics of a pure Interleukin-1 receptor
      antagonist (IL-1ra). We studied the in vitro effect of human recombinant IL-1ra
      on proliferation of AML blasts. Spontaneous as well as IL-1 stimulated AML
      proliferation was significantly inhibited by the addition of 50 ng/ml of
      recombinant IL-1ra in a dose dependent manner. The inhibitory effect of IL-1ra
      was measurable after 12 hours of culture and reached a plateau at 60 hrs. We
      found that IL-1ra could compete with IL-1 in binding to specific IL-1 receptors
      on AML cells. As expected, culture supernatants of unstimulated leukemic samples
      contained IL-1 beta and GM-CSF activity. The incubation of the same leukemic
      blasts with IL-1 ra was followed by reduction or disappearance of GM-CSF in
      culture supernatants whereas the IL-1 beta production was only partially
      modulated. By Northern blot experiments performed on freshly isolated, uncultured
      leukemic blasts, we found a constitutive expression of the IL-1 beta gene in 19
      of 23 AML cases analyzed. On the contrary, only three of these patients express
      the IL-1 RA mRNA. All together these results suggest that imbalanced secretion of
      IL-1 and its natural receptor antagonist could contribute to the unrestricted
      growth of AML cells.

PMID- 8361210
TI  - Reconstitution of functional human GM-CSF receptor in mouse NIH3T3 fibroblasts
      and BA/F3 proB cells.
AB  - Granulocyte-macrophage colony-stimulating factor (GM-CSF) plays a critical role
      in growth and differentiation of myeloid cells. We previously reconstituted high
      affinity human GM-CSF receptor (hGM-CSFR) in a proB cell line BA/F3 by
      cotransfecting alpha and beta chain cDNA clones and showed that the reconstituted
      receptor could transduce growth promoting signals. The high affinity hGM-CSFR was
      also reconstituted in mouse NIH3T3 cells, but its ability to transduce signals in
      fibroblasts remained unanswered. In the present study, we further characterized
      signal transduction by the reconstituted hGM-CSFR both in NIH3T3 cells and BA/F3
      cells. We found that the reconstituted hGM-CSFR transduces signals in NIH3T3
      fibroblasts and BA/F3 cells in response to human GM-CSF to activate transcription
      of c-fos, c-jun and c-myc protooncogenes. hGM-CSF also induces protein tyrosine
      phosphorylation and DNA synthesis in both cell types. The ability of hGM-CSFR to
      transduce signals was affected by inhibitors of tyrosine kinase. These results
      indicated that the hGM-CSFR is functional in fibroblasts, that signal
      transduction via the hGM-CSFR in fibroblasts involves tyrosine kinase(s) and that
      association of hGM-CSFR with factor(s) specific to hematopoietic cell lineage is
      not essential to transduce growth promoting signals.

PMID- 8361211
TI  - Analysis of Pim-1 function in mutant mice.
AB  - The Pim-1 gene has frequently been found activated by proviral insertion in
      haematopoietic tumors in mice. The fact that overexpression of Pim-1 can
      contribute to lymphomagenesis was formally proven by overexpressing a Pim-1
      transgene in lymphoid cells. The transgene induces a low incidence of T cell
      lymphomas and an increased susceptibility to chemically (ENU) and virally
      (MoMuLV) induced lymphomas. The mouse Pim-1 gene encodes two cytoplasmic protein
      serine/threonine kinases. Northern analysis shows the highest expression to be in
      haematopoietic tissues, especially early in development. High expression has also
      been noted in testis and ES cells. Expression can be induced by growth factors
      and mitogens. The gene is evolutionarily highly conserved. Inactivation of both
      Pim-1 alleles in ES cells or mice did not reveal any obvious abnormalities. In
      order to look more closely for possible haematopoietic abnormalities specific
      growth factor response were studied in vitro. The IL-3 response of bone marrow
      derived mast-cell cultures (BMMC) was found to be severely impaired in mast cells
      derived from Pim-1 deficient mice.

PMID- 8361212
TI  - Activation of the erythropoietin receptor and leukemia induction in mice.

PMID- 8361213
TI  - In vivo role of macrophage growth factors as delineated using CSF-1 deficient
      op/op mouse.
AB  - Total absence of CSF-1 in the op/op mouse leads to a profound and generalized
      deficiency of macrophages and to osteopetrosis subsequent to the absence of
      osteoclasts. These observations confirm that CSF-1 is a genuine regulator of
      macrophage and osteoclast formation in vivo. Further studies in affected animals
      have shown that the CSF-1 absence variably affects macrophage differentiation
      stages and different organ macrophage populations, and that functionally
      competent macrophages are produced in low numbers without CSF-1, presumably under
      the influence of GM-CSF and IL-3. The op/op mice have increased levels of both
      endogenous GM-CSF and IL-3, which apparently are not fully able to compensate for
      the absence of CSF-1. Macrophage deficiencies but not osteoclast deficiencies in
      the op/op mouse could be completely corrected by exogenous GM-CSF, while
      exogenous CSF-1 corrects both osteoclast and macrophage deficiencies, but only in
      those tissues which could be reached by CSF-1 from the circulation. Despite
      severe quantitative macrophage deficiencies, the op/op mice demonstrate normal in
      vivo phagocytosis and immune functions suggesting that CSF-1 dependent
      macrophages do not contribute significantly to those processes in vivo. On the
      other hand, the op/op mice demonstrate severe secondary deficiencies of TNF
      alpha, IL-1 alpha, and G-CSF suggesting that major function of CSF-1 dependent
      macrophages is the release of monokines.

PMID- 8361214
TI  - Growth factor regulation of the maintenance and differentiation of human long
      term culture-initiating cells (LTC-IC).
AB  - Current evidence suggests that the most primitive of hematopoietic progenitors
      detectable in adult human marrow are cells that can give rise to clonogenic cells
      for > 5 weeks in vitro when co-cultured with certain stromal cells. Procedures
      developed to isolate these so-called long-term culture-initiating cells (LTC-IC)
      in highly purified form allow their separation from most other hematopoietic
      cells as well as from stromal cells and their precursors also present in the
      marrow. We have used such procedures in conjunction with the LTC system to
      identify specific growth factors that support human LTC-IC maintenance and
      differentiation and to make comparisons with effects on later events in
      hematopoiesis. In some studies, soluble growth factors were added exogenously to
      the study cultures. In others, marrow-derived fibroblasts were genetically
      engineered to allow increased levels of specific human growth factors to be
      endogenously produced. In both of these ways, the influence of granulocyte-
      macrophage colony-stimulating factor (GM-CSF), G-CSF, Interleukin-3 (IL-3), IL-6,
      and Steel factor were investigated. Increased provision of GM-CSF alone (or in
      combination with other factors) enhanced terminal cell differentiation
      (production of granulocytes and macrophages), although the same conditions had no
      influence on LTC-IC differentiation (production of clonogenic cells) or on LTC-IC
      maintenance. In contrast, G-CSF, IL-3 and IL-6 alone (and more so when combined)
      in the presence of feeders effectively enhanced LTC-IC differentiation and was
      less active on later stages of granulopoiesis. Provision of additional exogenous
      Steel factor also enhanced LTC-IC differentiation, although Steel factor alone,
      without feeders or other growth factors, did not support either the initial
      differentiation of LTC-IC into clonogenic cells or their subsequent
      differentiation into mature granulocytes and macrophages. No combination of
      exogenously added growth factors was found that enhanced LTC-IC maintenance over
      that achieved with primary marrow feeders. However, some murine fibroblasts
      (including those of SI/SI origin), as well as certain exogenous growth factors
      (including Steel factor), were able to substitute for feeders in this regard.
      These observations highlight the likelihood of redundancy in factors that can
      elicit similar biological responses at the earliest as well as later stages of
      hematopoietic cell development. Nevertheless, it appears that the responses of
      hematopoietic cells at different stages of differentiation to any particular
      factor may differ markedly and that the nature of any particular response is not
      yet predictable from a knowledge of effects on earlier or later cell types.

PMID- 8361215
TI  - In vitro culture of bone marrow cells for autografting in CML.
AB  - Long-term maintenance of normal hematopoiesis in vitro is possible when very
      primitive progenitors are cocultivated with certain non-hematopoietic stromal
      cells that may co-exist in (or be derived from cells that co-exist in)
      hematopoietic tissues. Such long-term cultures (LTC) have been used to develop
      quantitative assays for the most primitive populations of hematopoietic cells
      currently detectable in adult marrow. In addition they provide a unique model for
      analysis of the complex molecular mechanisms that may regulate primitive
      hematopoietic cell population dynamics in vivo. Similar studies with LTC of cells
      from patients with chronic myeloid leukemia (CML) have made it possible to detect
      and characterize very primitive neoplastic cell populations in this disease.
      These latter studies have revealed differences in the properties of primitive CML
      cells that both reflect and explain their increased turnover and are thus
      presumably part of the mechanism that enables the neoplastic clone to expand in
      vivo. In addition, the most primitive neoplastic cells in CML patients are
      abnormally distributed between the marrow and blood and their ability to maintain
      their numbers in LTC has also been found to be defective. Assessment of the
      number and behaviour of primitive cells in LTC of CML marrow has been used to
      identify those patients most likely to benefit from intensive therapy supported
      by transplantation of cultured autologous marrow. Twenty-two such CML patients
      have now been treated with this experimental protocol. The results to date have
      clearly established the feasibility of this novel treatment strategy and,
      together with more recent laboratory findings, suggest future avenues for
      significantly improving the management of CML patients.

PMID- 8361216
TI  - Identification of P-glycoprotein/multidrug resistance genes from model organisms.
AB  - Using degenerate oligonucleotides from conserved portions of the ATP-binding
      domain of the active transporter genes, several new members of this gene
      superfamily have been cloned from Drosophila, Saccharomyces cerevisiae, and E.
      coli DNA. The Drosophila and E. coli genes contain two sets of transmembrane
      domains and two ATP-binding domains, whereas the yeast gene contains single
      transmembrane and ATP-binding domains. All three genes show a high degree of
      similarity to the mammalian P-glycoprotein/multidrug resistance (MDR) genes. The
      E. coli sequence is the only known transporter gene containing both ATP and
      transmembrane domains in a single open reading frame. While the function of these
      sequences has not been determined, they may prove to be useful for developing a
      model to study the function of P-glycoproteins.

PMID- 8361217
TI  - Follow-up of the first two successive German multicentre trials for adult ALL
      (01/81 and 02/84). German Adult ALL Study Group.

PMID- 8361218
TI  - Chronic myelocytic leukemia: development of conditioning regimens for marrow
      transplantation.

PMID- 8361219
TI  - Leukaemias in Africa.
AB  - Until recently, cALL has been uncommon in sub-Saharan Africa, but there is now
      emerging a peak of incidence at the age 3 to 5 years in west and southern Africa.
      Prognosis for African patients with cALL is poor because of a multitude of
      clinical, biological and social factors. AML is seen at high frequency (probably
      indicating truly high incidence) in male children 5-14 years, of whom up to a
      quarter present with chloroma. It is predicted that the incidence of AML in
      adults may rise in the near future, related to cigarette smoking, occupational
      and environmental exposures to benzene and other pollutants, and the prescription
      of alkylating agents to young people with malignant disease. CML shows no
      particular epidemiological features, except for a high frequency in young adults
      and children, reflecting the age structure of the whole population. There are two
      forms of B-CLL: one is seen most commonly in women of low socioeconomic status
      towards the end of the their reproductive life, and is probably related to an
      initially polyclonal expansion of B-cells in response of recurrent malaria and
      other infections; the other is seen over the age of 45 years, with men being
      affected twice as commonly as women, as in the western world.

PMID- 8361220
TI  - Treatment results of three consecutive Brazilian cooperative childhood ALL
      protocols: GBTLI-80, GBTLI-82 and -85. ALL Brazilian Group.
AB  - The Brazilian Cooperative Group for Treatment of Childhood Acute Lymphocytic
      Leukemia (GBTLI) has started clinical activities trials in 1980. Three
      consecutive multicenter studies in children with unprevious treated ALL have been
      completed including 994 patients. The first GBTLI-80 accrued 203 children from
      1980 to 1982. It was delineated with the standard three drugs induction therapy,
      CNS protection for all pts comprised cranial irradiation and intrathecal
      Methotrexate. For low risk pts cranial irradiation with 18Gy was compared in a
      randomized trial with 24Gy. Maintenance therapy continued for 120 weeks. The 12
      years of the event free survival rates for all risk groups is 50% (SD 5%).
      Regarding CNS relapses there was no significant statistical difference between
      pts that received 18 or 24Gy. The treatment strategy of GBTLI-82 (n = 360) from
      1982 to 1985, consisted of the same previous induction, consolidation, CNS
      therapy with cranial irradiation 18 Gy (low risk) or 24Gy (high risk), followed
      by continuous maintenance for 2 years. The main question in this study was the
      comparison between sequential rotation or pulses of 3 pairs of drugs during
      maintenance. At a median follow-up of 10 years, the overall event free survival
      rates for all children is 58% (SD 4%). There was no significant difference
      between the two maintenance regimens. The successor GBTLI-85 ran from 1985 to
      1988 and registered 431 pts. For the first time no cranial radiation was given to
      children with very good prognosis. For them, CNS protection was done with triple
      intrathecal therapy during all treatment. A consolidation therapy with high dose
      ARA-C was introduced for high risk pts and infants The 6.5 years event free
      survival for all children is 70% (SD 4%). Significant better results were
      achieved for high risk and infants pts (EFS 50%). Early intensification therapy
      and rotational combination chemotherapy improved the outcome in childhood ALL in
      Brazil.

PMID- 8361221
TI  - Ethnicity and survival in children with acute lymphoid leukemia.

PMID- 8361222
TI  - Stem cell regulation and engraftment.

PMID- 8361223
TI  - 1992 Stohlman Memorial Lecture: targeting the IL-2 receptor.
AB  - Patients with human T-cell lymphotropic virus I (HTLV-I)-associated
      leukemia/lymphoma were treated with different forms of IL-2 receptor (IL-2R)
      directed therapy that exploit the difference in IL-2R expression between normal
      and malignant cells. Using unmodified anti-Tac monoclonal antibody, one-third of
      the patients with adult T-cell leukemia (ATL) treated have undergone a remission,
      in two cases complete. There was little toxicity observed; however, unmodified
      monoclonal antibodies are limited by their immunogenicity and their poor effector
      functions. To address these issues, "humanized" anti-Tac was produced that
      contains the complementarity-determining regions from the mouse with the
      remainder of the molecule derived from human IgG1 kappa. This antibody is
      dramatically less immunogenic than the murine version, has improved
      pharmacokinetics, and, in contrast to the parent antibody, manifests antibody
      dependent cellular cytotoxicity (ADCC). To enhance its effector function, anti
      Tac was armed with toxins and alpha- and beta-emitting radionuclides. In a
      clinical trial of 90Y-anti-Tac in ATL patients, at the doses used (5, 10, and 15
      mCi 90Y-anti-Tac per patient), 10 of the 15 patients with ATL treated to date
      underwent sustained partial or complete remission. Thus, the clinical application
      of IL-2R-directed therapy represents a new perspective for the prevention of
      allograft rejection and for the treatment of graft-versus-host disease, select
      autoimmune disorders, and leukemia/lymphoma.

PMID- 8361224
TI  - A song in praise of peptide palindromes.
AB  - Peptide palindromes are invariably found in all proteins, and long palindromes
      exceeding 10 residues in length are not rare. They are particularly abundant in
      DNA-binding proteins such as H1 histone. When a complementary strand of the
      coding sequence is translatable being free of a chain terminator, a complementary
      protein encode by it becomes equally abundant in peptide palindromes. The
      simultaneous musical transformation of both strands of mouse H1 histone variety-1
      DNA enable us to appreciate the symmetrical beauty of successive palindromes
      appearing in both H1 histone and its complementary protein.

PMID- 8361225
TI  - Hematopoietic cytokines: from biology and pathophysiology to clinical
      application.

PMID- 8361226
TI  - P53 mutations in human cancer.
AB  - A 53,000 dalton protein called p53, was noted to be mutated in human cancer in
      1987. Further studies have shown that p53 is a tumor suppressor gene which may be
      one of the most frequently altered genes in cancer of all types. These
      alterations include interactions with viral antigens, coding mutations and
      inactivating rearrangements. Accumulating evidence suggests that p53 acts by
      binding DNA and activating transcription. Expression of p53 after transfection
      with a constitutive promotor, blocks cellular proliferation and leads to an
      apoptotic cell death. In normal cells, p53 expression is induced by irradiation;
      this has led to the hypothesis that p53 acts to inhibit replication during
      genetic repair. Cells which lack p53 are more prone to develop amplification.
      Mice lacking p53 are born normal but develop cancer after a lag of months, this
      suggests that p53 is not an initiating mutation in cancer, but probably a late
      event.

PMID- 8361227
TI  - The mitogenic response of AML blasts to tumor necrosis factor-alpha requires
      functional c-jun/AP-1.
AB  - The c-jun proto-oncogene belongs to the family of immediate early response genes
      and is inducible by serum growth factors and Tumor Necrosis Factor (TNF). In the
      present study we have addressed the role of c-jun for the mitogenic response of
      primary acute myelogenous leukemia (AML) blasts to TNF-alpha. Our data indicate
      that TNF-alpha treatment of these cells is associated with transcriptional
      activation of c-jun and accumulation of c-jun mRNA. In order to elucidate the
      role of c-jun for TNF-mediated growth stimulation, an antisense (AS) oligomer
      directed towards the translation initiation site of c-jun was instrumental.
      Uptake studies of oligonucleotides showed that incorporation of oligomers was
      maximal at 4 hours. Oligodeoxynucleotides remained stable in these cells for up
      to 24 hours. Treatment of AML blasts with the AS oligonucleotide resulted in
      intracellular duplex formation followed by efficient translation blockade of c
      jun/AP-1. In contrast, sense (S) and none-sense (NS) oligodeoxynucleotides failed
      to form intracellular duplexes and also did not interfere with translation of c
      jun/AP-1, suggesting specific elimination of c-jun/AP-1 by the AS oligomer. AML
      blasts cultured in the presence of AS to c-jun, but not of S or NS, failed to
      proliferatively respond to TNF-alpha stimulation. Taken together, our results
      indicate that activation of c-jun/AP-1 plays a pivotal role in the signaling
      cascade initiated by TNF which leads to a proliferative response of its target
      cells.

PMID- 8361228
TI  - Stromal regulation of hemopoiesis and the role of subliminal growth factor
      production.

PMID- 8361229
TI  - p53 protein expression in Reed-Sternberg cells of Hodgkin's disease.
AB  - Hodgkin's disease (HD) is perceived to be a malignant disease of the lymphoid
      system. One of the main obstacles into the investigation of the cell biology of
      Hodgkin's disease is the relative paucity of Reed-Sternberg cells (or variants),
      the presumed neoplastic component of this condition, which often make up less
      than 1% of the total cell number.

PMID- 8361230
TI  - The isolation of a yeast artificial chromosome which spans the chromosome 11q23
      region involved in a number of translocations in acute leukaemias.

PMID- 8361231
TI  - T cell development: new approaches.
AB  - The differentiation of T lymphocyte precursors into functionally mature progeny
      proceeds in distinct stages. Since these are identified by characteristic
      constellations of phenotypic markers, the effects of experimental manipulations
      on T cell development can be readily monitored. In order to complete their
      developmental program, thymocytes must interact with stromal elements, which
      positively and negatively select the functional T cell receptor (TCR) repertoire.
      This process normally assures self tolerance and immunocompetence. Disturbances
      are of practical importance for clinical disorders including immunodeficiencies
      and autoimmune phenomena, raising a particular interest in human T cell
      development and repertoire formation. Here, we discuss results and possible
      applications of a culture system for human thymocytes. Further, we describe an in
      vitro approach addressing the requirements for a crucial step in T cell
      development; the transition from the immature CD4 CD8 double positive (DP) to the
      mature CD4 single positive (SP) stage.

PMID- 8361232
TI  - Ligand-induced apoptosis of mature T lymphocytes (propriocidal regulation) occurs
      at distinct stages of the cell cycle.
AB  - We previously demonstrated that mature T lymphocytes responding to either IL-2 or
      IL-4 undergo apoptosis upon T cell antigen receptor stimulation, and have termed
      this potential negative feedback pathway propriocidal regulation. Using cell
      cycle inhibitors, we now show that T cell growth lymphokines cause the entry of T
      cells into vulnerable stages of the cell cycle in which T cell receptor occupancy
      causes apoptosis.

PMID- 8361233
TI  - Memory and the lifespan of human T lymphocytes.
AB  - The properties of human CD45RA and CD45R0 T cells are described. CD45R0 cells
      respond to recall antigens and provide help for B lymphocytes. They produce a
      wide variety of cytokines including IL-2, IL-4 and IFN-gamma. CD45RA T cells
      respond poorly to recall antigens and produce mainly IL-2. The phenotype of
      CD45R0 cells suggests that they may be in cycle and in vivo data shows that they
      have a short lifespan while CD45RA cells are long lived. The lineage relationship
      of the two subsets is not clear but in vivo and in vitro evidence suggests
      bidirectional conversion between CD45RA and CD45R0 phenotypes.

PMID- 8361234
TI  - Regulation of human T cell receptor beta gene expression by Ets-1.
AB  - Expression of the human TcR beta gene is controlled by an enhancer located 6kb 3'
      to the C beta 2 gene segment. The activity of this enhancer has been shown to be
      inducible with phorbol esters. Within the enhancer the beta E2 element is
      responsible for the major part of the inducibility, multimerised beta E2 alone is
      also highly phorbol ester inducible. The beta E2 element contains a consensus ets
      binding site as well as a core motif, and we have shown that the beta E2 ets site
      binds both Ets-1 and Ets-2 in vitro and that purified core binding factor (CBF)
      can bind the core site present in beta E2. Mutations which specifically disrupt
      Ets-1 and Ets-2 binding abolish inducibility as well as reducing activity,
      whereas mutants which cannot bind CBF have only reduced basal activity. In
      Jurkat, which has a high level of endogenous Ets-1, multimerized beta E2 was
      inactive unless treated with PMA. However when transfected into cells with no
      detectable Ets-1 the beta E2 multimer was highly active in the absence of PMA. Co
      transfection of an Ets-1 expression construct with the full enhancer into Jurkat
      cells led to a repression of enhancer activity, suggesting a repressive role for
      Ets-1. Co-transfection of Ets-1 was also able to repress strongly the activity of
      the beta E2 multimer. Repression of activity from both the full enhancer
      construct and the beta E2 multimer was most dramatic in the presence of PMA,
      suggesting that Ets-1 could block TcR beta activation. The Ets-1 expression
      construct used transactivated the HTLV-1 LTR which has also been shown to bind
      Ets-1. The repression of beta E2 activity by Ets-1 appears therefore to be
      specific. In conclusion, the combination of ets and core sites in beta E2
      constitutes a novel inducible element, which is specifically transrepressed by
      Ets-1.

PMID- 8361235
TI  - Studies of HIV-2 promoter activity and cell specific ablation.
AB  - We have a developed a retroviral mediated molecular ablation method to
      specifically eliminate HIV Tat-expressing cells. This approach utilizes the Tat
      inducible HIV-2 promoter and a conditional toxin gene. The Herpes Simplex Virus
      thymidine kinase gene product is toxic to mammalian cells only after treatment
      with Ganciclovir (GCV) or other nucleoside analogues. We demonstrate here that
      certain promoter modifications can decrease basal expression while retaining the
      ability to be transactivated. Furthermore, we show that a HIV-2 promoter
      thymidine kinase gene cassette transduced via retroviral vectors into tissue
      culture cells can specifically promote the ablation of HIV-Tat expressing cells
      in the presence GCV. We also show that there is a large differential in HIV
      thymidine kinase gene transcription and lethal drug dose between Tat-expressing
      cells and Tat-negative cells.

PMID- 8361236
TI  - Lymphoproliferative disorders in an IL-7 transgenic mouse line.
AB  - A high incidence of severe lymphoproliferative disease was observed in a newly
      generated strain of mice carrying murine IL-7 as a transgene under the control of
      the E alpha (MHC class II) promoter. An analysis of the cells from lesions in
      these mice shows the selective expansion of cells at an early stage of B cell
      development and, more interestingly, expansion of cells phenotypically identical
      to the recently reported bipotent (B/macrophage) stem cell populations described
      in midgestation embryonic liver. Such cells can be propagated (and remain
      dependent upon) bone marrow feeder cell lines obtained from IL-7 transgenic mice.
      A molecular analysis of fresh and cultured cells reveals that the lesions are
      oligoclonal, or in rare cases monoclonal, and include clones of cells with
      unrearranged Ig heavy chain loci. These data suggest that IL-7 acts at multiple
      stages of B cell development. Furthermore cell lines derived from IL-7 transgenic
      mice may provide a novel source of rare factor-dependent bipotent stem cells.

PMID- 8361237
TI  - Recent approaches to induction of cytotoxic lymphocytes against leukemia.
AB  - We have shown that therapy of AML patients in second remission with continuous
      infusion of IL-2 resulted in generation of cytotoxic lymphocytes in peripheral
      blood and bone marrow. However, these lymphocytes mediated cytotoxicity only
      against tumor cell lines, and not against AML blasts. Additional in vitro
      activation with higher dose of IL-2 was necessary for induction of AML blast
      oncolysis. This indicates that the concomitant treatment with continuous and
      periodic bolus IL-2 infusion may be necessary, to achieve higher levels of IL-2
      and subsequently, more potent lymphocyte activation. Alternatively, it may not be
      possible to induce optimal antileukemia response in vivo with tolerable doses of
      IL-2, and the adoptive therapy with in vitro supremely activated lymphocytes may
      represent an option. In this article, we discuss several approaches to the
      supreme activation of cytotoxic lymphocytes against highly resistant AML blasts
      and their possibilities in leukemia therapy.

PMID- 8361238
TI  - Natural history of HTLV-I infection: relationship to leukemogenesis.

PMID- 8361239
TI  - Adult Day Health Care Evaluation Study.

PMID- 8361240
TI  - Implications of the Adult Day Health Care Evaluation Study for program revision
      and research.
AB  - With no additional effort to revise adult day health care (ADHC) services or the
      types of patients who receive them, it would appear that adding an ADHC program
      to a VA Medical Center would not achieve the desired objectives. The authors
      discuss here the advantages, disadvantages, and feasibility of 2 options for
      program revision. The first is to target ADHC to those types of patients who may
      be most likely to benefit. A targeting scheme should use the most objective
      criteria possible and may need to be implemented as part of a case-managed
      package of community-based services. The second option for program revision is to
      reduce the costs of ADHC services. A cost model developed as a part of the study
      demonstrated the effect of possible revisions, including increasing enrollment,
      reducing staffing costs, decreasing length of stay in ADHC, and increasing
      substitution of ADHC for other services. These changes differ in the level of
      administrative support and clinician behavior change needed for their
      implementation. This report then concludes with a discussion of the implications
      of the results for implementation of VA-ADHC versus contract ADHC, and a
      discussion of possible directions for future research.

PMID- 8361241
TI  - The Adult Day Health Care Evaluation Study--impact on VA programs.
AB  - The research study in Adult Day Health Care (ADHC) has had a fourfold impact on
      the Veterans Administration: 1) It defined the health care focus of ADHC and
      shaped consequent program design; 2) It forged a partnership between research and
      clinical staff in ADHC programmatic development; 3) It enhanced the perception of
      research in program development in long-term care; and 4) It provided VA with
      direction for program redesign to render ADHC more cost-effective. With careful
      planning, the program is expected to grow in the future as a part of VA's
      continuum of long-term care programs.

PMID- 8361242
TI  - One more battle lost to friendly fire--or if you spend too much it's hard to save
      money.

PMID- 8361243
TI  - Program implications of the Veterans Adult Day Health Care studies.

PMID- 8361244
TI  - Data collection in the Adult Day Health Care Evaluation Study.
AB  - This report presents data collection measures and methods for the evaluation of
      Adult Day Health Care (ADHC) in the Department of Veterans Affairs (VA). Measures
      of patient health were survival, the Sickness Impact Profile, self-rated health,
      the Mini-Mental State Exam, Psychological Distress Scale, Social Support Scale,
      and Problem Behaviors Scale. Measures of health for the care giver were:
      Activities of Daily Living, Instrumental Activities of Daily Living, health
      perceptions, Psychological Distress Scale, life satisfaction, Social Support
      Scale, and Caregiver Burden Scale. We also assessed patient and care giver
      satisfaction with the care received by the patient. Measures of health status and
      outcomes were assessed primarily through patient and care giver interview at
      study enrollment, 6 months, and 12 months. Utilization and cost both within and
      outside VA were assessed for hospital, ambulatory care, nursing home, ADHC, home
      care, pharmacy, laboratory, and other forms of health care. Sources of
      utilization data included VA's computerized patient database, VA medical records,
      patient questionnaires, care giver questionnaires, and health care providers
      outside VA. Costs were obtained from VA's cost accounting system, VA Central
      Office, VA's contracts with outside providers, and directly from outside
      providers. Utilization and cost were assessed for each patient for a period of 1
      year after entry into the study.

PMID- 8361245
TI  - Adult day health care organizational and program characteristics.
AB  - A survey of 31 adult day health care (ADHC) programs assessed the extent to which
      the programs were implemented as intended by the VA. The study described and
      compared the host communities, ADHC organizational characteristics, program
      characteristics, and patient use of services. Four of the centers were operated
      by the Department of Veterans Affairs in VA Medical Center facilities. The
      remaining 27 centers were community providers serving veterans on contract
      through four additional VA Medical Centers. Veterans Administration programs were
      located in larger facilities, with lower client/staff ratios and fewer hours of
      operation than community contract programs. Patients on the average made 45
      visits to the VA-ADHC programs and 58 visits to the contract ADHC programs. The
      VA and contract programs were generally found to have been implemented as
      planned, i.e., they followed VA guidelines for staffing, space, and equipment.

PMID- 8361246
TI  - Overview and patient recruitment in the Adult Day Health Care Evaluation Study.
AB  - Although Adult Day Health Care (ADHC) is increasingly prominent in the continuum
      of long-term care services, the results from previous studies of the effects of
      ADHC are mixed. The objectives of the ADHC Evaluation Study were to determine the
      effect of ADHC on health status, utilization, and cost of care. The first phase
      was a randomized controlled trial evaluating ADHC provided directly by the VA.
      Patients at four medical centers (n = 826) were randomly assigned to receive
      either ADHC or customary care, and outcomes were compared for the two groups. The
      second phase was a prospective cohort study evaluating ADHC provided under
      contract to community agencies in which patients at four additional medical
      centers (n = 163) were assigned to contract ADHC programs. Outcomes were compared
      with those of similar patients in the randomized trial. Patients and care givers
      were assessed at intake and 6 and 12 months after intake. To be admitted to the
      study, patients must have met one of the following criteria: residence in a
      nursing home; dependence in ambulation, dressing, or toileting; bowel
      incontinence; or significant cognitive impairment. Patients at intake
      demonstrated major impairment in function and high levels of prior use of health
      care services.

PMID- 8361247
TI  - Effects of VA adult day health care on health outcomes and satisfaction with
      care.
AB  - It was hypothesized that ADHC would have a positive effect on the health of
      patients and their care givers and result in greater satisfaction with care than
      customary care. Measurement of health outcomes for patients included assessment
      of overall, psychological, and social health, and survival. Care giver assessment
      concentrated on psychosocial health. Findings indicated no difference in health
      outcomes between patients assigned to ADHC or their care givers and their
      counterparts assigned to customary care. Further analysis of subgroups found that
      there were 3 subgroups of patients for whom those assigned to ADHC had better
      outcomes (as indicated by lower Sickness Impact Profile scores) than those
      assigned to customary care. These subgroups included those who were 1) not
      married, 2) most satisfied with their social support network, and 3) not
      hospitalized at the time of enrollment in the study. Patients and their care
      givers assigned to ADHC were more satisfied with their care than those in nursing
      homes, but not more satisfied than those in hospital-based home care. Care givers
      reported significantly greater satisfaction with patient care in ADHC than did
      care givers of patients receiving care in nursing homes or ambulatory care
      clinics.

PMID- 8361248
TI  - Cost of VA adult day health care programs and their effect on utilization and
      cost of care.
AB  - The VA-ADHC Evaluation included a detailed assessment of the cost of the VA-ADHC
      programs and an evaluation of their effect on patients' utilization and costs of
      other health care services. Although each VA-ADHC program had little variation in
      its program costs over the 3 years of the study, there were large variations
      between the programs in total costs, their costs per patient day, and in some
      cost components. The 3 most important factors in determining the level of program
      costs were: the way patients were transported to and from ADHC, the availability
      of space to house the program, and the staff-to-patient ratio. The total cost of
      health care for patients randomly assigned to VA-ADHC was significantly (15.5%)
      higher than those assigned to customary care. Although ADHC care did substitute
      for certain other forms of care (i.e., home care and clinic visits), there was
      not enough of a substitution effect to offset the additional costs of ADHC
      services.

PMID- 8361249
TI  - Effects of adult day health care on utilization and cost of care for subgroups of
      patients.
AB  - An important goal of the Adult Day Health Care (ADHC) Evaluation Study was to
      identify subgroups of patients assigned to ADHC for whom the health care costs
      were less than, or not higher than, the costs of similar patients assigned to
      customary care. Patients eligible for VA services because of a severe disability
      that occurred during military service had significantly lower costs when assigned
      to ADHC compared with customary care. For several types of patients, total health
      care costs were not significantly higher for those assigned to ADHC compared with
      those assigned to customary care: patients who at study intake 1) were at highest
      risk of going to a nursing home, 2) had high levels of physical dysfunction as
      measured by the Sickness Impact Profile, 3) had multiple behavior problems, and
      4) were eligible for VA services because of a less severe service-connected
      disability but admitted to the ADHC for treatment of that disability. Two types
      of patients were found to have particularly high costs when assigned to ADHC
      compared with customary care: patients with low levels of physical dysfunction
      and patients with few behavior problems. Significant differences in the relative
      costs of ADHC versus customary care also were found between the 4 study sites.

PMID- 8361251
TI  - Comparison of utilization and cost among contract adult day health care, VA adult
      day health care, and customary care.
AB  - The contract ADHC evaluation compared the utilization and costs of patients
      assigned to contract ADHC with patients assigned to VA-ADHC care or customary
      care in the VA-ADHC evaluation. The ADHC costs per patient day were lower on
      average in the contract sites than in the VA-ADHC sites, although they were
      similar to the costs at 2 of the 4 VA-ADHCs. The contract site patients received
      significantly more days of ADHC care, offsetting their lower cost per day.
      Contract site patients had significantly fewer VA clinic visits and VA nursing
      home admissions than did patients in the VA-ADHC or customary care groups.
      Patients at the contract sites also had significantly fewer days of nursing home
      care than did the customary care group patients. Propensity scores based on
      intake characteristics were used to adjust for initial differences between the
      patients in the 2 evaluations. After adjustments, the total cost of care for
      contract ADHC patients was found to be significantly higher than the cost for
      customary care patients, but no significant difference was found between contract
      ADHC patients and VA-ADHC patients.

PMID- 8361250
TI  - Effects of contract adult day health care on health outcomes and satisfaction
      with care.
AB  - The second phase of the ADHC Evaluation Study was designed to assess ADHC
      provided under contract by community ADHC programs. Outcomes for the 163 patients
      enrolled in this prospective cohort evaluation were compared with those of
      patients assigned to ADHC provided directly by VA (VA-ADHC) and customary care in
      the randomized trial phase of the study. In spite of identical admission
      criteria, contract ADHC patients were significantly different from VA-ADHC and
      customary care patients on several characteristics and were more impaired in
      health status at study intake. They were also more impaired in physical health
      status at 12 months, even after controlling for baseline differences. There were
      no significant differences in any other patient or care giver health outcomes.
      Contract ADHC patients were more satisfied than customary care patients in
      nursing homes (but not more satisfied than patients in home care), whereas VA
      ADHC patients were more satisfied than those in contract ADHC. It is suggested
      that differences in physical function are due to differences in patient health
      status at intake rather than a detrimental effect of contract ADHC.

PMID- 8361252
TI  - Summary and discussion of methods and results of the Adult Day Health Care
      Evaluation Study.
AB  - This article summarizes the study results and presents an evaluative summary of
      the implementation of study methods designed to provide guidance in the degree of
      confidence with which the results may be accepted and generalized to other
      situations. Patients who were offered VA-ADHC services in the first phase of this
      study had significantly higher VA health care costs on average than patients
      assigned to customary care, with no apparent incremental health benefit to
      themselves or their care givers. One can have a high level of confidence in these
      results. The ADHC clinical services were implemented as planned, the randomized
      controlled trial was implemented successfully, and such threats to validity as
      insufficient numbers of patients and differential attrition were not present.
      Certain subgroups of patients assigned to VA-ADHC had VA costs of care that were
      not significantly higher than those assigned to customary care, although these
      results must be interpreted with caution. The findings of the second phase of the
      study evaluating contract ADHC provide no support for choosing to provide either
      contract ADHC or VA-ADHC over the other. The nonrandomized design and smaller
      sample size suggest that inferences from the contract ADHC evaluation should be
      drawn with more caution than those from the VA-ADHC evaluation.

PMID- 8361253
TI  - The fifth Paul Ehrlich Lecture, Virus strains as models of molecular evolution.

PMID- 8361254
TI  - Biotechnology in the drug discovery process: strategic and management issues.

PMID- 8361255
TI  - Stability of liposomal doxorubicin formulations: problems and prospects.

PMID- 8361256
TI  - Opportunistic/nosocomial infections. Treatment and developmental therapeutics. I.
      Cryptococcosis.

PMID- 8361257
TI  - Standards of clinical investigations in the USA.
AB  - The drug approval process in the USA is under constant surveillance, monitoring
      and evaluation. Several significant changes were made during the past few years
      and many others are under consideration. The FDA has undergone organizational
      changes, which together with the IND Rewrite and NDA Rewrite resulted in a shift
      of emphasis in clinical studies.

PMID- 8361258
TI  - The development of good clinical practice in the EEC and in Germany.
AB  - In 1965 the first EEC Directive on the approximation of the national provisions
      related to medicinal products (65/65/EEC) stipulated, beside others, that the
      application for registration shall contain results of clinical trials. Ten years
      later Directive 75/318/EEC ensured uniform standards and protocols for the
      performance of test and trials, especially clinical trials. In May 1987 the CPMP
      Recommended Basis for the conduct of clinical trials addressed the general norms
      and scientific principles for the conduct, performance and control of clinical
      trials of medicinal products. Based on 75/318/EEC and on CPMP Recommended Basis,
      intensive discussions continued in order to further improve the measures to
      thoroughly protect the rights and integrity of the trial subjects, to establish
      the credibility of data, and to improve the ethical, scientific and technical
      quality of trials. As a result of these negotiations CPMP adopted in 1990 the
      note for guidance: GCP for Trials on Medicinal Products in the EC. In July 1991
      Directive 91/507/EEC modifying 75/318/EEC was issued. It adopts the requirements
      to prove quality, safety and efficacy to the latest state of the art. The German
      Drug Law (AMG) from 1976 transposed 65/65/EEC in its substantial parts. AMG
      contains its own section called "Protection of the human being during the
      clinical trial", which only stipulates a list of general conditions to be
      fulfilled before starting the trial. In Dec. 1987 German Health Ministry (BMG)
      published a paper on the orderly execution of clinical trials to establish rules
      on the planning, execution, evaluation and documentation of clinical trials (BMG
      Principles).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361259
TI  - Status of the GCP guidelines in Europe.
AB  - Two key factors are of main importance for the development of a common GCP
      legislation in the Member States of the European Community: 1) July 1991,
      Enforcement of the EEC Note for Guidance: "Good Clinical Practice for Trials on
      Medicinal Products in the European Community". This enforcement was setting into
      operation GCP guidelines which were, however, not yet legally binding at that
      time. 2) January 1992, Enforcement of EEC Commission, Directive 91/507/EEC:
      Analytical, pharmacotoxicological and clinical standards and protocols in respect
      of the testing of medicinal products. By this enforcement the EEC Member States
      were obliged to bring into force the laws, regulations and administrative
      provisions necessary to comply with the Directive which requests--besides others-
      all clinical trials to be designed, implemented and recorded in accordance with
      GCP. Facing the different national regulations covering clinical trials already
      being in force at that time, some of the European countries are considered to
      already be in compliance with EEC-GCP. In other countries, however, the Directive
      causes situations in which EEC-GCP is more demanding than the existing
      legislation or even contradictory. Country by country this has to be regulated
      soon by appropriate measures of the legislators in order to establish a uniform
      standard which will assure clinical trials to be internationally acceptable. Only
      recently the CPMP introduced the requirement for a "Compliance with GCP"
      Statement as an indispensable part of the Clinical Expert Reports in registration
      documentations. Even more than in legislation, there is a lack of inspections in
      clinical trials by health authorities in most European countries.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8361260
TI  - Inspection of clinical investigations by the German health authorities.
AB  - Based on the regulations of the German Drug Law of 1976 (Arzneimittelgesetz, AMG)
      the inspections of clinical investigations by the competent health authorities
      focus on the protection of the human being taking part in the trial. Standards
      for the planning, methodology, conduct, report and documentation of clinical
      trials are laid down in a guideline (Grundsatze fur die ordnungsgemasse
      Durchfuhrung der klinischen Prufung, Dec. 1987), a kind of national GCP standard
      which has to be respected by sponsors, physicians and authorities, not only for
      inspection but also for drug registration.

PMID- 8361261
TI  - Experiences with GLP/GCP from the pharmaceutical industry's viewpoint.
AB  - The European Commission Directive 91/507/EEC has been enforced since January 1,
      1992. It requires that all trials of a clinical development program be performed
      in compliance with Good Clinical Practice (GCP) guidelines which became effective
      on July 1, 1991 after approval by the CPMP in July 1990. Good Laboratory Practice
      (GLP) guidelines originated in the USA in 1978 and have been adopted in general
      in the OECD guidelines (OECD principles of Good Laboratory Practice, 1983) and in
      the appropriate national laws and guidelines, e.g., Chemikaliengesetz vom
      14.3.1990, Germany. All GLP guidelines unambiguously address "non-clinical
      laboratory studies", for example, toxicological studies but not studies utilizing
      human subjects. The impact/non-impact of these guidelines is addressed by the day
      to-day work in a clinical pharmacology unit within the pharmaceutical industry.

PMID- 8361262
TI  - Good clinical practice and phytotherapy.
AB  - The GCP Guideline of the European Community on the performance of clinical trials
      became obligatory in June 1991. As the GCP standards have mainly been set for
      innovative drugs, there is a certain danger that these criteria could not be
      fulfilled by medicines used in phytotherapy. As regards, the chances and risks of
      the European guideline, especially for herbal medicines, the differences between
      chemically-defined and herbal drugs, as well as the extent, to which herbal
      medicines might be concerned by the guideline, have to be taken into account.
      Herbal medicines are different from chemically defined medicines in their
      character as well as in their medicinal use. They always contain a mixture of
      numerous substances. Data on preclinical investigations are often incomplete,
      whereas, on the other hand, physicians and patients have a long-term experience
      in applying these medicines. They are, in general, well-tolerated and therefore
      suitable for the treatment of chronic diseases. Due to a characteristic taste and
      smell, the production of placebos is often impossible. The GCP directive also
      contains basic elements concerning chemically defined drugs as well as herbal
      medicines in a similar way.

PMID- 8361263
TI  - [Occupational health services in the future. Elimination or transformation?].

PMID- 8361264
TI  - [District physicians working together are transformed into competing family
      physicians].

PMID- 8361265
TI  - ["Giraffe language"--new "high-class" medical terminology?].

PMID- 8361266
TI  - [Evaluate new methods!].

PMID- 8361267
TI  - [Take a popular vote on euthanasia!].

PMID- 8361268
TI  - [Dynamic psychotherapy has its place both in clinical work as well as in
      education].

PMID- 8361269
TI  - [Surgeons: register complications!].

PMID- 8361271
TI  - [Preventive vitamin K and childhood cancer. A Swedish study shows no connection].

PMID- 8361270
TI  - [Therapeutic alternatives in acute cerebral embolism].

PMID- 8361273
TI  - [Attitudes to condoms and knowledge about STD. An inquiry among patients at a
      department of veneorology].

PMID- 8361272
TI  - [Do ACE inhibitors potentiate snake venom? Severe and prolonged hypotension
      caused by adder bite].

PMID- 8361274
TI  - [Prevention of stroke. Blood pressure lowering changes in life style and diet are
      highly effective].

PMID- 8361275
TI  - [X-ray findings in persons seeking asylum. Diagnosis and follow-up are
      important].

PMID- 8361276
TI  - [Early discharge from maternity wards. Medical safety for the child and the
      family is achieved by follow-up visits].

PMID- 8361277
TI  - [Practical handling of bacterial meningitis. Mortality and sequelae can be
      dramatically influenced].

PMID- 8361278
TI  - [Corticosteroids in bacterial meningitis. An old therapeutic principle with new
      interest].

PMID- 8361279
TI  - [A new drug against heart failure was retracted after an alarm about increased
      mortality].

PMID- 8361280
TI  - [Cancer panorama prior to the next century. Doubled number of living cancer
      patients].

PMID- 8361281
TI  - [How should the reduced health resources be distributed? Prioritization must be
      discussed].

PMID- 8361282
TI  - [Successful therapy and analysis of mechanisms. Prestigious prizes to cancer
      researchers].

PMID- 8361283
TI  - Multichannel (Ineraid) cochlear implant update.
AB  - From April 1984 to May 1991, 49 profoundly deaf patients received implantation of
      the Ineraid multichannel cochlear implant at the University of Utah. The auditory
      results of 48 patients indicated improvement in mean pure-tone performance to 500
      Hz (32.9 +/- 10.1 dB), 1000 Hz (27.1 +/- 10.0 dB), and 2000 Hz (30.1 +/- 9.8 dB).
      This group of patients had mean performances of 61.2% on auditory-only
      environmental sounds (Minimum Auditory Capabilities [MAC] battery), 48.8% on
      auditory-only CID sentences, and 95.5% on auditory-plus-visual CID sentences. The
      percutaneous pedestal has been well-tolerated. Changes in the surgical skin
      incisions have been made. A home use speech therapy program has been developed on
      VHS tapes.

PMID- 8361284
TI  - Acute epiglottitis in the adult: experience with a seasonal presentation.
AB  - Acute epiglottitis in adults may follow an unpredictable clinical course,
      complicated by acute airway obstruction. Our experience with this disease was
      evaluated by looking at yearly incidence, seasonal occurrence, and clinical
      variables of both intubated and conservatively managed patients. In our series of
      17 cases from 1987 through 1990, 16 occurred in 1988 and 1989. Ten of 17 cases
      occurred during the summer months. The two patients who developed stridor went on
      to require intubation and tracheotomy. Statistical analysis of our data revealed
      that, in adult acute epiglottitis, stridor is a strong predictor of airway
      obstruction. A significant summer seasonal predominance was seen, as well as a
      suggestion of an epidemic in 1988 and 1989.

PMID- 8361285
TI  - Hashimoto's thyroiditis and carcinoma of the thyroid: optimal management.
AB  - Several authors have noted a high incidence of thyroid carcinoma in patients with
      Hashimoto's thyroiditis (HT), and some have even considered HT a premalignant
      condition. The authors evaluated all patients with surgically proven HT at Beth
      Israel Medical Center in New York from 1985 through 1990. Of these 48 patients, 8
      (17%) had thyroid carcinoma in addition to HT. No statistically significant
      difference between patients with and without concurrent carcinoma was noted in
      the percentage of patients with a dominant mass, irregular thyromegaly,
      compressive symptoms, suspicious fine needle aspiration biopsies (FNABs), or a
      cold nodule on thyroid scintigraphy. However, patients with neither a positive
      FNAB nor a cold nodule were much less likely to have carcinoma than patients with
      one or both of these tests positive (0% vs. 26%, P < or = .05). A management
      scheme for patients with HT is proposed to adequately and efficiently evaluate
      and treat patients for concurrent thyroid carcinoma.

PMID- 8361286
TI  - Contact diode laser microvascular anastomosis.
AB  - Contact diode laser microvascular anastomosis appears to be a valuable technique
      for anastomosing small arteries and veins. Significantly less foreign body
      reaction and markedly decreased operative time has been shown to be a major
      advantage of using contact diode laser technology. The authors have found that
      contact diode laser anastomosis can be performed in vessels as small as 1 mm in
      size using a 200-microns flat tip synthetic sapphire probe. Light microscopy has
      shown a significant decrease in foreign body reaction at the level of the
      anastomosis using laser techniques as compared to standard vessel anastomosis
      with 10-0 nylon sutures. The role of fibronectin and changes in collagen
      associated with laser anastomosis were also explored. Light microscopic electron
      microscopic results as well as biotin-avidin immunoperoxidase fibronectin studies
      will be discussed.

PMID- 8361287
TI  - Nodal size of metastatic squamous cell carcinoma of the neck.
AB  - The preoperative use of computed tomographic (CT) scanning continues to be the
      best diagnostic method for preoperative detection of metastatic neck disease.
      Current accepted criteria for CT diagnosis of nodal disease are not uniform,
      although nodal size, nodal grouping, and central necrosis correlate strongly with
      malignancy. To assess the relationship of nodal size and malignancy, a
      multicenter study was designed to evaluate the nodes from 100 neck dissections.
      Sixty-nine positive neck dissections were analyzed, and every node was measured.
      The relationship of central necrosis was also compared with node size. Our
      results showed that CT scanning continues to provide a reliable picture of the
      histologic status of lymph nodes. Using the criterion of central necrosis or node
      size larger than 1 cm, only 7% of necks had nodal disease that would have been
      missed by CT interpretation. This study supports the continued use of
      preoperative CT evaluation for metastatic neck disease.

PMID- 8361288
TI  - Orthotopic laryngeal transplantation: is it time?
AB  - The notion of returning phonatory and respiratory function by transplanting
      larynges has fascinated and challenged the minds of laryngologists for many
      years. In the past, the problems of revascularization, tissue rejection, and
      physiologic vocal fold motion have stymied the success of research in this area.
      Today, advances in microvascular surgery, graft versus host response, and
      selective reinnervation have made laryngeal transplantation a theoretical, if not
      a practical reality. Despite this progress, serious ethical and fiscal
      considerations remain unresolved. This report will discuss these advances as well
      as concerns and will present the current UCLA laryngeal physiology laboratory
      experience with canine laryngeal transplantation.

PMID- 8361289
TI  - Localization of glucocorticoid receptors and glucocorticoid receptor mRNAs in the
      rat cochlea.
AB  - The distribution of glucocorticoid (GR) receptor messenger RNAs (mRNAs) and GR
      receptors was studied by in situ hybridization histochemistry and
      immunocytochemistry, respectively. In situ hybridization histochemistry was
      performed with a biotin-labeled riboprobe complementary to rat GR receptor mRNA.
      GR receptor mRNAs were demonstrated in spiral ligament cells, spiral limbus
      cells, and spiral ganglion cells. GR receptor mRNAs were demonstrated neither in
      cells of the stria vascularis nor in cells of the organ of Corti region. With the
      use of a monoclonal and a polyclonal antibody, GR receptors were observed in the
      spiral ligament cells, stria vascularis cells, spiral limbus cells, and spiral
      ganglion cells by immunocytochemistry. Binding of anti-GR-receptor antibodies to
      a lesser extent was observed in the organ of Corti region; however, cellular
      distribution of the GR receptors could not be resolved with the applied
      techniques. These results suggest that the GR receptor is expressed differently
      in the heterogeneous cochlear tissues.

PMID- 8361290
TI  - A methodological study of hemilaryngeal phonation.
AB  - An excised hemilarynx setup was developed. The phonatory characteristics of nine
      excised canine larynges were examined. The left vocal fold of each larynx was
      then removed and substituted with a vertical plexiglass plate. The larynges were
      phonated again. Recordings were made of phonation threshold pressure, sound
      pressure level, average glottal flow, fundamental frequency, and amplitude of
      vocal fold vibration as observed with a video stroboscope. Measurements were made
      over a range of subglottal pressures. For the hemilarynx, simultaneous recordings
      of intraglottal pressure and vocal fold contact area were also made. It was found
      that amplitude and frequency of vocal fold vibration of the hemilarynx, as well
      as rates of change of amplitude and frequency as a function of subglottal
      pressure, were similar to those of the full larynx. Also similar were phonation
      threshold pressures and ranges of subglottal pressure over which the larynges
      phonated. The average airflow of the hemilarynx was approximately half that of
      the full larynx, and the sound pressure level, under similar conditions, was one
      fourth (about 6 dB less) in the hemilarynx.

PMID- 8361291
TI  - Use of bone for obliteration of the nasofrontal duct with the osteoplastic flap:
      a cat model.
AB  - The management of the frontal sinus remains controversial for traumatic and
      inflammatory disease. The osteoplastic flap with fat obliteration has become the
      treatment standard, although late failures with infection and mucocele formation
      may arise. Theories for mucocele formation include regrowth of residual mucosa
      from the sinus and ingrowth of mucosa from a nonobliterated nasofrontal duct. A
      study to evaluate the means of nasofrontal duct obliteration was developed. Three
      cat groups were evaluated at 1, 2, and 3 months. Group 1 had the duct and sinus
      obliterated with fat. Group 2 had the duct obliterated with bone and the sinus
      with fat. Group 3 had only the duct obliterated with bone. There was no mucosal
      ingrowth in any of the sinuses for the intervals studied. In group 1, fat volume
      was seen to decrease over time with replacement by fibrous tissue within the
      duct. Groups 2 and 3 developed progressive obliteration of the duct with new bone
      formation. One may infer that fat obliteration alone does not provide a
      predictable stable situation as fat atrophies within the duct and may allow
      mucosal ingrowth. Bone obliteration was shown to be progressive within the duct
      from osteogenesis. This is the first experimental model to correlate clinical
      observations of the use of bone for sinus obliteration. This study concluded that
      bone obliterates the nasofrontal duct better than the accepted standard of fat,
      independent of the material used to obliterate the sinus.

PMID- 8361292
TI  - Functional endoscopic surgery in children: a retrospective analysis of results.
AB  - The impact of chronic sinusitis on children has become more apparent as the
      awareness of the disease has increased. Consequently, the knowledge of its effect
      in the pediatric patient has expanded dramatically. Functional endoscopic sinus
      surgery (FESS) has become the primary surgical modality for treatment of this
      illness in children who have not responded to optimal medical management. A
      retrospective study was conducted in patients from 7 months to 17 years of age
      who were treated with FESS for chronic sinusitis refractory to medical therapy.
      Using a comprehensive parental questionnaire and a review of the medical charts,
      results were analyzed from these post-FESS children. Parents of the children were
      interviewed with a mean follow-up time of 21.8 months postoperatively. Factors
      discussed included chronic nasal obstruction, purulent nasal discharge, postnasal
      drip, chronic cough, halitosis, headaches, behavioral problems, allergies, and
      asthma symptoms. This preliminary investigation suggests that FESS is effective
      in treating medically recalcitrant severe chronic sinusitis in children.

PMID- 8361293
TI  - Microbial colonization of Blom-Singer prostheses in postlaryngectomy patients.
AB  - The microbial colonization of 44 Blom-Singer valves obtained from 16 patients
      over an 11-month period was investigated both by standard microbial culture
      methods and scanning electron microscopy (SEM). The valves were all removed from
      the patients after failure to function correctly. The microbiology cultures
      revealed that Candida species and Staphylococcus aureus were present either
      individually or in combination on 43 valves. SEM showed yeast hyphae attached to
      and penetrating the surfaces of the 5 valves examined. Colonies of staphylococci
      were also seen on 2 of these 5 valves. Unlike similar investigations on other
      voice prostheses, S aureus colonization was associated with Candida colonization
      and valve failure.

PMID- 8361294
TI  - Nasal airway size in cleft and noncleft children.
AB  - Although the effects of cleft lip and palate on nasal airway size and breathing
      have been reported for adults, little information is available on children. The
      present study assessed the effect of age on nasal cross-sectional size and, in
      particular, whether type of cleft influenced the outcome. The results indicate
      that, while the cleft nose continues to grow with age, it remains about 30%
      smaller than the noncleft nose. The airway is smallest in patients with
      unilateral cleft lip and palate and is largest in those with bilateral clefts.
      The prevalence of oral breathing is considerably higher in the cleft population
      in comparison to noncleft.

PMID- 8361295
TI  - Snoring and nasal resistance during sleep.
AB  - Although it is widely accepted that nasal obstruction leads to snoring and sleep
      apnea, the relationship between these variables is not clear, mainly because of
      the lack of studies in which nasal resistance (Rna) and snoring were measured
      concurrently. The authors studied eight nonapneic snoring men with healthy noses
      by nocturnal polysomnography that included quantitative assessment of snoring and
      concomitant nasal resistance. In six of these eight patients nasal resistance
      increased during sleep, but there was no significant change for the group as a
      whole between wakefulness (0.209 +/- 0.224 Pa/cm3 per second) and sleep (0.292 +/
      0.203 Pa/cm3 per second). Linear regression analysis showed no significant
      correlation between sleeping nasal resistance and snoring index (partial R2 =
      .44, P = .071). We used each subject as his own control and compared the snoring
      profile at a time during sleep when nasal resistance was at its highest (0.550 +/
      0.375 Pa/cm3 per second) and lowest (0.146 +/- 0.090 Pa/cm3 per second) levels.
      Despite the significant (P < .01) differences in nasal resistance, they were not
      reflected in the number of snores or their sound intensity. It is concluded that
      nasal obstruction during sleep is not correlated significantly to frequency or
      intensity of snoring during exclusively nasal breathing.

PMID- 8361296
TI  - Image-guided intervention for diagnosis and treatment of disorders of the head
      and neck.

PMID- 8361297
TI  - Technique of tracheoesophageal puncture using flexible fiberoptic esophagoscopy.

PMID- 8361298
TI  - Gold weight or spring implants and MRI.

PMID- 8361299
TI  - Temporoparietal fascial flap in orbital reconstruction.

PMID- 8361300
TI  - Suboccipital vestibular neurectomy: results and complications.

PMID- 8361301
TI  - Endoscopic-guided otosurgery in the prevention of residual cholesteatomas.

PMID- 8361302
TI  - Directory of otolaryngological societies.

PMID- 8361303
TI  - A comparison of suture versus laser-assisted microvascular anastomosis (LAMA) in
      the pig buttock flap model.
AB  - Introduction of microvascular free-tissue transfer to head and neck surgery has
      completely altered the current approach to extirpation and reconstruction. The
      increased flexibility now available offers multiple options for reconstruction
      and has essentially removed the limitations of size and geometry which existed
      with other types of repair. Despite these advantages, increased surgical time and
      potential flap failure loom as limiting factors. Since the initial use of sutures
      to perform microvascular anastomoses, numerous experiments have been conducted in
      order to identify other options for vessel approximation. Laser-assisted
      microvascular anastomosis (LAMA) was first attempted with the neodymium-yttrium
      aluminum garnet (Nd:YAG) laser and, subsequently, other wavelengths were used in
      experimental models. Success with this technique has been repeatedly documented.
      Although a comparable animal model to study skin flaps was initially described in
      1979, little is currently available in the literature that describes the actual
      use of a microvascular free flap model. Certainly, nothing exists regarding the
      role of LAMA and microvascular free-tissue transfer. This study was designed to
      establish a reliable and reproducible animal model to study free-tissue transfer.
      Through the use of laser Doppler flowmetry, values of blood perfusion of flaps
      can be determined. Anastomoses with standard suture and various laser-assisted
      techniques could then be done and compared, analyzing the parameters of time and
      blood flow. Histologic evaluation could be correlated with clinical observations.
      In so doing, LAMA could be objectively evaluated as a potentially viable method
      of vascular reconstruction in microsurgical free-tissue transfer.

PMID- 8361304
TI  - The role of H2 antagonists in perennial allergic rhinitis.
AB  - The biological effects of anti-H2 in allergic reactions are dose dependent: low
      doses enhance, and high doses significantly decrease the reaction of
      hypersensitivity. The administration of cimetidine H2 antagonist to 20 perennial
      allergic rhinitis patients brought about an abatement in the symptoms and a
      decrease in the total serum immunoglobulin E (IgE) levels in 72% of treated
      patients, but no variation was perceived in placebo-treated patients. These
      results strengthen the hypothesis of anti-H2-induced immunoregulatory effects and
      suggest a possible way of inhibiting IgE synthesis in vivo.

PMID- 8361305
TI  - Effect of specific bacteria on lymphocyte proliferation in diseased and
      nondiseased tonsils.
AB  - Tonsillar tissue lymphocyte (TTL) function as measured by lymphocyte
      proliferation was assessed in vitro in 38 tonsils--30 diseased and 8 normal
      controls. TTLs from diseased and control tonsils were challenged with intact,
      heat-inactivated bacteria which may be found in the core of diseased tonsils;
      these bacteria were Streptococcus pyogenes and Hemophilus influenzae type B
      (HIB), as well as the dominant bacterium (DB) grown from that particular
      tonsillar core. The phytomitogen leukoagglutinin (LA) was used as a nonspecific
      activator. Lymphocyte proliferation was quantified and reported using a
      stimulation index (SI) which was based upon viable cell counts at 2, 4, and 6
      days following inoculation. Overall, the greatest degree of lymphocyte
      proliferation in diseased TTLs (SI = .91) was produced by HIB. However, both SP
      and HIB produced more lymphocyte proliferation in the nondiseased TTLs than in
      the diseased TTLs (P < .01). H influenzae (non-B) and group A beta-hemolytic
      streptococci were the pathogens most frequently cultured as the dominant bacteria
      from the core of diseased tonsils; Streptococcus viridans was most frequently
      cultured in nondiseased tonsils. The DB caused greater TTL proliferation in
      diseased (SI = .89) versus control (SI = .63) TTLs (P < .001). These findings
      suggest a differential proliferative response in vitro for diseased and
      nondiseased TTLs in response to specific bacteria. The role of possibly
      pathogenic bacteria and commensals, as well as the implications for clinical
      disease, are discussed.

PMID- 8361306
TI  - Immunoperoxidase study of the endolymphatic sac in Meniere's disease.
AB  - A growing body of evidence suggests that some cases of Meniere's disease may be
      mediated by immune mechanisms. Because endolymphatic sac dysfunction is believed
      to be an underlying cause of Meniere's disease, this study used
      immunohistochemical techniques to demonstrate the presence of immune complex
      deposition in the sacs of patients with Meniere's disease. Positive
      immunoglobulin G (IgG) staining was noted in 10 of 23 sac biopsies from Meniere's
      patients, with 2 specimens showing perivascular deposition. Only 1 of 5 control
      specimens was only slightly positive for IgG. Clinical correlation showed a
      statistically significant increase in disease bilaterality (P < .05), larger
      summating potential/action potential (SP/AP) ratios with electrocochleography
      (ECoG), and a tendency toward worse hearing and more progressive disease among
      the immunopositive Meniere's patients. The results provided histological evidence
      of immune injury in the endolymphatic sacs of patients with Meniere's disease.

PMID- 8361307
TI  - An analysis-by-synthesis approach to the estimation of vocal cord polyp features.
AB  - This paper deals with a new noninvasive method of estimating vocal cord polyp
      features through hoarse-voice analysis. A noteworthy feature of this method is
      that it enables us not only to discriminate hoarse voices caused by pathological
      vocal cords with a single golf-ball-like polyp from normal voices, but also to
      estimate polyp features such as the mass and dimension of polyp through the use
      of a novel model of pathological vocal cords which has been devised to simulate
      the subtle movement of the vocal cords. A synthetic hoarse voice produced with a
      hoarse-voice synthesizer is compared with a natural hoarse voice caused by the
      vocal cord polyp in terms of a distance measure and the polyp features are
      estimated by minimizing the distance measure. Some estimates of polyp dimension
      that have been obtained by applying this procedure to hoarse voices are found to
      compare favorably with actual polyp dimensions, demonstrating that the procedure
      is effective for estimating the features of golf-ball-like vocal cord polyps.

PMID- 8361308
TI  - Facial nerve near the external auditory meatus in man: computer reconstruction
      study--preliminary report.
AB  - The anatomy of the facial nerve relative to its intratemporal and extratemporal
      courses varies over time with developmental changes. Otologic and parotid surgery
      in infants and children demands detailed knowledge of the precise anatomy of the
      facial nerve with respect to the tympanic ring and external auditory canal. The
      authors analyzed this area using our three-dimensional (3-D) computer-aided
      reconstruction and measurement method studying the spatial relations of the
      facial nerve to the tympanic ring and stylomastoid foramen. Temporal bones from
      five normal individuals aged 36 gestational weeks, 3 months, 8 months, 4 years,
      and 17 years were retrieved from the temporal bone collection stored at the
      Elizabeth McCullough Knowles Otopathology Laboratory in Pittsburgh. Three
      dimensional reconstruction of the facial nerve comparing the developmental
      anatomy across the various age groups provides the surgeon with the technical
      information necessary to address problems in this area.

PMID- 8361309
TI  - Ionized serum calcium levels following combined treatment for cancer of the head
      and neck.
AB  - Thyroid function may be reduced after treatment of cancer of the head and neck,
      and hypothyroidism is much more common after combination therapy. Whether
      hypoparathyroidism and subsequent hypocalcemia also occur after such treatment is
      unknown. Few related studies have been published in which changes in total serum
      calcium have been studied after cancer treatment with radioactive iodine or
      external radiation. Twenty-two disease-free head and neck cancer patients were
      studied, 1 to 3 years after multimodal treatment, to determine if changes in
      serum ionized calcium levels or thyroid function were present. Our results
      suggest that parathyroid function, as represented by ionized calcium levels
      remains normal after multimodality (surgery, radiation and/or chemotherapy)
      combined treatment.

PMID- 8361310
TI  - Ossification patterns of the tympanic facial canal in the human fetus and
      neonate.
AB  - Dehiscences in the bony facial canal are comparatively common in the human adult.
      The highest incidence occurs in the tympanic segment of the facial nerve near the
      region of the oval window. Thirty-three fetal temporal bones, ranging from 16 to
      40 weeks' gestation, and four from 1, 2, 4 and 12 weeks' postpartum neonates,
      were studied to evaluate the normal patterns of ossification of the fallopian
      canal of the tympanic facial nerve segment in the human. The tympanic facial
      nerve segment elongates three-fold during this period (from 1 mm to 3 mm). The
      ossification starts at 21 weeks' gestation anteriorly from apical otic
      ossification centers and at 26 weeks from canalicular ossification centers near
      the stapedius muscle. The ossification proceeds in an anterior-to-posterior
      direction as two periosteal shelves of bone surround the facial nerve. The
      superior periosteal bony ledge contributes 75% of the circumference of the
      fallopian canal. The anterior ossification center forms over 83% of the fallopian
      canal length. The two centers fuse post partum near the region of the oval
      window. The anatomic location of the facial nerve, nerve branching, and neural
      vasculature precede ossification. In 80% of the paired temporal bones, this
      ossification pattern appears to be symmetrical. The patterns and incidence of
      bony dehiscences within the tympanic fallopian canal segment can be explained by
      these observations. This study demonstrates that fallopian canal dehiscences are
      not congenital anomalies, but variations of normal developmental anatomic
      processes.

PMID- 8361311
TI  - Parietal bone graft and titanium plate fixation in nasal reconstruction.

PMID- 8361312
TI  - Directory of otolaryngological societies.

PMID- 8361313
TI  - Determination of vocal fold mucosal wave velocity in an in vivo canine model.
AB  - The vocal fold traveling wave is essential to normal voice production. The
      present investigation examined whether the velocity of the traveling wave (TWV)
      could be consistently determined in an in vivo canine model and if traveling wave
      velocity is affected by changes in the amplitude of recurrent laryngeal nerve
      stimulation (RLNS) and superior laryngeal nerve stimulation (SLNS). The results
      showed that traveling wave velocity increased with an increase in recurrent
      laryngeal nerve stimulation at low constant superior laryngeal nerve stimulation,
      but was poorly correlated with increases in recurrent laryngeal nerve stimulation
      at a high level of superior laryngeal nerve stimulation. Furthermore, traveling
      wave velocity was significantly correlated with superior laryngeal nerve
      stimulation at constant recurrent laryngeal nerve stimulation. This study
      demonstrated the feasibility of objectively measuring traveling wave velocity in
      vivo.

PMID- 8361314
TI  - Revision stapedectomy.
AB  - The need for revision stapedectomy surgery still exists despite the many changes
      that have occurred in the surgical technique for the treatment of stapedial
      otosclerosis over the past 30 years. Sixty-six revision stapes operations were
      analyzed to determine the causes of failure of previously operated cases of
      stapedial otosclerosis, and to evaluate the hearing results following a revision
      stapedectomy. Failure was most often due to erosion of the incus (41%),
      displacement of the prosthesis from the incus (24%), or migration of the
      prosthesis from the center portion of the oval window (24%). Postoperative
      improvement of hearing was observed in 81% of ears operated on for a conductive
      hearing loss. Closure to within 10 dB, however, occurred in 61%. Two ears
      suffered a deterioration in the sensorineural hearing level following the
      revision surgery. Speech discrimination scores following revision surgery were
      improved in 5% of ears and unchanged in the remainder. Although the overall
      hearing results are less favorable than those seen in primary stapedectomy,
      revision stapedectomy surgery should continue to be offered to patients whose
      primary stapes surgery failed or whose initial good result declined over time.

PMID- 8361315
TI  - Factors affecting the development of cerebrospinal fluid leak and meningitis
      after translabyrinthine acoustic tumor surgery.
AB  - Meningitis and cerebrospinal fluid (CSF) leak are serious complications of
      acoustic tumor surgery. Previous reports have varied in the incidence of and the
      predisposing factors to these complications. This study reviews a series of 723
      acoustic tumors removed via the translabyrinthine approach at the House Ear
      Clinic in Los Angeles. The incidences of CSF leak and meningitis were 6.8% and
      2.9%, respectively. The patients who developed these problems were compared to
      the remainder of the study population for differences in age at surgery, tumor
      size, operative time, and length of hospital stay. Meningitis occurred more
      frequently in larger tumors, and patients with either complication had a longer
      hospital stay. The presence of CSF leak did not predispose to meningitis. It is
      concluded that technical factors account for postoperative CSF leak and
      meningitis after translabyrinthine acoustic tumor removal.

PMID- 8361316
TI  - Intrasubject test-retest variability in clinical electrocochleography.
AB  - Seventeen healthy volunteers without a history of auditory or vestibular
      difficulty and with normal screening audiometry had bilateral (34 ears)
      electrocochleography performed repeatedly at 1-week intervals. Each subject had
      from four to seven electrocochleograms performed on each ear. Measurements were
      made in the external auditory canal using a gold-foil "TIPtrode." Amplitude and
      latency for the summating potential (SP) and action potential (AP) were measured
      and SP/AP ratios were calculated. Averages and standard deviations for amplitude,
      latency, and SP/AP ratios were computed. The average SP/AP ratio was 0.22 with a
      standard deviation of 0.06. The range was 0.04 to 0.50. The average difference
      between the highest and lowest SP/AP ratio for a given individual was 0.155
      (i.e., the range 0.03 to 0.31) with a standard deviation of 0.07. These normative
      data are useful in assessing the results of dehydration electrocochleography and
      in establishing how much test-retest variation is required to suggest pathology.

PMID- 8361318
TI  - Treatment of an acoustic neuroma in an only-hearing ear: case reports and
      considerations for the future.
AB  - Current options regarding the treatment of acoustic neuroma in an only-hearing
      ear include: observation, attempted hearing preservation surgery, and
      stereotactically guided radiation therapy. A patient who had a left
      labyrinthectomy for Meniere's disease presented 15 years later with a large right
      acoustic neuroma. Due to anticipated profound deafness, he fit the criteria for
      cochlear implantation. Promontory stimulation of the left ear was positive. He
      underwent successful left cochlear implantation with the Nucleus 22-channel
      device and was successfully rehabilitated. He then underwent translabyrinthine
      removal of his right-sided 2.5-cm acoustic neuroma. This case is used to
      illustrate a new option available to those faced with treating a patient with
      acoustic neuroma in an only-hearing ear. How this approach may fit in with other
      available options will be discussed.

PMID- 8361317
TI  - Photodynamic therapy of human squamous cell carcinoma in vitro and in xenografts
      in nude mice.
AB  - Photodynamic therapy (PDT) of cancer is an experimental tumor therapy which is
      based on the combined use of a systematically administered photosensitizer to a
      tumor-bearing host and local illumination of the lesion by a high-intensity
      visible light source, typically a tunable argon dye laser. Human squamous cell
      carcinoma (HSCC) is the most frequently encountered malignancy of the head and
      neck. In this study, responses of HSCC cells to PDT were examined in in vitro and
      in vivo systems. In in vitro studies, the HSCC cells showed a positive
      photodynamic response with Photofrin-II (Pf-II), chloroaluminum phthalocyanine
      tetrasulfonate (AlPcTS), and a newly synthesized silicon phthalocyanine (SiPc
      IV). Single cell suspension of HSCC injected subcutaneously on the back of
      athymic nude mice resulted in a well-circumscribed tumor mass. The animals
      required a low tumor dose for the successful establishment of a tumor. The tumor
      was minimally immunogenic and showed neither macroscopic signs of early
      metastasis to lung, kidney, liver, or spleen nor evidence of surrounding
      erythema, fluctuation, or tenderness until the late stages of necrosis.
      Intraperitoneal administration of AlPcTS or SiPc IV to tumor-bearing mice
      resulted in rapid uptake of the photosensitizers in liver, skin, and tumor
      tissue. Twenty-four hours following the intraperitoneal administration of AlPcTS
      or SiPc IV to tumor-bearing animals, the tumor to normal skin ratio of the
      photosensitizer was 1.6 or 1.5, respectively. Administration of Pf-II (5 mg/kg)
      to tumor-bearing animals followed 24 hours later by irradiation of the tumor (135
      J/cm2, 630 nm light from an argon pumped-dye laser) resulted in greater than 80%
      ablation in tumor volume 24 hours post-PDT. These characteristics make this tumor
      model system suitable for PDT studies of human tumor cells in vitro as well as in
      vivo.

PMID- 8361319
TI  - Hemodynamics of the rodent abdominal skin flap following primary ischemia.
AB  - The effect of varying periods of ischemia and reperfusion times on subsequent
      blood flow was studied in the rodent abdominal skin flap. Using perfusion
      fluorometry, measurements of blood flow were quantified in 60 Sprague-Dawley rats
      undergoing clamp-induced ischemic periods ranging from 0 to 6 hours and
      reperfusion times ranging from 2 to 8 hours. Flaps subjected to ischemia times of
      0, 2, 4, or 6 hours require 8 hours of reperfusion time before reaching baseline
      levels of blood flow. Blood flow in flaps subjected to 6 hours of ischemia was
      statistically less than the flow in flaps ischemic for 0, 2, and 4 hours and was
      directly related to length of reperfusion. These results demonstrate that flap
      perfusion does not fully take place immediately after clamp release. The factors
      thought to be responsible for these findings and the implications for the design
      and interpretation of flap ischemia experiments are discussed.

PMID- 8361320
TI  - Coronal CT scan abnormalities in children with chronic sinusitis.
AB  - Coronal computed tomography (CT) scans are currently the optimal study to display
      the normal and abnormal anatomy in children with chronic and recurrent acute
      sinusitis after failure of medical therapy. To assess the extent and distribution
      of disease as well as associated anatomic abnormalities in this pediatric
      population, 74 coronal CT scans of children with continued symptoms of sinusitis
      after failure of extensive medical therapy were reviewed retrospectively. Twelve
      children with cystic fibrosis showed the characteristic features of medial
      displacement of the lateral nasal wall in the middle meatus and uncinate process
      demineralization, creating the appearance of a maxillary sinus mucocele. Nine of
      these 12 children had increased attenuation in the maxillary sinus on soft-tissue
      windows. In the remaining 62 children, a significantly greater frequency of
      disease, when compared with that reported for adults, was seen in the maxillary,
      anterior ethmoid, posterior ethmoid, and frontal sinuses. Children with asthma (n
      = 33) had more extensive disease. Bony anatomic abnormalities were similar to
      those reported for adults, except for a lower incidence of septal deformity.

PMID- 8361321
TI  - Penetrating trauma of the oropharynx in children.
AB  - Penetrating trauma of the oropharynx is not an uncommon problem in the pediatric
      population. Innocuous injuries with minor soft-tissue trauma have been associated
      with severe neurologic sequelae. A review of 77 oral trauma cases that occurred
      from 1981 to 1990 at Boston Children's Hospital was undertaken to see if constant
      factors could be identified so that a treatment protocol might be outlined for
      these patients. Twenty-three (30%) patients sustained injury to the soft palate
      and peritonsillar area. Fifty percent of these cases required surgical
      debridement and repair. None of the 23 patients developed neurological sequelae.
      Physical examination may not correlate with the development of symptoms nor the
      mechanism of injury. Care should be taken during the examination to identify any
      neurological problems that may not relate to the degree of injury. Conservative
      management can be entertained if no abnormal neurologic findings are noted.

PMID- 8361322
TI  - Insertional trauma of multichannel cochlear implants.
AB  - Insertional trauma to the cochlea from three different multichannel cochlear
      implant electrodes was evaluated in a single-blind controlled study in fresh
      human temporal bones. Sixteen fresh human temporal bones were implanted with one
      of three types of multichannel electrodes (Symbion/InnerAid, Cochlear/Nucleus, or
      Storz/UCSF). Seven temporal bones were used as controls where a cochleostomy only
      was created. The temporal bones were evaluated histologically and cochlear
      histograms of the trauma were created. Although the three electrode designs
      caused damage which was unlikely to hinder implant performance, a distinct
      pattern of trauma was seen with each of the three electrode types. The least
      traumatic of the three electrode designs in this study was the Nucleus type. The
      degree of insertional trauma may be relevant to changing indications for
      insertion of cochlear implants as well as for patients with device failure who
      require reimplantation.

PMID- 8361323
TI  - Nicotine-induced analgesia in rats: the role of calcium and the diversity of
      responders and nonresponders.
AB  - Following a single dose of nicotine, (NIC, 1 mg/kg s.c.), 60% of tested rats
      revealed significant antinociception as measured by the tail-flick (TF) test, and
      were classified as responders, with those in which TF latencies did not change,
      nonresponders. The following experiments were carried out one week later. In
      nonresponders, pretreatment with ethylenediaminetetraacetic acid (EDTA, 250
      microM/kg s.c. four times every 15 min) followed by 1 mg NIC, produced
      significant analgesia in 50% of rats, to the same magnitude as did nicotine alone
      (1 mg) in responders. The other 50% of rats which failed to respond to EDTA
      pretreatment, all revealed similar analgesia following the higher dose of NIC
      (1.5 mg/kg s.c.), with similar side effects, as generally observed in responders.
      In responders, pretreatment with CaCl2 (1.5 mM/kg s.c.) completely abolished NIC
      (1 mg/kg s.c.)--induced analgesia in all rats. Our data provide stronger evidence
      and a further verification that EDTA potentiates, whereas CaCl2 completely
      abolishes, nicotine-induced analgesia in rats; supporting our hypothesis of the
      involvement of calcium ions in this effect.

PMID- 8361324
TI  - Lysosomal delivery of ANP receptors following internalization in PC12 cell.
AB  - Internalization and intracellular processing of ANP-B and C receptors play an
      important role in regulating cell responsiveness to atrial natriuretic peptides
      (ANP). Receptor internalization was indirectly monitored with 125I labelled
      ligand. When 125I-ANP(99-126) was internalized by the cells at 37 degrees C, 55%
      of the internalized radioactivity was localized in the lysosomal fraction. When
      receptors were affinity-labelled with 125I-ANP(99-126) and allowed to internalize
      for varying time periods, two radiolabelled proteins in the m.wt range of 56 and
      52 KDa were detected in the cytosolic extract. These proteins appear to be the
      hydrolytic products of the ANP-C receptor expressed on the plasma membrane. In
      addition to lysosomal delivery, shedding of the ANP-C receptor from the cell
      surface was detected following incubation of cells with 125I-ANP(99-126). The
      dual processes may function to clear exogenous ANP from the extracellular
      compartments.

PMID- 8361325
TI  - Endogenous creatinine clearance in the rat: strain variation.
AB  - The clearance of endogenous creatinine was examined in five strains of rats
      (Wistar, Wistar Kyoto, Spontaneously Hypertensive Rats, Biobreeding/Worcester
      diabetic prone and diabetic resistant rats). Creatinine clearance was compared
      with inulin clearance as the standard. Conditions for clearance measurements were
      also varied (anesthesia with constant infusion, overnight collection of urine,
      fed vs. unfed state, single-injection technique). The clearance of creatinine
      adequately reflects the glomerular filtration rate in three strains (Wistar,
      Wistar-Kyoto and the Spontaneously Hypertensive Rat). In the two strains of the
      Biobreeding/Worcester rat creatinine clearance is consistently lower than the
      inulin clearance. When creatinine clearance is measured from an overnight
      collection of urine with food withheld it is always lower than when food is
      present. This clearance should always be validated by comparison with inulin
      clearance measured simultaneously or under comparable conditions. The ease with
      which endogenous creatinine clearance can be measured makes it a reasonable
      method when large numbers of repeated determinations of glomerular filtration
      rate are required.

PMID- 8361326
TI  - Absorption of methylmercury from hair ingested by rats.
AB  - Hair taken from rats dosed with 203Hg-labeled methylmercury was fed to previously
      untreated rats in order to determine if the organomercurial was available for
      release from the hair matrix within the gut lumen and for subsequent systemic
      absorption. Cumulative fecal excretion data were consistent with an absorption of
      about 80% of the ingested methylmercury. The relative amounts of methylmercury
      and of its metabolite, inorganic mercury, in the feces indicated that the
      percentage of the parent compound released from hair within the intestine equaled
      or exceeded the estimated bioavailability. Radioactivity in tissues of animals
      killed 42 hr following hair consumption confirmed that mercury absorption had
      occurred.

PMID- 8361327
TI  - Inhibitors of Ca2+ channels, calmodulin and protein kinases prevent A23187 and
      other inductions of metallothionein mRNA in EC3 rat hepatoma cells.
AB  - The role of calcium in the induction of MT mRNA has been studied in EC3 rat
      hepatoma cells, using various inducers (A23187, TPA, norepinephrine, and 2
      chloroadenosine) and inhibitors (H7:PK-A and PK-C; W7:calmodulin;
      verapamil:calcium channel blocker; and TMB-8; cytosolic calcium chelator). The
      inhibitions of inductions observed in this study were consistent with calcium
      playing an important role in MT mRNA induction by itself and via crosstalk among
      the PK-A, PK-C, and calmodulin-dependent protein kinase pathways. Calcium has an
      important role in the complicated second messenger pathways which result in the
      positive interaction of transcription factors with the promoters of MT genes.

PMID- 8361328
TI  - Ouabain causes kaliuresis and works synergistically with aldosterone in vivo.
AB  - The effect of ouabain on urinary Na and K excretion was compared with that of
      aldosterone by injecting 0.1 or 0.5 mg ouabain or 0.25 micrograms aldosterone.
      The administration of 0.25 micrograms aldosterone caused sodium-retention without
      kaliuresis, whereas the administration of 0.5 mg ouabain caused kaliuresis
      without sodium-retention. These results indicate that ouabain is a kaliuretic
      agent. The effect of a combination of aldosterone and ouabain was evaluated by
      injecting 0.25 micrograms aldosterone simultaneously with 0.1 or 0.5 mg ouabain.
      The combination of aldosterone and ouabain caused both sodium-retention and
      kaliuresis. These results indicate that ouabain works synergistically with
      aldosterone to increase mineralocorticoid action by inducing K depletion from the
      cells in various tissues.

PMID- 8361329
TI  - Prolactin protection against lethal effects of Salmonella typhimurium.
AB  - The immunoregulatory role of prolactin (PRL) has been well established. In order
      to clarify if the hormone is also able to stimulate a protective activity against
      pathogens-induced infections we have studied the modifications of the infective
      capacity of Salmonella typhimurium induced in mice by repeated treatments with
      ovine PRL. A significant dose-dependent reduction in the mortality rate was
      observed in comparison to controls. This activity is probably related to the
      observed increases in phagocytosis and intracellular killing of the peritoneal
      macrophages and chemotaxis of the peritoneal granulocytes induced by the hormonal
      treatment. On the contrary, the number of leukocytes in blood was not modified by
      PRL treatment excluding a mobilization of cells from other districts. Our
      findings confirm the existence of a linkage between the neuroendocrine and immune
      systems suggesting a possible role for PRL in the regulation of non-specific
      immune response.

PMID- 8361330
TI  - Morphine treatment in vitro or in vivo decreases phagocytic functions of murine
      macrophages.
AB  - Studies were performed to compare in vitro and in vivo effects of morphine on the
      phagocytic function of murine peritoneal macrophages. Macrophage monolayers were
      incubated with Candida albicans for 30 min in the absence of autologous serum.
      Morphine added in vitro was found to decrease both the phagocytic activity
      (percent of phagocytic cells) and the phagocytic index (average number of
      ingested yeasts per cell) in a concentration-dependent manner, with maximal
      effects of 26% and 41%, respectively, at 10(-6) M. When morphine was administered
      in vivo via an implanted 75-mg pellet, there was a 22% decrease in phagocytic
      activity and a 40% decrease in the phagocytic index. Naltrexone completely
      blocked the effects of morphine both in vitro and in vivo. The results suggest
      that morphine is capable of interacting directly with opioid receptors on
      macrophages, resulting in a decrease in phagocytic function.

PMID- 8361331
TI  - Neuron-specific enolase (NSE) and non-neuronal enolase (NNE) mRNAs are co
      expressed in neurons of the rat cerebellum: in situ hybridization histochemistry.
AB  - Using in situ hybridization histochemistry, we analysed the localization of mRNAs
      for neuron-specific enolase (NSE) and non-neuronal enolase (NNE) in the rat
      cerebellum at various postnatal developmental stages. Synthetic 45 meric
      oligonucleotides corresponding to partial sequences of the non-coding region of
      rat NSE or NNE mRNA were 35S-labeled to approximately the same specific activity
      and used as hybridization probes. On examination of the adult rat cerebellum,
      both NSE and NNE signals were detected in all identified and presumed neurons
      which included Purkinje cells, internal granule cells and presumed
      stellate/basket cells in the cerebellar cortex and neurons of the dentate
      nucleus. Examination of the cerebellum during postnatal development also revealed
      coexistence of NSE and NNE signals in these neurons from early stages. During
      development, both signals coincidentally increased in Purkinje cells and neurons
      of the dentate nucleus, while only NSE signals showed a gradual increase in the
      internal granule cells in which NNE signals remained at the same level from early
      postnatal to adult stages. The external granule cells showed NNE signals until
      postnatal day 7 but thereafter the signals became less distinct, especially in
      cells if the inner zone of the external granule cell layer. Thus, it was shown
      that NSE and NNE were commonly coexpressed at the mRNA level in various neurons
      of the cerebellum except for very undifferentiated external granule cells which
      expressed only NNE mRNA.

PMID- 8361332
TI  - Molecular cloning of a developmentally regulated brain protein, chicken drebrin A
      and its expression by alternative splicing of the drebrin gene.
AB  - Drebrins are developmentally regulated proteins found in the chicken brain and
      are classified into three forms, E1, E2 and A. Previously we isolated two cDNAs
      corresponding to the embryonic drebrin mRNAs from a chick embryo cDNA library.
      They differed in that an internal 129-nucleotide sequence, designated ins1, was
      inserted in the cDNA encoding drebrin E2 and was deleted in the other cDNA
      encoding drebrin E1. To search for the cDNA clone encoding drebrin A, a cDNA
      library of 1-day-old chick brains was screened using embryonic drebrin cDNA
      fragments as probes. Consequently, a novel cDNA was isolated, the sequence of
      which was entirely identical with that of drebrin E2 except for the insertion of
      a 138-nucleotide sequence, designated ins2, in the 5' direction immediately
      upstream from ins1. Since the translation product of the entire coding region was
      similar to that of drebrin A, this cDNA should correspond to the mRNA for drebrin
      A. Sequencing analysis of three drebrin cDNAs clearly indicated that the
      heterogeneity of chicken drebrins was caused by the insertion or deletion of the
      two sequences, ins1 and ins2. The amino-terminal half region including ins2 and
      two short sequences in the carboxyl-terminal region of the predicted drebrin A
      were highly evolutionarily conserved. Cloning and sequencing of the drebrin gene
      revealed that ins1 and ins2 were independently encoded by separate exons and
      three drebrin isoforms were thought to arise by alternative splicing from a
      single drebrin gene. The difference in the time course of expression and tissue
      distribution of each drebrin suggests that the machinery of alternative splicing
      site selection of the drebrin gene is regulated in a developmental stage
      dependent and tissue-specific manner.

PMID- 8361333
TI  - Developmental differences of angiotensinogen mRNA in the preoptic area between
      spontaneously hypertensive and age-matched Wistar-Kyoto rats.
AB  - In order to know the possible involvement of the central angiotensin system in
      hypertension, angiotensinogen mRNA (AomRNA) levels of eight discrete brain areas
      were measured by Northern blot hybridization analysis in the spontaneously
      hypertensive rats (SHR), compared with those in age-matched normotensive Wistar
      Kyoto rats (WKY). In 16-week-old SHR (hypertensive stage), AomRNA levels in the
      preoptic area (POA), but not in the ventromedial hypothalamus, lateral
      hypothalamus and mammillary body, among the hypothalamic nuclei, were higher
      (approximate 50%) than in WKY. There were no differences in other brain areas,
      such as the striatum, septum, amygdala and cerebellum between both the strains.
      The AomRNA levels in POA were already higher (38%) in 4-week-old SHR
      (prehypertensive stage) without significance, and the difference was augmented
      (82%) in 7-week-old SHR (evolving stage). These results suggest that the
      developmental changes of AomRNA levels at POA may be related in some aspect to
      hypertension process.

PMID- 8361334
TI  - Neuron specific expression of a membrane protein, HPC-1: tissue distribution, and
      cellular and subcellular localization of immunoreactivity and mRNA.
AB  - The monoclonal antibody HPC-1 recognizes a protein antigen in the hippocampus,
      and its specific reactivity to the plasma membrane of the amacrine cell somas and
      the inner plexiform layer in rat retina has been reported. Sequencing the cDNA
      indicated in our previous study that the HPC-1 antigen was a membrane protein. By
      means of immunoblotting, an antiserum against the fusion protein of Escherichia
      coli beta-galactosidase and the HPC-1 antigen detected several proteins of about
      35 kDa in the nervous tissues including retina, cerebral cortex, hippocampus,
      cerebellum and spinal cord, but no signal was obtained in the non-neuronal
      tissues. Immunofluorescent histochemistry of the various rat tissues revealed
      that the HPC-1 antigen was confined to the nervous system, including the matrices
      of the cerebral cortex and hippocampus, the molecular layer, membranes of
      granular cell somas and glomeruli in the cerebellum and gray matter of spinal
      cord. However, little staining was seen in the white matter of the central
      nervous tissues. Thus, the HPC-1 antigen was accumulated in the synapse-rich
      regions of neuronal cells. In situ hybridization revealed that the HPC-1 mRNA was
      present in most, if not all, neurons in the central and peripheral nervous
      systems except for the retina. In the retina, mRNA signals were detected in
      amacrine and ganglion cells in which HPC-1 immunoreactivity was absent in their
      soma, suggesting polarized localization of the HPC-1 mRNA on the ganglion cell
      axon terminal.

PMID- 8361335
TI  - Estrogenic regulation of proenkephalin mRNA expression in the ventromedial
      hypothalamus of the adult male rat.
AB  - Endogenous opioid peptides and their receptors are regulated by gonadal steroid
      hormones in the rat hypothalamus. Recent evidence suggests that gonadal steroids
      are capable of regulating the expression of proenkephalin (PE) mRNA in the
      ventromedial hypothalamus (VMH) of female, but not male rats. Therefore, we
      examined the effect of gonadectomy with or without four weeks of hormone
      treatment on PE mRNA expression in adult male Fisher 344 rats using quantitative
      in situ hybridization histochemistry. Gonadectomy reduced plasma testosterone and
      dihydrotestosterone (DHT) levels compared to intact rats, while subsequent
      estradiol (E2) or DHT treatment increased plasma E2 and DHT levels, respectively.
      Furthermore, gonadectomy reduced PE mRNA expression in the VMH, but not in the
      striatum nor the olfactory tubercle compared to intact rats, and this reduction
      was prevented in the presence of E2, but not DHT. The results suggest that the
      activation of estrogen receptors normally functions to maintain the level of VMH
      PE mRNA expression, which is sensitive to hormonal regulation in adult male rats.
      Thus gonadal steroid hormones might regulate those reproductive functions which
      are modulated by PE-derived opioid peptides in the male rat brain.

PMID- 8361336
TI  - Antisense oligonucleotide blocks progesterone-induced lordosis behavior in
      ovariectomized rats.
AB  - Antisense oligonucleotides were utilized to interfere with the synthesis of
      progesterone receptor. A specific aODN was shown to decrease significantly the
      levels of PR in the T47D cell line known to express the PR gene. The molecule
      described was proved to be effective in hindering the effect of progesterone on
      target gene expression in T47D cells. The aODN was then utilized in an in vivo
      study to test its efficacy on the female rat sex behavior. Its injection in the
      ventromedial hypothalamus significantly inhibited the estrous responsiveness
      induced by progesterone. This study provides a clear demonstration of the full
      involvement of PR in the manifestation of lordosis behavior and demonstrates the
      activity of an aODN as antiprogestative.

PMID- 8361337
TI  - Altered expression and phosphorylation of amyloid precursor protein in heat
      shocked neuronal PC12 cells.
AB  - The pathology of the Alzheimer's disease (AD) brain, including amyloid plaques,
      neurofibrillary tangles and neuronal degeneration, indicates that neurons
      affected by AD exist under conditions of stress. In fact, the brains of AD
      patients undergo many changes classically associated with the heat shock
      response, which is one form of a stress response. These changes include reduced
      protein synthesis, disrupted cytoskeleton, increased number of proteins
      associated with ubiquitin, and the induction of heat shock proteins. To
      investigate the response of neurons to stress, we examined neuronal PC12 cells
      incubated at either 37 degrees C (control cells) or 45 degrees C (heat-shocked
      cells). After a 30 min exposure at 45 degrees C, the heat-shocked cells exhibited
      several features characteristic of the classical heat shock response including a
      45% reduction in total protein synthesis, the induction of heat shock protein 72,
      and an increased phosphorylation of the protein synthesis initiation factor eIF-2
      alpha. We used this cellular model system to study the neuronal response to
      stress specifically focusing on protein synthesis elongation factor 2 (EF-2) and
      the Alzheimer's amyloid precursor protein (APP), the precursor form of beta
      amyloid peptide. Hyperphosphorylation of EF-2 has been observed in the neocortex
      and hippocampus of AD brain. However, in our system, we find no
      hyperphosphorylation of EF-2 in response to heat shock. Heat-shocked neuronal
      PC12 cells exhibited two additional APP-like polypeptides not present in
      controls. We also found a significant decrease in the phosphorylation state of
      APP in response to heat shock.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361338
TI  - Reversible phosphorylation of tau to form A68 in heat-shocked neuronal PC12
      cells.
AB  - A68, the primary protein constituent of Alzheimer's disease-associated
      neurofibrillary tangles, is an abnormally phosphorylated form of the microtubule
      associated protein tau. We find that A68 is formed in neuronal PC12 cells when
      the cells are subjected to a heat shock (45 degrees C for 30 min). A68 was
      identified by immunoprecipitation with two different anti-tau antibodies (tau-2
      and Alz50). Upon separation by SDS-polyacrylamide gel electrophoresis, the tau
      immunoprecipitates from heat-shocked cells exhibited an additional polypeptide of
      reduced electrophoretic mobility (approximately 68 kDa) when compared to control
      cells. A68 was formed with heat shock in the presence of cycloheximide,
      suggesting that its production occurred by post-translational modification of
      existing polypeptides. The tau/A68 polypeptides were identified as
      phosphoproteins by incorporation of 32P into the immunoprecipitates. The
      phosphorylation of tau to form A68 was reversed with recovery of the intact cells
      from the heat shock. Finally, immunoprecipitation of lysates from heat-shocked
      cells with antibodies to heat shock protein (hsp) 72/73 resulted in co
      precipitation of tau with hsp 72, which indicates a stable complex formation
      between these two proteins. On the other hand, A68 remained unassociated with hsp
      during the heat shock. These results suggest that tau is reversibly
      phosphorylated to form A68 in neuronal PC12 cells under conditions of stress.

PMID- 8361339
TI  - Dopamine antagonist haloperidol increases carboxypeptidase E mRNA in rat
      neurointermediate pituitary but not in various other rat tissues.
AB  - Carboxypeptidase E (CPE) is involved with the biosynthesis of many neuropeptides,
      including several whose genes are regulated by haloperidol treatments. In this
      study, we examined whether haloperidol alters CPE mRNA levels in a variety of
      tissues. Rats were treated for either 1, 3, 7, 14, or 21 days with 2 mg/kg
      haloperidol, and then Northern blot analysis performed on RNA from
      neurointermediate pituitary, anterior pituitary, hypothalamus, striatum,
      cerebellum, and adrenal. The 14 and 21 day treatments produced a significant 90
      110% elevation of CPE mRNA in neurointermediate pituitary. However, the levels of
      CPE mRNA in the other tissues were not significantly influenced by the
      haloperidol treatments. This finding indicates that CPE is not co-regulated with
      peptide hormone mRNAs in all tissues.

PMID- 8361340
TI  - Distribution of type II adenylyl cyclase mRNA in the rat brain.
AB  - We studied the distribution of type II Ca2+/calmodulin (CaM)-insensitive adenylyl
      cyclase mRNA in the adult rat brain by in situ hybridization histochemistry.
      Although type II adenylyl cyclase mRNA was distributed throughout the
      rostrocaudal extent of the brain, the labeling intensity varied among regions.
      Strong expression was seen in fairly restricted regions such as CA1 and dentate
      gyrus of the hippocampus, some thalamic nuclei, mammillary nucleus, dorsal raphe
      nucleus, parabrachial nucleus and locus coeruleus. The distribution of this type
      of mRNA was significantly different from that of type I Ca2+/CaM-sensitive
      adenylyl cyclase mRNA. The characteristic localization of type II mRNA suggests
      that this type of adenylyl cyclase may be involved in some neuronal functions
      different from the type I enzyme.

PMID- 8361341
TI  - Soluble derivatives of beta/A4 amyloid protein precursor in human cerebrospinal
      fluid are both N- and O-glycosylated.
AB  - The linkage of the glycan chain to the beta/A4 amyloid protein precursor (APP) in
      cerebrospinal fluid (CSF) was studied by Western blot analysis. The apparent
      molecular weight of APP in CSF was reduced from 103 to 100 kDa by N-glycanase,
      and to 96 kDa by O-glycanase treatment, respectively. These data indicate that
      APP is both N- and O-glycosylated in one molecule. The extent of glycosylation of
      APP was not altered in the CSF from patients with Alzheimer's disease.

PMID- 8361342
TI  - Cell-specific expression of preproenkephalin intronic heteronuclear RNA in the
      rat forebrain.
AB  - Using in situ hybridization with multiple probes to the rat preproenkephalin
      gene, we have identified a novel population of cells in the reticular thalamic
      nucleus and basal forebrain which express RNA derived from the preproenkephalin
      gene. These cells contain nuclear RNA from downstream of an alternate
      transcription start site in intron A of the preproenkephalin gene (Kilpatrick et
      al., Mol. Cell Biol., 10 (1990) 3717-3726), while in the same cells
      preproenkephalin exon 2 RNA is undetectable. The results suggest that in this
      population of cells, preproenkephalin gene transcription initiates from the
      intron A initiation site, and is regulated by an additional mechanism which
      results in the accumulation of nuclear preproenkephalin intron A-derived
      heteronuclear RNA. The anatomical distribution of these cells indicates that they
      may be involved in the control of cerebral cortical function.

PMID- 8361343
TI  - Hormonal regulation of androgen receptor mRNA in the brain and anterior pituitary
      gland of the male rat.
AB  - To determine possible cellular mechanisms governing androgen action in the brain,
      we examined the hormonal regulation of androgen receptor (AR) mRNA in neural
      tissues by Northern blot hybridization and RNase protection analysis. While a
      single hybridizable species of AR mRNA of approximately 11 kb was found in the
      anterior pituitary gland (AP) and ventral prostate gland (VP), an additional
      species of AR mRNA, approximately 2 kb smaller, was revealed in neural tissues.
      Furthermore, in these neural tissues, hormonal regulation of the two species of
      mRNA was coordinated; long-term castration increased levels of both forms, while
      testosterone replacement reduced them. The same pattern of regulation was
      observed for the single 11 kb form in the AP. An RNase protection assay was
      validated and utilized to quantitatively analyze the hormonal regulation of AR
      mRNA. Castration (4 days) resulted in significantly increased AR mRNA in the AP
      and hypothalamic-preoptic area, but not the amygdala, which subsequent
      administration of dihydrotestosterone (DHT; 1 day; 2 mg/animal) significantly
      decreased. In the AP, administration of estradiol benzoate (EB) for 1 or 5 days
      also reversed this effect. However, EB treatment increased the amount of total
      RNA isolated per gland. Consequently, when the data are normalized to RNA content
      per gland, 5 days of EB treatment resulted in a significant increase in AR mRNA
      content. These findings suggest that in contrast to the AP and VP, two forms of
      androgen receptor mRNA exist in the brain. In addition, there appears to be
      tissue and hormone specific regulation of AR mRNA.

PMID- 8361344
TI  - Expression of prostaglandin endoperoxide synthase in rat brain.
AB  - Developmental and regional expression of prostaglandin endoperoxide synthase
      (PES) transcript was examined in the rat brain and in primary mixed cultures of
      neurons and glial cells from neonatal brain. Although the PES mRNA level in the
      brain was much lower than that in peripheral rat tissues such as lung, liver,
      spleen and kidney, a significant 3.0 kb band was detected in brain samples by
      Northern blot analysis. During development, PES mRNA was first detectable at
      postnatal day 7, and increased thereafter toward adulthood. The highest level of
      3.0 kb PES mRNA was observed in the olfactory bulb, midbrain, and hypothalamus;
      and the lowest level in the hippocampus. In primary cultures of neonatal brain
      cells, the level of 3:0 kb transcript of PES transiently and dramatically
      increased about 30-fold on the third day after plating. Simultaneously, two cross
      hybridizing signals were detected at 4.0 and 7.0 kb. This increase in PES mRNAs
      was completely inhibited by addition of cytosine-1-beta-D-arabinofuranoside. The
      induction of PES mRNA was in parallel with the increase in PES protein, as
      assessed by Western blot analysis. Immunostaining of cultured cells with anti-PES
      monoclonal antibody revealed that PES protein was induced mainly in neurons but
      not in glial cells. These results suggest that PES is expressed in the central
      nervous system at a low concentration under normal conditions, and that the
      neuronal cells possess an ability to express high levels of PES mRNA and protein.

PMID- 8361345
TI  - Sodium dodecyl sulfate- and carbamylcholine-induced changes in circular dichroism
      spectra of acetylcholine receptor synthetic peptides.
AB  - The effect of sodium dodecyl sulfate (SDS) on the conformation of acetylcholine
      receptor alpha-subunit synthetic peptides was investigated by circular dichroism.
      In the presence of SDS (0.01-0.02%), the affinity of a 173-204 32 residue peptide
      and a 172-227 56 residue peptide for the competitive antagonist alpha
      bungarotoxin increases about 10-fold to the nanomolar range. Circular dichroism
      spectroscopy of these peptides revealed significant changes in the secondary
      structure of the peptides in the presence of SDS at concentrations below the
      critical micelle concentration. It is concluded that SDS induces a conformation
      of the peptides that is conductive to high affinity binding. Carbamylcholine, an
      acetylcholine analog, produced small but significant changes in the spectrum of
      the 173-204 peptide. This change could be the result of agonist-induced
      conformational changes in this region of the acetylcholine receptor alpha-subunit
      or to changes in the asymmetric environments of aromatic chromophores in the
      binding site. These studies demonstrate that synthetic peptides alone are capable
      of retaining significant functional activity and contain significant secondary
      structure.

PMID- 8361346
TI  - Structure and regulation of the gene encoding the neuron-specific protein PEP-19.
AB  - PEP-19 is a 61 amino acid polypeptide that is localized to neurons. PEP-19 is
      translated from a 0.6 kb poly(A)+ RNA; however, the gene from which it is
      transcribed spans more than 30 kbp and comprises three exons and two large
      introns. Exon 1 contains the 5'-untranslated region of PEP-19 and the first three
      amino acids of the coding sequence; exon 2 codes for the next 17 amino acids
      while the majority of the PEP-19 mRNA, comprising the remaining 42 amino acids
      and the 3'-untranslated region, is in exon 3. Gel retardation analysis identifies
      a region of DNA in the putative promoter of PEP-19 that binds preferentially to
      nuclear extracts from cerebellum. However, constructs containing 1.35 kbp of 5'
      upstream genomic DNA of PEP-19 fused to lacZ do not express in transgenic mice,
      suggesting that intragenic DNA may be essential for the regulation of PEP-19.

PMID- 8361347
TI  - Reserpine causes differential changes in the mRNA levels of chromogranin B,
      secretogranin II, carboxypeptidase H, alpha-amidating monooxygenase, the
      vesicular amine transporter and of synaptin/synaptophysin in rat brain.
AB  - Brains of rats treated with a high dose of reserpine were analyzed by in situ
      hybridization. The mRNA levels of several components of large dense core and
      small synaptic vesicles were determined. After drug treatment the secretogranin
      II message was elevated in the parvocellular neurons of the paraventricular
      nucleus, in the zona incerta, dorsal raphe, locus coeruleus and in the nucleus
      tractus solitarius. The levels of chromogranin B mRNA were increased in the
      dorsal raphe and in the substantia nigra compacta. In control animals messages
      for synaptin/synaptophysin could be found in most of the nuclei investigated,
      that of the vesicular amine transporter was only detectable in substantia nigra
      compacta, the dorsal raphe and the locus coeruleus whereas those of
      carboxypeptidase H and the alpha-amidating monooxygenase could only be determined
      in the paraventricular nucleus. All these messages were not changed after
      reserpine. We conclude that the chromogranin B/secretogranin II messages are
      regulated concomitantly with various neuropeptides. They represent useful general
      markers to identify stimulated neurons. Our results are consistent with the
      concept that stimulation of neurons leads to an increased synthesis of secretory
      peptides and consequently to large dense core vesicles filled with higher quanta
      of peptides.

PMID- 8361348
TI  - Regulation by Ca2+ in the Yersinia low-Ca2+ response.
AB  - The Yersinia low-Ca2+ response (LCR) is a regulatory response in which a set of
      plasmid-borne operons is transcriptionally regulated at 37 degrees C in response
      to the presence or absence of mM concentrations of Ca2+. LCR-regulated operons
      encode secreted proteins with regulatory and virulence roles as well as non
      secreted regulatory proteins and components of the secretion machinery.
      Downregulation by Ca2+ is imposed by a signalling cascade that includes secreted
      proteins and possibly also components of the secretion system and is hypothesized
      to act on membrane-bound inductive components. An important role in LCR induction
      is played by LcrD, an inner-membrane protein with homologues in several virulence
      associated and flagella assembly-related systems in diverse bacterial species.
      The mechanism of signal transduction in response to Ca2+ is not known, and the
      proteins that bind DNA to downregulate transcription have not been identified.

PMID- 8361349
TI  - Physical organization of lipids in the cell wall of Mycobacterium chelonae.
AB  - Mycobacterial cell wall functions as an effective permeability barrier, making
      these bacteria resistant to most antibacterial agents. It has been assumed that
      this low permeability was due to the presence of a large amount of unusual lipids
      in the cell wall, but it was not known how these lipids are able to produce such
      an exceptional barrier. We report here the first experimental evidence on the
      physical arrangement of these lipids based on X-ray diffraction studies of
      purified Mycobacterium chelonae cell wall, a result suggesting that the
      hydrocarbon chains of the cell-wall lipids are arranged predominantly in a
      direction perpendicular to the cell wall surface, probably producing an
      asymmetric bilayer structure.

PMID- 8361350
TI  - Multicopy plasmid instability: the dimer catastrophe hypothesis.
AB  - Multimer formation reduces plasmid copy number and is an established cause of
      segregational instability. Nevertheless, it is difficult to rationalize
      observations that low levels of dimers can cause severe instability, if we assume
      they are distributed evenly in cell populations. We report here that dimer
      distribution is in fact heterogeneous in recombination-proficient strains. Most
      cells in the population contain only monomers; dimers are confined to a small
      subpopulation from which plasmid-free daughters arise at high frequency. In a
      rec+ culture where 4% of pBR322 molecules are dimers, more than half are in dimer
      only cells. We show that this situation is inevitable because dimers replicate at
      twice the rate of monomers. Runaway multimerization is avoided because dimer
      containing cells grow more slowly than their monomer-containing counterparts. A
      computer simulation is used to show how dimers proliferate after formation by
      homologous recombination. The equilibrium concentration of dimers is proportional
      to the inter-plasmid recombination rate and is essentially independent of the
      rate at which homologous recombination converts dimers to monomers.

PMID- 8361351
TI  - The alkane oxidation system of Pseudomonas oleovorans: induction of the alk genes
      in Escherichia coli W3110 (pGEc47) affects membrane biogenesis and results in
      overexpression of alkane hydroxylase in a distinct cytoplasmic membrane
      subfraction.
AB  - The alkane hydroxylase system of Pseudomonas oleovorans, which catalyses the
      initial oxidation of aliphatic substrates, is encoded by three genes. One of the
      gene products, the alkane hydroxylase AlkB, is an integral cytoplasmic membrane
      protein. Induction leads to the synthesis of 1.5-2% AlkB relative to the total
      cell protein, both in P. oleovorans and in recombinant Escherichia coli DH1. We
      present a study on the induction and localization of the alkane hydroxylase in E.
      coli W3110, which appears to be an interesting host strain because it permits
      expression levels of AlkB of up to 10-15% of the total cell protein. This
      expression level had negative effects on cell growth. The phospholipid content of
      such cells was about threefold higher than that of wild-type W3110. Freeze
      fracture electron microscopy showed that induction of the alk genes led to the
      appearance of membrane vesicles in the cytoplasm; these occurred much more
      frequently in cells expressing alkB than in the negative control, which contained
      all of the alk genes except for alkB. Isolation and separation of the membranes
      of cells expressing alkB by density gradient centrifugation showed the customary
      cytoplasmic and outer membranes, as well as a low-density membrane fraction. This
      additional fraction was highly enriched in AlkB, as shown both by SDS-PAGE and
      enzyme activity measurements. A typical cytoplasmic membrane protein, NADH
      oxidase, was absent from the low-density membrane fraction. alkB expression in
      W3110 changed the composition of the phospholipid headgroup in the membrane, as
      well as the fatty acid composition of the membrane. The major changes occurred in
      the unsaturated fatty acids: C16:1 and C18:1 increased at the expense of C17:0cyc
      and C19:0cyc.

PMID- 8361352
TI  - Molecular genetic analysis of the moa operon of Escherichia coli K-12 required
      for molybdenum cofactor biosynthesis.
AB  - A 3.2 kb chromosomal DNA fragment which complements the defects in a series of
      twelve moa::Mucts insertion mutants has been sequenced. Five open reading frames
      (ORFs) were identified and these are arranged in a manner consistent with their
      forming an operon. The encoded proteins (MoaA-MoaE) have predicted molecular
      weights of 37,346, 18,665, 17,234, 8843 and 16,981 respectively. Examination of
      subclones of the whole locus in an expression system demonstrated the predicted
      products. N-terminal amino acid sequences for the moaA, B, C and E products
      confirmed the translational starts. Genetic analysis distinguished four classes
      of moa mutants corresponding to genes moaA, C, D and E. Potential promoter
      sequences upstream of moaA and a possible transcription termination signal have
      been identified. Genetic analysis of the chlA1 and chlM mutants, which have been
      biochemically characterized as defective in molybdopterin biosynthesis, indicates
      that these carry lesions in moaA and moaD respectively. The moa locus is
      orientated clockwise at 17.7 minutes in the chromosome.

PMID- 8361353
TI  - The presence of a novel type of surface polysaccharide in Rhizobium meliloti
      requires a new fatty acid synthase-like gene cluster involved in symbiotic nodule
      development.
AB  - Bacterial exopolysaccharide (EPS) and lipopolysaccharide (LPS) molecules have
      been shown to play important roles in plant-bacterium interactions. Here we have
      demonstrated that the fix-23 loci, which compensate for exo mutations during
      symbiotic nodule development, are involved in the production of a novel
      polysaccharide that is rich in 3-deoxy-D-manno-2-octulosonic acid (Kdo) but is
      not the classical LPS. This molecule is likely to be a surface antigen since
      antiserum to whole Rhizobium meliloti cells reacts strongly with it, and since
      mutations in fix-23 result in an inability to produce this polysaccharide and to
      bind bacteriophage 16-3. It is likely that this Kdo-rich polysaccharide is
      analogous to certain Escherichia coli K-antigens which are anchored to the
      membrane via a phospholipid moiety. DNA sequence analysis of one gene cluster of
      this region revealed that the predicted protein products of six genes exhibit a
      high degree of homology and similar organization to those of the rat fatty acid
      synthase multifunctional enzyme domains.

PMID- 8361355
TI  - The obligate intracellular bacterium Chlamydia trachomatis is auxotrophic for
      three of the four ribonucleoside triphosphates.
AB  - Using well-characterized mutant host cell lines, deficient in specific enzymes of
      energy and nucleotide metabolism, we addressed numerous questions regarding
      nucleotide metabolism in the obligate intracellular bacterium Chlamydia
      trachomatis. The results presented indicate that C. trachomatis: (i) does not
      absolutely depend on mitochondrial generated ATP for survival; (ii) does have a
      significant draw on host-cell NTP pools but does not have a detrimental effect on
      the ability of the host cell to maintain its energy charge; (iii) lacks the
      ability to synthesize purine and pyrimidine nucleotides de novo; (iv) is not
      capable of interconverting purine nucleotides; and (v) possesses the pyrimidine
      metabolic-pathway enzymes CTP synthetase and deoxycytidine nucleotide deaminase.
      In total our results indicate that C. trachomatis is auxotrophic for host-cell
      ATP, GTP and UTP. In contrast, CTP can be obtained from the host cell or it can
      be synthesized from UTP by the parasite.

PMID- 8361354
TI  - Expression of the ferric enterobactin receptor (PfeA) of Pseudomonas aeruginosa:
      involvement of a two-component regulatory system.
AB  - Expression of the ferric enterobactin receptor in Pseudomonas aeruginosa is
      inducible by enterobactin and requires sequences upstream of the structural gene
      (pfeA). Nucleotide sequencing of a 2.5 kilobase pair (kb) region of DNA
      immediately upstream of pfeA revealed two open reading frames (ORFs), pfeR and
      pfeS, which appeared to comprise an operon. The predicted products of pfeR and
      pfeS (molecular weight 26,796 and 50,597, respectively) exhibited a high degree
      of homology to response-regulator and sensor components, respectively, of the
      superfamily of prokaryotic environmentally responsive protein pairs. Consistent
      with an apparent role in regulating expression of pfeA in response to
      enterobactin, introduction of pfeR/pfeS into P. aeruginosa on a high-copy-number
      vector enhanced enterobactin-dependent expression of pfeA. Furthermore, a pfeR
      mutant obtained by in vitro mutagenesis and gene replacement failed to express
      PfeA despite the presence of enterobactin in the culture medium. Analysis of the
      hydropathy profiles of PfeR and PfeS supported a cytoplasmic location for PfeR
      and a cytoplasmic membrane location for PfeS.

PMID- 8361357
TI  - Preparation and analysis of isogenic mutants in the transferrin receptor protein
      genes, tbpA and tbpB, from Neisseria meningitidis.
AB  - Isogenic mutants were constructed in the tbpA and tbpB genes from Neisseria
      meningitidis strain B16B6, which code for the transferrin receptor proteins, Tbp1
      and Tbp2. Insertion mutants of the tbpA and tbpB genes were obtained by shuttle
      mutagenesis and by in vitro cassette mutagenesis, respectively. The isogenic
      mutants were verified by Southern blot and Western blot analysis. Isogenic
      mutants deficient in Tbp1 or Tbp2 demonstrated a reduced transferrin binding
      activity in intact cells and total membranes but were incapable of utilizing
      transferrin iron for growth. Tbp1 could be isolated by affinity methods from the
      mutant lacking Tbp2 but isolation of Tbp2 from the mutant lacking Tbp1 required
      the presence of exogenous Tbp1.

PMID- 8361356
TI  - Isolation and analysis of a linear plasmid-located gene of Borrelia burgdorferi
      B29 encoding a 27 kDa surface lipoprotein (P27) and its overexpression in
      Escherichia coli.
AB  - Using an antiserum of a patient with cutaneous manifestations of Lyme borreliosis
      we have isolated the gene encoding a 27 kDa protein antigen (P27) of Borrelia
      burgdorferi B29 from a lambda-gt11 expression library. Nucleotide sequence
      analysis revealed that it is a basic protein of 248 amino acids with a typical
      prokaryotic leader sequence of 17 amino acid residues at the N-terminus of the
      proposed translation product. Biochemical investigations showed that P27 is a
      surface-exposed lipoprotein. From pulsed-field gel electrophoresis and subsequent
      Southern blot analysis it is evident that the p27 gene is located on a linear
      plasmid of a size of approximately 55 kb. It was overexpressed in Escherichia
      coli and the purified recombinant protein was used for biochemical and
      serological studies. Northern and Western blot analysis demonstrated that p27 is
      expressed in the European B. burgdorferi strain B29, but not in the American
      strain B31.

PMID- 8361358
TI  - The region of human transferrin involved in binding to bacterial transferrin
      receptors is localized in the C-lobe.
AB  - Iron-saturated human transferrin was digested with either chymotrypsin or trypsin
      to produce C-lobe and N-lobe protein fragments. Individual protein fragments were
      purified by a combination of gel filtration and Concanavalin A affinity
      chromatographic procedures. The C-lobe and N-lobe fragments of human transferrin
      were then used in binding assays to assess their ability in binding to the
      bacterial transferrin receptors. Competitive binding assays demonstrated that the
      C-lobe fragment of human transferrin binds as well as intact human transferrin to
      bacterial transferrin receptors from Neisseria meningitidis, Neisseria
      gonorrhoeae and Haemophilus influenzae. Using isogenic mutants of N. meningitidis
      deficient in either of the transferrin-binding proteins (Tbps), we demonstrated
      that both transferrin-binding proteins were able to bind to the C-lobe fragment
      of human transferrin.

PMID- 8361359
TI  - Identification of an operon involved in the assimilatory nitrate-reducing system
      of Azotobacter vinelandii.
AB  - A number of mutants lacking nitrate reductase (Nas-) or nitrite reductase (Nis-)
      activities have been isolated and characterized. An operon including two new
      genes (nasA and nasB) has been defined and cloned from an Azotobacter vinelandii
      gene bank. nasA encodes for nitrite reductase apoenzyme, whereas nasB is specific
      for nitrate reductase activity. Nitrate reductase exerts a regulatory effect on
      nasAB.

PMID- 8361360
TI  - Lactococcus lactis: high-level expression of tetanus toxin fragment C and
      protection against lethal challenge.
AB  - To determine if the food-grade bacterium Lactococcus lactis holds promise as a
      vaccine antigen delivery vector we have investigated whether this bacterium can
      be made to produce high levels of a heterologous protein antigen. A regulated
      expression system has been developed which may be generally suitable for the
      expression of foreign antigens (and other proteins) in L. lactis. The system
      utilizes the fast-acting T7 RNA polymerase to transcribe target genes, and
      provides the first example of the successful use of this polymerase in a Gram
      positive bacterium. When the performance of the expression system was
      characterized using tetanus toxin fragment C (TTFC) up to 22% of soluble cell
      protein was routinely obtained as TTFC. Mice immunized subcutaneously with L.
      lactis expressing TTFC were protected from lethal challenge with tetanus toxin.
      These results show for the first time that L. lactis is able to express
      substantial quantities of a heterologous protein antigen and that this organism
      can present this antigen to the immune system in an immunogenic form.

PMID- 8361361
TI  - ATPase activity and ATP/ADP-induced conformational change in the soluble domain
      of the bacterial protein translocator HlyB.
AB  - The haemolysin exporter HlyB and its homologues are central to the unconventional
      signal-peptide-independent secretion of toxins, proteases and nodulation proteins
      by bacteria. HlyB is a member of the ATP-binding cassette (ABC) or traffic ATPase
      superfamily, and resembles closely in structure and function mammalian exporters
      such as the multidrug-resistance P-glycoprotein, combining both integral membrane
      and cytosolic domains. Overproduction of the HlyB cytoplasmic domain as a C
      terminal peptide fused to glutathione S-transferase allowed the direct affinity
      purification and concentration of 30-50 mg ml-1 of soluble protein (GST-Bctp) in
      an apparently dimeric form possessing both transferase and ATPase activity. GST
      Bctp bound to ADP-agarose and was eluted specifically by ATP and ADP, affinity
      behaviour which was confirmed in both the full-length HlyB and the unfused HlyB
      cytoplasmic domain synthesized in vitro. The stoichiometry of binding to MgATP
      and MgADP was close to equimolar and both ligands induced substantial
      conformational change in the protein. Mg(2+)-dependent ATPase activity of GST
      Bctp (Vmax 1 mumol min-1 mg-1, Km 0.2 mM) was comparable with the activity of the
      bacterial importer MalK and human P-glycoprotein reconstituted into
      proteoliposomes, and over an order of magnitude higher than in vitro measurements
      of disaggregated MalK purified from inclusion bodies. Activity was unaffected by
      inhibitors of F- and V-type ATPases, non-hydrolysable ATP analogues, or
      translocation substrate, but was severely inhibited by inhibitors of E1E2 (P
      type) ATPases, and the acidic phospholipid phosphatidyl glycerol.

PMID- 8361362
TI  - Yeast DNA recombination and repair proteins Rad1 and Rad10 constitute a complex
      in vivo mediated by localized hydrophobic domains.
AB  - The Saccharomyces cerevisiae Rad1 and Rad10 proteins are required for damage
      specific incision during nucleotide excision repair and also for certain mitotic
      recombination events between repeated sequences. Previously we have demonstrated
      that Rad1 and Rad10 form a specific complex in vitro. Using the 'two-hybrid'
      genetic assay system we now report that Rad1 and Rad10 proteins are subunits of a
      specific complex in the cell nucleus. The Rad10-binding domain of Rad1 protein
      maps to a localized region between amino acids 809-997. The Rad1-binding domain
      of Rad10 protein maps between amino acids 90-210. These domains are
      evolutionarily conserved and are hydrophobic in character. Although significant
      homology exists between Rad10 and the human-DNA-repair protein Ercc1 in this
      region, we were unable to detect any interaction between Ercc1 and Rad1 proteins.
      We conclude that Rad1 and Rad10 operate in DNA repair and mitotic recombination
      as a constitutive complex.

PMID- 8361363
TI  - Medicare and Medicaid anti-kickback law.

PMID- 8361364
TI  - Investing in the 1990s: in search of guidance.

PMID- 8361365
TI  - Dignity and the child's dental appointment.

PMID- 8361366
TI  - Is disability income part of your financial plan?

PMID- 8361367
TI  - Florida dentists still dealing with aftermath of Hurricane Andrew.

PMID- 8361368
TI  - Visualization of exocytosis by quick freezing and freeze-fracture.

PMID- 8361369
TI  - Vaccinia virus vectors for study of membrane fusion mediated by human
      immunodeficiency virus envelope glycoprotein and CD4.

PMID- 8361370
TI  - Electropermeabilized platelets: a preparation to study exocytosis.

PMID- 8361371
TI  - Exocytotic membrane fusion as studied in toxin-permeabilized cells.

PMID- 8361372
TI  - Calculation and control of free divalent cations in solutions used for membrane
      fusion studies.

PMID- 8361374
TI  - Use of Tetrahymena and Paramecium in studies of exocytosis.

PMID- 8361373
TI  - Manipulation of cytosolic free calcium transients during exocytosis in intact
      human neutrophils.

PMID- 8361375
TI  - Calcium-dependent membrane-binding proteins in cell-free models for exocytotic
      membrane fusion.

PMID- 8361376
TI  - In vitro studies of endocytic vesicle fusion.

PMID- 8361377
TI  - Fluorescence methods for monitoring phagosome-lysosome fusion in human
      macrophages.

PMID- 8361378
TI  - In situ resonance energy transfer microscopy: monitoring membrane fusion in
      living cells.

PMID- 8361379
TI  - Detection of sperm-egg fusion.

PMID- 8361380
TI  - Membrane area and electrical capacitance.

PMID- 8361381
TI  - Fusion of human immunodeficiency virus-infected cells with uninfected cells.
AB  - CD4-dependent HIV envelope glycoprotein-induced membrane fusion events play a key
      role in the life cycle of HIV and are involved both in infection mediated by
      viral particles and in virally mediated cytopathic processes. The relevant events
      involve binding interactions between the HIV envelope glycoprotein gp120 and the
      cellular receptor CD4 and membrane fusion processes mediated by the HIV envelope
      glycoprotein gp41. A straight forward, rapid, and convenient assay procedure
      useful for analysis of these processes and identification of inhibitors is
      described.

PMID- 8361382
TI  - Intracellular delivery of nucleic acids and transcription factors by cationic
      liposomes.

PMID- 8361383
TI  - Electroinjection.

PMID- 8361384
TI  - pH-sensitive liposomes for delivery of macromolecules into cytoplasm of cultured
      cells.

PMID- 8361385
TI  - Kinetics of cell fusion mediated by viral spike glycoproteins.

PMID- 8361386
TI  - Protein conformational changes in virus-cell fusion.

PMID- 8361387
TI  - Monitoring protein conformational changes during membrane fusion.

PMID- 8361388
TI  - Synthetic peptides as probes of function of viral envelope proteins.

PMID- 8361389
TI  - Simultaneous electrical and optical measurements of individual membrane fusion
      events during exocytosis.

PMID- 8361390
TI  - Duramycin increases intracellular calcium in airway epithelium.
AB  - Duramycin increases short-circuit current (Isc) and net Cl- secretion in tracheal
      epithelium. We measured the intracellular free calcium ([Ca2+]i) response to
      duramycin using Indo-1 and bovine and canine tracheal cell suspensions, and the
      effect of an intracellular calcium chelator, BAPTA, and the protein kinase C
      inhibitor, staurosporine, on the Isc and [Ca2+]i response to duramycin. [Ca2+]i
      increased in a dose-dependent manner from basal levels of 34 +/- 5 to 949 +/- 136
      nM at 5 x 10(-6) M duramycin. Both BAPTA (50 microM) and staurosporine (5-50 nM)
      pretreatment blunted the increase in Isc and net Cl- secretion produced by
      duramycin. BAPTA also blunted the rise in [Ca2+]i produced by duramycin (5 x 10(
      6) M) in the presence of extracellular calcium (499 +/- 122 nM). In the absence
      of extracellular calcium, the duramycin-induced (5 x 10(-6) M) rise in [Ca2+]i
      was blunted from 949 +/- 136 nM (stimulation in the presence of Ca2+) to 621 +/-
      122 nM, and was further decreased in the presence of BAPTA to 197 +/- 42 nM. In
      contrast, staurosporine (50 nM) pretreatment had no effect on the rise in [Ca2+]i
      produced by duramycin (basal 90 +/- 27 to 861 +/- 110 nM at 5 x 10(-6) M).
      Duramycin had no effect on [Ca2+]i in human neutrophils. These data demonstrate
      that duramycin releases calcium from intracellular stores and stimulates the
      influx of calcium in airway epithelial cells. These data also demonstrate that,
      in the presence of protein kinase C pathway blockade, an increase in
      intracellular free calcium is not sufficient for chloride secretion; thus,
      duramycin-stimulated chloride secretion may depend upon protein kinase C.

PMID- 8361391
TI  - In vitro susceptibility of Haemophilus ducreyi to several antibiotics.
AB  - Haemophilus ducreyi was isolated from 59 (52%) of 113 men with a clinical
      diagnosis of chancroid. The following MIC50 (MIC90) values for H. ducreyi were
      obtained: erythromycin 0.14 (0.5) micrograms/ml, trimethoprim 0.25 (8.0)
      micrograms/ml, ceftriaxone 0.009 (0.14) micrograms/ml, and ciprofloxacin 0.007
      (0.04) micrograms/ml. These data indicate that all isolates appear to be fully
      susceptible to erythromycin and the other antimicrobial agents tested, although
      ciprofloxacin was the most effective antibiotic.

PMID- 8361392
TI  - Effects of chlorhexidine diacetate and cetylpyridinium chloride on whole cells
      and protoplasts of Saccharomyces cerevisiae.
AB  - Chlorhexidine diacetate (CHA) and the quaternary ammonium compound,
      cetylpyridinium chloride (CPC), were fungicidal to Saccharomyces cerevisiae A364A
      and CHA to its mannoprotein mutant LB6-5D. Both CHA and CPC induced leakage of K+
      and pentose material from both strains and both agents induced protoplast lysis
      as well as interacting with crude cell sap. Differences were observed between CHA
      and CPC in protoplast lysis and in cell sap interaction. Q25 values for A364A
      with CHA as test agent were 5.6 and 1.6 (fungicidal activity, depending on method
      of calculation), 1.46 (cell sap interaction) and 0.77 (leakage of pentoses). A
      sub-lytic concentration of CHA reduced considerably protoplast regeneration.
      Although the plasma membrane is an important target site for both agents,
      interaction with other cellular components also contributes to fungal death.

PMID- 8361393
TI  - Conditions suitable for the recovery of biocide-treated spores of Bacillus
      subtilis.
AB  - Various factors were studied in order to determine the optimum conditions for the
      recovery of Bacillus subtilis spores treated with two iodine preparations, two
      chlorine-releasing agents or glutaraldehyde. The composition of the recovery
      medium was not usually important except that counts on brain heart infusion agar
      were significantly lower than on other media for iodine-treated spores. The
      addition to recovery media of soluble starch, charcoal, D-glucose or yeast
      extract usually had no discernible beneficial effect on colony counts. Maximum
      counts of survivors were obtained after an incubation period of 3 days and an
      optimum incubation temperature of 30 or 37 degrees C. Germination and outgrowth
      of biocide-exposed spores were more sensitive to changes in incubation
      temperature than were control spores.

PMID- 8361394
TI  - Salmonella and Shigella carriage by gulls (Larus sp.) on the east Black Sea
      region of Turkey.
AB  - Sea gull faeces (616 samples in toto) were examined for enteric human pathogens,
      and 1.3% and 0.60% were found to contain Salmonella spp. and Shigella spp.,
      respectively. All positive samples were near sewage outfalls and refuse tips. The
      Salmonella serotype was isolated as S. typhi and the Shigella serotype as S.
      sonnei. Pathogenic bacteria were isolated from the faecal samples collected only
      in the Trabzon area.

PMID- 8361395
TI  - On-line measurement of microvascular diameter and red blood cell velocity by a
      line-scan CCD image sensor.
AB  - A line-scan charge-coupled device (CCD) image sensor (256 photo sites) was
      equipped for on-line measurement and calculation of red blood cell velocity and
      microvascular diameter. The principle of measurement is based on a sequential
      readout of the CCD-sensor photo signal at predefined time intervals. The velocity
      is calculated by a computer by cross correlation of a given set of readouts.
      Rotation of the sensor into a position perpendicular to the microvessel axis
      allows measurement of the diameter, which is related to the red blood cell column
      moving under the sensor. At low magnification (up to 38-fold) diameters up to 80
      microns can be measured. Calibration, which was performed by comparing diameters
      measured in vivo by the CCD-based system with microphotographically obtained
      measurements, revealed a mean CCD/photo ratio of 0.98 +/- 0.08. Calibration of
      velocity measurements in glass tubes of different diameters by a calibrated pump
      with known bulk flow resulted in a mean conversion factor of 1.59 +/- 0.2 (mean
      +/- SD). The CCD sensor is mounted such that it can freely rotate on the
      microscope. In conjunction with a programmable scanning table, several vessels
      can be measured sequentially in one preparation. The interval between two
      combined measurements and calculations of velocity and diameter is 1.1 sec.

PMID- 8361396
TI  - Differential reactivity of cortical and juxtamedullary glomeruli to adenosine-1
      and adenosine-2 receptor stimulation and angiotensin-converting enzyme
      inhibition.
AB  - A recently developed modification of the technique of the split hydronephrotic
      rat kidney enables intravital assessment of vascular reactivity of cortical and
      juxtamedullary (JM) glomeruli and their vascular network. Effects of the
      adenosine-1 receptor agonist N6-cyclohexyladenosine (CHA) and the adenosine-2
      receptor agonist N-ethylcarboxamide-adenosine (CHA) and the adenosine-2 receptor
      agonist N-ethylcarboxamide-adenosine (NECA) on these renovascular structures were
      examined before and after angiotensin II-converting enzyme (CE) inhibition by
      quinapril (0.9 mg kg-1 iv). CE inhibition was undertaken to test for an
      interdependence of adenosine and angiotensin II, as we have previously
      demonstrated for cortical glomeruli and CHA. In the first series of experiments
      (n = 7), CHA (in local dosages from 10(-8) to 10(-6) mole liter-1 produced a dose
      dependent vasoconstriction of all preglomerular vessels and a decrease of
      cortical glomerular blood flow that was markedly attenuated by CE inhibition. In
      JM glomeruli, CHA also led to a dose-dependent vasoconstriction, but these
      effects were, on the contrary, unchanged or even increased by CE inhibition. In
      the second series (n = 6), NECA (in local dosages from 10(-8) to 10(-5) mole
      liter-1) led to a vasodilation and an increase in glomerular blood flow both
      before and after CE inhibition in both cortical and JM glomeruli. The reactions
      induced by NECA alone in the principal preglomerular vessel segments were
      significantly larger than those under NECA and simultaneous CE inhibition,
      thereby demonstrating an attenuation of NECA effects induced by CE inhibition. In
      additional series, we demonstrated a dose-dependent vasoconstriction of all pre-
      and postglomerular cortical vessel segments by local application of angiotensin I
      (dosage 10(-8) to 10(-6) mole liter-1) and the abolition of these effects by
      quinapril. Our findings demonstrate a differential reactivity of cortical and
      juxtamedullary glomeruli to adenosine receptor agonists and, additionally, an
      interdependence of adenosine-and angiotensin II-induced renovascular effects.

PMID- 8361397
TI  - O2 gradients and countercurrent exchange in the cat vitreous humor near retinal
      arterioles and venules.
AB  - Recessed cathode O2 microelectrodes were used to measure spatially detailed
      oxygen tension (PO2) gradients in the vitreous humor near the cat retina.
      Measurement sites (n = 41 in 8 cats) included single arterioles and venules and
      parallel vessel pairs. Mean vitreous PO2 was 37.9 +/- 1.5 (SE) Torr. Close to the
      retinal surface (approximately 200 microns), PO2 was found to be both higher and
      lower than the vitreous PO2, depending on the proximity of the microelectrode tip
      to retinal vessels. Both positive (inward) and negative (outward) O2 fluxes (JO2)
      were measured, consistent with the anatomy and expected boundary conditions in
      the eye. The PO2 at the closest approach above arterioles was 55.2 +/- 2.3 Torr,
      significantly higher than in the vitreous (P < 0.0001). All arterioles had
      outward JO2 with an overall mean of -2.58.10(-6) ml O2/sec/cm2. Some of the
      venules were also losing O2, but at much lower rates than arterioles. Several
      venules were gaining O2. Countercurrent transport (A-V shunting) was also seen
      between vessel pairs. Our experimental results allow theoretical predictions to
      be made for the axial drop in blood PO2 along an arteriole as a function of blood
      flow.

PMID- 8361398
TI  - A micropipette which allows in situ perfusion of arterioles and capillaries.
AB  - In order to investigate capillary physiology, a glass micropipette system was
      developed that allowed in situ perfusion of microvessels as well as rapid changes
      of perfusion solutions. Theta tube (WPI, Inc.; 1.5-mm o.d. glass stock capillary
      tubing which is divided into two hemicylindrical sides by a central glass septum)
      was pulled to a smaller diameter of approx 300-600 microns and inserted into the
      shank of a sharpened cannulating micropipette tip constructed from large-bore
      glass stock (1.6 mm i.d.). The resulting dead volume between the end of the Theta
      supply tube and the tip of the outer cannulating tip was approximately 90 nl. The
      perfusate was driven in a circuit from a pressurized feed reservoir down one side
      of the Theta supply tube pipette and back through the second side into a
      reservoir maintained at a lower pressure. The pressure gradient between the two
      reservoirs established a high-volume flow rate and subsequently a short perfusate
      transit time from the feed to the collection reservoir. The average pressure in
      the two reservoirs determined the pressure which drove the perfusate from the
      cannulating tip. At normal pressures and flows, the time required to change
      perfusion fluid composition at the pipette tip was less than 1 min, and discharge
      hematocrit of a red blood cell suspension was indistinguishable from the
      hematocrit measured in the feed reservoir.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361399
TI  - Direct measurement of retinal microvascular pressures in the live, anesthetized
      cat.
AB  - Microvascular pressures in retinal circulation were measured in living,
      anesthetized cat by the servonull micropuncture technique. Of the total vascular
      pressure drop 32% was in the segment proximal to the large retinal arteries when
      intraocular pressure was set at 10 mm Hg and decreased to 27% when intraocular
      pressure was increased to 20 mm Hg. The pressure in the retinal veins was
      substantially (> 7 mm Hg) greater than intraocular pressure at both values of
      intraocular pressure. There was negligible pressure drop within venous segment;
      however, the pressure drop from the retinal veins to the systemic veins was large
      and cannot be explained on the basis of a venous waterfall within the retina.

PMID- 8361400
TI  - Effects of nonsteroidal anti-inflammatory drugs on microvascular dynamics.
AB  - Techniques of intravital microscopy were used to assess the effect of the
      nonsteroidal anti-inflammatory drugs (NSAIDs), indomethacin and ibuprofen, on the
      microcirculation. Hemodynamics in venules of the rat mesentery were studied in
      terms of vessel diameter, red blood cell velocity, and leukocyte-endothelium
      interactions: leukocyte-endothelium adhesion (LEA), white blood cell (WBC)
      marginating flux, and WBC velocity. Measurements were made during (1) control
      conditions (topical suffusion with ringer-gelatin drip), (2) topically suffused
      indomethacin or ibuprofen, (3) an induced inflammatory response (suffusion with
      the chemoattractant N-Formyl-Methionyl-Leucyl-Phenylalanine (FMLP)), and (4)
      concomitant suffusion with FMLP and NSAID. Short term topical suffusion (90 sec)
      with indomethacin and ibuprofen had little or no effect on control hemodynamics.
      Five-minute suffusions with indomethacin (5 x 10(-5) to 5 x 10(-4) M)
      significantly increased LEA while ibuprofen (5 x 10(-3) M) significantly
      decreased LEA. Topical suffusion with the chemotactic agent FMLP induced
      inflammation and significantly increased LEA in venules. Treatment with
      indomethacin during induced inflammation had no effect on the inflammatory
      reaction in terms of the microvascular hemodynamics measured in this study.
      Treatment with ibuprofen during induced inflammation significantly reduced LEA
      and increased red blood cell velocity. In conclusion, although both of the NSAIDs
      studied here are known to block the cyclooxygenase pathway of arachidonic acid
      metabolism, the actions of indomethacin and ibuprofen on the inflammatory process
      are very different with an important effect of ibuprofen being to decrease LEA.

PMID- 8361401
TI  - Three-dimensional analysis of contrast-filled microvessel diameters.
AB  - Organ blood flow is controlled, in part, by changes in diameter of resistance
      vessels. In thick tissue, vessels can be imaged with a microscope using contrast
      enhancing methods (e.g., fluorescence) and image analysis techniques can be used
      for quantitative diameter estimations. However, a change in the position of a
      vessel with respect to the plane of focus can be misinterpreted as a diameter
      change. In order to address this problem, a 3D image in a light microscope is
      obtained by serial optical sectioning, and a 3D deconvolution procedure (Avinash
      et al., 1991, "Fourteenth Association for Research in Otolaryngology Midwinter
      Meeting, St. Petersberg, FL," Abstract 156) is used to deblur 3D image data.
      Deblurred sections are computationally projected onto a 2D plane to give an
      extended-focus image, from which diameter estimates of microvessels are made
      using a quantitative, 2D diameter-tracking algorithm (Miles, 1987, "Semiautomatic
      Quantitative Image Analysis of Dynamic in Vivo Cochlear Microvessel Diameters."
      Ph.D. dissertation, Univ. Michigan; Miles and Nuttall, 1992, IEEE Trans. Biomed.
      Eng.). Justification for 3D preprocessing before diameter analysis is provided by
      absolute and relative error analyses using computer-generated synthetic vessels.
      The 3D diameter analysis technique is validated using a capillary tube of known
      diameter, filled with fluorescent solution. Demonstration of its applicability is
      shown in diameter measurements from the vessels of guinea pig cochlea. Our
      approach, using extended-focus images, minimizes overestimation of microvascular
      diameters and underestimation of relative diameter changes. Therefore,
      unambiguous diameter measurements are possible with extended-focus images.

PMID- 8361402
TI  - Evaluation of carbocyanine-labeled erythrocytes for microvascular measurements.
AB  - Red blood cells labeled with the carbocyanine dyes, 1,1'-dioctadecyl-3,3,3',3'
      tetramethylindocarbocyanine perchlorate (DiI) and 3,3'-dioctadecyloxacarbocyanine
      perchlorate (DiO), were evaluated for use in making microvascular measurements in
      rat small intestine and spinotrapezius muscle. We determined the minimum
      concentration of each dye which produced near maximal fluorescent intensity and
      labeled cell fraction. These dyes, which have excitation and emission spectra
      similar to fluorescein and rhodamine derivatives, have a number of advantages
      over the isothiocyanates: (1) the labeling procedure is quicker, easier, and less
      expensive; (2) the labeled cell fraction and the fluorescent intensity of DiI and
      DiO cells are stable for long periods of time in the rat circulation; and (3) DiI
      labeled cells are brighter and transmit light through overlying erythrocytes
      better than rhodamine X isothiocyanate. However, in vitro and in vivo evaluations
      illustrate the potential limiting effects of vessel diameter and cell velocity on
      the accuracy of microvascular measurements made using this technique. In the
      small intestine and spinotrapezius muscle preparations, measurements of labeled
      cell flux were readily reproducible and could be partly automated with image
      analysis only in capillaries and small venules. Counting labeled cells in larger
      vessels by human observation or with automation was not reproducible, presumably
      due to absorption and dispersion of the fluorescent signal by overlying
      erythrocytes and smearing of the cell image at high cell velocities.

PMID- 8361403
TI  - Gender differences in facial skin blood perfusion during basal and heated
      conditions determined by laser Doppler flowmetry.

PMID- 8361404
TI  - Unplanned teen pregnancies subject of CURN scholar study.

PMID- 8361405
TI  - [Comparison of latex agglutination and coagglutination methods for the
      determination of bacterial antigens in cerebrospinal fluid].
AB  - The latex agglutination and coagglutination tests were used to demonstrate
      specific bacterial antigens in cerebrospinal fluid of patients with bacterial
      meningitis. Latex agglutination was more sensitive than coagglutination. It
      detected 90% (18/20) of culture positive CSF specimens, whereas coagglutination
      detected 60% (12/20). Antigens were also detected by latex agglutination in seven
      of seven additional cerebrospinal fluid specimens after 32-48 hours of
      antimicrobial therapy, but four of seven by coagglutination.

PMID- 8361406
TI  - [Isolation of Gardnerella vaginalis from vaginal discharge specimens].
AB  - In this study specimens taken from 93 patients who admitted to outpatient clinics
      of SSK Ankara Gynaecology and Obstetrics Hospital with vaginal discharge were
      examined for G. vaginalis, T. vaginalis, C. albicans and N. gonorrhoeae. We
      evaluated the smell, pH, direct microscopic examinations, stained preparations
      and specific culture results of the discharges which were taken from posterior
      fornix. We isolated G. vaginalis from 13 patients (13.9%), T. vaginalis from 5
      patients (5.3%) and C. albicans from 19 patients (20.4%). N. gonorrhoeae could
      not be isolated from any of the specimens. In our control study, we isolated G.
      vaginalis in three out of 50 patients (6%) without vaginal discharge. We observed
      T. vaginalis in specimens of 3 control patients. C. albicans and N. gonorrhoeae
      could not be isolated in this study in this study.

PMID- 8361407
TI  - [Identification of dermatophytes as possible agents in clinically and
      microbiologically diagnosed dermatophytosis].
AB  - In this study we have investigated the distribution of dermatophyte species
      clinically and microbiologically on 110 patients with dermatophytosis. The
      distribution of the dermatophytes according to the localization sites are: Tinea
      Capitis 13 (11.8%), T. Corporis 12 (10.9%), T. Inguinalis 22 (20%), T. Pedis et
      Manum 47 (42.7%), T. Unguinum 16 (14.5%). The species of dermatophytes which have
      been cultured were, Trichophyton rubrum 32 (29%), T. mentagrophytes 32 (29%), T.
      schoenleini 4 (3.6%), T. tonsurans 1 (0.9%), Epidermophyton floccosum 16 (14.5%),
      Microsporum canis 1 (0.9%), M. audouini 1 (0.9%), various molds 3 (2.7%) and also
      number of negative cultures obtained were 20 (18.1%).

PMID- 8361408
TI  - [The effect of calcium ions on the activation of Escherichia coli hemolysin].
AB  - The calcium requirement for hemolytic activity Escherichia coli hemolysin is
      controversial. Thus, we aimed to study the calcium-dependent and independent
      hemolytic activity in an in vitro system. It was found that the free calcium in
      the cultivation medium might activate the hemolysin and once activated the
      hemolytic activity could not be inhibited by calcium chelator, EGTA. However,
      when the free calcium in the medium was chelated by EGTA before the inoculation
      of bacteria, the hemolytic activity was found to be almost entirely dependent
      upon the exogenous calcium supply to the test system. We also obtained some
      evidence showing that the calcium ions could take part in stabilization of this
      protein.

PMID- 8361409
TI  - [The effect of the inoculum concentration on the in vitro sensitivity of
      Pseudomonas aeruginosa].
AB  - Using a broth microtiter dilution method, the minimum inhibitory concentrations
      of antipseudomonal antibiotics were determined against 19 P. aeruginosa isolates.
      Two different concentration of inoculum, 10(5) and 10(8), were used to show the
      inoculum concentration effect of in vitro antibiotic susceptibility tests. On the
      basis of the MIC values and using Howard B.J. (1) breakpoints, the effect of
      inoculum density was most prominent for amikacin and aztreonam, intermediate for
      mezlocillin, ticarcillin, piperacillin, cefotaxime, cefoperazone, netilmicin,
      tobramycin, gentamicin, and least apparent for ciprofloxacin and carbenicillin
      respectively.

PMID- 8361410
TI  - [In vitro susceptibility to cefoperazone and sulbactam/cefoperazone combination
      of bacterial strains isolated from various patient materials].
AB  - Susceptibility of 110 bacterial strains isolated from clinical materials to
      Cefoperazone (CPZ) and Sulbactam/Cefoperazone (SBT/CPZ) combination was
      investigated and every strain was examined for beta-lactamase activity. Total
      beta-lactamase positivity rate was 40.9%. Antibacterial activity of SBT/CPZ
      combination was found to be higher than CPZ alone, especially on beta-lactamase
      producing bacteria.

PMID- 8361411
TI  - [Antimicrobial sensitivity of some gram-negative bacterial strains causing
      hospital or community-acquired infections].
AB  - The susceptibility to various antimicrobics of E. coli, Klebsiella, S.
      typhimurium, Pseudomonas, Proteus and Edwardsiella strains causing hospital or
      community acquired infections were investigated by Kirby-Bauer's disk diffusion
      method. It was found that ampicillin was the least and quinolones were the most
      effective antimicrobics for the both hospital and community acquired infections.
      In general, the antimicrobic resistance was significantly increased for the
      hospital isolates.

PMID- 8361412
TI  - [Ofloxacin treatment of salmonella infections].
AB  - In the present study, 33 adult patients with salmonella infections consisting of
      13 typhoid fever, 9 paratyphoid fever, 8 enterocolitis, 2 carriers, 1 acute
      gastroenteritis have been treated with ofloxacin. The duration of treatment was
      10 days for typhoid fever, 7 days for paratyphoid fever, 5 days for
      enterocolitis, 3 days for acute gastroenteritis and 7 days for asymptomatic
      carriers. All the patients recovered without any complication and fever declined
      to normal levels within a mean of 3.0 +/- 1.34 days. Two carriers of S.
      enteritidis became salmonella free after 7 days of ofloxacin treatment. One of
      the patients who had severe S. paratyphi B bacteremia remained carrier for about
      6 months. None of the patients have relapsed. The antibiotic therapy proposals on
      salmonella in adults were discussed in the light of our results and the other
      studies.

PMID- 8361413
TI  - [Demonstration of Chlamydia trachomatis IgG using ELISA in transsexuals and
      homosexuals].
AB  - In this study, 27 sera samples collected from transsexuals and homosexuals have
      been searched for Chlamydia trachomatis IgG antibodies with ELISA. Anti-Chlamydia
      IgG have been found positive in 18 cases (66.7%). In our study group there were
      no clinical symptoms except one case of transsexuals. Seropositivity rate of
      homosexuals (8/15) and transsexuals (10/12) were found to be important for
      transmitting the disease.

PMID- 8361414
TI  - [Relationship of histocompatibility groups to chronic HBV infections].
AB  - HLA-A, B, C and DR locus specificities studied in 168 patients (71 Chronic active
      Hepatitis, 97 Chronic Persistent Hepatitis) serologically and histopathologically
      proven Chronic Hepatitis B Virus infection. There were 113 men and 55 women with
      a mean age of 23.2 (21-52) years. Hundred and seventy four healthy subjects (107
      men, 67 women) included in control group with a mean age of 26.4 (20-54) years.
      The frequency of HLA A3 (p < 0.01), HLA A11 (p < 0.01), HLA B35 (p < 0.05) and
      HLA B51 (p < 0.01) were significantly higher in patients than in healthy control
      subjects. Comparisons among the other HLA-A, B, C and DR locus were found to be
      statistically non-significant.

PMID- 8361415
TI  - [Chlamydia trachomatis IgA and IgG antibodies in prostitutes and women having
      spontaneous abortion].
AB  - In this study, the sera taken from 34 prostitutes, 34 women having spontaneous
      abortion and 34 control group were tested for C. trachomatis IgA and IgG
      antibodies. C. trachomatis antibodies were found positive in 30 (88.2%) of
      prostitutes, 11 (32.3%) of women having spontaneous abortion, 9 (26.4%) of
      controls. When the positivity rate of prostitutes and women having spontaneous
      abortion compared with control groups statistically, it was found significant in
      prostitutes (p < 0.05), but not found significant in women having spontaneous
      abortion (p > 0.05).

PMID- 8361416
TI  - [Actinomycosis abscess developing in the rectus muscle. (One case history)].
AB  - A 36 year old male patient having an abscess in right rectus muscle's cover 2
      years after stomach operation; attended to our hospital. The abscess was
      discharged. Following this, at 6 months intervals new abscess were formed in left
      lower and right upper rectus cover and discharged. Samples from abscess were
      routinely observed microbiologically and for tuberculosis; but the etiologic
      agent could not be identified. Six months later the patient attended to our
      hospital with abscess in right lower rectus cover again. The sample taken from
      the patient was examined thinking actinomycosis. After clinical and
      microbiological observation, the causative agent was identified as Actinomyces
      israeli.

PMID- 8361418
TI  - Childhood hyperactivity.

PMID- 8361417
TI  - [The role of Helicobacter pylori in the etiology of peptic ulcer and its
      therapy].
AB  - The isolation of Helicobacter pylori from human gastric mucosa by Warren and
      Marshall in 1984, has given new approaches in etiology of peptic ulceration.
      Approximately all of duodenal ulcer patients have displayed antral gastritis with
      Helicobacter pylori, made strong suspicion of the bacteria in the etiology of
      duodenal ulcer. In therapy, combination of antibiotics to acid suppressive
      therapy should be preferred to antibiotics only.

PMID- 8361419
TI  - What have we learned from meta-analysis?

PMID- 8361420
TI  - The emergence of graduate medical schools in Australia.

PMID- 8361422
TI  - Desktop publishing and the author's disk.

PMID- 8361421
TI  - The stakes are high in public health.

PMID- 8361423
TI  - Football injuries in Australia at the elite level.
AB  - OBJECTIVE: To determine injury profiles for the elite level competitions of
      football played in Australia. DESIGN: Over the 1992 seasons, all injuries were
      prospectively recorded from 26 clubs in football competitions which included the
      Australian Football League (AFL), New South Wales Rugby League (NSWRL) and New
      South Wales Rugby Union (NSWRU). RESULTS: Some 2398 injuries were reported. In
      Australian Rules football, the most common injury was the hamstring tear (13%);
      this also accounted for the most time missed due to injury (16%). In rugby league
      and union, the most common injuries were head and facial lacerations (11% and
      20%) followed by concussion (8% and 5%). The injuries accounting for most time
      missed were fractures and knee ligament injuries in the rugby codes. In
      Australian Rules football there were more lower limb muscle strain injuries, a
      high proportion of which were recurrences, with a significant incidence during
      training sessions. In the rugby codes, minor injuries to the head and neck were
      more common, particularly in forwards. While rugby league players suffered the
      most injuries, AFL injuries were on average more severe and consequently the
      total time missed through injury by players in these two codes was very similar.
      Rugby union had a significantly lower injury prevalence at the elite club
      competition level than rugby league or Australian Rules football. CONCLUSION:
      Injury rates in the elite football competitions are high, warranting ongoing
      analysis and further study in particular areas.

PMID- 8361424
TI  - Australian Rules football injuries in children and adolescents.
AB  - OBJECTIVE: To ascertain the incidence, severity, risk factors, and outcomes of
      injuries in children and adolescents playing Australian Rules football. DESIGN: 
      SETTING AND SUBJECTS: A prospective cohort study of football injuries in children
      and adolescents playing community football. We studied a stratified random sample
      of 54 teams and clinics (18 under-15 teams, 18 under-10 teams and 18 Vickick
      clinics for children under 10 years) from the Melbourne metropolitan area.
      Football exposure, injuries and associated risk factors were recorded for 1253
      players during the 1992 football season. RESULTS: Vickick, a modified form of the
      game, had the lowest rates of injury for all levels of injury severity, with an
      overall rate of 3.49 injuries per 1000 player-hours. The rate in the under-10 age
      group was 2.4 times higher (95% confidence interval [CI], 1.5-3.8) than that in
      Vickick, and the under-15 rate was 1.2 times (95% CI, 0.9-1.6) that of the under
      10s. The under-15 age group had significantly more injuries that led to use of
      health services than the under-10 and Vickick groups, with rates of 3.93 (95% CI,
      2.9-4.9), 0.64 (95% CI, 0.2-1.4), and 0.33 (95% CI, 0.1-0.8) injuries per 1000
      players-hours respectively. Injuries were largely to soft tissues (sprains 26%,
      haematomas 25%) and to the lower limb (43%). Very few serious injuries occurred
      (19 fractures and three injuries with loss of consciousness); nearly all of these
      were in the under-15s. Rule modifications in under-10 teams and clinics were
      associated with an injury rate of 5.8 injuries per 1000 player-hours (95% CI, 4.4
      7.3) compared with 7.5 injuries per 1000 player-hours (95% CI, 5.2-9.8) when no
      modification was used. Alterations to the ruck contest, decreased contact, field
      size and player numbers were significantly associated with lower injury rates,
      while body size was not. Of the 30% of injuries resulting in a health service
      consultation, the most common health provider was a medical practitioner. Very
      few required expensive investigation or treatment. CONCLUSION: Injury rates were
      low in children under age 10, but higher in adolescents. Most injuries were
      minor, and did not result in a health professional consultation. Rule
      modifications were associated with substantially lower injury rates at the under
      10 level, and should be promoted as a safe way to learn football skills.

PMID- 8361425
TI  - Domestic violence victims in a hospital emergency department.
AB  - OBJECTIVE: To determine the prevalence and predictors of domestic violence
      victims among attenders at the emergency department at Royal Brisbane Hospital in
      1991. DESIGN: Cross-sectional study in which randomly selected nursing shifts
      were used to screen attenders. RESULTS: Of all attenders at the emergency
      department, 14.1% disclosed a history of domestic violence. Women were more
      likely than men to disclose domestic violence ("raw" relative risk, 2.31; 95%
      confidence interval [CI], 1.83-2.91; relative risk adjusted for age and history
      of child abuse, 4.50; 95% CI, 3.02-6.71). The greatest risks for being an adult
      victim of domestic violence were being female and having experienced abuse as a
      child. Most of those who had experienced domestic violence within the last 24
      hours (1.1% of attenders) came to the department after-hours when social work
      staff were unavailable for referral. CONCLUSIONS: The prevalence and risk factors
      have implications for the training of doctors and nurses in domestic violence
      problems and for the provision of adequate resources to deal with the
      psychosocial aspects of domestic violence.

PMID- 8361426
TI  - Hospital admissions and attendances for asthma--a true increase?
AB  - OBJECTIVE: To compare the ratio of hospital admissions for asthma to total
      hospital admissions and to admissions for non-asthma respiratory conditions, over
      an 11-year period, to see if there has been a true increase in admissions for
      asthma or merely a change in diagnostic labelling. A similar comparison was made
      for presentations with asthma and non-asthma respiratory conditions to the
      accident and emergency department. DESIGN AND SETTING: A case review of all
      patients with a confirmed diagnosis of respiratory disease admitted to hospital
      or attending the accident and emergency department at the Camperdown Children's
      Hospital between 1979 and 1989. RESULTS: There was a 98% increase in the number
      of patients admitted with a confirmed diagnosis of asthma. While the ratio of
      admissions for asthma to total admissions increased from 0.053 in 1979 to 0.09 in
      1989, the ratio of admissions for non-asthma respiratory conditions to total
      admissions remained relatively constant. The ratio of attendances for asthma to
      total accident and emergency attendances rose from 0.017 in 1979 to 0.072 in
      1989, whereas the ratio of attendances for non-asthma respiratory conditions to
      total accident and emergency attendances had a maximum variation of 0.065 to
      0.09. CONCLUSIONS: These results suggest that there has been a major increase in
      the number of cases of asthma being treated at this hospital and that this is a
      true increase, perhaps representing increased severity, rather than a change in
      diagnostic labelling.

PMID- 8361427
TI  - Hepatitis B in urban Australian schoolchildren. No evidence of horizontal
      transmission between high-risk and low-risk groups.
AB  - OBJECTIVE: To document the prevalence of hepatitis B virus (HBV) infection in
      urban Australian primary schoolchildren, and to look for evidence of horizontal
      transmission of HBV in schools between children at high risk of infection and
      those at low risk. We compared the prevalence of infection in a group of low-risk
      children attending control schools (less than 5% of students from high-risk
      groups) with the prevalence in low-risk children attending test schools (more
      than 20% of students from high-risk groups). METHODS AND RESULTS: Venous blood
      was collected and tested for hepatitis B markers by radioimmunoassay; 2883
      children (1431 boys) of mean age 11.3 years (SD, 0.7) from 50 schools were
      tested. Evidence of past or current infection was present in 169 children (5.9%).
      This number comprised three of the 1347 low-risk children (0.2%), 10 of the 602
      medium-risk children (1.7%), 154 of the 731 high-risk children (21.1%) and two of
      the 203 other children (1%). Fifty-four of the 169 infected children were
      hepatitis B surface antigen (HBsAg) positive, 36 of the 54 were also positive for
      hepatitis B e antigen (HBeAg). There was no difference between children in the
      low-risk group in test and control schools for markers of hepatitis B virus
      infection. CONCLUSIONS: A low prevalence of HBV infection was found in low-risk
      school-children irrespective of the proportion of high-risk children in their
      classes. Targeting vaccination to infants and children with known risk factors is
      the most important strategy in low endemicity countries; vaccination of children
      without risk factors could be delayed till early adolescence.

PMID- 8361428
TI  - Skin diseases in the tropics.
AB  - Australian physicians may encounter a number of tropical skin diseases. Migrants
      or visitors may travel here with a skin disease, or people living in the tropical
      or subtropical regions of Australia may develop skin conditions. The most
      important of these are cutaneous leishmaniasis, cutaneous amoebiasis, tinea
      imbricata, favus, sporotrichosis, chromomycosis, cutaneous tuberculosis, Buruli
      ulcer, cutaneous larva migrans and dracontiasis.

PMID- 8361429
TI  - Leprosy in the tropics and Australia.
AB  - Leprosy is no longer the feared disease of the past, but it still causes
      significant morbidity in countries where it is endemic, and it is estimated that
      up to 2500 million people are at risk of contracting the disease. Control with
      dapsone monotherapy over the past 20-30 years has been effective in some
      countries but secondary and, more recently, primary drug resistance is now
      widespread. This situation prompted the development of multidrug therapy regimens
      which are proving highly effective. Here the natural history and clinical
      features are described, as well as the history and impact of leprosy in
      Australia. Early diagnosis and the current multidrug regimens offer hope for long
      term control of the disease.

PMID- 8361430
TI  - Intra-arterial streptokinase in acute ischaemic stroke. A pilot study.
AB  - AIMS: To assess the safety and efficacy of the intra-arterial administration of
      streptokinase within 24 hours of acute ischaemic stroke. METHODS: Patients who
      presented to the Austin Hospital casualty department between 3 and 22 hours after
      an acute stroke were considered for the study. Eligible patients had pretreatment
      non-contrast computed tomographic scans of the brain to exclude haemorrhage.
      Streptokinase (250,000 units) was administered directly into the common carotid
      artery or the cervical portion of the internal carotid artery. MAIN OUTCOME
      MEASURES: The incidence of symptomatic and asymptomatic cerebral haemorrhage,
      haemorrhagic transformation of infarction, angiographic reperfusion, clinical
      outcome at seven to 10 days and the frequency of other complications. RESULTS:
      Thirteen patients were treated over a 16-month period. Major clinical improvement
      occurred in five patients (39%) at 48 hours. This was associated with
      angiographically demonstrated recanalisation of a middle cerebral artery
      occlusion in two patients and partial recanalisation in two others. Significant
      hypotension in two patients required therapy to be stopped. In five other cases
      mild hypotension developed but the streptokinase infusion was completed.
      Haemorrhagic transformation of the infarct occurred in four patients without
      clinical deterioration. CONCLUSION: Intra-arterial administration of
      streptokinase is safe in selected patients with acute ischaemic stroke. The
      theoretical benefit of an increased local thrombolytic effect and reduced
      systemic complications, compared with the use of higher intravenous doses,
      justifies a randomised clinical trial. If therapies such as this are to be
      successful, rapid referral to an appropriate centre is necessary.

PMID- 8361432
TI  - Prevention of HIV and HBV transmission in general practice.

PMID- 8361431
TI  - Albuminuria in aborigines and Europids of south-eastern Australia.
AB  - OBJECTIVE: To determine the prevalence of albuminuria in Aborigines and
      Australians of European descent (Europids), as part of an epidemiological study
      of glucose intolerance and cardiovascular risk factors based in country towns of
      south-eastern Australia. DESIGN: Population-based cross-sectional study, with
      Aborigines and Europids of south-eastern Australia as the reference populations.
      METHOD: Random urine samples were collected from people aged > or = 35 years, and
      tested with Albuscreen (a test kit sensitive to urinary albumin concentrations of
      0.03 g/L) and two other methods in the field. The samples were later analysed for
      the calculation of urinary albumin:creatinine ratios, which were then categorised
      according to cut-off points for abnormal renal function that have been proposed
      in the literature. RESULTS: Three hundred and six Aborigines and 553 Europids
      participated, with response rates of 90% and 94% respectively. According to
      Albuscreen, albuminuria was more common in Aborigines than in Europids. In men,
      36% (95% confidence interval [CI], 20%-52%) of Aborigines exceeded the albumin
      concentration of 0.03 g/L, compared with 14% (CI, 9%-19%) of Europids (P < 0.01);
      in women, 39% (CI, 27%-51%) of Aborigines exceeded 0.03 g/L, compared with 18%
      (CI, 12%-24%) of Europids (P < 0.01). Sixty-one per cent (CI, 44%-78%) of
      Aboriginal men had a urinary albumin:creatinine ratio of > or = 1.30 mg/mmol,
      compared with 12% (CI, 7%-17%) of Europid men (P < 0.01); 56% (CI, 44%-68%) of
      Aboriginal women exceeded this cut-off point, compared with 23% (CI, 16%-30%) of
      Europid women (P < 0.01). CONCLUSION: A higher prevalence of renal disease in the
      Aboriginal population of south-eastern Australia is expected. Risk factors for
      renal disease in Aborigines throughout Australia require elucidation.

PMID- 8361433
TI  - A report of human parvovirus B19 infection in hydrops fetalis. First Australian
      cases confirmed by serology and immunohistology.
AB  - OBJECTIVE: To present the first Australian cases of fetal hydrops induced by
      parvovirus B19. CLINICAL FEATURES: Autopsies on two cases of intrauterine fetal
      death with hydrops fetalis and pallor revealed evidence of myocarditis and
      widespread characteristic inclusion-bearing cells, predominantly erythroblasts.
      The diagnosis of hydrops fetalis induced by parvovirus B19 was confirmed in both
      cases by immunohistological localisation of the viral inclusions by means of a
      monoclonal antibody to the VP1 and VP2 proteins of parvovirus B19. A low level of
      parvovirus B19 IgM antibodies was detected in the second case. CONCLUSIONS: It is
      possible that our relatively small population and lack of familiarity with the
      histopathological features may have led to underdiagnosis rather than a true
      absence of fetal parvovirus B19 infection in Australia. The condition can be
      diagnosed and treated antenatally and therefore should be included in the
      differential diagnosis of causes of hydrops fetalis.

PMID- 8361434
TI  - Do the teaching hospitals of the University of Queensland really want a four-year
      medical course? A guarded yes.
AB  - OBJECTIVE: To gauge the measure of support among clinical teaching staff for the
      University of Queensland's proposals to introduce a four-year graduate entry
      integrated medical curriculum. SETTING: The three largest teaching hospitals of
      the University of Queensland Faculty of Medicine. METHODS: A questionnaire was
      sent to 565 consultants and 493 junior medical staff regarding deficiencies of
      the present six-year course, deficiencies in present methods of selecting
      students, and possible solutions. RESULTS: 154 (68%) full-time consultants, 174
      (51%) visiting consultants and 197 (40%) junior staff replied. Ninety per cent of
      the consultants and 60% of the junior staff were current teachers. Respondents
      strongly supported the need for major change, the integration of biomedical
      sciences into clinical teaching and the use of problem-based learning. Regarding
      selection, over 80% of respondents considered graduate entry to have no advantage
      over undergraduate entry, but there was strong support for an external
      examination including sciences. There was also strong support for broadening
      entry criteria to include common sense, motivation and empathy. Seventy-two per
      cent of consultants and 82% of juniors opposed the proposals in their present
      form. However, 52% of consultants (but only 23% of juniors) would support the
      concept of a four-year integrated course if the issue of selection criteria could
      be resolved. CONCLUSION: A majority of consultants support the concept of a four
      year integrated curriculum which uses problem-based learning methods. They do not
      support the proposed selection criteria based upon graduate entry, but would
      support a predominantly science-based selection process, not necessarily
      restricted to graduate applicants, but incorporating broader personal
      characteristics than are used at the present time.

PMID- 8361435
TI  - Frequency of bleeding in football.

PMID- 8361436
TI  - Rare disease surveillance in children.

PMID- 8361437
TI  - Recurrent bacterial meningitis associated with strongyloides hyperinfection.

PMID- 8361439
TI  - Dry mouth in HIV infection.

PMID- 8361438
TI  - Redbacks re-visited.

PMID- 8361440
TI  - Thiamine anaphylaxis.

PMID- 8361441
TI  - Heat treatment at 100 degrees C of factor VIII and IX coagulation factor
      concentrates.

PMID- 8361442
TI  - Vigabatrin in drug-resistant epilepsy.

PMID- 8361443
TI  - Ambient environment may affect saliva ferning fertility test.

PMID- 8361444
TI  - Hereditary factors in strabismus.

PMID- 8361445
TI  - Laparoscopic cholecystectomy.

PMID- 8361446
TI  - Guidelines: dying with dignity.

PMID- 8361447
TI  - The potential for elderly donors to increase renal transplantation rates in
      Australia.

PMID- 8361448
TI  - The reform of medical education.

PMID- 8361449
TI  - Addison's disease in the acquired immunodeficiency syndrome.

PMID- 8361450
TI  - Medical management of miscarriage with RU486.

PMID- 8361451
TI  - Tacrine for Alzheimer's disease.

PMID- 8361452
TI  - Ketorolac for seasonal allergic conjunctivitis.

PMID- 8361453
TI  - Influenza vaccine, 1993-1994.

PMID- 8361454
TI  - International Society of Pediatric Oncology (SIOP) XXV Meeting. San Francisco,
      California, October 5-9, 1993. Abstracts.

PMID- 8361455
TI  - Public health focus: physical activity and the prevention of coronary heart
      disease.
AB  - Coronary heart disease (CHD) is the leading cause of mortality in the United
      States: each year, CHD is newly diagnosed in approximately 1.5 million persons
      and accounts for an estimated $47 billion in direct and indirect health-care
      costs (1). Multiple risk factors associated with CHD include genetic
      susceptibility, elevated serum cholesterol, low levels of high-density
      lipoprotein cholesterol, cigarette smoking, uncontrolled hypertension, obesity,
      diabetes mellitus, and physical inactivity (2). This report summarizes
      information about the potential efficacy and cost-effectiveness of physical
      activity promotion as a strategy for preventing CHD.

PMID- 8361456
TI  - Handwashing and glove use in a long-term-care facility--Maryland, 1992.
AB  - Residents of long-term-care facilities (LTCFs) are at risk for acquiring facility
      associated infections and consequent mortality (1,2). Despite this risk, no
      national guidelines exist for infection-control practices in LTCFs, and
      information regarding the nature of infection-control practices in LTCFs is
      limited. To evaluate glove use and handwashing practices in an LTCF, and to
      determine factors associated with compliance with infection-control policies and
      the frequency of microbial transmission, Maryland Department of Health and Mental
      Hygiene (DHMH) and CDC staff observed glove use and handwashing practices on a
      chronic-care ward of an LTCF in Maryland for a 1-month period during 1992. This
      report summarizes the findings of this study.

PMID- 8361457
TI  - Alcohol use and aquatic activities--United States, 1991.
AB  - Drowning, a leading cause of death from unintentional injury in the United
      States, accounted for approximately 4600 fatalities in 1991 (1,2). Although 25%
      50% of adolescents and adults who drowned had consumed alcohol near the time of
      death (3), information regarding drinking behaviors during aquatic activities is
      limited. To assist in refining strategies for prevention of alcohol-related
      injury in aquatic settings, during July 15-September 30, 1991, the Boston
      University School of Public Health surveyed a national sample of adolescents and
      adults regarding their participation in aquatic activities and associated alcohol
      use. This report summarizes these findings.

PMID- 8361458
TI  - Characteristics of death certifiers and institutions where death is pronounced-
      Fulton County, Georgia, 1991.
AB  - Information from death certificates (DCs) is used to measure health status and to
      set public health priorities at all levels in the United States. However, because
      of limitations in the training of physicians who certify deaths, the completeness
      and accuracy of cause-of-death information varies (1-3). To develop a basis for
      targeting education of physicians who certify deaths, CDC, in cooperation with
      the Fulton County (Georgia) Vital Records Office, reviewed a consecutive series
      of 500 DCs filed in Fulton County (1990 population: 648,951) from April 10
      through May 2, 1991, to characterize the number and proportion of personal
      physicians (PPs) (defined as physician certifiers not acting in the capacity of
      medical examiners or coroners [MECs]) and MECs certifying death, as well as other
      factors. This report summarizes the results of that review.

PMID- 8361459
TI  - Adult blood lead epidemiology and surveillance--United States, second quarter,
      1993.

PMID- 8361460
TI  - New pediatric formulation of Recombivax HB.

PMID- 8361461
TI  - Influenza A outbreaks--Louisiana, August 1993.
AB  - In August 1993, the Louisiana Department of Health and Hospitals (LDHH)
      investigated reports of acute respiratory illness among residents of two nursing
      homes and workers on a dredging barge in southern Louisiana; influenza type A has
      been confirmed as the cause of these outbreaks. This report summarizes the
      investigations of the outbreaks.

PMID- 8361462
TI  - Behavioral Risk Factor Surveillance System--Michigan, 1987-1991.
AB  - A national health objective for the year 2000 is to implement periodic analysis
      and publication of each state's progress toward the objectives for each
      racial/ethnic group that constitutes at least 10% of the state's population
      (objective 22.5a). In Michigan (1990 population: 9.3 million), blacks represent
      approximately 12% of the adult population*; prevalence estimates for risk factors
      for the black population derived from the Behavioral Risk Factor Surveillance
      System (BRFSS) have varied in consistency because of the limitations of small
      sample sizes. To improve the precision of risk factor prevalence estimates for
      blacks in Michigan and to improve measurement of the state's progress toward the
      national year 2000 objectives for blacks, in 1993, the Michigan Department of
      Public Health (MDPH) aggregated annual state BRFSS data for 1989-1991. This
      report summarizes the findings of this analysis and compares them with an
      analysis of annual state BRFSS data for 1987-1991.

PMID- 8361463
TI  - Tuberculosis morbidity--United States, 1992.
AB  - In 1992, 26,673 cases of tuberculosis (TB) (10.5 cases per 100,000 population)
      were reported to CDC from the 50 states, the District of Columbia, and New York
      City, a 1.5% increase over the number reported in 1991 (26,283 [10.4 cases per
      100,000]). In addition, 370 cases were reported from Puerto Rico (312) and the
      U.S. territories (58). This report summarizes final TB surveillance data for 1992
      and compares findings with previous years.

PMID- 8361464
TI  - Public health focus: impact of safety-belt use on motor-vehicle injuries and
      costs--Iowa, 1987-1988.
AB  - Each year in the United States, motor-vehicle-related trauma results in
      approximately 40,000 deaths, 5.4 million nonfatal injuries, and $15.4 billion in
      direct medical costs and costs of emergency services. The use of safety belts
      reduces the number and severity of injuries from motor-vehicle crashes, and since
      states began enacting safety-belt laws, the prevalence of safety-belt use in the
      United States has increased substantially. In Iowa, where a safety-belt use law
      was enacted in 1986, the observed rate of safety-belt use increased from 18% in
      1985 to 55% in 1988. Data from the Iowa Safety Restraint Assessment were used to
      estimate the effect of this increase on injury severity and hospital costs and to
      estimate the statewide savings in direct costs (i.e., hospital and professional
      fees) and indirect costs (i.e., administrative costs and loss of productivity)
      for 1 year. This report summarizes the findings of this study.

PMID- 8361465
TI  - Update: hantavirus-associated illness--North Dakota, 1993.

PMID- 8361466
TI  - Sensitivity of the test for antibody to hepatitis B surface antigen--United
      States.
AB  - Beginning in March 1986, some test kits for antibody to hepatitis B surface
      antigen (anti-HBs) were modified to increase sensitivity, and new anti-HBs tests
      were introduced with increased sensitivity for detecting anti-HBs. To assess the
      impact of this increased sensitivity on the interpretation of hepatitis B
      postvaccination testing results, the Food and Drug Administration (FDA) conducted
      a study of currently distributed anti-HBs test kits to determine the lower limits
      of their sensitivity relative to the World Health Organization (WHO) Anti-HBs
      Reference Preparation. In addition, CDC conducted a study among a group of
      vaccinated public safety workers to determine the positive predictive values of
      the current anti-HBs tests when used to evaluate immunity after hepatitis B
      vaccination. This report provides background to and summarizes the results of
      these two studies.

PMID- 8361467
TI  - [Usefulness of subtotal colectomy with colorectal anastomosis for chronic
      ulcerative colitis].
AB  - Recently in Japan, most of surgeons have been performing restorative
      proctocolectomy with ileoanal anastomosis for ulcerative colitis, leaving
      unsolved problems with regard to postoperative complications. Analysis was made
      on subtotal colectomy with colorectal anastomosis with the following policies.
      Firstly, the inflammation of the remnant intestine could be easily and correctly
      controlled by medication in outpatient. Secondly, carcinomas associated with
      ulcerative colitis can be discovered by postoperative colonoscopic examinations.
      Operations were carried out to 26 cases of ulcerative colitis for the past 13
      years. Subtotal colectomy with colorectal anastomosis were performed to 11 cases.
      Three cases of colorectal carcinomas associated with ulcerative colitis were
      experienced. One of the resected specimen was investigated using stereomicroscopy
      after alcian blue staining to formalin fixed one. As a result of this research,
      we have convinced that colorectal anastomosis should be favorable surgical potion
      to the cases of chronic ulcerative colitis because postoperative anal function
      and quality of life are excellent in our series, in addition, carcinomas in the
      remnant intestine can be probably easily found out at the early stage by annual
      colonoscopic examinations with dye staining.

PMID- 8361468
TI  - [Anatomical measurements of the internal anal sphincter--the relative site of the
      dentate line in the internal anal sphincter].
AB  - Not only the length and the width of the internal anal sphincter but also the
      relative site of the dentate line in the internal anal sphincter were
      investigated in 62 resected specimens obtained by abdominoperineal resection of
      the rectum for malignancy. Mean length and width of the internal sphincter were
      25.8 +/- 4.1mm (mean +/- standard deviation) and 4.0 +/- 1.1mm, respectively. The
      length of the internal sphincter from its distal end to the level of the dentate
      line was 11.3 +/- 3.1mm, which corresponded to 44% of the total length of the
      internal sphincter. The individual difference in the site of the dentate line in
      the internal sphincter was objectively demonstrated. It seems to be therefore
      important to modulate the extent of sphincterotomy in order to minimize
      postoperative anal dysfunction on the surgery for fissure or fistula-in-ano, in
      which sphincterotomy is widely practiced up to the level of the dentate line.

PMID- 8361469
TI  - [Therapeutic plasmapheresis to treat postoperative hepatic failure clinical
      course and therapeutic outcome in Japan].
AB  - The most serious hepatic complication after surgical procedure is postoperative
      hepatic failure. There is no therapy for this condition except plasma exchange.
      Precise clinical definition of postoperative hepatic failure was discussed based
      on a questionnaire distributed by the association in 1989, and in 1991 by the
      working group. Giving special consideration to the use of therapeutic
      plasmapheresis, the clinical definition of postoperative hepatic failure was
      established as hepatic injury after surgery, without obstructive causative
      factors, laboratory values for total bilirubin over 5mg/dl with continuous
      elevation, and hepaplastin activity under 40%. Key factors in determining
      initiation, efficacy, and cessation of plasmapheresis were coma grade (II-III),
      total bilirubin levels, and the activities of coagulation tests. The majority of
      underlying diseases were hepato-biliary in nature. The causative factors of
      hepatic injuries were massive bleeding and infection. The morbidity was estimated
      at 600 to 3000 cases/year. The frequency of plasma exchange was one session
      every/1.4-1.6 days. The volume of exchanged fresh frozen plasma was about 3292
      ml/a session. Nafamostat mesilate was used as an anticoagulant. The survival rate
      was 14% to 40%. Earlier initiation of plasma exchange is indicated.

PMID- 8361470
TI  - [Experimental study of liver regeneration and tumor growth following partial
      hepatectomy].
AB  - An experimental study was performed aiming to clarify the mechanism of early
      recurrence of hepatocellular carcinoma following hepatectomy. AH109A ascites
      hepatoma cells were implanted in a liver or subcutaneous tissue of male Donryu
      rats 5 days prior to 70% partial hepatectomy (H group) or simple laparotomy (L
      group) or non operation control (C group). Rats were sacrificed at 1, 3, 7
      postoperative days. Tumor size, labelling index (LI), tissue blood flow (TBF) and
      regeneration rate of the remnant liver were measured. Tumor size of the remnant
      liver in hepatectomy group was 492 +/- 117 mm3 against 129 +/- 63 mm3 in
      laparotomy group showing enhancement of tumor growth following partial
      hepatectomy with statistical significance (p < 0.01). On the contrary, there was
      no difference in the growth of subcutaneous tumor among H, L, C group. A
      significant increase of LI in both liver and subcutaneous tumor cells comparable
      to regenerating liver cells at 24 hours after hepatectomy was observed in H
      group. It suggests that some humoral hepatotrophic factors increased DNA
      synthesis of not only tumor cells but liver cells. TBF in the tumor and remnant
      area of the liver were increased. This result supports that increased
      hepatotrophic factors and TBF led to the enhancement of tumor growth in the
      remnant liver following partial hepatectomy.

PMID- 8361471
TI  - [Modes of spread and surgical strategy for gallbladder carcinoma with subserosal
      invasion].
AB  - The mode of spread and the prognosis were investigated in 22 patients with
      resected gallbladder carcinoma invading the subserosal layer. By the Kaplan-Meier
      method, the 5-year survival rate was 68.8% in patients receiving curative or
      relatively noncurative resection. On the other hand, no patient survived for more
      than 3 years after noncurative resection. The mode of subserosal infiltration was
      classified according to the general rules for gastric cancer study. At least
      systemic lymph node dissection (R2) should be performed in patients with ss alpha
      cancer, because lymph node metastasis in these patients were confined to the 1st
      group. More extensive lymph node dissection (R2 with 9, 16) is essential for
      patients with ss beta and ss gamma, because lymph node metastasis to at least the
      2nd group were seen in 75% of them. The surgical margin was positive for cancer
      in all patient with infiltration of the hepatoduodenal ligament. Therefore, it
      was considered that hepatoligamentectomy should be performed in these patients to
      obtain a cancer free surgical margin. Among patients undergoing curative or
      relatively noncurative resection, the recurrence rate was 43% in those with lymph
      node metastasis and 50% in those with DNA aneuploidy. Therefore, it appears that
      adjuvant chemotherapy should be given to such patients.

PMID- 8361472
TI  - [Hormone therapy of tamoxifen in resected carcinoma of the pancreas].
AB  - Greenway et al reported estrogen receptor existed in the carcinoma of the
      exocrine pancreas in 1981. We followed the study by using immunohistochemical
      method with monoclonal antibody ER-D5 (Amersham) and found high levels of
      estrogen receptor in 21 cases out of 27 carcinomas of the pancreas (77.8%).
      Furthermore, we gave randomly the hormone therapy by Tamoxifen 20 mg per day
      adding to immuno-chemotherapy (Tegaful, Mitomycin, Krestin, OK-432) to the
      patients with resected carcinoma of the pancreas. There was no significant
      difference of the survival rate of pancreatic carcinoma without hormone therapy
      between 10 cases with estrogen receptor and 4 cases without estrogen receptor at
      the 6th month and 12th month. However, in cases treated by Tamoxifen, remarkable
      high survival rate at 12 months of 11 cases with estrogen receptor was obtained
      to be 85.7% according to Kaplan-Meier method. Two cases without estrogen receptor
      died within 5 months. One year survival rate of Tamoxifen group (13 cases) was
      78.6% and that of non Tamoxifen group (14 cases) was 21.4%. These findings
      indicated that estrogen receptor existed at the high level in the carcinoma
      tissues of the pancreas and anti-estrogen treatment might offer a new approach to
      the treatment of pancreatic carcinomas.

PMID- 8361473
TI  - [Experimental study of multi-visceral transplantation in dogs].
AB  - The purpose of the present study was to examine the technical, functional and
      immunologic aspects in the multivisceral transplantation using canine model.
      After removal of upper abdominal organs en bloc, the composite graft including
      the liver, pancreas, spleen and duodenum was orthotopically transplanted in 35
      dogs. Ten recipients survived more than 3 days, and 6 more than 6 days. Cause of
      early death was massive lymphatic leakage, and late death was due to acute
      rejection or other complications. As technical considerations, perfusion of the
      graft should be only via aorta to prevent pancreatic edema, and reperfusion
      should be at first with arterial blood flow to minimize the ischemic damage of
      the graft. Hepatic and pancrease-endocrine functions were recovered by 3 days,
      after grafting, and 2-3 days later pancreas-exocrine function was restored.
      Thereafter the hepatic function was progressively deteriorated again from 6 to
      8th day, although the pancreatic function was well maintained until death. At
      autopsy this hepatic dysfunction was histologically confirmed to be caused by
      severe acute rejection. On the other hand, the pancreas and duodenum were
      morphologically almost normal. The results demonstrated the dissociation in
      functional recovery after grafting and extent of rejection reaction among each
      grafted organ in the multivisceral transplantation.

PMID- 8361474
TI  - [Full thickness chest wall resection for recurrent breast cancer with reference
      to prognostic factors].
AB  - Full thickness chest wall resection surgery has been carried out in 16 patients
      with local recurrence after previous mastectomy. Seven of 16 patients had
      isolated chest wall recurrence, but 9 had mediastinal invasion and/or distant
      metastasis of carcinoma. Recurrent breast carcinoma involving the bony chest wall
      was resected, and the chest wall defects were reconstructed with myocutaneous
      flaps using rectus abdominis or latissimus dorsi, or breast flap. Marlex mesh was
      utilized under the flap in 10 patients. The 3 year survival probability was 79%
      and the 5 year one was 57% with mean follow-up period of 43 month. Local
      recurrence was classified into 3 types according to cancer infiltration; i.e.,
      demarcated, scattered and diffuse types. The patients with demarcated type showed
      better prognosis than those with diffuse type. Patients who received curative
      surgery showed better prognosis than those receiving palliative surgery. A
      disease free interval (DFI) after mastectomy longer than 5 years correlated well
      with a long survival rate after chest wall resection. Thus, local recurrence
      presenting demarcated tumor with possible curative surgery as well as a longer
      DFI after mastectomy is a favorable prognostic factor for full thickness chest
      wall resection.

PMID- 8361475
TI  - [Results of arterial reconstruction in Buerger's disease].
AB  - One hundred and eight bypass operations for Buerger's disease were performed
      between November 1976 and August 1990. The bypass procedures, prostheses,
      cumulative patency rate and the influence of smoking on the results were
      discussed. Five-year cumulative patency rate of Aorto-femoral bypass was 88.2%.
      Aorto-femoral bypass should be always indicated as a standard procedure for the
      iliac lesion in Buerger's disease, because the patency rate was very low in aorto
      iliac bypass group or ilio-femoral bypass group. Five-year cumulative patency
      rate of infrainguinal bypass using autogenous vein was 64.8%, and that in the
      patients who quit cigarette smoking was as high as to 73.3%. We should use
      autogenous vein as much as possible for infraiguinal bypass and discontinuance of
      cigarette smoking is considered to be one of the important factors to improve the
      patency rate in Buerger's disease.

PMID- 8361477
TI  - [The production of spontaneous liver metastasis model from colon carcinoma in
      nude mice: preliminary report].

PMID- 8361476
TI  - [A case report of atypical Fabry's disease with colon cancer].
AB  - An atypical case of Fabry's disease, a rare congenital disorder of glyco-lipid
      metabolism, associated with sigmoid cancer was reported. A 50-year-old man who
      had been diagnosed as having atypical form of Fabry's disease complained of lower
      abdominal pain and difficult defection. A barium enema and an endoscopic
      examination disclosed sigmoid colon cancer. The cancer was curatively resected.
      Fabry's disease is often associated with intestinal disease, but the patient with
      Fabry's disease associated with intestinal malignancy has not been reported.

PMID- 8361478
TI  - [Stimulation of tissue lipoprotein lipase activity in cancer cachectic rats:
      preliminary report].

PMID- 8361479
TI  - [In vitro establishment of murine class II MHC antigen restricted autoreactive T
      helper cell clone and its antitumor effect: preliminary report].

PMID- 8361480
TI  - [Three-dimensional angio-computed tomography of coronary arteries: preliminary
      report].

PMID- 8361481
TI  - [Expression of elongation factor 1 gamma-related sequence in human gastric
      cancer: preliminary report].

PMID- 8361482
TI  - [Tyrosine protein kinase: role in the process of activating lymphocytes].
AB  - Some types of receptor and intracellular protein-tyrosine kinases are reviewed.
      These enzyme systems play an important role in activation of T- and B-lymphocytes
      and their precursors. The relationship is shown between the two main ways of
      lymphocyte activation: the phosphatidylinositol metabolic pathway, induced by
      protein kinase C, and the protein-tyrosine kinase pathway of intracellular
      protein and enzyme phosphorylation.

PMID- 8361483
TI  - [Genotoxic modification of nucleic acid bases and biological consequences of it.
      Review and prospects of experimental and computational investigations].
AB  - The review is presented of experimental and computational data on the influence
      of genotoxic modification of bases (deamination, alkylation, oxidation) on the
      structure and biological functioning of nucleic acids. Pathways are discussed for
      the influence of modification on coding properties of bases, on possible errors
      of nucleic acid biosynthesis, and on configurations of nucleotide mispairs. The
      atomic structure of nucleic acid fragments with modified bases and the role of
      base damages in mutagenesis and carcinogenesis are considered.

PMID- 8361484
TI  - [Preparation of hybrid proteins consisting of human interleukin-2 and the
      cytotoxic A-subunit of Shigella toxin].
AB  - Recombinant plasmids providing the synthesis of chimeric proteins consisting of
      amino acid sequences of human interleukin-2 (IL-2) and Shiga toxin cytotoxic A
      subunit (ILA and AIL chimeric toxins) were constructed. The ILA and AIL chimeric
      toxins were shown to inhibit protein synthesis in the rabbit reticulocytes cell
      free system. These chimeric toxins displayed two opposite activities of the
      constituent parts of their molecules on T-lymphocytes from the peripheral blood
      of healthy volunteers. Hybrid protein AIL (approximately 10(-6) g/ml) has caused
      the most significant depression of T-lymphoblast proliferation.

PMID- 8361485
TI  - [Use of a series of synthetic peptides and purified major histocompatibility
      complex I (H-2K(b)) molecules for inhibiting T-suppressors, specific for the K(b)
      molecule, and their induction by peptides in vivo].
AB  - Six synthetic peptides of the MHC class 1 molecule corresponding to individual H
      2kb participants in amino acid sequences of domains alpha 1 (peptide 1 and 2) and
      alpha 2 (peptide 3, 4, 5, 6) were selected. Kb-specific suppressor T cells (Ts)
      were in vivo in mice, then pretreated with a set of peptides and assayed by
      proliferation decrease in the third-partial mixed lymphocyte culture (MLC).
      Effector function of Ts was abolished by the complex of the alpha 2-domain
      peptides (but not by the alpha 1-domain peptides) and decreased by each peptide
      (4, 5, 6) of the alpha 2-domain. Both alpha 1 and alpha 2 domain peptides, added
      at high concentrations, decreased the otherwise efficient enrichment of Ts during
      the absorption-elution procedure on the syngeneic macrophage (MP) monolayers. A
      similar significant effect was observed the purified Kb molecule (100 mg/ml) on
      the allogeneic MP monolayer. Interaction between Ts receptors with some MHC
      peptides indicates effector Ts activation in vivo by induction with peptides 5+6
      of the alpha 2 domain. The fine mechanisms of interaction between MHC class I
      molecule epitopes and T cell receptors (TCR) of each of the T cell subsets
      separately are under study now.

PMID- 8361486
TI  - [Nonenzymatic covalent modification of human hemoglobin by pyridoxal-5-phosphate
      under the effect of visible light].
AB  - Under the action of visible light, PLP with apo-, oxy- and deoxy-Hb at 4-20
      degrees C and neutral pH produced adducts stable to dialysis and Sephadex gel
      filtration. The stable adduct formation enhanced with an increase in radiation
      intensity and/or irradiation time. Under light, production of stable adducts
      occurred most effectively for apo-Hb and was significantly slowed down in the
      case of met-Hb as well as in the presence of an electron acceptor, methylene
      blue. PLP-Hb adducts possessed intense fluorescence coinciding in properties with
      the fluorescence of stable PLP adducts obtained after Schiff base reduction by
      NaBH4. Stable adduct formation is assumed to proceed owing to Schiff base aldimin
      link reduction by photoejected electrons. During isoelectrofocusing of
      hemoglobins which had formed stable adducts with PLP under light or after NaBH4
      treatment of solutions, essentially the same pictures were observed as to the
      number of new bands and their position in the isoelectroforegram, with the band
      intensity being different. This is related to the distinctions in the electron
      seeking properties of the Schiff bases produced by PLP with alpha-NH2 groups of
      Val-1 and epsilon-NH2 groups of lysine residues of the protein alpha- and beta
      chains.

PMID- 8361487
TI  - [Calorimetric studies of the effect of amino acid replacements 16Gln-Leu and
      26Tyr-Asp on the structural organization and stability of the Cro-repressor from
      phage lambda].
AB  - The scanning calorimetry technique has been used to study the influence of amino
      acid substitutions on thermodynamic parameters of formation and stabilization of
      a cooperative structure of Cro repressor of bacteriophage lambda molecule. It is
      shown that substitutions 16Gln-Leu and 26Tyr-Asp enhances the protein molecule
      stability by 32 degrees C as compared with the wild-type protein. It is also
      demonstrated that the denaturation enthalpy of the mutated Cro differs slightly
      from that of the wild-type protein at the same temperature, while the effective
      enthalpy value is significantly lower. The analysis of excess heat capacity of
      the mutated protein shows that this complex function determined experimentally is
      approximated by two functions, which is indicative of the presence of two quasi
      independent transitions. Thus, the stabilization and redistribution of
      intermolecular interactions evoked by the above substitutions leads to
      disintegration of the single cooperative repressor molecule in two interacting
      cooperative domains. The plausible mechanism of formation of such a domain
      structure is discussed on the basis of the available calorimetric data.

PMID- 8361488
TI  - [Features of the biogenesis of Escherichia coli alkaline phosphatase during its
      supersynthesis].
AB  - The oversynthesis of the secreted alkaline phosphatase (PhoA) in E.coli K12802
      cells due to transformation with the PhoA+ plasmid pHI-7 leads to a change in its
      biogenesis--alternative localization and accumulation of the enzyme intermediate
      forms corresponding to different stages of the its post-translational
      modification. Instead of the soluble PhoA available in the parent strain mostly
      as a completely processed mature metazyme III localized in the periplasm, five
      enzyme forms were discovered in the PhoA overproducer: a cytoplasmic PhoA
      precursor (prePhoA) as insoluble aggregates; three soluble metazymes of a mature
      active form localized in the periplasm as in well as in culture medium; and a
      soluble high-molecular form in the periplasm. PrePhoA was isolated and purified
      by removal of soluble cell fractions using differential centrifugation,
      solubilization of membrane proteins with Triton X100, dissolution of the
      aggregates in the buffer with 8M urea and FPLC on MonoQ. Extracellular PhoA was
      purified by ultrafiltration, thermal treatment, and gel chromatography on
      Sepharose CL-4B. It was shown that the isolated prePhoA can be transformed into a
      mature form in the presence of a leader peptidase in 0.8 urea and is completely
      cleaved with proteinase K. Three forms of the mature PhoA vary in resistance to
      proteinase K and trypsin. Metazyme I, the unprocessed mature PhoA, is the most
      resistant to proteolysis.

PMID- 8361490
TI  - [Poly(U)-dependent interaction of yeast tRNA(Phe) and its fragments with
      Escherichia coli ribosomes. II. Localization of tRNA binding centers with a P
      site].
AB  - Poli(U)-dependent binding of yeast tRNA(Phe) lacking the 3'-terminal CA or CCA
      residues, and fragments of tRNA prepared by splitting the tRNA(Phe) at the G18 or
      7mG46 nucleotides, to the 70S ribosomal P-site was studied. Equilibrium binding
      constants and free energies of binding were measured. The contribution of C74 and
      C75 was estimated at 3.9 kJ/mol and 3.0 kJ/mol, respectively, at 10 mM Mg2+ and
      30 degrees C. The free energies of the binding of the anticodon arm the tRNA
      lacking its CCA terminus, and the tRNA fragment containing bases N1-N45 were
      found to be nearly equal. These results indicate that only the anticodon arm and
      the CCA terminus take part in deacylated tRNA-P-site interaction.

PMID- 8361489
TI  - [Expression of the Oct-2 protein during cell differentiation in vivo and in
      vitro].
AB  - The expression of an Oct-binding protein Oct-2 was studied during differentiation
      of three cell lines. Two inductors were used in our experiments: retinoic acid
      and DMSO. It was shown that all these cells have heterogeneous population of Oct
      2 mRNA. Under differentiation the pattern of Oct-2 RNA and expression of active
      Oct-2 proteins was changed.

PMID- 8361491
TI  - [Expression of the gene for transforming growth factor type alpha, transferred
      into A431 cells by a recombinant retroviral vector].
AB  - Cells of human epidermoid carcinoma A431 were used for obtaining of the cell line
      constantly expressing TGF-alpha. Recombinant virions were obtained by introducing
      the proviral DNA into PA317 cells by means of electrotransfection. A protein with
      the EGF-competing activity was found in a conditioned media of the chosen clone
      A431/1522-4. The concentration of this protein was several times higher than in a
      conditioned media of wild type A431 cells. By means of electrophoresis,
      isoelectric focusing, and immunochemical analysis it was shown that the protein
      is TGF-alpha. Similarly to EGF, the extracted TGF-alpha entirely displaced 125I
      EGF specifically bound to receptor. TGF-alpha produced by the A431/1522 cells
      also stimulated autophosphorylation of the EGF receptor.

PMID- 8361492
TI  - [Electron-microscopic study of the morphology of scaffold-like structures in
      chromosomes, formed by formamide].
AB  - Isolated human metaphase chromosomes treated with formamide and prepared for
      electron microscopy by protein monolayer technique have an appearance of loop
      shaped chromatin fibers coming off the central scaffold-like structures, such
      chromosomes having approximately the same histone content as those before
      treatment. The morphology of scaffold-like structures at different formamide
      concentrations is described. It is shown that during formamide treatment the
      protein-protein and/or protein-DNA interactions are weakened because of
      disruption of hydrogen bonds. However, the intermolecular interactions in the
      chromosomes allow them to preserve their shape and size. The changes in the
      structure of formamide-treated chromosomes become readily visible after spreading
      on the hypophase surface. It is shown that after removal of formamide from the
      incubation solution by dialysis, chromosomes condense drastically. The data
      obtained are in good agreement with the loop model of chromosome organization.
      However they evidence also that the scaffold in the form of a rigid
      characteristic chromosome structure arises as a result of redistribution and/or
      aggregation of chromosomal proteins during chromosome preparation.

PMID- 8361493
TI  - [Formation of various types of complexes upon the interaction of anthraquinones
      with DNA].
AB  - The optical properties (circular and linear dichroism) of the 11 anthraquinone
      antibiotics complexed with DNA molecules under conditions giving rise to
      cholesteric liquid-crystalline dispersions were investigated. Complexes of
      compounds A911 and A912 with double-stranded linear or circular DNA molecules
      differ strongly in their properties from those of other anthraquinones. The
      possible reasons of these differences and their possible correlation with the
      biological activity of the A911 and A912 are discussed.

PMID- 8361494
TI  - [Immunoreactivity of synthetic peptides, corresponding to B-cellular epitopes of
      human type I T-lymphotrophic virus structural proteins].
AB  - The immunoreactivity of 25 synthetic peptides corresponding to amino acid
      fragments of the HTLV-I structural proteins p19 gag, gp46 and gp21 env were
      studied in enzyme linked immunosorbent assay using a serum panel of 70 reference
      positive specimens with anti-HTLV-I antibodies. The location of the synthetic
      peptides containing the B-cell epitopes of HTLV-I was established. Anti-HTLV-I
      antibodies effectively recognized these peptides. The significance of some amino
      acids for forming the HTLV-I antigenic determinants was estimated. The synthetic
      peptides with amino acid sequences 100-130 p19 gag and 176-201 gp46 env were
      found to have most immunoreactivity (90-99% recognition by sera of HTLV-I
      infected patients) and mimic the immunodominant B-cell epitopes of HTLV-I
      structural proteins.

PMID- 8361495
TI  - [Loss of total 5-methylcytosine from the genome during cell culture aging
      coincides with the Hayflick limit].
AB  - Analyzing the data about the age-related 5-methylcytosine (5mC) loss from DNA of
      cell cultures, the following conclusions have been made: 1. The rate of 5mC loss
      from DNA does not depend on the cell donor age; it remains constant during the
      logarithmic phase of cell growth, and may vary significantly in different cell
      lines. 2. The rate is inversely proportional to their Hayflick limit and to the
      species lifespan of cell donors. 3. In immortal cell lines the 5mC content in DNA
      is stable or increases with aging. 4. Hayflick limit estimations coincide with or
      are lower than the number of cell population doublings that corresponds to all
      5mC loss from cell genome. A simple and fast method has been proposed for
      Hayflick limit prognostication by analysis of the rate of DNA hypomethylation. It
      may be used for early diagnosis of precrisis and immortal cell lines. Evidence
      has been obtained that age-dependent 5mC loss from DNA is the result of
      accumulating 5mC-->T+C substitutions that occur during DNA methylation in every
      cell division. The loss of all genomic 5mC residues during the lifespan may
      correspond to accumulation of about 3 x 10(6) 5mC-->T transitions or, on average,
      one mutation per gene. This may be one of the main reasons of the "catastrophe of
      errors" and cessation of cell proliferation. It is calculated that the rate of
      5mC-->T transitions in normal cells may be 2.3 x 10(-5) per site in each cell
      doubling in human, 6 x 10(-5) in hamster, and 4.6 x 10(-4) in mouse. DNA
      methylation as a generator of mutations may be a "counter" of cell divisions and
      thus be one of the molecular mechanisms of the Hayflick phenomenon. The
      conclusion is made that the DNA methylation system may be considered as a
      genetically programmed mechanism for accumulating mutations during cell aging.

PMID- 8361496
TI  - [Characteristics of the pH2-42 probe for the D13S25 locus of human chromosome 13:
      nucleotide sequence, localization, and PCR markers].
AB  - The sequence of the HindIII-HindIII fragment of probe pH2-42 of locus D13S25 of
      human genome is given. Localization of the probe in q14-q21 of human chromosome
      13 is confirmed by hybridization in situ. Seven oligonucleotide primers for the
      polymerase chain reaction are chosen so that amplified products almost completely
      cover the analyzed sequence. Reconstruction of localization of polymorphic SspI
      sites in D13S25 was based on the data of Bowcock and Hebert [3] and this study.
      The results obtained make it possible to use the primer sets to screen cosmid
      libraries and to mark the D13S25 locus of human chromosome 13.

PMID- 8361497
TI  - [Formation and properties of S-protein complexes with S-peptide-containing hybrid
      polypeptides].
AB  - The fused polypeptides of human epidermal growth factor and one or two S-peptide
      of RNase A was shown to form stoichiometric (1:1) strong noncovalent and
      enzymatically active complexes with S-protein of RNase A. The dissociation
      constants for these complexes were found to be 5.0 x 10(-7) M and 1.1 x 10(-7) M.
      The complexes of polypeptides with S-protein were capable to hydrolyze
      ribopolynucleotides, and pyrimidine-2',3'-cyclophosphates specifically, like
      RNase S'. A possibility was shown of effective purification of the S-peptide
      containing polypeptides by affinity chromatography in which S-protein is
      immobilized on solid supports.

PMID- 8361498
TI  - [Functioning and silent regrouped immunoglobulin genes in the hybridoma genome].
AB  - Rearranged genes for heavy and light immunoglobulin chains have been studied in
      the genomes of hybridoma PTF-02 and parent myeloma P3-X63.Ag8.653. The hybridoma
      was shown to contain three rearranged allelic variants of the heavy chain gene's
      locus. Gene H2, responsible for the synthesis of the heavy chain of the antibody
      to transferrin, was transmitted to the hybridoma cell from a lymphocyte. The
      structure of the 5'-terminal codons of this gene corresponds to N-terminal amino
      acid residues of a heavy chain expressed by PTF-02 hybridoma. Two other genes (H1
      and H3) were found both in the hybridoma and parent myeloma. Both H1 and H3 genes
      have serious defects in their structure and do not function. Rearranged k-genes
      were also identified both in the hybridoma and parent myeloma. A functional (K2)
      gene appeared in the hybridoma genome from an antigen-stimulated lymphocyte. The
      fetal mouse Vk gene, which has high homology (96.5%) with the K2 gene, was cloned
      and sequenced. Both K2 and the Vk fetal gene belong to one subfamily of k-genes.
      The rearranged gene K1 is nonfunctional because it has lost the Jk locus. This
      gene was transmitted from myeloma used for fusion. In such a way, the origin of
      all rearranged heavy and light chain genes in hybridoma PTF-02 was established.

PMID- 8361499
TI  - [Model of the spatial structure of peptide T].
AB  - The spatial structure model of peptide T (AIDS reproduction inhibitor, the amino
      acid sequence of which corresponds to the fragment into the binding site of the
      virus protein gp120 with T4 receptor) is proposed. Peptide structure modelling
      has been carried out by the previously developed method based on joint usage of
      the molecular mechanics algorithms and NMR spectroscopy data. To build the model,
      two-dimensional nuclear Overhauser effect spectroscopy data for RNase A
      homologous fragment 22-26 were taken from the literature. The result of the
      presented work was a set consisting of six types of low-energy structures with
      different spatial packing of the peptide main chain. All structural types have
      been shown to be characterized by the lack of strict determination of the side
      chain conformations of the amino acid residues that can be realized in a few
      states providing approximately equal (within the given type) stabilization of one
      main chain form. At the same time, despite the definite differences, all of the
      selected structures were characterized by the presence of two consecutive reverse
      polypeptide chain turns at the C-terminal pentapeptide fragment. This site is
      supposed to be responsible for the peptide binding with T4 receptor and the
      antiviral effect.

PMID- 8361500
TI  - [Creation of a hybrid protein gene based on Bacillus thuringiensis delta
      endotoxins CryIIIA and CrIA(a) and expression of its derivatives in Escherichia
      coli].
AB  - The 5'-terminal fragment (containing 1-565th codons) of Bacillus thuringiensis
      var. tenebrionis gene for the Coleoptera-specific delta-endotoxin CryIIIA was
      cloned. This sequence was extended with either only a homologous fragment of
      CryIA(a) or that one together with in-frame NPTII or GUS coding sequences. The
      obtained gene derivatives were expressed in E. coli. The analysis of hybrid
      polypeptides confirmed the enzymatic activities of bifunctional proteins and
      showed toxic properties of "insectotoxin-NPTII" against Colorado potato beetle
      (Leptinotarsa decemlineata).

PMID- 8361501
TI  - An element of the transforming growth factor-beta 1 5'-untranslated region
      represses translation and specifically binds a cytosolic factor.
AB  - In many cell types, there is a discrepancy between transforming growth factor
      beta 1 (TGF-beta 1) mRNA and TGF-beta 1 protein, suggesting that expression of
      TGF-beta 1 is regulated posttranscriptionally. We have previously shown that a
      137-nucleotide (nt) region of the TGF-beta 1 5'-untranslated region (UTR)
      potently inhibits the expression of a heterologous reporter gene, suggesting a
      role for this region in the posttranscriptional inhibition of TGF-beta 1
      expression. To study the mechanism of inhibition, a chimeric plasmid containing
      this region of the TGF-beta 1 5'-UTR and the reading frame of the human GH gene
      was stably transfected into C2C12 myoblastic cells. Our results show that the TGF
      beta 1 5'-UTR inhibits GH expression by inhibiting GH mRNA translation. In vitro
      gel retardation and cross-linking assays using a radiolabelled RNA probe
      transcribed from this region of the TGF-beta 1 5'-UTR demonstrate the specific
      binding of a cytosolic factor. Deletion of a potential stem-loop-forming region
      abolishes binding of this factor and partially restores GH production. These
      results suggest that posttranscriptional inhibition of TGF-beta 1 expression is
      at the level of mRNA translation and that a cytosolic factor may regulate TGF
      beta 1 mRNA translation.

PMID- 8361502
TI  - A naturally occurring growth hormone receptor mutation: in vivo and in vitro
      evidence for the functional importance of the WS motif common to all members of
      the cytokine receptor superfamily.
AB  - To obtain an animal model for studying the role of the GH receptor (GHR) in
      growth and development, we analyzed a sex-linked dwarf (SLD) chicken strain
      (Leghorn) which exhibits phenotype similarities with a human genetic growth
      disorder, an autosomal recessive GH resistance condition (Laron dwarfism). Having
      previously demonstrated the responsibility of the human GHR gene in the Laron
      phenotype, we focused our analysis on the corresponding gene in SLD chickens.
      Sequencing of the whole coding region of the chicken GHR cDNA identified a G-to-T
      transversion segregating with the SLD phenotype and generating an isoleucine
      instead of a serine at position 199 within a highly conserved region close to the
      junction between the extracellular and transmembrane domains. This defect
      involves the last invariant amino acid of the WS-like motif (amino acid sequence
      WSXWS) common to all members of the cytokine receptor superfamily. Transfection
      of a mutated GHR cDNA containing this mutation into eukaryotic cells led to the
      synthesis of a receptor protein that displayed impaired plasma membrane
      expression and binding activity. These data define the molecular basis for the
      SLD phenotype and identify this strain as an interesting model for studying Laron
      dwarfism in humans; this animal model may also represent a system in which
      therapeutic strategies to promote growth can be evaluated. Finally, the nature of
      the molecular defect identified provides direct evidence for the functional
      importance of the WS motif in GHRs and related receptors.

PMID- 8361503
TI  - The risk of childhood cancer after neonatal exposure to vitamin K.
AB  - BACKGROUND: Two recent studies have found that infants who received intramuscular
      vitamin K were at twice the expected risk for cancer during childhood. Since
      nearly all newborns in the United States receive this drug, the public health
      implications of this association, if confirmed, would be substantial. METHODS: We
      examined the relation between vitamin K and cancer in a nested case-control study
      that used data from the Collaborative Perinatal Project, a multi-center,
      prospective study of pregnancy, delivery, and childhood. Among 54,795 children
      born from 1959 through 1966, 48 cases of cancer were diagnosed after the first
      day of life and before the eighth birthday. Each case child was matched with five
      randomly selected controls whose last study visit occurred at or after the age
      when the case child's cancer was diagnosed. Exposure to vitamin K was determined
      from study forms and medical records. RESULTS: Vitamin K had been administered to
      68 percent of the 44 case children and 71 percent of the 226 controls for whom
      data were available (matched odds ratio, 0.84; 95 percent confidence interval,
      0.41 to 1.71). The odds ratio was 0.47 (95 percent confidence interval, 0.14 to
      1.55) for leukemia and 1.08 (95 percent confidence interval, 0.45 to 2.61) for
      other cancers. Sequential adjustment for potential confounding factors did not
      change the results substantially. CONCLUSIONS: We found no association between
      exposure to vitamin K and an increased risk of any childhood cancer or of all
      childhood cancers combined, although a slightly increased risk could not be ruled
      out. The benefits of neonatal vitamin K prophylaxis against hemorrhagic disease
      have been well described. Unless other evidence supporting an association between
      vitamin K and cancer appears, there is no reason to abandon the routine
      administration of vitamin K to newborns.

PMID- 8361504
TI  - Rearrangement of the MLL gene in acute lymphoblastic and acute myeloid leukemias
      with 11q23 chromosomal translocations.
AB  - BACKGROUND: Translocations involving chromosome band 11q23 are very frequent in
      both acute lymphoblastic and acute myeloid leukemias and are the most common
      genetic alteration in infants with leukemia. In all age groups and all phenotypes
      of leukemia, an 11q23 translocation carries a poor prognosis. A major question
      has been whether one or several genes on band 11q23 are implicated in these
      leukemias. Previously, we identified the chromosomal breakpoint region in
      leukemias with the common 11q23 translocations and subsequently cloned a gene
      named MLL that spans the 11q23 breakpoint. METHODS: We isolated a 0.74-kb BamHI
      fragment from a complementary DAN (cDNA) clone of the MLL gene. To determine the
      incidence of MLL rearrangements in patients with 11q23 abnormalities, we analyzed
      DNA from 61 patients with acute leukemia, 3 cell lines derived from such
      patients, and 20 patients with non-Hodgkin's lymphoma and 11q23 aberrations.
      RESULTS: The 0.74-kb cDNA probe detected DNA rearrangements in the MLL gene in 58
      of the patients with leukemia, in the 3 cell lines, and in 3 of the patients with
      lymphoma. All the breaks occurred in an 8.3-kb breakpoint cluster region within
      the MLL gene. The probe identified DNA rearrangements in all 48 patients with the
      five common 11q23 translocations involving chromosomes 4, 6, 9, and 19, as well
      as in 16 patients with uncommon 11q23 aberrations. Twenty-one different
      chromosomal breakpoints involving the MLL gene were detected. CONCLUSIONS: MLL
      gene rearrangements were detected with a single probe and a single restriction
      enzyme digest in all DNA samples from patients with the common 11q23
      translocations as well as in 16 patients or cell lines with other 11q23
      anomalies. The ability to detect an MLL gene rearrangement rapidly and reliably,
      especially in patients with limited material for cytogenetic analysis, should
      make it possible to identify patients who have a poor prognosis and therefore
      require aggressive chemotherapy or marrow transplantation.

PMID- 8361505
TI  - Analysis of dystrophin expression after activation of myogenesis in amniocytes,
      chorionic-villus cells, and fibroblasts. A new method for diagnosing Duchenne's
      muscular dystrophy.
AB  - BACKGROUND: DNA analysis of peripheral-blood leukocytes is routinely used to
      demonstrate mutations in the dystrophin gene in patients with Duchenne's or
      Becker's muscular dystrophy. In approximately 35 percent of patients, DNA studies
      are not informative; in these patients immunochemical analysis of a muscle-biopsy
      specimen can determine whether dystrophin, the protein product of the gene for
      Duchenne's dystrophy, is present at reduced levels or absent. DNA analysis can be
      performed in amniocytes or chorionic-villus cells to identify mutations of the
      dystrophic gene prenatally, but immunochemical testing for dystrophin cannot be
      performed because the protein is not expressed in these cells. METHODS: To
      circumvent this limitation in prenatal diagnosis, we induced myogenesis in 21
      cultures of skin fibroblasts, 49 amniocyte cultures, and 6 chorionic-villus cell
      cultures by infecting the cells with a retrovirus vector containing MyoD, a gene
      regulating myogenesis. Transfection of MyoD into cells that do not normally
      develop into muscle cells results in the production of a protein that switches on
      myogenesis. We performed immunocytochemical analysis for dystrophin in the MyoD
      converted muscle cells. RESULTS: We found that 60 of 61 myotube cultures from
      subjects with no family history of Duchenne's dystrophy expressed dystrophin.
      Both myotube cultures from the two patients with Becker's dystrophy also
      expressed dystrophin, but all cultures from nine patients and two fetuses with
      Duchenne's dystrophy were dystrophin-deficient. CONCLUSIONS: Immunocytochemical
      analysis of dystrophin in genetically altered non-muscle cells is feasible and
      may be applicable to the prenatal and postnatal diagnosis of Duchenne's muscular
      dystrophy when conventional DNA analysis is not informative.

PMID- 8361506
TI  - Brief report: deletion of the dystrophin muscle-promoter region associated with X
      linked dilated cardiomyopathy.

PMID- 8361507
TI  - Images in clinical medicine. Paradoxical Embolus.

PMID- 8361508
TI  - Possible influence of the prospective payment system on the assignment of
      discharge diagnoses for coronary heart disease.
AB  - BACKGROUND: The prospective payment system, under which diagnosis-related groups
      (DRGs) are used to reimburse hospitals for the care of Medicare patients,
      replaced the fee-for-service method of payment in Rhode Island in 1983 and in
      Massachusetts in 1985. Changes in financial incentives resulting from the use of
      the DRG system may have influenced the assignment of discharge diagnostic codes
      away from those with lower reimbursement toward codes with higher reimbursement.
      METHODS: We collected data from the hospital records of patients 35 through 74
      years of age who were discharged with codes 410 through 414 (representing various
      categories of coronary heart disease) of the International Classification of
      Diseases, 9th Revision, Clinical Modification (ICD-9-CM). The patients were
      discharged from seven hospitals in two New England communities (one in Rhode
      Island and one in Massachusetts) between 1980 and 1988. The rates of diagnosis of
      various forms of coronary heart disease were determined by studying ICD-9-CM
      hospital discharge codes (codes 410 and 411 for acute forms of coronary heart
      disease and codes 412, 413, and 414 for chronic forms) and by using a
      computerized diagnostic algorithm designed to detect definite myocardial
      infarction and fatal coronary heart disease. RESULTS: The rates of definite
      coronary events diagnosed by the algorithm and by the study of ICD-9-CM codes 410
      through 414 were constant or increased slightly during the study period. However,
      the frequency of assignment of codes for the acute forms of coronary heart
      disease (which entail higher reimbursement) rose from 35.2 percent to 48.4
      percent among discharged patients with cardiac disease after the institution of
      DRGs. The majority of this increase was associated with the code for unstable
      angina pectoris. The frequency of assignment of codes for the chronic forms of
      coronary heart disease (which entail lower reimbursement) decreased reciprocally,
      from 64.8 percent to 51.6 percent (P < 0.001). CONCLUSIONS: Our data are
      consistent with the hypothesis that the prospective reimbursement system has
      influenced the assignment of hospital discharge codes in a way that would
      increase payment to hospitals. However, the data do not permit us to distinguish
      whether hospitals began to assign more precise diagnoses with the advent of the
      DRG system, or whether they began to favor diagnoses of acute conditions solely
      for financial reasons.

PMID- 8361509
TI  - Tick-borne diseases in the United States.

PMID- 8361510
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 38-1993. Renal failure and a painful toe in a 70-year-old man
      after an acute myocardial infarct.

PMID- 8361511
TI  - Vitamin K and the newborn.

PMID- 8361512
TI  - Progress in defining the causes of idiopathic dilated cardiomyopathy.

PMID- 8361513
TI  - Unraveling the fat embolism syndrome.

PMID- 8361514
TI  - Health care in Canada and the United States.

PMID- 8361515
TI  - Health care in Canada and the United States.

PMID- 8361516
TI  - Health care in Canada and the United States.

PMID- 8361517
TI  - Attention deficit-hyperactivity disorder.

PMID- 8361518
TI  - Attention Deficit-hyperactivity disorder.

PMID- 8361519
TI  - Management of chronic obstructive pulmonary disease.

PMID- 8361520
TI  - Management of chronic obstructive pulmonary disease.

PMID- 8361521
TI  - Management of chronic obstructive pulmonary disease.

PMID- 8361522
TI  - Treatment of neurocardiogenic syncope.

PMID- 8361523
TI  - Treatment of neurocardiogenic syncope.

PMID- 8361524
TI  - Treatment of neurocardiogenic syncope.

PMID- 8361525
TI  - 14-year follow-up of central embolization by a guide wire.

PMID- 8361526
TI  - Potentiometric stripping analysis of selected heavy metals in biological
      materials.
AB  - Different biological materials such as edible oils, refined and unrefined cane
      and beet sugar and tea (black and green) leaves were assayed for the heavy metals
      cadmium, copper, lead and zinc. The results revealed significant differences in
      heavy metal contents within each class of the biological materials (P < 0.05).
      Cadmium was not detectable in sugar samples. Among the oils, highest amounts of
      copper (0.263 microgram/g) and lead (0.154 microgram/g) were in corn oil and zinc
      in olive oil (3.01 micrograms/g) whereas cadmium exhibited a narrow range (0.023
      0.033 microgram/g). The samples of beet-sugar generally contained higher levels
      of the heavy metals than cane-sugar. Black and green tea leaves contained 0.411
      0.908 microgram Cd/g, 6.500-9.220 micrograms Cu/g, 2.200-5.238 micrograms Pb/g,
      and 14.500-25.180 micrograms Zn/g.

PMID- 8361527
TI  - Oral intake of cadmium, cobalt, copper, iron, lead, nickel, manganese and zinc in
      the university student's diet.
AB  - A duplicate diet meal study was carried out with a group of university students
      living in a hostel, in order to estimate the intake of Zn, Cd, Co, Cu, Fe, Mn, Ni
      and Pb. Zn, Cu, Fe, Mn and Ni were determined by flame atomic absorption
      spectrophotometry and Cd, Co and Pb by graphite furnace atomic absorption
      spectrophotometry after a nitric acid wet digestion procedure. The estimated
      intake values from the contents of breakfast, lunch, dinner and drinks were
      compared with the values of the Provisional Tolerable Daily Intake (PTDI) in the
      case of Cd and Pb, Recommended Dietary Allowances (RDA) of Co, Fe and Zn and
      Estimated Safe and Adequate Dietetic Daily Intake (ESADDI) of Cu and Mn. Neither
      excessive intake of Pb and Cd nor deficiencies in Zn, Co, Fe, Mn or Ni were
      observed, but Cu intake was lower than the ESADDI.

PMID- 8361528
TI  - Role of vasoactive intestinal polypeptide (VIP), secretin and gastrin in the
      genesis of the late exocrine pancreatic hypersecretion, food intake dependent in
      conscious dogs.
AB  - Plasma levels of vasoactive intestinal polypeptide (VIP), secretin and gastrin
      were studied in four saphenous vein-catheterized dogs during the first 12 h after
      ingestion of a standard solid meal. Under these conditions we found significant
      postprandial increases in secretion only, which rose from a basal value of 219 +/
      27 pg/ml to 449 +/- 66 pg/ml 60 min postprandial (p < 0.001), and remained
      elevated until 4 h after food intake. However, no increase was seen from 8 to 12
      h in any of the hormones studied, indicating that they are not directly involved
      in the enhancement of exocrine pancreatic secretion during this period.

PMID- 8361529
TI  - RNA splicing. Question of commitment.

PMID- 8361530
TI  - Contraception. Towards healthier infertility.

PMID- 8361531
TI  - Tumour suppressor genes. No room at the p53 inn.

PMID- 8361532
TI  - Cell checkpoint and radiosensitivity.

PMID- 8361533
TI  - Disruption of the CNTF gene results in motor neuron degeneration.
AB  - CNTF is a cytosolic molecule expressed postnatally in myelinating Schwann cells
      and in a subpopulation of astrocytes. Although CNTF administration prevents
      lesion-mediated and genetically determined motor neuron degeneration, its
      physiological function remained elusive. Here it is reported that abolition of
      CNTF gene expression by homologous recombination results in a progressive atrophy
      and loss of motor neurons in adult mice, which is functionally reflected by a
      small but significant reduction in muscle strength.

PMID- 8361534
TI  - UK scientists test liposome gene therapy technique.

PMID- 8361535
TI  - Backlash threatens biomedicine.

PMID- 8361536
TI  - Inverse-dynamics model eye movement control by Purkinje cells in the cerebellum.
AB  - Many lines of evidence suggest that the cerebellum is involved in motor control.
      But what features of these movements are encoded by cerebellar neurons? For slow
      tracking eye movements, the activity of Purkinje cells in the ventral
      paraflocculus of the cerebellum is known to be correlated with eye velocity and
      acceleration. Here we show that the complex temporal pattern of the firing
      frequency that occurs during the ocular following response elicited by movements
      of a large visual scene can be reconstructed by an inverse-dynamics
      representation, which uses the position, velocity and acceleration of eye
      movements. Further analysis reveals that the velocity and acceleration components
      can provide appropriate dynamic drive signals to ocular motor neurons, whereas
      the position component often has the wrong polarity. We conclude that these
      Purkinje cells primarily contribute dynamic command signals.

PMID- 8361538
TI  - Spondylometaphyseal dysplasia in mice carrying a dominant negative mutation in a
      matrix protein specific for cartilage-to-bone transition.
AB  - The vertebrate skeleton is formed primarily by endochondral ossification,
      starting during embryogenesis when cartilage anlagens develop central regions of
      hypertrophic cartilage which are replaced by bony trabeculae and bone marrow.
      During this process chondrocytes express a unique matrix molecule, type X
      collagen. We report here that mice carrying a mutated collagen X transgene
      develop skeletal deformities including compression of hypertrophic growth plate
      cartilage and a decrease in newly formed bone, as well as leukocyte deficiency in
      bone marrow, reduction in size of thymus and spleen, and lymphopenia. The defects
      indicate that collagen X is required for normal skeletal morphogenesis and
      suggest that mutations in COL10A1 are responsible for certain human
      chondrodysplasias, such as spondylometaphyseal dysplasias and metaphyseal
      chondrodysplasias.

PMID- 8361537
TI  - Different roles of alpha beta and gamma delta T cells in immunity against an
      intracellular bacterial pathogen.
AB  - Several bacterial pathogens of medical importance are able to persist and
      replicate inside host mononuclear phagocytes. Protective immunity depends on
      specific T lymphocytes that induce granulomatous lesions at the sites of
      bacterial multiplication. Listeria monocytogenes is an intracellular pathogen
      that replicates inside mononuclear phagocytes and hepatocytes of mice. Invasion
      from the phagosomal compartment into the cytoplasmic compartment is the principal
      mechanism of intracellular survival. Early in infection, resistance against L.
      monocytogenes is mediated by polymorphonuclear phagocytes which destroy infected
      liver cells, followed by natural killer cells which activate macrophages by means
      of interferon-gamma (refs 6, 7). A specific immune response by T cells then
      develops which leads to sterile eradication of the microbes. T cells are also
      responsible for the highly effective protection in vaccinated mice against
      secondary infections. Although the role of alpha beta T cells has been
      demonstrated in these immune responses, that of gamma delta T cells is unclear.
      Here we use mice that selectively lack either alpha beta or gamma delta T cells
      as a result of targeted germ-line mutations in their T-cell receptor genes to
      investigate the relative roles of these T-cell populations during experimental
      infection with L. monocytogenes. We find that in primary listeriosis, either
      alpha beta or gamma delta T cells are sufficient for early protection. Resistance
      to secondary infection is mediated mainly by alpha beta T cells but also involves
      gamma delta T cells. Thus alpha beta T-cell-deficient mice can be rendered
      partially resistant by vaccination, and gamma delta T cells are shown to be
      responsible for this protective effect. In infected gamma delta T-cell-deficient
      mice we noticed the appearance of unusual liver lesions, indicating that gamma
      delta T cells have a unique regulatory role in this bacterial infection.

PMID- 8361539
TI  - Cloning and gene defects in microsomal triglyceride transfer protein associated
      with abetalipoproteinaemia.
AB  - The microsomal triglyceride transfer protein (MTP), which catalyses the transport
      of triglyceride, cholesteryl ester and phospholipid between phospholipid
      surfaces, is a heterodimer composed of the multifunctional protein, protein
      disulphide isomerase, and a unique large subunit with an apparent M(r) of 88K
      (refs 1-3). It is isolated as a soluble protein from the lumen of the microsomal
      fraction of liver and intestine. The large subunit of MTP was not detectable in
      four unrelated subjects with abetalipoproteinaemia, a rare autosomal recessive
      disease characterized by a defect in the assembly or secretion of plasma
      lipoproteins that contain apolipoprotein B (ref. 6). We report here the isolation
      and sequencing of complementary DNA encoding the large subunit of MTP. A
      comparison of this sequence to corresponding genomic sequences from two
      abetalipoproteinaemic subjects revealed a homozygous frameshift mutation in one
      subject and a homozygous nonsense mutation in the other. The results indicate
      that a defect in the gene for the large subunit of MTP is the proximal cause of
      abetalipoproteinaemia in these two subjects, and that MTP is required for the
      secretion of plasma lipoproteins that contain apolipoprotein B.

PMID- 8361540
TI  - Presynaptic A-current based on heteromultimeric K+ channels detected in vivo.
AB  - A wide variety of voltage-gated K+ channels are involved in the regulation of
      neuronal excitability and synaptic transmission. Their heterogeneity arises in
      part from the large number of genes encoding different K+ channel subunits
      (reviewed in ref. 1). In addition, heterologous expression studies indicate that
      assembly of distinct subunits into heteromultimeric channels may contribute
      further to K+ channel diversity. A question has been whether heteromeric K+
      channels actually form in vivo, and if so, whether specific combinations of
      subunits could account for major K+ currents identified in neurons. We present
      here biochemical evidence that Kv1.4 and Kv1.2, two K+ channel subunits of the
      Shaker subfamily, co-assemble in rat brain. The Kv1.4/Kv1.2 heteromultimer
      combines features of both parent subunits, resulting in an A-type K+ channel.
      Immunocytochemical evidence suggests that the heteromultimers are localized in
      axons and nerve terminals. We propose that Kv1.4/Kv1.2 heteromultimers may form
      the molecular basis of a presynaptic A-type K+ channel involved in the regulation
      of neurotransmitter release.

PMID- 8361541
TI  - Heteromultimeric K+ channels in terminal and juxtaparanodal regions of neurons.
AB  - Voltage-gated potassium (K+) channels display a wide variety of conductances and
      gating properties in vivo. This diversity can be attributed not only to the
      presence of many K(+)-channel gene products, but also to the possibility that
      different K(+)-channel subunits co-assemble to form heteromultimeric channels in
      vivo. When expressed in Xenopus oocytes or transfected cells, K(+)-channel
      polypeptides assemble to form tetramers. Certain combinations of Shaker-like
      subunits have been shown to co-assemble, forming heteromultimeric channels with
      distinct properties. It is not known, however, whether K(+)-channel polypeptides
      form heteromultimeric channels in vivo. Here we describe the co-localization of
      two Shaker-like voltage-gated K(+)-channel proteins, mKv1.1 and mKv1.2, in the
      juxtaparanodal regions of nodes of Ranvier in myelinated axons, and in terminal
      fields of basket cells in mouse cerebellum. We also show that mKv1.1 and mKv1.2
      can be coimmunoprecipitated with specific antibodies that recognize only one of
      them. These data indicate that the two polypeptides occur in subcellular regions
      where rapid membrane repolarization may be important and that they form
      heteromultimeric channels in vivo.

PMID- 8361542
TI  - Inhibition of DNA replication factor RPA by p53.
AB  - The tumour suppressor p53 specifically interferes with the onset of S phase. The
      mechanism of the growth suppression action of the protein is unclear, though
      recent evidence points to transcriptional activation and repression functions of
      the protein. A competing hypothesis suggests that p53 interacts with the DNA
      replication apparatus and directly interferes with DNA replication. The major
      evidence for this hypothesis is that p53 interacts with the simian virus 40
      (SV40)-encoded protein T antigen and interferes with the ability of T antigen to
      unwind the SV40 origin of DNA replication, and recruit DNA polymerase alpha to
      the replication initiation complex. Here we report that p53 physically interacts
      with and inhibits the function of a cellular DNA replication factor, the single
      stranded DNA-binding protein complex RPA.

PMID- 8361543
TI  - Continuing confusion.

PMID- 8361544
TI  - Continuing confusion.

PMID- 8361545
TI  - Gaining time.

PMID- 8361546
TI  - Specific commitment of different pre-mRNAs to splicing by single SR proteins.
AB  - Higher eukaryotic cells express a family of essential splicing factors with a
      characteristic RNA-binding domain and serine/arginine-rich (SR) motif. These SR
      proteins, which include SC35 and SF2/ASF, are conserved from Drosophila to man,
      are required for early steps of spliceosome assembly and can influence splice
      site selections. To address their mechanisms of action, SR proteins were examined
      for their role in committing pre-messenger RNA to the splicing pathway. I report
      here that SC35 was sufficient on its own to form a committed complex with human
      beta-globin pre-mRNA. Examination of other SR proteins and pre-mRNA substrates
      revealed that single SR proteins committed different pre-mRNAs to splicing with
      pronounced substrate specificity. These results suggest that splicing of
      different pre-mRNAs may require distinct sets of SR proteins, and that the
      commitment by SR proteins may be a critical step at which alternative and tissue
      specific splicing is regulated.

PMID- 8361547
TI  - Non-injection methods for the production of embryonic stem cell-embryo chimaeras.
AB  - The simple aggregation of pluripotent ES cells with morulae-stage embryos can
      result in viable chimaeras at a similar frequency to that of blastocyst
      injection. The savings in time and equipment inherent in the aggregation
      techniques, however, make this approach well worth considering.

PMID- 8361549
TI  - Multiple inhibitory mechanisms mediate non-adrenergic non-cholinergic relaxation
      in the circular muscle of the guinea-pig colon.
AB  - The mechanisms responsible for nerve-mediated, non-adrenergic, non-cholinergic
      (NANC) relaxation in mucosa-free circular muscle strips from the proximal colon
      of the guinea-pig were investigated. Electrical field stimulation (EFS, 1-20 Hz,
      trains of 5 s duration, 100 V, 0.25 ms pulse width) in the presence of atropine
      (1 mumol/l) and guanethidine (3 mumol/l) evoked a triphasic motor response
      consisting of: (a) a primary relaxation, (b) a rebound contraction and (c) a
      secondary relaxation. These three responses were abolished by tetrodotoxin (1
      mumol/l). B oth apamin (0.01-0.3 mumol/l), a known blocker of low conductance,
      calcium-activated potassium channels in smooth muscles, and L-nitro-arginine (L
      NOARG) (1-100 mumol/l), a known blocker of nitric oxide (NO) synthase, increased
      the tone of the strips. Maximum effects on tone were observed with 0.1 mumol/l
      apamin (21 +/- 3% of KCl-induced contraction) and 30 mumol/l L-NOARG (26 +/- 4%
      of KCl response). The combined administration of 0.1 mumol/l apamin and 30
      mumol/l L-NOARG produced an increase in tone (47 +/- 5% of KCl response) that was
      larger than that produced by either compound alone. Neither apamin (0.1 mumol/l)
      nor L-NOARG (30 mumol/l) affected the isoprenaline-induced relaxation. Apamin
      (0.1 mumol/l) depressed, but did not abolish, the primary relaxation to EFS at
      all frequencies without affecting the secondary relaxation.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8361548
TI  - Autoradiographic characterisation and localisation of 5-HT1D compared to 5-HT1B
      binding sites in rat brain.
AB  - The regional distribution and the pharmacology of the binding sites labelled with
      the novel 5-hydroxytryptamine (serotonin) 5-HT1B/1D selective radioligand
      serotonin-O-carboxy-methyl-glycyl-[125I]tyrosinamide (abbreviated [125I]GTI for
      the sake of simplicity) was determined using quantitative autoradiography in rat
      brain. The distribution of [125I]GTI binding sites was largely comparable to that
      of [125I]iodocyanopindolol ([125I] ICYP) which labels 5-HT1B binding sites (in
      the presence of 8-OH-DPAT (8-hydroxy-[2N-dipropylamino]tetralin) and
      isoprenaline, to prevent binding to 5-HT1A and beta-adrenoceptor binding sites),
      although a detailed analysis revealed differences. The pharmacology of the
      [125I]GTI binding sites was analysed using compounds known to display high
      affinity for and/or distinguish between 5-HT1B and 5-HT1D sites: 5
      carboxamidotryptamine (5-CT), sumatriptan, CP 93129 (5-hydroxy-3(4-1,2,5,6
      tetrahydropyridyl)-4-azaindole), (-)pindolol, PAPP (4[2-[4-[3
      (trifluoromethyl)phenyl]-1- piperazinyl]ethyl]benzeneamine), rauwolscine, and 8
      OH-DPAT. The displacement of [125I]GTI by 5-CT was monophasic. By contrast, the
      selective 5-HT1B compound CP 93129 and (-)pindolol produced biphasic curves
      showing a majority of high affinity sites in the globus pallidus and the
      substantia nigra, whereas PAPP and sumatriptan (which are somewhat 5-HT1D
      selective) produced biphasic curves indicating a minority of high affinity sites
      in these areas. In addition, by blocking the 5-HT1B sites with 100 nM CP 93129,
      the remaining population of [125I]GTI binding sites could be studied and was
      found to have high affinity for PAPP, rauwolscine and 8-OH-DPAT. The
      pharmacological profile of the major binding component was typical of the 5-HT1B
      type: 5-CT > CP 93129 > or = (-)pindolol > sumatriptan > or = PAPP > rauwolscine.
      The profile of the minor component of [125I]GTI binding is best characterised as
      that of a 5-HT1D site: 5-CT > PAPP > or = sumatriptan > rauwolscine > (-)pindolol
      > or = CP 93129. The localisation of the non 5-HT1B [125I]GTI binding sites was
      characterised by blocking the 5-HT1B receptors with 100 nM CP 93129. Low
      densities of the 5-HT1D recognition sites were found to be present in globus
      pallidus, ventral pallidum, caudate-putamen, subthalamic nucleus, entopeduncular
      nucleus, substantia nigra (reticular part), nuclei of the (normal and accessory)
      optic tract, different nuclei of the geniculate body and frontoparietal cortex,
      although higher densities of 5-HT1B sites were always observed in the same
      structures.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8361551
TI  - N-acetyl-L-cysteine protects endothelial cells but not L929 tumor cells from
      tumor necrosis factor-alpha-mediated cytotoxicity.
AB  - The effect of N-acetyl-L-cysteine on the cytotoxicity of tumor necrosis factor
      alpha was investigated in cultured bovine pulmonary artery endothelial cells and
      L929 mouse tumor cells. In endothelial cells, a 72-h incubation with tumor
      necrosis factor-alpha (100 ng/ml) reduced the number of viable cells to 27% of
      control. Simultaneous incubation with N-acetyl-L-cysteine (0.5-5 mmol/l)
      protected endothelial cells from tumor necrosis factor-alpha-mediated
      cytotoxicity and increased viability in a concentration-dependent fashion to 69%
      of control. Under the same conditions, a 72-h incubation with tumor necrosis
      factor-alpha (100 ng/ml) reduced the number of viable L929 tumor cells to 31% of
      control. However, this cytotoxic response remained unaltered in the presence of N
      acetyl-L-cysteine (0.5-5 mmol/l). Similar results were obtained when using a
      lower concentration of tumor necrosis factor-alpha (50 ng/ml). These findings
      demonstrate protection from tumor necrosis factor-alpha-mediated toxicity by N
      acetyl-L-cysteine in endothelial cells but not in a tumor cell line. It is
      concluded that N-acetyl-L-cysteine might serve as a therapeutic agent to limit
      the vascular toxicity of tumor necrosis factor-alpha without affecting its
      antineoplastic activity.

PMID- 8361550
TI  - Morphine-induced hyperactivity in rats--a rebound effect?
AB  - The behavioural nature of the delayed hyperactivity induced by systemic
      administration of morphine was studied in rats. Different components of motility
      induced by morphine with or without naloxone or haloperidol at different times
      were analyzed by observation and quantified by an Opto-Varimex-3 Activity Meter.
      By this automatic recording system motility was discriminated into horizontal and
      two different vertical components and the total distance run by each of the rats
      was quantified by a computer program. Simultaneously the running pattern was
      recorded by a XY-plotter. By means of these recordings, three subsequent phases
      of behaviour could be recorded after morphine (15 mg/kg i.p.): 1. a depressed
      phase (akinesia) lasting 1.5-2 h, followed, 2. by an intermediate phase for 1-1.5
      h, still dominated by akinesia but interrupted by sudden bursts of hyperactivity.
      Finally, 3. a hyperactivity phase lasted for 1.5-2 h, characterized by an equal
      enhancement of locomotor activity and stereotypy. After 30 mg/kg of morphine the
      hyperactivity was predominantly characterized by locomotor activity and
      stereotypy and rearing were less prominent than after the smaller dose. Naloxone
      (2 mg/kg i.p.) given at the beginning of the hyperactivity phase significantly
      antagonized rearing but not other motility parameters. However, coadministration
      of naloxone (2 mg/kg i.p.) simultaneously with morphine (15 mg/kg) clearly
      antagonized akinesia and completely prevented the development of the delayed
      hyperactivity. Haloperidol (0.2 mg/kg i.p.) at the beginning of the hyperactivity
      phase clearly antagonized all of the motility parameters seen during this
      phase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361552
TI  - [Acute myocardial infarct? Open the blood vessel involved].

PMID- 8361553
TI  - [Immediate coronary angioplasty for acute myocardial infarct: indications on the
      move].

PMID- 8361554
TI  - [Effect of clozapine in schizophrenia; starting points for current
      pharmacotherapeutics].

PMID- 8361555
TI  - [Thrombolysis of leg arteries].

PMID- 8361556
TI  - [Long-term prognosis following a myocardial infarct: clinically prognostic
      variables and cardiovascular risk factors].
AB  - The long-term prognosis after myocardial infarction; clinical predictive
      variables and cardiovascular risk factors. In predicting long-term survival of
      304 consecutive patients discharged after myocardial infarction between 1978 and
      1981, and under 65 years of age, the significance of both hospital data and
      cardiovascular risk factors was examined. After discharge from hospital, the ten
      year all-cause total mortality was 35.5%. Sudden death accounted for 42% of the
      recorded causes of death. The patients were not yet treated with thrombolysis at
      that time. After multivariate analysis, age, previous myocardial infarction,
      abnormal chest X-ray (increased cardiothoracic ratio or pulmonary congestion) and
      an increased cholesterol level were found to be independent and significant
      predictors of the ten-year mortality. Hypertension and gender were not associated
      with mortality. Patients with a previous myocardial infarction had, after
      adjustment for differences in age and other variables, a relative risk of dying
      within ten years of 1.70 (95% confidence interval 1.05-2.75) compared with those
      with a first infarction. A gradual increase of the ten-year mortality with
      elevated serum cholesterol level could be demonstrated (relative risk 1.14 per
      mmol/l, 95% CI 1.01-1.28). In conclusion, several routinely obtained parameters
      after myocardial infarction were related to subsequent long-term survival. Of the
      prognostic factors that may lead to useful therapeutic intervention after
      myocardial infarction, hypercholesterolaemia was most clearly associated with a
      reduced survival in the present study.

PMID- 8361557
TI  - [Good results of endoscopic paranasal sinus surgery for chronic or recurrent
      sinusitis and for nasal polyps].
AB  - Endoscopic sinus surgery is being applied increasingly for chronic or recurrent
      sinusitis and nasal polyps. We investigated the results, which we classified as
      subjective results (i.e. the opinion of the patient) and objective results (i.e.
      the result as seen with nasal endoscopy). The subjective result was 'good' in 85%
      of 92 patients with chronic or recurrent sinusitis, the objective result in 77%
      of the treated sides, with a median follow-up of 46 months. In 90 patients with
      nasal polyps the percentages were 90% and 65% respectively, with a follow-up of
      24 months. In 63% of 30 patients with chronic obstructive lung disease and nasal
      polyps the pulmonary function increased postoperatively (FEV1). In 4.2% of 1235
      operated sides in 593 patients local complications were seen. These were mainly
      minor complications. Only in 0.3% serious complications as a orbital hematoma or
      a CSF leak were seen. Endoscopic sinus surgery has good results and little
      morbidity.

PMID- 8361558
TI  - [Trends in incidence of sexually transmissible disorders in The Netherlands].
AB  - In 1983 the Chief Medical Inspectorate set up a national registration of sexually
      transmitted diseases (STD), beside the system of statutorily notifiable diseases
      in the Netherlands. Data for this registration are collected by the nursing staff
      in STD clinics. Besides diagnosis and sex of the patient epidemiological
      background information is registered. The data show a decrease in the total
      number for gonorrhoea and syphilis in the period 1984-1990. Among homosexual men
      gonorrhoea increased after 1989. A decrease in STD was demonstrated among
      prostitute women. Further, the share of penicillinase producing Neisseria
      gonorrhoeae was found to be increasing in various subgroups, but not in
      homosexual men. Comparison of age, sex, prostitution, and sexual inclination of
      over 25,000 patients with Chlamydia trachomatis, gonorrhoea or syphilis
      infections indicate that syphilis was significantly more frequent among older
      patients and women than gonorrhoea, but less frequent among prostitutes. Syphilis
      patients were significantly more often visitors of prostitutes than patients with
      gonorrhoea, and were more often homosexual or bisexual. Chlamydiosis patients
      were mostly women and younger than gonorrhoea patients, they were less often
      working as a prostitute and less often homosexual or bisexual.

PMID- 8361559
TI  - [Sexual possibilities following total penis amputation].
AB  - A male aged 45 was subjected to total penis amputation because of a penile
      carcinoma; a perineal urethral stoma was created. The postoperative course was
      uneventful. One month after the last operation the patient for the first time
      felt the need for sexual contact, but his wife hesitated. After medical
      sexological counselling, the partners achieved satisfactory sexual functioning
      with the husband occasionally having an orgasm.

PMID- 8361560
TI  - [Hearing disorders in nursing home patients is difficult to assess when relying
      on caregivers' and patients' judgment].

PMID- 8361561
TI  - [Hearing disorders in nursing home patients are difficult to assess when relying
      on caregivers' and patients' judgment].

PMID- 8361562
TI  - [Good results from treatment with 100% oxygen for acute carbon monoxide
      poisoning; for the moment no indication for hyperbaric oxygenation].

PMID- 8361563
TI  - [Endometrial carcinoma during estrogen replacement therapy in spite of addition
      of progestagens].

PMID- 8361564
TI  - [Parametrial coitus].

PMID- 8361565
TI  - [Magnetic resonance spectroscopy in cerebral blood flow metabolism (series 8)].

PMID- 8361566
TI  - [Molecular biological characteristics of brain tumor].

PMID- 8361567
TI  - [Histological study of the outer membrane of chronic subdural hematoma: possible
      mechanism for expansion of hematoma cavity].
AB  - Relationship between the histological features of the outer membrane of chronic
      subdural hematoma and computed tomography (CT) findings, and the period from
      trauma to surgery were studied, and the mechanism of hematoma enlargement was
      discussed. This study included 43 patients aged 16 to 84 years. The outer
      membranes collected during operation were examined by hematoxylin and eosin
      staining and elasticavan Gieson staining. Histological features were classified
      into 4 types according to maturity and intensity of the inflammatory reaction and
      hemorrhage. Type I: Noninflammatory membrane. This type of membrane was observed
      in 3 cases. This membrane, containing immature fibroblasts and collagen fibers,
      was associated with very slight or sparse cell infiltration and neocapillaries.
      Type II: Inflammatory membrane. This type of membrane was observed in 21
      patients. The type, consisting of one layer of immature connective tissue, was
      associated with marked cell infiltration and vascularization throughout the
      entire thickness. Type III: Hemorrhagic-inflammatory membrane. This type of
      membrane was observed in 14 patients. This type had a structure of 2 or 3 layers,
      and was associated with capillaries with a large lumen on the side of the dura
      mater and marked cell infiltration and many thin new vessels on the side of the
      hematoma cavity. Some patients showed a layer consisting of only collagen fibers
      and fibroblasts between two such layers. In addition, hemorrhage into the
      membrane was often observed. Type IV: Scar-inflammatory membrane. This type of
      membrane was observed in 4 patients. This type showed inflammatory cell
      infiltration, neovascularization and hemorrhage in the outer membrane of
      cicatricial tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361569
TI  - [Treatment and prognosis of spinal AVM].
AB  - Spinal arteriovenous malformation (AVM) is a relatively rare disease. We assessed
      the results of treatment of spinal AVM in 17 patients. Our classification was
      based on the radiographic appearance in selective spinal angiograms. There were 3
      cases of single coiled type AVM, 3 of juvenile type, 5 of glomus type, and 6 of
      so-called dural AVM. All three patients with single coiled type AVM underwent
      microsurgical resection of the AVM. All three with the juvenile type underwent
      artificial embolization. Both patients with glomus type and dural AVM were
      treated by either embolization and/or surgery. Magnetic resonance imaging and
      magnetic resonance angiography visualized the spinal AVM well, and were useful
      for diagnosis and post-treatment follow-up.

PMID- 8361568
TI  - [Nutritional assessment for patients with neurosurgical diseases].
AB  - There have been few guidelines in the field of nutritional management with regard
      to neurosurgical patients. In this review, caloric intake and nutritional
      parameters were measured in 24 patients in the acute stage and 32 patients in the
      chronic stage (prolonged unconscious state). We ascertained (1) whether the
      caloric intake was adequate or not, (2) the relationship between the grade of
      neurological damage and the nutritional assessment, and (3) we discussed the
      relationship between diseases and the nutritional assessments. The acute-stage
      patients, 14 male and 13 female, consisted of both a neurologically good
      prognostic group and a neurologically poor prognostic group. All of the prolonged
      unconscious patients revealed poor prognosis. The nutritional assessment was
      referred to such parameters as, diet and nutrition, anthropometric measurements,
      laboratory tests, immunological parameters and prognostic nutritional index. The
      results were, 1) the acute stage patients received less caloric intake than their
      resting energy expenditure, 2) the neurologically poor prognostic patients showed
      muscle atrophy and decrease of creatinine-height index which represents muscle
      content, 3) there was no significant differences between the assessment
      parameters in each disease, and 4) serum electrolytes decreased in prolonged
      unconscious patients with a small amount of caloric intake.

PMID- 8361570
TI  - [Clinical problems in the management of aged patients with severe head injury:
      analysis of neurological findings and CT findings].
AB  - Aged patients were defined as those of 65 years or more of age. Among 457
      patients with severe head injury [Glasgow Coma Scale score (GCS) of 8 or less],
      sixty-five aged patients (14%) were analyzed with special reference to their
      pretreatment neurological status, CT findings and outcome in comparison with 141
      (31%) of those from 40 to 64 years of age. As a cause of injury, the incidence of
      traffic accidents and falls and tumbles did not differ statistically in both
      groups. Neither did the severity (GCS score) significantly differ in the two
      groups. Three important neurological findings [pupillary abnormality, impaired or
      absent oculocephalic reflex and poor motor response (GCS motor score < or = 3)],
      were analyzed as the prognostic factors. Poor motor response was the sole finding
      that was significantly more frequent in the aged. On CT in the aged, acute
      subdural hematoma was most common among the extraparenchymal hematoma.
      Hemorrhagic lesions were the more common parenchymal lesions. On the other hand,
      diffuse cerebral swelling was rare in the aged. The outcome was significantly
      poor in the aged; only 6% had good outcome (good recovery and moderate
      disability), and 80% died. In conclusion, these results suggested that the poor
      outcome was due to severe primary brain damage added to poor brain plasticity in
      the aged.

PMID- 8361571
TI  - [Arteriovenous malformation resembling galenic aneurysm].
AB  - A girl who had just turned one year old was transported to our hospital because
      of an episode of general convulsive seizure. Neurological examinations
      demonstrated a comatose consciousness level, moderate right hemiparesis and
      conjugate deviation to the right. CT scan on admission revealed an intracerebral
      hematoma in the left medial temporal lobe associated with intraventricular
      hemorrhage in the lateral and third ventricles. MRI also showed the hematoma with
      evidence of a dilated venous system. Angiography demonstrated a huge venous sac
      fed by the left posterior choroidal artery and left anterior choroidal artery
      drained ultimately into the remnant of the tentorial sinus. Firstly, two courses
      of transfemoral embolization using platinum micro-coils were performed.
      Initially, the posterior choroidal artery and a branch of the anterior choroidal
      artery were occluded successfully. Then, two branches from the posterior cerebral
      artery were occluded one week after the initial procedure. She underwent the
      operation via the left subtemporal approach. After the CSF removal through the
      Sylvian fissure, the gentle elevation of the left temporal lobe allowed the
      visualization of the feeders and the pulsating venous sac. After the complete
      obliteration of the feeding arteries and removal of the nidus, the interruption
      was verified by using doppler sonography and intraoperative angiography.
      Postoperative course was uneventful. The infant was discharged without deficit on
      the 30th postoperative day. The authors discussed the embryological implications
      of this type of AVM and the role of endovascular surgery.

PMID- 8361572
TI  - [Two cases of metastatic brain tumor treated by interstitial brachytherapy].
AB  - The prognosis of patients with metastatic brain tumor is very poor. Median
      survival of these patients has ranged from 1 month with no therapy, to 2 months
      with steroid, and from 3 to 6 months with brain radiation therapy of the whole
      brain. A more recent study comparing radiation therapy alone with surgery plus
      radiation, has shown good results in the combined surgery and radiation therapy
      group. But surgical excision is usually limited to patients with a surgically
      accessible solitary metastasis. And therapeutic options are limited once the
      tumor recurs locally after whole brain irradiation. Interstitial irradiation
      allows the delivery of a high dose of localized irradiation in the area of tumor
      recurrence with minimal risk of radiation damage to the surrounding brain tissue.
      But brachytherapy for brain metastasis has been performed in few cases. We
      reported two patients with unresectable metastatic brain tumors who were
      successfully treated with iridium-192 interstitial brachytherapy, and we discuss
      the strategy of the treatment. Case 1: A 78 year-old-man underwent a total
      gastrectomy for gastric cancer. Five months after surgery, he developed right
      hemiparesis. CT scan revealed a left occipital tumor with massive brain edema and
      a tiny nodule of tumor in the left thalamic region. The primary site was well
      controlled and no systemic disease was seen during subsequent whole body
      examination. The occipital lesion was surgically excised and he received a
      postoperative radiation therapy of 50 Gy to the whole brain. The thalamic tumor
      had not responded to the irradiation and the size of tumor rapidly
      increased.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361573
TI  - [A case of a giant epidermoid cyst on the occipital scalp].
AB  - The authors report a case of a 61-year-old woman presenting with a giant mass on
      the occipital scalp. The patient had no neurological deficits and was of normal
      intelligence. The lesion was soft and covered by an unremarkable epidermis. The
      preoperative radiologic evaluation was made by CT, MR Imaging, and by cerebral
      angiogram. The mass produced an inhomogeneously low-intensity signal involving
      also a high-intensity signal. It was shown, on the T1 weighted image, that it did
      not communicate with the intracranial space, and there was no gadolinium-enhanced
      lesion. MR Imaging was superior to CT in the evaluation of the giant mass on the
      scalp and was particularly useful in surgical planning. At surgical resection, a
      soft fluffy, white-colored tumor which measured 16 x 10 x 7 cm was totally
      removed. Pathological diagnosis of the tumor was epidermoid cyst.

PMID- 8361574
TI  - [A case of intra- and extracranially extensive metastatic brain tumor of tracheal
      cancer origin].
AB  - The authors report a case of metastatic brain tumor of tracheal cancer origin,
      itself a rare condition. A 55-year-old man was admitted with complaints of
      headache, atonic seizure of left lower limb and right temporal swelling. On
      admission, the patient had left recurrent nerve palsy. CT scan displayed right
      temporal bone destruction and ring-enhanced mass. MRI disclosed that the mass
      contained an inner necrotic region and a perifocal edema. Right common carotid
      angiogram revealed that the tumor was fed only by narrowed vessels of the middle
      meningeal artery. Subtotal removal of the tumor was performed, and histological
      examination revealed cranial metastasis of tracheal squamous cell carcinoma.
      Postoperative course was uneventful, and the patient underwent medical treatment
      for the primary lesion before post-operative brain-irradiation.

PMID- 8361575
TI  - [Delayed vasospasm complicated with the postoperative stage of the meningioma: a
      case report].
AB  - Though it has been reported infrequently that delayed vasospasm may appear in
      head-injured patients, it is rather rarer to see it as a complication arising
      from tumor removal. Such a case was presented and gave rise to speculation of a
      possible underlying pathophysiology. A 46-year-old female patient was admitted to
      our neurosurgical service, complaining of aching pain in the forehead. No
      neurological deficits were elicited on admission. CT scans as well as MR imagings
      confirmed the existence of a left sphenoid wing meningioma whose gross total
      removal was accomplished. She was doing well till the 3rd postoperative day, when
      she developed transcortical motor aphasia. 123I-IMP SPECT revealed low perfusion
      over the left middle cerebral artery territory, and CT scans also showed low
      density areas in the same region, including the putamen, corona radiata and
      temporal lobe on the left side. Left carotid angiography disclosed diffuse
      arterial narrowings involving C1, C2, A1 and M1 portions. The authors suspect
      that indirect injury to those arteries and/or some kind of inflammatory process
      might have played a role.

PMID- 8361576
TI  - [Radiation-induced cerebrovasculopathy: a case report and review of the
      literature].
AB  - We reported a case of a patient who suffered from a cerebrovasculopathy after
      irradiation therapy for astrocytoma located at the left temporal lobe. An eleven
      year-old boy who presented himself with headache and vomiting as his chief
      complaints received partial removal of a tumor. Histological diagnosis of the
      tumor was astrocytoma (grade II). His preoperative cerebral angiograms showed
      mass sign solely, without stenosis or occlusion of the cerebral vessel.
      Postoperatively, he was treated with irradiation therapy involving the whole
      brain with a total of 30 Gy, and gamma knife therapy. Six months after
      irradiation, he started suffering from frequent cerebral ischemic attacks, but
      there was no regrowth of the tumor visible on CT scans. Cerebral angiograms were
      made again, and revealed multifocal stenoses in the bilateral internal carotid
      arteries, middle cerebral arteries, and the anterior cerebral artery. His
      symptoms did not improve after conservative treatment with steroids, calcium
      antagonist, or low molecular weight dextran. Although he received a superficial
      temporal artery-middle cerebral artery (STA-MCA) anastomoses bilaterally,
      multiple cerebral infarctions appeared. Although irradiation therapy is
      acceptable in patients with brain tumor, a cerebrovasculopathy after irradiation
      should be considered as one of the most important complications, and the risk
      incurred by irradiation therapy should lead to more careful consideration and
      caution when treating intracranial brain tumors, especially in children. From our
      experience, the usefulness of bypass surgery for radiation-induced
      cerebrovasculopathy is still controversial.

PMID- 8361577
TI  - Assessment of 8-OH-DPAT induced spontaneous tailflicks as an in vivo model of 5
      HT1A function in young rats.
AB  - Spontaneous tailflicks, measured as elevation of the tail above the body axis in
      restrained animals, have been studied in both adult and young rats. The selective
      5-HT1A agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), induced dose
      related increases in spontaneous tailflicks in adult (> 60 days) male rats. These
      responses were antagonised by the 5-HT1A antagonists (-)-propranolol and (-)
      pindolol. 8-OH-DPAT (1 mg/kg) induced tailflicks could be observed in 30, 25 and
      20 day old male rats and were also antagonised by (-)-propranolol and (-)
      pindolol although drug-induced rotation of the 20 and 25 day old animals hindered
      assessment. At 14 and 10 days, 8-OH-DPAT (1 mg/kg) produced Straub tail responses
      which precluded the observation of tailflicks. Lower doses of 8-OH-DPAT, which
      did not elicit Straub tail in these younger animals also failed to produce
      tailflicks. Thus 8-OH-DPAT induced spontaneous tailflicks reflect in vivo
      activation of 5-HT1A receptors in adult and 30 day old male rats but are
      inappropriate for the study of 5-HT1A mediated behaviour in younger animals.

PMID- 8361578
TI  - Opioid action on spinal cord reflexes due to dorsolateral pontine tegmentum
      stimulation.
AB  - Electrical stimulation of the dorsolateral pontine tegmentum (DLPT) produces
      phasic facilitatory and inhibitory actions on the lumbar spinal monosynaptic
      reflexes (MSRs) of both flexor and extensor muscle nerves in the decerebrate cat.
      Naloxone, an opioid receptor antagonist, given intravenously or intraspinally
      enhanced the DLPT-induced potentiation of MSRs in most of the reflexes studied.
      However, systemic naloxone had no significant effect on the unconditioned MSR of
      the spinal cord. Intraspinal microinjections of naloxone significantly attenuated
      the DLPT-induced inhibition of MSRs of both flexors and extensors, similar to the
      action of systemic injection of naloxone, indicating a direct opioid action at
      the spinal ventral horn level upon DLPT stimulation. Results of the present
      experiment further support the anatomical finding that there are pontospinal
      enkephalinergic pathways in the cat, and indicate that these descending pathways
      modulate spinal motor outflow.

PMID- 8361579
TI  - Inhibitory effects of the 5-HT1A agonists, 5-hydroxy- and 5-methoxy-(3-di-n
      propylamino)chroman, on female lordosis behavior.
AB  - Sexually receptive, intact, proestrous rats were infused bilaterally into the
      ventromedial nucleus of the hypothalamus with one of several serotonin (5-HT)
      agonists and with the endogenous ligand, 5-HT. Serotonin (2000 ng) and the 5-HT1A
      agonists, 8-hydroxy-2-(di-n-propylamino)tetralin [8-OH-DPAT (200 ng)], 5-methoxy
      3-(di-n-propylamino)chroman [5-MEO-DPAC (200-2000 ng)] and 5-hydroxy-3-(N-di-n
      propylamino)chroman [5-OH-DPAC (200-2000 ng)] inhibited female lordosis behavior
      within 10 min of the infusion. The rank order of the effectiveness of these
      compounds was 8-OH-DPAT > 5-OH-DPAC > or = 5-MEO-DPAC > 5-HT. The nonselective 5
      HT agonist, 1-(m-trifluoromethyl) piperazine [TFMPP (2000 ng)], did not reduce
      lordosis behavior. In addition to their reduction of lordosis behavior, the 5
      HT1A agonists elicited resistive behavior toward the male's attempts to mount.
      There were minimal effects of the 5-HT1A agonists on either quality of the
      lordosis reflex or on proceptivity. However, rats pretreated with TFMPP and
      infused with 8-OH-DPAT 1 hr later, did show a transient suppression of lordosis
      quality. These results provide further evidence that the ventromedial nucleus of
      the hypothalamus contains 5-HT1A sites, the activation of which reduces lordosis
      behavior in regularly cycling, proestrous rats.

PMID- 8361580
TI  - The effects of adrenalectomy and ovariectomy on the behavioral and hypothermic
      responses of rats to 8-hydroxy-2(di-n-propylamino)tetralin (8-OH-DPAT).
AB  - The aim of this study was to determine the effects of sex, corticosterone and
      oestradiol-17 beta on the hypothermia and motor behavioural syndrome induced by
      the 5-HT1A receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) in
      the rat. The hypothermia, but not the behavioural syndrome induced by 8-OH-DPAT
      was significantly greater in female compared with male rats. Adrenalectomy in
      male rats enhanced the hypothermic response, an effect prevented by
      corticosterone implants. Ovariectomy significantly attenuated the hypothermia
      induced by 8-OH-DPAT, an effect prevented by oestradiol-17 beta implants. Neither
      type of steroid manipulation affected the behavioural syndrome. These results
      show that sex, corticosterone and oestradiol-17 beta modulate the hypothermic
      response to 8-OH-DPAT in the rat, with corticosterone and oestradiol-17 beta
      having opposing effects.

PMID- 8361581
TI  - Role of calcium ions in dopamine release induced by sodium cyanide perfusion in
      rat striatum.
AB  - We have previously reported a transient and remarkable increase in dopamine (DA)
      release in the rat striatum during application of 2 mM sodium cyanide (NaCN)
      through a brain microdialysis membrane. In the present study we examined the
      involvement of extracellular Ca2+ in this response. Rats were divided into 4
      groups. In the NaCN group a microdialysis probe inserted into the striatum was
      perfused with Ringer's solution containing 2 mM NaCN for 60 min. The Ca2+ free +
      NaCN group was subjected to perfusion with NaCN dissolved in Ca2+ free Ringer's
      solution, and the CdCl2 + NaCN group with the same plus 0.3 mM CdCl2 (a non
      specific Ca2+ channel blocker). In the NaCN and Ca2+ free + NaCN groups DA levels
      in the dialysates increased to 36- and 44-fold of the control level,
      respectively, while this was suppressed to only a 16-fold increase in the CdCl2 +
      NaCN group. In response to a 100 mM KCl perfusion given 3 hr later DA levels were
      increased (22-fold) in the control group. On the other hand this response was
      inhibited in the NaCN group (3-fold), but not in the other two groups. An in
      vitro study with striatal slices showed a gradual increase in intracellular Ca2+
      during incubation with 2 mM NaCN. These results suggest that excessive influx of
      extracellular Ca2+ during NaCN perfusion may contribute partly to the increase in
      the extracellular DA level in the striatum, and also to the suppression of a DA
      increase in response to high K+ stimulation observed 3 hr later.

PMID- 8361582
TI  - Tolerance and cross-tolerance to the antinociceptive effects of [D-Arg2]
      dermorphin tetrapeptide analogue and morphine.
AB  - Rats were given repeated subcutaneous injections of [D-Arg2, Sar4]-dermorphin (1
      4) [DAS-DER-(1-4)] and/or morphine over a period of 4 or 7 days. Antinociception
      was determined at 90 min for DAS-DER (1-4) and 30 min for morphine after each
      morning injection (9:00 a.m.), using the tail-flick and digit pinching tests in
      rats. Subcutaneous administration of DAS-DER (1-4) and morphine produced the
      development of antinociceptive tolerance, respectively. A marked tolerance to DAS
      DER (1-4) and morphine was seen in rats made tolerant to morphine. However,
      administration of morphine produced no significant decrement in the
      antinociceptive activity in rats made tolerant to DAS-DER (1-4). These results
      suggest that the site of action of DAS-DER (1-4) may be more limited than that of
      morphine in the nociceptive pathways, for lack of its antinociceptive efficacy in
      morphine-tolerant rats.

PMID- 8361583
TI  - Met-enkephalin-Arg6-Phe7 in spinal cord and brain following traumatic injury to
      the spinal cord: influence of p-chlorophenylalanine. An experimental study in the
      rat using radioimmunoassay technique.
AB  - The possibility that trauma to the dorsal horn may affect the release and
      distribution of enkephalin was examined using the opioid peptide Met-Enk-Arg6
      Phe7 (MEAP) as a marker in a rat model. The peptide content of samples of spinal
      cord and whole brain was measured using a radioimmunoassay (RIA) technique. In
      addition, the possible functional relation between this peptide and serotonin was
      evaluated using a pharmacological approach that included depletion of endogenous
      serotonin. A focal trauma to the right dorsal horn in the T10-11 segments (2 mm
      deep and 5 mm long) markedly modified the content of MEAP of the adjacent rostral
      and caudal segments of the cord, as well as the content of MEAP of the brain.
      Depletion of serotonin with p-CPA (an inhibitor of the synthesis of serotonin)
      significantly elevated the content of MEAP in the whole brain without affecting
      the regions of the spinal cord (except T9 level which showed a 25% decrease from
      an intact control group). Trauma to the spinal cord in the serotonin-depleted
      animals did not alter the content of MEAP further, as compared to a p-CPA-treated
      but untraumatized group. These results indicate that enkephalin (i) participates
      in the pathophysiology of spinal cord trauma and (ii) suggest that the peptide is
      somehow functionally related with serotonin.

PMID- 8361585
TI  - Child abuse and basic training.

PMID- 8361584
TI  - Prenatal cocaine exposure: decreased sensitization to cocaine and decreased
      striatal dopamine transporter binding in offspring.
AB  - Pregnant mice were treated with cocaine, 10 mg/kg/day, during days 13 to 20 of
      gestation. Cocaine sensitization and dopamine transporter binding were evaluated
      in offspring at 6 weeks of age. Sensitization, defined as the increase in
      activity after 5 injections of cocaine compared to 1 injection, was reduced in
      cocaine-exposed mice. Dopamine transporter binding in striatum was also
      significantly reduced in cocaine-exposed mice compared to controls.

PMID- 8361586
TI  - Educating about military field/medical duty.

PMID- 8361587
TI  - Outpatient treatment of posttraumatic stress disorder.

PMID- 8361588
TI  - Forensic dental identification of casualties during Operation Desert Storm.
AB  - Forensic dental identification of casualties during Operation Desert Storm was
      performed at the Dover Port Mortuary, Dover Air Force Base, under the auspices of
      the Office of the Armed Forces Medical Examiner. A total of 251 dental
      identifications were attempted and 244 individuals were positively identified by
      dental comparison. The panoramic radiographs on file at the Central Panograph
      Storage Facility were the primary antemortem records utilized in establishing the
      dental identification. The inability to establish a positive dental
      identification was most often the result of a lack of available antemortem dental
      records.

PMID- 8361589
TI  - The role of military medicine in military civic action.
AB  - We are moving into an era when U.S. military forces will be called upon
      frequently to perform military civic action (MCA) projects. Such projects, have
      been used successfully and unsuccessfully, primarily in the areas of medicine and
      engineering, to enhance the standing of military forces with indigenous
      populations. However, the available criteria for planning and assessing MCA
      projects are not widely known. These related and overlapping criteria are
      supported by facts, interpretative data, anecdotes, and common sense, but none
      can be considered absolute. Selected criteria are defined, reviewed, and
      illustrated with examples of past successes and failures.

PMID- 8361591
TI  - Immunization status of a military dependent population.
AB  - The immunization status of active duty pediatric dependents served by the
      National Naval Medical Center was surveyed to estimate the degree to which this
      group was in compliance with immunization requirements. Four hundred sixteen
      patients who presented consecutively to a pediatric acute care clinic had their
      medical and immunization records screened. Ten percent of patients did not have
      complete records of immunization. Of the 375 patients remaining, 52 (13.9%) were
      deficient in one or more required immunizations based on their current age. The
      highest rates of delay were seen for the Haemophilus influenza vaccine followed
      by measles, mumps, rubella, and diphtheria, tetanus, and pertussis. The most
      common reason for missing immunizations was parental unfamiliarity with the
      recommended schedule. This study suggests that a significant number of dependents
      in our catchment area were delayed in immunization and that accurate record
      keeping and patient education about immunizations needs to be improved.

PMID- 8361590
TI  - Nutritional status of rural Bolivian children.
AB  - While providing health care in rural Bolivia, 349 children under 4 years old were
      seen. Height and weight were measured and demographic data obtained. The purpose
      was to describe the prevalence of malnutrition and its associated socioeconomic
      factors. The sample included Mataco Indians and Bolivians of European or of mixed
      descent. Using international standards, 21% of the children had weight below the
      fifth percentile for age; 27% had height below the fifth percentage for age; 17%
      were below the fifth percentile for weight/height. Malnutrition was more common
      in younger children (peak prevalence in 1-2 year olds). Malnutrition was
      associated with race and water source, but not with family size, literacy,
      immunizations, meals per day, or deaths in family. Attempts to improve nutrition
      should focus on the youngest children.

PMID- 8361592
TI  - The military physician and conservation of force.
AB  - The military physician, while uniquely qualified to command medical units, is
      challenged during military operations to "conserve the fighting strength" of the
      combat arms units he supports. To meet the obligations of his command, the
      military physician must involve himself in the training, planning, and execution
      of his unit's specific mission. In peacetime, this involvement must be given
      priority and include field training exercises as well as continuing education.

PMID- 8361593
TI  - Israel defence forces experiences with treatment of POWs and families: an
      innovative multifaceted treatment model.
AB  - This paper attempts to provide an integrative, multifaceted treatment approach
      for the surviving POW and his family. The model takes into account the
      individual, family, interpersonal, and community effects of captivity from the
      time of captivity until 1 year later. Ramifications of this model are discussed.

PMID- 8361594
TI  - Hemarthrosis of the clinically stable knee due to sports and military training in
      young recruits: an arthroscopic analysis.
AB  - Findings of an early arthroscopy performed in 108 consecutive hemarthrotic and
      clinically stable knees were analyzed. The patients were young conscripts, the
      mean age being 19.9 years. Fifty-seven of the knees were injured during military
      training, 36 in different sports activities, 9 at falls, and 6 in motorbike
      accidents. The lesions were divided into "primary" (lesions needing operative
      treatment or the supposed most common lesions in incidence) and "secondary"
      (other lesions). An average of 1.6 lesions were observed per knee. Dislocation of
      the patella was the most common diagnosis in 38 (35%) cases. Dislocation of the
      patella was associated with military exercise (p < 0.001). Lesions of the
      anterior cruciate ligament (ACL) were observed in 37 (34%) cases. ACL ruptures
      were related to sport activities (p < 0.0001).

PMID- 8361595
TI  - Utilization of occupational therapy in combat stress control during the Persian
      Gulf War.
AB  - This article chronicles the deployment and subsequent utilization of occupational
      therapy personnel in support of combat stress control operations during the
      Persian Gulf War. It presents a discussion of occupational therapy's military
      history, evolving doctrine, and selected training experiences which led to the
      attachment of occupational therapy personnel to the 528th Medical Detachment
      (Psychiatric OM Team). A description of roles, functions, methods of operation,
      and lessons learned help to clarify the direction of occupational therapy in its
      future wartime mission.

PMID- 8361596
TI  - Health promotion in a shrinking military: the call for structural integration and
      a conceptual systems approach.
AB  - The evolution of health promotion in the military is reviewed and contrasted with
      developments in private sector activities. Programs in both arenas generally take
      a mechanistic, mortality and risk factor-based approach which targets lifestyle
      and behavioral change. In the military, that has resulted in a fragmentation of
      function and perception in the line and medical communities about health
      promotion. A "world view" model and a conceptual systems approach to health
      promotion are presented in which human resources, occupational health, life
      style, and health benefits programs are integrated to achieve efficiencies in
      program management, decreased mortality, and reduced medical care costs.

PMID- 8361597
TI  - Diarrheal and respiratory disease aboard the hospital ship, USNS-Mercy T-AH 19,
      during Operation Desert Shield.
AB  - Diarrhea and respiratory disease were common problems among ground troops
      deployed to the Middle East during Operation Desert Shield. In order to determine
      the prevalence and impact of diarrheal and upper respiratory disease among
      shipboard personnel during this period, an epidemiologic survey was conducted on
      the hospital ship, USNS Mercy T-AH 19. An episode of acute diarrhea was reported
      by 46% of the surveyed population, and 79% reported upper respiratory symptoms.
      Six percent of personnel were temporarily unable to perform scheduled duties due
      to gastrointestinal symptoms and 7% due to respiratory symptoms. Officers were at
      increased risk of experiencing an episode of diarrhea, and female crew members
      more often reported respiratory complaints. Improved strategies to prevent
      diarrhea and respiratory disease among shipboard personnel are needed.

PMID- 8361598
TI  - A descriptive study of care processes using total quality management as a
      framework in a USAF regional hospital emergency service and related services.
AB  - The purpose of this descriptive study was to investigate access to care processes
      in a military regional hospital Emergency Service (ES) and related services using
      a Total Quality Management framework. Tabulations of demographic survey data
      revealed that the ES is used mainly as a primary care clinic, with a greater
      proportion of pediatric care provided during peak hours. An analysis of patterns
      of care processes in the organizational system revealed that there was little in
      common between Total Quality Management and Continuous Quality Improvement
      principles and the care processes. The results of the analysis lend support to
      the proposed USAF decentralized, coordinated health care system with more
      authority and control given to local commands and emphasis upon increased
      responsibility and accountability within professional and beneficiary
      communities.

PMID- 8361599
TI  - Primary malignant tumors of the small intestine: a retrospective review in a
      military hospital.
AB  - Small intestinal malignancies are rare and highly variable in clinical
      presentation. Thirteen cases were found in the Tumor Registry of Naval Hospital,
      Oakland, California (NHO). We compared the NHO incidence to that of other
      civilian institutions. Suspicion of these tumors is necessary for early diagnosis
      and appropriate therapy. We advocate that data from a large number of hospitals
      be pooled to improve quality of care and better understand possible carcinogenic
      factors. This review is intended to share our findings and to stimulate further
      studies.

PMID- 8361600
TI  - Preparation for Desert Storm: expansion of an overseas Air Force hospital
      pharmacy to handle casualties.
AB  - The planning and execution for contingency pharmacy services in support of
      Operations Desert Shield/Desert Storm in an overseas Air Force Medical Center are
      described. These operations presented the staff with far different challenges
      than the contingency support plan that had been in place for several years. That
      plan focused medical operations based on armed conflict in Central Europe. With
      conflict now imminent in the Persian Gulf, over 8 hours flying time away from our
      facility, our priorities and mission changed tremendously. This conflict demanded
      prompt action by the Department of Pharmacy to ensure comprehensive services in
      support of Operations Desert Shield/Desert Storm without interruption of services
      to the local military community. Pharmacy planning focused on four basic areas:
      (1) supply requirements, (2) contingency staffing requirements, (3) expansion of
      inpatient pharmacy services, and (4) modifications to outpatient pharmacy
      services. A modified contingency plan assured professional pharmaceutical
      services for over 3,000 patients suffering injuries in the 12 months American
      forces were deployed to the Persian Gulf.

PMID- 8361601
TI  - A review of lower limb overuse injuries during basic military training. Part 1:
      Types of overuse injuries.
AB  - Lower limb injuries present the greatest source of medical problems during basic
      military training. These main overuse lower limb injuries, anterior compartment
      syndrome, stress fractures, Achilles tendinitis, plantar fasciitis, shin splints,
      and chondromalacia patellae, are reviewed with respect to current knowledge of
      rates, diagnosis, and treatment. Part 2 shall review possible etiological factors
      involved in the causation of these injuries.

PMID- 8361602
TI  - A review of lower limb overuse injuries during basic military training. Part 2:
      Prevention of overuse injuries.

PMID- 8361603
TI  - The "un-comfort-able": making sense of adaptation in a war zone.
AB  - Unanticipated deployment of medical personnel from a fixed medical facility to a
      hospital ship creates significant psychological anxiety. Analysis of the
      stressors which the August 1990 deployment of the USNS Comfort in support of
      Operation Desert Shield/Storm precipitated in its crew are detailed and coping
      strategies are discussed. Recommendations to assist personnel in adapting to
      future deployments of this type are made. This unique event demonstrates the
      continued importance of applying the principles of social psychology to
      operational military events preventively.

PMID- 8361604
TI  - National Guard training: Fort Irwin MEDDAC experience during Operation Desert
      Storm.
AB  - The expansion of the USA MEDDAC, Fort Irwin, California, during Operation Desert
      Storm is described. During Operation Desert Storm, Fort Irwin and the National
      Training Center was responsible for training the 48th Separate Infantry Brigade
      National Guard from Georgia. The impact of this training upon the MEDDAC is
      described.

PMID- 8361605
TI  - Undiagnosed shrapnel of the tongue.
AB  - A case of a large metal fragment in the tongue is reported in a soldier injured
      in Operation Desert Storm. The fragment was not diagnosed for 57 days as the
      patient was evacuated through multiple U.S. Army medical facilities for other
      injuries. Diagnosis and treatment of the case are discussed.

PMID- 8361606
TI  - Unequal refractive error and high astigmatism associated with orbital
      lymphangioma.

PMID- 8361607
TI  - [Clinical hemorrheology and arterial hypertension].
AB  - In order to have a good haemorheological approach to hypertensives, we have put
      together a review with haemorheological subjects and with the relationships
      between plasmatic and haematic viscosity and hypertension in relation to
      pathophysiology, diagnosis, prognosis and treatment. In this review we deal with:
      (1) Clinical haemorheology. (2) Haematic viscosity. (3) The relationship between
      haemorheology and hypertension and between antihypertensive drugs and
      haemorheology. The study of viscosity and erythrocytes deformability, and of
      erythrocytes and platelets stickiness could pharmacologically correct the
      haemorheological disorders which can be some of the causes of hypertension.

PMID- 8361608
TI  - [Evolution of pacing modes in patients with implanted pacemakers. Personal
      considerations on a case load of 171 patients].
AB  - In this study retrospectively analyse pacemaker-implantation activity carried out
      during the last 5 years at the Laboratory of Electrophysiology, affiliated with
      the Cattedra di Cardiologia of the University of Naples--II Ateneo. Evolution in
      pacing modes is considered with regard to the patient age, the underlying
      pathologies and the technical progress in the field. The study has been performed
      in our laboratory, which is fit up for electrophysiologic studies and
      implantation of either temporary or permanent pacemakers. Patients included in
      this study have been implanted in our laboratory either for urgency or for
      election. They have been retrospectively divided into two groups (age < 65 yrs,
      129 patients, and age < 65 yrs, 42 patients); in addition the patients have been
      classified according to the pathology leading to the implantation: atrio
      ventricular block (second degree or third degree), low frequency fibrillation,
      sick sinus syndrome and carotid sinus syndrome. 171 patients have been examined,
      of whom 129 > 65 yrs. and 42 < 65 yrs. As for the pacing indication, 54 were
      atrio-ventricular block (56.1%), 50 were sick sinus syndrome (31.6%), 20 low
      frequency fibrillation (11.7%), and 1 was carotid sinus syndrome (0.6%). The
      ratio between single- and dual-chamber pacemakers has been progressively
      changing: in 1987 we implanted 33 single-chamber and no dual-chamber pacemaker,
      compared to 7 single- and 23 dual-chamber pacemaker implanted in the last year.
      This trend is in good agreement with literature data.

PMID- 8361609
TI  - [Evaluation of regression of left ventricular hypertrophy after antihypertensive
      therapy. Comparative echo-Doppler study of ace inhibitors and calcium
      antagonists].
AB  - This study evaluates 33 patients suffering from mild-moderate arterial
      hypertension (systolic blood pressure over 160 mmHg; diastolic blood pressure
      over 95 mmHg) and with concomitant indications of concentric left ventricular
      hypertrophy at echocardiography. Twenty patients completed the trial according to
      the criteria established in the protocol and were found suitable for evaluation
      of the results at the end of the study. Ten patients were treated with 40 mg of
      nifedipine retard tablets, administered twice (1 x 20 mg tablet twice daily) and
      10 patients were treated with a single administration of 20 mg quinapril (1 x 20
      mg tablet per day). Total follow-up was performed for one year (variability 12-14
      months) with evaluation of the pressure response at 1-3-6-12 months and clinical
      evaluation and echocardiographic control for comparison with the baseline at the
      end of the study. The left ventricular mass values measured at the end of the
      study presented a statistically significant reduction (p < 0.001) with respect to
      the baseline in both groups. In the patients treated with quinapril the
      percentage regression of left ventricular hypertrophy was 19.39%, and slightly
      higher (19.5%) in the patients treated with nifedipine. Finally, although the
      series is perhaps too limited to draw conclusions, the finding that the
      indicators of diastolic filling of the left ventricle improved, and, in
      particular, were correlated with an increase in the speed of the first fast
      filling phase, and thus that there was a partial improvement in left ventricular
      compliance, is important.

PMID- 8361610
TI  - [Critical ischemia of the lower limbs: pathogenesis, clinical course and therapy.
      Results of authors' experience in 337 cases].
AB  - The definition of an ischaemic condition at lower limb level, may imply any
      different degree of the pathology, starting from a simple chronic slight
      claudication up to a severe ischaemia. Critical Limb Ischaemia is the term
      defined to identify an ischaemic condition, which endangers the limb or part of a
      limb and requires a prompt and appropriate treatment. However the pathophysiology
      of this condition remains to be well established and depends on various vascular
      factors. For the European Working Group on Critical Limb Ischaemia (Berlin 1989,
      Rudesheim 1991) the definition is strictly restricted to Fontaine's stage III B
      and IV, while in our opinion the definition could be very simple in all the
      patients with a prognostic limb-threatening condition (for localization and wide
      extension of the lesions) independent of the Fontaine's stage, which are going
      towards a future amputation if radical improvement of blood flow cannot be
      achieved with an adequate revascularization. In our five year late experience, we
      observed and surgically treated 337 patients with CLI (74% males and 80%
      atherosclerotic lesions). We discuss the preoperative findings, diagnostic
      procedures, surgical techniques and relate results.

PMID- 8361611
TI  - [Current role of extra-anatomical revascularization of the lower limbs].
AB  - In vascular reconstructive surgery of the lower limbs for aorto-iliac disease the
      first choice procedure is TEA or aorto-femoral bypass. In "high risk patients"
      alternative procedures like extra-anatomical bypass (axillo-femoral or femoro
      femoral bypass grafts) are available. In some cases, such us infection of a
      retroperitoneal prosthesis, an axillo-femoral bypass is mandatory in order to
      obtain revascularization of the lower limbs. In this article we report our late
      experience in this surgery and our opinion on the correct indication for the use
      of these procedures.

PMID- 8361612
TI  - [Cor triatriatum associated with inter-atrial defect: diagnosis by
      transesophageal echocardiography].
AB  - Cor triatriatum (CT) is a rare malformation consisting of a fibromuscolar
      membrane that subdivides the left atrium in a postero-superior (or accessory)
      chamber and an antero-inferior chamber (true left atrium, containing the left
      atrial appendage). In its classic form, the accessory chamber receives the
      pulmonary veins and communication with the left atrium is accomplished by way of
      one or more fenestrations in the membrane. The malformation is usually isolated,
      but in about one in four patients is associated with other congenital defects of
      a complex nature. We describe a case of CT associated with atrial septal defect,
      in which transthoracic echocardiography failed to document the existence of CT
      membrane, while this abnormality was clearly seen and defined by use of
      transesophageal echocardiography. The patient was a 26 year-old girl, presented
      at our outpatient clinic after an episode of palpitations and dyspnea, which
      lasted for two hours. She suffered of mild dyspnea on exertion during the last
      three months. Physical examination revealed the typical findings of an atrial
      septal defect (ASD), and the electrocardiogram revealed right bundle branch
      block. The two-dimensional echocardiography disclosed an ostium secundum ASD with
      left to right shunt; dilatation of the right cavities; paradoxical movement of
      the interventricular septum. A small linear echo originating from the lateral
      wall of the left atrium, with no evidence of turbulent flow on pulsed wave
      Doppler and color flow examination, was interpreted as an artifact.
      Transesophageal echocardiography clearly visualized a tense, bulging membrane
      separating left atrium into two chambers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361613
TI  - [Ventricular fibrillation during stress test on a treadmill. Apropos of a case].
AB  - A case of ventricular fibrillation occurring in the recovery phase of treadmill
      exercise test is described. A 64-year-old man was admitted to the hospital
      because of chest pain. The resting electrocardiogram was normal, but during a
      stress test (Bruce protocol) ventricular ectopic beats and ischemic S-T
      depression were observed. The echocardiogram showed septal hypertrophy and septal
      and apical hypokinesia. Ten days later he, during antianginal therapy, underwent
      treadmill exercise testing. In contrast with the previous stress test,
      ventricular ectopic beats decreased during the effort, but the S-T segment
      depressed, at the third step, with mild chest pain and hypotension. While angina
      and electrocardiogram improved, suddenly ventricular fibrillation developed. The
      patient was successfully resuscitated with electrical defibrillation, with a 350
      joules shock. Echocardiogram was unchanged; serum enzymes were slightly modified
      (secondary to DC-shock). The ischemic changes observed at the electrocardiogram
      in the anterior wall within seven days returned in the normal range. Ten days
      later the patient underwent cardiac catheterization. At ventriculography the
      posterior and diaphragmatic wall was diskinetic, ejection fraction was 70%; a
      complete occlusion of the right coronary artery at the origin, a critical
      stenosis of left descending artery, with occlusion in the middle tract were
      found. Circumflex artery was occluded at the origin with omo-etero-coronary
      collateral channels. Twenty days later, he had a successful bypass surgery.
      Postsurgical echocardiogram revealed a moderate depression of ejection fraction
      (41%), inferior diskinesia, apical hypokinesia, mild mitral regurgitation. The
      patient was discharged with digitalis, nitrates, aspirin and amiodarone for
      prophylactic treatment of paroxystic atrial fibrillation.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8361614
TI  - [Vascular complications in drug addicts. Intermittent claudication in a HIV
      seropositive heroin addict].
AB  - The widespread use of heroin has revealed the growing life-threatening
      complications consequent on drug practice. The effects of heroin on the
      cardiovascular, pulmonary, renal and central nervous system have been well
      described in medical literature, but the vascular complication of chronic
      occlusive arterial disease of the lower limbs is rare. We report a case of a
      young female patient who was a chronic drug addict for over five years, with
      concomitant serum positiveness for HIV infection. The etiologic and pathogenetic
      mechanisms of such an uncommon vascular complication are discussed on the basis
      of the existing literature.

PMID- 8361615
TI  - [Primary mesothelioma of the pericardium with long-term survival].
AB  - We report the case of a 52-year-old man admitted to our Hospital for a massive
      pericardial effusion already discovered at an X-ray examination of the chest more
      than one year before, but never submitted to further investigation. Four months
      after a first surgical intervention of "pericardial windowing" and a drainage of
      1700 ml of clear pericardial fluid, the patient was again hospitalized because of
      cardiac tamponade and underwent open pericardial drainage. At inspection, the
      pericardium and the myocardial muscle were fused in a single mass that at
      histological examination was discovered to be a primary mesothelioma of the
      pericardium, epithelial type. We discuss the clinical course and review the
      scientific literature inherent in these rare cases of primary neoplastic diseases
      of the heart.

PMID- 8361616
TI  - Optimalized in vivo production of monoclonal antibodies in mouse ascitic fluid.
AB  - The note contains a brief summary of the method in use at the National Institute
      of Public Health for the production of monoclonal antibodies in mouse ascitic
      fluid. This method of obtaining large amounts of monoclonal antibodies is widely
      used. Refining the in vivo method and increasing the yield from each mouse could
      result in a reduction of the number of animals used.

PMID- 8361617
TI  - Time variations in injury incidence.
AB  - STUDY OBJECTIVE: to present time variations in the incidence of injuries on a
      community level. POPULATION AND METHODS: all injuries which occurred in a defined
      population of the municipality of Harstad were registered prospectively from 1
      January 1986 to 31 December 1991. Variations over time in monthly incidence of
      seven types of injuries (home, traffic, street, sports, work, other, unknown)
      were analysed by the Autoregressive Integrated Moving Average Analysis (ARIMA).
      RESULTS: a total of 9,685 injuries was registered during the six year follow-up
      period. No significant secular trend was observed for any of the analysed types
      of injuries. Series of monthly incidence of traffic, street, and sports injuries
      showed seasonal-dependent variations. Incidence of traffic injuries was highest
      during the summer months, while incidence of sports and street injuries was
      highest during the winter months. CONCLUSIONS: both the existence of seasonal
      dependency in injury incidence and the relatively high random variations in
      monthly injury incidence imply that evaluation of community based injury control
      programmes should include incidence during at least a one year period before the
      intervention has started.

PMID- 8361618
TI  - Heat shock partially protects rat pheochromocytoma PC12 cells from amyloid beta
      peptide toxicity.
AB  - Rat pheochromocytoma PC12 cells are killed by amyloid beta protein (ABP), a
      component of plaques and other amyloid deposits in Alzheimer's disease. To
      investigate the possibility of protection from ABP toxicity by induced heat shock
      proteins (hsps), PC12 cells were heat treated for 60 min at 42 degrees C. The
      stress response of the PC12 cells was examined at the protein level using hsp72
      specific monoclonal antibodies. Hsp72 immunoreactivity was highly induced
      following heat treatment. The toxic effect of the beta 25-35 ABP peptide
      fragment, the major cytotoxic sequence within ABP, was reduced in heat pretreated
      PC12 cultures. These data indicate a protective role of hsps in neuronal cells
      exposed to ABP.

PMID- 8361619
TI  - Near infrared spectroscopy (NIRS): a new tool to study hemodynamic changes during
      activation of brain function in human adults.
AB  - In healthy human adults, cerebral concentrations of oxygenated hemoglobin
      ([HbO2]) and deoxygenated hemoglobin ([HbR]) were assessed during brain
      activation using near infrared spectroscopy (NIRS). Measurements were made either
      in the frontal cortex (n = 10) during performance of cognitive tasks or in the
      occipital cortex (n = 6) during visual stimulation (flash-light exposure, picture
      observation). The typical findings during brain activation were an increase in
      [HbO2] and a decrease in [HbR]. We demonstrate that these findings are not due to
      alterations in skin blood flow. NIRS is a simple bedside technique for the
      assessment of hemodynamic alterations accompanying brain activation.

PMID- 8361620
TI  - The effect of ketamine anesthetic induction on muscle responses to transcranial
      magnetic cortex stimulation studied in man.
AB  - In man, an anesthetic agent that induces surgical anesthesia with minimal
      influence on descending pyramidal tract activity remains to be found. Anesthesia
      with ketamine allows recording of stable compound muscle action potentials
      (CMAPs) to single transcranial magnetic stimulations of the motor cortex
      (CortStim) in monkeys. This report describes the findings in 5 patients, where
      CMAPs to CortStim were recorded from the right hypothenar during anesthesia
      induction with ketamine. The agent was injected intravenously every 90 s in 6
      steps of 0.5 mg up to a maximum of 3 mg/kg body weight (BW). Surgical anesthesia
      was achieved after ketamine injection of 1.5 (n = 4 patients) or 2.0 mg/kg BW (n
      = 1). In the five individuals tested, CMAP amplitudes and latencies (mean; range)
      were 2.6 (1.6-5.8) mV and 22.8 (20.4-24.6) ms before induction, and 1.6 (0.3-4.7)
      mV and 23.5 (21.7-24.5) ms after administration of the maximum dose. The paired
      differences (mean +/- 1 S.D.) were 0.8 +/- 0.6 mV and 1.0 +/- 0.8 ms and were
      statistically not significant (n = 5, P = 0.1, Wilcoxon-test). With ketamine as a
      single anesthetic induction agent CMAPs to single CortStim remain easily
      recordable even in dosages higher than those necessary to induce surgical
      anesthesia. All other previously tested anesthetic agents suppress CMAPs to
      CortStim as soon as the patient is unconscious.

PMID- 8361621
TI  - Measles virus-induced hippocampal neurodegeneration in the mouse: a novel,
      subacute model for testing neuroprotective agents.
AB  - The hamster neurotropic (HNT) strain of measles virus causes non-inflammatory
      encephalopathy in Balb/c mice, associated with neurodegeneration in hippocampal
      CA1 and CA3 regions. This loss of pyramidal cells can be prevented by twice daily
      systemic treatment with 1 mg/kg dizocilpine (5-methyl-10,11-dihydro-5H
      dibenzo(a,d)cyclo-hepten-5,10-imine maleate; MK-801) for 7 days. By varying the
      MK-801 treatment protocol, we now found that drug administration during the last
      4 days prior to sacrifice (i.e. days 4-7 post inoculation, p.i.) is essential for
      neuroprotection. In contrast, MK-801 treatment during the first days (days 0-4
      p.i.) did not prevent the neuronal necrosis. These data suggest that the
      concentration of an excitotoxic factor in the mouse brain increases after virus
      inoculation, reaching toxic levels by days 4-5 p.i. This novel 'subacute' mouse
      model of neurodegeneration therefore constitutes an attractive tool for
      mechanistic and interventional studies in excitotoxicity research.

PMID- 8361622
TI  - Sustained graded pain and hyperalgesia from harmless experimental tissue acidosis
      in human skin.
AB  - The present study was performed to decide whether tissue acidosis can induce
      sustained pain and, by that, possibly contribute to the pain in inflammation or
      ischaemia. A motorized syringe pump was used to infuse an isotonic phosphate
      buffer solution (pH 5.2) via sterile filter and cannula into the palmar forearm
      skin of human subjects (n = 6). This resulted in a localized burning pain
      sensation (edema and flare response) that was sustained as long as a constant
      flow was maintained. Flow rates between 1.2 and 12 ml/h were needed to reach
      individual pain ratings around 20% of a visual analogue scale (VAS). Increasing
      the flow in multiples of this basic rate led to approximately log-linear
      increases in individual pain ratings with reasonable congruence of the slopes.
      Stopping the pump or cooling the skin close to the cannula caused an abrupt pain
      relief. Prolonged infusion at flow rates producing pain ratings around 20% VAS
      led to localized changes in mechanical sensitivity: The touch threshold increased
      -as it did with control infusion of phosphate buffer at pH 7.4. However, the
      punctate force producing a threshold sensation of pain dropped from 64 to 5.7 mN
      (median values); the final level was usually reached within 15 min. In
      conclusion, experimental tissue acidosis provides a controllable and harmless
      method to produce sustained, graded and spatially restricted pain and
      hyperalgesia to mechanical stimulation.

PMID- 8361623
TI  - Ultrastructural study of Bunina bodies in the anterior horn neurons of patients
      with amyotrophic lateral sclerosis.
AB  - We ultrastructurally investigated Bunina bodies (BB) in the anterior horn neurons
      of 20 amyotrophic lateral sclerosis patients with BB. As for novel findings,
      filaments thicker than neurofilaments were not uncommonly observed inside the BB.
      They were occasionally observed around the periphery of the BB. Some of them were
      composed of bundles of filaments which appeared constricted at 40-50 nm intervals
      and were 20-25 nm in maximum width. Others consisted of bundles of unconstricted
      filaments measuring about 20-25 nm in diameter. The BB occasionally contained
      bundles of filaments of about 20 nm in diameter that closely resembled those
      found in ubiquitin-positive skein-like inclusions. It seems that some molecular
      disturbances such as ubiquitin play a role in the formation of the constricted
      and unconstricted filaments. Probably cytoskeletal or non-cytoskeletal proteins
      in anterior horn cells are damaged and accumulate to form aggregation of the
      filaments associated with BB.

PMID- 8361625
TI  - Regulation of the transcription factor c-JUN by nerve growth factor in adult
      sensory neurons.
AB  - We examined the regulation by nerve growth factor (NGF) of the immediate-early
      gene (proto-oncogene) c-jun in adult dorsal root ganglion (DRG) neurons using
      immunocytochemistry to c-JUN (the protein product of the proto-oncogene c-jun).
      Following a sciatic nerve crush, the injury-induced increase in c-JUN-like
      immunostaining was reduced in DRG neurons by continuous intrathecal infusion of
      NGF for one week. Conversely, in intact DRG neurons (i.e., without Wallerian
      degeneration), c-JUN-like immunoreactivity was markedly increased following four
      weeks of daily NGF antiserum injections (to remove target tissue-derived NGF)
      into the hindfoot. Taken together, these findings indicate that nerve transection
      (axotomy) results in a loss of target tissue-derived NGF leading to induction of
      the transcription factor c-jun which may play a role in axonal regeneration.

PMID- 8361624
TI  - Chondroitin sulfate proteoglycan form of cellular and cell-surface Alzheimer
      amyloid precursor.
AB  - The biological function of the amyloid precursor protein (APP) is still not fully
      understood. Recently, we reported that secreted truncated APP occurs in a
      chondroitin sulfate proteoglycan form. Here we present evidence that full length
      APP-chondroitin sulfate proteoglycan is present on the cell surface of C6 glioma
      cells. In addition, densitometric quantitation of Western blots showed that
      approximately 50% of the mature cell-associated full length APP is in the
      proteoglycan form. These findings suggest that the proteoglycan nature of APP may
      be important for the implementation of its biological function.

PMID- 8361626
TI  - Spatial re-arrangement of the vesicle apparatus in forebrain synapses of chicks
      30 min after passive avoidance training.
AB  - A quantitative ultrastructural study of synapses was carried out in the forebrain
      IMHV (intermediate and medial hyperstriatum ventrale) of 1-day-old chicks 30 min
      after training to avoid pecking at a bead coated with methyl anthranilate. In 10
      birds (5 control and 5 trained), the length, curvature and the number of the
      synaptic active zone profiles were measured, and the active zone profile length
      was observed to increase in trained chicks. The spatial arrangement of synaptic
      vesicles with respect to the active zone was examined using a statistical
      stereological approach. This showed that vesicles are not located uniformly but
      accumulate in two spatial pools which appear to rearrange following training,
      with a greater number of vesicles near the active zone. These data may reflect
      subtle changes in the functional efficacy of synapses in the IMHV in the initial
      phases of memory formation.

PMID- 8361627
TI  - Lipopolysaccharide induces fever and decreases tail flick latency in awake rats.
AB  - In humans, somatic aches and pains are frequently reported during fever. To
      determine whether exogenous pyrogen administration increases nociceptive
      responsiveness in rats, the tail flick reflex evoked by noxious heat was compared
      in animals that received an intraperitoneal injection of exogenous pyrogen
      (lipopolysaccharide) or vehicle (saline). There were no differences in skin
      temperature between lipopolysaccharide- and vehicle-injected rats. Awake rats
      injected with lipopolysaccharide exhibited an increase in colonic temperature and
      a decrease in tail flick latency when compared to vehicle-injected rats. Neural
      events that trigger fever may therefore also modulate nociceptive responsiveness.

PMID- 8361628
TI  - Ethanol dose-dependently attenuates NMDA-mediated thermal hyperalgesia in the
      rat.
AB  - Recent observations using acute and persistent pain models have suggested that
      activation of the N-methyl-D-aspartate (NMDA) receptor is required for mechanisms
      that underly the development and maintenance of thermal hyperalgesia. The present
      results document that both NMDA-mediated thermal hyperalgesia produced after
      acute intrathecal NMDA administration and NMDA-mediated thermal hyperalgesia
      produced in a model of neuropathic pain are dose-dependently and reversibly
      attenuated by intrathecal administration of ethanol (0.5-1.0%; total dose, 106
      213 nmol, i.t.). This is consistent with recent reports that ethanol may function
      as a selective NMDA receptor antagonist at low concentrations and further extends
      the evidence that thermal hyperalgesia is mediated by NMDA receptors.

PMID- 8361629
TI  - Brain S-adenosylmethionine decarboxylase activity is increased in Alzheimer's
      disease.
AB  - We measured the activity of S-adenosylmethionine decarboxylase (SAMDC), a key
      regulatory enzyme of polyamine biosynthesis, in autopsied brain from 13 patients
      with Alzheimer's Disease (AD). As compared with the controls, mean enzyme
      activity was increased by 37-96% in all seven examined brain regions with
      statistically significant increases in temporal cortex (+96%), frontal cortex
      (+69%) and hippocampus (+90%). The elevated SAMDC may have occurred as part of a
      generalized polyamine response to brain injury, which has been previously
      described in experimental animal conditions. Above-normal SAMDC activity implies
      increased levels/metabolism of spermidine and spermine, two polyamines which are
      involved in neuronal regeneration, growth factor production, and activation of
      excitatory N-methyl-D-aspartate preferring glutamate receptors. Our data suggest
      the involvement of the polyamine system in the brain reparative and/or
      pathogenetic mechanisms of AD.

PMID- 8361630
TI  - Selective neurotoxicity of COOH-terminal fragments of the beta-amyloid precursor
      protein.
AB  - The primary component of amyloid deposits found in the brains of patients with
      Alzheimer's disease is the beta-amyloid protein, a derivative of a much larger
      precursor protein (beta PP). We have previously reported that overexpression of
      carboxyl (COOH)-terminal fragments of beta PP from an integrated DNA construct
      leads to degeneration of neuronally differentiating mouse embryonic stem cells
      and that the neuronal degeneration is related to approximately 14- and 15-kDa
      COOH-terminal fragments of the precursor protein. We here demonstrate that these
      putative cytotoxic fragments contain intact beta-amyloid protein. When such
      transformed cell lines are treated with dimethyl sulfoxide to induce
      differentiation into muscle cells, however, the resulting muscle cells remain
      viable (as do control non-transformed cells), despite the production of
      comparable amounts of the 14- and 15-kDa fragments. These results are consistent
      with the hypothesis that particular COOH-terminal fragments of beta PP are
      amyloidogenic and neurotoxic.

PMID- 8361631
TI  - The effects of aging on diurnal water intake and melatonin binding in the
      suprachiasmatic nucleus.
AB  - In vitro autoradiography was used to quantify [125I]melatonin binding in young
      rats and in aged rats that were screened for diurnal drinking prior to
      neurobiological study. Among the aged subjects studied, some rats exhibited a
      blunted diurnal rhythm in that a decreased percentage of water was consumed
      during the dark phase. Other aged animals maintained a strong nocturnal pattern
      of water intake similar to young rats. The density of [125I]melatonin binding in
      the suprachiasmatic nucleus (SCN) of the hypothalamus was significantly
      correlated with diurnal drinking, i.e. lower binding was associated with a more
      blunted rhythm. Thus, [125I]melatonin binding in the SCN may provide a marker for
      age-related decline in some aspects of biological functions.

PMID- 8361632
TI  - Expression of a TGF beta regulated, brain-specific mRNA in serum-free mouse
      embryo (SFME) cells.
AB  - The serum-free mouse embryo (SFME) cell line was isolated from 16-day-old Balb/c
      mouse embryos in medium in which the usual serum supplement to the culture medium
      was replaced by purified growth factors and other components. SFME is an unusual
      line that does not undergo senescence in vitro, maintains an apparently normal
      karyotype, and is growth inhibited by serum. Transforming growth factor beta (TGF
      beta) or calf serum induces expression of the astrocyte marker glial fibrillary
      acidic protein (GFAP) in these cells, and similar cells can be isolated directly
      from brain. By differential screening of a cDNA library derived from SFME cells,
      a calf serum- and TGF beta-regulated 8.5 kb mRNA was identified in SFME cells and
      the cDNA partially sequenced. This mRNA was detected only in RNA preparations
      from brain among a number of tissues examined, and may provide an additional
      marker of TGF beta-regulated differentiation in these cells.

PMID- 8361634
TI  - Chloramphenicol prevents carbachol-induced REM sleep in cats.
AB  - Twenty-four cats were implanted for chronic sleep recordings. One week after the
      surgery, cats were divided into four groups. Two groups were treated with three
      i.p. injections of 150 mg/kg chloramphenicol (CAP) separated by 12 h. Carbachol
      (8 micrograms/1 microliter) or saline (1 microliter) was injected into the
      pontine reticular formation (PRF) 1 h after the last injection of CAP. The other
      two groups received saline or carbachol into the PRF without CAP pre-treatment.
      Polygraphic recordings were started immediately after the microinjection and
      lasted 11 h. Carbachol increased REM sleep (P < 0.001) and reduced SWS2 (P <
      0.05). In contrast, chloramphenicol reduced REM sleep (P < 0.001) and increased
      SWS2 (P < 0.01). The combination of these drugs increased wakefulness (P < 0.01)
      and reduced both SWS2 and REM sleep (P < 0.001). This data shows that
      chloramphenicol prevents carbachol induced REM sleep. Results are discussed in
      terms of an interaction between brain proteins and the cholinergic system to
      induce REM.

PMID- 8361633
TI  - Differential loss of dopamine D2 receptor mRNA isoforms during aging in Fischer
      344 rats.
AB  - Effects of aging on the expression of dopamine D2 receptor isoforms (D2-long and 
      short) in neostriatal subregions was examined by in situ hybridization
      histochemistry. Hybridization of a probe selective for the D2-long transcript was
      compared with signal generated by a probe recognizing both variants of D2 mRNA.
      Lateral quadrants of the neostriatum in old rats appeared to show declines in
      primarily the long transcripts. On the other hand, decreases in the expression of
      D2-short transcripts appeared to occur during aging in the ventromedial region of
      the striatum. These data suggest that the mechanisms involved in alternative
      splicing of D2 mRNA may be differentially altered in neostriatal subregions
      during aging.

PMID- 8361635
TI  - Changes in the neural cell adhesion molecule patterns on the rat glial cell
      surfaces with development and contact formation in vitro.
AB  - In monolayer cultures of newborn rat hippocampal cells, immunogold-labelling at
      the electron microscope level was used to study quantitatively the neural cell
      adhesion molecule (N-CAM) arrangement on the surface of glial soma and processes
      on 5 and 12 days in vitro (DIV). Four corresponding samples of micrographs were
      formed. To quantify the labelling, a stochastic geometry approach was used.
      Spectra of lateral distances between labels as well as simulated images of the
      surface label arrangement (invisible in micrographs) were derived and compared.
      The data show that, on both 5 and 12 DIV, N-CAM density on the surface of
      processes is approximately 2 times higher than that in somata; 12-DIV cells
      showing a lower (approximately 25%) N-CAM surface density as compared with the 5
      DIV cells. This suggests that N-CAM expression in glia surfaces decreases while
      the cells form contacts, and N-CAM sorting between soma and processes remains
      stable. The simulated topographies of the lateral N-CAM arrangement might
      highlight fundamental mechanisms that underlie formation of the neural network.

PMID- 8361636
TI  - Dopamine D2 receptors in the hippocampus and amygdala in Alzheimer's disease.
AB  - Receptor autoradiography was used to quantify the number of dopamine D2 receptors
      labeled with [125I]epidepride in the medial temporal lobe of seven cases of
      Alzheimer's disease in comparison to eight cases of neurologically intact
      controls. The Alzheimer's disease cases showed the greatest losses of D2
      receptors in the basolateral nucleus of the amygdala and molecular layer of the
      dentate gyrus and the smallest differences from controls in the perirhinal region
      and subiculum. The loss of D2 receptors in the hippocampus and amygdala of cases
      with Alzheimer's disease in concert with alterations in dopaminergic innervation
      could contribute to the clinical symptoms of this disorder.

PMID- 8361637
TI  - Area-dependent changes in GABAergic function after acute and chronic cold stress.
AB  - (1) The function of the gamma-aminobutyric acid (GABA)ergic system in certain
      areas of the rat brain was investigated after acute and chronic cold stress. (2)
      GABA concentration, [3H]GABA uptake and the activity of the synthesis enzyme
      glutamate decarboxylase (GAD) were measured. (3) Acute stress: (a) reduced GABA
      concentration in the corpus striatum (29%); (b) decreased GAD activity (under non
      saturating substrate concentration) in the olfactory bulbs (24%); (c) diminished
      neuronal uptake of [3H]GABA in the frontal cerebral cortex (65%), hypothalamus
      (86%) and olfactory bulbs (82%). (4) Chronic stress: (a) reduced the endogenous
      levels of GABA in the frontal cerebral cortex (51%), hypothalamus (26%) and
      olfactory bulbs (15%); (b) decreased GAD activity in the corpus striatum (32%)
      and olfactory bulbs (34%); (c) decreased neuronal uptake of [3H]GABA in the
      hypothalamus (83%). (5) These findings suggest that compensatory changes may
      develop in the GABAergic system after chronic stress.

PMID- 8361638
TI  - Iron uptake in the brain of the myelin-deficient rat.
AB  - The role of oligodendrocyte-derived transferrin in the transport and regional
      accumulation of iron has been studied in myelin-deficient (md) rats, which lack
      functional oligodendrocytes and have an almost complete depletion of transferrin
      in the brain, although they have normal peripheral levels of transferrin. The
      regional uptake of 59Fe into the brain has been studied autoradiographically in
      md and littermate control rats. Differences in uptake were found in only three of
      the 28 regions studied. These results suggest that the uptake and distribution of
      iron is not impaired in the md rat despite a markedly reduced level of brain
      transferrin. The choroid plexus contains high levels of transferrin mRNA and it
      is therefore likely that transferrin synthesized by choroid plexus epithelial
      cells can mediate the transport of iron within the brain.

PMID- 8361639
TI  - Partial hippocampal kindling increases paired-pulse facilitation and burst
      frequency in hippocampal CA1 neurons.
AB  - For up to 3 weeks after 15 evoked afterdischarges (partial kindling) in the
      hippocampus in vivo, paired-pulse facilitation of the CA1 apical dendritic
      excitatory postsynaptic potentials (EPSPs), recorded from single neurons in
      vitro, was significantly larger in neurons of kindled than control rats. Partial
      kindling did not significantly affect the resting membrane potential, the
      threshold or size of the action potential (AP), the fast afterhyperpolarization,
      input resistance, time constant or the EPSP threshold. The number of APs induced
      within the initial 20 ms of a long-duration 0.5-nA depolarizing current was
      significantly higher in the kindled than control neurons. The increase in paired
      pulse facilitation and intrinsic spiking in hippocampal CA1 after partial
      kindling may contribute to an increase in seizure susceptibility.

PMID- 8361640
TI  - Excitatory and inhibitory effects of 5-hydroxytryptamine on the firing rate of
      medial vestibular nucleus neurons in the rat.
AB  - The effects of microiontophoretic application of 5-hydroxytryptamine (5-HT) on
      the neuronal firing rate of the medial vestibular nucleus (MVN) were studied in
      anaesthetized rats. Ninety-three % of the units modified their background
      activity following 5-HT iontophoresis, enhancements of the firing rate being
      recorded in 42%, decreases in 38% and biphasic effects in 13%. 5-HT antagonists
      methysergide and ketanserin blocked the excitatory but not the inhibitory
      responses to 5-HT. These latter were, however, mimicked by 5-HT agonists 5
      methoxy-N,N-dimethyltryptamine (5MeODMT) and 8-hydroxy-2(di-n-propyl
      amino)tetralin (8-OH-DPAT). It is concluded that 5-HT can variously influence the
      background activity of MVN neurons and that 5-HT2 and probably 5-HT1A receptors
      are involved in the responses.

PMID- 8361641
TI  - Changes in protein kinase C isozymes in the rat hippocampus following transient
      hypoxia.
AB  - The effects of hypoxia on protein kinase C (PKC) isozymes (alpha, beta I, beta
      II, and gamma) were examined in the hippocampus from rats subjected to hypoxic
      conditions (5% O2 in 95% N2) for 30 min in a chamber. Western blot analysis
      revealed that the total amounts of PKC-alpha (-26.0% of control) and -gamma (
      32.7% of control) were decreased significantly at the end of hypoxia, which was
      followed by the reduction of that of PKC-beta II (-23.7% of control at 7 days
      after hypoxia). Whereas, the PKC activities, which were measured by the
      incorporation of [gamma-32P] into a specific PKC substrate peptide, in both the
      cytosolic and the particulate fractions did not change. The reductions of PKC
      gamma and -alpha at the end of hypoxia may be related to the following neuronal
      degeneration.

PMID- 8361642
TI  - Cooling down to hibernate: sleep and hibernation constitute a physiological
      continuum of energy conservation.

PMID- 8361643
TI  - Deep and superficial noxious stimulation increases Fos-like immunoreactivity in
      different regions of the midbrain periaqueductal grey of the rat.
AB  - We have reported that the lateral region of the caudal third of the midbrain
      periaqueductal grey (PAG), which mediates flight and hypertension, receives
      inputs from lamina I and IIo and the lateral cervical nucleus (LCN) of the upper
      cervical spinal cord (UCC); whereas the ventrolateral PAG region, which mediates
      hypotension, quiescence and immobility, is targeted by cells in laminae VII, VIII
      and X. In the UCC the cells of laminae VII and VIII receive a significant
      afferent input from the deep neck muscles, whereas cells of laminae I and IIo and
      the LCN receive a large input from cutaneous nociceptors. Thus we investigated
      the hypothesis that nociceptive activation of the deep neck muscles would
      activate the spinal-ventrolateral PAG projection, whereas cutaneous nociceptive
      stimulation would activate the spinal-lateral PAG projection, by examining the
      expression of Fos protein. We found that deep noxious stimulation led to Fos
      positive cells predominantly in the ventrolateral PAG and superficial noxious
      stimulation led to Fos-positive cells predominantly in the lateral PAG. THE
      RESULTS: (i) indicate that the UCC afferent regulation of the PAG arises from
      topographically separable and functionally dissociable populations of neurons and
      (ii) raise the possibility that the ventrolateral and lateral PAG play important
      but different roles in mediating the distinctive affective, emotional and
      autonomic responses evoked by pain arising from deep or superficial structures.

PMID- 8361644
TI  - Distribution of corticotropin-releasing factor immunoreactive neurons in the
      brain of the tigerfrog, Rana tigrina.
AB  - The distribution of immunoreactive (ir) neurons containing corticotropin
      releasing factor (CRF) is described in the brain of the tigerfrog, Rana tigrina.
      The olfactory bulb, medial pallium, nucleus of the diagonal band of Broca and
      medial area of the amygdala of the telencephalon showed ir-CRF perikarya. The
      anterior and ventromedial thalamic nuclei, and the magnocellular nucleus
      preopticus (NPO) revealed several ir cells; a few NPO neurons were cerebrospinal
      fluid contacting in nature. The nucleus hypothalamicus ventromedialis contained a
      few cells, but the nucleus infundibularis ventralis of the infundibulum revealed
      several diffusely distributed perikarya. Individual ir-CRF perikarya were
      visualized in the optic tectum and interpeduncular nucleus. Extensive fiber
      terminals were present in the median eminence, but no fibers were discerned
      either in the neural lobe or in the pituitary gland.

PMID- 8361645
TI  - Target cells for the isthmo-optic fibers in the retina of the Japanese quail.
AB  - The isthmo-optic nucleus (ION) is the major origin of the centrifugal fibers
      projecting to the avian retina. The retinopetal fibers from the ION were labeled
      with biocytin and examined light- and electron-microscopically in the Japanese
      quail. The terminals were seen on cell bodies in the inner part of the inner
      nuclear layer. These neurons innervated with the isthmo-optic fibers appear to
      constitute a separate population different from the 'ordinary' amacrine cells.

PMID- 8361646
TI  - CSF and serum metabolic profile of patients with Huntington's chorea: a study by
      high resolution proton NMR spectroscopy and HPLC.
AB  - We studied both cerebrospinal fluid (CSF) and serum of 11 patients suffering from
      Huntington's disease (HD) and 12 control subjects by combining high resolution
      proton NMR spectroscopy and HPLC. NMR spectroscopy analysis of the CSF shows a
      significant increase (60%) in pyruvate concentration in HD patients. No
      unexpected molecules were detected. Glutamate, glutamine, aspartate, proline and
      GABA levels were found unchanged in the CSF of HD patients, using HPLC analysis.
      Conversely, a significant increase (30%) in the CSF level of glycine was
      detected. These observations are in agreement with the metabolic hypothesis of HD
      physiopathogenesis. In addition, the protocol combining NMR spectroscopy and HPLC
      provides a straightforward evaluation of brain metabolic status and blood-brain
      barrier function.

PMID- 8361647
TI  - Excitatory and inhibitory pathways modulate kainate excitotoxicity in hippocampal
      slice cultures.
AB  - In organotypic hippocampal slice cultures, kainate (KA) specifically induces cell
      loss in the CA3 region while N-methyl-D-aspartate induces cell loss in the CA1
      region. The sensitivity of slice cultures to KA toxicity appears only after 2
      weeks in vitro which parallels the appearance of mossy fibers. KA toxicity is
      potentiated by co-application with the GABA-A antagonist, picrotoxin. These data
      suggest that the excitotoxicity of KA in slice cultures is modulated by both
      excitatory and inhibitory synapses.

PMID- 8361648
TI  - Topography of excitatory and inhibitory muscle responses evoked by transcranial
      magnetic stimulation in the human motor cortex.
AB  - Transcranial magnetic stimulation of the motor cortex produces a motor-evoked
      potential (MEP) in the electromyogram followed by a silent period (SP) which is
      thought to be due to cortical inhibition. In this study, the topography and size
      of the cortical areas from which an MEP and SP are evoked in the abductor
      pollicis brevis muscle (APB) of the hand were compared. The SP area was found to
      be large, encompassing and surrounding the MEP area. These findings infer the
      existence of an inhibitory surround limiting the excitatory area for APB in the
      human motor cortex.

PMID- 8361649
TI  - The upregulation of a glial cell surface antigen at the astrocytic scar in the
      rat.
AB  - The upregulation of a 106-kDa glial protein was examined using indirect
      immunohistochemical methods. The protein is recognized by the monoclonal antibody
      AMP1. Previous studies demonstrated that the AMP1 antigen is found on the
      external surface of cultured astrocytes and is involved in stabilizing adhesive
      interactions between these cells. In sections of injured adult rat brain, the
      spatial distribution of the AMP1 antigen correlated with the region of reactive
      gliosis. The relative intensity of immunofluorescence indicates that the AMP1
      antigen is dramatically upregulated at the gliotic scar. The correlation between
      AMP1 antigen upregulation and reactive gliosis suggests that this molecule is
      critical to the process of CNS scar formation.

PMID- 8361650
TI  - Reduction of HSP70 and HSC70 mRNA inductions by bifemelane hydrochloride after
      transient ischemia in gerbil brain.
AB  - The effect of bifemelane hydrochloride (BFH) on the induction of heat shock
      protein (HSP) 70 and heat shock cognate protein (HSC) 70 mRNAs after transient
      global ischemia in gerbil brain was investigated by in situ hybridization using
      cloned cDNA probes selective for each mRNA species. Following 3.5 min of
      ischemia, HSP70 and HSC70 mRNAs were induced in all hippocampal cells. The CA1
      cells were almost lost by 7 days. Treatment with BFH twice before and after
      ischemia (total 60 mg/kg, i.p.) reduced the induction of HSP70 and HSC70 mRNAs
      both at 8 h and 1 day of the reperfusion, and about half of the CA1 cells
      survived at 7 days. Thus, the reduction of HSP70 and HSC70 mRNA inductions after
      ischemia may suggest that BFH reduced intra- and/or post-ischemic stress, and
      protected CA1 cells from ischemic damage.

PMID- 8361651
TI  - The Cystatin-C gene is not linked to early onset familial Alzheimer's disease.
AB  - The APP717 mutations discovered in only a few early onset Alzheimer's disease
      (AD) families have confirmed the genetic heterogeneity of this disorder. To
      identify the other gene(s) involved in the disease we selected the protease
      inhibitor, Cystatin-C, as a candidate gene. Cystatin-C is an amyloidogenic
      protein causing hereditary cerebral haemorrhage with amyloidosis-Icelandic type
      (HCHWA-I). It is localised with the beta-amyloid peptide in the arterial walls of
      AD brains. We have analysed the segregation of a polymorphic marker in this gene
      in 8 early onset AD families. Two early onset families showed clear non
      segregation of the marker with the disease. When the 8 families are analysed
      together (assuming only one other gene is involved), they present exclusion
      linkage criteria. These data indicate that Cystatin-C is not the site of the
      defect in 2 families and is not likely to be in the other families analysed. We
      conclude that the deposition of Cystatin-C in AD is a secondary event in the
      disease process, and that this gene is not pathogenic in familial AD.

PMID- 8361652
TI  - Band-pass filtering by voltage-dependent membrane in an insect photoreceptor.
AB  - The membrane properties of short type blowfly photoreceptors (R1-6) were
      investigated in dark and light adaptation with single electrode current and
      voltage clamp techniques. The impedance of the cells was defined in frequency
      domain by using discontinuous current clamp and white-noise-modulated current
      injection. We found that the slow activation and relaxation of the voltage
      dependent K+ conductance transform the photoreceptor membrane effectively into a
      band-pass filter. This behaviour could be observed under current clamp as voltage
      dependent outward and inward rectification of the membrane. The voltage-dependent
      band-pass filtering is likely to be present in all neurons with graded potentials
      and voltage-dependent membrane conductances.

PMID- 8361653
TI  - GABA- and glycine-like immunoreactivities in the cerebellum of the frog.
AB  - Immunocytochemistry was performed on consecutive semi-thin sections of frog
      cerebellum with antibodies raised against GABA and glycine. Somata of Purkinje
      cells and stellate cells were immunoreactive for GABA but not for glycine. In the
      granular layer some neurons were immunoreactive for GABA, fewer for glycine and
      even fewer for both GABA and glycine. Most of the GABA-positive neurons appear to
      be Golgi cells. Most of the glycine-positive neurons appear to be displaced
      cerebellar nucleus neurons. Compared with mammals true basket cells are missing,
      stellate cells are fewer in number and colocalization of GABA and glycine in
      Golgi neurons is encountered about ten times less often in the frog than in the
      rat.

PMID- 8361654
TI  - Corpus callosotomy effects on cerebral blood flow and evoked potentials
      (transcallosal diaschisis).
AB  - The role of the corpus callosum in diaschisis was examined through the acute
      effects of stereotactic corpus callosum section on cerebral blood flow and
      somatosensory or auditory evoked potentials bilaterally during unilateral brain
      retraction ischemia, using a previously reported swine model. Cerebral blood flow
      and evoked potential amplitude contralateral to retraction increased during
      retraction with the corpus callosum intact, compared with post-callosal section
      values. With retraction following callosal section, there was no increase in
      cerebral blood flow or evoked potential amplitude contralateral to retraction.
      Diaschisis during the early stages of a focal, unilateral injury takes the form
      of a contralateral disinhibition (as measured by cerebral blood flow and evoked
      potentials), an effect which is lost following callosal section.

PMID- 8361655
TI  - Changes in parvalbumin-immunoreactive neurons in the rat hippocampus following a
      kainic acid lesion.
AB  - Changes in a sub-population of hippocampal non-pyramidal neurons following a
      unilateral lesion with kainic acid were examined using an antibody raised against
      the Ca-binding protein parvalbumin. A loss of 71-97% of the parvalbumin
      immunoreactive neurons occurred at the three post-lesion times studied (1, 2 and
      4 weeks) in all areas of the ipsilateral hippocampus, but no such loss was
      observed in the dentate gyrus. Resistant parvalbumin-immunoreactive neurons
      occurred principally in stratum pyramidale and displayed altered morphology from
      the normal with swollen dendrites and dendritic varicosities. The contralateral
      hippocampus exhibited losses of parvalbumin-immunoreactive cells, but this was
      restricted to stratum oriens of CA1. This data demonstrates the loss of a
      specific and important population of non-pyramidal neurons which might be
      responsible for the chronic loss of functional inhibition seen in this animal
      model of temporal lobe epilepsy.

PMID- 8361656
TI  - Unique properties of norepinephrine release from terminals arising from the locus
      coeruleus: high potassium sensitivity and lack of linopirdine (DuP 996)
      enhancement.
AB  - The dose-response of K+ to elicit the release of norepinephrine (NE),
      acetylcholine (ACh), dopamine (DA) and serotonin (5-HT) from rat brain slices was
      examined. Cerebral cortical and hippocampal [3H]NE release had steeper K+ dose
      response curves than those observed for apparent hippocampal [3H]ACh, striatal
      [3H]DA and striatal [3H]5-HT release. In contrast, the apparent release of [3H]NE
      from the hypothalamus had a K+ dose-response curve similar to those observed for
      the release of [3H]ACh, [3H]DA and [3H]5-HT. Linopirdine, a drug which enhances
      K(+)-stimulated release of [3H]Ach, [3H]DA and [3H]5-HT, had no effect on
      cerebral cortical [3H]NE release even at submaximal K+ stimulation. Hippocampal
      [3H]NE release was also not affected by linopirdine, however the compound
      significantly enhanced K(+)-evoked [3H]NE release from hypothalamic slices. These
      data point to unique properties of [3H]NE release from terminals arising from the
      locus coeruleus (i.e. those found in the cerebral cortex and hippocampus) when
      compared to [3H]NE release from terminals derived from the lateral tegmentum
      (i.e. those found in the hypothalamus) and the release properties of other
      neurotransmitters. The relative high K+ sensitivity of NE release from coerulear
      terminals may be related to the lack of linopirdine effects on cerebral cortical
      and hippocampal [3H]NE release.

PMID- 8361657
TI  - Glucocorticoid modulation of neurotrophin expression in immortalized mouse
      hippocampal neurons.
AB  - To see whether glucocorticoid hormones can influence the regulation of
      neurotrophin expression in hippocampal neurons, we have used reverse
      transcription followed by polymerase chain reaction to investigate changes in the
      mRNA levels of nerve growth factor (NGF) and neurotrophin-3 (NT-3) in
      immortalized hippocampal neurons after dexamethasone application. Our results
      show that NGF mRNA levels rise in both embryonic and postnatal neurons, but with
      different time courses, while NT-3 levels rise in the embryonic but not in the
      postnatally derived cell line. Modulation of NT expression by glucocorticoids may
      therefore be developmentally regulated.

PMID- 8361659
TI  - Mutant mouse cerebellum does not provide specific signals for the selective
      migration and development of transplanted Purkinje cells.
AB  - Embryonic cerebellum transplanted to adult Purkinje cell degenerate mice was
      assessed for integration and Purkinje cell migration by using the antigenic
      markers Thy-1 and Leu-4. It was found that the grafted cells migrated into the
      host's molecular layer, but there was no evidence for specific migration of
      Purkinje cells. Furthermore, grafted cells were found to form normal cerebellar
      cyto-architecture only with other grafted cells and not with the host's cells.

PMID- 8361658
TI  - Voltage-dependent K+ currents in guinea pig Muller (glia) cells show different
      sensitivities to blockade by Ba2+.
AB  - The effect of externally applied Ba2+ and Na+ on K+ currents was investigated by
      means of whole-cell patch-clamp in isolated and in situ Muller cells from guinea
      pig retina. Muller cells express a typical set of K+ currents, i.e. an ohmic
      current, an inactivating inward current (IK(IR)), a delayed rectifier (IK(DR))
      and an inactivating outward current (IK(A)). Inactivation of the inward current
      did not occur when extracellular Na+ was replaced by choline. When administered
      in increasing concentrations, Ba2+ blocked these K+ currents in a typical
      sequence: the ohmic current and IK(A) were most sensitive, followed by IK(IR),
      whereas IK(DR) was not completely blocked even in 1 mM Ba2+. The differential
      sensitivity of Muller cell K+ currents to external Ba2+ may be a tool which can
      be used to improve our understanding of the Muller cell response to physiological
      stimulation of the retina.

PMID- 8361660
TI  - The inhibition by indoleamines (tryptamine and serotonin) of ocular serotonin-N
      acetyltransferase from Rana perezi is temperature-dependent.
AB  - Temperature effects on ocular serotonin N-acetyltransferase (NAT) kinetics
      characteristics from Rana perezi have been studied with respect to tryptamine and
      serotonin as substrates. Monoamine oxidase (MAO) activity does not interfere in
      NAT assay at acceptoramine concentrations used in NAT kinetics characterization
      from R. perezi retina. NAT shows an inhibition by high substrate (serotonin)
      concentration, which is temperature-dependent. NAT follows the Michaelis-Menten
      equation at low temperature, whereas at high temperatures (> 10 degrees C) an
      inhibition by serotonin is observed. This inhibition of NAT activity by serotonin
      could act as an amplification mechanism to increase daily melatonin rhythm
      amplitude in the retina of ectotherms.

PMID- 8361661
TI  - Gamma-L-glutamyl-L-glutamate is an endogenous dipeptide in the rat olfactory bulb
      which activates N-methyl-D-aspartate receptors.
AB  - The concentration of gamma-L-glutamyl-L-glutamate (gamma-glu-glu), a potent
      displacer of excitatory amino acid receptor binding, and other structurally
      related dipeptides were determined in extracts of the rat olfactory bulb by a
      novel liquid chromatographic method. Whole-cell patch clamp recordings of
      currents from freshly isolated neurons showed that gamma-glu-glu produced inward
      currents at negative holding potentials, provided microM concentrations of
      glycine were added and no Mg(2+)-ions were present, indicating activation of N
      methyl-D-aspartate receptors. Consistently, geometry optimization of gamma-glu
      glu using molecular mechanics calculations, suggested a bent conformer with
      structural features supporting this view.

PMID- 8361662
TI  - Delayed histologic damage and neuron death in the substantia nigra reticulata
      following transient forebrain ischemia depends on the extent of initial striatal
      injury.
AB  - Transient forebrain ischemia in normoglycemic, normotensive rodents reproducibly
      causes selectively vulnerable neurons in the striatum to degenerate within 24 h.
      Neurons in the substantia nigra reticulata (SNR) are resistant to this acute
      process. Histologic evidence demonstrates that the combination of acute ischemic
      injury to the caudate nucleus and globus pallidus is associated with delayed
      neuron degeneration in the SNR that matures at 3 weeks after reperfusion.
      Ischemia, like certain ablative neurotoxin lesions, may provoke degenerative,
      perhaps transneuronal events that continue to evolve long after the initial
      insult.

PMID- 8361663
TI  - Dystrophin and dystrophin-related protein expression in Torpedo marmorata
      electric organ.
AB  - The presence of different dystrophin-related protein forms was investigated in
      electric organ as compared to cardiac, white or red skeletal muscles from Torpedo
      marmorata. Two strategies were followed. First, we used specific C-terminal
      dystrophin and dystrophin-related protein monoclonal antibodies which we
      characterized in the present study. 400 kDa protein bands were detected in the
      tissues mentioned above with both specific types of antibodies. Second, we
      produced monoclonal antibodies raised against a dystrophin-enriched preparation
      from T. marmorata electric organ. Western blot and immunofluorescence analyses
      showed the tissue specificity of T. marmorata antibodies and allowed us to
      classify them as types I, II and III. Vessel walls and neuromuscular junctions
      were labeled with T. marmorata type II and III antibodies in human muscles
      (skeletal and smooth). Both approaches demonstrated that the T. marmorata
      electric organ contained different proteins related with dystrophin: a dystrophin
      form, a dystrophin-related protein form and a dystrophin-related protein isoform,
      homologous to the dystrophin-related protein present in muscle vessel walls and
      at the neuromuscular junctions of human tissues. The presence of dystrophin and
      dystrophin-related protein is finally discussed relative to their functions and
      organ specificities.

PMID- 8361664
TI  - Alternative splicing of the mRNA encoding the alpha subunits of the G(o) GTP
      binding protein during brain development and in neuronal cell lines.
AB  - The RNA encoding the alpha subunit of the G(o) GTP-binding protein is
      alternatively spliced in some tissues to produce mRNAs encoding two distinct
      forms of the protein which differ at the carboxyl terminus. This alternative
      splicing process is observed at all stages during development of the rat brain
      and heart and in some but not all neuronal cell lines. These effects are
      discussed both in terms of the regulation of the alternative splicing event and
      the functional role(s) of the two forms of the protein which it produces.

PMID- 8361665
TI  - Electrophysiological changes in the surrounding brain tissue of photochemically
      induced cortical infarcts in the rat.
AB  - Small infarctions in the parietal cortex of Wistar rats were produced
      photochemically using the Rose Bengal technique. The infarctions evoked
      reproducible cortical lesions of about 2 mm diameter. In the surrounding brain
      tissue changes in electrophysiological responses occurred. Whereas in control
      animals a paired-pulse inhibition could be evoked all over the neocortex, in
      infarcted animals the paired-pulse inhibition was significantly reduced or even
      absent within an area extending up to 5 mm lateral from the lesion center. The
      changes in paired-pulse inhibition were already present on the first day and
      persisted at least up to 60 days after infarction. These functional changes may
      contribute to neurological deficits occurring after cerebral infarcts.

PMID- 8361666
TI  - The preconditioned hippocampus accelerates HSP70 heat shock gene expression
      following transient ischemia in the gerbil.
AB  - To evaluate the mechanism of tolerance for ischemia, inductions of heat shock
      protein (HSP) 70 mRNA and immunoreactive HSP70 protein were studied in the
      preconditioned gerbil hippocampus. Following the single 3.5-min ischemia, HSP70
      mRNA was induced in all hippocampal cells. However, the hippocampal CA1 cells
      produced only a minimum HSP70 protein, and the cells were almost lost by 7 days.
      Following the 3.5-min ischemia after 2-min pretreatment, the CA1 cells produced a
      strong immunoreactive HSP70 signal and large populations of the CA1 cells
      survived at 7 days. The peak time of the HSP70 mRNA induction shifted to earlier
      period of reperfusion in the CA1 cells as compared to the case with single
      ischemia. This accelerated change of HSP70 expression could play an important
      role for the acquisition of ischemic tolerance of the hippocampal CA1 neurons.

PMID- 8361667
TI  - Functional evidence for a L-AP3-sensitive metabotropic receptor different from
      glutamate metabotropic receptor mGluR1.
AB  - The efficacy of mGluR agonists quisqualate and 1S,3R-aminocyclopentane-1,3
      dicarboxylic acid (1S,3R-ACPD) in stimulating the inositol phosphate (IP)
      formation in primary cultures of cerebellar granule neurons correlated with
      mGluR1 mRNA expression and was affected by the medium KCl content. L-2-Amino-3
      phosphonopropionic acid (L-AP3) mimicked the stimulatory action of mGluR
      agonists. Maximal stimulatory doses of mGluR agonist 1S,3R-ACPD and L-AP3 were
      additive, suggesting the action of L-AP3 on a receptor different from mGluR1.
      Indeed, in embryonic kidney 293 cells transfected with mGluR1 cDNA quisqualate
      and 1S,3R-ACPD but not L-AP3 stimulated the IP formation.

PMID- 8361668
TI  - Early and transient effects of neutron irradiation on dopamine receptors in the
      adult rat brain.
AB  - The early neurochemical effects of neutron-gamma radiation exposures were studied
      through ligand dopamine D1, D2 receptors binding experiments. The parameters of
      binding were investigated on crude preparations from striatum at different delays
      (from 2 to 72 hours) after irradiation. An early and transient increase in the
      total number of sites was seen after exposure, even at infra-lethal dose. This
      'radiosensitivity' was higher for D1 than for D2 receptor. It is assumed that
      these modifications could participate in the early neuro-vegetative syndrome
      observed in irradiated persons.

PMID- 8361669
TI  - The rat nucleus accumbens: two levels of complexity in the distribution of
      glutamic acid decarboxylase (67 kDa) and preproenkephalin messenger RNA.
AB  - The distribution of messenger RNAs (mRNAs) encoding the 67 kDa isoform of
      glutamic acid decarboxylase (GAD67), a rate-limiting enzyme in the biosynthesis
      of gamma-aminobutyric acid, and preproenkephalin (PPE), the precursor of
      enkephalin, was analysed in the rat nucleus accumbens (NAS) taking in account its
      compartmentation in 'core' (NAS(core)) and 'shell' (NASshell). While GAD67 mRNA
      levels were more abundant (+48%) in NASshell than in NAS(core), hybridization
      signals for PPE mRNA were mainly found in NAScore. At a cellular level,
      hybridization signals for GAD67 mRNA were present in 75% and 80% of neurons
      NASshell and NAS(core), respectively. The level of GAD67 mRNA found higher in the
      NASshell corresponds in fact to a greater density of neurons in NASshell than in
      the NAS(core). The hybridization signals for PPE mRNA were observed in very few
      neurons of NASshell and in around half of the neurons in NAS(core). Besides this
      medio to lateral difference, GAD67 and PPE mRNAs were distributed in NAS(core)
      according to a rostro-caudal gradient, the content of both mRNAs being higher in
      the rostral part than the caudal part of this area.

PMID- 8361670
TI  - Prenatal D1, D1b and D3 dopamine receptor gene expression in the rat forebrain:
      detection by reverse polymerase chain reaction.
AB  - Three dopamine receptor mRNAs were detected by reverse polymerase chain reaction
      in the rat forebrain during ontogeny. The D1 receptor mRNA gave a faint signal
      from gestational day 11 (G11) on, while the D1b receptor was not detectable
      before G12. The D3 receptor mRNA was slightly expressed at G11 and clearly
      present at G14. Our results show that these mRNAs are present at early stages of
      fetal life, each one with its specific time of appearance.

PMID- 8361671
TI  - Morphometric characterization of the arcuate nucleus neurons of the rat. A Golgi
      study.
AB  - Six types of neurons were identified and characterized by the Golgi technique in
      the hypothalamic arcuate nucleus of the rat: non-ramified unipolar, ramified
      unipolar, non-ramified bipolar, ramified bipolar, small multipolar, and large
      multipolar. All had few spines, both somatic and dendritic spines.
      Characterization of the neuronal cytoarchitecture of the arcuate nucleus could be
      useful in developmental studies under specific experimental conditions.

PMID- 8361672
TI  - Effect of aluminum chloride, -citrate, and -maltol on the calcium-mediated
      degradation of neurofilament proteins.
AB  - Aluminum (Al) has been observed to cause neurofilament protein accumulation in
      both experimental animals and cultured cells. Impairment of axonal transport is
      thought to be a mechanism of toxicity. Inhibition of the degradation of
      neurofilament proteins, however, resulting in accumulation of these proteins may
      be an alternative mechanism for Al toxicity. In the present study, the effect of
      calcium (Ca) on the proteolysis of the neurofilament triplet proteins by calcium
      activated neutral proteases (CANP) was studied in the isolated sciatic nerve
      explants. The extent of the degradation was found to be dependent on the Ca
      concentration. The effect of Al chloride, -citrate and -maltol on the calcium
      induced degradation was studied. No effect of any of the Al compounds was
      observed, suggesting that the metal may exert its neurotoxic effect via a
      mechanism other than impairment of neurofilament proteolysis. Maltol itself was
      found to enhance the effect of Ca on the degradation of neurofilament proteins,
      probably by facilitating the movement of Ca across the neuronal membrane.

PMID- 8361673
TI  - Workshop on the X-ray fluorescence of lead in bone: conclusions, recommendations
      and summary.
AB  - A workshop on the use of X-ray fluorescence (XRF) to noninvasively measure lead
      in bone was convened by the National Institutes of Environmental Health Sciences
      (NIEHS) and the Environmental Health Sciences Center of the Mount Sinai School of
      Medicine. The impetus for the workshop stemmed partly from NIEHS' concern that
      XRF machines produced for this purpose are licensed by the Food and Drug
      Administration as research devices, a designation that indicates they are safe to
      use on people but says nothing about the precision and accuracy of the data they
      generate. Therefore, a major purpose of the workshop was to scientifically
      examine these issues in a multi-disciplinary setting, to explore the current
      status of XRF research employing two different XRF techniques for lead-bone
      measurements: K-shell and L-shell XRF spectroscopy (K-XRF, L-XRF) and to make
      recommendations for future research in these techniques.

PMID- 8361674
TI  - Cocaine cytotoxicity in serum-free environment: C6 glioma cell culture.
AB  - Rat glioma C6 cells were employed to determine the vulnerability of the CNS
      derived cells to cocaine. The cells were cultured either in the presence of serum
      or in serum-free (defined) medium to model glial development in the normal brain.
      In serum-containing medium, cocaine in amounts up to 100 micrograms/ml neither
      retarded cell proliferation nor altered cell morphology. In the absence of serum,
      the culture growth was profoundly retarded and cell death was observed with
      amounts as small as 0.1 micrograms/ml. Even brief (24 hrs) exposure to low
      cocaine concentrations in serum-free medium irreversibly decreased the cell
      number. However, an initial 24 hr exposure to 0.1-2.5 micrograms/ml cocaine
      prolonged survival of cells subsequently exposed to a lethal concentration (100
      micrograms/ml). Benzoylecgonine in amounts up to 100 micrograms/ml had no effect
      on cell proliferation, with or without serum. These data show that cocaine in the
      absence of serum is highly cytotoxic, which indicates a possibility that the
      blood-brain-barrier-protected CNS cells may be particularly vulnerable to the
      drug when it enters the nervous system.

PMID- 8361675
TI  - Sex-related spatial learning differences after prenatal cocaine exposure in the
      young adult rat.
AB  - Prenatal cocaine exposure in humans is associated with a variety of adverse
      neurobehavioral effects. In the rat, in utero cocaine exposure has been shown to
      elicit learning impairment during early postnatal development. However, little
      research has focused on the persistence of these behavioral disruptions. The
      current study examines the long-term effects of prenatal cocaine exposure on
      learning performance during young adulthood. Fetal cocaine exposure evoked
      differential effects in male and female rats on radial-arm maze learning
      performance. Cocaine-treated females showed significantly impaired choice
      accuracy during acquisition of radial-arm maze performance when compared to
      control females. In contrast, cocaine-treated males showed no impairment and in
      fact showed significantly improved performance on one measure of choice accuracy.
      For both sexes, this effect was apparent during the final third of acquisition.
      No evidence was found to suggest altered sensitivity to anticholinergic drugs.
      While both nicotinic and muscarinic cholinergic antagonists caused significant
      impairments in memory performance, control and cocaine-exposed rats were effected
      equally. Single doses of these drugs which caused moderate memory deficits were
      chosen for use in the current study. The entire dose range should be evaluated to
      determine the relative sensitivity of cocaine-exposed and control animals to
      these drugs. The results of this study indicate that there are cognitive effects
      of prenatal cocaine exposure which persist into adulthood and the sex of the
      offspring seems to be critical.

PMID- 8361676
TI  - Age-related susceptibility to MPTP-induced neurotoxicity in mice.
AB  - 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is known to cause
      neurotoxicity in rodents and nonhuman primates. In this study the ontogeny of
      MPTP-induced DA depletion and formation of reactive oxygen species (ROS) were
      evaluated in mouse striatum. C57/B6N mice were injected four times with 0 or 10
      mg/kg MPTP (i.p.) at two-hour intervals on either postnatal day 23, at about 7
      months of age, and at one year of age. Animals were sacrificed 1, 2, 4, 8, 12,
      24, 48 and 72 hours after the last dose. Brains were rapidly removed and striata
      were dissected for neurochemical analysis. Dopamine (DA) and its metabolites 3,4
      dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) were measured by
      HPLC/EC. ROS formation was measured by a fluorescence probe, 2',7'
      dichlorofluorescein-diacetate (DCFH-DA). MPTP produced a slight but significant
      decrease of DA only 4 hours post dosing on PND 23. DOPAC and HVA levels decreased
      up to 4 and 8 hours post dosing respectively and returned to control values
      thereafter. At 7 months of age, MPTP produced a 50-65% decrease of DA and its
      metabolites (DOPAC and HVA) in striatum 24 hours post dosing. In one year old
      mice, MPTP produced an 80% decrease of DA and 60-80% decrease of DOPAC and HVA in
      striatum. In contrast, ROS formation in striatum was not significantly increased
      by MPTP treatment at any age but was decreased at 1 hour only in PND 23 and 7
      month old mice. These studies suggest that MPTP-induced neurotoxicity is age
      dependent in the mouse.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361677
TI  - The role of the septohippocampal pathway in the mediation of colchicine-induced
      compensatory changes in the rat hippocampus.
AB  - To study the involvement of the septohippocampal pathway in colchicine-induced
      changes in the hippocampus, colchicine was used to lesion the septum and/or
      hippocampus of male, Fischer-344 rats. Rats were killed 12 weeks post-lesion and
      histochemical and biochemical measurements were performed. [3H]-QNB binding,
      choline acetyltransferase (ChAT) activity and agonist-stimulated release of
      inositol phosphates (IPs) were measured in hippocampal slices. AChE
      histochemistry was also performed to visualize AChE positive fibers in the
      hippocampus. Increases in ChAT activity, AChE staining and carbachol-stimulated
      IP release observed in hippocampal-lesioned animals were attenuated in animals
      receiving both septal and hippocampal lesions. However, the decrease observed in
      [3H]-QNB binding sites after intradentate colchicine was not affected by septal
      lesions. Subsequent studies also found enhanced sensitivity to excitatory amino
      acid (EAA)-stimulated IP release in hippocampal-lesioned animals. Similar to the
      changes observed in carbachol-stimulated PI hydrolysis, this increase was also
      long-lasting. However, the hyperstimulation of EAA-induced IP release was not
      attenuated by the septal lesion. Thus, it appears that the neurochemical and
      morphological changes observed in the hippocampus following intradentate
      colchicine are dependent upon more than one afferent projection to the
      hippocampus.

PMID- 8361678
TI  - Neurobehavioural effects on workers in a video tape manufacturing factory in
      Singapore.
AB  - This study was carried out in a video tape manufacturing factory in Singapore
      where workers were exposed to mixed solvents consisting of methyl ethyl ketone
      (MEK), cyclohexanone (CHE), tetrahydrofuran (THF), and toluene (TOL). The
      objectives were to quantify workers' exposure to the various solvents and to
      evaluate if there were any neurobehavioural changes among the workers compared to
      controls. Nineteen exposed workers out of the workforce of forty-five were
      studied. Twenty-six workers (with no exposure) matched for ethnic group, age, and
      years of education served as controls. Eight-hour personal environmental samples
      were analyzed for the 19 workers along with symptom questionnaires, clinical
      examinations, and neurobehavioural tests including the Santa Ana Dexterity,
      Finger Tapping, Digit Span, and Visual Reproduction tests. The mean TWA
      concentrations for MEK, THF, CHE, and TOL were all below the current American
      Conference of Governmental Industrial Hygienists Threshold Limit Values (TLV).
      However, the total solvents concentration index exceed unity in one of the work
      areas. Significant differences were observed for prevalence of headache, and eyes
      and nose irritation among the exposed workers. There were also significant
      differences for the Santa Ana test for both-hands, Digit Span test and Visual
      Reproduction test. However, no dose-effect relation between behavioral scores and
      airborne solvent exposure was noted. The study suggests that solvent-exposed
      workers in video tape manufacturing plants may have poorer visual motor control
      and recent memory impairment (visual and verbal) than unexposed workers. Dermal
      absorption of solvents may have played a role in these results by increasing
      workers exposure.

PMID- 8361679
TI  - Microchromatographic analysis of lipids, protein, and occurrence of lipid
      peroxidation in various brain areas of vanadium exposed rats: a possible
      mechanism of vanadium neurotoxicity.
AB  - Administration of sodium metavanadate (3 mg/kg) to adult female Sprague Dawley
      rats for 5 consecutive days by intreaeritoneal route resulted in major
      alterations in lipid profiles and protein concentration in all the brain regions.
      Sodium metavanadate exposure displayed phospholipids, cholesterol and
      cerebrosides, and protein, but ganglioside concentration was significantly
      increased in various areas of the brain. Loss of body weight observed in this
      study could be attributed to the loss of appetite; loss of nutrients and wasting
      of tissues. It is likely that large amount of body water was lost through
      diarrhoea. Gas liquid chromatography has revealed that oleic acid, linoleic acid,
      linolenic acid, and archidonic acid were preferentially lost in the brain of
      vanadium-exposed rats. Thin layer chromatography further proved degradation of
      individual lipids. Sphingomyelin was substantially decreased followed by
      phosphatidyl choline and phosphatidyl ethanolamine, but phosphatidyl serine and
      phosphatidyl inositol were slightly affected. Our recent work has demonstrated
      vanadium-induced stimulation of lipid peroxidation in the various regions of the
      rat brain. It is speculative that deterioration of myelin sheath by vanadium
      exposure contributed to preferential lipid loss but lesser loss of protein. These
      studies also indicate that vanadium-induced stimulation of lipid peroxidation is
      characterized by a selective loss of brain polyunsaturated fatty acids and thus
      comprehensive degradation of lipids in the different regions of the rat brain.
      However, the mechanism involved in the elevation of ganglioside levels is not yet
      fully understood. It is concluded that these perturbations produced damage to the
      associated physiological functions leading to CNS dysfunctions.

PMID- 8361680
TI  - Short-term, preweaning treatment with tetracycline affects physical development
      and behavior in rats.
AB  - Tetracycline (TC) was administered indirectly to rat pups through maternal milk,
      giving mothers diluted TC solutions as a single source of drinking water, during
      13-16 days of postnatal age (PND) in Experiment 1. In Experiment 2, using rats of
      a different strain, TC dose and its application period were reduced from 0.5
      mg/ml to 0.25 mg/ml and from PND 13-16 to PND 13-15, respectively. In Experiment
      3, TC was administered directly to the pups via stomach intubation during PND 13
      16. The effects of these short-term treatments were tested in adulthood. Brain
      weight decreased, although no abnormal changes were found histologically in the
      cerebral cortex. Immobility time in the forced swimming test was decreased more
      in the TC group as compared to the controls. These results suggest that even a
      small amount of TC could affect physiological development and behavior. In
      Experiment 4, mothers were given TC in their drinking water (0.5 mg/ml) for 1 to
      5 days, beginning on PND 12. On each of the treatment days, measurements were
      made of the weight of brain and body, and of the concentration of TC in the brain
      and in gastric curd of offspring. The greater the TC intake by dams was, the more
      remarkable was the decrease in the brain weight of offspring. TC concentration of
      gastric curd was on the order of 1-3.5 micrograms/g curd.

PMID- 8361681
TI  - Morphological alterations of neurons and astrocytes in guinea pigs exposed to low
      levels of inorganic lead.
AB  - Both astrocytes and neurons potentially undergo structural and functional
      alterations in the brains of animals exposed to low levels of lead (Pb). No
      morphometric studies of astrocytes have been reported to date in animals in low
      Pb exposure. In the present study, morphometric measurements of astrocytes and
      pyramidal neurons in the frontoparietal cortex were made in guinea pigs exposed
      postnatally (5 or 10 days) or prenatally (gestational day 22 to birth) to low Pb
      levels. Although few significant effects of Pb treatment were detected by the
      rigorous statistical model applied, a recurring trend was noted for postnatal Pb
      treatment to increase astrocyte maximum diameter (dmax). In addition, prenatal Pb
      treatment was associated with increased apical and basal dendritic length,
      increased total apical dendrites per cell and an increased basal branching
      complexity in neurons.

PMID- 8361682
TI  - Effect of L-dopa on copper concentrations in the rat brain.

PMID- 8361683
TI  - Timetables of neurogenesis in the human brain based on experimentally determined
      patterns in the rat.

PMID- 8361684
TI  - Quantitative studies on aluminum deposition and its effects on neurofilament
      protein expression and phosphorylation, following the intraventricular
      administration of aluminum maltolate to adult rabbits.
AB  - The deposition of aluminum (Al) in the brain and spinal cord of adult male New
      Zealand white rabbits was monitored following the intraventricular administration
      of Al maltolate. Although decreasing concentrations of Al were observed from the
      injection site (approximately 10 micrograms/g dry tissue) to the lumbar cord (2.1
      micrograms/g), argyrophilic tangles were present in the perikarya and proximal
      neurites of neurons as far distal as the lumbar and sacral cord areas.
      Quantitative immunoblot studies of the three neurofilament protein isoforms
      failed to detect changes resulting from Al maltolate treatment. Similarly no
      significant alterations in the total phosphate content of these cytoskeletal
      proteins were observed. Lastly, on Northern blots, the expression of genes
      encoding for the 200 kDa and 68 kDa neurofilament proteins also was unaffected by
      Al maltolate treatment.

PMID- 8361685
TI  - Mrs. Nelson's cabin.

PMID- 8361686
TI  - Myths & facts ... about lead poisoning.

PMID- 8361687
TI  - Documentation do's and dont's.

PMID- 8361689
TI  - Am I doing enough?

PMID- 8361688
TI  - How to apply a transdermal drug patch.

PMID- 8361690
TI  - Managing chest drainage problems.

PMID- 8361691
TI  - Managing the modern care plan.

PMID- 8361692
TI  - Treating a jellyfish sting.

PMID- 8361694
TI  - Points worth hearing.

PMID- 8361693
TI  - Beat the clock: saving the heart with thrombolytic drugs.

PMID- 8361695
TI  - Blood glucose: the right levels.

PMID- 8361696
TI  - Why was Lois so demanding?

PMID- 8361697
TI  - Exposing late allergies.

PMID- 8361698
TI  - "Hey nurse ... thanks".

PMID- 8361699
TI  - Pediatric hospice nursing: making the most of each moment.

PMID- 8361700
TI  - Understanding neurovascular assessment.

PMID- 8361701
TI  - Diabetes update 93.

PMID- 8361702
TI  - Delirium in the elderly.

PMID- 8361703
TI  - Endoscopic thoracotomy: how it can spare patients from major thoracic surgery.

PMID- 8361704
TI  - AIDS update: caring for patients with diarrhea.

PMID- 8361705
TI  - One nurse's lesson.

PMID- 8361706
TI  - Teaching a patient to perform Kegel exercises.

PMID- 8361708
TI  - Norms and nursing science: a question of values.

PMID- 8361707
TI  - Nursing and medicine: two different disciplines.

PMID- 8361709
TI  - Changing family patterns and health.

PMID- 8361710
TI  - Nursing centers without nursing frameworks: what's wrong with this picture?

PMID- 8361711
TI  - The adequacy and scope of Roy's adaptation model to guide cross-cultural pain
      research.
AB  - The purpose of this study was to examine the adequacy (operational, empirical,
      and pragmatic) and scope of the Roy adaptation model and the gate control theory
      of pain to guide the cross-cultural study of pain. The sample consisted of 60
      Mexican-American and Anglo-American women undergoing elective cholecystectomy.
      The conceptual-theoretical-empirical structure developed by Fawcett and Downs
      (1986) provided the framework for designing the study. Operational adequacy was
      determined by examining the reliability and validity of the empirical indicators
      used; it was judged adequate. Empirical adequacy was evaluated by comparing
      empirical data to hypothesized expectations. Only some of the conceptual
      theoretical relational statements were supported. Pragmatic adequacy was assessed
      by determining whether innovative practice strategies might be derived from the
      data; several were recommended. Finally, the scope was determined by examining
      the variables identified by the model and several additional variables. Scope was
      judged adequate to the current stage of the model's development.

PMID- 8361712
TI  - The lived experience of grieving the loss of an important other.
AB  - The purpose of this study was to uncover the structure of the lived experience of
      grieving the loss of an important other using Parse's research methodology.
      Parse's theory of human becoming provided the nursing perspective for the study.
      Five participants described their experience of grieving the loss of an important
      other through dialogical engagement with the researcher. The researcher dwelled
      with the transcribed descriptions and through the processes of extraction
      synthesis uncovered the structure of the lived experience of grieving the loss of
      an important other as an anguished suffering in devastating void amidst consoling
      movements away from and together with the lost one and others while confidently
      moving beyond personal doubts. Linked to the major concepts of Parse's theory
      through heuristic interpretation, the structure was abstracted as valuing the
      connecting-separating in transforming. The study adds to knowledge about grieving
      and expands Parse's theory of nursing. Recommendations for practice and further
      research are offered.

PMID- 8361713
TI  - Recovering in depressed women: research with Peplau's theory.
AB  - The purpose of this research was to describe the process of recovering in women
      who have been depressed. The descriptive research design for this study was
      guided by Peplau's interpersonal theory of nursing. The sample consisted of seven
      women who had at one time been hospitalized with a diagnosis of depression and
      who now considered themselves to be recovering. Audiotaped interviews were
      conducted in the women's homes. Verbatim transcripts were analyzed using content
      analysis. The analysis revealed that the process of recovering as described by
      the seven depressed women consisted of eight categories which comprised three
      phases. Recovering was initiated by a crisis or turning point experience. Phase I
      consists of the turning point and professional support; phase II consists of
      determination, work-over-time, support of family and friends, and successes; and
      phase III consists of self-esteem and maintaining balance. The process of
      recovering is internal and ongoing. Further research is suggested.

PMID- 8361714
TI  - Health for people with a terminal diagnosis.
AB  - A naturalistic study was designed to investigate how people with terminal
      diseases describe health. Three domains emerged. The mental/emotional domain
      included hope, love, and control. The spiritual domain contained belief in a
      higher power, recognition of mortality, and self-actualization. The physical
      domain consisted of health promotion activities, feeling good, and relationship
      with a physician. This investigation suggested many similarities with Newman's
      model. One area of agreement was in the informants' belief that their disease was
      a part of their health. The emergence of the disease pattern allowed health to
      unfold. Many informants believed they became healthier because of their
      diagnoses.

PMID- 8361715
TI  - How to develop a teaching plan that integrates IVD.

PMID- 8361716
TI  - Lifting weights.
AB  - As with engineering improvements, many administrative changes can reduce back
      injuries. The following administrative steps are recommended: Training for all
      employees. Increase awareness with posters and meetings. Notify suppliers of
      reduced weight limit. Job rotation for heavy lifting jobs. Proper maintenance and
      housekeeping. Use back belts when necessary. Some recommendations should enable
      employers to begin implementing changes immediately. Other suggestions will
      require time and money but are worth the investment.

PMID- 8361717
TI  - Heat protection. Garments may shield from burns but heat can attack inside out.

PMID- 8361718
TI  - Oral medicine as a specialty.

PMID- 8361719
TI  - Unusual progression of impacted third molars.

PMID- 8361720
TI  - Third molars as an acute problem in Finnish university students.
AB  - The study was carried out to determine the risk of acute disease of third molars
      in young adult patients. The subjects in this case-control study were 100
      consecutive university students who complained of third molar problems when
      making an appointment. The third molars were mostly mandibular, partly erupted,
      and distoangularly oriented. Severity of discomfort and interference with daily
      activities were graded by the patients on average as 5.0 (SD +/- 2.7) and 3.6 (SD
      +/- 2.9), on a scale from 0 through 10. Distoangular lower third molars caused
      the most discomfort and interfered most with activities of patients. The risk of
      acute disease in patients with distoangularly oriented third molars was 3.6 times
      that in other patients. Bivariate analysis showed that if the follicle of a
      distoangular third molar were enlarged, the risk of acquiring acute disease was
      44 times that in other patients. It was concluded that early removal of partially
      erupted and distoangularly oriented lower third molars is recommended, especially
      when they are associated with an enlarged follicle.

PMID- 8361721
TI  - Temporomandibular joint dysfunction and facial pain caused by neoplasms. Report
      of three cases.
AB  - The most frequent causes of painful limitation of temporomandibular joint
      function are myofascial pain dysfunction or anterior disk displacement. A
      potential problem in dealing with those patients is the risk of misdiagnosing the
      rare patient who has a neoplastic disease, primary or metastatic to the
      epipharyngeal region, parotid gland, jaws, or temporomandibular joint. Three
      cases are presented in which progressively worsening limitation of mandibular
      movement and increasing pain led to the diagnosis of a neoplasm in the
      temporomandibular joint region. The article illustrates the necessity of
      performing a thorough clinical and radiographic examination.

PMID- 8361722
TI  - Intracranial schwannoma as atypical facial pain. Case report.
AB  - Facial pain is a common complaint that leads those who have it to seek
      professional help. Often times, the general dentist is the first clinician that a
      patient consults because of a presumed odontogenic origin of the pain.
      Occasionally a small number of these patients will be found to have an
      intracranial tumor. The case reported here is one such patient who was diagnosed
      and treated for a seventh nerve schwannoma.

PMID- 8361723
TI  - Bilateral parotid swelling associated with chronic obstructive pulmonary disease.
      A case of pneumoparotid.
AB  - Acute enlargement of the parotid glands due to air insufflation is well reported
      under various names, the most appropriate of which is pneumoparotid. We report an
      unusual example of pneumoparotid, which was difficult to diagnose, that involved
      background swelling of the parotids because of the respiratory effort of chronic
      obstructive pulmonary disease and acute exacerbations associated with episodes of
      coughing.

PMID- 8361724
TI  - Accidental displacement of a lower third molar. Report of a case in the lateral
      cervical position.
AB  - A report of a case of the accidental displacement of an unerupted third molar to
      the lateral region of the neck as a complication of exodontia. A review and an
      analysis of the possible causes of this rare complication is included.

PMID- 8361725
TI  - Changes in the oral microflora during cytotoxic chemotherapy in children being
      treated for acute leukemia.
AB  - Thirty-four children with diagnosed cases of acute leukemias and being treated
      with cytotoxic chemotherapy at St James' Hospital, Leeds, were followed for
      between 6 months and 1 year to determine the changes in their oral microflora.
      They were examined before treatment commenced and then at monthly intervals.
      Swabs were taken from the oral cavity to test for the presence or absence of
      bacteria and Candida. Saliva samples were also used to assess the levels of
      Streptococcus mutans in the mouth. Sensitivity tests were carried out to assess
      the effect of the cytotoxic agents on the oral flora. All children received
      prophylactic nystatin and chlorhexidine gluconate mouthrinses four times daily
      for the whole period of the study. There was significant difference (p < 0.0001)
      for counts of S. mutans at different treatment stages. Sensitivity tests showed
      that S. mutans was sensitive to the cytotoxic drug daunorubicin, and this drug
      was probably responsible for the fall in S. mutans counts. A significant
      difference was also found in the types of bacteria isolated between the study and
      reference groups, but there was no change in the composition of the flora in the
      study group during treatment. These bacteria were also found to mirror those
      cultured from routine blood samples in children with acute leukemia.

PMID- 8361726
TI  - Risk factors for oropharyngeal candidiasis in patients who receive radiation
      therapy for malignant conditions of the head and neck.
AB  - Twenty-seven consecutive patients receiving radiation to the head and neck were
      followed to assess risk factors for the development of candidiasis. One-third of
      the patients developed oral candidiasis during radiation therapy. Xerostomia was
      shown to correlate with risk of oropharyngeal infection (p = 0.033). The presence
      and use of oral prostheses were shown to correlate with oral colonization of
      Candida albicans before radiation therapy (p = 0.011). Alcohol use and smoking
      represent risk factors for oral colonization by Candida during radiation therapy
      (p = 0.023 and p = 0.045 respectively). These factors must be assessed in future
      studies of oropharyngeal candidiasis in radiation therapy.

PMID- 8361727
TI  - Oral findings in patients with active or inactive Crohn's disease.
AB  - The frequency and type of oral mucosal lesions, dental infections, and salivary
      constituents were evaluated in 53 patients with Crohn's disease, who were divided
      into inactive, mildly active, and severely active groups on the basis of clinical
      and endoscopic criteria. Buccal biopsies from nine patients with active disease
      showed morphologic changes that suggested Crohn's disease-related lesions.
      Panoramic radiographs revealed more infectious foci in the teeth of patients with
      active Crohn's disease than in patients with inactive disease. Salivary flow
      rate, buffering capacity, total protein, amylase, and IgA and IgG concentrations
      did not differ with respect to the activity of Crohn's disease. The observed
      mucosal inflammation in patients with active Crohn's disease, although high in
      frequency, was mild and did not need therapy, but the great number of dental
      infections in association with the activity of Crohn's disease should be taken
      into account in the treatment of these patients.

PMID- 8361728
TI  - Globulomaxillary cyst revisited.
AB  - Classically, the globulomaxillary cyst was considered to be an inclusion or
      developmental cyst that arises from entrapped nonodontogenic epithelium in the
      globulomaxillary suture. Subsequently Christ disputed the existence and
      histogenesis of this lesion stating that the evidence indicated that facial
      processes per se did not exist. The development of the anterior maxilla was
      attributed to the merging of growth centers rather than fusion of facial
      processes, and hence ectodermal entrapment was ruled out. Recent embryologic
      studies, however, have demonstrated that Christ's view of facial development was
      incorrect. Fusion of facial processes does occur, and epithelium is entrapped in
      areas that later will lie between the maxillary lateral incisors and canines.
      This review argues that embryologically and histopathologically the
      globulomaxillary cyst should again be considered as an identifiable
      clinicopathologic entity.

PMID- 8361729
TI  - The so-called "globulomaxillary cyst" is extinct.

PMID- 8361730
TI  - Clinical features of a family with X-linked amelogenesis imperfecta mapping to a
      new locus (AIH3) on the long arm of the X chromosome.
AB  - X-linked amelogenesis imperfecta is a condition that affects dental enamel
      characterized by vertical banding of the enamel in heterozygous females in
      contrast with more uniform appearances in males. The clinical features of a
      family with amelogenesis imperfecta are described. The disease in this family has
      been shown to be unlinked to the amelogenin gene locus on the distal short arm of
      the X chromosome. It maps instead to a locus on the long arm of the X chromosome
      in the Xq22-q28 region. There was considerable variability in clinical features
      in affected females in this family in contrast with the more consistent findings
      in families linked to the amelogenin gene locus region.

PMID- 8361731
TI  - Enamel ultrastructure and protein content in X-linked amelogenesis imperfecta.
AB  - X-linked amelogenesis imperfecta has been proven in a number of families to be
      linked to or involve a variety of mutations in the X chromosome amelogenin gene.
      The purpose of this study was to characterize the enamel ultrastructure and
      enamel protein in a kindred affected by X-linked amelogenesis imperfecta.
      Exfoliated primary teeth were obtained from two related persons (one male, one
      female) who had X-linked amelogenesis imperfecta with marked hypoplasia. Normal
      enamel (age and sex matched) was used as the control for all analyses. The teeth
      were evaluated using light microscopy, scanning electron microscopy, and
      microradiography. The enamel of the heterozygous female was hypoplastic and rough
      with marked surface depressions. Enamel beneath these depressions was poorly
      organized and lacked a prismatic structure. The affected male had very thin
      enamel (approximately 40 microns) that also lacked an organized structure. Enamel
      protein from the teeth of the heterozygous female and the control was
      characterized using amino acid analysis. The protein content of the enamel of the
      female with amelogenesis imperfecta was 0.40% (N = 1) whereas the control enamel
      ranged from 0.17% to 0.45% (N = 4; mean = 0.34%). This study indicates that
      although the enamel in both the male and female with X-linked amelogenesis
      imperfecta displayed marked structural abnormalities the enamel protein was
      similar in quantity and amino acid composition for normal and X-linked
      amelogenesis imperfecta (female) enamel.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361732
TI  - Chronic idiopathic hyperphosphatasemia. Case report.
AB  - Chronic idiopathic hyperphosphatasemia, or juvenile Paget disease is a very rare
      syndrome that is characterized by fragile bones, bowing deformities, shortness of
      stature, large head, premature loss of teeth, radiographic evidence of expanded
      osteoporotic long bones with coarse trabeculations, and widened bones of the
      skull. Increased levels of serum alkaline phosphatase and increased levels of
      urinary total hydroxyproline are notable. We present a case of juvenile Paget
      disease that was associated with a history of precocious puberty. The patient had
      odontogenic osteomyelitis of the mandible that was treated by drainage, surgical
      debridement and antibiotic therapy.

PMID- 8361733
TI  - Investigation into the histogenesis of congenital epulis of the newborn.
AB  - Five previously unreported cases of congenital epulis of the newborn are
      presented. All five cases were on the anterior maxillary alveolar ridge. Four
      were removed at 2 days of age and one at 7 weeks. Light microscopy demonstrated
      large eosinophilic granular cells within vascular fibrous connective tissue.
      Immunohistochemical studies revealed a positivity for vimentin and neuron
      specific enolase. Cytogenetic evaluation performed on one case was normal.
      Estrogen and progesterone receptors were absent in the one case so studied.
      Electron microscopy demonstrated tumor cells that were filled with
      autophagosomes. Cellular organelles were significantly reduced and inversely
      related to the number of cytoplasmic autophagosomes. Many of the autophagosomes
      contained collagen precursors. Poorly formed junctional complexes were seen.
      Occasional tumor cells demonstrated long processes that contained contractile
      microfilaments, pinocytosis, and areas of exocytosis. These studies suggest the
      tumor cells represent early mesodermal cells that express pericytic and
      myofibroblastic features that undergo cytoplasmic autophagocytosis.

PMID- 8361734
TI  - Role of T cells in the pathogenesis of periapical lesions. A preliminary report.
AB  - The pulps of mandibular molars of 15 athymic and 15 conventional rats were
      surgically exposed and left open to their oral flora. Each group was divided into
      three subgroups of five animals each. The rats were killed after their pulps were
      exposed for 2, 4, or 8 weeks. After fixing, decalcifying, and embedding, the
      specimens were sectioned and stained with hemotoxylin and eosin. They were then
      examined under a microscopic grid and quantified by percentages of surface areas
      of bone, connective tissue, bone marrow, intrabony spaces, periapical lesions,
      and numbers of osteoclasts, with the use of a DataVoice computerized data
      collection and analysis system. Statistical analysis showed no significant
      difference between periapical tissue responses of the conventional and athymic
      groups. The results indicate that the pathogenesis of periapical lesions is a
      multifactorial phenomenon and is not totally dependent on the presence of T-cell
      lymphocytes.

PMID- 8361735
TI  - Electron microscopic changes in human pulps after intraligamental injection.
AB  - Because of its advantages, intraligamental injection is becoming a popular
      anesthetic technique to achieve anesthesia in vital pulps. This study
      investigated the possible effects of intraligamental injection on human pulps
      under electron microscope. Forty-two mandibular and maxillary premolars were
      scheduled to be extracted for orthodontic reasons after being anesthetized with
      intraligamental injections of 2% lidocaine, 1:100,000 epinephrine (experimental
      group). The same anesthetic solution was used on the contralateral teeth with
      either nerve or field blocks (control group). To examine the effects of ischemia
      on odontoblasts, 12 anesthetized premolars were extracted, and their pulps were
      placed in physiologic saline solution for different time intervals (15 minutes to
      6 hours). The teeth in the experimental and control groups were then
      reanesthetized with nerve or field blocks of 3% carbocaine without epinephrine
      after time periods that ranged from 15 minutes to 28 days. After extraction, the
      teeth were sectioned vertically and their pulps were fixed in 3% glutaraldehyde.
      The odontoblastic layer of each pulp was examined under electronic microscope.
      Nuclear and cytoplasmic changes started an hour after ischemia in the pulps
      placed in physiologic saline. In contrast, little or no cellular changes occurred
      in pulps of the experimental or controls groups. On the basis of the results, it
      appears that intraligamental injection has no long-term deleterious effects on
      pulps of young human premolars.

PMID- 8361736
TI  - Effect of recapitulation on accuracy of electronically determined canal length.
AB  - The accuracy of an electronic apex locator to measure canal length during
      instrumentation when nonrecapitulated dentin debris is present has not been
      evaluated. The purposes of this study were (1) to compare actual with electronic
      canal length before and after instrumentation, and (2) to compare the accuracy of
      electronic length in recapitulated and nonrecapitulated canals. Actual canal
      lengths of 30 mature anterior teeth were determined, teeth mounted in an in vitro
      system, and canal lengths determined with the electronic apex locator. Canals
      were step-back prepared to a size 35 file. Fifteen canals were recapitulated and
      the other 15 were not. Canals were dried and lengths again determined with the
      electronic apex locator. Data showed that for electronically determined versus
      actual lengths: 1) 63% were longer, 23% equal, and 13% shorter before
      instrumentation, 2) 30% were longer, 0% equal, and 70% shorter after
      instrumentation, 3) instrumentation caused a mean shortening of 0.63 mm, and 4)
      recapitulation of nonpatent canals was necessary to obtain length reading with
      the electronic apex locator.

PMID- 8361737
TI  - Observer variation in interpretation of magnetic resonance images of the
      temporomandibular joint.
AB  - The purpose of this study was to measure interobserver and intraobserver
      variation in reporting magnetic resonance images of the temporomandibular joint.
      This study was based on magnetic resonance images of 149 joints. The images were
      interpreted independently by two of us on two occasions, 2 to 4 weeks apart. We
      were trained together before starting the study. The magnetic resonance images
      were interpreted for the position and configuration of the disk and osseous
      changes. The intraobserver agreement for reporting the position of the disk was
      95%, configuration of the disk was 90%, and osseous changes was 97% (average of
      both observers). The agreement between the two observers was 90% on the position
      of the disk, 89% on the configuration of the disk, and 94% on reporting osseous
      changes (average of both readings). The results suggest that interobserver and
      intraobserver variation in reporting magnetic resonance images of the
      temporomandibular joint can be kept at a low level with high quality images,
      suitable training of the observers, and well-defined criteria for interpretation.
      The low observer variation together with the high diagnostic accuracy reported in
      other studies suggests that magnetic resonance imaging of the temporomandibular
      joint is a reliable and valid imaging technique for assessment of this joint.

PMID- 8361738
TI  - Direct digital dental x-ray imaging with visualix/VIXA.
AB  - Visualix (VIXA in North America) is a new commercial system for direct dental x
      ray imaging. It is based on a special charged-coupled device sensor and a
      personal computer platform with dedicated peripherals. Application software is
      installed that manages the operation of the sensor and provides a user interface
      specifically conceived for real time imaging. Given the high sensitivity of the
      sensor and the corresponding low dosage required, the performance of the system
      in terms of signal-to-noise ratio is essentially determined and limited by the
      quantized nature of the original radiologic information in the x-ray beam. At
      full scale range, the dose requirements are approximately six times less than
      those for a D-speed film.

PMID- 8361739
TI  - Layer thickness in panoramic radiography as defined by different noise-equivalent
      passbands.
AB  - The layer thickness in rotational panoramic radiography is presented with the use
      of the concept of the noise-equivalent passband. Conventionally, the layer
      thickness has been calculated only from one-dimensional data in the horizontal or
      rotational dimension of panoramic radiography. In the present study, results from
      calculations using both one- and two-dimensional data are presented. When the
      vertical dimension is included in the calculations, the layer is wider than when
      calculated from data in the horizontal dimension only. It is pointed out that the
      wider layer that follows from the introduction of the vertical dimension may be
      the most reliable measure of layer thickness in panoramic radiography.

PMID- 8361740
TI  - Computed tomography of the jaws in familial adenomatosis coli.
AB  - Familial adenomatosis coli is known to be associated with tooth impactions,
      odontomas, and osteomas. Three cases were examined by panoramic radiography and
      computed tomography. Computed tomography was especially useful for detecting
      osteomas in the maxilla and also revealed a wavy cortical thickening in the
      mandible in one instance. The latter finding has been reported for other bones in
      the body but not previously for the mandible.

PMID- 8361741
TI  - Pencil injury.

PMID- 8361742
TI  - Iodoform gauze with a radiopaque filament.

PMID- 8361743
TI  - Paramolar with bifid crown.

PMID- 8361744
TI  - Supernumerary teeth in twins.

PMID- 8361745
TI  - [Surgical management of left cor triatriatum in adults].
AB  - Cor triatriatum sinistrum is a rare congenital cardiac anomaly in which a
      membrane divides the left atrium. Severity of the disease depends on the size of
      the opening on the membrane. The anomaly presents with severe pulmonary
      hypertension and prognosis is unfavourable without surgery. From 1976 through
      1992, 5 adult patients were treated surgically in our institution. Cor
      triatriatum can be corrected surgically with a low mortality and excellent late
      results if an early preoperative diagnosis has been made. Clinical findings and
      cardiac catheterization do not provide sufficient data for the correct diagnosis.
      From a review of our experience it is concluded that echocardiography is superior
      to angiography for diagnosing cor triatriatum.

PMID- 8361746
TI  - [Lymph drainage from the breast to the parasternal lymph nodes].
AB  - Breast lymphography revealed linkage between the axillary and parasternal lymph
      nodes in three out of 55 patients with breast cancer. In all the cases the
      efferent lymph vessels outlined laterally and, according to Berg's scheme, lymph
      node groups I, II and III were filled. Lymph vessel responsible for the filling
      of the parasternal lymph nodes branched from the area of group I lymph nodes. In
      two out of the 3 cases axillary metastasis was detected in one case, however, the
      axillary was found unaffected. The lymph vessel linkage observed doesn't seem to
      support the widely accepted concept, according to which there are only direct
      efferent lymph vessels running from the breast to the parasternal lymph nodes.
      This finding also explains why the incidence of parasternal metastases in the
      breast is higher in the case of tumorous obstruction of the axillary lymph nodes.

PMID- 8361747
TI  - [Azidothymidine in the management of immune deficiency complex].
AB  - The nucleoside-analogue azidothymidine is the first effective drug in the
      management of HIV-infection although it is not a causal therapy. Azidothymidine
      increases the life-span of the HIV-positive patients, decreases the incidence of
      opportunistic infections and enhances the quality of life. The current
      recommendations is to use the drug at a dose of 500 mg daily in persons with CD4+
      counts of less than 500. The (unwanted) side-effects are less prominent at this
      lower dose. Although there is a very significant research work all over the world
      for newer drugs for HIV-therapy, it seems that for the foreseeable future
      azidothymidine will remain the cornerstone of antiretroviral therapy.

PMID- 8361748
TI  - [Ophthalmoplegia in herpes zoster: clinical review based on two case reports].
AB  - The authors describe two cases of ophthalmic herpes zoster complicated with
      ophthalmoplegia. This rare complication developed in the 2nd week after beginning
      of the disease and it is only slightly influenced by antiviral therapy, but
      improvement was observed after the administration of corticosteroids. A short
      overview summarizes the diagnostic possibilities, the therapy and the
      complication of the disease.

PMID- 8361749
TI  - [Parenteral administration of fat-soluble vitamins].

PMID- 8361750
TI  - [Trends in therapy by "manipulation", basic concepts of manual therapy].

PMID- 8361751
TI  - Suppression in transformed avian fibroblasts of a gene (crp) encoding a cysteine
      rich protein containing LIM domains.
AB  - Using cDNA subtraction and differential hybridization techniques, a cDNA library
      derived from normal quail embryo fibroblasts was screened for clones
      corresponding to genes whose expression was suppressed in v-myc-transformed, as
      compared with normal, quail embryo fibroblasts. One of the isolated cDNA clones
      corresponded to a 0.9-kb mRNA that was present in normal quail and chicken embryo
      fibroblasts, but was virtually absent from all transformed avian cells tested:
      quail embryo fibroblasts transformed by the v-myc, v-myc/v-mil or v-src
      oncogenes, cells derived from a methylcholanthrene-induced quail fibrosarcoma or
      v-myc-transformed chicken macrophages. Nucleotide sequence analysis of the
      original and supplementary cDNA clones indicated that the corresponding gene
      encodes a 194 amino acid cysteine-rich protein (M(r) 20,911). A database search
      revealed that the gene is the avian homolog of a human primary response gene
      (crp) of unknown function. Both the quail and human CRP proteins contain two
      copies of a cysteine-rich amino acid sequence motif (LIM) with putative zinc
      binding activity that was previously identified in several proteins with presumed
      regulatory functions essential for cell growth or differentiation.

PMID- 8361753
TI  - Molecular cloning and characterization of the mouse RB1 promoter.
AB  - We report the isolation and characterization of the mouse RB1 promoter and
      surrounding DNA sequences, and the identification of elements required for basal
      transcriptional activity. The mouse RB1 promoter, like the human homologue, has a
      high G + C content, constitutes a CpG island and is devoid of typical TATA and
      CAAT boxes. The first 235 base-pairs upstream of the translation initiation codon
      in the mouse promoter exhibit 80% sequence homology with the human sequence. This
      homology includes a region which contains putative binding sites for the
      transcription factors Sp1, ATF and E2F/DRTF1. Four major transcription initiation
      sites were identified downstream of this conserved region. Mutational analysis
      revealed that the Sp1 and ATF binding sites, but not the putative E2F/DRTF1
      binding site, are critical for promoter activity. Complete disruption of the
      putative Sp1 and ATF sites abrogated transcription, whereas the introduction of
      point mutations, previously identified in the Sp1 and ATF sites in two low
      penetrance retinoblastoma families, reduced promoter activity in a cell type
      specific manner. Less reduction in activity occurred in retinoic acid induced
      differentiated P19 cells and NIH3T3 mouse fibroblasts than in undifferentiated
      embryonal carcinoma P19 cells. Activity of the RB1 promoter was found to be
      stimulated in retinoic-acid induced differentiated P19 cells compared to
      undifferentiated P19; this stimulation required intact Sp1 and ATF sites but not
      the putative E2F/DRTF1 binding site. Our results indicate that basal level of RB1
      expression is governed by Sp1 and ATF.

PMID- 8361752
TI  - The carboxy-terminal domain of c-Myb activates reporter gene expression in yeast.
AB  - We have shown previously that c-myb expressed in the yeast S. cerevisiae mediated
      efficient transcriptional activation of reporter genes designed with specific Myb
      Recognition Elements (MRE's), confirming that this proto-oncogene is able to
      function as a regulator of transcription in that heterologous context. Here we
      show that in yeast, as in higher eucaryotic cells, the central domain of c-Myb
      displays transactivating capacity. In yeast, however, the carboxy-terminal
      region, defined as a negative regulatory domain in higher cells, activates
      transcription as well and appears to be a more potent transactivating domain than
      the central domain itself. Within this region two domains, namely C1 and C2, have
      been defined that contribute about equally to the activity of the carboxy
      terminal region. C1 spans the sequences missing in AMV v-myb while C2, which
      contains the leucine-zipper motif is specifically absent in the E26 v-myb in
      addition to C1. The c-Myb DNA-binding domain itself has no effect on the level of
      transcription in yeast. We also show that AMV v-Myb stimulates gene expression in
      yeast with about half the efficiency of full length c-Myb. The fact that the
      carboxy-terminal region either stimulates or inhibits transactivation properties
      of c-Myb, depending on the cellular context, stresses the participation of
      putative c-Myb partner proteins in Myb regulated processes and reopens the
      question of whether the oncogenic activation of c-myb is indeed due to the
      increased transactivation capacity of its onco derivatives.

PMID- 8361754
TI  - Two new members of the maf oncogene family, mafK and mafF, encode nuclear b-Zip
      proteins lacking putative trans-activator domain.
AB  - The v-maf oncogene of the avian musculoaponeurotic fibrosarcoma virus, AS42,
      encodes a nuclear protein which contains a characteristic b-Zip domain. By
      screening a chicken embryo fibroblast (CEF) cDNA library under moderately
      stringent hybridization conditions, we picked up a series of cDNA clones for a
      novel maf-related gene which we named mafK. We also identified another maf
      related gene named mafF by screening a chicken genomic library using a mafK
      probe. Structural analyses suggested that the mafK and mafF genes consist of
      three exons. The exon-intron structures of the two genes resemble each other, but
      differ from that of the chicken c-maf gene. As compared to the c-Maf protein, the
      proteins encoded by the mafK and the mafF genes are rather small in size and lack
      the regions corresponding to the amino terminal acidic domain present in the c
      Maf protein. On the other hand, the structures of the b-Zip domain are well
      conserved among these Maf-related proteins. When overexpressed by using an avian
      retroviral vector, the two maf-related genes did not induce morphological
      transformation of CEF cells but induced colony formation in soft agar with very
      low efficiencies. With a specific antibody, the MafK protein was detected
      predominantly in the nuclei of the cells infected with the virus which carries
      the mafK gene. Tissue distributions of these three maf-family genes are different
      from one another, probably reflecting their different functions in vivo.

PMID- 8361755
TI  - A trans-activator Tax of human T-cell leukemia virus type 1 binds to NF-kappa B
      p50 and serum response factor (SRF) and associates with enhancer DNAs of the NF
      kappa B site and CArG box.
AB  - A transcriptional activator of human T-cell leukemia virus type 1 (HTLV-1)
      activates at least three distinct enhancers: the viral 21-bp enhancer, the NF
      kappa B binding site of the IL-2R alpha gene and the CArG box of the c-fos gene.
      To understand the mechanisms of Tax transactivations of the NF-kappa B enhancer
      and CArG box, the interactions of Tax protein with their binding factors were
      analysed. Using a DNA affinity precipitation (DNAP) assay, we found here that Tax
      associates with the DNA sequences of the NF-kappa B site and CArG box. These Tax
      associations with enhancers were observed only in the presence of a nuclear
      factor(s) and were equal to the activating capacities of Tax mutants. To identify
      the nuclear factor(s), we defined conditions under which no Tax binding to the NF
      kappa B binding site and CArG box was detected with a nuclear extract of 293T
      cells. Under these conditions, transfections with cDNAs of the NF-kappa B p50 and
      serum response factor (SRF) produced a factor(s) that mediated Tax binding to the
      NF-kappa B site and the CArG box respectively. Furthermore, purified Tax protein
      interacted with purified NF-kappa B p50 and purified SRF, indicating their direct
      bindings. These observations indicate that Tax protein associates with enhancer
      sequences of the NF-kappa B site and CArG box through NF-kappa B p50 and SRF
      respectively. Previously we demonstrated that Tax interacts with CREB and CREM
      proteins that bind to the 21-bp enhancer DNA. These results together suggest that
      indirect binding of Tax to DNA through each enhancer binding protein is a general
      mechanism for Tax transactivation of transcription.

PMID- 8361756
TI  - Transforming activity and tissue tropism of hybrid retroviral genomes containing
      portions of the v-abl and v-src oncogenes.
AB  - The v-abl and v-src oncogenes encode activated cytoplasmic tyrosine kinases with
      considerable sequence similarity. The v-abl oncogene of the Abelson murine
      leukemia virus exhibits a narrow tissue tropism for transformation, almost
      exclusively forming pre-B-cell tumors, while the v-src oncogene can induce a
      variety of sarcomas and other tumors. To localize the determinants of the narrow
      tropism of the v-abl gene, we generated a series of hybrid retroviral genomes
      containing portions of the v-abl and v-src oncogenes in a Moloney murine leukemia
      virus backbone. Each virus was tested for transforming activity in NIH3T3 cells;
      for transforming activity on bone marrow cultures; and for pathogenicity in
      newborn mice. Many of the hybrid oncogenes carried by these viruses exhibited
      transforming activity, and demonstrate that the SH2 domain of each oncogene can
      be utilized by the kinase domain of the other oncogene for that activity. The
      results further suggest that a portion of the C-terminal region of v-abl is
      necessary for the pre-B-cell specificity of the oncogene.

PMID- 8361757
TI  - H-ras and raf-1 cooperate in transformation of NIH3T3 fibroblasts.
AB  - We examined the effect of overexpression of growth factor-regulated second
      messenger enzymes, alone and in combination, on transformation of NIH3T3 cells.
      Signal transducers included phospholipase C-gamma (PLC-gamma), protein kinase C
      gamma (PKC-gamma), and two proto-oncogenes, c-H-ras and c-raf-1. Three of these
      proteins, PLC-gamma, PKC-gamma and Raf-1, did not transform NIH3T3 cells alone or
      in combination. c-H-ras, which under its own promoter control has low
      transforming activity, also did not cooperate with PLC-gamma or PKC-gamma. In
      contrast, the combination of normal or oncogenic p21 H-Ras with the Raf-1 kinase
      dramatically increased transformation efficiency. The level of Ras protein
      required for transformation was reduced in Raf-1 co-transfectants, implying that,
      at low levels of p21 Ras, p74 Raf-1 is rate limiting. As transformation by Ras
      depends on jun-mediated transcriptional events, we also examined H-ras and c-raf
      1 cooperation in transcriptional transactivation of TPA-responsive element (TRE)
      dependent reporters. Like the H-ras/c-raf-1 cooperation in transformation, we
      observed this synergistic stimulation of TRE-dependent transcription. This
      pathway for transformation and transcriptional activation by increased levels of
      normal Ras and Raf may be important in tumors that show overexpression but lack
      mutationally activated forms of these two proto-oncogenes.

PMID- 8361758
TI  - Several mutant p53 proteins detected in cancer-prone families with Li-Fraumeni
      syndrome exhibit transdominant effects on the biochemical properties of the wild
      type p53.
AB  - The identification of germ-line mutations in the p53 gene has provided a
      situation where comparable amounts of wild-type and mutant p53 co-exist in
      constitutional cells of certain individuals who are cancer-prone. Here we report
      the biochemical characteristics of several Li-Fraumeni syndrome associated mutant
      p53 proteins in order to assess the influence of germ-line mutant p53 on the
      functions of the wild-type p53. Unlike 248W mutant p53 protein, which was
      previously shown to have no effect on the wild-type p53 conformation (Milner &
      Medcalf, 1991; Cell 65, 765-774), germ-line associated mutant p53 proteins with
      residue 133T, 245D or 258K, converted the wild-type p53 conformation into the
      mutant conformation. Furthermore, lysates containing cotranslated wild-type p53
      and these mutant p53 proteins were significantly impaired for DNA and SV40 large
      T antigen binding. These observations suggest that at least some germ-line p53
      mutants might exhibit dominant effects on wild-type p53 functions and, like other
      mutant p53 proteins, the phenotype of germ-line mt p53 proteins might be variable
      depending on the particular mutation.

PMID- 8361759
TI  - Isolation and chromosomal localization of CRKL, a human crk-like gene.
AB  - We have identified and partially characterized a gene located on chromosome 22,
      band q11, centromeric of the chronic myelogenous leukemia breakpoint region. A
      number of overlapping cDNAs were isolated from this locus and the largest of 1.8
      kb was sequenced. Its deduced amino acid sequence shows homology to the SH2
      domains of protein tyrosine kinases such as FER, and is strikingly similar to the
      cellular part of the v-crk oncogene product. We identified one SH2 and two SH3
      domains within the 303 amino acid open reading frame of this crk-like gene, CRKL.
      The CRKL gene product is predicted to have a molecular mass of 36 kDa. In
      addition, we demonstrate that this gene does not represent the human homolog of v
      crk but rather a novel gene potentially capable of mediating the transduction of
      intracellular signals.

PMID- 8361760
TI  - MTCP-1: a novel gene on the human chromosome Xq28 translocated to the T cell
      receptor alpha/delta locus in mature T cell proliferations.
AB  - T-cell lymphoproliferative diseases are often associated with recurrent
      chromosomal translocations involving T cell receptor genes (TCR) and genes that
      are thought to play a role in the pathogenesis of these diseases. Whereas
      numerous such genes have already been identified in acute T cell leukemias, no
      candidate gene has yet been identified to play a role in the heterogeneous group
      of T cell proliferations with a mature phenotype. We here report the molecular
      cloning of two examples of the rare but recurrent t(X;14) translocation. The
      first translocation was associated with a benign clonal proliferation in an
      ataxia telangiectasia patient and the second with a T cell prolymphocytic
      leukemia. Both translocations implicated the TCR alpha/delta locus and a common
      breakpoint region on chromosome Xq28. A previously unidentified gene, abnormally
      transcribed in both T cell proliferations, was characterized in the immediate
      proximity of the breakpoints. This Xq28 gene has no homology with known
      sequences, uses a complex alternative splicing pattern and demonstrates two short
      open reading frames. This gene, named MTCP-1 (Mature T Cell Proliferation-1) is
      the first candidate gene potentially involved in the leukemogenic process of
      mature T cell proliferations.

PMID- 8361761
TI  - The v-Rel oncoprotein increases expression from Sp1 site-containing promoters in
      chicken embryo fibroblasts.
AB  - The v-Rel oncoprotein of the avian Rev-T retrovirus is a member of a family of
      related transcription factors, which also includes the subunits of NF-kappa B and
      several other interacting cellular proteins. We show here that v-Rel specifically
      increased expression from a reporter plasmid containing multiple Sp1 binding
      sites approximately sixfold in chicken embryo fibroblasts (CEFs), even though v
      Rel did not bind directly to these sites. v-Rel also increased expression from a
      reporter plasmid containing a human immunodeficiency virus type 1 (HIV-1) long
      terminal repeat (LTR) in which the kappa B binding sites were mutated but which
      still contained intact Sp1 binding sites. The increase in Sp1-site
      transactivation does not precisely correlate with transformation by v-Rel since
      one non-transforming v-Rel mutant still induced expression from the Sp1 site
      containing promoter. v-Rel appears to increase expression from Sp1 site
      containing promoters by affecting the transactivation domain of Sp1, since v-Rel
      increased the activity of a Gal4-Sp1 fusion protein, which contains the Sp1
      transactivation domain but lacks the Sp1 DNA-binding domain. As compared with v
      Rel, c-Rel induced only a slight increase in expression from the reporter plasmid
      containing Sp1 sites. However, v-Ras and v-Src (but not v-Myb) induced increases
      in transcription from the reporter plasmid containing Sp1 sites to the same
      extent as v-Rel, but through pathways that appear to be independent from v-Rel.
      These results suggest that certain oncoproteins might increase transcription from
      many genes that contain Sp1 binding sites, and that this might be important for
      certain aspects of transformation by these proteins.

PMID- 8361762
TI  - p54c-ets-1 and p68c-ets-1, the two transcription factors encoded by the c-ets-1
      locus, are differentially expressed during the development of the chick embryo.
AB  - The chicken c-ets-1 proto-oncogene encodes two transcription factors, p54c-ets-1
      and p68c-ets-1, which contain the same DNA-binding domain but differ in their
      transactivating activities. We have investigated the spatial and temporal
      distribution of the transcripts encoding p54c-ets-1 and p68c-ets-1 throughout the
      development of the chick embryo. We report that p68c-ets-1 as well as p54c-ets-1
      is expressed in a wide variety of cells of mesodermal origin, including
      endothelial cells and mesenchymal cells interacting with epithelium. However,
      whereas p54c-ets-1 transcripts are detected in most cells, p68c-ets-1 transcripts
      are restricted to a subset of these cells, randomly distributed. In contrast,
      p54c-ets-1 is expressed in the absence of p68c-ets-1 in T and B lymphocytes. We
      show that, during erythropoiesis, both p68c-ets-1 and p54c-ets-1 are expressed in
      immature erythroid cells in extraembryonic blood islands. The pattern of
      expression of p54c-ets-1 and p68c-ets-1 during embryonic development suggests the
      involvement of these transcription factors in the regulation of morphogenetic
      processes. In addition, we provide the first clue that p68c-ets-1, the cellular
      progenitor of the v-ets oncogene, is expressed in erythroid cells. This result is
      very important with respect to the properties of the v-ets oncogene, which
      confers on the retrovirus E26 the ability to transform erythroid cells.

PMID- 8361763
TI  - Role of first exon/intron sequences in the regulation of myc family oncogenic
      potency.
AB  - cis-Acting sequence elements that participate in the regulation of myc family
      gene expression in normal tissues and that serve as potential targets for the
      deregulation of expression in tumors have been localized to the first exon/intron
      region of all three myc family genes. To test directly the importance of these
      cis elements in the tumor-associated deregulation of myc family gene expression,
      we have compared the oncogenic activities of complete (exons 1, 2 and 3) and
      truncated (exons 2 and 3 only) c-, N- and L-myc expression constructs in the rat
      embryo fibroblast (REF) cooperation assay. Removal of the first exon/intron
      region from each construct was associated with a dramatic increase in oncogenic
      potency by several criteria. Analysis of N-myc/ras-transformed cell lines
      demonstrated (i) fewer transfected N-myc gene copies and an overall higher level
      of steady-state N-myc mRNA with the truncated N-myc expression construct and (ii)
      the presence of a significant block to transcriptional elongation in the first
      exon of the complete N-myc expression construct. These results indicate that the
      first exon of N-myc plays an important role in governing oncogenic potency,
      possibly through transcriptional control mechanisms.

PMID- 8361765
TI  - Cloning of a new member of the retinoblastoma gene family (pRb2) which binds to
      the E1A transforming domain.
AB  - The product of the retinoblastoma tumor suppressor gene (pRb) and p107 share a
      high degree of structural homology in the pocket region, which is thought to play
      a primary role in the function of these proteins. It is conceivable that there
      exists a larger family of cellular proteins containing this pocket region. In
      this communication, we report cloning of a new human cDNA encoding a polypeptide
      that shows a high level of identity with pRb and p107 and possesses a pocket
      region. We have named it pRb2. From the deduced amino acid sequence, pRb2 has a
      predicted molecular weight of approximately 120 kD and its in vitro translated
      product binds to the adenovirus E1A protein. Due to its size, pRb2 may correspond
      to p130, which has previously been shown by us to interact with the transforming
      region of E1A in in vivo studies. Interestingly, pRb2 fails to bind an E1A mutant
      in the transforming domain 2 suggesting that pRb2 is involved in the transforming
      capacity of E1A.

PMID- 8361764
TI  - Novel DNA binding of p53 mutants and their role in transcriptional activation.
AB  - The protein product of the normal p53 gene binds to the DNA p53CON element
      (GGACATGCCCGGGCATGTCC, Funk et al., 1992), thereby activating transcription from
      adjacent promoters. Two mutants, 248 (Arg-->Trp) and 281 (Asp-->Gly), failed to
      bind p53CON and to activate transcription. However, in contrast to previous
      reports that all p53 mutants fail to bind to the other p53 binding elements, two
      p53 mutants, 143 (Val-->Ala) and 273 (Arg-->His), retained both p53CON binding
      and transcriptional activation functions. A third mutant 175 (Arg-->His) bound to
      the p53CON but did not activate transcription. These data suggest that the DNA
      binding and transcriptional activation functions of p53 mutants in tumor cells
      are dependent on the specific missense mutations acquired in the p53 gene and the
      target sequences of p53 in the genome.

PMID- 8361766
TI  - I kappa B alpha can localize in the nucleus but shows no direct transactivation
      potential.
AB  - Although I kappa B is a cytoplasmic inhibitor of NF-kappa B and c-Rel that
      prevents nuclear translocation of NF-kappa B, some forms of I kappa B have been
      found in the nucleus. Given that some other proteins with ankyrin-type repeats
      are transcription factors, we wondered if a nuclear form of I kappa B alpha could
      itself be a transcriptional activator. We found that Gal4-I kappa B alpha fusion
      proteins strongly transactivate a Gal4 site-containing promoter in 3T3
      fibroblasts. The I kappa B alpha domain responsible for this transactivation is
      not the acidic domain of I kappa B alpha, but the ankyrin repeat domain which is
      responsible for protein-protein interactions. To enhance our ability to detect
      cellular I kappa B alpha by immunofluorescence, we overexpressed the protein in
      transfected cells, and found that overexpressed I kappa B alpha is largely
      cytoplasmic in serum-deprived cells, but nuclear in serum-stimulated cells.
      However, in cell fractionation studies under all treatment conditions, I kappa B
      alpha appears mainly in cytoplasmic fractions, suggesting that it can rapidly
      move out of the nucleus through nuclear pores during extract preparation. Using
      double antibody immunoprecipitations, we found that I kappa B alpha in
      proliferating cells is strongly associated with RelA(p65). When I kappa B alpha
      is fused to the Gal4 DNA-binding domain, nuclear Gal4-I kappa B alpha is
      associated with RelA(p65). Thus, the activation domain of the associated
      RelA(p65) molecule could account for the ability of Gal4-I kappa B alpha to
      transactivate the Gal4 promoter. Unlike Bcl-3, an I kappa B which has been
      recently shown to directly transactivate through kappa B sites when associated
      with NFKB2 (p52), I kappa B alpha shows no ability to directly transactivate
      target promoters via its association with RelA(p65).

PMID- 8361767
TI  - Structural analysis of the human ret proto-oncogene using exon trapping.
AB  - A genomic contig of the human ret protooncogene was created with four overlapping
      cosmid clones isolated from two libraries. After southern analysis with portions
      of the ret cDNA, eight cosmid fragments were analysed in detail for the presence
      of ret exons using exon trapping. PCR products corresponding to spliced exons
      were isolated and subcloned. Exon boundaries were delineated by comparison of the
      PCR product sequence and the published ret cDNA sequence. The exons were
      initially positioned on a genomic map defined by BamHI, EcoRI and HindIII
      restriction sites. The positions of the exons were then refined by amplifying
      genomic DNA using primer pairs derived from one or more exons along the ret gene,
      the length of the PCR product indicating the approximate genomic distance between
      the exon sequences. The ret proto-oncogene is composed of at least 20 exons,
      ranging in size from 60 bp to 287 bp, distributed along 30 kb of genomic DNA. The
      extracellular domain is encoded by 10 exons and the cytoplasmic domain by 9
      exons. The transmembrane domain is encoded by a single exon.

PMID- 8361768
TI  - Identification of amino acids in p21ras involved in exchange factor interaction.
AB  - Through the genetic analysis of vulva development in C. elegans several different
      sites of mutation have been identified in the let-60 ras protein which have been
      postulated to affect the function of normal but not oncogenic p21ras (Beitel, G.
      J., S. G. Clark, and H. R. Horvitz. 1990. Nature 348: 503-509). We have
      introduced these mutations into mammalian Ha-ras and determined their effect on
      the function of cellular ras (c-ras), an oncogenically activated variant D12ras
      and the dominant negative N17ras. From these studies we conclude that two of the
      mutations S89-->F89 and delta 103-108 destabilise ras when it is in the GDP-bound
      form. However mutations at A66 and G75 lead to stable proteins on which a ras
      exchange factor SCD25 is unable to promote the formation of ras-GTP. The
      mutations at A66 show for the first time that helix alpha 2 of p21ras is involved
      in the stimulation of guanine nucleotide exchange by exchange factors.

PMID- 8361769
TI  - Upregulation of mdm-2 expression in Meth A tumor cells tolerating wild-type p53.
AB  - Overexpression of mouse wild-type p53 (wt p53) in mouse Meth A tumor cells after
      transfection of wt p53 encoding vectors induced a strong growth-inhibitory
      response. Cells of only few of randomly selected surviving colonies contained and
      expressed the transfected wt p53 specific DNA. Despite expressing authentic wt
      p53, such cells (MethAp53wt) exhibited a similar phenotype as the parental Meth A
      cells. These cells overexpressed the mdm-2 (mouse double minute-2) gene, both at
      the RNA and at the protein level. Recently, the MDM-2 protein has been identified
      as a cellular target of p53, which can abolish its tumor suppressor activity. We,
      therefore, suggest that MDM-2 has mitigated the growth-inhibitory effect of wt
      p53 in MethAp53wt cells. Upregulation of mdm-2 expression in MethAp53wt cells was
      mediated by wt p53, as analysis of Meth A cells carrying a tsp53 (p53Val135)
      revealed a strict dependence of mdm-2 upregulation upon wt p53 expression. Our
      results propose that a balanced ratio of MDM-2 and p53 will allow cells to
      tolerate a limited expression of wt p53. This tolerance is not mediated by a
      direct inactivation of wt p53 via complex formation with MDM-2, as the majority
      of both MDM-2 and wt p53 in MethAp53wt cells was not complexed to each other.

PMID- 8361771
TI  - Joint statement on maintaining professional and legal standards during a shortage
      of nursing personnel.

PMID- 8361770
TI  - Unit-based case management benefits patients and nurses.

PMID- 8361772
TI  - Standards of nursing conduct.

PMID- 8361773
TI  - Modulation of the allergic reactivity of slum children by helminthic infection.
AB  - Infection by helminthic parasites can cause the polyclonal stimulation of IgE
      synthesis, possibly via an enhanced production of interleukin-4 (IL-4), and this
      has been suggested to influence the allergic reactivity of tropical populations
      where these parasites are endemic. We evaluated a group of urban slum children in
      Caracas, Venezuela, with a high prevalence of helminthic infection (70.8%), to
      establish the relationship between the elevated IgE levels (3696 IU/ml) induced
      by these parasites and various aspects of the allergic response. Although the
      absolute levels of IL-4 detected in the sera of these children were low (0.65 +/-
      0.20 ng/ml), a strong positive correlation (r = 0.78) was found between these and
      serum IgE. The cutaneous immediate hypersensitivity reactivity to extracts of
      common environmental allergens was relatively low (17.5% to house dust), although
      that to Ascaris extract was moderately high (49.4%). Significant inverse
      correlations were found between total IgE levels and the different skin test
      reaction diameters, including Ascaris. The positivity of Prausnitz-Kustner
      passive transfer tests was low in this group (34%), with a strong inverse
      correlation (r = -0.75) being found between this and total IgE levels.
      Significant inverse correlations were also found between total IgE levels and
      specific IgE antibody to environmental allergens, and to Ascaris antigen. We
      suggest that the polyclonal production of IgE stimulated by helminthic infection
      can suppress the allergic response to environmental and parasite allergens via
      both mast cell saturation and inhibition of specific IgE production.

PMID- 8361774
TI  - Influence of genes within the MHC on mortality and brain cyst development in mice
      infected with Toxoplasma gondii: kinetics of immune regulation in BALB H-2
      congenic mice.
AB  - Previous work has shown that genes within the major histocompatibility complex
      (MHC) of the mouse influence resistance and susceptibility to Toxoplasma gondii
      infection. Initial studies presented here using B10 H-2 congenic and recombinant
      haplotype mice inoculated via the oral route with the low virulence Beverley
      strain of T. gondii confirm the D region localization of MHC-linked control of
      brain cyst number. All B10 mice were, however, exquisitely sensitive to minor
      changes in virulence of the parasite inoculum resulting in high mortality during
      the early acute phase of infection. Further experiments examining mortality and
      brain cyst number in BALB MHC congenic mice inoculated via different routes
      indicated that the BALB background would provide a more favourable genetic
      environment in which to analyse kinetics of MHC controlled immune regulation
      following infection via the natural (oral) route. In studies comparing d and k
      haplotype mice a dramatic inverse relationship between splenic CD4:CD8 T cell
      ratios and brain cyst number was observed, particularly in the strain (BALB/K; H
      2k) most susceptible to high brain cyst numbers and subsequent toxoplasmic
      encephalitis. Of particular interest was the observation that splenomegaly and
      the relative increase in the splenic CD8 T cell population preceded and
      accompanied the very dramatic and rapid increase in brain cyst formation. The
      results suggest that the too rapid development of a potent anti-parasite response
      in the viscera may drive the parasite to encyst in the brain.

PMID- 8361775
TI  - Immobilization of Schistosoma mansoni miracidia by activation of the alternate
      complement pathway at unusually high serum dilution.
AB  - Free-swimming Schistosoma mansoni miracidia were immobilized by adding normal
      mammalian serum to the water. Miracidial immobilizing activity (MIA) was shown to
      result from activating the alternate pathway of complement (APC). MIA in normal
      sera was heat-sensitive and antibody independent; it was greatly reduced in
      factor B-depleted or C6-depleted, but not in C1-depleted, human serum. Addition
      of purified factor B to B-depleted serum totally restored MIA. Half-maximal MIA
      in normal human, rabbit, and guinea pig sera was detectable at final dilutions
      exceeding 1/100, 1/200, and 1/500, respectively, and normal rat serum was
      particularly potent, with MIA at dilutions exceeding 1/2000. Detection of APC
      activity at such high dilutions is quite extraordinary and attributed to the
      hypotonic conditions. We confirmed and extended previous findings that heat
      inactivated infection sera also display MIA. Immobilizing activity in irradiated
      cercarial vaccine rat serum cofractionated with rat IgG and anti-SWAP antibody
      activity. Antibody-dependent MIA titres were much lower than for APC-dependent
      MIA. Based upon light microscope and transmission EM studies, immobilization of
      miracidia by APC activation was attributed to severe tegumental damage. Miracidia
      within egg shells were insensitive to MIA.

PMID- 8361776
TI  - The schistosomulicidal activity and the production of IL-1 and TNF-alpha by
      peritoneal macrophages from infected mice and their potentiation by muramyl
      tripeptide-phosphatidyl ethanolamine (MTP-PE) treatment.
AB  - Production of TNF-alpha and IL-1 by adherent peritoneal exudate macrophages
      (APEM) was monitored for 20 weeks in Schistosoma mansoni infected mice in
      comparison to their schistosomulicidal activity. LPS-triggered IL-1 and TNF-alpha
      production by APEM peaked 10 weeks post infection (p.i.) and declined thereafter.
      The schistosomulicidal activity of APEM also peaked after 10 weeks but remained
      elevated thereafter. Infected mice were also treated with the immunostimulator
      liposomal muramyl tripeptide-phosphatidyl ethanolamine (MTP-PE) 6 or 10 weeks
      p.i., and their APEM were tested 4 weeks later. APEM from such treated animals
      showed elevated IL-1 and TNF-alpha production when treatment commenced 6 weeks
      p.i., while their schistosomulicidal activity increased when treatment commenced
      either 6 or 10 weeks p.i. The L-arginine inhibitor, NG monomethyl arginine,
      markedly inhibited the schistosomulicidal activity but not the IL-1 and TNF-alpha
      production of APEM. Our results show that monokine production increases during
      the acute phase of infection and declines during its chronic phase, while
      macrophage schistosomulicidal activity remains constant throughout. Furthermore,
      TNF-alpha or IL-1 may play a minor role in APEM mediated killing of
      schistosomula.

PMID- 8361777
TI  - Ablation of eosinophils with anti-IL-5 antibody enhances the survival of
      intracranial worms of Angiostrongylus cantonensis in the mouse.
AB  - Effects of depressed eosinophilia on the development of Angiostrongylus
      cantonensis in the mouse were studied using monoclonal rat anti-mouse-interleukin
      5 antibody (anti-IL-5). The administration of anti-IL-5 strongly depressed
      peripheral, cerebrospinal fluid (CSF) and medullary eosinophilic responses in
      mice infected with A. cantonensis, when compared with groups treated with
      phosphate-buffered saline solution (PBS) alone or isotype-matched rat IgG. There
      was no significant difference in A. cantonensis antigen specific IgG and IgE
      antibody responses between rat IgG treated and anti-IL-5 treated mice.
      Intracranial worm recovery in anti-IL-5 treated mice was consistently high
      throughout the course of the study and some worms migrated from the brain to the
      lungs. By contrast, almost all the intracranial worms in the mouse groups treated
      with PBS alone or rat IgG died before day 32. These data clearly indicate that IL
      5 is essential for eosinophil responses in A. cantonensis infected mice and also
      that eosinophils serve as a potential effector cell in the killing of the
      intracranial worms in mice.

PMID- 8361779
TI  - Investing your money the smart way.

PMID- 8361778
TI  - Immunogenicity in rabbits and monkeys of influenza ISCOMs conjugated with
      repeated sequences of the Plasmodium falciparum antigen Pf155/RESA.
AB  - Rabbits and monkeys were immunized with two fusion proteins, ZZ-M3 and ZZ-M5,
      coupled to pre-formed influenza virus membrane glycoprotein ISCOMs. The fusion
      proteins comprise two IgG-binding domains from staphylococcal protein A (ZZ) and
      repeated amino acid sequences from the C-terminal (M3) or central (M5) repeat
      regions of the Plasmodium falciparum antigen Pf155/RESA. The induced antibody
      responses were of long duration, could be efficiently boosted and were comparable
      to those obtained with Freund's Adjuvant. The produced antibodies reacted with
      M3, M5, protein A and the influenza glycoprotein, recognized Pf155/RESA and
      inhibited merozoite invasion in vitro. These results suggest that coupling of
      immunogens to pre-formed ISCOMs may be a basis for construction of multivalent
      subunit vaccines.

PMID- 8361780
TI  - The discriminating analysis in the differential diagnosis of monoclonal
      gammopathies.
AB  - The clinical diagnosis is not always easy in monoclonal gammopathies. Therefore
      we used discriminating analysis to obtain diagnosis statistically sure. The
      parameters considered were kappa-lambda ratio, marrow plasma cells percentage and
      labeling index, CD3, CD4, CD8 lymphocytic absolute values. The plasma cells
      percentage and their labeling index make the differential diagnosis between MM
      and MGUS or SMM and MGUS feasible and quite correct. Additional immunological
      parameters should be used for the diagnosis between SMM and MM.

PMID- 8361781
TI  - Atheromatosis and double media: uncommon vascular lesions of renal allografts.
AB  - Study of 45 renal allograft nephrectomy specimens revealed the presence of
      relatively uncommon arterial vascular lesions: atheromatosis (12 cases) and a
      double layer of smooth muscle in the intima (Double Media) (4 cases).
      Histopathologic features of atheromatosis showed the presence of large lipid
      laden cells localized in the intimal layer of arteries. Diagnosis of acute
      vascular rejection (AVR) was made in 19 cases. Diagnosis of chronic vascular
      rejection (CVR) was found in 4 cases. 22 cases showed lesions of both AVR and
      CVR. In 12 cases there was infiltration of the intima and media wall by foam
      cells closely resembling an atheromatous lesion. Four cases of Double Media were
      found in allografts with survival varying from 51 to 344 days. The presence of
      either atheromatous or double media does not correlate statistically with
      immunosuppressive treatment, blood pressure or with the presence of
      hypertriglyceridemia and/or hypercholesterolemia. Immunohistochemical
      investigation of atheromatosis revealed total negativity of the foam cells with
      antisera to: actin, myosin, desmin and myoglobin. Variable reactivity was
      observed with antisera to vimentin. Myointimal cells of Double Media expressed
      slight positivity for actin and vimentin. The double media lesion seems to be the
      result of a reparative vascular process secondary to rejection changes.
      Atheromatosis seems to be closely correlated to episodes of acute rejection.
      Vascular lesions in grafts are harbinger of poor prognosis. Double media lesion
      and atheromatosis do not seem to have a more unfavourable prognostic significance
      on the evolution of the transplants.

PMID- 8361782
TI  - [Strongyloides stercoralis hyperinfection with encephalitis manifestations].
AB  - A case of encephalitis in a 34 year old woman from Ivory Coast, referred to the
      Santo Spirito Hospital in Rome, is reported. During a coma which appeared
      terminal, a bronchoaspirate done for suspicious pulmonary TB, revealed many
      filariform larvae of Strongyloides stercoralis. A treatment with albendazole has
      rapidly ameliorated the situation but a relapse after 4 months caused the obitus
      of the patient.

PMID- 8361783
TI  - Effect of monensin administration on rat liver glycogen content: preliminary
      hystological observations.
AB  - The action of monensin, an electroneutral Na/H antiport, has been studied on
      liver glycogen content of female rats. The results showed that monensin, when
      administered in vivo, is able to determine liver glycogen depletion, in agreement
      with the increase of glycemia and the decrease of insulinemia. Glycogen stores
      are reformed in 3-4 hours. Moreover, glycogen depletion is more evident in
      periportal areas, in agreement with "metabolic zonation" of liver carbohydrate
      metabolism.

PMID- 8361784
TI  - [Prenatal diagnosis of thanatophoric dysplasia at 21st week of pregnancy].
AB  - We report making the prenatal diagnosis of thanatophoric dysplasia without
      "cloverleaf" skull at 21 weeks gestation. The ultrasound examination showed short
      and bowed limbs, narrow thorax, and large head. Radiological and histological
      studies confirmed the aborted fetus to be affected with thanatophoric dysplasia.
      The differential prenatal diagnosis with other skeletal dysplasias is discussed.

PMID- 8361786
TI  - [Spondylo-epiphyseal dysplasia tarda with progressive arthropathy: description of
      a patient whose mother showed minimal features of the disease].
AB  - An 8-year-old male patient with Spondylo-Epiphyseal Tarda with Progressive
      Arthropathy (SEDT-PA) or Progressive Pseudo-rheumatoid Arthropathy of Childhood
      is reported. Abnormal gait, fatigability, and joint symptoms began at 3 years.
      Radiological changes were: generalized osteoporosis, platyspondyly, and enlarged
      epiphyses. The patient's mother showed reduced muscular massa, joint swelling,
      moderate osteoporosis, and normal vertebrae. SEDT-PA has an autosomal recessive
      mode of inheritance. In this case, as the propositus' mother showed minimal signs
      of the disease, either an X-linked trait or an autosomal dominant mutation with
      variable expressivity could also be assumed.

PMID- 8361785
TI  - [OEIS complex. Description of a case associated with cardiopathy].
AB  - We describe a newborn affected by OEIS complex (Omphalocele--Exstrophy of bladder
      -Imperforate anus--Spinal defect) associated with atrial septal defect. Terminal
      ileostomy, closure of the abdominal wall defect and suture of the cecal and
      vesical plates were performed. The patient died at 5 months and four days.

PMID- 8361787
TI  - [Fryns syndrome. Description of a case].
AB  - We report on a female infant who presents a pattern of malformations including
      dysmorphic facies, Dandy-Walker anomaly, hypoplasia of the upper lobe of the
      right lung, associated with diaphragmatic elevation and slight digital anomalies.
      This whole clinical picture allows us to formulate the diagnosis of Fryns
      syndrome; this is one of the very few not lethal cases that are reported in
      literature.

PMID- 8361788
TI  - Are parents' self-reported total cholesterol levels useful in identifying
      children with hyperlipidemia? An examination of current guidelines.
AB  - OBJECTIVE: Recently, the American Academy of Pediatrics (AAP) Committee on
      Nutrition adopted the recommendation of the Expert Panel on Blood Cholesterol
      Levels in Children and Adolescents (NCEP) that children and adolescents with a
      family history of premature cardiovascular disease or parental
      hypercholesterolemia (> or = 240 mg/dL) be screened for hyperlipidemia. The
      rationale for using parental hypercholesterolemia as a screening trigger is based
      on sensitivity estimates using parents' actual lipid values. However, in clinical
      practice pediatricians may often have to rely on parents' self-reported
      cholesterol levels to determine a child's family risk history. This study
      examines the feasibility and utility of parental self-reported cholesterol levels
      as a means of identifying children with elevated total cholesterol levels.
      METHODS: As part of a school-based risk factor screening program that included
      total cholesterol measurement, conducted in nine elementary schools between 1989
      and 1991, parents of participating children were asked if they had their
      cholesterol tested in the past year and if they had, to provide their total
      cholesterol values. RESULTS: If only the children who had one parent with a self
      reported total cholesterol value > or = 240 mg/dL would have been screened,
      between 90% and 93% of children with elevated total cholesterol values, either >
      or = 170 mg/dL or > or = 200 mg/dL, would have been missed. CONCLUSIONS: These
      data suggest that parents' self-reported cholesterol values are an ineffective
      means of identifying children with elevated total cholesterol and modification of
      the current AAP, and NCEP guidelines for selective cholesterol screening in
      children may be warranted.

PMID- 8361789
TI  - Comparing prenatal and neonatal diagnosis of hemoglobinopathies.
AB  - OBJECTIVES: To compare the results of prenatal and neonatal hemoglobinopathy
      screening, a pilot program was developed at the Northern California Kaiser
      Permanente Health Care Program, a prepaid health maintenance program serving 2.5
      million members. METHODS: In this program, 54,700 pregnant women were screened
      for hemoglobinopathies. RESULTS: Of the 54,700 women screened, 1019 (1.9%) had a
      hemoglobinopathy trait, and 81 women with at-risk fetuses were identified. Half
      the women with fetuses at risk for thalassemia accepted prenatal diagnosis; of
      those whose fetuses were at risk for sickle-cell disease or other
      hemoglobinopathies, 30% accepted prenatal diagnosis. Of the 81 at-risk couples,
      53 refused amniocentesis for definitive fetal diagnosis; only 28 (35%) accepted;
      all 4 women who were carrying a fetus with thalassemia major elected to terminate
      the pregnancy. Only 7 of the 21 cases of hemoglobinopathies were diagnosed
      prenatally; 14 were discovered neonatally. CONCLUSIONS: Prenatal screening was
      not found to be an ideal method of identifying hemoglobinopathies of the newborn
      in this large population. With cost-effectiveness a high priority in health care
      delivery, we believe that testing of newborns for hemoglobinopathies will
      continue to be the preferred screening method. A combined prenatal and neonatal
      program would offer the maximum benefit to patients by adding prenatal
      counseling, parental options, education, and early complete diagnosis to neonatal
      screening.

PMID- 8361790
TI  - Prenatal detection of neuroblastoma: a ten-year experience from the Dana-Farber
      Cancer Institute and Children's Hospital.
AB  - OBJECTIVES: To assess the relative frequency of, the clinical and pathological
      correlates in, and the prognosis of the subset of infants with neuroblastoma who
      were identified initially by prenatal ultrasonography. DESIGN: Retrospective
      review of all patients with neuroblastoma evaluated between 1982 and 1992.
      SETTING: Large, urban, tertiary care children's hospital in Boston,
      Massachusetts. PATIENTS: Eleven infants with neuroblastoma initially detected
      with prenatal sonograms were identified. RESULTS: Nine patients had adrenal
      tumors; two had thoracic paraspinal tumors. Typical diagnostic evidence for
      neuroblastoma including a palpable abdominal mass and elevations in urinary
      catecholamines were not commonly seen postnatally. These patients had multiple
      favorable prognostic indicators including low stage of disease (10/11), favorable
      biological markers including cellular DNA content (5/5) and N-myc oncogene copy
      number (5/5), and histopathology suggestive for neuroblastoma in situ (7/11). All
      patients were treated by surgical resection. One patient exhibited progression of
      disease postoperatively, but demonstrated a complete clinical response to
      multiagent chemotherapy. Overall survival in our population was excellent with no
      deaths seen at a mean follow-up of 37 months (range 3 to 120 months).
      CONCLUSIONS: Patients with neuroblastoma identified by prenatal ultrasonography
      generally, although not exclusively, follow a clinically favorable course in
      which surgical resection is curative. Chemotherapy is not indicated unless
      substantial progression of disease occurs.

PMID- 8361791
TI  - Maternal rating of child health at school age: does the vulnerable child syndrome
      persist?
AB  - OBJECTIVES: To assess the extent to which parental ratings of child health,
      including perceived vulnerability to illness, are associated with current and
      past health events and sociodemographic characteristics of the family and the
      child. DESIGN: Prospective cohort study of children aged 8 to 10 years previously
      assessed in infancy in two multi-site studies. SETTING: Thirteen sites largely in
      eastern United States. PARTICIPANTS: 1877 children representing 65% of those
      originally selected for follow-up from the two previous studies. Participants
      were specifically selected on the basis of birth weight so that more than two
      thirds were low birth weight. MEASUREMENT: Parental interviews at school age
      including measures of several dimensions of child health and sociodemographic
      characteristics of the family. The former included a six-item scale assessing
      parental perceptions of child health overall, and on subscales assessing child
      current health, previous health, and resistance or susceptibility to illness.
      Data on health problems at birth were derived from previously collected birth
      certificates, medical records, and interviews. MAIN RESULTS: Although overall
      parental perceptions of child health reflected both current and past health
      events, a clear distinction emerged. Parental rating of current child health and
      resistance or susceptibility were associated with current child health problems,
      not events in infancy including very low birth weight. Nonwhite race and maternal
      rating of her own health also influenced maternal rating of child health.
      CONCLUSION: The results do not support the persistence of a vulnerable child
      syndrome, as health in infancy does not affect maternal rating of current child
      health at school-age in the absence of current health problems.

PMID- 8361792
TI  - Understanding of acquired immunodeficiency syndrome by elementary school children
      -a developmental survey.
AB  - OBJECTIVES: The developmental process by which young children acquire an
      understanding of the concepts of causality, treatment, and prevention of illness
      as related to acquired immunodeficiency syndrome (AIDS) is poorly understood.
      Previous studies have focused on adolescent populations and have measured the
      facts that children seem to know rather than their understanding of relevant
      concepts. Such approaches are likely to overestimate the child's true level of
      understanding and obscure significant misconceptions. The aims of this project
      are to measure directly the level of understanding of the concepts of causality,
      treatment, and prevention of AIDS in healthy, elementary school children and to
      assess the sociodemographic variables associated with their conceptual
      understanding. METHODS: Using a new, developmentally based, semistructured
      interview protocol (ASK, AIDS Survey for Kids), 361 children (57% black, 24%
      Hispanic, 19% white) in kindergarten through sixth grade at four public schools
      in New Haven, CT were interviewed. Responses to questions about causality,
      treatment, and prevention were scored for each of three illnesses (AIDS, and for
      comparison, colds and cancer) based on the level of conceptual sophistication of
      the response, irrespective of its factual accuracy. RESULTS: Scores for each of
      the concepts were highly intercorrelated and were correlated most strongly with
      grade level (R = .31 to .50, P < .0001 for each of these correlations, with the
      exception of the treatment of AIDS). Gender, race, and socioeconomic status did
      not contribute significantly to the variance observed for any of the concept
      scores in a linear regression model. Over-all, children's level of understanding
      of causality was significantly less sophisticated for AIDS than for colds (P <
      .0001); their level of conceptual understanding for the causality of AIDS was not
      significantly different from that of cancer (P = .9). CONCLUSIONS: Children's
      understanding of causality, treatment, and prevention of AIDS, as measured by the
      ASK, follows the same developmental sequence reported for children's
      understanding of general physical illness. Sociodemographic variables, such as
      race, gender, and socioeconomic status do not affect children's level of
      sophistication of these developmental concepts. These results have implications
      for the creation of developmentally appropriate and effective AIDS education
      curricula for primary and elementary grades. They also offer guidance to health
      care providers in their efforts to educate parents and young children about this
      important topic.

PMID- 8361793
TI  - Endotracheal administration of tolazoline in hypoxia-induced pulmonary
      hypertension.
AB  - STUDY OBJECTIVE: To compare the pulmonary and systemic vascular responses to
      intravenously (IV) and endotracheally (ET) administered tolazoline (Tz) in
      newborn lambs with hypoxia-induced pulmonary hypertension. DESIGN: Randomized,
      controlled study design. METHODS: Twenty lambs, 2 to 7 days of age, were
      anesthetized, intubated, and surgically catheterized for continuous physiologic
      monitoring and cardiac output measurements using radiolabeled microspheres. After
      a postoperative stabilization period, the lambs were ventilated with a hypoxic
      gas mixture which was titrated to increase mean pulmonary artery pressure (MPAP)
      30% to 50% above baseline. Each animal was randomly assigned to receive either IV
      Tz (2 mg/kg), ET-Tz (4 mg/kg), or ET-saline (Sal, control group). RESULTS: ET-Tz
      significantly (P < .05) reduced MPAP, PVRI (pulmonary vascular resistance index),
      MPAP/mean artery pressure (MAP) and PVRI/systemic vascular resistance index
      (SVRI), but not SVRI. IV-Tz lowered (P < .05) MPAP, PVRI, and PVRI/SVRI but also
      produced significant reductions in MAP and SVRI while only transiently decreasing
      MPAP/MAP: MPAP/MAP and PVRI/SVRI ratios were consistently lower in the ET-Tz
      animals than either the IV-Tz or ET-Sal animals. CONCLUSIONS: Our results suggest
      that ET-Tz produced a more selective pulmonary vascular response than IV-Tz and
      may warrant further investigation for potential clinical applications.

PMID- 8361794
TI  - Feeding iron-fortified premature formula during initial hospitalization to
      infants less than 1800 grams birth weight.
AB  - OBJECTIVE: A randomized, double-blind study was conducted comparing high-iron
      content (15 mg/L) with low-iron content (3 mg/L) premature formula given during
      initial hospitalization to infants with birth weights less than 1800 g to
      determine the influence of these differing intakes on the iron nutritional status
      during the first 4 months of life. A third group of similar infants received
      human milk mixed with an equal volume of liquid fortifier resulting in an iron
      content of approximately 1.7 mg/L. PATIENTS AND METHODS: Mean birth weight,
      gestational age, age at study entry, volume of blood removed for studies, and
      volume of red cells transfused were not different among the three groups. After
      hospitalization both formula-fed groups were given a cow milk formula with an
      iron content of 12 mg/L, and breast-fed infants were given an iron-containing
      multivitamin with a resulting iron intake of 10 mg/d. Infants were observed to 8
      weeks after discharge. RESULTS: There were no differences in serum iron,
      ferritin, transferrin, transferrin saturation, hemoglobin, hematocrit, or
      reticulocyte count among the three groups at study entry, although mean
      corpuscular hemoglobin and mean corpuscular volume were lower in infants in the
      low-iron formula group. Mean plasma ferritin was significantly lower in infants
      receiving low-iron content premature formula at the time of hospital discharge
      compared with the other two groups. The incidence of anemia (hemoglobin < 9.0
      g/dL) and low transferrin saturation (< 24%) was also greater in the low-iron
      content formula group. Eight weeks after discharge, the incidence of low plasma
      ferritin (< 19 ng/mL) remained greater in infants receiving low-iron content
      formula than in the other two groups. No adverse effects of iron intake were
      observed. Growth was not different among the three groups. CONCLUSIONS: These
      data indicate that preterm infants with < 1800 g birth weight receiving premature
      infant formula benefit from formula given during initial hospitalization
      containing 15 mg/L iron compared with that containing 3 mg/L.

PMID- 8361795
TI  - Effects of repeated application of emollient cream to premature neonates' skin.
AB  - OBJECTIVE: Emollient cream moisturizers are often used on premature newborns in
      neonatal intensive care units without accurate knowledge of the risks or benefits
      to the neonate. DESIGN: We prospectively compared premature neonates treated with
      a water-in-oil emollient cream for up to 16 days to untreated premature neonates.
      SETTING: The study was completed in a neonatal intensive care unit on neonates
      admitted for respiratory distress and/or possible sepsis. PATIENTS: Thirty-four
      neonates, between 29 and 36 weeks estimated gestational age, entered the study.
      INTERVENTIONS: One-half of the neonates were treated twice a day with an water-in
      oil emollient cream, and the other half served as controls. OUTCOME MEASURES: The
      skin condition of the neonates' hands, feet, and abdomen was evaluated on
      entering the study and twice a week. Fungal cultures and quantitative bacterial
      cultures were obtained from the axilla and abdomen on entering the study and
      twice a week. RESULTS: The mean gestational age of the treated neonates was 32.3
      weeks, whereas the mean gestational age of the control neonates was 32.5 weeks.
      The neonates treated with emollient cream demonstrated statistically less
      dermatitis of their hands (day 2 through day 11), their feet (day 2 through day
      16), and their abdomen (day 7 through day 11). Fungal cultures and quantitative
      bacterial cultures of the abdomen and axilla were equivalent in both groups.
      CONCLUSIONS: These studies document that emollient cream moisturizer therapy of
      premature neonates decreases dermatitis without changing the microbiological
      flora.

PMID- 8361796
TI  - Desmopressin acetate and nocturnal enuresis: how much do we know?
AB  - OBJECTIVES: Desmopressin acetate (DDAVP) is promoted to treat nocturnal enuresis
      but indications for its use are unclear. We reviewed all randomized controlled
      trials to determine (1) short- and long-term efficacy, (2) responders, (3) dose
      response curve, (4) side effects, and (5) comparative efficacy with other
      treatments. METHODS: A Medline search of the English language literature from
      January 1966 to August 1992, supplemented by contact with the drug companies,
      yielded 18 articles which were true randomized controlled trials (11 cross-over
      and 7 parallel studies). RESULTS: The 18 randomized controlled trials included
      689 subjects for most of whom some other type of treatment had failed. All
      studies found decreased mean frequency of wetting ranging from 10% to 91%, but
      only 24.5% of subjects achieved short-term dryness. One study of DDAVP responders
      directly tested long-term dryness and 21% stayed dry. In three studies that
      incidentally reported on long-term effects 5.7% stayed dry after stopping DDAVP:
      There was wide variation in the type of patient included. Seven studies addressed
      prognostic factors. Children more than 9 years old and with fewer initial wet
      nights do better. Four studies seem to include almost exclusively monosymptomatic
      children with nocturnal enuresis (ie, primary nocturnal enuresis, positive family
      history, and no urinary symptoms). Results were no better than those which
      included mixed symptoms. Five studies attempted to address the dose-response
      issue. Despite some methodological issues, there is probably some dose-response
      effect. Side effects were infrequent in the 589 subjects who received DDAVP as
      opposed to placebo. No cases of water intoxication and no significant shifts in
      electrolytes were reported in the four studies which measured them. Nasal
      stuffiness, headache, epistaxis, and mild abdominal pain seem to be the only side
      effects noted, and these were uncommon. Only one study compared DDAVP with
      conditioning alarms. Alarm patients had 10% fewer wet nights and a better long
      term result. CONCLUSIONS: DDAVP reduces wet nights in children for whom other
      treatments have failed but it produces complete dryness in a minority, and this
      is often a temporary effect. The literature focuses on short-term efficacy. The
      true role of DDAVP will be known when samples are carefully selected, prognostic
      factors are examined, and more comparisons with other treatments are conducted
      focusing on long-term outcomes. On the basis of current knowledge, DDAVP is
      inferior to conditioning alarms as a primary therapy.

PMID- 8361797
TI  - Head-upright tilt table testing in children with unexplained syncope.
AB  - Recurrent syncope in the young patient can be an anxiety-provoking experience
      that is often difficult to diagnose. Head-upright tilt table testing has emerged
      as a method for provoking episodes of vasodepressor syncope in predisposed
      individuals and thereby establishing a diagnosis. Currently indicated in the
      evaluation of young patients with recurrent unexplained syncope, it has also
      proven useful in differentiating convulsive syncope from epilepsy. Further
      studies will be needed to better define its role in the evaluation and management
      of recurrent syncope in children and adolescents.

PMID- 8361798
TI  - Significance of serial C-reactive protein responses in neonatal infection and
      other disorders.
AB  - OBJECTIVE: This study was performed to determine prospectively whether, in the
      presence of proved or presumed bacterial infection, the sensitivity of serum C
      reactive protein (CRP) response could be enhanced by serial rather than single
      determinations. We also sought to assess CRP responses to clinically identified
      noninfectious disorders. DESIGN: The CRP responses of 491 infants on 691
      occasions of suspected infection were assessed. CRP levels were measured
      initially and twice again at 12-hour intervals (rate immunonephelometry).
      Assessments also included a blood culture, complete blood cell count, and chest
      radiograph and culture of spinal fluid when appropriate. CRP responses were
      correlated with four designated clinical groups: (1) positive blood or
      cerebrospinal fluid cultures (n = 190); (2) negative blood culture-definite
      infection (necrotizing enterocolitis stages 2 and 3, pneumonia, subcutaneous
      abscess) (n = 52); (3) negative blood culture-possible infection (antenatal risk
      factors, meconium aspiration, positive urine group B streptococcus antigen,
      necrotizing enterocolitis stage 1, febrile infants) (n = 287); and (4) negative
      blood culture-no infection (respiratory distress syndrome, transient tachypnea of
      the newborn, patent ductus arteriosus, tissue trauma) (n = 160). Diagnoses were
      made before CRP results were known. RESULTS: In all, 187 (27%) of the blood
      cultures were positive. A single organism was recovered from 174 of these; two
      organisms from 13. Among the single-organism cultures, 50 (29%) were Gram
      negative, 120 (69%) were Gram-positive, and 4 (2%) were budding yeasts. CRP
      levels were elevated in various groups as follows: in the positive blood culture
      group (by organism), Gram-negative rods, 92% (46/50); group B streptococcus, 92%
      (12/13); Staphylococcus aureus, 89% (8/9); group D streptococcus, 71% (10/14);
      Streptococcus viridans, 60% (6/10); Staphylococcus epidermidis, 55% (40/73). In
      the negative blood culture-definite infection group, CRP levels were abnormal in
      88%; in the negative culture-possible infection group, CRP was elevated in 33%;
      and in the negative blood culture-no infection group, CRP was elevated in 9%.
      Serial determinations of CRP resulted in enhanced sensitivity in the positive
      blood culture group, the negative blood culture-definite infection group, and the
      negative blood culture-possible infection group. Initial determinations by
      themselves were inadequately sensitive. Serial determinations did not enhance
      sensitivity of the negative blood culture-no infection group. High specificity
      (91%) is suggested by the low incidence of abnormal CRP levels among infants who
      were not infected. CONCLUSIONS: These data suggest that it would be appropriate
      to conduct a cautious, controlled trial to assess the safety of discontinuing
      antibiotic therapy if three serial CRP measurements are normal and if there are
      no other clinical factors suggestive of infection. The data also indicate the
      necessity for serial determinations of CRP for optimal sensitivity.

PMID- 8361799
TI  - Factors influencing the interests, career paths, and research activities of
      recent graduates from an academic, pediatric residency program.
AB  - OBJECTIVE: This study was undertaken to characterize the professional activity of
      a cohort of young pediatricians who completed an academically oriented residency
      program, to analyze factors which influenced their interests, career choices, and
      research activity, and to understand what steps might be effective in attracting
      more young physicians into academic and research career paths. METHOD: We studied
      by questionnaire a cohort of 150 pediatric residents from the Children's Hospital
      in Boston who completed residency training between 1976 and 1981. RESULTS:
      Questionnaires were returned by 117 (78%) of 150 individuals. Of these, 73% were
      in academic medicine and 37% were in clinical practice. Individuals were engaged
      in various activities with a mean of 47% effort in clinical care, 25% effort in
      administration and teaching, and 28% effort in basic or clinical research. The
      majority of respondents (71 [61%] of 117) reported at least 10% effort in all
      three activities. Only 9 (8%) of 117 reported no clinical activity, 8 (7%) of 117
      reported no teaching or administrative activity, and 35 (30%) of 117 reported no
      research activity. Few individuals dedicated more than 50% of their time to
      research, and none reported a 100% commitment to research. Clinical sources
      provided 71% of all salary support, research grants 17%, government salaries 7%,
      and other sources 5%. For most respondents, interest in clinical practice
      predated medical school, whereas interest in research increased during
      preclinical training, particularly among those who engaged in research
      activities. Respondents identified previous research experience as the principle
      factor enhancing their decision and ability to do research. Factors that
      adversely influenced their decision or ability to do research included salary
      expectancy, funding, the perceived competitiveness of academic life,
      administrative duties, and family responsibilities. CONCLUSIONS: Efforts to
      encourage more young physicians to enter academic careers should focus on
      providing research experience during preclinical training and providing long-term
      support for research which enables physician scientists to maintain their
      interest and involvement in clinical medicine.

PMID- 8361800
TI  - Should chloral hydrate be banned?
AB  - OBJECTIVE: Current federal regulations of potentially carcinogenic environmental
      chemicals are based on the assumption that risks for humans can be extrapolated
      from the effects of chronic high-dose exposure of rodents. It is assumed that all
      chemicals induce cancer by a genotoxic mechanism (direct interaction with DNA)
      and that humans metabolize chemicals by the same pathways as the test rodents.
      Trichloroethylene, a former medicine, is now regulated because of rodent studies.
      Its major metabolite, chloral hydrate, widely used as a sedative in both adults
      and children, is in danger of being banned by comparable studies. This paper
      assesses the safety of chloral hydrate. DESIGN: Analysis of the literature
      regarding the metabolic, toxicologic, and epidemiologic data on trichloroethylene
      and chloral hydrate. RESULTS: The dose-response relationship for carcinogenesis
      of chloral hydrate and other chemicals in its metabolic breakdown pathway is
      nonlinear in rodents: very high doses given chronically, sufficient to cause
      cellular necrosis, are necessary for induction of malignancies. In addition,
      epidemiologic data on people exposed to substantial amounts of trichloroethylene
      (which is metabolized to chloral hydrate) show no increase in mortality or
      cancers. CONCLUSIONS: The assumptions underlying current regulatory practices for
      environmental chemicals are not applicable to the medicinal use of chloral
      hydrate. Instead, a threshold model is appropriate. The data do not suggest the
      need to ban chloral hydrate as a medicine; however, possible modifications in its
      use are suggested.

PMID- 8361801
TI  - Nosocomial Legionella pneumonia in the neonate.

PMID- 8361802
TI  - Linea vestibularis: follow-up of a normal genital structure.

PMID- 8361803
TI  - Turner syndrome with unusual conotruncal defect.

PMID- 8361804
TI  - Suprapubic aspiration of urine in very low birth weight infants.

PMID- 8361805
TI  - Acute flank pain and reversible renal dysfunction associated with nonsteroidal
      anti-inflammatory drug use.

PMID- 8361806
TI  - Adverse effect of chloral hydrate in two young children with obstructive sleep
      apnea.

PMID- 8361807
TI  - Cigarette smoke = radiation hazard.

PMID- 8361808
TI  - The treatment of nocturnal enuresis--where are we now?

PMID- 8361809
TI  - New series of essays on pediatric history.

PMID- 8361810
TI  - Conception and creation of the American Academy of Pediatrics.

PMID- 8361811
TI  - American Academy of Pediatrics Committee on Drugs and Committee on Environmental
      Health: Use of chloral hydrate for sedation in children.

PMID- 8361812
TI  - American Academy of Pediatrics Committee on Fetus and Newborn: Routine evaluation
      of blood pressure, hematocrit, and glucose in newborns.

PMID- 8361813
TI  - American Academy of Pediatrics Committee on Pediatric Emergency Medicine: First
      aid for the choking child.

PMID- 8361814
TI  - American Academy of Pediatrics Committee on Infectious Diseases: Haemophilus
      influenzae type b conjugate vaccines: recommendations for immunization with
      recently and previously licensed vaccines.

PMID- 8361815
TI  - American Academy of Pediatrics Committee on Early Childhood, Adoption, and
      Dependent Care: The pediatrician's role in promoting the health of patients in
      early childhood education and/or child care programs.

PMID- 8361816
TI  - American Academy of Pediatrics Committee on Genetics: Folic acid for the
      prevention of neural tube defects.

PMID- 8361817
TI  - American Academy of Pediatrics Section on School Health: Residency training and
      continuing medical education in school health.

PMID- 8361818
TI  - Resident education in school health: an issue whose time has come.

PMID- 8361819
TI  - American Academy of Pediatrics Committee on School Health. Guidelines for the
      administration of medication in school.

PMID- 8361820
TI  - American Academy of Pediatrics Committee on Infectious Diseases: Use of ribavirin
      in the treatment of respiratory syncytial virus infection.

PMID- 8361821
TI  - Lead poisoning: twenty years after.

PMID- 8361822
TI  - Passive tobacco exposure and sudden infant death syndrome.

PMID- 8361823
TI  - Passive tobacco exposure and sudden infant death syndrome.

PMID- 8361825
TI  - The lead controversy.

PMID- 8361824
TI  - Ceftriaxone for otitis media.

PMID- 8361826
TI  - The lead controversy.

PMID- 8361827
TI  - Neuroendocrine effects of toxic and low blood lead levels in children.

PMID- 8361828
TI  - Temporal constraints on apparent motion in auditory space.
AB  - The hypothesis that the extent of spatial separation between successive sound
      events directly affects the perception of time intervals between these events was
      tested using an apparent motion paradigm. Subjects listened to four-tone pitch
      patterns whose individual tones were sounded alternately at one of two
      loudspeaker positions, and they adjusted the alternation rate until they could no
      longer distinguish the four-tone ordering of the pattern. Four horizontal and two
      vertical loudspeaker separations were tested. Results indicate a direct relation
      between horizontal separation and the critical stimulus onset asynchrony (SOA)
      between successive tones within a pattern. At the critical SOA, subjects reported
      hearing not a four-tone pattern, but two pairs of two-note groups overlapping in
      time. The findings are discussed in the context of auditory spatial processing
      mechanisms and possible sensory-specific representational constraints.

PMID- 8361829
TI  - Perception of local shape from shading.
AB  - Theoretically, metric solid shape is not determined uniquely by shading.
      Consequently, human vision has difficulty in categorizing shape when shading is
      the only cue. In the present research, subjects were required to categorize
      shaded quadric surfaces. We found that they were rather poor at this task; they
      confused hyperbolic and elliptic (both convex and concave) shapes easily. When a
      cast shadow visually indicated the direction of the illuminant, they were able to
      notice the concavity or convexity of elliptic shapes. However, they still
      confused elliptic and hyperbolic ones. Finally, when an animated sequence of
      eight intensity patterns belonging to one quadric shape had been displayed, the
      subjects were able to categorize the quadrics. However, the results are still
      quite moderate. Our experiments indicate that local shading structure is only a
      weak shape cue when presented in the absence of other visual cues.

PMID- 8361830
TI  - Recovery of 3-D shape from binocular disparity and structure from motion.
AB  - Four experiments were conducted to examine the integration of depth information
      from binocular stereopsis and structure from motion (SFM), using stereograms
      simulating transparent cylindrical objects. We found that the judged depth
      increased when either rotational or translational motion was added to a display,
      but the increase was greater for rotating (SFM) displays. Judged depth decreased
      as texture element density increased for static and translating stereo displays,
      but it stayed relatively constant for rotating displays. This result indicates
      that SFM may facilitate stereo processing by helping to resolve the stereo
      correspondence problem. Overall, the results from these experiments provide
      evidence for a cooperative relationship between SFM and binocular disparity in
      the recovery of 3-D relationships from 2-D images. These findings indicate that
      the processing of depth information from SFM and binocular disparity is not
      strictly modular, and thus theories of combining visual information that assume
      strong modularity or independence cannot accurately characterize all instances of
      depth perception from multiple sources.

PMID- 8361831
TI  - Haptic identification of objects and their depictions.
AB  - Haptic identification of real objects is superior to that of raised two
      dimensional (2-D) depictions. Three explanations of real-object superiority were
      investigated: contribution of material information, contribution of 3-D shape and
      size, and greater potential for integration across the fingers. In Experiment 1,
      subjects, while wearing gloves that gently attenuated material information,
      haptically identified real objects that provided reduced cues to compliance,
      mass, and part motion. The gloves permitted exploration with free hand movement,
      a single outstretched finger, or five outstretched fingers. Performance decreased
      over these three conditions but was superior to identification of pictures of the
      same objects in all cases, indicating the contribution of 3-D structure and
      integration across the fingers. Picture performance was also better with five
      fingers than with one. In Experiment 2, the subjects wore open-fingered gloves,
      which provided them with material information. Consequently, the effect of type
      of exploration was substantially reduced but not eliminated. Material compensates
      somewhat for limited access to object structure but is not the primary basis for
      haptic object identification.

PMID- 8361832
TI  - Counterexample to the hypothesis of functional similarity between tactile and
      visual pattern perception.
AB  - In earlier work, the author has demonstrated that tactile pattern perception and
      visual pattern perception exhibit many parallels when the effective spatial
      resolution of vision is reduced to that of touch, thus supporting the hypothesis
      that the two pattern senses are functionally similar when matched in spatial
      bandwidth. The present experiments demonstrate a clear counterexample to this
      hypothesis of functional similarity. Specifically, it was found that the lateral
      masking effect of a surround on tactile character recognition increases when the
      surround changes in composition from solid lines to dots, whereas for vision,
      recognition performance goes in the opposite direction. This finding necessitates
      some modification of the model of character recognition proposed by the author
      (Loomis, 1990) as it applies to the sensing of raised tactile patterns. One
      possible modification would be to incorporate, as the initial stage of pattern
      transformation, the continuum mechanics model for the skin that was developed by
      Phillips and Johnson (1981b).

PMID- 8361833
TI  - Additivity of loudness across critical bands: a critical test.
AB  - The use of magnitude estimation as well as axiomatic measurement theory has led
      to the suggestion that loudness adds across critical bands. In the present paper,
      we challenge this postulate by applying a more sensitive methodology, based on
      Falmagne's (1976) random conjoint measurement procedure. A necessary condition
      for additivity of loudness was investigated in tone complexes consisting of 2-kHz
      and 5-kHz (resp. 3-kHz) components; the results showed systematic deviations from
      additivity. We argue that these deviations are due to asymmetric masking of the
      higher component by the lower one, and we propose a tentative quantitative model
      to account for the data. Such a model is in line with results from tone-on-tone
      masking, which show masking to be effective over a range of several critical
      bands.

PMID- 8361834
TI  - Response selection, sensitivity, and taste-test performance.
AB  - Tasters selected the odd stimulus from among sets of three samples of party dip.
      Two samples came from one batch, and one sample came from another batch. The
      physicochemical difference between the batches consisted of the presence or
      absence of added salt. Two different tests of discriminability were undertaken by
      the same subjects with the same stimuli: the triangle test and the three
      alternative forced-choice (3-AFC) method. Although different numbers of correct
      selections were obtained in the two tasks, an index of discriminability, d', had
      the same value when the data were analyzed in accordance with the Thurstone-Ura
      and signal-detection models, respectively. The average data support Frijters's
      (1979b) contention that different models of the discrimination process are
      appropriate to the results of the triangular and the 3-AFC procedures. Further
      analysis of the data revealed that discrimination was poorer for trios containing
      one physicochemically weak stimulus and two stronger stimuli than it was for
      trios containing one stronger stimulus and two weak stimuli. A two-signal 3-AFC
      task was undertaken by some subjects, and d' estimates from this task were lower
      than expected on the basis of performance in the other tasks.

PMID- 8361835
TI  - Alternating prism exposure causes dual adaptation and generalization to a novel
      displacement.
AB  - In two experiments, we examined the hypothesis that repeatedly adapting and
      readapting to two mutually conflicting sensory environments fosters the
      development of a separate adaptation to each situation (dual adaptation) as well
      as an increased ability to adapt to a novel displacement (adaptive
      generalization). In the preliminary study, subjects alternated between adapting
      their visuomotor coordination to 30-diopter prismatic displacement and readapting
      to normal vision. Dual adaptation was observed by the end of 10 alternation
      cycles. However, an unconfounded test of adaptive generalization was prevented by
      an unexpected prism-adaptive shift in preexposure baselines for the dual-adapted
      subjects. In the primary experiment, the subjects adapted and readapted to
      opposite 15-diopter displacements for a total of 12 cycles. Both dual adaptation
      and adaptive generalization to a 30-diopter displacement were obtained. These
      findings may be understood in terms of serial reversal learning and "learning to
      learn."

PMID- 8361836
TI  - Limits on the limitations of context-conditioned effects in the perception of [b]
      and [w].
AB  - We investigated the conditions under which the [b]-[w] contrast is processed in a
      context-dependent manner, specifically in relation to syllable duration. In an
      earlier paper, Miller and Liberman (1979) demonstrated that when listeners use
      transition duration to differentiate [b] from [w], they treat it in relation to
      the duration of the syllable: As syllables from a [ba]-[wa] series varying in
      transition duration become longer, so, too, does the transition duration at the
      [b]-[w] perceptual boundary. In a subsequent paper, Shinn, Blumstein, and Jongman
      (1985) questioned the generality of this finding by showing that the effect of
      syllable duration is eliminated for [ba]-[wa] stimuli that are less schematic
      than those used by Miller and Liberman. In the present investigation, we
      demonstrated that when these "more natural" stimuli are presented in a multi
      talker babble noise instead of in quiet (as was done by Shinn et al.), the
      syllable-duration effect emerges. Our findings suggest that the syllable-duration
      effect in particular, and context effects in general, may play a more important
      role in speech perception than Shinn et al. suggested.

PMID- 8361837
TI  - Viewing behavior: ocular and attentional disengagement.
AB  - In five experiments, we examined the role of the ocular and attentional systems
      in determining saccadic latencies. Prior to making a saccade to a target
      stimulus, subjects were required to direct their attention to a foveal stimulus
      or to an eccentric stimulus. Either stimulus could be extinguished before the
      onset of the target. Saccadic latencies were shortest when the foveal stimulus
      was extinguished, regardless of whether it was attended or not. Control
      experiments showed that subjects were able to attend properly and that warning,
      arising from turning off a stimulus before target onset, could not completely
      account for the results. The results were discussed in terms of ocular
      disengagement, attentional disengagement, and joint ocular-attentional
      disengagement. It was concluded that an explanation emphasizing ocular
      disengagement provided the best account of the data.

PMID- 8361838
TI  - Stereo-motion cooperation and the use of motion disparity in the visual
      perception of 3-D structure.
AB  - When an observer views a moving scene binocularly, both motion parallax and
      binocular disparity provide depth information. In Experiments 1A-1C, we measured
      sensitivity to surface curvature when these depth cues were available either
      individually or simultaneously. When the depth cues yielded comparable
      sensitivity to surface curvature, we found that curvature detection was easier
      with the cues present simultaneously, rather than individually. For 2 of the 6
      subjects, this effect was stronger when the component of frontal translation of
      the surface was vertical, rather than horizontal. No such anisotropy was found
      for the 4 other subjects. If a moving object is observed binocularly, the
      patterns of optic flow are different on the left and right retinae. We have
      suggested elsewhere (Cornilleau-Peres & Droulez, in press) that this motion
      disparity might be used as a visual cue for the perception of a 3-D structure.
      Our model consisted in deriving binocular disparity from the left and right
      distributions of vertical velocities, rather than from luminous intensities, as
      has been done in classical studies on stereoscopic vision. The model led to some
      predictions concerning the detection of surface curvature from motion disparity
      in the presence or absence of intensity-based disparity (classically termed
      binocular disparity). In a second set of experiments, we attempted to test these
      predictions, and we failed to validate our theoretical scheme from a
      physiological point of view.

PMID- 8361839
TI  - Organizational factors and the perception of motion in depth.
AB  - When two stationary, stereoscopically separated targets are viewed in a
      completely dark surround, and no cues concerning their egocentric distances from
      the observer are salient, the farther target tends to be seen at the same
      distance it would have assumed if it were by itself. The nearer target is seen as
      being closer than it would have been if seen alone. The present studies extend
      this previous finding (now termed the far-anchor effect) into the domain of
      targets that move in stereoscopic space. Observers viewed two small illuminated
      targets, which began at either the same or different stereoscopic distances. One
      of the targets was moved in depth and the observers identified the target that
      appeared to move. Conditions varied according to the initial depth location of
      the moving target. Significantly more correct responses were reported when the
      nearer target moved than when the farther one moved, consistent with the
      hypothesis that the perception of motion in depth is affected by the
      aforementioned perceptual anchoring effect of the farther target.

PMID- 8361840
TI  - Visual angle as a determinant of perceived interobject distance.
AB  - Two new experiments and a reanalysis of Toye's (1986) data are used to examine
      the relationship between true distance and perceived distance in natural scenes.
      In the first experiment, 8 subjects estimated 78 interobject distances, formed by
      all pairs of 13 objects, while viewing the objects from a fixed position. The
      results showed that estimated distance is a linear function of the visual angle
      between objects as well as of the true distance. This relationship results in
      distances perpendicular to the line of sight being overestimated in relation to
      true distances and to distances parallel to the line of sight. These findings
      were confirmed by reanalysis of a comparable data set from Toye. Since changes in
      the visual angle can come about through changes in alignment with the line of
      sight, viewing distance, or interobject distance, Experiment 2 was designed to
      determine whether the visual angle effect was due to one of these, or whether it
      was an independent effect. In Experiment 2, 8 subjects estimated six interobject
      distances from 12 viewing positions. The results showed that visual angle
      predicted estimated distance independently of how the change in visual angle came
      about, suggesting that the greater the visual angle between objects, the more
      their separation is overestimated.

PMID- 8361841
TI  - What are human express saccades?
AB  - When a fixation point is removed 200 msec prior to target onset (the gap
      condition), human subjects are said to produce eye movements that have a short
      latency (80-120 msec), that form the early peak of a bimodal latency
      distribution, and that have been labeled "human express saccades" (see, e.g.,
      Fischer, 1987; Fischer & Breitmeyer, 1987; Fischer & Ramsperger, 1984, 1986). In
      three experiments, we sought to obtain this express saccade diagnostic pattern in
      the gap condition. We orthogonally combined target location predictability with
      the presence versus absence of catch trials (Experiment 1). When target location
      was fixed and catch trials were not used, we found mostly anticipations. In the
      remaining conditions, where responses were under stimulus control, bimodality was
      not frequently observed, and, whether it was or not, latencies were not in the
      express saccade range. Using random target locations, we then varied stimulus
      luminance and the mode of stimulus presentation (LEDs vs. oscilloscope) in the
      gap and overlap (fixation is not removed) conditions (Experiment 2). Bimodality
      was rarely observed, the gap effect (overlap minus gap reaction time) was
      additive with luminance, and only the brightest targets elicited saccades in the
      express range. When fixed locations and no catch trials were combined with
      latency feedback (Experiment 3), we observed many responses in the express
      saccade range and some evidence for bimodality, but the sudden introduction of
      catch trials revealed that many early responses were not under stimulus control.
      Humans can make stimulus-controlled saccades that are initiated very rapidly (80
      120 msec), but unless catch trials or choice reaction time is used, it is not
      possible to distinguish such saccades from anticipatory responses that are
      prepared in advance and timed to occur shortly after target onset. Because the
      express saccade diagnostic pattern is not a characteristic feature of human
      saccadic performance, we urge investigators to focus their attention on the
      robust gap effect.

PMID- 8361842
TI  - Henry Bence Jones: the best chemical doctor in London.

PMID- 8361843
TI  - Public hospitals--past, present, and future.

PMID- 8361844
TI  - Regulation of the acute phase response by cytokines.
AB  - Cytokines appear to function as part of a complex regulatory network, a signaling
      language in which informational content resides in the combinations, and perhaps
      sequence, of cytokines and other extracellular messenger molecules received by a
      cell. The effects of combinations of cytokines are complex and often differ from
      their in vitro effects or when administered by themselves. (From this
      perspective, to use a somewhat crude simile, individual cytokines can be thought
      of as words which bear informational content. Although individual cytokines may,
      on occasion, communicate a complete message, more commonly the actual messages
      received by cells probably resemble sentences, in which it is the combination and
      sequence of words which convey information.) Currently available data suggest an
      in vivo scenario in the acute phase response in which the hepatocyte receives a
      complex mixture of humoral or paracrine signals which are integrated by multiple
      interacting post-receptor and gene regulatory mechanisms to cause finely
      regulated changes in plasma protein synthesis. Regulation often occurs by
      transcriptional control, but post-transcriptional mechanisms, including
      translational regulation, may participate. Both the extracellular and
      intracellular mechanisms that mediate the response of the hepatocyte to
      inflammatory stimuli appear to be highly complex and involve multiple
      overlapping, concurrent, and parallel pathways. Enough is known at present to
      conclude that IL-6 is a major participant in these changes in man. Regulation of
      non-hepatocyte acute phase phenomena has not been delineated as thoroughly, but
      clearly involves a number of cytokines.

PMID- 8361845
TI  - Physician distinguish thyself: conflict and covenant in a physicians' moral
      development.

PMID- 8361846
TI  - Progesterone: the forgotten hormone?

PMID- 8361847
TI  - Arsenic, an old case: the chronic heavy metal poisoning of Raphaelle Peale (1774
      1825).

PMID- 8361848
TI  - The trials and tribulations of George Miller Sternberg (1838-1915)-- America's
      first bacteriologist.

PMID- 8361849
TI  - Dental services under New Mexico Medicaid.

PMID- 8361850
TI  - Commentary on freedom of movement.

PMID- 8361852
TI  - Specialisation in nursing. Nursing education vis-a-vis trends towards
      specialisation.

PMID- 8361851
TI  - Defense styles and choice of nursing career among women.

PMID- 8361853
TI  - Protecting, promoting and supporting breast feeding: the special role of
      maternity services.

PMID- 8361854
TI  - Low cost aids for teaching science subjects in nursing institutions.

PMID- 8361855
TI  - Equating nursing education with allied professions.

PMID- 8361856
TI  - Protecting, promoting and supporting breast feeding: the special role of
      maternity services.

PMID- 8361857
TI  - Evaluation of continuing education programmes in nursing.

PMID- 8361858
TI  - Anatomy of an antibody, and related misadventures in developing an effective
      treatment for septic shock.

PMID- 8361860
TI  - Understanding and treating dyslipidemia associated with noninsulin-dependent
      diabetes mellitus and hypertension.
AB  - Hypertension and diabetes appear to increase coronary heart disease risk in part
      by causing an abnormality in lipid metabolism. Most affected are patients with
      familial dyslipidemic hypertension (FDH) and noninsulin-dependent diabetes
      mellitus (NIDDM). The lipid disorders most often encountered in these patients
      are increased levels of triglycerides, very low-density lipoprotein (VLDL)
      cholesterol, and small, dense low-density lipoprotein (LDL) cholesterol, and low
      levels of high-density lipoprotein (HDL) cholesterol. These abnormalities appear
      to result from increased hepatic secretion of VLDL particles due to increased
      concentrations of free fatty acids and glucose, reduced VLDL clearance due to
      reduced activity of lipoprotein lipase, and reduced LDL clearance due to
      glycosylation of ligand proteins. Treatment of the dyslipidemia associated with
      FDH should follow the guidelines from the National Cholesterol Education Program.
      Treatment in men and women with NIDDM should be considered when LDL cholesterol
      levels are 130 mg/dl or above, triglyceride levels are 200 mg/dl or above, or non
      HDL cholesterol levels are 160 mg/dl or greater. Aggressive lifestyle changes
      should be initiated first, including weight loss in obese patients, control of
      glucose levels in those with NIDDM, avoidance of antihypertensive drugs that may
      worsen lipid levels in patients with FDH, and eating a diet restricting saturated
      fat and cholesterol. Addition of lipid-altering drugs should be considered if
      such changes do not achieve effective lipid control. The agent should be tailored
      to the patient's lipid profile, in general by using bile acid resins, niacin, or
      reductase inhibitors to lower LDL cholesterol and gemfibrozil or niacin to lower
      triglycerides. Niacin should be avoided in patients with NIDDM.

PMID- 8361859
TI  - The role of Helicobacter pylori in peptic ulcer disease.
AB  - The pathophysiology of peptic ulcer disease (PUD) is often described as an
      imbalance between aggressive factors such as acid and pepsin and alterations in
      the mucosal protective mechanisms. Helicobacter pylori is a gram-negative
      organism that has been identified as a potential causative agent in the
      pathogenesis of PUD. The exact mechanism by which it contributes to mucosal
      damage is unknown. It is thought that the organism may disrupt the protective
      mucous layer, allowing the underlying epithelium to be injured by gastric acid.
      Significant evidence indicates that H. pylori is a major etiologic factor in type
      B gastritis. Data confirming its etiologic role in duodenal ulcer (DU) disease is
      not conclusive; however, eradication of the organism is associated with a
      reduction in the recurrence of DU. Optimum therapy to eradicate H. pylori has not
      been established, although several multidrug regimens have been evaluated.
      Treatment of H. pylori infection should be reserved for individuals in whom
      conventional therapy for DU is unsuccessful and those whose ulcers relapse during
      maintenance therapy.

PMID- 8361861
TI  - Liver disorders in patients receiving chlorpromazine or isoniazid.
AB  - Based on information derived from computers and clinical records obtained from
      general practitioners in the United Kingdom, we estimated the frequency of liver
      toxicity associated with two known hepatotoxins, chlorpromazine and isoniazid.
      Among the cohort of 10,502 users of chlorpromazine, 14 had illnesses compatible
      with drug-induced liver disease, a frequency of 1.3/1000 users (95% Cl 0.8, 2.2).
      Four presumed cases of the disorder occurred among 921 users of isoniazid, for a
      frequency of 4/1000 users (95% Cl 1.7, 11.1). This study provides population
      based quantification of the frequency of liver disorders associated with the use
      of these two agents.

PMID- 8361862
TI  - Differences in serum concentrations of and responses to generic verapamil in the
      elderly.
AB  - STUDY OBJECTIVE: To determine if there are greater differences in bioavailability
      of generic verapamil at steady state in elderly patients than in healthy young
      subjects. DESIGN: Double-blind, randomized, three-way crossover study. SETTING:
      Clinical research center at a general teaching hospital. SUBJECTS: Eight young,
      healthy subjects between ages 18 and 45 years, and eight elderly, hypertensive
      patients over 65 years of age. INTERVENTIONS: Each participant was randomly
      assigned to receive brand-name verapamil or one of two generic preparations.
      Young subjects received each of the three preparations 80 mg twice/day for 7 days
      separated by a 1-week washout. Elderly patients took the three preparations for
      21 days. Serum drug levels and blood pressure were measured and
      electrocardiograms performed 13 times after the last dose of drug. MAIN RESULTS:
      In young subjects, the pharmacokinetics and pharmacodynamics of the three
      preparations were nearly identical. There was, however, a great deal of
      variability in the bioavailability of the generic products. In the elderly
      patients, one generic product had a maximum serum concentration and area under
      the curve that were 77% and 43% greater, respectively, than the brand-name
      product (p < 0.02). Assessments of bioequivalency (based on confidence intervals)
      demonstrated that this generic drug's bioavailability was from 4-118% and peak
      serum concentration from 10-139% greater than the brand-name drug. This was
      associated with greater prolongation of the PR intervals. CONCLUSIONS: A generic
      verapamil product that is bioequivalent in young subjects may not be
      bioequivalent in elderly subjects. Testing of drugs with complex pharmacokinetics
      in young subjects may not reliably predict the clinical outcomes in elderly
      hypertensive patients.

PMID- 8361863
TI  - Zidovudine pharmacokinetics in HIV-positive women during different phases of the
      menstrual cycle.
AB  - STUDY OBJECTIVE: To examine the pharmacokinetics of zidovudine during the
      menstrual cycle in human immunodeficiency virus- (HIV-) positive women. DESIGN:
      Open, unblinded study. SETTING: A women's clinic for acquired immunodeficiency
      syndrome (AIDS) at a large medical center. PATIENTS: HIV-positive women with a
      CD4+ cell count above 200/mm3, receiving long-term zidovudine therapy, with a
      history of regular menstrual cycles. INTERVENTIONS: All patients received a 100
      mg dose of zidovudine in the fasted state on three occasions. MEASUREMENTS AND
      MAIN RESULTS: Zidovudine and zidovudine-glucuronide plasma concentrations were
      measured with radioimmunoassay to determine the pharmacokinetic characteristics
      during each menstrual phase. The drug's mean peak plasma concentrations (range
      233-808 ng/ml) were 556 +/- 145, 385 +/- 132, and 495 +/- 143 ng/ml during the
      menstrual, late follicular-ovulatory, and luteal phases, respectively. Initially,
      plasma concentrations declined in a linear fashion from 0 to 4 hours, with a
      prolonged elimination phase in many patients after 4 hours. The mean zidovudine
      area under the curve was 886 +/- 156, 845 +/- 268, and 775 +/- 167 ng.hour/ml.
      The mean percentage of dose recovered was 44.2 +/- 26.0, 56.9 +/- 19.1, and 42.2
      +/- 16.6, respectively. CONCLUSIONS: The pharmacokinetics of zidovudine were not
      different during the three phases of the menstrual cycle; however, considerable
      intrapatient and interpatient variability was noted for many of the values.

PMID- 8361864
TI  - Relationship between pain severity and serum beta-endorphin levels in
      postoperative patients.
AB  - STUDY OBJECTIVE: To examine the relationship among postoperative pain severity,
      serum beta-endorphin level, and serum morphine level in pediatric patients after
      posterior spinal fusion with instrumentation. DESIGN: A prospective study.
      SETTING: University-based medical center. PATIENTS: Ten patients age 13-17 years
      admitted for posterior spinal fusion with instrumentation. INTERVENTIONS: Each
      subject was administered an initial dose of intravenous morphine 100
      micrograms/kg, followed by a constant infusion of 50 micrograms/kg/hour. The
      primary physician was allowed to titrate the dosage as required to meet the
      patient's requirement for analgesia. Whole blood was obtained for the analysis of
      serum morphine and beta-endorphin levels preoperatively, after the initial
      morphine dose, 24 hours after initiation of the infusion, and before any change
      in dosage. At each blood sampling time, pain severity ratings were obtained from
      the subject, nurse, and parent using a 10-point linear scale. MEASUREMENTS AND
      MAIN RESULTS: No statistical difference between serum beta-endorphin values
      preoperatively and after the initial dose of morphine was observed; mean values
      were 68 and 60 pg/ml, respectively. The relationships between serum beta
      endorphin level and pain scores were statistically significant only for self
      (subject) pain scores (p = 0.014, r = 0.30). Mean serum morphine level was 21.9
      ng/ml for patients with self pain scores of 4 or less. CONCLUSION: The clinical
      usefulness of serum beta-endorphin as a measure of pain severity was not
      established under the experimental conditions of this study.

PMID- 8361865
TI  - Influence of hyperbaric oxygen on the pharmacokinetics of single-dose gentamicin
      in healthy volunteers.
AB  - STUDY OBJECTIVE: To determine the single-dose pharmacokinetics of gentamicin in
      healthy humans undergoing hyperbaric oxygen (HBO) exposure. DESIGN: Randomized,
      crossover trial. SETTING: Specialized hyperbaric research facility within a
      United States Air Force medical center. SUBJECTS: Five healthy men between 28 and
      43 years of age. INTERVENTIONS: Each subject received a total of two doses of
      intravenous gentamicin 1.5 mg/kg lean body weight spaced at least 2 weeks apart.
      One dose was infused under normobaric oxygen (NBO) conditions and the other under
      HBO conditions. MEASUREMENTS AND MAIN RESULTS: Gentamicin pharmacokinetic values
      were determined on 11 serum samples per subject collected sequentially out to 300
      minutes after infusion. Using PCNONLIN, the following results demonstrated no
      difference between the pharmacokinetic values under HBO and NBO conditions,
      respectively: beta half-life (112, 115 min); volume of distribution (0.201, 0.184
      L/kg); peak concentration (6.52, 7.23 mg/L); clearance (0.0754, 0.0676 L/kg/hr).
      CONCLUSIONS: Hyperbaric oxygen produced no changes in the measured
      pharmacokinetic values of gentamicin under the conditions specified in this
      study. It is possible that numerous HBO exposures could produce a cumulative
      effect on gentamicin pharmacokinetics that would not be discernible in a single
      dose study. Because of the profound physiologic effects of HBO, drugs with narrow
      therapeutic indexes should be evaluated under HBO conditions if they are to be
      given to patients receiving HBO treatments.

PMID- 8361866
TI  - Evaluation of transdermal theophylline pharmacokinetics in neonates.
AB  - Theophylline may be administered by several routes, but problems are associated
      with neonatal dosing. The transdermal route may provide a safer and noninvasive
      method of administration, yet produce therapeutic concentrations in a consistent
      and reliable manner. To study the feasibility of this in the apnea of
      prematurity, stable neonates were administered a subtherapeutic transdermal dose
      for 24 hours in order to assess pharmacokinetics and bioavailability. This was
      followed with routine intravenous theophylline therapy according to institutional
      policy. Six of nine neonates had detectable serum theophylline concentrations
      that increased slowly after patch application. Mean (+/- SD) maximum serum
      concentration was 2.4 +/- 1.3 micrograms/ml, mean time to maximum serum
      concentration was 22 +/- 8.2 hours, and mean latency period was 8.0 +/- 4.9
      hours. Mean total amount of theophylline delivered to the skin was 18.6 +/- 4.1
      mg. Mean fractional absorption at 30 hours was 0.25 +/- 0.12. These data
      demonstrate that it is possible to produce systemic theophylline concentrations
      with a transdermal patch in preterm infants sufficient to study pharmacokinetics
      and bioavailability, and that transdermal delivery of therapeutic doses is
      technologically feasible.

PMID- 8361867
TI  - Patterns of acetaminophen use in alcoholic patients.
AB  - Alcoholics may be predisposed to the hepatotoxicity of acetaminophen due to
      increased activity of the cytochrome P-450 system and decreased hepatic
      glutathione. To date, scattered case reports provide only a brief sketch of the
      frequency and pattern of acetaminophen use by alcoholics. To determine these
      variables, we obtained a detailed ethanol and drug history from patients
      answering yes to at least one of four questions on the CAGE questionnaire.
      Patients were classified in terms of their acetaminophen use as nonusers, users
      as necessary, or regular users. Regular users were further classified as nondaily
      or daily users, or abusers (> 4 g/day). A total of 64 patients were enrolled in
      the study. The average number of positive responses to the CAGE questionnaire was
      3.27 +/- 0.91. Of the 64 patients, 34 (53.1%) were continuous daily drinkers, 28
      (43.8%) binge drinkers, and 2 (3.1%) had completely discontinued using alcohol.
      By history, 32 (50)% were nonusers of acetaminophen. Of the 32 users, 12 (37.5%)
      stated they took it as needed and 20 (62.5%) took it regularly. Of the 20 regular
      users, 7 (35%) were nondaily users, 11 (55%) were daily users, and 2 (10%) were
      abusers. Approximately 31% of alcoholics used acetaminophen regularly, most on a
      daily basis, with 1 of every 10 abusing the drug. Of the 64 alcoholics
      interviewed, 3 (4.7%) fit the drinking and acetaminophen use patterns
      theoretically associated with hepatotoxicity.

PMID- 8361868
TI  - Institution-specific patterns of infection and Gram's stain as guides for empiric
      treatment of patients hospitalized with typical community-acquired pneumonia.
AB  - STUDY OBJECTIVE: To determine the appropriateness of cefazolin as empiric
      treatment of typical, as opposed to atypical, bacterial community-acquired
      pneumonia at our institution. DESIGN: Combination of retrospective chart review
      and prospective determination of microbial susceptibilities and cefazolin
      associated cost savings. SETTING: General acute-care referral hospital. PATIENTS:
      We evaluated the charts of patients discharged with a diagnosis of community
      acquired pneumonia over a 10-year period. Gram's stains and culture results of
      sputum samples processed over 2 months were analyzed to determine the ability of
      the stains to predict positive Haemophilus influenzae cultures. The
      susceptibility and beta-lactamase status of clinical isolates of H. influenzae
      were determined. Cost savings of cefazolin as empiric treatment for community
      acquired pneumonia were evaluated. MEASUREMENTS AND MAIN RESULTS: The frequency
      of H. influenzae pneumonia at our institution was 15% of the three major
      bacterial community-acquired pneumonias. Gram's stain was highly accurate in
      predicting the presence or absence of Haemophilus sp in sputum. Five patients had
      positive outcomes with cefazolin treatment despite being diagnosed with H.
      influenzae pneumonia. The organism isolates demonstrated intermediate sensitivity
      to cefazolin and 85% were beta-lactamase negative. Our program that encourages
      empiric use of cefazolin over cefuroxime for typical bacterial community-acquired
      pneumonia has allowed a modest projected annual cost savings of $24,000.
      CONCLUSIONS: We concluded that when Gram's stain of sputum does not show
      Haemophilus sp in patients with typical bacterial community-acquired pneumonia,
      empiric treatment with cefazolin is appropriate and results in cost savings.

PMID- 8361869
TI  - Potentially serious drug interactions secondary to high-dose diltiazem used in
      the treatment of pulmonary hypertension.
AB  - Two patients had potentially serious drug interactions (phenytoin, digoxin) that
      were probably attributable to changes in pharmacokinetics and pharmacodynamics
      caused by high-dose calcium channel blocker therapy (diltiazem) in the treatment
      of pulmonary hypertension. Even in the approved normal dosages for the treatment
      of angina and hypertension, calcium channel blockers are known to cause
      significant changes in the metabolism of other drugs. Currently, no data exist on
      the effects of the very high dosages of these drugs, administered to patients
      with pulmonary hypertension, on the metabolism and clearance of other agents,
      although, based on our experience and literature reports, recommendations for
      monitoring therapy can be made.

PMID- 8361870
TI  - Can garlic lower blood pressure? A pilot study.
AB  - A popular garlic preparation containing 1.3% allicin at a large dose (2400 mg)
      was evaluated in this open-label study in nine patients with rather severe
      hypertension (diastolic blood pressure > or = 115 mm Hg). Sitting blood pressure
      fell 7/16 (+/- 3/2 SD) mm Hg at peak effect approximately 5 hours after the dose,
      with a significant decrease in diastolic blood pressure (p < 0.05) from 5-14
      hours after the dose. No significant side effects were reported. Our results
      indicate that this garlic preparation can reduce blood pressure. Further
      controlled studies are needed, particularly with more conventional doses (e.g., <
      or = 900 mg/day), in patients with mild to moderate hypertension and under
      placebo-controlled, double-blind conditions.

PMID- 8361871
TI  - Development and implementation of simplified aminoglycoside empiric dosing
      guidelines.
AB  - Poor empiric dosing of aminoglycosides continues to be a problem in many
      hospitals. Consequently, a two-phase study was undertaken to evaluate gentamicin
      and tobramycin (G-T) dosing in our institution and to develop practical
      guidelines to achieve optimum initial G-T serum concentrations. In the pre
      intervention phase (phase 1), approximately one-third of 232 G-T treatment
      courses were initiated with regimens that resulted in low initial serum
      concentrations. Empiric dosing guidelines were subsequently developed using
      Pharmacy Pharmacokinetic Service data and literature recommendations. They were
      validated with patients in phase 1. Compared with earlier dosing methods, the
      guidelines resulted in initial serum G-T concentrations within the therapeutic
      range in an equivalent proportion of patients. To simplify the procedure,
      recommended dosages were based on age, total weight, and serum creatinine only.
      The guidelines were tabular in format, and prescriber calculations were not
      required. Pocket and wall chart guidelines were distributed and promoted. During
      the post-intervention phase (phase 2), the impact of the guidelines was assessed.
      A review of 232 phase 1 and 203 phase 2 treatment courses revealed an increase in
      the initial mean dose per interval prescribed after the intervention (p < 0.01).
      No change in the mean interval was noted. When guidelines were followed, a higher
      proportion of treatment courses achieved early therapeutic serum concentrations
      (Cpmax 5-10 mg/L, 80% vs 54%; p < 0.005). The new empiric guidelines appear to be
      a practical alternative to existing methods of dosing aminoglycosides.

PMID- 8361872
TI  - [Circadian rhythm of blood pressure and pulse rate in young men with diabetes
      mellitus type I depending on duration of disease].
AB  - In order to investigate the blood pressure-heart rate interrelation and their
      circadian pattern in type I diabetes mellitus, we performed ambulatory blood
      pressure monitoring in 28 normotensive patients without clinical nephropathy
      divided in two groups. Group A consisted of 14 males with short-term DM (mean 2
      years, mean age 28 +/- 6 years), group B consisted of 14 males with long-term DM
      (mean 12 years, mean age 31 +/- 7 years). Ambulatory blood pressure monitoring
      revealed significantly higher night heart rate in B group (74 +/- 13 l/min vs. 62
      +/- 11 l/min in A, p < 0.01) and day diastolic blood pressure (83 +/- 9 mm Hg vs.
      74 +/- 8 mm Hg in A, p < 0.01) and night diastolic blood pressure (73 +/- 10 mm
      Hg vs. 62 +/- 8 mm Hg in A, p < 0.01). The linear regression SBP/HR equation were
      significantly different (p < 0.02) (HR = 0.48 x SBP + 21, r = 0.40 in A vs. HR =
      0.29 x SBP + 69, r = 0.28 in B). We concluded that type I diabetes duration has
      significant influence on diastolic blood pressure and heart rate even in patients
      without diabetic nephropathy and could be related to changed sensitivity of the
      baroreceptors.

PMID- 8361873
TI  - [Levels of insulin in serum during fasting and circadian blood pressure profile
      in young health men].
AB  - In order to investigate the relation of ambulatory blood pressure values to
      fasting plasma insulin, non-invasive 24-hour blood pressure monitoring was
      performed in 32 young normotensive males. Systolic and diastolic blood pressures
      were averaged for awake and asleep periods. Fasting plasma insulin levels
      correlated significantly with both asleep (r = 0.61; p < 0.001) and awake
      systolic blood pressures (r = 0.44; p < 0.02) but not with casual systolic blood
      pressure (r = 0.27). There were no significant associations of awake, asleep and
      causal diastolic blood pressures values with fasting plasma insulin levels (r =
      0.15, 0.05 and 0.21, respectively). These results support the hypothesis that
      insulin may be a physiological determinant of blood pressure.

PMID- 8361874
TI  - [Indices of left heart ventricle relaxation after 5-months of hypotensive therapy
      with guanfacine].
AB  - The subject of the work is to assess the clinical parameters and diastolic
      function in patients with mild or moderate essential hypertension after 5-month
      treatment with guanfacine 0.5-3 mg/day, mean 1.7 mg. In the group there were 8
      women and 8 men, mean age 53.7 +/- 7.6. The diastolic function of the left
      ventricle was assessed from the echocardiographic M-mode paper sweep of the left
      ventricle by the method of Gibson and Brown. In clinical parameters systolic,
      diastolic and mean blood pressure was found to decrease significantly, the heart
      rate was unchanged. Essential improvement of the markers of relaxation was
      received while amelioration of filling was not significant. The before treatment
      data were compared with the similar ones of the 60 persons of the control group.
      The significant differences were found in values of blood pressure, markers of
      relaxation and indices Iv and Ip.

PMID- 8361875
TI  - [Enalapril in patients with diabetes mellitus type I with microalbuminuria
      without hypertension].
AB  - The studies included 18 normotensive patients with diabetes mellitus type I (mean
      age 29 years) and constant microalbuminuria (UAE-30 - 300 mg/24 hours). Group A
      consisted of 10 patients treated with enalapril, and group B--10 patients given
      placebo. Glomerular filtration rate, ERPF, and UAE were measured before and after
      6 months of therapy. UAE decreased significantly in patients of group A (p =
      0.02) after 6 months while evident proteinuria was seen in two patients of group
      B. Arterial blood pressure dropped in patients of group A (131/84 vs 122/78 mm
      Hg), and increased significantly in patients of group B (126 +/- 8 vs 136 +/- 15
      mm Hg; p < 0.05). Blood flow through kidneys improved (p = 0.02) and renal
      vascular resistance decreased (p = 0.02) in patients of group A. The obtained
      results suggest that enalapril may prevent diabetic nephropathy in diabetics with
      constant microalbuminuria.

PMID- 8361876
TI  - [Principles of hypotension treatment in patients with diabetes].
AB  - Epidemiological studies have revealed, that elevated blood pressure is in
      diabetics 1.5-3.0-times more frequent that in general population. It is one of
      the most important factors increasing the morbidity and mortality due to small
      and big arteries disease. Hypotensive therapy should be commenced in diabetic
      persons earlier than in patients without diabetes mellitus. In many such diabetic
      patients blood pressure normalization could be obtained by dietary adaptations
      and metabolic compensation. In more advanced cases pharmacological treatment
      should be undertaken. When selecting the drug for a diabetic person one has to
      balance between positive and adverse actions. The drugs of the first choice are
      the ACE inhibitors, drugs blocking the slow calcium channel and alpha 1
      adrenergic receptors, because they do not influence negatively the carbohydrate
      and lipid metabolism. On contrary, prazosin and ACE inhibitors increase the
      tissue sensitivity to insulin. The latter group decrease also intraglomerular
      pressure and albuminuria. As a routine the treatment begins with small, testing
      dose of a single hypotensive drug. The dosage may be increased slowly up to the
      average dose level. If this manipulation does not permit normalization of blood
      pressure one may combine 2 or 3 hypotensive drugs. Selection of the drug and of
      its dose rely also on the type and intensity of late diabetic complications--at
      first nephropathy and autonomic neuropathy.

PMID- 8361877
TI  - [Level of glycosylated hemoglobin in children with newly diagnosed diabetes
      during their hospitalization].
AB  - Percent of HbA1 was determined in 60 children with newly diagnosed diabetes
      mellitus at the beginning and end of their first hospitalization. High levels of
      HbA1 (over 15%) were found in the majority of children at the admittance which
      means late diagnosis. A decrease in HbA1 by 0.5-7.5% was noted in 76% of all
      diabetic children treated at the hospital for 7-24 days. In 54% out of these
      children HbA1 levels decreased by 1.5-4.5%. Mean HbA1 value was 3.6% following a
      two-week hospitalization, and 3.7%--after 3 weeks. Mean decrease in HbA1 for all
      treated children was 0.18% per week. Positive correlation between HbA1 and its
      percentage and mean glycaemia at the beginning of hospitalization was seen. No
      correlation between HbA1 values measured at the end of hospitalization and blood
      glucose levels determined during the whole hospitalization period was found.

PMID- 8361878
TI  - [Zinc plasma and erythrocyte levels in insulin dependent diabetes].

PMID- 8361879
TI  - [Effect of nonselective beta-adrenergic blockade on blood plasma levels of
      glucagon in plasma during insulin-induced hypoglycemia].
AB  - An effect of nonselective beta-adrenergic blockade with propranolol on the blood
      plasma level of glucagon during insulin-induced hypoglycemia was studies in 20
      control dogs and 20 alloxan diabetic dogs. Increased sensitivity to exogenous
      insulin and prolonged hypoglycemia were noted during nonselective beta-adrenergic
      blockade. However, glucagon response to insulin-induced hypoglycemia following
      propranolol administration was increased.

PMID- 8361880
TI  - [Incidence of the most important metabolic disorders in the population of a
      little town in Poland].
AB  - The study aimed at establishing a risk for metabolic diseases in the randomly
      selected population in the age over 18 years, inhabitants of the little town in
      Siedlce Voivodeship. Using comparative tables, in was found that percent of women
      and men in the investigated group is similar to that in the population of this
      town. Women prevailed slightly in the investigated group which characterized also
      relatively low age (42 years) and low diastolic blood pressure. Obesity was found
      in 40% of the investigated subjects. Over 2.6% had diabetes mellitus and 11.4%-
      improper glucose tolerance (according to WHO criteria). Every fifth subject has
      blood lipids disorders. Such disorders were more frequent in the subgroup of men.
      Additionally, relationships between these findings were analysed. Body weight
      index markedly correlated with blood triglycerides level and less pronounced with
      blood total cholesterol and uric acid. Negative correlation between BMI and HDL
      cholesterol levels was noted. The lack of correlation between glycaemia,
      cholesterolemia and triglyceridemia results from the fact that there is such a
      correlation in men but not in women. The obtained results indicate the necessity
      of preventive measures.

PMID- 8361881
TI  - [Dynamics of growth and glucose uptake in cultured human fibroblasts collected
      from patients with diabetes mellitus, type 2].
AB  - Dynamics and glucose uptake in the human fibroblasts cultures were investigated
      for 14 days. Fibroblasts were taken from 16 patients with diabetes mellitus type
      2 and 8 patients adjusted with age but with no history of diabetes mellitus. It
      was found that diabetic fibroblasts grew much slower than controls and reached
      the stationary phase later. Glucose uptake in both groups of fibroblasts-
      measured as the diminishment of glucose levels in the medium every two days--did
      not differ markedly in the phase of the rapid proliferation whereas was
      significantly higher in the stationary phase in the cultures of diabetic
      fibroblasts in comparison with the controls. It may thus assumed that diabetic
      fibroblasts reveal abnormal glucose metabolism in addition to reported
      intracellular disorders in protein, nucleic acids, lipids, collagen, and
      glycosaminoglycans synthesis.

PMID- 8361882
TI  - [Osteoporosis in insulin dependent diabetes].
AB  - A case of female patient with non-compensated diabetes mellitus is presented.
      Pathological bone fractures caused by the diabetic osteoporosis were produced in
      the relatively short period of time. An emphasis is on the role of pathogenetic
      factors leading to the diabetic osteoporosis, prevention and treatment of this
      disease are discussed.

PMID- 8361883
TI  - [Renin-angiotensin system in diabetes mellitus].

PMID- 8361884
TI  - [Determination of blood glucose values with glucostix].
AB  - The study involved 214 patients of both sexes, including those treated at the
      Institute of Oncology in Gliwice and children treated for diabetes mellitus at
      the Diabetic++ Out-Patient Clinic in Gliwice. Blood glucose was assayed with
      GLUKOZA EO kit manufactured by POCh and strip test Glucostix (visually and with
      reflectance meter Glucometer II Ames). In case of blood glucose assays with strip
      tests a deviation of +/- 25% of the determined value was considered as a
      difference which does not affect diagnostic value. Blood glucose concentration
      determined visually with Glucostix test is similar or lower than that found in
      the laboratory. Moreover, the use of reflectance meter does not improve
      diagnostic value of an assay.

PMID- 8361885
TI  - [Full assortment of national preparations of insulin places Poland foremost among
      world producers].

PMID- 8361886
TI  - [Basal and reactive renin and aldosterone secretion in arterial hypertension of
      insulin dependent diabetics].
AB  - The aim of the study was to assess the significance of the renin-angiotensin
      aldosterone system (R-A-A) in the pathogenesis of arterial hypertension in
      patients with diabetes type I (IDDM). Testing was accomplished in the hospital
      conditions in a group of 131 patients with long-term IDDM, who beside of diabetes
      mellitus and its chronic complications did not show any symptoms of additional
      diseases. The patients were divided in 5 groups (A-E) depending on the type of
      coexisting late diabetic complications. The control group was consisted of 20
      healthy persons matched for sex and age. In each case the following tests were
      performed: measurement of blood pressure in succumbent position, daily profile of
      glycemia and glucosuria, Hb A1 level, ophthalmoscopy, functional assessment of
      kidney and autonomic system status. Tenin activity in plasma (ARO) and plasma
      aldosterone (ALD) were determined in basal (after 6 h of succumbent position) and
      after i.v. administration of 40 mg of furosemide and 3 h of standing position
      (reactive values). In all groups under study the significant decrease of average,
      basal and reactive ARO was found in comparison with the control group. This
      abnormality was the most distinct in subjects with diabetic nephropathy. The
      autonomic neuropathy was abolishing this tendency. The mean concentration ob
      basal ALD was in all diabetic subgroups similar as in the controls. The mean
      reactive ALD was however significantly decreased. In diabetes complicated by
      retinopathy the negative correlation between ARO and systolic, diastolic and mean
      blood pressure existed. In diabetes complicated by nephropathy the dependence
      between blood pressure and ARO and ALD was not found.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8361887
TI  - [Role of the EDRF system--that is, nitric oxide--in vasodilation].

PMID- 8361888
TI  - [The effect of blood pressure changes during hemodialysis on left ventricular
      systolic function].
AB  - Echocardiographic study was performed in 31 uremic patients on maintenance
      hemodialysis (HD) with no apparent heart failure, valvular heart disease,
      pericardial effusion or coronary artery disease. On the basis of blood pressure
      patients were classified into two groups: 1) patients with normal arterial
      pressure (group I) (n = 19), 2) patients with blood hypertension (group II) (n =
      12). Cardiac function was assessed immediately before and after HD session. Left
      ventricular end-diastolic diameter (EDD), left ventricular end-systolic diameter
      (ESD) and ejection fraction (EF) were calculated. Body weight, heart rate and
      mean blood pressure (mBP) were also measured. A significant decrease of EDD was
      noted in both groups during HD but it was less evident in group II (p < 0.05).
      ESD decreased significantly in group II (p < 0.01) when it did not change in
      group I. EF increased significantly only in group II (p < 0.05). Blood pressure
      decreased during HD in both groups. A significant inverse linear association
      between EF and ESD was noted during HD in both groups (r = -0.685; p < 0.001) but
      was more evident in group II. There was no association between and EDD (r =
      0.199; NS). Similar analysis shows that ESD was significantly with mBP (group II-
      r = 0.914; p < 0.001, group I--r = 0.565; p < 0.05). Such association were not
      found for EDD and RR. Only in group II the decrease in mBP was statistical
      significantly correlated with the increase in EF. The decrease in EDD during HD
      exists probably due to changes in intravascular volume.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8361889
TI  - [Early and late results of simultaneous and multiple artificial valve replacement
      in patients with multiple heart valve defects].

PMID- 8361891
TI  - [Exercise tolerance in children with primary bicuspid valve prolapse syndrome].
AB  - Exercise tolerance in children with the primary bicuspid valve prolapse syndrome
      has been evaluated with ergometric test. Additionally, an effect of environmental
      factors on exercise tolerance has been assessed in children from the urban and
      rural areas. A good tolerance of submaximal loads has been shown in both groups.
      However, the obtained results have been significantly more favourable in children
      from rural areas. The authors have concluded that limitation of exercise in
      children with bicuspid valve prolapse is not necessary during an intensive
      growth.

PMID- 8361890
TI  - [Effect of treatment with vasodilators on physical exercise tolerance in patients
      with chronic congestive heart failure].
AB  - The studies were performed in 46 patients with chronic congestive heart failure
      (CCHF), III and IV NYHA classes. During the first two weeks all patients received
      digoxin (D) and furosemide (F) in optimal doses (stage O). Then, patients were
      randomly divided into two groups. During the stage A group I (n = 26) received
      digoxin, furosemide and nifedipine (N), while in the stage B captopril (K) was
      added to that treatment and it was continued for 4 weeks. During the following
      two weeks (stage C) patients were treated the same as in stage A. During the same
      stages group II (n = 20) received D, F and isosorbide dinitrate (S), then, D, F,
      S and K followed by D, F and S, respectively. After the termination of each stage
      of the treatment all patients performed physical exercise on bicycle ergometer,
      until limiting symptoms have occurred. Power (M) and duration (t) of exercise,
      systolic (ps) and diastolic (Pd) arterial blood pressures, heart rate (HR) at the
      peak load, and HR x Ps and HR/M indices were determined. It was found that N did
      not significantly affect the investigated ergometric parameters. Combined
      treatment with D, F, N and K induced an increase in M, t and HR, and a decrease
      in. This effect persisted through the stage C. Following the treatment with D, F
      and S, a significant increase in M and decrease in HR/M were observed. Addition
      of K to D, F, and S did not induce further improvement in the physical exercise
      tolerance of these patients.

PMID- 8361892
TI  - [Certain characteristics of myocardial infarction in young patients as compared
      with those over 65 years old].
AB  - Death rate due to myocardial infarction shows constantly growing tendency,
      especially in young subjects. This fact is even referred to as overmortality of
      young and middle-aged men. The aim of the present study was to evaluate certain
      clinical elements of myocardial infarction in young subjects. Out of 668 patients
      with acute myocardial infarction treated at the I Cardiac Department in Cracow
      from 1979 to 1988 a group of 102 patients (5 women, 97 men) below 45 years of age
      (mean = 40) was selected. The control group consisted of 241 patients with
      myocardial infarction, including 146 men and 98 women over 65 years of age (mean
      = 73). The following clinical date were analyzed: sex, presence of retrosternal
      pain and its aggravation, time from the onset of pain to hospitalization, anginal
      pain preceding the infarction and such complication as sudden cardiac arrest,
      pulmonary edema, cardiogenic shock, in-hospital deaths. The infarction in
      patients below 45 years of age occurred mainly in men. They experienced
      retrosternal pain more frequently than the elderly patients. It did not, however,
      affect the time of hospitalization. Serious complications of the infarction
      developed less frequently in younger patients and the in-hospital mortality was
      also lower in that group.

PMID- 8361893
TI  - [Type of behavior pattern and risk factors in young men after myocardial
      infarction].
AB  - The studies involved 102 male patients, aged between 23 and 40 years, with a
      history of one myocardial infarction. Behaviour pattern was determined with The
      Jenkins Activity Survey questionnaire. Total serum cholesterol, triglycerides,
      glucose, and uric acid concentrations were assayed, both diastolic and systolic
      blood pressures were measured, all patients were weighed, and reported the number
      of smoked cigarettes. A mean number of risk factors per patient was calculated as
      well as their incidence in various behaviour patterns. It was found behaviour
      pattern A predominates in young male patients with a history of myocardial
      infarction. However, serum total cholesterol, triglycerides, and uric acid levels
      were lower in this group in comparison with those representing behaviour patterns
      B and X. The authors suggest that behaviour pattern A may be an independent risk
      factor for myocardial infarction in young subjects. Further studies are,
      therefore, needed within the programs of circulatory diseases prevention.

PMID- 8361894
TI  - [New outlook on aldosterone].

PMID- 8361895
TI  - [Therapeutic effectiveness of molsidomine in patients with exercise-induced
      angina pectoris].
AB  - Exercise tolerance was tested with cycloergometer, and ECG recorded in 33
      patients with exercise-induced angina pectoris. Patients' age ranged from 36 to
      65 years. Tests were performed prior to and after a single oral dose 2 mg of
      molsidomine or placebo. Molsidomine reduced the number of patients with exercise
      induced coronary pain from 33 to 25, i.e. from 84.5% to 27.27%. Pain-free period
      was significantly longer in patients given molsidomine whereas postexercise pain
      and total duration of the coronary pain were significantly shorter. Total work
      was markedly higher, and maximum ST depression in ECG record following exercise
      was significantly lower than the values noted prior to molsidomine administration
      and in placebo group. Heart rates both resting and during exercise did not differ
      in molsidomine and placebo groups. Molsidomine may be considered as an effective
      drug preventing exercise-induced anginal pain within 1 hour after administration.

PMID- 8361896
TI  - [Hemolysis after bioprosthesis implantation in the mitral valve].
AB  - Rare case of hemolysis following an implantation of the biological mitral valve
      is presented. In 1985, biological mitral valve of Ionescu-Shiley type was
      implanted to a 45-year female patient for post-rheumatic mitral defect. Patient
      was in the III NYHA class before surgery. Her health status improved after
      operation. Several echocardiographic examinations have shown normal functioning
      of the implanted valve (normal gradient across the valve, no retrograde wave).
      Upper respiratory infection with subsequent progressive weakness, anemia, yellow
      skin, and heart failure occurred in 1991. Echocardiography has shown significant
      increase (twice) in the gradient across the valve (max 26, mean--14 mm Hg) and
      retrograde wave of the II degree as well as mitral insufficiency of the II
      degree. Laboratory tests have shown marked anemia with reticulosis, increase in
      blood bilirubin, increase in LDH activity (by about ten times), and a decrease in
      haptoglobins. Mitral valve dysfunction with hemolysis has been diagnosed. Patient
      was reoperated. Intraoperatively, incompletely healed valvular ring, and lesions
      to the leaves such as: fibrosis, thickening and partial deficits. Biological
      mitral valve was replaced with Corin-Carbotest artificial valve. Postoperative
      course was uncomplicated.

PMID- 8361897
TI  - [Selective ablation of slow conduction pathway in a patient with atrioventricular
      nodal reentrant tachycardia].
AB  - In a 42-year female with paroxysmal atrioventricular nodal reentrant tachycardia
      of the type I (slow/fast) verapamil did not prevent it. Verapamil injections
      terminated tachycardia but marked hypotonia followed. Electrophysiologic study
      revealed dual conduction pathway within the atrioventricular node that made the
      substrate for reentrant tachycardia. An effective refractory period od the slow
      conduction pathway in antegrade direction was less than 220 msec. An effective
      refractory period of the fast pathway in antegrade and retrograde directions was
      300 msec. Radiofrequency current ablation was performed at the site of slow
      pathway morphology electrogram recording. A single application of the
      radiofrequency current that lasted 40 sec. producing the maximum 60C successively
      ablated the slow pathway. Follow-up electrophysiologic study before and after
      atropine administration proved the success of this procedure. No other heart
      structures were damaged. A 4-month follow-up period did not show tachycardia.

PMID- 8361898
TI  - [Cardiac arrhythmias in patients with chronic congestive heart failure].

PMID- 8361899
TI  - [Effect of anti-arrhythmia therapy on mortality of patients after myo cardial
      infarction].

PMID- 8361900
TI  - [Reperfusion injury to the myocardium].
AB  - Reperfusion injury is of increasing importance due to new techniques of restoring
      blood flow to acutely ischaemic areas by means of thrombolysis, angioplasty, or
      acute coronary artery bypass surgery. Reperfusion of ischaemic myocardium can
      results in the acceleration of surrounding reversibly injured myocytes and
      endothelial cells to irreversibly injured cells. The complex group of phenomena
      associated with reperfusion include: no-reflow, arrhythmias, "stunned" myocardium
      impaired contractile power and abnormalities of relaxation. Experimental studies
      have demonstrated that microvascular damage may play an important role in the
      pathogenesis of this phenomenon. The causal factors of reperfusion injury are not
      clarified, but include free radicals, calcium and various inflammatory mediators.
      The deleterious effects of reperfusion are related importantly to the action of
      oxygen-derived free radicals. These effects can be reduced or even prevented with
      scavengers of free radicals. However, the value of these agents in patients
      remains to be tested. Prophylactic chronic treatment of patients at high risk of
      coronary occlusion with a beta-adrenergic blocking agent or a calcium antagonist
      slow cell death causing limitation of infarct size.

PMID- 8361901
TI  - [Effect of heparin on the interaction between platelets with collagen].
AB  - An effect of a standard heparin preparation on the interaction between blood
      platelets and collagen has been investigated. The experiments have shown, that
      the addition of heparin in the concentration of 0.3; 0.6 or 0.9 IU/mL did not
      change the interaction between blood platelets and collagen. Such interaction
      increased, when heparin concentration was 1,2 IU/mL, and remained unchanged
      despite the further increase in heparin concentration. The authors suggest that
      such a course of this interaction results from the stimulating action of heparin
      added in adequate concentration on protein release from platelet alpha
      granulations--which bound GP II b/III a complex with collagen.

PMID- 8361902
TI  - [Activation of the fibrinolytic system following subcutaneous administration and
      inhalation of heparin].
AB  - Heparin was administered to 113 patients at risk of thrombosis classified to
      abdominal surgery either alone (subcutaneously or in inhalation) or in
      combination with anabolic steroid (nandrolone). No pharmaco-prophylaxis was used
      in 10 patients. On the day of surgery, heparin activated plasma fibrinolytic
      activity, prior to an introduction to anesthesia. Measurements of euglobulins
      clot lysis have shown an increase in endogenous fibrinolytic activity dependent
      and independent on Hageman's factor and an increase in exogenous fibrinolysis,
      tested after venous stasis was produced. Heparin had profibrinolytic activity,
      stimulating plasminogen activators in the blood plasma without the signs of
      hyperplasminemia. Fibrinolytic system response was the same following
      subcutaneous injection and heparin inhalations. Administration of heparin
      combined with anabolic steroid has no additional effect on plasma fibrinolytic
      activity.

PMID- 8361903
TI  - [Risk of alloimmunization in the granulocyte concentrate recipient].
AB  - Forty five patients with diffused peritonitis, complicated with septic shock and
      neutropenia, have been analysed. Granulocyte concentrate has been administered to
      25 patients with negative results of tests detecting lymphocytotoxic and leuko
      agglutinin antibodies. Such antibodies have been detected in 35.5% of all
      patients. These patients have not received granulocyte concentrate. During a 20
      day follow up period, antibodies have been produced in 20% of granulocyte
      concentrate recipients. No signs of alloimmunisation have been noted in 49% of
      patients with severe peritonitis during the whole follow up period. Non-hemolytic
      symptoms after transfusions have been seen in 40% of granulocyte recipients and
      accompanied 16% of all transfusions. No correlation with the symptoms of
      alloimmunisation was noted.

PMID- 8361904
TI  - [Occurrence of antifibrinogen antibodies in serum of individuals diagnosed with
      serum sickness].
AB  - Occurrence and antifibrinogen antibodies level have been determined in sera of 50
      individuals with serum sickness and in 50 blood donors constituting the control
      group. Antifibrinogen antibodies have been detected in blood of 41 (82%) blood
      recipients. Titre of these antibodies have ranged from 1:8 to 1:512, and their
      agglutination potency has ranged from 5 to 67 Dunsford's units. Immediately after
      serum sickness diagnosis a decrease in both level and agglutination potency of
      these antibodies has been noted. Further treatment with full blood constantly
      increased both the level and agglutination potency of antifibrinogen antibodies.
      It is probable, that fibrinogen and its degradation products present in the given
      blood stimulated antibodies production. This hypothesis is fortified by the
      observation, that stable decrease in both the level and agglutination potency of
      antifibrinogen antibodies in patients with serum sickness treated with washed
      erythrocytes. Antifibrinogen antibodies of a titre ranging from 1:4 to 1:16, and
      agglutination potency of 5-18 Dunford's units have been detected in 14 blood
      donors constituting a control group. Specificity of the detected antifibrinogen
      antibodies as well as their IgG character have been also confirmed.

PMID- 8361905
TI  - [Fibrinolytic activity and tissue plasminogen activator level in healthy
      individuals prior to and after a ten-minute venous stasis].
AB  - Fibrinolytic activity and tissue plasminogen activator (t-PA) level were measured
      in 33 healthy individuals prior to and after fibrinolytic system stimulation
      (i.e. a ten-minute venous stasis). Fibrinolytic activity was measured with the
      aid of euglobin lysis time, and lysis test on the fibrin plates (in own
      modification). Tissue plasminogen activator concentration was assayed
      spectrophotometrically with the COA-SET t-PA (Kabi Vitrum). No fibrinolytic
      activity of plasma specimens taken before the venous stasis was noted during
      fibrin lysis plate test whereas it was seen in 13 subjects after the venous
      stasis. Fibrinolytic activity of the plasma euglobins, measured as a surface on
      fibrin plates, increased significantly after the venous stasis in both sexes (by
      35.5 mm2 on the average, i.e. by 51%). It was more marked in men than in women
      both prior to and after venous stasis (by 10.9% and 19.0%, respectively). A time
      of plasma euglobin lysis was shorter after venous stasis (by 110 minutes, on the
      average). There was no significant difference between the sexes. Tissue
      plasminogen activator concentration increased by 5.8 times (from 1.7 IU/ml to 9.9
      IU/ml) after the stasis. Correlation between t-PA concentrations and fibrinolytic
      activity, measured on the fibrin plates, was highly positive. No such a
      correlation existed between t-PA concentrations and the time of euglobin lysis.
      The obtained results indicate variety of assessments of fibrinolytic system
      activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361906
TI  - [Evaluation of phagocytic and bactericidal activities of neutrophils in
      peripheral blood of patients with anemia due to iron deficit].
AB  - Phagocytic and bactericidal properties of neutrophils have been evaluated in 20
      women with anemia due to iron deficit. Twenty healthy women in corresponding age
      and domicile served as a control group. No statistically significant difference
      in both phagocytic and bactericidal properties of peripheral blood neutrophils
      have been noted in both groups. A decrease in plasma bactericidal activity has
      been sen in patients with anemia due to iron deficit. It may be one of the causes
      of increased susceptibility to infections noted in patients with plasma iron
      deficit.

PMID- 8361908
TI  - [Reoperation of internal arterio-venous shunt for hemodialysis in children].

PMID- 8361907
TI  - [Treatment of blood hyperviscosity syndrome with continuous plasma exchange using
      a Fenval CS 3000 separator in patients with multiple myeloma].

PMID- 8361909
TI  - [Production of human anti-ferritin antibodies and RIA tests for determining
      ferritin in serum].

PMID- 8361910
TI  - [Tissue plasminogen activator as a fibrinolytic agent].

PMID- 8361911
TI  - [Autotransfusion--trials at intensification with erythropoietin].

PMID- 8361913
TI  - [Hemolytic-uremic syndrome in children and adults].

PMID- 8361912
TI  - [Sickle cell anemia--drepanocytosis].

PMID- 8361914
TI  - Thinking it through.

PMID- 8361915
TI  - Two-year follow up of bipolar hemiarthroplasty.
AB  - Forty-seven bipolar hemiarthroplasties were performed from January 1985 to
      December 1986. Twenty-three patients (24 hips) returned for a history, physical,
      and repeat radiographs. Ten primary press-fit and two cemented primary bipolar
      hemiarthroplasties were performed. Four patients underwent cemented and eight
      received press-fit revision bipolar hemiarthroplasties. Fourteen patients had
      simultaneous cancellous, reamed femoral head autograft, or allograft acetabular
      bone augmentation. Omitting one patient who had replacement for Levi's
      pleonosteosis, the average acetabular migration among the remaining 23 patients
      was 4 mm of superior and 1.5 mm of medial progression. The mean modified
      d'Aubigne hip score was 33 for primary press-fit arthroplasty, 30 for primary
      cemented arthroplasty, 22 for press-fit revisions, and 32 for cemented bipolar
      revision arthroplasty. Morcellized bone graft tended to variably resorb with
      time. Among the press-fit stems, all but two patients complained of at least
      occasional thigh pain. All but one patient with primary press-fit
      hemiarthroplasty walked with a limp. We conclude that, although good early
      results can be obtained, significant number of patients will have groin and thigh
      pain. We have found no evidence either radiologically or clinically that
      nonstructural bone grafting with reamed femoral head will reliably incorporate or
      prevent further acetabular migration.

PMID- 8361916
TI  - Reflex sympathetic dystrophy in children: an orthopedic perspective.
AB  - To design diagnostic criteria for reflex sympathetic dystrophy (RSD) and to
      initiate a prospective treatment protocol, we reviewed our experience with 49
      episodes of RSD in 36 children. There were 24 females and 12 males; mean age at
      diagnosis was 13.4 years (range: 8 to 19); mean time from pain onset to correct
      diagnosis was 9.2 months (range: 1 to 53). Lower extremity involvement
      predominated. Pain was "severe" in 61%, and skin color changes, swelling,
      hyperesthesia, abnormal skin temperatures, muscle weakness, and decreased range
      of motion were all present in at least 75% of cases. Osteopenia was observed in
      15 of 38 radiographs; of 24 bone scans, 7 were normal, 11 showed increased
      uptake, and 6 demonstrated decreased uptake. Of the 23 children who had
      psychological evaluations, 83% revealed some type of significant emotional
      dysfunction. Analgesic and antiinflammatory medications were not helpful, nor
      were local injections or regional blockades effective. An inpatient diagnostic
      and rehabilitation program for treating chronic pain, including orthopedics,
      rheumatology, psychology, and twice-daily physical therapy was most likely to
      lead to resumption of age-appropriate activities. Despite extensive physiological
      testing, physician, parent, and/or patient reluctance to accept absence of a
      primary organic disease was common. We present diagnostic criteria for pediatric
      RSD.

PMID- 8361917
TI  - Obturator internus bursitis: a common factor in low back pain.
AB  - The presence of irritation of the obturator internus bursa (OIB) is identified as
      a common but thus far overlooked focus of myofascial irritability in association
      with low back pain. Eighteen of 50 consecutive patients with low back pain (36%)
      demonstrated the presence of tenderness at the anatomical site of the OIB. OIB
      was found in 11% of men and 43% of women. Nineteen of the 50 patients had
      regional myofascial pain; of these, eight (42%) had OIB tenderness. Palpation of
      the OIB will commonly reveal local tenderness in patients suffering from low back
      pain. In these patients, conservative treatment of regional myofascial disorders
      may be made more effective when therapy and/or local steroid injections are
      appropriately directed to the obturator internus bursa.

PMID- 8361918
TI  - The plight of the traumatic amputee.
AB  - This retrospective review of the long-term problems of patients with lower
      extremity amputation from trauma fails to support the opinion that most traumatic
      amputees do well. Overall, anatomic problems involved 51% of the amputees, and
      social problems involved 56%. Attempting limb salvage with subsequent secondary
      amputation did not seem to compromise the long-term outcome for these problems.
      The surgeon performing the amputation should try to obtain the best possible
      stump and insure that the patient gets the careful follow up and
      multidisciplinary team support needed to manage the anticipated problems.

PMID- 8361919
TI  - Scoliosis surgery in a steroid-dependent asthmatic.

PMID- 8361920
TI  - Factitious infections in orthopedic patients.

PMID- 8361921
TI  - Rupture of the brachial artery from closed posterior dislocation of the elbow in
      a wrestler.

PMID- 8361922
TI  - Stress fractures of the femoral neck following hardware removal from healed
      intertrochanteric fractures.

PMID- 8361924
TI  - Radiologic case study. Insufficiency fracture of the sacrum.

PMID- 8361923
TI  - The use of Dall-Miles cables in total hip arthroplasty.

PMID- 8361925
TI  - Is it bacterial or viral? Laboratory differentiation.
AB  - To differentiate viral, chlamydial, and mycoplasmal infections from bacterial
      disease in office and in emergency room practice, a combination of epidemiologic
      and clinical features usually will suggest one or a few microorganisms. Following
      that, laboratory diagnosis can be more targeted. Definition of the specific
      etiology will enable the proper management choice of antibiotics, antivirals, or
      symptomatic therapy.

PMID- 8361926
TI  - Sepsis in the newborn.

PMID- 8361927
TI  - The pediatrician's role in infant feeding decision-making.

PMID- 8361928
TI  - The acute management of paroxysmal supraventricular tachycardia in children.

PMID- 8361929
TI  - Nicotine dependence: diagnosis, chemistry, and pharmacologic treatments.

PMID- 8361930
TI  - Index of suspicion. Case 1. Acute epiglottitis.

PMID- 8361931
TI  - Index of suspicion. Case 2. Occult fracture.

PMID- 8361932
TI  - Index of suspicion. Case 3. Systemic lupus erythmatosus.

PMID- 8361933
TI  - Giardiasis.

PMID- 8361934
TI  - [Function of the pituitary-thyroid axis in chronic renal failure].

PMID- 8361935
TI  - [Molecular basis of capacitation and acrosomal reaction].
AB  - There has been described molecular events towards preparation of spermatozoa for
      fertilization as capacitation (process known to be characterized by increased
      mobility of membrane components on sperm surface) and acrosomal reaction (fusion
      of spermatozoon plasmalemma with outer acrosomal membrane with following
      destruction of acrosomal compartment and enzyme release). There have been also
      described hypotheses concerning activity of exposed during acrosomal reaction
      receptors for gamete binding and especially sperm receptors located on egg's zona
      pellucida. The role of acrosomal enzymes in penetration of zona pellucida by
      sperm as well as inhibition of enzymatic action were discussed in aspect of
      contraceptive potential.

PMID- 8361936
TI  - [Structure and function of LDL receptors in familial hypercholesterolemia].
AB  - Structure and function of the LDL-receptor in genetic disorder--familial
      hypercholesterolemia is described as well as the structure of receptor coding
      gene. General outline of therapy in FH is also described.

PMID- 8361937
TI  - [Function, properties and clinical significance of n-acetyl-beta-D
      hexosaminidase].
AB  - Function, tissue distribution and consequence of the inherited deficit of HEX A
      or HEX B, were described. The diagnostic value of the HEX determination in the
      renal diseases and diabetes, was reviewed.

PMID- 8361938
TI  - Thyroid dysfunction in the severely ill and elderly. Forget the classic signs and
      symptoms.
AB  - Manifestations of thyrotoxicosis and hypothyroidism are often ill-defined in
      elderly and seriously ill patients, and signs and symptoms may suggest a
      nonendocrine disease process instead. It is vitally important that physicians be
      aware of the possibility of thyroid disease in such patients. Failure to suspect
      the diagnosis may result in improper treatment and use of invasive diagnostic
      tests that not only fail to yield helpful results but also are potentially
      detrimental to the outcome. It is also essential to be able to distinguish
      between test abnormalities that indicate primary thyroid dysfunction and those
      that reveal an adaptive response to nonthyroidal illness.

PMID- 8361939
TI  - The facts about fibroids. Presentation and latest management options.
AB  - Uterine fibroids, which eventually develop in more than 50% of women, are usually
      asymptomatic, but they can cause many different symptoms and complications that
      challenge clinicians. For example, they can complicate pregnancy, mask the
      diagnosis of ovarian neoplasms, and confuse the management of menopause by
      causing abnormal uterine bleeding. The best noninvasive method of diagnosis is
      ultrasonography. Progestogens may be used to suppress menorrhagia, but use of
      these agents to treat fibroids is not routine. Gonadotropin-releasing hormone
      (GnRH) agonist analogues offer a promising medical approach to the treatment of
      fibroids; they have been shown to decrease fibroid size and to decrease uterine
      bleeding. Thus they may allow deferment of surgical treatment in selected
      patients (thereby preserving fertility) or decrease the risks involved when
      surgery is necessary. Further study is needed to assess the long-term effects of
      GnRH analogues on bone density, cholesterol levels, and risk of coronary artery
      disease. Surgical treatment is primarily by hysterectomy, unless myomectomy is
      indicated because of reproductive considerations.

PMID- 8361940
TI  - Your 'family doctor' may be a nurse!

PMID- 8361941
TI  - Helicobacter pylori and peptic ulcer disease. Reexamining the therapeutic
      approach.
AB  - Now that Helicobacter pylori has been strongly implicated as a causative factor
      in peptic ulcer disease, the dictum "no acid--no ulcer" may no longer be valid.
      However, H pylori has proved difficult to eradicate, and the approach to
      treatment of peptic ulcer is undergoing changes. At present, a triple-drug
      combination of bismuth and antibiotics is advised, and cultures should be
      obtained before and after treatment to monitor its efficacy. Side effects include
      pseudomembranous colitis and drug resistance.

PMID- 8361942
TI  - Congestive heart failure: today's approaches and tomorrow's directions.

PMID- 8361943
TI  - Noninvasive assessment of systolic and diastolic function. Important clues to
      differentiating types of congestive heart failure.
AB  - The clinical distinction between systolic and diastolic dysfunction as the cause
      for congestive heart failure (CHF) is readily made with noninvasive diagnostic
      testing. Patient history, physical examination, chest films, and
      electrocardiography provide readily obtainable clues to the presence of left
      ventricular dysfunction. Noninvasive imaging methods are an important
      quantitative adjunct in evaluation. Among these, echocardiography and
      radionuclide angiography are the most widely available and accepted techniques.
      Other advances, such as new radionuclide imaging agents, cine magnetic resonance
      imaging, and cine computed tomographic scanning, may also be useful in selected
      circumstances. Functional assessments using ventilatory gas analysis can aid in
      the evaluation of patients with CHF and in the timing of intervention with
      cardiac transplantation.

PMID- 8361944
TI  - Invasive testing in congestive heart failure. When is it useful?
AB  - Not only are findings from invasive studies in patients with congestive heart
      failure important for diagnosis, they may also be crucial in deciding on
      appropriate treatment and predicting prognosis. Hemodynamic evaluation may be
      useful for tailoring medical therapy, determining the need for mechanical
      support, predicting survival, deciding when valve surgery is needed, locating
      intracardiac shunts precisely, assessing the severity of pulmonary hypertension
      before cardiac transplantation, or diagnosing unexplained dyspnea. Contrast
      angiography can be used to evaluate systolic function if information from non
      invasive studies is inadequate. Coronary arteriography can help determine the
      severity and extent of coronary artery disease and is needed if revascularization
      is being contemplated. Endomyocardial biopsy can be used to identify the cause of
      cardiomyopathy.

PMID- 8361945
TI  - Are you recognizing depression in your patients?
AB  - Major depression is a prevalent condition that causes significant morbidity and
      mortality. Diagnosis may be complicated in depressed patients who offer a medical
      symptom as their chief complaint. Once the diagnosis is established, treatment is
      relatively straightforward. In prescribing an antidepressant, consideration
      should be given to the patient's previous response to medications, the documented
      efficacy of various agents, their side-effect profiles, and their potential for
      toxicity. Although the more severe and complicated cases should be referred to a
      psychiatrist, most depressed patients can be treated by their primary care
      physician.

PMID- 8361946
TI  - Modern management of epilepsy. Recommended medical and surgical options.
AB  - Effective treatment of epilepsy requires accurate diagnosis. This relies heavily
      on proper identification of seizure type, which may require long-term
      electroencephalography with video monitoring. Successful drug therapy requires a
      proper understanding of medication half-life and indications. Attempts should be
      made to control seizures with monotherapy; more than one agent should be tried
      only after monotherapy has failed. If medical management fails, surgical
      intervention should be considered. Such surgery is now considered relatively safe
      and highly effective.

PMID- 8361947
TI  - Increased striatal lipid peroxidation after intracerebroventricular MPP+
      administration to mice.
AB  - Mice received different doses intracerebroventricularly of MPP+ (1-methyl-4
      phenylpyridinium ion), the active metabolite of MPTP (1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine), a drug which induces a Parkinson model in rodents. Two
      indexes of lipid peroxidation were monitored at different times after
      administration: 1) production of thiobarbituric acid-reactive substances and 2)
      formation of lipid fluorescence products. A regional-selective overproduction of
      thiobarbituric acid-reactive substances was observed in corpus striatum and
      midbrain, but not in frontal cortex, cerebellum nor hippocampus. Enhancement was
      70% and 198% at 30 and 60 min. in striatum and 88% at 30 min. in midbrain, when
      compared with respective controls injected intracerebroventricularly with saline
      solution. MPP+ also induced lipid fluorescence products formation enhancement in
      corpus striatum. This increase was dose-dependent in the range of MPP+ doses
      which induced striatal dopamine depletion. Striatal LFP formation was found
      increased 24 hr after MPP+ administration (38% vs control), indicating long
      lasting lipid peroxidation overproduction. These results suggest that lipid
      peroxidation might be involved in the neurotoxic effects of MPP+ in vivo.

PMID- 8361948
TI  - Increased biliary transferrin excretion following parenteral aluminium
      administration to rats.
AB  - Aluminium accumulates in the livers of patients receiving either parenteral
      nutrition or haemodialysis. When given parenterally to rats, aluminium causes
      cholestasis. However, the mechanism of hepatic aluminium uptake and the fate of
      aluminum in the liver are poorly understood. We examined the effect of parenteral
      aluminium administration on biliary excretion of transferrin, the major
      circulating aluminum-binding protein. Male Wistar rats were given parenterally
      aluminum 5 mg/kg/day for 1-14 days. Bile was collected for 3 hr at the end of the
      study period. Biliary total protein concentration and IgA/total protein were
      unaffected by up to 14 days of parenteral aluminium administration. However,
      biliary transferrin excretion increased with duration of aluminum administration
      up to five-fold by day 14. Biliary transferrin concentration and
      transferrin/total protein was higher in aluminum treated rats than controls after
      7 and 14 days of study. Hepatic aluminum concentration reached a maximum after 4
      days of parenteral aluminum administration, at which time serum bile acid and
      alanine amino transferase values were not different from controls. Since biliary
      transferrin is normally derived from the serum, it is likely that aluminum
      promotes hepatocellular uptake of transferrin and that aluminum enters the
      hepatocyte bound to transferrin. We postulate that transferrin may direct
      aluminum to intracellular sites where its toxic effects would be minimized.

PMID- 8361949
TI  - Bioactivation of 2-amino-1-methyl-6-phenylimidazo[4,5-b]-pyridine by liver
      microsomes from three different rat strains.
AB  - The biotransformation of 2-amino-1-methyl-6-phenylimidazo[4,5-b]-pyridine (PhIP)
      and the protein binding of PhIP and 2-amino-3-methylimidazo[4,5-f]quinoline (IQ)
      was studied using microsomes from PCB-pretreated or untreated male rats of the
      strains, Wistar, Fischer and Sprague-Dawley. The microsomal monooxygenases,
      P450IA1 and IA2, which are important for the biotransformation of heterocyclic
      amines, were quantified by immunoblots. The two metabolites detected, 2-amino-1
      methyl-6-(4'-hydroxyphenyl)imidazo[4,5-b]pyridine (4'OH-PhIP) and 2-hydroxyamino
      1-methyl-6-phenylimidazo[4,5-b]pyridine (N2-OH-PhIP) were formed in similar
      amounts whereas no minor metabolites were found in our highly sensitive
      radiochemical assay. Irrespective of the rat strain used, pretreatment with PCB
      significantly induced both the activation and the detoxication in all three rat
      strains. Except for a significantly higher concentration of P450IA2 in microsomes
      from control and PCB induced Wistar rats, no major differences between the
      strains were found.

PMID- 8361950
TI  - Potential antidepressive properties of amantadine, memantine and bifemelane.
AB  - The effects of amantadine, its dimethyl derivative, memantine and the chemically
      unrelated compound bifemelane were tested for antidepressant activity. Reserpine
      induced hypothermia and the forced swim test (Porsolt test) were selected for
      this purpose. In the former test amantadine and bifemelane but not memantine were
      effective. In the forced swim test all three agents produced antidepressive-like
      activity (decreased immobility time), but in case of bifemelane it was less
      pronounced. The effect in the forced swim test was specific i.e. it was
      apparently not the result of an increase in general activity as evidenced by
      control experiments in the open field. The mechanism of amantadine and memantine
      action may involve indirect dopaminomimetic activity resulting from the blockade
      of NMDA receptors. However in reserpine-induced hypothermia this explanation is
      not valid considering the lack of effect of memantine and positive action of
      amantadine. Hence, amantadine may have an additional central sympathomimetic
      action that memantine is lacking. Bifemelane antidepressant-like activity might
      be attributed to an enhancement of noradrenergic transmission. We suggested that
      amantadine and bifemelane could be particularly useful therapeutically when
      depressive symptoms are present in patients suffering from Parkinson's disease
      and dementia.

PMID- 8361951
TI  - Effects of 5-HT1A receptor agonists on patterns of rat motor activity in relation
      to effects on forebrain monoamine synthesis.
AB  - The effects of the 5-HT1A receptor agonists 8-OH-DPAT (0.15-2.5 mumol kg-1
      subcutaneously), flesinoxan (0.6-10.0 mumol kg-1 subcutaneously) and buspirone
      (1.9-30.0 mumol kg-1 subcutaneously) on spontaneous motor activity in male
      Sprague-Dawley rats was examined in a photocell-equipped open-field arena.
      Following motor activity observations, the cerebral aromatic L-amino acid
      decarboxylase inhibitor NSD-1015 (100 mg kg-1 intraperitoneally) was administered
      and 30 min. later the animals were decapitated for subsequent analysis of the
      accumulated forebrain DOPA and 5-HTP levels, as an estimate of the rate of
      monoamine synthesis. 8-OH-DPAT and flesinoxan produced a similar and
      characteristic pattern of changes of the spontaneous motor activity in normal
      animals i.e. a moderate decrease in locomotor activity, a marked suppression of
      rearing and an increase in the relative amount of forward locomotion and of
      activity in the periphery of the open-field arena. This behavioural profile was
      closely related to a decrease in forebrain 5-HTP accumulation, indicating 5-HT
      receptor stimulation. In agreement with these observations buspirone also
      produced an increase in peripheral activity and a suppression of rearing. In
      contrast to effects by 8-OH-DPAT and flesinoxan, however, buspirone produced a
      further reduction of locomotor activity and reduced the forward locomotion. This
      difference in behavioural profile between buspirone and the other two compounds
      is probably explained by its DA receptor blocking properties, as indicated by an
      increased DOPA accumulation in the neostriatum. At least partially, 8-OH-DPAT,
      flesinoxan and buspirone, all antagonized reserpine-induced (5 mg kg-1
      subcutaneously--16 hr) suppression of locomotor activity. This stimulation of
      locomotor activity in reserpine-treated rats is in all probability related to 5
      HT1A receptor stimulation since concomitant DA D2 receptor blockade, in the case
      of buspirone, did not markedly affect this behavioural response.

PMID- 8361952
TI  - Purification and properties of malate dehydrogenase from Paracoccus
      denitrificans.
AB  - Affinity chromatography on immobilized Cibacron Blue (Matrex Gel Blue A) gel
      permeation chromatography on UltroPac TSK G 3000 SWG column and ion-exchange
      chromatography on "Mono Q" column were used to purify the malate dehydrogenase
      (MDH) from P. denitrificans to electrophoretic homogeneity. The last two
      purification steps were performed in FPLC system. The enzyme having a specific
      activity of about 2300 nkat/mg protein was obtained with an approximate 70%
      yield. MDH is a dimer with a molecular mass of 80,000 +/- 10,000 and an
      isoelectric point of 4.85 +/- 0.05. Absorption, fluorescence and CD-spectra were
      also measured and basic kinetic parameters were obtained for the homogeneous
      enzyme. The present paper also suggests the possibility of using the prepared
      enzyme for the determination of aspartate transferase (AST) in blood serum.

PMID- 8361953
TI  - Improved chromatographic purification of pea seedlings diamine oxidase.
AB  - An improved and simplified purification procedure has been developed for the
      isolation of diamine oxidase from pea seedlings (DAO EC 1.4.3.6). It involves
      ammonium sulphate precipitation, hydrophobic interaction chromatography, ion
      exchange chromatography and size-exclusion chromatography. The homogeneity of the
      final enzyme preparations and molecular weight were determined by size-exclusion
      chromatography and by polyacrylamide gel electrophoresis in the presence of
      sodium dodecyl sulphate (SDS PAGE). The isoelectric point of 7.35 +/- 0.05 was
      determined by chromatofocusing and by polyacrylamide gel isoelectric focusing.

PMID- 8361954
TI  - Purification of a second kallikrein from bovine pancreas.
AB  - Two kallikreins were identified in a homogenate of bovine pancreas in terms of
      their differential elution from an anion-exchange chromatography column. The
      kallikreins were quantified by their ability to release kinin from a partially
      purified preparation of bovine kininogen. The second kallikrein, designated
      kallikrein B, was purified by a three-step procedure following anion-exchange
      chromatography consisting of affinity chromatography on a benzamidine-agarose
      resin, gel filtration and hydrophobic interaction chromatography. An overall
      purification factor of 556-fold was achieved with a 58% recovery of enzymatic
      activity. The final material was shown to be homogeneous by a number of
      electrophoretic analyses. The relative molecular mass of pro-kallikrein B was
      found to be 26,700 by gel filtration and that of kallikrein B to be 26,000 by SDS
      gel electrophoresis. Gel isoelectric focusing revealed the presence of several
      isoenzymic forms ranging in isoelectric point from pH 4.05 to 4.35.

PMID- 8361955
TI  - Study on the purification of growth hormone-like substance from pituitaries of
      the snake Ptyas mucosa.
AB  - Extract from the snake (Ptyas mucosa) pituitaries was capable of inhibiting the
      binding of 125I-labelled bovine growth hormone to female rat liver membranes. The
      growth hormone-like substance was not adsorbed on Concanavalin A-Sepharose nor
      DEAE-cellulose, but could be purified by gel filtration on Sephadex G-50. It
      possessed a molecular weight of about 19,000 as judged by SDS-polyacrylamide gel
      electrophoresis. The iodinated snake growth hormone-like substance bound to
      membranes prepared from female rat and pregnant rabbit livers. The binding could
      be inhibited by unlabelled snake growth hormone-like substance as well as by
      bovine growth hormone.

PMID- 8361956
TI  - Characterization of human kappa-casein purified by FPLC.
AB  - Because previous purification procedures for human kappa-casein may have caused
      the loss of some carbohydrate, relatively gentle methods were used. The protein
      was isolated by a four-step procedure which included isoelectric precipitation of
      whole casein, gel chromatography on Sephadex G-200 in the presence of SDS,
      removal of the SDS with Extracti-Gel D, and FPLC chromatography on Mono Q with
      buffers containing 6 M urea. The purified protein was nearly identical in amino
      acid composition to that found earlier by amino acid analysis and peptide
      sequencing and a molar extinction coefficient of 11.2 +/- 0.1 was determined on
      the basis of amino acid analysis with a norleucine internal standard. Hydrolysis,
      acylation, and methylsilylation of the carbohydrate, followed by gas
      chromatographic analysis on a fused silica column, yielded approximately 5%
      fucose, 17% galactose, 18% N-acetylglucosamine, 8% N-acetylgalactosamine and 7%
      sialic acid, totaling almost 55% by weight. The percentages from two different
      donors were almost the same. About 1 mole phosphorus per mole of kappa-casein was
      also detected. Using low-speed sedimentation equilibrium methods, a molecular
      weight of only 33,400 was obtained for human kappa-casein, suggesting
      carbohydrate lability. Human beta-casein with four phosphoryls was stabilized
      against precipitation by 10 mM Ca+2 ions at a level greater than 95% when the
      molar ratio of kappa/beta exceeded 0.15.

PMID- 8361957
TI  - Selective extraction of alkaline phosphatase and 5'-nucleotidase from milk fat
      globule membranes by a single phase n-butanol procedure.
AB  - A single phase extraction procedure employing 8% (v/v) n-butanol at room
      temperature extracted over 90% of alkaline phosphatase activity and over 60% of
      5'-nucleotidase activity from bovine milk fat globule membranes (MFGM). For 5'
      nucleotidase, higher n-butanol concentrations lead to loss of activity, while
      lower concentrations were ineffective in extracting the enzyme. When extractions
      were performed at 0 degrees C, similar yields were obtained for alkaline
      phosphatase extraction with 8% (v/v) n-butanol, but 5'-nucleotidase extraction
      required 10% (v/v) n-butanol for similar yields. However, 5'-nucleotidase was
      less susceptible to denaturation during extraction at 0 degrees C. The Km values
      and substrate specificities for both alkaline phosphatase and 5'-nucleotidase
      were unchanged by extraction with 8% (v/v) n-butanol. The 8% (v/v) n-butanol
      extraction procedure provides a 3-fold purification step, and an enzyme
      preparation suitable for further purification.

PMID- 8361959
TI  - Enhanced sensitivity of pancreatic cells to cholecystokinin octapeptide in
      obstructive jaundice.
AB  - Exocrine function of the pancreas in obstructive jaundice was examined using
      dogs. Jaundice induced by choledochal ligation over 3 weeks showed pancreatic
      hypersecretion in response to cholecystokinin octapeptide (CCK-8) stimulation. To
      clarify the mechanism of pancreatic hypersecretion in obstructive jaundice, three
      experiments were undertaken. In a perfusion experiment performed on isolated
      pancreas, hypersecretion in obstructive jaundice was observed in response to CCK
      8 stimulation. An incubation experiment showed an increase in secretion in
      response to CCK-8 stimulation in a dose-dependent manner, producing a greater
      increase in dogs with obstructive jaundice than in controls, despite the fact
      that basal secretion in both groups was the same. This would suggest that at
      least one of the mechanisms of pancreatic hypersecretion in obstructive jaundice
      may be related to the degree of sensitivity of acinar cells to CCK-8. In
      morphological observation of acinar cells by electron microscopy, the average
      number of zymogen granules and total granular area per unit of cytoplasm in both
      groups before and after stimulation with CCK-8 were compared. There was no
      difference between the groups before stimulation. Following stimulation, values
      for the control group decreased but appeared to increase in the jaundiced
      pancreas. These results strongly suggest that pancreatic acinar cells in
      obstructive jaundice may retain their secretory potential after stimulation for
      60 min, though the potential in nonjaundiced pancreatic acinar cells may decrease
      after stimulation.

PMID- 8361958
TI  - Neurons containing gastrin releasing peptide-like immunoreactivity in the human
      pancreas.
AB  - Gastrin releasing peptide (GRP) is known to stimulate pancreatic enzyme and islet
      hormone secretion. In the present immunohistochemical study, the localization and
      distribution of GRP-like immunoreactivity were investigated in the human pancreas
      using two antisera with different specificities. GRP-like immunoreactivity (GRP
      LI) was observed in numerous nerve fibers diffusely distributed to the exocrine
      pancreas, but was not seen in intrapancreatic nerve cells of normal pancreatic
      specimens examined. Nerve fibers and terminals with GRP-LI were found in
      abundance around pancreatic acini and capillaries, with moderate density around
      ductules and in the walls of arterioles, and a few were seen in islets. This
      distribution pattern was quite similar to that of vasoactive intestinal
      polypeptide (VIP)-LI nerve fibers. The study, using the antibody elution method,
      strongly suggests the co-localization of GRP- and VIP-LIs within a part of VIP
      containing nerve fibers. In the chronic pancreatitis specimens, neurons with GRP
      LI were frequently found, and > 90% of intrapancreatic nerve cells were VIP
      immunoreactive. Immunostainings for GRP and for VIP on serial adjacent sections
      of intrapancreatic ganglia from chronic pancreatitis specimens suggested the co
      localization of the two immunoreactivities in > 70% of intrapancreatic neurons.
      The present findings may provide a morphological basis for neurotransmitter
      and/or neuromodulator roles of GRP in the human pancreas.

PMID- 8361960
TI  - Does acetylsalicylic acid interfere with stimulated pancreatic secretion? An
      experimental study in the rat.
AB  - To evaluate the effect of the prostaglandin inhibitor acetylsalicylic acid (ASA)
      on rat exocrine pancreas secretion, three groups of rats were administered ASA by
      infusion: Groups 1-3, 50, 100, and 200 mg/kg body wt, respectively; Group 4
      received saline. Twenty minutes later these ASA-pretreated groups were given
      intraarterial secretin (18 CU/kg) and cholecystokinin (CCK) (18 micrograms/kg).
      In an additional three groups of seven rats each, saline solution rather than
      secretin-CCK was given after ASA pretreatment. Pancreatic juice was collected
      every 10 min by means of a chronic pancreatic fistula. Bicarbonate and protein
      concentrations were measured and variations in outputs observed. No significant
      variations were found in the bicarbonate concentrations and outputs of rats with
      different types of pharmacological treatment, while protein concentrations and
      outputs were found to vary with time and type of experiment. There was, however,
      no interaction between these two variables. At lower ASA dosages, the bicarbonate
      and protein concentrations and outputs of secretin-CCK-stimulated rats were
      higher than the basal values and the levels of rats without hormonal stimulation.
      At higher dosages, no difference was found between the two groups. In conclusion,
      ASA seems to interfere with stimulated pancreatic exocrine secretion of proteins,
      even when its effect on bicarbonate concentration is factored in, and its effect
      seems to be present at the highest dosages considered in the study. Among the
      various hypotheses that may explain this phenomenon, an antagonizing effect of
      ASA on secretin-CCK action should be the first to be considered.

PMID- 8361961
TI  - Modulation of human periodic interdigestive gastrointestinal motor and pancreatic
      function by the ileum.
AB  - Following ingestion of a meal, unabsorbed nutrients may reach the distal
      intestine partly after the termination of the prandial period, i.e., in the
      presence of interdigestive motor and secretory patterns. To determine if
      interdigestive motility and pancreatic enzyme secretion are modulated by the
      delivery of nutrient into the ileal lumen, six fasting volunteers were intubated
      with an oroileal multilumen tube system that permitted multiple small intestinal
      manometry, gastric and duodenal aspiration, and perfusions of marker and test
      solutions. Ileal perfusions of nutrient or saline solutions were started during
      phase I of the interdigestive motility cycle. Ileal perfusion with carbohydrate
      or lipids increased the duration of motor quiescence and decreased the length of
      the interdigestive cycle, mainly by decreasing the proportion of phase II
      activity compared with ileal saline (p < 0.01). Pancreatic outputs of amylase,
      trypsin, and chymotrypsin prior to ileal perfusions were low because, due to the
      protocol, perfusions were started during phase I. With ileal saline, enzyme
      outputs increased (p < 0.05) in association with the occurrence of phase II
      motility, as expected. By contrast, ileal carbohydrate and triglyceride perfusion
      prevented the phase II-associated increase in enzyme outputs (p < 0.05). The data
      suggest that the presence of nutrients within the ileal lumen may modulate
      interdigestive motor and pancreatic functions.

PMID- 8361962
TI  - Putrescine uptake in rat pancreatic acini: effect of secretagogues and growth
      factors.
AB  - Polyamines [putrescine (Put), spermidine, and spermine] are normal cellular
      constituents that can modulate cellular proliferation and differentiation in a
      number of tissue and cell types. Transport is one of the mechanisms that control
      intracellular polyamine content. The present investigation explores the influence
      of cholecystokinin (CCK), other secretagogues [carbachol, bombesin, vasoactive
      intestinal polypeptide (VIP)], insulin, insulin-like growth factor 1 (IGF-1), and
      epidermal growth factor (EGF) on Put uptake in rat pancreatic acini. Insulin, IGF
      1, and EGF stimulated Put uptake by 30-40%. Insulin did not enhance intracellular
      metabolism of Put. In contrast, CCK and the other secretagogues inhibited this
      transport system by 40-50% of control (VIP by 23% only). Further investigations
      of the inhibitory effect of CCK revealed that the maximal uptake rate of Put
      (Vmax) shifted from 346 pmol [14C]Put/mg DNA-min (control) to 265 pmol
      [14C]Put/mg DNA-min (100 pM CCK), whereas the Km was only moderately influenced.
      Augmented Put efflux as well as increased production of endogenous Put (possibly
      induced by CCK) did not contribute to this change in transport kinetics. In
      addition, the inhibition of Put uptake induced by CCK was specific and dose
      dependent up to 100 pM. CCK at 1,000 pM exerted only minor inhibition (20% of
      control). Incubation with the Ca-ionophore A 23187 did not influence Put
      accumulation, whereas treatment with the phorbol ester phorbol 12-myristate-13
      acetate led to enhanced Put uptake (30-40%). Pretreatment of the acini with 1 mM
      ouabain led to a reduction of Put uptake by 43%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361963
TI  - Release of platelet-activating factor in acute experimental pancreatitis.
AB  - This study demonstrates the formation of platelet-activating factor (PAF) in rats
      with acute experimental pancreatitis (AEP). The AEP was induced by infusing
      sodium taurodeoxycholate and trypsin into the bile-pancreatic duct. The PAF
      content was increased in blood samples and in pulmonary and pancreatic tissue as
      compared with control animals. Significant amounts of PAF were also found in
      peritoneal fluid. The PAF content did increase in blood samples and in pulmonary
      tissue after administration of endotoxin intravenously. The effects of
      intraperitoneal PAF administration were also studied and showed an increase of
      polymorphonuclear cells in blood samples. These findings suggest that acute
      pancreatitis might generate and release PAF. Whether PAF release is associated
      with the pathophysiology of complications in acute pancreatitis remains to be
      elucidated.

PMID- 8361964
TI  - Ethionine-induced atrophy of rat pancreas involves apoptosis of acinar cells.
AB  - The mechanism of acinar cell loss occurring during ethionine-induced atrophy of
      the pancreas was investigated. Rats were given a standard diet, a protein
      depletion diet (PDD), or a PDD with low- (0.04 g/kg body wt; LDE) or high- (0.4
      g/kg; HDE) dose ethionine administered intraperitoneally daily for 10 days.
      Changes were most extensive in the animals given a PDD and HDE: After 10 days,
      pancreatic weight was reduced by 72%, and most of the acinar cells had
      disappeared. Prior to their deletion, these cells showed cytoplasmic vacuolation
      and enhanced autophagy. The main mechanism involved in their deletion was
      apoptosis, the apoptotic bodies being phagocytosed and degraded by adjacent
      acinar cells and intraepithelial macrophages. In contrast, necrosis of acinar
      cells was rare. Interstitial inflammation and apoptosis of capillary endothelial
      cells were also observed. In animals given a PDD and LDE, enhanced apoptosis
      occurred later and was more limited in extent, and additional manifestations of
      cell injury were not evident. As in other circumstances where glandular atrophy
      is effected by apoptosis, the basic tissue architecture was preserved, thus
      explaining the known capacity for the pancreas to regenerate after ethionine is
      discontinued.

PMID- 8361965
TI  - The effect of epinephrine on insulin and glucagon secretion from the endotoxic
      rat pancreas.
AB  - This study determined whether in vivo endotoxin treatment alters the ability of
      epinephrine to inhibit immunoreactive insulin (IRI) secretion or to stimulate
      immunoreactive glucagon (IRG) secretion from the in vitro perfused rat pancreas
      preparation. Insulin and glucagon secretion were measured from pancreases
      obtained from control and endotoxin-treated rats. The pancreases were perfused
      with 240 mg/dl glucose in the presence and the absence of 13.6 nM epinephrine.
      The absolute ability of epinephrine to inhibit glucose-induced IRI secretion was
      similar for both "control" and "endotoxic" pancreases. However, since endotoxic
      pancreases hypersecrete insulin, the relative ability of epinephrine to inhibit
      insulin secretion was reduced in endotoxic compared with control pancreases.
      Epinephrine did not appreciably alter IRG secretion in control pancreases.
      However, epinephrine prevented a progressive decrease in IRG secretion in
      endotoxic pancreases. The results suggest that the relative inability of
      epinephrine to inhibit the excess insulin secretion due to endotoxin treatment
      contributes to endotoxin-induced hyperinsulinemia. Furthermore, the additional
      observation that epinephrine supported glucagon secretion in the endotoxic
      pancreas in the face of high glucose levels suggests epinephrine may play a
      deleterious role with respect to glucose homeostasis during endotoxicosis. The
      results provide a partial mechanism to explain endotoxin-induced hyperinsulinemia
      and also demonstrate a possible role for epinephrine with regard to the
      production of elevated glucagon levels during endotoxicosis.

PMID- 8361966
TI  - Extraislet infiltration in NOD mouse pancreas: observations after
      immunomodulation.
AB  - This study describes the morphology, time appearance, persistence, and
      immunomodulation of extraislet infiltration in the nonobese diabetic (NOD) mouse
      pancreas. Female NOD mice were subdivided into two groups: untreated, killed at
      week 5 (n = 8), 10 (n = 8), or 21 (n = 8) of life; ganglioside treated (200 mg/kg
      body wt/day given from week 4 until week 21 of life, plus complete Freund's
      adjuvant at week 4), killed at week 10 (n = 6), 21 (n = 6), or 25 (4 weeks after
      the end of the ganglioside treatment; n = 6). Mononuclear elements were seen
      around small ductules located both in the vicinity of and far from the islets.
      Larger ducts were completely devoid of inflammation, thus evidencing that
      periductulitis is specific only to small ductules. Moreover, an exocrine focal
      pancreatitis was seen along septa and may demonstrate that macrophage activation
      takes place throughout the pancreatic connective tissue. Immunomodulation
      determines some suppression of insulitis; nevertheless, after treatment
      withdrawal, a reinfiltration occurs both within and outside the islets.

PMID- 8361967
TI  - Xanthine oxidase-mediated intracellular oxidative stress in response to cerulein
      in rat pancreatic acinar cells.
AB  - Intralobular oxygen radical formation was examined in cerulein-stimulated rat
      pancreatic acinar cells by digital imaging microscopic fluorography using a
      hydroperoxide-sensitive fluorescent probe, dichlorofluorescin (DCFH) diacetate.
      The isolated pancreatic acinar cells loaded with DCFH diacetate were
      microscopically observed, and the dichlorofluorescein (DCF) fluorescence yielded
      by DCFH oxidation via hydroperoxides was digitally processed. Within the initial
      20 min after the application of cerulein (10 microM), intracellular oxidative
      stress was observed as indicated by the increase in DCF fluorescence intensity
      and reached its maximum at 60 min. DCF fluorescence intensity was then gradually
      decreased until 80 min, followed by a marked increase in propidium iodide (PI)
      fluorescence, suggesting irreversible cell death. Allopurinol (1 microM), a
      xanthine oxidase inhibitor, significantly attenuated the early increase of DCF
      fluorescence intensity as well as the late cell damage. Treatment with hyperbaric
      oxygen (PO2 300 mm Hg) also significantly attenuated both the increase of DCF
      fluorescence and the number of PI-positive cells. The results suggest that
      xanthine oxidase-mediated oxygen radicals may play an important role in cerulein
      induced intracellular oxidative stress in pancreatic acinar cells of rats.

PMID- 8361968
TI  - Inhibitory effect of intraduodenal administration of somatostatin analogue SDZ CO
      611 on rat pancreatic exocrine secretion.
AB  - The inhibitory effect of the intraduodenal administration of a new somatostatin
      analogue, SDZ CO 611 (SDZ), on pancreatic secretion was evaluated in the rat. The
      exocrine pancreas was stimulated by either intravenous infusion of both secretion
      (0.06 CU/kg/h) and cholecystokinin octapeptide (CCK-8) (0.03 microgram/kg/h) or
      intraduodenal infusion of oleic acid (0.25 mmol/h) or casein (200 mg/h).
      Intraduodenal administration of SDZ in three different doses, 0.5, 1.0, and 2.0
      mg/kg/h, resulted in dose-related inhibition of pancreatic secretion, including
      juice volume, bicarbonate, and amylase, stimulated by exogenous secretin and CCK.
      Intraduodenal oleic acid- and casein-induced increases in pancreatic secretion in
      terms of juice volume, bicarbonate, and amylase were also significantly
      suppressed by intraduodenal administration of SDZ in a dose of 2.0 mg/kg/h.
      Moreover, SDZ (2.0 mg/kg/h) significantly inhibited basal pancreatic secretion.
      It is concluded that the intraduodenal administration of SDZ inhibits pancreatic
      secretion stimulated by exogenous secretin and CCK-8 in physiological doses and
      by intestinal nutrients in the rat.

PMID- 8361969
TI  - Identification of enterostatin, the pancreatic procolipase activation peptide in
      the intestine of rat: effect of CCK-8 and high-fat feeding.
AB  - Enterostatin, the procolipase activation peptide, has been suggested in previous
      studies to act as a satiety signal for food intake, with a specificity for fat
      intake. In this study, by use of a competitive enzyme-linked immunosorbent assay
      with a detection limit of 4.115 nmol/L and within 6% intra- and interassay
      variation, the immunoreactive and chromatographic characterization of
      enterostatin in intestinal content was undertaken in Sprague-Dawley rats.
      Following intravenous infusion of cholecystokinin octapeptide (CCK-8; 200
      pmol/kg/h) for 60 min, the concentration of intestinal enterostatin increased
      from a basal level of 2.0 +/- 0.7 microM to 5.64 +/- 1.1 microM at time point 60
      min. The enterostatin level remained at 4.24 +/- 0.54 microM for 120 min after
      the CCK infusion had ceased. Pancreatic lipase and colipase activities in rat
      intestinal content also increased during the CCK-8 infusion. The enzyme
      activities reached the maximal level after 30 min of CCK infusion and thereafter
      progressively decreased to basal levels, remaining there during the following 2
      h. The basal level of intestinal enterostatin in rats fed with standard pellets
      was found to be increased from 1.42 +/- 0.14 to 3.86 +/- 0.4, 3.17 +/- 0.54, and
      5.02 +/- 1.6 microM on days 1, 3, and 7, respectively, after high-fat feeding.
      Parallel to the increase in intestinal enterostatin, there was a significant
      increase in pancreatic lipase and colipase activities in the intestine during the
      ingestion period of high-fat diet as compared with the control group. The
      estimated molecular mass of enterostatin immunoreactivity of intestinal content
      was similar to that of the synthetic pentapeptide. These results suggest that
      immunoreactive enterostatin (Val-Pro-Gly-Pro-Arg) is normally present in rat
      intestinal content, is significantly increased after stimulation with CCK-8, and
      is also increased after prolonged high-fat feeding.

PMID- 8361970
TI  - Pancreatic cancer presenting with resolving pseudocyst during octreotide therapy.
AB  - Pancreatic cancer presenting as acute pancreatitis is relatively uncommon.
      Pancreatic cancer should be included in the differential diagnosis of
      "idiopathic" acute pancreatitis, particularly in the elderly. The following case
      report describes a patient in whom pancreatic cancer presented as acute
      pancreatitis with pseudocyst formation and subsequent resolution with octreotide
      therapy. Various implications of this case are reviewed.

PMID- 8361971
TI  - Methods to facilitate early exploratory testing of novel psychopharmacologic
      agents in humans.

PMID- 8361972
TI  - Diagnostic heterogeneity in relation to drug evaluation: antidepressants.

PMID- 8361973
TI  - Serotonin receptor subtypes.

PMID- 8361974
TI  - Dose-effect relationships for tricyclic antidepressants: the basis for rational
      clinical testing of new antidepressants.

PMID- 8361975
TI  - Dose-effect and concentration-effect relationships with new antidepressants.

PMID- 8361976
TI  - Therapeutic potentials of recently introduced antidepressants. Danish University
      Antidepressant Group.
AB  - The DUAG studies showed that in well-designed and rigorously executed multisite
      drug trials three representatives (citalopram, paroxetine, and moclobemide) from
      two classes of recent antidepressant drugs were less effective than the standard
      reference drug, clomipramine. The most important reasons for the superiority of
      clomipramine was probably that clomipramine was given in a high and fixed dose of
      150 mg per day throughout the entire treatment period and that patient compliance
      was ensured through drug monitoring. When the DUAG studies are compared with "no
      difference" studies, the difference between DUAG and others lies not so much in a
      different efficacy of the test drugs but in the efficacy of the reference drugs,
      where clomipramine in the DUAG studies was more effective than reference
      tricyclics in most other studies with flexible dose regimens. A relatively high
      rate of adverse drug reactions with clomipramine administered in high and fixed
      doses was probably due to a considerable interindividual variability in the
      pharmacokinetic properties. (Gram 1990), and the development of side effects may
      be predicted and prevented when better knowledge of plasma concentration and dose
      response relations for classical tricyclic antidepressants allow individual dose
      adjustments. Such studies are under way with in the DUAG. The results of such
      studies may reduce the need for new antidepressants which, although less toxic
      than the classical tricyclics, may prove to be also less potent. The DUAG studies
      were performed in hospitalized, moderately to severely, endogeneously depressed
      adult patients and conclusions from the DUAG studies about the superiority of
      clomipramine over three recent antidepressants cannot readily be generalized to
      cover less homogeneous groups of outpatients with milder depression.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8361977
TI  - Role of genetic polymorphism in psychopharmacology--an update.

PMID- 8361978
TI  - Phenotypes for psychotropic drug metabolism in the elderly.

PMID- 8361979
TI  - Analysis of 935 haloperidol concentration measurements obtained during routine
      drug monitoring of 134 patients.

PMID- 8361980
TI  - Developmental regulation of 5-HT2 and 5-HT1c receptor gene expression in rat
      brain.

PMID- 8361981
TI  - Relevance of 5-HT autoreceptors for psychotropic drug action.

PMID- 8361983
TI  - Monthly prostaglandin bibliography prepared by Sheffield University Biomedical
      Information Service.

PMID- 8361982
TI  - Brain serotonin subsystem complexity and receptor heterogeneity: therapeutic
      potential of selective serotonin agonists and antagonists.

PMID- 8361984
TI  - The lupus anticoagulant and eicosanoids.

PMID- 8361985
TI  - Effect of chronic ethanol consumption on the spontaneous contractions,
      prostaglandin production, triglycerides and glucose metabolism of uterine strips
      isolated from pregnant rats and in embryos.
AB  - The constancy of spontaneous isometric developed tension (IDT) and the metabolism
      of triglycerides (TGs), U-14C-Glucose and 14C-arachidonic acid (14C-AA) in
      uterine strips isolated from controls and from chronic ethanol (ETOH) fed
      pregnant rats were explored. The studies were performed on isolated uterine
      strips suspended in glucose-containing as well as a glucose-free medium. The
      spontaneous decrement of IDT as time progressed after tissue isolation and
      mounting was significantly higher in tissue preparations obtained from pregnant
      rats drinking 20% ETOH, than the controls. This situation was evident in uterine
      strips isolated from rats at 10 and at 16 days of pregnancy, both in solutions
      containing glucose or in glucose-free conditions. On the other hand, uterine
      strips isolated from control rats at 7, 10 and 16 days of pregnancy exhibited
      almost no decrement of IDT after 60 min of activity in a solution containing
      glucose or in a glucose-free medium. The absolute values of TGs in uteri obtained
      from rats drinking ETOH were significantly greater (p < 0.001) than in non
      drinking controls. TG levels did not differ at 0 min (initial or postisolation)
      to those at 60 min in control uterine preparations obtained from pregnant rats at
      7, 10 or 16 days of pregnancy and incubated either in a medium with or without
      glucose. On the contrary, in strips from ETOH-fed animals isolated on the same
      day of pregnancy, TG levels determined at 60 min following isolation and mounting
      were significantly lower, when glucose was present or absent from the suspending
      solution.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361986
TI  - Tiaprofenic acid inhibits the renal reabsorption of sulfate in rats.
AB  - The objectives of the current investigation were: (1) to examine the effects of
      the nonsteroidal anti-inflammatory drug, tiaprofenic acid (TA), on sulfate renal
      reabsorption, and (2) to determine if concomitant prostaglandin E2 (PGE2) could
      reverse these effects. In crossover studies, female Lewis rats (n = 9) received
      either TA (as an intravenous (i.v.) bolus injection of 15 mg/kg and constant
      infusion of 0.02 mg/min) or its vehicle for 6 h. A blood sample was obtained at 5
      h and urine was collected between 4 and 6 h. At a steady-state TA serum
      concentration of approximately 190 micrograms/ml, the PGE2 urinary excretion rate
      was inhibited by > 90% with no change in glomerular filtration rate (GFR), as
      measured by creatinine clearance. TA administration resulted in a significant
      decrease in serum sulfate concentrations (0.65 +/- 0.22 vs 1.1 +/- 0.15 mM, mean
      +/- SD, p < 0.01) and increase in sulfate clearance ratio (0.32 +/- 0.14 vs 0.13
      +/- 0.06, p < 0.01) when compared to the vehicle-treated period. There was also a
      significant decrease in the fraction of sulfate reabsorbed by the kidneys (0.68
      +/- 0.14 vs 0.87 +/- 0.06 in the vehicle-treated period, p < 0.01). In a second
      crossover study, rats received either TA or TA plus PGE2. PGE2 was administered
      as an infusion (0.1 micrograms/min) beginning 210 min after the start of the TA
      infusion. An additional group of rats served as controls and received both
      vehicles.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8361987
TI  - The effect of regular and enteric-coated aspirin on bleeding time, thromboxane,
      and prostacyclin.
AB  - We compared the effect of different aspirin schedules, dosages, and formulations
      on various bleeding time parameters including bleeding time, plasma and total
      blood volume, and levels of the stable metabolites of thromboxane A2 (TXA2) and
      prostacyclin (PGI2) (respectively, TXB2 and 6-keto-prostaglandin F1 alpha (6-keto
      PGF1 alpha)) to determine the optimal dosage and formulation of aspirin to
      inhibit TXA2 production while sparing PGI2. In a randomized, parallel study, 52
      healthy male volunteers (62 independent observations) with no history of bleeding
      disorders were given 80 mg or 325 mg of regular aspirin, or 325 mg of enteric
      coated aspirin to ingest daily (14 pills) or every other day (7 pills) for a
      continuous 14 day period. Bleeding times were performed on day 1 before aspirin,
      6 h after aspirin on day 1, and before aspirin on day 14. Bleeding times, plasma
      volume, and total volume increased significantly from before aspirin to after 6 h
      and 14 days (p < 0.0001 for all parameters) for all aspirin formulations. For day
      1 before aspirin ingestion to 6 h later, both TX and PGI2 (p < 0.008) decreased
      significantly. 6 h after ingestion of aspirin on day 1 to day 14, both TX and
      PGI2 levels also significantly decreased (p < 0.0001). There was a highly
      significant decrease in PGI2 production on every other day aspirin schedules (p =
      0.0001) particularly with 80 mg of aspirin, while the decrease in PGI2 production
      on daily aspirin was not significant (p = 0.10). The most favourable ratio of 6
      keto-PGF1 alpha to TXB2 occurred with 80 mg daily.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8361988
TI  - Increased thromboxane A2 production at primary tumor site in metastasizing
      squamous cell carcinoma of the larynx.
AB  - In order to evaluate the possible role of prostaglandins (PG) in invasion and
      metastasis of malignant cells in larynx carcinoma, arachidonic acid (AA)
      metabolite production by tumor tissue, peritumor tissue and node metastasis was
      investigated in comparison to that by healthy mucosa and unaffected lymph nodes.
      The study was performed by evaluating PGE2, 6ketoPGF1 alpha and thromboxane B2
      (TXB2) production by radioimmunoassay in specimens from eight patients who
      underwent surgical treatment. The highest rate of AA metabolism was observed in
      peritumor tissue. PGE2 was the main metabolite produced in all tissues and its
      levels were significantly higher than those of 6ketoPGF1 alpha and TXB2 (p <
      0.05). 6ketoPGF1 alpha production was higher (p < 0.01) than that of TXB2 and did
      not significantly change among the different tissues. TXB2 production was
      significantly increased (p < 0.05) by peritumor tissue as compared to healthy
      mucosa. The ratio between TXB2 and 6ketoPGF1 alpha production was found to be
      almost twofold higher in tumor tissue, peritumor tissue, metastatic and non
      metastatic lymph nodes as compared to control tissue. The lowest AA metabolism
      was found in affected lymph nodes. These findings demonstrate a different AA
      metabolism at primary tumor sites in comparison to healthy mucosa suggesting a
      prometastatic role of TXB2 and supporting the hypothesis of the occurrence of an
      imbalance between TXB2 and 6ketoPGF1 alpha production in favouring metastatic
      spread.

PMID- 8361989
TI  - Interaction between vitamin B6 deficiency and low EFA dietary intake on kidney
      phospholipids and PGE2 in the rat.
AB  - Vitamin B6 is involved in the metabolism of long chain polyunsaturated fatty
      acids and phospholipids. We have studied the interaction between pyridoxine
      deficiency and low amounts of dietary essential fatty acids (EFA) in the rat. The
      fatty acid composition of kidney phospholipids of pyridoxine deficient animals
      shows a decrease of 20:3 n9 and an increase of 20:4 n6 in comparison with control
      and pair fed animals. This variation of fatty acid composition could be due to
      the simultaneous effect of vitamin B6 deficiency, which reduces the oxidation of
      linolenate, and of a low intake of EFAs which stimulates delta-6-desaturase. The
      dietary treatment also influences kidney Prostaglandin E2 (PGE2) levels which are
      higher in vitamin B6 deficient animals. This effect could be correlated with a
      higher response to sympathetic stimulation caused by the simultaneous presence of
      vitamin B6 deficiency and low EFA availability. Also the higher level of
      arachidonate could be involved in promoting PGE2 synthesis.

PMID- 8361990
TI  - Metabolic polymorphisms.
AB  - Polymorphisms have been detected in a variety of xenobiotic-metabolizing enzymes
      at both the phenotypic and genotypic level. In the case of four enzymes, the
      cytochrome P450 CYP2D6, glutathione S-transferase mu, N-acetyltransferase 2 and
      serum cholinesterase, the majority of mutations which give rise to a defective
      phenotype have now been identified. Another group of enzymes show definite
      polymorphism at the phenotypic level but the exact genetic mechanisms responsible
      are not yet clear. These enzymes include the cytochromes P450 CYP1A1, CYP1A2 and
      a CYP2C form which metabolizes mephenytoin, a flavin-linked monooxygenase (fish
      odour syndrome), paraoxonase, UDP-glucuronosyltransferase (Gilbert's syndrome)
      and thiopurine S-methyltransferase. In the case of a further group of enzymes,
      there is some evidence for polymorphism at either the phenotypic or genotypic
      level but this has not been unambiguously demonstrated. Examples of this class
      include the cytochrome P450 enzymes CYP2A6, CYP2E1, CYP2C9 and CYP3A4, xanthine
      oxidase, an S-oxidase which metabolizes carbocysteine, epoxide hydrolase, two
      forms of sulphotransferase and several methyltransferases. The nature of all
      these polymorphisms and possible polymorphisms is discussed in detail, with
      particular reference to the effects of this variation on drug metabolism and
      susceptibility to chemically-induced diseases.

PMID- 8361991
TI  - The role of phosphodiesterase inhibitors in heart failure.
AB  - Myocardial contractility is dependent on available intracellular calcium and this
      can be enhanced by increasing intracellular cyclic adenosine monophosphate. One
      way of achieving this is by inhibiting the phosphodiesterase III enzyme. Over the
      last 15 years, a number of new drugs with this mechanism of action have been
      studied in man and have been found not only to have a positive inotropic action
      on the heart but also a vasodilating action on peripheral blood vessels. This
      combination of effects produces favourable haemodynamic improvement in patients
      with chronic heart failure. While some smaller studies showed that this did
      translate into an improvement in symptoms and functional capacity, a large well
      designed and controlled clinical trial showed that survival was decreased when
      milrinone was used in target daily doses of 40 mg. For this reason, chronic long
      term oral therapy with phosphodiesterase III inhibitors is not currently being
      actively pursued. They may still have a role as acute short-term therapy in
      severely ill patients who do not respond adequately to optimal standard drug
      therapy. Milrinone has been one of the most widely studied drugs in this regard.
      Even during short-term administration, its use should be closely monitored for
      any evidence of an increase in ventricular arrhythmias or decrease in ventricular
      function.

PMID- 8361992
TI  - Neuronal control of airways smooth muscle.
AB  - Sensory afferent nerves relay impulses from the airways to the central nervous
      system so that appropriate changes in bronchomotor tone and breathing patterns
      may occur. The dominant efferent control of airways smooth muscle is exerted via
      bronchoconstrictor parasympathetic cholinergic nerves. In some species this is
      opposed by bronchodilator sympathetic noradrenergic nerves. In addition, there
      exist both excitatory bronchoconstrictor and inhibitory bronchodilator non
      adrenergic, non-cholinergic pathways. This review examines the role of the
      different branches of the autonomic nervous system in the control of airways
      smooth muscle tone with particular reference to modulation of these branches and
      the interactions which may exist between them.

PMID- 8361993
TI  - Chloroquine: mechanism of drug action and resistance in Plasmodium falciparum.
AB  - Quinoline-containing drugs such as chloroquine and quinine have had a long and
      successful history in antimalarial chemotherapy. Although these drugs are known
      to accumulate by a weak base mechanism in the acidic food vacuoles of
      intraerythrocytic trophozoites and thereby prevent hemoglobin degradation from
      occurring in that organelle, the mechanism by which their selective toxicity for
      lysosomes of malaria trophozoites is achieved has been subject to much discussion
      and argument. In this review the recent discovery that chloroquine and related
      quinolines inhibit the novel heme polymerase enzyme that is also present in the
      trophozoite food vacuole is introduced. The proposal that this inhibition of heme
      polymerase can explain the specific toxicity of these drugs for the
      intraerythrocytic malaria parasite is then developed by showing that it is
      consistent with much of the disparate information currently available. The
      clinical usefulness of chloroquine, and in some recent cases of quinine as well,
      has been much reduced by the evolution and spread of chloroquine resistant
      malaria parasites. The mechanism of resistance involves a reduced accumulation of
      the drug, although again the mechanism involved is controversial. Possible
      explanations include an energy-dependent efflux of preaccumulated drug via an
      unidentified transmembrane protein pump, or an increase in vacuolar pH such that
      the proton gradient responsible for drug concentration is reduced. New data are
      also presented which show that heme polymerase isolated from chloroquine
      resistant trophozoites retains full sensitivity to drug inhibition, consistent
      with the observation that resistance involves a reduced accumulation of the drug
      at the (still vulnerable) target site. The significance of this result is
      discussed in relation to developing new strategies to overcome the problem
      presented by chloroquine resistant malaria parasites.

PMID- 8361994
TI  - P450 enzymes of estrogen metabolism.
AB  - Endogenous and exogenous estrogens undergo extensive oxidative metabolism by
      specific cytochrome P450 enzymes. Certain drugs and xenobiotics have been found
      to be potent inducers of estrogen hydroxylating enzymes with C-2 hydroxylase
      induction being greater than that of C-16 hydroxylase. Oxygenated estrogen
      metabolites have different biological activities, with C-2 metabolites having
      limited or no activity and C-4 and C-16 metabolites having similar potency to
      estradiol. Pathophysiological roles for some of the oxygenated estrogen
      metabolites have been proposed, e.g. 16 alpha-hydroxyestrone and 4
      hydroxyestrone. These reactive estrogens are capable of damaging cellular
      proteins and DNA and may be carcinogenic in specific cells.

PMID- 8361996
TI  - Cyclosporin metabolism in transplant patients.
AB  - The immunosuppressant cyclosporin, a cyclic undecapeptide, is metabolized to more
      than 30 metabolites. Cytochrome P450IIIA enzymes located in liver and small
      intestine are responsible for the biotransformation of cyclosporin and its
      metabolites and are the site of several drug interactions. It is still under
      discussion, whether the cyclosporin metabolites are involved in the
      immunosuppressive and/or toxic activities of cyclosporin. While isolated
      metabolites show not more than 10-20% of the activity of the mother compound in
      vitro, metabolite combinations have additive and synergistic effects. Isolated
      metabolites show no toxic effects in rat models while there is an association
      between metabolite blood concentrations and cyclosporin toxicity in several
      clinical studies. Possible mechanisms for the toxic effect of cyclosporin
      metabolites are covalent binding to macromolecules in liver and kidney,
      alteration of the cytochrome P450 pattern in liver and kidney, increased
      endothelin production in the kidney and synergistic effects of cyclosporin
      combinations on mesangial cells. Liver dysfunction leads to an alteration of the
      metabolite patterns and to increased concentrations of cyclosporin metabolites in
      blood. In conclusion there is evidence that cyclosporin metabolites may
      contribute to cyclosporin toxicity and high metabolite blood concentrations in
      patients should not be tolerated.

PMID- 8361995
TI  - Human high molecular weight-melanoma associated antigen mimicry by mouse anti
      idiotypic monoclonal antibodies MK2-23. Experimental studies and clinical trials
      in patients with malignant melanoma.
AB  - Following a description of the characteristics of the human high molecular weight
      melanoma associated antigen (HMW-MAA), the rationale to use anti-idiotypic (anti
      id) monoclonal antibodies (mAb) as immunogens to implement active specific
      immunotherapy in patients with malignant diseases is discussed. Among the anti-id
      mAb developed in this laboratory the mAb MK2-23, which had been elicited with the
      syngeneic anti-HMW-MAA mAb 763.74, has been shown with serological and
      immunochemical assays to bear the mirror image of the determinant recognized by
      mAb 763.74 on HMW-MAA. The anti-id mAb elicited humoral anti-HMW-MAA immunity in
      about 60% of patients with malignant melanoma. The immunogenicity of mAb MK2-23
      is markedly enhanced by conjugation to a carrier and administration with an
      adjuvant, but is not affected by the administration of low doses of
      cyclophosphamide. Development of anti-HMW-MAA immunity in patients with malignant
      melanoma is associated with survival prolongation. These results in conjunction
      with the lack of major side effects in spite of repeated administrations of mAb
      MK2-23 suggest that active specific immunotherapy with mAb MK2-23 represents a
      useful therapeutic approach to malignant melanoma.

PMID- 8361997
TI  - Postmenopausal hot flushes and their management.
AB  - Hot flushes are frequently incapacitating to the patient and the severe vasomotor
      disturbances may seriously impair normal daily life. This review attempts to
      provide an understanding of the pathophysiology of the hot flush as a basis for
      rationale therapy for each individual patient. The physiological mechanisms
      controlling body temperature are discussed briefly, and the changes in the system
      which precipitate the menopausal hot flush are detailed. The neuroendocrine
      events leading to the onset of the flushing syndrome are then considered.
      Finally, the therapeutic strategies which may be used in the management of the
      affected patient are discussed.

PMID- 8361998
TI  - Cerebral vasoconstrictor mediators.
AB  - Endogenous cerebral vasoconstrictor mediators regulate vascular resistance and
      blood flow in the brain as a whole and in various regions and participate in the
      pathogenesis of cerebral circulatory disturbances. Vasoconstrictors are effective
      in the treatment of diseases associated with cerebral vasodilatation. There are
      variations in the response of cerebral arteries from primate and subprimate
      mammals; therefore, information as to similarities and differences in their
      response is quite important in evaluating the physiological role, involvement in
      pathogenesis and therapeutic usefulness of the mediators in healthy men and
      patients. In this review we described characteristics of the action of
      vasoconstrictors (amines, peptides, prostanoids, and others) on isolated cerebral
      arteries from mammals, including humans and monkeys.

PMID- 8361999
TI  - Cerebral circulation during diabetes mellitus.
AB  - Diabetes mellitus is characterized by hyperglycemia, a decrease in circulating
      insulin and the development of macro- and microvascular pathology. Hyperglycemia
      appears to be a primary determinant for the structural, biochemical and
      functional changes that occur in large and small blood vessels during diabetes
      mellitus. While much research has focused on the effects of diabetes mellitus on
      the peripheral circulation, it is clear that diabetes mellitus also has profound
      effects on the cerebral circulation. Thus, the focus of this review is to discuss
      morphological and functional alterations in the cerebral circulation during
      diabetes mellitus.

PMID- 8362000
TI  - [The "rete venosum plantare" (the plantar venous network or Lejars' venous sole
      of the foot)].
AB  - Looking at the bibliography of the venous sole of the foot (Lejars), the authors
      point out the opposite convictions concerning this structure. For some ones, it
      doesn't exist, but fort the others, it is a very important network of tiny veins,
      such as it was described by Lejars himself. However, all this studies, are made
      upon cadavers, injected or not, and must be compared with results from living
      people by the mean of angiography, non invasive Vascular Assessment, or RMN,
      which take in account vasomotricity.

PMID- 8362001
TI  - [Lejars' sole. "A minimal network which secretes more saliva and ink than
      blood"].

PMID- 8362002
TI  - [The superficial veins of the sole of the foot].

PMID- 8362003
TI  - [The muscular pump of the foot: physiological and clinical importance].

PMID- 8362004
TI  - [Phylogeny, verticalis and venous return in man. Various personal experimental
      Doppler ultrasound aspects].

PMID- 8362005
TI  - [The epidemiology and socio-economics of venous diseases in Germany].
AB  - The author reports the conclusions of a multicentre investigation lead in
      Germany. According to this study, varicose veins are more frequent in women than
      in men, either in ordinary population or in in-patients. Adults are not
      exclusively the only ones who suffer from varicose veins; children often suffer
      from them too. People suffer equally from phlebitis or post phlebitis syndromes.
      Moreover, heredity and obesity tend to favour this tendency. Thus, the socio
      economic impact is so important that the cost of treatment, hospitalization and
      the social cost of sick-leave must be taken into consideration. So, it is
      necessary for the Authorities to prevent venous diseases and be aware of the
      importance of phlebology.

PMID- 8362006
TI  - [Evaluation of an reference anatomo-clinical classification of varices of the
      lower limbs].
AB  - In order to set up a common and objective language for everyone, the authors have
      laid the foundation of anatomoclinical classification which can be used as a
      reference in the study of varicose veins in lower limbs. They are comparing a
      group of patients with varicose veins to a control group of healthy patients. The
      groups are classified in four stages according to the importance of the varicose
      pathology and the histological characteristics. The conclusion is the following:
      there is no parallelism between these four clinical stages and the histological
      characteristics. According to the authors, it is necessary to make a distinction
      between fibrous reaction veins and muscular wall veins. This phenomenon is
      reported to have particular therapeutic implications in the prescription of
      substances of exciting venous tonicity.

PMID- 8362007
TI  - [The development of pre- and post-natal veins].
AB  - Superficial and deep veins have different evolutions, structures and functions.
      Phylogenetically, superficial veins of limbs appear before the deep ones. In
      mammals other than man, both anatomical and histological abnormalities of
      superficial and deep veins have been noticed. In phlebology, the date of the
      first appearance of these veins was examined, from the infantile age to the age
      of 60 in 2,259 patients. Incomplete truncal varicose veins or an excess of
      certain perforating veins were found in 13.9% cases among children of school age.
      In 71.0% cases, these defects had a hereditary origin.

PMID- 8362008
TI  - [Instrumental research of the functional character of the skin adnexa and
      microcirculation during chronic venous insufficiency].
AB  - We have led a microcirculatory and functional research of skin adnexa over 3
      groups of 20 people each, who were affected with IVC at different grades and we
      have compared them to another group of 20 normal people. The microcirculatory
      researches (laser-Doppler, skin oximetry and thermometry) and functional ones of
      skin adnexa (sebometry and skin hydration) allowed us to get a nonunivocal
      behaviour between normal subjects and phlebopathies of I degree. For this reason,
      it is possible to consider these exams as screenings tests to determine the
      starting phases of phlebopathy, failing any skin marks. The reduced fluximetrical
      response taken by laser Doppler after postural variation and the reduction of
      hydration degree have been considered particularly significant.

PMID- 8362009
TI  - [Osteoporosis in phlebology].
AB  - Patient often think that the pains of their extremities (especially during the
      night) are caused by a plebo or an angiopathy whereas they are in fact due to a
      vertebral or lumbar discal affection. 84 patients with osteoporosis were treated
      by an intramuscular injection of deca-durabolin (25 mg/month) and calcium
      phosphate (tertiare). Results were satisfactory: six months later, 62 patients no
      longer suffered, 13 had felt improvement and 2 remained unchanged.

PMID- 8362010
TI  - [Phlebology and podiatry].
AB  - By their tensing and relaxation, the muscles of the leg are thought to be
      responsible for compressing and relaxing the vascular walls and the lumen of
      vessels. In order to study the way the muscle structure of the lower limb (in
      particular the leg and the foot) functions, it is necessary to understand the
      step and break down its components. The weight of the body is transmitted to the
      ground by the astralagus which distributes the different forces throughout the
      fives systems of ossei trabeculae of the astralagus and the heel. The valgus heel
      determines a continuous traction on the tendon and the hind leg muscle which
      determines with time a dragging of the foot. When the body goes forward, the
      weight levels the transverse fore arch. The flexor muscles of the toes bend the
      phalanxes, gripping them to the ground, they avoid the falling forward of the
      body with the proximal insertion on the tibia. The sesamoids increase the muscles
      power as well as that of the kneecap on the quadriceps. The internal curvature of
      the foot on the ground is furthered by the decreasing length of the metatarsal
      bones. This is counterbalanced by the long fibular muscle which lowers the medial
      axis and raises the external axis. The supination of the forefoot depends only in
      part on the varus valgus of the rear of the foot. The plantar aponeurosis and the
      flexor tendons have an impact on the metatarsi because they increase the power
      and bring the insert closer. The complex articular system of the feet depends on
      the extrinsic and intrinsic muscle structure which, at the same time as a
      position variation can also play an important part in the venous alteration.

PMID- 8362011
TI  - [The muscular pump of the calf. Video-phlebography and simultaneous EMG].
AB  - Gastrocnemical insufficiency is a common syndrome (in modern society mainly
      affecting young females who have been taking the pill for several years). Often
      it is the starting point for superficial varicosis. The clinical diagnosis is
      easy, provided the doctor is informed of its symptoms. Phlebography or Duplex
      scan are compulsory, deciding surgical treatment. Varicose muscular veins have
      two different causes: avalvulation at the popliteal vein or compression by the
      Post. Tib. nerve. Persistent pain, deterioration of the superficial network or
      neuromyositis are the main reasons for deciding upon surgical treatment. The
      results are gratifying and lasting.

PMID- 8362012
TI  - [Loco-regional thrombolysis in deep venous thrombosis].
AB  - Anticoagulation, by means of heparin and warfarin is, till now, the most common
      treatment in deep venous thrombosis. Although thrombolytic agents have been
      available for over 10 years, their use remains quite low, ranging from 15 to 20%
      of deep venous thromboses. This is due to the relatively high incidence of
      contraindications as well as to the fact that the potential advantages versus
      heparin are diminished by the increased bleeding risk and by the potential risk
      of pulmonary embolism (migration of partially lysed thrombi). Following the
      example of the "triple armed therapy" proposed by Rosenthal for the treatment of
      pulmonary embolism, we will evaluate if loco-regional thrombolysis, with the
      catheter wedged against the thrombus, associated with a temporary vena cava
      interruption by means of an intraluminal filter, can achieve a better lysis of
      the thrombus without pulmonary embolism. In our Unit 18 patients affected by
      proximal deep venous thrombosis were submitted to thrombolytic therapy, 6 to
      systemic treatment, 3 to local treatment and the last 9 to loco-regional
      thrombolysis, using recombinant tissue-type Plasminogen Activator. We obtained 10
      complete lyses, 1 with systemic and 9 with loco-regional treatment. There were no
      major complications. Thus, we think that venous loco-regional thrombolysis with
      rt-PA at lower doses, associated with temporary caval interruption, can probably
      achieve a better lysis than systemic treatment without risk of pulmonary embolism
      and with a very low haemorrhagic risk, as in arterial loco-regional thrombolysis.
      Furthermore, loco-regional thrombolysis, by means of a faster thrombus
      dissolution, could better prevent post-phlebitic syndrome.

PMID- 8362013
TI  - [Venous insufficiency and varicose disease. Sequelae of lower limb thrombosis.
      The role of crenotherapy].
AB  - The writers reminded that a consensus on Classification of veinous diseases,
      necessary to build up homogeneous samples, was being set up. Now, they are
      introducing a thermal nosology that is as useful. Next, the history of spas, the
      characteristics of Thermal Springs and thermal practices as well as their results
      are described. The writers present a standardization of the observation and
      control parameters of the therapeutic effects. The rigorous and scientific
      process was defined by an interdisciplinary scientific process was defined by an
      interdisciplinary scientific Council and it is based on the creation of a
      Computerized Laboratory of Research and a Thermal University. It has become an
      example in the field of thermalism. According to the results and the modern
      indications, the water cure has to be prescribed at an early stage. The
      practitioner must think about it and insert the water cure in the arsenal of
      veinous diseases. According to the hydrogeologists' estimates, BARBOTAN les
      thermes, the first European spa with about 22,000 patients is thought to possess
      enough water to allow from 40,000 to 60,000 people to be treated yearly. A
      thermal environment is the ideal place for an efficient vascular rehabilitation
      and functional re-education. In phlebology, more than one million people should
      benefit from a water cure yearly ... Only 70,000 follow this treatment. Everyone
      has to wonder about this situation, which, to those who do not benefit from a
      thermal cure in phlebology, is as astonishing as prejudicial.

PMID- 8362015
TI  - [Childhood difficulties: representations by the family and caregivers; value of
      interviews].
AB  - This investigation was conducted in 7 consultation centers in child psychiatry of
      the Lyon region (France). The aim was to evaluate the influence of the care
      professional's response to the demands of the consulting party, on the evolution
      of the child. The investigation is based on what is said about the difficulties
      of the child, as manifested in the way care professionals, parents and children
      perceive them. Relevant instruments and a reliable methodology are used in
      assessing these various parameters. Results indicate that what happens in the
      first interview might be more important than the effective type of intervention
      in determining the evolution of the subsequent intervention.

PMID- 8362014
TI  - [Veno-lymphatic insufficiency. 4,729 patients undergoing hormonal and procyanidol
      oligomer therapy].

PMID- 8362016
TI  - [Interactions of infants with adults in day care centers. Evolutive dependencies
      vs. counter-evolutive risks and characteristics of the mother-infant
      relationship].
AB  - As part of a broader research project on the construction of the self, six
      infants were observed longitudinally in day-care centers between the ages of five
      months and three years. Interviews were conducted with the six mothers in order
      to evaluate the intersubjective characteristics of the mother-infant
      relationship. For three of the six children, the mother was a caregiver in the
      center. This article deals with "propping" processes, defined as the affective
      cognitive transformations by means of which infants develop networks of links
      with and between external and internal objects which are used for support during
      development and serve as a relay of the maternal object. The present analysis is
      limited to propping on the adults in the day-care center (caregivers, observer,
      and, for three of the children, mothers). Two factors were considered: the
      intersubjective quality of the mother-infant relation, and the presence or
      absence of the mother as a caregiver in the day-care center. The results showed
      that (1) even when very young, the infants under observation differentiated
      between the various functions of the adults, and adapted their behavior to them;
      (2) each child exhibited a unique and sometimes very creative way of using
      dependencies on an adult's psychic apparatus to construct his or her own modes of
      psychic functioning; and (3) the developmental dynamics and the richness of the
      observed transformations were found to depend on the quality of the contact and
      distancing in the mother-infant relationship and on the concrete conditions for
      its actualization, which can either promote or hinder, and sometimes even block,
      the construction of the mother's absence.

PMID- 8362017
TI  - [Characteristics and functions of friendship in adolescence].
AB  - This article reviews recent studies which have examined various aspects of
      friendship relations in adolescence. Friendship relations are of central
      importance in the social life of adolescents because they assume a crucial role
      in certain developmental functions: emancipation from parental guardianship,
      commencement of heterosexual relations and affirmation of one's identity. This
      article reports on various aspects of friendships in adolescence: number of
      friends, places of recruitment, frequency of meetings, and common themes of
      conversations. Friendship relations are relatively conflict free in adolescence.
      They can be characterised by three main elements: trust, communication and
      intimacy. Friendships evolve in adolescence from a common interest in activities
      to a sharing of opinions, emotions and feelings. At all ages, girls value the
      elements of friendship more than boys. In the last ten years research has
      demonstrated that there is a correlation between adolescent friendship, coping
      mechanisms, and the acquisition of social skills. The quality of friendship
      relations and particularly the ability to communicate personal worries predicts
      this correlation better than the number of friends. The research in the field of
      friends versus parent influence has abused the concept of peer pressure in
      committing delinquent crimes. Indeed there is a great deal of agreement between
      parents and friends in terms of moral values and academic and vocational
      aspirations. The influence of friends predominates only when there are severe
      conflicts between parents and their children.

PMID- 8362018
TI  - [Malaise in teachers].
AB  - A lot is said about present days sense of disarray in teachers. How real is the
      fact? How come the debate on education is so passionate? Why such
      shortsightedness in society's vision of its educational system? There truly is
      happiness in teaching, and this happiness can evolve out of the worst hardships.
      Nevertheless that happiness is fragile. It is threatened by situational factors
      and some may be tempted to adopt identity assertive behaviors. Moreover,
      achieving that happiness might be costly to the individual: situations area often
      hard on the narcissism, and frequently provoke deceptions proportionate to the
      moments of complicity shared with the children and adolescents, who reflect
      passing illusions of what teachers themselves were.

PMID- 8362019
TI  - [Post-partum blues: a critical review of the literature].
AB  - The abundant literature dealing with the post partum blues has failed to describe
      a possible causing factor in these emotional and physical manifestations which
      are frequently observed in mothers during the first few days following delivery.
      The post partum blues has been considered as a promising model for depressive
      states but its function has never been clearly established. No agreement has been
      reached as to its physiological mechanism. Presently there is a renewed interest
      for the "third day blues" in relation to post-birth depression, which is known to
      be frequent, and to the early interactions. The authors present a review of the
      literature and emphasize the necessity to approach this issue from a new
      standpoint and with new conceptual and measurement tools. The role of post partum
      blues could well be, through a biological process involving the dopamine, to
      facilitate the establishment of early mother-infant bonds by provoking a decrease
      in blunted affect.

PMID- 8362020
TI  - [Cognitive disorders and psychiatric manifestations in the fragile X syndrome.
      Autism and fragile X].
AB  - The fragile X syndrome is one of the main etiologies of mental retardation in
      human beings. Some of its specific cognitive and language disturbances are
      nowadays well known. Disturbances of behavior are frequent. They are akin to
      psychotic manifestations and are mainly described in terms of autistic syndromes.
      The question of the possible links between autism and the fragile X syndrome is
      being discussed since 1980. The authors give a synthetic and critic overview of
      the studies reporting on the frequency of co-occurrence of these syndromes and
      offer some reflexion on the true questions at stakes in the debate. They
      emphasize the determining role of future clinical research in autism in order to
      objectively contribute to the progression of knowledge in this field.

PMID- 8362022
TI  - [Dual diagnoses: addiction and other psychiatric disease. Theory, empirical
      findings and basic therapeutic considerations of a new concept].
AB  - A special group of psychiatric patients appeared during the last few years;
      patients who confront their therapists with many diagnostical and therapeutic
      problems, namely patients with dual diagnosis. These patients suffer from a
      severe psychiatric illness (such as schizophrenia) and at the same from an
      addition (e.g. an alcohol-dependency). The management for patients with dual
      diagnosis is inappropriate as well in psychiatric units as in specialized
      addition units. Today specialized units for patients with dual diagnosis are non
      existent in Switzerland. The following review presents theoretical implications,
      empirical data and therapeutic possibilities for patients with dual diagnosis.

PMID- 8362021
TI  - [New point of view on psychosis. Psychosis, death, and family].
AB  - Without denying relevance to previous postulates related to psychosis, the author
      proposes to view psychosis in the extended context of the immediate family and
      its generations. After recalling prior literature on overmortality in psychotic
      patients, on the role of psychic transmission from one generation to the other in
      the genesis of psychosis, and on the offsprings of families with psychotic
      members, the author presents the results of her own research: occurrence of
      psychosis in a family is frequently associated with the death of one or more
      children among the siblings, and with a tendency towards extinction of the family
      branch to which the psychotic subject belongs.

PMID- 8362023
TI  - [The aggressive patient--comments on the social psychology of violence].
AB  - The management of the violent patient in hospital requires highly skilled
      therapeutic staff. Prevention, restriction and therapy of aggressive behaviour
      needs adequate diagnosis and therapy of the underlying disorder, furthermore a
      well structured ward milieu. This study pays attention to maladaptive structuring
      of the therapeutic milieu, which interferes with the integration of the violent
      patient. Modernized psychiatric institutions with liberal administration tend to
      expel the troublesome, especially the violent patient, when the formal
      organization of the institution superstructure is weakened.

PMID- 8362024
TI  - [Improving the ward atmosphere on the acute psychiatric unit].
AB  - Patients and nurses assessed the social atmosphere in two psychiatric acute care
      units and their behavior was recorded before and after the observation ward and
      the residential ward were transformed into two fully functioning admission wards,
      avoiding transference of patients. Consequently, the initially high amount of
      isolated behavior decreased, social behavior and outdoor activities increased.
      For the patients, however, the stereotype of a psychiatric acute care unit does
      not change so soon because of their higher aspiration levels and their
      uncertainty about the treatment concept. As the new structures increasingly are
      filled with life, "environmental therapy" aimed at the patients' involvement
      gains a great importance.

PMID- 8362025
TI  - [Psychotherapy in the psychiatric institution--on therapy at the other pole of
      the diagnostic spectrum].
AB  - In psychiatric facilities we treat patients with severe disturbances under
      conditions which do not fulfill what are generally thought to be the necessary
      ingredients of psychotherapy. Additionally our staff tend to devalorate
      themselves by thinking that in fact they should work differently that, what they
      do, was actually not real psychotherapy. The present paper shows with concrete
      examples what is psychiatric psychotherapy, it asks what are the needs of
      severely ill patients, and concludes that this difficult work is real
      psychotherapy in the best sense of the word.

PMID- 8362026
TI  - [Psychotherapeutic ambulatory care of a psychiatric department in a general
      hospital].
AB  - This is a survey of the treatment courses provided so far during the initial
      period after the foundation of a psychotherapeutic outpatient ward of a
      Department of Psychiatry in a General Hospital. A relatively small benefit only
      is actually derived from this institution by the Department of Psychiatry: this
      benefit consisting of the fact that inpatients requiring psychotherapeutic
      treatment can be referred quickly to outpatient treatment in the
      psychotherapeutic ward. As a matter of fact, however, the outpatient ward barely
      fills the considerable gap in psychotherapeutic facilities available in the city
      of Oberhausen in Germany, whereas on the other hand adequate financial sponsoring
      has not been satisfactorily assured to date. Almost half of the referred patients
      were unsuitable for the depth psychology treatment offered by the outpatient ward
      and had therefore to be ruled out.

PMID- 8362027
TI  - [Disordered coping with illness by personal prejudices of patients with
      schizophrenic psychoses].
AB  - Negative prejudices against psychiatry and psychiatric patients are a reality
      today. But prejudices are also existent in the patients self, especially in
      schizophrenic patients, leading to adverse therapeutic reactions. Prejudices of
      the patients himself may be a hidden, unconscious problem in some cases of
      treatment resistance in rehabilitation of schizophrenic patients. Therapeutic
      strategies are discussed on the basis of case reports.

PMID- 8362028
TI  - [5 years "cognitive training" in a psychiatric district hospital--a report of
      experiences].
AB  - In a big psychiatric hospital we began 1987 to practice cognitive training with
      our patients after teaching this therapy to male and female nurses. Now we report
      how this project found its development, which overall experiences there were made
      and which corrections still have to be done.

PMID- 8362029
TI  - [Wagner von Jauregg and development of malaria therapy].
AB  - In this history of psychiatric therapy the progressive paralysis deserves special
      interest: for the first time an organic psychosis was treatable successfully by a
      procedure found by scientific methods. This article describes life and work of
      Julius Wagner, Ritter von Jauregg (1857-1940) and remembers the introduction of
      the malaria-therapy, which was developed by Wagner 75 years ago.

PMID- 8362030
TI  - Society for Psychophysiological Research. 33rd annual meeting. October 27-31,
      1993. Rottach-Egern, Germany. Abstracts.

PMID- 8362031
TI  - Anecdote beats out science-popular but unfortunate.

PMID- 8362032
TI  - Biologic problems of the light-cured composite resin.

PMID- 8362033
TI  - Single discolored tooth: an alternative treatment approach.
AB  - A single discolored tooth is often difficult to treat, but one with an
      obliterated pulp chamber and root canal presents an even greater challenge. The
      use of nightguard bleaching is offered as a simpler, alternative treatment to
      either root canal therapy or the removal of sound tooth structure for fabrication
      of a facial veneer or a complete-coverage crown.

PMID- 8362034
TI  - Extending the use of rubber dam isolation: alternative procedures. Part III.
AB  - This paper, the third of series, describes additional modified rubber dam
      utilizations that are generally not attempted with restrictive orthodox
      application methods. Part III offers practical hints and other means of retention
      with the emphasis on pedodontic applications.

PMID- 8362035
TI  - The removal of restorations and foreign objects from root canals.
AB  - A review is presented of some of the techniques available for removing
      restorations and foreign objects from root canals. Consideration is given to the
      removal of root restorations, sealers, and root canal obstructions, including
      fractured instruments and intact or broken posts and cores.

PMID- 8362036
TI  - The ideal dental photographic system.
AB  - After the limitations of dental camera systems with regard to their lens and
      their flash unit are explained, a point-ring-flash combination is presented. The
      flash was tested in practical use and by systematic test shots. The flash
      combination allows the dentist to use a point flash or a ring flash
      alternatively. Nearly all problems in dental photography can be solved by using
      this equipment.

PMID- 8362037
TI  - Geriatric prosthodontics: an overview. Part I. Pretreatment considerations.
AB  - A rising geriatric population remains dentate and requires more dental care to
      maintain dental health and function. This article discusses psychological aspects
      of aging and considerations of age-related changes of teeth, oral tissues,
      nutrition, and metabolism in the elderly. Aging affects all tissues and systems,
      as do nutritional and metabolic factors. Numerous factors alter healing, host
      resistance, digestion and absorption, mastication, metabolic competency, renal
      and hepatic function, and excretory capability. Complex drug regimens further
      confuse clear diagnoses. Full consideration must be given these factors before
      treatment plans are formulated.

PMID- 8362038
TI  - Attitudes to identification of dentures: the patients' perspective.
AB  - The importance of placing identification marks on dentures has long been
      acknowledged by the dental profession. More recently, following the fatalities at
      the Bradford City, England, football club fire, the need for marking dentures has
      been made more public. This paper outlines the different types of marking systems
      available and describes a survey on denture wearers to investigate their attitude
      toward the placement of identification marks on dentures. Results show that few
      dentures are marked at manufacture but that wearers are in favor of having their
      name on their denture. Of the 63 subjects sampled, 93.5% did not know that
      identification marks could be placed on dentures. The profession must be
      encouraged to routinely label all dentures at manufacture.

PMID- 8362039
TI  - Bond strength of dentinal adhesives in primary teeth.
AB  - The purpose of this project was to test the in vitro bond strength of three
      dentinal bonding agents to primary dentin. Scotchbond 2, All-Bond, and
      Amalgambond were applied to 63 teeth according to manufacturer's instructions.
      Valux composite resin was placed in a cylindrical matrix and light cured to the
      treated dentin. After they were thermocycled for approximately 800 cycles between
      6 degrees C and 60 degrees C, the specimens were mounted in stone and placed in
      an Instron universal testing machine. They were placed under continuous load
      until failure. Fracture was at the dentin-bonding agent interface for all
      materials tested. Incisor bond strength was significantly stronger than molar
      bond strength for all three materials. Materials analysis revealed that the mean
      bond strength for Scotchbond 2 (6.99 MPa) was significantly different from those
      of All-Bond (13.01 MPa) and Amalgambond (13.03 MPa).

PMID- 8362040
TI  - Trismus appliances and indications for use.
AB  - Trismus is a condition that impairs eating, interferes with oral hygiene,
      restricts access for dental procedures, and may adversely affect speech and
      facial appearance. The success of treatment depends on recognition of the cause
      and initiation of appropriate management. Ideally, trismus appliances are used in
      conjunction with physical therapy and are most effective when the condition is
      the result of muscle fibrosis or scar tissue that has not yet matured. Trismus
      appliances act either externally or internally, and the forces they impart can be
      continuous or intermittent, light or heavy, and elastic or inelastic. Six
      appliances have been described in the literature. A seventh appliance, a plastic
      tapered cylinder, is also effective. The tapered cylinder relies on the patient's
      depressor muscles to separate the jaws, and allows easy appreciation of the
      progress made. The stretching force applied with this appliance is limited by the
      strength of the patient's depressor muscles.

PMID- 8362041
TI  - An in vitro study of parameters related to marginal and internal seal of bonded
      restorations.
AB  - The wall-to-wall contraction of the cementing layer of bonded restorations is
      compensated for mainly by elastic and plastic tooth substrate-cement deformation
      but may result in adhesive fracture. Occlusally flattened teeth and corresponding
      computer-designed onlays, both positioned in a special device, were used to study
      marginal and internal seal of the adhesive interface with respect to four
      variables: rigidity of the restoration-substrate setup, cement thickness,
      adhesive configuration (enamel-dentin ratio and bonding agent), and luting agent.
      The results of dye infiltration tests revealed the significant influence of the
      adhesive configuration and rigidity of the setup. A high enamel-dentin ratio, use
      of a dentinal adhesive on dentinal margins and relative restoration-substrate
      "mobility" are required to preserve satisfactory marginal seal. However, in the
      present experimental conditions, no statistically significant differences were
      found among the diverse cement thicknesses or the luting agents evaluated.

PMID- 8362042
TI  - Shade selection and laboratory communication.
AB  - This article reviews some of the factors involved in shade selection for
      prosthetic teeth and suggests simple techniques for accurately transmitting
      information about the desired color to the laboratory technician.

PMID- 8362043
TI  - Custom ceramometal pontics in a Kennedy Class IV maxillary removable partial
      denture: a clinical report.
AB  - A technique in which the custom-made anterior ceramometal pontics are securely
      attached to the metal framework of a Kennedy Class IV removable partial denture
      is described. This technique results in a more esthetic prosthesis with less
      palatal coverage.

PMID- 8362044
TI  - Periodontal surgical techniques used to conserve maxillary anterior esthetics.
AB  - The maxillary anterior region presents a difficult and unique therapeutic
      challenge in the treatment of periodontal disease. The periodontist should use
      therapeutic procedures to prevent or minimize esthetic problems, such as
      increased tooth length and loss of interdental papilla, without compromising the
      main goals of periodontal treatment. This article presents various periodontal
      treatment modalities that can be used in the anterior maxillary area with
      acceptable esthetic results. A better understanding of the problem, the treatment
      steps, and the various options available may improve the communication between
      the general practitioner and the periodontist, producing satisfactory long-term
      results.

PMID- 8362045
TI  - Adhesive restoration of an endodontically treated incisor.
AB  - Glass-ionomer cement and composite resin can be used in combination for
      restoration of an endodontic access preparation. Adhesive restorations using
      these materials avoid the problems of marginal leakage and tooth discoloration,
      characteristic of silver amalgam restorations, and preclude the need for complete
      coronal restoration. A detailed clinical procedure for placement of a stratified
      glass-ionomer cement and composite resin restoration for an endodontically
      treated permanent incisor is described.

PMID- 8362046
TI  - "Killer" canine removal and its sequelae in Addis Ababa.
AB  - Children and adolescents, aged 2 to 18 years, from 300 poor families in Addis
      Ababa were examined to determine the prevalence of the traditional practice of
      primary canine tooth removal. Fifteen percent of the primary canine teeth were
      found to have been affected, and 7% of the permanent canines had been damaged by
      this practice. A questionnaire to a subset of 40 families revealed some of the
      reasons that this procedure is still carried out, in spite of the considerable
      associated morbidity.

PMID- 8362047
TI  - A radiographic study of aging changes of the dental pulp and dentin in normal
      teeth.
AB  - One aspect of a previous retrospective radiographic study was an examination of
      diameter and length changes of root canals at various ages. It was found that
      root canal shrinkage increased with advancing age. In the present follow-up
      study, a larger population (500 subjects) was used and only mandibular anterior
      teeth were evaluated. Root canal shrinkage was calculated vertically and
      horizontally. Measurements taken were tooth length, coronal length, apical
      length, root canal length, cervical width, midroot width, and apical width. Six
      age groups were examined: 17 through 29; 30 through 39; 40 through 49; 50 through
      59; 60 through 69; and 70 through 79. Root canals showed statistically
      significantly more shrinkage with advancing age; there were significant changes
      among all groups. These findings could prove useful in anthropology and forensics
      and as an aging biomarker.

PMID- 8362048
TI  - Bonding durability of photocured phenyl-P in TEGDMA to smear layer-retained
      bovine dentin.
AB  - The long-term durability of a photocured resin bond to ground bovine dentin with
      its smear layer retained was investigated. The bonding resin that was employed
      was composed of 5.0 wt% 2-(methacryloxy)ethyl phenyl hydrogen phosphate (phenyl
      P) as a diffusion-promoting monomer, 0.5 wt% camphorquinone as a photosensitizer,
      and 0.5 wt% N-phenylglycine as a reducing agent in triethyleneglycol
      dimethacrylate. Following polymerization of the bonding resin, a composite resin
      was placed and photocured for 60 seconds. Prepared specimens were stored in 37
      degrees C water for 1 day, 6 months, and 1 year. Measured tensile bond strengths
      were 6.7 MPa after 1 day of storage, 4.1 MPa after 6 months of storage, and 2.8
      mPa after 1 year of storage. Examinations of the interfaces after fracture under
      tensile loading suggested that long-term water-immersion weakened the bonds
      between the photocured adhesive resin and the smear layer-retained dentin because
      there was insufficient diffusion of the adhesive resin through the retained smear
      layer.

PMID- 8362049
TI  - Assessment of local side effects of casting alloys.
AB  - A retrospective survey was performed to assess side effects of alloys used in
      fixed and removable partial prosthodontics. Nineteen clinicians reported the
      status of prosthodontic appliances that had up to 31 years of service and the
      reactions in the corresponding oral mucous membrane. Survey charts of 335
      patients, who had a total of 915 fixed and 87 removable prosthodontic units, were
      received. Almost half of these prostheses were made from base metal alloys,
      mainly nickel-chromium alloys for the fixed partial dentures, and cobalt-chromium
      for the removable partial dentures. The rest were classified as gold and
      palladium-type alloys or as miscellaneous. There were no or only slight
      deviations from the normal uniform luster of the metal components in all groups.
      Only four units were reported to have moderate reactions of severe tarnish and
      signs of corrosion. The gingiva and oral mucosa adjacent to the restorations were
      normal but showed slight changes in all groups. Twenty-three of the 335 patients
      were reported to have moderate reactions, and two patients had severe reactions.
      The soft tissue reactions were considered to be largely due to factors other than
      the metal components.

PMID- 8362050
TI  - Geriatric prosthodontics: an overview. Part II. Treatment considerations.
AB  - This two-part paper discusses treatment considerations for geriatric patients--a
      population that is on the rise. The first part of this paper examined the effects
      of aging on general health and on the oral environment. The second part discusses
      restorative treatment options for geriatric patients with caries, tooth wear, or
      missing teeth.

PMID- 8362051
TI  - Herpetic whitlow.
AB  - This paper describes a case of transmission of herpetic whitlow to the index
      finger of a dental student from a patient with herpes simplex virus. The
      recognition of intraoral viral infections in patients is important because these
      viruses have serious implications for health care providers. Rubber gloves must
      be worn when patients with primary or secondary herpetic lesions are treated.
      Asymptomatic permanent herpes virus carriers must also be treated with
      appropriate precautions.

PMID- 8362052
TI  - Role of magnetic resonance imaging in hyperparathyroidism.
AB  - Magnetic resonance imaging is indicated for the localization of the abnormal
      gland or glands in patients with recurrent or persistent hyperparathyroidism. The
      accuracy of MRI is equivalent or superior to thallium subtraction scans and high
      resolution ultrasonography for identifying the abnormal glands in the neck and
      superior to other noninvasive imaging techniques for recognizing ectopic glands
      in the thorax. Most glands have low to medium intensity on T1-weighted images and
      high intensity on T2-weighted images; however, glands with unusual signal
      intensity characteristics occur infrequently. Abnormal glands have shown
      considerable enhancement on T1-weighted images after use of gadolinium DTPA. Some
      pitfalls in the identification of abnormal parathyroid glands are now recognized.

PMID- 8362053
TI  - Practical considerations in the scintigraphic evaluation of endocrine
      hypertension. The adrenal cortex and medulla.
AB  - A nuclear scan maps the distribution of a radiopharmaceutical that is specific
      for a physiologic property of a targeted tissue. As such, it is not limited by
      the anatomic changes necessary for CT and MR scans. It is just because of this
      that maps of specific metabolic precursors of adrenal medullary and cortical
      hormones offer information crucial to the therapeutic strategy of endocrine
      hypertension. NP-59 and MIBG scans can specify the nature of abnormalities
      revealed by anatomic images and because of the ease of surveying the whole body
      can give transcendent information about lesions remote from the adrenals. In
      instances when the origin of endocrine hypertension is not forthcoming from CT or
      MR imaging or when the anatomic and biochemical findings are in conflict, NP-59
      or MIBG can almost always provide the answer.

PMID- 8362054
TI  - The dilemma of bilateral adrenocortical nodularity in Conn's and Cushing's
      syndromes.
AB  - Bilateral adrenal nodularity in Conn's and Cushing's syndrome leads to a more
      complex differential diagnosis than the presence of a unilateral mass or
      bilateral hyperplasia. In Conn's syndrome, bilateral nodularity is not synonymous
      with hyperplasia, and adrenal venous sampling is required to detect those cases
      of surgically correctable aldosteronoma. In Cushing's syndrome, bilateral
      nodularity can result from an ACTH-dependent or an autonomous adrenal cause of
      hypercortisolemia. The appropriate therapeutic decisions depend on the
      recognition of these different entities.

PMID- 8362055
TI  - Endocrine angiography and venous sampling.
AB  - Localization procedures are performed only after the diagnosis of endocrine
      disease is established. Arteriography and venous sampling may be essential to
      locate a small hyperfunctioning endocrine tumor or to assist in distinguishing
      between disease caused by a solitary tumor and disease caused by diffuse
      hyperplasia. These procedures require a detailed knowledge of vascular anatomy
      and must be performed meticulously to avoid incorrect results. Close cooperation
      between the radiologist and the endocrinologist is essential for optimal results.
      These procedures are complex and are rarely performed outside of the few centers
      where endocrine problems are frequently evaluated. In many cases, the patient may
      be best served by referral to an institution where these radiologic studies are
      routine.

PMID- 8362056
TI  - Adrenal, pancreatic, and scrotal ultrasound in endocrine disease.
AB  - Ultrasound is an ancillary tool in adrenal imaging in adults and a primary tool
      in children. Intraoperative sonography is the method of choice for pancreatic
      endocrine tumors. In the scrotum, the benign adrenal rest tumors must be
      distinguished from the more common malignant mass.

PMID- 8362057
TI  - The ovary. Computed tomography and magnetic resonance imaging.
AB  - CT and MR imaging can both contribute valuable clinical information in women with
      benign and malignant ovarian masses; the superior soft tissue contrast and
      multiplanar capabilities provided by MR imaging make it a valuable tool to
      evaluate the normal ovary, polycystic ovaries, endometriosis, and disorders of
      sexual differentiation. CT is currently the recommended modality to stage ovarian
      carcinoma, and peritoneal implants as small as 5 mm can be visualized. With the
      addition of contrast-enhanced images to conventional MR sequences, however,
      improved visualization of intratumoral architecture has also allowed for accurate
      MR characterization of benign versus malignant ovarian masses. Fat saturation
      techniques used with conventional MR sequences can also be used for definitive
      characterization of benign fat-containing teratomas and differentiate these
      tumors from hemorrhagic ovarian cysts or endometriomas. Finally, the detailed
      visualization of the normal-sized ovary on MR images provided by both the body
      coil and the new phased-array coil allows detection of the normal ovaries,
      ovarian follicles, and ovarian cysts throughout the premenopausal and
      postmenopausal years. Findings of polycystic ovarian syndrome, which cannot be
      evaluated by CT, are characteristic on MR images. MR is unparalleled in the
      evaluation of disorders of sexual differentiation because MR images can depict
      ectopic and normally positioned gonads and provide multiplanar depiction of the
      other pelvic organs and perineum as well. CT and MR imaging can provide valuable
      and specific clinical information about the ovary and benign and malignant
      ovarian disease.

PMID- 8362058
TI  - Radiologic diagnosis of osteoporosis. Current methods and perspectives.
AB  - Osteoporosis is defined as a decrease in bone mass accompanied by structural
      changes, leading to an increase in fracture propensity. Early diagnosis of
      osteoporosis, fracture risk prediction, and assessment of efficacy of therapy
      therefore are of great interest. A number of noninvasive techniques are available
      for measuring bone mass at multiple sites of the skeleton. This article reviews
      basic methodology and developments in radiology such as x-ray and photon
      absorptiometry and quantitative computed tomography, which are routinely used in
      clinical practice. Recent techniques for assessment of bone mineral density and
      structure, such as ultrasound measurements, and their possible clinical
      applications also are discussed.

PMID- 8362059
TI  - Hypothalamic and pituitary pathology.
AB  - This article details the intricate anatomy and elegant physiology of the
      hypothalamic-pituitary axis. The discussion is meant to confer an understanding
      of the principles of neuroendocrinology appropriate for the radiologist
      interpreting imaging studies of this region. The clinical presentations of the
      diseases that occur in this area of the central nervous system are unique and
      therefore are discussed in some detail. The radiologic features of the diseases
      affecting the hypothalamic-pituitary axis are described and correlated with the
      relevant pathology.

PMID- 8362060
TI  - Radioisotopic evaluation of the thyroid and the parathyroids.
AB  - Since the inception of the discipline of nuclear medicine, thyroid evaluation and
      therapy with radioactive isotopes have remained an important and constant
      component of thyroidology. Parathyroid scintigraphy with 201Tl/99mTc subtraction
      has been a more recent and also very useful addition in the assessment of
      hyperparathyroidism, particularly at reoperation. The radioactive iodine uptake
      test gives important metabolic information on thyroid function in such diverse
      disease states as hyperthyroidism, hypothyroidism, the thyroiditides, and thyroid
      carcinoma. Thyroid scintigraphy is also a key contributor to the assessment of
      patients with hyperthyroidism or with single versus multiple thyroid nodules,
      those with a history of head and neck irradiation during childhood, and those
      requiring diagnostic follow-up studies with 131I after total thyroidectomy for
      differentiated thyroid carcinoma. Each of these topics is reviewed and expanded
      on in this article, with a diversity of illustrative scans provided to complement
      the discussion.

PMID- 8362061
TI  - Learning contracts in clinical education.
AB  - This study explored the outcomes of using learning contracts in a radiologic
      science program. Telephone surveys of contract learning participants and other
      radiologic science graduates provided data regarding graduate career
      satisfaction, lifelong learning habits and attitudes toward learning. Statistical
      comparison data found that contract learning participants reported higher job
      satisfaction, participated more in continuing education, demonstrated more self
      motivation and independence, felt less competitive and anxious about courses and
      grades and felt more involved in their clinical courses.

PMID- 8362062
TI  - RTs performing venipuncture: a survey of state regulations.
AB  - Venipuncture is an Essential component for nuclear medicine technologists and is
      expected to become an Essential for radiographers. A descriptive survey of
      radiation safety offices in the 50 states and the District of Columbia was
      conducted to determine which states license or certify nuclear medicine
      technologists, radiographers and/or radiation therapists and to identify specific
      statutory terminology relative to drug administration or venipuncture. Results
      showed only six states specifically addressed the issue of drug administration or
      venipuncture for radiographers and radiation therapists. With so few states
      addressing this issue, the question arises whether technologists who perform
      venipuncture or administer drugs are protected against litigation for performance
      of these procedures.

PMID- 8362065
TI  - Nurse opines on non-natural childbirth: freedom of speech.

PMID- 8362064
TI  - Treating the adolescent cancer patient.

PMID- 8362063
TI  - Indicators of potential success among radiography students.
AB  - As the demand for qualified radiographers grows and the number of applicants to
      schools far exceeds the available capacity, program directors across the country
      face increasing difficulty in screening candidates for admission. This study
      sought to determine if there was a significant correlation between high school
      class rank, Scholastic Aptitude Test scores and the successful completion of a
      radiography curriculum as measured by a passing score on the American Registry of
      Radiologic Technologists examination.

PMID- 8362066
TI  - Nurse refuses to "stay out of it": termination. Case in point: Kirk v. Mercy
      Hosp. Tri-County 851 S.W. 2d 617--MO (1993).

PMID- 8362067
TI  - Legal case briefs for nurses. GA: failure to monitor intubated patient:
      "physician testimony" on nursing standares; FL: Board adopts Dr.'s "surgical care
      rule": nurses lack standing at hearings.

PMID- 8362068
TI  - Age Discrimination Act violation charged: "constructive discharge". Case in
      point: Clowes v. Allegheny Valley Hospital 991 F. 2d 1159--PA (1993).

PMID- 8362069
TI  - Aspects of protein energetics and dynamics.

PMID- 8362070
TI  - Psychoneuroendocrine assessment of posttraumatic stress disorder: current
      progress and new directions.
AB  - 1. Studies in our laboratory have used the psychoendocrine strategy to explore
      differences in basal hormone levels between patients with posttraumatic stress
      disorder (PTSD) and other groups. This approach has allowed us to explore the
      relationship between hormone levels and specific psychological and biological
      processes which appear to develop following exposure to extreme trauma. 2. The
      concurrent assessment of several hormonal systems provides an opportunity to
      explore differences in hormonal patterns in various psychiatric disorders. PTSD
      appears to be characterized by a specific profile of hormonal changes that is
      distinct from that of other diagnostic groups and normal controls. These findings
      raise the possibility that the psychoendocrine approach may be useful in further
      exploring the pathophysiology and diagnosis of PTSD. 3. This paper reviews
      psychoendocrine changes in PTSD and describes updated multivariate methods that
      further elucidate psychological and neurochemical correlates of hormonal
      alterations in this disorder.

PMID- 8362071
TI  - Course and outcome in panic disorder.
AB  - 1. Panic disorder (PD) is an illness that can be acute or chronic and is often
      complicated by depression, phobias and obsessions. This illness affects at least
      10% of the population. 2. Panic disorder has been recognized as a
      psychopathologic condition for at least 100 years. Over the last several decades,
      health professionals have changed their view of PD, and in 1987 the DSM-III
      included PD as a distinctive syndrome. 3. Several studies have shown PD to be a
      chronic illness with only little to no improvement in 36-40% of the subjects
      after 1 to 20 years of treatment. Studies also suggest that duration of illness
      affects the degree of impairment: subjects who had PD for more than 6 months
      showed more impairment that subjects who had PD for less than 6 months. 4.
      Several studies show that 50-75% of patients with PD have had at least one
      episode of major depression. Findings also indicate that subjects with both PD
      and secondary depression are a more severely ill group. 5. The HARP study is an
      ongoing 12-site naturalistic, longitudinal examination of patients with current
      or past PD. One of the major goals of this study is to describe the patterns of
      the clinical course of PD related disorders. 6. Clinical experience indicates
      that an estimated 40% of PD patients may need treatment for one year and between
      20-40% will require continued maintenance treatment. Long-term treatment may
      include behavioral therapy and/or medication. 7. Anxiety disorders are common and
      familial and are consistently higher among women. Panic Disorder is a chronic
      condition frequently complicated by Axis I and II disorders. Continued long-term
      maintenance studies of medications and psychotherapy for anxiety disorders is
      critical in the treatment of this chronic illness.

PMID- 8362072
TI  - Neuroendocrine and psychosocial mechanisms in post-partum psychosis.
AB  - (1) Results from a study investigating psychosocial and neuroendocrine influences
      on post-partum psychosis are presented. Subjects were 43 pregnant women with
      histories of affective disorder (bipolar or schizoaffective disorder, n = 26;
      major depressive disorder, n = 17), together with 45 pregnant women without any
      psychiatric history. (2) At 36 weeks antenatal assessments were carried out of
      the women's psychiatric histories, current psychiatric state and also the
      occurrence of life events in the preceding year. They were then monitored for 6
      months after delivery during which time psychiatric state and any further life
      events were recorded. Illness was defined according to Research Diagnostic
      Criteria (RDC); 22 high risk women and 3 control women were categorised as RDC
      'cases' during the post-partum follow-up period. Fifteen of the
      bipolar/schizoaffective women (8 of whom subsequently became ill within 3 months
      of delivery) and 15 controls (all of whom remained well) also participated in a
      neuroendocrine test at 4 days post-partum when their growth hormone response to a
      challenge dose of the dopamine agonist, apomorphine, was measured. (3) The
      results showed that women with histories of depression and control women who
      became ill after delivery were three times more likely to have had a life event
      in the year preceding onset of illness than women from these subgroups who
      remained well. In contrast, for women with histories of bipolar or
      schizoaffective disorder, life events appeared to be unimportant. Instead
      bipolar/schizoaffective women who became ill showed an enhanced growth hormone
      response to the apomorphine challenge test compared to those who remained well
      and controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362073
TI  - Cognitive performance as modified by age and ECT history.
AB  - 1. Cognitive processing, as measured by 15 subtest from the Wechsler Memory Scale
      (WMS) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) was assessed in
      109 depressed inpatients who were classified as under age 65 (N = 54) or 65 or
      older (N = 55). Within each age group, patients were further classified according
      to whether they had no prior ECT (N = 40), one prior ECT series (N = 37), or two
      or more prior series of ECT (N = 32). 2. After examining the data set for
      possible sources of bias such as group differences in the severity of depression,
      time since last ECT series, unilateral vs. bilateral electrode placement,
      adjunctive use of psychotropic medication, gender, education and so forth, a
      MANCOVA and a series of 15 two (age) by three (ECT history) by two (gender)
      analyses of covariance (education served as the covariate) were used to examine
      the main effects of ECT history, age and their interaction on cognitive
      performance. 3. No generalized adverse effects of prior ECT treatment were found
      but older patients with two or more prior ECT series performed significantly more
      poorly than other subgroups on 4 of 15 cognitive tests: (1) Personal and Current
      Information from the WMS, (2) WMS Stories recall, (3) 30-minute delayed WMS
      Stories and (4) WAIS-R Similarities. 4. These findings suggest that the verbal
      narrative memory functioning of depressed geriatric patients with a history of at
      least one prior ECT series is particularly vulnerable to disruption.

PMID- 8362074
TI  - Histories of substance abuse, panic and suicidal ideation in schizophrenic
      patients with histories of post-psychotic depressions.
AB  - 1. Forty patients who had had syndromally-defined episodes of post-psychotic
      depression at least 6 months previously were interviewed in detail for life-time
      histories of substance abuse, panic attacks, and suicidal ideation. 2. No
      relationship was found between life-time history of suicidal ideation and
      substance abuse. 3. Statistically significant associations were found between
      lifetime history of suicidal ideation and both a life-time history of panic
      attacks and the panic disorder syndrome.

PMID- 8362075
TI  - TRH test in psychiatric research.

PMID- 8362076
TI  - ["Mother" and "father" in psychoanalytic case vignettes. On some latent rules in
      the discourse of psychoanalysis].
AB  - Proceeding from the conviction that there is a collective gender-specific
      unconscious within the community of psychoanalysts which determines latent rules
      operative in psychoanalytic discourse, the authors have conducted a research
      project extending over a number of years and systematically examining case
      descriptions in psychoanalytic journals to see to what extent those latent gender
      specific rules are in fact observed in such publications. The project examines
      the way in which male and female analysts employ the terms "mother" and "father"
      in these publications and also the frequency and connotations of concepts related
      to "mother" and "father". Significant differences between male and female
      analysts become apparent, substantiating the assumption of a collective gender
      specific unconscious. The authors conclude that this unconscious finds its way
      into psychoanalytic therapy, leading to unconscious counter-transference
      reactions that are acted out rather than worked on.

PMID- 8362077
TI  - [The son of man. Freud's Oedipus myth].
AB  - In formulating his psychology of the unconscious, Freud makes constant reference
      to Sophocles' version of the Oedipus myth. The author provides detailed proof of
      the fundamental differences between the two versions, demonstrating that Freud's
      interpretation does violence to the source. Bollack marshals impressive evidence
      to substantiate his contention that from the early letters to Fliess all the way
      up to Moses and Monotheism Freud's sole concern was to point up the ubiquitous
      power of the unconscious (incestual desire, patricide) within the "holy"
      (nuclear) family, whereas Sophocles was preoccupied with an entirely different
      problem. In Bollack's view, Oedipus rex is the drama of the self-destruction of a
      royal family, a drama in which incest and murder have no very essential
      significance. Freud, by contrast, set out to de-mystify the fate that dogs the
      royal family from one generation to the next and to naturalise it into a form of
      unconscious behaviour--a tendency which Bollack sees as deriving from the
      tradition of the "drama of destiny", a genre prevalent in the 19th century.

PMID- 8362078
TI  - [The driving force in the thinking of Norbert Elias. An attempt at psychoanalytic
      interpretation].
AB  - The theory of civilization proposed by the eminent sociologist Norbert Elias, who
      died in 1990, has its roots in Freud's theory of culture. Elias always denied the
      importance of personal factors in connection with his work, but as has been
      demonstrated in connection with artists such as Leonardo da Vinci and indeed
      Freud himself, this does not make it any the less legitimate to go in search of
      those infantile/unconscious motifs and affective sources powering Elias'
      prodigious scholarly creativity and informing his work, in however sublimated a
      form. Proceeding from the observation that successful scholarly or artistic
      production represents a synthesis of the forces of id, ego and super-ego, i.e. of
      affect, knowledge and conscience, the author demonstrates that concerns of
      central moment to Elias' thinking--commitment and non-involvement, establishment
      and outsider, the restraining of aggression in the civilizational process,
      interdependence of individuals--are partly the product of early experiences which
      Elias was able to turn to fruitful account in his work.

PMID- 8362079
TI  - Microvasculature and radiation damage.

PMID- 8362081
TI  - Radiopathology of the lung: experimental and clinical observations.

PMID- 8362080
TI  - Combined chemo-radiotherapy with carboplatin, 5-fluorouracil and folinic acid for
      cancer of the urinary bladder: acute and late side effects.

PMID- 8362082
TI  - Diagnosis of radiation-pneumonitis.

PMID- 8362083
TI  - Lung effects after total body irradiation of mice and bone marrow transplant
      patients: comparison of experimental and preliminary clinical data.

PMID- 8362084
TI  - Experimental studies on the pathogenesis of damage in the heart.

PMID- 8362085
TI  - Myocardial infarction after irradiation in Hodgkin's disease: a review.

PMID- 8362086
TI  - The time factor for late reactions in radiotherapy: repopulation or intracellular
      repair?

PMID- 8362088
TI  - Myelopathy and hyperfractionated accelerated radiotherapy: a radiobiological
      interpretation.

PMID- 8362087
TI  - Experimental radiation damage of the central nervous system.

PMID- 8362089
TI  - Irradiation-induced brain dysfunction in children.

PMID- 8362090
TI  - Central nervous system injury from implanted isotopes.

PMID- 8362091
TI  - Long-term cerebral side-effects of total body irradiation and quality of life.

PMID- 8362092
TI  - Eye sequelae following external irradiation.
AB  - The early reactions of the eye to radiation are conjunctivitis and, with higher
      doses, corneal damage. The inflammatory reactions are transient and remit within
      a few weeks after the end of radiotherapy. Doses above 60 Gy can produce corneal
      ulcerations with the risk of perforation and loss of the eye. The most frequent
      late reaction of the eye is cataract of the lens. The tolerance dose (about 5 Gy)
      is extremely low and the latent period varies from 6 months to 3 years. The lens
      in children has a much lower tolerance. The increasing potential for optical
      support and ophthalmic surgery over recent decades has reduced the fear of this
      complication. The most severe late complications are retinopathy (RR) and
      neuropathy of the optic nerve (RON), both of which are caused by radiation
      induced microangiopathy. Visual loss is very frequent and complete blindness is
      seen with high doses in the range of 50-60 Gy. The latent period of these
      injuries varies widely from 1 month to 15 years, but they usually occur within 3
      years of treatment. Conflicting frequencies are reported in the literature.
      Beyond 30 Gy, usually no RR is seen. However, the lowest recorded dose producing
      RR is 11 Gy. In the high dose range of 60-70 Gy RR and RON are found in 10%-100%
      of patients. There is a great need for prospective trials to estimate the true
      risk to patients with nasopharyngeal, maxillo-ethmoidal, and orbital tumors,
      pituitary adenomas, and tumors of the salivary glands. To minimize complications
      of radiotherapy to the eyes daily fractions should be reduced to 1.7
      1.8Gy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362093
TI  - Late side effects of pediatric radiotherapy.

PMID- 8362094
TI  - Side-effects after combination therapy for Ewing's sarcoma.

PMID- 8362095
TI  - Subclinical impairment of renal function after radiotherapy for Hodgkin's disease
      in children.

PMID- 8362096
TI  - Incidence of secondary malignancies in patients with Hodgkin's disease:
      preliminary results.

PMID- 8362097
TI  - The response of tissues to very low doses per fraction: a reflection of induced
      repair?

PMID- 8362098
TI  - Clinically important factors modifying the response of tumors and normal tissue
      to radiation therapy.

PMID- 8362099
TI  - Dose-response relationships for late effects on skin and mucosa.

PMID- 8362100
TI  - Early and late normal tissue injury after postmastectomy radiotherapy.

PMID- 8362101
TI  - Muscle injury in experimental intraoperative irradiation.

PMID- 8362102
TI  - An experimental in vivo model in mice to evaluate the change in reservoir
      function of the urinary bladder due to irradiation alone or combined with
      chemotherapy.

PMID- 8362103
TI  - [Pulmonary tuberculosis and HIV seropositivity at the Principal Hospital of Dakar
      (Senegal)].
AB  - In a prospective survey conducted in 1990 in the Principal Hospital of Dakar,
      pulmonary tuberculosis was 2.3 times more frequent in HIV seropositive patients
      (12.5%) than in HIV seronegative patients. We studied 22 cases of pulmonary
      tuberculosis in HIV+ patients and compared them with a control group of HIV-
      patients admitted for pulmonary tuberculosis. Tuberculosis occurred in 6 out of
      22 asymptomatic HIV+ patients, in 15 out of 22 patients with clinical AIDS and in
      1 patient with ARC syndrome. Clinical signs were the same as in controls, except
      for patients with advanced AIDS who developed cardinal signs. TB intra-dermal
      reactions were more often negative in HIV+ patients, notably those with HDV1,
      expressing immunodepression. Radiological images were typical in 81% of patients
      and in 86% of controls. However, concomitant infections were common in both
      groups, with atypical radiology and hyperleukocytosis. At light microscopy, there
      was no difference in the frequency of acid and alcohol fast bacilli between the
      two groups. The mortality rate was increased in HIV+ patients, but this was not
      due to tuberculosis. Relapses were frequent in both groups, due to poor
      compliance with treatment.

PMID- 8362104
TI  - [Consequences of specific prevention on the diagnosis of Pneumocystis carinii
      pneumonia in patients with HIV infection. Comite SIDA de l'Hopital Saint
      Antoine].
AB  - In a prospective study the authors compared the clinical, radiological,
      biochemical and diagnostic features of Pneumocystis carinii pneumonia (PCP) in
      HIV-infected patients who were or were not receiving a specific prophylactic
      treatment. The study included 386 patients with suspected PCP, 201 of whom were
      under specific prophylactic therapy. Induced expectoration and/or bronchoalveolar
      lavage provided a diagnosis of PCP in 89 patients, 21 of whom were under specific
      prophylaxis. Apart from a number of circulating CD4 lymphocytes that was
      significantly lower in the patients under prophylaxis, there was no significant
      difference between the two groups. Thus, being under specific prophylaxis should
      have no effect on the diagnosis of PCP in HIV-infected patients.

PMID- 8362105
TI  - [Detection of subjects at risk of type 1 diabetes. GOFEDI. Groupe Ouest-France
      pour l'Etude du Diabete Insulino-dependant].
AB  - The so-called type 1 (insulin-dependent) diabetes is an autoimmune disease
      occurring in genetically predisposed subjects. The clinical onset of the disease
      is preceded by a subclinical period during which insulin-producing cells are
      progressively destroyed by immunological effectors. This prediabetic phase can be
      detected by the presence of autoantibodies directed against islet cells and
      sometimes associated with anti-insulin antibodies in children, and later on by
      the disappearance of the early insulin secretion peak in response to intravenous
      glucose. It is at this prediabetic phase that immunomodulators specific to the
      antipancreas process and devoid of side-effects will be used, when available, and
      that an early insulin therapy will be instituted.

PMID- 8362106
TI  - [Infection and diabetes].
AB  - The susceptibility of diabetic patients to infection is well known, but there is
      a difference between susceptibility to bacterial and viral infections.
      Susceptibility to bacterial infections is obvious: septicaemias are more frequent
      in diabetics than in the non-diabetic population. Its mechanism is the influence
      of glycaemia on polymorphonuclear cell functions. Some particular clinical
      entities, such as urinary tract infection, "diabetic foot" or infectious
      cellulitis, are studied; their bacteriological characteristics may require
      changes in the first-line antibiotic therapy. It has been demonstrated that
      hyperglycaemia does not alter the pharmacokinetics of antibiotics. In all cases
      the role played by normoglycaemia must not be overlooked in the fight against
      bacteria. The viral infection problem is very different since, apart from
      autoimmune phenomena, the cellular and humoral responses are not modified in
      diabetic patients. A few, special mycological infections are also described.

PMID- 8362107
TI  - [Hematologic manifestations in Campylobacter coli septicemia. Apropos of a case].
AB  - We report the case of a 71-year old male patient with a chronic lymphoid
      leukaemia of 10 years' duration who abruptly suffered deterioration of this
      general condition and haematological disturbances suggesting worsening of this
      blood disease (Richter's syndrome). Blood cultures demonstrated a Campylobacter
      coli septicaemia. Treatment with antibiotics resulted in a return to the previous
      clinical and biological situation. The various visceral manifestation of the
      infection are discussed.

PMID- 8362108
TI  - [Septic Campylobacter fetus thrombophlebitis: a new case].
AB  - The diagnosis of septic thrombophlebitis is difficult and often delayed, but it
      must be borne in mind in all cases of venous thrombosis accompanied by signs of
      local and/or systemic infection, or deteriorating under heparin therapy. We
      report a case of septic thrombophlebitis caused by Campylobacter fetus subspecies
      fetus. The characteristic features, obtained from the literature, of septic
      thrombophlebitis caused by Campylobacter spp are presented.

PMID- 8362109
TI  - [Severe hyponatremia disclosing adenohypophyseal insufficiency with empty sella
      syndrome].
AB  - We report a case of extremely severe hyponatraemia which led to the discovery of
      anterior hypophysis insufficiency associated with empty sella turcica in a
      dysimmune context. This type of hyponatraemia is consecutive to corticotropic and
      thyreo-tropic hormones deficiency and to inappropriate secretion of arginine
      vasopressin. These endocrine abnormalities are of suprapituitary origin. They can
      be explained by a hypothalamo-hypophyseal dysregulation of little known
      mechanism, or by a lesion of the hypothalamus.

PMID- 8362110
TI  - [Alcoholism and severe pneumococcal infection. Apropos of a case of purpura
      fulminans caused by Streptococcus pneumoniae].
AB  - A 43-year old woman presented with lethal purpura fulminans caused by a
      Streptococcus pneumoniae infection with pneumonia, bacteraemia and meningitis.
      The only predisposing factor identified was severe chronic alcoholism. The high
      morbidity and mortality rates of pneumococcal infections in alcoholics are
      emphasized.

PMID- 8362111
TI  - [Spontaneous dissection of the anterior interventricular coronary artery in the
      postpartum period].
AB  - We report a case of anterior myocardial infarction which occurred in a young
      woman without history of cardio-vascular disease 10 days after she had given
      birth. Coronary arteriography performed 2 months later showed a pseudo-aneurysm
      of the anterior interventricular artery consecutive to spontaneous dissection of
      this vessel. The other coronary arteries were normal.

PMID- 8362112
TI  - [Malignant transformation of leg ulcers].
AB  - The authors report a case of malignant transformation (carcinoma cuniculatum) of
      a venous leg ulcer developed since 60 years. They draw the principal lessons from
      the review of literature.

PMID- 8362113
TI  - [Value of ketoconazole in the treatment of Cushing disease].
AB  - Ketoconazole has been successfully used in short-term treatment of Cushing's
      syndrome. We treated 4 patients who had Cushing's disease with ketoconazole
      administered during 5 to 18 months. Two of them are still controlled after 15
      months of treatment and 7 months after treatment was withdrawn. In the other two
      patients, treatment was ineffective primarily and after 5 months. Our data
      confirm the usefulness of ketoconazole in the treatment of Cushing's disease, but
      they also show that primary resistance and tachyphylaxis in long-term treatment
      may occur, as previously reported.

PMID- 8362114
TI  - [Hemorrhagic colitis following a treatment with metacycline].

PMID- 8362116
TI  - [Cholangiopathies in AIDS].

PMID- 8362115
TI  - [Unexpected beneficial effect of the ingestion of zolpidem (Stilnox)].

PMID- 8362117
TI  - [Internal medicine: attempt at definition and appeal to a consensus].

PMID- 8362118
TI  - [Disorders of the hypothalamo-hypophyseal-ovarian axis in chronic alcoholic
      women].
AB  - This paper deals with the physiology of menstrual cycle disturbances in alcoholic
      women. Nineteen women, aged from 25 to 45 years, were investigated for the
      quality of their menstrual cycle (amenorrhoea in 6, spanomenorrhoea in 5, normal
      cycle in 8) and for their clinical, biochemical and, when possible, histological
      hepatic status. In all these women, hormone levels were measured (in the early
      follicular phase for those with normal menses), including E2, E1, LHRH test, T,
      delta 4A, SBG, T4L, T3L, cortisol and prolactin. According to their hormonal
      profile, these women were classified as hypothalamo-pituitary amenorrhoea (n =
      4), premature menopause (n = 2), ovarian dystrophy (n = 1) and normal hormone
      levels (n = 12). Although our results are too few for statistic value, it appears
      that the amount of alcohol consumed, the degree of malnutrition and the hepatic
      abnormalities observed are more important in women with abnormal hormonal
      profile.

PMID- 8362119
TI  - Case for nephron-sparing surgery in managing renal cell carcinoma.

PMID- 8362120
TI  - Screening for prostate cancer in 1993: is it appropriate, or not?
AB  - Screening for prostate cancer is a complex problem with scientific, medicolegal,
      and socioeconomic consequences. Recommendations regarding screening should be
      based on scientific studies rather than on personal biases. At present, the value
      of screening is unknown, and hopefully proper studies will provide adequate
      information in the future. Until then, patients should be educated about the
      advantages and disadvantages of screening and should participate in the decision.

PMID- 8362121
TI  - Treatment of pathological stage T3N+M0 bladder cancer: the case for observation.

PMID- 8362122
TI  - Treatment of high-stage bladder cancer: case for adjunctive chemotherapy.

PMID- 8362123
TI  - Management of penile carcinoma: the case for selective application of inguinal
      lymph node dissection in stages T1-T4.

PMID- 8362124
TI  - The case for inguinal lymph node dissection in the treatment of T2-T4, N0 penile
      cancer.
AB  - The battle for the control of squamous cell carcinoma of the penis is either won
      or lost at the level of the inguinal lymph nodes. Few patients die of distant
      metastasis without prior development of ilioinguinal nodal disease. If death or
      recurrence does occur, it does so typically within 2 years. In clinical stage T2
      T4, N0 disease, there is a high risk of nodal involvement. In those patients with
      positive nodes, lymphadenectomy can be curative. It is apparent that forms of
      therapy other than a surgical approach are distinctly inferior. Awaiting the
      development of nodal metastasis carries the risk of a significantly lower
      survival time. Unfortunately, highly sensitive and specific forms of preoperative
      staging do not exist. With current techniques, ILND can be accomplished with
      minimal morbidity. For these reasons, it is recommended that all patients with
      clinical T2-T4, N0 squamous cell carcinoma of the penis undergo immediate
      inguinal lymphadenectomy.

PMID- 8362125
TI  - Has the pendulum swung too far for continent diversion? A case for ileal conduit.

PMID- 8362126
TI  - [Hydration of the patient at the end of life].

PMID- 8362127
TI  - [Pathophysiology of dehydration].
AB  - The pathophysiology of dehydration is reviewed. The normal response to
      dehydration, i.e. decreased effective arterial blood volume or effective
      circulating volume is described. Due to water retention and drinking following
      stimulation of ADH secretion and thirst, osmoregulation is overruled by volume
      conservatory mechanisms, which lead to hyponatremia. Only patients with impaired
      mental function or those who are unable to drink will develop a progressive water
      deficit--with or without salt depletion--recognizable by hypernatremia. Decreased
      effective arterial blood volume and hypernatremia affect cerebral function in a
      way that perception of external stimuli as well as perception of pain will be
      impaired. Alert dehydrated patients are disturbed mainly by thirst and dryness of
      the mouth. Both symptoms are perceived more intensely by young than by elderly
      persons. Dryness of the mouth increase thirst on its own. Distress by thirst and
      oral dryness increases as a function of the level and the rapidity of developing
      hypernatremia. The simple act of filling the oral cavity with fluid and
      swallowing alleviates thirst in the absence of any change in plasma sodium
      concentration. Thirst quenching efficacy is increased by administering chilled
      hypotonic fluid with lemon or other fruit acid added (for stimulation of
      salivation).

PMID- 8362129
TI  - [Technical aspects of rehydration].
AB  - Rehydration of terminally ill patients is from a technical point of view not more
      difficult than fluid treatment of any other patient. The difficulty lies in the
      balanced decision between the appropriate method on one hand and the desirability
      of a rehydration on the other hand. The route of choice in terms of burden for
      the patient as well as from a logistic point of view is the oral one. If it fails
      fluid can be administered via transnasal gastric tube. Percutaneous endoscopic
      gastrostomy and other types of gastrostomy do not provide any advantage over
      gastric tube for patients with imminent early mortality and those in a hospital.
      Subcutaneous infusions provide at least for a short time a suitable method for
      rehydration also and in particular for terminally ill patients. Peripheral venous
      catheters are suitable for rehydration, however only for a period of few days
      until another solution is found.

PMID- 8362128
TI  - [Fluid administration in terminally ill geriatric patients].
AB  - Dehydration is common in the elderly. It is caused by a diminished perception of
      thirst, drugs, and many acute illnesses. Dehydration leads to unspecific signs
      and symptoms. Proper diagnosis reverses the situation. A restriction of hydration
      in the sense of palliative terminal care must therefore exclude carefully
      reversible dehydration and establish clearly that a terminal situation is
      present. If the careful evaluation of the patient leads to the conclusion that a
      rapidly progredient worsening of his condition is to be expected, that neither a
      cure nor a symptomatic improvement are possible and death will occur within days
      or a few weeks and that the patient would probably consent: a terminal
      dehydration can be appropriate.

PMID- 8362130
TI  - [A case from practice (272)--cerebral cysticercosis (neurocysticercosis)-
      infection with larvae of Taenia solium, swine tapeworm].

PMID- 8362131
TI  - Managing organisational stress, Part 2.

PMID- 8362132
TI  - Citizenship and user-involvement in health provision.

PMID- 8362133
TI  - Profiling the high-risk altered body image patient.

PMID- 8362134
TI  - Caring on the outside.

PMID- 8362135
TI  - Strategy for nursing research.

PMID- 8362136
TI  - Project 2000 and local staff nurse development.

PMID- 8362137
TI  - Shared practice in community nursing.

PMID- 8362138
TI  - Liberal education and the purchaser-provider link.

PMID- 8362139
TI  - Theory-to-practice links.

PMID- 8362140
TI  - Perceived value of the ENB framework.

PMID- 8362141
TI  - Residualism by attrition.

PMID- 8362142
TI  - Teaching nursing research.

PMID- 8362143
TI  - Nursing at a managerial crossroads?

PMID- 8362144
TI  - [The esophagus in Chagas' disease].

PMID- 8362145
TI  - [Toxocariasis. A rare disease or rarely recognized?].

PMID- 8362146
TI  - [Non-neoplastic polyps of the colon].
AB  - Non-neoplastic colon polyps are benign lesions with normal histology components,
      we present our experience with colonoscopy polypectomy in 10 years. We resected
      187 polyps in 96 patients (50 males) with medium age of 49.3 years and range 2
      82. Most common indication was hemorrhage (37%) taking out the hyperplastic
      polyps who were found in asymptomatic patients with the highest frequency (41%).
      Juvenile polyps follows with 25%. 71% polyps were unique but hamaetomatous polyps
      of Peutz-Jeghers syndrome were multiple (39%). Juvenile (retention) polyps were
      found among the youngest patients (average 13.2 years) and frequently had
      hemorrhage (21-25). Lipomas were found in elder patients (range 52.5 years). We
      had no major complications with hemorrhage or mortality, minor complications were
      found in 3.09%.

PMID- 8362147
TI  - [The in-vitro digestive availability of lipase and trypsin in pancreatic
      supplements under different degrees of acidity].
AB  - We evaluated the in vitro disintegration time and the remanent digestive activity
      of eight pancreatic supplements under pH conditions similar to the
      gastrointestinal tract. They were incubated for 45 min at various pH levels (1, 3
      or 6) and continued thereafter at pH 6, for another 135 min. The activities of
      lipase and trypsin were evaluated titrimetrically every 15 min. At pH 6, the
      products without an enteric coat and Creon, showed the shortest disintegration
      times; under acidic conditions, those times were longer in all the enteric coated
      products. At constant pH 6, lipase activity was greater in Creon, Pankreon and
      Cotazym-B; trypsin activity was greater in Nutrizym-C, Onoton and Cotazym-B.
      After acidic pH exposure enzyme bioavailability was decreased in all the
      products. Disintegration times and acid inactivation of enzymes, should be
      considered when prescribing PS.

PMID- 8362148
TI  - [Mirizzi's syndrome: a rare cause of obstructive jaundice].
AB  - We present five patients with Mirizzi syndrome diagnosed by ERCP. This syndrome
      is a rare cause of obstructive jaundice due to common biliary duct compression by
      a gallstone impacted in the cystic duct, neck of the gallbladder or Hartmann's
      pouch. Complications are bilio-biliary fistula, cholangitis and secondary biliary
      cirrhosis. Diagnostic methods, importance of preoperative diagnosis and surgical
      technics are reviewed.

PMID- 8362149
TI  - [Hemangioma of the rectosigmoid. A report of a case treated by conservative
      surgery of the sphincters].

PMID- 8362150
TI  - [Toxocara canis associated with splenic rupture].

PMID- 8362152
TI  - CDT today: why does it take so long for candidates to get test results?

PMID- 8362151
TI  - [Chagasic megaesophagus with positive serology and xenodiagnosis].

PMID- 8362153
TI  - Denture esthetics: festooning the complete denture.

PMID- 8362154
TI  - Improved method to secure Harder clips.

PMID- 8362155
TI  - Final OSHA standard on occupational exposure to bloodborne pathogens.

PMID- 8362156
TI  - Procedures for fabricating precision-fitting bridge castings: a consistently
      accurate approach.

PMID- 8362157
TI  - Crown and bridge/implant waxing and spruing step list.

PMID- 8362158
TI  - Solving set up problems.

PMID- 8362159
TI  - Technician-dentist communication: the key to superior restorations.

PMID- 8362160
TI  - Fabrication of custom milled attachments with screw fixation.

PMID- 8362161
TI  - Mastering the dental surveyor: an instrument for the whole laboratory.

PMID- 8362162
TI  - "Dental Technology 2000" conference and "Building Legislative Coalitions" NADL's
      1993 legislative conference.

PMID- 8362163
TI  - In the public interest.

PMID- 8362164
TI  - Inside the dental laboratory: management's perspective of remakes and
      communication.

PMID- 8362165
TI  - ADA legislative activity: who fights the battles and how?

PMID- 8362166
TI  - Getting a piece of the action.

PMID- 8362167
TI  - Crown lengthening: what is it? Who needs it?

PMID- 8362168
TI  - The role of CT in functional endoscopic sinus surgery.
AB  - The intricate anatomy of the paranasal sinus unit (sinus/nasal cavities and
      ostia) and its relations to the orbit and anterior cranial fossa make accurate
      pre-operative evaluation of disease in this region mandatory before undertaking
      functional endoscopic sinus surgery (FESS). Plain radiography often fails to
      provide vital information in cases of chronic rhinosinusitis, especially of the
      ethmoid labyrinth, which is a key area of the paranasal sinus unit. Computerized
      tomography has significantly enhanced the scope of endoscopic sinus surgery by
      offering the surgeon hitherto inaccessible information regarding the sinus
      status. In this article, we review the pros and cons of the two imaging
      modalities, and present our experience fo 70 CT scans in patients of FESS. We
      also propose a surgical classification of CT findings. All in all, plain
      radiographs prove to be of little value for pre-operative assessment in FESS,
      while CT scans are an essential tool.

PMID- 8362169
TI  - Nasal hyperreactivity. A histamine provocation model.
AB  - The aim of the study was to see whether it is possible to select non-allergic
      persons with hyperreactivity, especially in the nose, from healthy individuals
      with a histamine standardization test. Another aim was to elucidate whether a so
      called priming effect could be present in such a non-allergic disorder. Seven
      patients with a history of perennial rhinitis, expressed as either or both
      swelling or discharge from the nose and a negative allergic investigation, were
      examined on three up to seven consecutive occasions. Rhinostereometry was used to
      register the reaction in the mucous membrane to a solution of histamine in
      successively increased concentrations. The results showed a statistically
      significant difference between this group compared with a control group of
      healthy volunteers. We could not detect any increase in the sensitivity during
      repeated provocations.

PMID- 8362170
TI  - The role of acoustic rhinometry in studying the nasal cycle.
AB  - The nasal cycle has been demonstrated in man using several techniques, including
      magnetic resonance imaging, anterior rhinoscopy, rhinomanometry, all of which
      have limitations due to expense, discomfort, limited scope or poor
      reproducibility. Acoustic rhinometry is a new technique which analyses nasal
      geometry throughout the nasal cavity, not just at the flow-limiting segment. Six
      adult volunteers were examined at 15-to 30-min intervals using acoustic
      rhinometry. The classical alternating cycle was seen in three subjects, a non
      classical cycle was seen in two, and no cycle seen in one subject. Changes
      occurred throughout the nasal cavity and corresponded with fluctuations in
      subjective scores of obstruction and, in one case, with nasal resistance
      measurements. Acoustic rhinometry is a rapid, reproducible and non-invasive
      technique. This pilot study demonstrates that it has potential for studying in
      detail the physiology of the nasal cycle.

PMID- 8362171
TI  - Continuous infrared thermometry of the nasal mucosa.
AB  - This study aims to continuously measure nasal mucosal temperature without
      interruption of nasal breathing using infrared thermometry. An infrared
      thermometer (Medi-Therm 310; Everest Interscience, Inc.) was directed at the
      nasal septum from a distance of 15 cm. Infrared radiation was continuously
      collected, then converted to an electrical signal proportional to the mucosal
      temperature and output to a chart recorder. In 70 subjects the mean nasal mucosal
      temperature was 30.4 +/- 2.0 degrees C on inspiration and 32.0 +/- 1.8 degrees C
      on expiration. Using multiple regression, nasal mucosal temperature was
      significantly related to atmospheric temperature (p < 0.0001) and inversely
      related to the airway patency of the ipsilateral nasal passage (p < 0.05).

PMID- 8362172
TI  - Repair of saddle nose deformity in Wegener's granulomatosis and ectodermal
      dysplasia.
AB  - Two cases are reported involving surgical treatment of a saddle nose deformity
      due to Wegener's granulomatosis and ectodermal dysplasia, respectively. The
      association of ozena with both diseases requires special consideration for any
      type of transplants because of a high risk of infectious complications. By
      extranasal incisions the nasal dorsum has been successfully reconstructed by
      transplanting autogenic conchal cartilage. There has been no resorption or
      displacement of the transplant after twelve months in the case of ectodermal
      dysplasia, and after 25 months in the patient with Wegener's granulomatosis
      despite a severe recurrence of this disease.

PMID- 8362173
TI  - Transnasal electrocoagulation of the vidian nerve.
AB  - Vidian neurectomy has previously been reported as having a high success rate in
      alleviating secreto-motor rhinopathies. We report a prospective study of 24
      consecutive patients who underwent transnasal vidian electrocoagulation. An
      overall improvement in symptoms was found in 59.1%. A worsening of overall nasal
      symptoms was complained of by 27.3%. The possible reasons for this are discussed.

PMID- 8362174
TI  - The effect of methacholine on nasal transmucosal potential difference in normal
      human subjects.
AB  - This study was proposed to test the hypothesis that the parasympathetic system
      might attribute to the transmucosal potential difference. In a double-blind,
      placebo-controlled study six volunteers had nasal transmucosal potential
      difference (NTPD) recorded at 4-min intervals during 12-min periods of rest,
      before and after treatment, as well as during exercise and recovery. Application
      of placebo did not significantly alter NTPD at rest. There was a significant rise
      during exercise (p < 0.05). The application of methacholine significantly
      increased NTPD at rest (p < 0.01); there was a further rise during exercise (p <
      0.02). We conclude that parasympathetic stimulation can increase the transmucosal
      potential difference.

PMID- 8362175
TI  - A preliminary comparison of the effects of halothane and isoflurane on nasal
      mucosal blood flow.
AB  - The differing effects of halothane and isoflurane on nasal mucosal blood-flow was
      investigated by means of laser-doppler flowmetry in a total of fourteen patients
      who received one of these inhalational agents during anaesthesia. A trend towards
      lower nasal flux was seen in the halothane group but, due to insufficient
      numbers, significance could not be demonstrated. These changes in flux appeared
      not to be related to the falls in perfusion pressure which were seen in both
      groups of patients and were thought to be due to locally vasoactive effects.

PMID- 8362176
TI  - Blindness after intranasal ethmoidectomy.
AB  - Orbital haemorrhage is an unusual and frustrating complication of ethmoid
      surgery. A case of reversible blindness which was due to intra-operative orbital
      haemorrhage occurring after intranasal ethmoidectomy is presented. Prevention and
      management of this kind of blindness can be reversed, if treated aggressively.

PMID- 8362177
TI  - Nasal dorsal cyst after rhinoplasty.
AB  - Nasal dorsal cyst formation after rhinoplasty is considered a rare complication.
      These cysts are due to entrapment of mucosal remnants in the subcutaneous space.
      Meticulous surgical technique aimed at preserving the mucosal lining may prevent
      cyst formation. Surgical excision with the open approach is a reliable treatment.
      A case of nasal dorsal cyst after previous rhinoplasty is presented. After four
      years no sign of recurrence is noted.

PMID- 8362178
TI  - Perennial non-allergic rhinitis (NAR) is a chronic nonpurulent disease.

PMID- 8362179
TI  - Time to give up an ineffective method of assessing fractures.

PMID- 8362180
TI  - It takes awareness and vigilance to stop lead poisoning.

PMID- 8362181
TI  - Not everyone listed in this data bank made a serious error.

PMID- 8362182
TI  - Innovations in practice. Yes, nursing care is cost-effective.

PMID- 8362183
TI  - Beyond QA, the easy way.

PMID- 8362184
TI  - Cutting postop pain.

PMID- 8362185
TI  - Von Hippel-Lindau: a relentless disorder.

PMID- 8362186
TI  - A nurse fights the system--and wins.

PMID- 8362187
TI  - OTC interactions. Antacids.

PMID- 8362189
TI  - Deciphering the new food labels.

PMID- 8362190
TI  - You be the judge.

PMID- 8362188
TI  - Catheterization: how far should you go?

PMID- 8362191
TI  - Phantom breast pain following mastectomy.

PMID- 8362192
TI  - Bedpans and blood--changing perceptions about nursing.

PMID- 8362193
TI  - This RN had a close call with RSDS.

PMID- 8362194
TI  - What about the rash that signals Lyme disease?

PMID- 8362195
TI  - Effects of oral rinsing with triclosan and sodium lauryl sulfate on dental plaque
      formation: a pilot study.
AB  - Mouthwashes containing 0.3% or 0.15% triclosan in combination with 1.5% sodium
      lauryl sulfate (SLS) produced a significant reduction in plaque formation in a
      test panel of 11 students who refrained from oral hygiene during the test
      periods, during which they rinsed twice daily with different mouthwashes. Pl.I.
      was evaluated after each test period. A mouthwash containing only 1.5% SLS
      inhibited plaque to almost the same degree. In both cases, the major effect was
      on the buccal/lingual surfaces, where score 2 was changed to score 0. Addition of
      triclosan appeared to reduce the untoward side-effects of mouth-washes containing
      SLS alone (i.e. desquamation and a burning sensation in the mouth).

PMID- 8362196
TI  - Specific antibodies against Actinobacillus actinomycetemcomitans in serum and
      saliva of patients with advanced periodontitis.
AB  - The aim of the present study was to discover any possible correlation between
      specific antibodies against Actinobacillus actinomycetemcomitans (A.a.) in serum
      and saliva. The test group consisted of 38 patients aged 31-68 yr (mean 49) with
      advanced periodontitis. Twenty-nine subjects aged 23-67 yr, without periodontal
      destruction, formed a control group with a reference level of specific salivary
      antibodies against A.a. A subgingival plaque sample for culturing A.a., a
      specimen of stimulated whole saliva, and a sample of venous blood were taken from
      each subject of the test group. Specific IgG and IgA antibodies against A.a. were
      determined from serum and stimulated whole saliva by means of the ELISA test.
      Fifteen of the patients (39%) had cultivable A.a. Six of the 15 A.a. culture
      positive patients and one of the 29 reference subjects exhibited very high
      antibody titers against A.a. in saliva. Specific IgG and IgA antibodies in saliva
      correlated highly significantly with the corresponding antibody values in serum
      among the patients in the test group. It was concluded that among patients with
      severe adult periodontitis, the less invasive saliva sample has a diagnostic
      value equal to that of the serum sample concerning specific antibodies against
      A.a.

PMID- 8362197
TI  - Effect on human teeth of renal transplantation: a postmortem study.
AB  - Extracted teeth from five deceased patients treated by renal transplantation were
      examined radiographically and histologically, and compared with teeth from
      healthy persons of approximately the same age. In three of the patients with a
      renal transplant, the radiographs showed normal pulp chamber sizes, but
      histologic examination revealed a widened predentin zone, approximately four
      times greater than in the controls. In two of the patients the radiographs showed
      marked reduction of the pulp chamber size. The histologic changes of these teeth
      were mainly an extensive amount of secondary dentin along the pulp chamber walls
      and the root canals, with a markedly reduced pulp space. One explanation for the
      difference between the patients was that patients with extensive pulp
      calcifications were given a higher total amount of corticosteroids than patients
      with a widened predentin zone.

PMID- 8362198
TI  - A modified device for collection and flow-rate measurement of submandibular
      sublingual saliva.
AB  - The aims of the present study were to measure stimulated submandibular-sublingual
      (SM-SL) salivary flow rate with a modified Block-Brottman collection device, and,
      further, to evaluate the reliability of measurements of stimulated SM-SL salivary
      flow rate by means of this modified Block-Brottman device, as compared to
      measurements of parotid flow rate using modified Carlson-Crittenden cups. Twenty
      nine healthy female volunteers, aged 36 +/- 7 yr, were included. Saliva
      stimulation was achieved by application of a 3% citric acid solution to the rims
      of the tongue four times/min, for 3 s every 15 s. On 3 consecutive days,
      stimulated parotid and SM-SL salivas were collected for 2 min at 07.30, before
      breakfast (morning value), and at 10.00, 2 h after a standard breakfast
      (lunchtime values). SM-SL saliva was also collected on one occasion for 2 min x
      3. For parotid and SM-SL saliva, the mean stimulated flow rates were in the
      morning, 1.50 +/- 0.83 and 2.25 +/- 1.12 ml/min, and at lunchtime, 1.71 +/- 1.16
      and 2.54 +/- 1.01 ml/min, respectively. For both salivas, lunchtime values were
      significantly higher than morning values by about 13-14%. Comparing parotid and
      SM-SL saliva flow rates, we found the SM-SL saliva flow rate to exceed the
      parotid flow rate by about 50% both in the morning and at lunchtime. Variations
      in flow rate were analyzed by means of ANOVA. Interindividual variance and
      variance between measurement days and times of day made up 88% of parotid and 83%
      of SM-SL total variance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362199
TI  - Protein composition, adhesion, and agglutination properties of saliva in burning
      mouth syndrome.
AB  - Resting and stimulated whole saliva and parotid saliva of men and pre- and post
      menopausal women with burning mouth syndrome (BMS) and their matched controls
      were studied. Women with BMS had slightly, but not significantly, higher flow
      rates than their controls. The total protein concentration in stimulated saliva
      of women with BMS was significantly lower than that of controls. This difference
      was not associated with the flow rate. The proportional amount of sialic acid,
      used as an indicator of mucin concentration, was higher in subjects with BMS than
      in their controls. SDS-PAGE showed no consistent differences in the protein
      profiles of saliva, nor were any differences observed in the adhesion or
      agglutination assays between subjects with BMS and their matched controls. Thus,
      the present results indicate that BMS is not associated with a decrease in the
      protecting and lubricating properties of saliva.

PMID- 8362200
TI  - Cortical bone mineral density in the mandible and osteoporosis status in
      postmenopausal women.
AB  - Mineral density of the cortical bone of the mandible was determined by single
      energy QCT (quantitative computed tomography) for 77 menopausal women. Bone
      mineral densities (BMD) were measured in the buccal and lingual layers of the
      cortex, distally from the foramen mentale, on both sides of the mandible. All the
      women were edentulous in that region, and the alveolar processes were far
      resorbed. These results were compared with the BMD values of the femoral neck,
      lumbar spine, and trabecular portion of the mandible between the detected layers
      of cortex. The BMD of the buccal cortex correlated remarkably well with all
      values, except those of the trabecular portion. Of the women tested, the
      correlations were lowest in the least osteoporotic group. The values for the
      lingual cortex did not correlate with other variables as well as did those for
      the buccal cortex, but in the most osteoporotic part of the sample the lingual
      cortex values correlated significantly with the BMD of the trabecular portion.
      The BMD values for the buccal cortex were significantly higher than those for the
      lingual cortex.

PMID- 8362201
TI  - Effect of subperiosteally implanted polytetrafluoroethylene (PTFE) material on
      alveolar bone in the rat.
AB  - The aim of this study was to examine the effect on osteocytes after subperiosteal
      implantation of polytetrafluoroethylene (PTFE) material in the rat maxilla. In
      four young conventional albino rats, mucoperiosteal flaps were elevated by
      sulcular incision, and segments (1 x 4 mm) of PTFE material were implanted
      between bone and flap tissue. After a healing period of 14 days, specimens
      containing implants and adjacent bone were processed for transmission electron
      microscopy. The specimens were stepwise reduced to obtain a total of 16 levels
      for thin sectioning. Osteocytes (n = 640) in alveolar bone underlying implanted
      material (region 1) and adjacent bone (region 2) were studied to determine the
      ratio of intact to degenerated cells. In alveolar bone covered by implanted
      material (region 1) and adjacent bone (region 2), 56% and 16% of the osteocytes,
      respectively, showed distinct signs of necrocytosis. This study has shown that
      subperiosteal placement of PTFE material results in partial necrosis of
      superficial alveolar bone.

PMID- 8362202
TI  - Cytotoxic and antibacterial effects of orthodontic appliances.
AB  - The cytotoxic and antibacterial effects of orthodontic appliances were assessed.
      Metallic devices used in orthodontics, such as molar bands, brackets, and
      archwires were tested by the agar overlay cytotoxicity test with mouse fibroblast
      cells. The same devices were tested for antibacterial effect with Streptococcus
      mutans and S. sanguis. The multicomponent devices, which are bonded with silver-
      and copper-based brazing alloys, were more cytotoxic than the single-component
      devices, probably because copper is more cytotoxic than nickel. The devices had a
      definite, but low, antibacterial effect, as compared with the 0.05% chlorhexidine
      positive control. A cytotoxic effect of the devices per se might contribute to a
      localized gingivitis. It is uncertain whether orthodontic devices have any
      significant inhibitory effect on dental plaque viability.

PMID- 8362203
TI  - Clinical study of oral galvanism: no evidence of toxic mercury exposure but
      anxiety disorder an important background factor.
AB  - A total of 142 women and 76 men with self-diagnosed oral galvanism who were
      referred from dentists and medical doctors for clinical evaluation during the
      last 2 yr are described from the perspective of general medicine. No case of
      clinically suspected mercury intoxication was found. Mean concentration of
      mercury in whole blood (B-Hg) was 17.3 nmol/l, and no value exceeded 50 nmol/l.
      Amalgam burden and B-Hg were not associated with clinical signs or symptoms
      except for a significantly lower mean value of B-Hg in patients with psychologic
      main symptoms than in those without (mean 15.4 vs. 18.1 nmol/l). It was possible
      to make one or several diagnoses in all 218 cases as reasonable alternatives to
      the concept of oral galvanism. Mental disorder was the main diagnosis in 93 cases
      (42.7%), including 41 cases of generalized anxiety disorder and 12 cases of panic
      disorder. A total of 87 patients (40%) did not work because of medical reasons or
      unemployment. Amalgam removal was recommended in a total of 65 cases (29%),
      mainly on psychologic indications, but in 22 cases because of oral conditions.
      The clinical conditions behind the concept of oral galvanism seem to be
      explicable in terms of general medicine, and no generalized toxic effect of
      amalgam fillings need be suspected.

PMID- 8362204
TI  - Nordic dentists' opinions on the safety of amalgam and other dental restorative
      materials.
AB  - The safety of amalgam and other restorative materials has caused concern among
      dental patients in recent years. The aim of this study was to obtain information
      on dentists' perceived competence in handling different filling materials and
      their opinions on the safety of these. A random sample of practising dentists in
      Denmark, Finland, Norway, and Sweden received a mail questionnaire in spring
      1990. Answers were received from 1732 dentists (65%). The study showed that the
      respondents believed that their theoretic knowledge and clinical skills were
      generally at a high level regarding restorative materials. The risks of the side
      effects of gold, ceramic materials, and glass ionomer were considered to be low
      by about 90% of the respondents. Amalgam was considered to be significantly more
      hazardous by the Swedish respondents than the others. Interestingly, composite
      was considered to be associated with a high risk of side-effects by about half of
      the dentists in all Nordic countries. The dentists' opinions were not found to be
      greatly influenced by their sex, age, or place of residence but rather by their
      country and service sector. Against the background of the present lack of
      scientific evidence on the hazardousness of amalgam or other restorative
      materials for patients' general health, these findings indicate that dentists are
      influenced by discussions in the mass media about dental treatment and materials
      and, of course, by the guidelines given by the health authorities in their own
      countries. Few dentists were shown to be concerned about occupational risks
      associated with the use of amalgam, and they had not had their own amalgam
      fillings replaced.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362205
TI  - Evaluation of three silicoating methods for resin-bonded prostheses.
AB  - Three different methods of increasing the bond strength of resin to metal were
      tested: the original Silicoater technique, the Silicoater MD technique, and the
      Rocatec system. Metals used for the resin-bonded prostheses were gold, a cobalt
      chromium (Co-Cr) alloy, and titanium. Silicoating increased the bond strength to
      sandblasted specimens. The original Silicoater technique produced the highest
      bond strengths, especially when used with the Co-Cr alloy and titanium. The
      Silicoater MD technique showed the lowest bond strengths for all of the test
      metals. Storage for 7 days with protective film on the silicoated surface did not
      affect the bond strength, as compared with specimens bonded immediately. The
      retention of the resin to the gold specimens (Rocatec system) decreased after
      thermocycling, but retention to the Co-Cr alloy and titanium was not affected.
      Various resin cements were tested and showed the same retention with the
      exception of Microfill Pontic, which gave a weaker bond. Scanning electron
      microscope (SEM) and energy-dispersive X-ray analysis (EDAX) of the specimens
      before and after the measurements gave no clear explanation of the differences in
      bond strengths between the test metals. However, it was concluded that
      silicoating of the metal surfaces contributed to the retention of the resin by
      chemical action, as no differences in adaptation of the resin to the metal were
      seen between specimens pretreated by sandblasting and those which were also
      silicoated.

PMID- 8362206
TI  - Crown retention and cyclic loading (in vitro).
AB  - Cast gold crowns were luted on extracted and prepared human teeth with zinc
      phosphate cement and subjected to a fatigue test by cyclic loading. The
      correlation between crown retention and three retention variables was determined
      by the fatigue test. The results show that the smallest convergence angle tested,
      20 degrees, gave better retention than did angles of 40 degrees and 60 degrees,
      and that surface roughness, surface size, height, and base diameter of the
      preparations had no influence on crown retention within the parameter sizes
      tested.

PMID- 8362207
TI  - Helicobacter pylori infection in peptic ulcer disease.

PMID- 8362208
TI  - Intestinal permeability and function in patients infected with human
      immunodeficiency virus. A comparison with coeliac disease.
AB  - The relationships among intestinal permeability, advancing human immunodeficiency
      virus (HIV) infection, and the presence of diarrhoea or weight loss were
      investigated in 51 HIV patients and 20 healthy controls. Ten patients with
      untreated coeliac disease were also investigated for comparison. Fasting subjects
      drank an isosmolar test solution containing D-xylose, lactulose (LL), L-rhamnose
      (R) and 3-O-methyl-D-glucose. Urine was collected for 5 h, test sugar content
      being subsequently measured by thin-layer chromatography for the dosing sugars.
      Intestinal permeability (LL/R excretion ratio) and recovery of D-xylose and 3-O
      methyl-D-glucose in urine were abnormal in patients with HIV disease, and
      especially those with diarrhoea, as they were in coeliac disease. Patients with
      coeliac disease and HIV disease, especially when diarrhoea and/or weight loss
      were present, had significantly reduced 5-h excretion of L-rhamnose, D-xylose,
      and 3-O-methyl-D-glucose. These data indicate that abnormal permeability and
      reduced intestinal absorption capacity are common in HIV patients, occur at all
      stages of HIV disease, especially in the presence of diarrhoea, and, with the
      exception of lactulose permeation, are relatively similar to the alterations seen
      in coeliac disease.

PMID- 8362209
TI  - Functional gastrointestinal disorders in unselected patients with non-cardiac
      chest pain.
AB  - Patients with non-cardiac chest pain (NCCP) (n = 387) and cardiac chest pain
      (CCP) (n = 93) were compared with community controls (n = 81), using a symptom
      questionnaire that assessed the presence of irritable bowel syndrome (IBS),
      functional dyspepsia, and oesophageal dysfunction and chest pain characteristics.
      A significantly (p < 0.05) increased prevalence of symptoms compatible with IBS
      occurred in NCCP patients when compared with those with CCP and with controls.
      Dysphagia was more frequent in both those with non-cardiac and cardiac chest pain
      than in controls; this was not apparent, however, when patients with concomitant
      IBS were excluded. The presence of oesophageal or gastrointestinal symptoms did
      not enable discrimination with regard to the chest pain characteristics. We
      conclude that unselected referred patients with documented NCCP are more likely
      to have IBS and that the presence of oesophageal symptoms such as dysphagia may
      merely reflect the spectrum of the 'irritable gut'.

PMID- 8362210
TI  - Myofibroblast-like cells produce mRNA for type I and III procollagens in chronic
      active hepatitis.
AB  - In chronic active hepatitis the rate of collagen biosynthesis is largely
      determined by intracellular mRNA concentrations. To localize procollagen mRNA
      producing cells, we investigated biopsy specimens from five patients with
      hepatitis B surface antigen-positive chronic active hepatitis and five patients
      without liver disease by in situ hybridization. We used type I and III
      procollagen cDNAs for transcription to (35S)-labeled probes. Parallel sections
      were stained with anti-actin monoclonal antibodies. Our results show that cells
      in which collagen synthesis is ostensibly enhanced can be localized by in situ
      hybridization of procollagen mRNAs. These cells were also anti-actin-positive in
      parallel sections and were localized in areas of inflammatory cell infiltration
      and necrosis. We conclude that myofibroblast-like cells may express procollagen
      mRNAs in chronic active hepatitis. Moreover, in situ hybridization may be a
      valuable diagnostic tool for providing additional morphologic information on the
      degree of fibrogenesis activity.

PMID- 8362211
TI  - Follow-up of patients positive in reticulin and gliadin antibody tests with
      normal small-bowel biopsy findings.
AB  - Twenty-five patients with positive serum reticulin or gliadin antibody titres and
      having normal small-bowel mucosal villous architecture were re-biopsied after a
      follow-up period of 1 to 7 years. Seven were found on control examination to have
      small-bowel villous atrophy. At the initial examination, when coeliac disease was
      'excluded', they thus belonged to the entity latent coeliac disease.
      Morphometrically minor mucosal changes in the initial biopsy specimen, suggesting
      an ongoing process, were seen in only three of them. Especially the serum IgA
      class reticulin antibody test was a good predictor of latent coeliac disease.
      This study implies that patients with so-called false-positive IgA-class
      reticulin or gliadin antibody test should be re-examined.

PMID- 8362212
TI  - Expression of glycoconjugates in pancreatic, gastric, and colonic tissue by
      Bauhinia purpurea, Vicia villosa, and peanut lectins.
AB  - We have earlier prepared a pancreatic cancer-associated mucin, whose altered
      carbohydrate structure was recognized by Vicia villosa (VVA), Bauhinia purpurea
      (BPA), and peanut (PNA) lectins and which was found preferentially in the sera of
      patients with pancreatic or gastric cancer. Cancer-associated structures of the
      sugar chain on serum antigen may reflect those occurring in malignant tissues.
      Accordingly, we investigated the tissue distribution of carbohydrate structures
      reactive to these lectins by using lectin histochemistry in pancreatic cancer,
      gastric cancer, and colonic cancer tissue specimens and in their normal
      counterparts. VVA showed a higher affinity for pancreatic cancer (77.5%), gastric
      cancer (89%), and colonic cancer (87%) cells than for the cells of their normal
      counterparts, whose affinity was 0%, 41.7%, and 36.4%, respectively. PNA showed a
      higher affinity for pancreatic (70%) and colonic cancer cells (86.5%). BPA failed
      to show significant binding differences between neoplastic and normal cells in
      any of the pancreatic, gastric, or colonic tissue specimens. It did, however,
      bind to intraductal contents in most of the pancreatic cancer tissues but bound
      to intraductal contents in only a few chronic pancreatitis and normal pancreatic
      tissues. VVA and PNA did not bind to intraductal contents in any of the normal,
      chronic pancreatitis, or pancreatic cancer tissues. These results imply that,
      among the lectins used so far, VVA has the highest affinity for neoplastic cells,
      and it may provide a supplement for use in the pathologic diagnosis of malignant
      diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362213
TI  - Serum selenium, copper, and zinc concentrations in Crohn's disease and ulcerative
      colitis.
AB  - Serum selenium, copper, and zinc levels were studied in 47 patients with Crohn's
      disease, 117 patients with ulcerative colitis, and 123 age- and sex-matched
      healthy controls. Serum selenium levels were lower and serum copper levels were
      higher in men and women with Crohn's disease than in controls (p < 0.001 and p <
      0.01, respectively). Trace element levels were not significantly influenced by
      extent or localization of Crohn's disease. Men and women with ulcerative colitis
      had higher levels of copper and zinc than did controls (p < 0.01 and p < 0.05,
      respectively). Men with pancolitis had significantly lower selenium and higher
      copper levels than men with proctitis. The implications of abnormal trace element
      status in patients with inflammatory bowel disease are discussed.

PMID- 8362214
TI  - Changes in gastric mucosal ornithine decarboxylase and tyrosine phosphorylation
      of proteins in postgastrectomy patients.
AB  - There is evidence to suggest that partial gastrectomy is associated with an
      increased risk of developing gastric carcinoma in humans. Since ornithine
      decarboxylase (ODC) and tyrosine phosphorylation of proteins are involved in the
      regulation of cell proliferation, the present study was undertaken to examine the
      time-dependent changes of these variables in the postgastrectomy stomach. Thirty
      seven postgastrectomy patients (Billroth I (BI), n = 7, and Billroth II (BII), n
      = 30) underwent gastroscopy. For comparison, five patients with intact stomachs
      (three healthy and two postvagotomy and pyloroplasty) were also studied. Gastric
      mucosal biopsy specimens were obtained within 5 cm of the anastomosis and
      analyzed for ODC activity. In addition, tyrosine phosphorylation of membrane
      proteins was also determined in representative samples of BII patients. Gastric
      mucosal ODC activity was significantly higher in BII patients in whom gastrectomy
      had been performed > 15 years earlier compared with those in whom it had been
      performed < 15 years earlier (p < 0.001) or controls (p = 0.004). Although the
      mean ODC activity was higher in BII than in BI patients, the difference was not
      significant (p = 0.103). Isolated patients with high ODC activity demonstrated
      increased phosphorylation of tyrosine membrane proteins with M(r) of 55-60.

PMID- 8362215
TI  - Chemical nature and distribution of calcium compounds in radiolucent gallstones.
AB  - A high failure rate for radiolucent cholesterol gallstones to dissolve with oral
      bile acids may be due to the presence of insoluble calcium compounds. Twenty sets
      of radiolucent gallstones, 7-20 mm in diameter, obtained from 20 patients
      undergoing cholecystectomy, were cut, and the outer surface, outer rim, middle
      portion, and central core areas were scanned for calcium by energy-dispersive X
      ray microanalysis (EDX) and scanning electron microscopy (SEM). Scrapings from
      the four areas of each stone were analysed by infrared spectroscopy. A sample of
      the crushed stone was used for chemical estimation of cholesterol. Eleven (55%)
      of the 20 cholesterol (84-96% dry weight of cholesterol) stones showed presence
      of calcium by EDX; the distribution was peripheral in 5, homogeneous in 4, and
      central in 2. The chemical compound was calcium bilirubinate in 10 and calcium
      carbonate in 8 stones. Calcium compounds are present in a high proportion of
      radiolucent gallstones considered suitable for chemodissolution by conventional
      criteria. Their unrecognized presence may explain the high failure rate of such
      stones to respond to medical therapy.

PMID- 8362216
TI  - Effect of short- and long-term treatment with omeprazole on cell cycle
      distribution in the gastric mucosa. Results of a flow cytometric study.
AB  - Omeprazole may exert an effect on gastric mucosal proliferation by inhibiting
      gastric acid secretion and increasing serum gastrin levels. It may also influence
      the kinetics of endocrine cells and the oxyntic mucosa. The aim of the present
      study was to evaluate the cell cycle in different gastric compartments following
      short- (1 month) and long-term (6 months) administration of two different dosages
      of omeprazole by means of a flow cytometric method. We also determined serum
      gastrin levels at the same time. No differences in cell cycle distribution of the
      antrum, body, and fundus were found in the two different dosage groups after 1
      month of therapy, considering the synthetic phase (S-phase) of the cell cycle. A
      statistically significant increase in S-phase was reported after long-term
      therapy in the mucosa of the fundus and body of the stomach in both groups.
      Gastrin levels showed no clear correlation with cell cycle distribution
      variables. We postulate a proliferative adaptation of the oxyntic mucosa to long
      term drug administration not mediated by gastrin influence.

PMID- 8362217
TI  - Secretin and portal blood flow.
AB  - Using a duplex Doppler technique, we investigated the effect of low doses of
      secretin on the portal blood flow. In eight healthy volunteers successive
      intravenous secretin infusions of 0, 8, and 32 pmol x kg-1 x h-1 resulted in
      proportional increases in plasma secretin levels. The portal venous flow,
      however, was unaffected. A bolus injection of 930 pmol of secretin caused plasma
      secretin levels to increase 100-fold, whereas blood flow in the portal vein
      increased only by a factor three. This suggests that secretin in the present dose
      range is of no quantitative importance as a regulator of portal venous flow under
      physiologic conditions.

PMID- 8362218
TI  - Pituitary adenylate cyclase-activating peptide is a potent modulator of human
      colonic motility.
AB  - Pituitary adenylate cyclase-activating peptide (PACAP) represents a novel brain
      gut peptide with high sequence homology to vasoactive intestinal polypeptide
      (VIP). Since PACAP has been identified in the human gut, the effect of the two
      molecular forms PACAP-(1-38) and PACAP-(1-27), the hybrid PACAP-(1-23)VIP-(24
      28), and VIP on the contractility of the longitudinal muscle of human sigmoid
      colon was tested in vitro. All peptides inhibited the spontaneous phasic
      contractions and relaxed concentration-dependently carbachol-precontracted
      preparations. The effects of the peptides remained unaffected by tetrodotoxin, by
      inhibition of phosphodiesterase activity, and by inhibition of nitric oxide
      synthesis. Apamin reduced only the effects of the PACAP peptides, whereas
      tetraethylammonium blocked only the effect of VIP. In conclusion, PACAP peptides
      and VIP mediate their relaxant effects via activation of specific PACAP and VIP
      receptors coupled to different potassium channels.

PMID- 8362219
TI  - Gastric acid secretion, serum pepsinogen I, and serum gastrin in Japanese with
      gastric hyperplastic polyps or polypoid-type early gastric carcinoma.
AB  - We determined the maximum secretion of gastric acid and the fasting serum levels
      of pepsinogen I and gastrin in Japanese patients with gastric hyperplastic polyps
      or polypoid-type early gastric carcinoma, comparing those findings with
      observations in control subjects. Both the maximum acid secretion and fasting
      levels of serum pepsinogen I were significantly lower in the patients with
      gastric hyperplastic polyps or polypoid-type early gastric carcinoma than in the
      controls. Fasting serum gastrin levels were significantly higher in the patients
      with gastric hyperplastic polyps than in the other two groups of subjects. These
      data demonstrated that the combination of hypochlorhydria, a low level of
      pepsinogen I, and hypergastrinemia (type-A gastritis) was common in the patients
      with gastric hyperplastic polyps, whereas hypochlorhydria and a low pepsinogen I
      without hypergastrinemia (type-B gastritis) were common in those with polypoid
      type early gastric carcinoma.

PMID- 8362220
TI  - Autonomic vagal nerve dysfunction in patients with ulcerative colitis.
AB  - Autonomic nerve function was evaluated in 40 patients with total ulcerative
      colitis and in 25 patients with irritable bowel syndrome by three established non
      invasive tests based on the heart reactions to deep breathing (E/I ratio) and
      tilt (acceleration and brake index). None of the patients were diabetic. Most of
      the patients with ulcerative colitis were clinically and biochemically inactive;
      10 had previously undergone colectomy. The results were compared with a control
      group consisting of 56 healthy individuals and 33 previously investigated
      patients with Crohn's disease, 45% of whom demonstrated autonomic neuropathy
      (AN). Patients with ulcerative colitis had a significantly lower E/I ratio than
      controls in age-corrected values, indicating vagal nerve dysfunction. Altogether,
      35% had signs of AN. In patients with irritable bowel syndrome 36% had evidence
      of AN, a figure in agreement with observations from other investigators. We
      conclude that AN is common in patients with ulcerative colitis, regardless of
      disease activity and previous colectomy. In contrast to a predominantly
      sympathetic dysfunction in Crohn's disease, AN in ulcerative colitis was vagal.

PMID- 8362221
TI  - Propranolol absorption in peptic ulcer disease.
AB  - This study was designed to determine whether gastroduodenal ulcer influences
      propranolol absorption. Eleven patients with peptic ulcer disease and eight
      healthy subjects received 80 mg of propranolol orally. Serum propranolol levels
      were measured with high-performance liquid chromatography. Ulcer patients showed
      a significant decrease in mean peak concentration of propranolol (90 +/- 12 ng/ml
      versus 151 +/- 23 ng/ml) (p < 0.025), in the absorption constant (1.43 +/- 0.21 h
      1 versus 0.96 +/- 0.12 h-1) (p < 0.05), and in the area under concentration-time
      curve (802 +/- 129 ng/ml.h versus 492 +/- 73 ng/ml.h) (p < 0.05). No significant
      difference was seen in drug effect on the heart at 90 min. We conclude that
      propranolol is absorbed more slowly in ulcer patients than in healthy subjects,
      but this delay has no clinical effect after a single dose.

PMID- 8362222
TI  - Epidemiological features of type 22 echovirus infection.
AB  - During a 25-year observation period, isolates of type 22 echovirus were obtained
      from 109 patients. 92% of the patients were < 2 years old. Echovirus type 22 was
      isolated with peaks both during late summer and autumn, as enterovirus
      infections, and during the winter months and early spring, as respiratory
      viruses. Diarrhea was the most common symptom, followed by obstructive bronchitis
      and, less often, CNS symptoms. Nosocomial infections were common. In a noticeable
      number of the children, maternal neutralizing antibodies were most probably
      present at the time of infection. The epidemiologic features of type 22 echovirus
      infections with regard to age and seasonal distribution, contagiousness and a
      relative lack of protection by neutralizing antibodies differed from most
      enterovirus infections.

PMID- 8362223
TI  - Patients treated in hospital for infectious mononucleosis and risk of cancer.
AB  - The risk of cancer was evaluated in a cohort of 1,234 patients with severe
      infectious mononucleosis between 1954 and 1983. The diagnosis of mononucleosis
      was confirmed by reviewing patient records. The observed numbers of cancer cases
      up to 1988 were obtained through record linkage from the Finnish Cancer Registry,
      which is nationwide and population-based. There were 11 cases of cancer in the
      cohort, as against 17.4 expected on the basis of the 24,288 person-years at risk
      and of incidence rates specific for age, sex and period in the area. This gives a
      standardized incidence ratio of 0.6 (95% confidence interval 0.3-1.1). There was
      only 1 lymphoma case. No malignancies were diagnosed during the first 5 years
      after infectious mononucleosis. The results indicate that infectious
      mononucleosis with severe symptoms does not imply an increased risk of cancer.

PMID- 8362224
TI  - HIV-antibody testings among injecting drug users (IDUs) in the Stockholm area,
      1984-91: information compiled from testing laboratories.
AB  - The available information about testings for HIV antibodies in injecting drug
      users (IDUs) carried out in Stockholm between 1984 and 1992 has been compiled.
      These testings were carried out mainly in special settings. The use of codes (the
      first 2 digits giving the age and the last 4 the 6 and checking figures in the
      individual's personal identity number) precluded exact identification of
      individuals; in most cases, however, complementary information made it possible
      to recognize patients at follow-up. The data indicated that 9,150 persons
      associated with current or previous drug addiction were tested. The first
      extensive testings were performed in 1985 and 1986. After this period, 4,500
      persons were retested. 11% of the IDUs tested in 1984-85 were found to be HIV
      antibody-positive. After 1988, 1% were estimated to seroconvert each year. While
      in the first phase the heroin users predominated among those infected, in later
      years the rates of newly diagnosed infections became similar for all types of
      IDUs. The age profiles of the IDUs tested were similar up to 1988, after which
      there was an indication that also younger persons had entered the scene. However,
      the infected IDUs discovered belonged mainly to the 'old' cohort born between
      1950 and 1960.

PMID- 8362226
TI  - The C-reactive protein responses in HIV-infected patients with pneumonia.
AB  - The acute phase C-reactive protein (CRP) was measured in serum of HIV-infected
      patients suffering from Pneumocystis carinii pneumonia (PCP) (32 patients),
      bacterial pneumonia (10 patients), and in 19 immunocompetent patients with
      bacterial pneumonia. The HIV-infected patients with bacterial pneumonia had a
      significantly lower CRP level than the immunocompetent patients (50% versus 95%
      had an s-CRP level > 80 mg/l). No significant difference was found in the CRP
      response to P. carinii or bacteria in HIV-infected patients with pneumonia due to
      these microorganisms (20% versus 50% had s-CRP > 80 mg/l). In the group of PCP
      patients, a significantly lower CRP level was found in those with CD4 positive
      lymphocyte counts below 50 x 10(6)/l. There was no correlation between the CRP
      response and the severity of the PCP as estimated by the degree of hypoxia. We
      conclude that the CRP level cannot be used to discriminate between PCP and
      bacterial pneumonia in HIV-infected patients.

PMID- 8362225
TI  - Screening for anti-HIV and HBsAg in pooled sera from a clinical chemistry section
      as a tool for epidemiological survey.
AB  - With the aim of estimating the unknown spread of HIV into the general society, a
      program for testing pooled routine sera from a clinical chemistry laboratory has
      been tried. Serum samples obtained from the daily inflow of blood tubes at the
      Clinical Chemistry Laboratory, Malmo General Hospital, and not labelled as risk
      samples for blood-borne infection(s), were collected and pools of up to ten sera
      each were constructed according to a special protocol. All serum pools were
      screened for anti-HIV and HBsAg. During the 32-months period of the study 3,016
      serum pools from men and the same number from women were collected and analysed.
      These pools together contained sera from 26,468 male and 26,891 female patients,
      respectively. Altogether 33 male and 2 female pools were found anti-HIV positive.
      Anti-HIV-positive males appeared in all age groups, without significant
      difference between the groups. Two female pools from the age group 15 to 24 years
      were anti-HIV positive; these samples were drawn during the last year of testing.
      HBsAg was detected in 189 male and 129 female pools. From 1989 to the first half
      of 1991 the mean anti-HIV prevalence among the male samples investigated was
      0.10%, with 95% confidence limits from 0 to 0.25%. If the upper confidence limit
      is exceeded in the future, this could be a warning of increased spread of HIV of
      in society.

PMID- 8362227
TI  - Detection of pneumococcal capsular antigen in the presence of penicillin in
      vitro.
AB  - Eight strains of Streptococcus pneumoniae were tested in vitro for their ability
      to produce capsular antigen in the presence of penicillin. It was found that,
      provided 10(6) to 10(7) pneumococci/ml were present, capsular antigen could be
      detected during the 72 h in which the experiment was conducted, irrespective of
      whether penicillin was added at 0 h or 8 h, and even when no viable pneumococci
      remained. When fewer pneumococci were present, capsular antigen could not be
      detected at any time in the presence of penicillin. Control cultures, without
      penicillin, yielded detectable capsular antigen only when the threshold value of
      10(6)-10(7) pneumococci/ml was reached. It is concluded that the presence of
      penicillin does not influence the detection of pneumococcal capsular antigen, but
      demonstration of this antigen is totally dependent on the number of pneumococci
      present.

PMID- 8362228
TI  - Erythromycin treatment is beneficial for longstanding Moraxella catarrhalis
      associated cough in children.
AB  - The benefits of antibiotic treatment and a nasopharyngeal culture in children
      with longstanding cough were analysed in a prospective randomized open study.
      Clinically suspected pertussis was excluded. Of 40 children given erythromycin
      for 7 days, 35 (88%) recovered in one week, compared with 17/47 (36%) untreated
      (p < 0.0001). Erythromycin eliminated Moraxella catarrhalis from the nasopharynx
      in 21/31 children (68%), compared with spontaneous disappearance in 7/35 (20%)
      untreated controls (p < 0.001). Purulent bronchitis or otitis media occurred in 2
      children (5%) in the treatment group and in 21 (45%) in the control group (p <
      0.01). To evaluate the clinical role of isolated pathogens, the 47 untreated
      subjects were studied. Seven of 35 children harbouring M. catarrhalis recovered,
      compared with 8/12 in whom this bacterium was absent (p < 0.01). No correlation
      was found between the isolation of Haemophilus influenzae or Streptococcus
      pneumoniae and the clinical outcome. Children with persistent cough > 10 days may
      benefit from erythromycin treatment. M. catarrhalis in the nasopharynx indicates
      prolonged symptoms and increased risk of bacterial complications.

PMID- 8362229
TI  - Comparative studies on pharyngeal carriage of Neisseria meningitidis during a
      localized outbreak of serogroup C meningococcal disease.
AB  - An outbreak involving 20 cases of serogroup C meningococcal disease,
      predominantly among teenagers, occurred over a 7-month period in the Randers area
      of Denmark. The cases were caused by serogroup C:2a:P1.2 sulphonamide-resistant
      strains. The available evidence was against the transmission being related to
      particular schools. The outbreak was experienced as 3 clusters. At 2 schools
      involved in the first and the third cluster of the outbreak, 351 students were
      examined regarding pharyngeal carriage of meningococci, 282 of whom were tested
      again 17 weeks later; 308 students attending two similar schools in a nearby area
      were examined once. The majority of strains isolated from group C carriers in the
      high-risk area were serologically indistinguishable from the outbreak strain
      (13/14 = 95%), but less often sulphonamide-resistant (5/13 = 38%). In both areas,
      the overall rate (30%), the overall group C rate (3%), the carrier rate for the
      outbreak strain (1%) were the same. The attack rate for the outbreak strain
      differed significantly: 1/40 in the high-risk area versus 1/2,500 in the normal
      risk area. No conditions that might explain this difference were revealed.
      Immediately after recognition of the first and the third cluster, 780 and 13,300
      students, respectively, were vaccinated with meningococcal polysaccharide vaccine
      A+C. It was concluded that the definition of target groups for vaccination should
      be liberal, because the "at risk" population may be difficult to recognize at the
      onset of an outbreak.

PMID- 8362230
TI  - Deep obstetrical and gynecological infections caused by non-typeable Haemophilus
      influenzae.
AB  - Six patients with deep obstetrical and gynecological infections due to non
      typeable Haemophilus influenzae are presented. 3 patients had tubo-ovarian
      abscesses, 2 septic abortions and 1 postpartum sepsis. All our patients with tubo
      ovarian abscesses had used intra-uterine contraceptive devices until admission
      and all had a protracted course of illness. Both patients with septic abortion
      had a severe course, one of them with disseminated intravascular coagulation
      demanding treatment in the intensive care unit. The patient with postpartum
      infection had a milder course. The possibility of infection with H. influenzae
      and the emergence of beta-lactamase producing strains warrant adequate culture
      procedures in women with obstetrical and gynecological infections in order to
      ensure proper treatment.

PMID- 8362231
TI  - Significant decrease of gram-negative anaerobic bacteremia in a major hospital
      from 1967-73 to 1981-89: an effect of the introduction of metronidazole?
AB  - Declining rates of anaerobic bacteremia are reported from medical centres all
      over the world. At Odense University Hospital the frequency of Gram-negative
      anaerobic bacteremia decreased from 1.62% in 1967-73 to 0.83% in 1981-89 (p <
      0.001). Metronidazole prophylaxis prior to bowel surgery seems to be the most
      important explanation, as the association of Bacteroides bacteremia with surgery
      decreased from 80% to 48% (p < 0.01) and no cases of Bacteroides bacteremia
      occurred during metronidazole treatment without the presence of abscess or
      gangrene. A contributory factor may be improved methods for abscess localization
      and drainage. Other drugs having an effect on anaerobes seem of minor importance.
      A new category of patients seems to be those who have undergone aorto-femoral
      bypass operation for aneurysm of the aorta. They contract anaerobic Gram-negative
      bacteremia from infected hematomas or intestinal gangrene.

PMID- 8362232
TI  - Factors affecting prognosis of neonatal tetanus.
AB  - Neonatal tetanus is associated with a high mortality rate, despite intensive
      care. Although it can be prevented by immunization of expectant mothers and by
      good hygiene and asepsis during delivery, neonatal tetanus is still a common
      cause of neonatal mortality in underdeveloped countries. In our study, hospital
      records of 133 newborns with neonatal tetanus were evaluated to identify the
      possible factors affecting prognosis of neonatal tetanus; 79 were males and 56
      females, and 54 (41.6%) of the 133 died. Sex and birth weight did not affect the
      prognosis. As a result of our study, we found that age on admission < 10 days,
      symptoms < 5 days and presence of risus sardonicus and fever indicate a poor
      prognosis in neonatal tetanus.

PMID- 8362233
TI  - Management of indwelling central venous catheters in pediatric cancer patients
      with fever and neutropenia.
AB  - This prospective study comprises 97 episodes of fever and neutropenia in children
      with cancer and central venous access. In 76% of episodes, patients had a Broviac
      Hickman-like catheter, and in 24% a totally implanted venous access chamber
      system. The need for catheter removal during a febrile infection was 0.32/1000
      catheter days, and the documented sepsis rate was 0.59/1000 catheter days. Our
      data indicate that 94% of episodes of fever and neutropenia in total, 78% of
      documented septicemias, and 97% of fevers of unknown origin were curable with
      broad-coverage antimicrobial therapy without removing the central venous line.
      Totally implanted chambers had a lower infection rate than catheters of Broviac
      Hickman type.

PMID- 8362234
TI  - Susceptibility of respiratory tract pathogens in Finland to cefixime and nine
      other antimicrobial agents.
AB  - The in vitro activity of cefixime and 9 other orally used antimicrobial agents
      against 545 selected clinical respiratory tract pathogens was tested using the
      plate-dilution method. Of the strains tested, 144 were Haemophilus influenzae
      strains, 151 group A streptococci, 105 pneumococci and 145 Moraxella catarrhalis
      isolates. Ciprofloxacin was the most active drug, with a minimal inhibitory
      concentration (MIC) of < 0.06 mg/l for more than 87% of the isolates. With
      cefixime, a MIC of 0.06 mg/l inhibited 55% of the strains tested and a MIC of 1.0
      mg/l inhibited all except one of the 545 strains. One pneumococcal strain was
      resistant to cefixime. Beta-lactamase producing H. influenzae and M. catarrhalis
      strains were clearly more susceptible to cefixime than to other oral
      cephalosporins (cephalexin, cefaclor, cefuroxime). However, penicillin,
      ampicillin and cefuroxime were more effective against beta-hemolytic streptococci
      and pneumococci than was cefixime. The new third generation cephalosporin,
      cefixime, showed markedly better in vitro activity against certain major
      respiratory tract pathogens than the other peroral antimicrobials commonly used
      against respiratory tract infections.

PMID- 8362235
TI  - Pneumocystis carinii pneumonia presenting as an upper lobe cavity after
      aerosolized pentamidine prophylaxis in an HIV-infected patient.
AB  - We describe an atypical diagnostic feature of a breakthrough Pneumocystis carinii
      pneumonia (PCP) during primary prophylaxis with aerosolized pentamidine. Our case
      disclosed infiltrates restricted to the left upper lobe. After 2 weeks a solitary
      cavity developed. Diagnosis was easily established by bronchoalveolar lavage when
      performed in the affected segment bronchus. Cavitation clearly demonstrated
      localized infection, with tissue destruction as one main pathogenetic pattern of
      a breakthrough PCP during aerosolized pentamidine prophylaxis.

PMID- 8362236
TI  - Fatal disseminated infection by Scedosporium inflatum after bone marrow
      transplantation.
AB  - A case of disseminated infection caused by Scedosporium inflatum is reported in a
      patient undergoing autologous bone marrow transplantation for acute myeloblastic
      leukemia. The fungus was isolated from a blood culture and necropsy studies
      showed a disseminated infection involving numerous organs. In vitro studies
      showed the isolate to be resistant to amphotericin B, 5-fluorocytosine,
      ketoconazole and miconazole.

PMID- 8362237
TI  - Nasal administration of IgA to individuals with hypogammaglobulinemia.
AB  - Many immunodeficient patients constantly carry non-typable Hemophilus influenzae
      (NTHI) in the nasopharynx, despite seemingly adequate antibiotic therapy. We have
      studied the effect of nasal administration of IgA on nasopharyngeal colonization
      in 5 patients with hypogammaglobulinemia, with a productive cough, especially in
      the mornings, who were constant carriers of NTHI in the nasopharynx, and had IgA,
      1 ml 6 times/day, given nasally for 14 days. Nasopharyngeal cultures were
      obtained on days 0, 7, 14 and 28. Two of the patients became culture-negative
      during the treatment, and the cough was alleviated in all patients.

PMID- 8362239
TI  - Genetics and male sexual orientation.

PMID- 8362238
TI  - Absence of human T-lymphotropic retrovirus type-1 (HTLV-1) in different
      populations of Mongolia.
AB  - The prevalence of human T-lymphotropic retrovirus type-1 (HTLV-1) was surveyed in
      Mongolia. A total of 1100 blood samples from different ethnic groups of the
      Mongolian population were examined for the presence of antibodies to HTLV-1 by
      serological tests using particle agglutination and immunofluorescence. All sera
      tested proved negative and Mongolian populations are therefore considered to be
      free from HTLV-1 infection.

PMID- 8362240
TI  - Genetics and male sexual orientation.

PMID- 8362241
TI  - A heavy ion accelerator gears up to fight cancer.

PMID- 8362242
TI  - Cholesterol and the Golgi apparatus.

PMID- 8362243
TI  - DNA conformation-induced activation of an enediyne for site-specific cleavage.
AB  - Neocarzinostatin chromophore (NCS chrom) was found to induce site-specific
      cleavage at the 3' side of a bulge in single-stranded DNA in the absence of
      thiol. This reaction involved the oxidative formation of a DNA fragment with a
      nucleoside 5'-aldehyde at its 5' terminus and generated an ultraviolet light
      absorbing and fluorescent species of post-activated drug containing tritium
      abstracted from the carbon at the 5' position of the target nucleotide. The DNAs
      containing point mutations that disrupt the bulge were not cleavage substrates
      and did not generate this drug product. Thus, DNA is an active participant in its
      own destruction, and NCS chrom may be useful as a probe for bulged structures in
      nucleic acids.

PMID- 8362244
TI  - Rat annexin V crystal structure: Ca(2+)-induced conformational changes.
AB  - Annexins are a family of calcium- and phospholipid-binding proteins implicated in
      mediating membrane-related processes such as secretion, signal transduction, and
      ion channel activity. The crystal structure of rat annexin V was solved to 1.9
      angstrom resolution by multiple isomorphous replacement. Unlike previously solved
      annexin V structures, all four domains bound calcium in this structure. Calcium
      binding in the third domain induced a large relocation of the calcium-binding
      loop regions, exposing the single tryptophan residue to the solvent. These
      alterations in annexin V suggest a role for domain 3 in calcium-triggered
      interaction with phospholipid membranes.

PMID- 8362245
TI  - Determining whitefly species.

PMID- 8362246
TI  - Hemostasis in liver transplantation: the surgeon's view.

PMID- 8362247
TI  - Hemostasis in advanced liver disease.

PMID- 8362248
TI  - Coagulation and fibrinolysis in orthotopic liver transplantation: current views
      and insights.
AB  - Bleeding in OLT is related to two different mechanisms. There is no doubt that
      the extensive surgical trauma plays a critical role in the origin of serious
      bleeding. However, this bleeding can be aggravated by defects in the hemostasis
      system. Hemostasis defects can be divided into those present before the operation
      and secondary to the underlying liver disease and those originating during the
      operation. Intraoperative defects can be classified according to the three main
      systems of hemostasis: coagulation, fibrinolysis, and platelet function. Serious
      problems with coagulation are clearly related to the quality of the graft and are
      less frequent now since better graft preservation techniques have been
      introduced. Adequate intraoperative monitoring and substitution therapy with
      plasma products is also important in controlling coagulation defects. However,
      problems resulting from hyperfibrinolysis seem to be of clinical importance,
      especially during the anhepatic stage and after graft reperfusion. While lack of
      hepatic clearance seems to be an important cause of t-PA increase during the
      anhepatic stage, enhanced release may be important for the rise after graft
      reperfusion. There is also evidence that decreased platelet numbers and function,
      especially after graft reperfusion, play a role. The clinical relevance of this
      finding remains to be elucidated. Finally, it has recently been demonstrated that
      antifibrinolytic agents may reduce intraoperative blood loss. However, the effect
      of aprotinin and other antifibrinolytic agents has still to be confirmed by
      randomized clinical studies. Future scientific research should focus on the
      mechanisms underlying the hemostasis defects. It can be expected that these
      efforts may finally result in a further reduction in the usage of blood products
      during liver transplantation.

PMID- 8362249
TI  - Thrombocytopenia and platelet dysfunction in orthotopic liver transplantation.

PMID- 8362250
TI  - Hemostasis in heterotopic liver transplantation.

PMID- 8362252
TI  - Retrospective statistical analysis of coagulation parameters after 250 liver
      transplantations.
AB  - Extensive transfusion of blood components as a typical feature of OLT has been
      described by many authors. The perioperative requirement for transfusion,
      however, follows a downward trend, although the indications for OLT have been
      extended. Functional disturbances such as hyperfibrinolysis or platelet
      dysfunction, demonstrated by laboratory tests, such as platelet counts, PT, aPTT,
      TT, fibrinogen, and ATIII are often used to direct the transfusion of blood
      components, although preoperative data give insight only into the insufficient
      function of the old liver, which will be explanted and replaced by the donor
      graft. We have described a retrospective statistical analysis of laboratory data,
      clinical data, and perioperative blood requirements from 250 liver
      transplantations performed in our hospital from 1988 to 1992. The OLT was
      performed according to the usual surgical methods using a venovenous bypass
      system. Intraoperatively, volume was restored with packed RBC and FFP according
      to hemodynamic data, hemoglobin, and diuresis; clotting data were not used as
      indications for blood replacement. This analysis demonstrated that neither
      preoperative nor intraoperative clotting parameters were able to allow a
      prediction of the intraoperative requirement for transfusion of blood components;
      these findings parallel those of previous reports. With respect to other studies
      showing that perioperative transfusion rates correlated with postoperative
      infections and mortality, we strongly suggest that perioperative clotting
      measures as indicators for transfusion requirement should be analyzed with
      caution. Whether other diagnostic methods such as TEG are useful alternatives has
      to be determined.

PMID- 8362251
TI  - Hemostasis in children undergoing liver transplantation.
AB  - We reviewed the records of 200 children who underwent 238 orthotopic liver
      transplantations in order to determine which preoperative factors could predict
      intraoperative blood loss. A coagulation abnormality score (CAS) was calculated
      by allowing one point for each abnormality in six preoperative coagulation tests.
      The mean CAS values were significantly greater in children suffering from
      fulminant hepatic failure (Fulm) or post-necrotic cirrhosis (PNC) and those
      having retransplantation (ReTx) than in those with disease of other etiologies.
      No correlation was found between the CAS and the mean blood requirements in the
      different etiology groups. According to the amount of blood transfused, children
      could be divided in two groups. Group 1 were those with biliary atresia and ReTx,
      who received more than 200 ml/kg. Group 2 included those with PNC, Fulm,
      metabolic diseases, and Alagille syndrome and Byler disease, who received less
      than 140 ml/kg. The mean CAS was significantly lower and the PT significantly
      better in Group 1. We conclude that preoperative coagulation tests were weak
      predictors of intraoperative bleeding. The etiology of the underlying liver
      disease and previous abdominal surgery play an important role in the occurrence
      of severe bleeding. Intraoperatively, children presented the same hemostatic
      changes as adults.

PMID- 8362253
TI  - Intraoperative monitoring and postoperative reevaluation of hemostasis in
      orthotopic liver transplantation.

PMID- 8362254
TI  - Laboratory measures of hemostasis for monitoring liver graft function.

PMID- 8362255
TI  - Clinical use of synthetic antifibrinolytic agents during liver transplantation.

PMID- 8362256
TI  - Antithrombin III replacement in orthotopic liver transplantation.

PMID- 8362257
TI  - Role of protein S in orthotopic liver transplantation.

PMID- 8362258
TI  - The "lytic state" during orthotopic liver transplantation: plasminogen activators
      and other protease activities.

PMID- 8362259
TI  - Recovery of antithrombin III in patients undergoing orthotopic liver
      transplantation after administration of an antithrombin III concentrate.

PMID- 8362260
TI  - Biochemical and pharmacologic profile of defined molecular weight fractions of
      heparin.

PMID- 8362261
TI  - Venous thromboembolism after hospital discharge.
AB  - Several methods of prophylaxis have significantly reduced the risk of developing
      VTE during hospital admission. There is a current tendency toward a reduction in
      the hospital stay, which does not necessarily mean that patients are protected
      from experiencing thrombotic complications after leaving the hospital. A number
      of patients will develop DVT and PE after hospital discharge if prophylaxis is
      prematurely discontinued while they persist at risk. Further studies are
      necessary to establish whether extending prophylaxis beyond discharge will reduce
      the rate of late-onset thromboses and which are the best prophylactic
      alternatives for the different patient groups at risk. Meanwhile, it is our
      standard of practice to utilize a combination of GES and either low-dose heparin
      or warfarin, at least for 3 or 4 weeks after discharge in high-risk patients. In
      countries where low molecular weight heparins are available, these agents
      represent an attractive alternative to unfractionated heparin because of their
      better dosage schedule and safety profile.

PMID- 8362262
TI  - Venography used for deep vein thrombosis screening of asymptomatic patients
      undergoing total hip replacement.

PMID- 8362263
TI  - Endpoints for diagnosis of postoperative thromboembolism in hip fracture surgery.

PMID- 8362264
TI  - Measurement of beta-thromboglobulin and platelet factor 4 to follow up patients
      with artificial heart valves.
AB  - Efficient antithrombotic therapies are necessary for the prevention of thrombotic
      complications in patients with artificial heart valves. Antiplatelet drugs are
      commonly used since platelet activation is a feature frequently found in these
      pathologic conditions. The measurement of beta TG and PF4 is useful for the
      diagnosis of platelet activation, which may increase the thrombotic risk. Two
      commercially available ELISA kits for beta TG and PF4 were tested and compared
      with the corresponding RIA methods used previously. Coefficients of correlation
      were 0.976 for beta TG and 0.985 for PF4. Both methods gave identical results,
      although RIA was expressed in nanograms per milliliter, whereas ELISA results
      were in international units per milliliter by comparison with International
      Standards. For both parameters 1 IU/ml was found to be almost equal to 1 ng/ml.
      beta TG was elevated in the group of patients with heart valves (57.28 IU/ml); so
      was PF4 but to a lesser extent (11.28 IU/ml). The mean concentrations on a normal
      population were, respectively, 22.40 (+/- 5.15) IU/ml and 4.10 (+/- 2.02) IU/ml.
      The monitoring of patients with heart valves allowed the identification of two
      distinct groups: those who had persistent elevated levels of beta TG and PF4, and
      those whose levels of the same parameters were in the subnormal ranges. All the
      thrombotic complications were observed in the first group and were preceded by an
      elevation of platelet markers. beta TG was the most predictive and correlated
      closely with the evolution of the clinical state. Cerebrovascular accidents were
      the commonly observed complications. These patients were treated by hypocoagulant
      therapy and with antiplatelet drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362265
TI  - Antithrombotic activities of aprosulate sodium (LW 10082) and its neutralization
      by protamine.

PMID- 8362266
TI  - Antithrombotic effect and clinical potential of defibrotide.

PMID- 8362267
TI  - Contrast media influence on thrombotic risk during coronary angioplasty.

PMID- 8362268
TI  - Antithrombin III- and heparin cofactor II-mediated anticoagulant and antiprotease
      actions of heparin and its synthetic analogues.
AB  - A chemically synthesized pentasaccharide, a specific ligand for AT III, and a
      synthetic, sulfated bis-lactobionic acid amide, a ligand for HC-II, were studied
      along with heparin to determine the relative contribution of AT III and HC II in
      the inhibition of protease activation in plasma. The global clotting assays (PT,
      APTT, Heptest, TT), amidolytic anti-IIa and anti-Xa assays, and defined
      biochemical systems supplemented with purified AT III and HC II were used in this
      study. In the plasma-based assays, heparin exhibited strong inhibition in both
      thrombin and Factor Xa-based assays, whereas pentasaccharide was only active in
      Factor Xa-based assays and lactobionic acid was only active in thrombin-based
      assays. In the AT III supplemented systems, heparin was able to inhibit strongly
      both Factor Xa and thrombin, while pentasaccharide could only inhibit Factor Xa.
      Lactobionic acid was ineffective at mediating its actions through AT III. In the
      HC II-mediated inhibition of thrombin, heparin and lactobionic acid both had
      strong inhibitory actions. Pentasaccharide was ineffective in this assay. All
      three agents failed to inhibit Factor Xa via HC II. These studies suggest that
      specific synthetic analogues of heparin such as the pentasaccharide and
      lactobionic acid can be used to study the relative contributions of AT III and HC
      II in the control of protease activation during thrombogenesis.

PMID- 8362269
TI  - Comparative pharmacologic profile of a glycosaminoglycan mixture, Sulodexide, and
      a chemically modified heparin derivative, Suleparoide.

PMID- 8362270
TI  - Coacute heparin: a new simple monotest for monitoring heparin treatment.
AB  - Anti-factor Xa methods have been generally accepted for the monitoring of heparin
      treatment mainly due to their sensitivity to LMWH and excellent performance on
      automated equipment. When such equipment is not available, as in small
      laboratories or on the night shift, there is a need for a simple manual method.
      In the present method, activated Factor X and a chromogenic peptide substrate are
      colyophilized in plastic cuvettes under conditions that avoid reaction between
      the two constituents. The assay is performed accordingly. Plasma (200
      microliters) is diluted in 3.0 ml predispensed Tris buffer containing dextran
      sulfate 8000 to avoid losses of heparin due to platelet factor 4, for example.
      The diluted plasma (400 microliters) is added to a cuvette. The reagents are
      rapidly dissolved and the reactions start. The rate of Factor Xa inhibition is
      proportional to the heparin activity. During the incubation, the substrate is
      also hydrolyzed by the remaining enzyme. This combination of reactions is
      insensitive to changes in temperature making it possible to perform the assay at
      room temperature. After 10 minutes incubation, the reaction is stopped by adding
      400 microliters of 5% acetic acid. The absorbance is read in a well-calibrated
      photometer and the results plotted on a graph available in the kit. Eleven
      commercially available heparins have been tested with the assay and they all fell
      within a narrow range, showing the relevance of using a standard plot for all
      heparins. The LMWH behaved differently and it may also be that they demand
      different therapeutic strategies.

PMID- 8362271
TI  - A new approach in monitoring recombinant hirudin during cardiopulmonary bypass.

PMID- 8362272
TI  - Problems in financing the care of AIDS patients.
AB  - The problem of financing the care of patients with acquired immune deficiency
      syndrome (AIDS) has reached crisis proportions. How will the United States cope
      with paying for the care of AIDS patients, many of whom either are denied private
      insurance or simply do not have money to pay for medical care? This article
      discusses how each component of the U.S. health care financing system is
      attempting to minimize its financial exposure to AIDS. It presents remedies that
      have been suggested in the literature. Finally, it points out the flaws in the
      current system for dealing with people who suffer from catastrophic illnesses.

PMID- 8362273
TI  - A community-based approach to HIV case management: systematizing the
      unmanageable.
AB  - This article presents an analysis and typology of community-based care for a
      young Hispanic mother with acquired immune deficiency syndrome (AIDS). It
      develops a conceptual framework that examines retrospectively the needs generated
      by AIDS over time, the appropriateness of the services, and an assessment of the
      interventions. Community-based case management can effectively address some of
      the diverse and changing needs of AIDS patients and their families, such as
      bridging service gaps and fortifying patient and system strengths while
      minimizing their weaknesses. Community-based case managers may also be better
      equipped than hospital case managers to work with difficult patients and
      coordinate community- and hospital-based care. Conclusions are presented
      regarding the definition and implementation of community-based, culturally
      sensitive, family-centered human immunodeficiency virus case management, as well
      as the importance and difficulty of developing relationships among the family,
      health care providers, and institutions within the community.

PMID- 8362274
TI  - Testing the sexually abused child for the HIV antibody: issues for the social
      worker.
AB  - The frequency of HIV transmission to children and adolescents through sexual
      abuse is unknown. Because the incidences of HIV infection and of reported sexual
      abuse are both increasing, the transmission of HIV to children through sexual
      abuse may also be increasing. Social workers may have expanding roles in the
      decision-making process for testing and subsequent management of children
      infected with HIV through sexual abuse. This article discusses the benefits of
      identifying children who have been infected with HIV through sexual abuse and
      reviews guidelines for testing. Social workers can contribute to test decision
      making in instances when perinatal HIV transmission is a possibility, when it may
      be possible to test the assailant, and when parents or legal guardians insist on
      testing the child. Other issues discussed include family education and coping,
      physical education and support, social casework and research with pedophiles, and
      service needs for care and follow-up of children found to be HIV infected as a
      result of sexual abuse.

PMID- 8362275
TI  - Influence of education on self-perceived attitudes about HIV/AIDS among human
      services providers.
AB  - Participants in a number of different HIV/AIDS educational programs, varying in
      content, length of course, and student audience, were surveyed to determine if
      education could help reduce fear and increase comfort in work with HIV/AIDS
      clients. It was hypothesized that attitude scores would improve following
      exposure to the educational programs. A retrospective pretest-posttest survey
      design consisting of Likert statements was used. A t test for paired samples
      determined if attitude scores improved following exposure to the educational
      programs. An analysis of variance determined if significant differences in
      pretest and posttest scores existed among the groups. Within groups, there was a
      positive increase in self-assessed attitude scores. Multiple group comparisons
      indicated significant differences between groups that appear to be related to
      program content and length. Workplace risk and whether a program was elective may
      have also been factors affecting attitude.

PMID- 8362276
TI  - Judgments of personal responsibility for HIV infection: an attributional
      analysis.
AB  - This article examines the influence that attributions of personal responsibility
      for infection with the human immunodeficiency virus have on service and policy
      responses to the epidemic. A model of attributed responsibility is proposed that
      classifies social judgments of another person's behavior that take into account
      the extent to which the behavior caused the situation, the person knew or should
      have known the potential consequences of the behavior, the person intended to
      engage in the behavior, and factors over which the person had little or no
      control might have influenced the behavior. Research has shown that attributions
      of responsibility lead to increased anger, decreased empathy, and a diminished
      willingness to offer help to others in need. The author concludes that awareness
      of attributions of responsibility may help reduce their discriminatory effects at
      all levels of social work practice.

PMID- 8362277
TI  - AIDS and social work: the ethics and civil liberties agenda.
AB  - Social workers are becoming increasingly involved in casework and social policy
      debate related to the acquired immune deficiency syndrome (AIDS) crisis. To
      enhance their delivery of services and contribution to policy formulation, social
      workers need to be familiar with a wide range of ethical and civil liberties
      issues that have been generated by the AIDS epidemic. This article provides an
      overview of six major ethical and civil liberties issues pertaining to social
      work practice related to AIDS: (1) mandatory screening and testing of clients for
      the human immunodeficiency virus (HIV), (2) client access to health insurance,
      (3) professionals' duty to treat HIV-infected clients, (4) privacy and
      confidentiality, (5) client involvement in AIDS research, and (6) relevant legal
      issues. Implications for social work practice are highlighted, particularly with
      respect to protecting clients' rights and formulating a social action agenda.

PMID- 8362278
TI  - Differences among adolescent, young adult, and adult callers of suicide help
      lines.
AB  - The authors examined data on 165 adolescents (ages 12 to 19), 65 young adults
      (ages 20 to 26), and 175 adults (ages 27 and older) who called two suicide help
      lines in Los Angeles County during a two-week period. One crisis line is operated
      by a major suicide prevention center; the second is a crisis help line for
      adolescents that offers peer counselors. Adults and young adults reported
      depression as the primary reason for contemplating suicide; adolescents reported
      interpersonal problems. Despite the chronic nature of the presenting problems,
      referrals were provided to fewer than one-half of the adults and young adults and
      fewer than one-third of the adolescent callers. Although the callers reported
      suicide ideation, a very small percentage fell into the high-risk categories with
      regard to degree of suicide planfulness and lethality of chosen method.

PMID- 8362279
TI  - Support systems and stress reduction among workers caring for dependent parents.
AB  - This study investigated the impact of three types of support--from family and
      friends, the workplace, and community services agencies--on the perceived stress
      and health outcomes of 133 employed caregivers of dependent parents. The stressor
      support-stress-reaction model guided the research. Support from family and
      friends and community agencies was found to buffer the negative impact of
      caregiving and work and family role strain, and a supportive work environment was
      one predictor of lessened physical strain.

PMID- 8362280
TI  - Reconstruing codependency using self-in-relation theory: a feminist perspective.
AB  - Judging from advertisements for professional books, continuing education
      workshops, and speakers, social workers appear to believe that codependency is a
      problem about which they should be knowledgeable. This article traces the
      evolution of the codependency construct and its burgeoning popularity in the
      1980s. It critically examines codependency from the perspective of researchers
      who have found little empirical support for the constellation of characteristics
      used to define the term and from the perspective of feminist analysis. In
      addition, the article analyzes the assumptions about health and relationships
      that are embedded in the concept of the codependency and contends, from the
      perspective of self-in-relation theory, that the concept does not provide a
      useful framework for social work conceptualization and intervention with women.

PMID- 8362281
TI  - Economic questions concerning leprosy control.

PMID- 8362282
TI  - Serological diagnosis of Toxoplasma gondii infection in women associated with
      gyneco-obstetric problems.
AB  - The latex agglutination test (Toxoreagent) was used to detect the sero-prevalence
      of Toxoplasma gondii in 302 Bangladeshi women who were under treatment for
      various gyneco-obstetric problems at the Mymensingh Medical College during
      January to June 1991. The over-all sero-prevalence rate was 15.89%, of which
      6.25% reacted at 1:32, 33.33% at 1:64, 16.67% at 1:128, 22.92% at 1:256, 6.25% at
      1:512 and 14.58% at 1:1024. The positivity rate of 18.60% recorded in women
      between 31 and 40 years was insignificantly (p > 0.05) higher than that of 15.44%
      in women between 17 and 30 years of age. Over-all 26.49% of infections resulted
      in abortion, 6.62 in stillbirths and 30.79% in dystocia, of which 20.0%, 30.0%
      and 7.53% women had positive titers to T. gondii, respectively, whereas 17.43%
      women with normal live births had also positive titers to T. gondii. The over-all
      prevalence rate of abortion in association with T. gondii infection was 5.30%
      which was higher than the rates of stillbirths (1.99%) and perinatal death
      (0.66%). It is concluded that toxoplasmosis can cause abortion, stillbirths and
      perinatal death in Bangladeshi women.

PMID- 8362283
TI  - Immunoproliferative small intestinal disease (IPSID) in Thailand.
AB  - Immunoproliferative small intestinal disease (IPSID) is prevalent in the
      Mediterranean region and in many Third World countries but is rare in Southeast
      Asia. Between 1980-1990, 4 cases of IPSID were admitted to Ramathibodi Hospital,
      Bangkok. Three were males and the mean age was 32 +/- 20.2 years. All patients
      presented with chronic diarrhea of 7 months to 6 years duration, and weight loss
      of 15 to 31 kg. All were malnourished, three cachectic, and one patient showed
      growth retardation. Intestinal parasites were found in all cases: two had
      multiple infections and three had uncommon protozoal infections (coccidium,
      cryptosporidium). Barium radiographs revealed intestinal mucosal fold thickening
      with malabsorption pattern in all cases. Alpha chain IgA was detected in one
      patient. The remainder underwent exploratory laparotomy and the histological
      finding was of plasma lymphocytic infiltration of the small intestinal mucosa.
      All patients responded to oral tetracycline with complete remission occurring in
      one case. During the follow-up period, 3 cases had progressive retractable
      clinical courses but all died 2 to 5 years after the diagnosis. The causes of
      death in these patients were secondary bacterial infection (1 case), intestinal
      tuberculosis (1 case), fungal infection (1 case) and immunoblastic sarcoma in
      another case. The results of this study confirm the occurrence of IPSID in
      Thailand. IPSID responds to oral antibiotic therapy and complete remission may be
      achieved during the early reversible benign phase, thus an awareness of its
      occurrence is of clinical importance.

PMID- 8362284
TI  - The occurrence of salmonellae in bean sprouts in Thailand.
AB  - Detection of Salmonella spp. in 344 samples of bean sprouts was attempted by pre
      enriched in buffered peptone water (BPW) or lactose broth (LB) at 37 degrees C,
      followed by selective enrichments, selenite cystein broth (SCB) and Rappaport
      medium (RV) at 43 degrees C. Four selective media, bismuth sulphite agar (BSA),
      brilliant green agar (BGA), Salmonella-Shigella agar (SSA) and MacConkey agar
      (MA) were used for isolation. Salmonellae were isolated from 30 (8.7%) samples.
      They were serotypes lexington (56.7%), orion (16.7%), senftenberg (16.7%),
      tennessee (3.3%), poona (3.3%) and weltevreden (3.3%). Pre-enrichment in LB,
      followed by enrichment in SCB and streaking on to BSA gave the highest
      recoveries. Fifteen of 30 strains isolated were sensitive to all 14 antibiotics
      tested. Seven strains were resistant to one, and a strains showed multiple
      resistance to 2-4 antimicrobial agents.

PMID- 8362285
TI  - Ileal perforation in typhoid: bacteriological and immunological findings.
AB  - In typhoid perforation patients, Salmonella typhi was isolated from blood in 4%,
      ileal contents in 23%, peritoneal pus in 13% and from mesenteric lymph nodes in
      71%. While isolation of S. typhi was made from patients with less than 4 days of
      chloramphenicol therapy, cultures were negative from these sites after 5 days of
      therapy; however, S. typhi appeared to remain viable in the lymph nodes even
      after such therapy. All isolates of S. typhi were sensitive to chloramphenicol.
      Significant SAT titers (0 > or = 1/240) were obtained in only 7/21 (33%) of
      patients. The perforated group had lower geometric mean titers (0-1/138; H-1/46),
      when compared to matched patients with uncomplicated typhoid fever (0-1/476; H
      1/148). This difference was significant (0- p < 0.005; H- p < 0.0025). The two
      groups (uncomplicated and perforated) showed no significant difference in total
      serum IgG, IgM and IgA or isohemagglutinin levels, indicating that the apparent
      hyporeactivity was not due to a generalized humoral immunodeficiency. Mesenteric
      lymph node histology showed hyporeactivity in both the T cell and B cell zones.
      These findings are discussed with the suggestion that S. typhi-specific host
      immunological hyporeactivity could be an explanation for these observations and a
      basis for the pathogenesis of perforation. Aerobic cultures of the peritoneal pus
      gave 39 isolates from 25 patients; the predominant isolates were Escherichia coli
      (24) and Klebsiella pneumoniae (12). On no occasion was S. typhi the predominant
      isolate. Gentamicin and kanamycin were the only two antibiotics which were
      consistently effective in vitro against the aerobic isolates from peritoneal pus.

PMID- 8362286
TI  - Pasteur oral cholera vaccine: studies of reactogenicity, clinical acceptability
      and immunogenicity in human volunteers.
AB  - Pasteur cholera vaccine consists of isolated antigenic fractions from V. cholerae
      El Tor Ogawa and Inaba. Enteric coated microgranules were prepared from antigen
      lyophilisate. Three doses of this vaccine were administered orally to 19 healthy
      young Thai adults at one week intervals. None of the volunteers experienced
      untowards reactions. The vibriocidal antibody responses manifested a significant
      antibody rise (> or = 4 fold) to serovar Inaba in 8 vaccinees (42.1%) and Ogawa
      in 4 (21.1%). Five and 6 vaccinees (26.3% and 31.6%) showed a > or = 4 fold rise
      of IgG and IgA anti-LPS, respectively.

PMID- 8362287
TI  - The effect of permethrin impregnated bednets on the incidence of Plasmodium
      falciparum, in children of north Guadalcanal, Solomon Islands.
AB  - The effect of permethrin impregnated bednets was studied for the first time
      amongst a large community in North Guadalcanal, Solomon Islands. The community
      was divided into two; one covered 23 villages with 860 people who were given
      bednets impregnated at 0.5 g/m2, and the other 20 villages with 520 people was
      used as control. Parasitological data were collected by regular prevalence
      surveys and examination of records of malaria patients who have sought treatment
      in clinics. Entomological data by landing catches using human bait. The
      entomological results showed a 71% reduction of Anopheles farauti. Even though
      there was no significant reduction observed with An.punctulatus, as the density
      was already very low, the number biting indoor was much lower than those outdoor
      of houses with treated bednets. Parasitologically there was a steady decline in
      the incidence between surveys with Plasmodium falciparum in the under 10 years
      old. Even though there was no significant reduction in the other variables
      measured, there was a steady increase in the clearance rate between surveys which
      might also be due to easy accessibility to chemotherapy. The study showed the
      significant beneficial effect of permethrin impregnated bednets, which was found
      to be still effective up to twelve months, against stable P. falciparum malaria
      in children.

PMID- 8362288
TI  - Studies on the effect of lambdacyhalothrin on Anopheles maculatus Theobald and
      its response to residual spraying at Jeram Kedah, Negeri Sembilan, Malaysia.
AB  - A field trial was carried out to study the effect of lambdacyhalothrin on
      Anopheles maculatus in trap huts in Jeram Kedah, Negeri Sembilan, Malaysia. Two
      trap huts were built, of which one was sprayed with lambdacyhalothrin at a dosage
      of 25 mg ai/m2 and the other served as control. Eight collectors commenced
      collecting mosquitos from 1900 to 2400 hours, two each indoors and outdoors.
      Bioassay was also carried out in the treated and control huts to determine
      susceptibility of adult mosquitos to lambdacyhalothrin. In the treated hut more
      mosquitos were present during the pre- spraying period. Lambdacyhalothrin gave a
      mortality of 100% against An. maculatus for 8 months.

PMID- 8362289
TI  - Mosquito larvae and associated macroorganisms occurring in gem pits in southern
      Tha Mai District, Chanthaburi Province, Thailand.
AB  - Aquatic field studies were conducted in Tha Mai District, Chanthaburi Province,
      Thailand. Larval habitats of Anopheles dirus were examined from November 1986
      through June 1988 in 42 manmade gem pits. Larvae were found in pits containing
      clear water under full or partial shade. The abundance of different kinds of
      mosquito larvae were related to seasonal changes in these aquatic habitats.
      Variations in An. dirus density and occurrence were related to predators
      populations, ie Notonectidae and fish.

PMID- 8362291
TI  - Laboratory evaluation of two commercial repellants against Leptotrombidium
      fletcheri (Acari: Trombiculidae).
AB  - Two commercial repellants were evaluated in the laboratory against
      Leptotrombidium fletcheri chiggers. The active ingredient in one was DEET and in
      the other was citrus oil. Excito-toxicity effect was studied and it was
      determined by the time ("escape time") chiggers took to move off filter papers
      treated with the repellants. All chiggers exposed on filter papers treated with
      DEET died and did not move off the treated papers. None of the chiggers that were
      placed on papers treated with citrus oil were killed. Escape times on papers
      treated with a 2-sec spray of citrus oil were longer than those for the 4- and 8
      sec sprays. The weights of citrus oil deposited increased with increasing spray
      times. Electron microscopy showed that the repellants had no effect on the
      texture of the filter papers. It was concluded that the spray containing DEET was
      more effective; however, both repellants should be further evaluated under field
      conditions for protection against chigger bites.

PMID- 8362290
TI  - Biting density, behavior and age distribution of Culex quinquefasciatus, say in
      Mysore City, India.
AB  - The seasonal abundance, night indoor biting behavior and parity of Culex
      quinquefasciatus were investigated for a period of one year from June 1988 to May
      1989 in Mysore City. Twelve-hour night-time biting catches were carried out from
      1800-0600 hours at four selected urban localities. The biting cycle revealed that
      Cx. quinquefasciatus was active throughout the night, with peak activity at 2200
      2300 hours. The biting proportion of nulliparous and parous mosquitos during
      different hours of the night showed that nulliparous mosquitos increased from
      1800 to 0600 hours (dusk to dawn), while parous mosquitos (aged) decreased from
      early night to the morning. One major and two minor biting peaks were encountered
      here. The maximum density noticed was during March 1989 (147.5 per man night) and
      the lowest was during July 1988 (58.3 per man night). The biting behavior/density
      of this important urban mosquito vector under the existing climatic conditions
      are discussed in the light of the earlier reports elsewhere.

PMID- 8362292
TI  - Natural parasitic infection of the golden apple snail, Pomacea canaliculata.
AB  - Golden apple snails, Pomacea canaliculata, were collected once a month during a
      year to search for their natural parasites. The collections were made at two
      localities having different ecological environments. Of 576 collected snails from
      a canal, 176 individuals (30.6%) were infected by three groups of metacercariae.
      These parasites were amphistome, distome and echinostome metacercariae, which had
      prevalences of 23.5, 19.5 and 0.5%, respectively. The incidence of infection was
      highest (68.4% in October) when the snail population was composed of the old,
      juvenile and young Pomacea. Amphistome metacercariae were found most frequently
      and echinostome metacercariae the least frequently; both parasites were localized
      in the foot muscle of the snails and had a Shannon index of zero. The range of
      amphistomes was 1 to 115 with the mean +/- SD of 1 +/- 2 and 95% CL of 1, 2.
      Distome metacercariae were found primarily in the heart (range: 1-13), and also
      in the foot muscle (range: 1-5) and kidney (range: 1-14), with a Shannon index of
      0.4. The means +/- SD (with 95% CL) were 3 +/- 4 (95% CL = 1, 5), 3 +/- 4 (95% CL
      = 2, 4) and 2 +/- 1 (95% CL = 1, 2) for the foot muscle, heart and kidney,
      respectively. The snails from a pond, another locality, had a low proportion of
      infected individuals. Of 605 snails, only 24 individuals (4.0%) were infected,
      with the prevalence of amphistomes, distomes and echinostomes being 0.8, 1.8 and
      2.1%, respectively. The incidence of infection for each month was zero or less
      than 10%, except in May when it was 30.2%.

PMID- 8362293
TI  - Studies on the cobra neurotoxin inhibiting activity in an extract of Curcuma sp.
      (Zingiberaceae) rhizome.
AB  - A study was carried on the mode of action and some properties of a cobra
      neurotoxin inhibitor found in the extract of Curcuma sp. (Zingiberaceae). When
      the principal postsynaptic neurotoxin (STX) of the Thai cobra (Naja naja
      siamensis) was mixed with an aqueous extract of Curcuma sp. rhizome, the STX was
      inactivated as tested in mice or in vitro using a rat hemidiaphragm preparation.
      The 'neurotoxin inhibitor' ('NTxI') was found only in the water insoluble
      fraction of the rhizome extract. Using radioactively labeled neurotoxins, 125I
      STX and 3H-STX, it was demonstrated that the neurotoxin did not form a stable
      complex with the 'NTxI'; the inactivated neurotoxin remained in the supernatant
      of the reaction mixture. After inactivation by 'NTxI', the STX exhibited an
      unchanged molecular weight as judged by SDS-polyacrylamide gel electrophoresis
      and an unchanged isoelectric point in isoelectric focusing. Extraction of the
      Curcuma sp. rhizome with at least 0.2% Triton X-100 resulted in solubilization of
      a component capable of forming a soluble and stable complex with 3H-STX. By
      column chromatography on Sephadex G-200 in the presence of 0.1% Triton X-100, the
      toxin-binding compound was shown to have a molecular weight of about 150 kDa.
      This 150 kDa component was obtained by Triton extraction of the water-insoluble
      fraction, and much less from the water soluble fraction, of Curcuma sp. rhizome.
      It did not possess any carbohydrate side-chain capable of binding the lectin
      Concanavalin A. The time course of the 150 kDa-3H-STX complex formation was
      extremely slow (approx 22 hours).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362295
TI  - Snakebites at Maharat Nakhon Ratchasima Regional Hospital.
AB  - One hundred and ninety-nine victims of snakebite hospitalized at Maharat Nakhon
      Ratchasima Hospital between 1898 and 1991 were studied. The male:female ratio was
      1.9:1 and their mean age (+/- SD) was 30.0 +/- 18.6 years. The most common of
      victims were farmers and laborers. Dead snakes were identified as follows: 72
      were Trimeresurus sp. (36.2%), 36 were Naja kaouthia (17.6%), 4 were Bungarus
      fasciatus (2.0%), 1 were Colloselasma rhodostoma (0.5%) and 1 was Vipera russelli
      (0.5%). No death was noted among the victims bitten by Trimeresurus sp, C.
      rhodostoma and V. russelli. Fifty-eight victims exhibited complications,
      constituting 29.1%. Four cases died from the bite of N. kaouthia, 2 from B.
      fasciatus and 1 from unidentified snake. A total death rate was 3.5% (7 in 199
      cases). The mean duration in the hospital for patients bitten by Trimeresurus sp.
      and N. kaouthia were 2.3 days and 2.0 days, respectively. In order to decrease
      the morbidity and mortality of snakebite victims in Nakhon Ratchasima Province,
      prevention and control of this entity should be emphasized in health education of
      local people, training programs on appropriate management of snakebites for the
      medical and paramedical personnel working in the remote rural district hospitals
      and health centers. In addition, antivenoms and other necessary medical supplies
      should be adequately provided.

PMID- 8362294
TI  - Some characteristics of hospitalized HIV seropositive patients in Myanmar.
AB  - Twenty-two hospitalized HIV seropositive patients were studied prospectively
      between July 1991 and January 1992. The majority of the patients were intravenous
      drug users (IVDUs). Their age ranged from 20 to 38 years with a male
      preponderance of 12 to 1. Anemia, lymphopenia and thrombocytopenia were observed
      in 100%, 36% and 41%, respectively. The common pathogens like malaria parasites,
      Mycobacterium tuberculosis, Entamoeba histolytica, Streptococcus and Salmonella
      were isolated/identified rather than opportunistic organisms.

PMID- 8362297
TI  - Urinary fibrin (-ogen) degradation products in Russell's viper (Daboia russelii
      siamensis) bite victims.
AB  - Serum and urine concentrations of fibrin (-ogen) degradation products (FDP) were
      estimated in 20 proven Russell's viper bite (RVB) cases with severe
      defribination. All patients had similar degrees of high serum FDP levels.
      However, the ten who developed into acute renal failure (ARF) had significantly
      (p < 0.001) higher urinary FDP levels than those who did not. The urinary FDP
      levels of ARF cases increased correspondingly with high serum FDP levels but not
      in cases without ARF. Serial comparison of serum and urinary FDP levels in RVB
      cases with severe defibrination may be of value in predicting the likelihood of
      developing ARF. The present study favored disseminated intravascular coagulation
      as the main cause of ARF in Myanmar RVB cases.

PMID- 8362296
TI  - Renal histopathology following Russell's viper (Vipera russelli) bite.
AB  - Renal lesions in ten patients following Russell's viper bite were studied. Renal
      biopsies were available in six and autopsies in four patients. Autopsied tissues
      from two cases of traumatic death served as controls. Both qualitative and
      quantitative changes in the glomeruli, tubules, interstitium and blood vessels
      were evaluated. Tubular necrosis was detected in five, tubular degeneration in
      nine, glomerular changes in nine and interstitial changes in four cases.
      Generally tissues from expired cases had more severe and extensive renal lesions
      than those that survived.

PMID- 8362298
TI  - Polymicrobial infective endocarditis with anterior spinal artery syndrome in a
      drug addict.

PMID- 8362299
TI  - An easy technique for histological sections of split intestinal tissue.

PMID- 8362300
TI  - The "P" in GMP--a major shift in growth monitoring program of a primary health
      care project.
AB  - Growth monitoring and promotion (GMP) is the monitoring of a child's growth to
      promote, maintain and restore health. The "P" in GMP relates to the promotive,
      preventive and curative actions which accompany the monitoring process. Data from
      two of the Primary Health Care field sites of The Aga Khan University, Essa Nagri
      and Azam Basti (squatter settlements), in Karachi for May 1989 was analyzed to
      determine the relationship between weight change and nutritional status. 21% of
      2,838 children had a decrease in weight from April to May 1989. Children in Grade
      I malnutrition (n = 274) contributed much more to this decrease than children
      with Grades II and III (54 and 5, respectively). By focusing attention only on
      those with Grades II and III malnutrition, the obvious ones, we have been missing
      the opportunity to prevent a deterioration of those in Grade I, though it is
      easier and less time consuming to reverse this trend in early stages of
      malnutrition. To ensure more quality-time for community health workers' focus on
      the at-risk population, three alternative "high-risk" groups are proposed.
      Promotion of growth and weight change needs to be stressed more, instead of the
      nutritional status only in GMP programs.

PMID- 8362301
TI  - Smoking habits and attitudes among doctors in a Malaysian hospital.
AB  - A study of the smoking habits and attitudes toward smoking among 120 doctors at
      the Hospital Universiti Sains Malaysia was conducted between May to August 1991.
      Eighteen percent of the doctors were smokers, 13% ex-smokers and 69% had never
      smoked. All the smokers were male and all except one smoked only cigarettes.
      Three of the 32 female doctors were ex-smokers. Nineteen of the 21 smokers only
      smoked in areas where they could not be seen by the public. Most doctors (equally
      among smokers and non-smokers) had first-degree relatives (mostly males) who were
      smokers and 28% had relative with smoking-related disease. 81% non-smoking and
      43% smoking doctors had advised healthy people to stop smoking. 92% non-smoking
      and 52% smoking doctors support the smoking-ban in the hospital. Seven of the 21
      smokers had never attempted to quit smoking.

PMID- 8362302
TI  - Leprosy trends in northern Thailand: 1951-1990.
AB  - Data of new, previously untreated leprosy patients from 6 northern provinces of
      Thailand, diagnosed at McKean Rehabilitation Center, Chiang Mai and associated
      clinics between 1951 and 1990 were analysed. The following trends were found: 1)
      Decreasing numbers of new, previously untreated patients. 2) Increasing average
      age of patients at onset and presentation of disease. 3) Decreasing duration
      between onset and presentation. 4) Increasing percentage of patients presenting
      within the first year of symptoms. 5) Increasing percentage of paucibacillary
      cases. 6) Decreasing percentage of patients presenting with deformity. These
      trends are a reflection of those seen for the whole of Thailand and indicate that
      leprosy control is being effective. Patients are presenting at an earlier stage
      than before, with consequent reduction in disability and infectivity. Better
      usage of chemotherapy since 1976 has helped to reduce the transmission of bacilli
      from person to person, combined with effective health education activities which
      have dispelled some wrong ideas about leprosy and encouraged patients to seek
      help early in the course of the disease. Additional factors related to public
      health and living standards have also contributed.

PMID- 8362303
TI  - Impact of an educational program on the treatment practices of diarrheal diseases
      among pharmacists and drugsellers.
AB  - The impact of an intervention program, measured by changes in the prescription of
      ORS, antibiotics and antidiarrheal drugs by those pharmacists and drugsellers
      after administering the proposed educational package was assessed. The results of
      the study indicated that, before the educational program started, ORS was
      prescribed by pharmacists for 31.4% and 15.7% of watery diarrhea and dysentery
      episodes, respectively. Only 18.9% and 13.3% of drugsellers gave ORS to assessors
      in case of watery diarrhea and dysentery. Antibiotics and antidiarrheal agents
      were prescribed extensively, watery and dysenteric diarrhea (84% and 56% for
      watery diarrhea by pharmacists and drugsellers; 92% and 60% for dysentery).
      Antidiarrheal drugs were used as frequently. After the educational program, the
      assessment of the prescription behavior of the pharmacists showed no change in
      ORS, antibiotics and antidiarrheal drugs prescribed to treat watery diarrhea. In
      dysentery, the effective percent change in prescribing ORS between pre- and post-
      intervention program was much higher in intervention group than the control
      group. For drugsellers, effective percent change in ORS usage in treatment of
      watery diarrhea was 11.8% compared with -7.7% in the control group. No such
      change was observed in treatment of dysentery. There was a slight significant
      change in behavior concerning use of antibiotics among subjects getting
      information by mail, compared to those who got full intervention, when the pre
      intervention behavior, store type and treatment type was taken into account.

PMID- 8362304
TI  - Latrine use in rural Sarawak, Malaysia.
AB  - A cross-sectional survey covering 976 households in 41 rural villages covered by
      the Rural Health Improvement Scheme in Sarawak was carried out to determine the
      type of latrines they have and their usage of pourflush latrines. The survey was
      carried out by inspection and interview. Fifty-six percent of the households had
      pourflush latrines and upon inspection 91.3% of them showed signs of recent use.
      Based on the interview, ninety percent of the women responded that they always
      use the latrine for defecation. It was also reported that 86.5% of the husbands
      and 47.6% of the children below five years, always used the latrine for
      defecation. The most common reason for not using the latrine among adults was the
      lack of water to flush the latrines as well as not being home when the need
      arises. The reason for using the latrines were to keep the compound clean,
      convenience and health reasons. It is recommended that building latrines continue
      to be a prerequisite for getting water supply under the program and that non
      health-related reasons be emphasized in health education which aim to motivate
      people to build and use the latrines.

PMID- 8362305
TI  - Clinical trials with halofantrine in acute uncomplicated falciparum malaria in
      Thailand.
AB  - The antimalarial efficacy of halofantrine was compared with mefloquine in an open
      label, randomized comparative trial in adult male patients with acute
      uncomplicated falciparum malaria. Twenty-eight patients received halofantrine and
      27 received mefloquine. Halofantrine was administered in 3 doses of 500 mg at 6
      hour intervals and mefloquine was administered in divided doses of 1,250 mg or
      1,500 mg depending on whether the patients weighed less than or more than 60 kg.
      The patients were followed for 42 days and observed for drug tolerance and
      evidence of recrudescence. Response to treatment was favorable with both drugs,
      but three patients (two treated with halofantrine and one with mefloquine) did
      not completely eliminate malaria parasites from peripheral blood films in seven
      days. The parasite and fever clearance times were 75.6 and 55.7 hours, and 80.1
      and 61.3 hours, respectively for halofantrine and mefloquine. However, 12
      patients recrudesced during the 42 day follow-up period. Nine of these had been
      treated with halofantrine and three with mefloquine. The 42-day cure rate for the
      two drugs was 56% and 84%, respectively. The side-effects of halofantrine and
      mefloquine were comparable and transient. These are diarrhea, dizziness,
      orthostatic hypotension and black out. However, vomiting was found to be more
      common in mefloquine group (41% vs 22%).

PMID- 8362306
TI  - Intramuscular artemether in female patients with uncomplicated falciparum
      malaria.
AB  - Thirty-three female patients suffering from acute uncomplicated falciparum
      malaria were treated with intramuscular artemether for 5 days during May-October
      1990. Fourteen patients received 160 mg as an initial dose, followed by 80 mg
      daily for 4 days. Nineteen patients with low body weight (mean weight of 36.5 kg)
      were given artemether at 3.2/kg as a loading dose and followed by 1.6 mg/kg/dose
      for another 4 days. The geometric mean of parasitemia was 17,378/microliters
      (range 640-234,720). The mean fever (FCT) and parasite clearance time (PCT) were
      41.8 and 49.4 hours, respectively. Two patients had probable intercurrent
      infection with FCT of over 7 days. Thirty-one patients had completed the 28-day
      follow-up. The cure rate was 90.3% (28/31). Three patients had RI type of
      response. Mild and transient adverse effects were experienced in eleven patients;
      these consisted of pain at the injection sites, vomiting, dizziness, abdominal
      pain, palpitation and diarrhea. These symptoms may in part be due to symptom
      complex of malaria. The MIC of chloroquine, quinine, quinidine and mefloquine was
      performed in all patients but only 25 isolates were successfully cultured and
      tested. The MIC of all tested drugs were shown to be higher than that of previous
      studies, suggesting that there is a rapid increase of mefloquine resistant
      strains of falciparum malaria. In conclusion, artemether proves to be effective
      against multiple drug resistant falciparum malaria (including mefloquine
      resistant strains) and can be considered as an alternative antimalarial to
      mefloquine. The drug was well tolerated in female patients with mild and
      transient side-effects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362308
TI  - The temperature--dependent expression of GST of Schistosoma japonicum (Philippine
      strain).
AB  - Obtained from pSj5, the cDNA gene encoding GST antigen of Schistosoma japonicum
      (Philippine strain) was ligated with efficient temperature-dependent PBV220
      vector which was constructed in CAPM, and then introduced into host bacterium-DH5
      alpha (E. coli) by transformation. Transformants were selected by ampicillin and
      recombinant clones were identified by restriction mapping. The result showed that
      recombinant clone 43 was the one carrying recombinant plasmid PBV 220 with the
      correct insertion of the gene fragment. The GST expression ability of clone 43
      was investigated by GST enzymic activity assay and SDS-PAGE. A relatively high
      level of GST enzymic activity was expressed by this clone under the temperature
      dependent condition, that is, cultured at 30 degrees C and expressed at 42
      degrees C. A more strongly stained 26 kDa protein band was identified by SDS
      PAGE. The result indicated that GST of S. japonicum (Philippine strain) could be
      expressed not only by IPTG induction, but also by the temperature-dependent
      method.

PMID- 8362307
TI  - Studies on chemotherapy of parasitic helminths: efficacy of artemether on
      Japanese strain of Schistosoma japonicum in mice.
AB  - Effects of artemether were examined on Schistosoma japonicum in mice. When the
      drug was given at a daily dosage of 200 mg/kg for 4 successive days from 46 days
      post-infection, a significant reduction in worm recovery was observed. A
      significant reduction in size of worms from the medicated mice was also seen
      compared with that from non-medicated controls.

PMID- 8362309
TI  - The antigenicity of GST antigen extracted from Chinese strain of Schistosoma
      japonicum.
AB  - The GST antigen, similar to Sj26 (Philippine strain), which plays an important
      role in inducing protective immunity against Schistosoma japonicum, can be
      extracted and purified from adult worms of the Chinese strain of S. japonicum.
      There are two bands at 26 kDa and 28 kDa of GST antigen called the 26-28 kDa GST
      antigen as identified by SDS-PAGE, and these have GST activities. Mice were
      immunized with the 26-28 kDa antigen and the specific antibody response in serum
      was assayed by ELISA, IFA and western blot. The antigenicity of the 26-28 kDa GST
      antigen in mice was significant. For example, the antigen could stimulate mice to
      increase the level of serum IgM and IgGl; the antibodies in serum of immunized
      mice could be localized in the antigenic determinants of tegument or body of the
      worms; specific antibodies against the antigens increased markedly after
      immunization as measured by ELISA or IFA; the antibody from mice immunized with
      the 26-28 kDa GST antigen can recognize 26-28 kDa antigenic molecules, identified
      by immunoblot assay.

PMID- 8362310
TI  - Comparative study on antigenicity and immunogenicity of 26-28 kDa antigen and
      recombinant Sj26 (RSj26) of Schistosoma japonicum.
AB  - This paper reports a comparison of the recombinant Sj26 (rSj26) antigen derived
      from the Philippine strain and the 26-28 kDa antigen isolated and purified from
      the Chinese strain of Schistosoma japonicum with respect to their antigenicity
      and immunogenicity. The results showed that there were obvious cross reactions
      between rSj26 and 26-28 kDa antigen when rSj26 antigen was tested against
      specific antibodies in sera of mice infected with the Chinese strain of S.
      japonicum or the 26-28 kDa antigen was tested against specific anti-rSj26
      antibodies by ELISA, IFA and Western blotting. Both the 26-28 kDa and the rSj26
      antigen had weak cross reactions with SEA antigen. The worm reduction rate after
      challenging with Chinese strain cercariae in mice immunized with rSj26 was 26
      32%, similar to that in mice immunized with 26-28 kDa antigen. It is suggested
      that rSj26 antigen can induce a certain level of specific protective immunity in
      the host against infection by the Chinese strain of S. japonicum cercariae.

PMID- 8362311
TI  - The possibility of GST antigen from Chinese strain of Schistosoma japonicum for
      immunodiagnosis of schistosomiasis.
AB  - The GST antigen (called 26-28 kDa antigen) extracted and purified from
      Schistosoma japonicum adult worms was applied to the detection of specific
      antibodies in sera of infected mice and mice immunized with the above protein
      antigen by ELISA technique. The 26-28 kDa antigen was better than crude antigens
      (SEA, SWAP) when used to detect specific antibodies in sera from immunized mice.
      As with crude antigens (SEA and SWAP), the 26-28 kDa antigen could be used to
      detect specific antibodies in infected sera, with titers as high as 1:160-1:320.
      There were no false positive reactions and a positivity rate as high as that
      using SWAP occurred when the 26-28 kDa antigen was used in schistosomiasis
      patients and normal subjects by intradermal test. It is suggested that the 26-28
      kDa antigen may be a suitable candidate for immunodiagnosis of schistosomiasis.

PMID- 8362312
TI  - The Hoeppli phenomenon in schistosomiasis japonica: historical findings and
      additional investigation in bovines.
AB  - The present paper deals with a buried knowledge of the early findings of the
      Hoeppli phenomenon in cattle infected with Schistosoma japonicum together with a
      revised list of bovines and other mammalian species in which this phenomenon has
      been found. It was noted that the percentage of the mature-egg granulomas with
      positive Hoeppli phenomena varied with the species of bovines, ie, higher
      positive percentage in the more susceptible cattle than in the less susceptible
      buffalos. The radiating filaments in fringes of the phenomenon were also stronger
      in cattle than in buffalos.

PMID- 8362313
TI  - Ivermectin in the treatment of bancroftian filarial infection in Orissa, India.
AB  - Ivermectin treatment was evaluated for its efficacy and side reactions in sixty
      patients of Orissa with Bancroftian filarial infection and microfilaremia.
      Ivermectin was administered as a single oral dose at four dosage levels (20, 50,
      100 and 200 micrograms/kg), and both microfilarial clearance and associated side
      reactions were monitored in a double blind fashion. Blood microfilariae were
      cleared in all patients at all dosages within 1 to 14 days. In most patients
      microfilariae reappeared by third month. The microfilaria appearance by third and
      sixth month averaged 12.2 to 44 percent of pretreatment values in the four study
      groups. Side reactions were encountered in almost all patients, the commonest
      being fever, headache, weakness, myalgia and cough which occurred most
      prominently 12 to 72 hours after treatment. Side reactions were more frequent and
      severe in patients with high microfilaria counts. Clinical reaction scores for
      each group were independent of the dose administered. The 200 micrograms dose
      group showed significantly more rapid microfilariae clearance and its delayed
      reappearance as compared with the other dosage groups and without inducing
      significantly greater clinical reaction scores.

PMID- 8362314
TI  - Some epidemiological aspects of hookworm infection among the rural population of
      Bali, Indonesia.
AB  - Stool examination using direct smear method, Kato-Katz thick smear technique and
      modified Harada Mori test tube cultivation method were done on 2,331 people among
      the rural population of Bali. The serum ferritin was examined by ELISA technique
      and hemoglobin concentration by cyanmethemoglobin technique. Overall prevalence
      of hookworm infection was 24.02% with heterogeneity in local prevalences. The
      highest prevalence was found in wet highland area (46.3%), followed by wet
      lowland (27.7%), dry highland (14.2%) and dry lowland (10.9%). The majority of
      hookworm infection cases were associated with Ascaris and Trichuris infections.
      Most of the hookworm infections (73.3%) were light/very light in intensity with a
      mean EPG of 619. The prevalence and intensity of infection were increasing with
      age, and the age-prevalence and age-intensity curves were slightly convex. There
      was no significant difference of prevalence or intensity of infection between
      males and females. The condition and humidity of soil found to be an important
      determinant for prevalence of hook-worm infection. The frequency distribution of
      the intensity of hookworm infection showed an over-dispersed distribution pattern
      with 10% of people harboring more than 63% of parasite burden as measured by EPG.
      The prevalence of anemia was higher, but not statistically significant, in
      hookworm infected persons compared with people without infection. But this study
      failed to show a significant correlation between intensity of infection with
      hemoglobin level. There was a significant correlation between serum ferritin
      level with intensity of infection.

PMID- 8362315
TI  - Cryptococcal intracerebral mass lesions associated with cryptococcal meningitis.
AB  - 12 patients with cryptococcal intracerebral mass lesions associated with
      cryptococcal meningitis are reported. There were 6 males and 6 females with a
      mean age of 41 years. Most of them presented with symptoms and signs of
      meningitis initially without focal neurological signs. Computed tomography
      revealed single or multiple, well or poorly marginated hypodense lesions without
      perilesional edema, except 1 case which had marked edema, with or without ring
      enhancement. One case had small hyperdense, diffuse, enhanced nodules. New
      lesions or progression of the existing lesions occurred during medical therapy in
      some patients. The clinical manifestations of patients with intracranial mass
      lesions did not significantly differ from patients without mass lesions, but the
      mortality was higher (50% vs 29%).

PMID- 8362316
TI  - Acute injuries to cervical joints. An autopsy study of neck sprain.
AB  - A comparative study of cervical spines from 16 subjects who died of major trauma
      and 16 control subjects who died of natural causes, showed clefts in the
      cartilage plates of the intervertebral discs in 15 of 16 spines from the trauma
      victims. These were quite distinct from the uncovertebral clefts and central disc
      fissures that are a normal feature of aging in cervical discs. Posterior disc
      herniation through a damaged anulus fibrosus and hemarthrosis in facet joints
      were also observed. No directly comparable lesions were found in the control
      subjects, but two discs in this group showed "rim lesions," which may be old
      injuries. Disc lesions are common in injured cervical spines where translation is
      much greater than in the lumbar spine and these lesions are slow to heal. It is
      suggested that such injuries could cause the pain experienced by patients with
      neck sprain.

PMID- 8362317
TI  - An early comparative analysis of the use of fibular allograft versus autologous
      iliac crest graft for interbody fusion after anterior cervical discectomy.
AB  - During a 2-year period (1988-1989), 23 cases of anterior cervical discectomy were
      performed with cadaveric fibular allograft instead of autologous iliac crest
      graft. The mean age of the patients was 35 years. There were 10 men and 13 women.
      In most cases, a one-level fusion was performed at the C5-6 level. The Smith
      Robinson technique was used for discectomy and fusion, for both one- and two
      level fusions. Evidence of radiographic fusion was achieved in 92% of the cases.
      Twenty-five cases of anterior cervical discectomy in which autologous iliac crest
      graft was used (1987-1988) were examined retrospectively for comparison. The mean
      duration of hospital stay was less in the allograft group (5.4 days vs. 7.25
      days). In addition, postoperative pain was less in the allograft group because
      the allograft group did not have pain from the donor site. In conclusion, the use
      of fibular allograft for interbody fusion after anterior cervical discectomy can
      be performed with acceptable rates of fusion and less postoperative pain, as
      compared to the use of autologous iliac crest graft.

PMID- 8362318
TI  - Use of sciatic neurogenic motor evoked potentials versus spinal potentials to
      predict early-onset neurologic deficits when intervention is still possible
      during overdistraction.
AB  - Spinal evoked potentials, sciatic neurogenic motor evoked potentials, and
      somatosensory evoked potentials were recorded before and after overdistraction of
      the spinal cord, and compared with the clinical status of 14 pigs. The sciatic
      neurogenic motor evoked potential consisted of two components: fast and slow. The
      fast component was more sensitive and associated to a greater degree with motor
      function in wake-up tests than the slow component somatosensory evoked potential
      and spinal evoked potential. Furthermore, the loss of only the fast component in
      the initial status allowed the possibility of improvement of motor activity in
      the final wake-up test. The peripheral neurogenic motor evoked potentials
      recording yielded more information about spinal cord function: motor and sensory.
      The current study suggests that a peripheral response is a better index to the
      onset of overdistraction and to the efficiency of intervention, when the
      neurologic deficit after overdistraction of the spine is reversible.

PMID- 8362319
TI  - Correlation between histopathologic features and magnetic resonance images of
      spinal cord lesions.
AB  - The authors report a correlation between histopathologic features and magnetic
      resonance images of spinal cord lesions in 19 human spinal cords with various
      types of lesions. Abnormally high T2-weighted image signal intensities appeared
      nonspecifically in mildly altered lesions or areas with edema. In the gray
      matter, a low T1-weighted image in addition to a high T2-weighted image signal
      intensity appeared in severely altered lesions with necrosis, myelomalacia, or
      spongiform change. In the white matter, abnormally high T1-weighted image
      intensities appeared in severely altered lesions. Based on these preliminary
      results, it appears that a correlation between the degree of histopathologic
      alteration of the spinal cord and magnetic resonance images in clinical cases can
      be made. This is the first study to clarify the correlation between
      histopathologic features and magnetic resonance images of the diseased human
      spinal cord.

PMID- 8362320
TI  - Study of distribution and characteristics of spinal disorders using a validated
      questionnaire in a group of male subjects not exposed to occupational spinal risk
      factors.
AB  - This article presents the content and the application criteria of a questionnaire
      intended for the study of spinal disorders in workers and the results of an
      investigation, carried out via this questionnaire, in a group of 1205 male
      workers not exposed to occupational risks for the spine either currently or in
      the past. The data, stratified into three age classes (26-35, 36-45, and 46-55
      years) concern: cases of disc herniation, cases of acute lumbago, subjects with
      spinal disorders in the period before the last 12 months. In addition, for each
      spinal segment (cervical, thoracic, and lumbar) data are reported on cases
      classified as positive according to predefined criteria, cases with disorders of
      any degree, disability caused by disorders, absence from work, and recourse to
      treatment for disorders. These data constitute a reference for cross-sectional
      epidemiologic studies on the diffusion and features of spinal disorders in
      workers exposed to occupational risks for the spine, performed using the same
      questionnaire. The authors discuss selection criteria and criteria for use of the
      data in inferential analysis for the purposes of producing correct assumptions on
      the causal relationships between occupational risk and spinal disorders.

PMID- 8362321
TI  - The variable screw placement spinal fixation system. Report of a prospective
      study of 250 patients enrolled in Food and Drug Administration clinical trials.
AB  - The variable screw placement (VSP) system uses transpedicular screws and slotted
      plates to achieve constrained segmental fixation of the spine. A prospective
      multicenter study of 250 patients was performed under a Food and Drug
      Administration approved protocol to test the safety and effectiveness of this
      system. Complete 2-year follow-up data are reported for 169 of 223 (73%) patients
      who had fixation of three spinal levels or fewer. "Clinical success" was defined
      as an excellent or good result or improvement of two grades in a 10-point
      combined pain and function scale. "Fusion success" was defined by presence of
      continuous trabecular bone bridging the fusion area. For 86 patients with
      postsurgical failed back syndrome, clinical success was achieved in 69 (80.2%)
      and fusion success in 76 of 83 (91.6%) patients. These success rates were
      statistically higher than previous literature reports (P = 0.01 for clinical
      success and P = 0.02 for fusion success). For spondylolisthesis, clinical success
      was achieved in 44 of 57 patients (86.3%) and fusion success in 43 of 47 (91.5%)
      patients. For spinal stenosis, clinical success was achieved in 25 of 32 patients
      (78.1%) and fusion success in 30 of 31 (96.8%) patients. Overall fusion success
      was achieved in 186 of 200 (93%) patients with no statistical difference when
      comparing the numbers of levels fused. There were 21 device-related complications
      (8.4%) and 16 non-device-related complications (6.4%).

PMID- 8362322
TI  - New methods of measuring vertebral rotation from computed tomographic scans. An
      intraobserver and interobserver study on girls with scoliosis.
AB  - The purpose of this study was to search for constant and reliable reference
      points on the computed tomographic scans of scoliotic spines to measure vertebral
      rotation. Several methods using different sets of reference points on computed
      tomographic scans were tested for reliability. Two methods that gave minimum
      variation between the readings are presented here with interobserver and
      intraobserver reliability on 17 girls with adolescent idiopathic scoliosis. The
      selection of reference points for the two methods were as follows: In method 1,
      the vertebral rotation was an angle formed by two lines; one, a line joining the
      junction of the inner surfaces of two laminae and the midpoint of the posterior
      surface of the vertebral body and second, the vertical plane of the computed
      tomographic machine. In method 2, three datum points were marked; one at the
      junction of the inner surfaces of the laminae, and the other, one each at the
      junction of the inner surfaces of the lamina and the pedicle. A line bisecting
      this angle is drawn by the computer and the vertebral rotation was an angle
      between this line and the vertical plane. The 95% confidence intervals of these
      two methods for intraobserver variation were between 1.2 to 4.4 degrees. There
      was no significant difference between the readings obtained by each observer
      except on three occasions for observer 1. When these methods were tested for
      interobserver reliability, method 1 showed significant statistical differences
      between the readings obtained by the two observers. However, the readings
      obtained using method 2 were not significantly different between the two
      observers (95% confidence intervals = 3.2 to 5.8 degrees).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8362323
TI  - Three-dimensional head axis of rotation during tracking movements. A tool for
      assessing neck neuromechanical function.
AB  - The purpose of this article is to report normal variation in the screw (helical)
      axis of rotation of the head during various types of natural tracking movements.
      Nine normal subjects and eighteen subjects with neck injury faced a grid of
      targets separated by 10-degree intervals, and were instructed to use a head
      pointer (laser) to track whatever target was lit. Various horizontal, vertical,
      and oblique target sequences were employed. The normal subjects exhibited several
      consistent trends in finite screw axis parameter variation: vertical movements
      have a laterally-directed axis whose midsagittal plane crossing position is a
      function of the head orientation (typical range C3-T1); oblique movements have a
      diagonally-directed axis and an even greater orientation-specific range (C1-T1);
      and horizontal movements have a vertical axis that is modified near horizontal
      orientation extremes and is asymmetrically influenced by upward and downward bias
      orientations. Subjects with neck injury were seen to exhibit a variety of
      abnormal screw axis patterns.

PMID- 8362324
TI  - Can lumbar spine radiographs accurately determine fusion in postoperative
      patients? Correlation of routine radiographs with a second surgical look at
      lumbar fusions.
AB  - Controversy centers on the determination of surgical fusion in lumbar spinal
      patients. What method best determines the nature of surgical arthrodesis remains
      unanswered. Numerous studies have investigated the accuracy of different
      radiologic tests. Although the best method has not been determined, plain
      radiography is certainly the most widely used in many centers and reported in
      scientific articles. In most of the literature a poor agreement between
      radiographic interpretation and surgical findings was observed. The main reasons
      seemed to be the lack of an accurate method to assess the radiographs. The
      authors rely on a radiologist or spinal surgeon to estimate the success of bony
      fusion by reviewing a two-dimensional radiograph. The purpose of this study was
      to determine the accuracy of plain radiographs to predict the presence of a
      surgical fusion. Forty-nine patients underwent fusion site exploration in the
      course of hardware removal. All patients had a one- or two-level posterolateral
      fusion and posterior lumbar interbody fusion with pedicle screw/link rod
      instrumentation. Immediate preoperative anteroposterior and lateral radiographs
      were taken before hardware removal that included both visual assessment and a
      Kocher mechanical test. Two spinal surgeons and two musculoskeletal radiologists
      blindly judged the preoperative radiographs as to the absolute presence or
      absence of successful arthrodesis. A second review was repeated at 3 months. The
      overall agreement between radiographic assessment and actual surgical findings
      was 69%. The range among observers was 57-77%. The overall false positive rate
      was 42% (0-75%), while the false-negative rate was 29% (20-51%). Success of
      observed surgical arthrodesis at the time of the second look was 90% and this
      number was used as the standard in the agreement process. In comparing the
      radiographic observations with the surgical findings it is suggested that in one
      of five cases the plain radiographs underestimate the degree of fusion. This
      finding agrees with the authors' knowledge of osteoid and mineralized bone. The
      premineralized osteoid may be functionally fused, but appear radiolucent on
      radiographic film. Once solid trabecular bony bridging occurs radiographic
      identification of fusion is easier to determine.

PMID- 8362325
TI  - Roentgenographic evaluation of thinning of the lumbar pedicles.

PMID- 8362326
TI  - The etiology of focal spinal arachnoiditis. An experimental study.
AB  - Focal arachnoiditis and back pain have been attributed to potentially irritating
      substances leaking into the spinal canal from the lumbar intervertebral disc or
      facet joints. Through experimentation this hypothesis was tested: the nucleus
      pulposus (escaping from the intervertebral disc), lactic acid (from anaerobic
      glycolysis in the disc), chondroitin sulfate (a component of glycosaminoglycans
      in the disc), or synovial fluid (from degenerating facet joints) causes
      inflammation in the meninges if it contacts the dura mater. The test and control
      substances were injected into the epidural space of monkeys. Twelve weeks later
      the animals were killed; the dural sac was exposed by total lumbar laminectomy,
      grossly inspected, and then removed, fixed, sectioned, stained, and examined
      microscopically. Nucleus pulposus produced significant fibrosus in the arachnoid
      and epidural spaces; the other substances did not cause fibrosus or inflammation.
      The study suggests that leakage of nucleus pulposus into the epidural space
      causes an inflammatory response in the arachnoid and epidural spaces.

PMID- 8362327
TI  - Cross-sectional study of the isokinetic muscle trunk strength among school
      children.
AB  - Our surveys have shown lifetime prevalence of L.BP. over 30% among
      schoolchildren. The purpose of this study was to evaluate the relationship
      between back and isokinetic trunk strength, anthropometric parameters, and sports
      activities. One hundred and seventeen healthy children aged 10-16 years were
      included. All these volunteers had semi-structured interview, anthropometric and
      dynamic strength measurements. Lifetime prevalence of back pain was 44.5% and
      point prevalence was 13%. In this cross-sectional study, anthropometric and
      strength profiles were significantly related to age and gender. Non specific low
      back pain was not correlated to trunk muscle strength and/or sports activities.

PMID- 8362328
TI  - Forces exerted during spinal manipulative therapy.
AB  - Spinal manipulative therapy has been widely recognized in the medical fields as a
      conservative treatment modality for spinal dysfunction and pain. Spinal
      manipulative therapy consists of an application of a thrusting force on a
      specific part of the spine in a well-defined direction. The magnitude of this
      force has been associated with positive treatment effects, such as realigning
      vertebral bodies, mobilizing spinal joints, relaxing back musculature through
      reflex pathways, and producing a respiratory burst. However, direct force
      measurements during spinal manipulative therapy in a clinically relevant
      situation have not been performed to date. The purpose of this study was to
      measure the forces exerted onto patients during spinal manipulative therapy on
      various locations of the spinal column. Force measurements were obtained using a
      thin, flexible pressure mat. The results indicate that peak and preload forces
      are considerably smaller for spinal manipulative therapy performed on the
      cervical spine compared to corresponding values obtained on the thoracic spine
      and sacroiliac joint. Furthermore, for treatments on the thoracic spine and
      sacroiliac joint, a significant relation was found to exist between preload and
      peak forces.

PMID- 8362329
TI  - Compression strength of donor bone for posterior lumbar interbody fusion.
AB  - Forty-three blocks of allograft bone used clinically for posterior lumbar
      interbody fusion and twenty-three blocks of xenograft bone from goats and cows
      were tested in compression and compared with the clinical mechanical requirements
      of posterior lumbar interbody fusion. Variations in processing methods allowed
      evaluation of the effects of processing on mechanical strength. Fresh-frozen
      cancellous bone from Os Bone (Cleveland, OH) failed at an average load of 863 +/-
      615 N. Fresh-frozen cancellous bone from the Mid American Tissue Center
      (Massilon, OH) failed at an average load of 3492 +/- 1720 N. Freeze-dried
      cancellous bone obtained from the American Red Cross failed at an average load of
      1595 +/- 1031 N. Air-dried ethylene oxide sterilized cancellous bone from Os Bone
      failed at an average load of 1338 +/- 691 N. Air-dried ethylene oxide sterilized
      cancellous bone from Mid America failed at an average load of 1616 +/- 1157 N.
      Fresh-frozen tricortical bone from Mid America failed at an average load of 2257
      +/- 1081 N. Air-dried ethylene oxide sterilized tricortical bone from Os Bone
      failed at an average load of 2474 +/- 1928 N. Air-dried ethylene oxide sterilized
      tricortical bone from Mid America failed at an average load of 2308 +/- 422 N.
      Bovine Surgibone from Unilab (Hillside, NJ) failed at an average load of 2967 +/-
      399 N. Strength of bone in compression was not weakened by freeze drying, air
      drying, ethylene oxide sterilization, or by incubation at 37 degrees C for 1 week
      before testing.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362330
TI  - Bilateral pedicular stress fractures after successful posterior spinal fusion for
      adult idiopathic scoliosis.
AB  - A patient with adult idiopathic scoliosis who was successfully treated with
      posterior spinal fusion with segmental instrumentation from T3 to L4 is
      presented. One year after surgery fractures of both L4 pedicles developed, which
      were managed nonoperatively. Clinical union was achieved in 2 months and the
      patient was followed with serial computed tomographic scans to confirm union. A
      review of the current literature is also presented.

PMID- 8362331
TI  - Central retinal artery occlusion after scoliosis surgery with a horseshoe
      headrest. Case report and literature review.
AB  - Central retinal artery occlusion is a well-documented entity that occurs after
      trauma and embolic, thrombotic, or spasmodic episodes in both children and
      adults. Its occurrence as a complication of elective surgery is very rare but
      quite tragic. This report describes a case of central retinal artery occlusion
      occurring in a child after scoliosis surgery in which a horseshoe headrest was
      used. Recommendations are given on how to avoid this serious complication.

PMID- 8362332
TI  - Lumbosacral agenesis. Three cases of reconstruction using Cotrel-Dubousset or L
      rod instrumentation.
AB  - Three patients with lumbosacral agenesis underwent surgery to lock the
      lumbopelvic instability. All three patients had an unstable sitting position and
      a kyphotic bearing that impaired intestinal transit or hampered further colostomy
      or ureterostomy. Luque instrumentation with iliac fixation performed according to
      Galveston was used in one patient. Cotrel-Dubousset instrumentation was used for
      the two other patients. Autografts plus allografts provided sufficient bone for
      fusion without requiring lower leg amputations. Increased hip flexion was
      obtained after pelvic stabilization, but knee flexion contracture remained the
      same. All patients showed improved intestinal transit or decreased urinary
      infections, and two patients attained a stable sitting position without aid.

PMID- 8362333
TI  - Delayed post-traumatic vertebral collapse (Kummell's disease): case report with
      serial radiographs, computed tomographic scans, and bone scans.
AB  - A case of delayed posttraumatic vertebral collapse (Kummell's disease) is
      described and documented with serial radiographs, computed tomographic scans, and
      bone scans. The bone scan was normal before the back injury occurred and showed
      increased radionuclide uptake 3 weeks after injury and before vertebral collapse.
      Plain radiographs and computed tomographic scans taken during the interval
      between injury and collapse revealed no evidence of fracture or bone destruction.
      The authors believe this represents the first example of Kummell's phenomenon
      documented with serial computed tomographic and bone scans, and provides further
      support to the ischemic necrosis theory as the underlying process.

PMID- 8362334
TI  - A case-control study of risk factors for industrial low back injury. The utility
      of preplacement screening in defining high-risk groups.
AB  - Using a cohort of 8183 postal workers, this study assesses the efficacy of
      preplacement medical examinations in defining the risk of occupational low back
      injuries. From this cohort, 154 subjects with occupational low back injuries
      between 1983 and 1988 and 942 control subjects who did not have low back injuries
      were identified. A multivariate logistic regression shows that a history of prior
      disability, odds ratio 2.90 (95% confidence interval 1.88-4.48), and a heavy
      lifting job, odds ratio 1.91 (1.32-276) are associated with occupational low back
      injuries. However, a history of previous back injury on screening examination is
      not associated with subsequent occupational injury. The association between a
      history of disability and occupational low back injury has not been previously
      noted and warrants further research.

PMID- 8362335
TI  - When pharmacologic anesthesia is precluded: the value of hypnosis as a sole
      anesthetic agent in dentistry.
AB  - Occasionally, a dental patient presents his/her dentist with a history of
      hypersensitivity to local anesthetic agents. The symptoms may include immediate
      reactions to the injection procedure (dizziness, shortness of breath,
      tachycardia, etc), or delayed reactions to the anesthetic (swelling, urticaria,
      etc). Although the true incidence of local anesthetic allergy is low, such a
      history often involves the patient's anxiety regarding the use of the drug in
      question, and the dentist's apprehension to treat the "problematic" patient. In
      such cases, hypnosis can play a major role in controlling pain and the associated
      distress. In the present article, the method concerning the implementation of
      hypnosis to induce local anesthesia is described and illustrated through case
      demonstrations.

PMID- 8362336
TI  - Cohort differences among aging populations: a challenge for the dental
      profession.
AB  - The pattern of utilization of oral health services by older adults is changing as
      more older people maintain their natural teeth. Heterogenicity among persons aged
      65 and older is probably greater than in any other period in the life cycle;
      however, all too often, all age groups over age 65 have been grouped together for
      program planning or data analysis. The socio-dental and historical influences on
      five specific age cohorts born between 1905 and 1945 are presented so that
      dentists may better understand the differences in attitudes and expectations of
      these individuals when they seek treatment.

PMID- 8362337
TI  - A suggested curriculum for teaching conscious sedation in advanced general
      practice programs: GPR and AEGD. American Association of Hospital Dentists.
AB  - Previously published national guidelines related to the teaching and performance
      of conscious sedation in dentistry have not included guidance in this area for
      program directors of General Practice Residency and Advanced Education in General
      Dentistry Programs. A suggested curriculum is presented here for use by program
      directors of such programs who wish to design training experiences in their own
      programs or as a reference for program directors who wish to compare their
      programs with experiences provided in other locations. Guidelines are provided
      for facilities, equipment, personnel, records and preparation necessary to
      perform conscious sedation procedures, as well as goals, objectives, and
      evaluation methodology for training residents in conscious sedation.

PMID- 8362338
TI  - Identification of appropriate outcomes for an aging population.
AB  - Outcome measures are necessary for assessment of the appropriateness, quality,
      necessity for, and effectiveness of oral health care. With the growing number of
      older adults in the United States, it is appropriate to reflect on the unique
      characteristics of this segment of our society and how these characteristics may
      influence the identification of appropriate outcome measures. Older people often
      demonstrate multiple acute or chronic oral diseases with interrelated symptoms
      and clinical findings. Older persons are more likely to take medications with
      potentially adverse oral health effects. Patients experience a variety of disease
      processes over many years and have variable access to and experiences with the
      dental care system. These characteristics make the selection and interpretation
      of outcomes complex. Limitations of existing measures and considerations for the
      development of new outcomes measures specifically for older populations are
      reviewed.

PMID- 8362339
TI  - AIDS education and training centers (AETCs) as resources.

PMID- 8362340
TI  - An evaluation of the effectiveness of four mechanical plaque-removal devices when
      used by a trained care-provider.
AB  - Many care-dependent elderly individuals live in nursing homes and must depend on
      nursing home aides for oral hygiene care. It is generally agreed that the level
      of oral hygiene care among care-dependent nursing home residents is less than
      optimal. Two reasons are time constraints and the difficulty involved in brushing
      other individuals' teeth. The identification of effective and efficient plaque
      removal devices for use by care-providers should make it easier for nursing home
      aides to incorporate effective oral hygiene care into their daily routines. This
      pilot study was undertaken to determine the relative effectiveness of four plaque
      removal devices with different basic designs when used by a non-professional care
      provider on 10 healthy volunteers. A brush with curved bristles on the lateral
      aspect of the brush head and short straight bristles in the center (Collis-curve)
      and an electric toothbrush with tufts that rotate reciprocally (Interplak) were
      the most effective, a conventional brush (Oral-B) was somewhat less effective,
      and a disposable foam brush (Abco) was least effective and similar to the
      prebrushing plaque score (baseline). All the volunteers reported that the Collis
      curve was the most comfortable brush, and the care-provider reported that it was
      the easiest to use.

PMID- 8362341
TI  - Normal and atopic IgE responses.

PMID- 8362342
TI  - Leukotriene antagonists and inhibitors as modulators of IgE-mediated reactions.

PMID- 8362343
TI  - Regulation of IgE synthesis: from the membrane to the genes.

PMID- 8362344
TI  - Can anti-IgE be used to treat allergy?
AB  - A summary of the properties of CGP 51901 is shown in Table 3. On the basis of its
      binding to IgE and IgE-secreting cells and its activity in vitro and in vivo, CGP
      51901 is expected to be able to decrease serum IgE by direct clearance of IgE and
      by reduction of the numbers and productivity of IgE-secreting cells. The end
      result of reduction of IgE in the circulation and on mast cells is expected to be
      the attenuation of IgE-mediated reactions and the improvement in allergy
      symptoms. The effective serum concentration of CGP 51901 is expected to be in the
      range 1-10 micrograms/ml. Because CGP 51901 is an antibody specific for IgE, it
      is expected to be highly selective in its activity. Because IgE does not appear
      to be essential and because CGP 51901 has been rigorously tested to confirm its
      non-anaphylactic nature, this treatment is not expected to have any adverse
      effects. Therefore, CGP 51901 is expected to be safe and to have a good
      probability of being effective when it is tested in human clinical trials.

PMID- 8362346
TI  - Transpedicular decompression and stabilization of burst fractures of the lumbar
      spine.
AB  - Twenty-seven consecutive patients with neurological impairment due to burst
      fractures of the lumbar spine were operated upon, via the postero-lateral route,
      over a 38-month-period. Transpedicular fixation devices [posterior segmental
      fixator (PSF) or variable screw placement system (VSP)] were applied in all
      cases, in order to achieve short-segment fusion of the fractured spinal segment.
      Return to useful motor power or neurological normality (median follow-up: 18.7
      months) occurred in 22 cases (81% of the whole series), with this outcome
      resulting in all but one of the cases with preoperative incomplete neurological
      deficit. Postoperative encroachment of the spinal canal, degree of kyphotic
      deformity, and reduction of the vertebral height showed statistically significant
      differences compared with the corresponding preoperative values.

PMID- 8362347
TI  - The gravitational shunt: an alternative approach to cerebrospinal fluid shunting.
AB  - Current cerebrospinal fluid shunts use complex differential pressure values to
      regulate drainage. Such systems are prone to overdrainage and obstruction, and
      thus have an unpredictable effect on intracranial pressure (ICP). The
      gravitational shunt (GS) introduces an alternative approach. It uses a single,
      simple valve to balance the pressures generated within a vertical shunt system.
      The ICP is then regulated by the position of the valve along the cranioabdominal
      shunt axis and not by the mechanical properties of the valve. Bench testing
      demonstrated that when using the GS (1) a linear correlation (r = 0.91, p <
      0.001) exists between the ICP and the position of the valve along the vertical
      shunt axis, (2) positive and negative ICPs are maintained, and (3) the ICP can be
      predicted by an equation derived from theoretical principles. The GS uses a
      single, simple valve as a pressure regulator and an antisiphon device. It allows
      the maintenance of a normal negative ICP in the upright position without risk of
      over-drainage. The other benefits of this system are discussed.

PMID- 8362345
TI  - Adhesion molecules in a primate model of allergic asthma: clinical implications
      for respiratory care.

PMID- 8362348
TI  - Hydrocephalus: slit ventricles, shunt obstructions, and third ventricle shunts: a
      clinical study.
AB  - In a retrospective 5 year study of patients with ventricle shunts for
      hydrocephalus (N = 88), studies were developed on slit ventricles in teenagers
      and in young adults. These studies presented here are (1) time to slit ventricles
      from first shunt and average upright ICP associated (N = 24); (2) upright ICP in
      asymptomatic long-term ventricle shunt patients without slit ventricles (N = 21),
      (3) clinical course of patients with uncorrected slit ventricles and lateral
      ventricles or third ventricle shunts (N = 31), (4) resolution of slit ventricles
      by Zero ICP Shunt with normal upright ICP (N = 28), (5) no resolution of slit or
      large ventricles in shunted patients with normal upright ICP (N = 23), and (6)
      unreliability of CT ventricle size (slit or enlarged) after normal upright ICP
      achieved (N = 28; 23). Surprisingly, slit ventricle patients with the ventricular
      catheter in collapsed lateral ventricles develop shunt obstruction within 20
      months (21/31; 71%; 10/31 29%) patients with ventricle catheters incidentally in
      the third ventricle did not obstruct during the 4 1/2 year follow-up.

PMID- 8362349
TI  - Long-term outcome in surgically treated encephalocele.
AB  - This report describes long-term operative outcome of 24 cases with occipital
      encephalocele. The follow-up periods are between 4 and 20 years. Of the 24
      patients with occipital encephalocele, two have died. Of the 22 living patients,
      16 are living without neurological deficit, while six are disabled mentally
      and/or physically. Four cases of encephalocele developed hydrocephalus, and two
      of them died while the other two are still living with severe handicap. The
      presence of gross brain tissue in the sac of encephalocele and the size of the
      sac were also unfavorable factors for the prognosis. We conclude that the size
      and the content of the sac and associated hydrocephalus are the important factors
      that influence the long-term prognosis of occipital encephalocele.

PMID- 8362350
TI  - Giant aneurysm of internal carotid artery in a four-year-old child: a case
      report.
AB  - A case of giant saccular aneurysm in early childhood is reported. An internal
      carotid aneurysm presenting with episodic headache was successfully clipped with
      complete relief of symptoms. The patient was also investigated for a possible
      collagen deficiency which proved negative. Clinical features and pathogenesis of
      this rare lesion are discussed.

PMID- 8362351
TI  - Discrepancy between provocative test and clinical results following endovascular
      obliteration of spinal arteriovenous malformation.
AB  - We report a case of spinal arteriovenous malformation with no signs of
      neurological deterioration after transarterial embolization, although the results
      of a provocative test with injection of lidocaine was positive on monitoring of
      clinical findings and somatosensory-evoked potentials (SEPs). We discussed the
      possible overestimation by the provocative test, and the limitations of SEP
      monitoring during endovascular surgery.

PMID- 8362353
TI  - Multifocal giant cell glioblastoma: case report.
AB  - Glioblastoma multiforme (GM) of the cerebellum is a rare tumour. A variant of GM,
      a multifocal giant cell glioblastoma, initially presenting in the cerebellum, has
      not previously been reported. A giant cell glioblastoma occurring in a 46-year
      old man who presented initially with a cerebellar tumour is described. One month
      after excision of the tumour, the patient had a grand mal seizure. Computed
      tomography (CT) showed a low-density lesion in the left temporal lobe. Four
      months later he developed dysphasia and right-sided hemiparesis. Repeat CT scan
      revealed a large temporal lobe tumour which was excised, and histologically found
      to be a giant-cell glioblastoma with histopathological similarities to the
      original cerebellar tumour. The clinical course, computed tomographic and
      pathological features of this tumour are described and discussed.

PMID- 8362352
TI  - Suprasellar embryonal carcinoma which developed ten years after local radiation
      therapy for pineal germinoma.
AB  - We recently encountered a case of suprasellar embryonal carcinoma which developed
      10 years after local radiation therapy for pineal germinoma. This 29-year-old
      male was admitted because of abnormal behavior, disturbed consciousness, and
      increased intracranial pressure. Computed tomography and magnetic resonance
      imaging disclosed a tumor spreading from the suprasellar region to the third
      ventricle and the anterior horn of the left lateral ventricle, accompanied by
      fresh hemorrhage within the tumor. He underwent subtotal removal of the tumor,
      followed by chemotherapy with cisplatin and etoposide. The tumor was
      histologically rated as embryonal carcinoma with differentiation into yolk sac
      tumor and choriocarcinoma.

PMID- 8362354
TI  - Cerebral revascularization with an artificial graft: long-term follow-up and
      discussion of the role of graft pretreatment with modified host endothelial
      cells.
AB  - Controversy remains regarding the effectiveness of EC/IC bypass for the
      prevention of stroke and the authors believe that some studies suggest that a
      subcategory of patients disabled by transient flow-related symptoms may benefit
      from surgery. The authors present a 7 1/2 year follow-up analysis of a patient
      who had undergone an EC/IC bypass from the proximal extracranial carotid to the
      middle cerebral artery using a 4 mm Gore-Tex prosthesis. Following his death from
      pulmonary sepsis, the graft was retrieved. Pathological and electron microscopic
      findings are reviewed.

PMID- 8362355
TI  - Paroxysmal bilateral dysosmia treated by resection of the olfactory bulbs.
AB  - Dysosmia, or the distortion of olfaction, is most commonly preceded by viral
      illness or head trauma, but has a variety of etiologies. The precise nature of
      the disease process remains obscure. Medical management is largely empiric, and
      has been aimed at treating underlying illnesses, restricting triggering
      medications, as well as various pharmacologic interventions. Successful
      eradication of a severe case of persistent unilateral paroxysmal dysosmia with
      resection of the ipsilateral olfactory bulb has been reported. We report here a
      case of bilateral paroxysmal dysosmia, refractory to medical therapy,
      successfully treated with bilateral olfactory bulb resection.

PMID- 8362356
TI  - Anastomosis of occipital artery to anterior inferior cerebellar artery with
      interposition of superficial temporal artery. Case report.
AB  - A 56-year-old man with vertebrobasilar insufficiency and associated findings
      including quadriparesis, dysarthria, cerebellar ataxia, nystagmus, and somnolence
      underwent left occipital artery (OA) to anterior inferior cerebellar artery
      (AICA) anastomosis with interposition of a superficial temporal artery (STA)
      graft. This procedure was chosen because cerebral angiograms demonstrated
      occlusion of the right vertebral artery (V3) and severe stenosis of the V4
      segment of the left vertebral artery, with perfusion of the territory of the left
      posterior inferior cerebellar artery via the ipsilateral AICA, and because
      dissection of the OA is a relatively difficult and time-consuming procedure.
      Dissection of the STA, on the other hand, is much easier. Preoperative
      measurements of local cerebral blood flow in the vertebrobasilar circulation
      before and after intravenous administration of acetazolamide (500 mg) were
      obtained, and demonstrated low flow and hemodynamic compromise in the posterior
      circulation. The patient's hemodynamic and neurological status improved following
      surgery. In this report, we present a new and simplified method of OA-AICA
      anastomosis with interposition of STA graft.

PMID- 8362357
TI  - Terms describing brain ischemia by tempo are no longer useful: a polemic (with
      apologies to Shakespeare).

PMID- 8362358
TI  - Selective peripheral denervation for spasmodic torticollis: surgical technique,
      results, and observations in 260 cases.
AB  - A total of 260 cases of spasmodic torticollis or of the cervical component of
      diffuse dystonias have been surgically treated with selective peripheral
      denervation of the involved muscles sparing their antagonists, after verification
      with electromyography and, if necessary, nerve blocks. Total or marked relief of
      symptoms with preservation of normal or nearly normal movements has been obtained
      in 88% of the patients with surgery followed by early physiotherapy. There are
      minimal sequelae with this approach. Selective denervation may be recommended if,
      after 2 years, conservative treatment, including botulinum injections, does not
      offer satisfactory relief of symptoms.

PMID- 8362359
TI  - Tissue formation on cementum surfaces in vivo.
AB  - The purpose of the present investigation was to study cell colonization of and
      tissue formation on denuded (anorganic) cementum surfaces as well as denuded
      demineralized cementum surfaces. The most conspicuous finding was the distinctly
      different pattern of cell colonization and subsequent tissue formation on etched
      and non-etched denuded cementum surfaces. Non-etched cementum surfaces displayed
      a limited number of resorbing cells and resorption lacunae, while etched cementum
      surfaces displayed an abundance of fibroblast-like cells in varying stages of
      activity in a meshwork of fibres, probably collagenous. These fibres were
      organized in a layer parallel to the root surface. This appearance of a fibrous
      capsule-like structure has previously been associated with periodontal healing
      with a non-functional repair-tissue. It may be concluded, based on the present
      results that, a cementum surface in which collagen fibers have been exposed
      presents a suitable surface for colonization by mesenchymal cells. However, if
      collagen fibers are not exposed in the cementum surface leaving mineralized
      surface, mesenchymal cells appear not to be able to attach.

PMID- 8362361
TI  - Changes in comprehensive dental care of the primary dentition from 1979 to 1989.
      II. Restorative treatment of primary molars in a population treated at a
      university dental clinic.
AB  - The aim of this study was to compare the success of operative caries therapy of
      primary molars in two cohorts, one of children born in 1971, Cohort '71, and the
      other of children born in 1981, Cohort '81, followed up from the age of 3 to 8
      years. There were significantly fewer caries lesions to treat in Cohort '81 than
      in Cohort '71. In Cohort '71, silver amalgam was used while in Cohort '81 silver
      amalgam was inserted in 65% and glass polyalkeonate cement (GPA) in 35%.
      Significantly fewer restorations were replaced in Cohort '81 than in Cohort 71,
      49 v. 106. When the proportion of replacements was studied in relation to the
      number of proximal caries lesions, the percentage of replacements in Cohort '71
      was 17% and in Cohort '81 14%, the distal surface of the lower first molar
      showing the same proportion in both cohorts, 21%. Of all replacements in Cohort
      '81, 41% were performed in the high caries prevalence group. In Cohort '81, 22%
      of all silver amalgam and 6% of all GPA fillings were replaced. The number of
      extracted primary molars decreased significantly, from 4% in Cohort '71 to 2% in
      Cohort '81. The success rate of the operative caries therapy did not increase
      much. Instead, cost benefits were found in decreasing caries prevalence and later
      onset of manifest caries.

PMID- 8362360
TI  - Vertical forces developed by the jaw elevator muscles during unilateral maximal
      clenching and their distribution on teeth and condyles.
AB  - The activity of the jaw elevator muscles (EMG) was recorded during maximal
      clenching in ICP and unilaterally on 2nd and 1st molars, premolars, canines and
      central incisors in ten subjects with complete dentitions, normal occlusal
      relationships, and without signs and symptoms of craniomandibular disorders. The
      EMG activities were converted to relative muscle force. The distribution of this
      relative muscle force on teeth and condyles was then calculated by means of a
      three-dimensional mathematical model. The results suggest that the magnitude of
      the muscle force is strongly associated with the localization of the biting
      point. Thus the greatest muscle force is produced during clenching in the
      intercuspal position (100%). At unilateral clenching 75% of this ICP-force is
      reached during rubber pad clenching on 2nd molars, 85% during rubber pad
      clenching on 1st molars and 45% during clenching on incisors. The calculations of
      the mathematical model showed then that highest bite force should be produced on
      2nd molars (55% of the muscle force produced in ICP-clenching) and lowest on
      incisors (20%). Highest condylar load should be found on non-biting side condyles
      (20% of the muscle force produced in ICP-clenching) and lowest on biting side
      condyles (0%).

PMID- 8362362
TI  - Changes in oral status and dental treatment in long term hospital inmates in
      Stockholm from 1988 to 1990.
AB  - The proportion of elderly in the Swedish population is increasing. In future
      elderly people will have retained more teeth and will require higher standards of
      dental care as long as they are healthy. There is an increasing trend towards
      admission of only severely compromised patients to long term institutions. This
      study was undertaken to evaluate whether changing concepts in community geriatric
      care and criteria for admission to long term hospitals were reflected in the oral
      status and the treatment level of geriatric hospital patients. The study confirms
      that the inmates were older and more medically compromised and that the change
      was discernible during such a short period of time as two years. Edentulousness
      had decreased from 30 percent to 24 percent. The mean number of remaining teeth
      was 15.2 in 1988 and 13.0 in 1990. The content of treatment had changed between
      1988 and 1990. The dentist had adjusted the treatment level to the patient's
      condition and to the unexpected shortage of dental personnel. It can be concluded
      that the maintenance of life-long good oral health demands life-long regular
      dental care, with an increasing content of professional preventive care in long
      term care at home or in hospital.

PMID- 8362364
TI  - Successful financial arrangements: a team approach.

PMID- 8362363
TI  - An evaluation of image quality for the assessment of the marginal bone level in
      panoramic radiography. A comparison of radiographs from different dental clinics.
AB  - The diagnostic image quality of panoramic radiographs originating from different
      clinics was examined. Two samples of 98 and 100 radiographs, respectively, were
      from a department of oral radiology. The radiographs of one of these samples were
      checked using immediate subjective analysis of the image quality before inclusion
      in the study whereas the radiographs of the other sample were randomly selected.
      A third sample consisted of radiographs from 20 randomly selected dental clinics.
      The subjective overall image quality of the whole panoramic radiograph was
      classified as adequate, marginal or inadequate. The three observers also assessed
      the reason for inferior image quality. The overall image quality of the
      radiographs was better for the checked sample from the department of oral
      radiology compared to the sample form the 20 dental clinics. The main reason for
      unacceptable image quality of the radiographs was too low density and/or contrast
      irrespective of sample. Other faults were incorrect positioning of the patient
      but in the sample from the 20 clinics improper film handling was also frequent.
      We conclude that image quality in panoramic radiography can be improved.
      Improvement of the image quality is a prerequisite if panoramic radiography in
      the future is to replace the full-mouth examination.

PMID- 8362365
TI  - High mutation rate loci in a subdivided population.
AB  - Analytic and simulation studies were carried out in order to predict the average
      geographic area occupied by alleles in a continuously distributed population. The
      properties of three statistics were investigated: the sum of the squared
      distances between members of allelic classes, the sum of the root mean squared
      distances, and the sum of the squares of the numbers of alleles. The expectations
      of these quantities can be obtained analytically from both stepping-stone and
      branching diffusion models. The predictions of these two models are similar for
      wide ranges of parameter values and are consistent with the simulation results
      from a stepping-stone model. These results suggest that measures of the
      geographic distribution of alleles can be useful for estimating average dispersal
      distances at loci, such as minisatellite and microsatellite loci, at which
      mutation rates are high enough that they can be estimated with confidence.

PMID- 8362366
TI  - Two-state spatial dynamics in the absence of age.
AB  - This paper investigates the simplest multistate population model, a one-age
      group, two-living-state model with constant rates of birth, death, and interstate
      movement. A general solution for the model is presented, and special attention is
      given to the process of convergence to stability and its relationship to spatial
      population momentum. The constant ultimate level of the speed of convergence, or
      the intrinsic force of convergence, is found to be twice the difference between
      the two eigenvalues of the model's transition matrix. Spatial population momentum
      is shown to be directly proportional to the initial growth rate of the population
      under the stationary rates and inversely proportional to the intrinsic force of
      convergence. A population increases in size during the transition to zero growth
      only when the faster growing state is a larger fraction of the initial population
      than of the stationary population. Hypothetical calculations with an urban/rural
      population model illustrate the importance of the speed of convergence, and show
      the great growth potential inherent in spatial momentum.

PMID- 8362367
TI  - The establishment of underdominant chromosomal rearrangements in multi-deme
      systems with local extinction and colonization.
AB  - The fate of an underdominant chromosomal mutant was investigated in multideme
      models with high rates of local extinction and colonization. Four models with
      different patterns of colonization (number of colonists and place of origin of
      colonists) were studied by performing a large number of computer simulations with
      the Monte Carlo method for several sets of values of the following parameters:
      coefficient of selection against the heterozygote, extinction rate of each deme,
      deme size, and number of demes. The probability of the newly arisen rearrangement
      being established in the multi-deme system depends strongly on the pattern of
      colonization, other things being equal. In the three models in which there is
      absent or scarce mixing of gene pools of different demes when a new deme is
      founded, the fixation probability of the new chromosomal rearrangement is rather
      close to that calculated by R. Lande (1979, Evolution 33, 234-251; 1985, Heredity
      54, 323-332), which is equal to the corresponding probability in a single deme
      divided by the number of demes. In the model with extensive mixing of gene pools
      of demes, the corresponding probability is lower (considerably in some cases).
      Furthermore, in the models where the fixation probability is higher, the analysis
      of the time of the process leads to the conclusion that in systems consisting of
      a large number of demes, overlapping of several different processes of fixation
      of chromosomal rearrangements occurs.

PMID- 8362368
TI  - PPACK attenuates plasmin-induced changes in endothelial integrity.
AB  - In order to determine whether plasmin affects endothelial cell integrity
      directly, confluent bovine aortic endothelial cells were treated with plasminogen
      and a plasminogen activator. The permeability of the monolayer to [125I]-albumin
      was shown to be increased significantly (P < 0.01) with a concomitant decrease in
      viability. Plasmin activity correlated significantly with endothelial cell
      permeability (p < 0.004; r = 0.82). Coincubation with D-phenylalanyl-L-prolyl-L
      arginyl chloromethylketone, a tripeptide inhibitor of plasmin, reduced the
      increase in endothelial permeability induced by plasmin by 59% (p = 0.033).
      Monolayers studied in parallel were stained with rhodamine-phalloidin to
      visualize F-actin. There were significant morphologic changes in the endothelial
      monolayers exposed to plasmin compared to control monolayers, and these changes
      could be attenuated by coincubation with D-phenylalanyl-L-prolyl-L-arginyl
      chloromethylketone. These studies show that: 1) plasmin induces significant
      increases in endothelial cell permeability with accompanying morphologic changes;
      and 2) these deleterious functional and morphologic effects can be attenuated by
      coincubation with the plasmin inhibitor, D-phenylalanyl-L-prolyl-L-arginyl
      chloromethylketone.

PMID- 8362369
TI  - Comparison of the sequence of fibrinopeptide A cleavage from fibrinogen fragment
      E by thrombin, atroxin, or batroxobin.
AB  - In order to investigate the sequence of fibrinopeptide release from the amino
      terminal end of a dimeric fibrinogen-derived substrate by thrombin or
      batroxobins, we studied their effects on plasmic fragment E1, a core fragment
      from the central domain of fibrinogen containing both A alpha chain
      fibrinopeptide A (FPA) sequences. Isoelectric focussing (IEF) was employed as a
      means of resolving des A-fragment E1, from which one FPA had been cleaved, from
      des AA-fragment E1 resulting from the loss of both FPA's. Using densitometric gel
      scanning for quantification of the levels of intact fragment E1, des A-fragment
      E1, and des AA-fragment E1, in mixtures incubated with enzyme for various periods
      of time, we found similar catalytic rate constants (k1, k2) for release of the
      first fibrinopeptide A, (FPA1) or the second, (FPA2) from fragment E1, with
      either thrombin or batroxobin (k2:k1 ratios of 1.10 +/- 0.42, 1.34 +/- 0.26
      respectively). Atroxin released FPA2 more slowly than FPA1 with a k2:k1 ratio of
      0.34 +/- 0.1. Th finding that the cleavage of FPA2 by Atroxin is three-fold
      slower than thrombin and almost four-fold slower than batroxobin, suggest that
      batroxobin and thrombin cleavage of FPA2 may be cooperative in nature. However,
      the cooperativity in the cleavage sequence is insufficient to markedly suppress
      the evolution of intermediate des A fragment E species during early and
      intermediate phases of FPA cleavage from fragment E.

PMID- 8362370
TI  - Sequential intrapulmonary and systemic activation of coagulation and fibrinolysis
      during and after total hip replacement surgery.
AB  - Hip joint replacement surgery, using acrylic cement for prosthesis fixation, is
      associated with intraoperative cardiorespiratory dysfunction, and a high
      frequency of postoperative proximal deep vein thrombosis (DVT). Levels of
      prothrombin fragments 1+2 (F1+2), tissue plasminogen activator antigen (t-PA),
      plasminogen activator inhibitor 1 activity (PAI-1), D-dimer and interleukin 6 (IL
      6) were measured in arterial (AB) and mixed venous blood (MVB) in five patients
      during and after total hip replacement operation with acrylic cement prosthesis
      fixation. Sequential peaks of F1+2, t-PA, PAI-1 and IL-6 appeared, starting with
      activation of coagulation during preparation of bone, closely followed by
      activation of fibrinolysis. Later, this was counteracted by an antifibrinolytic
      response and increase of IL-6. After a fibrinolytic shutdown on the third
      postoperative day as evidenced by a drop in t-PA and D-dimer concentrations, a
      second wave of coagulation was seen at the end of the first week. The present
      model, with frequent sampling of blood entering and leaving the lungs, confirms
      our earlier findings of the lung as a key organ in promoting coagulation
      following traumatic activation.

PMID- 8362371
TI  - Regulation of endothelial cell protein C activation and fibrinolysis by
      procoagulant albumin.
AB  - Endothelial cell regulation of protein C activation and fibrinolysis are
      important components of the hemostatic response to vascular injury or
      perturbation. Procoagulant albumin (P-A1), a constituent of normal human plasma
      has been purified and identified as an inducer of endothelial cell tissue factor
      activity. The purpose of the studies reported herein was to investigate the
      effects of P-A1 on human endothelial cell protein C activation and fibrinolysis.
      P-A1 suppressed protein C activation, enhanced release of plasminogen activator
      inhibitor-1, but had no effect on tissue-plasminogen activator release.
      Plasminogen activator inhibitor-1 released by P-A1 was functional as evidenced by
      the capacity to form a covalent complex with 125I-urokinase. Inactive albumin
      (isolated during the same purification procedure as P-A1, but without tissue
      factor-inducing activity) did not suppress protein C activation or increase
      plasminogen activator inhibitor-1 release. These results indicate that P-A1, a
      component of human plasma, can modulate multiple vascular hemostatic properties,
      and support the hypothesis that P-A1 is involved in normal or pathologic
      hemostasis.

PMID- 8362372
TI  - Purification and characterisation of a snake venom phospholipase A2: a potent
      inhibitor of platelet aggregation.
AB  - An inhibitor of human platelet aggregation was identified from the venom of an
      Australian Copperhead snake, Austrelaps superba, as a novel phospholipase A2. The
      inhibitor was purified to homogeneity by chromatography on Q-Sepharose, S
      Sepharose and C8 reverse phase HPLC. The purified phospholipase A2 has a
      molecular weight of 15 kDa as assessed by sodium dodecyl sulphate polyacrylamide
      gel electrophoresis (SDS-PAGE). N-terminal sequence analysis of the platelet
      inhibitor revealed 70-80% sequence identity to other previously described
      secretory phospholipase A2. Phospholipase activity of the purified protein was
      confirmed by the ability of the enzyme to hydrolyse lecithin. Pretreatment of the
      purified protein with the specific phospholipase A2 inhibitor p-bromophenacyl
      bromide, resulted in abrogation of both its enzyme and platelet inhibitory
      activity. The phospholipase A2 inhibited platelet aggregation and serotonin
      release, induced by a variety of platelet agonists, in a time and dose dependent
      manner.

PMID- 8362373
TI  - Protein C and protein S in patients with peripheral arterial occlusive disease.

PMID- 8362374
TI  - Inhibition of heparin/antithrombin III cofactor activity by anticardiolipin
      antibodies: a mechanism for thrombosis.
AB  - Anticardiolipin antibodies (aCL) are autoantibodies which react with negatively
      charged phospholipids and are associated with thrombotic disease and recurrent
      fetal loss. We have found that 11% of aCL are cross-reactive with the
      glycosaminoglycans heparin and heparan sulphate. One of these antibodies was
      studied in detail and was found to inhibit the heparin dependent activation of
      antithrombin III by up to 80%. The inhibition of heparin dependent antithrombin
      III activation represents a new mechanism by which anticardiolipin antibodies may
      induce thrombosis or fetal loss in some patients with these antibodies.

PMID- 8362375
TI  - Reactive oxygen intermediates and ischemia-reperfusion injury release tissue
      plasminogen activator from isolated rat hearts.
AB  - Tissue plasminogen activator (t-PA) is a marker of endothelial cell injury or
      activation. The release of t-PA from isolated rat hearts (Langendorff model)
      subjected to ischemia-reperfusion or reactive oxygen intermediates (ROI)
      generated by H2O2 was investigated. H2O2 (200 microM) increased t-PA activity in
      the coronary effluent to 305 +/- 84% of initial value (mean +/- SEM, p < 0.04 vs
      controls) at the end of a 10 min intervention. The hydroxyl radical scavenger
      thiourea (10 mM) only partially inhibited the increase (175 +/- 27%, p < 0.01
      compared to controls). 20 min normothermic ischemia increased t-PA activity to
      416 +/- 108% (p < 0.005 compared to controls) at the start of reperfusion. In
      conclusion, cardiac injury by ischemia-reperfusion or ROI increases release of t
      PA.

PMID- 8362376
TI  - Fibrin--recombinant human factor XIII a-subunit association.
AB  - The association of factor XIII a-subunits with fibrin was characterized using
      recombinant human placental factor XIII (rFXIII) and native fully hydrated fibrin
      clots formed from purified fibrinogen and thrombin. Binding was assessed using
      small columns containing fibrin and perfusing them with radioiodinated rFXIII.
      Results show that thrombin activation of rFXIII led to fibrin binding. The
      association was partially reversible since much of the bound enzyme could be
      removed by percolating clots with more buffer. Binding was blocked by antibody
      directed against the COOH-terminal part of fibrinogen A alpha-chain (A alpha 389
      402) and also by the COOH-terminal A alpha-chain peptide fragment A alpha 241-476
      (Hi2-DSK).

PMID- 8362377
TI  - Suppressive effect of human blood coagulation factor XIII on the vascular
      permeability induced by anti-guinea pig endothelial cell antiserum in guinea
      pigs.
AB  - We investigated the effect of blood coagulation factor XIII (FXIII) on enhanced
      permeability induced by anti-endothelial cell antiserum, that was produced by the
      immunization of guinea pig endothelial cells with adjuvant into rabbits
      repeatedly. We have found that this antiserum reacts to human and guinea pig
      endothelial cells but not guinea pig fibroblast cells. The permeability was
      enhanced by intradermal injection of 400-fold dilution of this antiserum into
      dorsal skin of guinea pigs. The mixture of equal volume of antiserum and FXIII
      was intradermally injected into dorsal skin of guinea pig after Evans blue
      injection, and 15 minutes later the quantity of Evans blue at the each injection
      site was determined. We recognized the suppressive effect of FXIII on the dye
      leakage. We also studied the suppressive effect on swelling induced by the
      antiserum. After the subcutaneous injection of the mixture of antiserum and FXIII
      into the back of guinea pigs, we measured the thickness of skins at the injection
      site after day 1, 2 and 3. As a result, FXIII significantly suppressed the
      swelling. We found that FXIII suppresses the acute and subacute permeability
      enhancement. These results suggest that FXIII plays an important role on an
      inflammatory site and that it may exert as an anti-inflammatory protein.

PMID- 8362378
TI  - The effect of short-term exercise on plasma procoagulant activity in patients
      with type II (non-insulin-dependent) diabetes and healthy volunteers.
AB  - The effect of exercise on plasma coagulant activity was studied in 16 subjects
      with newly-diagnosed type II diabetes without vascular complications and 9
      healthy volunteers. Generation of thrombin was determined by a computer-assisted
      chromogenic method and results expressed as time to generate 50% maximal thrombin
      activity (T50/s). In addition, APTT, factor VIII and thrombin-antithrombin III
      (TAT) complex levels were measured. Pre-exercise FVIII:C [mean (+/- SD)] was
      increased in diabetic compared to control subjects [1.5 (0.4); 0.9 (0.2) IU ml-1;
      (p < 0.001) respectively]. No significant differences in APTT, TAT or T50 were
      detected between the groups. Exercise induced a rise in FVIII complex, reduction
      of APTT [33 (2) s to 31 (2) s; (p = 0.004)] and T50 [58 (6) s to 53 (6) s; (p =
      0.01)] in controls and an increase in FVIII complex but no significant changes in
      APTT or T50 in diabetic patients, with no change in TAT in either group. A
      greater increase in FVIII:C than vWF levels occurred in controls [0.2 (0.1); 0.1
      (0.1) IU ml-1; (p = 0.005)] and patients [0.3 (0.4); 0.2 (0.1) IU ml-1; (p =
      0.032)]. In patients, FVIII:C correlated inversely with APTT (r = -0.522, p =
      0.038) and T50 (r = -0.592, p = 0.016). The results show that FVIII:C levels are
      increased at diagnosis in patients with type II diabetes without vascular disease
      but there is no enhancement of plasma procoagulant activity. In healthy
      individuals, exercise induced activation of coagulation which was not seen in
      patients, suggesting that it does not precipitate a state of accelerated
      thrombogenesis in subjects with uncomplicated type II diabetes.

PMID- 8362379
TI  - Role of the platelet integrin glycoprotein IIb-IIIa in intracellular signalling.

PMID- 8362380
TI  - Anticoagulant and antithrombotic action of the factor Xa inhibitor antistasin
      (ATS).

PMID- 8362381
TI  - [Disability insurance on the decline].

PMID- 8362382
TI  - [Seizures and traffic risks].

PMID- 8362383
TI  - [Physicians and drivers' licences].

PMID- 8362384
TI  - [Serotonin antagonists against nausea and vomiting induced by oncologic therapy].

PMID- 8362386
TI  - [Role of phospholipids in hemostasis].
AB  - This article reviews the significance of phospholipids in the haemostatic
      process. The plasma membranes of activated human blood platelets provide a
      catalytic phospholipid surface on which the "tenase" complex (factor IXa-factor
      VIIIa) and the "prothrombinase" complex (factor Xa-factor Va) can be assembled.
      The formation of a procoagulant platelet surface involves the exposure of anionic
      phospholipids e.g. phosphatidylserine, and is associated with shedding of
      microvesicles from the membranes of activated platelets. Moreover, tissue-factor,
      which plays a key role in blood coagulation by initiating the extrinsic
      coagulation pathway, requires the presence of phospholipids for optimal
      biological activity. The phospholipid dependency of the coagulation system
      explains the prolongation of phospholipid dependent clotting tests in patients
      with phospholipid directed antibodies such as lupus anticoagulants.

PMID- 8362385
TI  - [On what indication should serotonin antagonists be used? A retrospective study
      of the use of ondansetron at an oncologic unit].
AB  - 561 chemotherapy-cycles administered to 191 patients during the period 1990-92 at
      the University Hospital, Tromso, were retrospectively analysed for combination
      with ondansetron. 65% of the cycles were combined with ondansetron. The frequency
      increased from 1991 (50%) to 1992 (69%). Among moderate emetogenic regimens
      (MIME, MMM, High-dose MTX, EBVP, ELF) the frequency had changed from 44% to 91%.
      The increased ondansetron-treatment in moderate emetogenic regimens raised the
      total cost of treatment. Better cost-effectiveness can possibly be achieved by
      "low dose-ondansetron" (4 mg x 2) and more frequent supplementary use of
      diazepam, corticosteroids or haloperidol. Use of ondansetron regimens extending
      beyond 24 hours is not cost-effective. Peroral treatment is less expensive and
      usually adequate to control acute emesis.

PMID- 8362387
TI  - [Therapeutic drug monitoring with the help of serum concentration measurements.
      How are the analytic results distributed in a population?].
AB  - Therapeutic drug monitoring includes measurement of serum concentrations of drugs
      when this is possible and appropriate. A therapeutic range is defined for
      populations where the serum levels represent an optimal relationship between
      clinical effects and side effects for most of the individuals in the population.
      Compared with the rest of the population, some individuals are atypical, both
      with respect to response to and elimination of drugs. Therapeutic drug monitoring
      makes individualization of dosages in these individuals easier, but often
      requires extra effort. Compilation of serum level measurements for different
      drugs for a period of six months showed that the tailoring of digitoxin,
      carbamazepine, lithium and phenobarbital is as close to optimal as can be
      expected for a population. For amitriptyline, digoxin and theophylline, a
      considerable increase in clinical effect within a population of users could
      probably be achieved by bringing more individual serum levels from the
      subtherapeutic into the therapeutic range. Nor does the therapeutic potential of
      phenytoin, nortriptyline and valproate seem to be fully utilized.

PMID- 8362388
TI  - [Infantile autism among children in the county of Nordland. Prevalence and
      etiology].
AB  - Few epidemiological studies of infantile autism have been conducted in Norway. A
      prevalence of four per 10,000 children was found in Nord-Trondelag. Studies from
      Sweden, England and Japan show prevalence figures of 2-13 per 10,000. Causal
      factors of autism are complicated, but many studies in recent years indicate that
      both genetic and neurological factors are important. The aim of this study was to
      establish the prevalence of infantile autism in Nordland county and look for
      causal factors and disabilities among the children. Together with the Autism-Team
      we found 28 persons, born between 1975 and 1991, who lived in the county in 1992.
      This gives a prevalence of 5.5 per 10,000. 21 were boys, seven girls, 26 were
      mentally retarded, 13 had no verbal speech. Nine had epilepsy. 13 children were
      diagnosed before the age of four. Different diseases and impairments associated
      with autism were discovered in 19 children. In the case of eight children we
      found associated disease. When a diagnosis of infantile autism is made, the child
      should undergo a thorough medical and neurological examination. This should
      include CT brain scan, EEG, chromosome analysis, and screening for metabolic
      diseases and intrauterine virus infections. Sometimes examinations of liquor and
      auditory brain-stem responses are indicated.

PMID- 8362389
TI  - [Eosinophilic gastroenteritis].
AB  - We describe the case of a 33 year-old woman who was hospitalized for ascites,
      abdominal pain and food allergy. Blood samples and histologic examination of a
      jejunal specimen removed by laparotomy revealed that the patient suffered from
      eosinophilic gastroenteritis. This disease is classified among the
      hypereosinophilic syndromes, and food allergy may be of etiologic importance.
      Clinically eosinophilic gastroenteritis may present with ascites, malabsorption
      or gut obstruction. The eosinophilic blood cell count is usually elevated and the
      erythrocyte sedimentation rate is usually normal or slightly increased.
      Polyarteritis nodosa, Crohn's disease and nematodal infections of the gut must be
      excluded. Most patients respond well to corticosteroid therapy and the long-term
      prognosis is good, even though the disease is chronic in nature.

PMID- 8362390
TI  - [Pulmonary embolism as a late complication of heart contusion].
AB  - A 57 year-old woman was hospitalized because of a sternal fracture inflicted
      during a car accident. During the following two weeks she became breathless and
      was readmitted after having syncope, induced by exertion. A perfusion scan of the
      lungs showed pulmonary emboli in both the lower lobes. After anti-coagulation
      treatment her symptoms faded, but the ultrasonographic signs of pulmonary
      hypertension persisted for nearly four months. The probable mechanism behind the
      pulmonary embolism was transmural contusion of the right ventricle, leading to a
      mural thrombus which eventually became detached. The authors review the
      literature and discuss problems connected to the diagnostic criteria for cardiac
      contusion, as well as delayed complications, of which pulmonary embolism is a
      potentially lethal condition.

PMID- 8362391
TI  - [Cystitis cystica--a premalignant condition?].
AB  - Although cystitis cystica is considered to be a premalignant disease of the
      urinary bladder, remarkably few reports document the progression from cystitis
      cystica and glandularis to carcinoma of the bladder. We describe three patients
      where cystitis cystica was demonstrated 12, three and one month before diagnosis
      of cancer. We believe cystitis cystica reflects mobilization of the humoral
      immune defence mechanism in response to various agents, among these a subclinical
      malignant tumour.

PMID- 8362392
TI  - [Brodie's abscess].
AB  - Brodie's abscess is a localized subacute or chronic osteomyelitis independent of
      any known previous acute infection. The entity is often mistaken for a bone
      tumour. The diagnosis requires biopsy. The treatment is curettage, drainage and
      antibiotics for a minimum of six weeks. We describe the characteristics of
      Brodie's abscess and describe a patient with an illustrating history, but with an
      unusual localization of the abscess (osilium).

PMID- 8362393
TI  - [Adenocarcinoid (mucinous carcinoid) of the vermiform appendix].
AB  - Adenocarcinoid (mucinous carcinoid or goblet cell carcinoid) is an unusual tumour
      of the appendix with histologic and prognostic features between those of
      carcinoid and adenocarcinoma. Most patients with adenocarcinoid tumours of the
      appendix present with symptoms consistent with those of acute appendicitis. We
      describe a 31 year-old male who presented with such symptoms. Ultrasonography
      demonstrated an acutely inflamed appendix with a hypoechoic area in the
      midportion of the appendix, suspicious of a tumour. This rare type of tumour is
      briefly presented.

PMID- 8362394
TI  - [Poisonings and gas accidents].
AB  - Recent trends in the treatment of acute poisoning, including exposure to gas, are
      briefly discussed. According to the new WHO/IPCS guidelines, a more restrictive
      use of gastric lavage and induction of emesis is recommended. Toxicokinetic
      evaluation of the efficacy of elimination procedures has lead to very few
      remaining indications for haemoperfusion, and forced acidic diuresis is no longer
      recommended.

PMID- 8362395
TI  - [Coma from cerebral and metabolic causes].
AB  - The medical causes of coma fall into two main categories: intercranial diseases,
      and metabolic disturbances. The clinical examination should define 1) vital
      functions, 2) depth of coma, 3) whether cerebral signs are diffuse or local, 4)
      any signs of organ disease. The blood sugar level must be determined.
      Hypoglycemia may be the cause even if the signs point to another cause. Head
      injury and intoxication/poisoning must always be considered, even if a medical
      cause is suspected. Prolonged coma calls for repeated clinical and laboratory
      examination. Combinations of causes, e.g. organ disease plus intoxication should
      be considered.

PMID- 8362396
TI  - [Phospholipid antibodies (lupus anticoagulant and cardiolipin antibodies).
      Detection and clinical significance].
AB  - Phospholipid antibodies may be detected by their ability to prolong phospholipid
      dependent coagulation tests, and are then called lupus anticoagulants. When ELISA
      tests with cardiolipin as coating antigen are used, the term anticardiolipin
      antibodies is employed. The association with thrombosis is best documented in
      patients with systemic lupus erythematosus. However, the "antiphospholipid
      syndrome", i.e. repeated thrombotic episodes and/or foetal loss in combination
      with a high positive anticardiolipin antibody test and/or an unequivocally
      positive lupus anticoagulant test, may be seen in individuals without any known
      underlying disease. The article describes techniques for the detection of
      antiphospholipid antibodies and adequate processing and handling of plasma
      samples.

PMID- 8362397
TI  - [Driver's licence and seizures].
AB  - The authors consider various types of seizures and their medico-legal
      consequences in connection with motor vehicle driving. Epilepsy, syncope,
      transitory ischemic attacks, migraine, electrolyte disturbances, hypoglycaemia,
      hypersomnia, and alcohol-induced fits are discussed in brief. The authors also
      discuss risk of recurrence, the seizure-free interval before driving can be
      resumed, and possible mitigating factors.

PMID- 8362398
TI  - [Driver's licenses and medicine. A review of legal requirements and practice].
AB  - There are health requirements for acquiring and renewing a driver's license.
      Physicians are legally obliged to inform the local health authorities when a
      patient no longer meets these health requirements. This paper describes the
      current Norwegian legislation, formalities of administration, and practice of
      traffic medicine. Visual acuity, field of vision, seizures, heart disease,
      diabetes mellitus, abuse of alcohol and drugs, psychiatric disorders, aging and
      dysfunction of the locomotor system are discussed in brief.

PMID- 8362399
TI  - [Detection of antibodies in erythema infectiosum--now also possible in Norway].

PMID- 8362400
TI  - [Mononucleosis and neurologic manifestations].

PMID- 8362401
TI  - [Treatment of endocrine diseases in adolescents and adults].

PMID- 8362402
TI  - [More adverse effects of EDP].

PMID- 8362403
TI  - [Refugees and immigrants].

PMID- 8362404
TI  - [Jumper's knee or take-off knee?].

PMID- 8362405
TI  - [Joint European monitoring of differences in health care. A description of
      practices established by the European Community for reporting accidents and near
      accidents in relation to the use of medical technology].

PMID- 8362406
TI  - [Personnel crisis of Norwegian laboratory medicine].

PMID- 8362407
TI  - [Useful drug information on CD-ROM].

PMID- 8362408
TI  - Sequence-specific oligonucleotide typing in Shona patients with rheumatoid
      arthritis and healthy controls from Zimbabwe.
AB  - Seventy-two patients with rheumatoid arthritis (RA) and 82 controls have been
      typed with the XI Histocompatibility Workshop DRB1 and DQB1 sequence-specific
      oligonucleotide probes. The increase of DRB1*04 corresponds to an increase of the
      serologically defined DR4, previously found in a small group of Zimbabwean RA
      patients and we now show that this increase is due to the subtype DRB1*0405 in
      association with DQB1*0302. In addition there is a clearcut increase of DRB1*1001
      equivalent to the serologically defined DR10. There was no increase amongst RA
      patients of DRB1*0102 which was the predominant DR1 sub-type amongst controls. In
      the course of our investigation, we observed a DRB1*04 variant which corresponds
      to DRB1*0412, newly defined in the XIth Histocompatibility Workshop.

PMID- 8362409
TI  - On the HLA-DQ(alpha 1*0501, beta 1*0201)-associated susceptibility in celiac
      disease: a possible gene dosage effect of DQB1*0201.
AB  - The HLA-associated susceptibility to develop celiac disease (CD) seems mainly to
      be conferred by a particular HLA-DQ heterodimer encoded by the DQA1*0501 and
      DQB1*0201 genes either in cis or in trans position. To study the possible
      influence of DRB1 or other DQA1 and DQB1 alleles on the CD susceptibility
      conferred by these DQ genes, we performed genomic HLA typing of 94 CD patients,
      selected those who carried at least one copy of the DRB1*0301-DQA1*0501-DQB1*0201
      haplotype (N = 89) and compared them to 47 random, healthy Norwegians matched
      with the patients to carry at least one copy of the above haplotype. We found an
      excess of DQB1*0201 homozygosity in the patients. This was due to an increased
      frequency of the DRB1*0301-DQA1*0501-DQB1*0201 and DRB1*0701-DQA1*0201-DQB1*0201
      haplotypes present on the other chromosome. We propose that, in individuals
      carrying the DQA1*0501 and DQB1*0201 alleles, the presence of a second copy of
      the DQB1*0201 allele increases susceptibility to CD.

PMID- 8362411
TI  - Primary structure shows HLA-B59 to be a hybrid of HLA-B55 and HLA-B51, and not a
      subtype of HLA-B8.

PMID- 8362410
TI  - A human monoclonal antibody that detects HLA-A1, A23 and A24 antigens.
AB  - We report the production and characterization of a human monoclonal IgM (mu,
      kappa) antibody recognizing the HLA A1, A23 and A24 antigens. B lymphocytes
      obtained from a multiparous Japanese woman were transformed in vitro by Epstein
      Barr virus, screened with an immune adherence assay, and fused with a murine
      myeloma cell line, P3-X63-Ag8.653. After subcloning by limiting dilution three
      times, a stable antibody-secreting hybridoma cell line, 4-35-7, was identified.
      The culture supernant had a titer of 1:32-64 against each of A1-, A23- and A24
      positive lymphocyte panels, and showed complete correlation (r = 1.00) with the
      A1, A23 and A24 antigens on a lymphocyte panel of 287 unrelated, class I HLA
      typed donors by the NIH cytotoxicity assay. Monoclonality of the antibody was
      ensured by Southern blot analysis of the human immunoglobulin heavy chain gene of
      4-35-7. In view of the published data on HLA class I nucleotide sequences, the
      antibody may recognize an antigeneic determinant including two amino acid
      residues, Asp-166 and Gly-167, in the alpha 2 helix of the class I molecule that
      are specific for A1, A23 and A24 so far analyzed.

PMID- 8362412
TI  - A monospecific HLA-B27 fluorescein isothiocyanate-conjugated monoclonal antibody
      for rapid, simple and accurate HLA-B27 typing.

PMID- 8362413
TI  - A new DR11 allele in Singaporean Chinese.

PMID- 8362414
TI  - A new HLA Cw6 split -Cw6.2- detected in three ethnic groups that is inherited in
      families.

PMID- 8362415
TI  - Molecular analysis of a novel HLA-A33 subtype associated with HLA-B44.

PMID- 8362416
TI  - Structural and biosynthetic features of the Mo5 human myeloid differentiation
      antigen.

PMID- 8362417
TI  - Simplified preparation from anti-coagulated blood for HLA-DR genomic typing.

PMID- 8362418
TI  - Carotid endarterectomy and the measurement of stenosis.

PMID- 8362419
TI  - Predicting complications of carotid endarterectomy.
AB  - BACKGROUND AND PURPOSE: Carotid endarterectomy has been shown to be beneficial in
      patients with high-grade carotid stenosis and ipsilateral transient ischemic
      attack or stroke. This benefit will be realized only if the operation is
      performed safely. We sought to determine the extent to which clinically
      significant adverse events occurring after carotid endarterectomy can be
      predicted from clinical data available before surgery. METHODS: Eleven hundred
      sixty patients were randomly selected from all patients who underwent carotid
      endarterectomy and were discharged during the calendar years 1988, 1989, and 1990
      in 12 academic medical centers in 10 states. Clinical data abstracted from
      hospital charts were analyzed retrospectively. A model was developed and
      validated to predict the occurrence of stroke, myocardial infarction, or death
      during the postoperative period of hospitalization. RESULTS: Eight patients
      (6.9%) suffered at least one adverse event. Rates for individual complications
      were as follows: death, 1.4%; nonfatal stroke, 3.4%; nonfatal myocardial
      infarction, 2.1%; and nonfatal stroke or death, 4.8%. Significant predictors of
      adverse events were age 75 years or older, symptom status (ipsilateral symptoms
      versus asymptomatic or nonipsilateral symptoms), severe hypertension
      (preoperative diastolic blood pressure of greater than 110 mm Hg), carotid
      endarterectomy performed in preparation for coronary artery bypass surgery,
      history of angina, evidence of internal carotid artery thrombus, and internal
      carotid artery stenosis near the carotid siphon. The presence of two or more of
      these risk factors was associated with a nearly twofold increase in risk of an
      adverse event (relative risk, 1.7; 95% confidence interval, 1.0 to 3.0).
      CONCLUSIONS: Clinical data can be used to stratify patients undergoing carotid
      endarterectomy according to risk of postoperative in-hospital stroke, myocardial
      infarction, or death.

PMID- 8362420
TI  - Measuring carotid stenosis. Time for a reappraisal.
AB  - BACKGROUND AND PURPOSE: Data from recent multicenter carotid endarterectomy
      trials have questioned the validity and reliability of Doppler ultrasound in the
      assessment of carotid stenosis. METHODS: We prospectively analyzed 45 patients
      undergoing carotid angiography to compare the North American Symptomatic Carotid
      Endarterectomy Trial (NASCET) and European Carotid Surgery Trial (ECST) methods
      of measuring carotid stenosis with those of direct visualization ("eyeballing")
      and duplex ultrasound. Linear NASCET and ECST measurements were also converted
      into area using the pi r2 function and termed "squared NASCET" (N2) and "squared
      ECST" (E2). In 15 of 45 patients undergoing carotid endarterectomy, the carotid
      plaque was removed intact, sectioned, and photographed for computer measurement
      of cross-sectional area. Comparison of this "gold standard" was then made to each
      method of measurement. RESULTS: Comparison between duplex and the various
      angiographic measurement techniques revealed significant differences between
      NASCET and duplex (P < .0001), ECST and duplex (P < .01), and E2 and duplex (P <
      .01) but not between N2, eyeballing, and carotid duplex methods. Even the NASCET
      and ECST methods themselves differed significantly (P < .006). When comparison
      was made with computerized planimetric measurements of the carotid plaque, there
      were significant differences for both NASCET (P < .0007) and ECST (P < .007).
      Correlation was demonstrated only between planimetry and N2, E2, and duplex.
      CONCLUSIONS: NASCET and ECST angiographic methods of measurement consistently
      underestimate the "true" anatomic stenosis. As such, they represent only
      "indexes" of carotid stenosis severity. Duplex provides a more accurate
      measurement of carotid stenosis.

PMID- 8362421
TI  - Carotid artery intimal-medial thickness distribution in general populations as
      evaluated by B-mode ultrasound. ARIC Investigators.
AB  - BACKGROUND AND PURPOSE: B-mode ultrasound is a widely used technique for the
      clinical and epidemiological assessment of carotid atherosclerosis. This article
      provides a description of the distribution of carotid atherosclerosis in the
      general population. METHODS: Intimal-medial arterial wall thickness was measured
      by B-mode real-time ultrasound as an index of atherosclerotic involvement in the
      extracranial carotid arteries as part of the population-based Atherosclerosis
      Risk in Communities (ARIC) study. The distribution was described by race-sex
      strata, in which 759 to 4952 individuals were imaged depending on strata and
      location in the carotid system. RESULTS: Median wall thickness ranged between 0.5
      and 1 mm at all ages; fewer than 5% of ARIC participants had values exceeding 2
      mm. Individuals tended to have a larger wall thickness in the carotid bifurcation
      than in the common carotid artery. Internal carotid artery values were more
      variable, with higher proportions of both large and small wall thicknesses than
      in the common carotid. The proportion of individuals with a large wall thickness
      was greatest at the bifurcation and smallest at the common carotid artery. Men
      had uniformly larger wall thickness than women. Cross-sectional analysis suggests
      that age-related increases in wall thickness average approximately 0.015 mm/y in
      women and 0.018 mm/y in men in the carotid bifurcation, 0.010 mm/y for women and
      0.014 mm/y for men in the internal carotid artery, and 0.010 mm/y in both sexes
      in the common carotid artery. CONCLUSIONS: Estimates provided for wall thickness
      percentiles can serve as "nomograms" by age, race, and sex.

PMID- 8362422
TI  - Transcranial color duplex sonography in childhood and adolescence. Age dependence
      of flow velocities and waveform parameters.
AB  - BACKGROUND AND PURPOSE: Transcranial color duplex sonographic examinations in
      children and adolescents without cerebrovascular disease were evaluated
      retrospectively. Flow velocities and waveform parameters were determined and
      their side-to-side differences and age dependence analyzed and, finally, compared
      with analogous data of a previously described group of healthy adults. METHODS:
      With a 2.0-MHz sector transducer of a computed sonographic system, the anterior,
      middle, and posterior cerebral arteries were examined in 64 children and
      adolescents between 1.5 and 17.5 years of age. Angle-corrected systolic peak, end
      diastolic maximum, time-averaged, and time-averaged maximum velocities, and the
      resistance, pulsatility, and spectral broadening indexes were determined in all
      vessels. RESULTS: Mean +/- SD values for time-averaged maximum velocity (and time
      averaged velocity) were 92.2 +/- 13.0, 79.9 +/- 17.7, and 63.9 +/- 13.6 (55.3 +/-
      11.7, 40.4 +/- 10.4, and 34.2 +/- 9.2) cm/s, respectively, in the middle,
      anterior, and posterior cerebral arteries in children under 10 years of age;
      values were 83.2 +/- 11.9, 69.4 +/- 13.8, and 55.6 +/- 10.1 (50.8 +/- 9.0, 39.9
      +/- 10.5, and 33.1 +/- 6.3) cm/s, respectively, in children 10 years of age and
      older. Time-averaged maximum velocity decreased significantly with age in all
      vessels (P < .001). Although time-averaged velocity did not change significantly
      during childhood and adolescence, a clear decline occurred from adolescence to
      adulthood (P < .0001 in the middle and posterior cerebral arteries; P < .01 in
      the anterior cerebral artery). The spectral broadening index decreased
      significantly from childhood to adolescence in the anterior and posterior
      cerebral arteries (P < .0001). The resistance and pulsatility indexes remained
      stable throughout childhood. CONCLUSIONS: Transcranial color duplex sonography
      allows angle-corrected measurements of "true" flow velocities in basal cerebral
      arteries. Additional determination of time-averaged velocity permits more
      detailed evaluation of flow characteristics for all age groups. The transcranial
      color duplex technique may provide deeper insights on normal cerebral perfusion
      and its disorders.

PMID- 8362423
TI  - Magnetic resonance angiography in vertebrobasilar ischemia.
AB  - BACKGROUND AND PURPOSE: Magnetic resonance angiography is a new, noninvasive
      technique whose diagnostic value in vertebrobasilar artery disease has not yet
      been determined. METHODS: Forty-one patients with acute cerebellar and/or brain
      stem ischemia were examined by routine magnetic resonance imaging, extracranial
      and transcranial Doppler ultrasound, and selective intra-arterial arteriography.
      Results were correlated with magnetic resonance angiography. Magnetic resonance
      angiography was accomplished using a three-dimensional time-of-flight gradient
      echo technique. RESULTS: Magnetic resonance angiography correctly identified all
      occlusions, stenoses, and an aneurysm within the distal vertebrobasilar system as
      revealed by conventional intra-arterial arteriography but missed the diagnosis of
      vertebral artery dissection in one case. This results in a sensitivity of
      magnetic resonance angiography of 97% and a specificity of 98.9%. However, the
      degree of stenoses was difficult to evaluate by magnetic resonance angiography.
      At least for severe obstructive lesions, this drawback can be eliminated by
      application of presaturation pulses, which allow the analysis of flow direction
      and collateral blood flow. Doppler ultrasound studies add useful hemodynamic
      information for less severe degrees of stenoses. CONCLUSIONS: The combined use of
      magnetic resonance angiography and Doppler ultrasound findings may replace the
      invasive intra-arterial arteriography examination in many patients with suspected
      macroangiopathy of the vertebrobasilar arteries.

PMID- 8362424
TI  - Longitudinal changes in proton magnetic resonance spectroscopy in cerebral
      infarction.
AB  - BACKGROUND AND PURPOSE: Proton magnetic resonance spectroscopy has revealed
      changes in lactate and N-acetyl-aspartate in acute cerebral infarction. However,
      the details of these drastic changes and subsequent chronic changes have not been
      clarified. The purpose of this study was to disclose longitudinal changes in
      spectra seen in proton magnetic resonance spectroscopy. METHODS: Six patients
      with completed cerebral infarction were examined longitudinally with localized
      proton magnetic resonance spectroscopy. RESULTS: (1) In the acute stage (within 2
      days after onset), two drastic changes were observed: N-acetyl-aspartate
      decreased rapidly and severely within 2 days after onset, and lactate increased
      immediately and reached a high level in the acute stage after onset. (2) In the
      chronic stage (more than 1 month after onset), two features were observed:
      lactate, which had increased in the acute stage, remained high for more than 1
      month, and other signals such as those of N-acetyl-aspartate, choline, and
      phosphocreatine/creatine decreased dramatically. CONCLUSIONS: These results
      suggest that N-acetyl-aspartate and lactate as revealed by proton magnetic
      resonance spectroscopy can be useful indicators of the ischemic damage to the
      brain in clinical cases of cerebral infarction.

PMID- 8362425
TI  - Value of single-photon emission-computed tomography in acute stroke therapeutic
      trials.
AB  - BACKGROUND AND PURPOSE: New therapeutic interventions for acute ischemic stroke
      are aimed at improving cerebral blood flow in the first 3 to 6 hours after
      symptom onset. Single-photon emission-computed tomography (SPECT) performed in
      the setting of clinical therapeutic trials may give us a better understanding of
      the physiological response to new forms of treatment and could impact acute
      management decisions. METHODS: We prospectively studied 15 patients with
      hemispheric ischemic stroke with SPECT within 6 hours of symptom onset and again
      at 24 hours. The ischemic defect was assessed in a semiquantitative manner that
      used computer-generated regions of interest (SPECT graded scale). This measure
      was correlated with clinical presentation (National Institutes of Health [NIH]
      Stroke Scale), initial clinical course (change in NIH Stroke Scale), long-term
      outcome (Barthel Index at 3 months), and complications of cerebral hemorrhage and
      edema. RESULTS: The severity of the SPECT graded scale on the admission scan
      correlated with the severity of neurological deficit (admission NIH Stroke Scale)
      (P < .05) and was positively associated with poor long-term outcome as measured
      with the Barthel Index (P < .001) and the complications of cerebral hemorrhage
      and massive cerebral edema (P < .005). In fact, there was a threshold value for
      the SPECT graded scale above which all patients suffered poor long-term outcome
      and the complications of cerebral hemorrhage and edema. CONCLUSIONS: The
      measurement of an ischemic defect using SPECT is a valid assessment of
      hemispheric stroke severity in the hyperacute setting and may be useful for
      selecting or stratifying patients in clinical therapeutic trials.

PMID- 8362426
TI  - The relevance of detecting carotid artery calcification on plain radiograph.
AB  - BACKGROUND AND PURPOSE: The aim of this study was to determine the potential
      value of carotid artery calcification observed on plain radiographs in patients
      referred for carotid angiogram in the diagnosis of carotid artery stenosis.
      METHODS: One hundred sixty consecutive patients with suspected carotid artery
      stenosis underwent both plain radiographs of the carotid arteries and digital
      subtraction angiography of the same vessels. In addition, 108 of these patients
      also had duplex ultrasound of the same vascular area. The clinical usefulness of
      the carotid artery calcification was assessed by calculating the likelihood
      ratios for different test results against results of angiography and duplex
      ultrasound. RESULTS: There is a statistically significant association between the
      degrees of calcification and carotid disease as demonstrated by angiography (P =
      .0001), although positive correlations of the degrees of stenosis and
      calcification was only fair (Spearman correlation coefficient r = .4). The
      sensitivity of carotid calcification in detecting clinically significant stenosis
      assuming any calcification is abnormal was 89% with a specificity of 46%. The
      likelihood ratios for 50% stenosis by angiography varied from 0.24 (no
      calcification) to 3.41 (level III) and for 50% stenosis by duplex ultrasound
      varied from 0.21 (no calcification) to more than 5.87 (level III). Assessments of
      the degree of calcification based on plain radiographs had excellent
      reproducibility (all intraclass correlation coefficients were greater than .9).
      CONCLUSIONS: In this population with a high prevalence of carotid artery disease,
      there is an association between the presence of carotid calcification and
      atheromatous disease. If subsequent studies were to show this to apply in the
      general population, this could be of value in identifying asymptomatic patients
      at increased risk.

PMID- 8362427
TI  - Lack of asymmetry of middle cerebral artery blood velocity in unilateral
      migraine.
AB  - BACKGROUND AND PURPOSE: A recent transcranial Doppler study found reduced blood
      velocity in seven patients during migraine attacks in the middle cerebral artery
      at the headache side. This would implicate vasodilation of the middle cerebral
      artery in the pathogenesis of headache in migraine. We attempted to confirm this
      finding. METHODS: We determined blood velocity with transcranial Doppler
      ultrasonography in the middle cerebral arteries of 51 migraine patients with
      unilateral headache (5 with aura, 46 without aura) and of 14 patients with
      bilateral headache, during and outside attacks. During attacks, median time from
      onset of attack to transcranial Doppler examination was 6 hours (range, 1 to 35
      hours). RESULTS: We found no difference between blood velocity at the headache
      and nonheadache sides nor between blood velocity during and outside attacks.
      Similar results were obtained in a subgroup of 11 patients who were investigated
      in the first 4 hours of an attack. There were also no differences between attacks
      with unilateral or bilateral headache. CONCLUSIONS: We cannot support the
      hypothesis that migraine is associated with vasodilation of the middle cerebral
      artery ipsilateral to the headache.

PMID- 8362428
TI  - Pathogenesis of subcortical hyperintense lesions on magnetic resonance imaging of
      the brain. Observations in patients undergoing controlled therapeutic internal
      carotid artery occlusion.
AB  - BACKGROUND AND PURPOSE: Factors associated with the pathogenesis of subcortical
      hyperintense lesions on magnetic resonance imaging of the brain are not known. We
      describe four cases of de novo genesis of subcortical hyperintense lesions in
      patients undergoing controlled therapeutic internal carotid artery occlusion, and
      we speculate on associated pathophysiological mechanisms. METHODS: Twelve
      consecutive patients underwent controlled therapeutic internal carotid artery
      occlusion for symptomatic giant cerebral aneurysm using the detachable balloon
      technique under full anticoagulation. Preocclusion (within 2 weeks) and
      postocclusion (within 6 weeks) magnetic resonance imaging of the brain was
      performed in eight cases and evaluated for preexisting and new appearance of
      subcortical hyperintense lesions. RESULTS: There were four instances of de novo
      genesis of subcortical hyperintense lesions after carotid occlusion. New
      subcortical hyperintense lesions were ipsilateral to carotid occlusion in every
      instance and in two cases were associated with ipsilateral hemispheric ischemic
      symptoms despite anticoagulant therapy. In one instance, there were transient
      hemispheric symptoms without the appearance of new subcortical hyperintense
      lesions. Age, vascular risk factors, and preexisting subcortical hyperintense
      lesions did not appear to predispose patients to de novo genesis of new
      hyperintensities. CONCLUSIONS: This is the first documentation of de novo genesis
      of subcortical hyperintense lesions in a controlled setting of hemodynamic
      ischemic insult. Symptomatic and asymptomatic lesions can be detected in this
      setting. Anticoagulation does not appear to provide protection from this
      phenomenon. Careful prospective studies are required to further evaluate risk
      factors and possible clinical consequences associated with the genesis of new
      subcortical hyperintense lesions.

PMID- 8362429
TI  - Silent infarcts in patients with ischemic stroke are related to age and size of
      the left atrium.
AB  - BACKGROUND AND PURPOSE: Possible specific risk factors for silent infarcts remain
      unknown. The aim of this study was to investigate whether risk factors for silent
      infarcts differ from those for symptomatic infarcts in stroke patients. METHODS:
      Silent infarcts were defined as asymptomatic infarcts detected on computed
      tomographic scan in patients free of history of stroke and unrelated to the
      symptoms and signs of the index stroke. Of 595 consecutive patients with stroke
      or transient ischemic attacks, 116 (19%) had at least one silent infarct on the
      first computed tomographic scan performed within 24 hours after onset. They were
      compared with the 479 remaining patients for cerebrovascular risk factors and for
      presumed mechanism of stroke by means of the odds ratio method. A discriminant
      analysis was then performed in the subgroup of 216 patients with ischemic stroke
      who underwent an exhaustive cardiac and vascular workup. RESULTS: One hundred
      forty-one silent infarcts (99% confidence interval [CI], 29% to 41%) and 265
      symptomatic infarcts (99% CI, 59% to 71%) were subcortical infarcts smaller than
      15 mm. Univariate analysis showed that patients with silent infarcts were more
      likely to be older than 65 years (odds ratio [99% CI], 1.11 to 3.49) and to have
      left atrial enlargement on echocardiogram (odds ratio [99% CI], 1.02 to 26.70)
      and leukoaraiosis (odds ratio [99% CI], 1.39 to 4.21). Discriminant analysis
      found only two independent risk factors for silent infarcts: left atrial
      enlargement (P = .007) and age older than 65 years (P = .03); leukoaraiosis was
      not found to be an independent risk factor (P = .86). CONCLUSIONS: Age and left
      atrial enlargement are the main risk factors for silent infarcts in patients with
      ischemic stroke or transient ischemic attacks.

PMID- 8362430
TI  - Cocaine-induced platelet defects.
AB  - BACKGROUND AND PURPOSE: Numerous studies have demonstrated an association between
      acute cardiac events, cerebrovascular accidents, and cocaine use. The underlying
      mechanisms leading to these complications have not been well defined. Using
      various in vitro model systems, it has been reported that cocaine, up to or
      greater than an order of magnitude of the lethal dose, causes either inhibitory
      or proaggregatory effects on platelet function. METHODS: To address these
      reported discrepancies, we examined the effect of cocaine and its carrier on the
      activation and aggregation of human platelets in vitro. RESULTS: We found that
      cocaine inhibited platelet aggregation when platelets were challenged with ADP,
      collagen, or arachidonic acid. This inhibition was due to a direct effect on
      fibrinogen binding to the activated platelet. Cocaine also caused the
      dissociation of preformed platelet aggregates. At these same concentrations,
      cocaine did not inhibit agonist-mediated increases in cytosolic calcium or
      inhibit platelet shape change, suggesting that its effect on platelet aggregation
      was a selective process and not due to a total destruction of platelet function.
      Interestingly, the organization of the cytoskeleton of activated platelets, a
      secondary event critical to cell receptor clustering and clot retraction, was
      disrupted by cocaine treatment. In addition, alterations in platelet protein
      electrophoretic patterns were observed on preincubation of platelets with
      cocaine. CONCLUSIONS: We conclude that cocaine may have a direct inhibitory
      effect on the ability of platelets to participate in thrombus formation. The
      contribution of this effect as an underlying mechanism of sudden death in cocaine
      abusers is unknown.

PMID- 8362431
TI  - Effect of low-intensity warfarin anticoagulation on level of activity of the
      hemostatic system in patients with atrial fibrillation. BAATAF Investigators.
AB  - BACKGROUND AND PURPOSE: The Boston Area Anticoagulation Trial for Atrial
      Fibrillation (BAATAF) demonstrated that low-intensity warfarin anticoagulation
      can, with safety, sharply reduce the rate of stroke in patients with nonvalvular
      atrial fibrillation. The beneficial effect of warfarin was presumably related to
      a decrease in clot formation in the cardiac atria and subsequent embolization.
      METHODS: To assess the effect of warfarin therapy on in vivo clotting in patients
      in the BAATAF, we measured the plasma level of prothrombin activation fragment
      F1+2. One sample was obtained from 125 patients from the BAATAF; 62 were taking
      warfarin and 63 were not taking warfarin (control group). RESULTS: The warfarin
      group had a 71% lower mean F1+2 level than the control group (mean F1+2 of 1.57
      nmol/L in the control group compared with a mean of 0.46 nmol/L in the warfarin
      group; P < .001). F1+2 levels were higher in older subjects but were consistently
      lower in the warfarin group at all ages. Fifty-two percent of patients in the
      control group were taking chronic aspirin therapy at the time their F1+2 level
      was measured. Control patients taking aspirin had F1+2 levels very similar to
      control patients not taking aspirin (mean of 1.52 nmol/L for control patients on
      aspirin compared with 1.64 nmol/L for control patients off aspirin; P > .1).
      CONCLUSIONS: We conclude that prothrombin activation was significantly suppressed
      in vivo by warfarin but not aspirin among patients in the BAATAF. These findings
      correlate with the marked reduction in ischemic stroke noted among patients in
      the warfarin treatment group observed in the BAATAF.

PMID- 8362432
TI  - Familial aggregation of stroke. The Framingham Study.
AB  - BACKGROUND AND PURPOSE: Family history is perceived to be an important risk
      factor for stroke despite conflicting published data. We examined patterns of
      familial aggregation of stroke among three generations using data from the
      Framingham Study. METHODS: Cox proportional hazards analyses, adjusting for known
      stroke risk factors, were used to examine familial concordance in three groups:
      (1) members of the original Framingham cohort using reported parental stroke
      death; (2) members of the Framingham Offspring Study and their parents (members
      of the original Framingham Study); and (3) sibships within the original
      Framingham cohort. RESULTS: We found no association between stroke or transient
      ischemic attack among original cohort members and their reported parental stroke
      death (n = 4933; relative risk [RR] = 1.07). Using verified cases of parental
      stroke or transient ischemic attack, the Offspring analyses revealed that both
      paternal (n = 1762; RR = 2.4; 95% confidence interval [CI], 0.96 to 6.03) and
      maternal (n = 2074; RR = 1.4; 95% CI, 0.60 to 3.25) histories were associated
      with an increased risk. Parental history of coronary heart disease was strongly
      associated with stroke or transient ischemic attack among Offspring Study members
      (RR = 3.33; 95% CI, 1.27 to 8.72). Sibling history of stroke or transient
      ischemic attack was not associated with stroke or transient ischemic attack among
      original cohort members, although a non-statistically significant increased risk
      associated with sibling history of atherothrombotic brain infarction was observed
      (RR = 1.8; 95% CI, 0.68 to 4.94). CONCLUSIONS: These analyses suggest that
      parental history of stroke may be a risk factor for stroke. As more stroke or
      transient ischemic attack events develop among the Offspring Study members, it
      will be valuable to reexamine these associations.

PMID- 8362433
TI  - The prognostic value of admission blood pressure in patients with acute stroke.
AB  - BACKGROUND AND PURPOSE: Patients with acute stroke are often found to have high
      blood pressures at hospital admission. Previous studies have shown variable
      results regarding the prognostic value of high blood pressure in acute stroke.
      The aim of this study was to investigate the prognostic value of admission blood
      pressure in a population-based sample of patients with acute stroke. METHODS:
      Eighty-five patients with intracerebral hemorrhage and 831 with ischemic disease
      were included in the study. The relations between admission blood pressure and 30
      day mortality were studied by logistic regression analyses. RESULTS: High blood
      pressure in patients with impaired consciousness on hospital admission was
      significantly related to 30-day mortality in patients with intracerebral
      hemorrhage (P = .037) and in patients with ischemic disease (P < .0001). In
      patients without impaired consciousness, high blood pressure at time of admission
      was not related to increased mortality at 30 days. CONCLUSIONS: High admission
      blood pressure in alert stroke patients was not related to increased mortality.
      Stroke patients with impaired consciousness showed higher mortality rates with
      increasing blood pressure. However, this does not provide a basis for
      recommending antihypertensive therapy for such patients.

PMID- 8362434
TI  - Decrease in cerebral blood flow with blood pressure reductions in patients with
      chronic stroke.
AB  - BACKGROUND AND PURPOSE: Possible effects of changes in blood pressure on the
      cerebral circulation were studied in patients with chronic stroke and age-matched
      nonstroke control subjects at 28 +/- 10 months (mean +/- SD) (range, 18 to 54
      months) and 27 +/- 6 months (range, 19 to 44 months), respectively, after the
      first measurement. METHODS: Cerebral blood flow was measured by the 133Xe
      inhalation method in 55 patients (mean +/- SD age, 62 +/- 11 years; 39 with brain
      infarction and 16 with hemorrhage) and 10 control subjects (mean +/- SD age, 61
      +/- 9 years). Correlations between changes in cerebral blood flow and blood
      pressure were evaluated. RESULTS: Among brain infarctions, average cerebral blood
      flow did not change from the first study; however, changes in cerebral blood flow
      in each individual were closely related to changes in systolic and mean arterial
      blood pressures (P < .01 and P < .05, respectively). Of these, in 10 patients
      with cerebral blood flow decreased more than 15% from the initial levels,
      systolic and mean arterial blood pressures decreased by 25 +/- 32 mm Hg and 16 +/
      14 mm Hg (P < .05 and P < .005, respectively). In contrast, in 29 patients with
      unchanged or increased cerebral blood flow, changes in systolic (0 +/- 19 or -2
      +/- 12 mm Hg, respectively) and mean arterial blood pressures (3 +/- 22 or -1 +/-
      11 mm Hg, respectively) were not significant, and their systolic blood pressure
      levels were maintained above 110 mm Hg. CONCLUSIONS: Blood pressure importantly
      correlates with cerebral circulatory changes among patients with chronic brain
      infarction. Early detection of cerebral hemodynamic changes should be useful for
      determining the most favorable levels of blood pressure and for selecting
      appropriate therapy.

PMID- 8362435
TI  - Decline in US stroke mortality in the era before antihypertensive therapy.
AB  - BACKGROUND AND PURPOSE: This study was done to determine if reported declines in
      stroke mortality in the era before antihypertensive therapy are artifactual.
      METHODS: This study involved analyses of national and state vital statistics data
      using adjusted and specific rates. RESULTS: Adoption of the third revision of the
      International List of Causes of Death in 1921 produced an abrupt 6.6% decrease in
      stroke mortality rates, but otherwise, changes in disease classification systems
      had little effect on stroke mortality rates. Adoption of the second revision of
      the joint-cause manual produced a 9.2% drop in stroke death rates, but other
      revisions of the joint-cause selection rules had little effect. While rates for
      the expanding group of states in the death registration area progressively
      declined, rates for fixed component areas remained constant until around 1925 and
      then declined. Reselection of the underlying cause from aggregate multiple cause
      data for 1917, 1925, and 1940 using uniform selection rules confirmed a decline
      after 1925. Correlation analyses of rates of change for stroke and heart disease
      rates did not support a shift in diagnosis to explain the divergent trends.
      CONCLUSIONS: The apparent decline in stroke mortality rates before 1925 is an
      artifact of changes in disease classification systems, joint-cause selection
      rules, and nonrandom incorporation of states with different mortality rates into
      the expanding registration area. The decline after 1925 could not be explained by
      changes in coding systems or joint-cause selection rules or by a shift in
      diagnosis from stroke to heart disease.

PMID- 8362436
TI  - Suppressed sympathetic skin response in brain infarction.
AB  - BACKGROUND AND PURPOSE: Autonomic failure is known to manifest commonly in
      stroke, but very little attention has been given to various features of
      sympathetic dysfunction such as sudomotor dysregulation in cerebrovascular
      diseases. In the present study, our purpose was to assess quantitatively
      sympathetic reflex activity in brain infarction by measuring the sympathetic skin
      response. METHODS: We recorded the sympathetic skin response to electric and
      auditory stimulations simultaneously on both hands in 58 patients with brain
      infarction and in 36 healthy control subjects. RESULTS: The response amplitudes
      were significantly decreased and the latencies prolonged in both hemispheral (n =
      49) and brain stem (n = 9) infarctions compared with the control subjects. The
      amplitudes were diminished in both the acute and late phases of infarction, but
      the latencies were prolonged only in the acute phase. CONCLUSIONS: Sympathetic
      dysfunction in brain infarction seems to be much more extensive than has
      previously been thought. In the present study, we have demonstrated impaired
      sympathetic skin responses, reflecting definite suppression of the reflex
      activity of the sympathetic nervous system.

PMID- 8362437
TI  - Screening for neuroborreliosis in patients with stroke.
AB  - BACKGROUND AND PURPOSE: Borrelia burgdorferi, the etiologic agent of Lyme
      disease, can cause different neurological manifestations. We studied the
      prevalence of Lyme neuroborreliosis in patients with stroke. METHODS: During a 1
      year period, sera from patients with cerebral thrombosis or transient ischemic
      attack without cardioembolism were investigated for antibodies against B
      burgdorferi. RESULTS: One of 281 patients had a positive serum immunoglobulin M
      titer and 23 of 281 (8%) had positive serum immunoglobulin G titers against B
      burgdorferi. One of the 24 seropositive patients, with a diagnosis of transient
      ischemic attack due to dysphasia, had a lymphocytic pleocytosis and intrathecal
      antibody production against B burgdorferi. The medical history revealed a 9-month
      period of general and neurological symptoms compatible with Lyme neuroborreliosis
      before the strokelike incidents. CONCLUSIONS: We conclude that Lyme
      neuroborreliosis may imitate stroke, but screening for antibodies against B
      burgdorferi seems to be of little value and may be replaced by a careful medical
      history.

PMID- 8362438
TI  - Extracranial vertebral artery pseudoaneurysm presenting as subarachnoid
      hemorrhage.
AB  - BACKGROUND AND PURPOSE: True aneurysms of the extracranial vertebral artery are
      rare. The usual pathogenesis of aneurysms in this location is either penetrating
      or blunt trauma with resultant pseudoaneurysm formation. We report a postpartum
      patient with a presumed traumatic pseudoaneurysm of the extracranial vertebral
      artery presenting with subarachnoid hemorrhage. CASE DESCRIPTION: A 41-year-old
      woman had three episodes of neck stiffness 1 month after an uncomplicated vaginal
      delivery. The last episode, 3 days before admission, was accompanied by intense
      neck and head pain and paresthesias that extended into the left arm, thumb, and
      forefinger. RESULTS: Lumbar puncture showed subarachnoid hemorrhage. Angiography
      revealed a left vertebral artery dissection from C6-7 to C3 with pseudoaneurysm
      at C5-6. Computed tomography demonstrated impingement of the C6 root at the
      foramen by this lesion. The lesion was successfully treated by balloon occlusion
      of the vertebral artery. CONCLUSION: We present a patient with an extracranial
      vertebral pseudoaneurysm with subarachnoid hemorrhage and cervical root
      impingement. To our knowledge, this is the first case of such a lesion presenting
      as subarachnoid hemorrhage. The lesion was successfully treated using
      endovascular techniques.

PMID- 8362439
TI  - Intracerebral hemorrhage caused by transmural dissection of the anterior cerebral
      artery.
AB  - BACKGROUND AND PURPOSE: Spontaneous dissection of the intracranial carotid artery
      or its main branches is an unusual condition. CASE DESCRIPTION: A 72-year-old
      hypertensive woman after an intense nuchal rigidity showed a subarachnoid
      hemorrhage and an interhemispheric hematoma by computed tomography. The
      neuropathological study revealed a transmural dissection of the pericallosal
      artery. CONCLUSIONS: The authors suggest that the dissection origin is an
      atheromatous plaque that bleeds, producing a dissection plane from the lumen to
      the adventitial artery.

PMID- 8362441
TI  - Trials of trials in acute ischemic stroke. The Humana Lecture.

PMID- 8362440
TI  - Subarachnoid hemorrhage without detectable aneurysm. A review of the causes.
AB  - BACKGROUND: In 15% to 20% of patients with a spontaneous subarachnoid hemorrhage,
      no aneurysm is found on the first angiogram. This review emphasizes that this
      group of patients is in fact heterogeneous and describes the clinical features,
      pattern of hemorrhage on early computed tomographic (CT) scan, prognosis, and
      proposed management in the several and distinct subsets of these patients.
      SUMMARY OF REVIEW: Patients in whom no aneurysm is revealed on the initial
      angiogram can be subdivided mainly according to the pattern of hemorrhage on an
      early CT scan. In two thirds of these patients the CT scan shows a
      perimesencephalic pattern of hemorrhage (ie, blood confined to the cisterns
      around the midbrain); these patients invariably have a good prognosis, which
      obviates the need for a second angiogram. Patients with diffuse or anteriorly
      located blood on CT scan are at risk of rebleeding. In most of these patients the
      source of hemorrhage is an occult aneurysm, but intracranial artery dissections,
      dural arteriovenous malformations, mycotic aneurysms, trauma, bleeding disorders,
      substance abuse, or a cervical origin of the hemorrhage should also be
      considered. Patients with no blood revealed on an early CT scan but with
      xanthochromic cerebrospinal fluid are extremely rare. These patients deserve a
      second reading of the scan for blood in the prepontine cistern, which can be the
      only site of hemorrhage in perimesencephalic hemorrhage. CONCLUSIONS: The
      prognosis and management of patients in whom no aneurysm is found on the initial
      angiogram depends on the pattern of hemorrhage on the initial CT scan. Patients
      should no longer be designated with the umbrella term "angiogram-negative
      subarachnoid hemorrhage."

PMID- 8362442
TI  - Stroke in the young.

PMID- 8362443
TI  - Ischemic stroke due to or associated with deficiency of coagulation inhibitors?

PMID- 8362444
TI  - Spontaneous cervical internal carotid dissection presenting with intracerebral
      hematoma.

PMID- 8362445
TI  - Red blood cell deformability related to perfusion pressure in cerebral infarction
      with and without hypertension.

PMID- 8362446
TI  - Blood pressure changes after stroke: abolishing the white-coat effect.

PMID- 8362447
TI  - A reliable method to occlude a middle cerebral artery in Wistar rats.

PMID- 8362448
TI  - Rat models of middle cerebral artery ischemia.

PMID- 8362449
TI  - Malaria chemosuppression in pregnancy. III. Its effects on the maternal malaria
      immunity.
AB  - The malaria immune status of pregnant women participating in a malaria
      prophylaxis study was assessed using their sera reactivity to the R32tet32
      antigen. Supervised prophylaxis started early in pregnancy till delivery. Women
      randomly received either chloroquine once weekly (CQ), or proguanil daily (PROG),
      or a combination of the two drugs (CQ + PROG). Blood was collected at enrollment,
      then after 8, 16, and 24 weeks of prophylaxis. Of the 312 women who received
      prophylaxis for more than 10 consecutive weeks before delivery, anti-sporozoite
      antibodies were assayed in 232 at enrollment, 258 after 8 weeks, and 254 after 16
      weeks. Titres at enrollment were comparable by parity and the residential area.
      Antibodies in women of the PROG group who were parasitaemic before the
      assessments decreased with the increasing number of breakthrough and clinical
      episodes. The converse was true for antibodies in the CQ and CQ + PROG groups.
      Group differences in the parasite densities would explain this. Parity and
      placental malaria did not influence titres significantly. Overall, antibodies of
      the CQ + PROG group decrease significantly with time, possibly due to its long
      period of aparasitaemia. This suggested interference with the immune
      responsiveness of the women. PROG, which was equally efficacious, offers better
      prophylaxis.

PMID- 8362450
TI  - Upsurge of malaria-related convulsions in a paediatric emergency room in Nigeria.
      Consequence of emergence of chloroquine-resistant Plasmodium falciparum.
AB  - From January through December 1988 the causative factor of each case of childhood
      seizure seen in the Children's Emergency Room of the University of Calabar
      Teaching Hospital, Calabar, Nigeria, was prospectively studied with a focus on
      the relative importance of malaria-related seizures. Of the 134 seizure cases
      seen, febrile convulsion (FC) formed the majority (55%) with cerebral malaria
      (CM) as the only major (33%) rival. Other conditions such as meningitis,
      epilepsy, hypoglycaemia and drug poisoning together (12%) played a minor role.
      Malaria was the dominant cause (73%) of FC; 81% of these cases did not respond to
      chloroquine. On comparing the number of cases of CM accumulated in the same unit
      from 1986, there was a significant increase (P < 0.001) in the proportion of
      yearly CM admissions from 1986 through 1988. The study confirms the premier
      position of malaria in the causation of childhood seizures and also suggests a
      possible upsurge in the prevalence of CM in the environment. This upsurge
      probably derives from the emergence of chloroquine-resistant Plasmodium
      falciparum (CRPF) reported in Nigeria which appeared to have been identified in
      the present study. While more studies are needed to confirm this hypothesis,
      clinicians in areas of CRPF are alerted about a possible upsurge in CM in their
      locality.

PMID- 8362451
TI  - Comparative efficacy of a single 400 mg dose of albendazole or mebendazole in the
      treatment of nematode infections in children.
AB  - The relative efficacy of a single 400 mg dose of albendazole or mebendazole in
      the treatment of nematode infections was assessed in 2- to 9-year-old children
      living in two different Bolivian rural communities. Both agents were equally very
      effective (100% cure rate) in treating ascariasis. Albendazole was clearly more
      active than mebendazole against hookworm infections, both in terms of egg
      reduction rate (92.8% vs. 62.4%) and cure rate (81.8% vs. 17.2%). As far as
      trichuriasis is concerned, albendazole produced a higher egg reduction rate than
      mebendazole (45.7% vs 15%), but a lower cure rate (33.3% vs 60%). Both drugs were
      well tolerated.

PMID- 8362452
TI  - Profile of cardiac disease in an out-patient cardiac clinic.
AB  - The pattern of cardiac disease differs from one region of the world to that of
      another. This paper aims at providing the profile of heart disease as seen in a
      Children's Hospital. A total of 468 patients were seen in a follow-up conducted
      between August 1989 and February 29, 1992. Among these 168 (35.9%) had congenital
      heart disease (CHD); 278 (59.4%) had rheumatic heart disease (RHD); while 14 (3%)
      had acquired heart disease of non-rheumatic origin. In patients having RHD, the
      mitral valve was commonly affected. Ventricular septal defect was the commonest
      CHD seen followed by patent ductus arteriosus. The results show that RHD is the
      commonest heart disease seen in a Children's Hospital in Addis Ababa. It is
      recommended that the issues of school surveillance, better organized secondary
      prophylaxis need to be addressed.

PMID- 8362454
TI  - Solitary thyroid nodule in adult Ethiopian patients. Analysis and experience in
      management in a teaching hospital.
AB  - Between February 1986 and January 1991, a total of 340 patients with thyroid
      diseases were seen; 115 (33.8%) had solitary nodules. Of the latter, 28 had toxic
      adenoma and 87 had euthyroid nodules (M:F = 0.14:7.21); the mean age for the non
      toxic cases was 32.8 +/- 10.0 years and for the toxic cases, 40.2 +/- 15.2 years.
      Clinically, the toxic nodules were 0.5 to 6 cm in diameter, cystic in over 36%
      and firm in the rest; no regional lymph node enlargement was noted. Thyroid scan
      in 45 (52%) patients showed 38 'cold', 4 hypofunctioning and 3 hyperfunctioning
      nodules. Ultrasonography in 22 patients (25.3%) revealed 9 cystic and 13 solid
      nodules, consistent with the clinical finding. Fine needle aspiration biopsy
      (FNAB) in 61 patients (70.1%) showed 30 cystic, 15 benign, 2 follicular adenoma,
      2 Hurtle cell adenoma, 1 papillary carcinoma and 1 thyroiditis. Ten patients were
      operated; histology confirmed the cytology diagnosis in all but 1 in whom the
      cytology was benign but histology showed papillary carcinoma. The fine needle
      aspiration was also useful in the treatment of cystic lesions; hence it should be
      adopted particularly in areas where there is bed shortage.

PMID- 8362453
TI  - Surgical management of toxic goitre in Khartoum.
AB  - Seventy patients with toxic goitre treated surgically in two surgical firms in
      Khartoum during a 10-years period were studied. Of these patients 62.9% had
      diffuse goitres, 34.3% nodular and 2.8% hot clinically solitary nodules. The age
      ranged between 15 and 54 years and the M:F ratio was 1.0:6.7. Ninety per cent of
      the patients had large size goitres (grade III). Preoperative carbimazole and
      inderal were found to be superior to other drug combinations. Subtotal
      thyroidectomy was the standard procedure and no serious postoperative
      complications were noted. Fifteen patients had postoperative hectic period i.e.
      fever, headache and tachycardia that responded to temporary inderal and steroids.
      Surgical treatment of toxic goitre in developing countries could be extended to
      include more patients since drug availability and patient compliance are minimal.

PMID- 8362455
TI  - Testicular infarction complicating strangulated inguinal herniae in Nigerian
      children.
AB  - Between 1985 and 1990 30 children were operated on for strangulated inguinal
      herniae in the University of Benin Teaching Hospital, Benin City, Nigeria. Six of
      the children (20%) had testicular infarction secondary to the strangulated
      hernia. Half of the children with infarcted testes had viable bowel at operation.
      The surgeon dealing with African children with strangulated herniae needs to be
      sensitised to this condition and the possibility that the testis may well be
      infarcted before the intestines.

PMID- 8362456
TI  - Identification of the ligamentum teres hepatis by ultrasound and the clinical
      importance of its thickening.
AB  - In a survey of 100 healthy persons or patients without any obvious abdominal
      pathology the ligamentum teres hepatis (LTH) was detected by ultrasound in 87%.
      The mean diameter of the normal LTH was determined as 4.5 mm (range 3-6 mm). In a
      second group of 131 patients with obvious abdominal pathology, the LTH could be
      identified in 82 patients (63%). Among these, the LTH was thickened (diameter >
      or = 7 mm) with a mean diameter of 11.9 mm (range 7-33 mm) in 47 patients (57%).
      Twenty-six patients had uniform or smooth thickening, 21 patients had nodular
      thickening. Smooth thickening was a feature mainly seen in cases of portal
      hypertension with a lumen demonstrable in one-third of them. Nodular thickening
      was mainly associated with metastasising intra-abdominal malignancy. However,
      smooth or nodular thickening of the LTH may also be caused by non-pathological
      accumulation of fat within the ligament.

PMID- 8362457
TI  - Multiple lentigines syndrome in a Nigerian family.
AB  - Three cases of the multiple lentigines syndrome are reported in a Nigerian
      family, involving a father and two of his children. The major abnormalities in
      this syndrome include: multiple lentigines, cardiac defects, genitourinary
      malformations, neurological deficits, growth retardation, cephalofacial
      dysmorphism and a family history consistent with an autosomal dominant mode of
      inheritance. We hereby report these cases in whom the main features are multiple
      lentigines, ocular hypertelorism, electrocardiographic defects and a pattern
      consistent with an autosomal dominant mode of inheritance.

PMID- 8362458
TI  - Epileptic fit: the most dramatic sign of tuberous sclerosis.
AB  - This rare disease of dominant inheritance is described with the symptom triad of
      epilepsy, mental deficiency (oligophrenia) and adenoma sebaceum. The skin
      manifestation may be manifest in the first year, but the parents seek the help of
      the physician only when the dramatic symptom of convulsion occurs.

PMID- 8362459
TI  - Lifetime of reusable syringes and needles. A field study.
AB  - For planning of supplies and costs it is important for an immunization unit to
      know how many times reusable syringes and needles can be used. A field study
      found that BCG syringes, which had their rubber seals replaced once, could be
      used at least 150 times, and DPT syringes more than 200 times even when
      sterilized in tap water with a hardness of 88 mg calciumoxyde per liter. Needles
      could be used 100 times and when resharpened several times even more.

PMID- 8362460
TI  - Sarcoptes scabiei in animals spreading to man.
AB  - An outbreak of Sarcoptes scabiei in animals was observed from mid-November 1991
      to mid-December 1991 in two adjacent villages, Fewgram and Nurpur, in Birbhum
      District, West Bengal State, India, starting from goats to cattle, then to sheep
      and even to dogs. Nineteen goats and one cattle died of manage infection. The
      infection spread to man in the last week of December 1991, and affected forty-two
      human beings, tending and rearing animals. The animals treated with deltamenthrin
      (synthetic pyrethroid) and amitraz (triazapentadiene) were completely cured. In
      man, the disease seemed to be self-limited in some cases and 2% hexachlorobenzene
      was successfully used for treatment of the others. The outbreak was effectively
      controlled in March 1992.

PMID- 8362461
TI  - Scarcity of radiodiagnostic services in developing countries.

PMID- 8362462
TI  - Imaging equipment for small hospitals.
AB  - Imaging equipment is expensive and the correct choice is difficult. Guidelines
      are provided. The proper choice will result in high quality x-rays and ultrasound
      scans even where electrical power is unreliable and no technical staff are
      available.

PMID- 8362463
TI  - Evaluation of methods for treating obstructive lung disease. Minireview based on
      a doctoral thesis.

PMID- 8362464
TI  - In vitro screening of putative compounds inducing fetal porcine pancreatic beta
      cell differentiation: implications for cell transplantation in insulin-dependent
      diabetes mellitus.
AB  - Successful transplantation of fetal pancreatic beta-cells to diabetic recipients
      requires that differentiation of the immature beta-cells is achieved. Animal
      experiments have shown that this can occur in vivo, but it would be desirable to
      induce beta-cell maturation in vitro prior to transplantation. For that purpose
      the effect of several putative inducers of beta-cell differentiation and/or
      replication in explant cultures of fetal porcine pancreatic islet-like cell
      clusters (ICC) were investigated. Initial screening experiments indicated that
      dexamethasone (DEX; 200 ng/ml) and sodium butyrate (BUT; 2 mM) might promote beta
      cell differentiation as evidenced by increased insulin/DNA contents in the ICC.
      In subsequent experiments these two substances, and also nicotinamide (NIC; 10
      mM) which previously has been found to promote fetal beta-cell differentiation,
      were added alone or in combinations to the basal control medium consisting of
      RPMI 1640 + 1% human serum. All three test agents alone or in combinations
      increased the insulin content/DNA of the ICC compared with that of the control
      group. The combination of NIC+DEX increased the insulin mRNA levels of the ICC.
      No significant stimulation of insulin release was observed in any test group
      after short-term incubation with high glucose alone. Addition of 5 mM
      theophylline to high glucose stimulation, however, increased the insulin
      secretion in most groups of ICC. Finally, ICC in groups of about 600, which had
      developed in the presence of NIC or NIC+DEX, were transplanted under the kidney
      capsule of alloxan-diabetic nude mice. However, neither the time for reversal of
      diabetes (4 weeks) nor the amount of insulin secretion during perfusion from the
      grafted ICC were further affected by adding DEX to the NIC supplemented medium.
      The marked increase of the insulin content of the ICC cultured with DEX
      supplementation, appeared transient and was not manifested after transplantation.
      In conclusion, the present study demonstrated that some compounds can stimulate
      porcine fetal beta-cells in an in vitro system, but in order to attain terminal
      differentiation of the beta-cells including glucose-sensitive insulin secretion,
      longer observation periods might be required than used herein. Alternatively, an
      in vivo environment like that after transplantation is mandatory for this
      process.

PMID- 8362466
TI  - A protocol for structured observation of motor performance in preterm and term
      infants.
AB  - A new protocol for structured observation of motor performance has been designed
      for assessment of the progress and quality of motor development in preterm and
      term infants. A detailed scale of motor development based on the present
      knowledge of motor development in healthy term infants has been constructed. The
      motor performance is observed in each part of the infant's body in the supine and
      prone positions and in the whole body with the infant sitting, standing and
      during locomotion, and is evaluated in relation to defined levels of motor
      performance. If the quality of motor performance is optimal for a certain level,
      no deviation is noted. Any deviation from the motor performance described in the
      protocol for the level in question is graded as suspected or clear and classified
      by type. All observations are recorded on videotape for documentation. In a study
      of inter- and intraobserver agreement, such recordings from 17 infants were
      reassessed on two occasions more than one year apart. The interobserver agreement
      ranged between 73 and 87% and the intraobserver consistency between 77 and 88%.
      The protocol is currently being used in a follow-up study.

PMID- 8362465
TI  - Carbon-13 NMR studies of alpha-elastin.
AB  - NMR investigations of model protein of elastic fibre is presented. Detailed
      conformation of alpha-elastin polypeptide chain is discussed by comparison with
      the conformation of synthetic repeat peptides of elastin. Amino acid composition
      of alpha-elastin obtained from C-13 NMR spectra correlates with the results of
      sequencing of tropoelastin.

PMID- 8362467
TI  - A protocol for structured observation of motor performance in preterm and term
      infants. Interobserver agreement and intraobserver consistency.
AB  - A new protocol for structured observation of motor performance, for use both in
      term and preterm infants, has been tested regarding interobserver agreement and
      intraobserver consistency. Ten different motor items are assessed concerning the
      developmental level as described in the protocol. Any deviations from the
      description of the level are noted. The two main observers twice reassessed video
      recordings of 17 infants who had primarily been assessed by them both in an
      ongoing follow-up study. The two observers arrived at the same level of
      development in 75% of the observed items at the first reassessment and in 81% at
      the second, and agreed concerning deviation in 73 and 79% of the observations at
      the two reassessments, respectively. Each observer arrived at the same level of
      development at all three assessments in 62% of the observed items. Thus when used
      by these two observers the protocol has an acceptable degree of interobserver
      agreement and intraobserver consistency.

PMID- 8362468
TI  - Relations between mixed venous oxygen saturation and hemodynamic variables in
      patients subjected to abdominal aortic aneurysm surgery and in patients with
      septic shock.
AB  - In order to study if oxygen saturation in mixed venous blood (SvO2) could be used
      as a marker for heart performance, oxygen delivery (DO2) or consumption (VO2) in
      critically ill patients 134 hemodynamic measurements were performed by a
      thermodilution pulmonary catheter in 23 patients after abdominal aortic aneurysm
      surgery. These data were compared to 200 measurements performed in 30 patients
      with septic shock. When analysed on an individual basis SvO2 was only closely
      related to DO2 or VO2 in a minority of the patients. Neither could SvO2 be used
      as a reliable marker for heart rate, hemoglobin concentration, stroke volume or
      cardiac index. On the other hand SvO2 was found to be an excellent marker for
      oxygen extraction (OER) in both groups of patients (median r = 0.98. p < 0.0001).
      In conclusion, the present study shows that SvO2 could not be used as a reliable
      marker for the important hemodynamic variables CI, DO2 or VO2 in critically ill
      patients. However, SvO2 was found to be an excellent marker for OER.

PMID- 8362469
TI  - Enteric neuropathy in horses with grass sickness.
AB  - The degeneration of enteric neurones has been recorded in grass sickness, but the
      distribution of the lesions in the gut and their possible relationship with the
      severity of the clinical signs has not been established. Samples obtained from 11
      anatomically defined sites along the gastrointestinal tract of eight control
      horses without gastrointestinal disease, five horses with acute grass sickness
      and three horses with chronic grass sickness were examined histologically. The
      organisation of the enteric ganglia was similar to that in other large mammalian
      species. Minor exceptions included the presence of fundic mucosal nerve cell
      bodies and blood vessels within submucosal ganglia. All the horses with grass
      sickness had severe enteric neuropathy, widespread in the acute cases but
      localised to the distal small intestine in the chronic cases. These neuronal
      lesions are consistent with, and may explain the intractable gastrointestinal
      propulsive deficit that characterises grass sickness.

PMID- 8362470
TI  - Demonstration of co-resistance of Haemonchus contortus to ivermectin and
      moxidectin.
AB  - Studies were conducted to determine whether organisms which are resistant to
      ivermectin are also resistant to moxidectin. The mechanisms of action of
      moxidectin and ivermectin were compared by measuring the changes in membrane
      conductance they induced in leg muscle fibres of the common shore crab
      (Pachygrapsus crassipes) by using standard micro-electrode techniques. Meriones
      unguiculatus (jirds) were infected with ivermectin-resistant or -susceptible
      strains of Haemonchus contortus, treated with moxidectin or ivermectin at a dose
      which routinely clears more than 98 per cent of the susceptible strain, and
      examined for parasite clearance. The results showed that moxidectin induced a
      rapid loss of membrane resistance in the muscle preparation, and that the effect
      was almost 50 per cent reversible with the chloride channel-blocker picrotoxinin;
      this pattern of activity is qualitatively similar to that of ivermectin. In the
      jird model, moxidectin achieved a clearance of only < or = 47.2 per cent against
      ivermectin-resistant H contortus at a dose which invariably clears > or = 98 per
      cent of an ivermectin-susceptible strain. These results indicate that moxidectin
      and ivermectin share a common mechanism of action, and that organisms that are
      resistant to ivermectin are also likely to be resistant to moxidectin.

PMID- 8362471
TI  - Clinical disease associated with Trypanosoma theileri infection in a calf in
      Ireland.
AB  - A four-month-old calf had a clinical history of pyrexia, anaemia, weight loss and
      behavioural abnormality. Clinical examination revealed evidence of regenerative
      anaemia and a lymphocytosis which was characterised by a relatively large B cell
      population. The calf deteriorated clinically while under observation and its
      prescapular and prefemoral lymph nodes became enlarged. Examination of a blood
      smear revealed the presence of a large number of circulating Trypanasoma
      theileri. Serological examination showed the presence of the invariant, stage
      specific, trypanosome surface antigen, ISG70 and antibodies against ISG70. ISG70
      was first identified in the bloodstream forms of Trypanosoma brucei and has not
      previously been found in T theileri. Clinical recovery was associated with an
      increase in packed cell volume, a decrease in the levels of circulating anti
      ISG70 antibodies and the complete disappearance of circulating ISG70.

PMID- 8362472
TI  - Aspergillus niger isolated in an outbreak of rhinitis in rats.

PMID- 8362473
TI  - Efficacy of morantel citrate against benzimidazole resistant field strains of
      Ostertagia circumcincta.

PMID- 8362474
TI  - Possible basis of adverse reactions to vaccination against equine influenza.

PMID- 8362475
TI  - Incidence of hypomagnesaemia.

PMID- 8362476
TI  - Severe foul-in-the-foot in dairy cattle.

PMID- 8362477
TI  - Solar haemorrhages in dairy cattle.

PMID- 8362478
TI  - Canine dysautonomia: another case report.

PMID- 8362480
TI  - Elizabethan collars and plastic bags.

PMID- 8362479
TI  - Anaemia in a dog.

PMID- 8362481
TI  - Homoeopathic nosode questionnaire.

PMID- 8362482
TI  - Role of acid mucopolysaccharides in the depletion of clenbuterol.

PMID- 8362483
TI  - Effects of abattoir and slaughter handling systems on stress indicators in pig
      blood.
AB  - Pigs from four farms were slaughtered at two abattoirs, each with two slaughter
      handling systems. Pigs at abattoir X were electrically stunned, either in a floor
      pen holding five pigs or in a race-restrainer. At abattoir Y pigs were stunned
      either in a floor pen holding five pigs or in a dip-lift carbon dioxide stunner.
      At exsanguination, 96 blood samples (24/farm) were collected from pigs
      slaughtered through each slaughter handling system (384 samples in total). Serum
      samples were analysed for cortisol, creatine phosphokinase (CPK) lactate
      dehydrogenase (LDH) and LDH-isoenzymes. There were no significant differences
      between the systems at abattoir X. At abattoir Y, pigs slaughtered through the
      floor pen system had higher levels of LDH-5 (39.84 +/- 1.39 per cent of total LDH
      vs 34.76 +/- 1.21 per cent, P < 0.05) indicating greater skeletal muscle damage
      in the floor pen. Pigs at abattoir Y had higher mean serum levels of CPK than
      pigs at abattoir X (3.63 log10 U/litre vs 3.41 log10 U/litre, 0.03 sed, P <
      0.001), higher total LDH activities (1269.5 U/litre vs 922.8 U/litre, P < 0.001)
      and higher cortisol concentrations (1.70 log10 ng/ml vs 1.51 log10 ng/ml, P <
      0.001). These differences suggested that the levels of physical and psychological
      stress were higher at abattoir Y.

PMID- 8362484
TI  - Typing of feline calicivirus isolates from different clinical groups by virus
      neutralisation tests.
AB  - One hundred and thirteen isolates of feline calicivirus originating from seven
      different clinical groups were typed by virus neutralisation tests using eight
      different cat antisera. The clinical groups comprised 'healthy' cats, cases of
      acute oral/respiratory disease, chronic stomatitis, acute febrile lameness
      syndrome, vaccine reactions (clinical disease seen within 21 days of vaccination)
      and vaccine breakdowns (clinical disease seen more than 21 days after but within
      one year of vaccination). Isolates from the vaccine reaction cases were grouped
      into those associated with acute oral/respiratory disease alone and those
      associated with the lameness syndrome, and the latter group was further
      subdivided according to the vaccine used. Two groups appeared significantly
      different from others with some of the antisera. Thus the lameness vaccine
      reaction isolates associated with vaccine B were significantly different from the
      isolates from all the other clinical groups, including other lameness isolates,
      with a number of the antisera. In addition, the chronic stomatitis isolates were
      significantly different from those from the 'healthy' and the acute
      oral/respiratory disease groups with one or two of the antisera. Eighty-five to
      88 per cent of the isolates were neutralised by antisera raised against F9 or F9
      like vaccine strains at a dilution of 1 in 2. Twenty antibody units of such
      antisera neutralised 42 to 80 per cent of the isolates. A bivalent antiserum
      raised against a vaccine F9 strain and field strain LS015 neutralised 96 per cent
      of the isolates at a dilution of 1 in 2, and 20 antibody units neutralised 68 per
      cent of isolates. Antisera to field strain F65 neutralised all the remaining
      isolates at a dilution of 1 in 2 and 44 per cent of the remaining isolates at a
      dilution of 20 antibody units. Therefore, strains LS015 and F65 may be of use in
      the production of a polyvalent feline calicivirus vaccine, together with the
      widely used strain F9.

PMID- 8362485
TI  - Occurrence of spiral-shaped bacteria in gastric biopsies of dogs and cats.

PMID- 8362486
TI  - Heterospermic insemination of cattle using three bulls of the same breed.

PMID- 8362487
TI  - EC standards.

PMID- 8362488
TI  - Orthopaedic surgery in wild animals.

PMID- 8362489
TI  - Cryptosporidium species in ostriches.

PMID- 8362490
TI  - Mushroom poisoning in a dog.

PMID- 8362491
TI  - Diagnosis of grass sickness by ileal biopsy.
AB  - Ileal biopsies were obtained from 18 horses with grass sickness, 15 horses with
      other alimentary disease and three horses without gastrointestinal disease.
      Samples of small intestine were also obtained from nine cases of obstruction due
      to small intestinal strangulation. Histological examination revealed that severe
      enteric neuropathy in the absence of other significant morphological changes was
      confined to the horses with grass sickness.

PMID- 8362492
TI  - Comparison of outer-membrane fractions of Serpulina (Treponema) hyodysenteriae.
AB  - Sarkosyl-insoluble fractions (outer-membrane proteins) and endoflagella (EF)
      fractions of Serpulina hyodysenteriae serotypes 1-7 were examined for protein
      differences using SDS-PAGE. Both the outer-membrane proteins (OMP) and
      endoflagella were also examined for antigenicity using porcine sera from acutely
      infected and convalescent swine. Seven major staining proteins were resolved in
      outer-membrane enriched fractions ranging in molecular weight between 42 and 32
      kDa. A comparison of purified EF to OMP from serotype 1 and 2 isolates of
      Serpulina hyodysenteriae demonstrated that six of the seven OMP were actually EF.
      Sera from swine with acute swine dysentery identified only a portion of the
      proteins from both preparations. In contrast, immune sera from convalescent swine
      identified all the proteins in the OMP and EF preparations as well as an
      additional 16 kDa carbohydrate antigen.

PMID- 8362493
TI  - A cytotoxicity test for the detection of Campylobacter jejuni toxin.
AB  - A 7-h 51Cr-release cytotoxicity assay has been developed to detect the presence
      of Campylobacter jejuni toxin in the culture supernatant. Some of the culture
      supernatants have cytotoxic effects against labeled chicken lymphocytes, while
      some others do not have this effect. There is no direct correlation between the
      pathogenicity of the organisms and the presence of the toxin. The supernatant of
      C. jejuni retains its cytotoxicity after heating at 100 degrees C for 10 min.;
      therefore, it is a heat stable toxin.

PMID- 8362495
TI  - Species-specific recombinant DNA probes for Mycoplasma meleagridis.
AB  - Two recombinant DNA probes (pMM-2 and pMM-13) were isolated from a Mycoplasma
      meleagridis strain 17529 genomic library prepared in plasmid pUC8, and
      Escherichia coli strain JM83. In dot blot assays, 32P-labeled pMM-13 with a DNA
      insert of 3.5 kbp, hybridized with 18 isolates of M. meleagridis but not with 16
      other known species of avian mycoplasmas. Except for weaker signals on
      hybridization with the M. meleagridis cultures, pMM-2 with an DNA insert of 0.85
      kbp, showed a similar reaction pattern. The minimal concentration of M.
      meleagridis strain 17529 chromosomal DNA that pMM-13 and pMM-2 detected were 1
      and 8 ng, respectively. Neither probe hybridized with chromosomal DNA of M.
      gallisepticum strain S6, M. synoviae strain WVU-1853, or M. iowae strain I-695 at
      concentration of 256 ng.

PMID- 8362494
TI  - Comparison of ovine abortion and non-abortion isolates of Chlamydia psittaci
      using inclusion morphology, polyacrylamide gel electrophoresis, restriction
      endonuclease analysis and reactivity with monoclonal antibodies.
AB  - Twelve reference and four Northern Ireland ovine Chlamydia psittaci isolates
      including ovine abortion, faecal, conjunctivitis and arthritis isolates were
      compared. Inclusion morphology was shown to provide a useful means of
      differentiating the abortion and the non-abortion isolates studied. Identical SDS
      PAGE polypeptide profiles were produced by the ovine abortion isolates. The
      polypeptide profiles of the non-abortion isolates were similar to one another and
      clearly distinct from the abortion isolate profiles. The restriction endonuclease
      profiles of the abortion isolates were remarkably similar whereas different
      profiles were produced by most of the non-abortion isolates. Monoclonal
      antibodies were prepared and characterized. A number of these reacted with all
      the isolates of chlamydia tested. Three mAbs reacted exclusively with the ovine
      abortion isolates while four mAbs reacted exclusively with a number of the faecal
      isolates.

PMID- 8362496
TI  - Borrelia burgdorferi infection in dairy cows, rodents, and birds from four
      Wisconsin dairy farms.
AB  - A combination of culture and subsequent spirochete identification with the
      polymerase chain reaction technique was used to identify cows, rodents, and birds
      infected with Borrelia burgdorferi. Animals were trapped on four Wisconsin dairy
      farms during the summer of 1990. Farms 1 and 2 were located in counties
      nonendemic for Lyme disease and Farms 3 and 4 were located in counties endemic
      for Lyme disease. The results of the rodent and bird samples were as follows
      given as the number yielding organisms number tested: Farm 1, 1/17 Mus musculus
      and 2/52 Peromyscus domesticus; Farm 2, 4/49 M. musculus, 1/2 P. maniculatus, 1/1
      P. leucopus, and 1/35 P. domesticus; Farm 3, 0/27 M. musculus, 0/5 P. leucopus,
      0/12 P. maniculatus and, 3/58 P. domesticus; and Farm 4, 1/24 M. musculus, 2/19
      P. leucopus, 1/12 Microtus pennsylvanicus, and 0/17 P. domesticus. One P.
      leucopus and one M. musculus from Farm 2 were pregnant and fetal tissues from
      both were positive. Cow blood sample results were as follows: Farm 1, 7/47 in
      July, and 2/45 in August; Farm 2, 0/28 in August and 0/23 in October; Farm 3,
      0/13 in July and 1/18 in August 29; and Farm 4, 3/45 in August. Ticks were found
      on rodents on Farm 4 and on one bird on Farm 3. Spirochetemic cows, rodents, and
      birds were found in non-Lyme endemic counties suggesting that alternate modes of
      transmission other than by ticks may be important. Transplacental transmission
      was shown in M. musculus and P. leucopus.

PMID- 8362497
TI  - Differences in protein expression of Haemophilus somnus grown under conditions of
      iron-restriction.
AB  - Outer membrane protein profiles were compared in 14 H. somnus strains isolated
      from brain and lung lesions as well as from the genital tract of asymptomatic
      carriers during in vitro growth under iron-restricted conditions. Ethylenediamine
      di-O-hydroxyphenyl acetic acid (EDDA) was used to obtain iron-restricted
      conditions in media used for this study. The outer membrane protein profiles were
      studied by the discontinuous sodium dodecyl sulfate-polyacrylamide gel
      electrophoretic system (SDS-PAGE), and the proteins were stained with silver or
      transferred to nitrocellulose sheets and western blots conducted. Growth under
      iron-restricted conditions resulted in the induction of outer membrane proteins
      in most H. somnus strains examined. Studies also indicated differences among H.
      somnus strains in the number of induced proteins and their molecular weights but
      the results did not indicate a specific relationship between these strain
      dependent differences and tissue trophism. Western blot analysis revealed a high
      degree of immunological relatedness among strains of H. somnus in their iron
      regulated proteins. However, hyperimmune serum used in these assays failed to
      recognize certain iron-regulated proteins expressed by some H. somnus strains, a
      finding which may have important implications for the induction of protective
      immunity in cattle against this bovine pathogen.

PMID- 8362498
TI  - Instrumentation of exercising thoroughbreds to determine blood gas tensions and
      acid-base status.
AB  - A device was constructed of easily obtained medical supplies, and hardware and
      could be used to obtain multiple arterial samples when manually triggered. The
      right carotid arteries in five normal horses were surgically elevated, thereby
      permitting percutaneous cannulation. Each horse was galloped on a 1.6-km test
      track at approximately 500 m/min, and the rider triggered the mechanism at each
      0.4-km mark. Each horse underwent 10 test gallops, and a mean and standard error
      was determined for each sampling mark including preexercise and postexercise
      samples. The results indicated that horses ridden under the aforementioned
      conditions became acidemic and hypoxic.

PMID- 8362499
TI  - Blood gas tensions, acid-base status, heart rates, and venous profiles in
      exercising horses with laryngeal hemiplegia before and after corrective surgery.
AB  - The physiologic effects of exercise were studied in four horses with complete
      laryngeal hemiplegia. Right carotid arteries were surgically elevated to a
      subcutaneous position for percutaneous catheterization. Each horse was fitted
      with a device designed to obtain multiple arterial samples while the horse was
      exercised over a 1.6-km course. After each horse completed 10 test gallops, the
      laryngeal hemiplegia was treated using a laryngeal prothesis and ventriculectomy.
      The horses were then reconditioned, and the exercise test and sampling were
      repeated. Horses with laryngeal hemiplegia became acidotic, hypoxic, and
      hypercapnic compared to normal horses. Surgical treatment improved blood gas and
      acid-base status, but the values were not equivalent to those in normal horses
      similarly tested.

PMID- 8362500
TI  - Marsupialization of umbilical vein abscesses with involvement of the liver in 13
      calves.
AB  - Omphalophlebitis with liver involvement was diagnosed by ultrasonography in 13
      calves. In the initial surgical procedure, the infected umbilical vein was
      marsupialized by cranial translocation in a median celiotomy and was flushed
      daily until healing occurred. In a second surgical procedure, the contracted
      umbilical vein was removed. Nine calves were clinically healthy after treatment.
      One had reformation of two abscesses because of inadequate post-surgical
      treatment. One calf was euthanatized because of an intussusception of the small
      intestine, and two calves had adverse reactions and developed septic shock when
      some of the lavage fluid, which was applied under pressure, entered the systemic
      circulation. It was concluded that umbilical vein abscesses should not be flushed
      under pressure in calves younger than 2 months of age. The principal advantages
      of cranial translocation of the umbilical vein in a median celiotomy are that
      only one abdominal incision is required and that the infected umbilical vein
      tissue does not have to be passed intraabdominally to a paramedian position.

PMID- 8362501
TI  - Primary repair of abomasal fistulae resulting from right paramedian abomasopexy
      in eight adult dairy cattle.
AB  - Abomasal fistulae resulting from right paramedian abomasopexy in eight adult
      dairy cattle were treated by primary closure of the abdominal wall after surgical
      resection of the fistulae. The median elapsed time from the abomasopexy to
      recognition of fistula formation was 16 days (range, 10 to 90 days). All cows had
      normal electrolyte values, and five cows had mildly increased base excess values
      (range = 4.0 to 7.8 mEq/L). Surgery was performed with the cows in dorsal
      recumbency using general anesthesia. The fistulated tissue was resected and the
      abomasum and body wall were closed primarily. One or two layers of appositional
      sutures using #2 or #3 polyglactin 910 were used to close the body wall. Mean
      surgical time was 2.2 hours (range, 1.8 to 2.9 hours). Two cows were lost to
      follow-up. Five of the remaining six cows returned to production (range, 5 to 30
      months). Primary closure of the abdominal wall should be considered in the
      surgical repair of abomasal fistulae in cows that do not have diffuse
      peritonitis.

PMID- 8362502
TI  - Ex vivo biomechanics of Kirschner-Ehmer external skeletal fixation applied to
      canine tibiae.
AB  - The purpose of this study was to determine the respective contribution of each of
      the following parameters to the compressive, bending, and torsional rigidity of
      the Kirschner-Ehmer (KE) external fixation splint as applied to canine tibiae
      with an osteotomy gap: bilateral versus unilateral splints; increasing the number
      of fixation pins; altering the diameter of fixation pins and side bars;
      decreasing side bar distances from the bone; increasing pin separation distances
      in each pin group; decreasing distances between pin groups; altering pin clamp
      orientation; and altering side bar conformation. Bilateral splints were 100%
      (mean) stiffer than unilateral splints, with stiffness enhanced to the greatest
      extent in mediolateral bending and torsion. Increasing pin numbers stiffened both
      bilateral (mean, 41%; 8 versus 4) and unilateral splints (mean, 14%; 8 versus 4).
      Medium KE splints were 85% (mean) stiffer than small KE splints. Decreasing side
      bar distances to the bone from 1.5 cm to 1.0 cm to 0.5 cm increased stiffness of
      both bilateral and unilateral splints by a mean of 13% to 35%. Widening pin
      spacing from 1.67 cm to 2.5 cm increased stiffness in craniocaudal bending only
      (56% increase, bilateral splints; 73% increase, unilateral splints). Decreasing
      the distance between pin groups from 5.84 cm to 2.5 cm increased stiffness in
      torsion between 23% (unilateral splints) and 45% (bilateral splints) and
      decreased stiffness of unilateral splints by 29% in craniocaudal bending.
      Altering pin clamp configuration so that the bolts of the clamp were inside the
      side bar rather than outside the side bar increased stiffness in axial
      compression only (73% increase, bilateral splints; 54% increase, unilateral
      splints). Conforming the lateral side bar to the tibiae increased only axial
      compressive stiffness by 77% but was no different than placing the clamps inside
      the side bars of an unconformed bilateral splint. These results quantify the
      relative importance of specific parameters affecting KE splint rigidity as
      applied to unstable fractures in the dog.

PMID- 8362503
TI  - In vitro loss of tensile strength and elasticity of five absorbable suture
      materials in sterile and infected canine urine.
AB  - The loss of breaking strength and elasticity of five absorbable suture materials
      (polydioxanone [PDS-II], polyglycolic acid [PGA], polyglactin 910 [PG-910],
      polyglyconate [GTMC], and chromic gut) after in vitro incubation in sterile,
      Escherichia coli- and Proteus mirabilis-inoculated canine urine was studied.
      Biomechanical testing, in a controlled environment, was performed during the 28
      day study period. Polydioxanone and chromic gut retained greater than 90% of
      their original strengths after 28 days of incubation in sterile urine and 87% of
      original strengths in E. coli-inoculated urine. Polyglyconate retained 24% and
      18% of original strength, respectively, after incubation in sterile and E. coli
      inoculated urine for 28 days. Polyglycolic acid and PG-910 retained less than 30%
      of original strength in sterile urine and only 7% in E. coli-inoculated urine
      after 21 days of incubation. In P. mirabilis-inoculated urine, loss of tensile
      strength and elongation was significant for all suture materials. Polyglycolic
      acid and PG-910 lost all strength after 24 hours of incubation. Polydioxanone
      lost all strength after 7 days of incubation, whereas GTMC retained 19% at day 7.
      Chromic gut retained 78% at day 7 and 16% after 21 days of incubation, however,
      the absence of normal phagocytic destruction of chromic gut in this in vitro
      study may have artificially elevated these values. In sterile urine with
      chemically modified pH, loss of strength and elongation was greater in alkaline
      urine than in neutral or acidic urine for all types of suture materials.

PMID- 8362505
TI  - Oxalate nephrosis and renal sclerosis after renal transplantation in a cat.
AB  - A 10-year-old castrated domestic shorthair cat received two renal allografts, 14
      days apart, for the treatment of chronic renal failure. Oxalate nephrosis
      developed in both allografts, and they became nonfunctional. During the
      transplantation period, the cat was not exposed to exogenous sources of oxalate,
      and there was no evidence of primary type 2 hyperoxaluria before surgery.
      Urologic surgery, in particular renal transplantation, has been identified as a
      factor that can precipitate renal failure in human patients with decompensated
      renal function and hyperoxaluria. If hyperoxaluria was present before surgery in
      this cat, it was most likely caused by increased absorption or decreased
      metabolism of dietary oxalate.

PMID- 8362504
TI  - Clinical, biochemical, and hematologic evaluation of normal dogs after
      administration of rabbit anti-dog thymocyte serum.
AB  - Renal allografting is the only long-term alternative to euthanasia in dogs with
      end-stage kidney disease. The purpose of this study was to determine the
      clinical, biochemical, and hematologic effects of rabbit anti-dog thymocyte serum
      (RADTS) in normal dogs and to develop a safe and practical route of
      administration before its use in an allograft immunosuppressive protocol.
      Thirteen mongrel dogs were divided into three groups; each received RADTS
      subcutaneously, intramuscularly, or intravenously. The inflammation and pain
      associated with subcutaneous administration was unacceptable. A significant (p <
      or = .05) leukopenia and lymphopenia developed in all dogs, regardless of the
      route of administration of RADTS. Thrombocytopenia was a consistent finding after
      intravenous administration and with high doses given intramuscularly. Both the
      intravenous and intramuscular routes were well tolerated by all dogs with minimal
      or no discomfort. Serum creatinine was unchanged, whereas serum alanine
      aminotransferase activity increased in one dog. There were no histologic changes
      in any of the kidneys examined.

PMID- 8362506
TI  - Cecal-colic volvulus in two dogs.
AB  - Cecal-colic volvulus was confirmed by surgery in two dogs. Both dogs were intact,
      male Great Danes. The clinical and diagnostic findings were not specific for
      large bowel volvulus. Clinical signs included peracute to acute onset of
      vomiting, mild abdominal distention and pain, lack of feces, and tenesmus.
      Abdominal radiographs demonstrated severe dilatation of bowel loops in both dogs.
      One dog survived.

PMID- 8362507
TI  - Parenteral anticholinergics in dogs with normal and elevated intraocular
      pressure.
AB  - Dogs given parenteral anticholinergic drugs have been thought to be at risk for
      development or exacerbation of elevated intraocular pressure (IOP). In a
      randomized, blinded, placebo-controlled study, we evaluated the effect of
      intramuscular glycopyrrolate (0.01 mg/kg) on pupil diameter and IOP in
      unanesthetized normal dogs. Treatment with glycopyrrolate did not change pupil
      diameter or IOP from baseline, nor were there differences between glycopyrrolate
      and saline-treated (control) dogs. In addition, the authors retrospectively
      reviewed the medical records of 2,828 dogs undergoing general anesthesia between
      April 1987 and September 1990 to determine if there was an association between
      parenteral anticholinergic medication and postanesthetic elevation in IOP. The
      authors also determined the frequency of bradycardia requiring anticholinergic
      therapy during anesthesia in dogs with glaucoma. Of the 2,828 cases reviewed, the
      records of 46 dogs coded for glaucoma were examined in detail. The 46 dogs
      underwent 62 episodes of anesthesia, with 23 episodes including exposure to an
      anticholinergic drug. An increase in IOP from preanesthetic to postanesthetic
      measurement occurred in three dogs. One of these dogs received anticholinergic
      medication for bradycardia during anesthesia. The postanesthetic elevation in IOP
      in this dog was probably not drug related. Preanesthetic anticholinergic
      administration did not affect the incidence of anticholinergic administration for
      bradycardia during the anesthetic episode. Anticholinergic therapy during
      anesthesia was more frequent when the preanesthetic medication included an opiate
      drug. These studies do not indicate an association between parenteral
      anticholinergic administration and elevations in IOP.

PMID- 8362508
TI  - Endotracheal tube displacement during cervical manipulation in the dog.
AB  - A retrospective study was performed to identify positional changes of
      endotracheal tubes (ETT) during cervical spine radiography in 153 dogs. Three
      neck positions were identified: traction, hyperextension, and flexion. A properly
      placed ETT was defined as having the caudal tip of the tube located between the
      caudal half of the fourth cervical (C) vertebra (C4) and the caudal half of C7.
      In the traction position, before neck flexion and extension, the caudal tip of
      13% of ETT were located caudal to C7, and one tube was in the endobronchial
      position at the seventh thoracic (T) vertebra (T7). In the hyperextended
      position, 60% of ETT moved cranially. The average distance moved was 0.6
      vertebral spaces. In the flexed position, all ETT moved caudally. The average
      distance moved was 3.5 vertebral spaces, with 81.8% of ETT located caudal to C7
      and seven tubes in endobronchial positions. Endotracheal tube occlusion caused by
      kinking at the atlanto-occipital joint was seen in four dogs during flexion of
      the neck. Based on this study, ETT position should be monitored during cervical
      manipulation.

PMID- 8362510
TI  - How far shall we go in the predonation selection of blood donors to safeguard
      patients for blood-transfusion-related infections?

PMID- 8362509
TI  - Intraosseous cannulation and drug administration for induction of anesthesia in
      chickens.
AB  - Twenty-four chickens were randomly assigned to one of three treatments (ketamine,
      30 mg/kg; thiopental, 20 mg/kg; saline, 0.8 mL). Baseline data (heart rate,
      respiratory rate, systolic blood pressure, and cloacal temperature) were recorded
      before ulnar intraosseous cannulation and administration of drug treatment and
      for 30 minutes after administration. One investigator, unaware of the treatment
      administered, assessed the reaction to cannulation, number of attempts per
      cannulation, reaction to injection, time to induction and recovery, and quality
      of induction and recovery. Respiratory rate increased significantly (p < .05)
      from baseline after thiopental. Other parameters did not vary within groups or
      between groups. Most birds did not react or had a mild reaction to cannulation
      and injection, and on average fewer than two attempts were necessary. Quality of
      recovery was significantly (p < .05) better after thiopental. Time to recovery
      was significantly (p < .05) shorter after thiopental. No major histopathologic
      changes were noted in bone marrow samples from the injection site. This study
      demonstrates that the intraosseous route may be used to induce anesthesia in
      chickens, and that minimal changes in the variables studied were produced by
      ketamine and thiopental.

PMID- 8362511
TI  - Blood transfusion and immunomodulation: a possible mechanism.
AB  - To induce an immunogenic response in vivo, an antigen-presenting (stimulator)
      cell must present both antigen-specific (class II MHC) and an accessory signal to
      the CD4 T cell. Failure to express the accessory signal has been shown in vitro
      to induce a state of specific unresponsiveness (anergy) in the T cell. We have
      shown that although stimulator cells in blood continue to express class II MHC
      molecules during refrigerated storage, their ability to present the accessory
      signal diminishes, reaching zero in all units tested by about 13 days. This
      implies that blood in excess of 2 weeks old should not alloimmunize but could
      induce some degree of immunosuppression. UV-B irradiation and, to a lesser
      extent, gamma-irradiation, were also shown to inhibit expression of the accessory
      signal by stimulator cells in blood.

PMID- 8362512
TI  - Ultraviolet irradiation inhibits killer-target cell interaction.
AB  - The effects of ultraviolet (UV) irradiation on cell-mediated cytolysis were
      examined in order to clarify the inhibitory mechanisms of allosensitization by UV
      irradiation. UV-B-irradiated target cells (Sa; an Epstein-Barr virus-transformed
      B cell line) exhibited more resistance against alloreactive cytotoxic T
      lymphocytes (CTL) than mitomycin C (MMC)-treated target cells. In the conjugate
      formation assay, UV-B-irradiated target cells showed a considerably lower binding
      to alloreactive CTL than MMC-treated target cells. UV-B irradiation induced a
      reduction of HLA-class I, -DR, CD54 (ICAM-1) and CD58 (LFA-3) expression on
      target cells. However, it does not seem to contribute to the inhibition of cell
      adhesion induced by UV-B irradiation because a similar reduction of cell surface
      antigens was observed in MMC-treated target cells. Number of cells capped with
      anti-HLA-class I, -DR, CD54 or CD58 monoclonal antibody were markedly reduced by
      UV-B irradiation compared to that by MMC treatment. These findings suggest the
      possibility that the inhibition of cell adhesion between UV-B-irradiated Sa
      target cells and alloreactive CTL is due to the impaired mobility of cell surface
      antigens which will affect the early process of cell-mediated cytolysis.

PMID- 8362513
TI  - Transfusion-transmitted Yersinia enterocolitica infection. Protection through
      buffy coat removal and failure of the bacteria to grow in platelet-rich or
      platelet-poor plasma.
AB  - In a previous study, removal of white blood cells (WBC), by filtration 5 h after
      deliberate contamination of whole blood with a type 0:3 strain of Yersinia
      enterocolitica, was shown to be an effective way of avoiding bacterial growth in
      red blood cells (RBC) during storage. In the present study the Opti-System
      technique was used to remove the buffy coat from whole blood, leaving 10-20% of
      the original number of WBC in the RBC preparation. In one series of experiments,
      all of 4 units of RBC suspension, from which buffy coats were removed 2 h after
      inoculation of 112 colony-forming units (cfu) per ml of Y. enterocolitica, became
      Yersinia-free, while abundant bacterial growth occurred in all of 4 units where
      RBC suspension and buffy coat had been recombined. In a second series of 10
      experiments, with an inoculum of 80 cfu/ml, no growth was found in platelet-poor
      plasma stored for 42 days at 4 degrees C. Five out of 10 RBC suspensions in SAGM
      additive solution remained Yersinia-free throughout a 6-week storage period; 4 of
      these 10 units showing growth of Yersinia after 4 weeks and 5 after 6 weeks. In
      the buffy coats bacterial growth was found in 1 out of 10 units after 1 week, 4
      after 2 weeks, and in all of 10 units after 4 weeks. In 2 control experiments
      with WBC-reduced RBC inoculated with the same bacterial dose, growth started
      within 24 h and was abundant after 1 week.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362514
TI  - Human monoclonal anti-D-induced clearance of human D-positive red cells in a
      chimpanzee model.
AB  - Two human monoclonal anti-Rh0(D) antibodies, one IgG1, and one IgG3, were tested
      for their ability to clear human D-positive red blood cells (RBCs) from
      chimpanzee circulation. Human RBCs (phenotype A1, R1r) from 1 donor were
      radiolabelled with chromium 51 and injected into 4 chimpanzees. One day later the
      control animal received isotonic saline whereas 2 animals received 400 micrograms
      of purified human monoclonal anti-D, either IgG1 or IgG3. The remaining animal
      received both antibodies together (200 micrograms of IgG1 and 200 micrograms of
      IgG3). Both individual antibody-mediated clearance of human D-positive cells and
      synergy was not observed when both antibodies were used in combination. IgG1 was
      slightly more effective than IgG3. This animal model is a suitable alternative
      for conducting in vivo experiments in human beings, especially at the preclinical
      study phase of monoclonal anti-D antibodies.

PMID- 8362515
TI  - Evidence for the protective effect of maternal FcR-blocking IgG alloantibodies
      HLA-DR in Rh D-haemolytic disease of the newborn.
AB  - In cases of Rh D alloimmunization, strong results in the antibody-dependent cell
      mediated cytotoxicity (ADCC) assay (> 80% lysis as compared to that of the
      standard anti-D serum) are indicative of severe hemolytic disease to occur in the
      newborn (HDN). However, discrepant cases were found in which the maternal anti-D
      gave strong ADCC results and the newborns had no or only mild hemolysis. In the
      majority of these cases the mother had produced monocyte-reactive IgG
      alloantibodies, mostly with HLA-DR specificity. Such antibodies may be capable of
      blocking FcR-mediated functions of the fetal MPS, and it has been postulated that
      they inhibit destruction of anti-D-sensitized red cells. We here describe 2
      families in which such discrepancies were noticed. In 1 family, in spite of ADCC
      results of > 80%, the Rh D-positive second child was born without signs of
      hemolysis. However, the Rh D-positive third child suffered from very severe
      hemolytic disease. The mother had produced monocyte-reactive HLA-DR antibodies in
      the second pregnancy which, however, did not react with the cells of the third
      child. In the other family, the severely Rh D-alloimmunized mother had lost her
      fourth child because of intrauterine death due to HDN. The Rh D-positive fifth
      child was born with only mild HDN and only in this pregnancy had the mother
      produced such antibodies. These 2 case histories give further evidence that
      maternal monocyte-reactive alloantibodies, in both these cases directed against
      HLA-DR antigens, can protect the Rh D-positive child against hemolytic disease in
      case of severe Rh D alloimmunization.

PMID- 8362516
TI  - Protection against Rh D-haemolytic disease of the newborn by a diminished
      transport of maternal IgG to the fetus.
AB  - IgG present in the circulation of newborn infants is predominantly of maternal
      origin. In cases of severe Rh D alloimmunization, the maternal anti-D anti-bodies
      may lead to Rh D-haemolytic disease of the newborn. However, an impaired
      placental transport of maternal IgG could be associated with the protection of
      the fetus/newborn against haemolytic disease as shown in this case report.

PMID- 8362517
TI  - Plasma and red-cell glycolipid patterns of Le(a+b+) and Le(a+b-) Polynesians as
      further evidence of the weak secretor gene Se(w).
AB  - Monoclonal antibodies and thin-layer chromatography were used to study the
      unusual erythrocyte Lewis phenotypes found in healthy Polynesians. A single
      monoclonal anti-Leb reagent 073 (clone LM129) was found which could detect Leb
      antigen on the Polynesian erythrocytes of samples that were unreactive with
      various polyclonal and monoclonal anti-Leb reagents. Glycolipid fractions
      prepared from the plasma and erythrocytes of selected Polynesian samples of red
      cell Le(a-b-), Le(a+b-) and Le(a+b+) phenotypes were found to have Leb
      glycolipids. The Leb antigen in some individuals is so weakly expressed that it
      is undetectable by routine erythrocyte phenotyping. Unusually large glycolipids
      bearing the Leb epitope were also found in some Polynesian samples, although the
      contribution of these novel glycolipids to phenotyping is unclear. The inability
      to detect Leb by routine methods and the presence of novel structures can be
      partially explained in terms of the presence of a weak secretor gene Se(w).

PMID- 8362518
TI  - Confirmation of anti-ELO as a cause of haemolytic disease of the newborn.

PMID- 8362519
TI  - Anti-HIV in Spanish blood donations from 1988 to 1991. Spanish Study Group on HIV
      blood donations screening.

PMID- 8362520
TI  - Dose of anti-D immunoglobulin for the prevention of RhD immunisation after RhD
      incompatible platelet transfusions.

PMID- 8362521
TI  - Observations on Australia antigen in Japanese. Vox Sang 1968:15:374-85.

PMID- 8362522
TI  - Immunofixation electrophoresis: a technique for the study of protein
      polymorphism. Vox Sang 1969:17:445-52.
AB  - A technique is described which allows direct visualization of individual proteins
      in mixtures by specific antiserum after electrophoresis. By minimizing diffusion
      it permits rapid, direct, and clear detection of genetic polymorphism and
      'conversion' of proteins in the complement and coagulation systems.

PMID- 8362523
TI  - ISBT Working Party on Terminology for Red Cell Surface Antigens. Sao Paulo
      report.

PMID- 8362524
TI  - WHO Expert Committee on Specifications for Pharmaceutical Preparations. Thirty
      third report.

PMID- 8362525
TI  - Is preoperative radiographic localization of islet cell tumors in patients with
      insulinoma necessary?
AB  - Preoperative localization tests [sonography, computed tomography, angiography,
      percutaneous transhepatic portal venous sampling for insulin radioimmunoassay
      (PTP)] have a sensitivity of 60% to 90% in cases of organic hyperinsulinism. In
      all publications, however, the sensitivity of intraoperative localization, 75% to
      100%, is distinctly higher. With the exception of PTP, all tumors that can be
      identified by preoperative localization can also be detected using palpation or
      intraoperative sonography. Preoperative localization diagnosis is therefore not
      absolutely necessary prior to primary operation in the case of organic
      hyperinsulinism. It is requested by many surgeons because: (1) only a few clinics
      have extensive experience with patients with an organic hyperinsulinism; (2) only
      a few clinics have extensive experience with intraoperative sonography; (3) the
      accuracy of palpation is improved following appropriate preoperative
      localization; and (4) in rare cases, the results of a PTP influence the operative
      procedure.

PMID- 8362526
TI  - Use of selective arterial secretin injection test to guide surgery in patients
      with Zollinger-Ellison syndrome.
AB  - It is often difficult to localize gastrinomas in patients with Zollinger-Ellison
      syndrome (ZES). We have developed a new useful method, the selective arterial
      secretin injection test (SASI test), for localizing gastrinomas in patients with
      ZES. The SASI test first determines the arteries feeding the gastrinomas and then
      locates the gastrinomas. In 12 patients with ZES, the SASI test clearly localized
      the gastrinomas, while results obtained with computed tomography or portal venous
      blood sampling had a positive predictability of less than 10%. Following
      localization with the SASI test, curative resection of gastrinomas was
      successfully performed on 7 patients who consented to the operation. Each of 3
      patients had one duodenal submucosal microgastrinoma and one or more metastatic
      lymph node; the other 4 patients had 2 to 10 microgastrinomas or large
      gastrinomas in the duodenum or the pancreas. All 7 patients, who exhibited
      negative responses with a postoperative secretin test, have been completely cured
      from 3 months to 4 years postoperatively. The usefulness of the SASI test for
      preoperative evaluation is demonstrated by the fact that it gives a 100% positive
      predictability rate as well as a 100% negative predictability rate. Hence the
      SASI test precisely locates functioning gastrinomas.

PMID- 8362527
TI  - Intraarterial calcium stimulation test for detection of insulinomas.
AB  - Occult insulinomas are adenomas not visualized by routine preoperative imaging
      studies, including ultrasonography (US), computed tomography (CT), magnetic
      resonance imaging (MRI), and arteriography. Reliance for detecting occult
      insulinomas has been placed on portal venous sampling (PVS), a sensitive (> 75%)
      but invasive procedure that requires considerable experience to enable sampling
      of small veins about the pancreatic head. For the past 2 years we have attempted
      to localize insulinomas by stimulating the release of insulin with a selective
      intraarterial injection of calcium gluconate and sampling for insulin gradients
      in the hepatic veins. This study replaces PVS by indicating the region of the
      pancreas within which the tumor lies, although, like PVS, it does not directly
      visualize the tumor. Our experience in 9 patients with surgically proved
      insulinomas is reviewed, comparing the results with PVS as well as with US, CT,
      MRI, and arteriography.

PMID- 8362528
TI  - Surgical treatment of the Zollinger-Ellison syndrome.
AB  - A consecutive series of patients with Zollinger-Ellison syndrome (ZES) is
      reported. A total of 53 cases were diagnosed, treated, and followed by one
      department during the period 1971-1990. Curative surgery was considered in all
      cases after suppression of acid secretion and after localization of the tumors.
      Exploratory laparotomy was not employed. Of the 53 patients 13 (24%) died from
      metastatic gastrinoma during the study. Tumors were ultimately located in 31 of
      the patients, and 21 of these patients were operated. A total of 12 patients
      (21%) were cured. The best results were obtained after Whipple
      pancreaticoduodenectomy in patients with small tumors located after percutaneous
      transhepatic portography with blood sampling for gastrin assay. In this group 9
      of 10 operated patients were cured. Multiple endocrine neoplasia type I did not
      seem to preclude curative resection. The findings support an aggressive attitude
      toward local diagnosis and surgical treatment in ZES patients, but they also
      stress the need for improvements in methods for localizing tumors.

PMID- 8362530
TI  - Experimental study of pylorus and pyloric vagus preserving gastrectomy.
AB  - In an attempt to prevent the sequelae of conventional gastrectomy, such as rapid
      gastric emptying, dumping syndrome, intestinal content reflux, indigestion, and
      poor absorption, we have devised the pylorus and pyloric vagus preserving
      gastrectomy (PPVPG). Experimenting on 48 dogs, we found theoretic grounds for
      using our design and obtained the desired effects--retaining the merits of
      conventional subtotal resection of the stomach, with acidity reduction, while
      avoiding the above-mentioned complications.

PMID- 8362529
TI  - Control of gastric acid hypersecretion in the management of patients with
      Zollinger-Ellison syndrome.
AB  - During the last 5 years important advances have occurred in the control of
      gastric acid hypersecretion in Zollinger-Ellison syndrome (ZES). The increased
      availability of potent gastric acid antisecretory agents such as histamine H2
      receptor antagonists and more recently the H+K(+)-ATPase inhibitors such as
      omeprazole and lansoprazole have made it possible to medically control acid
      secretion in all patients. Increased understanding of the variation in
      antisecretory drug dosage between individual patients has led to identification
      of criteria to ensure effective antisecretory control and to the recognition of
      subgroups of patients who require special monitoring. Effective regimens for
      parenteral antisecretory control during surgery have been established. The
      importance of parathyroidectomy in patients with multiple endocrine neoplasia
      type I with ZES and the possible usefulness of highly selective vagotomy have
      been investigated. We review here the new data that led to increased
      understanding in each of these areas from our studies and studies by others.

PMID- 8362531
TI  - Exogenous growth hormone: effects on the catabolic response to surgically
      produced acute stress and on postoperative immune function.
AB  - The first purpose of the present prospective randomized study was to determine if
      the protein catabolic response after operation could be restrained by
      administration of hypocaloric parenteral nutrition (HPN) plus human growth
      hormone (hGH). Our second aim was to determine if the administration of hGH could
      improve the systemic host defenses, thereby reducing the risk of infection. We
      performed a placebo-controlled randomized double-blind trial in 180 patients
      after elective cholecystectomy with or without choledochoduodenostomy (placebo =
      control group, n = 93; hGH-treated group, n = 87). The results obtained in this
      study show that positive nitrogen balance can be achieved during the
      postoperative period from the first 24 hours onward, with a combination of HPN
      support (1.0-1.5 g protein/kg/day and 900 kcal/day) together with the
      administration of small doses (8 IU) of hGH. The potassium balance tended to
      follow the same positive balance as the nitrogen balance. Our study shows that in
      the control group, treated only with HPN, a significant decrease in serum levels
      of some acute-phase proteins (retinol-binding protein, transferrin, prealbumin),
      albumin, total proteins, and immunoglobulins occurs by the 5th postoperative day.
      In the GH group the values of all the above-mentioned proteins do not change or
      tend to rise if compared to preoperative levels. In the GH-treated group liver
      function appeared to improve at the start of the study. GH and somatomedin C
      levels were similar in the two groups and had not changed significantly in the
      control group by the 5th postoperative day.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362532
TI  - Laparoscopic cholecystectomy: a minor abdominal trauma?
AB  - Clinical observations following laparoscopic surgery indicate a shorter period of
      postoperative ileus than after conventional surgery. The aim of our study was to
      verify disorders of postoperative motility of the small intestine by means of
      implanted electrodes after laparoscopic and conventional cholecystectomy (CHE) in
      an animal model. Four weeks after implantation of three electrodes on the
      jejunum, CHE was performed laparoscopically in 5 dogs and in an additional 5 dogs
      by laparotomy. Independent of the type of operation, normal motility (especially
      the migrating motility complex) was abolished during the early postoperative
      period. Electrical activity was characterized by the basic electrical rhythm.
      Time to the occurrence of the first postoperative activity front, indicating
      restoration of motility, varied significantly depending on the type of operation:
      It was 5.5 +/- 1.0 hours after laparoscopic CHE and 46 +/- 5 hours after
      conventional CHE. These results support the hypothesis that small peritoneal
      incisions and less manipulation of the intestine during laparoscopic surgery
      result in reduced abdominal trauma.

PMID- 8362533
TI  - Pulmonary function after cholecystectomy performed through Kocher's incision, a
      mini-incision, and laparoscopy.
AB  - Comparative pulmonary function after cholecystectomy performed through Kocher's
      incision, a mini-incision, and laparoscopy was evaluated. Forty-five patients
      were randomly and prospectively divided into three groups of 15 each, depending
      on the surgical access employed. Forced vital capacity (FVC), forced expiratory
      volume at 1 second (FEV1), and forced expiratory flow at 25% to 75% (FEF25-75%)
      were determined 1 to 3 days before and 16 to 24 hours after cholecystectomy. The
      percent reduction of FVC (p = 0.0170), FEV1 (p = 0.0191), and FEF25-75% (p =
      0.0045) was smaller after laparoscopic cholecystectomy than after Kocher's
      incision cholecystectomy. The percent reduction of FVC (p = 0.0170) was smaller
      after mini-incision cholecystectomy than after Kocher's incision cholecystectomy.
      There was no difference in the FEV1 (p = 0.0971) or FEF25-75% (p = 0.2058)
      between these two groups. FEF25-75% was significantly less impaired in the
      laparoscopic group than in the mini-incision group (p = 0.0327). No difference
      between these two groups was found in FVC (p = 0.5755) or FEV1 (p = 0.3952). It
      is concluded that postoperative pulmonary function is less impaired after
      laparoscopic cholecystectomy than after either mini-incision or Kocher's incision
      cholecystectomy.

PMID- 8362534
TI  - Bile duct injury during laparoscopic cholecystectomy: mechanism of injury,
      prevention, and management.
AB  - Although several studies have shown a low incidence of bile duct injuries during
      laparoscopic cholecystectomy, concerns remain because of the sustained increase
      in the number of referrals for biliary reconstruction after the procedure. Twenty
      one patients have been referred to our institution because of major bile duct
      injuries after laparoscopic cholecystectomy. The injury was recognized during the
      laparoscopic procedure in only 6 of the 21 (29%). Nineteen patients underwent
      hepaticojejunostomy at least once, one patient required hepaticojejunostomy and
      repair of a choledochoduodenal fistula, and one patient needed repair of a
      biliary colonic fistula. Hepaticojejunostomy above the bifurcation was required
      in 10 patients (50%), at the bifurcation in 3, and below the bifurcation in 7.
      Nine of the eleven patients in whom the initial repair was performed at the local
      hospital presented with early stricture (median 7 months). The common denominator
      of the development of bile duct injuries during laparoscopic cholecystectomy is
      the failure to identify the structures of the triangle of Calot. Specific steps
      during laparoscopic cholecystectomy to avoid bile duct injuries are described.
      Expertise in hepatobiliary surgery appears to optimize results of biliary
      reconstruction.

PMID- 8362536
TI  - John Hunter, 1728-1793.

PMID- 8362535
TI  - Management of bile duct injuries and strictures following cholecystectomy.
AB  - During 7057 conventional cholecystectomies (1972-1991), 16 bile duct injuries
      occurred, amounting to a risk of 0.22%. A total of 1022 laparoscopic
      cholecystectomies were performed without such a complication since April 1990. In
      a retrospective study, 64 patients (16 of our patients and 48 referrals) with an
      injury or stricture due to conventional cholecystectomy were investigated. In 14
      of our 16 patients the injury was recognized and immediately repaired with a good
      long-term result of 93%, including one successful repair of a subsequent
      stricture. Two cases of unrecognized injury were managed by nonoperative means.
      The group of 48 referred patients comprised 10 early postoperative complications
      (21%) and 38 strictures after an "uneventful" cholecystectomy. Of the 64 total
      patients, 10 (16%) underwent nonoperative treatment, and 54 required surgery. The
      mean follow-up period after surgery was 7.4 +/- 4.9 years. Most cases (93%) were
      repaired by bilioenteric anastomosis (i.e., foremost hepaticojejunostomy) with an
      18% restricture rate. Including second and third repairs for restricture, a total
      of 60 operations (14 primary and 46 secondary reconstructions) were performed
      without hospital mortality. A good long-term result after stricture repair was
      achieved in 75% of the patients, whereas 17% had a poor outcome owing to
      restricture or death (10% had related mortality within 10 years). The other 8%
      had a moderate result due to recurrent cholangitis. Thus immediate repair of a
      bile duct injury offers the better chance of a favorable prognosis compared to
      secondary stricture repair.

PMID- 8362538
TI  - [Allocation and fairness problems in current medicine exemplified by
      transplantation medicine].

PMID- 8362537
TI  - [Ethical values in the transition of health systems].

PMID- 8362539
TI  - [Economic regulation and ethical conflicts in general practice].

PMID- 8362540
TI  - [Economic treatment waiver and patient selection as a legal problem].

PMID- 8362542
TI  - [The contribution of medical ethics to cost reduction in health care].

PMID- 8362541
TI  - [Between self determination and outside control--on the role of the physician in
      health care].

PMID- 8362543
TI  - [Intestinal helminthiasis].

PMID- 8362544
TI  - [Value of prognostic factors in prostate cancer].

PMID- 8362545
TI  - [Diagnostic errors in kidney and urinary tract findings].

PMID- 8362546
TI  - [From general practice of an expert assessment service: abdominal pain always
      need extensive examination].

PMID- 8362547
TI  - [A case from general practice (11): a young man with angina pectoris].

PMID- 8362548
TI  - [Carl Arnold Ruge--the "Meesta"].

PMID- 8362549
TI  - Dedicated to Ezras Asratovich Asratian for the 90th anniversary of his birth.

PMID- 8362550
TI  - Development of conditioned reflexes theory in E. A. Asratyan's school (90 years
      from the birthday).

PMID- 8362551
TI  - [The dynamics of individual preference in the probability and value of
      reinforcement in the development of experimental neurosis].
AB  - After single and repeated negative emotiogenic (neuroticizing) influences in
      phlegmatics and cholerics in a situation with different probability and value of
      reinforcement a change of behaviour strategy takes place--from the preference of
      a reinforcement of higher probability but worse quality to that of low
      probability but valuable. Strategy of behaviour of sanguinics and melancholics
      remains unchanged with the preference of a reinforcement of low probability but
      better quality. The greatest sensibility to negative emotiogenic influence (a
      conflict situation) was established in phlegmatics and the lowest sensibility--in
      sanguinics. The obtained data are discussed from the positions of P. V. Simonov's
      concept on the four brain macrostructures (the hippocampus, amygdala,
      hypothalamus, and the frontal cortex) in the aspect of significance of the level
      of their functioning and interaction for the pathogenesis of neuroses.

PMID- 8362553
TI  - [The effect of diazepam on behavior and hippocampal electrical activity in the
      dog].

PMID- 8362552
TI  - [The "circular" interaction of the signal, motivational and emotiogenic
      structures in food and defensive (classical and instrumental) conditioned
      reflexes].
AB  - In experiments with dogs was shown the role of motivational and emotional
      structures of the hypothalamus in reproduction of the adaptive motor reaction
      both in classical and instrumental conditioned reflexes (alimentary and
      defensive). Change of parameters of electrostimulation gave a possibility to
      activate differentially the motivational, emotional negative, and emotional
      positive structures of the hypothalamus. Electrostimulation of the motivational
      structures reproduced alimentary but not defensive adaptive motor reaction and
      decreased the threshold of the motor reaction which was used as a signal during
      classical alimentary conditioning. Electrostimulation of the emotional negative
      structures reproduced defensive adaptive reaction and inhibited alimentary
      unconditioned response. Elaboration of the avoidance of the stimulation of the
      lateral hypothalamus was a proof for the activation of the emotional negative
      structures. Electrostimulation of the emotional positive structures which was
      used as an unconditioned stimulus during self-stimulation conditioning reproduced
      neither defensive nor alimentary conditioned response.

PMID- 8362554
TI  - [The autonomic component of food and defensive conditioned reflexes acquired to
      bursts of light and electrostimulation of the limbic structures and the basal
      ganglia].
AB  - Alimentary and defensive instrumental conditioned responses (CRs) to light
      flashes, electrical stimulation of the dorsal hippocampus and the nucleus
      caudatus were elaborated in seven dogs. These CRs were tested by
      electrostimulation of the limbic structures and the basal ganglia. Motor and
      vegetative components of CRs were compared. If there occurred an instrumental
      movement during the conditioned stimulus the heart rate increased with a high
      probability. If there were no movement the heart rate increase approached the
      level of significance only in five dogs of seven. The heart rate always increased
      in the positive generalization tests while in the negative ones the heart rate
      either decreased or increased to a lesser degree.

PMID- 8362555
TI  - [The functional role of the motor area of the cortex in the acquisition of escape
      reactions in dogs].
AB  - The model of escape conditioning similar to classical (pavlovian) was proposed.
      During shock application to the hind limb (a conditioned stimulus) the
      ipsilateral foreleg flexion was elicited by a stimulation of the motor cortex (an
      unconditioned stimulus); both stimuli were turned off in the course of the
      forepaw lifting. Such uniform pairings resulted in elaboration of a reaction of
      the foreleg flexion in response to the shock. Prolonging the shock by 3 s after
      the cortical stimulation led to a rapid extinction of the acquired response. So a
      possibility to instrumentalize movements elicited by stimulation of the motor
      cortex (MI) was proved. This is in argument in favour of an assumption that the
      established "instrumental" connection (drive-motor structures) can be addressed
      directly to the motor cortex.

PMID- 8362556
TI  - [Frontal-hypothalamic interaction in cats in the realization of a free choice of
      reinforcement].
AB  - In experiments with four cats instrumental delayed responses with a reinforcement
      of different quality were elaborated by the method of "active choice" the time of
      delay of the motor reaction serving as a signal of quality of the reinforcement.
      Individually varying ability to chose the quality of the reinforcement was used
      for classification of typological properties of cats (self-control and
      impulsiveness). Multiunit activity was recorded from the motor cortex and the
      lateral nucleus of the hypothalamus. Analysis of interneuronal connections was
      made by the cross-correlation method. Identified connections between hypothalamic
      and motor cortex neurons were found in 13-18% of all the possible connections.
      The interneuronal cortical-hypothalamic relationships were characterized by
      temporal delays from 0 to 100 ms. The analogy was found in distribution curves of
      temporal delays in all the time ranges investigated for the neurons of the
      hypothalamic-motor coordination in each group of cats in spite of the
      manifestation of preferred or alternative conditioned reactions. The number of
      identified connections of hypothalamus-motor cortex coordination with temporal
      delays up to 30 ms was significantly higher for the cats working in impulsiveness
      paradigm. At the same time, there were significantly more identified connections
      of hypothalamus-motor cortex coordination with temporal delays of 60-100 ms in
      cats demonstrating self-control. The question is discussed on the role of the
      hypothalamus-motor cortex relationships in the choice of behaviour strategy and
      typological characteristics of cats.

PMID- 8362557
TI  - [Hypothalamic neurons and defensive reflexes].
AB  - Identified groups of neurons in positive (the lateral hypothalamic area, the
      lateral preoptic area) and negative (the ventromedial hypothalamus) emotional
      regions were examined under the different levels of food motivation and
      emotionally positive and negative intracranial stimulation. The responses of the
      neurons in classical and operant conditioning were different. This difference was
      manifested in tonic (during location of the animal into the chamber) and phasic
      alterations of neuronal activity and at certain stages of conditioned reflex
      performance. During classical conditioning were revealed the reciprocal relations
      in unit activity of the positive and negative emotional structures. During the
      operant reflex more complicated pattern of reactions was observed being connected
      with realization of a necessity of removing from the negative influences. During
      defensive reflex in the cases of classical conditioning and avoidance reaction
      reinforcement was related with engaging the negative emotional mechanisms while
      in the course of escape reaction the positive emotional mechanism being engaged.

PMID- 8362558
TI  - [The correlation between the changes in synaptic efficiency and cellular
      excitability in the acquisition of a conditioned reflex analog].
AB  - By calculating correlation coefficients was revealed the positive linear
      correlation between the conditioned changes of direct and indirect components of
      the pyramidal tract response pointing to a correlation between changes of
      synaptic efficiency and coincident shifts of cellular excitability. Coincidence
      of the maximal value of this connection with that of cellular excitability
      dependent on the activation of the lateral hypothalamus points to the role of
      this subcortical motivational structure in starting intracellular reactions
      leading to a formation of a common molecular substrate underlying interaction of
      the membrane and synaptic mechanisms. Precedence of the maximal manifestation of
      this interaction to the highest increase of synaptic efficiency testifies to the
      contribution of this process to the manifestation of the basic mechanism of
      conditioned reflex.

PMID- 8362559
TI  - [The nerve centers of the emotions].
AB  - The participation and the role of the brain formations in the genesis of
      emotional reactions of higher animals and man are discussed according to E.A.
      Asratian's concept of the nervous centre as a complex of brain structures,
      situated in different areas of the central nervous system, comprising the total
      morpho-functional unity and realizing a definite specific function. The data are
      given testifying that the frontal and temporal areas of the neocortex,
      hippocampus, amygdala and hypothalamus are correspondingly connected with
      reflecting-estimating, compensatory, transferring and reinforcing functions of
      emotions. The reinforcing function is phylogenetically the most ancient. It is
      connected with solution of the universal behavioural task of maximization
      minimization of the appeared emotion, striving for "to" or "from". Replacing and
      transferring functions have been formed later, while reflecting-estimating one is
      the most young. It namely provides the wealth and diversity of emotions, based on
      complicated vital, social and cognitive needs. Such succession coincides with the
      evolution of the corresponding brain formations, with their phylogenetic age.

PMID- 8362560
TI  - [The bioelectrical activity of the human brain in representatives of different
      temperamental types].
AB  - The goal of the paper was to reveal integral characteristics of temperament
      related to the peculiarities of interhemispheric interaction. With this aim in
      view, the types of temperament were studied in persons with different
      professional orientation. The temperament type with a "strong" nervous system and
      a higher capacity for work was shown to be characterized by a higher level of
      synchronization of biopotentials in the frontal regions of the brain, and that
      between the distant brain areas (frontal and occipital ones) as well as by more
      intensive activation of the right hemisphere in the process of mental work. This
      type of temperament was more often found among the persons whose profession was
      connected with artistic creative activity.

PMID- 8362561
TI  - [Asynchronous asymmetry (sexual and lateral differentiation--a consequence of
      asynchronous evolution)].
AB  - In the paper is presented a unified interpretation of sex differentiation and
      lateral asymmetry as asynchronous evolution. The operative subsystems, i.e. the
      male and the left hemisphere of the brain evolutionize earlier than the
      conservative ones, i.e. the female and the right hemisphere. New functions appear
      at first in males and after many generations they are transferred to females. The
      leading centers of their control are at first originated in the left hemisphere,
      then they are translocated to the right one. The criterion for functions
      localization in the hemisphere is their evolutionary age: new functions are
      controlled by the left hemisphere, old functions by the right one. Therefore the
      left hemisphere is socio-cultural, ethnic, the right one is biological, special.
      The theory explains from a single standpoint the phenomena of sex, handedness,
      nervous crossover, as well as many know facts, and predicts the new ones.

PMID- 8362562
TI  - [A structural analysis of the behavior of cynomolgus macaques under the
      conditions of their group housing in cages].
AB  - The conceptual basis of the present study is an idea on systemic interdependence
      of neurobiological phenomena (at any level of their occurrence, including the
      integral behavioural level). Characteristic peculiarities of probable
      organization of natural behavioural activity of Java monkeys (M. irus) kept in
      cages in monosexual groups were studied by recording ethograms with subsequent
      computer analysis. By ranging probabilities of transitions between separate
      behavioural acts and classifying them by motivational categories, were described
      the probable etiological structures of individual behaviour and intraspecific
      interaction in a group. Only in case of intraspecific interaction these
      behavioural structures were characterized by a high variability of the
      probability of their occurrence in different observations. The data obtained were
      considered from the position of biological significance of the probabilities of
      transitions between separate specific behavioural patterns in the organization of
      the whole behavioural activity.

PMID- 8362563
TI  - [The modification of the intraspecific behavior of male rats raised in isolation
      with different variants of interaction with related animals].
AB  - It was found that intraspecific behaviour of male rats having been transformed in
      consequence of breeding under the conditions of social isolation could be
      modified afterwards by an experience of social contacts. Long-term keeping the
      isolatedly bred rats with their mates in adulthood decreases the level of
      intraspecific sociability but does not affect the relatively high level of
      aggression of the animals under study. On the contrary, the short-term periodic
      social contacts with the mates in a situation of competition for water decrease
      only the level of aggression but not that of intraspecific sociability. However,
      in any case the transformations of the species-typical ritual of aggressive
      behaviour in consequence of early isolation are steady and are not corrected by
      later social contacts.

PMID- 8362564
TI  - [The role of glucose in facilitating defensive reactions during feeding in the
      edible snail Helix lucorum].
AB  - The glucose role in a regulation of defense responses during feeding behaviour
      was studied in the snail Helix lucorum. It was found that 15-20 min after the
      beginning of the food intake the foot withdrawal response evoked by a train of
      electrical pulses was facilitated up to 20-30%. At the same time glucose
      concentration in the haemolymph increased from 0.5 +/- 0.1 mM in the starved
      molluscs to 0.9 +/- 0.5 mM in the snails at 20-25 min of eating. In the food
      satiated snails and 30-90 min after the food intake the glucose level in the
      haemolymph was 1.6 +/- 0.5 mM. It was shown that 0.5 ml glucose solution (5 mM)
      injected into the mantle cavity also facilitated the foot withdrawal defense
      response in the fastened snail, whereas injection of 2.5 mM or 10 mM glucose
      solutions were ineffective. These data support a supposition that glucose in one
      of the endogenous factors involved in regulation of defense behaviour during
      feeding in snails.

PMID- 8362565
TI  - [The spectral characteristics of the electrical activity of the cortex and
      subcortex in the dominant of thirst].
AB  - Dominant of thirst was elaborated in water-deprived rabbits by sound stimuli. One
      judged about the formation of the dominant by a regular appearance of the
      swallowing or chewing reactions in response to testing stimulations. Spectral
      analysis of the brain electrical activity revealed a generalized lowering of the
      spectral power of the potentials of the studied cortical and subcortical areas
      all over the analysed frequency range. The paraventricular nucleus, the lateral
      preoptic and anterior hypothalamic areas, in spectrograms of which an increase of
      estimations in the slow frequency range took place, were an exception. Analysis
      of the electrical activity recorded at different moments of the dominant
      manifestation (the tonic state of dominant and that immediately before the
      summation movement) showed that to each of these dominant states corresponded an
      appropriate maximum in the theta-frequency range, probably reflecting different
      levels of motivational-emotional excitation.

PMID- 8362566
TI  - [An electrographic analysis of the dynamic change in the functional state of the
      rat brain after destruction of the locus coeruleus].
AB  - Bilateral destruction of the Locus coeruleus in rats was carried out by means of
      6-hydroxydopamine injections. Sham-operated animals served as control ones.
      Electrical activity was recorded in the region of the Locus coeruleus, the dorsal
      hippocampus, and in the caudatus-putamen complex. Beginning from the second week
      after surgery in experimental rats was observed a generalization of the theta
      rhythm (7-9 Hz) in electrical activity of the Locus coeruleus, hippocampus and
      the caudatus-putamen complex during orienting-exploratory activity. At the same
      time such a rhythm was enhanced in animals with motor and orienting-exploratory
      agitation. In comparison to the sham-operated animals there were no changes in
      expression in the electrical activity of the subcortical structures of the rhythm
      of 5-6 Hz, accompanying immobilization state as well as that of 9-11 Hz,
      accompanying teeth chattering. The dynamics of changes of subcortical electrical
      activity of rats after the Locus coeruleus destruction may serve an index of the
      functional state of the animals under the conditions of noradrenergic deficiency.
      Changes of the brain electrical activity and behaviour of the animals revealed
      are considered to be a consequence of a relative enhancement of the central
      serotoninergic regulation of the subcortical structures being caused by a
      weakening of noradrenergic influences.

PMID- 8362567
TI  - [The effect of different regimens of intracellular electrostimulation on the
      dynamics of neuronal adaptation processes].
AB  - Was studied the influence of rhythmic, random and contingent intracellular
      electrostimulation on the character of the initial spike activity of individual
      identified and nonidentified neurons of the isolated CNS of Lymnaea stagnalis
      snail under the conditions of the controlled experiment. Stimulation and
      recording of neuron activity were realized via the same microelectrode. In the
      process of neuron adaptation to the regimens of stimulation used two phases were
      distinguished being estimated with the help of various statistic criteria. The
      expression and stability of observed adaptive alterations of endogenous rhythm
      system were different during the phases determined. At the first phase which
      reflected a search for the strategy of the optimization of input external
      influences, the dispersion of interspike intervals and disorder of discharge
      patterns increased. The true neuron adaptation was developed at the second phase
      and observed only at contingent reinforcement. Such an adaptation was followed by
      steady alterations of endogenous rhythm system resulted in minimization or
      maximization of frequency of associative auto-reinforcements. Alterations
      accompanying the effect of optimization of external influences were the most
      expressive at the end of the epoch of corresponding contingent stimulation and
      remained for some minutes after its cessation. In the paper are discussed the
      possible mechanisms of the observed endo-neuronal adaptive reconstructions of
      spike activity.

PMID- 8362568
TI  - [The behavioral consequences of prenatal hemic hypoxia in rat progeny].
AB  - The prenatal hemic hypoxia was caused by methemoglobin inducing agent, sodium
      nitrite, injected intraperitoneally in different doses from 10th to 19th day of
      pregnancy. It was shown that perinatal hemic hypoxia evoked delayed neurological
      deficit (disorders of motor coordination, hypodynamia) and disturbances of
      mnestic functions (impairment of learning and memory in passive and active
      avoidance paradigms and in the test of extrapolative water escape). The most
      pronounced disorders of CNS functions were shown in offsprings of male rats
      injected with sodium nitrite in a dose of 40 mg/kg.

PMID- 8362569
TI  - [The role of the right hemisphere in the invariance of the recognition of faces].

PMID- 8362570
TI  - [The behavioral and neurohormonal manifestations of repeated emotional stress in
      intact and chronically alcoholized monkeys].

PMID- 8362571
TI  - [The partial replacement of a complex stimulus by one of its components during
      animal learning].

PMID- 8362572
TI  - Correlation of cytologic and histologic features in variants of papillary
      carcinoma of the thyroid.
AB  - Different morphologic variants have been described for papillary carcinoma of the
      thyroid, but little emphasis has been placed on their cytologic patterns. We
      studied fine needle aspiration (FNA) smears and histologic sections from 48 cases
      of papillary carcinoma, including 24 of the usual type, 13 of the follicular
      variant, 7 of the encapsulated variant and 4 of the tall cell variant, in an
      attempt to correlate the cytologic features and the different histologic
      variants. Single cells, monolayers and papillary fragments were present in all
      the variants. The presence of follicles was not restricted to the follicular
      variant. Nuclear grooves and cytoplasmic pseudoinclusions were present in most of
      the cases, with nuclear grooves the most common finding in all the variants (92.3
      100%). Psammoma bodies were an infrequent finding (0-25%) and were absent from
      the follicular variant. Colloid was present in all the variants and was a
      frequent finding in the follicular variant (84.6%). The findings suggest that the
      exact histologic variant of papillary carcinoma cannot be predicted from the
      appearance of the fine needle aspirate.

PMID- 8362573
TI  - Effect of fine needle aspiration biopsy on the histology of thyroid neoplasms.
AB  - We evaluated the effect of fine needle aspiration biopsy (FNAB) upon the
      histology of thyroid adenoma and differentiated thyroid carcinoma. When surgery
      was performed within three months of FNAB, infarction was found histologically in
      8/82 (9.8%) of the tumors. It was extensive in four patients, with one patient
      having no residual neoplastic cells identifiable within the nodule. No infarction
      was seen in the histologic specimens from patients with similar pathology whose
      surgery was performed without prior FNAB. These findings confirm previous reports
      that infarction may be caused by FNAB and can be so extensive as to interfere
      with the histologic diagnosis.

PMID- 8362574
TI  - Needle aspiration cytology of chondrosarcomas.
AB  - The rarity of chondrosarcomas, limited experience with the spectrum of
      histopathologic and cytologic features, and the drastic treatment options that
      ensue present a diagnostic challenge to many cytopathologists who interpret
      needle aspirate biopsies of these neoplasms. Twelve fine needle (FNA) aspirates
      were performed at University Hospitals of Cleveland on eight patients with
      primary (three), locally recurrent (seven) or metastatic (two) chondrosarcoma
      between 1980 and 1991. The cytologic features of chondrosarcoma in all three
      clinical settings were characterized by the presence of isolated or loosely
      cohesive aggregates of oval or polygonal chondrocytes with vacuolated or granular
      cytoplasm and a background of chondroid matrix. FNA cytology is utilized most
      commonly in the diagnosis of recurrent and metastatic chondrosarcoma. FNA
      cytology, when employed in the diagnosis of chondrosarcoma, necessitates the same
      considerations employed in evaluating surgical biopsies. They include (1) the
      cytologic features and their limitations and differential diagnoses, (2) the
      clinical and radiographic data, and (3) the clinical impact of the cytologic
      diagnosis.

PMID- 8362575
TI  - Processing fine needle aspiration biopsies for electron microscopic examination.
      Experience implementing a procedure.
AB  - While processing needle rinses from fine needle aspiration biopsy material for
      electron microscopy, we experienced difficulties not fully outlined previously.
      Problems in preservation were traced to the time elapsed before glutaraldehyde
      was added to the needle rinse, which had been held in a physiologic transport
      medium; a tendency toward hypotonicity of the commercially prepared transport
      medium; and vigorous handling of the needle rinse. When these problems were dealt
      with, preservation improved dramatically. The problem of scanty material
      available for ultrastructural evaluation was dealt with by decreasing the number
      of smears made and filtering the needle rinse to capture tissue fragments.
      Implementation of the procedure required leadership, good communication,
      motivated cytotechnologists and cytopathologists, and continuous supervision and
      monitoring. In cases with adequately cellular well-preserved material available
      for electron microscopy, ultrastructural evaluation made a contribution of
      clinical value to the diagnosis in 48% of cases.

PMID- 8362576
TI  - Cytologic diagnosis of pulmonary cryptococcosis in immunocompetent hosts.
AB  - Four immunocompetent patients with pulmonary cryptococcosis were diagnosed by
      either fine needle aspiration (FNA) cytology or sputum cytology over five years.
      The pulmonary manifestations were subpleural nodules and pneumonic infiltrates.
      Percutaneous transthoracic FNA under real-time ultrasound guidance for the
      subpleural nodules was used, as were periodic acid-Schiff stain and Liu's stain.
      Three of the patients with no evidence of extrapulmonary involvement received no
      antifungal therapy, and spontaneous resolution of the infection without
      recurrence was noted during follow-up. The role of cytology in the diagnosis of
      this unique and often-unsuspected subset of pulmonary fungal disease is
      emphasized.

PMID- 8362577
TI  - Abdominal tuberculosis. Diagnosis by fine needle aspiration cytology.
AB  - One hundred five cases of tuberculosis of the abdomen (excluding genitourinary
      involvement) diagnosed initially by fine needle aspiration cytology between 1988
      and 1991 were analyzed retrospectively. The diagnosis of tuberculosis was
      suspected clinically in 60% of the cases prior to aspiration. The anatomic
      locations of the lesions were ileocecal in 69 cases, lymph node in 18, colon in
      10, jejunoileal in 2, duodenojejunal in 1, peritoneal in 1 and liver in 4.
      Cytomorphologic analysis of the aspirates from these 105 cases showed only
      necrotic material in 19 cases, necrotic material with epithelioid granuloma in 36
      cases and epithelioid granuloma without necrosis in 50 cases. Ziehl-Neelsen
      staining for acid-fast bacilli was positive in 47 of 105 cases (45%). Cultures
      for mycobacteria were positive in 5 of 24 cases. Histologic confirmation was
      available in five cases only. The cytodiagnosis correlated well with the
      radiologic findings and response to antituberculosis chemotherapy.

PMID- 8362578
TI  - Aspiration biopsy cytology of primary cutaneous tumors.
AB  - Primary cutaneous neoplasms may undergo fine needle aspiration during the workup
      of patients with suspected metastatic disease. Such aspirates present a wide
      range of epithelial and nonepithelial proliferations that must be separated from
      more common metastatic deposits. The majority of primary cutaneous tumors are
      composed of squamous or basaloid cells that can be confused with metastatic
      squamous cell carcinoma. In addition, primary cutaneous lymphomas and mesenchymal
      tumors morphologically overlap their more common systemic or metastatic
      counterparts in appearance. Both clinical and cytologic features aid in the
      differentiation of pilomatrixomas, basal cell carcinomas, sebaceous carcinomas,
      primary squamous cell carcinomas, Merkel cell tumors and epidermal inclusion
      cysts from metastatic squamous cell carcinomas. The presence of small basaloid
      cells in an aspiration smear favors the diagnosis of a primary neoplasm, such as
      pilomatrixoma or basal cell carcinoma. Clinical findings and cell marker studies
      are important in the cytologic diagnosis of primary cutaneous lymphomas. Complex
      convolutions in the nuclei of neoplastic lymphoid cells favor a primary cutaneous
      origin. We report the cytologic features of 94 primary cutaneous tumors seen in a
      series of 558 aspirates of subcutaneous and cutaneous nodules.

PMID- 8362579
TI  - Homogenization of sputum with dithiothreitol for early diagnosis of pulmonary
      malignancies.
AB  - Homogenization of sputum with dithiothreitol (DTT) has not been used in cytology
      for the detection of malignant cells. We examined the efficacy of this method as
      compared to the conventional "pick and smear" (PS) method. Smears were prepared
      from sputum samples using the PS technique to act as the control. The remaining
      sputum was digested with an equal volume of 0.3% DTT in 70% ethanol at room
      temperature. The cells were washed with 35% ethanol and smears prepared. The DTT
      treated specimens gave a much higher concentration of evenly distributed cells.
      The background was clear and the morphology comparable to that of the control.
      More positive cases were detected with the DTT than the conventional PS
      technique. Homogenization of sputum with DTT is a simple and effective method of
      screening for pulmonary malignancies.

PMID- 8362580
TI  - Peroral fine needle aspiration cytology of parapharyngeal lesions.
AB  - Peroral fine needle aspiration cytology (FNAC) was carried out on 63 patients
      with parapharyngeal lesions from January 1986 to March 1992. The age of the
      patients ranged from 4 to 87 years. Analysis of the results showed 12
      inflammatory lesions, 28 benign tumors and 23 malignant neoplasms. Correlation
      with histopathology showed a diagnostic accuracy of 88.2%, with no false-positive
      reports. FNAC can replace incisional biopsy, which may be hazardous in this area.
      Surgery can be avoided for inflammatory lesions.

PMID- 8362581
TI  - Vaginal intraepithelial neoplasia. Reproducibility of pathologic diagnosis and
      correlation of smears and biopsies.
AB  - Masked slides of 124 vaginal smears and 70 corresponding biopsies obtained from
      45 patients with a reported cytologic diagnosis of vaginal intraepithelial
      neoplasia (VAIN) were examined by two pathologists to assess the interobserver
      reproducibility and histopathologic correlation of cytopathologic diagnoses of
      VAIN. The cytopathologic diagnoses by the two pathologists were identical in 94
      (76%) cases and matched the originally reported diagnosis in 45 (46%) cases. The
      histopathologic diagnoses by the two pathologists agreed in 47 (67%) cases and
      matched the originally reported diagnosis in 35 (55%). The consensus
      cytopathologic and histopathologic diagnoses rendered by the pathologists agreed
      within one grade in 49 (70%) cases. A consensus histopathologic diagnosis of VAIN
      2 was rendered in only 1 (10%) of 10 cases in which the cytopathologic diagnosis
      was VAIN 2. These results suggest that the cytopathologic and histopathologic
      grading of VAIN is moderately reproducible. Because (1) combining VAIN 2 and 3
      under the diagnosis of high grade squamous intraepithelial lesion provided a
      slight improvement in diagnostic reproducibility and cytopathologic
      histopathologic correlation and (2) the cytopathologic diagnosis of VAIN 2 was
      employed rarely and rarely confirmed histopathologically, we advocate the use of
      the term high grade squamous intraepithelial lesion to designate VAIN 2 and 3.

PMID- 8362582
TI  - Atypical glandular cells in cervical smears from women who have undergone cone
      biopsy. A potential diagnostic pitfall.
AB  - Twelve cervical smears from nine women who had cervical cone biopsies performed
      at least six months preceding the smears contained atypical glandular cells that
      raised the possibility of adenocarcinoma in situ (AIS). However, these smears
      differed from those usually seen in AIS in that the abnormal cells were less
      frequent and part of a spectrum of more benign-appearing cells, some of which
      appeared to be endometrial. A separate review of cervical smears following 31
      consecutive cone biopsies showed that 16 of 54 contained crowded glandular cells.
      However, in only one case were they suggestive of AIS. Alteration of the
      microscopic anatomy of the endocervix following cone biopsy may be responsible
      for the exfoliation of such cells.

PMID- 8362583
TI  - Value of urine cytology in screening patients with prostatitis syndromes.
AB  - We reviewed the results of urine cytology examination of 206 patients with a
      diagnosis of prostatitis syndromes in the period 1985-1991. The urine samples
      showed an incidence of 20.4% for slight to moderate atypia and 6.3% for severe
      atypia. In these patients, cystoscopy, bladder biopsies and intravenous urography
      were performed to exclude malignancies. In only 6 of the 13 patients with severe
      atypia of the urine cytology were malignancies found. In cases of malignancy, the
      ages of the patients ranged from 51 to 64 years (mean, 58.6), and they complained
      most frequently of irritative bladder symptoms. In these patients, urinalysis
      frequently showed leukocyturia, and in all the samples, erythrocyturia was found.

PMID- 8362584
TI  - Cytologic diagnosis of cholesterol granuloma. A case report.
AB  - Cholesterol granuloma is a rare lesion of the orbit occurring in adults and must
      be distinguished from epidermoid cholesteatoma and other mass lesions of the
      orbit. We report the case of a 31-year-old man who presented to our institution
      with right eye proptosis secondary to a soft tissue mass. At surgery, cyst fluid
      from the lesion was sent for cytologic evaluation. The fluid was remarkable for
      numerous inflammatory cells, blood breakdown products, multinucleate giant cells
      and cholesterol crystals. The absence of squamous- or respiratory-type epithelium
      led to a diagnosis of cholesterol granuloma. This was confirmed by histologic
      examination of the tissue submitted. The differential diagnosis and cytologic
      features of orbital lesions are discussed.

PMID- 8362585
TI  - Cytodiagnosis of Coats' disease from an ocular aspirate. A case report.
AB  - This paper describes the cytologic findings in a rare condition, Coats' disease,
      which was diagnosed from a sample of ocular aspirate in a 19-month-old boy. The
      cytologic findings were characterized by the presence of numerous cholesterol
      crystals, rare foamy macrophages, several pigment-laden macrophages, pigment
      bearing epithelial cells and free pigment, which stained positive for melanin by
      Schmorl's stain. The case was unusual in that the clinical diagnosis was
      persistent hyperplastic primary vitreous, and other diagnoses, such as Coats'
      disease, were unsuspected. The cytologic findings suggested Coats' disease and
      seemed to exclude retinoblastoma or another malignancy, although the negative
      findings with the presence of cholesterol crystals and macrophages were regarded
      as somewhat nonspecific for unequivocally excluding any of the above.

PMID- 8362586
TI  - Papillary carcinoma of the male breast. Report of a case diagnosed by fine needle
      aspiration cytology.
AB  - An 81-year-old male with prostatic carcinoma presented with a large right breast
      mass and underwent a fine needle aspiration biopsy, which revealed a primary
      papillary carcinoma of the breast. This lesion was unrelated to the patient's
      prostatic carcinoma and is the first case of papillary carcinoma of the male
      breast, to our knowledge, diagnosed by fine needle aspiration cytology. This case
      is described, and previous literature on the cytologic features of papillary
      breast carcinoma and carcinoma of the male breast is briefly reviewed.

PMID- 8362587
TI  - Diagnosis of collagenous spherulosis of the breast by fine needle aspiration
      cytology. A report of two cases.
AB  - We describe the cytopathologic features of two cases of collagenous spherulosis
      of the breast on fine needle aspiration cytology. The main findings were a
      moderately rich cellular aspirate, monolayered epithelial clusters with bland
      nuclei, naked bipolar nuclei and light green (Papanicolaou stain) or pink (Diff
      Quik) spherules surrounded by a ring of comma-shaped nuclei resembling
      myoepithelial cells, located either at the heart of the epithelial clusters or
      detached from them. We also comment on the differential diagnosis with adenoid
      cystic carcinoma of the breast, signet-ring carcinoma and myospherulosis.

PMID- 8362588
TI  - Pericardial extramedullary hematopoiesis in a neonate with congenital heart
      disease. A case report.
AB  - A case of pericardial extramedullary hematopoiesis in a neonate with congenital
      heart disease was diagnosed by fine needle aspiration cytology. Undifferentiated
      blasts, promyelocytes, metamyelocytes and nucleated red blood cells were evident
      in the pericardial fluid specimen. The differential diagnosis of bone marrow
      contamination of pericardial fluid secondary to inadvertent sampling of neonatal
      hypodense bone tissue is also discussed. To our knowledge, this is the first
      reported case of neonatal pericardial extramedullary hematopoiesis associated
      with congenital heart disease.

PMID- 8362589
TI  - Intraoperative demonstration of Mikulicz cells in nasal scleroma. A case report.
AB  - The frozen section diagnosis of scleroma (rhinoscleroma) may pose some difficulty
      to the unsuspecting pathologist. Intraoperative cytology is a helpful technique
      that, when combined with frozen section, enhances the diagnostic accuracy.
      Imprint smears obtained from a tissue sample of an obstructive nasal mucosal mass
      demonstrated the characteristic Mikulicz cells, thus confirming the frozen
      section diagnosis of scleroma. The importance of intraoperative cytology in the
      evaluation of surgical specimens is emphasized.

PMID- 8362591
TI  - Follicular carcinoma of the thyroid with an adenoid cystic pattern. Report of a
      case with aspiration biopsy cytology, immunohistochemistry and electron
      microscopy.
AB  - Aspiration biopsy of a histologically confirmed follicular carcinoma of the
      thyroid with an adenoid cystic pattern revealed numerous epithelial cells with
      scant cytoplasm and oval or pleomorphic nuclei present singly, in clusters or
      around round, laminated bodies.

PMID- 8362590
TI  - Fine needle aspiration cytology of primary squamous cell carcinoma of the thymus.
      A case report.
AB  - We present the cytologic findings of a rare case of primary thymic squamous cell
      carcinoma with ultrastructural examination and histologic confirmation of the
      tumor. The clinicopathologic features of thymic carcinomas are discussed.
      Although the cytodiagnosis of squamous cell carcinomas in general is not
      difficult, we have observed some cytologic (and histologic) features that we
      think are distinctive in thymic squamous carcinoma.

PMID- 8362592
TI  - Microfilariae of Wuchereria bancrofti in a lymph node aspirate. A case report.
AB  - Microfilariae of Wuchereria bancrofti were detected by fine needle aspiration
      biopsy (FNAB) in an axillary lymph node from a 27-year-old female. The patient
      also had intestinal tuberculosis. A routine hemogram did not show any
      eosinophilia, and three consecutive night blood samples also were negative for
      microfilariae. This was an early case of filariasis without microfilaremia and
      was detected by FNAB of the lymph node. The association of filariasis and
      tuberculosis was purely coincidental.

PMID- 8362593
TI  - Ultrasonically guided fine needle aspiration of the parathyroid. A report of two
      cases.
AB  - Two cases of parathyroid adenoma were diagnosed with ultrasound-guided fine
      needle aspiration. Both patients were clinically suspected of having features of
      primary hyperparathyroidism. On aspiration, one had an associated cystic change
      with golden brown fluid and the other a markedly cellular aspirate. The cells
      aspirated were differentiated from thyroid epithelial cells.

PMID- 8362594
TI  - Fine needle aspiration cytology of lipid-secreting breast carcinoma. A case
      report.
AB  - Lipid-secreting carcinoma is a rare type of invasive carcinoma of the breast
      first described by Aboumrad et al in 1963. We believe lipid-secreting carcinoma
      to be a specific type of breast carcinoma and that it has to be differentiated
      from invasive lobular carcinoma. We report for the first time the fine needle
      aspiration cytologic features along with the histologic and electron microscopic
      findings.

PMID- 8362595
TI  - Intraparotid Leishmania donovani lymphadenitis: diagnosis by fine needle
      aspiration.

PMID- 8362596
TI  - Microfilaria in a thyroid aspirate smear: an unusual finding.

PMID- 8362597
TI  - Localized pulmonary amyloidosis diagnosed by fine needle aspiration cytology.

PMID- 8362598
TI  - Diagnosis of malignant melanoma of soft parts in a nodal metastasis by fine
      needle aspiration cytology.

PMID- 8362599
TI  - Megakaryocyte, erythroid and granulocyte-macrophage colony formation in
      myelodysplastic syndromes.
AB  - Bone marrow progenitor cell assays of three cell lineages, i.e., colony-forming
      unit megakaryocytes (CFU-Meg), burst-forming unit erythrocytes (BFU-E) and colony
      forming unit granulocyte-macrophages (CFU-GM), were performed for 21 patients
      with myelodysplastic syndromes (MDS). Markedly reduced or absent colony formation
      was found in 67% of the patients for CFU-Meg and all patients except 2 with
      refractory anemia (RA) for BFU-E. Abnormal CFU-GM colony formation was found in
      only 5 of 12 patients with RA and RA with ring sideroblasts, in contrast to all
      of the RA patients with excess of blasts and excess of blasts in transformation.
      Defective colony formation of all three cell lineages was seen in 63% of the MDS
      patients. The colony number of CFU-Meg correlated significantly with the numbers
      of both BFU-E and CFU-GM. These findings indicate that hematopoiesis in MDS
      patients is disturbed due to a qualitative or quantitative defect at the
      multipotent stem cell level.

PMID- 8362600
TI  - Hematotoxicity of interleukin-2 in man: clinical effects and comparison of
      various treatment regimens.
AB  - BACKGROUND: Immunotherapy using recombinant human interleukin-2 (rIL-2) produces
      objective responses in a proportion of advanced cancer patients. While early
      investigators employed intravenous (i.v.) treatment regimens, recent clinical
      trials applied therapy schedules via subcutaneous (s.c.) injection, mostly in
      combination with recombinant human interferon-alpha (rIFN-alpha). There were no
      significant differences in reported response rates between i.v. and s.c.
      treatment regimens. METHODS: We retrospectively evaluated 148 treatment cycles of
      s.c. immunotherapy administered to 107 outpatients. Adverse effects of s.c.
      cytokine therapy were described with regard to hematotoxicity, and compared to
      adverse effects reported upon high- or intermediate-dose i.v. rIL-2 therapy. Our
      study population consisted of 15 patients who received s.c. rIL-2 at doses of 4.8
      14.4 million IU/m2/day on 5 days per week, 20 patients who were treated with rIFN
      alpha 2b at 3.0-6.0 million U/m2/day thrice weekly, and 72 patients who were
      given s.c. rIFN-alpha 2b at 6.0 million U/m2/day thrice weekly plus s.c. rIL-2 at
      14.4-18.0 million IU/m2/day on days 1 and 2, followed by 4.8 million IU/m2/day, 5
      days per week. RESULTS: Subcutaneous immunotherapy as administered in this study
      was well tolerated in the outpatient setting. Thus, there were no treatment
      related deaths, and no patient developed grade III or IV (WHO) toxicity.
      Subcutaneous rIL-2 as a single agent produced grade II anemia and
      granulocytopenia in 7% of patients, respectively. In combination with s.c. rIFN
      alpha, s.c. rIL-2 yielded grade II anemia and granulocytopenia in 8 and 14% of
      patients, respectively. In comparison, rIFN-alpha as a single agent produced
      grade III anemia and grade I granulocytopenia in 5 and 20% of patients,
      respectively. Upon s.c. rIL-2/rIFN-alpha combination therapy, a mean hemoglobin
      nadir of 114.4 g/l (p < 0.0001 when compared to baseline) was noted, and the mean
      granulocyte nadir was 2.3/nl (p < 0.0005). These mild laboratory changes due to
      cytokine-induced hematotoxicity were in marked contrast to severe anemia,
      thrombocytopenia, and granulocytopenia reported upon i.v. rIL-2 therapy.
      CONCLUSIONS: Palliative s.c. rIL-2-based immunotherapy as used in this study
      abrogates profound hematotoxicity, previously seen upon rIL-2-based i.v.
      immunotherapy. Subcutaneous rIL-2/rIFN-alpha combination therapy can be given in
      the ambulatory setting with good practicability and excellent safety. This
      outpatient regimen is as effective in advanced renal cell cancer as the most
      aggressive i.v. rIL-2-based protocols reported.

PMID- 8362601
TI  - Pancytopenia in children with brucellosis: clinical manifestations and bone
      marrow findings.
AB  - Among 276 paediatric cases of brucellosis seen over a 7-year period, 16 patients
      (5.8%) with pancytopenia were identified. The most frequent presentations were
      fever, malaise, anorexia, weight loss, arthralgia, and hepatosplenomegaly.
      Fourteen patients (87.5%) had positive blood and/or bone marrow cultures for
      Brucella melitensis. Bone marrow aspiration specimens showed hypercellularity in
      14 patients and normocellularity in 2. Histiocytes, eosinophils and plasma cells
      were increased in every marrow aspirate, and haemophagocytosis was observed in 14
      patients (87.5%). Non-caseating granulomas were present in the bone marrow biopsy
      of 11 patients (68.8%). The pancytopenia was transient, and resolved on treatment
      of the Brucella infection.

PMID- 8362602
TI  - Management of hemosiderosis complicated by coexistent anemia with recombinant
      human erythropoietin and phlebotomy.
AB  - Patients with hemosiderosis who also suffer from coexistent anemia may be unable
      to tolerate frequent phlebotomies needed for depletion of body iron stores.
      Chelation therapy, an alternative approach, may be unsuitable for some patients
      due to allergic reactions, poor response or intolerance of long-duration
      subcutaneous administration. The use of recombinant human erythropoietin in such
      patients could increase the hematocrit and improve exercise tolerance allowing
      for more frequent phlebotomies. We report the successful use of this combined
      approach in two such patients.

PMID- 8362603
TI  - Late relapse after allogeneic bone marrow transplantation for Philadelphia
      positive acute lymphoblastic leukaemia.
AB  - Late relapse of leukaemia is rare in patients with chronic myeloid leukaemia
      (CML) subjected to allogeneic bone marrow transplantation in chronic phase.
      Herein, we report a patient who presented with acute lymphoblastic leukaemia who
      after chemotherapy developed a picture consistent with CML in chronic phase. He
      then received an allograft from an HLA-identical sister and remained in complete
      remission for 4 years, before he eventually relapsed with features of myeloid
      transformation of CML. We speculate that the same population of already
      transformed leukaemic progenitor cells may have given rise to the original
      lymphoid blast cells and the myeloid blast cells that characterized the terminal
      relapse.

PMID- 8362604
TI  - Pure red cell aplasia associated with systemic lupus erythematosus: remission
      after a single course of intravenous immunoglobulin.
AB  - Pure red cell aplasia is characterized by severe anemia, with reticulocytopenia
      and absence of precursor cells in the bone marrow. Many modes of treatment have
      been described, including the use of immunosuppressive agents. Recently repeated
      courses of high-dose intravenous immunoglobulins have been used successfully in
      patients with idiopathic pure red cell aplasia. We here describe a 22-year-old
      woman who developed pure red cell aplasia in the course of systemic lupus
      erythematosus. After failure of corticosteroid therapy the patient was treated
      with one course of high-dose intravenous immunoglobulins with complete remission.
      No further therapy was required.

PMID- 8362605
TI  - Periodic production of antiplatelet autoantibody directed against GPIIIa in
      cyclic thrombocytopenia.
AB  - We report here a female patient with cyclic thrombocytopenia associated with
      antiplatelet autoantibodies. There was an inverse relationship between the level
      of platelet-associated IgG and platelet count. Bone marrow megakaryocytes were
      normal in number even during the thrombocytopenia. The binding of monoclonal
      antibodies (mAbs) against glycoprotein (GP) IIb/IIIa to patient platelets was
      significantly inhibited in the thrombocytopenic phase, while these mAbs normally
      bound to patient platelets obtained during the normal platelet count. Western
      blotting and mAb-specific immobilization of platelet antigens showed that both
      plasma autoantibody and the eluted IgG from the patient platelets bound to
      GPIIIa. These results suggest that the periodic production of antiplatelet
      autoantibody against GPIIIa caused cyclic destruction of platelets in this
      patient.

PMID- 8362606
TI  - Localized renal pelvic fungal ball in a patient undergoing bone marrow
      transplantation.

PMID- 8362607
TI  - Decrease in the density of IgG-Fc receptor III (CD16) on 'toxic' neutrophils.

PMID- 8362608
TI  - Statistical analysis of Glanzmann's thrombasthenia in Japan.

PMID- 8362609
TI  - Megadose methylprednisolone for myelofibrosis.

PMID- 8362610
TI  - Autoimmune hemolytic anemia and cutaneous T cell lymphoma: review of the
      literature.

PMID- 8362611
TI  - [V Scientific and Educational Conference of the Polish Society of Haematology and
      Blood Transfusion. Platelet Disorders -- New Trends in Diagnosis and Treatment.
      Lublin, June 4-5, 1993. Proceedings and abstracts].

PMID- 8362612
TI  - [Secondary and primary thrombocythemia].
AB  - Reactive thrombocytosis is an elevation of platelet count occurring in
      association with certain underlying diseases such as various infections,
      inflammatory, neoplastic and asplenic states. Essential thrombocythemia is a
      myeloproliferative syndrome affecting megakaryocytes, which leads to increased
      numbers of circulating platelets. This disorder is characterized by splenomegaly
      and a clinical course punctuated by hemorrhagic and/or thrombotic episodes.

PMID- 8362613
TI  - [Autoimmune thrombocytopenia in pregnant women].

PMID- 8362614
TI  - [Clinical significance of platelet alloantibodies].

PMID- 8362615
TI  - [Thrombocytopenia associated with HIV infection].
AB  - Thrombocytopenia is a common complication of human immunodeficiency virus (HIV)
      infection. Its pathogenesis has not yet been established. An increased platelet
      destruction either due to the nonspecific deposition of circulating immune
      complexes on platelets or to the presence of specific antiplatelet antibodies as
      well as direct infection of megakaryocytes by HIV with a resulting decrease in
      platelet production have been reported as possible mechanisms. About 30-50% of
      patients with moderate thrombocytopenia may show spontaneous remission. Patients
      with either severe thrombocytopenia (platelet count < 20 x 10(9)/l) or bleeding
      are usually first treated with corticosteroids or azidothymidine. If improvement
      does not occur, further therapeutic approaches are the same as for chronic
      idiopathic thrombocytopenic purpura. HIV-associated thrombocytopenia has no
      prognostic significance with regard to AIDS risk.

PMID- 8362616
TI  - [Clinical aspects of autoimmune thrombocytopenic purpura].
AB  - Autoimmune thrombocytopenic purpura (ATP) is a relatively common haematological
      problem. ATP comprises three distinct clinical entities: idiopathic acute
      thrombocytopenic purpura, idiopathic chronic thrombocytopenic purpura and
      secondary autoimmune thrombocytopenia which is associated with other autoimmune
      diseases. In acute ATP the majority of patients recover spontaneously within 3
      months. In chronic ATP 75% of patients respond to corticosteroids and splenectomy
      and need no further therapy. Other forms of treatment have been evaluated for
      refractory patients. This is a group of particularly high risk and more
      aggressive forms of treatment, which can be justified, are discussed.

PMID- 8362617
TI  - [Laboratory diagnosis of congenital platelet function disorders].
AB  - Up-dating of diagnostics of hereditary platelet disorders has been done. Due to
      the development of laboratory techniques some of the thrombopathies are now well
      characterized at the molecular level, and it can be seen that the classification
      of these defects has greatly progressed. However, the most frequent inherited
      disorders of platelet function encountered fall into the class "platelet
      secretion defect" and remain incompletely defined. Evidence of storage pool
      deficiency should be considered in all patients with an unexplained prolongation
      of the bleeding time, even in the absence of the classical aggregation
      abnormalities.

PMID- 8362618
TI  - [Contribution of blood platelets to hemostasis].

PMID- 8362619
TI  - [Immunology of blood platelets].
AB  - Platelet specific antigen systems, their molecular structure and localization in
      cell membrane is presented. New techniques for the detection of platelet
      antibodies are discussed.

PMID- 8362620
TI  - Comparative anatomical studies of arteriographs of the hand and foot in primates
      including man.
AB  - In this study we have tried not only to report the variations in the arteries of
      the hand in Hominoidea (Pongidae and Hominidae) and the frequency with which
      these deviations occur, but also to deal with them phylogenetically and
      ontogenically. The arterial system of the human hand and foot are considered to
      have changed from the ground plan of Old World monkeys. In this paper, the entire
      arterial system of the primates including man (Cercopithecidae, Pongidae and
      Hominidae) is discussed in a stereoscopic analysis of angiographs. In the hand, a
      three-dimensional angiographic analysis of the deep palmar arterial arches and
      their correlating arteries revealed the following features. In Cercopithecidae, 3
      deep palmar arches are formed by branches of the 2nd dorsal metacarpal artery: 2
      proximal arches (the catella volaris proximalis and arcus volaris profundus) and
      1 distal arch (the catella volaris distalis). The palmar intermetacarpal arteries
      arise from the catella volaris proximalis and the palmar metacarpal arteries
      arise from the arcus volaris profundus. In Pongidae, the arches are formed by the
      perforating branches of the 1st dorsal metacarpal artery, and the catella volaris
      proximalis is more developed than the arcus volaris profundus. In Hominidae, the
      arches are formed by the perforating branches of the 1st dorsal metacarpal
      artery, and they consist of the arcus volaris profundus and an incomplete catella
      volaris distalis. This change may have been caused by the development of the
      thumb and its effect on finger movements. In the foot of Macaques, the saphenous
      artery, instead of the anterior tibial artery, reaches the dorsum of the foot and
      its branches supply most of the foot. The dorsal arteries are dominant as far as
      the metatarsal spaces of the lateral four toes. The 2nd dorsal metatarsal artery
      shows a tendency to be the single dominant artery and to give rise to even 4th
      plantar common digital artery through the catella plantaris distalis. This
      tendency was observed more clearly in other macaque species than the Japanese
      monkey. The perforating branch at the second proximal metatarsal space forms the
      arcus plantaris profundus, which is accompanied by the deep branch of the lateral
      plantar nerve. Beneath the arch, the catella plantaris proximalis is formed on
      the metatarsal bones among the perforating branches of dorsal metatarsal
      arteries. The posterior tibial artery forms the arcus plantaris superficialis,
      whose thin branches commonly enter the plantar common digital arteries. As
      described above, some similar arterial patterns in the hand and foot are ones
      that are secondarily acquired in man.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8362621
TI  - The retroesophageal subclavian artery--a case report and review.
AB  - In an 80-year-old Japanese male cadaver, the right subclavian artery originated
      from the aortic arch distal to the origin of the left subclavian artery, i.e., it
      was the last branch of the aortic arch. It coursed obliquely upwards and to the
      right behind the esophagus and trachea heading for the superior thoracic
      aperture. Its area of distribution was normal. Here, we describe this rare
      anomaly, and discuss its morphologic types, development, incidence, common
      associated anomalies and clinical correlations.

PMID- 8362622
TI  - [Functional anatomy of the hypothalamic-hypophysial system: neuroendocrine
      control mechanism].
AB  - The hypothalamic neuroendocrine mechanisms involved in the regulation of the
      anterior pituitary functions were reviewed on the basis of the findings obtained
      mainly in rats. The hypothalamic-hypophysial system has long been considered as a
      hormonary associated organ system. Recent development of immunohistochemistry and
      molecular biology, however, has localized the hormone-synthesizing neurons in the
      hypothalamus, and disclosed the synaptic junctions between them, between those
      neurons and non-hormonal neurons in the hypothalamus, and further, between
      neurons in the hypothalamus and other brain parts as well as peripheral nervous
      systems. Based on these findings, we have designated five functional areas in the
      hypothalamus: septopreoptic, suprachiasmatic, magno- and parvicellular
      paraventricular, and arcuate-median eminence areas. The neuronal transmitters in
      the synaptic junctions were classical transmitters and hormonal or nonhormonal
      peptides. Some mutual synaptic connections were found between different hormonal
      peptide-synthesizing neurons within the same area and even between those in the
      different areas. Although the significance of the neuronal regulation system
      cooperating with the hormonal events is largely still uncertain, they may serve
      to integrate the functions of hypothalamic hormone-synthesizing neurons as a
      whole in adjusting the homeostasis of the internal milieu of the living body.
      Intimate relations have recently been reported between immune system and
      endocrine system or hypothalamic neuroendocrine system. In this connection, it is
      clear that the hypothalamus acts not only as the center for neuroendocrine
      regulation but also as the center of the neuroendocrine-immune regulation of the
      living body. To thereby understand the living and reproductive strategies of
      animals, further accurate knowledge on the neuronal connections within the
      hypothalamus is needed.

PMID- 8362623
TI  - Structural changes of iliac cancellous bone in postmenopausal women: a scanning
      electron microscopic study.
AB  - The functional state of iliac cancellous bones in healthy postmenopausal women
      was investigated by scanning electron microscopy (SEM) using a modified organic
      preparation method. SEM analysis of the location, number, size and phase of the
      remodeling sites showed that normal iliac cancellous bone of postmenopausal women
      has high resorbing activity in the early stage of postmenopause in both the
      region near the cortico-endosteum and the midway region, while in the late stage
      of postmenopause there is a great difference in resorbing activity between the
      two regions; namely, the resorbing activity progressively decreases with age, but
      high resorbing activity is continuously present in the region near the cortico
      endosteum. Our results suggest the possibility that at the region near the
      cortico-endosteum the bone volume loss occurs continuously throughout all the
      stages of post-menopause, while at the midway region it occurs only in the early
      stage and not in the late stage of postmenopause.

PMID- 8362624
TI  - [Morphological study on edentulous mandibula].
AB  - For the purpose of studying morphology of edentulous mandibula, not only the bone
      change of edentulous alveolar part, but the whole morphological change of
      edentulous mandibula was examined. Thirty-three edentulous mandibulae that have
      no sockets owing to the bone absorption of alveolar ridge and eighty dentulous
      mandibulae that possess no missing teeth except wisdom teeth were measured and
      compared. The authors obtained the following results concerning the morphological
      change of edentulous mandibula: 1. Although the body height was significantly low
      on account of bone absorption at the alveolar ridge, bone absorption at base of
      mandibula was not much observed. 2. Both condylar process height and coronoid
      process height were significantly low. 3. Mandibular angle of edentulous
      mandibular was greater. 4. In dentulous mandibula a negative correlation between
      mandibular angle and condylar process height, coronoid process height was found.
      A correlation between mandibular angle and the difference of total mandibular
      length and body length was observed. A great mandibular angle was found because
      it seems that the bone deposition was less at the inferior and posterior margin
      of mandibular angle part. 5. It seems that bone absorption at inferior and
      posterior margin of edentulous mandibular angle part was due to less bone
      deposition. Because a bite force decreased for missing teeth.

PMID- 8362626
TI  - Visual acuity: calculating appropriate averages.
AB  - Controversy surrounds the averaging of visual acuity scores. We examine this
      debate and provide a series of guidelines and worked examples to enable
      investigators to select an average (e.g. arithmetic mean, geometric mean, median)
      appropriate for their data.

PMID- 8362625
TI  - Computer-assisted instruction in emergency ophthalmological care.
AB  - The use of computer-assisted instruction in medical education has increased
      steadily in the last decade with the availability of personal computers. Many
      computer-assisted instruction programs train the user to handle various forms of
      disease or injury. Our intent was to provide medical students with more
      experience in managing ophthalmological emergencies, and we therefore designed a
      computerized teaching system for emergency ophthalmological care. The system
      makes it possible for inexperienced students to develop these skills, without
      jeopardizing the patient's health during training. Colour illustrations help
      teach the student to judge clinical signs. First, two classes of altogether 35
      students used the teaching system. The students were shown to have gained
      significantly better knowledge of conditions which had been presented to them by
      the computerized teaching, than of conditions which had not been presented in
      this way. After having used the system, two other classes were asked about their
      attitudes towards this teaching modality. A majority regarded it as a valuable or
      very valuable addition to traditional methods of teaching. This type of
      instruction system may improve the quality of ophthalmic teaching without
      increasing teaching staff requirements.

PMID- 8362627
TI  - Effect of bicycle ergometer test on intraocular pressure in elderly athletes and
      controls.
AB  - To evaluate the effect of intensive physical exercise on intraocular pressure
      (IOP) in 66- to 85-year-old subjects IOP was measured before and after a maximal
      bicycle ergometer test. The non-glaucomatous subjects comprised 85 males and 36
      female athletes and 16 male and 22 female controls of corresponding age drawn
      from a population register. IOP was measured using a non-contact tonometer. The
      results indicated a decrease (> or = 2 mmHg) in 34% of the subjects, no change in
      57% and an increase in 9%. The decrease was more pronounced in subjects with
      higher pre-test values. In all four subjects with a pre-test value above 22 mmHg
      a reduction from 4 to 11 mmHg was observed. The change in IOP during physical
      loading was not significantly associated with the intensity and duration of
      exercise test. Three of the 5 male subjects with diagnosed glaucoma and
      undergoing hypotensive medication, who were analyzed separately, also showed a
      reduction in IOP during loading. In the pre- or post-test values there were no
      differences between the athletes and controls, while women tended to have higher
      IOP values than men. It is concluded that physical loading has predominantly a
      moderating effect, if any, on IOP in elderly men and women.

PMID- 8362628
TI  - Three-dimensional evaluation of optic disc pallor in open angle glaucoma.
AB  - We evaluated the extent of pallor on the walls of the optic cup three
      dimensionally using simultaneous stereophotographs of the optic discs of 29
      normals, 29 ocular hypertensives and 28 primary open angle glaucomas. Pallor was
      located at the bottom of the optic cup. Pallor ascends the walls of the cup as
      its extent increases. Statistically significant differences in the extent of
      pallor in all four quadrants of the optic cup were observed, with the glaucomas
      having greater extents of pallor than ocular hypertensives, and the ocular
      hypertensives greater than the normals. The greatest percentage increase in mean
      pallor from normals to open angle glaucomas occurred on the nasal and inferior
      walls. This differential extent of pallor could be useful in characterizing
      ocular hypertension and chronic open angle glaucoma.

PMID- 8362629
TI  - The effect of hyperbaric oxygen breathing on the visual field in glaucoma.
AB  - Following the hypothesis that chronic ischemia is the main cause of functional
      deficiency in glaucoma, a double blind clinical experiment was carried out to
      study the effect of hyperbaric oxygenation in 51 glaucoma subjects, of which 31
      were in the experimental group and 20 in the control group. In the experimental
      group there was a significant improvement of visual fields (p < 0.05), whereas
      there was no change in the subjects in the control group. Hyperbaric oxygen did
      not have any influence on intraocular pressure. The achieved visual field
      improvements remained stable for 3 months (p < 0.05), except for I3 and I4
      isopters of the left eye and I4 isopter of the right eye, while they were
      considerably reduced after 6 months (p > 0.05).

PMID- 8362630
TI  - Properties of high-pass resolution perimetry targets.
AB  - Relationships between high-pass resolution perimetry ring targets and
      conventional perimetry and acuity targets were explored by optical analytical
      techniques and by comparative measurements in normal humans. High-pass resolution
      and acuity targets produced closely proportional resolution measurements, showing
      that the critical ring detail is the width of the bright core. High-pass
      resolution and conventional perimetry thresholds were not equally well
      correlated. From a purely optical point of view, high-pass resolution targets
      appeared to lose somewhat more contrast on defocusing. On the other hand, high
      pass resolution appears to show less variability in practical, clinical use.

PMID- 8362631
TI  - Two-year follow-up of intra-ocular pressure control with long duration argon
      laser trabeculoplasty.
AB  - The two-year results of intra-ocular pressure control in the first prospective
      study of standard (0.1 second) and long (0.2 second) duration argon laser
      trabeculoplasty are presented. The two groups were comparable for intra-ocular
      pressures and treatment scores at the start of the study. An early benefit in
      intra-ocular pressure reduction was found for 0.2 second trabeculoplasty in the
      first year, which disappeared during the second-ond year of follow-up. No
      reduction in medications occurred following laser trabeculoplasty. There was no
      difference in the frequency of further interventions (repeat trabeculoplasty or
      drainage surgery) between the two groups. There was a strong correlation between
      the intra-ocular pressures of the first and second treated eyes. No clinical
      benefit was demonstrated for the longer duration over standard argon laser
      trabeculoplasty.

PMID- 8362632
TI  - Treatment of concomitant eye and genital chlamydial infection with erythromycin
      and roxithromycin.
AB  - A single blind study of 10 days' randomly allocated treatment with erythromycin
      (1000 mg/day) and roxithromycin (300 mg/day) in 14 (group A) and 13 (group B)
      adults, respectively, all with culture-proven chlamydial conjunctivitis was
      performed. For comparison, 14 days' treatment with 1 g erythromycin daily given
      to 35 adults (Group C) with chlamydial conjunctivitis was also evaluated. Follow
      up was made approximately one month after start of therapy. Only 2 of the 37 men
      and 1 of the 25 women studied, all of whom had signs of conjunctivitis, had
      noticed concomitant symptoms of infection from the genital tract. Nasopharyngeal
      cultures were chlamydia-positive in 7 (50%), 7 (54%) and 20 (57%) of the patients
      in Group A, B and C, respectively, while for genital cultures the corresponding
      figures were 9 (64%), 8 (62%) and 23 (66%), respectively. The course with
      erythromycin in group C cured the conjunctivitis in 34 (97%) of the patients both
      clinically and microbiologically. Ten days' treatment with the same dose (Group
      A) did not eradicate chlamydiae from the eye in one, from the nasopharynx in 5
      and from the genital tract in still another patient. The roxithromycin treatment
      (Group B) resulted in negative chlamydial cultures from the eyes in all 13 cases,
      while the nasopharyngeal and genital cultures were still positive in one patient
      each. The study showed that in spite of the eye being cured by macrolide therapy,
      other sites like the nasopharynx and the genital tract may still be colonized,
      why sampling for C. trachomatis from these sites should be made in tests for cure
      in chlamydial conjunctivitis cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362633
TI  - Histochemical identification of hyaluronan in the rabbit anterior segment during
      the healing period after extracapsular lens extraction.
AB  - Extracapsular lens extractions were performed in rabbits. The eyes were examined
      at different time intervals after surgery with a histochemical method visualizing
      hyaluronan. There was positive staining for hyaluronan in the wound region from 2
      to 90 days postoperatively. The staining was most intense and widespread between
      7 and 14 days after surgery. A hyaluronan staining in the corneal stroma extended
      from the wound towards the central cornea 4 to 14 days postoperatively. The iris
      showed increased staining on the second postoperative day, but much less so at
      the other times studied. Cells on the posterior lens capsule were surrounded by
      hyaluronan from the seventh postoperative day throughout the observation time up
      to 90 days postoperatively. It is concluded that hyaluronan reacts during corneal
      wound healing.

PMID- 8362634
TI  - Ocular fatigue is the major symptom of dry eye.
AB  - A total of 524 consecutive new patients (195 male, 329 female, 43.4 +/- 20.8
      y.o.) were evaluated for the presence of ocular fatigue and/or dry eye. Dry eye
      was diagnosed based on our criteria, which included symptoms, vital staining,
      break-up time (BUT) measurement, and the Schirmer test. Among all the patients,
      21.2% (111/524) reported symptoms of ocular fatigue and 15.3% (80/524) were
      diagnosed as having dry eye with symptoms. Of the 111 patients who complained of
      ocular fatigue, 51.4% (57/111) had dry eye, which was significantly higher than
      the 15.3% for the entire group (p < 0.001). Additionally, 71.3% (57/80) of dry
      eye patients with symptoms complained of ocular fatigue, which was also
      significantly higher than the 21.2% among all patients (p < 0.001). Dry eye
      patients had a greater number of complaints (4.3 +/- 2.1 per patient) compared to
      controls (1.9 +/- 1.3 per patient) (p < 0.001). These findings suggest that there
      is a strong relation between ocular fatigue and dry eye.

PMID- 8362635
TI  - Variation of corneal thickness with age in young New Zealanders.
AB  - The central thickness of the left eyes of 1082 New Zealand students aged 5 to 20
      years were measured using optical pachometry. No significant variation in corneal
      thickness was found with increasing age. The mean corneal thickness of the left
      eye was 540 +/- 25 microns. No significant differences in corneal thickness were
      found when the effects of sex or cultural groupings were examined. Corneal
      thickness appears to remain constant between the age of 5 and 20 years,
      irrespective of sex or cultural grouping.

PMID- 8362636
TI  - Toxic effects of ouabain on the rabbit corneal endothelium.
AB  - Rabbit corneas kept in a standard tissue culture medium, were continually exposed
      to ouabain 10(-3) M, and cultivated for 2, 3 and 4 days. The endothelium was
      still intact with a complete cell cover after 2 days of ouabain exposure. Total
      destruction of the endothelium was found in the corneas cultivated for 3 and 4
      days. The corneal epithelium, however, appeared to be unaffected. Other rabbit
      corneas were exposed for three days to ouabain concentrations of 10(-4) M, 10(-5)
      M, 10(-6) M, 10(-7) M, 10(-8) M, and 0 M. The corneas exposed to 10(-4) M
      demonstrated total endothelial cell damage. The specimens exposed to
      concentrations from 10(-5) to 10(-8) M, presented dose dependent endothelial
      impairment as compared with the control corneas (0 M). Tracer experiments showed
      that the endothelial barrier was intact as long as there was a continuous cell
      cover, as estimated by light, transmission and scanning electron microscopy.

PMID- 8362637
TI  - Brown's syndrome. A longitudinal long-term study of spontaneous course.
AB  - The prognosis for spontaneous improvement of Brown's syndrome has not yet been
      clarified. The present longitudinal long-term study comprised 10 patients with
      idiopathic Brown's syndrome arising or noticed during the first or second year of
      life. They were followed for an average of 13 years during which each had a mean
      of 9 examinations. Spontaneous improvement occurred in 9 of the patients, 3 of
      whom were cured, obtaining normal motility. All three cases had initially been
      permanent and monolateral, with initially mild, moderate, and severe restriction,
      respectively. In the remaining 6 patients who changed for the better, the
      spontaneous improvement consisted of a reduction of the initial hypotropia and
      the initial depression of the adducted eye. When the patients were last seen, the
      sensorial state of binocular vision demonstrated in 4 of the 10 normal
      binocularity, in 2 binocularity corresponding to microstrabismus, and in 4
      alternating suppression.

PMID- 8362638
TI  - Intraocular pressure after extracapsular cataract extraction with implantation of
      posterior chamber lenses.
AB  - To determine factors which influence postoperative intraocular pressure (IOP) we
      retrospectively reviewed changes in pressure during the first postoperative week
      in 633 consecutive eyes undergoing extracapsular cataract extraction (ECCE) with
      implantation of a posterior chamber lens. The material was restricted to four
      surgeons and two types of lenses. IOP was measured preoperatively, one day and
      one week after surgery. Glaucomatous eyes (n = 113) as well as exfoliative non
      glaucomatous eyes (n = 79) had a higher mean IOP (27.8 and 26.1 mmHg) the first
      postoperative day compared to 'simple' cataract eyes (20.1 mmHg). After one week
      mean IOP in glaucomatous eyes still remained elevated while exfoliative non
      glaucomatous eyes had regained preoperative values. Mean IOP on the first
      postoperative day (18.8, 24.5, 23.1 and 13.2 mmHg respectively) was also
      dependent on surgeon. To some extent the IOP could be correlated to tightness of
      suturing as estimated by keratometry. Only one surgeon had significant difference
      between irrigated and non-irrigated visco-elastic substance. Postoperative
      pressure was not only dependent on the status of the patient's eye, but factors
      for the individual surgeons seemed to be as important.

PMID- 8362639
TI  - Refractive results after phacoemulsification and ECCE. A comparative study.
AB  - The refractive results were evaluated in 79 patients undergoing cataract
      extraction by phacoemulsification using a 6-7 mm tunnel incision, and compared
      with a group of 77 patients undergoing planned extracapsular cataract extraction
      (ECCE) by the same surgeon. A mean increase in the keratometric cylinder of 0.05D
      and 0.52D was found in the phacoemulsification and the extracapsular cataract
      extraction group, respectively. This was significantly different from zero for
      the extracapsular cataract extraction group (p < 0.05) but not for the
      phacoemulsification group (p > 0.05). By vector analysis, the mean surgically
      induced astigmatism was 0.91D and 1.36D in the phacoemulsification and the
      extracapsular cataract extraction group, respectively (p < 0.01). The IOL power
      prediction error (spectacle plane) was found to be 0.17D (+/- 0.69 SD) in the
      phacoemulsification group and 0.02 D (+/- 0.79 SD) in the extracapsular cataract
      extraction group, respectively. We conclude that phacoemulsification improves the
      surgical control of the refractive outcome of cataract surgery.

PMID- 8362640
TI  - Autofluorescence in cataractous human lens and its relationship to light scatter.
AB  - The autofluorescence profile of the lens was measured from 84 eyes of 84 patients
      with cortical, nuclear, posterior subcapsular, or mixed lens opacities.
      Measurements were performed with a fluorometer in the blue-green autofluorescence
      range (495 nm/520 nm). The mean maximum autofluorescence value differed in every
      cataract group statistically significantly from that of the age matched controls
      (p < or = 0.0058). The highest autofluorescence values were measured in nuclear
      and mixed cataract groups (p < 0.0001) with high and narrow autofluorescence
      profile. In cortical cataracts the curve was low and flattened and the mean
      maximum autofluorescence value was lower than in the control eyes (p < 0.0001).
      The maximum autofluorescence was related to lens coloration as well as to visual
      acuity only in nuclear cataract. The regression between maximum autofluorescence
      and light scatter was statistically significant only in the nuclear cataract
      group (p = 0.0004). Since the autofluorescence profiles differed not only in
      height but also in width between the cataract groups, various width/maximum
      autofluorescence ratios were measured. In nuclear and mixed cataract groups the
      ratio 75% width/maximum autofluorescence was statistically significantly lower
      than in other groups (p < 0.0001). In cortical cataracts the ratio (50% width -
      75% width)/maximum autofluorescence was statistically significantly higher than
      in other groups (p < 0.0001).

PMID- 8362641
TI  - Long-term effectiveness of modified grid laser photocoagulation for diffuse
      diabetic macular edema.
AB  - Fifty eyes of 42 patients with background diabetic retinopathy and diffuse
      macular edema were included in a prospective, randomized, clinical study to
      determine the long-term visual results of modified grid laser photocoagulation
      compared with the natural course of the disease. At the end of the three annual
      follow-up visits there were more eyes with improved visual acuity in the
      treatment group and more eyes with worse visual acuity in the control group.
      However, statistical analysis of the data showed that only at the end of the
      first and the second year was there a significant statistical difference between
      the two groups. At the end of the third year no statistically significant
      difference was found. These results suggest that modified grid laser
      photocoagulation is not an effective procedure for the long-term management of
      diffuse diabetic macular edema compared with the natural course of the disease.

PMID- 8362642
TI  - Natural course in fellow eyes of patients with unilateral age-related exudative
      maculopathy. A fluorescein angiographic 4-year follow-up of 45 patients.
AB  - A prospective fluorescein angiographic study of 45 patients with unilateral age
      related exudative maculopathy revealed at the 4-year follow-up that 14 (31%) had
      developed neovascular membranes in the fellow eyes. Age, drusen size and
      confluence, as well as pigmentary changes of these 14 were compared with the
      corresponding characteristics of the 31 eyes that remained non-exudative
      (atrophic). No significant differences were found. Among the 14 eyes that
      developed exudative maculopathy, visual acuity (Snellen) deteriorated 3-4 steps
      in 6 eyes (43%), 5-6 steps in 4 eyes (28.5%), and 7-8 steps or more in 4 eyes
      (28.5%). Among the 31 eyes that remained non-exudative, visual acuity was
      unchanged in 20 eyes (64%), deteriorated 1-2 steps in 7 eyes (23%), 3-4 steps in
      3 eyes (10%), and 5-6 steps in 1 eye (3%). Social blindness (6/60 or less in the
      better eye) was found among 79% of the patients who had developed exudative
      maculopathy, whereas the figure was 19% among patients who still had atrophic
      macular degeneration.

PMID- 8362643
TI  - Maculopathy caused by welding arcs. A report of 3 cases.
AB  - It is well known that radiation from welding arcs can cause keratoconjunctivitis
      and 'glassblower's cataract'. In literature only few cases of welding arc
      maculopathy have been reported. Three cases are presented.

PMID- 8362644
TI  - Results of Crawford tube intubation in children.
AB  - Between 1987-1991 we inserted Crawford tubes in the nasolacrimal system in 24
      children with recurrent epiphora following unsuccessful probing. Twenty-two are
      free of epiphora and discharge from 6 months to 4 years after the removal of
      tubes and 2 children show no improvement. Apart from mild epistaxis at the time
      of the tube insertion and tube displacement within 2 weeks of insertion in 3
      children, we report no other complications.

PMID- 8362645
TI  - Intraocular lens prediction and oculometric harmony. With special reference to
      skew ratios between axial length and corneal curvature radius.
AB  - The oculometric features have been analysed in two groups of cataract patients,
      each comprising 30 subjects. All had undergone ECCE and insertion of biconvex
      Rayner 2 Superflex posterior chamber IOL. Using Binkhorst and SRK II routinely,
      the groups were given by a good fit between methods (discrepancy between
      emmetropia predictions numerically < 1 D) and a poor fit (actual discrepancy
      range 1.6-4.1 D, all with the same sign, the lower values being predicted by
      Binkhorst). A certain overlapping between groups was found regarding axial length
      and corneal curvature radius, the ranges being 21.5-25.1/22.7-29.9 mm and 7.3
      8.5/7.2-8.1 mm, respectively. In contrast there was no overlapping regarding the
      ratio between axial length and corneal curvature radius; the ranges were 2.80
      3.05 and 3.06-3.90 in the two groups. Evaluating the actual prediction errors by
      the two methods (follow-up after at least 4 months), they did not primarily
      pertain to very short or very long eyes, as usually advanced. Skew ratios between
      axial length and corneal curvature appeared more decisive. Possible implications
      for the current IOL prediction formulas, including the newer generations, are
      discussed.

PMID- 8362646
TI  - The histopathological changes of keratoconus.
AB  - Seven keratoconus corneas and two normal corneas were examined in a light
      microscope. The histopathological changes are described with emphasis on
      breaklines in Bowman's layer. They seem to be a late and a secondary phenomenon.
      The severity of the findings are compared to the loss of visual acuity. It seems
      that there is no fixed correlation between the histopathological findings and the
      loss of visual acuity. Two of the keratoconus corneas showed the same
      histological changes as those found in the normal corneas.

PMID- 8362647
TI  - Bilateral intraocular pressure elevation and decrease of facility of aqueous
      humour outflow as a consequence of regional lymphoedema of head and neck.
AB  - Aqueous humour drainage to the deep cervical lymphatics has been proven in animal
      experiments, but there have been no observations of changes in intraocular
      pressure (IOP) or aqueous humour drainage as a consequence of lymph drainage
      dysfunction. The history of a patient with non-Hodgkin's lymphoma, who underwent
      a left-sided radical neck dissection in January 1991, is reported. From the end
      of 1991 lymphoedema of the head and neck, predominantly on the right side,
      developed without venous stasis but with significant bilateral IOP elevation and
      aqueous humour outflow reduction, refract to conventional treatment. Two days
      after cytostatic treatment the lymphoedema disappeared, and IOP and aqueous
      humour outflow became normal. Four days later the patient died because of an
      acute bronchopneumonia. The pathological examination revealed an intact internal
      jugular venous system, enlarged lymph nodes and, as a consequence of previous
      irradiation, cicatrization in the right side of the neck. On the left side, there
      was absence of the internal jugular vein and jugular lymphatic trunk due to
      previous radical neck dissection. Our case suggests that regional lymphatic
      stasis and the absence of the collateral drainage to the contralateral side
      significantly reduces the aqueous humour outflow and leads to a bilateral,
      secondary IOP elevation.

PMID- 8362648
TI  - Unintentional intraocular injection of corticosteroids.
AB  - In this report we present a patient on whom a sub-Tenon injection of steroids was
      performed, with the intention of treating an active chorio-retinitis threatening
      the macula. The globe was inadvertently penetrated and part of the steroid
      solution released into the vitreous cavity. Conservative treatment was decided
      upon and a spontaneous complete resolution of the complication was observed after
      a period of 24 days.

PMID- 8362649
TI  - Clinicopathology of a case with retinopathy of pancreatitis.
AB  - Bilateral retinopathy of pancreatitis developed in a 36-year-old male patient
      during recurrent acute necrotizing pancreatitis. The retinopathy remained
      clinically unchanged between the detection and the death 6 days later.
      Characteristics of the retinal lesions were histologically similar to cotton-wool
      spots of other origin, but all the retinal vessels including vessels around and
      in the cotton-wool spots were intact and contained plasma and red blood cells.
      Absence of vascular occlusion and endothelial damage suggests that in acute
      pancreatitis vascular embolisation in the retina is not necessary to the
      development of cotton-wool patches.

PMID- 8362650
TI  - High prevalence of myopia among medical students?

PMID- 8362651
TI  - [Correlation between the structures and physicochemical properties of
      chemotherapeutic fluoroquinolone agents].
AB  - The acid-base properties, the lipophilicity and the HPLC behaviour of nine
      antibacterial fluoroquinolone derivatives were studied to reveal relationship
      between these physico-chemical parameters and the chemical structure. Basicity of
      compounds with two proton-binding sites is depicted here in terms of protonation
      macro- and microconstants. The concentrations of microspecies (cation,
      zwitterion, neutral and anion) were calculated in the function of pH. The
      microspeciation of fluoroquinolones were used to derive relationship between the
      apparent and true octanol/water partition coefficients. An analysis of structure
      chromatographic behaviour has been performed utilizing the retention values was
      determined in a chromatographic system methanol-aqueous phosphate buffer/ODS.
      Close correlation was found between the lipophilicity and chromatographic
      behaviour of the tested compounds when pH dependence and the influence of an
      ionpairing agent were investigated.

PMID- 8362652
TI  - [Syntheses of potential drugs from 1-[bis(hydroxymethyl)methyl]-6,7-dialkoxy
      1,2,3,4-tetrahydrois o- quinolines].

PMID- 8362653
TI  - [The formulation aspects of drug liberation].
AB  - Author raised problems and showed through research data some simple possibilities
      to achieve controlled release drug liberation. The dosage form developed during
      drug formulation work may influence the biological effects exerted by the active
      ingredients and therefore may alter the therapeutic efficacy, too. The dosage
      from itself includes all the chemical properties of active ingredients (salt-,
      ester form, polar-apolar material etc.), the physical state (crystal, amorphous,
      polymorphous, particle size, surface area, solvated state etc.), the value of
      stability and the parameters of auxiliary materials and manufacturing processes.
      The aim of formulation -among others-is to achieve the optimal liberation and
      bioavailability of drugs. The article reviews the possibilities through examples
      (theophylline, nitrofurantoin, phenacetin, antacids) how to make production
      prescriptions with high reproducibility used for the preparation of prolonged
      action systems with controlled release drug liberation.

PMID- 8362654
TI  - [Degradation of succinylcholine chloride].
AB  - Quantitative thin-layer chormatographic method has been developed for the
      investigation of the degradation of injection formulations containing
      succinylcholinium chloride. The method is based on the denistometric
      determination of the main degradation product, choline at 430 nm after
      visualization with iodine vapour. The stability of the injection was investigated
      under various storage conditions and it has been stated that considerable
      decomposition takes place during as short a period as one week.

PMID- 8362655
TI  - [Research work in the Department of Pharmaceutical Technology of the Albert Szent
      Gyorgyi Medical University].
AB  - A short review is given of the research carried out in recent years in the
      Department of Pharmaceutical Technology headed by the author on the occasion of
      the 75th birthday of Professor Karoly Nikolics. The main results of the
      scientific activities performed in the four research groups are reported and a
      few important references to literature are made.

PMID- 8362656
TI  - NMR and time-resolved optical studies of brain imaging.
AB  - The classical optical method of the biochemist used in so many applications to
      determine stoichiometry kinetics, quantitative analysis of biochemical systems
      which was subsequently applied to tissue studies by G.A. Millikan and others
      seems now to have a new lease on life provided by time and frequency resolved
      studies which appear to afford the essential quantification lacking in the
      earlier methods. The fact that localization seems possible as well may bring the
      optical technology into the arena of new non-invasive technology capable of high
      sensitivity, high resolution and rapid data acquisition.

PMID- 8362657
TI  - IR thermal imaging of a monkey's head: local temperature changes in response to
      somatosensory stimulation.

PMID- 8362658
TI  - Optical access to the brain: how artificial are cranial window techniques?

PMID- 8362659
TI  - Multiparametric imaging of microregional circulation over the brain cortex by
      videoreflectometry.

PMID- 8362660
TI  - Towards imaging of cerebral blood flow and metabolism on a microscopical scale in
      vivo.

PMID- 8362661
TI  - Towards human brain near infrared imaging: time resolved and unresolved
      spectroscopy during hypoxic hypoxia.

PMID- 8362662
TI  - Diffusion properties of brain tissue measured with electrode methods and
      prospects for optical analysis.

PMID- 8362663
TI  - Measuring oxygen using oxygen dependent quenching of phosphorescence: a status
      report.

PMID- 8362664
TI  - Infrared-interference videomicroscopy of living brain slices.

PMID- 8362665
TI  - Blood-brain barrier transport measurements using PET-scanning and intravenous
      double indicator technique.

PMID- 8362666
TI  - Autoradiographic and biochemical imaging in cerebral ischemia.

PMID- 8362667
TI  - Measurement of human hypothermic cerebral oxygen metabolism by transmission
      spectroscopy.

PMID- 8362668
TI  - Optical CT imaging of hemoglobin oxygen-saturation using dual-wavelength time
      gate technique.
AB  - Our results may be summarized as follows: 1. In-vivo hemoglobin oxygen-saturation
      images of rat brain can be obtained using near-infrared light. 2. The transmitted
      light has multiple scattered components, which degrade spatial resolution, though
      most of the scattering can be excluded by a suitable time-gating technique. 3.
      The hemoglobin oxygen-saturation of the cerebellum is higher than that of the
      cerebrum in untreated anesthetized rats. Although further improvements in the
      technique should result in better resolution, we have demonstrated the
      feasibility of using near-infrared light to obtain in-vivo hemoglobin oxygen
      saturation images.

PMID- 8362669
TI  - Optical properties of normal human intracranial tissues in the spectral range of
      400 to 2500 nm.

PMID- 8362670
TI  - Optical imaging of the functional architecture in cat visual cortex: the layout
      of direction and orientation domains.

PMID- 8362671
TI  - Mapping of neural activity patterns using intrinsic optical signals: from
      isolated brain preparations to the intact human brain.

PMID- 8362672
TI  - Fiber optic imaging of subcortical neural tissue in freely behaving animals.

PMID- 8362673
TI  - Olfactory information processing in insects revealed by real-time optical imaging
      of intrinsic signals.

PMID- 8362674
TI  - Wavelength dependence of the differential pathlength factor and the log slope in
      time-resolved tissue spectroscopy.

PMID- 8362675
TI  - Infrared imaging of brain function.

PMID- 8362677
TI  - [Endoscopic correction of vesicoureteral reflux by Teflon].
AB  - From March 1988, 19 vesicoureteral reflux (VUR) patients were treated by
      endoscopic injection of Teflon paste. Of these patients 17 cases 27 ureters were
      followed for more than one year. After injection of Teflon paste, reflux was
      eliminated in 63%, decreased in 30%, and unchanged in 7%. Then 7 ureters were
      injected twice and 1 ureter three times. Finally, reflux was eliminated in 93% of
      all cases, and decreased in 7%. Early complications were fever up in 4 cases,
      flank pain 3, acute cystitis 1. In the follow up period, acute cystitis occurred
      in 1 patient, ureter stone in 1, and renal failure in 1. However, the ureter
      stone and renal failure were probably not caused by this procedure.

PMID- 8362676
TI  - [Dietary control for out-patients in urinary stone clinic].
AB  - We studied the dietary habits of 113 upper urinary tract stone formers and 24-h
      urine specimens before and after dietary control. Protein intake was decreased in
      male patients after dietary control but urinary risk factors were not changed
      significantly. The excretion of urinary risk factors (calcium, uric acid and
      oxalate) was decreased in the patients who had calcium excretion of more than 250
      mg per day or uric acid excretion more than 650 mg per day or oxalate excretion
      more than 45 mg per day before the control. The daily protein intake was
      significantly correlated to urinary uric acid, calcium, and phosphate excretion
      and the daily vitamin C intake to urinary citrate excretion. There was a negative
      correlation between the daily calcium intake and urinary oxalate. The mean stone
      episode rate of these patients was significantly decreased from 0.174 to 0.059
      stones per year by dietary control (p < 0.005).

PMID- 8362678
TI  - [Safety of bladder irrigation and usefulness of BLADMAN for bladder training in
      the patients with spinal cord injury].
AB  - First, we used BLADMAN system for bladder irrigation on 47 outpatients with
      spinal cord injury. A syphon phenomenon of BLADMAN was applied to irrigation of
      the bladder. Irrigating liquid was a physiological saline solution and its volume
      was 500-1,000 ml. Bladder irrigation was done for 1 to 2 hours. As a result of
      bladder irrigation by this system, urine was clearer and the number of leucocyte
      in urine was decreased. There was no trouble and no side effects occurred while
      using this system. BLADMAN is safe and considered to be applicable to the
      patients with spinal cord injury. Secondly, we used BLADMAN for bladder training
      to the patients with spinal cord injury. Bladder training was done for 7 to 28
      days on the patients with indwelling urethral catheter. The bladder function was
      compared before and after training. Bladder volume and compliance were
      significantly improved. There was no trouble while the patients used the BLADMAN
      system. We consider that the BLADMAN system is one of the best methods of bladder
      training for the patients with spinal cord injury.

PMID- 8362679
TI  - [Partial colpocleisis for vesicovaginal fistulas].
AB  - Four patients with a vesicovaginal fistula were operated upon transvaginally
      using the Latzko technique of partial colpocleisis. In 3 of the 4 patients, the
      fistulas had been formed after total hysterectomy for myoma uteri or
      endometriosis. The periods from fistulization-to-surgery intervals in these 3
      patients were 4 months, 12 months, and 4 years and 4 months, respectively. The
      fistulas in the remaining one patient had been formed after forceps delivery. The
      patient underwent surgery 8 days after delivery. An indwelling catheter was
      retained for 3 to 14 days after surgery. The 4 patients were all cured of
      vesicovaginal fistulas after a single operation. This paper describes our partial
      colpocleisis technique and discusses its clinical utility. The partial
      colpocleisis has the advantages of dispensing with such procedures as fistula
      excision, fistula opening suture, and suturation of the bladder musculature, and
      of closing the fistulas using a demucosated vaginal wall. Having minimal surgical
      invasiveness and being easy to perform and reliable, the technique appears to be
      excellent for coping with vesicovaginal fistulas.

PMID- 8362680
TI  - [Mainz pouch urinary diversion with appendix stoma].
AB  - The modified Mainz pouch urinary diversion was performed on 5 patients with
      bladder cancer using the submucosally embedded in situ appendix as a continence
      mechanism. It proved to be successful on 4 patients showing the complete urinary
      continence without difficulty in self catheterization. One patient became
      incontinent and a balloon catheter was retained. Advantages of the appendix stoma
      in the Mainz pouch are the reduction of the ileal segment to be isolated for
      creation of the pouch, relative simplicity of the operative technique, and the
      avoidance of use of foreign bodies such as metal staples or Marlex meshes.

PMID- 8362681
TI  - [Clinical study of the timed voiding schedule for urinary incontinence in
      demented elders].
AB  - Fourty-one demented elderly patients who had been diapered because of urinary
      incontinence in Hanwa-Senboku Hospital were treated with the one-week timed
      voiding schedule. Finally 14 patients (34%) became dry, and free from diapers for
      more than 1 week after the treatment. With regard to their cystometrogram
      findings, 10 (67%) of 15 patients having normoactive detrusor function, 3 (14%)
      of 21 patients having overactive detrusor function and 1 (20%) of 5 patients
      having underactive detrusor function became free from diapers after the
      treatment. Therefore a patient with normoactive detrusor function is thought to
      be a good candidate for the timed voiding schedule. Regardless of their detrusor
      function, those who showed good responsiveness to the treatment had better
      activities in daily life (better than D in the Katz index) and small amount of
      residual urine (less than 80 ml), indicating that not only the detrusor function
      but also both activities in daily life and the amount of residual urine are the
      important factors to reestablish voiding behavior in demented elderly patients.
      The timed voiding schedule is thought to be a useful method to treat incontinence
      in demented elderly patients, and should be tried first of all, although
      intermittent catheterization and/or other alternatives would be necessary for
      those with a large amount of residual urine with poor activities in daily life.

PMID- 8362682
TI  - [The characteristics of hormone responsiveness of glandular epithelium and stroma
      in male accessory sex organs].
AB  - We investigated the hormonal responsiveness of gland and stroma in the male
      accessory sex organs (ventral prostate, dorsolateral prostate and seminal
      vesicle). Immature rats (3 weeks old) were castrated and left untreated for 4
      weeks and then distributed at random into 3 groups, A, B, C. The rats in groups
      A, B and C were injected subcutaneously with 0.2 ml of soybean oil, 5 alpha
      dihydrotestosterone (DHT, 500 micrograms/day) or estradiol-17 beta (E2-17 beta, 5
      micrograms/day), respectively, for 14 days before they were killed. DHT
      administration in prepuberal castrates stimulated collagen synthesis and
      accumulation in the stroma of male accessory sex organs as well as the
      proliferation and differentiation of the glandular epithelium in these organs. In
      E2-17 beta treated rats, the glandular epithelium of ventral prostate and seminal
      vesicle had mostly a single layer structure, but the glandular epithelium of
      dorsolateral prostate had a mostly multilayer structure. On the other hand, in E2
      17 beta treated rats, the EMBP content, an indicator of glandular epithelium
      differentiation in male accessory sex organs, did not increase even in the
      dorsolateral prostate which showed a multilayer gland epithelium. Collagen
      synthesis and accumulation in the seminal vesicle was stimulated by E2-17 beta
      treatment several times as much as in the ventral and dorsolateral prostate.
      Histological investigation demonstrated that the seminal vesicle in prepuberal
      castrates treated with E2-17 beta resembled that of fibromuscular type human
      benign prostatic hyperplasia.

PMID- 8362683
TI  - [A case of retroperitoneal extramedullary plasmacytoma].
AB  - Extramedullary plasmacytoma (EMP) is a very rare disease and mainly arises in the
      head and neck area. We herein reported a case of EMP arising in the
      retroperitoneal space. A 46-year-old man was referred to our outpatient clinic in
      November 1989 with the complaint of flank pain on the left side. Radiological
      examinations showed a tumor formation in the retroperitoneal space, which
      involved the left kidney, spleen and pancreas. Immunoelectrophoresis showed an
      elevation of serum IgG level and a spike of M-protein was detected in the serum
      protein electrophoresis. No bone lesions were detected, and bone marrow
      aspiration showed no abnormal cells. US-guided needle biopsy of the tumor led to
      the histological diagnosis as plasmacytoma of the IgG-kappa type. Following three
      cycles of preoperative chemotherapy (a THP-COP regimen), which resulted in a size
      reduction of the tumor by 40%, extensive resection of the tumor including
      extirpation of the left kidney, spleen, and tail of pancreas was performed.
      Because of tumor extension into the posterior wall of the stomach, however, the
      surgery resulted in incomplete resection. A total of 11 cycles of postoperative
      chemotherapy (THP-COP) was performed periodically for the residual tumor in the
      stomach. Rapid tumor spreading in addition to re-elevation of the serum IgG
      level, however, developed after the 11th postoperative chemotherapy, which
      extensively involved the stomach and intestines. The patient died of the disease
      33 months after the initiation of treatment.

PMID- 8362684
TI  - [Multiple calcium oxalate stone formation in a patient with glycogen storage
      disease type I (von Gierke's disease) and renal tubular acidosis type I: a case
      report].
AB  - A case of multiple urinary stones in a patient with glycogen storage disease type
      1 (GSD-1) is reported. In spite of the presence of hyperuricemia, these stones
      did not consist of uric acid, but mainly of calcium oxalate. Laboratory studies
      revealed distal renal tubular acidosis and hypocitraturia, but no significant
      abnormality in calcium metabolism. We discussed the mechanism of calcium stone
      formation in our case, and its prophylactic treatment by oral administration of
      citrate compound.

PMID- 8362685
TI  - [Synchronous bilateral renal cell carcinoma in mass examination: a case report].
AB  - A 65-year-old female with bilateral renal cell carcinoma which was incidentally
      found by general check-up developed left hemiplegia following left nephrectomy.
      Marked metastasis of cervical spine was demonstrated by computerized tomography
      scanning, which was not evident before the operation by X-ray examinations. The
      patient died of respiratory paralysis one month after the operation. This case
      was difficult to treat, because the disease advanced so rapidly.

PMID- 8362686
TI  - [A case of bilateral synchronous renal cell carcinoma treated with partial
      nephrectomy with temporary occlusion of the segmental renal artery (segmental
      nephrectomy)].
AB  - We present a case of bilateral synchronous renal cell carcinoma. A 57-year-old
      man visited our hospital with a complaint of fever up. On ultrasonography and
      computerized tomography scan, a round tumor about 2.5 cm in diameter in the
      posterior portion of the right kidney and another tumor about 7 cm in diameter
      arising from the upper pole of the left kidney. Selective renal arteriogram
      showed that the inferior branch of the posterior segmental artery supplied blood
      to the right renal tumor. Left partial nephrectomy with temporary occlusion of
      the main renal artery and posterior segmental nephrectomy of the right kidney
      were performed at the same time. In patients with cancer confined to the
      posterior segment of the kidney, segmental nephrectomy can be performed while
      allowing unimpaired perfusion to the remainder of the kidney from the main renal
      artery.

PMID- 8362687
TI  - [Percutaneous resection of renal pelvic carcinoma: a case report].
AB  - A 72-year-old male patient underwent antegrade percutaneous resection of a
      solitary and papillary tumor in the lower calyx of left kidney. He had undergone
      right nephroureterectomy one month previously due to right nonfunctioning kidney
      caused by right ureteral carcinoma. Percutaneous electroresection of the tumor
      was performed after puncture of a lower calyx. Pathological findings revealed a
      grade 2 transitional cell carcinoma. Second look biopsy was done on the 11th
      postoperative day, which showed no residual tumor pathologically. Continuous
      instillation of mitomycin-C 50 mg/50 ml saline with 40 cm H2O pressure for one
      hour was done through the nephrostomy catheter once a day, totally 7 days as an
      adjuvant therapy. No side effect was noticed. Cytological, radiographic studies
      were negative 24 months after the treatment. We discuss the indication and
      technical aspect of percutaneous approach to renal pelvic carcinoma.

PMID- 8362688
TI  - [A case of prostatic carcinoma presenting as abdominal mass].
AB  - A 69-year-old man was admitted to the hospital on August 7, 1991 because of a
      lower abdominal mass. On physical examination, firm, rough-surfaced, unmovable
      masses of over fist size were palpable in the lower abdomen along with some small
      masses in the bilateral inguinal regions. On rectal examination the prostate was
      rough, hard and stony and larger than a chicken's egg in size. The serum
      prostatic acid phosphatase and prostatic specific antigen levels were elevated. A
      computerized tomography scan disclosed a large mass in the pelvis. Both a needle
      biopsy of the prostate and resection of an inguinal mass revealed moderately
      differentiated adenocarcinoma. Bone scintigram disclosed multiple metastases.
      Treatment with diethylstilbestrol diphosphate, etoposide, peplomycin and
      ifosfamide was effective, resulting in regressed intrapelvic masses and decreased
      serum prostatic acid phosphatase and prostatic specific antigen levels close to
      the normal limits. In November 1991, the patient was discharged and was surviving
      with the tumor as of August 1992.

PMID- 8362689
TI  - [A case of testicular tumor with liver metastases maintaining complete remission
      for a long period].
AB  - A 20-year-old man was admitted with multiple lung, liver and retroperitoneal
      lymph node metastases from right testicular tumor. The serum hCG level was
      170,000 mIu/ml. Orchiectomized right testis showed choriocarcinoma and teratoma
      pathologically. After 3 courses of chemotherapy of cisplatin, vinblastine and
      bleomycin, retroperitoneal lymph nodes were resected. Three courses of salvage
      chemotherapy of VP-16 (etoposide) were performed. The serum hCG level became
      normal and all metastases disappeared. For 37 months after operation there has
      been no recurrence of tumor. The 29 cases of testicular tumor with liver
      metastasis reported in the Japanese literatures during the last 7 years were
      discussed. The prognosis of testicular tumor with liver metastasis is very poor.
      However, adequate combination therapy might be effective for the far-advanced
      testicular tumor.

PMID- 8362690
TI  - [Pregnancy obtained by in vitro fertilization (IVF) with epididymal spermatozoa
      in obstructive azoospermia: report of two cases].
AB  - Epididymal spermatozoa aspiration was performed in two cases of obstructive
      azoospermia. After the procedure, in both cases, the patient's wives obtained
      twin pregnancies by this method in conjunction with in vitro fertilization (IVF)
      and embryo transfer (ET). The patient's wife in one case had a normal delivery.
      The patient's wife in the other case, however, aborted artificially because she
      had cerebral infarction. Epididymal spermatozoa aspiration proved efficacious for
      male sterility in cases of obstructive azoospermia.

PMID- 8362691
TI  - [Clinical studies of tosufloxacin on chronic bacterial prostatitis].
AB  - In a multicenter trial at 17 institutions, the usefulness of an oral dose of 300
      mg of tosufloxacin (TFLX) twice a day for 14 days were assessed in the management
      of chronic bacterial prostatitis (CBP) diagnosed by Meares and Stamey method.
      Nineteen patients who were evaluated by the UTI criteria were chosen out of the
      27 patients diagnosed with CBP. The isolated bacteria from EPS were 18 species
      and 27 strains. In terms of MICs of isolates, TFLX gave lower MICs than any of
      the control drugs (CPFX, NFLX, OFLX, CCL). In particular, this tendency was clear
      for gram-positive coccus and anaerobes. The bacteriological elimination rate
      obtained for 14 strains and 19 species was 89.5% (17/19) [GPC; 75.0% (6/8), GNR;
      100% (7/7), Anaerobes; 100% (4/4)]. The overall clinical efficacy by the UTI
      criteria was documented in 94.7% (18/19). According to the doctor's evaluation,
      the overall clinical efficacy rate was 68.4%. Safety evaluation revealed the
      development of gastrointestinal symptoms in 3 cases, which were not serious, with
      an incidence rate of 4.0% (3/75), while no laboratory abnormalities were
      observed. Transference of TFLX into the prostate is slightly lower than in other
      new quinolones. However, from this study we considered that the higher
      antibacterial activity of TFLX is one of the reasons for its usefulness for CBP.

PMID- 8362692
TI  - Paracervical vs. intracervical block during LEEP.

PMID- 8362693
TI  - Anomia as a symptom of herpes simplex encephalitis.

PMID- 8362694
TI  - Physicians and the flu vaccine.

PMID- 8362695
TI  - Calcium channel blockers in the treatment of hypertension.
AB  - Physicians need to weigh the efficacy, adverse effects and cost of first-line
      antihypertensive agents. Calcium channel blockers lower blood pressure, improve
      coronary blood flow and depress cardiac contractility by relaxing smooth muscle
      and cardiac muscle. They have beneficial or neutral effects in hypertensive
      patients with angina, asthma, chronic obstructive pulmonary disease, postural
      hypotension, peripheral vascular disease, depression, sexual dysfunction,
      diabetes and hyperlipidemia. The major adverse effect of some calcium channel
      blockers is that they may worsen congestive heart failure in some patients.
      Because calcium channel blockers are metabolized in the liver, the dosage must be
      lowered in the elderly and in patients with hepatic disease. Diltiazem, verapamil
      and nifedipine represent prototypes of the three classes of calcium channel
      blockers, each with slightly different effects.

PMID- 8362696
TI  - Emergency management of acute coma in children.
AB  - A deteriorating neurologic state in a child with an acute brain insult is a life
      threatening situation, and the decisions made during the first few minutes of
      management will frequently determine the outcome. Often, the family physician is
      the first person contacted by the parents to evaluate the sudden change in a
      child. Attention must be first directed toward ensuring an airway and maintaining
      adequate circulation. Computed tomographic study, toxicology screen and
      determination of acid-base status should follow. Possible causes of acute coma in
      children include trauma, child abuse, intracerebral hemorrhage, tumor, meningitis
      and poisoning.

PMID- 8362697
TI  - Obtaining an exposure history. Agency for Toxic Substances and Disease Registry.
      United States department of Health and Human Services, Public Health Service,
      Atlanta, Georgia.
AB  - Because many environmental diseases either manifest as common medical problems or
      have nonspecific symptoms, an exposure history is vital for correct diagnosis.
      The primary care physician can--by obtaining a thorough exposure history--play an
      important role in detecting, treating and preventing diseases caused by toxic
      exposure. The exposure history consists of three parts: exposure survey, which
      includes information about current and past exposure, and health and safety
      practices at work; work history, including all past jobs and military service;
      and environmental history, which includes information about the home environment.

PMID- 8362698
TI  - High-resolution CT of the lungs.
AB  - High-resolution computed tomography (CT) of the lung provides detailed
      visualization of the lung parenchyma. The technique involves the use of thin
      section axial tomography. High-resolution CT can facilitate the diagnosis of
      certain pulmonary processes. It is useful in differentiating similar patterns of
      abnormalities seen on chest radiographs, such as those seen in lymphangitic
      carcinomatosis and sarcoidosis, and in delineating the extent of co-morbid lung
      diseases, such as emphysema and asbestosis. In some chronic processes such as
      idiopathic pulmonary fibrosis, high-resolution CT can be used for biopsy of areas
      of active inflammation, thus increasing the diagnostic yield. As clinicians and
      radiologists become more familiar with high-resolution CT, it is likely that its
      role in the diagnosis and assessment of lung disease will increase.

PMID- 8362699
TI  - NIH recommends universal screening of infants for hearing impairment.

PMID- 8362700
TI  - AIDS update.

PMID- 8362701
TI  - The birth and progress of the first heart journal.

PMID- 8362702
TI  - Mechanisms of angiographically successful directional coronary atherectomy:
      evaluation by intracoronary ultrasound and comparison with transluminal coronary
      angioplasty.
AB  - To assess the mechanisms of luminal improvement, 40 patients undergoing
      directional coronary atherectomy and a matched control group of 25 patients
      undergoing angioplasty were evaluated with intracoronary ultrasound imaging
      before and after intervention. Despite similar sized vessels, a similar
      angiographic severity of diameter stenosis (75 +/- 12% for the angioplasty group
      vs 69 +/- 15% for the atherectomy group, p = NS), and a similar plaque burden
      (percent plaque area) before intervention (84 +/- 5% in the angioplasty group vs
      85 +/- 13% in the atherectomy group, p = NS), the residual plaque area after
      intervention was significantly smaller in the atherectomy group (54 +/- 14%)
      compared with the angioplasty group (65 +/- 13%, p = 0.002). Despite excellent
      angiographic results, significant residual plaque was noted after either
      successful intervention. Based on the absolute changes in lumen area, plaque
      area, and vessel area, improvement in the lumen area in the atherectomy group
      occurred as a result of plaque "compression" (48%), plaque removal (37%), and
      vessel expansion (15%). In the angioplasty group, plaque "compression" accounted
      for 94% of the improvement in lumen area, whereas vessel expansion contributed
      6%. Thus "compression" of plaque remains the major mechanism of luminal
      improvement during atherectomy.

PMID- 8362703
TI  - Heterogeneity of reperfusion after reversible regional myocardial ischemia in a
      canine model.
AB  - Variability of regional myocardial blood flow (RMBF) during reflow after 20
      minutes of left anterior descending (LAD) coronary occlusion was measured by the
      radioactive microsphere technique in nine open-chest dogs. Preocclusion RMBF in
      the LAD territory was 0.89 +/- 0.27 ml/min/gm. Twenty minutes of LAD occlusion
      resulted in uniform and severe ischemia (RMBF < or = 0.25 ml/min/gm). After 1
      minute of reperfusion, RMBF in the LAD territory rose to 3.48 +/- 1.88 ml/min/gm,
      and declined to 1.06 +/- 0.29 ml/min/gm after 20 minutes of reperfusion. RMBF
      variance increased significantly from 0.046 preocclusion to 0.2857 after 1 minute
      of reperfusion (p < 0.01) and declining to 0.086 after 20 minutes of reperfusion.
      By contrast, RMBF variance analysis of myocardial segments from the nonischemic
      left circumflex territory exhibited no significant change throughout the
      experiment. In any given dog this heterogeneous reperfusion of previously
      ischemic tissue resulted in a disorganized topography of blood flow rates.
      Myocardium with relatively high regional flow was intermingled with islands of
      tissue with relatively low blood flow. In conclusion, despite a relatively
      uniform and severe myocardial ischemic insult, the subsequent initial hyperemic
      response during reperfusion exhibits marked spatial heterogeneity. The
      juxtaposition of myocardial regions exposed to vastly differing rates of oxygen
      delivery and washout of toxic metabolites may set the stage for nonuniform
      recovery of myocardial function.

PMID- 8362704
TI  - Sex-related differences in patients undergoing direct angioplasty for acute
      myocardial infarction.
AB  - Important sex-related differences have been recognized in several coronary artery
      disease presentation and treatment subsets. Little data exist describing the
      relative findings and outcome in women versus men who received direct
      percutaneous transluminal coronary angioplasty for acute myocardial infarction.
      We studied 670 such patients of whom 464 (69%) were men and 206 were women. The
      women were significantly older (67 +/- 11 years vs 61 +/- 11, p < 0.001) but had
      undergone less prior coronary artery bypass graft surgery (6% vs 12%, p = 0.02),
      whereas prior myocardial infarction (17% women vs 22% men) and coronary artery
      disease distribution were not significantly different. Forty-one percent of women
      and 43% of men had single-vessel disease (p = NS). Both women and men had 1.5
      lesions/patient dilated acutely, with similar success rates (95% women, 91% men;
      p = 0.08). Mean ejection fractions were similar (48% in both groups), and a
      similar percentage in each group had an ejection fraction < 30% (10% women vs 13%
      men). Over a mean follow-up period of 86 weeks, the need for repeat
      catheterization was frequent and was similar in both groups (44% women, 47% men;
      p = NS), whereas documented restenosis was less common in women (20% vs 28% of
      patients, p < 0.05). The need for coronary artery bypass grafting was similar
      (15% women, 17% men; p = NS), as was the need for repeat percutaneous
      transluminal coronary angioplasty in the infarct vessel (14% women, 18% men; p =
      NS) and overall mortality (7% women, 9% men; p = NS).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8362705
TI  - The relationship of inferior ST depression, lateral ST elevation, and left
      precordial ST elevation to myocardium at risk in acute anterior myocardial
      infarction.
AB  - The purpose of this study was to examine the relationship between the presence or
      absence of ST segment depression in inferior leads (II, III, and aVF) and ST
      segment elevation in lateral (I and aVL) or left precordial (V5 and V6) leads
      with the amount and location of myocardium at risk for infarction in patients
      with acute anterior myocardial infarction. Forty-three patients with anterior
      infarctions were injected with technetium 99m-sestamibi when they were first seen
      and underwent tomographic imaging to measure the amount and location of
      myocardium at risk. Patients with inferior ST depression (n = 10) compared with
      those without ST depression (n = 33) had perfusion defects that extended
      significantly further into the lateral wall (47 degrees vs 20 degrees, p = 0.04)
      and larger anterior injury vectors (6.47 vs 4.92, p = 0.008). There was no
      significant association with the percentage of myocardium at risk, disease of the
      right coronary artery, the presence of an inferior perfusion defect, or the size
      of the inferior injury vector. Among the patients with ST elevation in lateral
      leads (n = 16) compared with those without (n = 27), there was a significantly
      more lateral defect border (47 degrees vs 25 degrees, p = 0.007) and a larger
      anterior injury vector (6.07 vs 4.81, p = 0.01). There was no significant
      correlation with the percentage of myocardium at risk. A significant relationship
      could not be demonstrated between the presence of ST elevation in the left
      precordial leads and any measure of the amount or location of myocardium at risk.
      These data support the theory that inferior ST depression in patients with
      transmural anterior ischemia is a "reciprocal" finding and does not represent
      inferior ischemia. The presence of inferior ST depression or lateral ST elevation
      is associated with a more lateral perfusion defect. Neither of these ECG findings
      is associated with the amount of myocardium at risk for infarction.

PMID- 8362706
TI  - 99mTc-antimyosin antibody imaging for the detection of acute myocardial
      infarction in human beings.
AB  - 111In-antimyosin imaging is a highly sensitive and specific technique for the
      detection of myocardial necrosis. Two new methods of labeling antimyosin with
      99mTc have been developed, and were compared with the standard 111In-antimyosin
      imaging technique in 29 patients with acute myocardial infarction. Fourteen
      patients (group I) received directly labeled 99mTc-antimyosin, and 15 (group II)
      were given RP-1 conjugated 99mTc-antimyosin. 99mTc-antimyosin imaging was
      performed at 6, 12, and 24 hours, and 111In-antimyosin imaging was done at 24 and
      48 hours following injection. The images were interpreted by three blinded
      observers. In group I, 99mTc-antimyosin uptake could be detected in 3, 6, and 12
      cases at 6, 12, and 24 hours, respectively, compared with only 8 cases at 24
      hours with 111In-antimyosin. At 48 hours all patients showed 111In-antimyosin
      uptake. In group II, 99mTc-antimyosin uptake could be detected in 2, 3, and 6
      cases at 6, 12, and 24 hours, respectively, compared with 8 and 12 cases at 24
      and 48 hours, respectively, with 111In-antimyosin. Gated blood pool studies could
      be obtained in all patients following 99mTc-antimyosin injection and could be
      used to identify regional wall motion abnormalities. The plasma half-lives of
      99mTc-antimyosin in group I and group II were 2.67 +/- 0.3 hours and 4.23 +/- 0.3
      hours, respectively, and the plasma half-life of 111In-antimyosin was 6.3 +/- 0.4
      hours.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362707
TI  - The effects of chronic oral milrinone therapy on early postinfarction left
      ventricular remodeling.
AB  - Left ventricular remodeling following acute transmural myocardial infarction may
      result in early left ventricular enlargement. To characterize the effects of
      milrinone on components of early left ventricular dilation, rats (n = 120)
      underwent left coronary artery ligation or sham surgery. In the immediate
      postoperative period, rats received either no treatment or milrinone (3.17 +/-
      0.08 mg/kg/day) dissolved in drinking water for 20 days. Twenty-one days after
      the initial surgery, hemodynamic measurements were made. The rats were then put
      to death and the hearts arrested in diastole were excised and fixed at a constant
      pressure for morphometric analysis. To examine the effects of milrinone on the
      relative contribution of infarcted and noninfarcted segments to early left
      ventricular dilation after acute myocardial infarction, a subgroup of infarcted
      rats chosen randomly was put to death 3 days after the initial surgery for
      morphometric analysis. Compared with infarcted untreated rats, infarcted
      milrinone-treated rats had a lower left ventricular volume (1.41 +/- 0.07 ml/kg
      vs 2.16 +/- 0.19 ml/kg, p < 0.001), lower left ventricular wall stress (0.64 +/-
      0.03 vs 0.91 +/- 0.06, p < 0.001), and a lower expansion index (1.61 +/- 0.12 vs
      2.61 +/- 0.22, p < 0.001). Morphometric analysis revealed that the noninfarcted
      segment length did not differ between the two infarcted groups either 3 days or
      21 days after left coronary artery ligation. Infarct segment length also did not
      differ between the two infarcted groups at 3 days, but at 21 days infarct segment
      was shorter in the milrinone-treated group compared with the untreated group (p <
      0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362708
TI  - Comparison of the natural history of irregular and smooth coronary lesions:
      insights into the pathogenesis, progression, and prognosis of coronary
      atherosclerosis.
AB  - The coronary arteriograms of 255 patients who had two to four arteriograms within
      2.6 +/- 1.7 years were reviewed. Two hundred three patients had lesions on at
      least one arteriogram; among the 167 patients without coronary surgery, there
      were 48 complex irregular lesions (suggesting a ruptured plaque and/or
      thrombosis) and 141 smooth lesions with follow-up, and 73 irregular and 164
      smooth lesions with preceding arteriograms available. Severe irregular lesions (>
      or = 90% diameter occlusion) progressed to total occlusion (46%) more often than
      did severe smooth lesions (11.5%) (p < 0.01). Less severe lesions usually did not
      progress, with no difference in incidence of progression between irregular and
      smooth lesions (27.8% vs 23.9%). Irregular lesions > or = 80% usually occurred as
      a result of progression in less severe smooth lesion or occurred in areas that
      were minimally diseased or appeared normal, whereas smooth lesions > or = 80% had
      usually not changed since the previous arteriogram. Irregular lesions very rarely
      became smooth. A study of lesions in 36 patients with surgery was confirmatory.
      We conclude that plaque rupture is a common mechanism for progression of coronary
      disease but is not a common pathway for the growth of smooth lesions; irregular
      lesions remain irregular for years. There is no relationship between the severity
      of smooth plaques and their likelihood to rupture. Progression of coronary
      disease can occur by either of two modes: (1) gradual growth of a smooth-walled
      plaque or (2) plaque rupture with marked progression to a severe irregular
      lesion. Because most smooth and most irregular lesions remain stable for years,
      except possibly for > or = 90% irregular lesions, there is no anatomic finding
      that justifies urgent revascularization. Instability is a clinical diagnosis.

PMID- 8362709
TI  - Angiographic suitability for catheter revascularization of total coronary
      occlusions in patients from a community hospital setting.
AB  - To assess the frequency of totally occluded coronary arteries and their
      angiographic suitability for catheter-based revascularization in an unselected
      patient population, all coronary angiograms showing > or = 50% diameter stenosis
      obtained from patients in a community hospital setting, were reviewed during a 1
      year period. There were 112 totally occluded arteries in 101 patients (35%).
      Based on coronary morphologic variables previously identified as predictive of
      successful revascularization, 52 (46%) totally occluded arteries were judged
      suitable for coronary angioplasty. Totally occluded arteries with unfavorable
      features for coronary angioplasty were present in 29% of patients with
      multivessel coronary artery disease and were more commonly present in the right
      coronary artery. Thus totally occluded coronary arteries are found in
      approximately one third of patients with suspected or known coronary artery
      disease studied by means of coronary arteriography in a community hospital
      setting. Approximately one half of the total occlusions have features favoring
      successful coronary angioplasty.

PMID- 8362710
TI  - Immediate and 6-month follow-up results of coronary angioplasty for restenosis:
      analysis of factors predicting recurrent clinical restenosis.
AB  - To determine the results of coronary angioplasty for a first restenosis, the
      clinical, anatomic, and procedural data of 400 consecutive patients were compared
      with the data of 507 consecutive patients undergoing a first angioplasty. After
      angioplasty for restenosis, emergency redilatation had to be performed in only
      0.7% of the patients versus 3.1% of the control group (p = 0.02); nevertheless,
      the major in-hospital event (death, myocardial infarction, emergency coronary
      surgery, cerebrovascular accident) rate for patients was only slightly lower
      (3.3% vs 4.2%, p = NS). During the 6-month follow-up period, there were no
      cardiac deaths and only two myocardial infarctions in the study group, but
      recurrent ischemia was more frequent (37% vs 31%, p = 0.05) and resulted in
      considerably more elective coronary surgery (16% vs 2.6%, p = 0.001). In the
      study group, stepwise discriminant analysis revealed four variables significantly
      related to the occurrence of a second restenosis: time interval between first and
      second angioplasty, male gender, severity of angina, and complexity of the
      restenotic lesions. However, their individual predictive power was low. In
      conclusion, compared with angioplasty for primary lesions, angioplasty for
      restenosis was associated with fewer periprocedural complications and, after a 6
      month follow-up, serious cardiac events were almost nonexistent but recurrent
      ischemia was more frequent.

PMID- 8362711
TI  - Usefulness of exercise SPECT-thallium to detect asymptomatic restenosis in
      patients who had angina before coronary angioplasty.
AB  - The usefulness of exercise single photon emission computed tomography (SPECT)
      thallium for detecting asymptomatic restenosis was assessed prospectively in 62
      patients with angina before angioplasty, who underwent < or = 6-month re
      angiography and exercise SPECT-thallium imaging. Among patients with restenosis,
      nine had recurrence of angina but eight did not. These two subgroups had
      equivalent percentages of restenosis (71 +/- 16% vs 64 +/- 16%, NS) and extent of
      reversible thallium defects (2.8 +/- 1.7 vs 4.1 +/- 2.6, NS), and both subgroups
      had poorer hemodynamic responses to exercise compared with patients without
      restenosis (maximal) rate-pressure product [X 100], 258 +/- 54 and 239 +/- 33 vs
      302 +/- 61; p < 0.05 and p < 0.01, respectively). Exercise testing detected fewer
      patients with restenosis compared to exercise SPECT-thallium imaging, especially
      among asymptomatic patients (25% vs 100%, p < 0.005). Asymptomatic restenosis
      occurs frequently, induces an amount of stress ischemia equivalent to that of
      symptomatic restenosis, and is efficiently detected by exercise SPECT-thallium
      with rest-reinjection but not by exercise testing.

PMID- 8362712
TI  - Myocardial perfusion scintigraphy in left bundle branch block: a perspective on
      the issue from image analysis in a clinical context.
AB  - Among selected study populations, myocardial perfusion scintigraphy (MPS) in
      patients with left bundle branch block (LBBB) has been reported to show a low
      specificity for the diagnosis of coronary disease. However, the stress
      electrocardiogram (ECG) is nondiagnostic in this setting. To place this method in
      its appropriate clinical context, we evaluated MPS in all 69 consecutive patients
      with LBBB studied with scintigraphy for clinical reasons during a 4-year period.
      Among 32 patients who underwent coronary angiography for clinical indications,
      per patient sensitivity, 96%; per vessel sensitivity, 84%, 50%, and 100% for left
      anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA)
      involvement, respectively; and per vessel specificity, 95% and 68% for LCX and
      RCA disease, respectively, were not significantly different from those previously
      published for the method in patients without LBBB. Although per patient
      specificity, 38%, and specificity, 39%, for LAD disease were low, the predictive
      value of a positive test remained relatively high (83%) owing to the small number
      of patients selected for angiography, in part based on scintigraphic findings,
      with normal coronary anatomy. In addition to a possible specific pathophysiologic
      cause related to LBBB, apparent perfusion abnormalities in the LAD distribution
      may relate to generic conditions that can make scintigraphic interpretation
      ambiguous, often in the anterior distribution, regardless of the clinical
      setting. Additionally, the apparent lack of scintigraphic specificity in the LAD
      distribution could relate in part to a selection bias toward catheterization of
      patients with induced scintigraphic abnormalities, especially in the LAD
      distribution.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362713
TI  - Effect of antianginal agents on the relationship between rate-pressure product
      and myocardial oxygen uptake.
AB  - To evaluate the effects of antianginal agents on the correlation between rate
      pressure product and myocardial oxygen uptake, multistage supine leg exercise
      tests were performed by 21 patients with stable effort-induced angina pectoris
      before and after administration of antianginal drugs (a calcium channel blocker
      of the dihydropyridine class [10 mg of nisoldipine orally] in 11 patients and a
      beta-blocker [0.2 mg/kg of propranolol intravenously] in 10 patients). The rate
      pressure product was closely correlated with myocardial oxygen uptake before and
      after administration of each drug. However, the slope of the regression line of
      rate-pressure product (X) and myocardial oxygen uptake (Y) became significantly
      steeper after the calcium channel blocker administration, and the Y-intercept was
      significantly increased by administration of the beta-blocker. Myocardial oxygen
      uptake was increased after administration of the calcium channel blocker and the
      beta-blocker compared with control values at corresponding rate-pressure product.
      These observations should be considered when the rate-pressure product is used to
      predict myocardial oxygen uptake in patients with angina pectoris who are
      receiving antianginal drugs.

PMID- 8362714
TI  - Visual versus quantitative assessment of the severity of coronary artery
      stenoses: can the angiographer's eye be reeducated?
AB  - The percent reduction of intraluminal diameter of 102 coronary stenoses before (n
      = 26), immediately after (n = 24), and 6 months after (n = 52) coronary balloon
      angioplasty as assessed by two observers experienced in quantitative coronary
      angiography and by automated measurement by means of the Cardiovascular
      Angiographic Analysis System (CAAS) was compared. Two hundred twenty-seven still
      frames were selected for analysis by CAAS and displayed for assessment by each of
      the observers, who were unaware of CAAS results. Comparisons with CAAS
      measurements were made for all still frames ("per view" analyses) and for each
      coronary stenosis after averaging the values obtained for a given coronary
      segment ("per stenosis" analyses). Intraobserver variability was tested on 21
      still frames from 10 stenoses, assessed 6 weeks apart by one observer.
      Intraobserver variability was 5% (r = 0.98); interobserver variability was 6% (r
      = 0.94). Per view analyses showed that observer measurements correlated well with
      CAAS measurements (r = 0.89 and r = 0.90); the accuracy was -0.9% and -0.7% for
      observers 1 and 2, and the precision was 9% and 8%, respectively; for per
      stenosis analyses, the accuracy was -0.5% and -0.8% (r = 0.92 and 0.94) and the
      precision 7% and 6%, respectively. There was no difference in the accuracy and
      precision of visual assessment for lesions with < 50%- or > 50%-diameter
      stenoses. The occurrence of restenosis was likewise detected visually with a high
      sensitivity and specificity compared with CAAS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362715
TI  - Coronary artery diameter and coronary risk factors: a study with ultrafast
      computed tomography.
AB  - Coronary artery dilation has been described as an early effect of
      atherosclerosis. No noninvasive technique has been available to measure coronary
      size. In this study coronary diameters were measured in 100 asymptomatic subjects
      (89 men and 11 women, mean age 40 +/- 6 years) by means of ultrafast computed
      tomography (UFCT), with 3 mm thick ECG gated scans. Subjects without evidence of
      coronary calcium were studied. The diameter of the left main (LD) and right (RD)
      coronary arteries were measured. Total coronary diameter, TD = LD + RD, was
      determined, and univariate analysis was performed with respect to total, high
      density lipoprotein and low-density lipoprotein cholesterol, mean blood pressure,
      age, body surface area, and triglycerides. Mean LD was 4.23 +/- 0.85 mm, and mean
      RD was 3.06 +/- 1.08 mm. TD increased with body surface area (p < 0.001). No
      other variable showed any significant effect on TD in this group without evidence
      of atherosclerosis. UFCT can be used to noninvasively measure coronary artery
      diameters and may be a useful technique to detect early changes of
      atherosclerosis in individual patients and in population studies.

PMID- 8362716
TI  - Medical diagnosis of type A behavior.
AB  - The objective of this investigation was to develop a medically oriented
      examination (including a search for physical signs in addition to elicitation of
      symptoms) for the accurate diagnosis of type A and type B behaviors. Comprising
      the study were 99 post-myocardial infarction patients, 15 clinically well persons
      in whom clinical coronary heart disease subsequently developed, and 23 healthy
      type B subjects. All participants were subjected to a videotaped clinical
      examination during which, in addition to eliciting responses to questions, 14
      possible physical or psychomotor signs (many of which are newly discovered) of
      type A behavior were also observed. Each physical sign and symptom was given an
      arbitrarily weighted score (according to its observed frequency of occurrence in
      previously studied and authenticated type A behavior). These total scores were
      then statistically analyzed to obtain a critical "diagnostic score" for the
      presence of type A behavior. The medically oriented videotaped clinical
      examination detected the presence of type A behavior in 97 of 99 (98%)
      successively examined postinfarction patients and in 14 of 15 (93%) subjects who
      were clinically well at the time of their videotaped clinical examination but who
      subsequently had clinical coronary heart disease. Conversely type A behavior was
      diagnosed by videotaped clinical examination in only 1 of 23 (4%) healthy men who
      previously had been found to exhibit type B behavior by prior diagnostic
      procedures.

PMID- 8362717
TI  - Usefulness of serial follow-up electrophysiologic studies in predicting late
      outcome of radiofrequency ablation for accessory pathways and atrioventricular
      nodal reentrant tachycardia.
AB  - A total of 408 patients received radiofrequency catheter ablation for paroxysmal
      supraventricular tachycardia, and 326 patients underwent serial follow-up
      electrophysiologic studies (early and late) after initially successful
      radiofrequency catheter ablation of accessory pathways (group 1, 186 patients
      with Wolff-Parkinson-White syndrome) and slow atrioventricular (AV) nodal
      pathways (group 2, 140 patients with AV nodal reentrant tachycardia). Among the
      patients in group 1, early (4 +/- 1 days) and late (129 +/- 14 days) studies
      found recurrent conduction through the accessory pathways in 12 and 16 patients,
      respectively. During a follow-up period of 21 +/- 7 months, recurrence of
      accessory pathway-mediated tachyarrhythmias was noted in six patients. Of these
      six patients, all had tachycardia inducible in the late study but not in the
      early study. Among the patients in group 2, four had recurrence of AV nodal
      reentrant tachycardia during a follow-up of 16 +/- 6 months. Of the four
      patients, one had tachycardia inducible in the early (4 +/- 1 days) study and
      three in the late (130 +/- 12 days) study. The results demonstrated that the
      early study was not as sensitive as the late follow-up electrophysiologic study
      in predicting late outcome of radiofrequency ablation, but both the early and
      late studies had a high total predictive accuracy (> 90%) in groups 1 and 2.
      Furthermore, only 4 of the 326 patients had initial evidence of recurrent
      tachycardia activated by programmed electrical stimuli during follow-up studies,
      suggesting that follow-up electrophysiologic studies in asymptomatic patients are
      not warranted.

PMID- 8362718
TI  - New approach to the estimation of the extent of myocardial fibrosis in patients
      with dilated cardiomyopathy: use of signal-averaged electrocardiography.
AB  - To determine whether the extent of myocardial fibrosis in dilated cardiomyopathy
      could be estimated noninvasively, signal-averaged electrocardiograms were
      recorded in 32 patients with dilated cardiomyopathy, followed by left ventricular
      endomyocardial biopsy. The root mean square voltage for the last 40 msec (V40),
      the duration of the filtered QRS complex (fQRSd) and the duration of low
      amplitude signals < 40 microV (LAS) were obtained by signal-averaged
      electrocardiography. The extent of fibrosis in all biopsy samples was measured by
      the point-counting method. The extent of myocardial fibrosis closely correlated
      with fQRSd (r = 0.623, p < 0.001), LAS (r = 0.570, p < 0.001), and V40 (r = 
      0.355, p < 0.05). When fibrosis was classified into intercellular and
      interfascicular types, the extent of intercellular fibrosis more closely
      correlated with fQRSd (r = 0.695, p < 0.0001), LAS (r = 0.640, p < 0.0001), and
      V40 (r = -0.533, p < 0.005). These results suggest that signal-averaged
      electrocardiograms might be useful for estimation of the extent of myocardial
      fibrosis, especially intercellular fibrosis in patients with dilated
      cardiomyopathy.

PMID- 8362719
TI  - Spectrum and outcome of congestive heart failure in a hospitalized population.
AB  - There are very few contemporary studies on the frequency and cause of congestive
      heart failure (CHF) in a general population. In western Sweden, inhabited by 1.64
      million people, a retrospective survey was performed. All hospital records of
      patients with CHF, ages 16 through 65 years, were examined in all hospitals in
      the region. During the study period 2711 patients fulfilled the criteria for CHF
      or cardiomyopathy. Patients were monitored for 37 +/- 28 months. The most common
      cause of heart failure was coronary artery disease (IHD) (40%). Other common
      causes were hypertension (17%), valvular disease (13%), alcohol (11%), diabetes
      mellitus (10%), and systemic diseases (10%). There were positive correlations
      between the male sex and IHD, alcohol, and dilated cardiomyopathy; the female sex
      was associated with systemic diseases, valvular heart disease, and diabetes. The
      incidence of CHF requiring hospitalization per 100,000 in the population was 1.2
      to 263 men and 1.1 to 129 women, in the youngest (age 16 to 30 years) and oldest
      (61 to 65 years) age groups, respectively. The 5-year survival rate was 50%.
      Analysis of causes performed with Cox's proportional hazards model for survival
      showed that age, IHD, alcohol, and diabetes were independent and powerful
      predictors of mortality (p < 0.001). The mode of death was progressive heart
      failure in 54% and sudden death in 26%. We concluded that the prognosis in
      patients with CHF was still very poor, even among this young population. The most
      common cause of CHF was IHD, and the second was hypertension.

PMID- 8362720
TI  - Ovarian vein thrombosis.
AB  - We report five cases of OVT and review the literature on this disease. Among our
      patients OVT was not suspected clinically and was diagnosed by CT scanning or
      MRI. Ultrasound imaging, utilized in three cases, failed to detect OVT. Although
      this disease usually occurs after delivery, in two cases it was diagnosed before
      delivery. Of the two postpartum cases, one had a typical presentation and the
      other was asymptomatic. The final case was diagnosed incidentally 5 months after
      removal of an ovarian carcinoma. Our experience suggests that this disease may be
      underdiagnosed. More widespread use of CT scanning and MRI may lead to more
      frequent diagnosis of OVT. The role that clinically silent OVT may play in
      peripartum pulmonary embolism should be clarified.

PMID- 8362721
TI  - The cardiologist's approach to evaluation and management of the patient with
      essential hypertension.

PMID- 8362722
TI  - Evolution of echocardiographic modalities in detection of postmyocardial
      infarction ventricular septal defect and papillary muscle rupture: study of 62
      patients.
AB  - Diagnostic sensitivity of various echocardiographic modalities was assessed for
      postinfarct ventricular septal defect (40 patients) and papillary muscle rupture
      (22 patients). Two-dimensional transthoracic echocardiography enabled direct
      visualization of ventricular septal defect in 68% and combined two-dimensional
      Doppler echocardiography was diagnostic in 95%. Papillary muscle rupture was
      directly visualized in 45%, and severe mitral regurgitation was present on
      Doppler color flow images in 100%. Transesophageal echocardiography was
      diagnostic in all nine patients (five with ventricular septal defect and four
      with papillary muscle rupture) in whom this modality was applied. Thus two
      dimensional Doppler echocardiography (transthoracic and transesophageal if
      necessary) is highly sensitive in detecting postinfarct ventricular septal defect
      and papillary muscle rupture.

PMID- 8362723
TI  - Biplane transesophageal pacing echocardiography compared with dipyridamole
      thallium-201 single-photon emission computed tomography in detecting coronary
      artery disease.
AB  - TPE is a new diagnostic technique that uses simultaneous graded transesophageal
      left atrial pacing and biplane transesophageal echocardiography for the detection
      of pacing-induced wall motion abnormalities. In a prospective study 30 patients
      underwent biplane TPE, dipyridamole thallium-201 single-photon emission computed
      tomography (SPECT), and coronary arteriography. The sensitivity (86% vs 95%, p =
      not significant [NS]), specificity (89% vs 56%, p = NS), positive predictive
      value (95% vs 73%, p = NS), and negative predictive value (83% vs 83%, p = NS) of
      biplane TPE and thallium-201 SPECT in identifying patients with significant
      coronary artery disease was similar. In the 90 vascular territories analyzed, the
      agreement between biplane TPE and thallium-201 SPECT for presence or absence of
      significant disease was 71%. Analysis of the three major vascular territories
      demonstrated that each imaging modality had a high sensitivity and specificity in
      the left anterior descending and right coronary artery segments. However, the two
      techniques demonstrated poorly sensitivity in the segmental distribution of the
      circumflex coronary artery. In conclusion, biplane TPE compared favorably with
      thallium-201 SPECT in terms of safety and accuracy for detecting significant
      coronary artery disease. Accordingly, biplane TPE may be a suitable alternative
      for those patients with nondiagnostic thallium-201 SPECT studies and in those
      with contraindications to adenosine or dipyridamole.

PMID- 8362724
TI  - Interventional electrophysiology--state-of-the-art 1993.
AB  - The field of clinical electrophysiology has broadened significantly in the last
      several years, spawning a new discipline known as Interventional or Therapeutic
      Electrophysiology. In the United States, Electrophysiology has its own training
      path and accreditation requirements. One of the reasons for the growth of
      interest in electrophysiology is the exciting introduction of nonpharmacologic
      methods of arrhythmia therapy, including curative radiofrequency catheter
      ablation and implanted devices for antitachycardia pacing/defibrillation. The
      arrhythmia specialist now has at his/her disposal a wide range of options for
      patients with symptomatic or life-threatening cardiac arrhythmias.

PMID- 8362725
TI  - Successful very early in-office treatment of stress test-induced myocardial
      infarction with anistreplase.

PMID- 8362726
TI  - Release of immunoreactive endothelin from the heart during percutaneous
      transluminal coronary angioplasty.

PMID- 8362727
TI  - Postinfarction left ventricular aneurysm and ventricular septal defect assessed
      by precordial and transesophageal echocardiography.

PMID- 8362728
TI  - Acute impact of percutaneous transluminal coronary angioplasty on the ischemic
      burden in stable and unstable angina.

PMID- 8362729
TI  - Mobile thrombi in atherosclerotic lesions of the thoracic aorta: the diagnostic
      impact of transesophageal echocardiography.

PMID- 8362730
TI  - Diagnosis of papillary fibroelastoma of the mitral valve complicated by non-Q
      wave infarction with apical thrombus: transesophageal and transthoracic
      echocardiographic study.

PMID- 8362731
TI  - Radiofrequency catheter ablation of an accessory pathway with discontinuous
      retrograde conduction: potential insight into mechanism of longitudinal
      dissociation.

PMID- 8362732
TI  - Radiofrequency catheter ablation of atrial flutter in a patient with
      postoperative congenital heart disease.

PMID- 8362733
TI  - Radiofrequency catheter ablation of the accessory pathway in the permanent form
      of junctional reciprocating tachycardia.

PMID- 8362734
TI  - Bradycardia-dependent manifestation of retrograde triple atrioventricular nodal
      pathways: possible evidence of phase-4 block in the atrioventricular node.

PMID- 8362735
TI  - Cerebral thromboembolization after cardioversion of atrial fibrillation in
      patients without transesophageal echocardiographic findings of left atrial
      thrombus.

PMID- 8362736
TI  - Usefulness of transesophageal Doppler echocardiography in the surgical drainage
      of a loculated purulent pericardial effusion.

PMID- 8362737
TI  - Purulent pericarditis caused by group B streptococcus with pericardial tamponade.

PMID- 8362739
TI  - Embolic chondrosarcoma: an unusual cause of pulmonary embolism.

PMID- 8362738
TI  - Recurrent pulmonary embolism with second-degree atrioventricular block and near
      syncope.

PMID- 8362740
TI  - Acute pulmonary edema due to pulmonary venous obstruction by left atrial
      dissection.

PMID- 8362741
TI  - Aneurysm of the atrioventricular septum between the left ventricle and right
      atrium without septal defect.

PMID- 8362742
TI  - Multiple myeloma involving the pericardium associated with cardiac tamponade and
      constrictive pericarditis.

PMID- 8362743
TI  - QT interval prolongation and cardiac arrest during antibiotic therapy with
      spiramycin in a newborn infant.

PMID- 8362744
TI  - Role of a long-short sequence for initiation of atrioventricular reentry in Wolff
      Parkinson-White syndrome.

PMID- 8362745
TI  - Penetrating atherosclerotic aortic ulcers: the role of transesophageal
      echocardiography in diagnosis and clinical management.

PMID- 8362746
TI  - Flail tricuspid valve in ruptured aneurysm of the right sinus of Valsalva.

PMID- 8362747
TI  - A comparison of heparin strategies after thrombolytic therapy.

PMID- 8362748
TI  - ST0 or ST60.

PMID- 8362749
TI  - The cardiac renin-angiotensin system in heart failure.
AB  - The success of angiotensin-converting enzyme (ACE) inhibitors in reducing
      cardiovascular morbidity and mortality rates has led to a reexamination of the
      role of the renin-angiotensin system in pathophysiology. Ventricular dysfunction
      leading to congestive cardiac failure is associated with sequential activation of
      the sympathetic system and increases in plasma atrial natriuretic peptide;
      however, increases in plasma renin and aldosterone do not occur until very late.
      The renin-angiotensin system is now regarded as both a circulating and tissue
      hormonal system. All components of the renin-angiotensin system have been
      detected in the heart. ACE is localized in discrete areas of the heart, including
      the cardiac valves, coronary vessels, atria, and myocardium. After experimental
      myocardial infarction in the rat, although plasma renin and aldosterone levels
      are not increased, ACE in the myocardium is markedly increased. Treatment with
      ACE inhibitors suppresses cardiac ACE and is associated with hemodynamic
      improvement, reversal of the neurohumoral activation, prevention of ventricular
      dilatation, and remodeling and reduction in mortality rates. These results
      suggest that the beneficial effects of ACE inhibitors in treating congestive
      cardiac failure, preventing ventricular remodeling, and regressing left
      ventricular hypertrophy may involve not only reducing preload and afterload but
      also suppressing the local cardiac renin-angiotensin system.

PMID- 8362750
TI  - Endothelial function in congestive heart failure.
AB  - There is evidence that the endothelium plays an important role in the control of
      human vascular tone by releasing endothelium-derived nitric oxide and, therefore,
      a defective endothelial function could be involved in the increased peripheral
      vasoconstriction of patients with chronic congestive heart failure. To
      investigate endothelial function in humans in vivo, agents such as acetylcholine,
      a short-acting stimulator of the release of endothelium-derived nitric oxide, has
      been used. Conversely, N-mono-methyl-L-arginine, a specific inhibitor of nitric
      oxide synthesis from L-arginine, has recently been shown to decrease blood flow
      during infusion into the brachial artery of healthy volunteers (control subjects)
      by inhibiting the basal release of nitric oxide. Consistent with experimental
      studies, the blood flow response to acetylcholine is blunted in patients with
      chronic heart failure compared with healthy age-matched volunteers. In contrast,
      the decrease in blood flow induced by N-mono-methyl-L-arginine appears to be
      exaggerated in congestive heart failure. The blood flow response to nitroglycerin
      or sodium nitroprusside, endothelium-independent vasodilators, is usually
      preserved in patients with chronic, nonedematous heart failure, indicating a
      normal response of the vascular smooth muscle of resistance vessels to exogenous
      nitric oxide. In contrast, the dilator response of the radial artery diameter to
      nitroglycerin and flow-dependent dilation is impaired in patients with chronic
      heart failure, indicating that the abnormal flow-mediated relaxation of large
      arteries may be caused by both endothelial and structural abnormalities.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8362751
TI  - Systemic and regional hemodynamic effects of perindopril in experimental heart
      failure.
AB  - The effects of converting-enzyme inhibition by perindoprilat (0.5 mg/kg,
      intravenously, short-term administration) or perindopril (2 mg/kg, orally, long
      term administration once a day for 21 days) on systemic and regional hemodynamics
      were studied on a new rat model of heart failure, which was induced by
      microembolization of coronary vessels by 15 microns plastic microspheres. Cardiac
      output and regional blood flows were measured by microsphere technique; the tone
      of the venous vessels was determined as mean circulatory filling pressure in
      conscious, freely moving rats. Perindoprilat evoked a much more prominent
      increase in kidneys, adrenal glands, intestine, and skin blood flows in embolized
      rats than in sham-operated rats. The differences between the effects of long-term
      treatment with perindopril in sham-operated and embolized rats were highly
      significant. Mean circulatory filling pressure was decreased by short-term and
      long-term administration of an angiotensin-converting enzyme inhibitor. It is
      concluded that venous vessels could be one of the target sites for the effects of
      perindopril-like drugs.

PMID- 8362752
TI  - Intrinsic alterations of diaphragm muscle in experimental cardiomyopathy.
AB  - Diaphragmatic function was investigated in the cardiomyopathic Syrian hamster
      (CSH) from the dilated Bio 53:58 strain, after long-term therapy with the
      angiotensin-converting enzyme inhibitor perindopril. Twenty-two 1-month old CSHs
      were treated during a 5-month period by either oral gavage with perindopril (1
      mg/kg/day) (n = 11) or placebo (n = 11). Control hamsters from the F1B strain
      received placebo (n = 7). Mechanical properties were studied in isolated
      diaphragm strips electrically stimulated in both twitch and tetanic conditions.
      Compared with F1B control hamsters, peak active tension and positive (+dP/dtmax)
      and negative (-dP/dtmax) peaks of isometric tension derivative were significantly
      depressed in placebo treated CSHs. Compared with placebo-treated CSHs, peak
      active tension was significantly higher in perindopril-treated CSHs in both
      twitch (25 +/- 4 vs 16 +/- 1 mN/mm2; p < 0.01) and tetanus modes (56 +/- 4 vs 38
      +/- 2 mN/mm2; p < 0.01). Moreover, +dP/dtmax and -dP/dtmax were improved
      significantly in twitch (p < 0.01 and p < 0.01, respectively) and tetanus modes
      (p < 0.05 and p < 0.01, respectively). We conclude that, in the CSH, long-term
      therapy with the angiotensin-converting enzyme inhibitor perindopril helped to
      preserve the diaphragmatic function.

PMID- 8362753
TI  - Regional hemodynamic effects of perindopril in congestive heart failure.
AB  - The onset of heart failure is associated with complex neurohumoral, cardiac, and
      vascular changes. These disorders partly explain that, in this situation,
      regional distribution of blood flows is hardly modified with stability or
      increase in heart and brain flows and impairement of limb, renal, and splanchnic
      blood flows. Using the bidimensional Doppler technique to measure brachial blood
      flow and diameter and standard clearance techniques to determine renal and
      hepatic blood flows, we studied the effects of perindopril, a long-lasting
      angiotensin-converting enzyme inhibitor, on regional hemodynamics. We
      demonstrated that perindopril produces a very marked increase in forearm and
      kidney flows but a very minor increase in the hepatosplanchnic territory,
      resulting in a regional distribution of cardiac output that favors the renal and
      musculocutaneous territories. This mechanism of action might be an important
      contribution to clinical improvement observed with perindopril.

PMID- 8362754
TI  - Angiotensin-converting enzyme inhibition in congestive heart failure: benefit and
      perspective.
AB  - Therapy with angiotensin-converting enzyme (ACE) inhibitors was developed
      approximately 15 years ago as a novel therapeutic approach to hypertension.
      Although ACE inhibitor therapy was initially reserved for patients with severe
      hypertension, extensive clinical experience has broadened its use. These agents
      should now be considered as cornerstone therapy for patients with symptomatic
      heart failure and are of proved value in preventing the development of this
      syndrome. This article reviews the key studies that have documented the efficacy
      of ACE inhibitors in improving clinical outcome for patients with overt
      congestive heart failure, as well as for those with asymptomatic left ventricular
      dysfunction.

PMID- 8362755
TI  - Autocorrelation of short-term and daily average exposure levels in workplaces.
AB  - Based on workplace exposure data for 16 worker-chemical combinations, the degree
      of autocorrelation in a series of short-term time-weighted average (TWA) exposure
      concentrations (7.5-min, 15-min, 30-min, and 60-min TWAs) was investigated. For
      7.5-min and 15-min TWAs, consecutive values generally exhibited no correlation or
      positive correlation, but not negative correlation. Consecutive 30-min TWAs and
      60-min TWAs showed either positive correlation, negative correlations, or no
      correlation. Autocorrelation functions displayed various patterns that depended
      on the exposure time series. The mean of the autocorrelation coefficients across
      all worker-chemical combinations was similar to an exponential function, which
      signifies that the degree of autocorrelation, on average, decreased as the
      interval between two averaging periods increased. Autocorrelation in a series of
      8-hr TWAs also was analyzed for 10 worker-chemical combinations. In general,
      little autocorrelation was observed. Based on this analysis, the authors discuss
      a sampling strategy that, on average, would minimize the degree of correlation
      between measurements of short-term TWAs.

PMID- 8362756
TI  - Inter-rater agreement in the assessment of solvent exposure at a car assembly
      plant.
AB  - This study investigated the feasibility and the reproducibility of a
      retrospective assessment of solvent exposure in the painting operations of a car
      assembly plant. Five industrial hygienists (the raters) reviewed summary
      documents on plant operations and solvent exposure levels, developed from plant
      records and interviews. The raters independently reviewed 695 department-job-year
      combinations compiled from 29 work histories and used semi-quantitative scores to
      rate solvent exposure. Inter-rater agreement was evaluated by computing the
      percent concordance index and the intraclass correlation coefficient (rI). There
      was discordance among raters, a large proportion of which pertained to low
      exposure levels (1-5 ppm). The computation of the rI is sensitive to the
      distribution of exposure levels. A low rI can be observed for a rare exposure
      even if the percent concordance is high. Inter-rater agreement was good for
      cumulative exposure scores computed for frequent exposures: coatings (rI = 0.67),
      aromatic hydrocarbons (rI = 0.66), and petroleum distillates (rI = 0.62).

PMID- 8362757
TI  - Experimental study on the fibrogenic properties of different types of alumina.
AB  - The fibrogenicity of seven alumina samples was tested in rats by intratracheal
      instillation, and in mice by intraperitoneal injection. Histopathological studies
      were carried out on all animals. As an indicator for inflammatory reaction, a
      bronchoalveolar lavage (BAL) was performed in rats. Lactate dehydrogenase
      activity and protein content of the supernatant as well as the free-cell
      population of the lungs were studied. None of the five aluminas used for primary
      aluminum production showed any fibrogenic potential, while the other two, a
      chemical grade and a laboratory produced sample, induced fibrotic lesions. A
      correlation between cytological and biochemical parameters studied in BAL and the
      fibrosis determined by histology could be established for the quartz-treated
      rats, but not in the alumina-treated animals.

PMID- 8362758
TI  - Work-related symptoms and checkstand configuration: an experimental study.
AB  - Supermarket checkers are known to be at risk of upper-extremity cumulative trauma
      disorders. Forty-two experienced checkers checked a standard "market basket" of
      items on an experimental checkstand. The counter height could be adjusted (high =
      35.5, low = 31.5 inches), and the pre-scan queuing area length (between conveyor
      belt and laser scanner) could be set to "near" or "far" lengths. Each subject
      scanned under the high-near, high-far, low-near, and low-far conditions in random
      order. Seven ordinal symptom scales were used to describe comfort. Analysis
      showed that both counter height and queuing length had significant effects on
      symptoms. Furthermore, the height of the subject affected the degree and
      direction of the impact of the checkstand configuration differences. The study
      suggests that optimization of design may be experimentally evaluated, that
      modification of postural as well as frequency loading may be beneficial, and that
      adjustability for the individual may be advisable.

PMID- 8362759
TI  - Effect of tool shape and work location on perceived exertion for work on
      horizontal surfaces.
AB  - Thirty subjects drove screws into perforated sheet metal mounted on a horizontal
      surface using three air-powered tools that varied in shape (right-angle, in-line,
      and pistol-shaped). The four horizontal work locations ranged from 13-88 cm in
      front of the body and were placed at 25 cm intervals. The vertical placement of
      the horizontal beam was at midthigh, elbow, and midchest height. Subjects drove
      25 screws at each tool/work location combination before rating that condition
      using the Borg 10-point ratio rating scale. The ratings of perceived exertion
      increased with increasing horizontal distance from the body. When tool shape was
      not considered, the perceived exertion was virtually equal for driving screws at
      midthigh or elbow height. The ratings at midchest height were significantly
      higher than elbow and midthigh height. When tool shape was taken into account,
      subjects perceived less exertion driving screws with the pistol-shaped tool at
      midthigh height. The in-line and right-angle tools had the lowest ratings of
      perceived exertion for driving screws at elbow and midchest height.

PMID- 8362760
TI  - Lead exposures during shipboard chipping and grinding paint-removal operations.
AB  - Shipboard chipping and grinding paint-removal operations were evaluated to
      determine personnel exposures to airborne lead concentrations. Lead
      concentrations found in the bulk lead-paint samples ranged from 0.0037 to 11.5%
      by weight. Of the personnel conducting paint removal operations, 62% were exposed
      at or above the Occupational Safety and Health Administration (OSHA) Permissible
      Exposure Limit for lead of 50 micrograms/m3. Correlations of airborne lead
      concentrations and bulk lead-paint contents for chipping and grinding operations
      were statistically significant. Blood lead (Pb) levels were significantly higher
      in the follow-up blood tests when compared to the initial blood tests taken prior
      to paint removal. However, blood Pb levels were well below the OSHA allowable
      level of 40 micrograms/100 g.

PMID- 8362761
TI  - Physiological evaluation of liquid-barrier, vapor-permeable protective clothing
      ensembles for work in hot environments.
AB  - Work clothes using fabrics with vapor-transmitting characteristics are in limited
      use in various industrial applications, and there is a growing interest in their
      purported ability to help reduce heat stress. This study was performed to compare
      two vapor-transmitting ensembles with other clothing ensembles previously tested.
      The evaluation was based on an established experimental protocol that determines
      the critical values of air temperature and water-vapor pressure so that an
      individual maintains thermal balance, while controlling other factors that
      contribute to worker heat stress (e.g., air motion and metabolism). There were no
      differences between the two vapor-transmitting garments in their effects on
      worker heat stress. When compared to the results of other studies, the two vapor
      transmitting garments had critical environmental characteristics similar to two
      layers of cotton coveralls and they performed better from a heat stress
      standpoint than a disposable vapor-barrier suit worn over cloth coveralls.

PMID- 8362762
TI  - Outcome after acute myocardial infarction in patients with prior coronary artery
      bypass surgery.
AB  - Little is known concerning the influence of remote prior coronary artery bypass
      grafting (CABG) on the outcome of patients with acute myocardial infarction
      (AMI). Therefore, this study evaluated 2,494 patients with AMI of whom 219 (8.8%)
      had a history of CABG a mean of 7.1 +/- 3.7 years before the index AMI. Compared
      with all other patients, those with a history of CABG had an increased prevalence
      of a history of prior AMI (153 [70%] vs 547 [24%]), congestive heart failure (48
      [22%] vs 236 [10%]), and angina pectoris (165 [75%] vs 787 [35%]), all p < 0.001.
      There was no difference in age, but patients with prior CABG were more often men
      (192 [88%] vs 1,702 [75%], p < 0.001). During the hospitalization for AMI,
      patients with prior CABG had more recurrent ischemic pain (100 [46%] vs 732 [32%,
      p < 0.001]), and more frequently developed non-Q-wave AMI (72 [33%] vs 514 [23%],
      p < 0.01). In-hospital mortality did not differ among patients with or without
      prior CABG (15 [7%] vs 195 [9%]). At hospital discharge, more patients with prior
      CABG had complex ventricular ectopic activity on 24-hour ambulatory
      electrocardiographic monitoring (48 of 74 [65%] vs 327 of 797 [41%], p < 0.0001),
      and radionuclide ejection fraction < 0.45 (53 of 99 [54%] vs 430 of 1,024 [42%],
      p < 0.01). Among patients undergoing coronary angiography during the first 2
      months, multivessel coronary artery disease was more prevalent among patients
      with prior CABG (78 of 107 [73%] vs 508 of 959 [53%], p < 0.01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8362763
TI  - Angiographic predictors of a rise in serum creatine kinase (distal embolization)
      after balloon angioplasty of saphenous vein coronary artery bypass grafts.
AB  - Distal coronary embolization is thought to be increased in the balloon
      angioplasty of coronary by-pass vein grafts. One hundred fifty-five procedures of
      balloon angioplasty involving single vein graft dilatation were successfully
      performed. Distal coronary embolization was defined as an elevation of creatine
      phosphokinase greater than twice the preangioplasty value and positive MB
      fraction. Twenty procedures were found to have embolism by this definition. Forty
      preangioplasty angiograms were randomly selected from the remaining procedures
      and analyzed as a control group. Eight angiographic features were evaluated as
      possible risk factors for distal coronary embolization, i.e., diffusely diseased
      vein graft, presence of thrombus, ulcerated lesion surface, marked eccentricity,
      large plaque volume, lesion angulation, abrupt proximal face and ectasia. A
      diffusely diseased vein graft (p = 0.002), presence of thrombus (p = 0.006),
      irregular or ulcerated lesion surface (p = 0.007), large plaque volume (p = 0.02)
      and marked eccentricity (p = 0.03) were found to be important predictors by
      univariate analysis. A diffusely diseased vein graft and a large plaque volume
      were found to be important independent predictors by multivariate analysis. The
      presence of thrombus and an irregular or ulcerated lesion surface frequently
      coexist with a diffusely diseased vein graft. It is concluded that a diffusely
      diseased vein graft and a large plaque volume are important independent
      predictors of distal embolization, and thrombus and an ulcerated lesion surface
      are also important.

PMID- 8362764
TI  - Open, noncontrolled dose-finding study with a novel recombinant plasminogen
      activator (BM 06.022) given as a double bolus in patients with acute myocardial
      infarction.
AB  - The novel recombinant plasminogen activator (r-PA) (BM 06.022) is a mutant of
      tissue-type plasminogen activator expressed in escherichia coli which can be
      given as a bolus because of a prolonged half-life. The primary objective of this
      trial was to determine the efficacy of an intravenous r-PA double bolus (first
      bolus of 10 MU followed by 5 MU after 30 minutes) in patients with acute
      myocardial infarction. All patients received heparin intravenously and
      acetylsalicylic acid orally. Efficacy was assessed from infarct artery patency by
      coronary angiography (Thrombolysis in Myocardial Infarction trial perfusion
      grades 2 or 3) in 50 patients. Ninety minutes after administration of the first r
      PA bolus, the infarct-related coronary artery was patent in 39 of 50 patients
      (78%; 95% confidence interval 64 to 88%). An angiographically confirmed
      reocclusion occurred in 1 patient between 90 minutes and 24 to 48 hours. The
      reocclusion rate was influenced by 8 interventions and 1 angiogram missing at 24
      to 48 hours. Measurements of hemostatic parameters showed a decrease in
      fibrinogen to 37% of baseline value. There were 3 clinical reinfarctions before
      discharge and 2 major puncture site hemorrhages. No further serious bleeding and
      no serious adverse event with lethal outcome occurred. The 10 + 5 MU r-PA double
      bolus regimen appears to be effective with regard to patency and the success of
      thrombolysis. The incidence of reocclusion is very low. From the limited number
      of patients treated in this study, one need not be concerned about the safety
      profile of r-PA.

PMID- 8362765
TI  - Effects of thrombolysis and atenolol or metoprolol on the signal-averaged
      electrocardiogram after acute myocardial infarction. Late Potentials Italian
      Study (LAPIS).
AB  - Late potentials (LPs) detected on the signal-averaged (SA) electrocardiogram
      (ECG) predict arrhythmic events after acute myocardial infarction (AMI). The
      effect of thrombolysis on the incidence of LPs after AMI is controversial and its
      impact on subsequent arrhythmic events is not known. Moreover, the effects of
      beta blockers on the SAECG have not been studied. Six hundred eighteen patients
      with AMI were studied; thrombolysis was given to 228 (37%). In comparison with
      patients treated conventionally, those receiving thrombolysis were significantly
      younger and more frequently male, had higher peak values of creatine kinase, a
      lower prevalence of non-Q-wave AMI, and a higher incidence of ventricular
      fibrillation in the acute phase, and more frequently received beta blockers. An
      SAECG obtained 6 to 8 days after AMI showed LPs in 24% of patients receiving and
      in 25% not receiving thrombolysis (p = NS). On admission, intravenous beta
      blockers were administered to 110 patients (18%); those receiving beta blockers
      were younger, had lower peak values of creatine kinase and more frequently
      received thrombolysis. LPs were less frequently found in patients treated than in
      those not treated with beta blockers (15 vs 27%; p = 0.007); however, this effect
      was found only in those with an ejection fraction > or = 40%. Independent
      predictors of LPs by multivariate analysis were an ejection fraction < 40% (p =
      0.007), ventricular fibrillation in the acute phase (p = 0.02), and absence of
      beta-blocking therapy (p = 0.03). During a mean follow-up of 12 +/- 7 months,
      there were 39 cardiac deaths (6%), 13 of which were sudden (2%), and 9 sustained
      ventricular tachycardias.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362766
TI  - Usefulness of continuous ST monitoring in inferior wall acute myocardial
      infarction for describing the relation between precordial ST depression and
      inferior ST elevation.
AB  - To explore the relation between precordial and inferior ST-segment changes within
      individual patients, continuous 12-lead electrocardiographic recording was
      performed in 19 patients with acute inferior infarction given intravenous
      thrombolytic therapy. Monitoring was performed for 519 +/- 269 minutes. The
      extent of inferior ST elevation varied considerably with time in all patients.
      With use of the maximal precordial ST depression recorded to classify patients,
      11 had precordial ST depression (sigma V1-3) > 0.2 mV (group A) and 8 had < or =
      0.2 mV or no precordial ST depression (group B). The maximal recorded precordial
      ST depression correlated inversely with the corresponding inferior ST elevation
      in the 19 patients (r = -0.78, p < 0.001). Within individual patients, continuous
      12-lead monitoring revealed a close negative correlation between the inferior and
      precordial ST levels for the entire recording period in many patients, but 5 of
      the 19 patients (26%) (2 in group A and 3 in group B) did not have this relation.
      Moreover, precordial ST depression was not always present during inferior ST
      elevation in group A patients: 4 of 11 (36%) had some electrocardiographs showing
      < 0.1 mV precordial ST depression despite summed inferior ST elevation > 0.6 mV.
      These data indicate that precordial ST depression is not just the simple
      electrical reciprocal projection of the abnormal inferior wall ST vector, and its
      fluctuation cannot be predicted by changes in inferior ST level in every
      patient.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362767
TI  - Alteration in regulation of myocardial blood flow in one-vessel coronary artery
      disease determined by positron emission tomography.
AB  - The behavior of myocardial blood flow (MBF) regulation in territories supplied by
      angiographically normal vessels of patients with coronary artery disease (CAD)
      has been poorly investigated. Resting MBF and coronary reserve were evaluated in
      32 patients with stable angina, no previous myocardial infarction, and isolated
      left anterior descending or left circumflex coronary artery stenosis (> or = 50%
      diameter narrowing). MBF was measured, in the absence of any medical therapy, by
      means of dynamic positron emission tomography and 13N-ammonia. MBF measurements
      at baseline and after intravenous dipyridamole (0.56 mg/kg administered over 4
      minutes), were obtained both in the stenosis-related regions and in contralateral
      territories. As a control group, 14 normal subjects were evaluated according to
      the same protocol. At rest, the 32 patients with CAD had similar MBF values in
      the stenotic and remote regions (0.76 +/- 0.21 and 0.77 +/- 0.19 ml/min/g,
      respectively, p = NS); both these values were significantly (p < 0.01) reduced
      with respect to mean MBF in normal subjects (1.03 +/- 0.25 ml/min/g). The
      dipyridamole study was completed in 30 patients; these patients had lower values
      of maximal MBF in the stenotic than in the remote regions (1.52 +/- 0.65 vs 1.76
      +/- 0.68 ml/min/g, p < 0.05); however, both these values were significantly
      reduced (p < 0.01) with respect to mean dipyridamole MBF in normal subjects (3.66
      +/- 0.92 ml/min/g). Thus, in patients with CAD, resting and maximal MBF can be
      reduced not only in myocardial territories supplied by stenotic arteries, but
      also in territories supplied by angiographically normal arteries.

PMID- 8362768
TI  - Relation between clinical presentation and angiographic findings in unstable
      angina pectoris, and comparison with that in stable angina.
AB  - The diagnosis of unstable angina encompasses a broad spectrum of patients with
      myocardial ischemia, varying widely in cause, prognosis and responsiveness to
      therapy. A new clinical classification of unstable angina is based on the
      following 2 components: severity, and the clinical setting in which unstable
      angina develops. The hypothesis that this clinical classification correlates with
      the underlying coronary artery anatomy was tested. In 238 consecutive patients,
      an unstable angina score ranging from 2 to 6 was determined by adding the scores
      for severity (1 = unstable angina without pain at rest; 2 = pain at rest > 48
      hours before angiography; and 3 = pain at rest < or = 48 hours before
      angiographic evaluation) and the clinical setting of unstable angina (1 =
      unstable angina secondary to a noncardiac condition; 2 = primary unstable angina;
      and 3 = early postinfarction unstable angina). Fifty concurrently studied
      consecutive patients with stable angina were assigned a score of 0. Patients with
      unstable angina averaged 63 +/- 11 years of age, and 165 were men (69%). Pain at
      rest occurred in 202 of 238 patients (85%), and angiography was performed < or =
      48 hours in 139 of these patients (69%). Among patients with unstable angina, 5
      (2%) had secondary unstable angina, 143 (60%) had primary unstable angina, and 90
      (38%) had postinfarction unstable angina. Multivariable regression analysis
      identified the unstable angina score as the most important predictor of
      intracoronary thrombus (p = 0.011) and lesion complexity (p = 0.004) in the
      ischemia-related artery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362769
TI  - Relation of cardiovascular responses to mental stress and cardiac vagal activity
      in coronary artery disease.
AB  - Forty-six patients with documented coronary artery disease were studied to
      examine the relation of cardiovascular reactivity to mental stress and cardiac
      vagal activity. Cardiac vagal activity was measured by means of frequency-domain
      analysis of heart rate variability with 48-hour out-of-hospital Holter
      monitoring. The amplitude of the high-frequency component (0.16 to 0.40 Hz) of
      heart rate variability is considered to be an index of cardiac vagal activity.
      Cardiovascular reactivity was measured in the laboratory during a 3-minute public
      speaking task. Results revealed that (1) the amplitude of the high-frequency
      component was significantly higher during sleep (24.6 +/- 11.3 ms) than during
      waking (18.2 +/- 8.0 ms) (p = 0.002); (2) compared to subjects with low diastolic
      blood pressure reactivity, those who displayed high diastolic blood pressure
      reactivity exhibited a significantly lower amplitude of the high-frequency
      component (19.2 +/- 6.9 vs 23.4 +/- 9.6 ms, p = 0.03). These results indicate
      that decreased cardiac vagal activity may contribute to the exaggerated diastolic
      blood pressure reactivity to mental stress in patients with coronary artery
      disease.

PMID- 8362770
TI  - Comparative evaluation of bicycle and dobutamine stress echocardiography with
      perfusion scintigraphy and bicycle electrocardiogram for identification of
      coronary artery disease.
AB  - In 66 patients with suspected coronary artery disease (CAD), exercise
      electrocardiography (ECG), exercise echocardiography, dobutamine stress
      echocardiography (dosage, 5 to 40 micrograms/kg/min), single-photon emission
      computed tomography (SPECT) using methoxy-isobutyl-isonitrile (MIBI) and coronary
      angiography were performed prospectively to compare methods for detecting CAD.
      CAD was defined as 70% luminal area stenosis in at least 1 coronary artery at
      coronary angiography. Significant CAD was present in 50 patients. Compared with
      exercise ECG, exercise echocardiography, dobutamine stress echocardiography and
      MIBI-SPECT had a significantly higher sensitivity (52% vs 80, 79 and 89%; p <
      0.01, p < 0.01 and p < 0.001, respectively). There were no significant
      differences in sensitivity between exercise echocardiography, dobutamine stress
      echocardiography and MIBI-SPECT. Specificity of MIBI-SPECT was lowest (71%),
      whereas exercise ECG, exercise and dobutamine echocardiography had higher
      specificities (93, 87 and 81%, respectively). Significance, however, was not
      achieved. Differences in overall accuracy between exercise echocardiography
      (82%), dobutamine stress echocardiography (80%) and MIBI-SPECT (85%) were not
      significant. Comparison with accuracy of exercise ECG (62%) was significant (p <
      0.05, p < 0.05 and p < 0.01, respectively). In 1-vessel disease, exercise ECG had
      a lower sensitivity (45%) than exercise and dobutamine echocardiography and MIBI
      SPECT (79, 78 and 84%; p < 0.02, p < 0.02 and p < 0.01, respectively). Regarding
      the 24 patients with false-negative exercise ECG results, 67% had positive
      exercise echocardiography findings, 71% positive dobutamine echocardiography
      results and 84% positive technetium-99m MIBI-SPECT results.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8362771
TI  - Time course of hemodynamic changes and improvement of exercise tolerance after
      cardioversion of chronic atrial fibrillation unassociated with cardiac valve
      disease.
AB  - This study prospectively assessed the time course, magnitude and mechanism of the
      hemodynamic changes after restoration of sinus rhythm in patients with chronic
      atrial fibrillation (AF) unassociated with valvular disease. Severe cardiac
      dysfunction may occur after chronic supraventricular tachycardia in patients with
      and without underlying cardiac disease. Improvement may follow abolishment of the
      arrhythmia or adequate slowing of the ventricular rate. Eight patients were
      studied with a mean previous duration of AF of 10 +/- 9 months. Ejection
      fraction, exercise capacity and the atrial contribution to the left ventricular
      filling (only during sinus rhythm) were studied before cardioversion, after
      cardioversion and 1 week, 1 month and 6 months thereafter. A significant
      improvement in ejection fraction from 36 +/- 13 to 53 +/- 8% (p < 0.05) occurred
      at 1 month after cardioversion. Concomitantly, peak oxygen consumption had
      increased at 1 month, from 20.1 +/- 7 to 25.2 +/- 6 ml/min/kg (p < 0.05).
      Thereafter, no further improvement in hemodynamic parameters occurred. The atrial
      systole improved already at 1 week (from 3 +/- 5 to 16 +/- 11%, p < 0.05) and
      remained unchanged thereafter. Thus, restoration of sinus rhythm was associated
      with a delayed improvement in ejection fraction and maximal exercise capacity,
      preceded by an early restoration of atrial contractility and an acute slowing of
      the heart rate. The discrepancy in time course of restoration of atrial and
      ventricular function parameters suggests that an intrinsic left ventricular
      cardiomyopathy is present in patients with AF.

PMID- 8362772
TI  - Effectiveness and costs of digoxin treatment for atrial fibrillation and flutter.
AB  - Clinical outcomes and costs associated with the use of digoxin in atrial
      fibrillation and flutter were evaluated in a prospective, observational study at
      18 academic medical centers in the United States. Data were collected on 115
      patients (aged > 18 years) with atrial fibrillation or flutter who were treated
      with digoxin for rapid ventricular rate (> or = 120 beats/min). The median time
      to ventricular rate control (i.e., resting ventricular rate < 100 beats/min,
      decrease in ventricular rate of > 20%, or sinus rhythm) was 11.6 hours from the
      first dose of digoxin for all evaluable patients (n = 105) and 9.5 hours for
      those only receiving digoxin (n = 64). Before ventricular rate control, the mean
      +/- SD dose of digoxin administered was 0.80 +/- 0.74 mg, and a mean of 1.4 +/-
      1.8 serum digoxin concentrations were ordered per patient. Concomitant beta
      blocker or calcium antagonist therapy was instituted in 47 patients (41%); in 19
      of these, combination therapy was initiated within 2 hours. Adenosine was
      administered to 13 patients (11%). Patients spent a median of 4 days (range 1 to
      25) in the hospital; 28% spent time in a coronary/intensive care unit and 79% in
      a telemetry bed. Loss of control (i.e., resting ventricular rate returned to >
      120 beats/min) occurred at least once in 50% of patients and was associated with
      a longer hospital stay (p < 0.05). Based on 1991 data, the estimated mean
      hospital bed cost for patients with atrial fibrillation or flutter was $3,169 +/-
      $3,174.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8362773
TI  - Disparate cardiovascular response to stress tests during isradipine and
      fosinopril therapy.
AB  - Optimal antihypertensive therapy should control blood pressure at rest and during
      stress while preserving the physiologic hemodynamic response. In patients with
      mild to moderate hypertension, the hemodynamic profile and catecholamine response
      at rest, during isometric, mental, and orthostatic stresses were compared before
      and 12 weeks after angiotensin-converting enzyme inhibition or calcium channel
      blockade. Antihypertensive therapy was titrated either with the angiotensin
      converting enzyme inhibitor fosinopril (10 to 40 mg; n = 9) or with the calcium
      antagonist isradipine (5 to 20 mg; n = 10) until diastolic blood pressure < 90 mm
      Hg was achieved. Groups were comparable in race, sex, body mass index,
      pretreatment mean arterial pressure and response to isometric stress (25%
      increase in mean arterial pressure) before treatment. At rest, total peripheral
      resistance was reduced to the same extent (18%) in both groups. After fosinopril,
      the percent increase in stroke volume was higher and heart rate lower than with
      isradipine. During isometric stress, the percent increase in mean arterial
      pressure and cardiac output was higher, with isradipine (p < 0.05) reaching
      pretreatment levels. Plasma catecholamines were also higher with isradipine (p <
      0.05), increasing by 100% with plasma norepinephrine compared with 16% before
      treatment. During orthostatic stress significant reductions in mean arterial
      pressure and stroke volume were observed after isradipine but not after
      fosinopril. Neither medication significantly modified the response to mental
      stress. Our data suggest that despite a comparable reduction in total peripheral
      resistance at rest, fosinopril preserves a more physiologic hemodynamic response
      to isometric and orthostatic stress than isradipine.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8362774
TI  - Comparison of clinical findings in idiopathic dilated cardiomyopathy in women
      versus men. The Italian Multicenter Cardiomyopathy Study Group (SPIC)
AB  - Clinical and laboratory findings were compared in 65 women and 238 men with
      invasively documented idiopathic dilated cardiomyopathy. Women had more severe
      symptoms (New York Heart Association class > or = III in 48 vs 39%; p < 0.05),
      presented more frequently with heart failure signs (63 vs 41%; p < 0.01), and had
      a higher cardiothoracic ratio (0.56 +/- 0.06 vs 0.53 +/- 0.06; p < 0.05) and
      higher frequency of left bundle branch block (41 vs 29%; p < 0.05).
      Echocardiographic measurements in women showed significantly greater left
      ventricular (LV) end-diastolic (42 +/- 7 vs 39 +/- 6 mm/m2; p < 0.0001) and end
      systolic (36 +/- 7 vs 33 +/- 6 mm/m2; p < 0.001) diameters, and mean myocardial
      thickness (11 +/- 2 vs 10 +/- 2 mm; p < 0.05). Exercise duration was shorter in
      women than in men (7 +/- 3 vs 10 +/- 4 minutes; p < 0.001). After 18 +/- 16
      months, 9 women and 27 men died, and 7 and 17, respectively, received
      transplants. Transplant-free survival was not significantly different according
      to gender. By Cox multivariate analysis, LV ejection fraction was a significant
      independent predictor of cardiac death or heart transplantation in both sexes (p
      < 0.05 in men, and p < 0.005 in women), together with left atrial diameter index
      (p < 0.01) in women, and mean pulmonary artery pressure (p < 0.001) in men. In
      conclusion, women with idiopathic dilated cardiomyopathy present a more advanced
      phase of the disease with greater LV dilation, but do not have a different
      prognosis.

PMID- 8362775
TI  - Ventriculo-coronary arterial connections in pulmonary atresia with intact
      ventricular septum, and their influences on ventricular performance and clinical
      course.
AB  - To define the influence of ventriculo-coronary (VC) arterial connections on
      ventricular performance and late outcome, and associated wall motion
      abnormalities in patients with pulmonary atresia and intact ventricular septum,
      21 patients aged > or = 6 months (mean 4.3 +/- 3.3 years, range 0.5 to 11.8) were
      reviewed. Ventricular volumes, mass, systolic functional variables and regional
      wall motion were measured using biplane ventricular cineangiography. Fourteen
      patients had VC connections, 11 of whom had coronary artery abnormalities. In
      comparing patients with VC connections and coronary abnormalities (group I) with
      those without coronary abnormalities (group II), no hemodynamic differences were
      observed, except the expected increased right-to-left ventricular systolic
      pressure ratio in group I (1.33 +/- 0.24 vs 0.72 +/- 0.50). Wall motion
      abnormalities were observed in 8 patients (7 in group I, and only 1 in group II
      [p < 0.05]). Ejection fraction in patients with abnormal wall motion was
      significantly lower (50 +/- 6% vs 57 +/- 7%; p < 0.05) and ventricular systolic
      pressure ratio significantly higher (1.46 +/- 0.16 vs 0.80 +/- 0.45; p < 0.05)
      than in those with normal wall motion. Five patients died during follow-up, all
      of whom had wall motion abnormalities. The findings suggest that patients with VC
      connections and coronary abnormalities have a higher incidence of wall motion
      abnormalities, which may reflect ongoing ischemia, and are at risk for late
      death.

PMID- 8362776
TI  - Transcatheter occlusion of patent ductus arteriosus in adults.
AB  - This study examines whether transcatheter closure of a patent ductus arteriosus
      (PDA) using a Rashkind PDA occluder device is safe and effective in adults, or if
      adults have complications not sited in children owing to prolonged
      aorticopulmonary communication, high surgical risks or calcified PDAs. Fifteen
      patients aged 22 to 76 years (mean 42 +/- 14) were referred for transcatheter PDA
      occlusion. Exercise intolerance was the most frequent clinical manifestation.
      Eleven of 15 patients had surgical risk factors that included left ventricular
      failure (n = 10), biventricular failure (n = 1), elevated pulmonary pressures (n
      = 1), and a calcified PDA (n = 5). Twelve millimeter devices were placed in 4
      PDAs < or = 3 mm in diameter; 17 mm devices were placed in 11 PDAs 3 to 6 mm in
      diameter. Seven (47%) were occluded angiographically shortly after device
      placement; another 5 PDAs (33%) were occluded echocardiographically within 24
      hours of the procedure. Completed occlusion in this time interval was more likely
      to occur in PDAs < 5 mm in diameter (p = 0.0009). Of the 3 remaining PDAs with
      follow-up ranging from 9 to 38 months, 2 have demonstrated gradual diminution of
      shunting and have trivial leaks by color/Doppler flow. The other patient with a
      residual PDA has no ductal flow after placement of a second device. No
      complications related to device implantation or closure of the PDA occurred in
      any patient. No complications were reported in the follow-up patients who
      received evaluation (14 of 15 patients; range 1 to 38 months).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8362777
TI  - Implication of aneurysmal transformation in isolated perimembranous ventricular
      septal defect.
AB  - Defects on the membranous ventricular septum (perimembranous ventricular septal
      defect [VSD]) may spontaneously close or diminish in size by "aneurysmal
      transformation" (i.e., adherence of the tricuspid valve or adjacent tissue onto
      the VSD). It was recently shown that the appearance of aneurysmal transformation
      may be associated with subaortic ridges, as well as left ventricular (LV)-to
      right atrial (RA) shunts. In all, 877 consecutive patients with isolated
      perimembranous VSD were retrospectively studied. Results of actuarial analysis
      showed that patients with a perimembranous VSD had a 98% probability of
      aneurysmal transformation by the age of 240 months. Of these patients, the
      expected probabilities of developing LV-RA shunt, spontaneous closure and
      subaortic ridge were 45, 35 and 6%, respectively. Patients with LV-RA shunts had
      higher probabilities of developing infective endocarditis (p = 0.002) and
      persistent left-to-right shunts (p < 0.001). The presence of a subaortic ridge
      may be accompanied by LV outflow tract obstruction (10 of 25 patients),
      infundibular pulmonary stenosis (n = 3), or aortic valve deformity or aortic
      regurgitation (n = 5), and none of those with a subaortic ridge closed
      spontaneously. It was confirmed that a substantial proportion of aneurysmal
      transformation of isolated perimembranous VSD is associated with LV-RA shunts and
      subaortic ridges.

PMID- 8362778
TI  - Predictive value of dobutamine echocardiography just before noncardiac vascular
      surgery.
AB  - This study prospectively evaluated 75 consecutive patients (mean age 69 +/- 9
      years) undergoing major vascular surgery to test the hypothesis that dobutamine
      stress echocardiography can be used to predict perioperative cardiac events. A
      positive test was defined as a new or worsening wall motion abnormality in at
      least 2 of 18 wall segments. Up to 40 micrograms/kg/min of dobutamine was
      administered. All readings were done by physicians unaware of the patients'
      symptoms and electrocardiographic response. In addition, physicians caring for
      the patients were unaware of the test result. End points of the study were
      unstable angina with documented electrocardiographic changes, nonfatal myocardial
      infarction or cardiac death. The perioperative ischemic event rate was 7% (5 of
      75 patients). Three patients developed unstable angina and 2 sustained nonfatal
      myocardial infarctions. All of these patients had positive results on dobutamine
      stress echocardiography (sensitivity 100%). However, 22 patients who also had
      positive results on dobutamine stress echocardiography did not have perioperative
      events (specificity 69%). The corresponding positive predictive value was 19%.
      None of the 48 patients who had negative results on dobutamine stress
      echocardiography had events (negative predictive value 100%). In conclusion,
      dobutamine stress echocardiography can be used to predict perioperative events
      with great sensitivity, but its positive predictive value in this patient
      population in low, likely due to the low incidence of perioperative events in
      patients with known coronary artery disease and the imperfect specificity of
      dobutamine stress echocardiography in identifying significant coronary stenosis.
      Dobutamine stress echocardiography is most useful in this setting when negative,
      because it predicts safety from complications with confidence.

PMID- 8362779
TI  - Rate-dependent hemodynamic responses during incremental atrial pacing in chronic
      constrictive pericarditis before and after surgery.
AB  - Chronic constrictive pericarditis is a frequent cause of diastolic dysfunction,
      and results in impaired ventricular filling. Unlike in normal subjects,
      ventricular filling in constrictive pericarditis occurs almost entirely in the
      initial one third of diastole, and cardiac output is dependent predominantly on
      heart rate. Tachycardia impairs ventricular filling in normal subjects, but its
      effects in patients with constrictive pericarditis have not been studied. The
      effect of increasing heart rate alone with atrial pacing on the central and
      peripheral hemodynamics of patients with untreated chronic constrictive
      pericarditis before and after pericardiectomy was evaluated. Increased heart rate
      with atrial pacing increased cardiac output, whereas stroke volume remained
      unchanged up to heart rates of 140 beats/min. Further increases in heart rate
      resulted in reductions of cardiac output and stroke volume. There were no
      significant changes in ventricular filling pressures. Infusion of 300 ml of
      saline solution at peak pacing rates did not improve cardiac output. After
      successful surgical pericardiectomy, the hemodynamic effects of atrial pacing
      returned to normal. It is concluded that moderate tachycardia improves the
      hemodynamic profile of patients with constrictive pericarditis.

PMID- 8362780
TI  - Accuracy and reproducibility of left ventricular mass measurement by subcostal M
      mode echocardiography in hypertensive patients and professional bicyclists.
AB  - In some patients, left ventricular (LV) mass cannot be evaluated by M-mode
      echocardiography because the parasternal long-axis view is not available. The aim
      of this study was to determine whether the subcostal view obtained by M-mode
      echocardiography under 2-dimensional guidance allows accurate and reproducible LV
      mass determination. Using the cube formula, LV mass was calculated, from
      parasternal and subcostal views in 96 subjects: 73 hypertensives and 23
      professional bicyclists, covering a wide range of LV dimensions. M-mode tracings
      were read by 2 experienced echocardiographers and the interobserver variability
      was evaluated. With use of the subcostal view, the interobserver reproducibility,
      expressed as observer 1-observer 2, was excellent: -0.3 +/- 1.3 mm for LV
      diastolic diameter, -0.1 +/- 1.0 mm for ventricular diastolic septal thickness,
      0.2 +/- 0.6 mm for diastolic free wall thickness and 0.03 +/- 16.7 g for LV mass.
      In 96% of cases, the difference in LV mass between the 2 observers did not exceed
      30 g. With use of the parasternal and subcostal approaches, LV mass was not
      statistically different (202.6 +/- 2.2 g and 206.5 +/- 2.0 g, respectively) and
      the difference was < 52 g (clinically significant threshold) in 91 of 96 cases.
      It is concluded that, using the cube formula, LV mass calculation based on the
      subcostal view was accurate and not statistically different from that provided by
      the usual parasternal approach.

PMID- 8362781
TI  - The best hospitals in the USA for patients with heart disease.

PMID- 8362782
TI  - An inappropriate article.

PMID- 8362783
TI  - A growth control approach to Class II, Division 1 cases during puberty involving
      the simultaneous application of maxillary growth restriction and mandibular
      forward induction.
AB  - A simple method that used headgear and a functional appliance simultaneously was
      used for the correction of Class II, Division 1 cases with severe denture base
      discrepancy. The treatment restricted the forward growth of the maxilla and
      advanced the mandible. The functional appliance, referred to as the mandibular
      growth advancer (MGA), advances the mandible progressively with a splint, with
      the objective of remodeling the condyle and the glenoid fossa in the
      temporomandibular joint. Functional adaptation was achieved as the muscles that
      are attached to the mandible adjusted to new positions. In the two cases that
      illustrate this method, the ANB angle decreased and the Ar-B distance increased
      over a short period to four and six times the mean Japanese growth rate,
      respectively. After the correction of the denture-base discrepancy, a
      multibracket fixed appliance was used for dental alignment, and good skeletal,
      occlusal relationships and profiles were obtained. Treatment of severe denture
      base discrepancy in this manner may reduce the skeletal abnormality, decrease the
      number of extraction cases, and shorten the subsequent multibracket treatment
      time. And it may reduce the iatrogenic side effects caused by prolonged
      mechanotherapy with a fixed appliance.

PMID- 8362784
TI  - Mandibular condyle position: comparison of articulator mountings and magnetic
      resonance imaging.
AB  - This study evaluated the reliability of jaw positions, the existence of distinct
      jaw positions, and condyle-disk-fossa relationships in a symptom-free population
      by using articulator mountings and magnetic resonance imaging (MRI). The subjects
      examined included 28 men, 22 to 35 years of age, all having Angle Class I molar
      relationships and no discernible TMJ dysfunction. Records taken included the
      following: an axiographic face-bow to locate retruded hinge axis position, an
      interocclusal registration of retruded position (RE), a series of interocclusal
      registrations for centric occlusion (CO), a leaf gauge-generated centric relation
      (CR), a series of interocclusal registrations for CR, and MRI. The mandibular
      position indicator of the SAM articulator (Great Lakes Orthodontics, Ltd.,
      Tonawanda, N.Y.) was used to determine reliability and existence of distinct jaw
      positions. Magnetic resonance imaging also evaluated jaw positions and anatomic
      relationships. The results indicate: (1) The articulator analysis of CO and CR is
      statistically replicable. (2) A distinct jaw position could be demonstrated for
      CO that was separate from RE and CR. It was not possible to discriminate between
      RE and CR. (3) Condylar concentricity was observed in half of the sample and
      remained consistent in RE, CO, and CR. (4) Of the sample 13% demonstrated
      anteriorly displaced disks that were not influenced by posterior condyle
      placement. (5) The clinical concept of treating to CR as a preventive measure to
      improve disk-to-condyle relationships was not supported by this study.

PMID- 8362785
TI  - Bimaxillary protrusion in black Americans--an esthetic evaluation and the
      treatment considerations.
AB  - This study attempted to discover what black Americans find attractive about their
      profile. Fifteen black patients (eight males, seven females) were selected at
      random and used as models. Lateral photographs were taken on each patient, and a
      computer was used to alter the profiles to depict different levels of bimaxillary
      protrusion. Each patient was manipulated into four different profile types
      according to specific numerical guidelines. A vertical reference line from soft
      tissue glabella, perpendicular to Frankfort horizontal, was used to measure the
      lip position. In each profile type only the horizontal lip position was altered.
      The four profile types were classified as S (straight) BM1, (bimax one), BM2
      (bimax two) and BM3 (bimax three). The S profile was considered a straight or
      white facial profile, and the BM3 was an extreme example of bimaxillary
      protrusion. The photographs were surveyed among black and white laypersons,
      general dentists, and orthodontists. The results found the BM1 profile to be the
      most attractive. This was consistent with all groups surveyed. The BM1 profile
      would be considered a slightly convex profile and is more protrusive than white
      orthodontic norms. In this study comparisons of this profile to other standards
      are made and treatment considerations for black patients are discussed.

PMID- 8362786
TI  - Comparison of bond strength between lingual and buccal surfaces on young
      premolars.
AB  - The purpose of this experiment was to compare the bond strength and the failure
      interfaces on lingual and buccal surfaces of young human premolars. Premolar
      buccal brackets were adapted and bonded on the lingual or buccal surfaces of
      crowns after etching with a 37% phosphoric acid solution for 15 seconds. The bond
      strengths were 7.2 MPa and 7.0 MPa for lingual and buccal surfaces, respectively.
      The bond failure interfaces were located between the bracket and the resin,
      within the resin itself, or between the resin and the enamel. Tooth fragmentation
      was not found. There were no statistically significant differences (p > 0.05).
      This indicates that it is not necessary to specially treat a lingual surface for
      increasing the bond strength.

PMID- 8362787
TI  - The influence of bracket design on moment production during axial rotation.
AB  - The interaction between the bracket of an axially rotated tooth and arch wire
      produces a moment. This moment influences tooth movement and rotational control
      and is itself influenced by bracket width and bracket ligation. Self-ligating
      spring clip brackets fasten to and interact with arch wires differently than
      conventionally ligated brackets. An in vitro study with a simulated orthodontic
      model was undertaken to evaluate the effects of bracket width and ligation
      technique on the moment production of conventional and self-ligated brackets
      during axial rotation. Bracket widths ranged from 1.890 mm (0.0744 inch) to 2.809
      mm (0.1106 inch). Steel tie, elastomeric, and self-ligating spring clip ligation
      techniques were used. Empirically, both bracket width and ligation technique
      significantly effect the moment produced during axial rotation. For the range of
      bracket widths and types evaluated, ligation technique was found to have a
      greater influence on moment production than did bracket width. The self-ligated
      spring clip bracket delivered the least force over the greatest range of axial
      rotation.

PMID- 8362788
TI  - Relationships between mandibular canine calcification stages and skeletal
      maturity.
AB  - Hand wrist radiographs and dental panoramic radiographs of 200 boys and 215 girls
      were assessed to determine the relationship between the developmental stages of
      the mandibular canine and skeletal maturity indicators of the pubertal growth
      spurt. Chi-square and Kendall's tau statistics demonstrated significant (P <
      0.001) relationships between skeletal maturity indicators. Associations between
      canine development and skeletal maturity ranged from 0.53 to 0.85. Most children
      having attained canine stage G showed the presence of the adductor sesamoid
      (81%), capping of the diaphysis of the third middle phalanx (77%), and capping of
      the fifth proximal phalanx (87%). Growth reference data for American children
      suggest that stage G occurred approximately 0.4 years and 1.3 years before peak
      height velocity for girls and boys, respectively. It is indicated that canine
      calcification could serve as a useful tool for evaluating childrens' skeletal
      maturation and, by association, somatic maturity.

PMID- 8362789
TI  - Mandibular growth in patients with cleft lip and/or cleft palate--the influence
      of cleft type.
AB  - A total of 229 adult white patients with cleft lip or palate were evaluated,
      through cephalometric radiographs, to determine cleft-type influence on
      mandibular structure and spatial position. The sample includes adult patients
      with unilateral complete cleft lip and alveolus (n = 50), complete cleft lip and
      palate (n = 118), and isolated cleft palate (n = 61). A group of 65 subjects with
      normal occlusion and without cleft lip or palate was used as a control group. All
      groups were matched according to sex. When compared, the cleft groups and the
      normal group showed that the mandibular structure was significantly different.
      The mandible in the cleft groups displayed shorter mandibular ramus and body
      length, without difference between the cleft types. Mandibular position relative
      to cranial base was similar in the cleft groups with involvement of the palate,
      and differed significantly from that observed in the group with cleft lip and
      alveolus and in the subjects without cleft. Palatal clefts induce a significant
      downward and backward rotation of the mandible associated with a more obtuse
      gonial angle. Thus a small mandible is a structural characteristic of all cleft
      types studied. However, mandibular shape and spatial position are strongly
      influenced in clefts that involve the palate.

PMID- 8362790
TI  - Clinical versus quantitative assessment of headgear compliance.
AB  - This study was undertaken to determine if clinicians could accurately evaluate
      headgear compliance. Headgear timers were used covertly to quantitatively assess
      the headgear compliance of 28 patients over 3 consecutive months. Investigators
      subjectively evaluated the patients to determine how many hours per day they felt
      the patient had been wearing the headgear. Investigators were divided into three
      groups: (1) 5 orthodontists (2 board certified, 3 board eligible--total of 50
      years of orthodontic experience); (2) 10 residents; and (3) 11 assistants. At
      least two investigators from each group evaluated the same person for all three
      appointments. The average error values were 2.86 hours, 3.27 hours, and 3.61
      hours, respectively, for the three groups. The standard deviations were also very
      large, indicating that no group could accurately or consistently assess headgear
      wear. In this study no difference was found in compliance between sexes. Patients
      10 to 12 years of age were more compliant than those 12 to 14 years of age, which
      were more compliant than the > 16 age group. The least compliant was the 14 to 16
      year age group.

PMID- 8362791
TI  - An American Board of Orthodontics case report: the orthodontic-surgical
      correction of a Class I malocclusion with high mandibular plane angle,
      bimaxillary protrusion, and vertical maxillary excess.
AB  - This is the case report of a 26-year-old black woman with a Class I malocclusion
      and a skeletal Class II profile and vertical maxillary excess. Extraction spaces
      were closed, creating a Class II malocclusion to augment anticipated surgery
      (LeFort I osteotomy and genioplasty). The treatment result provided outstanding
      occlusal function and optimal facial esthetics. Attention to detail was
      mandatory, i.e., identify the patient's chief complaint, provide treatment
      options to resolve the complaint, and treat and maintain the dentition as ideally
      as possible. [This case was presented to the American Board of Orthodontics in
      partial fulfillment of the requirements for the certification process conducted
      by the Board.]

PMID- 8362792
TI  - An American Board of Orthodontics case report: treatment of a crowded Class II
      malocclusion in an adult.
AB  - A case report is presented of an adult with a crowded Class II, Division I
      subdivision left malocclusion. There was a moderate arch length deficiency in
      both arches. All four canines were prominent and had gingival recession. The
      patient's profile necessitated nonextraction treatment. Free gingival grafts were
      placed to prevent further recession and the Class II relationship and crowding
      were resolved with a positive profile change. [This case was presented to the
      American Board of Orthodontics in partial fulfillment of the requirements for the
      certification process conducted by the board.]

PMID- 8362793
TI  - Serious sports injuries requiring hospitalization seen in a pediatric emergency
      department.
AB  - OBJECTIVE: To define the spectrum of serious sports injuries requiring
      hospitalization seen in a pediatric emergency department. DESIGN: Trauma registry
      and retrospective chart reviews. SETTING: Emergency department, Children's
      Hospital, Boston, Mass. STUDY PARTICIPANTS: One hundred forty-two patients with
      sports injuries presenting to the emergency department and requiring
      hospitalization over 2 years. MEASUREMENTS/RESULTS: Serious sports injuries
      accounted for 13% of admissions for trauma, 0.6% of visits to the emergency
      department for trauma, and approximately 0.14% of total encounters. Injuries
      included fractures (77%), abdominal injuries (7%), multiple trauma (5%), cerebral
      contusions or hemorrhages (4%), and dislocations (3%). The most frequently
      injured areas were the extremities (69%), head and neck (16%), and abdomen (3%).
      Compared with nonsports injuries requiring hospitalization, sports injuries
      occurred in older patients (11.5 vs 7.3 years, P < .001) and more often in males
      (83% vs 64%, P < .001). Sports injuries also resulted in higher Injury Severity
      Scores (10 vs 8.8, P = .021) and in more fractures (77% vs 51%, P < .001) and
      neck injuries (4% vs 1%, P = .002). CONCLUSION: Serious sports injuries evaluated
      in the emergency department affect predominantly male teenagers and result
      predominantly in fractures involving the extremities. The spectrum of injuries is
      dissimilar to that resulting from other mechanisms.

PMID- 8362794
TI  - Radiological case of the month. Choledochal cyst.

PMID- 8362795
TI  - Pathological case of the month. Meningioangiomatosis.

PMID- 8362796
TI  - Pathological case of the month. Benign rheumatoid nodules.

PMID- 8362797
TI  - Picture of the month. Acute guttate psoriasis.

PMID- 8362798
TI  - Thyrotoxicosis presenting with seizures and coma in two children.

PMID- 8362799
TI  - Monitoring retinopathy of prematurity: a new form for the nursery.

PMID- 8362800
TI  - Kids are working.

PMID- 8362801
TI  - Hereditary angioedema: danazol therapy in a 5-year-old child.

PMID- 8362802
TI  - Hyponatremia and water intoxication.

PMID- 8362803
TI  - Perinatal acute scrotum: controversies in the management of torsion of the
      testis.

PMID- 8362804
TI  - Community response to medical need.

PMID- 8362805
TI  - Alarming heart rates.

PMID- 8362806
TI  - Dermatitis and nutritional deficiency. Another acrodermatitis enteropathica-like
      eruption.

PMID- 8362807
TI  - Aplastic anemia in neonatal lupus erythematosus.
AB  - OBJECTIVE: To describe an infant with neonatal lupus erythematosus associated
      with aplastic anemia. SETTING: The pediatric department in a tertiary-care
      hospital. INTERVENTIONS: Packed red blood cell transfusions and a 3-week course
      of high-dose steroid therapy. MEASUREMENTS/MAIN RESULTS: The patient presented
      with severe anemia and a circumscribed, reticular, macular rash on the face and
      neck at 5 months of age. Skin lesion biopsy revealed epidermic hyperkeratosis,
      hydropic degeneration of the basal layer, and deposition of immunoglobulins and
      granular C1q at the dermoepidermal junction. Ro/SS-A antibodies were present in
      the infant. BFU-E (erythroid progenitor burst-forming unit) colonies in bone
      marrow increased by about tenfold when suppressor CD8+ T lymphocytes were
      removed, indicating immune suppression of hematopoiesis. High-dose steroid
      therapy failed. The infant subsequently developed gram-negative sepsis, severe
      metabolic acidosis, and consumptive coagulopathy and died. CONCLUSIONS: Neonatal
      lupus erythematosus may present as part of a spectrum. The disease may range from
      mild and transient to a severe, life-threatening condition requiring immediate
      intervention, as in the case reported here. This is the first report of neonatal
      lupus associated with aplastic anemia due to immune-mediated suppression of
      hematopoiesis.

PMID- 8362808
TI  - The value of early treatment of deer tick bites for the prevention of Lyme
      disease.
AB  - OBJECTIVE: To determine if the early antibiotic treatment of deer tick bites
      prevented Lyme disease. DESIGN: Prospective, double-blind, placebo-controlled,
      antibiotic treatment. SETTING: Private practice in an area endemic for Lyme
      disease. STUDY PARTICIPANTS: Patients between 3 and 19 years of age who received
      antibiotic treatment within 3 days following a deer tick bite. INTERVENTIONS:
      Patients received an antibiotic or placebo and were followed up for stage I and
      II disease. All patients had blood drawn at the time of presentation and 6 weeks
      later for immunofluorescent antibodies (IFA). MEASUREMENTS/MAIN RESULTS: One
      patient in the placebo group developed clinical Lyme disease associated with an
      IFA titer of 1:32, considered weakly positive. Three other patients in the
      placebo group developed an IFA titer of 1:32; one had an influenzalike illness
      and two had no symptoms. None of the study patients developed any neurologic,
      cardiac, or arthritic symptoms in the 1- to 3-year follow-up. CONCLUSION: Based
      on the low frequency of illness, the absence of stage II disease, and the
      inability to establish the efficacy of early antibiotic treatment, we suggest
      that physicians not routinely use prophylactic antibiotics for deer tick bites.

PMID- 8362809
TI  - Granulomatous hepatitis in three children due to cat-scratch disease without
      peripheral adenopathy. An unrecognized cause of fever of unknown origin.
AB  - OBJECTIVE: To report the clinical experience of three patients with fever of
      unknown origin ultimately diagnosed as having cat-scratch granulomatous hepatitis
      in the absence of peripheral adenopathy. DESIGN: Case-control study. SETTING:
      Referral center at university-based referral practice. PATIENTS: Three children
      with fever of unknown origin. Follow-up following presentation was 6 months for
      each patient. MEASUREMENT AND RESULTS: All three patients with fever of unknown
      origin were diagnosed radiographically to have multiple hepatic defects. The
      defects were shown histologically to be granulomatous. Two of the three patients
      had Warthin-Starry staining bacilli in the granulomas consistent with a diagnosis
      of Afipia felis. All three had positive cat-scratch skin test results.
      CONCLUSIONS: Cat-scratch disease in the absence of peripheral adenopathy is a
      heretofore unrecognized cause of fever of undetermined origin and may account for
      a small, but significant, percentage of children presenting with it.

PMID- 8362810
TI  - Acrodermatitis enteropathica-like syndrome secondary to isoleucine deficiency
      during treatment of maple syrup urine disease.
AB  - We describe a patient with maple syrup urine disease in whom an acrodermatitis
      enteropathica-like syndrome developed while he was receiving a branched-chain
      amino acid-free formula. Iatrogenically induced isoleucine deficiency developed
      and resulted in a decreased protein accretion and persistent increase in the
      plasma concentrations of leucine. A rapid clinical response to isoleucine
      supplementation was noted. This observation underscores the risks of using amino
      acid-free formulas without adequate supplementation of deficient amino acids.

PMID- 8362811
TI  - Fanconi's syndrome with hepatorenal glycogenosis associated with phosphorylase b
      kinase deficiency.
AB  - OBJECTIVE: To describe two patients with Fanconi's nephropathy secondary to
      glycogen storage disease and speculate on the possible etiology. DESIGN:
      Convenience sample. SETTING: Tertiary care, referral center. PATIENTS: Two
      related children referred for failure to thrive, rickets, and hepatomegaly.
      INTERVENTION: Dietary and therapeutic measures for rickets and renal tubular
      acidosis. MEASUREMENTS AND RESULTS: The main laboratory findings were fasting
      hypoglycemia and massive glucosuria, with evidence of multiple renal tubular
      dysfunction characteristic of the Fanconi syndrome. Liver and kidney biopsy
      specimens were consistent with glycogen storage disease. Enzymatic assay of liver
      homogenates revealed marked deficiency of phosphorylase b kinase in one patient
      and absent activity in the other. CONCLUSION: Phosphorylase b kinase deficiency
      may be causally related to hepatorenal glycogenosis with the Fanconi syndrome.
      More patients with this syndrome need to be studied before a definitive causal
      role is implicated.

PMID- 8362812
TI  - Episodes of bradycardia during early infancy in the term-born and preterm infant.
AB  - OBJECTIVE: To document the incidence of transient episodes of bradycardia in a
      group of healthy term and preterm infants during the first 1 to 6 months of life.
      DESIGN: Longitudinal polysomnographic study. SETTING: Sleep laboratory in a
      university-affiliated urban medical center. PARTICIPANTS: Fourteen healthy term
      born infants, nine preterm infants with apnea in the nursery, and 10 preterm
      infants without apnea. Infants with neonatal morbidity except apnea were
      excluded. MEASUREMENTS: Transient episodes of bradycardia (< or = 100 beats per
      minute) were identified in 2- to 4-hour early evening polysomnographic tracings.
      The relationship with apnea, transcutaneous oxygen levels, and sleep state was
      determined. RESULTS: Transient episodes of bradycardia to 60 to 70 beats per
      minute were common, but there were no drops below 50 beats per minute. The
      incidence of transient episodes of bradycardia was inversely related to heart
      rate. Results for apneic and nonapneic premature infants were similar.
      CONCLUSIONS: Transient episodes of bradycardia are considered normal reflex
      responses and are not related to risk for sudden infant death syndrome. These
      results have implications for the setting of monitor alarms.

PMID- 8362814
TI  - The reliability of midstream urine culture from circumcised male infants.
AB  - The reliability of midstream urine culture from circumcised male infants was
      studied in 60 infants aged 1 to 21 weeks. A midstream urine specimen was
      collected after cleansing the penis. When the bladder was full again, a
      suprapubic bladder aspiration (SPA) was also performed. The results of the urine
      cultures were almost identical in specimens obtained midstream and by SPA. In 37
      infants the cultures were sterile and in 13 positive, with the same microorganism
      being cultured in both instances. In one case, few colonies of Staphylococcus
      epidermidis grew only from the midstream culture. In nine infants, only midstream
      specimens were obtained because three attempts at SPA were unsuccessful. These
      results suggest that in circumcised male infants, the midstream method of
      obtaining urine for a culture is as reliable as SPA.

PMID- 8362813
TI  - Immunization status and reasons for immunization delay among children using
      public health immunization clinics.
AB  - OBJECTIVES: To determine whether children attending our local health department
      clinics were being immunized in a timely manner, and to investigate the reasons
      for children not being immunized on schedule. DESIGN: Cross-sectional research
      design. SETTING: Five Salt Lake City/County Health Department immunization
      clinics in Utah. PARTICIPANTS: All patients presenting to the clinics for
      immunization from November 1990 to March 1991 when minor illness is prevalent.
      INTERVENTIONS: Data were gathered through interview and questionnaire.
      MEASUREMENTS/MAIN RESULTS: Children were mostly white; they came from two-parent
      households with reasonably high incomes and high parental education level. Only
      four children were denied vaccination, all for inappropriate timing. None were
      denied for illness. More than 75% had postponed bringing their children in for
      immunization. The most common reason given for delay was minor illness in the
      child. CONCLUSION: Even in this "low-risk" population, parental misperception
      regarding immunizations is a significant, contributing factor to low immunization
      rates. Public educational programs directed at increasing parental knowledge must
      be developed.

PMID- 8362815
TI  - Acquired subglottic cysts in the low-birth-weight infant. Characteristics,
      treatment, and outcome.
AB  - OBJECTIVE: To provide a descriptive summary of characteristics, including
      demographics, symptoms, risk factors, and outcome of acquired subglottic cysts
      identified in the neonatal period. DESIGN: Patient series. SETTING: A tertiary
      neonatal care unit and referral neonatal follow-up clinic. PARTICIPANTS: One
      hundred seventy-four preterm infants undergoing flexible bronchoscopy, 21 (12%)
      referred for airway evaluation because of symptoms and 153 (88%) examined
      consecutively following 7 days or more of endotracheal intubation. INTERVENTION:
      None. MEASUREMENTS/RESULTS: Subglottic cysts were identified in 11 (7.2%) of 153
      preterm infants examined prospectively at discharge from the neonatal intensive
      care unit after prolonged intubation and two (10%) of 21 infants referred for
      airway evaluation. Infants with subglottic cysts were extremely preterm (mean +/-
      SEM gestation, 26.7 +/- 0.5 weeks) and very low birth weight (894.6 +/- 64.6 g).
      The mean duration of intubation was 28.5 +/- 5.0 days. Most infants, particularly
      those with large cysts, were symptomatic with stridor, hoarseness, or obstructive
      apnea. In two cases, airway symptoms began after discharge from the neonatal
      intensive care unit. Ten (91%) of the 11 patients were discharged receiving home
      oxygen. Generally, multiple cysts were present in the subglottic space, most
      prominently located in the posterior aspect of the trachea. Three of five
      patients with large cysts received a tracheostomy. Two additional patients had
      surgical marsupialization of the cysts, and six others experienced resolution
      without treatment. One patient with large cysts died of viral pneumonia 10 months
      after surgical intervention. An additional patient with large cysts died before
      surgical intervention secondary to chronic lung disease and cor pulmonale. All
      surviving infants had resolution of signs of airway obstruction and 10 of the 11
      did not require supplemental oxygen or have symptoms of chronic pulmonary disease
      at age 1 year. CONCLUSION: Intubation-acquired subglottic mucous cysts in the
      neonate may occur more commonly than was previously recognized. Symptoms of this
      lesion may mimic features of chronic lung disease. Early identification of the
      cysts with flexible bronchoscopy is important since airway compromise may
      progress and surgical intervention may be lifesaving.

PMID- 8362816
TI  - The morbidity of cardiac nondisease revisited. Is there lingering concern
      associated with an innocent murmur?
AB  - BACKGROUND: The phenomenon of cardiac nondisease was first reported in 1967 to
      call attention to the fact that some children were being restricted from their
      normal activities because their parents believed that they had a heart problem
      when, in fact, the child's heart was perfectly normal. This influential article
      and others have suggested that there may be significant morbidity in children who
      have been found to have innocent cardiac murmurs. METHODS: Parents of 71
      schoolchildren were interviewed 1 to 5 years after their child had been examined
      by a pediatric cardiologist. Parents were asked about the presence of a family
      history of heart disease, their recall of the diagnosis and recommendations made
      by the cardiologist, and their level of satisfaction with the visit to the
      cardiologist. Parents were extensively questioned for evidence of restriction of
      the child's activities and for the presence of a belief that their child's murmur
      was something to still be concerned about. RESULTS: None of the parents reported
      restricting their child's activity, but 12 (17%) were still concerned about the
      murmur. A statistically significant relationship between parents reporting being
      less than "very satisfied" with the visit to the cardiologist and the presence of
      concern was found (P = .0006 by chi 2, Yates' correction). No other associations
      were noted. CONCLUSION: The association with a lower degree of satisfaction
      suggests that communication issues are relevant to the presence of lingering
      parental concern. Because the parents of a child with an innocent murmur may
      consider him or her to be "vulnerable," primary care physicians should follow up
      with parents of children referred to pediatric cardiologists for evaluation of a
      murmur so that any potential misunderstandings can be clarified.

PMID- 8362817
TI  - The art of referral. Pediatricians and the emergency department.

PMID- 8362818
TI  - First, do no harm. Low birth weight and adolescent obesity.

PMID- 8362819
TI  - Do primary care physicians prefer dictated or computer-generated discharge
      summaries?
AB  - OBJECTIVE: To determine the preference of primary care physicians for computer
      generated vs dictated discharge summaries from a neonatal intensive care unit.
      DESIGN: Survey mailed to primary care physicians. SETTING: Regional referral area
      of a level III neonatal intensive care unit. PARTICIPANTS: Pediatricians and
      family medicine physicians caring for infants discharged from the neonatal
      intensive care unit. RESULTS: Of 58 questionnaires sent, 45 (78%) were returned.
      Overall, 33 physicians (73%) either strongly or mildly preferred the computer
      generated discharge summary; eight (18%) had no preference; and four (9%)
      preferred the dictated discharge summary (P < .001). The category of strongest
      preference was relevance of information for continued patient care. Preference
      for type of discharge summary was not significantly influenced by time in
      practice, type of practice, preference to read or scan summaries, or frequency of
      computer use. CONCLUSION: Primary care physicians prefer computed-generated
      discharge summaries to dictated discharge summaries.

PMID- 8362820
TI  - An updated pediatric perspective on the Apert syndrome.
AB  - This review of the Apert syndrome, based on our research experience with 136
      cases, provides a clinically relevant pediatric perspective. The brain is
      megalencephalic, resulting in a disproportionately high cranium and a mean birth
      length and weight above the 50th percentile. The growth pattern in childhood
      consists of a slowing of linear growth so that most values fall between the 5th
      and 50th percentiles. From adolescence to adulthood, slowing becomes more
      pronounced. Central nervous system abnormalities may occur in some cases,
      including malformations of the corpus callosum and limbic structures, gyral
      abnormalities, hypoplastic white matter, and heterotopic gray matter. Distortion
      ventriculomegaly is found because of the large brain in a misshapen skull.
      Progressive hydrocephalus is uncommon. Intelligence in patients with the Apert
      syndrome varies from normality to mental deficiency. Early release of the coronal
      suture and advancement and reshaping of the frontal bone reduce further
      dysmorphic and unwanted growth changes in the skull, but probably do not affect
      mentation. Associated cardiovascular and genitourinary anomalies occur in 10% and
      9.6% of cases, respectively. Other important findings reviewed include upper- and
      lower-airway compromise, calvarial development, cervical vertebral anomalies,
      limb defects, ocular and otologic manifestations, and dermatologic
      characteristics.

PMID- 8362821
TI  - Medicine is a calling--not a business.

PMID- 8362822
TI  - Can we triage alcoholics with end-stage liver disease?

PMID- 8362823
TI  - Treatment of Crohn's disease with 5-ASA.

PMID- 8362824
TI  - Gastrointestinal toxicity of newer NSAIDs.
AB  - The linkage between gastroduodenal mucosal injury and nonsteroidal anti
      inflammatory drugs (NSAIDs) is now well established. Fifteen percent to 20% of
      patients taking these agents develop gastric or duodenal ulcer, and about 3% of
      this group goes on to experience hemorrhage or perforation. Gastrointestinal (GI)
      complications occur primarily in certain high risk groups, notably elderly female
      patients and patients with a prior history of peptic ulcer or GI bleeding.
      Recently, two new NSAIDs, nabumetone and etodolac, which are reportedly safer
      because they selectively inhibit prostaglandin synthesis in target tissues but
      spare that in the stomach, have been introduced in the United States. Further,
      data from clinical trials of oxaprozin, an NSAID not yet available in the United
      States, indicate that this agent may have a better safety profile than older
      NSAIDs. A review of the literature concerning the mucosal toxicity of these three
      agents reveals that the overall ulceration and major complication rate is low.
      However, a direct comparison with older NSAIDS in a large group of patients in a
      dose with similar efficacy is lacking.

PMID- 8362825
TI  - Clinical applications of electrogastrography.
AB  - Recently, electrogastrography (EGG) has received more and more attention. While
      gastroenterologists are interested in its clinical applications, concerns remain
      regarding the reliability and analysis of the EGG and the correlation between the
      EGG and gastric motility. The aims of this paper are to address these concerns
      and to review the potential clinical applications of the EGG. The following areas
      are discussed, based on the literature and our own experience with EGG: the
      refined method for the measurement of the EGG, the advanced techniques for
      quantitative analyses of the EGG, the reliability of the EGG in measuring gastric
      myoelectrical activity, the correlation between the EGG and gastric motility, and
      applications of the EGG in clinical gastroenterology.

PMID- 8362826
TI  - Liver transplantation for patients with alcoholism and end-stage liver disease.
AB  - Liver transplantation for alcoholic cirrhosis remains controversial. In
      particular, criteria for the selection of patients who will remain recovered from
      alcoholism post-transplant require better definition. We analyzed the long-term
      predictive value of categorizing transplant referral patients with alcoholism and
      end-stage liver disease into risk groups for recidivism and noncompliance. Forty
      seven patients with the diagnosis of alcoholism and advanced liver disease were
      evaluated and placed into predefined risk groups (low-, moderate-, and high-risk)
      for recidivism and noncompliance. No absolute period of abstinence from alcohol
      was required. All patients were asked to sign a contract not to drink alcohol and
      comply with a rehabilitation program before and after transplantation. Compliance
      with alcohol rehabilitation, abstinence, functional level, employment, and
      survival were assessed. Patients who were not compliant with the rehabilitation
      program or consumed alcohol were scored as failures. Thirty-one patients were
      ranked as low risk, and were accepted for liver transplantation; 27 patients were
      transplanted. Five of 31 patients (16%) drank alcohol. One patient drank before
      and four patients drank transiently after transplantation. Ten patients were
      categorized as moderate risk, and were deferred for transplantation; two patients
      underwent later transplantation. All 10 patients (100%) were noncompliant or
      drank alcohol, including two patients who drank after transplantation after a
      period of abstinence and rehabilitation. Six patients were ranked as high risk,
      and were denied liver transplantation. Five patients (83%) drank alcohol and were
      noncompliant. Minimum follow-up was 12 months (mean, 24 months; range, 12-41
      months). The mean Karnofsky performance score was 34 before and 84 after liver
      transplantation. Actuarial survival of alcoholic patients undergoing
      transplantation was 93%. We conclude that categorization of transplant referral
      patients with alcoholism and liver failure into predefined risk groups for
      recidivism and noncompliance accurately predicts pre- and post-transplant
      behavior. As defined, only low-risk alcoholic patients are good candidates for
      liver transplantation.

PMID- 8362828
TI  - Prospective evaluation of optimal number of biopsy specimens and brush cytology
      in the diagnosis of cancer of the colorectum.
AB  - We prospectively studied the diagnostic accuracy of endoscopic biopsy and
      cytology in the diagnosis of colorectal cancer and sought to ascertain the
      optimal number of biopsy specimens that should be taken. Seventy consecutive
      patients with colorectal masses or polypoid lesions that could not be removed by
      endoscopic polypectomy and which were referred for surgery were studied. Lesions
      were first brushed for cytology. A series of 10 biopsies were then obtained from
      each lesion; the first four were placed into the first container, and two were
      placed into each of three other containers. Cytology and biopsies were read
      blindly by one pathologist. Findings were compared with the resection specimen
      results. Ten lesions were benign; all had negative biopsies and cytology. Sixty
      lesions were malignant: cytology was positive in 77.2% and biopsies in 78.3%. The
      yield was increased to 91.7% when both were done (cytology plus six biopsies).
      Cytology detected seven cancers that were missed by biopsy. Biopsy detected eight
      cancers not diagnosed by cytology. Five cancers were missed by both. Of the 47
      cancers detected by biopsy, the first four biopsies made the diagnosis in 41
      cases. Taking two more biopsies (six total) identified six more cancers. No
      additional cancers were identified by taking more biopsies (eight or 10 total).
      When six different biopsy-cytology strategies were examined: 1) cytology alone,
      2) four biopsies (Bx), 3) six Bx, 4) 10 Bx, 5) cytology + four Bx, and 6)
      cytology + six Bx, the yield was 77.2%, 68.3%, 78.3%, 78.3%, 90.0%, and 91.7%,
      respectively. We conclude that biopsy and cytology are complementary in the
      diagnosis of colorectal cancer. The combination of cytology and four to six
      biopsies is recommended. There appears to be little additional yield to taking
      more than six biopsies. Even combined biopsy and cytology will miss 8-10% of
      cancers.

PMID- 8362827
TI  - Long-term management of Crohn's disease with mesalamine capsules (Pentasa).
      Pentasa Crohn's Disease Compassionate Use Study Group.
AB  - Current long-term treatment of Crohn's disease is unsatisfactory. Based on the
      Crohn's Disease Activity Index (CDAI), this multicenter trial enrolled patients
      with either active Crohn's disease (CDAI > or = 150) or disease in remission
      (CDAI < 150). The primary measure of therapeutic response was mean change in CDAI
      from baseline to final visit. All patients began treatment with a dosage of < or
      = 4 g/day of mesalamine that ranged from 3.7 g at baseline to 3.4 g at final
      visit. Overall, 467 patients were enrolled: 333 (active disease) and 134
      (remission). The median study participation time was 14 months. For patients
      entering with active disease, the mean reduction in CDAI was 77 points, with 42%
      (122/289) achieving remission by their final visit. For patients entering in
      remission, there was an increase in mean CDAI from 90 at baseline to 96 at final
      visit, with 79% (95/120) of patients in remission at final visit and 72% (31/43)
      in remission continuously after 12 months of therapy. From baseline to final
      visit, the mean prednisone dose decreased 5 mg/day in patients with active
      disease and 11 mg/day in patients in remission. Mesalamine was well tolerated and
      no adverse laboratory trends were observed. These results suggest that controlled
      release mesalamine shows promise as a steroid-sparing agent and as a safe and
      effective long-term therapy for the induction of and maintenance of remission of
      mild-to-moderate Crohn's disease.

PMID- 8362829
TI  - Utility of endoscopic retrograde cholangiopancreatography in the evaluation of
      idiopathic abdominal pain.
AB  - We investigated the role of endoscopic retrograde cholangiopancreatography in 86
      consecutive patients with idiopathic chronic or recurrent abdominal pain. There
      were 18 males and 68 females with a mean age of 48 yr. Forty patients (47%) had
      previous cholecystectomy. Patients were divided into two groups: group I (normal
      serum alkaline phosphatase and total bilirubin) (n = 52), and group II (elevated
      serum alkaline phosphatase and/or total bilirubin) (n = 34). Pancreatograms were
      normal in all patients, including five with pancreas divisum. Cholangiograms were
      abnormal in 10 of the 34 patients in group II (30%), and in only three of the 52
      patients in group I (6%) (p = 0.003). Bile duct stones were present in 18% of the
      patients in group II, and in none of the patients in group I (p = 0.003). Of the
      40 post-cholecystectomy patients, four patients had bile duct stones and five had
      common bile duct dilation without stones. However, no stones were found in any
      post-cholecystectomy patients with normal liver tests. Of the 46 patients with
      gallbladder in situ, two patients with abnormal liver tests had common bile duct
      stones and two patients had common bile duct dilation without stones. These
      results indicate that, among patients with idiopathic abdominal pain,
      cholangiography should be performed primarily in those with abnormal liver tests;
      however, further investigation with pancreatography is unnecessary.

PMID- 8362830
TI  - Long-term Helicobacter pylori recurrence after successful eradication with triple
      therapy.
AB  - To establish the rate of Helicobacter pylori recurrence after a standard triple
      therapy regimen (bismuth subsalicylate, tetracycline, metronidazole) and
      determine which clinical factors affect reinfection, we prospectively followed
      118 patients after successful H. pylori eradication. Elimination of H. pylori was
      confirmed by repeat endoscopy and urea breath test 4 wk after completion of
      therapy. Serial [13C]urea breath tests were performed at 3-month intervals;
      antral biopsies were used to verify reinfection. Recurrence of H. pylori
      infection occurred in 4/118 (3.4%) patients. Three of the four relapses occurred
      in the 1st yr after treatment. Gender, age, ethnic group, alcohol consumption,
      cigarette use, and gastrointestinal diagnosis do not predict H. pylori
      recurrence. We conclude that the rate of recurrence after successful H. pylori
      eradication is low, and that when reinfection takes place, it occurs most
      commonly within the 1st yr after treatment.

PMID- 8362831
TI  - Gastric mucosal hydrophobicity and Helicobacter pylori: response to antimicrobial
      therapy.
AB  - The hydrophobic properties of the gastric mucosa are reduced by NSAIDs and by
      Helicobacter pylori infection. Our investigation was to determine whether this
      abnormality was due to the bacteria or to the inflammatory response. Contact
      angle measurements were made on gastric antral and corpus biopsies taken from 10
      H. pylori-infected volunteers before eradication therapy, after 2 and 14 days of
      therapy, and 4 weeks after therapy. The contact angle improved steadily and
      statistically throughout the 2 weeks of therapy (for day 0, 3, 14, respectively)
      antral mucosa 54.2 +/- 2, 59.3 +/- 2, and 63.2 +/- 2; corpus mucosa 55 +/- 1,
      57.8 +/- 3, and 66.6 +/- 1. After 2 days of therapy, H. pylori bacteria were no
      longer evident, and yet the contact angle continued to improve, suggesting that
      bacteria and bacterial products (e.g., lipases) may not be critical factors. H.
      pylori was eradicated in five and failed in five. One month after ending therapy,
      the contact angles of those with recrudescence of infection and those with
      eradication were similar and higher (p < 0.05) than before therapy (antrum: 69.8
      +/- 1 vs. 71.1 +/- 2, corpus: 66.4 +/- 4 vs. 70.8 +/- 2) (p > 0.25 for both). We
      conclude that gastric surface hydrophobicity abnormalities do not appear to be
      directly related to the presence of H. pylori organisms or the histologic
      features of acute inflammation, but are responsive to antimicrobial therapy.

PMID- 8362832
TI  - Evaluation of new therapy for eradication of H. pylori infection in nude mouse
      model.
AB  - OBJECTIVES: developing a new therapy for eradication of H. pylori by using the
      nude mouse model. METHODS: By quantifying the number of colonies of Helicobacter
      pylori and the score of H. pylori-associated gastritis from the gastric tissue
      following different drug regimens in inoculated nude mice, we evaluated the
      effectiveness of each regimen, including a new drug, plaunotol. Drugs were
      administered daily for a 1-wk period, beginning 4 wk after inoculation. RESULTS:
      In the examination after therapy, the number of colonies of H. pylori and the
      score of gastritis in the triple-therapy group were significantly lower than in
      any of the singly- and dual-drug groups or control group from 5 wk to the end of
      the study after inoculation. Inflammation of the stomach was less apparent in the
      treatment groups than in the control group. CONCLUSION: With the nude mouse
      model, we quantitatively demonstrated that the new triple therapy is the most
      effective therapy for eradication of H. pylori.

PMID- 8362833
TI  - Helicobacter pylori and intestinal metaplasia: comparison between British and
      Yemeni patients.
AB  - There have been suggestions linking gastric carcinoma with Helicobacter pylori on
      the one hand and type III intestinal metaplasia on the other hand. This study was
      aimed at investigating the relationship between intestinal metaplasia and its
      subtypes, and the presence or absence of H. pylori in gastric biopsies from two
      geographically different patient populations, one with a much higher prevalence
      of H. pylori than the other. Antral biopsies from 179 British and 123 Yemeni
      patients with dyspepsia were examined. Sections stained with hematoxylin and
      eosin, Alcian blue/periodic acid-Schiff, high iron diamine/Alcian blue, and
      Warthin-Starry stains were used to assess the presence or absence of
      inflammation, H. pylori, and intestinal metaplasia with its three subtypes.
      Although Yemeni patients had a significantly higher prevalence of H. pylori than
      British patients (113/123. 92% vs. 83/179, 46% respectively; p < 0.001), Yemeni
      patients had a significantly lower prevalence of all types of intestinal
      metaplasia (23/123, 19% vs. 60/179, 34%; p < 0.001), as well as type III
      metaplasia (4/123, 3% vs. 39/179, 22%, p < 0.001). These trends persisted when
      only patients above the age of 40 yr were considered. However, in British
      patients, intestinal metaplasia was more commonly seen in those with H. pylori
      than in those without (36/83, 43%, and 24/96, 25%, respectively, p < 0.01),
      although the prevalence of type III metaplasia was not significantly different in
      the two groups (23/83, 28% vs. 16/96, 17%, respectively). The contrasting
      findings in the two patient populations suggest the presence of other factors,
      possibly genetic, which control the development of intestinal metaplasia and
      possibly gastric carcinoma in H. pylori-positive patients.

PMID- 8362834
TI  - Premature lower esophageal sphincter closure as a cause of dysphagia.
AB  - Impaired lower esophageal sphincter (LES) relaxation is highly correlated with
      dysphagia. A variation of the impaired relaxation of the LES of achalasia has
      been described, characterized by premature closure after normal relaxation. With
      a microtransducer system, standard manometric testing followed by food ingestion
      identified 33 patients (12 male, 21 female, 18-79 yr old) who exhibited premature
      LES closure. Twenty-three (70%) of these patients had a presenting complaint of
      dysphagia. Of these, seven (30%) experienced dysphagia during food ingestion.
      Manometry documented a concurrent motor abnormality in the esophageal body in 28
      (85%) patients. Of the five remaining patients who did not have a concurrent
      motor abnormality, all had a presenting complaint of dysphagia, and three (60%)
      experienced dysphagia during food ingestion. The incidence of dysphagia during
      testing reported by patients with premature LES closure is comparable to that
      reported by patients with achalasia (45%) or diffuse esophageal spasm (38%) who
      have been studied during food ingestion in our laboratory.

PMID- 8362835
TI  - Esophageal dilation with polyvinyl bougies, using a marked guidewire without the
      aid of fluoroscopy: an update.
AB  - One hundred thirty-eight patients with esophageal stricture underwent polyvinyl
      bougie dilations whereby American Endoscopy dilators were passed over a marked
      guidewire that had been placed endoscopically. Fluoroscopy was not utilized
      during the dilations. The dilations were performed only after the guidewire was
      properly placed, with 60-cm markings at the incisors, which ensured that the tip
      of the guidewire was in the antrum. One hundred fourteen patients had benign
      strictures and 24 had malignant strictures. There were 197 sessions of dilations
      for a total of 748 individual dilations. In 97 of 138 patients, the guidewire was
      placed in the antrum under direct vision. The remaining 41 patients had
      significant esophageal stenosis which prevented passage of the endoscope into the
      stomach; therefore, the guidewire was placed by advancing it blindly through the
      stenosis. There were no procedure-related complications. During this period,
      eight patients were dilated without complications, using fluoroscopic placement
      of guidewire because endoscopic placement of the guidewire was not considered
      safe. We conclude that esophageal strictures can be safely dilated in most
      patients by means of the American Endoscopy dilator system and the marked
      guidewire without the aid of fluoroscopy.

PMID- 8362836
TI  - Abnormal gallbladder function in patients with irritable bowel syndrome.
AB  - Abnormalities of the autonomic nervous system function and cholecystokinin
      release have been described in patients with irritable bowel syndrome. Because
      the autonomic nervous system and cholecystokinin have an important role in the
      normal functioning of the gallbladder, we studied gallbladder contraction in
      response to a meal, using real time ultrasonography in irritable bowel syndrome
      patients (n = 20) and healthy controls (n = 15). The following parameters were
      studied: 1) fasting gallbladder volume, 2) residual volume after maximal
      contraction and at the end of 2 h, 3) maximum percent of gallbladder emptied, and
      4) the time taken for maximal contraction. Fasting gallbladder volume (26.21 +/-
      1.81 ml vs 15.21 +/- 1.63 ml, p < 0.001), and residual volume after maximal
      contraction (14.2 +/- 1.69 ml vs. 5.86 +/- 0.98 ml, p < 0.001) and at the end of
      2 h (18.81 +/- 1.73 ml vs. 11.65 +/- 1.45 ml, p < 0.01) were significantly higher
      in the patient group, compared with controls. The maximum emptying was less
      (49.55 +/- 2.75% vs. 63.98 +/- 4.55%, p < 0.01) and the time taken for maximal
      contraction (59.25 +/- 3.8 min vs. 42.33 +/- 2.04 min, p < 0.001) was longer in
      the patient group than in the controls. Based on these observations, we conclude
      that patients with irritable bowel syndrome have significant abnormalities of
      gallbladder motor function.

PMID- 8362837
TI  - Does use of the Coloscreen Self-Test improve patient compliance with fecal occult
      blood screening?
AB  - Occult blood-screening methods which do not require stool manipulation have been
      devised in an attempt to improve patient compliance with fecal occult blood
      testing. We performed a randomized, prospective study comparing patient
      compliance with the Coloscreen Self Test, a fecal occult blood detection method
      which does not require stool manipulation, and standard guaiac-impregnated cards
      in a VA clinic and a university-based private practice to determine whether the
      Coloscreen Self-Test would improve patient compliance with fecal occult blood
      testing. Overall, there was no significant difference in compliance between the
      two tests, with a compliance of 71% (105/147) for the guaiac cards and 60%
      (88/136) for the Coloscreen Self-Test (p = 0.49). However, multiple logistic
      regression showed that, when using the Coloscreen Self-Test, patients at the VA
      clinic had significantly reduced compliance. Only 46% (23/50) returned the
      Coloscreen Self-Test compared with 84% (42/50) who returned the guaiac cards (p <
      0.05). We conclude that the Coloscreen Self-Test does not improve patient
      compliance with fecal occult blood testing, and may reduce compliance in some
      sectors of the population.

PMID- 8362838
TI  - The morphologic relationship of sinus and fistula formation to intestinal
      stenoses in children with Crohn's disease.
AB  - Sinus and fistula (SF) formation in adults with Crohn's disease has been ascribed
      to increased intraluminal pressure from stenotic lesions or to inflammation. We
      retrospectively evaluated 55 surgically resected specimens from 30 children with
      Crohn's disease for stenotic lesions, sinuses, fistulas, and inflammation.
      Eighteen of 30 children had one operation, and there were 12 multiple surgeries.
      Thirty-one of 55 specimens (56%) contained stenoses. SF formation was seen in 16
      of 31 specimens with stenosis; it developed proximal to the stenosis in seven
      patients, distal in five, and both proximal and distal in four. SF formation was
      also noted in 12/24 specimens without stenosis. In 93% of the cases, the SF was
      associated with moderate to severe inflammation. Although 56% of the patients had
      stenoses, SF frequently developed independent of stenosis. All SF were associated
      with inflammation. Therefore, inflammation rather than increased intraluminal
      pressure appears to be the primary factor in SF formation in children with
      Crohn's disease.

PMID- 8362839
TI  - Recurrent gallstone formation after successful extracorporeal shock-wave
      lithotripsy.
AB  - Gallstone recurrence was evaluated in 184 patients exhibiting complete stone
      disappearance after successful extracorporeal shock-wave lithotripsy (ESWL) and
      concomitant oral bile acid therapy. Follow-up examinations conducted 6-43 months
      after termination of adjuvant bile acid therapy revealed recurrent calculi in
      40/184 (21.7%) patients (27 females, 13 males, p < 0.01; 13 patients with
      solitary, 27 patients with multiple stones) after a median stone-free period of
      11 months (range 1-33 months; mean +/- SD, 13 +/- 8 months). Therefore, an
      overall probability of stone recurrence of 11.8% was observed 12 months after
      complete stone disappearance had been confirmed sonographically and bile salt
      therapy terminated, and a probability of 25.5% after 24 months. Gallstone
      reformation occurred in 30/146 (20.5%) patients with initially solitary and 10/38
      (26.3%) patients with multiple calculi [not significant (NS)]. Only 3/40 (8%)
      patients with recurrent calculi reported biliary colic. Sonographic gallbladder
      contractility values acquired at the time recurrent stones were detected did not
      show any significant differences, compared with the data obtained in the
      pretreatment examinations; neither were any differences noted between the
      patients with gallstone reformation and those who remained stone-free. In 20/33
      (61%) patients with recurrent stones who opted for further conservative
      retreatment (ESWL and/or oral litholysis), complete stone disappearance was
      achieved a second time. The recurrence rates achieved within the first 3 yr after
      successful shock-wave lithotripsy of biliary calculi cover a range similar to the
      rates noted after dissolution therapy.

PMID- 8362840
TI  - Obesity and weight reduction do not influence gastric emptying and antral
      motility.
AB  - A dual radioisotope technique was used to measure gastric emptying of a mixed
      solid and liquid meal in 30 obese (> 125% of ideal body weight) subjects and 23
      age- and sex-matched nonobese control subjects. Gastroduodenal motility studies
      were also performed on seven obese and 10 nonobese subjects to compare
      postprandial antral motility. In addition, eight obese subjects underwent gastric
      emptying studies before and after substantial weight reduction (mean 8.3%).
      Gastric emptying of both solids and liquids was similar in obese and nonobese
      subjects, and antral motility indices did not differ between the groups. Gastric
      emptying rates before and after substantial weight reduction were similar. We
      conclude that neither gastric emptying nor antral motility appear to be abnormal
      in morbidly obese subjects; neither does gastric emptying appear to be affected
      by substantial acute weight reduction.

PMID- 8362841
TI  - Endoscopic diagnosis and resection treatment for flat adenoma with severe
      dysplasia.
AB  - In a prospective study from 1988 to 1991, we discovered 31 flat colon adenomas in
      29 patients and performed endoscopic resection of 27 of these lesions, using the
      strip biopsy technique. All of these lesions were safely and completely resected
      even in the thin walls of the colon. All 27 lesions were histologically flat
      adenomas confined to the mucosa, with a maximum diameter of 3-20 mm. Thirteen
      were identified as severe dysplasia, three as moderate dysplasia, and 11 as mild
      dysplasia. These lesions were more clearly defined after they were sprayed with
      indigo carmine endoscopically. The 13 flat adenomas with severe dysplasia were
      morphologically slightly depressed red lesions with elevation of the surrounding
      mucosa (six lesions) and flat round red lesions with no changes in the
      surrounding mucosa (seven lesions). Due to the high incidence of severe dysplasia
      found in flat adenomas, removal using strip biopsy is recommended.

PMID- 8362842
TI  - Octreotide in the treatment of bleeding due to angiodysplasia of the small
      intestine.
AB  - Three patients with a history of bleeding due to small bowel angiodysplasia
      (repeated melena or occult fecal blood with serious anemia) were treated for 10
      40 months with octreotide, a somatostatin analog that reduces the splanchnic
      flow. A dose of 0.1 mg subcutaneously twice a day was followed by an increase in
      hemoglobin, and reduction or elimination of the need for transfusions. There were
      no further melena episodes, and stool hemoglobin became stably negative in two
      cases. Suspension of the drug after 6 months in one case was followed by renewed
      bleeding, and resumption led to a further response. Lower doses tried in another
      case were ineffective. Although these uncontrolled clinical cases do not prove
      its efficacy, octreotide appears to be beneficial in the control and prevention
      of bleeding due to diffuse small bowel angiodysplasia. There is no evidence that
      it results in regression of angiodysplasias, as they persisted in the patient
      subjected to control jejunoileoscopy.

PMID- 8362843
TI  - Impact of stress on serum gastrin in Zollinger-Ellison syndrome.
AB  - We report an impressive case with Zollinger-Ellison syndrome (ZES), in which
      stress-induced sympathetic discharge influenced serum gastrin. Our patient was a
      35-yr-old female who complained of frequent and massive vomiting (more than 4000
      ml of gastric juice) which was aggravated especially by psychosocial stress.
      Basal hypergastrinemia (1900 pg/ml) was found after the admission. The most
      striking finding was that laboratory stress dramatically increased serum gastrin
      (from 1900 to 5400 pg/ml) and plasma noradrenaline (from 180 to 1130 pg/ml).
      Mental arithmetic stress further enhanced hypergastrinemia (5800 pg/ml) with a
      concomitant increase in plasma noradrenaline (1240 pg/ml). Neostigmine (10
      micrograms/kg im) also increased serum gastrin up to 6100 pg/ml but propranolol
      (40 micrograms/kg i.v.) reduced these elevations (noradrenaline: 990 pg/ml,
      gastrin: 5000 pg/ml). In this case, the effect of stress on serum gastrin
      mimicked the effect of catecholamine infusion in ZES. These findings suggest that
      psychological stress induces serum gastrin secretion via beta-adrenoceptor with
      exacerbation of symptoms in some cases with ZES.

PMID- 8362844
TI  - A case of radical resection for solid cystic tumor of the pancreas with
      widespread metastases in the liver and greater omentum.
AB  - Solid cystic tumor (SCT) of the pancreas is known to be a low-grade malignant
      tumor and distant metastasis is very rare. A 50-year-old Japanese female was
      hospitalized because of a large mass in the upper abdomen. Computerized
      tomography revealed a large calcified tumor in the body-tail of the pancreas, and
      multiple liver tumors. Abdominal angiography demonstrated the pancreatic tumor
      and multiple hepatic tumors as a hypervascular mass, and disclosed a small tumor
      stain in the branch of the right gastroepiploic artery. The patient underwent a
      distal pancreatectomy with splenectomy, extended right hepatic lobectomy, and
      removal of the omental metastases. Histopathological and electron microscopic
      studies made a definitive diagnosis of SCT. She is well without any signs of
      tumor recurrence 1 yr and 2 months after the operation. This may be the first
      patient receiving simultaneous radical resection for both the main tumor and
      widespread distant metastases.

PMID- 8362845
TI  - Hepatic and pancreatic involvement in systemic amyloidosis.

PMID- 8362846
TI  - Diffuse gastrointestinal dysmotility in a patient with rheumatoid arthritis.

PMID- 8362847
TI  - Diagnostic endoscopy via gastrostomy or PEG stoma.

PMID- 8362848
TI  - Acute gastrointestinal hemorrhage from non-Hodgkin's lymphoma of the jejunum
      after orthotopic heart transplantation.

PMID- 8362849
TI  - Pancreatic pseudocysts involving both hepatic lobes.
AB  - We report a patient who developed pancreatic pseudocysts involving both hepatic
      lobes, after an episode of alcoholic pancreatitis. The possible routes by which
      pancreatic secretions may reach the liver, as well as diagnostic and therapeutic
      approaches, are discussed.

PMID- 8362851
TI  - Embolization therapy for lower GI bleed: benefit or "bombs away"?

PMID- 8362850
TI  - Inflammatory pseudotumor of the liver in a patient with chronic sclerosing
      cholangitis.
AB  - Inflammatory pseudotumor of the liver (IPL) is a rare fibro-inflammatory mass of
      unknown etiology, resembling a neoplasm. We report the occurrence of such a
      lesion in a young male Cambodian refugee to Canada who had a history of chronic
      cholangitis. Imaging studies suggested an intrahepatic abscess. Our report
      suggests that the lesion in this patient may have resulted from chronic portal
      pyemia.

PMID- 8362852
TI  - Unlocking the mysteries of portal hypertensive gastropathy.

PMID- 8362853
TI  - Response to Dr. Robert Fitzgibbons' editorial on laparoscopic cholecystectomy:
      the procedure of choice for acute cholecystitis.

PMID- 8362854
TI  - Corrugated ringed esophagus.

PMID- 8362855
TI  - A multicenter, randomized, controlled trial to evaluate the effect of
      prophylactic octreotide on ERCP-induced pancreatitis.

PMID- 8362856
TI  - Chyloperitoneum associated with sarcoidosis.

PMID- 8362857
TI  - Liver dysfunction caused by parvovirus B19.

PMID- 8362858
TI  - Caffeine withdrawal, metoclopramide, and depression.

PMID- 8362859
TI  - Gastric toxoplasmosis in the acquired immunodeficiency syndrome.

PMID- 8362860
TI  - Endothelin level in human ascitic fluid.

PMID- 8362861
TI  - Is taurine effective for treatment of painful muscle cramps in liver cirrhosis?

PMID- 8362862
TI  - National survey shows rise in drug use among young secondary school students.

PMID- 8362863
TI  - Cigarette smoking rate stabilizes after years of decrease.

PMID- 8362864
TI  - Physicians say direct-to-consumer advertising affects patient behavior.

PMID- 8362866
TI  - Forming a student hospital pharmacy society.

PMID- 8362865
TI  - Family and Medical Leave Act of 1993.

PMID- 8362867
TI  - Planning for simultaneous vacations.

PMID- 8362868
TI  - Visual compatibility of premixed theophylline or heparin with selected drugs for
      i.v. administration.

PMID- 8362869
TI  - Drug allergies, adverse drug reactions, and the patient record.

PMID- 8362870
TI  - ASHP national survey of hospital-based pharmaceutical services--1992.
AB  - The results of a national mail survey of pharmaceutical services in community
      hospitals conducted by ASHP during summer 1992 are reported and compared with the
      results of earlier ASHP surveys. A simple random sample of community hospitals
      (short-term, nonfederal) was selected from community hospitals registered by the
      American Hospital Association. Questionnaires were mailed to each director of
      pharmacy. The adjusted gross sample size was 889. The net response rate was 58%
      (518 usable replies). The average number of hours of pharmacy operation per week
      was 105. Complete unit dose drug distribution was offered by 90% of the
      respondents, and 67% offered complete, comprehensive i.v. admixture programs. A
      total of 73% of the hospitals had centralized pharmaceutical services. Some 83%
      provided services to ambulatory-care patients, including clinic patients,
      emergency room patients, patients being discharged, employees, home care
      patients, and the general public. A computerized pharmacy system was present in
      75% of the departments, and 86% had at least one microcomputer. More than 90%
      participated in adverse drug reaction, drug-use evaluation, drug therapy
      monitoring, and medication error management programs. Two thirds of the
      respondents regularly provided written documentation of pharmacist interventions
      in patients' medical records, and the same proportion provided patient education
      or counseling. One third provided drug management of medical emergencies. One
      fifth provided drug therapy management planning, and 17% provided written
      histories. Pharmacokinetic consultations were provided by 57% and nutritional
      support consultations by 37%; three fourths of pharmacist recommendations were
      adopted by prescribers. A well-controlled formulary system was in place in 51% of
      the hospitals; therapeutic interchange was practiced by 69%. A total of 99%
      participated in group purchasing, and 95% used a prime vendor. The 1992 ASHP
      survey revealed a continuation of the changes in many hospital-based
      pharmaceutical services documented in earlier surveys (e.g., growth in clinical
      services, ambulatory-care services, computerization) and identified static areas
      that merit the attention of pharmacy leaders (e.g., provision of complete,
      comprehensive i.v. services).

PMID- 8362871
TI  - Leaching of diethylhexyl phthalate from polyvinyl chloride containers by selected
      drugs and formulation components.
AB  - The extent of leaching of diethylhexyl phthalate (DEHP) from polyvinyl chloride
      (PVC) bags by several organic solvents and surfactants used as formulation
      components and by 12 drug products containing these solvents and surfactants was
      studied. The organic solvents ethanol, polyethylene glycol, and propylene glycol,
      the surfactants polysorbate 80 and polyoxyethylated castor oil, and the 12 drugs
      were admixed separately in PVC bags of 5% dextrose injection. At the time of
      preparation and after 4, 8, and 24 hours at 24 degrees C, the concentration of
      DEHP in duplicate samples was determined in duplicate by high-performance liquid
      chromatography. Ethanol, polyethylene glycol, and propylene glycol at
      concentrations of 25% and the drugs containing these components did not leach
      DEHP within the study period. Polysorbate 80 1% to 25% leached detectable amounts
      of DEHP in as little as one hour at the high concentration and within four hours
      at the lower concentrations; at 24 hours, DEHP concentrations ranged from 36
      micrograms/mL for 1% polysorbate 80 to 237 micrograms/mL for 25% polysorbate 80.
      Similar results were observed for polysorbate 80 plus ethanol and for
      polyoxyethylated castor oil plus ethanol. Drug products containing surfactants,
      including cyclosporine, miconazole, and teniposide, and the vehicles used in
      formulating taxol and taxotere, leached relatively large amounts of DEHP in 24
      hours. Smaller amounts were leached by chlordiazepoxide hydrochloride and
      etoposide. DEHP was leached from PVC containers by a variety of surfactants and
      drug products containing these surfactants. Drugs that leach DEHP should be
      prepared in non-PVC containers and administered through non-PVC tubing.

PMID- 8362872
TI  - Compatibility and stability of ondansetron hydrochloride, dexamethasone, and
      lorazepam in injectable solutions.
AB  - The stability of ondansetron hydrochloride, dexamethasone sodium phosphate, and
      lorazepam in 5% dextrose injection or 0.9% sodium chloride injection in polyvinyl
      chloride (PVC) minibags and glass bottles was studied. Triplicate solutions of 8
      or 32 mg of ondansetron (as the hydrochloride salt) mixed with 20 mg of
      dexamethasone phosphate (as the sodium salt) with or without 2 mg of lorazepam
      were compounded in 50-mL PVC minibags and glass bottles containing either 5%
      dextrose injection or 0.9% sodium chloride injection and stored at 23-25 degrees
      C. Duplicate measurements were performed when drugs were added and at 1, 2, 4, 8,
      and 24 hours after addition. Samples of the 32-mg ondansetron admixtures were
      collected under aseptic conditions to inspect for precipitation and to count
      particles with a laser particle analyzer. Samples of all admixtures were
      evaluated for chemical stability by stability-indicating high-performance liquid
      chromatography. Ondansetron hydrochloride and dexamethasone were physically
      compatible and chemically stable for up to 24 hours under the study conditions.
      The concentration of lorazepam in PVC containers dropped below 90% of the
      original concentration within four hours. In addition, particle counts in
      lorazepam-containing solutions were higher when 0.9% sodium chloride injection
      was the diluent than when 5% dextrose injection was the diluent. In admixtures
      containing all drugs, ondansetron hydrochloride and dexamethasone sodium
      phosphate in 5% dextrose injection or 0.9% sodium chloride injection were stable
      for up to 24 hours when stored in PVC bags or glass bottles.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8362873
TI  - Converting from a hospital mainframe to a pharmacy stand-alone system.

PMID- 8362874
TI  - Converting from a hospital mainframe to an interim stand-alone system in a home
      infusion company.

PMID- 8362875
TI  - Changing to a new vendor and new hospital information system.

PMID- 8362876
TI  - Converting from manual to computerized medication administration records.

PMID- 8362877
TI  - Improving drug use through purchase agreement commitments.

PMID- 8362878
TI  - Diagnoses and prescribing for pediatric patients at two hospitals in Harare,
      Zimbabwe.

PMID- 8362879
TI  - Optically scannable form for documenting pharmacists' patient-care activities.

PMID- 8362880
TI  - Pharmacist liability.
AB  - The various legal theories under which pharmacists may be found liable are
      reviewed. The pivotal element in determining pharmacist malpractice is the study
      that was owed to the patient. A pharmacist's principal duties to the patient are
      to dispense the correct drug and to label it correctly; failure to fulfill either
      of these responsibilities had led to successful claims of malpractice. There have
      been only a few cases in which the court ruled that the pharmacist had a duty to
      warn the patient about a potential adverse drug effect or interaction. However,
      as the role of the pharmacist expands, more courts may begin to find pharmacists
      liable for failing to warn the patient under specific circumstances. Pharmacists
      have a heightened duty to warn the patient about potential problems associated
      with nonprescription drugs that they recommend. A pharmacist may escape liability
      if there was a lack of proximate cause. Similarly, the defenses of contributory
      or comparative negligence and voluntary assumption of risk are based on some
      conduct by the plaintiff that negates or modifies the pharmacist's negligence.
      Statutes of limitation can also exclude liability. Courts have not found
      pharmacists liable under strict liability theories. A breach of warranty claim
      has rarely been successful. Pharmacists could be found liable for negligent
      selection of therapeutic alternatives but probably not for injuries allegedly
      caused by correctly selected equivalent agents. Although no cases have been
      reported, pharmacists could be subjected to negligence-based liability for
      nondistributive pharmaceutical services. As pharmacists assume more
      responsibilities, pharmacist malpractice law will expand.

PMID- 8362881
TI  - Hospital's obligation to monitor medical services. Thompson v. Nason Hospital.

PMID- 8362882
TI  - Draft technical assistance bulletin on quality assurance for pharmacy-prepared
      sterile products. American Society of Hospital Pharmacists, Council on
      Professional Affairs.

PMID- 8362883
TI  - Draft guidelines on compounding of nonsterile products in pharmacies. American
      Society of Hospital Pharmacists.

PMID- 8362884
TI  - ASHP technical assistance bulletin on pharmacy-prepared ophthalmic products.
      American Society of Hospital Pharmacists.

PMID- 8362886
TI  - Biologic response modifiers: Clinical effects and pharmacoeconomic issues.

PMID- 8362885
TI  - An outpatient pharmacy services benefit in a reformed health care system.
      Coalition for Consumer Access to Pharmaceutical Care.

PMID- 8362887
TI  - Reimbursement and pharmacoeconomic perspectives in biotechnology.
AB  - Problems associated with reimbursement for biotechnology agents and strategies
      for solving these problems are reviewed. Because of the many different insurers
      in the U.S. health care system, a variety of reimbursement strategies have been
      developed for the biotechnology drugs that are now reaching the market. These
      strategies can vary by insurer, contract, treatment setting, and patient
      condition. With the advent of high-cost biotechnology drugs, pharmacists have
      taken on the additional roles of institutional educators and reimbursement
      specialists. Case studies involving three biotechnology agents illustrate how
      insurers deal with reimbursement for these drugs. Thrombolytic agents are
      reimbursed under Medicare, but the diagnosis-related-group (DRG) payment for
      myocardial infarction was not changed until two years after alteplase was
      marketed. Septic shock therapies potentially face similar reimbursement problems,
      which are compounded because the drugs can be lifesaving--leading to longer
      hospital stays. When filgrastim is administered, the amount reimbursed depends on
      the treatment setting. When claims for biotechnology agents are denied, the
      institution or provider should contact the payer to provide the needed
      information (in the case of missing information) or to discuss payer policies
      that may need review. Through proper case management, pharmacists and other
      institutional personnel can ensure reimbursement for these lifesaving
      biotechnology therapies.

PMID- 8362888
TI  - Strategic management of biotechnology agents.
AB  - The use of biologic response modifiers to demonstrate a value-driven approach to
      strategic management by pharmacists is described. To participate in decisions on
      the use of technology in their institutions, pharmacists must practice strategic
      management. This process includes environmental scanning, analysis of clinical
      and pharmacoeconomic data, and development of clinical management approaches. It
      is ideal for analyzing biologic response modifiers such as filgrastim and
      sargramostim. Emphasis must be placed on maximizing the fit among the products,
      the institution, and the health care environment. Pharmacists will find plentiful
      opportunities for clinical management with biotechnology agents. Practitioners
      who specialize in determining the total cost of care by using pharmacoeconomic
      methods are needed, as are practitioners trained to monitor the complicated
      biotechnology agents. Also, the institution needs to forecast accurately the
      impact of emerging biotechnology agents. If pharmacists can develop and control
      clinical, pharmacoeconomic, and reimbursement information databases for
      biotechnology agents, the pharmacy profession will be in a strong position to
      meet the challenges of biotechnology and realize the inherent opportunities.

PMID- 8362889
TI  - Overview of the immune and hematopoietic systems.
AB  - Current knowledge of the immune and hematopoietic systems is reviewed. All blood
      cells are derived from the totipotent stem cell, also known as the pluripotent
      stem cell. The differentiation of pluripotent peripheral stem cells into blood
      cells is controlled by a variety of biologic response modifiers, including colony
      stimulating factors (CSFs) and interleukins. Among the known CSFs are stem cell
      growth factor, granulocyte-macrophage CSF, multilineage CSF (interleukin-3),
      granulocyte CSF, macrophage CSF, and erythropoietin. CSFs are categorized as
      class I (those that stimulate the production of several types of blood cells;
      also called pluripotent) and class II (those that stimulate only one cell line;
      also called unipotent). Effects of CSFs can be studied using laboratory tests of
      colony-forming-unit activity. Pathogens entering the body through damaged skin or
      mucous membranes are met with both a cellular response (neutrophils, macrophages,
      cytotoxic T lymphocytes, and natural killer cells) and a humoral response
      (antibodies and complement). There is interplay between these two arms of the
      immune system to defend against foreign antigens. This interplay can occur by
      cell-to-cell contact and by cytokines. Hematopoietic and immune cells of the body
      are produced and destroyed under precise control of many different biologic
      response modifiers, including the colony-stimulating factors, interleukins, and
      interferons.

PMID- 8362890
TI  - Case report: hypothalamic tuberculoma associated with secondary
      panhypopituitarism.
AB  - Tuberculosis of the central nervous system remains quite rare in developed
      countries, accounting for only 0.53% of cases of tuberculosis in the United
      States. The most common form of intracranial tuberculosis is tuberculous
      meningitis; however, involvement may also take the form of a solid granulomatous
      mass (tuberculoma), which accounts for 15% to 30% of the neurosurgical cases in
      developing countries. An unusual case of a hypothalamic tuberculoma is presented
      in a man, who initially presented with signs and symptoms consistent with
      panhypopituitarism. Brain biopsy on two occasions confirmed caseating granuloma,
      and treatment with several antituberculous medications led to clinical
      improvement and radiographic resolution of the disease.

PMID- 8362891
TI  - Acute lung injury: what have we learned from animal models?
AB  - In 1950, Carl John Wiggers, philosopher and physiologist, wrote, "Reactions to
      definite types of stimulation may be observed or recorded, and concealed
      phenomena may be revealed by the use of apparatus that transforms them into forms
      that are recognizable by human senses. But complete understanding of
      physiological reactions often necessitates extensive operative procedures and
      sometimes the ultimate sacrifice of life. For this reason experimentation on
      animals is indispensable." Acute lung injury is still a significant cause of
      death in the developed world, and modern pharmacology and intensive care have
      failed to alter the clinical course of this complex condition. In the past
      decade, there was an explosion in understanding of the pathophysiology of acute
      lung injury, and with this has come the development of a new generation of agents
      that may provide a tool with which to combat this disorder. Use of animal model
      systems led to this greater understanding and is currently at the heart of
      evaluating the new therapeutic agents. This review briefly addresses the
      contribution animal model systems have made to what appear to be a watershed in
      attempts to obviate the effects of this mortal condition.

PMID- 8362892
TI  - Obesity and the heart.
AB  - Obesity can result in alterations in cardiac structure and function even in the
      absence of systemic hypertension and underlying organic heart disease. Increased
      total blood volume creates a high cardiac output state that may cause ventricular
      dilatation and ultimately eccentric hypertrophy of the left (and possibly the
      right) ventricle. Eccentric left ventricular (LV) hypertrophy produces diastolic
      dysfunction. Systolic dysfunction may ensue due to excessive wall stress if wall
      thickening fails to keep pace with dilatation. This disorder is referred to as
      obesity cardiomyopathy. The presence of systemic hypertension in obese
      individuals facilitates development of LV dilatation and hypertrophy. Congestive
      heart failure may occur in such individuals, and may be attributable to LV
      diastolic dysfunction or to combined LV diastolic and systolic dysfunction. The
      sleep apnea/obesity hypoventilation syndrome occurs in 5% of morbidly obese
      individuals and is potentially life-threatening. Treatment of obesity
      cardiomyopathy consists of weight loss, salt restriction, and diuretics.
      Digitalis and vasodilators may be useful in selected cases. Central obesity is
      probably a risk factor for the development of coronary heart disease. Alterations
      in lipid and insulin metabolism may facilitate development of coronary heart
      disease in obese patients.

PMID- 8362893
TI  - Current physician screening and treatment of hypercholesterolemic patients.
AB  - To determine resident physician recognition and treatment of
      hypercholesterolemia, a retrospective chart audit was performed on 300
      systematically selected patients seen in an internal medicine resident's
      continuity care clinic during the spring of 1992. A self-administered resident
      survey was given after completion of chart selection. Of the 300 patients, 64
      (21%) did not have a cholesterol reading on the chart. The frequency of screening
      was unaffected by cardiac risk factors, patient race or sex, or resident level of
      training or specialty. Of the 96 patients who had a total cholesterol greater
      than 240 mg/dL documented in the chart, 48% received diet therapy, 46% received
      other nonpharmacologic therapy, 24% received drug therapy, 4% were referred to a
      lipidologist, and 30% received no treatment. Fasting lipid profiles were ordered
      for 57% of these patients. The frequency of therapy was unaffected by patient
      race or sex, resident level of training or specialty, or presence of two or more
      cardiac risk factors, although patients with a diagnosis of hypercholesterolemia
      and patients younger than age 65 were treated significantly more often. Resident
      action primarily involved evaluation rather than therapy. Efforts to improve the
      aggressiveness of treatment for hypercholesterolemia by resident physicians are
      necessary.

PMID- 8362894
TI  - Induction of cardiac insulin-like growth factor I gene expression in pressure
      overload hypertrophy.
AB  - Molecular mechanisms regulating the cardiac hypertrophic response to increased
      hemodynamic load are understood poorly. Insulin-like growth factor I (IGF I) is a
      mitogen that is thought to play a key role in pre- and postnatal growth. To
      investigate a possible role of IGF I in the cardiac response to pressure
      overload, rats underwent banding of the ascending aorta immediately above the
      aortic valve using a hemoclip, or a sham procedure. An analysis of left
      ventricular RNA by Northern hybridization using a 32P-labeled IGF I cDNA revealed
      four messenger ribonucleic acid transcripts of 7.6, 4.6, 1.7, and 0.9 to 1.2 Kb.
      Insulin-like growth factor I messenger ribonucleic acid was quantitated by
      ribonuclease protection assays using a rat exon 3 riboprobe. There was a
      sustained increase in IGF I mRNA levels that correlated temporally with the
      development of left ventricular hypertrophy. These results indicate that left
      ventricular pressure overload is associated with an induction of cardiac IGF I
      gene expression. Insulin-like growth factor I may play a role in the response to
      increases in wall stress and likely contribute to cardiac hypertrophy.

PMID- 8362895
TI  - Heparin does not stimulate coronary-collateral growth in a canine model of
      progressive coronary-artery narrowing and occlusion.
AB  - To investigate the possible effect of heparin on coronary-collateral growth, dogs
      were instrumented chronically with a left circumflex (LCF) flow probe, an ameroid
      constrictor, a balloon occluder, and left and right atrial and aortic catheters.
      Collateral blood flow was measured at least weekly or when the coronary artery
      was occluded. Animals were allocated randomly to a control or treatment group.
      The latter received a continuous right-atrial infusion of a heparin solution at a
      rate of 2 to 3 ml/hour and a concentration adjusted daily to increase the
      activated clotting time to approximately 3 times the pre-drug level. After LCF
      occlusion, coronary-collateral flow was measured during exercise. There was no
      difference in time to LCF occlusion in the anticoagulated dogs. Furthermore,
      neither the rate of collateral development, the magnitude of collateral flow
      shortly after spontaneous LCF occlusion, nor the degree of collateral vascular
      reserve during exercise was different in the two groups. Therefore, in this model
      of coronary obstructive disease, heparin does not accelerate coronary-collateral
      development.

PMID- 8362896
TI  - Determination of rebreathing oxygen consumption and derivation of oxygen delivery
      in intubated mongrel dogs after phlebotomy and isoproterenol infusion.
AB  - This study attempted to determine the correlation between oxygen consumption
      (VO2), pulmonary-capillary blood flow (QEPC), and oxygen delivery (DO2) by
      rebreathing and invasive techniques obtained over a range of hemoglobin
      concentration and cardiac output. Twenty mongrel dogs were instrumented with
      central arterial and venous catheters to determine DO2 by thermodilution cardiac
      output and standard formulas. The animals were administered isoproterenol in
      doses that increased DO2 and subsequently were serially phlebotomized by 30%,
      40%, and 50% to decrease DO2. All animals were studied using a rebreathing
      technique to determine noninvasively VO2, QEPC, and DO2. Sixteen dogs completed
      the experimental protocol. A correlation analysis was carried out for VO2, QEPC,
      and DO2 obtained by the rebreathing and invasive methods. Thermodilution cardiac
      output increased from 3.91 +/- 1.77 L/min at baseline to 8.19 +/- 2.50 L/min
      during isoproterenol infusion. Hemoglobin varied from 12.21 +/- 1.26 gm% at
      baseline to 5.21 +/- 1.36 g% at 50% phlebotomy. Over this range of conditions,
      significant correlations were obtained between rebreathing VO2 and invasive VO2
      (r = 0.80, p < 0.0001), rebreathing QEPC and invasive QEPC (r = 0.79, p <
      0.0001), and rebreathing DO2 and invasive DO2 (r = 0.82 p < 0.0001). These data
      demonstrate that the rebreathing technique can be used to monitor oxygen
      metabolism over wide ranges of DO2.

PMID- 8362897
TI  - Analysis of the expression of seven G protein alpha subunit genes in
      hematopoietic cells.
AB  - Various heterotrimeric GTP-binding proteins may have important functions in
      hematopoietic cells. There has been no comprehensive information, however,
      regarding their expression in various-lineage hematopoietic cells. In this
      report, the expression level of seven G protein alpha subunits (Gs alpha, Gi1
      alpha, Gi2 alpha, Gi3 alpha, Go alpha-1, Go alpha-2, and Gx alpha) in 13
      hematopoietic cell lines were analyzed by Northern blot analysis. Gi1 alpha, Go
      alpha-1, Go alpha-2, and Gx alpha, were expressed in a limited number of cell
      lines whereas Gs alpha, Gi2 alpha, and Gi3 alpha were expressed ubiquitously in
      nearly all cell lines tested. Gi1 alpha was expressed selectively in a pre-T cell
      line, P30/PHK among lymphoid-lineage cell lines and a myeloblastic cell line, KG
      1 among myelomonocytoid cell lines. Go alpha-1 was expressed only in a chronic
      myelocytic-leukemia cell line, K-562, whereas Go alpha-2 was not expressed in any
      cell lines tested after ordinary exposure of autoradiography (within 4 days). Gx
      alpha was expressed abundantly in a rat basophilic-leukemia cell line, RBL-2H3,
      and expressed in K-562. A barely detectable amount of Gx alpha messenger
      ribonucleic acid (mRNA) was found after a long exposure of autoradiography in
      several cell lines with megakaryoblastoid phenotype.

PMID- 8362898
TI  - Creating an objective structured clinical examination for the internal medicine
      clerkship: pitfalls and benefits.
AB  - The objective-structured clinical examination (OSCE) is a useful tool in
      evaluating clinical competence. Traditional clinical-evaluation measures have
      been criticized as arbitrary and lacking reliability, whereas written exams test
      primarily cognitive aspects. The OSCE focuses on learner actions rather than
      abstract knowledge and evaluates in a uniform fashion. A 15-station OSCE was
      created for an internal medicine junior clerkship, based on predetermined skill
      and content goals. The exams then were scored by a single, blinded reviewer,
      again in a predetermined fashion. The OSCE has been studied in terms of
      reliability, content validity, and construct validity. The exam has become
      accepted by the department and has guided the continuing curricular development.
      The OSCE is not designed to measure all the domains of a learner's educational
      process. However, when used in conjunction with other evaluating mechanisms, it
      provides an objective outcome measure of the medical education process.

PMID- 8362899
TI  - Reducing financial barriers enhances the return rate of stool Hemoccult packets.
AB  - Patient compliance in returning fecal-hemoccult card packets has been studied in
      recent years but no specific interventions have been shown consistently to
      improve the return rate. It was wondered whether removing a small financial
      barrier for indigent patients would positively affect compliance. Therefore, the
      effect of prepaid postage on the rate of return was studied. Pre-prepared packets
      containing hemoccult cards with return envelopes were distributed in a randomized
      fashion to indigent and private insurance patients in outpatient clinics. On half
      of the return envelopes return postage was applied. The main outcome measure was
      the rate of return of stamped and unstamped packets stratified between indigent
      and private insurance patients. The overall rates of return were 117 of 159 (74%)
      for the stamped packets and 102 of 166 (61%) for unstamped packets (p < 0.02).
      After stratification, in the indigent patients (n = 177), 73 of 95 (77%) stamped
      packets were returned compared to 46 of 82 (56%) unstamped packets (p < 0.006).
      In the private insurance patients (N = 148), 44 of 64 stamped packets (69%) and
      52 of 84 unstamped packets (62%) were returned (p > 0.10). Removing even small
      financial barriers (eg, providing a postage stamp) can enhance compliance for
      indigent patients.

PMID- 8362900
TI  - Cytogenetic findings of a child with transcobalamin II deficiency.
AB  - Transcobalamin II deficiency is a rare, probably autosomal recessive, inborn
      error of protein metabolism [Hakami et al., 1971]. Several authors have described
      the morphological characteristics of bone marrow aspirates from patients with
      this disorder; no reports have detailed the cytogenetic findings [Hitzig et al.,
      1974; Hakami et al., 1971; Niebrugge et al., 1982]. We report the cytogenetic
      findings of the bone marrow aspirates from an infant with transcobalamin II
      deficiency and identify fragile site expression in the hematopoietic cells in
      this patient.

PMID- 8362901
TI  - Newly recognized blepharofacioskeletal syndrome.
AB  - A mother and daughter are described with similar facial and skeletal
      manifestations. The syndrome consists of blepharophimosis, malar hypoplasia,
      small thin lips, and long tapering fingers. The facial phenotype changes with
      age. Autosomal dominant inheritance is suggested.

PMID- 8362902
TI  - Pericentric inversion of chromosome 6 in a patient with cleidocranial dysplasia.
AB  - We describe a male patient with a pericentric inversion of chromosome 6 and
      classic cleidocranial dysplasia (CCD), mild to moderate mental retardation,
      hearing deficiency, and unusual facial appearance. We conclude that there is a
      causal relationship between the chromosomal disorder and the CCD.

PMID- 8362903
TI  - Case of ring chromosome 7: the first report of neuropathological findings.
AB  - We report on a boy with ring chromosome 7 who had severe mental retardation,
      growth failure, microcephaly, cleft lip and palate, cafe-au-lait spots, nevus
      flammeus, and genital abnormalities, and died of pneumonia at age 20 months. On
      autopsy he had fusion of the anterior cerebral hemispheres, accompanied by
      agenesis of olfactory bulbs and tracts, closely resembling those found in
      semilobar holoprosencephaly. In addition, heterotopic Purkinje cell clusters in
      the cerebellar white matter, absence of pigmentation within the brainstem
      pigmented neurons, and severe hypomyelination in the whole brain were noted. The
      patient may represent the most severe manifestation of ring chromosome 7, and
      this is the first detailed neuropathological report on this subject.

PMID- 8362904
TI  - Brachydactylous dwarfs of Mseleni.
AB  - Eight individuals with an unusual dwarfing skeletal dysplasia have been
      investigated in a remote rural area in Northern Zululand, South Africa. These
      dwarfed individuals are members of a community numbering some 10,000 persons;
      approximately 20% have a degenerative arthropathy affecting mainly the major
      joints of the hips, knees, ankles, and spine. The pathogenesis of the latter
      disorder, which is known as Mseleni joint disease (MJD), remains obscure. The
      dwarfed persons have some radiological findings in keeping with MJD, but they
      are, in addition, of short stature and have marked brachydactyly of their fingers
      and toes. The pathogenetic relationship between these conditions, if any, is
      unclear but may have important implications for their causal elucidation.

PMID- 8362905
TI  - Decrease in thyrocalcitonin-containing cells and analysis of other congenital
      anomalies in 11 patients with DiGeorge anomaly.
AB  - Experimental studies have demonstrated that the DiGeorge anomaly is due to
      cranial neural crest abnormalities. In the present study, the quantitation of
      thyrocalcitonin immunoreactive cells (C-cells) has been used to evaluate whether
      cells derived from the cranial neural crest are or are not present in normal
      proportions in patients with this anomaly. Thyroid sections from 11 such patients
      and 11 control patients were studied immunohistochemically at autopsy in order to
      determine the number and distribution of thyrocalcitonin-containing cells.
      Patients with DiGeorge anomaly showed thymic and parathyroid aplasia/hypoplasia
      and cardiovascular defects, such as type B interrupted aortic arch, truncus
      arteriosus and tetralogy of Fallot. Other associated defects were alobar
      holoprosencephaly and meningocele (previously unreported defects in this
      anomaly), arhinencephaly, renal cystic dysplasia, ureterohydronephrosis,
      esophageal atresia with tracheoesophageal fistula, and cleft lip and palate. The
      volume density of C-cells (1.187%) and the mean number of C-cells per follicle
      (1.42) was significantly lower in patients with DiGeorge anomaly than in control
      patients (3.475% and 2.367, respectively). These results indicate a decrease in
      cells derived from the neural crest in patients with DiGeorge anomaly, and
      support the hypothesis of a neural crest disturbance as the pathogenetic factor
      responsible for this anomaly.

PMID- 8362906
TI  - Unbalanced translocation, t(18;21), detected by fluorescence in situ
      hybridization (FISH) in a child with 18q- syndrome and a ring chromosome 21.
AB  - We report on an 8-year-old girl with minor anomalies consistent with 18q-
      syndrome and mild developmental delay. Initially cytogenetics showed a terminal
      deletion of chromosome 21 with mosaicism for a small ring chromosome 21 as the
      only apparent karyotypic abnormality: mos 45,XX,-21/46,XX,+r(21) (48%/52%).
      Further studies including FISH and DNA analysis demonstrated a de novo unbalanced
      translocation of chromosomes 18 and 21 with the likely breakpoints in 18q23 and
      21q21.1. Most of 21q was translocated to the distal long arm of one chromosome
      18, and this derivative 18 appeared to lack 18q23-qter. The small ring chromosome
      21 [r(21)], present in only 52% of the patient's blood lymphocytes, did not
      appear to be associated with the abnormal phenotype since all 13 chromosome 21
      markers that were examined in genomic DNA were present in 2 copies, and the
      phenotype of the patient was consistent with the 18q- syndrome. The karyotype was
      reinterpreted as mos 45,XX,-18,-21,+der(18) t(18;21) (q23;q21.1)/46,XX,-18,
      21,+der(18) t(18;21) (q23;q21.1), +r(21) (p13q21.1) (48%/52%). These results
      demonstrate the power of FISH in conjunction with DNA analysis for examination of
      chromosome rearrangements that may be misclassified by traditional cytogenetic
      studies alone.

PMID- 8362907
TI  - Prenatal in situ hybridization test for deleted steroid sulfatase gene.
AB  - X-linked ichthyosis results from steroid sulfatase (STS) deficiency; 90% of
      affected patients have a complete deletion of the entire 146 kb STS gene on the
      distal X chromosome short arm (Xp22.3). In these families prenatal diagnosis and
      carrier testing can be completed in 2 days by hybridizing simultaneously 2
      different cosmid probes labeled with fluorescein or Texas red and counterstaining
      interphase nuclear DNA with DAPI. An STS gene probe labeled with Texas red
      hybridizes specifically to the steroid sulfatase gene on the X chromosome. A
      second flanking probe labeled with fluorescein hybridizes to both the normal Y
      chromosome and normal and STS deleted X chromosomes. In this fashion the
      interphase nuclei of normal males, affected males, normal females, and carrier
      females can be distinguished unambiguously. Because normal males and carrier
      females each show two yellow-green fluorescein spots and one Texas red STS spot,
      use of this test prenatally requires determining fetal sex independently with
      repetitive X and Y chromosome-specific probes. This procedure can be used with
      lymphocytes, direct and cultured chorionic villus cells, direct and cultured
      amniocytes, and fibroblasts. Similar methods are anticipated to be useful for
      rapid diagnostic assessment of other aneuploid gene disorders.

PMID- 8362908
TI  - Mandibulofacial dysostosis: report on two Brazilian families suggesting autosomal
      recessive inheritance.
AB  - We report on mandibulofacial dysostosis in 2 brothers born to normal
      nonconsanguineous parents, and a girl (F = 1/16) born to normal consanguineous
      parents. Normal clinical, skeletal, audiologic, and cephalometric studies in the
      parents, as well as the absence of limb anomalies in these children, exclude the
      autosomal recessive (Nager and Genee-Widemann) mandibulofacial dysostoses. The
      data of the present patients associated with the few additional reports on
      mandibulofacial dysostosis recurring in sibs, suggest the possibility of an
      autosomal recessive Treacher Collins-like mandibulofacial dysostosis.

PMID- 8362910
TI  - Uniparental disomy revisited: the first twelve years.
AB  - Uniparental disomy (UPD), the exceptional derivation of a pair of the offspring
      chromosomes from one parent only, may be compatible with normal or abnormal
      development and can result from gamete complementation, chromosome loss in
      trisomy, or duplication in monosomy (with or without residual mosaicism) and
      somatic recombination. In isodisomy, the uniparental pair is a duplicate of a
      same chromosome DNA template and causes an increased risk of recessive disorder
      by reduction to homozygosity. In heterodisomy, the pair remains heterozygous,
      made up of 2 non-recombinant homologous segments. But both iso- and heterodisomy
      may also cause disruption of the genomic imprints needed for differential
      expression of some maternal and paternal genes crucial to growth and development.
      Pure UPD preserves euploidy and, when harmful, is best regarded as a genomic
      qualitative imbalance by symmetrical excess and loss of parental homologous
      contribution affecting zygosity and imprint content. Instances of UPD reported
      till the spring 1992 are reviewed and their deleterious effects are described as
      they carried out lethality or morbidity by altering imprinting processes,
      mimicking deletions, generating recessive disorders, or prompting malignant
      cellular growth.

PMID- 8362909
TI  - DNA analysis of cystic fibrosis in Brazil by direct PCR amplification from
      Guthrie cards.
AB  - A 3 bp deletion of codon 508 (phenylalanine) of the cystic fibrosis (CF) gene
      constitutes the mutation of most CF chromosomes. The frequency of this mutation
      (referred to as delta F508), varies considerably between populations, ranging
      from 26% of the CF mutations in Turkey to 88% in Denmark. To determine the
      frequency of the delta F508 mutation in Brazilian Caucasoid CF patients, we used
      direct polymerase chain reaction (PCR) amplification of DNA obtained from dried
      blood spots on Guthrie cards, followed by ethidium bromide staining of gels.
      Although the overall frequency of the delta F508 mutation was 47% of 380 CF
      chromosomes from Brazilian Caucasoids born in five different states, significant
      interstate differences were observed, ranging from a delta F508 frequency of 27%
      to 53%. While our method could be used to screen patients and their relatives for
      carrier testing and prenatal diagnosis, the efficacy of screening only for the
      delta F508 mutation would be low, and would vary from state to state. Screening
      for a panel of local mutations will be needed to increase the mutation detection
      rate and optimize genetic counseling.

PMID- 8362911
TI  - Regional mapping of the gene for familial Mediterranean fever on human chromosome
      16p13.
AB  - Familial Mediterranean fever (FMF) is an autosomal recessively inherited
      inflammatory disorder characterized by recurrent short episodes of fever,
      peritonitis, arthritis, and pleuritis. Recently, linkage was demonstrated between
      FMF and the VNTR probes 3'HVR and 5'HVR of the alpha-globin complex at 16p13.3
      (theta = 0.06-0.10, Lodmax = 9.76-14.47) and the insertion/deletion polymorphism
      detected by the probe CMM65 of D16S84 (theta = 0.04, Lodmax = 9.17). We have now
      mapped the FMF gene between the two flanking markers D16S283/D16S291 (theta =
      0.038) and D16S80 (theta = 0.159). The proximity of the microsatellite markers in
      D16S283 and D16S291 to the FMF gene allows preclinical diagnosis in most
      pedigrees with affected individuals.

PMID- 8362912
TI  - Acalvaria: a unique congenital anomaly.
AB  - Acalvaria is a rare malformation usually regarded as a postneurulation defect. It
      consists of absence of the calvarial bones, dura mater and associated muscles in
      the presence of a normal skull base and normal facial bones. The condition is
      frequently confused by prenatal ultrasonography with anencephaly or an
      encephalocele. Whereas the cerebral hemispheres are absent in anencephaly, the
      cranial contents in acalvaria are generally complete, though some
      neuropathological abnormality is often present. The presumed pathogenesis of
      acalvaria is faulty migration of the membranous neurocranium with normal
      placement of the embryonic ectoderm, resulting in absence of the calvaria but an
      intact layer of skin over the brain parenchyma. We describe 2 cases of acalvaria,
      one misdiagnosed ultrasonographically as an occipital encephalocele prenatally.
      The brain in one fetus demonstrated semilobar holoprosencephaly and
      micropolygyria, but in the other, was structurally and histologically normal with
      the exception of hydrocephalus.

PMID- 8362913
TI  - No evidence for linkage to the type 1 or type 2 neurofibromatosis loci in Noonan
      syndrome families.
AB  - A linkage analysis has been performed on 6 two-generation families with classical
      Noonan syndrome to determine whether the syndrome is linked to neurofibromatosis
      type 1 on chromosome 17q or to neurofibromatosis type 2 on chromosome 22q. A
      significantly negative location score was obtained between 10 cM centromeric to
      and 15 cM telomeric from the neurofibromatosis type 1 locus. A significantly
      negative lod score was obtained with a marker mapping within the region where
      neurofibromatosis type 2 is thought to be located. These data indicate that
      Noonan syndrome is not tightly linked to either neurofibromatosis type 1 or type
      2.

PMID- 8362914
TI  - Brain magnetic resonance imaging findings in the Opitz G/BBB syndrome: extension
      of the spectrum of midline brain anomalies.
AB  - We report the brain magnetic resonance imaging findings in 4 patients with the
      Opitz BBB/G syndrome. The scans were assessed by subjective interpretation and
      computerized image analysis. Findings noted in 3 of the 4 patients include
      hypoplasia or agenesis of the corpus callosum (3 patients), cerebellar vermal
      hypoplasia (2 patients), cortical atrophy and ventriculomegaly (3 patients),
      macro cisterna magna (3 patients), and a wide cavum septum pellucidum (1
      patient). One patient had a normal scan. The demonstration of a wide cavum septum
      pellucidum extends the spectrum of midline brain anomalies (ventral induction
      defects) reported in this condition. This study along with other recent reports
      suggests that midline brain anomalies may be frequent findings in Opitz syndrome.

PMID- 8362915
TI  - Frontonasal dysplasia in two successive generations.
AB  - Frontonasal dysplasia is thought to be a sporadic condition limited to the face
      and head. We describe a family from the Bahamas in which a mother, 2 of her
      children, and the mother's brother have variable manifestations of frontonasal
      dysplasia. The mother has extremely mild expression, but her brother and 2 sons
      are more severely affected. Besides polydactyly no other birth defects were noted
      in any other relatives. The pedigree is consistent with autosomal or X-linked
      dominant inheritance. A description of each patient is presented along with a
      discussion of the genetic counseling issues and review of the literature for
      other possibly familial cases of frontonasal dysplasia.

PMID- 8362916
TI  - Moving satellites and unstable chromosome translocations: clinical and
      cytogenetic implications.
AB  - We describe 2 families in which acrocentric short arm material moved from one
      chromosome to another. In case 1, a meiotic event resulted in movement of an
      unusually large paternal 21p to chromosome 13 in the fetus. In case 2, a mitotic
      event resulted in fetal mosaicism. The short arm material from a paternal
      chromosome 15 moved to chromosome 14 in some of the fetal cells. Movement of
      acrocentric short arm material resulted from breakage and exchange in centromeric
      areas of repetitive DNA. We suggest the mechanism may be similar to that of
      previously reported "jumping" translocations. Failure to recognize movement of
      the short arms of acrocentric chromosomes can result in erroneous interpretation
      of prenatal cytogenetic results and of other cytogenetic assays dependent on
      acrocentric short arm polymorphisms.

PMID- 8362917
TI  - Congenital nonprogressive myopathy with Mobius and Robin sequence--the Carey
      Fineman-Ziter syndrome: a confirmatory report.
AB  - Recently, we evaluated a 27-month-old boy with congenital generalized nonspecific
      myopathy, Mobius sequence, Robin sequence, and failure to thrive. We think the
      child has the same entity described by Carey, Fineman, and Ziter in 1982 [J
      Pediatr 101:353-364] and as such represents only the third example of this
      unusual syndrome. Review of the large number of conditions in which the Robin
      sequence occurs supports heterogeneity. Our case strengthens the Mobius-Robin
      association and further defines the Carey-Fineman-Ziter syndrome as a viable
      entity. It is most likely inherited as an autosomal recessive trait.

PMID- 8362918
TI  - Is visual field reduction a component manifestation of osteopathia striata with
      cranial sclerosis?
AB  - A girl with fully expressed osteopathia striata with cranial sclerosis (OS) was
      also found to have a contraction of the two visual fields, a sign never
      previously described in OS syndrome. We suggest that the visual field defect is a
      component manifestation of OS syndrome, whose pathogenesis is represented by
      distortion of the optic canal and narrowing of the optic foramina.

PMID- 8362919
TI  - Unusual fingerprint patterns in Smith-Fineman-Myers syndrome.

PMID- 8362920
TI  - Unusual complex of congenital malformations.

PMID- 8362921
TI  - Thrombocytopenia in the Brachmann-de Lange syndrome.

PMID- 8362922
TI  - On Saraiva and Baraitser and Joubert syndrome: a review.

PMID- 8362923
TI  - Earliest illustration of an aortic aneurysm by Albrecht von Haller.

PMID- 8362924
TI  - Axial mesodermal dysplasia spectrum: variable symptoms in affected sibs.

PMID- 8362925
TI  - Supravalvular aortic stenosis cosegregates with a familial 6; 7 translocation
      which disrupts the elastin gene.
AB  - Supravalvular aortic stenosis (SVAS) is an autosomal dominant disorder
      characterized by abnormalities of development of the great vessels. SVAS is also
      commonly part of Williams syndrome. Linkage to the elastin gene on chromosome
      7q11 has recently been reported in two kindreds with SVAS. Previous reports of
      patients with 7q11 deletions have noted great vessel abnormalities in some. We
      report on a family in which SVAS is cosegregating with a balanced reciprocal
      translocation, t(6:7) (p21.1;q11.23), providing further evidence that SVAS is the
      result of a mutation of elastin at 7q11.23 region. The propositus of the
      translocation family has some minor anomalies which occur in Williams syndrome,
      suggesting that elastin abnormalities may cause some of the abnormalities found
      in Williams syndrome.

PMID- 8362926
TI  - On attitudes and appreciation 6 months after predictive DNA testing for
      Huntington disease in the Dutch program.
AB  - We have studied the 6-month follow-up attitudes of 63 individuals, after
      predictive testing for Huntington disease (HD). Reducing uncertainty (81%) and
      family planning (60%) were the major reasons for taking the test. Twenty-four
      individuals were diagnosed as having an increased risk (+/- 98%), and 39 a
      decreased risk (+/- 2%). Among those with an increased risk, denial or
      minimization of the ultimate impact of the increased risk result was observed.
      Most of them (84%) rated their current life situation, at the very least, as
      being good. Twenty-one percent of individuals with an increased risk who
      originally planned to have a family, decided to refrain from having children.
      Sixty percent of those with increased risk who still wished to have children,
      would choose to have prenatal testing. In most individuals with increased risk,
      the test result did not increase the previously expected control over their own
      future. Half of the partners of persons with increased risk acknowledged the
      burden of the future disease. Half had no one in whom they could confide. They
      showed loyalty to the denial and avoidance reactions of their spouses. Half of
      the individuals with decreased risk denied the impact of the result, as reflected
      by absence of relief, and emotional numbness. A third of persons with decreased
      risk experienced involvement with problems of affected relatives. We found that
      20% of all participants were discontented with the support given by their general
      practitioner, who is normally regarded as being the most significant professional
      for aftercare. Our findings suggest that the perpetuation

PMID- 8362927
TI  - What is associated with the fragile X syndrome?
AB  - In addition to mental retardation (MR), fragile X[fra(X)] syndrome has been
      associated with a variety of other disorders. Despite earlier reports, it has
      been shown that MR fra(X) males are at no greater risk for autism than is any MR
      male. Therefore, studies in which fra(X) has been associated with behavioral,
      developmental, and psychopathological disabilities were examined to determine
      whether fra(X) individuals were at an increased risk for these dysfunctions as
      well. Psychiatric disorders among fra(X) individuals were found not to occur more
      frequently than in other individuals with cognitive deficits. It was also
      observed that hyperactivity and attention deficit disorder among MR fra(X)
      individuals do not occur more frequently than in other MR individuals. Pooled
      results from studies of cognitive profiles used to characterize fra(X) phenotypes
      also indicated that there are no consistent patterns in either males or females.
      Plausible explanations for a variable phenotype include allelic heterogeneity and
      pleitropy.

PMID- 8362928
TI  - Associations of disease with genetic markers: deja vu all over again.

PMID- 8362929
TI  - Candidate genes in psychiatry: an epidemiological perspective.
AB  - Interest in candidate genes in psychiatry has been revived by the success of that
      approach in Alzheimer's disease as well as by discouragement over the results to
      date of searches for linkage. If mutations in candidate genes could be detected
      directly many of the complexities of searching for them indirectly through
      linkage could be avoided. As attractive as this approach may sound, mutation
      searches with candidate genes will introduce a new set of difficulties: the large
      number and low a priori probability of potential candidate genes virtually
      guarantees that most positive findings will be false positives. Consequently, if
      candidate genes are to be systematically studied, procedures need to be
      established for minimizing and efficiently disconfirming false positive results.

PMID- 8362930
TI  - Review of the putative association of dopamine D2 receptor and alcoholism: a meta
      analysis.
AB  - Eight recent studies have focused on the putative association of the dopamine D2
      receptor (DRD2) gene and alcoholism. In this report, these studies are reviewed
      and the data and findings are examined in a meta-analysis. Four reports find a
      statistically significant increased risk for alcoholism in subjects carrying the
      A1 allele and 4 failed to observe a significant increase in risk. Overall, our
      meta-analysis of the results from all 8 studies supported a statistically
      significant association between the A1 allele of DRD2 and alcoholism, with an
      apparent increase in relative risk associated with increased severity of
      alcoholism. These results must be interpreted cautiously because the A1 allele of
      DRD2 varies significantly in frequency from one population to another. This
      variability in the population frequency of the A1 allele could result in an
      apparent association resulting from unrelated population differences. These
      findings support the need for carefully designed studies that minimize the ethnic
      heterogeneity of the subject and control populations.

PMID- 8362931
TI  - Power to detect linkage with heterogeneity in samples of small nuclear families.
AB  - Computer simulation methods were used to investigate the power of genetically
      homogeneous or heterogeneous samples of nuclear families to detect linkage of a
      rare dominant disease allele to flanking DNA markers (three-point analysis,
      admixture text). Phase was assumed to be unknown (no grandparents available), and
      unaffected siblings were not considered. A sample of 95 families with an ill
      parent and two ill offspring, or 45 families with three ill offspring,
      demonstrated 90% power to detect a lod score of 3.0 when 50% of families were
      assumed to be segregating for a disease allele located midway between two DNA
      markers (PIC = .70) that were .05 M apart. When the proportion of linked families
      (alpha) = .25, 90% power required 380 and 160 families, respectively. For alpha <
      .25, samples size requirements become prohibitive. Issues are reviewed concerning
      the use of the admixture test in the case of more complex disease models.
      Screening of the genome with adequate sample sizes for low values of alpha is
      likely to require multiple large collaborative efforts.

PMID- 8362932
TI  - Practice activities and career satisfaction among fellows of the South Atlantic
      Association of Obstetricians and Gynecologists.
AB  - OBJECTIVE: The practice activities and career satisfaction of obstetricians and
      gynecologists in private practice were compared with those in a teaching faculty
      setting. STUDY DESIGN: The 475 fellows of the South Atlantic Association of
      Obstetricians and Gynecologists were surveyed; 314 responses (66.1%) were
      received. Private practice and teaching faculty respondents were compared
      regarding practice description, factors influencing choice of practice type,
      practice activities, and career satisfaction. Data were examined by chi 2 testing
      and analysis of variance. RESULTS: Patient care involvement was the primary
      influence in practice choice by 86.0% of private practitioners; interest in
      teaching was the most important single factor for 58.2% of the teaching faculty.
      Significantly more teaching faculty than private practitioners had done research
      work during residency (81.2% vs 53.4%, p < 0.001). There were no differences
      regarding presentations at medical meetings during residency or publications from
      work performed during residency. The private practice group recorded more nights
      on call and more scheduled time off. The teaching faculty showed more
      publications, continuing medical education credits, hours worked per week, and
      medical meeting attendance. There were no differences in vacation days,
      malpractice charges, or expert witness appearances. The group showed no
      significant differences in their ratings of career satisfaction, but more of the
      teaching faculty group would elect again to enter obstetrics and gynecology if
      completing school today (82.4% vs 55.3%, p < 0.001). CONCLUSION: Professional
      activities of private practice physicians differ from those of teaching faculty
      physicians. The great majority of both groups are satisfied with their careers.

PMID- 8362933
TI  - Predicting success of external cephalic version.
AB  - OBJECTIVE: Many authors have identified prognostic factors for external cephalic
      version success, but there has not been an attempt to integrate these factors
      into a simple, quantitative scoring system for predicting version success. Nor
      have any prognostic factors been prospectively tested. STUDY DESIGN: We examined
      the clinical characteristics of 108 consecutive breech versions performed between
      1984 and 1986. These characteristics were evaluated by stepwise linear regression
      and discriminate analysis to identify those factors associated with success. Five
      factors explained the majority of the variability in outcome (parity, placental
      location, dilation, station, and estimated fetal weight). A model was developed
      to incorporate the trends identified among these five variables to create a
      scoring system similar to that of Bishop. This scoring system was then applied to
      286 women undergoing external cephalic version since October 1986. RESULTS: There
      was a positive relationship between a rising version score and the likelihood of
      successful breech version. No versions were successful with a score < or = 2, and
      all breech versions were successful with a score of 9 or 10. The results of the
      version score may have significantly altered physician recommendations in more
      than one third of cases. CONCLUSION: We believe that this simple, quantifiable
      scoring system is a refinement in our ability to predict the likelihood of
      external cephalic version success.

PMID- 8362934
TI  - A rationale for omitting two-hour postprandial glucose determinations in
      gestational diabetes.
AB  - OBJECTIVE: In making decisions regarding initiation of insulin therapy in
      gestational diabetes, most maternal-fetal obstetricians rely more on elevated
      fasting glucose values than on elevated 2-hour postprandial levels. We sought to
      determine whether the latter test is necessary. STUDY DESIGN: From the patients
      with gestational diabetes mellitus managed over a 17-month period at Grady
      Memorial Hospital, we retrospectively analyzed data to determine whether normal
      (< 105 mg/dl) fasting plasma glucose values predict elevated 2-hour postprandial
      values and whether the latter predict adverse outcome. RESULTS: From 194 patients
      with gestational diabetes mellitus, 546 paired fasting and 2-hour postprandial
      glucose values were recorded. Fasting levels were normal in 467 (85%); in those,
      2-hour levels were < 120 mg/dl in 83% and < 140 in fully 96%. In 131 women with
      all fasting plasma glucose values normal, the birth weights and the rates of
      cesarean delivery, shoulder dystocia, and macrosomia were similar, regardless of
      whether 2-hour postprandial glucose values were > or = 120. The actual cost of
      the 546 2-hour postprandial glucose tests was nearly $10,000. CONCLUSION: For
      metabolic surveillance in gestational diabetes mellitus, the 2-hour postprandial
      glucose test seems unnecessary, provided fasting plasma glucose values remain
      normal.

PMID- 8362935
TI  - A rapid test for abruptio placentae: evaluation of a D-dimer latex agglutination
      slide test.
AB  - OBJECTIVE: Our purpose was to evaluate a rapid latex agglutination slide test for
      D-dimer, a byproduct of clot lysis, in the prediction of abruptio placentae.
      STUDY DESIGN: Four groups were studied: (1) 15 patients with normal pregnancies
      at 40 weeks' gestation, (2) 17 participants with preeclamptic pregnancies, (3) 14
      patients with preterm labor, and (4) 15 patients with confirmed abruptio
      placentae. The latex agglutination slide test was performed with positive and
      negative reference solutions and plasma dilutions of 1:1, 1:2, 1:4, and 1:8. A
      test was considered positive if, at 2 minutes, agglutination was present at
      dilutions of > or = 1:2 (> or = 1.0 micrograms/ml fibrin equivalent units). Test
      results were compared in patient groups with and without abruptio placentae by
      means of the chi 2 test. RESULTS: The likelihood of a positive D-dimer test
      result was not significantly different among patients in the non-abruptio
      placentae groups (p = 0.454). Patients in the abruptio placentae group were
      significantly more likely to have a positive D-dimer slide test result than those
      in the non-abruptio placentae groups (p = 0.0001). The D-dimer test conferred
      sensitivity, specificity, positive predictive value, and negative predictive
      value of 67%, 93%, 91%, and 48%, respectively. In contrast, other laboratory
      measures of coagulation (e.g., platelet count, prothrombin time, partial
      thromboplastin time, and fibrinogen levels) yielded no better than a 20%
      sensitivity for abruptio placentae. CONCLUSIONS: The D-dimer slide test may be a
      superior rapid method to improve early diagnosis of abruptio placentae.

PMID- 8362936
TI  - Myocardial infarction during pregnancy: management and outcome of two
      pregnancies.
AB  - OBJECTIVE: Each year in the United States approximately 500,000 women die from
      ischemic heart disease. However, there are < 100 reported cases of myocardial
      infarction occurring during pregnancy. The current management of these patients
      is empiric, with pulmonary artery catheterization during labor being frequently
      reported. STUDY DESIGN: In the past year we have managed and delivered two such
      patients, including the first reported case of myocardial infarction with a
      triplet gestation. RESULTS: Both patients had clinical and laboratory signs of
      myocardial infarction and underwent coronary angiography. They subsequently had
      preeclampsia and were prematurely delivered of viable fetuses. One patient had
      angina pectoris during labor and was successfully treated with sublingual
      nitroglycerin. Neither patient suffered reinfarction or heart failure. Invasive
      hemodynamic monitoring was not used, and the mode of delivery was determined
      solely on obstetric indications. CONCLUSION: In pregnant patients with myocardial
      infarction, invasive central monitoring is unnecessary in patients with good
      cardiac function and reserve and the mode of delivery should be based on
      obstetric indications.

PMID- 8362937
TI  - Vaginal length and sexual function after colpopexy for complete uterovaginal
      eversion.
AB  - OBJECTIVE: Our objective was to evaluate vaginal length and sexual function after
      colpopexy for complete uterovaginal eversion. STUDY DESIGN: Measurements of
      postoperative vaginal length were performed on 59 patients having various types
      of repair for complete uterovaginal eversion. Sexual function was evaluated when
      possible. Controls were 61 normal premenopausal and postmenopausal patients both
      with and without a uterus. Anatomic measurements from the introitus to the middle
      of sacrospinous ligament and to the sacral promontory were obtained from 21 fresh
      autopsy specimens. RESULTS: Average vaginal length for controls was 9.2 cm in
      premenopausal patients with a uterus and 8.5 cm for patients without a uterus and
      averaged 8.5 and 8.2 cm, respectively, for postmenopausal patients with and
      without a uterus. Vaginal length after posterior culdeplasty was 9.2 cm, 8.2 cm
      after sacrospinous fixation, and 11.3 cm after sacral colpopexy. CONCLUSION: If
      maximum vaginal length is the objective, it is best maintained with a sacral
      colpopexy.

PMID- 8362938
TI  - Loop electrosurgical excision procedures for cervical dysplasia: experience in a
      community hospital.
AB  - OBJECTIVE: The study was undertaken to evaluate the use of the loop
      electrosurgical excision procedure as an outpatient hospital or surgicenter
      procedure. STUDY DESIGN: The records of 358 patients treated for cervical
      intraepithelial neoplasia at a large community hospital over a 1-year period were
      reviewed. RESULTS: The specimens obtained by loop electrosurgical excision
      procedure and laser cone excision were comparable in size but smaller than those
      by means of cold-knife conization. Seventy-two percent of loop electrosurgical
      excision procedure specimens consisted of two to eight tissue fragments (mean
      3.4). In addition, 48% of the loop electrosurgical excision procedure specimens
      and 38% of laser cones had moderate or severe thermal artifacts. Fragmentation
      and cautery damage precluded orientation of tissue and evaluation of margins in
      19% of the cases. CONCLUSIONS: The advent of the loop electrosurgical excision
      procedure has shifted the management of cervical intraepithelial neoplasia from
      the office to the outpatient surgery centers. This negates and, in fact, reverses
      the advantage of loop electrosurgical excision procedure over other methods in
      regard to cost and convenience through evaluating and treating a patient with
      cervical intraepithelial neoplasia in one office visit. Loop electrosurgical
      excision procedures provide specimens that are inferior compared with cold-knife
      cones; therefore the role of loop electrosurgical excision procedure for the
      management of cervical intraepithelial neoplasia outside the office appears
      limited.

PMID- 8362939
TI  - Diagnostic and treatment results from a southeastern academic center-based
      premenstrual syndrome clinic: the first year.
AB  - OBJECTIVES: We attempted to ascertain the following: (1) the yield of a
      structured workup in a premenstrual syndrome clinic coordinated by a university
      based gynecology department in the southeast, (2) referral patterns and care
      provided before consultation, and (3) therapeutic outcomes. STUDY DESIGN: The
      first 100 women seen prospectively entered a uniform diagnostic and treatment
      protocol. Data analysis was performed with analysis of variance and confidence
      interval for a population proportion. RESULTS: Thirty-eight women (95% confidence
      interval 28% to 48%) had premenstrual syndrome, 24 had premenstrual magnification
      syndrome (95% confidence interval 16% to 32%), 13 had an affective or other
      psychiatric disorder (95% confidence interval 6% to 20%). Only 44% of women
      previously given a diagnosis of premenstrual syndrome were found to have
      premenstrual syndrome. Overall, 84% of women with premenstrual syndrome and
      premenstrual magnification syndrome responded to treatment. CONCLUSIONS: Too many
      women are still given the diagnosis of premenstrual syndrome without appropriate
      prospective documentation. Premenstrual magnification represents an important
      diagnostic category. Therapeutic responses to present treatments are encouraging.

PMID- 8362940
TI  - Paraaortic lymph node sampling by means of an extraperitoneal approach with a
      supraumbilical transverse "sunrise" incision.
AB  - OBJECTIVES: Extraperitoneal approaches to removal of lymph nodes for staging in
      cervical cancer patients are numerous, and each has disadvantages. We developed a
      supraumbilical transverse incision to initiate irradiation within days of
      cervical cancer staging. STUDY DESIGN: Twenty patients with advanced stage IIB or
      IIIB cervical cancer underwent surgical staging with a supraumbilical incision
      during the time period Jan. 1, 1988, to Aug. 1, 1992. The incisions were made 6
      cm above the umbilicus and carried laterally in a caudad manner to the iliac
      crests. All nodes were removed in an extraperitoneal fashion. RESULTS: In the 20
      patients who were operated on, the mean number of nodes removed was 9.8.
      Estimated blood loss ranged from 50 to 300 ml. The procedure time ranged from 50
      to 150 minutes. All patients but two had irradiation initiated within 2 weeks of
      the procedure. Complications included an identified and repaired ureteral injury,
      a prolonged ileus, and a small bowel obstruction. CONCLUSIONS: An extraperitoneal
      approach with the "sunrise" incision allows irradiation to begin within days of
      surgery. The operating time is relatively short. The incision can be extended
      caudally and extraperitoneally if needed for removal of bulky pelvic nodes.

PMID- 8362941
TI  - Incidence of perceived and actual face shield contamination during vaginal and
      cesarean delivery.
AB  - OBJECTIVE: The purpose of this study was to determine the rate of potential
      contamination or splashes to the face of obstetricians during vaginal and
      cesarean delivery. STUDY DESIGN: Clear plastic face shields were worn during 50
      consecutive vaginal and 50 consecutive cesarean deliveries. The face shields were
      then analyzed for evidence of contamination, and rates of contamination were
      compared. RESULTS: The contamination rate of the face shields was 50% during
      cesarean deliveries and 32% during vaginal deliveries. Ninety-two percent of the
      contaminated face shields were undetected by physicians at the time of cesarean
      delivery and 50% were undetected at the time of the vaginal delivery.
      CONCLUSIONS: Obstetricians commonly receive blood or amniotic fluid splashes to
      the face during deliveries and should wear protective eyeglasses or face shields
      during all deliveries to minimize the risk of exposure to potentially infectious
      blood and body fluids.

PMID- 8362942
TI  - Control of postpartum hemorrhage with uterine packing.
AB  - OBJECTIVE: A historic survey of the literature and nine recent examples of
      uterine packing for control of postpartum hemorrhage are presented. Once a
      frequently practiced art, intracavitary packing for the control of uterine
      postpartum bleeding became a lost skill to most physicians after the 1950s.
      Objections to the practice are presented through a review of the literature.
      STUDY DESIGN: The technique of uterine packing is critical in the control of
      hemorrhage and is briefly reviewed. RESULTS AND CONCLUSION: Whether used early or
      late in patient management, uterine packing for the control of postpartum
      hemorrhage is a safe, quick, and effective procedure.

PMID- 8362943
TI  - Treatment of male infertility and idiopathic failure to fertilize in vitro with
      under zona insemination and direct egg injection.
AB  - OBJECTIVE: Failure to fertilize eggs in vitro may be countered by
      micromanipulation of gametes to place selected spermatozoa underneath the zona
      pellucida of the egg or directly into the egg, thereby improving chances of
      fertilization and production of viable embryos. Analysis of our clinical data for
      assisted fertilization was undertaken to assess those factors of relevance in
      this therapy, and a description of our procedures are given. STUDY DESIGN:
      Retrospective analysis of 85 cycles (73 couples) of in vitro fertilization and
      embryo transfer performed at a private infertility clinic, in which
      micromanipulation for assisted fertilization was used to overcome either severe
      male factor infertility or idiopathic failure to fertilize, was performed.
      RESULTS: In 60 cycles where only embryos from under zona insemination were
      available for uterine transfer, 15 singleton and two twin pregnancies occurred
      (28.3% viable pregnancy rate per transfer, 14.1% embryonic implantation). In 14
      of these cycles embryos arose only after repeated under zona insemination adding
      more spermatozoa; this accounted for four of the singleton and one of the twin
      pregnancies (38.5% pregnancy rate, 22.2% embryonic implantation). No embryos
      arose from partial zona dissection performed in five cycles on sibling eggs.
      However, in 16 cycles conventional insemination yielded fertilization in six
      cycles, and mixed transfer of these embryos and sibling embryos from under zona
      insemination gave rise to one pregnancy from four transfers (pregnancy rate 25%,
      embryonic implantation 7.1%). Likewise, in nine cycles donor spermatozoa yielded
      fertilization in eight cycles, and mixed transfer with sibling embryos fertilized
      by under zona insemination with partner's spermatozoa gave rise to two
      pregnancies from five transfers (pregnancy rate 40%, embryonic implantation
      15.8%). Fertilization and pregnancy rates did not differ whether couples suffered
      either from male factor infertility or from previous idiopathic fertilization
      failure. Direct egg injection of a single spermatozoon into 105 eggs gave an
      88.6% egg survival and 32.3% fertilization. Mixed transfers with sibling embryos
      from conventional and under zona insemination yielded one triplet, one twin, and
      three singleton pregnancies. CONCLUSIONS: Overall, a 24.7% (21/85) viable
      pregnancy rate per cycle initiated occurred when only embryos from assisted
      fertilization were available. This strongly indicates that assisted fertilization
      made a real contribution in cases where either insufficient spermatozoa were
      available for conventional insemination or in cases where previous fertilization
      failure had arisen. The wide range of seminal parameters were found to be
      unhelpful in defining chances of success with assisted fertilization.

PMID- 8362944
TI  - Intraamniotic 15(s)-15-methyl prostaglandin F2 alpha and termination of middle
      and late second-trimester pregnancy for genetic indications: a contemporary
      approach.
AB  - OBJECTIVE: Our purpose was to determine whether intraamniotic 15(s)-15-methyl
      prostaglandin F2 alpha could serve effectively and safely as a surrogate for
      natural prostaglandin F2 alpha when used to effect middle and late second
      trimester pregnancy termination for genetic indications. Further, we sought to
      compare efficacy and side effects with those found when intravaginal
      prostaglandin E2 is used. STUDY DESIGN: A total of 62 patients received
      intraamniotic 15(s)-15-methyl prostaglandin F2 alpha and urea, and intracervical
      laminaria. Case patients at < or = 20 weeks' gestation (n = 32) were compared
      with case patients at > 20 weeks (n = 30) and with a matched group (n = 64; 1:2
      ratio) of control patients in whom cervical laminaria and intraamniotic urea were
      used with prostaglandin E2 vaginal suppositories. RESULTS: The mean induction-to
      abortion interval among the case patients (gestational age 16 to 27 weeks) was 13
      hours 11 minutes; 60 of 62 (97%) were delivered within 24 hours. There was a
      statistically significant negative correlation between the induction-to-abortion
      interval and gestational age (p = 0.04). When patients at < or = 20 weeks and
      those at > 20 weeks were compared, few differences were noted. The mean induction
      to-abortion interval for case patients at < or = 20 weeks was 13 hours 54 minutes
      versus 19 hours 34 minutes for control patients (p = 0.001). One of 32 (3%) case
      patients remained undelivered beyond 24 hours compared with 17 of 64 (27%)
      control patients (p < 0.01). Immediate and delayed complications were uncommon in
      either group. CONCLUSION: Our study demonstrates that 15(s)-15-methyl
      prostaglandin F2 alpha can serve safely as a surrogate for prostaglandin F2 alpha
      when used in combination with urea and laminaria for termination of pregnancy.
      This technique appears safe for use through 27 weeks' gestation; further
      investigation is encouraged.

PMID- 8362945
TI  - Atypical pelvic inflammatory disease: can we identify clinical predictors?
AB  - OBJECTIVE: We used data from a large multicenter case-control study of tubal
      infertility to analyze further the relationship among demographic variables,
      behavioral measures, history of previous sexually transmitted diseases, and past
      contraceptive practices, for women with and without a history of pelvic
      inflammatory disease. STUDY DESIGN: We identified 283 white women with tubal
      infertility who requested care at seven participating institutions. Of these
      women, 238 (84%) did not have a history of pelvic inflammatory disease ("atypical
      pelvic inflammatory disease") whereas 45 reported a history of pelvic
      inflammatory disease ("overt pelvic inflammatory disease"). We compared these
      groups with 1629 white women without a history of either infertility or pelvic
      inflammatory disease who were delivered of their first live-born child at the
      same institutions as the infertile cases. RESULTS: Women with atypical pelvic
      inflammatory disease were demographically more like fertile control subjects and
      had behavioral characteristics midway between those of the overt pelvic
      inflammatory disease group and the fertile group. Both oral contraceptive and
      diaphragm use protected against tubal infertility for women with either atypical
      or overt pelvic inflammatory disease. Atypical pelvic inflammatory disease was
      related to a history of Trichomonas infection but not to a reported history of
      gonorrhea, genital herpes, or other vaginitis. CONCLUSION: Atypical pelvic
      inflammatory disease is probably more common than its symptomatic counterpart.
      Whereas this condition is associated with some characteristics of a sexually
      transmitted infection, clinical predictors remain elusive.

PMID- 8362946
TI  - Fetal heart circumference as a predictor of menstrual age in fetuses affected by
      disturbances in growth.
AB  - OBJECTIVE: The purpose of this study was twofold: (1) to evaluate the
      relationship between fetal heart circumference and gestational age and (2) to
      determine the effect, if any, of disturbances in fetal growth on heart
      circumference. STUDY DESIGN: Heart circumference was measured in 262 women with
      normal gestations (control group) and in two study groups consisting of 52 large
      for-gestational age 32 small-for-gestational age fetuses. Standardized,
      gestational age-adjusted values in the two study groups were compared with
      normative data provided by the control group. RESULTS: There was a close
      correlation (R2 = 0.94) between heart circumference and gestational age in
      normally growing fetuses. Disturbances of fetal growth (i.e., macrosomia and
      growth retardation) were found to have an inconsistent effect on heart
      circumference. CONCLUSION: Heart circumference cannot be used as an independent
      parameter for gestational age evaluation in fetuses with disturbances of growth.

PMID- 8362947
TI  - Multicenter randomized, controlled trial of a preterm birth prevention program.
      Collaborative Group on Preterm Birth Prevention.
AB  - OBJECTIVE: The results of a randomized, controlled trial of a preterm birth
      prevention program at five centers with primarily low-income populations are
      presented. STUDY DESIGN: Pregnant women at high risk for preterm labor were
      independently randomized into intervention and control groups at each of five
      centers (2395 women). Specially trained staff instructed women in the
      intervention group to recognize early signs of preterm labor and to notify the
      staff should any sign of preterm labor occur, and women came in weekly for pelvic
      examinations after 20 to 24 weeks' gestation. Because the intervention had very
      different and contrary effects on preterm birth rates across these sites, the
      analysis focused on patient risks and on measures of the process of care as
      possible explanations for the differences in outcomes. RESULTS: The observed
      spontaneous preterm birth rates, when averaged for all sites, were not lower in
      the intervention group than in the control groups (16.1% vs 15.4% for < 37
      completed weeks' gestation, 11.9% vs 10.9% for < 36 completed weeks). There was
      substantial heterogeneity of program effects between centers (p < 0.01 for
      homogeneity test statistic). The differences in intervention effects between
      centers were explainable only in part by patient risk characteristics (p < 0.10
      for homogeneity test statistic). The only intermediate measure of the process of
      care that tended to differentiate among sites with positive intervention effects
      was the rate of hospital admission for preterm labor. Sites with elevated
      admission rates in the intervention group versus the control group tended to have
      negative intervention effects on outcomes. CONCLUSION: Because the preterm birth
      prevention program did not show a reliable benefit and because the reasons for
      varied outcomes are not understood, the use of the program cannot be recommended
      for predominantly low-income populations.

PMID- 8362948
TI  - Lyme disease and pregnancy outcome: a prospective study of two thousand prenatal
      patients.
AB  - OBJECTIVE: The purpose of the study was to determine if prenatal exposure to Lyme
      disease was associated with an increased risk of adverse pregnancy outcome. STUDY
      DESIGN: Approximately 2000 Westchester County, New York, women completed
      questionnaires and had sera tested for antibody to Borrelia burgdorferi at their
      first prenatal visit and at delivery. Fetal death, birth weight, length of
      gestation at delivery, and congenital malformations were examined in relation to
      maternal Lyme disease exposure before and during pregnancy. RESULTS: Maternal
      Lyme disease or an increased risk of exposure to Lyme disease was not associated
      with fetal death, decreased birth weight, or length of gestation at delivery.
      Tick bites or Lyme disease around the time of conception was not associated with
      congenital malformations. Tick bites within 3 years preceding conception were
      significantly associated with congenital malformations, but this could have
      reflected reporting differences between exposed and unexposed women. CONCLUSIONS:
      Maternal exposure to Lyme disease before conception or during pregnancy is not
      associated with fetal death, prematurity, or congenital malformations taken as a
      whole. We have not ruled out the possibility that exposure to Lyme disease as
      defined by maternal history increases the risk of specific malformations or has
      an effect if it is not treated. We have insufficient numbers of women who were
      seropositive at their first prenatal visit to determine if this subgroup of
      exposed women are at a moderately increased risk of having a child with a
      congenital abnormality. The low frequency of seroconversion at delivery in this
      endemic area suggests that preventive measures are being taken by obstetricians
      and patients.

PMID- 8362949
TI  - Routine testing for Chlamydia trachomatis on Curacao, Netherlands Antilles.
AB  - OBJECTIVE: Although genital Chlamydia trachomatis infection is most often
      asymptomatic, early treatment may prevent serious complications. For screening or
      routine testing to be cost effective, the prevalence of the infection must not be
      too low. STUDY DESIGN: On Curacao, Netherlands Antilles, the prevalence of
      chlamydial infection in 205 asymptomatic women of reproductive age, who were seen
      by a general practitioner or gynecologist for a gynecologic examination was
      measured. RESULTS: The overall prevalence was found to be 5.4% (95% confidence
      interval 2.7% to 9.4%) with the enzyme-linked immunosorbent assay method. Of all
      possible predictors of a chlamydial infection, only young age (< 25 years,
      prevalence 10.3%) seemed to be indicative of such an infection. CONCLUSION:
      Routine testing for Chlamydia trachomatis in sexually active women on Curacao and
      on other Caribbean islands is indicated for women < 25 years old.

PMID- 8362950
TI  - Erythrocytes in fetuses with abnormal umbilical artery flow velocity waveforms.
AB  - OBJECTIVE: Our purpose was to measure erythrocyte indexes in fetuses with two
      grades of Doppler-defined umbilical placental insufficiency. STUDY DESIGN: A
      prospective study comprising 110 infants categorized into control, moderate, and
      severe groups by umbilical artery waveform studies was undertaken at the
      University of Sydney at Westmead Hospital. Fetal erythrocyte indexes were
      measured in umbilical venous blood. Multivariate analyses of variance with post
      hoc Bonferroni t tests were used in the statistical analysis. RESULTS: The
      erythrocyte count, hematocrit, and hemoglobin concentration were all
      significantly higher (p < 0.001) in the two placental insufficiency groups than
      in the controls. Both placental insufficiency groups were affected to the same
      extent. CONCLUSIONS: Differences exist in the erythrocyte populations of fetuses
      with Doppler-defined placental insufficiency compared with controls. Importantly,
      these differences occur in more than just the most severe cases. These changes
      may represent a compensatory response to the placental vascular lesion detected
      by abnormal umbilical artery waveforms.

PMID- 8362951
TI  - Early prenatal ultrasonographic diagnosis of osteogenesis imperfecta: a case
      report.
AB  - A case of lethal osteogenesis imperfecta detected at 14 weeks' gestation by
      transvaginal ultrasonography is described. The prenatal diagnosis of limb
      shortening deformities caused by fractures and their repair is discussed.

PMID- 8362952
TI  - Ovarian cortex surrounding benign neoplasms: a histologic study.
AB  - OBJECTIVE: Our purpose was to assess the functional morphologic features of the
      ovarian cortex surrounding benign cysts. STUDY DESIGN: Fifty-four specimens (13
      mature teratomas, nine benign cystadenomas, and 32 endometriomas) were obtained
      from the area of maximum distention of the ovarian cortex overlying benign cysts
      from 48 patients. The type and number of follicles were scored on a
      semiquantitative scale (0 to 4). Alterations of the cortical stroma that were
      related to the primary tumor were investigated. The vascular network was assessed
      by means of monoclonal antibodies directed against endothelial cells (anti-VW,
      QBEND/10) and scored on a scale from 0 to 2. The chi 2 and Mann-Whitney U test
      were used for statistical analysis. RESULTS: Morphologic patterns similar to
      those of the normal ovarian cortex were observed in the cortical tissue
      surrounding mature teratomas, benign cystomas, and endometriomas in 92%, 77%, and
      19% (p < 0.01) of specimens, respectively, and a regular vascular network was
      observed in 84%, 78%, and 22% (p < 0.01). Although microscopic endometriosis was
      observed surrounding the endometrioma in the stroma of 82% of specimens, stromal
      alterations related to the ovarian tumor were absent in the cortex surrounding
      mature teratomas and cystadenomas. CONCLUSIONS: The study shows that the ovarian
      cortex, which is stretched and thinned by the growth of a benign tumor, is not
      morphologically altered in the presence of teratomas or benign cystadenomas.
      Endometriomas are associated with microscopic stromal implants and reduced
      follicular number and activity.

PMID- 8362953
TI  - Pregnancy in patients with cyclic neutropenia.
AB  - Cyclic neutropenia is characterized by periodic episodes of neutropenia that are
      often associated with infectious complications. A patient with cyclic neutropenia
      experienced two pregnancies with an amelioration of her infectious complications
      and an increase in neutrophil count. Cyclic neutropenia may follow a benign
      course during pregnancy.

PMID- 8362954
TI  - Moyamoya disease in pregnancy: a case report.
AB  - Moyamoya disease is a rare condition characterized by narrowing and occlusion of
      the internal carotid arteries. The disease usually presents as alteration of
      consciousness caused by intracranial hemorrhage. We describe a case of moyamoya
      disease presenting as seizures in a pregnant patient. The characteristic
      angiographic appearances and plan of management are described.

PMID- 8362955
TI  - Tumor necrosis factor, interleukin-1, and interleukin-6 in normal human
      pregnancy.
AB  - OBJECTIVE: Our purpose was to investigate the cytokines, tumor necrosis factor,
      interleukin-1, and interleukin-6 in normal human pregnancy and labor. STUDY
      DESIGN: Bioassays were used to measure these factors in extraembryonic coelomic
      fluid, amniotic fluid, placenta, and maternal and cord serum. RESULTS: Little or
      no tumor necrosis factor, interleukin-1, or interleukin-6 was found in coelomic
      fluid or amniotic fluid in the first trimester. Interleukin-6 appeared in second
      trimester amniotic fluid. At term tumor necrosis factor was present (median 17
      pg/ml) and increased with the onset of labor (median 58 pg/ml), as did
      interleukin-1 (median 188 to 680 pg/ml) and interleukin-6 (median 399 to 4800
      pg/ml). Maternal serum interleukin-6 increased during pregnancy with a further
      increment with the onset of labor. Cord interleukin-6 also increased with labor
      but at a lower level. CONCLUSION: The cytokines tumor necrosis factor,
      interleukin-1, and interleukin-6 may play a role in the onset of normal labor.

PMID- 8362956
TI  - Ultrasonographic measurement of cheek-to-cheek diameter in fetal growth
      disturbances.
AB  - OBJECTIVE: Our purpose was to assess the value of the cheek-to-cheek diameter and
      the cheek-to-cheek diameter/biparietal diameter ratio in the ultrasonographic
      detection of abnormal fetal growth. STUDY DESIGN: The cheek-to-cheek diameter and
      cheek-to-cheek diameter/biparietal diameter ratio were examined in 21 small-for
      gestational-age (< 10th percentile for estimated weight) and 87 large-for
      gestational-age (> 90th percentile) fetuses. Statistical analysis consisted of
      Student's t test comparison between means and analysis of covariance for
      comparison of regression lines slope between these 108 fetuses and previously
      published nomograms of appropriate-for-gestational-age fetuses. RESULTS: The mean
      cheek-to-cheek diameters in small-for-gestational-age fetuses were significantly
      smaller than in appropriate-for-gestational-age fetuses (p < 0.0001). In large
      for-gestational-age fetuses the mean cheek-to-cheek diameters were significantly
      larger (p < 0.005). Although large-for-gestational-age fetuses of diabetic
      mothers exhibited higher cheek-to-cheek diameter/biparietal diameter ratios than
      did appropriate-for-gestational-age fetuses (p < 0.0001), in fetuses of
      nondiabetic mothers this ratio was only minimally larger (p < 0.05). CONCLUSION:
      The cheek-to-cheek diameter and cheek-to-cheek diameter/biparietal diameter ratio
      are innovative ultrasonographic parameters for detecting abnormal fetal growth.
      Furthermore, the cheek-to-cheek diameter/biparietal diameter ratio permits
      insight into the possible underlying pathophysiologic mechanisms of fetal
      macrosomia.

PMID- 8362957
TI  - Embryopathic effects of the oral hypoglycemic agent chlorpropamide in cultured
      mouse embryos.
AB  - OBJECTIVES: The oral hypoglycemic agent chlorpropamide was evaluated for
      embryopathic effects in the mouse embryo model. STUDY DESIGN: Mouse embryos (n =
      10 to 31 per group) were exposed in whole embryo culture to serum from
      chlorpropamide-treated rats or chlorpropamide-supplemented control rat serum.
      Hypoglycemic serum from chlorpropamide-treated rats was supplemented with glucose
      to control for effects of hypoglycemia. Differences in malformation rates were
      evaluated by Fisher's exact test and numerical differences by analysis of
      variance. RESULTS: Mouse embryos were malformed by > or = 24 micrograms/ml of
      chlorpropamide, embryonic protein content and somites were decreased by > or =
      130 micrograms/ml of chlorpropamide, and visceral yolk sac protein was reduced by
      > 500 micrograms/ml of chlorpropamide. Similar development occurred in serum from
      chlorpropamide-treated rats and chlorpropamide-supplemented control serum, and
      growth was not improved by adding glucose. CONCLUSIONS: Chlorpropamide produces
      malformations and growth retardation in mouse embryos in vitro at concentrations
      overlapping therapeutic levels in humans. Chlorpropamide-induced defects are not
      mediated by hypoglycemia or by products of chlorpropamide metabolism.

PMID- 8362958
TI  - Plasma oxytocin and nocturnal uterine activity: maternal but not fetal
      concentrations increase progressively during late pregnancy and delivery in
      rhesus monkeys.
AB  - OBJECTIVE: The purpose of the study was to determine whether rising maternal or
      fetal plasma oxytocin concentrations could be responsible for the increasing
      levels of nocturnal uterine activity on the nights preceding delivery. STUDY
      DESIGN: Chronically catheterized pregnant rhesus monkeys were exposed to a 16
      hour light, 8-hour dark photoperiod (dark 11 PM to 7 AM). Uterine activity and
      maternal arterial plasma oxytocin concentrations were measured concurrently at
      weekly intervals in late gestation, on the night preceding term delivery (158 to
      167 days, n = 4), and during delivery (149 to 170 days, n = 6). Fetal carotid
      arterial plasma oxytocin levels were measured during episodes of nocturnal
      uterine activity in six animals. The effect of oxytocin infusions into the fetus
      (30 to 480 ng/kg/hr) on uterine activity and on maternal and fetal plasma
      oxytocin levels was also determined (n = 3). RESULTS: Maximal nocturnal oxytocin
      concentrations in the maternal plasma rose progressively during late gestation
      from 9.9 +/- 3.5 pg/ml at 130 to 139 days to 28.7 +/- 9.8 pg/ml on the night
      preceding term delivery (p < 0.005); a significant increase in nocturnal uterine
      activity accompanied this rise (p < 0.001). Maternal oxytocin concentrations were
      elevated during labor and increased further at delivery (62.5 +/- 5.5 pg/ml, p <
      0.05). There was no increase in fetal plasma oxytocin during nocturnal uterine
      activity (3.1 +/- 0.2 pg/ml) or during labor. Fetal oxytocin infusions raised
      fetal plasma oxytocin concentrations sixtyfold but had no effect on maternal
      plasma oxytocin concentrations or on uterine activity. CONCLUSIONS: Elevated
      maternal plasma oxytocin concentrations are responsible, at least in part, for
      the increasing magnitude of nocturnal uterine activity episodes as term
      approaches and for the elevated uterine activity before delivery at night. Fetal
      plasma oxytocin does not contribute to nocturnal uterine activity or to maternal
      plasma oxytocin concentrations.

PMID- 8362959
TI  - Transfer of maternally administered magnesium sulfate into the fetal compartment
      of the rat: assessment of amniotic fluid, blood, and brain concentrations.
AB  - OBJECTIVE: Our purpose was to determine whether parenteral magnesium sulfate
      crosses the rat placenta and enters the fetal brain. STUDY DESIGN: Twenty-eight
      pregnant female Long-Evans rats were divided into four groups, seven animals in
      each group. These groups included the following: single saline solution injection
      group evaluated after 20 minutes (control), single magnesium sulfate injection
      (270 mg/kg) evaluated after 20 minutes, and prolonged (2 and 4 hours) serum
      magnesium elevation (270 mg/kg loading and then 27 mg/kg every 20 minutes for
      maintenance). Each animal was killed, and maternal and fetal sera, amniotic
      fluid, and specific brain areas were analyzed for levels of magnesium.
      Statistical analysis included analysis of variance, multiple comparison
      procedure, and linear regression analysis. RESULTS: All three regimens of
      maternal subcutaneous magnesium sulfate resulted in significantly elevated
      maternal serum magnesium concentrations (p < 0.01). Fetal blood magnesium
      concentration rose from 3.9 +/- 0.3 to 4.9 +/- 0.1 mg/dl after 2 hours of
      continuous injections (p < 0.05), and to 5.3 +/- 0.0 mg/dl after 4 hours (p <
      0.01). Amniotic fluid magnesium concentrations rose from 4.2 +/- 0.2 to 5.1 +/-
      0.1 mg/dl after 4 hours (p < 0.05). Maternal blood magnesium concentrations were
      significantly correlated with amniotic fluid concentrations (r = 0.59, p < 0.01).
      Four hours of maternal magnesium sulfate treatment resulted in a 25% increase in
      magnesium concentrations in the fetal forebrain (38.3 +/- 2.3 to 47.9 +/- 3.5
      mg/dl/gm, p < 0.05). No significant changes in magnesium concentrations were
      detected in hindbrain. CONCLUSION: Magnesium sulfate injected subcutaneously into
      rats crosses the placenta within 2 hours of sustained magnesium levels, enter the
      fetal blood-brain barrier, and concentrates in the forebrain.

PMID- 8362960
TI  - Perihepatic adhesions and pelvic infection.

PMID- 8362961
TI  - Ultrasonography in hereditary angioneurotic edema during pregnancy.

PMID- 8362962
TI  - The smaller-than-expected first-trimester fetus.

PMID- 8362963
TI  - Chlamydia and recurrent pregnancy loss.

PMID- 8362964
TI  - Amniotic fluid volume determination.

PMID- 8362965
TI  - Calculation of blood loss at delivery.

PMID- 8362966
TI  - "The effect of presentation and mode of delivery on neonatal outcome in the
      second twin"--is this study biased?

PMID- 8362967
TI  - Expression and localization of tumor necrosis factor-alpha and its mRNA in
      idiopathic pulmonary fibrosis.
AB  - The expression of tumor necrosis factor alpha and its mRNA was investigated in
      surgical biopsies from idiopathic pulmonary fibrosis by immunohistochemistry, in
      situ hybridization, and Northern blotting. Normal areas of lungs resected for
      cancer were used as controls. Tumor necrosis factor alpha mRNA levels were higher
      in idiopathic pulmonary fibrosis than in normal lungs as determined by Northern
      blots. In normal lungs, tumor necrosis factor alpha and its mRNA were identified
      in alveolar and interstitial macrophages. In fibrotic lungs, tumor necrosis
      factor alpha was detected in macrophages and, to a greater extent, in epithelial
      cells (presumably type II cells) lining the thickened septae. Tumor necrosis
      factor alpha mRNA was found only in some interstitial cells and some of the cells
      lining the alveolar septae. An elevated concentration of tumor necrosis factor =
      alpha, particularly within the alveolar epithelium, might contribute to the
      alveolar damage and proliferation of interstitial cells in idiopathic pulmonary
      fibrosis.

PMID- 8362968
TI  - A putative marker for human melanoma. A monoclonal antibody derived from the
      melanoma gene in the Xiphophorus melanoma model.
AB  - A MoAb was raised against a peptide corresponding to an exposed domain of the
      putative tyrosine kinase receptor protein encoded by Xmrk, a gene involved in
      melanoma formation and/or progression in the Xiphophorus fish melanoma model. The
      antibody reacts specifically with cells from human melanocytic lesions, ie,
      common acquired nevi, primary and metastatic melanoma biopsies. No reactivity
      with other cells, including normal melanocytes, was observed in the biopsies or
      with cells in biopsies from normal tissue (skin, liver, lung, spleen) and from
      other malignancies including those of neuroectodermal origin. The reactivity was
      very weak and variable in metastatic melanomas but very strong and characteristic
      of a receptor-type antigen in primary melanomas, a stage in melanoma progression
      in which cells have acquired metastasizing potential. It is suggested that the
      antigen recognized may be involved in growth promotion and represents the human
      equivalent of the fish melanoma gene product.

PMID- 8362969
TI  - Interstitial collagenase gene expression in colonic neoplasia.
AB  - Tumor invasion and metastasis are complex phenomena believed to be facilitated by
      the disruption of collagen and elastin fibers in the extracellular matrix.
      Interstitial collagenase gene expression was studied in colonic adenocarcinoma
      and adenoma using in situ hybridization. The data indicated that three cell types
      within the tumor stroma expressed collagenase transcripts; they were eosinophils,
      fibroblasts, and vascular endothelium. In all 12 adenocarcinomas, a high to
      moderate level of expression was seen in 1 to 5% of eosinophils and in occasional
      fibroblasts, whereas these cell types in non-neoplastic mucosa adjacent to tumor
      showed no detectable expression. Two adenocarcinomas showed expression in
      hyperplastic endothelium in vascularized granulation tissue. Two out of three
      adenomas showed expression in eosinophils and fibroblasts at a reduced level.
      Tissue inhibitor of metalloproteinase-1 gene expression was, however, negligible
      in all tissue examined. These results suggest that interstitial collagenase gene
      activation in the tumor stroma, especially eosinophils, may have an important
      role in tumor invasion and metastasis.

PMID- 8362970
TI  - LFA-1 expression on exocrine glands as a potential novel marker of malignant
      disease.
AB  - The lymphocyte function associated antigen 1 has been found only on leukocytes
      and lymphoid tissues; however, the expression of lymphocyte function associated
      antigen 1 on nonhematopoietic cells has not been reported previously. In this
      study, immunohistochemical expression of lymphocyte function associated antigen 1
      was examined on various tissues from 35 patients with malignant diseases and 36
      patients with benign diseases including benign tumors. The expression of
      lymphocyte function associated antigen 1 was found on various exocrine tissues
      (eg, gastric glands, bronchial epithelium, alveolar epithelium, duodenal glands,
      bile ducts, pancreatic acini, and salivary glands) uninvolved by tumor in
      patients with malignant diseases. Localization of lymphocyte function associated
      antigen 1 was limited to the exocrine glands and differed from tissue
      infiltrating leukocytes. The expression of lymphocyte function associated antigen
      1 on exocrine tissues was confirmed in all 35 cases of malignant diseases that
      were examined. These included a wide spectrum of carcinomas and hematopoietic
      tumors. In contrast, none of the 36 cases with benign diseases examined expressed
      lymphocyte function associated antigen 1 on their exocrine glands. These results
      indicate a strong correlation between lymphocyte function associated antigen 1
      expression on exocrine glands and malignant disease. The expression of lymphocyte
      function associated antigen 1 on nonhematopoietic cells was further confirmed in
      nonhematopoietic cell lines. Two of 19 nonhematopoietic cell lines (MKN45 and
      PANC-1; exocrine gland cell lines) examined expressed lymphocyte function
      associated antigen 1 on both cell surface and cytoplasm. These results suggested
      that immunohistochemically defined lymphocyte function associated antigen 1
      molecules on nontumorous exocrine gland cells are a potential marker for the
      presence of malignant diseases.

PMID- 8362971
TI  - Pancreatic acinar cell carcinoma. An analysis of cell lineage markers, p53
      expression, and Ki-ras mutation.
AB  - In a series of 22 pancreatic acinar cell carcinomas, including two acinar
      cystadenocarcinomas, cellular differentiation was analyzed by immunocytochemistry
      and electron microscopy. In addition, overexpression of p53 protein and Ki-ras
      codon 12 mutation was studied. Four of the 20 noncystic acinar cell carcinomas
      showed a pure acinar pattern, nine an acinar-solid, and seven a solid pattern.
      All tumors stained for at least one of the following pancreatic acinar markers:
      trypsin (21 of 22), lipase (19 of 22), chymotrypsin (13 of 22), phospholipase A2
      (nine of 22), and pancreatic stone protein (19 of 22). One-third of the tumors
      expressed neuroendocrine markers (synaptophysin, eight of 22; chromogranin A, six
      of 21) and duct cell markers (CA19.9, nine of 21; B72.3, six of 21). Cellular
      coexpression of trypsin and synaptophysin was demonstrated in one tumor. Electron
      microscopy revealed zymogen granules (nine of nine). In only one of 16 tumors a
      Ki-ras mutation at codon 12 was found, whereas in none of 19 tumors could
      overexpression of p53 protein be demonstrated. The results suggest that acinar
      cell carcinomas show obvious capacity to differentiate into several directions,
      but nevertheless constitute an entity different from ductal adenocarcinomas or
      endocrine tumors.

PMID- 8362972
TI  - Alterations of thymus cortical epithelium and interdigitating dendritic cells but
      no increase of thymocyte cell death in the early course of simian
      immunodeficiency virus infection.
AB  - The role of the thymus in the pathogenesis of simian acquired immunodeficiency
      syndrome was investigated in 18 juvenile rhesus monkeys (Macaca mulatta). The
      thymus was infected from the first week post-SIVmac inoculation, but the amount
      of virus-positive cells was very low (< 1 in 10(4) T cells) as demonstrated by
      polymerase chain reaction and in situ hybridization. First morphological
      alteration was a narrowing of the cortex at 12 and 24 wpi. Morphometry revealed
      no increase of pyknotic T cells but a decrease of the proliferation rate and flow
      cytometry showed a reduction of the immature CD4+/CD8+ double-positive T cells.
      Ultrastructural analysis revealed vacuolization, shrinkage, and finally cytolysis
      of the cortical epithelial cells and the interdigitating dendritic cells.
      Immunofluorescence staining exhibited a widespread loss of cortical epithelial
      cells. This damage to the thymic microenvironment could explain the breakdown of
      the intrathymic T cell proliferation. It preceded fully developed simian acquired
      immunodeficiency syndrome and is therefore considered to play a major role in its
      pathogenesis.

PMID- 8362973
TI  - Expression of cell-cell and cell-matrix adhesion proteins by sinusoidal
      endothelial cells in the normal and cirrhotic human liver.
AB  - We compared the expression of cell-cell and cell-matrix adhesion proteins by
      sinusoidal endothelial cells in normal human liver, in which the endothelial
      lining of hepatic sinusoids is discontinuous and devoid of basement membrane, and
      in cirrhosis, during which sinusoids might undergo a process of capillarization
      and acquire a continuous lining and a typical basement membrane. In normal liver,
      sinusoidal endothelial cells displayed a very restricted repertory of cell
      adhesion molecules: the intercellular adhesion molecules PECAM-1 and CD34 were
      undetectable and only two integrins, alpha 1 beta 1 and alpha 5 beta 1, were
      present, whereas the laminin receptors alpha 6 beta 1 and alpha 2 beta 1 were
      undetectable and the beta 3 integrins were faintly expressed. In capillarized
      sinusoids, sinusoidal endothelial cells displayed striking changes in their
      repertory of cell-adhesion molecules, including the expression of PECAM-1 protein
      and messenger RNAs and the induction of the laminin receptors alpha 6 beta 1 and
      alpha 2 beta 1. Such changes co-localized with subendothelial laminin deposits.
      In conclusion, normal sinusoidal endothelial cells express a distinctive set of
      cell-adhesion molecules, adapted to their structural and microenvironmental
      characteristics, and this repertory is dramatically modified during sinusoidal
      capillarization, possibly as a consequence of the concomitant matrix changes.

PMID- 8362974
TI  - Type 1 plasminogen activator inhibitor gene expression following partial
      hepatectomy.
AB  - A murine model of partial hepatectomy (PH) was employed to investigate type 1
      plasminogen activator inhibitor (PAI-1) gene expression in regenerating liver.
      Mice were anesthetized, and a portion of the left lobe of the liver was ligated
      and resected distal to the ligature, and at various times thereafter, total liver
      RNA was prepared and analyzed by Northern blotting. PH caused a transient
      increase in PAI-1 messenger (m)RNA that was apparent within 1 to 2 hours after
      surgery, was maximal at 8 hours (ninefold increase over sham-operated controls),
      and then slowly declined. Analysis of discrete liver segments demonstrated much
      greater induction of PAI-1 mRNA in the region adjacent to PH than in more distal
      regions. Further analysis of the adjacent tissue by in situ hybridization
      revealed that PAI-1 mRNA was induced primarily in hepatocytes in the transition
      zone created by the occluding hemostatic ligature between viable and necrotic
      tissue. Expression of PAI-1 mRNA could also be detected in this transition zone
      in capsular mesothelial cells, subcapsular hepatocytes, and venous endothelial
      cells bordering the area. A much weaker signal was evident in hepatocytes
      dispersed throughout the remaining intact lobes of PH mice, and no signal was
      detected in the livers of sham-operated mice. These observations suggest that PAI
      1 may be of importance in local tissue remodeling events accompanying liver
      regeneration.

PMID- 8362975
TI  - Platelet activation releases megakaryocyte-synthesized apolipoprotein J, a highly
      abundant protein in atheromatous lesions.
AB  - Apolipoprotein J (apoJ) is an abundant glycoprotein in many biological fluids,
      and its constitutive high level synthesis is characteristic of many epithelial
      cells exposed to harsh fluids such as urine, bile, and gastric secretions. In
      addition, dramatic induction of apoJ occurs in cells surrounding several kinds of
      pathological lesions. Because platelets and circulating inflammatory cells
      represent critical elements in numerous pathological processes, we evaluated bone
      marrow cells for the presence of apoJ. Based upon messenger RNA in situ
      hybridization and immunofluorescent protein detection, high-level apoJ gene
      expression and protein accumulation occurred exclusively in mature
      megakaryocytes. Our results indicate that apoJ is stored in platelet granules and
      is released into extracellular fluid following platelet activation. Because
      atheromatous plaque development involves platelet aggregation and activation, we
      looked for and found abundant apoJ protein in advanced human atheromatous
      lesions. Thus, platelet sequestration and activation may lead to the rapid
      deployment of apoJ into sites of vascular injury. We hypothesize that platelet
      derived apoJ participates in both short-term wound repair processes and chronic
      pathogenic processes at vascular interfaces.

PMID- 8362976
TI  - Distribution of ICAM-3-bearing cells in normal human tissues. Expression of a
      novel counter-receptor for LFA-1 in epidermal Langerhans cells.
AB  - The LFA-1 integrin mediates its function in leukocyte intercellular interactions
      by recognition of at least one of its three identified counter-receptors,
      intercellular adhesion molecules 1 (ICAM-1), 2, and 3. The ICAM-1 molecule is
      expressed in an inducible-dependent manner by endothelial and epithelial cells,
      as well as by other cell types, including leukocytes. On the other hand, ICAM-2
      is constitutively expressed mainly by endothelial cells. We have studied the
      tissue distribution of the ICAM-3 molecule by immunohistochemical staining of
      lymphoid and nonlymphoid organs. Only cells from the leukocyte lineage were found
      bearing the ICAM-3 antigen, showing a pattern of expression clearly distinct from
      those of ICAM-1 and ICAM-2. Interestingly, we have found that ICAM-3 is expressed
      by epidermal dendritic Langerhans cells as assessed by double immunostaining with
      antibodies specific for CD1. In contrast, staining of skin sections with anti
      ICAM-1 and ICAM-2 antibodies showed an undetectable expression of these two
      molecules on Langerhans cells. However, CD1+ Langerhans cells localized in the
      paracortical area of dermatopathic lymph nodes expressed both ICAM-1 and ICAM-3
      antigens. Our results indicate that ICAM-3 is the main LFA-1 counter-receptor in
      human resident epidermal Langerhans cells. ICAM-3 may have an important role in T
      cell antigen stimulation driven by Langerhans cells during skin immune reactions.

PMID- 8362977
TI  - Eosinophils expressing heparin-binding EGF-like growth factor mRNA localize
      around lung microvessels in pulmonary hypertension.
AB  - In pulmonary hypertension, induced in rats breathing high oxygen at normobaric
      pressure, vascular cell hypertrophy and hyperplasia thicken the walls of lung
      microvessels (15-100 microns in diameter). Over a 28-day time course, new
      contractile cells develop from intimal precursor smooth muscle cells, which
      include intermediate cells and interstitial fibroblasts. Cell labeling studies in
      vivo have shown that these cells proliferate more than other vascular cells and
      that most of this activity occurs between 4 and 7 days of hyperoxia. The growth
      factors responsible for this proliferation are unknown. In the present study, we
      investigate the expression of mRNA for the epidermal growth factor (EGF)-related
      protein, heparin-binding EGF-like growth factor (HB-EGF), a newly discovered
      mitogen for fibroblasts and smooth muscle cells. Northern analysis shows HB-EGF
      mRNA levels to be low in normal lung but increased 100-fold by day 7 of
      hyperoxia. In situ hybridization identifies a select group of cells expressing HB
      EGF mRNA. In normal lung, hybridizing cells are randomly distributed in the
      alveolar wall and space. By day 7, they increase in number and cluster around the
      microvessels. Histochemical techniques identify cells expressing HB-EGF mRNA as
      eosinophils.

PMID- 8362978
TI  - The production of interleukin-1 receptor antagonist by human bronchogenic
      carcinoma.
AB  - Bronchogenic carcinoma displays an aggressive clinical course that may reflect a
      capacity to evade host defenses. We postulated that tumors may elaborate
      interleukin-1 receptor antagonist protein (IRAP) to escape host interleukin-1
      dependent responses. Homogenates of human bronchogenic lung tumors demonstrated
      significant increases of IRAP compared with normal lung tissue controls (n = 48).
      There was no significant difference in interleukin-1 beta levels between tumor
      and normal lung tissue. Immunohistochemical staining localized IRAP to tumor
      cells. Semiquantitative pathological analysis demonstrated a modest inflammatory
      cell infiltrate with qualitative differences between tumors of different
      histology. Western blot analysis of tumor homogenates demonstrated several
      molecular weight forms of IRAP. Finally, antigenic IRAP was detected in
      supernatants of the human bronchogenic carcinoma cell line (A549) maintained in
      vitro. These findings illustrate the capacity of bronchogenic tumors to produce
      and secrete IRAP that may be important in tumor evasion of host defenses.

PMID- 8362979
TI  - Effects of human immunodeficiency virus sera and macrophage supernatants on
      mesangial cell proliferation and matrix synthesis.
AB  - Patients with human immunodeficiency virus (HIV) infection are prone to the
      development of focal segmental glomerulosclerosis, a lesion in which increased
      mesangial cell proliferation and matrix synthesis may play a role. We undertook
      the present study to determine whether HIV sera may affect mesangial cell
      proliferation and matrix synthesis either directly or indirectly via effects on
      macrophage supernatants. Pooled HIV sera was found to significantly enhance (P <
      0.01) mesangial cell proliferation in a concentration-related manner. Mesangial
      cell proliferation was significantly suppressed by two medications commonly
      utilized in HIV-infected patients, azidothymidine and
      trimethoprim/sulfamethoxazole, and was not significantly altered by
      lipopolysaccharide, suggesting that these medications as well as recurrent
      infection are unlikely to account for the proliferative effect of HIV sera.
      Supernatants from HIV sera-treated macrophages were found to significantly
      enhance (P < 0.01) mesangial cell incorporation of [3H]proline, a marker for
      synthesis of the matrix component collagen, compared to supernatants from control
      sera-treated macrophages. These results suggest that HIV sera may directly
      enhance mesangial cell proliferation and may indirectly increase mesangial cell
      matrix synthesis by altering macrophage secretory products. These effects may
      play a role in the development of glomerulosclerosis in patients with HIV
      infection.

PMID- 8362980
TI  - Abnormal cytoskeletal assembly in platelets from uremic patients.
AB  - The mechanisms involved in the hemostatic abnormality of uremic patients remain
      obscure. We have explored the response of normal and uremic platelets to surface
      activation at the ultrastructural level and analyzed changes in the composition
      of proteins associated with normal and uremic platelet cytoskeletons after
      stimulation with thrombin (0.01 and 0.1 U/ml). Cytoskeletons were obtained by
      extraction with Triton X-100, processed by sodium dodecylsulfate-polyacrylamide
      gel electrophoresis, and the presence of cytoskeletal proteins analyzed by
      densitometry. Under static conditions, uremic platelets spread with difficulty on
      formvar-coated grids. The percentage of platelets that spread fully on this
      polymer surface was statistically reduced compared with that of control platelets
      (11 +/- 1.4 vs. 21 +/- 1.6; P < 0.05). An impairment of cytoskeletal organization
      was observed in resting uremic platelets but abnormalities were more evident
      after thrombin activation. The incorporation of actin into the cytoskeletons of
      thrombin-stimulated uremic platelets was significantly reduced with respect to
      controls (6 +/- 3% vs. 29 +/- 5%; P < 0.01 after 0.01 U/ml and 28 +/- 9% vs. 59
      +/- 10%; P < 0.05 after 0.1 U/ml). Decreased associations of actin-binding
      protein (P < 0.01), alpha-actinin (P < 0.05), and tropomyosin (P < 0.05) with the
      cytoskeletons of uremic platelets were also noted. No difference was observed for
      the incorporation of myosin into the cytoskeletons of activated uremic platelets.
      These results suggest functional and biochemical alterations of the platelet
      cytoskeleton in uremia, which may contribute to the impairment of platelet
      function observed in uremic patients.

PMID- 8362981
TI  - Response of macaque bronchiolar epithelium to ambient concentrations of ozone.
AB  - Recently, we reported that exposure to ambient concentrations of ozone, near the
      U.S. National Ambient Air Quality Standard (0.12 ppm), induced significant nasal
      epithelial lesions in a non-human primate, the bonnet monkey. The present study
      defines the effects of ambient concentrations of ozone on the surface epithelium
      lining respiratory bronchioles and on the underlying bronchiolar interstitium in
      these same monkeys. Bonnet monkeys were exposed to filtered air or to 0.15 or
      0.30 ppm ozone 8 hours/day for 6 or 90 days. At the end of exposures, monkeys
      were anesthetized and killed by exsanguination. Microdissected bronchiolar
      airways of infusion-fixed lungs were evaluated morphometrically by light
      microscopy and quantitatively by scanning and transmission electron microscopy
      for ozone-induced epithelial changes. Hyperplasia of nonciliated, cuboidal
      epithelial cells and intraluminal accumulation of macrophages characterized ozone
      induced lesions in respiratory bronchioles. There were no significant differences
      in epithelial thickness or cell numbers among ozone-exposed groups. Ozone-exposed
      epithelium was composed of 80% cuboidal and 20% squamous cells compared with 40%
      cuboidal and 60% squamous cells in filtered air controls. In addition, the
      arithmetic mean thickness of the surface epithelium, a measure of tissue mass per
      unit area of basal lamina, was significantly increased in all of the ozone
      exposed groups. The number of cuboidal epithelial cells per surface area of basal
      lamina was increased above control values by 780% after 6 days exposure to 0.15
      ppm, 777% after 90 days to 0.15 ppm, and 996% after 90 days exposure to 0.30 ppm.
      There was also a significant ozone-induced increase in the thickness of the
      bronchiolar interstitium that was due to an increase in both cellular and
      acellular components. These results demonstrate that exposure to low ambient
      concentrations of ozone, near the current. National Ambient Air Quality Standard,
      induces pulmonary lesions in primates. The alterations do not appear to be
      concentration- or time-dependent, suggesting that the current National Ambient
      Air Quality Standard may be at or above the threshold for deep lung injury in
      primates.

PMID- 8362982
TI  - Glycoprotein CD44 expression and its association with survival in breast cancer.
AB  - To investigate the clinical significance of CD44 expression (lymphocyte-homing
      receptor) in adenocarcinoma, deparaffinized sections from 198 female breast
      carcinomas were stained with Hermes-3 MoAb for CD44 glycoprotein. In 16% of the
      cancers most (> or = 90%) of the cancer cells stained positively for CD44,
      whereas the rest of the cancers were either heterogenous (46%) or negative (38%)
      in CD44 staining. Cancers with > 50% CD44 positive cells were more often poorly
      differentiated (grade 3) than those with < or = 50% positive cells (38 vs. 19%, P
      = 0.006), they had higher mitotic counts (P = 0.04), and were more often estrogen
      receptor negative (52 vs. 31%, P = 0.01). Among ductal not otherwise specified
      cancers and node-positive cancers strong CD44 expression was associated with poor
      outcome (P = 0.05 and 0.02, respectively). However, CD44 expression was not an
      independent prognostic factor in these subgroups in a multivariate analysis.
      Unlike in lymphomas the unfavorable prognosis associated with CD44 expression may
      not be explained by the greater metastatic potential of CD44-positive cells,
      because the difference in mortality between the groups appeared to diminish with
      time, and CD44 positivity was associated with aggressive histological features.

PMID- 8362983
TI  - Atheromatous plaque macrophages produce plasminogen activator inhibitor type-1
      and stimulate its production by endothelial cells and vascular smooth muscle
      cells.
AB  - The capacity of macrophages to influence directly and indirectly fibrinolytic
      processes in atherosclerosis was studied using macrophages isolated from
      atherosclerotic plaques of patients undergoing surgical repair of distal aortic
      and femoral arteries. These cells were characterized by their morphology,
      adherence, esterase positivity, and expression of CD14 antigen. Production of
      plasminogen activator inhibitor type-1 (PAI-1) by plaque macrophages (6.7 +/- 2.7
      ng/10(5) cells/24 hours [mean +/- SEM]) was significantly greater than PAI-1
      production by blood monocytes isolated simultaneously from the same patients (1.8
      +/- 1.5 ng/10(5) cells/24 hours). Production of tissue type plasminogen activator
      and urokinase type was not augmented compared to blood monocytes. Conditioned
      medium from cultured plaque macrophages significantly increased production of PAI
      1 by endothelial cells (85 +/- 11% above basal) and vascular smooth muscle cells
      (25 +/- 10%) in vitro. This response was significantly greater than the response
      to monocyte-conditioned medium (endothelial cells 38 +/- 11%, vascular smooth
      muscle cells 2.5 +/- 2.0%). Stimulation of endothelial cell PAI-1 production by
      macrophage-conditioned medium was partially inhibitable by a monoclonal antibody
      to transforming growth factor-beta. Tissue type plasminogen activator production
      by endothelial cells and vascular smooth muscle cells was not affected by plaque
      macrophage- or monocyte-conditioned medium. Urokinase type plasminogen activator
      production by endothelial cells and vascular smooth muscle cells was undetectable
      in control medium and was augmented to similar levels in response to plaque
      macrophage- and monocyte-conditioned media. These results demonstrate
      upregulation of PAI-1 production by macrophages in atheromatous plaques and the
      capacity of soluble products from plaque macrophages to upregulate PAI-1
      production by endothelial cells and vascular smooth muscle cells in vitro. These
      data suggest that macrophages in atherosclerotic plaques may inhibit thrombolysis
      both directly and indirectly by effects of their soluble products on endothelial
      cells and vascular smooth muscle cells.

PMID- 8362984
TI  - Serine protease inhibitor antithrombin III and its messenger RNA in the
      pathogenesis of Alzheimer's disease.
AB  - The classical plasma protein antithrombin III (ATIII), an inhibitor of the blood
      coagulation cascade, is a member of the serpins that are gaining import in the
      nervous system. In this study, we examined the presence of ATIII in the
      pathological lesions of Alzheimer's disease (AD). Antibodies to ATIII
      consistently detected approximately 58-kd protein(s) on immunoblots of cerebral
      cortex and brain microvessels. Immunocytochemical studies showed ATIII reactivity
      within amyloid deposits, neurites associated with plaques, and neurofibrillary
      tangles in neocortex and hippocampus of virtually all the AD cases examined. In
      some cases, astrocytes were also stained, suggesting ATIII in these cells. ATIII
      immunoreactivity in neurofibrillary tangles was further defined by electron
      microscopy, which showed it to be associated with paired helical filaments. Using
      the polymerase chain reaction technique to amplify ATIII complementary DNA, we
      found low levels of messenger RNA expression, relative to liver, in control human
      brain samples, and these were increased in AD samples, particularly in the white
      matter. Our results suggest the increased presence of ATIII commensurate with
      astrogliosis and association with the neurofibrillary pathology of AD. We
      conclude that in concert with other amyloid-associated serine protease
      inhibitors, ATIII may play a role in the pathogenesis of cerebral amyloidosis.

PMID- 8362985
TI  - Microtubule antagonists activate programmed cell death (apoptosis) in cultured
      rat hepatocytes.
AB  - We investigated the mechanism of lethal injury following the disruption of
      microtubules in cultured hepatocytes treated with vinblastine (VBL) or colchicine
      (COL). These agents kill hepatocytes by a process readily distinguished from two
      well-known pathways that lead to a loss of viability, namely, oxidative stress
      and inhibition of mitochondrial electron transport. Cell killing with VBL and COL
      was accompanied by fragmentation of DNA. Both the loss of viability and the
      fragmentation of DNA were prevented by the inhibition of protein synthesis within
      6 hours following exposure to VBL or COL. Cell death and the fragmentation of DNA
      were also prevented when Ca2+ was removed from the culture medium. By contrast,
      the inhibition of protein kinase C prevented cell killing by VBL or COL, but did
      not alter the extent of DNA fragmentation. The requirements here for protein
      synthesis, extracellular Ca2+, and protein kinase C activity define a model of
      apoptosis, or programmed cell death, that seems to involve mechanisms that can be
      dissociated from the fragmentation of DNA.

PMID- 8362986
TI  - Microtubule disruption stimulates DNA synthesis in bovine endothelial cells and
      potentiates cellular response to basic fibroblast growth factor.
AB  - Cultured endothelial cells characteristically form a monolayer and become
      quiescent at saturation density. This study shows that microtubule
      destabilization in confluent cultures of bovine aortic endothelial cells
      stimulates fibroblast growth factor 2 (FGF-2, bFGF)-dependent DNA synthesis.
      Twenty-four hours after addition of the microtubule-disrupting drug colchicine,
      tritiated thymidine incorporation increases up to fivefold when compared to
      control cultures. Significant stimulation is seen with doses from 0.05 to 1.0
      microgram/ml. The effect of colchicine is quantitatively similar to stimulation
      of the same cultures with 5 ng/ml FGF-2. Furthermore, the stimulation of DNA
      synthesis by colchicine can be completely blocked by the addition of a
      neutralizing antibody to FGF-2. This suggests that colchicine may stimulate
      bovine aortic endothelial cells by modulating endogenous FGF-2/receptor
      interactions or that colchicine acts by a different mechanism that requires the
      growth factor for mitogenicity. The combined effects of colchicine and FGF-2 are
      more than additive, which supports the idea that microtubule disruption may
      facilitate cellular response to FGF-2. Cytochalasin B, preventing actin
      polymerization, inhibits the mitogenic response to FGF-2 but not the response to
      colchicine. These results are best interpreted as evidence that colchicine
      stimulates endothelial cell DNA synthesis by a pathway that requires endogenous
      FGF-2 and may be facilitating cellular responsiveness to the growth factor by
      disrupting the monolayer via the cytoskeleton.

PMID- 8362987
TI  - Activation of hepatocyte growth factor by the plasminogen activators uPA and tPA.
AB  - Hepatocyte growth factor, also known as scatter factor, is a complete mitogen for
      hepatocytes that bears sequence and structural homology with plasminogen. Because
      it exists in both a mitogenically inactive single-chain form and an active two
      chain form, we were interested in determining whether plasminogen activators
      could properly cleave single-chain hepatocyte growth factor to generate active
      two-chain hepatocyte growth factor. Herein we report that both urokinase-type
      plasminogen activator and tissue-type plasminogen activator can cleave single
      chain hepatocyte growth factor, generating two-chain hepatocyte growth factor.
      When equal quantities of plasminogen activator-treated and activator-untreated
      hepatocyte growth factor are compared in serum-free in vitro bioassays, the
      treated hepatocyte growth factor is mitotically more active. Also, urokinase-type
      plasminogen activator was inactive against hepatocyte growth factor molecules
      with a mutated cleavage site. This suggests that urokinase-type and tissue-type
      plasminogen activator may be natural biological regulators of hepatocyte growth
      factor. Because the active form of hepatocyte growth factor is a powerful
      stimulator of DNA synthesis and cell motility, these findings may be relevant in
      understanding the role of plasminogen activators in the biology of cancer
      invasion and metastasis.

PMID- 8362988
TI  - Chronic Lyme borreliosis in the laboratory mouse.
AB  - C3H/HeJ mice were inoculated intraperitoneally with 10(7) uncloned Borrelia
      burgdorferi at 4 weeks of age and examined on days 30, 90, 180, and 360.
      Spirochetes were isolated from multiple tissues at all intervals. Joint and heart
      disease were present in all mice at 30 days and resolved after 90 days. At 180
      and 360 days, some mice had mild recurrent joint and heart disease, and most had
      peripheral segmental periarteritis. The protein electrophoretic migration of 360
      day isolates differed from the original inoculum. The experiment was repeated
      with C3H/HeN and BALB/cByJ mice inoculated intradermally with 10(4) cloned B.
      burgdorferi. Characterization of infection and disease at 180 and 360 days were
      similar to those of the first experiment, but spirochetal proteins of isolates
      from both intervals displayed no protein variation in electrophoretic mobilities.
      Spirochetes isolated at 360 days were fully pathogenic in naive mice. Sera from
      infected mice showed an initial immunoglobulin M response, followed by a
      sustained immunoglobulin G response, involving IgG1, IgG2a, IgG2b and IgG3, with
      expanding reactivity against multiple antigens over time. These results indicate
      that immunocompetent mice sustain persistent infections and develop early acute
      joint and heart lesions that resolve and then recur intermittently.

PMID- 8362989
TI  - A spontaneous mutation characterized by chronic proliferative dermatitis in C57BL
      mice.
AB  - Chronic proliferative dermatitis is a new spontaneous mutation in C57BL/Ka mice.
      Breeding results suggest an autosomal recessive mode of inheritance. Mutant mice
      develop skin lesions at the age of 5 to 6 weeks. The lesions occur in the ventral
      and dorsal skin of the body, whereas ears, footpads, and tail are not involved.
      The lesions are characterized by epidermal hyperplasia, hyper- and parakeratosis,
      and single cell necrosis of keratinocytes. The dermis and epidermis are
      infiltrated by granulocytes and macrophages, and occasionally subcorneal and
      intracorneal microabscesses are formed. The number of mast cells in the dermis
      progressively increases with age. There is dilatation and proliferation of dermal
      capillaries. Similar lesions develop in the mouth, esophagus, and forestomach,
      which, in the mouse, are all lined by orthokeratinizing stratified squamous cell
      epithelium. Studies with bromodeoxyuridine confirm the increased rate of
      epithelial cell proliferation. Most inflammatory cells in the affected skin
      express Mac-1, and few express the T lymphocyte marker CD3. There is increased
      expression of intracellular adhesion molecule-1 on keratinocytes and endothelial
      cells. Infiltration of neutrophils and macrophages are also seen in the liver,
      lung, and several joints. The disease could not be transferred by bone marrow or
      spleen transplants into irradiated normal syngeneic hosts. Treatment of the mice
      with triamcinolone, a long-acting corticosteroid, resulted in nearly complete
      regression of the lesions over a period of 4 weeks, whereas systemic cyclosporin
      A treatment was ineffective.

PMID- 8362990
TI  - Women and smoking.

PMID- 8362991
TI  - Toward a smoke-free society: opportunities and obstacles.

PMID- 8362992
TI  - Smoking control in the 1990s: a national cancer institute model for change.

PMID- 8362993
TI  - Profits of doom.

PMID- 8362995
TI  - Commitment to the common good.

PMID- 8362994
TI  - The tobacco industry, state politics, and tobacco education in California.
AB  - OBJECTIVES: Proposition 99 added 25 cents to the California state cigarette tax
      and mandated that 20% of the new revenues be spent on tobacco education and
      prevention programs. This paper examines the implementation of these programs and
      the tobacco industry's response to Proposition 99. METHODS: Political expenditure
      data for twelve tobacco firms and associations were gathered from California's
      Fair Political Practices Commission and secretary of state's Political Reform
      Division. Tobacco education expenditure data were collected from Governor's
      Budgets and the Department of Finance. RESULTS: Since Proposition 99 passed,
      tobacco industry political expenditures in California have risen 10-fold, from
      $790,050 in the 1985-1986 election to $7,615,091 in the 1991-1992 election. The
      tobacco industry is contributing more heavily to the California legislature than
      to Congress. A statistical analysis of data on campaign contributions indicates
      that California legislators' policy-making is influenced by campaign
      contributions from the tobacco industry. Since fiscal year 1989-1990, the state
      has ignored the voters' mandate and spent only 14.7% of the new revenues to
      tobacco education. Medical care programs received more money than permitted by
      the voters. CONCLUSIONS: The tobacco industry has become politically active in
      California following the passage of Proposition 99. One result may be that the
      state has underfunded tobacco education by $174.7 million through the 1993-1994
      fiscal year. The estimated redirection of funds to medical care would essentially
      eliminate the tobacco education campaign by the year 2000.

PMID- 8362996
TI  - Integrating smoking control policies into employee benefits: a survey of large
      California corporations.
AB  - OBJECTIVES: Public health policy promotes the use of risk-rating health insurance
      and payment for smoking cessation as economic incentives to encourage smoking
      cessation. This study was undertaken to learn more about the adoption of these
      policies in large corporations. METHODS: A random sample survey of 280 private
      California corporations with more than 500 employees was undertaken to document
      the prevalence of policies integrating smoking control into employee benefit
      designs. RESULTS: Only 8.6% of large corporations had ever considered risk-rating
      health insurance premiums using smoking status and only 2.15% had implemented a
      risk-rating policy. Nearly 20% of the companies offered health insurance plans
      that covered smoking cessation services. Subsidization or payment for smoking
      cessation outside health insurance was provided by over 37% of the companies
      surveyed, and 87% had adopted formal work-site smoking policies. CONCLUSION:
      Benefit policies that provide financial support to smokers to participate in
      smoking cessation services are much more prevalent and are viewed more positively
      by the benefits managers in large corporations than are policies to risk-rate
      health insurance premiums on the basis of smoking.

PMID- 8362998
TI  - The long-term prevention of tobacco use among junior high school students:
      classroom and telephone interventions.
AB  - OBJECTIVES: The purpose of this study was to implement and evaluate the
      effectiveness of a long-term tobacco use prevention program for junior high
      school students that used college undergraduate change agents and telephone
      boosters. METHODS: A psychosocial intervention combining refusal skills training,
      contingency management, and other tobacco use prevention methodologies such as
      telephone and mail boosters was implemented in 11 junior high schools in San
      Diego County, California. Eleven other junior high schools served as controls. Of
      the 2668 participants, 57% were White/non-Hispanic, 24% were Hispanic, and 19%
      were of other racial/ethnic groups. College undergraduates served as change
      agents for both the classroom and booster interventions, the latter of which was
      delivered in the third (ninth-grade) year of the program. RESULTS: At the end of
      the third year, the prevalence of tobacco use within the past month was 14.2%
      among the intervention students and 22.5% among the controls, yielding an odds
      ratio of 0.71 for analysis at the school level. CONCLUSIONS: Both college
      undergraduate change agents and direct one-to-one telephone interventions appear
      to provide cost-effective tobacco-related behavior modification.

PMID- 8362997
TI  - Work-site cardiovascular risk reduction: a randomized trial of health risk
      assessment, education, counseling, and incentives.
AB  - OBJECTIVES: This study reports an efficacy trial of four work-site health
      promotion programs. It was predicted that strategies making use of behavioral
      counseling would produce a greater reduction in cardiovascular disease risk
      factors than screening and educational strategies. METHODS: Twenty-eight work
      sites were randomly allocated to a health risk assessment, risk factor education,
      behavioral counseling, or behavioral counseling plus incentives intervention.
      Participants were assessed before the intervention and at 3, 6, and 12 months.
      RESULTS: Compared with the average of the health risk assessment and risk factor
      education conditions, there were significantly higher validated continuous
      smoking cessation rates and smaller increases in body mass index and estimated
      percentage of body fat in the two behavioral counseling conditions. The
      behavioral counseling condition was associated with a greater reduction in mean
      blood pressure than was the behavioral counseling plus incentives condition. On
      average among all groups, there was a short-term increase in aerobic capacity
      followed by a return to baseline levels. CONCLUSIONS: Work-site interventions
      that use behavioral approaches can produce lasting changes in some cardiovascular
      risk factors and, if implemented routinely, can have a significant public health
      impact.

PMID- 8362999
TI  - Project towards no tobacco use: 1-year behavior outcomes.
AB  - OBJECTIVES: We present 1-year follow-up data from a school-based tobacco use
      prevention project designed to test the effectiveness of three main components of
      social influence programs. The components teach refusal skills, awareness of
      social misperceptions about tobacco use, and misconceptions about physical
      consequences. METHODS: Four different curricula were developed and tested in a
      randomized experiment involving 48 junior high schools. The outcome variables
      examined were changes in initial and weekly cigarette and smokeless tobacco use 1
      year after the intervention. RESULTS: Analyses indicated that each of the
      component programs were effective in decreasing both the initial and the weekly
      use of cigarettes except for the curriculum in which refusal skills were taught.
      Also, each curriculum was effective in decreasing the initial use of smokeless
      tobacco except for the one aimed at correcting social misperceptions. Only the
      combined curriculum showed an effect on the weekly use of smokeless tobacco.
      CONCLUSIONS: The combined intervention was the most effective overall in reducing
      the initial and weekly use of cigarettes and smokeless tobacco. This suggests
      that different reasons for use exist and need to be counteracted simultaneously.
      However, since single programs were also effective in reducing all but weekly
      smokeless tobacco use, any of these components may be worthwhile prevention
      tools.

PMID- 8363000
TI  - Error in smoking measures: effects of intervention on relations of cotinine and
      carbon monoxide to self-reported smoking. The Lung Health Study Research Group.
AB  - OBJECTIVES: Sources of measurement error in assessing smoking status are
      examined. METHODS: The Lung Health Study, a randomized trial in 10 clinical
      centers, includes 3923 participants in a smoking cessation program and 1964 usual
      care participants. Smoking at first annual follow-up was assessed by salivary
      cotinine, expired air carbon monoxide, and self-report. Each of these measures is
      known to contain some error. Sensitivity and specificity were calculated by
      comparing a biochemical measure with self-report to produce an undifferentiated
      estimate of error. Classification error rates due to imprecision of the
      biochemical measures and to the error in self-report were estimated separately.
      RESULTS: For cotinine compared with self-report, the sensitivity was 99.0% and
      the specificity 91.5%. For carbon monoxide compared with self-report, the
      sensitivity was 93.7% and the specificity 87.2%. The classification error
      attributed to self-report, estimated by comparing the results from intervention
      and control groups, was associated with the responses of 3% and 5% of
      participants, indicating a small but significant bias toward a socially desirable
      response. CONCLUSIONS: In absolute terms in these data, both types of error were
      small.

PMID- 8363001
TI  - Age patterns of smoking in US black and white women of childbearing age.
AB  - OBJECTIVES: The purpose of the study was to describe age patterns of smoking
      among Black and White women of reproductive age, with cohort membership
      controlled for. METHOD: Data from the 1987 National Health Interview Survey
      Cancer Supplement, weighted to be nationally representative, were used to
      calculate the fractions of women who were ever smokers, quitters, and current
      smokers by age and race. Summary distributions of age patterns of smoking
      behaviors by race were estimated; proportional hazard models were used to avoid
      confounding of age and cohort. RESULTS: White women begin smoking at younger ages
      than do Blacks but are more likely to quit and to do so at young ages. Rates of
      current smoking converge between Blacks and Whites by age 25, and may cross over
      by 30. Education-standardized results show larger Black-White differentials in
      ever smoking and smaller differences in quitting. CONCLUSIONS: Our findings
      confirm that women's age patterns of smoking vary by race. Age x race
      interactions should be considered in smoking research and anti-tobacco
      interventions. For Black women, delayed initiation and failure to quit call for
      increased emphasis on interventions tailored to adults. These findings have
      possible implications for understanding Black-White differences in low
      birthweight, child health, and women's health.

PMID- 8363002
TI  - Cigarette smoking and bone mineral density in older men and women.
AB  - OBJECTIVES: The association between cigarette smoking and bone mineral density
      was examined prospectively in a population-based study of older Caucasian men and
      women. METHODS: Smoking patterns were determined at a 1972-1974 baseline
      evaluation and, again, 16 years later when 544 men and 822 women had bone mineral
      density measurements taken. RESULTS: Men and women who were cigarette smokers at
      baseline demonstrated significantly reduced bone mineral density of the hip
      compared with nonsmokers. Baseline smoking was not associated with significantly
      lower bone density at non-hip sites. Women demonstrated a significant dose
      response relationship between baseline smoking status at all hip sites measured.
      Both sexes exhibited significant dose-response relationships between hip bone
      mineral density and change in smoking status between baseline and follow-up,
      demonstrating that smoking cessation in later life was beneficial in halting bone
      density loss associated with smoking. CONCLUSIONS: Smoking was positively and
      significantly associated with decreased hip bone mineral density in old age. Bone
      loss associated with smoking would be expected to predict an increased risk of
      hip fracture in those who do not succumb earlier to another complication of
      tobacco use.

PMID- 8363003
TI  - Tobacco use: a modifiable risk factor for dental disease among the elderly.
AB  - OBJECTIVES: Because the public health literature contains few analytic studies of
      modifiable behavioral risk factors for dental disease among older community
      dwelling populations, the New England Elders Dental Study was undertaken as an
      epidemiologic study of the oral health status of a representative sample of older
      adults living within the six New England states. METHODS: Five dentists conducted
      comprehensive in-home oral health examinations on 1156 community-dwelling adults
      aged 70 and older to determine whether lifetime use of tobacco products was a
      significant risk factor for tooth loss, caries, and periodontal disease. RESULTS:
      Among New England elders, tobacco use was more common among men (18.1%) than
      women (7.9%), with a combined rate of 12.3%. Further, 64.7% of men and 36.6% of
      women were previous tobacco users. Years of exposure to tobacco products was a
      statistically significant risk factor for tooth loss, coronal and root caries,
      and periodontal disease, regardless of other social and behavioral factors.
      CONCLUSIONS: Lifelong tobacco use is a modifiable risk factor for poor dental
      health among older adults. Dental practitioners need to intervene with all their
      adult patients to discourage use of tobacco products for oral as well as general
      preventive health care.

PMID- 8363004
TI  - Smoking, alcohol consumption, and susceptibility to the common cold.
AB  - OBJECTIVES: This study was conducted to test the supposition that both smoking
      and consuming alcohol suppress host resistance to viral infections. METHODS: The
      relations between smoking, alcohol consumption, and the incidence of documented
      clinical colds were prospectively studied among 391 subjects intentionally
      exposed to one of five respiratory viruses and 26 subjects given saline. Clinical
      colds were defined as clinical symptoms verified by the isolation of virus or by
      an increase in virus-specific antibody titer. Analyses included control variables
      for demographics; body weight; virus; and environmental, immunological and
      psychological factors. RESULTS: Smokers were at greater risk for developing colds
      than nonsmokers because smokers were more likely both to develop infections and
      to develop illness following infection. Greater numbers of alcoholic drinks (up
      to three or four per day) were associated with decreased risk for developing
      colds because drinking was associated with decreased illness following infection.
      However, the benefits of drinking occurred only among nonsmokers. CONCLUSIONS:
      Susceptibility to colds was increased by smoking. Although alcohol consumption
      did not influence risk of clinical illness for smokers, moderate alcohol
      consumption was associated with decreased risk for nonsmokers.

PMID- 8363005
TI  - Smoking control in restaurants: the effectiveness of self-regulation in
      Australia.
AB  - OBJECTIVES: The provision of smoke-free areas in restaurants has been a
      controversial issue; the restaurant industry largely opts for a self-regulation
      approach. This study aimed to examine the effectiveness of self-regulation as a
      strategy in meeting the industry's and customers' perceived needs. METHODS:
      Restaurateur and customer perspectives on the provision of smoke-free areas in
      restaurants were examined by survey among 365 restaurateurs and 1327 customers in
      New South Wales, Australia. RESULTS: Less than 2% of restaurants were totally
      smoke-free; 22% provided some smoke-free areas. Customers were much more likely
      than owners to think that smoke-free areas should be provided. Owners appeared to
      be unaware of customers' views about smoke-free areas in restaurants.
      CONCLUSIONS: Little evidence was found to support the effectiveness of the self
      regulation policy adopted by the restaurant industry. Characteristics of
      restaurants and owners associated with the provision of smoke-free areas are
      presented and implications of the findings are discussed.

PMID- 8363006
TI  - Health insurance and subjective health status: data from the 1987 National
      Medical Expenditure survey.
AB  - OBJECTIVES: The relationship between health insurance and subjective health
      status was investigated. It was hypothesized that persons without health
      insurance would have lower levels of subjective health status than those with
      health insurance and that this relationship would hold for both poor and nonpoor
      persons. METHODS: Data from the 1987 National Medical Expenditure Survey were
      analyzed to examine the relationship between health insurance and self-reported
      health status. The analysis controlled for sociodemographic and attitudinal
      variables and medical conditions. RESULTS: Persons without health insurance had
      significantly lower levels of subjective health status than did persons with
      insurance. This adverse effect persisted after adjustments were made for the
      effects of age, sex, race, income, attitude toward the value of medical care and
      health insurance, and medical conditions. The detrimental effect of lacking
      health insurance on subjective health status was present for persons at all
      income levels and was greater than the effect on subjective health status found
      for 2 of the 11 reported medical conditions. CONCLUSIONS: Lacking health
      insurance is associated with clinically significant lower levels of subjective
      health status in both poor and non-poor persons.

PMID- 8363007
TI  - The distribution of canine exposure to Borrelia burgdorferi in a Lyme-Disease
      endemic area.
AB  - OBJECTIVES: A serosurvey of canine exposure to Borrelia burgdorferi, the
      causative agent of human Lyme disease, was conducted in Westchester County, New
      York, to determine the distribution of exposure in an area endemic for Lyme
      disease. METHODS: A total of 1446 blood samples was collected from resident dogs
      and tested by modified enzyme-linked immunosorbent assay. Equivocal samples were
      further tested by immunoblot. A mean number of 57.8 samples was collected from
      each of 25 towns and cities. RESULTS: Seroprevalence rates for municipalities
      ranged from 6.5% to 85.2%. County seroprevalence was 49.2%. There was a
      significant difference among the rates for the northern (67.3%), central (45.2%),
      and southern (17.3%) regions. Multiple range analysis indicated homogeneity
      between the southern and central regions and the central and northern regions.
      CONCLUSIONS: Canine exposure to B burgdorferi increases in a south to north
      gradient within the county. Intensity of exposure, measured by enzyme-linked
      immunosorbent assay titers, indicates a similar pattern. The close association
      between dogs and humans suggests that human risk of acquiring Lyme disease within
      Westchester County is equally disparate and is inversely related to the degree of
      urbanization.

PMID- 8363008
TI  - Occupation as a risk identifier for breast cancer.
AB  - OBJECTIVES: Breast cancer mortality may be reduced if the disease is detected
      early through targeted screening programs. Current screening guidelines are based
      solely on a woman's age. Because working populations are accessible for
      intervention, occupational identification may be a way of helping to define and
      locate risk groups and target prevention. METHODS: We used a database consisting
      of 2.9 million occupationally coded death certificates collected from 23 states
      between 1979 and 1987 to calculate age-adjusted, race-specific proportionate
      mortality ratios for breast cancer according to occupation. We performed case
      control analyses on occupational groups and on stratifications within the
      teaching profession. RESULTS: We found a number of significant associations
      between occupation and frequency of breast cancer. For example, white female
      professional, managerial, and clerical workers all had high proportions of breast
      cancer death. High rates of breast cancer in teachers were found in both
      proportionate mortality ratio and case-control analyses. CONCLUSIONS: These
      findings may serve as in an aid in the effective targeting of work-site health
      promotion programs. They suggest that occupationally coded mortality data can be
      a useful adjunct in the difficult task of identifying groups at risk of
      preventable disease.

PMID- 8363010
TI  - Child care arrangements and repeated ear infections in young children.
AB  - OBJECTIVES: The purpose of this study was to assess the association between child
      care arrangements and repeated ear infections in young children. METHODS: Data on
      5818 children younger than 6 years of age were taken from the 1988 National
      Health Interview Survey of Child Health. RESULTS: Seventeen percent of the
      children had had repeated ear infections in the year preceding the interview.
      Multiple logistic regression analysis showed that factors significantly
      associated with repeated ear infections were age (1 to 2 years), race (White),
      sex (male), and medical history (repeated tonsillitis, enlarged adenoids, or
      asthma). When these factors were controlled for, children in a current child care
      arrangement still had a 50% higher chance of repeated ear infections than did
      children not in care. Children in day care centers were at higher risk than
      children cared for in homes. Care in settings with more than six children
      elevated the risk, but hours per week of care did not. CONCLUSIONS: Decreasing
      the risk of repeated ear infections in young children in out-of-home child care
      settings may require smaller group sizes. Given the increasing use of child care,
      research should continue to identify specific aspects of child care that
      contribute to this problem.

PMID- 8363009
TI  - Cervical cancer screening in hospitals: the efficacy of legislation in Maryland.
AB  - OBJECTIVES: The purpose of the study was to examine the efficacy of a Maryland
      law requiring Pap testing to be offered during hospital admissions. "In-reach"
      strategies emphasize cancer screening within existing health care contacts (such
      as inpatient stays) rather than additional visits solely for screening. METHODS:
      Data from a 1986 telephone survey of Maryland women were used to examine the
      effect of hospitalization on self-reported Pap testing in a 3-year period. The
      effect of hospitalization on screening was examined by age and income to assess
      whether inpatient screening was more prevalent among certain subgroups of women.
      RESULTS: For the group as a whole, the odds of Pap screening did not vary with
      hospitalization. However, among women aged 45 to 54 years with annual household
      incomes over $20,000, hospitalized women were more likely than nonhospitalized
      women to report recent Pap tests. For low-income women aged 75 years and older,
      hospitalization actually decreased the likelihood of reporting Pap tests.
      CONCLUSIONS: Despite legislation, inpatient cervical cancer screening appears to
      mirror outpatient patterns, leaving elderly and low-income women unscreened.
      Methods for increasing inpatient Pap testing for underscreened women are
      discussed.

PMID- 8363012
TI  - The influence of smoking cessation on body weight may be temporary.
AB  - The relationships of bodyweight and body mass index with smoking cessation were
      examined among 1633 adults in Humboldt, Saskatchewan, Canada. Mean body mass
      index was highest in ex-smokers and lowest in smokers, and that of non-smokers
      was intermediate. Body mass index decreased significantly with increasing years
      after smoking cessation in female ex-smokers after adjusting for age, education,
      location of work, and physical activity. This trend, however, was not significant
      in men. The body weight data showed similar results. The prevalence of obesity
      (body mass index greater than 30 kg/m2) in all subjects showed a decrease with
      increasing years after smoking cessation.

PMID- 8363011
TI  - Respiratory disease among military personnel in Saudi Arabia during Operation
      Desert Shield.
AB  - OBJECTIVES: The purpose of this study was to determine whether respiratory
      disease due to crowded living conditions and high levels of suspended and blowing
      sand had a major adverse impact on US military personnel during Operation Desert
      Shield. METHODS: A questionnaire survey was administered to 2598 combat troops
      stationed in Northeast Saudi Arabia for a mean of 102 days. Samples of surface
      sand from seven different locations were analyzed by scanning electron microscopy
      and x-ray diffraction. RESULTS: Among surveyed troops, 34.4% reported a sore
      throat, 43.1% complained of a cough, 15.4% complained of chronic rhinorrhea, and
      1.8% were unable to perform their routine duties because of upper respiratory
      symptoms. Evaluation of sleeping accommodations indicated that complaints of a
      sore throat and cough were most closely associated with sleeping in air
      conditioned buildings; in contrast, complaints of rhinorrhea were associated with
      exposure to the outdoor environment while living in tents. Sand samples consisted
      mostly of quartz, with just 0.21% by weight of respirable size (< 10 microns in
      diameter). CONCLUSIONS: These findings indicate that upper respiratory complaints
      were frequent among Operation Desert Shield troops and were related both to the
      troops' housing and to their exposure to the outside environment.

PMID- 8363013
TI  - Factors associated with late smoking initiation in Minnesota women.
AB  - This case-control study investigated factors associated with late initiation
      (i.e., initiation after the age of 17 years) of smoking among young women. The
      most significantly elevated odds ratios for late initiation were having a
      significant other who smoked and having friends who found smoking acceptable at
      initiation. Peers, especially significant others, played an important role in
      smoking initiation among young women. Prevention efforts should focus on
      strategies that reduce the acceptability of smoking in the social environment.

PMID- 8363014
TI  - Cotinine concentrations in semen, urine, and blood of smokers and nonsmokers.
AB  - Cotinine levels in the semen, urine, and blood of 88 male smokers and nonsmokers,
      aged 18 to 35, were analyzed via radioimmunoassay. Detectable cotinine levels
      were found in all three body fluids, and cotinine levels in all three fluids were
      highly correlated. Cotinine levels in semen and blood were of similar magnitude;
      cotinine levels in urine were an order of magnitude or more higher. In all three
      fluids, cotinine levels increased with an increase in cigarette smoke exposure.

PMID- 8363015
TI  - Environmental tobacco smoke concentrations in no-smoking and smoking sections of
      restaurants.
AB  - To characterize the effectiveness of a local ordinance that restricts smoking in
      restaurants to one third of the seating area, this study made simultaneous
      measurements of two markers of environmental tobacco smoke, respirable suspended
      particles and nicotine, in the smoking and no-smoking sections of seven
      restaurants. The mean concentrations of respirable suspended particles and
      nicotine were 40% and 65% lower, respectively, in the no-smoking than in the
      smoking sections, indicating substantial but not complete protection against
      exposure.

PMID- 8363016
TI  - An evaluation of the workplace smoking bylaw in the city of Toronto.
AB  - Random-digit dialing surveys were conducted before (n = 1543) and 8 to 9 months
      after (n = 1430) implementation of the city of Toronto workplace smoking bylaw.
      Compared with workers in the rest of metropolitan Toronto and persons not working
      outside the home, city workers evidenced more positive changes in regard to
      knowledge of the bylaw, its requirements, and enforcement provisions. City
      workers reported more changes in workplace restrictions and satisfaction with
      such restrictions. Patterns of smoking at work changed.

PMID- 8363017
TI  - Smoking, depression, and suicide.

PMID- 8363018
TI  - Sudden infant death syndrome and maternal smoking conclusions questioned.

PMID- 8363019
TI  - Chlorination or ozonation?

PMID- 8363020
TI  - What does America's public health report card reflect?

PMID- 8363021
TI  - Drug users' self-reported false-positive HIV status.

PMID- 8363022
TI  - Bias in weighted vs unweighted estimates.

PMID- 8363023
TI  - The attribution of health problems to aging.

PMID- 8363024
TI  - [Postoperative pain therapy--an urgent interdisciplinary task].

PMID- 8363026
TI  - [Pulmonary CO2 elimination in laparoscopic cholecystectomy. A clinical study].
AB  - METHODS: We measured pulmonary elimination of carbon dioxide (VCO2), end-tidal
      and arterial CO2 tensions (PETCO2, PaCO2), deadspace ventilation (VD/VT), and
      arterial oxygen tension (PaO2) using a Siemens 930 CO2 analyzer incorporated into
      a servoventilator and arterial blood gas analyses, respectively, in 31 patients
      undergoing laparoscopic cholecystectomy with a median duration of
      pneumoperitoneum (PP) of 60 min. RESULTS: During the first 30 min of PP VCO2
      increased significantly by a mean of 30% (Fig. 1). At the same time, with
      constant minute ventilation PETCO2 und PaCO2 increased by about 8 mm Hg each
      (Fig. 3, Table 1). In a subgroup of 10 patients who could be observed for up to
      75 min of PP, we found a stepwise increase in minute ventilation with no further
      increase in PETCO2 and PaCO2 after 30 min PP, but a slowly rising VCO2 (Fig. 2).
      Arterial-to-end-tidal CO2 tension difference (Pa-PETCO2) remained constant at
      about 4 mm Hg with institution and during the course of PP (Fig. 4), as did VD/VT
      at a median value of 0.38-0.40 (Fig. 5). PaO2 (FIO2 = 0.5) did not change
      significantly with PP (Table 1). With desufflation we found a short-term increase
      in VCO2 (Table 2). CONCLUSIONS: During PP, CO2 is reabsorbed from the peritoneal
      cavity. During the initial unstable phase with rising PaCO2, reabsorption of CO2
      is the sum of increased pulmonary elimination of CO2 above baseline and uptake of
      CO2 into gas stores of the body. We estimated CO2 reabsorption to be on the order
      of 70 ml/min during the first 30 min of PP. During the later, stable phase,
      reabsorption of CO2 equals increased pulmonary elimination of CO2 above baseline
      and was estimated to be in the order of 90 ml/min in 10 patients with 30-75 min
      of PP (hatched area in Fig. 2). PET-CO2 corresponded well with PaCO2 in these
      patients. VD/VT and arterial oxygenation did not change significantly with
      institution or during the course of PP. Monitoring VCO2 probably is a useful aid
      in the early detection of CO2 emphysema (Fig. 6).

PMID- 8363025
TI  - [Fiberoptic intubation and stress].
AB  - Nasotracheal intubation of the trachea by means of fiberoptic endoscopy is an
      accepted approach to difficult airways. The associated avoidance of direct
      laryngoscopy may affect the stress response to nasotracheal intubation. We tested
      this hypothesis by means of a prospective, randomized, controlled clinical study.
      METHODS. Informed consent was obtained from 30 patients presenting for
      maxillofacial surgery for participation in this study. Patients were allocated to
      three groups: nasotracheal intubation to be performed either fiberendoscopically
      (group 1) or laryngoscopically, with (group 2) or without (group 3) topical
      anaesthesia of the larynx. Haemodynamic variables (arterial blood pressure and
      heart rate) and concentrations of catecholamines* in plasma (adrenaline,
      noradrenaline; HPLC) were documented at four (two*) time points, respectively:
      prior to induction of anaesthesia*, after induction, 1 min after tracheal
      intubation*, 5 min after tracheal intubation. Differences between time points and
      between groups were analysed with the chi-square test; a probability of P < 0.05
      was considered statistically significant. RESULTS. With respect to age, body
      weight and gender, the groups were comparable. No major hemodynamic or endocrine
      stress responses were observed in any group. Diastolic blood pressures were
      significantly lower in groups one and two, one minute after tracheal intubation.
      DISCUSSION. Nasotracheal intubation does not provoke a major stress response,
      when performed in accordance with the protocol of this study. However, topical
      anaesthesia of the larynx, as well as the fiberendoscopic approach proved
      superior to control with respect to diastolic arterial pressure. We conclude that
      fiberoptic nasotracheal intubation, or laryngoscopy preceded by topical
      anaesthesia of the larynx may be useful in patients for whom an increase in rate
      pressure product would be undesirable.

PMID- 8363027
TI  - [ST segment changes in the ECG. Anesthesia induction with propofol, etomidate or
      midazolam in patients with coronary heart disease].
AB  - Induction of anaesthesia with propofol and fentanyl can lead to marked reductions
      in mean arterial pressure (MAP) and heart rate (HR). Thus, the application of
      propofol in patients with severely reduced coronary artery perfusion is
      controversial. METHODS. The study group consisted of 60 patients undergoing
      coronary artery bypass grafting (CABG). Anaesthesia was induced over 30 s with
      propofol (P 1.5 mg/kg), etomidate (E 0.3 mg/kg), or midazolam (M 0.15 mg/kg)
      following a bolus dose of fentanyl (5 micrograms/kg). Vecuronium was used as a
      muscle relaxant. During induction we continuously measured MAP and HR and
      recorded the occurrence of myocardial ischaemia using an automatic ST-segment
      analyser (Marquette 7010). ST-segment deviations of more than 1 mm in leads II
      and V5 were interpreted as significant signs of myocardial ischaemia. RESULTS.
      All groups showed reductions in MAP and HR on induction that were marked in the P
      group. Intubation caused elevation of MAP and HR to pre-induction levels (HR: all
      groups) or slightly above (MAP: E, M). Four patients in the P group and 3 in each
      other group showed significant ST-segment deviation prior to induction. In the P
      group these deviations disappeared in 2 patients after injection while they
      remained unchanged in the M group. In the E group injection had no effect on the
      ischaemic ECG changes but produced another case of significant ST-segment
      deviation. Laryngoscopy and intubation produced no further significant ST-segment
      deviation in either group. DISCUSSION. Induction is a critical phase of
      anaesthesia, especially in patients with limited coronary reserve. Induction
      agents should alleviate the stress response while causing minimal haemodynamic
      changes. Despite marked reductions in MAP in the P group, the number of patients
      with ischaemic ECG changes was cut by half. Their number was unchanged or even
      raised in the other groups. After application of P, with an alleged reduction of
      coronary perfusion, a compensational reduction in myocardial oxygen consumption
      may occur.

PMID- 8363028
TI  - [Continuous monitoring of spontaneous respiration in the postoperative phase. 4.
      The effect of postoperative pain therapy on cutaneous oxygen and carbon dioxide
      partial pressure following gynecologic surgery with neuroleptanalgesia].
AB  - METHODS: Cutaneous O2 and CO2 pressures were monitored for 16 h in 55 female
      patients recovering from major gynaecological surgery performed under neurolept
      anaesthesia. Postoperative pain was managed either with an antipyretic analgesic
      (i.m. or i.v. metamizol up to 2.5 g/4 h; group NLA) or with i.v. patient
      controlled analgesia using fentanyl (demand dose 34 micrograms, infusion rate 4
      micrograms/h, hourly maximum dose 0.25 mg, lock-out time 1 min; group NLA/PCA).
      In addition, 11 patients received a single i.v. bolus injection of 150 mg
      amiphenazole, a respiratory stimulant, at the beginning of PCA treatment (group
      NLA/PCA/AMI). Data were collected and stored by a personal computer, using the
      TCM3 system with a combination electrode for simultaneous measurement of
      cutaneous oxygen and carbon dioxide partial pressures (TINA, Radiometer) at 30-s
      intervals. The overall observation period was four times 240 min; patients from
      the NLA group who required additional opioids were excluded from the analysis.
      Means and standard deviations were calculated for individual data and data pooled
      for 15- or 60-min intervals. Groups were compared by means of the chi-square
      test, Student's t-test or analysis of variance (level of significance, P < or =
      0.05). RESULTS: The 55 patients were classified as ASA I-II. The study groups
      were comparable with respect to demographic and anaesthesiological data, except
      that those in the NLA group were younger and had received less intraoperative
      fentanyl (Table 1). Mean PCA fentanyl consumption was 0.6-0.7 mg in the 16-h
      observation period (Table 2). In all groups, pctO2 levels were decreased and
      pctCO2 levels elevated in the first observation hours and slowly returned to
      normal within the first observation period (Figs. 1, 2, Tables 3, 4). Episodes of
      hypercapnia (pct-CO2 > 50 or > 55 mm Hg) were frequent in the first 2 h (8-29% of
      individual values for pctCO2 > 50, up to 5% of values recorded for pctCO2 > 55;
      Table 4). There were no statistically significant differences between patients
      treated with metamizol and those treated with fentanyl. Amiphenazole did not
      significantly improve postoperative respiration. PCA patients had occasional
      episodes of hypercapnia (up to 19% of all values for pctCO2 > 50, up to 5% for
      pctCO2 > 55) even in the last observation period (13-16 h after surgery),
      indicating the need for close monitoring of spontaneous ventilation during PCA
      following neurolept anaesthesia. DISCUSSION AND CONCLUSIONS: The present study
      confirmed that spontaneous respiration in the early postoperative period can be
      monitored non-invasively by measuring cutaneous partial pressures of carbon
      dioxide and, less precisely owing to wide individual variations, oxygen. It
      showed that spontaneous respiration is less effective immediately after
      termination of surgery under neurolept anaesthesia and recovers slowly over the
      next 4 h. During the first observation period, ventilation was no worse with i.v.
      PCA using fentanyl than with conventional pain management using the antipyretic
      analgesic metamizol, confirming the hypothesis that opioid-induced respiratory
      depression occurs only at overdosage (which is not a problem with individualized
      dose titration using PCA). Since all patients in the NLA group required
      additional opioids after the first observation period and had to be excluded from
      further analysis, it cannot be decided from the present data whether late
      hypercapnia was due to PCA or to residual effects of surgery and anaesthesia. The
      respiratory stimulant amiphenazole (150 mg i.v.) was not helpful in improving
      ventilation; there was no indication of analgesic effects or interactions of
      amiphenazole.

PMID- 8363030
TI  - [The preclinical efficacy of emergency care. A prospective study].
AB  - Quality assurance has become an important issue in emergency medicine. At
      present, no prospective studies are available that quantify the efficacy of
      interventions performed by emergency doctors. The development and implementation
      of a rapid, yet simple scoring system, allowing preclinical assessment of all
      emergency medicine patients, is required. Once the scoring system is implemented,
      evaluation of the prehospital intervention, based upon objective parameters, is
      possible. METHODS. The Mainz Emergency Evaluation Score (MEES) is based on seven
      parameters: level of consciousness, heart rate, heart rhythm, arterial blood
      pressure, respiratory rate, partial arterial oxygen saturation and pain. A coded
      value is assigned to each parameter, with the normal physiological condition
      securing a score of 4, while a life-threatening condition receives a value of 1.
      For the parameter of pain there is no life-threatening condition, so the lowest
      value allowed is 2 (Table 2). Addition of the respective values from the seven
      parameters yields the MEES value, which objectively reflects the patients'
      condition (minimum = 8, maximum = 28). Comparing the MEES value before (MEES1)
      and after the intervention (MEES2) allows an objective evaluation of the efficacy
      of the preclinical care (delta-MEES = MEES2-MEES1). A difference of > or = +2 is
      considered an improvement, +1, +/- 0, -1 are rated as unchanged and < or = -2 is
      considered a deterioration in the patients condition. For more detailed
      evaluation the patients were allocated to 16 diagnosis groups (Table 3).
      Statistical evaluation utilized analysis of variance, the rank sum test
      (Wilcoxon) and the correlation coefficient (Kendall-Tau). RESULTS. In 356
      patients the condition of 187 (52%) patients improved during the preclinical
      treatment; the condition of 156 (44%) patients did not change. In 13 patients
      (3%) the condition became worse (Table 5, Fig. 2). Allocation to 16 diagnosis
      groups revealed that the improvement in the patient's condition depended on the
      underlying disease (Table 3); the disease-specific parameter improved in all
      cases (Table 7). CONCLUSIONS. With the MEES score one can assess the patient's
      prehospital condition and monitor any improvement or deterioration during
      subsequent intervention and transport. The MEES was found to be easy to use,
      reliable and not an additional burden to emergency doctors. The MEES provides a
      means of assessing the efficacy of preclinical treatment. This score does not
      allow outcome prediction; this requires the inclusion of hospital data.
      Assessment of the efficacy of prehospital intervention is an important first step
      in the inclusion of quality assurance in emergency medical systems.

PMID- 8363029
TI  - [The incidence of postoperative pain on general surgical wards. Results of
      different evaluation procedures].
AB  - Knowledge of the incidence and significance of postoperative pain is essential
      for the establishment of effective pain treatment programmes. Detailed
      investigations on the incidence, severity and quality of postoperative pain from
      the surgeon's perspective are scarce in German hospitals. It was the aim of our
      study to investigate postoperative pain in general surgery under routine
      conditions. PATIENTS AND METHODS. A total of 168 patients scheduled for
      abdominal, vascular and orthopaedic surgery were investigated in a prospective
      trial. Pain was assessed by means of a 100-point visual analogue scale (VAS), a 5
      point verbal rating scale (VRS), the original version of the McGill Pain
      Questionnaire (MPQ) and the short form of the McGill Pain Questionnaire (SFMPQ).
      These were applied preoperatively and daily thereafter up to the 7th
      postoperative day. Patients were randomly assigned into two groups with different
      sequences of application of the instruments. The pain treatment programme
      included intravenous analgesia with tramadol/metamizol (max. tramadol 400
      mg+metamizol 5 g in any 24 h) after major surgery and additional administration
      of piritramide as needed (max. 60 mg/24 h.i.v.). After minor surgery ibuprofen
      was routinely given for analgesia (3 x 500 mg). RESULTS. All patients had pain on
      the days 1 and 2 postoperatively. The mean intensity of pain was 44 VAS points on
      day 1 and 6.8 points on day 7. The mean intensity of pain measured by the VRS on
      the 1st postoperative day was between "mild" and "moderate". The quality of pain
      showed a constant pattern concerning the mean scale values of descriptors of each
      subgroup (sensory, evaluative, affective, mixed) for both the original and the
      short form of the McGill Pain Questionnaire up to the 7th postoperative day.
      Sensory descriptors were reported more frequently than affective descriptors.
      Typical pain patterns were identified for different operations. After subtotal
      thyroidectomy, for example, patients perceived a high intensity of pain of short
      duration. In contrast, patients still have a high intensity of pain up to 7 days
      after abdominal and rectal operations. CONCLUSIONS. We conclude from our results
      that patients perceive significant postoperative pain under current standardized
      pain treatment in our department. Effective programmes for pain relief should
      take account of the different patterns of pain after different operations, as
      identified in this study.

PMID- 8363031
TI  - [Anesthesia simulators and training devices].
AB  - Simulators and training devices are used extensively by educators in 'high-tech'
      occupations, especially those requiring an understanding of complex systems and
      co-ordinated psychomotor skills. Because of advances in computer technology,
      anaesthetised patients can now be realistically simulated. This paper describes
      several training devices and a simulator currently being employed in the training
      of anaesthesia personnel at the University of Florida. This Gainesville
      Anesthesia Simulator (GAS) comprises a patient mannequin, anaesthesia gas
      machine, and a full set of normally operating monitoring instruments. The patient
      can spontaneously breathe, has audible heart and breath sounds, and palpable
      pulses. The mannequin contains a sophisticated lung model that consumes and
      eliminates gas according to physiological principles. Interconnected computers
      controlling the physical signs of the mannequin enable the presentation of a
      multitude of clinical signs. In addition, the anaesthesia machine, which is
      functionally intact, has hidden fault activators to challenge the user to correct
      equipment malfunctions. Concealed sensors monitor the users' actions and
      responses. A robust data acquisition and control system and a user-friendly
      scripting language for programming simulation scenarios are key features of GAS
      and make this system applicable for the training of both the beginning resident
      and the experienced practitioner. GAS enhances clinical education in anaesthesia
      by providing a non-threatening environment that fosters learning by doing.
      Exercises with the simulator are supported by sessions on a number of training
      devices. These present theoretical and practical interactive courses on the
      anaesthesia machine and on monitors. An extensive system, for example, introduces
      the student to the physics and clinical application of transoesophageal
      echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363032
TI  - [Acute obstruction of an anesthetic gas evacuation system. Ventilation with a
      Servo Ventilator 900D].
AB  - During aorto-coronary bypass surgery acute expiratory airway obstruction occurred
      in two patients during controlled ventilation with a Servo D ventilator (Siemens
      Elema) in combination with a Servo EVAC 180 gas evacuation system. In this system
      expiratory volume passes from the ventilator to the reservoir bag. Distension of
      the bag will open the valve to the receiving unit by vertical dislocation of the
      valve spring. The mechanism relies on free mobility of the valve spring within
      the reservoir bag. We observed an increase in mean expiratory and inspiratory
      airway pressure above 40 mmHg due to blockage of the expiratory gas outlet by
      external lateral dislocation of the valve spring. In conclusion, while free
      mobility of the valve spring within the hanging Evac bag has to be ascertained at
      all times for safe application of the EVAC 180 system, the manufacturer should
      provide some appropriate mechanical shelter around the bag.

PMID- 8363033
TI  - [Pseudo-faulty location of a Swan-Ganz catheter in a persistent left superior
      vena cava].
AB  - The insertion of a Swan-Ganz catheter may cause various complications including
      intravascular malpositioning due to congenital anomalies of the large veins. A
      persistent left superior vena cava is the most frequent anomaly of the large
      vessels. It is usually diagnosed either as an incidental finding at autopsy or
      during X-ray imaging for confirming proper position of central venous and
      pulmonary catheters. The incidence of this condition based on autopsy series is
      approximately 0.3%. CASE REPORT. A 52-year-old patient was admitted to the
      surgical ICU with the diagnosis of acute pancreatitis. Because of haemodynamic
      instability, a pulmonary artery flotation catheter was inserted via the left
      subclavian vein without difficult. The chest radiograph showed the catheter along
      the left border of the heart going into the right pulmonary artery. An
      angiographic examination with bolus contrast injection confirmed a persistent
      left superior vena cava. CONCLUSION. This type of malposition calls for further
      detailed diagnosis of the vascular status, as the knowledge of accompanying
      congenital cardiovascular defects is essential for further invasive diagnostic
      and surgical procedures. The intensivist should be aware of its occurrence in
      order to not mistake catheters as being present in the arterial circulation or
      malpositioned outside the venous circulation.

PMID- 8363034
TI  - [Securing the airway in children with the Morquio-Brailsford syndrome].
AB  - Mucopolysaccharidosis IVA (Morquio-Brailsford syndrome) results from an inborn
      deficiency of n-acetyl-galactosamine-6-sulphate sulphatase. Clinical features
      include skeletal deformities with hypoplasia or absence of the odontoid process
      of the axis. The resulting atlanto-axial subluxation compresses the spinal cord,
      resulting in cervical myelopathy. Without treatment, quadriplegia ensues sooner
      or later; consequently, surgical decompression and dorsal fusion of the cervical
      vertebrae is recommended, either prophylactically or therapeutically.
      Anaesthesiological management must focus on protection of the airway without
      compromising integrity of the cervical spinal cord; quadriplegia subsequent to
      positioning of the head under anaesthesia has been reported. We have performed
      fiberendoscopic nasotracheal intubation in a 23-month-old child presenting for
      neurosurgical treatment of cervical myelopathy resulting from Morquio-Brailsford
      syndrome. CASE REPORT. A 23-month-old girl (84 cm, 11 kg) with Morquio-Brailsford
      syndrome presented for surgical decompression and dorsal fusion of the cervical
      spine. Pre-anaesthetic examination revealed enamel defects, chronic bronchitis,
      and splenomegaly; the neck was immobilised with a collar. Radiological
      examinations (X-ray and NMR) revealed narrowing of the atlanto-occipital and
      atlanto-axial spaces (Fig. 1) and compression of the cervical spinal cord (Figs.
      2 and 3). Pre-anaesthetic medication consisted of midazolam juice (4 mg). After
      establishing intravenous access, atropine (0.5 mg), midazolam (1 mg), and
      ketamine (10 mg) were administered. A 22 Fr nasopharyngeal airway (Wendl) was
      lubricated with local anaesthetic gel and introduced into the right nostril;
      oxygen was administered through a probe to the left nostril. The Wendl-airway was
      then removed, another 5 mg ketamine was administered, and a 3.5-mm flexible
      fiberendoscope--over which a 20 Fr armored tube was slipped--was introduced
      through the right nostril. With the child spontaneously breathing, the glottis
      was visualised and the fiberscope introduced into the trachea (Fig. 4); 1 mg
      midazolam and 35 mg ketamine was administered and the endotracheal tube was
      advanced through the nose into the trachea, utilizing the fiberscope as a guide.
      The distance between endotracheal tube and carina was assessed endoscopically,
      the fiberscope withdrawn, and the tube connected to the breathing system. Pulse
      oxymetric readings were 98% during induction of anaesthesia including
      endotracheal intubation. Anaesthesia was continued with enflurane, alfentanil,
      midazolam, and atracurium; 315 min after induction the trachea was extubated and
      the child discharged to the paediatric intensive care unit. The postsurgical
      course was uneventful, and the child resumed co-ordinated gait. DISCUSSION.
      Airway management in patients with mucopolysaccharidoses may be extremely
      difficult. Recommended methods such as blind nasal intubation are not feasible in
      small children. Anaesthetic management in children younger than 2 years with
      Morquio-Brailsford syndrome presenting for cervical spine surgery has not yet
      been described. Fiberoptically guided nasotracheal intubation is a means of
      airway management that does not require repositioning of the head and may be
      performed with the stabilising collar left in place (Fig. 4); preservation of
      cervical spinal cord integrity may hence be assumed. Analgosedation with ketamine
      and midazolam allows sufficient spontaneous breathing and--to some extent-
      maintenance of protective laryngeal reflexes. In conclusion, anaesthetic
      management of patients with Morquio-Brailsford syndrome is a challenge that is
      further increased by extending indications for surgical intervention to include
      infants. With respect to protecting the airway, fiberoptic nasotracheal
      intubation of the spontaneously breathing child is our method of choice.

PMID- 8363035
TI  - [Experience with the anesthesia pass].

PMID- 8363036
TI  - [Regional anesthesia techniques and hemostasis disorders].
AB  - Hereditary or acquired disorders of coagulation often lead to the question of
      whether it is permissible to perform regional anaesthetic techniques. Disorders
      of coagulation that cannot be treated are generally contraindications to regional
      anaesthesia. The history and clinical findings represent the most important
      measures before employing a regional anaesthetic technique. The use of
      anticoagulant agents as well as non-steroidal antirheumatics and acetylsalicylic
      acid should be determined. In addition to coagulation studies, the use of
      regional anaesthetic techniques during simultaneous anticoagulant treatment
      requires a clear arrangement with the operative department in question. In most
      instances there will be a tendency to perform general anaesthesia, however,
      considering the fact that general anaesthesia is also associated with
      complications (intratracheal bleeding), regional anaesthesia represents an
      alternative method, especially in patients with significant concomitant
      disorders. In this situation the possibility of peripheral nerve blockade should
      be taken into consideration.

PMID- 8363037
TI  - Immunohistochemical visualization of the enteric nervous system using antibodies
      against protein gene product (PGP) 9.5.
AB  - Both the investigation of the enteric nervous system and the diagnosis of its
      pathological changes require reliable staining methods. In order to assess the
      potential of protein gene product (PGP) 9.5 as a marker for the enteric nervous
      system, we examined its immunoreaction in whole-mount preparations of the guinea
      pig and porcine small intestine, using a rabbit polyclonal antiserum. The
      immunohistochemical technique reveals the fundamental architectural features of
      the ganglionic and aganglionic plexuses. Furthermore, it enables a reproducible
      and differentiated visualization of the enteric nerve cells to be made, so that
      the various nerve cell types can be morphologically identified.

PMID- 8363038
TI  - Lectin histochemical study of early postnatal vascularization of the developing
      pars distalis adenohypophysis of the gray short-tailed opossum (Monodelphis
      domestica, Marsupialia).
AB  - Individuals from 18 litters between 0.5 day and 13 days post partum, and two
      adult specimens of Monodelphis domestica (Marsupialia), were studied by TEM and
      lectin histochemistry. Positive reactions for PO-lectins in the developing
      pituitary were found in the vascular and/or perivascular elements; secretory
      cells did not react. Positive vascular reactions varied with both the type of
      lectin and the age of the developing animal. In the adults, the reactions were
      reversed: there were no vascular, but a variety of positive cellular reactions.
      It is concluded that the adenohypophyseal blood vascular system is very far from
      being complete and mature in the newborn M. domestica. According to specific data
      taken from the literature, the lectin histochemistry indicates a sequential
      appearance of several components of the extracellular matrix, suggesting also
      that the actively organ-invading capillaries may be a good model for the study of
      basement membrane development.

PMID- 8363039
TI  - Ultrastructural and morphometric studies on the peripheral course of the vagus in
      the domestic fowl, with particular reference to the cholinergic innervation of
      the pancreas.
AB  - Cytochemical and morphometric studies were carried out to ascertain the
      peripheral course of the vagus nerve to the chicken pancreas. Nerve bundles
      accompanying the left gastric artery were named tentatively the left gastric
      artery nerve which contained unmyelinated and myelinated nerve fibers showing the
      acetylcholinesterase positive reaction. After vagotomy various degenerating
      features were observed in both the unmyelinated and myelinated nerve fibers of
      the left gastric artery nerve. The ratio of unmyelinated nerve fibers to
      myelinated nerve fibers decreased significantly following vagotomy, whereas there
      was no significant difference in the total number of myelinated nerve fibers
      between the control and vagotomized chickens. Thus, it is hypothesized that the
      total number of unmyelinated nerve fibers decreases significantly following
      vagotomy. Our studies yielded the evidence that the left gastric artery nerve
      contains the unmyelinated nerve fibers derived from the vagus nerve. Moreover,
      the coeliac plexus showed no significant change in the ratio of unmyelinated to
      myelinated nerve fibers nor signs of degeneration following vagotomy, although
      both were observed in the nerve bundles accompanying the pancreatico-duodenal
      artery. It is, therefore, concluded that a peripheral branch of the vagus nerve
      runs together with the left gastric and the pancreatico-duodenal arteries, and
      must innervate the pancreas as the preganglionic nerve fiber.

PMID- 8363040
TI  - [C-cells in the thyroid gland and in the remainder of the ultimobranchial body of
      bison].
AB  - C cells of the thyroid gland of 85 European bison, 43 males and 42 females, of
      age ranging from 1 month to 25 years were examined. For the identification of the
      C cells by Grimelius silver impregnation, toluidine blue, pseudoisocyanin and
      azur A stainings were employed. In the thyroid of the bison the C cells in the
      central region were distributed denser than in the peripheral region. They may
      particularly appear in great numbers in the interior of ultimobranchial (UB)
      remnants; in these cases, however, a great variety of changes has been observed.
      In part of the adults animals individual differences of the hyperplasia C cells
      in the preserved UB structures were observed: C cells have not been detected in
      the internal parathyroid glands. In the discussion, the meaning of paracrine has
      been described in autoregulatory mechanisms controlling the thyroid activity.

PMID- 8363041
TI  - [The vascular system of the intestines of Gallus domesticus].
AB  - The vascular system of the chicken intestine was investigated by corrosion cast,
      light and electron microscopic methods. In the intestinal villi the
      "Fontainentyp" is present with a single arteriole rising to the apex and draining
      into subepithelial capillaries. Occasionally ramifications of the arteriole occur
      in the upper third of the villi. Another variation is splitting of the arteriole
      into a capillary net at the base of the villi in the caeca between the regions
      with and without villi. At the tip, at the margins and at the base of the villi
      the capillaries fuse into venules, which proceed to the inside and empty into
      veins. At the base above the propria they form a superficial net with connecting
      veins arising to an inferior venous plexus below the region of crypts. The
      submucosal collecting veins descend from short vascular truncs, which originate
      from the inferior plexus and cross the muscularis mucosae. Elements of a
      vasoregulatory system like arterio-venous marginal loops, submucosal arterio
      venous anastomoses, sphincter-arteries, precapillary sphincters and sphincter
      veins well known in the literature are not found in the intestine of the domestic
      chicken. Therefore arterioles, capillaries and muscle bundles concentric around
      the veins in the villi seem to take over this function.

PMID- 8363042
TI  - Fibrous trabeculae in the liver of alligator (alligator mississippiensis).
AB  - In the mature alligator, fibrous trabeculae run from the portal areas and capsule
      through the hepatic parenchyma. The extent of these trabeculae becomes clear only
      after staining for collagen with, for example, Fast green or Picrosirius red. The
      trabeculae are less well developed in young caiman. The alligator's liver might
      use the trabeculae to withstand thrashing of the body.

PMID- 8363043
TI  - Craniofacial angle in dolicho-, meso- and brachycephalic dogs: radiological
      determination and application.
AB  - Observations on craniofacial axes and angles were made on fifty dogs belonging to
      five breeds, by means of radiological techniques (lateral radiographs) and
      biostatistical methods. The craniofacial angles were found to be 25-26 degrees
      (greyhound), 19-20 degrees (pointer), 20-21 degrees (German shepherd), 13-14
      degrees (boxer) and 9-10 degrees (Pekinese). Shortening of the head in
      brachycephalic dogs implies a more perpendicular development of the cranium
      relative to the facial axis. The possible application of these data in the
      determination of morphological types in many fields is discussed.

PMID- 8363044
TI  - [Ontogeny of the human temporomandibular joint].
AB  - An analysis of the human temporomandibular joint is done regarding to the
      appearance of secondary cartilage formations during the prenatal development of
      condylus and temporal joint elements. Sagittal sections of nine human fetuses (49
      mm CRL to 315 mm CRL) show a closed relationship between the development of the
      bony and soft tissues of the joint. The temporary appearance of secondary
      cartilage in the temporal joint area is induced by the functional loading of the
      capitulum. This process requires the genesis of the two free articular cavities
      on the one side and the functional attachment of the lateral pterygoid muscle to
      the discus and the collum mandibulae on the other. Pointing out the clear
      relationship of the articulating joint surfaces and the in between discuss, a
      left temporomandibular joint of a fetus (125 mm CRL) is reconstructed in a
      medioventral view with the help of a three dimensional drawing. The location of
      the temporal secondary cartilage formation within the centre of the temporal
      loading area of the condyle assures its functional genesis during the
      embryological development of the human temporomandibular joint.

PMID- 8363045
TI  - Morphological classification of the masticatory muscles in dogs based on their
      innervation.
AB  - The masticatory muscles and their innervations in dogs are classified, from deep
      to superficial layers, as follows: 1) medial pterygoid muscle and medial
      pterygoid nerve, 2) lateral pterygoid muscle and lateral pterygoid nerve, 3)
      anterior deep part of temporal muscle and anterior deep temporal nerve, 4)
      posterior deep part of temporal muscle and posterior deep temporal nerve, 5)
      superficial part of temporal muscle and superficial temporal nerve, the only
      branch of the temporal nerve which passes out from the infratemporal fossa, 6)
      zygomaticomandibular part of masseter muscle, which is thought to belong to the
      masseter muscle, and masseter nerve, 7) deep layer of masseter muscle and
      masseter nerve, 8) superficial layer of masseter muscle and masseter nerve.

PMID- 8363046
TI  - Clinical anatomy of the subcutaneous veins in the dorsum of the hand.
AB  - Ninety adult upper extremities from human cadavers were used to study the
      patterns of the subcutaneous veins in the dorsum of the hand, with careful
      dissection and measurement under magnification. In our series, the distribution
      of the veins was not symmetrical in the dorsum of the hand. In 83.3% of the
      cases, the veins were arranged in two groups, radial and ulnar, above the
      transverse midline of the dorsum. The area between these two groups,
      corresponding to the proximal halves of the second metacarpal bone, the second
      intermetacarpal space and the third metacarpal bone, might be called "vein
      lacking area". Crossing branches of veins were found in all cases. There were on
      average three crossing branches in each case, and their internal diameters were
      0.9 +/- 0.2 mm. This study established that the subcutaneous veins in the dorsum
      of the hand are arranged in two layers. They communicate freely with the veins in
      the palmar aspect through the intermetacarpal spaces. The average number of
      perforating branches was 3.9, and their internal diameters were 1.0 +/- 0.4 mm.
      The perforating branch in the first intermetacarpal space was wide (internal
      diameter: 1.8 +/- 0.3 mm) and very constant (appearance rate: 100%). This branch
      may be the most important communication between the superficial and deep veins.
      We found the venous values in 70.0% of the perforating branches, which prevent
      the blood flowing from the dorsum to the palm.

PMID- 8363047
TI  - One hundred years of anthropological studies in Bulgaria.
AB  - The anthropological studies are divided into three distinct periods: initial-
      covering the last decades of the 19th century, classical--mirroring the results
      of studies carried out in the first half of the 20th century, and contemporary-
      marked by the organization of the Section of Anthropology and Human Anatomy in
      the Institute of Morphology at the Bulgarian Academy of Sciences (actually the
      Institute of Cell Biology and Morphology) in 1953, and by the research done
      during the second half of the current century. The roles and contributions of Dr.
      Jonas Basanovichjus, Prof. Stefan Vatev, D. Sc., Dr. Krum Dronchilov, Prof. Milko
      Balan, D. Sc., Prof. Dimitar Kadanov, D. Sc. and others to the development of
      Bulgarian anthropology is underscored.

PMID- 8363048
TI  - Long-term osteopenic changes in cancellous bone structure in ovariectomized rats.
AB  - Cancellous bone mass decreases following ovariectomy in rodents, providing a
      useful model for post-menopausal bone loss in humans. This study describes and
      quantifies the longer-term changes in cancellous bone structure in the
      ovariectomized (OVX) rat. Rats were OVX or sham-OVX at 100 days of age and bones
      were collected 540 days later. Lumbar vertebral bodies were prepared for
      microradiography and structural analyses (nodal analyses and star volume
      analyses) of cancellous bone. Proximal humerii were prepared for scanning
      electron microscopy (SEM). Microradiography confirmed the loss of cancellous bone
      from the central spongiosa regions of the vertebral bodies and the humerii in the
      OVX rats. Changes in trabecular structural elements included relative increases
      in the number of free to free, cortical to free, cortical to node struts and
      decreases in the node to node struts in the OVX animals compared with controls.
      There were increases in average lengths of the node to free, node to node, and
      free to free trabecular struts in the OVX animals. The marrow star volume was
      increased in the OVX animals indicating a greater trabecular separation in these
      animals compared with controls. Viewed by SEM, metaphyseal trabeculae in the
      controls consisted of rods and plates but in the OVX animals the remaining
      trabeculae were mostly longitudinal rods with smaller transverse connecting rods.
      The remaining bone in the OVX animals was found in the lateral metaphyseal areas
      and is consistent with maintenance of the structural capacity of the
      bone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363049
TI  - Ultrastructural localization of a nuclear autoantigenic sperm protein in
      spermatogenic cells and spermatozoa.
AB  - This study demonstrates the ultrastructural localization of rabbit nuclear
      autoantigenic sperm protein (NASP) in spermatogenic cells and spermatozoa. NASP
      is present in rabbits, rats, mice, and human testes and spermatozoa. It has
      recently been sequenced in rabbits and humans and characterized as an acidic,
      histone binding protein. Currently it has been proposed that NASP may play a role
      in regulating early events of spermatogenesis through its ability to bind and
      translocate testicular histone variants to nucleosomes. The ultrastructural
      localization of NASP confirms that it is initially present in primary
      spermatocytes in their Golgi regions and nucleus. In round spermatids it is
      present in the nucleus as well as in the acrosome and subacrosomal space. In
      later spermatids, testicular spermatozoa, and ejaculated spermatozoa, NASP is
      concentrated over the nucleus, although some is still present in the acrosome. It
      is likely that NASP would be carried into the ovum with the sperm nucleus at
      fertilization.

PMID- 8363050
TI  - Ultrastructure and morphometry of the urethral glands in normal, castrated, and
      testosterone-treated castrated male mice.
AB  - Recent studies of the urethral glands in the male mouse and rat have suggested
      that they are testosterone-dependent glands that may be potential sites for
      secretory immunity in the male genital tract. In the present study we describe
      the ultrastructural features of these glands in normal mice and provide
      quantitative data on the sizes of the acinar cells and their organelles in sham-,
      oil-, and testosterone-treated castrated mice. Acinar cells in urethral glands
      from normal mice contain numerous secretory granules, prominent Golgi complexes,
      elongated mitochondria, and an abundance of rough endoplasmic reticulum (RER)
      with large and dilated cisternae, all of which are features characteristic of
      secretory cells. In some acinar cells the cisternae of the RER were filled with
      closely packed, unbranched, straight, tubular structures that were oriented
      parallel to one another, that radiated from aggregates of dense material, or that
      were randomly arranged. In other acinar cells the cisternae of the RER showed a
      network of branching and anastomosing vesicular-like structures whose limiting
      membranes were occasionally seen in continuity with the membranes of the RER.
      Secretory acini showed large, unbranched tubules in the acinar lumen. When cut at
      right angles the large tubules exhibited a distinct fuzzy outer coat with fine
      projections radiating outwards. The ultrastructure of the acinar cells and the
      presence of tubules in the lumen suggests that they are engaged in secretion of a
      tubular protein. Morphometric analysis of acinar cells in the urethral glands
      showed that the mean volumes of nuclei, cytoplasm, secretory granules, vacuoles,
      and mitochondria were significantly reduced in castrated mice in comparison to
      either normal or testosterone-treated castrated mice. This confirms earlier
      observations that the urethral glands are targets of testosterone.

PMID- 8363051
TI  - Seasonal changes of the blood-testis barrier in viscacha (Lagostomus maximus
      maximus): a freeze-fracture and lanthanum tracer study.
AB  - Adult male viscachas (Lagostomus maximus maximus) were gathered from their
      natural habitat during the period of complete spermatogenesis (June) and during
      the month of maximum testicular regression (August). The testes were processed by
      conventional electron microscopic technique using lanthanum nitrate (electron
      dense intercellular tracer) to define the intercellular spaces below the inter
      Sertoli tight junctions and by freeze-fracture techniques. During complete
      spermatogenesis the tracer surrounds spermatogonia, preleptotene, and leptotene
      spermatocytes and stops at the level of the inter-Sertoli tight junctions below
      all germ cells displaying synaptonemal complexes (zygotene-pachytene
      spermatocytes) and germ cells in more advanced stages of differentiation.
      Conversely, during testicular regression the tracer percolates all intercellular
      spaces between Sertoli cells and the remaining germ cells (spermatogonia and few
      preleptotene and leptotene spermatocytes). During complete spermatogenesis,
      freeze-fracture replicas exhibit numerous inter-Sertoli tight junction strands
      parallel to each other and to the basal lamina. During spermatogenesis decay, the
      inter-Sertoli tight junctions are found to be short, tortuous, frequently
      interrupted, and often associated with extented membranous areas of gap
      junctions.

PMID- 8363052
TI  - Apical excrescences in the gallbladder epithelium of the female Syrian hamster in
      response to medroxyprogesterone.
AB  - All the intact female Syrian hamsters treated with medroxyprogesterone (MP) for a
      one-month period, without dietary manipulation, display gallbladder surface
      epithelial changes, and intraluminal deposits. These changes include excrescences
      in various stages, bulging, and extrusion of material from the epithelial cells.
      The most striking scanning electron microscopic observations are the dramatic
      events, comparable to apocrine-like secretory events observed in another related
      study using oophorectomized hamsters. Since the hamster gallbladder does not
      possess mucous goblet cells, it appears that this phenomenon could be a response
      to the MP treatment, thus providing a larger amount of mucous product than usual
      with cellular material, in addition to the possible alteration in the quality of
      the bile following this treatment. As a result of MP treatment, intraluminal
      deposits were also confirmed by using light and transmission electron microscopy.
      In control hamsters these events were not observed, however, small blebs
      outlining surface epithelial cells are seen. The results in this report
      complement the previous studies using the male and oophorectomized Syrian hamster
      model subjected to similar experimental conditions.

PMID- 8363053
TI  - Localization of glycogen synthase activity in liver of fasted normal and
      adrenalectomized rats after injection of dexamethasone.
AB  - Hepatic glycogen synthase activity was localized in normal and adrenalectomized
      (ADX) rats after fasting overnight and in fasted ADX rats after injection of
      dexamethasone (DEX) 2-8 h prior to sacrifice to stimulate glycogen synthesis.
      Cryostat sections were incubated in medium containing substrate to demonstrate
      glycogen synthase activity as indicated by glycogen synthesized during
      incubation. Sections from fasted normal rats showed limited dispersed glycogen
      synthase activity in both periportal and centrilobular regions. In contrast,
      activity for glycogen synthase in hepatocytes from fasted ADX rats appeared as
      large aggregates in random hepatocytes throughout the lobule. Two hours after
      injection of DEX the reaction product appeared as aggregates in some hepatocytes,
      but other cells revealed dispersed enzyme activity. Glycogen synthase activity
      was evident in more hepatocytes after 4 h treatment with DEX and after 8 h
      virtually all hepatocytes contained abundant reaction product. The results
      suggest that synthase activity becomes concentrated in limited regions of
      selected hepatocytes in fasted ADX rats. DEX stimulation of glycogen synthesis
      for 4-8 h results in increased enzyme activity.

PMID- 8363054
TI  - Cardiac conduction system in the chicken: gross anatomy plus light and electron
      microscopy.
AB  - Twenty-three chicken hearts were used to study the cardiac conduction system by
      light and electron microscopy. In addition to a sinus node, atrioventricular node
      (AVN), His bundle, left and right bundle branches (LBB, RBB), the chicken also
      has an AV Purkinje ring and a special middle bundle branch (MBB). The sinus node
      lies near the base of the lower portion of the right sinoatrial valve. The AV
      node is just above the tricuspid valve and anterior to the coronary sinus. The
      His bundle descends from the anterior and inferior margin of the AV node into the
      interventricular septum, then dividing into right, left and middle branches some
      distance below the septal crest. The middle bundle branch turns posteriorly
      toward the root of the aorta. The AV Purkinje ring originates from the proximal
      AV node and then encircles the right AV orifice, joining the MBB to form a figure
      of-eight loop. The chicken conduction system contains four types of myocytes: 1)
      The P cell is small and rounded, with a relatively large nucleus and sparse
      myofibrils. 2) The transitional cell is slender and full of myofibrils. 3) The
      Purkinje-like cell resembles the typical Purkinje cell, but is smaller and
      darker. 4) The Purkinje cell is found in the His bundle, its branches, and the
      periarterial and subendocardial Purkinje network.

PMID- 8363055
TI  - Expression and accumulation of interstitial collagen in the neonatal rat heart.
AB  - Significant physiological changes occur in the heart following birth including
      increased arterial blood pressure and heart rate. Concurrently, biochemical and
      structural alterations are evident in the neonatal heart in response to these
      dynamic physiological properties. Prominent among these is the elaborate
      development of the cardiac extracellular matrix, composed primarily of
      interstitial collagen. The collagenous fibers, together with other matrix
      components, form an elastic, stress-tolerant network which functions in the
      dissipation of force throughout the heart wall. The present studies have used
      biochemical and molecular techniques to show the temporal and spatial patterns of
      interstitial collagen accumulation and expression during late fetal and neonatal
      development of the rat heart. The use of biochemical and particularly molecular
      methodologies allows the analysis of the expression of matrix components at a
      resolution previously not attained by structural studies alone. These data show
      relative increases in interstitial collagen immediately following birth as well
      as spatial differences in collagen mRNAs within the heart. The data presented
      provide further evidence for a role of mechanical stimulation in the regulation
      of collagen gene expression during this period of heart development.

PMID- 8363056
TI  - Vascularization of the pineal complex in the lizard Tiliqua rugosa.
AB  - The vascularization of the pineal complex in the lizard Tiliqua rugosa was
      investigated by vascular corrosion and latex casting techniques. The fine
      structure of the pineal capillaries was also studied by transmission electron
      microscopy. The pineal complex in T. rugosa consists of an elongated pineal gland
      proper and a separate, distinct parietal eye. The pineal complex derives an
      abundant blood supply from branches of the middle and posterior cerebral
      arteries. Scanning electron microscopy of vascular corrosion casts revealed a
      dense and extensive pineal capillary bed which drains ultimately into a wide
      longitudinal sinus suggesting an efficient pathway for the rapid removal of
      substances secreted by the gland. The parietal eye, which receives a unilateral
      left-sided blood supply from the unpaired anterior pineal artery, is shown to be
      a highly vascularized structure. The close morphological relationship between the
      pineal gland and dorsal sac, where the two structures apparently share the same
      blood vessels, suggests a functional relationship between them. The pineal
      capillaries are fenestrated with tight junctions between adjoining endothelial
      cells. Podia-like abluminal extensions of the endothelial cells were observed in
      close relation to unmyelinated nerve bundles. The basal margin of the pineal
      parenchyma is highly invaginated with thin finger-like cytoplasmic protrusions
      into the pericapillary space. Distinct bands of microfibrils form "struts"
      anchoring the pineal parenchyma to the endothelial wall. These features may have
      a role in the transfer of materials between the pineal gland and the blood
      stream.

PMID- 8363057
TI  - Prolactin alters the expression of integumental glycoconjugates in the red
      spotted newt, Notophthalmus viridescens.
AB  - Prolactin (PRL)-mediated changes in the texture and secretory activity of the
      skin in adult red-spotted newts may involve alterations in the distribution
      and/or expression of structural and secretory epidermal glycoconjugates. To
      explore this possibility, skin samples were obtained from groups of conditioned
      animals that had received injections of either ovine prolactin or amphibian
      saline over a 14-day period. Glycoconjugates within the epidermis and cutaneous
      glands were examined by means of lectin histochemistry using a panel of eight HRP
      labelled lectins. PRL increased levels of sialic acid and n-acetylglucosamine in
      the stratum corneum. In contrast, glycoconjugates containing fucose, galactose, n
      acetylgalactosamine, and galactose-(1,3)-n-acetylgalactosamine were decreased by
      PRL within both glands and epidermis. These results suggest that the integumental
      effects associated with prolactin in the red-spotted newt are mediated, at least
      in part, through the alteration of epidermal and glandular glycoconjugates.

PMID- 8363058
TI  - Ultrastructural characteristics of primordial germ cells in the quail embryo.
AB  - An avian species, the quail has become a desirable animal model in experimental
      embryology and reproductive biology. To understand the ultrastructural
      characteristics of primordial germ cells (PGC) of this species, we studied PGC in
      the Japanese quail (Coturnix coturnix japonica) embryo at various developmental
      stages from their appearance in the germinal crescent through migration to
      settlement in the gonadal ridges by means of electron microscopy. The results
      were compared with those of another well-known avian species, the chick. Several
      ultrastructural characteristics of quail PGC not described previously in chick
      PGC were observed as follows: 1) No glycogen particles were detected in the
      cytoplasm at any stage examined. 2) Electron-dense and membrane-bounded granules
      were found in the PGC cytoplasm during the sexually indifferent gonadal stages.
      3) Quail PGC were characterized by a prominent nucleolus associated with
      condensed chromatin (heterochromatin), and the developmental changes of the
      nucleus were noted; the nucleolus initially appeared as a compact mass at the
      germinal crescent stage and became dispersed at later stages during the
      colonization of the gonadal ridges. These findings suggest several physiological
      and functional differences in the cell cycle between these two avian species.
      This is the first report describing detailed ultrastructural characteristics of
      PGC in the quail embryo.

PMID- 8363059
TI  - Development of innervation of skeletal muscle fibers in man: relation to
      acetylcholine receptors.
AB  - The aim of this study was to establish the time scale of developmental changes in
      innervation of skeletal muscle fibers in man. Specimens of thigh and intercostal
      muscle from 19 embryos and 18 infants were examined with histological methods
      which enabled the discrimination between fetal (gamma) and adult (epsilon) types
      of acetylcholine receptors (AChRs). At 8 weeks of development, AChRs were
      distributed diffusely in the myotube membranes. Following onset of innervation in
      approximately the ninth week the length of the AChR positive area diminished and
      reached its shortest size at the sixteenth developmental week. At the sixteenth
      and eighteenth week some nerve terminals opposed the muscle membrane outside the
      AChR positive area. Decrease in the number of nerve terminals, strongly
      suggesting elimination of polyneuronal innervation, started in the sixteenth week
      and was completed in the twenty-fifth week. This fetal (gamma) type of AChR could
      no longer be demonstrated after the thirty-first week. The length of the end
      plates as determined by the presence of AChRs increased again in the last week
      before birth and reached a plateau size by the end of the first year after birth.
      It is concluded that in man the transition from poly- to mononeuronal innervation
      takes place between the sixteenth and twenty-fifth weeks of development. The
      evidence available suggests that the retraction of nerve terminals is preceded by
      loss of AChRs from the muscle membrane facing the terminals. There is no
      relationship between retraction of nerve terminals and the switch from fetal to
      adult type of AChR. The size of the presynaptic apparatus changes little after
      the first year of life.

PMID- 8363060
TI  - Effects of maternal bilateral ureteral ligation on fetal development of kidney in
      rats: morphometrical changes in glomerular components.
AB  - Development of the glomerulus in fetal kidney was studied morphometrically
      following ligation of both ureters of pregnant rats. The ligation was performed
      on days 17, 19, and 21 of gestation, and autopsy was done 24 hr after each
      operation. The percentage volumes of the five glomerular components (epithelial
      cells, capillary, mesangium, glomerular basement membrane, and Bowman's space)
      were determined by point counting, and the surface area of glomerular basement
      membrane per unit volume of glomerulus was calculated by intercept counting. On
      fetal days 18, 20, and 22, percentage volume of Bowman's space in the fetuses
      from the ligated mothers was significantly smaller than that in the fetuses from
      sham-ligated mothers. On fetal days 20 and 22, surface area of glomerular
      basement membrane and glomerular capillary length per unit volume of glomerulus
      and percentage of glomerular capillary volume in the fetuses from the ligated
      mothers were significantly larger than those in the fetuses from sham-ligated
      mothers. These results suggest that maternal bilateral ureteral ligation induces
      an increase in filtration area of glomerulus in fetal kidney when the fetal
      kidney is functional.

PMID- 8363061
TI  - Histogenetic potential of rat hind-limb interdigital tissues prior to and during
      the onset of programmed cell death.
AB  - The histogenetic potential of interdigital tissues isolated from the autopod of
      rat embryonic hind-limbs between 14.5 and 16.5 days was investigated. A wedge of
      tissue containing ectoderm and mesoderm was excised from between the developing
      digits and grafted beneath the kidney capsule of adult rats for two weeks. We
      have previously demonstrated that the renal capsule is an excellent site for
      permitting limb tissues to proliferate and differentiate (Chan et al.: J. Exp.
      Zool., 260:74-83, 1991). At 14.5 days, when cell death (revealed with neutral red
      stains) within the interdigital zone was limited to the apical ectodermal ridge
      (AER), the interdigital mesoderm was capable of developing into bone, cartilage,
      and loose connective tissue in the kidney. It was estimated that the skeletal
      elements occupied approximately 38% of the overall area of the grafts. In
      addition, the ectoderm was able to produce keratinized epithelium, hair
      follicles, and sebaceous glands. In 15.5 day autopod, necrosis was present both
      in the AER and the mesoderm between the AER and marginal sinus. Interdigital
      mesoderm obtained from this stage of development formed cartilage but not as
      extensively as that derived from 14.5 day autopod (4% as compared with 38%).
      Necrotic cells were present in all of the interdigital zones at 16.5 days. Ten
      explants were introduced into the kidney at this stage, but only 4 grafts were
      recovered after 2 weeks. In all cases, the explants did not produce cartilage.
      Only a small amount of keratinized epithelium and loose connective tissue was
      found. In summary the interdigital mesoderm has the potential to develop bone,
      cartilage, and loose connective tissue, but this ability is progressively lost
      during morphogenesis.

PMID- 8363062
TI  - Quantitative ultrastructural analysis of the periaqueductal gray in the rabbit.
AB  - The fine structure of the periaqueductal gray (PAG) of the rabbit was examined
      using the transmission electron microscope. On the basis of synaptic polarity,
      vesicle size, and the nature of the pre- and post-synaptic elements, 10
      essentially different synaptic types could be discerned (6 axo-dendritic, 2 axo
      somatic, 1 axo-axonic, and 1 dendro-dendritic). Synaptic contacts on the soma of
      PAG neurons were small and covered, on average, only 1.6% of the soma surface.
      The most striking feature of the synaptic structure of the PAG was that more than
      94.1% of all synapses were axo-dendritic. Of these, 83.5% were of the symmetrical
      type. Most of these contacts occurred on buttons of small to medium size, and
      contained either round vesicles of medium size or pleomorphic vesicles of medium
      size. Boutons containing only flattened vesicles were quite rare. Boutons
      contacting larger dendrites were generally small-to-medium in size, made
      asymmetric-type synaptic contacts, and contained pleomorphic vesicles of medium
      to-large size. Medium-sized dendrites were contacted principally by small boutons
      exhibiting either symmetrical or asymmetrical junctions containing medium-sized
      pleomorphic vesicles, and in addition a few of these boutons contained both
      large, and small, round vesicles. Dendritic spines were generally provided with
      only one synaptic contact, stretching the entire width of the spinous process.
      Boutons and the spines on dendrites were approximately the same size. Synapses
      between two vesicle-containing structures (axo-axonic or dendro-dendritic
      synapses) were rare (1.4%). They were generally asymmetric and contained round
      vesicles of medium size. Complex synapses, where a glial sheet enclosed the
      synapse, were occasionally observed. Also seen were multiple synapses, with up to
      11 contacts on a single dendritic profile. Large dense-core vesicle were seen in
      approximately 40% of all synapses, whereas small dense-core vesicles were only
      found in about 3%. Data is provided on how different synaptic features relate to
      ventral, lateral, dorsal, and medial PAG. Principally this is in relation to
      neuron size, glia cell content, axonal characterization, and vesicular type.

PMID- 8363063
TI  - Incidence and histology of human accessory parotid glands.
AB  - The parotid glands of 228 Japanese human cadavers were examined to determine the
      incidence and histological features of accessory parotid glands. The incidence
      was found to be 56% with no differences between right and left sides or between
      sexes. Thirty parotid glands and their associated accessory glands were examined
      histologically: eight of these accessory glands were found to be mixed secretory
      glands (i.e., containing both serous and mucous acini). Thus, the pattern of
      differentiation of a significant fraction of accessory glands differs from that
      of the main parotid gland: it appears that mixed acini, present in the early
      stages of development, persist into later life, and their presence may be related
      to tumors developing at these sites.

PMID- 8363064
TI  - General versus regional anesthesia for peripheral vascular surgery. Is the
      problem solved?

PMID- 8363065
TI  - Sympathetic nervous system activation and hyperdynamic circulation associated
      with desflurane: not all isomers are created equal.

PMID- 8363066
TI  - Perioperative morbidity in patients randomized to epidural or general anesthesia
      for lower extremity vascular surgery. Perioperative Ischemia Randomized
      Anesthesia Trial Study Group.
AB  - BACKGROUND: Perioperative morbidity may be modifiable in high risk patients by
      the anesthesiologist's choice of either regional or general anesthesia. This
      clinical trial compared outcomes between epidural (EA) and general (GA)
      anesthesia/analgesia regimens in a group of patients at high risk for cardiac and
      other morbidity who were undergoing similarly stressful surgical procedures.
      METHODS: One hundred patients scheduled for elective vascular reconstruction of
      the lower extremities were randomized to receive either EA for surgery followed
      by epidural analgesia, or GA for surgery followed by intravenous patient
      controlled analgesia. Hemodynamic monitoring, blood pressure, and heart rate
      limits were determined prior to randomization. Management of anesthesia in the
      immediate postoperative period was standardized. The data collected included
      continuous electrocardiographic monitoring from the day before surgery through
      the third postoperative day, serial electrocardiograms, and cardiac enzymes.
      Cardiac ischemia, myocardial infarction, unstable angina, and cardiac death were
      identified by a cardiologist blinded to the type of anesthesia received. Other
      major morbidity was determined at the time of hospital discharge and at 1 and 6
      months after surgery. RESULTS: Eleven patients who received GA required
      regrafting or an embolectomy during their hospital stay, compared with two
      patients who received EA. This association of GA with reoperation remained
      significant after adjustment for baseline differences. Cardiac outcomes were
      similar in the two groups with respect to perioperative death (1 EA and 1 GA),
      death within 6 months (4 EA and 3 GA), nonfatal myocardial infarction within 7
      days (2 EA and 2 GA), unstable angina (0 EA and 2 GA), and myocardial ischemia
      following randomization (17 EA and 23 GA). Rates of major infections in the two
      groups (1 EA and 2 GA), renal failure (3 EA and 3 GA), and pulmonary
      complications (3 EA and 7 GA) also were similar. CONCLUSIONS: Carefully conducted
      epidural and general anesthesia appear to be associated with comparable rates of
      cardiac and most other morbidity in patients undergoing lower extremity vascular
      surgery. However, compared with general anesthesia, epidural anesthesia is
      associated with a lower incidence of reoperation for inadequate tissue perfusion
      and, therefore, may be advantageous for this surgical population.

PMID- 8363067
TI  - The effects of different anesthetic regimens on fibrinolysis and the development
      of postoperative arterial thrombosis. Perioperative Ischemia Randomized
      Anesthesia Trial Study Group.
AB  - BACKGROUND: The purpose of this clinical trial was to compare the effects of
      different anesthetic and analgesic regimens on hemostatic function and
      postoperative arterial thrombotic complications. METHODS: Ninety-five patients
      scheduled for elective lower extremity vascular reconstruction were randomized to
      receive either epidural anesthesia followed by epidural fentanyl (RA) or general
      anesthesia followed by intravenous morphine (GA). Intraoperative and
      postoperative care were controlled by protocol using predetermined limits for
      heart rate, blood pressure, and other monitoring criteria. Data collection
      included serial physical examinations, electrocardiograms, and cardiac isoenzymes
      to detect arterial thrombosis (defined as unstable angina, myocardial infarction,
      or vascular graft occlusion requiring reoperation). Fibrinogen, plasminogen
      activator inhibitor-1 (PAI-1), and D-dimer levels were measured preoperatively
      and at 24 and 72 h postoperatively. RESULTS: Preoperative fibrinogen levels were
      similar in both groups, remained unchanged after 24 h, and increased equally
      (45%) in the first 72 h postoperatively. PAI-1 levels in the GA group increased
      from 13.6 +/- 2.1 activity units (AU)/ml to 20.2 +/- 2.6 AU/ml at 24 h and
      returned to baseline at 72 h. In contrast, PAI-1 levels in the RA group remained
      unchanged over time. Twenty-two of 95 patients (23%) had postoperative arterial
      thrombosis, 17 of whom had received GA and 5 of whom, RA. Preoperative PAI-1
      levels were higher in patients who developed postoperative arterial thrombosis
      (20.5 +/- 3.6 AU/ml vs. 11.2 +/- 1.4 AU/ml). Multiple logistic regression
      analysis indicated that GA and preoperative PAI-1 levels were predictive of
      postoperative arterial thrombotic complications. CONCLUSIONS: Impaired
      fibrinolysis may be related causally to postoperative arterial thrombosis.
      Because RA combined with epidural fentanyl analgesia appears to prevent
      postoperative inhibition of fibrinolysis, this form of perioperative management
      may decrease the risk of arterial thrombotic complications in patients undergoing
      lower extremity revascularization.

PMID- 8363068
TI  - Sympathetic hyperactivity during desflurane anesthesia in healthy volunteers. A
      comparison with isoflurane.
AB  - BACKGROUND: Desflurane has been reported to produce more tachycardia and
      hypertension on induction than isoflurane. The present study employed
      microneurography to determine whether these cardiovascular effects were related
      to sympathetic outflow. METHODS: In 14 healthy, young (age 20-31 yr) volunteers,
      arterial pressure was measured from the radial artery, forearm blood flow was
      derived by strain gauge plethysmography, and sympathetic nerve activity (SNA)
      directed to skeletal muscle blood vessels was recorded from a tungsten needle
      placed percutaneously into the peroneal nerve. Heart rate, blood pressure, muscle
      SNA, respiration, tidal volume, end-tidal carbon dioxide, and desflurane or
      isoflurane concentrations (infrared spectroscopy) were continuously monitored
      before and during anesthesia. Two minutes after administering thiopental (5
      mg/kg) and vecuronium (0.2 mg/kg), desflurane (n = 7) or isoflurane (n = 7) was
      titrated gradually to the inspired gas over several minutes to 1.5 MAC. RESULTS:
      The initiation of desflurane anesthesia resulted in significant changes that
      included a 2.5-fold increase in SNA, hypertension (peak mean arterial pressure
      114 +/- 3 mmHg), tachycardia (peak heart rate 102 +/- 6 beats/min), facial
      flushing, and tearing. Moderate upper airway obstruction developed in three
      subjects approximately 4 min after initiating desflurane, despite neuromuscular
      blockade. These responses were not observed in subjects receiving isoflurane.
      After tracheal intubation, the anesthetic concentration was maintained at 0.5 MAC
      for 30 min. Steady-state measurements of hemodynamics and SNA were obtained.
      Similar steady-state measurements were obtained 15 min after establishing 1.0 and
      1.5 MAC. Both anesthetics produced a progressive reduction in blood pressure and
      forearm vascular resistance, and muscle SNA gradually increased. In subjects
      receiving desflurane, heart rate remained unchanged until the 1.5-MAC level was
      reached, at which time tachycardia (a 10-beat/min increase) was noted. The
      transition from 1.0 to 1.5 MAC desflurane resulted in significant heart rate
      increases (> 30 beats/min), hypertension (> 30 mmHg), and a doubling of SNA that
      persisted for several minutes. These responses did not occur in the isoflurane
      group. CONCLUSIONS: Titration of desflurane following thiopental induction and
      increasing the concentration of desflurane from 1.0 to 1.5 MAC result in sympatho
      excitation, hypertension and tachycardia in healthy, young volunteers. Until
      methods are determined to attenuate these responses, desflurane should be
      administered with great caution to patients who may be placed at risk by these
      responses.

PMID- 8363069
TI  - Awareness and recall during general anesthesia. Facts and feelings.
AB  - BACKGROUND: Experiences of awareness and recall during general anesthesia can be
      most distressing for patients. To obtain relevant information, the authors
      systematically interviewed patients in whom awareness during surgery had
      occurred, and questioned them about their experiences. METHODS: Twenty-six
      patients, referred by colleagues, described the facts and feelings they had
      experienced during the period of awareness, and whether these had had any
      consequences. Available anesthetic records were independently judged by three
      experienced anesthesiologists for relevant parameters. RESULTS: Auditory
      perception and the sensation of paralysis were most frequently mentioned,
      followed by the sensation of pain. Patients' feelings were mostly related to
      anxiety, panic, powerlessness, and helplessness. Eighteen patients (70%)
      experienced unpleasant aftereffects, including sleep disturbances, dreams and
      nightmares, and flashbacks and anxiety during the day. Only nine patients (35%)
      had informed their anesthesiologists about what had taken place. Twelve
      anesthetic records were assessed. In three, the occurrence of awareness had been
      indicated, while, in a fourth, it was noted that an amnesic drug had been given
      at a moment of increased blood pressure. Experienced anesthesiologists were
      unable to reliably distinguish awareness cases from matched controls when judging
      the records. CONCLUSIONS: Details recalled from the period of awareness
      correspond with data from the literature. The anesthesiologist's role in
      discussing, and dealing with, traumatic experiences related to anesthesia may be
      of great importance. The hand-written anesthetic record is of limited value in
      retrospectively explaining why awareness and recall have occurred.

PMID- 8363070
TI  - The threshold for thermoregulatory vasoconstriction during nitrous
      oxide/isoflurane anesthesia is lower in elderly than in young patients.
AB  - BACKGROUND: Thermoregulatory vasoconstriction minimizes further core hypothermia
      during anesthesia. Elderly patients become more hypothermic during surgery than
      do younger patients, and take longer to rewarm postoperatively. These data
      indicate that perianesthetic thermoregulatory responses may be especially
      impaired in the elderly. Accordingly, the authors tested the hypothesis that the
      thermoregulatory threshold for vasoconstriction during nitrous oxide/isoflurane
      anesthesia is reduced more in elderly than in young patients. METHODS: The
      authors studied 12 young patients aged 30-50 yr and 12 elderly patients aged 60
      80 yr. All were undergoing major orthopedic or open abdominal surgery. Anesthesia
      was induced with thiopental and fentanyl, and maintained only with nitrous oxide
      (70%) and isoflurane (0.6-0.8%). Core temperature was measured in the distal
      esophagus. Fingertip vasoconstriction was evaluated using forearm minus
      fingertip, skin-temperature gradients. A gradient of 4 degrees C identified
      significant vasoconstriction, and the core temperature triggering
      vasoconstriction identified the thermoregulatory threshold. RESULTS: The
      vasoconstriction threshold was significantly less in the elderly patients (33.9
      +/- 0.6 degree C) than in the younger ones (35.1 +/- 0.3 degrees C) (P < 0.01).
      The gender distribution, weight, and height of the elderly and young patients did
      not differ significantly. The end-tidal isoflurane concentration at the time of
      vasoconstriction did not differ significantly in the two groups. CONCLUSIONS:
      These data indicate that thermoregulatory responses in the elderly are initiated
      at temperatures approximately 1.2 degrees C less than that in younger patients.
      Thus, it is likely that elderly surgical patients become more hypothermic than do
      younger patients, at least in part, because they fail to trigger protective
      thermoregulatory responses.

PMID- 8363071
TI  - Clonidine comparably decreases the thermoregulatory thresholds for
      vasoconstriction and shivering in humans.
AB  - BACKGROUND: Clonidine stops postoperative shivering, but its underlying mechanism
      of action is unknown. Clonidine may impair central control of thermoregulation or
      act on peripheral receptors. Accordingly, the authors tested the hypothesis that
      clonidine reduces both the vasoconstriction and shivering thresholds, a pattern
      consistent with central thermoregulatory impairment. METHODS: Seven healthy
      volunteers participated in the study. Thermoregulatory vasoconstriction was
      evaluated using forearm minus fingertip, skin-temperature gradients; values
      exceeding 4 degrees C were considered to be significant vasoconstriction.
      Systemic oxygen consumption (VO2) was measured with a canopy system. In addition,
      shivering was qualitatively evaluated using a simple scale, graduated from 0 (no
      shivering) to 2 (intense shivering). The tympanic membrane temperatures
      triggering significant vasoconstriction and grade 1 shivering were considered to
      be the thresholds for the two thermoregulatory responses. Measurements were
      performed after a 10-min steady state period and during cooling by central venous
      infusion of Ringer's lactate solution at 4 degrees C. Each subject was evaluated
      at two sessions, separated by at least 48 h. They were randomly and blindly
      assigned to received either an intravenous bolus of 75 micrograms clonidine or a
      placebo before cooling. When the shivering score equaled 2, 75 micrograms
      clonidine was injected intravenously, and repeated if necessary, to completely
      stop shivering.

PMID- 8363072
TI  - Postarthroscopy analgesia with intraarticular bupivacaine/morphine. A randomized
      clinical trial.
AB  - BACKGROUND: Postarthroscopy analgesia has been provided with intraarticular
      bupivacaine, but the duration of analgesia may be only a few hours. More
      recently, longer-lasting analgesia has been achieved using intraarticular
      morphine, although the onset of analgesia may be delayed. The combination of
      intraarticular morphine and bupivacaine has been suggested as an ideal analgesic
      after knee arthroscopy. METHODS: One hundred and twenty ASA Physical Status 1-2
      outpatients, age 18-60 yr, having knee arthroscopy, were randomized into one of
      four treatment groups. Exclusion criteria included relevant drug allergy,
      extensive debridement or synovectomy, arthrotomy, postoperative intraarticular
      drainage, tracheal intubation, and patient refusal. All patients received general
      anesthesia with intravenous fentanyl, propofol, N2O, O2, and isoflurane. At the
      end of surgery, before tourniquet release, the following were injected
      intraarticularly through the arthroscope: group 1, 0.25% bupivacaine; group 2, 1
      mg morphine in saline; group 3, 2 mg morphine in saline; and group 4, 1 mg
      morphine in 0.25% bupivacaine. The volume injected was 30 ml, and all solutions
      contained 1:200,000 epinephrine. Postoperative analgesia was provided with
      intravenous fentanyl and/or oral acetaminophen/codeine, and was recorded for 24
      h. Visual analog pain scale (VAPS) scores and the McGill Pain Questionnaire (MPQ)
      were performed hourly from 1-6 h, and at 24 h postoperatively. RESULTS: Visual
      analog pain scale and MPQ scores were lowest in groups 1 and 4 at 1-6 h, but at
      24 h, VAPS scores were lowest in groups 2, 3, and 4. Analgesic requirements were
      lower for the first 12 h in groups 1 and 4, but no difference was seen between
      groups over the 24-h study period. No adverse effects were noted. CONCLUSIONS:
      Morphine, 1 mg intraarticular, in 30 ml 0.25% bupivacaine, with 1:200,000
      epinephrine, may provide superior postoperative analgesia for up to 24 h versus
      bupivacaine or morphine alone.

PMID- 8363073
TI  - Computer-controlled infusion of alfentanil for postoperative analgesia. A
      pharmacokinetic and pharmacodynamic evaluation.
AB  - BACKGROUND: Although computer-controlled infusion (CCI) of alfentanil has been
      shown to be effective intraoperatively, this technique has not been validated for
      postoperative use. Therefore, the authors examined the efficacy of this technique
      in providing postoperative pain relief. The study comprised both a validation of
      published pharmacokinetic data sets and the definition of the minimum effective
      analgesic concentrations after major orthopedic surgery. METHODS: The bias and
      inaccuracy of the implemented pharmacokinetic data set were examined, in 20
      patients who had undergone major orthopedic surgery, by determination of the
      median performance error (MDPE) and median absolute performance error (MDAPE).
      The performance of two other published pharmacokinetic data sets was also
      examined by simulating the plasma concentrations that would have been predicted,
      had these data sets been implemented. The minimum effective analgesic
      concentrations (MEAC) were determined at the following time points: at the onset
      of pain, at 9:00 PM on the day of surgery, and at 9:00 AM and 9:00 PM on the
      first postoperative day. RESULTS: Measured plasma concentration-time profiles
      generally were parallel to the target concentration-time profiles. The MDPE and
      MDAPE obtained were 12% and 28%, respectively. The MEACs ranged from < 1 to 175
      ng/ml and showed substantial interindividual variability. The median MEACs at the
      four study times were 59, 52, 65, and 43 ng/ml. The MEAC at 9:00 PM on the first
      postoperative day was significantly lower than those at the other study times (P
      < 0.05). CONCLUSION: Computer-controlled infusion of alfentanil provides adequate
      postoperative analgesia. The study demonstrated that pharmacokinetic data sets
      that are useful for intraoperative CCI of alfentanil are equally valid in the
      postoperative phase. Although required plasma concentrations of alfentanil are
      reasonably stable in time, interindividual variations are large, necessitating
      individual titration.

PMID- 8363074
TI  - Sufentanil increases intracranial pressure in patients with head trauma.
AB  - BACKGROUND: Sufentanil is an intravenous opioid often used as a component of
      anesthesia during neurosurgical procedures. However, the effects of sufentanil on
      intracranial pressure in patients with diminished intracranial compliance are not
      well established, and remain controversial. METHODS: Ten patients with head
      trauma, in each of whom the trachea was intubated, were studied for the effects
      of sufentanil on intracranial pressure (ICP) and on cerebral perfusion pressure
      (CPP). In all patients, ICP monitoring was instituted before the study. Sedation
      was obtained using a propofol infusion, and paralysis was achieved with
      vecuronium. After obtaining control of ICP (between 15 and 25 mmHg) hemodynamic
      values and blood gas tensions (PaCO2 between 30 and 35 mmHg), the level of
      sedation was deepened with an intravenous injection of sufentanil (1 microgram/kg
      over 6 min), followed by an infusion of 0.005 microgram.kg-1min-1. Mean arterial
      pressure (MAP), ICP (fiberoptic intracranial pressure monitor), and end-tidal CO2
      were continuously measured and recorded at 1-min intervals throughout the 30-min
      study period. RESULTS: Sufentanil injection was associated with a statistically
      significant increase in ICP of 9 +/- 7 mmHg (+ 53%), which peaked at 5 min. Then
      ICP gradually decreased and returned to baseline after 15 min. This was
      accompanied by a significant decrease in MAP (24% decrease) and, thus, CPP (38%
      decrease). After 5 min, MAP and CPP gradually increased, but remained
      significantly decreased throughout the study. CONCLUSIONS: The results of the
      current study indicate that caution should be exercised in the administration of
      sufentanil bolus to patients with abnormal intracranial elastance, particularly
      if ICP is significantly increased.

PMID- 8363075
TI  - Desflurane and isoflurane have similar effects on cerebral blood flow in patients
      with intracranial mass lesions.
AB  - BACKGROUND: Before desflurane is advocated for patients undergoing neurosurgical
      procedures, it is necessary to determine the effect of desflurane on cerebral
      blood flow (CBF). In this study, CBF values are compared between desflurane and
      isoflurane at two doses. In addition, CBF reactivity to CO2 and the effect of
      prolonged exposure were compared between the two agents. METHODS: Cerebral blood
      flow measurements with intravenous 133Xe were performed in 24 patients undergoing
      craniotomy for mass lesions, randomized to receive either isoflurane or
      desflurane in oxygen and air. Cerebral blood flow was determined at 1 and 1.5 MAC
      concentrations at PaCO2 of 25 mmHg in the absence of surgical stimulation.
      Intraoperatively, with 1.25 MAC anesthesia, CBF was determined at target PaCO2 of
      25 and 35 mmHg. In 15 patients, an additional measurement at 1.25 MAC was made
      before closure. RESULTS: At 1.0 MAC, mean +/- SD CBF values for the desflurane
      and isoflurane groups were 18 +/- 2 and 20 +/- 3 ml x 100 g-1 x min-1,
      respectively. At 1.5 MAC, CBF values were the same for the two anesthetics; 17 +/
      3 ml x 100 g-1 x min-1 for isoflurane and 19 +/- 4 ml.100 g-1 x min-1 for
      desflurane. During 1.25 MAC anesthesia, there were no differences between groups,
      with CO2 reactivity 1.3 +/- 1.2 ml x 100 g-1 x min-1 x mmHg-1 for desflurane and
      1.6 +/- 0.6 ml.100 g-1 x min-1 x mmHg-1 for isoflurane. There was no demonstrable
      decrease in CBF with prolonged exposure to either agent. CONCLUSIONS: Desflurane
      and isoflurane are similar in terms of absolute CBF, the response to increasing
      doses, and the preservation of CO2 reactivity.

PMID- 8363076
TI  - Continuous calculation of intratracheal pressure in tracheally intubated
      patients.
AB  - BACKGROUND: Intratracheal pressure (Ptrach) should be the basis for analysis of
      lung mechanics. If measured at all, Ptrach is usually assessed by introducing a
      catheter into the trachea via the lumen of the endotracheal tube (ETT). The
      authors propose a computer-assisted method for calculating Ptrach on a point-by
      point basis by subtracting the flow-dependent pressure drop delta PETT(V) across
      the ETT from the airway pressure (P(aw)), continuously measured at the proximal
      end of the ETT. METHODS: The authors measured the pressure-flow relationship of
      adult endotracheal tubes with different diameters (ID, 7-9 mm) at different
      lengths and of tracheostomy tubes (ID, 8-10 mm) in the laboratory. The
      coefficients of an approximation equation were fitted to the measured pressure
      flow curves separately for inspiration and expiration. In 15 tracheally intubated
      patients under volume-controlled ventilation and spontaneous breathing, the
      calculated Ptrach was compared with the measured Ptrach. RESULTS: The authors
      present the coefficients of the "nonlinear approximation": delta PETT = K1.VK2,
      with delta PETT being the pressure drop across the ETT and K1 and K2 being the
      coefficients relating V to delta PETT. An important result was an
      inspiration/expiration asymmetry: the pressure drop caused by the inspiratory
      flow exceeds that of the expiratory flow. A complete description of the pressure
      flow relationship of an ETT, therefore, requires a set of four coefficients: K1I,
      K2I, K1E, and K2E. The reason for this asymmetry is the abrupt sectional change
      between ETT and trachea and the asymmetric shape of the swivel connector.
      Comparison of calculated and measured Ptrach in patients gives a correspondence
      within +/- 1 cmH2O (mean limits of agreement). The mean root-mean-square (rms)
      deviation is 0.55 cmH2O. CONCLUSIONS: Ptrach can be monitored by combining our
      ETT coefficients and the flow and airway pressure continuously measured at the
      proximal end of the ETT.

PMID- 8363077
TI  - Perioperative myocardial ischemia. Its relation to anatomic pattern of coronary
      artery stenosis.
AB  - BACKGROUND: Recently, the frequency of intraoperative myocardial ischemic
      episodes in patients with steal-prone coronary anatomy, compared with other
      groups of patients undergoing coronary artery surgery (CABG), has been
      characterized. Because the relationship between anatomic distribution of coronary
      stenosis and myocardial ischemic episodes over the entire perioperative period
      has not been well defined, the authors sought to examine this relationship in 100
      adult patients undergoing CABG surgery. METHODS: Continuous electrocardiographic
      (ECG) monitoring was performed in the pre-, intra-, and postoperative periods,
      quantifying the frequency (episodes/hour of monitoring [epis/h]) and duration
      (minutes/hour of monitoring [min/h]) of ECG ischemic episodes defined as a
      reversible ST segment shift > or = 1 mm at J + 60 ms of > or = 1 min duration.
      Based on preoperative coronary angiography, patients were categorized into the
      following groups: group 1 (n = 40), steal-prone coronary anatomy (occluded major
      coronary artery and > or = 50% stenosis of left main coronary artery or > or =
      70% proximal stenosis 2 (n = 17), left main or equivalent coronary stenosis (> or
      = 50% stenosis of left main coronary artery or > or = 70% proximal stenosis of
      the left anterior descending and circumflex coronary arteries); and group 3 (n =
      43), coronary artery stenosis > or = 70% not fitting the preceding categories.
      RESULTS: Compared with group 3, patients in group 1 had more frequent and longer
      ECG ischemic events preoperatively, and were nearly two times more likely
      (relative risk 1.82, 95% confidence interval 1.07-3.10) to develop an ischemic
      event during this period. There were no differences in the relative risk,
      frequency, or duration of an ischemic episode between groups 1 and 3 during the
      intraoperative and postoperative periods, or between groups 1 and 2 or groups 2
      and 3 during any perioperative period. In group 2 patients, the frequency of
      ischemic epis/h was less intra- compared with preoperatively, while, in group 3,
      the ischemic epis/h decreased postoperatively compared with the intraoperative
      period. The duration of ischemic episodes (min/h) in group 3, however, increased
      postoperatively compared with the pre- and intraoperative periods, while, in
      group 2, the duration of ischemic episodes (min/h) was less intraoperatively
      compared with the preoperative period. Ninety-seven percent of preoperative ECG
      ischemic episodes occurred without symptoms. Postoperative myocardial infarction
      occurred in three patients in group 3, two in group 2, and one in group 1. There
      were no perioperative deaths. CONCLUSION: These data indicate that, compared with
      patients with non-left main or equivalent coronary stenosis, those with steal
      prone coronary anatomy have more frequent and longer ECG ischemic episodes
      preoperatively. The data also indicate that there are no other differences in the
      risk, frequency, or duration of ischemic episodes between groups perioperatively.
      Thus, different distributions of coronary artery stenosis may be associated with
      changes in the perioperative characteristics of ECG ischemic episodes.

PMID- 8363078
TI  - Intravenous or epidural clonidine for intra- and postoperative analgesia.
AB  - BACKGROUND: Intravenous and epidural clonidine both produce postoperative
      analgesia. Several experimental reports demonstrate a spinal site of action for
      the analgesic effects of this alpha 2-adrenoceptor agonist. Therefore, the
      authors evaluated the clinical analgesic benefits of using clonidine, both intra-
      and postoperatively, by the epidural or the intravenous route. METHODS: Using a
      randomized prospective double-blind study design, 40 patients, between 18 and 50
      yr of age, undergoing intestinal surgery under general propofol/nitrous oxide
      anesthesia, were enrolled. Before anesthesia, an epidural catheter was inserted
      at the L1-L2 interspace. At induction, a clonidine infusion was started at the
      doses of 4 micrograms/kg in 10 ml during 20 min, followed by 2 micrograms.kg-1 x
      h-1 (5 ml/h) during 12 h, either by the epidural (group 1) or by the intravenous
      (group 2) route. Intraoperatively, increased blood pressure and heart rate not
      responding to additional propofol bolus (0.5 mg/kg) was treated with a bolus of
      alfentanil (7 micrograms/kg). Postoperatively, morphine boluses (1.5 mg) were
      given through a PCA device according to the patient's need. Intraoperative
      analgesia was assessed by the alfentanil requirements. Postoperative analgesia
      was assessed by recording the morphine requirements, the visual analogue scale
      (VAS) at rest and after mobilization, and the patients' analgesia scale at 0, 3,
      6, 12, 18, 24, and 36 postoperative hours. Sedation analogue scale and side
      effects were also recorded. Heart rate and blood pressure were particularly
      detailed during the first 2 h of the clonidine infusion. Plasma clonidine
      concentrations were measured after 20 min and 6, 12, and 24 h. RESULTS: Epidural
      clonidine significantly reduced the intraoperative alfentanil requirements (0.93
      +/- 1.2 in group 1 vs. 2.4 +/- 1.8 mg in group 2). The postoperative morphine
      requirements were also reduced during the first 6 h (8.3 +/- 5.8 in group 1 vs.
      17.8 +/- 13.4 mg in group 2). The VAS were comparable in both groups, despite the
      better patients' analgesia score reported in the epidural group during the first
      12 h. There was no difference in sedation score at any time interval considered.
      Epidural and intravenous clonidine reduced heart rate and blood pressure to the
      same extent. The plasma clonidine concentrations were less in the epidural group
      only after the loading doses. CONCLUSIONS: Epidural clonidine reduces the intra-
      and early postoperative analgesic requirements when compared with the same dose
      given by the intravenous route. The side effects were similar with the two routes
      of administration.

PMID- 8363079
TI  - Clonidine and ketanserin both are effective treatment for postanesthetic
      shivering.
AB  - BACKGROUND: Although meperidine is an effective treatment of postanesthetic
      shivering, its mechanism of action remains unknown. Investigation of other drugs
      might help clarify the mechanisms by which shivering can be controlled.
      Accordingly, we investigated the efficacy of clonidine, an alpha 2-adrenergic
      agonist, and ketanserin, a 5-hydroxytryptamine antagonist, in treating
      postanesthetic shivering. METHODS: First, 54 patients shivering after general
      anesthesia were allocated randomly to receive an intravenous bolus of saline, 150
      micrograms clonidine, or 10 mg ketanserin. A second study explored the dose
      dependence of clonidine. Forty shivering patients were given saline or clonidine,
      37.5, 75, or 150 micrograms. RESULTS: The duration of shivering was significantly
      shorter in those given clonidine (2.1 +/- 0.9 min) than in the other two groups
      and shorter in the ketanserin group (4.3 +/- 0.9 min) than in the saline group
      (12.0 +/- 1.6 min). Clonidine and ketanserin significantly decreased systolic
      arterial blood pressure when compared to saline. Core rewarming was significantly
      slower in the clonidine group. In the second study, 37.5 micrograms clonidine was
      no more effective than saline. Two minutes after treatment, 150 micrograms
      obliterated shivering in all patients. Five minutes after treatment, all patients
      given 75 micrograms had stopped shivering. Systolic arterial pressure and heart
      rate decreased significantly in patients given 75 and 150 micrograms clonidine.
      CONCLUSIONS: Clonidine (150 micrograms) and ketanserin (10 mg) both are effective
      treatment for postanesthetic shivering. The effect of clonidine on shivering is
      dose-dependent: whereas 37.5 micrograms had no effect, 75 micrograms clonidine
      stopped shivering within 5 min.

PMID- 8363080
TI  - Autologous platelet-rich plasma does not reduce transfusion of homologous blood
      products in patients undergoing repeat valvular surgery.
AB  - BACKGROUND: Patients undergoing cardiac surgery employing cardiopulmonary bypass
      frequently require transfusion of homologous blood products and, therefore, are
      exposed to the risk of transfusions. Autologous platelet-rich plasma
      administration may reduce homologous transfusion and attendant risks. METHODS: In
      a blinded, randomized fashion, patients undergoing repeat sternotomy and valvular
      surgery received either a sham product (n = 28) or autologous platelet-rich
      plasma (n = 28) at the conclusion of cardiopulmonary bypass. Perioperative blood
      loss, coagulation profiles, and transfusion requirements were compared between
      the two groups. RESULTS: In the first 24 h postoperatively, both the platelet
      rich plasma and sham groups received a median of 10.5 units of homologous blood
      products. Total median perioperative homologous transfusion requirements were 13
      and 11.5 units for the platelet-rich plasma and sham groups, respectively. There
      was no significant difference in intraoperative or postoperative bleeding between
      the groups. CONCLUSIONS: Autologous platelet-rich plasma did not reduce
      perioperative bleeding or transfusion requirements in repeat valvular surgery.

PMID- 8363081
TI  - The medullary dorsal horn. A site of action of morphine in producing facial
      scratching in monkeys.
AB  - BACKGROUND: Pruritus is a common side effect of epidural and intrathecal morphine
      administration in humans. This naloxone-reversible pruritus is typically present
      on the trunk, but is often severe around the eyes and nose, of the patients. The
      brain stem has been proposed as the site where opioids act to produce this
      effect. The authors studied the effect of morphine administered into the
      medullary dorsal horn (MDH), the brain stem homologue of the spinal dorsal horn,
      on facial-scratching behavior in monkeys. METHODS: Morphine was unilaterally
      microinjected into the MDH of rhesus monkeys. Systemic injections of the opioid
      receptor antagonist naloxone (0.5 mg/kg intramuscularly) were also made in
      combination with morphine microinjection. Systemic injections of the
      antihistamine chlorcyclizine (1.0 and 2.5 mg/kg intramuscularly) were also made
      to determine if facial scratching was mediated through histamine release. The
      monkeys were videotaped for 10-15 min before and 1-2 h after opioid
      microinjection, and the number and location of scratches were counted. RESULTS: A
      dose-response curve was established for the mu/delta-opioid-receptor agonist
      morphine (0.5, 1.0, 2.5, and 5.0 micrograms). Specificity of the site of action
      within the MDH was examined by systematically changing the microinjection site,
      and examining the area of the face that the monkeys scratched. Morphine produced
      large dose-dependent increases in facial scratching ipsilateral to the
      microinjection. Increases in facial scratching were also observed contralateral
      to the microinjections. These effects were reversed by naloxone. The facial area
      scratched after microinjection of morphine was directly related to the injection
      site, with 1-mm changes in the location of the microinjection resulting in
      pronounced changes in the area of the face that the monkeys scratched. Systemic
      injection of chlorcyclizine produced only a small, transient attenuation of
      morphine's effect. CONCLUSIONS: Data from this study demonstrate that the MDH is
      a site where morphine acts to produce facial scratching in monkeys by acting at
      opioid receptors. It is also likely that the MDH is a site where centrally
      administered opioids act in producing facial pruritus in humans. The effects of
      morphine on facial-scratching behavior were only modestly attenuated with
      chlorcyclizine, indicating a minor involvement of a histamine-dependent mechanism
      of action.

PMID- 8363082
TI  - Anesthetics and automaticity in latent pacemaker fibers. IV. Effects of
      isoflurane and epinephrine or norepinephrine on automaticity of dominant and
      subsidiary atrial pacemakers in the canine heart.
AB  - BACKGROUND: Anesthesia and surgery may be associated with atrioventricular
      junctional or ventricular rhythm disturbances. These may be caused by alteration
      of automaticity of primary and subsidiary pacemakers. METHODS: The direct effects
      of isoflurane, alone or in combination with epinephrine (E) and norepinephrine
      (NE), as well as single effects of E and NE, were examined on automaticity of
      primary and subsidiary atrial pacemakers (SAP) using a perfused canine right
      atrial preparation (n = 29). Preparations were perfused with oxygenated Krebs'
      solution at a constant perfusion pressure of 87 mmHg and a temperature of 36.5 +/
      0.5 degrees C. Delivered concentrations of isoflurane of 1.4 and 2.8%
      corresponded to measured perfusate concentrations of 315 +/- 7 and 617 +/- 16
      microM in experiments with E (n = 14), and 316 +/- 10 and 610 +/- 26 microM in
      experiments with NE (n = 15). Epinephrine or NE perfusate concentrations were 2
      and 5 micrograms/l or 5 and 10 micrograms/l, respectively. To determine the site
      of earliest activation, extracellular recordings were made from the SA node
      region and distal sites (approximately 1, 2, and 3 cm) along the sulcus
      terminalis, the previously reported locations of SAP. Sites of earliest
      activation shifts from SA node to SAP were scored 1, 2, or 3 depending on the
      distance from the control pacemaker. The summed shift scores (magnitude score)
      were normalized by dividing by the total number of preparations for each
      experimental condition. RESULTS: Exposure to isoflurane, NE, or E alone did not
      produce a significant increase in the incidence of pacemaker shifts or normalized
      pacemaker shift scores. Only the high dose of E significantly increased the
      incidence of pacemaker shifts and normalized shift scores. Dysrhythmogenic
      potential of E and NE tended to be greater after earlier exposure to isoflurane.
      Every combination of isoflurane with E or NE produced a significant increase in
      the incidence of pacemaker shifts and normalized shift scores. CONCLUSIONS: It
      was concluded that isoflurane with E or NE acts synergistically to increase
      dysrhythmic potential in the arterial tissue.

PMID- 8363083
TI  - Comparative efficacy of antiarrhythmic agents in preventing halothane-epinephrine
      arrhythmias in rats.
AB  - BACKGROUND: Because the relative efficacy of antiarrhythmic agents on halothane
      epinephrine arrhythmias has not been well characterized, this study was
      undertaken to comparatively evaluate the antiarrhythmic action of Na(+)-, K(+)-
      and Ca(2+)-channel blockers on epinephrine-induced ventricular arrhythmias during
      halothane anesthesia in rats. METHODS: Rats were anesthetized at random with
      either halothane (1.5%), isoflurane (2.0%), or pentobarbital (50 mg/kg
      intraperitoneally), and the lungs were mechanically ventilated with oxygen. The
      rats were studied in three consecutive protocols. Protocol I determined the
      arrhythmogenic thresholds of epinephrine during the three types of anesthesia in
      33 rats. Protocol II determined the arrhythmogenic thresholds of epinephrine
      during halothane anesthesia in 64 rats receiving saline (control) or one of five
      antiarrhythmic agents. Protocol III measured the duration of epinephrine-induced
      arrhythmias during halothane anesthesia in 42 rats receiving saline (control) or
      one of five antiarrhythmic agents. RESULTS: In protocol I, the arrhythmogenic
      doses of epinephrine during halothane, isoflurane, or pentobarbital anesthesia
      were 1.7 +/- 3.2, 11.1 +/- 0.6, and 39.0 +/- 3.9 micrograms/kg, respectively, and
      the corresponding plasma concentrations were 4.3 +/- 0.8, 103.7 +/- 9.2, and
      246.7 +/- 28.9 ng/ml, respectively. In protocol II, the arrhythmogenic doses were
      similar in rats receiving saline and in those receiving lidocaine. The
      arrhythmogenic doses in rats receiving verapamil, flecainide (Na(+)- and K(+)
      channel blocker), E-4031 (K(+)-channel blocker), or amiodarone(K(+)-channel
      blocker with Na(+)-, Ca(2+)-, and beta-blocking activity) increased
      significantly, i.e., 4.2, 4.2, 5.5, and 31.7 times control (P < 0.01). In
      protocol III, lidocaine had no effect on the duration of arrhythmias. Flecainide,
      E-4031, and verapamil markedly reduced the duration of arrhythmias induced by
      epinephrine, 8 micrograms/kg intravenously (P < 0.01), whereas only amiodarone
      markedly reduced the duration of arrhythmias induced by epinephrine, 16
      micrograms/kg intravenously (P < 0.01). CONCLUSIONS: It was concluded that agents
      with K(+)-channel blocking properties were the most effective in preventing
      halothane-epinephrine arrhythmias in rats.

PMID- 8363084
TI  - Effects of ketamine on contraction and synthesis of inositol 1,4,5-trisphosphate
      in smooth muscle of the rabbit mesenteric artery.
AB  - BACKGROUND: Ketamine acts directly on vascular smooth muscle, causing relaxation.
      It has been suggested that the mechanism underlying this action involves an
      interference with transmembrane Ca2+ influx and an inhibition of Ca2+ release
      from intracellular Ca2+ stores. In vascular smooth muscle cells, agonist-induced
      Ca2+ release is thought to be mediated by an intracellular second messenger,
      inositol 1,4,5-trisphosphate (InsP3). To investigate the site at which ketamine
      acts on agonist-induced contraction, the authors studied the effects of ketamine
      on contraction and on the synthesis of InsP3 in smooth muscles of the rabbit
      mesenteric artery. METHODS: Changes in isometric tension of smooth muscle fibers
      were measured by attaching a thin circular strip from the rabbit mesenteric
      artery to a strain gauge. To measure the norepinephrine (NE)-induced production
      of InsP3, smooth muscle strips of the rabbit mesenteric artery were exposed to
      the agents and homogenized. Inositol 1,4,5-trisphosphate in the supernatant
      fractions was then assayed. RESULTS: Ketamine dose-dependently inhibited
      contractions induced by high K+, NE, and histamine in normal Krebs solution.
      Ketamine also inhibited the NE- or histamine-induced contraction in Ca(2+)-free
      solution containing 2 mM ethylene-glycol bis-(beta-aminoethylether)-N,N,N',N'
      tetraacetic acid (EGTA), indicating that this drug inhibits agonist-induced Ca2+
      release from intracellular stores. Norepinephrine (10 microM) transiently
      increased the synthesis of InsP3 in Ca(2+)-free solution, and ketamine (0.1-1.0
      mM) inhibited this effect, in a dose-dependent manner. CONCLUSIONS: These results
      indicate that, in the rabbit mesenteric artery, ketamine inhibits agonist-induced
      Ca2+ release through its inhibitory action on the agonist-induced synthesis of
      InsP3. Thus, it is possible that ketamine interferes with the synthesis of
      intracellular second messengers.

PMID- 8363086
TI  - Swallowing as a protective reflex for the upper respiratory tract.

PMID- 8363085
TI  - Hypothermic acid-base management does not affect cerebral metabolic rate for
      oxygen at 27 degrees C. A study during cardiopulmonary bypass in rabbits.
AB  - BACKGROUND: It has been contended that, during cardiopulmonary bypass at 27
      degrees C, pH-stat management decreases cerebral metabolic rate for oxygen
      (CMRO2) more than alpha-stat management. In contrast, other studies have not
      found CMRO2 to differ between techniques. Using each animal as its own control,
      the authors assessed the effect of alpha-stat versus pH-stat management of CMRO2,
      cerebral blood flow (CBF), and brain oxygen extraction during cardiopulmonary
      bypass at 27 degrees C. METHODS: Fourteen New Zealand White rabbits, anesthetized
      with fentanyl and diazepam, underwent cardiopulmonary bypass at 27 degrees C
      (membrane oxygenator, centrifugal pump, and bifemoral arterial perfusion). Group
      1 animals (n = 7) had alpha-stat management for the initial 65-70 min of bypass,
      and were then changed to pH-stat management for the remaining 30 min of bypass.
      Group 2 animals (n = 7) had pH-stat management for the initial 65-70 min of
      bypass, and were then changed to alpha-stat management for the remaining 30 min.
      Measurement of CBF (radiolabeled microspheres), CMRO2 (CBF x brain arterial
      venous oxygen content difference), brain temperature, systemic hemodynamics, and
      arterial blood gases were made in each animal under both alpha-stat and pH-stat
      conditions. RESULTS: CMRO2 did not differ between alpha-stat and pH-stat
      conditions (1.4 +/- 0.3 ml.100 g-1.min-1; median +/- quartile deviation), and was
      independent of order of determination. Changes in CBF between alpha-stat and pH
      stat conditions were associated with proportional opposite changes in cerebral
      oxygen extraction. Cerebral blood flow was significantly greater with pH-stat
      management than with alpha-stat management (37 +/- 5 vs. 30 +/- 3 ml.100 g-1.min
      1, respectively). The CBF response to changing PaCO2 was significantly greater
      when going from alpha-stat to pH-stat conditions (group 1) than in the reverse
      order (group 2). CONCLUSIONS: During cardiopulmonary bypass at 27 degrees C,
      hypothermic acid-base management has no measurable effect on CMRO2. CMRO2 was
      neither extraction limited nor dependent on either PaCO2, CBF, or hemoglobin
      oxygen affinity differences between alpha-stat and pH-stat management. Cerebral
      blood flow responses to changing CMRO2 depend on the "starting" conditions, with
      alpha-stat management appearing to better preserve CBF reactivity than pH-stat
      management.

PMID- 8363087
TI  - Transesophageal echocardiographic diagnosis of pulmonary artery catheter
      entrapment and coiling.

PMID- 8363088
TI  - Internal common gas line disconnect.

PMID- 8363089
TI  - Implantable cardiovertor/defibrillator placement in a patient with amiodarone
      pulmonary toxicity under thoracic epidural anesthesia.

PMID- 8363090
TI  - Effect of subarachnoid catheter position on the efficacy of intrathecal baclofen
      for spinal spasticity.

PMID- 8363091
TI  - Can flumazenil antagonize cardiac responses induced by midazolam.

PMID- 8363092
TI  - Prior vasectomy and anaphylaxis following protamine: no cause and effect.

PMID- 8363093
TI  - A normal cervical spine X-ray does not "clear" the patient with suspected
      cervical spine injury.

PMID- 8363094
TI  - A simple device to enable capnography during jet ventilation for laryngoscopy.

PMID- 8363095
TI  - Epidural versus intravenous fentanyl following thoracotomy.

PMID- 8363096
TI  - An evaluation of proposed graphical symbols for medical devices.

PMID- 8363097
TI  - Unattended continuous infusion of fentanyl for postoperative pain management.

PMID- 8363098
TI  - A new device to check the anesthesia machine low-pressure system.

PMID- 8363099
TI  - Unusual complication of nasotracheal suctioning.

PMID- 8363100
TI  - The importance of in vitro assay temperature when using volatile anesthetics.

PMID- 8363101
TI  - Unequivocal determination of sire allele origin for multiallelic microsatellites
      when only the sire and progeny are genotyped.
AB  - The effect of a segregating economic trait locus (ETL) can be detected with the
      aid of a linked genetic marker, if specific alleles of each locus are in
      association among the individuals genotyped for the genetic marker. For dairy
      cattle this can be achieved by application of the 'granddaughter design'. If only
      the sires and their sons are genotyped for the genetic markers, then the allele
      origin of sons having the same genotypes as their sires cannot be determined.
      Seven sires and 101 sons were genotyped for five microsatellites. The mean
      frequency of heterozygous sires was 77%. The mean number of alleles per locus was
      8.2. Frequency of informative sons per locus ranged from 60% to 80% with a mean
      of 72%. With highly polymorphic microsatellites, at least 60% more grandsire
      families can be included in the analysis, and the number of sons assayed can be
      reduced by 40%, as compared to diallelic markers.

PMID- 8363102
TI  - Sequence variation in D-loop mtDNA of cow lineages selected for high and low
      maternal effects on milk production.
AB  - The four highest and four lowest cow lineages for milk production were selected
      from 324 maternal lineages of the Israeli Holstein population. For a single cow
      from each lineage, the mitochondrial D-loop region was amplified using the
      polymerase chain reaction and directly sequenced for 719bp. Eighteen polymorphic
      sites were found of which 17 were substitutions and one was an insertion. Only
      two alleles were found for each polymorphic site, one of which corresponded to
      the sequence of Anderson et al. (1982), which was the more frequent allele, in
      all but two sites. None of the polymorphic sites had an apparent effect on milk
      production, even though an effect > or = 0.33 phenotypic standard deviations,
      equivalent to 470 kg milk, could be detected by this experimental design.
      Furthermore, there was no indication that moderately increasing the sample size
      would have altered the result, since all rare alleles found in more than a single
      lineage were found in both the high and low subgroups.

PMID- 8363103
TI  - DNA sequence analysis of serologically detected ELA class II haplotypes at the
      equine DQ beta locus.
AB  - The genetic diversity at the ELA DQ beta locus was investigated using polymerase
      chain reaction and DNA sequencing. Based upon serological methods 16 class II
      homozygous animals were selected and their genomic DNA was used. A DQ beta gene
      from an equine cDNA library was also sequenced. Our methodology and the
      similarity between the genomic and the cDNA sequences suggest that the studied
      locus is expressed on equine lymphocytes. In the predicted amino acid sequence
      the most extensive variation is located at residues 56-60. The pattern of these
      five amino acids is strongly correlated to the serological ELA class II
      specificities (W13, W22, W23, Be200). The alleles corresponding to the W23
      specificity are the most divergent among the equine DQ beta alleles and also from
      other mammalian DQ beta sequences.

PMID- 8363104
TI  - Common swine leucocyte antigen (SLA) haplotypes in NIH and Sinclair miniature
      swine have similar effects on the expression of an inherited melanoma.
AB  - Mixed lymphocyte culture and serological typing of NIH and Sinclair miniature
      swine indicate that the two herds share a common SLA haplotype. NIH haplotype a
      (International Haplotype H10) appears identical to Sinclair haplotype B, which
      has significant effects on the penetrance of Sinclair swine cutaneous malignant
      melanoma (SSCM). Offspring of crosses between melanoma-bearing Sinclair swine
      homozygous for the B haplotype and non-melanoma NIH aa swine have tumour
      incidence identical to Sinclair melanoma BB x Sinclair non-melanoma BB offspring.
      Our results provide further support for the involvement of the swine leucocyte
      antigen (SLA) complex in the inheritance of SSCM, and identify a new source of
      non-tumour animals that have all of the genes for SSCM except those at the tumour
      initiator locus.

PMID- 8363105
TI  - Haemoglobin I: a new beta-globin chain variant found in sheep of Italian breeds.
AB  - A rather common haemoglobin variant was detected in the Sardinian and Altamurana
      sheep breeds. The mutated globin chain appears to be produced under the control
      of an allele at the HBB locus and due to a neutral amino acid substitution. The
      variant will be provisionally referred to as the Hb I.

PMID- 8363107
TI  - A new bovine dinucleotide repeat microsatellite: microsatellite INRA 18.

PMID- 8363106
TI  - Ovine microsatellites at the OarAE16, OarAE54, OarAE57, OarAE119 and OarAE129
      loci.

PMID- 8363108
TI  - A new bovine dinucleotide repeat microsatellite: microsatellite INRA 30.

PMID- 8363109
TI  - Ovine microsatellites at the OarHH35, OarHH41, OarHH44, OarHH47 and OarHH64 loci.

PMID- 8363110
TI  - Ovine microsatellites at the OarVH98, OarVH110, OarVH116, OarVH117 and OarVH130
      loci.

PMID- 8363111
TI  - Ovine microsatellites at the OarVH34, OarVH41, OarVH58, OarVH61 and OarVH72 loci.

PMID- 8363112
TI  - Effect of standard-dose versus high-dose epinephrine on myocardial high-energy
      phosphates during ventricular fibrillation and closed-chest CPR.
AB  - STUDY OBJECTIVE: To evaluate the effects of standard-dose versus high-dose
      epinephrine on myocardial high-energy phosphate metabolism during resuscitation
      from cardiac arrest. DESIGN: Prospective, nonrandomized, controlled study using a
      swine model of cardiac arrest and resuscitation. INTERVENTIONS: After anesthesia,
      intravascular pressure instrumentation, and ten minutes of ventricular
      fibrillation arrest, closed-chest CPR was begun. After three minutes of CPR,
      animals were allocated to receive either 0.02 mg/kg i.v. standard-dose
      epinephrine (eight) or 0.2 mg/kg i.v. high-dose epinephrine (nine). The animals
      underwent thoracotomy and rapid-freezing transmural myocardial core biopsy for
      high-energy phosphate analysis 3.5 minutes after epinephrine administration. High
      energy phosphate values were blindly determined using high-pressure liquid
      chromatography. RESULTS: Intravascular pressure (mm Hg) and high-energy phosphate
      (nmol/mg protein) results for standard-dose epinephrine versus high-dose
      epinephrine are, respectively, coronary perfusion pressure, 15.3 +/- 7.8 versus
      23.7 +/- 5.5 (P = .0009); phosphocreatine, 0.4 +/- 0.8 versus 6.2 +/- 4.4 (P =
      .0003); adenosine triphosphate, 9.8 +/- 4.8 versus 12.7 +/- 5.7 (P = .30);
      adenosine diphosphate, 5.4 +/- 2.1 versus 6.1 +/- 1.3 (P = .41); and adenylate
      charge, 0.68 +/- 0.12 versus 0.72 +/- 0.12 (P = .87). CONCLUSION: High-dose
      epinephrine does not deplete myocardial high-energy phosphate when given in this
      model of prolonged ventricular fibrillation. High-dose epinephrine increases
      coronary perfusion pressure compared with standard-dose epinephrine. High-dose
      epinephrine administration repletes phosphocreatine during closed-chest CPR,
      thereby increasing myocardial energy stores.

PMID- 8363113
TI  - Use of activated charcoal in a simulated poisoning with acetaminophen: a new
      loading dose for N-acetylcysteine?
AB  - STUDY OBJECTIVES: To investigate the ability of a supranormal dose of N
      acetylcysteine to overcome the effects of activated charcoal on N-acetylcysteine
      bioavailability and to determine the effects of activated charcoal on serum
      acetaminophen levels. DESIGN, SETTING, AND PARTICIPANTS: Ten healthy adult
      volunteers participated in a controlled cross-over experiment. During phase I
      (control), subjects ingested 3 g acetaminophen, followed one hour later by the
      normal loading dose of N-acetylcysteine (140 mg/kg). During phase II (charcoal),
      subjects ingested 3 g acetaminophen, followed one hour later by 60 g activated
      charcoal and a supranormal loading dose of N-acetylcysteine (235 mg/kg). MAIN
      OUTCOME MEASURES: Serum levels of N-acetylcysteine were measured every 30 minutes
      for six hours. A serum acetaminophen level was measured at four hours. RESULTS:
      The area under the curve for N-acetylcysteine was significantly higher for phase
      II than phase I (P < .05, two-tailed paired t-test). Peak N-acetylcysteine and
      time to peak were not significantly different. The four-hour serum acetaminophen
      level was significantly lower for phase II than phase I (P < .05, two-tailed
      paired t-test). Diarrhea occurred during both phases, but N-acetylcysteine was
      otherwise well tolerated. CONCLUSION: These results suggest that activated
      charcoal can be used safely for victims of acetaminophen overdose. A beneficial
      effect in preventing acetaminophen absorption can be expected if it is given
      within one hour after ingestion. If N-acetylcysteine is needed because of a toxic
      serum acetaminophen level, bioavailability can be ensured by increasing the N
      acetylcysteine loading dose from 140 mg/kg to 235 mg/kg.

PMID- 8363114
TI  - Cyanide and methemoglobin kinetics in smoke inhalation victims treated with the
      cyanide antidote kit.
AB  - STUDY OBJECTIVE: To evaluate serial cyanide, methemoglobin, and carbon monoxide
      levels in smoke inhalation patients. SETTING: Regional poison center and regional
      toxicology treatment center. PARTICIPANTS: Seven critically ill smoke inhalation
      patients referred to the regional poison center. INTERVENTIONS: Peak level and
      half-life were determined by obtaining serial carboxyhemoglobin, cyanide, and
      methemoglobin levels. RESULTS: The mean observed half-life of cyanide was 3.0 +/-
      0.6 hours. Methemoglobinemia was evaluated in four patients after sodium nitrite
      administration. The peak measured methemoglobin levels (mean, 10.5% +/- 2%;
      range, 7.9% to 13.4%) did not occur until a mean of 50 minutes (range, 35 to 70
      minutes) following administration of sodium nitrite. The total oxygen-carrying
      capacity reduced by the combination of carboxyhemoglobin and methemoglobin was
      never more than 21% (range, 10% to 21%) in this series. CONCLUSION: The
      administration of sodium nitrite to smoke inhalation patients in the presence of
      concomitant carbon monoxide poisoning may be relatively safe.

PMID- 8363116
TI  - Fellowship programs in medical toxicology.

PMID- 8363115
TI  - Double-blinded comparison of diphenhydramine versus lidocaine as a local
      anesthetic.
AB  - STUDY OBJECTIVE: To evaluate the efficacy, onset of action, duration of action,
      and side effects of 1% diphenhydramine compared with 1% lidocaine when used as a
      local anesthetic agent. DESIGN: Prospective, double-blinded, cross-over study.
      SETTING: Emergency medicine residency program, research section. PARTICIPANTS:
      Ten healthy male volunteers, aged 26 to 38 years old. INTERVENTIONS: Baseline
      levels of sensation to pinprick (18-gauge needle) within a 2.4-cm-diameter
      midvolar forearm area and levels of sedation were recorded on 10.2-cm visual
      analog scales. Subjects then underwent subcutaneous infiltration of 20 mg (2 mL)
      of the study agent using a 27-gauge needle. Visual analog scale sensation and
      sedation scores were recorded at five, ten, and 15 minutes and then every 15
      minutes until return to baseline. Subjects were studied one week later with the
      alternate agent. Nonparametric data were analyzed using the Mann-Whitney U test
      with significance at P < .05. RESULTS: No significant differences in mean
      pinprick sensation were seen from baseline to 30 minutes. Significant differences
      were seen at 45 (P = .036) and 60 minutes (P = .036). The mean duration of
      effective anesthesia was significantly longer for lidocaine than diphenhydramine
      (81 versus 42 minutes, P = .028). No significant differences were seen in the
      sedation scores or in the frequencies of local reactions. One subject developed
      skin necrosis at the injection site with diphenhydramine. CONCLUSION: The
      duration of local anesthesia for 1% lidocaine was significantly longer and the
      depth of anesthesia after 30 minutes was significantly higher than that of 1%
      diphenhydramine. Diphenhydramine resulted in skin necrosis in one test subject.

PMID- 8363117
TI  - Blood pressure during the first minutes of focal cerebral ischemia.
AB  - STUDY OBJECTIVE: To determine whether blood pressure declines spontaneously
      during the first minutes and hours of focal cerebral ischemia. DESIGN: Multiple
      blood pressure measurements as part of an urgent stroke therapy trial (treatment
      within 90 minutes of stroke onset). SETTING: Thirteen hospitals in three
      metropolitan communities. PARTICIPANTS: Sixty-nine patients (mean age, 65 +/- 9
      years) with acute ischemic stroke who were participants in a phase I urgent
      stroke therapy trial of recombinant tissue plasminogen activator. MAIN OUTCOME
      MEASURE: Blood pressures recorded at the scene of stroke by life-squad personnel,
      in the emergency department, and in the ICU. RESULTS: The mean time from stroke
      onset to the time of first blood pressure measurement was 19 +/- 13 minutes.
      Twenty-four of the 69 patients in the urgent stroke therapy trial had an initial
      systolic blood pressure of at least 160 mm Hg. Of these, 23 had a significant
      decline in systolic and diastolic blood pressure during the first 90 minutes
      after the onset of stroke (mean change in systolic pressure, -29 +/- 22 mm Hg, P
      < .001; mean change in diastolic pressure, -10 +/- 14 mm Hg, P < .01). No
      patients received antihypertensive therapy during the time in which the decline
      in blood pressure was noted. CONCLUSION: Mildly or moderately elevated blood
      pressure frequently declines spontaneously during the first minutes and hours of
      focal cerebral ischemia and generally does not require urgent pharmacologic
      treatment.

PMID- 8363118
TI  - Safety assessment of high-dose narcotic analgesia for emergency department
      procedures.
AB  - STUDY OBJECTIVE: To evaluate the safety of high-dose IV narcotics in patients
      requiring analgesia for painful emergency department procedures. DESIGN:
      Prospective multicenter clinical trial. SETTING: Five adult urban EDs. METHODS
      AND MEASUREMENTS: All patients received IV meperidine (1.5 to 3.0 mg/kg) titrated
      to analgesia followed by a painful procedure. Vital signs and alertness scale
      were recorded at regular intervals, and patients were observed for four hours.
      Adverse events were monitored and documented. Comparisons between baseline and
      postanalgesia intervals were made with a repeated measures ANOVA (Dunnett's
      test). RESULTS: Although statistically significant changes in vital signs and
      alertness scale occurred, they were not clinically significant. Opiate reversal
      with naloxone was not needed in any patient, and no significant respiratory or
      circulatory compromise occurred. CONCLUSION: This study of 72 patients
      demonstrates that high-dose narcotic analgesia is appropriate, well tolerated,
      and safe when used in selected patients before painful procedures in the ED.
      Narcotic antagonists and resuscitation equipment nonetheless should be available
      to maximize safety.

PMID- 8363119
TI  - Reference accuracy in the emergency medicine literature.
AB  - STUDY OBJECTIVE: To determine the incidence and nature of errors in the citation
      and quotation of references contained in the emergency medicine literature.
      DESIGN: A retrospective analysis of a random sample of articles and references
      found in the three major emergency medicine journals. SETTING: A
      university/county hospital. METHODS: We examined single issues of three emergency
      medicine journals: Annals of Emergency Medicine, Journal of Emergency Medicine,
      and American Journal of Emergency Medicine. INTERVENTIONS: None. MEASUREMENTS:
      Four independent reviewers assessed 145 references from 46 referring authors for
      citational and quotational accuracy. MAIN RESULTS: Major and minor citation
      errors were found in 10.3% and 17.2% of reference listings, respectively.
      Qualitative quotational errors were found in 35.2% of references. Eighty-two
      percent of these errors were considered to be major. Quantitative quotational
      errors were found in 47% of references reviewed. Secondary rather than primary
      reference sources were used in 41.4% of references reviewed. CONCLUSION: This
      study demonstrates a substantial error rate in the citation and quotation of
      reference sources in the emergency medicine literature. In addition, verification
      of primary source material was not done by a large percentage of the authors
      reviewed. Recommendations for improving the accuracy of the emergency medicine
      literature are offered.

PMID- 8363120
TI  - Unusual etiology for left flank pain in a 29-year-old man.

PMID- 8363121
TI  - An introduction to the use of interim data analyses in clinical trials.
AB  - During a controlled clinical trial, data accumulate that contain information on
      the relative efficacy of the two treatments, yet these data often are not
      inspected or analyzed until the planned sample size has been reached and the
      trial has been terminated. This type of fixed-sample-size trial design, with a
      single terminal data analysis, has the ethical disadvantage that more patients
      than are necessary to obtain a reliable result may be randomized to the less
      efficacious treatment, whichever one that turns out to be. Thus, it often is
      desirable to schedule one or more analyses of the data, to be conducted before
      planned termination, to see if a reliable conclusion may be drawn from the data
      and the trial terminated early. Such analyses are called interim analyses. When
      interim analyses occur after each of severe relatively large groups of patients,
      the trial is called a group-sequential trial. Interim data analyses must be
      planned in advance to avoid increasing the risk of committing a Type I error and
      to achieve adequate power. This article introduces the statistical issues
      involved in the planning of interim data analyses and the design of group
      sequential clinical trials.

PMID- 8363122
TI  - Accidental administration of activated charcoal into the lung: aspiration by
      proxy.
AB  - We report a case of accidental activated charcoal instillation into the lung of a
      30-year-old man being managed for a cyclic antidepressant overdose. The patient
      was treated with multidose activated charcoal, and between his first and second
      doses, he pulled his nasogastric tube out of position. The tube was reinserted
      past the endotracheal tube into the right mainstem bronchus, and a dose of
      activated charcoal with sorbitol was administered into the lung. He subsequently
      developed an adult respiratory distress syndrome but gradually improved after
      bronchoscopic removal of charcoal and supportive care. He was discharged 14 days
      later.

PMID- 8363123
TI  - Propranolol treatment of albuterol poisoning in two asthmatic patients.
AB  - The cases of two asthmatic adolescents who overdosed on albuterol are presented.
      Both patients were tremulous, tachycardic, and hypokalemic. Both were treated
      successfully with IV propranolol. Neither patient developed bronchospasm. The
      toxicity of albuterol overdoses and its treatment are discussed.

PMID- 8363124
TI  - Spontaneous clostridial myonecrosis with abdominal involvement in a
      nonimmunocompromised patient.
AB  - Spontaneous clostridial myonecrosis is a rare but aggressive disease usually
      associated with underlying immunosuppression or malignancy. We present a fatal
      case of clostridial myonecrosis arising in a patient with intact immune defenses.

PMID- 8363125
TI  - Fatality secondary to massive overdose of dimenhydrinate.
AB  - A 19-year-old woman presented with status epilepticus and ventricular
      dysrhythmias less than one hour after ingesting 5,000 mg dimenhydrinate
      (Dramamine). Aggressive resuscitation including the use of physostigmine
      stabilized the cardiac rhythm; however, she suffered a severe neurologic deficit.
      Development of ischemic and infarcted bowel necessitated colonic resection. After
      surgery, her condition worsened, and after demonstration of minimal cerebral
      activity, supportive measures were withdrawn, and she died. Overdose with
      dimenhydrinate and diphenhydramine, both of which are over-the-counter drugs, can
      result in rapid central nervous system stimulation, including status epilepticus.
      Death can occur within two hours. To our knowledge, this is the first reported
      fatality resulting from ingestion of dimenhydrinate.

PMID- 8363126
TI  - Phenytoin toxicity from smoking crack cocaine adulterated with phenytoin.
AB  - Drugs of abuse often are adulterated with agents designed to lower cost or alter
      the intoxication. Recently, we began to hear of the intentional addition of
      phenytoin to crack cocaine. We report the cases of five patients with measurable
      phenytoin levels attributable to smoking crack cocaine adulterated with
      phenytoin. Three of these patients presented with signs, symptoms, and phenytoin
      levels consistent with phenytoin toxicity. Clinicians should be aware of this
      practice when faced with cocaine users with altered mental status, ataxia, or
      nystagmus.

PMID- 8363127
TI  - The role of calcium gluconate in the treatment of hydrofluoric acid eye burn.
AB  - Hydrofluoric acid is used for different purposes in industry and in the home as a
      rust remover. Most exposures are accidental and may result in severe superficial
      and deep tissue injury as well as systemic toxicity. There is uncertainty
      regarding the optimal treatment of hydrofluoric acid eye injury. A patient in
      whom a solution of 49% hydrofluoric acid induced a large corneal erosion is
      described. Repeated instillation of 1% calcium gluconate eye drops combined with
      the conventional treatment of acid eye burns resulted in a complete and quick
      recovery.

PMID- 8363128
TI  - On credentials and manpower in emergency medicine.

PMID- 8363129
TI  - On credentials and manpower in emergency medicine.

PMID- 8363130
TI  - On credentials and manpower in emergency medicine.

PMID- 8363131
TI  - On credentials and manpower in emergency medicine.

PMID- 8363132
TI  - On credentials and manpower in emergency medicine.

PMID- 8363133
TI  - On credentials and manpower in emergency medicine.

PMID- 8363134
TI  - On credentials and manpower in emergency medicine.

PMID- 8363135
TI  - On credentials and manpower in emergency medicine.

PMID- 8363136
TI  - On credentials and manpower in emergency medicine.

PMID- 8363137
TI  - On credentials and manpower in emergency medicine.

PMID- 8363138
TI  - On credentials and manpower in emergency medicine.

PMID- 8363139
TI  - On credentials and manpower in emergency medicine.

PMID- 8363140
TI  - On credentials and manpower in emergency medicine.

PMID- 8363141
TI  - [Therapeutic aspects of hypercholesterolemia in childhood].

PMID- 8363142
TI  - [Food preferences among students].
AB  - The results of a food preference survey using a questionnaire on 2,567
      schoolchildren of sixth, seventh and eighth grade (11 to 14 years of age) from 26
      public schools in the city of Barcelona (Spain) are presented. Foods based on
      potatoes and cereals have the maximum acceptability, followed by dairy and meat
      products. Chicken is the meat with highest acceptance. Fish has a medium
      acceptance, and preference for dry beans and peas, fruits and vegetables is
      lower, although it is high for some specific foods. Important differences among
      sexes are observed. Boys have higher preference for meat, milk and yogurt, and
      girls for fish and some vegetables. Differences among genders increase with
      increasing age. These results are relevant for planning interventions on diet in
      schools from a health promotion perspective, and for the planning of school lunch
      programs.

PMID- 8363143
TI  - [Maternity ward routines in Barcelona].
AB  - Twenty-one maternity wards in Barcelona were visited in order to evaluate the
      degree of compliance with the OMS/UNICEF guidelines for breast-feeding
      protection. Breast-feeding is initiated within the first hour after birth in only
      2 of these hospitals. In only 5 cases is demand feeding encouraged. In only 6 of
      these maternity wards do the newborn babies remain with their mothers all day
      long and in only one are newborn babies not given water or dextrose. In only two
      hospitals is the pacifier discouraged. Furthermore, only two of the hospitals do
      not receive free formula supplies from the industry. Immediate changes are needed
      if the mother's right to breast-feed is to be protected.

PMID- 8363144
TI  - [Severe bone malformations in fetal valproic acid disease].
AB  - The dysmorphogenic and teratogenic effects of valproic acid, when administered to
      pregnant women, have been noted in several reports. We report the case of a 3
      month-old infant with multiple congenital anomalies, including severe skeletal
      malformations, congenital heart defect and facial dysmorphism, whose mother was
      treated with valproic acid (1000 mg/day) throughout the pregnancy. This is the
      second published case reporting major skeletal malformations and supports the
      possible teratogenic effects of valproic acid.

PMID- 8363145
TI  - [Severe malformations associated with congenital diaphragmatic hernia:
      conditioning factors for mortality].
AB  - We have retrospectively reviewed the clinical records of 42 newborns with
      congenital diaphragmatic hernia (CDH) treated in our Neonatal Unit between
      January 1974 and December 1991. In 20 of the children, the CDH was associated
      with other malformations, which were major in 11 cases (26.2%). The malformations
      which occurred most frequently were cardiovascular, followed by chromosomal
      anomalies and those affecting the central nervous system (CNS). All of the
      newborns with major malformations are included in the high risk group or those
      with early diagnosis. Overall mortality was 57.1%. Nine out of the 11 cases with
      major malformations died (81.8%).

PMID- 8363146
TI  - [Angelman syndrome. Early diagnosis].
AB  - We report two patients who were less than two years old that were diagnosed as
      having Angelman syndrome. Cytogenetic confirmation of the disease was performed.
      We emphasize clinical and electroencephalographic features in infants that allow
      an early diagnosis of this syndrome and allow for prompt genetic counseling.

PMID- 8363148
TI  - [Magnetic resonance++ with gadolinium in Sturge Weber syndrome].
AB  - We report four patients with Sturge Weber syndrome in which the pial angioma was
      visualized better with Gd-DOTA enhanced MR imaging. MR alone demonstrated
      thickened cortex with diminished convolutions, abnormal white matter and
      prominent subependymal veins. However, Gd-DOTA enhanced MR imaging improved the
      visualization of the angioma, localizing and demonstrating the extent of the
      malformation in Sturge Weber syndrome. We believe that this is the procedure of
      choice to recognize the extent of the intracranial involvement and which would
      help to select those patients that would benefit from surgical treatment.

PMID- 8363147
TI  - [C-peptide in cord blood from macrosomatic and low birth weight for gestational
      age newborns].
AB  - Forty-six newborn babies (11 macrosomic, 11 small-for-dates and 24 of normal
      weight) have been prospectively studied. The levels of C-peptide in the umbilical
      blood were determined and the results were statistically analyzed for
      relationships to several perinatal variables of the mother, newborn and placenta.
      A positive correlation between C-peptide levels and neonatal weight, newborn
      ponderal index and maternal weight-gain during gestation were observed. Some
      other variables strongly related to neonatal infant weight (maternal weight, net
      placental weight and placental volume) were independent of C-peptide levels.

PMID- 8363149
TI  - [Homocystinuria: effectiveness of the treatment with pyridoxine, folic acid, and
      betaine].
AB  - We present the results achieved with vitamin (pyridoxine and folic acid) and
      betaine (trimethyl-glycine) treatment of three patients with homocystinuria.
      Cases 1 and 2 were detected by having clinical findings suggestive of the disease
      (ocular and orthopedic alterations) and case 3 was diagnosed after a family
      metabolic screening was done. All presented a positive Brand's test and an
      abnormal elevation of plasma and urine homocysteine, as well as high methionine
      and low cystine levels in the plasma. Initially, when pyridoxine (600 mg/d) and
      folic acid (10 mg/d) were given for one month, a partial fall in the homocysteine
      levels was observed in cases 2 and 3, but not in case 1. When betaine was added
      (6 g/d), homocysteine disappeared from the plasma after the first month in cases
      2 and 3, but only after the third month in case 1. Case 1 also showed a moderate
      clinical improvement in behavior and school performance. The treatment was
      maintained for two years in case 1, and for one year in cases 2 and 3. After
      betaine therapy, no disturbances were observed in the hepatic, renal and bone
      marrow functions, nor were there any clinically relevant ill-effects. These
      findings show that betaine offers a therapeutic alternative in the treatment of
      this disease, independent of the patient's response to pyridoxine.

PMID- 8363150
TI  - [Neonatal conjunctivitis: microbiologic study and antibiotic sensitivity].
AB  - We have analyzed retrospectively fifty conjunctival samples from infants less
      than one month of age affected with conjunctivitis. Of these samples, 84% had a
      positive bacterial culture, with the microorganisms isolated, in order of
      frequency, being: Staphylococcus epidermidis (14%), Staphylococcus aureus (14%),
      Streptococcus pneumoniae (12%), Haemophilus sp, Chlamydia and alpha-hemolytic
      Streptococcus (8%). All of these showed a high sensitivity to most of the drugs
      tested, except to penicillin and its derivatives. Cefotaxime, ceftriaxone and
      ciprofloxacin showed the highest in vitro activities. Of the pharmacological
      ophthalmic preparations commercially available in our country, sulfonamides,
      chloramphenicol, rifampicin, erythromycin and tobramycin are the agents more
      active against the bacteria described above.

PMID- 8363151
TI  - [Organochlorine compounds: blood levels in mothers, newborns, and infants, in
      maternal milk and formula. Study in the province of Huelva].
AB  - We have studied the presence of organochlorine compounds (OCC), DDT, HCB, HCH and
      isomers alpha, beta and gamma or lindane, hepta-chloro-epoxide (HE) and
      polychlorobiphenyl compounds (PCB), in 50 mothers and their newborn babies. The
      samples studied included the umbilical cord blood, blood from the mothers during
      the delivery, blood from the baby at one and three months of age, and the milk
      fed to the babies at these periods (breast n = 30; bottle n = 20). The objectives
      of the study were: 1) To detect the levels of OCC in the different samples. 2) To
      discover the difference in levels between breast and bottle fed babies. 3) To
      quantify the variations of the levels in the different samples. 4) To check
      whether the acceptable daily intake (ADI) established for these OCC is exceeded
      among these babies. The analyses were done in the National Institute of
      Toxicology in Seville, by using the following methods, gas chromatography,
      electron capture detector and mass spectrometry. The statistical analysis was
      based on the Kruskal-Wallis, Shapiro-Wilks, Levene, Pooled and Separate tests. We
      have found significant levels of OCC in the samples analyzed. The PCBs are the
      compounds in our study which have the highest levels, indeed being one of the
      highest levels documented to date. We verify the decline in OCC of agricultural
      origin in relation to previous reports in our country, as has also been reflected
      in the international literature in recent years. The levels of OCC in breast fed
      babies are significantly higher than those in bottle fed babies.

PMID- 8363152
TI  - [Study of Navarra (PECNA). Correlation of arterial blood pressure, in a child
      young population, with anthropometric and biochemical parameters].
AB  - As part of an epidemiological study on cardiovascular risk factors among children
      and adolescent in Navarra, arterial blood pressure (BP) readings were taken in
      5,829 children. These children, both males and females, between the ages of 4 and
      17 years, were selected at random from the public and private school population
      in our community. The correlation between systolic blood pressure and diastolic
      blood pressure with anthropometric and biochemical parameters was analyzed. The
      correlation coefficient for systolic BP readings were always higher than those
      for diastolic BP. The highest correlations for both BP scores were found with
      weight, followed by height. Correlation with total weight parameters is superior
      to that found with body fat parameters. There were no significant correlations
      between BP and the lipid parameters. When analyzing multiple regression
      equations, we find that with only the child's weight and age, both systolic and
      diastolic BP can be predicted with correlation coefficients of 0.597 and 0.492,
      respectively. When doing a partial correlation analysis, the correlation between
      systolic BP and age, at a fixed height value, disappears; while the correlation
      of systolic BP with height remains when using a set age. This suggest that the
      best definition for hypertension is based on BP-height percentile, rather than BP
      age.

PMID- 8363153
TI  - [Coffin-Siris syndrome. Review of the literature].

PMID- 8363154
TI  - [Incidence of Candida infections in very low birth weight newborns. Importance of
      an early diagnosis and evaluation of therapeutic approaches].

PMID- 8363155
TI  - [Omphalocele and gastroschisis. Report of 14 cases].

PMID- 8363156
TI  - [Seckel syndrome: study of 2 new cases].

PMID- 8363157
TI  - [Bullous mastocytosis (diffuse cutaneous mastocytosis): report of a case and
      review of the literature].

PMID- 8363158
TI  - [Treatment with imipenem-cilastatin in a girl with resistant pneumococcal
      meningitis].

PMID- 8363160
TI  - [Congenital postero-medial angulation of the tibia].

PMID- 8363159
TI  - [Ileal ulcer as a cause of rectal hemorrhage].

PMID- 8363161
TI  - [Congenital adrenal gland hypoplasia with sudden death in an 18-month-old child.
      Necropsy study].

PMID- 8363162
TI  - [Mediastinal tubercular abscess].

PMID- 8363163
TI  - [Acute airway obstruction in an infant, secondary to laterocervical abscess].

PMID- 8363164
TI  - Efficacy of psyllium in reducing serum cholesterol levels in hypercholesterolemic
      patients on high- or low-fat diets.
AB  - OBJECTIVES: To determine the efficacy of psyllium in reducing serum cholesterol
      levels in patients on high- or low-fat diets. DESIGN: Double-blind, placebo
      controlled, 16-week parallel trial. The study included an 8-week baseline period
      and an 8-week treatment period. PATIENTS: Healthy men and women, 21 to 70 years
      old, with primary hypercholesterolemia (total serum cholesterol > or = 5.7 mmol/L
      [220 mg/dL]). Thirty-seven participants followed a high-fat diet and 81
      participants followed a low-fat diet. INTERVENTION: Participants were randomly
      assigned to either psyllium, 5.1 g twice a day, or placebo. MEASUREMENTS: Fasting
      lipid and apolipoprotein concentrations, including direct low-density lipoprotein
      (LDL) cholesterol quantification; nutritional analyses of 4 days of 7-day food
      records to monitor dietary compliance; and physical examinations, clinical
      chemistry and hematologic studies, and urinalysis to assess treatment safety.
      MAIN RESULTS: Psyllium recipients in both the high- and low-fat diet groups
      showed small but significant decreases (P < 0.05) in total cholesterol and low
      density lipoprotein (LDL) cholesterol levels. Total cholesterol and LDL
      cholesterol levels decreased 5.8% and 7.2%, respectively, in psyllium recipients
      on high-fat diets and 4.2% and 6.4%, respectively, in psyllium recipients on low
      fat diets. No significant difference was seen in LDL cholesterol response when
      psyllium recipients on low- and high-fat diets were compared (P >  0.2). No
      significant reductions in lipid levels were observed in placebo recipients. Based
      on the National Cholesterol Education Program LDL cholesterol classification
      system, 39% of the psyllium recipients improved in LDL cholesterol classification
      (P < 0.0001) compared with 20.3% of placebo recipients (P > 0.2). CONCLUSIONS:
      Psyllium produces a modest but significant improvement in total cholesterol and
      LDL cholesterol levels in persons on either low-fat or high-fat diets. Psyllium,
      when added to a prescribed low-fat diet, may obviate the need for typical lipid
      lowering medications or may prove to be a valuable adjunct to other treatments in
      patients with moderately elevated LDL cholesterol levels.

PMID- 8363165
TI  - A linoleate-enriched cheese product reduces low-density lipoprotein in moderately
      hypercholesterolemic adults.
AB  - OBJECTIVE: To test the effect of substituting a modified-fat cheese product into
      the diets of hypercholesterolemic adults. DESIGN: A 4-month, randomized, double
      blind, crossover substitution trial. SETTING: General community outpatient study.
      PARTICIPANTS: Twenty-six healthy adult volunteers (17 men, 9 women) with moderate
      hypercholesterolemia (total cholesterol > 5.69 mmol/L but < 7.24 mmol/L).
      INTERVENTION: Daily substitution of 100 g of cheese, either partial skim-milk
      mozzarella or modified-fat (vegetable oil) mozzarella cheese product, into
      participants' normal diets. Participants consumed an assigned cheese for 2
      months, at which time they crossed over to consume the other study cheese. MAIN
      OUTCOME MEASURES: Plasma lipid and apolipoprotein levels were measured at
      baseline and at 2 and 4 months after initiation of the study. Compliance was
      assessed by body weight and by biweekly dietary records and interviews. RESULTS:
      No differences in weight or in the amount or type of calories consumed were found
      during the study. No statistically significant changes in lipid values resulted
      from consumption of mozzarella cheese. Modified-fat cheese substitution resulted
      in a decreased low-density lipoprotein cholesterol level when compared with
      levels at both baseline (-0.28 mmol/L; 95% Cl, -0.14 to -0.42 mmol/L) and during
      consumption of the skim-milk mozzarella cheese (-0.38 mmol/L; 95% Cl, -0.2 to 
      0.70 mmol/L). Findings for total cholesterol were similar. High-density
      lipoprotein cholesterol, plasma triglyceride, and apolipoprotein A-l and B-100
      levels were unaltered. Both sexes responded similarly. CONCLUSIONS: A linoleate
      enriched cheese product, in the absence of any other changes in diet or habits,
      substituted into the normal diets of hypercholesterolemic adults reduced low
      density lipoprotein and plasma cholesterol levels.

PMID- 8363166
TI  - Prosthetic valve endocarditis resulting from nosocomial bacteremia. A
      prospective, multicenter study.
AB  - OBJECTIVE: To determine the incidence of endocarditis in bacteremic patients with
      prosthetic heart valves and the risk factors for and the effect of duration of
      antibiotic therapy on development of endocarditis in such patients. DESIGN:
      Multicenter, prospective observational study. SETTING: Six university teaching
      hospitals with high-volume cardiothoracic surgery. PARTICIPANTS: One hundred
      seventy-one consecutive patients with prosthetic heart valves who developed
      bacteremia during hospitalization. MEASUREMENTS AND MAIN RESULTS: Patients were
      evaluated when they were identified as having bacteremia and 1, 2, 6, and 12
      months after its occurrence. Of 171 patients, 74 (43%) developed endocarditis:
      Fifty-six (33%) had prosthetic valve endocarditis at the time bacteremia was
      discovered ("endocarditis at outset"), whereas 18 (11%) developed endocarditis a
      mean of 45 days after bacteremia was discovered ("new endocarditis"). Mitral
      valve location and staphylococcal bacteremia (Staphylococcus aureus or S.
      epidermidis) were significantly associated with the development of "new"
      endocarditis. All 18 cases of new endocarditis were nosocomial, and in 6 of these
      cases (33%) bacteremia was acquired via intravascular devices. Twenty-one
      patients without evidence of endocarditis at the time of bacteremia received
      short-term antibiotic therapy (< 14 days); 1 patient (5%) developed endocarditis.
      Eleven of 70 patients (16%) who received long-term antibiotic therapy (> 14 days)
      developed endocarditis (P > 0.2). CONCLUSIONS: Bacteremic patients with
      prosthetic heart valves were at notable risk for developing endocarditis, even
      when they received antibiotic therapy before endocarditis developed and
      regardless of the duration of such therapy. Intravascular devices were a common
      portal of entry.

PMID- 8363167
TI  - Pituitary-testicular function in nephropathic cystinosis.
AB  - OBJECTIVE: To evaluate reproductive function in patients with cystinosis and in
      renal transplant recipients without cystinosis. DESIGN: Cross-sectional study.
      SETTING: Clinical Center, National Institutes of Health. PATIENTS: Ten male
      patients, 15 to 28 years old, with nephropathic cystinosis and renal allografts
      formed the study group; 11 renal transplant recipients who had a primary renal
      disorder other than cystinosis and were matched with study patients for age and
      renal function served as the control group. MEASUREMENTS: Tanner staging, serum
      gonadotropin determinations, and testosterone and testosterone-binding globulin
      assessments. Selected patients also had a human chorionic gonadotropin (HCG)
      stimulation test, a gonadotropin-releasing hormone (GnRH) stimulation test, and
      serial sampling for luteinizing hormone (LH). MAIN RESULTS: Although testosterone
      levels were within normal limits in 7 of 10 patients with cystinosis, the mean
      testosterone level in patients with cystinosis was 11.5 +/- 2.0 nmol/L compared
      with 24.2 +/- 3.0 nmol/L in control patients (P < 0.005). No patient with
      cystinosis reached Tanner stage 5 (full pubertal development), whereas 9 of 11
      control patients did. Seven of 10 patients with cystinosis had elevations in LH
      or follicle-stimulating hormone (FSH) levels, suggesting testicular failure.
      These patients also had normal LH and FSH responses after GnRH stimulation,
      increased LH pulse frequency, and reduced testosterone response after HCG
      stimulation. In comparison, only 3 of 11 control patients had minimally elevated
      gonadotropin levels, and all 11 had normal testosterone levels. Microscopic
      testicular examination in one patient showed cystine crystals, germinal
      dysplasia, increased fibrosis, and Leydig cell hyperplasia. CONCLUSIONS:
      Abnormalities in the pituitary-testicular axis are common in male patients with
      cystinosis. These changes appear to be related to the disease cystinosis and not
      to treated renal failure per se.

PMID- 8363168
TI  - Acute liver disease associated with erythromycins, sulfonamides, and
      tetracyclines.
AB  - OBJECTIVE: To determine whether erythromycins, sulfonamides, and tetracyclines
      are associated with an increased risk for acute hepatitis. DESIGN: Case-control
      study. SETTING: Medicaid billing data from Michigan and Florida between 1980 and
      1987. PATIENTS: The 107 cases included patients hospitalized with acute
      symptomatic hepatitis without an identifiable cause of liver disease noted in the
      medical record. Four controls per case were randomly selected and were matched
      for age, sex, and state. RESULTS: Five cases (4.7%) and four controls (0.9%) were
      exposed to erythromycins, yielding an odds ratio of 5.2 (95% Cl, 1.1 to 26.6). No
      case or control was exposed to erythromycin estolate. Eight cases (7.5%) and
      three controls (0.7%) were exposed to oral sulfonamides, yielding an odds ratio
      of 11.4 (Cl, 2.7 to 67.8). All (except one control) had received
      trimethoprimsulfamethoxazole. Five cases (4.7%) and four controls (0.9%) were
      exposed to tetracyclines, yielding an odds ratio of 5.2 (Cl, 1.4 to 19.7). The
      results did not change substantively for erythromycin or sulfonamides after
      adjustment using multiple logistic regression for age, sex, state, and use of
      other hepatotoxic drugs. With tetracyclines, however, the odds ratio decreased to
      3.6 (Cl, 0.9 to 14.3). Associations were also seen with isoniazid (P = 0.008) and
      rifampicin (P = 0.04). The number of patients developing acute symptomatic liver
      disease resulting in hospitalization for each million patients treated with a 10
      day course of erythromycin was 2.28 cases; for sulfonamides, this figure was 4.8
      cases; and for tetracycline, the figure was 1.56 cases. CONCLUSION: Erythromycin,
      sulfonamides, and tetracyclines are associated with acute symptomatic hepatitis
      resulting in hospitalization. Given the widespread use of these drugs, they will
      be among the more common drugs associated with hepatitis.

PMID- 8363170
TI  - Primary cutaneous tuberculosis after a needlestick injury from a patient with
      AIDS and undiagnosed tuberculosis.

PMID- 8363169
TI  - Efficacy and toxicity of single daily doses of amikacin and ceftriaxone versus
      multiple daily doses of amikacin and ceftazidime for infection in patients with
      cancer and granulocytopenia. The International Antimicrobial Therapy Cooperative
      Group of the European Organization for Research and Treatment of Cancer.
AB  - OBJECTIVE: To compare the efficacy and toxicity of single daily dosing of
      amikacin and ceftriaxone with that of multiple daily dosing of amikacin and
      ceftazidime for febrile episodes in patients with cancer and granulocytopenia.
      DESIGN: A prospective, randomized, unblinded, multicenter trial. SETTING: Twenty
      one tertiary care or university medical centers. PATIENTS: Six hundred seventy
      seven patients with cancer and granulocytopenia (858 febrile episodes).
      INTERVENTIONS: Random assignment to empiric therapy with a single daily dose of
      amikacin (20 mg/kg) and ceftriaxone (adults, 30 mg/kg; children, 80 mg/kg) (24
      hour group) or with multiple daily doses of amikacin (6.5 mg/kg every 8 hours)
      and ceftazidime (33 mg/kg every 8 hours) (8-hour group). MEASUREMENTS: Percentage
      response to each regimen and occurrence of nephrotoxicity and ototoxicity.
      RESULTS: Single daily dosing of amikacin and ceftriaxone was as effective as
      multiple daily dosing of amikacin and ceftazidime (71% compared with 74%;
      difference, -3%; 95% Cl, -10% to 3%; P > 0.2). Equivalent responses also were
      noted for each category of infection. Median peak (30 minutes after a 60-minute
      infusion) serum concentrations of amikacin were higher in the 24-hour group than
      in the 8-hour group (45.6 compared with 21 micrograms/mL, P < 0.001), whereas
      trough (preinfusion) levels were lower (0.9 compared with 2 micrograms/mL, P <
      0.001). Nephrotoxicity was 3% in the 24-hour group and 2% in the 8-hour group
      (difference, 1%; Cl, -1% to 4%). Increases in serum creatinine, however, were
      delayed (P = 0.048) and smaller (P = 0.06) in the 24-hour group than in the 8
      hour group and occurred almost exclusively after other nephrotoxic drugs were
      added. Audiometry was only done in 144 patients (21%). Ototoxicity was 9% in the
      24-hour group and 7% in the 8-hour group (difference, 2%; Cl, -7% to 11%; P >
      0.2). Further infections developed in 15% and 12% of patients, respectively
      (difference, 3%; Cl, -2% to 9%). The overall mortality rate was 11% in both
      treatment groups (difference, 0%; Cl, -5% to 5%). CONCLUSIONS: Single daily
      dosing of amikacin and ceftriaxone was as effective and no more toxic than
      multiple daily dosing of amikacin and ceftazidime for the empiric therapy of
      infection in patients with cancer and granulocytopenia.

PMID- 8363171
TI  - Effect of garlic on total serum cholesterol. A meta-analysis.
AB  - OBJECTIVE: To assess the size and consistency of garlic's effect on total serum
      cholesterol in persons with cholesterol levels greater than 5.17 mmol/L (200
      mg/dL). DATA SOURCES: Clinical trials were identified by a computerized
      literature search of MEDLINE and by an assessment of the bibliographies of
      published studies and reviews. STUDY SELECTION: Trials were selected if they were
      randomized and placebo-controlled and if at least 75% of their patients had
      cholesterol levels greater than 5.17 mmol/L (200 mg/dL). Studies were excluded if
      they did not provide enough data to compute effect size. Five of 28 studies were
      selected for review. DATA EXTRACTION: Details of study design, patient
      characteristics, interventions, duration of therapy, and cholesterol measurements
      were extracted by one author and were verified by another. DATA SYNTHESIS: Study
      quality was evaluated by multiple reviewers using a closed-ended questionnaire.
      Patients treated with garlic consistently showed a greater decrease in total
      cholesterol levels compared with those receiving placebo. Meta-analysis of
      homogeneous trials estimated a net cholesterol decrease attributable to garlic of
      0.59 mmol/L (95% CI, 0.44 to 0.74) (23 mg/dL [CI, 17 to 29]) (P < 0.001).
      CONCLUSIONS: Meta-analysis of the controlled trials of garlic to reduce
      hypercholesterolemia showed a significant reduction in total cholesterol levels.
      The best available evidence suggests that garlic, in an amount approximating one
      half to one clove per day, decreased total serum cholesterol levels by about 9%
      in the groups of patients studied.

PMID- 8363172
TI  - Treatment of gallstones.
AB  - PURPOSE: To critically review the risks and benefits of therapy for asymptomatic
      and symptomatic persons with gallstones who are considering therapy to prevent
      future episodes of biliary pain or complications including acute cholecystitis,
      pancreatitis, or gallbladder cancer. DATA SOURCES: Review of English-language
      literature regarding the natural history of persons with gallstones and the
      operative mortality rates for open cholecystectomy and laparoscopic
      cholecystectomy. Mathematical simulation modeling was used to derive estimates of
      lifetime risks for gallstone-related mortality and for life expectancy, for
      prophylactic cholecystectomy and expectant management, for men and women of
      different ages. RESULTS: For persons with asymptomatic gallstones, natural
      history is so benign that treatment is generally not recommended. For persons
      with symptomatic gallstones, (that is, that have caused an episode of biliary
      pain), the rate for subsequent pain is high so that many persons probably choose
      cholecystectomy to avoid pain; however, about 30% of persons who have had pain do
      not have further episodes of pain. The expected loss of life for persons with
      symptomatic stones managed expectantly is roughly several months, on average, and
      may not be considered high enough in itself to warrant therapy. Although
      laparoscopic cholecystectomy has become popular with patients and physicians, its
      safety is yet unknown compared with open cholecystectomy. CONCLUSION:
      Prophylactic cholecystectomy should be recommended for most persons with
      symptomatic gallstones unless the person wants to try a period of watchful
      waiting to see if pain recurs. Nonsurgical therapy may be suitable for persons
      with high operative risk. For persons with asymptomatic gallstones, watchful
      waiting is the best course.

PMID- 8363173
TI  - A conflict of interest.

PMID- 8363174
TI  - The quest for a cholesterol-decreasing diet: should we subtract, substitute, or
      supplement?

PMID- 8363175
TI  - Here come the couples.

PMID- 8363176
TI  - Weight loss and mortality.

PMID- 8363177
TI  - Acute mountain sickness at moderate altitudes.

PMID- 8363178
TI  - Acute mountain sickness at moderate altitudes.

PMID- 8363179
TI  - Management of thyroid nodules.

PMID- 8363180
TI  - Treatment of gastrointestinal motility disorders in pregnancy.

PMID- 8363181
TI  - Effect of HIV infection on response to syphilis.

PMID- 8363182
TI  - Polymorphism of IgG Fc receptors in meningococcal disease.

PMID- 8363183
TI  - Alopecia associated with fluconazole treatment.

PMID- 8363184
TI  - Failure of APSAC thrombolysis.

PMID- 8363185
TI  - The blurred intersection of beneficence, competence, and autonomy.

PMID- 8363186
TI  - More on the common communion cup.

PMID- 8363187
TI  - More on the common communion cup.

PMID- 8363188
TI  - Methods for Voluntary Weight Loss and Control. Proceedings of NIH Technology
      Assessment Conference. Bethesda, Maryland, 30 March-1 April 1992.

PMID- 8363189
TI  - Cultural and psychosocial determinants of weight concerns.
AB  - Several sociocultural and psychological factors underlie Western society's
      intense preoccupation with the body. These factors include the social value of
      attractiveness, the strong correlation between attractiveness and perceived
      fitness, the interrelation among attractiveness, a good body image, and feelings
      of self-worth, and the relation between pressures to succeed in both the
      appearance- and work-related domains. The strong societal emphasis on appearance
      and slimness has translated to both intense body preoccupation and a willingness
      to try almost any weight-loss strategy. Thus, dieting occurs across all weight
      categories in response to these powerful social and psychological motivators.

PMID- 8363190
TI  - Descriptive epidemiology of body weight and weight change in U.S. adults.
AB  - Data on body weight and weight change collected from nationally representative
      samples of U.S. adults are reviewed. The body mass index (weight [kg]/height
      [m2]) has a low correlation with height and is used to compare body weights
      between persons of differing heights. The BMI varies to a greater degree in women
      than in men. Below the 75th percentile of the BMI distribution, women have lower
      BMIs than men, whereas at the 75th percentile and above, women have higher BMIs
      than men. Overweight is defined as a BMI of 27.8 or more in men and of 27.3 or
      more in women, corresponding to approximately 20% or more above desirable weight
      in the 1983 Metropolitan Life Insurance Company tables. For persons of average
      height (men, 5'9"; women, 5'4") this definition is equivalent to a body weight
      above 85 kg (187 pounds) in men and above 72 kg (158 pounds) in women. Among
      adults 20 to 74 years of age, 24% of men and 27% of women are overweight,
      yielding an estimated total of 34 million persons in the United States. The
      prevalence of overweight increases with age, for both men and women but to a
      greater degree in women. Blacks and Hispanics have a higher prevalence of
      overweight than do whites, especially among women. Between 1960 and 1980, the
      prevalence of overweight among whites increased by 3% in women and by 6% in men.
      In blacks, however, the prevalence of overweight increased by 7% in women and by
      28% in men. Longitudinal body weight measurements taken 10 years apart show that
      adults younger than 55 years tend to gain weight, whereas those 55 years and
      older tend to lose weight. The youngest adults gain the most weight, and the
      oldest adults lose the most weight. In all age groups, women have substantially
      greater variation in their 10-year weight change than do men.

PMID- 8363191
TI  - Special issues regarding obesity in minority populations.
AB  - Special attention must be given to obesity as it occurs in and affects ethnic
      minorities (that is, black Americans, Hispanic Americans, Asian and Pacific
      Islander Americans, American Indians and Alaska Natives, and Native Hawaiians) in
      the United States. In most of these groups, the prevalence of obesity is
      substantially higher than in whites, especially among women. Poverty and lower
      educational attainment, which are associated with higher than average rates of
      female obesity (independent of ethnicity), affect proportionately more persons in
      these minority populations than in white populations. Diabetes mellitus and
      certain other obesity-related conditions occur to a markedly greater than average
      extent in many minority populations. A high-risk body fat distribution (upper
      body or central obesity) occurs to a greater extent in some minority populations
      than in whites. Because of situational and cultural factors, effective obesity
      prevention and treatment approaches may need to be defined on an ethnicity
      specific basis. Increased attention to obesity as it occurs in and affects
      diverse ethnic groups can help to address critical minority health issues. Such
      efforts can also broaden and enrich aspects of obesity research for which models
      based on white populations are inappropriate or limited.

PMID- 8363192
TI  - Medical hazards of obesity.
AB  - The medical hazards of obesity are discussed. Risks include insulin resistance,
      diabetes mellitus, hypertriglyceridemia, decreased levels of high-density
      lipoprotein cholesterol, and increased levels of low-density lipoprotein
      cholesterol. Obesity is also associated with gallbladder disease and some forms
      of cancer as well as sleep apnea, chronic hypoxia and hypercapnia, and
      degenerative joint disease. Obesity is an independent risk factor for death from
      coronary heart disease. A central distribution of body fat enhances the risk for
      most of these conditions.

PMID- 8363193
TI  - Weight control practices of U.S. adults trying to lose weight.
AB  - OBJECTIVE: To estimate the relative prevalence of different types and
      combinations of practices among weight-loss practitioners and to describe the
      relations between individual characteristics and various features of weight-loss
      regimens. DESIGN: A telephone survey of a random digit-dialed probability sample
      of adults in the continental United States who reported that they were trying to
      lose weight. PARTICIPANTS: A total of 1431 persons 18 years or older who were
      attempting to lose weight. MEASUREMENTS: Self-reports of a detailed inventory of
      more than 35 specific practices that might be used as part of a voluntary weight
      loss plan, along with information about individual characteristics such as
      current weight, weight-loss history, demographic profile, motivations to lose
      weight, sources of information, and knowledge about diet and health. RESULTS: The
      average respondent had a current weight-loss attempt lasting from 5 to 6 months,
      had tried a similar plan before, and had averaged one attempt a year for the past
      2 years. Seventy-one percent of women and 62% of men reported that they were both
      changing their diet and exercising more as part of a current weight-loss attempt.
      Frequently reported weight-loss practices included weighing oneself regularly
      (71% and 70% for women and men, respectively), walking (58% and 44%), using diet
      soft drinks (52% and 45%), taking vitamins and minerals (33% and 26%), counting
      calories (25% and 17%), skipping meals (21% and 20%), using commercial meal
      replacements, (15% and 13%), taking diet pills (14% and 7%), and participating in
      organized weight-loss programs (13% and 5%). Sex, education, and overweight
      status influenced the choice of a weight-loss practice. CONCLUSIONS: Individual
      approaches to weight-loss vary and are characterized by their duration and by
      their recurrent nature. Policy efforts should be directed toward increasing the
      long-term effectiveness of individual weight-loss plans.

PMID- 8363194
TI  - Weight control practices of U.S. adolescents and adults.
AB  - OBJECTIVE: To estimate the prevalence of various weight-loss practices in U.S.
      adolescents and adults. DESIGN: The Youth Risk Behavior Survey, a self
      administered survey of a random sample of high school students in 1990 and the
      Behavioral Risk Factor Surveillance System, a random-digit dial survey in 1989.
      SETTING: Thirty-eight states and the District of Columbia. PARTICIPANTS: High
      school students (n = 11,467) and adults 18 years and older (n = 60,861). RESULTS:
      Among high school students, 44% of female students and 15% of male students
      reported that they were trying to lose weight. An additional 26% of female
      students and 15% of male students reported that they were trying to keep from
      gaining more weight. Students reported that they had used the following weight
      control methods in the 7 days preceding the survey: exercise (51% of female
      students and 30% of male students); skipping meals (49% and 18%, respectively);
      taking diet pills (4% and 2%, respectively); and vomiting (3% and 1%,
      respectively). Among adults, 38% of women and 24% of men reported that they were
      trying to lose weight, whereas 28% of each sex reported that they were trying to
      maintain their weight. CONCLUSIONS: Attempts to lose or maintain weight are very
      prevalent among both adolescents and adults, especially among females.

PMID- 8363195
TI  - Who in America is trying to lose weight?
AB  - OBJECTIVES: To describe the characteristics and weight-loss methods of persons
      who are trying to lose weight; to compare the knowledges and practices regarding
      weight loss between those persons trying to lose weight and those not trying to
      lose weight; and to evaluate trends in these knowledges and practices between
      1985 and 1990. DESIGN: Large (approximately 120,000 persons per year), nationally
      representative random sample of the U.S. population. SETTING: The 1985 and 1990
      Health Promotion Disease Prevention Current Health Topics Supplements to the
      National Health Interview Survey. PARTICIPANTS: Random sample of the U.S.
      population. MEASUREMENTS: Proportions of the NHIS sample with characteristics of
      interest weighted to be representative of the U.S. population. RESULTS:
      Approximately 44 million persons 25 years or older were trying to lose weight in
      1990; 61.8% of men and 59.6% of women were doing so by increasing their physical
      activity. Both proportions are significantly increased compared to the 1985
      proportions of 56.9% and 56.2%, respectively. Twenty-seven percent of those
      persons who saw themselves as overweight were not trying to lose weight.
      CONCLUSIONS: More than one third of Americans see themselves as overweight, but
      fewer than two thirds of these persons are trying to lose weight. About 4% of
      self-perceived underweight persons and 11.4% of persons who think their weight
      was about right are also trying to lose weight. Most persons who are trying to
      lose weight are doing so by eating less, by increasing their physical activity,
      or by a combination of these methods.

PMID- 8363196
TI  - Proposed standards for judging the success of the treatment of obesity.
AB  - The purpose of this report is to propose standards for the successful treatment
      of obesity. This process is somewhat arbitrary because obesity is a
      multifactorial disease and because standards need revision as diagnostic and
      treatment techniques improve. Weight loss, the classic standard of success, does
      not account for individual variability. Reduction in other measures of body size,
      such as body mass index, percentage of excess weight, and body fat, may be
      preferable. Improvement in known complications of obesity (diabetes mellitus,
      hypertension, hyperlipoproteinemia, sleep apnea, and psychosocial problems) are
      equally valid measures of success. Because obesity is a chronic disease,
      maintenance of weight loss is included as a standard of success. Response to
      obesity treatment varies, and thus criteria to define minimal, intermediate, and
      full success for each variable are necessary.

PMID- 8363197
TI  - Evidence for success of caloric restriction in weight loss and control. Summary
      of data from industry.
AB  - Data voluntarily supplied by industry were examined to evaluate the success of
      commercial weight loss programs and products. Information about the safe loss of
      weight, the maintenance of this lowered weight, and resultant health benefits
      were reviewed. Information was received from companies that produce over-the
      counter preparations designed for persons with a small weight loss goal and from
      physician-supervised programs for morbidity obese persons placed on very-low
      calorie diets. Regardless of the products used, successful weight loss and
      control was limited and required individualized programs consisting of restricted
      caloric intake, behavior modification, and exercise. Although some manufacturers
      of physician-supervised weight loss products for obese persons hav defined the
      effectiveness of their programs with controlled clinical studies, other industry
      programs have only begun to accurately assess their effectiveness or safety.
      Given the importance to public health of reducing obesity, rigorous studies on
      current weight control practices should be pursued aggressively.

PMID- 8363198
TI  - Treatment of obesity by moderate and severe caloric restriction. Results of
      clinical research trials.
AB  - Recent studies of the treatment of obesity by moderate and severe caloric
      restriction show that patients treated in randomized trials using a conventional
      1200 kcal/d reducing diet, combined with behavior modification, lose
      approximately 8.5 kg in 20 weeks. They maintain approximately two thirds of this
      weight loss 1 year later. Patients treated under medical supervision using a very
      low-calorie diet (400 to 800 kcal/d) lose approximately 20 kg in 12 to 16 weeks
      and maintain one half to two thirds of this loss in the following year. Both
      dietary interventions are associated with increasing weight regain over time,
      although regain can be minimized with the recognition that obesity, in many
      cases, is a chronic condition that requires continuing care. Patients who
      participate in a formal weight-loss maintenance program, exercise regularly, or
      both are likely to achieve the best long-term results.

PMID- 8363199
TI  - Obesity treatment: can diet composition play a role?
AB  - Diet composition can play a role in obesity treatment because it can influence
      energy intake and nutrient balance. The greatest potential effect of diet
      composition occurs not during weight reduction but during maintenance of a
      reduced body weight. During weight reduction, the extent of negative energy
      balance is the greatest determinant of the amount and rate of weight loss, and
      any effects of diet composition are likely to be very small. Conversely, during
      the maintenance period after weight reduction, maintenance energy requirements
      are reduced and the rate of fat oxidation may be low. Prevention of fat storage
      and regain of body weight can be achieved either by increasing fat oxidation (for
      example, by increasing exercise) or by reducing the fat content of the habitual
      diet. The treatment with the greatest chance for success combines a reduced-fat
      diet with aerobic exercise.

PMID- 8363200
TI  - Evidence for success of behavior modification in weight loss and control.
AB  - Behavior modification applied to the treatment of obesity has evolved from the
      environmental control of eating behavior to a broader approach characterized by
      systematic manipulation of all factors associated with eating and exercise
      patterns. This approach has shown success in helping obese persons lose modest
      amounts of weight. The average length of treatment is 18 weeks, and the average
      weight loss is 9.9 kg. About 66% of these weight losses are maintained at 52
      weeks of follow-up. Because obesity is a chronic condition with a substantial
      potential for relapse, longer-term treatments are needed. In the future,
      behavioral modification is likely to be further combined with other treatment
      methods.

PMID- 8363201
TI  - Evidence for success of exercise in weight loss and control.
AB  - Physically active men and women may be less likely than their sedentary peers to
      become overweight. Caloric restriction in overweight persons produces larger
      weight losses than does exercise, although more of the weight loss by dieting is
      from lean body mass. The addition of exercise to diet intervention produces more
      weight loss than does dieting alone. Exercise has a favorable effect on body fat
      distribution, with a reduction in waist-to-hip ratio with increased exercise.
      Exercise is especially important in maintaining weight loss in overweight
      persons. Several prospective studies have shown that overweight men and women who
      are active and fit have lower rates of morbidity and mortality than overweight
      persons who are sedentary and unfit. Therefore, exercise is of benefit to
      overweight persons, even if it does not make them lean. Exercise is recommended
      as an important part of a weight control program.

PMID- 8363202
TI  - Use and abuse of appetite-suppressant drugs in the treatment of obesity.
AB  - Most of the available appetite-suppressant drugs act on noradrenergic and
      possibly dopaminergic receptors to produce satiety. A smaller number increase
      excess neuronal serotonin levels by blocking serotonin reuptake or by increasing
      its release. All these drugs produce significantly greater weight loss than does
      placebo in most studies. Abuse is a problem with amphetamine, methamphetamine,
      and benzphetamine, whereas other drugs have minimal or no potential for abuse.
      Weight loss can be sustained for up to 36 months. Net weight loss, compared with
      placebo, ranges from 2 to 10 kg, and weight regain after terminating drug
      treatment proves that drugs do not work when not taken. The stigma of obesity,
      the public opprobrium toward obese persons, and regulatory rigidity have led to
      unjustified distrust in the potential of drug treatment for obesity.

PMID- 8363203
TI  - Comparison of medically supervised and unsupervised approaches to weight loss and
      control.
AB  - The rising incidence of obesity in the United States has given physicians an
      increased role in its treatment. Although unsupervised programs can produce
      significant weight losses, the lack of medical supervision increases the
      potential for health problems. As with other lifestyle changes (for example,
      smoking cessation and blood pressure control), even minimal physician involvement
      may enhance outcome. In published clinical trials, the absence of contact with
      health professionals among control group participants may account in part for
      their poor success at weight loss or for their weight gain. Smaller trials
      examining the value of physician advice and encouragement among dieting patients
      have shown promising results. Physicians should monitor the health of obese and
      overweight patients during and after weight loss as is appropriate for the
      patient, depending on caloric levels, rate of weight loss, weight-loss goals, and
      intercurrent health events. Medical supervision is necessary for patients on very
      low-calorie diets, for severely obese patients (body mass index > 35), and for
      patients with other health problems.

PMID- 8363204
TI  - Minnesota studies on community-based approaches to weight loss and control.
AB  - Community-based approaches to weight control including worksite interventions,
      intervention by home correspondence, and multimodal community strategies are
      reviewed. Community-based programs have shown the ability to treat large numbers
      of obese persons, many of whom probably would not spontaneously seek professional
      care. Community-based approaches produce modest weight losses at lower costs than
      do clinical interventions. Although no community program has yet to reduce the
      prevalence of obesity in the general population, this area is relatively new and
      deserves further study. Recommended areas for future research include strategies
      for recruitment to community programs and primary prevention of weight gain.

PMID- 8363205
TI  - Short-term medical benefits and adverse effects of weight loss.
AB  - Weight loss reduces many of the health hazards associated with obesity including
      insulin resistance, diabetes mellitus, hypertension, dyslipidemia, sleep apnea,
      hypoxemia and hypercarbia, and osteoarthritis. Potential adverse effects of
      weight loss include a greater risk for gallstone formation and cholecystitis,
      excessive loss of lean body mass, water and electrolyte problems, mild liver
      dysfunction, and elevated uric acid levels. Less consequential problems such as
      diarrhea, constipation, hair loss, and cold intolerance may also occur. The short
      term adverse effects are not severe enough to contraindicate weight loss, nor do
      they outweigh its short-term benefits.

PMID- 8363206
TI  - Relation of dieting and voluntary weight loss to psychological functioning and
      binge eating.
AB  - Voluntary weight loss in obese patients consistently reduces negative emotions
      such as depression and anxiety in the short term. Dieting by persons of normal
      weight is associated with low self-esteem and depressive symptoms. Dieting is
      linked to the development and maintenance of eating disorders such as anorexia
      nervosa and bulimia nervosa, although the precise nature of this association is
      unclear. Dieting cannot be a sufficient causal condition and must combine with
      other still undetermined vulnerabilities to cause eating disorders.
      Identification of these risk factors must precede the development of effective
      programs to prevent eating disorders.

PMID- 8363207
TI  - The association between weight loss and increased longevity. A review of the
      evidence.
AB  - Six published observational epidemiologic studies have reported evidence of
      reduced mortality rates in persons who have lost weight. In two studies, the
      reported protective effects of weight loss on mortality could not be justified by
      the data. In two other studies, weight loss was associated with both increased
      and decreased longevity in different subgroups. Only one study provided
      information on whether the weight loss was voluntary, but this study found
      similar effects of weight loss regardless of volition. These studies provided
      only limited information on the magnitude of weight loss associated with changes
      in longevity and no information on the types of methods used to achieve weight
      loss. Because of difficulties in studying long-term health outcomes related to
      obesity treatment, randomized, controlled trials are unlikely to provide a
      practical study design for this issue. Properly designed observational studies
      will probably provide the most useful information on the effects of voluntary
      weight loss on longevity.

PMID- 8363208
TI  - Long-term effects of change in body weight on all-cause mortality. A review.
AB  - OBJECTIVE: To summarize published studies analyzing the effects of long-term
      change in body weight on all-cause mortality and have not been reported elsewhere
      in these proceedings. DATA SOURCES: Thirteen reports from 11 diverse population
      studies, 7 from the United States and 4 from Europe. STUDY SELECTION: All studies
      included a weight change period of 4 or more years, followed by a mortality
      assessment period of 8 or more years. All weight changes occurred in persons 17
      years or older. DATA EXTRACTION: Data from individual studies are presented as
      number of participants, number of deaths, ages at initial and final weight
      measurements, duration of the mortality follow-up period, consideration of
      cigarette smoking and other potential confounders, exclusion criteria, temporal
      separation between the weight change and mortality follow-up periods, and the
      association between weight change and all-cause mortality. DATA SYNTHESIS:
      Results are summarized by weight change associated with the lowest mortality rate
      and by the effects of long-term weight loss on mortality rate. CONCLUSIONS:
      Despite the diversity of the populations studied, the degree of "clinical clean
      up" at entry, the techniques used to assess weight change, and the differences in
      analytic techniques (including consideration of potentially confounding
      variables), certain conclusions may be drawn. Evidence suggests that the highest
      mortality rates occur in adults who either have lost weight or have gained
      excessive weight. The lowest mortality rates are generally associated with modest
      weight gains.

PMID- 8363209
TI  - Weight loss and subsequent death in a cohort of U.S. adults.
AB  - OBJECTIVE: Because we previously found that weight loss was associated with
      increased risk for death in all but very overweight men in a cohort of U.S.
      adults, we undertook a new analysis to determine whether inadequate control for
      preexisting illness or cigarette smoking contributed to this association. DESIGN:
      Cohort study. SETTING: The first National Health and Nutrition Examination Survey
      (NHANES I, 1971 to 1975) collected information on maximum lifetime weight and
      measured current weight on a probability sample of U.S. adults. The NHANES I
      Epidemiologic Follow-up Study determined the vital status of participants through
      1987. PARTICIPANTS: Men (n = 2453) and women (n = 2739) who were 45 to 74 years
      old at the time of the NHANES I examination. RESULTS: The effect of excluding
      persons who died within the first 5 and first 8 years after baseline was examined
      to limit the influence of weight loss due to preexisting illness. For women,
      extension of the exclusionary period weakened the association between weight loss
      and increased risk for death from noncardiovascular disease. However, excluding
      death for as much as 8 years after baseline did not affect the strong association
      between weight loss and increased risk for death from cardiovascular disease
      among men and women with maximum body mass indexes between 26 and 29 (relative
      risks of up to 2.1 and 3.6 for men and women, respectively, after excluding
      deaths in the first 8 years). Results were not substantially altered by limiting
      the analysis to persons who never smoked. CONCLUSIONS: Preexisting illness may
      influence the association between weight loss and death principally through
      deaths from noncardiovascular disease. For some persons, weight loss is
      associated with an increased risk for death, even after excluding deaths
      occurring in the first 8 years.

PMID- 8363210
TI  - Body weight change, all-cause mortality, and cause-specific mortality in the
      Multiple Risk Factor Intervention Trial.
AB  - OBJECTIVE: To evaluate the relation between weight variability and death in high
      risk, middle-aged men participating in the Multiple Risk Factor Intervention
      Trial (MRFIT). DESIGN: Cohort study with 3.8 years of follow-up. SETTING:
      Multicenter, collaborative, primary prevention trial conducted at 22 clinical
      centers in the United States. PARTICIPANTS: Men (n = 10,529) who were 35 to 57
      years old at baseline and who were in the upper 10% to 15% of risk for coronary
      heart disease because of smoking, high blood pressure, and elevated cholesterol
      level. Participants were seen at least annually for 6 to 7 years for medical
      evaluations in study clinical centers. MEASUREMENTS: Death from cardiovascular
      disease (228 deaths) and from all causes (380 deaths). RESULTS: The primary
      measure of weight variability was the intrapersonal standard deviation of weight
      (ISD), which was calculated from measured weights obtained at clinic visits
      during a 6- to 7-year period. All-cause death rates per 1000 person-years of
      follow-up across ISD quartiles were 8.28, 8.25, 10.57, and 11.07 from the first
      to fourth quartiles, respectively. After adjusting for baseline risk factors
      associated with weight change, the relative risk for all-cause mortality in the
      fourth compared with the first quartile was 1.64 (95% CI, 1.21 to 2.23).
      Cardiovascular death and ISD showed a similar pattern. The association between
      weight change and death was not observed in the heaviest men. CONCLUSION: Greater
      weight variability was associated with a greater risk for cardiovascular disease
      and all-cause mortality in some types of high-risk men.

PMID- 8363211
TI  - Benefits and adverse effects of weight loss. Observations from the Framingham
      Study.
AB  - OBJECTIVE: To identify the benefits and adverse effects of weight loss. DESIGN:
      Longitudinal, epidemiologic study in a defined population. PARTICIPANTS: Men and
      women (n = 2500) who were between 35 and 54 years old at baseline, followed for
      20 years in Framingham, Massachusetts. MEASUREMENTS: Height, weight, lipid
      levels, blood pressure, smoking status, diet, physical activity, prevalent and
      incident cardiovascular disease, diabetes, other diseases, and mortality rate
      were assessed. RESULTS: Compared with those whose body mass index (BMI) or weight
      changed least, men and women who lost weight during a 10-year period were older,
      heavier, and had higher blood pressures and cholesterol levels initially but had
      the smallest gains in blood pressure and cholesterol levels. However, rates of
      cigarette smoking were higher, and rates of smoking cessation were lower. During
      20 years of further follow-up, death rates were highest in those whose BMI
      decreased and in those with the highest BMI at study entry. Relative risks for
      death from cardiovascular disease, coronary heart disease, and all causes were
      significantly greater by 33% to 61% in men whose BMI decreased after adjusting
      for age and risk factors for cardiovascular disease. In women, weight loss and
      weight gain were associated with higher relative risks for cardiovascular disease
      and coronary heart disease, but only the 38% increase in total mortality rate
      among women who lost weight was statistically significant after adjusting for
      age. CONCLUSIONS: Weight loss was associated with improvements in blood pressure
      and cholesterol levels but also with continued cigarette smoking, prevalent and
      incident cardiovascular disease, diabetes mellitus, other diseases, and higher
      death rates. Leanness and maintenance of stable weight were beneficial to risk
      factors, and to the prevention of morbidity, and death.

PMID- 8363212
TI  - Methods for voluntary weight loss and control. NIH Technology Assessment
      Conference Panel. Consensus Development Conference, 30 March to 1 April 1992.
AB  - One quarter to one third of Americans are overweight; as many as 40% of women and
      24% of men are trying to lose weight at any given time; many have tried a variety
      of methods, such as diets, exercise, behavior modification, and drugs. In
      controlled settings, participants who remain in weight loss programs usually lose
      approximately 10% of their weight. However, one third to two thirds of the weight
      is regained within 1 year, and almost all is regained within 5 years. For many
      overweight persons, achieving and maintaining a healthy weight is a lifelong
      challenge. Successful weight loss improves several cardiovascular risk factors
      and diabetic control; effects on mortality are not clear. Several epidemiologic
      studies have found that weight loss is associated with increased mortality but
      the reasons for weight loss were not known. Survey data also confirm that many
      Americans who are not overweight, particularly young women, are trying to lose
      weight, which may have adverse physical and psychological consequences. Because
      of the importance of these issues, research on weight and on weight loss and
      control should assume a high priority on the nation's health agenda.

PMID- 8363213
TI  - Immunomodulating drugs: major advances in research and development.

PMID- 8363214
TI  - Rapamycin's inhibition of thymocyte proliferation, unlike that of cyclosporin A
      or prednisolone, is not associated with cytotoxicity.

PMID- 8363215
TI  - Rapamycin inhibits lymphocyte proliferation in a popliteal lymph node model via
      an IL-2-independent mechanism.

PMID- 8363216
TI  - Rapamycin in a porcine renal transplant model.

PMID- 8363217
TI  - Synthesis and background chemistry of 15-deoxyspergualin.

PMID- 8363218
TI  - 15-Deoxyspergualin, a novel immunosuppressive drug: studies of the mechanism of
      action.

PMID- 8363219
TI  - Successful treatment with a novel immunosuppressive agent, deoxyspergualin, in
      type II collagen-induced arthritis in mice.

PMID- 8363220
TI  - Preclinical studies with 15-deoxyspergualin in various animal models for
      autoimmune diseases.

PMID- 8363221
TI  - 15-Deoxyspergualin: a novel immunosuppressive drug with clinical potential.
AB  - The studies discussed in this review suggest that DSG is a potent
      immunosuppressive agent, with at least some of its activity due to its direct
      effects on macrophages and B cells. The effects of DSG on macrophages include
      inhibition of IL-1, chemiluminescence, expression of MHC Class I antigen on the
      surface, and development of MAF. The agent may well interfere with antigen
      processing and the discovery of its binding to the heat-shock protein 70 may shed
      some light on this area. The effects of DSG on B lymphocytes include inhibition
      of surface Ig expression and B cell differentiation. In addition, however, DSG
      exhibits some effects on both B and T lymphocytes and is markedly active in
      blocking both the primary and secondary cytotoxic T cell and antibody-producing
      cell generation. The agent is relatively nontoxic at the doses in which it exerts
      these marked effects. Thus, an overall assessment of DSG shows that it may
      provide immune suppression at levels different from those of immunosuppressive
      agents already available. Advances in human organ transplantation have for the
      most part occurred stepwise with the introduction of progressively improved
      techniques of immunosuppression. Tissue-matching, organ preservation, techniques
      of transplantation, and surgical post-operative care of organ transplant
      recipients have all improved over the 30 years since organ transplantation began,
      but have not been the major factors in the improved survival of both patients and
      grafts seen at the present time. The initial advance in immunosuppression which
      made the first organ transplants possible was the finding of the
      immunosuppressive capabilities of azathioprine (Imuran) and the ability to
      reverse acute rejection crisis with prednisone. Anti-thymocyte or anti-lymphocyte
      globulin, introduced in 1966, achieved variable results, with some groups
      reporting excellent patient and graft survival using this agent. Others using
      different variations of this drug showed no improvement in results. By the mid
      1970s, transplant results had improved at a number of units, with graft survivals
      of kidney and heart recipients in the 70 percent range at 1 to 2 years. No major
      progress was reported in most units, however, until the introduction in 1978 of
      cyclosporine. A major effect of cyclosporine was to create a universal
      improvement in graft survival in all units surveyed around the world with a 70 to
      75 percent one-year cadaver kidney graft survival, representing the basic
      standard for clinical results.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8363222
TI  - Deoxyspergualin in allogeneic kidney and xenogeneic islet transplantation: early
      clinical trials.

PMID- 8363223
TI  - Deoxyspergualin: clinical trials in renal graft rejection. Japan Collaborative
      Transplant Study of Deoxyspergualin.
AB  - The percentage of efficacy of DSG, when used alone, was 76 percent in patients
      having acute rejection within 6 months after grafting. The doses of 3 to 5
      mg/kg/day was judged to be recommendable and the duration of treatment of 7 days
      was evaluated as a suitable duration. Rescue use of DSG was effective in 70
      percent of patients having MP-resistant rejection. In acute rejection, the
      percentage of efficacy of DSG plus MP combination was 88 percent. In addition, we
      should note that the percentage of efficacy of DSG was 66 percent even in acute
      or chronic rejection. The main adverse reactions with DSG included a sensation of
      numbness of the face, lips, and limbs, gastrointestinal troubles, and bone marrow
      suppression, but these adverse reactions were not serious. DSG has a mechanism of
      action different from that of other immunosuppressive agents, and it has fewer
      adverse effects than other drugs. Different from biological preparations, DSG is
      a strong immunosuppressive agent that can be used repeatedly.

PMID- 8363224
TI  - A member of the Hsp70 family of heat-shock proteins is a putative target for the
      immunosuppressant 15-deoxyspergualin.

PMID- 8363225
TI  - Effects of 15-deoxyspergualin on the expression of surface immunoglobulin in
      70Z/3.12 murine pre-B cell line.

PMID- 8363226
TI  - Guanine arabinoside as a bone marrow-purging agent.
AB  - Arabinosylguanine (araG) is a nucleoside analogue that is rapidly converted by
      cells of the T lymphoid lineage to its corresponding arabinosylguanine nucleotide
      triphosphate (araGTP), resulting in inhibition of DNA synthesis and selective in
      vitro toxicity to T lymphoblastoid cell lines as well as to freshly isolated
      leukemia cells from patients with T cell acute lymphoblastic leukemia (ALL). We
      have previously demonstrated that araG is an effective agent to use for
      chemoseparation of malignant T lymphoblasts from human bone marrow. When freshly
      isolated human T leukemia cells or T lymphoblastoid cells were treated with 100
      microM araG for 18 hours, up to 6 logs of clonogenic T cells are eliminated
      without appreciable toxicity to the normal myeloid, erythroid, and
      megakaryocytoid clonal progenitor cells. We subsequently described studies in a
      murine model of T cell acute lymphoblastic leukemia (ALL) in which we tested
      whether bone marrow contaminated with malignant T cells and purged ex vivo with
      araG, could reconstitute both the lymphoid and myeloerythroid lineages in the
      absence of leukemic relapse. The model utilized 6C3HED tumor cells, derived from
      a Thy 1.2+ malignant murine T cell line, which were shown to cause lethal
      leukemia in C3H/HeN mice. Intravenous injection of 10(6) 6C3HED cells resulted in
      100 percent mortality within 18 days, with autopsy revealing tumor infiltration
      of multiple organs. Evidence of araG's ability to purge bone marrow of malignant
      tumor cells without causing significant toxicity to normal marrow-derived
      hematopoietic progenitor cells was documented in experiments in which 75 percent
      of lethally irradiated mice receiving transplants of syngeneic bone marrow
      contaminated with 6C3HED tumor cells and treated ex vivo with 100 mM araG for 18
      hours survived for 250 to > 400 days. Reconstitution of the lymphoid, myeloid,
      and erythroid lineages with donor cells in surviving mice was documented. The
      data presented indicate that araG may effectively purge bone marrow of malignant
      T cells without irreversible toxicity to hematopoietic stem cells. This purging
      regimen is recommended for consideration for clinical trials in patients with T
      cell malignancies undergoing autologous bone marrow transplantation and may also
      be a viable option for T cell depletion as a strategy to prevent graft versus
      host disease.

PMID- 8363227
TI  - Application of X-ray crystallographic methods in the design of purine nucleoside
      phosphorylase inhibitors.

PMID- 8363228
TI  - Activities of two 9-deazaguanine analogue inhibitors of purine nucleoside
      phosphorylase, CI-972 and PD 141955, in vitro and in vivo.

PMID- 8363229
TI  - Levamisole-induced neopterin synthesis.

PMID- 8363230
TI  - Recent clinical trials with levamisole.

PMID- 8363231
TI  - Sex hormones as immunomodulators of disease.

PMID- 8363232
TI  - Corticosteroids as immunomodulators.
AB  - Corticosteroids are potent anti-inflammatory and anti-immunologic modulators.
      They interact with cellular receptors, which eventually leads to modification of
      DNA transcription. These changes sometimes inhibit cell function and sometimes
      increase production of cell products. A number of effects are seen throughout the
      organism, leading to downregulation of allergic responses, inhibition of cell
      mediated immunity, decreased accumulation of inflammatory cells, and a lessening
      of proinflammatory stimuli and blood-vessel responses.

PMID- 8363233
TI  - Overview on the chemistry and immunomodulating properties of novel pyrimidinones.

PMID- 8363234
TI  - Bropirimine in bladder cancer: clinical studies.

PMID- 8363235
TI  - Immunosuppressive activity of mycophenolate mofetil.

PMID- 8363236
TI  - Study of the immunosuppressive properties of cyclosporine analogues.

PMID- 8363237
TI  - Suppression of alloantigen presentation by prodigiosin, a T cell-specific
      immunosuppressant.

PMID- 8363239
TI  - Syntheses of macromolecular immunomodulators and conjugates employing haloacetyl
      reagents.

PMID- 8363238
TI  - In vivo antitumor activity of the hypoxanthine derivatives ST 789 and ST 689.

PMID- 8363240
TI  - Immunomodulating activity of myelopeptides: clinical trials.
AB  - Bone marrow cells of various animal species and the human produce a group of
      bioregulatory peptides called myelopeptides (MPs). A highly purified myelopeptide
      (MP) fraction and some individual molecules have been isolated from the
      supernatant of the porcine bone marrow cell culture by successive gel
      chromatography and HPLC. Myelopeptides have a wide spectrum of functions
      including immunoregulatory, differentiating, and opiate-like activities. A new
      immunoreactive drug, Myelopidum, has been created on the basis of myelopeptides.
      This drug is effectively used in Russian medicine for treating diseases
      accompanied by immunodeficiency and in veterinary practice for prophylaxis and
      treatment of newborn and young animals with such diseases as pneumonia and
      enteritis. Treatment of patients by Myelopidum after major surgery prevents 50 to
      70 percent of postsurgical complications, particularly postsurgical pneumonia.
      Myelopidum normalizes the number and balance of T helper and T suppressor cells
      and B lymphocytes in patients with chronic pulmonary diseases and promotes the
      beneficial clinical effect of significant prolongation of periods of remission.

PMID- 8363241
TI  - Structural nature and functions of transfer factors.
AB  - Transfer factors are molecules that "educate" recipients to express cell-mediated
      immunity. This effect is antigen-specific. The most consistent effects of
      transfer factors on the immune system are expression of delayed-type
      hypersensitivity and production of lymphokines such as macrophage migration
      inhibitory factor (MIF), which is probably identical to gamma-interferon in
      response to exposure to antigen. Transfer factors bind to antigens in an
      immunologically specific manner. This discovery has enabled us to isolate
      individual transfer factors from mixtures that contain several transfer factors.
      This reactivity probably explains the specificity of individual transfer factors,
      and it has provided a method for purification of individual transfer factors to
      apparent homogeneity. The purified materials are immunologically active and
      antigen-specific. They have molecular weights of approximately 5,000 Da and
      appear to be composed entirely of amino acids. Transfer factors appear to offer a
      novel means of molecular immunotherapy for certain patients with defective cell
      mediated immunity.

PMID- 8363242
TI  - Effect of oral administration of heat-killed Enterococcus faecalis FK-23 on the
      leukocyte-reconstituting capacity in immunosuppressed dogs.

PMID- 8363243
TI  - Antitumor and antimicrobial activities of enterococcal preparation orally
      administered to mice.

PMID- 8363244
TI  - Immunostimulating peptide derived from soybean protein.

PMID- 8363245
TI  - Two simple glucose derivatives with opposite immunoactivities.

PMID- 8363246
TI  - Immunopharmacologic study of glucofructan from Symphytum asperum roots.

PMID- 8363247
TI  - The Edward Jenner Lecture. Biological spinoffs of organ transplantation.

PMID- 8363248
TI  - The George Hitchings and Gertrude Elion Lecture. The pharmacology of
      azathioprine.

PMID- 8363249
TI  - The Gerhard Domagk Lecture. Transcription factors in lymphoid development.

PMID- 8363250
TI  - Immunomodulating drugs: whence and whither.

PMID- 8363252
TI  - Immunomodulating activity of antifungal drugs.
AB  - 1. The immunomodulating activity of antifungal drugs was reviewed. Although
      results are conflicting, all azole drugs tend to be immunosuppressive, except for
      fluconazole, which has no immunologic effect. In contrast, the polyene antibiotic
      amphotericin B (AMPH) is immunostimulatory. 2. AMPH induced host resistance to
      Pseudomonas aeruginosa infection in mice, whereas no azole drugs did so. 3.
      Polymorphonuclear leukocytes are activated by AMPH, but not by any azole drugs,
      in terms of the level of their adherence. 4. No azole drugs induce in vitro tumor
      necrosis factor alpha (TNF) production by macrophages, whereas AMPH slightly but
      substantially does so. 5. AMPH potently primes macrophages in vitro and in vivo
      so that they produce large amounts of TNF after the secondary stimulation
      (triggering) by bacterial lipopolysaccharides or a streptococcal preparation used
      for antitumor immunotherapy, OK432. 6. Viable or heat-killed Candida albicans
      cells are capable of inducing in vitro TNF production by macrophages. This
      activity of the fungal cells is enhanced by AMPH.

PMID- 8363251
TI  - Immunomodulator effects on the Friend virus infection in genetically defined
      mice.
AB  - The disease induced by the Friend virus complex (FV) in F1 hybrid mice containing
      the Rfv-3r/s genotype in the presence of H-2a/a was used to evaluate a variety of
      immunomodulating substances. In these genetically defined mice, the FV disease
      results in splenomegaly, early production of high titers of cell-associated and
      plasma virus, high levels of splenic viral RNA, increased hematocrit, and
      eventual death. As the disease progresses, reduced levels of infectious virus
      correlate with development of specific antibody; reduction in T cell populations,
      increase in B cells, and decrease in T-cell function also occur. The following
      immunomodulators were evaluated, listed in the order of their ability to inhibit
      the FV disease: imexon > MVE-2 > human recombinant IFN-alpha A/D > AS101 >
      ampligen > AM-3 = oxamisole > ImuVert > bropirimine. In fact, bropirimine, used
      with certain treatment regimens, appeared to enhance the FV disease. These data
      suggest that certain immunomodulators may have potential value in the treatment
      of HIV disease, but also indicate that caution should be exercised in their
      clinical use.

PMID- 8363253
TI  - Immunopharmacologic properties of inosine 5'-methyl monophosphate (MIMP).

PMID- 8363254
TI  - Immunomodulatory properties of AZT.

PMID- 8363255
TI  - Antiviral activity of a synthetic double-stranded polyribonucleotide interferon
      inducer in a murine AIDS retrovirus model. Role of augmentation of natural killer
      cell activity and synergy with oral AZT.

PMID- 8363256
TI  - Modulation of cytokine responses in sepsis.

PMID- 8363257
TI  - Interventions for the treatment of septic shock.

PMID- 8363258
TI  - Pleiotropic effects of transforming growth factor-beta on cells of the immune
      system.
AB  - It is now apparent that the TGF-beta has potent immunoregulatory properties.
      Although most reports have described the immunosuppressive activities of TGF
      beta, recent evidence supports the concept that TGF-beta can have both inhibitory
      and stimulatory actions. The delivery of sufficient quantities of TGF-beta has
      proven beneficial in several disease models such as allograft rejection and
      autoimmunity. Moreover, the increased levels of TGF-beta found in several disease
      states associated with immunosuppression suggests that inhibitors of TGF-beta may
      be clinically useful in some diseases. Thus, TGF-beta or antagonists to TGF-beta
      have exciting potential for use in treating or preventing several diseases (Table
      6).

PMID- 8363259
TI  - Cytokines and modulation of diseases of immediate hypersensitivity.

PMID- 8363260
TI  - Therapeutic peptides that block interaction of T cells with MHC in experimental
      allergic encephalomyelitis.

PMID- 8363261
TI  - Antigen presentation by the murine renal proximal tubule: a mechanism of self
      tolerance?

PMID- 8363262
TI  - Immunologic aspects of kampo medicine.

PMID- 8363263
TI  - Inhibition of hypersensitivity reactions by saiboku-to (TJ-96), particularly on
      type IV reaction.

PMID- 8363264
TI  - Effect of an herbal preparation, saiboku-to (TJ-96), on antigen-induced airway
      hyperresponsiveness and eosinophil infiltration in actively sensitized guinea
      pigs. off.

PMID- 8363265
TI  - Effects of saiboku-to (TJ-96) on the production of platelet-activating factor in
      human neutrophils.
AB  - Platelet-activating factor (PAF) has been recognized as an important chemical
      mediator in allergic and inflammatory reactions. Evidence suggests that PAF is
      deeply involved in the pathogenesis of bronchial asthma, in which PAF induces
      profound bronchospasms, increased vascular permeability, and
      eosinophil/neutrophil accumulation in the respiratory tract. The precise
      pharmacologic mechanisms of Kampo preparations are still obscure, but extensive
      experience has established their clinical effectiveness for the treatment of
      patients with allergic and inflammatory disorders. We tried to examine the
      effects of Saiboku-to (TJ-96), a Kampo prescription, on in vitro PAF production
      by human neutrophils because this preparation is widely used for the management
      of patients with bronchial asthma and bronchitis. Saibokuto inhibited in vitro
      PAF production in a dose-dependent manner. Among the major natural components of
      Saiboku-to, saiko (Bupleuri radix) and kanzo (Glycyrrhizae radix) showed
      inhibitory effects on PAF production, whereas ohgon (Scutellariae radix) had no
      inhibitory effect. Saikosaponin a and c, purified elements extracted from saiko,
      showed no inhibitory effects, but saikosaponin d and glycyrrhizin, extracted from
      kanzo, inhibited PAF production dose-dependently. Further studies are needed to
      evaluate the clinical significance of Kampo medicines in allergic diseases, but
      our present results suggest that the pharmacologic benefit of Saiboku-to is
      partially due to its inhibitory effect on PAF production.

PMID- 8363266
TI  - Rapamycin: in vitro profile of a new immunosuppressive macrolide.

PMID- 8363267
TI  - A multicenter clinical trial of TJ-96 in patients with steroid-dependent
      bronchial asthma. A comparison of groups allocated by the envelope method.

PMID- 8363268
TI  - Cytokines and their role as growth factors and in regulation of immune responses.

PMID- 8363270
TI  - The role of the T cell receptor alpha chain in antigen-specific immune
      suppression.

PMID- 8363269
TI  - The interleukin-2 receptor: a target for immunotherapy.

PMID- 8363271
TI  - Autoantibodies against cytochromes P-450 in drug-induced autoimmune hepatitis.

PMID- 8363272
TI  - Immunity to halothane metabolite-modified proteins in halothane hepatitis.

PMID- 8363273
TI  - Effects of small doses of dioxins on the immune system of marmosets and rats.
AB  - There is no doubt that TCDD is capable of inducing effects on a variety of
      components and functions of the immune system in a variety of species. In fact,
      such changes seem to belong to the most sensitive variables affected by TCDD.
      Some of the biological effects, induced at rather high doses of TCDD exhibiting
      general toxicity (> 3 micrograms TCDD/kg body wt), may be considered unspecific
      or the result of the pronounced thymus involution. However, other effects (such
      as that on lymphocyte subtype patterns in marmosets or a reduced resistance of
      mice to influenza viruses) have been reported to occur at dose levels far from
      those leading to thymic involution or general toxicity. It should be remembered
      that the pathognomonic relevance for man of subtle modifications in the pattern
      of lymphocyte surface receptors is largely unknown. Until now, such deviations
      are considered rather as biological phenomena than indications or causes of
      specific diseases. Nevertheless, such changes represent clear-cut biological
      effects induced by TCDD. Since effects of TCDD on components and defined
      functions of the immune system have been revealed in several species, it would be
      surprising if humans were largely resistant to such effects, but reliable data in
      humans with high exposures to defined dioxins verified by an appropriate
      quantification of the exposure are scarce as of now. Data published so far have
      not revealed pronounced alterations of such variables. However, no studies of
      well-defined human populations with quantified body burdens have been performed
      with modern methods (such as flow cytometry) analyzing a wide variety of surface
      receptors. Performance of such studies is essential for a better and reliable
      risk assessment, and the technology is available. Some of the effects observed
      (such as the changes in the pattern of lymphocyte subpopulations) must certainly
      be considered as biological effects induced by TCDD, and the situation is similar
      to the induction of hepatic monooxygenases, which are also observable in this
      dose range. However, the relevance of such changes with respect to adverse health
      effects in humans is presently difficult to judge in the absence of clear-cut
      functional deficits demonstrated so far either in vivo or in vitro.

PMID- 8363274
TI  - Prevention and treatment of allograft rejection in vivo by rapamycin: molecular
      and cellular mechanisms of action.

PMID- 8363275
TI  - Immunologic approaches to the therapy of HIV-1 infection.

PMID- 8363276
TI  - Gene transfer for therapy and prophylaxis of HIV-1 infection.

PMID- 8363277
TI  - Modulation of macrophage function by transforming growth factor beta, interleukin
      4, and interleukin-10.
AB  - The findings reviewed above leave no doubt as to the complexity of actions of TGF
      beta, IL-4, and IL-10 on monocytes/macrophages. Along with MDF, whose actions
      were recently reviewed elsewhere, TGF-beta, IL-4, and IL-10 are the only
      presently known, purified cytokines that have been shown to have strong
      macrophage-deactivating effects. However, none of them can be categorized as
      purely macrophage deactivating since they also exert macrophage-activating
      effects. In vitro, their effects, both in terms of extent and direction
      (activating vs. deactivating), are strongly influenced by the stimulation
      conditions (e.g., triggering signal, cytokine concentration, timing of cytokine
      addition), the species (mouse vs. human), the source (blood vs. peritoneal,
      alveolar, colostral) and the state of differentiation/activation of the
      macrophage (e.g., resting vs. inflammatory). In addition, TGF-beta, as well as IL
      4 and IL-10, up- and/or downregulates the function of several cell types other
      than macrophages, which further hampers our ability to predict, on the basis of
      in vitro experiments with macrophages, possible effects during an immune response
      in vivo. Despite this complexity, the highly reductive approach of in vitro
      studies has revealed important differences in the ability of TGF-beta, IL-4, and
      IL-10 to modulate the phenotype of monocytes/macrophages. The disparities have
      been most striking with regard to the secretory function of monocytes/macrophages
      (see Table 2). First, TGF-beta, IL-4, and IL-10 have a different spectrum of
      activity. Thus, TGF-beta, but not IL-4 or IL-10, can induce resting human
      monocytes to produce TNF, IL-1, and IL-6. Second, they affect monokine and RNI
      and ROI production to a different extent. For example, IL-10 is an approximately
      25-fold more potent suppressor of LPS-induced TNF production by mouse macrophages
      than is TGF-beta. Third, they differ in their ability to overcome additional
      activating stimuli, so that in the presence of LPS, IL-4, but not TGF-beta or IL
      10 suppresses IFN gamma-induced RNI release. Fourth, their macrophage
      deactivating effects require different stimulation conditions. Thus, IL-4, but
      not TGF-beta, interferes with RNI release strongly only after preincubation of
      the macrophages. Finally, these agents deactivate macrophages by distinct
      mechanisms. For example, IL-10 causes massive downregulation of TNF mRNA, whereas
      TGF-beta suppresses TNF release on a translational level. It will be a challenge
      to define clinical applications for these potent macrophage modulators on the
      basis of their different spectrum of activities. For TGF-beta and IL-4 such
      studies have already been initiated.

PMID- 8363278
TI  - Rapamycin prolongs survival of murine recipients of fully allogeneic donor grafts
      when administered during the graft-versus-host disease process.

PMID- 8363279
TI  - Pseudomonas exotoxin and recombinant immunotoxins derived from it.
AB  - Pseudomonas exotoxin (PE) is a bacterial toxin that kills mammalian cells by
      gaining entry to the cytosol and inactivating protein synthesis. The toxin binds
      and enters cells via the alpha 2-macroglobulin receptors. Within cells, the toxin
      is processed in several steps to produce an enzymatically active 37-kDa C
      terminal fragment which translocates to the cytosol and ADP-ribosylates
      elongation factor 2. Because PE is a very potent toxin, derivatives of it have
      been produced which, when joined to various binding ligands, are capable of
      killing specific target cells. It is hoped that this strategy will lead to the
      development of effective therapeutic agents for the treatment of human diseases
      such as cancer, AIDS, and various immunologic disorders.

PMID- 8363280
TI  - Superantigens in infectious diseases, including AIDS.

PMID- 8363281
TI  - RNA drug therapy acting via the 2-5A synthetase/RNase L pathway.

PMID- 8363282
TI  - Specific RNA drug therapy of hepatitis viruses.

PMID- 8363283
TI  - Quantitative determination of HLA-DR antigen expression on cell surfaces with
      monoclonal antibody by Dot-ELISA.

PMID- 8363284
TI  - Immunosuppressive effects of lymphocyte-specific histamine congener treatment of
      an adoptive transfer model.

PMID- 8363285
TI  - Issues in the development of a prophylactic HIV vaccine.

PMID- 8363287
TI  - Vaccines based on synthetic polyions and peptides.

PMID- 8363286
TI  - T cell vaccines for autoimmune diseases.

PMID- 8363288
TI  - Advances in influenza virus vaccine research.
AB  - Influenza epidemics occur annually in the United States and are characterized by
      high frequencies of illness among children and young adults, high hospitalization
      rates among infants and older persons, and high death rates among the elderly.
      Vaccines that can prevent infection must stimulate anti-hemagglutinin antibody in
      serum and secretions; those that stimulate anti-neuraminidase antibody or T cell
      cytotoxic responses can reduce the severity of infection and illness or hasten
      recovery. Advances in vaccine research are permitting evaluation of pure subunit
      vaccines, new adjuvants, topical immunization, and the use of immunomodulators
      for enhancing immune responses. In young adults, doses of HA of up to 405
      micrograms were well tolerated and provided enhanced antibody responses. Although
      use of a muramyl-dipeptide derivative as an adjuvant resulted in unacceptable
      reactogenicity, other adjuvants may be acceptable. Development of topical
      immunization and immunomodulators are under way. The cold-adapted live attenuated
      influenza virus vaccines for nasal administration are nearing availability. They
      are safe, immunogenic, and protective with greatest effectiveness among young
      children, in whom inactivated vaccines are less useful. Use among children should
      moderate the high frequencies of illness and hospitalization in this group and
      reduce spread of influenza in the community. CRV also provide an alternative to
      inactivated vaccines among young adults, in whom they can be equally protective.

PMID- 8363289
TI  - Effects of orally administered rapamycin in animal models of arthritis and other
      autoimmune diseases.

PMID- 8363290
TI  - The effects on pupil size and accommodation of sympathetic and parasympatholytic
      agents.
AB  - The time-response effect of two currently used mydriatics, phenylephrine and
      tropicamide, were evaluated in 524 eyes. Four different types of dilating
      regimens were used: 2.5% phenylephrine, 10% phenylephrine, 0.5% tropicamide, and
      the combination of 2.5% phenylephrine and 0.5% tropicamide. The analysis
      indicated that the recovery from mydriasis occurs between 5.5 and 7.0 hours with
      2.5% phenylephrine and at more than 7 hours with 10% phenylephrine. The 0.5%
      tropicamide induced rapid dilation, whereas the combined treatment, 2.5%
      phenylephrine plus 0.5% tropicamide, produced the largest maximum pupillary
      diameter. Tropicamide, alone or in combination, also produced a longer mydriatic
      effect, lasting more than 7.0 hours. The recovery from the cycloplegic effect of
      the mydriatics occurred between five and seven hours in the majority of patients,
      with tropicamide alone or in combination with phenylephrine requiring the most
      time to revert to normal ranges of accommodation. The findings in this study
      indicate that, in normal subjects, the recovery from the effect of mydriatic
      agents is longer than what is generally reported in the literature.

PMID- 8363291
TI  - The effect of wrist rest, caffeine, and oral timolol on the hand steadiness of
      ophthalmologists.
AB  - Because hand steadiness is an important aspect of microsurgical technique, hand
      movement, amplified by a hand-held laser pointer, was measured in 14
      ophthalmology trainees on four separate mornings when each had ingested (1) 200mg
      of caffeine, (2) 12.5mg of timolol (2.5mL of timolol 0.5% ophthalmic solution),
      (3) a combination of caffeine and the beta-adrenergic blocker, or (4) a placebo.
      Caffeine increased the resting pulse and hand movement. Although the beta
      adrenergic blocker and the combination of caffeine and this drug decreased the
      resting heart rate from that of placebo, they did not significantly change hand
      steadiness. However, compared with caffeine alone, the beta-adrenergic blocker
      caffeine combination significantly decreased hand movement and the pulse. Resting
      the wrist significantly steadied hand movements. Hand movement was not correlated
      with the level of ophthalmology training, the trainee's weight, or their daily
      caffeine consumption.

PMID- 8363292
TI  - Thirty years of cryoophthalmology.
AB  - Thirty years ago, the method of cataract cryoextraction was reported. The
      possibilities of low-temperature application in medicine were revealed and gave
      rise to the new branch of ophthalmology called cryoophthalmology. This article
      presents the development of this science, its achievements in ophthalmology, and
      the theoretic basis for using low temperatures in ocular diseases. Thirty years
      have passed, but cryoophthalmology still maintains its importance and usefulness,
      and many research centers all over the world are involved with it.

PMID- 8363293
TI  - Monolateral chorioretinitis with multiple foci in one case of Lyme disease.
AB  - Lyme disease involves numerous anatomic areas and systems and is caused by a
      spirochete, Borrelia burgdorferi. In this article, we describe one case of
      monolateral chorioretinitis with multiple foci in a 22-year-old myopic man. The
      diagnosis of this disease was confirmed by positive specific anti-B. burgdorferi
      antibodies titrated with an enzyme-linked immunosorbent assay method and by serum
      conversion occurring approximately six weeks after the end of therapy.
      Considering the potential effect of this disease on the world's population, we
      wish to draw attention to its occurrence because it frequently involves ocular
      structures. Prompt and adequate therapy guarantees complete healing and avoids
      both short- and long-term complications.

PMID- 8363294
TI  - Macular infarction after intravitreal amikacin.
AB  - A case of macular infarction after intravitreal amikacin was observed in a
      patient with postoperative endophthalmitis. A review of the literature revealed
      no previously documented case occurring after intravitreal amikacin. Suggestions
      to avoid such a complication in an otherwise recovered patient are discussed.
      Also, better alternatives to intravitreal aminoglycosides should be sought.

PMID- 8363295
TI  - Pseudoretinitis pigmentosa in patients with systemic lupus erythematosus.
AB  - A 42-year-old woman and a 62-year-old man with systemic lupus erythematosus (SLE)
      had bilaterally mottled retinas with spots or clumps of pigment. Their
      electroretinographic responses were subnormal. Their fundi resembled those of
      patients with retinitis pigmentosa. The fundus lesions of our patients may have
      resulted from vascular occlusion associated with SLE.

PMID- 8363296
TI  - Nonpenetrating trauma in the right eye induces anterior uveitis and secondary
      glaucoma in the contralateral eye.
AB  - A 31-year-old woman was shot with a toy bullet OD. Intracameral cells and fibrin
      were found, but no penetrating wound was noticed. Flare was observed in the left
      anterior chamber three days after the incident, and the intraocular pressure OS
      had increased. No specific type of uveitis or systemic inflammatory disease was
      identified. We believe that bilateral uveitis was precipitated in our patient by
      the nonpenetrating trauma.

PMID- 8363297
TI  - [Primary carcinoid of the larynx. Apropos of a case. Review of the literature].
AB  - We report a new case of primary atypical carcinoid of the larynx. This rare neuro
      endocrine neoplasm of the larynx was initially mis diagnosed in 50% of the cases
      published. Since, characteristically these are lesions of the epilarynx causing
      dysphonia at early stages of development, the diagnosis should be kept in mind
      when the work-up for dysphonia reveals a small tumor of the epiglottis or
      aryepiglottic folds. The histological diagnosis should be oriented by Grimelius
      staining and confirmed immunoperoxidase marker studies for chromogranin and
      cytokeratin. Although, atypical carcinoids of the larynx are aggressive malignant
      tumors, the prognosis for early lesions of less than 1 cm is excellent. However,
      unlike early squamous cell carcinomas, these tumors do not respond well to
      radiation therapy. Primary surgery is the treatment of choice.

PMID- 8363298
TI  - [Cervical leiomyosarcoma. Apropos of a case and review of the literature].
AB  - A case of leiomyosarcoma of the head and neck is presented together with a review
      of the literature. The histopathological diagnosis is difficult in spite of
      immunocytochemistry. Surgery is the therapy of choice.

PMID- 8363299
TI  - [Cervical cystic lymphangioma in adults].
AB  - Cystic hygromas, infrequent in children, are even rarer in adults where they once
      were generally an unexpected operative findings. Now, with the progress in modern
      medical imaging the diagnosis can be suggested before operation. Analysis of the
      embryogenesis helps to explain the different anatomical and clinical forms and
      the relations of the cystic hygroma with neighboring tissues, particularly of
      renous origin, grases of cystic hygroma of the neck in adults are reported and
      discussed with 26 other well documented cases from the literature. The diagnosis
      can be confirmed only after operation and histological examination. Surgical
      removal is technically less difficulte in adults than in children and recurrences
      are rare.

PMID- 8363300
TI  - [A new approach to the mechanism of vestibular response to caloric stimulation].
AB  - Barany's classical hydrodynamic theory has been called into question by the zero
      gravity Spacelab experiments, and several new hypotheses are put forth to explain
      the vestibular response to caloric stimulation. We have developed a mathematic
      model based on the analysis of an experimental model of the semicircular canal,
      incorporating observations done with zero-gravity and with gravity. Two purely
      mechanical phenomena are involved: one one hand, the modification of the
      hydrostatic pressure on both sides of the cupula due to a temperature variation
      if the semicircular canal is not in the horizontal plane in normal gravity
      conditions; on the other hand, local changes in endolymph pressure and volume due
      to the mechanical and osmotic properties of the canal, which are independent from
      gravity and from the position of the canal. These mechanical processes, though
      not exclusive, are predominant and therefore sufficient to explain the caloric
      response of the vestibulum in all cases.

PMID- 8363301
TI  - [Bacterial epidemiology of chronic otitis. Prophylactic and therapeutic
      deductions].
AB  - Antimicrobial sampling was performed in the external auditory canal and in the
      mastoid cavity when possible in 80 middle ears operated on during the last 15
      months. These samplings concerned 20 cholesteatomas. 25 suppurative chronic
      otitis, 25 non suppurative chronic otitis and 6 miscellaneous. In 20 out of 80
      cases (25%), one or several microbial agents were identified: cholesteatomas
      (35%), suppurative chronic otitis (38%), non suppurative ones (4%) and
      miscellaneous (16%). In most cases a staphylococcus or a negative gram agent was
      sensitive to amoxycillin-clavulanique acid. When sampling was performed in the
      mastoid cavity, the agent was not sensitive to this antibiotic (80% of cases).
      This study demonstrates that a prophylactic therapy against aerobic and anaerobic
      agents is necessary in non suppurative chronic otitis whereas the antimicrobial
      therapy must be adapted in other pathologies.

PMID- 8363302
TI  - [Clinical evaluation of otolithic function by the measurement of ocular
      cyclotorsion and skew deviation].
AB  - The ocular tilt reaction (OTR) consists in an association of an eye-head postural
      reaction, alteration of vertical perception, conjugated eye cyclotorsion, skew
      deviation and head tilt. We observed this condition following unilateral
      vestibular neurectomy and labyrinthectomy performed in patients suffering from
      severe Meniere's disease. All patients described postoperative vertical diplopia
      and vertical perception tilt. One illustrative case is reported in detail here.
      Changes in visual vertical were measured using a vertical frame with a pivoting
      pointer and the Maddox rod calibrated with a spirit level. The actual eye torsion
      was measured by a photography of eye-fundus. In the follow-up, it was found that
      vertical diplopia disappeared within a few days while conjugated eye cyclotorsion
      lasted weeks to months. Mechanisms involved in the OTR could be the consequence
      of a unilateral deafferentation of the utricular and saccular organs. We feel
      that the techniques of examination which we used with this patient might be a
      useful measurement for the clinical evaluation of unilateral otolithic
      dysfunction.

PMID- 8363303
TI  - [Diagnostic perspectives in rhinology].
AB  - The physical evaluation of the nasal cavity and paranasal sinuses has been
      improved by recent advances in diagnostic endoscopic systems and computerized
      tomography. Today, nasal endoscopy is considered to be the only comprehensive
      diagnostic rhinoscopic examination and computerized tomography has replaced the
      standard plain film roentgenograms in the initial evaluation of the paranasal
      sinuses. Advances have also been made in the evaluation of nasal functions,
      particularly in the assessment of obstruction. Rhinomanometry is the only method
      of objective assessment of the patency of the nasal cavities and makes it
      possible to perform nasal provocation tests. Today, this method of exploration
      should not be overlooked. Secretory function may be assessed by various methods:
      nasal cytology, quantification of inflammatory mediators in nasal cavity washing,
      and biochemical analysis of nasal secretions (albumin/protein ratio). Mucociliary
      function can be evaluated by measuring the nasal mucociliary clearance, by
      determining the frequency of cilia strokes (after brushing of the nasal mucosa
      and microscopic examination under stroboscopic light) and by election microscopic
      ultra-structure studies. Other methods of exploration which do not yet have a
      practical application are currently being investigated: rheologic studies of the
      mucus, immunologic evaluation of nasal secretions and acoustic rhinometry.

PMID- 8363304
TI  - [Rhinosinusal manifestations of cystic fibrosis].
AB  - The generalized disorders which characterize cystic fibrosis often involve the
      nose and paranasal sinuses and may frequently lead to the development of nasal
      polyps. A retrospective study of 78 patients with cystic fibrosis, 3 to 28 years
      old, was undertaken in order to determine the incidence of nasal involvement and
      to define an approach to the treatment of disabling recurrent nasal polyposis.
      65% of these patients presented chronic symptoms such as rhinorrhea, nasal
      obstruction and disturbances of smell. Nasal polyps were found in 50% of patients
      and were more frequent in adults than in children. Clinical symptoms were
      directly related to the extent of polyp development which could be classified
      according to 3 groups. CT scans showed maxillary sinus involvement in almost all
      patients. The incidence and extent of ethmoidal sinus involvement on CT scans was
      correlated to the grade of polyp development. Medical treatment of polyposis
      failed in all cases. Polypectomy was always followed by recurrence. Intranasal
      ethmoidectomy seems to be an interesting alternative, since 73% of patients
      undergoing this procedure had clinical improvement.

PMID- 8363305
TI  - [Metastatic basal cell carcinoma].
AB  - A case of basal cell carcinoma in a 17-year old male patient complicated, 5 years
      later, by inguinal and pulmonary metastases is reported. This clinical case
      raises two problems: the reality of the entity and the long-term follow-up of
      this type of tumours.

PMID- 8363307
TI  - [Value of methotrexate in a case of florid cutaneous sarcoidosis].
AB  - The effectiveness of methotrexate against cutaneous sarcoidosis lesions resistant
      to corticosteroids or synthetic anti-malarial drugs has been reported by a few
      authors, and it is confirmed by the following case-report. A 54-year old woman
      had been suffering from sarcoidosis since 1977. Most of the lesions affected the
      skin and consisted of a very large plaque over the forehead and lesions on the
      elbow, forearm and knee. She also had Lofgren's syndrome stage II and Perthes
      Jungling osteitis. The highly inflammatory and extensive features of these
      lesions, and the patient's plea for treatment justified a systemic therapy. A
      first 4-day course of methylprednisolone succinate given as intravenous bolus
      injection was remarkably effective with collapse of the skin lesions, but these
      recurred about 4 months later. A second 4-day course of methylprednisolone was
      followed by an oral combination of mepacrine and chloroquine. Four years later,
      reactivation of the lesions required another course of corticosteroids given
      intravenously, then orally for a long time, but the use of these drugs in doses
      exceeding 30 mg per day, the poor results obtained and the appearance of diabetes
      mellitus made it necessary to discontinue this treatment. The patient was then
      put on methotrexate 10 mg per week. After 13 months, the results were dramatic,
      and the improvement observed has remained progressive and persistent. The drug
      was well tolerated, both clinically and biochemically. Although the skin lesions
      of sarcoidosis are innocuous, a treatment is indispensable in view of the major
      cosmetic damage inflicted on the patient.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363306
TI  - [Oculocutaneous type II tyrosinosis].
AB  - Richner-Hanhart syndrome, also called oculo-cutaneous tyrosinosis type II, is a
      recessive autosomal genodermatosis consecutive to a disorder of tyrosine
      metabolism. It presents as a varying association of palmo-plantar keratosis,
      bilateral keratitis and mental retardation. The authors report a new case which
      is atypical in that palmoplantar keratosis made a late appearance. The diagnosis
      was confirmed by the presence of hypertyrosinaemia, hypertyrosinuria and urinary
      excretion of phenolic acids, and the absence of hepato-renal lesion. Needle
      biopsy of the liver, which demonstrates the deficiency of soluble cytosolic
      tyrosine aminotransferase, is not indispensable to the diagnosis and was not
      performed in our patient. Treatment consisted of a dietary measure: a controlled
      phenylalanine and tyrosine intake to obtain a tyrosinaemia below 10 mg/100 ml.
      This resulted in a favourable and durable course of the oculo-cutaneous lesions.
      In case of isolated skin lesion, retinoids can be prescribed either alone of
      combined with a diet, making it less strict.

PMID- 8363308
TI  - [Palmoplantar linear porokeratocic hamartoma].

PMID- 8363309
TI  - [Familial cutaneous amyloidosis].
AB  - Familial diseases with skin lesions of amyloidosis are numerous and diverse,
      including widely different entities. The most homogeneous group is the one where
      cutaneous amyloidosis is clinically isolated and of the lichenoid type. It is
      probable that in most of these forms the amyloid protein is a keratin. A genetic
      approach of the candidate gene type would confirm or infirm this hypothesis. In
      the second group of diseases the lesions of amyloidosis are associated with other
      genodermatoses and with two other familial diseases: Partington's disease and
      hereditary multiple endocrine neoplasia with cutaneous and visceral lesions. The
      position of amyloidosis in these different diseases varies and the mechanisms of
      its occurrence are unknown. The third group is that of skin amyloidosis as part
      of hereditary systemic amyloidosis. Future advances in this matter will rest on
      the characterization of the amyloid protein involved and on the discovery of
      genetic abnormalities responsible for these diseases.

PMID- 8363310
TI  - [Physiopathology of scleroderma].
AB  - Scleroderma (systemic sclerosis) is a connective tissue disease characterized by
      an excessive accumulation of collage in the main body organs. The subsequent
      progressive fibrosis may result in severe functional impairment of the tissue(s)
      involved. In this paper, recent advances in the understanding of the disease are
      reviewed. Particular emphasis is placed on the role played by vascular lesions,
      inflammatory cell infiltrates, autoimmunity and possibly abnormal secretion of
      cytokines in the disturbance of connective tissue production. A better knowledge
      of the pathophysiological process involved in scleroma might lead to the
      development of new therapeutic approaches.

PMID- 8363311
TI  - [A case for diagnosis: cutaneous alternariosis].

PMID- 8363312
TI  - [Complications of local anesthetics].

PMID- 8363313
TI  - [Drug-induced pseudolymphoma with predominantly cutaneous manifestation].

PMID- 8363314
TI  - [Pruritus sine materia: a pharmacological approach].

PMID- 8363315
TI  - [Effects of sublingual nifedipine on the velocity of pulse wave evaluated by
      Doppler echocardiography of the thoracic aorta].
AB  - Sublingual nifedipine has a rapid and powerful hypotensive effect. Its action on
      arterial distensibility can be assessed by measurement of pulse wave velocity
      (PWV) by Doppler echocardiography (DE). Ten patients were used to evaluate intra
      observer reproducibility (Group 1). Fifteen hypertension patients (Group 2), not
      taking a calcium antagonist, 64 +/- 13 years-old, were studied by DE before and
      15 minutes after 10 mg of SL nifedipine. The following were measured: systolic
      and diastolic blood pressures (SBP and DBP), heart rate (HR), echocardiographic
      shortening fraction (SF) and PWV, with sternal length (SL) taken as being
      identical to the length of the abdominal aorta between the isthmus and the
      coeliac region, and by measuring delta t: time interval for propagation of the
      pulsed Doppler velocimetric wave between the isthmic aorta and the coeliac aorta
      located by echocardiography: PWV = SL/delta t. Evidence was found in the
      nifedipine group (n = 15) of a fall in SBP (159.5 +/- 27.8 cf. 140.9 +/- 21 mmHg;
      p = 0.002); in DBP (88.6 +/- 13 cf. 79.6 +/- 8.3 mmHg; p = 0.005) and an increase
      in HR (72.3 +/- 10.7 cf. 76.8 +/- 12.9 bpm; p = 0.04). PWV decreased after
      nifedipine (10.5 +/- 3.9 cf. 7.15 +/- 12.9 bpm; p = 0.002). There was a linear
      correlation between the percentage reduction in PWV and left ventricular HR: y =
      194x - 53; r = 0.56; p = 0.029.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363316
TI  - [Symptomatic sinus dysfunction. A new use of electrophysiology].
AB  - The authors undertook a prospective electrophysiological study of 950 patients:
      53 subjects considered to be "controls" since they were free of any history of
      syncope or faintness were identified, as well as 39 symptomatic subjects with a
      strong suspicion of sinus dysfunction, since no other detectable cause of
      fainting episodes was found by extracardiac investigation, 24 hour ECG nor
      electrophysiology. Following the creation of a computerised tool enabling not
      only the entry of indirect tests, processing, averaging of results, printing and
      memorization, but also assistance in interpretation, several electrophysiological
      parameters were used: heart rate and existence of sinus arrhythmia, Strauss tests
      with adjusted data or not, effective nodal refractory period, Guize, Narula and
      Mandel tests, and an atropine (0.03 mg/kg) test which was performed only in the
      symptomatic group. These tests were studied by single-variate and correlative
      analysis to define their normal ranges, their critical values and their
      dependence or independence. The performance of each test (i.e. its efficiency,
      and the specificity and sensitivity of each critical value) was measured. Tests
      found to be most useful (specificity and efficiency > 90%) were as follows:
      Mandel test = CSRT > or = 534 ms, Narula test = TECASA > or = 339 ms, heart rate
      < or = 55/min, type II, IIa and chaotic Strauss curve associated with a
      pathological Guize test. The combination of these tests in this algorithm
      resulted in an increase in sensitivity to 84%, at the price of a very moderate
      fall in specificity to 87%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363317
TI  - [Compression of the coronary trunk by aneurysm of the antero-left Valsalva sinus
      associated with acute mitral insufficiency caused by rupture of the chordae
      following valvular prolapse. Successful triple surgical operation in a 66-year
      old patient].
AB  - Tearing of the chordae is a common complication of prolapse of the mitral valve;
      which becomes increasingly common with age. In contrast, aneurysm of the Valsalva
      sinus is rare in patients over 65 years of age. The antero-left sinus is an
      unusual location, but may be complicated by compression of the left coronary
      artery, which is reported in 16 cases in the literature. The case reported is
      unusual due to the combination in a 66-year old subject of acute mitral
      incompetence, due to tearing of the chordae following prolapse of the mitral
      valve, and an aneurysm pressing on the coronary trunk whilst remaining
      asymptomatic. Complete correction of the lesions was successfully achieved by
      surgery.

PMID- 8363318
TI  - [Left bundle-branch block and chest pain of simultaneous occurrence during
      exercise].
AB  - The authors report a new case of left bundle branch block with pain during
      exercise, with arteriographically normal coronary arteries. Clinical findings and
      the course of the condition are reviewed. Pathophysiological mechanisms are
      discussed, with attribution of first place to an ischemic theory.

PMID- 8363319
TI  - [Value of the methylergometrin maleate test in recurrent cardio-circulatory
      arrests].
AB  - A 56-year-old man, with no particular past history, sustained two cardio
      circulatory arrests preceded by constrictive chest pain. Coronary arteriography
      was normal during etiological investigations. The methylergometrine maleate
      (Methergin (tm)) test enabled the diagnosis of severe spastic angina and guided
      appropriate management of this patient.

PMID- 8363320
TI  - [Evaluation of embolic cerebrovascular complication: contribution of
      transesophageal echography].
AB  - Ischemic cerebrovascular accidents are classically attributed to an embolism of
      cardiac origin in 15% of cases. This longstanding concept is questioned by trans
      esophageal echocardiography (TEE). The incidence of anomalies which could be the
      origin of a cerebral embolism involves more than 50% of cases in certain series.
      The superiority of TEE over trans-thoracic echocardiography (TTE) emerges in
      particular when certain abnormalities such as an intra-atrial thrombus,
      spontaneous atrial contrast, an intra-aortic atherosclerotic plaque, a patent
      foramen ovale or an aneurysm of the inter-atrial septum are sought. The high
      incidence of such abnormalities in a population having sustained an ischemic
      cerebrovascular accident is not sufficient to establish a cause-and-effect
      relationship between the abnormality and the cerebral event. Certain
      abnormalities are commonly associated with each other or with emboligenic
      arrhythmias (atrial fibrillation). Studies hence remain required to determine the
      respective responsibilities of these various abnormalities and stratify their
      embolic risk by defining certain risk factors. While awaiting the result of such
      studies, it would seem valid to suggest the more routine use of TEE in the
      investigation of ischemic cerebrovascular accidents in young patients free of
      clinically obvious heart disease, and this regardless of the result of TTE.

PMID- 8363321
TI  - [Triangular or rectangular rehabilitation after myocardial infarction.
      Comparative study by drawing of lots evaluating performance and respiratory gas
      exchange].
AB  - Triangular and rectangular rehabilitation techniques were assessed by comparative
      exercise performance and respiratory evaluation in twenty six phase II post
      myocardial infarction patients. Patients all performed a standard exercise test
      with measurement of VO2, before and after 40 rehabilitation sessions. Clinical,
      exercise and ventilatory parameters were identical in the two groups before
      rehabilitation (triangular--n = 13; rectangular--n = 13). Exercise capacity was
      increased by 18% and 19% respectively after rehabilitation. Maximum aerobic
      capacity nevertheless remained unchanged (27.6 +/- 7.1 before; 28.3 +/- 6.7
      ml/kg/min after) in all patients. Analysis of variance failed to reveal
      superiority of one of the two rehabilitation techniques over the other.

PMID- 8363322
TI  - [Infectious endocarditis on permanent endocavitary pacemakers: value of
      echocardiography and review of the literature].
AB  - Infectious endocarditis around indwelling pacemakers is rare (0.15% of all
      implantations). They have a gloomy prognosis with a global mortality rate of
      nearly 34% as emerges from this review of the literature concerning 58 cases of
      infectious endocarditis published within the past 16 years. On the basis of the 6
      cases which the authors report, they stress the importance and sometimes
      difficulty of using ultrasound in a positive diagnosis. Cardiographic ultrasound,
      which can determine the size and emboligenic nature of vegetations is capital in
      choosing how to remove the pacemakers. Percutaneous ablation by simply pulling or
      by catheterization currently gives the best results, but it may be necessary to
      resort to surgery involving right atriotomy if emboligenic vegetations are
      present. By combining antibiotic treatment and ablation of the intracavitary
      material, a cure is obtained in 92% of cases. These figures should be compared
      with the lack of success of using antibiotic treatment alone which results in a
      high level of mortality (84%).

PMID- 8363323
TI  - Quality of medical care and quality assurance.

PMID- 8363324
TI  - Quality assurance in medicine: research and evaluation activities towards quality
      control in Singapore.
AB  - Quality assurance and medical audit requires a good Health Management Information
      System (HMIS) to support it. In Singapore, there is a well developed HMIS built
      on the routine reporting of utilisation and activity statistics from public
      sector and private sector hospitals, government clinics and support services. In
      addition, there is a computerised national surveillance system for disease
      monitoring, which includes the disease condition, operations done and the
      physician and surgeon responsible for managing any inpatient or day case admitted
      into any hospital in Singapore. This forms the basis for the computerised
      national health system known as Medinet. Supplementing this are ad hoc surveys on
      quality of service, medical audit studies and supplementary information systems
      such as the Births and Deaths registration system and the Census of Population.
      Such a well developed HMIS greatly facilitates medical audit in Singapore.
      Indicators for audit can be generated from existing health databases, which point
      to areas requiring further inquiry and investigation. The use of a unique
      National Registration Identity Card (NRIC) for every Singaporean enables
      healthcare utilisation at all levels to be linked, further enhancing the
      capability for medical audit here.

PMID- 8363326
TI  - The unripe cervix and its management for labour induction.
AB  - Cervical state plays an important part in the outcome of induced labour. The
      mechanism governing the process of ripening, which is part of the continuum
      ending in labour, is still not fully understood, but is thought to involve
      several hormonal interactions including oestrogens, progesterone, and
      prostaglandins. The prostaglandins have been found to produce the best results
      for inducing labour when the cervix is unripe and are most effective when
      administered locally and most convenient when placed in the vagina as a viscous
      gel, wax pessary or slow release pessary. They are of benefit for labour
      induction in cases previously delivered by lower segment caesarean section,
      breech presentation, and multiple pregnancies. Hyperstimulation and fetal
      distress may occur and this might be reduced with the use of the controlled
      release hydrogel pessary. Newer approaches using an antiprogestin or recombinant
      relaxin are being explored in the hope that further improvements in outcome can
      be obtained.

PMID- 8363325
TI  - Trends in human immunodeficiency virus infection: epidemiology in Singapore.
AB  - The acquired immunodeficiency syndrome (AIDS), caused by the human
      immunodeficiency virus (HIV) and recognised a decade ago, has reached pandemic
      proportions worldwide. By early 1992, the World Health Organisation estimates
      that at least 10 to 12 million people are infected with HIV globally. The
      majority of these infections are the result of heterosexual transmission. In
      South and South-east Asia, the AIDS pandemic is growing rapidly due to
      intravenous drug use and heterosexual transmission. Since 1985, the major route
      of HIV transmission in Singapore has been sexual. The transmission pattern,
      however, has changed from one that was predominantly homosexual or bisexual to
      one that is increasingly heterosexual from mid-1990. In addition, HIV infections
      among intravenous drug users, children and organ recipients who received
      transplantation overseas have also surfaced since 1990. It is estimated that
      there will be 400 cases of HIV infection in Singapore by the mid-1990s.

PMID- 8363327
TI  - Significance of assisted reproductive technology for other areas of medicine.
AB  - Assisted reproductive technology has achieved its place in the management of
      women with infertility. It is now being used to refocus gynaecological attention
      on patients with other enigmatic benign gynaecological conditions, such as
      endometriosis, and their medical treatments. Now that reasonable success rates
      can be achieved without risking unacceptable multiple pregnancy rates, many other
      medical disciplines are becoming involved. Specialists in these other disciplines
      need to modify their treatments accordingly to allow for future parenthood if
      this is appropriate. These specialists need also to be aware of past ethical
      dilemmas that infertility units have had to confront during the first ten years
      of this new technology.

PMID- 8363328
TI  - Occupational cancer in developing and newly industrialized countries.
AB  - Cancer is a worldwide public health problem, accounting for an increasing
      proportion of all deaths. It is the second leading cause of death in most of the
      industrialised world, and developing countries appear to be launched on a cancer
      epidemic, similar to that in industrialised countries. In developing countries,
      most cancer deaths are due to tumours of the stomach, oesophagus, lung, liver and
      uterine cervix; occupational cancers account for an undetermined number of these
      cases. Occupationally associated neoplasms may either be related directly to
      specific exposures within a workplace, e.g., bladder cancer in benzidine-exposed
      workers, or reflect indirect factors, including socioeconomic status and
      conditions of life. Asbestos-induced pneumoconiosis is recognised as an
      occupational disease in many developing countries, whereas asbestos-related
      malignancies draw less attention. The rising prevalence of cigarette smoking in
      these countries greatly magnifies the effect of asbestos in inducing lung cancer.
      Transplantation of industries from developed to developing countries is often
      accompanied by a reduction in the standard of working conditions. The rising
      unemployment in developing countries is unlikely to incite workers to claim
      better conditions.

PMID- 8363329
TI  - Changing prognosis of childhood cancer--an overview.
AB  - Significant advances in diagnosis and management have cured the majority of
      children with cancer. In the leukaemias, the commonest childhood malignancy,
      intensive induction-consolidation is important to ensure a lasting cure in about
      65-80% and to eliminate the traditionally bad prognostic risk factors associated
      with less intensive treatment. Bone marrow transplantation (BMT) has a curative
      role in the minority who relapse particularly while on treatment. With few
      exceptions, most paediatric solid tumours are curable. Although the multimodal
      approach is responsible for the progress made, chemotherapy has emerged to play a
      dominant role. It has, in several tumours, obviated or reduced the need for
      radiotherapy and/or surgery. In Wilms' tumour and Hodgkin's disease, refinement
      of treatment is now in progress to reduce therapy-related morbidity while not
      sacrificing efficacy.

PMID- 8363330
TI  - Acute injury of the neck: anatomical and pathological basis of pain.
AB  - Headache, upper torso and upper limb pain can all originate in lesions of the
      cervical spine. The pain distribution is similar whether the cause is traumatic
      or degenerative. Nociceptive fibres are present in many cervical spine structures
      including the disc annulus, facet joint capsules, muscles, meninges, arteries,
      nerve roots and dorsal root ganglia. Such nerves are not present in the disc
      nucleus, facet articular cartilages and the ligamentum flavum. Central nervous
      connections between the trigeminal nucleus and upper cervical sensory input
      provide an explanation for some forms of headache and facial pain. This paper
      focuses on neck sprain from road traffic accidents as a cause of pain. Similar
      lesions are seen in the cervical spines of those who die immediately and
      survivors who die some years after a neck injury, from unrelated causes. Both
      discs and facet joints are injured. The common disc injury is a "rim lesion" or
      transverse tear near the anterior vertebral rim. It is caused by distraction and
      shearing in sudden extension. Both the posterior disc and the facets are
      compressed, causing disc contusion or herniation, facet haemarthroses, bruising
      around the C2 nerve, or fractures of articular processes. Suboccipital vascular
      congestion and annulus calcification are also seen in the "survivors". Chronic
      pain develops in 20-40% of the "survivors". The reasons include altered spinal
      mechanics, neural damage and vascular changes. Management must always start with
      an accurate diagnosis based on a history and physical examination. Simple
      investigations such as extension X-rays may reveal vacuum clefts in the same
      anatomical position as rim lesions. Nuclear scans detect increased uptake at
      damaged end plates or facet fractures.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363331
TI  - Facial pain: trigeminal neuralgia.
AB  - Atypical facial pain is a loose term used to encompass a wide range of facial
      pain syndromes including those of dental and ear, nose and throat (ENT)
      aetiology. Often, it is associated with psychiatric conditions like depression
      and psychosomatic illnesses. This facial pain typically does not follow
      anatomical boundaries or its explainable by present day neurophysiological
      understanding. The pain is often constant with no remission and is aggravated by
      stress. Treatment is difficult and often directed to the psychiatric cause.
      Surgical treatment is contraindicated. Trigeminal neuralgia on the other hand,
      can be effectively treated. Pain in the trigeminal distribution is paroxysmal,
      precipitated by trigger factors and there is no pain in between attacks. The
      aetiology of trigeminal neuralgia is still unknown though current thinking is
      that there is a peripheral disturbance or damage with cerebral brainstem
      disinhibition of the trigeminal apparatus. This results in a paroxysmal discharge
      and reverberation of pain impulses when a trigger point is elicited. Therefore,
      anti-epileptic drugs like tegretol can be effective in controlling trigeminal
      neuralgia in the majority of patients, at least in the initial stages. For
      unknown reasons however, medical treatment either is not effective at all from
      the very beginning or fails after a few years. Surgery then becomes the only
      available therapeutic option. If the peripheral disturbance is due to an organic
      cause like a tumour, surgical approaches should be directed towards its removal.
      Often the pain will also resolve. If the trigeminal neuralgia is of the
      idiopathic variety, then the surgeon has a choice of either peripheral
      percutaneous retrogasserian ganglionectomies or central approaches like
      microvascular decompression and trigeminal tractotomy.

PMID- 8363332
TI  - New directions in cardiovascular mapping and therapy.
AB  - Cardiovascular mapping has allowed us to fully understand the mechanisms of some
      of the cardiac arrhythmias and enabled us to devise new therapeutic options for
      them. Endocardial mapping by electrophysiological studies using three to four
      endocardial catheters introduced via the vein or artery to the heart allows us to
      directly map the electrical activity of the heart during sinus rhythm and during
      abnormal tachyarrhythmias. The simultaneous recording of electrical activity from
      the surface electrocardiogram, right ventricular apex, His bundle, high right
      atrium, coronary sinus, with or without a roving mapping catheter, enables us to
      precisely map the electrical activation sequence in the heart. This technique has
      been especially useful for mapping supraventricular tachycardias and the precise
      mapping of the accessory pathway or slow pathway potentials have now allowed us
      to selectively ablate them using radiofrequency energy delivered via the tip of
      the endocardial catheter. Intraoperative direct cardiac mapping has allowed us to
      reconfirm the findings of endocardial catheter mapping immediately prior to
      surgery. The intraoperative mapping is more precise and allows direct
      visualisation of the abnormal site for the surgeon to operate. Computerised
      mapping using multichannel recordings has facilitated mapping of the abnormal
      site for patients with haemodynamically unstable or nonsustained ventricular
      tachycardia, and thus allows the surgeon to perform surgical resection or
      cryoablation of the abnormal site. Cardiovascular mapping has thus enabled us not
      only to understand the mechanisms of cardiac arrhythmias but allows us to provide
      curative therapy for patients who are at risk from sudden arrhythmic death or
      otherwise need life long drug therapy.

PMID- 8363333
TI  - The 11th Gordon Arthur Ransome Oration: ethical and legal issues arising from new
      frontiers in medicine.

PMID- 8363334
TI  - Obstetric litigation--what are the problems.

PMID- 8363335
TI  - Quality assurance in medicine: a dental audit system.
AB  - Two principal components of a quality assurance system for dental plans are
      described, using a case report to illustrate the methodology. Criteria of
      acceptable quality of patient care for general practice were developed first.
      Then plan, practice and patient profiles, derived from claims or encounter data,
      were used to identify the nature and extent of aberrant patterns which were
      uncovered. Based on analysis of the profiles, site visits were made to a targeted
      sample of practices and selected patient dental records were evaluated for
      various levels of the process of care. Categories were rated as either acceptable
      or unacceptable. Principal dentists were debriefed on the findings and a report
      including corrective action plans prepared for the responsible agency. Follow-up
      to monitor compliance is planned. Although aberrant profiles do not necessarily
      mean that care is unacceptable, the findings from the record review confirmed the
      concerns raised by the data analysis.

PMID- 8363336
TI  - Quality assurance in the training of primary health care doctors and specialists.
AB  - Training of doctors is expensive as it requires at least six years of supervision
      while on the job plus sponsorship for courses, examination and even overseas
      training. Quality assurance of training is essential to ensure maximum throughput
      of the required number of specialist doctors for national needs. First, there is
      competition for training posts at basic (three years) and advanced (three years)
      levels. Basic training prepares doctors to sit and pass the relevant postgraduate
      examinations. Fifty percent of each cohort of doctors are selected as Basic
      Trainees but 40% finally complete Advanced Training. Second, trainees complete a
      training programme under supervision and record their clinical and learning
      experience in log books which are checked and certified by appointed supervisors
      who are consultants in government and restructured hospitals or institutions.
      Third, supervisor reports are submitted six monthly to the respective bodies:
      Academy of Medicine, School of Postgraduate Medical Studies or the Ministry of
      Health and Training Committees which vet these with the aim to continue the
      training or to terminate the training. Fourth, Parts I and II of relevant
      examinations must be passed within stipulated time frames. By these measures,
      there is quality assurance in the postgraduate training of our doctors.

PMID- 8363337
TI  - Neonatal jaundice: update on phototherapy management.
AB  - Phototherapy is now the standard form of treatment for infants with neonatal
      hyperbilirubinaemia. Though gradual in its effect, it finally produces a
      prolonged reduction in bilirubin values; retreatment with phototherapy is
      relatively rare. Factors that affect efficacy of phototherapy are: initial
      bilirubin level, birth weight, gestational age, postnatal age, aetiology of
      jaundice and light intensity and spectral emission. Phototherapy has now been
      demonstrated to be highly effective and safe; with simple precautions, no
      untoward side-effects will occur. The guidelines for commencement, monitoring and
      cessation of phototherapy are provided.

PMID- 8363338
TI  - Colonic pouch after low anterior resection of the distal third of the rectum.
AB  - Very low anterior resection with construction of colo-anal anastomosis for
      carcinoma of the distal third of the rectum may result in an increased bowel
      frequency and urgency. These latter problems have been correlated directly with
      the decreased capacity and compliance of the neo-rectum. Clinical trials have
      shown a significant advantage of the colonic pouch-anal anastomosis over
      conventional colo-anal anastomosis in decreasing post-operative bowel frequency
      and urgency as the former increases neo-rectal capacity. Recent innovations in
      pouch design and construction with the ingenious use of mechanical stapling
      devices will enable the widespread use of the colonic pouch to benefit more
      patients who require very low anterior resection for carcinoma of the distal
      third of the rectum.

PMID- 8363339
TI  - The modified radical mastectomy of Patey: technique and experience.
AB  - We report our experience from 193 patients with breast cancer treated by Modified
      Radical Mastectomy of Patey and describe the technique used, amplified by
      illustrations. We achieved a low morbidity viz symptomatic lymphoedema five
      cases, chronic shoulder stiffness one case, skin grafting two cases, and all
      cases of chest wall pain cleared by four years. Cancer recurred, to date, local
      in nine cases (4.6%), local and systemic in 17 cases (8.9%) and systemic in 27
      cases (13.9%). We compile, for the first time, all references by Patey and
      Richard Handley to the procedure. We recommend the operation as achieving
      complete primary clearance with safe and full axillary node removal. Histological
      state of the nodes allows rational decisions on adjuvant therapy with hormones
      and chemotherapy.

PMID- 8363340
TI  - Poisons information in Singapore.
AB  - The Poisons Information Centre (PIC) provides viral and timely information to
      prevent and manage poisoning episodes. Comprehensive information on household,
      agricultural and industrial chemicals, natural toxins, pharmaceuticals, local
      antidote stocks and local poisons experts is retrieved from the Centre's
      computerised information system and printed literature. Public subscribers can
      obtain poisons information through Teleview.

PMID- 8363342
TI  - Multifocal mucus secreting papillary adenocarcinoma of the bile duct causing
      obstructive jaundice.
AB  - We present a 64-year-old Malay lady who had undergone a choledochoduodenostomy
      (CDD) two years ago for obstructive jaundice. She was admitted with jaundice and
      underwent ultrasonography, percutaneous transhepatic cholangiography (PTC),
      endoscopic retrograde cholangio pancreatography (ERCP) and computed tomographic
      (CT) scanning of the liver and biliary tree. All the investigations confirmed a
      type IVa choledochal cyst. At operation, the grossly dilated biliary system was
      packed with a thick mucoid material and the mucosa of the bile ducts was visibly
      abnormal with scattered nodules. This mucoid material had caused occlusion of the
      entire biliary tree resulting in obstructive jaundice. To the best of our
      knowledge, this is probably the first report of obstructive jaundice caused by
      thick mucus. The peculiar management problems of this case and the risk of
      malignant change in choledochal cysts are discussed.

PMID- 8363341
TI  - Altered immunity in haemophiliacs treated exclusively with cryoprecipitate.
AB  - Sixty-five patients with haemophilia A from Singapore General Hospital, treated
      within the last 15 years exclusively with cryoprecipitate, were studied for the
      effect of the total number of exposures to random blood donors on their immune
      system. These haemophiliacs were aged 4 to 71 years (median 24 years) and were
      all apparently healthy with no clinical evidence of viral infection. None of them
      was a homosexual or intravenous drug user. All of them tested negative for human
      immuno-deficiency virus antibody and hepatitis B surface antigen. Analysis of the
      T-lymphocyte subset population showed 20 out of 65 haemophiliacs or 30.8% had
      reversal of T4/T8 ratio, ie. less than 1.00. There was no significant difference
      in the mean age of the 20 patients with abnormal T4/T8 ratios compared with the
      45 with normal T4/T8 ratios. The mean age of the former group was 23 and the
      latter was 25. The group with reversal of T4/T8 ratio had exposure to 827.4 +/-
      137.3 (mean +/- SEM) random blood donors, which is significantly higher than
      402.5 +/- 64.1 in the group with normal T4/T8 ratio (p < 0.05). The reversal of
      T4/T8 ratio is predominantly due to the suppression of absolute T4 cell counts,
      with slightly raised absolute T8 cell counts. This abnormality may be transient
      or permanent. Interestingly, all the six out of 65 haemophiliacs with factor VIII
      inhibitor did not show any reversal of T4/T8 ratio in this study.

PMID- 8363343
TI  - Clinical profile of stage D carcinoma of the prostate--a ten-year experience.
AB  - Carcinoma of the prostate has become one of the top ten malignancies in Singapore
      but to date, there has been little local clinical data available on the disease.
      This study aims to establish the clinical profile of Stage D carcinoma of the
      prostate in the local population. Forty-seven patients with Stage D disease
      treated by the department over a ten-year period, 1981-90, were studied. The
      majority (47.7%) fell in the age-group 66-75 years and the most common presenting
      symptom was bone pain (36.2%). Both acid and alkaline phosphatases were found to
      be poor diagnostic markers of the extent of the disease. Acid phosphatase was not
      elevated in 25.0% and alkaline phosphatase not elevated in 39.1% of our patients.
      Forty of these patients had orchidectomy and of these, ten were also treated with
      oral stilbesterol. Five-year survival for the orchidectomy group was 22.7% and
      that for the orchidectomy-plus-stilbesterol group was 23.0%. This compares well
      with other studies done in the West. Eight patients died within the first year of
      diagnosis but of those who survived, all remained symptom-free within this first
      year. The proportion of those who remained symptom-free fell to 25.0% of the
      survivors for subsequent years.

PMID- 8363344
TI  - Hepatic candidiasis: persistent pyrexia in a patient with acute myeloid leukaemia
      after recovery from consolidation therapy-induced neutropenia.
AB  - Fever, a frequent manifestation in acute leukaemia patients who develop treatment
      induced neutropenia, usually resolves when the neutrophil count returns to normal
      irrespective of whether an infective agent is isolated or not. A persistent
      pyrexia following neutrophil recovery and associated with multiple negative
      microbiological cultures should signal a careful search for a deep-seated fungal
      infection in any leukaemic patient who is complete remission. We report here a 39
      year-old Chinese man with acute myeloid leukaemia in first complete remission
      whose unresolved fever after recovery from consolidation therapy-induced
      neutropenia was ultimately confirmed to be caused by focal hepatic candidal
      microabscesses by an open liver biopsy.

PMID- 8363345
TI  - Third chapter of surgeons lecture: revolution in urology and its evolution in
      Singapore.
AB  - Urology has been an evolving specialty since the time of Hippocrates. The
      itinerant surgeon was known to go from town to town to remove bladder stones in
      the early middle ages. In this century, urologists had been at the forefront in
      pioneering minimally invasive surgery with the introduction of transurethral
      resection of the prostate more than 50 years ago in the United States. This could
      be considered the first revolution in urology and this has influenced the
      evolution of urology in Singapore. Transurethral surgery had proved to be far
      superior to open surgery for most lesions of the lower urinary tract. This
      technique was introduced to Singapore in the early 1970s by Dr N E Wong. Because
      of the need for special instruments, skill and training, there was a need for a
      Department of Urology. This was not to be until after the second revolution in
      urology. The second revolution saw the introduction of endoscopic surgery of the
      upper urinary tract and Extra-corporeal Shockwave Lithotripsy in the early 1980s.
      This had truly revolutionised the treatment of urinary stones and today almost
      95% of patients can be treated with these non to minimally invasive techniques.
      These new modalities of treatment were rapidly introduced in Singapore in the mid
      1980s. The need for the establishment of urology as a specialty was more urgently
      felt. The Singapore Urological Association was formed in February 1986 and in
      March 1987, a Division of Urology was formed at the Singapore General
      Hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363346
TI  - Distinguished academician 1992 lecture. Role of the surgeon in scientific medical
      progress.

PMID- 8363347
TI  - Synaptic plasticity in Alzheimer's disease.

PMID- 8363348
TI  - Transplants for stroke patients?

PMID- 8363349
TI  - Human positron emission tomographic [18F]fluorodopa studies correlate with
      dopamine cell counts and levels.
AB  - Postmortem counts of dopaminergic cell densities in the substantia nigra (5
      subjects) and striatal levels of dopamine (DA) and its metabolites (6 subjects)
      were determined on 1 parkinsonian (PD), 3 progressive supranuclear palsy (PSP), 1
      amyotrophic lateral sclerosis, and 1 Alzheimer's case who had been positron
      emission tomography scanned with 6-[18F]fluorodopa during life. [18F]Fluorodopa
      uptake rate constants, which presumably depend on the number of functioning
      striatal DA terminals, were strictly proportional to cell densities (significant
      correlation with zero intercept) and also correlated significantly with striatal
      DA levels but with an intercept indicating greater losses of DA than of terminals
      in PSP and PD. Postmortem data on 6 PD, 1 PSP, and 9 neuronally normal controls
      substantiated the significant correlation between cell counts and DA levels, with
      the latter being the more depressed in pathological cases.

PMID- 8363350
TI  - Correlation of striatal fluorodopa uptake in the MPTP monkey with dopaminergic
      indices.
AB  - Striatal 18F-6-fluorodopa (FD) uptake constants were measured by positron
      emission tomography in (1) normal cynomolgus monkeys and (2) a series of
      cynomolgus and rhesus monkeys that had received intracarotid infusions of 1
      methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). After the animals were killed,
      the number and average size of dopaminergic neurons in the substantia nigra pars
      compacta were measured. Striatal levels of dopamine and its metabolites, and the
      striatal activities of the dopaminergic synthetic enzymes, were also determined.
      The striatal FD uptake constants showed highly significant positive correlations
      with both number and size of dopaminergic neurons, indicating atrophy of
      surviving neurons in MPTP-treated animals. The uptake constants also showed
      significant positive correlations with striatal levels of dopamine, total
      catecholamines, and the activities of the synthetic enzymes. Both histochemical
      and biochemical data on tyrosine hydroxylase suggested some contralateral enzyme
      loss in these MPTP-treated monkeys, as well as decreased enzyme activity in
      surviving neurons on the lesioned side. However, residual enzyme activities were
      apparently not rate limiting to striatal FD uptake. It is concluded that PET-FD
      measurements by positron emission tomography provide a good index of the
      integrity of the nigrostriatal pathway.

PMID- 8363351
TI  - Magnetic stimulation of the brain in generalized epilepsy: reversal of cortical
      hyperexcitability by anticonvulsants.
AB  - Observations on experimental models suggest that diffuse cortical
      hyperexcitability is an important abnormality in the generalized epilepsies. We
      used the threshold for transcranial magnetic stimulation as an index of motor
      cortical excitability in 89 neurologically normal control subjects and 56
      patients with idiopathic generalized epilepsy (20 untreated and 36 chronically
      treated with anticonvulsants). Magnetic stimulation was repeated in 10 patients
      after valproate monotherapy had been commenced and in 23 control subjects. The
      threshold intensity was significantly lower in the untreated patients (46 +/- 5%
      [mean +/- 95% confidence interval]) than in the control subjects (56 +/- 2%).
      Treated patients had significantly higher thresholds (64 +/- 4%) than did
      untreated patients and control subjects. A significant increase in threshold
      intensity (8 +/- 2%) occurred in patients retested after starting valproate;
      there was no significant change in retested control subjects (-1 +/- 2%).
      Threshold intensity was positively correlated with plasma valproate levels (rs =
      0.37). The findings suggest that cortical excitability is increased in idiopathic
      generalized epilepsy and is reduced following anticonvulsant treatment.
      Transcranial magnetic stimulation is of use in examining the pathophysiology of
      generalized epilepsy. Furthermore, changes in threshold intensity in response to
      anticonvulsant treatment may prove useful in guiding therapy.

PMID- 8363352
TI  - Quantitative assessment of synaptic density in the entorhinal cortex in
      Alzheimer's disease.
AB  - We quantified the synaptic density in the entorhinal cortex (Brodmann area 28) in
      autopsy material from 10 individuals with Alzheimer's disease and compared them
      to 11 age-matched, postmortem-matched control subjects without dementia, using
      standard electron microscopy. The statistical data showed no change in synaptic
      density between control and Alzheimer subjects, in either lamina III or V of the
      cortex. There were no correlations between synaptic density and synaptic
      apposition length or density of senile plaques. The entorhinal cortex stands in
      marked contrast to other cortical areas that show a significant decline in
      synaptic numbers with Alzheimer's disease. This preservation of synaptic numbers
      may be related to a plasticity response that is greater in the entorhinal area
      than in other areas of the cortex.

PMID- 8363353
TI  - Functional integration of cortical grafts placed in brain infarcts of rats.
AB  - Five to 6 days after a right middle cerebral artery occlusion, a cell suspension
      of fetal neocortex was grafted into the infarcted area of adult spontaneously
      hypertensive rats. Three to 17 months later, functional integration of the grafts
      into the afferent somatosensory pathway was tested using the 2-[14C]deoxyglucose
      method for estimation of glucose utilization. Grafted rats (n = 8) and control
      rats (n = 5) with no arterial occlusion were stimulated in the left vibrissal
      region resulting in an increased glucose utilization in the left trigeminal
      sensory nucleus and the right ventroposterior nucleus of the thalamus, whereas
      the same regions in a group (n = 5) of nonstimulated grafted rats were not
      activated. Glucose uptake in the right somatosensory cortex of control rats was
      96 +/- 5 (mean +/- SEM) mumol/100 gm/min. Neocortical grafts consumed less
      glucose than cortex in control rats but the vibrissae-stimulated group displayed
      a 110% higher value than the nonstimulated grafted group (32 +/- 5 vs 15 +/- 2, p
      < 0.05). We conclude that graft glucose metabolism is increased following
      stimulation of the host somatosensory pathway, which demonstrates that
      transplanted neurons can be functionally integrated with neural circuitries of
      the host after an ischemic insult.

PMID- 8363354
TI  - Differential neural activity in the human temporal lobe evoked by faces of family
      members and friends.
AB  - In 6 patients, depth electrodes revealed differential evoked responses to
      familiar versus novel faces. These differential responses were obtained in the
      amygdala, hippocampus, and temporal neocortex but not in the dorsolateral frontal
      or cingulate cortex. The limbic and temporal structures that differentiated novel
      from familiar faces did not respond differentially to variations in luminance.
      Limbic structures and temporal cortex thus appear to participate in face
      recognition and in encoding the familiarity of visual experiences.

PMID- 8363355
TI  - Neurological cholinesterases in the normal brain and in Alzheimer's disease:
      relationship to plaques, tangles, and patterns of selective vulnerability.
AB  - Butyrylcholinesterase (BChE) and an altered form of acetylcholinesterase (AChE)
      accumulate in the plaques and tangles of Alzheimer's disease (AD). The sources
      for these plaque- and tangle-bound cholinesterases have not been identified. We
      now report that AChE and BChE activities with pH preferences and inhibitor
      selectivities identical to those of plaque- and tangle-bound cholinesterases are
      found in the astrocytes and oligodendrocytes of control and AD brains. These
      glial-type cholinesterases are selectively inhibited by indolamines and protease
      inhibitors. In control brains glial-type cholinesterases appear confined to the
      intracellular space, whereas in patients with AD they decorate plaques and
      tangles as well. In control and AD brains AChE-positive glia are distributed
      throughout the cortical layers and subcortical white matter, whereas BChE
      positive glia reach high densities only in the deep cortical layers and white
      matter. In non-AD control brains, the ratio of BChE to AChE glia was higher in
      entorhinal and inferotemporal cortex, two regions with a high susceptibility to
      the pathology of AD, than in primary somatosensory and visual cortex, two areas
      with a relatively lower susceptibility to the disease process. There was no age
      related differences in the density or distribution of cholinesterase-positive
      glia. In comparison with age-matched control specimens, AD brains had a
      significantly higher density of BChE glia and a lower density of AChE glia in
      entorhinal and inferotemporal regions but not in the primary somatosensory or
      visual areas. These results suggest that glia constitute a likely source for the
      cholinesterase activity of plaques and tangles and that a high ratio of BChE- to
      AChE-positive glia may play a permissive or causative role in the neuropathology
      of AD.

PMID- 8363356
TI  - Conjugal Alzheimer's disease: is there an increased risk in offspring?
AB  - Thirty-one couples in which both spouses had the clinical diagnosis of
      Alzheimer's disease (AD) (confirmed by autopsy in 12) were ascertained. The mean
      age of onset of dementia was 75.1 +/- 7.4 years. These couples had 87 children,
      63 still living. Seventeen (19.5%) of the children developed dementia, with a
      mean age of onset of 68.9 +/- 8.3 years. Thirty of the children of the conjugal
      AD couples survived to age 65 or longer and 14 (47%) of them developed dementia.
      This prevalence of dementia in the children of affected couples is much greater
      than that in the children of two control groups consisting of 234 couples in
      which one spouse had AD and 192 couples in which neither spouse was demented.
      Twenty-one of the conjugal AD couples had a family history of AD but the
      prevalence of dementia in their children was not greater than that in the
      children of conjugal AD couples without a family history of AD. These results
      represent additional evidence of an important genetic component in late-onset AD
      and provide empirical risk data for the children of conjugal AD couples.

PMID- 8363357
TI  - Cortical vascular abnormalities in the syndrome of celiac disease, epilepsy,
      bilateral occipital calcifications, and folate deficiency.
AB  - The pathological changes in the syndrome of celiac disease, folate deficiency,
      bilateral occipital calcifications, and intractable epilepsy have not been
      previously described. A child with this disorder had a field defect correlating
      with active lateralized epileptic discharges and asymmetrical lesions. After
      resection of the right occipital lobe she was seizure free for 4 years. A
      cortical vascular abnormality with patchy pial angiomatosis, fibrosed veins, and
      large jagged microcalcifications was found. These pathological abnormalities were
      similar though not identical to those found in the Sturge-Weber syndrome.

PMID- 8363358
TI  - Role of the left and right supplementary motor areas in memory-guided saccade
      sequences.
AB  - Six right-handed patients with a lesion affecting the left (3 patients) or right
      (3 patients) supplementary motor area were studied using single and sequential
      memory-guided saccade paradigms. Accuracy of single saccades was preserved in
      both groups, compared to control subjects, and the chronology of saccade
      sequences was disturbed in the group with the left lesion but not in the group
      with the right lesion. The results suggest that neither side of the supplementary
      motor area is involved in spatial memory, and that the left supplementary motor
      area plays a greater role in motor sequencing than does the right supplementary
      motor area.

PMID- 8363360
TI  - Pain-triggered seizures.

PMID- 8363359
TI  - Failure of 3,4-diaminopyridine to reverse conduction block in inflammatory
      demyelinating neuropathies.
AB  - 3,4-Diaminopyridine was administered to 6 patients with inflammatory
      demyelinating neuropathies in whom partial conduction block was demonstrable.
      Four had Guillain-Barre syndrome and 2 had chronic inflammatory demyelinating
      neuropathy. Nerve conduction studies were performed before the administration of
      a single oral dose of 3,4-diaminopyridine, and at regular intervals thereafter.
      Neither resolution of conduction block nor clinical benefit were seen.

PMID- 8363361
TI  - Laser microprobe mass analysis in Alzheimer's disease.

PMID- 8363362
TI  - Aphasic dementia and motor neuron disease.

PMID- 8363363
TI  - Positron emission tomographic imaging of the dopamine transporter with 11C-WIN
      35,428 reveals marked declines in mild Parkinson's disease.
AB  - Parkinson's Disease (PD) is characterized by a selective loss of nigrostriatal
      dopaminergic neurons that results in a marked reduction of dopaminergic nerve
      terminals in the striatum. Recently, 11C-WIN 35,428, a cocaine analogue that
      specifically labels the dopamine transporter, was developed and can be used to
      label dopaminergic nerve terminals in vivo by positron emission tomography. In
      healthy control subjects, binding of 11C-WIN 35,428 is highest in the striatum.
      In addition, 2 symmetrical focal areas of low binding were observed in the
      midbrain. The cerebellum functioned as an appropriate region for nonspecific
      binding. The binding of 11C-WIN 35,428 in patients with PD (Hoehn-Yahr II) was
      compared with that in healthy control subjects by using the (region
      cerebellum)/cerebellum ratio for data acquired 34 to 82 minutes after injection.
      In control subjects, this ratio varied, at approximately 2, in the striatum. In
      patients with PD, binding in the posterior putamen was reduced by 78%, whereas
      the anterior putamen and the caudate nucleus showed a reduction of 59 and 39%,
      respectively. The reduction in 11C-WIN 35,428 binding was highest in the midbrain
      (84%). The high specific/nonspecific binding ratio and the pronounced reduction
      in binding in mild PD may permit detection of even earlier stages of PD or
      presymptomatic individuals with dopaminergic cell loss.

PMID- 8363364
TI  - Penetration of lipophilic agents with multiple protonation sites into bacterial
      cells: tetracyclines and fluoroquinolones as examples.

PMID- 8363365
TI  - Characterization of the gene for chromosomal trimethoprim-sensitive dihydrofolate
      reductase of Staphylococcus aureus ATCC 25923.
AB  - The gene for the trimethoprim-sensitive (Tmps) chromosomal dihydrofolate
      reductase (DHFR) of Staphylococcus aureus ATCC 25923 was cloned and
      characterized. The structural gene encodes a polypeptide of 159 amino acid
      residues and has a calculated molecular weight of 18,251. The amino acid
      sequences of this Tmps DHFR and those of the trimethoprim-resistant type S1 DHFR
      encoded by transposon Tn4003 are 80% identical. In contrast to the trimethoprim
      resistant enzyme, the Tmps DHFR can be highly overexpressed in Escherichia coli,
      with most of the recombinant protein occurring in a soluble and an active form.

PMID- 8363366
TI  - Penicillin-binding proteins of Rhodococcus equi: potential role in resistance to
      imipenem.
AB  - Rhodococcus equi is a gram-positive coccobacillus which, like other members of
      the order Actinomycetales, is increasingly reported as an opportunistic pathogen
      in patients with AIDS. The use of combinations of antibiotics that include
      imipenem (IMP) has been suggested for the treatment of patients infected with R.
      equi. An antagonism between IMP, meropenem, cefoxitin, ceftriaxone, moxalactam,
      and oxacillin and other beta-lactams, such as penicillin, amoxicillin,
      cephalothin, and ticarcillin, was detected in vitro both on Mueller-Hinton agar
      and in broth for all 10 IMP-susceptible R. equi strains examined. To study the
      mechanism of the antagonism between beta-lactams, a mutant with decreased
      susceptibility to IMP (isolate IpR) was selected in vitro from a susceptible
      clinical isolate of R. equi (isolate IpS). IpR exhibited decreased susceptibility
      to IMP, meropenem, cefoxitin, ceftriaxone, moxalactam, and oxacillin but not to
      penicillin, amoxicillin, cephalothin, or ticarcillin. No beta-lactamase was found
      in IpS, IpS cultured with antagonistic beta-lactams, or IpR strains. Labeling of
      penicillin-binding proteins (PBPs) revealed four PBPs with molecular masses of
      ca. 59, 56, 43, and 26 kDa in IpS. In IpR, PBP 3 disappeared and was replaced by
      PBP 3a of 40 kDa. The 50% saturation of PBP 3 and PBP 3a by the carbapenems
      correlated with the MICs of these antibiotics, respectively, for IpS and IpR
      strains. However, PBP 3a was not detected in IpS when IpS was cultured in the
      presence of beta-lactams, with which antagonism was observed. The present work
      describes the PBPs of R. equi and reports that IMP resistance in R. equi is
      related to an altered PBP pattern.

PMID- 8363367
TI  - Antibiotic susceptibilities of Afipia felis in axenic medium and in cells.
AB  - Afipia felis, one of the putative agents of cat scratch disease (CSD), is a
      facultative intracellular bacterium. Although CSD is considered not to be
      susceptible to antibiotic therapy, sporadic case reports indicated that
      aminoglycosides may be effective. We determined the in vitro antibiotic
      susceptibilities of three A. felis strains in axenic medium and in a cell model.
      In axenic medium, A. felis was susceptible to imipenem, aminoglycosides, and
      rifampin when using either the broth dilution technique or the agar technique.
      When grown in HeLa cells, A. felis was susceptible to amikacin and tobramycin but
      was resistant to the other compounds tested. Despite its intracellular location,
      A. felis can apparently be reached by aminoglycosides. Thus, the in vitro data
      presented here are in accord with the clinical data obtained in patients
      suffering CSD.

PMID- 8363368
TI  - Pharmacokinetics of cefepime in cystic fibrosis patients.
AB  - The purposes of this study were to determine and compare the single- and multiple
      dose pharmacokinetics of cefepime in patients with and without cystic fibrosis.
      Twelve patients with cystic fibrosis hospitalized for treatment of acute
      pulmonary exacerbations were studied. In addition, pharmacokinetic data for seven
      of the patients with cystic fibrosis were compared with those for seven age
      matched control patients. The cefepime dose was 50 mg/kg of body weight (maximum,
      2 g) administered as a 30-min intravenous infusion every 8 h for a minimum of 8
      days. Serial plasma and urine samples, obtained after the first and last doses,
      were analyzed for cefepime content by a validated high-pressure liquid
      chromatographic assay. By standard noncompartmental analysis, the pharmacokinetic
      parameters ascertained were area under the concentration in plasma-time curve,
      elimination half-life, total body clearance, renal clearance, and volume of
      distribution at steady state. In addition, the maximum concentration in plasma
      was recorded. Mean (+/- standard deviation) results of the first dose analysis in
      patients with cystic fibrosis were as follows: maximum concentration in plasma,
      142.6 (+/- 26.07) micrograms/ml; area under the concentration in plasma-time
      curve, 265.3 (+/- 114.31) micrograms.h/ml; elimination half-life, 1.8 (+/- 0.53)
      h; total body clearance, 127.2 (+/- 50.94) ml/min; renal clearance, 91.1 (+/-
      38.86) ml/min/kg; volume of distribution at steady state, 14.1 (+/- 4.31) liters.
      Analysis for the last dose in patients with cystic fibrosis did not vary
      appreciably from these values, nor did those from the controls. Thus, it appears
      that the first-dose pharmacokinetics of cefepime are predictive of those at
      steady state. In order to consistently exceed the MIC for Pseudomonas aeruginosa
      for the entire dosing interval in patients with cystic fibrosis, a higher dose
      and/or different dosing interval compared with those used in this study may be
      necessary.

PMID- 8363370
TI  - Pharmacokinetic interaction between rifampin and zidovudine.
AB  - A potential pharmacokinetic interaction between rifampin (Rimactan, Rifadin) and
      zidovudine (AZT, Retrovir) was investigated in the population of human
      immunodeficiency virus-infected patients at our hospital. The results from four
      patients who were on long-term (> or = 6 months) combination therapy with
      zidovudine and rifampin are presented. In all cases of combined use of zidovudine
      and rifampin, a lower area under the plasma concentration-time curve (AUC) and,
      consequently, a higher apparent clearance of zidovudine were found, compared with
      a reference population of zidovudine users. Patients had a low to normal maximum
      concentration of zidovudine in plasma. Elimination half-lives were normal in all
      but one patient. Zidovudine glucuronide concentrations were determined in three
      patients and three control subjects. The patients all had relatively higher peak
      plasma concentrations and higher AUCs of zidovudine glucuronide than the control
      subjects. In one patient, zidovudine and zidovudine glucuronide were also
      measured 2.5 months after discontinuation of rifampin. The AUC of zidovudine
      increased by a factor of 2. These data are in agreement with an enzyme-inducing
      effect of rifampin on the glucuronidation of zidovudine. They indicate that long
      term combination therapy of rifampin and zidovudine leads to increased clearance
      of zidovudine, which may have therapeutic consequences.

PMID- 8363369
TI  - Anti-Pneumocystis carinii activity of PS-15, a new biguanide folate antagonist.
AB  - A newly synthesized biguanide inhibitor of dihydrofolate reductase in Plasmodium
      species was evaluated for its anti-Pneumocystis carinii activity. The compound N
      3-(2,4,5-trichlorophenoxypropyloxy)-N'-(1-methylethyl)imidoca rbonimidic diamide
      hydrochloride, designated PS-15, was administered prophylactically and
      therapeutically to immunosuppressed rats latently infected with P. carinii. Doses
      of 5 and 25 mg of PS-15 per kg of body weight per day given orally during 7 weeks
      of dexamethasone immunosuppression prevented P. carinii infection in all (100%)
      19 rats given the drug, while 6 of 9 (67%) untreated control rats developed P.
      carinii pneumonitis. A single weekly dose of 50 mg of PS-15 per kg also prevented
      the infection in all 10 rats. P. carinii pneumonitis was established after 4
      weeks of immunosuppression and was then treated orally for 3 weeks with 25, 5,
      and 1 mg of PS-15 per kg/day. Complete resolution of the infection occurred in
      all (100%) 10 rats given 25 mg of PS-15, 6 of 9 (67%) rats given 5 mg of PS-15,
      and 6 of 8 (75%) rats given 1.0 mg of PS-15 per kg per day and in all (100%) 9
      rats treated with trimethoprim-sulfamethoxazole. PS-15 was well tolerated at all
      doses. Because drug studies in the P. carinii rat model have been highly
      predictable of the effects of drugs on the disease in humans, these experiments
      suggest that PS-15 may have promise as a drug for the treatment of P. carinii
      pneumonitis in humans.

PMID- 8363371
TI  - Shedding of Clostridium difficile, fecal beta-lactamase activity, and
      gastrointestinal symptoms in 51 volunteers treated with oral cefixime.
AB  - Microbial changes including the shedding of Clostridium difficile, fecal beta
      lactamase activity, and gastrointestinal symptoms were assessed in 51 healthy
      volunteers given 200 mg of cefixime twice daily for 8 days. The number of
      organisms of the family Enterobacteriaceae (means +/- standard deviations)
      dropped from 6.9 +/- 1.1 to 3.9 +/- 1.8 log CFU/g of feces (P < 0.01), whereas
      counts of enterococci rose from 7.0 +/- 1.5 to 9.0 +/- 1.0 log CFU/g of feces (P
      < 0.01). Both counts returned to their initial levels 50 days after the cessation
      of treatment. Cefixime did not significantly modify the frequency of fecal
      excretion of Pseudomonas aeruginosa, Staphylococcus spp., yeasts, or members of
      the Enterobacteriaceae resistant to ceftazidime or ampicillin. The proportion of
      subjects shedding C. difficile rose from 6% before treatment to 57% (P < 0.01) at
      the end of treatment but returned to 8% 50 days thereafter. No case of
      pseudomembranous colitis was observed. Stool changes occurred in 13 volunteers
      during treatment (25%) and in 2 others more than 10 days after the end of
      treatment (4%). These changes were not significantly associated with the shedding
      of toxigenic strains of C. difficile or with the presence of toxin A in feces. By
      contrast, during treatment, stool changes occurred in 8 of the 18 volunteers
      (44%) who had antibiotic activity in their feces but in only 5 of the 33 (15%)
      for whom no such activity was found (P < 0.05). The absence of antibiotic
      activity in the feces was itself linked with the presence of beta-lactamase
      activity in the feces. Since we had found earlier that fecal beta-lactamase
      activity afforded protection against alteration in stool consistency during
      treatments with oral cephalosporins, the present study confirmed our previous
      preliminary results in this respect.

PMID- 8363372
TI  - Synergistic combinations of Ro 11-8958 and other dihydrofolate reductase
      inhibitors with sulfamethoxazole and dapsone for therapy of experimental
      pneumocystosis.
AB  - We compared Ro 11-8958, an analog of trimethoprim (TMP) with improved
      antimicrobial and pharmacokinetic properties, other dihydrofolate reductase
      (DHFR) inhibitors, sulfamethoxazole (SMX), and dapsone (DAP) in the treatment of
      Pneumocystis carinii pneumonia in an immunosuppressed rat model. In contrast to
      previous reports, high dosages of the DHFR inhibitors were used in combination
      with fixed, low dosages of SMX (3 mg/kg of body weight per day) or DAP (25
      mg/kg/day). When administered alone at these dosages, SMX and DAP reduced the
      median P. carinii cyst count about 5- to 15-fold. Ro 11-8958, TMP, and
      diaveridine used at a dosage of 20 mg/kg/day with SMX were only slightly more
      effective than SMX used alone. However, administration of these DHFR inhibitors
      at a dosage of 100 mg/kg/day with SMX lowered the cyst count about 500- to 1,000
      fold, indicating a synergistic effect. Little or no synergism was found when
      other DHFR inhibitors (pyrimethamine, cycloguanil, and tetroxoprim) were combined
      with SMX. Regimens of Ro 11-8958 at a dosage of 20 mg/kg/day with DAP and of TMP
      or diaveridine used at a dosage of 100 mg/kg/day with DAP showed comparable anti
      P. carinii activity, lowering the cyst count 100- to 200-fold. By contrast, Ro 11
      8958 administered at a dosage of 100 mg/kg/day with DAP reduced the cyst count >
      1,000-fold. Thus, the experimental approach used here enables the rat model of
      pneumocystosis to be used to compare synergistic combinations of antifolate
      drugs. The favorable results achieved with Ro 11-8958 indicate that it should be
      considered for clinical trials.

PMID- 8363373
TI  - In vitro susceptibility of Borrelia burgdorferi to 11 antimicrobial agents.
AB  - The in vitro susceptibility of Borrelia burgdorferi to 11 antimicrobial agents
      was investigated. The antimicrobial agents evaluated included ceftizoxime, FK037,
      cefotaxime, dirithromycin, clarithromycin and its metabolite 14-hydroxy
      clarithromycin, erythromycin, doxycycline, amoxicillin, ciprofloxacin, and
      ofloxacin. Isolates of B. burgdorferi tested included two reference strains (B31
      and ATCC 53899), six isolates from the midwestern United States, and three from
      Europe. A broth macrodilution method was used to determine MICs and MBCs. B.
      burgdorferi was inhibited by < or = 0.5 micrograms of each of the agents except
      the quinolones per ml. The MBCs for 90% of strains tested of ceftizoxime, FK037,
      clarithromycin, 14-OH clarithromycin, and dirithromycin (< or = 1.0 microgram of
      each per ml) were superior to those of amoxicillin (2.0 micrograms/ml) and
      doxycycline (4.0 micrograms/ml). Further in vivo studies are warranted to
      determine whether these agents may be efficacious in the treatment of Lyme
      borreliosis.

PMID- 8363374
TI  - Comparison of ampicillin-sulbactam with vancomycin for treatment of experimental
      endocarditis due to a beta-lactamase-producing, highly gentamicin-resistant
      isolate of Enterococcus faecalis.
AB  - Increasing antibiotic resistance in the enterococci, including the capacity for
      beta-lactamase production and the development of high-level aminoglycoside
      resistance, has complicated the treatment of serious enterococcal infections,
      which often require synergistic antibiotic combinations for cure. We utilized the
      rabbit model of aortic valve endocarditis to investigate the effects of various
      antibiotics, alone and in combination, against a multiply antibiotic-resistant
      isolate of Enterococcus faecalis. Female New Zealand White rabbits were infected
      with either a beta-lactamase-producing, gentamicin-resistant isolate of E.
      faecalis or a non-beta-lactamase-producing, aminoglycoside-susceptible isolate,
      and the mean log10 CFU per gram of vegetation were determined. The most active
      agents were low-dose ampicillin-sulbactam (200 mg/kg of body weight per day),
      high-dose ampicillin-sulbactam (400 mg/kg of body weight per day), and vancomycin
      (150 mg/kg of body weight per day), which reduced the titers of bacteria by 2.27,
      2.76, and 2.85 log10 (CFU/g, respectively, compared with controls. While
      ampicillin-sulbactam and vancomycin were equally efficacious in reducing titers
      of bacteria in vegetations, no animals were cured (defined as < 2 log10 CFU/g of
      vegetation) by either agent, whether treatment was continued for 3 or 7 days. The
      addition of gentamicin was not associated with increased killing in rabbits
      infected with the aminoglycoside-resistant isolate. Both high-dose ampicillin
      sulbactam and vancomycin regimens demonstrated significant, continued reduction
      in bacterial titers with the longer periods of treatment (P < or = 0.05); 7-day
      treatment with high-dose ampicillin-sulbactam produced a greater reduction in
      bacterial titers in vegetation than 7-day treatment with vancomycin (P < or =
      0.05). We conclude that ampicillin-sulbactam and vancomycin are equally effective
      in the treatment of experimental endocarditis due to beta-lactamase-producing,
      highly gentamicin-resistant E. faecalis. The optimum therapy for such infections
      in humans is not known.

PMID- 8363375
TI  - Evaluation of bacterial interference and beta-lactamase production in management
      of experimental infection with group A beta-hemolytic streptococci.
AB  - The in vivo effects of penicillin and cefprozil therapy on the interaction
      between organisms commonly recovered from inflamed tonsils were studied by using
      a subcutaneous abscess model in mice. These organisms were group A beta-hemolytic
      streptococci (GABHS), Streptococcus salivarius (which is capable of interfering
      with GABHS), and Staphylococcus aureus. In mice infected with GABHS and S.
      salivarius alone or in combination, penicillin eliminated both organisms and
      cefprozil eliminated GABHS and S. aureus but not S. salivarius. Penicillin did
      not, however, reduce the number of GABHS or S. salivarius in the presence of S.
      aureus. The present study demonstrated the ability of beta-lactamase-producing S.
      aureus to protect GABHS from penicillin. However, no such protection was present
      following the administration of cefprozil. Furthermore, the preservation of S.
      salivarius that interferes with GABHS growth may provide protection from
      reinfection with GABHS. This study supports and provides an explanation for the
      increased efficacies of cephalosporins administered orally over that of
      penicillin when treating patients with acute GABHS pharyngitis or tonsillitis.

PMID- 8363376
TI  - Characterization of the aac(6')-Ib gene encoding an aminoglycoside 6'-N
      acetyltransferase in Pseudomonas aeruginosa BM2656.
AB  - Pseudomonas aeruginosa BM2656 was resistant to tobramycin and susceptible to
      gentamicin and amikacin by disk diffusion testing. This unusual resistance was
      not transferable by conjugation to Escherichia coli or P. aeruginosa PAO38, and
      plasmid DNA was not detected in this strain. A 0.9-kb fragment harboring the
      tobramycin resistance gene was cloned from BM2656 into pUC18, generating pAT129.
      Analysis for aminoglycoside-modifying activity in extracts of BM2656 and E. coli
      harboring pAT129 indicated that tobramycin resistance was due to synthesis of an
      aminoglycoside 6'-N-acetyltransferase type I [AAC(6')-I] enzyme which modified
      amikacin and tobramycin. Although amikacin was acetylated, the bactericidal
      synergism of this aminoglycoside with ceftazidime against BM2656 was minimally
      affected. The sequence of the DNA fragment was determined. It contained an aac
      (6')-Ib-like gene and was located downstream from a conserved region related to
      Tn21. The translated sequence of this aac(6')-Ib gene possessed 99.2% identity
      with the putative products of the aac(6')-Ib gene cassettes from Serratia
      marcescens and Klebsiella pneumoniae and 69% identity with the putative aacA(6')
      II gene product from P. aeruginosa. We conclude that an aac(6')-Ib gene has
      spread to the chromosome of P. aeruginosa, probably by transposition.

PMID- 8363377
TI  - Facilitation of penicillin haptenation to serum proteins.
AB  - Traditionally, penicillin binding to serum proteins was believed to be a passive
      chemical process; however, it appears to be facilitated by serum factors. The
      objectives of this in vitro investigation were to examine facilitated penicillin
      haptenation, to study the kinetics of haptenation, and to determine the nature of
      haptenation-facilitating factors. The model involved addition of
      [3H]benzylpenicillin to serum or albumin solutions (at pH 7.3 to 7.4) and
      incubation at 37 degrees C for up to 72 h. The extent of penicillin binding to
      proteins in serum was found to be four- to fivefold higher than with solutions
      having comparable concentrations of purified albumin, total protein, or total
      immunoglobulin. Ultrafiltration of serum reduced penicillin binding to serum
      proteins substantially. An ultrafiltrable haptenation-facilitating factor(s) was
      found to be less than 0.5 kDa but was not calcium or magnesium. Finally, the
      extent of penicillin binding was related to albumin purity, as binding
      substantially increased with albumin purity. These findings suggest that there is
      a factor(s) in serum that facilitates covalent binding of penicillin to serum
      proteins. The factor(s) can be removed and then restored to increase penicillin
      binding to albumin. It appears that at least one component of the facilitation
      factor is less than 0.5 kDa, which suggests that it is not a peptide and that it
      is some simple serum component other than calcium or magnesium.

PMID- 8363378
TI  - Bioequivalence of oral and intravenous ofloxacin after multiple-dose
      administration to healthy male volunteers.
AB  - The bioequivalence of oral and intravenous ofloxacin was investigated after the
      administration of multiple doses of 400 mg every 12 h to 20 healthy male
      volunteers in a randomized, crossover, open-label study. Ofloxacin concentrations
      in plasma were evaluated after 4 days of oral or intravenous (1-h infusion)
      dosing with a 3-day wash-out period between regimens. As expected, delivery to
      the systemic circulation took slightly longer after the oral dosing (time to
      maximum concentration of drug in serum of 1.7 h) relative to the 1-h intravenous
      infusion, but the systemic availabilities of ofloxacin by the two routes of
      administration were equivalent (area under the concentration-time curve from 0 to
      12 h ratio of 95%). Since previous studies have not demonstrated any change in
      the bioavailability of ofloxacin in infectious disease patients, this study
      supports the interchangeability of these dosing regimens.

PMID- 8363379
TI  - 4-Guanidino-2,4-dideoxy-2,3-dehydro-N-acetylneuraminic acid is a highly effective
      inhibitor both of the sialidase (neuraminidase) and of growth of a wide range of
      influenza A and B viruses in vitro.
AB  - The sialidase (neuraminidase) inhibitor 4-guanidino-2,4-dideoxy-2,3-dehydro-N
      acetylneuraminic acid (4-guanidino-Neu5Ac2en) has been examined for the ability
      to inhibit the growth of a wide range of influenza A and B viruses in vitro in
      comparison with amantadine, rimantadine, and ribavirin. 4-Guanidino-Neu5Ac2en
      inhibited plaque formation by laboratory-passaged strains of influenza A and B
      viruses, with 50% inhibitory concentrations ranging from 0.005 to 0.014 microM. A
      wider range of values (0.02 to 16 microM) was obtained with more recent clinical
      isolates, but in all cases 4-guanidino-Neu5Ac2en inhibited influenza A and B
      virus replication at lower concentrations than amantadine, rimantadine, or
      ribavirin. Inhibition by 4-guanidino-Neu5Ac2en was not obviously affected by the
      passage history of the viruses or by resistance to amantadine or rimantadine. 4
      Guanidino-Neu5Ac2en was a very potent inhibitor of the sialidases of all the
      influenza viruses examined, with 50% inhibitory concentrations ranging from
      0.00064 to 0.0079 microM. No cytotoxicity was observed with 4-guanidino-Neu5Ac2en
      at up to 10 mM. 4-Guanidino-Neu5Ac2en therefore represents a new potent and
      selective inhibitor of influenza A and B virus sialidase activity and replication
      in vitro.

PMID- 8363380
TI  - Biliary excretion of cefixime: assessment in patients provided with T-tube
      drainage.
AB  - The biliary excretion profile of cefixime was studied in 10 patients provided
      with T-tube drainage of the common bile duct after cholecystectomy. Following a
      single 200-mg oral dose, the peak concentration of cefixime in bile reached 56.9
      +/- 70 mg/liter, approximately 20 times as high as the peak concentration in
      serum, 2.3 +/- 0.85 mg/liter. Cefixime levels in bile proved relatively
      sustained, since a concentration of 4.3 +/- 3.7 mg/liter was still found 20 h
      after dosing. The cumulative amount of cefixime recovered in the 24-h bile
      drainage averaged 10.0 +/- 12.3 mg, which is 5% of the administered dose and
      positions this beta-lactam antibiotic among the most highly bile-excreted
      cephalosporins. The presented results show that a single 200-mg oral dose of
      cefixime provided drug levels in bile consistently higher than the MICs for the
      most frequently recovered members of the family Enterobacteriaceae in biliary
      tract infections and maintained these levels for over 20 h after dosing.
      Accordingly, this cephalosporin deserves further clinical trials to assess its
      usefulness in both prophylaxis and treatment of biliary tract infections.

PMID- 8363381
TI  - Activity of bilobalide, a sesquiterpene from Ginkgo biloba, on Pneumocystis
      carinii.
AB  - The sesquiterpene bilobalide, extracted from Ginkgo biloba leaves, was tested in
      vitro and in vivo for the ability to inhibit Pneumocystis carinii growth.
      Bilobalide was inhibitory to trophozoites cultured on human embryonic lung
      fibroblasts (HEL 299) at approximately the same concentration as trimethoprim
      plus sulfamethoxazole (lowest effective concentration, 50 micrograms of
      bilobalide per ml versus 9/45 microgram of trimethoprim-sulfamethoxazole per ml),
      inducing microscopically detectable morphological changes in the cytoplasm of the
      parasite. In pharmacologically immunosuppressed Sprague-Dawley rats
      transtracheally infected with a suspension of about 5 x 10(6) P. carinii
      trophozoites per ml, the daily intraperitoneal administration of bilobalide (10
      mg/kg of body weight for 8 days) lowered the number of organisms by approximately
      2 logs (that is, about 99%). There was no apparent toxicity either in uninfected
      HEL 299 feeder cells or in infected and uninfected animals. These studies suggest
      that the sesquiterpene bilobalide might be useful for therapy of and prophylaxis
      against P. carinii infections in humans.

PMID- 8363382
TI  - Treatment of experimental visceral leishmaniasis in a T-cell-deficient host:
      response to amphotericin B and pentamidine.
AB  - In experimental visceral leishmaniasis, euthymic but not athymic (nude) BALB/c
      mice respond to conventional treatment with pentavalent antimony, indicating that
      the in vivo efficacy of antimony is T cell dependent. This finding correlates
      with frequent antimony treatment failures for T-cell-deficient patients with
      visceral leishmaniasis. To determine whether the in vivo efficacies of
      alternative antileishmanial agents also require T cells, Leishmania donovani
      infected euthymic and nude BALB/c mice were treated with pentamidine or
      amphotericin B. Pentamidine induced leishmanistatic activity in euthymic mice but
      had little effect in nude mice. In contrast, amphotericin B exerted potent
      leishmanicidal activities in both euthymic and nude animals. These results
      suggest that amphotericin B may be of particular use for T-cell-deficient
      patients with visceral leishmaniasis.

PMID- 8363383
TI  - Local gastric and serum amoxicillin concentrations after different oral
      application forms.
AB  - The high recolonization rate after monotherapy of Helicobacter pylori-positive
      gastritis may be due to insufficient local drug concentrations. To investigate
      the role of local diffusion, we measured levels of amoxicillin, a drug with good
      in vitro activity against H. pylori, in the mucosa and serum. One gram of
      amoxicillin was given to healthy volunteers as a tablet (n = 6) or as water
      dissolved, fizzing "Tab" (n = 6). Gastroscopy with biopsies from the antrum,
      corpus, and fundus was performed at 30, 60, and 90 min. Concentrations in the
      mucosa were measured after homogenization with the agar diffusion method using
      Bacillus subtilis as the biological indicator. Serum samples, taken basally and
      every 15 min, were analyzed by high-pressure liquid chromatography. Drug levels
      in the fundus and corpus remained far below those in the antrum for both
      application forms. The highest concentrations were reached after 30 min, with
      bactericidal levels in the antrum in two of six subjects who took the tablet form
      and five of six subjects who used Tabs. At 60 and 90 min, almost all values were
      below the MBC for 90% of the strains tested. The concentrations in serum,
      however, rose continuously, to reach a maximum after 75 or 90 min. These results
      show that incomplete elimination may be due to subbactericidal concentrations of
      antibiotics with high in vitro efficiency at the desired site of action in vivo
      and that local diffusion in the mucosa is essential for therapeutic effectiveness
      against H. pylori.

PMID- 8363385
TI  - Passage of cefotaxime and ceftriaxone into cerebrospinal fluid of patients with
      uninflamed meninges.
AB  - Cefotaxime and ceftriaxone have proven to be effective in pyogenic infections of
      the central nervous system. Since in some bacterial central nervous system
      infections the blood-cerebrospinal fluid (CSF) barrier is either minimally
      impaired or recovers in the course of the illness, we studied the penetration of
      both antibiotics in the absence of inflamed meninges. Patients who had undergone
      external ventriculostomies for noninflammatory occlusive hydrocephalus received
      either cefotaxime (2 g/30 min) or ceftriaxone (2 g/30 min) to treat extracerebral
      infections. Serum and CSF were drawn repeatedly after the first dose. With
      ceftriaxone, they were also drawn after the last dose. The concentrations of
      cefotaxime, its metabolite desacetylcefotaxime, and ceftriaxone were determined
      by high-performance liquid chromatography with UV detection. Maximum
      concentrations of cefotaxime in CSF were reached 0.5 to 8 h (median = 3 h; n = 6)
      after the end of the infusion and ranged from 0.14 to 1.81 mg/liter (median =
      0.44 mg/liter; n = 6). Maximum levels of ceftriaxone in CSF ranging from 0.18 to
      1.04 mg/liter (median = 0.43 mg/liter; n = 5) were seen 1 to 16 h (median = 12 h;
      n = 5) after the infusion. The elimination half-life of cefotaxime in CSF was 5.0
      to 26.9 h (median = 9.3 h; n = 5), and that of ceftriaxone was 15.7 to 18.4 h
      (median = 16.8 h; n = 3). It is concluded that after a single dose of 2 g,
      maximal concentrations of cefotaxime and ceftriaxone in CSF do not differ
      substantially. The long elimination half-lives guarantee uniform concentrations
      in CSF. These concentrations reliably inhibit highly susceptible bacteria but
      cannot be relied on to inhibit staphylococci and penicillin G-resistant
      Streptococcus pneumoniae.

PMID- 8363386
TI  - Use of cephalosporins for prophylaxis and therapy of polymicrobial infection in
      mice.
AB  - Cefoxitin, cefotetan, and cefmetazole were compared in 10-day therapy of intra
      abdominal and subcutaneous infections caused by three organisms: Bacteroides
      fragilis and Bacteroides thetaiotaomicron combined with either Escherichia coli
      or Staphylococcus aureus. Intra-abdominal infection was caused by B. fragilis
      plus B. thetaiotaomicron plus E. coli. Therapy was initiated immediately before
      inoculation or was delayed for 8 h. Mortality was 14 of 30 (47%) for saline
      treated mice, and all survivors developed abscesses. Immediate therapy reduced
      mortality and the percentage of mice with abscesses (in survivors), respectively,
      to 17 and 20% with cefoxitin, 0 and 13% with cefotetan, and 0 and 17% with
      cefmetazole, and the numbers of all bacteria were reduced by all the
      cephalosporins. Delayed therapy reduced mortality and abscess formation,
      respectively, to 20 and 8% of mice with cefoxitin, 10 and 93% with cefotetan, and
      7 and 96% with cefmetazole. B. thetaiotaomicron survived in all abscesses treated
      with cefotetan and cefmetazole. Subcutaneous abscesses were caused by each
      organism alone or in combinations of one aerobe (S. aureus or E. coli) and one or
      two Bacteroides species. Early therapy reduced the numbers of all bacteria
      independent of their in vitro susceptibility. All agents reduced the number of
      each Bacteroides species with either E. coli or S. aureus. However, when therapy
      was delayed, cefotetan and cefmetazole were less effective than cefoxitin against
      B. thetaiotaomicron. Cefotetan was the most active agent against E. coli, and
      cefmetazole was the most effective against S. aureus. These data illustrate the
      efficacy of all tested cephalosporins in the prophylaxis of polymicrobial
      infections.

PMID- 8363384
TI  - Gentamicin administered during gestation alters glomerular basement membrane
      development.
AB  - Gentamicin during gestation alters glomerular basement membrane development. A
      drug-induced nephrotoxicity was described for neonates after gentamicin was given
      intraperitoneally to pregnant Wistar rats; glomerular alterations and changes in
      permselectivity were important. We investigated the ultrastructure of the
      glomerular basement membrane (GBM), the arrangement of anionic sites, and the
      urinary proteins at two ages, with 1-day- and 12-month-old control and prenatally
      exposed animals. For neonates, the pattern of glomerular differentiation was
      similar, anionic sites were made of heparan sulfate proteoglycans, and the GBM
      had the same total thickness in both groups. After transplacental gentamicin
      exposure, the lamina densa was larger; the laminae rarae were thinner; the
      density of anionic sites was increased; the levels of hydroxyproline, sulfate,
      and hexuronic acid in the kidney were increased; and the immunoelectrophoresis of
      urinary proteins was abnormal. For adults, prenatal exposure to gentamicin led to
      altered juxta-medullary glomeruli with a larger GBM and abundant anionic sites,
      especially in the lamina densa, and to a protein excretion different from that of
      controls. Thus, gentamicin administered during pregnancy leads to permanent
      alterations of the GBM with modifications of both the layers and the anionic
      sites, possibly because of a perturbed protein metabolism. These altered
      glomeruli are at risk during life and could be the starting point for a kidney
      disease.

PMID- 8363387
TI  - Ethambutol inhibition of glucose metabolism in mycobacteria: a possible target of
      the drug.
AB  - The addition of D-arabinose, D-galactose, D-glucosamine, or D-mannose to the
      growth medium of Mycobacterium smegmatis suppressed the inhibitory effects of
      ethambutol both on acetate labeling of cell wall-linked mycolic acids and on the
      increase in the delipidated cell dry weight. The addition of D-glucose or D
      fructose had no effect. It is proposed that ethambutol inhibits an early step of
      glucose conversion into the monosaccharides used for the biosynthesis of
      structurally and biologically important cell wall polysaccharides:
      arabinogalactan, arabinomannan, and peptidoglycan.

PMID- 8363388
TI  - Suramin prevents duck hepatitis B virus infection in vivo.
AB  - The effect of suramin on duck hepatitis B virus (DHBV) infection was investigated
      in vivo. Suramin pretreatment of Pekin ducklings completely prevented DHBV
      infection. In contrast, suramin given at the time of or after inoculation with
      DHBV did not inhibit viral infection, replication, or gene expression. These data
      indicate that suramin effectively blocks the early stages of DHBV infection in
      vivo.

PMID- 8363389
TI  - In vitro antibacterial activity and beta-lactamase stability of CP-70,429 a new
      penem antibiotic.
AB  - In in vitro susceptibility tests, the new penem CP-70,429 showed potent
      antibacterial activity against gram-positive and gram-negative bacteria except
      Pseudomonas aeruginosa and Xanthomonas maltophilia. CP-70,429 was stable to
      various types of beta-lactamases except for the enzyme from X. maltophilia and
      was 16- to 128-fold more active than the other compounds against beta-lactamase
      producing strains of Enterobacter cloacae and Citrobacter freundii.

PMID- 8363391
TI  - Ciprofloxacin susceptibility testing by MIC and disk elution of drug-resistant
      Mycobacterium tuberculosis and Mycobacterium avium complex.
AB  - The ability to provide susceptibility data for certain species of mycobacteria
      can be clinically useful. In this study, the disk elution method for
      susceptibility testing was adapted for testing ciprofloxacin against
      mycobacterial isolates. Of the 75 Mycobacterium tuberculosis isolates tested,
      including 23 multiply drug-resistant isolates, 96% were susceptible to
      ciprofloxacin at a breakpoint concentration of 2 micrograms/ml.

PMID- 8363390
TI  - In vitro susceptibilities of isolates of Haemophilus ducreyi from Thailand and
      the United States to currently recommended and newer agents for treatment of
      chancroid.
AB  - We determined the in vitro susceptibilities of 54 isolates of Haemophilus ducreyi
      from Thailand (29 isolates) and San Francisco (25 isolates) to penicillin G,
      tetracycline, amoxicillin-clavulanic acid, ceftriaxone, cefixime, erythromycin,
      azithromycin, ciprofloxacin, ofloxacin, and trimethoprim-sulfamethoxazole.
      Isolates were susceptible to < or = 0.25 microgram of ceftriaxone per ml, < or
      less 0.5 microgram of cefixime per ml, < or = 0.125 microgram of ciprofloxacin
      per ml, and < or = 0.06 microgram of ofloxacin per ml. Erythromycin was active
      against all isolates (MIC for 90% of isolates tested, 0.25 microgram/ml), as was
      azithromycin (MIC, < or = micrograms/ml). In contrast, all but one isolate were
      resistant to > or = 8.0 micrograms of tetracycline per ml, 11.1% of the isolates
      were resistant to and 40.9% of the isolates were resistant to trimethoprim
      sulfamethoxazole (MIC, > or = 4/76 microgram/ml.)

PMID- 8363392
TI  - Enoxacin relieves symptoms of recurrent urinary infections more rapidly than
      cefuroxime axetil.
AB  - In patients with a history of recurrent infections, treatment with enoxacin (200
      mg/12 h for 3 days) relieved symptoms of acute urinary infection significantly
      more rapidly than treatment with cefuroxime axetil (125 mg/12 h for 7 days).
      Other parameters, including clinical and bacteriological cure rates and patients'
      overall opinion of their treatment, did not differ significantly between the
      treatments.

PMID- 8363393
TI  - In vitro activity of roxithromycin against 16 species of atypical mycobacteria
      and effect of pH on its radiometric MICs.
AB  - The antimycobacterial spectrum of roxithromycin, a semisynthetic 14-membered ring
      macrolide, was determined against 28 strains belonging to 16 species of atypical
      mycobacteria by measuring radiometric MICs by BACTEC methodology at two different
      pH values, i.e., 6.8 and 7.4. The MICs obtained at pH 7.4 were 1 to 2 dilutions
      lower or more than those obtained at pH 6.8 for some of the species.
      Roxithromycin possessed promising MICs against such potential pathogens as the
      Mycobacterium avium complex, M. scrofulaceum, M. szulgai, M. malmoense, M.
      xenopi, M. marinum, M. kansasii, and rare pathogens like M. chelonei subsp.
      chelonei and M. chelonei subsp. abscessus but not against M. simiae.
      Roxithromycin showed lower MICs against M. fortuitum var. peregrinum than M.
      fortuitum var. fortuitum.

PMID- 8363394
TI  - The role of magnetic resonance imaging in the diagnostic evaluation of
      dermatomyositis.

PMID- 8363395
TI  - Citation classics in clinical dermatologic journals. Citation analysis,
      biomedical journals, and landmark articles, 1945-1990.
AB  - BACKGROUND AND DESIGN: Analysis of the most frequently cited dermatology articles
      and the journals in which they appear identifies and emphasizes the impact of
      works of colleagues and predecessors, recognizes key advances in cutaneous
      medicine and surgery, and adds useful data about historical developments in
      dermatology. Use of citation analysis to examine the dermatologic literature
      reveals quantitative information about authors, articles, and journals helpful in
      identifying classic works and high-impact journals. We analyze the
      characteristics of all dermatology articles cited 100 or more times in one of the
      10 most highly ranked clinical dermatology journals as indicated by the Institute
      of Scientific Information (Philadelphia, Pa) database from 1945 through 1990 and
      also discuss the standard and, as well, more recently described bibliometric
      indexes for dermatologic journals. RESULTS: Thirty-one institutions located in 11
      different countries produced 129 landmark articles. Ninety-two percent of the
      citation classics originated in the United States, United Kingdom, Sweden, and
      Germany. There were 16 authors with three or more top-cited articles. Fifty-two
      percent of the articles were of the clinical type, 22% were clinical review
      articles, and 26% discussed basic science topics. The mean number of authors has
      increased gradually over the past 80 years. The average classic article was
      published in 1969, peaked in popularity 9 years later with 26 peer citations, and
      received only 11 citations in 1990. CONCLUSIONS: Citation frequency and citation
      analysis reveal useful and interesting information about scientific
      communication. The data on citation classics we describe can be interpreted in
      many ways, but certainly reflects the attention that articles have received over
      the past 48 years. The half-life of the average citation classic of about 10
      years reflects the rapid pace of advances in the science and practice of
      dermatology over the past several decades. This information, along with current
      bibliometric indexes, may assist physicians in optimizing the time they spend
      reading the medical literature.

PMID- 8363396
TI  - Association of tissue-fixed cytoplasmic deposits of immunoglobulin in epidermal
      keratinocytes with lupus erythematosus.
AB  - BACKGROUND AND DESIGN: We have observed that tissue-fixed deposits of
      immunoglobulin (Ig) are occasionally present in the cytoplasm (CYT) of epidermal
      keratinocytes. This study was conducted to examine the frequency, significance,
      and possible cause of this finding. RESULTS: Direct immunofluorescence studies
      were performed on 302 sequential skin specimens obtained from patients with lupus
      erythematosus (n = 98), bullous diseases (n = 114), or other dermatoses (n = 90).
      Abnormal epidermal CYT deposits were observed in 22 of the patients with lupus
      erythematosus (22.5%), four of those with bullous diseases (3.5%), and two of
      those with other dermatoses (2.2%). The deposits were more common in systemic
      than in discoid lupus erythematosus, and in skin lesions than in normal skin. By
      indirect immunofluorescence, circulating antibodies to epidermal upper CYT
      antigens were present in 100% of 12 patients with tissue-fixed CYT deposits
      (average antibody titer, 300) and in 21% of 19 individuals without CYT deposits
      (average titer, 43). By Western immunoblot analysis these antibodies were
      directed to proteins in keratin extracts of skin. CONCLUSIONS: These findings
      indicate that deposits of Ig in the cytoplasm of keratinocytes in human skin are
      associated with high levels of serum antibodies to upper CYT antigens and with
      lupus erythematosus.

PMID- 8363397
TI  - Aneuploid malignant T cells from a patient with Sezary syndrome can be visualized
      by in situ hybridization.
AB  - BACKGROUND AND DESIGN: Enumeration of malignant cells in Sezary syndrome often
      relies on the identification of the Sezary cell nucleus. This morphologic method
      is, however, nonspecific and unreliable in the enumeration of the proportion of
      malignant lymphocytes in peripheral blood of patients with Sezary syndrome.
      Malignant lymphocytes of patients with mycosis fungoides and Sezary syndrome are
      often characterized by multiple chromosome aberrations. Herein, we demonstrate
      that fluorescent in situ hybridization can visualize and accurately enumerate
      malignant aneuploid mononuclear cells in a patient with Sezary syndrome. RESULTS:
      Fluorescent in situ hybridization demonstrated that 90% of the mononuclear cells
      in the patient with Sezary syndrome showed numerical aberrations for both
      chromosome 7 and X, a figure confirmed by flow cytometry. CONCLUSION: Fluorescent
      in situ hybridization may be a valuable tool to visualize and enumerate aneuploid
      tumor cells in patients with cutaneous T-cell lymphoma.

PMID- 8363398
TI  - Outcomes of cryosurgery in keloids and hypertrophic scars. A prospective
      consecutive trial of case series.
AB  - BACKGROUND AND DESIGN: A variety of therapeutic regimens has been used in keloids
      and hypertrophic scars with unsatisfactory final results. Application of
      cryosurgery could be beneficial since it was reported to produce less scarring
      after treatment of skin tumors compared with other surgical procedures. We
      performed a prospective consecutive trial of randomly enrolled case series
      including 32 months of average follow-up to assess the outcomes of cryosurgical
      treatment in keloids and hypertrophic scars and to determine factors influencing
      the therapeutic result. Ninety-three white patients, aged 10 to 79 years (median
      age, 26 years) with keloids (n = 55; median duration, 36 months; median size, 4
      cm2) and with hypertrophic scars (n = 38; median duration, 12 months; median
      size, 2 cm2) were treated using the contact method. One freeze-thaw cycle of 30
      seconds per lesion and session was employed, and, if needed, treatment was
      repeated every 20 to 30 days. RESULTS: Excellent responses (ER) were recorded in
      30 subjects (32.3%), good responses (GR) in 27 (29.0%), poor responses (PR) in 27
      (29.0%), while nine subjects (9.7%) did not respond at all. Hypertrophic scars
      responded better (n = 38; GR to ER, 76.3%) than keloids (n = 55; GR to ER, 50.9%;
      P < .005; odds ratio, 6.92). No progressions or recurrences occurred.
      Histologically, neovascularization, loss of the anarchic arrangement of collagen
      bundles, increased fibroblasts in a stroma running parallel to the skin surface,
      and mononuclear cells mostly arranged at the perivascular area were found in
      clinically responding lesions. Improved responses were detected in subjects
      treated with three or more sessions (n = 57; GR to ER, 78.9%) compared with
      subjects treated once or twice (n = 36; GR to ER, 33.3%; P < .001; odds ratio,
      13.68). The cryosurgical treatment was generally well tolerated, with local pain
      during freezing and/or shortly after treatment (n = 32, 34.4%) and
      hypopigmentation or hyperpigmentation (n = 11, 11.8%) being the most frequent
      side effects. CONCLUSIONS: Cryosurgery was found effective and safe in keloids
      and, especially, in hypertrophic scars, in an open, uncontrolled study.
      Satisfactory results could be obtained after at least three cryosurgical sessions
      of 30 seconds each, applied once monthly using the contact method of treatment.

PMID- 8363399
TI  - Pretibial mucin. Histologic patterns and clinical correlation.
AB  - BACKGROUND AND OBJECTIVE: We identified several patients with a histologic
      diagnosis of pretibial myxedema in whom thyroid disease was not found. The
      purpose of this study was to investigate if histologic characteristics can
      distinguish between pretibial mucinosis secondary to Graves' disease and that
      unassociated with thyroid disease. METHODS: Biopsy specimens interpreted as
      compatible with pretibial myxedema were reviewed; these included 12 cases of
      pretibial mucinosis with documented Graves' disease, and six cases of pretibial
      mucinosis without evidence of Graves' disease. Ten specimens interpreted as
      compatible with stasis dermatitis were also evaluated for histologic
      characteristics, including the possible presence of mucin. RESULTS: Features that
      distinguish between pretibial mucinosis associated with Graves' disease and
      pretibial mucinosis without Graves' disease included preservation of a zone of
      normal-appearing collagen in the superficial papillary dermis (12/12 with Graves'
      disease, 0/6 without), mucin deposition in the reticular dermis (12/12 with
      Graves' disease, 0/6 without), lack of mucin deposition in the superficial
      papillary dermis (11/12 with Graves' disease, 1/6 without), angioplasia (2/12
      with Graves' disease, 6/6 without), and the presence of hemosiderin (2/12 with
      Graves' disease, 6/6 without). Mucin deposition in the papillary dermis was found
      in six of 10 specimens interpreted as stasis dermatitis. CONCLUSIONS: There are
      patients with pretibial mucinosis in whom there is no thyroid disease. Specimens
      from patients without Graves' disease have features of stasis dermatitis in
      addition to mucinosis. We conclude that pretibial mucinosis may result from
      stasis or Graves' disease and that histologic differences allow for accurate
      differentiation.

PMID- 8363400
TI  - Expression of p53 protein is an early event in ultraviolet light-induced
      cutaneous squamous cell carcinogenesis.
AB  - BACKGROUND AND DESIGN: p53 Is known to be a tumor-suppressor gene and has been
      suggested to play an important role for multistep carcinogenesis of cutaneous
      squamous cell carcinoma (SCC). To evaluate the role of ultraviolet light (UV) in
      p53 mutation in squamous cell carcinogenesis, paraffin-embedded sections of SCCs
      were immunohistochemically stained with the CM-1 antibody for p53 protein.
      Positive staining suggests mutation of the p53 gene since the mutant p53 protein
      gains prolonged half-life to be detectable by this method. The specimen included
      SCCs induced by UV (SCCs on sun-exposed areas, SCCs on patients with xeroderma
      pigmentosum), roentgen rays, scar, and miscellaneous causes. In addition, solar
      keratoses that are precancerous lesions of UV-related SCCs were also analyzed.
      RESULTS: Fourteen (54%) of 26 UV-related SCCs were positive, whereas five (19%)
      of 26 UV-unrelated SCCs were positive. Among the UV-related SCCs, five (45%) of
      11 well-differentiated SCCs and nine (60%) of 15 moderately to poorly
      differentiated SCCs were positive. Eleven (48%) of 23 solar keratoses were
      positive for p53. CONCLUSIONS: These results indicate that UV acts as a mutagen
      for the p53 gene, and this event may occur at a relatively early stage of
      multistep UV carcinogenesis.

PMID- 8363401
TI  - Radiation therapy of giant aggressive keratoacanthomas.
AB  - BACKGROUND AND DESIGN: Giant aggressive keratoacanthoma is a rare destructive
      subset of keratoacanthoma that frequently involves the facial region, grows
      rapidly to a large size, and often recurs after surgical management. The
      effectiveness of ionizing radiation therapy was examined in a retrospective study
      involving 16 patients; 14 of the tumors had recurred after surgical therapy.
      RESULTS: All tumors resolved with satisfactory cosmetic results and without
      recurrence following a fractionated course of superficial radiation therapy.
      CONCLUSIONS: Radiation therapy is an effective therapeutic modality for giant
      aggressive keratoacanthomas.

PMID- 8363402
TI  - Serum soluble interleukin 2 receptor levels in erythrodermic cutaneous T-cell
      lymphoma correlate with response to photopheresis-based treatment.
AB  - BACKGROUND: Cutaneous T-cell lymphoma (CTCL) comprises a spectrum of
      presentations, including erythroderma, pruritus, lymphadenopathy, and circulating
      atypical lymphocytes. Photopheresis is an extracorporeal treatment in which white
      blood cell concentrates are subjected to UV irradiation when the serum
      methoxypsoralen level is above 50 ng/mL. Of patients with CTCL, those with
      erythroderma have been most responsive to this therapy. In some conditions,
      including certain malignant hematologic neoplasms, serum soluble interleukin 2
      receptor levels (SIL2R) correlate with disease activity. We sought to determine
      whether serum SIL2R levels correlated with disease activity in six erythrodermic
      patients with CTCL treated primarily with photopheresis. We measured SIL2R levels
      in five patients with stage III or greater erythrodermic CTCL and one with stage
      IIa CTCL. We compared SIL2R values with clinical course, skin scores, CD4/CD8
      ratios, peripheral white blood cell counts, and Sezary cell counts, using Pearson
      correlation coefficients. OBSERVATIONS: The SIL2R levels correlated with clinical
      course and skin scores, even when controlled for other factors noted above.
      CONCLUSION: Data preliminarily suggest that serum SIL2R levels may be useful
      indicators of disease activity in erythrodermic CTCL patients treated with
      photopheresis.

PMID- 8363404
TI  - The Archives of Dermatology annual trainee award.

PMID- 8363403
TI  - Subcutaneous T-cell lymphoma. Report of two additional cases and further
      observations.
AB  - BACKGROUND: Peripheral T-cell lymphomas involving subcutaneous tissue are rare.
      With modern immunohistochemical stains, subcutaneous T-cell lymphomas may be
      demonstrated in patients previously thought to have fatal Weber-Christian
      disease, malignant histiocytosis, and histiocytic cytophagic panniculitis.
      OBSERVATIONS: We describe two young women with subcutaneous lymphomas. They
      presented with erythematous nodular lesions, which suggested benign panniculitis.
      Skin biopsy specimens in both patients demonstrated large atypical lymphocytes in
      the subcutaneous tissue, karyorrhexis, and cytophagia. Immunohistochemical
      studies confirmed a T-cell phenotype. Molecular genetics studies performed in one
      patient showed a major T-cell clonal population. CONCLUSIONS: Subcutaneous T-cell
      lymphoma is a rare, distinct subtype of postthymic peripheral T-cell lymphoma.
      Cytophagic "histiocytic" panniculitis is frequently a prominent histologic
      feature. Early systemic chemotherapy may offer therapeutic advantages in patients
      with this disease.

PMID- 8363405
TI  - Considering excellence.

PMID- 8363406
TI  - Papular lesions in an immunocompromised patient. Trichophyton rubrum granulomas
      (Majocchi's granuloma).

PMID- 8363407
TI  - Ichthyosiform rash and fever in a child. Tinea corporis and capitis due to
      Trichophyton tonsurans.

PMID- 8363408
TI  - Multiple cutaneous ulcers of the legs. Mycobacterium chelonae infection.

PMID- 8363409
TI  - Subcutaneous nodule in a cardiac transplant. Cutaneous aspergillosis.

PMID- 8363410
TI  - Controlled trial of azathioprine and plasma exchange in addition to prednisolone
      in the treatment of bullous pemphigoid.

PMID- 8363411
TI  - Chronic skin ulcers and the biology of skin grafts.

PMID- 8363412
TI  - Clinical pharmacology.

PMID- 8363413
TI  - Malignant melanoma of unknown origin presenting as a systemic vasculitis.

PMID- 8363414
TI  - A cutaneous lesion associated with primary polymyositis.

PMID- 8363415
TI  - Lentigo maligna is more common on the driver's side.

PMID- 8363416
TI  - Malignant melanoma and a squamous cell carcinoma in recessive dystrophic
      epidermolysis bullosa.

PMID- 8363417
TI  - Malignant melanoma arising from a small congenital nevus in a black child.

PMID- 8363418
TI  - Transverse white lines in the fingernails induced by combination chemotherapy.

PMID- 8363419
TI  - [20 years of mitral valve replacement. Development of a patient profile and
      operative mortality].
AB  - Between 1971 and 1991, 1,179 mitral valve replacements (MVR) were carried out in
      1,134 patients. The sex ratio was stable over this period (0.7 men/women) whereas
      the average age of the patients increased by 10 years (50 years in 1971, 61 years
      in 1991). Since 1980, patients over 60 years of age represent about 60% and those
      over 70 years of age 16 to 22% of the population. The functional status of the
      patients has tended to be less severe, the NYHA stages III and IV which were
      initially preponderant, only represent 50 to 60% of patients operated nowadays.
      This reduction in the severity of symptoms is reflected in the average value of
      the cardio thoracic index which was 60 in 1971 and 54.8 in 1991. Similarly, the
      mean pulmonary artery pressures (measured in 823 patients, 69.8%) have decreased
      from 37.4 mmHg in 1971 to 29.9 mmHg in 1991. Rheumatic fever has tended to be
      replaced by degenerative etiologies which, since 1985, represent 40 to 50% of
      cases. Ischemic mitral regurgitation rare before 1980, is more common, presently
      making up 5 to 15% of MVR cases. In relation with the etiological changes mitral
      stenosis is giving way to mitral regurgitation as the commonest valve lesion (40
      to 50% of cases in 1991). The annual operative mortality is lower (6 to 8%) than
      in 1982, despite the increasing number of emergency cases (7 to 10% of cases
      since 1985). The number of MVR with associated tricuspid valve repair has
      decreased with respect to isolated MVR or associated with aortocoronary bypass
      grafting. The only constant feature is the death rate due to myocardial
      dysfunction which remains over 50% whereas mortality related to the prosthetic
      valves varied over the years.

PMID- 8363421
TI  - [Incidence of inducible supraventricular tachycardia in dysplasia of the right
      ventricle].
AB  - Arrhythmogenic right ventricular dysplasia (ARVD) is classically associated with
      ventricular tachycardia and the prevalence of supraventricular tachycardia in
      this condition is not well known. The aim of this study was to observe the
      response of 20 patients with ARVD to programmed atrial stimulation and compare it
      with 150 subjects without cardiac disease or spontaneous supraventricular
      tachycardia. The protocol used 2 atrial extra-stimuli delivered on 3 paced
      cycles. Programmed atrial stimulation with 1 extrastimulus was repeated after
      infusion of 20 to 30 micrograms of Isoproterenol. Sustained supraventricular
      tachycardia could be induced in 13 patients with ARVD (65%) and 17 control
      subjects (11%) (p < 0.001). It was not possible to distinguish patients with
      inducible supraventricular tachycardia from those without inducible arrhythmias
      by electrophysiologic parameters. Isoproterenol facilitated the induction of VT
      but not supraventricular tachycardia. Three patients with inducible
      supraventricular tachycardia developed spontaneous atrial fibrillation. In
      conclusion, there is a relatively high incidence of inducible supraventricular
      tachycardia in ARVD: Isoproterenol does not facilitate this tachycardia, contrary
      to ventricular tachycardia.

PMID- 8363420
TI  - [Mitral valvuloplasty during the acute phase of endocarditis].
AB  - Thirty-five patients were operated in the acute phase of mitral valve
      endocarditis between 1986 and 1991. The surgical indications were hemodynamic
      (22), echocardiographic (9), embolic (2) and infectious (2). There were pre
      existing valve lesions in 45% of cases. The causal organism was identified in 90%
      of cases: streptococcus (19), staphylococcus (9) and Gram negative bacilli (4).
      Preoperative antibiotic therapy was prescribed for an average of 18 days. The
      aortic valve was infected in 9 patients and tricuspid valve in 1 patient. The
      mitral lesions were: abscess (11), vegetations (11), perforations (16), and
      ruptured chordae tendinae (22). All patients underwent Carpentier's mitral
      valvuloplasty. The operative mortality was 5.7% (2 patients). Early reoperation
      was required in 1 case. Follow-up was possible in 96% of cases for an average of
      23 months. No recurrences of endocarditis were observed. One patient was
      reoperated and 3 died. All the others were in Classes I and II of the NYHA. None
      had significant mitral regurgitation or stenosis. These results show that mitral
      valvuloplasty is possible in the acute phase of endocarditis in 90% of cases. The
      mortality and morbidity are low and long-term results are stable.

PMID- 8363422
TI  - [Myocardial infarction treated within 4 hrs: comparison of the cost-benefit ratio
      of 3 thrombolytic treatments: APSAC, rt-PA and streptokinase in 270 patients].
AB  - Two hundred and seventy patients under 71 years of age with myocardial infarction
      less than 4 hours old, defined by clinical and electrocardiographic criteria,
      were included in this trial and followed up for 1 year: two groups of 89 and 92
      patients were randomised to receive APSAC (30 mg i.v. over 5 minutes) or rt-PA
      (10 mg bolus + 5000 IU of heparin as a bolus, followed by 90 mg rt-PA over 3
      hours) and compared with a control series of 89 consecutive patients treated with
      streptokinase (1.5 MU in 1 hour). Heparin and aspirin (250 mg/day) were
      prescribed systematically. A score of efficacy was established from the following
      4 parameters: patency of the infarct-related artery on coronary angiography at
      day 6 +/- 2 (N = 252), dyssynergic score on radiological ventriculography,
      infarct size on resting Thallium myocardial scintigraphy performed between day 15
      and 21 (N = 242) and radionuclide ejection fraction performed at the same time.
      This score (0-24) was respectively 17.8 +/- 6.4 for rt-PA, 17.7 +/- 6.0 for APSAC
      and 18.1 +/- 6.0 for streptokinase (NS). The costs of hospital treatment were
      assessed by including: the cost of thrombolytic therapy (ranging from 1.7% of
      total cost for streptokinase to 16% for rt-PA), the cost of other treatments and
      biological investigations (10% of total cost); the cost of followed coronary
      angiography, in 33% of patients, by an angioplasty (21% of total cost), the cost
      of hospital stay averaging 17 days (49% of total cost in the rt-PA and APSAC
      groups and 56% in the streptokinase group NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363423
TI  - [Initial experience of percutaneous catheter ablation using radiofrequency of
      atrioventricular accessory pathways].
AB  - This paper reports the authors' preliminary experience in catheter ablation by
      radiofrequency current of 46 accessory atrioventricular pathways in 45
      symptomatic patients with supraventricular tachyarrhythmias resistant to medical
      therapy. With an average follow-up period of 5.5 +/- 4 months the global success
      rate was 80%, ranging from 96% in left lateral to 33% in antero septal accessory
      pathways. It increased from 65% in the first 20 patients to 88% in the last 25
      patients. The average duration of radioscopy was significantly shorter in left
      lateral pathways than in other localisations (p < 0.02); it was also shorter when
      ablation was successful. Complications were observed in 4 patients (9%) and
      included one complete atrioventricular block and 3 femoral arterial lesions.
      Anaesthetic assistance was required in 14 cases (31%), either at the patient's
      request or to allow reduction of atrial fibrillation. Percutaneous catheter
      ablation of accessory atrioventricular pathways with radiofrequency current is
      effective and gives good results; very strict selection of initial patients and
      the respect of certain conditions taking into account the experience of the
      medical team, the technically difficult approach of certain accessory pathways
      and the risks of ablation of pathways running near the atrioventricular node or
      His bundle, are necessary for successful results when learning this technique.

PMID- 8363424
TI  - [Cardiorespiratory and metabolic changes during prolonged exercise at 50% of the
      maximal load. Application to rehabilitation of severe cardiac insufficiencies].
AB  - The object of physical training in patients with chronic cardiac failure and
      severe left ventricular dysfunction is to improve skeletal muscle adaptation
      without impairing myocardial function. It is acknowledged that aerobic exercise
      limits increased ventricular strain. Therefore, the authors decided to determine
      whether exercise at 50% maximal power load constituted aerobic training. Eight
      patients with chronic cardiac failure (age 57 +/- 10 years; resting radionuclide
      ejection fraction: 25 +/- 5%) performed a rectangular submaximal exercise for 20
      minutes at 50% of maximal aerobic load (MAL) as determined by a prior triangular
      exercise test at 10 W/mn (MAL = 92 +/- 26 Watts-Peak VO2 = 14.8 +/- 2.4
      ml/Kg/mn). Gaseous exchanges (VO2, VCO2) minute volume (MV) and serum lactates
      were measured at rest and every 5 minutes during exercise. MV, VO2 and VCO2
      increased significantly (p < 0.005) with a change of less than 5% between the
      20th and 10th minute. Respiratory quotient was unchanged until the end of
      exercise and serum lactate levels stabilised between the 10th (3.4 +/- 0.66
      mmol/l) and the 20th minute of exercise (3.5 +/- 0.47 mmol/l). No significant
      relationship was observed between ventilation and serum lactate or between
      respiratory quotient and serum lactate. These results confirm that exercise at
      50% of maximal load is aerobic training even in patients with severe left
      ventricular dysfunction. This parameter would appear to be more useful than using
      the heart rate which is often abnormal in chronic cardiac failure (abnormal
      chronotropic response, atrial or ventricular arrhythmias).

PMID- 8363425
TI  - [Prognosis after aortic valve replacement for aortic valve stenosis with or
      without associated coronary lesions].
AB  - With the increasing age of patients and the progression of degenerative
      pathologies, the management of aortic stenosis (AS) with coronary artery disease
      is becoming more frequent. Reported results of combined valve and coronary
      surgery are equivocal especially with respect to the increased risk compared with
      aortic valve replacement without coronary surgery. The authors assessed the
      results of combined surgery by comparing two groups of patients with AS operated
      between 1979 and 1991: 122 patients with coronary lesions undergoing combined
      valve and coronary surgery (Group I) and 122 patients without coronary artery
      disease undergoing isolated aortic valve replacement (Group II) and paired with
      Group I patients for 5 prognostic factors (age, sex, functional status, date of
      surgery and left ventricular ejection fraction). Pairing the patients provided
      comparable populations for these 5 factors. The average age was high (68 years in
      Group I with over 50% of patients over 70 years of age) and most patients were in
      functional classes III or IV (67% in Group I). In Group I, 67% of patients had
      multivessel disease (average 2 vessel disease). Aortic valve replacement was
      associated with an average of 1.7 coronary bypass grafts per patient. Myocardial
      protection was the same in all cases using cold potassium enriched cardioplegic
      solutions. Operative mortality was 10.6% in Group I compared with 4.9% in Group
      II (NS) and the respective perioperative infarction rates were 6.6% and 0.8% (p <
      0.02). Seven year actuarial survival rates were 71.8% in Group I and 74.9% in
      Group II (NS) without any increased late mortality in Group II.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8363426
TI  - [Lipomatous hypertrophy of the interatrial septum. Apropos of 3 cases and review
      of the literature].
AB  - Lipomatous hypertrophy of the interatrial septum is characterised by an
      accumulation of fatty tissue in the interatrial septum. The authors report three
      cases, one presenting with sinus tachycardia and the other two being chance
      findings. Echocardiography associated with cardiac computerised tomography or
      magnetic resonance imaging usually confirms the diagnosis. In half the cases,
      supraventricular arrhythmias and suggestive P wave abnormalities are observed on
      the electrocardiogram. The diagnostic value of transoesophageal echocardiography
      is emphasised; it demonstrates the massive forms which may obstruct flow from the
      superior vena cava into the right atrium. The authors observe a discrepancy
      between the prevalence of this condition in autopsy series (about 1%) and the
      small number of cases described at echocardiography, suggesting that the
      diagnosis is probably missed.

PMID- 8363427
TI  - [Quantitative evaluation of the cardiovascular risk associated with hormone
      substitution therapy during menopause].
AB  - The cardiovascular risk of postmenopausal hormone replacement therapy is a
      controversial subject. A quantitative evaluation of 12 studies of cohorts show a
      global relative risk of major ischemic cardiac disease of 0.69 (95% confidence
      interval: 0.60-0.79) in women having or having had oestrogen therapy compared
      with women who have never taken this treatment. This relative risk was 0.94 (95%
      confidence interval: 0.77 to 1.15) for stroke and 0.80 (95% confidence interval:
      0.65-0.97) for cardiovascular mortality. These results are coherent with the
      hypothesis of a protective effect of oestrogens against coronary artery disease
      in postmenopausal women. However, they cannot be generalised to hormone
      replacement therapy usually proposed in France. The influence of an association
      of oestrogen-progesterone therapy and the effects of administering oestrogens by
      an extra-gastrointestinal route on vascular risk are unknown. Randomised clinical
      trials are needed to determine the effects of postmenopausal hormone replacement
      therapy on athero-thrombotic disease.

PMID- 8363428
TI  - [Spontaneous coronary artery dissection: apropos of a case with associated spasm
      and regression of the dissection].
AB  - The authors report the case of a 34 year old woman with postpartum myocardial
      infarction due to spontaneous coronary dissection of the distal circumflex
      artery. A spontaneously regressive spasm of the right coronary artery was also
      observed. The outcome with heparin, glyceryl trinitrate and calcium antagonist
      therapy was favourable. Over one year later, coronary angiography showed total
      resolution of the dissection and a large aneurysm of the inferior and septal
      walls of the left ventricle. This case is an example of post-partum spontaneous
      coronary dissection, in a particular vascular context. There are, however, other
      causes of spontaneous coronary artery dissection (atherosclerosis, eosinophilic
      syndrome...). Spasm may aggravate the consequences of coronary artery dissection
      and cause worse myocardial damage. The medical treatment, especially with regards
      to thrombolytic therapy, requires further codification.

PMID- 8363429
TI  - [Primary aspergillus endocarditis].
AB  - A 38-year old man was admitted for investigation of suspected endocarditis
      presenting with two cerebrovascular accidents and pyrexia. The initial clinical,
      echocardiographic and infectious investigations were normal, apart from a
      neutrophilic leukocytosis. The clinical course was marked by the recurrence of
      systemic embolism in the lower limbs, the appearance of cervical and axillary
      lymphadenopathy and, within a short period of time, of massive aortic valve
      vegetations. The diagnosis of aspergillosis was made from the culture of a
      peripheral embolus recovered by a Fogarty catheter and this was confirmed by the
      positivity of serological investigations. The patient died within two months
      despite antifungal therapy. Aspergillus endocarditis is characterised by its
      rapid progression, the volume and embolic tendency of the vegetations, the
      relative inefficacy of medical therapy and the potential benefits of early
      surgical management.

PMID- 8363431
TI  - [Airborne Japanese red cedar allergens studied by the immunoblotting technique-
      comparison with pollen counts obtained by Durham sampling and effect of weather].
AB  - We collected airborne particles with Burkard's sampling tape in Toyama from March
      to July. According to the immunoblotting technique (Takahashi et al, 1990), the
      airborne pollen allergens were reacted with anti-Cry j I polyclonal antibody and
      were stained as blue spots. The areas of these spots were measured with a color
      image analyzer (CIA) and a densitometer. There were significant correlations
      between the airborne Cry j I allergen spots (CIA and densitometer) and the pollen
      counts obtained with a Durham sampler (r = 0.624, 0.555, p < 0.001). The airborne
      Cry j I allergens however, tended to maintain a higher level than the pollen
      counts (Durham) in May. We theorized that this discrepancy is caused by cross
      reactivity with other pollen or crushed cedar pollen particles have
      allergenicity. There was a negative correlation between the Cry j I spots and
      rainfall. The pollen counts had a negative correlation with rainfall, and a
      positive correlation with average wind speed. These results suggest that this
      method is useful in evaluating fluctuations in airborne Cry j I allergen.

PMID- 8363430
TI  - [Diffuse cholesterol embolism after fibrinolysis for myocardial infarction].
AB  - The authors report the case of a 57 year old man admitted to hospital 3 hours
      after the onset of an infero-latero-basal infarct who underwent thrombolytic
      therapy with intravenous streptokinase, in whom the immediate outcome was
      complicated by multiple cholesterol embolisation which cause renal failure,
      mesenteric ischemia, medullary ischemia and livedo reticulosis of the lower half
      of the body complicated by gangrene of the toes, despite the fact that cardiac
      catheterisation had not been performed. This case (fifth reported case) of
      multiple cholesterol embolisation from the abdominal aorta caused by thrombolysis
      is the earliest presentation of this complication in the literature.

PMID- 8363432
TI  - [Changes in antigen-specific IgG, IgG4, and IgE antibodies in patients receiving
      immunotherapy with house-dust extract].
AB  - We measured allergen-specific IgG, IgG4, IgE antibodies and total IgE in sera
      from 64 patients who were receiving conventional immunotherapy (IT) with house
      dust (HD) extract. The sera were taken before and after IT. To measure allergen
      specific antibodies, we used crude DF antigen, Der f I and Der f II for IgG and
      IgG4 antibodies, and crude DF antigen for IgE antibodies. The patients were
      divided into 3 groups: very short term group (IT period < 2 years, n = 9); short
      term group (2 < = IT period < 7 years, n = 25); long term group (7 years < = IT
      period, n = 30). The specific IgG antibodies for DF crude antigen did not change
      in any group. The specific IgG antibodies for Der f I and Der f II increased in
      the short term group and in the long term group. The specific IgG4 antibodies for
      all three antigens increased remarkably in the short term group and in the long
      term group. In the very short term group, however, the specific IgG4 antibodies
      did not increase for any antigen. Total IgE and the specific IgG antibodies did
      not change through IT. The specific IgG4 antibodies increased significantly
      through IT, but the time course of the increment of the IgG4 antibodies was not
      parallel with the clinical course of IT.

PMID- 8363433
TI  - [Lymphocyte subpopulation in asthmatic children with chronic bronchial
      obstruction].
AB  - Lymphocyte subpopulations in peripheral blood were examined in asthmatic
      children, using fluorescent monoclonal antibodies. The patients were divided into
      three groups: Group I, no attack (FEV1.0% > or = 80% group), Group II, no attack
      (FEV1.0% < 80% group) and Group III, asthmatic attack group. The percentage of
      CD3HLADR/CD3 in the Group II and Group III were 5.58 +/- 3.59 and 5.44 +/- 4.34,
      respectively, which were significantly higher than that in the Group I subjects
      (2.70 +/- 2.17). This finding suggests that the patients with long lasting
      bronchial obstruction may have chronic inflammation in the airway even in the
      remission stage of asthmatic attacks.

PMID- 8363434
TI  - [The influence of indoor environmental factors on the onset of allergic disease].
AB  - To predict and prevent the onset of allergic diseases, we studied the effects of
      indoor environmental factors, such as diet, on pregnant women and carried out
      follow-up studies on their infants. Blood samples were collected at random from
      women who were diagnosed as pregnant (n = 2045). Umbilical cord blood was
      collected at delivery (n = 1453). To evaluate the efficacy of food guidance, the
      pregnant women were divided into two groups--one receiving simple diet guidance
      starting in the later stages of pregnancy, and one receiving no guidance
      whatsoever. A follow-up survey on allergic symptoms was done on their two-year
      old infants, revealing a lower incidence of symptomatic manifestations in the
      diet guidance group (p < 0.001). Respiratory symptoms (p < 0.05) were associated
      with maternal smoking and outside work during pregnancy. A study on food guidance
      in combination with environmental factors revealed that the incidence of
      respiratory symptoms in two-year-old infants whose mothers received diet guidance
      in a good indoor environment was held down to around 36.1%, while the incidence
      in infants whose mothers received diet guidance in a poor indoor environment was
      48.1%.

PMID- 8363435
TI  - [Evaluation of the relationship between immediate hypersensitivity and
      environmental factors by intracutaneous skin tests and specific IgE antibodies in
      allergic children. Part 2. The age distribution of immediate hypersensitivity by
      intracutaneous skin test and radioallergosorbent test].
AB  - To evaluate immediate hypersensitivity and environmental factors, 2,187 allergic
      children were given intradermal skin tests (ID test) and specific IgE antibodies
      (RAST) at Kudanzaka Hospital for 21 years (1967-1987). The incidence of positive
      ID test to house dust (HD) was 23% at 1 year, 50% at 2 years, 63% at 3 years and
      84% at 8 years of age. The results of average positive test obtained at an
      earlier age in 1975 and 1985 than in 1965. Children born recently begin to have
      positive test scores earlier than those born between 1965 and 1969. This could be
      related to the recent increase in the number of HD mites. The incidence of
      positive ID test to Japanese cedar pollen (sugi) was 5% at 1 year, 10% at 4
      years, 16% at 8 years and 30% at 15 years of age. The positive test scores were
      again obtained at an earlier age in 1975 and 1985 than in 1965, in the same way
      as for HD mites. Children born between 1965 and 1969 showed 30-60% positive rate
      after 13 years of age; this level was seen after 10 years of age in children born
      in 1975 and 1979, and after 6 years in those born between 1980-1984. This could
      be due to the recent increase in the amount of sugi pollen. Only Candida showed
      any significant rises in positive rate 27% at 1 year of age; slow increase was
      observed in the case of ragweed, molds, epidermals and others. No remarkable
      change was seen in ragweed and Alternaria at the years of examination and the
      years of birth.

PMID- 8363437
TI  - [Evaluation of the Magic Lite SQ specific IgE kit].
AB  - The new IgE specific antibody assay kit (Magic Lite SQ) was evaluated by
      comparing its results with those obtained by the Phadebas RAST and the skin prick
      tests. Sera from allergic children were used in the tests. The correlation
      coefficients between the Magic Lite SQ and the Phadebas RAST were as follows:
      0.87 for D.p., 0.89 for D.f., 0.87 for HD1, 0.55 for HD2, 0.76 for orchard grass,
      0.93 for cat dander, 0.78 for Alternaria, 0.88 for egg white, 0.75 for egg york,
      0.81 for milk, 0.75 for say bean, and 0.60 for shrimp. The concordance rate of
      the two methods was high, except on the case of HD2. The sensitivity and
      specificity of Magic Lite SQ to the skin prick test was high, except on the case
      of HD2 and orchard grass. Dilution tests using samples from D.f. positive
      patients showed a good linearity and excellent quantitativeness. When mite
      allergen was added to D.f. positive pool serum, mite specific IgE antibody
      yielded an excellent inhibition curve of up to a maximum of 96%. Since the Magic
      Lite SQ requires only a small sample of serum and can completed the test in a
      short time, it is a useful and specific IgE antibody assay kit.

PMID- 8363436
TI  - [Improvement of intractable nocturnal asthma treated by therapeutic awakening].
AB  - A 33-year-old female was admitted to our hospital because of intractable asthma
      which had not been improved by intensive treatment at another hospital. Her
      asthmatic attacks were improved within a week by treatments including systemic
      corticosteroids and mechanical ventilation. However, in a few weeks nocturnal
      asthma recurred frequently, and it was resistant to various bronchodilators and
      steroids. Therapeutic awakening, that is, awakening the patient quietly at 3 a.m.
      with inhalation of 2.5 mg salbutamol was started. Her symptoms and physical
      findings rapidly improved thereafter. It was concluded that therapeutic awakening
      may be effective for the treatment of refractory morning dipping of asthma.

PMID- 8363438
TI  - [Detection of antibody specific to rifampicin metabolite by ELISA--mechanism of
      sensitization by rifampicin].
AB  - A 46-year-old male tuberculosis patient developed acute renal failure and liver
      dysfunction following the oral administration of rifampicin (RFP). The mechanism
      of the reaction was examined by means of enzyme-linked immunosorbent assay
      (ELISA). 3-formylrifamycin-SV (Formylrifamycin), which is one of RFP metabolites,
      was conjugated to human serum albumin. ELISA was performed with this conjugate
      (Formylrifamycin-HSA) as an antigen. We also evaluated 100 tuberculosis patients
      receiving oral RFP and 45 healthy volunteers in order to determine the incidence
      of sensitization by RFP. IgG and IgM antibodies specific to Formylrifamycin-HSA
      were detected in serum from the patient with RFP-induced renal failure. Among the
      IgG subclasses, IgG1 antibody was detected. IgG and IgG1 antibodies specific to
      Formylrifamycin-HSA were detected in serum from only one of the 100 tuberculosis
      patients. Our results indicate that sensitization to RFP can occur on oral
      administration, and that acute renal failure was caused by IgG, IgM, and IgG1
      antibodies specific to Formylrifamycin as a hapten.

PMID- 8363439
TI  - [Influence of airway temperature and humidity of hyperventilation induced
      bronchoconstriction in rabbits].
AB  - It has been suggested that humidity and temperature of inspired air is important
      in determining the severity of hyperventilation induced bronchoconstriction
      (HIB). To investigate whether water loss or heat loss from airway plays more
      important role to induce HIB, we compared the effect of temperature and humidity
      of inspired air on HIB, in sensitized and non-sensitized rabbits. Inspired air
      containing 5% CO2 was conditioned to dry or humidified and to temperature of 9
      degrees C or 25 degrees C during isocapnic hyperventilation. In sensitized
      rabbits, marked bronchoconstriction was observed when inspired air dry regardless
      of temperature. We conclude that 1) HIB is produced in sensitized rabbits and 2)
      humidity rather than temperature of inspired air is more important to induce HIB.

PMID- 8363440
TI  - [A method for the quantification of interleukin-4 in serum (sandwich ELISA) and
      IL-4 levels in patients with atopic dermatitis].
AB  - We have developed a sandwich enzyme-linked immunosorbent assay (ELISA) using
      chemiluminescent enzyme substrate AMPPD for the quantification of interleukin 4
      (IL-4) in serum. IL-4 in serum could be measured in concentrations from 0.17
      pg/ml. The IL-4 levels in patients with atopic dermatitis were significantly
      higher than those in normal controls.

PMID- 8363441
TI  - Landau-Kleffner syndrome: some suggestions.

PMID- 8363442
TI  - Poor tolerability of MK-458.

PMID- 8363443
TI  - Cognition in relation to magnetic resonance imaging in head-injured children and
      adolescents.
AB  - To investigate the relationship between cognitive sequelae and magnetic resonance
      imaging (MRI) findings following closed head injury of varying severity in the
      pediatric age range, 76 head-injured children and adolescents were studied at
      least 3 months after trauma and compared with 57 normal controls. Problem
      solving, planning, verbal and design fluency, memory, and response modulation
      were assessed. Significant effects of injury were obtained on all of the
      cognitive measures. Cognitive impairment was more consistently present on the
      various outcome measures in children who were 6 to 10 years old at the time of
      the study than in the older children and adolescents. Magnetic resonance imaging
      disclosed areas of abnormal signal in the frontal lobes of 42 patients, whereas
      focal lesions restricted to the extrafrontal region were found in 15 children.
      Regression analyses disclosed that taking into account the size of frontal lobe
      lesion enhanced the relationship between cognitive performance and the severity
      of injury.

PMID- 8363444
TI  - Long-term survival of veterans with traumatic spinal cord injury.
AB  - OBJECTIVE: To investigate the long-term survival of veterans with traumatic
      spinal cord injury (SCI). DESIGN: Survival in a retrospective inception cohort of
      veterans suffering service-connected traumatic SCI is compared with survival
      among veterans disabled by other conditions, survival among nondisabled veterans,
      and a population-based life table. SETTING: Subjects were identified from a
      national census of veterans with service-connected disabilities, using a
      selection algorithm based on disability codes. PATIENTS: A retrospective cohort
      of 5545 male veterans with traumatic SCI, surviving at least 3 months after
      injury, is compared with a stratified random sample of 7077 disabled veterans
      without SCI, a stratified random sample of 6967 nondisabled veterans, and a life
      table formed from similarly aged American males. MAIN OUTCOME MEASURE: Survival
      curves, extending from 3 months to 40 years after injury. RESULTS: The mean life
      expectancy of veterans suffering traumatic SCI and surviving at least 3 months is
      an additional 39 years after injury, 85% that of similarly aged American males.
      Although survival with traumatic SCI was comparable to that of the disabled
      control subjects for approximately 20 years after onset, a clear deficit occurred
      beyond this point. Older age at injury is a stronger predictor of poorer long
      term survival than is complete quadriplegia. CONCLUSIONS: Among patients who
      survive the acute phase of their traumatic SCI, long-term survival is relatively
      good. Health care planners, providers, and communities should anticipate an
      increasing number of persons aging with SCI.

PMID- 8363445
TI  - Cerebral abnormalities in myotonic dystrophy. Cerebral blood flow, magnetic
      resonance imaging, and neuropsychological tests.
AB  - OBJECTIVE: To study cerebral abnormalities in myotonic dystrophy (MD) and
      determine the different patterns of cerebral function in patients with MD with
      maternal (mMD) vs paternal (pMD) inheritance. DESIGN: Patients with MD and normal
      controls were studied with neuropsychological testing, magnetic resonance
      imaging, and single photon emission computed tomography. SETTING: Studies were
      done at Harbor-UCLA Medical Center, Torrance, Calif. PATIENTS AND OTHER
      PARTICIPANTS: Twenty-two consecutive-patients with MD, 11 of whom had pMD and
      eight mMD, and 10 normal controls were studied. Diagnoses were made on the basis
      of family history, electromyography, and clinical examinations. Normal subjects
      in the same age distribution were studied for comparisons. RESULTS: We found
      significantly lower neuropsychological performance and cerebral blood flow in the
      patients with MD compared with the controls. Patients with mMD had statistically
      lower scores on IQ tests and more extensive cerebral hypoperfusion when compared
      with those with pMD. Changes in cerebral blood flow were most severe in the
      frontal and temporoparietal association cortex. Cerebral blood blow measures
      strongly correlated with IQ. CONCLUSIONS: Patients with mMD had earlier onset of
      disease and lower IQs than the pMD group. The pattern of cerebral perfusion in
      the mMD group was consistent with a diffuse brain injury, while cerebral
      perfusion in pMD showed more minor changes. These findings emphasize the
      cognitive differences between mMD and pMD.

PMID- 8363446
TI  - Idiopathic granulomatous angiitis of the central nervous system. Diagnostic
      challenges.
AB  - OBJECTIVE: Granulomatous angiitis of the central nervous system (CNS) is a rare
      cause of vasculitis involving the brain and spinal cord and is included in lists
      of disorders causing strokes. To determine the frequency of strokes (eg, sudden
      onset of focal symptoms) as a presenting complication and to determine the
      sensitivity of angiography and other technologies in detecting vasculitis in
      histologically proved cases of idiopathic granulomatous angiitis of the CNS
      (IGANS), we reviewed the published literature. DATA SOURCES: A biopsy-proved case
      of IGANS in a patient presenting without strokes and with a normal angiogram is
      reported. Additional cases of pathologically proved IGANS where results of
      angiography or other neuroimaging procedures were available were found by search
      of MEDLINE and bibliographies of pertinent articles and books. DATA EXTRACTION:
      We compared our case with 39 reported cases of histologically proved
      granulomatous angiitis of the CNS not associated with Hodgkin's disease, herpes
      zoster, sarcoidosis, or other proximate cause. We included only those cases that
      had been evaluated with angiography or other neuroimaging techniques before death
      or biopsy. DATA SYNTHESIS: Analysis of these cases shows that strokes as
      presenting complications are rare in IGANS. Most patients present with a diffuse
      encephalopathy and, when focal symptoms develop, they tend to develop gradually.
      Including our case, 56% of 41 angiograms performed in 31 reported patients with
      histologically proved IGANS were abnormal, but only 27% were diagnostic for
      vasculitis. CONCLUSIONS: We conclude that stroke is uncommon as a presenting
      complaint in IGANS and angiography is insensitive as a screening test for these
      patients.

PMID- 8363447
TI  - Neuropsychological patterns and language deficits in 20 consecutive cases of
      autopsy-confirmed Alzheimer's disease.
AB  - A retrospective chart review of clinical symptoms was done for 20 consecutive
      patients in whom postmortem examination had revealed senile plaques and
      neurofibrillary tangles in a distribution consistent with Alzheimer's disease.
      All patients had met clinical diagnostic criteria for probable Alzheimer's
      disease. On initial examination, 1 to 14 years beyond putative onset of the
      dementia, all patients displayed at least some memory impairment. In 16 patients,
      disturbances of attention or recent memory were among the most salient features.
      In two patients, language disturbances, and in two others, visuospatial deficits,
      were more prominent than difficulties with memory and attention. On initial
      examination, 17 of the 20 patients displayed word-finding difficulties,
      characteristically in the context of a fluent, anomic aphasia. All of the 12
      reexamined patients demonstrated progressive, although variable, deterioration.
      In general, the initial salient deficit remained salient during much of the
      disease course. Language comprehension was spared in the earlier stages but
      eventually deteriorated. Severe deficits emerged in all major cognitive domains
      as the disease reached the terminal stages. Nonfluent aphasias (eg, Broca's
      aphasia) were not observed even in the advanced stages of the disease.

PMID- 8363448
TI  - Amygdala atrophy in Alzheimer's disease. An in vivo magnetic resonance imaging
      study.
AB  - OBJECTIVES: To study the ability of magnetic resonance imaging to measure the
      volume of the amygdala and detect amygdala atrophy in patients with early
      Alzheimer's disease. DESIGN: Prospective case-control study and "blind"
      measurements. SETTING: Subjects were ambulatory outpatients selected from an
      institutional practice in Paris, France. PATIENTS: We studied 11 patients with
      probable Alzheimer's disease according to National Institute of Neurologic and
      Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders
      Association (NINCDS-ADRDA) and Consortium to Establish a Registry for Alzheimer's
      Disease (CERAD) inclusion and exclusion criteria, as well as six age-matched
      control subjects. INTERVENTION: None. MAIN OUTCOME MEASURE: A 1.5-T magnetic
      resonance imager was used to acquire the images. Two neuroradiologists
      independently and blindly measured the volume of the right and left amygdalas on
      high-resolution contiguous slices. In addition, other cerebral structures, ie,
      the sylvian fissures, temporal lobes, lateral and third ventricles, corpus
      callosum, and hippocampal formation, were measured on a single slice. RESULTS:
      The values obtained by the two observers correlated highly (r = .90), and
      interrater variability was 13%. The Alzheimer's disease group showed significant
      (33%, P < .0001) atrophy of the amygdala when compared with the control group.
      The other structures showed less variation. CONCLUSION: Significant amygdala
      atrophy can be detected in vivo in patients with early Alzheimer's disease by
      means of standard magnetic resonance imaging. This technique may be useful in the
      early diagnosis of Alzheimer's disease.

PMID- 8363449
TI  - Temporal lobe regions on magnetic resonance imaging identify patients with early
      Alzheimer's disease.
AB  - OBJECTIVE: The goal of the study was to examine the volume of selected brain
      regions in a group of mildly impaired patients with Alzheimer's disease (AD).
      Five regions were selected for analysis, all of which have been reported to show
      substantial change in the majority of patients with AD at some time in the course
      of disease. DESIGN: Case-control study with the experimenter "blinded." SETTING:
      Hospital-based magnetic resonance imaging center. PARTICIPANTS: Fifteen subjects,
      eight patients with the diagnosis of probable dementia of the Alzheimer type made
      in concordance with National Institute of Neurological and Communicative Diseases
      and Stroke/Alzheimer's Disease and Related Disorders Association criteria and
      seven age-matched healthy control subjects. RESULTS: Three of the volumetric
      measures were significantly different between patients with AD and controls: the
      hippocampus, the temporal horn of the lateral ventricles, and the temporal lobe.
      Two of the measures did not significantly differentiate patients with AD and
      controls: the amygdala and the basal forebrain. A discriminant function analysis
      demonstrated that a linear combination of the volumes of the hippocampus and the
      temporal horn of the lateral ventricles differentiated 100% of the patients and
      controls from one another. CONCLUSIONS: The results suggest that the hippocampus
      and the temporal horn of the lateral ventricles may be useful as antemortem
      markers of AD in mildly impaired patients.

PMID- 8363450
TI  - Cerebral glucose metabolism as a predictor of recovery from aphasia in ischemic
      stroke.
AB  - OBJECTIVE: The recovery of language function seen in poststroke aphasia is
      significantly related to the severity of the initial neurologic deficit. However,
      a great deal of variability still remains in the improvement that is actually
      achieved. To detect predictors that will help in explaining this variability,
      positron emission tomography (PET) and fluorodeoxyglucose F 18 (18-F
      fluorodeoxyglucose) were used and the results were analyzed by stepwise
      regression. DESIGN: Using PET imaging after injection of fluorodeoxyglucose F 18,
      the regional changes in glucose metabolism in 26 patients at a period of 12 to 18
      days following an ischemic stroke involving the left middle cerebral artery were
      examined. A second PET examination was performed on 17 of our 26 patients who
      were able to perform speech activation exercises. All patients received an
      initial and a 4-month follow-up evaluation of language performance. SETTING:
      During the two PET studies and the first language assessment, the patients were
      hospitalized in a neurologic clinic. The follow-up evaluation of language
      performance was performed when the patients were ambulatory. PATIENTS: Twenty-six
      patients (10 women, 16 men; aged 38 to 77 years; mean +/- SD, 60 +/- 9.2 years)
      were selected in the study. Their aphasias were of various types and of varying
      severity ranging from mild impairment to severe global aphasia. MAIN OUTCOME
      MEASURES: For the stepwise regression analysis of variables, the following
      variables were analyzed in resting and activation PET to explain residual
      variance from the first to the second Token Test: regional cerebral metabolic
      rate for glucose of infarct and mirror region, left and right cerebral and
      cerebellar hemispheres, left and right Broca's area, left and right Wernicke's
      area, and left and right temporoparietal cortex. RESULTS: As was expected, early
      and late Token Tests exhibit a high correlation (.85). The stepwise regression
      analysis shows that only the left cerebral hemisphere glucose value of the
      resting PET had significant effect on the residual variance of the Token Test
      regression. Regional metabolic rates during speech activation had the largest
      contribution to a significant recovery from aphasia. The infarct area and its
      corresponding mirror region, the left Broca's area, and the entire left cerebral
      hemisphere accounted for 80% of the residual variance. CONCLUSIONS: These results
      emphasize not only the application of PET activation studies in the prediction of
      a tissue's potential reserve capacity but also the importance of left hemisphere
      integrity in the recovery of functional language.

PMID- 8363451
TI  - Hippocampal atrophy in normal aging. An association with recent memory
      impairment.
AB  - OBJECTIVE: To estimate the prevalence of radiographically detectable hippocampal
      atrophy (HA) in a normal aging sample and to test whether such atrophy is
      associated with memory dysfunction. DESIGN: One hundred fifty-four medically
      healthy and cognitively normal elderly persons (aged 55 to 88 years) received
      magnetic resonance imaging and/or computed tomographic scans designed to identify
      HA. One hundred forty-five of these subjects also underwent psychometric tests of
      memory function. Multivariate analyses of variance were used to evaluate
      differences in memory performance between subjects with and without HA. SETTING:
      This study was conducted at a research clinic for the investigation of age
      associated neuropsychological and neuroradiologic changes. PARTICIPANTS: Based on
      the following criteria, 154 subjects were consecutively selected from a larger
      group of elderly research volunteers participating in a study of normal aging:
      age of 55 years or greater; Global Deterioration Scale score of 2 or less; and
      Mini-Mental State examination score of 28 or greater. Subjects with evidence for
      significant medical, psychiatric, or neurologic disease were excluded. MAIN
      OUTCOME MEASURES: Outcome measurements included individual psychometric test
      scores and computed tomographic-magnetic resonance imaging hippocampal atrophy
      ratings. RESULTS: Nearly 33% of the subjects had radiographic evidence for HA.
      The prevalence of HA increased significantly with age and was more common in male
      than female subjects. After controlling for age, level of education, and
      vocabulary, subjects with HA were found to perform more poorly on tests of recent
      (secondary) verbal memory when compared with subjects without HA (P < .01). No
      significant differences were found for tests of immediate (primary) memory.
      CONCLUSION: We conclude that HA is a common accompaniment of normal aging and is
      associated with mild memory impairment. Additional research is needed to
      determine whether HA constitutes a significant risk for future dementia.

PMID- 8363452
TI  - Ophthalmologic manifestations in MELAS syndrome.
AB  - We describe a 15-year-old boy with full-blown mitochondrial myopathy,
      encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and chronic
      progressive external ophthalmoplegia (CPEO). He presented with visual
      disturbance, hearing impairment, continuous partial epilepsy on the right aspect
      of the face, and right hemiparesis since the age of 13. Four months later, he
      experienced another strokelike episode with continuous partial epilepsy on the
      left hand. Serial computed tomographic scans revealed bilateral parieto-occipital
      hypodense lesions with gyral enhancement and an additional low-density lesion in
      the right frontal area 4 months later, respectively. Results of laboratory
      examinations disclosed lactic acidosis and mitochondrial myopathy with many
      ragged-red fibers. To identify the defective gene in mitochondrial DNA, a simple
      molecular test was performed by using restriction endonuclease Apa I. A
      transition from A to G was found at nucleotide position 3243 of the tRNA(Leu)
      gene. Interestingly, the patient also had marked external ophthalmoplegia and
      ptosis commonly found in patients with CPEO. Therefore, we suggest that
      ophthalmoplegia also occurs in the MELAS syndrome.

PMID- 8363454
TI  - Updating Keratospeak IV.

PMID- 8363453
TI  - Visual evoked potential characteristics and early diagnosis of Pelizaeus
      Merzbacher disease.
AB  - OBJECTIVE: Early diagnosis of Pelizaeus-Merzbacher disease; assessment of disease
      progression. DESIGN: Pediatric neuro-ophthalmology evaluation of visual function
      with pattern and luminance visual evoked potentials; behavioral state assessment;
      electrophysiological diagnostic test; baseline estimates at the age of 11 weeks;
      1-year follow-up. SETTING: University hospital electrodiagnostic vision research
      laboratory. PATIENTS:  CASE STUDY: X-linked Pelizaeus-Merzbacher disease;
      leukodystrophy; patient tested at the age of 11 weeks and at the age of 58 weeks
      for follow-up; five age-matched normal controls. INTERVENTIONS: Physical therapy,
      medication, evaluation. MAIN OUTCOME: Early diagnosis; diagnostic confirmation;
      objective monitor of disease progression. RESULTS: Abnormal spatial and temporal
      vision and abnormal visual pathway maturation; visual evoked potentials of
      proband with Pelizaeus-Merzbacher disease were grossly abnormal, reflecting
      myelination disorder. CONCLUSIONS: Visual evoked potential pediatric
      electrodiagnosis yields reliable measures of visual function and visual system
      maturation in leukodystrophy.

PMID- 8363455
TI  - Fixation of conjunctival autografts with an organic tissue adhesive.

PMID- 8363456
TI  - Predictive factors for endothelial cell loss after penetrating keratoplasty.

PMID- 8363458
TI  - Branhamella (Moraxella) catarrhalis endophthalmitis.

PMID- 8363457
TI  - Posttraumatic endophthalmitis caused by Lactobacillus.

PMID- 8363459
TI  - Streptococcus pneumoniae endophthalmitis following strabismus surgery.

PMID- 8363460
TI  - A diagnostic dilemma: one foreign body or two?

PMID- 8363461
TI  - Glaucoma and the law. Cox v District of Columbia.

PMID- 8363462
TI  - Looking behind the eyes. The proper use of modern imaging.

PMID- 8363463
TI  - Advising patients about age-related macular degeneration.

PMID- 8363464
TI  - 0.3% ciprofloxacin ophthalmic ointment in the treatment of bacterial keratitis.
      The Ciprofloxacin Ointment/Bacterial Keratitis Study Group.
AB  - OBJECTIVE: To determine the efficacy and safety of topical 0.3% ciprofloxacin
      hydrochloride ophthalmic ointment in the treatment of bacterial keratitis.
      DESIGN: Prospective case series with a nonrandomized comparison of culture
      positive, evaluable cases (ciprofloxacin ointment group) with culture-positive,
      concurrent patients (nonenrolled group) treated with conventional therapy.
      SETTING: Multicenter clinical study. PATIENTS: After informed consent was
      obtained, 253 eligible patients underwent corneal scrapings and received topical
      ciprofloxacin ointment; 145 (57%) had positive cultures and completed the follow
      up schedule. Forty (70%) of 57 apparently eligible patients had culture-positive
      bacterial keratitis but were not enrolled in the ciprofloxacin ointment study
      during the same period. INTERVENTION: Ciprofloxacin ophthalmic ointment instilled
      every 1 to 2 hours for 2 days, then every 4 hours for 12 days. MAIN OUTCOME
      MEASURES: Clinical evaluation of signs at 1, 3, 7, and 14 days of treatment and
      the overall condition classified as clinical success (cured or improved) or
      failure (unchanged or worse) during and after therapy. RESULTS: Clinical success
      with the initial treatment occurred in 135 patients (93%) in the ciprofloxacin
      ointment group and in 28 patients (70%) in the nonenrolled group. Of the 10
      ciprofloxacin clinical failures, seven were staphylococcal; two, pneumococcal;
      and one, polybacterial. The 90% minimum inhibitory concentration of ciprofloxacin
      was 3 mg/L or less for corneal bacterial isolates. No serious adverse event
      attributable to ciprofloxacin ointment occurred, although 32 (13%) of 253
      patients developed a transient white crystalline corneal precipitate shown with
      liquid chromatography in two cases to be ciprofloxacin. CONCLUSION: Ciprofloxacin
      ophthalmic ointment is an effective and safe topical antimicrobial agent for the
      treatment of bacterial keratitis caused by susceptible microorganisms.

PMID- 8363465
TI  - Optic nerve sheath decompression for glaucomatous optic neuropathy with normal
      intraocular pressure.
AB  - OBJECTIVE: To report our therapeutic experience with optic nerve sheath
      decompression in patients with normal-pressure glaucoma. DESIGN: A case series of
      seven eyes from six patients with glaucoma and normal intraocular pressures who
      continued to have progressive visual field loss despite conventional therapy.
      SETTING: A hospital-based, referral glaucoma service. PATIENTS: Three men (67,
      67, and 72 years of age) and three women (58, 61, and 70 years of age).
      INTERVENTIONS: Optic nerve sheath decompression. MAIN OUTCOME MEASURES: Visual
      field data and visual acuity measurements were obtained at regular intervals
      during the postoperative periods (range, 3 to 18 months). RESULTS: Two of seven
      eyes from six patients appear to have enjoyed an initial significant improvement
      in their visual fields with improved visual acuity in one eye of one patient. The
      visual fields, however, appear to have deteriorated 18 months after the initial
      procedure in these two patients. In the remaining four patients, no further
      improvement or deterioration was observed within a limited follow-up period.
      CONCLUSIONS: The transient improvement in the visual fields of one eye from each
      of two patients documents an initial successful use of optic nerve sheath
      decompression in patients with nerve fiber bundle damage in the absence of optic
      nerve head swelling. However, the long-term potential of optic nerve sheath
      decompression in these patients may be of limited value.

PMID- 8363466
TI  - Central serous chorioretinopathy in endogenous hypercortisolism.
AB  - OBJECTIVE: To examine the potential association of central serous
      chorioretinopathy with endogenous hypercortisolism (Cushing's syndrome). DESIGN:
      Ophthalmologic survey of consecutively admitted patients with endogenous
      Cushing's syndrome. SETTING: An eye clinic of a research center (National Eye
      Institute, Bethesda, Md). PATIENTS: Sixty consecutive patients with confirmed
      endogenous Cushing's syndrome. MAIN OUTCOME MEASURES: Findings from complete
      ophthalmologic evaluation. RESULTS: Three (5%) of 60 patients had one or more
      episodes of appropriately documented central serous chorioretinopathy. In all
      cases, the episodes occurred during the period of hypercortisolism. CONCLUSIONS:
      Central serous chorioretinopathy is an uncommon manifestation of endogenous
      Cushing's syndrome. Since central serous chorioretinopathy has been associated
      with other hypercortisolemic states, we suggest that glucocorticoids may play a
      role in the development of this disease.

PMID- 8363467
TI  - Dual-perspective analysis of vascular formations in sickle cell retinopathy.
AB  - OBJECTIVE: To examine the sickle cell retina in dual perspective (vascular
      patterns en bloc and structure in serial sections) to gain new insights into
      sickle cell retinopathy. METHODS: We analyzed the retinas of two patients with
      sickle cell disease (a 54-year-old patient with hemoglobin SC, heterozygous for
      the S and C mutation in the beta chain of the globin gene, and a 20-month-old
      patient with sickle cell anemia [SS], homozygous for the S mutation) using the
      previously described adenosine diphosphatase flat-embedding technique. RESULTS:
      The dual-perspective analysis afforded by our technique revealed that the primary
      site of occlusions was located at the precapillary level. An unusual neovascular
      formation, the hairpin loop, was observed in both patients' retinas and appeared
      to result from recanalization of the wall of an occluded vessel. Many
      autoinfarcted pre-retinal neovascular formations were observed in the older SC
      patient. Two patent preretinal formations were studied in detail and their
      evolution appeared to be influenced by mechanical factors. The vessels appeared
      to have been extruded from the retina, perhaps owing to hydrostatic pressure
      secondary to downstream occlusions. Small pigmented lesions consisting of retinal
      pigment epithelial cells ensheathing channels that resembled autoinfarcted
      vessels were found in the eye of the SC patient. CONCLUSIONS: This study
      illustrates unusual morphological features of intraretinal and preretinal
      neovascularization and of chorioretinal lesions in sickle cell retinopathy and
      suggests alternative mechanisms for their formation.

PMID- 8363468
TI  - The Linxian cataract studies. Two nutrition intervention trials.
AB  - OBJECTIVE: To determine whether the vitamin/mineral supplements used in two
      cancer intervention trials affected the risk of developing age-related cataracts.
      DESIGN: Two randomized, double-masked trials with a duration of 5 to 6 years and
      end-of-trial eye examinations. SETTING: Rural communes in Linxian, China.
      PARTICIPANTS: In trial 1, 2141 participants aged 45 to 74 years, and, in trial 2,
      3249 participants aged 45 to 74 years. INTERVENTIONS: Multivitamin/mineral
      supplement or matching placebo in trial 1; factorial design to test the effect of
      four different vitamin/mineral combinations in trial 2 (retinol/zinc,
      riboflavin/niacin, ascorbic acid/molybdenum, and selenium/alpha-tocopherol/beta
      carotene). MAIN OUTCOME MEASURES: Prevalence of nuclear, cortical, and posterior
      subcapsular cataracts in treatment groups at end of trials. RESULTS: In the first
      trial, there was a statistically significant 36% reduction in the prevalence of
      nuclear cataract for persons aged 65 to 74 years who received the supplements. In
      the second trial, the prevalence of nuclear cataract was significantly lower in
      persons receiving riboflavin/niacin compared with persons not receiving these
      vitamins. Again, persons in the oldest group, 65 to 74 years, benefited the most
      (44% reduction in prevalence). No treatment effect was noted for cortical
      cataract in either trial. Although the number of posterior subcapsular cataracts
      was very small, there was a statistically significant deleterious effect of
      treatment with riboflavin/niacin. CONCLUSIONS: Findings from the two trials
      suggest that vitamin/mineral supplements may decrease the risk of nuclear
      cataract. Additional research is needed in less nutritionally deprived
      populations before these findings can be translated into general nutritional
      recommendations.

PMID- 8363469
TI  - Ocular clinicopathologic study of the mitochondrial encephalomyopathy overlap
      syndromes.
AB  - Recent advances in molecular genetics have led to a better understanding of
      mitochondrially inherited diseases. Mitochondrial encephalomyopathy overlap
      syndrome is one such group of diseases in which ocular abnormalities are
      frequently manifest. The authors describe the clinical, molecular genetic, and
      pathologic findings of two patients with the mitochondrial encephalomyopathy
      overlap syndrome. The patients shared a similar clinical course with features
      overlapping the three traditionally distinct clinical phenotypes (the Kearns
      Sayre syndrome; the syndrome of mitochondrial encephalopathy, lactic acidosis,
      and stroke [MELAS], and the syndrome of myoclonus, epilepsy, and ragged red
      fibers [MERRF]). The patients had identical mitochondrial DNA mutations (at
      nucleotide position 3243) and had similar ultrastructural abnormalities,
      including abundant enlarged mitochondria with "whorled" and "tubular" cristae.
      These abnormal mitochondria appeared to be preferentially distributed in cells
      with high metabolic activity (retinal pigment epithelium, corneal endothelium,
      and extraocular muscles).

PMID- 8363470
TI  - The prevalence of primary angle closure glaucoma and open angle glaucoma in
      Mamre, western Cape, South Africa.
AB  - OBJECTIVE: To determine the prevalence of primary angle closure glaucoma in the
      so-called Cape people of mixed ethnic background. DESIGN: A population-based
      prevalence study. SETTING: Mamre, a village near Cape Town, South Africa.
      PARTICIPANTS: Individuals aged 40 years or older. Historically, their ancestors
      were Southeast Asians and indigenous Africans and, to a lesser extent, Europeans.
      Of a total of 1194 people, 987 (82.7%) were examined. MAIN OUTCOME MEASURE:
      Primary angle closure glaucoma was diagnosed in individuals with previous acute
      or intermittent symptoms of angle closure and in individuals with an "occludable"
      angle and an intraocular pressure of greater than 21 mm Hg or a glaucomatous
      visual field. MAIN RESULTS: An age-related trend toward hypermetropia was found,
      which was greatest in women older than age 50 years. Gonioscopy identified
      Shaffer grade 1 angles in 89 (9%) of 987 subjects. The prevalence of primary
      angle closure glaucoma was 2.3% (23 subjects) and increased with age in both
      sexes. Women were affected more than four times as often as men and the sex
      difference persisted across all age groups. In comparison, the prevalence of
      primary open angle glaucoma was 1.5% (15 subjects). Primary glaucoma (angle
      closure plus open angle) was the leading cause of bilateral blindness in the
      community, with a prevalence rate of 0.5% (five subjects). CONCLUSIONS: This
      study identified primary angle closure glaucoma as a significant public health
      problem in the Western Cape Province. Because of the ethnic back-ground of the
      people studied, these findings may also apply to the populations of Southeast
      Asia.

PMID- 8363471
TI  - Indocyanine green angiography and ultrasonography of a varix of vortex vein.

PMID- 8363473
TI  - Problems with the design of observations and their statistical analysis.

PMID- 8363472
TI  - Whitnall's sling with superior tarsectomy for the correction of severe unilateral
      blepharoptosis.
AB  - The management of severe unilateral blepharoptosis is problematic. In the
      presence of poor levator function, conventional surgical techniques frequently do
      not adequately elevate a ptotic eyelid. From May 1988 through July 1991, we used
      4- to 5-mm external resections of the superior tarsus in conjunction with a
      maximal aponeurectomy (Whitnall's sling procedure) to augment blepharoptosis
      correction in selected cases of severe unilateral blepharoptosis. Seventeen (68%)
      of 25 patients with poor levator function blepharoptosis who underwent this new
      surgical procedure achieved a lid height within 1 mm of the opposite lid with
      good or excellent ocular function, cosmesis, and eyelid crease formation. Mild to
      moderate degrees of exposure keratopathy developed early in the postoperative
      period in all patients. This exposure keratopathy ultimately resolved in most
      patients. Superior tarsectomy safely augments the blepharoptosis correction of a
      Whitnall sling procedure in severe blepharoptosis, improving the results of
      aponeurotic surgery in patients with severe unilateral blepharoptosis.

PMID- 8363474
TI  - Biliary injury at laparoscopic cholecystectomy: recognition and prevention.

PMID- 8363475
TI  - The case against open neck biopsy.
AB  - Many patients present with lateral neck lumps due to benign or malignant
      conditions, and they may be difficult to differentiate clinically. It is
      detrimental to perform an open neck biopsy on a patient with a cancer originating
      from the head and neck region (upper aerodigestive tract or skin) prior to
      definitive treatment. The biopsy interferes with the assessment and management of
      the neck, increasing morbidity. It may also decrease curability and perhaps
      induce fungation. A protocol to avoid the need for an open biopsy, using fine
      needle aspiration cytology and a thorough examination of the upper aerodigestive
      tract is recommended. The authors also recommend combined radical radiotherapy
      and surgery for the patient who has had an open biopsy. A thoughtless biopsy is
      both needless and harmful.

PMID- 8363476
TI  - Bile duct injury during laparoscopic cholecystectomy: a report of the Standards
      Sub-committee of the Victorian State Committee of the Royal Australasian College
      of Surgeons.
AB  - A survey of Victorian surgeons performing laparoscopic cholecystectomy was
      carried out. This report discusses the bile duct injuries identified in the
      survey. Twelve injuries were recorded, a rate of 0.2%. Three of the 12 required
      formal repair, the other 9 being treated by T-tube alone. Possible mechanisms of
      these injuries, the experience of the surgeon, the role of operative
      cholangiography and delays in recognition of the injury are discussed.

PMID- 8363477
TI  - Injuries to the bile duct resulting from laparoscopic cholecystectomy.
AB  - Laparoscopic cholecystectomy has now become the treatment of choice for
      symptomatic gall stones. There does, however, appear to be an increased incidence
      of bile duct injuries. In this article, experience with eight patients who
      sustained a bile duct injury and were referred to the Hepatobiliary Service at
      Westmead Hospital, between 1990 and 1992, is reported.

PMID- 8363478
TI  - Percutaneous cystogastrostomy for treatment of pancreatic pseudocysts.
AB  - Cystogastrostomy or cystojejunostomy at open operation has been the usual
      treatment for symptomatic pancreatic pseudocyst. The aim of this study was to
      assess prospectively the results of percutaneous cystogastrostomy (PCG) for the
      treatment of symptomatic pseudocysts. The technique of PCG comprised initially of
      drainage of the pseudocyst with a 10 Fr percutaneous, transgastric catheter. This
      initial drainage catheter had two components; the first, between the pseudocyst
      and the stomach, drained the pseudocyst and the second, between the stomach and
      exterior, acted as a percutaneous gastrostomy. The initial drain was left in situ
      for 14 days, at which time it was exchanged percutaneously for the definitive
      PCG; a double ended Mallecot type catheter that drained between the pseudocyst
      and the stomach. The latter catheter was left in situ until there was no residual
      pseudocyst demonstrated on computerized tomography scan and was removed
      endoscopically. Eleven patients with large (> 6 cm), symptomatic pseudocysts have
      been treated with PCG. All patients were treated successfully without the need
      for surgical intervention. The median time to radiological resolution was 24
      days. There were four episodes of sepsis, two related to central venous line
      infections nad two related to catheter blockage. Percutaneous, cystogastrostomy
      blockage was managed by either replacing the initial drain or inserting a second
      catheter. The median follow up after successful treatment was 9 months (range 2
      17). There were no symptomatic recurrences and one small (2 cm) asymptomatic
      recurrent pseudocyst. This preliminary experience with PCG demonstrates the
      efficacy of this procedure for treating symptomatic pancreatic pseudocysts.

PMID- 8363479
TI  - Computer assisted diagnosis of the acute abdomen.
AB  - Computer assisted diagnosis (CAD) has been claimed to improve the accuracy of
      assessment of the acute abdomen. Alternative techniques that may improve decision
      making are briefly reviewed and CAD is examined critically. The structured
      collection of complete clinical data with performance feedback, results in
      improvements comparable to CAD. Computer systems are costly and when installed
      are used selectively and variably by clinicians. Their place in surgical practice
      remains to be established.

PMID- 8363480
TI  - Leiomyosarcoma of the rectum and anal canal.
AB  - Leiomyosarcoma of the rectum and anal canal is rare and the optimal treatment is
      not clear. Eight patients with isolated anorectal leiomyosarcoma treated
      surgically were reviewed. The age ranged from 44 to 76 years (median 63 years)
      and the follow up ranged from 6 months to 4.5 years (median 2 years). All
      patients were symptomatic at presentation. All tumours involved the muscularis
      propria of the low and/or mid-rectum with three tumours also involving the anal
      sphincters. The tumour size ranged from 1.2 to 10 cm (median 4 cm). Mucosal
      involvement occurred in only three patients and there was no lymph node
      involvement. All showed microscopic infiltration at the advancing border, despite
      macroscopic circumscription. Only one patient was thought to have a tumour
      sufficiently small (3 cm) and localized on clinical and intrarectal ultrasound
      examinations (UST2N0) to be suitable for wide local excision. That patient
      remained tumour-free after 2 years. The remaining patients (88%) were treated by
      abdomino-perineal resection. The disease free interval in this latter group
      ranged from 3 months to 4.5 years. All recurrences were detected within 15 months
      of surgery and the mean interval from detection of recurrence to death was 9
      months. Using a histological grading system that included tumour differentiation,
      mitotic count and amount of necrosis, high grade sarcomas were associated with a
      worse prognosis. Other factors associated with a poor outcome included large
      tumour size (> 6-7 cm) and prior incomplete local excision.

PMID- 8363481
TI  - Common bile duct calculi at laparoscopic cholecystectomy: a technique for
      management.
AB  - Laparoscopic cholecystectomy was attempted in 150 unselected patients. The use of
      routine intraoperative cholangiography prevented serious bile duct injury in one
      patient. It also showed 75% of patients suspected pre-operatively of having
      common duct stones, had passed them by the time of cholecystectomy. Eight of 12
      diagnosed duct stones (5 suspected, 7 unsuspected) were removed laparoscopically.
      A technique is described using inexpensive and readily available equipment that
      allows the transcystic duct treatment of the majority of common duct stones. The
      development and use of such techniques to laparoscopically treat duct stones will
      once more allow surgeons to treat all biliary calculi at the one procedure and
      reduce unnecessary dependence on endoscopic retrograde
      cholangiopancreatography/sphincterotomy.

PMID- 8363482
TI  - Left lateral laparoscopic cholecystectomy and its relevance to
      choledocholithiasis.
AB  - One of the current challenges to the laparoscopic biliary surgeon is the
      management of bile duct stones. While laparoscopic bile duct exploration is in
      its infancy, pre- and postoperative endoscopic retrograde
      cholangiopancreatography with or without endoscopic papillotomy (ERCP/EP)
      currently plays a significant role. Intra-operative ERCP/EP has advantages over
      pre- and postoperative ERCP/EP; however it has not gained popularity due, partly,
      to the difficulties associated with ERCP/EP being performed with the patient in
      the supine position. This study prospectively assessed, in 10 consecutive
      patients, the feasibility of performing laparoscopic cholecystectomies in the
      left lateral position, a position amenable to intra-operative ERCP/EP if
      necessary. It is concluded that laparoscopic cholecystectomy in the left lateral
      position can be performed safely, with similar ease and results as in the supine
      position, increasing the options available to manage choledocholithiasis.

PMID- 8363483
TI  - Evaluation of a method to teach cardiothoracic surgery to medical students.
AB  - This report describes a method to teach undergraduate students the knowledge base
      and skills needed to maximize the educational value of a subsequent
      cardiothoracic surgical clerkship. Sixty-three fourth year medical students
      underwent a structured teaching programme in which groups of five students
      rotated through a series of six teaching stations. Subject material, presented
      during 20 min at each station, covered the key issues relating to coronary artery
      disease, congenital heart disease, chest trauma, lung cancer, prosthetic heart
      valves, pacemakers, thoracic sepsis and dysphagia. Group knowledge increased
      significantly (P < 0.001) from a mean mark of 23% (s.d. 12) in a pre-test to a
      mean mark of 46% (s.d. 12) in a test conducted 1 month after the teaching. The
      time taken to conduct the structured teaching/assessment was 5 h compared with 32
      h to run the same programme by the traditional ward tutorial system. The dollar
      cost to stage the structured teaching was less than that to run the traditional
      tutorial programme. It was concluded that the teaching method is effective,
      economical and practical and that it has a role in an undergraduate curriculum to
      prepare students for clinical clerkship.

PMID- 8363484
TI  - The probability of passing at resits in the Part I Fellowship examination.
AB  - The study aimed to determine the relationship of a candidate's attempt number and
      proximity of the aggregate score to the pass mark, individually and in
      combination, to the probability of passing at the next attempt at the Part I
      FRACS examination. The results of 36 examinations, in which 3513 candidates sat
      5891 tests, were analysed. While 40.5% of all candidates who sat these
      examinations passed, the first attempt pass rate was 44%. Overall about one-third
      of the candidates who had sat the examination previously passed at the next
      attempt, the probability of passing remained fairly constant up to the fourth
      attempt and fell thereafter. As expected, the further the candidate's aggregate
      score was below the pass mark, the lower the probability of passing at the next
      attempt. Considering both attempt number and proximity to the pass mark,
      probability of passing decreased with successive attempts except for very weak
      candidates. The results indicate that, while the imposition of an upper limit on
      the number of resits at the examination is not justified, candidates who fall
      significantly below the pass mark should be advised against resitting for a
      reasonable period, and those who repeatedly do so should be advised against
      resitting for a reasonable period, and those who repeatedly do so should another
      career. It is suggested that feedback to the candidates about the probability of
      passing at the next attempt be based on the results obtained in this study.

PMID- 8363485
TI  - Removal of bulky tissue at laparoscopic surgery.

PMID- 8363486
TI  - Ocular melanoma in childhood.
AB  - A case of primary ocular melanoma of the iris in a 10 year old girl is reported.
      Primary melanoma of the eye is exceedingly rare in childhood. The incidence and
      risk factors for ocular melanoma are discussed and possible reasons why this
      tumour is so uncommon in younger age groups are considered.

PMID- 8363487
TI  - Carcinoid syndrome secondary to a primary tumour in a Meckel's diverticulum.

PMID- 8363488
TI  - Laparoscopic removal of a pelvic endometrioma attached to the ureter.

PMID- 8363489
TI  - Dentures: difficult oesophageal foreign bodies.
AB  - Oesophageal foreign bodies occur commonly, but dentures are swallowed
      infrequently. Two cases are reported that demonstrate the difficulties in the
      localization and retrieval of ingested dentures, because they are radiolucent and
      have an awkward shape. Early rigid oesophagoscopy is recommended as the most
      appropriate investigation and method of removal.

PMID- 8363490
TI  - Papillary carcinoma arising in a thyroglossal cyst.
AB  - Carcinoma arising in a congenital thyroglossal cyst is rare, with less than 150
      cases reported worldwide. This is a case report of a papillary carcinoma arising
      within a thyroglossal cyst in a 51 year old woman. Management of this condition
      remains controversial. Most of these tumours arise from ectopic thyroid tissue
      within the cyst. Prognosis is good as metastasis is uncommon. Sistrunk procedure
      is adequate if histology does not reveal extracystic extension.

PMID- 8363491
TI  - Bifrontal meningeal fibrosarcoma in a patient with metastases to the liver,
      kidneys and suprarenal glands.
AB  - Primary meningeal sarcoma is a rare malignant tumour of the central nervous
      system and metastases to the liver, kidney and the suprarenal gland have not been
      reported elsewhere. A 47 year old Chinese woman who presented with a short
      history of headache and vomiting was found to have metastatic meningeal
      fibrosarcoma in the liver 4 months after resection of primary bifrontal meningeal
      fibrosarcoma. The computerized tomography findings and relevant histology are
      presented.

PMID- 8363492
TI  - Virulence of Salmonella typhimurium mutants for White Leghorn chicks.
AB  - A strain of Salmonella typhimurium that is highly virulent for 1-day-old white
      leghorn chicks was genetically modified by deletion (delta) of the adenylate
      cyclase (cya) and cyclic AMP receptor protein (crp) genes or by removal (curing)
      of the 91-kilobase virulence plasmid. These mutants were then compared with the
      wild-type S. typhimurium strain for virulence in 1-day-old chicks and for their
      ability to colonize chicks of various ages. The plasmid-cured mutant showed a
      slight reduction in virulence, whereas the delta cya delta crp mutant was
      completely avirulent. The wild-type strain and both mutant strains were capable
      of colonizing various organs within the chicks. At all time points, the delta cya
      delta crp strain colonized chicks at lower levels than the wild-type strain.
      Titers of the plasmid-cured strain increased more slowly in visceral organs than
      did those of the wild type.

PMID- 8363493
TI  - Effects of vitamin A deficiency on the reproductive system of mature White
      Leghorn hens.
AB  - Two groups of 100 white leghorn hens were fed rations either supplemented or
      deficient in vitamin A for 32 weeks. At the conclusion of the study, vitamin A
      supplemented hens laying normally were also compared with a group of vitamin A
      supplemented hens in a state of low egg production. Mean egg retinol equivalents
      (microgram retinol/g egg yolk), egg production, and hatchability in the vitamin A
      deficient group were decreased significantly by 4, 20, and 28 weeks,
      respectively, after beginning treatment. The ovaries of vitamin A-deficient
      chickens had increased numbers of atretic follicles compared with the ovaries of
      vitamin A-supplemented hens (20, 24, 28, and 32 weeks), and these atretic
      follicles contained moderate to severe hemorrhage. Hemorrhage was located either
      uniformly throughout the follicle or more commonly between the detached granulosa
      cell layer and the theca interna. Hemorrhagic follicles were uncommon in both
      vitamin A-supplemented hens and low-production vitamin A-supplemented hens.

PMID- 8363494
TI  - Heterophil chemotaxis in chickens with natural Staphylococcal infections.
AB  - Heterophil chemotaxis using heterophils isolated from the peripheral blood of
      five commercial broiler chickens naturally infected with staphylococcal bacteria
      was compared by the modified Boyden-chamber technique with chemotaxis of
      heterophils from two chickens from the same flock not infected with
      Staphylococcus (field controls) and from four healthy laboratory control broiler
      chickens. The infected chickens had gross and histologic lesions of
      staphylococcal tenosynovitis and osteomyelitis. Staphylococci were isolated from
      the lesions. Hematologic parameters and histologic lesions of infected chickens
      also were examined. Compared with field and laboratory controls, Staphylococcus
      infected chickens had heterophilic leukocytosis. The heterophils of
      Staphylococcus-infected chickens had significantly lower chemotactic activity
      than both control groups in terms of random movement and directed chemotactic
      movement in response to stimulus. Toxic changes were observed in heterophils of
      some of the Staphylococcus-infected broilers.

PMID- 8363495
TI  - Development of immunity in broilers continuously exposed to Eimeria sp.
AB  - A series of experiments was conducted to determine the time required to induce
      absolute immunity to three species of Eimeria in young broiler chickens
      continuously exposed to the parasite. Acquisition of immunity was measured by
      cessation of oocyst production in each bird. Initial experiments were performed
      in broilers beginning at age 7 days with continuous oocyst administration for 28
      days with E. tenella, E. maxima, or E. acervulina. Evaluation of oocyst
      production demonstrated a major decline in oocyst output of E. maxima and E.
      tenella by 2 weeks, with cessation by 25 days. Exposure to E. acervulina caused
      cessation of oocyst production by day 16. To study whether chickens of different
      ages varied in their capacity to immunize within this time frame, 1-day-old birds
      also were studied. For E. tenella, exposures also were initiated in 14- and 21
      day-old birds. This study demonstrated that regardless of the age of the broiler,
      all were capable of establishing complete protective immunity to E. tenella, E.
      maxima, and E. acervulina under continuous exposure within 25, 24, and 16 days,
      respectively.

PMID- 8363496
TI  - Tibial dyschondroplasia of chickens induced by Fusarochromanone, a mycotoxin.
AB  - Chicks were fed for 3 weeks a practical broiler starter diet amended with
      fusarochromanone (FC), a mycotoxin. In Hubbard broiler chicks, the highest test
      dose of FC (75 ppm) suppressed body weight by 33% and humoral response to sheep
      erythrocytes by 34% to 50%, and increased the incidence of tibial
      dyschondroplasia (TD) to 100%. The intermediate dose (35 ppm) significantly
      increased the incidence of TD in both types of broiler chicks (Hubbard and Indian
      River), but its effect on humoral response to sheep erythrocytes was not
      consistent across several experiments. A minimum dietary concentration greater
      than 20 ppm was required to significantly increase the incidence of TD. Excessive
      dietary copper or zinc (200 ppm) alleviated the effect of FC on TD. However,
      activities of copper-dependent ceruloplasmin and superoxide dismutase was not
      affected by FC. Cartilage mineral profiles in FC- or Thiram-induced TD differed
      from that of 1-day-old hypertrophic embryonic cartilage core (less K and Mn). FC
      did not induce TD in leghorn chicks.

PMID- 8363497
TI  - Characterization of isolates of Haemophilus paragallinarum from Argentina.
AB  - The biochemical and serological properties of Haemophilus paragallinarum isolates
      recovered from 11 recent outbreaks of infectious coryza in layer hens and one
      case of swollen-head syndrome in broilers in Argentina are described. Twenty-four
      isolates had the typical biochemical properties of H. paragallinarum. All
      isolates were serotyped according to the Page scheme. Ten of the isolates were
      serovar A, 11 were serovar B, one was serovar C, and two isolates could not be
      serotyped. The isolates were also examined using a panel of monoclonal antibodies
      (MAbs) for Page serovars A (one MAb available) and C (three MAbs available). The
      serovar B isolates all failed to react with any MAb. The serovar C isolate
      reacted with all three serovar C MAbs but not with the serovar A MAb. Only six of
      the 10 serovar A isolates reacted with the serovar A MAb. These results indicate
      that H. paragallinarum isolates from Argentina are antigenically distinct from
      those examined in other countries, and it is suggested that coryza vaccines
      intended for use in Argentina may be more effective if based on local strains.

PMID- 8363498
TI  - A sequential histopathologic and immunocytochemical study of chicken anemia virus
      infection at one day of age.
AB  - Detection systems for chicken anemia virus (CAV) antigen in paraffin sections
      were evaluated. Mouse monoclonal antibodies to CAV used in conjunction with an
      avidin-biotin-peroxidase-complex detection system gave best results.
      Immunoreactivity of CAV was markedly affected by fixation. Fixation in neutral
      buffered formalin for 6 hours gave best results. Use of decalcifying fluid
      containing formic acid eliminated immunoreactivity of CAV, whereas use of an EDTA
      solution did not. In a sequential study, CAV antigen and lesions were first
      detected in bone marrow, thymus, and spleen at days 3-4 postinoculation (PI).
      Subsequently, antigen and/or cells containing nuclear inclusions were found in
      many tissues, but usually within lymphoid tissue therein. Thymus, spleen, bone
      marrow, proventriculus, and ascending duodenum contained most antigen. No antigen
      was detected after 26 days PI. The results indicated that CAV replicates in
      thymic lymphoblasts, intra- and extra-sinusoidal hemocytoblasts, and reticular
      cells, with consequent lymphocytic depletion of the thymic cortex and hypoplasia
      of the bone marrow, and that CAV antigen is widely distributed in the body.

PMID- 8363499
TI  - Characterization of Salmonella california and S. typhimurium strains with reduced
      ability to colonize the intestinal tract of broiler chicks.
AB  - This study determined the ability of eight strains of Salmonella and their
      agarsubcultured variants to colonize the intestinal tract of broiler chicks.
      Nalidixic-acid (NAL)-resistant and streptomycin-resistant subcultured strains (S.
      california 1989/A and S. typhimurium 3366/A) that persisted in the ceca of chicks
      in lower numbers than their NAL-resistant parent strains (1989/O and 3366/O) were
      selected for additional study S. typhimurium strain 3366/A was present in the
      ceca of chicks in lower numbers than the parent strain 3366/O when given
      concomitantly with the parent strain or when the two strains were given
      separately to different chicks. S. california 1989/A strain was present in the
      ceca in lower numbers than the parent strain after concomitant oral or
      intracloacal inoculation. Strains 3366/O and 3366/A of S. typhimurium differed in
      growth rates in BHI broth and cecal mucus. The lipopolysaccharide (LPS) profile
      indicated that LPS components present in S. california 1989/O were missing from
      strain 1989/A. A mutant of 1989/O--2095/R--was also LPS- and colonization
      deficient.

PMID- 8363500
TI  - Avian Eimeria: effects of gamma irradiation on development of cross-species
      immunity in foreign and natural host birds.
AB  - Repeated inoculation (immunization) of white leghorn chickens with oocysts of the
      turkey coccidium, Eimeria adenoeides, resulted in significantly improved weight
      gain and feed-conversion ratios (feed efficiency) after E. tenella challenge.
      However, the development E. tenella in the immunized chickens did not differ
      markedly from that in unimmunized chickens, and intestinal lesions remained
      severe (greater than 3.0). Apparently improved weight gain and feed efficiency
      can be maintained in the presence of extensive parasite development. The ability
      to elicit cross-protective immunity was abrogated when the E. adenoeides oocysts
      were exposed to 15 kRad of gamma irradiation before inoculation into the
      chickens. Sporozoites existing from irradiated oocysts of E. acervulina also
      failed to immunize the chickens against challenge with E. tenella but protected
      chickens almost completely against homologous challenge with E. acervulina. The
      results indicate that cross-species immunity is not elicited by all
      developmentally arrested sporozoites and that the ability to produce cross
      species immunity can be destroyed by gamma irradiation of the immunizing species.

PMID- 8363501
TI  - Effects of chicken anemia virus on macrophage function in chickens.
AB  - One-day-old chicks were inoculated intramuscularly with chicken anemia virus
      (CAV). Four birds were killed at 7, 14, 21, 28, and 42 days postinoculation (PI),
      and macrophages were recovered from spleen and bone-marrow suspensions. These
      were tested for interleukin-1 (IL-1) production, Fc receptor expression,
      phagocytosis, and bactericidal activity. Macrophages recovered from uninoculated
      chickens at the same sample times, and exposed to CAV in vitro, were also tested.
      IL-1 production, Fc receptor expression, phagocytosis, and bactericidal activity
      were significantly lower in all macrophage cultures from CAV-inoculated chickens,
      and in cultures exposed to the virus in vitro, than in uninfected controls.

PMID- 8363502
TI  - Effects of chicken anemia virus on cell-mediated immune function in chickens
      exposed to the virus by a natural route.
AB  - Three-week-old chicks were inoculated orally with CAV and killed at various times
      postinoculation (PI). The spleens were removed, the cells were stimulated with
      concanavalin A, and lymphocyte transformation responses were determined.
      Supernatants from these cultures were also assayed for T-cell growth factor
      (TCGF) and interferon. Adherent macrophages from spleen or bone marrow were
      assayed for interleukin-1 production, Fc receptor expression, phagocytosis, and
      bactericidal activity. All CAV-inoculated chickens developed CAV antibodies, but
      no anemia was seen. Controls remained CAV-antibody-negative throughout the
      experiment. CAV-inoculated chickens showed significant differences from controls
      in their lymphocyte transformation responses and in production of TCGF and
      interferon. Differences were greatest at 14, 21, and 28 days PI. Significant
      differences were also observed in interleukin-1 production by spleen macrophages,
      as well as in Fc receptor expression, phagocytosis, and bactericidal activity of
      bone-marrow macrophages.

PMID- 8363503
TI  - Identification of the putative cytadhesin gene of Mycoplasma gallisepticum and
      its use as a DNA probe.
AB  - A portion of the putative Mycoplasma gallisepticum (MG) cytadhesin gene was
      identified and used as a diagnostic DNA probe. Degenerate oligonucleotide primers
      corresponding to conserved regions of the cytadhesin proteins from two human
      mycoplasmas, M. pneumoniae and M. genitalium, were synthesized for use in the
      polymerase chain reaction (PCR) on genomic MG DNA. A 583-base-pair MG DNA
      fragment was amplified and subsequently cloned and sequenced. The MG DNA fragment
      is predicted to encode a 193-amino-acid peptide. This peptide demonstrates
      significant homology to the expected portions of the two human mycoplasmal
      cytadhesin proteins. Used as a probe to study the distribution of this fragment
      in pathogenic and nonpathogenic avian mycoplasmas, the PCR product hybridized to
      genomic DNA from all seven MG strains tested. However, it failed to hybridize to
      M. synoviae, M. meleagridis, M. iowae, or M. gallinarum DNA.

PMID- 8363504
TI  - Effect of short-chain fatty acids on the growth of Salmonella typhimurium in an
      in vitro system.
AB  - Previous studies have revealed a reduction of cecal Salmonella carriage from
      feeding either carbohydrate or short-chain fatty acids (SCFAs). This in vitro
      study presents a profile of the relative SCFA content of the ceca when chicks are
      fed an unmedicated diet with 2.5% carbohydrate. Subsequent incorporation of these
      acids into culture medium was used to demonstrate their antagonistic activity
      toward in vitro growth of Salmonella typhimurium. Commonly found concentrations
      of SCFAs based upon the above findings reduced in vitro Salmonella growth by at
      least 50%, and 10 x concentrations inhibited growth more than 80%. An explanation
      of the mechanism(s) involved in growth reduction is offered.

PMID- 8363505
TI  - Efficacy of experimental animal and vegetable oil-emulsion vaccines for Newcastle
      disease and avian influenza.
AB  - Acceptable oil-emulsion vaccines were sought to replace mineral oil-emulsion
      vaccines that, by regulations, require a 42-day minimum holding period for
      poultry between injection and slaughter for consumption. Water-in-oil emulsions
      were prepared using animal or vegetable oils in a ratio of 4 parts oil to 1 part
      Newcastle disease or avian influenza aqueous antigen. Beeswax particles suspended
      in the oil at the 5% or 10% level (wt:vol) served as the oil-phase surfactant.
      Hemagglutination-inhibition titers induced by mineral-oil vaccines were not
      significantly different from those induced by the most efficacious formulations
      prepared from animal and vegetable oils. Tissue reaction from injection of animal
      and vegetable-oil vaccines was less than that induced by mineral-oil vaccines.
      An inactivated avian influenza vaccine formulated from peanut oil induced
      protection against morbidity and death when vaccinated chickens were challenged
      with a virulent isolate of avian influenza virus.

PMID- 8363506
TI  - Effect of induced molting on the susceptibility of White Leghorn hens to a
      Salmonella enteritidis infection.
AB  - Older white leghorn hens (more than 52 weeks old) were induced to molt using a 14
      day feed-removal protocol. On day 4 of feed removal, groups of hens were infected
      with varying 10-fold dilutions of Salmonella enteritidis, and these hens were
      examined for S. enteritidis intestinal shedding 7 days later. Molting hens
      infected with a 10(-2) dilution of S. enteritidis shed 3-4 logs more of the
      organism at 7 days postinfection than the unmolted group receiving a similar
      dose. The mean infectious dose (ID50) for S. enteritidis in unmolted hens ranged
      from 0.65 x 10(4) to 5.6 x 10(4), whereas in molting hens the ID50 was found to
      be less than 10(1), a 2-3 log increase in the susceptibility of the hens to the
      organism.

PMID- 8363507
TI  - Effect of Vibrio cholerae toxin on oral immunization of chickens.
AB  - Cholera toxin from Vibrio cholerae has been shown to increase the secretory
      immune response when given orally with some antigens in mice and rabbits. The
      present study was designed to determine if cholera toxin was also an effective
      mucosal adjuvant in chickens. Tetanus toxoid was chosen as a model antigen, and
      response was measured by enzyme-linked immunosorbent assays of intestinal
      excreta, bile samples, and serum samples. Chickens given 20 micrograms of tetanus
      toxoid had a significant suppression of response when 20 or 50 micrograms of
      cholera toxin was given. Chickens given 100 micrograms of tetanus toxoid appeared
      to be mucosally tolerant, but there was apparent abrogation of the mucosal
      tolerance when 20 or 50 micrograms of cholera toxin was given. Cholera toxin
      apparently failed as a mucosal adjuvant in chickens but may have some anti
      mucosal tolerogenic effect.

PMID- 8363509
TI  - Enteritis (so-called runting stunting syndrome) in Georgia broiler chicks.
AB  - So-called runting stunting syndrome (RSS) afflicts chicks worldwide. The present
      study in Georgia chicks is the first report of unique histologic features of RSS
      pathology in chicks in the United States. Various combinations of avian nephritis
      virus, enterovirus-612, and reovirus were always isolated from chick small
      intestines. Ultrastructurally, only small round viruses were seen in small
      intestinal lesions. Although finding intralesional virus in small intestinal
      segments from chicks with signs and gross lesions consistent with RSS constitutes
      a reasonable criterion for making a diagnosis of this disease, chicks without
      intralesional viruses and with bacterial or protozoal enteritis may also be small
      and abnormally feathered. Because just what constitutes RSS remains a diagnostic
      dilemma, we recommend that the use of the imprecise acronym "RSS" be
      discontinued.

PMID- 8363508
TI  - Immunohistochemical detection of Newcastle disease virus in chickens.
AB  - An immunoperoxidase histochemical technique utilizing a monoclonal primary
      antibody was developed for detection of Newcastle disease virus (NDV) antigen in
      tissues from chickens. The technique was applied to trachea, lung, spleen,
      Harderian gland, and cecal tonsil harvested from specific-pathogen-free (SPF)
      chickens at 2, 5, 7, 10, and 14 days postinoculation (PI) with NDV, and to
      corresponding tissues from commercial broiler chickens representing 30 cases of
      spontaneous respiratory disease. Positive staining occurred in the cytoplasm of
      respiratory epithelial cells in the trachea or bronchi of NDV-inoculated SPF
      chickens at 5 and 7 days PI. Staining also occurred in the respiratory epithelium
      of the trachea and bronchi of commercial broilers from seven of 30 cases of
      spontaneous respiratory disease. These results indicate that the immunoperoxidase
      technique has value as a rapid diagnostic test for Newcastle disease.

PMID- 8363510
TI  - Local pathological reactions and immune response of chickens to ISA-70 and other
      adjuvants containing Newcastle disease virus antigen.
AB  - Chickens were examined for gross and microscopic changes at the injection site
      for 16 weeks after an intramuscular injection of the following oil adjuvant
      emulsions containing inactivated Newcastle disease virus (NDV) antigen: ISA-70,
      Freund's incomplete adjuvant (FIA), Freund's complete adjuvant (FCA), and
      aluminum phosphate gel (APG). The reactions induced by ISA-70 emulsion were
      characterized by proliferation of macrophages, epithelioid cells, and fibroblasts
      around the small cysts in the muscle. Infiltration of lymphocytes and plasma
      cells also was present. These changes peaked 2 weeks postinjection and were
      milder than lesions due to the Freund's adjuvants. FCA induced the most severe
      granulomatous lesions with abscess formation. The reactions to APG were
      characterized by proliferation and accumulation of macrophages. The serological
      results revealed that the enhancing effect of ISA-70 on NDV antigen was the same
      as that of FIA.

PMID- 8363511
TI  - Determination of the detection limit of the polymerase chain reaction for chicken
      infectious anemia virus.
AB  - Chicken infectious anemia virus (CIAV) DNA in infected cell cultures and chicken
      tissues was detected using a polymerase chain reaction (PCR) assay. The complete
      CIAV genome of several strains was amplified in two segments with two sets of
      primer pairs. The DNA segments of four CIAV strains and full-length Cux-1 strain
      DNA were cloned. After amplification, 100 original genome equivalents were
      detected by Southern hybridization. The sensitivity of the assay was enhanced
      considerably by performing a reamplification with nested primers. This
      modification permitted the detection of one molecule of CIAV DNA. Some problems
      of the assay and its possible application are discussed.

PMID- 8363512
TI  - A lipid-conjugated immunostimulating complex subunit vaccine against Salmonella
      infection in turkeys.
AB  - Immunostaining complexes (ISCOMs) are multimeric particles and have been used
      successfully for presentation of membrane proteins. In this study, outer-membrane
      proteins (OMPs) from Salmonella heidelberg were incorporated into lipid
      conjugated ISCOM particles and evaluated for their use in a vaccine for turkeys
      against homologous and heterologous Salmonella challenge. Two types of lipid
      conjugated ISCOMs were examined: ISCOM-phospholipid and ISCOM-sphingolipid
      preparations. The turkeys were challenged with one of the three Salmonella
      serotypes: S. heidelberg, S. reading, or S. enteritidis. The turkeys were
      monitored for clinical signs, shedding pattern post-challenge, and clearance of
      the challenge Salmonella from selected internal organs. Vaccines containing OMP
      with either lipid-conjugated ISCOM preparation produced significantly greater (P
      < 0.01) immune response than OMP alone. Cloacal swabs from turkeys given OMP
      along with ISCOM-phospholipid and challenged with a homologous serotype were
      completely negative for Salmonella. A certain degree of cross-protection against
      heterologous Salmonella was afforded by both OMP-ISCOM vaccines. The isolation
      rate of Salmonella from internal organs was significantly lower (P < 0.0001) in
      vaccinated turkeys than in unvaccinated controls.

PMID- 8363513
TI  - Depletion of CD4+ and CD8+ T lymphocyte subpopulations by CIA-1, a chicken
      infectious anemia virus.
AB  - The suppressive effect of chicken infectious anemia virus (CIAV) on T-lymphocyte
      subpopulation was evaluated in vivo by flow cytometry and dual immunostaining on
      frozen sections. Between 14 and 21 days postinoculation (PI), the percentage of
      CD4-, CD8-, and CT1-positive (CD4+, CD8+, and CT1+) cells was significantly lower
      in chickens infected at 1 day of age with CIA-1 strain of CIAV than in controls.
      The mean percentage of CD4+ cells in the thymus was only 43%, whereas in the
      controls it was 77%. The mean percentages of CD8+ cells in the thymus in infected
      and control chickens was 54% and 90%, respectively, and of CT1+ cells, 44% and
      92%, respectively. At 28 days PI, the percentage of CD4+, CD8+, and CT1+ cells
      was similar in infected and control chickens. Also at 14 and 21 days PI,
      immunoperoxidase staining demonstrated fewer CD4+, CD8+, and CT1+ cells in the
      thymus of infected chickens than in controls. In frozen sections of thymus
      stained with CIA-1 antibodies and CD4, CD8, or CT1, few of the cells positive for
      CIAV antigen seen in the outer zone of the cortex carried CD4, CD8, or CT1
      molecules. These results suggest that CIA-1 infection either destroys cells
      expressing CD4, CD8, or CT1 molecules on their surface or interferes with the
      expression of these molecules.

PMID- 8363514
TI  - Monoclonal antibody-based detection system for Salmonella enteritidis.
AB  - Two monoclonal antibodies that react with Salmonella enteritidis in chicken
      tissue, eggs, and environmental samples were used to develop a rapid enzyme
      linked immunosorbent assay (ELISA) screen and agglutination assay for the
      specific detection of S. enteritidis. S. enteritidis was detected in 100% of egg
      samples and 99.8% of various field and research samples by both ELISA and
      traditional microbiological isolation and identification techniques. Results of
      titer experiments indicate that as few as 10(4) organisms can be detected by
      ELISA.

PMID- 8363515
TI  - Antibody prevalence and isolation of Chlamydia psittaci from pigeons (Columba
      livia).
AB  - The isolation of Chlamydia psittaci and serological detection of Chlamydia
      specific antibodies in racing pigeons and pigeons from public parks is described.
      Several serological methods (complement fixation test, indirect
      microimmunofluorescence test, and enzyme-linked immunosorbent assay) were
      compared with bacteriological techniques (isolation both in embryonated eggs and
      McCoy cell monolayers). Tests confirmed that 28.6%, 33.5%, and 35.9% of the
      pigeons, respectively, were seropositive by the tests mentioned above. Chlamydiae
      were isolated from 13% of the fecal specimens in ovocultures and from 18% of the
      fecal specimens in cell cultures. No significant differences between the two
      groups of pigeons were found (at a 95% confidence level, alpha = 0.05) using the
      hypothesis test of the difference between proportions of two populations. The
      serological and bacteriological techniques used are compared and discussed.

PMID- 8363516
TI  - Effect of mixed cecal microflora maintained in continuous culture and of dietary
      lactose on Salmonella typhimurium colonization in broiler chicks.
AB  - Mixed cecal microflora obtained from a mature chicken were maintained in vitro in
      continuous-flow (CF) culture. The effect of the CF culture and dietary lactose on
      Salmonella typhimurium cecal colonization in broiler chicks was evaluated. When
      averaged across four replicates, chicks treated with the culture alone (1.75
      log10 decrease) or with 5% dietary lactose alone (2.98 log10 decrease) were
      protected against S. typhimurium. Optimum protection against S. typhimurium was
      observed when birds were treated with the culture in combination with dietary
      lactose (4.27 log10 decrease). Dietary lactose resulted in reduced cecal pH. A
      large increase in cecal propionic acid was observed in the birds given the CF
      culture. A significant correlation (P < 0.001) was observed between the cecal
      concentration of undissociated propionic acid and protection against S.
      typhimurium colonization (r = -0.78). The results indicated that indigenous cecal
      flora that protect against Salmonella colonization can be maintained without loss
      of efficacy in CF culture.

PMID- 8363517
TI  - Staphylococcosis of turkeys. 6. Development of penicillin resistance in an
      interfering strain of Staphylococcus epidermidis.
AB  - Staphylococcus epidermidis strain 115, used as an interfering agent to help
      reduce the incidence of staphylococcosis in turkeys, was converted into a
      penicillin- and chloramphenicol-resistant strain designated 115R. This was
      accomplished by introducing a plasmid carrying the beta-lactamase (penicillinase)
      and chloramphenicol-resistance genes into S. epidermidis 115 by electroporation.
      The resultant strain, 115R, was an efficient producer of beta-lactamase and had
      marked increased resistance to penicillin and chloramphenicol. A beta-lactamase
      DNA probe was used to confirm the presence of the beta-lactamase gene in strain
      115R. S. epidermidis strain 115R retained the characteristics of tissue
      adherence, bacteriocin production, and non-virulence that were present in the
      original non-transformed strain 115, and in addition should theoretically remain
      colonized in poults following treatment with penicillin.

PMID- 8363518
TI  - Effect of so-called chicken anemia agent maternal antibody on chick serologic
      conversion to viruses in the field.
AB  - Chicken anemia agent (CAA)-antibody-positive and -negative broiler chicks and
      specific-pathogen-free chicks were confined in six broiler houses. Data on
      seroconversion to common avian pathogens and production performance were
      collected. No significant differences were seen between CAA-antibody-positive and
      -negative chickens in geometric mean antibody titers against common avian
      pathogens or in production performance.

PMID- 8363519
TI  - Virus isolation accuracy: an evaluation of eight laboratories involved in poultry
      diagnostics.
AB  - A study was undertaken to evaluate the accuracy of diagnostic laboratories at
      isolation of common avian viral pathogens. Fourteen "unknown" samples were
      submitted to eight laboratories in seven states. All positive and negative
      samples were guaranteed pure by SPAFAS. Virus-isolation results were erroneous in
      many cases. Based on this study, it appears that protocol for virus isolation of
      avian pathogens should be standardized throughout the United States.

PMID- 8363520
TI  - Characterization of Haemophilus paragallinarum isolates from China.
AB  - The biochemical and serological properties of 11 isolates of Haemophilus
      paragallinarum from outbreaks of infectious coryza in the People's Republic of
      China are described. All 11 isolates had the typical biochemical properties of H.
      paragallinarum, and all belonged to Page serovar A.

PMID- 8363522
TI  - Verminous encephalitis apparently caused by the filarioid nematode Chandlerella
      quiscali in emus (Dromaius novaehollandiae).
AB  - Verminous encephalitis attributed to Chandlerella quiscali was diagnosed in a
      flock of emus (Dromaius novaehollandiae). Clinically affected birds showed
      torticollis and progressive ataxia. Filarioid parasites with morphological
      characteristics resembling C. quiscali were identified in one case. Histologic
      lesions in the brain and spinal cord consisted of mild to moderate perivascular
      cuffing and scattered areas of variable mild necrosis. Parasites observed within
      the parenchyma of the brain and spinal cord often were not associated with either
      necrosis or an inflammatory reaction. Ivermectin administered subcutaneously at 4
      week intervals at a dose rate of 200 micrograms/kg body weight appeared to
      prevent clinical signs in flocks in the presumed endemic area.

PMID- 8363523
TI  - Acute hemorrhagic enterocolitis in ratites: isolation of eastern equine
      encephalomyelitis virus and reproduction of the disease in ostriches and turkey
      poults.
AB  - Two emus died with acute hemorrhagic enterocolitis. Eastern equine
      encephalomyelitis (EEE) virus was isolated in Vero cells from non-pooled samples
      of brain and intestine. Enterocolitis with splenic and hepatic necrosis was
      reproduced by intramuscular or oral inoculation of this isolate in two ostriches
      and three turkey poults.

PMID- 8363521
TI  - Paralysis of undetermined origin in bobwhite quail.
AB  - Paralysis of undetermined etiology occurred in a group of pen-reared bobwhite
      quail. Other than severe dehydration, no gross or microscopic lesions were
      observed, and the cause was not identified. Fumonisin B1 was detected in the feed
      at 17.7 ppm. In an attempt to reproduce the condition, a feeding trial was
      conducted utilizing the suspect feed. The feeding trial was not successful in
      reproducing the symptoms observed in the field case.

PMID- 8363524
TI  - Isolation of Mycobacterium avium from ringneck pheasants (Phasianus colchicus).
AB  - Tuberculous lesions were observed at necropsy in the liver, spleen, and intestine
      of five 10-month-old ringneck pheasants (Phasianus colchicus) from a flock of
      birds raised in captivity for breeding. Histological examination of the tissues
      revealed granulomas with associated acid-fast bacilli. The history and lesions
      are unusual in that very few bacteria were found in any given lesion, the birds
      were all in good flesh when necropsied, and five birds from this same group at 6
      months of age were observed to have acid-fast bacteria in the small intestine.
      Mycobacterium avium was isolated and serotyping was attempted, but the colonies
      were too dry to serotype.

PMID- 8363525
TI  - Characteristics of fowl cholera diagnosed in Georgia, 1989-91.
AB  - One hundred seventy-six cases of fowl cholera were diagnosed at the Georgia
      Poultry Laboratory over a 3-year period. The disease occurred throughout the
      year, with peak incidence during March and April. Fowl cholera was diagnosed in
      flocks from 4 to 83 weeks of age, with a mean of 33 weeks of age. The Pasteurella
      multocida isolates were highly susceptible to all antimicrobial agents tested,
      except sulfonamides. The serotypic distribution of isolates showed that serotype
      3,4 predominated (40%), followed by serotype 3 (22%), serotype 1 (18%), untypable
      (15%), serotype 5 (3%), and serotype 4 (2%). Associations were found between the
      P. multocida serotypes isolated from birds of different ages and between the age
      of the bird and the sites of choice for isolating the organism.

PMID- 8363526
TI  - Coumafuryl (Fumarin) toxicity in chicks.
AB  - Coumafuryl (Fumarin) toxicity was diagnosed in chickens less than 1 week of age.
      Mortality rate was 100%. Necropsy showed crops and gizzards to be full of feed.
      There was diffuse hemorrhage and unclotted blood in the abdomen and thorax.
      Histological examination showed congestion and hemorrhage. Chemical analysis of
      crop and gizzard contents contained approximately 340 ppm coumafuryl. The source
      of the coumafuryl was found to be the wood-straw mats in the chick boxes.

PMID- 8363527
TI  - Pharmacokinetic properties of gentamicin and amikacin in the cockatiel.
AB  - Gentamicin and amikacin are commonly used in veterinary medicine to treat a
      variety of gram-negative bacterial infections. The present study evaluates the
      pharmacokinetics of gentamicin sulfate and amikacin sulfate in the cockatiel
      (Nymphicus hollandicus), a small (approximate body weight = 100 g) psittacine
      bird, utilizing treatment regimens developed in larger parrot species. Serum
      antibiotic concentrations were determined in cockatiels following twice-daily
      intramuscular treatment with 5 mg gentamicin/kg body weight and 15 mg amikacin/kg
      body weight. In the present study, peak values of gentamicin were 4.6 +/- 1.45
      micrograms/ml, and trough values were 0.17 +/- 0.04 micrograms/ml. Amikacin
      administration resulted in peak values of 27.3 +/- 6.9 micrograms/ml and trough
      concentrations of 0.9 +/- 0.3 micrograms/ml. Based on the present study, an
      appropriate intramuscular dose regimen for gentamicin in cockatiels is 5 to 10
      mg/kg body weight either two or three times per day. An intramuscular amikacin
      dosage of 15 to 20 mg/kg body weight either two or three times per day is
      recommended for treatment of infections caused by susceptible bacteria.

PMID- 8363528
TI  - The National Mental Health Policy: implications for public psychiatric services
      in Australia.
AB  - The Health Ministers of all Australian States, Territories and the Commonwealth
      endorsed a National Mental Health Policy in April 1992. This Policy is intended
      to set a clear direction for the future development of mental health services
      within Australia. The Policy recognises the high prevalence of mental health
      problems and mental disorders in the Australian community and the impact of these
      on consumers, carers, families and society as a whole. It also clearly accepts
      the need to address the problems confronting the promotion of mental health and
      the provision of mental health services.

PMID- 8363529
TI  - On the perception of madness.
AB  - Since the beginning of recorded history, mental illness has been recognised as
      being primarily in the province of the healing profession. This view has
      continued, despite the fact that psychiatry left the mainstream of medicine with
      the development of asylums during the 19th century. With the advent of
      deinstitutionalization however, psychiatrists, particularly in Australia, have
      increasingly left public practice. As a result, the treatment of the severely and
      chronically mentally ill, especially those with behavioural disorder, has become
      neglected. It is argued that moves toward the mainstreaming of acute psychiatry
      to general hospitals offer a new opportunity for the profession to reassert
      itself in this essential but difficult area of psychiatric practice.

PMID- 8363530
TI  - Genetic linkage and schizophrenia: methods, recent findings and future
      directions.
AB  - Family, twin and adoption studies have shown that familial clustering in
      schizophrenia is predominantly due to genetic factors. On the basis of
      segregation analyses of the illness distribution in relatives of patients,
      various models of the mode of transmission have been put forward but as yet there
      is no consensus. Linkage analysis based on molecular genetic techniques provides
      a more direct approach to discovering precisely what is inherited (one gene, a
      small number of genes or many genes?) that generates vulnerability to
      schizophrenia. To date there has been no sufficiently replicated finding of one
      or more linked genes and many methodological complexities remain. However, the
      rate of progress in addressing these issues gives hope that genetic linkage
      analysis of schizophrenia will provide some answers.

PMID- 8363531
TI  - Interethnic variations in the presence of Schneiderian first rank symptoms.
AB  - Differences in the presence of Schneiderian First Rank Symptoms in first
      admission schizophrenic patients were examined in five subcultural groupings
      treated in the same facilities. Examination of the case notes of 212 patients
      revealed that first rank symptoms were most prevalent in the UK immigrant group
      and least frequently present in the Greek immigrant group. First rank symptoms
      were more prevalent in patients admitted recently, admitted voluntarily, and
      amongst those who had at least some command of English.

PMID- 8363532
TI  - Borderline disorder and post-traumatic stress disorder: an equivalence?
AB  - This paper draws attention to various similarities between Borderline Personality
      Disorder and Post-traumatic Stress Disorder. It is argued that the former may be
      considered to be an equivalent of the latter, with the difference that the trauma
      has either undergone repression or, having been suffered before the establishment
      of speech, has not been registered in verbal form. The criteria for Borderline
      Personality Disorder are presented in terms of symptoms of failed attachment
      consistent with early trauma, and various research papers linking these concepts
      are considered. Other research in infant attachment suggests intergenerational
      links between disorganised attachment patterns in infancy and parents with
      unresolved problems with their own parents. Research concerning the biochemical
      underpinning of emotional responses is quoted to link these conditions more
      securely, and may offer a conceptual framework in which to understand the need of
      these patients for a therapeutic milieu in which early developmental needs may be
      understood.

PMID- 8363533
TI  - Lithium-associated transient thyrotoxicosis in 4 Chinese women with autoimmune
      thyroiditis.
AB  - Four Chinese female patients who suffered from manic-depressive disorder and
      underlying autoimmune thyroiditis developed transient episodes of thyrotoxicosis
      during maintenance lithium therapy. Endocrinologically speaking, three of them
      had "Hashitoxicosis", while the other had silent lymphocytic thyroiditis. Albeit
      rare among Western patients, such lithium-associated thyroid dysfunctions
      appeared to be more likely to occur in Hong Kong Chinese. They seemed to involve
      multiple aetiological factors, such as autoimmune thyroid disease, the toxic and
      immunomodulatory roles of lithium and perhaps genetic and dietary factors.
      Because of their self-limiting nature, the importance of avoiding unnecessary and
      potentially deleterious antithyroid treatment is emphasised.

PMID- 8363534
TI  - Lessons from a mood disorders unit.
AB  - Specialist treatment centres, such as the Mood Disorders Unit (MDU) at Prince
      Henry Hospital, Sydney, have developed in response to the high prevalence of mood
      disorders and their frequent persistence and treatment resistance. The MDU's
      assessment and treatment of patients from a state-wide catchment area and its
      teaching and research effectiveness are reviewed. Of 479 patients assessed
      between 1985 and 1989, there were 304 with primary depressive disorders, of whom
      154 were followed up by clinical assessment at 52 weeks and 231 by telephone
      interview at 3 1/2 years. At intake, 59% were tertiary referral patients and 88%
      were from outside the local area. Two-thirds were recovered 3 1/2 years later,
      despite the disorders having been generally severe and protracted. Treatment
      modality was associated primarily with diagnosis, but also with age and somewhat
      with the patient's personality and consultant psychiatrists' preferences. No
      consistent predictors of outcome were discerned. Specialist tertiary referral
      centres, such as the MDU, contribute significantly to treatment success,
      especially of difficult cases, and enrich teaching and research.

PMID- 8363535
TI  - Parental evaluation of treatment outcome and satisfaction with an inpatient
      program for eating disorders.
AB  - This study is concerned with the service provided to adolescent patients with
      eating disorders admitted to a private hospital. The patients' parents were asked
      to evaluate the service. Parental satisfaction was assessed by means of a
      questionnaire devised for this purpose and comments were elicited as to how the
      service could be improved. Parents of a consecutive series of 56 patients were
      asked to complete the questionnaire 6 months after admission; 82% (N = 46)
      responded. Most parents were pleased with the service provided but nevertheless
      many made some criticisms (35%) or suggestions for improvement (37%). The
      parental responses were discussed with the staff involved in treatment, resulting
      in changes to the service.

PMID- 8363536
TI  - Helping agency contact for emotional problems in childhood and early adolescence
      and the risk of later disorder.
AB  - Despite waning enthusiasm for labelling theories in the development of
      psychopathology, it has been claimed that contact with professional agencies in
      childhood can be associated with increased levels of later problem behaviour. In
      this study, help-seeking by parents for children with behaviour problems was
      examined using a birth cohort followed longitudinally to age 15 years. No
      evidence was found to support the hypothesis that agency contact increased the
      risk of later mental health disorder, either in childhood or adolescence. Rather,
      the results suggested that help-seeking was associated with a reduction in both
      the risk of DSM-III disorder and problem behaviour scores, up to five years after
      agency contact.

PMID- 8363537
TI  - Psychological maladjustment among homeless adolescents.
AB  - The prevalence of psychological maladjustment in homeless adolescents (n = 54)
      was compared to a control group (n = 58) in Brisbane, Australia using the Youth
      Self-Report Scale. Overall, 74% of the homeless group and 22.4% of the control
      group scored within the clinical range on one or more of the clinical subscales.
      There was considerable diversity of symptomatology in the homeless group. Less
      than half of the homeless group were within the clinical range on both the
      delinquent subscale and the thought disorder subscale. Depressive, Aggressive and
      Somatic Complaints were also prevalent. The study challenges preconceived notions
      of a simple relationship between adolescent homelessness and delinquency, and
      draws attention to the psychological needs of this group of adolescents.

PMID- 8363538
TI  - Are oppositional and conduct disorders of adolescents separate conditions?
AB  - This study explores the factor structure of behaviours that correspond to
      symptoms of DSM-III-R oppositional defiant (OD) and conduct disorder (CD). It
      also seeks to clarify how those hypothetical factors may relate to diagnoses of
      OD and CD. Using exploratory factor analysis and cluster analysis of parent
      questionnaire data from a group of referred adolescents (N = 528) diagnosed
      according to DSM-III criteria the authors extracted four factors. One of them
      corresponded closely to DSM-III-R OD, while the others comprised different
      aspects of the CD construct. The findings suggest there are subtypes of conduct
      problems in adolescents, and give some support to the distinction between conduct
      and oppositional disorders.

PMID- 8363539
TI  - The concepts of selfobject function and empathy in couples therapy.
AB  - A model is advanced for couples therapy that uses a dyadic approach in which the
      partners bring about change in themselves as well as in the other by learning to
      tolerate and support that change. The model utilises concepts of selfobject
      function and empathic interaction between the partners; these are taken from
      Kohut's theory of human development.

PMID- 8363540
TI  - Structural characteristics of Australasian psychiatric practice.
AB  - A questionnaire examining structural and basic process characteristics of
      psychiatric practice was prepared by the RANZCP Quality Assurance Committee and
      circulated to all Fellows of the College in 1991. There were 830 replies (48%). A
      one in two sample of the replies was analysed and forms the basis of the
      descriptive report presented in this paper.

PMID- 8363541
TI  - Supervision in the training of a psychiatrist.
AB  - Supervision is the cornerstone of psychiatric training and yet receives scant
      attention either in the psychiatric literature or in training institutions. It is
      frequently a focus of ambivalence for those involved. This paper discusses the
      functions of supervision and the roles of the supervisor in the belief that
      attention to these issues will help resolve a number of ambiguities that exist in
      the supervisory relationship.

PMID- 8363542
TI  - Peer review of psychotherapeutic treatments in psychiatry: a review of the
      literature.
AB  - This paper reviews the literature concerning the current status of peer review of
      psychotherapeutic treatments in psychiatry. Accounts of the aims and mechanisms
      of peer review, administrative issues and the effects of peer review on patient
      care and professional practice are examined.

PMID- 8363543
TI  - The psychiatrist and peer review: a psychodynamic perspective.
AB  - Consideration of peer review is timely, given that formalization of peer review
      processes is one of the responses the psychiatric profession could make to
      increasing calls for accountability from within and without the profession. The
      establishment of formal peer review evoked strong, often hostile, responses among
      psychiatrists in the United States, reflecting considerable underlying anxiety.
      This paper examines the responses to formal peer review in psychiatrists from a
      psychodynamic perspective.

PMID- 8363544
TI  - Assault on staff in psychiatric hospitals: a safety issue.
AB  - All reported injuries between 1985 and 1987 in a large Queensland psychiatric
      hospital were studied. There were 650 incidents investigated; travelling injuries
      and injuries sustained by staff members not involved with patient care were
      excluded. Forty-eight per cent (n = 323) were assault based injury. Student
      nurses were most frequently assaulted. It was concluded that training in
      aggression management should include both counselling and self defence
      techniques, and that patient and staff rights should be balanced. Student nurses
      should have experience in wards with a low injury rate, prior to being rostered
      to the high risk wards.

PMID- 8363545
TI  - Sexual misconduct: is censure enough?
AB  - Although sexual relationships between medical practitioners and their patients
      have been forbidden by most professional and statutory bodies, the reported
      prevalence of sexual misconduct does not appear to have altered in the last 20
      years. A recent Australian study has also suggested that psychiatrists are over
      represented in comparison to others in the medical workforce. The reasons that
      may account for this finding are discussed, and issues which require further
      debate by the profession are outlined. These include the acceptability of post
      termination relationships, the applicability of criminal statutes, the role of
      treatment in the management of offenders, and whether mandatory reporting of
      sexual misconduct should be considered.

PMID- 8363546
TI  - Inquiries at Lakeside and Aradale Hospitals: lessons and advances?
AB  - The release of reports of inquiries into two related psychiatric hospitals
      (Lakeside and Aradale) in Victoria occurred in 1991. These inquiries identified
      deficiencies in patient care standards and organisational dynamics. Knowledge of
      institutional dysfunction was available from similar Australian and overseas
      inquiries but nonetheless this knowledge had not prevented organisational inertia
      and decline in these two psychiatric hospitals. This paper examines the possible
      contribution of a failed medical hegemony model to organisational dysfunction and
      discusses organisational life-cycles. It reaches the conclusions that politically
      motivated inquiries do not achieve long term positive outcomes and that there is
      a need for academic research into the organisation of psychiatric services and
      staff productivity and morale.

PMID- 8363547
TI  - Promoting non-drug therapies.

PMID- 8363548
TI  - On combining TCAs and MAOIs.

PMID- 8363549
TI  - Efficacy of dynamic psychotherapy.

PMID- 8363550
TI  - The neglect of prevention in psychiatry.

PMID- 8363551
TI  - Fluoxetine-tricyclic combinations.

PMID- 8363552
TI  - Evaluation of psychotherapy.

PMID- 8363553
TI  - Polymorphism of transferrin found in the laboratory rat and wild rats in Japan.
AB  - Polymorphism of the transferrin locus (Tf) was found in the laboratory rat and
      wild rats in Japan by polyacrylamide gel electrophoresis. Two phenotypes, "a" and
      "b," were distinguished in homozygotes. It is suggested that these are controlled
      by autosomal codominant alleles. In 10 laboratory strains, only the IS strain
      showed the a type. This allele found in the IS strain was broadly distributed in
      Japanese wild rats. It is considered to be derived from a wild rat in Japan.
      Linkage relationship between Tf and Alp-1 was not established.

PMID- 8363554
TI  - The Gus-e locus regulates estrogen repression of androgen-induced beta
      glucuronidase expression in mouse kidney.
AB  - Both enzyme activity and mRNA concentration of beta-glucuronidase were measured
      in kidneys of mice treated with testosterone and the synthetic estrogen,
      diethylstilbestrol. Six congenic strains, all having a C57BL6/J genetic
      background but each having a different haplotype of the beta-glucuronidase gene
      complex, were compared. In each strain the induction caused by androgen was
      partially repressed by estrogen. The extent of this antagonism varied among the
      six haplotypes and was not coordinate with the extent of induction by androgen
      alone. Antagonism appears to be regulated by at least two alleles of a new locus,
      Gus-e, within the beta-glucuronidase gene complex. Repression by estrogen, like
      induction by androgen, appears to take place primarily at the transcriptional
      level. Kinetic studies revealed that estrogen causes the androgen response curve
      to plateau earlier and at a lower level. This suggests that estrogen increases
      the rate of gene deactivation rather than decreasing the rate of gene activation.
      Isoelectric focusing of beta-glucuronidase from Gus-ea and Gus-eb mice and their
      F1 progeny revealed that the genes are regulated in cis. Together, these findings
      support a model in which both sex hormones exert their effects on separate DNA
      response elements located in close proximity to the gene or within the gene
      itself.

PMID- 8363555
TI  - Malate dehydrogenase (MDH; EC 1.1.1.37) isozymes in tissues and callus cultures
      of Cereus peruvianus (Cactaceae).
AB  - Malate dehydrogenase (MDH; EC 1.1.1.37) isozymes were investigated in seeds and
      in seedlings and calli cultures of C. peruvianus to determine if the changes in
      MDH isozyme banding patterns could be used as biochemical markers to identify the
      origin of regenerated plants from callus tissues. Four cytoplasmic MDH isozymes
      (sMDH), five mitochondrial MDH isozymes (mMDH), and one glyoxysomal MDH isozyme
      (gMDH) were detected and showed tissue- and stage-specific expression. A
      relationship of mMDH and gMDH isozyme patterns with callus tissues subcultured in
      three hormonal combinations and with the plants regenerated from these callus
      tissues was demonstrated. Furthermore, temperature and mechanical stress were
      found to be closely related to mMDH-1 activity in callus culture. Therefore, the
      different patterns of MDH isozymes in the various tissues of C. peruvianus can be
      used as biochemical markers for the study of gene expression during development
      and as powerful tools in monitoring studies on callus cultures.

PMID- 8363556
TI  - Genetic mapping and protein product diversity of the self-incompatibility locus
      in wild tomato (Lycopersicon peruvianum).
AB  - Phenotypic diversity of self-incompatibility (S) alleles within nine natural
      populations of Lycopersicon peruvianum was investigated. Only 7 incompatible
      responses were observed of a total of 276 unique combinations tested, on the
      basis of controlled pollinations, indicating the large number of alleles that
      exist within these populations. Molecular weight polymorphism for specific major
      stylar proteins observed on SDS-PAGE was also evident in two of the populations
      examined. Five proteins were shown to map to the S locus and to be associated
      with different S alleles through controlled pollinations and segregation of the
      proteins. Two of these S related proteins had been described previously in terms
      of spatial and temporal expression consistent with their involvement in self
      incompatibility (Mau et al., Planta 169, 184-191, 1986). A mapping population
      derived from a fully compatible cross was used to establish linkage of the S
      locus to two DNA markers, CD15 and TG184, that lie on chromosome 1. The order of
      the markers and estimates of map distances are given.

PMID- 8363557
TI  - A comparison of genetic variation in two sibling species pairs of haplodiploid
      insects.
AB  - Sibling species pairs of sweat bees (Halictus confusus and H. tumulorum) and pine
      sawflies (Neodiprion pratti and N. maurus) were surveyed for genetic variability
      using enzyme electrophoresis. Levels of heterozygosity were found to be within
      the ranges earlier recorded for Hymenoptera. Expected heterozygosities were not
      significantly higher in the sawflies than in the sweat bees. Estimates of genetic
      identity between the sibling species were not lower than those generally found
      for diplodiploid insect species: no evidence was found for an increased rate of
      evolution in these haplodiploids. Genetic identity data among populations of H.
      confusus and between Halictus species were within the range expected for
      conspecific populations and sibling species, respectively. In Neodiprion all
      genetic distances were low but the two populations of N. pratti had similar
      genetic distances as each did to N. maurus, indicating the necessity for further
      systematic studies of the genus.

PMID- 8363558
TI  - Localization in the fourth linkage group of a gene di affecting diabetes
      insipidus in rats.
AB  - The diabetes insipidus gene has been localized in the fourth linkage group at a
      distance of 23.1 +/- 1.9 cM from the nonagouti loci and 29.5 +/- 2.1 cM from the
      Svp-1 loci based on the backcross progeny analysis of rats Rattus norvegicus
      mating (August x Brattleboro) F1 x Brattleboro. The proposed gene order is Svp-1-
      a--di.

PMID- 8363560
TI  - Tamoxifen decreases the rate of proliferation of rat vascular smooth-muscle cells
      in culture by inducing production of transforming growth factor beta.
AB  - Tamoxifen selectively and reversibly decreased the rate of proliferation of adult
      rat aortic vascular smooth-muscle cells (VSMCs). Half-maximal inhibition of
      proliferation occurred at 2-5 microM tamoxifen for VSMCs and at > 50 microM for
      adventitial fibroblasts. The cell cycle time for all the VSMCs in the population
      was increased from 35 +/- 2 h to 54 +/- 4 h in the presence of 33 microM
      tamoxifen. Tamoxifen did not affect the time of entry into DNA synthesis, but
      delayed arrival at mitosis by > 24 h. It therefore extended the duration of the
      G2-to-M phase of the cell cycle. However, the rate of proliferation of VSMCs was
      not decreased by tamoxifen (at concentrations up to 50 microM) in the presence of
      neutralizing antibody to transforming growth factor beta (TGF-beta). The level of
      mRNA for TGF-beta 1 in VSMCs was strongly induced by 10 microM tamoxifen, and TGF
      beta activity in conditioned medium from tamoxifen-treated cells was more than 50
      fold higher than from control cells. Tamoxifen therefore extended the G2-to-M
      phase of the cell cycle in VSMCs by increasing TGF-beta activity in the culture.

PMID- 8363561
TI  - The activation of the arginine-citrulline cycle in macrophages from the
      spontaneously diabetic BB rat.
AB  - The activity of the arginine-citrulline cycle was investigated in macrophages
      from the spontaneous immunologically mediated diabetic BB rat. Peritoneal
      macrophages were prepared from male diabetes-prone (BBdp), diabetic (BBd) and age
      matched non-diabetes-prone (BBn) rats. Cells were incubated at 37 degrees C for 2
      h in Krebs-Henseleit bicarbonate buffer containing 0.5 mM L-arginine, 0.1 mM L
      [ureido-14C]citrulline and 5 mM D-glucose to measure the activity of the arginine
      citrulline cycle. The uptakes of citrulline and arginine by macrophages were
      measured during a 5 min incubation period with L-[ureido-14C]citrulline and L
      [2,3-3H] arginine respectively. The production of NO3- (the major stable
      oxidation product of NO) increased (P < 0.01) by 112% and 151% in 75-day-old BBdp
      and 115-day-old BBd macrophages respectively, compared with age-matched BBn
      cells. The conversion of [14C]citrulline into [14C]arginine increased (P < 0.01)
      by 704%, 892% and 904% in 50- and 75-day-old BBdp and 115-day-old BBd macrophages
      respectively, compared with age-matched BBn cells. The enhanced NO synthesis in
      BBdp and BBd macrophages was associated with a 25-35% increase in the uptake of L
      arginine. However, there were no differences in the uptake of citrulline between
      BBdp or BBd macrophages and age-matched BBn cells. Our results demonstrate for
      the first time the activation of the arginine-citrulline cycle in macrophages in
      an autoimmune condition. The inherent increase in the recycling of L-citrulline
      to L-arginine in BBdp and BBd macrophages may reflect an innate metabolic
      disorder in these cells. This increased L-arginine synthesis from L-citrulline
      may play a role in sustaining a sufficient intracellular L-arginine concentration
      for prolonged generation of NO in BBdp and BBd macrophages. A role for NO in the
      autoimmune destruction of pancreatic beta-cells in insulin-dependent diabetes
      mellitus warrants further investigation.

PMID- 8363562
TI  - Ca2+ release from platelet intracellular stores by thapsigargin and 2,5-di-(t
      butyl)-1,4-benzohydroquinone: relationship to Ca2+ pools and relevance in
      platelet activation.
AB  - The effects of the Ca(2+)-ATPase inhibitors thapsigargin (Tg) and 2,5-di-(t
      butyl)-1,4-benzohydroquinone (tBuBHQ) were examined by using Ca(2+)-regulatory
      systems of platelet mixed membranes, saponin-permeabilized and intact platelets.
      Both agents inhibit Ca(2+)-ATPase activities of platelet mixed membranes, without
      any effect on the basal Mg(2+)-ATPase activity. Tg is more effective (EC50 = 35
      nM) than tBuBHQ (EC50 = 580 nM). The effect of the two inhibitors on 45Ca2+
      release from saponin-permeabilized platelets has also been characterized. 45Ca2+
      uptake into non-mitochondrial intracellular stores occurs via an ATP-dependent
      mechanism, and if added at equilibrium the second messenger Ins(1,4,5)P3 releases
      50% of the accumulated 45Ca2+. Maximally effective concentrations of Tg (1
      microM) and tBuBHQ (50 microM) release 77% and 68% of the accumulated 45Ca2+.
      Addition of Ins(1,4,5)P3 together with either Tg or tBuBHQ resulted in a non
      additive release which was the same as with either Tg or tBuBHQ alone, indicating
      that the Ins(1,4,5)P3-sensitive Ca2+ pool was a subset of the pool that is
      sensitive to the Ca(2+)-ATPase inhibitors. Release of 45Ca2+ by either Tg or
      tBuBHQ was not affected by heparin, which totally blocked Ins(1,4,5)P3-induced
      Ca2+ release, and Tg was found not to affect [32P]Ins(1,4,5)P3 binding to its
      receptor on mixed membranes. Thus both Tg and tBuBHQ release Ca2+ from a pool
      that totally overlaps the Ins(1,4,5)P3-sensitive pool without affecting
      Ins(1,4,5)P3 function. In intact indomethacin-treated Fura 2-loaded platelets, Tg
      and tBuBHQ cause Ca2+ elevation, arising from release from intracellular stores
      and influx from the outside. Both Tg and tBuBHQ elevated Ca2+ to similar levels,
      which were less and slower than those observed with thrombin. Addition of
      thrombin to cells already treated with Tg or tBuBHQ produced further elevation of
      Ca2+, indicating agonist utilization of a Ca(2+)-ATPase inhibitor-insensitive
      pool. In aggregation experiments Tg and tBuBHQ showed different functional
      effects. In indomethacin-treated cells Tg induces slow aggregation and secretion
      responses, whereas tBuBHQ only induces shape change. Both agents show synergistic
      secretory responses with the protein kinase C activator dioctanoylglycerol
      (DiC8). Tg also showed greater ability than tBuBHQ to release [3H]arachidonic
      acid (AA) from [3H]AA-labelled platelets. Additionally, in [32P]Pi-labelled
      platelets both Tg and tBuBHQ induced phosphorylation of myosin light chain, a 27
      kDa protein and the 45 kDa protein pleckstrin, but Tg showed a greater ability
      than tBuBHQ to cause phosphorylation of pleckstrin. These studies indicate that
      Tg and tBuBHQ are effective in releasing the Ins(1,4,5)P3-sensitive Ca2+ pool in
      platelets.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8363563
TI  - Biochemical and immunological characterization of multiple glycoforms of mouse
      mast cell protease 1: comparison with an isolated murine serosal mast cell
      protease (MMCP-4).
AB  - Five highly soluble, chymotrypsin-like, neutral serine proteases, with molecular
      masses in the range 30-33 kDa, were isolated from Trichinella spiralis-infected
      mouse small intestine. These enzymes were closely related antigenically on
      Western blotting and by Ouchterlony double diffusion using a polyclonal, cross
      absorbed, sheep antibody raised against mouse mast cell protease-1 (MMCP-1) and
      on the basis of N-terminal amino acid sequence analysis, were identified as
      variant forms of MMCP-1. Substrate and inhibitor analysis confirmed that the five
      variants (MMCP-1 A-E) had similar characteristics, although highly significant (P
      = 0.025 to P < 0.0001) variations in Km and kcat, were detected. Against human
      alpha 1-proteinase inhibitor the Ki for MMCP-1C (45 pM) was significantly (P <
      0.0001) greater than those for the other proteases (0.76-2.2 pM). The differences
      in electrophoretic mobility are probably a result of variable glycosylation,
      since removal of N-linked carbohydrate produced a polypeptide of approx. 28 kDa
      in each case which was, like the native enzyme, immunoreactive on Western
      blotting. A much less soluble 28 kDa enzyme was isolated from serosal mast cells
      and identified as MMCP-4 by N-terminal amino acid sequencing. Like MMCP-1 it has
      chymotrypsin-like substrate specificities with activity at neutral pH. However,
      it was antigenically distinct from MMCP-1 and, using sheep anti-MMCP-1, was not
      detected on Western blotting or by Ouchterlony double diffusion, e.l.i.s.a. or
      immunohistochemistry. This last technique established that the MMCP-1 variants
      were uniquely present in enteric mast cells, thereby providing a highly selective
      means of distinguishing the mucosal and connective tissue mast cell subsets in
      the mouse.

PMID- 8363559
TI  - Phospholipids in animal eukaryotic membranes: transverse asymmetry and movement.

PMID- 8363565
TI  - Identification of the putative hexose-phosphate translocator of amyloplasts from
      cauliflower buds.
AB  - Starch synthesis in amyloplasts isolated from cauliflower buds is strongly
      inhibited by the addition of micromolar concentrations of 4,4'-di-isothiocyano
      2,2'-stilbenedisulphonic acid (DIDS). Using [3H]DIDS it was possible to label
      specifically a 31.6 kDa membrane protein of the envelope fraction of isolated
      amyloplasts. The intensity of the radioactive label was decreased in the presence
      of glucose 6-phosphate or dihydroxyacetone phosphate, indicating that this
      protein might be the amyloplastic hexosephosphate translocator.

PMID- 8363564
TI  - Differences in expression of transcription factor AP-1 in human promyelocytic HL
      60 cells during differentiation towards macrophages versus granulocytes.
AB  - Commitment of HL-60 cells to macrophage or granulocytic differentiation was
      achieved by incubation with 4 beta-phorbol 12-myristate 13-acetate (PMA) for 30
      60 min or with dimethyl sulphoxide (DMSO) for 24 h respectively. The commitment
      stage towards PMA-induced macrophage differentiation was associated with
      increases in jun B and c-fos mRNA levels, as well as with an increase in the
      binding activity of transcription factor AP-1. Nevertheless, gel retardation
      analysis indicated that the AP-1 activity detected in untreated cells was
      drastically reduced during the commitment stage of DMSO-induced HL-60
      differentiation towards granulocytes. When HL-60 cells were treated with sodium
      butyrate, which induced monocytic differentiation, a remarkable increase in AP-1
      binding activity was detected. Treatment of HL-60 cells with 1 alpha,25
      dihydroxyvitamin D3, another monocytic differentiation agent, induced a weak, but
      appreciable, increase in AP-1 activity. Furthermore, addition of sodium butyrate
      or 1 alpha,25-dihydroxyvitamin D3 to HL-60 cells induced the expression of c-fos,
      c-jun, jun B and jun D proto-oncogenes. In contrast, when HL-60 cells were
      treated with retinoic acid, a granulocytic differentiation inducer, no enhanced
      AP-1 binding activity was observed, and only a weak increase in jun D mRNA level
      was detected. These data indicate that formation of AP-1 is not required for the
      induction of HL-60 differentiation towards granulocytes, whereas induction of
      monocytic differentiation is correlated with an increase in AP-1 activity. The
      differential expression of AP-1 activity may be critical in the differentiation
      of HL-60 cells towards monocytic or granulocytic lineages.

PMID- 8363566
TI  - Endothelin (ETA) receptor number and calcium signalling are up-regulated by
      protein kinase C-beta 1 overexpression.
AB  - To evaluate the role of protein kinase C (PKC) in regulation of cellular
      responsiveness to mitogens, we used rat 6 (R6) fibroblasts that stably
      overexpress the beta 1 isoenzyme of protein kinase C (PKC-beta 1). The potent
      vasoconstrictor and mitogen endothelin-1 (ET-1; 100 nM) was substantially more
      effective in stimulating InsP3 accumulation in PKC-beta 1-overexpressing
      fibroblasts (PKC3 cells) than in control fibroblasts lacking the PKC-beta 1 cDNA
      insert. PKC3 cells were found to express a 7-fold greater number of endothelin
      receptors than did control cells, whereas both cell lines showed equivalent Kd
      values. These receptors were of the ETA subtype, as defined by a 1000-fold
      greater affinity for ET-1 than for ET-3. Changes in intracellular free Ca2+
      levels ([Ca2+]i) in response to ET-1 measured with the fluorescent Ca2+ indicator
      fura-2 showed that ET-1 was more potent and efficacious in stimulating [Ca2+]i in
      PKC3 cells than in control fibroblasts. The ET-1-induced Ca2+ rise was completely
      blocked by the selective ETA antagonist BQ123, but only slightly diminished by
      extracellular application of 2 mM EGTA. In contrast with the effects of PKC-beta
      1 overexpression on responsiveness to ET-1, alpha-thrombin, which was previously
      found to have a weaker effect on InsP3 accumulation in PKC-beta 1-overexpressing
      cells, was also a less effective stimulator of [Ca2+]i in PKC3 cells than in
      control cells. These results demonstrate that, although the Ca2+ response to
      alpha-thrombin is diminished by PKC-beta 1 overexpression, ETA receptor number
      and cellular responsiveness to ET-1 are increased in PKC-beta 1-overexpressing
      cells.

PMID- 8363568
TI  - Restoration in vitro of normal rates of very-low-density lipoprotein
      triacylglycerol and apoprotein B secretion in hepatocyte cultures from diabetic
      rats.
AB  - Hepatocytes derived from diabetic rats were cultured in serum-free Waymouth's
      medium containing various supplements, after an initial 4 h period during which
      the cells were allowed to attach to the culture dish in the presence of foetal
      bovine serum (10%). After removal of serum, these cells secreted much less very
      low-density lipoprotein (VLDL) apoprotein B (apoB) and triacylglycerol than those
      derived from normal rats when cultured for 24 h in the basal medium. Inclusion of
      oleate (0.75 mM) in the medium initially increased the output of apoB and
      triacylglycerol, but the rates remained lower than those observed in normal
      hepatocytes and declined to zero after 72 h. This time-dependent decline in VLDL
      output was prevented by addition of dexamethasone to the oleate-containing
      medium. Levels of apoB and triacylglycerol output characteristic of normal
      hepatocytes could only be completely restored, however, by further addition of a
      mixture of lipogenic substrates (lactate plus pyruvate) to the medium.
      Restoration of normal levels of VLDL secretion in diabetic hepatocytes in vitro
      by this means was accompanied by a normal inhibitory response of apoB and
      triacylglycerol output to short-term (24 h) treatment with insulin or glucagon.
      Exposure of the cells to insulin for 72 h enhanced the secretion of VLDL, whereas
      treatment with glucagon for the same period potentiated the original inhibitory
      effect. The defective secretion of VLDL apoB observed when diabetic hepatocytes
      were cultured in the basal medium for 24 h could also be rectified by inclusion
      of a mixture of oleate (0.75 mM), lactate (10 mM), pyruvate (1 mM), dexamethasone
      (1 microM) and insulin (78 nM) in the medium during the 4 h attachment period in
      the presence of serum. Under these conditions, the increase in the secretory
      response of triacylglycerol was not so pronounced.

PMID- 8363567
TI  - Sex-dependent expression and growth hormone regulation of class alpha and class
      mu glutathione S-transferase mRNAs in adult rat liver.
AB  - The sex-dependent expression and growth hormone (GH) regulation of rat liver
      glutathione S-transferase (GST) was examined using oligonucleotide probes that
      distinguish between closely related class Alpha (Ya1, Ya2, Yc) and class Mu (Yb1,
      Yb2, Yb3) GST mRNAs [Waxman, Sundseth, Srivastava and Lapenson (1992) Cancer Res.
      52, 5797-5802]. Northern-blot analysis revealed that the steady-state levels of
      GST Ya1, Yb1 and Yb2 mRNAs are 2.5-3-fold higher in male as compared with female
      rat liver. In contrast, GST Yc and Ya2 mRNAs were expressed at a 2-3-fold higher
      level in female rat liver. Microsomal GST mRNA did not exhibit significant sex
      dependent differences in rat liver. Treatment of male rats with GH by continuous
      infusion suppressed expression of the male-dominant GST Ya1, Yb1 and Yb2 mRNAs to
      levels at or below those found in female rat liver. This suppressive effect of GH
      was liver-specific, insofar as GH treatment did not alter kidney GST Ya1 mRNA
      levels. Hypophysectomy increased expression of the male-dominant GSTs,
      particularly in female rats (e.g. 8-fold elevation of GST Ya1 mRNA). GST Yc mRNA
      was increased approx. 2-fold in hypophysectomized males, indicating that this
      mRNA is subject to negative regulation by one or more pituitary-dependent
      factors. Continuous GH treatment of the hypophysectomized rats suppressed the
      expression of mRNA of GSTs Ya1, Yb1 and Yb2 when given as a continuous infusion,
      but not when given by an intermittent (twice daily) GH-injection schedule.
      Combination of continuous exposure to GH with thyroxine treatment resulted in a
      more complete suppression of GSTs Ya1, Yb1 and Yb2. In contrast, thyroxine
      increased the expression of GST Yc in hypophysectomized rats. These studies
      establish that several Alpha and Mu class GSTs are expressed in a sex-dependent
      fashion in adult rat liver, where they are regulated by multiple pituitary
      dependent hormones through pretranslational mechanisms.

PMID- 8363569
TI  - Species-specific induction of cytochrome P-450 4A RNAs: PCR cloning of partial
      guinea-pig, human and mouse CYP4A cDNAs.
AB  - PCR was used to demonstrate the presence of a conserved region and to clone novel
      members of the cytochrome P-450 4A gene family from guinea pig, human and mouse
      cDNAs. This strategy is based on the sequences at nucleotides 925-959 and at the
      haem binding domain (nucleotides 1381-1410) of the rat CYP4A1 gene. Murine Cyp4a
      clones showed high sequence identity with members of the rat gene family, but
      CYP4A clones from human and guinea pig were equally similar to the rat/mouse
      genes, suggesting that the rat/mouse line had undergone gene duplication events
      after divergence from human and guinea-pig lines. The mouse Cyp4a-12 clone was
      localized to chromosome 4 using interspecific backcross mapping, in a region of
      synteny with human chromosome 1. The assignment of the human CYP4A11 gene to
      chromosome 1 was confirmed by somatic cell hybridization. An RNAase protection
      assay was shown to discriminate between the murine Cyp4a-10 and Cyp4a-12 cDNAs.
      Treatment of mice with the potent peroxisome proliferator methylclofenapate (25
      mg/kg) induced Cyp4a-10 RNA in liver, and to a lesser extent in kidney; there was
      no sex difference in this response. Cyp4a-12 RNA was present at high levels in
      male control liver and kidney samples, and was not induced by treatment with
      methylclofenapate. However, Cyp4a-12 RNA was present at low levels in control
      female liver and kidney RNA, and was greatly induced in both organs by
      methylclofenapate. Guinea pigs were exposed to methylclofenapate (50 mg/kg), but
      there was no significant induction of the guinea-pig CYP4A13 RNA. These findings
      are consistent with a species difference in response to peroxisome proliferators
      between the rat/mouse and the guinea pig.

PMID- 8363570
TI  - Detection, isolation and characterization of multiple lectins from the haemolymph
      of the cockroach Blaberus discoidalis.
AB  - Three agglutinins (lectins), designated BDL1, BDL2 and BDL3, were identified in
      the haemolymph of the cockroach Blaberus discoidalis by erythrocyte cross
      adsorption and sugar inhibition tests. With the use of (NH4)2SO4 fractionation,
      anion-exchange and affinity chromatography, BDL1 and BDL2 have been purified to
      homogeneity, and BDL3 has been partially purified to three bands on SDS/PAGE.
      BDL1 has a molecular-mass estimate of 390 kDa by gel filtration and approx. 158
      kDa by SDS/PAGE under non-reducing conditions, further reduced to subunits of 36
      kDa under reducing conditions. BDL2 has a molecular mass of approx. 140 kDa and
      is composed of subunits of 67 kDa which can be further reduced to identical
      subunits of 23 kDa. Isoelectric focusing in agarose gels revealed that BDL1 and
      BDL2 both focused as single bands at pH 6.0 and pH 5.2 respectively. The purified
      forms of BDL1 and BDL2 were stained by the periodic acid/Schiff's reagent showing
      that both lectins are glycoproteins. In addition, BDL1 was deglycosylated by endo
      beta-N-acetylglucosaminidase H. Immunological tests showed that these three
      lectins are not structurally related. All three lectins bind galactose but have
      different specificities for binding other sugars and for a range of vertebrate
      erythrocytes. BDL1 is specifically inhibited by D-(+)-glucose, D-(+)-mannose and
      N-acetyl-D-mannosamine, but not by N-acetyl-D-glucosamine, and BDL2 is inhibited
      by N-acetyl-D-glucosamine, but not by D-(+)-glucose, D-(+)-mannose or N-acetyl-D
      mannosamine. BDL3 is strongly inhibited by N-acetyl-D-galactosamine, but not by
      any of the other above-mentioned sugars. Erythrocyte specificities showed that
      BDL1 is more specific for rabbit than mouse erythrocytes, whereas BDL2 and BDL3
      are more specific for mouse than rabbit erythrocytes. The haemagglutinating
      activities of both the serum and isolated lectins are Ca(2+)-dependent.
      Localization of BDL1 and BDL2 with fluorescein isothiocyanate-labelled antibodies
      showed that both lectins are associated with the granules and other areas of the
      cytoplasm of all blood cell types.

PMID- 8363573
TI  - The kinetics of slow-binding and slow, tight-binding inhibition: the effects of
      substrate depletion.
AB  - Inhibitors with dissociation constants in the micromolar to nanomolar range are
      important, but hard to characterize kinetically, especially when the substrate
      concentration in the assay is less than Km. When inhibition increases during the
      course of the assay (slow-binding inhibition) the concentration of substrate may
      decrease appreciably. Methods that take substrate depletion into account are
      described for analysing experiments in which the initial substrate concentration
      is below Km. Fitting progress curves gives the rate constants for the second
      (slow) step in a two-step mechanism. An approximate value for the overall
      dissociation constant may be determined from measurements of rates when the
      reaction is treated as a first-order process. When the concentrations of
      inhibitor and enzyme are comparable numerical methods are required. Procedures,
      suitable for implementation on a microcomputer, for the solution of the
      differential equations and the fitting of progress curves are described.

PMID- 8363571
TI  - An insulin receptor peptide (1135-1156) stimulates guanosine 5'-[gamma
      thio]triphosphate binding to the 67 kDa G-protein associated with the insulin
      receptor.
AB  - Peptides representing two putative G-protein-binding motifs (GPBP1 and GPBP2)
      derived from insulin-receptor sequences were tested for their ability to
      stimulate guanosine 5'-[gamma-thio]-triphosphate (GTP[S]; 'GTP gamma S') binding
      to a preparation containing the 41 and 67 kDa G-proteins that are associated with
      the insulin receptor [Jo, Cha, Davis and McDonald (1992) Endocrinology
      (Baltimore) 131, 2855-2861]. GPBP2 (residues 1135-1156) specifically stimulated
      GTP[S] binding, whereas GPBP1 (1319-1333) did not. Substitution of Arg-1152 with
      Gln in GPBP2 corresponding to a mutation site in insulin-resistant patients
      [Cocozza, Porcellini, Riccardi, Monticelli, Condorelli, Ferrera, Pianese, Miele,
      Capaldo, Beguinot and Varrone (1992) Diabetes 41, 521-526] attenuated the
      stimulatory potency of GPBP2. Size-exclusion chromatography and studies with
      purified 67 kDa G-protein revealed that GPBP2 stimulated GTP[S] binding only to
      the 67 kDa G-protein. These studies provide evidence for a potential regulatory
      site for G-protein interaction with the insulin receptor in the tyrosine kinase
      domain.

PMID- 8363572
TI  - Stereoselectivity of Ins(1,3,4,5)P4 recognition sites: implications for the
      mechanism of the Ins(1,3,4,5)P4-induced Ca2+ mobilization.
AB  - Ins(1,3,4,5)P4 was able to mobilize the entire Ins(1,4,5)P3-sensitive
      intracellular Ca2+ store in saponin-permeabilized SH-SY5Y human neuroblastoma
      cells in a concentration-dependent manner, yielding an EC50 value of 2.05 +/-
      0.45 microM, compared with 0.14 +/- 0.03 microM for Ins(1,4,5)P3. However, L
      Ins(1,3,4,5)P4 [= D-Ins(1,3,5,6)P4] failed to cause mobilization of intracellular
      Ca2+ at concentrations up to 100 microM. Binding studies using pig cerebellar
      membranes as a source of both Ins(1,4,5)P3/Ins(1,3,4,5)P4-specific binding sites
      have revealed a marked contrast in their stereospecificity requirements.
      Ins(1,4,5)P3-receptors from pig cerebella exhibited stringent stereospecificity,
      L-Ins(1,4,5)P3 and L-Ins(1,3,4,5)P4 were > 1000-fold weaker, whereas
      Ins(1,3,4,5)P4 (IC50 762 +/- 15 nM) was only about 40-fold weaker than D
      Ins(1,4,5)P3 (IC50 20.7 +/- 9.7 nM) at displacing specific [3H]Ins(1,4,5)P3
      binding from an apparently homogeneous Ins(1,4,5)P3 receptor population. In
      contrast, the Ins(1,3,4,5)P4-binding site exhibited poor stereoselectivity.
      Ins(1,3,4,5)P4 produced a biphasic displacement of specific [32P]Ins(1,3,4,5)P4
      binding, with two-site analysis revealing KD values for high- and low-affinity
      sites of 2.1 +/- 0.5 nM and 918 +/- 161 nM respectively. L-Ins(1,3,4,5)P4 also
      produced a biphasic displacement of specific [32P]Ins(1,3,4,5)P4 binding which
      was less than 10-fold weaker than with D-Ins(1,3,4,5)P4 (IC50 values for the high
      and low-affinity sites of 17.2 +/- 3.7 nM and 3010 +/- 542 nM respectively).
      Therefore, although L-Ins(1,3,4,5)P4 appears to be a high-affinity Ins(1,3,4,5)P4
      binding-site ligand in pig cerebellum, it is a very weak agonist at the Ca(2+)
      mobilizing receptors of permeabilized SH-SY5Y cells. We suggest that the ability
      of D-Ins(1,3,4,5)P4 to access intracellular Ca2+ stores may derive from specific
      interaction with the Ins(1,4,5)P3- and not the Ins(1,3,4,5)P4-receptor
      population.

PMID- 8363574
TI  - A method for extracting rate constants from initial rates of stopped-flow kinetic
      data: application to a physiological electron-transfer reaction.
AB  - The most commonly used methods for analysis of stopped-flow kinetic data require
      performing a series of measurements in which one reactant is varied at
      concentrations significantly greater than the concentration of the other
      reactant. For enzyme-catalysed reactions this may not be possible, because the
      dissociation constants for the enzyme-substrate complex are often of the same
      order of magnitude as the high concentrations of enzyme that must frequently be
      used in stopped-flow studies. An alternative method of data analysis is presented
      which allows the determination of microscopic rate constants from initial rates
      of stopped-flow kinetic data in which substrate is varied in a range of
      concentrations approximately the same as the enzyme. This method also provides a
      simple and accurate method for determining k4, the rate of the reverse reaction.
      This method has been used to describe a physiological electron transfer reaction
      between a quinoprotein, methylamine dehydrogenase, and a copper protein,
      amicyanin. At 20 degrees C, the rate of the electron-transfer reaction from
      methylamine dehydrogenase to amicyanin was 24 s-1, and the dissociation constant
      for complex-formation was 1.9 microM.

PMID- 8363575
TI  - 13C-n.m.r. of the cyanylated apoflavodoxin and flavodoxin from Clostridium
      pasteurianum.
AB  - The thiol group of the flavodoxin from Clostridium pasteurianum has been
      cyanylated in a single step using [cyanato-13C]2-nitro-5-thiocyanatobenzoic acid.
      This chemical modification increases the dissociation constant of the
      apoflavodoxin-FMN complex 10-fold from 0.33 +/- 0.15 nM to 2.9 +/- 1.3 nM. The
      thiocyanate carbons of the cyanylated cysteine residue of apoflavodoxin and
      flavodoxin had chemical shift values of 114.7 and 112.3 p.p.m. respectively. From
      these chemical shifts we conclude that the binding of FMN by the cyanylated
      apoflavodoxin causes a decrease in the polarity and/or hydrogen bonding capacity
      of the environment of the thiocyanate group. We compare these results with those
      obtained from similar studies on the cyanylated apoflavodoxin and flavodoxin from
      Megasphaera elsdenii and we discuss how FMN binding and cyanylation perturb the
      structures of apoflavodoxins from Megasphaera elsdenii and Clostridium
      pasteurianum.

PMID- 8363577
TI  - Xyloglucan glucosyltransferase in Golgi membranes from Pisum sativum (pea).
AB  - Cell membranes from etiolated Pisum sativum (pea) tissues were separated by
      ultracentrifugation on linear sucrose density gradients and assayed for membrane
      marker and glycosyltransferase activity. Membrane fractions were shown to
      incorporate glucose from UDP-D-[14C]glucose into polysaccharides with glycosyl
      linkages consistent with synthesis of xyloglucan. A combined assay using g.c.,
      radiogas proportional counting and m.s. was employed to determine the identities
      of 14C-labelled glycosyl residues and the glycosyl linkages between them. In
      glucan synthase I assays, membrane fractions enriched for Golgi membranes showed
      14C incorporation into 4- and 4,6-glucose residues, with minor incorporation into
      3-glucose residues. In glucan synthase II assays, all 14C incorporation was into
      3- and 3,4-glucose. There was a shift in glycosyl linkage of 14C incorporation
      from predominantly 4-glucose at low UDP-glucose concentration to predominantly 3-
      and 3,4-glucose at high UDP-glucose concentrations. Mn2+ stimulated incorporation
      of radioactivity into 4,6-glucose residues characteristic of xyloglucan
      polysaccharides. Addition of exogenous UDP-xylose to assay mixtures stimulated
      incorporation into 4,6-glucose, with a maximum at 15 microM UDP-xylose.

PMID- 8363576
TI  - A putative glutathione-binding site in CdZn-metallothionein identified by
      equilibrium binding and molecular-modelling studies.
AB  - Glutathione (GSH) has been found to form a complex with both vertebrate and
      invertebrate copper-metallothionein (CuMT) [Freedman, Ciriolo and Peisach (1989)
      J. Biol. Chem. 264, 5598-5605; Brouwer and Brouwer-Hoexum (1991) Arch. Biochem.
      Biophys. 290, 207-213]. In this paper we report on the interaction of GSH with
      CdZnMT-I and CdZnMT-II from rabbit liver and with CdMT-I from Blue crab
      hepatopancreas. Ultrafiltration experiments showed that all three MTs combined
      with GSH. The measured binding data for the three MTs could be described by a
      single binding isotherm. The GSH/MT stoichiometry was 1.4 +/- 0.3 and Kdiss. = 14
      +/- 6 microM. Partially Zn-depleted MT does not significantly bind GSH,
      indicating that the GSH-binding site is located on MT's Zn-containing N-terminal
      domain. The putative GSH-binding site on rabbit liver MT was investigated using
      molecular-graphics analysis. A cleft on the MT's N-terminal domain, which has the
      labile Zn-2 at its base, could easily accommodate GSH. Cysteine-ligand exchange
      between the terminal (non-bridging) Cys-26, bound to Zn-2, and the cysteine in
      GSH is stereochemically possible. Based on these considerations a model of MT-GSH
      was built in which GSH's cysteine replaces Cys-26 as a terminal Zn-2 ligand. This
      complex was energy-minimized by molecular-mechanics calculations, taking into
      account computed partial electrostatic charges on all atoms, including Cd and Zn.
      These calculations showed that the MT-GSH complex was thermodynamically more
      stable than MT, due to favourable non-bonded, electrostatic and van der Waals
      interactions. Six hydrogen bonds can form between GSH and MT. The average
      pairwise root-mean-square deviations (RMSD) of the metals in energy-minimized MT
      and MT-GSH, compared with the metals in the crystal structure, were 0.0087 +/-
      0.0028 nm (0.087 +/- 0.028 A) and 0.0168 +/- 0.0087 nm (0.168 +/- 0.087 A)
      respectively. The RMSD values for the polypeptide-backbone alpha carbons were
      0.0136 +/- 0.0060 nm (0.136 +/- 0.060 A) and 0.0491 +/- 0.0380 nm (0.491 +/-
      0.380 A) respectively. No other docking sites for GSH were found. The energy
      minimized structure of an MT-2-mercaptoethanol complex was somewhat less stable
      than the native MT domain, attesting to the specificity of the MT-GSH
      interaction. The possible physiological significance of the MT-GSH interaction is
      discussed.

PMID- 8363578
TI  - Organization and sequences of genes for the subunits of ATP synthase in the
      thermophilic cyanobacterium Synechococcus 6716.
AB  - The sequences of the genes for the nine subunits of ATP synthase in the
      thermophilic cyanobacterium Synechococcus 6716 have been determined. The genes
      were identified by comparison of the encoded proteins with sequences of ATP
      synthase subunits in other species, and confirmed for subunits alpha, beta, delta
      and epsilon, by determining their N-terminal sequences. They are arranged at
      three separate loci. Six of them are in one cluster in the order a: c: b': b:
      delta: alpha, and those for the beta and epsilon subunits form a second and
      separate cluster. The gene for the gamma-subunit is at a third site. As in other
      bacteria, the gene for subunit a is immediately preceded by a gene coding for a
      small hydrophobic protein of unknown function, known as uncI in Escherichia coli.
      The gene orders in Synechococcus 6716 are related to the orders of ATP synthase
      genes in the plastid genomes of higher plants, and particularly of a red alga and
      a diatom. The sequences of the subunits are similar to those of chloroplast ATP
      synthase, the alpha, beta and c subunits being particularly well conserved.
      Differences in the primary structures of the Synechococcus 6716 and chloroplast
      gamma subunits probably underlie different mechanisms of activation of ATP
      synthase. The nucleotide sequences that are presented also contain 12 other open
      reading frames. One of them encodes a protein sequence related to the E. coli DNA
      repair enzyme, photolyase, and another codes for a protein that contains internal
      repeats related to sequences in the myosin heavy chain.

PMID- 8363579
TI  - Purification of a 100 kDa phospholipase A2 from spleen, lung and kidney:
      antiserum raised to pig spleen phospholipase A2 recognizes a similar form in
      bovine lung, kidney and platelets, and immunoprecipitates phospholipase A2
      activity.
AB  - Phospholipase A2 (PLA2) plays a key role in the production of intracellular and
      extracellular chemical mediators such as arachidonic acid, eicosanoids and
      platelet-activating factor, which modulate membrane channel activity, signal
      transduction, are vasoactive and chemotactic, and are implicated in many
      pathophysiological mechanisms of inflammation and tissue injury. We previously
      identified, purified and characterized an arachidonic acid-selective cytosolic
      100-110 kDa PLA2 from bovine platelets and rat kidney that is activated during
      cell stimulation. The purification schemes previously published resulted in low
      yields of enzyme, insufficient for extensive biochemical characterization. We
      report the purification of a large-molecular-mass (100 kDa) PLA2 from pig spleen,
      bovine kidney and bovine lung, using a novel large-scale purification scheme. The
      enzyme was purified to near homogeneity from an acidified extract obtained from
      4.8 kg of pig spleen by sequential use of DEAE-cellulose anionic exchange, Butyl
      Toyopearl hydrophobic chromatography and DEAE-5PW h.p.l.c., and further purified
      by non-denaturing PAGE. This purification scheme will permit the preparation of
      quantities of purified native enzyme sufficient to study its properties and
      regulation. To generate antiserum against the PLA2 enzyme, the 100 kDa protein
      was excised and electroeluted from SDS/PAGE gels of the active fractions after
      DEAE-5PW h.p.l.c., and this was used as antigen. This polyclonal antibody against
      pig spleen 100 kDa PLA2 protein reacted with 100 kDa bands in preparations
      partially purified from bovine platelets, kidney and lung as well as pig spleen,
      and immunoprecipitated PLA2 activity from these sources. The antibody also
      immunoprecipitated a 100 kDa protein from cytosolic fractions of cultured renal
      mesangial cells, human erythroleukaemia cells and human monocytic U937 cells.
      Considerable PLA2 activity was present in the immunoprecipitates. To our
      knowledge this antibody is unique in its ability to permit measurement of PLA2
      activity in the immunoprecipitate itself, and will be a useful tool for the study
      of the regulation and the activation mechanisms of the native PLA2 enzyme.

PMID- 8363580
TI  - Osteoblast-specific factor 2: cloning of a putative bone adhesion protein with
      homology with the insect protein fasciclin I.
AB  - A cDNA library prepared from the mouse osteoblastic cell line MC3T3-E1 was
      screened for the presence of specifically expressed genes by employing a combined
      subtraction hybridization/differential screening approach. A cDNA was identified
      and sequenced which encodes a protein designated osteoblast-specific factor 2
      (OSF-2) comprising 811 amino acids. OSF-2 has a typical signal sequence, followed
      by a cysteine-rich domain, a fourfold repeated domain and a C-terminal domain.
      The protein lacks a typical transmembrane region. The fourfold repeated domain of
      OSF-2 shows homology with the insect protein fasciclin I. RNA analyses revealed
      that OSF-2 is expressed in bone and to a lesser extent in lung, but not in other
      tissues. Mouse OSF-2 cDNA was subsequently used as a probe to clone the human
      counterpart. Mouse and human OSF-2 show a high amino acid sequence conservation
      except for the signal sequence and two regions in the C-terminal domain in which
      'in-frame' insertions or deletions are observed, implying alternative splicing
      events. On the basis of the amino acid sequence homology with fasciclin I, we
      suggest that OSF-2 functions as a homophilic adhesion molecule in bone formation.

PMID- 8363581
TI  - Expression of transcripts for two interleukin 8 receptors in human phagocytes,
      lymphocytes and melanoma cells.
AB  - Two cDNAs coding for distinct interleukin 8 (IL-8) receptors, IL-8R1 [Murphy and
      Tiffany (1991) Science 253, 1280-1283] and IL-8R2 [Holmes, Lee, Kuang, Rice and
      Wood (1991) Science 253, 1278-1280] have been reported, and biochemical studies
      on human neutrophils have revealed two proteins (p70 and p44) that bind IL-8 with
      high affinity [Moser, Schumacher, von Tscharner, Clark-Lewis and Baggiolini
      (1991), J. Biol. Chem. 266, 10666-10671]. We have cloned the cDNA coding for IL
      8R1 from a library of differentiated HL-60 cells. Transfection of this cDNA into
      Jurkat cells resulted in the expression of high-affinity binding for IL-8 and two
      related cytokines, GRO alpha and neutrophil-activating peptide 2 (Kd 0.5-1.0 nM).
      Northern-blot analysis with the IL-8R1 cDNA as probe revealed abundant expression
      of transcripts of different size in human neutrophils and low-level expression of
      a single RNA species in HL-60 cells differentiated with dimethyl sulphoxide and
      retinoic acid. Because of the extensive nucleotide sequence similarity of the
      cDNAs for IL-8R1 and IL-8R2, the reverse-transcription PCR method was used for
      analysis of RNA expression in myeloid and lymphoid cells, 19 cell lines
      established from human primary melanomas or metastases, two melanocyte and one
      fibroblast cell lines. IL-8R1 mRNA transcripts were expressed at high levels in
      neutrophils, and to a lesser extent in blood monocytes and the myeloid cell
      lines, HL-60 and AML 193, but were not found in THP-1 cells, lymphocytes and
      Jurkat cells. IL-8R2 mRNA transcripts, by contrast, were found in all blood cells
      and related cell lines, as well as in all melanoma, melanocyte and fibroblast
      cell lines tested. As for IL-8R1, IL-8R2 mRNA expression was highest in
      neutrophils. These results suggest that IL-8R1 and IL-8R2 may both be involved in
      neutrophil activation by IL-8 and related cytokines, and presumably correspond to
      p70 and p44, the receptors that were identified biochemically. Possible IL-8
      functions on lymphocytes and melanoma cells, e.g. chemotaxis and proliferation,
      must be independent of IL-8R1 and may be mediated by IL-8R2.

PMID- 8363582
TI  - Abundant bacterial expression and reconstitution of an intrinsic membrane
      transport protein from bovine mitochondria.
AB  - The oxoglutarate carrier, an intrinsic membrane-transport protein of the inner
      membranes of bovine-heart mitochondria, has been expressed at an abundant level
      in Escherichia coli. It accumulates in the bacterium as inclusion bodies, and
      none of the protein was detected in the bacterial inner membrane. The
      mitochondrial ADP/ATP carrier, a member of the same super-family of transport
      proteins as the oxoglutarate carrier, has also been expressed in E. coli.
      However, the expression of the ADP/ATP carrier in bacteria retards their growth,
      and so the levels of expression that were attained were lower than those of the
      oxoglutarate carrier. The oxoglutarate carrier inclusion bodies have been
      disaggregated with the detergent N-dodecanoyl-sarcosine, and the protein has been
      incorporated into liposomes. In its ability to transport oxoglutarate and malate
      and other known substrates of the carrier in mitochondria, and in its inhibition
      characteristics by a wide range of non-competitive and competitive inhibitors,
      this reconstituted oxoglutarate carrier is similar to the natural protein in the
      inner membranes of mitochondria, and to the carrier that has been purified from
      mitochondria and reconstituted in liposomes. These experiments remove significant
      obstacles to crystallization trials and to site-directed mutagenesis of the
      oxoglutarate carrier.

PMID- 8363583
TI  - Effect of lead acetate and carbon particles on the expression of glutathione S
      transferase YfYf in rat liver.
AB  - Administration of intracardiac lead acetate produces a complex response in
      glutathione S-transferase (GST) YfYf expression in rat liver. The earliest
      response, an elevation of GST expression in Kupffer cells, can be mimicked by
      administering a suspension of carbon particles. The second effect of lead acetate
      administration is a marked elevation of GST YfYf in some but not all hepatocytes
      (the 'patchy' response). This effect is most marked 48-76 h after administration
      of a single dose of lead acetate and is easily detected by immunoblotting.
      Dexamethasone down-regulates the lead response in hepatocytes.

PMID- 8363585
TI  - Conformational properties of Bacillus subtilis RNA polymerase sigma A factor
      during transcription initiation.
AB  - By the use of a partial proteolysis method and Western-blot analysis, the
      conformational properties of Bacillus subtilis sigma A factor in the
      transcription initiation stage were studied. From a comparison of the trypsin
      digestion patterns of free sigma A and of sigma A associated with core enzyme, it
      was found that the production of 45 kDa sigma A tryptic-derived fragment was
      enhanced when sigma A was associated with the core enzyme. More importantly, a 40
      kDa sigma A tryptic-derived fragment was found exclusively in this associated
      state. Based on the change of the digestion kinetics when producing the 45 kDa
      tryptic fragment and the generation of this new 40 kDa tryptic fragment from
      sigma A, it was apparent that a conformation change of sigma A occurred during
      the association of sigma A with the core enzyme. Also, similar patterns were
      found for the sigma A present in the holoenzyme-promoter DNA complex. These
      findings suggest that no further distinctive conformational change of sigma A
      occurs at the step of RNA polymerase holoenzyme and promoter DNA complex
      formation. Trypsin-digestion patterns of sigma A in different RNA polymerase
      holoenzyme and promoter DNA complexes were also studied. The presence of similar
      trypsin digestion-patterns of sigma A in those complexes strongly supports the
      idea that a similar sigma A conformation is used in the recognition of different
      sigma A-type promoters and the formation of different open complexes.

PMID- 8363584
TI  - Substrate-dependent changes in mitochondrial function, intracellular free calcium
      concentration and membrane channels in pancreatic beta-cells.
AB  - Microfluorimetric and patch-clamp techniques have been combined to determine the
      relationship between changes in mitochondrial metabolism, the activity of KATP
      channels and changes in intracellular free calcium concentration ([Ca2+]i) in
      isolated pancreatic beta-cells in response to glucose, ketoisocaproic acid (KIC)
      and the electron donor couple tetramethyl p-phenylenediamine (TMPD) and
      ascorbate. Exposure of cells to 20 mM glucose raised NAD(P)H autofluorescence
      after a delay of 28 +/- 1 s (mean +/- S.E.M., n = 30). The mitochondrial inner
      membrane potential, delta psi m (monitored using rhodamine 123 fluorescence),
      hyperpolarized with a latency of 49 +/- 6 s (n = 17), and the [Ca2+]i rose after
      129 +/- 13 s (n = 5). The amplitudes of the metabolic changes were graded
      appropriately with glucose concentration over the range 2.5-20 mM. All variables
      responded to KIC with shorter latencies: NAD(P)H autofluorescence rose after a
      delay of 20 +/- 3 s (n = 5) and rhodamine 123 changed after 21 +/- 3 s (n = 6).
      The electron donor couple, TMPD with ascorbate, rapidly hyperpolarized delta psi
      m and raised [Ca2+]i. When [Ca2+]i was raised by sustained exposure to 20 mM
      glucose, TMPD had no further effect. TMPD also decreased whole-cell KATP currents
      and depolarized the cell membrane, measured with the perforated patch
      configuration. These data are consistent with a central role for mitochondrial
      oxidative phosphorylation in coupling changes in glucose concentration with the
      secretion of insulin.

PMID- 8363586
TI  - Inactivation of mouse liver glutathione S-transferase YfYf (Pi class) by
      ethacrynic acid and 5,5'-dithiobis-(2-nitrobenzoic acid).
AB  - Mouse liver glutathione S-transferase YfYf (Pi class) reacts with [14C]ethacrynic
      acid to form a covalent adduct with a stoichiometry of 1 mol per mol of subunit.
      Proteolytic digestion of the enzyme-[14C]ethacrynic acid adduct with V8 protease
      produced an 11 kDa fragment containing radioactivity. Sequencing revealed this to
      be an N-terminal peptide (minus the first 15 residues, terminating at Glu-112)
      which contains only one cysteine residue (Cys-47). This is tentatively identified
      as the site of ethacrynic attachment. Kinetic studies reveal that glutathione S
      conjugates protect against inactivation by ethacrynic acid, but the level of
      protection is not consistent with their potency as product inhibitors. A model is
      proposed in which glutathione S-conjugates and ethacrynic acid compete for the
      free enzyme, and a second molecule of ethacrynic acid reacts covalently with the
      enzyme-ethacrynic acid complex. The native protein contains one thiol reactive
      with 5,5'-dithiobis-(2-nitrobenzoic acid) at neutral pH. The resultant mixed
      disulphide, like the ethacrynic acid adduct, is inactive, but treatment with
      cyanide (which incorporates on a mol for mol basis) restores activity to 35% of
      that of the native enzyme.

PMID- 8363587
TI  - Disulphide cross-linking of smooth-muscle and non-muscle caldesmon to the C
      terminus of actin in reconstituted and native thin filaments.
AB  - It was reported that chicken gizzard smooth-muscle caldesmon Cys-580 can be
      disulphide-cross-linked to the C-terminal pen-ultimate residue (Cys-374) of
      actin, indicating that these residues are close in the protein complex [Graceffa,
      P. and Jancso, A. (1991) J. Biol. Chem. 266, 20305-20310]. Since the possibility
      that the cross-link involves a cysteine residue other than actin Cys-374 was not
      absolutely excluded, more direct evidence was sought for the identify of the
      cysteine residues involved in the cross-link. We show here that caldesmon could
      not be disulphide-cross-linked to actin which had Cys-374 removed by
      carboxypeptidase A digestion, providing direct support for the participation of
      actin Cys-374 in the cross-link to caldesmon. In order to assign the caldesmon
      cysteine residue involved in the cross-link, use was made of caldesmon from
      porcine stomach muscle, which is shown to contain one cysteine residue close to,
      or at, position 580, in contrast with chicken gizzard caldesmon, which has an
      additional cysteine residue at position 153. The porcine stomach caldesmon also
      formed a disulphide-cross-link to actin, further supporting the original
      conclusion that Cys-580 of the chicken gizzard caldesmon had been cross-linked to
      actin. Disulphide-cross-linking with similar yield was also observed in native
      chicken gizzard muscle thin filaments, indicating that the interaction between
      actin and the C-terminal domain of caldesmon is the same in native and
      reconstituted thin filaments. The much smaller non-muscle isoform of caldesmon,
      from rabbit liver, could be similarly cross-linked to actin, consistent with the
      sequence similarity between the C-terminal domain of muscle and non-muscle
      caldesmon. The ability to cross-link caldesmon Cys-580 to actin Cys-374 suggests
      the possibility that the Cys-580 region of caldesmon and the C-terminus of actin
      form part of the actin-caldesmon binding interface.

PMID- 8363588
TI  - High-level expression of soluble rat hsc70 in Escherichia coli: purification and
      characterization of the cloned enzyme.
AB  - We have cloned the cDNA of rat hsc70 (clathrin-uncoating ATPase) into a T7
      expression system and have expressed this enzyme in Escherichia coli. The
      recombinant clathrin-uncoating ATPase is in the cytosolic fraction of the
      bacterium and is soluble. It was purified to homogeneity by DEAE-cellulose and
      ATP-agarose column chromatography. From 1 litre of bacterial culture (0.3-0.4 g
      of proteins), 5-20 mg of pure recombinant clathrin-uncoating ATPase was routinely
      obtained. The cloned enzyme is capable of dissociating clathrin from bovine
      coated vesicle. Furthermore, it is not methylated on basic amino acid residues
      and is not blocked at the N-terminus, indicating that these modifications on
      hsc70 are not essential for uncoating of clathrin. Binding of [alpha-32P]ATP by
      purified recombinant hsc70 was analysed by Scatchard plot. The results indicate
      that there one high-affinity binding component with a Kd (dissociation constant)
      of 0.2-0.3 microM. The peptide-stimulated ATPase activities of recombinant hsc70
      at 37 degrees C with respect to S-peptide peptides P3a and GT4 at a concentration
      of 1.2 mM are 142 +/- 6, 214 +/- 8 and 362 +/- 5 pmol/h per micrograms of hsc70
      protein respectively. The EC50 values of hsc70 ATPase for S-peptide, peptides P3a
      and GT4 are 2, 0.67 and 0.17 mM respectively. On the other hand, the dissociation
      constants of S-peptide, peptides P3a and GT4 for recombinant hsc70 are 7.6, 13
      and 100 microM respectively. Thus peptide GT4 is the only peptide examined for
      which the binding constant is comparable with the EC50 for stimulation ATPase
      activity, albeit it has the lowest affinity for hsc70.

PMID- 8363589
TI  - Expression of precursor and mature carnitine palmitoyltransferase II in
      Escherichia coli and in vitro: differential behaviour of rat and human isoforms.
AB  - cDNAs corresponding to the precursor and mature forms of rat carnitine
      palmitoyltransferase II (CPT II) were found to be readily expressed in
      Escherichia coli. In both cases, catalytically active immunoreactive protein was
      produced and became largely membrane-associated. The precursor form of the enzyme
      was not proteolytically processed. Removal of 126 bp from the 5' end of the cDNA
      coding region allowed expression of a truncated CPT II (lacking the N-terminal 17
      residues of the mature protein), but this product was inactive. cDNAs encoding
      the precursor and mature forms of human CPT II resisted direct expression in E.
      coli. However, the impediment was overcome when the latter cDNA was ligated in
      frame 3' to sequence encoding a glutathione S-transferase. This construct yielded
      abundant quantities of the corresponding fusion protein, a portion of which was
      soluble and catalytically active. In vitro transcription and translation of the
      various cDNAs established that the lower mobility on SDS/PAGE of rat CPT II
      compared with its human counterpart (despite their identical numbers of amino
      acids) is an intrinsic property of the primary sequences of the proteins
      themselves. Also, the human cDNA was found to contain an artifactual termination
      signal for T3 RNA polymerase that could be bypassed by the T7 polymerase. Thus
      rat CPT II can be expressed in active form in E. coli with characteristics
      similar to those of the enzyme in mitochondria, opening the way to future
      location of active sites within the molecule. An alternative expression system
      will be needed for similar studies on human CPT II.

PMID- 8363590
TI  - Control analysis applied to single enzymes: can an isolated enzyme have a unique
      rate-limiting step?
AB  - Control analysis is used to analyse and quantify the concept of a rate-limiting
      step within an enzyme. The extent to which each rate constant within the enzyme
      limits the steady-state rate of the enzyme and the levels of enzyme intermediate
      species are quantified as flux and concentration control coefficients. These
      coefficients are additive and obey summation theorems. The control coefficients
      of triose phosphate isomerase, carbamate kinase and lactate dehydrogenase are
      calculated from literature values of the rate constants. It is shown that,
      contrary to previous assumption, these enzymes do not have a unique rate-limiting
      step, but rather flux control is shared by several rate constants and varies with
      substrate, product and effector concentrations, and with the direction of the
      reaction. Thus the general assumption that an enzyme will have a unique rate
      limiting step is unjustified.

PMID- 8363591
TI  - Purinergic (P2) receptor-operated calcium entry into rat thyroid cells.
AB  - In the epithelial cell line FRT, derived from rat thyroid, extracellular ATP, at
      a concentration as low as 1 x 10(-7) M, specifically increases cytosolic Ca++ two
      fold over the basal level of 255 +/- 45 nM. A maximum increase of 5 fold over
      basal is seen at 1 x 10(-5) M ATP. The effect occurs in the absence of any
      measurable phosphatidyl inositol metabolism and requires the presence of
      extracellular Ca++, but is independent of extracellular Na+; it is duplicated by
      ATP gamma S but not by adenosine, AMP, ADP, AMP-PNP, AMP-CPP, or AMP-PCP. In the
      presence of the P2-receptor antagonist suramin, the ATP induced Ca++ influx is
      completely inhibited, whereas Mg++, La , and verapamil are ineffective. It
      appears that the most likely (and unique) mechanism of ATP induced increase of
      cytosolic Ca++ in FRT cells in an increased influx through the activation of a P2
      receptor operated Ca++ channel.

PMID- 8363592
TI  - Identification of two human brain aryl sulfotransferase cDNAs.
AB  - A 1,179 bp and a 1,424 bp full-length aryl sulfotransferase cDNAs were isolated
      from a human brain cDNA library. Their coding domains are 93% identical, each
      encoding a cytosolic protein of 295 amino acids. Their deduced amino acid
      sequences of these cDNAs are also 93% identical. The 1179 bp brain cDNA has an
      identical coding domain to a previously reported human liver aryl
      sulfotransferase cDNA but it has a different 5' noncoding sequence. Northern blot
      analysis using a probe specific for the 1,424 bp cDNA identified a 1500 bp band
      in mRNA of human liver, colon, kidney and lung. In a human hepatocellular
      carcinoma the same band plus an extra larger band was also recognised. An intron
      of the gene encoding the 1424 bp cDNA was also identified.

PMID- 8363593
TI  - Nucleotide sequence of the rabbit gamma-preprotachykinin I cDNA.
AB  - We succeeded in amplifying tachykinin I specific cDNAs from cerebral tissue of
      guinea pig, rabbit, rat, hamster, trout and tupaia in the expected size range of
      820-980 bp. The amplified 859 bp rabbit gamma-preprotachykinin I cDNA was
      sequenced and consisted of the whole 345 bp gamma-PPT I coding sequence including
      the substance P and neurokinin A coding regions and a 505 bp large 3'
      nontranslated region. Both, molecular weight and sequence comparison emphasizes
      the very high phylogenetic age of the preprotachykinin I gene.

PMID- 8363594
TI  - Annexins from bovine adrenal cortex exhibit specific cytosol/membrane solvation.
AB  - Cytosol/membrane localization of annexins I to VI was analyzed in tissue extracts
      from bovine adrenal cortex. Based on their solubility in either aqueous or
      detergents solutions, they were subfractionated in three groups named cytosolic
      (C), membrane-bound (MB) and membrane-inserted (MI). Less than 1% of the total
      annexins present in the tissue were recovered in the C fraction when as much as
      76.5 and 22.5% were obtained respectively in the MB and the MI fractions. By
      immunoblotting after SDS-PAGE, it was shown that the various members of the
      annexin family were not equally recovered in the different fractions. A-V and A
      VI were found present in the three fractions whereas the distribution of A-I, A
      II, A-III and A-IV was distinct, suggesting different cellular functions.

PMID- 8363595
TI  - Inhibitory effect of arachidonic acid on GTPase activating protein is antagonized
      by 1-stearoyl, 2-arachidonoyl glycerol.
AB  - The intrinsic GTPase activity of cellular protein p21ras is strongly increased by
      cytosolic GTPase activating protein (GAP). The activity of this enzyme has been
      shown to be inhibited by arachidonic acid. We report here that this inhibition is
      antagonized by the presence of 1-stearoyl, 2-arachidonoyl glycerol. This effect
      is structure specific and dose dependent, being maximum at 200 micrograms/ml of
      diacylglycerol (DG). These results suggest that production of DG in response to
      hormones or growth factors stimulation could indirectly modulate the interaction
      between p21ras and GAP.

PMID- 8363596
TI  - Specific regulation of male rat liver cytosolic estrogen receptor by the
      modulator of the glucocorticoid receptor.
AB  - Modulator is a novel low-molecular-weight organic compound that regulates
      activities of glucocorticoid and mineralocorticoid receptors as well as protein
      kinase C. In this study we show that male rat liver cytosolic estrogen receptor
      activation is inhibited by modulator in a dose-dependent manner. Fifty percent
      inhibition is obtained with 1 unit/ml modulator purified from bovine liver which
      is within the physiological concentration for modulator. However, sheep uterine
      cytosolic estrogen and androgen receptors are insensitive to regulation by
      modulator. Exogenous sodium molybdate treatment inhibits activation of all of
      these receptors of liver or uterus origin in an identical manner, further
      differentiating the effects of modulator and the molybdate anion.

PMID- 8363597
TI  - Alteration of protein kinase C activity in diabetic rat prostate.
AB  - Protein kinase C activity is present in rat prostatic epithelial cells in both
      cytosolic and membrane subcellular fractions. Partial purification by ion
      exchange chromatography and characterization of cofactor requirements showed its
      behavior as a classical Ca(2+)- and phospholipid-dependent enzyme activated by
      1,2-diacylglycerol (or by mimicking agents such as tumor-promoting phorbol
      esters). Streptozotocin-induced diabetes resulted in an increase of the
      membrane/cytosolic enzyme ratio suggesting a redistribution of protein kinase C
      from the cytosolic to the membrane fraction (an index of enzyme activation) that
      could be reversed toward control conditions by insulin treatment. Differences
      observed in cofactor requirements for maximal enzyme activation argue for a some
      distinct expression of protein kinase C isozymes in control and diabetic
      conditions. These results are a new aspect of the complex set of alterations
      exhibited by the diabetic prostate in the signal transduction mechanisms that
      mediate cell functions and proliferation in this gland which could be related to
      the prostate atrophy and impaired fertility characteristic of this disease.

PMID- 8363598
TI  - Unique preS sequence in a gibbon-derived hepatitis B virus variant.
AB  - A unique hepatitis B virus (HBV) variant has been identified in a gibbon
      (Hylobates lar) which could be passed to a chimpanzee by experimental
      inoculation. This HBV variant had been shown to have no reactivity to a
      monoclonal anti-preS2 antibody (preS2 mAb 116-34) differentiating it from all
      human HBV specimens tested. This gibbon sera also was not recognized by an anti
      preS1 mAb which binds the preS1 hepatocyte receptor region, amino acids 27-35. In
      this paper, we report the DNA sequence of the gibbon HBV PreS gene. The lack of
      preS2 mAb (116-34) binding can be explained by a unique nucleotide substitution
      of A for C in the second codon of the preS2 region leading to the replacement of
      glutamine with lysine. Two other unique changes were observed at the seventh and
      24th amino acid positions in the preS2 gene leading to a substitution of a valine
      for threonine and alanine, respectively. Unlike all human derived HBV sequences
      in the preS1 region, the gibbon HBV had a glutamic acid instead of an aspartic
      acid at amino acid residue 27. Another unique substitution was a leucine for
      alanine at preS1 position 33. These amino acid changes in the gibbon HBV may
      explain its unique preS mAb reactivity.

PMID- 8363599
TI  - Inositol 1,4,5-trisphosphate-induced calcium release in permeabilized platelets
      is coupled to hydrolysis of inositol 1,4,5-trisphosphate to inositol 1,4
      bisphosphate.
AB  - Metabolism of inositol 1,4,5-trisphosphate (IP3) and IP3-induced release of Ca2+
      was analyzed in permeabilized human platelets. Both rapid Ca2+ release and
      hydrolysis of IP3 to inositol 1,4-bisphosphate (IP2) was observed after addition
      of IP3 to permeabilized, Ca(2+)-loaded platelets. In the absence of ATP or in the
      presence of inhibitors of the Ca(2+)-ATPase of the endoplasmic reticulum, no
      release of Ca2+ and little hydrolysis of IP3 occurs, indicating a coupling
      between the Ca2+ gradient across the membrane of the IP3-sensitive Ca2+ store and
      conversion of IP3 to IP2. In addition, the rapid recovery of the sensitivity of
      the IP3-sensitive Ca2+ store after successive additions of IP3 (increment
      detection) appears to be associated with hydrolysis of IP3.

PMID- 8363600
TI  - Interaction of immobilized human plasminogen and plasmin with streptokinase.
AB  - The complex of immobilized human plasminogen (iHPlg) and streptokinase (SK) has a
      lower catalytic activity in hydrolysis of plasmin-specific substrate S-2251 with
      a kcat/Km of 0.005 microM-1 x s-1, compared to 0.031 microM-1 x s-1 of
      immobilized human plasmin (iHPlm) and 0.078 microM-1 x s-1 of HPlm. The SK in the
      complex could be removed by acid buffer solution, and the iHPlg will remain
      catalytically active. IHPlm.SK complex could activate bovine plasminogen (BPlg),
      whereas iHPlg.SK complex could not. IHPlg could be activated by interaction with
      a combination of SK and HPlg or urokinase. The activated iHPlg.SK complex had the
      ability to activate BPlg as iHPlm.SK. The reasonable explanation is that iHPlg
      was converted to iHPlm in reaction with the combination of HPlg and SK. However,
      iHPlg was converted to a virgin enzyme in reaction with SK alone and could not
      activate BPlg. A new modified mechanism for the interaction of HPlg or HPlm with
      SK was proposed.

PMID- 8363601
TI  - A small influence of HSP90 levels on the trehalose and heat shock element
      inductions of the yeast heat shock response.
AB  - Heat shock protein (HSP) induction is only one change elicited in yeast by heat
      shock. Trehalose is also accumulated, while declining intracellular pH stimulates
      plasma membrane ATPase activity. Recently the trehalose induction was shown to be
      regulated by levels of HSP70 and, to a lesser extent, HSP104. Another HSP which
      might contribute to regulation is HSP90, especially as HSP90 forms complexes with
      heat shock transcription factor and several of the regulatory proteins of
      eukaryotic cells. This possibility was investigated using isogenic yeast strains
      with normal, decreased or elevated HSP90. The results show HSP90 levels having a
      small negative influence over the heat inductions of trehalose and the heat shock
      element, a minor effect compared with the major regulation exerted by HSP70.

PMID- 8363602
TI  - Inhibition of ret tyrosine kinase activity by herbimycin A.
AB  - We examined the effect of herbimycin A, a potent inhibitor of tyrosine kinases,
      on NIH(ret) cells and TPC-1 papillary thyroid carcinoma cells, both of which
      express the active ret genes. Herbimycin A reversed the morphology of NIH(ret)
      cells to flat cells with a concomitant reassembly of microfilament bundles. On
      the other hand, it did not induce a significant change in cell shape of TPC-1
      cells. When tyrosine kinase activities of the active ret gene products in
      herbimycin A-treated NIH(ret) and TPC-1 cells were examined in immunocomplex
      kinase assays, they drastically decreased in both cells as compared with
      untreated cells. In addition, herbimycin A strongly inhibited tyrosine
      phosphorylation of 40 kDa and 31 kDa proteins present in the immunoprecipitates
      of both cells, suggesting that these proteins could associate with the Ret
      proteins.

PMID- 8363603
TI  - Characterization of HeLa nuclear factors which interact with a conditionally
      processed rat fibronectin pre-mRNA.
AB  - It is demonstrated that several HeLa nuclear proteins interact in a magnesium
      dependent fashion with a conditionally processed pre-mRNA derived from an
      alternatively spliced region of the rat fibronectin gene. HnRNP C proteins
      crosslink under both permissive and non-permissive conditions (high and low
      magnesium, respectively), whereas hnRNP I/PTB is observed only under the latter.
      Thus hnRNP I/PTB represents a potential inhibitor of splicing for this intron. A
      protein that was observed to crosslink under permissive conditions has been
      identified as splicing factor U2AF65, which thus represents a candidate positive
      factor in the splicing of this pre-mRNA. We interpret these results with a
      working model for the conditional selection of the 3' splice site of alternative
      exon EIIIB.

PMID- 8363604
TI  - Three-dimensional recognition requirements for angiotensin agonists: a novel
      solution for an old problem.
AB  - A novel approach involving the search for a common spatial arrangement of
      functionally important (pharmacophoric) groups in low-energy conformers of AT and
      its active analogs has been employed to determine the receptor-bound
      ("biologically active") conformation(s) for angiotensin II (Asp1-Arg2-Val3-Tyr4
      Val/Ile5-His6-Pro7-Phe8, AT). The four pharmacophoric groups for AT are the
      aromatic moieties of Tyr4, His6 and Phe8 residues, as well as the C-terminal
      carboxyl. Geometrical comparison of the sets of low-energy backbone conformers
      for AT itself, and two analogs, [(alpha Me)Phe4]-AT and [Pro5]-AT, yielded the
      model for the receptor-bound conformation(s), which is compatible with cyclic AT
      analogs possessing substantial binding to specific AT receptors. A new analog, [D
      Tyr4, Pro5]-AT, was designed based on the proposed receptor-bound conformation.
      The analog showed a good affinity (IC50 = 42.8 nM) towards specific AT receptors.

PMID- 8363605
TI  - Lack of evidence for a role of Cys-138 as a base catalyst in the skeletal muscle
      6-phosphofructo-2-kinase reaction.
AB  - The role of Cys-138 in the catalysis of the skeletal muscle 6-phosphofructo-2
      kinase reaction was investigated by mutating this residue to serine, glutamine
      and alanine, expressing the mutants in E. coli with a T7 RNA polymerase-based
      expression system, and analyzing their kinetic properties. The Cys138Ala mutant
      had greatly diminished activity, while the Cys138Ser and Cys138Gln mutants had
      maximal velocities 2-3 fold higher than the wild-type enzyme. It was concluded
      that Cys-138 does not act as a base catalyst in the kinase reaction, but that it
      plays a significant structural role in the enzyme's active site.

PMID- 8363606
TI  - Novel affinity support prepared by crosslinking purified insulin receptors to
      agarose.
AB  - The insulin receptor interacts with other membrane proteins and possibly also a
      cytoplasmic second messenger(s) of insulin action. As an approach to identify and
      purify these ligands of the insulin receptor, we have developed an insulin
      receptor affinity support which retains the properties of the membrane associated
      insulin receptors. Insulin receptors first were purified from rat liver by
      affinity chromatography on wheat germ lectin agarose and insulin agarose. The
      purified insulin receptors then were crosslinked to agarose. The agarose
      immobilised insulin receptors had an affinity for insulin indistinguishable from
      the native receptors. In addition, insulin enhanced the autophosphorylation of
      the beta-subunit of these agarose immobilised insulin receptors. The insulin
      binding and autophosphorylation activities were stable for at least one week when
      this novel affinity support was stored at 4 degrees C.

PMID- 8363607
TI  - Cell density-dependent DNA fragmentation and its suppression by heparin in
      primary culture of adult rat hepatocytes.
AB  - We show here that the internucleosomal DNA fragmentation, which is a biochemical
      hallmark of apoptosis, was induced in a cell density-dependent manner in primary
      culture of adult rat hepatocytes. This DNA fragmentation could be suppressed by a
      gene expression inhibitor, indicating the active nature of this process.
      Moreover, the viability changes in high and low cell density cultures showed a
      tendency corresponding with the incidence of the DNA fragmentation in them. These
      results suggest that in hepatocytes there may be a cell density-dependent
      apoptosis mechanism. In this report, we also show that heparin could suppress
      this DNA fragmentation with high specificity, and the cell death to some extent.

PMID- 8363608
TI  - Organ distributions of liposome-loaded rat platelets.
AB  - Past in vitro functional assays have demonstrated that platelet function is not
      inhibited by liposome uptake. In the present study, the organ distributions of
      control and liposome-loaded Sprague-Dawley rat platelets were examined to
      determine whether liposome uptake enhances RES uptake. Platelets were isolated
      using STRactan density gradient centrifugation, incubated with small unilamellar
      liposomes in vitro for 1 hour, labeled with 51Cr and injected into a cohort group
      of rats. One hour post-injection the spleen, liver, lungs, blood, kidneys and
      bladder contents were removed and the percentages of the recovered dose localized
      per total organ (%RD) were determined. The RES index, defined as %RDliver +
      %RDspleen, were 24.8 +/- 4.5 and 20.5 +/- 5.0 for the control platelets and
      liposome-loaded platelets, respectively. These results indicate that liposome
      uptake does not enhance RES uptake.

PMID- 8363609
TI  - The uniquely distributed isoprenylated protein methyltransferase activity in the
      rat brain is highly expressed in the cerebellum.
AB  - Isoprenylated protein methyltransferase, the enzyme which catalyzes the
      reversible methylation of signal transducing G-proteins was studied in nine brain
      regions of the rat brain using S-farnesyl cysteine analogs as substrates. Enzyme
      activity, as determined with N-acetyl-S-farnesyl-L-cysteine (AFC) was found in
      the nuclear, synaptosomal and microsomal fractions of all brain regions but not
      in the cytosol. The enzyme is a unique methyltransferase with respect to its
      brain distribution. The rank order of activity of the enzyme is cerebellum >>
      midbrain > medulla > forebrain regions, where activities in cerebellar
      synaptosomal and nuclear fractions (28-32 pmol AFC [methyl-3H]ester formed/min/mg
      prot) are 20 to 30 times higher than those of the corresponding fraction of the
      forebrain regions. This distribution is reminiscent of that of neurotransmitter
      receptors and signal transduction molecules and suggests a regulatory role for
      the enzyme, particularly in the cerebellum.

PMID- 8363610
TI  - Inhibition of DNA repair and sensitization of cisplatin in human ovarian
      carcinoma cells by interleukin-1 alpha.
AB  - Interleukin-1 alpha induced an increase in both the cellular accumulation of cis
      diamminedichloroplatinum (II) (cisplatin) and DNA platination and significantly
      reduced the removal of platinum from DNA of human ovarian (NIH: OVCAR-3)
      carcinoma cells in culture. The combinations of IL-1 alpha and cisplatin were
      highly synergistic against these ovarian carcinoma cells and maximum levels of
      sensitization (15-20-fold) were observed during simultaneous exposure of
      cisplatin and IL-1 alpha. IL-1 alpha specific receptor antagonist decreased this
      synergy. These results strongly indicate that IL-1 alpha inhibits DNA repair, and
      this inhibition of DNA repair may explain, in part, a strong synergistic
      interaction between IL-1 alpha and cisplatin in NIH: OVCAR-3 cells.

PMID- 8363611
TI  - Butyric acid and its monosaccharide ester induce apoptosis in the HL-60 cell
      line.
AB  - Butyric acid is a potent cell growth inhibitor and differentiation inducer (1-4).
      However, the short plasma half-life of this fatty acid limits its potential
      therapeutic use (5,6). The recent synthesis of several monosaccharide esters of
      butyric sodium salt (BuONa) with a prolonged plasma half-life and similar
      biological properties as the sodium salt opens new perspectives (7-12). We report
      here that the human myeloid HL-60 cell line can be induced to apoptosis when
      cultured with one of these esters, monoacetone glucose 3-butyrate (MAG = 3but) or
      BuONa. Cytospin slide preparations and flow cytometric studies showed that HL-60
      cells treated with 1 mM MAG = 3but or BuONa exhibited a reduction in cell volume
      and condensation of nuclear structure characteristic of apoptosis, associated
      with monocytic differentiation. Time course studies demonstrated that DNA
      fragmentation, as determined by agarose gel electrophoresis, was detected 4 hours
      after incubation with the drugs, while morphologic signs appeared at day 3.
      Apoptotic cells increased with culture time and reached a maximum at day 6 of 20
      +/- 5% with BuONa, 25 +/- 5% with MAG = 3but, and only 5 +/- 2% in controls.
      These findings suggest that these drugs may exert their actions, at least in
      part, through induction of apoptosis.

PMID- 8363612
TI  - Isolation and structural characterization of the rat gene encoding the brain
      specific snRNP-associated polypeptide "N".
AB  - We isolated the gene encoding the brain specific snRNP-associated polypeptide "N"
      from a rat genomic library. Some intronless genes have previously been reported
      for this polypeptide in the rat. In contrast, our gene consists of at least nine
      exons (the last exon(s) encoding the 3'-end of the mRNA has not been isolated).
      The second intron of the gene is probably so long as to hamper the cloning of the
      complete gene into a single phage vector. Therefore, we used polymerase chain
      reaction amplification of the rat genome with oligonucleotides designed on the
      basis of known cDNA sequences that allowed us to isolate and clone the first two
      exons at the 5'-end of the gene. Primer extension studies revealed multiple
      transcription start sites, all of them contained within the first exon. The
      intron/exon organization coincides with the alternative splicing events suggested
      by the sequences of the various cDNA species isolated so far. As also reported by
      others, genomic Southern analysis suggests the presence of other genomic regions
      containing sequences strongly hybridizing to the cDNA. We isolated and
      characterized two of these regions. They contain sequences very similar to the
      cDNA, not interrupted by introns and flanked by a polyA tail at their 3'-ends;
      hence they are considered two different pseudogenes.

PMID- 8363613
TI  - Multi-level regulation of lysosomal gene expression in lymphocytes.
AB  - The expression of the gene coding for the lysosomal enzyme, beta-glucuronidase
      (Gus), was examined in functionally distinct T, B and plasma cell lines. Each of
      the different groups of cells had different intracellular levels of active Gus
      enzyme and numbers of Gus mRNA copies per cell. Analysis of the molecular forms
      of Gus mRNA and protein by Northern and Western blotting revealed that the
      different types of cells all produced a single mature 2.7 kb transcript and a 73
      kDa polypeptide. However, the utilisation of the Gus mRNA to produce the Gus
      antigen, and the subsequent posttranslational processing of the polypeptide to
      generate the mature, enzymically active Gus, were found to be cell type-specific.
      Control of the functional expression of the Gus gene is thus exerted at both the
      transcriptional and translational levels, and appears to differ between different
      types of lymphocyte.

PMID- 8363614
TI  - Stoichiometry of the human lysosomal carboxypeptidase-beta-galactosidase complex.
AB  - The understanding of the lysosomal beta-galactosidase-carboxypeptidase
      neuraminidase multienzymatic complex structure and function requires an efficient
      system for dissociation and association of its isolated protein components under
      controlled conditions. In this paper such a system was used to determine the
      stoichiometry of the two main components of this complex--beta-galactosidase and
      carboxypeptidase. The complex, after affinity purification from human placenta,
      was dissociated at pH 7.5 and beta-galactosidase and carboxypeptidase were
      separated and purified to homogeneity by FPLC anion-exchange chromatography. The
      680 kD complex of beta-galactosidase and carboxypeptidase was reconstituted in
      vitro by mixing the isolated enzymes in a 1:2 molar ratio at pH 7.5 and then
      progressively acidifying the medium towards the intralysosomal pH value of 4.75.
      Under the same conditions, beta-galactosidase and carboxypeptidase independently
      existed as 306 kDa tetramer and 98 kDa dimer, respectively. Reconstitution
      experiments with various ratios of purified beta-galactosidase and
      carboxypeptidase allowed us to conclude that the whole complex is made of 4 beta
      galactosidase and 8 carboxypeptidase monomers. Cross-linking of the native and
      reconstituted complexes with dimethylsuberimidate or glutaric dialdehyde
      suggested that the native and the reconstituted complexes have the same
      supramolecular structure.

PMID- 8363616
TI  - Conformational changes of human beta 1 thyroid hormone receptor induced by
      binding of 3,3',5-triiodo-L-thyronine.
AB  - To understand the structural basis in the hormone-dependent transcriptional
      regulation of human beta 1 thyroid hormone receptor (h-TR beta 1), we studied the
      conformational changes of h-TR beta 1 induced by binding of 3,3',5-triiodo-L
      thyronine (T3). h-TR beta 1 was treated with trypsin alone or in the presence of
      T3, thyroid hormone response element (TRE) or T3 together with TREs. Without T3,
      h-TR beta 1 was completely digested by trypsin. Binding of TREs had no effect on
      the tryptic digestion pattern. However, T3-bound h-TR beta 1 became resistant to
      tryptic digestion and yielded trypsin-resistant peptide fragments with molecular
      weight of 28,000 and 24,000. Chymotryptic digestion also yielded a T3-protected
      24 Kd peptide fragment. Using anti-h-TR beta 1 antibodies and amino acid
      sequencing, the 28 Kd fragment was identified to be Ser202-Asp456. The 24 Kd
      tryptic fragments were found to be Lys239-Asp456 and Phe240-Asp456. The 24 Kd
      chymotryptic fragment was identified to be Lys235-Asp456. The structural changes
      as a result of T3 binding could serve as a transducing signal to modulate the
      gene regulating activity of h-TR beta 1.

PMID- 8363615
TI  - GTP-binding protein couples with metabotropic glutamate receptor in bovine
      retinal on-bipolar cell.
AB  - GTP-binding protein (G protein) linking to metabotropic glutamate receptor of
      bovine retinal on-bipolar cell was studied by use of pharmacologically selective
      ligands, 2-amino-4-phosphonobutyric acid (APB) on bacterial toxin-catalyzed ADP
      ribosylation and GTP gamma S-binding. In contrast to the electrophysiological
      findings reported, G protein coupling to APB-sensitive glutamate receptor served
      as a substrate for pertussis toxin but did not for cholera toxin. Several
      glutamate analogues effective on on-bipolar cell, as well as APB, increased GTP
      gamma S binding to retinal membranes devoid of rod outer segments. The
      enhancement of GTP gamma S binding by APB was completely abolished when the
      membranes were pretreated with pertussis toxin and NAD. These results suggest
      that, in retinal on-bipolar cell, the G protein which couples metabotropic
      glutamate receptor to hyperpolarizing response of the cell is sensitive to
      pertussis toxin.

PMID- 8363618
TI  - Control of heme polymerase by chloroquine and other quinoline derivatives.
AB  - To evaluate the response of heme polymerase to treatment of malaria with
      chloroquine, we used mice infected with Plasmodium berghei. Six hours after
      treatment with 3 mumoles of chloroquine intraperitoneally per mouse, heme
      polymerase activity in parasitized erythrocytes decreased from 238 to 37
      nanomoles of ferriprotoporphyrin IX polymerized per hour per mumole of
      ferriprotoporphyrin IX in preformed hemozoin, and nonhemozoin ferriprotoporphyrin
      IX increased in vivo from 40 to 123 nanomoles per ml of packed, parasitized
      erythrocytes. Other 4-aminoquinoline derivatives were similar in effect to
      chloroquine. Treatment with quinine, mefloquine, primaquine, or naphthalene
      derivatives caused no reduction in heme polymerase activity. In contrast to 4
      aminoquinoline derivatives, quinine and mefloquine, which are quinolinemethanol
      derivatives, antagonized the effect of chloroquine.

PMID- 8363617
TI  - UTP activates phospholipase C-Ca2+ system through a receptor different from the
      53-kDa ATP receptor in PC12 cells.
AB  - Extracellular ATP (a purine nucleotide) and UTP (a pyrimidine nucleotide) both
      activated phospholipase C with a similar potency and efficacy; however, in
      contrast to ATP which induced a remarkable norepinephrine release, UTP-induced
      norepinephrine release was small in PC12 cells, a rat pheochromocytoma cell line.
      ATP, its derivatives (2-methylthioadenosine 5'-triphosphate (MeSATP) and 2'- and
      3'-O-(4-benzoylbenzoyl)adenosine 5'-triphosphate (BzATP)) and UTP increased
      intracellular Ca2+ in the presence of 2 mM extracellular Ca2+ with the potency
      order of ATP > MeSATP > BzATP = UTP. Under the low extracellular Ca2+ conditions,
      the Ca2+ response to purine nucleotides was markedly reduced, but the UTP
      response was not. The [32P]BzATP labeling of a 53-kDa putative ATP receptor
      coupled to a channel system (Majid, M.A., Okajima, F., and Kondo, Y. (1992)
      Biochim. Biophys. Acta 1136, 283-289) was markedly inhibited by ATP, but not by
      UTP. These results suggest that UTP activates the phospholipase C-Ca2+ system
      through a receptor different from the 53-kDa ATP receptor.

PMID- 8363619
TI  - Neuron-specific splicing of the Alzheimer amyloid precursor protein gene in a
      mini-gene system.
AB  - Several forms of Alzheimer amyloid precursor protein (APP) mRNA are generated by
      alternative splicing. Among them, the APP695 mRNA skipping the exon 7 and 8 is
      expressed specifically in neurons, suggesting that this alternative splicing is
      regulated in a neuron-specific manner. As the first step for investigating the
      mechanism of the neuron-specific splicing, a mini-gene system was developed, in
      which mini-APP genes consisting of the exon 6, 7, 8, 9 and their flanking regions
      were introduced into neuronal and nonneuronal cultured cell lines to see their
      expression profiles. In the system the exon 7 and 8 of the mini-gene were
      significantly skipped in the neuronal cell, and the deletion study indicated that
      cis-acting elements for skipping the exons existed in the corresponding skipped
      exon and its flanking regions. A small deletion upstream of the exon 8 suppressed
      the skipping of the exon 8 in the neuronal cell, suggesting that one of the
      regulatory sequence(s) for the exon skipping exists in a small region upstream of
      the skipped exon.

PMID- 8363620
TI  - Computational studies on the decarboxylation of 2-(1-carboxy-1-hydroxyethyl)-3,4
      dimethylthiazolium dipolar ion, an analog of the complex of pyruvic acid and
      coenzyme of the pyruvate decarboxylase.
AB  - We have obtained the optimized geometrical structure of 2-(1-carboxy-1
      hydroxyethyl)-3,4-dimethylthiazolium dipolar ion and investigated its geometric
      and electric changes during decarboxylation process by the MNDO-PM3 method, a
      molecular orbital method. The salient features of the optimized structure are
      that the dihedral angle of C4-C1-C2-S3 is 5.4 degrees and the distance between
      thiazolium S3 and carboxyl O6 is about 1.8 A (the bond order between S3 and O6 is
      about 0.4). The lowest energy decarboxylation profile is the following process.
      First the dihedral angle of C4-C1-C2-S3 becomes about 90 degrees, then the
      distance between C1-C2 increases while the dihedral angle holds about 90 degrees,
      and finally the C1-C2 bond disappears. The most remarkable change caused by the
      90 degrees rotation is the disappearance of the S3-O6 bond, and this
      disappearance causes electric changes that prompt the decarboxylation.

PMID- 8363621
TI  - Transport of the immunosuppressant 15-deoxyspergualin in human peripheral blood
      lymphocytes.
AB  - 15-deoxyspergualin (DSG) is a potent immunosuppressive compound currently in
      clinical trials. In this study, we have characterized the uptake and
      intracellular localization of DSG in human peripheral blood lymphocytes (PBL's).
      DSG is transported into human PBL's and reaches an estimated maximum
      concentration of approximately 500 microM in 6 hours. The majority of the [3H]
      DSG remains in the cytoplasm of cells and that which is associated with the
      nucleus is only loosely associated. DSG was transported by HeLa cells, as well,
      suggesting uptake is not specific for hematopoietic cells. Positively charged
      amino acids and polyamines, which are structurally similar to DSG, were unable to
      compete for DSG transport suggesting that DSG is transported into cells via a
      pathway distinct from amino acids or polyamines.

PMID- 8363622
TI  - Effects of changes in gonadal hormones on the amount of aromatase messenger RNA
      in mouse brain diencephalon.
AB  - Aromatase in brain is known to play a crucial role in development and maintenance
      of androgen dependent sexual behavior of males. Biochemical studies have shown
      that the aromatase activity in brain is influenced by androgen. In this study, we
      measured the aromatase mRNA content of mouse brain quantitatively to gain a
      deeper insight into this phenomenon. We found that in the diencephalic area it is
      sexually dimorphic, as reported for aromatase activity. The amount of aromatase
      mRNA in this area in males was 150% higher than that in females and decreased to
      the level in females after castration. The content of aromatase mRNA in castrated
      males was elevated by 2-fold by injection of testosterone and restored to the
      level observed in intact males. Injection of testosterone also affected the level
      of aromatase mRNA in normal mice of both sexes, though to lesser extent. On the
      contrary, injection of estrogen decreased the amount of aromatase mRNA in
      gonadectomized mice of both sexes. These results show that transcriptional
      control of the aromatase gene is involved in the mechanism of testosterone to
      affect sexual behavior.

PMID- 8363623
TI  - Effects of added albumin on the kinetic isotope effect observed in the microsomal
      oxidative demethylation of the methoxyl group.
AB  - The kinetic deuterium isotope effect on the microsomal oxidative demethylation of
      methoxyl groups was measured using methoxychlor, an insecticide, as a model
      compound. When the metabolic reactions were conducted in the presence of bovine
      serum albumin, the observed isotope effect was smaller than that in its absence.
      The values were unaltered when the albumin concentration was changed from 1% to
      2%. The results were interpreted by the alteration of the ES-complex
      formation/dissociation rate with the interaction between substrate and albumin.

PMID- 8363624
TI  - Bio-metabolism of green S and indigo carmine through caecal microflora of rats.
AB  - Bio-metabolism of two permitted food colours viz., Green S and Indigo Carmine,
      through caecal microflora of rats was investigated. Incubation of Green S with
      caecal flora resulted in one coloured and two fluorescent metabolites with the
      corresponding Rf values of 0.83, 0.33, 0.22, respectively. Indigo carmine was
      metabolized by caecal microflora to four [corrected] fluorescent metabolites with
      Rf values of 0.09, 0.27, 0.5 and 0.72. The DI 50 value of Green S was
      considerably higher (456 min) as compared to that of Indigo carmine (54 min).
      These results suggest that Green S and Indigo carmine are biotransformed to a
      variety of metabolites by rat caecal microflora.

PMID- 8363626
TI  - Strong promoter activity of human and rat islet amyloid polypeptide/amylin gene
      constructs in mouse beta cells (betaTC3).

PMID- 8363625
TI  - Attachments of pentaammineruthenium(III) to Trichoderma reesei cellobiohydrolase
      I increases its catalytic activity.
AB  - Pentaammineurthenium(III) was covalently attached to cellobiohydrolase I (CBH I,
      EC 3.2.1.91), the major component of Trichoderma reesei cellulase, resulting in
      0.7 mol ruthenium/mol CBH I and an electrode potential of +95 mV. Fractionation
      of modified CBH I by chromatofocusing resulted in the separation of fractions
      with a 1.4- to 3.2-fold increase in specific activity toward p
      nitrophenylcellobioside, depending on the assay conditions, over that of native
      enzyme. The extent of the hydrolysis of insoluble cellulosic substrates (Avicel
      and newsprint) to glucose by modified CBH I was also greater than that observed
      by the native enzyme.

PMID- 8363627
TI  - Protein identification by mass profile fingerprinting.
AB  - We have developed an algorithm for identifying proteins at the sub-microgram
      level without sequence determination by chemical degradation. The protein,
      usually isolated by one- or two-dimensional gel electrophoresis, is digested by
      enzymatic or chemical means and the masses of the resulting peptides are
      determined by mass spectrometry. The resulting mass profile, i.e., the list of
      the molecular masses of peptides produced by the digestion, serves as a
      fingerprint which uniquely defines a particular protein. This fingerprint may be
      used to search the database of known sequences to find proteins with a similar
      profile. If the protein is not yet sequenced the profile can serve as a unique
      marker. This provides a rapid and sensitive link between genomic sequences and 2D
      gel electrophoresis mapping of cellular proteins.

PMID- 8363628
TI  - Simultaneous resistance to vincristine and adriamycin appears at higher
      frequencies than to vincristine and etoposide in Chinese hamster ovary cells.
AB  - Efficacy of combination chemotherapy depends on the probability of a cell being
      resistant to at least two drugs simultaneously. In this study, we determined the
      frequencies of double drug resistance in the CHO AA8 cell line under combined
      exposure to vincristine plus adriamycin, vincristine plus etoposide, and
      adriamycin plus etoposide. These frequencies were compared to the expected
      frequencies which are the product of the independent frequencies observed for
      each drug alone. The results show a high frequency (up to 700-fold) of double
      resistance to adriamycin plus vincristine, a low increase (up to 30-fold) in
      frequency of resistance to vincristine plus etoposide, and an intermediate
      increase (200 to 300-fold) in frequency of cells resistant to adriamycin plus
      etoposide. The differences observed between combinations seem to be related, at
      least in part, to the mechanism(s) of resistance generally involved in the
      resistance to each drug: P-glycoprotein overexpression and/or DNA topoisomerase
      II alteration.

PMID- 8363629
TI  - Validation and use of cloned, expressed human drug-metabolizing enzymes in
      heterologous cells for analysis of drug metabolism and drug-drug interactions.

PMID- 8363630
TI  - Inhibition by Ro 31-8220 of acid secretory activity induced by carbachol
      indicates a stimulatory role for protein kinase C in the action of muscarinic
      agonists on isolated rat parietal cells.
AB  - The bisindolylmaleimide Ro 31-8220 is a selective inhibitor of protein kinase C.
      This compound was used to investigate the involvement of protein kinase C in the
      stimulation of gastric acid secretion by the muscarinic cholinergic receptor on
      rat isolated parietal cells. The accumulation of the weak base aminopyrine by
      both crude and enriched preparations of parietal cells was used as an index of
      secretory activity. Ro 31-8220 antagonized (IC50, 1.0 microM) the effect of the
      activator of protein kinase C,12-O-tetradecanoylphorbol 13-acetate (TPA), on
      histamine-stimulated aminopyrine accumulation. Ro 31-8220 (0.1-2.14 microM)
      inhibited the aminopyrine response to 0.1 mM carbachol (IC50, 0.78 microM; 49%
      inhibition at 2.14 microM Ro 31-8220) and shifted the dose-response curve for the
      effect of carbachol concentration of aminopyrine accumulation downwards and to
      the right. No inhibition of aminopyrine accumulation induced by histamine was
      found with Ro 31-8220 (0.1-2.14 microM). In a preparation containing > 80%
      parietal cells incubated with 0.1 mM carbachol, 2.14 microM Ro 31-8220 inhibited
      aminopyrine accumulation by 43%, but had no effect on the increase in
      intracellular Ca2+ which was measured by using the fluorescent probe FURA-2. In
      conclusion, Ro 31-8220 (0.1-2.14 microM) produced a selective reduction in
      secretory activity in parietal cells by inhibition of protein kinase C. The
      predominant role of protein kinase C in parietal cells activated with carbachol
      is not to cause feedback inhibition of the response but to facilitate stimulation
      of secretory activity.

PMID- 8363631
TI  - Taurine protects against the cytotoxicity of hydrazine, 1,4-naphthoquinone and
      carbon tetrachloride in isolated rat hepatocytes.
AB  - Exposure of rat hepatocytes to hydrazine, carbon tetrachloride or 1,4
      naphthoquinone results in cytotoxicity determined as uptake of Trypan blue and
      leakage of lactate dehydrogenase (LDH). After exposure of hepatocytes to
      hydrazine and 1,4-naphthoquinone, ATP was also measured and was found to be
      depleted. Addition of the beta-amino acid taurine to the hepatocyte incubation
      buffer partially protects the cells against the cytotoxicity of these three
      different cytotoxic compounds, as indicated by Trypan blue uptake and LDH
      leakage. Taurine also reduces the depletion of ATP caused by 1,4-naphthoquinone
      but not hydrazine. It is suggested that taurine may have a cytoprotective effect
      in vitro and may be a useful tool for the investigation of mechanisms of
      cytotoxicity.

PMID- 8363632
TI  - Suicide inhibition of monoamine oxidases A and B by (-)-deprenyl. A computer
      aided solution for determining inhibition specificity.
AB  - An analytical solution to the differential equations describing the kinetics of
      the suicide inhibition of a two-enzyme system has been derived and the modelling
      of suicide inhibition of the monoamine oxidases A and B (MAO A and B, EC 1.4.3.4)
      by a quasi-selective agent, (-)-deprenyl, is presented as an example. A new
      parameter, the specificity index is defined and used in a model which describes
      the specific and non-specific binding of (-)-deprenyl to MAO B and MAO A,
      respectively. This type of analysis may be of therapeutic value by indicating
      optimal dosage of quasi-selective MAO B inhibitors for the treatment of
      Parkinson's disease.

PMID- 8363633
TI  - Metabolism of methylamine by semicarbazide-sensitive amine oxidase in white and
      brown adipose tissue of the rat.
AB  - The metabolism of [14C]methylamine (MA) by amine oxidase activity in rat white
      and brown adipose tissue homogenates, and in mature adipocytes from these tissues
      has been studied. Oxidation of MA was completely inhibited by 0.1-1 mM
      semicarbazide, without being affected by the monoamine oxidase (MAO) inhibitor,
      pargyline (1 mM), indicating that MA is metabolized by semicarbazide-sensitive
      amine oxidase (SSAO) and not by MAO. The mean Km for MA deamination in all of
      these sources was around 250-300 microM. SSAO activity towards MA was also
      demonstrated in white and brown pre-adipocytes, transformed to the adipose
      phenotype by treatment in culture for 7 days with lipogenic agents. These results
      are similar to previous findings that SSAO in vascular smooth muscle is able to
      metabolize aliphatic amines such as MA, and furthermore suggest that SSAO may
      play a role in adipose tissue function and/or maturation.

PMID- 8363634
TI  - Changes in monoamine oxidase activity in mouse brain associated with d
      methamphetamine dependence and withdrawal.
AB  - The long-term effects of d-methamphetamine (MP, 5 mg/kg) on brain mitochondrial
      monoamine oxidase (MAO) activity were studied in mice given MP intraperitoneally
      daily for 4 weeks. The MAO activities decreased when serotonin (5-HT) and
      dopamine (DA) were used as substrates. A marked elevation in MAO activity was
      seen during MP withdrawal when 5-HT, DA, beta-phenylethylamine (beta-PEA) and
      norepinephrine (NE) were used as substrates. The kinetics of MAO showed a
      significant decrease in Km values, but no significant change in Vmax values
      during MP withdrawal, despite the presence of NE. The Km and Vmax values
      increased when NE was the substrate. Inhibition of MAO by MP or its metabolites
      (amphetamine, p-hydroxyamphetamine and p-hydroxymethamphetamine) increased with
      the use of the following substrates in the order: DA, 5-HT, NE and beta-PEA.

PMID- 8363635
TI  - Are lethal effects of nitracrine on L5178Y cell sublines associated with DNA
      protein crosslinks?
AB  - Nitracrine (Ledakrin, 1-nitro-9-(3,3-N,N-dimethylaminopropylamino)-acridine) is
      of interest as a DNA intercalator and alkylator with very high cytotoxic potency,
      especially against hypoxic cells. DNA-DNA crosslinks [Konopa et al., Chem Biol
      Interact 43: 175-197, 1983; Pawlak et al., Cancer Res 44: 4289-4296, 1984] or DNA
      protein crosslinks (DPCs) [Woynarowski et al., Biochem Pharmacol 38: 4095-4101,
      1989; Szmigiero and Studzian, Biochim Biophys Acta 1008: 339-345, 1989] are
      related to the toxicity of the drug. The cytotoxic effect of and DNA damage
      induced by nitracrine were measured in two sublines of mouse lymphoma L5178Y, LY
      R (resistant to ionizing radiation) and LY-S (sensitive to ionizing radiation).
      LY-R cells were more sensitive to nitracrine (D10 = 0.11 microM) than LY-S (D10 =
      0.35 microM) when treated for 1 hr at 37 degrees. To a DNA-DNA crosslinking
      agent, mitomycin C, the comparative sensitivity was opposite. LY-R cells were
      more resistant to this drug than LY-S cells (D10 = 7.1 vs 2.3 microM). DNA damage
      induced by nitracrine was measured by the alkaline elution method and by
      nitrocellulose filter binding assay. Nitracrine treatment with biologically
      relevant concentrations (0.1-3.0 microM, 1 hr, 37 degrees) induced only DPCs.
      Interstrand crosslinks and DNA breaks were not detected. Nitracrine produced
      about two times more DPCs in LY-R cells than in LY-S cells. Both sublines removed
      50% of initial lesions during 2 hr post-treatment incubation. The greater
      sensitivity of LY-R cells to nitracrine is thus not related to the efficiency of
      DNA repair, but may be a consequence of enhanced initial damage in the form of
      DPCs. This finding is consistent with the latter lesion being responsible for the
      cytotoxicity of nitracrine.

PMID- 8363636
TI  - Changes in amounts of cytochrome P450 isozymes and levels of catalytic activities
      in hepatic and renal microsomes of rats with streptozocin-induced diabetes.
AB  - Hepatic microsomal cytochrome P450s, which are involved in the metabolism of
      drugs, hormones, prostaglandins and fatty acids, change when animals develop
      diabetes. We studied changes in cytochrome P450 isozymes in both hepatic and
      renal microsomes of rats with diabetes caused by streptozocin, and compared the
      results with changes in catalytic activities in the microsomes. In hepatic
      microsomes of diabetic rats, the amount of cytochrome P450 2E1, an acetone
      inducible isozyme, was two and a half times that of control rats, and that of
      P450 4A2, a major renal isozyme, was three times that in the controls. The
      amounts of cytochrome P450s 2A1, 2C6, 2C7, 3A2 and 4A3 increased in hepatic
      microsomes of diabetic rats, and P450 2C11 decreased. Treatment with insulin
      restored these to the levels in the controls. The catalytic activities of aniline
      hydroxylation, 7-ethoxycoumarin O-dealkylation, testosterone 2 beta, 6 beta, 7
      alpha, and 16 beta-hydroxylation, and omega-, (omega-1)-hydroxylation of lauric
      acid were high in the hepatic microsomes of diabetic rats, and testosterone 2
      alpha and 16 alpha-hydroxylation activities were low. In renal microsomes of
      diabetic rats, cytochrome P450s 2E1, 4A2 and K-4 were induced, and omega- and
      (omega-1)-hydroxylation activities were high. These changes were reversed by
      insulin treatment. The induction and suppression of cytochrome P450 isozymes in
      diabetic rats were consistent with the changes in the catalytic activities. In
      both hepatic and renal microsomes, P450s 2E1 and 4A2 were induced, altered
      metabolism of ketones and fatty acids in diabetes may contribute to these
      changes.

PMID- 8363637
TI  - Reduction in the numbers of muscarinic receptors by an endogenous protein.
AB  - The soluble fraction from the ileal longitudinal muscle of guinea pigs was
      examined for the presence of an endogenous modulator of muscarinic receptors. In
      the presence of the soluble fraction, the binding of [3H]quinuclidinyl benzilate
      to the membranes from the tissue was inhibited in a concentration-dependent
      manner. The inhibitory activity in the soluble fraction was heat stable, but was
      inactivated by trypsin treatment. Several protease inhibitors had no effect on
      the inhibitory activity. These results suggest the existence of an endogenous
      protein that inhibits the binding of the muscarinic ligand to the receptor.
      Ultrafiltration demonstrated that the protein factor had a molecular mass of more
      than 10,000 Da. Saturation binding and dissociation kinetic experiments indicate
      neither a competitive nor allosteric mode of inhibitory action and suggest that
      an irreversible block or internalization of muscarinic receptors is induced by
      the endogenous protein.

PMID- 8363638
TI  - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) induced ethoxyresorufin-O-deethylase
      (EROD) and aldehyde dehydrogenase (ALDH3) activities in the brain and liver. A
      comparison between the most TCDD-susceptible and the most TCDD-resistant rat
      strain.
AB  - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a potent inducer of ethoxyresorufin
      O-deethylase (EROD) and aldehyde dehydrogenase (EC 1.2.1.3., ALDH3) enzyme
      activities in the liver. Little is known about their inducibility by TCDD in the
      brain, although it may be a target organ for TCDD toxicity. Two strains of rat,
      Long-Evans (L-E) and Han/Wistar (H/W) exhibit an over 1000-fold difference in
      their LD50-values for TCDD. The induction of EROD and ALDH3 in discrete brain
      regions and in the liver of L-E and H/W rats were now compared at 10 days after
      TCDD exposure to assess the role of these responses in the strain difference.
      Liver EROD and ALDH3 were maximally induced at 5 micrograms/kg and 50
      micrograms/kg, respectively, in both strains. In the brain 50 micrograms/kg TCDD
      was mostly needed to enhance EROD activity in both strains. The induction
      occurred especially in olfactory bulbs, but was also seen in the midbrain plus
      thalamus of both rat strains. The induced EROD activity in the olfactory bulb was
      almost totally abolished by a monoclonal antibody (Mab) 1-7-1 raised against
      CYP1A1. ALDH3 activities were increased more dose dependently in olfactory bulbs
      of H/W than L-E rats. In other brain areas measured, ALDH3 activities were
      induced more in L-E rats. Kinetic factors did not explain the differential
      induction of EROD and ALDH3 among discrete brain regions. We conclude that both
      EROD and ALDH3 are induced in the brain by TCDD although the activities are much
      lower than in the liver. The induction in the brain is region specific with
      olfactory bulbs being the most responsive area. As in the liver, the TCDD-induced
      activity of EROD in the brain is primarily associated with CYP1A1. According to
      the present findings, enzyme induction in the brain does not seem to have a
      crucial role in determining the strain susceptibility to the acute lethality of
      TCDD.

PMID- 8363639
TI  - Characterization of the transport system of prostaglandin A2 in L-1210 murine
      leukemia cells.
AB  - Prostaglandin (PG) A2 has been shown to be actively incorporated into mammalian
      cells and transferred to the cell nucleus. To characterize the properties of the
      PGA2 transfer system, we examined the status of PGA2 in L-1210 cells with
      modified cellular glutathione (GSH) levels. PGA2 in the cytosol fraction of the
      cells existed in its free-form, the GSH conjugate-form and a macromolecule
      associate-form (protein bound-form). When the GSH level was lowered under culture
      conditions, the amount of free-form increased while that of the protein bound
      form was unchanged. When PGA2-loaded cells were incubated in a salt solution,
      free- and conjugate-forms were emitted from the cells. A concomitant decrease and
      increase of protein bound PGA2 in cytosol and nuclei, respectively, were
      observed. Subsequent studies with isolated cellular fractions revealed that PGA2
      bound to cytosolic protein was transported into the nuclear interior in a
      temperature-dependent manner. The binding of PGA2 to the protein and subsequent
      transport to the nuclei were inhibited by PGJ2 and 4-hydroxy-cyclopentenone, but
      not by PGB2, PGD2, PGE2, PGF2 alpha, arachidonic acid or oleic acid. N
      Ethylmaleimide (NEM) and p-chloromercuribenzoate (PCMB) strongly interfered with
      these transfer processes, suggesting that sulfhydryl components are involved in
      the transport of PGA2. Subfractionation of cytosol by gel chromatography proved
      the presence of two proteins (100-150 kDa and 25-35 kDa) that are capable of
      transporting PGA2 to cell nuclei. Though 40-45 kDa proteins, which correspond to
      GSH S-transferases, bound to PGA2, they lacked the nuclear transport activities.

PMID- 8363640
TI  - Association of galactosamine-induced hepatitis in the rat with
      hyperhyaluronanaemia and decreased hyaluronan uptake by the isolated, perfused
      liver.
AB  - Plasma hyaluronan (HA) concentration and the rate of HA uptake by the isolated,
      perfused liver were measured in rats treated with saline, D-galactosamine (GaI
      NH2, 50 mg/100 g body wt), gadolinium chloride (GdCl3) (0.5 mg/100 g body wt),
      and GdCl3 + GaI-NH2. GdCl3 was given 24 hr before GaI-NH2 or saline. Plasma L
      alanine:2-oxoglutarate aminotransferase (EC 2.6.1.2), a marker for hepatocyte
      damage, was increased by 8 hr and remained elevated for 24 hr after GaI-NH2
      injection. GdCl3 did not affect plasma enzyme levels when given alone or in
      association with, but prior to, GaI-NH2. Plasma HA levels were increased (200%)
      within 24 hr after GaI-NH2 administration. A plateau was reached at 8 hr, which
      was maintained for at least 24 hr. Although GdCl3 alone did not affect plasma HA
      levels, it slightly delayed the increase in HA concentration in GaI-NH2-treated
      rats. Livers, isolated 24 hr after GaI-NH2 treatment, exhibited a severe
      depression (approximately 67%) of HA uptake. GdCl3 did not prevent this
      suppression. The data presented indicate that: (1) one of the sinusoidal
      endothelial cell-dependent functions of the liver, i.e. removal of HA from the
      blood stream, is profoundly impaired during galactosamine-induced hepatitis, and
      (2) the adverse effect of GaI-NH2 on this sinusoidal endothelial cell function
      may not be dependent on CdCl3-suppressible Kupffer cell functions.

PMID- 8363641
TI  - Effects of calcium channel antagonists on the phosphorylation of major protein
      kinase C substrates in the rat hippocampus.
AB  - K(+)-induced depolarization of rat hippocampal slices resulted in significant
      increases in the phosphorylation state of myristoylated, alanine-rich C kinase
      substrate (MARCKS; also known as 87K, pp80) and neuromodulin [also known as
      growth associated protein 43 (GAP43), B50, F1] as determined by back
      phosphorylation using protein kinase C. The effect of organic and inorganic Ca2+
      antagonists on the phosphorylation of these major protein kinase C substrates in
      the rat hippocampus was studied to determine whether Ca2+ influx through L- or N
      type voltage-sensitive Ca2+ channels was required for the phosphorylation changes
      observed. The depolarization-induced changes appeared to be dependent on
      extracellular Ca2+, based on evidence indicating that the chelation of
      extracellular Ca2+ with ethylene glycol-bis (beta-amino-ethyl ether)-N,N,N',N'
      tetraacetic acid (EGTA) inhibited these changes. In addition, pretreatment of the
      slices with 500 microM Cd2+, but not 300 nM nimodipine, 10 microM omega-conotoxin
      GVIA or 10 microM MK-801, blocked the K(+)-induced change in phosphorylation.
      These results suggest that K(+)-induced changes in the phosphorylation of MARCKS
      and neuromodulin are mediated by Ca(2+)-dependent mechanisms other than, or in
      addition to, those sensitive to the organic Ca2+ channel antagonists employed.

PMID- 8363642
TI  - Induction of rat liver drug-metabolizing enzymes by heterocycle-containing mono-,
      di-, tri- and tetra-arylmethanes.
AB  - The effect of a nitrogen heterocycle constituent on the ability of arylmethanes
      to induce phase I and phase II drug-metabolizing enzymes has been examined. Rats
      were treated with tetra-, tri-, di- or monoarylmethane compounds daily for 3 days
      at a dose of 75 mg/kg. Induction of UDP-glucuronosyltransferase (morphine)
      activity was seen with twelve of the eighteen compounds investigated, and for
      three compounds it occurred independent of any induction of cytochrome P450.
      Induction of glutathione S-transferase activity was seen with ten of the
      compounds and was generally paralleled by changes in overall cytochrome P450
      concentration and in both pentoxyresorufin and erythromycin dealkylase
      activities. Major induction of ethoxyresorufin deethylase activity was only
      apparent with two diarylmethanes that contained a 1-substituted imidazole moiety.
      UDP-glucuronosyltransferase (1-naphthol) activity was coinduced by these two
      compounds. A third compound, diphenyl-4-pyridylmethane, induced UDP
      glucuronosyltransferase (1-naphthol) activity without increasing ethoxyresorufin
      deethylase activity. Cytosolic sulfotransferase activity was not induced by the
      administration of any compound in this study. Among arylmethane derivatives, the
      presence of two aryl groups appeared to be a minimum requirement for induction of
      drug-metabolizing enzymes. If one of the aryl groups was not a heterocycle, or if
      the nitrogen atom of the heterocycle was sterically hindered, major induction of
      cytochrome P450 did not occur. With triarylmethanes, induction was independent of
      whether the heterocycle was imidazole, pyridine or pyrimidine.

PMID- 8363643
TI  - Interaction of adriamycin aglycones with isolated mitochondria. Effect of
      selenium deficiency.
AB  - Adriamycin (AdM) aglycones have dramatic effects on isolated heart mitochondria,
      oxidizing pyridine nucleotides, modifying sulfhydryl groups, and triggering a
      permeability transition of the inner membrane that results in free passage of
      solutes smaller than 1500 Da. In this investigation, the role of glutathione
      (GSH) peroxidase in these actions of the aglycones was evaluated, by comparing
      mitochondria from selenium-deficient and selenium-supplemented rats, with the
      following results. Selenium deficiency was without effect on the permeability
      transition of heart mitochondria, followed via Ca2+ release and triggered by AdM
      aglycone or by t-butyl hydroperoxide (TBH) or H2O2, both of which are authentic
      substrates of the peroxidase. The permeability transition of liver mitochondria
      was delayed by selenium deficiency regardless of the triggering agent; however,
      substantial triggering by the aglycone and TBH persisted in mitochondria from
      selenium-deficient animals. Selenium deficiency inhibited thiol modification
      elicited by AdM aglycone and H2O2 in heart mitochondria and by the aglycone, TBH,
      and possibly H2O2 in liver mitochondria. It would thus appear that AdM aglycone,
      TBH, and H2O2 can induce the permeability transition of isolated heart
      mitochondria via a process (or processes) distinct from the catalytic activity of
      the peroxidase. Furthermore, even in liver, where involvement of the peroxidase
      is observed, mechanisms other than the GSH cycle can contribute to transition
      induction by the aglycone and by TBH. Finally, mitochondrial-SH group
      modification by the aglycones appeared not to be causally linked to induction of
      the permeability transition. This laboratory has suggested that the effects of
      aglycone metabolites of AdM on mitochondria mediate the cardiotoxicity that
      limits use of the parent drug. The data presented in this paper argue against the
      involvement of GSH peroxidase in that process. They are in agreement with in vivo
      studies, which have generally failed to find evidence for amelioration of AdM
      cardiotoxicity in selenium-deficient animals.

PMID- 8363644
TI  - 9-cis-retinoic acid: a direct-acting dysmorphogen.
AB  - Experiments in vitro with cultured rat conceptuses demonstrated that 9-cis
      retinoic acid (9-cis-RA) (300 ng/mL amniotic fluid) produced branchial arch and
      somite defects similar to those elicited by equal concentrations of all-trans
      retinoic acid (all-trans-RA), but with an increase in cephalic defects that
      included missing optic vesicles. After conceptuses were intraamniotically
      microinjected with 600 ng 9-cis-RA/mL amniotic fluid on day 10 of gestation, an
      unusual heart defect was also observed. HPLC analyses indicated that 9-cis-RA
      readily underwent conversion to the less active metabolite, 13-cis-retinoic acid
      (13-cis-RA), in cultured conceptuses during the first 4 hr after treatment but
      only after 6 hr could elevated levels of the potent dysmorphogen all-trans-RA be
      detected. In separate experiments, conversion of 13-cis-RA or of all-trans-RA to
      9-cis-RA could not be detected during a 6-hr embryo culture period. Endogenous
      levels of 9-cis-RA in whole rat embryos also were below limits of detection but
      small quantities of this isomer could be detected in neonatal rat eye and human
      embryonic brain. Our present study strongly suggests that 9-cis-RA is a direct
      acting dysmorphogen with probable specific target sites of action.

PMID- 8363645
TI  - Membrane permeation mechanisms of 2',3'-dideoxynucleosides.
AB  - The mechanism of membrane permeation of several 2',3'-dideoxynucleosides was
      investigated at 37 degrees with human erythrocytes using an "inhibitor-stop"
      assay. Transport (per 5 microL cells) via the nucleoside and nucleobase carriers
      was assessed by inhibition of influx with dilazep and adenine, respectively.
      Mechanisms of cellular entry were highly individualized: 2',3'-dideoxyadenosine
      and 3'-deoxythymidin-2'-ene via nonfacilitated diffusion, with high rates; 2',3'
      dideoxyguanosine mainly via the nucleobase carrier (Km = 390 microM, Vmax = 32
      pmol/sec); 2',3'-dideoxyinosine by both nucleobase (Km = 850 microM, Vmax = 2.7
      pmol/sec) and nucleoside (Km = 7.4 mM, Vmax = 16 pmol/sec) carriers, with a low
      rate of nonfacilitated diffusion; and 2',3'-dideoxycytidine, equally by the
      nucleoside carrier (Km = 23 mM, Vmax = 65 pmol/sec) and by nonfacilitated
      diffusion, with a low rate. These results demonstrate that the nucleobase carrier
      plays an important role in the influx of two of these dideoxynucleotides and that
      nonfacilitated diffusion is not necessarily the chief mode of membrane permeation
      of this class of drugs.

PMID- 8363646
TI  - Prevention of neocarzinostatin-induced cell death and morphologic change in SK-N
      SH human neuroblastoma cells by continuous exposure to nerve growth factor.
AB  - Neocarzinostatin is an antineoplastic agent that induces differentiated
      morphology in human (SK-N-SH) neuroblastoma cells in culture. We have compared
      this morphological differentiation with that induced by the endogenous
      differentiation inducer, nerve growth factor (NGF), and have explored the effects
      of exposure to NGF upon the morphological changes induced by neocarzinostatin in
      SK-N-SH cells. Both NGF and neocarzinostatin induced process outgrowth in these
      cells. The processes formed in the presence of NGF however, were shorter and
      thinner than those induced by neocarzinostatin. Furthermore, only
      neocarzinostatin induced enlargement of the somata of the cells, and caused cell
      death in a concentration-dependent fraction of the culture. These distinguishing
      features of treated cells allowed us to determine whether or not NGF exposure
      altered responsiveness of the cells to neocarzinostatin. NGF (100-1000 ng/mL)
      protected SK-N-SH cells from the morphological and cytocidal effects of
      neocarzinostatin (1-hr exposure, 0.017 to 0.033 micrograms/mL). Protection from
      neocarzinostatin required that NGF be continuously present for a period beginning
      24 hr prior to neocarzinostatin exposure and continuing for the duration of the
      experiment, implying that the protection afforded by NGF has a latency
      necessitating pretreatment, and is reversible. These results suggest that
      neocarzinostatin is taken up by the cells and can exert its effects once NGF is
      removed, even after neocarzinostatin is washed out of the medium. The signal
      transduction cascade triggered by NGF receptor binding may prevent the action of
      neocarzinostatin or the expression of the cellular changes induced in SK-N-SH
      cells by neocarzinostatin.

PMID- 8363648
TI  - Effect of structural modification of alkyl N-propargylamines on the selective
      inhibition of monoamine oxidase B activity.
AB  - A series of alkyl N-methyl-propargylamine derivatives has been discovered
      recently to be very potent selective irreversible monoamine oxidase B inhibitors
      (MAO-B). In the present study, we used a simple compound in this series, namely N
      2-butyl-N-methylpropargylamine.HCl (2-BuMP), as the basic structure to
      investigate the effect of structural modification on the effectiveness and
      selectivity of the inhibition of MAO activities. When the N-methyl group was
      replaced by a hydrogen atom, an ethyl group or a propargyl group, MAO inhibitory
      activity was abolished. The modification of the propargyl group, e.g. to 3
      butynyl, N-cyanomethyl or to allyl groups, also destroyed the inhibitory
      activity. The potency of the inhibitors was related to the carbon chain length of
      the alkyl group as well as to the substitution of the alpha or the terminal
      carbon atoms. Substitution of hydroxyl, carboxyl or carboethoxyl groups on the
      terminal carbon of the alkyl chain drastically reduced the inhibitory activity.
      More potent MAO inhibitory activity was observed for molecules with a single
      methyl group substitution on the alpha carbon in comparison with those
      substituted with two hydrogen or two methyl groups. Other branched alkyl N
      methylpropargylamines, e.g. N-methyl-N-(3-pentyl)propargylamine, appeared to be
      slightly less selective in the inhibition of MAO-B activity. Some of these alkyl
      propargylamine MAO-B inhibitors, which do not possess the amphetamine-like moiety
      of L-deprenyl, may have significant neuropsychopharmacological implications.

PMID- 8363647
TI  - Hepatic disposition of acetaminophen and metabolites. Pharmacokinetic modeling,
      protein binding and subcellular distribution.
AB  - Successful pharmacokinetic modeling often requires the ability of a simple model
      to describe a complex series of physiological processes. However, a simple model
      may be inappropriate. Physiologically-relevant modeling may offer a more
      appropriate description, but requires further support from in vitro/in vivo data.
      A well-stirred hepatic model with linear processes was proposed to describe in
      vivo disposition of acetaminophen and metabolites after a 100 mg/kg bolus of
      acetaminophen to vehicle- or phenobarbital-pretreated, renal-ligated rats. Model
      simulations underpredicted acetaminophen glucuronide (AG) concentrations at early
      time points in serum, and were inconsistent with AG biliary excretion-rate
      profiles. Intracellular binding of AG by ligandin was hypothesized, and a
      cytosolic compartment with reversible binding was incorporated into the model. In
      this second model, only AG bound in the cytosolic compartment was available for
      excretion into bile. Model 2 better described the AG biliary excretion rate-time
      profiles based on calculated Akaike's information criterion values. However, no
      apparent change was observed in the underprediction of AG serum concentrations.
      Parameter estimates derived from the two models also were different. The rate
      constants regulating AG formation and sinusoidal egress were increased
      significantly after phenobarbital pretreatment according to model 1, while the AG
      biliary excretion rate constant was decreased significantly. Parameter estimates
      based on model 2 suggested that phenobarbital pretreatment impaired the cytosolic
      binding of AG but increased significantly the AG biliary excretion rate constant.
      The physiologic relevance of model 2 was not supported by a subsequent
      investigation of the protein binding and subcellular distribution of
      acetaminophen and metabolites. Acetaminophen, AG and acetaminophen sulfate (AS)
      were not bound extensively in hepatic cytosol (mean +/- SD unbound fractions were
      0.90 +/- 0.08, 0.97 +/- 0.08, and 0.88 +/- 0.06, respectively). Phenobarbital
      pretreatment did not alter significantly the unbound fractions of acetaminophen,
      AG or AS in hepatic cytosol. Acetaminophen was distributed to a greater extent in
      lysosomes than in the nuclear, mitochondrial, microsomal and cytosolic fractions.
      Distribution of AS predominated in cytosolic and lysosomal fractions. AG was
      detected only in cytosol. Phenobarbital pretreatment decreased the content of
      acetaminophen, AG and AS in all hepatic fractions. This study demonstrates the
      utility of pharmacokinetic modeling in exploring mechanistic hypotheses. However,
      these results underscore the importance of obtaining pivotal data from in
      vitro/in vivo studies to validate hypothesized mechanisms.

PMID- 8363649
TI  - Excretion balance and urinary metabolism of indobufen in rats and mice.
AB  - The excretion balance and the urinary metabolism of indobufen (+/- 2-[p-(1-oxo-2
      isoindolinyl)-phenyl] butyric acid), a platelet aggregation inhibitor, has been
      studied in rats and mice after oral administration. The urinary metabolic profile
      of indobufen exhibited a marked species difference. The major metabolic pathway
      in the mouse was acyl glucuronidation followed by renal excretion, whereas in
      rats, 5-hydroxylation and subsequent sulphation at the introduced hydroxyl group
      predominated. Comparison of these results with previous data obtained in humans
      indicates that the mouse, and not the rat, is the rodent species of choice to be
      considered in the study of this compound.

PMID- 8363650
TI  - 2',2'-Difluoro-deoxycytidine (gemcitabine) incorporation into RNA and DNA of
      tumour cell lines.
AB  - Gemcitabine (dFdC) is a new cytidine analogue which is active mainly by the
      incorporation of its triphosphate (dFdCTP) into DNA, leading to cell death. We
      determined incorporation of dFdC into nucleic acids of two solid tumour cell
      lines: the murine colon carcinoma cell line Colon 26-10, the human ovarian
      carcinoma cell line A2780, and the human leukemic cell line CCRF-CEM. dFdC was
      not only incorporated into DNA, but also into RNA. The extent of incorporation
      into DNA was highest in A2780 cells and lowest in CCRF-CEM cells (2-4-fold
      difference). The same pattern was observed for incorporation into RNA, but with a
      10-20-fold difference. In A2780, incorporation into DNA was about twice that of
      the incorporation into RNA, in CEM cells 10-20-fold that of RNA. Incorporation
      into RNA was verified using two methods for separation of RNA and DNA, acid
      precipitation and CsCl-gradient centrifugation. Incorporation into DNA was time
      and concentration dependent, but incorporation into RNA seemed to be only
      concentration dependent. We also determined the effect of dFdC on DNA and RNA
      synthesis by measurement of thymidine and uridine incorporation, respectively,
      using similar conditions as for the incorporation studies. In all three cell
      lines DNA synthesis was inhibited almost completely, even at 0.1 microM dFdC and
      at 4-hr exposure. RNA synthesis inhibition did not exceed 50% in both solid
      tumour cell lines, even at 1 microM dFdC exposure for 24 hr. A clear
      concentration effect was only observed in the CCRF-CEM cell line and only after
      24 hr exposure. At a 1 microM dFdC exposure for 24 hr, RNA synthesis was
      completely inhibited in these cells. Incorporation of dFdC into RNA and
      inhibition of RNA synthesis represent an unrecognized but possibly important
      mechanism of action of this drug.

PMID- 8363651
TI  - Orally administered prostaglandin E1 derivative can enhance liver regeneration in
      partially hepatectomized rats.
AB  - The effect of orally administered 17(S),20-dimethyl-6-oxo prostaglandin E1 (PGE1)
      methyl ester (OP) on liver regeneration was examined in 66% hepatectomized rats.
      Administration of OP increased the mitotic index of the hepatocyte 3 days after
      hepatectomy, and the mitotic index response due to OP was dose dependent. The OP
      administration had no effect on food intake, but reduced water intake. The serum
      scores relative to nutrition and hepatic function showed transient change after
      OP administration, whereas the serum blood urea nitrogen level indicated a slight
      renal dysfunction with OP. The fat store in the body was transiently reduced.
      These observations lead us to conclude that orally administered OP is capable of
      stimulating liver regeneration without serious systemic effects.

PMID- 8363652
TI  - The effect of 1,4-dihydropyridine and 1,4-dihydroindeno[1,2-b]pyridine
      derivatives on glutathione S-transferase activity in vitro.
AB  - The 1,4-dihydropyridine (1,4-DHP) and 1,4-dihydroindeno[1,2-b]pyridine (1,4-DHIP)
      derivatives were investigated as glutathione S-transferase (GT) inhibitors. The
      obtained results indicate that some of the 1,4-DHP's containing lipophylic and
      bulky substituents have inhibitory effects on GT in vitro. The derivatives of 1,4
      DHIP are more pronounced inhibitors.

PMID- 8363653
TI  - [Approach to the study of natural peptides from structure to functions. III.
      Structural organization of an adrenorphin molecule and its synthetic analogs].
AB  - Spatial structure of the peptide hormone adrenorphin was investigated by the
      theoretical conformational method. A solution of the "reverse conformational
      problem" for adrenorphin made it possible to predict a series of the modified
      synthetic analogues, which may assume one of the low-energy conformations of the
      native hormone.

PMID- 8363654
TI  - [Cloning the repeat sequence of the oxytocin gene].
AB  - Cloning of a synthetic gene of the oxytocin trimer is accompanied by deletions,
      caused by nicks in the plasmid DNA. Use of covalently closed circular double
      stranded DNA greatly reduces the number of the deletions.

PMID- 8363655
TI  - Antenatal diagnosis of Down's syndrome.

PMID- 8363656
TI  - A recombinant 15-kilodalton carboxyl-terminal fragment of Plasmodium yoelii
      yoelii 17XL merozoite surface protein 1 induces a protective immune response in
      mice.
AB  - Since the developmental stages of malarial parasites which replicate within
      erythrocytes are responsible for the morbidity and mortality associated with this
      disease, antigens produced by these stages have been proposed as candidates for a
      vaccine. One surface protein of merozoites (MSP-1) has been shown to immunize
      both rodents and primates against virulent challenge infection in experimental
      systems. However, little is known of relevant epitopes on the molecule, and
      attempts to obtain recombinant MSP-1 polypeptides in a native configuration have
      proven difficult. We have found that the cysteine-rich, carboxyl-terminal region
      of the MSP-1 protein from the rodent malarial parasite Plasmodium yoelii yoelii
      can be expressed in a native configuration as a fusion protein in Escherichia
      coli. This recombinant polypeptide containing 15 kDa of the predicted 197-kDa
      protein elicits antibodies in mice which recognize the native parasite MSP-1.
      Most significantly, both inbred and outbred mice immunized with the fusion
      protein in Ribi adjuvant are partially and in some cases completely protected
      against challenge infection with an otherwise lethal parasite strain. This is the
      first observation of such significant protection obtained with a small portion of
      the MSP-1 produced in recombinant systems.

PMID- 8363657
TI  - Medical messages on television. Copycat overdoses coincidental.

PMID- 8363658
TI  - Better quality data for Down's syndrome register.

PMID- 8363659
TI  - [Usefulness of electroencephalogram and transcranial Doppler sonography for brain
      function monitoring during selective cerebral perfusion].
AB  - It is well known that neurologic complications greatly affect the postoperative
      mortality of patients with aortic arch aneurysm. Selective cerebral perfusion
      (SCP) has been reported to be useful in maintaining cerebral circulation during
      aortic arch surgery. However, there has been no appropriate method to evaluate
      brain function during SCP. The purpose of this study was to introduce two new
      devices, the Lifescan electroencephalogram (EEG) monitor (Neurometrics) and the
      TC2-64 (EME) transcranial Doppler sonography (TCD), both used for monitoring
      brain function during SCP in patients undergoing aortic arch surgery. The
      Lifescan performs aperiodic analysis, and maps each waveform in relation to its
      frequency, amplitude, and time of occurrence rather than averaging a large number
      of waveforms over a given period. The Lifescan shows 80% of the whole amplitude
      of each wave as the activity edge (AE). The flow velocity of the middle cerebral
      artery was measured by TCD during SCP. With a decrease in body temperature, the
      EEG and AE gradually showed a trend toward a slower wave and lower amplitude.
      When circulatory arrest occurred prior to SCP, EEG and AE rapidly showed burst
      suppression, which was restored after the introduction of SCP. TCD could measure
      the flow velocity of the left middle cerebral artery even during cardiopulmonary
      bypass. The flow velocity disappeared during circulatory arrest and was restored
      after the induction of SCP. It is concluded that the adoption of EEG and TCD is
      useful in determining the intraoperative cerebral function during SCP.

PMID- 8363660
TI  - Advanced trauma life support.

PMID- 8363661
TI  - 12-O-tetradecanoylphorbol-13-acetate and staurosporine induce increased
      retinoblastoma tumor suppressor gene expression with megakaryocytic
      differentiation of leukemic cells.
AB  - The phorbol ester, 12-O-tetradecanoylphorbol-13-acetate (TPA), induced increased
      expression of the retinoblastoma (RB) tumor suppressor gene product in the course
      of megakaryocytic differentiation of the K562 human leukemia cell line, a
      differentiatively multipotent hematopoietic precursor cell. The induced increase
      in RB protein per cell occurred early, by 8 h of treatment, preceding any
      significant phenotypic differentiation evidenced by cellular expression of the
      CD41 differentiation-specific megakaryocytic cell surface marker, but not
      inhibition of cell cycle transit, leading to a cell population arrested with 2 n,
      4 n, and 8 n DNA content. The increase in RB protein per cell occurred for cells
      in all cell cycle phases. Staurosporine (STSP) was found to induce a similar
      course of cell cycle arrest and differentiation. Furthermore, STSP caused an up
      regulation of RB expression similar to that caused by TPA. Almost all of the RB
      protein is phosphorylated in untreated cells, but TPA and STSP both caused the
      late appearance of hypophosphorylated RB protein following cell cycle arrest. The
      STSP-caused hypophosphorylation was much later than the TPA effect.
      Hypophosphorylation of RB is, thus, not necessarily a prerequisite for cell cycle
      arrest but may be a consequence of G0. Given that TPA can be an activator and
      STSP an inhibitor of protein kinase C, it appears that the induced processes of
      tumor suppressor gene regulation and growth and differentiation control are not
      necessarily protein kinase C dependent in K562 cells. Furthermore, the findings
      that these two presumably divergent inducing agents caused a similar increase in
      RB gene expression suggests that the up-regulation of RB associated with
      differentiation is not a coincidence of just one specific inducer but may be a
      common essential feature of the induced differentiation. The amount of RB protein
      per cell increased within hours of exposure to TPA or STSP and may have a role in
      the induced metabolic cascade producing the new phenotype.

PMID- 8363662
TI  - Women and AIDS.

PMID- 8363663
TI  - Dental implant care: should it be a specialty?
AB  - There is a growing demand and need for dental implants, but treatment is reaching
      only a selected patient population. There is no indication that the profession is
      unable to meet current needs. The profession must make this care available to
      more patients, direct preventive measures to susceptible edentate populations and
      address the issue of entitlement to primary care.

PMID- 8363664
TI  - Fatal bronchospasm following streptokinase.

PMID- 8363665
TI  - Why have child pedestrian death rates fallen?
AB  - Pedestrian injuries are a leading cause of childhood mortality and disability.
      Over the past two decades in Britain child pedestrian death rates have fallen
      despite large increases in traffic volume. In this paper Roberts examines the
      likely reasons for this decline. He argues that neither prevention programmes nor
      improvements in medical care are a plausible explanation and that the decline is
      most likely the result of a substantial reduction in children's traffic exposure.
      He believes, however, that restricting children's traffic exposure exacerbates
      socioeconomic differentials in childhood mortality and denies children their
      right to mobility. Roberts is convinced that one answer is for British transport
      policy to be aimed at providing mobility equitably rather than struggling to meet
      the ever increasing demands of car travel.

PMID- 8363666
TI  - Surveillance for gonorrhea and primary and secondary syphilis among adolescents,
      United States--1981-1991.
AB  - PROBLEM/CONDITION: During the 1980s, an increasing proportion of adolescent women
      reported having had premarital sexual intercourse, thus potentially placing an
      increasing number of young persons at higher risk of acquiring a sexually
      transmitted infection. REPORTING PERIOD COVERED: To determine rates and examine
      trends of sexually transmitted infections among adolescents, we analyzed data for
      reported cases of gonorrhea and primary and secondary syphilis among 10- to 19
      year-olds for 1981 through 1991. DESCRIPTION OF SYSTEM: Summary data for cases of
      gonorrhea and primary and secondary syphilis that were identified and reported to
      state health departments were sent annually to CDC. These data included total
      number of cases by disease (gonorrhea, primary and secondary syphilis), sex,
      racial/ethnic group (white, not of Hispanic origin; black, not of Hispanic
      origin; Hispanic; Asian/Pacific Islander; or American Indian/Alaskan Native), 5
      year age group, and source of report (public, private). RESULTS: From 1981
      through 1991, 24%-30% of the reported morbidity from gonorrhea and 10%-12% of the
      reported morbidity from primary and secondary syphilis in the United States
      affected the adolescent age groups. Some of the highest rates of gonorrhea during
      that time period were among 15- to 19-year-olds. Gonorrhea rates among
      adolescents increased or remained unchanged from 1981 through 1991, while the
      rates among older age groups decreased. Although primary and secondary syphilis
      rates were lower among adolescents than older age groups, adolescents contributed
      to the epidemic of syphilis that occurred from 1987 through 1990. Differences in
      reported rates of both syphilis and gonorrhea among white, black, and Hispanic
      adolescents increased during the latter half of the 1980s. INTERPRETATION:
      Reporting biases could account for some the differences among rates for white,
      black, and Hispanic adolescents. However, if gonorrhea has been underreported for
      any racial group, the high rates of gonorrhea among 15- to 19-year-olds
      represented an underestimate of the true infection rate. Increases in sexual
      activity among adolescents and a lack of clinical services in settings convenient
      to adolescents could have contributed to the increasing rates of gonorrhea and
      syphilis among these young persons during this time period. ACTIONS TAKEN: If
      gonorrhea and other sexually transmitted infections are cofactors for
      facilitating the transmission of human immunodeficiency virus (HIV), the high
      incidence of gonorrhea in some locales among some populations of adolescents
      could result in dramatic increases in HIV acquisition, a situation that demands
      attention from public health organizations.

PMID- 8363667
TI  - [Comparative study of HMB-45 monoclonal antibody uptake on various benign and
      malignant melanocytic lesions].
AB  - In order to evaluate a possible discriminatory diagnosis interest of HMB-45
      monoclonal antibody in different melanocytic population, it was tested on 48
      benign and malignant melanocytic lesions embedded in paraffin. There were made of
      16 benign nevus (33%), 18 dysplastic nevus (38%) and 14 malignant melanomas
      (29%). The reaction was positive in 11 benign tumors (69%), 18 dysplastic nevus
      (100%), and 12 malignant melanomas (86%); negative in 5 dermal nevus (31%) and 2
      desmoplastic melanomas (14%). We have researched, by the KHI square (chi 2)
      statistical test, a relation between the reaction intensity, its cutaneous
      location, and the tumor type. The reaction intensity is not statistically linked
      with the tumor type. The cutaneous location of the reaction is statistically more
      heterogeneous in malignant melanoma than in benign or dysplastic melanocytic
      lesions. Among the dysplastic nevus, 6 cases (38%), of the familial type, have an
      heterogeneous reaction looking like the malignant melanoma's one. However, there
      is no significant difference, in the reaction pattern, between dysplastic and
      benign lesions. Nevertheless some dysplastic nevus seems to have a phenotypic
      expression for HMB-45 midway between benign and malignant melanocytic lesion,
      that will be interesting to precise. Otherwise, the simple use and the staining
      of HMB-45 monoclonal antibody are of great interest to assess the depth of
      primary cutaneous melanoma and to diagnose secondary melanoma. However, the
      negativity of the spindle cell type justify the association of other markers,
      particularly the S100 protein, which is more sensitive, in the diagnosis of
      desmoplastic malignant melanoma.

PMID- 8363669
TI  - [Localized osteoplastic bronchopathy with tumoral expression, including Al
      amyloidosis].
AB  - We report a case concerning a 65 year old man who suffered from a drug resistant
      asthma and radiographically visible mass in the right lower lobe of the lung.
      Pathological studies demonstrated it to be "Bronchopathia Osteoplastica",
      involving segmental bronchi, with completed hematopoietic metaplasia. This rare
      dystrophic lesion was associated with localized lambda light chain amyloidosis as
      was proved by the immunohistochemistry. This association suggests a possible
      relation between amyloidosis and abnormal osteogenesis.

PMID- 8363668
TI  - [Diagnosis of maxillo-facial Burkitt's lymphoma by needle puncture and cytologic
      examination. Experience in Cameroon].
AB  - The authors report their experience on diagnosis of maxillo-facial Burkitt's
      lymphoma using needle aspiration and cytology. In all the 21 patients presenting
      a histological proved Burkitt's lymphoma, the diagnosis was done before with
      cytology. This method has a 100% sensibility. Thus, cytologic diagnosis of
      maxillo-facial Burkitt's lymphoma is very reliable. In tropical areas with little
      revenues and where Burkitt's lymphoma is frequent, needle aspiration and cytology
      need to be well known and used.

PMID- 8363670
TI  - [Fibroma of the breast. A clinicopathologic study of a case].
AB  - Fibromatosis is a fibroblastic proliferation which has infiltrative properties
      and which is not expected to metastasize. Mammary fibromatosis is infrequent.
      Clinically, it may mimic breast carcinoma. So, the diagnosis is made from the
      microscopic examination. Wide local excision is the treatment of choice. But,
      local recurrence are frequent.

PMID- 8363671
TI  - [Report of a case of rhabdomyosarcoma of the central nervous system. Histologic,
      immunohistochemical and ultrastructural study].
AB  - A patient, aged 26, had a large parietal tumor, clinically revealed by
      intracranial hypertension and left sized paresthesia. Removal of tumor was
      followed by a rapid recurrence. Rhabdomyosarcoma was diagnosed on the second
      surgical specimen. These tumors are rare in the central nervous system. They
      occur mostly, though not exclusively, in young adults. Their prognosis is poor
      and their histogenesis is still unclear.

PMID- 8363672
TI  - [A cutaneous parasitosis rarely observed in France: chromomycosis].
AB  - The authors report a case of chromomycosis presenting like a tumoral lesion in a
      patient coming from the Isle de Mayotte. The causative agent is Fonsecaea
      pedrosoi. The evolution was favorable after surgical treatment. The epidemiology,
      the histopathological features, the diagnosis problems and the evolution of the
      illness are studied.

PMID- 8363673
TI  - [Histopathologic lesions in erythromelalgia during essential thrombocythemia].
AB  - Erythromelalgia is a vascular disorder of the extremities and is sometimes
      related to myeloproliferative syndrome with thrombocythemia. We report the
      cutaneous histopathology in case of erythromelalgia that revealed a
      thrombocythemia vera. Small arteries were occluded by thrombi of different age
      and narrowing of the lumen occurred by intimal proliferation of smooth muscle
      cells. There was no involvement of venules or capillaries. These vascular changes
      are highly suggestive of erythromelalgia and have not to be confused with
      necrotizing and/or granulomatous angiitis because of absence of fibrinoid
      necrosis and sparse inflammatory cells.

PMID- 8363674
TI  - [Autopsy protocol in the sudden infant death syndrome (SIDS)].

PMID- 8363675
TI  - [Malacoplakia of the breast].

PMID- 8363676
TI  - [A skin eruption 10 years after a trip to Haute-Volta].

PMID- 8363677
TI  - [Askin's tumor: a clinicopathologic entity?].

PMID- 8363678
TI  - [Polymerase chain reaction (PCR) and pathology. Technical principles and
      application].

PMID- 8363679
TI  - The role of single ECG, creatinine kinase, and CKMB in diagnosing patients with
      acute chest pain.
AB  - The objective of this study was to determine the combined accuracy of emergency
      department (ED) cardiac enzymes and electrocardiograms (ECGs) in patients who
      were admitted to "rule-out" myocardial infarction (ROMI). A retrospective
      analysis of ED creatinine kinase (CK), CKMB, and ECG was performed and the
      results were compared with final hospital diagnosis of MI, in the ED of a medical
      school- and university hospital-affiliated teaching Veterans Affairs Medical
      Center. Approximately 222 consecutive ED patients admitted to ROMI, including 43
      (19%) MI patients, 29 (67%) of whom presented to the ED within 24 hours of
      symptom onset were eligible to participate. Interventions included an analysis of
      CK and CKMB results and ECG findings. There were no statistical differences in
      the sensitivities, specificities, and predictive values when the two cardiac
      enzymes were compared. Almost all of the elevated cardiac enzyme results occurred
      in MI patients who presented within 24 hours of symptom onset, more than half of
      whom had ED cardiac enzyme elevations. For all MI patients, regardless of
      duration of symptoms, more than half of the ED ECGs had new ST-T changes
      consistent with an acute MI or acute myocardial ischemia. In the MI patients who
      presented within 24 hours of symptom onset, 79% had positive enzymes or ECG or
      both in the ED. No statistically significant difference in the sensitivity rates
      for MI between the CK and CKMB comparing enzymes with ECGs was found.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8363680
TI  - Effect of extreme temperatures on drugs for prehospital ACLS.
AB  - Advanced cardiac life support drugs undergo a wide range of temperature exposures
      in the prehospital setting. Although manufacturers place temperature restrictions
      for drug stability on their products, it has been shown that these limits are
      often exceeded in the prehospital environment. We exposed four different drugs to
      temperatures of -20 degrees C (-6 degrees F) and 70 degrees C (150 degrees F) and
      subsequently performed assays to determine their respective chemical stability
      compared with that of control samples. We determined that no significant
      difference in chemical structure occurred between the standard sample and the
      four drugs exposed to extreme temperatures (P > .05). This information has
      obvious implications in making further recommendations for drug storage. More
      work to determine bioactivity of temperature-exposed drugs may show results with
      implications for success in prehospital cardiac resuscitation.

PMID- 8363681
TI  - Oral labetalol versus oral nifedipine in hypertensive urgencies in the ED.
AB  - Therapy in hypertensive urgencies is debated and complicated by the side effects
      of available agents. In a prospective, randomized, open labeled study, the use of
      oral labetalol, an alpha- and beta-adrenergic blocker, with oral nifedipine in
      hypertensive urgencies in the emergency department was compared. Patients with
      diastolic blood pressures (DBP) of more than 120 mm Hg without criteria for a
      hypertensive emergency were eligible. The drugs were given in a loading manner
      with doses and timing based on their respective pharmacokinetics until a DBP of
      110 mm Hg or lower was obtained or 4 hours had passed. Either an initial
      labetalol dose of 200 mg and a repeat dose of 100 to 200 mg at 2 hours, depending
      on the DBP or nifedipine, 10-mg bite and swallow every hour up to a total dose of
      20 mg were given. Ten patients were enrolled into each study group. A 100%
      response rate was defined as a DBP of 110 mm Hg or less was observed for
      nifedipine and an 80% response rate for labetalol (P > .2) was observed. The mean
      time to control was 67.5 minutes for labetalol and 60.0 minutes for nifedipine (P
      > .2). The pretreatment pressure for labetalol was 195/127 mm Hg and for
      nifedipine was 198/128 mm Hg (P > .2), which decreased to a posttreatment
      pressure for labetalol of 154/100 mm Hg and for nifedipine of 163/100 mm Hg (P >
      .2). The mean decrease in systolic (SBP)/DBP was 42.6/26.5 mm Hg with labetalol
      and 34.9/28.4 mm Hg for nifedipine (P > .2). No significant side effects occurred
      with either drug.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363682
TI  - The effect of a class IV hurricane on emergency department operations.
AB  - The objective of this study was to determine the impact on emergency department
      (ED) operations of Hurricane Hugo, a class IV hurricane that struck Charleston,
      South Carolina, on September 21, 1989. The study design was a retrospective
      record-based descriptive study and mail survey of the ED of a 300-bed regional
      medical center directly in the path of the storm. During the 3 weeks after the
      storm, ED patient volume increased 19% over that of the 3 weeks before the storm.
      Increased visit volumes were evident for at least 3 months. Compared with a
      similar period of the previous year, there was an increase in the proportion of
      patients seen for lacerations of all types, puncture wounds, stings, and falls.
      Sixty-two percent of physician offices were still closed 7 days after the storm.
      The direct effects of a class IV hurricane on ED operations included major
      alterations in the volume and types of patient visits. Because of the evacuation
      of approximately 40% of the coastal population and storm damage hindering travel,
      the increase in visit volume was less in magnitude but of longer duration has
      been reported in class III hurricanes.

PMID- 8363683
TI  - Lupus patients with peripheral vascular thrombosis: the significance of measuring
      anticardiolipin antibody.
AB  - The purpose of this study was to determine the significance of measuring
      anticardiolipin (ACL) antibodies in Chinese lupus patients with peripheral
      vascular thrombosis. A total of 252 lupus patients were evaluated prospectively
      for the presence of peripheral vascular thrombosis in a 3-year period. Tests of
      ACL antibodies with three isotypes were done serially during follow-up. There
      were 10 lupus patients with five episodes of arterial thrombosis and seven
      episodes of venous thrombosis by the evidence of angiographical and/or
      pathological findings. The ACL antibody status was negative (< 2 standard
      deviation [SD]), low (2 to 5 SD) and high (> 5 SD) for 43.3%, 22.6%, and 34.1%
      patients, respectively. Patients with high levels (> 5 SD) of ACL antibodies had
      a high frequency of peripheral vascular thrombosis than patients with negative
      levels (> 2 SD) of ACL antibodies (P < .05). It is concluded that serial
      measurement of ACL antibodies in lupus patients is useful in predicting the
      occurrence of peripheral vascular thrombosis. Clinicians should be alert to the
      possibility of such complication in lupus patients with high ACL antibodies
      levels when visiting the emergency service.

PMID- 8363684
TI  - Infantile methemoglobinemia associated with acute diarrheal illness.
AB  - A case of an infant with diarrhea and acidosis associated with methemoglobinemia
      is presented. Of interest is that the association of diarrhea and acidosis with
      methemoglobinemia is more common than previously thought and can produce
      dangerously high methemoglobin levels. A review of the literature of this unusual
      occurrence along with clues to making the diagnosis are discussed.

PMID- 8363685
TI  - Isolated jejunal perforation from nonpenetrating abdominal trauma.
AB  - Although jejunal perforation from blunt trauma is a common injury, isolated
      jejunal perforation is an uncommon entity. A case of isolated jejunal perforation
      from blunt trauma is presented. This case showed that symptoms and physical
      findings from jejunal perforation may be minimal. The use of various diagnostic
      procedures, such as chest radiograph for free air, diagnostic peritoneal lavage,
      or abdominal computed tomography for diagnosing intestinal perforation were
      reviewed. Serial abdominal examination continued to be paramount in diagnosing
      intestinal injuries. Sufficient vigilance and suspicions of small bowel
      perforation should always be considered after blunt trauma even when symptoms and
      physical findings are minimal.

PMID- 8363686
TI  - Acute suppurative salpingitis with concomitant intrauterine pregnancy.
AB  - A 20-year-old woman presented to the emergency department with a history of lower
      abdominal pain and recent loss of consciousness. She was admitted with a primary
      diagnosis of abdominal pain; ectopic pregnancy was ruled out. The culture of the
      endocervix was positive for Neisseria gonorrhoeae. Surgical exploration of the
      pelvis was performed, and histological analysis of the specimen showed an acute
      suppurative salpingitis and an intrauterine pregnancy. The patient was placed on
      intravenous antibiotics. Postoperative course was unremarkable, and the patient
      was discharged on oral antibiotics. Although a rare entity acute suppurative
      salpingitis with concomitant intrauterine pregnancy are not mutually exclusive.
      Ectopic pregnancy should be the presumptive diagnosis when clinical presentation
      is consistent with pelvic inflammatory disease and pregnancy especially in the
      first trimester. Patients who are pregnant and exhibit clinical signs and
      symptoms that are consistent with salpingitis should be admitted for aggressive
      management of their high-risk pregnancy. Fetal wastage seems to be significant in
      spite of aggressive management. Endocervical culture for N gonorrhoeae should be
      obtained from all pregnant patients with follow-up treatment pending culture
      results. The following is a case presentation along with a review of the existing
      cases in the English literature and discussion of the possible pathogenesis and
      clinical outcome of this entity.

PMID- 8363687
TI  - Ruptured ectopic pregnancy after medical management: current conservative
      management strategies.
AB  - A case of hypotension caused by hemorrhage in a patient receiving systemic
      methotrexate to treat a known ectopic pregnancy is presented. A primary goal of
      gynecologic practice in the 1990s is to conserve tubal patency and fertility.
      Consequently, ectopic pregnancy is more frequently being managed by conservative
      strategies. The emergency physician must be familiar with conservative methods
      for the management of ectopic pregnancy and the complications that may cause
      emergency presentations in these patients.

PMID- 8363689
TI  - Cases in electrocardiography.

PMID- 8363688
TI  - The shorthand vertical mattress stitch: evaluation of a new suture technique.
AB  - The shorthand vertical mattress suture is a new suture technique that provides
      the same amount of wound eversion in less time than the classic method. A
      randomized, prospective clinical trial was designed to test this hypothesis in a
      University-affiliated community hospital. Thirty patients who presented to the
      emergency department with traumatic lacerations requiring primary closure were
      eligible for this study. Wounds involving the hands, feet, or face were excluded.
      Patients meeting inclusion criteria were allocated randomly to have either
      shorthand or classic vertical mattress sutures. Wound information was collected
      on data sheets and included physician training level, repair time, number of
      knots placed, and degree of wound-edge eversion for each suture technique.
      Subjects were then asked to return to the emergency department in 7 to 10 days
      for wound assessment and suture removal. Thirty-six lacerations to the scalp,
      trunk, and extremities were evaluated. Shorthand vertical mattress sutures were
      used on 20 wounds (56%) and classic mattress sutures were used on 16 (44%)
      wounds. The shorthand stitch provided the same amount of wound eversion in half
      the time as the classic technique. No infectious complications, delayed wound
      healing, or cosmetic problems were observed with the shorthand technique. The
      shorthand vertical mattress stitch described is an efficient, alternative method
      for laceration repair without compromising wound eversion or cosmetic results.

PMID- 8363690
TI  - Humanism in emergency medicine.
AB  - Emergency medicine has not yet appropriated "humanism" as a term of its own.
      Medical humanism needs to be interpreted in a way that is consistent with the
      practical goals of emergency medicine. In this essay, humanism in emergency
      medicine is defined by identifying the dehumanizing aspects of sudden illness and
      exploring of ways for sustaining the humanity of emergency department patients.
      Excerpts from Dr Oliver Sacks' autobiographical work A Leg to Stand On give voice
      to the human needs created by sudden illness and its treatment.

PMID- 8363691
TI  - Acute hemolytic anemia after ingestion of fava beans.

PMID- 8363692
TI  - Corneal abrasions secondary to activated charcoal.

PMID- 8363693
TI  - The case for lateral stiffness in walking orthoses for paraplegic patients.
AB  - The provision of walking for paraplegic patients has therapeutic benefits but
      must be at a low energy cost. Although claims have been made regarding the need
      for high lateral stiffness in any orthosis targeted at this group, much of the
      supporting evidence was confusing. This paper presents the theoretical reasoning
      behind this claim and reviews recent evidence that would appear to support it.

PMID- 8363694
TI  - Pressurization of bone cement under standard, flanged and custom acetabular
      components for total hip replacement.
AB  - Custom acetabular components are proposed to achieve uniform cement mantles, even
      in irregular acetabula presented at revision, in order to enhance fixation. One
      aim of developing custom components was to permit pressurization of bone cement
      by the components at insertion and maintain the pressure during polymerization. A
      model acetabulum was set up for the insertion of standard, flanged and custom
      components under constant force. Cement pressure was measured at the floor of the
      acetabulum by means of a piezoelectric diaphragm transducer. Polythene tubes were
      inserted in the model acetabular walls to estimate penetration of cement into
      cancellous bone. Insertion of the standard and flanged components caused cement
      pressures up to 106 kPa which decayed to less than 21 kPa as cement escaped at
      the rim and the components came into contact with the acetabulum. The custom
      component maintained a pressure of over 60 kPa during polymerization from an
      initial pressure of 105 kPa and examination of cement mantles on removal showed
      no evidence of contact. The custom component also showed enhanced penetration of
      cement, especially around the rim of the acetabulum. It is concluded that the
      custom component design achieves higher cement pressures and that better fixation
      will result.

PMID- 8363695
TI  - Friction and lubrication in cushion form bearings for artificial hip joints.
AB  - Two hip joint prostheses were designed and constructed to be
      elastohydrodynamically equivalent producing approximately equal initial contact
      areas and theoretical film thicknesses. One was made from conventional UHMWPE
      (ultra-high molecular weight polyethylene) and the other was a cushion component
      which had a low modulus layer introduced into the joint space. Friction
      measurements were carried out on a pendulum simulator apparatus and the two
      joints were compared. In addition the experimental results were compared with
      theoretical values of friction predicted from elastohydrodynamic lubrication
      theory. Values for the friction factor at peak load and peak velocity in the
      cushion cup (0.003-0.009) were much lower than in the UHMWPE cup (0.017-0.042).
      The low friction values in the cushion cup are consistent with fluid film
      lubrication in the contact with the thin lubricating film being preserved by
      microelastohydrodynamic action.

PMID- 8363696
TI  - Load concentrations around crystal aggregates in articular cartilage under short
      term loading.
AB  - The deposition of crystals in joints is a feature of a number of joint diseases.
      Crystals are frequently observed on the surface of articular cartilage and in the
      mid-zone. The purpose of this investigation was to model the stress
      concentrations in the mid-zone of the cartilage layer arising from the presence
      of large crystal aggregates. Scanning electron microscopy was used to determine
      the geometry and distribution of crystal aggregates within the cartilage layer.
      Finite element and photoelastic approaches were then used to predict the stress
      distribution around spherical aggregates 50 and 100 microns in diameter. The
      implication of the results is that very densely packed and tightly bound
      spherical aggregates will themselves carry a certain amount of load. However,
      less tightly packed aggregates, perhaps interspersed with fibrous tissue, are
      potentially much more damaging.

PMID- 8363697
TI  - Wear of articular cartilage: the effect of crystals.
AB  - An investigation of the effect of crystals in a lubricant on the wear of
      articular cartilage in vitro was carried out in order to examine the hypothesis
      that crystals present in synovial fluid could cause abrasive damage of the
      articular surface. Plugs of cartilage were worn against a stainless steel
      counterface in a pin-on-disc wear rig. The concentration of cartilage debris
      present in the lubricant was assessed by measuring the bound sulphate originating
      from the glycosaminoglycans by ion chromatography. Results indicated that the
      presence of crystals in the lubricant significantly increased the concentration
      of wear debris and that the crystal size and morphology influenced the type of
      damage sustained by the cartilage. Other experimental evidence suggested that
      cartilage scratched in vivo was no more susceptible to further in vitro damage in
      this experimental model than normal cartilage. These results implied that
      crystals present in the synovial fluid of arthritic joints have the potential to
      cause excessive wear of the articular surface, but that if such crystals are
      removed the scratched cartilage may not be susceptible to any further damage by
      abrasive wear.

PMID- 8363698
TI  - Sliding friction analysis of phosphatidylcholine as a boundary lubricant for
      articular cartilage.
AB  - Dipalmitoyl phosphatidylcholine (DPPC), the major lipidic component of the
      synovial fluid (45 per cent), has been implicated in previous studies in synovial
      joint lubrication as a potential boundary lubricant for articular cartilage. The
      purpose of this study was to evaluate the effectiveness of DPPC as a boundary
      lubricant at physiological stresses experienced by weight-bearing joints (up to
      7.5 MPa). The sliding coefficients of static and kinetic friction for glass
      surfaces coated with DPPC layers of physiological thickness (70 nm) were measured
      as a function of average contact stress, contact geometry (point and line),
      applied load and relative velocity (from 25 to 0 mm/s) and compared to the
      coefficient of friction for clean glass in the same conditions. The coefficient
      of friction for DPPC-lubricated surfaces was dependent on contact geometry,
      obeyed Amonton's law (not dependent on axial load or contact area), was dependent
      on relative velocity within the range stated and was an effective lubricant at
      physiological stresses. This study showed that dipalmitoyl phosphatidylcholine
      can be an effective boundary lubricant at stresses observed in load-bearing
      joints. Because of their surface-active nature, these adsorbed molecules might
      also act as a protective layer for the articular surfaces.

PMID- 8363699
TI  - Ligament forces at the knee during isometric quadriceps contractions.
AB  - A mathematical model of the knee in the sagittal plane was used to investigate
      the ligament forces resulting when a posteriorly directed external force, applied
      to the tibia, resists extension of the knee under increasing isometric quadriceps
      contractions. The model is based on simple geometric representations of the
      bones, ligaments and muscles at the knee. An elementary mechanical analysis was
      used to predict which ligament, the anterior or posterior cruciate, was loaded at
      a given flexion angle and known line of action of the external force. Ligament
      force, as a proportion of the external force, was calculated first assuming the
      ligaments to be represented by single, inextensible lines. Modelling the
      ligaments as continuous arrays of extensible fibres then showed that tibio
      femoral translations and ligament forces increased non-linearly with increasing
      muscle forces and approached asymptotic values which depended on flexion angle.
      In most positions of the joint, the calculated asymptotic ligament force values
      were less than the reported ultimate strength of human ligament, despite
      quadriceps forces of over three times body weight. The possibility of these
      asymptotic values of ligament force may explain why, at certain flexion angles,
      large forces can be developed by the muscles at the knee without ligament
      rupture.

PMID- 8363700
TI  - Application of 2D 1H NMR spectroscopy to the study of the brain, spinal cord, and
      sciatic nerve.
AB  - Homonuclear 1H 2D NMR spectroscopy (COSY experiments at 400 and 600 MHz) were
      used to study the rat brain in vivo and the rabbit spinal cord and sciatic nerve
      in vitro. The following metabolites were identified: lactate, alanine, threonine,
      GABA, glutamine/glutamate, N-acetyl aspartate, aspartate, taurine, inositol
      derivatives, choline derivatives, and glucose. The sciatic nerve spectra showed
      characteristic COSY graphs of saturated and unsaturated fatty acids, and linoleic
      and linolenic type structures were identified.

PMID- 8363701
TI  - Dopamine receptors status after unilateral nigral 6-OHDA lesion. Autoradiographic
      and in situ hybridization study in the rat brain.
AB  - The physiological effects of dopamine (DA) are mediated by several distinct
      receptor subtypes. The effects of unilateral nigral 6-hydroxydopamine (6-OHDA)
      lesions on DA receptors were investigated by receptor autoradiography using the
      D1 selective ligand [3H]SCH 23390 as well as the D2 ligand [3H]spiroperidol. mRNA
      distribution was studied by in situ hybridization. Lesioned rats were sacrificed
      at different time intervals. Receptor binding studies were performed on tissue
      sections using selective ligands. [35S]UTP labeled RNA probes were prepared from
      the different cDNA (D1, D2, D3) and used for in situ hybridization. A specific
      loss of receptor binding sites and mRNA hybridization was found in the lesioned
      substantia nigra pars compacta (SNc) at all times examined. Receptor binding
      studies revealed a different time-dependent increase in both D1 and D2 receptors.
      In situ hybridization showed that only D2 receptor mRNA increased in the caudate
      putamen (CPu) of the lesioned side 15 d after 6-OHDA. No changes were observed in
      D1 and D3 receptor mRNA during the entire time-course.

PMID- 8363702
TI  - The value of transcranial Doppler sonography in the differential diagnosis of
      Alzheimer disease vs multi-infarct dementia.
AB  - Primary degenerative dementia of the Alzheimer type and multi-infarct dementia
      exhibit differences in cerebrovascular blood flow velocity profiles, which were
      investigated by means of transcranial Doppler sonography. The pulsatility
      indices, as angle-independent parameters of peripheral vascular resistance,
      measured in middle cerebral and basilar arteries of patients with multi-infarct
      dementia (MID), were significantly increased (p < 0.005) with respect to cases of
      primary degenerative dementia of the Alzheimer type and to healthy age-matched
      controls. Approximately 75% of all MID patients exhibited small vessel disease
      rather than thromboembolism from the extracranial arteries and the heart, as
      judged by extracranial and transcranial Doppler sonographies, computerized
      cerebral tomographies, EEGs, and, if necessary, 2-D echocardiographies.

PMID- 8363703
TI  - Natural histidine-containing dipeptide carnosine as a potent hydrophilic
      antioxidant with membrane stabilizing function. A biomedical aspect.
AB  - A review on the distribution and biological effects of carnosine and a hypothesis
      for its biological mechanisms of action are presented. Carnosine and its
      structural and functional relative, anserine, were found in skeletal muscles at
      the beginning of the century. Their effects on muscle-working capacity, on the
      stability of membrane-bound enzymes, as well as their potent immunomodulating
      property, could not be explained by their pH-buffering capacity or formation of
      the secondary metabolites histidine and beta-alanine alone. This article suggests
      that the basis for the biological activities of carnosine and relative compounds
      is their potent antioxidant and membrane-protecting activity. The plausible
      chemical mechanism of this activity is discussed, and data regarding the usage of
      carnosine as a drug for treatment of immunodeficiency are summarized.

PMID- 8363704
TI  - The role of the active site amino acid residues on the catalytic activity of
      Cu2Zn2SOD.
AB  - Copper, zinc superoxide dismutase, the enzyme that catalyzes the dismutation of
      the superoxide ion, is a key enzyme for neurodegenerative processes caused by the
      formation into tissues of this reactive free radical. Although the structure of
      enzyme is known, the catalytic mechanism has not yet fully elucidated. The copper
      ion represents the center, which exchanges electrons with the superoxide ion, but
      other residues present in the active site seem to play a relevant role. The most
      recent advancements in clarifying the structure-function relationship in this
      enzyme are discussed.

PMID- 8363705
TI  - Membrane lipid degradation during ischemia and impact on the monolayer surface
      pressure area diagram (SPAD).
AB  - This article briefly reviews the importance and relevance of membrane lipid
      degradation to the pathogenesis of ischemic brain damage ranging from the
      liberation and accumulation of free fatty acids (FFA) to their consequences on
      the biophysical characteristics of membrane lipids. The rapid accumulation of
      brain FFA during cerebral ischemia is a hallmark of the evolution and
      pathogenesis of ischemic brain damage: It signals the degradation of membrane
      lipids; it generates the precursors to the metabolically and physiologically
      potent eicosanoids; and it promotes the generation of lipid oxidizing free
      radicals, which could propagate the destruction of membrane lipids. The impact of
      ischemia-induced changes in cerebral membrane lipid composition on membrane
      function is difficult to assess in vivo. Some estimate of the impact of the
      changes, however, can be obtained by evaluating the changes induced in the
      surface pressure-area diagrams (SPAD) of membrane lipid monolayers at the air
      water interface. Lipid monolayers are used as model membranes to study the
      effects of lipid composition on the biophysical behavior of membrane lipids and
      their interaction. Regional brain lipids were quantitated at different times
      during ischemia, and their impact on their surface pressure area diagrams was
      assessed and their potential impact on membrane function discussed.

PMID- 8363706
TI  - Evidence for a membrane lipid defect in Alzheimer disease.
AB  - We have previously shown that cells normally maintain their lipid metabolic pools
      at a critical composition, appropriate for spontaneous assembly of a stable
      membrane bilayer at their physiological temperature. When disease affects
      membrane lipids such that the new composition will only form a stable bilayer at
      a critical temperature (T*), which differs from the physiological value, membrane
      destabilization and hence cellular damage will necessarily ensue. We have
      previously tested this pathogenetic mechanism in metachromatic leukodystrophy, a
      disorder with a known primary lipid metabolic defect. In the present study, we
      found T* for cerebral cortex lipids from three Alzheimer disease (AD) patients
      ranged between 19 and 28 degrees C, independent of membrane protein composition.
      Control cortex lipids yielded a normal value for T* of 37 degrees C. Thus, one
      possible mechanism for neurodegeneration in AD is membrane destabilization
      secondary to a lipid compositional aberration, which shifts T* away from 37
      degrees C. This lipid defect is brain region-specific as cerebellar lipids from
      the AD patients gave a normal value for T*. Studies aimed at delineating the
      nature of the biochemical anomaly are in progress.

PMID- 8363707
TI  - Inflammation and the brain.
AB  - Inflammation in the brain selectively damages the myelin sheath resulting in a
      variety of clinical syndromes of which the most common is multiple sclerosis. In
      these disorders, the areas of inflammation and demyelination can be identified in
      life by magnetic resonance imaging. Events occurring at the blood-brain barrier
      depend on T-cell activation, which increases immune surveillance within the
      central nervous system. T-cells activated against brain antigens persist to
      establish the conditions needed for inflammatory demyelination and this depends
      on local release of cytokines, culminating in removal of oligodendrocytes and
      their myelin lamellae by macrophages or microglia. These interactions involve
      binding between receptors present on microglia for the Fc portion of antibody and
      complement components to corresponding ligands on target cells. Taken together,
      the evidence from clinical and experimental studies provides a rationale for the
      issue of immunological treatments in patients with multiple sclerosis.

PMID- 8363708
TI  - Mechanisms of hypoxic and ischemic injury. Use of cell culture models.
AB  - Cell cultures are useful tools to study the mechanisms involved in cell death
      following hypoxia or ischemia. By manipulating the extracellular environment,
      conditions that closely mimic the conditions that are thought to occur in vivo
      can be produced. These conditions permit study of cell's reaction to the trauma
      under specific conditions. Monitoring of the extracellular pH and ionic
      environment in cell cultures is much easier than in vivo. Further, metabolites
      produced by injured cells can be quantitated easier from cultures than from
      tissues in vivo. Cell cultures have recently been used to examine in detail the
      neurotoxicity of glutamate. Intracellular Ca2+ increases appear to be involved in
      the mechanisms of neurotoxic cell death. This Ca2+ entry appears to be through
      the NMDA receptor's Ca2+ channel. Ischemic and hypoxic injury produced by
      mechanisms other than glutamate neurotoxicity appear to involve increases in
      intracellular Ca2+ by releasing internal Ca2+ stores or by the influx of
      extracellular Ca2+. This Ca2+ entry may be through voltage-gated channels of the
      NMDA channel, or may be attributable to membrane perturbations. Through the use
      of cell cultures, each of the mechanism's involvement in the injury can be
      delineated.

PMID- 8363709
TI  - Pseudoverdin, a compound related to the pyoverdin chromophore from a Pseudomonas
      aeruginosa strain incapable to produce pyoverdins.
AB  - From a genetically manipulated strain of Pseudomonas aeruginosa ATCC 15692 (PAO1
      strain) a compound named pseudoverdin, 3-formylamino-6,7-dihydroxycoumarin, was
      obtained which is related to the typical pyoverdin chromophore and thus allows to
      shed some light on the biogenesis of the latter.

PMID- 8363710
TI  - Azadirachtin inhibits proliferation of Sf 9 cells in monolayer culture.
AB  - Azadirachtin A in ppm quantity inhibits proliferation and monolayer formation of
      Spodoptera frugiperda (Sf9) insect cells in monolayer culture. The incubated
      cells demonstrate reduced rates of protein synthesis which finally leads to cell
      death. This growth inhibiting activity is compared with other botanicals such as
      ohchinin, salannin and volkensin. The high and specific activity of azadirachtin
      A on insect cells is discussed in comparison with its effect on a mammalian cell
      line, based on 2 D PAGE analysis of the total protein contents.

PMID- 8363711
TI  - Inter- and intraspecific variation of the nucleotide sequence of the cytochrome b
      gene in Cory's (Calonectris diomedea), Manx Shearwater (Puffinus puffinus) and
      the Fulmar (Fulmarus glacialis).
AB  - The cytochrome b gene of three European taxa of the family of Procellariidae was
      amplified from total DNA and sequenced. The sequence comparison shows that the
      Fulmar (Fulmarus glacialis) is significantly distinct from shearwaters, whereas
      Cory's (Calonectris diomedea) and Manx Shearwater (Puffinus puffinus) are closely
      related. Although the populations of C. diomedea can be distinguished
      morphologically, the sequences of cyt b differ only slightly between the Atlantic
      and Mediterranean subspecies (i.e. C. d. borealis versus C. d. diomedea) and do
      not reveal other population differences within subspecies.

PMID- 8363713
TI  - [Autopsy-confirmed nosocomial infections among the deaths in an intensive care
      unit].
AB  - In a 6-year retrospective study the occurrence of autopsy-confirmed nosocomial
      infections in 282 deceased patients of an intensive care unit was investigated.
      The autopsy rate was 100%. In 107 deceased (37.9%) 126 nosocomial infections were
      confirmed. The most common nosocomial infection was bronchopneumonia (54%). The
      main ailment was non-tumorous diseases of the digestive system (43.9%). In nearly
      60% of the 107 deaths, nosocomial infections were the immediate cause of death.
      In all 282 deceased, hospital infections were the direct cause of death in 22.7%
      of these cases. The study emphasizes the importance of nosocomial infections as a
      causal or contributory factor in the death of patients in an intensive care unit.

PMID- 8363712
TI  - [Should the use of succinylcholine in pediatric anesthesia be re-evaluated?].
AB  - We report on the occurrence of cardiac arrests within a few minutes following
      succinylcholine in 9 children, all of whom were later shown to have occult
      neuromuscular disease. Five of the children did not survive the catastrophic
      event. The anaesthetist in most cases, when discussing premedication, got the
      impression that the patients were in good health; just in 2 children were there
      indications of myopathy. Myopathic children coming to surgery and anaesthesia are
      rare. In these cases the administration of succinylcholine is contraindicated.
      But the anaesthetist must be aware of the fact that a small number of paediatric
      patients with unknown/subclinical myopathies might be referred to him. In these
      cases, without warning muscle rigor, bradycardia and hyperkalemia cardiac arrest
      may develop within minutes following administration of succinylcholine. The
      anaesthetist must be prepared for such a challenging event--particularly
      mentally. Misinterpretation of the symptoms as signs of malignant hyperthermia
      should be excluded. Resuscitation must start without delay and must continue for
      more than 30 minutes. Therapeutic attempts to lower extracellular potassium with
      glucose and insulin must fail for pharmacokinetic reasons. Therapy with
      intravenous calcium under control of the e.c.g. seems to be the only rational
      approach to the problem. It is suggested that in every healthy child coming to
      anaesthesia the physician should consider whether relaxation could not be
      achieved by other agents. Succinylcholine may well be defined as a "membrane
      poison"--especially considering the efflux of potassium, myoglobin and creatine
      kinase from the intracellular space into the bloodstream. The answer to the
      question asked in the title must therefore be: definitely--yes.

PMID- 8363714
TI  - [Intraoperative cardiopulmonary disorders during esophagectomy in relation to the
      surgical technique].
AB  - Twenty-one healthy female sheep were anaesthetised in a standard technique with
      ketamine, dehydrobenzperidol and etomidate. In seven sheep an endoscopic
      esophagectomy was made (group 1), in seven a blunt esophagectomy (group 2) and in
      a further seven a thoraco-abdominal esophagectomy (group 3). ECG monitoring,
      invasive blood pressure measurement, measurement of the central venous pressure
      and the pulmonary artery pressure with estimation of cardiac output, arterial and
      mixed venous blood gas analyses were made. The measurement times were: ZDM 1 =
      preoperative, ZDM 2 = after laparotomy, ZDM 3 = after cervical esophagus
      preparation or thoracotomy, ZDM 4 = after esophagectomy, ZDM 5 = after inflation
      of the lungs and ZDM 6 = after a second exploration of the esophagus bed (only
      groups 1 and 2). Finally the sheep in groups 1 and 2 were thoracotomised on the
      right side. In group 1 the measurement parameters remained largely unchanged
      during the entire experiment. In group 2 significant and by the end of the
      operation irreversible pathological changes occurred immediately after the blunt
      esophagus resection (ZDM 4): decrease of MAP, paO2 and CO, increase of AaDO2 and
      PVR. In group 3 similar changes were observed, they began, however, during ZDM 3.
      The measurement results can be explained in accordance with the operative
      anatomical findings. How far postoperative pulmonary complications can be avoided
      in patients with the endoscopic technique must be demonstrated in clinical use.

PMID- 8363715
TI  - The use of an assessment tool in managing placement on pressure relief surfaces.

PMID- 8363716
TI  - A pressure ulcer prevention program.
AB  - The prevention and management of pressure ulcers often creates challenging
      situations requiring specialized knowledge and expert, consistent nursing care.
      In order to promote pressure ulcer prevention and control costs at a 350-bed
      community hospital, a "Pressure Ulcer Prevention Program" was developed. This
      program was developed upon completion of a baseline audit determining the extent
      of skin problems, equipment in use, and nursing documentation regarding skin
      care. Five months after initiation of the program, a second audit was conducted
      to evaluate the effectiveness of the program. An overall decrease in pressure
      ulcer incidence was found and the documentation of pressure ulcer prevention was
      improved.

PMID- 8363717
TI  - Clinical validation of pressure ulcer risk factors.
AB  - The maintenance of skin integrity is considered to be a survival need in the
      human need nursing framework. Risk factors for the nursing diagnosis High Risk
      For Impaired Skin Integrity: Pressure Ulcer were identified in a diagnostic
      content validity study. The purpose of this study was to use a pressure ulcer
      risk assessment instrument based on results of that study. The clinical
      validation model was used to analyze the ulcer risk factor cluster present in a
      sample of older adults residing in two nursing homes in the Mid-Atlantic region
      of the United States. A convenience sample of 108 residents were each assessed
      independently by two research assistants. Interrater reliability of the
      instrument was 93 percent. There were eight risk factors present in more than 60
      percent of the subjects in the pressure ulcer group; six in the high risk group,
      and five in the low risk group. Findings suggest that three factors may be the
      best discriminators for pressure ulcer risk: (1) friction, (2) being dependent in
      self-care, and (3) being confined to bed/chair.

PMID- 8363718
TI  - The process and criteria for national coverage decisions by HCFA's Medicare
      program. Excerpted from an oral presentation delivered by Dr. Sam Shekar.

PMID- 8363719
TI  - Veridien expects FDA approval soon on HIV virus-killing Sterihol.

PMID- 8363720
TI  - O/WM board members are invited to peer review AHCPR draft of literature review
      summary on dressings.

PMID- 8363721
TI  - Activation-induced cell death (apoptosis) of mature peripheral T lymphocytes.
AB  - Programmed cell death (apoptosis) is triggered in immature thymocytes and T-cell
      hybridomas by signalling via the CD3-T-cell receptor pathway. In this paper,
      Dieter Kabelitz and colleagues catalogue the recently accumulating evidence that
      apoptosis can also be initiated in mature peripheral T cells; this may constitute
      an important aspect of cellular immune regulation.

PMID- 8363722
TI  - Antigen presentation, loss of immunological memory and AIDS.
AB  - A key factor causing immunodeficiency in HIV infection seems to be defective
      antigen presentation. Consequently, CD4+ T-cell populations, initially those
      expressing CD45RO, decrease in number not because of their destruction, but
      because they fail to expand in response to antigenic stimulation. This view
      implies that it would be mistaken to aim therapies only at correcting T-cell
      function or preventing infection of T cells.

PMID- 8363723
TI  - Can soluble antigens induce CD8+ cytotoxic T-cell responses? A paradox revisited.
AB  - Cytotoxic T lymphocyte (CTL) induction usually follows processing of antigens via
      endogenous pathways before presentation on the cell surface in association with
      MHC class I molecules. Soluble antigens do not, in general, induce specific CTL
      responses. Here, Syamal Raychaudhuri and John Morrow suggest that a novel
      adjuvant formulation can elicit CTL responses to soluble antigens and discuss the
      implications for vaccine development.

PMID- 8363724
TI  - Map of the human MHC.

PMID- 8363725
TI  - Bidirectional cytokine interactions in the maternal-fetal relationship: is
      successful pregnancy a TH2 phenomenon?
AB  - Pregnant females are susceptible to intracellular pathogens and are biased
      towards humoral rather than cell-mediated immunity. Since TH1 cytokines
      compromise pregnancy and TH2 cytokines are produced at the maternal-fetal
      interface, we hypothesize that these TH2 cytokines inhibit TH1 responses,
      improving fetal survival but impairing responses against some pathogens.

PMID- 8363726
TI  - Signal transduction events leading to T-cell lymphokine gene expression.
AB  - The expression of T-cell derived lymphokines is regulated by signal transduction
      events initiated by the T-cell antigen receptor and other T-cell surface
      molecules. Substantial progress has been made in characterizing the signal
      transduction events initiated at the plasma membrane of the T cell and their
      targets which control lymphokine gene expression in the nucleus. This review will
      summarize recent progress in this area of investigation.

PMID- 8363727
TI  - Myasthenia gravis: recognition of a human autoantigen at the molecular level.
AB  - The symptoms of myasthenia gravis are primarily or exclusively due to an
      autoimmune response against the muscle nicotinic acetylcholine receptor (AChR)
      and this has been the object of intensive investigations for almost 20 years. A
      detailed picture at the molecular level of the interaction of this autoantigen
      with the key elements involved in the autoimmune response, such as anti-AChR
      antibodies, the T-cell receptor and restricting major histocompatibility complex
      molecules, is now emerging for both human myasthenia gravis and its experimental
      model, experimental autoimmune myasthenia gravis. Here, Maria Pia Protti and
      colleagues focus on the molecular interactions occurring in human myasthenia
      gravis and summarize recent information on pathogenic mechanisms of the
      autoimmune response, and the structure of epitopes recognized by B cells and CD4+
      T cells of myasthenic patients on the AChR molecule.

PMID- 8363728
TI  - Why cyclosporin is an effective drug.

PMID- 8363729
TI  - Nonselective actions of herbimycin A.

PMID- 8363730
TI  - A flaw in the detection of antigenic sites.

PMID- 8363731
TI  - Neural wave representation in early vision.
AB  - The neural wave representation which describes spatiotemporal information in
      early vision is proposed in terms of extended Gabor functions in this paper. Its
      reasonability, completeness and uncertainty in spatiotemporal domains and their
      frequency domains were investigated. The ranges of these parameters in this
      representation were estimated on electrophysiological and psychophysical data. We
      derived the partial differential equations which the neural wave satisfied. The
      general significance of 3D neural wave representation has been explored.

PMID- 8363732
TI  - The properties of an HBV surface antigen protein carrying the binding site for
      the receptor of hepatocytes--its formation of surface antigen particles and
      secretion from discrete cell lines.
AB  - A human hepatitis B virus (HBV) gene, which encodes the major surface antigen
      protein (S protein) carrying the hepatocyte receptor-binding site, was
      constructed with site-directed mutagenesis and in vitro recombination. When
      expressed in monkey kidney cell line COS-M6, this gene product (S309 protein)
      formed surface antigen (HBsAg) particles and secreted from the cells. It was
      stable within the cells and in the culture medium and could be immunoprecipitated
      with antisera directed against plasma-derived HBsAg or synthetic preS1
      polypeptide. Isopycnic CsCl gradient centrifugation showed that the density of
      S309 protein particles (1.25 g/ml) was slightly higher than that of S protein
      particles. The S309 protein was readily secretable from hepatoma cell lines, and
      the amount secreted was comparable to that of the S protein. By contrast, only
      about 10% of the S309 protein was secreted from COS-M6 cells, and its appearance
      in culture medium was delayed. The efficiency of the secretion of the S309
      protein can be improved when it is coexpressed with the S protein.

PMID- 8363734
TI  - Effect of the esters of gallic acid on model and human blood platelet membranes
      studied by Fourier transform infrared spectroscopy.
AB  - Gallic acid is one of the components of Chinese herbal drug Radix paeoniae used
      for promoting blood circulation to remove blood stasis. This paper studied the
      effects of gallic acid and its esters (e.g. ethyl, propyl, isobutyl and butyl
      gallate) on model and human blood platelet membranes by FTIR which was used for
      monitoring the physical state of the acyl chain, interfacial and head group
      region of the membrane lipid bilayer. From the experimental results it can be
      seen that the gallic acid and its esters have the modifying function on the pure
      and cholesterol-containing DPPC model membranes, and have the quantity-effective
      and structural-effective relationships. In addition, it is discovered that these
      esters have the modifying effect on the structure of human blood platelet
      membrane and can reverse the effect of ADP. That the effect of the esters of
      gallic acid counteracts the effect of cholesterol and ADP on human blood platelet
      perhaps provides a new explanation of the mechanism of Chinese herbal drugs used
      for promoting blood circulation to remove blood stasis.

PMID- 8363733
TI  - The production of monoclonal antibody to androstenedione and the effect of
      passive immunization on Xinjiang fine-wool sheep with it.
AB  - Five hybridomas stably secreting monoclonal antibodies (McAbs) to androstenedione
      were prepared by using artificially synthesized androstenedion-11 alpha-succinyl
      conjugate with bovine serum albumin (BSA) as antigen. These McAbs showed slightly
      high cross-reactivity with testosterone (8.1-12.3%) and estrone (0.8-2.5%) and
      high affinities ranging from 2.0 x 10(7) to 2.8 x 10(8) L/M. They were all of the
      IgG1 subclass. Xinjiang finewool ewes which were passively immunized with McAbs
      had higher circulating levels of progesterone (P) and luteinizing hormone (LH)
      than those of control ewes in two oestrous cycles and these changes led to
      increased ovulation rate and twin lambs born in young ewes.

PMID- 8363735
TI  - Effects of bovine follicular fluid and partially purified bovine inhibin on FSH
      and LH release by bovine pituitary cells in culture.
AB  - We have established a dispersed bovine pituitary cell culture system to study the
      effects of charcoal-extracted bovine follicular fluid (BFF) or bovine inhibin,
      partially purified by immunoaffinity chromatography (IPI), on the spontaneous
      release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
      Pituitary cells were plated at 0.25, 0.5 or 1 x 10(6) viable cells/well (c/w) and
      incubated for 48 h. The medium was replaced and BFF (0, 0.54, 2.7, 13.7, 68.7 or
      343.5 micrograms protein) or IPI (0, 0.01, 0.06, 0.29, 1.45 or 7.25 micrograms
      protein) added to the cultures and the incubation was continued for 48 h.
      Concentrations of FSH and LH in spent medium were determined by RIA and data
      analyzed by ANOVA with means compared by Student-Neuman-Keuls (SNK) test. We have
      shown an increase in spontaneous FSH and LH release attributable to both number
      of bovine pituitary cells plated and to the length of incubation. The addition of
      BFF reduced spontaneous FSH release over 48 h incubation. The dose-dependent
      inhibition curves observed in culture in which different numbers of cells were
      plated, indicates that inhibition was greater when 1 x 10(6) c/w were plated
      compared to 0.25 or 0.5 x 10(6) c/w. Bovine follicular fluid at 0.45 micrograms
      of protein (equivalent to 0.01 microliters of BFF) incubated with 1 x 10(6) c/w,
      suppressed FSH release by 10.6% compare to control. Maximal suppression of 34.1%
      was obtained with 50 micrograms (equivalent to 1.56 microliters of BFF).
      Immunopurified bovine inhibin at 1.45 micrograms tended to suppress FSH release
      and at 7.25 micrograms significantly reduced FSH release. Neither BFF nor IPI had
      a measurable effect on LH release. We conclude that BFF and IPI suppress the
      spontaneous release of FSH from bovine pituitary cells in culture in a dose
      dependent manner, without concomitant suppression of LH release.

PMID- 8363736
TI  - Production of estradiol by the fetal rat testis.
AB  - Testes from 17- to 20-d-old rat fetuses were cultured in vitro for various time
      intervals in Medium 199 alone or with added gonadotrophins. Estradiol released
      into the culture media was determined by radioimmunoassay. A basal estradiol
      secretion rate was inexistant or undetectable at all stages studied. In early
      stages (17 and 18 d) there was no difference in the stimulatory effect of FSH or
      LH at the same concentration. At 19 d, the prevalence of FSH became apparent. At
      20 d, a significant action of FSH was noted after only 3 h culture time. 1-Methyl
      1, 4-androstadiene-3,17-dione, an aromatase inhibitor, markedly depressed FSH
      stimulated estradiol secretion. In the 20-d old testis, stimulation of estradiol
      production by FSH was more rapid and reached a higher level than by (Bu)2cAMP. It
      is suggested that the difference in the action of LH and FSH reflects the
      difference in the time of appearance of the corresponding receptors in the
      developing fetal testis.

PMID- 8363737
TI  - Alterations in the morphology of nuages in spermatogonia of the fish, Oryzias
      latipes, treated with puromycin or actinomycin D.
AB  - A germ-cell specific organelle, nuage, in Oryzias latipes is polymorphic. Nuages
      with a strand-like structure and amorphous fibrous bodies can be discriminated
      from each other; furthermore 2 types of nuages of intermediate morphology are
      also present. After the administration of puromycin or actinomycin D, nuage
      morphology in spermatogonia was examined by electron microscopy. Puromycin as
      well as actinomycin D caused a significant increase in the incidence of nuages
      with a strand-like structure. These observations indicate that the loss of supply
      of some materials can induce morphological changes in nuages, suggesting that the
      polymorphism in nuages of O latipes possibly results from the turnover of nuage
      materials.

PMID- 8363738
TI  - Plasma levels of luteinizing hormone in intact and castrated photosensitive
      blackheaded buntings (Emberiza melanocephala) exposed to stimulatory and
      nonstimulatory photoperiods.
AB  - Experiments were performed to investigate the effects of castration and/or
      photostimulation on plasma luteinizing hormone (LH) in photosensitive blackhead
      buntings. Castration evoked a significant rise in plasma LH in birds held under 8
      h light: 16 h darkness (8L:16D). On exposure to 18L:6D for 24 d, both the intact
      birds and the castrates exhibited a significant rise in plasma LH, although the
      change in LH levels in the castrates was approximately 8 times greater than in
      the intact birds. When control birds under 8L:16D which showed no change in
      plasma LH up to d 13 were transferred to a 36-h resonance cycle (8L:28D), plasma
      LH rose significantly within 4 cycles of the treatment. Furthermore, the intact
      buntings showed rapid increase and decrease in the plasma LH levels during a 16
      wk exposure to long (16L:8D) but not to short (8L:16D) photoperiods. These
      results suggest that: i) the photoperiodic drive on LH secretion is inhibited by
      the testes; ii) the blackheaded bunting has a strong photoresponsive system; and
      iii) a circadian rhythm of photosensitivity is involved in the photoperiodic time
      measurement in this species.

PMID- 8363739
TI  - Comparative duodenal, jejunal and ileal responses to luminal saline load.
AB  - Intestinal ionic exchanges were studied in rat duodenal, jejunal and ileal
      ligated loops in response to different luminal saline loads: NaCl concentration
      varied from 150-0 mM, solutions being made isoosmotic with mannitol. The contact
      delay was 60 min. An exponential relationship was found between water, Na and Cl
      movements and the initial saline concentration. Maximal absorption was obtained
      with 150 mM NaCl, and was significantly higher in the duodenum than in the
      jejunum and ileum. The NaCl concentration for which water, Na, and Cl movements
      were null was approximately 70 mM NaCl in the duodenum and jejunum, 41 mM for Na
      and 18 mM for Cl in the ileum. The water efflux induced by the 0-mM NaCl test
      solution was maximal in the duodenum (1.5 +/- 0.2 ml/h) and decreased in the
      jejunum (0.8 +/- 0.1 ml/h) and ileum (0.3 +/- 0.1 ml/h) as did sodium, chloride
      and non-chloride anion efflux. These data support the functional heterogeneity of
      the small intestine regulating the water and ion exchange in response to luminal
      saline load, the main difference being connected with the efflux capacity of the
      mucosa, decreasing from the duodenum to the jejunum and ileum.

PMID- 8363740
TI  - Effect of coconut oil in the post-weaning starter diet on growth and carcass
      qualities of male lambs, weaned early and intensively fattened in winter.
AB  - The influence of medium-chain fatty acids (5% coconut oil) introduced in a
      starter diet (ALc) for 21 d after weaning was investigated in 230 Lacaune male
      lambs. They were weaned early, intensively fattened during winter and slaughtered
      at a constant live-weight (39 kg). Comparisons have been made regarding the
      individual growth rates and carcass qualities with an isocaloric and
      isonitrogenous reference diet (ALr) from lamb sub-samples. During the period of
      actual starter diet utilization, ALc induced a higher growth rate (+ 59%)
      independently of the weaning weight (Wto). The feed conversion ratio was lower
      with ALc (P < 0.01). The induced weight difference remained after the lambs were
      fed on the same finishing diet. The growth pattern for the entire fattening
      period was more regular with ALc, particularly when lamb weight was medium (12
      kg) of light (Wto < 11 kg) at weaning. The volatile fatty acid pattern in the
      rumen fluid over time (sampling with a rumen vacuum pump) and throughout the
      transition between starter and fattening diets (Rusitec procedure) did not show a
      clear coconut oil effect. ALc induced a slight increase in the external fat layer
      at slaughter 2 months later, especially in heavy lambs. Firmness and colour of
      subcutaneous fatty tissue were not different, but ALc tended to result in firmer
      and whiter carcasses in the case of the heavier lambs at weaning.

PMID- 8363741
TI  - [Effects of treatments (heat and fermentation by Rhizopus oligosporus sp-T3) of
      sweet white lupin seeds on certain factors of its nutritional use].
AB  - For improving the nutritional value and functional properties of sweet white
      lupin (SWL), a solid fermentation process using Rhizopus oligosporus was
      developed for the preparation of lupin products. A comparison of the effects of
      soaking + thermal treatment and fermentation was made from 3 lupin products: non
      treated lupin seeds (SWLnt), heated lupin seeds (steamed at 100 degrees C for 30
      min) (SWLh), and fermented lupin products (SWLf) from SWLh on chemical
      characteristics and protein efficiency ratio (PER) in rats. The major effect of
      soaking and thermal treatment is a loss of protein solubility and available
      lysine (from 3.02 +/- 0.18 g/16 g N to 2.3 +/- 0.25). Fermentation leads to a
      modification, of amino acid composition and to an increase in available lysine
      compared to heating (2.90 +/- 0.12 g/16 g N). The nutritional quality of SWLnt is
      low (PER = 0.83 +/- 0.09), thermal treatment decreases it (0.58 +/- 0.18) and
      fermentation compensates heating effect (0.74 +/- 0.25). It is suggested that the
      modifications of nutritional quality depends on the availability of lysine rather
      than on the variations of the levels of other amino acids.

PMID- 8363742
TI  - [Automated micro-determination by transfer analyzer of circulating alpha-amino
      nitrogen].
AB  - An automated method for the determination of plasma free amino groups is
      described. The analysis is performed on a discrete computerized analyzer after
      plasma deproteinization using trichloracetic acid. The method is based on the
      formation of a complex between terminal NH2 radicals and 2,4,6-trinitrobenzene
      sulfonate (TNBS). The method is accurate (coefficient of variation = 2%), linear
      over a range of 0.2-7 mM/l and requires small analytic volumes; it also
      correlates well in the bovine with results from standard liquid chromatography (r
      = 0.953). With this method a single operator can determine free amino group
      contents of 50 samples per h.

PMID- 8363743
TI  - New whole blood analyzers and their impact on cardiac and critical care.
AB  - Miniaturized whole blood biosensors, patient-focused hospitals, and rising
      expectations of patients and physicians are shifting laboratory diagnostics to
      the point of care. Expanding transplantation and intensive care are increasing
      the need for rapid test results. Whole blood analysis improves accuracy,
      eliminates centrifugation, reduces response time, and conserves blood volume.
      Several hand-held, and over 20 portable or transportable whole blood instruments
      are now available. Criteria for instrument evaluation include test menus, point
      of-care features, analysis time, on-site performance, and information
      integration. Whole blood analyzers measure several vital indicators (pO2, pCO2,
      pH, hematocrit, K+, Ca2+, Na+, Cl-, glucose, and lactate) simultaneously in less
      than 2 min with less than 200 microliters of whole blood. Other in vitro tests
      are available (Mg2+, osmolality, CO2 content, urea nitrogen, beta
      hydroxybutyrate, hemoglobin, coagulation) or under development (HCO3-
      phosphorus). Some can be monitored in vivo (O2 saturation, pO2, pCO2, pH,
      glucose) or ex vivo. The clinical impact is demonstrated by ionized calcium, now
      established in importance for cardiac and neurologic problems, and ionized
      magnesium, a promising new measurement. The hybrid laboratory (a composite of
      conventional clinical laboratory and patient-focused testing), performance maps,
      and quality paths facilitate implementation of new whole blood analyzers for
      optimal support of cardiac and critical care, and improved patient outcomes
      (prospects).

PMID- 8363744
TI  - Clinical aspects of glycoprotein biosynthesis.
AB  - Glycoproteins are widely distributed among species in soluble and membrane-bound
      forms, associated with many different functions. The heterogenous sugar moieties
      of glycoproteins are assembled in the endoplasmic reticulum and in the Golgi and
      are implicated in many roles that require further elucidation. Glycoprotein-bound
      oligosaccharides show significant changes in their structures and relative
      occurrences during growth, development, and differentiation. Diverse alterations
      of these carbohydrate chains occur in diseases such as cancer, metastasis,
      leukemia, inflammatory, and other diseases. Structural alterations may correlate
      with activities of glycosyltransferases that assemble glycans, but often the
      biochemical origin of these changes remains unclear. This suggests a multitude of
      biosynthetic control mechanisms that are functional in vivo but have not yet been
      unraveled by in vitro studies. The multitude of carbohydrate alterations observed
      in disease states may not be the primary cause but may reflect the growth and
      biochemical activity of the affected cell. However, knowledge of the control
      mechanisms in the biosynthesis of glycoprotein glycans may be helpful in
      understanding, diagnosing, and treating disease.

PMID- 8363745
TI  - [The risk factors for home accidents in children. A case-control study].
AB  - INTRODUCTION: The main objective was to determine the risk factors involved in
      unintentional injuries in children under 10 years old occurring at home. MATERIAL
      AND METHODS: A Case Control study was conducted in the emergency room of three
      pediatrics hospitals in Mexico City. The sample size was 160 cases and 320
      controls. RESULTS: Boys were more affected than girls (OR) 1.7, C.I. (95%) 1.2
      2.5. The age group more affected was two-three years old (OR) 1.6, C.I.1.1-2.2.
      When children play outside home (roof, stairs, patio) the risk was OR 2.48, C.I.
      1.63-3.76. If mother is not encharged of children care (OR) 2.9, C.I. 1.8-4.8.
      The age > 40 years old of the person encharged of children care (OR) 2.2, C.I.
      1.4-3.5. CONCLUSIONS: The results showed us how necessary is to develop injury
      prevention programs especially to implement passive measures, with target
      populations people encharged of children care.

PMID- 8363746
TI  - [7 years' experience with neonatal tetanus in Yucatan].
AB  - Forty-six patients with neonatal tetanus (NT) were studied to identify factors
      for poor prognosis which could be used to select a therapeutic regimen with
      intravenous diazepam or neuromuscular blockade (NB) with pancuronium. Nine
      patients with NT grades II and III were successfully treated with diazepam; none
      of them died. Of the patients with NT grades IV and V, 27 received diazepam and
      ten received pancuronium. The mortality rate in these groups was 55% and 100%,
      respectively. Factors predicting poor prognosis among patients treated with
      diazepam were apneas (P = 0.01), and an age on admission of seven days or less (P
      = 0.0002). Patients who received diazepam and died, generally presented a rapidly
      fatal course (mean of four days); in this group tetanus was the main cause of
      death (73%). Patients treated with pancuronium survived a comparably longer
      period (mean = 15.7 days, P = 0.05), but generally died from nosocomial
      infections (70%, P = 0.04). On the basis of our results we propose that NT grades
      IV and V with the aforementioned factors for poor prognosis be treated with NB.
      In hospitals with limited resources and high rates of nosocomial infection, we
      suggest that NT grades IV and V without such factors initially be managed with
      diazepam, reserving NB for therapeutic failures. Finally, NT grades I-III may be
      effectively treated with diazepam alone.

PMID- 8363747
TI  - [The therapeutic use of pulmonary surfactant in neonatal hyaline membrane
      disease].
AB  - Preliminary report of our experience with the therapeutic use of pulmonary
      surfactant in newborn infants of less than 30 weeks gestation with hyaline
      membrane disease. The use of pulmonary surfactant was held under the "rescue"
      modality, with up to 36 hours of postnatal life. The blood gas changes are
      described and the assisted ventilation progress, as well as the general response
      on the clinical condition of each case. Discussion in centered in the risk of use
      and in the criteria for prescribing the therapeutic pulmonary surfactant. It is
      concluded that meeting the recommended requirements for its use, the pulmonary
      surfactant is a therapeutic alternative in the treatment of hyaline membrane
      disease in newborn infants of less than 33 weeks gestation, being different the
      immediate ventilatory response in terms of therapeutic control, with one or other
      forms of pulmonary exogenous surfactant, without differences in the final result.

PMID- 8363748
TI  - [Variation in the blood lipids in premature newborns during the use of the "all
      in-one" total nutritional mixture].
AB  - This prospective study was performed for the evaluation of the lipids in serum;
      the metabolic and other effects related with septicaemia, stability and
      compatibility of the parenteral nutrition combining in one continent amino acids,
      carbohydrates and fats; this system is called nutritional total mixture, "all in
      one" or three in one. Twenty prematures neonates were included in the study. The
      variables analyzed were: weight, gestational age; the laboratory exams taken
      before the installation of the system and seven days after were: total lipids,
      triglycerides, phospholipids, cholesterol, sodium, potassium, chloride, glucose,
      urea nitrogen, creatinine, hepatic enzymes and proteins, cellular blood count and
      coagulations tests. We obtained the next results: the mean gestational age and
      weight were 34 +/- 5 weeks and 1327 +/- 172 g, have been observed rise of lipids
      (P < 0.001), declination of potassium levels (P < 0.001), increment of calcium
      levels (P < 0.001), increment of albumin (P < 0.001) and platelets (P < 0.01). It
      is concluded that nutritional total mixture is a sure method in management of
      premature newborn with good stability, compatibility, with a increment of fats in
      serum physiological levels, with metabolic tolerance without repercussion renal,
      hepatic, hematological and without infections.

PMID- 8363749
TI  - [Anorectoplasty with a distal tubular flap via a posterior sagittal approach].
AB  - Were combined posterior sagittal approach and a posterior flap of the rectal
      wall. This allowed to perform the pull through operation in two patients with
      anorectal malformation who had a prior colostomy which just one intervention.
      With this combination we spare surgical procedures.

PMID- 8363751
TI  - [Arterial hypertension in children].
AB  - It is considered hypertension in children, the persistent increase of the blood
      pressure values above percentile 95 for age and sex, in no less than three
      determinations, with adequate register techniques. Blood pressure is maintained
      mainly by the regulation of metabolism of sodium and water in the intravascular
      space, through the adequate balance of intake, filtration, reabsorption and renal
      throughout. It is also regulated by hormonal factors. Weight gain control in teen
      agers could be useful to prevent high blood pressure in adults. In children, it
      is generally secondary to renal, reno-vascular, endocrinological or tumoral
      diseases. Clinical manifestations and the recommended diagnostic procedures are
      analysed to detect the most frequent causes of hypertension at different ages.
      Most cases response with antihypertensive drugs in combination with hyposodic
      diet. For the hypertensive crisis, asa diuretics and powerful antihypertensive
      drugs may be employed. Patients with chronic renal insufficiency could also need
      dialytic treatments. Renovascular diseases require almost always invasive
      treatments. Better prognosis in children with severe high blood pressure is
      related with recent diagnostic procedures, surgical techniques and
      antihypertensive drugs improvements.

PMID- 8363750
TI  - [The Griscelli-Prunieras syndrome: a case report].
AB  - It is presented a six-year-old girl with silvered hair syndrome, of Griscelli
      Prunieras variety; hereditary sickness with regressive autosomic and
      distinguished by partial albinism and leukocytic alterations. She presented the
      acute phase of the sickness distinguished by: hepatosplenomegaly,
      thrombocytopenia, lymphadenopathy generalized, and systematic infection; it is
      corroborated how a hemophagocytic syndrome; during her evolution developed
      pancerebellar syndrome. By laboratory were corroborated: decrease phagocytosis,
      degranulation 0%, decrease of globulins gamma, neutropenia, skin test of PPD and
      Candidin negatives, there were not find the giant inclusions in bone marrow
      leukocyte and peripheric blood that are feature of Chediak-Higashi syndrome.
      Another alteration that was the distribution of mote of melanin on the hair that
      in the Griscelli-Prunieras syndrome are six times bigger in the Chediak-Higashi
      syndrome.

PMID- 8363752
TI  - [Drug allergy].
AB  - Adverse reaction to drugs are classified as immunological and non-immunological.
      It is consider that one to five percent of the general population reactions to
      drugs. Allergic reactions are the most intense and dangerous, but they represent
      only five to ten per cent of all of them. Immunological adverse reactions may be
      induced by the drug or by their metabolites. There are risk factors to induced
      allergic reactions such as doses, administration time and way of administration.
      The four mechanism of damage from Gell and Coombs are discussed regarding to
      drugs, stressing the penicillin issue. Other common drugs reactions in the diary
      practice are cutaneous reactions with unknown immunological mechanism as it
      happens in febrile mucocutaneous syndrome and the phototoxic and photoallergic
      reactions. Pseudoallergic or "anaphylactoid" reactions have signs and symptoms
      like those of anaphylaxis, but the mechanism of damage is not immunological, as
      with local and general anesthetics and radiopaque media. Treatment for any
      adverse events is to stop the administration as soon as possible. The drug of
      choice is 1:1000 subcutaneous adrenaline besides colloid solutions, steroids and
      antihistaminics.

PMID- 8363753
TI  - Hematologic aspects of HIV infection.

PMID- 8363754
TI  - A survey of synthetic HIV-1 peptides with natural and chimeric sequences for
      differential reactivity with Zimbabwean, Tanzanian and Swedish HIV-1-positive
      sera.
AB  - OBJECTIVE: To determine whether the known sequence differences between African
      and non-African HIV-1 strains are reflected in the serological response. DESIGN
      AND METHODS: We investigated the antibody reactivity of 34 Swedish, 30 Tanzanian
      and 42 Zimbabwean HIV-1-positive sera to 67 synthetic peptides with sequences
      from North American and African HIV-1 isolates, mostly derived from regions of
      gag and env known to be antigenic. Not all sera were tested against all peptides.
      RESULTS: Differences in frequency of reactivity were noted with peptides covering
      the entire third variable domain (V3), which is a primary neutralization
      determinant, and the carboxyl terminus of gp120, in two regions of gp41, and the
      carboxyl terminus of p24. In env Tanzanian sera reacted preferentially with a V3
      peptide from the strain JY1 (Zaire). Gradual substitutions in the central motif
      in V3 of ELI from GLGQ to GPGR, typical of many non-African strains, led to a
      gradual increase in reactivity of many Swedish sera, but did not affect Tanzanian
      and Zimbabwean sera, suggesting that the major epitopes recognized by these
      African sera are outside GPGR. V3 peptides from the MN and Z3 strains reacted
      with most sera, but missed 30% of those of Tanzanian origin. In the carboxyl
      terminus of gp120 both sets of African sera reacted preferentially with peptides
      from strains JY1 and MAL. Swedish sera reacted strongest with analogues from
      strains Z321 and HXB2. In gp41, Swedish sera showed a weak preference for
      reactivity with HXB2-derived peptides in the immunodominant region (amino acids
      590-620), and further towards the carboxyl terminus (amino acids 620-665).
      CONCLUSION: The differences in serological reactivity were as great between
      Zimbabwe and Tanzania as between the two African sets and the Swedish. The
      geographical differences in the pattern of reactivity with HIV peptides probably
      depend on both host and viral variation and may be developed into a
      seroepidemiological tool, useful for optimization of future HIV vaccines.

PMID- 8363755
TI  - Phylogenetic analysis of gag genes from 70 international HIV-1 isolates provides
      evidence for multiple genotypes.
AB  - OBJECTIVE: To determine the extent of genetic variation among internationally
      collected HIV-1 isolates, to analyse phylogenetic relationships and the
      geographic distribution of different variants. DESIGN: Phylogenetic comparison of
      70 HIV-1 isolates collected in 15 countries on four continents. METHODS: To
      sequence the complete gag genome of HIV-1 isolates, build multiple sequence
      alignments and construct phylogenetic trees using distance matrix methods and
      maximum parsimony algorithms. RESULTS: Phylogenetic tree analysis identified
      seven distinct genotypes. The seven genotypes were evident by both distance
      matrix methods and maximum parsimony analysis, and were strongly supported by
      bootstrap resampling of the data. The intra-genotypic gag distances averaged 7%,
      whereas the inter-genotypic distances averaged 14%. The geographic distribution
      of variants was complex. Some genotypes have apparently migrated to several
      continents and many areas harbor a mixture of genotypes. Related variants may
      cluster in certain areas, particularly isolates from a single city collected over
      a short time. CONCLUSIONS: The genetic variation among HIV-1 isolates is more
      extensive than previously appreciated. At least seven distinct HIV-1 genotypes
      can be identified. Diversification, migration and establishment of local,
      temporal 'blooms' of particular variants may all occur concomitantly.

PMID- 8363756
TI  - Protection of monkeys by a split vaccine against SIVmac depends upon biological
      properties of the challenge virus.
AB  - OBJECTIVE: To investigate the role of the anti-cellular immune response in the
      protection of rhesus macaques against infection with the simian immunodeficiency
      virus SIVmac. To determine the biological differences between SIV challenge
      stocks grown either on human T-cell lines or on monkey peripheral blood
      mononuclear cells (MPBMC). DESIGN: A protective SIVmac split vaccine was
      administered to rhesus macaques and their anti-, B- and T-cell response
      monitored. Vaccinees and controls were challenged with SIVmac grown either on
      human or on monkey cells. The in vivo replication rate of, and the immune
      response to, the two viruses was compared. METHODS: Five rhesus macaques were
      immunized with a total of 2 mg each of purified SIVmac251/32H grown on the human
      C8166 T-cell line. The antibody and proliferative T-cell responses were evaluated
      by enzyme-linked immunosorbent assay and T-cell proliferation assay,
      respectively. Four protected animals and four controls were reboosted and
      challenged with MPBMC-grown SIVmac251 (SIVmac251/MPBMC). Cell-free virus load was
      determined by titration of plasma for SIV infectivity on C8166 cells and antigen
      with a core antigen capture assay. RESULTS: Protection from virus challenge with
      C8166-grown SIVmac251/32H or SIVmac251/MPBMC did not correlate with anti-cellular
      antibodies or proliferative T-cell reactivities. Control animals infected with
      SIVmac251/MPBMC showed high persistent antigenaemia and high plasma virus titres.
      Both were absent in controls infected with complement C8166-grown SIVmac251/32H.
      Whereas the latter always seroconverted against the full panel of viral
      polypeptides, SIVmac251/MPBMC-infected animals showed a drastically decreased
      antibody response. CONCLUSIONS: Neither the antibody nor the proliferative T-cell
      response to SIVmac correlates with protection from virus challenge. In contrast
      to SIVmac251/32H grown on C8166 cells, the MPBMC-grown challenge virus SIVmac251
      appears to belong to the 'rapid-high' phenotype, possibly explaining the lack of
      protection against this SIV.

PMID- 8363758
TI  - Recombinant alpha-interferon 2b in the treatment of HIV-related thrombocytopenia.
AB  - OBJECTIVE: To assess the efficacy and the mechanism of action of alpha-interferon
      (alpha-IFN) in the treatment of HIV-related thrombocytopenia. METHODS: Thirteen
      HIV-positive subjects [nine men and four women with severe thrombocytopenia
      (platelets, < or = 30 x 10(9)/l)] were treated with alpha-IFN 2b alone at a dose
      of 3 x 10(6) U three times a week for 5 weeks. Haematological parameters,
      platelet kinetic and bone-marrow myeloid progenitor cultures [megakaryocyte
      colony-forming units (CFU-MK); granulocyte macrophage CFU (CFU-GM) and erythroid
      burst-forming units (BFU-E)] were evaluated before and after treatment in
      responsive subjects. RESULTS: Seven out of 13 subjects showed a partial response
      (platelets, 50-149 x 10(9)/l) after alpha-IFN 2b therapy. Platelet survival as
      evaluated by 111In-oxine significantly increased, while platelet turnover showed
      a slight but not statistically significant increase after treatment. The growth
      of bone-marrow myeloid progenitor cells decreased after alpha-IFN 2b therapy,
      again without statistical significance. CONCLUSION: alpha-IFN 2b may increase the
      platelet count in HIV-positive subjects with severe symptomatic thrombocytopenia
      by prolonging platelet survival. The immunomodulatory and antiviral action of
      this drug may be responsible for prolonged platelet survival.

PMID- 8363757
TI  - Augmentation of HIV-specific lymphoproliferation in HIV-infected individuals by
      TraT: a novel T-cell immunopotentiating agent.
AB  - OBJECTIVE: To evaluate the potential of TraT to restore HIV-specific cell
      mediated immunity. DESIGN: CD4+ T cell-associated antiviral and recall antigen
      specific lymphoproliferative responses are generally impaired or absent in HIV
      infected individuals. METHODS: Using peripheral blood mononuclear cells (PBMC)
      from a group of asymptomatic and symptomatic HIV-infected individuals, we
      compared the immunomodulatory effects of exogenous interleukin-2 (IL-2) with the
      effects elicited by the bacterial integral membrane protein, TraT. RESULTS:
      Exogenous IL-2 enhanced lymphoproliferation induced by an immunodominant
      synthetic HIV gp41 analogue, gp41[8] (amino acids 593-604), in four out of 10
      asymptomatics and six out of 19 symptomatics. In contrast, TraT acted
      synergistically with gp41[8] to augment HIV-specific proliferation with higher
      frequency and greater magnitude than exogenous IL-2. Moreover, this TraT-mediated
      enhancement of HIV-specific lymphoproliferation occurred in the majority of HIV
      infected individuals, irrespective of CD4+ T-cell count in peripheral blood or
      disease status, and thus appears not to be major histocompatibility complex
      restricted. TraT also augmented lymphoproliferation induced by well-known recall
      antigens and other less immunodominant HIV analogues. CONCLUSIONS: These findings
      suggest that TraT, in combination with HIV-derived peptides, could be used to
      maintain or restore cell-mediated immune functions of HIV-infected individuals,
      as well as cellular immune functions in individuals suffering from other
      immunodeficiency disorders.

PMID- 8363759
TI  - Treatment of cryptococcosis with liposomal amphotericin B (AmBisome) in 23
      patients with AIDS.
AB  - OBJECTIVE: To determine the safety and efficacy of liposomal amphotericin B
      (AmBisome) in the primary treatment of AIDS-associated cryptococcosis. DESIGN: A
      Phase II, multicentre, European, non-comparative, open study to assess the use of
      AmBisome in 23 patients (26 enrolments) with cryptococcosis. Dose requirements,
      mycological response and toxicity were documented. SETTING: Hospital-based HIV
      units. PATIENTS: Twenty-three HIV-1-seropositive patients. RESULTS: Drug
      toxicity, assessed in 25 enrolments, was well-tolerated with little renal,
      hepatic or haematological toxicity. Eighteen out of 23 (78%) enrolments responded
      clinically. Nineteen enrolments had cryptococcal meningitis: sterilization of
      spinal fluid was achieved in 12 out of the 18 (67%) who were mycologically
      evaluable. Fourteen out of the 19 (74%) responded clinically. CONCLUSION:
      AmBisome is well-tolerated and may be an effective formulation in the treatment
      of cryptococcosis.

PMID- 8363760
TI  - Protein-losing enteropathy and hypoalbuminemia in AIDS.
AB  - OBJECTIVE: To assess the contribution of protein-losing enteropathy to AIDS
      associated hypoalbuminemia. DESIGN: Prospective assessment of patients with AIDS.
      SETTING: An urban county hospital (Los Angeles & University of Southern
      California Medical Center. USA). PATIENTS: Four groups of patients with AIDS were
      studied: (1) patients with normal serum albumin (> or = 3.9 g/dl) and normal
      bowel habits; (2) patients with normal serum albumin and diarrhea (> or = four
      loose or watery stools per day for > or = 2 weeks); (3) patients with
      hypoalbuminemia (< or = 3.0 g/dl) and normal bowel habits; and (4) patients with
      hypoalbuminemia and diarrhea. MAIN OUTCOME MEASURE: Fecal alpha 1-antitrypsin
      concentration was used as a measure of protein loss in the gut. RESULTS: Patients
      with hypoalbuminemia had a significantly higher mean fecal alpha 1-antitrypsin
      concentration than those with normal albumin (10.8 +/- 3.0 mg/g dry stool versus
      2.4 +/- 0.4 mg/g dry stool; P < or = 0.001). Although mean fecal alpha 1
      antitrypsin concentrations were similar in patients with and without diarrhea in
      the normal albumin group, patients with hypoalbuminemia and diarrhea had
      significantly higher levels of fecal alpha 1-antitrypsin than those with
      hypoalbuminemia and normal bowel habits (17.3 +/- 5.8 mg/g dry stool versus 4.6
      +/- 1.0 mg/g dry stool; P = 0.009). Twelve out of 36 (33%) patients with normal
      albumin had elevation of fecal alpha 1-antitrypsin compared with 33 (70%) of 47
      patients with hypoalbuminemia (P < or = 0.001). Linear regression analysis showed
      a significant negative correlation between serum albumin and fecal alpha 1
      antitrypsin concentration (r = -0.38; P < or = 0.001). Fecal alpha 1-antitrypsin
      was significantly higher in patients with mucosal disease visualized at upper
      endoscopy or flexible sigmoidoscopy than in those without gross abnormalities
      (13.5 +/- 5.8 mg/g dry stool versus 2.4 +/- 0.7 mg/g dry stool; P = 0.005).
      CONCLUSION: Protein-losing enteropathy is common in patients with AIDS and may
      contribute to the development of hypoalbuminemia in these patients.

PMID- 8363762
TI  - Risk behaviour, anti-HIV and anti-hepatitis B core prevalence in clinic and non
      clinic samples of gay men in England, 1991-1992.
AB  - OBJECTIVE: To describe the sexual risk behaviour of and HIV and hepatitis B
      antibody prevalence in gay men in England. DESIGN: Cross-sectional. RESPONDENTS:
      Gay men recruited from community settings (bars, clubs, gay organizations) and
      genito-urinary clinics in London, Manchester, the Midlands and Bristol; men who
      participated in an earlier study. METHODS: Interview including demographic
      information, sexual behaviour, partner type and health service use. Subjects
      donated saliva, which was screened for antibodies to HIV-1 by immunoglobulin G
      (IgG) antibody capture enzyme-linked immunosorbent assay (GACELISA) and to
      hepatitis B core (HBc) antigen by IgG antibody capture radioimmunoassay (GACRIA).
      RESULTS: Ninety-four out of 580 (16.2%) men were HIV-antibody-positive; 6.2% of
      men aged < or = 25 years were positive versus 19.5% of men aged > or = 26 years.
      HIV-antibody prevalence was highest in London (21.1%), and twice that previously
      reported outside London (10.5%). Ninety-four out of 568 (16.5%) men were HBc
      antibody-positive; 6.9% of men aged < or = 25 years were positive versus 19.7% of
      men aged > or = 26 years. Anti-HBc prevalence was highest in London (19.8 versus
      12.7% outside London). Manual workers were more likely to be anti-HBc-positive,
      as were men who reported recent high-risk intercourse. Sexually transmitted
      diseases associated with frequent partner change (gonorrhoea, non-specific
      urethritis) were reported. CONCLUSION: The HIV epidemic in gay men in England
      continues, particularly outside London, where prevalence was double that of
      previous studies. We found relatively high rates of infection in young men whose
      main sexual experience has been in a time of unprecedented awareness of AIDS. Our
      data on hepatitis B suggests that further pro-active immunization programmes are
      urgently required. These findings add to concerns about provision of
      interventions targeting gay men.

PMID- 8363761
TI  - Sentinel surveillance for HIV-1 among pregnant women in a developing country: 3
      years' experience and comparison with a population serosurvey.
AB  - OBJECTIVES: To establish unlinked, anonymous sentinel surveillance for HIV-1
      among pregnant women attending an antenatal clinic, to determine age-specific
      seroprevalences, to monitor trends and to compare seroprevalence with that
      detected by a population serosurvey. To establish the sustainability and costs of
      surveillance. DESIGN: Sentinel surveillance for HIV through serial collection of
      unlinked, anonymous seroprevalence data from antenatal care; comparison of
      sentinel data with those from a population serosurvey; financial and general
      audit of the sentinel surveillance. SETTING: A community antenatal clinic in a
      large urban centre, Mwanza Municipality, Tanzania, eastern Africa, between
      October 1988 and September 1991. PATIENTS: Pregnant women attending for antenatal
      care. MAIN OUTCOME MEASURE: Age-specific HIV-1 seroprevalences, trends over time,
      difference from age-specific population seroprevalences, sustainability and
      costs. RESULTS: Overall HIV-1 seroprevalence was 11.5% (95% confidence interval,
      10.5-12.4); differences in age-specific prevalences were not significant. There
      was no clear evidence of change in seroprevalence over the study period in any
      age group, although there was some indication of a rise in some age groups in
      1988-1989. Sentinel surveillance among pregnant women may have significantly
      underestimated population HIV-1 seroprevalence for women under the age of 35
      years. HIV-1 surveillance proved feasible and sustainable. Additional recurrent
      costs were US$1.7 per specimen for unlinked anonymous testing and US$0.57 per
      woman for syphilis screening. CONCLUSIONS: HIV-1 seroprevalence did not change
      significantly over 3 years, probably implying a substantial incidence of HIV-1
      infection. In this setting seroprevalence in pregnant women may have
      underestimated population seroprevalence in women aged under 35 years. With
      modest inputs and good organization unlinked anonymous HIV-1 sentinel
      surveillance of pregnant women can be introduced and sustained in an African
      setting. This may usefully be carried out in conjunction with syphilis screening.

PMID- 8363763
TI  - Sex role separation in sexual diaries of homosexual men.
AB  - OBJECTIVE: To measure types of sex role prevalence in common and risk-related
      behaviours among gay men for modelling HIV transmission. DESIGN: Cohort study of
      385 homosexually active men recording sexual diaries over 1-month periods.
      METHODS: Measures of incidence of behavioural sex roles for masturbation,
      fellatio, anal intercourse and anilingus by relationship type, derived from 1
      month sexual diary data. RESULTS: Low behavioural role rigidity for masturbation
      and fellatio, but higher rigidity for anal intercourse and anilingus.
      Participants with no regular partner showed a relatively low frequency of anal
      intercourse, whereas those in closed relationships showed a high frequency.
      CONCLUSION: Although anal intercourse shows a certain degree of behavioural role
      rigidity, this rigidity is not large enough to conclude that gay men exclusively
      engage in either an active or a passive role. Typical rates for exclusive active
      and passive roles for anal intercourse during the month the diaries were recorded
      were in the range of 12-15%; the dual role was significantly higher.

PMID- 8363765
TI  - Lack of anti-nuclear antibodies during HIV infection.

PMID- 8363766
TI  - Secondary diabetes induced by megestrol acetate therapy in a patient with AIDS
      associated cachexia.

PMID- 8363764
TI  - Condom use with primary partners among injecting drug users in Bangkok, Thailand
      and New York City, United States.
AB  - OBJECTIVE: To determine factors associated with likelihood or failure to use
      condoms with primary sexual partners among injecting drug users (IDU) in two
      cities. DESIGN AND METHODS: Interviews were conducted with 601 IDU in Bangkok in
      1989 and with 957 IDU in New York City in 1990-1991. Subjects were recruited from
      drug-use treatment programs and a research storefront. Informed consent was
      obtained and a World Health Organization standardized questionnaire about AIDS
      risk behaviors administered by a trained interviewer. RESULTS: A substantial
      minority (37%) of IDU in Bangkok and a majority (55%) of IDU in New York City
      reported penetrative intercourse (vaginal, anal or oral) with a primary partner
      in the 6 months before the interview. Of those reporting penetrative intercourse
      with a primary partner, only 12% in Bangkok and 20% in New York reported that
      they always used condoms. Parallel bivariate and multiple logistic regression
      analyses were conducted to distinguish between subjects who reported always using
      condoms and subjects who reported unsafe sexual activity with primary partners.
      The same two factor--knowing that one is HIV-seropositive and talking about AIDS
      with sexual partners--were most strongly associated with always using condoms
      with primary partners in both cities. CONCLUSIONS: Programs to prevent sexual
      transmission of HIV among IDU should provide voluntary and confidential/anonymous
      HIV counseling and testing, and should facilitate discussions of AIDS and sexual
      transmission of HIV between IDU and their sexual partners. That the same two
      factors were associated with always using condoms with primary partners among IDU
      in these two cities suggests that these factors may also be important in other
      groups at high risk for HIV.

PMID- 8363767
TI  - Kussmaul respiration and abdominal pain secondary to metabolic acidosis in AIDS
      patients with disseminated Mycobacterium avium complex infection receiving
      clofazimine.

PMID- 8363768
TI  - Low prevalence of positive tuberculin tests in homo-/bisexual white men from
      Seattle: implications for anergy testing.

PMID- 8363769
TI  - Fetal organs infected by HIV-1.

PMID- 8363770
TI  - Conversion of HIV-1 viral markers during the first few months of life in HIV
      infected children born to seropositive mothers.

PMID- 8363771
TI  - Secondary prevention of HIV: knowledge and beliefs about HIV, therapy and
      community resources.

PMID- 8363772
TI  - Helicobacter pylori infection in an HIV-seropositive patient with diarrhoea.

PMID- 8363774
TI  - AIDS 1992/1993. A year in review.

PMID- 8363773
TI  - AIDS 92/93. Virology: overview.

PMID- 8363775
TI  - Epidemiology of tuberculosis in the era of HIV.

PMID- 8363776
TI  - AIDS 92/93. Vaccines and immunology: overview.

PMID- 8363777
TI  - Cell-mediated immunity in HIV infection.

PMID- 8363778
TI  - Use of new vectors for the development of vaccines.

PMID- 8363779
TI  - Human trials of experimental AIDS vaccines.

PMID- 8363780
TI  - Primate models for HIV vaccines.

PMID- 8363781
TI  - AIDS 92/93. Clinical treatment: overview.

PMID- 8363782
TI  - Antiretroviral and immune-based therapies: update.

PMID- 8363783
TI  - Update on opportunistic infections.

PMID- 8363784
TI  - The role of lymphoid organs in the immunopathogenesis of HIV infection.

PMID- 8363785
TI  - Treatment and prevention of tuberculosis in HIV infection.

PMID- 8363786
TI  - Update on HIV and neoplastic disease.

PMID- 8363787
TI  - Organ-specific manifestations of HIV infection. I. Gastrointestinal diseases.

PMID- 8363788
TI  - Organ-specific manifestations of HIV infection. II. Update on cutaneous
      manifestations of HIV infection.

PMID- 8363789
TI  - Organ-specific manifestations of HIV infection. III. The neurology of HIV
      infection: clinical, pathogenetic and treatment perspectives.

PMID- 8363790
TI  - Organ-specific manifestations of HIV infection. IV. Oral manifestations of HIV
      infection: comments on the present classification.

PMID- 8363791
TI  - The maturation of an epidemic: update on pediatric HIV infection.

PMID- 8363792
TI  - Treatment, prophylaxis and research priorities for developing countries.

PMID- 8363793
TI  - AIDS 92/93. Social, cultural and political aspects: overview.

PMID- 8363794
TI  - The history of AIDS.

PMID- 8363795
TI  - Methodological issues in HIV/AIDS social research: recent debates, recent
      developments.

PMID- 8363796
TI  - Sustaining safe sex: sexual practices, HIV and social context.

PMID- 8363797
TI  - Community development as a response to HIV among drug injectors.

PMID- 8363798
TI  - Housing rights and housing needs in the context of AIDS.

PMID- 8363799
TI  - International AIDS aid: the response of development aid agencies to the HIV/AIDS
      pandemic.

PMID- 8363800
TI  - AIDS pathogenesis: mathematical models of HIV and SIV infections.

PMID- 8363801
TI  - HIV-1 infection of animals: the search for a pathogenesis model continues.

PMID- 8363802
TI  - Receptor-mediated activation of the viral envelope and viral entry.

PMID- 8363803
TI  - Molecular biology of HIV-1: positive and negative regulatory elements important
      for virus expression.

PMID- 8363804
TI  - AIDS 92/93. Epidemiology: overview.

PMID- 8363805
TI  - AIDS surveillance and prediction of the HIV and AIDS epidemic: methodological
      developments.

PMID- 8363806
TI  - Surveillance definitions for AIDS.

PMID- 8363807
TI  - The epidemiology of HIV-1 infection and AIDS in women.

PMID- 8363808
TI  - Risk factors for vertical transmission of HIV-1 and early markers of HIV-1
      infection in children.

PMID- 8363809
TI  - HIV transmission through blood, tissues, and organs.

PMID- 8363810
TI  - Insurance for sickness (health insurance?)

PMID- 8363811
TI  - Heterotopic ossification. The utility of osteocalcin in diagnosis and management.
AB  - The status of 12 patients after severe traumatic brain injury was investigated to
      determine the clinical significance of serum osteocalcin levels during the active
      phase of neurogenic heterotopic ossification. The diagnosis of heterotopic
      ossification was confirmed on the basis of radiologic findings. The mean interval
      between the initial injury and diagnosis of heterotopic ossification was 29
      weeks. At the time of diagnosis, serum osteocalcin and total alkaline phosphatase
      levels were determined along with 24-hour urinary calcium and hydroxyproline
      excretion. The mean serum osteocalcin level was normal at 4.3 ng/ml (normal range
      1.6-6.6 ng/ml) in contrast to the elevated mean values for serum alkaline
      phosphatase (mean = 173 units/liter; normal range 0-105 units/liter) and urinary
      hydroxyproline concentration (mean = 39.6 mg/24 h; normal range 7-25 mg/24 hr).
      Only 17% of the subjects demonstrated an elevated serum osteocalcin level,
      whereas 58% of the patients had an elevated serum alkaline phosphatase level.
      Urinary calcium excretion and hydroxyproline excretion were elevated in 33% and
      70% of subjects, respectively. These data did not reveal a significant
      correlation between serum osteocalcin and serum alkaline phosphatase, urinary
      calcium excretion or urinary hydroxyproline at the time of diagnosis or in serial
      measurements. Therefore, serum osteocalcin is not a valuable adjunct in
      confirming the diagnosis of neurogenic heterotopic ossification once the
      diagnosis has been suggested on the basis of clinical findings and it does not
      appear to play a role in assessing the maturation of heterotopic ossification.

PMID- 8363812
TI  - Changes in bone mineral content and density after stroke.
AB  - The purpose of this study was to determine whether there are differences in bone
      mineral content and density between paralyzed and nonparalyzed sides of patients
      who had sustained strokes associated with unilateral muscle weakness, to
      determine the relationship between duration of stroke and degree of
      demineralization and to compare the degree of demineralization in upper and lower
      limbs. The bone mineral content and density were measured by dual photon
      absorptiometry (high resolution scanning mode, Lunar DP4) in ambulant patients
      with a history of single completed strokes associated with unilateral weakness.
      The bone mineral content and density of each limb was determined by the region of
      interest analysis program. In the 30 patients included in this study, the bone
      mineral content and density were significantly less on the paralyzed than on the
      nonparalyzed side. The degree of demineralization was more pronounced in the
      upper than in the lower limbs. The mean percentage differences in bone mineral
      content and density between paralyzed and nonparalyzed arms were 13.8% (P <
      0.00001) and 7.95% (P = 0.0003), respectively, and between paralyzed and
      nonparalyzed legs the differences were 4.5% (P = 0.0012) and 3.42% (P = 0.0028),
      respectively. A better correlation was noted between the time elapsed since the
      stroke and the degree of demineralization in the upper limbs (r = 0.75, P <
      0.0001), than in the lower limbs (r = 0.60, P = 0.0004). In conclusion, patients
      who have strokes associated with muscle weakness are at an increased risk of
      developing osteoporosis on the paralyzed side and particularly in the upper
      limbs.

PMID- 8363813
TI  - Alcohol use among spinal cord-injured patients.
AB  - Patients with spinal cord injury (SCI) are at greater risk than others for
      alcohol abuse because they face physical, psychological and vocational
      difficulties that include sensory impairment, pain, depression and reduced
      opportunities to participate actively in society. This study assesses the utility
      of using a brief screening interview questionnaire, the CAGE (cut, annoyed,
      guilty and eye opener), to further evaluate patients with SCI for alcohol use,
      including alcoholism using retrospective data. The study explores patterns of
      alcohol consumption among SCI patients and investigates the relationship between
      self-reported alcohol use, age, previous history of drug and alcohol abuse and
      medical complications after discharge. Results suggest that the CAGE is a valid
      measure to be used with SCI patients. Age did not correlate significantly with
      patient's CAGE scores. However, SCI subjects with higher mean CAGE scores also
      had a higher incidence of medical complications. CAGE scores were significantly
      correlated with previous history of alcohol and drug abuse and with the average
      weekly number of drinks reportedly consumed before injury.

PMID- 8363815
TI  - Non-weightbearing exercise may increase lumbar spine bone mineral density in
      healthy postmenopausal women.
AB  - Seven postmenopausal women exercised regularly at moderate intensities (60-80% of
      maximum heart rate) for eight months on bicycle ergometers. Evaluation of bone
      mineral density by dual photon absorptiometry revealed a significant (P < 0.01) +
      3.55 +/- 1.43% (mean +/- SE) increase in lumbar spine density in the exercisers
      compared with the 2.44 +/- 0.81% decrease noted in seven sedentary controls. No
      significant difference in change in femoral neck density was noted between the
      two groups (+2.51 +/- 2.10% v -0.74 +/- 0.72% for exercisers and controls,
      respectively; P > 0.10). Dietary intake of calcium and vitamin D was similar in
      both groups, as was previous exposure to estrogen replacement therapy. These data
      provide evidence of a prospective nature that non-weightbearing exercise may be
      effective in reversing bone loss in healthy postmenopausal women.

PMID- 8363814
TI  - Sympathetic skin response and R-R interval variation in rheumatoid arthritis. Two
      simple tests for the assessment of autonomic function.
AB  - Autonomic nervous system involvement with peripheral neuropathy is a well known
      complication of rheumatoid arthritis (RA). In the assessment of autonomic
      function of patients with rheumatoid arthritis, we performed sympathetic skin
      response (SSR) and R-R interval variation (RRIV) tests in 30 patients and in 30
      normal controls. Of 30 patients, 5 had complaints of clinical dysautonomic
      symptoms. SSRs were abnormal in 6 of 30 patients, whereas 8 showed abnormal RRIVs
      during deep breathing. Nine of 30 patients also showed electrophysiologic
      evidence of peripheral neuropathy. All 5 of the patients with clinical
      dysautonomic symptoms showed abnormal SSR and RRIV test results. No patients with
      normal results on both tests had clinical dysautonomia. This study showed that
      there are frequent abnormalities in SSR and RRIV tests in patients with
      rheumatoid arthritis whether there is a clinical symptom of autonomic dysfunction
      or not.

PMID- 8363816
TI  - The functional significance of the fifth metacarpus and hypothenar in two useful
      grips of the hand.
AB  - Two useful grips for daily living and professional life concerning the two ulnar
      fingers, designated the "locking grip" and the "supporting grip," are presented.
      Flexion of the fifth metacarpus was recorded by an electrogoniographic method
      together with an electromyogram of the hypothenar muscles during formation of the
      two grips. For the locking grip the flexed position of the fifth metacarpus was
      shown to be the functional basis of the hypothenar muscles, especially the
      abductor digiti minimi, operating on the proximal phalanges of the little finger,
      thus giving full strength to the grip together with the ulnar hand flexor. For
      the supporting grip the flexed metacarpus enables the stretched little finger to
      prop up an ordinary plate and hold it horizontally. After immobilization of the
      ulnar fingers as a result of trauma or in the after care of cases of entrapments
      of the ulnar nerve, there often arise difficulties in restoring the two grips,
      mostly because of the atrophy of the hypothenar. A simple method, based on the
      statements above, of reactivating an atrophic hypothenar and exercising the
      fingers is suggested. A functional positioning of the fifth metacarpus and ulnar
      fingers during immobilization to favor the rehabilitation of the two grips is
      also recommended.

PMID- 8363817
TI  - Analysis of casualties referred to Army physical medicine services during the
      Persian Gulf conflict.
AB  - This study describes the casualties referred during the Persian Gulf War and
      underscores the valuable role of Army physical medicine and rehabilitation (PMR)
      services in evaluation and early rehabilitation of wartime casualties. Data
      regarding demographics, injury types, medical complications, complications of
      immobility and functional limitations were collected by military physiatrists at
      five Army Medical Centers with PMR services. Active duty soldiers injured in the
      Persian Gulf War who were referred totalled 222. Musculoskeletal injuries
      occurred in 57%, peripheral nerve injuries in 44%, penetrating wounds in 32%,
      fractures in 28%, brain injuries in 8%, amputations in 7%, burns in 6% and spinal
      cord injuries in 3%. The primary referral service was orthopedics (64%).
      Electrodiagnosis evaluations were performed for 41% of all referrals. Lower limb
      and upper limb contractures occurred in 10% and 9% of patients, respectively.
      Ambulatory impairments were seen in 48%. Nerve injuries were associated with
      penetrating wounds in 68%, with amputations in 67% and with fractures in 58%.

PMID- 8363818
TI  - Prevalence of kyphosis in a healthy sample of pre- and postmenopausal women.
AB  - Kyphosis, initially modest, progresses to the well recognized dowager's hump of
      the postmenopausal osteoporotic woman. Kyphosis is not only associated with
      relatively altered vertebral body shape (anterior wedging), but also with reduced
      bone density and fitness, as well as decreased muscle strength, and is associated
      with reduced survival. We found an unexpectedly high (35%) incidence of kyphosis
      in a healthy sample of well women 20 to 64 years of age. The correlation between
      normal postural index of kyphosis (I/K) and upright postural I/K was substantial
      (r = 0.799). Among the postmenopausal women, normal postural I/K was inversely
      correlated with age. Upright postural kyphosis was not related to age, nor was
      normal postural I/K in the premenopausal woman. There was no direct relationship
      demonstrated between current calcium consumption and I/K. Similarly, neither
      estrogen levels nor follicle-stimulating hormone levels were related to current
      posture. Women with satisfactory exercise habits had significantly lower I/K.
      Because the capacity to stand up straight was consistently higher than the normal
      postural score, yet closely correlated to it, there may be a role for postural
      kyphosis in changing the architecture of the vertebral column. As normal posture
      becomes kyphotic, an individual can no longer straighten the vertebral column.
      The surveyor's flexicurve, which we employed for this study, provided a simple
      and inexpensive method for assessing postural index. This measurement can be
      routinely included in the comprehensive health examination. Assessment of bone
      health in women should be made within the context of a fixed postural kyphosis.

PMID- 8363819
TI  - The difficulty placing younger Medicaid beneficiaries in nursing facilities.
      Commentary.

PMID- 8363820
TI  - Ethical considerations of goal setting for patient care in rehabilitation
      medicine.
AB  - This article examines the process of setting goals for patient treatment in
      rehabilitation. It explores ethical considerations and moral conflict inherent to
      the formulation of patient goals, and it provides a framework to help resolve
      such conflicts. Goal setting is also considered within the larger context of
      justice in the use of medical resources.

PMID- 8363821
TI  - A method to assess the trainee profiles of medical students attracted to our
      physical medicine and rehabilitation residency training program.

PMID- 8363823
TI  - Pathological hepatic accumulation of long-chain n-alkanes ("paraffin liver") in
      cows (Harbitz and Folling, 1940). An overlooked discovery. Description of lesions
      and identification of alkanes.
AB  - About 50 years ago crystalline deposits of a substance representing approximately
      7 per cent wet tissue weight and believed to be hentriacontane or a mixture of
      similar long-chain n-alkanes (30-34 carbon atoms) were detected in two
      discoloured and swollen cow livers. Stored purified extracts from these livers
      were recently reanalysed using gas chromatography and mass spectrometry. They
      were found to contain about equal amounts of nonacosane and hentriacontane with a
      small admixture of tritriacontane and other long carbon-chain alkanes. On the
      basis of histological findings, five additional cases of "paraffin liver" in cows
      have been recorded. In the discussion comparison is made with the only known case
      of a similar disorder in a human, visceral accumulation of the same three alkanes
      as in the cows, which was recently described in the literature. Concerning the
      origin of the deposits, importance is given to the fact that the long-chain
      alkanes with odd carbon numbers identified both in cattle and man predominate in
      the cuticular waxes of many dietary plants. The very large quantities of the
      abnormal substance in the cow livers indicate low toxicity, and evidently
      accumulation over long periods of time.

PMID- 8363822
TI  - Experimental Yersinia enterocolitica infection in rodents: a model for human
      yersiniosis.
AB  - Yersinia enterocolitica infection in humans causes a broad spectrum of diseases
      ranging from acute bowel disease to extraintestinal manifestations such as
      reactive arthritis, erythema nodosum and uveitis. During the last decade a
      fascinating part of the molecular biology of the pathogenicity of human
      pathogenic Yersinia species has been unraveled. Pathogenicity factors such as
      protein tyrosine phosphatase, protein kinase, thrombin- and collagen-binding
      factors have been identified and characterized on the molecular level. In
      contrast to many animal models for human enteropathogenic microorganisms,
      experimental Y. enterocolitica infection in rodents resembles yersiniosis in
      humans and thus offers extraordinary opportunities to study the sequential steps
      of the infectious process. Rabbits are suitable animals in which to study
      Yersinia-induced enteritis (enterotoxin-mediated) and the humoral immune response
      after oral infection. The role of Peyer's patches (PP) in the entry of
      enteropathogenic Yersinia species has been elucidated in mice and rabbits. M
      cells are probably the primary target cells of invading Yersiniae. Surprisingly,
      after penetration of the mucosal epithelial cell layer Yersinia bacilli were
      visualized to be exclusively extracellular in PP tissue. Obviously neutrophils
      within PP were unable to phagocytize the invading microorganisms. Presently, it
      is not clear how the microorganisms disseminate from PP into lymph nodes, spleen,
      liver and lung of mice where they form abscesses and granuloma-like lesions.
      Immunohistologically the involvement of macrophages and T cells could be
      demonstrated in Yersinia-induced lesions of mice. Direct evidence for the role of
      T cells and cytokine-activated macrophages in the host defense reaction against a
      primary Yersinia infection in mice could be obtained from experiments including
      adoptive transfer of Yersinia-specific T cells and in vivo neutralization of TNF
      alpha and IFN-gamma. The experimental rat model turned out to be a suitable model
      for studying Yersinia-induced aseptic arthritis. Lewis- and SHR rats proved to be
      arthritis-susceptible. Arthritogenicity of Yersinia for rats appeared to be
      restricted to Y. enterocolitica of serotype 08 and correlated with the virulence
      potential of this serotype. Surprisingly, expression of YadA, the collagen
      binding factor, was not necessary for arthritis induction. A close association
      between both susceptibility to arthritis induction and Yersinia infection could
      be demonstrated in various rat strains. Depletion of alpha/beta T-cell receptor
      (alpha beta-TCR)-positive T cells by treatment with alpha beta-TCR-specific
      antibody revealed that T cells were required for clearance of the
      pathogen.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8363824
TI  - Defective T-cell stimulatory pathways in patients after allogeneic bone marrow
      transplantation (BMT) in man.
AB  - Immunological reconstitution after allogeneic bone marrow transplantation in man
      is characterized by a decreased lymphocyte transformation response to various
      mitogens and antigens during a period of from months to years. One reason for the
      decreased proliferative capability could be an inverted CD4/CD8 ratio; however,
      the present investigation demonstrates that this is not the only explanation for
      the immunodeficiency, since the CD4 as well as the CD8 subset, when studied in
      isolation, have qualitative defects, as evidenced by a reduced response of both
      subsets to stimulation with PHA, anti-CD2 and anti-CD3 MABs. The reason for the
      qualitative defect is unknown but a distorted composition of the CD4+ as well as
      the CD8+ T-cell subsets is suggested by the present investigations. We also
      observed that the PHA response was almost completely reconstituted one year after
      BMT, while the PWM response was still severely affected. The present study
      suggests that T-cell subsets which differ in their capacity to respond to PHA and
      PWM have different kinetics of reconstitution after BMT.

PMID- 8363825
TI  - Improved identification of Staphylococcus aureus using a new agglutination test.
      Results of an international study.
AB  - A new reagent for the identification of Staphylococcus aureus, SLIDEX STAPH-KIT,
      operates on the principle of a latex and red blood cell combination
      agglutination: red blood cells are coated with fibrinogen for the detection of
      clumping factor, and latex particles are sensitized with anti-S. aureus serotype
      18 monoclonal antibody for the detection of protein A and antigen 18. French
      strains belonging to serotype 18 are methicillin-resistant. The performance of
      this reagent was compared with STAPHYSLIDE and STAPHAUREX in Europe (France,
      Germany, Italy), in the United States and in Japan using 548 methicillin
      resistant S. aureus strains, 392 methicillin-sensitive S. aureus strains, and 441
      non-aureus staphylococci. The specificity of the three reagents was equivalent
      (98.8% for SLIDEX STAPH-KIT, 99.1% for STAPHYSLIDE, 98.1% for STAPHAUREX). SLIDEX
      STAPH-KIT (97.3%) was more sensitive than STAPHYSLIDE (93.5%) and STAPHAUREX
      (89.7%) for all S. aureus strains due to a higher rate of identified methicillin
      resistant S. aureus strains.

PMID- 8363826
TI  - Cervical cancers in Greenlandic women diagnosed after negative results on
      cervical cytology: perspectives in a high-risk population.
AB  - A total of 160 indigenous Greenlandic women had incident cervical cancer
      diagnosed during 1976-1991, and 41 of these women (27%) had had at least one
      negative smear reported during the 10 years preceding the diagnosis of cancer.
      Thirteen patients had previously had abnormalities of the cervix. Of the
      remaining 28 patients, 17 had so-called interval cancer diagnosed within three
      years after a negative smear result. In seven of these cases, representing 4% of
      all incident cancers during the period, there had previously been two or more
      negative smears. Suboptimal sampling of negative smears was suggested in roughly
      one out of two interval cancers. The results suggest that rapid biological
      development of cervical cancer is infrequent among Greenlandic females and that
      efforts should be aimed at increasing the smear test's sensitivity and providing
      a better follow-up of women with cervical abnormalities rather than shortening
      the three-year rescreening interval.

PMID- 8363827
TI  - Analysis of heterogeneous viral populations by direct DNA sequencing.
AB  - The ability of direct PCR sequencing to detect and quantify sequence
      polymorphisms was investigated using samples containing mixed populations of HIV
      1. A part of the genome encoding the polymorphic variable region 3 of the
      envelope was directly sequenced to yield a consensus sequence of the virus
      population. The results were compared with sequences obtained by analysis of
      multiple clones derived from the same clinical samples. The results of five
      patients suggested that the direct-sequencing method can be used as a rapid tool
      to analyze and quantify heterogeneous viral populations. Reconstitution
      experiments using cloned material demonstrated that it was possible to detect and
      quantify minor sequence variants present in as little as 10% of the total virus
      population. The use of the method for molecular diagnosis is discussed.

PMID- 8363828
TI  - PCR amplification of HIV and cellular DNA sequences in formaldehyde-fixed,
      immunoreactive white blood cells.
AB  - Full utilization of the diagnostic power of PCR amplification of specific DNA
      sequences has been hampered by the logistical difficulties in handling
      potentially infectious human DNAs and by the polymerization of nonspecific,
      competing DNA products in PCR assays of low-frequency DNA sequences. To overcome
      these difficulties, we have devised a sensitive, specific PCR strategy that
      readily detects 5 copies of HIV provirus in a background of 10(5) disinfected
      white blood cells collected from formaldehyde-fixed peripheral blood.

PMID- 8363829
TI  - Quantification of hepatitis B virus DNA by competitive amplification and
      hybridization on microplates.
AB  - Present methods for quantification of hepatitis B virus (HBV) particles from
      serum samples are not sensitive enough for some recent clinical applications. We
      describe a test that allows quantification of HBV DNA in a broad dynamic range
      from less than 40 to 10(6) molecules based on competitive PCR. The specimen DNA
      and a known amount of an internal standard (IS) are co-amplified in the same tube
      with the same primers, one of which is biotinylated. The two biotinylated
      products can be quantified by hybridization on microplates coated with
      streptavidin, because their internal sequences are nonhomologous. An adequate
      standard curve is obtained by amplifying HBV DNA from a plasmid clone together
      with an IS. The ratio of amplified HBV DNA to IS DNA enables quantification of
      the original amount of HBV without tedious titrations of each sample with
      competitor. The lower limit for quantitative analysis with radioactive probes was
      between 4 and 40 virus particles in a 10-microliters serum samples.

PMID- 8363832
TI  - A high-sensitivity electrochemiluminescence-based detection system for automated
      PCR product quantitation.
AB  - A high-sensitivity nonisotopic system has been developed for post-PCR product
      detection. The probe-based detection system exploits a chemiluminescent reaction
      that takes place on the electrode surface in an electrochemical cell. The
      detection system incorporates a biotin-streptavidin capture reaction onto a solid
      support that permits fast post-PCR product detection at the attomole level. The
      system precision is within 5% relative standard deviation over a linear dynamic
      range of greater than three orders of magnitude. In this paper, the principles
      and features of the electrochemiluminescent-based detection system, together with
      its application to PCR product quantitation, are described in detail.

PMID- 8363830
TI  - Limiting detection of an amplification signal for HLA-D region and VNTR genes by
      32P-PCR.
AB  - The limiting detection signal for identification of human genetic markers, such
      as HLA-D and VNTR genes, was determined using DNA isolated from a series of
      decreasing numbers of lymphocytes carrying the target marker in the polymerase
      chain reaction (PCR). The PCR procedure was assembled by incorporating 32P
      labeled dCTP in the reaction mixture. Primers specific for detection of MHC Class
      II genes such as HLA-DR1, -DR2, -DRw52 and -DRw53 were utilized when cells were
      mismatched by one DR type, and primers for the identification of the region of
      variable number of tandem repeats (VNTRs) were utilized where cells had the same
      DR types. The 32P-incorporated amplified DNA was analyzed by polyacrylamide gel
      electrophoresis followed by exposure to x-ray film. The sensitivity of the test
      varied for different allelic markers as evaluated by amplification of DNA from
      each set of a mixture of lymphocytes. The target HLA-DR markers were detectable
      in a cell ratio of as high as 1:100,000, whereas the VNTR markers were detectable
      at a 1:1000 cell ratio. The approach described here offers certain advantages: 1)
      increased sensitivity, 2) quantitative power, 3) reduced assay time, 4)
      simplified procedure and 5) less expense. This method provides valuable
      information for studies involving forensic specimens and marrow engraftment after
      allogenic bone marrow transplantation (BMT) that require discrete representation
      of one allele relative to another in a heterozygous sample where limited
      quantities of target DNA are available.

PMID- 8363831
TI  - Use of an automated laboratory workstation for isolation of genomic DNA suitable
      for PCR and allele-specific hybridization.
AB  - In this paper we describe the isolation of genomic DNA by using anion exchange
      chromatography performed on a Biomek 1000 Automated Laboratory Workstation. This
      procedure allows the automated isolation of DNA suitable for most molecular
      analyses employed in diagnosis of genetic pathologies and infectious diseases.
      The genomic DNA isolated by using the Biomek 1000 was indeed found to be suitable
      for polymerase chain reaction and allele-specific hybridization.

PMID- 8363833
TI  - Extraction of DNA from cryopreserved clotted human blood.

PMID- 8363834
TI  - Dried umbilical cords as a source of DNA for genetic studies.

PMID- 8363835
TI  - Prenatal diagnosis for beta-thalassemia by PCR from single chorionic villus.

PMID- 8363836
TI  - A method for PCR sequencing of the p53 gene from a single 10-microns frozen or
      paraffin-embedded tissue section.

PMID- 8363837
TI  - A fast method for nonisotopic single-strand conformation polymorphism.

PMID- 8363838
TI  - Reducing artifact and increasing the yield of specific DNA target fragments
      during PCR-RACE or anchor PCR.

PMID- 8363839
TI  - Lyophilization as a method to store samples of whole blood.
AB  - We have investigated the feasibility of using lyophilization as a method of
      preserving whole blood samples for HLA class II molecular typing. Genomic DNA
      extracted from lyophilized blood appears similar in size to that extracted from
      fresh or frozen blood and is suitable for both PCR amplification and Southern
      blot analysis.

PMID- 8363840
TI  - Simultaneous mutagenesis of multiple sites: application of the ligase chain
      reaction using PCR products instead of oligonucleotides.
AB  - A method is described for preparing mutants with multiple, site-directed
      mutations by ordered coupling of PCR-generated fragments catalyzed by a
      thermostable DNA ligase. Annealing of the sense strands of the fragments to a
      single-stranded (antisense) template created a full-length sense strand leaving
      only nicks that were closed by ligation. Mutations were introduced in the PCR
      primers. Following 40 cycles of denaturation and annealing, tags on the flanking
      primers of the ligase chain reaction product were used specifically to amplify
      the mutated product with specific primers that could not amplify the original
      template. The amplified ligation product was cloned and was found to contain the
      desired restriction sites introduced by way of the mutagenic primers.

PMID- 8363841
TI  - PCR in situ: a rapid alternative to in situ hybridization for mapping short, low
      copy number sequences without isotopes.
AB  - A new technique for rapid localization of short, low copy number sequences is
      described, which uses a form of PCR on preparations of fixed metaphase
      chromosomes on microscope slides, with the temperature cycling controlled by a
      flatbed thermal cycler. In its present form, the method is capable of detecting
      very low copy number sequences, and further development is expected to achieve
      the target of localizing unique sequences. It has advantages over conventional
      fluorescent in situ hybridization, both in the speed (easily complete within a
      work-day) and in the potential sensitivity.

PMID- 8363842
TI  - Cycle sequencing using degenerate primers containing inosines.
AB  - A modified protocol for cycle sequencing DNA amplified by polymerase chain
      reaction (PCR) is described. The method involves two sequential linear PCR
      amplifications using a small amount of double-stranded DNA as a template and a
      stringent annealing temperature: 1) alpha-35S-dATP labeling of specific primers
      initially in degenerate primer mixture and 2) dideoxy-ribonucleotide termination
      of the extended and alpha-35S-dATP-labeled specific primers. The method does not
      require end labeling and is useful in sequencing PCR-amplified DNA sequences from
      highly degenerate primers when the sequences of the regions flanking those to be
      primed are unknown.

PMID- 8363843
TI  - Preferential hybridization: amplification of hybridization signals with nested
      probes.
AB  - This paper describes a protocol for the amplification of hybridization signals
      using single-stranded, digoxigenin-labeled probes of increasing length. Probes of
      different lengths were produced by a unidirectional polymerase chain reaction.
      Labeled probes were purified and collectively applied for the detection of
      immobilized nucleic acids. The method provides for a higher signal intensity than
      that observed with probes that cover the entire length of the target sequence. An
      increase of up to 4-fold in the intensity of the detection signal was observed.

PMID- 8363845
TI  - [A clinico-MRI study of extrapyramidal symptoms in multiple system atrophy-
      linear hyperintensity in the outer margin of the putamen].
AB  - We did a clinico-MRI study concerning extrapyramidal symptoms and T2-weighted MRI
      findings of the putamen in twenty patients with multiple system atrophy (MSA) as
      well as twenty-five with idiopathic Parkinson's disease. Nine out of twenty MSA
      patients showed extrapyramidal symptoms. And we could not observe cerebellar
      ataxia in two of these patients because of severe rigidity and akinesia. Eight
      out of nine MSA patients with extrapyramidal symptoms showed linear
      hyperintensity in the outer margin of the putamen. This abnormal intensity was
      bilateral and symmetric in most patients. However, in MSA patients without
      extrapyramidal symptoms, only one patient showed the linear hyperintensity. We
      could not find such abnormal intensity in any patients with Parkinson's disease.
      On proton density MRI, the signal intensity in the lesion was higher than that in
      the gray matter, which leads the speculation that the hyperintensity is gliosis
      of the putamen or increased extracellular fluid space caused by severe shrinkage
      of the putamen. This characteristic MRI finding is useful to distinguish MSA with
      extrapyramidal symptoms from Parkinson's disease.

PMID- 8363844
TI  - [Spinocerebellar ataxia 1--clinical study of 17 patients in a large pedigree].
AB  - We studied a large pedigree with dominant spinocerebellar ataxia, genetically and
      clinically. At now, 27 members over 5 generations have been affected. Linkage
      study for the disease locus to D6S89 in a total of 44 individuals showed maximum
      lod scores of 3.99 at theta = 0.000. This result indicates that the disease locus
      of this pedigree locates near D6S89 on chromosome 6p (SCA 1). We studied 17
      patients clinically. Mean age at onset was 37.7 +/- 8.6, and mean duration after
      onset was 11.3 +/- 6.8 years. Their clinical features were characterized by
      progressive ataxia, pyramidal involvement with hyperreflexia or spasticity, and
      mild posterior column involvement. Mild gaze nystagmus at early stage became
      unclear with the progress of illness. The frequent signs in the advanced stage
      were diffuse amyotropy, twitching of face or tongue, bulbar palsy, slow saccade,
      external ophthalmoparesis, mydriasis, coarse postural tremor, and dementia with
      emotional disturbance. There are so much clinical similarities between our
      pedigree and other SCA 1 pedigrees in the literature. Generally, SCA 1 shows
      hyperreflexia, spasticity, and terminal slow saccade. On the other hand, non-SCA
      1 type OPCA is characterized by progressive hyporeflexia, slow eye movement from
      early stage, and frequent choreoathetosis. Gaze nystagmus, external
      ophthalmoparesis, amyotrophy, and spasticity are common in both SCA 1 and Machado
      Joseph disease (MJD). However, they are more frequent in MJD than SCA 1.
      Moreover, extrapyramidal signs, such as dystonia, are rare is SCA 1. Based on
      these difference, SCA 1 could be clinically differentiated from other similar
      hereditary ataxias.

PMID- 8363846
TI  - [Clinical research of patients with epilepsy over age 50 years--a retrospective
      study of early onset case].
AB  - One hundred-sixteen patients with epilepsy over 50 years old were investigated to
      explore the clinical characteristics of epilepsy in elderly persons. Eighty-four
      patients having seizures within the last 3 years (residual group) were compared
      with 32 patients having no seizures within the last 3 years (disappeared group).
      Regarding the epilepsy type, there were 87 partial epilepsies (64 in the residual
      group and 23 in the disappeared group) which were approximately 70 percent of the
      total patients. Generalized epilepsies were comparatively rare in the both
      groups. Eleven patients with progressive myoclonus epilepsy were observed in the
      residual group. Regarding the seizure type, generalized convulsive seizures (GCS)
      were more likely to disappear than partial seizures regardless of number of
      seizures the patient had. Thirty-eight patients (29 in the residual group and 9
      in the disappeared group) had histories of psychiatric problems. Paranoid states
      were most commonly seen in 12 patients in the residual group and 5 patients in
      the disappeared group. Intellectual disturbance was seen more frequently in the
      residual group.

PMID- 8363847
TI  - [Analysis of water content in young rats brain edema by Raman spectroscopy].
AB  - Cerebral edema, classified into vasogenic edema and cytotoxic edema, has long
      been studied and recognized to be complicated. The authors studied the cerebral
      edema models of young rats suffered from cryo-injury and triethyl tin chloride
      (TET) injury by Raman spectroscopy which can physiologically evaluate the
      cerebral water content (%) of very restricted area. The cryo-injury model was
      conducted in the following manner. A cryo-probe (-196 degrees C) was contacted to
      the exposed cranium for 20 seconds in an anesthetized 4-5-week-old Sprague-Dawley
      young rat. A coronal section of the injured brain covered with a slide glass and
      wrapped by Parafilm was obtained 2, 4, 6, 8, 12, 24, 48, 72 hours after the cryo
      injury in order to measure the water content by Raman spectroscopy employed by
      Tashibu and Huizinga. TET injury model was obtained by intraperitoneal
      administration of TET (4.5 mg/Kg). The water content was observed by the same
      manner as for the cryo-injury model. Subsequent to the cryo-injury, the water
      content of the white matter which seemed to be higher than in adult rats
      increased rapidly and persisted in the same condition within 72 hours. Subsequent
      to TET injury, the water content of the white matter increased more rapidly than
      that of the gray matter, however, in adult rats the water content of the gray
      matter showed more rapid increase than that of the white matter. Increased water
      content followed by TET injury was higher in adult rats than in young
      rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363848
TI  - [Effects of interferon-gamma on cytotoxicity of murine activated macrophages
      against murine glioma cells].
AB  - We studied the effects of mouse IFN-gamma on the cytotoxic activity of murine
      activated macrophages (M phi) against mouse VM-Glioma cells (H-2b). Activated M
      phi were obtained from peritoneal exudate cells of mice from four strains,
      C57BL/6 (H-2b), C3H/He(H-2k), DBA/2 (H-2d), and BALB/c (H-2d), following
      intraperitoneal injection of (1) LPS 200 micrograms, (2) BCG 200 micrograms, (3)
      C. parvum 200 micrograms, or (4) MDP 350 micrograms 7 days prior to 20-hr 51Cr
      release-assay. Of the various combination of mouse strains and activating agents
      tested, that of activated M phi of the C3H/He mouse with induction by LPS had the
      most tumoricidal effect against the glioma cells, which was not MHC restricted.
      Although LPS-activated M phi underwent marked loss of cytotoxicity following
      initiation of in vitro culture, this 24 hr pretreatment with IFN-gamma inhibited
      this reduction in tumoricidal effects in a dose-dependent fashion. On the other
      hand, 24 hr pretreatment of target cells with IFN-gamma did not increase their
      susceptibility to lysis by activated M phi. These findings suggest that IFN-gamma
      augments the in vitro tumoricidal activation of M phi; This effect appears to be
      unrelated to any influence of IFN-gamma on target sensitivity to lysis by
      macrophages.

PMID- 8363849
TI  - [An occlusion and stenosis of the venous drainage system in cerebral AVMs-
      angiographical investigation].
AB  - We investigated angiographically occlusion or stenosis of draining veins in cases
      of arteriovenous malformations (AVMs). The subjects were 51 cases who were
      diagnosed as cerebral AVMs by angiography in our hospital between April 1973 and
      January 1991. Those consisted of 8 dural AVMs, 3 mixed pial-dural AVMs, and 40
      pial AVMs. Angiography was stereoscopically done in all cases. Angiograms
      obtained prior to treatment were retrospectively analyzed. Cases of dural AVMs or
      arteriovenous fistulae in the cavernous sinus were excluded from the subjects.
      Eight of 51 cases (16%) had occlusion or stenosis of draining veins; i.e., 2
      dural AVMs, 1 mixed pial-dural AVM, 5 pial AVMs. One of 2 dural AVMs was located
      in the sigmoid sinus, and another involved the superior sagittal sinus. One mixed
      pial-dural AVM was a vein of Galen aneurysm. Occlusion or stenosis was recognized
      at the junction of the vein of Galen to the straight sinus (3 cases), in the
      straight sinus (2 cases), at the junction of the vein of Labbe to the transverse
      sinus (1 case), in the superior sagittal sinus (1 case), and in the sigmoid sinus
      (1 case). Two of 8 cases with occlusion or stenosis of draining vein presented
      with hemorrhage at the site of AVMs. In cases of pial AVMs, occlusion or stenosis
      of draining vein seemed be related to endothelial changes due to turbulent and
      irregular flow. On the other hand, in cases of dural AVM with dural sinus
      occlusion, sinus abnormalities may precede the formation of fistulous
      communications.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363850
TI  - [Sequential changes in SPECT using 201T1 chloride during the treatment of
      intracranial gliomas].
AB  - The authors followed up the change in SPECT using 201Tl chloride (Tl-SPECT)
      according to the course of treatment of intracranial gliomas and analyzed the
      difference in Tl-SPECT between the stable and progressive groups. The subjects
      were 26 series of supratentorial gliomas subjected to Tl-SPECT before and after
      the treatment (radio-therapy and chemotherapy). They were put on Tl-SPECT after
      10 minutes (early image) and 4 hours (delayed) following 74 MBq of 201Tl chloride
      intravenous injection. Besides, RI count ratio (L/N) in the tumor lesion (L) and
      contralateral parenchyma (N) was measured. The patients were divided into stable
      and progressive groups judging from the therapeutic effects, the change in L/N
      ratio between before and after the treatment was analyzed. The stable group
      showed a significant post-treatment decrease in L/N ratio compared with a
      significant post-treatment increase therein for the progressive group. This
      result suggested Tl-SPECT to change according to the course of treatment and to
      be applicable to the judgement of the therapeutic effect on gliomas.

PMID- 8363851
TI  - [Herpetic simplex encephalitis followed by myelopathy].
AB  - A 48-year-old male was admitted to our hospital because of fever, headache and
      vomiting. At admission, the level of consciousness was depressed (drowsy) with
      slight confusion. Extremely miotic pupils, nuchal stiffness, ataxia and myoclonic
      movements of both upper limbs were observed. The eye movements were almost normal
      and there was no definite limb weakness or sensory impairment. A few days after
      admission, his level of consciousness further decreased, and opsoclonus, ataxic
      breathing and intestinal paralysis appeared. The body temperature fluctuated
      remarkably ranging from 33.0 degrees C to 39.0 degrees C. The cerebrospinal fluid
      (CSF) examination revealed lymphocytic dominant pleocytosis, increase of protein
      and decrease of glucose. Enzyme-linked immunosorbent assay (ELISA) showed
      increased antibody (IgG) to herpes simplex virus (HSV) in both serum and CSF. The
      antibody in CSF further elevated at the later examination. Magnetic resonance
      imaging (MRI) demonstrated high signal intensity areas mainly in the cerebellum
      and sporadically in the supratentorial subcortical white matter on T2-weighted
      images. Administration of Gadolinium-DTPA also revealed an additional lesion in
      the pons. From these findings, he was diagnosed as herpetic encephalitis
      involving the brainstem and the cerebellum, and acyclovir was administered.
      Although his initial symptoms and signs started to recover three weeks after
      admission, he newly developed complete flaccid paraplegia, dysuria and sensory
      disturbance with the spinal cord level of the 4th thoracic segment. The
      oligoclonal IgG bands were detected in the cerebrospinal fluid of the
      convalescent stage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363853
TI  - [A case of cervical vagus neurinoma with hypoglossal palsy].
AB  - Cervical vagus neurinoma with hypoglossal palsy is extremely rare and only one
      case has been reported so far in Japan. A 52-year-old female complained of
      dysarthria. She has hypoglossal palsy with left-deviated tongue and the left half
      of her tongue was markedly atrophic. Cervical mass was not palpable and she had
      no other complaint such as hoarseness or dysphagia. CT scan and MRI revealed a
      tumor at a caudal part of the left jugular foramen. A hypoglossal canal was
      intact. Cerebral angiography demonstrated arterio-venous dissociation but
      vascular formation or tumor stain was not revealed. The tumor was totally removed
      by transpetrosal approach. The vagus nerve became thicker above C2 level and
      changed into the yellowish tumor with clear margin. The hypoglossal nerve was
      compressed between the tumor and an occipital bone. The authors think this is why
      hypoglossal palsy appeared. Histologically, the tumor was neurinoma. Clinical
      symptoms, diagnosis, and treatment were discussed.

PMID- 8363852
TI  - [Cerebellopontine angle lipoma--case report].
AB  - Intracranial lipomas are rare. Cerebellopontine angle lipomas are extremely rare.
      We report a case of right cerebellopontine angle lipoma. A 47-year-old woman has
      been suffering from right trigeminal neuralgia for about 1 year. Neurological
      examination showed right 5th and 8th cranial nerve dysfunction. MRI demonstrated
      the high intensity mass lesion at right cerebellopontine angle. The lesion was
      demonstrated as negative intensity in an opposed image by using Dixon's
      technique. CT showed the lesion as a very low density area (-104 Hounsfield
      units). Subtotal removal of the tumor was performed following right suboccipital
      craniectomy. Pathological diagnosis was lipoma. We review the literature on this
      rare tumor and discuss the clinical symptoms, radiological findings and
      management. We suggest that the operation should be prudently performed for the
      case with only hearing disturbance because there is a high possibility that
      hearing disturbance will worsen.

PMID- 8363854
TI  - [A 70-year-old man with right hemiparesis and mutism].
AB  - We report a 70-year-old man who had a sudden onset of right hemiparesis and
      mutism. The lower extremity was more involved than the upper one. He had a long
      history of diabetes and chronic renal failure for which hemodialysis was
      necessary. On August 30, 1990, he had an sudden onset of right hemiparesis and
      mutism. Neurological examination revealed awake but mute in no acute distress. He
      could only respond to very simple commands such as opening his mouth or
      protruding his tongue. He did not appear to understand more difficult questions.
      In addition, he could not answer verbally. He was totally mute. Cranial nerves
      appeared intact except for slight right central facial paresis and severe
      diabetic retinopathy. He had complete paralysis of his right leg and a moderate
      weakness in his right upper extremity. Deep reflexes were diminished in both
      upper extremities and absent in the lower limbs. Frotal signs such as grasp and
      snout reflexes were present. Cranial CT scans revealed an ill-defined low density
      area in the left parasagittal subcortical area and a part of the anterior
      cerebral artery territory. The supplementary motor area appeared at least in part
      to be involved. He was treated with glycerol and other supportive cares, however,
      his clinical course was complicated by pneumonia, heart failure, septicemia, and
      he expired two months after his stroke. The patient was discussed in a
      neurological CPC, and the chief discussant arrived at a conclusion that he had an
      artery-to-artery embolism at the internal carotid bifurcation resulting in the
      cerebral infarction mainly in the territory of the anterior cerebral
      artery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363855
TI  - Quantitative analysis of trabecular bone structure.

PMID- 8363856
TI  - Marrow space star volume can reveal change of trabecular connectivity.

PMID- 8363857
TI  - Relation between 2- and 3-dimensional architecture of trabecular bone in the
      human spine.
AB  - By means of a new preparation technique which allows the combined 2- and 3
      dimensional analysis of trabecular bone we analyzed the vertebral bodies of 22
      autopsy cases. None of these cases had any skeletal disease. With increasing age
      bone volume was decreased in all vertebral bodies (2nd cervical to 5th lumbar
      body) but this decrease was more pronounced in the lower vertebrae. In the upper
      cervical spine there was nearly no age-related loss of trabecular bone volume. 3
      D analysis demonstrated that the loss of bone tissue is due to a loss of
      trabecular plates which are transformed to trabecular rods by perforations. The
      number of plates and rods could be measured directly. In the 2nd lumbar vertebra
      at the age of 20 years the density of plates was 0.61 mm, the density of rods was
      0.2/mm. At the age of 80 years the density of plates was 0.2/mm. The density of
      rods remained constant at all ages. Perforations could be seen directly. They
      were located mainly in trabecular plates. At higher ages they occurred in rods
      either. The number of vertically oriented trabeculae was about twice the number
      of horizontal ones. The rate of age-dependent reduction of trabeculae was the
      same in horizontal and vertical trabeculae. It was possible to do real 3
      dimensional measurements of the diameter of trabecular rods. These values were
      compared to the calculated values of trabecular plates. In mean trabecular plates
      are thinner than rods. It could be demonstrated that microcallus formation is a
      common feature in the human spine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363858
TI  - Stereology and histogram analysis of backscattered electron images: age changes
      in bone.

PMID- 8363859
TI  - Changes of interstitial bone thickness with age in men and women.
AB  - Mean interstitial bone thickness has been estimated from mean trabecular
      thickness and mean wall thickness (It.Th = Tb.Th-2*W.Th) with varying results.
      Some authors found age-related changes of It.Th while others did not. We measured
      It. Width (It.Wi, 2D) directly, in cancellous iliac crest bone from 23 women aged
      20-78 yrs. and 21 men aged 23-74 yrs. At grid-selected sites coupled measurements
      were done of Tb.Wi and It.Wi, together with W.Wi. It.Wi was defined as the
      distance between cement lines nearest to the surface at both sides of a
      trabecula. A thionine stain was used to visualize the cement lines. When the
      persons studied were divided into two age groups: 20-49 yrs (Group 1) and 50-79
      yrs (Group 2) significant but opposite age-related trends were seen both in men
      and women. Group 1: Men: r = -.68; p < .02; n = 11; Women: r = -.68; p < .02; n =
      11. Group 2: Men: r = .79; p < .01; n = 10. Women: r = .59; p < .05; n = 12 (r =
      coeff. of correlation). Men: It.Wi 63.3 microns (3rd decade [dec.]); 50.8 microns
      (6th dec.); 67.8 microns (8th dec.). Women: It.Wi 63.7 microns (3rd dec.); 48.3
      microns (6th dec.); 63.8 microns (8th dec.). Measured It.Wi values appeared
      considerably larger than their calculated counterparts (mean delta: 35%). The
      decline of It.Wi is interpreted as a sign of negative bone balance at the BMU
      level, leading to thinning of trabeculae, the subsequent increase has to be the
      result of both declining resorption depth and disappearance of the thinner
      trabeculae.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363860
TI  - The Conneulor: unbiased estimation of connectivity using physical disectors under
      projection.
AB  - The Euler number and the connectivity of an arbitrary object is defined, and it
      is illustrated why the connectivity of an n-dimensional object cannot be
      estimated in an (n-1)-dimensional section. The disector--principle for 3-D
      counting of the Euler--events is illustrated in cancellous bone. The correct
      handling for unbiased counting of events at artificial edges is outlined. A
      nomogram for predicting the precision of an estimate is provided.

PMID- 8363861
TI  - Repair of large cortical defects with block coralline hydroxyapatite.

PMID- 8363862
TI  - Structural and cellular assessment of bone quality of proximal femur.

PMID- 8363863
TI  - Histomorphometric analysis of tricalcium phosphate ceramic implanted into
      turkeys.
AB  - Porous cylinders of tricalcium phosphate of two pore size distributions and four
      pore densities were implanted bilaterally into the ulnae of twelve skeletally
      mature turkeys. Morphometric analyses at two, four, and six post-operative months
      indicate implant resorption begins prior to the second post-operative month and
      that physical changes and biologic response continue at a rate dependent upon
      pore size distribution.

PMID- 8363864
TI  - Methods for the histological study of femoral neck bone remodelling in patients
      with fractured neck of femur.

PMID- 8363865
TI  - The identification of cortical microdamage in fatigue-loaded bone using a non
      invasive impulse response vibration testing technique.

PMID- 8363866
TI  - Determination of femur structural properties by geometric and material variables
      as a function of body weight in rats. Evidence of a sexual dimorphism.
AB  - Femur diaphyses of male and female Wistar rats were densitometrically and
      biomechanically assayed. The BMD-dependent material properties were better in
      female than in male bones, but cross-section geometric properties were better in
      male femurs. As a result, mechanical properties of the integrated diaphyses were
      better in males, but differences disappeared after statistical adjustment of data
      to a common body weight. Results evidence a feed-back mechanism locally
      controlling the strain-dependent bone modelling and the corresponding cross
      sectional design as related to bone stiffness, with a set-point adjusted to
      animal biomass. A sexual dimorphism of bone biomechanics is also described for
      the species.

PMID- 8363867
TI  - Insulin like growth factors and the local regulation of bone formation.

PMID- 8363868
TI  - Anabolic effect of parathyroid hormone on cancellous and cortical bone histology.

PMID- 8363869
TI  - Prostaglandin E2 restores cancellous bone to immobilized limb and adds bone to
      overloaded limb in right hindlimb immobilization rats.
AB  - The purpose of this study was to determine whether prostaglandin E2 (PGE2) can
      restore cancellous bone mass and architecture to osteopenic, continuously
      immobilized (IM), proximal tibial metaphysis (PTM) in female rats. The right
      hindlimb of three and one-half-month-old Sprague-Dawley female rats were
      immobilized by right hindlimb immobilization (RHLI) in which the right hindlimb
      was underloaded and the contralateral left limb was overloaded during ambulation.
      After 4 or 12 weeks of RHLI, the rats were treated with 3 or 6 mg PGE2/kg/day and
      RHLI for 8 or 16 weeks. Bone histomorphometry was performed on microradiographs
      of PTM. Immobilization (IM) induced a transient cancellous bone loss and
      decreased trabecular thickness, number and node density, and increased free end
      density that established a new steady state after 4 weeks of IM. Three or 6 mg
      PGE2/kg/d for 8 weeks beginning at 4 or 12 weeks of IM completely restored
      cancellous bone mass (+127% to +188%) and structure to the age-related control
      levels in spite of continuous IM. Another 8 weeks of treatment maintained bone
      mass and architecture at these levels. No differences in cancellous bone mass and
      architecture were found between the overloaded PTM or RHLI rats and the age
      related controls. However, 3 and 6 mg/kg/d of PGE2 treatment started at 4 or 12
      weeks for 8 weeks significantly increased cancellous bone mass in the overloaded
      PTM (+45 to +74% of untreated controls), and another 8 weeks of treatment
      maintained bone mass at these levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363870
TI  - Alkaline phosphatase-positive human osteoblasts do not normally express MHC class
      II antigens in vivo.

PMID- 8363871
TI  - Estrogen induces bone formation on non-resorptive surfaces in the rat.
AB  - We have recently found that 17 beta-estradiol (E2) stimulates bone formation in
      rat cancellous bone, and that this bone formation is suppressed by (3-amino-1
      hydroxypropylidene)-1-bisphosphonate (AHPrBP). To analyse the relationship
      between bone resorption and bone formation in the action of E2, we injected 13
      week-old female rats sequentially with three fluorochromes (calcein, tetracycline
      and xylenol orange) at 7-day intervals. E2 (40 micrograms/kg) or vehicle was
      injected daily for 15 days, starting 24 hrs after the first fluorochrome. A third
      group was injected with AHPrBP (0.3 mg/kg) 24 hrs after the first two
      fluorochromes. The rats were killed 48 hrs after the third fluorochrome. We found
      that the perimeter of all three fluorochrome labels was increased by E2. The
      entire perimeter of the first label was non-crenated. Since the first label was
      given before E2-administration, this suggests that label that would otherwise
      have been eluted from the bone surface had been fixed in bone by E2-induced bone
      formation, which might have occurred either through prolongation of pre-existing
      bone formation, or induction of bone formation on quiescent surfaces. In either
      case, our results suggest that resorption did not precede formation at the site
      of bone formation. Since induction of bone formation by E2 is suppressed by
      inhibition of bone resorption, this suggests that the coupling of E2-induced
      formation to resorption in the rat does not necessarily require that formation
      occurs at the same site as bone resorption.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363872
TI  - A method for the localization of cytokine mRNA expression in adult human bone by
      in situ hybridization.

PMID- 8363873
TI  - Analysis of gene expression in skeletal tissues by in situ hybridization.

PMID- 8363874
TI  - Marrow stromal (Western-Bainton) cells: identification, morphometry, confocal
      imaging and changes in disease.

PMID- 8363875
TI  - Evaluation of osteoblastic activity by morphometric comparison of alkaline
      phosphatase cytochemistry vs. tetracycline fluorescence.
AB  - Alkaline phosphatase (ALP) activity was used as a novel histomorphometric index
      of osteoblastic surfaces involved in mineralization. The enzyme cytochemical
      reaction was done on sections of low temperature processed, glycol methacrylate
      (GMA) embedded bone biopsies from 39 patients with various types of renal
      osteodystrophy (age 48 +/- 12 yrs; 19 males, 20 females) who had received
      tetracycline labelling. Sets of three serial sections were obtained from each
      tissue block: the 1st section (2 microns thick) was stained with Methylene blue
      Azure 11 for morphology; the 2nd section (2 microns thick) was used for ALP
      cytochemistry; the 3rd section was left unstained for UV microscopy. ALP positive
      osteogenic cells on bone surfaces displayed either of two distinct morphologies:
      a) typical plump, 'active' osteoblasts, and b) flat, elongated cells otherwise
      indistinguishable from 'bonelining cells'. These ALP+ flat cells were in contact
      with sites of active osteoid and mineral deposition and also codistributed with
      tetracycline labels outside of, and in continuity with, osteoid seams. Flat
      lining cells which were ALP negative were never associated with labels.
      Therefore, ALP activity also provided an objective criterion for differentiating
      two different 'phenotypes' among flat bone lining cells (ALP+ and ALP-),
      associated or not associated with matrix mineralization, respectively. The
      following histomorphometric variables were measured: Ob.S/BS, OS/BS, MS/BS and
      ALP.S/BS. Ob.S/BS, OS/BS and MS/BS were different in different types of ROD.
      However, OS/BS always exceeded MS/BS which, in turn, always exceeded Ob.S/BS.
      ALP.S/BS exceeded OS/BS in controls, mixed ROD and hyperparathyroidism, whereas
      the reverse occurred in osteomalacia and aplastic bone, due to the abundance of
      ALP lining cells over nonmineralizing surfaces.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363876
TI  - Immunohistochemical study of activating osteoblasts from undifferentiated
      mesenchymal cells by electrical stimulation.

PMID- 8363877
TI  - Gene expression at single cell resolution associated with development of the bone
      cell phenotype: ultrastructural and in situ hybridization analysis.

PMID- 8363878
TI  - A comparison of microanatomic basis for coupling between bone formation and bone
      resorption in man and the rat.
AB  - The trabecular bone of the secondary spongiosa of mature rats shows a coupling of
      bone formation to resorption. In adult man the coupling of formation and
      resorption involves a site-specific sequence of events, in which bone resorption
      is normally followed, at the same site, by bone formation. Whether the coupled
      processes of bone resorption and formation also occur at the same site in the rat
      is unknown. To elucidate the spatial relationship between bone formation and
      resorption in the rat, we compared the percentage of crenated and non-crenated
      cement lines with the percentage of crenated and non-crenated bone surfaces in
      the proximal tibia of adult rats aged 16 weeks-two years. A similar comparison
      was also made using bone from adult human iliac crest. We found that the
      trabecular bones of 16-week and seven-month-old rats exhibited a low percentage
      of crenated cement lines. In contrast, the surfaces of rat bone trabeculae showed
      a similar low proportion of crenated surface to human bone. However, in older
      (two years) rats, in which bones have ceased to grow in length, the percentage of
      cement lines that were crenated increased to towards human levels. These results
      imply that most of the bone formed in the secondary spongiosa of growing rats
      occurs on non-resorbed surfaces. Thus, although there is substantial evidence
      that bone formation is coupled to resorption in the rat, such that increased
      resorption is associated with increased formation, and suppression of resorption
      suppresses bone formation, bone formation does not necessarily occur on a
      previously resorbed site.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363879
TI  - Characterization of osteopenia in feline mucopolysaccharidosis VI and evaluation
      of bone marrow transplantation therapy.
AB  - Studies on a feline model of MPS VI demonstrated a marked osteopenia in iliac
      crest bone samples from young adult animals with fewer, finer trabeculae. In the
      absence of significant differences in bone remodeling, this was considered due to
      defects in endochondral ossification and the formation of fewer trabeculae. Cell
      level bone formation was normal despite the presence of vacuolated osteoblasts.
      Affected animals had vacuolated osteocytes in larger lacunae. Cats of the same
      age who had received a bone marrow transplant 12 months prior as young kittens,
      had significantly more trabecular bone with thicker trabeculae. The presence of
      smaller osteocyte lacunae in these animals as compared to their untreated MPS VI
      cats appeared to be a direct effect of bone marrow transplantation and a useful
      parameter to monitor its efficacy.

PMID- 8363880
TI  - Animal models for the study of bone loss after cessation of ovarian function.

PMID- 8363881
TI  - Calcium-restricted ovariectomized Sinclair S-1 minipigs: an animal model of
      osteopenia and trabecular plate perforation.
AB  - The ovariectomized rat model has now been generally accepted as a useful model
      for screening different therapeutic agents, but there is a major requirement to
      identify reliable large animal models for osteoporosis research. In this study,
      the calcium restricted, ovariectomized minipig has been thoroughly investigated
      in order to define a large animal model with trabecular and cortical bone
      remodeling which would be reliable for further testing of agents that had shown
      promise of efficacy during the screening procedure. Twenty six female, 4-month
      old minipigs were randomized into four groups and fed either normal diet (0.90%
      calcium (Ca.)) or diet with restricted calcium content (0.75%, 0.50%). At the age
      of ten months, 3 groups were ovariectomized (OVX) while one group on normal diet
      was shamoperated. The groups were followed for six months after the operation. At
      death, bone mass was determined by densitometry and by ashing. Additionally,
      biomechanical competence was assessed in trabecular bone cores from the vertebral
      bodies. Finally, histomorphometry (static and dynamic parameters) and structural
      analyses (star volume) were performed on the vertebral bodies. The study revealed
      an OVX-related decline of 6% in vertebral bone mineral density (BMD) and a
      decline of 15% in trabecular bone volume (BV/TV). In contrast, a 15% increase in
      mean trabecular plate separation (Tb.Sp.) and a small increase in marrow space
      star volume (Ma. Star V.) were detected. The structural changes became more
      pronounced when OVX was combined with mild Ca. restriction (0.75% Ca.) with an
      increase in Ma. Star V. to 164%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363882
TI  - Bone histomorphometry in baboons in captivity.

PMID- 8363883
TI  - The long-term effect of ovariectomy on the quality and quantity of cortical bone
      in the young cynomolgus monkey: a comparison of density fractionation and
      histomorphometric techniques.

PMID- 8363884
TI  - Bone remodeling during calcitonin excess: reconstruction of the remodeling
      sequence in medullary thyroid carcinoma.

PMID- 8363885
TI  - Primary hyperparathyroidism: iliac crest cortical thickness, structure and
      remodeling evaluated by histomorphometric methods. Aarhus Bone and Mineral
      Research Group.

PMID- 8363886
TI  - Non-invasive measurements of bone mass in adult renal osteodystrophy.

PMID- 8363887
TI  - Long-term effect of oral calcitriol pulse therapy on bone in hemodialysis
      patients.

PMID- 8363888
TI  - Synergistic effect of 1,25-vitamin D3 and fluoride on bone aluminum accumulation.

PMID- 8363889
TI  - Morphometry of bone resorption: introduction and overview.

PMID- 8363890
TI  - Assessment of erosion depth by lamellar counting.

PMID- 8363891
TI  - Assessment of resorption cavity characteristics in trabecular bone: changes in
      primary and secondary osteoporosis.

PMID- 8363892
TI  - Histomorphometry of Howship's lacunae formed in vivo and in vitro: depths and
      volumes measured by scanning electron and confocal microscopy.

PMID- 8363893
TI  - Proliferation of bone surface-derived osteoblastic cells and control of bone
      formation.

PMID- 8363894
TI  - Histomorphometry of active osteoblast surface labelled by antibodies against non
      collagenous bone matrix proteins.

PMID- 8363895
TI  - Osteoblast density and the evolution of BMUs in vertebral osteoporosis.

PMID- 8363896
TI  - Greater bone formation induction occurred in aged than young cancellous bone
      sites.
AB  - We have determined the differences in the effects of continual prostaglandin E2
      (PGE2) treatment in aged (non-growing) and young (growing) cancellous bone sites
      in 7-month-old Sprague-Dawley rats. The sites involved are the aged distal tibial
      metaphysis (DTM) with a closed epiphysis and the young proximal tibial metaphysis
      (PTM) with a slow growing, open epiphysis. The study involved rats treated with
      0, 1, 3 or 6 mg PGE2/kg/d for 60, 120 and 180 days. Static and dynamic
      histomorphometry of percent trabecular area, and tissue-referent bone formation
      rate (BFR/TV) were determined in both DTM and PTM. In pretreatment controls, the
      secondary spongiosa of the two metaphyses contain the same amount of cancellous
      bone (11% in DTM vs. 13% in PTM), but markedly less bone formation in DTM (0.6%/y
      in DTM vs. 41.5%/y in PTM). After 60 days of 6 mg PGE2/kg/d treatment, %Tb.Ar was
      increased 607% in DTM and 199% in PTM, BFR/TV was increased to nearly 14 fold in
      DTM and only 5 fold in PTM. These results indicated the aged metaphysis of the
      DTM was much more responsive to PGE2 treatment than young, growing metaphysis of
      the PTM. The results of 120 and 180 days treatment did not significantly differ
      from 60 days treatment in both sites, indicating that the effect of continuous
      daily PGE2 treatment were in equilibrium after 60 days. We concluded that aged
      metaphysis was much more responsive to PGE2 treatment than young growing
      metaphysis.

PMID- 8363897
TI  - Calculation of active formation period using label escape and three labels.

PMID- 8363898
TI  - Maintaining restored bone with bisphosphonate in the ovariectomized rat skeleton:
      dynamic histomorphometry of changes in bone mass.
AB  - This experiment contains the crucial data for the Lose, Restore and Maintain
      (LRM) concept, a practical approach for reversing existing osteoporosis. The LRM
      concept uses ovariectomy (ox) to lose bone, an anabolic agent to restore bone
      mass and then switches to an antiresorptive agent to maintain bone mass. We ox'd
      or sham-ox'd rats for 150 days (Loss Phase), treated them with 6 mg PGE2/kg/d for
      75 days to restore lost cancellous bone mass (Restore Phase) and then stopped
      PGE2 treatment and began treatment with 1 or 5 micrograms/kg Risedronate, a
      bisphosphonate twice a week for 60 days (Maintain Phase). During the Loss Phase,
      cancellous bone volumes of the proximal tibial metaphysis (PTM) in the ox'd rat
      fell to 19% of initial controls. During the Restore Phase, the PTM bone volume in
      ox'd rats doubled. However, when PGE2 treatment was stopped, the PGE2-induced
      cancellous bone disappeared. In contrast, 5 micrograms of Risedronate inhibited
      the bone loss and maintained it at the PGE2 treatment level. The key dynamic
      histomorphometry value for the restore (R) and maintenance (M) phases was the
      ratio of bone formation to resorption rates. The ratio was elevated to 5.8 in the
      R phase and depressed to 0.4 for no and 1 microgram Risedronate treated M phase
      and to a ratio of near unity of 1.1 for the 5 micrograms Risedronate treatment.
      These findings indicate that we were successful in maintaining the new PTM bone
      induced by PGE2 after discontinuing PGE2 by administering enough Risedronate, a
      resorption inhibitor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363899
TI  - The aminobisphosphonate alendronate inhibits bone loss induced by thyroid hormone
      in the rat. Comparison between effects on tibiae and vertebrae.
AB  - The aims of this study were to develop a rat model of hyperthyroidism and to
      determine the efficacy of alendronate in the prevention of thyroid hormone
      induced bone loss. Ten week-old Sprague-Dawley rats injected with thyroxine 250
      micrograms/kg/day (+T4) or vehicle (-T4) were treated with alendronate (+ALN) or
      vehicle (-ALN) orally 0.5 mg/kg/day. After 3 weeks of treatment histomorphometric
      parameters of cancellous bone remodeling were assessed in the proximal tibia and
      in the first lumbar vertebra. In the secondary spongiosa of the tibia T4
      treatment caused significant bone loss, associated with increased bone turnover;
      trabecular bone volume, trabecular thickness and trabecular number were
      significantly decreased. Osteoid and osteoclast surfaces increased in +T4/-ALN as
      compared to control. Alendronate prevented the increase in bone turnover and
      increased bone volume above control values without interfering with the
      recruitment of osteoclasts. These changes were not apparent in the vertebra. It
      is concluded that excess thyroid hormone in the rat induces high turnover bone
      loss in the tibia which can be prevented by alendronate through an inhibition of
      osteoclastic activity. The lack of effects of thyroid hormone on the vertebra may
      be ascribed to a lower rate of basal bone turnover at that site.

PMID- 8363900
TI  - Histomorphometric effect of six month treatment with oral Risedronate in patients
      with multiple myeloma.

PMID- 8363901
TI  - Immobilisation induced bone loss in the sheep is not modulated by calcitonin
      treatment.
AB  - The effect of calcitonin on immobilisation-induced loss of cortical and
      trabecular bone was studied in adult female sheep. The left calcaneus of 24 adult
      female Welsh mountain sheep was protected from normal loading by placing an
      external fixator across the hock joint, from the tibia to the metatarsus. In vivo
      strain gauge recordings from similar animals showed that this procedure resulted
      in a 50% reduction in principal strain magnitude in the shaft of the calcaneus
      during walking. All animals received intramuscular injections three times weekly.
      Half of the sheep received 100 i.u. of salmon calcitonin while the remainder
      received vehicle alone. The experiment was conducted blind. Over the 12 week
      period of the experiment, dual photon absorptiometry was performed at monthly
      intervals to measure the bone mineral content (BMC) of the calcanei. In all the
      animals, the loss of bone associated with the functional protection afforded by
      the fixator was highly significant (p < 0.0001). There was however, no
      significant difference in either the amount or rate of bone loss between animals
      which had received calcitonin and those which had not. Post mortem measurement of
      the cortical thickness of the shaft of the calcaneus revealed a specific pattern
      of loss which was also not different in the two groups. In this model, calcitonin
      treatment was ineffective in preventing or retarding loss of bone associated with
      reduced functional load-bearing over a 12 week period.

PMID- 8363902
TI  - Relationship between bone formation rate and osteoblast surface on different
      subdivisions of the endosteal envelope in aging & osteoporosis.

PMID- 8363903
TI  - Early histomorphometric changes in response to parathyroid hormone therapy in
      osteoporosis: evidence for de novo bone formation on quiescent cancellous
      surfaces.

PMID- 8363904
TI  - In vitro tetracycline labelling and bone cell survival in human trabecular bone
      explants.
AB  - Results are presented which document the feasibility and utility of human
      trabecular bone explants for in vitro bone research. This approach is
      advantageous because it allows bone cells to maintain their natural orientation
      on the endosteal surface, and keeps surrounding marrow intact--thus retaining the
      immediate local microenvironment. In addition, bone cells are not exposed to
      transient, but sometimes harsh, isolation procedures. Data are presented which
      show greater initial bone cell numbers from younger donors and the change in
      these numbers over culture periods up to 21 days. A technique is presented which
      achieves single and double tetracycline label incorporation into the mineralizing
      front of bone explants in vitro using a pulse-chase methodology.

PMID- 8363905
TI  - Optimizing multiple fluorochrome bone histodynamic markers.

PMID- 8363906
TI  - Electron microscope examination of osteoblast-like cells (ROS 17/2.8) after
      colorimetric evaluation of the proliferation.

PMID- 8363907
TI  - Quality assurance-quality control in bone histopathology and bone
      histomorphometry.

PMID- 8363908
TI  - Strategies for regenerating bone of the craniofacial complex.

PMID- 8363909
TI  - A non-human primate model for the study of osteoporosis and oral bone loss.

PMID- 8363911
TI  - You make the diagnosis: case study. Ineffective airway clearance, fluid volume
      deficit.

PMID- 8363910
TI  - Alveolar bone augmentation following the local administration of prostaglandin E1
      by controlled-release pellets.
AB  - E-Series prostaglandins (PGE) are powerful osteogenic substances when given in
      vivo. The purpose of this work was to determine the ability of locally
      administered PGE1 to promote alveolar bone formation. Controlled-release pellets
      containing PGE1 were implanted on the lateral mandibular surface of Beagle dogs
      and tissues collected 4 weeks later. There was a dose-related increase in
      alveolar bone thickness and bone formation rates following PGE1 administration.
      In many cases, there was substantial new bone formation on the alveolar crest.
      Some increase in alveolar bone remodeling occurred with higher doses of PGE1.
      These results demonstrate that locally administered PGE1 may be useful for the
      augmentation of alveolar bone.

PMID- 8363912
TI  - Nursing diagnoses and functional health patterns in patients receiving external
      radiation therapy: cancer of the digestive organs.
AB  - A descriptive study using clinical methodology was conducted to identify and
      describe core and site-specific symptoms reported by 15 patients with cancer of
      the digestive organs who received external radiation therapy. A 47-item Radiation
      Symptom Scale was designed by the investigators for this study. Symptoms
      identified by patients with a mean occurrence of at least "sometimes" were
      considered potential defining characteristics and were submitted to a panel of
      experts for identification of nursing diagnoses. Seventeen nursing diagnoses,
      with their associated defining characteristics, were identified and classified
      within eight Functional Health Patterns (FHP). Half of the nursing diagnoses were
      formulated within the Nutritional-Metabolic and Elimination patterns. Four of the
      FHPs were related to primarily functional patterns; four were primarily
      psychological-behavioral. Results of the study describe the nursing needs of
      patients who receive radiotherapy to the digestive organs.

PMID- 8363913
TI  - Nursing diagnosis by computers: an application of neural networks.
AB  - In a pilot-test application of the neural network, test case diagnoses made by
      the ART-2 neural network agreed with those made independently by nurses. The main
      conclusion is that the ART-2 neural network is promising as a decision-making
      aid. It can handle probabilistic and ill-defined data through a process of
      pattern recognition without programming rules. A disadvantage is that the ART-2
      neural network requires "training" by the nurse using at least one example to
      define a diagnosis. In practice, however, this requirement does not affect its
      usefulness. Moreover, providing the ART-2 neural network with several training
      examples enables it to identify new patterns that are "close" to the textbook
      case but vary in one or more characteristics.

PMID- 8363914
TI  - High risk for violence.

PMID- 8363916
TI  - You make the diagnosis: case study. Ineffective airway clearance.

PMID- 8363915
TI  - Validation of social isolation related to maturational age: elderly.
AB  - The purpose of this study was to obtain expert validation of the defining
      characteristics used when diagnosing social isolation in the elderly and to
      compare these characteristics with those identified in the NANDA Taxonomy I
      Revised (1990) and the characteristics identified by the investigator through a
      literature review. A descriptive survey design using Fehring's Diagnostic Content
      Validity Model and a Q-Sort methodology was used. The sample consisted of 300
      registered nurses (68% response rate) selected randomly from the ANA's Council of
      Gerontology and Community Health. Findings suggest the need for clinical
      validation of this diagnosis and the possible need for the addition of
      developmental age categories to the defining characteristics of social isolation.

PMID- 8363917
TI  - Taxonomic validation: an overview.
AB  - A valid taxonomy legitimizes the elements that make up the taxonomy and increases
      trust in its generalizability and predictability. There is a concern that the
      NANDA Taxonomy is not a valid taxonomic structure. Despite on-going work to
      validate individual nursing diagnoses, there is little research that focuses on
      validation of groups of diagnoses (taxons) within the NANDA taxonomy. This last
      article in a series of four will familiarize the readers with why, what, and how
      a taxonomy of nursing diagnoses can be validated. This article highlights
      assessment of the validity and reliability of a taxonomy, compares the process of
      taxonomic validation to the research process, and explores examples of validation
      design.

PMID- 8363918
TI  - We're worth it!

PMID- 8363919
TI  - Nursing diagnosis: the central theme in nursing knowledge.
AB  - The author's purpose is to argue that theory development involving nursing
      diagnoses is a central element in the development of nursing knowledge. Nursing
      diagnosis is viewed as a way of conceptualizing the domain of nursing when human
      responses are viewed as a nursing focus. Differing views from the literature on
      what should be the central focus of nursing are presented. These authors conclude
      that nursing's growth as a science can be facilitated by taxonomy development as
      nursing diagnoses delineate nursing's unique domain. The importance of theory
      development surrounding nursing diagnoses is explored and ideas on how theory
      development might proceed are presented. Ultimately, theory supporting nursing
      diagnoses must account for description, explanation, prediction, and control of
      phenomena that nurses autonomously treat. Theory development associated with
      nursing diagnoses will help develop the unique knowledge base of the discipline
      of nursing.

PMID- 8363920
TI  - You make the diagnosis: The hypermetabolic state: case study.

PMID- 8363921
TI  - Validation of the defining characteristics of altered sexuality patterns.
AB  - Human sexuality is a complex and multifaceted phenomenon that encompasses
      physical, psychological, and social components. The nursing diagnosis altered
      sexuality patterns labels the human response to alterations in sexuality that
      occur as the result of various health problems. This validation of the defining
      characteristics of the diagnosis was based on a substantive theory derived from a
      qualitative grounded theory study. In the original study, data from 11 adult
      insulin-dependent diabetics living in a rural area of the Midwest were analyzed
      and relevant experiences conceptualized through the core concept of transforming
      and the supporting concept of valuing self and meeting intimacy needs. The theory
      was then used as a framework to formulate specific defining characteristics for
      the nursing diagnosis. A single diagnosis of altered sexuality has emerged that
      encompasses the perception of change in sexuality as well as the change itself.

PMID- 8363922
TI  - An axial representation of community mental health nursing diagnoses of a country
      at war: El Salvador.
AB  - This paper explores the impact of a workshop on the formulation of community
      mental health diagnoses in El Salvador. The author taught the process of
      diagnosis from the NANDA framework and explored diagnostic decision making
      through Caplan's Crisis Model. An epidemiologic framework was also incorporated
      in the diagnostic process so that host, agent, and environment could be
      scrutinized. The workshop resulted in the formulation of three universal
      community mental health diagnoses for this (then) war-torn country: depression,
      aggression, and anxiety; the development of a proposal for the implementation of
      mental health services; and an invitation to explore implementation of community
      mental health care services in five rural communities in El Salvador. Although
      the politics of El Salvador have changed, this example is typical of many Third
      World and war-torn countries.

PMID- 8363923
TI  - New diagnosis: caregiver role strain.
AB  - Caregiver role strain is a new diagnosis accepted by NANDA in 1992. The diagnosis
      is a well-described family phenomenon that can be measured and predicted. Sources
      of variance for the various defining characteristics have been identified. The
      diagnosis is also important to society. Nurses can play a significant part in
      reducing the role strain caregivers feel or preventing its occurrence.

PMID- 8363924
TI  - Sequence-selective metal ion binding to DNA oligonucleotides.
AB  - Metal ion titrations of several DNA oligonucleotides, 10 dodecamers and one
      decamer have been monitored by 1H NMR spectroscopy in order to elucidate metal
      ion binding patterns. Also, the effects of paramagnetic impurities on resonance
      linewidths and NOESY cross-peak intensities have been reversed by EDTA back
      titration experiments. 1H 1D NMR spectra were recorded after successive additions
      of aliquots of different metal salts to oligonucleotide samples. Paramagnetic
      manganese(II) salts were used in most cases, but a few samples were also titrated
      with diamagnetic zinc(II). From this study, we conclude that there exists a
      sequence-selective metal ion binding pattern. The metal ions bind predominantly
      to 5'-G in the contexts 5'-GC and 5'-GA. The order of preference seems to be GG >
      or = GA > GT > > GC. No evidence of metal ion binding to 5'-G in 5'-GC steps or
      to non-G residues was found. The H6 or H8 resonances on preceding (5'-) bases
      were affected by the adjacent bound paramagnetic metal ion, but no effect was
      observed on the protons of the succeeding (3'-) base. The metal binding site in
      the duplexes is most likely at G-N7, as manifested by the pronounced paramagnetic
      line broadening or diamagnetic shift of the G-H8 signal. This sequence
      selectivity may be qualitatively explained by a sequence-dependent variation in
      the molecular electrostatic potentials of guanine residues (MEPs) along the
      oligonucleotide chain.

PMID- 8363925
TI  - NMR studies of a plant flavonoid--DNA oligonucleotide complex.
AB  - A structural model of the solution complex between a flavonoid and a DNA
      dodecamer containing the E. coli wild-type lac promoter sequence (TATGTT) was
      obtained using simulated annealing for refinement. The distance constraints were
      derived from NOESY NMR spectra. The minor groove binding of this flavonoid
      displays possible hydrogen bonds to the DNA, and these can take part in complex
      formation. This work is the first description of how a molecule of this class of
      natural compounds may interact with DNA.

PMID- 8363926
TI  - President's message: Nursing's challenge: become a part of the solution.

PMID- 8363927
TI  - New policy reduces wound care reimbursement.

PMID- 8363928
TI  - Chronic generalized erythroderma: a guide for nurses.
AB  - Chronic generalized erythroderma (CGE) is a persistent, cutaneous, inflammatory
      response triggered by some underlying benign or malignant cause. Understanding
      the definition, pathogenesis, incidence, cutaneous and systemic manifestations,
      etiology, diagnosis, prognosis, and treatment of CGE with particular emphasis on
      nursing implications will help dermatology nurses care for these patients.

PMID- 8363929
TI  - Photodamage: cause, clinical manifestations, and prevention.
AB  - It is now recognized that intrinsic aging changes are distinct from those caused
      by habitual exposure to the sun (photoaging). Not only are these sun-induced
      alterations unsightly, but they also serve as a marker for patients at risk for
      developing skin cancer. Because of increased leisure time and affluence in our
      society, and an emphasis on sunbathing and other outdoor recreational activities
      during the last few decades, photoaging and skin cancer are becoming an ever
      increasing problem and source of concern for health care professionals. The
      purpose of this article is to review the cause, clinical manifestations, and
      implications of photodamage. Photoprotection and other preventive measures to
      minimize photoaging and the risk of skin cancer will be discussed.

PMID- 8363930
TI  - What's your assessment? Pigmented basal cell.

PMID- 8363931
TI  - Managing the patient with hives.
AB  - Urticaria, or hives, is a usually transient reaction involving the upper dermis.
      Understanding the causes and treatments of urticaria will help the dermatology
      nurse manage the patient with hives.

PMID- 8363932
TI  - Micropigmentation: a burn survivor's case study. Part 3.
AB  - A clinical methodology involving consultation, assessment, plan, implementation,
      and evaluation is important in meeting patients' skin care and cosmetic needs.
      Part III of this three-part series examines how this systematic and practical
      approach was used in camouflaging a burn survivor's appearance permanently.

PMID- 8363933
TI  - Dermatology Nurses' Association position statement on prevention and early
      detection of skin cancer.
AB  - The Dermatology Nurses' Association recognizes the urgent need to educate the
      public about the prevention and early detection of skin cancer. This position
      statement has been developed to serve as a guide in meeting this need.

PMID- 8363934
TI  - Yellow fever in 1991.

PMID- 8363935
TI  - Expanded programme on immunization (EPI). Poliomyelitis in 1992.

PMID- 8363936
TI  - A strategy to improve communication between health care professionals and people
      living with cancer. I. Improvement of teaching and assessment of doctor-patient
      communication in Canadian medical schools.
AB  - A task force was established by the Canadian Cancer Society and the National
      Cancer Institute of Canada to make recommendations aimed at improving
      communication between health care professionals and people living with cancer. An
      annotated bibliography of the research literature on the subject was commissioned
      by the task force. This was followed by a research workshop. With this
      background, the task force organized a workshop on "The Teaching and Assessment
      of Communication Skills in Canadian Medical Schools." Participants included
      expert panelists; senior faculty from all Canadian medical schools;
      representatives from patient and ethnic groups, faculties of nursing and social
      work, the Canadian licensing and accrediting bodies, the College of Family
      Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada.
      A consensus statement regarding general principles, recommendations, and
      requirements for implementation of improved teaching and assessment of doctor
      patient communication in Canadian medical schools was produced and circulated
      widely throughout Canada. The initial response to this initiative has been
      positive.

PMID- 8363937
TI  - Teaching communication with cancer patients and terminally ill patients to
      medical students.

PMID- 8363938
TI  - A comparison of knowledge and communication skill evaluations by written essay
      and oral examinations in preclinical medical students.
AB  - While both oral and written communication skills are important in the daily work
      of physicians, medical school evaluation methods focus on content of written
      essays or often answers to multiple choice questions. To determine the
      feasibility and value of oral examinations for preclinical medical students, we
      gave a written short essay examination and an oral examination on the same
      question to 106 second-year medical students in a required neoplastic diseases
      course. Examination performance by each method was evaluated according to the
      same specific content and, separately, based on four communication skills
      criteria. We found high levels of inter-rater reliability with two oral examiners
      for both content and skills. Content and skills performance on both written and
      oral evaluations could be separately determined. Content performance was greater
      on the written evaluation.

PMID- 8363939
TI  - Use of questionable methods and physician education.
AB  - It is contended that medical students and physicians are not sufficiently
      familiar with questionable cancer methods to communicate effectively with
      patients, families, or the news media. A national survey by the American Cancer
      Society revealed that 9% of patients with cancer use questionable methods. There
      were substantial discrepancies between perspectives of patients and physicians.
      Since the physician's role is key, educational efforts are imperative for all
      persons involved in the care of patients with cancer. Suggestions are made.

PMID- 8363940
TI  - Physicians' attitudes and reported practices toward smoking intervention.
AB  - The objective of this study was to examine differences in the attitudes and
      reported practices toward smoking intervention of 224 internal medicine, family
      practice, and surgical physicians from one medical school faculty. Most
      internists and family practice physicians reported intervening with their
      patients who smoke, whereas only 50% of surgeons reported intervening with their
      patients who smoke. Each of the physician groups attached a high degree of
      importance to smoking cessation in patients with various chronic diseases.
      Physicians reported that they were most likely to intervene in the smoking habits
      of young patients, those with reversible disease, those who were receptive to
      intervention, and with those who had made previous quit attempts. The three
      obstacles identified by the various physician groups most related to the delivery
      of quit smoking intervention included the amount of time involved, patient
      receptivity, and associated lifestyle problems. The results of this study suggest
      differences among physician specialties in their intervention efforts with
      smokers and those factors related to the delivery of stop smoking advice. Further
      reinforcement of specific physician specialty groups for the important role of
      physicians in assisting their patients to stop smoking remains.

PMID- 8363941
TI  - Cancer patients' awareness of disease and satisfaction with services: the
      influence of their general education level.
AB  - Forty-five cancer patients, 22 with a low and 23 with a high general educational
      level, receiving chemotherapy in the chemotherapy day clinic of the Cerrahpasa
      Medical Faculty, were interviewed individually by a clinical psychology Master's
      Program student. The interview covered 45 questions about the level of their
      awareness of disease and treatment, prognosis, and the sources of information and
      whether these affected their satisfaction with the services given. The answers of
      the two groups with different educational levels were compared. There was no
      significant difference between the two groups in awareness of disease or in
      satisfaction with the services. However, there was significant difference between
      the two groups in patient-physician dialogue as to asking more and direct
      questions and thus in the source of information. Six attending physicians in
      charge of the clinic were also interviewed about their guesses on the patients'
      answers, and their reasons for giving different levels of information to their
      patients. It was suggested that general public education on the communities'
      concept of cancer was the most important single factor in the formation of demand
      and therefore revealing correct information during patient-physician
      communication.

PMID- 8363942
TI  - Communication: a crucial concern for cancer curricula.

PMID- 8363943
TI  - Expanding horizons in breast and prostate cancer prevention and early detection.
      The 1992 Samuel C. Harvey Lecture.
AB  - Breast cancer and prostate cancer, the most common cancers in American women and
      men, respectively, are major public health concerns. Investigations into the
      prevention and early detection of breast and prostate cancer include research on
      the potential impact of diet, particularly dietary fat, on breast cancer risk;
      the chemoprevention of breast cancer using tamoxifen and N-(4
      hydroxyphenyl)retinamide(4-HPR); the importance of mammography in early detection
      of breast cancer; the potential of finasteride in preventing or retarding the
      progression of early-stage prostate cancer; and improved detection of prostate
      cancer by combining various screening modalities. The importance of transferring
      information gained though such research to the health care community cannot be
      overemphasized. Further, it is critical that cancer prevention and detection
      education be built into the curricula of leading medical and biomedical
      institutions. Education is key to developing a strong and vigorous cancer
      prevention and early detection research program.

PMID- 8363944
TI  - Teachers involved in AIDS training left out in the cold.

PMID- 8363946
TI  - Environmental health: in the wake of the Braer. Interview by Alex Mathieson.

PMID- 8363945
TI  - Four new cases of AIDS reported in Scotland.

PMID- 8363947
TI  - Community care: the cost of caring.

PMID- 8363948
TI  - The epidemiology of pressure sores.
AB  - This article presents details of epidemiological studies undertaken to assess the
      extent of pressure sores in hospital. Both prevalence and incidence studies,
      which reveal the full extent of the problem and its predisposing factors, are
      discussed. The author also outlines the statistical terms used by epidemiologists
      as well as general considerations which must be made in the interpretation of
      epidemiological studies.

PMID- 8363949
TI  - Fit or fatuous.

PMID- 8363950
TI  - Trends in managing schizophrenia (continuing education credit).

PMID- 8363951
TI  - Community nursing: nurses' effectiveness in supporting carers.
AB  - This article outlines the results of a research project to evaluate the
      effectiveness of service support to informal carers. There are many ways in which
      community nurses can support carers, and carers frequently report the benefits of
      the service. The potential significance of the community nursing service in this
      role, however, is yet to be realised as nursing is still highly task-orientated,
      with priority given to specific medical interventions. As a result, some carers
      face difficulties in obtaining nursing support.

PMID- 8363952
TI  - A study on the nursing care of HIV positive and AIDS patients.

PMID- 8363953
TI  - Community care: what price means-testing?

PMID- 8363954
TI  - De-stress call. The Rosemary Cook column.

PMID- 8363955
TI  - Dissect your managers.

PMID- 8363956
TI  - A qualified 'yes' to nursing.

PMID- 8363957
TI  - Should we deny people with learning difficulties their childlike indulgences.

PMID- 8363958
TI  - Is this mental health nursing's last stand?

PMID- 8363960
TI  - Today's lifestyles affect elderly care.

PMID- 8363959
TI  - New report highlights neglect of older people with HIV/AIDS.

PMID- 8363962
TI  - A philosophy of care.

PMID- 8363961
TI  - AIDS education. Getting sex taped.

PMID- 8363963
TI  - Clinical grading: quids in or quids out?

PMID- 8363964
TI  - The health of the nation: the path to good health.

PMID- 8363965
TI  - Teaching psychology: the Australian view.
AB  - Teaching psychology to student nurses has assumed great importance in recent
      years. Making the course applicable to clinical practice, however, remains a
      challenge. The authors discusses techniques being used in Australia to make
      psychology relevant to nursing and highlights aspects which could be adopted in
      the UK.

PMID- 8363966
TI  - Statistical tests (Part 2): Parametric tests.

PMID- 8363967
TI  - Care of urinary catheters (continuing education credit).

PMID- 8363968
TI  - Intubation training: an ethical practice?
AB  - Some hospitals allow junior doctors, nurses and paramedical staff to practise the
      technique of intubation on recently deceased patients. The Royal College of
      Nursing, in common with the British Medical Association, believes that this
      practice can only be justified in the most exceptional circumstances where the
      deceased patient has suffered severe head, neck or facial injuries. It may then
      be acceptable for learners already skilled in intubation techniques to extend
      their knowledge for the benefit of future patients with similar injuries who
      might, as a result, have a prospect of survival.

PMID- 8363969
TI  - Computer reviews. The travel program.

PMID- 8363971
TI  - Cardiology update. Emergency bypass.

PMID- 8363970
TI  - Cardiology update. Resuscitation update.

PMID- 8363972
TI  - Cardiology update. Intraosseous infusion.

PMID- 8363973
TI  - The influence of amitriptyline and flunarizine on catecholamine response to light
      in patients with migraine.
AB  - The effect of amitriptyline on catecholamine (CA) response to light of 20
      migrainous patients was studied. The drug was given orally, 36 mg daily (12 mg x
      3), for ten days. Before therapy, the migraineurs responded to light by an
      increase in epinephrine (E) excretion and not by the rise in norepinephrine (NE)
      excretion, noticed in controls. The NE excretion of migrainous subjects underwent
      very often a depression after photostimulation. Amitriptyline therapy prevented
      the post-photic rise in E excretion of migraineurs, without influencing
      significantly the variation in NE excretion produced in them by light. In other 8
      migrainous subjects the effect of flunarizine, a selective calcium channel
      blocker, on CA response to light was tested. The dosage was of 5 mg daily, for
      ten days. Flunarizine had similar effects to those displayed by amitriptyline;
      the drug prevented the rise in E excretion produced by light without normalizing
      the NE response to light of migrainous subjects. The results suggest that the
      efficiency of these two drugs in migraine prophylaxis is connected with the
      ability of these substances to block the E discharge produced in migraineurs by
      light or by other stimuli. The interpretation is all the more likely as
      propranolol, another drug applied in migraine prophylaxis also blocks the post
      photic E discharge of migraineurs.

PMID- 8363974
TI  - Pseudotumor cerebri. A review.

PMID- 8363975
TI  - Clinical, polysomnographic and computerized electroencephalographic research in
      temporal lobe epilepsies.
AB  - The present study has selected 125 cases with psychomotor attacks (sometimes
      secondarily generalized). Polysomnographic recordings were carried out for a
      continuous period of eight hours. All this time, the patients have been observed
      by video-monitorization on a closed infrared circuit screen. The diagnostic
      procedure was supported by several computerized EEG mappings (CEM) according to a
      model achieved by us, transcribing the primary data which were obtained by
      Hjorth's NSD parameters (activity and ability) from the Siemens-Elema Mingograph
      to a microcomputer. In many cases, we have employed an interface which had been
      envisaged by us for analog-digital conversion of amplitudes and frequencies from
      the Mingograph to the microcomputer. Sleep organization anomalies were found:
      increase of the percentages of light slow-wave sleep (LSWS) and of REM sleep and
      reduction of the percentages of deep slow-wave sleep (DSWS). The temporal foci
      appeared with the greatest frequency and with a clear-cut evidence during LSWS,
      especially in REM sleep and in the transitional states of SWS to REM sleep and
      from REM sleep to wakefulness. Our researches supplemented with CEM, demonstrate
      a peculiar activation of the temporal foci during REM sleep, during the states of
      LSWS and during the transitional states, showing that many psychomotor attacks
      appear predominantly during these sleep states and that many cases initially
      clinically misinterpreted as grand mal seizures are, in fact, focal temporal
      epilepsies secondarily generalized.

PMID- 8363976
TI  - Genomic imprinting and fragile X-syndrome in psychiatric disorders.

PMID- 8363977
TI  - Polysomnographic and computerized electroencephalographic studies in myoclonic
      petit mal epilepsies.
AB  - The study included 203 epileptic absences: 1. Simple; (30 cases); 2. Myoclonic
      petit mal absences (62 cases); 3. Amyotonic-akinetic absences (41 cases); 4.
      Temporal lobe absences (62 cases); 5. "Hybrid" absences in Lennox-Gastaud disease
      (13 children). This paper presents only the myoclonic petit mal absences (57
      cases). Correlations of the clinical, EEG and polysomnographic data were found by
      several methods: a. The patients were video-monitored on an infrared closed
      circuit TV screen: b. The Hjorth's NSD parameters were computed on a Siemens
      Elema Mingograph; c. The EEG graphoelements were morphologically analyzed every
      second throughout the discharges, by means of an original technique; d.
      Computerized EEG mappings (CEM) were performed for various periods, also
      including the sequential ones, second by second, all along the epileptic
      discharges; e. 8 hours of continuous polysomnographic recordings. The peculiar
      electroclinical features of the five types of absences have been emphasized.
      Regarding the myoclonic petit mal absences, the discharges of polyspikes and
      waves manifested an evident increase in the number and duration within the LSWS
      stages and during the transition from the wakefulness state to sleep and from the
      LSWS to the wakefulness, and a transformation in slow polyspikes and waves
      complexes during the stages III and IV. The CEM were always asymmetrical during
      sleep and the maximal amplitudes were seen on the anterior and posterior temporal
      regions. In all the REM stages, the polyspikes and waves disappeared.

PMID- 8363978
TI  - Clinical, EEG, electromyographic and polysomnographic studies in restless legs
      syndrome caused by magnesium deficiency.
AB  - The present paper reports biochemical and neurophysiological investigations in
      ten cases with restless leg syndrome. Other neuropsychiatric affections and
      factors which could generate the symptomatology of restless legs syndrome were
      not included. The EEG recordings demonstrated evident reticular neuronal
      hypersynchrony generated by hyperpnoea (sinusoidal slow waves). The classical EEG
      investigations pointed out neuromuscular hyperexcitability, but some
      modifications of the functional parameters of the neuromuscular excitability and
      conductibility (signs of neuropathy) were also noticed. In all the cases,
      continuous 8-hour polysomnographic recordings and monitorization on infrared TV
      screen were performed. Investigations reported: important disorders of sleep
      organization, agitated sleep with frequent periods of nocturnal awakenings,
      increase of the durations and percentages of light slow-wave sleep (LSWS) and
      rapid and frequent changes of various stages of LSWS, a decrease of duration and
      percentage of DSWS, a decrease of duration and percentage of REM sleep (as in
      other parasomnias caused by magnesium deficiency) and nocturnal EEG anomalies
      (long discharges of sinusoidal slow waves, of sharp waves and of sharp slow waves
      appearing in the LSWS stages with the disappearance in the REM sleep).

PMID- 8363979
TI  - Subacute subdural hematoma.
AB  - The subacute subdural hematoma (SASDH) is an entity which is still to be analyzed
      because the attention of the clinicians was directed towards the acute subdural
      hematoma (ASDH) and to the chronic subdural hematoma (CSDH). A series of 69
      patients with SASDH was studied outlining the particularities of the affection. A
      trauma caused the hematoma but it was a milder one. The associated cerebral
      lesions were generally produced by concussion (34%) and cerebral dilacerations
      represented only 8.4%. Clinical symptoms were obvious between the third and the
      fourteenth day after trauma due to the cerebral compression. The consciousness
      was moderately impaired. The patients with GCS < 8 represented 18.9%. The
      neurological picture stated with time allowed a programmed paraclinical
      investigation: a. radiography of the skull revealed cranial fractures in 10.1%;
      b. carotid arteriography showed a lentiform aspect of the avascular space; c. CT
      presented variable densities (isodensity--3%, hypodensity--14.5%, and
      hyperdensity--27.5%) depending on the length of the interval between trauma and
      admission. The operation evacuated the liquid blood collection through a widened
      burr hole. Death during operation was 17.4% and 79.8% survived.

PMID- 8363980
TI  - British Association of Dermatologists and Canadian Dermatology Association, joint
      annual meeting. Oxford, United Kingdom, 6-10 July 1993. Abstracts.

PMID- 8363981
TI  - Critical analysis of the methods commonly employed in the assessment of cell
      proliferation: advantages of the NOR silver-staining technique in routine cyto
      histopathology.
AB  - The methods commonly employed for the assessment of cell proliferation have been
      critically considered. Some 'historical' techniques, such as the mitotic count
      and the thymidine labeling index, cannot be proposed for routine pathology
      because of their complexity and difficult quantification. Other techniques, such
      as in vitro bromodeoxyuridine incorporation or in vivo bromodeoxyuridine infusion
      coupled with DNA flow cytometry, permit a very sophisticated analysis of the
      tumour cell kinetics, but can be performed only in highly specialized centers.
      During the past few years the immunohistochemical detection of antigens related
      to the cell cycle--particularly Ki67 or proliferating cell nuclear antigen
      (PCNA)/cyclin--has been rapidly introduced in numerous laboratories, and, at
      present, certainly represents the most common method for the assessment of cell
      proliferation in tumour samples. However, a new marker of cell proliferation has
      been recently described which presents technical features particularly suitable
      for routine use: the quantitative evaluation of interphase silver-stained
      nucleolar organizer regions (AgNORs). The NOR silver-staining technique is
      simple, very rapidly executed, inexpensive, easily quantifiable and, most
      important, can be performed on routinely processed cytological and histological
      samples.

PMID- 8363982
TI  - Pattern of nucleolar organizer regions in human leukemic cells.
AB  - The pattern of nucleolar organizer regions in bone marrow smears of 40 patients
      with acute myeloid leukemia (AML), 27 with acute lymphoid leukemia (ALL) and 15
      control cases were studied. All normal blasts as well as leukemic blasts revealed
      at least one cluster of AgNORs. In AML the mean number of clusters (2.87 +/-
      0.48) and dots (0.23 +/- 0.17) per cell was significantly lower than in normal
      myeloblasts (3.27 +/- 0.14 resp. 0.34 +/- 0.12). In ALL the number of clusters
      (2.82 +/- 0.62) was not significantly different from that of AML blasts. While in
      all control cases the distribution of the number of clusters per cell within a
      case could be approximated by a modified Poisson equation, this did not hold for
      9 ALL and in 13 AML patients. The histogram of those cases showed a lower
      dispersion. In ALL, but not in AML, the number of clusters per cell correlated
      with the peripheral leukocyte count. The present results strengthen the concept
      that clusters and dots should be regarded as separate entities and suggest that
      their pattern is related to duration of cell cycle as it has been shown in other
      tissues.

PMID- 8363983
TI  - Minimum spanning tree, integrated optical density and lymph node metastasis in
      bronchial carcinoma.
AB  - Surgical specimens comprising 80 primary lung carcinoma (lobes and lungs) were
      expanded by insufflation of air into the main bronchi, and fixed with buffered
      formalin for 24 h. After the usual tissue procedures, 3-4 microns thick
      histological sections of the tumour mass were Feulgen stained and various nuclear
      features such as integrated optical density (IOD), area, form factor, etc. were
      measured using an automated image analysing system (VISIAC). The geometrical
      centres of the nuclei were defined as vertices and the corresponding minimum
      spanning tree (MST) was calculated according to the distance between the
      vertices. The tumour mass was measured by serial sections of the surgical
      specimens; the lymph node stage was defined according to the rules of the UICC.
      Non-tumour infiltrated lymph nodes of the same case served as controls for the
      IOD and MST. The results revealed a DNA index of 1.1-3.0, a malignancy index
      (Bocking) 0.90-1.08 and a percentage of S-phases 10-23% (confidence limits). Only
      19% of the bronchial carcinoma were found to be not aneuploid. Based upon the
      weighted MST, the distance of neighbouring cells, the IOD of the centre cells and
      IOD/area of neighbouring cells revealed statistically significant differences
      between tumours with and without lymph node metastases. The more advanced the
      lymph node stage, the 'closer' was the 'packing' of the tumour cells.

PMID- 8363984
TI  - Non-distorted assemblage of the digital images of adjacent fields in histological
      sections.
AB  - In the following article a method is described for the distortion-free
      reassemblage of adjacent digitised microscopic images of histological sections.
      The correct positioning of the microscopic specimen is achieved via a computer
      controlled scanning stage. During an internal calibration step the correction
      function for the image distortions and the parameters of the transformation
      scanning-stage-to image-coordinate system are determined. In the subsequent
      application phase the new positions the scanning stage has to move to can now be
      computed in such a way that the distortion-corrected digitised images of the
      section parts under consideration neatly fit together to one composite image.

PMID- 8363985
TI  - Detection of the Ki-67 antigen in fixed proliferating cells.

PMID- 8363986
TI  - Adhesion molecules: cellular recognition mechanisms. The Pezcoller Foundation
      Symposia, Rovereto, June 24-26, 1992.

PMID- 8363987
TI  - The take-home message: doctors' views on letters and tapes after a cancer
      consultation.
AB  - BACKGROUND: Patients' understanding of their disease and treatment varies in
      detail and accuracy. In order to participate in decisions about their care
      patients must understand, evaluate and retain complex information. METHODS: We
      canvassed doctors' views about the use of individualised letters and the use of
      audiotapes of the initial cancer consultation to improve doctor-patient
      communication. The study sample consists of doctors whose patients participated
      in a trial of the latter technique. RESULTS: One hundred sixty of 194 doctors
      (82%) responded to a mailed questionnaire. Sixty-one percent of respondents felt
      that providing patients with a tape of their initial cancer consultation would be
      beneficial, and 71% felt that an individualised letter would be better. General
      practitioners were more supportive of providing tape recordings to patients than
      were specialists (p = 0.057), but both groups favoured letters over tapes.
      Specialists were more concerned about the risks of providing tapes to patients
      than were general practitioners (p = 0.001), but only 13% of respondents felt
      that the risks were prohibitive. DISCUSSION: Wide support for providing
      individualised letters or tapes to patients, and copies to their doctors,
      indicate that the doctors surveyed believe that both doctor-patient and doctor
      doctor communication could be improved by the use of these techniques.

PMID- 8363988
TI  - Suramin in combination with mitomycin C in hormone-resistant prostate cancer. A
      phase II clinical study.
AB  - BACKGROUND: Hormone-resistant prostate cancer can respond to mitomycin C or to
      suramin. This trial was undertaken to investigate the value of mitomycin C given
      with low dose suramin. PATIENTS AND METHODS: Thirty-two patients with hormone
      refractory prostate cancer were given suramin 350 mg/m2 daily for 5 days,
      followed by 350 mg/m2 weekly starting on day 14. Mitomycin C 12 mg/m2 was given
      every 5 weeks starting on day 14. RESULTS: Toxicity included maculo-papular skin
      rash in 8 patients, haematological toxicity in 16 (anaemia 13, leucopenia 11 and
      thrombocytopenia 9, bleeding 8), infection in 4 and fatigue in 11. Ten patients
      developed neurotoxicity, (temporary sensory peripheral neuropathy in 8, upper
      limb motor neuropathy in 1, and restless legs syndrome in 1) and 9 developed
      proteinuria. Other toxicities were mild nausea and vomiting, oedema, transient
      elevation of liver enzymes, stomatitis, upper gastrointestinal symptoms, and
      alopecia. During induction treatment the median trough suramin level was 140
      micrograms/ml (range 100-273) and during maintenance treatment the median suramin
      level was 93 micrograms/ml. The median overall trough level was 93 micrograms/ml.
      There were one complete and 6 partial responses. Fifteen patients had disease
      stabilization. The median time to treatment failure was 103 days, and the median
      survival 209 days. CONCLUSION: The combination of suramin and mitomycin C has
      therapeutic activity, but causes significant toxicity in patients with hormone
      resistant prostatic carcinoma.

PMID- 8363989
TI  - Fludarabine: an active agent in the treatment of previously-treated and untreated
      low-grade non-Hodgkin's lymphoma.
AB  - BACKGROUND: Fludarabine (FLU) is a new antimetabolite chemotherapeutic agent with
      a promising therapeutic activity in the lymphoproliferative disorders. PATIENTS
      AND METHODS: We performed a phase II study with this drug in previously untreated
      and treated patients with resistant and/or relapsed low-grade non-Hodgkin's
      lymphoma (LG-NHL) to determine its response rate. Twenty-one patients were
      treated at a dosage of 25 mg/m2 per day for 5 consecutive days. RESULTS: Of the
      21 patients, 3 achieved complete responses (CR) and 11 partial responses (PR). In
      addition, three patients obtained minor responses, and the remaining 4 showed no
      benefit from the treatment. An increased response rate was achieved in 8
      untreated patients in which 3 CR and 3 PR were documented. Furthermore, 4 of the
      5 patients showing a leukemic blood picture experienced significant reductions of
      lymphocyte count and 2 patients with macroglobulinemic lymphomas experienced
      significant reductions of the IgM monoclonal component from 7.8 and 5.9 g/100 mL
      to 1.0 and 1.1 g/100 mL, respectively. The toxicity on platelets was negligible.
      The major toxic effects observed were neutropenia (62%) and infections and/or
      febrile episodes (19%) that were fatal to only one patient. CONCLUSIONS: In
      consideration of its significant activity, the role of FLU needs to be further
      evaluated in the management of pretreated and untreated patients with LG-NHL.

PMID- 8363990
TI  - The non-invasive monitoring of low dose, infusional 5-fluorouracil and its
      modulation by interferon-alpha using in vivo 19F magnetic resonance spectroscopy
      in patients with colorectal cancer: a pilot study.
AB  - BACKGROUND: 5-Fluorouracil (5-FU) is the most widely used cytotoxic drug in
      oncology and the only one useful in the management of colorectal cancer - a
      leading cause of cancer death worldwide. Recent studies of 5-FU have focused on
      increasing efficacy and reducing toxicity by varying the delivery schedule and
      combining it with modulators. With the development of whole body magnetic
      resonance systems it is now possible to examine the metabolism of 5-FU in vivo by
      exploiting the magnetic properties of the fluorine atom which is an integral
      component of the drug. PATIENTS AND METHODS: Magnetic Resonance Spectroscopy
      (MRS) was used to non-invasively monitor the metabolism of 5-FU in the liver
      metastases of colorectal cancer patients. The patients were treated with a
      continuous low dose intravenous infusion of 5-FU until the point of refractory
      disease, at which time interferon-alpha was added with the objective of
      modulating 5-FU activity. MRS was performed at specific phases of the treatment.
      RESULTS: Twenty-six patients were treated with 5-FU, 11 (42%) achieving partial
      response. Of the 15 given interferon when disease became refractory to 5-FU, 4
      showed signs of further response. In patients observed by MRS during the first 8
      weeks of 5-FU treatment, those with a visible 5-FU signal were likely to respond
      to treatment (p = 0.017). At the time of interferon-alpha addition, MRS showed
      that 7 patients developed new or increased 5-FU signals, and 4 patients showed a
      signal from the active metabolites of 5-FU. The patients who exhibited a new or
      increased 5-FU signal were more likely to show further response to interferon
      alpha (p = 0.007). CONCLUSIONS: MRS is a powerful technique for monitoring
      intratumoural metabolism and modulation of 5-FU enabling prediction of tumour
      outcome. Direct metabolic information may facilitate the rapid development of
      optimal clinical schedules for 5-FU and its modulators, thus maximising
      antitumour effect and minimising toxicity to the patient. This technique may be
      applied to other areas of clinical medicine where knowledge of the tissue
      metabolism of a fluorinated drug is of interest.

PMID- 8363991
TI  - Fever and neutropenia during intensive chemotherapy.

PMID- 8363992
TI  - Phase II trial of mitomycin C (MMC) in advanced gallbladder and biliary tree
      carcinoma. An EORTC Gastrointestinal Tract Cancer Cooperative Group Study.
AB  - BACKGROUND: Based on a recent pharmacokinetic study suggesting that high biliary
      levels of mitomycin C (MMC) may be achieved as a result of an entero-hepatic
      recycling mechanism, we conducted a Phase II EORTC trial which involved MMC
      administration to patients with non-resectable biliary tract carcinoma. PATIENTS
      AND METHODS: Of the 34 patients entered in the study, 30 were eligible (11m +
      19f, median age 58 yrs). I.V. bolus injections of 15 mg/m2 MMC were administered
      at six-week intervals. The tumors were confined to the liver in 17 patients and
      13 had extra-hepatic localizations. RESULTS: All 30 eligible patients were
      evaluable for toxicity and response. Mild thrombocytopenia was the main toxic
      side effect. Severe, WHO grade III/IV thrombocytopenia was limited to 4 patients.
      The haemolytic uraemic syndrome was not observed and there were no toxic deaths.
      Of 30 patients, 3 had partial remissions (overall response 10%, 95% confidence
      interval 2%-27%). CONCLUSIONS: This study, the largest such ongoing phase II
      trial, shows no significant activity of single-agent MMC in patients with
      advanced biliary tract carcinoma.

PMID- 8363993
TI  - Pharmacology, toxicology and human pharmacokinetics of tropisetron.
AB  - Tropisetron is a novel, potent and highly selective 5-HT3 receptor antagonist,
      which is active in the treatment of nausea and vomiting induced by highly
      emetogenic chemotherapeutic drugs such as cisplatin. Tropisetron selectively
      blocks the excitation of the presynaptic 5-HT receptors of the peripheral
      neurones involved in the emetic reflex, and may have other direct actions in the
      CNS on 5-HT3 receptors, mediating the actions of vagal inputs to the area
      postrema. Toxicological studies show that tropisetron is generally well tolerated
      by all animal species investigated and no specific organ toxicity was observed,
      other than slight loss of body weight development. In man, tropisetron metabolism
      is linked to the cytochrome P-450 2D6 isoenzyme system, which determines the
      polymorphism of debrisoquine/sparteine metabolism. As a result, there are
      phenotypical populations of extensive and poor metabolizers. The two main adverse
      events in human volunteer tolerability studies with tropisetron were headache and
      constipation. These adverse events tended to be slightly more intense and to last
      longer in poor metabolizers, compared with extensive metabolizers. Tropisetron
      had similar pharmacokinetic characteristics in elderly patients and renal
      patients, compared with healthy subjects. From a toxicological and
      pharmacokinetic point of view, therefore, daily doses of 5 mg tropisetron can be
      administered to both poor and extensive metabolizers, as well as to special
      populations, without any particular precautions.

PMID- 8363994
TI  - The development of tropisetron in its clinical perspective.
AB  - This review discusses the development of tropisetron as an antiemetic drug with
      the patient in mind. The original aims of the programme and the progress achieved
      towards them to date are described. The efficacy and safety data from two dose
      ranging studies and four comparative-treatment studies with tropisetron were
      combined in a prospectively planned meta-analysis of 799 patients. An integrated
      safety summary is presented which includes all patients from the six studies.
      Tropisetron at a dose of 5 mg once daily is an effective and well-tolerated,
      single-agent, antiemetic treatment, which can be given without special
      precautions to all patients receiving highly emetogenic chemotherapy. In
      comparison with metoclopramide, tropisetron is more effective in the prevention
      of nausea and vomiting. When compared with the most potent cocktail treatments
      currently in use (containing high-dose metoclopramide, dexamethasone and
      lorazepam or diphenhydramine), tropisetron is equally effective in the prevention
      of acute vomiting and somewhat less effective in the prevention of nausea.
      Overall, tropisetron is an effective and well-tolerated antiemetic treatment that
      is simple to administer, comparing well with currently available antiemetic
      cocktails. Tropisetron remains effective for the prevention of nausea and
      vomiting during multiple chemotherapy courses. The simple dosing schedule (5 mg
      i.v. day 1; one 5 mg capsule daily, days 2-6) makes tropisetron ideal for both
      inpatient or outpatient use.

PMID- 8363995
TI  - Tropisetron in the prevention of chemotherapy-induced nausea and vomiting in
      patients responding poorly to previous conventional antiemetic therapy.
AB  - An open, two-armed, multicentre trial was conducted in 231 patients with
      malignant disease who had previously failed to respond to conventional antiemetic
      treatment for the prevention of chemotherapy-induced nausea and vomiting.
      Patients were randomized to receive either tropisetron (5 mg/day; n = 115) or a
      standard antiemetic therapy, which was considered optimal for each individual but
      did not include a 5-HT3 receptor antagonist (n = 116). Acute vomiting on Day 1
      was controlled in 60 (52%) tropisetron patients, compared with only 29 (25%)
      patients receiving optimal standard therapy (p < 0.001). Acute nausea was
      completely inhibited in 37 (32%) tropisetron patients, compared with 22 (19%)
      patients on optimal standard therapy (p < 0.05). On Day 1, delayed vomiting was
      also significantly better prevented by tropisetron (p < 0.001). Side effects from
      tropisetron (headache and constipation) were mild, and no extrapyramidal symptoms
      were observed in any tropisetron patients, in contrast, to 14 (13%) patients in
      the 'optimal standard' group. In conclusion, in cases of acute nausea and
      vomiting it is more effective to switch refractory patients to tropisetron rather
      than attempt to optimize the dose of standard antiemetic therapy. For delayed
      nausea and vomiting, combination antiemetic therapy, with differing types of
      receptor antagonism and corticosteroids may provide the best way forward. Such
      studies are in progress.

PMID- 8363996
TI  - Current issues in the management of nausea and vomiting.
AB  - This state-of-the-art review describes the development, over the past 12 years,
      of new agents for the control of chemotherapy- and radiotherapy-induced emesis.
      While the mechanism of chemotherapy-induced nausea and vomiting is still not
      fully understood, significant progress in prevention of the symptoms has been
      achieved. The discovery that high-dose metoclopramide was very effective in
      antiemetic control ultimately led to the development of a new class of
      antiemetics, the 5-HT3 receptor antagonists, of which tropisetron is the most
      recent to be introduced. The emphasis of the review is on acute chemotherapy
      induced emesis and includes current thinking on the influence of patient
      characteristics on the emetic outcome. The new 5-HT3 receptor antagonists do not
      demonstrate any of the distressing extrapyramidal reactions so frequently
      encountered with conventional antiemetics acting at dopamine receptor sites. Mild
      headache is the most characteristic side effect of this class of agents. The
      major advantages of the newer 5-HT3 receptor antagonists, such as tropisetron,
      over the conventional antiemetic regimens are convenience, flexibility and, above
      all, single-dose usage.

PMID- 8363997
TI  - Efficacy and tolerability of tropisetron and dexamethasone in the control of
      nausea and vomiting induced by cisplatin.
AB  - A multicentre study was performed at four oncology centres in Sweden, in 160
      chemotherapy-naive women, primarily with ovarian or endometrial carcinomas.
      Abdominal surgery preceded chemotherapy in 146 (91%) women, and another 39 (24%)
      women had a history of radiotherapy. The chemotherapy regimens contained
      cisplatin (50-100 mg/m2), in combination with a variety of other agents. In
      Course 1, all patients received tropisetron (5 mg i.v. Day 1; 5 mg p.o. Days 2-6)
      and 84% of patients achieved total or partial control of vomiting; 95% of
      patients achieved total or partial control of nausea during the first 24 hours.
      Vomiting was least successfully controlled on Day 2 (73% total or partial
      control) and Days 2-4 for the control of nausea (81, 83, 88% total or partial
      control, respectively). Patients with partial response in Course 1 (39% of
      patients) were randomized to addition of dexamethasone or placebo in Course 2. In
      Course 2, tropisetron plus dexamethasone (Group B2) prevented acute vomiting in
      75% of patients, compared with 40% of patients receiving tropisetron plus placebo
      (Group B1). Over the entire 6 days, there was no vomiting at all in 54% and 20%
      of B2 and B1 patients, respectively. In Course 2, acute nausea was prevented in
      75% of patients (receiving B1) and in 37% of patients (receiving B2). For nausea,
      over the complete 6 days, the figures were 64% and 3% (p < 0.001). This indicated
      that patients with incomplete control of emesis in Course 1 benefited from the
      addition of dexamethasone, provided that it was added for each of the 6 days
      studied.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8363998
TI  - Tropisetron in the control of nausea and vomiting induced by combined cancer
      chemotherapy in children.
AB  - The efficacy of tropisetron, a new 5-HT3 receptor antagonist, was evaluated in a
      group of 15 children with a variety of malignant tumours. The majority of
      children (14/15) received fractionated chemotherapy and on day one complete
      control of acute nausea and vomiting was observed in 68.7% of all patients with a
      single, 15-minute, i.v. infusion of tropisetron. Partial control of vomiting was
      observed in 25% of patients and of nausea in 31.3% of patients on Day 1. Complete
      control of delayed nausea and vomiting was more variable, with an observed range
      between 50%-81% of patients over Days 2-6. There was no loss of appetite in 75%
      of patients treated with tropisetron on Day 1 and, more variably, in 62%-87% of
      patients on Days 2-6. Side effects were recorded in 18.8% of chemotherapy cycles,
      the most significant being insomnia in 12.5% of cycles and slight fever in 6.3%
      of cycles. It was concluded that tropisetron was well suited for children and
      could be recommended for those receiving a high burden of fractionated
      chemotherapy.

PMID- 8363999
TI  - Tropisetron in the prevention of chemotherapy-induced nausea and vomiting: the
      Nordic experience.
AB  - An open, non-comparative, Nordic multicenter study was performed during 1991-1992
      to evaluate the new 5-HT3 receptor antagonist tropisetron, as an antiemetic agent
      in various types of cancer chemotherapy. More than 600 patients were recruited
      from 16 cancer centers in Sweden, Finland and Denmark. In this report an interim
      analysis on 231 patients is presented. Gynecological cancers (61%), lung cancer
      (14%) and breast cancer (7%), were the main diagnoses. In 118 of 231 patients
      (51%) prior experience of chemotherapy was documented. In 91 patients (39%)
      cisplatin was part of the cytostatic regimen. Carboplatin (27%), doxorubicin
      (32%), epidoxorubicin (18%) were also frequently included. In all, 18 cytostatic
      agents were studied. The median number of courses studied was 3.3 (range 1-15).
      Overall 153 of 231 patients (67%) were completely protected from acute nausea and
      vomiting during the first course of chemotherapy. Delayed nausea and vomiting
      (Days 2-6) were completely controlled in 45%-72%. Treatment efficacy remained
      stable (57%-89%) over 10 consecutive courses of chemotherapy. For non-cisplatin
      regimens complete protection was achieved in 78% compared with 51% for cisplatin
      regimens (p < 0.0001). Patients with no prior experience of chemotherapy had
      greater control of acute nausea and vomiting (73%) than patients treated before
      (61%) in the first course, but not in subsequent courses. There were no such
      differences in control of delayed nausea and vomiting between chemotherapy-naive
      and previously treated patients. Sex and age were significant prognostic factors
      with regard to antiemetic response. Adverse events were recorded in 19%-36% of
      the cases during long-term follow-up. Headache (16%) and constipation (5%) were
      most frequent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364000
TI  - Compassionate use of tropisetron in patients at high risk of severe emesis.
AB  - Tropisetron is a 5-HT3 receptor antagonist which suppresses nausea and vomiting
      induced by cancer chemotherapeutic agents. In this study, tropisetron was
      evaluated on a compassionate-need basis in 545 cancer patients who had either
      proved refractory to antiemetic treatment during previous chemotherapy or who
      were at high risk of emesis as a result of current therapy. Tropisetron (5 mg or
      10 mg) was administered as a 15-minute infusion prior to chemotherapy, with the
      further possibility of an additional dose, either orally or parenterally, on one
      or more subsequent days. In some patients the drug was administered orally on the
      day before treatment. On Day 1 of Course 1, 64.7% of patients had a complete
      response to tropisetron, i.e. no nausea or vomiting, and 26.9% of patients had a
      partial response. More than 80% of patients with a complete response in Course 1
      had a complete response in Course 2 and of the partial responders in Course 1,
      37% achieved a complete response in Course 2. Of the 7.6% failures in Course 1, a
      further 26% achieved a complete response in Course 2. Tropisetron was well
      tolerated, with adverse effects recorded in only 45 (8%) patients.

PMID- 8364001
TI  - Pharmacological control of hypertriglyceridemia.
AB  - Hypertriglyceridemia has been recently recognized as a vascular risk factor,
      based on both clinical and experimental findings. Epidemiological studies clearly
      showed that elevated plasma triglycerides in subjects with low high-density
      lipoprotein (HDL) cholesterol (<35 mg/dl) and/or a low-density lipoprotein
      (LDL)/HDL cholesterol ratio > 5 are associated with an elevated risk for coronary
      heart disease (CHD), while intervention studies indicate that triglyceride
      lowering with drugs may lead to a significant CHD reduction. Elevated blood
      triglycerides are associated with major alterations in the structure/function of
      plasma lipoproteins, which become more atherogenic, and with abnormalities in the
      clotting system, which may predispose to coronary thrombosis. New criteria for
      the classification of hypertriglyceridemias and a stepwise approach to the
      management of patients with elevated plasma triglycerides have been recently
      developed. Nonpharmacological interventions, i.e., weight reduction, alcohol and
      smoking cessation, and physical exercise, are the first-line actions to control
      hypertriglyceridemia. Drug therapy should be considered when the
      nonpharmacological approaches are ineffective or inadequate. Fibric acid
      derivatives and nicotinic acid (and its derivatives) are the drugs of choice when
      treating hypertriglyceridemic patients; n-3 fatty acids (fish oil) and metformin
      (especially in diabetic patients) represent additional therapeutic agents.

PMID- 8364002
TI  - Effect of dobutamine on left ventricular relaxation and filling phase in patients
      with ischemic heart disease and preserved systolic function.
AB  - The beneficial effects of dobutamine on left ventricular systolic and diastolic
      phases have been described in patients with congestive heart failure. Its
      influence on left ventricular diastolic phase in patients with preserved systolic
      function, absence of dys- or akinetic areas, and left ventricular dilatation has
      not yet been adequately investigated. Thus a simultaneous echo-Doppler and
      hemodynamic study was performed in 15 patients with ischemic heart disease and
      preserved systolic function in order to assess the effect of dobutamine on left
      ventricular relaxation and filling phase. The infusion of dobutamine at a rate of
      10 micrograms/kg/min induced a marked inotropic action, as shown by the
      significant increase in positive dP/dt (from 1392 +/- 224 to 2192 +/- 295
      mmHg/sec, p < 0.001), dP/dt/P (from 32 +/- 8.1 to 50 +/- 17 sec-1; p < 0.0001),
      and in peak of systolic pressure (from 143 +/- 25 to 168 +/- 36 mmHg; p < 0.005).
      In addition, dobutamine reduced the end-systolic volume index (from 30 +/- 16 to
      26 +/- 19 ml/m2; p < 0.05), the end-systolic stress (from 222.2 +/- 65.3 to 198.4
      +/- 84 g/cm2; p < 0.006), and had favorable effects on relaxation and the early
      filling phase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364003
TI  - Hemodynamic effects of prolonged enoximone infusion (7 days) in patients with
      severe chronic heart failure.
AB  - This study investigated the hemodynamic effects and tolerance of infusion of 10
      micrograms/kg/min enoximone over 7 days in 12 patients (mean age 64.3 years) with
      severe chronic heart failure (10 NYHA Class III and 2 Class IV) with idiopathic
      dilated cardiomyopathy. Hemodynamic parameters were measured 10 minutes, 3 hours,
      6 hours, 18 hours, 24 hours, and 7 days after the start of infusion.
      Catecholamines were assayed before the start of the infusion and on day 7. The
      heart rate increased on an average from 90.8 +/- 13.7 before infusion to 108.5 +/
      8.2 beats/min (p < 0.05) on day 7 (+20%). The mean arterial pressure decreased
      by approximately 10% (p < 0.05) between the start and end of the infusion. The
      pulmonary artery diastolic pressure dropped by a maximum of 30% at the 24th hour
      (23.1 +/- 5.1 to 16 +/- 5.4 mm Hg; p < 0.01). This decrease remained significant
      on day 7; the index cardiac was increased a maximum of 40% between the 18th and
      the 24th hour; p < 0.01). This increase was still significant on day 7 (2.35 +/-
      0.44; p < 0.05; +22%). Finally, the decrease in systemic arterial resistance,
      which reached a maximum of 30% of the 24th hour, persisted on day 7 (-22%); 2076
      +/- 451 to 1612 +/- 283 dynes/sec/cm5; p < 0.05). The norepinephrine level did
      not change significantly (4.5 +/- 1.2 nmol/l before infusion vs. 4.2 +/- 1.1
      nmol/l on day 7). Infusion had to be stopped in one patient after 30 minutes
      because of prolonged severe hypotension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364004
TI  - Effect of enoximone alone and in combination with metoprolol on myocardial
      function and energetics in severe congestive heart failure: improvement in
      hemodynamic and metabolic profile.
AB  - The hemodynamic and myocardial metabolic effects of enoximone (phosphodiesterase
      III inhibitor), alone or in combination with metoprolol (beta-adrenergic
      blocker), were studied in patients with congestive heart failure. Ten patients
      (New York Heart Association Class III-IV) underwent right heart and coronary
      sinus catheterization, and parameters were assessed at basal condition, at peak
      enoximone response (mean intravenous loading dose = 2.2 mg/kg), and after the
      combination with metoprolol (mean intravenous dose = 8.5 mg). Heart rate tended
      to increase during enoximone administration (from 102 +/- 16 to 107 +/- 16 min-1,
      ns) and was reduced during enoximone plus metoprolol (to 88 +/- 15 min-1, p <
      0.05 vs. basal). Cardiac index was increased during enoximone (from 2.2 +/- 0.2
      to 3.8 +/- 0.5 1/min/m2, p < 0.05) and decreased during enoximone plus metoprolol
      (to 2.8 +/- 0.5 1/min/m2, p < 0.05 vs. enoximone). Mean pulmonary wedge pressure
      fell during enoximone and remained reduced during enoximone plus metoprolol (from
      27 +/- 9 to 9 +/- 3 and to 13 +/- 4 mmHg, respectively, both p < 0.05).
      Myocardial oxygen consumption did not change during enoximone (from 27 +/- 8 to
      25 +/- 13 ml/min, ns) and was reduced during enoximone plus metoprolol (to 19 +/-
      8 ml/min, p < 0.05 vs. basal). Myocardial lactate extraction tended to be lower
      during enoximone and during enoximone plus metoprolol conditions (from 38 +/- 17%
      to 26 +/- 20% and to 29 +/- 24%, respectively), but no statistical significance
      was found. Myocardial efficiency was increased during enoximone and during
      enoximone plus metoprolol (from 9 +/- 3% to 15 +/- 6% and to 14 +/- 6%,
      respectively, both p < 0.05). Thus in patients with congestive heart failure
      enoximone improves hemodynamics and, in most cases, it does not influence
      energetics. The addition of metoprolol to enoximone reduces heart rate, cardiac
      index, and myocardial oxygen consumption without any other major changes,
      producing a more physiologic hemodynamic and metabolic profile.

PMID- 8364005
TI  - Assessment of the cardiostimulant action of propionyl-L-carnitine on chronically
      volume-overloaded rat hearts.
AB  - Chronic volume overload was induced in young rats of Wistar strain by surgical
      opening of the aorto-caval fistula. Three months later, during in vitro perfusion
      with exogenous palmitate, left ventricular function and energy turnover (QO2) of
      hypertrophied hearts were severely depressed. This seemed to be related to
      impaired long-chain fatty acid utilization, as reflected by decreased 14CO2
      production from U-14C-palmitate and decreased tissue levels of L-carnitine.
      Another group of rats exposed to chronic volume overload was pretreated for 2
      weeks before sacrifice with propionyl-L-carnitine (250 mg/kg/day), and the hearts
      were perfused with 1.2 mM palmitate and 10 mM propionyl-L-carnitine. In this
      group, both mechanical performance and the oxygen consumption rate were quite
      comparable to those of untreated controls. On the other hand, tissue levels of L
      carnitine were only slightly increased, and the rate of 14CO2 production from U
      14C-palmitate was insignificantly improved. This suggests that propionyl-L
      carnitine administration promotes the mechanical performance of normoxic volume
      overloaded hearts via a mechanism other than improved palmitate utilization. The
      possibility that propionyl moieties themselves replenish with mitochondrial
      intermediates of the tricarboxylic cycle (malate, acetyl-CoA) is not excluded.

PMID- 8364006
TI  - Electrophysiological effects of flecainide acetate on stretched guinea pig left
      atrial muscle fibers.
AB  - The electrophysiological effects of flecainide acetate (3 x 10(-6) M) on
      stretched atrial tissue were investigated using guinea-pig left atrial muscle
      fibers. Before stretching, the resting membrane potential was not affected by
      flecainide at 1 Hz, although the overshoot potential (Eov) and the action
      potential duration at 50% repolarization (APD50) were slightly but significantly
      decreased by 2 +/- 1 mV and 2 +/- 1 msec, respectively. The effective refractory
      period (ERP) was increased by 3 +/- 1 msec. The reduction of Vmax was 20.6 +/-
      1.2%. The half-maximum potential (Vh) of the relationship between Vmax and the
      resting potential was shifted to become more negative by flecainide (from -60.6
      +/- 2.1 mV to -63.2 +/- 1.7 mV). After 90-120 min of washout with drug-free
      Tyrode's solution, the tissue was mechanically stretched to 150% of its slack
      length. Stretching significantly decreased the Vmax by 16.9 +/- 3.1%, along with
      a slight but significant increase in ERP (3 +/- 1 msec) and shifted Vh to become
      more negative (from -60.6 +/- 2.1 to -63.1 +/- 1.8 mV). In the presence of
      flecainide, Vmax further decreased by 20.2 +/- 2.6%, and Vh shifted from -63.1 +/
      1.8 to -65.0 +/- 1.5 mV. Comparison with the control unstretched fibers showed
      that flecainide significantly decreased Vmax by 34.0 +/- 2.7%, reduced the
      resting membrane potential by 3 +/- 1 mV, decreased Eov by 4 +/- 1 mV, and
      shifted Vh from -60.6 +/- 2.1 to -65.0 +/- 1.5 mV, while the APD50 and ERP did
      not change. In conclusion, the reduction of Vmax in the presence of flecainide
      was much greater in the stretched atrial muscle fibers than in the unstretched
      fibers, because the Vmax-resting potential relationship was shifted towards more
      negative potentials by both flecainide and stretching. These results suggest that
      flecainide exerts a stronger antiarrhythmic action on stretched atrial muscle
      fibers than on normal fibers.

PMID- 8364007
TI  - ACE inhibitors.

PMID- 8364008
TI  - Verapamil prevents sudden death in patients with increased heart size after an
      acute myocardial infarction.

PMID- 8364009
TI  - Disordered methionine/homocysteine metabolism in premature vascular disease. Its
      occurrence, cofactor therapy, and enzymology.
AB  - Mild homocysteinemia occurs surprisingly often in patients with premature
      vascular disease. We studied the possible enzymatic sources of this mild
      hyperhomocysteinemia and the control of homocysteine levels in plasma by
      treatment of patients with the cofactors and cosubstrates of homocysteine
      catabolism. We assessed homocysteine metabolism in 131 patients who had premature
      disease in their coronary, peripheral, or cerebrovascular circulation by using a
      standard oral methionine-load test. Impaired homocysteine metabolism occurred in
      28 patients. We assayed levels of the primary enzymes of homocysteine catabolism
      in cultured skin fibroblast extracts from 15 of these 28 patients. The patients'
      cystathionine beta-synthase levels (3.68 +/- 2.52 nmol/h per milligram of cell
      protein, mean +/- SD) were markedly depressed compared with those from 31 healthy
      adult control subjects (7.61 +/- 4.49, P < .001). The patients' levels of 5
      methyltetrahydrofolate: homocysteine methyltransferase were normal. While
      betaine: homocysteine methyltransferase was not expressed in skin fibroblasts, 24
      hour urinary betaine and N,N-dimethylglycine measurements were consistent with
      normal or enhanced remethylation of homocysteine by betaine: homocysteine
      methyltransferase in the 13 patients tested. When treated daily with choline and
      betaine, pyridoxine, or folic acid, there was a normalization of the
      postmethionine plasma homocysteine level in 16 of 19 patients. Our results
      indicate that mild homocysteinemia in premature vascular disease may be caused by
      either a folate deficiency or deficiencies in cystathionine beta-synthase
      activity. It does not necessarily involve deficiencies of either 5
      methyltetrahydrofolate:homocysteine methyltransferase or betaine:homocysteine
      methyltransferase. Effective treatment regimens are also defined.

PMID- 8364011
TI  - In vitro large-wound re-endothelialization. Inhibition of centrosome
      redistribution by transient inhibition of transcription after wounding prevents
      rapid repair.
AB  - Rapid, efficient re-endothelialization of large wounds is characterized by a
      specific sequence of cytoskeletal events that occur after wounding. Wounds 1.5 mm
      wide were created down the middle of confluent porcine aortic endothelial
      monolayers to study regulation of repair. The wounded cultures were incubated for
      short periods with cycloheximide or actinomycin D to test the hypothesis that
      transient inhibition of translation and transcription at the time of wounding
      disrupts rapid repair by interfering with centrosome redistribution to the front
      of the cell, an early event associated with cell migration. Although centrosome
      reorientation did not occur when protein synthesis was inhibited with 20
      micrograms/mL cycloheximide for 1 hour before and for up to 4 hours after
      wounding, reorientation did occur by 2 hours after cycloheximide was washed out.
      The times taken for the wound to close for cycloheximide-treated and control
      cells did not differ (60 +/- 1.1 vs 60 +/- 0.8 hours). When transcription was
      inhibited with 0.25 micrograms/mL actinomycin D for 1 hour before and for 1 hour
      after wounding, re-endothelialization was dramatically reduced. The time taken
      for the wound to close was almost five times longer (288 +/- 5.3 hours) than for
      control cells. The cells moved very slowly, maintaining a flattened, spread-out
      shape, as opposed to being elongated. The centrosomes did not reorient to the
      front of the cell throughout the entire period. However, addition of actinomycin
      D for 2 hours when centrosomes had already moved to the front of the cells (4
      hours after wounding) did not reduce subsequent wound repair (60 +/- 1.3 hours).
      This study supports our hypothesis that centrosome redistribution is essential
      for efficient wound repair and suggests that redistribution is regulated by
      transcription of essential gene(s) that is induced immediately after wounding by
      an unknown short-lived signal. Two possible signals are the loss of cell contact
      and/or a soluble substance released from the cells at the time of wounding. When
      the signal is unable to induce transcription, dysfunctional repair occurs by a
      very slow centrosome-independent process.

PMID- 8364010
TI  - Concerted effects of lipoproteins and angiotensin II on signal transduction
      processes in vascular smooth muscle cells.
AB  - Low-density (LDL) and high-density (HDL3) lipoproteins dose-dependently activate
      phosphoinositide turnover and elevate cytosolic free Ca2+ concentrations
      ([Ca2+]i) in cultured vascular smooth muscle cells (VSMCs) from either human
      (microarterioles and aorta) or rat (aorta) sources. High-performance liquid
      chromatography analysis of cell extracts revealed comparable spectra of inositol
      phosphate isomers generated in response to either LDL, HDL3, or angiotensin II
      (Ang II). Thus, lipoproteins and Ang II may use similar, if not identical, signal
      transduction pathways for the generation and metabolism of inositol phosphates
      and intracellular Ca2+ mobilization in VSMCs. When Ang II was added in
      combination with either LDL or HDL3, the phosphoinositide and [Ca2+]i responses
      of VSMCs were either equal to or even greater than the sum of the effects
      elicited by the agonists individually. This additivity/synergy between Ang II and
      the lipoproteins was not accompanied by alteration in the half-maximally
      effective dose requirements of VSMCs for either Ang II (approximately 2 nmol/L,
      with or without lipoproteins) or lipoproteins (approximately 50 micrograms/mL for
      LDL and HDL3, with or without Ang II). Neither short-term (up to 10 minutes) nor
      long-term (48 hours) exposure of VSMCs to lipoproteins caused desensitization of
      phospholipase C and intracellular Ca2+ mobilization responses to either Ang II or
      lipoproteins. Since constant exposure of VSMCs to lipoproteins is a physiological
      circumstance, and because elevation of [Ca2+]i and activation of phosphoinositide
      turnover are pivotal events for VSMC contraction and growth, we suggest that the
      low concentrations of lipoproteins in the vessel intima may play an important
      role in regulating the response of the vasculature to Ang II.

PMID- 8364012
TI  - Beta-VLDL in hepatic lipase deficiency induces apoE-mediated cholesterol ester
      accumulation in macrophages.
AB  - Hepatic lipase-deficient subjects in the Ontario kindred are compound
      heterozygotes for hepatic lipase mutations (Ser267-->Phe and Thr383-->Met).
      Cholesteryl ester-rich beta-very-low-density lipoprotein (beta-VLDL) accumulates
      in plasma and such subjects have premature atherosclerosis. To determine a
      possible mechanism, we hypothesized that hepatic lipase-deficient beta-VLDL,
      homozygous for apolipoprotein (apo) E3, would cause cholesteryl ester
      accumulation and foam cell formation in macrophages. beta-VLDL and pre-beta-VLDL
      were isolated by Pevikon electrophoresis and incubated with J774 macrophages,
      cells that do not secrete apoE. beta-VLDL increased cellular cholesteryl ester
      content 13-fold, whereas pre-beta-VLDL increased cholesteryl ester sevenfold.
      beta-VLDL increased acyl CoA:cholesterol acyltransferase activity fourfold
      (measured as [14C]oleate incorporation into cholesteryl ester). Preincubation of
      hepatic lipase-deficient beta-VLDL with the anti-apoE monoclonal antibody 1D7,
      which inhibits binding of apoE to low-density lipoprotein receptors, inhibited
      cellular cholesteryl ester accumulation by 75%, whereas the anti-apoB blocking
      monoclonal antibody 5E11 failed to inhibit cellular cholesteryl ester
      accumulation. In contrast to hepatic lipase deficiency, beta-VLDL from type III
      subjects (E2/E2) failed to increase cellular cholesteryl ester or acyl
      CoA:cholesterol acyltransferase more than 1.5-fold. Thus, hepatic lipase
      deficient beta-VLDL readily induces cholesteryl ester accumulation in J774
      macrophages, a process mediated by functional apoE3. This may explain the
      premature atherosclerosis observed in this kindred.

PMID- 8364013
TI  - Natural history of aortic and coronary atherosclerotic lesions in youth. Findings
      from the PDAY Study. Pathobiological Determinants of Atherosclerosis in Youth
      (PDAY) Research Group.
AB  - Pathology laboratories in nine cooperating centers collected arteries from 1532
      persons 15 through 34 years of age who died of external causes, principally
      homicides, accidents, and suicides. A central laboratory stained the arteries and
      evaluated the atherosclerotic lesions. All of the aortas and about half of the
      right coronary arteries in the youngest age group (15 through 19 years) had
      lesions. The mean percent intimal surface involved by lesions, in 5-year age
      groups, increased from 15 through 34 years. Raised lesions increased with age in
      extent and prevalence in the aorta and the right coronary artery. Black subjects
      had more extensive fatty streaks than white subjects in all three arterial
      segments. Young women had more extensive fatty streaks in the abdominal aorta;
      young men had more in the thoracic aorta. Male subjects had more extensive and a
      higher prevalence of raised lesions than did female subjects in the right
      coronary artery. White and black subjects did not differ significantly in the
      extent of raised lesions. Among the three arterial segments, the right coronary
      had the least percentage of intimal surface involved with all types of lesions
      but had the highest proportion of raised lesions among total lesions. These
      results confirm the origin of atherosclerosis in childhood and show that the
      prevalence and extent of fatty streaks and fibrous plaques increase rapidly
      during the 15- through 34-year age span.

PMID- 8364014
TI  - Familial HDL deficiency due to marked hypercatabolism of normal apoA-I.
AB  - In this article, we describe a 46-year-old man with severe high-density
      lipoprotein (HDL) deficiency and his kindred. In the proband, HDL cholesterol and
      apolipoprotein (apo) A-I levels were 5 and 4.5 mg/dL, respectively. Xanthomata,
      xanthelasma, arcus corneae, and hepatosplenomegaly were not present. The proband
      had coronary artery disease, but it was impossible to state whether the HDL
      deficiency cosegregated with premature coronary artery disease in this kindred.
      Pedigree analysis was suggestive of a codominant familial disease. Polymerase
      chain reaction amplification of the apoA-I gene of the proband, followed by
      subcloning and sequencing, did not reveal any mutation in either the coding
      regions or intron-exon junctions. A kinetic study using deuterated leucine to
      endogenously label apoA-I was performed to elucidate the metabolic basis of the
      apoA-I deficiency. We demonstrated marked hypercatabolism of apoA-I in the
      proband, with a fractional catabolic rate more than 10 times faster than normal;
      the plasma residence time of apoA-I in the proband was only 0.38 day compared
      with 4.10 days in a control subject. The apoA-I production rate was also
      substantially decreased in the proband. The association of a normal apoA-I gene
      sequence with marked hypercatabolism of apoA-I is similar to that described in
      Tangier disease. However, except for the presence of mild, diffuse, corneal
      deposits, this patient had no evidence of the reticuloendothelial cholesterol
      deposition characteristic of Tangier disease. This study establishes that a form
      of severe hypoalphalipoproteinemia distinct from Tangier disease can be caused by
      marked hypercatabolism of a normal A-I apolipoprotein.

PMID- 8364015
TI  - LDL inhibits the mediation of cholesterol efflux from macrophage foam cells by
      apoA-I-containing lipoproteins. A putative mechanism for foam cell formation.
AB  - Although the accumulation of cholesterol in macrophages appears to be an initial
      step in atherogenesis, low-density lipoprotein (LDL), a major risk factor for
      atherosclerosis, does not promote cholesterol accumulation in macrophages in its
      native form. On the other hand, apolipoprotein (apo) A-I-containing lipoprotein
      removes cholesterol from cholesterol-loaded macrophages (foam cells) and prevents
      cholesterol from accumulating in the cells. We examined the effect of LDL on
      cholesterol removal by two species of apoA-I-containing lipoproteins, one
      containing only apoA-I (LpA-I) and the other containing apoA-I and apoA-II (LpA
      I/A-II). When foam cells were incubated with LpA-I or LpA-I/A-II, cellular
      cholesterol mass was reduced. In contrast, when LDL was added, the cholesterol
      reducing capacities of these lipoproteins were dose-dependently inhibited by LDL.
      In the presence of LDL, LpA-I and LpA-I/A-II removed free cholesterol
      preferentially from LDL rather than from the plasma membrane of foam cells. In
      addition, a fair amount of cellular cholesterol was directly moved to LDL rather
      than to LpA-I or LpA-I/A-II. The cellular cholesterol that moved to LDL was
      completely compensated for by the cholesterol influx from LDL to foam cells.
      Thus, net cholesterol efflux (a combination of influx and efflux) from foam cells
      was inhibited by LDL. These results, taken together, indicate that LDL may
      accelerate foam cell formation by inhibiting cholesterol removal from the cells
      and that elevated levels of plasma LDL may become a risk factor for
      atherosclerosis by inhibiting the function of LpA-I and LpA-I/A-II at the
      cellular level.

PMID- 8364016
TI  - Homocysteine, a risk factor for premature vascular disease and thrombosis,
      induces tissue factor activity in endothelial cells.
AB  - Elevated blood levels of homocysteine represent an independent risk factor for
      premature arterial vascular disease and thrombosis. We investigated whether
      homocysteine could induce tissue factor (TF) procoagulant activity in cultured
      human endothelial cells. Homocysteine increased cellular TF activity in a time-
      and concentration-dependent manner. Low concentrations of homocysteine (0.1 to
      0.6 mmol/L), similar to those found in the blood of patients with homocystinuria,
      enhanced TF activity by 25% to 100%. Other sulfur-containing amino acids
      (cystine, homocystine, cysteine, and methionine) induced less TF activity than
      did homocysteine; however, beta-mercaptoethanol and dithiothreitol were more
      effective than homocysteine in increasing TF activity. Preincubation of
      homocysteine with a sulfhydryl inhibitor such as N-ethylmaleimide prevented
      homocysteine induction of TF activity. A quantitative polymerase chain reaction
      method indicated that homocysteine increased TF mRNA in endothelial cells. These
      results indicate that an atherogenic amino acid, homocysteine, can initiate
      coagulation by the TF pathway through a mechanism involving the free thiol group
      of the amino acid and by TF gene transcription. These data support the hypothesis
      that perturbation of vascular coagulant mechanisms may contribute to the
      thrombotic tendency seen in patients with homocystinuria.

PMID- 8364017
TI  - Interaction of oxidized HDLs with J774-A1 macrophages causes intracellular
      accumulation of unesterified cholesterol.
AB  - Uptake of modified lipoproteins by resident arterial monocytes/macrophages is
      believed to be a key event in the formation of foam cells and thus in the early
      phases of atherosclerosis. Low-density lipoproteins (LDLs) that undergo oxidative
      changes become suitable for uptake by macrophages through a specific scavenger
      receptor that leads to cholesteryl ester accumulation. Because the interaction of
      other oxidized lipoproteins with macrophages has been poorly investigated, we
      studied the effect of oxidatively modified high-density lipoproteins (HDLs) on
      the sterol metabolism of J774-A1 macrophages. Unlike native HDLs, oxidized HDLs
      caused a concentration-dependent accumulation of unesterified cholesterol and
      decreased [14C]oleate incorporation into steryl esters. Oxidized HDLs also
      decreased [14C]acetate incorporation into newly synthesized sterols. Cell surface
      binding of 125I-oxidized HDLs to the macrophages was saturable, with an apparent
      dissociation constant (Kd) of 0.96 nmol/mL. Both oxidized and acetylated LDLs but
      not native lipoproteins could compete for binding of 125I-oxidized HDL. The data
      support the conclusion that the effects elicited by oxidized HDLs on the sterol
      metabolism of macrophages are significantly different from those of native HDLs.
      The binding of oxidized HDLs to macrophages occurs at sites that are likely the
      same as those for modified LDLs. We speculate that, if occurring in vivo, HDL
      oxidation would generate modified lipoproteins capable of modulating the
      cholesterol homeostasis of macrophages.

PMID- 8364018
TI  - Inhibition of thromboxane biosynthesis and platelet function by indobufen in type
      II diabetes mellitus.
AB  - Indobufen is a reversible inhibitor of platelet prostaglandin G/H-synthase. To
      verify the dose dependence of the antiplatelet effect of indobufen on ex vivo and
      in vivo indexes of thromboxane (TX) biosynthesis and TXA2-dependent platelet
      function, we studied nine patients with non-insulin-dependent diabetes mellitus
      (NIDDM). This was a randomized, double-blind, crossover study in which each
      patient was treated with three different daily regimens (50 mg BID, 100 mg BID,
      and 200 mg BID) of indobufen for 1 week, with a 7-day washout period between
      treatments. Urinary 11-dehydro-TXB2 excretion averaged 58.2 +/- 21.8 ng/h at
      baseline. TX metabolite excretion was reduced dose dependently by indobufen: by
      67% at 50 mg BID, 72% at 100 mg BID, and 81% at 200 mg BID. Platelet
      cyclooxygenase activity, ATP release, collagen-induced platelet aggregation, and
      bleeding time also were modified dose dependently by indobufen. Biochemical
      demonstration of suppressed platelet TXA2 in vivo was accompanied by evidence of
      inhibited platelet function as assessed ex vivo. Under pathophysiological
      conditions, such as NIDDM, which are associated with enhanced TXA2 synthesis,
      more than 95% suppression of platelet cyclooxygenase activity may be necessary to
      produce virtually maximal inhibition of platelet TXA2 biosynthesis in vivo.

PMID- 8364019
TI  - Macrophage-conditioned medium and beta-VLDLs enhance cholesterol esterification
      in SMCs and HSFs by LDL receptor-mediated and other pathways.
AB  - Thioglycolate-elicited mouse peritoneal macrophages were incubated for 24 hours
      in serum-free Dulbecco-Vogt medium containing 0.5% fatty acid-poor bovine serum
      albumin. This conditioned medium, designated MP medium, was used for experiments
      with bovine aortic smooth muscle cells (SMCs) or human skin fibroblasts (HSFs).
      Dulbecco-Vogt medium of the same albumin content but without macrophages served
      as a control medium. In SMCs labeled from plating the [3H]cholesterol and
      incubated with hypercholesterolemic rabbit beta-very-low-density lipoprotein
      (beta-VLDL) in Dulbecco-Vogt medium for 24 hours, there was an increase in
      cellular [3H]cholesteryl ester (CE) content compared with cells incubated without
      lipoprotein. When MP medium was used for the incubation of SMCs with beta-VLDL,
      cellular [3H]cholesteryl ester content increased threefold compared with cells
      incubated with Dulbecco-Vogt medium. A smaller increase in cholesterol
      esterification in the presence of MP medium was also encountered with low-density
      lipoprotein (LDL). The MP medium-induced increase in [3H]cholesterol
      esterification was not evident up to 6 hours of incubation. Similar results were
      also obtained with HSFs. The increase in [3H]cholesterol esterification with MP
      medium in the presence of beta-VLDL was also elicited in cells obtained from LDL
      receptor-negative donors with familial hypercholesterolemia (FH-HSF), even though
      in these cells significantly less [3H]cholesteryl ester was formed in the
      presence of beta-VLDL. MP medium contains numerous agents that could be
      responsible for the increase in cellular [3H]cholesteryl ester induced by
      lipoproteins. The first considered was lipoprotein lipase, but lack of inhibition
      of the MP medium effect by antiserum to lipoprotein lipase did not support this
      possibility.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364020
TI  - Exercise training decreases plasma cholesteryl ester transfer protein.
AB  - To assess the effect of exercise on the plasma concentration of cholesterol ester
      transfer protein (CETP) and its possible influence in mediating the exercise
      associated redistribution of cholesterol among plasma lipoproteins, we measured
      plasma CETP in 57 healthy normolipidemic men and women before and after 9 to 12
      months of exercise training. The training protocol resulted in significant
      changes in VO2max (mean +/- SD, +5.3 +/- 3.5 mL.kg-1 x min-1), body weight (-2.5
      +/- 3.5 kg), plasma triglycerides (-25.7 +/- 36.3 mg/dL), high-density
      lipoprotein cholesterol (HDL-C) (+2.6 +/- 6.2 mg/dL), and ratios of total
      cholesterol to HDL-C (-0.30 +/- 0.52) and low-density lipoprotein cholesterol
      (LDL-C) to HDL-C (-0.18 +/- 0.45) (all P < or = .05) but no change in
      lipoprotein(a). CETP concentration (in milligrams per liter) fell significantly
      in response to training in both men (n = 28, 2.47 +/- 0.66 to 2.12 +/- 0.43; %
      delta = 14.2%; P < .005) and women (n = 29, 2.72 +/- 1.01 to 2.36 +/- 0.76; %
      delta = 13.2%; P < .047). The CETP change was observed both in subjects who lost
      weight (n = 28, delta mean weight = -5.0 kg; delta CETP = -0.42 +/- 0.79; % delta
      = 15.4%; P < .009) and in those who were weight stable (n = 29, delta mean weight
      = -0.12 kg; delta CETP = -0.29 +/- 0.78; % delta = 10.4%; P < .055).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8364021
TI  - Influx, efflux, and accumulation of LDL in normal arterial areas and
      atherosclerotic lesions of white Carneau pigeons with naturally occurring and
      cholesterol-aggravated aortic atherosclerosis.
AB  - This study investigated the hypothesis that increased influx of low-density
      lipoprotein (LDL) accounts for the natural development of atherosclerosis in a
      characteristic (susceptible) site in the distal thoracic aorta of White Carneau
      (WC) pigeons and the exacerbation of atherosclerosis by cholesterol feeding. The
      influence of dietary cholesterol-induced changes in LDL composition on LDL influx
      into the artery was also investigated. As a measure of the influx of LDL into the
      artery, we determined the arterial accumulation of radiolabeled LDL after 1 hour.
      Nine 50-month-old WC pigeons with naturally occurring atherosclerosis and seven
      14-month-old WC pigeons with atherosclerosis accelerated by 10 months of
      cholesterol feeding were studied. In the absence of atherosclerotic lesions, we
      found no evidence for increased accumulation of LDL at the susceptible site. In
      fact, more LDL accumulated in less susceptible normal arterial areas near the
      heart (approximately 90 nl/h per square centimeter) than in the susceptible
      distal thoracic aorta (approximately 35 nl/h per square centimeter). In the
      absence of atherosclerotic lesions, LDL accumulation (nanoliters per hour per
      square centimeter) was not influenced by hypercholesterolemia, although mass
      transport of LDL cholesterol into the artery was increased. Naturally occurring
      atherosclerotic lesions accumulated five times as much LDL as the adjacent normal
      arterial area (P < .001), whereas cholesterol-aggravated atherosclerotic lesions
      in different arterial sites accumulated four to 26 times as much LDL as the
      adjacent normal artery (P < .05). Cholesterol-aggravated atherosclerotic lesions
      at the most susceptible site accumulated five times as much LDL as naturally
      occurring atherosclerotic lesions in the corresponding arterial site (823 +/- 241
      vs 175 +/- 45 nl/h per square centimeter, mean +/- SEM; P < .005). Arterial
      accumulation of LDL was influenced very little by changes in LDL composition
      induced by cholesterol feeding. In another study with young WC pigeons free of
      atherosclerosis and other WC pigeons with cholesterol-aggravated atherosclerosis,
      we injected differently labeled LDL 0.5 and 1 hour before sacrifice to
      investigate whether efflux of LDL from the artery was significant during a 1-hour
      period of LDL uptake. Although efflux of LDL from all arterial sites occurred
      during 1 hour, differential efflux could not account for regional differences in
      1-hour arterial LDL accumulation. This study suggests that the characteristic
      susceptibility of the distal thoracic aorta of WC pigeons to atherosclerosis and
      the exacerbation of atherosclerosis by cholesterol feeding cannot be explained by
      differences in influx or efflux of LDL.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8364022
TI  - Abundant expression of apoprotein E by macrophages in human and rabbit
      atherosclerotic lesions.
AB  - Previous studies have demonstrated the presence of apoprotein (apo) E protein and
      message in arterial lesions. To determine the source of the synthesized apoE, we
      performed simultaneous in situ hybridization and immunocytochemistry on human and
      rabbit atherosclerotic tissue. Studies of serial sections of aortic
      atherosclerotic lesions from humans and hypercholesterolemic New Zealand White
      rabbits and Watanabe heritable hyperlipidemic rabbits revealed a similar pattern
      of macrophage-specific apoE expression in the rabbit and human lesions. In early
      lesions of rabbit atherosclerotic tissue, in which many macrophages were present,
      there was abundant expression of apoE mRNA. Northern blot analyses of total mRNA
      obtained from arterial macrophage-derived foam cells, freshly isolated from
      ballooned, cholesterol-fed New Zealand White rabbits, demonstrated positive
      hybridization with an apoE-specific riboprobe. Western blot analyses of
      conditioned media from the isolated foam cells placed in culture for up to 24
      hours demonstrated the presence of secreted apoE. These studies demonstrated that
      in atherosclerotic lesions, arterial wall macrophages synthesize and secrete apoE
      and probably account for most of the apoE synthesized in the atherosclerotic
      artery.

PMID- 8364023
TI  - Effects of site-directed mutagenesis on the N-glycosylation sites of human
      lecithin:cholesterol acyltransferase.
AB  - There are four potential N-glycosylation site (Asn-X-Ser/Thr) in human
      lecithin:cholesterol acyltransferase (LCAT, residues 20, 84, 272, and 384). To
      study the role of the N-linked sugars, the codon for Asn at these positions was
      replaced with one for Thr (AAC to ACC). The wild-type and mutant LCAT cDNAs were
      used to transfect COS-6 cells from which RNA was isolated; cDNAs were synthesized
      by reverse transcription and subjected to the polymerase chain reaction, which
      showed that all transfectants synthesized LCAT-specific mRNA. No intracellular or
      secreted LCAT was detected with the Asn272-->Thr transfectants, indicating that
      this residue is essential for intracellular processing. All other single-point
      transfectants were secretion-competent. Although there was detectable LCAT
      protein inside the cells and in the media of the transfectant, Asn84-->Thr, its
      specific activity and secreted amount were only 26% and 58% of the wild type,
      respectively. This implies that Asn84 is critical for full activity but not for
      intracellular processing. The amount secreted, specific activity, and Vmax of
      LCAT (Asn20-->Thr) were similar to those of the wild-type LCAT. LCAT (Asn384-
      >Thr) differed from the wild-type LCAT only by a lower Km. These results suggest
      that glycosylation at residues 20 and 384 is not essential for intracellular
      processing, secretion, or activity.

PMID- 8364024
TI  - Structure of an interleukin-1 beta mutant with reduced bioactivity shows multiple
      subtle changes in conformation that affect protein-protein recognition.
AB  - Site-specific mutagenesis was used to obtain the human interleukin-1 beta mutant
      protein with glycine substituted for threonine at position 9 (IL-1 beta Thr9Gly).
      The mutant maintains receptor binding but exhibits significantly reduced
      biological activity. The crystal structure of IL-1 beta Thr9Gly has been
      determined at 2.4-A resolution by molecular replacement techniques and refined to
      a crystallographic R-factor of 19.0%. IL-1 beta Thr9Gly crystallizes in a
      different space group (P6(5)22) than does native IL-1 beta (P4(3)); thus the
      molecules pack differently. Their overall structure is similar, nevertheless,
      with both composed of 153 amino acids which form 12 antiparallel beta-strands.
      However, significant conformational differences both close to and far from the
      site of the mutation may explain the mutant's altered properties.

PMID- 8364025
TI  - Structural basis for transfer RNA aminoacylation by Escherichia coli glutaminyl
      tRNA synthetase.
AB  - The structure of Escherichia coli glutaminyl-tRNA synthetase complexed with
      tRNA2Gln and ATP refined at 2.5-A resolution reveals structural details of the
      catalytic center and allows description of the specific roles of individual amino
      acid residues in substrate binding and catalysis. The reactive moieties of the
      ATP and tRNA substrates are positioned within hydrogen-bonding distance of each
      other. Model-building has been used to position the glutamine substrate in an
      adjacent cavity with its reactive carboxylate adjacent to the alpha-phosphate of
      ATP; the interactions of the carboxyamide side chain suggest a structural
      rationale for the way in which the enzyme discriminates against glutamate. The
      binding site for a manganese ion has also been identified bridging the beta- and
      gamma-phosphates of the ATP. The well-known HIGH and KMSKS sequence motifs
      interact directly with each other as well as with the ATP, providing a structural
      rationale for their simultaneous conservation in all class I synthetases. The
      KMSKS loop adopts a well-ordered and catalytically productive conformation as a
      consequence of interactions made with the proximal beta-barrel domain. While
      there are no protein side chains near the reaction site that might function in
      acid-base catalysis, the side chains of two residues, His43 and Lys270, are
      positioned to assist in stabilizing the expected pentacovalent intermediate at
      the alpha-phosphate. Transfer of glutamine to the 3'-terminal tRNA ribose may
      well proceed by intramolecular catalysis involving proton abstraction by a
      phosphate oxygen atom of glutaminyl adenylate. Catalytic competence of the
      crystalline enzyme is directly shown by its ability to hydrolyze ATP and release
      pyrophosphate when crystals of the ternary complex are soaked in mother liquor
      containing glutamine.

PMID- 8364026
TI  - Crystal structure determination and refinement at 2.3-A resolution of the lentil
      lectin.
AB  - We report on the X-ray structure determination of the orthorhombic crystal form
      of lentil lectin by molecular replacement using the pea lectin coordinates as a
      starting model. The structure was refined at 2.3-A resolution with a combination
      of molecular dynamics refinement and classical restrained least-squares
      refinement. The final R value for all data Fo > 1 sigma (Fo) between 7.0- and 2.3
      A resolution is 0.164%, and deviations from ideal bond distances are 0.014 A. The
      C-terminus of the beta-chain proved to be 23 amino acids longer than found in
      previous studies. This together with several inconsistencies between the
      previously determined amino acid sequence and the observed electron density
      forced a redetermination of the amino acid sequence of the protein. The overall
      structure is very similar to that of pea lectin and isolectin I of Lathyrus
      ochrus, the most prominent deviations being confined to loop regions and the
      regions of intermolecular contact. The largest difference between the pea and
      lentil lectin monomers is situated in the loop region of amino acids 73-79 of the
      beta chain. There are no significant differences between the two crystallographic
      independent lentil lectin monomers in the asymmetric unit. The model includes 104
      well-defined water molecules, of which a significant number have a counterpart in
      the pea lectin structure. As for the other legume lectins, each lentil lectin
      monomer contains one calcium ion in a highly conserved environment. On the
      contrary, the manganese binding sites are distorted with respect to the pea
      lectin and concanavalin A structures. The Asp beta 121 side chain apparently does
      not ligate the Mn2+ ion. This difference is consistent in both lentil lectin
      monomers and agrees with earlier solution studies. Possible implications for
      oligosaccharide binding are discussed.

PMID- 8364027
TI  - Oxygen equilibrium properties of asymmetric nickel(II)-iron(II) hybrid
      hemoglobin.
AB  - Asymmetric Ni(II)-Fe(II) hybrid hemoglobin,
      XL[alpha(Fe)beta(Fe)][alpha(Ni)beta(Ni)], in which the alpha 1 beta 1 dimer
      containing ferrous protoporphyrin IX and the complementary alpha 2 beta 2 dimer
      containing Ni(II) protoporphyrin IX were cross-linked between Lys-82 beta 1 and
      Lys-82 beta 2 by reaction with bis(3,5-dibromosalicyl) fumarate, was synthesized
      and characterized. We have previously shown that (i) Ni(II) protoporphyrin IX,
      which binds neither oxygen nor carbon monoxide, mimics a fixed deoxyheme with
      respect to its effect on the oxygen equilibrium properties of the counterpart
      iron subunits in both symmetric Ni(II)-Fe(II) hybrid Hbs [Shibayama, N.,
      Morimoto, H., & Miyazaki, G. (1986) J. Mol. Biol. 192, 323-329] and (ii) the
      cross-linking used in this study little affects the oxygen equilibrium properties
      of hemoglobin [Shibayama, N., Imai, K., Hirata, H., Hiraiwa, H., Morimoto, H., &
      Saigo, S. (1991) Biochemistry 30, 8158-8165]. These remarkable features of our
      model allowed us to measure the oxygen equilibrium curves for the first two steps
      of oxygen binding to the alpha 1 beta 1 dimer within the hemoglobin tetramer. At
      all pH values examined, the affinities of this asymmetric hybrid for the first
      oxygen molecule are as low as those of native hemoglobin. The hybrid did not show
      cooperative oxygen binding at pH 6.4, while significant cooperativity was
      observed with rising pH; i.e., the Hill coefficient was increased from 1.41 to
      1.53 upon a pH change from 7.4 to 8.4. The electronic absorption spectrum of
      Ni(II) protoporphyrin IX in the alpha 2 subunit was changed upon carbon monoxide
      (or oxygen) binding to the alpha 1 beta 1 dimer.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364028
TI  - Disulfide bond assignments and secondary structure analysis of human and murine
      interleukin 10.
AB  - Interleukin 10 (IL-10), which was first discovered by its ability to inhibit the
      synthesis of various cytokines, most notably gamma interferon, from Th1 helper
      cells, displays pleiotropic immunoregulatory properties. Human and murine IL-10
      have a high amino acid sequence identity (ca. 73%) which includes the
      conservation of all four cysteine residues in human IL-10 and the first four out
      of five cysteine residues for murine IL-10. Chemical analysis was used to
      determine that both recombinant human and recombinant murine IL-10 contain two
      disulfide bonds. The disulfide pairs for each were determined by mass
      spectrometric and reversed-phase HPLC analysis of trypsin-derived polypeptide
      fragments. The disulfide bond assignments for both species were similar in that
      the first cysteine residue in the sequence paired with the third and the second
      paired with the fourth. The fifth cysteine in murine IL-10 was determined by
      chemical modification to be unpaired. Far-UV circular dichroism analysis
      indicated that the secondary structure of recombinant human and murine IL-10 are
      composed of ca. 60% alpha-helix. Reduction of the disulfide bonds structurally
      destabilized the protein and led to a structure containing only 53% alpha-helix.
      The reduced protein displayed no in vitro biological activity in a mast cell
      proliferation assay. These studies indicate that IL-10 is a highly alpha-helical
      protein containing two disulfide bonds, either one or both of which are critical
      for its structure and function. In addition, these properties suggest that this
      interesting cytokine may belong to the alpha helical cytokine class of
      hematopoietic ligands.

PMID- 8364029
TI  - Dimerization and tetramerization properties of the C-terminal region of
      chromogranin A: a thermodynamic analysis.
AB  - Chromogranin A, which is a high-capacity, low-affinity Ca2+ binding protein, has
      recently been shown to exist in monomer-dimer and in monomer-tetramer equilibria
      at pH 7.5 and 5.5, respectively [Yoo, S. H., & Lewis, M. S. (1992) J. Biol. Chem.
      267, 11236-11241]. The pH appeared to be a necessary and sufficient factor
      determining the types of oligomer formed. In the present study, using 14
      synthetic peptides representing various portions of chromogranin A, we have
      identified a region in chromogranin A which exhibited dimerization and
      tetramerization properties at pH 7.5 and 5.5, respectively. Of the 14 peptides,
      only the conserved C-terminal region (residues 407-431), represented by peptide
      14, showed the oligomerization property, existing in a dimeric state at pH 7.5
      and in a tetrameric state at pH 5.5. The delta G degrees values of
      tetramerization were approximately -18.0 kcal/mol, and the delta G degrees value
      of dimerization was -4.6 kcal/mol. Although peptide 14 represented only 6% of the
      entire sequence, the delta G degrees value of -18.0 kcal/mol accounted for 80-83%
      of the delta G degrees values (-21.6 to -22.7 kcal/mol) of tetramerization of
      intact chromogranin A. Unlike the tetramerization mechanisms of intact
      chromogranin A where the presence of 35 mM Ca2+ changed the tetramerization
      mechanism from an enthalpically driven to an entropically driven reaction, the
      tetramerization mechanism of peptide 14 remained entropically driven regardless
      of the presence of Ca2+. Likewise, dimerization of the peptide was also
      entropically driven.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364030
TI  - Purification and biochemical characterization of tubulin from the budding yeast
      Saccharomyces cerevisiae.
AB  - We describe a method for isolating milligram quantities of assembly-competent
      tubulin from the budding yeast Saccharomyces cerevisiae. The tubulin is > 95%
      purified and free of contaminating enzyme activities. As a result, it has been
      possible to determine the yeast tubulin equilibrium-binding constant for Mg-GTP
      and the tubulin GTPase activity under nonassembling and assembling conditions. We
      also determined the critical concentration for yeast tubulin polymerization and
      found it to be significantly lower than that for bovine brain tubulin under
      identical conditions. Similarly, the dynamic properties both of individual yeast
      microtubules and of bulk microtubule suspensions were significantly different
      from those of bovine brain microtubules free of microtubule-associated proteins.
      The data suggest that the properties of the yeast tubulin may reflect the
      particular functional requirements of the yeast cell. With this method, it is now
      possible to introduce any desired tubulin gene mutation into the budding yeast
      and correlate the phenotypic effects of the mutation in cells with the effects of
      the mutation on the biochemical and polymerization properties of the tubulin.

PMID- 8364031
TI  - Phage display and selection of a site-directed randomized single-chain antibody
      Fv fragment for its affinity improvement.
AB  - The affinity of an antibody Fv fragment was improved by semirational design
      involving site-directed randomization and phage display. On the basis of the
      predicted model of an anti-2-phenyloxazol-5-one (phOx) antibody Fv fragment, into
      which the ligand was inserted with the help of nuclear Overhauser enhancement
      (NOE) data, residues close to the hapten were identified. Seven of these residues
      in the third hypervariable regions of light and heavy chains were randomized in
      polymerase chain reactions (PCR) using degenerate oligonucleotides. Resulting
      clones were expressed as single-chain Fv (scFV) fragments on the surface of
      filamentous phage and selected for binding to phOx-conjugated bovine serum
      albumin. Selected Fv fragments were analyzed for hapten affinity by fluorescence
      quenching, and several mutants with improved affinities were identified. Phage
      selection on the basis of binding was very successful when phage scFv mutants
      differed in affinity by at least a factor of 6. Smaller differences did not
      result in predominant selection of the best binder. Combination of the two point
      mutations most crucial for improved hapten binding decreased the dissociation
      constant of the Fv for phOx 11-14-fold. Hapten binding of the improved Fv was
      analyzed in NOE experiments.

PMID- 8364032
TI  - Apocytochrome P450cam is a native protein with some intermediate-like properties.
AB  - Holo- and apocytochrome P450cam were studied by differential scanning calorimetry
      (DSC), limited proteolysis, second-derivative spectroscopy, circular dichroism,
      and size-exclusion chromatography. The holoprotein shows three folding units
      (domains) in DSC. The prosthetic group is related to the most unstable domain,
      which has a thermal transition at 41.9 degrees C. Compared with the holoprotein,
      apocytochrome P450cam has a reduced helix content. The protein is compact as
      judged by the Stokes radius and is still able to undergo a two-state transition.
      However, the enthalpy change at thermal melting is reduced from 980 kJ/mol for
      the holoprotein to 135 kJ/mol for the apo form. Parts of the molecule have a
      destabilized tertiary structure. This is indicated by second-derivative
      spectroscopy, circular dichroism in the near-ultraviolet region, and a high
      susceptibility to proteolytic digestion. Apocytochrome P450cam is considered a
      native protein with the extremely low stability of delta G = 7.5 kJ/mol, thus
      showing at the same time intermediate-like properties. The importance of the
      properties for in vivo folding are discussed.

PMID- 8364033
TI  - Cytochrome P450 4A4: expression in Escherichia coli, purification, and
      characterization of catalytic properties.
AB  - Rabbit lung prostaglandin omega-hydroxylase (P450 4A4) was expressed in
      Escherichia coli using the isopropyl beta-D-thiogalactopyranoside (IPTG)
      inducible expression vector pCWori+, containing the full-length cDNA encoding the
      P450 4A4. The first seven codons were changed to reflect E. coli codon bias [a
      modification of the method of Barnes et al. (1991) Proc. Natl. Acad. Sci. U.S.A.
      88, 5597-5601]; only the second residue of P450 4A4 was altered (Ser to Ala),
      while the remaining mutations were silent. This strategy was adopted in order to
      minimize changes in the structure of the expressed enzyme. Induction by IPTG of
      the apoprotein peaked after 6 h, and by including the heme precursor delta
      aminolevulinic acid, enzymatic activity peaked 12 h after addition of IPTG. The
      isolated membrane fraction, free of cell debris, contained 12-15 nmol of P450/L
      of media. The expressed enzyme was purified to electrophoretic homogeneity, and
      kinetic and spectrophotometric data indicate that this expressed, purified enzyme
      is equivalent to the enzyme purified from rabbit lung. The Km for PGE1 was
      determined to be 3.0 microM, which is the same as that obtained for the enzyme
      purified from lung [Williams et al. (1984) J. Biol. Chem. 259, 14600-14608]. The
      CO-reduced difference spectrum of purified P450 4A4 exhibited a lambda max at 450
      nm, and the absolute absorbance spectrum of the pyridine hemochromogen revealed a
      typical b type heme. To characterize P450 4A4 further, the catalytic activities
      with prostaglandin E1 (PGE1), arachidonate, 15-hydroxyeicosatetraenoic acid (15
      HETE), and palmitate were investigated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364034
TI  - Critical assessment of the presence of an NADPH binding site on neutrophil
      cytochrome b558 by photoaffinity and immunochemical labeling.
AB  - The presumed NADPH dehydrogenase function of the heterodimeric cytochrome b558 in
      the neutrophil oxidase complex has been investigated by combined photoaffinity
      labeling and immunoblot analysis of membrane proteins from bovine neutrophils.
      The photoaffinity probe was a radiolabeled analog of NADPH, [4-[N-(4-azido-2
      nitrophenyl)[3H]amino]butyryl]NADPH ([3H]azido-NADPH), and the antibodies were
      directed against the C-terminal regions of the two subunits of cytochrome b558.
      Plasma membrane vesicles obtained by differential centrifugation of bovine
      neutrophil homogenates were routinely used as a source of NADPH oxidase. They
      were permeabilized by sodium deoxycholate to facilitate the access of NADPH or
      its azido analog to the totality of the specific binding sites. In the absence of
      light, azido-NADPH behaved as a competitive inhibitor of NADPH oxidase with a Ki
      of 6 microM, and was able to bind to high-affinity specific binding sites with a
      Kd of 5-6 microM, indicating a higher affinity of the oxidase for the photoprobe
      than for the substrate NADPH (KM = 30-40 microM). Upon photolabeling, the oxidase
      was fully inactivated. Following resolution of the membrane proteins by SDS-PAGE,
      a predominant photolabeled protein band of 80-100 kDa was revealed, which
      coincided with the large subunit (beta) of cytochrome b558 identified by
      immunoblot in a parallel gel. The enzymatic deglycosylation of photolabeled
      neutrophil membranes shifted the masses of both the photolabeled band and the
      immunoreactive beta subunit from 80-100 to 55-65 kDa in accordance with the
      glycoprotein nature of the beta subunit.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364035
TI  - Inhibition of scavenger receptor-mediated modified low-density lipoprotein
      endocytosis in cultured bovine aortic endothelial cells by the glycoprotein
      processing inhibitor castanospermine.
AB  - Castanospermine (1,6,7,8-tetrahydroxyoctahydroindolizidine) is a plant alkaloid
      that inhibits alpha-glucosidases, including the glycoprotein processing
      glucosidase I. When endothelial cells were grown for 48 h, or longer, in the
      presence of this alkaloid, they produced scavenger receptors for modified low
      density lipoproteins (LDL) that had mostly Glc3Man7-9(GlcNAc)2 structures rather
      than the usual complex types of oligosaccharides. Furthermore, growth in the
      presence of castanospermine resulted in a substantial inhibition in degradation
      of endocytosed 125I-acetylated LDL, as well as a dose-dependent inhibition of
      125I-acetylated LDL binding to these cells. Scatchard analysis of binding curves
      indicated that the diminished binding was due to a decrease in the number of
      scavenger receptor molecules at the cell surface rather than to a change in the
      affinity of the receptors for their ligand. Since castanospermine-treated cells
      had the same total number of cellular receptor molecules as did controls cells,
      it seemed likely that castanospermine caused an alteration in receptor targeting,
      rather than an inhibition in receptor synthesis or a stimulation in receptor
      degradation. Density gradient fractionation of cell homogenates showed that
      castanospermine-treated cells did have a much greater percentage of scavenger LDL
      receptor molecules in the endoplasmic reticulum-Golgi fraction and fewer
      receptors in the plasma membrane fraction, whereas normal cells showed the
      opposite distribution.

PMID- 8364036
TI  - Actin-binding peptide from smooth muscle myosin light chain kinase.
AB  - The objective of this study was to localize the actin-binding site in the smooth
      muscle myosin light chain kinase. Limited proteolysis by thermolysin indicated
      that hydrolysis of the kinase at the N-terminal end of the molecule resulted in
      loss of actin-binding ability. Various methods of cleavage were investigated for
      the generation of a discrete actin-binding peptide. The method chosen was
      cleavage at the cysteine residues by the 5,5'-dithiobis(2-nitrobenzoic acid)
      cyanide complex. This procedure yielded an actin-binding peptide of approximate
      M(r) 17,000. The peptide was purified and shown to possess the actin-binding
      properties of the native myosin light chain kinase. The binding constant of the
      isolated peptide and parent enzyme to actin was estimated as 7.5 x 10(4) M-1.
      From the amino acid composition of the peptide and comparison with the sequence
      of gizzard myosin light chain kinase, it was suggested that the actin-binding
      site is located within the N-terminal sequence 1-114. Comparison with other actin
      binding proteins shows some similarities to gizzard alpha-actinin and caldesmon.

PMID- 8364037
TI  - Crystallographic analysis of C-C-A-A-G-C-T-T-G-G and its implications for bending
      in B-DNA.
AB  - Stacked B-DNA double helices of sequence C-C-A-A-G-C-T-T-G-G exhibit the same 23
      degrees bend at -T-G-G C-C-A- across the nonbonded junction between helices that
      is observed in the middle of the decamer helix of sequence C-A-T-G-G-C-C-A-T-G,
      even though the space group (hexagonal vs orthorhombic), crystal packing, and
      connectedness at the center of the bent segment are quite different. An identical
      bend occurs across the interhelix junction of every monoclinic crystal structure
      of sequence C-C-A-x-x-x-x-T-G-G, suggesting that T-G-G-C-C-A constitutes a
      natural bending element in B-DNA. The bend occurs by rolling stacked base pairs
      about their long axes; there is no "tilt" component. Of the three possible models
      for A-tract bending--bent-A-tract, junction bends, or bent-non-A--which cannot be
      distinguished by solution measurements, all crystallographic evidence over the
      past 10 years unanimously supports the non-A regions as the actual bending loci.

PMID- 8364038
TI  - Pit-1/GHF-1 binds to TRH-sensitive regions of the rat thyrotropin beta gene.
AB  - Three regions within the 5'-flanking region of the TSH beta gene have A-T-rich
      sequences which have sequence similarity to binding sites for the pituitary
      specific POU domain transcription factor Pit-1/GHF-1. These three regions have
      been termed TSH A (-274 to -258 bp), TSH B (-336 to -326 bp), and TSH C (-402 to 
      384 bp). TSH A and TSH C are able to confer 2-6-fold TRH stimulation to the
      heterologous viral thymidine kinase (tk) promoter in transient expression assays
      in GH3 pituitary cells; TSH C can confer a 3-10-fold increase in basal enhancer
      activity as well. TSH A, B, and C DNAs all bound Pit-1 from GH3 cell nuclear
      extracts, based on gel mobility shift analysis in which antibody against Pit-1
      prevented the formation of specific DNA-GH3 nuclear protein complexes. TSH A and
      TSH C also each formed several additional DNA-nuclear protein complexes which
      were not observed with TSH B. Some of these complexes may contain Pit-1 as their
      formation was inhibited by the addition of Pit-1 antibody; other complexes,
      however, were not altered by antibody treatment. All three A-T-rich elements
      bound in vitro translated Pit-1, with calculated affinities of 360 (A), 125 (B),
      and 38 (C) nM, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364039
TI  - Ribonucleoprotein particle assembly and modification of U2 small nuclear RNA
      containing 5-fluorouridine.
AB  - An in vitro assembly/modification system was used to study the effect of 5
      fluorouridine (5-FU) incorporation on the biosynthesis of the U2 small nuclear
      ribonucleoprotein particle (U2 snRNP). Labeled U2 RNAs were transcribed in vitro
      with 5-fluoro-UTP either partially supplementing or completely replacing UTP
      during synthesis. The resulting U2 RNAs have levels of 5-fluorouridine that range
      from 0 to 100% of the uridine content. When incubated in reactions containing
      extracts from HeLa cells, these 5-FU U2 RNAs are assembled into RNPs that are
      recognized by anti-Sm monoclonal antibody even when there is a complete
      replacement of uridine with 5-FU. However, when the in vitro assembled U2 snRNPs
      are subjected to buoyant density gradient centrifugation, the particles that
      contain 100% 5-FU are not resistant to salt dissociation. When the in vitro
      assembled U2 snRNPs were analyzed by velocity sedimentation gradient
      centrifugation, 5-FU incorporation correlated with a shift in the sedimentation
      rate of the particles. With 100% 5-FU incorporation, the peak of radioactivity
      shifted to approximately 15 S (control U2 RNA was at approximately 12 S). This
      peak from 5-FU U2 snRNPs was not resistant to dissociation on cesium sulfate
      gradients. The amount of pseudouridine (psi) found in the RNA from snRNP
      assembled in vitro on control and 5-FU-containing U2 RNAs was determined, and
      even at very low levels of 5-FU incorporation (5% replacement), the formation of
      psi was severely inhibited (36% of control). At higher levels of 5-FU
      incorporation, there was essentially no psi formed.

PMID- 8364040
TI  - Perturbation of the carboxy terminus of HIV-1 Rev affects multimerization on the
      Rev responsive element.
AB  - Perturbations within the transactivation and carboxy-terminal domains of HIV-1
      Rev were examined for effects on Rev responsive element (RRE) binding activities
      in vitro and biological activity in vivo. Binding affinities, specificities, and
      multimerization of the transactivation mutants M10 and Rev/Rex M10-16 on the RRE
      were equivalent to wild-type Rev. Substitution of the Rex transactivation domain
      within Rev resulted in the incorporation of an internal methionine residue which,
      when cleaved with CNBr and subsequently purified, produced a protein species
      (CNBr-Rev) unable to fully multimerize on the RRE. Instead, two discrete protein
      dependent species were generated in the gel shift assay. Furthermore, CNBr-Rev
      was observed to bind to the RRE with high specificity and an equilibrium binding
      constant of 6 x 10(-10) M. A C-terminal Rev deletion mutant (Rev M9 delta 14)
      lacking amino acids 68-112 displayed identical RRE binding characteristics to the
      CNBr-Rev protein. This protein, which lacks both the activation and the C
      terminal domains, was biologically inactive but maintained the ability to
      discriminate the RRE from nonspecific RNA. Deletion of amino acids 92-112
      resulted in a Rev mutant (Rev M11 delta 14) which bound to the RRE with wild-type
      affinity and high specificity. This purified mutant was observed to be aberrant
      in multimerization activity on the RRE with reduced multimerization apparent in
      the gel shift assay. However, Rev M11 delta 14 possessed biological activity
      equivalent to wild-type Rev in a cell-based p24 ELISA assay. These results
      suggest that polymerization on the RRE is dispensable for Rev activity and that
      two monomeric Rev proteins bound to the RRE are sufficient for biological
      activity. Furthermore, in vivo experiments using the Rev/Rex chimeric mutant and
      the M10 transdominant mutant as well as in vitro dissociation rate studies with
      Rev M11 delta 14 and Rev M9 delta 14 suggest that the M9 through M11 domain of
      the protein may be involved in RRE-dependent specific Rev dimerization.

PMID- 8364042
TI  - Mechanism of inhibition of human leucocyte elastase by monocyclic beta-lactams.
AB  - The kinetic and catalytic mechanisms of time-dependent inhibition of human
      polymorphonuclear leukocyte elastase (HLE) by the monocyclic beta-lactams
      described by Knight et al. [Knight, W.B., et al. (1992) Biochemistry 31, 8160]
      are investigated in this work. The dependence of the pseudo-first-order rate
      constant (k(obs)) on inhibitor concentration was saturable. The individual
      kinetic constants for the inhibition by L-680,833, [S-(R*,S*)]-4-[(1-(((1-(4-
      methylphenyl)butyl)amino)carbonyl)-3,3-diethyl-4-oxo-2-
      azetidinyl)oxy]benzeneacetic acid, and L-683,845, [S-(R*,S*)]-4-[(1-(((1-(5
      benzofuranyl)butyl)amino)carbonyl)- 3,3-diethyl-4-oxo-2
      azetidinyl)oxy]benzeneacetic acid, at pH 7.5 were k(inact) = 0.08 and 0.06 s-1
      and Ki = 0.14 and 0.06 microM, respectively. The relative potency of this class
      of compounds as measured by k(inact)/Ki is primarily controlled by the Ki, term
      which ranged from 6 nM to 8 mM, while K(inact) was relatively insensitive to
      structural changes and varied by only an order of magnitude. Inactivation by the
      beta-lactams was efficient, requiring only 1.3 and 1.7 equiv of L-680,833 and L
      683,845 to inactivate HLE. These values are indicative of some partitioning
      between turnover of inhibitor and inactivation. The partition ratio ranged as
      high as 3.5:1 depending upon the structure of the inhibitors, but this ratio was
      essentially independent of the availability and identity of a leaving group at C
      4 of the lactam ring. Inactivation and partitioning liberate the leaving group
      when present at C-4. p-Hydroxy-m-nitrophenylacetic acid is liberated from this
      position at a rate similar to that for enzyme inactivation, suggesting kinetic
      competence of this process. Other products observed during the interaction of L
      680,833 with HLE include a substituted urea, a species previously observed during
      the base-catalyzed decomposition of this class of compounds, and small amounts of
      products observed during reactivation of beta-lactam-derived HLE-I complexes.
      Both the pH dependence of k(inact)/Ki for the inactivation of HLE by [S-(R*,S*)]
      4-[(1-(((1-(4-methylphenyl)butyl)amino)carbonyl)-3,3-diethyl - 4-oxo-2
      azetidinyl)oxyl]benzoic acid and V/K for HLE-catalyzed substrate hydrolysis
      indicate that a single ionizable group with a pK of approximately 7 must be
      deprotonated for both processes. This group is likely the active site histidine.
      The data are consistent with initial formation of a Michaelis complex, acylation
      of the catalytic serine, and loss of the leaving group at C-4 of the original
      beta-lactam ring followed by partitioning between regeneration of active enzyme
      and production of a stable enzyme-inhibitor complex.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8364041
TI  - Thermodynamic and kinetic studies of DNA triplex formation of an
      oligohomopyrimidine and a matched duplex by filter binding assay.
AB  - The filter binding method was found to be a powerful method for studying the
      formation of triplexes composed of a single-stranded homopyrimidine and a duplex
      with a matched purine-pyrimidine tract. With this technique, we were able to
      determine thermodynamic and kinetic parameters for triplex formation between a
      homopyrimidine 19-mer (5'-TCCTCTTCTTTTCTTTCTT-3') and a duplex with sequence 5'
      GCAGGAGAAGAAAAGAAAGAACG-3' for the purine strand. The experiments were performed
      over a wide pH range (3.8-7.4) and a temperature range of 0-35 degrees C. pH and
      temperature dependencies of the thermodynamic parameters were best explained in
      terms of a three-state model for triplex formation at low temperatures relative
      to the melting point. The main results were as follows: (1) pH dependence of the
      dissociation constants of the triplex is a result of the rapid acid-base
      equilibrium of pyrimidine single strands; (2) the association rate for triplex
      formation decreases with increasing pH in accordance with the dissociation
      constants; (3) the dissociation constant is virtually temperature-independent at
      low pH, while it becomes strongly temperature-dependent with increasing pH (these
      results can be explained in terms of a negative, non-zero delta Cp for triplex
      formation at low pH); (4) the association rate decreases with increasing
      temperature, and the resulting negative activation energy indicates that the
      triplex formation process involves a quasi-stable intermediate; (5) the triplex
      formation is a second-order reaction at low pH, whereas it can be interpreted as
      a third-order reaction at neutral pH, suggesting that different triplex formation
      pathways are observed depending on the pH.

PMID- 8364044
TI  - Recombinant expression and partial characterization of the human formyl peptide
      receptor.
AB  - FMLP-receptor DNA was expressed in Escherichia coli. The expressed product could
      specifically bind FMLP. This is the first-reported expression of a functional
      FMLP receptor in Escherichia coli. We confirm that receptor glycosylation is not
      essential for ligand binding. A deletion mutant did not bind FMLP, suggesting
      that the deleted portion plays a role in ligand binding.

PMID- 8364045
TI  - [Radiology of stroke].
AB  - Today radiologic methods play an important role in the diagnosis of cerebral
      stroke. The aim of the radiologist, however, should not only be to classify the
      stroke into the four main categories (ischemic stroke, intracerebral bleeding,
      subarachnoid hemorrhage, sinovenous thrombosis), but also to interpret the
      findings with regard to the etiology of the disease. The pattern of lesions gives
      information about the etiology of ischemic stroke; the correct interpretation of
      these lesion patterns allows one to optimize therapeutic decisions. This paper
      additionally focuses on the differential diagnosis of intracerebral hemorrhage
      and the CT and MR signs of sinovenous thrombosis. New developed concepts in the
      field of stroke therapy and prophylaxis call for authority and continuous
      education of the radiologist on this topic. Pure descriptions of radiologic
      findings without an understanding of the pathogenesis of the disease will be
      ignored by the clinician. On the other hand, the radiologist can turn the
      therapeutic decisions in the right direction by combining morphological
      descriptions with pathogenetic orientated interpretations. In this way, the
      radiologist can contribute to the reduction of costs in the public health system.

PMID- 8364043
TI  - Mitogenic action of osteogenic growth peptide (OGP): role of amino and carboxy
      terminal regions and charge.
AB  - We have recently reported the discovery of a 14-amino-acid osteogenic growth
      peptide (OGP). In vivo OGP increases bone formation and trabecular bone density.
      Physiologically it is found in serum complexed to an OGP binding protein (OGPBP).
      In vitro OGP has a biphasic effect on osteoblastic MC 3T3 E1 and fibroblastic NIH
      3T3 cell proliferation; at low concentrations (0.01-1.0 and 1.0-100.0 pM,
      respectively) it is highly stimulatory with an inhibition at higher doses. To
      assess possibilities of labeling synthetic OGP to obtain radio- or fluorescent
      ligands, OGP analogues were extended at the N- or C-termini with Cys or Cys(S
      NEtSucc) or the OGP Tyr-10 replaced by 3-I(Tyr). All analogues with N-terminal
      modifications, as well as the [Cys15]OGP-NH2 retained the OGP-like dose-dependent
      effect on proliferation of the MC 3T3 E1 and NIH 3T3 cells, although the
      magnitude of stimulation was lower, approx. 2/3 that of the native-like synthetic
      OGP. The [Cys15(S-NEtSucc)]OGP-NH2 and [3-I(Tyr10)]OGP shared only the inhibitory
      activity of OGP. This suppression is further shared by a number of other
      positively and negatively net charged, but not net neutral, peptides. Both N
      terminal-modified analogues displayed a decreased binding activity to the OGPBP.
      All analogues except reverse OGP, [3-I(Tyr10)]OGP and [Cys15(S-NEtSucc)]OGP-NH2
      reacted with anti-OGP antibodies. These data are not only important for labeling
      purposes but suggest a respective role for the OGP N-and C-terminal regions in
      binding to the OGPBP and putative OGP receptor. It appears that the OGP
      proliferative activity represents the net effect of stimulation specific to the
      OGP structure and nonspecific inhibition associated with the peptide's high
      positive net charge.

PMID- 8364046
TI  - [Quality criteria of DSA in neurologic problems].
AB  - The further development of quality assurance in radiology requires also criteria
      for more complex examinations like digital subtraction angiography (DSA). The
      physical condition of the patient and his cooperation, the knowledge and
      experience of the physician, as well as the technical parameters of the DSA-unit,
      and the technique of examination determine the quality of any angiography.
      Aspects of these factors are discussed. It is found that, especially for
      neuroradiologic studies, the complex problem of quality can only be solved in
      part by measurable parameters. Only the performance of the DSA-system can be
      defined by measurements. Other factors defining quality cannot be measured at
      least to the same degree. The most relevant criteria of quality, however, are:
      have there been complications and can the clinical question be answered
      adequately by the DSA-study.

PMID- 8364047
TI  - [Signal to noise ratio or the number of perceptible gray tones in the x-ray
      picture. I. The dependence on the system sensitivity S (DIN 6867)].
AB  - It is shown that the number of contrasts which can be differentiated on a
      radiograph depends on the detail size, the noise, and the viewing conditions. The
      minimum signal-to-noise ratio (SNR) for a perception approach is equivalently
      described by the SGA value. This testing method was first developed by De Belder
      and Bollen to examine the visibility of low contrast details. The correlation
      between the SGA and the speed class S of the system can be explained by this
      method.

PMID- 8364048
TI  - [Feasibility of the differential diagnostic imaging of neck lymphomas].
AB  - In 51 patients with cervical swellings, pretherapeutic examinations by
      ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) were
      carried out for the confirmation of exclusion of cervical lymph node metastases.
      By use of the M/Q ratio and morphological criteria, it is possible with
      ultrasound to differentiate between relatively enlarged lymph modes and lymph
      node metastasis with a certainly of > 90%. This was only possible in CT after
      administration of contrast media and the success rate was lower (72%). Both by
      use of the M/Q ratio and contrast medium administration, MRI is able to
      distinguish between lymph node metastases and reactively altered lymph nodes.
      Differentiation between Hodgkin/non-Hodgkin lymphomas of the neck and reactively
      enlarged lymph nodes is also possible with the aid of the M/Q ratio. In such
      cases, sonography and MRI are superior to CT. A certain differentiation between
      lymph node metastases and Hodgkin/non-Hodgkin lymphomas is only possible in some
      cases. However, there are indicative criteria for differential diagnosis. A
      delineation between specific lymph node inflammations and glomus carotid tumors
      is also possible because of the differing take-up of contrast medium in CT and
      MRI and via doppler sonographic criteria.

PMID- 8364049
TI  - [Different evaluations of the staging of Hodgkin's and non-Hodgkin's lymphomas
      (NHL) with computer tomography and lymphography by different observers].
AB  - In this report, the differences in the evaluation of CT and lymphography findings
      by different observers is discussed. The study included 132 men and 79 women (146
      NHL and 65 Hodgkin lymphomas). A total of 185 CT examinations and 78
      lymphographies were available for reevaluation. In the lymphographies,
      discongruent findings were reported twice as frequently as in the CT scans (15%
      and 9%). An optimized examination protocol for CT and consistent criteria for the
      interpretation of lymphographic findings could possible lead to a better
      diagnostic evaluation.

PMID- 8364050
TI  - [The thoracic radiologic significance of the width of the azygous vein and its
      correlation with right atrial blood pressure].
AB  - The widths of the azygos vein were measured in 150 patients and correlated with
      the pressure in the right heart-atrium. We found a significant logarithmic
      correlation (r = 0.8) between the two parameters. Radiologic measurement of the
      width of V. azygos in chest radiographs or CT is useful to evaluate the function
      of the right heart.

PMID- 8364051
TI  - [Change in radiation exposure in x-ray diagnosis today?].
AB  - The dosage for the single exposure is today from a half to a quarter of the
      dosage used 20 years ago. The number of diagnostic X-ray examinations performed
      has increased; this increase concerns mainly patients whose life expectancy is
      shorter than the latency period to the manifestation of an X-ray induced
      malignoma and whose reproduction probability is very low. The genetic risk
      therefore is zero. This was demonstrated for coronary angiography. The dose
      distribution in the body shows important differences between conventional X-ray
      diagnostic and computed tomography. One cannot calculate the radiation risk of
      roentgen diagnostics from a dose applied to the population or from a dose per
      head of a population. Such a dose is not suitable for comparison with radiation
      exposure due to natural sources and civilization. The overall risk of disease is
      not altered by radiation exposure of an adequate roentgen diagnosis method.

PMID- 8364052
TI  - [Sonographic demonstration and guided fine needle biopsy of subcutaneous
      lipomas].
AB  - Lipomas are common soft tissue tumours. Patients are sometimes referred to
      ultrasound examinations because of diagnostic problems. Nine cases of
      cytologically or histologically verified subcutaneous lipomas are presented
      focusing on their sonographic appearances and on the fine-needle biopsy
      technique.

PMID- 8364053
TI  - [Contrast medium nephropathy--a contribution to the reduction of examination
      risks].
AB  - The radiologist is rarely directly confronted with contrast medium-induced renal
      impairment or even renal failure. In contrast to allergic side effects, the
      disorders do not become apparent until a few days after the investigation. The
      relevance of "contrast-medium nephropathy" should not, however, be
      underestimated: prior contrast medium injections are the initial cause of at
      least 10% of all cases of acute renal failure. The risk associated with such an
      investigation can be reduced if the risk factors are known, the patient receives
      an affective premedication in preparation for the investigation, and if
      preference is given to non-ionic contrast media.

PMID- 8364054
TI  - [Typical nuclear spin tomographic intensity distribution patterns in different
      knee joint diseases using a gradient echo sequence].
AB  - The knee joints of 31 patients and 3 volunteers were examined with a 1.5 T
      Magnetom using 3D-gradient echo sequences. We measured for the most widespread
      diseases: the gonarthrosis (n = 23) and rheumatoid arthritis (n = 8) the signal
      intensities in all joint parts and the typical signal plots were worked out. In
      case of minimal changes at the articular cartilage, the method developed and
      tried out by us can facilitate diagnosis. A special aspect of this method is also
      the patient follow-up which is now possible quantitatively and objectively.

PMID- 8364055
TI  - [Wrong diagnosis of a foreign body incorporation after a dog bite in the hand].
AB  - The case of a patient with foreign body incorporation after a dog bite is
      reported. The radiographic aspect and the density in CT was that of a fragmented
      tooth. The particle was visible in plain radiography. After operative extraction,
      the patient was discharged without any symptoms.

PMID- 8364056
TI  - [Nuclear spin tomographic findings in compensated chronic hemolysis. A case
      report of a hereditary spherocytosis].
AB  - A case report of a 58-year-old patient with hereditary spherocytosis and large
      paravertebral masses in the thorax and abdomen is presented MRI detects the
      origin of the masses with typical signal intensities of the masses and the bone
      marrow in T1 and T2 weighted sequences as extramedullary hematopoiesis. In this
      special case there is bleeding into these masses and, as often, liver
      hemosiderosis and splenomegaly.

PMID- 8364057
TI  - [MR tomography and MR angiography of an extensive glomus jugulare tumor].
AB  - The diagnosis of a glomus jugulare tumour was established by MR tomography and MR
      angiography. MR tomography demarcated the tumour from the surrounding tissue and
      MR angiography showed the vascularity of the glomus tumour.

PMID- 8364058
TI  - [Magnetic resonance tomography in heart septal defects. Model studies on
      parameter optimizing].
AB  - Various flow phenomena can occur in MR tomography of the heart. In the present
      study the influence of various examination parameters on the imaging of flow
      phenomena behind cardiac septum defects was investigated by means of a model. In
      the examination by fast field echo sequence (FFE) the contrast between
      poststenotic jet and surrounding area was most pronounced if short echo times (TE
      10 ms), a narrow flip angle (d = 10 degrees) and layers of minor thickness (d = 5
      mm) had been selected. The number of acquisitions and the flow compensation
      exercised only slight influence on contrast. Our results point to the possibility
      of obtaining quantitative information on cardiac septum defects if the influence
      of examination parameters on the imaging of flow phenomena is accurately known.

PMID- 8364059
TI  - [Serotonin as a photoprotector of the oxygen-transporting function of
      hemoglobin].
AB  - Oxygen-binding properties of human hemoglobin modified by UV-light (240-400 nm)
      in dose range (1.51 + 6.04) x 10(2) J/m2 together with serotonin (10(-4) M) has
      been studied by means of spectrophotometry. UV-radiation results in increase of
      the oxygen affinity of hemoglobin. Serotonin displays the photoprotective effect
      on the hemoglobin oxygen-transport function. Mechanisms of photoprotection of the
      biogenic amine are proposed for discussion.

PMID- 8364060
TI  - [Salt-induced critical type phase transition in a water-protein matrix of serum
      albumin molecules].
AB  - Effective thermodynamic parameters of activation of label transition between two
      microsurroundings in water-protein matrix (WPM) of spin-labelled molecules of
      serum albumin (HSA-SL) in 0.001 M phosphate buffer, pH 7.3 within concentration
      range of NaCl (m3) (10(-3) M to 2 M and concentration range of protein (m2) 50 to
      200 mg/ml were determined. The phase transition (PT) between two structures of
      water in WPM is revealed within the m3 range 0.01 M to 0.1 M. It is close to the
      type I PT and more expressed at high protein concentrations. As m3 increases (to
      0.2 M when m2 = 50 mg/ml and to 0.7 when m2 = 200 mg/ml) PT-I is transformed into
      PT of the critical type. This is indicated to zero values of the higher order
      derivatives of Gibbs energy of activation with respect to salt concentration, as
      well as by the maximum values of positive disjoining pressure in these points.
      The biological significance of this phenomenon is discussed.

PMID- 8364062
TI  - [The effect of point amino acid substitutions on the stability of phage T4
      lysozyme. I. Asn101---Asp substitution].
AB  - The amino acid replacement Asn101-->Asp in the T4 phage lysozyme was obtained by
      site-directed mutagenesis and the plasmid mutant protein expression was
      constructed. Though the mutant protein circular dichroism (CD) spectrum is
      virtually unchanged as compared with the wild type protein and the enzymatic
      activity is 90% of that of the wild type protein, the stability of this mutant to
      urea-induced unfolding decreases and two stages in the denaturation process are
      observed.

PMID- 8364061
TI  - [Temperature causes structural and functional changes in lactate dehydrogenase
      from fish skeletal muscles].
AB  - Adaptation of fishes to low and high environmental temperatures gives rise to
      certain changes in kinetic and structural properties of LDH from skeletal
      muscles. The KM versus temperature plot for pyruvate of the enzyme isolated from
      fishes adapted to low temperatures has a minimum at low measurement temperatures,
      whereas adaptation to high temperatures leads to the enzyme showing a minimum at
      high temperatures. The LDH isolated from fishes adapted to low environmental
      temperatures is more stable relative to both thermal and urea-induced
      inactivation. The differences in the kinetic properties of the enzymes from
      fishes adapted to low and high temperatures disappear after treatment with urea
      and subsequent reactivation.

PMID- 8364063
TI  - [The effect of point amino acid substitutions on T4 phage lysozyme stability. II.
      Transition of a protein molecule to the "molten globule" state with replacements
      Asp10---His, Asn101---Asp, Arg148---Ser].
AB  - The amino acid replacements (Asp10-->His, Asn101-->Asp, Arg148-->Ser) in the T4
      phage lysozyme were obtained by site directed mutagenesis and the plasmid for
      mutant protein expression was constructed. At acid pH (pH 2.7) the mutant is in
      the conformational state with properties of the molten globule (Ptitsyn, 1992):
      1) the mutant protein molecule is essentially compact, 2) its circular dichroism
      (CD) spectrum in the near ultra violet (UV) region is drastically reduced in
      intensity as compared with the wild type protein spectrum, 3) the CD spectrum in
      the far UV region indicates the presence of a pronounced secondary structure in
      the mutant, 4) unlike the wild type protein, the mutant protein can bind the
      hydrophobic fluorescent probe ANS.

PMID- 8364064
TI  - [The effect of fixed water molecules on fractal properties of globular protein
      surfaces].
AB  - On the base of the technique developed by the authors together with Schmidt the
      fractal properties of the 17 globular proteins have been analysed using the
      crystal structure data at high resolution. For all the proteins there are the
      coordinates of fixed water molecules in the protein data bank. For each protein
      the fractal dimension of its surface D has been calculated with and without
      taking into account the fixed water molecules located inside a 3-Angstrom
      hydrated layer. Small but systematic decrease of the DS values for the proteins
      with the fixed water molecules has been demonstrated. It means that the fixed
      water molecules tend to fill gaps on the protein surfaces and in that way to
      smooth the surfaces. The volumes and the molecular surfaces of the proteins have
      been also calculated on the base of the cube technique. The molecular surfaces of
      the proteins with the fixed water molecules prove to decrease. This fact can be
      considered as the indirect evidence that the protein surfaces become to be
      smoother.

PMID- 8364065
TI  - [IR-spectroscopic study of the interaction of chromium salts with native DNA].
AB  - Infrared spectra of some unoriented films of DNA contained CrCl3, K2Cr2O7 and
      Cr2(SO4)3 have been obtained at relative humidities (r.h.) 0 to 93%. Chromium
      cations were shown to interact with phosphoric groups of DNA molecules. Cr2(SO4)3
      or K2Cr2O7 content exceeds 0.1 Cr/P, the sugar-phosphate backbone of the double
      helix becomes irregular and nucleic bases unstacked, i.e. denaturation of DNA
      occurs. A very small amount of the salt, less than 0.01 Cr/P contained in DNA
      films prevents the conformational transition of the double helix from the B to A
      form induced by r.h. decreasing. The efficiency of the chromium salts in
      preventing the transition falls in the row: Cr2(SO4)3 > K2Cr2O7-CrCl3.

PMID- 8364066
TI  - [Prevention of binding of Nile red with hydrophobic proteins and surface cuvettes
      using detergents].
AB  - The nile red fluorescence in solutions containing Triton X-100, human serum
      albumin and hexadecane in different combinations was investigated. The dye
      fluorescence in phosphate buffer after 2-4 min incubation strongly decreased
      because of the dye aggregation and was stable in a detergent solution. The
      intensity of nile red fluorescence in the detergent solution was not changed
      after the addition of equal weight concentration of albumin and increased more
      than 2 times after the addition of the same concentration of hexadecane. The
      detergent eliminated the nile red sorption by cuvette surface. It is concluded
      that the detergent addition increases nile red selectivity as a lipid probe in
      the lipid-protein systems.

PMID- 8364067
TI  - [Conformational mechanism for transforming energy during active ion transport in
      a biological membrane].
AB  - A statistical model of active transport of ions in the biomembrane is presented.
      The coefficient of energy conversion for linear and non-linear processes in this
      system is obtained. It is shown that in the linear case this coefficient is equal
      to that obtained in linear thermodynamics. On the basis of the maximum of this
      coefficient transport parameters for ions are found. The results of the
      statistical model are in a good agreement with the experiments on the biological
      membranes.

PMID- 8364068
TI  - [Model of the response of the membrane transport system to an alternating
      electric field].
AB  - We suggest a mathematical model of the transmembrane ionic transport system,
      which can produce the damped concentration oscillations. The influence of the
      periodic electric field is considered under assumption, that the ionic fluxes
      near the membrane depend on the medium potential. The estimated resonance
      frequency for the K(+)-H+ antiport system in bilayer membrane is less than 1 Hz.

PMID- 8364069
TI  - [Change in the permeability of liposome phospholipid membranes under the effect
      of Bacillus thuringiensis delta-endotoxins].
AB  - We studied release of the fluorescent calcein marker from egg-lecithin liposomes
      under action of intact delta-endotoxin from Bacillus thuringiensis var.
      israilensis, and hydrolysed preparation of delta-endotoxin from Bacillus
      thuringiensis var. kurstaki together with the motional parameters of 5- and 12
      doxyl stearic radical probes in the liposomal membrane. The yield of the non
      penetrating fluorescent marker was shown to be a sensitive indicator of the
      disturbance of the membrane barrier function.

PMID- 8364070
TI  - [H+-K+-exchange and formation of H2 in E. coli mutants with defects in the H+
      ATPase complex and potassium transport].
AB  - It was shown that 2H(+)-K(+)-exchange through H(+)-K(+)-pump composed of H(+)
      ATPase complex F0F1 and Trk-system of potassium accumulation, H(+)-K(+)-exchange
      through H(+)-K(+)-antiport, composed of H(+)-channel F0 and of system with Trk
      defect, and H2-production in E. coli grown in anaerobic conditions, change in
      mutants with defects of F0F1 and potassium transport. In unc-mutant of E. coli AN
      936 with defects of c-subunit F0 (M(r) 8,4 kDa) H(+)-K(+)-exchange and H2
      production disappeared. Mutants of E. coli TK 509 (2240) with defect of Trk
      system not able to perform 2H(+)-K(+)-exchange, performed, however H(+)-K(+)
      exchange and H2-production which can be blocked of N, N'-dicyclohexylcarbodiimide
      (DCCD). In mutant of E. coli Tk 509 (2242) with defects of KdpA-protein of Kdp
      system of potassium accumulation, Trk A and Trk D proteins of corresponding
      systems of potassium accumulation, the H(+)-K(+)-exchange disappeared, while H(+)
      formation and H2-production, blocked by DCCD, external osmotic pressure and
      absence of potassium in the medium, persisted. It is assumed that 2H(+)-K(+)
      exchange, H(+)-K(+)-exchange and H2-production are connected, and the membrane
      bound format-hydrogenlyase oxidizing format to H2 and CO2, directly take part in
      interaction with F0F1 and Trk, as well as F0 and defective Trk-system in
      formation of supercomplexs. It is assumed that the format-hydrogen-lyase can
      interact with F0F1 without the Trk-system.

PMID- 8364071
TI  - [The effect of pyrazole on the conformational state of cell membrane
      phospholipids].
AB  - A change of conformation of phospholipids in the presence of pyrazole was studied
      by the method of 1H-NMR spectroscopy with the use of hydrophilic paramagnetic
      probes Pr3+. It was shown that the ratio of transformation of the polar groups of
      the bilayer surface of sonicated phosphatidyl-choline increased in the presence
      of pyrazole as compared to the experimental values of the induced pseudocontact
      shifts of the phosphorylcholine groups. It was established that the earlier
      discovered complexes of pyrazole-phospholipids in the inert solution exhibited in
      the water phase.

PMID- 8364072
TI  - [The effect of nonequibrilium states of membrane-area electrolyte during dilution
      of cell suspensions].
AB  - The flow rate distribution in the diluted suspension of human red blood cells was
      measured across the long rectangular capillary. The calculated rate distribution
      of Pousaseil's flow was shown to be spoiled, if the substances influencing the
      red blood cell aggregation were added to the suspension. The Pousaseil's flow
      rate distribution takes place under the same conditions which support the
      sedimentation rate distribution predicted for the small particles without
      interaction. The sedimentation and flow anomalies are suggested to arise from the
      simultaneous lateral media flow along the cell surface and ion transfer across
      the cell membrane.

PMID- 8364073
TI  - [Effect of radiation on the structural state of erythrocyte membranes].
AB  - Using fluorescent probe 4-(n-dimethyl-aminostyryl)-1-methyl-pyridine (DSM) the
      effect of electrons with the energy 5 MeV on the structure of erythrocyte
      membrane has been investigated. It was found that in the irradiated erythrocyte
      ghosts the number of DSM binding sites increases. Irradiation was suggested to
      increase the negative surface charge of the erythrocyte membrane.

PMID- 8364074
TI  - [The role of photomodification, prevented by lipid peroxidation inhibitors, in
      the therapeutic effect of UV-irradiated blood in peritonitis in rats].
AB  - The blood of healthy animals was irradiated at 254 nm with incident dose 0.05
      Einstein/m2 and was thirdly infused to the rats in volume 2 ml/Kg body weight.
      The infusion of irradiated blood decreased the lethality of rats. Maximal
      therapeutic action was observed at 7-9th day after peritonitis induction. This
      effect was completely inhibited by injection the cyclooxygenase inhibitors
      aspirin or indomethacin (but not lipid antioxidants BHT or alpha-tocopherol) into
      irradiated portion of blood before irradiation. The therapeutic effect of
      irradiated blood is due to cyclooxygenase activation by UV-radiation.

PMID- 8364075
TI  - [Features of walking kinematics in early human development].
AB  - Kinematic regularities between independent principal parameters of baby's (8-9
      months age) walking were analysed. For the initial period of walking with support
      two characteristic properties were revealed: the duration of step cycle was close
      to constant and the structure of cycle--relation between duration of the swing
      and support phases was constant as well. Due to these properties a child's
      walking is different from the adult's one characterized by decrement duration of
      the cycle and an increase of the cycle structure with an increase of walking
      speed. The principles of neurophysiological model of generator which provides
      initial primitive organization and the following complication of kinematic
      program of walking are discussed.

PMID- 8364076
TI  - ["Tendon" action of two-joint muscles during human locomotion: transfer of
      mechanical energy between links in shock-absorbing and push-off phases].
AB  - We hale evaluated experimentally the amounts of the mechanical energy transferred
      by the two-joint muscles between the links of legs during squat vertical jumps
      and landings after jumping down from a height of 0.5. The experiments have been
      conducted on file healthy subjects in the course of locomotions. The coordinates
      of markers attached to the subjects' bodies and the ground reaction forces have
      been registered. The energy transferred by the two-joint muscles from and to the
      links forming each joint has been determined by integration of the difference
      between the power developed in the joint by the control moment and the total
      power of the muscles serving the given joint. It has been shown, that at squat
      vertical jump (the push-off phase) the two-joint muscles transfer mechanical
      energy from the proximal links of the leg to the distal ones: from pelvis to
      shank (by the rectus femoris m.), and from thigh to foot (by the gastrocnemius
      m.). At landing (the shock-absorbing phase) the two-joint muscles transfer energy
      from the distal to proximal links: from foot to thigh (by the gastrocnemius m.),
      and from shank to pelvis (by the rectus femoris m.). Thus the one-joint muscles
      of the proximal links compensate for the deficiency in the force developed by the
      one-joint muscles of the distal links due to the "tendon action" of the two-joint
      muscles. During push-off, the muscles of the proximal links contribute to
      increase in the energy of the distal links, and in the shock-absorbing phase, to
      its dissipation.

PMID- 8364078
TI  - Febrile neutropenia.
AB  - Severe neutropenia and its related infectious complications remain a permanent
      threat for patients receiving intensive chemotherapy, especially in the context
      of bone marrow transplantation. Chemoprophylaxis and use of colony-stimulating
      factors have altered the severity of the clinical picture in a favorable
      direction: neutropenia can be shortened, and gram-negative infection can be made
      less frequent; neither can be yet abolished. Early therapy, eg, empiric
      combination treatment, remains the cornerstone of our approach to febrile
      neutropenia; the actual choice of agents is probably less important and should be
      guided by local epidemiologic conditions. The concepts of empiric therapy also
      starts to be more widely accepted for the control of fungal and viral infections.
      Finally, it is fair to recognize that, at the other end of the spectrum of
      febrile neutropenia, conventional chemotherapy that results in only moderate and
      short neutropenia can usually be managed without much problem, namely with broad
      spectrum monotherapy. Other possible simplified approaches should be investigated
      under controlled conditions and in patients selected on the basis of favorable
      prognostic factors.

PMID- 8364079
TI  - Clinical approaches to nutritional support in cancer.
AB  - Anorexia and weight loss are frequent complications of cancer and AIDS.
      Assessment of dietary records and nutritional requirements in patients with
      decreased food intake and weight loss will assist the dietitian, nurse, or
      physician in initially addressing the problem. Patients may respond well to
      nutritional counseling and food supplements, but persistent severe anorexia is
      common. Various pharmacologic strategies to reverse anorexia and weight loss have
      been tested, including corticosteroids, anabolic steroids, cyproheptadine,
      hydrazine sulfate, dronabinol, and megestrol acetate. Dronabinol was recently
      found to improve appetite in AIDS patients. Megestrol acetate is so far the only
      agent associated with improvements in appetite and weight in patients with cancer
      and AIDS. Enteral and parenteral nutrition may be helpful in selected patients
      with gastrointestinal obstruction or dysfunction, but it is not generally
      indicated in patients with end-stage disease.

PMID- 8364077
TI  - [Collective properties of the mutual-learned neuronal net systems in the
      information field].
AB  - Model of neural networks system, in which networks interact by transmission and
      associative recognition of signals, is studied by computer simulation and
      qualitative approach. System behavior depends on the value of learning parameter
      epsilon, which determines the weight of writing in memory of each network every
      transmissible signal. Two different regimes are found: regime of auto-governed
      behavior, which depends only on initial networks characteristics, and regime of
      collective recognition of initial signal in form of a certain stable signals
      cycle. Analogy of this model and Aigen's hypercycle, the problem of creation of
      some new information in this model are discussed, too.

PMID- 8364080
TI  - Paraendocrine syndromes.
AB  - Paraendocrine syndromes are the remote effects of cancer that result from ectopic
      hormonal production. Recent investigations have concentrated in five areas that
      include the evaluation of diagnostic studies, the recognition of rare cases, the
      contribution of secondary hormones, the clinical distinctions of ectopic
      syndromes from endocrine disorders, and the efficacy of pharmaceutical agents in
      correcting hormonally induced biochemical imbalances. The three most common
      paraendocrine syndromes (humoral hypercalcemia of malignancy, the syndrome of
      inappropriate antidiuretic hormone production, and ectopic Cushing's syndrome)
      are the subject of this review.

PMID- 8364081
TI  - Unproven methods in cancer treatment.
AB  - The nature-based and nontoxic image makes application of unproven methods in
      oncology attractive in contrast to application of a mechanized scientific
      medicine. The application frequency of these treatments ranges from 10% to
      greater than 60%. Increasingly, the promoters try to create a scientific
      impression through a pseudologic cancer theory, a harmless diagnostic test, and a
      holistic treatment of every cancer. Of the big variety of unproven methods, which
      are summarized in 11 groups in this review, the following are discussed:
      anthroposophic and other mistletoe preparations; homeopathy; Maharishi Ayur-Veda;
      unproven anticancer diets; orthomolecular medicine, including ascorbic acid; and
      methods supposedly stimulating unspecific and specific defense mechanisms. In
      conclusion, physicians should beware of and have knowledge of currently used
      unproven cancer treatments for epidemiologic, social, economic, and scientific
      reasons.

PMID- 8364082
TI  - Cytogenetics and experimental models of sarcomas.
AB  - The sarcomas are an extremely heterogeneous group of neoplasms that continue to
      present substantial diagnostic and therapeutic challenges. It is notable,
      therefore, that great strides have been made in the genetic characterization of
      sarcomas over the past few years. The very consistent chromosome translocations
      in Ewing's sarcoma, myxoid liposarcoma, and alveolar rhabdomyosarcoma have been
      cloned, and the oncogenes deregulated by these translocations have been
      identified. These characteristic genetic aberrations can now be used as
      diagnostic markers.

PMID- 8364083
TI  - Osteosarcoma.
AB  - Findings from molecular genetic and cytogenetic investigations suggest that
      mutations in suppressor genes play a key role in osteosarcoma pathogenesis. RB
      and p53 are frequently involved and are speculated to be indispensable
      components. Alterations in putative suppressor genes on chromosomes 18q and 3q
      additionally may be involved in various patterns. The high resolution of magnetic
      resonance imaging in osteosarcoma imaging is confirmed, and the validity of
      dynamic gadolinium-enhanced imaging for estimation of tumor response is stated.
      The efficacy of single-drug high-dose methotrexate convincingly is shown to be
      19%. Phase II trials with nonspecific immunostimulation using a synthetic
      liposomal mycobacterium-derived antigen (liposomal muramyl tripeptide
      phosphatidylethanolamine) do not yet allow us to draw conclusions on eventual
      efficacy. A novel and promising approach may be intervention in the endocrine or
      orthocrine and paracrine tumor growth regulation. Hypophysectomy in mice
      dramatically reduced plasma or insulin-like growth factor and local as well as
      systemic growth of transplanted osteosarcoma. The close interrelation between
      tumor response, surgical margins, and local control is demonstrated, as well as
      the fatal prognosis after local failure. Also, the validity of known risk factors
      in patients undergoing intensive chemotherapy has been confirmed. Interestingly,
      dose intensity was not found to influence prognosis.

PMID- 8364084
TI  - Rhabdomyosarcomas and other soft tissue sarcomas in pediatric patients.
AB  - Current therapy for childhood sarcomas, particularly rhabdomyosarcomas, is a
      multidisciplinary effort requiring input from various specialists. Significant
      progress has been made in lower-stage disease because of advances in
      chemotherapy, radiotherapy, and surgery, but cure rates remain poor in high-stage
      lesions, and there is significant morbidity after treatment of lesions with a
      favorable outcome. Histologic classification is not always predictive of
      behavior, but recent modifications promise better prognostic significance. Great
      advances have also been made in our understanding of the biology of these
      lesions; these advances offer the promise of future therapeutic applicability.
      Detection of genetic alterations in predisposed individuals is possible but
      raises several significant nontherapeutic issues.

PMID- 8364085
TI  - Soft tissue sarcoma in adults.
AB  - Over the past year, improved delineation of prognostic factors and other aspects
      of staging of localized sarcomas have been reported. Although little progress has
      been made in terms of improvement in adjuvant therapy, new efforts to enhance
      therapy for advanced disease, particularly through use of dose-intensive
      chemotherapy regimens with colony-stimulating factor support, have resulted in
      improved response rates and may herald the development of new chemotherapy
      regimens, which may be employed in future randomized studies in the early disease
      setting.

PMID- 8364086
TI  - The Lynch syndromes.
AB  - The Lynch syndromes, also referred to as hereditary nonpolyposis colorectal
      cancer, are reviewed, with particular attention given to their natural history,
      diagnosis, surveillance, and management. Lynch syndrome I is characterized by an
      autosomal dominantly inherited predisposition to early onset colorectal cancer,
      with proximal predominance and an excess of synchronous and metachronous
      colorectal cancers. Lynch syndrome II manifests all of the features of Lynch
      syndrome I but, in addition, shows an integral association with extracolonic
      cancers, particularly carcinomas of the endometrium and the ovary. There are no
      premonitory physical signs or biomarkers of genotypic risk. Therefore, the
      natural history features of the Lynch syndromes are crucial to their surveillance
      and management.

PMID- 8364087
TI  - New imaging techniques in gastrointestinal cancer.
AB  - Impressive advances in both anatomic and functional imaging of gastrointestinal
      tumors have been made in recent years, with several interesting studies appearing
      this past year. Increasingly, different imaging modalities have been used in
      combination and have shown complementation and improved accuracy. Improvements in
      detecting and defining local versus extended sites of cancer in various
      gastrointestinal organs have been made by conventional methods and by newer
      functional tests, including positron-emission tomography, receptor scintigraphy,
      and radioimmunodetection. With the US Food and Drug Administration approval of
      the first antibody-based cancer imaging agent, a new class of biologic imaging
      agents is coming of age in oncology and will likely experience the most use in
      management of colorectal cancer, permitting improved staging and disclosure of
      occult disease. In addition to gamma camera imaging, these radioactive biologic
      targeting agents hold promise for positron-emission tomography scanning and for
      cancer radioimmunotherapy.

PMID- 8364088
TI  - New surgical approaches to gastrointestinal cancer.
AB  - The outlook for patients with gastrointestinal malignancies has not altered
      appreciably over the past three decades. Surgery offers the only possibility of
      cure; it is important that, as less-invasive techniques are introduced, survival
      is not compromised. Most patients will have occult disseminated disease at
      presentation, and it is therefore important to evaluate adjuvant therapies.
      Regional therapy offers considerable potential for patients with advanced or
      recurrent disease. Better surgery, better staging, more appropriate surgery, the
      use of adjuvant therapy, and new approaches to the problem of advanced disease
      are likely to result in the reduction of mortality over the next decade. The
      surgical oncologist has an important role in defining optimum treatment of
      individual patients and in evaluating new therapies.

PMID- 8364091
TI  - Sarcomas.

PMID- 8364090
TI  - Supportive care.

PMID- 8364089
TI  - Combined modality treatment of gastrointestinal cancer.
AB  - During the past year, little of finite value has been published to change the
      approach to combined treatment modalities for the patient with gastrointestinal
      cancer. The value of adding other modalities to surgery to improve the cure rate
      has been marginal. Neoadjuvant and adjuvant treatment appear to be making inroads
      into the treatment of esophagus cancer, and newer development of less toxic
      treatment offers promise for the future. In stomach cancer, combined modality
      treatment is only of value for patients with locally advanced disease. In the
      United States, adjuvant chemotherapy is accepted as being of value for patients
      with colon cancer, and adjuvant treatment with both radiotherapy and chemotherapy
      is considered to be best for patients with surgically treatable rectum cancer.
      Primary liver cancer continues to offer a challenge for combined modality
      treatment, but a call for prospective, randomized control trials seems to be in
      order.

PMID- 8364092
TI  - Gastrointestinal tract.

PMID- 8364093
TI  - Conformational studies of hairpin sequences from the ColE1 cruciform.
AB  - Inverted repeat sequences derived from the ColE1 cruciform were investigated by
      nuclear magnetic resonance (NMR) and UV spectroscopy. It was shown that 15
      different sequences exist as stable hairpin structures over a range of buffer
      conditions and DNA concentrations. Experiments with six oligomers (1-6)
      containing the native stem sequence and five base loops, found that the two
      hairpins with the wild-type loops (1-2) served as upper and lower bounds for the
      thermodynamic stability of all the other sequences. NMR experiments, including
      rotational correlation time measurements and NOESY spectra, were then performed
      on 1, the most stable hairpin sequence to begin to uncover a structural basis of
      its stability.

PMID- 8364094
TI  - Affinity labeling of bovine brain protein kinase C by tosyl lysyl chloromethane.
      A kinetic study.
AB  - The kinetics of inactivation of bovine brain protein kinase C (PKC) by N alpha-p
      tosyl L-lysyl chloromethane (TosLysCH2Cl) were investigated. In absence of
      activators PKC gave non-linear semilog inactivation plots. At each reagent
      concentration a plateau of residual activity was reached after some time; its
      value was inversely proportional to TosLysCH2Cl concentration but the plateau was
      not due to inactivator depletion. On the other hand, in the presence of Ca2+,
      phosphatidylserine and phorbol 12-myristate 13-acetate, the activity loss
      followed saturation kinetics, with k(inact) = 0.6 x 10(-3) s-1 and Kinact = 1.9
      mM. The study of protection effects by ATP Mg2+ and histone required the presence
      of 50% glycerol in the incubation mixtures, otherwise the controls (kinase in the
      presence of activators and ATP Mg2+ or histone) rapidly lost activity. In the
      presence of 50% glycerol, the inactivation parameters were somewhat altered
      (k(inact) = 0.3 x 10(-3) s-1 and K(inact) = 0.2 mM); ATP Mg2+ proved to afford a
      mixed competitive-non competitive protection effect, while histone protected in a
      competitive manner with a Kp of 0.06 microgram/ml. In the presence and the
      absence of glycerol, plots of log k(obs) versus log inactivator concentration
      yielded straight lines with slopes of 0.7-0.9, indicating that 1 mol of reagent
      is sufficient for inactivation. The results described in this paper suggest that
      the reagent TosLysCH2Cl hits the catalytic domain of activated PKC at the active
      site, which is not available in resting PKC; in non-activated PKC, the labeling
      site would be different.

PMID- 8364095
TI  - Colicin A lysis protein promotes extracellular release of active human growth
      hormone accumulated in Escherichia coli cytoplasm.
AB  - The colicin A lysis protein (Cal) was used to direct the extracellular release of
      recombinant proteins produced in Escherichia coli. The cal gene, under the
      control of its inducible promoter, was introduced into an expression vector
      encoding the human growth hormone devoid of its signal sequence (Met-hGH). Cal
      and Met-hGH were simultaneously expressed at two different levels of Met-hGH
      induction. The results indicate that Cal causes the excretion of non-aggregated
      Met-hGH from the cytoplasm to the culture medium and that the Met-hGH is
      correctly folded since the released Met-hGH is antigenically indistinguishable
      from the authentic mature hGH and is biologically active in binding to specific
      receptor sites.

PMID- 8364096
TI  - An attempt to substitute the cell binding domain of human fibronectin in lambda
      phage J protein: computer design and expression.
AB  - We superimposed hydropathic indexes of the human fibronectin cell binding domain
      (CBD) on the lambda phage J protein by computer, and substituted 22 amino acids
      from the fibronectin CBD for a part of the lambda phage J protein. The
      fibronectin cell binding domain -Arg-Gly-Asp-Ser- (-RGDS-) localizes at the
      junction of hydrophobicity and hydrophilicity. We selected a similar hydrophobic
      to-hydrophilic junction in the J protein region for substitution. This junction
      corresponds to 150 bp of the PstI fragment of J protein cDNA. We synthesized 150
      bp of the relevant PstI fragment that includes the cell binding domain region.
      The region was then constructed by serial cloning as an expression vector, pJCBD.
      The vector pJCBD expressed the fused protein named JCBD (M(r) 32 kDa) in E coli
      XL1-BLUE. The expressed JCBD protein was identified by Western blot analysis in
      the extract of the pJCBD carrying bacterial lysate using both rabbit anti-lambda
      phage antiserum and anti-CBD of fibronectin antibody. The JCBD protein appeared
      to recognize retinoblast cell membrane RGDS-directed receptors, detected by
      enzyme-linked immuno-sorbent assay and also by binding competition assay with
      synthetic pentapeptides, Gly-Arg-Gly-Asp-Ser (GRGDS) and Gly-Arg-Gly-Glu-Ser
      (GRGES). The former competitor inhibited completely fibronectin CBD-dependent
      binding activity of JCBD, the latter had no inhibitory activity. These results
      suggest that certain functional proteins engineered by computer design between
      human fibronectin cell binding domain and lambda phage J protein can be produced.

PMID- 8364097
TI  - Properties of Barrier, a novel Saccharomyces cerevisiae acid protease.
AB  - We have studied the specificity of Barrier, a protease secreted by Saccharomyces
      cerevisiae, towards its natural substrate alpha-factor, a tridecapeptide mating
      pheromone. Sub-fragments of alpha-factor synthesized or prepared by cyanogen
      bromide cleavage and a related pheromone from Saccharomyces kluveri were studied
      as potential substrates or competitive inhibitors. None of the tested peptides
      was a potent inhibitor or substrate for Barrier. Barrier shares extensive
      sequence similarity to the active site residues of aspartyl proteases but
      universal irreversible inhibitors of this class of enzymes failed to inactivate
      Barrier, suggesting that it is a novel fungal aspartyl protease.

PMID- 8364098
TI  - The rne gene and ribonuclease E.
AB  - The cloned rne+ gene complements temperature sensitive RNase E mutations and
      directs the synthesis of a polypeptide. In vitro the RNA transcribed from the rne
      gene directs the synthesis of a number of polypeptides, one of which is identical
      in size to the in vivo product of the rne gene. A rabbit reticulocyte cell free
      extract programmed with this RNA produced RNase E activity. Thus, it is evident
      that the rne gene is the structural gene for RNase E. However, the in vivo
      product of the cloned RNase E gene is more thermolabile than the chromosomal gene
      product. When cells containing the rne plasmid were treated with chloramphenicol,
      the pre-existing RNase E became less heat labile with time. This leads to the
      suggestion that in the cell RNase E undergoes post-translational modification(s).

PMID- 8364099
TI  - Effect of flavins on the rate of proteolytic digestion of muscle glycogen
      phosphorylase b.
AB  - The kinetics of tryptic proteolysis of rabbit skeletal muscle phosphorylase b has
      been registered by the diminishing of protein fluorescence intensity at lambda =
      335 nm (excitation at 290 nm) or by the disappearance of the enzyme activity
      (0.02 M Hepes buffer, pH 6.8, 37 degrees C). The first procedure showed that
      flavins (riboflavin, FMN, FAD) protected the enzyme against tryptic digestion.
      Microscopic dissociation constants for the complexes of phosphorylase b with
      riboflavin, FMN and FAD were calculated from dependences of the initial digestion
      rate on the flavin concentration. They where equal to 30 +/- 1, 15.8 +/- 0.2 and
      36 +/- 1 microM, respectively. No influence of FMN on the rate of the tryptic
      hydrolysis of phosphorylase b was observed when using the second procedure
      (enzyme activity test). FMN completely prevents the formation of 69-, 81- and 85
      kDa fragments during 20 min incubation of phosphorylase b with trypsin.

PMID- 8364100
TI  - Does histone H1 bind specifically to the nuclear factor I recognition sequence?
AB  - The issue of whether histone H1 possesses specificity of binding to certain
      nucleotide sequences in DNA is of fundamental importance to the suggested role of
      the linker histone in the regulation of gene transcription. The purpose of the
      present study was to reinvestigate the specificity of binding of histone H1 to
      the putative nuclear factor I (NFI) recognition sequence suggested by a previous
      report in the literature. The interaction of purified mouse liver histone H1 with
      a synthetic oligonucleotide representing the natural NFI binding site from the
      adenovirus 2 origin of replication cloned in pBR322 has been studied by filter
      binding and a solid-phase procedure performed on nitrocellulose filter
      immobilized protein dots. No indication of specific interactions of the lysine
      rich histone H1 with the NFI recognition sequence was obtained.

PMID- 8364101
TI  - [First impressions regarding the use of expandable esophageal prosthesis].
AB  - The authors report their views on the treatment of unoperable neoplastic esophago
      gastric stenoses with Nitinol prostheses. Despite a number of advantages (reduced
      trauma, greater tolerability) in relation to plastic prostheses, the paper
      highlights some problems (difficulty of unfastening, incomplete opening) which
      may be eliminated by improved materials.

PMID- 8364102
TI  - [Serum lipids and biliary sludge during pregnancy].
AB  - We have examined serum lipids and apoprotein levels and the formation of biliary
      sludge in 56 pregnant women. During pregnancy, 8 women showed biliary sludge
      which disappeared after delivery. Pregnant women with sludge had serum levels of
      total cholesterol, triglycerides, LDL-cholesterol and apo-B higher than women
      without sludge, although it was not statistically significant. Moreover, these
      women had serum levels of HDL-cholesterol and apoA1 significantly lower and
      LDL/HDL and apoB/apoA1 ratio significantly higher than the women without sludge.
      Thus, biliary sludge seems to be associated with serum lipid and apoprotein
      variations. Further investigations are required to clarify if these variations
      are also expressed in the bile.

PMID- 8364103
TI  - [Endoscopic aspects of primary non-Hodgkin's lymphoma of the stomach].
AB  - The introduction of endoscopy has led to a striking improvement in the diagnosis
      of primary non-Hodgkin gastric lymphomas due to the possibility of viewing the
      lesions directly and performing histological and cytological biopsies. Endoscopic
      findings are however polymorphous and may present difficulties of interpretation.
      The aim of this study was to re-examine the endoscopic data in 40 cases (25 M and
      15 F) of gastric lymphoma observed during the period 1983-1990. There were three
      main endoscopic findings: ulcerated lesions (55%), infiltrating lesions (40%) and
      polypoid lesions (5%). In 75% of cases the biopsies carried out during the course
      of endoscopic examination were positive for lymphoma; in 7.5% of cases
      histological diagnosis was made using macrobiopsies carried out using a
      diathermic loop whereas in 17.5% it was made during the course of laparotomy. It
      may be possible to make further progress towards an early diagnosis following the
      introduction of echoendoscopy which will allow an in-depth evaluation of lesions
      and the involvement of lymph node stations and nearby organs.

PMID- 8364104
TI  - [Endoscopic and pharmacologic treatment with omeprazole of upper digestive
      hemorrhage].
AB  - Upper gastrointestinal bleeding is still a subject much discussed as much for the
      diagnostic approach and as by the therapeutic decisions read. The authors present
      their experience of the treatment of upper gastrointestinal bleeding not caused
      by portal hypertension or by neoplasm. The patients undergo emergency endoscopy
      by haemostatic treatment if necessary and pharmacological therapy by omeprazole.
      The evaluation criteria are: stopped bleeding, the need of blood transfusion, the
      healing of the bleeding site. Stopped bleeding has been watched at first
      endoscopic check in 85% of patients; only 26 blood units has been necessary; the
      complete healing of bleeding injury happened not later than 30 days.

PMID- 8364105
TI  - [Evaluation of the cost of maintenance therapy (6 months) with 150 mg ranitidine
      vs 20 mg omeprazole vs 20 mg omeprazole every other day in duodenal ulcer].
AB  - Prevention of ulcer relapse and of its complications is a problem which remains
      to be solved. Our study involved 250 patients, with healed duodenal ulcer. We
      evaluated efficacy and costs of three different maintenance therapies: ranitidine
      150 mg/day, omeprazole 20 mg/day every other day and omeprazole 20 mg/day. Six
      months later, we found the incidence of relapse to be 24.4% (32/131) in the once
      a-day ranitidine group, 19.7% (13/66) in the day every-other-day omeprazole
      group, and 3.8% (2/53) in the once-a-day omeprazole group. Further, we evaluated
      costs relative to relapsing patients, and total costs for each treatment group.
      From these data, we conclude that personalized maintenance therapy with
      omeprazole is the most cost-effective: a dosage of 20 mg/day is extremely
      effective in maintaining remission, and is therefore most indicated in patients
      at risk; omeprazole 20 mg/day every-other-day affords better compliance, lower
      costs and fewer relapses with respect to standard H2-antagonist dosages.

PMID- 8364106
TI  - [Comparison of 3 methods of preparation for colonoscopy].
AB  - We compared three cleansing methods of preparation for colonoscopy in 150
      patients: the first containing a mixture of cathartics, especially sennosides:
      the second containing polyethyleneglycol: the third containing a mixture of
      monosodic monohydrated and bisodic heptahydrated phosphate. We evaluated the
      tolerability, the compliance and the side effects of the preparations. Regarding
      the evaluated parameters, it was found that the mixture of monosodic and bisodic
      heptahydrated phosphate was more valid than the other preparations.

PMID- 8364107
TI  - [Ischemic hepatitis. Description of 4 cases and review of the literature].
AB  - We studied four patients who presented a striking elevation of blood
      transaminases suggesting acute hepatitis. The post mortem histological
      examination of the liver revealed centrolobular necrosis that is commonly
      diagnosed as ischaemic hepatitis. The liver necrosis arose from heart failure
      which was worsened by an acute anaemia in one patient and by a severe hypoxemia,
      due to respiratory failure, in another. In three subjects there was evidence of
      disseminated intravascular coagulation that may be responsible for aggravating
      the condition of liver hypoxia. The authors also review the literature on the
      various aspects of ischaemic hepatitis.

PMID- 8364108
TI  - [Protein C: mechanisms of activation and anticoagulant effect].
AB  - The mechanism of functioning of protein C can briefly be presented as follows.
      Thrombin and factor Xa formed in the blood via coagulation, interact with
      endothelial thrombomodulin and thereby activate protein C circulating in the
      blood. The activated protein C inhibits factors V and VIII and, in so doing,
      blocks the further production of thrombin. In this way protein C intermediates
      the loop of the negative feedback and prevents excessive thrombin generation.
      Besides, activated protein C enhances fibrinolysis, causing the release of the
      tissue plasminogen activator. Activated protein C is inhibited by a heparin
      dependent inhibitor and alpha 1-antitrypsin and is then excreted from the
      organism. Congenital deficiency of protein C gives rise to thromboses; thrombotic
      diseases of various etiology are accompanied by protein C decline in the blood.
      Injection of exogenous protein C into the blood increases the anticoagulant
      activity of the blood and produces an antithrombotic effect.

PMID- 8364109
TI  - [Substrate specificity of T4 RNA-ligase: the role of a purine nucleotide base in
      forming a covalent AMP-RNA-ligase complex].
AB  - The NTP binding site of bacteriophage T4 RNA-ligase (EC 6.5.1.3) was studied
      using several ATP analogs modified in the purine moiety of the nucleotide at
      positions 1, 2, 6 and 8: adenosine-N'-oxide 5'-triphosphate (I), 6-chloropurine
      riboside 5'-triphosphate (II), 6-mercaptopurine riboside 5'-triphosphate (III),
      1,N6-ethenoadenosine 5'-triphosphate (IV), 8-sulphoadenosine 5'-triphosphate (V),
      8-bromoadenosine 5'-triphosphate (VI), inosine 5'-triphosphate (VII) and
      guanosine 5'-triphosphate (VIII). For all of the ATP analogs under study a
      reversible inhibition was demonstrated. These analogs appeared to be competitive
      inhibitors of the T4 RNA-ligase adenylation reaction and only V, VI and VII were
      efficient as substrates. The kinetic parameters for the competitive inhibition,
      (I50, Ki) were determined. A putative structure for the T4 RNA-ligase active site
      was proposed.

PMID- 8364110
TI  - [Transport of ions into human erythrocytes in various forms of hemolytic anemia:
      a correlation analysis].
AB  - The activity of Na+, K(+)-ATPase (ouabain-inhibited 86Rb influx), Na+, K+
      cotransport (ouabain-insensitive furosemide-inhibited 86Rb or 22Na influx),
      Na+/Na+ exchange (ouabain-insensitive phloretin-inhibited 22Na influx) and
      Na+/Li+ exchange (ouabain-insensitive Na0(+)-depended Li+ efflux) as well as the
      passive permeability of the erythrocyte membrane for Na+, K+ and Li+ have been
      studied in patients with primary (microspherocytosis, hemoglobinopathy) and
      secondary (autoimmune) hemolytic anemia. The activities of the Na+, K(+)-pump and
      Na+, K(+)-cotransport were increased in patients with microspherocytosis-by 45%
      and 70%, respectively. In patients with hemoglobinopathy the Na+/Li+ exchange and
      passive permeability for K+ were increased 2-3-fold in comparison with the
      control with the control group. The increased passive permeability for K+ may
      partly be due to the increased K+, Cl(-)-cotransport. In patients with autoimmune
      anemia the 3-fold increase in the passive permeability for monovalent cations and
      the 2-fold increased activity of Na+, K+ cotransport were found. There was no
      significant correlation between the Na+/Na+ and Na+/Li+ exchange which suggests
      that the cellular mechanisms of activity control in those ion transport systems
      differ essentially. No correlation was found between the passive permeability for
      Na+ and K+ either. These data indicate that simple diffusion (leakage) is not the
      only pathway for the passive permeability of the erythrocyte membrane for
      monovalent cations.

PMID- 8364111
TI  - [The effect of glycolipids [correction of glycoproteins] on the oligomeric
      structure and catalytic activity of alpha-L-fucosidase from human kidneys].
AB  - alpha-L-Fucosidase (EC 3.2.1.51) has been isolated from human kidney and purified
      to homogeneity by affinity chromatography on concanavalin A-Sepharose and
      fucosylamino-Sepharose. The catalytic activity and oligomeric structure of the
      enzyme were studied in a reversed micelle system of aerosol OT in octane.
      Depending on the degree of hydration (a parameter determining the geometrical
      sizes of the inner aqueous cavity of micelles), fucosidase is present within
      micelles as 53 kDa monomers, 110 kDa dimers, 230 kDa tetramers and 480 kDa
      octamers. Association of the monomers into tetra- or octamers causes a 3-4 fold
      increase in the specific catalytic activity of alpha-L-fucosidase. At pH and
      ionic strength values corresponding to intralysosomal ones alpha-L-fucosidase is
      isolated from tissues exclusively in a tetrameric form. After treatment with
      sodium cholate and subsequent dialysis this tetramer irreversibly dissociates
      into monomers; this reaction is accompanied by 2-3-fold decreases in the specific
      catalytic activity of alpha-L-fucosidase. The enzyme tetrameric structure and
      specific catalytic activity may be reconstituted in a reversed micelle system in
      the presence of glycolipids-di- and trihexosylceramides, GM1-ganglioside and a
      mixture of bovine brain gangliosides.

PMID- 8364112
TI  - [Isolation and characteristics of Bacillus megaterium metalloproteinase].
AB  - Stepwise application of affinity chromatography on bacitracin-silochrome, gel
      filtration on Acrylex P-10, rechromatography on bacitracin-Sepharose 4B and gel
      filtration on Sephadex G-15, a homogeneous metalloproteinase (M(r) = 35,000 Da)
      has been isolated from the cultural filtrate of B. megaterium strain 599. The
      amino acid composition and N-terminal sequence (20 amino acids) of the enzyme
      have been determined. The proteinase is not inhibited by diisopropyl
      fluorophosphate, is inhibited by o-phenanthroline, EDTA, and Zn2+, and is
      activated by Co2+. The enzyme has a peak activity at 60-65 degrees C. The maximum
      of the enzymatic activity after hydrolysis of synthetic substrates is at pH 6.5
      7.0. The enzyme is stable at pH 7.0-9.0 and retains its stability at 45-60 C for
      several hours. In acid media the enzyme undergoes irreversible inactivation. The
      dependence of kcat/Km on pH points to the involvement of an ionogenic group with
      pKa 7.5 in the catalytic act, most probably of the imidazole group of histidine.
      The metalloproteinase hydrolyzes synthetic peptide substrates at the bonds formed
      by the amino groups of hydrophobic amino acids-Phe, Leu, Ile and Val.

PMID- 8364113
TI  - [A new method of isolation and purification of SsoII restriction endonuclease].
AB  - A new method for isolation and purification of restriction endonuclease SsoII
      which results in a homogeneous preparation suitable for all types of fine physico
      chemical assays has been elaborated. The procedure includes four chromatographic
      steps: fractionation on butyl-Toyopearl, combined chromatography on SP-Toyopearl
      and phosphocellulose PII, and chromatography on DEAE-Toyopearl and on QAE
      Toyopearl. The use of fast flow sorbents (Toyopearl) makes it possible to reduce
      the time needed for the separation of proteins and to optimize the fractionation
      conditions, thus avoiding the dialysis between the chromatographic steps which
      significantly decreased the enzyme activity yields in previous purification
      schemes. The isolation of restriction endonuclease SsoII by the new method
      usually takes four days.

PMID- 8364114
TI  - [Renaturation of bacterial metalloproteinases].
AB  - After denaturation by phenol or acid ethanol bacterial metalloproteinases
      secreted by Bacillus thermoproteolyticus and Bacillus megaterium cells can be
      renatured by dissolution in 99.7% formic acid with subsequent dilution of the
      solution and its neutralization with an appropriate amount of an alkali.
      Renaturation is optimal at pH 9.0 in the presence of 30% glycerol as stabilizer,
      Ca2+ and Zn2+ ions needed for the formation of a native structure and
      reconstitution of the enzyme catalytic center. The active enzyme yield is 60-80%.
      Reactivated metalloproteinases retain their enzymatic properties, amino acid
      composition and molecular mass. Under these conditions autolysis of
      metalloproteinases does not significantly influence their renaturation.

PMID- 8364115
TI  - [Co-precipitation of pepsin with products from the enzymatic synthesis of
      peptides as a factor limiting the effectiveness of the enzyme].
AB  - Porcine pepsin behaviour during the synthesis of peptide p-nitroanilides and
      esters has been studied. In many cases, especially when long-chain peptides, such
      as Z-Ala-Ala-Phe-Leu-Ala-Ala-OMe, were synthesized, pepsin disappeared from the
      solution, being entrapped by the product precipitate rather than inactivated.
      Sorption of the enzyme on the product might be partially responsible for this
      effect. The active enzyme could be eluted from the precipitate by NaCl and
      isopropanol. Non-proteolytic proteins (lysozyme, bovine albumin, carbonic
      anhydrase) could also co-precipitate with pepsin.

PMID- 8364116
TI  - [IgG, modified with coproporphyrin I and the possibility of direct measurement of
      the antigen-antibody complex].
AB  - Modification of rabbit IgG by coproporphyrin I activated by Woodward's reagent K
      as well as antigen-binding and fluorescent properties of coproporphyrin-IgG have
      been studied. It was shown that coproporphyrin I modified IgG retains its
      capacity to bind the antigen. The formation of the immune antigen-antibody
      complex increases the intensity of coproporphyrin-IgG fluorescence.

PMID- 8364117
TI  - [Interaction of serum albumin with apoprotein E and very low density lipoproteins
      in human blood].
AB  - The complex formation between apolipoprotein E (apoE) isolated from human plasma
      very low density lipoproteins (VLDL) and human serum albumin (HSA) in both native
      and fully reduced states has been studied. Using measurements of fluorescence
      anisotropy and fluorescence intensity of the fluorescein-labelled apoE, the
      elution profiles of the apoE/HSA complex and the kinetics of the protein cross
      linking within the complex by a water-soluble bifunctional reagent, the existence
      of a kinetically unstable complex of apoE with native albumin has been shown. The
      complex became more stable after the reduction of the S-S links in the albumin
      molecules capable of forming aggregates under these conditions. The interaction
      between native HSA as opposed to the fully reduced one and the isolated VLDL
      particles was far more pronounced, apparently due to the existence of amphipathic
      alpha-helical regions. It is suggested that the ability of the apolipoprotein to
      interact with albumin is determined by the inner stability of the albumin
      molecular structure and that the complexes detected in vitro may be regarded as a
      new transport form of apolipoproteins in a lipid-free form in the serum.

PMID- 8364118
TI  - [Affinity modification of proteins, binding nucleic acids in mammalian cells, by
      alkylating derivatives of oligonucleotides].
AB  - Using the 32P-labelled alkylating oligonucleotide derivative (pT)16, the
      oligonucleotide interaction with mammalian cells has been studied. The majority
      of fibroblastoid cell lines tested in this study (COS-1, vero, L-671, Ag 17-1,
      CHO, B7) as well as mouse hepatocytes were found to contain proteins specifically
      interacting with oligonucleotides. Cells of Ag 17-1 and COS-1, apart from the 79
      kDa protein specific for all fibroblast lines, contained also a protein with a
      molecular mass of 83 kDa. In BALB/c mouse hepatocytes the 83 kDa protein is the
      major oligonucleotide binding protein. Analysis of concentration dependencies of
      specific modification of receptor proteins in liver cells has made it possible to
      determine the values of constants for the oligonucleotide derivatives binding to
      the protein. The binding constant for the alkylating oligonucleotide derivative
      pT16 and the corresponding phosphothioate oligonucleotide has been found to be
      equal to 5 x 10(6) M-1.

PMID- 8364119
TI  - [The effect of progesterone and tamoxifen on EGF-dependent activation of
      phospholipid turnover in uterine and breast tumor cells].
AB  - The in vitro effects of the epidermal growth factor (EGF) and progesterone on
      phospholipid turnover in cells of 19 human adenocarcinomas (postsurgical
      material) have been studied. In 58% of tumours EGF increased the 32P
      incorporation into two basic cell phospholipids--phosphatidylcholine and
      phosphoinositides. In EGF-insensitive cells progesterone induced no noticeable
      changes in the basal level of phospholipid metabolism. However, in 10 out of 11
      positively responding to EGF adenocarcinomas progesterone inhibited the EGF
      dependent activation of 32P incorporation into the phospholipids already on the
      15th min after its addition to the cells. Analysis of effects of EGF and the anti
      estrogen drug tamoxifen on phospholipid turnover in 22 human mammary tumours did
      not reveal any significant differences in tamoxifen effect on tumour cells
      differing in their sensitivity to EGF. Independently of cell sensitivity to EGF,
      tamoxifen caused some decrease in the 32P incorporation into phosphatidylcholine
      but increased the label incorporation into phosphoinositides. Tamoxifen added to
      tumour cells prestimulated with EGF or 17 beta-estradiol failed to abrogate the
      effect of these compounds on phospholipid turnover. At the same time, treatment
      of cells with the protein kinase C activator 12-O-tetradecanoyl-phorbol-13
      acetate fully inhibited the effect of tamoxifen on phospholipid metabolism. The
      results obtained suggest that the EGF-dependent activation of intracellular
      phospholipid turnover is under the negative control of progesterone. As for
      tamoxifen, its effect on cells is independent of EGF and consists, apparently, in
      the inhibition of protein kinase C activity.

PMID- 8364120
TI  - [Properties, production, and practical uses of alkaline phosphatase].
AB  - Literary data concerning the properties, isolation, purification and practical
      applications of alkaline phosphatase isolated from different sources are reviewed
      with special reference to the macromolecular structure and action mechanism of
      the enzyme in the reactions of phosphomonoester hydrolysis. The practicality of
      alkaline phosphatase as a helpful tool in conducting enzyme-linked immunoassays
      is demonstrated.

PMID- 8364121
TI  - [Tannin-mediated attachment of avidin to erythrocytes does not cause their lysis
      by complement].
AB  - It was shown previously that avidin attachment to biotinylated erythrocytes
      induced their lysis by a homologous complement via an alternative pathway. This
      phenomenon hindered the use of avidin-coated immuno-erythrocytes as carriers for
      drug targeting. In the present work it has been demonstrated that avidin
      attachment to erythrocytes via a cross-linking reagent (tannin) does not induce
      any lysis by the complement. Tannization provides an attachment of up to 5 x
      10(5) avidin molecules per erythrocyte which is commensurate with the value
      obtained after treatment with biotin esters. However, in contrast with
      biotinylated avidin-coated erythrocytes tannized cells are not lysed by the
      complement, while tannization itself does not diminish the erythrocyte
      sensitivity to lysis by the complement in the presence of activators (hemolytic
      antibody or activators of the alternative pathway). The avidin-induced lysis by
      the complement depends on the mode of avidin attachment to erythrocytes.
      Complement-resistant avidin-coated tannized erythrocytes bind biotinylated
      immunoglobulins and may therefore be used as carriers for drug targeting. The use
      of hemolytic antibody in biotinylated immunoglobulins attached to avidin-coated
      erythrocytes provides their controlled lysis by a complement activated via a
      classical pathway.

PMID- 8364123
TI  - [ATPase activity and K+ transport in membranes of anaerobically grown trk-mutants
      of Escherichia coli].
AB  - A notable (twofold) increase in N,N'-dicyclohexylcarbodiimide (DCCD)-sensitive
      ATPase activity at increasing concentrations of K+ ion--from zero to 100 mM was
      found in isolated membranes of anaerobically grown E. coli. This was also
      observed during changing of Rb+ concentration (but not that of Na+, CL- or NO3-)
      and only in the wild precursor strain and trkG (but not in trkA, trkE, or trkH
      mutants). The DCCD-sensitive ATPase activity did not depend on K+ concentration
      in membranes of bacteria grown in the presence of NaNO3. TrkG or trkH mutants of
      E. coli with unc-deletions displayed a slight ATPase activity which was
      insensitive to DCCD. The growth of the trkG mutant, unlike other trk mutants, did
      not depend on K+ concentration above 0.4 mM. In this case accumulation of K+ in
      this mutant under positive osmotic shock was notably higher. These results
      suggest that K(+)-dependent DCCD-sensitive ATPase activity in membranes of
      anaerobically grown bacteria depends critically on the functioning of F1F0-ATPase
      and Trk of the K+ uptake system and may be explained by a direct relationship
      between these transport systems. It is also probable that the trkG gene has no
      functional activity in anaerobically grown bacteria.

PMID- 8364122
TI  - [Some features of enkephalin metabolism in the rat brain after administration of
      bestatin].
AB  - The effect of a single bestatin dose on enkephalin content, activities of
      enkephalin convertase, enkephalinase A and aminopeptidases as well as on the
      level of specific binding of (3H) (D-Ala-2,D-Leu-5)enkephalin in rat midbrain
      (including hypothalamus) and striatum has been studied. Using ANOVA and
      correlation analyses, the relationship between the changes in these parameters
      has been established. The different responses of the enkephalin system of rat
      brain seem to be due not only to differences in the ratios of the "enkephalinase"
      and "aminopeptidase" pathways of enkephalin catabolism but, also, to structural
      peculiarities of enkephalin-containing conduction tracts.

PMID- 8364124
TI  - [Supramolecular structure based on protein conjugates with polyalkyleneoxides.
      Complexes with beta-cyclodextrin].
AB  - The reaction of the complex formation between beta-cyclodextrin and alpha
      chymotrypsin conjugates with two-component ethylene oxide copolymers with
      propylene oxide has been described for the first time. The complex formation has
      been shown to depend on the mode of distribution of the polymer chains in the
      conjugate. The complex is a crystalline water-insoluble compound; its
      stoichiometric composition has been determined. The alpha-chymotrypsin conjugate
      with polyethylene glycol forms a water-soluble complex with beta-cyclodextrin.

PMID- 8364125
TI  - [Study of the interaction of DNA primase from calf thymus and human placenta with
      oligonucleotides matrices of various length and structure].
AB  - Human placenta DNA-primase as a component of the DNA-polymerase alpha-primase
      multienzyme complex was examined with a view of establishing the dependence of Km
      values in the reaction of oligoriboadenylate synthesis from ATP on the length of
      a poly(dT) template. The pKm values increased linearly up to ten monomeric units
      of the oligo(dT)n template. These data favour oligo(dT)10 as an optimal template
      covered by the active site of this enzyme. The DNA-primase catalyzed processively
      the synthesis at each polymerization cycle of a unique length primer (7-10
      nucleotides) as follows from the analysis of the primer length and its
      distribution with time. It is suggested that the 10 mer DNA-RNA duplex of the
      template and the primer is a critical size for dissociation of primase and
      further elongation of the primer by DNA-polymerase in the presence of dNTP.

PMID- 8364126
TI  - [Proteolytic enzymes in human lymphocytic leukemia cells. II. Comparative
      characteristics of proteolytic enzymes and their inhibitors in three differing
      types of lymphoid cells].
AB  - A comparative study of proteolytic enzymes and their inhibitors in three human
      leukemic lymphoid cell populations has been carried out. The lysates of all
      lymphoid cells contained cathepsins D, B, L and H as well as serine trypsin-like
      proteinases, several aminopeptidases, dipeptidyl aminopeptidase IV and
      plasminogen activator (urokinase type). The activities of individual proteinases
      and their ratios in all cell types under study varied essentially, suggesting
      that lymphoid cells with different functions have different sets of proteolytic
      enzymes. FPLC chromatography of the lysates revealed the presence of inhibitors
      of cysteine and serine trypsin-like proteinases. The procedure for isolation of
      cathepsins D, B, L and H and of their inhibitors has been proposed and partially
      purified protein preparations obtained. Some properties of cathepsins B and L and
      those of their inhibitor have been examined.

PMID- 8364127
TI  - [The effect of new synthetic cholesterol derivatives on cholesterol metabolism in
      cultured rabbit hepatocytes].
AB  - The effects of three novel synthetic derivatives of cholesterol with ethoxy (I),
      aminoethoxy (II), azidoethoxy (III) and toluenesulfonyloxyethoxy (IV) groups in
      the 3 beta-hydroxy position of cholesterol on cholesterol synthesis as well as on
      apolipoprotein B and bile acid secretion in cultured rabbit hepatocytes have been
      studied. 3 beta-(2-hydroxyethoxy)-cholest-5-en (I) was used as a standard. It was
      found that the inhibiting effect of these compounds on cholesterol synthesis
      depends on their structure. Compound II (1 microgram/ml), which inhibited acetate
      incorporation into cholesterol by 30-50%, appeared to be the most effective among
      the other compounds tested. This derivative had no effect on the production of
      bile acids. Compound III was less effective, while compound IV had no effect on
      cholesterol synthesis. All the compounds under study reduced by 20-36% the
      secretion of the total apolipoprotein B as measured by the enzyme-linked
      immunosorbent assay (ELISA). None of the synthetic cholesterol derivatives
      influenced the leucine incorporation into the total protein fraction. The results
      obtained indicate that 3 beta-(2-aminoethoxy)cholest-5-en, the most effective
      compound among other cholesterol derivatives tested in the study, can serve as a
      basis for synthesizing novel cholesterol derivatives able to inhibit cholesterol
      biosynthesis in liver cells and to decrease the secretion of very low density
      lipoproteins in cultured rabbit hepatocytes.

PMID- 8364128
TI  - [The effect of the composition of phospholipid bilayer membranes on the steady
      state kinetic transfer of protons].
AB  - When the hydrogen ion flux was induced by nigericin across the planar bilayer
      lipid membrane (BLM) with the bulk pHs being equal at the opposite sides of the
      BLM, the formation of the boundary potential difference (delta phi b) on the BLM
      was observed using the method of the inner membrane field compensation. The
      increase in the buffer (citrate, phosphate, MES) concentration caused a decrease
      in the delta phi b. The latter is generated in the presence of phosphatidylserine
      in membrane-forming solutions only. It was assumed that the steady state
      difference of the surface hydrogen ion concentration is created under conditions
      of equal pHs near the BLM surface. In another experimental series the monensin
      mediated formation of the surface protein concentration difference gave rise to
      the formation of a potassium ion gradient induced by nigericin. Thus, a
      possibility of performing work due to the surface proton concentration gradient
      was demonstrated. The relevance of these findings to the processes of energy
      transduction during membrane phosphorylation in mitochondria and chloroplasts is
      discussed.

PMID- 8364129
TI  - Gastric anti-secretory, mucosal protective, anti-pepsin and anti-Helicobacter
      properties of ranitidine bismuth citrate.
AB  - Ranitidine bismuth citrate is a novel compound formed from ranitidine and a
      bismuth citrate complex. In conscious dogs, ranitidine bismuth citrate had
      similar activity to ranitidine hydrochloride as an inhibitor of histamine-induced
      gastric acid secretion when oral doses containing equivalent amounts of
      ranitidine base (0.1 or 0.3 mg/kg) were compared. In the rat, ranitidine bismuth
      citrate (3-30 mg/kg p.o.) prevented gastric mucosal damage induced by ethanol
      (fundic damage) and indomethacin (antral damage). Ranitidine hydrochloride and
      tripotassium dicitrato bismuthate were also effective against indomethacin
      induced damage, but were both significantly less potent than ranitidine bismuth
      citrate in this model. Ranitidine hydrochloride was inactive against ethanol
      induced damage. In vitro, ranitidine bismuth citrate (1 mmol/L) inhibited human
      pepsin isoenzymes 1, 2, 3 and 5. Pepsin 1 was inhibited to a similar extent by
      ranitidine bismuth citrate, bismuth citrate and tripotassium dicitrato bismuthate
      at concentrations equivalent to 1 mmol/L bismuth, but ranitidine (1 mmol/L) was
      inactive. Ranitidine bismuth citrate was more potent than tripotassium dicitrato
      bismuthate as an inhibitor of pepsins 2, 3 and 5. Ranitidine bismuth citrate
      inhibited both Helicobacter pylori (effective concentration 4-32 micrograms
      bismuth/ml) and H. mustelae (1-4 micrograms bismuth/ml); similar results were
      obtained with tripotassium dicitrato bismuthate. Bismuth citrate was slightly
      less effective, and ranitidine hydrochloride was inactive (> 125 micrograms/ml).
      In ferrets naturally colonized with H. mustelae, oral treatment with ranitidine
      bismuth citrate, 12 or 24 mg/kg twice daily for 4 weeks, caused a dose related
      clearance of H. mustelae. Qualitatively similar results were obtained in a small
      study with tripotassium dicitrato bismuthate and bismuth citrate.

PMID- 8364130
TI  - Prospective study of the need for long-term antisecretory therapy in patients
      with Zollinger-Ellison syndrome following successful curative gastrinoma
      resection.
AB  - A long-term cure is now possible in more than 30% of selected patients with
      Zollinger-Ellison syndrome who undergo gastrinoma resection. The need, however,
      for continued gastric acid antisecretory therapy in these patients remains
      controversial. The current study was designed to determine whether post-operative
      antisecretory therapy is needed in patients who have undergone successful
      gastrinoma resection and, if so, to attempt to define criteria with which to
      identify patients who require therapy. Twenty-eight consecutive patients who had
      previously undergone curative gastrinoma resection were prospectively studied.
      When antisecretory therapy was discontinued, 43% (12/28) of these patients
      developed gastro-oesophageal reflux, diarrhoea, acid-peptic symptoms or
      endoscopic evidence of acid-peptic disease within 2 weeks and were deemed to have
      failed a trial of antisecretory drug withdrawal. The remaining 57% (16/28) of
      patients who successfully discontinued antisecretory therapy were followed for a
      mean time of 31 months after withdrawal of therapy. Analysis of acid output
      studies pre-operatively, as well as at the time of drug withdrawal, demonstrated
      that patients who were unable to discontinue antisecretory therapy exhibited
      higher pre-operative maximal acid output values and higher basal acid output
      values at the time of attempted drug withdrawal than patients who were able to
      discontinue therapy. Despite these findings, there was significant overlap in
      acid output values between groups so that it was not possible to define specific
      acid output criteria for successful drug withdrawal. Pre-operative clinical
      characteristics, such as the presence or absence of gastro-esophageal reflux or
      acid-peptic disease, or post-operative laboratory values, such as the fasting
      serum gastrin level, did not correlate with the ability to discontinue
      antisecretory therapy. We conclude that following successful curative gastrinoma
      resection, 40% of patients still require antisecretory therapy and that both
      symptom evaluation as well as upper endoscopy should be used to guide attempted
      drug withdrawal. Although patients who are not able to discontinue therapy have
      significantly higher acid output measurements than those who are able to
      discontinue therapy, neither acid output criteria nor any other laboratory or
      clinical characteristics are able to predict the need for continued antisecretory
      therapy in these patients.

PMID- 8364131
TI  - A placebo-controlled investigation of duodenal ulcer recurrence after withdrawal
      of long-term treatment with ranitidine.
AB  - Ninety-two patients with duodenal ulcer disease, who had received long-term
      continuous treatment with ranitidine for an average of 7.5 years, participated in
      a double-blind, placebo-controlled study to determine whether stopping ranitidine
      resulted in ulcer recurrence. Patients were randomized to continue with
      ranitidine (n = 46) or to receive placebo (n = 46) and were followed up for six
      months. Treatment failure was defined as the first symptomatic recurrence of
      ulcer. The occurrence of epigastric pain during the follow-up period was
      significantly less frequent in the ranitidine group (13%) than in the placebo
      group (43%) (P = 0.001). At six months, 9% of the ranitidine group had developed
      ulcer recurrence, compared with 48% in the placebo group (P < 0.001, logrank
      test). Multivariate analysis using the Cox proportional hazards model showed that
      younger age (P = 0.041) and a long history of ulcer disease (P = 0.025) were risk
      factors for ulcer recurrence but gender, smoking and duration or dose of previous
      ranitidine treatment were not predictive of relapse during treatment with
      placebo. In conclusion, withdrawal of ranitidine after more than five years of
      continuous treatment results in almost half of the patients developing
      symptomatic ulcer recurrence within six months. Thus, long-term continuous
      therapy does not alter the natural history of duodenal ulcer disease. Younger
      patients and those with a long history of ulcer disease appear to be at increased
      risk of developing ulcer recurrence if long-term treatment is withdrawn.

PMID- 8364132
TI  - Zinc supplementation restores plasma concentrations of zinc and thymulin in
      patients with Crohn's disease.
AB  - The aim of this work was to evaluate whether oral supplementation with zinc
      sulphate (ZnSO4) could restore thymic endocrine function in patients with Crohn's
      disease who showed decreased plasma concentrations of zinc and active thymulin, a
      zinc-dependent thymic hormone. Twenty-seven patients in clinical remission were
      randomly assigned to receive, for 3 months, one of the following treatments: 60
      mg/day ZnSO4; 200 mg/day ZnSO4 or placebo. Plasma thymulin activity and zinc
      concentrations significantly increased only in patients treated with 200 mg/day
      ZnSO4. Lymphocyte subpopulations, within the range of normality before zinc
      supplementation, were unaffected by any of the administered treatments. In
      conclusion, low plasma concentrations of zinc and thymulin in Crohn's disease
      patients were restored by the administration of high doses of zinc.

PMID- 8364133
TI  - Effect of zinc therapy on natural killer cell activity in inflammatory bowel
      disease.
AB  - Disturbances in zinc metabolism have been documented in patients with
      inflammatory bowel disease. In this study we evaluated the effect of in vivo
      treatment with zinc on the in vitro natural killer cell activity in thirteen
      inflammatory bowel disease patients, with stable disease and mild-moderate
      disease activity, in a double-blind randomized cross-over trial. The results of
      our study show a long-lasting effect of in vivo zinc administration, which
      decreased peripheral blood natural killer cell activity in inflammatory bowel
      disease.

PMID- 8364134
TI  - The effects of 300 mg ranitidine at night, twice daily and four times daily on
      intragastric acidity in normal subjects.
AB  - The aim of this study was to compare to placebo the effects of 300 mg ranitidine
      nocte, b.d. and q.d. on intragastric acidity. The study was performed on healthy
      male subjects and intragastric acidity measured by radiotelemetry. All active
      treatments significantly decreased 24-hr acidity, with a median suppression of
      61.0% with 300 mg ranitidine nocte, 77.7% with 300 mg b.d. and 78.0% with 300 mg
      q.d.s. There was no significant difference between the effects of two higher dose
      regimens; although the 300 mg q.d.s. suppressed daytime acidity more than 300 mg
      b.d. (88.9% vs. 77.8%), it suppressed nocturnal acidity less effectively (65.5%)
      than either 300 mg nocte (92.9%) or 300 mg b.d. (90.0%). These data suggest that
      only modest additional therapeutic acid inhibition can be achieved by increasing
      the dose of ranitidine above 600 mg daily.

PMID- 8364135
TI  - Rolling review: gastro-oesophageal reflux disease.

PMID- 8364136
TI  - Short report: high-dose omeprazole and amoxycillin in the treatment of
      Helicobacter pylori-associated duodenal ulcer.
AB  - Thirteen consecutive patients with active duodenal ulcer disease were assigned to
      a treatment schedule with high-dose omeprazole and amoxycillin. Duodenal ulcer
      was diagnosed endoscopically in all patients, at which time antral biopsies were
      taken for culture and histology. All were positive for Helicobacter pylori and
      histological gastritis. Treatment was for 2 weeks: 80 mg omeprazole daily plus
      500 mg amoxycillin syrup t.d.s. in the first week, followed by 40 mg omeprazole
      daily in the second week. Repeat gastroscopy was performed 4 weeks after
      completion of treatment in all patients. Duodenal ulcer healing occurred in 4/13
      patients. H. pylori eradication was achieved in 2/4 patients with healed ulcers
      and in 3/9 patients with persistent ulceration. This study suggests that a short
      period of treatment with high-dose omeprazole and amoxycillin achieves low rates
      of ulcer healing and H. pylori eradication.

PMID- 8364137
TI  - Short report: octreotide in the treatment of external pancreatic fistulas.
AB  - The efficacy of the long-lasting somatostatin analogue, octreotide, in the
      treatment of high-output pancreatic fistulas was investigated in this
      prospective, open study. Sixteen patients with post-operative pancreatic fistulas
      were treated with subcutaneous injections of octreotide 0.1 mg b.d. The output of
      the fistulas before the somatostatin therapy ranged between 190 and 570 ml/day.
      The therapy was begun on average 17 days following the appearance of the fistula
      (range 4 to 35 days). The decrease in volume one day after initiation of therapy
      ranged from 26% to 69%. By the third day of treatment the fistula volume
      decreased to 0-45% of the initial output. The treatment resulted in the closure
      of 14 of the 16 fistulas; the time to closure ranging from 3 to 15 days. The
      results suggest that octreotide is a useful adjuvant agent in the treatment of an
      external pancreatic fistula.

PMID- 8364138
TI  - Short report: effect of two prokinetic drugs on the electrical and motor activity
      of the small bowel in dogs.
AB  - The effects of trimebutine and domperidone, on the electrical and motor activity
      of the upper small bowel in dogs, were studied simultaneously by means of a
      suction electrode and a manometric catheter. Trimebutine, given during phases I
      and II of the migratory motor complex, was followed by a period of regular spike
      potentials and contractions; the increased motor activity was significantly
      greater when the drug was given during phase II. Domperidone, when injected in
      phase I, was followed by an irregular pattern of spike potentials and
      contractions of low amplitude. By contrast, activity was not augmented when the
      drug was given during phase II. We conclude that the effects of drugs, such as
      trimebutine and domperidone, on the canine small bowel are influenced by the
      phase of the migratory motor complex.

PMID- 8364139
TI  - Short report: prednisolone withdrawal followed by lymphoblastoid interferon in
      the therapy of adult patients with presumed childhood-acquired chronic hepatitis
      B virus infection.
AB  - Eighteen patients with presumed childhood acquisition of chronic hepatitis B
      virus infection were initially entered into this randomized controlled trial.
      Twelve were treated with prednisolone for 4 weeks followed, after a 2-week gap,
      by thrice weekly lymphoblastoid alpha-interferon for 12 weeks. Two of these had
      previously acted as untreated controls. Three of the 12 patients (25%) [who were
      initially hepatitis B virus (HBV) surface antigen (HBsAg), 'e' antigen (HBeAg)
      and HBV-DNA positive] became HBeAg and HBV-DNA negative during therapy and
      remained so after 12 months post-therapy follow-up. One of these also lost HBsAg.
      A further two patients lost HBeAg and HBV-DNA during therapy but relapsed 6 and 9
      months later. Two additional patients were HBV-DNA negative but HBeAg positive at
      the end of follow-up. None of the eight untreated control patients seroconverted
      during an identical follow-up period. Two further patients were HBsAg and HBeAg
      positive but HBV-DNA negative at the start of therapy. These were omitted from
      the final analysis: both subsequently lost HBeAg. The treatment response was
      associated with a rise in aspartate aminotransferase, peaking 2-6 weeks after
      prednisolone withdrawal, loss of HBV-DNA 0-8 weeks later and subsequent
      normalization of liver function tests. Treatment was well tolerated.

PMID- 8364140
TI  - Efficacy of continuous therapy for peptic ulcer in controlled clinical trials.
AB  - Long-term studies have confirmed unequivocally the clinical efficacy of
      continuous therapy with H2-receptor antagonists in reducing the incidence of
      ulcer recurrence. However, studies have also reported varying relapse rates as a
      result of differences in study design, particularly the frequency of endoscopy
      and hence the detection of asymptomatic ulcer relapse. Risk factors for ulcer
      relapse include smoking, stress, previous history of frequent ulcer relapses,
      duration of disease for more than 10 years and concomitant administration of non
      steroidal anti-inflammatory drugs. In the prevention of relapse with H2-receptor
      antagonists, choice of agents also may influence the rate of relapse. A meta
      analysis of data from direct comparative trials indicates that recurrence rates
      of duodenal ulcer are significantly lower after one year of treatment with
      ranitidine (150 mg nocte) than with cimetidine (400 mg nocte). It has been
      claimed that patients with peptic ulcer disease can be successfully managed by
      intermittent courses of treatment with H2-receptor antagonists which are taken in
      response to the development of symptoms. However, high relapse rates (64-100%)
      have been reported during the first year of follow-up of patients who were
      receiving intermittent treatment with H2-receptor antagonists. High complication
      rates (haemorrhage 11.4%, perforation 1.2%) have also been reported over a seven
      year follow-up, while continuous treatment with H2-receptor antagonists
      significantly decreases the risk of haemorrhage in the event of ulcer recurrence.

PMID- 8364141
TI  - The need for long-term treatment of peptic ulcer.
AB  - Some 10% of the population in Western countries will suffer a duodenal ulcer or
      gastric ulcer at some time in their lives. Although there has been an improvement
      in the survival rate of patients with peptic ulcer haemorrhage, the mortality is
      still approximately 10%. There is evidence to suggest that peptic ulcer disease
      is a life-long condition and that ulcers remain active with an unchanged
      potential for complications such as haemorrhage and perforation. Over the past 15
      years anti-ulcer drugs with different mechanisms of action have been developed,
      and their use results in complete healing of an ulcer in four to eight weeks.
      However, most patients experience recurrence of their peptic ulcer after
      discontinuation of the healing therapy. Studies of continuous H2-receptor
      antagonist therapy have shown that recurrence occurs less frequently than in
      untreated patients, is largely asymptomatic, and is rarely characterized by
      haemorrhagic complications. Limited data on therapy for the eradication of
      Helicobacter pylori suggest that this may be an alternative approach for selected
      patients. As protection afforded by H2-receptor antagonists remains undiminished
      over the course of several years and is also observed in ulcers which have bled
      in the past, the implementation of long-term management with these agents
      constitutes a rational policy.

PMID- 8364142
TI  - Management issues for debate: the problems in perspective.

PMID- 8364143
TI  - [Development of a lower limb model for the study of accident sequelae of vehicle
      pedestrian collisions].
AB  - A major goal of the development and associated experimental investigation of car
      bumpers is the minimization of injuries in car-to-pedestrian collisions. Because
      the lower leg is particularly prone to injuries in a collision between a vehicle
      and a pedestrian, a lower leg model has been developed that makes it possible to
      simulate most of the processes occurring during an injury. In cooperation with
      the Institut fur Biomedizinische Technik (Institute for Biomedical Technology) of
      the University of Stuttgart and the Kunststofflabor des Fachbereiches fur
      Produktionstechnik (Institute for Production Methods) of the Fachhochschule fur
      Technik (Polytech) Esslingen, a muscle tissue model has been designed that makes
      it possible to simulate in a first approximation the mechanical behaviour of
      biological tissue under accident-specific pressure, or in the case of a crush
      injury. Initial prototypes were built with bone models of the tibia and fibula
      and with a skin model whose relevant material parameters were taken from the
      literature.

PMID- 8364144
TI  - [Experimental determination of muscle coordination of the lower extremity].
AB  - In order to describe the lines of action of muscles acting on joints, data on the
      geometrical position of insertions and origins are needed. These are of
      fundamental relevance for the biomechanical analysis, in particular for the
      calculation of joint loading. A measuring device with an accuracy of 0.1 mm was
      designed and constructed for the collection of three-dimensional experimental
      data from wet anatomical specimens. The main design features of the device
      include a vertically adjustable stand on wheels and a rotatable scale ring with a
      radial pointer. After setting the reading, the apparatus permits the measurement
      of cylindrical coordinates The margins of the attachments of muscles acting on
      the hip and knee joints were measured in two specimens. Two extensive sets of
      morphological data are now available and can be used to create complex
      biomechanical computer models.

PMID- 8364145
TI  - [Possibilities for optimizing prosthetic management of leg amputees using
      quantitative movement analysis].
AB  - First, the differences between natural and artificial lower extremities are
      discussed from a biomechanical perspective. Their effects on the motion can be
      quantified with the help of optoelectronic gait analysis. The differences in
      motion between natural gait and walking with an above-knee prosthesis are
      illustrated with an example. Based on this, design possibilities for the
      improvement of the gait of prosthesis wearers are considered, and the effects of
      these designs are documented with the help of gait analysis. Finally, the
      advantages of the simultaneous measurement of forces and motion are discussed,
      and with this, a new development direction of integrated gait analysis is
      described which could be of major significance.

PMID- 8364146
TI  - Characterization of p-bis(O-methylstyryl)benzene as a lifetime and anisotropy
      decay standard for two-photon induced fluorescence.
AB  - We describe the fluorescence spectral properties of p-bis(O-methylstyryl)benzene
      (bis-MSB) as a standard for time-resolved measurements of two-photon induced
      fluorescence. Bis-MSB displays the same single exponential intensity decay in
      several solvents for one- and two-photon excitation. The anisotropy decay
      displays the same single correlation time of one- and two-photon excitation. The
      amplitudes of the anisotropy decay are distinct for one- and two-photon
      excitation. At some excitation wavelengths the anisotropy amplitude appears to be
      solely the result of one- and two-photon photoselection, but at shorter
      wavelengths the anisotropy amplitudes are not related by single constant factor.
      The absorption range of bis-MSB makes it a suitable standard for one- and two
      photon excitation of intrinsic protein fluorescence and extrinsic fluorophores.

PMID- 8364147
TI  - Intensity and anisotropy decays of [Leu5] enkephalin tyrosyl fluorescence by 10
      GHz frequency-domain fluorometry.
AB  - The technique of 10 GHz frequency-domain fluorometry was used to resolve the
      complex picosecond intensity and anisotropy decays of the tyrosyl emission of
      [Leu5] enkephalin. Enhanced resolution of anisotropy decay was obtained by using
      acrylamide quenching of the tyrosyl fluorescence and global analysis of the
      frequency-domain anisotropy data obtained with different amounts of acrylamide.
      The data indicates a 44 ps correlation time for local tyrosine motions, and a 219
      ps correlation time for overall rotational diffusion of the pentapeptide. Our
      data are consistent with an initial loss of fluorescence anisotropy from r0 = 0.4
      to a value of r0 = 0.326 occurring during the first two picoseconds after
      excitation.

PMID- 8364148
TI  - Stable self-sustained potential oscillations across a membrane filter impregnated
      with triolein.
AB  - When applying constant electric current, periodic self-sustained potential
      oscillations with high stability are observed across a membrane filter
      impregnated with triolein, placed between KCl and NaCl aqueous solutions.
      Stability, reproducibility and controllability of the oscillation are much
      improved by the application of constant electric current compared with those
      obtained without application of electric current. Relations among value of
      electric current, base potential and period of the oscillations are studied, and
      it is concluded that the oscillation period can be controlled by base electric
      potential. Effects of temperature on the oscillations are investigated, and it is
      shown that Arrhenius plots for both base conductance and conductance amplitude of
      each oscillation fitted well to an individual straight line and that values of
      activation energies are similar to those of bulk salt solutions. From all data
      obtained it is suggested that the oscillations occur as a result of rhythmic
      repetition of opening and closing of hole(s) in the membrane, which is due to
      breakdown and restoration of a part of the membrane.

PMID- 8364150
TI  - Energetics of corneal epithelial cell-ocular mucus-tear film interactions: some
      surface-chemical pathways of corneal defense.
AB  - The role of ocular mucous gel in the corneal epithelial hydration, lubrication,
      cleansing, wettability and defense against pathogens, is investigated based on a
      modified DLVO theory that accounts for the apolar, as well as polar, "acid-base"
      surface interactions. A strong polar repulsion keeps mucus in the form of highly
      hydrated "sloppy" gel, which does not adhere to the normal epithelium. Due to its
      strong electron donor type monopolarity, the mucus gel can form an effective
      barrier against contamination of the underlying epithelium by both the apolar
      (e.g., tear film lipids, cell debris) and the polar (e.g., hydrophilic bacteria)
      entities. In the absence of mucus, epithelial contamination becomes energetically
      favorable, which can also compromise its wettability by tears. Finally, a loss of
      polar surface properties can lead to adhesion of mucus to the cornea.

PMID- 8364149
TI  - Thermotropic behavior of phosphatidylcholine-glucosyl ceramide mixtures: effects
      of phospholipid acyl chain composition and interaction with water.
AB  - The thermotropic behavior of multilamellar vesicles composed of mixtures of
      dimyristoyl phosphatidylcholine-glucosyl ceramide and of egg phosphatidylcholine
      glucosyl ceramide was investigated using differential scanning calorimetry.
      Macroscopic demixing of the lipid components occurred when multilamellar vesicles
      were prepared from mixtures of glucosyl ceramide and egg phosphatidylcholine by
      conventional methods. This problem was overcome by a technique based on spray
      drying of the lipid mixture. The results obtained for the two systems are
      compared with data available for dipalmitoyl phosphatidylcholine-glucosyl
      ceramide mixtures (Biochemistry 22 (1983) 3497-3501). All three
      phosphatidylcholines perturb the complex thermotropic behavior of glucosyl
      ceramide. The data suggest that the interference with intermolecular interactions
      among glycosyl ceramide molecules by phospholipid molecules is related to the
      molecular miscibility of the two components. This is strongly dependent on the
      acyl chain composition of the phosphatidylcholine and the water activity of the
      ambient aqueous phase.

PMID- 8364151
TI  - Molecular dynamics simulation of the stability of a 22-residue alpha-helix in
      water and 30% trifluoroethanol.
AB  - A molecular dynamics (MD) simulation was performed on the alpha-helix H8-HC5, the
      C-terminal part of myoglobin (residue 132-153), under periodic boundary
      conditions in two different solutions, water and water with 30% (v/v) 2,2,2
      trifluoroethanol (TFE), at 300 K to investigate the stability of the helix. In
      both simulations, the initial configuration was a canonical right-handed alpha
      helix. In the course of the MD trajectory in water (200 ps), the helix clearly
      destabilized and began to unfold after 100 ps. In the TFE solution, two stable
      parts of helical regions were observed after 70 ps of a 200-ps MD simulation,
      supporting the notion that TFE acts as a structure-forming solvent.

PMID- 8364152
TI  - Conformational transitions using molecular dynamics with minimum biasing.
AB  - The molecular dynamics algorithm (MD), which simulates intramolecular motions on
      the subnanosecond timescale, has been modified to allow the investigation of slow
      conformational transitions that do not necessarily occur spontaneously in MD
      simulations. The method is designated CONTRA MD (CONformational TRAnsitions by
      Molecular Dynamics with minimum biasing). The method requires the prior
      definition of a single conformational variable that is required to vary
      monotonically from an initial conformation to a final target conformation. The
      simulation is broken up into a series of short free MD segments, and we
      determine, after each segment of MD, whether or not the system has evolved toward
      the final conformation. Those segments that do not move the system in that
      direction are deleted. Those that do move it toward the final conformation are
      patched together sequentially to generate a single representative trajectory
      along the transition pathway. The CONTRA MD method is demonstrated first by
      application to the simultaneous C2'-endo to C3'-endo repucker and anti to syn N
      glycosidic torsion transitions in 2'-deoxyadenosine and then to the large-scale
      bending in phenylalanine transfer RNA.

PMID- 8364153
TI  - Synthesis and conformational study of peptides possessing helically arranged
      delta ZPhe side chains.
AB  - Z-Dehydrophenylalanine (delta ZPhe) possessing four oligopeptides, Boc-(L-Ala
      delta ZPhe-Aib)n-OCH3 (n = 1-4: Boc, t-butoxycarbonyl; Aib, alpha-aminoisobutyric
      acid), were synthesized, and their solution conformations were investigated by 1H
      nmr, ir, uv, and CD spectroscopy and theoretical CD calculation. 1H-nmr (the
      solvent accessibility of NH groups) and ir studies indicated that all the NH
      groups except for those belonging to the N-terminal L-Ala-delta ZPhe moiety
      participate in intramolecular hydrogen bonding in chloroform. This suggests that
      the peptides n = 2-4 have a 4-->1 hydrogen-bonding pattern characteristic of
      3(10)-helical structures. The uv spectra of all these peptides recorded in
      chloroform and in trimethyl phosphate showed an intense maximum around 276 nm
      assigned to the delta ZPhe chromophores. The corresponding CD spectra of the
      peptides n = 2-4 showed exciton couplets with a negative peak at longer
      wavelengths, whereas that of the peptide n = 1 showed only weak signals.
      Theoretical CD spectra were calculated for the peptides n = 2-4 of several
      helical conformations, on the basis of exciton chirality method. This calculation
      indicated that the three peptides form a helical conformation deviating from the
      perfect 3(10)-helix that contains three residues per turn, and that their side
      chains of delta ZPhe residues are arranged regularly along the helix. The center
      to-center distance between the nearest phenyl pair(s) was estimated to be
      approximately 5.5 A. The chemical shifts of the delta ZPhe side-chain protons (H
      beta and aromatic H) for the peptides n = 2-4 indicated anisotropic shielding
      effect of neighboring phenyl group (s); the effect also supports a regular
      arrangement of the delta ZPhe side chains along the helical axis.

PMID- 8364154
TI  - The contribution of helical potential to the in vitro receptor binding activity
      of a neuropeptide Y N-terminal deletion fragment.
AB  - In its dimeric form neuropeptide Y (NPY) folds into a compact structure in which
      the antiparallel oriented proline and alpha-helices apparently associate to form
      a primitive hydrophobic core. To investigate the contribution of helical
      stability to the receptor binding activity of NPY and its N-terminal deletion
      fragments, we synthesized and studied the solution conformational properties and
      in vitro activities of NPY, N alpha-acetyl-NPY2-36, NPY15-36, N alpha-propionyl
      NPY15-36, and N alpha-succinyl-NPY15-36. NPY15-36 is significantly less helical
      than both NPY and N alpha-acetyl-NPY2-36, and this decreased helical potential is
      attributed to the absence of the intramolecular stabilizing interaction afforded
      by the proline helix in the latter analogues. However, in accord with the helix
      dipole model, the helical potential of NPY15-36 is significantly increased by N
      terminal succinylation, whereas propionylation has no effect. In addition to an
      increase in helical potential, N alpha-succinyl-NPY15-36 is 2.5 and 4.6 times
      more active than NPY15-36 and N alpha-propionyl-NPY15-36, respectively, and is
      equipotent with N alpha-acetyl-NPY2-36 in displacing 1 nM [3H]-NPY from specific
      binding sites in rat brain membranes. The demonstration of a positive correlation
      between % alpha-helix content and in vitro binding activity suggests that the
      helical potential of N-terminal NPY deletion fragments contributes to their in
      vitro activity in the rat brain, and that a second role of the proline helix
      might be to stabilize the receptor-active conformation of the NPY alpha-helix.

PMID- 8364155
TI  - Crystal structures of Boc-D- and L-Iva-L-Pro-OBzl: unturned conformation of Aib
      Pro sequence unaffected by replacement of Me with Et in Aib.
AB  - The crystal structures of the isovaline (Iva) containing dipeptides, Boc-D-Iva-L
      Pro-OBzl and Boc-L-Iva-L-Pro-OBzl, were determined by x-ray diffraction. The
      diastereomeric peptides were shown to adopt unturned conformations closely
      similar to each other (phi Iva 52 degrees, psi Iva 46 degrees, phi Pro -65
      degrees, and psi Pro 143 degrees for D-Iva-L-Pro sequence and phi Iva 52 degrees,
      psi Iva 44 degrees, phi Pro -63 degrees, and psi Pro 148 degrees for L-Iva-L-Pro
      sequence). The Pro ring of each peptide was in C gamma-endo conformation. The
      unusually large angle CIva-NPro-C delta Pro values (131 degrees in both peptides)
      were observed, that was due to steric repulsion between the delta-methylene of
      Pro and the alkyl side chain of Iva residue. These conformations were essentially
      the same as that of the corresponding alpha-aminoisobutyric acid (Aib)-containing
      peptide Boc-Aib-L-Pro-OBzl. The result has demonstrated that replacement of
      either one of the two methyl groups of the Aib residue in Boc-Aib-L-Pro-OBzl with
      an ethyl group does not cause any significant change in the unturned conformation
      of the dipeptide.

PMID- 8364156
TI  - The hydration of proteins in nearly anhydrous organic solvent suspensions.
AB  - Water sorption isotherms at 27 degrees C have been measured for lysozyme and
      chymotrypsin in suspensions of toluene, di(n-butyl) ether, n-propanol, and a
      solution of 1M n-propanol in benzene. Sorption isotherms for the different
      suspensions are compared by converting solvent water content to the thermodynamic
      activity of water in each solvent. The sorption behavior is also compared to that
      for the two proteins hydrated from the vapor phase. At low water activities, all
      sorption isotherms are similar when compared on the basis of water activity.
      However, at higher activities, water sorption by the proteins in the organic
      suspensions is suppressed relative to the sorption of water vapor. The greatest
      suppression is observed for n-propanol, which suggests that the suppression may
      be due to a competition for water-binding sites on the protein by the organic
      solvent. Sorption isotherms at low water activities have also been predicted
      using a thermodynamic model in which it is assumed that water binds selectively
      to the ionizable residues on the surface of the protein. A comparison of
      predicted and measured sorption isotherms shows that the model can provide
      reasonable estimates of water sorption in nonpolar or moderately polar organic
      solvent suspensions at low levels of hydration.

PMID- 8364157
TI  - Proton magnetic resonance studies of bradykinin antagonists.
AB  - Bradykinin (BK) is a peptide hormone with sequence Arg1-Pro2-Pro3-Gly4-Phe5-Ser6
      Pro7-Phe8-Arg9 and has been implicated in a multitude of pathophysiological
      processes such as the ability to lower systemic blood pressure and stimulate
      pain. BK analogues having bulky, beta-branched D-aliphatic residues at position 7
      combined with bulky L-aliphatic residues at position 8 have now been observed to
      be strong antagonists. Conformational studies based on two-dimensional nmr
      experiments in methanol/water (80/20 v/v) were carried out on several such active
      antagonists in a polar solvent. Included in this study were the very active
      antagonists, [D-Arg0,Hyp3,Thi5,D-Cpg7,Cpg8]-BK [Cpg: alpha-cyclo-pentyl-glycine;
      Hyp: trans-4-hydroxy-L-proline; Thi: beta-(2-thienyl)-L-alanine] (I), [D
      Arg0,Hyp3,D-Cpg7,Cpg8]-BK (II), as well as its variant with D-Cpg7 replaced by
      Cpg7, namely [D-Arg0,Hyp3,Cpg7,Cpg8]-BK (III). A turn-like structure, which
      coexists with the extended conformation, was observed between residues 2 and 5
      for the most active antagonists I and II, in direct correlation with the peptide
      activities. No turn-like structure was found for residues 6-9. In peptide III, a
      turn-like structure was not identified. The existence of a turn at the C-terminal
      end of bradykinin and its analogues has been predicted by empirical calculations
      and supported by nmr measurements. But the present nmr study on the most active
      antagonists (I, II) does not support this hypothesis. Instead, the data suggest
      that a turn-like structure between residues 2 and 5 could be important for
      antagonist activity. Finally, one weak inhibitor [D-Cpg7]-BK (IV) showed no
      defined secondary structure.

PMID- 8364158
TI  - Computer simulations of the flexibility of a series of synthetic cyclic peptide
      analogues.
AB  - The flexibility of a series of cyclic peptides derived from the epitope of a
      snake toxin is investigated using computer simulation techniques. Molecular
      dynamics (MD) simulations and vibrational analyses are performed on chemically
      constrained peptides modeled on the parent protein loop. In the 50 ps MD
      simulations, large variations in the atomic fluctuations are seen between the
      peptides, and can be related to the nature of the chemical constraints present in
      the molecules. Normal mode analyses are performed on energy-minimized
      configurations derived from the dynamics trajectories. The atomic fluctuations
      calculated from the normal modes are about 30% of those of the molecular dynamics
      for the more flexible peptides and 70% for the more constrained molecules. The
      calculated differences in flexibility between the molecules are much less
      significant in the harmonic approximation.

PMID- 8364159
TI  - The solution conformation of Ac-Pen-Arg-Gly-Asp-Cys-OH, a potent fibrinogen
      receptor antagonist.
AB  - The solution conformation of Ac-Pen-Arg-Gly-Asp-Cys-OH, a potent fibrinogen
      receptor antagonist, was characterized in DMSO-d6 by the combination of nmr and
      molecular modeling. The conformational space available to the peptide was
      explored using a distance geometry algorithm with distance constraints derived
      from 1H-nmr spectra. The dynamics of the peptide were examined by relaxation time
      measurements and low temperature studies. The results from the low temperature
      studies suggest that the peptide backbone does not exist in a single, well
      defined conformation but undergoes exchange between multiple conformers. This
      result is consistent with the inability to find a single structure that satisfies
      all the nmr-derived constraints. The constraints could only be satisfied by
      considering pairs of conformers to represent the experimental data. The low
      energy conformers comprise type II' or type V beta-turns with distinct side-chain
      directionality. The Arg-Gly-Asp portion of the ring is flexible and can be
      described by amide-plane rotations of the Arg-Gly and Gly-Asp peptide bonds.
      Although some backbone flexibility is evident, the incorporation of beta,beta
      dimethyl cysteine imparted greater conformational rigidity as compared to the
      previously studied cyclic pentapeptide, Ac-Cys-Arg-Gly-Asp-Cys-OH.

PMID- 8364160
TI  - Effects of a human urinary kininogenase (SK-827) on cerebral and cutaneous
      microcirculation in rabbits.
AB  - Pharmacological effects of a human urinary kininogenase (SK-827) on the cerebral
      and cutaneous microcirculation were studied in anesthetized normal rabbits.
      Intravenous administration of SK-827 had no effect on the diameter of pial
      arterioles or the hemoglobin content (IHb) of the brain. On the other hand, SK
      827 increased IHb of the skin, dose-dependently and dilated cutaneous arterioles
      transiently with increased capillary red blood cell velocity. These findings
      suggest that the pharmacological effects of SK-827 on the microcirculation of the
      brain and the skin differ from each other due to the activity of the
      autoregulatory mechanism.

PMID- 8364161
TI  - Development and mitotic activity of the metrial gland in rat uterus during mid
      pregnancy.
AB  - Development and mitotic activity of metrial gland in rat uterus were investigated
      focusing on the point of implantation during mid-pregnancy. In decidua basalis,
      the granulated metrial gland (GMG) cells slightly increased in number during days
      8-12 of pregnancy and then decreased, while the cells appearing in the
      mesometrial triangle on day 9 continued to increase until day 16, forming the
      metrial gland in situ. By contrast, the mitotic change in the mesometrial
      triangle was similar to that in the other 2 regions, decidua basalis and the
      inner layer of myometrium. In all 3 regions, mitotic rate rose drastically on day
      9, and then gradually decreased until day 16. However, most of the mitotic cells
      lacked the PAS-positive cytoplasmic granules in any regions. Mitotic activity in
      GMG cells was very low and almost unchanged throughout the gland development.
      These results suggest that the rapid rise of mitotic rate is due to the active
      mitosis of PAS-negative cells, presumably GMG precursor cells, existing widely in
      the implantation point of rat uterus during the early development of the gland.
      Immunocytochemical study revealed that progesterone receptors were localized in
      decidual and muscle cells and fibroblasts, but not in GMG cells during the
      development of the gland. The present study suggests that the metrial gland cells
      are proliferated, differentiated and maintained by the progesterone-sensitive
      stromal cells, such as decidual cells and/or fibroblasts.

PMID- 8364162
TI  - No inhibitory effects of danazol estrogen production by ovaries of
      hypophysectomized rats stimulated by gonadotropins.
AB  - The effects of danazol on estrogen production by rat ovaries were investigated.
      Hypophysectomized immature female rats were injected daily with 2.5 or 5 IU of
      pregnant mare serum gonadotropin (PMS) and simultaneously daily given vehicle
      only or danazol (100 mg/kg body weight) for 14 days. Danazol did not decrease the
      activities of 3 beta-hydroxysteroid dehydrogenase, 17 alpha-hydroxylase, 17, 20
      lyase and aromatase in the ovaries of rats stimulated by 5IU of PMS. Danazol also
      did not decrease the activities of 3 beta-hydroxysteroid dehydrogenase and
      aromatase, and the production of aromatizable androgens (androstenedione plus
      testosterone) from progesterone in the ovaries of rats stimulated by 2.5 IU of
      PMS. In accordance with these results, danazol did not reduce the level of
      estradiol-17 beta in the sera of rats stimulated by 2.5 and 5 IU of PMS. The
      present results suggest that danazol does not inhibit estrogen production by the
      rat ovary through its direct action on the ovary.

PMID- 8364163
TI  - The RBG-banded karyotype of Oryctolagus cuniculus at the 550-band stage.
AB  - Representative haploid RBG-banded karyotypes of Oryctolagus cuniculus and
      diagrammatic representation of the banding patterns at the 550 band stage are
      presented.

PMID- 8364164
TI  - Expression of proto-oncogenes and cytoskeletal actin gene in foreign body-induced
      murine sarcomas.
AB  - To investigate possible differences in the process of tumorigenesis induced by
      genotoxic and non-genotoxic agents, the expression of several oncogenes and
      cytoskeletal actin gene was examined in murine sarcomas induced by foreign body
      (plastics) and 3-methylcholanthrene treatments. RNAs isolated from the resultant
      tumors were analyzed by dot blot and Northern blot hybridization with various
      oncogene probes. Levels of expression of c-myc, c-Ha-ras, c-Ki-ras, c-N-ras c
      raf, c-src and cytoskeletal actin were similar and in distinguishable in both
      sarcoma groups. c-yes, c-erbB and c-sis transcripts were not detected in either.
      The single difference found was concerned with high levels of c-fos expression in
      fibrous capsules formed around the foreign body plastic material. Thus the
      pattern of expression of the above cellular genes was not specific and could not
      be used to distinguish sarcomas induced by non-genotoxic treatments from those
      caused by genotoxic exposure.

PMID- 8364165
TI  - Age-related changes in gonadotropin, prolactin and growth hormone levels with
      reference to the development of uterine adenomyosis in female SHN mice.
AB  - The patterns of serum FSH, LH, PRL and GH levels in SHN mice were determined by
      radioimmunoassay between 1 and 12 months of age. In addition, the incidence of
      spontaneous development of uterine adenomyosis and mammary tumor was also studied
      for 12 months. Serum FSH level increased gradually with age while the level of LH
      was almost constant during the observation period. On the other hand,
      concentrations of PRL and GH significantly increased with age. The present data
      showed that the development of adenomyosis and mammary tumor rapidly increased
      after 6 and 9 months of age, respectively. Pituitary grafting at 30 days of age
      resulted in a high incidence of adenomyosis after 6 months of age. There were no
      significant differences in FSH and LH levels between mice with and without
      pituitary grafting. However, pituitary grafting resulted in the increase in PRL
      and GH levels compared with age-matched controls. These findings altogether
      suggest that the spontaneous development of adenomyosis in SHN mice may be
      related to the elevation in PRL and GH levels as a function of age.

PMID- 8364166
TI  - Inhibition of rat mammary tumorigenesis by voluntary exercise.
AB  - In this study, the anti-promoting effect of voluntary (wheel) exercise on 7, 12
      dimethylbenz(a)anthracene (DMBA)-induced mammary tumorigenesis was investigated.
      All rats were fed high fat diets (23% of calories as fat) to mimice the typical
      western diet. Two doses of DMBA were used to determine if the antipromoting
      effects of exercise were dependent on the strength of the initiating agent. In
      addition, tumor estrogen receptors were assayed to determined whether exercise,
      through an estrogen-suppressing mechanism, selects for estrogen receptor-negative
      tumors. Female Sprague-Dawley rats were fed a semi-purified 23% fat (corn oil)
      diet (AIN-76A) and, on day 50 of age administered DMBA by gavage at 5 or 10
      mg/rat. Rats were then randomized into 4 groups (n = 30) as follows: 1) low
      DMBA/sedentary; 2) low DMBA/exercise; 3) high DMBA/-sedentary; and 4) high
      DMBA/exercise. Active rats were placed in wheel-cage units, which allowed
      voluntary access to an activity wheel for 133 (low DMBA) and 77 (high DMBA) days,
      respectively, Sedentary rats were placed in conventional cages. Both active
      groups exhibited significantly lower total tumor numbers than their sedentary
      controls: 75 vs 102 (low DMBA) (p < 0.05) and 90 vs 160 (high DMBA) (p < 0.001).
      Compared to sedentary controls, latency was significantly lengthened in the low
      but not the high DMBA active groups; multiplicity, in contrast, was significantly
      decreased in the high, but not the low DMBA exercised group. Exercise had no
      effect on overall tumor incidence. When segregated into exercise tertiles, total
      tumor active compared to the least active tertile, particularly in the high DMBA
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364167
TI  - Opioid dependency and T-helper cell functions in rhesus monkey.
AB  - Administration of morphine sulfate to rhesus monkeys may activate the quiescent
      lymphocyte for proliferation, induce a transient increase in the T cell
      proliferative response to mitogens, and cause an enhanced interleukin-2 release
      from the mitogen-stimulated lymphocytes. However, longitudinal studies of the
      animals dependent upon morphine or L-a-acetyl-methadol, a long-acting opioid,
      revealed an overall immunosuppression of T helper functions. In vitro studies
      using morphine and its antagonist naloxone suggested that the immunosuppression
      was not a result of a direct interaction between the opioids and conventional
      opiate receptors which might have been present on the lymphocytes. The studies
      also showed the importance of measuring [3H]thymidine incorporation rather than
      its uptake into cells to assess T cell activation.

PMID- 8364168
TI  - Unusual behaviour of the LNCaP prostate tumour xenografted in nude mice.
AB  - The tumourigenicity of the LNCaP prostatic cell line was investigated in vivo
      after prostatic (orthotopic), subcutaneous (ectopic) and concomitant
      implantations in male Balb/c nude mice. Swollen lymph nodes were detected in the
      inguinal region only after subcutaneous implantation but could not be
      characterized by immunohistochemistry. However, when grafted to Endoxan
      pretreated mice, they generated well differentiated tumours which secreted
      prostate-specific acid phosphatase. A parallel study was conducted to investigate
      the metastatic potential of the LNCaP tumour using several routes of implantation
      (intravenous, bone contact, intrasplenic and intracranial). Tumours grew only
      after intracranial implantation. No production of either haematogenous or bony
      metastases was recorded.

PMID- 8364169
TI  - The acute toxicity and in vivo antitumour activity against L1210 leukemia of
      triphenyltin 3,5-diisopropylsalicylate, bis (di-n-butyl-(s)-2-pyrrolidone-5
      carboxylato)tin oxide and di-n-butyltin bis(3-amino-4-methylbenzoate).
AB  - Triphenyltin 3,5-di-isopropylsalicylate, compound 1, is characterized by a
      maximum tolerated dose (MTD) of 20 mg/kg. Bis[di-n-butyl(2-pyrrolidone-5
      carboxylato)tin] oxide, compound 2, and (di-n-butyltin bis(3-amino-4-methyl
      benzoate), compound 3, exhibit similar acute toxicities (MTD = 8 mg/kg) despite
      their lower in vitro activity, as compared to compound 1, against the two human
      tumor cell lines MCF-7 and WiDr. All three are inactive in vivo against L1210
      leukemia in mice.

PMID- 8364171
TI  - Electron microscopic investigations of progressive early metastasis of cutaneous
      melanoma.
AB  - Primary metastasis of cutaneous malignant melanoma seems to occur especially via
      the initial lymphatics (IL). In samples of 50 melanomas examined by TEM melanoma
      cells (MCs), invading IL were demonstrated in 24 specimens. MCs were scarcely
      found in the immediate vicinity of blood vessels. After the MC has escaped from
      the MC-complex, connective tissue fibers and cells represent physiological guide
      ways that lead the MC to the IL. Located close to the IL, the MC develops
      pseudopodium-like cytoplasmic processes that penetrate the abluminal fibrous
      network, fuse partially with the endothelium and destroy it. It seems to be
      important that the melanomas invade IL as single cells and not in form of cell
      clusters.

PMID- 8364170
TI  - Effect of a biological response modifier, PSK, on intestinal flora of tumor
      bearing mice.
AB  - PSK, a protein-bound polysaccharide derived from basidiomycetes, is a biological
      response modifier that exhibits a variety of activities following oral
      administration, including prevention of infection. In this study, the effects of
      oral administration of this drug on microbial flora of tumor-bearing mice were
      examined. Numbers of Staphylococcus, Streptococcus and Pseudomonas were
      increased, and those of Bifidobacterium and Lactobacillus were reduced in fresh
      feces of mice from later than 9 weeks after inoculation of sarcoma 180. However,
      these changes were prevented by oral administration of PSK. In mice bearing
      sarcoma 180, the increases in numbers of Staphylococcus and Pseudomonas and the
      decrease in those of Bifidobacterium were further enhanced by intraperitoneal
      administration of anticancer agent mitomycin C, but such changes were suppressed
      by oral administration of PSK. These results suggest that PSK has a preventive
      effect against abnormal conditions of the intestinal flora induced by tumor
      inoculation or the administration of anticancer agents.

PMID- 8364172
TI  - Quality assurance: an Australian lawyer's perspective.

PMID- 8364173
TI  - Quality assurance in the United Kingdom.
AB  - In short, quality assurance in UK healthcare has developed since the mid-1980s
      driven by a series of national policy initiatives in the NHS, by increasing
      determination of the clinical professions to maintain standards, and by a general
      consumer movement to know more about public and professional services. Much has
      been achieved but there remains substantial debate about quality assurance
      leadership, coordination, funding and evaluation--or even what to call it.

PMID- 8364174
TI  - An investigation of awareness of antenatal protocols.
AB  - Previous audit at the Homerton Hospital had revealed a poor level of compliance
      with established antenatal protocols mandated by risk factors detected at the
      booking visit. Medical staff were questioned as to their awareness of five of the
      most important protocols and their response was analysed by a new scoring system.
      The scores were generally low though consultants scored more highly than junior
      staff. Scores were related to the length of obstetric experience and duration of
      work in the obstetric unit but were not related to frequency of the use of the
      protocol manual nor to the last time that reference was made to the manual. To
      improve compliance within the unit, the following recommendations were made: (1)
      regular revision of protocols to incorporate the current views of senior
      clinicians and (2) improved dissemination of information. The scoring system
      described here should prove to be a simple and effective method for the
      assessment of protocols within any unit.

PMID- 8364175
TI  - Emergency treatment of bronchospastic attacks in an emergency medicine
      department: effects of a quality improvement project.
AB  - New insights have recently changed the therapeutical approach to bronchospastic
      attack (BA). In this paper we present the results of a quality assurance study
      devised to: (1) verify the extent to which these new insights are put into
      practice in our Emergency Medicine Department (EMD); (2) evaluate changes in EMD
      medical staff behaviour faced with BA after discussion and distribution of
      medical practice guidelines on the treatment of BA (a document produced by a
      group of experts in pulmonary medicine working in the EMD on the basis of current
      literature and personal experiences); (3) assess the impact of such guidelines on
      quality care. A retrospective analysis demonstrated an incorrect treatment of BA
      in the EMD. After the introduction of the guidelines we observed: (1) an
      improvement in physician behaviour that completely agreed with guidelines in 56%
      of instances after discussion and distribution of the document, in 8% before; (2)
      an improvement in the outcome of patients treated for BA in the EMD (13 versus
      36% relapses for patients treated in the EMD and discharged).

PMID- 8364176
TI  - Improving quality in emergency services to reduce hospital admission.
AB  - At the Emergency Department of Udine General Hospital (Italy) a programme to
      reduce admissions to the Internal Medicine Department was introduced in 1991. The
      majority of these admissions come from the Emergency Department, where many
      people, often without acute conditions, claim medical care. The programme
      consisted in organizational, professional and economic changes. At the end of
      1991, the overall number of admissions to Udine General Hospital, as compared to
      1990, decreased by 7.1%, but admissions to the Internal Medicine Department
      showed an 11.2% reduction. Finally, examinations for internal medical complaints
      in the emergency ward, not followed by hospitalization, increased by 15.5%. These
      results showed a reduction in admissions to the Internal Medicine Department
      greater than previously planned, with an increase in the number of outpatient
      examinations in the emergency room not followed by admission. Further targets
      were planned for 1992 to increase the quality of the service.

PMID- 8364177
TI  - Delivery of primary care in hospital and community settings in Australia.
AB  - This study examined the interface between emergency departments and community
      general practice in terms of their delivery of primary care services. Through the
      collection of casemix and treatment data, and interviews with patients,
      information was gathered relating to the extent of primary care delivery in
      emergency departments, problems managed and treatments provided in the two
      settings and patients' characteristics and reasons for choosing to seek primary
      care in the emergency department. The results indicate a high proportion of
      primary care delivery is in emergency departments, and that there is a need for
      delivery in this setting to continue. The results are discussed in terms of such
      quality assurance issues as monitoring primary care in emergency departments and
      addressing patient needs.

PMID- 8364178
TI  - Data comparability issues in international research and quality assurance.
AB  - Impediments to and progress toward valid and reliable international quality
      comparisons at the diagnosis or case type level are identified and discussed. The
      need for uniformity in each of the following is established: (1) international
      clinical data set, (2) definitions of clinical data elements and (3) data
      collection practices. The need to establish a clinically adequate international
      data base is discussed and action steps are identified.

PMID- 8364179
TI  - Adverse patient occurrences in a university hospital: a comparison of screening
      results registered by specialists and by external review.
AB  - A quality assurance system for generic screening of patient care has been
      developed in a university hospital in The Netherlands. This system is based on
      the Medical Management Analysis System, developed in the United States. Patient
      care is systematically screened for adverse patient occurrences (APOs). Screening
      criteria have been developed and some adjustments have been made to the original
      system, because of structural differences in health care between the United
      States and The Netherlands. The results of a study comparing two screening
      strategies are presented: screening by a medically trained, outside reviewer and
      screening by the Ear, Nose and Throat specialists themselves. The reviewer
      screened almost all admissions to the department as opposed to the specialist,
      who filled in screening forms of only 77.5% of the admissions. Specialists are
      found to register more APOs in their own domain (42%) as compared to the screener
      (28%). Issues concerning the nursing process receive less attention by the
      specialists (14%) than by the screener (22%). Because the personnel delivering
      direct patient care are more familiar with and informed about this process of
      care, the importance is stressed of getting specialists as well as nurses
      involved in the evaluation of the care they deliver to patients.

PMID- 8364180
TI  - Registration of adverse patient occurrences in a university hospital: relations
      between adverse patient occurrences and characteristics of hospitalized patients.
AB  - This paper reports the results of a survey on adverse patient occurrences (APOs)
      in patient care in a university hospital in The Netherlands. Screening for APOs
      is important as an instrument of quality assurance. Results from 1 year of
      screening have been related to specific patient characteristics. Age, length of
      stay and diagnosis group are strongly related to the identified APOs. The chances
      of APOs are very high if the patient belongs to certain diagnosis groups
      (operation procedure salivary gland, malignant disorder ear, nose, throat) and at
      the same time has a long length of stay in the hospital. The chances of being
      afflicted with more than one APO are strongly related to age and length of stay.
      With regard to the types of APO, this study shows a relation between patient
      characteristics and some APOs, but the statistical significance or the nature of
      these relations varies with type.

PMID- 8364181
TI  - Quality in alternative care.

PMID- 8364182
TI  - Quality of care in eastern Europe: the diagnosis is clear, the therapy not.

PMID- 8364183
TI  - Macrophage inflammatory protein: its characteristics, biological properties and
      role in the regulation of haemopoiesis.
AB  - Studies on haemopoietic stem cells had led to the realisation that negative
      feedback inhibitors play an important role in regulating their proliferation. One
      such molecule was identified as MIP-1 alpha. One of a family of cytokines,
      originally recognised as inflammatory molecules, MIP-1 alpha is now potentially
      valuable as a means of manipulating and protecting haemopoietic (and possibly
      other) stem cells during chemotherapy. This short review briefly considers the
      structural classification of MIP-1 alpha and its molecular relatives and
      indicates some of the probable human/murine equivalent molecules outlining the
      evidence for the equivalence of MIP-1 alpha (murine) and LD78 (human). Sources of
      MIP-1 alpha/LD78 are identified as monocyte/macrophage and lymphocytic cells and
      their role in inflammatory responses is seen to be significant. All proliferation
      in haemopoietic tissue is now recognised as a major target for MIP-1 alpha
      action. In vitro it synergises with certain growth factors to promote progenitor
      cell colony formation, but effects are dependent on the maturational age of the
      cells promoted. With more primitive cells it is seen as inhibitory. This property
      is particularly valuable in vivo where MIP-1 alpha can protect stem cells against
      the effects of cytotoxic agents. Since it appears that leukaemic stem cell
      proliferation is not inhibited, MIP-1 alpha/LD78 present great potential for stem
      cell protection in the theatre of cytotoxic therapies.

PMID- 8364184
TI  - Regional distributions of beta-thalassemia mutations in Turkey.
AB  - The distributions of twelve beta-thalassemic mutations in samples (n = 139
      chromosomal samples) from four regions of Turkey were determined. The frequencies
      of these mutations did not reveal a notable region specific heterogeneity. In
      particular, the four mutations, IVS.1/nt.110(G/A), IVS.1/nt.6(T/C),
      IVS.1/nt.1(G/A) and nonsense codon.39(C/T), with country-scale frequencies of
      35.9%, 21.6%, 13.0% and 7.2%, respectively, were found to be distributed with
      rather similar frequencies also on a regional scale.

PMID- 8364185
TI  - Flow cytometric determination of active oxygen (hydroperoxide) produced by
      peripheral blood neutrophils in patients with hematological disorders.
AB  - We analyzed active oxygen (hydroperoxide; H2O2) production by peripheral
      neutrophils in various hematological diseases by flow cytometry. One hundred
      microliters of heparinized fresh blood was sequentially incubated at 37 degrees C
      with 2',7'-dichlorofluorescein diacetate and with or without phorbol myristate
      acetate (PMA). After hemolysis, the pelleted white blood cells were subjected to
      flow cytometry, and the neutrophil fraction was gated on the cytogram. Production
      of H2O2 by the fraction was estimated by determining the increase in the relative
      intensity of fluorescence emitted from the fraction in response to stimulation by
      PMA. In controlled chronic myelogenous leukemia (CML) (WBC < 1 x 10(10)/1), H2O2
      production was normal, while in uncontrolled CML (WBC > or = 1 x 10(10)/1), it
      was reduced. In myelodysplastic syndrome (MDS), H2O2 production was also reduced,
      but no significant difference was observed among FAB classification disease types
      in MDS patients. In untreated acute non-lymphocytic leukemia (ANLL), H2O2
      production was reduced, while in the complete remission stage of ANLL, its level
      was normal, suggesting recovery from normal clones. In aplastic anemia, the H2O2
      production level was normal. Steroid therapy might be responsible for the
      reduction of H2O2 production in non-Hodgkin's lymphoma and multiple myeloma. The
      production of H2O2 is closely related to the oxygen-dependent bactericidal
      activity of neutrophils, and, hence, can be utilized as an index to indicate
      susceptibility to infection. This neutrophil function can be determined easily in
      ordinary clinical facilities by using flow cytometry, and care should be taken to
      prevent infection when H2O2 production is reduced.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8364186
TI  - Disappearance of Ph1 chromosome with intensive chemotherapy and detection of
      minimal residual disease by polymerase chain reaction in a patient with blast
      crisis of chronic myelogenous leukemia.
AB  - We diagnosed a patient with chronic myelogenous leukemia (CML) in chronic phase
      (CP) on the basis of clinical findings, Ph1 chromosome detected by cytogenetic
      analysis, and bcr-abl fusion mRNA detected by reverse transcriptase-dependent
      polymerase chain reaction (RT-PCR). One month after diagnosis, the patient
      developed extramedullary blast crisis in the lymph nodes, and then medullary
      blast crisis in the bone marrow, in which different surface markers were shown.
      Combination chemotherapy with BH-AC, VP16, and mitoxantrone was administered;
      this resulted in rapid disappearance of the lymphadenopathy, restoration of
      normal hematopoiesis, and no Ph1 chromosome being detected by cytogenetic
      analysis. RT-PCR performed to detect the residual Ph1 clone revealed that
      although the Ph1 clone was preferentially suppressed, it was still residual. The
      intensive chemotherapy regimen preferentially suppressed the Ph1-positive clone
      and led to both clinical and cytogenetic remission in this patient with BC of
      CML; we suggest that RT-PCR is a sensitive and useful method for detecting
      minimal residual disease during the clinical course of this disease.

PMID- 8364187
TI  - Primary pulmonary non-Hodgkin's lymphoma in a Japanese renal transplant
      recipient.
AB  - Pulmonary non-Hodgkin's lymphoma (NHL) developed in a 31-year-old renal
      transplant recipient 3 years after transplantation. Chest roentgenogram showed
      rapidly progressive multiple nodules in both lungs. The pleural fluid obtained by
      needle aspiration contained many atypical cells with surface B cell antigen and
      abnormal karyotype. The patient died of pulmonary edema shortly after combination
      chemotherapy was begun without regression of the tumors. Autopsy revealed diffuse
      large cell NHL confined to both lungs. Immunological examination and DNA analysis
      of the tumor showed monoclonal B cell NHL.

PMID- 8364188
TI  - Autoimmune hemolytic anemia after Kawasaki disease in a child.
AB  - A 2-year-old male presented with upper respiratory tract infection symptoms,
      continuous high fever, extensive truncal rash with desquamation, lymphadenopathy,
      subconjunctival hemorrhage, and oral stomatitis. He was diagnosed with Kawasaki
      disease and did well on aspirin. Approximately 8 weeks after initial presentation
      he had evidence of severe immune hemolysis. At that time a direct antiglobulin
      test was microscopically positive; it became strongly positive (3 + IgG, w + C3)
      2 weeks later. The serology was unusual in that a warm IgG autoantibody and a low
      titer high thermal range cold antibody of unusual specificity (anti-Ena or anti
      Pr) were present. We were uncertain as to which antibody caused the hemolysis, or
      whether they worked synergistically. The hemolysis resolved following treatment
      with high dose prednisone.

PMID- 8364189
TI  - CD33, CD4-double positive blastic transformation in a patient with chronic
      myelogenous leukemia.
AB  - We report a 19-year-old female with blastic transformation of chronic myelogenous
      leukemia whose blasts had CD33 and CD4 phenotypes, although no significant
      characteristics were detected by morphological and histochemical analysis. In a
      colony assay with hematopoietic growth factors, the blasts proliferated and
      differentiated into myelo-monocytic lineage, particularly in the presence of GM
      CSF or IL-3 + G-CSF. The blasts transformed from CML were assumed to be myelo
      monocytic progenitor cells, corresponding to GM colonies. Blastic transformation
      expressing such a phenotype has not been reported previously.

PMID- 8364190
TI  - Gamma/delta T-cell lymphoma with hepatosplenomegaly: report of a case.
AB  - We describe the case of a patient with peripheral gamma/delta T-cell lymphoma (T
      ML) with hepatosplenomegaly, generalized lymphadenopathy, and bone marrow
      involvement. A 44-year-old man had lymphoma, which became clinically apparent 2
      months after the onset of myositis and insulin-dependent diabetes mellitus. A
      cervical lymph node biopsy specimen showed diffuse infiltration by large
      neoplastic cells with vascular proliferation. The neoplastic cells expressed the
      T-cell receptor (TCR)delta chain detected by TCR delta 1 and delta-TCS1, CD3,
      CD30, CD45RO, and epithelial membrane antigen, but not the TCR beta chain
      detected by beta F1, CD1a, CD2, CD4, CD5, CD7, CD8, CD25, HLA-DR, and terminal
      deoxynucleotidyl transferase. The cells had a clonal rearrangement of TCR gamma
      chain gene and a germ-line configuration of immunoglobulin heavy chain gene and
      TCR beta chain gene. Despite chemotherapy, the patient died of refractory
      lymphoma 4 months after diagnosis. Examination at autopsy revealed that the main
      hepatic and splenic neoplastic infiltration sites were the portal area and white
      pulp, respectively. Our patient differed from those with gamma/delta T-ML with
      hepatosplenic involvement reported previously with respect to the hepatic and
      splenic neoplastic infiltration patterns and the presence of lymphadenopathy.

PMID- 8364191
TI  - Workshop on organization and methods in diagnostic haematology, Bad Homburg, 9-11
      October 1992.

PMID- 8364192
TI  - Calcitriol: the major humoral mediator of hypercalcemia in Hodgkin's disease and
      non-Hodgkin's lymphomas.

PMID- 8364193
TI  - Antibody response in patients with Gaucher disease after repeated infusion with
      macrophage-targeted glucocerebrosidase.
AB  - Recent clinical data have shown that enzyme replacement therapy with macrophage
      targeted glucocerebrosidase (GCR) can be effective in treating type 1 Gaucher
      disease. Sera from 262 patients, repeatedly infused with GCR, were assessed for
      the presence of antibodies to this therapeutic protein. Patient serum samples
      obtained at 3-month intervals were assessed by enzyme-linked immunosorbent assay
      and those with values greater than two standard deviations above the mean value
      obtained with a pool of normal human sera were further characterized by
      radioimmunoprecipitation. At the time of these analyses, the duration of patient
      treatment varied from 3 months to approximately 3 years. Of the 262 patients
      analyzed, 34 (12.9%) showed IgG antibodies, as confirmed by
      radioimmunoprecipitation. All patients who seroconverted did so within 1 year of
      treatment. The predominant antibody developed was the IgG1 subclass. Fourteen
      patients in the study experienced periodic symptoms suggestive of immediate
      hypersensitivity. Nine of these 14 patients had antibody to GCR as determined by
      radioimmunoprecipitation, whereas 5 patients were antibody negative. There was no
      evidence of the development of IgE antibodies in these 14 patients. The presence
      of GCR antibodies did not appear to effect efficacy of therapy in any of the
      patients treated to date.

PMID- 8364194
TI  - Treatment of adult chronic autoimmune thrombocytopenic purpura with repeated high
      dose intravenous immunoglobulin.
AB  - Intravenous (i.v.) infusions of Ig concentrates are an effective but expensive
      treatment for patients with autoimmune thrombocytopenic purpura (AITP). The
      optimal treatment protocol and the long-term results are uncertain, and the
      precise mechanism by which the platelet count increases is poorly understood.
      Twenty adult patients with chronic AITP were enrolled in a prospective study to
      compare the respective efficacy of two high-dose IVIgG induction regimens (1 g v
      2 g/kg body weight) and the long-term effect of six 1 g/kg body weight i.v. IgG
      reinfusions. An initial response was observed in all 18 evaluable patients: the
      platelet count increased to a mean value of 251 x 10(9)/L (range 72 to 836 x
      10(9)/L) and the mean pretreatment platelet count was multiplied by 14.6. No
      difference in efficiency was observed between the two i.v. IgG dosages. The
      degree of the platelet count increment correlated in both groups with the
      increase in the clearance of antibody-coated red blood cells, measured by an
      isotopic method, but not with the serum IgG elevation. Treatment was considered
      to have failed in 11 patients, 90 days after the last i.v. IgG reinfusion (D90),
      because the platelet counts were comparable with pretreatment values. In
      contrast, a complete response was observed at D90 in five patients (mean platelet
      count: 184 x 10(9)/L; range: 150 to 250 x 10(9)/L) and a partial response at D90
      was obtained in the remaining two patients (platelet counts: 70 and 104 x
      10(9)/L). Five of the 7 responders at D90 kept a platelet count above 50 x
      10(9)/L during the entire follow-up period (mean 33 months; range: 5 to 66) with
      no further treatment; unfortunately, no clinical or biologic criteria were found
      to be predictive of the long-term response. This study shows that an i.v. IgG
      infusion regimen of 1 g/kg body weight could safely replace the classical 2 g/kg
      body weight dosage, at least in patients who do not have life-threatening
      thrombocytopenia. Moreover, repeated i.v. IgG reinfusion could be an alternative
      for AITP patients in whom splenectomy is contraindicated.

PMID- 8364195
TI  - Long-term follow-up of patients with invasive fungal disease who received
      adjunctive therapy with recombinant human macrophage colony-stimulating factor.
AB  - Mortality of bone marrow transplant (BMT) patients who develop invasive fungal
      infection is greater than 80%. Long-term follow-up of 46 consecutive BMT patients
      who received recombinant human macrophage colony-stimulating factor (rhM-CSF) as
      adjunctive therapy with standard antifungal treatment who were entered into phase
      I/II trials at The Fred Hutchinson Cancer Research Center is reported. rhM-CSF
      (100 micrograms/m2 to 2,000 micrograms/m2; Chiron/Cetus Corporation, Emeryville,
      CA) was administered from day 0 to 28 after determination of progressive fungal
      disease. Results of long-term follow-up of fungal infection, relapse, and
      survival were compared with 58 similar historical controls. Multivariable
      analysis of the patients who received rhM-CSF showed two factors that
      significantly correlated with poor survival: Karnofsky score < or = 20% and
      Aspergillus infection. Overall, survival of patients who received rhM-CSF was
      greater than that of historical patients (27% v 5%) and was entirely because of a
      50% survival rate in patients with Candida infection and Karnofsky scores greater
      than 20%. Prospective, randomized, controlled trials to determine efficiency of
      rhM-CSF are indicated and should be directed at patients with invasive
      candidiasis.

PMID- 8364196
TI  - A novel 37-Kd adhesive membrane protein from cloned murine bone marrow stromal
      cells and cloned murine hematopoietic progenitor cells.
AB  - The adhesion of hematopoietic progenitor cells to bone marrow stromal cells is
      critical to hematopoiesis and involves multiple effector molecules. Stromal cell
      molecules that participate in this interaction were sought by analyzing the
      detergent-soluble membrane proteins of GBI/6 stromal cells that could be adsorbed
      by intact FDCP-1 progenitor cells. A single-chain protein from GBI/6 cells having
      an apparent molecular weight of 37 Kd was selectively adsorbed by FDCP-1 cells.
      This protein, designated p37, could be surface-radiolabeled and thus appeared to
      be exposed on the cell membrane. An apparently identical 37-Kd protein was
      expressed by three stromal cell lines, by Swiss 3T3 fibroblastic cells, and by
      FDCP-1 and FDCP-2 progenitor cells. p37 was selectively adsorbed from membrane
      lysates by a variety of murine hematopoietic cells, including erythrocytes, but
      not by human erythrocytes. Binding of p37 to cells was calcium-dependent, and was
      not affected by inhibitors of the hematopoietic homing receptor or the cell
      binding or heparin-binding functions of fibronectin. It is proposed that p37 may
      be a novel adhesive molecule expressed on the surface of a variety of
      hematopoietic cells that could participate in both homotypic and heterotypic
      interactions of stromal and progenitor cells.

PMID- 8364197
TI  - Generation of natural killer cells from both Fc gamma RII/III+ and Fc gamma
      RII/III- murine fetal liver progenitors.
AB  - In vitro culture of day-15.5 murine fetal liver (FL) cells in the presence of
      recombinant interleukin-2 (IL-2) results in the expansion of Fc gamma RII/III+
      CD3-Ti-NK1.1+ cells displaying both natural killer (NK) and antibody-dependent
      cell cytotoxicity (ADCC) cytolytic activities. These FL-derived NK cells express
      Fc gamma RIII (CD16) in association with an Fc epsilon RI gamma homodimer on
      their surface. In contrast, in vitro expansion of FL cells in the absence of IL-2
      generates noncytotoxic cells belonging to the myelomonocytic lineage
      (Mac1+Gr1+NK1.1-). Hence, IL-2 appears to be critical for the proliferation and
      differentiation of NK cells from FL progenitors. Experiments in which FL cells
      were fractionated by density gradient centrifugation before in vitro expansion
      showed that NK progenitors are contained within a cell population with a density
      of 1.04 < d < 1.08 g/mL. Cells with d > 1.08 g/mL (representing > or = 40% of FL
      cells) have no such NK progenitor activity. In addition, after intrathymic
      injection into Ly5 congenic host animals, day-15.5 CD4-CD8- FL cells mature into
      CD4+CD8+ thymocytes within 12 days. Interestingly, this T-cell progenitor
      activity is restricted to subpopulations of FL cells that also contain NK
      progenitors, but is absent in high-density (d > 1.08 g/mL) FL cells. Finally,
      fractionation of FL cells according to surface expression of Fc gamma RII/III
      complexes shows that NK (and T-lymphocyte) progenitors are found in both Fc gamma
      RII/III+ and Fc gamma RII/III-FL subpopulations.

PMID- 8364198
TI  - Rescue of W-associated mast cell defects in W/Wv bone marrow cells by ectopic
      expression of normal and mutant epidermal growth factor receptors.
AB  - The normal human epidermal growth factor receptor (EGF-R) (HERc), a chimeric EGF
      R/v-erbB (HERerbB) receptor, and the ligand-independent oncogenic EGF-R variant
      (v-erbB) were used to correct the mast cell defects in W/Wv bone marrow (BM)
      cells. In culture, all three receptor molecules transduced functional mitogenic
      signals in infected interleukin-3 (IL-3)-dependent bone marrow-derived mast cells
      (BMMCs) and enabled their differentiation into safranin-positive mast cells
      resembling connective tissue-type mast cells (CTMCs). Furthermore, expression of
      these receptors restored the capacity of W/Wv BMMCs to colonize the peritoneal
      cavity of mast cell-deficient W/Wv mice where they differentiated to safranin
      positive cells with similar frequencies as wild-type BMMCs. These experiments
      show that expression of normal and mutant EGF-Rs in W/Wv BM cells is able to
      complement the function of the c-kit-encoded Steel factor receptor (SLF-R) in
      mast cell development. We conclude that signal transduction by normal and mutant
      EGF-Rs in murine hematopoietic cells apparently involves components also used by
      the SLF-R, which suggests that these receptors use overlapping pathways for
      signal transduction.

PMID- 8364200
TI  - Role of stromal cells and macrophages in fibronectin biosynthesis and matrix
      assembly in human long-term marrow cultures.
AB  - Fibronectin is a major component of the extracellular matrix of adherent layers
      of human long-term marrow cultures where it may stabilize the extracellular
      matrix network and provide adhesion sites for primitive hemopoietic cells. This
      study was devised to analyze the role of adherent cell populations in fibronectin
      synthesis, matrix assembly, and degradation. In cultures performed under the
      conditions described by Gartner and Kaplan, immunoprecipitation after metabolic
      labeling showed that adherent cells synthesized a fibronectin variant comprising
      the EDa domain and lacking the EDb one. Vascular smooth muscle-like stromal cells
      were the cell subset responsible for this synthesis. Once synthesized by stromal
      cells, EDa+fibronectin was secreted into the supernatant and incorporated into
      the extracellular matrix. The cumulation in the extracellular matrix was
      predominant by weeks 5 and 6 of culture, when a decrease in the stromal cell
      intracytoplasmic content of fibronectin was observed. Stromal cells from a
      transformed cell line, L2Ori-, were also able to synthesize the EDa+fibronectin
      variant, although for these cells the assembly into the extracellular matrix was
      partly impaired. Besides stromal cells, other cell types participated in
      fibronectin synthesis: early-adhering granulomonocytic cells and macrophages
      appearing later in culture were able to synthesize an EDa-, EDb- fibronectin
      variant, clearly distinct from the EDa+ variant produced by stromal cells.
      Studies on cultures in which macrophage growth was stimulated at the expense of
      stromal cells by adding granulocyte-macrophage colony-stimulating factor (50
      ng/mL) to the culture medium showed a striking decrease in amounts of fibronectin
      measured in the adherent layer. This decrease was caused by a lack of
      incorporation of fibronectin in the extracellular matrix, disclosing a major
      difference between stromal cells and macrophages in terms of matrix assembly.
      This study confirms the similarity between stromal cells and vascular smooth
      muscle cells, because in vivo subendothelial intimal aortic smooth muscle cells
      and cultured smooth muscle cells from the aortic media express the EDa+, EDb-
      fibronectin variant. Furthermore, our results suggest that the level of
      fibronectin in adherent layers is regulated by stromal cells and macrophages. The
      balance between these two cell populations may therefore be crucial for the local
      control of hemopoiesis by regulating the extracellular fibronectin available for
      the adhesion of hematopoietic cells. Our data indicate that it may be essential
      to study the adhesion of stem cells to EDa+, EDb- fibronectin instead of EDa-,
      EDb- soluble fibronectin, as found in human plasma.

PMID- 8364199
TI  - Relative contributions of human types 1 and 2 T-helper cell-derived
      eosinophilotrophic cytokines to development of eosinophilia.
AB  - The relative contributions of type 1 and 2 T-helper (Th1 and Th2) cell-derived
      interleukin (IL-5), granulocyte-macrophage colony-stimulating factor (GM-CSF),
      and IL-3 were studied in the regulation of sequential events in the development
      of eosinophilia. Using eosinophils from normal donors and neutralizing antibodies
      that selectively block cytokine activities, we analyzed the effects of these
      cytokines in supernatants (SN) of well-characterized allergen-specific Th2 and
      Th1 T-lymphocyte clones (TLC) generated from atopic and nonatopic individuals,
      respectively. Eosinophil colony formation from CD34+ bone marrow progenitor cells
      in semisolid cultures could be induced both by Th1 and Th2 SN, mainly mediated by
      the synergistic effects of GM-CSF and IL-3, whereas IL-5 had only a minor
      additive effect. High production of mature eosinophils in liquid cultures of
      unseparated mononuclear bone marrow cells could only be induced by Th2 SN, which
      could be more than 90% blocked by anti-IL-5, but not by anti-IL-3 or anti-GM-CSF.
      Chemotaxis of mature peripheral blood eosinophils could equally well be induced
      by Th1 and Th2 SN, although the relative contribution of the individual cytokines
      was clearly different in the two sets of SN. Priming of platelet-activating
      factor (PAF) release by peripheral blood eosinophils was regulated by additive
      effects of the three cytokines and was stronger induced by the Th2 SN than by the
      Th1 SN. The present results indicate that IL-5, GM-CSF, and IL-3 control
      eosinophils throughout the course of development of eosinophilia, having
      different individual contributions in different compartments. The apparent strong
      and selective IL-5-dependence of certain yet undefined steps in eosinophil
      production in the bone marrow supports the concept of the generally assumed
      causal relation between predominant activation of IL-5-producing Th2 cells in
      response to allergens and development of eosinophilia in atopic disease.

PMID- 8364201
TI  - Erythropoietin structure-function relationships: high degree of sequence homology
      among mammals.
AB  - To investigate structure-function relationships of erythropoietin (Epo), we have
      obtained cDNA sequences that encode the mature Epo protein of a variety of
      mammals. A first set of primers, corresponding to conserved nucleotide sequences
      between mouse and human DNAs, allowed us to amplify by polymerase chain reaction
      (PCR) intron 1/exon 2 fragments from genomic DNA of the hamster, cat, lion, dog,
      horse, sheep, dolphin, and pig. Sequencing of these fragments permitted the
      design of a second generation of species-specific primers. RNA was prepared from
      anemic kidneys and reverse-transcribed. Using our battery of species-specific 5'
      primers, we were able to successfully PCR-amplify Epo cDNA from Rhesus monkey,
      rat, sheep, dog, cat, and pig. Deduced amino acid sequences of mature Epo
      proteins from these animals, in combination with known sequences for human,
      Cynomolgus monkey, and mouse, showed a high degree of homology, which explains
      the biologic and immunological cross-reactivity that has been observed in a
      number of species. Human Epo is 91% identical to monkey Epo, 85% to cat and dog
      Epo, and 80% to 82% to pig, sheep, mouse, and rat Epos. There was full
      conservation of (1) the disulfide bridge linking the NH2 and COOH termini; (2) N
      glycosylation sites; and (3) predicted amphipathic alpha-helices. In contrast,
      the short disulfide bridge (C29/C33 in humans) is not invariant. Cys33 was
      replaced by a Pro in rodents. Most of the amino acid replacements were
      conservative. The C-terminal part of the loop between the C and D helices showed
      the most variation, with several amino acid substitutions, deletions, and/or
      insertions. Calculations of maximum parsimony for intron 1/exon 2 sequences as
      well as coding sequences enabled the construction of cladograms that are in good
      agreement with known phylogenetic relationships.

PMID- 8364202
TI  - Evidence for a second type of fibril branch point in fibrin polymer networks, the
      trimolecular junction.
AB  - Fibrin molecules polymerize to double-stranded fibrils by intermolecular end-to
      middle domain pairing of complementary polymerization sites, accompanied by
      fibril branching to form a clot network. Mass/length measurements on scanning
      transmission electron microscopic images of fibrils comprising branch points
      showed two types of junctions. Tetramolecular junctions occur when two fibrils
      converge, creating a third branch with twice the mass/length of its constituents.
      Newly recognized trimolecular junctions have three fibril branches of equal
      mass/length, and occur when an extraneous fibrin molecule initiates branching in
      a propagating fibril by bridging across two unpaired complementary polymerization
      sites. When trimolecular junctions predominate, clots exhibit nearly perfect
      elasticity.

PMID- 8364203
TI  - Oxidative inactivation of plasmin and other serine proteases by copper and
      ascorbate.
AB  - Fibrin thrombi form at sites of injury, where leukocytes release a variety of
      oxidants. To determine whether oxidants might affect proteins of the fibrinolytic
      system, we examined the effects of various oxidants on plasmin. Plasmin was not
      inhibited by micromolar concentrations of hypochlorous acid, chloramine T, or
      H2O2. Neither Fe nor Cu affected plasmin alone or in the presence of H2O2.
      However, incubation of plasmin with 5 mumol/L Cu(I or II) in the presence of the
      reducing agent ascorbic acid resulted in a loss of its hydrolytic activity
      towards proteins as well as towards small synthetic substrates. The addition of
      EDTA, but not mannitol, prevented its inactivation. Inactivation was prevented by
      the addition of catalase and accelerated by hydrogen peroxide. Preincubation of
      plasmin with the competitive inhibitor alpha-N-acetyl-L-lysine methyl ester
      prevented inactivation by Cu(II) and ascorbate. These results together suggest
      site-specific oxidation of plasmin's active site. Treatment of the plasminogen
      activators tissue plasminogen activator and two-chain urokinase-type plasminogen
      activator, as well as trypsin, neutrophil elastase, and thrombin with Cu(II) and
      ascorbate resulted in a loss of their amidolytic and proteolytic activity,
      indicating the general susceptibility of serine proteases to this type of
      oxidation. Oxidation of the zymogens Glu-plasminogen and single-chain urokinase
      type plasminogen activator by Cu(II) and ascorbate resulted in the failure of
      these molecules to generate active enzymes when treated with plasminogen
      activators or plasmin, respectively. The active site His residue may be the
      target of oxidative inactivation, as evidenced by the partial protection afforded
      plasmin by the addition of Zn(II), histidine, or the platinum derivative,
      platinum(II) (2,2':6',2"-terpyridine) chloride. Because platelets contain
      micromolar concentrations of Cu and leukocytes are rich in ascorbate, Cu
      dependent site-specific oxidation might play a role in modulating proteolytic
      events and the life span of thrombi formed at sites of tissue injury.

PMID- 8364204
TI  - Persistent expansions of CD4+ CD8+ peripheral blood T cells.
AB  - CD4+ CD8+ cells are present during T cell differentiation in the thymus. Less
      than 2% of normal T cells that coexpress CD4 and CD8 also are released in the
      circulation and are present in the peripheral blood. In this study, nine
      individuals are described that manifested persistent expansions (11% to 43%) of
      circulating CD4+ CD8+ T cells that in three cases had large granular lymphocyte
      (LGL) morphology in the absence of either lymphocytosis or overt
      lymphoproliferative disorders. Southern blot hybridization of enriched CD4+ CD8+
      cells with T-cell receptor beta (TCR beta) and TCR gamma probes showed that most
      cases had the 12-kb Eco RI germinal band deleted or of decreased intensity. In
      several individuals new TCR beta-specific bands of different intensity and
      distinct from case to case suggested either monoclonal or oligoclonal and
      polyclonal expansions. Immunophenotypic analysis showed that in 7 out of 9 cases
      the CD4+ CD8+ T cells presented with CD8 dim expression. Furthermore, all the
      CD4+ CD8+ cells did not express many of the known activation antigens (low or
      absent CD25, CD38, CD71, HLA-DR), whereas they expressed high levels of CD2,
      CD29, CD56, and CD57. In addition, the CD4+ CD8+ cells of 5 out of 9 subjects
      coexpressed CD45RA and CD45RO suggesting that these cells might be "frozen" in an
      intermediate state between naive and memory T cells. In conclusion, the present
      CD4+ CD8+ cases fall within a larger spectrum of disorders ranging from
      apparently normal to reactive or proliferative situations and encompassing cells
      with LGL morphology or LGL-associated antigens expression either in the presence
      or in the absence of absolute lymphocytosis that deserve careful follow-up
      investigations.

PMID- 8364205
TI  - Synthesis of interleukin-5 by activated eosinophils in patients with eosinophilic
      heart diseases.
AB  - Eosinophilic endomyocardial disease represents a major evolutive risk in chronic
      eosinophilia-associated disorders. Eosinophil granule proteins appear to be
      involved in cardiac injury, but the mechanisms leading to eosinophil infiltration
      and degranulation are not clear. Interleukin-5 (IL-5) has been recently shown to
      be produced by eosinophils and might play a role in both chemoattraction and
      degranulation of eosinophils. In four cases of eosinophilic diseases with severe
      cardiac failure, we evaluated the proportion of eosinophil phenotypes and the
      serum levels of eosinophil cationic protein (ECP) and soluble IL-2 receptor (sIL
      2R), markers of disease activity in the hypereosinophilic syndromes. All four
      patients showed a markedly increased proportion of hypodense eosinophils with
      elevated serum ECP and sIL-2R levels. In all four patients, extracellular
      deposition of eosinophil granule proteins and features of eosinophil activation
      were observed in cardiac tissues. The synthesis of IL-5 by eosinophils was
      detected in myocardial sections and blood cells by in situ hybridization and by
      immunostaining with a monoclonal antibody against human IL-5. Sixty percent to
      90% of tissue eosinophils expressed IL-5 mRNA and IL-5 protein. These data
      suggest that IL-5 can be produced by eosinophils at the sites of myocardial
      tissue damage and might participate in local eosinophil activation.

PMID- 8364206
TI  - Identification, cloning, and characterization of a novel human T-cell-specific
      tyrosine kinase located at the hematopoietin complex on chromosome 5q.
AB  - Signal transduction through the T-cell receptor and cytokine receptors on the
      surface of T lymphocytes occurs largely via tyrosine phosphorylation of
      intracellular substrates. Because neither the T-cell receptor nor cytokine
      receptors contain intrinsic kinase domains, signal transduction is thought to
      occur via association of these receptors with intracellular protein tyrosine
      kinases. Although several members of the SRC and SYK families of tyrosine kinases
      have been implicated in signal transduction in lymphocytes, it seems likely that
      additional tyrosine kinases involved in signal transduction remain to be
      identified. To identify unique T-cell tyrosine kinases, we used polymerase chain
      reaction-based cloning with degenerate oligonucleotides directed at highly
      conserved motifs of tyrosine kinase domains. We have cloned the complete cDNA for
      a unique human tyrosine kinase that is expressed mainly in T lymphocytes (EMT)
      and natural killer (NK) cells. The cDNA of EMT predicts an open reading frame of
      1866 bp encoding a protein with a predicted size of 72 Kd, which is in keeping
      with its size on Western blotting. A single 6.2-kb EMT mRNA and 72-Kd protein
      were detected in T lymphocytes and NK-like cell lines, but were not detected in
      other cell lineages. EMT contains both SH2 and SH3 domains, as do many other
      intracellular kinases. EMT does not contain the N-terminal myristylation site or
      the negative regulatory tyrosine phosphorylation site in its carboxyterminus that
      are found in the SRC family of tyrosine kinases. EMT is related to the B-cell
      progenitor kinase (BPK), which has recently been implicated in X-linked
      hypogammaglobulinemia, to the TECI mammalian kinase, which has been implicated in
      liver neoplasia, to the more widely expressed TECII mammalian kinase, and to the
      Drosophila melanogaster Dsrc28 kinase. Sequence comparison suggests that EMT is
      likely the human homologue of a recently identified murine interleukin-2 (IL-2)
      inducible T cell kinase (ITK). However, unlike ITK, EMT message and protein
      levels do not vary markedly on stimulation of human IL-2-responsive T cells with
      IL-2. Taken together, it seems that EMT is a member of a new family of
      intracellular kinases that includes BPK, TECI, and TECII. EMT was localized to
      chromosome 5q31-32, a region that contains the genes for several growth factors
      and receptors as well as early activation genes, particularly those involved in
      the hematopoietic system. Furthermore, the 5q31-32 region is implicated in the
      genesis of the 5q- syndrome associated with myelodysplasia and development of
      leukemia.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8364208
TI  - T-cell-rich B-cell lymphoma.
AB  - We analyzed 23 cases of T-cell-rich B-cell lymphomas (BCL) to determine if the
      clinical features are characteristic of a discrete entity. Cases encoded as T
      cell-rich BCL in the hematopathology archives of the University of Texas M.D.
      Anderson Cancer Center between 1988 and 1991 formed the basis of this study. At
      least 50% of the total population of cells were required to be of T-cell
      phenotype. Actually, all but one patient had more than 70% T cells in the total
      population. Sixty-five percent of all cases were referred with other diagnosis
      such as Hodgkin's mixed cellularity, peripheral T-cell lymphoma (PTCL), or
      diffuse mixed lymphoma, and had received therapy accordingly. With the exception
      of splenomegaly, which occurred in 35% of cases, the other clinical
      characteristics and the response to therapy did not indicate that this entity
      represents a distinct type of lymphoma. Ann Arbor stage I-II presentations were
      seen in 10 of 23 (43%) T-cell-rich BCLs. Serum lactate dehydrogenase (LDH) was
      elevated in eight of 19 patients. Age, sex, and beta 2-microglobulin were not
      significantly different from classical B-cell large cell lymphoma. The clinical
      presentation and clinical outcome of T-cell-rich BCL did not differ from that of
      common B-cell large cell lymphoma, except for the higher proportion of
      splenomegaly seen in patients with T-cell-rich BCL. The presence of the T-cell
      rich infiltrate varied: it frequently was not seen at relapse or at other sites
      of disease at presentation. It was thus considered an unstable parameter. The
      major importance of identifying this entity is to distinguish it pathologically
      from other disorders such as Hodgkin's disease and PTCL, which would be treated
      in a different manner.

PMID- 8364207
TI  - Lysis of human monocytic leukemia cells by extracellular adenosine triphosphate:
      mechanism and characterization of the adenosine triphosphate receptor.
AB  - The present study shows that extracellular adenosine triphosphate (ATP) has the
      capacity to mediate dose-dependent lysis of the monocytic leukemia cell line THP
      1. The lysis, assessed by 51Cr release, was found to be selective for ATP,
      because adenosine diphosphate (ADP) or other nucleotides were less effective in
      their ability to lyse the cells. The amount of 51Cr released was particularly
      enhanced by the stimulation of the cells with 1,000 U/mL of interferon gamma (IFN
      gamma) for 3 days, and the sensitivity was time and dose dependent. Analysis of
      the mechanism of lysis indicated that the fully ionized form, ATP4-, mediated the
      lysis, because the addition of cation chelators or the absence of the divalent
      cations, Ca2+ and Mg2+, in the culture medium of a 6-hour 51Cr release assay
      increased the percent specific lysis. Therefore, the ATP receptors on THP-1 cells
      were classified as P2Z purinoceptors. Moreover, it is shown here that the
      Ca2+/calmodulin complex plays a role in the regulation of the lysis by
      extracellular ATP of THP-1 cells, because antagonists of this complex, such as
      trifluoperazine or KN-62, were found to inhibit the ATP-mediated cell lysis.

PMID- 8364209
TI  - Effects of agents that inhibit cellular iron incorporation on bladder cancer cell
      proliferation.
AB  - Agents that interfere with cellular iron (Fe) incorporation inhibit tumor cell
      proliferation, including metals that bind to transferrin (Tf) such as gallium
      (Ga) or indium (In) and Fe chelators such as desferrioxamine (DFO). Ga nitrate is
      effective in the treatment of metastatic bladder cancer and these patients
      exhibit evidence for interference with Fe metabolism. We show here that bladder
      cancer cell proliferation in vitro is dependent on Tf-Fe. Concentrations of DFO
      that can be readily achieved in vivo inhibit cellular proliferation even in the
      presence of physiologic concentrations of Tf-Fe. Inhibition of proliferation by
      Tf-Ga is associated with decreased cellular Fe incorporation. However, when a
      physiologic concentration of Tf-Fe is added to an equimolar concentration of Tf
      Ga, significant Fe incorporation is evident despite inhibition of proliferation.
      Thus, besides interference with Fe incorporation, Ga may also interfere with
      intracellular Fe distribution and/or directly inhibit an Fe- (or non-Fe-)
      requiring process necessary for cellular proliferation. DFO followed sequentially
      by Tf-Ga results in marked potentiation of inhibition of proliferation. The
      effects of this combination appear to be related to both interference with Fe
      metabolism and increased Ga uptake. This sequential combination may be useful in
      the treatment of bladder cancer.

PMID- 8364210
TI  - Long-term follow-up of residual disease in acute lymphoblastic leukemia patients
      in complete remission using clonogeneic IgH probes and the polymerase chain
      reaction.
AB  - We sequentially studied bone marrow (BM) samples of 25 patients in complete
      remission of an acute lymphoblastic leukemia (ALL) using a simplified polymerase
      chain reaction (PCR) strategy (direct use of the PCR product as a clonogenic
      probe recognizing rearranged Ig heavy chain sequences) as a first approach. BM
      aspirates were serially investigated after obtention of a complete response. When
      sensitivity was less than 1:10(4), the PCR fragment was sequenced and a specific
      oligonucleotide was synthetized and used as a probe (five cases). Cases in which
      minimal residual disease (MRD) became undetectable were cross-controlled using
      either TCR delta rearrangement or a specific translocation to circumvent the
      problem of false-negative results arising from clonal evolution. The median
      follow-up was 30 months (3 to 51 months). Within the first 3 months of complete
      remission, MRD was detectable in 22 of 23 investigated patients and remained so
      in 19 of 21 patients examined at 6 months, regardless of the long-term clinical
      outcome. In patients remaining in complete remission at 30 months or more, two
      patterns of MRD emerged during the follow-up. Either it continuously decreased to
      ultimately become undetectable (five patients) or remained detectable (five
      patients) with an increase after discontinuation of treatment in two. In the
      eight patients who relapsed, MRD persisted throughout the clinical course, and
      eventually increased 3 to 12 months before relapse was clinically detectable. In
      one case, clonal evolution of the VDJ heavy chain region was observed and
      recurrence of MRD shown by the use of TCR delta rearrangement as a control. We
      conclude that the use of this simplified methodology is a valuable tool for the
      follow-up of MRD in a majority of ALL patients, though in a few cases, sequencing
      needs to be performed to achieve a relevant sensitivity. The possibility of
      clonal evolution requires a cross-control of any sample becoming negative
      whatever the initial rearrangement used to generate a probe. In patients on
      therapy, sequential search for MRD seems to be a good tool for predicting the
      long-term outcome. In addition, patients remaining positive at the time treatment
      is discontinued or with a high tumor burden after a few months therapy may be at
      a higher risk of subsequent relapse, although a longer follow-up is needed to
      answer this question.

PMID- 8364211
TI  - Molecular analysis of VH and VL regions expressed in IgG-bearing chronic
      lymphocytic leukemia (CLL): further evidence that CLL is a heterogeneous group of
      tumors.
AB  - We report the heavy (H) and light (L) chain variable (V) region sequences of
      cDNAs encoding the Ig receptor of two cases of CD5+ IgG-bearing CLL P87 and P103.
      In both CLL cases the H chain was encoded by members of the VH3 gene family. The
      L chain expressed by P87 belonged to the V lambda IV subgroup, whereas P103 used
      a member of the V kappa III subgroup. The VH3.P87 gene differed by only three
      nucleotides from 38P1, a VH3 gene previously cloned from a fetal liver cDNA
      library. Nucleotide sequence analysis demonstrated that the V kappa III.P103 gene
      differed by seven nucleotides from its most homologous germline counterpart, the
      Humkv325 gene, a highly conserved gene frequently expressed in IgM-bearing CLL.
      The nucleotide sequences of VH3.P103 and V lambda IV.P87 could not be reliably
      matched with reported germline V genes. The analysis of multiple independently
      obtained VH and VL cDNA clones from each tumor showed a lack of intraclonal
      diversification. The data show that V regions expressed in isotype-switched CD5+
      CLL may be either in/near germline configuration or somatically mutated.
      Furthermore, these tumors, like their IgM-bearing counterparts, do not seem to
      undergo intraclonal diversification.

PMID- 8364212
TI  - Neutrophils do not bind to or phagocytize human immune complexes formed with
      influenza virus.
AB  - Neutrophils appear to form the first line of defense against influenza virus, yet
      it is unclear how these leukocytes recognize influenza-infected cells. While
      demonstrating that neutrophils adhere specifically to the sialic acid-binding
      site on the hemagglutinin molecule (HA) on the surface of influenza-infected
      (WSN[H1N1]) epithelial cells and not to other viral or epithelial cell antigens,
      it was observed that human neutrophils do not recognize immune complexes formed
      with influenza virus. Intact antibodies (mouse monoclonal antibodies [MoAbs] IgG1
      and IgG2b, human immune heat-inactivated serum [predominantly IgG1], and IgG
      purified from human immune serum) that block the sialic acid-binding site on HA
      significantly reduced (> 80%) neutrophil adherence to influenza-infected
      epithelial cells. Binding and phagocytosis of free influenza virions and
      neutrophil agglutination by influenza virus were completely prevented by these
      antibodies. Intact and F(ab')2 fragments of mouse MoAbs to other viral epitopes
      caused increased neutrophil adherence to infected cells. This binding was
      eliminated by F(ab'2) fragments of MoAbs against the sialic acid-binding site on
      HA, but not by saturating amounts of MoAbs, which block the neutrophil Fc
      receptors. Thus, it appears that human neutrophils show little ability to bind
      via their Fc receptors to the immune complexes formed with antibody and either
      influenza-infected epithelial cells or the free virion. These findings are in
      contrast to the general dogma, and are the first example of antibody opsonization
      reducing, rather than enhancing, neutrophil binding and phagocytosis of a
      pathogen.

PMID- 8364213
TI  - Analysis of delta-globin gene mutations in Greek cypriots.
AB  - We recently described four delta-globin gene mutations in Greek Cypriots studied
      by polymerase chain reaction (PCR) amplification and automated fluorescence-based
      DNA sequence analysis (Blood 78:3298, 1991). Selective restriction enzyme
      digestion of PCR products facilitated direct mutation detection. Twenty-eight
      additional samples from unrelated Cypriots with Hb A2 levels ranging from 0.6% to
      3.6% were studied by PCR and showed the following: twelve had the delta 27 (ala-
      >ser) mutation, one was heterozygous for the delta IVS-2 AG-->GG change, and none
      had either the delta 116 (arg-->cys) or delta 141 (leu-->pro) mutations. The
      remaining samples were divided into two groups: 11 with borderline normal Hb A2
      values that were not pursued; and four with abnormal Hb A2 values. The delta
      globin genes from these four samples were sequenced and the same four changes
      identified in each: a C-->T at -199, a C-->T at codon 4 (thr-->ile), a silent C-
      >T at codon 97, and an AT deletion at position 722 in IVS-2. The codon 4 change
      abolishes a Ple I site whereas the codon 97 creates an Nla III site, thus
      facilitating rapid identification. All four changes are in cis position,
      suggesting that the -199 C-->T, the C-->T at codon 97, and the AT deletion in IVS
      2 are neutral polymorphisms present on the codon 4 (thr-->ile) chromosome. DNA
      haplotype analysis suggests all five delta-globin gene mutant alleles arose
      independently on different chromosomal backgrounds.

PMID- 8364214
TI  - Molecular basis of spectrin deficiency in hereditary pyropoikilocytosis.
AB  - Hereditary pyropoikilocytosis (HPP) is a recessively inherited hemolytic anemia
      characterized by severe poikilocytosis and red blood cell fragmentation. HPP red
      blood cells are partially deficient in spectrin and contain a mutant alpha or
      beta-spectrin that is defective in terms of spectrin self-association. Although
      the nature of the latter defect has been studied in considerable detail and many
      mutations of alpha-spectrin and beta spectrin have been identified, the molecular
      basis of spectrin deficiency is unknown. Here we report two mechanisms underlying
      spectrin deficiency in HPP. The first mechanism involves a thalassemia-like
      defect characterized by a reduced synthesis of alpha-spectrin as shown by studies
      involving synthesis of spectrin in two unrelated HPP probands and their parents:
      One parent carries the elliptocytogenic spectrin mutation, whereas the other
      parent is fully asymptomatic. Peripheral blood mononuclear cells as a source of
      erythroid burst-forming unit (BFUe) were cultured in a two-phase liquid culture
      system that gives rise to terminally differentiated erythroblasts. Pulse-labeling
      studies of an equal number of erythroblasts or morphologically identical maturity
      showed that the synthesis of alpha-spectrin as well as the mRNA levels as
      measured by the competitive polymerase chain reaction (PCR) method are markedly
      reduced in the presumed asymptomatic carriers and the HPP probands. In contrast,
      the synthesis and mRNA levels of beta-spectrin were normal. These results
      constitute a direct demonstration of an alpha-spectrin synthetic defect in a
      subset of asymptomatic carriers of HPP and HPP probands. The second mechanism
      underlying spectrin deficiency involves increased degradation of mutant spectrin
      before its assembly on the membrane. This is evidenced by pulse labeling studies
      of erythroblasts from a patient with HPP associated with a homozygous state for
      spectrin alpha I/46 mutation (leu-pro mutation at AA 207 of alpha-spectrin).
      These studies showed that although spectrin is synthesized in the cytosol in
      normal amounts, the rate of turnover of alpha-spectrin is faster resulting in
      about 40% to 50% reduced assembly of alpha-spectrin and beta-spectrin on the
      membrane. Thus, spectrin deficiency in this case is at least in part caused by
      increased susceptibility of the mutant spectrin to degradation before its
      assembly on the membrane. We conclude that at least two separate mechanisms
      underlie the molecular basis of spectrin deficiency in HPP.

PMID- 8364215
TI  - Elliptopoikilocytosis associated with the alpha 469 His-->Pro mutation in
      spectrin Barcelona (alpha I/50-46b).
AB  - We present two Spanish children with hereditary elliptopoikilocytosis. The mother
      displayed a symptomless elliptocytosis. Spectrin maps showed the alpha I/50-46b
      abnormality in the mother and in the children. The change was more conspicuous in
      the children than in the mother. The father carried the alpha V/41 allele, which
      is a common allele endowed with low expression. The alpha V/41 allele was also
      present in the children accounting for the much more severe expression of the
      alpha I/50-46b variant. The responsible mutation yielding the latter appeared to
      be the alpha 469 His-->Pro substitution (CAT-->CCT), which is a novel
      abnormality. The corresponding spectrin was designated spectrin Barcelona. As is
      often the case in hereditary elliptocytosis or poikilocytosis related to alpha
      spectrin variants, the change involved a helix 3; namely, helix 3 of repeating
      segment alpha 5.

PMID- 8364217
TI  - Rhesus D genotyping using polymerase chain reaction.

PMID- 8364216
TI  - Inhibition of factor VIIa/tissue factor by antithrombin III and tissue factor
      pathway inhibitor.

PMID- 8364218
TI  - Sulfamethoxazole-related antiplatelet antibody.

PMID- 8364219
TI  - Imprinting and loss of ABO antigens in leukemia.

PMID- 8364220
TI  - Expression of phospholamban mRNA during early avian muscle morphogenesis is
      distinct from that of alpha-actin.
AB  - We have studied the expression of phospholamban during the early development of
      chick embryos by in situ hybridization and have compared it to that of alpha
      cardiac and alpha-skeletal actin. In adult cross-striated muscles there is only
      one phospholamban gene and it is expressed exclusively in the heart and slow
      muscles. In the heart phospholamban transcripts were first detected at stage 14
      in the region of presumptive ventricle and at stage 20 in the atrium. In the
      myotomal portion of the somites phospholamban mRNA was first detected at stage
      20, which lagged behind the appearance of the alpha-actins. In the limb rudiments
      all three mRNAs were barely detectable through stage 24, but increased by stage
      28+. However, quantitative analysis of signal intensity at stage 28+ indicated
      that less phospholamban mRNA is present in the limb bud than in the myotome since
      for phospholamban the ratio of the signal density in the myotome to that in the
      limb rudiments was about twice the value of the ratio determined for the alpha
      actins. Northern blot analysis of embryonic day 11 chick fast pectoralis muscle
      showed that phospholamban mRNA was not detected in vivo while alpha-cardiac actin
      mRNA was. Moreover, no phospholamban mRNA was detected in primary cultures
      derived from pectoralis muscle of the same age. In concert with previous
      observations that phospholamban is not detectable at stage 30-32 in wing or thigh
      muscle, these results suggest that phospholamban mRNA is expressed independently
      of the alpha-actins in the limb buds during early myogenesis.

PMID- 8364221
TI  - Differential expression of the two delta-crystallin genes in lens and non-lens
      tissues: shift favoring delta 2 expression from embryonic to adult chickens.
AB  - Chicken argininosuccinate lyase (ASL)/delta-crystallin, a lens enzyme-crystallin,
      is encoded in two linked genes (delta 1 and delta 2); only the delta 2
      polypeptide contains ASL activity. Here we have quantified delta 1- and delta 2
      crystallin mRNA in the lens, cornea, neural retina, heart, and brain at different
      stages of embryonic development and in 1-wk-old and 1-yr-old chickens by the
      polymerase chain reaction using internal delta 1 and delta 2 RNA standards. The
      delta 1/delta 2 mRNA ratio differed for every tissue and was regulated during
      development. In the embryo there was more delta 1 than delta 2 mRNA in the lens
      (50-100 times), cornea (3-4 times), and neural retina (2-20 times), about equal
      amounts of delta 1 and delta 2 mRNA in the heart, and more delta 2 mRNA in the
      brain (15 times). delta 1-Crystallin mRNA differentially decreased in every
      tissue after hatching; by contrast, the delta 2 mRNA remained about the same
      except for the lens, where it decreased 50-fold between 1 wk and 1 yr after
      hatching. In the 1-yr-old chicken, the delta 2/delta 1 mRNA ratios were 7 in the
      lens, 175 in the cornea, 22 in the neural retina, 107 in the heart, and 136 in
      the brain, indicating that delta 2-crystallin is strongly favored in all adult
      tissues of the chicken. The excess of delta 1 to delta 2 mRNA in the embryonic
      lens, cornea, and neural retina is intriguing, and suggests some connection with
      developing transparent eye tissues. Finally, we raise the possibility that
      expression of both delta-crystallin genes may create tetrameric ASL isoenzymes
      (perhaps with different specific activities). The unexpected predominance of
      delta 2 mRNA in the 1-yr-old lens suggests that both the enzymatic and refractive
      functions of ASL/delta-crystallin are operative and spatially separated, with the
      enzymatic role present in the cortical fibers and the refractive role in the
      center of the lens.

PMID- 8364223
TI  - Developmental regulation and cell type-specific expression of the murine gamma F
      crystallin gene is mediated through a lens-specific element containing the gamma
      F-1 binding site.
AB  - The mouse gamma F-crystallin gene, one of six differentially regulated members of
      the gamma-crystallin gene family, is expressed exclusively in central nuclear
      fiber cells of the adult lens. The expression of this gene is controlled through
      regulatory elements contained in two upstream enhancers and the proximal
      promoter. Here we show that while the upstream enhancers and the proximal
      promoter could each direct gene expression in fiber cells formed at early stages
      of lens growth and development, cooperation between these elements is required to
      achieve expression in fiber cells formed at later stages. Evidence is provided
      that cooperative interaction between these elements modulates gene expression by
      increasing promoter strength. We also show that sequences within the proximal
      promoter region that bind lens cell nuclear factor gamma F-1 are sufficient to
      elicit gene expression in central nuclear fiber cells of the adult lens.

PMID- 8364222
TI  - Molecular markers of differentiation in Caenorhabditis elegans obtained by
      promoter trapping.
AB  - Differentiation of specific cell types during animal development can be detected
      by monitoring expression of appropriate genes. For this study, six different beta
      galactosidase expression patterns which can be used as differentiation markers in
      the nematode Caenorhabditis elegans are described. An earlier promoter trap
      screen identified pools of recombinant plasmids which gave patterns of beta
      galactosidase expression when used to transform C. elegans. Each recombinant
      plasmid contained a random fragment of C. elegans genomic DNA fused upstream of a
      promoterless lacZ gene. Six of these pools were chosen, and individual pattern
      producing plasmids within these pools were identified. The expression patterns
      have been characterized more thoroughly than in the original screen, thereby
      providing molecular markers for differentiation of several cell types. Many of
      the expression patterns involve more than one cell type. The genomic origin of
      the inserts of active plasmids were determined through localization on the
      physical genome map.

PMID- 8364224
TI  - Evidence that the border of the neural plate may be positioned by the interaction
      between signals that induce ventral and dorsal mesoderm.
AB  - In the early Xenopus embryo, a quadrant of endodermal cells that have descended
      from the vegetal dorsal localization in the zygote produces signals that pass
      into the animal hemisphere and induce dorsal mesoderm from the marginal zone.
      From the remaining three quadrants of the bordering endoderm, signals pass into
      the animal hemisphere and induce ventral mesoderm in the marginal region. There
      is evidence that suggests that these same mesoderm-inducing signals continue
      through the plane of the tissue of the animal hemisphere where they may at least
      begin the processes of neural and epidermal induction by changing the competence
      of the prospective ectodermal cells, and possibly influencing the early regional
      biasing of later expression of at least some gene products, such as Epi-1 whose
      expression in the future epidermal domain seems specified before gastrulation. We
      hypothesized that the interaction of the ventral and dorsal signals within the
      plane of the tissue of the animal hemisphere may position the border of the
      neural plate. If this is so, then transplantation into the animal pole of cells
      that signal induction of ventral mesoderm should drive the neural plate boundary
      back toward the blastopore and shorten the anterior-posterior axis. Removal of
      cells that induce ventral mesoderm should result in an axis that is longer than
      normal. Results of our experiments support these predictions. Also, by late
      pregastrula stage 9, increasing the ventral signals has no effect. Thus the
      evidence suggests that the position of the anterior neural plate boundary is
      established before gastrulation begins by the interaction of the signals that
      induce the ventral and dorsal mesoderm.

PMID- 8364226
TI  - The expression of xenobiotic-metabolizing cytochromes P450 in fetal tissues.

PMID- 8364225
TI  - gli, a zinc finger transcription factor and oncogene, is expressed during normal
      mouse development.
AB  - The oncogene GLI is amplified and expressed in some cases of human malignant
      glioma and undifferentiated childhood sarcoma and is the prototype for a gene
      family characterized by a highly conserved set of five tandem zinc fingers and a
      consensus cysteine-histidine link. This zinc finger motif has been shown to bind
      DNA with sequence specificity and may mediate transcriptional regulation. Since
      GLI is expressed in embryonal carcinoma cell lines but not in most normal adult
      tissues and shows significant sequence similarity within its zinc finger domain
      to cubitus interruptus dominant (ciD), a Drosophila segmentation gene known to be
      important in the morphogenesis of the posterior portion of each larval segment,
      we established the temporal and tissue expression patterns of the mouse homologue
      of human GLI in day 10 through 18 mouse embryos with Northern blotting, reverse
      transcriptase coupled PCR, and in situ hybridization. gli transcripts were
      demonstrated on days 10 through 18 of mouse embryonic development as well as in
      normal adult uterus, brain, testis, and limb. Tissue expression of gli during
      gestation was demonstrated in Meckel's precartilage mesenchyme, the basis
      occipitus, rib mesenchymal condensations, primordial vertebral bodies, digital
      mesenchymal condensations in forefoot and hindfoot plates, the ependymal layer of
      the spinal cord, and the mesoderm of the gastrointestinal tract. Expression
      persisted throughout gestation in developing bone and cartilage of the
      extremities, the ribs, and the vertebral bodies, as well as the gastrointestinal
      tract mesoderm. These findings support a role for gli family genes in normal
      craniofacial and digital development in mammals first suggested by the
      demonstration of translocation breakpoints within the GLI3 gene in families with
      the Greig cephalopolysyndactylyl syndrome and subsequently by reduced gli3
      expression in the mouse mutant extra toes. It is surprising that a single gene
      would be expressed in such a wide range of mesenchymal structures.

PMID- 8364228
TI  - Use of a polypropylene mesh in fixing a chronic intracerebroventricular cannula.
AB  - Surgical implantation of an intracerebroventricular cannula allows investigators
      to determine the effects of central administration of compounds on
      physiological/pathological events taking place in the periphery. Attempts to
      examine the influence of repeated, chronic drug administration on
      gastrointestinal function have been hampered by the tendency of cannulae to
      become dislodged and lost during the course of such studies. We describe herein
      the insertion of surgical polypropylene mesh between the skull and the fixative
      during surgical implantation of an intracerebroventricular (i.c.v.) cannula. This
      inexpensive addition to a standard surgical procedure extends the period of time
      during which the cannula remains viable for i.c.v. drug administration. Extending
      the active life of the cannula, in turn, allows the investigator to reduce the
      number of animals used.

PMID- 8364227
TI  - A method for the study of swimming stress and stress-induced antinociception in
      preweanling rats.
AB  - Stress-induced antinociception (SIA) which is well characterized in the adult rat
      can also be observed in young rats, and, by varying swimming times, it can be
      dissociated into opioid and nonopioid forms. However, swimming ability in the rat
      does not fully develop until the third postnatal week and this has precluded the
      study of swim SIA in neonates. We report here the development of a harness device
      to aid swimming in young rats which we have successfully employed down to the age
      of 2 days without distress to the animals. Further we have also shown the
      development of the opioid form of swim SIA in the rat using this device. Swim SIA
      is absent at days 2 and 5, but at postnatal day 10 a small level of SIA is
      evident which is reversed by naloxone (10 mg/kg). Swim SIA develops rapidly
      thereafter, and the adult profile is observed by day 25.

PMID- 8364229
TI  - Endothelium inactivation in in vitro perfused vascular beds. Comparison of
      methods.
AB  - In order to choose the best procedure to inactive the endothelium from vascular
      beds perfused in vitro, we compared four methods: perfusion with sodium
      deoxycholate 0.3% for 30 sec; 3-[(3-cholamidopropyl)dimethylammonio]-1-propane
      sulfonate 0.3% (CHAPS) for 2.5 min; collagenase 0.2% for 15 min, and distilled
      water for 10 min, using the mesenteric arterial bed (MAB) of the rat. The
      effectiveness of the treatments used to inactivate the endothelium was assessed
      functionally by using acetylcholine and sodium nitroprusside and histologically
      using light microscopy. Phenylephrine was used to test the contractile properties
      of the preparations after each treatment. After collagenase, distilled water, and
      CHAPS treatment, a potentiated response to phenylephrine was observed, whereas
      sodium deoxycholate treatment did not modify phenylephrine-induced responses.
      Acetylcholine-induced responses were reduced by collagenase (60% reduction),
      CHAPS (30% reduction), and distilled water (52% reduction) treatment, and sodium
      deoxycholate completely abolished acetylcholine-induced responses. Except after
      collagenase treatment, smooth muscle relaxant responses were not altered. Medial
      smooth muscle cells displayed an unchanged morphology, appearing similar to those
      in control mesenteric arterial beds, except for collagenase and distilled water.
      Despite the fact that sodium deoxycholate treatment completely abolished
      acetylcholine-induced response, endothelial cells were still found. No treatment
      totally removed endothelial cells. In conclusion, we suggest that sodium
      deoxycholate treatment is the best procedure to inactivate endothelial cells from
      vascular beds perfused in vitro since it completely abolished endothelium
      dependent relaxation and did not interfere with smooth muscle vasodilating and
      contracting properties.

PMID- 8364230
TI  - A simple and reproducible cerebral thrombosis model in rats induced by a
      photochemical reaction and the effect of a plasminogen-plasminogen activator
      chimera in this model.
AB  - In this study a new model of cerebral ischemia, based on a middle cerebral artery
      (MCA) thrombosis in rats is described. Furthermore, the effect of the novel
      plasminogen activator (SUN9216), a plasminogen-plasminogen activator chimera,
      comprising the fibrin kringle 1 domain of a plasminogen, and the two kringles,
      and the serine protease domains of wild-type tissue plasminogen activator (t-PA),
      including a modification of the mannose glycosylation site on the kringle 1 of t
      PA (PK1de1FE1X), was studied in this model. In the newly described model of
      thrombotic cerebral ischemia, an occlusive thrombus occurred usually within 8 min
      in the MCA as a consequence of an endothelial injury subsequent to a
      photochemical reaction between a systemically administered photosensitive dye
      (rose bengal) and a transillumination of the MCA with a high-intensity green
      light with a wavelength of 540 nm. The study was quantitated by means of
      pathological examination of the MCA and the brain. A platelet-rich thrombus was
      observed in the MCA using electron microscopical analysis based on ion beam
      bombardment. At 24 hr after induction of the thrombus, the brain was removed from
      13 control animals, nine coronal sections were stained from each brain with
      triphenyltetrazoliumchloride (TTC), and the ischemic area was quantitated. A
      constant area of infarction was observed in the cortex and the lateral part of
      the basal ganglia. In a second group (n = 8), at 1 or 8 weeks after induction of
      the thrombosis in the MCA, the coronal sections were stained with hematoxylin and
      eosin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364231
TI  - Gastric mucosal damage due to copper aspirinate.

PMID- 8364232
TI  - The differences between forensic psychiatry and forensic psychology.
AB  - Forensic psychiatry and forensic psychology face a common threat: the erosion of
      their credibility. It is proposed that they can combat this threat better by
      collaboration than by independent efforts. Similarities between the two
      professions are reviewed to examine their potential for collaboration. Their
      differences are reviewed to demonstrate the value of that which they can
      contribute collaboratively, beyond that which either can contribute
      independently, to increasing their credibility in the eyes of the public and the
      courts. Three specific areas for collaboration are proposed: individual practice,
      quality control of expert testimony, and training.

PMID- 8364233
TI  - Effects of professional affiliation on group therapists' confidentiality
      attitudes and behaviors.
AB  - This study examines the influence of group therapists' professional
      characteristics on their attitudes and practices regarding confidentiality.
      Eighty-three highly experienced and well-trained group therapy providers
      representing the fields of psychiatry, psychology, and social work completed a
      survey questionnaire inquiring into their confidentiality practices. Although
      there is considerable consensus between medical and nonmedical practitioners on
      the issues addressed, there are also interesting differences and trends.
      Implications of the findings for clinical practice, ethics training, and
      confidentiality legislation are addressed.

PMID- 8364234
TI  - Major mental disorder and antisocial personality disorder: a criminal
      combination.
AB  - Much evidence now suggests that patients with major mental disorders are at
      increased risk for crimes and violence. Leading experts in forensic psychiatry
      have proposed that the illegal behaviors are a consequence of these major
      disorders. Yet, longitudinal studies have consistently indicated that adult
      criminality is preceded by a childhood history of antisocial behavior. We
      hypothesized that among offenders with major mental disorders there are two
      groups: (1) the first group has a secondary diagnosis of antisocial personality
      disorder (APD), and a childhood history of antisocial and criminal behavior
      preceding the onset of the major disorder; (2) the second group do not meet the
      criteria for APD, and behave criminally only as adults. This hypothesis was
      tested on a representative sample of penitentiary inmates with major mental
      disorders. It was found that those with APD had a significant childhood history
      of criminal activity and antisocial behavior, endorsing, on average, eight of ten
      possible indices. In comparison, the mentally disordered inmates without APD
      endorsed on average two indices. The mentally disordered offenders with APD began
      their criminal careers earlier, and had significantly more convictions and more
      convictions for nonviolent offenses than those without APD. APD was not
      associated with violence among men with major mental disorders.

PMID- 8364235
TI  - The health care proxy for mental illness: can it work and should we want it to?

PMID- 8364236
TI  - How bad is civil commitment? A study of attitudes toward violence and involuntary
      hospitalization.
AB  - Civil commitment statutes throughout the nation authorize involuntary
      hospitalization for persons who are believed dangerous to others, even though
      clinicians' ability to predict violence is imperfect. Decision-makers faced with
      ambiguous evidence about future violence must make either-or decisions about
      involuntary hospitalization. Such decisions can be characterized as "true
      positives" (hospitalization of a person who would have acted violently if
      released), "true negatives" (nonviolent person is not hospitalized), "false
      positive" (nonviolent person is hospitalized), or "false negative" (person is
      released and subsequently acts violently). This paper presents two pilot studies
      of attitudes about false negative and false positive decisions, and explains how
      Decision Theory can use information gleaned from such studies to establish
      optimal decision thresholds for initiating involuntary hospitalization. Subjects
      expressed a broad range of implicit tolerances for false negative and false
      positive predictions. Though most subjects preferred being hospitalized for three
      days to being the victim of a knife-wielding attacker, a substantial minority
      preferred being attacked to being hospitalized. The article briefly explores the
      practical implications of these findings, which include an implicit endorsement
      of stringent commitment policies that would release a large fraction of
      potentially violent persons.

PMID- 8364237
TI  - Screening services in civil commitment of the mentally ill: an attempt to balance
      individual liberties with needs for treatment.
AB  - Screening services are a central feature of New Jersey's new civil commitment
      law. This law, more commonly referred to as the screening law, exemplifies a
      nationwide trend in civil commitment legislation, attempting to balance liberty
      interests and the need to treat the mentally ill. Screening services, designated
      as the preferred process of entry into involuntary hospitalization, were expected
      to prevent unnecessary commitment and to provide community mental health
      services. When deemed necessary, commitment in local general hospitals rather
      than in state mental hospitals was to occur. This paper reports results of a
      study of screening centers that were already in operation in New Jersey prior to
      the implementation of the new law. It assesses the function of screening services
      and their potential impact on the commitment process in light of the objectives
      of the law. Data were obtained from in-depth interviews with key informants from
      the screening centers as well as from their environment, and from statistical
      reports on hospitalizations in state hospitals, admissions to screening centers,
      and admissions to psychiatric inpatient units of general hospitals. Analysis
      suggests that without more resources for alternative community facilities,
      screening services cannot achieve their objectives and the new reform may not
      live up to expectations. Shortage of alternatives to hospitalization and lack of
      incentives to develop and use them appeared to be counterproductive to achieving
      the objectives of the law. The availability of screening service and psychiatric
      units in general hospitals for involuntary hospitalization, on one hand, and the
      lack of alternatives in the community, on the other, may actually lead to
      inappropriate commitments and an increase in the number of civil commitments.
      Furthermore, findings indicated that screeners encouraged hospitalization readily
      even if other, less restrictive environments could have been pursued. Screening
      centers may become "gate openers" instead of playing their expected role as "gate
      keepers."

PMID- 8364238
TI  - Memory processes in children: implications for investigations of alleged child
      sexual abuse.
AB  - Allegations of child sexual abuse naturally raise the ire of the populace at
      large, as well as the fears and apprehensions of those who may be falsely accused
      as perpetrators. Within this emotionally charged and litigious climate, the
      memory functions of children have become a matter of acute interest for those
      professionals involved in the ensuing investigations and legal proceedings. This
      is especially true, given that the child witness, approaching a court of law, is
      likely to encounter numerous circumstances that will invite memory distortion.
      These circumstances include interviews by concerned adults and protective service
      workers, as well as cross-examination by a defense attorney. Well-intentioned
      efforts may be replete with leading questions or subtle inferences that may
      distort episodic memory. The present paper will discuss developmental aspects of
      long-term memory functions in children, events, and cognitive processes that may
      contribute to memory distortion, and recommendations for improving procedures
      related to the investigations of alleged child sexual abuse.

PMID- 8364239
TI  - Toward the therapeutic use of obscene language: a legal and clinical review.
AB  - Obscenity has been the subject of a series of court cases centered around the
      First Amendment, and its interpersonal effects have been studied by
      psychotherapists and communications theorists. But little has been written about
      the impact of the use of obscenity by patients in group settings to discharge
      their feelings and to dominate and harass staff and other patients. The authors
      argue that if staff are to be able to work effectively with patient populations
      who utilize obscenity routinely for these purposes, they must become more
      comfortable with its use, and to treat it as another symptom of the patients'
      interpersonal difficulties. Guidelines for the therapeutic use/management of
      obscenity on the ward are offered.

PMID- 8364240
TI  - The relationship between insight and control in obsessive-compulsive disorder:
      implications for the insanity defense.
AB  - In this paper the authors examine the relationship between insight and control in
      patients with obsessive-compulsive disorder (OCD) in an effort to better
      understand the concept of volitional control of behavior especially as it relates
      to changes in the insanity defense that were recommended by the American
      Psychiatric Association (APA), specifically that the volitional prong be dropped.
      Yale-Brown Obsessive Compulsive Scale ratings in 56 subjects with OCD were
      reviewed with specific attention to items measuring the patients' subjective
      sense of decreased volitional control over their compulsions and their insight
      into their behavior. No statistically significant correlation was found between
      the control over compulsions item and the insight item. The authors conclude that
      the experience of volitional control in patients with OCD is not significantly
      related to the level of insight they have into the irrationality of their
      behavior. The authors then review cognitive therapy literature and show that
      though cognition and volition may appear to be dissociated in some disorders,
      even in the absence of insight, a relatively gross measure of legally relevant
      cognitive disturbance, subtle cognitive changes can be identified in patients
      with seemingly purely volitional disorders such as OCD.

PMID- 8364241
TI  - Infectious diarrhoea. Transmission and epidemiology.

PMID- 8364242
TI  - Mechanisms of diarrhoea.

PMID- 8364243
TI  - Escherichia coli diarrhoea.

PMID- 8364244
TI  - Other bacterial diarrhoeas.

PMID- 8364245
TI  - Infectious diarrhoea. Viruses.
AB  - Increased knowledge has been gained into the aetiology and pathogenesis of viral
      gastroenteritis during the past two decades. There are now thought to be four
      major subclassifications of gastroenteritis-causing viruses; these include
      rotavirus, enteric adenovirus, calicivirus, including Norwalk and Norwalk-like
      viruses, and astrovirus. The association of these agents with gastroenteritis has
      been made by their electron microscopic detection in stool and intestinal biopsy
      specimens from affected patients, the inability to detect the viruses after
      recovery from disease, and the subsequent development of immunoglobulin responses
      after infection; in some instances disease transmission was achieved in human
      volunteers. The association of these viral agents with gastroenteritis has
      facilitated the study of classification, epidemiology, immunity, diagnostic
      tests, methods of treatment and, most importantly, disease prevention strategies
      such as vaccine development for rotavirus. This chapter highlights the major
      features of these agents, with special attention being given to the pertinent
      molecular biology as well as current and future prospects for vaccination.
      Enteric viral infections of the gastrointestinal tract in patients with AIDS are
      also discussed.

PMID- 8364246
TI  - Intestinal parasites.

PMID- 8364247
TI  - Travellers' diarrhoea.
AB  - Although TD is usually a mild and self-limited illness, 30-50% of travellers from
      industrialized to less developed countries are affected. Enterotoxigenic E. coli
      (ETEC) remain the most frequent cause, being identified in 40-70% of cases. TD
      frequently occurs within the first 2 weeks of arrival in the foreign country. The
      clinical manifestation is variable, but watery diarrhoea is the most common
      clinical presentation. Chronic diarrhoea or remitting symptoms after empirical
      therapy in the returning traveller are indications for a stool culture and a
      careful search for stool parasites. Since the major precaution against TD is to
      avoid exposure to the infectious agents, careful selection of food and beverage
      is crucial. Bismuth subsalicylate has been proven to be safe and effective in the
      treatment and prophylaxis of TD. The tablet form has removed the inconvenience of
      previously required luggage space. Doxycycline, trimethoprim/sulphamethoxazole,
      trimethoprim and the quinolones have been shown to be effective for prevention of
      diarrhoea. However, side-effects, superinfection, development of antibiotic
      resistance and easy-to-treat illness may limit the use of these antimicrobial
      agents to those travellers with concomitant serious medical conditions that would
      be adversely affected by diarrhoea, or travellers with unaffordable temporary
      incapacity. A new oral-killed whole-cell and B-subunit cholera toxin vaccine was
      demonstrated to induce protection against severe ETEC-associated diarrhoea. This
      is a promising field under investigation. Finally, fluid replacement is the most
      important aspect of treatment. Patients with moderate to severe TD can be treated
      with one of the above-mentioned antimicrobial agents for 3-5 days. Selection of
      the antimicrobial agent is based on the pattern of resistance and the enteric
      organism prevalent in the geographical area. While TMP-SMX remains active against
      the strains prevalent in Mexico during summertime, the quinolones represent the
      choice for the therapy of diarrhoea acquired in the high-risk areas of South
      America, Africa and Asia.

PMID- 8364248
TI  - Diarrhoea in AIDS and other immunodeficiency states.

PMID- 8364249
TI  - Diagnostic procedures in the investigation of infectious diarrhoea.

PMID- 8364250
TI  - Rehydration and nutritional management.
AB  - Diarrhoea remains a leading worldwide cause of morbidity and mortality. In
      developing countries alone, 1.5 billion episodes of diarrhoea occur per year in
      children under 5 years of age and approximately 4,000,000 of these result in
      death. Early, appropriate therapy decreases the risk of complications and death
      due to diarrhoea. Regardless of the causative agent, oral rehydration and
      nutritional management are the mainstays of good management of infants, children
      and adults with diarrhoea. Diarrhoeal disease control programmes throughout the
      developing world have adopted the WHO case management plan as a standard. In this
      chapter, we review the history, successes and shortcomings of various oral
      rehydration therapies and recommend a case management approach that is similar to
      the WHO plan. Although ORT is safe, effective, convenient and economical, this
      therapy has not been universally implemented in health care settings. The
      challenge for clinical and public health practitioners in developing and
      developed countries is to identify and overcome the barriers that exist so that
      all patients with diarrhoea will have the opportunity to receive optimal care.

PMID- 8364251
TI  - Treatment of gastrointestinal infections.

PMID- 8364252
TI  - Vaccines to prevent enteric infections.
AB  - Considerable progress has been made in the last decade in developing vaccines
      against the enteric infections of greatest public health importance. A
      quadrivalent rotavirus vaccine consisting of rhesus rotavirus vaccine (which
      contains serotype 3 neutralization antigen) and three reassortant viruses (rhesus
      virus expressing neutralization antigens of serotypes 1, 2 or 4) is undergoing
      placebo-controlled field trials of efficacy in the USA and in two developing
      countries. Two new vaccines against typhoid fever (oral Ty21a and parenteral Vi
      polysaccharide) have been licensed in many countries. Even newer generations of
      typhoid vaccines are undergoing clinical testing, including new attenuated S.
      typhi strains and Vi polysaccharide-carrier protein conjugate vaccines. Two
      inactivated oral cholera vaccines, consisting of inactivated V. cholerae O1
      bacteria alone or in combination with purified B subunit of cholera toxin, each
      conferred 50-53% protection over 3 years in a field trial in Bangladesh where
      subjects were immunized with a three-dose regimen. In extensive clinical trials
      in adults and children in less-developed countries, an engineered live oral
      cholera vaccine, strain CVD 103-HgR, has been shown to be well tolerated and
      highly immunogenic following administration of just a single oral dose; a large
      scale field trial in 70,000 subjects is underway to investigate the efficacy of
      this vaccine. Several candidate vaccines against Shigella and enterotoxigenic
      Escherichia coli are in clinical trials. Accumulating knowledge on pathogenesis
      of enteric infections and advances in mucosal and cellular immunology, coupled
      with the application of modern biotechnology, have resulted in a plethora of
      vaccine candidates. It is expected that in future years efforts will be directed
      to construct vaccines against other enteric pathogens.

PMID- 8364253
TI  - Preventive strategies for the avoidance of infectious diarrhoea.

PMID- 8364254
TI  - Effects of 2',2'-difluorodeoxycytidine (Gemcitabine) on wild type and variant
      mouse leukemia L1210 cells.
AB  - 2',2'-Difluorodeoxycytidine (Gemcitabine, dFdCyd) is a cytotoxic agent which is
      active toward a variety of tumor cells. It has been shown that there are multiple
      intracellular sites of action which include ribonucleotide reductase and DNA
      polymerase. In these studies, the effects of dFdCyd on wild-type mouse leukemia
      L1210 cells and variant L1210 cell lines which had alterations at the
      ribonucleotide reductase site or at the deoxyribonucleoside kinase site were
      studied. For cell growth, the IC50 value for dFdCyd in wild-type L1210 cells was
      3.1 nM. In the variant cell lines, the IC50 values were: hydroxyurea-resistant
      (HU), 3.3 nM; deoxyadenosine-resistant (Y8), 1.8 nM;
      pyrazoloimidazole/deoxyadenosine-resistant (ED2), 1.9 nM; and deoxyguanosine
      resistant (dGuo-R), 44.7 nM. The dGuo-R cell line had a relatively specific loss
      of the deoxyribonucleoside kinase responsible for phosphorylating deoxyguanosine
      and cytosine arabinoside with little loss of the deoxycytidine kinase activity.
      DFdCyd had no effect on the total uptake of [14C]cytidine into the cells or
      incorporation into RNA. DFdCyd inhibited the conversion of [14C]cytidine to
      deoxycytidine nucleotides and incorporation into DNA. However, the incorporation
      of cytidine into DNA was inhibited to a greater extent than was the inhibition of
      in situ ribonucleotide reductase activity. Ribonucleotide reductase activity in
      cell-free extracts prepared from L1210 cells treated with dFdCyd (20 nM)
      overnight was reduced by 50%. These results show that cell lines which have
      increased levels of ribonucleotide reductase activity (HU and ED2) or loss of
      feedback inhibition by dATP (ED2 and Y8) are still sensitive to dFdCyd. The
      findings indicate that ribonucleotide reductase is not the primary site of
      inhibition by dFdCyd.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364255
TI  - Carboplatin-liposomes as activators of hematopoiesis.
AB  - Recombinant colony stimulating factors are studied in clinical trials with the
      purpose being the relief of the side effects of high dose chemotherapy and to
      make an optimized treatment regimen possible. The broad use of such factors is
      hindered by their relatively high costs, their short elimination half-lives, the
      occurrence of mild side effects, and the limitation of their action to the
      stimulation of mainly neutrophils. Therefore, exogenous preparations inducing an
      endogenous activation of hematopoiesis are being sought. In experiments in mice
      we have shown that carboplatin-liposomes injected intraperitoneally in a single
      dose of 100 mg/kg led to a strong two-peak increase in white blood cell counts. A
      maximum 10-fold elevation compared to controls of free carboplatin or empty
      liposomes was observed on day 2 and was probably due to the release and
      mobilization of cells from storage compartments. The second peak of about a 6
      fold increase occurred on day 7-8 and can be seen as an indicator of bone marrow
      stimulation. Differentiation of blood cells revealed that neutrophils,
      lymphocytes and platelets multiplied. We presume that this effect of carboplatin
      liposomes is due to a relatively fast uptake of these vesicles by macrophages as
      their natural target. Within these cells carboplatin is metabolized, leading to
      an almost total loss of antineoplastic activity against the murine P388 leukemia.
      Concomitantly, cytokines are apparently induced in and released from macrophages
      producing secondarily hematopoietic growth factors either directly or in
      combination with other cytokines. An involvement of macrophages is indicated by
      the fact that an intraperitoneal pretreatment of mice with zymosan caused a
      partial but significant suppression of hematopoietic stimulation. In an in vitro
      colony forming assay of serum of mice treated 1, 3, or 7 days with carboplatin
      liposomes, the number of colonies increased 20-fold compared to serum from saline
      treated animals. Additionally, a combined intraperitoneal treatment of mice with
      100 mg/kg of cyclophosphamide followed by carboplatin-liposomes one hour later
      demonstrated that prevention of cytostatic-induced leukopenia is possible by this
      method. Although the mechanism of stimulation of hematopoiesis by carboplatin
      liposomes is still partially unknown our results suggest that there should be
      further development of such a preparation for possible use in the treatment of
      cancer or other inherited or acquired hematopoietic disorders.

PMID- 8364256
TI  - Cytoplasmic membrane cholesterol and doxorubicin cytotoxicity in drug-sensitive
      and multidrug-resistant human ovarian cancer cells.
AB  - The possible involvement of cholesterol (CHOL) in the cellular transformations
      leading to the acquisition of the multidrug-resistance (MDR) phenotype has been
      evaluated in human ovarian cancer cells. To this end, the A2780 cell line and the
      52-fold doxorubicin (DX)-resistant counterpart A2780-DX3 were analyzed under two
      different growth conditions: standard culture medium (FCS medium), or medium
      deprived of CHOL (LPDS medium). The following variables were investigated: free
      and esterified cytoplasmic membrane CHOL, cell growth, DX uptake and
      cytotoxicity, and low-density lipoprotein uptake and degradation (as indirect
      variables of CHOL homeostasis). The impact of the calcium antagonist verapamil
      (VER) on these variables was assessed. The results obtained indicate that under
      standard growth conditions, A2780 and A2780-DX3 cells are different not only with
      respect to DX uptake and sensitivity, but also with respect to membrane CHOL
      content and the ratio of free-to-esterified CHOL. The deprivation of lipoproteins
      in the culture medium, apart from slowing cell growth, induced a decrease in the
      cytoplasmic membrane CHOL content (mainly of the esterified form) that was
      particularly evident in A2780 sensitive cells. In LPDS medium, a reduced DX
      uptake occurred in both cell lines, but to a greater extent in A2780 cells, in
      which DX cytotoxicity decreased to values comparable to that of A2780-DX3
      resistant cells. Restoration of DX sensitivity was achieved with the addition of
      10 microM VER.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364257
TI  - Identification of nitrosourea-resistant human rhabdomyosarcomas by in situ
      immunostaining of O6-methylguanine-DNA methyltransferase.
AB  - Cellular levels of O6-methylguanine-DNA methyltransferase (MGMT) correlate
      strongly with cellular resistance to carcinogenic and chemotherapeutic agents
      that produce adducts at the O6-position of guanine in DNA. Although biochemical
      and molecular assays can indicate the average MGMT content of tissues or tumors,
      they cannot distinguish mixed populations of cells, such as those that exist in
      tumor biopsy samples. We have determined MGMT at the cellular level in a panel of
      pediatric rhabdomyosarcoma xenografts by in situ immunostaining with a human MGMT
      specific antibody employing a very sensitive procedure that involves biotin
      avidin coupled horseradish peroxidase with silver-enhanced diaminobenzidine
      nickel staining. Two xenograft tumor lines known to be MGMT-deficient were not
      stained, whereas the nuclei in three MGMT-expressing lines were clearly stained.
      This is the first demonstration of an in situ procedure that discriminates drug
      sensitive MGMT-deficient tumors from drug-resistant MGMT expressing tumors. This
      procedure should prove useful, therefore, for predicting the susceptibility of
      tissues and tumors to O6-guanine alkylating agents.

PMID- 8364258
TI  - Reference listings in cancer research.

PMID- 8364259
TI  - Drug-related hospital admissions.
AB  - OBJECTIVE: To review and summarize studies reporting rates of drug-related
      hospital admissions. DATA SOURCES: Manual and computerized literature searches
      using MEDLINE, Index Medicus, and International Pharmaceutical Abstracts as
      databases (key words: drug, drug-related, or iatrogenic; admission, hospital
      admission, or hospitalization; and ADR or adverse drug reaction). References from
      retrieved articles were searched to locate further studies. STUDY SELECTION:
      Included were English-language studies of humans admitted to the hospital because
      of medications. Problems investigated were admissions prompted by adverse drug
      reactions (ADRs) when drugs were used by the patient and admissions resulting
      from a patient's noncompliant or unintentionally inappropriate drug use. Excluded
      were cases involving drug abuse, alcoholism, suicide attempts, intoxication, or
      inadequate prescribing. DATA SYNTHESIS: Between 1966 and 1989, ADR rates from 49
      hospitals or groups of hospitals in a variety of international settings were
      published in 36 articles. Samples sizes ranged from 41 to 11,891 patients, with a
      median of 714 (interquartile range [IQR] 275-1245) and a mean of 1412 (SD 2233).
      The prevalence of reported admissions resulting from ADRs ranged from 0.2 to 21.7
      percent; the median was 4.9 percent (IQR 2.9-6.7 percent) and the mean was 5.5
      percent (SD 4.1 percent). The weighted meta-analytic estimate was 5.1 percent (95
      percent confidence interval 4.4-5.8). Of those ADR admissions, 71.5 percent were
      side effects, 16.8 percent excessive effects, 11.3 percent hypersensitivity
      reactions, and 0.4 percent idiosyncratic; 3.7 percent of patients admitted for
      ADRs died. Eleven reports indicated that 22.7 percent of ADR hospitalizations
      were induced by noncompliance. CONCLUSIONS: Drug-induced hospitalizations account
      for approximately five percent of all admissions. Results apply only to people
      from highly developed industrialized countries. Economic analyses have not been
      performed. Future research should include the Third World and nonindustrialized
      nations as well as specific cultural groups.

PMID- 8364260
TI  - Comparative trial in volunteers to investigate possible ethanol-ranitidine
      interaction.
AB  - OBJECTIVE: To assess the effect of ranitidine on ethanol absorption after ethanol
      0.5 g/kg is given in three single doses of 0.167 g/kg to simulate normal social
      drinking. DESIGN: A double-blind, placebo-controlled, crossover trial was
      performed in 16 healthy men. Ethanol serum concentrations were measured on day 6
      of each of the three treatment periods (placebo, ranitidine 150 mg bid, or
      ranitidine 300 mg bid). METHODS: Ethanol 0.167 g/kg was administered followed by
      a standard meal at 1700. The last tablet of the test medication was given 15
      minutes later. Thirty and 60 minutes after the first intake, the same amount of
      ethanol was given again. Serum ethanol concentrations were measured multiple
      times during the four-hour period following oral ingestion of the first dose.
      RESULTS: Comparison of median serum ethanol concentrations, the areas under the
      curve, peak and time to peak serum ethanol concentrations showed no significant
      differences during medication with placebo, ranitidine 150 mg bid, or ranitidine
      300 mg bid. Peak ethanol concentrations (median values) were 153, 140, and 155
      mg/L, respectively. CONCLUSIONS: This study shows that treatment with ranitidine,
      in a dose up to 300 mg bid, has no significant effect on serum ethanol
      concentrations, even when ethanol was given in divided doses to simulate normal
      patterns of social drinking. This implies that concomitant dosing with ranitidine
      will not increase the adverse effects of moderate doses of ethanol on
      concentration and psychomotor function.

PMID- 8364261
TI  - Theophylline disposition following parenteral feeding of malnourished patients.
AB  - OBJECTIVE: To investigate the effect of parenteral nutrition on theophylline
      disposition in malnourished patients. DESIGN: Before-after trial. SETTING:
      Tertiary care center. PATIENTS: Ten patients with historic, anthropometric, and
      laboratory evidence of malnutrition. INTERVENTIONS: Patients received two 5-mg/kg
      intravenous infusions of theophylline separated by at least 48 hours of glucose
      based parenteral nutrition providing the entire estimated nutritional
      requirements. MAIN OUTCOME MEASURES: Following each theophylline administration,
      serum theophylline samples were collected over a 24-hour period for delineation
      of maximum plasma concentrations, volume of distribution, elimination rate
      constant, clearance, and area under the curve. RESULTS: Peak plasma theophylline
      concentrations were significantly lower prior to feeding (5.3 mumol/L, 95 percent
      confidence interval [CI] 0.78-10.0 mumol/L, p = 0.028). Volume of distribution
      decreased after parenteral feeding (0.08 L/kg, 95 percent CI 0.006-0.15 L/kg, p =
      0.037). The elimination rate of theophylline increased after parenteral feeding
      reflected by an increase in the elimination rate constant (0.06 h-1, 95 percent
      CI 0.01-0.10 h-1, p = 0.023). CONCLUSIONS: This study suggests that parenteral
      nutrition using a glucose-based solution acutely influences theophylline
      disposition in malnourished patients.

PMID- 8364262
TI  - Pharmacists' interventions using an electronic medication-event monitoring
      device's adherence data versus pill counts.
AB  - OBJECTIVE: To compare adherence data from an electronic medication-event
      monitoring device (MEMS, Aprex) with pill counts in assisting pharmacists in
      making recommendations regarding diabetes therapy. DESIGN: Two-month, double
      blind, randomized, controlled trial. SETTING: Veterans Affairs Medical Center
      ambulatory care clinics. PATIENTS: Forty-seven patients with poor to fair
      metabolic control of diabetes mellitus were enrolled. Patients were excluded if
      they were receiving insulin, had a concurrent infection, required child-resistant
      caps or medication remainder devices, or could not return for followup visits.
      Twenty patients were randomized to the MEMS and 27 to the control group (pill
      counts). Fasting plasma glucose concentrations were measured monthly and
      glycohemoglobin concentrations were measured at baseline and 60 days. Thirty-two
      patients were evaluable: 15 using MEMS and 17 using pill counts. INTERVENTION:
      Investigators made pharmacologic or educational recommendations to the patient's
      healthcare provider based on both laboratory data and MEMS readings in the
      treatment group or laboratory data and pill counts in the control group. MAIN
      OUTCOME MEASURE: Quantities and types of recommendations regarding diabetes
      therapy made by pharmacists using adherence data from the two methods were
      tabulated. RESULTS: In the MEMS group, 47 percent of the recommendations related
      to patient education compared with 12 percent in the control group (p = 0.028).
      MEMS data would have changed four recommendations in the control group to involve
      patient education. CONCLUSIONS: MEMS data resulted in different numbers and types
      of recommendations than pill counts. Pharmacists then could make specific
      recommendations regarding patient education before resorting to pharmacologic
      manipulations.

PMID- 8364263
TI  - Design, implementation, and use of a new antimicrobial order form: a descriptive
      report.
AB  - OBJECTIVE: To describe the development, implementation, and use of an
      antimicrobial order form. The article provides the design of the form and the
      rationale for including key aspects, and a report of the authors' experiences
      with the form over a three-year period. An analysis of compliance with the form
      and its impact on selected prescribing practices is also presented. DESIGN: Three
      thousand five hundred antimicrobial orders in four discrete sets over a three
      year period were analyzed to assess compliance and characterize prescribing
      patterns with respect to duration of therapy and dosing frequency. SETTING: The
      setting of the study was a 300-bed, university-affiliated, tertiary-care,
      teaching hospital. MAIN OUTCOME MEASURES: Analysis of the forms was organized
      into the following sections: (1) compliance with use of the form, (2) duration of
      therapy, and (3) impact on antimicrobial dosing intervals. RESULTS: Use of the
      form was essentially 100 percent. Seventy-eight percent of the forms had all
      required data elements completed in the period following implementation; this
      fell to 67 percent at the end of three years. Duration of surgical prophylaxis
      went beyond the recommended 24 hours in 10 percent of all cases in period 1, and
      in 18, 8, and 4 percent in periods 2, 3, and 4, respectively. Declines in
      inappropriate dosing frequency were seen with cefazolin (from 14 to 2.3 percent),
      ceftriaxone (from 23 to 4 percent), cefuroxime (from 21 to 0 percent), and
      clindamycin (from 43 to 7 percent). CONCLUSIONS: Our experience with
      implementation and use of the form was very positive. Significant difficulties
      with compliance were not encountered. Benefits of the form included reductions in
      the duration of surgical prophylaxis and in the frequency of inappropriate dosing
      intervals.

PMID- 8364264
TI  - Response to pancuronium after loss of atracurium-induced neuromuscular blockade.
AB  - OBJECTIVE: To describe a previously unreported event in which a patient became
      refractory to atracurium-induced neuromuscular blockade, but subsequently was
      adequately paralyzed with a standard dosage of pancuronium. CASE SUMMARY: A
      previously healthy 17-year-old woman who sustained multiple trauma developed
      tolerance to an atracurium infusion she was receiving while undergoing mechanical
      ventilation. On day 3 of neuromuscular blockade, she became unresponsive to
      atracurium as evidenced by excessive physical movement, increased peak airway
      pressures, and overbreathing assist control ventilation. Repeat boluses and
      increases in the atracurium infusion rate to a maximum of 1.27 mg/kg/h failed to
      provide a desired clinical response. A bolus dose of pancuronium 0.15 mg/kg was
      administered and the constant infusion was then changed to pancuronium 0.078
      mg/kg/h. Within minutes, decreased respirations, peak airway pressures, and
      agitation were noted. The pancuronium infusion rate was then tapered to 0.045
      mg/kg/h over 72 hours and continued to maintain adequate neuromuscular blockade.
      DISCUSSION: Potential pharmacokinetic and pharmacodynamic causes of loss of
      neuromuscular blockade in this patient are postulated. Possible explanations for
      loss of neuromuscular blockade include increased degradation of atracurium and/or
      a change in acetylcholine receptor physiology. CONCLUSIONS: The development of
      resistance to a specific neuromuscular blocking agent in the intensive care
      setting does not necessarily imply cross-tolerance or resistance to alternative
      agents. Also, loss of respiratory control by one neuromuscular blocking agent may
      be overcome by changing agents.

PMID- 8364265
TI  - Evaluation of plasmapheresis in the treatment of an acute overdose of
      carbamazepine.
AB  - OBJECTIVE: To report the use of plasmapheresis in the treatment of an acute
      overdose of carbamazepine. CASE SUMMARY: A 21-year-old black man was admitted
      unresponsive and combative following a carbamazepine overdose. The total body
      load of carbamazepine was approximated at 5.91 g using an assumed volume of
      distribution of 1.4 L/kg. The patient underwent three plasmapheresis treatments.
      A total of only 335.82 mg of carbamazepine was removed by this process.
      DISCUSSION: Case reports in the literature were reviewed and compared.
      Carbamazepine concentrations lack correlation with the clinical outcome. Our
      patient's symptoms were consistent with the Weaver classification system.
      Carbamazepine clearance increased by almost 70 percent above its natural
      clearance during plasmapheresis. However, a significant rebound effect was
      observed after plasmapheresis: 40.1 percent after the first and 18.3 percent
      after the second treatment. CONCLUSIONS: Plasmapheresis did not seem to have a
      great impact on the patient's clinical status. Under the circumstances we find it
      extremely difficult to recommend plasmapheresis in the treatment of an acute
      overdose of carbamazepine.

PMID- 8364266
TI  - Intrathecal administration of amikacin for treatment of meningitis secondary to
      cephalosporin-resistant Escherichia coli.
AB  - OBJECTIVE: To report a case of gram-negative bacillary meningitis (GNBM)
      secondary to cephalosporin-resistant Escherichia coli that was treated with
      intrathecal and intravenous amikacin and intravenous imipenem/cilastatin (I/C).
      CASE SUMMARY: A patient who had undergone two recent neurosurgical procedures
      developed GNBM and bacteremia. He was treated empirically with ceftazidime. Both
      bloodstream and cerebrospinal fluid isolates were identified as E. coli,
      resistant to third-generation cephalosporins, penicillins, tobramycin, and
      gentamicin. The patient was subsequently treated with intravenous and intrathecal
      amikacin plus intravenous I/C. He experienced subjective and objective
      improvement on days 2-4 of antimicrobial therapy; two generalized tonic-clonic
      seizures occurred on days 7 and 12. Intrathecal amikacin was discontinued after 6
      days, and intravenous amikacin and I/C were discontinued after 23 and 27 days,
      respectively. The patient's mental status did not completely return to
      premeningitis baseline. DISCUSSION: Third-generation cephalosporins are the
      treatment of choice for GNBM. In the case reported herein, bacterial resistance
      to these agents prompted the use of a therapy that has not been well studied and
      is also considered to be less safe and perhaps less efficacious. Treatment of
      GNBM with an intrathecally administered aminoglycoside or with intravenous I/C
      plus an aminoglycoside is reviewed. CONCLUSIONS: Patients with GNBM secondary to
      third-generation cephalosporin-resistant organisms may require therapies that may
      be less effective and more toxic. Further study of alternative agents is
      warranted.

PMID- 8364267
TI  - Acute verapamil toxicity in a patient with chronic toxicity: possible interaction
      with ceftriaxone and clindamycin.
AB  - OBJECTIVE: To report a case of acute toxicity in a patient with chronic verapamil
      toxicity, possibly precipitated by intravenous administration of the highly
      protein-bound drugs ceftriaxone and clindamycin. DATA SOURCES: Case reports,
      review articles, and relevant laboratory and clinical studies identified by
      MEDLINE (1984-forward), and relevant cross references from those articles. DATA
      EXTRACTION: Data were abstracted from pertinent sources by one author and
      reviewed by the remaining authors. CASE SUMMARY: A 59-year-old man who had been
      receiving sustained-release verapamil 240 mg q12h for more than two years for
      hypertension, and phenytoin 300 mg/d for many years for prophylaxis against
      seizures, was noted to be in junctional rhythm when he presented to the emergency
      room with bilateral pneumonia. Administration of intravenous ceftriaxone 1 g and
      clindamycin 900 mg precipitated symptoms of acute verapamil toxicity in this
      patient. The toxicity led to complete heart block requiring cardiopulmonary
      resuscitation and insertion of a temporary pacemaker. He spontaneously reverted
      to normal sinus rhythm after 16 hours. Subsequent cardiac evaluation, including
      echocardiogram, 48-hour dynamic electrocardiographic recording (Holter), and
      exercise stress test were normal. The patient has remained in sinus rhythm for
      more than one year after this episode. CONCLUSIONS: We believe that junctional
      rhythm on admission was a result of chronic verapamil toxicity. This may have
      been because of increased bioavailability of the drug or increased sensitivity of
      the receptors. Administration of ceftriaxone, clindamycin, or both agents might
      have precipitated acute verapamil toxicity by displacing verapamil from its
      protein-binding sites. Extreme caution is necessary when a highly protein-bound
      drug is given to a patient already receiving verapamil.

PMID- 8364268
TI  - Cefuroxime-induced fever.
AB  - OBJECTIVE: To report on three patients with cefuroxime-induced fever. CASE
      SUMMARIES: Recurrence of fever was noted in three patients after five to seven
      days of cefuroxime sodium therapy for acute exacerbation of chronic obstructive
      pulmonary disease. No source of infection was found and the fevers resolved
      within 30 hours of drug discontinuation. One patient was rechallenged; the same
      pattern of fever resulted. DISCUSSION: Fever secondary to cephalosporin
      administration is reviewed and the place of cephalosporins in the differential
      diagnosis of fever is postulated. CONCLUSIONS: Cefuroxime should be added to the
      list of cephalosporins that induce fever.

PMID- 8364269
TI  - Baclofen-induced bronchoconstriction.
AB  - OBJECTIVE: To report the occurrence of acute bronchospasm in one asthmatic
      patient and increased bronchial reactivity in another following the
      administration of a single dose of oral baclofen. CASE SUMMARY: On two separate
      occasions, a 46-year-old asymptomatic asthmatic man developed dyspnea and chest
      tightness one hour after the ingestion of baclofen 40 mg. Pulmonary function
      studies revealed a significant decrease in airflow relative to baseline. A 33
      year-old asymptomatic woman with a history of exercise-induced dyspnea and
      wheezing displayed bronchial hyperresponsiveness to inhaled metacholine 2 hours
      after ingesting 40 mg of baclofen. The patient had had a negative methacholine
      challenge test 72 hours earlier. DISCUSSION: The gamma-aminobutyric acid-agonist
      baclofen has been shown to reduce airway responsiveness to various
      bronchoconstricting agents in animal studies. The etiology of this seemingly
      paradoxical response in two patients is unclear, but may offer insight into the
      neurally mediated airway constriction that occurs in asthma. CONCLUSIONS:
      Clinicians should be aware of the possibility of baclofen-induced bronchospasm,
      especially in asthmatic patients.

PMID- 8364270
TI  - Clindamycin-induced lip and nasal passage swelling.
AB  - OBJECTIVE: To report a severe case of clindamycin-induced lip and nasal passage
      swelling. DESIGN: Single case report. SETTING: Six hundred eighty-four-bed
      community hospital. CASE SUMMARY: A 34-year-old, insulin-dependent diabetic white
      man with worsening cellulitis and osteomyelitis of the left great toe was
      admitted for treatment with intravenous antibiotics. Intravenous clindamycin was
      the first agent administered. Within 5 minutes after initiating the drug (600-mg
      dose) the patient began to sneeze and his eyes began to tear and itch. Within 10
      minutes, his lips and nasal passages began to swell. By the end of the infusion
      (approximately 20 min), the patient's lips were severely swollen and his nasal
      passages were completely closed off secondary to the swelling. The patient did
      not have difficulty breathing through his mouth and denied any shortness of
      breath. He did not develop a rash. His vital signs remained stable and no
      pharmacologic agents were administered for this reaction. No subsequent doses of
      clindamycin were given and complete resolution of all symptoms occurred within 24
      hours. CONCLUSIONS: Severe lip and nasal passage swelling is an uncommon adverse
      reaction associated with the use of intravenous clindamycin. We believe this to
      be the first published case of nasal passage swelling and only the second case
      reporting lip edema associated with the intravenous form of this agent.
      Clinicians should be aware of this uncommon but potentially severe reaction.

PMID- 8364271
TI  - Effect of heat treatment of potentially infected blood samples on therapeutic
      drug monitoring of selected drugs.
AB  - OBJECTIVE: To investigate the effect of heart treatment on the outcome of drug
      analysis in whole blood and serum for eight drugs routinely assayed for
      therapeutic monitoring. DESIGN: All blood and serum samples (n = 373) received at
      the pharmacy laboratory for therapeutic monitoring of carbamazepine, digoxin,
      gentamicin, kanamycin, phenobarbital, phenytoin, theophylline, and valproic acid
      were heated at 60 degrees C for 30 minutes. Serum was subsequently assayed by
      fluorescence polarization immunoassay (TDx). SETTING: The study was conducted at
      the analytical laboratory of the pharmacy, using standard laboratory procedures.
      MAIN OUTCOME MEASURES: Analyses of heated samples were compared with analyses of
      untreated samples using a paired Wilcoxon signed-rank test. RESULTS: Serum
      concentrations of phenytoin from treated whole blood, and gentamicin in treated
      serum, were significantly lower than in untreated samples. These differences,
      however, were small, clinically irrelevant, and lie within assay variation
      intervals. Heat treatment did not influence the outcome of analyses for
      carbamazepine, digoxin, kanamycin, phenobarbital, theophylline, and valproic
      acid. CONCLUSIONS: Heat treatment of whole blood and serum samples of the
      investigated drugs does not influence the outcome of drug analysis, although drug
      instability cannot be fully excluded. Heat treatment can protect laboratory
      technicians from HIV infection without influencing therapeutic monitoring of
      these drugs.

PMID- 8364272
TI  - Hematologic effects of ethanol consumption in trauma patients.
AB  - OBJECTIVE: To determine the effects of ethanol (EtOH) ingestion by trauma
      patients on the hematologic system as evidenced by coagulation abnormalities and
      transfusion requirements. DESIGN: Retrospective chart review. The injury severity
      score (ISS) was determined for each patient. Patients were grouped according to
      presence of EtOH (+EtOH) and absence of EtOH (-EtOH) with further subdivision
      based on an ISS < or = 8 or > or = 9. SETTING: University medical center.
      PATIENTS: All adult trauma patients admitted during a one-month period. MAIN
      OUTCOME MEASURES: The volume of resuscitation fluids (including blood products)
      administered, laboratory parameters indicative of bleeding, and length of stay.
      RESULTS: Of 104 evaluable patients, 38 had measurable EtOH concentrations, 46 had
      undetectable EtOH concentrations, and the remaining 20 patients had not been
      tested. Although isolated, statistically significant differences were found among
      groups for some of the outcome measures, there were no clinically important
      differences. CONCLUSIONS: EtOH ingestion prior to injury did not appear to cause
      significant alterations in the hematologic system of trauma patients, but a
      larger study is needed to confirm these findings.

PMID- 8364274
TI  - Amantadine and fatigue of multiple sclerosis.

PMID- 8364273
TI  - Accuracy of vancomycin serum concentrations in patients with renal failure.

PMID- 8364275
TI  - Use of tricyclic antidepressant concentrations to determine individual response.

PMID- 8364277
TI  - Current issues surrounding women and minorities in drug trials.
AB  - OBJECTIVE: Our principal objective is to make readers aware of conflicting
      demands placed on investigators and the pharmaceutical industry regarding
      inclusion of women and minorities in clinical research. Tremendous pressures have
      been placed to expedite the drug approval process. Moreover, during the last
      decade certain segments of society, particularly women and minorities, have
      demanded greater participation in clinical drug trials and earlier access to
      investigational drug therapies. Regulations that have served the clinical
      research community (pharmaceutical industry, investigators, institutional review
      boards) as guidelines for safe conduct of human clinical trials are being
      challenged by social and political change. This article provides an overview of
      some of the controversy relative to federal regulations governing clinical
      trials; scientific concerns; social, political and legal trends; and ethical
      principles applied to human clinical research. DATA SOURCES: Literature for this
      paper was retrieved from a variety of sources including the nonmedical press,
      editorials, peer-reviewed journals, Department of Health and Human Services
      regulations, National Institutes of Health policy, the Belmont Report, and
      regulations of the Food and Drug Administration. DATA SYNTHESIS: Scientists
      evaluating new therapeutic agents ask specific research questions to assess
      safety, efficacy, and the mechanism(s) of action. Because of concerns for
      scientific validity, safety, liability, and convenience, many early evaluations
      of new drugs involve patient populations that may not represent the ultimate
      users of a new drug. Federal regulations and ethical principles allow certain
      groups of people to be excluded from early research proposals because they are
      thought to be putting themselves at greater risk by participating than are other
      groups. However, women, minorities, and other populations are demanding greater
      access to investigational drugs. The focus has changed from protection from
      research risks and burdens to the potential benefits a person or class of people
      may obtain by participating in a study. CONCLUSIONS: Scientists, the
      pharmaceutical industry, regulators, and society must agree on a safe and
      efficient mechanism for new drug development that permits more equitable
      participation of subjects in the various phases of research.

PMID- 8364276
TI  - Leukotriene-receptor antagonists and 5-lipoxygenase inhibitors in asthma.
AB  - OBJECTIVE: To familiarize readers with a potentially new class of compounds for
      treating asthma. Background information on leukotrienes is provided in addition
      to an in-depth review of pertinent clinical trials. DATA SOURCES: Information was
      obtained from controlled clinical trials, abstracts, and review articles
      identified through a MEDLINE search of English-language articles. STUDY
      SELECTION: Emphasis was placed on early clinical trials that showed some benefit
      with these compounds as well as more recent studies using newer agents that
      produced more promising results. DATA EXTRACTION: Information regarding
      leukotriene biochemistry was extracted from basic science research and data from
      human studies were evaluated by the authors according to patient selection, study
      design, methodology, and therapeutic response. DATA SYNTHESIS: Leukotrienes have
      a pathophysiologic role in asthma. Two distinct but pharmacologically similar
      classes of leukotriene inhibitors are currently being clinically evaluated. These
      are leukotriene receptor antagonists and 5-lipoxygenase inhibitors. Early
      clinical trials with these agents yielded unfavorable results primarily because
      of lack of drug potency and selectivity, poor patient tolerance, and possibly the
      route of administration. Subsequent studies with more potent and selective agents
      have further implicated leukotrienes as biochemical mediators in asthma and,
      consequently, have shown promising clinical outcomes with respect to pulmonary
      function testing and patient tolerance. CONCLUSIONS: Advancements in the
      pathogenesis of asthma are beginning to define a role for the leukotrienes.
      Although more studies are needed to assess the efficacy of leukotriene
      inhibitors, recent clinical trials using leukotriene-receptor antagonists and 5
      lipoxygenase inhibitors indicate a potential for the expansion of therapeutic
      regimens currently used in the treatment of asthma.

PMID- 8364278
TI  - Vancomycin administration into the cerebrospinal fluid: a review.
AB  - OBJECTIVE: To discuss administering vancomycin directly into the cerebrospinal
      fluid (CSF) to treat serious central nervous system (CNS) infections. DATA
      SOURCES: References were obtained through an online search of MEDLINE, limited to
      material published in English. In addition, information was extracted from
      clinical trials, review articles, abstracts, and textbooks. STUDY SELECTION:
      Systematic evaluation of this topic in humans has not been done in a prospective
      manner. Related research articles describing the pathophysiology of CNS
      infections, intrathecal drug administration, and case reports of CSF vancomycin
      administration were reviewed. DATA EXTRACTION: Case reports regarding CSF
      vancomycin dosing were evaluated and included: drug dosing, infecting organism,
      infectious disease state, infectious outcome, CSF dynamics/flow abnormalities,
      methods of drug administration, drug monitoring, and toxicities. DATA SYNTHESIS:
      The results of this review are based on qualitative evaluations of anecdotal case
      reports and a basic understanding of intrathecal and intraventricular drug dosing
      principles. CSF administration of vancomycin is an effective means of bypassing
      the blood-brain barrier to achieve greater drug concentrations within the CSF.
      Current limitations to the CSF administration of vancomycin include a lack of
      data describing its safety, efficacy, and pharmacokinetics. CONCLUSIONS: CNS
      infections may require the CSF administration of vancomycin for successful
      eradication. Recommendations for dosing in the literature vary. Because of the
      potential toxicities associated with elevated CSF concentrations of vancomycin,
      dosing should be conservative.

PMID- 8364279
TI  - Assessment of patient acceptance and inhalation technique of a pressurized
      aerosol inhaler and two breath-actuated devices.
AB  - OBJECTIVE: To assess inhalation technique in patients after written instruction
      alone, written and verbal instruction, and clinical use of two new inhalation
      devices. DESIGN: Randomized, crossover evaluation of the albuterol Diskhaler and
      the terbutaline Turbuhaler. SETTING: Canadian tertiary-care hospital. PATIENTS:
      Twenty hospitalized adults with asthma or chronic obstructive pulmonary disease
      currently using an albuterol metered-dose inhaler (MDI). Nineteen patients
      received Diskhaler, 16 received Turbuhaler, 15 received both inhalers, and 10
      patients used both inhalers for three days each. INTERVENTIONS: Patients were
      randomized to receive either Diskhaler or Turbuhaler for three days. Inhaler
      technique was assessed after written instruction, written plus verbal
      instruction, at the first scheduled dose after instruction, and after three days
      of clinical use. Patients remaining in the hospital after three days crossed over
      to the other study inhaler and the same protocol was followed. MAIN OUTCOME
      MEASURES: Patient inhalation technique was assessed and compared for the MDI,
      Diskhaler, and Turbuhaler. RESULTS: Assessment of MDI technique revealed that 35
      percent of patients used their MDI correctly on the first puff, and 42 percent
      used it correctly on the second puff. Following written instruction alone,
      correct technique was demonstrated by 32 percent of patients with Diskhaler and 6
      percent with Turbuhaler. Technique significantly improved following verbal
      instruction, although 40 percent of the patients required up to three attempts to
      demonstrate correct technique on at least one of the study inhalers. After three
      days of clinical use, correct technique was demonstrated in only 54 percent of
      the Diskhaler and 64 percent of the Turbuhaler assessments. Performance at this
      assessment was, however, significantly better on the Turbuhaler than on the MDI
      (p = 0.01). Performance on the Diskhaler was not significantly different from the
      performance on the other inhalers. CONCLUSIONS: Written instruction alone is
      inadequate in teaching correct inhalation technique. Verbal instruction and
      technique assessment are essential for patients to achieve proper technique.
      Patients may perform better on the Turbuhaler than on other inhalation devices.

PMID- 8364280
TI  - Controversies in the management of Mycobacterium avium complex infection in AIDS
      patients.
AB  - OBJECTIVE: To update readers on the clinical management of infections secondary
      to Mycobacterium avium complex (MAC) in patients with AIDS. A general description
      of the organism, culture and susceptibility testing, and clinical manifestations
      of the disease is provided. Several aspects of the treatment of the disease,
      including an historical perspective, current approaches, and future research
      opportunities, are described. DATA SOURCES: Current medical literature, including
      abstracts presented at international meetings, is reviewed. References were
      identified through MEDLINE, Current Contents, and published meeting abstracts.
      STUDY SELECTION: Data regarding the epidemiology, clinical manifestations,
      culture and susceptibility testing, and treatment of MAC are cited. Specific
      attention is given to the management of patients with MAC infection. DATA
      EXTRACTION: Information contributing to the discussion of the topics selected by
      the author is reviewed. Data supporting and disputing specific conclusions are
      presented. DATA SYNTHESIS: Disseminated MAC infection is diagnosed antemortem in
      approximately 30 percent of patients with AIDS; postmortem rates of isolation
      exceed 50 percent. The incidence of MAC may increase as attempts at isolating the
      organism become more aggressive. The traditional approach to the isolation,
      susceptibility testing, and treatment of MAC has been derived from the management
      of Mycobacterium tuberculosis, with disappointing results. Newer radiometric in
      vitro methods of susceptibility testing appear to show more promise. Current
      mouse models of MAC are not true AIDS models; new CD4-deficient mouse models are
      being developed. Clinical mycobacteriologic and pharmacokinetic laboratory
      support have been underused, with treatment generally proceeding empirically. New
      agents that may contribute to the management of disseminated MAC infection
      include the macrolide derivatives clarithromycin and azithromycin. Research also
      continues with new rifamycins (including rifabutin) and fluoroquinolones
      (ciprofloxacin, sparfloxacin). Preliminary results suggest a central role for
      macrolides in the treatment of disseminated MAC; effective companion drugs are
      needed to prevent the rapid emergence of macrolide-resistant MAC. CONCLUSIONS:
      Treatment results for disseminated MAC infection remain poor. Therapy may be
      improved by selecting drugs on the basis of susceptibility data for each isolate,
      rather than by using empiric regimens based on susceptibility trends. Significant
      antimycobacterial drug malabsorption has been documented, and may contribute to
      poor outcomes. More-potent agents are needed to improve the clinical outcome in
      AIDS patients with MAC.

PMID- 8364281
TI  - Erythromycin-induced hypoacusis: 11 new cases and literature review.
AB  - OBJECTIVE: To report 11 cases of possible erythromycin-induced hearing loss and
      to review all cases reported in the literature. CASE SUMMARY: In the 11 cases
      reported, the following are reviewed: age, gender, time to onset of and recovery
      from hypoacusis in relation to erythromycin administration, presence or absence
      of renal or hepatic disease, underlying disorders, and concurrent administration
      of other drugs. Hypoacusis appeared with dosages equal to or higher than 4 g/d in
      patients with a mean age of 52.5 +/- 19 years, a high percentage of whom (45
      percent) presented with renal impairment. The hearing loss was reversible in all
      cases, and subsided a few days (median = 3) after dosage reduction or drug
      discontinuation. DISCUSSION: Our patients' characteristics are similar to those
      of patients reported in the literature. Most data indicate that erythromycin
      induced hypoacusis is a dose-dependent effect; however, its occurrence in
      patients otherwise free from disposing factors suggests that it is idiosyncratic.
      CONCLUSIONS: Erythromycin administered for appropriate indications and dosage
      adjustments in patients with impaired renal and/or liver function may prevent or
      reduce the incidence of erythromycin-induced hypoacusis.

PMID- 8364282
TI  - Pharmacoepidemiology of bleeding events after use of r-alteplase or streptokinase
      in acute myocardial infarction.
AB  - OBJECTIVE: To determine in nonresearch, general medical practice conditions the
      comparative incidence and types of bleeding complications after the use of
      streptokinase (SK) and r-alteplase (recombinant tissue plasminogen activator, rt
      PA) to treat acute myocardial infarction (AMI). DESIGN: Retrospective medical
      record review of concurrently treated patients (96-hour observation
      posttreatment) in 32 participating hospitals in the US. MAIN OUTCOME MEASURES:
      The medical record description of all bleeding events regarding the body site
      affected, changes in hemoglobin concentrations, blood products administered, and
      clinical outcome (permanent sequelae or death). Bleeding severity was determined
      by defined criteria. CONTROL DATA: Comorbidity and concomitant medications (e.g.,
      aspirin, heparin, warfarin) likely to predispose or contribute to bleeding events
      were analyzed. DATA ANALYSIS: Logistic regression analysis. RESULTS: Data from
      419 patients who received rt-PA and 207 who received SK were evaluated. In the 96
      hour period after initiation of thrombolytic therapy, 30.5 and 31.9 percent of rt
      PA and SK patients, respectively, experienced one or more bleeding events (crude
      risk ratio [CRR] = 1.04; 95 percent confidence interval [CI] 0.91-1.14; p =
      0.73). In the first 24-hour period, 21.5 percent of rt-PA and 15.9 percent of SK
      patients experienced bleeding events (CRR = 0.74; 95 percent CI 0.42-1.15; p =
      0.08). The leading types of bleeding and percents of all patients affected were:
      perivascular access site (18.4 percent), gastrointestinal (6.4 percent),
      skin/soft tissue/muscle (5.0 percent), urinary (3.4 percent), pulmonary (2.2
      percent), systemic (1.9 percent), and oral (1.4 percent). Intracranial bleeding
      occurred in 4 rt-PA and 2 SK patients; 4 of these patients died. Events deemed
      clinically significant occurred in 15 rt-PA and 9 SK patients (3.8 percent of all
      patients). Ten patients likely died from these events, 6 within the first 24
      hours. Three rt-PA patients and 1 who received SK (0.6 percent) died of
      cerebrovascular events within the first 24 hours. After controlling for
      demographic factors and therapeutic variables, using logistic regression
      analyses, no thrombolytic-related differences were found in the incidence or
      severity of bleeding following use of the two thrombolytics. CONCLUSIONS: These
      clinical data do not support a theoretical advantage of rt-PA to cause less
      bleeding propensity than SK.

PMID- 8364283
TI  - Computerized monitoring protocols as a pharmaceutical care practice enhancement:
      a conceptual illustration using diabetes mellitus.
AB  - OBJECTIVE: To illustrate how a computer system used in an ambulatory care
      pharmacy setting might enhance care of patients with diabetes by prospectively
      monitoring and prompting them to seek routine medical care. DATA SOURCES: A
      MEDLINE search to identify existing works on informatics was conducted. An
      epidemiology and general medical literature review of diabetes mellitus was also
      performed via MEDLINE. Additionally, known textbooks on the disease were
      consulted. CONCLUSIONS: Programming a computer system to prompt pharmacists to
      remind their patients of necessary medical interventions could save medical
      resources by warning chronically ill patients not to ignore routine medical care.
      Also, this would allow the pharmacist to prospectively monitor patient outcomes.
      By knowing when medical interventions are due and obtaining feedback from
      patients on the results of the medical contact, pharmacists increase their
      knowledge about patient outcomes and the rationale behind changes in
      pharmacotherapy. It is expected that such a system would prevent the
      inconspicuous development of chronic complications.

PMID- 8364284
TI  - Ceftazidime dosing in the elderly: economic implications.
AB  - OBJECTIVE: This study evaluated the prevalence and resulting costs of ceftazidime
      dosing in excess of product labeling recommendations in elderly hospitalized
      patients. Ceftazidime is a beta-lactam antibiotic excreted via glomerular
      filtration. According to product labeling, ceftazidime dosing can frequently be
      decreased in the elderly because glomerular filtration declines with age.
      METHODOLOGY: A multicenter, retrospective utilization audit involving 11 US
      academic medical centers examined 221 medical records of patients 65 years of age
      or older receiving ceftazidime (any brand, any indication). The creatinine
      clearance of each patient was estimated using the Cockcroft-Gault formula.
      RESULTS: Renal insufficiency, defined as an estimated creatinine clearance of
      less than 50 mL/min, was present in 111 of the patients (50 percent). Ceftazidime
      dosing in excess of product labeling recommendations was noted in 75 of those 111
      (68 percent). The cost of excess ceftazidime dosing for those 75 patients (i.e.,
      extra drug acquisition, preparation, administration) was $13,822.50. CONCLUSIONS:
      Although the dosage of ceftazidime required in a specific patient is based on
      many factors, ceftazidime is frequently overdosed in the elderly because renal
      function is not considered. Ceftazidime dose-adjustment in the elderly, based on
      the estimated creatinine clearance, can lead to cost savings. In the US, where
      hospital reimbursement by Medicare is based on diagnosis, institutions can
      realize direct cost savings.

PMID- 8364285
TI  - Gender and racial bias in clinical pharmacology trials.

PMID- 8364286
TI  - Prescription of antimicrobial drugs to hospitalized children.
AB  - OBJECTIVE: To analyze with regard to age, gender, and diagnosis, the profile,
      frequency of prescribing, and cost of antimicrobial drugs (AMDs) in hospitalized
      children. DESIGN: Retrospective study of medical records of children hospitalized
      during 1987 and 1988. SETTING: First Pediatric Clinic, Children's Teaching
      Hospital, Bratislava, Czechoslovakia (now Slovakia). PATIENTS: One thousand
      randomly selected hospitalized children. MAIN OUTCOME MEASURES: Patterns of AMD
      prescribing. Consumption is expressed by the number of drugs and cost per child.
      RESULTS: AMDs were prescribed to 69.9 percent of the patients (average 1.91 per
      patient). Ampicillin was the drug most frequently prescribed (20.0 percent),
      followed by oxacillin (12.8 percent). The mean length of stay was 15.9 days. An
      average of 3.61 drugs from other pharmacotherapeutic categories were prescribed
      per patient. Most children who received AMD treatment were in the 1-year group
      (patients between six months and 1.5 years of age [88.6 percent]). CONCLUSIONS:
      This study provides an overview of the prescribing of AMDs and other drugs in
      hospitalized children in Bratislava.

PMID- 8364287
TI  - Use of theophylline to control hematocrit in respiratory polycythemia.

PMID- 8364289
TI  - Perforation of colon diverticula during corticosteroid therapy for pemphigus
      vulgaris.

PMID- 8364288
TI  - Ketorolac and gastrointestinal ulceration.

PMID- 8364290
TI  - Clonidine-induced hyperglycemia in a young diabetic girl.

PMID- 8364291
TI  - Hydrocortisone-colestipol interaction.

PMID- 8364292
TI  - Treatment of cavernous hemangioma with vincristine.

PMID- 8364294
TI  - Gemfibrozil-induced impotence.

PMID- 8364293
TI  - Drug utilization evaluation of imipenem/cilastatin in patients with renal
      dysfunction.

PMID- 8364296
TI  - AHNA certificate program in holistic nursing courses. AHNA certificate program in
      healing touch courses.

PMID- 8364295
TI  - Comment: aminoglycoside dosing considerations.

PMID- 8364297
TI  - The right to die: who should choose?

PMID- 8364299
TI  - Talking to patients about sexual matters.
AB  - Specific counselling skills that will assist nurses in discussing sexual matters
      with patients can be learned. The possession of such skills by nurses will
      enhance the nurse/patient relationship and encourage patients in the era of
      HIV/AIDS, to discuss their concerns about sexual issues more openly. This article
      describes the place of conversation about sexual matters with patients.

PMID- 8364300
TI  - Treatment and prevention of hypothermia.
AB  - The onset of winter is the time when many voluntary agencies begin their
      campaigns regarding the dangers of the cold upon the elderly population. It is
      also the time when accident and emergency nurses treat the highest proportion of
      such people presenting in various degrees of accidental hypothermia. This article
      outlines the care required and highlights the health education advice needed to
      minimize the problem.

PMID- 8364298
TI  - Is quality assurance just a theoretical pedestal?

PMID- 8364301
TI  - Therapist self-disclosure in behavioural psychotherapy.
AB  - Therapist self-disclosure has been poorly defined until recently. This article
      presents a model of verbal self-disclosure and relates it to both client-centred
      therapy and counselling as social influence. The implications for behavioural
      psychotherapy are then reviewed.

PMID- 8364302
TI  - Prevention and management of pressure sores.
AB  - Continuity of care is needed when transferring patients at risk of developing
      pressure sores. The tools used to assess such patients must be consistent. A
      turning clock system has been developed for use with the patient.

PMID- 8364303
TI  - Management of lymphoedema: a community-based approach.
AB  - The community-based Enfield Lymphoedema Service received over 100 referrals in
      its first year, which suggests that it is suitably sited in the community.
      Patients have been offered previously unavailable information and treatment,
      while health care professionals have gained an improved awareness of and insight
      into lymphoedema and its treatment.

PMID- 8364305
TI  - Nurses should welcome a wider scope of practice.

PMID- 8364304
TI  - Quality management in a college of nursing and midwifery.
AB  - Colleges of nursing and midwifery are experiencing great change in their working
      environment and are now expected to offer cost-effective, high quality training
      and education. Mid Trent College of Nursing and Midwifery has met the challenge
      by introducing quality management strategies. This article explores their
      development.

PMID- 8364306
TI  - The living will: implications for nurses.
AB  - In certain states in the USA there has been, for some time, the right in law for
      patients who are terminally ill to declare their 'living will'. This article
      examines the concept of the living will and the situation surrounding euthanasia
      in Britain and Europe. Its aim is to give nurses further insight into and greater
      understanding of the possible future use of a living will.

PMID- 8364308
TI  - Nurses must adapt to changes in hospital psychiatric care.

PMID- 8364307
TI  - Legal aspects of first aid and emergency care: 2.
AB  - The first article in this series examined the nurse's duty to act at the scene of
      an accident. This article explores this theme further by looking at the legal
      implications and the four arenas of accountability.

PMID- 8364309
TI  - Nurses are wrong to outlaw all ritualistic practices.

PMID- 8364310
TI  - The role of nurses in counselling the terminally ill patient.
AB  - Facing one's own death is emotional, traumatic and frightening. Nurses can help
      patients and their families to cope with this crisis through the sensitive use of
      counselling skills. In so doing they will also become more aware of their own
      beliefs and feelings surrounding the subject.

PMID- 8364311
TI  - Attitudes of professionals to drug abusers.
AB  - Drug abusers are generally regarded as a demanding client group by health care
      professionals. The occupational background of health care professionals and their
      familiarity with drug users is likely to affect their emotional responses and
      attitudes. Professional carers who are more familiar with drug users, e.g.
      addiction counsellors and psychiatric nurses, tend to have a more positive
      attitude. Awareness of HIV infection may increase the fears and anxieties of
      professionals, resulting in a more negative attitude to drug users. Little
      research has been carried out into the attitudes of professional carers,
      particularly nurses, towards drug users. Attitudes of professional carers are
      very important in determining standards of care delivery and more research is
      needed into the effects of attitudes on the delivery of health care.

PMID- 8364312
TI  - Dimensions of nursing knowledge in wound care.
AB  - There is continuing debate as to whether nursing is an art or a science. This
      seems to be further fuelled by discussion about whether nursing is a profession.
      If nursing could be called a research-based science, would it become a recognized
      profession and be taken more seriously? This article relates the art/science
      debate to the teaching of wound care in clinical practice.

PMID- 8364313
TI  - Management of chronic obstructive airways disease.

PMID- 8364314
TI  - Can nurses take an accurate blood pressure?
AB  - It is over 20 years since the Briggs (1971) report extolled the virtues of
      nursing becoming a research-based profession. However, despite progress having
      been made towards achieving a research base, studies all too rarely inform
      nursing practice. This article offers a number of explanations for this failure
      and demonstrates the benefits of research by examining nurses' knowledge of the
      factors that are important in taking an accurate blood pressure reading.

PMID- 8364315
TI  - Accountability in nurse education.
AB  - Accountability has assumed a higher profile in these changing times and clearly
      this multifaceted concept is inextricably linked to professionalization. In
      addition, major changes have taken place in nurse education, resulting in role
      changes for the nurse teacher. Consequently, nurse teachers will have to examine
      more closely the many facets of accountability.

PMID- 8364316
TI  - Nurse practitioner title: ambiguous and misleading.

PMID- 8364317
TI  - Legal aspects of first aid and emergency care: 3.
AB  - The first and second articles in this series considered whether there was a duty
      in law to volunteer help when there was no pre-existing duty to do so and
      discussed the standard of care that should be followed. This article examines the
      volunteer's rights if he/she is injured while assisting at an accident.

PMID- 8364318
TI  - Who deserves care?

PMID- 8364319
TI  - When is holism not complementary?

PMID- 8364320
TI  - Introducing high quality infection control in a hospital setting.
AB  - Hospital infection is a quality issue and as such has become an important topic
      in the current health care debate. Quality assurance and resource management are
      becoming integral to the measurement of nursing standards in clinical practice.
      Quality assurance is, in many ways, inseparable from effective infection control.
      This article outlines the development of such a high profile demonstration unit
      named Quality Infection Control (QIC) and discusses its strengths and weaknesses.

PMID- 8364321
TI  - Preoperative ophthalmic procedures: ritualistic or necessary?
AB  - Routine ophthalmic nursing tasks are often seen as unnecessary, degrading the
      skill of the ophthalmic nurse in assessing, planning and implementing the care of
      the patient. Many ophthalmic departments have discontinued such tasks, but the
      reasoning and the consequences do not appear to have been documented.

PMID- 8364322
TI  - Discovering theory from psychiatric nursing practice.

PMID- 8364323
TI  - Home administration of intravenous antibiotics to children with cystic fibrosis.

PMID- 8364324
TI  - Analysis of the concept of holism within the context of nursing.
AB  - There is a need to define the term holism within the context of nursing in order
      to provide a common basis for practice. This article uses concept analysis and
      concept reassurance to clarify the use and meaning of the word holism.

PMID- 8364325
TI  - Ethical and legal issues in suicide.
AB  - Nurse-patient encounters are influenced by the law and by morality. These
      frequently overlap and hold certain principles in common, such as justice and
      rights. Despite such close connections, the law and morality do not necessarily
      correspond. The difficulty in and complexity of reaching the right and just
      decision in the healthcare setting often highlight this.

PMID- 8364326
TI  - Nurse-aid management of oral and maxillofacial emergencies.
AB  - Oral and maxillofacial emergencies can be very alarming and distressing to
      patients. This article introduces nurse aiders to the oral and maxillofacial
      specialty and explains the management of some oral and maxillofacial emergencies.

PMID- 8364327
TI  - American monitoring: standard and state of the art.
AB  - Monitoring of the anesthetized patient, the anesthesia machine, and the patient
      machine interface is an essential component of anesthetic practice in order to
      prevent anesthetic-related injuries resulting from equipment failure or human
      error. While the optimal monitor to detect anesthetic problems (hypoxia,
      esophageal intubation, hemodynamic compromise, for example) is unclear at
      present, American standards require continuous presence of qualified personnel
      who evaluate patient oxygenation, ventilation, circulation, and temperature. A
      common monitoring array includes electrocardiogram, autosphygmomanometer, pulse
      plethysmography/oximetry, stethoscope, anesthetic gas analyzer, thermistor, and
      nerve stimulator. The role of emerging technologies, including transesophageal
      echocardiography, automated electrocardiographic analysis of ST segments,
      transcranial Doppler, and transcranial near infrared spectroscopy are discussed.

PMID- 8364328
TI  - [Transesophageal echocardiography for evaluating left ventricular function].
AB  - By means of transesophageal echocardiography it is now possible to assess and to
      monitor left ventricular function during anesthesia and surgery. Furthermore, the
      determinants of the left ventricular function (preload, afterload and
      contractility) can also be evaluated in real time. Based on this information, a
      specific therapy can be started immediately should ventricular function become
      inadequate. In addition to global function, regional ventricular function can be
      analyzed at the same time. The detection of regional wall motion abnormalities
      can be most helpful for anesthetic management of patients with coronary heart
      disease and for the diagnosis of intraoperative myocardial ischemia.

PMID- 8364329
TI  - [Monitoring the right ventricle: methods and relevance].
AB  - For long, the right ventricle (RV) has been looked upon as a passive conduit of
      blood, which does not contribute to overall myocardial performance. While this is
      true under physiological conditions, it has been recognized only recently that an
      intact RV may be of crucial importance for the maintenance of cardiocirculatory
      stability under pathophysiological circumstances, e.g. in patients with increased
      pulmonary vascular resistance (PVR). Hence, several techniques have been
      developed to monitor RV function in these patients. With respect to the
      monitoring of RV preload, the validity of parameters based on pressure
      measurement (e.g. central venous pressure, RV end-diastolic pressure) is limited
      by the nonlinearity of the RV pressure-volume relationship, changes of RV
      compliance (e.g. ischemia, drugs), and changes of intrathoracic pressure. The
      measurement of RV end-diastolic volume (RVEDV) or size provides a more accurate
      estimation of true RV fiber preload and is currently performed using the fast
      response thermodilution technique. The exact quantitation of RV afterload
      requires the continuous assessment of RV pressure, geometry and wall thickness,
      which is not possible in the clinical setting. Mean pulmonary artery pressure
      (PAP and PVR may roughly reflect actual RV afterload under physiological
      conditions. However, neither PAP nor PVR take into account changes of afterload
      due to changes of RV size. With respect to RV contractility, none of the
      techniques presently available for its measurement is both valid and suitable as
      a tool for clinical monitoring.

PMID- 8364331
TI  - [Synopsis of the newest regulations for hemotherapy: consequences for physicians
      and hospital insurance].

PMID- 8364330
TI  - Blood pressure versus blood flow.
AB  - The pressure-volume diagram of the left ventricle is fundamental to understanding
      the mechanics of contraction and its modification by disease, drugs and
      anaesthetics. For monitoring patients perioperatively, we advocate variables
      derived from the pressure-volume diagram: cardiac output to monitor circulatory
      failure, pulmonary capillary wedge pressure to monitor the acute state of left
      ventricular filling and echocardiography to determine the chronicity and severity
      of chronic heart failure. Use of the pressure-volume diagram shows that whenever
      arterial pressure is raised by the use of vasoconstrictor agents, the flow of
      blood to the tissues is impaired. In patients in whom the heart is damage or
      failing, this adverse effect of raising arterial pressure causes further
      deterioration of circulatory failure and flow. In view of the prime need of the
      body tissues for blood flow, together with oxygen and substrates, it is advocated
      that vasoconstricting agents should not be used to maintain arterial pressure in
      the perioperative period. Plasma expansion and control of posture are preferred
      methods for maintaining the circulation. If circulatory failure continues in the
      presence of a high filling pressure of the left ventricle (wedge pressure), drugs
      combining positively inotropic and vasodilator properties are advocated.

PMID- 8364332
TI  - Accuracy of blood sampling through central venous lines in intensive-care unit
      patients.
AB  - OBJECTIVE: In intensive-care unit (ICU) patients it is common practice to sample
      blood from central venous lines (CVL). This study was designed to answer the
      question on how much blood has to be aspirated through the CVL before the actual
      blood sample is taken to get accurate laboratory findings. DESIGN AND SETTING:
      Simultaneous blood samples from a peripheral vein (intraindividual control) and 5
      ml portions from a CVL up to 25 ml were analyzed. PATIENTS: 5 patients of an
      internal ICU participated in the study. RESULTS: For the analyzed 24 different
      parameters it could be shown that after aspirating 10 ml of blood, the results
      are comparable to analyses from peripheral vein samples. CONCLUSIONS: Although
      blood sampling from a CVL--after aspiration of 10 ml blood--results in correct
      laboratory analyses, this procedure leads to a greater amount of blood loss and,
      hence, cannot be recommended in long-term ICU treatment.

PMID- 8364333
TI  - Posttransfusional changes of 2,3-diphosphoglycerate and nucleotides in CPD-SAGM
      preserved erythrocytes.
AB  - BACKGROUND: Posttransfusional changes of preserved red blood cells can influence
      the oxygen equilibrium curve which is mainly affected by the concentration of
      erythrocyte 2,3-diphosphoglycerate (DPG). MATERIAL AND METHODS: The regeneration
      kinetics of DPG and nucleotides (ATP, ADP, AMP, GTP, GDP) was determined over a
      period of 0-48 h in surgically treated patients following transfusion of DPG
      depleted packed red cells stored for 14 days in CPD-SAGM. RESULTS: 3 h after
      transfusion the DPG levels raised up to 40% of the patients' prior DPG
      concentrations. Complete regeneration of the DPG concentrations occurred 36-48 h
      after transfusion. Changes in the nucleotide pattern indicate, after a temporary
      decrease of ATP and GTP levels (after 10-30 min) and an activation phase (after 3
      12 h), the full regeneration of these parameters 24-48 h after transfusion.
      CONCLUSIONS: The regeneration kinetics of DPG should be taken into consideration
      for transfusions with blood units stored for more than 14 days, especially in
      patients with reduced compensatory mechanisms (coronary and cerebral scleroses,
      pacemaker, etc.) and large transfusion volumes.

PMID- 8364334
TI  - Assessment of the Fc function in human immunoglobulins for intravenous
      administration. Multicenter study of the section 'Blood plasma Constituents' of
      the German Association for Transfusion Medicine and Immunohematology (DGTI).
AB  - BACKGROUND: The working group 'Blood plasma Constituents' of the DGTI has carried
      out a multicenter study with human immunoglobulins for intravenous administration
      (IVIG). The aim of the ring study was the determination of the reproducibility of
      the IVIG Fc function method proposed for the European IVIG monograph. MATERIAL
      AND METHODS: Eight laboratories from Europe participated in this ring study. The
      test of Fc function was carried out according to a standardized procedure.
      RESULTS: The results showed good consistency between the participating
      laboratories. The reproducibility of the method showed coefficients of variation
      of 5-10%. CONCLUSIONS: All commercial IVIG preparations met the requirement of
      the Fc function of > or = 80% in relation to the Fc function of the standard, an
      immunoglobulin preparation for intramuscular (i.m.) administration.

PMID- 8364335
TI  - [Comments on HIV antigen screening of blood donors].

PMID- 8364336
TI  - Uncovering the ethic of care.

PMID- 8364337
TI  - The name of the journal "Praxis" becomes more than it appears.

PMID- 8364338
TI  - Nursing: towards a positive future.

PMID- 8364339
TI  - The experience of parenting a child with glue ear.

PMID- 8364340
TI  - Lessons from a cervical screening programme: are they transferable?

PMID- 8364341
TI  - Playgroup facilitation.

PMID- 8364343
TI  - The development of a community centre: the Rongotea Community Centre Incorporated
      Society.

PMID- 8364342
TI  - Women and HIV/AIDS: a literature review.

PMID- 8364344
TI  - Exemplar.

PMID- 8364345
TI  - A gut reaction.

PMID- 8364346
TI  - A study of relapses in subjects with mood disorder on lithium treatment.
AB  - In a sample of 213 mood disorder subjects on long-term lithium treatment, we
      analyzed the recurrence indices of relapses during the prophylactic treatment
      period. The differences found in the recurrence rates were due to the current age
      and age of onset, duration of illness and polarity of the probands. The patients
      with personality disorders showed the worst relapse indices and could represent a
      group of mood disorder subjects with a bad outcome of lithium treatment.

PMID- 8364347
TI  - Differential effects of the enantiomers R(-) and S(+) oxaprotiline on major
      endogenous depression, the sleep EEG and neuroendocrine secretion: studies on
      depressed patients and normal controls.
AB  - The effects of the optically active enantiomers of oxaprotiline (OXP), R(-) OXP
      and S(+) OXP, on depressive symptomatology and the sleep EEG were investigated in
      two separate exploratory studies. In addition, the neuroendocrine profile of both
      compounds was characterized in normal controls. In the patients treated with a
      daily oral dose of 150 mg S(+) OXP we found a Hamilton depression score that
      decreased from 29.1 +/- 1.8 (SEM) on day 0 to 14.7 +/- 3.2 on day 28 (P < 0.01).
      Six patients were judged to be full responders (HAMD score 0-7 points), three
      were improved (HAMD score 8-15) and four were nonresponders (HAMD score > 16).
      The therapeutic effect achieved with 150 mg R(-) OXP daily was less pronounced:
      the HAMD score decreased from 27.8 +/- 2.5 on day 0 to 19.4 +/- 3.2 on day 28 (P
      < 0.05). There were two full responders, one improved patient and seven
      nonresponders. The sleep EEG scoring revealed a marked suppression of REM sleep
      among patients treated with S(+) OXP but not with R(-) OXP. In the normal
      controls, a single oral dose of 75 mg S(+) OXP prompted an increase in the
      secretion of cortisol and growth hormone, whereas 75 mg R(-) OXP did not. Neither
      enantiomer influenced the secretion of testosterone or prolactin.

PMID- 8364348
TI  - Time course of improvement under antidepressant treatment: a survival-analytical
      approach.
AB  - A meta-analysis of an earlier multicenter, double-blind efficacy study comparing
      placebo, oxaprotiline and amitriptyline was performed in order to test the
      survival-analytical approach in modelling the onset of improvement and response
      to treatment with antidepressants. The sample consisted of moderately depressed
      male (n = 154) and female (n = 275) patients (aged 17-73), diagnosed according to
      DSM-III criteria for major depression. Of these, 120 were treated with
      oxaprotiline, 120 with amitriptyline and 189 with placebo. Efficacy criteria were
      Hamilton Depression (HAMD) and Anxiety (HAMA) and Zung Self-Rating scales. Up to
      eight ratings over a period of 40 days were available for analysis. The results
      showed that the sensitivity in discriminating between groups was substantially
      enhanced through the inclusion of drop-outs and consideration of the effect of
      time to withdrawal from the study due to lack of improvement. Withdrawal from the
      trial due to inefficacy occurred earliest under placebo (50% within the first 8
      days), whereas less than 40% dropped out within the first 12 days under active
      treatments. The most interesting and unexpected finding of the analysis was that
      the time course of improvement among responders was independent of the treatment
      modality, and thus identical in all three groups. Specifically, the efficacy of
      any of the given treatments was reflected only by the total number of responders
      or nonresponders. Once triggered, the time course of recovery from illness
      becomes identical to that of spontaneous remissions as observed, for example,
      under placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364349
TI  - Effects of valproate on early and late potassium currents of single neurons.
AB  - The effects of valproate sodium (VPA) on potassium currents were tested in
      identified neurons of the snail Helix pomatia. VPA was extracellularly and
      intracellularly applied. VPA (i) had no effects on the current-voltage relation
      of the early potassium outward current (IA), (ii) shifted the steady state
      inactivation function of IA to more positive potentials, (iii) increased the
      amplitude of the late potassium outward currents. It is suggested that the
      extrasynaptic effects on potassium currents markedly contribute to the
      antiepileptic and antimanic effects of VPA.

PMID- 8364350
TI  - A double-blind, placebo-controlled study of fluoxetine in patients with DSM-III-R
      obsessive-compulsive disorder. The Lilly European OCD Study Group.
AB  - We have studied the effect of three fixed daily doses of fluoxetine in patients
      with obsessive-compulsive disorder (OCD) diagnosed according to DSM-III-R. Two
      hundred and fourteen patients were evaluated in an 8-week double blind, placebo
      controlled study. A statistically significantly greater number of fluoxetine
      treated patients achieved the prospectively defined criteria for clinical
      response when compared to placebo treatment. There was a statistically
      significant overall difference in the PGI rating of symptom change (P = 0.045)
      and a marginally significant difference (P = 0.089) in the CGI severity rating
      between groups. Pairwise comparison against placebo showed a marginally
      statistically significantly greater improvement (P = 0.059) in Y-BOCS-Total score
      for patients receiving fluoxetine 60 mg daily, and a significantly higher
      response rate in patients receiving fluoxetine 40 mg or 60 mg daily (P < 0.05).
      One hundred and sixty one patients continued to a 16-week extension evaluation.
      There was no significant difference in the rate of reporting of any individual
      adverse event between placebo and fluoxetine, and the rate of discontinuation due
      to adverse events was low (< 6% in each study phase). This study supports the
      growing evidence for the safety and efficacy of fluoxetine in the treatment of
      OCD.

PMID- 8364351
TI  - Impact of neuropharmacology in the 1990s--strategies for the therapy of
      depressive illness. Task Force of the Collegium Internationale Neuro
      Psychopharmacologicum (CINP).

PMID- 8364352
TI  - Evaluation of TSH and prolactin responses to TRH as predictors of the therapeutic
      effect of ECT in depression.
AB  - In a group of 42 unipolar depressed patients with melancholia the thyrotropin
      (TSH) and prolactin (PRL) responses to TRH were studied in relation to the
      clinical response to an ECT course. Patients were categorized as responders or
      nonresponders using as criterion a 50% reduction in the Hamilton Rating Scale for
      Depression score. Comparison between responders and nonresponders with respect to
      the TSH and PRL responses to TRH did not reveal any significant differences.
      Thus, TSH and PRL responses were not proved to have a predictive value for the
      therapeutic ECT response in melancholia.

PMID- 8364353
TI  - Effects of fluoxetine given chronically on the responsiveness of 5-HT receptor
      subpopulations to their agonists.
AB  - The effect of chronic treatment (5 and 10 mg/kg i.p., twice daily, 14 days) with
      fluoxetine (FLU), an antidepressant drug which selectively inhibits the reuptake
      of 5-hydroxytryptamine (5-HT), on the responsiveness of 5-HT receptor
      subpopulations to their agonists in rats and mice was examined. FLU had no effect
      on the hypothermia (in mice) and the behavioural syndrome (in rats) induced by 8
      OH-DPAT (a 5-HT1A agonist). The m-CPP-induced hypothermia in mice (a 5-HT1B
      effect) was increased by FLU given chronically. FLU in a single dose decreased
      that effect. FLU given chronically attenuated the m-CPP-induced hypoactivity in
      rats (a 5-HT1C effect). The effects mediated by 5-HT2 receptors (L-5-HTP-induced
      head twitches in mice; fenfluramine-, m-CPP- and TFMPP-induced hyperthermias in
      rats) were reduced by chronic FLU. The above results indicate that FLU given
      chronically has no effect on the responsiveness of 5-HT1A receptors, increases
      the responsiveness of 5-HT1B receptors and decreases those of 5-HT1C and 5-HT2
      receptors.

PMID- 8364354
TI  - Effect of acetyl-L-carnitine treatment on brain adenylate cyclase activity in
      young and aged rats.
AB  - The aim of the present study has been to evaluate the effect of acetyl-L
      carnitine (ALCAR) on brain adenylate cyclase (AC) activity in adult and aged
      rats. In in vitro studies, ALCAR (1, 10 and 100 microM) did not exert any effect
      on frontal cortex basal AC activity. Acute and subchronic administrations of
      ALCAR were carried out in 4- and 25-month-old male Fisher rats and AC activity
      was determined in rat frontal cortex under both basal and stimulated conditions.
      The acute treatment of young rats with ALCAR (100 and 500 mg/kg s.c.) did not
      affect AC activity, whereas the subchronic administration of 250 mg/kg s.c. ALCAR
      enhanced the stimulation of AC by carbamylcholine (CCh), norepinephrine (NE) and
      dopamine (DA), without affecting the basal AC activity. Basal AC activity in old
      rats was lower than in young rats and was not modified by acute and subchronic
      ALCAR administration. Moreover, the response of the enzyme to CCh, NE and DA was
      potentiated by the subchronic administration of ALCAR. The concentration-response
      curve of CCh stimulation of AC activity in ALCAR-treated rats is shifted to the
      left in both young and aged rats. We conclude that ALCAR, subchronically
      administered, is able to enhance receptor-stimulated AC response in frontal
      cortex of both young and aged rats.

PMID- 8364355
TI  - Phytochrome A null mutants of Arabidopsis display a wild-type phenotype in white
      light.
AB  - Phytochrome is a family of photoreceptors that regulates plant
      photomorphogenesis; the best-characterized member of this family is phytochrome
      A. Here, we report the identification of novel mutations at three Arabidopsis
      loci (fhy1, fhy2, and fhy3) that confer an elongated hypocotyl in far-red but not
      in white light. fhy2 mutants are phytochrome A deficient, have reduced or
      undetectable levels of PHYA transcripts, and contain structural alterations
      within the PHYA gene. When grown in white light, fhy2 mutants are morphologically
      indistinguishable from wild-type plants. Thus, phytochrome A appears to be
      dispensable in white light-grown Arabidopsis plants. fhy2 alleles confer
      partially dominant phenotypes in far-red light, suggesting that the relative
      abundance of phytochrome A can affect the extent of the far-red-mediated
      hypocotyl growth inhibition response. Plants homozygous for the recessive fhy1
      and fhy3 mutations have normal levels of functional phytochrome A. The FHY1 and
      FHY3 gene products may be responsible for the transduction of the far-red light
      signal from phytochrome A to downstream processes involved in hypocotyl growth
      regulation.

PMID- 8364357
TI  - Afterword for the paperback edition of The American Way of Birth.

PMID- 8364356
TI  - Transgenic tobacco plants expressing the geminivirus BL1 protein exhibit symptoms
      of viral disease.
AB  - Bipartite geminiviruses, such as squash leaf curl virus (SqLCV), encode two
      movement proteins (MPs), BR1 and BL1, that are essential for viral movement in
      and subsequent infection of the host plant. To elucidate the biochemical
      functions of these MPs and define their respective contributions to viral
      infection, we have generated transgenic Nicotiana benthamiana plants expressing
      SqLCV BR1 and BL1. Transgenic plants expressing BR1 or a truncated BL1 were
      phenotypically indistinguishable from wild-type N. benthamiana. In contrast,
      transgenic plants expressing full-length BL1, alone or in combination with BR1,
      were strikingly abnormal both in their growth properties and phenotypic
      appearance, with leaves that were mosaic and curled under, thus mimicking typical
      SqLCV disease symptoms in this host. BL1 was localized to the cell wall and
      plasma membrane fractions, whereas BR1 was predominantly in the microsomal
      membrane fraction. These findings demonstrate that expression of BL1 in
      transgenic plants is sufficient to produce viral disease symptoms, and they
      further suggest that BL1 and BR1 carry out distinct and independent functions in
      viral movement.

PMID- 8364358
TI  - What is your recommendation at the Farm Midwifery Clinic about childhood
      immunizations?

PMID- 8364359
TI  - Entry level midwifery skills list revision #3.

PMID- 8364360
TI  - Verbal arts: survival skills for midwives.

PMID- 8364361
TI  - The Mother Self-Determination Act.

PMID- 8364362
TI  - A Canadian's thoughts.

PMID- 8364363
TI  - Mandatory breastfeeding questioned.

PMID- 8364364
TI  - An extraordinary breastfeeding experience. Interview by Ina May Gaskin.

PMID- 8364365
TI  - Interview with Anna Meenan, MD. Interview by Ina May Gaskin.

PMID- 8364367
TI  - Mediterranean diet and digestive precancerous lesions.

PMID- 8364366
TI  - Faecal occult blood tests in adenoma detection.

PMID- 8364368
TI  - Cancer prevention programmes in health promotion.

PMID- 8364369
TI  - Potentially malignant lesions and conditions of the mouth and oropharynx: natural
      history--cellular and molecular markers of risk.

PMID- 8364370
TI  - General overview of gastrointestinal precancer.

PMID- 8364371
TI  - Precancer lesions of oesophageal adenocarcinoma: phenotypic markers and growth
      factors.

PMID- 8364372
TI  - Oesophageal cancer: prospects for primary prevention.

PMID- 8364373
TI  - Epidemiology and pathology of precancerous lesions of the stomach.

PMID- 8364374
TI  - Diet and precancerous lesions of the stomach.

PMID- 8364375
TI  - Mechanisms of gastric carcinogenesis.

PMID- 8364376
TI  - Primary prevention of gastric precancerous lesions.

PMID- 8364377
TI  - The National Polyp Study.

PMID- 8364378
TI  - Rectal cell proliferation as an intermediate biomarker of risk of colorectal
      cancer.

PMID- 8364379
TI  - Intragastric mutagens and lowered anti-oxidant defence as risk factors for
      gastric cancer.

PMID- 8364380
TI  - Diet and the adenoma-carcinoma sequence.

PMID- 8364381
TI  - Interactive technology: the time is now.

PMID- 8364382
TI  - Grant funding to support staff development activities.

PMID- 8364383
TI  - Seven skills for successful speaking.

PMID- 8364384
TI  - Self-directed learning. To be a great facilitator, don't follow these steps.

PMID- 8364385
TI  - Organizational development: the educator's role.

PMID- 8364386
TI  - What's happening?!

PMID- 8364387
TI  - [Polarized phenomena in biological structures].

PMID- 8364388
TI  - [An electrophoresis method in low density agarose gel for analyzing the chromatin
      condensation process].

PMID- 8364389
TI  - [Toxic effects of the combined action of ionizing radiation and halogenated
      dibenzo-p-dioxins on mammals].

PMID- 8364390
TI  - [Regulation of enzymatic oxidation of thermostable comuton from rat liver
      mitochondria].

PMID- 8364391
TI  - [Characteristics of viruses in the BKM Y-2700 mycocinogenic strain of
      Cystofilobasidium bisporidii yeasts].

PMID- 8364392
TI  - Control of metaphase I formation in Xenopus oocyte: effects of an indestructible
      cyclin B and of protein synthesis.
AB  - A cytological analysis was performed in order to determine how the formation of
      the metaphase I- and metaphase II-spindles is dependent upon p34cdc2 kinase
      activity and protein synthesis during the meiotic maturation of Xenopus oocytes.
      The p34cdc2 kinase activity increases abruptly during the prophase-prometaphase I
      transition, then drops to a minimum level at the metaphase I/anaphase I
      transition and further increases again until reaching a maximum stable level at
      metaphase II. The injection of an indestructible cyclin B into oocytes arrests
      the maturation process at the onset of anaphase I and prevents the re-increase of
      p34cdc2 activity which accompanies normal entry into metaphase II. Inhibition of
      protein synthesis between the germinal vesicle breakdown and the onset of
      metaphase I spindle induces exit from M-phase and leads to an 'interphase-like'
      state characterized by the organization of nuclear-like structures. In contrast,
      inhibition of protein synthesis at metaphase II stage does not affect the
      metaphase II spindle nor p34cdc2 activity, indicating that metaphase I- and
      metaphase II-spindles are not regulated by the same effectors. When protein
      synthesis is inhibited before induction of M-phase by MPF transfer, it prevents
      the formation of the metaphase I spindle, despite a transient elevated level of
      p34cdc2 activity. To dissociate the role of protein synthesis and of p34cdc2
      kinase activity, the indestructible cyclin B was microinjected in the absence of
      protein synthesis. This allows the in vivo maintenance of a stable p34cdc2
      activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364393
TI  - Nuclear compartmentalization in transcriptionally activated hypothalamic neurons.
AB  - Transcription of cell-specific vasopressin and oxytocin genes as well as
      transcription of those housekeeping genes responsible for general metabolic
      activation and cellular hypertrophy is induced in supraoptic hypothalamic neurons
      by rises in plasma osmolarity. In this study, the nuclear volume, the
      ultrastructure of chromatin and the number and distribution of nuclear particles
      in the cell nuclei of supraoptic neurons of 3-month-old male Sprague-Dawley rats
      were analyzed after osmotically induced activation of transcription by periods of
      acute (1 day) and chronic (6 days) dehydration, and after halting the stimulation
      by rehydration of animals. The nuclear volume and the ultrastructure of chromatin
      were assessed on ultrathin sections. The number and distribution of nuclear
      particles were assessed on freeze-fracture replicas. The initial phase of
      osmotically induced enhancement of transcription was accompanied by an increase
      in nuclear volume and by a partial replacement of nuclear particles of large
      diameter (> 11 nm) by smaller nuclear particles. This latter change affected
      predominantly the nuclear periphery (0-1,000 nm from the nuclear membrane) and
      occurred simultaneously with a partial decondensation of chromatin clusters that
      may be related to chromatin unfolding. In chronically stimulated animals, the
      decondensation of chromatin and the replacement of large nuclear particles by
      smaller ones was enhanced in the nuclear periphery and was partially propagated
      to the interior of the nucleus. After suppression of cellular activation by
      rehydration of animals, the number of nuclear particles returned to control
      levels in the nuclear periphery while in the center of the nucleus the number of
      small particles decreased and the number of large particles increased as compared
      to control values. These results, together with the observation that in
      unstimulated cells the nuclear periphery and the nuclear interior differ in their
      composition of nuclear particles, evidence a structural and functional
      compartmentalization in the cell nucleus of supraoptic neurons.

PMID- 8364394
TI  - Sequence of the novel joints present in the amplified DNA of N-phosphonacetyl-L
      aspartate resistant Drosophila cells: implication on the mechanisms of
      amplification in these cells.
AB  - We have previously shown the presence, in the amplified DNA of a Drosophila cell
      line resistant to N-phosphonacetyl-L-aspartate (PALA), of two units of 150 kb and
      120 kb respectively duplicated and amplified. The two joints (J1 and J2) linking
      these units as well as their respective wild-type counterparts have been
      sequenced. Sequence analysis indicates that a region of the Drosophila genome
      which corresponds to the proximal boundary of the 150 kb unit is common to both
      joints. In addition to this common region, the J1 junction possesses a 26
      nucleotide sequence belonging to the J2 junction. This indicates that the J2
      junction was the first formed, and that J1, therefore, results from recombination
      between J2 and a region of the wild-type genome 120 kb distal to J2. Sequence
      analysis also reveals that the joints result from illegitimate recombination
      between unrelated regions. AT-rich sequences, strand bias composition and
      putative topoisomerase I and II sites were found in at least one of the two
      parental sequences involved in the formation of the joints. On the basis of these
      results we can hypothesize that after two illegitimate recombinations between
      sister chromatids, leading first to J2 and then to J1, the amplification may have
      arisen by a series of homologous (unequal crossing-over) or illegitimate
      recombinations, or by an intrachromosomal rolling circle.

PMID- 8364395
TI  - The elementary RNP fiber--not the higher order structure--determines the all-or
      none disintegration behaviour of Balbiani ring pre-messenger RNP particles upon
      RNase A treatment.
AB  - Balbiani ring premessenger ribonucleoprotein (RNP) particles are built from a 7
      nm RNP fiber which is tightly folded into a ring-shaped RNP ribbon. Isolated
      particles are known to disintegrate in all-or-none fashion upon RNase A
      treatment. In the present study we investigated whether this mode of
      disintegration is dependent on an intact particle structure or is inherent in the
      7-nm fiber. When treated at low ionic strength, the Balbiani ring (BR) particles
      lost their higher order structure and the 7-nm fiber was unpacked, as evidenced
      by sucrose gradient sedimentation and electron microscopy. When treated with
      RNase A, unfolded as well as intact particles disintegrated in the all-or-none
      fashion, with similar kinetics and without apparent intermediates. Proteinase K
      treatment, however, obliterated this pattern: the protein-free particle RNA
      degraded progressively. As the typical disintegration pattern of the particles
      was not altered by unfolding, but was lost by deproteinization, the all-or-none
      mode of disintegration is likely to be a property of the 7-nm RNP fiber.

PMID- 8364396
TI  - Ultrastructural cytochemistry of the nucleus and nucleolus in growing rabbit
      oocytes.
AB  - Ultrastructural changes of the germinal vesicle during the growth of rabbit
      oocytes were studied by means of light and electron microscopy, 3H-uridine
      autoradiography, Ag-NOR staining and E-PTA staining. Particular interest was paid
      to the nucleologenesis and condensation of chromatin. In contrast to other
      mammalian species, chromosome condensation in rabbit oocytes occurred
      concomitantly with rRNA synthesis-dependent nucleolar compaction and preceded
      nuclear envelope breakdown and resumption of meiosis.

PMID- 8364397
TI  - Culture of human preovulatory granulosa cells: effect of extracellular matrix on
      steroidogenesis.
AB  - Human luteal granulosa cells, harvested from preovulatory follicles during in
      vitro fertilization attempts, were cultured in a serum-precoated substratum
      ('serum cells') or on a collagen matrix ('collagen cells'). Concerning the 'serum
      cell' model, E2 secretion was very low in the absence of androgen; when
      androstenedione was added to the culture medium, cells secreted 180 +/- 52
      pmol/ml/24 h of estradiol, 440 +/- 78 pmol/ml/24 h of testosterone and lower
      quantities of estrone and estriol. Follicle stimulating hormone induced a
      significant increase in estradiol and estriol, while the secretion of the other
      steroids was not altered. The secretion of progesterone was 3.15 +/- 1 nmol/ml/24
      h and significantly enhanced by luteinizing hormone (+ 95%; P < 0.01). The
      secretions of 17 alpha-hydroxyprogesterone and 20 alpha-dihydroprogesterone were
      low and not modified by luteinizing hormone. 'Collagen cells', in basal
      conditions, showed an increased secretion of estradiol (+ 50%, P < 0.05), became
      rounded and were less responsive to gonadotropins when compared with 'serum
      cells'. Thus, the use of a collagen matrix, similarly to gonadotropins,
      stimulated granulosa cell steroidogenesis in relation to modifications of cell
      shape. The higher responsiveness of serum cells to gonadotropins makes this model
      more suitable for physiological and pharmacological studies than the collagen
      one.

PMID- 8364398
TI  - Endocytosis of alpha 1-acid glycoprotein variants by human monocytic lineage
      cells.
AB  - Human alpha 1-acid glycoprotein (AGP or orosomucoid) is a major glycoprotein of
      plasma. AGP can be separated on immobilized concanavalin A into three variants
      bearing none (AGP A), one (AGP B) or two (AGP C) biantennary glycans. In this
      paper, we show, using flow cytometry and confocal microscopy, that AGP C which is
      eluted from concanavalin A with mannose, binds to human monocytes, monocyte
      derived macrophages as well as human promonocytic cell lines such as THP1 or
      U937. Conversely HL60, a promyelocytic cell line, does not express the surface
      AGP C binding protein. AGP C is internalized and degraded with an efficiency
      depending on the state of differentiation of these cells. In contrast, AGP A
      which is not recognized by concanavalin A, does not bind to any of these cells.

PMID- 8364399
TI  - The effects of structural analogs of putrescine on proliferation, morphology and
      karyotype of glioblastoma cells in culture.
AB  - In a previous study, we identified regions on the surface of tumor cells which
      act as acceptor sites for putrescine (Put) and studied the competition between
      structural analogs of Put (N,N'-tetramethyl-alpha,omega-diaminoalkanes) and Put
      bound to latex microspheres. A chain of four to seven carbons was necessary for
      inhibition of Put-latex binding to the cell surface of human glioblastoma (U251)
      cells. We show here that under the experimental conditions, N,N'-tetramethyl-1,4
      butanediamine and N,N'-tetramethyl-1,7-heptanediamine exhibit an antitumor
      effect. In a first step (1-48 h after treatment), cells exposed to these
      compounds show large intracellular vacuoles. We failed to detect any acid
      phosphatase activity in these intracellular structures revealing that they were
      not lysosomes. Electron microscopy observations argue for the conclusion that
      these vacuoles are an hypertrophy of the endoplasmic reticulum (ER) and/or of the
      Golgi vesicles. Our hypothesis is that this typical effect of the analogs reveals
      that ER could be a physiological target of endogenous polyamines. At a later
      stage (6 days after treatment), the cells undergo morphological and biochemical
      changes: thin and long expansions characterize the cells and the GFA protein is
      overexpressed. Correlated to both these effects, karyotypic modifications are
      found in chromosomes 3 and 6. These changes evoke a differentiation of the
      treated cells. The work provides evidence that N-methylated polyamine analogs
      taking the place of endogenous putrescine demonstrate a hopeful antitumor effect.

PMID- 8364400
TI  - Interaction between Aspergillus fumigatus and basement membrane laminin: binding
      and substrate degradation.
AB  - Aspergillus fumigatus, the causative agent of human aspergillosis, binds to and
      degrades basement membrane laminin. Using immunoelectron microscopy, laminin
      binding appeared to be associated with the cell wall expansions of resting
      conidia, and progressively extended to the outer electron dense layer of the
      conidial wall during the germination process. Labeling of thin sections revealed
      numerous binding sites in the cytoplasm, whereas the inner cell wall and the
      plasma membrane were not labeled. Attachment of A fumigatus conidia on microtiter
      plates coated with laminin and its fragments P1 and E8 was also investigated.
      Conidia cells showed good adhesion to wells coated with laminin. As indicated by
      inhibition experiments, the interaction was specific and fragment P1 represented
      the major binding site on the laminin molecule. In addition, since A fumigatus
      produced an extracellular serine protease, we determined the susceptibility of
      laminin to this enzyme. We demonstrated that protease extract was capable to
      degrade laminin in solution as well as in tissue sections. The laminin cleavage
      products were detected by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. All the three chains were extensively degraded within 1 h.
      Treatment of the crude protease extract with the enzyme inhibitors,
      phenylmethylsulfonyl-fluoride and chymostatin, blocked the degradation of
      laminin, indicating a chymotrypsin-like serine protease activity.
      Immunofluorescence microscopy of cryostat sections of mouse and rat kidneys
      treated with the protease extract showed widespread loss of laminin epitopes from
      basement membranes. Enzyme treatment also removed immunoreactivity from lungs as
      observed after immunoperoxidase performed on paraffin sections. Binding and
      proteolytic degradation of laminin may together facilitate initial interaction of
      A fumigatus with the host tissues.

PMID- 8364401
TI  - In vitro attachment of Pneumocystis carinii from mouse and rat origin.
AB  - The attachment of Pneumocystis carinii to lung cells could play a role in the
      pathophysiology of P carinii pneumonia. The trophozoite attaches to type I
      alveolar epithelial cells. Physical, chemical, and extracellular matrix factors,
      involved in the mouse-or rat-derived P carinii attachment to fibroblastic cells
      in culture, were examined using a new model of in vitro adherence. The
      development of parasite filopodia penetrating deeply the host cell cytoplasm was
      observed using transmission electronic microscopy. Killed P carinii organisms
      were unable to attach to cultured cells. Also, parasites were unable to attach to
      killed target cells. The P carinii in vitro attachment was partially inhibited by
      cytochalasin B. In contrast, the parasite attachment was not affected when the
      target cell cytoskeleton was altered. In our work conditions, sialic acids were
      not involved in the attachment process. Present results showed that fibronectin
      (Fn) plays a role in the parasite attachment, and suggest that a specific Fn
      binding receptor is present at the surface of mouse-derived P carinii organisms.

PMID- 8364402
TI  - Association of the actin cytoskeleton with glass-adherent proteins in mouse
      peritoneal macrophages.
AB  - When mouse peritoneal macrophages adherent to glass surface were removed by
      treatment with triethanolamine and Nonidet P-40, fine thread structures of unique
      loops were left behind on glass at the sites of cell adhesion. To examine the
      ultrastructural relationship between such looped threads and cytoskeletal
      components in glass-adherent macrophages, we successfully used the 'zinc method'
      to remove most of the cytoplasm including nuclei and to expose the cytoskeleton
      associated with the ventral plasma membrane. The cytoskeleton was seen to be
      mainly composed of actin filaments forming dense networks. The network contained
      scattered star-like foci from which actin filaments radiated. When the ventral
      plasma membrane-cytoskeleton complex was further treated with Nonidet P-40, the
      membrane was dissolved to expose the glass surface with actin foci persisting on
      glass. When the complex was removed by further treatment with Nonidet P-40 and
      DNase I, the looped threads became visible. Confocal laser microscopy of glass
      adherent macrophages stained with fluorescent phalloidin showed the preferential
      distribution of F-actin in the ventral cytoplasm along the plasma membrane, where
      intense fluorescent spots were also scattered. Confocal interference reflection
      microscopy revealed densely populated dark dots and striae of focal contact,
      which corresponded in overall distribution to actin foci and looped threads.
      These observations suggest that actin cytoskeleton is closely associated with
      looped threads to reinforce cell adhesion to glass.

PMID- 8364403
TI  - The in vitro destruction of rumen fluid carotenoids by plant lipoxygenases.
AB  - An ability to destroy carotenoids in the rumen of cattle may be an effective
      method of limiting their absorption from the small intestine which, in turn, is
      likely to result in reduced adipose tissue colour. Plant lipoxygenases are well
      known for their ability to bleach beta-carotene. As lutein is the major
      carotenoid present in most forage grasses, we have investigated the bleaching of
      lutein as well as beta-carotene by lipoxygenase isolated from soybeans. In vitro
      studies, using micellar preparations of carotenoids, indicated that lutein was
      rapidly oxidised and that the progress of the reaction was similar to that
      observed for beta-carotene. The polyunsaturated fatty acid linoleate was
      essential. When bovine rumen fluid was used as a source of carotenoid for in
      vitro studies with preparations of lipoxygenase, a rapid decrease in carotenoid
      and chlorophyll concentrations was observed, again requiring the addition of
      linoleic acid. The direct addition of soya flour to bovine rumen fluid resulted
      in the effective bleaching of the pigments without the inclusion of linoleate.
      When compared with flours from a variety of other plant sources, soya flour was
      most effective. The inclusion of dietary sources of lipoxygenase may be an
      effective method for controlling carotenoid uptake in certain ruminant species.

PMID- 8364404
TI  - A comparison of beta-carotene-splitting activity isolated from intestinal mucosa
      of pasture-grazed sheep, goats and cattle.
AB  - The in vitro enzymatic conversion of beta-carotene to retinal by partially
      purified preparations from the intestinal mucosa of sheep, goats and cattle was
      demonstrated. At pH 7.8 and 37 degrees C, this enzyme from sheep, goats and
      cattle displayed Michaelis-Menten type kinetics with a Vmax (nmol substrate
      split/mg protein/h) of 0.21, 0.27, and 0.04 and an apparent Km of 4.66 x 10(-6)
      M, 13.4 x 10(-6) M and 1.27 x 10(-6) M respectively. Maximal reaction was
      obtained by addition of an appropriate combination of detergent and bile salt,
      sodium dodecyl sulphate and egg lecithin. The cattle enzyme was inhibited by
      sodium glycocholate. The activity of sheep enzyme was higher (P < 0.05) than that
      of goats and cattle. The measured activity of the preparations from sheep, goats
      and cattle grazed on the same pasture reflected their contents of the reaction
      product, retinol, in the liver.

PMID- 8364405
TI  - Involvement of calcium-dependent cysteine protease in fibronectin-induced
      chemotactic migration of NIH-L13 fibroblasts.
AB  - Fibronectin (FN)-induced chemotactic migration of NIH-L13 fibroblasts was
      suppressed by the inhibitors of cysteine proteases, leupeptin (IC50 = 3 microM),
      and the epoxysuccinyl derivatives [E-64c (10 microM), SUT-8801 (45 microM), and
      SUT-8818 (28 microM)], but hardly by phenylmethanesulfonyl fluoride (> 1 mM) and
      1-tosyl-amido-2-phenylmethyl chloromethyl ketone (> 1 mM). E-64d, a membrane
      permeant derivative of E-64c, was much more effective (IC50 = 4 microM) than E
      64c in preventing the cell migration. Furthermore, the FN-induced cell migration
      was blocked partially with EGTA and was reversed by addition of Ca2+ ion. These
      results suggest that intracellular Ca(2+)-dependent cysteine proteases may be
      involved in the FN-induced chemotactic migration of NIH-L13 fibroblasts.

PMID- 8364406
TI  - The effect of contraceptive steroids on plasma lipoprotein metabolism in female
      rats (II).
AB  - In order to investigate the effects of two contraceptive steroids given orally,
      which contain ethinyl estradiol in combination with different types and doses of
      progestins, on plasma lipoprotein metabolism, rat groups named according to
      progestin components were designated as short-and long-term groups of
      norethisterone acetate and levonorgestrel at low-and high-doses. At the end of
      the experiments, plasma triglyceride, phospholipid, apolipoprotein A1 and B, LDL
      , HDL-, HDL2- and HDL3-cholesterol levels and hepatic lipase activity were
      measured. When compared to controls, phospholipid and LDL-cholesterol were
      increased in all groups; triglyceride levels were also increased in all short
      term groups, but only in low-dose norethisterone and high-dose levonorgestrel of
      long-term groups. HDL- and HDL3- cholesterol were decreased in all groups, except
      in low-dose levonorgestrel groups, but HDL2-cholesterol were lower only at high
      doses and long period. In short-term, an increase in apolipoprotein A1 levels was
      significantly important at high doses; in long-term apolipoprotein A1 was
      increased at low doses, while decreased at high doses. Apolipoprotein B was
      elevated only in long-term high dose of norethisterone acetate group. Hepatic
      lipase activity was increased in long-term high-dose of levonorgestrel group,
      whereas decreased in all other groups. In conclusion, the data presented was
      interpreted that the effects of these combinations used in the study on plasma
      lipoprotein metabolism may be related to the changes observed in hepatic lipase
      activity.

PMID- 8364407
TI  - Isolation and characterization of the ND2 polypeptide of the bovine energy
      transducing NADH-ubiquinone oxidoreductase (complex I).
AB  - The M(r) 30,000 polypeptide of the hydrophobic protein fraction of the energy
      transducing NADH-ubiquinone oxidoreductase (complex I) of bovine heart
      mitochondria was identified as the ND2 gene product based on a comparison of
      amino acid analysis and partial N-terminal sequencing results with the known DNA
      sequence of ND2 (Anderson, S. et al. (1982) J. Mol. Biol. 156, 683-717). A simple
      purification procedure was devised for this ND2 gene product. The procedure,
      which is described, involves treatment of bovine complex I with a chloroform
      methanol (2:1 [v/v]) solution. The antiserum raised against this purified bovine
      ND2 gene product cross-reacted with the approximately M(r) 39,000 polypeptide
      extracted from the Paracoccus denitrificans membranes with chloroform-methanol
      (2:1 [v/v]).

PMID- 8364408
TI  - Protective role of metallothionein in nickel induced oxidative damage.
AB  - Recent studies have focussed on the role of thiol rich proteins especially
      metallothionein (MT) in the therapeutic interventions against oxidative damage.
      In our previous communication we showed that reactive oxygen species arising via
      Fenton's reactions are the proximal lipid oxidant during nickel-toxicity. The
      purpose of the present communication is to evaluate the role of zinc, cadmium or
      silver-metallothioneins on the protection against nickel-induced peroxidative
      damage. Our results demonstrate that Zn-MT provided maximum protection against
      nickel-induced mortality in mice and also served as an efficient antagonist in
      inhibiting nickel-mediated lipid peroxidation compared to Cd-MT or Ag-MT. Zn-MT
      also provided protection against iron (II)-ascorbate induced microsomal lipid
      peroxidation and reversed nickel-mediated inhibition of calcium sequenstration.
      We conclude that Zn-MT could serve as an excellent physiological antioxidant
      against nickel-mediated oxidative.

PMID- 8364410
TI  - Inhibition of glutamate dehydrogenase by covalent coenzyme-substrate adducts: a
      re-examination.
AB  - Covalent adducts of NAD+ with pyruvate and 2-oxoglutarate have been reported to
      inhibit differentially the activities of bovine glutamate dehydrogenase (GDH)
      towards these two oxoacid substrates, implying separate active sites. Thorough
      reinvestigation fails to confirm this finding, with the pyruvate adduct uniformly
      the more potent inhibitor of both substrate activities under several assay
      conditions. This suggests that bovine GDH provides amino acid dehydrogenation
      sites of one structural type only. Clostridial GDH, with a strong preference for
      oxoglutarate over pyruvate as substrate, is also more strongly inhibited by the
      pyruvate adduct in the oxoglutarate assay. These findings challenge the
      generality of the view that carbonyl substrates used in forming such adducts
      confer specificity for the corresponding substrate binding pocket in enzyme
      active sites.

PMID- 8364409
TI  - Duplication of secretion signal sequences is deleterious for the secretion of
      human interferon alpha 4 from Saccharomyces cerevisiae and Bacillus subtilis.
AB  - Tandem duplication of a mitochondrial import leader sequence has been shown to
      markedly increase the efficiency of translocation of chimaeric precursors across
      mitochondrial membranes to the mitochondrial matrix. The principle of leader
      sequence duplication was applied to the protein secretion system of the yeast
      Saccharomyces cerevisiae and of Bacillus subtilis. The secretion signal sequences
      of yeast invertase and B. subtilis neutral protease were used to direct the
      secretion of human interferon alpha 4. Our results show that the duplication of
      these N-terminal signal sequences does not enhance secretion of interferon alpha
      4 in either of the cell systems studied.

PMID- 8364411
TI  - Regulation of the annexin Icp35 gene in transfected mammary gland cell lines.
AB  - We have tested the ability of the 5' flanking region of the lactogen-regulated
      annexin Icp35 gene to drive the expression of the bacterial chloramphenicol
      acetyltransferase (CAT) gene in T-47D, HBL-100 and HC11 cells. A construct
      containing 1,400 bp of the 5' flanking region including the putative promoter,
      and the first two exons and intervening sequence showed lower activity compared
      with a similar construct containing only 250 bp of the 5' flanking region. This
      indicated the presence of negative regulatory elements in the distal 5' flanking
      region. Experiments were done to determine the effect of lactogens (either ovine
      prolactin, or human growth hormone) on the cp35 promoter using various hormone
      treatments, growth conditions and serum supplements. We did not observe any
      effect of hormones on the expression of the cp35/CAT constructs under the
      conditions tested.

PMID- 8364412
TI  - Two microassays for determination of a wide range of proteolytic activities using
      Azocoll as substrate.
AB  - Two micromethods for measuring proteolytic activity were developed. A
      semiquantitative assay on microtitre plates with granular Azocoll as substrate is
      based on the determination of the time of first appearance of pink colour, t, in
      the reaction mixture and proteolytic activity is expressed as 1/t. This simple,
      sensitive and economical method is convenient for preliminary testing of a large
      number of small samples with unknown proteolytic activity, such as fractions
      after chromatography. It speeds up considerably proteinase purification. The
      other test, a quantitative microassay, is a low-cost and time-saving version of
      the classical method which reduces material consumption and includes automated
      measurement of absorbance in microtitre plates by a Multiscan reader. Application
      of these methods are demonstrated.

PMID- 8364413
TI  - Calcium and dithiothreitol dependent conformational changes in beta-sheet
      structure of collagenase resistant fragment of human surfactant protein A.
AB  - Ca2+ dependent conformational change of collagenase resistant fragment (CRF) of
      human surfactant protein A (SP-A) was studied by measurements of the far UV
      circular dichroism spectrum. The spectrum was altered by Ca2+ and DTT. The beta
      sheet content was decreased by the addition of Ca2+ from 28.1 to 26.6%. On the
      other hand, the beta-sheet content was increased in the presence of
      dithiothreitol from 28.1 to 36.0%, and decreased by the addition of Ca2+ from
      36.0 to 30.5%. The total Ca2+ concentration required for half maximal change of
      the ellipticity at 220 nm was estimated to be 30 microM both in the presence and
      absence of dithiothreitol. One of the functions of SP-A, enhancement of
      phospholipid uptake by alveolar type II cells, was abolished by the addition of 2
      mercaptoethanol. These results strongly indicate a relationship between the
      conformation of CRF and SP-A functions.

PMID- 8364414
TI  - Comparative studies of intracellular activity, secretion and multiple forms
      spectra of human skin fibroblast alpha-L-fucosidase in the normaland after
      sucrose load.
AB  - Activity and multiple forms of intracellular and secreted alpha-L-fucosidases
      from human skin fibroblasts were studied in normal and sucrose-loaded cells-
      modelling intralysosomal nonhydrolyzable products' accumulation in vitro. Certain
      differences in secretion levels were found after sucrose load for alpha-L
      fucosidases from embryonal and postnatal cell lines. Different effects of sucrose
      load on multiple forms' spectra of the intracellular and secreted alpha-L
      fucosidases from embryonal and postnatal fibroblasts were revealed.

PMID- 8364415
TI  - Changes in intracellular potassium and thiol levels in Escherichia coli K12 under
      various stresses.
AB  - The levels of intracellular K+ and thiols were measured synchronously in E. coli
      cells under starvation stress and osmotic upshock,alkaline shift and cytoplasm
      acidification. The level of nonprotein thiols increased in response to osmotic
      upshock and alkaline shift but decreased under cytoplasm acidification. A
      positive correlation between the changes in the K+ pool and the level of
      nonprotein thiols was found under osmotic shock and alkaline shift. Inverse
      correlation between these parameters was observed after the acidification of
      cytoplasm. It is supposed that there is a tight relationship between the levels
      of K+, nonprotein thiols and intracellular pH.

PMID- 8364416
TI  - Characterization of platelet agglutinating protein p37 purified from the plasma
      of a patient with thrombotic thrombocytopenic purpura.
AB  - We have previously reported the purification of a 37 KDa platelet agglutinating
      protein (PAP p37) from the plasma of a patient with thrombotic thrombocytopenic
      purpura and have shown that it is present in a subset of TTP patients, but absent
      in normal subjects. In this study, we would like to report some of the physico
      chemical and immunological properties of this protein. The native molecular
      weight of PAP p37 from gel filtration was found to be 36,000, which is in
      agreement with denatured molecular weight (37,000), determined by SDS-
      polyacrylamide gel electrophoresis under both reducing and non-reducing
      conditions. The values of Stoke's radius (25A), diffusion coefficient (8.59 x 10(
      7)cm2/s) and frictional ratio (1.13), determined by molecular sieve
      chromatography, suggest that the native protein is compact and globular. The
      purified protein has an S20,w of 3.5s. Preliminary carbohydrate analysis
      suggested that p37 is a glycoprotein and contained about 11% neutral sugars and
      6.6% sialic acid. Amino acid analysis indicated that the protein is relatively
      rich in aspartate and serine and has low cysteine, methionine and tryptophan
      contents. In dot immunobinding ELISA assay, PAP p37 did not react with antibodies
      to thrombospondin, fibrinogen, fibronectin, plasminogen and von Willebrand
      factor. Our results suggest that PAP p37 is a single polypeptide compact and
      globular glycoprotein and is immunologically not related to the aforementioned
      proteins.

PMID- 8364417
TI  - Feedback and delays in neurological diseases: a modeling study using dynamical
      systems.
AB  - Numerous regulatory mechanisms in motor control involve the presence of time
      delays in the controlled behavior of the system. Experimentally, we have shown
      that an increase of the time delay in visual feedback induces different
      oscillations in control subjects and in patients with neurological diseases
      during the performance of a simple compensatory tracking task. A preliminary
      model is proposed to describe the oscillations observed in control subjects and
      in patients with neurological diseases. The influence of delays in two feedback
      loops are the main components of the motor control circuitry involved in this
      task and are studied from an analytical and physiological perspective. We
      analytically determine the influence in the model of each of these delays on the
      stability of the finger position. In addition, the influence of stochastic
      elements ("noise") in the modeling equation is seen to contribute qualitatively
      to a more accurate reproduction of experimental traces in patients with
      Parkinson's disease but not in patients with cerebellar disease.

PMID- 8364418
TI  - The kinetics of enzyme systems involving activation of zymogens.
AB  - A general model of zymogen activation is proposed and explicit kinetic equations
      for the time courses of the various species and products involved are given.
      These equations are valid for the whole course of the reaction and therefore for
      both the transient phase and the steady state. This model is sufficiently general
      to include mechanisms possessing one or more steps of zymogen activation besides
      possible steps of inhibition (reversible or irreversible) or inactivation.

PMID- 8364419
TI  - Langevin equation, Fokker-Planck equation and cell migration.
AB  - Cell migration can be characterized by two independent variables: the speed, v,
      and the migration angle, phi. Each variable can be described by a stochastic
      differential equation--a Langevin equation. The migration behaviour of an
      ensemble of cells can be predicted due to the stochastic processes involved in
      the signal transduction/response system of each cell. Distribution functions,
      correlation functions, etc. are determined by using the corresponding Fokker
      Planck equation. The model assumptions are verified by experimental results. The
      theoretical predictions are mainly compared with the galvanotactic response of
      human granulocytes. The coefficient characterizing the mean effect of the signal
      transduction/response system of the cell is experimentally determined to 0.08
      mm/V sec (galvanotaxis) or 0.7 mm/sec (chemotaxis) and the characteristic time
      characterizing stochastic effects in the signal transduction/response system is
      experimentally determined as 30 sec. The temporal directed response induced by
      electric field pulses is investigated: the experimental cells react slower but
      are more sensitive than predicted by theory.

PMID- 8364420
TI  - Comparative kinetics of embryo development.
AB  - A model of embryo energetics was fitted to data from the literature for species
      as different as snails and mammals. The model is based on assumptions about
      energy uptake, storage and utilization. It describes the animal by two state
      variables: volume and energy storage. Embryo weight is taken to be proportional
      to volume, yolk weight to energy storage, and respiration rate to storage
      utilization rate. The fits were good, with minor deviations occurring only in the
      early phases of development. For altricial birds, good model fits were obtained,
      but the parameter values markedly differed from those of other species. We
      hypothesized that, due to an increase in energy utilization towards hatching, the
      temperature of the embryo increases. As a result, metabolic processes are
      accelerated. When this was taken into account, parameter values were obtained
      that correspond better with those of other animals.

PMID- 8364421
TI  - Stress-induced alignment of actin filaments and the mechanics of cytogel.
AB  - Experimental evidence suggests that anisotropic stress induces alignment of
      intracellular actin filaments. We develop a model for this phenomenon, which
      includes a parameter reflecting the sensitivity of the microfilament network to
      changes in the stress field. When applied to a uniform cell sheet at rest, the
      model predicts that for sufficiently large values of the sensitivity parameter,
      all the actin filaments will spontaneously align in a single direction. Stress
      alignment can also be caused by a change in external conditions, and as an
      example of this we apply our model to the initial response of embryonic epidermis
      to wounding. Our solutions in this case are able to reflect the actin cable that
      has been found at the wound edge in recent experiments; the cable consists of
      microfilaments aligned with stress at the wound boundary of the epithelium. These
      applications suggest that stress-induced alignment of actin filaments could play
      a key role in some biological systems. This is the first attempt to include the
      alignment phenomenon in a mechanical model of cytogel.

PMID- 8364422
TI  - Cell migration in multicell spheroids: swimming against the tide.
AB  - Multicell spheroids, small spherical clusters of cancer cells, have become an
      important in vitro model for studying tumour development given the diffusion
      limited geometry associated with many solid tumour growths. Spheroids expand
      until they reach a dormant state where they exhibit a grossly static three
      layered structure. However, at a cellular level, the spheroid is demonstrably
      dynamic with constituent cells migrating from the outer well-nourished region of
      the spheroid toward the necrotic central core. The mechanism that drives the
      migrating cells in the spheroid is not well understood. In this paper we
      demonstrate that recent experiments on internationalization can be adequately
      described by implicating pressure gradients caused by differential cell
      proliferation and cell death as the primary mechanism. Although chemotaxis plays
      a role in cell movement, we argue that it acts against the passive movement
      caused by pressure differences.

PMID- 8364423
TI  - [Bronchial hyperreactivity after chronic use of salbutamol].
AB  - 15 patients with bronchial asthma received inhalations of salbutamol three times
      daily (200 mcg) for 2 months. Spirometry was carried out at the beginning of the
      study, one and two months after starting the study. The bronchodilating effect
      and non-specific bronchial hyperreactivity assessed with the histamine
      bronchoprovocation test were studied. Two month treatment with salbutamol
      decreased the bronchodilating effect and at the same time produced an increase of
      non-specific bronchial hyperreactivity.

PMID- 8364424
TI  - [Analysis of fenoterol efficacy given as an aerosol using various mouth pieces].
AB  - The effect of different mouth pieces on efficacy of fenoterol was studied in 40
      patients with atopic and non-atopic bronchial asthma with reversible bronchial
      constriction. Four devices were studied: standard MDI unit, MDI unit with
      Boehringer and Astra mouth pieces, MDI unit with spacer. PEF values were
      registered 7 hours following inhalation. Statistical differences were not
      significant within the whole group. In selected older patients (above 60 years of
      age) spacer and Astra mouth pieces produced significant changes.

PMID- 8364425
TI  - [Therapeutic examination of efficiency for vaccine desensitization with grass
      pollen catalet].
AB  - The results of a 5-year studies on the therapeutical efficiency of Catalet-
      desensitization vaccine containing grass pollen antigens adsorbed on aluminium
      hydroxide--are discussed. Catalet vaccine is manufactured by Sera and Vaccines
      Works in Krakow in the doses of 25 PNU/ml, 250 PNU/ml, 2500 PNU/ml, and 10,000
      PNU/ml. It was found that Catalet possesses a strong antigenic properties and
      enables complete or partial intensivity to grass pollens in the majority of
      treated patients. Therapeutical efficiency of Catalet has markedly been different
      than that of placebo, and had expressed fully following a two- or three-year
      treatment.

PMID- 8364427
TI  - [Effect of bacteria on chemotaxis of peripheral blood lymphocytes from nonatopic
      asthmatics].
AB  - The chemotactic response of peripheral blood lymphocytes from nonatopic
      asthmatics and healthy subjects in the gradients of various bacterial strains
      obtained from the airways of the asthmatic patients was investigated. The
      dominant autologous strains were found to be effective chemoattractants for
      lymphocytes form the asthmatics. However, none of the bacterial strains
      investigated in this study induced increased motility of lymphocytes from healthy
      subjects. These findings might explain the mechanisms of the accumulation of
      lymphocytes in the airways of nonatopic asthmatics.

PMID- 8364426
TI  - [Platelet aggregation and receptor expression of low affinity to IgE (Fc epsilon
      RII CD23) in patients with seasonal allergic rhinitis].
AB  - In 12 patients with pollinosis analysis of platelet function was carried out.
      Platelet function was assessed basing on the thromboelastogram curve and
      aggregation capability induced by ADP. Total serum IgE levels, as well as,
      specific antibodies to grass pollens, IgE and IgG4 levels and circulating
      receptor of low IgE affinity (sFc epsilon RII/sCD23) were also analysed. The
      study was carried out in a dynamic state, during natural allergen exposition and
      natural remission. A significant correlation was found between loss of platelet
      function and sCD23 levels. The observed relations were not influenced by seasonal
      changes.

PMID- 8364428
TI  - [Aerobic and anaerobic bacterial flora as a cause of lower respiratory tract
      infection].
AB  - Bronchial aspirates collected from a group of 100 patients with respiratory
      infections undergoing broncho-fiberscopic examination have been tested
      bacteriologically. Twenty five patients was suffered from bronchopneumonia, 35
      patients have had acute bronchitis, and 40 patients chronic bronchitis. Aerobic
      bacterial flora has been detected in 15% of patients, anaerobic flora in 13%, an
      mixed bacterial flora in 20%, totally in 48% of cases. Aerobic bacteria
      predominated in pneumonia. Bacteroides melaningogenicus prevailed in anaerobic
      flora. The tests of bacterial sensitivity to antibiotics have shown high
      sensitivity to cefotaxime, cefamandole, metronidazole, and rifampicin.

PMID- 8364429
TI  - Epidemiology of mites allergy of upper respiratory tract and mites occurrence in
      homes in Warsaw.

PMID- 8364430
TI  - [Bronchoalveolar lavage (BAL) in patients with pulmonary sarcoidosis. I.
      Correlations between cellular morphology of BAL with radiologic and respiratory
      function tests].
AB  - BAL, spirometric evaluation and compliance values were analysed in 51 patients
      (21 females, 30 males; age range 19-51 years). Basing on BAL criteria, 19 had
      active sarcoidosis, 32 non-active sarcoidosis. Radiological stages (I, II, III)
      were found in similar percentages in both forms of the disease. Mean respiratory
      function parameters were similar in the active and non-active stage of the
      disease. The most common abnormality found in 33% of the patients was decreased
      DLCO.

PMID- 8364431
TI  - [Bronchoalveolar lavage (BAL) in pulmonary sarcoidosis. II. Changes in BAL
      cellular morphology and respiratory function in patients with sarcoidosis treated
      with prednisone].
AB  - BAL and respiratory function were analysed in 26 patients with sarcoidosis (age
      range 22-48 years) before and after a 12 month steroid therapy trial. 11 patients
      were in the active stage according to the BAL criteria. After treatment a
      significant decrease in BAL lymphocytosis was found (a decrease from 31.4% to
      22.8%). A significant increase in TLC, DLCOSB and D/VA mean values was found. The
      effect of steroid therapy was similar in the active and non-active stage of the
      disease. The authors found BAL useful in monitoring of therapy.

PMID- 8364432
TI  - [Pulmonary function changes as a late diabetic complications].
AB  - During diabetic process angiopathy of lung vessels may be expected. In the study
      authors evaluated values of spirometric and gasometric parameters in patients
      with diabetes mellitus in two groups--with and without diabetic complications. It
      was documented that diabetic process caused the decrease of pulmonary diffusion
      volume and some gasometric disturbances. This above mentioned spirometric and
      gasometric changes indicated some coexistence with a late diabetic complications.

PMID- 8364434
TI  - [Effect of a single dose of nifedipine on pulmonary hypertension measured by
      doppler echocardiography].
AB  - In 14 patients with chronic obstructive pulmonary disease and symptoms of cor
      pulmonale a single dose of nifedypine was administered and Doppler
      echocardiography measurements were performed to evaluate a degree of pulmonary
      hypertension. An acceleration time (AcT) and mean pulmonary artery pressure
      (MPAP) before and after 20 mg dose of nifedypine were determined, parallel with
      evaluation of systolic and diastolic blood pressure. In performed examinations it
      was documented that 20 mg dose of nifedypine induced a decrease of MPAP in
      observed patients.

PMID- 8364433
TI  - [Pulmonary thromboembolism--random analysis of autopsy material].
AB  - In the study an analysis of 13216 autopsy materials was performed to evaluate a
      frequency of pulmonary thromboembolism incidence including localisation of
      detected changes. Pulmonary thromboembolism was determined in 5.5% autopsies,
      with evident increase in older subjects (up to 31.3% in 70-79 years old group).
      The most frequently (67.8%) pulmonary thromboembolism was observed in lobar and
      segmental arteries in a course of atherosclerosis (28.6%), neoplasmas (20.8%) and
      septic diseases (15.5%). In 25% cases of pulmonary thromboembolism has been
      diagnosed during clinical observations and has been confirmed by autopsy
      procedure.

PMID- 8364435
TI  - [Clinical evaluation of disodium cromoglycate with beta-2-agonist in therapy of
      patients with atopic bronchial asthma (preliminary study)].
AB  - In 38 patients with atopic bronchial asthma DNCG (disodium cromoglycate) and DNCG
      comp. (disodium cromoglycate and reproterol hydrochloride) were applied in
      inhalation way. After 7 days course spirometric values were monitoring in all
      patients. Decrease of Raw values and increases of FEF50 and FEV1 were noticed in
      all patients, especially in asthmatics treated with DNCG comp. Obtained results
      suggest a good clinical effect and improvement of spirometric values in patients
      with atopic bronchial asthma during DNCG and DNCG comp. therapy.

PMID- 8364436
TI  - [Foreign body of the bronchus in adults].
AB  - Two cases of endobronchial foreign bodies are presented. In both an uneventful
      clinical course following removal of the foreign body and antibacterial therapy
      was observed. The authors diagnostical problems in cases with scant symptoms,
      especially presence of non-specific symptoms and uncharacteristic medical
      history.

PMID- 8364437
TI  - [Pulmonary lymphangiomyomatosis and tuberous sclerosis--similarities and
      differences].
AB  - Two cases pulmonary lymphangioleiomyomatosis and tuberous sclerosis with
      pulmonary involvement were presented. Clinical picture of both diseases was
      similar. Breathlessness was the main symptom of lymphangioleiomyomatosis and
      there were signs of chylothorax. Chest x-ray interstitial changes disseminated in
      both lungs. High resolution computer tomography showed numerous cysts in both
      lungs. Proliferation of smooth muscle bundles was found in lung biopsy. Main
      symptoms of tuberous sclerosis were breathlessness on exertion and recurrent
      pneumothorax. Changes in chest x-ray, CT and lung biopsy were similar to found in
      lymphangioleiomyomatosis. Diagnosis of tuberous sclerosis was based on typical
      extrapulmonary signs and symptoms.

PMID- 8364438
TI  - [Extracorporeal membrane oxygenation].

PMID- 8364439
TI  - [Psychogenic disturbances of laryngeal function].

PMID- 8364440
TI  - [Who first described the Heimlich maneuver in Poland?].

PMID- 8364441
TI  - National advisory committee on immunization (NACI). Statement on hepatitis B
      vaccine.
AB  - The following recommendations on hepatitis B vaccine from NACI will appear in the
      4th edition of the Canadian Immunization Guide scheduled for publication in
      autumn 1993. They contain updated information on the epidemiology of hepatitis B
      in Canada and response to hepatitis B vaccine. In addition to vaccinating
      targeted high-risk populations, routine childhood immunization is now recommended
      although details on the preferred target age group and schedule are not yet
      finalized. There are some changes to the sections on pre-exposure immunization,
      post-exposure management, routine boosters (no longer needed), and post
      vaccination serology. Finally, the statement incorporates the new vaccine dosages
      for infants and children for Merck Sharp and Dohme's Recombivax HB, approved
      January 1992, and SmithKline Beecham's Engerix-B, approved September 1992.

PMID- 8364442
TI  - Fluorometric determination of L-tryptophan with methoxyacetaldehyde.
AB  - It was observed in our laboratory that methoxyacetaldehyde induced strong
      fluorescence with L-tryptophan in the presence of NaNO2 at pH 2.75. The reaction
      mixture was heated at 80 degrees C for 15 min and the fluorescence was measured
      at the excitation wavelength, 253 nm and the emission, 450 nm. Amino acids other
      than L-tryptophan did not produce fluorescence under the conditions employed. A
      good linear working curve was observed between 25 pmol/50 microliters and 500
      pmol/50 microliters of L-tryptophan. The limit of determination for L-tryptophan
      was 10 pmol/50 microliters. The coefficient of variation of the measurements (n =
      5) was 1.5% for 250 pmol/50 microliters of L-tryptophan. The proposed method was
      successfully applied to the analyses of tryptophan in a pooled human serum. Total
      tryptophan was determined after deproteinization with trichloroacetic acid, and
      free tryptophan was determined using the ultrafiltrate of a pooled human serum.
      Analytical recoveries of total and free tryptophan were 98.8% and 99.1%,
      respectively. The fluorescent products of L-tryptophan and methoxyacetaldehyde
      were characterized as beta-carboline and 1-methoxymethyl-beta-carboline by the
      use of liquid chromatography-mass spectrometry (LC-MS) and HPLC.

PMID- 8364443
TI  - Alteration in reactivity of sphingomyelinase from Streptomyces sp. modified with
      a polyethylene glycol derivative.
AB  - Purified sphingomyelinase of Streptomyces A9107 (NRRL 15100) was modified with ss
      PEG, methoxypolyethyleneglycol succinimidyl succinate, without loss of activity
      toward sphingomyelin in the mixed micelles with detergents such as sodium
      deoxycholate and Triton X-100 or toward a water-soluble, synthetic substrate,
      HNP, 2-(N-hexadecanoylamino)-4-nitrophenyl phosphocholine. The hemolytic and
      sphingomyelin-hydrolyzing activities of the enzyme toward intact bovine
      erythrocyte membrane were completely abolished by modification with ss-PEG,
      whereas the activity toward membranous sphingomyelin in the erythrocyte ghosts
      was fully retained. The enzyme activity toward liposomal sphingomyelin (large and
      small unilamellar vesicles) was significantly decreased by PEG-modification. The
      thermostability of sphingomyelinase was greatly increased by modification with ss
      PEG, whereas the sensitivity of the enzyme to proteolysis was not influenced by
      that modification.

PMID- 8364444
TI  - Reduction of nitro and azo compounds by NADPH-cytochrome P-450 reductase
      cytochrome c heme peptide system.
AB  - Octa heme peptide, an enzymic digestion product of Candida Krusei cytochrome c,
      was found to catalyze nitro and azo reduction in the presence of NADPH and NADPH
      cytochrome P-450 reductase under anerobic conditions. The reduction was dependent
      on the concentrations of heme peptide and reductase, and inhibited by carbon
      monoxide and oxygen. Comparison of the activities of the reductase-heme peptide
      system with liver microsomes revealed that heme peptide was as effective as
      cytochrome P-450 in nitro reduction, although less effective in azo reduction.
      Thus, cytochrome c heme peptide may serve as an artificial substitute for
      cytochrome P-450 at least in the reductive metabolism of xenobiotics.

PMID- 8364445
TI  - Effect of a monoclonal anti-sperm antibody (A-1) on in vitro fertilization in the
      mouse.
AB  - We prepared four monoclonal antibodies raised against mouse spermatozoa. The
      ability of the hybridoma culture supernatants to inhibit in vitro mouse
      fertilization was determined. One of these monoclonal antibodies, termed A-1,
      strongly inhibits sperm penetration into zona pellucida of egg in a concentration
      dependent fashion. On the other hand, even in the presence of the same
      concentration of A-1 antibody, sperm binding to comulus-free eggs was slightly
      inhibited and sperm-egg fusion was not inhibited at all. Immuno-fluorescence
      studies with A-1 showed that it recognizes an antigen(s) localized in the
      acrosome of mouse spermatozoa. In the case of unfixed sperm, the acrosome-intact
      sperm (i.e., sperm bound to egg zona pellucida) and unbound sperm were slightly
      immunostained with A-1 antibody (1.6% and 9.0%, respectively). All the full
      acrosome reacted sperm (i.e., sperm penetrating into the perivitelline space)
      were not immunoreacted. On the other hand, when sperm were fixed with methanol,
      approximately 80% of unbound sperm were immunoreacted with this antibody.
      Furthermore, almost all of zona-binding sperm were immunostained, whereas
      acrosome reacted, penetrating sperm were not. These data suggested that the
      antigen recognized by A-1 was located inside the plasma membrane of spermatozoa,
      and appeared on the surface of the spermatozoa during the period of penetration
      into egg zona pellucida. After sperm penetration into the perivitelline space
      this antigen must be released from the sperm.

PMID- 8364446
TI  - Effect of cupric ion on cholesteryl ester hydrolysis in rat peritoneal
      macrophages.
AB  - The inhibitory effects of Cu2+ on the hydrolysis of cholesteryl [4-14C]oleate
      droplets in rat peritoneal macrophages were studied. Macrophages rapidly
      incorporated cholesteryl [4-14C]oleate droplets and hydrolyzed at a linear rate
      over 9 h. When macrophages were preincubated in the medium containing Cu2+, the
      hydrolysis of cholesteryl oleate within macrophages was markedly inhibited by
      Cu2+ and eventually led to the accumulation of cholesteryl oleate in macrophages.
      The inhibitory effect on the hydrolysis of cholesteryl oleate was dependent on
      the concentration of Cu2+. Also, the activity of acid cholesteryl ester hydrolase
      (acid CEH) in lysosomal fractions isolated from rat peritoneal macrophages with
      Cu2+ showed a marked decrease. This decrease also occurred in a dose dependent
      manner. These results suggest that Cu2+ inhibits the hydrolysis of cholesteryl
      ester in macrophages, and that the accumulation of cholesteryl ester in
      macrophages of the early atheroscleotic lesion is responsible for the decrease of
      lysosomal acid CEH activity.

PMID- 8364447
TI  - Effect of histamine on memory retrieval in old rats.
AB  - Effects of intracerebroventricular (i.c.v) injection of histamine (Hi) and its
      related compounds on prolongation of the response latency ensuing after a long
      interruption of learning were studied by testing the active avoidance response in
      old rats. After Hi application at doses of 50 and 100 ng, the response latency
      became significantly shorter than that determined in the pre-injection periods,
      suggesting that Hi facilitates memory retrieval in old rats. H1-agonists, 2
      methylHi and 2-thiazolylethylamine, effected a dose-related shortening of
      response latency as seen after Hi application, whereas H2-agonists, 4-methylHi
      and impromidine, failed to prompt the response latency. Simultaneous i.c.v.
      injection of pyrilamine, a H1-antagonist and Hi abolished the Hi-induced
      shortening of response latency. Furthermore, intraperitoneal administration of
      histidine at doses of 200 and 500 mg/kg significantly shortened the response
      latency. Neither (R)-alpha-methylHi nor thioperamide caused a significant effect
      indicating that H3-receptor may not be involved in Hi-induced facilitation of
      memory retrieval. Based on these findings, it may be concluded that Hi takes an
      active part in facilitating memory recall via H1-receptor in old rats.

PMID- 8364448
TI  - Effect of bredinin on early embryonic development in mice.
AB  - Bredinin, an immunosuppressive agent, had a teratogenic effect and a decreasing
      effect in litter size in mice and in rats. We investigated the direct effect of
      bredinin on the development of mouse preimplantation embryos in vitro. Bredinin
      strongly inhibited the first differentiation step from the morula to the
      blastocyst stage, whereas the steps from the two-cell embryo to the morula stage
      were not inhibited. At 10(-6) or 10(-5) M of bredinin, only one or none of the
      morula embryos developed to a blastocyst after a 48 h culture; while
      approximately 90% of the embryos developed to blastocysts in the absence of
      bredinin. To determine whether the bredinin inhibition was reversible, the morula
      embryos were cultured with 10(-5) M of bredinin for 48 h. The embryos were
      transferred to bredinin-free culture conditions, and their development was
      observed. The inhibitory effect of bredinin was reversible. The expansion of zona
      free blastocyst was also inhibited by bredinin. When blastocyst embryos were
      cultured in the presence of bredinin (10(-6) M), the mean size of the embryos was
      reduced to half the initial size. In addition, the steps of hatching from the
      zona pellucida and attaching to the substratum were significantly inhibited by
      bredinin. Trophoblast outgrowth was completely inhibited by 10(-6) M bredinin;
      however, the area of trophoblast outgrowth was expanded to 18-fold the initial
      size after a 96 h culture in the absence of bredinin. Thus, the decrease in the
      number of offspring is due to the direct effect of bredinin on mice embryos.

PMID- 8364449
TI  - Formation of a new 1,1,1 adduct in the reaction of malondialdehyde, n-hexylamine
      and alkanal under neutral conditions.
AB  - The reactions of malondialdehyde (MDA) with n-hexylamine (HA) in the presence of
      alkanals at a neutral pH were investigated. Two new compounds, 1,1,1 adduct (4a)
      and fluorescent compound (3a), were isolated from the reaction of MDA, HA and
      acetaldehyde. Compounds 4a and 3a were identified as 2-formyl-3-hexylamino-3
      methylpropanal and 1-hexyl-5-hexyliminomethylene-4-methyl-1,4-dihydropyridine-3
      carba ldehyde, respectively. Similar compounds (4b and 3b) were obtained from the
      reaction of MDA, HA and propanal. Compound 4 was obtained in a high yield. In
      addition, the reactivity of MDA towards phenylethylamine (PEA) in the presence or
      absence of alkanals was investigated. The results indicated that MDA was of low
      reactivity in the absence of alkanals at neutral pH. However, when alkanals
      coexisted, MDA showed high reactivity towards PEA.

PMID- 8364450
TI  - Difference in rectal absorption of morphine from hollow-type and conventional
      suppositories in rabbits.
AB  - The bioavailability of morphine after rectal administration using three types of
      suppositories containing morphine hydrochloride (10 mg) in different added forms
      was evaluated in rabbits. Three types of suppositories were constructed with a
      base material (Witepsol H-15): a conventional suppository containing morphine
      hydrochloride mixed with a base material, a hollow-type suppository containing
      morphine in an aqueous solution in its cavity, and a hollow-type suppository
      containing morphine as a powder (hydrochloride salt) in its cavity. The plasma
      concentrations of morphine and its metabolites, morphine-3-glucuronide (M-3-G)
      and morphine-6-glucuronide (M-6-G), were determined. The mean AUC0-6 of morphine
      after rectal administration of the hollow-type suppository containing powdered
      morphine was significantly higher than that after the administration of a
      conventional suppository, whereas the mean AUC0-6 of M-3-G was lower than that
      after administration of a conventional suppository. The mean AUC0-6 of M-6-G by a
      hollow-type suppository containing powdered morphine was higher than that by a
      conventional suppository. Although the mean AUC0-6 ratio of M-3-G to morphine
      after administration of a conventional suppository was three times larger than
      that of a hollow-type suppository containing powdered morphine, the mean AUC0-6
      ratios of M-6-G to morphine after use of the three types of suppositories were
      all approximately 1.0. This study demonstrates that the hollow-type suppository
      containing powdered morphine is a more effective rectal dosage vehicle than the
      conventional suppository.

PMID- 8364451
TI  - Transport of aspirin and its metabolites through human erythrocyte membrane.
AB  - The transport of aspirin (ASP) and its metabolites (salicylic acid (SA),
      salicyluric acid (SAU), gentisic acid (GA) and gentisuric acid (GAU)) through
      human erythrocyte membrane was investigated. ASP permeated rapidly into the
      erythrocytes and the concentration dwindled gradually after the maximum
      concentration was attained almost within one minute. It was suggested that SA is
      released from the erythrocytes after ASP transported into the erythrocytes is
      hydrolyzed in them. In both an inward and outward direction, the transport rates
      of SA and GA were rapid, while those of SAU and GAU were lower by conjugating
      glycine. It was suggested that GAU remains for a long time in a living body. The
      rate of transport of GA and GAU were markedly obstructed by the band 3 protein
      inhibitor 4,4'-diisothiocyanostilbene-2,2'-disulfonate, although the transport
      rates of SA and SAU were obstructed only slightly. It was suggested that the
      transport of GA and GAU are mediated through band 3 protein.

PMID- 8364452
TI  - Effect of mexiletine on elimination and metabolic conversion of theophylline and
      its major metabolites in rats.
AB  - In an attempt to clarify the possible mechanism of the interaction between
      theophylline (TP) and mexiletine (ME), the elimination kinetics and in vitro
      metabolism of TP and its metabolites were investigated in rats. The plasma
      elimination of TP, 1,3-dimethyluric acid (1,3-DMU) and 1-methyluric acid (1-MU)
      was significantly delayed by the intravenous (i.v.) administration of ME. The
      oral administration of ME also decreased the elimination rate of TP to the same
      extent as the i.v. dosing. The in vitro metabolic experiment showed that ME
      significantly inhibited the metabolic conversion of TP to 1,3-DMU and, 1,3-DMU to
      1-MU, and slightly inhibited the conversion of TP to 3-methylxanthine, these
      processes being mediated by microsomal enzymes, with no inhibition of xanthine
      oxidase. Our results indicated that ME could inhibit the metabolic conversion of
      TP and its metabolite in rat, as reported in man.

PMID- 8364454
TI  - Controlled release of insulin from plasma-irradiated sandwitch device using poly
      DL-lactic acid.
AB  - The release behavior of insulin from a plasma-irradiated sandwitch (PIS) device
      using poly-DL-lactic acid (PLA) was studied. The controlled release device can be
      obtained by oxygen plasma irradiation (radiofrequency discharge operating at
      13.56 MHz) on the outer layer of the sandwitch device which was fabricated from
      an insulin-PLA matrix tablet as a core material and a mixture of plasma
      degradable polyoxymethylene (POM) and biodegradable PLA as a wall material. The
      release test indicated that insulin was released through the micropores formed by
      the vaporization of POM, and that the release behavior of insulin was affected
      largely by the molecular weight of PLA used as the outer layer rather than the
      plasma operational condition. The release of insulin can be controlled by the use
      of PLA with an average molecular weight of 11000 as the outer layer of the PIS
      device. Insulin from the PIS device maintained normal blood glucose levels for 10
      d in diabetic rats as an implantable dosage form. The duration of insulin
      effectiveness was relatively short considering the degradation rate of PLA,
      indicating that the degradation characteristics of biodegradable PLA were not
      well reflected in the PIS device.

PMID- 8364453
TI  - Enhancement effect of an ethanol/Panasate 800 binary vehicle on anti-inflammatory
      drug permeation across excised hairless mouse skin.
AB  - The novel binary vehicle system consisting of ethanol (EtOH) and Panasate 800 as
      tricaprylin was applied to five types of nonsteroidal anti-inflammatory drugs,
      and its enhancing effect on drug permeation across hairless mouse skin in vitro
      was assessed. The permeability of all drugs was remarkably increased by the
      treatment of skin with EtOH/Panasate 800 binary systems compared with either EtOH
      or Panasate 800 alone, and the effect reached a maximum in EtOH/Panasate 800
      (40/60) system. With regard to this binary system, the skin permeation ratio or
      flux of the drug increased in the following order: salicyluric acid (SU) >
      salicylic acid (SA) > alclofenac (ALC) > ketoprofen (KP) > ibuprofen (IBU). The
      one-layer skin model was applied concerning the above skin permeation profiles of
      the five drugs. Diffusion parameter (D'), partition parameter (K'), and
      permeation constant (Kp = D' x K') were calculated using the Laplace-transformed
      equations with the aid of MULTI (FILT). It was well demonstrated that the
      reduction of lag time and the increase of flux caused by EtOH/Panasate 800 binary
      vehicle systems was due to an increase of D' value by Panasate 800 and K' value
      by EtOH, respectively, in the skin. Especially, the EtOH/Panasate 800 (40/60)
      binary vehicle system produced the largest Kp value in each drug. In relation to
      all the EtOH/Panasate 800 binary vehicle systems, the logarithms of calculated Kp
      were found to be in inverse proportion to the logarithms of a n-octanol/water
      partition coefficient (P) of the drug which appeared in previous literature.

PMID- 8364456
TI  - Low mitogenic activity of synthetic lipid A analog, 2,3-acyloxyacylgalactosamine
      4-phosphate, in cultured murine splenocytes.
AB  - The mitogenicity of chemically synthesized lipid A analogs, 2,3
      acyloxyacylglucosamine-4-phosphate (A-103) and 2,3-acyloxyacylgalactosamine-4
      phosphate (A-113), was compared. Synthetic lipid A analogs of the disaccharide
      type (506), the monosaccharide-type (A-103) suspended in RPMI-1640 medium
      supplemented with triethylamine, and Salmonella typhimurium LT-2
      lipopolysaccharide (LPS) were capable of increasing the incorporation of
      [3H]thymidine into splenocytes of C57BL/6 mice at various doses ranging from 1.0
      to 100 micrograms/ml. However, the mitogenic activity of A-113 at these doses was
      markedly weaker than the activity of the above materials. When the A-103 and A
      113 were suspended in RPMI-1640 medium supplemented with ethanol, the mitogenic
      activity of A-113 also showed lower activity than that of A-103 in the
      splenocytes of C57BL/6 mice. These findings indicate that the mitogenic activity
      of synthetic lipid A of the monosaccharide-type is affected by a kind of composed
      sugar.

PMID- 8364455
TI  - A novel colorimetric method for determination of glycated protein based on 2-keto
      glucose release with hydrazine.
AB  - We tried to measure glycated proteins by a novel method based on colorimetry of 2
      keto-glucose which is released from the glycated protein (ketoamine) on heating
      with hydrazine. Reaction conditions were optimized with glycated human serum
      albumin (glc HSA) as a model compound. Ketoamine reacted quantitatively with
      hydrazine on heating at 100 degrees C for 0.5 h, followed by heating with
      phenylhydrazine at 60 degrees C for 1 h. Glucose interference with the assay was
      eliminated by preincubation of the sample with glucose oxidase at 37 degrees C
      for 0.5 h. Time courses for the coloration of glc HSA and human serum showed a
      profile similar to that of N-p-tolyl-D-isoglucosamine under optimized reaction
      conditions. The lower limit for the assay of glc HSA was 0.7 microM. The serum
      level of glycated proteins measured by the present method correlated well with
      that (fructoamine value, microM) measured by the conventional method (nitroblue
      tetrazolium-reducing method) (r = 0.92, n = 35). In conclusion, the present
      method is a novel, highly sensitive and reliable one for measuring glycated
      proteins in biological samples.

PMID- 8364458
TI  - S-methyl methane thiosulfonate, a new antimutagenic compound isolated from
      Brassica oleracea L. var. botrytis.
AB  - Though various antimutagens with desmutagenic activities have been found in our
      daily foods of plant origin, the numbers of antimutagens with bio-antimutagenic
      activities found so far are limited. In the present study, a compound with
      potential bio-antimutagenic activity to Escherichia coli B/r WP2 was newly
      isolated from cauliflower, Brassica oleracea L. var. botrytis, and its chemical
      structure was identified to be S-methyl methane thiosulfonate by NMR and MS
      analysis.

PMID- 8364457
TI  - Effects of dimethylpyrazine isomers on reproductive and accessory reproductive
      organs in male rats.
AB  - The effects of dimethylpyrazine isomers on reproductive and accessory
      reproductive organs in male rats were studied. Following the administration of
      2,5-dimethylpyrazine (100 mg/kg, s.c.) the weight of prostate and seminal
      vesicles, as well as testosterone levels in plasma were significantly decreased.
      One isomer of dimethylpyrazine, 2,6-dimethylpyrazine (100 mg/kg, s.c.), affected
      only the seminal vesicles, while 2,3-dimethylpyrazine had no influence on
      accessory reproductive organs. Following administration of 100 mg/kg of 2,5
      dimethylpyrazine, acid phosphatase activity in the prostate and fructose content
      in the seminal vesicles were also significantly decreased compared with tissues
      from vehicle-treated animals. Weight of the testes and acid phosphatase activity
      therein were not affected following the administration of 2,5-dimethylpyrazine,
      nor were numbers of spermatozoa in the epididymis. These results showed that 2,5
      dimethylpyrazine induced decrease in prostate and seminal vesicle weight by
      inhibiting testosterone uptake and reducing plasma testosterone levels.

PMID- 8364460
TI  - Specific inhibitory effect of hybrid liposomes on growth of human lymphoma-human
      lymphocyte B hybridoma cells in vitro.

PMID- 8364459
TI  - Isolation of bilobalide and ginkgolide A from Ginkgo biloba L. shorten the
      sleeping time induced in mice by anesthetics.
AB  - The leaves of Ginkgo biloba L. and aqueous extract from them shortened the
      sleeping time induced in mice by anesthetics (hexobarbital, alpha-chloralose and
      urethane, i.p.). Two characteristic terpenoids in G. biloba, bilobalide and
      ginkgolide A, significantly shortened the sleeping time induced by anesthetics. A
      toxic substance, 4-O-methylpyridoxine (MPN), responsible for "gin-nan food
      poisoning" isolated from the seed of G. biloba, was not detected from the extract
      of the leaves of G. biloba. Therefore, the Ginkgo biloba extract has no
      toxicities for MPN.

PMID- 8364461
TI  - Preparation of fluorescence labeled insulins, sulfobenzoxadiazolyl-insulins, for
      fluorescence immunoassay.
AB  - The preparation of insulins labeled with a fluorescent moiety at a definite
      position (Gly(A1) or Lys(B29)) on the molecule is described. Gly(A1)- and
      Lys(B29)-S-acetylthioglycoloyl-insulins and Gly(A1)-2(or 3)-acetylmercapto-3
      carboxypropranoyl-insulin were deacetylated and then reacted with 7-chloro-4
      sulfobenzoxadiazole, a fluorogenic reagent, to afford the corresponding
      fluorescence labeled insulins. The preparative separation of the fluorescence
      labeled insulins from the insulin derivatives that remained unreacted was carried
      out by anion-exchange high-performance liquid chromatography on a TSKgel DEAE-2SW
      column.

PMID- 8364462
TI  - Evidence of conversion of estradiol 17-sulfate to its 2- and 4-hydroxylated
      catechols by human placental microsomes.
AB  - When estradiol 17-sulfate (ES) was incubated with human placental microsomes
      under an NADPH-generating system, 2- and 4-hydroxyestradiol 17-sulfates (2- and 4
      OH-ES) formed as the main products. By kinetic experiments, the apparent Km
      values of 44.0 and 360 microM and apparent Vmax values of 236 and 140 pmol/mg
      protein/10 min were obtained for the 2- and 4-hydroxylation, respectively. The
      results indicate that human placental microsomes have fairly high 2- and 4
      hydroxylase activities toward ES. This paper describes the formation of 2- and 4
      OH-ES and speculates on their physiological role during pregnancy.

PMID- 8364463
TI  - Preparation and evaluation of fatty acid esters of 2-(4-hydroxyphenyl)-4,5
      diphenylimidazole as fluorescent substrates for measurement of lipase activity.
AB  - A series of four aliphatic carboxylic acid esters (acetate, caproate, laurate and
      palmitate) of 2-(4-hydroxyphenyl)-4,5-diphenylimidazole (HDPI) was prepared.
      Usefulness of these esters as fluorescent substrates for the measurement of
      lipase activity was evaluated using a high performance liquid chromatographic
      method. The hydrolysate, HDPI, could be well separated from each substrate by a
      reversed-phase column and detected at 440 nm emission (cutoff-filter) with 360 nm
      excitation. Lipase from Candida cylindracea was used for the investigation. From
      their kinetic parameters, the caproate and laurate were found to be suitable for
      the lipase. Using the laurate, from 5 to 500 mU per assay tube of the lipase was
      determined.

PMID- 8364464
TI  - Serum components induce beta-D-glucan-inhibitable uptake of zymosan particles by
      murine peritoneal macrophages.
AB  - Effects of murine serum (NMS) treatment on (1-->3)-beta-D-glucan inhibitable
      uptake of zymosan particles (ZYM) (GIZUP) by murine peritoneal macrophages (PM)
      and the structural specificity of the inhibition were examined. ZYM uptake by PM
      treated with NMS was enhanced in comparison with those treated with medium, and
      in a concentration- and incubation time-dependent manner. The enhanced ZYM uptake
      was significantly reduced by the pretreatment of PM with soluble (1-->3)-beta-D
      glucans. These facts suggest that NMS enhances GIZUP. The effect disappeared by
      the treatment of NMS with gelatin-Sepharose which removed fibronectin (FN) from
      the serum, suggesting a significant contribution of FN on GIZUP. In addition, the
      administration of beta-glucan in vivo elevated the concentration of FN in serum
      by acute phase response and enhanced GIZUP, suggesting the positive contribution
      of acute phase responses on beta-glucan mediated immunopharmacological
      activities. Of particular interest, the inhibition was shown by both antitumor
      active and inactive glucans. These facts suggested that the recognition of beta
      glucans by PM, which would proceed at a relatively early period of whole
      activation pathways, would not be enough to fully activate the host to show
      antitumor activity.

PMID- 8364465
TI  - Metabolism of mutagenicity-deprived 3-fluoroquinoline: comparison with mutagenic
      quinoline.
AB  - 3-Fluorinated quinoline (3FQ), a non-mutagenic derivative of the potent mutagen
      quinoline, was metabolized with a microsomal enzyme fraction isolated from the 3
      methylcholanthrene-treated rat liver. The metabolites were 3-fluoro-5,6
      dihydroquinoline-5,6-trans-diol (72%), 3-fluoroquinoline 1-oxide (6%), 3-fluoro
      5,6-dihydroquinoline-5,6-cis-epoxide (1%), and 4 unidentified metabolites (11%).
      Since this metabolic pattern is similar to that obtained with unfluorinated
      quinoline, the epoxidation of the benzene moieties of quinoline and 3
      fluoroquinoline is most likely a detoxication process and not mutagenic
      activation.

PMID- 8364466
TI  - Arabinogalactan core structure and immunological activities of ukonan C, an
      acidic polysaccharide from the rhizome of Curcuma longa.
AB  - Controlled Smith degradation of ukonan C, a phagocytosis-activating
      polysaccharide isolated from the rhizome of Curcuma longa L., was performed. The
      reticuloendothelial system-potentiating, anti-complementary and alkaline
      phosphatase-inducing activities of ukonan C and its degradation products were
      investigated. Methylation analyses of the primary and secondary Smith degradation
      products and of a de-arabinosylated product indicated that structural features of
      the arabinogalactan core of ukonan C include a backbone chain composed of beta
      1,3-linked D-galactose and beta-1,4-linked D-xylose. All of the galactose units
      in the backbone carry side chains composed of beta-1,6-linked D-galactosyl
      residues with or without terminal alpha-L-arabinose units at position 3. Ukonan C
      showed remarkable effects on both reticuloendothelial system-potentiating and
      alkaline phosphatase-inducing activities. Periodate oxidation caused a decrease
      in or disappearance of the immunological activities, but the controlled Smith
      degradation product having the arabinogalactan core structure of polysaccharide
      showed a pronounced effect on anti-complementary activity.

PMID- 8364467
TI  - Three rhamnose-binding lectins from Osmerus eperlanus mordax (olive rainbow
      smelt) roe.
AB  - Three rhamnose-binding lectins were purified from the roe of Osmerus eperlanus
      mordax (olive rainbow smelt) by affinity chromatography and ion-exchange
      chromatography. The apparent molecular weights of Osmerus eperlanus mordax lectin
      (OML) -1, -2 and -3 were 25000, 32000 and 26000, respectively, on sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) under reducing conditions.
      On native PAGE, these three lectins showed different migration patterns (Rm
      value; 0.37, 0.53 and 0.66, respectively). OMLs agglutinated rabbit and human
      type B erythrocytes and sarcoma 180 cells, but not human type A and O
      erythrocytes and AH109A cells. The most effective monosaccharide inhibitor was L
      rhamnose. L-Mannose and D-galactose were also good inhibitors. Furthermore, OML
      induced hemagglutination was inhibited more strongly by melibiose or raffinose
      rather than lactose or lactulose. Therefore, OMLs are L-rhamnose/alpha-D
      galactosyl type lectins. OMLs did not require a detergent, when extracted from
      crude material, and Ca2+, Mg2+, EDTA and dithiothreitol were not necessary for
      the OML-induced hemagglutination activities. The OMLs had similar N-terminal
      amino acid sequences.

PMID- 8364468
TI  - Neurotropic pyrimidine heterocyclic compounds. I. The newly synthesized
      pyrimidine compounds promote neurite outgrowth of GOTO and neuro 2a neuroblastoma
      cell lines, and potentiate nerve growth factor (NGF)-induced neurite sprouting of
      PC 12 cells.
AB  - From the study using cultured human and mouse neuroblastoma cells, we found that
      a new type of synthetic bicyclic pyrimidine compounds possessing piperazine
      moiety strongly promoted neurite outgrowth in neuroblastoma cell lines human GOTO
      and mouse neuro 2a. The most effective compounds of these 2-piperazinopyrimidine
      derivatives possessing nerve growth factor (NGF)-like activity were 2-piperazino
      6-oxo-5,6-dihydro(7H)pyrrolo[2,3-d]pyrimidine and 2-piperadino-6-methyl-5-oxo-5,6
      dihydro(7H)pyrrolo[3,4-d]pyrimidin e. The piperazinopyrimidine compounds were
      also shown to potentiate NGF-induced neurite sprouting of rat pheochromocytoma
      PC12 cells. The compounds were more effective in cell cultures than
      isopropylaminopyrimidine (isaxonine) which had been previously developed and then
      withdrawn. We discussed the merit of the method of the screening of neurotropic
      compounds by neurite sprouting activity in cultured neuroblastoma cells.

PMID- 8364469
TI  - Feasibility of use of several cardiovascular agents in transdermal therapeutic
      systems with l-menthol-ethanol system on hairless rat and human skin.
AB  - Effect of the simultaneous use of l-menthol and ethanol on the skin permeation of
      six potent cardiovascular agents: nicardipine hydrochloride, atenolol, captopril,
      nifedipine, vinpocetine and nilvadipine (in hydrophilic order) was investigated
      to evaluate the feasibility of their use in a transdermal therapeutic system
      (TTS). In vitro diffusion experiments were carried out using excised hairless rat
      and human skin, and the application area of TTS required for the minimum
      therapeutic effect was estimated by a simple pharmacokinetic calculation. Marked
      enhancing effect by the l-menthol-ethanol system was found independent of drug
      lipophilicity, but the mode of action was dependent on the lipophilicity of the
      drug. The action of the system on lipophilic drugs (nifedipine, vinpocetine and
      nilvadipine) was mainly due to their increase in solubility in the system, while
      that on hydrophilic (or water soluble) drugs (nicardipine hydrochloride, atenolol
      and captopril) was the result of increase in their skin permeability coefficient.
      This enhancing effect was adequate to assure their minimum effective
      concentration (MEC) in human. The area of application of a drug to maintain the
      MEC was calculated to be 0.15 cm2 for hydrophilic or water soluble drugs and 3.7
      13 cm2 for lipophilic drugs.

PMID- 8364471
TI  - In vivo release of water-soluble drugs from stabilized water-in-oil-in-water
      (W/O/W) type multiple emulsions following intravenous administrations using rats.
AB  - The in vivo release of four water-soluble drugs, cefadroxil, cephradine,
      antipyrine and 4-aminoantipyrine, from a stabilizing water-in-oil-in-water
      (W/O/W) type multiple emulsion was studied using rats. The W/O/W type multiple
      emulsion used in this study could be stabilized for 30 d after preparation at
      room temperature and also for 24 h in pH 7.4 isotonic phosphate buffer or in rat
      plasma at 37 degrees C. The cefadroxil and cephradine concentrations in rat
      plasma following intravenous administrations of their W/O/W type multiple
      emulsions containing drugs were considerably prolonged compared with those of
      respective aqueous solutions. Sustained-releasing properties of cefadroxil and
      cephradine from W/O/W type multiple emulsions could be explained by the mechanism
      underlying the long residence time of W/O/W type multiple emulsions and delay
      release of drugs from the W/O/W type multiple emulsions circulated with rat blood
      stream. However, antipyrine and 4-aminoantipyrine decreased rapidly following
      W/O/W type multiple emulsions and these plasma profiles coincided precisely with
      those following intravenous administration of the aqueous solutions of drugs.
      These in vivo releasing data correlated with in vitro drug release observation
      stated in the previous papers.

PMID- 8364470
TI  - Enhanced absorption of bumetanide from suppositories containing weak acids in
      rabbits.
AB  - The in vitro release of bumetanide from macrogol suppositories with and without
      weak acids (citric acid and tartaric acid) was studied. The release of bumetanide
      was not affected when weak acids were added to the suppositories. The in vivo
      rectal absorption of bumetanide from the suppositories was evaluated in rabbits.
      The bioavailability (absolute), expressed as the ratio of the area under the
      plasma concentration-time curve (AUC) following oral administration of
      bumetanide, was 39% that of intravenous administration. The value in bumetanide
      following rectal administration of the suppositories without weak acids was 32%.
      Each absolute bioavailability following rectal administration of the
      suppositories with 5% citric acid and 5% tartaric acid was 52% and 42%,
      respectively. These values were significantly larger than those of rectal
      administration of the suppositories without weak acids. Particularly, the
      bioavailability following rectal administration of the suppositories containing
      citric acid was significantly different from even those of oral administration.
      The absorption rate constants of bumetanide from the suppositories with weak
      acids were significantly larger than those following oral administration. These
      results indicated the possibilities of the rectal route of administration of
      drugs which are weak organic acids and show low or variable bioavailability
      following oral administration.

PMID- 8364472
TI  - Construction of a physiologically based pharmacokinetic model to describe the
      hepatobiliary excretion process of ligands: quantitative estimation of
      intracellular diffusion.
AB  - A physiologically based pharmacokinetic model was established to describe the
      hepatobiliary excretion process for ligands which are excreted into the bile
      without metabolic conversion. In this model, the following processes were taken
      into consideration: influx and efflux across the liver sinusoidal membrane,
      intracellular diffusion, and excretion across the canalicular membrane into the
      bile. The partial differential equation by which these processes were described
      was solved to obtain the Laplace transformed solution for the biliary excretion
      rate of ligands, based on the plasma concentration profiles as an input function.
      The time profiles for the biliary excretion rate of dibromosulfophthalein (DBSP;
      6.80 mg/kg b.w.) or cefodizime (15.0 mg/kg b.w.) after i.v. bolus administration
      to rats were fitted to the solution using a nonlinear least-squares program based
      on a fast inverse Laplace transform (MULTI-FILT [Y. Yano et al., Chem. Pharm.
      Bull., 37, 1035 (1989)] to determine the permeability-surface area product across
      the plasma membrane as well as the apparent intracellular diffusion coefficient.
      DBSP and cefodizime were used as model compounds since these two ligands possess
      different binding characteristics for cytosol protein(s). Although both ligands
      are present predominantly in the cytosol, DBSP binds to intracellular protein(s)
      (such as ligandin) to a great extent whereas the protein binding of cefodizime is
      not so extensive. The fitted lines were superimposed on the experimental
      results.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364473
TI  - Sensitive determination of ambenonium in plasma using inhibitory activity to
      acetylcholinesterase.
AB  - A sensitive analytical method for the determination of ambenonium, a selective
      acetylcholinesterase inhibitor, in plasma was developed. The procedure involves
      ultrafiltration to remove endogenous plasma cholinesterase, followed by
      colorimetric measurement of the inhibitory activity to acetylcholinesterase by
      the thiocholine method. Coefficient of variation of within-day triplicate
      analysis is less than 20% at the concentration of 5 nM. Detection limit of this
      method is 1 nM, which is twice lower than the most sensitive HPLC method reported
      previously. This assay procedure is applied to the pharmacokinetic study of
      ambenonium after intravenous administration of low dose (10-20 nmol/kg) to rat.
      This new method is rapid and simple and makes it possible to determine the
      ambenonium concentration in plasma with good accuracy.

PMID- 8364474
TI  - Binding of lysozyme to synthetic monosaccharide lipid A analogue, GLA60.
AB  - Recent studies by our group suggested that lysozyme (LZM) has a high affinity for
      bacterial lipopolysaccharide (LPS) of both the smooth and rough forms, and
      inhibits various immunomodulatory activities of LPS. GLA60 is a synthetic
      monosaccharide analogue of bacterial lipid A, well-known as sharing large part of
      lipid A activities but with very low toxicity. In this study, we characterized
      the interaction of LZM with GLA60 in comparison to that with E. coli 0111 LPS
      (smooth form), taking a physicochemical approach. Using a dansylated lysozyme
      probe (DNS-LZM), LZM was found to bind to GLA60 in all 3 of its forms, free acid,
      triethylamine (TEA) salt and bovine serum albumin (BSA) complex of GLA60, as well
      as natural LPS. Compared with LPS, the complex formation of the TEA salt was
      weakly dependent on temperature and incubation time. LZM also bound to
      biologically inactive GLA analogues, GLA 64 and GLA69, at a high affinity, as
      well as to GLA 60. By using chemically modified LZM, it was found that the ionic
      as well as hydrophobic interactions are important for the complex formation.

PMID- 8364475
TI  - Uptake of glycyrrhizin by isolated rat hepatocytes.
AB  - The mechanism of uptake of glycyrrhizin (GLZ) by isolated rat liver cells was
      studied. The uptake rate was dependent on the unbound GLZ concentration. The
      initial uptake rate with respect to the unbound GLZ concentration reflected the
      operation of both saturable and nonsaturable processes, which followed Michaelis
      Menten type kinetics; the process involves a Km of 11.3 microM, Vmax of 0.112
      nmol/min/10(6) cells, and a first-order rate constant (Kd) of 0.195
      nmol/min/10(6) cells/mM. GLZ adsorption on the cell membrane occurs at two types
      of binding sites with a linear adsorption coefficient = 2.81 nmol/10(6) cells/mM
      and a dissociation constant = 18.3 microM and its adsorption capacity = 0.12
      nmol/10(6) cells describing specific adsorption. GLZ uptake did not require the
      presence of Na+ in the incubation medium and was not significantly inhibited by
      ouabain. The Arrhenius plot of uptake of 10 microM GLZ presented a single
      straight line in the range of 4-37 degrees C, with an activation energy of 15.9
      kcal/mol. An energy requirement was also demonstrated, as all metabolic
      inhibitors studied (rotenone, antimycin A, 2,4-dinitrophenol, and KCN)
      significantly reduced the uptake of 10 microM GLZ (p < 0.01). The uptake was
      competitively inhibited by glycyrrhetinic acid (GLA), taurocholate (TCA), and
      probenecid (PBC) with inhibition constants, Ki, of 13.7, 48.5, and 115.9 microM,
      respectively, and it was noncompetitively inhibited by bromosulfophthalein (Ki
      9.2 microM) and indocyanine green (Ki 13.5 microM) only at low GLZ concentrations
      (5 and 10 microM).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364477
TI  - Fluorometric assay of rat brain N-methyltransferase with 4-methylnicotinamide.
AB  - A fluorometric method for the assay of rat brain N-methyltransferase (NMT) has
      been developed using rat brain 9000 x g supernatant fluid as an enzyme
      preparation. The method is based on the enzyme reaction at pH 8.6 using 4
      methylnicotinamide (4-MN) as the methyl acceptor substrate in the presence of
      cofactor S-adenosyl-L-methionine (AdoMet), and the fluorometric determination of
      the product 1,4-dimethylnicotinamide by means of its reaction with 4
      methoxybenzaldehyde. The apparent Km values for 4-MN and AdoMet were 0.47 mM and
      19 microM, respectively. The method was successfully applied to the studies of
      age- and sex-related differences of brain NMT activity in rats. The enzyme
      activity decreased gradually between 3 and 14 weeks of age whereas there were no
      differences between males and females in the levels of NMT activity.

PMID- 8364476
TI  - Stereoselective disposition of pranoprofen, a nonsteroidal antiinflammatory drug,
      in rabbits.
AB  - The stereoselective disposition of pranoprofen, a nonsteroidal antiinflammatory
      drug, was studied in rabbits. Plasma levels of S(+)-pranoprofen after oral and
      i.v. administration of the racemate pranoprofen were always higher than those of
      the R(-)-isomer. The elimination rate constant of the R(-)-isomer (2.74 h-1),
      calculated using a 2-compartment model, was significantly larger than that of the
      S(+)-isomer (2.14 h-1), while no significant difference was observed in the
      absorption rate constants between enantiomers. Pranoprofen was excreted in the
      urine exclusively in the form of pranoprofen glucuronide. The glucuronide of R(-)
      isomer was excreted more rapidly than the S(+)-isomer. However, no metabolite of
      pranoprofen was detected in plasma, owing to its instability in liver and plasma.
      Moreover, the elimination of the S(+)- and R(-)-isomers of pranoprofen was more
      rapid when the enantiomers were separately administered than when administered as
      the racemate. The R(-)-isomer showed a significantly higher elimination rate than
      the S(+)-isomer, compared to what was observed upon the administration of the
      racemate. No inversion to an R(-)-form or S(+)-form to their corresponding
      antipode after administration of the isomers separately was detected.
      Pranoprofen, especially the R(-)-isomer, was significantly distributed in the
      kidney. An in vitro metabolism experiment of pranoprofen showed the predominant
      glucuronidation to be in the kidney rather than in the liver because of rapid
      hydrolysis of glucuronide in the liver.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364478
TI  - Analysis of chondroitin sulfate/dermatan sulfate chains in rat peritoneal
      resident macrophages.
AB  - Chondroitin sulfate/dermatan sulfate (CS/DS) hybrid polymers obtained from rat
      peritoneal resident macrophages were analyzed by the enzymatic method; CS/DS
      chains were digested by chondroitinase, and the resultant unsaturated
      disaccharides were determined by HPLC with fluorometric detection. CS/DS in the
      resident macrophages are constituted of Di-4S, Di-6S, Di-diSE, Di-diSB and Di
      triS.

PMID- 8364479
TI  - Studies on pharmacological activation of human serum immunoglobulin G by chemical
      modification and active subfragments. IX. Anti-inflammatory activity of
      completely alkylated heavy chain (C.Fr.I-H).
AB  - The anti-inflammatory activity of completely reduced and carboxamide-methylated
      heavy chain of all disulfide bonds in human serum immunoglobulin G (IgG) (C.Fr.I
      H) was investigated using some experimental inflammatory models. C.Fr.I-H
      significantly inhibited carrageenin-induced paw edema and pleurisy, and serotonin
      induced paw edema. The carboxamide-methylated heavy chain of interchain disulfide
      bonds in IgG (Fr.I-H) exhibited similar inhibitory activities to C.Fr.I-H on
      carrageenin-induced paw edema and pleurisy, while it was ineffective on serotonin
      induced paw edema. These results suggest that complete alkylation of disulfide
      bonds in a heavy chain caused stronger anti-inflammatory activities than partial
      alkylation.

PMID- 8364480
TI  - Effect of pretreatment of skin with cyclic monoterpenes on permeation of
      diclofenac in hairless rat.
AB  - The promoting effect of d-limonene and l-menthol on the percutaneous absorption
      of nonionized and ionized diclofenac (DF) was investigated employing a
      pretreatment method. After the pretreatment of hairless rat skin with an ethanol
      buffer solution containing terpenes, the permeation study was performed in vitro.
      The permeability coefficients of nonionized (Pn) and ionized diclofenac (Pi) were
      calculated under the assumption that the total flux was composed of individual
      fluxes of nonionized and ionized DF. In the case of pretreatment with d-limonene,
      both Pn and Pi values were increased dramatically. However, the promoting
      magnitude was not affected by an extension of the pretreatment period. In
      contrast, when the skin was pretreated with l-menthol, the Pn and Pi values
      increased gradually as the pretreatment period increased. Based on the
      measurement of the solubility of terpenes in the pretreatment solution, the
      difference in promoting efficiency could arise from the difference in
      thermodynamic activity of the terpenes.

PMID- 8364481
TI  - Rectal absorption of acyclovir in rats and improvement of absorption by
      triglyceride base.
AB  - The rectal absorption of acyclovir has been evaluated after administration of
      suppositories without absorption enhancers in rats. The disappearance of plasma
      acyclovir followed biexponential kinetics after i.v. dosing. Rectal
      administration of a triglyceride (Vosco S-55 and Vosco S-55 + methylcellulose)
      suppository gave relatively high plasma concentrations and bioavailabilities
      (95.3 and 83.4%, respectively) compared with Witepsol and macrogol suppositories.
      However, the in vitro release profiles from suppositories did not accurately
      reflect plasma concentrations after rectal dosing. Our results suggest that the
      rectal administration of acyclovir suppositories may be a promising substitute
      for intravenous infusion, which is at present used for the treatment.

PMID- 8364482
TI  - Evaluation of bioavailability upon oral administration of phytonadione
      preparations in beagle dogs.
AB  - Bioavailability of phytonadione was investigated after oral administration to
      beagle dogs. The administrations of phytonadione in a surfactant solution
      (preparation a) and in an oleic acid solution (preparations b) greatly increased
      the bioavailability of phytonadione. The AUCs of preparations a and b were about
      2.5 times larger than those of commercially available tablets A and C. This
      result well corresponded to the results of the dissolution test previously
      reported. The absorption of phytonadione from the gastro-intestinal tract was
      affected by food and the bioavailability was largely increased under non-fasted
      conditions. However, a large scatter was observed in the data, and it was found
      that the evaluation of the bioavailability of phytonadione preparations could not
      be done in non-fasted animals.

PMID- 8364483
TI  - Chemical and biological degradation of 5-fluorouracil prodrugs having high serum
      albumin binding potencies.
AB  - In order to understand the fundamental structural features which yield both high
      serum albumin binding potency and desired property as a prodrug, the
      derivatization was performed at N-1 or N-3 position in 5-fluorouracil. The N-3
      derivatives were more stable than N-1 derivatives in vitro, whereas they were
      metabolized quickly in vivo. It is suggested that N-1 position should be blocked
      to avoid fast metabolism in vivo.

PMID- 8364484
TI  - An acute and focal osteopenia model using ovariectomized rats: a rapid detection
      of the protective effect of salmon calcitonin.
AB  - A screening method for anti-osteoporotics using ovariectomized rats was designed
      using a compact method to monitor the bone density. It was found that ovariectomy
      (OVX) of Wistar female rats (11 weeks old) induced acute and focal osteopenia
      within 2 weeks, which responded well to intermittent salmon calcitonin (SCT: 5
      and 20 U/kg, s.c., every other day) employed as the standard anti-osteoporotic
      and injected up to 4 weeks with or without a delay of 2 weeks after OVX.

PMID- 8364485
TI  - Labile 50S ribosome from partial macrolide-resistant Staphylococcus aureus.
AB  - Staphylococcus aureus S704 and 8325MMT7 show constitutive resistance to macrolide
      antibiotics such as erythromycin (EM), oleandomycin, spiramycin, rosamicin and
      josamycin, except for tylosin, rokitamycin (RKM), and mycinamicin as well as
      lincosamide and streptogramin type B antibiotics (PM-resistance). Whenever 70S
      ribosomes from either of them were dissociated into 30S and 50S subunits in a 10
      28%(W/W) linear sucrose gradient, the latter subunit was further cleaved into two
      small apparently equal particles (about 40S). RKM could no longer bind to either
      of the small particles. A prior exposure of 8325MMT7's 50S subunit to RKM (except
      EM) did not cause cleavage in any small particles. The largest component (M.W.
      33.0kDa) of 50S ribosomal proteins was absent in at least the small particles.
      The first finding suggests that the lability of the 50S ribosome may be
      responsible for PM-resistance.

PMID- 8364487
TI  - Proton NMR study on a histone-like protein, HU alpha, from Escherichia coli and
      its complex with oligo DNAs.
AB  - It was confirmed that the flexible arm region of HU alpha forms an antiparallel
      beta-sheet and that all of the residues of phenylalanines, together with some of
      leucines and/or valines, form a hydrophobic core within the dimer of HU alpha. HU
      alpha protein alone is thermally labile and melts at 38 degrees C, but it becomes
      remarkably stabilized and melts at 59 degrees C in the presence of DNA. Several
      resonances from both HU alpha and DNA perturbed by their complex formation,
      notably those of His C-2 and C-4 protons, downfield shifted C alpha protons in
      the antiparallel beta-sheet, as well as Arg C delta and Lys C epsilon protons.
      The results indicated that a beta-sheet region of HU alpha binds to DNA, and also
      showed that rapid equilibrium occurs on the NMR time scale between bound and
      unbound states of HU alpha. A few intermolecular nuclear Overhauser effects
      (NOEs) were also observed between the protein and H1' protons of DNA in the
      complex, suggesting that HU alpha binds primarily to the minor groove of DNA.

PMID- 8364486
TI  - Inhibitory effect of diltiazem on diazepam metabolism in the mouse hepatic
      microsomes.
AB  - In order to elucidate the drug interaction between diltiazem and diazepam, the
      effect of diltiazem on the N-demethylation of diazepam in the mouse hepatic
      microsomes was investigated. Kinetic study showed that diltiazem noncompetitively
      inhibited the N-demethylation of diazepam with inhibition constant (Ki) value of
      247.8 microM, indicating that diltiazem exhibits an inhibitory effect on the
      hepatic oxidative metabolism of diazepam. It was therefore suggested that
      diltiazem may impair the metabolism of diazepam in vivo.

PMID- 8364488
TI  - Purification of water-soluble bone-inductive protein from bovine demineralized
      bone matrix.
AB  - The water-soluble fraction containing bone-inductive activity was purified from
      guanidine-hydrochloride extracts of bovine demineralized bone. The purification
      steps include ultrafiltration, dialysis, affinity chromatography on heparin
      Sepharose and gel chromatography on Sephacryl S-200. Combination of these steps
      was proven to be an effective and rapid method for the purification of this
      protein. Subcutaneous implantation of the water-soluble protein with type I
      collagen was carried out in the thorax of rats. When alkaline phosphatase
      activity and calcium content in implants were used as indices for purification,
      the water-soluble bone-inductive protein was purified > 600-fold according to the
      enzyme activity and 64-fold according to the calcium content. A morphological
      examination revealed that many chondrocyte and osteoblast cells were seen in the
      location of the implanted material. Sodium dodecyl sulfate/gel electrophoresis of
      the protein produced in this way under non-reducing conditions revealed four
      protein bands of 18, 16, 14 and 11 kDa. None of the separated bands had any
      biological activity. This result suggests that the water-soluble bone-inductive
      activity depends on an associated form of various proteins in the range of 18 to
      11 kDa.

PMID- 8364489
TI  - Sialic acid in fibrinogen: effects of sialic acid on fibrinogen-fibrin conversion
      by thrombin and properties of asialofibrin clot.
AB  - The final stage in a series of blood coagulating reactions is fibrinogen-fibrin
      conversion by thrombin. This reaction consists of fibrinopeptide A and
      fibrinopeptide B release, polymerization of fibrin monomer, and stabilized fibrin
      formation by factor XIII. The latter two reactions require calcium. In the
      present study there was no difference in the rate of thrombin-induced
      fibrinopeptide release between fibrinogen and asialofibrinogen where sialic acid
      in the terminal end of carbohydrate moiety of fibrinogen was removed by
      neuraminidase, but turbidity associated with asialofibrin clot formation was
      increased more rapidly. In asialo-derivatives, the dissolution time of the clots
      in high concentrated urea solution tended to be shortened and rigidity as a gel
      tended to be decreased. In measurement by thromboelastography there was no
      difference in the reaction time (r) between fibrinogen and asialofibrinogen, but
      the maximum amplitude (ma) was obviously decreased in asialofibrinogen.
      Furthermore, when the rate of cross-link formation between gamma chains by F-XIII
      was compared, the production of gamma-dimer in the same reaction time was found
      to be lower and formation of stabilized fibrin tended to be retarded in
      asialofibrinogen. Sialic acid in fibrinogen thus may clearly influence the
      polymerization of fibrin-monomer and the formation of cross-linked fibrin in a
      series of reactions for fibrinogen-fibrin conversion. This may be consistent with
      the theory that fibrinogen sialic acid residues are low affinity calcium-binding
      sites and influence fibrin assembly.

PMID- 8364490
TI  - Characterization of capacitation inhibitory protein from rabbit seminal plasma:
      homology with human annexins.
AB  - A protein was purified from rabbit seminal plasma using preparative acrylamide
      disc electrophoresis, ammonium sulfate precipitation and gel filtration. The
      protein inhibited the in vitro fertilization of mouse ova inseminated with
      epididymal sperm and with capacitated sperm. The inhibition was not observed,
      however, when only ova were exposed to the protein prior to mixing with sperm.
      The partial protein sequence analysis revealed the strong homology of the rabbit
      fertilization inhibitory protein to human annexin V.

PMID- 8364491
TI  - Influence of liposomes on tryptic digestion of insulin.
AB  - The influence of phosphatidylcholine liposomes on the tryptic digestion of
      insulin was studied to obtain basic information on the interaction between
      liposomes and peptides or proteins. Protection of insulin from tryptic digestion
      by liposomes depended on the encapsulation efficiency and the method of
      preparation of liposomes. REV (reverse phase evaporation vesicles) were most
      effective for the protection of insulin from tryptic digestion. Tryptic digestion
      of insulin was accelerated by negatively-charged liposomes (containing 10%
      phosphatidylserine, phosphatidylinositol, or phosphatidic acid) or by neutral
      empty liposomes, this digestion being enhanced by progressively smaller liposome
      size (from 2 to 0.1 microns) in the case of neutral empty liposomes. These
      results suggest that this enhancement had occurred on the surface of the empty
      neutral or negatively-charged liposomes. Positively-charged empty liposomes
      (containing 10% of stearylamine) weakly suppressed the tryptic digestion of
      insulin. The size of the positively-charged liposomes increased after the
      addition of insulin, this size increase suggesting that these liposomes were
      fused by insulin. Presumably, insulin was protected by the lipids around the
      insulin molecule after the insulin-induced fusion or aggregation of positively
      charged liposomes.

PMID- 8364492
TI  - Inhibitory effect of beta-glucans on zymosan-mediated hydrogen peroxide
      production by murine peritoneal macrophages in vitro.
AB  - Effects of the pretreatment of murine peritoneal macrophages with several
      polysaccharides on the production of H2O2 induced with unopsonized zymosan were
      examined. Pretreatment with most of (1-->3)-beta-D-glucans for 6 h at 37 degrees
      C inhibited the zymosan-mediated H2O2 production by macrophages. The phorbol
      myristate acetate (PMA)-mediated H2O2 production was not affected by the
      pretreatment. The pretreatment of macrophages with (1-->3)-beta-D-glucans
      decreased the ability to ingest unopsonized zymosan, but did not affect the
      ingestion of IgG-coated sheep red blood cells (IgG-SRBC). These results suggested
      that the pretreatment with (1-->3)-beta-D-glucans interfered with the interaction
      of macrophages to zymosan and that the occupation of the receptor for the (1-->3)
      beta-D-glucans inhibited zymosan-mediated production of H2O2 by macrophages.
      Chemical modification by substitution with carboxymethyl groups or hydroxyethyl
      groups of a (1-->6)-branched (1-->3)-beta-D-glucan reduced the inhibitory effect
      of pretreatment on zymosan-mediated H2O2 production. The above results indicated
      the possibility that murine peritoneal macrophages possess certain receptors for
      beta-anomeric glucans, and one ligand specificity of the receptors is to restrict
      the intact (1-->3)-beta-D-glucosyl back bone.

PMID- 8364493
TI  - Effects of insulin and 1 alpha-hydroxy vitamin D3 on streptozotocin-induced
      diabetic rats fed a low zinc diet.
AB  - Streptozotocin-induced diabetic rats (LZ-DM rats) developed nephrocalcinosis
      after being fed a low zinc diet for 4 weeks. However, administration of 1 alpha
      hydroxy vitamin D3 (1-OHD3) or insulin inhibited the formation of
      nephrocalcinosis. The urinary calcium level increased when 1-OHD3 was
      administered to these rats, but decreased in the group receiving insulin. It was
      also observed that the femur recovered its hardness when insulin was
      administered, although the hardness in the LZ-DM rats remained lower than that of
      the control rats. Rat femur hardness, however, did not completely recover with 1
      OHD3 treatment. These results indicate that the effects of insulin and 1-OHD3
      differ, even though nephrocalcinosis was reduced by administration of either
      insulin or 1-OHD3. It appears that insulin assists bone formation, and the 1-OHD3
      hastens calcium excretion.

PMID- 8364494
TI  - Effect of benidipine hydrochloride (KW-3049), on cerebral ischemia induced by
      bilateral occlusion of the common carotid arteries in rats.
AB  - The effect of benidipine on experimental cerebral ischemia was investigated in
      rats subjected to occlusion of the bilateral common carotid arteries. Benidipine
      (30 micrograms/kg, i.p.) improved neurological symptoms such as ataxia,
      convulsion and loss of righting reflex, and prolonged survival time after
      occlusion of the bilateral common carotid arteries. In the nicardipine (100
      micrograms/kg, i.p.)-treated group, a similar effect was observed, whereas
      nifedipine (100, 300 micrograms/kg, i.p.) and verapamil (300 micrograms/kg, i.p.)
      did not show any beneficial effect in this model. Furthermore, pretreatment with
      benidipine (30 micrograms/kg, i.p.) suppressed the increase in cerebral water
      content 3 h after the occlusion. Nicardipine (100 micrograms/kg, i.p.) showed a
      tendency to reduce the increase in cerebral water content, though the effect was
      not statistically significant. Nifedipine (100 micrograms/kg, i.p.) produced no
      improvement. After occlusion of the bilateral common carotid arteries, depletion
      of adenosine triphosphate (ATP) and phosphocreatine (CP) and an accumulation of
      lactate occurred in a time-dependent manner. Prophylactic administration of
      benidipine (30 micrograms/kg, i.p.), 20 min before occlusion, attenuated the
      depletion of ATP and CP and the accumulation of lactate 3h after the occlusion.
      Furthermore, post-treatment with benidipine 30 min after occlusion also
      suppressed these metabolic disorders. In conclusion, the beneficial effects of
      benidipine in this severe cerebral ischemia model show that the compound has
      advantages over nicardipine, nifedipine and verapamil. Thus, these results
      suggest that benidipine may be useful in the treatment of acute ischemic cerebral
      damage.

PMID- 8364495
TI  - Inhibition by indomethacin of the already accelerated secretion of inhibin and
      estradiol in equine chorionic gonadotropin-primed immature female rats.
AB  - In immature female rats, the secretion of ovarian inhibin and estradiol is
      greatly accelerated by equine chorionic gonadotropin (eCG) treatment. The present
      study has been carried out to determine whether or not the levels of the two
      hormones are inhibited by a single s.c.-injection of indomethacin (INDO) 24 h
      after eCG administration. The levels of ovarian hormones and gonadotropins were
      measured by double-antibody radioimmunoassay using 125I-labeled radioligands. The
      serum levels of inhibin and estradiol were considerably inhibited within 24 and
      12 h, respectively, after INDO injection. In addition, the serum levels of
      follicle-stimulating hormone (FSH) after INDO injection remained lower than the
      basal levels before eCG treatment. The luteinizing hormone (LH) levels were
      significantly reduced within 12 h after INDO treatment. The results demonstrate
      that the levels of inhibin and estradiol, even in the situation where the
      production of both hormones is already accelerated by eCG pretreatment, are
      suppressed by an inhibitor of prostaglandin (PG) synthesis, suggesting that
      locally produced PGs may play a role in the regulation of the production of both
      hormones in the ovary.

PMID- 8364496
TI  - Preventive effect of beta-alanyl-L-histidinato zinc on the deterioration of bone
      metabolism in ovariectomized rats.
AB  - The preventive effect of beta-alanyl-L-histidinato zinc (AHZ) on the
      deterioration of bone metabolism was investigated in the femoral diaphysis of
      ovariectomized rats. AHZ (10, 30 and 100 mg/kg body weight/d) was orally
      administered to ovariectomized rats for 6 weeks. Ovariectomy produced a
      significant decrease in estradiol, calcitonin, calcium and inorganic phosphorus
      concentrations in the serum as compared with those from sham-operated rats. The
      dose of 30 and 100 mg AHZ/kg prevented any decrease in serum inorganic phosphorus
      concentration caused by ovariectomy. Alkaline phosphatase activity,
      deoxyribonucleic acid (DNA) and calcium contents in the femoral diaphysis of
      ovariectomized rats significantly decreased in comparison with those from sham
      operated rats. These decreases were completely prevented by the dose of AHZ (10,
      30 and 100 mg/kg). Electron microscopical analysis showed a rough alteration of
      bone matrix in the femoral diaphysis of ovariectomized rats. This alteration was
      clearly modified by the doses of AHZ (10, 30 and 100 mg/kg). Also, dosages of AHZ
      (30 and 100 mg/kg) restored the atrophy of osteoblasts and cartilage cells caused
      by ovariectomy. The present study suggests that oral administration of AHZ can
      prevent the deterioration of bone metabolism by ovariectomy. AHZ may have a
      therapeutic role in the treatment of osteoporosis.

PMID- 8364497
TI  - Expression of the Na+ dependent uridine transport system of rabbit small
      intestine: studies with mRNA-injected Xenopus laevis oocytes.
AB  - Xenopus laevis oocytes were used as an expression system to prove and
      characterize the carrier-mediated transport of uridine in the small intestine.
      Significant Na+ dependency was observed for the uptake of [3H]uridine by Xenopus
      laevis oocytes injected with poly(A)+RNA prepared from rabbit small intestinal
      mucosa. By contrast, the uptake of [3H]uridine was negligible in water-injected
      oocytes. There was no significant difference in the Na+ dependent uptake rates of
      [3H]uridine among oocytes expressed by using mRNA prepared by three different
      methods. The uptake of [3H]uridine by mRNA-injected oocytes was enhanced by
      increasing the culturing time after mRNA injection. Concentration dependency for
      uridine transport was observed with the Michaelis constant of 8.27 microM, which
      was comparable to that reported in the study using the brush-border membrane
      vesicles from rabbit small intestine (6.4 microM). Furthermore, the uptake of
      [3H]uridine was significantly inhibited by adenosine and thymidine, but not by
      adenine and uracil. Consequently, the transport system of uridine expressed in
      mRNA-injected oocytes is clarified to be similar to that functioning in the brush
      border membrane of the small intestine.

PMID- 8364498
TI  - Uptake mechanism of fractionated [3H]heparin in rat parenchymal hepatocytes in
      primary culture: effect of transport inhibitors on the uptake.
AB  - In order to elucidate the uptake mechanism of fractionated [3H]heparin by rat
      parenchymal hepatocytes, the concentration dependent uptake was kinetically
      analyzed in primary culture of rat parenchymal hepatocytes, and the effects of
      established transport inhibitors and heparin analogues on the uptake were also
      examined. The uptake rate of heparin measured over an extended period of 60 min
      was saturable, with the maximum uptake velocity (Vmax) of 0.36 +/- 0.05
      pmol/min/mg protein and the Michaelis constant (Km) of 21.2 +/- 5.4 nM. The
      uptake was inhibited by the addition of 4,4'-diisothiocyanatostilbene-2,2'
      disulfonic acid (DIDS), an inhibitor of the anion transport system, and rose
      bengal, an organic anion. Heparin analogues (pentosan polysulphate, or heparan
      sulphate) also inhibited the uptake of fractionated heparin. However, the uptake
      was not inhibited by the inhibitors of receptor-mediated endocytosis
      (phenylarsine oxide). These results suggest that fractionated heparin may be
      taken up by anion transport system, rather than by receptor-mediated endocytosis,
      though the fractionated [3H]heparin is a compound with the high molecular weight
      of about 20000 Da. At least the negative charge or sulphate group in the drug
      structure is supposed to play an important role in the uptake of fractionated
      heparin by parenchymal hepatocytes.

PMID- 8364499
TI  - Population pharmacokinetics of theophylline. II: Intravenous infusion to patients
      with stable chronic airway obstruction.
AB  - The population pharmacokinetics of theophylline were studied in 55 patients with
      stable chronic airway obstruction. Two hundred and seventy six theophylline serum
      concentrations after intravenous short infusion were analyzed using a nonlinear
      mixed-effect model. The influence of hepatic dysfunction, smoking habit, age and
      the measurement of arterial blood gases (oxygen tension: PaO2, carbon dioxide
      tension: PaCO2, blood pH) and clinical laboratory tests (serum albumin
      concentration, haematocrit) on the pharmacokinetic parameters of theophylline was
      examined by the likelihood ratio test. Assessment of each factor was made by a
      forward selection method. In the final regression model, the total body clearance
      (CL, l/h/kg) was related to the value of PaCO2 as well as to the presence of
      hepatic dysfunction, and the volume of distribution (Vd, l/kg) was related with
      the PaCO2 value as expressed in the following equations: CL = exp(-3.78 -
      0.525.HF + 0.0233.PaCO2) and Vd = exp(-1.12 + 0.00934.PaCO2), where HF is a
      categorical variable with a value of unity if a patient has hepatic dysfunction
      otherwise zero. The interactions among blood gas measurements were observed and
      the CL and Vd of theophylline would be inversely correlated with PaO2 or pH, if
      we selected PaO2 or blood pH to be a more important factor than PaCO2. The inter
      individual variabilities in CL and Vd were 38.5% and 12.5%, respectively, and the
      residual variability in theophylline serum concentrations was 10.6% as a
      coefficient of variation. This final model and the population parameters of
      theophylline will be useful for individualization of a drug dosage regimen by
      means of the Bayesian method.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364500
TI  - Effect of spacer groups connecting insulin with fluorophore in Gly(A1)
      sulfobenzoxadiazole-labeled insulins on the immunoreactivity toward anti-insulin
      antibody.
AB  - The immunoreactivity (specific binding) of three Gly(A1)-sulfobenzoxadiazole
      labeled insulins which have different spacer groups, Gly(A1)-[3-(4
      sulfobenzoxadiazol-7-ylthio)propanoyl]-insulin , Gly(A1)-[2-(4-sulfobenzoxadiazol
      7-ylthio)acetyl]-insulin, Gly(A1)-[3-carboxy-2(or 3)-(4-sulfobenzoxadiazol-7
      ylthio)propanoyl]-insulin, toward an antiporcine insulin monoclonal antibody was
      investigated, where solid-phase fluoroimmunoassay technique was utilized. The
      immunoreactivities of three labeled insulins were 2.1, 1.8 and 1 in that order.

PMID- 8364501
TI  - Influence of dietary lipids on glucuronidation and sulfation of phenol and its
      para substituent in the rat.
AB  - Rats were fed corn oil-free or corn oil-containing diets for 4 weeks to determine
      their effect on the competition between glucuronidation and sulfation in phenol
      and its para substituents. The activities of uridine diphosphate
      glucuronyltransferase (UDPGT) on chemicals were enhanced with a 12% corn oil
      diet, whereas sulfotransferase activity showed no significant change. Following
      the intravenous injection of p-ethylphenol and p-tert-butylphenol, an increase of
      glucuronide and a decrease of sulfate were observed in the rats fed the corn oil
      diet. In contrast, no significant changes were observed in phenol and p
      phenylphenol. These results are discussed in association with van der Waals
      volume (Vw) of substituent and phospholipid dependence of UDPGT.

PMID- 8364502
TI  - Cytotoxic effect of hinokitiol and tropolone on the growth of mammalian cells and
      on blastogenesis of mouse splenic T cells.
AB  - Hinokitiol (I) and tropolone (II) showed characteristic cytotoxic effects in
      vitro on five kinds of human and murine cell lines and blastic lymphocytes from
      mouse splenocytes. The cytotoxic effect of I on the growth of murine and human
      tumor cell lines, including RL male-1, MH134, HL60, K562 and KATO-III was
      definite when examined by thymidine incorporation into DNA and its 50% inhibitory
      concentration (IC50) on all cells was 0.3-0.6 microgram/ml. Compound II also
      showed comparable cytotoxic effects on these cell lines, indicating a little
      lower activity when compared to I. Furthermore, I and II also completely
      suppressed the [3H]thymidine ([3H]TdR) incorporation of mitogen-induced blastic
      lymphocytes. The suppressive activity on mouse lymphocyte proliferative response
      to concanavaline-A was also found with both compounds at a low concentration of
      0.32 microgram/ml. As compound I is known to be of fairly low toxicity (LD50: 453
      + 24 mg/kg in mice), the antitumor and immuno-suppressive effect of hinokitiol
      (I) should be further investigated.

PMID- 8364503
TI  - Nucleosides and nucleotides. CXIX. Inhibition of DNA-cytosine methylase HhaI by a
      self-complementary oligonucleotide containing 5-fluorocytosine.
AB  - A self-complementary decadeoxyribonucleotide, 5'd(GAAGFGCTTC)3', containing 5
      fluorocytosine (F) in substitution for cytosine at the methylation site of DNA
      cytosine methylase HhaI (MHhaI) has been synthesized. MHhaI was inhibited by the
      pre-incubation of the enzyme with d(GAAGFGCTTC).

PMID- 8364504
TI  - Evidence for serum factors modulating antibody production in normal and macular
      mice.
AB  - The macular mutant mouse is a model of Menkes' kinky hair disease, which is
      characterized by a deficiency of ceruloplasmin in the serum. In hemizygotic mice
      (ml/y), the antibody production against sheep red blood cells (SRBC) was
      decreased. Treatment with normal (+/y) mouse serum increased in a dose-dependent
      manner the antibody response of ml/y mouse spleen cells in vitro. However, +/y
      mouse serum had no effect on +/y mouse spleen cells, even at high doses up to 5%.
      In contrast, ml/y mouse serum decreased antibody production in +/y mouse spleen
      cells in a dose-dependent manner. Antibody production in +/y mouse spleen cells
      decreased with time, after pretreatment with ml/y mouse serum. However, serum
      from ml/y mice injected with ceruloplasmin did not decrease antibody production
      in +/y mouse spleen cells but rather increased it in ml/y mouse spleen cells.
      Ceruloplasmin had no effect on the production of antibodies against SRBC in ml/y
      and +/y mouse spleen cells in vitro. These findings suggest that one or more
      enhancers of antibody production exist in normal mouse serum and that one or more
      suppressors of normal antibody production exist in ml/y mouse serum. It is
      proposed that the activities of these factors in serum may be regulated by
      ceruloplasmin.

PMID- 8364505
TI  - Capillary gas chromatography quantification of cholesterol in copper-oxidized low
      density lipoprotein.
AB  - A simple analytical method, using capillary gas chromatography-mass spectrometry
      (GC-MS) was used to investigate the oxidative modification of cholesterol in
      copper-oxidized low-density lipoprotein (oxidized LDL). The incubation of LDL and
      5 microM CuSO4 in 0.15 M NaCl/0.02 M Tris-HCl buffer at pH 7.4 led to the
      peroxidation of LDL as shown by the detection of a thiobarbituric acid-reactive
      substance (TBA-RS). Oxidized LDL was shown to cause a significant fall in the
      unesterified and esterified cholesterol content, while oxysterols such as 7
      hydroxycholesterol (7-OH) and 7-ketocholesterol (7-Keto) were formed from
      cholesterol, these conversions occurred in a dose- and time-dependent manner.
      Both oxysterols were identified by GC-MS on a fused-silica capillary column. In
      addition, copper-oxidized high-density lipoprotein (oxidized HDL) also resulted
      in the generation of TBA-RS and oxysterols. In addition, changes in the
      composition and amount of oxysterols during the incubation of macrophages with
      oxidized LDL were investigated. The incubation of macrophages with oxidized LDL
      resulted in the accumulation of cholesterol, 7-OH and 7-Keto derivatives in
      macrophages and this accumulation also occurred in a dose-dependent manner. These
      results suggest that the measurement of oxysterols may afford an additional index
      of oxidized LDL, and that foam cell formation and early atherosclerotic lesions
      may be responsible for the accumulation of oxysterols in macrophages. In
      addition, this study shows that HDL is also modified when submitted to an
      oxidative process.

PMID- 8364506
TI  - Interaction of a protein-bound polysaccharide (PSK) with chicken gizzard
      caldesmon.
AB  - The interaction of a protein-bound polysaccharide (PSK) with caldesmon was
      studied in detail using sedimentation, low-shear viscometry, electron microscopy
      and affinity chromatography. The binding of caldesmon to F-actin was
      concentration-dependently inhibited by PSK. Bundle formation of actin filaments
      owing to caldesmon was also inhibited by PSK. Caldesmon bound to a PSK-Sepharose
      4B column at low ionic strength was released at about 400 mM NaCl, whereas G
      actin was not retained by the column. Treatment of caldesmon with chymotrypsin
      produced major fragments near 100, 80, 60, 38 and 25 kDa. In contrast, 60 and 25
      kDa fragments were rarely formed by this treatment in the presence of PSK.
      Fragments of 80 and 38 kDa, major products produced by chymotrypsin, bound
      individually to a PSK-Sepharose column, indicating that caldesmon has at least
      two binding sites for PSK. Addition of calcium and calmodulin partially released
      caldesmon from actin filaments. PSK-dependent release of caldesmon was also
      observed in the presence of calcium and calmodulin.

PMID- 8364507
TI  - A trypsin inhibitor trans-4-guanidinomethylcyclohexanecarboxylic acid 4-tert
      butylphenyl ester suppresses the onset of DNA synthesis in Escherichia coli cells
      synchronized by phosphate starvation.
AB  - trans-4-Guanidinomethylcyclohexanecarboxylic acid 4-tert-butylphenyl ester (GMCHA
      OPh'Bu), a trypsin inhibitor, dose-dependently inhibited the growth of
      Escherichia coli K-12 IAM1264. Growth inhibition was preceded by dose- and time
      dependent inhibition of DNA synthesis. These results strongly suggested
      participation of a trypsin-like proteinase in DNA synthesis. To clarify this
      suggestion, the effects of GMCHA-OPh'Bu on the doubling time and on the uptake of
      [methyl-3H]thymidine into DNA were examined with E. coli K-12 IAM1264
      synchronized by a modified version of phosphate starvation. The synchrony lasted
      for two or three cycles with a doubling time of 55 min and a cell division period
      of 15 min. The cell cycle of E. coli was divided into three periods, cell
      division period (P), the period between cell division and initiation of
      chromosome replication (Q) and the period between initiation of chromosome
      replication and cell division (R). The R period was subdivided into two periods,
      R1 in which the rate of thymidine uptake into DNA was increasing, and R2 in which
      it was constant. The addition of GMCHA-OPh'Bu at the R1 period did not affect the
      already-initiated round of cell division, however, it retarded the next round.
      The addition at P, Q or R2 retarded the cell division in the same round, causing
      prolongation of the R1 period. A sharp and momentary appearance of trypsin-like
      proteinase activity peaked at the Q/R1 boundary in one cell cycle, and inhibition
      of the activity prolonged the R1 period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364508
TI  - Amidinopiperidine-4-carboxylic acid 4-tert-butylphenyl ester, a trypsin
      inhibitor, suppresses the onset of DNA synthesis in HeLa cells synchronized by a
      double-thymidine block.
AB  - Release of HeLa cells arrested at the G1/S boundary by double-thymidine block
      caused abrupt uptake of [methyl-3H]thymidine into DNA after 5 min, and two sharp
      high activity peaks, peak I and peak II, were observed 8 and 23 min after removal
      of the thymidine block and this was followed by a gradual uptake of
      [3H]thymidine. The duration of the cell cycle was 23 h, and definite changes in
      cell density were observed between 12 and 13 h and also between 35 and 36 h after
      removal of the thymidine. Addition of amidinopiperidine-4-carboxylic acid 4-tert
      butylphenyl ester (APCA-OPh'Bu), a trypsin inhibitor, immediately after removal
      of the arrest strongly suppressed DNA synthesis and mitosis. In contrast,
      addition of APCA-OPh'Bu 10 min after removal of the arrest, and hence also after
      the appearance of peak I, had no effect on peak II nor on the uptake of thymidine
      occurring during the remainder of the first cell cycle, nor on mitosis. However,
      it strongly suppressed the second DNA synthesis and mitosis. These results
      suggest participation of a trypsin-like proteinase at the onset of DNA synthesis.
      Removal of thymidine from the arrested cells at a cell density of 2% (4 x 10(3)
      cells/cm2) induced an immediate and rapid rise in trypsin-like proteinase
      activity. However, the activity decreased with increasing cell density. No clear
      increase in the activity was seen at a cell density of 20% (4 x 10(4) cells/cm2).
      However, both trypsin-like proteinases obtained at cell densities of 2% and 20%
      were strongly inhibited by APCA-OPh'Bu and these inhibitory effects were
      similar.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364510
TI  - A novel metabolite of 3,4-methylenedioxyamphetamine (MDA): formation of 3-methyl
      6,7-methylenedioxy-1,2,3,4-tetrahydroisoquinoline and its pharmacological effect.
AB  - In 3,4-methylenedioxyamphetamine (MDA)-treated rat brain and urine, 3-methyl-6,7
      methylenedioxy-1,2,3,4-tetrahydroisoquinoline (3Me6,7MDTIQ) was detected as a new
      metabolite. The content of 3Me6,7MDTIQ in (R)-MDA-treated rat was significantly
      higher than that in (S)-MDA-treated brain and urine. This result suggests that
      this metabolism of MDA contains stereoselective pathways. The pharmacological
      effects of 3Me6,7MDTIQ on behavior differed from those of MDA. The ambulation
      score of 3Me6,7MDTIQ was significantly decreased compared to the control, and the
      rearing score of 3Me6,7MDTIQ was moderately decreased compared to the control in
      an open-field test.

PMID- 8364509
TI  - Studies on cytochrome P450 responsible for oxidative metabolism of imipramine in
      human liver microsomes.
AB  - The activity of imipramine 2-hydroxylase highly correlated with that of
      desipramine 2-hydroxylase but not with that of desipramine N-demethylase. The
      correlation was also found between N-demethylation and 2-hydroxylation when
      imipramine was used as a substrate, whereas no correlation was observed between
      them when desipramine was used in place of imipramine. Both activities of
      desipramine and imipramine 2-hydroxylase were markedly inhibited by quinidine but
      not by quinine. Although the activity of imipramine N-demethylase was slightly
      inhibited by both quinidine and quinine, the activity of desipramine N
      demethylase was unaffected under the same conditions. The activity of imipramine
      N-demethylase was roughly correlated with the amounts of P450 3A4
      immunochemically determined and the activities of testosterone 6 beta-hydroxylase
      in human liver microsomes. The P450 3A4 catalyzed imipramine N-demethylation much
      more efficiently than 2-hydroxylation in a reconstituted system, whereas neither
      N-demethylation nor 2-hydroxylation of desipramine was catalyzed by P450 3A4. The
      activity of imipramine N-demethylase was inhibited, to various extents, by anti
      P450 3A4 antibodies in human liver microsomes. Taking together these and other
      results, it is suggested that P450 3A4, other than P450 2Cmp, also partly
      contributes to N-demethylation of imipramine, depending on human liver
      microsomes.

PMID- 8364511
TI  - Percutaneous absorption of acemetacin from a membrane controlled transdermal
      system and prediction of the disposition of the drug in rats.
AB  - To avoid development of a lesion on the small intestine by acemetacin (ACM)
      following oral administration of the drug, we developed a new device for its
      percutaneous application. The device for transdermal application of ACM consisted
      of a silicon O-ring, a backing of aluminum foil and adhesive tape, and rate
      controlling membranes with three different pore sizes (HP-1100, 2100 and 4050).
      Two percent ACM gel ointment was contained in the device. In the in vitro release
      experiment, the ACM release from the device was limited by these membranes with
      release rate constants of 0.630 +/- 0.052, 0.289 +/- 0.012, 0.098 +/- 0.11 and
      0.083 +/- 0.011 h-1 for no membrane, HP-4050, HP-2100 and HP-1100 membranes,
      respectively. In the in vitro penetration experiment, the ACM penetrating through
      the skin appeared in the reservoir cell without the metabolic conversion to
      indomethacin (IM). After the application of the ACM device with the HP-2100 rate
      controlling membrane on the rat abdominal skin, ACM was not detected in the
      plasma but the therapeutic plasma concentration of IM could be maintained over a
      54 h period. These results indicate that the device with a rate-controlling
      membrane may be useful for the percutaneous application of ACM as an anti
      inflammatory drug and its clinical application. For the percutaneous absorption
      of ACM after application of the ACM devices, the values estimated by the proposed
      model which consisted of 6 compartments well fit to the data obtained from this
      in vivo experiment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364512
TI  - Two-layer membrane model for iontophoretic drug transport through excised rat
      skin.
AB  - Iontophoretic and passive transport of an ionized drug (sulfisoxazole) across
      excised rat skin was studied using a two-chamber cell with four electrodes under
      successive experimental conditions: without electrical current (stage-I) and with
      electrical current (stage-II). Two iontophoretic/diffusion models, i.e. a one
      layer membrane model and a two-layer membrane model, in which a difference in the
      electrical potential gradient was taken into account between the stratum corneum
      and epidermis/dermis layer, were constructed to describe the non-steady-state
      drug permeation process during ionotrophoresis. The observed iontophoretic lag
      time was two times greater than the calculated value based on the one-layer
      membrane model. According to the two-layer membrane model, the calculated
      ionotophoretic lag-time agreed with the observed value. It was revealed by model
      adaptation to the observed data that the stratum corneum fraction of the electro
      chemical potential difference across the whole skin caused by the iontophoresis
      was around 90%. This result was consistent with the observation that the direct
      current resistance of whole skin was seven times greater than that of stripped
      skin.

PMID- 8364513
TI  - Effects of aluminium-containing antacid on bioavailability of ofloxacin following
      oral administration of pivaloyloxymethyl ester of ofloxacin as prodrug.
AB  - We newly synthesized a pivaloyloxymethyl ester of ofloxacin (OFLX-PVM) as prodrug
      in order to avoid the chelate formation between new quinolone and metal cations
      such as Al3+, Mg2+, Ca2+, or Fe2+ in the gastrointestinal tract. This compound
      was rapidly hydrolyzed in an incubation experiment by 43% in plasma, by 92% in
      small intestinal mucosal homogenates, and by 97% in liver homogenates during 0.5
      h incubation, but was resistant to hydrolysis by pancreatic enzymes. In everted
      gut sac experiments, this compound was efficiently absorbed even in the presence
      of aluminium ion, whereas the absorption of ofloxacin (OFLX) was decreased
      significantly by the presence of aluminium ion. Minimal inhibitory concentration
      (MIC) values of OFLX-PVM were far higher than OFLX. Effects of aluminium
      hydroxide on the oral bioavailability of OFLX and OFLX-PVM were investigated in
      rabbits. The area under the plasma concentration-versus-time curve from zero to
      24 h (AUC0-24h) following oral administration of OFLX was decreased significantly
      by 47.6% by combined administration with aluminium hydroxide, but AUC0-24h values
      of OFLX-PVM coadministered with and without aluminium hydroxide were similar to
      that of OFLX alone. These observations indicate that this new compound is likely
      to offer a prodrug for avoidance of interaction between new quinolone and metal
      cations.

PMID- 8364514
TI  - Influence of composition of l-menthol-ethanol-water ternary solvent system on the
      transdermal delivery of morphine hydrochloride.
AB  - The influence of concentration of each component in l-menthol-ethanol-water
      ternary solvent system (MEW system) on the skin permeation of morphine
      hydrochloride (MPH) was investigated in hairless rats. The cumulative amount of
      MPH permeated through the excised abdominal skin over 8 h (Q-8) was selected as
      an index of skin permeability. With changing MPH concentration over a wide range
      from 0.01 to 10% in a MEW system (5% l-menthol and 40% ethanol), the values of Q
      8 were proportional to MPH concentration. The concentration was fixed at 1% for
      the following experiments. For the effect of the concentration of l-menthol at
      40% ethanol, the maximum Q-8 was observed at 5% l-menthol, and no greater
      enhancement of Q-8 was obtained by increasing l-menthol concentration above that.
      In the ethanol effect at 5% l-menthol, the maximum Q-8 was observed at 45%
      ethanol. When 2-propanol and methanol, which are more lipophilic and hydrophilic
      than ethanol, respectively, were used instead of ethanol, the maximum values of Q
      8 were observed at 40 and 55%. The maximum values for Q-8 were obtained in the
      vicinity of the solubility of l-menthol in the MEW system in all cases,
      suggesting that the skin permeation enhancing effect of the system is dependent
      on the thermodynamic activity of l-menthol.

PMID- 8364515
TI  - Pre-column derivatization and its optimum conditions for quantitative
      determination of urinary hydroxylysine glycosides by high-performance liquid
      chromatography.
AB  - A method has been developed for rapid analysis of the urinary hydroxylysine
      glycosides [glucosyl-galactosyl-hydroxylysine (GGH) and galactosyl-hydroxylysine
      (GH)] as collagen metabolites. The glycosides were fluorometrically derivatized
      with 5-dimethylaminonaphthalene-1-sulfonyl chloride, and then subjected to
      reversed-phase high-performance liquid chromatography using a gradient system.
      Suitable standard hydroxylysine glycosides which were not diastereoisomers were
      prepared from human urine. Urinary GGH and GH were analyzed within 1 h, including
      column washing. This method was applied to the urine samples of 68 healthy
      persons of different ages.

PMID- 8364516
TI  - The relationship between induction of peroxisomal beta-oxidation and long-chain
      fatty acid composition in rat liver.
AB  - The long-chain fatty acid composition in rat liver, by which peroxisomal beta
      oxidation system was induced, was analyzed in vitro and in vivo. In primary
      culture of hepatocytes, treatment with 0.4 mM clofibrate or long-chain fatty
      acids caused an increase in the peroxisomal beta-oxidation activity, in addition
      the oleic acid [18:1(n-9)] content in the cells was increased two-fold by
      addition of very long-chain fatty acids to the culture medium, but clofibrate had
      no effect. A two-fold of increase in 18:1(n-9) content was observed in the
      hepatic subcellular fractions from rats fed a diet containing 0.25% clofibric
      acid. The ratio of cis-vaccenic acid [18:1(n-7)] to total 18:1 content decreased
      by more than half compared with control in clofibric acid treated liver. The
      level of 18:1(n-7) was not changed in all experiments. It is suggested that
      perturbation of C-18 chain length fatty acids occurs in peroxisomal beta
      oxidation induced liver.

PMID- 8364517
TI  - Comparative bioavailability study of acetaminophen solutions used in hospital
      formulary.
AB  - To learn the influence of polyethylene glycol (PEG) on bioavailability, this
      study compared the bioavailability of acetaminophen in the presence of 10%
      ethanol (acetaminophen-ethanol liquid) to that in the presence of 10% PEG
      (acetaminophen-PEG liquid) since these two preparations are commonly used in
      hospital formulary. The results in Thai male volunteers showed there was not
      significantly different.

PMID- 8364518
TI  - The development of oral vaccines based on live attenuated Salmonella strains.
AB  - Safe, live attenuated Salmonella strains can be produced by introducing defined
      non-reverting mutations into the chromosome. Such rationally attenuated strains
      have proved to be excellent oral vaccines in several animal species and can
      therefore be considered as candidate vaccines against invasive salmonellosis in
      both animals and man. A panel of attenuating lesions is now available from which
      it is possible to tailor the level of attenuation and hence produce strains with
      different immunogenic properties. Because of the spectrum of immune responses
      produced by such Salmonella vaccine strains they have been utilised extensively
      as vectors for delivering heterologous antigens to the mammalian immune system.
      We have focussed on the development of a single dose oral tetanus vaccine based
      on attenuated Salmonella strains expressing a non-toxic, immunogenic protein
      derived from tetanus toxin (fragment C). Several different expression systems
      have been used for fragment C and candidate vaccine strains have been constructed
      that are capable of protecting orally immunised mice against a lethal challenge
      with tetanus toxin. An oral tetanus vaccine may help to reduce the mortality rate
      from tetanus in the developing world by overcoming the problems associated with
      the implementation of vaccine programmes using the current parenteral vaccine.

PMID- 8364519
TI  - In vitro activity of zidovudine alone and in combination with ciprofloxacin
      against Salmonella and Escherichia coli.
AB  - The in vitro antibacterial activity of zidovudine alone and in combination with
      ciprofloxacin was investigated. Zidovudine showed a good activity against
      Escherichia coli and Salmonella (MIC range 0.5-8 micrograms/ml and 1.5-62
      micrograms/ml respectively) isolated from biological samples of HIV-infected
      patients. These strains proved to be extremely susceptible to ciprofloxacin
      alone. The interaction between zidovudine and ciprofloxacin ranged from additive
      activity to indifference. No antagonism was observed: the FIC index for every
      combination resulted < or = 1.5. The addition of AZT 1 mg/l (clinically
      achievable plasma concentration after therapeutic doses of 1200 mg/day) did not
      affect the bactericidal activity of ciprofloxacin; on the contrary, in some cases
      we observed an increase of bactericidal effect of the quinolone. These data have
      to be considered in patients with AIDS who can be treated concomitantly with
      zidovudine and ciprofloxacin.

PMID- 8364520
TI  - High-affinity binding of laminin by Helicobacter pylori: evidence for a lectin
      like interaction.
AB  - Laminin, the major glycoprotein of basement membranes, was shown to be bound by
      the human gastric pathogen Helicobacter pylori. Binding of 125I-laminin by strain
      17874 was time-dependent, specific and saturable. Scatchard analysis of specific
      binding indicated about 2000 binding sites per cell with a dissociation constant
      of 8.5 pM. Treatment of the cells by heat (80 degrees) and with proteolytic
      enzymes drastically reduced laminin binding, suggesting that the laminin
      receptors are surface proteins. Some highly glycosylated glycoproteins inhibited
      laminin binding by 50%. Furthermore, N-acetylneuraminyllactose decreased laminin
      binding by 70% and neuraminidase treatment of laminin by 50%, while a recombinant
      B1 chain of laminin, containing high-mannose type oligosaccharides, inhibited
      binding by only 25%. This suggests that terminal sialic acids on laminin compete
      for a specific sugar binding protein(s) on H. pylori cells.

PMID- 8364521
TI  - Prevalence of IgA receptors in clinical isolates of Streptococcus pyogenes and
      Streptococcus agalactiae: serologic distinction between the receptors by blocking
      antibodies.
AB  - Group A and B streptococci (Streptococcus pyogenes and Streptococcus agalactiae)
      are the only known bacterial pathogens expressing IgA Fc-receptors. However, the
      IgA binding proteins of the two species have been found genetically unrelated. In
      the present investigation the binding of human IgA among clinical isolates of
      group A and group B streptococci was studied and the respective IgA-binding
      epitopes were compared serologically. Surface binding of radiolabelled,
      monoclonal human IgA1 occurred in 38% of 115 unselected group A streptococcal
      isolates. Comparing four predominant T-types, IgA-binding was found in 77% and
      85%, respectively, of types T4 and T28 strains but only in 5% and 25%,
      respectively, of T1 and T12 strains. In group B streptococci, 70% of 58 type Ib
      strains but only 2% of 399 strains of other serotypes bound IgA. Using rabbit
      immune sera raised to the two streptococcal species it was found that strains
      exhibiting IgA Fc-receptors often induced antibodies blocking the binding of IgA
      to bacteria. Furthermore, the blocking shown by an individual serum was
      restricted to the streptococcal group used for immunization showing that also the
      IgA-binding eptiopes in group A and B streptococci are conformationally distinct.
      Though infections with serotypes often binding IgA, compared to other types, are
      not known to differ, it is assumed that the non-immune binding of IgA might
      favour mucosal colonization of the organisms.

PMID- 8364522
TI  - Antigenic diversity of IgA receptors in Streptococcus pyogenes.
AB  - In a previous study, group A and group B streptococcal IgA receptors were shown
      to differ serologically, in agreement with their known structural unrelatedness.
      The present study was undertaken to serologically compare the IgA binding
      epitopes of group A streptococcal strains representing various serotypes by the
      use of antisera to this species. It was found that blocking antibodies occurred
      in antisera to IgA binding but not to non-binding strains and that binding of IgA
      to a streptococcal strain was generally blocked by antiserum to the homologous
      type. However, cross-testing of a panel of 11 IgA binding strains, representing
      various M and T serotypes, with 10 different antisera to group A streptococci,
      demonstrated that IgA receptors were inhibited to a highly variable degree and
      that inhibition patterns were unique for each type. Comparing solubilized IgA
      receptors of various strains in immunoblot experiments, a variation in the
      molecular mass, between approximately 35 and 45 kDa, emerged. The IgA binding
      epitopes, analogous to protective sites of streptococcal M-protein, thus
      exhibited hypervariability which may suggest that IgA binding also plays a key
      role for evading host immune defence mechanisms.

PMID- 8364523
TI  - Application of flow cytometry to the study of antiphagocytic properties of
      Klebsiella pneumoniae capsular polysaccharide.
AB  - We used flow cytometry to compare the effects of whole cells and capsular
      polysaccharides of Klebsiella pneumoniae on the phagocytic ability ot
      polymorphonuclear leukocytes. Our results showed a light decrease in phagocytic
      activity in the presence of capsular polysaccharides, but a marked decrease with
      whole cells. Our findings suggest that the resistance to phagocytosis in these
      microorganisms is not due exclusively to their capsule, as claimed by other
      authors.

PMID- 8364524
TI  - Animal and human antibodies reactive with the outer surface protein A and B of
      Borrelia burgdorferi are borreliacidal, in vitro, in the presence of complement.
AB  - Polyspecific antibodies present in ascitic fluids of mice (pMIAFs) immunized with
      whole Borrelia burgdorferi cells exerted borreliacidal activity in vitro when
      tested with complement and homologous antigen but not with heterologous B.
      hermsii. Similarly, monospecific mouse antibodies obtained by immunizing mice
      with purified preparations of outer surface protein A and B of B. burgdorferi
      were borreliacidal. On the contrary, mouse monospecific antibodies raised against
      the 41-kDa flagellar protein of B. burgdorferi did not kill borreliae in the
      presence of complement. A complement-mediated, in vitro, borreliacidal activity
      was observed in human sera from patients with Lyme disease when antibodies
      against OspA and/or OspB were detectable in sera by the Western blotting
      technique. The in vitro borreliacidal activity of human sera was evident after 14
      h incubation with live B. burgdorferi spirochaetes and complement, whereas
      antibodies present in mouse immune ascitic fluids killed borreliae after 1 h
      incubation.

PMID- 8364525
TI  - Analysis of intestinal flora of a patient with congenital absence of the portal
      vein.
AB  - A 14-year-old female patient, admitted for a closer examination of liver tumour
      (hepatocellular adenoma), was diagnosed as having a congenital absence of the
      portal vein. The blood ammonia level (approximately 120 micrograms dl-1) in the
      superior mesenteric vein was markedly low compared to the normal value of 300-350
      micrograms dl-1 in the portal vein. The decreased ammonia concentration and
      urease activity of the patient's faeces were demonstrated. The dominant
      intestinal flora in the faeces of the patient, before operation, was
      Bifidobacterium sp., Bifidobacterium breve, Bifidobacterium lonqum, Lactobacillus
      plantarum, and after the operation Bacteroides vulgatus, Veillonella parvula,
      Peptococcus magnus Bifidobacterium longum. In contrast, Bifidobacterium bifidum,
      Bacteroides ureolyticus, Bacteroides ovatus and Bacteroides distasonis, B.
      ovatus, Bifidobacterium adolescentis were dominant flora in the faeces of two
      healthy volunteers, respectively. Among microorganisms isolated from the patient,
      Morganella morganii, Candida sp., Eubacterium aerofacience and Eubacterium
      rectale were strongly positive in urease activity in vitro; Streptococcus mitior,
      Staphylococcus intermedius, Micrococcus kristinae, Selenomonas ruminantum,
      Bacteroides ureolyticus and Lactobacillus casei ss. pseudoplantarum from the
      healthy volunteers. These results imply the homeostatic regulation system of
      faecal ammonia concentration by urease-producing microorganisms in the patient.

PMID- 8364526
TI  - Extracellular fibrinogenolytic enzyme of Aspergillus fumigatus: substrate
      dependent variations in the proteinase synthesis and characterization of the
      enzyme.
AB  - To get a better understanding of the role of the previously reported
      fibrinogenolytic enzyme of Aspergillus fumigatus, we investigated the in vitro
      conditions of enzyme synthesis and attempted to characterize it. Modification of
      the nitrogen source did not influence the extracellular serine-proteinase
      profile, but resulted in important quantitative differences in the yields in
      batch cultures. The enzyme synthesis appeared to be an inducible phenomenon in A.
      fumigatus since it was initiated exclusively in the presence of proteins or
      protein hydrolysate. Free amino acids or inorganic nitrogen compounds could not
      promote significant enzyme production. Moreover, peptone at a concentration of
      0.1% appeared to be the best inducer of enzyme synthesis. Conversely,
      modification of the carbon source did not affect fungal growth or enzyme
      synthesis. However, the production of chymotrypsin was highly sensitive to the
      carbohydrate level in the culture medium and, with peptone as nitrogen source,
      highest yields were obtained in the presence of 0.3 or 0.5% glucose. Culture
      filtrates of A. fumigatus CBS 113.26 grown with peptone or nitrate as nitrogen
      source were analyzed by sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis. Comparison of the protein patterns suggested for the proteinase
      a molecular mass of 33 kDa which was confirmed by chromatographic purification of
      the enzyme through (N alpha-CBZ)-D-phenylalanine agarose.

PMID- 8364527
TI  - Feasibility of prophylaxis and therapy against gram-negative infections by human
      monoclonal antibodies.
AB  - In a murine model of Gram-negative sepsis, we have shown that the prophylactic
      application of human monoclonal antibodies (HmAbs) with specificity for
      lipopolysaccharides (LPS) of Pseudomonas aeruginosa protected against bacterial
      infection. In this paper we show that the therapeutical application of 5
      micrograms of these HmAbs up to 6 h after challenge with a lethal dose of live P.
      aeruginosa results in a protection rate of 70-90%. Administration 18 h after
      bacterial challenge, diminished the protection to 43% survival rate. Furthermore,
      using a mixture of HmAbs recognizing a total of six different P. aeruginosa
      serotypes, no interference in their protective capacities was found. Finally,
      these HmAbs also protected galactosamine-sensitized mice against lethal challenge
      with LPS. Our data show that the described HmAbs confer bactericidal activity as
      well as anti-endotoxic activity in vivo.

PMID- 8364528
TI  - What eye fixations tell us about phonological recoding during reading.
AB  - Evidence for phonological recoding during reading has depended on paradigms
      requiring readers to make some response in addition to reading (e.g.,
      proofreading, concurrent speaking). Our subjects simply read text for
      comprehension, and their eye movements were monitored for spontaneous disruptions
      when encountering homophonic errors (e.g., He wore blew jeans.) versus
      nonhomophonic errors (e.g., He wore blow jeans.). Eye fixation behaviour revealed
      that readers initially experienced as much difficulty when encountering a
      homophonic error as a nonhomophonic one; however homophony facilitated the
      recovery process, at least for homophones that shared the same length as their
      context correct mates (e.g., blew/blue but not war/wore). The results support a
      theory of lexical access in which phonological sources of activation and
      influence are delayed relative to orthographic sources, rather than a theory in
      which phonological codes predominate.

PMID- 8364529
TI  - The use of information below fixation in reading and in visual search.
AB  - Two experiments examined whether or not readers obtain useful information from
      below the currently fixated line. In Experiment 1, subjects read passages of text
      and the availability of visual information below the line fixated was manipulated
      using a variant of the moving window technique. Reading was no slower when there
      was no letter information below the fixated line than when there was full
      information below the fixated line. However, a condition which made the strings
      of letters below the fixated line less "wordlike" caused reading to be slowed
      down by about 6% relative to the other conditions. In Experiment 2, subjects
      searched for a target word through passages of text. Subjects occasionally
      detected targets below the line they were fixating; however, there was no clear
      evidence that the availability of information below the line made search more
      efficient. It thus appears that in reading (or in other tasks where words are
      being identified and the eyes move horizontally along a line of text), little
      visual information is extracted below the line of text fixated.

PMID- 8364530
TI  - Eye movement control during reading: fixation measures reflect foveal but not
      parafoveal processing difficulty.
AB  - The main purpose of this study was to determine whether, during natural reading,
      the difficulty of the upcoming parafoveal word affects eye movement behaviour on
      the currently fixated word. A model in which visual attention is allocated in
      parallel over both the fixated and the upcoming parafoveal word predicts such as
      effect, while a sequential attention allocation model in which attention is
      directed first to the fixated word and then to the upcoming parafoveal word, does
      not. The data reported here show that neither the frequency nor the combined
      length, frequency and class of the upcoming word affect eye movement behaviour on
      the current word. These data support the sequential attention--parallel
      programming model of eye movement control in reading.

PMID- 8364531
TI  - Thematic roles in sentence parsing.
AB  - Two eyetracking experiments examined the reading of sentences like "While the
      police/truck stopped the Datsun disappeared into the night." A paper by L. Stowe
      (Thematic structures and sentence comprehension. In G. N. Carlson and M. K.
      Tanenhaus (Eds.), Linguistic structure in language processing, 1989) indicated
      that an inanimate subject ("truck" in "After the truck stopped the Datsun
      disappeared ...") is taken as theme of the ergative verb ("stop"), preventing the
      assignment of the postverbal noun phrase ("the Datsun") as direct object. This
      eliminates the disruption of reading that is normally observed on the
      disambiguating verb ("disappear"). The present experiments found the pattern of
      results reported by Stowe when looking at the disambiguating region of a
      sentence. However, the results for earlier regions suggest that the postverbal
      noun phrase was initially taken as direct object of an ergative verb even when
      the subject was inanimate. It appears that the inanimacy of the subject may not
      have guided the initial syntactic analysis, but rather facilitated the revision
      of an initial misanalysis.

PMID- 8364532
TI  - Context effects in syntactic ambiguity resolution: discourse and semantic
      influences in parsing reduced relative clauses.
AB  - This article examines how certain types of semantic and discourse context affect
      the processing of relative clauses which are temporarily ambiguous between a
      relative clause and a main clause (e.g., "The actress selected by the director
      ..."). We review recent results investigating local semantic context and temporal
      context, and we present some new data investigating referential contexts. The set
      of studies demonstrate that, contrary to many recent claims in the literature,
      all of these types of context can have early effects on syntactic, ambiguity
      resolution during on-line reading comprehension. These results are discussed
      within a "constraint-based" framework for ambiguity resolution in which effects
      of context are determined by the strength and relevance of the contextual
      constraint and by the availability of the syntactic alternatives.

PMID- 8364533
TI  - The intensity dimension of thought: pupillometric indices of sentence processing.
AB  - This article explores the intensity of processing during sentence comprehension
      by measuring pupillary response during reading. Two experiments contrast the
      processing of simpler versus more complex sentences. The two more complex
      sentence types, object-relative center-embedded sentences and filler-gap
      sentences, not only take longer to process than their simpler counterparts, but
      they also produce a larger change in pupil diameter. We propose that the
      pupillary response is an indicator of how intensely the processing system is
      operating. The more complex sentences evoke some intense processing at the point
      in the sentence where a syntactic complexity is first encountered. The gaze
      durations at these points are elevated, indicating the immediate response to the
      demand of the syntactic processing. The pupil then starts to dilate, reaching a
      maximal diameter approximately 1.3 s later. The results from these various
      performance measures are integrated within a resource-limited computational model
      of comprehension. The paper develops a model of comprehension that includes an
      intensity dimension of thought, drawing a correspondence between the
      computational model's consumption of resources and the human pupillary response.

PMID- 8364534
TI  - Writing quality, reading skills, and domain knowledge as factors in text
      comprehension.
AB  - Subjects listened to and recalled three passages. Each subject was also given a
      general reading comprehension test. The passages were presented either in such a
      way that subjects could use their general knowledge to help understand them, or
      in such a way that no specific world knowledge seemed applicable. This was
      achieved by giving the passages a helpful title, versus no title or an unhelpful
      title. The passages were written in two different versions, preserving their
      content but varying their style. In one version, the language was as helpful as
      we could make it in signalling to the listener discourse importance, while in the
      other version the language was as unhelpful as we could make it while still
      writing an English text. All three factors--domain knowledge, writing style, and
      skill--significantly affected reproductive recall, and there were no interactions
      between these factors. However, while good writing was sufficient to improve the
      reproduction of the texts, an analysis of the recall elaborations subjects made
      revealed that the correctness of their elaborations depended strongly on the
      availability of appropriate domain knowledge. Thus, good writing and domain
      knowledge are not simply substitutable, but affect comprehension in somewhat
      different ways.

PMID- 8364535
TI  - Effects of sentence form on the construction of mental plans from procedural
      discourse.
AB  - Memory for procedural discourse was examined in two experiments. In Experiment 1,
      memory was assessed using recall; in Experiment 2, a recognition test was used.
      In both experiments, the memorability of three types of action statements were
      compared: a transitive verb form, in which the action was described by a main
      clause; a verbal adjective form, in which the action was indicated by an
      adjective derived from a verb; and an implicit action form, in which the action
      was only implied. Information associated with transitive verbs and verbal
      adjectives was more likely to be recalled than information associated with
      implicit actions. Although a manipulation of prior knowledge affected overall
      recall performance, it did not interact with sentence form. In addition,
      recognition accuracy was affected by neither sentence form nor prior knowledge.
      To account for these results, it was proposed that transitive verbs and verbal
      adjectives generate a semantic representation that includes features of the
      action, whereas implicit actions do not. This difference in semantic
      representation leads to structural differences in a mental plan for the task. The
      obtained effects on recall reflect these differences in plan structure.

PMID- 8364536
TI  - Characterization of a human alpha 1-antitrypsin null allele involving aberrant
      mRNA splicing.
AB  - alpha 1-Antitrypsin (alpha 1AT) is a major protease inhibitor present in high
      concentrations in the plasma. Inheritance of alpha 1AT deficiency or null alleles
      (alleles associated with no detectable serum alpha 1AT) is associated with an
      increased risk for emphysema. In contrast to beta zero-thalassemia variants in
      which RNA splicing and promoter mutations constitute more than 40% of beta zero
      thalassemia variants, all nine alpha 1AT null variants identified are the result
      of mutations involving the protein coding region of the alpha 1AT gene. During
      routine screening of individuals applying for enrollment in the USA alpha 1AT
      Deficiency Registry we identified an individual with emphysema and a Protease
      Inhibitor (PI*) type heterozygous for a novel alpha 1AT null allele. Direct DNA
      sequencing of this individual's alpha 1AT alleles demonstrated one normal and one
      novel allele, designated PI*QOwest, characterized by a single G-->T base
      substitution at position 1 of intron II, a highly conserved nucleotide position
      in vertebrate splice donor sites. Metabolic labeling of NIH-3T3 cells transfected
      with a plasmid vector containing an alpha 1AT minigene with the QOwest mutation
      demonstrated an absence of detectable immunoprecipitable alpha 1AT confirming
      that the G-->T mutation is responsible for the observed null phenotype. QOwest
      alpha 1AT minigene transfected cells expressed 25-100 fold less alpha 1AT mRNA
      than a normal control. DNA sequencing of polymerase chain reaction amplified mRNA
      obtained from transfected cells demonstrated the use of a cryptic splice site 84
      bases upstream from the normal splice site.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364537
TI  - Haplotype analysis to determine the position of a mutation among closely linked
      DNA markers.
AB  - Positional cloning involves first finding linkage between an inherited phenotype
      (such as a disease) and a DNA marker, followed by the use of a variety of
      physical and genetic mapping techniques to move from linkage to mutation. If
      there is a founder effect within a population, crossovers are often rare between
      the mutation causing the phenotype and closely situated markers and increasing
      disequilibrium may be observed as the site of the mutation is approached.
      Standard coefficients of disequilibrium may, however, be insensitive to the
      relative position of close markers and the mutation, because they depend upon
      allele frequencies in the normal population compared to those of the founder
      chromosome. Using cystic fibrosis in European populations as a model system,
      alternative methods for determining the position of a mutation are discussed.
      These include haplotype parsimony and three-way interval likelihood analysis.
      Both methods predict the location of the major CF mutation accurately from a real
      set of more than 600 European CF chromosomes.

PMID- 8364538
TI  - Variation of short tandem repeats within and between populations.
AB  - Using the polymerase chain reaction (PCR) the frequency distributions of three
      short tandem repeats (STR) were investigated in five populations: North European,
      Cypriot, Pakistani, Gujarati and Vietnamese. Each STR is situated within an
      intron; the markers are in the genes for human coagulation factor XIII (4bp
      repeat), lipoprotein lipase (4bp repeat) and CD4 (5bp repeat). Population data
      were generated for each STR and allele frequencies calculated. A calculation of
      the level of population substructuring for the three systems was also made. The
      lipoprotein lipase STR data showed no evidence for population substructuring, but
      there was a significant level of substructuring in the other two systems. This
      initial pilot study demonstrates the need to validate each marker used for DNA
      profiling in different human populations, and that some markers (such as LPL) can
      be used with confidence in widely differing ethnic groups, while others (such as
      CD4 and F13A) may be of value in distinguishing sub-groups.

PMID- 8364539
TI  - Functional complementation in mouse-human radiation hybrids assigns the putative
      murine scid gene to the pericentric region of human chromosome 8.
AB  - Fragments of human chromosome 8 were introduced into cells derived from murine
      scid mice via X-irradiation and somatic cell fusion. The resulting hybrid clones
      contained human DNA fragment(s) which complemented the hyper-radiosensitivity of
      the scid cells. Alu-PCR products from these hybrids were used for chromosome
      painting using the technique of chromosome in situ suppression hybridization,
      allowing assignment of the human HYRC (hyper-radiosensitivity of murine scid
      mutation, complementing) gene, a candidate for a V(D)J recombinase gene, to human
      chromosome 8q11.

PMID- 8364540
TI  - A physical map of the C6 and C7 complement component gene region on chromosome
      5p13.

PMID- 8364541
TI  - Sequencing of exons 16 and 17 of the beta-amyloid precursor protein gene fails to
      identify new mutations in Swedish Alzheimer's disease patients.

PMID- 8364542
TI  - A dinucleotide deletion (-delta GA115) in the tyrosinase gene responsible for
      type I-A (tyrosinase negative) oculocutaneous albinism in a Pakistani individual.

PMID- 8364543
TI  - A 4 basepair deletion in exon 4 of the human lipoprotein lipase gene results in
      type I hyperlipoproteinemia.

PMID- 8364544
TI  - A missense mutation (178Cys-->Tyr) and two neutral dimorphisms (115His and
      333Ser) in the human coagulation factor VII gene.

PMID- 8364545
TI  - A new disease-causing mutation in the GAP-related domain of the NF1 gene.

PMID- 8364547
TI  - An 8-bp deletion in exon B of the iduronate-2-sulphate sulphatase gene in a case
      of Hunter disease.

PMID- 8364546
TI  - A novel missense mutation in the phenylalanine hydroxylase gene of a homozygous
      Pakistani patient with non-PKU hyperphenylalaninemia.

PMID- 8364548
TI  - Human erythropoietic protoporphyria: identification of a mutation at the splice
      donor site of intron 7 causing exon 7 skipping of the ferrochelatase gene.

PMID- 8364549
TI  - A new mutation causing inherited growth hormone deficiency: a compound
      heterozygote of a 6.7 kb deletion and a two base deletion in the third exon of
      the GH-1 gene.

PMID- 8364550
TI  - A new mutation of exon 5 of the P53 gene in breast cancer.

PMID- 8364551
TI  - Dinucleotide repeat polymorphisms at the D4S126 and D4S114 loci.

PMID- 8364552
TI  - Dinucleotide repeat polymorphism at the DXS1146 locus.

PMID- 8364554
TI  - The detection of a VNTR at the Huntington disease genetic marker D4S10.

PMID- 8364553
TI  - A TaqI site identifies the *A allele at the ACP1 locus.

PMID- 8364555
TI  - Tetranucleotide repeat polymorphism at D17S846 maps within 40 kb of GAS at 17q12
      q22.

PMID- 8364557
TI  - Dinucleotide repeat polymorphism at the D11S982E locus.

PMID- 8364556
TI  - Dinucleotide repeat polymorphism at the human recoverin RCVI gene locus on
      chromosome 17p.

PMID- 8364558
TI  - Dinucleotide repeat polymorphism at the locus D13S231.

PMID- 8364559
TI  - A compound nucleotide repeat in the neurofibromatosis (NF1) gene.

PMID- 8364560
TI  - A microsatellite polymorphism at the THRB locus.

PMID- 8364561
TI  - A dinucleotide repeat polymorphism in the human LAMB2 gene on chromosome 1q.

PMID- 8364562
TI  - Dinucleotide repeat polymorphism at the D6S348 locus.

PMID- 8364563
TI  - Two consecutive dinucleotide repeats constitute an informative marker at the
      alpha 1-antichymotrypsin (AACT) locus.

PMID- 8364564
TI  - A CA dinucleotide polymorphism at D17S107 (17q12-q24).

PMID- 8364565
TI  - Length polymorphism within a complex dinucleotide repeat in the human decorin
      (DCN) gene.

PMID- 8364566
TI  - Tetranucleotide repeat polymorphism at the D8S344 locus.

PMID- 8364567
TI  - New human DNA polymorphisms submitted to the genome data base.

PMID- 8364568
TI  - Autosomal dominant supravalvular aortic stenosis: localization to chromosome 7.
AB  - Supravalvular aortic stenosis (SVAS) is a localized or diffuse congenital
      narrowing of the ascending aorta which may occur sporadically, as a familial
      defect, or in association with Williams syndrome. Familial cases suggest an
      autosomal dominant gene defect but the underlying molecular basis of SVAS is
      unknown. In this study, we sought to localize the genetic defect in familial SVAS
      by linkage analysis in a large three generation family. A total of 44 polymorphic
      markers were examined for linkage, including 17 Southern blot-based RFLPs, 2 PCR
      based RFLPs, and 25 microsatellites, primarily of the (CA)n repeat type. We
      report linkage of the disease phenotype to a highly informative (CA)n repeat
      marker, Mfd 50, at locus D7S440 which has been localized to chromosome arm 7q.
      Using a 100% penetrance model, which was more conservative than lower values of
      penetrance, a peak LOD score of 4.66 at a recombination frequency of 0.043 was
      found. A number of candidate genes have been localized to this region, including
      collagen 1A2, laminin B1, and elastin. Based on our preliminary linkage data, the
      abnormal microscopic appearance of aortic elastic fibers in SVAS, and analogous
      animal and human diseases associated with elastic fiber and vascular
      abnormalities, there is indirect evidence suggesting elastin as a possible
      candidate gene for this disorder.

PMID- 8364569
TI  - Exclusion of the involvement of all known retinitis pigmentosa loci in the
      disease present in a family of Irish origin provides evidence for a sixth
      autosomal dominant locus (RP8).
AB  - Retinitis Pigmentosa (RP) is the most prevalent degenerative retinal disease of
      mendelian origin, currently affecting approximately 1.5 million people worldwide.
      To date it has been established that a minimum of five different genes maybe
      involved in the pathogenesis of autosomal dominant forms of RP (adRP). The genes
      encoding two retinal specific proteins, rhodopsin and peripherin/RDS, have been
      implicated in causing adRP due to the observation of many different mutations in
      these genes in patients suffering from RP. The three remaining adRP genes have
      been mapped to specific regions of human chromosomes but as yet are
      uncharacterized. We have investigated if there is evidence for the presence of
      another locus in the genome which when mutated causes adRP. We have utilised
      polymorphic genetic markers which have previously been mapped to each of the
      regions known to harbour adRP genes, to test for the exclusion or linkage of the
      disease gene segregating in a pedigree of Irish origin and find no evidence for
      linkage. Hence we provide definitive evidence for the involvement of yet another
      locus. The implications of high levels of genetic heterogeneity inherent in adRP
      are discussed in relation to diagnosis, prognosis and future therapies.

PMID- 8364570
TI  - Mapping the Von Hippel-Lindau disease tumour suppressor gene: identification of
      germline deletions by pulsed field gel electrophoresis.
AB  - Von Hippel-Lindau (VHL) disease is a dominantly inherited familial cancer
      syndrome in which affected individuals have a greatly increased predisposition to
      the development of haemangioblastomas of the central nervous system and retina,
      renal cell carcinoma and phaeochromocytoma. The VHL gene has been mapped to
      chromosome 3p25-p26 by genetic linkage studies and we have previously
      demonstrated that the VHL gene is tightly linked to the D3S601 locus (Zmax =
      18.86 at theta = 0.0) suggesting that D3S601 maps close to the VHL disease gene.
      We have constructed a long range physical map around D3S601 and screened 91 VHL
      patients from 80 kindreds for germline rearrangements using pulsed field gel
      electrophoresis. Two patients showed abnormal fragments in Mlul digested DNA
      probed with D3S601. Further analysis was consistent with both patients having
      germline deletions (approximately 120 kb and 50 kb) telomeric to D3S601. These
      results have (i) established the position of the VHL disease gene with respect to
      D3S601, (ii) refined the localisation of the VHL disease gene to a small region
      (approximately 50 kb) of chromosome 3p25-p26 and (iii) excluded the plasma
      membrane Ca(+)+-transporting ATPase isoform 2 (PMCA-2) gene as a candidate gene
      for VHL disease.

PMID- 8364571
TI  - Mapping of the distal boundary of the X-inactivation center in a rearranged X
      chromosome from a female expressing XIST.
AB  - A female patient with primary amenorrhea, immature secondary sexual
      characteristics, and tall stature was found to have a normal X chromosome and a
      rearranged X [rea(X)] chromosome that resembled an 'isochromosome' Xp, but
      retained the proximal portion of Xq. The rea(X) was interpreted as rec(X)dup
      p,inv(X)(p11.4q13). Replication studies demonstrated that the rea(X) was always
      the late-replicating and, therefore, presumably inactive X chromosome, which must
      contain the X-inactivation center. Consistent with this interpretation,
      fluorescence in situ hybridization demonstrated that the rea(X) retained the XIST
      gene, and reverse transcription polymerase chain reaction analysis showed that
      XIST was expressed in the patient's cells. By fluorescence in situ hybridization
      with previously mapped probes, the breakpoint of the rea(X) was located within an
      approximately 500-kb region located approximately 200 to 700 kb distal to the
      XIST locus. This is the closest breakpoint distal to XIST in an inactivated X
      chromosome and, therefore, defines a new distal boundary for the X-inactivation
      center in humans.

PMID- 8364572
TI  - Construction of cosmid contigs and high-resolution restriction mapping of the
      Huntington disease region of human chromosome 4.
AB  - The gene responsible for Huntington disease (HD) has been localized to a 2.2
      million base pair (Mbp) region between the loci D4S10 and D4S98 on the short arm
      of human chromosome 4. As part of a strategy originally designed to clone the
      gene based on its chromosomal location, we and others previously identified
      overlapping yeast artificial chromosome (YAC) clones covering most of this
      region. While these YAC clones were useful for initially obtaining long-range
      clone continuity, a number of features of the YACs indicated that smaller clones
      are generally more useful in the subsequent steps of the positional cloning
      strategy. In this paper, we use these YAC clones to generate sets of overlapping
      cosmid clones covering most of the HD region. We isolated a large number of
      cosmids by screening a chromosome 4-specific cosmid library with labeled DNA from
      a minimal overlapping set of YAC clones. These cosmid clones were further
      analyzed by restriction mapping and hybridization experiments, leading to the
      assembly of 185 cosmids into eleven contigs covering more than 1.65 Mbp and to a
      fine-structure restriction map of the region. Nine of these contigs cover 90
      percent of the 1.7 Mbp subregion between loci D4S125 and D4S98 where the HD gene
      is now known to lie. The detailed restriction map and the cosmid clones should
      facilitate the identification and localization of cDNAs and polymorphic markers,
      and they provide reagents for large scale DNA sequencing of this region of the
      human genome. Our results suggest that this strategy should be generally useful
      for converting YAC clones into cosmid contigs and generating high-resolution
      restriction maps of genomic regions of interest.

PMID- 8364573
TI  - A microsatellite-based index map of human chromosome 11.
AB  - We have constructed a continuous index map of 25 microsatellite markers on human
      chromosome 11. The markers have been typed in 40 CEPH families, have
      heterozygosities of 69% or higher and can be typed by PCR. The odds against
      inversion of adjacent marker loci order are at least 10(5):1. The sex average map
      covers a total of 162 cM with no gap exceeding 15 cM. Total lengths for female
      and male maps are 205 and 123 cM, respectively. By use of a hybrid cell panel or
      by in situ hybridization, 16 of the markers have also been mapped
      cytogenetically, providing a good correlation of the index map with the
      cytogenetic map. The map will facilitate high resolution mapping of additional
      polymorphic loci and of disease genes on chromosome 11.

PMID- 8364575
TI  - Cloning of the breakpoints of a submicroscopic deletion in an Angelman syndrome
      patient.
AB  - The majority of cases of the two distinct disorders Prader-Willi syndrome (PWS)
      and Angelman syndrome (AS) result from cytogenetic deletions of chromosome 15q11
      q13. These deletions are exclusively of maternal origin in AS but of paternal
      origin in PWS indicating that the 15q11-q13 region is subject to genomic
      imprinting. Transmission of a submicroscopic deletion in one three generation
      family resulted in AS only upon maternal transmission of the deletion with no
      clinical phenotype associated with paternal transmission (1,2). The breakpoint of
      this submicroscopic deletion has been cloned and sequenced. This is the first
      deletion junction from the AS/PWS region which has been so characterized. The
      nucleotide sequence of the deletion junction revealed a 19 bp insertion of
      unknown origin with no evidence of repetitive elements. A probe from the proximal
      deletion breakpoint, PB11, lies within the currently defined minimum region of
      deletion overlap in PWS, which contains the SNRPN and D15S63 loci. Our results
      suggest that the imprinted gene(s) responsible for the PWS phenotype are proximal
      of pB11 in this deletion overlap region.

PMID- 8364574
TI  - PAX6 mutations in aniridia.
AB  - Aniridia is a congenital malformation of the eye, chiefly characterised by iris
      hypoplasia, which can cause blindness. The PAX6 gene was isolated as a candidate
      aniridia gene by positional cloning from the smallest region of overlap of
      aniridia-associated deletions. Subsequently PAX6 intragenic mutations were
      demonstrated in Smalleye, a mouse mutant which is an animal model for aniridia,
      and six human aniridia patients. In this paper we describe four additional PAX6
      point mutations in aniridia patients, both sporadic and familial. These mutations
      highlight regions of the gene which are essential for normal PAX6 function. In
      addition, the frequency at which we have found PAX6 mutations suggests that
      lesions in PAX6 will account for most cases of aniridia.

PMID- 8364576
TI  - Characterization of the human fumarylacetoacetate hydrolase gene and
      identification of a missense mutation abolishing enzymatic activity.
AB  - Hereditary tyrosinemia type 1 is an autosomal recessive disease caused by a
      deficiency of the last enzyme in the catabolic pathway of tyrosine,
      fumarylacetoacetate hydrolase (FAH). To analyze the mutations involved in this
      disease, and as a first step towards elucidating the mechanisms regulating the
      transcription of the FAH gene, we have isolated and characterized the human gene
      coding for FAH. The gene contains 14 exons and spans approximately 35 kilobases
      of DNA. The 5' end of the gene is highly GC-rich, and eleven putative binding
      sites for the transcription factor Sp 1 were identified in the proximal region of
      the promoter. We investigated the molecular basis of FAH deficiency in a
      hereditary tyrosinemia type 1 patient whose liver FAH showed a very low enzymatic
      activity. Sequencing of the liver FAH cDNA of the patient revealed a C to A
      transversion in the FAH mRNA, which predicted the replacement of an alanine (A)
      residue with an aspartic acid (D) residue at position 134 (A134D) of the amino
      acid sequence of the corresponding protein. Direct sequencing of genomic DNA
      indicated that the patient was heterozygous for the A134D mutation. The allele
      that does not carry the A134D mutation was expressed at a very low level in the
      liver of the patient. Expression of the mutant allele in CV-1 cells confirmed
      that the A134D mutation was responsible for the lack of enzymatic activity in the
      liver of the patient.

PMID- 8364577
TI  - The genes for X-linked ocular albinism (OA1) and microphthalmia with linear skin
      defects (MLS): cloning and characterization of the critical regions.
AB  - We have used cell lines from patients with deletions and translocations involving
      the Xp22 region to map the genes for two X-linked disorders, ocular albinism type
      1 (OA1) and microphthalmia with linear skin defects (MLS). Using existing and
      newly isolated DNA markers, the map position within Xp22 of key patient
      breakpoints, defining the boundaries of the genomic regions involved in these
      disorders (the critical regions), has been precisely determined. A 2.6 Mb yeast
      artificial chromosome (YAC) contig, spanning the critical regions for these two
      disorders, was assembled. Detailed long-range restriction analysis of the contig
      established the sizes of the critical regions to be 200 kb for OA1 and 800 - 925
      kb for MLS. Ten potential CpG-islands, representing candidate sites for genes,
      have been mapped within the 2.6 Mb region. Our data should greatly facilitate
      efforts aimed at cloning the genes for these developmental defects.

PMID- 8364578
TI  - Genomic organization of the sequence coding for fibrillin, the defective gene
      product in Marfan syndrome.
AB  - Marfan syndrome results from mutations in an extracellular matrix glycoprotein,
      fibrillin. Previous studies have characterized approximately 6.9-kb of the
      estimated 10-kb fibrillin transcript. We have now completed the primary structure
      of fibrillin, elucidated the exon/intron organization of the gene and derived a
      physical map of the genetic locus. Pre-fibrillin consists of 2,871 amino acids
      which, excluding the signal peptide, are arranged into five structurally distinct
      regions. The largest of these regions comprises about 75% of the entire protein
      and consists of numerous repeated cysteine-rich sequences homologous to the
      peptide motifs of the epidermal growth factor (EGF) and transforming growth
      factor-beta binding protein (TGF-bp). Forty-three of the forty-six EGF-like
      repeats contain a calcium binding consensus sequence (EGF-CB) conceivably
      mediating protein-protein interactions. Fibrillin exhibits a few additional
      cysteine-rich modules that are apparently unique to this macromolecule and may
      represent evolutionary variants of the EGF-CB and TGF-bp motifs. Almost all of
      the cysteine-rich repeats are encoded by single exons; consequently, the
      fibrillin gene is relatively large (approximately 110-kb) and highly fragmented
      (65 exons). This study provides the first comprehensive analysis of the fibrillin
      gene and relevant information for the full characterization of Marfan syndrome
      mutations.

PMID- 8364579
TI  - Paired STSs amplified from radiation hybrids, and from associated YACs, identify
      highly polymorphic loci flanking the ataxia telangiectasia locus on chromosome
      11q22-23.
AB  - The high resolution mapping of the ataxia telangiectasia (A-T) locus on
      chromosome 11q22-23 requires the generation of new polymorphic markers
      specifically within the segment of 11q22-23 to which the locus has been assigned.
      We have made use of a library of Alu-PCR clones, amplified from a radiation
      reduced somatic cell hybrid containing the relevant chromosome 11 segment, to
      generate sequence tagged sites (STS) within the 11q22-23 region and have used YAC
      clones to extend the loci identified by these STSs. The identification of paired
      polymorphisms (from Alu-PCR and the associated YAC derived clone), which are
      physically linked, but which show minimal linkage disequilibrium, provides a
      highly informative haplotype for use in genetic linkage analysis in A-T families.
      We describe the characterisation of 2 such polymorphic loci, D11S535 and D11S611,
      which map between existing flanking markers, and which provide additional
      information on the location of the major A-T locus.

PMID- 8364580
TI  - Identification of germline mutations in the RB1 gene by denaturant gradient gel
      electrophoresis and polymerase chain reaction direct sequencing.
AB  - Germline mutations in the RB1 gene confer hereditary predisposition to
      retinoblastoma. The majority of these mutations occur de novo and differ from one
      patient to another. Cytogenetics and Southern blotting were shown to detect less
      than 15% of constitutional rearrangements. In this study we used the polymerase
      chain reaction (PCR) combined with denaturant gradient gel electrophoresis (DGGE)
      to detect point mutations or small deletions and insertions in a pool of 120
      unrelated retinoblastoma patients. Partial DGGE analysis of the RB1 gene enabled
      us to identify sequence alterations generating stop codons, leading to amino acid
      substitution or affecting splice sites as well as several polymorphisms. Most of
      the nucleotide changes detected are flanked by direct repeats. The approach
      described here has proved to be a useful method for the detection of germline
      mutations in the RB1 gene.

PMID- 8364581
TI  - Molecular analysis of British facioscapulohumeral dystrophy families for 4q DNA
      rearrangements.
AB  - Facioscapulohumeral muscular dystrophy is an important autosomal dominant
      neuromuscular disorder that has been localised to 4q35. We have analysed our
      extensive panel of 45 families with a new DNA marker p13E-11. The findings, based
      on multiply informative individual meioses and multipoint mapping, suggest that
      probe p13E-11 is the closest marker for the disorder and it is likely to be
      located proximal to the disease locus as are all the other present markers. In
      nine of the ten new mutations studied, a new smaller EcoRI fragment which was not
      present in either of the parents was detected, indicating that a de novo DNA
      rearrangement is indeed associated with the development of the disease state.
      However, in view of the difficulty in defining the size of over 30kb alleles and
      the recombinant events observed with p13E-11, we suggest that it should be used
      in combination with another VNTR marker until a close distal flanking marker for
      this condition is identified or the gene itself is isolated.

PMID- 8364582
TI  - An alternatively-spliced mRNA in the carboxy terminus of the neurofibromatosis
      type 1 (NF1) gene is expressed in muscle.
AB  - The gene for neurofibromatosis type 1 (NF1) was identified by positional cloning
      and found to contain two alternatively spliced exons. The first described
      alternatively spliced exon (exon 23a) is located within the GAP-related domain of
      the gene and inserts an additional 63 nucleotides into the NF1 mRNA. The second
      alternatively spliced exon (exon 48a) is located near the extreme carboxy
      terminus of the gene and inserts an additional 54 nucleotides into the mRNA. This
      second isoform, termed 3'ALT, was originally detected while screening a fetal
      brain cDNA library. Examination of its expression by reverse-transcribed RNA PCR
      demonstrates high level of expression in cardiac muscle, skeletal muscle and
      smooth muscle. Trace levels of expression are detected in brain and nerve. The
      3'ALT isoform is expressed in fetal cardiac muscle, adult left ventricle and
      cardiac Purkinje cells. Further confirmation of the existence of this isoform was
      obtained by blotting the PCR products with a radiolabeled oligonucleotide
      entirely derived from sequences contained within exon 48a and by direct
      sequencing of the PCR products. Additionally, this isoform is expressed in muscle
      tissues from other vertebrate species. The expression of this isoform in muscle
      suggests that the NF1 gene may play additional tissue-specific roles in muscle
      development and signal transduction.

PMID- 8364583
TI  - The state of DNA methylation in the promoter and exon 1 regions of the human gene
      for the interleukin-2 receptor alpha chain (IL-2R alpha) in various cell types.
AB  - The gene for the human interleukin-2 receptor alpha chain (IL-2R alpha) is
      expressed only in stimulated, not in resting, human T lymphocytes. This gene, in
      conjunction with others, plays a pivotal role in eliciting the T cell-mediated
      immune response. We have investigated the promoter and exon 1 region, the
      nucleotide -300 to +300 region of this gene relative to the position of
      transcriptional initiation at nucleotide +1, particularly with respect to the
      extent of DNA methylation at the 5'-CG-3' sequences and its changes upon
      induction. By using RNA transfer analyses and the in vivo footprinting technique,
      we have confirmed the previously reported finding that, upon stimulation of
      lymphocytes by phytohemagglutinin (PHA) plus interleukin-2 (IL-2), the IL-2R
      alpha gene can be induced to be transcribed. The region of the IL-2R alpha gene
      analyzed for 5'-CG-3' methylation by the genomic sequencing method or a
      polymerase chain reaction-based method subsequent to HpaII or HhaI cleavage of
      the DNA does not seem to be significantly methylated in most cell types tested,
      except for the cytidine residue in position +198 which is partly methylated. In
      the DNA of cells from a chronic B cell lymphatic leukemia 5'-CCGG-3' sequences in
      the exon 1 region are almost completely unmethylated. These results suggest that
      the promoter of a gene that is crucial in promoting the immune response and may
      have to be activated momentarily, will not be silenced by a long-term mechanism
      like DNA methylation. It is striking that the absence of DNA methylation in this
      promoter and exon 1 segment also extends to cell types not directly associated
      with the immune response and even to continuous cell lines.

PMID- 8364584
TI  - Variants of glucose-6-phosphate dehydrogenase are due to missense mutations
      spread throughout the coding region of the gene.
AB  - Glucose-6-phosphate dehydrogenase (G6PD) is remarkable for its genetic diversity
      in humans. Many variants of G6PD have been described with wide ranging levels of
      enzyme activity and associated clinical symptoms. Fifty-eight different mutations
      have now been identified and these account for 97 named G6PD variants. The
      mutations are almost exclusively missense mutations, causing single amino acid
      substitutions. They are spread throughout the coding region of the gene, although
      there appears to be a cluster of mutations that cause a more severe clinical
      phenotype towards the 3' end of the gene. The absence of large deletions,
      frameshift mutations and nonsense mutations is consistent with the notion that a
      total lack of G6PD activity would be lethal.

PMID- 8364585
TI  - Mutations and polymorphisms in the prion protein gene.
AB  - Inherited forms of prion diseases are associated with mutations in the prion
      protein gene. A common polymorphism at codon 129 is also implicated in the
      predisposition of individuals to sporadic or iatrogenic forms of the disease.
      This update lists all the currently published mutations and polymorphisms
      together with their clinical phenotypes, and discusses the significance of the
      codon 129 genotype in inherited, sporadic, and iatrogenic cases. There are two
      categories of mutation. Insertions of additional numbers of an octapeptide lying
      within an octapeptide repeat region now account for six variations and there are
      also six point mutations. The identification of mutations in this gene has lead
      to a broadening of the spectrum of clinical phenotypes that can be classified as
      prion diseases and have provided an important tool in the diagnosis of familial
      dementias.

PMID- 8364586
TI  - Mutations and polymorphisms in the human ornithine transcarbamylase gene.
AB  - Deletions of variable size involving one or more exons, 29 different missense,
      nonsense, or frameshift mutations, and three polymorphisms have been found in
      patients with ornithine transcarbamylase (OTC) deficiency. Most of the deletions
      and mutations were found in patients with severe disease manifested clinically as
      acute neonatal hyperammonemia. A small number of mutations or somatic mosaicism
      for deletions were found in males with "late onset" disease and heterozygous
      females who were symptomatic. Approximately 10-15% of all molecular alterations
      associated with OTC deficiency are large deletions involving all or part of the
      OTC gene with or without contiguous genes on the short arm of the X chromosome.
      Approximately 10% of all point mutations involve the CpG dinucleotide of codon
      141 with a CGA-->CAA transition producing a deleterious Arg-->Gln substitution in
      position 109 of the mature enzyme and causing the elimination of a TaqI
      recognition site. The majority of the remaining mutations in the OTC gene are
      unique to the affected family and are usually not found in unrelated patients. To
      date, two mutations have been described in the sequence of the "leader" peptide,
      23 mutations have been found in the coding sequence of the "mature" enzyme, and
      four mutations have been discovered in splicing recognition sites. Approximately
      20 single base polymorphisms have been postulated to exist by comparing two
      reported OTC gene sequences; six of these substitutions cause amino acid changes
      of which three have been confirmed in patients. Of the known point mutations, 27
      are single base substitutions: 17 missense, 6 nonsense, 4 splice site, and the
      remaining 2 are single base deletions.

PMID- 8364587
TI  - Exon 44 nonsense mutation in two-Duchenne muscular dystrophy brothers detected by
      heteroduplex analysis.
AB  - Utilizing a heteroduplex method, we screened the dystrophin exon 43-45 region for
      point mutations, including small deletions and insertions. The method depends
      upon the formation of a heteroduplex between wild-type and mutant DNA PCR
      products. DNA specimens from one hundred and four DMD patients without detected
      deletions or duplications were multiplexed amplified for exons 43, 44, and 45.
      The PCR products were mixed with the PCR products from nonaffected controls,
      electrophoresed, and examined for the presence of altered mobility heteroduplex
      bands. An exon 44 nonsense mutation in two DMD brothers and a common intron 44
      polymorphism were identified using this approach. Although the exon 44-45 region
      is a hotspot for deletion breakpoints, it does not appear to be prone to point
      mutations. The technique is extremely useful for screening several exons
      simultaneously and it allowed us to screen a large number of patients.

PMID- 8364588
TI  - Paternal mosaicism for a COL1A1 dominant mutation (alpha 1 Ser-415) causes
      recurrent osteogenesis imperfecta.
AB  - We describe a dominant point mutation in the COL1A1 gene causing extremely severe
      osteogenesis imperfecta (OI type II/III) which was detected in the dermal
      fibroblasts of a proband, diagnosed by ultrasonography at 24 weeks of gestation.
      Type I collagen secretion was reduced and pro alpha 1(I) chains were
      overmodified. The mutation was localised in one COL1A1 allele by chemical
      cleavage of mismatched bases in normal cDNA/proband's mRNA heteroduplexes, and
      identified by cloning and sequencing. A G-to-A transition which causes the
      substitution of Gly-415 with serine in the alpha 1(I) triple helical domain was
      found. The same mutation was detected in the father's spermatozoa and
      lymphocytes. Mosaicism in the father's germline explains the occurrence in the
      family of two additional OI pregnancies, which were documented by X-ray and
      ultrasound investigations.

PMID- 8364589
TI  - A leucine to arginine amino acid substitution at codon 46 of rhodopsin is
      responsible for a severe form of autosomal dominant retinitis pigmentosa.
AB  - To evaluate the extent to which rhodopsin mutations are involved in autosomal
      dominant forms of retinitis pigmentosa (adRP) we collected DNAs from patients
      with adRP and screened the rhodopsin coding sequence with single-strand
      conformational polymorphism (SSCP) analysis and DNA sequencing. This screening
      revealed a thymidine to guanine transversion at nucleotide 431 (nucleotide
      sequence numbers as per Genebank) in affected members of one family (RFS04). The
      nucleotide substitution leads to a missense mutation at the 46th amino acid of
      rhodopsin. The mutation occurs at an amino acid conserved in mammals and changes
      the hydrophobic nature of the protein at a transmembrane-spanning region. The
      mutation causes the substitution of a non-polar hydrophobic amino acid, leucine,
      for the basic amino acid arginine (Leu46Arg). This nucleotide substitution is
      unique to the family studied and occurs in the affected individuals in the
      family. Full-field electroretinograms (ERGs) in four affected members of the
      family showed nondetectable rod responses at an early age, with markedly reduced
      cone responses, and a faster than average rate of progression of the phenotype as
      measured by yearly ERGs.

PMID- 8364590
TI  - Genetic diversity from a limited repertoire of mutations on different common
      allelic backgrounds: alpha 1-antitrypsin deficiency variant Pduarte.
AB  - alpha 1-Antitrypsin (alpha 1AT) is one of the most polymorphic gene loci in the
      human genome. alpha 1AT variants are typically identified by their migration
      position in an isoelectric focusing gel at pH 4-5. Heterogeneity of the
      isoelectric point of alpha 1AT variants, hence variant migration, most often
      results from amino acid substitutions which alter the net charge of the molecule.
      We identified an individual heterozygous for an alpha 1AT variant migrating in
      the "P" variant region which differs from other known "P" variants. Using
      isoelectric focusing on an immobilized pH gradient at pH 4.50-4.85 the novel P
      allele, Pduarte, migrates between Pst. albans and Plowell. Densitometric analysis
      of normal "M" type alpha 1AT and the deficiency variant Plowell major bands
      separated by isoelectric focusing demonstrates that Pduarte contributes
      approximately 41% as much alpha 1AT to the total serum alpha 1AT concentration as
      the normal "M" alpha 1AT, similar to Plowell. Direct DNA sequencing of the
      proband's genomic DNA demonstrates that the Pduarte allele differs from the
      normal M1 (V213) allele by two amino acid substitutions, R101 (CGT)-->H(CAT) and
      D256 (GAT)-->V(GTT). Individually, these amino acid substitutions characterize
      the normal M4 allele (R101-->H) and the deficient Plowell allele (D256-->V). Thus
      the Pduarte allele differs from the Plowell allele only by the normal allelic
      background in which the V256 mutation occurs. Comparison of amino acid sequences
      among several alpha 1AT variants demonstrates that Pduarte is an example of a
      more general observation regarding diversity within the PI (protease inhibitor)
      system.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364591
TI  - A molecular approach to estimating the human deleterious mutation rate.
AB  - We propose a method of measuring the human genomic deleterious mutation rate
      based on comparison of the rate of evolution per nucleotide per generation of
      neutral sequences, microN, with the overall rate of evolution of unique sequence
      DNA, microO. Data on microN, which are based on pseudogenes, permit an estimate
      of the total zygotic (twice the genomic) mutation rate, UT = 2 microNn = 2(2 x
      10(-8)(3 x 10(9)) approximately 10(2), where n is the number of nucleotides per
      genome. Data on microO can be obtained by comparison of representative samples of
      relatively short homologous sequences from the genomes of Homo and a related
      species. The fraction of the genome that is controlled by negative selection is
      fS = (microN - microO)/microN and the deleterious zygotic mutation rate, the
      expected number of new deleterious alleles carried by a zygote, is US = UTfS. If
      fS > 0.01, US > 1, which would have important implications for human genetics and
      evolutionary biology.

PMID- 8364592
TI  - Caveat to genotype-phenotype correlation in mucopolysaccharidosis type II:
      discordant clinical severity of R468W and R468Q mutations of the iduronate-2
      sulfatase gene.

PMID- 8364593
TI  - Phenylalanine hydroxylase gene: a novel splice mutation in intron 2 in two German
      and Polish families with severe phenylketonuria.

PMID- 8364594
TI  - Biomechanics of pitching with emphasis upon shoulder kinematics.
AB  - The American Sports Medicine Institute conducts research to increase
      understanding of mechanisms involved in upper extremity injuries to throwing
      athletes. This paper presents a qualitative overview of pitching and a detailed
      quantitative description of arm motion about the shoulder during this highly
      dynamic activity. Data on kinematics of arm motions about the shoulder are
      presented for 29 elite throwers. The major motion about the shoulder is
      external/internal rotation. Scapulothoracic and glenohumeral flexibility permit
      the arm to reach an externally rotated position of 175 degrees. Approximately 30
      msec before release, the arm internally rotates 80 degrees, reaching peak angular
      velocities near 7,000 degrees/sec. In rehabilitation of injured throwers, there
      is a need to appreciate the highly dynamic nature of this skill and to attempt to
      simulate these dynamic motions and loads as part of the final phase of treatment
      before the athlete returns to competition.

PMID- 8364595
TI  - Arthroscopic examination of the throwing shoulder.
AB  - Throwing athletes may develop a multitude of problems in the glenohumeral joint
      and subacromial area. On occasions when rehabilitation is unsuccessful,
      diagnostic arthroscopy and arthroscopic management of these disorders may be
      indicated. The present study demonstrates several common injury patterns noted on
      arthroscopic examination of the throwing shoulder.

PMID- 8364596
TI  - Classification and treatment of rotator cuff injuries in the overhand athlete.
AB  - Rotator cuff injury in athletes results from accumulation of microtrauma to both
      the static and dynamic stabilizers of the shoulder. Our classification of these
      injuries and treatment protocol is based on knowledge of the pathophysiology of
      events leading to rotator cuff failure. Rotator cuff disease is attributed to one
      of five different modes of failure: primary compressive disease, secondary
      compressive disease, primary tensile overload, secondary tensile overload, and
      macrotraumatic injuries. Although disease is categorized based on a single
      failure mode, there is often significant overlap between the mechanisms of injury
      leading to the disease. Categorization and, consequently, treatment of the injury
      rely upon proper identification of the primary pathology and an understanding of
      the causative factors leading to rotator cuff failure. In most cases conservative
      management is successful, but, in the refractory cases, minimally invasive
      surgical techniques have also been successful in returning most athletes to a
      premorbid level of function.

PMID- 8364597
TI  - Rehabilitation of the shoulder following rotator cuff injury or surgery.
AB  - Rotator cuff problems are encountered frequently and must be rehabilitated
      precisely. The pace and intensity of the program are regulated by the degree of
      pathology and the patient's activity requirements. As our ability to understand
      the biomechanics of shoulder motion improves, we realize that many rotator cuff
      problems are secondary to instability. This instability can be subtle. The
      following article details a rehabilitative program for patients with rotator cuff
      pathology and includes both conservative and postoperative programs for pathology
      secondary to instability as well as primary impingement.

PMID- 8364598
TI  - Classification and treatment of shoulder dysfunction in the overhead athlete.
AB  - There are two distinct pathological categories of shoulder injury. In the older
      population, shoulder injury is generally a result of the degenerative aging
      process. In the younger population, it is commonly a result of the
      repetitiousness of an overhead sport. In the latter group, instability is
      typically the core problem, leading to the continuum of subluxation, impingement,
      and rotator cuff tear. A classification scheme, proposing four definitive types
      of shoulder injury, assists in directing an effective management program. Once
      diagnosed (the first step of treatment) a conservative rehabilitation program
      that emphasizes strengthening of the glenohumeral protectors, scapulohumeral
      pivotors, humeral positioners, and power drivers is advised. The surgery of
      choice, for the small minority who fail to respond to the rehabilitation program,
      is the anterior capsulolabral reconstruction. A sports medicine team working
      together with the athlete is instrumental in his/her return to sport.

PMID- 8364599
TI  - Rehabilitation for the overhead athlete.
AB  - Rehabilitation of the shoulder of the overhead athlete has undergone significant
      changes during the past few years. This article illustrates shoulder problems
      related to repetitive overhead activities, such as throwing. Additionally, we
      present basic science contributions in this area, principles of shoulder
      rehabilitation, and a comprehensive rehabilitation program for the symptomatic or
      asymptomatic athlete based on these principles.

PMID- 8364600
TI  - Neuromuscular testing and rehabilitation of the shoulder complex.
AB  - The shoulder complex plays an integral role in performing an athletic skill
      involving the upper extremity. The intricacy of the neuromotor components
      controlling shoulder motion and athletic skill is an issue that the sports
      physical therapist deals with on a daily basis when rehabilitating athletic
      patients. The purpose of this article is to review neuromotor control of the
      shoulder complex and describe an exercise routine developed to enhance
      proprioception, kinesthesia, and neuromuscular control. Clinical research studies
      examining the strength of the rotator cuff and scapular stabilizers, in addition
      to joint position sense, are reviewed. The results of these studies are discussed
      as they apply to the exercises described in the article designed to improve
      dynamic stability. The results of these studies and implementation of these
      exercises will help the sports physical therapy clinician assist the athletic
      patient and improve dynamic and neuromotor control of the shoulder.

PMID- 8364602
TI  - Regulated expression of the rat medium chain hydrolase gene in transgenic rape
      seed.
AB  - Medium chain hydrolase (MCH) is an enzyme which regulates the chain length of
      fatty acid synthesis specifically in the mammary gland of the rat. During
      lactation, MCH interacts with fatty acid synthase (FAS) to cause premature
      release of acyl chains, thus providing medium chain fatty acids for synthesis of
      milk fat. In this study we have investigated the ability of rat MCH to interact
      with the phylogenetically more distant FAS structure present in plant systems and
      to cause a perturbation of fatty acid synthesis. In in vitro experiments,
      addition of purified MCH to rapeseed homogenates was found to cause a significant
      perturbation of fatty acid synthesis towards medium chain length products. The
      rat MCH gene was expressed in transgenic oilseed rape using a seed specific rape
      acyl carrier protein (ACP) promoter and a rape ACP plastid targeting sequence.
      Western analysis showed MCH protein to be present in transgenic seed and for its
      expression to be developmentally regulated in concert with storage lipid
      synthesis. The chimaeric preprotein was correctly processed and immunogold
      labelling studies confirmed MCH to be localized within plastid organelles.
      However, fatty acid analysis of oil from MCH-expressing rape seed showed no
      significant differences to that from control seed.

PMID- 8364601
TI  - Positive-negative selection gene targeting with the diphtheria toxin A-chain gene
      in mouse embryonic stem cells.
AB  - The diphtheria toxin A-chain gene was used in a positive-negative selection gene
      targeting vector to alter the CD4 gene which is transcriptionally silent in mouse
      embryonic stem cells. Expression of the toxin gene was driven by a constitutively
      active enhancer, yet the targeting construct exhibited only minimal transient
      toxicity while enriching for targeted clones 9- to 29-fold. Germline transmission
      of the stem cell-derived genome was obtained. These data suggest the usefulness
      of this diphtheria toxin A-chain cassette in replacement-type positive-negative
      selection vectors. Its potential for novel applications, particularly in the
      enrichment for 'hit-and-run' insertion-type vectors, is discussed.

PMID- 8364603
TI  - Degeneration of skeletal and cardiac muscles in c-myb transgenic mice.
AB  - In order to reveal cellular processes sensitive to abnormal c-myb expression in
      vivo, transgenic mice were produced by introducing the c-myb nuclear proto
      oncogene under the ubiquitous transcriptional regulatory unit of the cytoplasmic
      beta-actin gene. Expression of c-myb in thymus did not cause apparent
      abnormality, but the mice unexpectedly developed degenerative abnormalities in
      skeletal and cardiac muscles; this occurred predominantly in males. Expression of
      c-myb in skeletal muscle was correlated with an inflammation of muscle and was
      accompanied by vacuolar degeneration of muscle fibres, their regeneration, and
      lymphocyte infiltration. The identical pathological progression in cardiac muscle
      was associated with cardiomegaly.

PMID- 8364604
TI  - Pharmacokinetics of radioiodinated human and ovine growth hormones in transgenic
      mice expressing bovine growth hormone.
AB  - Pharmacokinetics of radioiodinated human growth hormone (hGH) and ovine growth
      hormone (oGH) were studied in normal mice and in transgenic mice carrying the
      bovine growth hormone (bGH) gene fused to phosphoenolpyruvate carboxykinase
      promoter/regulator (PEPCK-bGH). Multiexponential plasma decay curves were
      obtained in both normal and transgenic mice after a 125I-oGH injection and
      pharmacokinetic parameters were estimated by fitting blood concentration data to
      a three compartment model. The half-life for the rapid compartment was shorter in
      transgenic than in normal mice (t1/2 gamma: 1.2 +/- 0.3 vs. 2.2 +/- 0.5 min). The
      slow compartment had a t1/2 alpha of 160 +/- 23 min for transgenic and 70 +/- 8
      min for normal mice while the middle compartment had a t1/2 beta of approximately
      10 min for both groups of mice. The mean residence times were 167 +/- 24 and 55
      +/- 5 min for transgenic and normal mice, respectively. Specific liver uptake of
      radioactivity after injection of 125I-oGH or 125I-hGH was found in both groups of
      animals. Specificity studies indicated that, similarly to normal mice, livers of
      transgenic mice possess a mixed population of somatotropic and lactogenic
      receptors. Uptake of labelled hGH by the liver was dose-dependent and the doses
      that prevented 50% of liver uptake (ED50%) were 8 and 165 micrograms per 50 g
      body weight for normal and transgenic mice, respectively. These in vivo results
      confirm and extend previous in vitro findings that a life-long excess of bGH
      increases hepatic somatotropic and lactogenic receptors. Since elevation in
      growth hormone (GH) receptors was reported to be associated with an increase in
      GH binding protein (GHBP), we suspect that both the increase in the mean
      residence time and the reduction in specific uptake of GH in the livers of
      transgenic mice may be the result of an increase in GHBP levels.

PMID- 8364605
TI  - Assembly of an antibody and its derived antibody fragment in Nicotiana and
      Arabidopsis.
AB  - The yield and assembly of an IgG1 antibody and its derived F(ab) fragment were
      compared in Nicotiana and Arabidopsis. The results obtained showed a lot of
      interclonal variability. For 45% of the primary transgenic calluses, antigen
      binding entities represented less than 0.1% of the total soluble protein (TSP).
      Only two of the 103 analysed transformants contained more than 1% of antigen
      binding protein, with 1.26% being the highest yield. Analogous amounts of
      complete antibody and F(ab) accumulated in primary callus tissue. Moreover,
      yields were in the same range for both species as far as primary callus tissue is
      concerned. However, the accumulation of the F(ab) fragment in leaf tissue of
      regenerated plants differed significantly between Nicotiana and Arabidopsis. The
      F(ab) fragment accumulated to only 0.044% of TSP in Nicotiana leaves but up to
      1.3% in Arabidopsis leaves. Furthermore, both species showed differences in the
      assembly pattern of the complete antibody. Whereas Arabidopsis contained
      primarily fully assembled antibodies of 150 kDa, Nicotiana showed an abundance of
      fragments in the 50 kDa range.

PMID- 8364607
TI  - [The ontogeny of the origin of different forms of higher nervous activity].

PMID- 8364606
TI  - A series of vectors that simplify mammalian gene targeting.
AB  - In order to facilitate the procedure of mammalian gene targeting, we have
      produced and functionally tested a series of generic vectors. Homologous
      recombination has been achieved with each vector. The vectors are designed for
      both replacement and insertional recombination, are suitable for 'hit and run'
      strategies and contain all necessary genetic elements for both positive-negative
      and promoterless/gene fusion enrichment of homologous integrations. Multiple
      unique restriction sites are included to simplify the incorporation of genomic
      targeting sequences.

PMID- 8364608
TI  - [The sexual cycle in reflexively ovulating rabbits].
AB  - Reflexo-ovulating rabbits appeared to have oestrous and ovarian 11-12-day cycles.
      The condition of external sexual organs revealed the hormonal status and ovarian
      folliculogenesis, being an adequate index of the cycle stage. No release of
      preovulatory gonadotropin or spontaneous ovulation occurred in natural oestrus
      due, probably, to inadequate production of the pituitary gonadotropins and to low
      progesterone level in the blood during oestrus.

PMID- 8364609
TI  - [A device for determining the latency time of the reactions resulting from nerve
      resection].

PMID- 8364610
TI  - [The formulation of the conditions for the chromatographic separation of adrenal
      cortex mineralo- and glucocorticoids and androgens using the Milichrome
      chromatograph].

PMID- 8364611
TI  - [Patterns in the correlations between the indices of the hydration-electrolyte
      profile of the brain].
AB  - The hydration-electrolyte profile was studied in 18 CNS structures of dogs. The
      frequencies of correlation coefficients were found to be placed in diminishing
      order as follows: H2O/H2O, K/K, H2O/K, Na/Na, H2O/Na, Na/K. The closest relations
      were detected in the frontal cortex, the least number of interactions were
      characteristic of the spinal cord and the hippocampus. The interrelations based
      on functional, anatomic, embryo-phylogenetic principles were most frequently
      observed in the thalamic and caudate-frontal systems as well as in the cortex and
      in mesencephalon.

PMID- 8364612
TI  - [The effect of ethanol on carboxypeptidase H activity in the hypophysis and some
      sections of the brain in rats under different stressful exposures].
AB  - The combined effect of ethanol and stress induced a hyperactivation of the
      carboxypeptidase H in some areas of the rat brain. The carboxypeptidase H in
      supposed to be involved in regulation of the ethanol effect on the organism
      during stress.

PMID- 8364613
TI  - [The neuronal background impulse activity of the cerebellar dentate nucleus in
      the rat].
AB  - The analysis of serial correlograms of spontaneous neuronal activity of the rat
      cerebellum dentate nucleus revealed six main dynamic versions of the impulse
      flows. Independent haphazard distribution of interspike intervals, irregular
      sequences of short and long intervals, periodic changes of the impulse flow rate,
      were predominant.

PMID- 8364614
TI  - [The functional properties of the cochlear-vestibular acupuncture points of the
      external auditory canal].
AB  - Endaural acupuncture points were studied in 60 healthy subjects. The points were
      found to have obvious advantages as compared with the commonly accepted points of
      the ear.

PMID- 8364615
TI  - [The developmental dynamics of the erythroid stem cell in rat hematopoietic
      organs in ontogeny].
AB  - The cellular composition of peripheral blood, hematopoietic organs, and the
      content of erythroblastic islands of the red bone marrow revealed regular changes
      of concentrations of the RBCs, hemoglobin and reticulocytes thus corroborating
      the phenomenon of "early postnatal anemia" in rats. A considerable increase in
      number of the erythroblastic islands was revealed between the 10th and 45th days
      of life. Functional reconstruction of the islands in the postnatal ontogenesis
      was analysed in rats.

PMID- 8364616
TI  - [The role of the cerebral cortex venules in normal oxygen transport and in
      normobaric hyperoxia].
AB  - Mathematical processing revealed no statistically significant dependence of the
      oxygen tension distribution (pO2) over the wall of the vessel under study upon
      its diameter. The data obtained showed that, in hyperoxemia, oxygen diffusion
      from the blood to tissues occurs through the walls of the radial venules. In case
      the distance between arteriole and venule is less than 100 mcm, a diffuse shunt
      is possible.

PMID- 8364617
TI  - [Postural systemic vascular reactions].
AB  - Changes of hydraulic resistance of the vascular system were studied under
      conditions of stabilised blood expenditure in response to ortho- and
      antiorthostatic effects. The first type effects involved an increase in the
      resistance whereas the antiorthostasis decreased the resistance. Both ways of
      estimation of vascular responses are discussed from the standpoint of conditions
      for baroreflex control of vasomotor responses.

PMID- 8364618
TI  - [The phasic contraction of the guinea pig vas deferens in organotypic culture
      during periodic stretching].
AB  - Vas deferens explants from the adult guinea pigs were cultivated under
      organotypic conditions with repeated stretching. In control explants with no
      stretching over 9 days the occurring hypersensitivity is similar to the
      denervated one. Simultaneously phase component contractile response decreased in
      a 5.25 time. Repeated stretch preserve the hypersensitivity and more increased
      contractile response, however normalization of the phase component contractile.

PMID- 8364620
TI  - [The mechanisms of the dominant and thirst motivation].

PMID- 8364619
TI  - [Endogenous peptides as a single system of regulatory substances].
AB  - Endogenous peptides of the whole organism, irrespective of the place of their
      synthesis, mostly play the role of the elements constituting a code for
      triggering the integrative mechanisms of regulation of the functions of organs'
      systems or the whole organism. The data is presented on the results of radio
      immunological assessment of concentration changes in the regulatory peptides in
      response to effect of the substances introduced into the vascular bed of animals.

PMID- 8364621
TI  - [Liudvig Martynovich Pussep on Ivan Pavlovich Pavlov].

PMID- 8364622
TI  - [Epiphyseal interrelations with the striatum in the haloperidol-induced catalepsy
      model].
AB  - Removal of the rat pineal gland entailed an attenuation of haloperidol-induced
      catalepsy and readjustment of its time-course. This may depend on either direct
      of indirect effects of the pineal factors, mostly in the ventral portion of the
      striatum whose hyperactivity determines the main parameters of the neuroleptic
      effect.

PMID- 8364623
TI  - [The ultrastructure of smooth muscle cells under static stretching].
AB  - Smooth muscle cells of the guinea pig vas deferens in the organotypic culture
      change their phenotype from the contractile to the synthetic one within a month.
      The activating nucleoli, while increasing the number of free ribosomes and
      endoplasmic reticulum, decreased the amount of myofilaments and dense bodies.
      Longitudinal static stretching maintains the contraction phenotype in the
      longitudinal layer muscle but not in the circular layer.

PMID- 8364624
TI  - [Age-related changes in the parameters of the capillary blood flow in rat
      skeletal muscle: allometric relations and the hypothesis of capillary functional
      length].
AB  - The effect of growth on the capillary i.d. and density, the RBC velocity and tube
      hematocrit in the rat m. cremaster was studied in vivo. All these parameters
      decreased with growing as described by allometric equations. The mean capillary
      diameter and the hematocrit did not change significantly under the same
      conditions. A hypothetic explanation of the discrepancy between the bulk flow and
      capillary flow is suggested.

PMID- 8364625
TI  - [Functional changes in the mucosa of the small intestine of sturgeons in toxic
      exposures].
AB  - Exposure to toxic effect of sulfate lignin induced swelling of mucous folds and
      separate epithelial cells in the sturgeon gastrointestinal tract's mucous
      membrane. Cholinesterase was found in epithelial layers under the toxic effect.
      Participation of the meta-sympathetic nervous system in organisation of the
      intestinal tissue responses to unfavourable effects is discussed.

PMID- 8364626
TI  - [The thermogenic characteristics in the early ontogeny of rats developing
      normally and under conditions of decreased uterine-placental blood circulation].
AB  - The brown adipose tissue was shown to be the main source of heat production in 1
      day old rats, whereas by the 4th day their heat production becomes associated
      with non-contractile as well as contractile thermogenesis. Retarded rats revealed
      a disturbed adaptation to ambient conditions and they were unable to maintain
      their temperature homeostasis.

PMID- 8364627
TI  - [The reaction of gonadal endocrine function in mink to the administration of
      chorionic gonadotropin under artificial lighting conditions].

PMID- 8364628
TI  - [A method for conducting mass cardiac monitoring].

PMID- 8364629
TI  - [The interaction between physiological disciplines and scientific schools in the
      development of evolutionary physiology].

PMID- 8364630
TI  - [The contribution of the schools of L. A. Orbeli and V. N. Chernigovskii to the
      development of the physiology of the autonomic nervous system].

PMID- 8364631
TI  - [In the history of science there are events that determine the development of a
      new scientific direction].

PMID- 8364632
TI  - [On the way to the centenary of I. P. Pavlov's theory of conditioned reflexes.
      Fragments from history].

PMID- 8364633
TI  - [The importance of I. P. Pavlov's theory of conditioned reflexes in the emergence
      of a system of neurosciences].

PMID- 8364634
TI  - [Psychic functional operators in the classical salivary conditioned reflex].

PMID- 8364635
TI  - [The neurophysiological correlates of the organization and functioning of the
      cortical-caudate system in the formation and realization of conditioned-reflex
      behavior].

PMID- 8364636
TI  - [The history and outlook of research into the localization and organization of
      cerebral functions].

PMID- 8364637
TI  - [The conditioned reflex principle and the physiology of behavior].

PMID- 8364638
TI  - [Dmitrii Stepanovich Fursikov (on the centenary of his birth)].

PMID- 8364639
TI  - [The conditioned reflex in the systems organization of behavioral acts].

PMID- 8364640
TI  - [The Madrid speech of I. P. Pavlov and the psychophysiology of behavior].

PMID- 8364641
TI  - [The conditioned reflex in the biology and genetics of behavior].

PMID- 8364642
TI  - [The conditioned reflex as an instrument of research into the role and mechanisms
      of the participation of the brain in the structuring of behavior].

PMID- 8364643
TI  - [What can be written about human higher nervous activity in a work devoted to
      experimental results in animals?].

PMID- 8364644
TI  - [The structural-functional bases of behavior].

PMID- 8364645
TI  - [The formation of natural food conditioned reflexes in early ontogeny].

PMID- 8364646
TI  - [The neurophysiological and neuropharmacological analysis of conditioned reflex
      activity in primates].

PMID- 8364647
TI  - Ethical nursing.

PMID- 8364648
TI  - Caring for your back.

PMID- 8364649
TI  - Managing venous ulcers.

PMID- 8364650
TI  - Nursing overseas. Saving Somalis.

PMID- 8364651
TI  - It's all in the attitude.

PMID- 8364652
TI  - Practising safely.

PMID- 8364654
TI  - Similar problems face all nurses.

PMID- 8364653
TI  - A professional struggle. Interview by Teresa O'Connor.

PMID- 8364655
TI  - Professional development. The Canterbury experience.

PMID- 8364656
TI  - Professional development. A personal perspective.

PMID- 8364657
TI  - A cultural question.

PMID- 8364658
TI  - [Knee arthroplasty with total condylar endoprosthesis].
AB  - Authors report on experiences gained with the Total Condylar knee prosthesis,
      representing the third generation in the development of the knee endoprosthesis.
      Based on results of 17 operations it is stressed that after the implantation in
      the severely degenerated or destroyed knee joint they succeeded to reach a
      significant decrease of pain and increase of the range of movement. After the
      implantation of the prosthesis adequate stability can be gained in knee joints
      without cruciate ligaments.

PMID- 8364659
TI  - [Low contact stress knee prosthesis system. Results and complications].
AB  - This paper reports on the global results of the low contact stress knee
      prosthesis system with mobile weight bearing surfaces. The follow-up result of
      918 cemented and 963 cementless knee prostheses was in more than 90 per cent
      excellent and good 2-8 years after the operation. The ratio of complications
      connected with the construction decreased to 2.8 per cent in cementless
      prostheses. In the cemented series less variations of size were available and the
      problems with the tibial component were under 2, the complications with the
      patella remained under 1 per cent. The more than 12 years clinical use of the
      mobile weight bearing knee prosthesis system proved the success of the solution
      concerning the basic construction.

PMID- 8364660
TI  - [Experience with the implantation of porous coated hip endoprostheses and primary
      stability of implantation].
AB  - The use of porous coated cementless prosthesis, shows a worldwide spread in
      consequence of the advantages given by the "live" connection between the implant
      and the bone. Based on 40 implantations of prostheses of this type (Duraloc 1200
      acetabulum, AML shaft) authors report on the technique of the implantation and
      the primary stability reached. In consequence of the formation, the variety of
      size and the properly usable instruments for implantation, the prostheses could
      be used for every kind of deformed, dysplastic hips and good primary stability
      was reached in every case operated.

PMID- 8364661
TI  - [Does the flexed position of the wrist releave the stress on the suture in the
      flexor tendon?].
AB  - Authors have examined the optimal position of the wrist from the viewpoint of
      active motion during the postoperative care, after the suture of the flexor
      tendons of the hand. Based on clinical and cadaveric experiences a motion of the
      wrist (inverse) in contrary direction to the motion of the fingers is suggested
      i. e. flexion of the fingers in wrist extension and vice versa. The tendon
      injuries distally and proximally from the wrist are discussed separately.

PMID- 8364662
TI  - [Experience with the management of fractures of the distal tibial end penetrating
      into the joint].
AB  - Authors made a follow-up of the pilon fractures treated in the National Institute
      of Traumatology during the five years period of 1983 through 1987. 43 of them
      could be controlled after 4-8 years personally. A radiological follow-up result
      of at least 1-2 years was nearly in all cases available. The surgical therapy in
      this period was almost exclusively stable osteosynthesis. Fixateur externe was
      used only exceptionally. On the basis of their results it is thought that in the
      treatment of pilon fractures the stable osteosynthesis with exposure should have
      an important role in the future too.

PMID- 8364663
TI  - [The Boichev-Andreev surgical method in the management of recurrent post
      traumatic shoulder dislocations].
AB  - In the Boitchev-Andreiev operation the tip of the coracoid with the muscles
      having their origin here, is chiselled and after a transduction under the
      subscapular muscle it is refixed to its original place. One relapse from 28 cases
      was found in a mean follow up time of 3 years, in 2 cases subluxation was found.
      The average limitation of lateral rotation was 6.4 degrees. In the total follow
      up out of 28 cases 23 could be classified as good, 3 adequate and 2 poor.

PMID- 8364664
TI  - [Management of idiopathic femur head necrosis in adults using Sugioka's femur
      osteotomy method].
AB  - Authors report on the results achieved with Sugioka's osteotomy in 20 cases. In
      the stage III or less and if the damage of the femoral head was less than 100
      degrees, the result of the operation was good or excellent. The operation
      performed with adequate indication proved to be effective.

PMID- 8364665
TI  - [Significance of arthroscopy at the Orthopedic Department of a county hospital].
AB  - Author reports on the 300 arthroscopic examinations and operations performed in
      the Orthopaedic Department of the Salgotarjan County Hospital. He states that in
      possession of instruments they have now a diagnostic possibility, more sure and
      informative than all possibilities before. This gives, according to their
      practical experience, the freedom of operation without arthrotomy too. It is
      stressed that the modern orthopaedic care by now requires regular arthroscopic
      activity on the level of county hospitals in this country.

PMID- 8364666
TI  - [Management of 2 cases of pseudarthrosis].
AB  - Authors describe their standpoint concerning the choice of therapeutic methods in
      the solution of two cases of the lower leg's pseudarthrosis. On the basis of two
      cases treated successfully they strive after osteogenetic induction and adequate
      stability and in the formation of principles after the equilibrium of modernity
      and rationality.

PMID- 8364667
TI  - [Epidemiology of hand injuries in Vas County based on a survey].
AB  - Authors have found in a 1 year survey in the county Vas 7580 hand injuries. The
      major proportion of young men and adolescents in the material was conspicuous.
      The types of accidents were investigated together with the place of the accident
      and types of the injury. The material shows that in contrary to the work
      accidents in the recent past the number of the accidents at home has increased-
      and so their prophylaxis became the main point.

PMID- 8364668
TI  - Clinical practice guidelines: a curse or a cure?

PMID- 8364669
TI  - Guidelines for the transfer of critically ill patients. Guidelines Committee,
      American College of Critical Care Medicine, Society of Critical Care Medicine and
      the Transfer Guidelines Task Force.
AB  - OBJECTIVE: The development of practice guidelines for the conduct of intra- and
      interhospital transport of the critically ill patient. DATA SOURCES: A task force
      of experts in the field of patient transport drawn from the membership of the
      Society of Critical Care Medicine and the American Association of Critical-Care
      Nurses provided the personal experience and published literature from which these
      guidelines were developed. STUDY SELECTION: Study design was not a factor in
      selecting the literature to validate the experts' personal experience. The lack
      of well-designed clinical outcome studies was an important factor in determining
      the method of practice policy development utilized. DATA EXTRACTION: The expert
      task force met and developed a draft of these guidelines based on their
      experiences and the available literature. This draft document was then reviewed
      by an additional group of experts whose input was used by the task force to
      develop this final consensus report. RESULTS OF DATA SYNTHESIS: Each hospital
      should have a formalized plan for intra- and interhospital transport that
      addresses the following elements: pretransport coordination and communication,
      transport equipment, accompanying personnel, monitoring during the transport and
      documentation. The transport plan should be developed by a multidisciplinary team
      and should be evaluated and refined by the continuous quality improvement
      process. CONCLUSION: The available data has allowed the authors to develop an
      evidence-based practice policy for the intra- and interhospital transport of the
      critically ill.

PMID- 8364670
TI  - TIPS: a new alternative for the variceal bleeder.
AB  - BACKGROUND: Standard medical therapies for variceal bleeding secondary to portal
      hypertension (vasopressin, esophagogastric balloon tamponade and sclerotherapy)
      are associated with high rates of recurrent bleeding. Surgical shunting has a
      mortality rate of 15% to 50%. The transjugular intrahepatic portosystemic shunt
      offers a novel, minimally invasive procedure for nonsurgical portal
      decompression. METHOD: Following catheterization of the hepatic vein from a
      jugular vein approach, a needle is directed fluoroscopically from the hepatic
      vein into a branch of the portal vein along an intrahepatic tract. The
      intrahepatic tract is then dilated and held open with a stainless steel stent
      delivered on a balloon catheter. This creates a portosystemic shunt entirely
      within the liver. RESULTS: The collective experience of more than 300 cases from
      several centers has been reported. The technical success rate for the
      transjugular intrahepatic portosystemic shunt is 92% to 96%. Thirty-day mortality
      rates range from 0% to 14%, with less than 3% attributed to procedural
      complications. Primary shunt patency is about 90%, with a secondary patency rate
      of 100%. Rates of encephalopathy and rebleeding are 9% to 14%. Ascites resolves
      in 80% to 90% of patients. CONCLUSION: The transjugular intrahepatic
      portosystemic shunt appears to be a safe and effective procedure for management
      of variceal bleeding and holds promise for becoming the treatment of choice for
      portal hypertension.

PMID- 8364671
TI  - Evaluation and revision of a vasopressin/nitroglycerin protocol for use in
      variceal bleeding.
AB  - BACKGROUND: Continuous infusion of IV vasopressin have been widely used to lower
      portal pressure and reduce bleeding from esophageal varices. Recently, the
      combination of vasopressin and nitroglycerin has been noted to be superior to
      vasopressin alone. This is due to the ability of nitroglycerin to reduce the
      detrimental effects of vasopressin while preserving its beneficial effects. In
      September 1989 the authors initiated a protocol in the medical intensive care
      unit of a large university teaching center that directed caregivers in the
      simultaneous use of vasopressin and nitroglycerin for use in variceal bleeding.
      OBJECTIVE: To determine whether the protocol was being used correctly and whether
      the addition of nitroglycerin produced the desired cardiovascular effects.
      METHOD: Nineteen patients (25 separate episodes) assigned to the
      vasopressin/nitroglycerin protocol were monitored retrospectively over a 20-month
      period for a total of 1068 hours of vasopressin/nitroglycerin infusion. Twenty
      four patients received nitroglycerin at 10 to 50 micrograms per minute, 13 at 50
      to 100 micrograms per minute and 6 at 100 to 400 micrograms per minute. RESULTS:
      Nitroglycerin dosage was not advanced appropriately in 78% of episodes despite
      evidence of bradycardia, hypertension and peripheral vasoconstriction.
      CONCLUSIONS: Revision of the protocol, giving additional guidance to clinicians
      on assessment and nitroglycerin advancement, was necessary and was accomplished.

PMID- 8364672
TI  - The effect of positioning on hemodynamics and gas exchange in the critically ill:
      a review.
AB  - Positioning of critically ill patients affects hemodynamic and cardiopulmonary
      outcomes. A review of clinical studies indicates that backrest elevations up to
      60 degrees do not affect measurement of intracardiac pressures or cardiac output,
      but PaO2 may diminish in sitting positions following surgical procedures. In
      lateral positions, measurement of intracardiac pressures and cardiac output is
      not recommended, since a uniform reference point has not been identified for
      lateral positions. In patients with unilateral lung disease, PaO2 increases with
      the unaffected lung in the dependent position. Despite widespread use, the
      Trendelenburg position has not been shown to provide consistent beneficial
      effects. Prone positioning may be beneficial in adult respiratory distress
      syndrome and in weaning of mechanically ventilated patients. When planning
      positioning maneuvers, critical care nurses should consider these effects in
      relation to the specific needs of each patient. Hemodynamic and cardiopulmonary
      responses to positioning should be evaluated in conjunction with other
      therapeutic modalities such as those designed to preserve skin integrity and
      improve comfort.

PMID- 8364673
TI  - Withdrawal of mechanical ventilation: ethical principles and guidelines for
      terminal weaning.
AB  - BACKGROUND: Discontinuation of mechanical ventilation because of the recognition
      of futility of continued treatment or because of patient or family request is an
      increasingly frequent occurrence in critical care. Although there is broad
      consensus about the patient's right to refuse life support, little has been
      written about the actual procedure of withdrawing mechanical ventilation.
      OBJECTIVE: The purposes of this article are: (1) to review ethical arguments
      supporting the view that it may be morally permissible to withdraw mechanical
      ventilation from patients who are neither terminally ill nor imminently dying and
      (2) to provide guidelines for the procedure of ventilator withdrawal. METHOD:
      Ethical principles supporting the position that ventilator withdrawal under these
      conditions can be morally justified and principles suggesting that ventilator
      withdrawal is morally objectionable are evaluated. Factors contributing to
      clinicians' ambivalence about this issue and guidelines for planning and
      implementing treatment withdrawal are discussed.

PMID- 8364674
TI  - Epidemiology, pathophysiology and clinical presentation of gram-negative sepsis.
AB  - OBJECTIVE: To review the epidemiology and pathophysiology of gram-negative sepsis
      and the new consensus terminology describing the clinical signs of sepsis. DATA
      SOURCES: Review of the medical literature and compiled data from animal and
      clinical trials. PARTICIPANTS: Members of the Society of Critical Care Medicine,
      American College of Chest Physicians and American Association of Critical-Care
      Nurses with expertise on the subject of sepsis and its complications. RESULTS:
      Preconference and general sessions were offered at the National Teaching
      Institutes of the American Association of Critical-Care Nurses, with the goal of
      clarifying the epidemiology, risk factors and pathophysiology of gram-negative
      sepsis. In addition, current terminology and new (1992) consensus terminology
      describing the clinical signs of sepsis were presented. Special emphasis was
      placed on the role of the healthcare provider in the prevention and recognition
      of sepsis and the role of the septic mediators in the septic cascade.
      CONCLUSIONS: If the incidence of sepsis is to be reduced, the healthcare provider
      must be aware of the risk factors for sepsis and methods of reducing nosocomial
      infections. A thorough understanding of the role of mediators and consensus
      terminology used to describe sepsis, severe sepsis, septic shock and multiple
      organ dysfunction syndrome is necessary to recognize early or progressive signs
      of sepsis and to initiate state-of-the-art therapy.

PMID- 8364675
TI  - Nurses' beliefs and attitudes toward visiting in adult critical care settings.
AB  - OBJECTIVE: To assess the beliefs and attitudes of critical care nurses about the
      effects of visiting on patients, staff and family. DESIGN: Both interviews and
      questionnaires were used to gather data on nurses' attitudes and beliefs about
      visiting and open visiting according to the format of Ajzen and Fishbein's Theory
      of Reasoned Action. SETTING: Five Utah intensive care units and three Ohio
      intensive care units. SAMPLE: Critical care nurses in Utah (N = 29) and Ohio (N =
      41) were interviewed to assess their beliefs about the effects of visiting on
      patients, families, nurses and nursing care delivery. RESULTS: Nurses believed
      the consequence of visiting was more positive for the patient from a
      psychological perspective than from a physiological perspective but that the
      effects might differ depending on the patient, the visitor and the circumstances.
      They believed that visiting had negative consequences for families, because they
      became exhausted, and that visiting was disruptive for nursing care delivery.
      Their attitudes about effects of visiting on nursing staff were consistently more
      negative than were attitudes about the effects on the patient and the family.
      CONCLUSION: To provide an optimal situation for visiting, its negative
      consequences must be minimized and nurses' attitudes and beliefs about visiting
      must be assessed and addressed.

PMID- 8364676
TI  - The relationship of child acuity, maternal responses, nurse attitudes and
      contextual factors in the bone marrow transplant unit.
AB  - PURPOSE: This study was designed to examine the relationships between maternal
      perceptions of an acutely ill child, nurse caregivers and contextual factors in a
      pediatric critical care unit. METHODS: Subjects were mothers of 20 children who
      had had their first bone marrow transplant and the primary nurse of each child.
      The study was conducted on a bone marrow transplant unit. Variables included the
      acuity of the child, maternal satisfaction with nursing care, maternal vigilance
      as measured by the time spent at the child's bedside, nurses' attitudes toward
      family involvement with care, nursing experience and bone marrow transplant unit
      variables (census, unit acuity and staffing deficit). RESULTS: Positive
      associations were observed between the child's acuity and maternal satisfaction
      with nursing care, and between maternal vigilance and staffing deficit. There was
      an inverse relationship between maternal vigilance and length of nursing
      experience of the primary nurse and between positive attitudes of nurses toward
      family participation and years of nursing experience. CONCLUSION: These results
      show the complex nature of parental perceptions and involvement in the
      hospitalized child's care. They suggest that maternal attitudes about caregiving
      are associated with the child's acuity and that maternal vigilance is related to
      nursing and environmental factors, principally critical care experience of the
      primary nurse.

PMID- 8364677
TI  - Pacemaker update. Part IV: Antitachycardia devices.

PMID- 8364678
TI  - Severe anemia in the Jehovah's Witness: case report and discussion.
AB  - Major blood loss following trauma is common, but severe anemia is generally not
      life-threatening when managed with the administration of blood and blood
      products. Severe anemia becomes particularly challenging and potentially lethal
      when the patient is a Jehovah's Witness, for whom receiving a transfusion is
      contrary to religious principles. This case report describes the management and
      hospital course of a Jehovah's Witness who was seriously injured in an airplane
      crash.

PMID- 8364680
TI  - The hippocampus and space: are we flogging a dead (sea-)horse?

PMID- 8364679
TI  - Hippocampal morphology and spatially related behavior in Long-Evans and CFY rats.
AB  - Behavioral responses to novelty in an open field and spatial learning in a radial
      maze with four arms out of eight reinforced were tested in male and female CFY
      and Long-Evans rats. Subsequently, the sizes of the total hippocampi and of
      various hippocampal cell layers and terminal fields at the midseptotemporal level
      were measured in Timm-stained sections. No strain differences were found in the
      open field (except for defecation). In the radial maze, Long-Evans rats showed
      better spatial reference memory capabilities than rats of the CFY strain. The
      relative sizes of the intra- and infrapyramidal mossy fiber (IIP-MF) projections
      did not differ between the strains. Within the more variable CFY strain, a
      positive correlation between the size of the IIP-MF projection and radial maze
      performance was found. The absolute sizes of the entire hippocampi and all
      hippocampal layers at the midseptotemporal level were larger in the CFY strain.
      The size of the suprapyramidal mossy fiber projection was related to the number
      of granule cells and to the ratio between granule and CA3 pyramidal cells. In
      contrast, the size of the IIP-MF projection did not correlate with either of
      these variables. The results indicate that the size of the mossy fiber projection
      may be determined mainly by the available postsynaptic surface on the dendrites
      of CA3 pyramidal neurons. Furthermore, an increased number of granule cells and
      their larger projection to the apical dendrites of pyramidal neurons does not
      appear to result in physiological changes with behavioral consequences.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8364681
TI  - Modification of the responses of hippocampal neurons in the monkey during the
      learning of a conditional spatial response task.
AB  - In order to analyze the function of the hippocampus in learning, the activity of
      single neurons was recorded while monkeys learned a task of the type known to be
      impaired by damage to the hippocampus. In the conditional response task, the
      monkey had to learn to make one response when one stimulus was shown, and a
      different response when a different stimulus was shown. It had previously been
      shown that there are neurons in the hippocampal formation that respond in this
      task, to, for example, a combination of a particular visual stimulus that had
      been associated in previous learning with a particular behavioral response. In
      the present study, it was found that during such conditional response learning,
      the activity of 22% of the neurons in the hippocampus and parahippocampal gyrus
      with activity specifically related to the task altered their responses so that
      their activity, which was initially equal to the two new stimuli, became
      progressively differential to the two stimuli when the monkey learned to make
      different responses to the two stimuli. These changes occurred for different
      neurons just before, at, or just after the time when the monkey learned the
      correct response to make to the stimuli. In addition to these neurons, which had
      differential responses that were sustained for as long as the recordings
      continued, another population of neurons (45% of those with activity specifically
      related to the task) developed differential activity to the two new stimuli, yet
      showed such differential responses transiently for only a small number of trials
      at about the time when the monkey learned. These findings are consistent with the
      hypothesis that some synapses on hippocampal neurons modify during this type of
      learning so that some neurons come to respond to particular stimulus-response
      associations that are being learned. Further, the finding that many hippocampal
      neurons started to reflect the new learning, but then stopped responding
      differentially (the transient neurons), is consistent with the hypothesis that
      the hippocampal neurons with large sustained changes in their activity inhibited
      the transient neurons, which then underwent reverse learning, thus providing a
      competitive mechanism by which not all neurons are allocated to any one learned
      association or event.

PMID- 8364682
TI  - Changes in protein kinase C isozymes in the rat hippocampal formation following
      hippocampal lesion.
AB  - The cellular and regional distribution of the four protein kinase C (PKC)
      isoforms in the rat hippocampal formation and the response of PKC to lesions were
      determined by employing immunohistochemical and immunochemical techniques with
      antibodies specific to PKC(alpha), -(beta I), -(beta II), and -(gamma).
      PKC(alpha) intensely stained the periphery of the pyramidal cell in the stratum
      pyramidale. The granule cells, glial cells, and mossy fibers were anti-PKC(alpha)
      negative. The cytoplasm, axons, and dendrites of basket cells and interneurons in
      the hilus were labeled with anti-PKC(alpha). Anti-PKC(beta I) immunoreactivity
      was localized on the periphery of pyramidal cells and interneurons of the hilus,
      as well as the oriens, radiatum, and molecular layers of the CA regions. Anti
      PKC(beta II) immunoreactivity was mainly cytoplasmic, extending into the
      dendrites in the hippocampal pyramidal cells and the dentate granule cells, and
      also in some glial cells. In the stratum radiatum of the CA1, anti-PKC(gamma)
      immunoreactivity localized to the pyramidal cell cytoplasm, extending into the
      dendrites. Following fimbria-fornix (FF) lesions, the anti-PKC(alpha) and -(beta
      I) staining of the pyramidal cell periphery was markedly reduced. The anti
      PKC(gamma) staining of the pyramidal and granular cells of the dentate gyrus was
      reduced whereas the interneuron staining in the hilus was increased. In the FF
      lesioned hippocampus, anti-PKC(alpha) and anti-PKC(beta II) labeled reactive
      glial cells, whereas anti-PKC(beta I) and -(gamma) did not. Quantitative Western
      blot analysis revealed a dramatic increase in the particulate/total PKC for all
      isozyme forms, although the total levels of PKC, except PKC(gamma), did not
      change following FF lesions. The PKC(gamma) concentration doubled after FF
      lesions. Perforant path lesions resulted in a marked alteration in the neuronal
      staining in dentate gyrus with anti-PKC(alpha) and -(beta I) and in increased
      numbers of anti-PKC(alpha)- and anti-PKC(beta II)-positive glial cells. Anti
      PKC(gamma) staining did not change noticeably. The total PKC concentration did
      not change for isozymes alpha, beta I, and gamma, but PKC (beta II) concentration
      increased by 48% following perforant path lesions as detected by Western blot
      analysis. The particulate/total PKC decreased for all four isozymes although the
      reduction in PKC(beta I) concentration was not statistically significant. This
      change in PKC compartmentalization is in marked contrast to an increased level of
      particulate PKC following FF lesions. Thus, the effects of deafferentation and
      deafferentation for each PKC isoform were different.

PMID- 8364683
TI  - Hippocampal plasticity induced by primed burst, but not long-term potentiation,
      stimulation is impaired in area CA1 of aged Fischer 344 rats.
AB  - The effect of two types of electrical stimulation designed to induce long-lasting
      plasticity of the Schaffer/commissural inputs to CA1 pyramidal neurons was
      investigated using in vitro hippocampal slices made from young (3-6 month) and
      old (24-27 month) Fischer 344 rats. The first stimulation paradigm, primed burst
      (PB) stimulation, consisted of a total of five physiologically patterned stimuli:
      a single priming pulse followed 170 ms later by a burst of four pulses at 200 Hz.
      The second stimulation paradigm, long-term potentiation (LTP) stimulation,
      consisted of a 200 Hz/1 second train (a total of 200 stimuli). Primed burst and
      LTP stimulation were equally effective at inducing a lasting increase in the
      population spike recorded from slices made from young rats. However, the
      enhancement of population spike amplitude produced by PB, but not LTP,
      stimulation was significantly less in slices made from old rats. These results
      suggest that the capacity of the hippocampus to demonstrate long-lasting synaptic
      plasticity is not altered with age, but that engaging plasticity-inducing
      mechanisms becomes more difficult. Furthermore, these data suggest that
      physiologically patterned paradigms for inducing long-lasting synaptic plasticity
      may more accurately assess the functional status of hippocampal memory encoding
      mechanisms than does conventional LTP stimulation.

PMID- 8364684
TI  - Adenosine-induced suppression of synaptic responses and the initiation and
      expression of long-term potentiation in the CA1 region of the hippocampus.
AB  - The results of several previous studies have suggested that pretreatment with
      adenosine can block the induction of long-term potentiation (LTP), although other
      studies have found no effect of adenosine on the induction of LTP. The
      interaction of adenosine with the induction of LTP in the rat hippocampal slice
      was investigated. Inhibition of synaptic responses by adenosine either prior to
      or immediately after high-frequency or theta-burst stimulation did not affect LTP
      measured after washout of the adenosine. The only conditions under which
      adenosine blocked the development of LTP was when it was given 3-5 minutes prior
      to the stimulation train. To understand how it was possible to induce LTP, during
      the period 1-3 minutes following adenosine when synaptic responses were virtually
      eliminated, evoked responses during the 100 Hz stimulation train were recorded.
      Although synaptic responses to low-frequency stimulation were virtually
      eliminated by adenosine, they reappeared during high-frequency stimulation. These
      results suggest that although adenosine can depress synaptic responses, an
      increase in neurotransmission during a high-frequency train can partially
      overcome this effect of adenosine, and the hypothesis that adenosine can
      selectively block LTP is not supported.

PMID- 8364685
TI  - Spiny neurons of area CA3c in rat hippocampal slices have similar
      electrophysiological characteristics and synaptic responses despite morphological
      variation.
AB  - Area CA3c is an area of morphologically diverse neurons. In addition to the
      presence of interneurons and pyramidal cells that are similar to those found in
      other subfields of area CA3, many neurons of area CA3c are different. They do not
      resemble interneurons, since they bear numerous spines, yet they also differ
      substantially from pyramidal cells in their morphology. To determine if the
      variants of area CA3c spiny cells are distinct physiologically as well as
      morphologically, intracellular recordings were made to record the
      electrophysiological properties of area CA3c cells in rat hippocampal slices, and
      each cell was identified morphologically following intracellular dye injection.
      The results show that the spiny cells, regardless of their often extensive
      morphological variation, have relatively uniform, pyramidal-like
      electrophysiological properties. The aspiny cells are quite different from the
      spiny cells morphologically (i.e., in their paucity or complete lack of spines),
      and are also extremely different electrophysiologically, exhibiting features of
      "fast-spiking" cells. Thus, spiny cells in area CA3c correspond to cells with
      pyramidal-like electrophysiology, and the aspiny cells in area CA3c correspond to
      cells with interneuronal physiological properties. This correlation between
      structure and function appears to be a rule that pertains to each of the
      subfields of the hippocampus.

PMID- 8364686
TI  - Herring antifreeze protein: primary structure and evidence for a C-type lectin
      evolutionary origin.
AB  - A complementary DNA (cDNA) for a type II antifreeze protein (AFP) was isolated
      from an Atlantic herring liver cDNA library and sequenced. The predicted protein
      sequence is homologous to those of the type II fish AFP from smelt and sea raven;
      it is also homologous to the carbohydrate recognition domains (CRD) of calcium
      dependent (C-type) lectins and similar domains in lectin-like proteins. Herring
      belong to the infradivision Clupeomorpha, which is distinct from the Euteleostei
      to which all other AFP-producing fish belong. The occurrence of type II AFP in
      widely divergent fish groups and their homology to C-type lectin CRDs suggest
      that type II AFPs evolved from these lectins. Amino acid residues forming the
      hydrophobic cores of rat mannose-binding protein A (MBP-A) that are conserved in
      character among C-type lectins are also conserved in the herring AFP. The herring
      AFP also requires Ca2+ for thermal hysteresis activity. These results suggest
      that herring AFP is structurally and functionally similar to the CRDs of C-type
      lectins and related domains in other proteins.

PMID- 8364687
TI  - Molecular cloning and sequencing of omul prolactin cDNA.
AB  - We constructed a complementary DNA (cDNA) library from Baikal omul (Coregonus
      autumnalis migratorius Georgi) pituitary glands. Synthetic oligonucleotide probes
      corresponding to chum salmon prolactin (PRL) cDNA were used to select the
      recombinant plasmids carrying the omul PRL gene. The larger insert was sequenced
      and found to encode a polypeptide of 210 amino acid residues, including a
      putative signal sequence of 23 amino acids. Nucleotide and predicted amino acid
      sequence of omul PRL showed high homology with other salmonid PRLs.

PMID- 8364688
TI  - Interspecific and intrapopulation variation in mitochondrial ribosomal DNA
      sequences of Mytilus spp. (Bivalvia: Mollusca).
AB  - A 560-base pair portion of the mitochondrial 16S ribosomal DNA (16S rDNA) from
      three morphologically similar mussels, Mytilus edulis, M. galloprovincialis, and
      M. trossulus, was amplified with the polymerase chain reaction, and 349 base
      pairs were sequenced. These data showed that this gene in M. edulis and M.
      galloprovincialis has not diverged; however, the north Pacific mussel, M.
      trossulus, showed fixed differences from M. edulis and M. galloprovincialis at 5
      nucleotide positions. Furthermore, the population of M. trossulus at Tillamook
      Bay, Oregon, was found to contain two very divergent 16S rDNA genotypes that
      differ at 37 nucleotide positions. Thus, intraspecific variation in this gene in
      M. trossulus is greater than that seen interspecifically in M. edulis and M.
      galloprovincialis. Despite this large difference, in the absence of evidence of
      genetic isolation between these groups of M. trossulus, no taxonomic changes are
      proposed. These data are consistent with a north Pacific origin of the genus with
      subsequent dispersal to the Atlantic Ocean across the Artic Sea, giving rise to
      M. edulis in northern Europe and subsequently M. galloprovincialis in southern
      Europe and the Mediterranean Sea.

PMID- 8364689
TI  - Identification and localization of bacterial endosymbionts in hydrothermal vent
      taxa with symbiont-specific polymerase chain reaction amplification and in situ
      hybridization techniques.
AB  - Invertebrates that contain endosymbiotic chemoautotrophic eubacteria are widely
      distributed in a variety of reducing marine habitats, including deepsea
      hydrothermal vents. The mechanisms of symbiont transmission in these
      invertebrates are not understood. To test the hypothesis that symbionts are
      transmitted via the eggs of hosts, we used group-specific hybridization probes
      complementary to 16S ribosomal RNAs (rRNAs) to look for symbionts in eggs and
      ovaries. 16S rRNA sequences were examined for domains unique to the symbionts of
      three vent animals: Calyptogena magnifica, Bathymodiolus thermophilus, and Riftia
      pachyptila. Three 16S rRNA-directed oligodeoxynucleotide hybridization probes (CG
      1255R, RP-1243R, BT-1255R) specific for these endosymbionts were synthesized and
      evaluated by dot-blot hybridization. At higher stringencies, all three probes
      showed a high degree of specificity for their target endosymbionts rRNAs. The
      probes were also used as polymerase chain reaction (PCR) primers for detection of
      the symbiont 16S rRNA genes in genomic DNA isolated from host tissues known to
      contain symbionts. All three symbiont-specific probes were highly sensitive and
      specific as PCR primers; they successfully amplified 1 pg target DNA. However,
      all amplifications of extracted egg DNA from the vestimentiferan R. pachyptila
      with either universal eubacterial (Eub A/B) or the Riftia symbiont-specific (RP
      1243R/Eub B) primer sets were unsuccessful. Nonradioactive in situ hybridizations
      were performed on ovarian tissue from the vestimentiferan Ridgea piscesae using
      RP-1243R, 3' end-labeled with digoxigenin-11-dUTP (Boehringer Mannheim). The
      probe was subsequently detected with an alkaline phosphatase-conjugated
      immunoglobulin G antibody specific for the digoxigenin moeity. The probe bound
      only to the tissue of R. pisceasae coincident with the known location of symbiont
      cells and was not detected in any region of the ovary. These data indicate that
      transovarial symbiont transmission in the vestimentiferans does not take place
      and that symbiont acquisition is probably a post-spawning event.

PMID- 8364690
TI  - Codon usage in bony fishes.
AB  - Bony fishes are excellent experimental models that have been used extensively in
      biochemical and molecular genetic studies. As proteins are isolated and
      characterized from these organisms, information on codon usage by bony fishes can
      be used for subsequent recombinant DNA studies. Codon usage and nucleotide bias
      within codons from three species of bony fishes and two composites of 14 and 15
      bony-fish species were analyzed. Although differences in codon usage increased
      from seven amino acids between fish species to eight amino acids between fish
      genera, the small number of differences (3 amino acids) between a single species
      and a fish composite minus that species suggests that codon usage tables
      constructed from large numbers of fish species are representative of bony fish in
      general. Furthermore, we found few differences in codon usage between two
      vertebrate phyla (fish and rat). Codons in fish DNA sequences end predominantly
      in G or C, even though the coding sequences are not enriched in these
      nucleotides. This positional base bias can be used to locate putative protein
      coding regions in fish DNA sequences.

PMID- 8364691
TI  - Molecular phylogenetic position of hexactinellid sponges in relation to the
      Protista and Demospongiae.
AB  - Although it is generally accepted that the first multicellular organisms arose
      from unicellular ancestors, the phylogenetic relationships linking these groups
      remain unclear. Anatomical, physiological, and molecular studies of current
      multicellular organisms with relatively simple body organization suggest key
      characteristics of the earliest multicellular lineages. Glass sponges, the
      Hexactinellida, possess cellular characteristics that resemble some unicellular
      protistan organisms. These unique sponges were abundant in shallow seas of the
      early Cambrian, but they are currently restricted to polar habitats or very deep
      regions of the world oceans. Due in part to their relative inaccessibility, their
      potential significance to the early phylogeny of the eukaryotic kingdoms has been
      largely overlooked. We used sequences of the 18s ribosomal RNA gene of Farrea
      occa, a representative of the deep-water hexactinellid sponges, and Coelocarteria
      singaporense, a representative of the more common demosponges, and compared them
      with selected ribosomal RNA gene sequences available within the Protista. Using
      four computational methods for phylogenetic analysis of ribosomal DNA sequences,
      we found that the hexactinellid sponge-demosponge cluster is most closely related
      to Volvox and Acanthamoeba.

PMID- 8364692
TI  - Expression and inheritance of RSVLTR-rtGH1 complementary DNA in the transgenic
      common carp, Cyprinus carpio.
AB  - Transgenic common carp, Cyprinus carpio, possessing the long terminal repeat
      (LTR) sequence of avian Rous sarcoma virus (RSV) fused to the rainbow trout (rt)
      growth hormone (GH1) complementary DNA (cDNA) were produced by microinjection.
      Initial studies showed that the transgenic common carp transmitted the foreign
      DNA to a significant fraction of their progeny in three of four crosses of
      transgenic males with control females. These progeny grew 20 to 40% faster than
      their nontransgenic full siblings. In this study, additional experiments were
      conducted to evaluate inheritance and expression of the foreign GH gene in
      transgenic common carp, and the growth performance of these transgenic fish. Four
      P1 (parental generation produced by microinjection) x nontransgenic controls,
      four P1 x P1, and one P1 x F1 matings of transgenic carp containing RSVLTR-rtGH1
      cDNA were made. The percentages of transgenic progeny resulting from these
      matings were: 0, 32, 42, 100 (4 progeny only), 21, 21, 31, 30, and 23%,
      respectively. All crosses except 1 siblot (control x P1) exhibited progeny ratios
      below the expected 50 or 75% transgenic. These results indicate that most of
      these transgenic P1 had the foreign gene in their germ line but were mosaics, and
      at least one transgenic individual did not have the RSVLTR-rtGH1 cDNA in the
      gonadal tissue. Both P1 and F1 transgenic fish produce trout growth hormone mRNA
      and polypeptide as determined by reverse transcription polymerase chain reaction
      amplification, RNA dot-blot hybridization, and radio-immunobinding assay. Growth
      response by families of F1 transgenic fish to the addition of rtGH1 cDNA varied
      widely.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364693
TI  - A comparison of molluscan (Bivalvia) phylogenies based on palaeontological and
      molecular data.
AB  - The 18S rRNA gene from three scallop species (Placopecten magellanicus, Chlamys
      islandica, Argopecten irradians) and 7 mactrid clam species (Spisula solida, S.
      subtruncata, S. solidissima, Mactromeris polynyma, Tresus nuttallii, T. capax,
      Mulinia lateralis) have been fully sequenced. Phylogenetic analyses have
      supported the scheme of Waller (1991) for the Pectinidae but conflict with
      current evolutionary concepts and classification within the Mactridae. The
      Mactridae are shown to have evolved monophyletically. The current subfamilial
      position of Mactromeris, and the subgenera Spisula and Hemimactra of the genus
      Spisula, are not supported by this data.

PMID- 8364694
TI  - Enhanced incorporation of transgenic DNA into zebrafish chromosomes by a
      retroviral integration protein.
AB  - Manufacture of lines of fish containing specific transgenes is difficult because
      most fish that hatch from embryos injected with foreign DNA are mosaic; few have
      the transgenic DNA integrated in germ-line cells. To determine whether the
      process of integration of exogenously supplied DNA into fish genomes could be
      accelerated, we examined the ability of the Moloney murine leukemia virus (MoMLV)
      integration protein (IN) to function in embryonic zebrafish cells. We used
      partially purified IN from a baculovirus/insect cell expression system and
      unpurified IN from extracts of psi-2 mouse cells that carry a MoMLV provirus.
      Both forms of IN were able to enhance expression in zebrafish 10 days after
      fertilization. At day 14 of development, fish injected with IN had higher levels
      of transgenic DNA than control fish. The ability of IN to enhance integration of
      transgenic constructs was demonstrated by a ligation-mediated polymerase chain
      reaction procedure, which was employed to detect junction fragments of foreign
      and host genomic DNA, generated by IN-mediated integration.

PMID- 8364695
TI  - Rapid identification of yeast species using three primers in a polymerase chain
      reaction.
AB  - Classic methods for identification of yeasts rely on a variety of morphological
      and physiological tests that often take days to weeks to complete. We have been
      able to reduce the time to less than one day through the use of multiple segment
      specific oligonucleotide priming of a region of the large subunit rDNA in a
      polymerase chain reaction. The "hot start" reaction was used with two universal
      external delimiting primers and one internal species-specific primer. Five
      specific primers were tested: a primer for a biologically similar group of
      Rhodotorula species, a generic (Cystofilobasidium) primer, and 3 species-specific
      primers (Leucosporidium scottii, Cryptococcus muscorum, and Rhodotorula
      mucilaginosa). In the absence of specific target DNA, the universal rDNA segment
      is amplified; in the presence of target DNA, the specific primer region is
      amplified. The technique is accurate within two base position differences when a
      24 nucleotide-specific primer is used. The technique should be applicable to
      other marine eukaryotes.

PMID- 8364696
TI  - [Issues of nursing science toward the year 2000].

PMID- 8364697
TI  - [A study of changes in the nutritional status of patients receiving cancer
      chemotherapy].
AB  - In an attempt to find a method for effective nursing support which would maintain
      a favorable nutritional status in patients receiving chemotherapy, the
      nutritional status of 15 patients with lung cancer receiving cisplatin therapy
      was evaluated, and the factors influencing their status were studied. (1)
      Nutritional status was evaluated in terms of 7 indicators: body weight, skinfold
      thickness, arm muscle circumference, grip strength, hemoglobin level, serum total
      protein and serum albumin. Among these, skinfold thickness proved to be the most
      sensitive indicator of the changes in nutritional status of cancer patients
      during chemotherapy. (2) Multiple regression analysis revealed that skinfold
      thickness was influenced by dietary intake, which in turn was related to nausea,
      vomiting, trait anxiety level estimated by STAI and maximum body temperature
      associated with infection. (3) It was concluded that the following nursing
      interventions are significant for maintenance of favorable nutritional status for
      cancer patients during chemotherapy. First, periodic evaluation of their
      nutritional status by anthropometric measurements is necessary. Secondly, efforts
      should be made to reduce nausea and vomiting, to reassure patients with severe
      anxiety so that they become mentally stable, and to motivate the patients to
      perform self-care for prevention of infection, thereby achieving a sufficient
      dietary intake.

PMID- 8364699
TI  - [Trends in research--an analysis of studies published in the Journal of Japan
      Academy of Nursing Science from 1987-1992].

PMID- 8364700
TI  - [Confronting ethical issues among Japanese nurses and their responses].

PMID- 8364698
TI  - [Effects of music on relieving pain associated with a compulsory posture].
AB  - To assess the role of music on pain management, we examined effects of music to
      relieve a pain associated with a compulsory posture. Classical musics, which are
      recognized to make persons feel well, were chosen in this study. Five healthy
      adult females kept a supine position for 2 hours without music. Complains, and
      variations of heart beat and respiration were observed in each individual during
      the 2 hour experiment. After 5 days or more, these subjects had the same
      experience with music. Frequency and intensity of complains were significantly
      diminished by music. Heart rate was not changed by music. Respiration rate was
      increased in 3 subjects with music. Frequency of irregular respiration was
      significantly decreased by music. There was a positive correlation between
      frequency of irregular respiration and number of complaints in subjects kept
      without music. The present study demonstrated that music is effective to relieve
      a pain associated with a compulsory posture. Our results suggest that music plays
      a significant role on pain management in palliative therapy.

PMID- 8364701
TI  - Smoking in pregnancy.

PMID- 8364702
TI  - Clinical and genetic aspects of myotonic dystrophy.
AB  - Myotonic dystrophy is the commonest inherited muscle disease of adults. It causes
      significant clinical features in many organ systems and requires a broad-based
      approach for optimum management. Recent genetic advances promise to provide
      exciting new insights into the pathophysiology of the disease and may allow
      rational treatments to be developed.

PMID- 8364703
TI  - Dystrophia myotonica and difficult intubation.

PMID- 8364704
TI  - The gut and the skin.
AB  - Many disorders of the gastrointestinal tract have cutaneous manifestations. In
      this article the skin signs and diseases that are most commonly associated with
      gastrointestinal disease are described.

PMID- 8364705
TI  - Management of meningococcal infections.
AB  - The last 5 years has seen an increase in the number of cases of meningococcal
      infection. Despite the availability of highly active antibiotics, the mortality
      from this infection remains at 10%, rising to 40% in patients presenting in
      severe shock. Here we describe the spectrum and pathophysiology of meningococcal
      infections, and the most important aspects of treatment and management.

PMID- 8364706
TI  - Medical futility in context.

PMID- 8364707
TI  - The malignant thyroglossal cyst.

PMID- 8364708
TI  - Violence against doctors.

PMID- 8364709
TI  - Peer review of almighty judgments.

PMID- 8364710
TI  - Acoustic neuroma: triumphs outnumber the disasters.

PMID- 8364711
TI  - Retaining RHAs: iconoclastic support--and criticism.

PMID- 8364712
TI  - Retaining RHAs: iconoclastic support--and criticism.

PMID- 8364713
TI  - Retaining RHAs: iconoclastic support--and criticism.

PMID- 8364714
TI  - The alternative to magic medicine.

PMID- 8364715
TI  - Paedomorphosis and simplification in the nervous system of salamanders.
AB  - Comparative neuroanatomists since Herrick [1914] have been aware of the paradox
      that the brain of amphibians, especially salamanders, is less complex than one
      would expect based on their phylogenetic position among the Tetrapoda. Many
      features of the brain are less differentiated in salamanders than in tetrapod
      outgroups, including chondrichthyans and bony fishes, and for some brain
      characters, the salamander brain is even more simple than that of the agnathans.
      Here, we perform a cladistic analysis on 23 characters of four sensory systems
      (visual, auditory, lateral line and olfactory) and the brain. Our taxa include
      myxinoids, lampreys, chondrichthyans, actinopterygians, Latimeria, Neoceratodus
      and the lepidosirenid lungfishes, amniotes, frogs, caecilians, salamanders and
      bolitoglossine salamanders. Of the 23 characters we examined, 19 are most
      parsimoniously interpreted as secondarily simplified in salamanders from a more
      complex ancestral state, two characters are equally parsimonious under both
      hypotheses, one character (well developed ipsilateral retinotectal projections)
      is more complex in bolitoglossine salamanders than in vertebrates generally, and
      only one character (migration of neurons in the medial pallium) is most
      parsimoniously interpreted as retention of the plesiomorphically simple
      condition. Secondary simplification of the salamander brain appears to result
      from paedomorphosis, or retention of juvenile or embryonic morphology into
      adulthood. Paedomorphosis is correlated with an increase in genome size, which in
      turn is positively correlated with cell size, but negatively correlated with cell
      proliferation and differentiation rates. Available data suggest that, although
      increasing genome size and paedomorphosis tend to compromise the function of the
      salamander brain, compensating mechanisms have evolved that may restore or even
      enhance brain function.

PMID- 8364717
TI  - A prey-type dependent hypoglossal feedback system in the frog Rana pipiens.
AB  - Nerve transection experiments combined with high-speed videography and
      electromyography were used to characterize a prey-type dependent hypoglossal
      feedback system which coordinates mouth opening and tongue protraction in the
      common leopard frog, Rana pipiens. When feeding on small prey, sensory feedback
      from the tongue through the hypoglossal nerve is necessary to trigger mouth
      opening. If sensory feedback is prevented from reaching the brain by transection
      of the hypoglossal nerve, then the mouth fails to open although the feeding
      behavior appears otherwise normal. However, when feeding on large prey, the mouth
      opens normally even after the hypoglossal nerve has been transected. Thus,
      peripheral feedback is not necessary to trigger mouth opening when feeding on
      large prey, and presumably a central coordination mechanism is used. In Rana
      pipiens, the evolution of a new tongue morphology and a new motor pattern for
      feeding on small prey has been accompanied by the evolution of a novel,
      peripheral mechanism for coordinating tongue protraction and mouth opening.
      However, the primitive motor pattern for feeding on large prey and the primitive
      coordinating mechanism have been retained. These results imply that the neural
      circuits producing the different motor patterns for large and small prey are
      anatomically distinct at some level in the central nervous system. If they are
      not anatomically distinct, then sensory feedback should be necessary to trigger
      mouth opening regardless of which motor pattern is being expressed. While the
      anatomy of these distinct pathways remains to be elucidated, these results
      suggest that novel neural circuits may in fact underlie different behaviors even
      when they seem, superficially, to be relatively similar.

PMID- 8364716
TI  - Comparison of behavioural and morphological measures of visual acuity during
      ontogeny in a teleost fish, Forsterygion varium, tripterygiidae (Forster, 1801).
AB  - Ocular morphology was examined in larval, juvenile and adult F. varium. There was
      a 26-fold increase in eye size from 0.28 mm in the smallest larva (5.0 mm in
      length) to a maximum diameter of 7.2 mm in a 110 mm long adult. Larval fish had
      pure cone retinae at hatching, however, putative rod precursor cells were also
      present. Juvenile and adult fish had a duplex retina with cones arranged in a
      square mosaic in which 4 equal double cones surrounded a central single cone.
      Hypertrophy of cone ellipsoids with increasing eye size resulted in maintenance
      of a closely packed array in fishes of all sizes. Theoretical sensitivity,
      assessed in terms of convergence of rods:bipolars, rod density, and photoreceptor
      outer segment length, increased during the juvenile phase but was constant across
      the adult size range. Angular density of cones increased with increasing eye size
      such that theoretical spacial acuity was poor in smallest fish (1 degree 8') and
      improved to an asymptotic value of about 9' in adults. Behavioural acuity of a 1
      day-old larva determined using the optokinetic response (29 degrees), was very
      much poorer than histological estimates (1 degree 8'). Behavioural acuity
      improved to 4 degrees 18' at 14 days of age, compared to a theoretical value of
      54'. An estimate of Matthiessen's ratio based on histological measurements
      suggests that the larval eye is initially strongly myopic, and grows into focus.
      Development of the retractor lentis muscle was first apparent 7 days after
      hatching with the result that larval eyes are incapable of accommodative lens
      movements to correct for a refractive error. This apparent myopia is thought to
      account for at least part of the mismatch between theoretical and behavioural
      spatial acuity.

PMID- 8364718
TI  - Kindling in the perirhinal cortex.
AB  - In vitro experiments have indicated that the perirhinal cortex is highly
      excitable and its relationship to the basolateral amygdala and piriform cortex is
      altered by previous amygdala or dorsal hippocampal kindling. As a result, we felt
      it was important to assess the excitability of the perirhinal cortex in vivo by
      comparing its kindling profile to that of the basal amygdala, piriform cortex or
      dorsal hippocampus. We observed that the after-discharge (AD) threshold of the
      perirhinal cortex was higher than the other 3 structures but the AD duration was
      not different. Subsequently, the perirhinal cortex kindled more rapidly than the
      other 3 structures, and with extremely short latencies to onset of forelimb
      clonus. With the view that synchronized discharge in the perirhinal-piriform area
      provides the critical trigger for limbic kindled convulsions, the relationship of
      kindling rate and convulsion latencies and durations between the 4 structures was
      discussed.

PMID- 8364719
TI  - A cholinergic antagonist, mecamylamine, blocks light-induced fos immunoreactivity
      in specific regions of the hamster suprachiasmatic nucleus.
AB  - Recent studies have shown that light-induced phase shifts of the circadian rhythm
      of locomotor activity are associated with c-fos expression in the suprachiasmatic
      nucleus (SCN) of rodents. In order to explore further the importance of c-fos
      expression for the phase-shifting effects of light, we examined the effects of
      mecamylamine on light-induced Fos-like immunoreactivity (Fos-lir) in the SCN.
      Mecamylamine was chosen because it is a cholinergic antagonist that blocks the
      phase-shifting effects of light on the circadian activity rhythm in the golden
      hamster. Golden hamsters were entrained for at least 14 days to a 14 h light: 10
      h dark photoperiod. Animals were then placed in constant darkness (DD) and during
      exposure to DD were subjected to one or more of the following treatments: (1)
      vehicle alone; (2) mecamylamine alone (450 micrograms, i.c.v.) at circadian time
      (CT) 19; (3) vehicle plus a light pulse at CT 19; (4) mecamylamine 10 min prior
      to the light pulse at CT 19. Mecamylamine blocked the phase-shifting effects of
      light on the circadian rhythm of locomotor activity when compared to vehicle
      treated animals (P < 0.001). A light pulse at CT 19 induced Fos-lir in the SCN
      within 1 h, whereas treatment with vehicle or mecamylamine had no noticeable
      effect on Fos-lir in the SCN. Mecamylamine pretreatment dramatically reduced
      light-induced Fos-lir in the SCN by 75%. The most striking observation was the
      clear inhibition of Fos-lir by mecamylamine in the dorsomedial region of the SCN
      while there was little inhibition of Fos-lir in the most ventral portions of the
      SCN.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364720
TI  - Behavioural responses of bicucculline methiodide injections into the ventral
      hypothalamus of freely moving, socially interacting rats.
AB  - Several studies, using electrical stimulation of parts of the hypothalamus, have
      shown, that different parts of the hypothalamus yield different behavioural
      responses upon stimulation. In order to differentiate between stimulation of
      neuronal cell bodies and passing fibres and to investigate the role of GABA in
      hypothalamically elicited behaviour, 25 local injections with bicucculline
      methiodide, a GABA antagonist, (35 ng/0.2 microliter) were performed in the
      ventral parts of the hypothalamus of 16 freely moving rats in a social
      environment. A cannula system was used that allowed injection without
      interruption of the ongoing social interactions. Digging, gnawing, drinking and
      attack behaviour were elicited in different animals. By plotting the behavioural
      responses of the animals into a detailed hypothalamic atlas, we assessed the
      hypothalamic distribution of the elicited behavioural responses. A number of
      injections elicited a combination of two or three different responses, probably
      due to diffusion of the substance, thus disinhibiting more than one behavioural
      system. Our results are in general agreement with previous electrical stimulation
      data and show that, in an overlapping pattern, different populations of neurons
      are involved in the elicitation of digging, gnawing, drinking and attack
      behaviour. In the hypothalamus, a tonic GABAergic inhibition of neurons involved
      in the display of these types of behaviour appears to exist.

PMID- 8364721
TI  - A cellular model of oxidant-mediated neuronal injury.
AB  - Oxidants derived from the partial reduction of oxygen are thought to play a
      significant role in neuronal injury. We present here a cellular model of neuronal
      injury mediated by hydrogen peroxide (H2O2) using the PC 12 rat pheochromocytoma
      cell line. The organization of microtubules and microfilaments within neurites of
      PC 12 cells differentiated by exposure to nerve growth factor was examined after
      H2O2 injury using fluorescence microscopy. Concentrations of H2O2 as low as 100
      microM produced an initial periodic pattern of microtubule depolymerization over
      3-4 h which later progressed to complete depolymerization. Neuritic microspikes
      containing actin filaments were relatively more resistant to injury by H2O2 than
      microtubules. Blebbing of PC 12 cell bodies and neurites also was seen after H2O2
      injury and the blebs appeared to contain microtubules. The destructive changes
      affecting neuritic structure preceded but were not essential for PC 12 cell
      lysis. Exposure of the cells to the Ca2+ ionophore, ionomycin (25 microM) also
      produced the same pattern of microtubule depolymerization in PC 12 neurites as
      was seen after H2O2 injury suggesting that H2O2 may mediate its destructive
      effect on the neurites via elevation of intracellular Ca2+.

PMID- 8364722
TI  - Influence of phenytoin on cytoskeletal organization and cell viability of
      immortalized mouse hippocampal neurons.
AB  - Phenytoin (PHT) is a commonly used anticonvulsant drug; several side effects have
      been described, including morphological changes in brain cortex and cerebellar
      neurons and teratogenic lesions in infants of epileptic mothers. Evidence of
      other authors indicate that PHT may exert its action through the modification of
      phosphorylation patterns of cytoskeletal polypeptides. We have studied the
      influence of the anticonvulsant drug phenytoin on immortalized mouse hippocampal
      neurons in culture. This was done by means of MTT-assays, immunocytochemical and
      immunoblot analyses, measurements of cell metabolism, measurements of the length
      of neuronal processes, and electron microscopy. A distinct and pronounced effect
      of PHT could be characterized with regard to the formation of neuronal processes,
      involving malfunction of an assembly-mechanism of cytoskeletal constituents.
      These accumulated within appendages (blebs) or cytoplasmic condensations, instead
      of forming normally organized processes. However, PHT did not interfere with bulk
      synthesis of cell proteins and specific cytoskeletal components.

PMID- 8364723
TI  - Rapid increases in cerebellar Purkinje cell glutamic acid decarboxylase (GAD67)
      mRNA after lesion-induced increases in cell firing.
AB  - Loss of the inferior olive-climbing fiber input to the cerebellar cortex doubles
      the simple spike activity of the cerebellar Purkinje cell. There is a 3- to 4
      fold increase in Purkinje cell messenger RNA for the 67 kDa form of glutamic acid
      decarboxylase (a synthetic enzyme for the neurotransmitter GABA) within 4-5 h of
      the increase in electrical activity, suggesting a rapid response of mechanisms
      influencing neurotransmitter synthesis or stability to altered
      electrophysiological activity.

PMID- 8364724
TI  - Target regulation of neuronal differentiation in a temperature-sensitive cell
      line derived from medullary raphe.
AB  - Following infection of dissociated embryonic day 13 rat medullary raphe cells
      with a retrovirus encoding the temperature-sensitive mutant of SV40 large T
      antigen, a clonal cell line, RN33B, was isolated by serial dilution. At 33
      degrees C, RN33B cells divide with a doubling time of 48 h and show T antigen,
      vimentin, nestin, diffuse neuron-specific enolase, and low and medium molecular
      weight neurofilament immunoreactivities. RN33B cells are immortal, but not
      transformed, as they will not grow in soft agar. At non-permissive temperature
      (38.5 degrees C), T antigen expression is markedly decreased and RN33B cells
      cease mitotic activity and differentiate with phase bright cell bodies and
      'neuritic-like' processes. Differentiated RN33B cells express enhanced neuronal
      specific protein expression but do not synthesize astrocytic or oligodendrocytic
      specific proteins. Moreover, differentiated RN33B cells returned to 33 degrees C
      re-express T antigen, but do not de-differentiate or begin dividing. Co-culture
      with embryonic hippocampus and cerebral cortex, but not medullary raphe or spinal
      cord, resulted in significantly greater survival, more complex neuronal
      morphology, and enhanced expression of neuronal-specific antigens.
      Immunohistochemical and Northern blot analysis revealed high levels of low
      affinity NGF receptor protein and mRNA in differentiated RN33B cells. PCR
      analysis demonstrated the presence of trkB, but not trkA or trkC, mRNA in both
      undifferentiated and differentiated RN33B cells. These data suggest that the
      observed target regulation of RN33B cell neuronal differentiation in co-culture
      may be mediated by neurotrophin(s).

PMID- 8364725
TI  - Localization of corticotropin-releasing hormone (CRH) neurons in the
      paraventricular nucleus of the human hypothalamus; age-dependent colocalization
      with vasopressin.
AB  - Immunocytochemical staining, using a monoclonal antibody against corticotropin
      releasing hormone, was performed on hypothalami of 13 human subjects between 23
      and 91 years of age who had not suffered from a primary neurological or
      psychiatric disease. Corticotropin-releasing hormone (CRH) immunoreactivity was
      present in neurons of the paraventricular nucleus (PVN) and in their fibers
      running to the median eminence. The CRH-positive neurons were scattered
      throughout the PVN, but in the rostral part relatively few cells were present.
      There were large individual differences in the number and staining intensity of
      CRH neurons in the PVN and in the staining intensity of the median eminence.
      These differences seemed not to be attributed to age, sex, postmortem delay,
      fixation time or hour of death. In the rat, too, no relationship was found
      between a postmortem delay of up to 24 h and CRH staining intensity of the median
      eminence. Since the distribution of CRH-immunoreactive neurons in the human PVN
      strongly overlap with vasopressin, colocalization of these peptides was
      investigated in a double label study and indeed found in subjects ranging between
      43 and 91 years of age. However, cells staining for only one of the peptides were
      also observed. The vasopressin cells had a mean cellular profile area which was
      2.3 times as large as the CRH cells and 2.2 times as large as the CRH and
      vasopressin containing neurons. In younger subjects (23-37 years of age) no
      colocalization of the two peptides was seen. The age-dependent colocalization of
      CRH with vasopressin is interpreted as a sign of increased activation of the CRH
      neurons with age.

PMID- 8364726
TI  - Inhibition by the serotonin1A agonist, 8-hydroxy-2- (di-n-propylamino)tetralin,
      of antidromically identified paraventricular nucleus neurons in the rat.
AB  - Experiments were performed using urethane-anesthetized rats to delineate the role
      of serotonin (5-hydroxytryptamine, 5-HT) receptors of the 5-HT1A subtype in the
      neural regulation of hypothalamo-pituitary-adrenocortical (HPA) secretion. The
      activity of single paraventricular nucleus (PVN) neurons antidromically
      identified as projecting to the median eminence was recorded following injection
      of the 5-HT1A agonist, 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT).
      Intraperitoneal administration of increasing doses of 8-OH-DPAT caused dose
      dependent decreases in the spontaneous activity of all neurons tested. The data
      yielded an ED50 value of 0.19 mumol/kg for this effect. The decreases in PVN
      neuronal activity were accompanied by sustained decreases in mean arterial blood
      pressure, with an ED50 of 0.18 mumol/kg. These results provide evidence for an
      inhibitory role of 5-HT1A receptors in the regulation of PVN neuronal activity
      and support the suggestion that 5-HT may inhibit HPA secretory activity.

PMID- 8364727
TI  - Expression of terminin in the rat brain during neuronal differentiation.
AB  - Terminin is a cytoplasmic protein originally found in senescent cultured human
      fibroblasts. In the present study, we investigated terminin expression during
      development in three brain regions: the cerebral cortex, the neural retina and
      the cerebellum of the rat brain. By immunocytochemistry we found that terminin
      immunoreactivity in the brain is mainly localized in neurons. Immunoreactivity to
      terminin antibody was first noticed in the brain as early as embryonic day 15,
      and the staining intensity in the cerebral cortex reached maximum level at the
      first postnatal week, when the cerebral neurons become postmitotic and their
      synaptic connections with target cells are established. A similar pattern of
      terminin development was seen in the neural retinas of the same animals as well.
      Biochemical characterization shows that the anti-terminin antibody recognizes a
      90 kDa (Tp90) and a 60 kDa (Tp60) polypeptide in immunoblots of the detergent
      insoluble fraction of rat brains, while Tp90 was found in the detergent-soluble
      fraction. Both the Tp90 and Tp60 polypeptides appeared at embryonic day 15 and
      reached highest levels at postnatal day 1. With the advance of further neural
      differentiation, however, Tp90 in the detergent-insoluble fraction diminished,
      and remained only in the detergent-soluble fraction. In the detergent insoluble
      fraction Tp60 became the predominant species during the first postnatal week. In
      the cerebellum, where neuronal differentiation is known to be relatively late,
      quantitative densitometric measurement of terminin abundance on the immunoblots
      showed that Tp60 in the detergent-insoluble fraction was the predominant form in
      the second week. Thus, the appearance of a predominant Tp60 coincided with
      terminal neuronal differentiation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364728
TI  - Sustained cortical metabolic responsivity to physostigmine after nucleus basalis
      magnocellularis ablation in rats.
AB  - Unilateral nucleus basalis magnocellularis (NBM) ablation, which causes partial
      cholinergic denervation of the ipsilateral anterior neocortex, results in an
      acute but transient depression of regional cerebral metabolic rates for glucose
      (rCMRglc) in deafferented areas; rCMRglc normalizes within 2 weeks. To seek
      possible compensatory changes in cholinergic mechanisms following NBM ablation
      that could lead to rapid metabolic normalization, we studied rCMRglc responses to
      the receptor agonists nicotine and arecoline and the cholinesterase inhibitor
      physostigmine in rats at 2 weeks after unilateral NBM destruction. Physostigmine
      increased rCMRglc in 10 of 30 cortical areas contralateral to the NBM lesion.
      Compared to the unlesioned side, rCMRglc after physostigmine in the lesioned
      cortex was significantly lower in 2, significantly higher in 1 and not different
      (P < 0.05) in 27 areas. Neither arecoline nor nicotine treatment produced rCMRglc
      asymmetry in lesioned rats. These results demonstrate that responsivity to
      physostigmine is maintained in most regions of the rat neocortex after extrinsic
      cholinergic denervation by NBM ablation. This adaptive response appears not to
      result from cholinergic receptor upregulation and may reflect instead
      reorganization of cholinergic synapses.

PMID- 8364729
TI  - Stress and antidepressant effects on hippocampal and cortical 5-HT1A and 5-HT2
      receptors and transport sites for serotonin.
AB  - The interactions between 14 days of repeated restraint stress and daily
      administration of imipramine or tianeptine (2 h before the beginning of stress)
      were investigated in rats to assess responses of 5-HT2 and 5-HT1A receptors and
      serotonin transporter sites labelled by [3H]paroxetine in the cerebral cortex and
      hippocampus, two brain regions in which adrenal steroid effects on serotonin
      receptor-binding have been reported. 5-HT2 sites, labelled by [125I]7-amino-8
      iodo ketanserin, were decreased in parietal cerebral cortex layers 3 and 5 by
      imipramine treatment, but not by tianeptine treatment and not by daily restraint
      stress. Stress, but not antidepressant, depressed 5-HT1A sites labelled with
      [3H]8-hydroxy-DPAT in hippocampal fields CA3, CA4 and dentate gyrus.
      [3H]paroxetine-binding to serotonin transporter sites was decreased by tianeptine
      treatment as well as by imipramine in both hippocampus and cerebral cortex, with
      some overlap of the fields that were significantly affected, whereas there were
      no effects of stress per se and no evidence of a stress x drug interaction. These
      results are discussed in relation to similarities and differences in the effects
      of different antidepressant drugs on the serotonergic system of the rat brain.
      Whereas the actions of imipramine and tianeptine on 5-HT2 and 5-HT1A receptors
      are specific to each drug, the surprising finding of a similar effect of both
      drugs to reduce serotonin transporter sites labelled by [3H]paroxetine suggest
      the possibility of a common action for these two drugs in spite of their opposite
      effects on serotonin re-uptake.

PMID- 8364730
TI  - Neuropeptide Y and optic chiasm stimulation affect suprachiasmatic nucleus
      circadian function in vitro.
AB  - The retinohypothalamic tract (RHT) is a direct pathway from the retina to the
      suprachiasmatic nucleus (SCN). Electrical stimulation of the optic nerve or optic
      chiasm activates the RHT and produces shifts in phase of a circadian rhythm in
      SCN neuron activity in rat hypothalamic slices in vitro. The phase response curve
      (PRC) for this effect is very similar to that obtained from administration of
      light pulses to intact animals maintained in constant darkness. The effect of
      optic chiasm stimulation is blocked by tetrodotoxin. In addition to the RHT,
      there is a second entraining pathway, the geniculohypothalamic tract, which
      arises from neuropeptide Y (NPY)-containing neurons of the intergeniculate
      leaflet of the lateral geniculate complex. In contrast to optic chiasm
      stimulation. NPY produces phase shifts in the rhythms of SCN neuron firing rate
      in vitro with a PRC that similar to that for NPY infusion into the SCN in intact
      animals as well as that produced by a series of treatments that induce locomotor
      activity. These results indicate that phase shifts of the circadian rhythm of SCN
      neuron activity may be produced by activation of two different entraining
      pathways and that the physiological actions of these pathways on pacemaker
      function are markedly different.

PMID- 8364731
TI  - Encoding of amplitude-modulated tones by neurons of the inferior colliculus of
      the kitten.
AB  - Responses of single neurons of the central nucleus of the inferior colliculus
      (ICC) of kittens 4-43 days of age were studied using sinusoidally amplitude
      modulated (AM) tones delivered monaurally or binaurally via sealed and calibrated
      earphones. The carrier frequency of the AM signal was set to the CF of the
      neuron. CFs ranged from 2-26 kHz. During the about first 2 weeks of postnatal
      life, ICC neurons responded to sound with periodic bursts of activity. In
      response to AM tones, discharges of ICC neurons at all ages studied were phase
      locked to the envelope of the modulation waveform over a wide range of stimulus
      level and modulation depth. A linear relationship, independent of SPL, was found
      between the average phase of discharge on the modulation cycle and modulation
      frequency. The slope of the line represents a time delay, which was highly
      correlated with the first-spike latency to tone onset, and hence with the age of
      the animal. The mean effective phase of the discharge remained relatively
      constant with age. There was little systematic change in average phase of
      discharge with changing stimulus level or modulation depth, although the number
      of spikes evoked and the temporal pattern of the spikes within a modulation cycle
      could vary. The sensitivity function relating spike synchrony or spike count to
      modulation frequency was typically band-pass in nature. The most effective
      modulation frequency (MEMF) was, on average, 15 Hz, far below that reported for
      adult cat ICC cells. When AM tones were delivered binaurally, the discharge was a
      periodic function of the interaural phase difference of the stimulus envelopes.
      The results indicate that prior to the time the cochlea is able to respond to
      most environmental sounds, monaural and binaural circuits involving the ICC
      faithfully transmit information pertaining to amplitude-modulated signals in the
      rate and timing of their discharges. During the next several weeks, when neural
      thresholds fall to adult levels, ICC circuits are activated by amplitude
      modulated sounds at levels encountered in the normal acoustic environment even
      though they are restricted to modulation frequencies below those encoded by the
      adult.

PMID- 8364733
TI  - Neurochemical evidence of functional A10 dopamine terminals innervating the
      ventromedial axis of the neostriatum: in vitro voltammetric data in rat brain
      slices.
AB  - The neostriatum (CPu) and nucleus accumbens (NAc) receive their primary dopamine
      (DA) afferents from the A9 and A10 cell groups, respectively. Anatomical evidence
      has, however, shown that some clusters of A10 afferents innervate the medial
      (periventricular) aspect of the CPu14. The present study used fast cyclic
      voltammetry (FCV) at carbon fibre microelectrodes to locate and measure the size
      of these clusters on the basis of diagnostic differences in DA efflux in A9 and
      A10 terminal regions. All experiments were conducted in CPu or NAc slices
      superfused with oxygenated artificial CSF at 32 degrees C. Carbon fibre
      microelectrodes were placed 80 microns below the slice surface and bipolar
      stimulating electrodes were located 200 microns away. Except in experiments where
      the stimulation frequency, pulse width or number of pulses were investigated, DA
      efflux was evoked using 0.1 ms, 10 mA pulses applied singly (1p) or in 20 pulse
      trains (20p) at 50 Hz and monitored using FCV. The CPu was first mapped on the
      basis of the ratio of 20p:1p DA efflux. The CPu consisted mainly (64%) of low
      ratio (< 3) sites while the NAc core comprised exclusively high ratio (> 6) loci.
      Population analysis revealed a small percentage (10%) of striatal sites with high
      (> 6) ratios. These high ratio sites matched the reported distribution of A10
      afferent clusters, being found almost entirely along the ventromedial axis of the
      CPu. Individual clusters of high ratio sites (20p:1p ratios > 6), 'mapped' on the
      basis of evoked 20p DA efflux, were found to be irregular in outline and around
      500 microns across. In order to characterise the clusters further, the influence
      of stimulation frequency, train duration (number of pulses) and pulse width on DA
      efflux were examined. Peak DA efflux in the clusters and NAc occurred at 50 Hz
      while the striatal matrix had a flat frequency response. Both clusters and NAc
      showed a similar dependence of DA efflux on the number of pulses in the stimulus
      train. In the CPu matrix, DA efflux was less dependent on the number of pulses.
      In the striatal matrix, increasing the stimulation pulse width enhanced DA efflux
      on trains more than on single pulses while, in both NAc and striatal clusters,
      there was no preferential effect on trains. The medial location of these clusters
      within the CPu more closely matches the anatomical distribution of the A10
      afferents of Gerfen et al. than the more evenly dispersed striosomes.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8364732
TI  - Ion transport across lingual epithelium is modulated by chorda tympani nerve
      fibers.
AB  - Each chorda tympani (CT) nerve innervates taste cells in fungiform papillae on
      one side of the anterior two-thirds of mammalian tongues. In this study, three
      effects of unilateral CT transection were investigated: (1) the persistence of
      taste cells on the ipsilateral and contralateral sides; (2) the ability of the CT
      to modulate ion transport across the ipsilateral and contralateral sides of
      canine lingual lingual epithelia; and (3) the effect on contralateral CT
      responses. Unilateral transection of dog CT caused the mean number of taste
      buds/fungiform papilla on the ipsilateral side to decrease from five to zero by
      29-30 days after surgery. Taste buds reappeared after 44 days but in reduced
      numbers (two taste buds/papilla). This reappearance of taste buds after 44 days
      is consistent with the time predicted for the CT to regenerate and reach the
      anterior portion of the tongue. The number of taste buds/papilla remained
      unchanged on the contralateral side. Measurements of the short-circuit current
      (Isc) across both ipsilateral and contralateral sections of isolated canine
      lingual epithelia were performed at various times after unilateral CT
      transection. Both sides responded similarly. The Isc began to decline after 3
      days, reached a minimum after approximately 18 days (approximately 40% of control
      Isc) and increased to control values after approximately 40 days. This includes
      experiments performed 30 days after surgery, when no taste buds were present on
      the ipsilateral side and the Isc was 80% of control values. For all times after
      CT transection, amiloride, an epithelial Na+ channel blocker, inhibited Isc.
      Thus, epithelial cells in dog tongue have amiloride-inhibitable pathways. These
      results show that proteins involved in active Na+ transport across lingual
      epithelial can be modulated by CT nerve fibers.

PMID- 8364734
TI  - Co-localization of peptide-like immunoreactivities with glucocorticoid receptor-
      and Fos-like immunoreactivities in the rat parabrachial nucleus.
AB  - The parabrachial nucleus (PB) is a brainstem nucleus, which mediates autonomic
      information from the viscera to various forebrain nuclei, e.g. to the central
      nucleus of the amygdala (ACe) and to the medial preoptic area (MPOA). The neurons
      of the PB contain several neuropeptides, of which calcitonin-gene related peptide
      immunoreactive (CGRP-IR) and neurotensin (NT)-IR neurons provide input to the
      ACe, whereas corticotropin-releasing factor-IR (CRF) neurons project to the MPOA.
      The aim of the present paper was to study whether the neurons containing CGRP-,
      NT- and CRF-like immunoreactivities (LIs) in the PB also contain glucocorticoid
      receptor (GR)- and/or Fos-LIs after stress. No co-localization was observed with
      the GR-LI and peptide-LIs, suggesting that plasma glucocorticoids do not have
      direct effects on these neurons of the PB. After stress, the vast majority of the
      peptide-IR perikarya exhibited Fos-LI, suggesting that the peptidergic pathways
      from the PB to ACe and MPOA are activated in stress. The ACe and MPOA have been
      connected in various stress related responses, e.g. inhibiting the hypothalamo
      pituitary-gonadal axis, raising the blood pressure and pulse, and increasing the
      secretion of glucocorticoids. Therefore, the activation of the peptidergic
      pathways between the PB and the ACe and MPOA suggests that some of these
      responses may be elicited by the peptidergic input from the PB. Furthermore,
      since Fos acts as a transcription factor, stress may affect the expression of the
      neuropeptides studied.

PMID- 8364735
TI  - Interaction of concanavalin A and wheat germ agglutinin with Helix acetylcholine
      receptors.
AB  - The effects of lectins concanavalin A (Con A) and wheat germ agglutinin (WGA),
      were studied on acetylcholine (ACh) responses of physically isolated internally
      dialyzed Helix aspersa neurons using the concentration clamp method and on the
      binding of [3H]alpha-bungarotoxin to the cluster of neurons. Con A and WGA have
      different simple sugar specificity and produced different actions on ACh-evoked
      Cl conductance responses, which were antagonized by Con A (5 micrograms/ml) but
      were not altered by WGA. Con A depressed ACh responses when applied
      extracellularly while it had no effect on ACh responses of the same neuron when
      added to the intracellular solution, thus indicating that Con A specific
      glycoproteins are exposed on the surface of the neuron. The studies of the effect
      of Con A on the properties of the ACh binding site (receptor) have demonstrated,
      that (1) the onset of desensitization of ACh responses of the dialyzed neurons,
      determined from the decay of ACh-current from peak to plateau in the continued
      presence of agonist and best fitted by a double exponential function, was
      accelerated by Con A; (2) Con A depressed the maximal ACh induced current in a
      dose response relationship and altered the Hill coefficients; (3) Con A depressed
      the binding of [3H]alpha-bungarotoxin to the cluster of neurons. These results
      indicate that Con A receptors on the surface of the neuronal membrane play a
      regulatory role in the ACh-receptor system and suggest that binding of lectin
      molecules to their receptors leads to inhibition of binding of ACh to ACh
      receptors and to acceleration of the kinetics of desensitization of ACh
      receptors. All the effects of Con A, that is, on the peak amplitude,
      desensitization, dose-response relationship of ACh induced current and binding of
      [3H]alpha-bungarotoxin, could be recovered by D-mannose, a competitive inhibitor
      of Con A binding to its receptor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364736
TI  - Ischemic tolerance due to the induction of HSP70 in a rat ischemic recirculation
      model.
AB  - Various studies have demonstrated an increase in heat shock protein 70 (HSP70)
      synthesis in the brain following transiently induced ischemia, suggesting a
      protective role for HSP70 against ischemic insult. In this study, we determined
      the time course of HSP70 mRNA and protein induction in rat hippocampus following
      ischemia using Pulsinelli's four-vessel occlusion model, and suggested a
      protective role for HSP70 induction in limiting ischemic damage to neurons and
      delayed neuronal death. In Northern blotting analysis using human HSP70 DNA as a
      probe, the accumulation of HSP70 mRNA after 5 min ischemia became evident at 4 h,
      and continued until 16 h, while after 30 min ischemia, HSP70 mRNA appeared at 2
      h, and continued above control level until 24 h after treatment. In immunoblot
      analysis using anti-HSP70 antibody, induction of HSP70 protein appeared 24 h and
      reached a maximum 48 h after 5 min ischemia. In immunohistochemical analysis
      using anti-HSP70 antibody, staining was not detected in CA1 neurons until 16 h
      after 5 min ischemia, but staining in CA1 gradually increased 1 day after
      ischemia and reached a maximum level 2 days after ischemia. Similar time profiles
      in the staining pattern of HSP70 protein were observed in CA3 and CA4 neuronal
      cells following 30 min ischemia. When rats pretreated with 5 min ischemia (non
      lethal for CA1 pyramidal neurons) were exposed to a 30 min, lethal period of
      ischemia, 2 days after pretreatment, considerable staining of HSP70 was observed.
      Pretreated rats had much less neuronal damage in the CA1 sector than did rats
      subjected to lethal, 30 min ischemia alone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364737
TI  - Intrascapular brown adipose tissue (IBAT) temperature and blood flow responses
      following ventromedial hypothalamic stimulation to sham and IBAT-denervated rats.
AB  - Intrascapular brown adipose tissue temperature (TIBAT) and capillary blood flow
      along with colonic (Tc) and tail (Tt) temperatures as well as blood pressure and
      heart rate responses were measured simultaneously in groups of age-matched,
      anesthetised, sham control and IBAT-denervated Long-Evans rats following VMH
      electrical stimulation. Unilateral VMH electrical stimulation (0.5 ms pulses of
      100 microA at 50 Hz for 30 s) evoked rises in TIBAT (above core) and IBAT blood
      flow in the Long-Evans sham control group, along with increases in blood pressure
      and heart rate. Rises in IBAT temperature and capillary blood flow were absent in
      the surgical denervated group following VMH electrical stimulation whereas the
      evoked pressor and tachycardic responses were left intact and were similar to
      those responses seen in the sham control group. The results indicate that acute
      bilateral sectioning of the IBAT intercostal nerves blocks the IBAT temperature
      and capillary blood flow increases evoked by VMH electrical stimulation.

PMID- 8364738
TI  - The effects of lesions of the posterior piriform cortex on amygdala kindling in
      the rat.
AB  - The piriform cortex (PC) is thought to be critically involved in the genesis of
      forebrain (limbic type) seizures, including limbic kindled seizures. More recent
      studies have shown that the posterior PC is particularly sensitive to kindling
      stimulation, suggesting that the posterior PC contains specific generating sites
      which may be important for the stepwise progression of kindling. In the present
      experiments, we used microinjections of ibotenate to study the effect of
      selective lesions of the posterior PC on amygdala kindling in rats. Large
      unilateral lesions of the posterior PC and adjacent endopiriform nucleus markedly
      decreased the susceptibility of the ipsilateral basolateral amygdala to
      electrical stimulation, thus indicating that the posterior PC may normally
      contribute to regulation of physiologic excitability in amygdala. During
      kindling, rats with large lesions of the PC stayed longer in the initial phase of
      kindling (stage 1) than sham-lesioned controls, consistent with involvement of
      the posterior PC in the early stages of seizure propagation during kindling
      acquisition. However, the PC lesions were not capable of blocking or even
      severely retarding kindling. Following kindling development, rats with large
      lesions of the posterior PC had significantly higher focal seizure thresholds
      than kindled rats without lesion or rats with only small PC lesions, which
      suggests that the posterior PC is involved in the mechanisms which are
      responsible for the marked increase in seizure susceptibility induced by
      kindling. Taken together, the data substantiate that PC structures play a
      facilitatory role in kindling.

PMID- 8364739
TI  - Effects of the antiglucocorticoid RU 38486 on the induction of learned helpless
      behavior in Sprague-Dawley rats.
AB  - Learned helplessness (LH) is induced by exposure to an inescapable or
      uncontrollable stressor which results in an inability to escape or avoid the same
      stressor when subsequently presented in a different context. In order to
      understand which central mechanisms may influence the expression of the learned
      helpless phenotype, we have pursued an experimental approach that seeks to
      elucidate the behavioral effects of glucocorticoid (GC) hormones in this animal
      model of depression. We have previously shown that the induction of LH behavior
      is enhanced by adrenalectomy, an effect that is reversed by corticosterone. In
      this study, our aim was to attempt to locate CNS sites responsible for the
      observed effects of glucocorticoids on learned helpless behavior by introducing
      the type II GC receptor antagonist, RU 38486 to discrete brain regions. We did
      not observe a significant effect in LH with acute systemic, acute dentate gyrus
      or intracerebroventricular injection of RU 38486 in contrast to previous studies
      using the Porsolt swim test, another animal model of depression. However, we were
      able to observe a significant change upon chronic administration to the dentate
      gyrus. These findings suggest that glucocorticoids exert a long-term influence on
      stress-induced behavior, presumably by affecting glucocorticoid responsive genes
      in the dentate gyrus.

PMID- 8364740
TI  - Current source density analysis of the hippocampal theta rhythm: associated
      sustained potentials and candidate synaptic generators.
AB  - Single-electrode depth profiles of the hippocampal EEG were made in urethane
      anesthetized rats and rats trained in an alternating running/drinking task.
      Current source density (CSD) was computed from the voltage as a function of
      depth. A problem inherent to AC-coupled profiles was eliminated by incorporating
      sustained potential components of the EEG. 'AC' profiles force phasic current
      sinks to alternate with current sources at each lamina, changing the magnitude
      and even the sign of the computed membrane current. It was possible to include DC
      potentials in the profiles from anesthetized rats by using glass micropipettes
      for recording. A method of 'subtracting' profiles of the non-theta EEG from theta
      profiles was developed as an approach to including sustained potentials in
      recordings from freely-moving animals implanted with platinum electrodes. 'DC'
      profiles are superior to 'AC' profiles for analysis of EEG activity because 'DC'
      CSD values can be considered correct in sign and more closely represent the
      actual membrane current magnitudes. Since hippocampal inputs are laminated, CSD
      analysis leads to straightforward predictions of the afferents involved. Theta
      related activity in afferents from entorhinal neurons, hippocampal interneurons
      and ipsi- and contralateral hippocampal pyramids all appear to contribute to
      sources and sinks in CA1 and the dentate area. The largest theta-related
      generator was a sink at the fissure, having both phasic and tonic components.
      This sink may reflect activity in afferents from the lateral entorhinal cortex.
      The phase of the dentate mid-molecular sink suggests that medial entorhinal
      afferents drive the theta-related granule and pyramidal cell firing. The
      sustained components may be simply due to different average rates of firing
      during theta rhythm than during non-theta EEG in afferents whose firing rates are
      also phasically modulated.

PMID- 8364741
TI  - NMDA receptor antagonists, MK-801 and ACEA-1011, prevent the development of tonic
      pain following subcutaneous formalin.
AB  - Subcutaneous injection of formalin produces a biphasic pain response: an early,
      transient phase followed by a late tonic phase. The present study examined the
      involvement of the N-methyl-D-aspartic acid (NMDA) receptor in the development of
      the late pain produced following subcutaneous injection of formalin into the hind
      paw in mice. Blockade of the NMDA receptor by its non-competitive antagonist, MK
      801, prior to formalin injection, but not after, reduced pain during the late
      phase. Similarly, blockade of the NMDA receptor allosteric site by the novel
      glycine site antagonist, ACEA-1011, also reduced the pain response in the late
      phase. These results suggest that the development of the late phase of formalin
      pain is due to NMDA-mediated activity during the early phase.

PMID- 8364742
TI  - Delayed matching-to-sample, object retrieval, and discrimination reversal
      deficits in chronic low dose MPTP-treated monkeys.
AB  - Cognitive deficits following chronic exposure to low doses of the neurotoxin 1
      methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) were studied in monkeys
      asymptomatic for a gross parkinsonian motor disorder. Monkeys developed deficits
      in performance of delayed matching-to-sample, visual pattern discrimination
      reversal, and object retrieval tasks, all tasks that rely upon the integrity of
      the frontal-striatal axis. Performance on a visual pattern discrimination task,
      that relies primarily on inferotemporal cortex function, remained intact. These
      results extend previous findings of frontal-like cognitive deficits in MPTP
      treated monkeys and further support the use of this model for studying the
      pathophysiology of the cognitive deficits associated with parkinsonism.

PMID- 8364743
TI  - Regional specificity of membrane instability in Alzheimer's disease brain.
AB  - We report an inherent tendency towards the destabilisation of cellular membranes
      in Alzheimer's disease (AD) brain. This tendency is a natural consequence of
      abnormal membrane lipid composition, which has previously been documented in AD.
      Membrane destabilisation may contribute to AD pathogenesis in its own right and
      may also facilitate amyloid beta-protein deposition, which is potentially
      neurotoxic. The instability was found to co-localise selectively with areas of
      neurodegeneration in AD brain, thereby possibly accounting for the focal
      pathology observed in this disorder.

PMID- 8364744
TI  - [Eulogy of Jean Roche (1901-1992)].

PMID- 8364745
TI  - [Specificity of bronchopulmonary infection in cystic fibrosis].
AB  - Chronic lung colonization in CF is specific and due mainly to Pseudomonas
      aeruginosa. Since no phagocytic or immunological abnormalities seem to be
      responsible for this specificity, it is possible that post-translational
      alterations of respiratory mucins biosynthesis occur and modify the affinity of
      mucins for Pseudomonas aeruginosa.

PMID- 8364746
TI  - [Prenatal, neonatal and postnatal prevention in cystic fibrosis].
AB  - The efficiency of neonatal screening for CF could be improved by associating a
      molecular analysis to the immunoreactive trypsin test, on the same dried blood's
      sample. However the interest of such a screening for the patients benefit remains
      controversial. In most cases, antenatal diagnosis may be performed by a direct
      search of the mutation(s). However, the impact of antenatal diagnosis on CF's
      incidence will necessarily be limited if it can only be implemented after the
      birth of an affected child. Hence the interest of screening programs for the
      detection of healthy carriers. Carrier's detection does not raise any objection
      for the relatives of patients. It is still premature to recommend it to be
      undertaken in the general population.

PMID- 8364747
TI  - [Current view and outlook for cystic fibrosis therapy].
AB  - Cystic fibrosis therapy has obtained in the last few years substantial benefits
      optimizing nutritional antibiotic and ventilatory techniques. With the discovery
      of the gene and of CFTR protein pharmacological approach may be initiated:
      correction of transmembrane ionic exchanges, and of sputum rheology. Gene therapy
      represents the last development, but rises methodological and ethical problems
      even if representing an important hope. Pulmonary transplant is only indicated in
      severe forms of cystic fibrosis.

PMID- 8364748
TI  - [Eulogy of Clement Launay (1901-1992)].

PMID- 8364749
TI  - [Ocular lesions related to pellet pistols. Epidemiologic study of 160 patients].
AB  - We present a retrospective study of ocular trauma related to pellet guns. During
      5 years, 160 such patients were seen in our emergency unit. 80% of cases were
      men, and range age was 28 years. Ocular trauma circumstances was a fight in 85%.
      Ocular trauma was unilateral in 109 patients, and bilateral in 51 patients. We
      observed a complete disorganisation of the eye in 8 eyes, intraocular foreign
      bodies in 71 eyes, intraorbital foreign bodies without ocular lacerations in 23
      eyes, and blunt trauma in 108 eyes. Final vision is poor or absent in 31 eyes.

PMID- 8364750
TI  - [Role of neutralizing antibodies in protection of the fetal from an HIV positive
      mother].
AB  - The goal of this study is to compare serum Titers of Neutralizing antibodies in
      HIV 1 infected mothers to the virological status of their newborns. 38 infant
      mothers couples were tested. Serum Neutralizing antibodies Titers of the mothers
      were tested the day of birth. Virological status of new borns was determined by
      peripheric blood mononuclear cells culture and PCR. 18 Newborns were HIV 1
      infected. In 9 cases mothers had no neutralizing antibodies: 7 newborns were HIV
      1 infected. In 4 cases mothers had high level of neutralizing antibodies (< 640):
      none of the newborns was infected. In 25 cases mothers had intermediate value of
      neutralizing antibodies (between 80 and 320): 11 newborns were HIV 1 infected.
      Women with neutralizing antibodies to HIV 1, were less likely to transmit HIV 1
      to their infants than pregnant women without neutralizing antibodies. Serum
      neutralizing antibodies titers of pregnant women might be of predictive value in
      vertical transmission of HIV 1. Further investigations are needed.

PMID- 8364751
TI  - [Report of activity for 1991 and 1992 of the Terminology Group (Commission no.
      XIV--French)].

PMID- 8364752
TI  - [Surgery of carotid stenosis and prevention of cerebral infarction].
AB  - In 1983, the author, relating his personal experience, as well as those of other
      authors, presented a critical analysis of indications and results of surgical
      treatment for carotid artery stenosis in order to prevent stroke. The actual
      experience of the author is based on for 142 patients operated on from 1st
      January 1982 to 31st December 1986. This study includes 32 stage 0 (asymptomatic)
      patients, 95 stage I (transient) patients, and 15 stage IIIa (slight deficit)
      patients. The immediate mortality rate has been 2.1% with a rate of severe
      morbidity of 1.4%. The 5 year survival rate has been 72.3% decreasing fairly
      regularly from 90% for the first year. The conclusions of this study and other
      published at the same time in the literature were that there was a category of
      high-risk patients with over 70% stenosis, especially those with an history of
      transient ischemic attack. But unfortunately no randomized work was available for
      supporting these conclusions. Lately, two randomized studies have been published,
      the first one in Europe called ECST (European Carotid Surgery Trial), and the
      second one in North America called NASCET (North American Symptomatic
      Endarterectomy Trial). The European Trial based on 2,518 patients showed that for
      778 patients with a carotid stenosis between 70% and 99% and a history of a
      transient ischemic attack the cumulative risk of any ipsilateral stroke at 3
      years was 10.3% for the surgical group and 16.8% for the medical group. The North
      American Trial is still more accurate. For 659 patients in the same conditions,
      the risk of any ipsilateral stroke at 2 years is 9% for the surgical group and
      26% for the medical group. Those two studies make clear that carotid
      endarterectomy significatively lowers the risk of severe or lethal cerebral
      stroke in the patient group with a stenosis of ICA higher than 70% and a TIA.
      Nevertheless, there is no modification of the total mortality, of whose the first
      cause is coronary disease. Other studies are in progress in order to appreciate
      the results of surgery for stenosis between 30% and 69% and for asymptomatic
      patients.

PMID- 8364753
TI  - ["Idiopathic" extracapillary glomerulonephritides without immune deposits are
      vascularitides: clinical and serologic analysis].
AB  - To determine the spectrum of systemic diseases potentially associated with pauci
      immune rapidly progressive glomerulonephritis (GN), most of which being
      considered as idiopathic, we have analyzed extra-renal manifestations, occurrence
      of extra-glomerular vasculitis and incidence and specificity of ANCAs in 40
      patients selected only on histological criteria. Extra-renal symptoms were
      unexpectedly observed in all patients but one, and were suggestive of vasculitis
      in 24 of them. Extra-glomerular vasculitis was evidenced in 18 kidney biopsies
      and four biopsies from other organs. Among the 33 patients with suspected or
      established vasculitis, 13 had presumed or biopsy-proven Wegener's granulomatosis
      (WG), three had a macroscopic form of polyarteritis nodosa and 17 had a clinical
      presentation compatible with the so-called microscopic polyarteritis previously
      described in the british literature. An additional patient had clinical signs of
      WG without clinical and histological evidence of vasculitis. ANCAs were detected
      in 28/33 and 25/34 sera tested by IF and ELISA, respectively: 19 contained anti
      myeloperoxidase (MPO) antibodies and 6 had anti-proteinase 3 (Pr3) activity. Anti
      MPO and anti-Pr3 antibodies were present in all clinical subgroups but with
      various incidences: anti-MPO antibodies were surprisingly more often detected
      (6/12) than anti-Pr3 (4/12) in patients with suspected or histologically proven
      WG but anti-Pr3 antibodies were nonetheless 3- to 4-fold more frequent in WG than
      in non-WG systemic vasculitis (1/12) and necrotizing CGN without evidence of
      extra-renal vasculitis (1/10). These results strongly suggest that pauci-immune
      necrotizing CGNs belong to the broad spectrum of necrotizing vasculitides
      affecting glomerular capillaries. This hypothesis is also supported by the good
      response of patients to immunosuppressive treatments known for their efficacy in
      vasculitides, whereas these treatments are usually less successful in severe
      forms of extra-capillary GN with immune deposits.

PMID- 8364754
TI  - [Arrhythmogenic right ventricular dysplasia. A new clinical entity].
AB  - Arrhythmogenic right ventricular dysplasia has been identified in 1977. It
      affects the right ventricle and its etiology is unknown. It has been recently
      included in the group of cardiomyopathies since it affects mainly the right
      ventricular muscle. It is found in young adults, frequently sportsmen who have a
      nearly normal cardiac physical examination. Ventricular arrhythmias could lead to
      palpitations, syncopes or even sudden death. This accident could be the first
      presenting sign of the disease. Two physiopathogenic mechanisms have been
      considered: heredo-familial origin or the result of a burned out myocarditis
      which could be the result of an abnormal immunological response. Its treatment
      mainly involves antiarrhythmic drugs. In the resistant cases ablative techniques,
      implantable defibrillator or surgery and even cardiac transplantation could be
      considered. Correctly treated, ARVD has a good prognosis. More extensive studies
      are necessary both on the clinical as well as the basic science standpoints.

PMID- 8364755
TI  - [Comparative enantioselectivity of the disposition of two non-steroidal anti
      inflammatory agents, ketoprofen and carprofen, in man and animals].
AB  - After the administration of racemic ketoprofen and carprofen to man, both
      enantiomers of each compound exhibit similar plasma profiles. This contrasts with
      the rat where the active S(+) enantiomer is predominant. For carprofen,
      regardless of the route of administration, the R(-) enantiomer is predominant in
      the plasma of all investigated animal species. The S(+)/R(-) ratio of the "areas
      under the curves" during the time course of the kinetics, is: 0.60 in dogs, 0.53
      in Yucatan micro-pigs, 0.48 in mini-goats, 0.67 in calves and 0.19 in horses. For
      ketoprofen, the S(+) enantiomer is predominant in dogs, cats and horses, with
      ratios of 30.3, 5.3 and 1.5, respectively, while R(-) is the predominant
      enantiomer in sheep. The interpretation of these inter-species differences can be
      supported by experimental evidence, however some informations are lacking and
      additional investigation is required. In the case of ketoprofen where S(+) is
      predominant in rats, dogs and horses, the metabolic chiral inversion from R(-) to
      S(+), which has been demonstrated in rats, may also take place in the latter two
      species. In addition, the well documented stereoselective clearance of the
      glucuronides, possibly in favour of the enantiomer S(+), may explain the lower
      body clearance of the R(-) enantiomer in sheep. For carprofen, no metabolic
      chiral inversion was shown in rats and dogs after administration of each
      enantiomer individually, but for this compound, stereoselective clearance of
      glucuronides has been demonstrated which may support the idea of a plasma
      concentration shift of the enantiomeric proportions vs time in favour of the R(-)
      enantiomer. Regardless of the possible biological mechanisms which are
      responsible for these inter-species differences, the existence of these
      differences gives rise to at least two important issues: The choice of animal
      species which can be used in the research of drugs destined for human
      therapeutics: the most pertinent animal species will be the one which
      demonstrates an enantiomeric plasma profile closest to that observed in man. The
      present data show that the ideal animal species from this respect has still to be
      identified. For application in veterinary therapeutics, a careful balance must be
      established between the requirement of favourable bioavailability of the active
      S(+) enantiomer and the potential of any possible chiral inversion of R(-) to
      generate hybrid molecules in meat and milk which in turn may lead to residues,
      the toxicity of which to the human consumer is still unknown.

PMID- 8364756
TI  - [Hereditary protein lithiasis and calcium lithiasis: two different forms of
      hereditary pancreatitis].
AB  - We previously reported that the most frequent cases of chronic pancreatitis were
      the consequence of pancreatic lithiasis and that there were different forms of
      pancreatic lithiasis with different etiologies and composition of calculi. The
      most frequent form is the calcic lithiasis, generally due to nutritional
      disorders. The second most frequent form is proteic lithiasis. In this paper, we
      report 1.) Ten hereditary cases on a total of 36 patients presenting with proteic
      lithiasis (age at clinical onset 15 +/- 12 years); 2.) one hereditary case on a
      total of 150 patients with proteic lithiasis. In these two different maladies,
      the transmission seems to be dominant, autosomal with incomplete penetrance.
      Hereditary pancreatitis is therefore a group of at least two different diseases,
      hereditary protein lithiasis, the most frequent one and hereditary calcic
      lithiasis exceptional.

PMID- 8364757
TI  - [Pathologic features of a case of systemic brucellosis due to Brucella melitensis
      biovar 3 in a chamois (Rupicapra rupicapra)].
AB  - A case of systemic brucellosis caused by Brucella melitensis biovar 3 was
      identified in a chamois (Rupicapra rupicapra) in the southern French Alps.
      Clinical signs included bilateral orchiepididymitis and keratoconjunctivitis,
      polyarthritis, and neurological signs; pathological findings confirmed an
      ulcerative keratitis, orchiepididymitis with calcified or necrotic foci and
      serofibrinous and hemorrhagic polyarthritis. The kidney cortex showed calcified
      nodules and infarctions. A small focus of chronic pleuritis was also observed.
      Brain and pia mater showed degeneration, necrosis and calcification with
      perivascular lymphoplasmacytic and granulomatous inflammation. B. melitensis was
      evidenced in all these organs. This systemic brucellosis is unusual in our
      developed countries, in human an early medical action restricts the illness to
      localised lesions; domestic ruminants are slaughtered at the first clinical
      suspicion like abortion and/or after seroconversion.

PMID- 8364758
TI  - [Justification and imperatives of the campaign against excess cholesterol and
      prevention of atherosclerosis].
AB  - Recently, violent attacks have been orchestrated, by various media and the press
      against medical action, via diet or drug therapy, on excess cholesterol, in order
      to improve primary or secondary cardiovascular prevention. The amplitude of this
      campaign implies a dangerous risk of a deleterious effects both on the public and
      on medical guidelines. The opportunity for open discussion of this question, and
      of a clear reply, appears to be highly desirable for all concerned. Although it
      is quite true that total blood cholesterol levels in excess of 200 mg/dl (5.2
      mmol/l) are not automatically dangerous, they nonetheless require complete
      profiling of cholesterol distribution among the different fractions and, if
      possible, a complementary study of ApoB, ApoA1 and Lpa fractions. It must be
      recalled that even modest rises in total cholesterol (250 +/- 30 mgs/dl) can be
      atherogenic, and particularly, when present in the non-HDL fractions, and
      involving a low HDL Cholesterol level (< 36 mg/dl or 0.9 mmol/l). In all these
      cases, the associated determination of triglyceride levels is absolutely
      necessary. Moreover these modest rises in cholesterol have to take into account
      the possible association of other risk factors, such as hypertension, cigarette
      smoking, diabetes, obesity and ... hyperfibrinogemia. The claims of the natural
      protection of French people against atherosclerosis and of the irrelevance of
      precocious cholesterol screening, then finally of non-demonstrated benefits of
      such prevention, with respect to other risks due to diet or drug treatment of
      cholesterol disorders must be precisely rediscussed and clarified. The crucial
      importance of the maintenance of our present efforts in cardiovascular prevention
      for clinicians, concerned patients, and the general public, must be especially
      stressed.

PMID- 8364759
TI  - [Teratogenesis and autoimmunity: significance of an experimental murine model for
      human pathology].
AB  - Fetal malformations constitute a major problem of public health. Unfortunately
      the known causes do not account for more than 50% of the cases observed. The
      potential role of immune mechanisms is suggested by experimental studies in the
      rat indicating that antibodies reactive with the yolk sac induce fetal
      malformations. In this study we show that these antibodies are specific for a 280
      kDa protein expressed only in the kidney and the yolk sac by cell structures
      associated with the formation of endocytic vesicles. We further show that a
      similar protein is expressed in man by the yolk sac, the kidney and the
      trophoblasts. The possible role in pathology of antibodies against the human
      protein is discussed.

PMID- 8364760
TI  - [Monoxycarbogenic reaction of chloral: application to the obtention of
      carboxyhemoglobin and to its determination in blood].
AB  - Carbon monoxide CO, generated from chloral (10(-2) M) in a dilution of hemochrome
      (pH 13), turns the solution of hemochrome into a solution of carboxyhemoglobin.
      The spectrum of this solution is identical to the one obtained after bubbling
      with CO. The reaction is fast and makes it possible to determine the percentage
      of carboxyhemoglobinemia in whole blood.

PMID- 8364761
TI  - [Inhibition of phospholipase A2 of peritoneal macrophages in rats by 1,2-di-O
      hexadecyl-rac-glycero-3-phosphocholine].
AB  - The 1-O-stearoyl-2-O-[3H] arachidonyl-sn-glycero-3-phosphocholine, introduced in
      the culture medium, was taken up by the peritoneal macrophages activated by the
      ionophore A 23187. After intracellular phospholipase A2 activity, the [3H]
      arachidonic acid was found in cells and in extracellular fluids. It also reached
      the eicosanoid synthesis. When it was introduced in the culture medium with the
      tritiated phospholipid, the 1, 2 di-O-hexadecyl-rac-glycero-3-phosphocholine,
      which has a non hydrolysable alkylated structure in the 2 position of the
      glycerol, inhibited the intracellular phospholipase A2, then contributed to lower
      the eicosanoid synthesis.

PMID- 8364762
TI  - Confirmation of the taxonomic position of Callimico goeldi (Primates,
      Platyrrhini) on the basis of its highly repeated DNA patterns.
AB  - The systematic position of Callimico goeldi has been analyzed by comparison of
      its highly repeated DNA fragments with those of three species of Callithricidae
      and two species of Cebidae. Our data, in agreement with those obtained by other
      authors by means of cytogenetic and molecular biology techniques, are in favour
      of the classification of C. goeldi in the family Callithricidae.

PMID- 8364764
TI  - [Ultrastructural analysis of the optic nerve in microphthalmic rodents (Spalax
      leucodon)].
AB  - The optic nerve of a microphthalmic subterranean rodent, Spalax leucodon, has
      been examined at the ultrastructural level. The analysis of the optic nerve
      reveals only 1,790 unmyelinated axons. The axon diameter varies from 0.05 to 2.3
      microns, with a mean of 0.55 micron. We suggest that these axons mainly belong to
      the W type ganglion cells.

PMID- 8364763
TI  - [Presence of gregarine (Protozoa sporozoa) parasite of black-lipped pearl oysters
      Pinctada margaritifera (L.,1758) (Mollusca bivalvia) in French Polynesia].
AB  - High death rates have been recorded in populations of Pinctada margaritifera
      (natural or reared stocks) in atolls in the Tuamotu Archipelago (French
      Polynesia). An histological study of the oysters from the concerned areas
      revealed the occurrence of a protist of which ultrastructural features correspond
      to those of Gregarinea. It is still premature to establish a link between the
      presence of the Gregarine and recent deaths of pearl oysters.

PMID- 8364765
TI  - [Effects of NGF on chromaffin adrenaline-containing cells of adrenal medulla of
      rabbits transplanted into brains of mice].
AB  - The graft of chromaffin adrenaline-containing (A) cells of rabbit adrenal medulla
      implanted to mouse brain and treated with NGF contains more survived cells 1
      month after grafting than adrenal medulla alone. The cells developed either an
      intermediate (e.g. chromaffin cell and neuron) or a neuron-like phenotypes
      accompanied with a decrease in an immunoreactivity for PNMT (phenyletanolamine-N
      methyltransferase). A gap junctions and attached plaques were found between
      grafted cells. The grafts received a synaptic input. The NGF influence on the
      fate of chromaffin A-containing cells is discussed.

PMID- 8364766
TI  - [Quadri-dimensional analysis of the electroencephalography. First application to
      an episode of paradoxical sleep in man].
AB  - A first example of quadri-dimensional EEG analysis is presented which is
      characteristic of a series of ten analyses episodes of paradoxical sleep recorded
      in polygraphy during 5 nights' sleep in three human volunteers. A first EEG
      recording of wakefulness, eyes open, with visual fixation of a central point, was
      followed by a polygraphic night of sleep recording after habituation. The first
      subject was recorded during three nights; two other subjects during one night
      only after habituation. An EEG montage of 16 channels was quantified by spectral
      analysis and parametrization, after artefact rejection, for the reference
      sequence of wakefulness and further episodes of paradoxical sleep. After temporal
      and spatial interpolation algorithms, for each sequence, a series of root-mean
      square successive EEG maps were computed and displayed, between 0.5 to 30 Hz. Low
      amplitude values of locally activated areas were chosen during the wakefulness
      EEG sequence and provided filtering thresholds for isolating activated areas
      during paradoxical sleep. The first 30 maps of each episode were piled up one on
      top of the other, along a vertical time axis, then dynamically visualised in
      colors and 3D. The "trajectories of activated areas" were then displayed in a
      quadri-dimensional functional space (x-y: spatial map of the scalp; t: time;
      color or black and white: filtered or unfiltered rms EEG amplitudes). The EEG
      trajectories of awakened areas, appeared through time like unique "fibres" or
      double fibres after bifurcation. The unique fibres were located over left temporo
      central activated areas and a double fibre appeared after bifurcation over the
      right parietal area.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364767
TI  - Brain tumors.
AB  - At the same time that studies indicate an increase in the frequency of brain
      tumors, improvements in diagnosis and treatment have increased the clinician's
      ability to deal with these cancers. Dr. Posner, Chairman of the Department of
      Neurology at Memorial Sloan-Kettering Cancer Center in New York City, encourages
      physicians to be alert for symptoms of brain tumors, to be positive about
      treatment, and to be prepared to refer patients to investigative treatment so
      that progress can continue.

PMID- 8364768
TI  - Brain tumors.
AB  - Brain tumors are a relatively common cancer in all age groups, and the incidence
      of both primary and metastatic brain tumors is increasing. Fortunately, dramatic
      advances in methods of diagnosis, surgical technique, and adjuvant therapy have
      all contributed to an improved outlook for patients with brain tumors. This
      article reviews the classification, symptoms, diagnosis, and treatment of brain
      tumors.

PMID- 8364769
TI  - Pediatric brain tumors.
AB  - Brain tumors are the second most common cancer of children. Although children
      with brain tumors have a better prognosis than adults, treatment presents special
      problems, including possible damage to the developing brain. This article reviews
      the classification, symptoms, diagnosis, and treatment of pediatric brain tumors.

PMID- 8364770
TI  - Questionable methods of cancer management: 'nutritional' therapies.
AB  - Although dietary measures may be helpful in preventing certain cancers, there is
      no scientific evidence that any nutritionally related regimen is appropriate as a
      primary treatment for cancer. This paper focuses on seven questionable
      modalities: vitamin C, pau d'arco tea, the Gerson diet, Hoxsey herbal therapy,
      the macrobiotic diet, Manner metabolic therapy, and Kelley metabolic therapy.
      Some of these approaches involve a diet that is nutritionally inadequate. Some
      involve potentially toxic doses of vitamins and/or other substances. Some are
      quite expensive. All pose the risk that patients who use them will abandon
      effective treatment. The American Cancer Society therefore recommends that
      "nutritional cancer cures" be avoided.

PMID- 8364771
TI  - Clinical documentation of inflammation markers in asthma.

PMID- 8364772
TI  - Serum measurements of eosinophil cationic protein (ECP) in bronchial asthma.

PMID- 8364773
TI  - Clinical experience with the measurement of ECP: usefulness in the management of
      children with asthma.

PMID- 8364774
TI  - Canadian Cardiovascular Society Annual Meeting. Vancouver, British Columbia,
      October 27-30, 1993. Abstracts.

PMID- 8364775
TI  - Analysis of factors related to treatment and prognosis of leprosy patients in
      southern Taiwan.
AB  - This study was undertaken to investigate certain factors of leprosy, using
      bacterial indices, disability and regular treatment as outcome variables. One
      hundred and fifty seven leprosy patients were interviewed, face to face
      personally, using a standard questionnaire, and examined in order to grade these
      disabilities. Their clinic charts were reviewed and summarized. Percentage, Chi
      square test, Fisher's exact test and logistic regression were used to analyze the
      data. Most patients (88%) were of low educational level; 57% were regularly
      treated in 1985. About half of the patients were diagnosed within one year.
      Dapsone was used at first diagnosis, while multiple drug therapy was in present
      use. The mean correct answer rate of the knowledge of leprosy was 0.49.
      Interaction with family members was not unusual. The major reason for neglecting
      treatment of the disease was that "the time is not available". Many patients did
      not appreciate the severity of the disease. Univariate analysis found that both
      "drug usage at first diagnosis" and "current drug usage" were related to
      "bacterial index". Only one factor "time-to-diagnosis" was related to
      "disability". The factors related to "regular treatment" were the "the time is
      not available", and "religion". Multiple logistic regression analysis found that
      the results were the same as those in univariate analysis, except that two more
      significant continuous variables were also related to regularity of treatment:
      duration of disease and a score of "beliefs about leprosy", neither analyzed in
      univariate analysis.

PMID- 8364776
TI  - Colloidal bismuth subcitrate, ranitidine, and ranitidine plus metronidazole in
      the treatment of duodenal ulcer and Helicobacter pylori infection: a controlled
      and prospective study.
AB  - A controlled, prospective clinical trial of colloidal bismuth subcitrate (CBS),
      ranitidine and ranitidine plus metronidazole for the treatment of duodenal ulcer
      (DU) is reported here, with evaluation of the possible pathogenic role of
      Helicobacter pylori (HP) on DU in a six-month follow-up. A total of 42 patients
      with active DU on endoscopy were randomly selected to receive oral CBS (300 mg 1
      hour before each meal, and at bedtime, n = 16), ranitidine (150 mg bid; n = 12)
      or ranitidine (150mg b.i.d.) plus metronidazole (250 mg t.i.d; n = 14) treatment
      for one month. Ulcer healing was endoscopically evaluated. Healed patients
      received another two-week treatment; unhealed subjects received another one-month
      treatment with the same agents. Healed patients were followed endoscopically at
      1, 3, and 6 months after the cessation of medication without maintenance therapy.
      Unhealed or relapsed subjects were excluded. To assess HP status, during each
      endoscopy two prepyloric mucosal biopsies were taken for urease testing and
      culture of HP. The prevalence of HP in patients with DU was 95.2%. Data showed
      that those treated with CBS had a lower DU healing rate than those treated with
      ranitidine or ranitidine plus metronidazole after the one-month treatment, but
      there was no statistical significance in the DU healing rates after the two-month
      treatment, and at follow-up six months after the cessation of medication. After
      one month of treatment those treated by CBS showed the highest rates of HP
      clearance on gastric antral mucosa among the three groups.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8364777
TI  - Staging of bladder cancer by transabdominal real-time ultrasound.
AB  - In the past six years, there were 726 cases of proved bladder cancer in our
      hospital. Among these, 376 cases received transabdominal ultrasonographic
      examination of the urinary bladder for evaluation of the bladder tumor. Two
      hundred and fourteen cases of them were newly diagnosed as bladder cancer and had
      adequate pathological specimens for staging of the tumor. The retrospective
      comparison between preoperative local staging of the bladder tumor by ultrasound
      and final pathological report showed 78.5% of total accuracy, 9.8% of
      overstaging, and 11.7% of understaging. The accuracy is 87% for stage A tumor;
      60.5% for stage B; 41.2% for stage C; 83.3% for stage D. Strong echogenic foci on
      the surface or in the tumor were detected in 39.3% (84/214) of cases, which may
      indicate encrusted stones on the surface of the tumor or intratumoral dystrophic
      calcification. There was no strong correlation between tumor grading and staging,
      except that most of the grade I lesions were at stage A (30/31, 97%). The
      preoperative local staging of urinary bladder cancer by real-time ultrasound
      might be of great value to determine the management planning and prognosis of the
      patients.

PMID- 8364778
TI  - Dilatation of the biliary tract in pediatric patients.
AB  - Forty cases of dilatation of the biliary tract in infants and children were
      diagnosed and treated at the Veterans General Hospital, Taipei and Taichung
      between 1980 and 1992. The male to female ratio was 1:2.6 and the age ranged from
      1 day to 14 years. Major clinical presentations were abdominal pain (57.5%),
      jaundice (42.5%), vomiting (37.5%) and abdominal mass (30%); the classical triad
      of abdominal pain, jaundice and abdominal mass occurred in only three cases
      (7.5%). Abnormal liver function tests included elevated bilirubin (Bil) (22/37),
      aminotransferase (30/40), alkaline phosphatase (Alk-P) (34/37), lactic
      dehydrogenase (LDH) (22/34) and gamma-glutamyl transpeptidase (GGT) (13/15). The
      amylase in bile was detected in 16 cases with 10 cases higher than 500 Somogyi
      units/dL. All cases were diagnosed correctly, using real time sonography.
      Technetium-labeled scintiscan (Tc-99m DISIDA scan) was interpreted correctly in
      88% (15/17) and abdominal computerized tomography (CT) in 10 cases (10/10).
      According to Todani's classification, type I cyst was the most common (35 cases,
      87.5%) and the remaining cases were type IV-A (3 cases) and type V (2 cases).
      Operation was performed in 38 cases except for two who had type V dilatation of
      biliary tract (Caroli's disease). Complications included rupture of the gall
      bladder in two patients and common bile duct stone in one; mortality after
      operation occurred in one case. Surgical specimens of the liver revealed
      periportal fibrosis in nine instances.

PMID- 8364779
TI  - [Effect of implantation of an Ommaya reservoir on prognosis for cryptococcal
      meningitis].
AB  - Cryptococcal meningitis has a high mortality rate of central nervous infection.
      The patients usually die of the disease itself, or complications from increased
      intracranial pressure. Early diagnosis and treatment, including surgical
      drainage, will improve the results. In this series, twenty-one patients with high
      intracranial pressure (ICP > 300 mmH2 O) are presented. Fourteen received
      implantation of Ommaya reservoir to aspirate cerebrospinal fluid (CSF) for relief
      of symptoms of ICP. Meanwhile 4 of these 14 patients also received
      intraventricular injection of amphotericin B because of poor response to systemic
      drugs. Another seven patient received systemic drug therapy only. Survival during
      therapy occurred in 11 of 14 patients in the surgical group, compared with only 1
      of 7 patients treated by drug therapy alone (P = 0.019). In the 14 patients who
      received implantation of an Ommaya reservoir, there was one complication of CSF
      leakage when the reservoir ruptured because of repeated aspiration. For patients
      with cryptococcal meningitis with high ICP, early implantation of an Ommaya
      reservoir will improve the survival rate.

PMID- 8364780
TI  - [Efficacy of disodium cromolyn in adult chronic asthma].
AB  - Disodium cromolyn is effective in preventing asthma, but its steroid sparing
      effect remains controversial. In this prospective cross-over study, we used two
      different brands of disodium cromolyn, Intal and Ticromil, each for 4 weeks on 7
      adult patients with chronic asthma. The dosage was 20 mg qid via a special
      inhaler. The whole course of the study was 12 weeks for each patient, including 2
      run-in weeks and 2 wash-out weeks. Patients were followed up by the same
      physician at outpatient clinics every 2 weeks to measure FEV1, FVC, peak
      expiratory flow rate (PEFR), and reversibility after bronchodilator. The
      physician also assessed the severity of the patients' symptoms via a special
      score system. Patients recorded symptom severity and frequency of medications at
      home on daily diary cards. Patients also measured PEFR twice a day. At the end of
      the treatment, FEV1 was improved more in Intal group; daily prednisolone dosage
      was markedly reduced in Ticromil group; PEFR was improved in both group; but
      neither symptom severity nor airway reversibility was significantly changed. When
      two groups were calculated as a whole, PEFR increased significantly from 294 +/-
      20 l/min to 342 +/- 19 l/min (p = 0.0225). The daily prednisolone dosage reduced
      from 5.87 +/- 0.91 mg to 3.91 +/- 0.60 mg in the 3rd week and to 4.05 +/- 0.63 mg
      in the 4th week. The differences between these 2 dosages and the baseline dosage
      were statistically significant (both p < 0.05). Side effects were minimal in all
      patients. We concluded that after the use of disodium cromolyn for 4 weeks, PEFR
      was markedly improved and daily prednisolone dosage was also significantly
      reduced.

PMID- 8364781
TI  - Congenital tracheal stenosis: a report of two cases.
AB  - Congenital tracheal stenosis (CTS) is a rare, potentially lethal condition. Two
      cases were diagnosed in this hospital between 1986 and 1992. Diagnosis was
      confirmed by endoscopy and radiography. These two cases were noted to have
      symptoms of airway obstruction after an infectious process. Their outcomes were
      quite different. The first patient, a victim of CTS diagnosed at two years old,
      still lives well and has been asymptomatic for subsequent six years, though he
      has received no surgical intervention. The second patient, a three-month-old
      female, exhibited an exacerbation after bronchoscopy and died in spite of
      intensive care. Prompt recognition of symptoms and a thorough evaluation of
      airway, as well as other anomalies, is essential for proper management of
      children with CTS. The diagnostic modalities, management and risk factors are
      discussed.

PMID- 8364782
TI  - Malignant peritoneal mesothelioma: a case report.
AB  - Malignant peritoneal mesothelioma is a rare disease, not previously reported in
      Taiwan. The reported case concerns a 64-year-old veteran who had suffered from
      abdominal pain and distension for several days. After exploratory laparotomy,
      segmental resection of the small intestine, excised a mesenteric mass. A
      characteristic biphasic pattern resulting from the admixture of gland-like area
      and a sarcomatous stroma presented in the histologic section. A series of
      histochemical, immunohistochemical and ultrastructural studies proved this to be
      a malignant peritoneal mesothelioma. The patient died after a course of post
      operative chemotherapy. History of asbestos exposure, with which the tumor is
      usually intimately associated, could not be traced with certainty. Poor prognosis
      is the rule of the disease; almost all patients die within two years of
      diagnosis. An effective therapeutic modality is still unavailable. Here the
      clinical and pathologic characteristics of the tumor are described, with a brief
      review and discussion of the pathogenesis as well as the obscured therapeutic
      problem.

PMID- 8364783
TI  - [Combined pregnancy: a case report and literature review].
AB  - Combined or heterotopic pregnancy has been regarded as extremely rare in the past
      three decades. If it continues without diagnosis, a life-threatening situation
      may occur. A case of eight-week gestation is presented in which there was
      threatened abortion. The patient underwent exploratory laparotomy for internal
      bleeding. Upon operation, combined pregnancy, with a ruptured ectopic pregnancy,
      was diagnosed. Left salpingectomy was performed uneventfully. Neither chronic
      salpingitis nor administration of ovulation-induction agents was part of past
      history. A viable ongoing intrauterine pregnancy continued after operation, and a
      normal male was delivered by cesarean section after a 39-week gestation where
      labor progressed too slowly for normal delivery.

PMID- 8364784
TI  - [Infected common iliac aneurysm due to Salmonella: a case report].
AB  - A 62-year-old male, presenting with chills and fever and RLQ abdominal pain, was
      found to have an infected aneurysm of the right common iliac artery infected by
      Salmonella group C1. CT scan of abdomen and arteriography definitely identified
      the lesions. Antibiotic treatment and surgical intervention with aneurysmectomy
      and suprapubic crossover femoro-femoral artery graft resulted in a good recovery
      and outcome.

PMID- 8364785
TI  - Evaluation of the potential role of enzyme-linked immunosorbent assay in
      serodiagnosis of tuberculosis.
AB  - The serodiagnosis of tuberculosis was evaluated by means of enzyme-linked
      immunosorbent assay of IgG antibody to mycobacterial antigen 60. The study
      population consisted of 63 patients with active tuberculosis comprising 43
      pulmonary tuberculosis, 15 tuberculosis pleurisy, four miliary tuberculosis, and
      one tuberculous lymphadenitis. The control group consisted of 48 patients
      embracing 8 cases of inactive pulmonary tuberculosis, 31 cases of pulmonary
      disorders other than tuberculosis, and nine normal persons. There was a
      significant difference in antibody titers of sera between patients of active
      tuberculosis and control group (P < 0.001). The sensitivity of the test for
      active pulmonary tuberculosis was 81.4% and the specificity was 85.4% (cutoff
      value 300 units). The sensitivity for all active tuberculosis was 61.9%. There
      was positive correlation between serum titer of active pulmonary tuberculosis and
      the extent of disease on chest radiography (r = 0.4, P < 0.01). A positive
      correlation was found between the titers of pleural fluids, and the corresponding
      sera in 15 patients (eleven tuberculous pleurisy and four nontuberculous
      controls) (r = 0.85, P < 0.001). Whether serum or pleural fluid, the positive
      rate of the assay for tuberculous pleurisy was relatively low. In conclusion, the
      A60 IgG ELISA test may be useful in serodiagnosis of pulmonary tuberculosis and
      assessment of the disease extent, although it might not yield a high sensitivity
      for tuberculous pleurisy.

PMID- 8364786
TI  - Intraocular hemorrhage and mimicking lesions: role of gradient-echo and contrast
      enhanced MRI.
AB  - Intraocular hemorrhage and mimicking lesions on precontrast spin-echo magnetic
      resonance images were examined with contrast material and/or gradient-echo pulse
      sequence. Twenty-two melanomas, nine retinoblastomas, four hemorrhages, one
      metastasis, and one toxocara endophthalmitis were examined. With contrast
      material, all tumors demonstrated enhancement, whereas hemorrhage did not.
      Retinoblastomas demonstrated a heterogeneous enhancement pattern. Computed
      tomography demonstrated corresponding intratumoral calcifications at the areas of
      no enhancement. Gradient-echo images demonstrated a heterogeneous pattern in the
      majority of the lesions compared to spin-echo images. However, relatively
      characteristic small round areas of signal drop-off representing calcification
      were observed in about half of the retinoblastomas.

PMID- 8364787
TI  - Distribution of joint effusion in patients with traumatic knee joint disorders:
      MRI assessment.
AB  - One hundred forty-five knee magnetic resonance imaging examinations with joint
      effusions were reviewed to clarify the usual distribution of joint fluids in
      patients with traumatic knee joint disorders. Almost all knees (99%) had
      effusions in the central portion, and most knees (76%) had effusions in the
      suprapatellar pouch. Effusions were rarely found in the posterior femoral recess
      (9%) or subpopliteal recess (2%). However, this difference was considered to be
      only a reflection of anatomic communications. Effusions were occasionally found
      around posterior cruciate ligaments (36%), but were less frequently seen around
      anterior cruciate ligaments (18%).

PMID- 8364788
TI  - CT manifestations of lipomas of the small intestine and colon.
AB  - Seven cases of lipoma of the intestine demonstrated by computed tomography (CT)
      are reported. There were three men and four women who ranged in age from 47 to 78
      years. The lipomas were in the small intestine in four patients, and in the colon
      in three. CT documented the characteristic low attenuation (fat density) of these
      masses in all patients. It is concluded that intestinal lipomas are important
      indications for CT evaluations.

PMID- 8364790
TI  - CT and MRI manifestations of intraabdominal panniculitis.
AB  - We report a case of intraabdominal panniculitis. Computed tomography (CT) showed
      diffuse increased attenuation in the omentum, mesentery, and retroperitoneal
      region. As the disease progressed, the entire mesentery and retroperitoneal
      regions were involved. On magnetic resonance imaging (MRI), the lesion
      demonstrated an intermediate signal intensity on T1-weighted images and a
      slightly high signal intensity on T2-weighted images. Though the radiologic
      findings are not specific, this condition should be considered in the appropriate
      clinical context.

PMID- 8364789
TI  - Adenomyomatous hamartoma causing ileoileal intussusception in a young child.

PMID- 8364792
TI  - The role of computed tomography in management of patients with Crohn disease.
AB  - Twenty-five patients with Crohn disease were studied using computed tomography
      (CT). Assessment of bowel wall thickening, enlargement of the mesenteric lymph
      nodes, and clearness of the mesenteric vascular contour was carried out in all
      patients. Evidence of inflammatory reaction of the mesenteric fat was seen in 23
      patients (92%) and fibrofatty proliferation was observed in seven patients (28%).
      Nine patients underwent surgery when symptoms and signs were severe and of long
      duration, while 16 patients were treated conservatively. Degree of increase in
      fat density, clearness of the mesenteric vascular bundles, and enlargement of the
      mesenteric lymph nodes were seen more frequently in the surgical group of
      patients. CT shows improvement of inflammatory changes after conservative therapy
      in some cases. A large pseudodiverticulum, pseudopolyps, and a fistula formation
      were also observed in some cases. CT is an important diagnostic tool in the
      management of patients with Crohn disease.

PMID- 8364791
TI  - Computed tomography evaluation of posttraumatic pulmonary pseudocysts.
AB  - Two cases of posttraumatic pulmonary pseudocyst are reported. The characteristic
      thin-walled cystic lesions with air-fluid level were demonstrated in both cases
      by computed tomography but in only one case by conventional chest radiography. It
      is predicted that more such pseudocysts would be identified by using computed
      tomography with patients with blunt chest trauma.

PMID- 8364794
TI  - Retroperitoneal leiomyosarcoma. Its MR manifestations.
AB  - The magnetic resonance manifestations of retroperitoneal leiomyosarcomas in two
      patients are described. The tumors were isointense to muscle on T1-weighted
      images and exhibited a relatively high signal on T2-weighted images. Postcontrast
      T1-weighted images after the administration of gadolinium
      dietilenetriaminepentaacetic acid produced moderate enhancement except in regions
      of central necrosis.

PMID- 8364795
TI  - Computed tomography of an exophytic gastric hemangioma with torsion and
      intratumoral hemorrhage.
AB  - A case of exophytic gastric hemangioma with intratumoral bleeding due to torsion
      of the tumor pedicle is reported. A radiograph showed a mass without phleboliths.
      Computed tomography (CT) demonstrated a 14-cm mass with high densities due to
      hemorrhage, which was contiguous to the stomach and extended to the pelvis. The
      tumor showed no remarkable enhancement on post-enhanced CT due to torsion of the
      tumor pedicle.

PMID- 8364793
TI  - Primary ovarian tumors in the pediatric patient: CT evaluation.
AB  - Primary ovarian tumors in the pediatric age group are rare with limited
      descriptions on computed tomography (CT). We describe the CT findings in a series
      of nine mature cystic teratomas, one immature teratoma, two granulosa cell
      tumors, and one undifferentiated small cell tumor. Four mature cystic teratomas
      were atypical in their CT appearance. The immature teratoma was distinguished by
      its large, irregular, diffusely calcified solid component. The malignant tumors
      were large and nearly totally solid, or if multicystic, contained a large solid
      component.

PMID- 8364796
TI  - Iliac artery aneurysms. Radiographic evaluation.
AB  - We present seventeen cases of iliac artery aneurysm employing a variety of
      different imaging modalities (ultrasound, computed tomography, arteriography,
      magnetic resonance imaging). The utility of each of these techniques in the
      patient with iliac artery aneurysm is described.

PMID- 8364797
TI  - Diagnostic imaging update in skeletal dysplasias.
AB  - The mystique of bone dysplasias is gradually vanishing. A short historical
      overview introduces the subject of short stature. The pathogenesis and
      controversial classification of skeletal dysplasias are discussed and summarized
      in two tables; the use of different imaging modalities is laid out along the
      sequential diagnostic approach and review of common orthopedic complications.
      References to such advances in treatment as bone marrow transplantation, bone
      lengthening, and the encouraging positive effect of growth hormone therapy
      complete this updated revision.

PMID- 8364798
TI  - Dyspnea and chest pain in a 14-year-old boy.

PMID- 8364799
TI  - Highly presumptive identification of bacterial isolates associated with the
      recent Canada-wide mastitis epizootic as Nocardia farcinica.
AB  - A highly presumptive identification of Nocardia farcinica was made of 47
      bacterial isolates. Fifteen isolates from Alberta, 9 from Ontario, and 2 each
      from New Brunswick, Newfoundland, and Nova Scotia were from clinical cases
      involved in the Canadian mastitis epizootic. Seventeen additional isolates from
      Alberta were recovered from farm milk bulk tanks from herds found to have cows
      involved in the epizootic. All isolates were shown by high-performance liquid
      chromatography to possess mycolic acids of a size consistent with the genus
      Nocardia. All isolates were resistant to a concentration of 5 micrograms/mL of
      mitomycin C. Forty-five isolates grew well and 2 showed reduced growth in the
      presence of 50 micrograms/mL of kanamycin acid sulfate. Forty-six isolates were
      resistant to 5-fluorouracil at a concentration of 20 micrograms/mL. All isolates
      were resistant to lysozyme. Resistance to these compounds supported the placement
      of the isolates in the genus Nocardia. Thirty-five isolates produced strong beta
      galactosidase reactions and 12 showed weak reactions. The demonstration of beta
      galactosidase activity further supports the identification of the isolates as
      nocardiae. Attempts to identify the bacteria to species by high-performance
      liquid chromatography of mycolic acid esters were frustrated, since two species
      of Nocardia were found to have indistinguishable mycolic acid patterns. The
      physiological and growth characteristics of the isolates were consistent with
      Nocardia farcinica.

PMID- 8364800
TI  - Potential for carboxylation-dehydroxylation of phenolic compounds by a
      methanogenic consortium.
AB  - An anaerobic consortium that carboxylated and dehydroxylated phenol to benzoate,
      and 2-cresol to 3-methylbenzoic acid, under methanogenic conditions was studied.
      Phenol induced this transformation activity. Addition of 4-hydroxypyridine or an
      increase in the concentration of proteose peptone to 0.5% (w/v) delayed the
      transformation. Phenol enhanced the rate of transformation of 2-cresol whereas 2
      cresol delayed the transformation of phenol. Phenols with ortho-substitutions
      (chloro-, fluoro-, bromo-, hydroxyl-, amino-, or carboxyl-) were transformed to
      meta-substituted benzoic acids. However, meta- and para-substituted phenols
      (cresols, fluorophenols, and chlorophenols) were not transformed. Phenol was most
      rapidly metabolized, followed by catechol, 2-cresol, 2-fluorophenol, 2
      aminophenol, 2-chlorophenol, 2-hydroxybenzoic acid, and 2-bromophenol. The
      consortium O-demethylated anisole to phenol and 2-methoxyphenol to catechol, and
      oxidized 2-hydroxybenzyl alcohol to 2-hydroxybenzoic acid. Aniline, 2
      ethylphenol, 2-hydroxypyridine, 2-acetamidophenol, 2,6-dimethylphenol, 2
      phenylphenol, and 1-naphthol were not metabolized.

PMID- 8364801
TI  - The 73-kb pIAA plasmid increases competitive fitness of Pseudomonas syringae
      subspecies savastanoi in oleander.
AB  - Pseudomonas syringae subsp. savastanoi causes tumors on olive and oleander by
      producing the plant growth regulators indoleacetic acid (IAA) and cytokinins
      following infection of the plant. The contribution of IAA production to the
      ability of P. syringae subsp. savastanoi to grow and survive in oleander leaf
      tissue was studied. Bacterial strains differing only with respect to IAA
      production were characterized. Growth and survival of wild-type and two mutant
      strains of P. syringae subsp. savastanoi in oleander leaf tissue were monitored
      by weekly colony counts and IAA plate assays. Growth rate of the three strains in
      culture and in planta did not differ significantly. However, the wild-type strain
      reached a higher population density and maintained its maximum density at least 9
      weeks longer than either mutant population. An insertion mutant containing the
      IAA plasmid (pIAA), but incapable of IAA production, did not maintain a higher
      population density than a strain cured of the IAA plasmid. The pIAA-cured strain
      maintained a higher population density when coinoculated with an IAA-producing
      strain than when inoculated alone. These results suggest that IAA production may
      contribute to the fitness of P. syringae subsp. savastanoi in oleander tissue and
      that the iaa operon alone may be responsible for the competitive advantage of
      cells harboring pIAA.

PMID- 8364802
TI  - Phylogenetic grouping and identification of Rhizobium isolates on the basis of
      random amplified polymorphic DNA profiles.
AB  - Through the use of a single, random 15mer as a primer, between 1 and 12 DNA
      amplification products were obtained per strain from a selection of 84 Rhizobium
      and Bradyrhizobium isolates. A principal-coordinate analysis was used to analyse
      the resulting amplified DNA profiles and it was possible to assign isolates to
      specific groupings. Within the species Rhizobium leguminosarum, the biovar
      phaseoli formed a distinct group from the other biovars of the species, viciae
      and trifolii, which grouped together. Isolates of Rhizobium meliloti and
      Bradyrhizobium species formed their own clear, specific groups. Although it was
      possible to identify individual isolates on the basis of differences in their
      amplified DNA profiles, there was evidence that some amplified segments were
      conserved among individuals at the biovar and species levels.

PMID- 8364803
TI  - Distribution and identification of proteolytic Bacillus spp. in paddy field soil
      under rice cultivation.
AB  - Proteolytic bacteria in paddy field soils under rice cultivation were
      characterized and enumerated using azocoll agar plates. Bacillus spp. were the
      proteolytic bacteria that were most frequently present, comprising 59% of the
      isolates. They were always the numerically dominant proteolytic bacteria isolated
      from three kinds of fertilizer treatments (yearly application of rice-straw
      compost and chemical fertilizer, yearly application of chemical fertilizer, and
      no fertilizer application) and at three different stages of rice development
      (vegetative growth stage, maximal tillering stage, and harvest stage). Of the 411
      proteolytic bacteria isolated, 124 isolates had stronger proteolytic activity
      than others on the basis of gelatin liquefaction tests and most of them were
      Bacillus spp. (100% in 1989 and 92.4% in 1991). Bacillus subtilis and Bacillus
      cereus were the main bacteria of this group and Bacillus mycoides, Bacillus
      licheniformis, and Bacillus megaterium were also present. We conclude that these
      Bacillus spp. are the primary source of soil protease in these paddy fields.

PMID- 8364804
TI  - Opsonin-independent adherence and intracellular development of Legionella
      pneumophila within U-937 cells.
AB  - Legionella pneumophila adhered to and multiplied intracellularly in the human
      histiocytic lymphoma U-937 cell line. The infectious process was evaluated by
      viable bacterial cell colony counts and documented by transmission and scanning
      electron microscopy. In the absence of opsonins, wash-resistant bacterial
      adherence to host cells occurred within 1 h and attachment of 1 or 2 organisms
      per U-937 host cell involved close surface interactions at the prokaryotic and
      eukaryotic membranes. Intracellular multiplication of bacteria was maximal by 24
      h after inoculation of cell monolayers. Release of L. pneumophila from these
      cells appeared as a lytic process that resulted in an increase in the numbers of
      microorganisms in the extracellular fluids and a concomitant decline in the
      number of intracellular bacteria. The course of cellular infection was completed
      by 72 h. The cellular and ultrastructural events of L. pneumophila adherence and
      uptake by U-937 cells in the absence of antibody or complement have been defined.
      In addition, this work further establishes the U-937 cell as a suitable model for
      investigating Legionella--host cell interactions.

PMID- 8364805
TI  - Rural health care.

PMID- 8364806
TI  - Sentence: education in ethics.

PMID- 8364807
TI  - Alternative funding plans.

PMID- 8364808
TI  - More on physician location.

PMID- 8364809
TI  - More on physician location.

PMID- 8364810
TI  - Growth of self-help movement.

PMID- 8364811
TI  - Skin lesions not limited to AIDS.

PMID- 8364812
TI  - Cardiac arrest in your community: are there weak links in the chain of survival?

PMID- 8364813
TI  - Cancer trends and health care.

PMID- 8364815
TI  - The new American Heart Association guidelines for cardiopulmonary resuscitation
      and emergency cardiac care: presented by the Emergency Cardiac Care Subcommittee
      of the Heart and Stroke Foundation of Canada.
AB  - CPR courses (both basic and advanced) continue to evolve. The recent CPR and ECC
      guidelines by the AHA consolidate the research and vast experience in one
      document. These guidelines are helpful to lay people and health care
      professionals who intervene in cases of cardiac arrest. They are also excellent
      resources for those involved in coordinating ECC systems in the community.

PMID- 8364814
TI  - Report of the Canadian Hypertension Society Consensus Conference: 3.
      Pharmacologic treatment of essential hypertension.

PMID- 8364817
TI  - To each according to need: a community-based approach to allocating health care
      resources.
AB  - OBJECTIVE: To develop a method of allocating publicly funded health care
      resources among communities according to their relative levels of need for health
      care independent of their current patterns of use. DESIGN: For each health care
      program population mean levels of resource allocation were calculated and were
      adjusted for age and sex to produce a national age- and sex-adjusted share of
      program resources. Indices of relative need for health care (for most programs
      the standardized mortality ratio) were derived from existing data on aspects of
      illness and death and were then used to weight the age- and sex-adjusted shares
      for between-community differences in health risks and health care needs. SETTING:
      The populations of the 49 counties in Ontario were used as the communities among
      which resources were allocated. Health care expenditures in 1988-89 by the
      Ontario Ministry of Health were used as the "budget." MAIN RESULTS: Age- and sex
      adjusted resource allocations weighted for between-community differences in
      health care needs differed from allocations based on population size, in certain
      cases by up to 100%. CONCLUSION: Existing data can be used to propose allocations
      of health care resources that relate to relative levels of need for care across
      communities.

PMID- 8364816
TI  - Nonsteroidal anti-inflammatory drugs for the prevention of colon cancer.
AB  - OBJECTIVE: To summarize the results of animal and human studies of the effect of
      nonsteroidal anti-inflammatory drugs (NSAIDs) on neoplastic growth in the colon
      and to outline the possible mechanisms involved. DATA SOURCES: Research articles
      published in English before June 1992 were identified from MEDLINE. STUDY
      SELECTION: Nine articles on the polyp-cancer sequence were reviewed, 8 on the
      apparent pathophysiologic aspects of tumour inhibition by NSAIDs and 22 on animal
      and human research into the effect of NSAIDs on colon carcinogenesis. RESULTS:
      The results of animal and human research into the anticarcinogenic effect of
      NSAIDs suggest that the drugs are effective in preventing tumour growth in the
      colon. CONCLUSIONS: Intervention studies in humans are necessary to elucidate the
      therapeutic possibilities of NSAIDs, particularly in populations at increased
      risk for the development of colon cancer.

PMID- 8364818
TI  - Prostate cancer trends in Canada: rising incidence or increased detection?
AB  - OBJECTIVES: To analyse trends in the incidence and mortality rates of prostate
      cancer in Canada according to age distribution, temporal pattern and provincial
      variation; to determine any association with the rate of prostatectomy; and to
      determine whether any observed increase in the rate of prostate cancer was due to
      an increase in the detection rate. DESIGN: Descriptive epidemiologic study based
      on Canadian population data from 1959 to 1989 and chart review from one Canadian
      hospital. SETTING: The chart review was conducted at the Ottawa Civic Hospital.
      SUBJECTS: The data on prostate cancer trends were obtained from the Canadian
      population. Charts were reviewed for two groups of patients: (a) men discharged
      from inpatient care during 1976 and 1986-87 with prostate cancer first diagnosed
      in the same year and (b) men who underwent transurethral resection of the
      prostate (TURP) during 1976 and 1986. OUTCOME MEASURES: Incidence and mortality
      rates of prostate cancer, rates of prostatectomy and TURP, and correlations
      between them. From the hospital data, changes between 1976 and 1986-87 in
      distribution of cancer stages, distribution of cases detected incidentally after
      surgery for suspected benign prostatic hypertrophy and average number of slides
      analysed per gram of tissue obtained from prostatectomy. RESULTS: The
      epidemiologic data showed that the age-adjusted incidence rates increased by 72%
      overall, an increase seen in all age groups over 60 years. The mortality rates
      increased by 29% overall, primarily in men over 85 years old. The prostatectomy
      rate increased by 55%. There were significant linear correlations between the
      national and provincial incidence rates of prostate cancer and the TURP rates.
      The chart review revealed that during 1976, 53% of the cases of prostate cancer
      diagnosed were localized, as compared with 75% in 1986-87 (p < 0.01). The
      proportion of tumours diagnosed incidentally in men undergoing TURP increased by
      11%, whereas the number of procedures did not increase. Significantly more slides
      per gram of tissue were analysed in 1986-87 than in 1976 (p < 0.01). CONCLUSIONS:
      The correlations between the incidence rates of prostate cancer and those of TURP
      suggest that increased treatment of benign prostatic disease has led to increased
      detection of prostate cancer. Extrapolation of the data obtained from the chart
      review indicates that the increase in observed incidence rates can be attributed
      to an increase in the rate of localized disease and thus primarily to early
      detection rather than to elevated risk. However, because the rate of death from
      prostate cancer was elevated in elderly men, increases in exposure to
      unestablished risk factors cannot be ruled out.

PMID- 8364819
TI  - Prevalence of and risk factors for sudden infant death syndrome in Canada.
AB  - OBJECTIVE: To analyse and describe the prevalence of sudden infant death syndrome
      (SIDS) in the Canadian population in relation to the distribution of known risk
      factors for the syndrome. To explain the observed interprovincial variation in
      SIDS rates. DESIGN: Retrospective population-based case-control study. SETTING:
      All the provinces and territories of Canada except Quebec. SUBJECTS: The birth
      and infant death records of singleton births for 1986-88 were linked. The linkage
      was successful in matching 904 (86%) of the 1053 deaths attributed to SIDS to the
      birth file for the infant. For each SIDS case three control babies who survived
      infancy were chosen at random, matched by province of birth. MAIN OUTCOME
      MEASURES: Infant death classified as a "sudden infant death." Independent
      variables included infant's sex, birth weight and gestational age, being small
      for gestational age, mother's age, marital status and parity, and father's age.
      RESULTS: The risk of SIDS was greater for boys (odds ratio [OR] 1.47, 95%
      confidence limits [CLs] 1.26 and 1.70) than for girls and was greater for the
      infants of unmarried women (OR 3.48, 95% CLs 2.94 and 4.11) than for those of
      married women. The risk of SIDS was inversely related to birth weight (p <
      0.001), duration of pregnancy (p < 0.001) and mother's age (up to age 35) (p <
      0.001) and was directly related to parity (up to four) (p < 0.001). The available
      information on birth and death registrations enabled about 30% of deaths from
      SIDS to be predicted. CONCLUSIONS: Logistic regression equations based on the
      risk factors available in vital statistics data have low power to predict
      provincial differences in rates of SIDS. Consequently, there may be additional
      factors that may explain provincial variation. There is a need for a well
      designed case-control study that examines more variables than are available
      through vital registration systems.

PMID- 8364820
TI  - No prescription for despair.

PMID- 8364821
TI  - Statement on influenza vaccination for the 1993-94 season. The National Advisory
      Committee on Immunization.

PMID- 8364822
TI  - Life after Nancy B.

PMID- 8364823
TI  - British nurse gets life sentence after conviction for work-related murders.

PMID- 8364824
TI  - MDs in newly independent Latvia struggle to learn about medical advances in West.

PMID- 8364825
TI  - "Second sexual revolution" creating STD crisis in Canada, doctor warns.

PMID- 8364826
TI  - Controlled-drinking advocates challenge use of abstinence model in treatment of
      addiction.

PMID- 8364827
TI  - Sweeping demographic changes may provide major challenges for Canada's doctors.

PMID- 8364828
TI  - Legislative and regulatory update: federal reimbursement revisited.

PMID- 8364829
TI  - Shared governance: a power shift.

PMID- 8364830
TI  - Development of a transcultural health education program for the Hmong.
AB  - CNSs face unique opportunities and challenges in meeting the health care needs of
      culturally diverse populations. As an education consultant involved in the
      development and implementation of a transcultural health education program, a CNS
      is required to have expert knowledge of the target population's health beliefs,
      values, and practices as well as knowledge of their language, level of literacy,
      and traditional teaching-learning styles. A critical consideration includes the
      use of a pluralistic model of education that addresses both the implicit and
      explicit conditions of learning and education. This paper describes the model and
      its application in the development and implementation of a health education
      program for the Hmong. The transcultural education process is examined and
      analyzed for appropriateness and effectiveness.

PMID- 8364831
TI  - A program for water-intoxicated patients at a state hospital.
AB  - During normal circumstances, individuals have a delicate balance of water
      requirement and water intake. If the balance of water is altered, electrolyte
      imbalance can occur. If fluid intake continues uncurbed, an extreme condition may
      result known as self-induced water intoxication and psychoses. If untreated,
      complications may develop, including dilated and hypotonic bowel and bladder,
      hydronephrosis, renal failure, congestive heart failure, mild confusion, acute
      delirium, seizures, coma, and death. The ongoing problem of water intoxication
      presents a modern day nursing challenge to psychiatric nurses. The present study
      monitors nine chronically ill patients in a special program for water
      intoxication involving control and monitoring and a psychoeducational group
      approach in a closed unit of a state hospital. At the end of 3 months serum
      electrolytes, serum osmolality, and urine specific gravity were within normal
      limits since the start of the program. Anxiety, as evidenced by restlessness,
      pacing, increased talking, demanding behavior, hyperactivity, yelling, and
      irritability, had lessened. This improvement was accompanied by a stabilization
      of psychotic behavior. The use of restraints dropped from 1303 hr in the 3 months
      before the program to 20 hr and 55 min for the nine patients in the first 3
      months of the program. Progress in relation to the study hypothesis will be
      evaluated every 3 months.

PMID- 8364832
TI  - The role of the nurse in advanced practice in bereavement care.
AB  - The CNS may be instrumental in assisting patients, families, and staff in dealing
      effectively with loss and grief. This paper presents a review of theoretical and
      research literature examining theories and current research on grief. Physical
      and emotional responses to loss are discussed, and factors that influence the
      bereavement process are presented. The role of the CNS in facilitating grief
      resolution and in assisting the staff nurse to intervene appropriately with the
      bereaved is examined.

PMID- 8364833
TI  - Reminiscence: a viable option to enhance power in elders.
AB  - The purpose of this study was to investigate the usefulness of reminiscent
      storytelling as a therapeutic modality to enhance the sense of power in well
      elders (ages 60-86). The study was conceptualized within Rogers' (1986) Science
      of Unitary Human Beings and focused on Barrett's theory of power. A pre- and
      posttest design with experimental and control groups was used with Barrett's
      Power as Knowing Participation in Change Test, Version II as the measure of power
      (personal control). Experimental group subjects were pretested and then
      participated in three reminiscence sessions during a 1-week period. Subjects were
      then posttested both at the end of the reminiscence sessions and again after a 5
      week interval. Control group subjects were tested on a schedule identical to that
      of the experimental group, but participated in no reminiscence sessions. Although
      an overall significant difference (p = 0.003) in scores was found over the
      testing period, no differences were found between experimental and control
      groups. Both experimental (n = 34) and control (n = 41) groups demonstrated a
      small but insignificant decrease in power between the pretest and posttest 1.
      Both groups then experienced a significant increase in power between posttest 1
      and posttest 2. It is recommended that research energies continue to be directed
      toward the investigation of this topic. In our contemporary high tech world which
      often allows minimal human contact and diminishing quality of life for the aged,
      novel modalities such as reminiscence offer a human to human exchange, which may
      hold the key to this modern-day challenge.

PMID- 8364834
TI  - The association between CNS direct care time and total time and very low birth
      weight infant outcomes.
AB  - This study examined the association between the amount of direct care time and
      total time (direct and administrative) spent by CNSs with families of 39 very low
      birth weight infants (< or = 1500 grams) and infant outcomes (rehospitalizations
      and acute care visits). Documentation of the CNSs' time spent with infants and
      families was recorded during infant hospitalization and for 18 months after
      infant discharge. The number of infant rehospitalizations and acute care visits
      was recorded from hospital and physician records. The mean total time the CNS
      spent per infant for the 18-month period was 27.3 hours. After discharge, there
      were significant relationships between the amount of CNS direct care time and the
      number of acute care visits (r = 0.45, p < 0.01) and infant rehospitalizations (r
      = 0.51, p < 0.01). Although the study findings did not demonstrate improved
      infant outcomes associated with the amount of time the CNS spent with this high
      risk population, they document the amount of CNS time spent in intervention and
      follow-up of these infants. This study provides data for costing home visiting by
      the CNS in this patient population.

PMID- 8364835
TI  - Oh no, they're coming!

PMID- 8364836
TI  - Preparing the CNS for participation in quality assurance activities.
AB  - Preparation of CNSs must include advanced knowledge in the area of clinical
      specialty and experience in the various subroles of the clinical specialist. In
      order to enhance students' knowledge and skills related to these subroles, the
      authors instituted a clinical project focusing on quality assurance activities
      for students enrolled in the medical-surgical nursing major in a large graduate
      nursing program. Students begin the project during the clinical practicum by
      identifying an area in need of quality assurance monitoring. Students then
      develop monitoring tools, collect data, and make recommendations for changes in
      clinical practice. The project gives the students practical experience in an
      important area of clinical specialist practice and can be adapted or expanded for
      any clinical major.

PMID- 8364837
TI  - The CNS role: evolution within a shared governance environment.
AB  - Organizational change has a profound impact on the role of the CNS. Movement in
      our institution from a centralized structure to a shared governance philosophy
      redirected the work of the CNS. This article describes the change response spiral
      that reflects the CNS role evolution and activities required by the CNS to foster
      the change. Three phases of the response spiral are highlighted: creating a
      culture, restructuring, and adaptation. CNS activities and experiences associated
      with the change will be of interest to administrators and CNSs.

PMID- 8364838
TI  - Communicating the financial worth of the CNS through the use of fiscal reports.
AB  - To maintain the clinical nurse specialist's (CNS's) leading role within hospital
      nursing services, routine communication to hospital administration of the impact
      of the CNS role on the hospital's budget is imperative. The CNS group at
      Children's Hospital of The King's Daughters implemented a quarterly Fiscal Report
      to clarify the financial worth of CNS practice. The Fiscal Report presents cost
      savings and revenue generating activities utilizing the role components of the
      CNS. During fiscal year 1991, the CNS group reported a total impact of
      $1,600,000. This article describes in detail the use of the Fiscal Report.

PMID- 8364839
TI  - A patient-centered solution to an institution's need for information.

PMID- 8364840
TI  - The collaborative role of the CNS in support groups.
AB  - This project's purpose was to illustrate how the CNS is central to developing a
      support group using consultation and collaboration. Identification of patient and
      family needs is a growing challenge in general medicine. Otherwise left
      unresolved, the needs of the patient and family are addressed and met through the
      support group.

PMID- 8364841
TI  - The Bergmann Foot Scanner for automated orthotic fabrication.
AB  - The word automation sometimes can be misleading. I believe that some feel that
      automation of orthotic manufacturing results in a system in which orthotics are
      mass produced. Still others believe that the main reason for automation is to
      make orthotics quicker and cheaper and not individualized. As far as the author's
      laboratory is concerned, nothing could be further from the truth. We think of
      automation as the use of computer technology to make orthotics that are more
      accurate and more specialized as to the doctor's specific requirements. This is a
      method that takes the expertise of the podiatrist and the laboratory technician
      and gives them a tool that can be used to achieve the perfection in orthotic
      fabrication they are trying to attain. In testing out new types of cast
      correction designs, computer-designed images will give the repeatability needed
      in scientific research not found with manually applied corrections. The optical
      scanner has given us more than just a means of sending a cast to the laboratory
      quickly. It has turned out to be a method to help explain biomechanics of the
      patient's foot in a clear and concise way. We also have watched it develop into a
      research tool that podiatry schools and others can use to verify and further
      biomechanical principles.

PMID- 8364842
TI  - Computer-generated orthoses. A review.
AB  - It is obvious with the various casting techniques used in the study that the ease
      with which individuals adjust to the fashionette orthotic makes it a desirable
      device. It is tolerated well with higher-heeled shoes and shoes that are used
      more for fashion purposes. Future studies need to assess the degree of control
      compared with the type of deformity and the type of symptoms the patient has.
      These types of devices may be sufficient to minimize stress on a given deformity,
      such as a neuroma, but may not be sufficient enough to eliminate the need for the
      removal of the neuroma. Recurrence of the neuroma after it has been resected and
      the patient prescribed a fashionette orthosis also needs to be assessed. A
      neuroma is one example of a type of deformity that needs to be controlled and
      evaluated with regard to cause and response to orthotic therapy. Abnormal tylomas
      and pressure lesions need to be assessed on a symptomatic basis for their control
      with the different types of devices and the pathomechanic causing the pressure.
      This study indicates that milled orthoses are tolerated better than pressed
      orthoses. Milled orthoses require less adjustment and the adjustment is tolerated
      better, regardless of the casting position. The degree of position control had
      some variations. When comparing the pressed and the milled functional orthoses,
      there is a more rapid adjustment with the milled type of orthoses. This suggests
      that possibly the milled orthoses have less alteration in shape and loss of
      contour from the direct milling and the digitizing process compared with the
      pressing techniques. The long-term effect of pressing compared with milled
      orthotics was not assessed during this study with regard to fluid distortion of
      the polypropylene over time. The fluid nature has a tendency to suffer a loss of
      contour and progressive loss of function. The milled process theoretically has
      less change in the contour with the passage of time, although this needs to be
      assessed in further studies. Possibly, the fluid nature of the orthosis can be
      assessed by determining how soon the symptoms return between adjustments. Posting
      surfaces tend to wear over a period of time and distort with the fluid nature.
      The posting can break down from the type of material from which it is made. A
      model of assessment for future studies may be to check the duration of when heel
      spur types of symptoms or postural complex types of symptoms, such as knee pain
      or lower back pain, recur.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8364843
TI  - In-office computerized fabrication of custom foot supports. The AMFIT System.
AB  - This article familiarizes the podiatric physician with computer-aided design and
      manufacturing of custom orthoses in an office setting using the AMFIT System.
      Topics discussed include machine specifications and descriptions, data
      acquisition, and finishing.

PMID- 8364844
TI  - An overview of foot pressure measurement systems.
AB  - Pressure measurement systems are increasingly important for the clinician in the
      1990s; however, choosing the right device is still not an easy task. This
      article, an overview of current technologies, focuses on the basic principles of
      new systems and clarifies technical specifications but does not judge specific
      brands. Based on long-term experience with pressure measurement systems,
      requirements for everyday use are made and discussed with respect to currently
      available technologies. For all persons who are in the process of buying a
      system, this article serves as a reference to help them find the most ideal
      system for a specific application.

PMID- 8364845
TI  - The PEL-38 Electronic Podometer for static and dynamic analysis of foot
      biomechanics.
AB  - The PEL-38 Podometer is a practical computer system for the analysis of foot
      function. Designed, tested and used at leading medical centers on the European
      continent, it has been introduced in the United States by Physical Support
      Systems (6 Ledge Road, Windham NH 03087; 1-800-222-5009). The PEL-38 Podometer
      measures, records, and graphically analyzes foot pressure distribution in both
      static and dynamic modes.

PMID- 8364846
TI  - The E.D.G. System for dynamic analysis of gait.
AB  - It is important to recognize that the value of the E.D.G. system requires a
      higher level of understanding of the biomechanics of the lower extremity. This is
      needed to correlate the information gathered from the system with the actual
      episodes that are accurate. In addition, it is important to remember that the
      acquisition of any clinical assessment instrument should be based on what
      information you are attempting to acquire and whether the instrument can provide
      it. Ask yourself, "what do I want to know, and can this instrument provide the
      answers?" This article has been written to acquaint the reader with a working
      knowledge of the E.D.G. system, the science of clinical electrodynography, and
      its use as a clinical tool. The addition of dynamic in-shoe data to the basic
      static information allowed from a patient examination adds a new dimension to
      clinical assessment. Clinical decision making and treatment programs can now be
      instituted with reasonable assurance of a favorable outcome.

PMID- 8364847
TI  - The EMED System of foot pressure analysis.
AB  - The EMED System is actually a family of individual modules developed to measure
      and record pressure distribution under the plantar surface of the foot to provide
      important information regarding the loading characteristics of the lower
      extremity. One must distinguish between static measurements taken while the
      patient is standing and dynamic measurements taken during locomotion. With static
      measurement, it is not possible to determine the form or the loading pattern of
      the foot during function. Dynamic measurements are used to determine loading
      during the actual stance phase of gait, quantified by parameters such as the
      length and width changes of the foot, angle of gait, digital function, high
      pressure points, and many other parameters. Important measurement parameters are
      calculated automatically using either EMED-Intern or EMED-Extern software. Each
      module of the EMED System is designed specifically to provide the clinician or
      investigator with the appropriate tool to collect data for analysis of function,
      direct therapy, and aid in the diagnosis of functional foot problems.

PMID- 8364849
TI  - The optical pedobarograph.
AB  - The optical pedobarograph has proven to be very helpful in studying foot pressure
      abnormalities in a variety of clinical conditions and especially in diabetes
      mellitus and rheumatoid arthritis. Studies using this device have provided a very
      good insight into the etiopathogenesis and natural history of foot disorders. It
      has also allowed the conduction of intervention trials which assess the efficacy
      of new treatment. The main advantages of the pedobarograph include accuracy,
      reliability and high spatial resolution. Its drawbacks are its size and that it
      can only measure pressures between the foot-floor interface.

PMID- 8364848
TI  - The F-SCAN system of foot pressure analysis.
AB  - The age of computerized gait analysis is here. There are several systems
      available to meet the needs of the podiatric practitioner. This author believes
      that the F-SCAN technology system makes a significant contribution to the
      practice of podiatric medicine. The system is user friendly, accurate,
      reproducible, and affordable. Its graphic display capabilities are colorfully
      attractive and easily understood. The primary focus of the F-SCAN system is that
      of peak pressure distribution over time. Vertical plantar pressure dispersion
      across the plantar surface of the foot is recorded, processed, and graphically
      displayed in terms of sequential gait changes. The system further allows for the
      manipulation of the accumulated data to present it in a more comprehensive
      manner. Future updates on the F-SCAN software are already close at hand and are
      expected to enhance the diagnostic capabilities of the system further. The four
      primary areas of clinical application for F-SCAN have been identified and briefly
      discussed. The recognition of certain biomechanical abnormalities, monitoring
      preorthotic and postorthotic use, evaluation of the diabetic or neuropathic foot,
      and presurgical and postsurgical functional examinations constitute this group.
      The F-SCAN system largely helps to remove some of the unavoidable guess work from
      essential diagnostic and therapeutic procedures. As we increase our understanding
      of the pathomechanics of these clinical problems, so too will we improve our
      management of the associated complications. Years ago, at the time when
      computerized gait analysis was being introduced to the podiatric profession, a
      frequently asked question was: What does it tell me that I don't already know or
      can't see by watching the patient walk?(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364850
TI  - The computer era in gait analysis.
AB  - This article traces the history of the use of computers in the analysis of human
      gait. Following a brief retrospective review of the precomputer era, the topics
      of motion, force, and pressure analysis using computers are discussed. The need
      for careful justification of clinically applied techniques is stressed
      throughout, and some future trends are anticipated.

PMID- 8364851
TI  - The Vector System for dynamic gait analysis.
AB  - This article explores dynamic versus static biomechanics, quantitative versus
      qualitative data, and practical uses in a clinical setting for the Vector System
      of gait analysis. This system uses a video camera connected to a computer to
      analyze gait.

PMID- 8364852
TI  - The motion analysis system for dynamic gait analysis.
AB  - The research value of the Motion Analysis System, within its scope of
      limitations, is large and may allow the podiatrist to lend scientific data to
      support many areas that have been previously held to be of a theoretic or
      anecdotal basis. The whole concept of rearfoot control with orthoses is perhaps
      the most important of these. Podiatrists have been aware of the role of orthoses
      for years, but now there is the means to demonstrate these findings to other
      medical professions. The ability to compare a number of clinical variables is
      another truly useful feature. The Motion Analysis System and other similar
      equipment are not designed to replace or make obsolete the biomechanical
      examination and "trained human eye;" rather, they act to compliment these skills
      and to help bring the realm of podiatric biomechanics and orthotic therapy into
      the scientific arena.

PMID- 8364853
TI  - The peak performance system for dynamic gait analysis.
AB  - The PEAK Rearfoot Clinical Assessment System provides automated computer tracking
      of tibial-calcaneal motion via video equipment. Multiple trials from a single
      subject or across subjects can be acquired from which angular displacements and
      velocities can be computed. Graphic and tabular reports can be customized to
      generate rapid and specific documentation.

PMID- 8364854
TI  - OrthoGraphics. A two-dimensional surgical planning system.
AB  - Presurgical planning is a useful means of attaining consistent and predictable
      surgical results. The range of intraoperative errors is narrowed, and surgical
      time and materials are minimized. Computer-assisted presurgical planning is an
      extremely valuable tool for reconstructive foot surgery. A versatile, self-taught
      software program that permits longitudinal tracking of deformities and
      visualization of multiple surgical options, i.e., base wedge versus neck
      osteotomy, is effective in terms of cost, speed, accessibility, documentation,
      research, and education. The concept of CAD in presurgical planning is not new to
      other surgical specialties, but as of this date, it has not been implemented
      fully by podiatric surgeons. The cost factor for office computer use has
      decreased significantly over the years, and it is highly unusual to locate an
      office today that does not employ a computer in some aspect of office operation.
      The additional hardware and OrthoGraphics software at this date may represent
      between a $6000 and $20,000 investment, depending on how sophisticated an office
      operation is desired. It is of particular interest that one optical disk in the
      ICS can hold up to 1000 patient records with nearly 4000 radiographs. In
      addition, a 35-mm slide-creating interface is available along with the
      opportunity to modify existing programs to create custom software to meet special
      needs. It would appear that the teaching applications of this type of system are
      most compatible with the podiatric medical college clinical curriculum as a
      component of instructional programs in both biomechanics and surgery.

PMID- 8364855
TI  - The application of computer graphics in foot and ankle surgical planning and
      reconstruction.
AB  - This article presents examples of current technologies in computer graphics as
      applied to foot and ankle surgery. Presently, there are two areas of great
      potential in computer graphics: (1) preoperative surgical planning, and (2)
      computer-aided design and manufacturing of custom implants.

PMID- 8364856
TI  - The use of ADAM software in podiatry.
AB  - ADAM (Animated Dissection of Anatomy for Medicine) software is a versatile,
      multimedia computer program designed to enhance doctor-patient communication.
      This interactive software promises to play a major role in health care in the
      21st century. Podiatric applications of this software are discussed in this
      article.

PMID- 8364857
TI  - Aggressive pulmonary metastasectomy facilitated by use of median sternotomy and
      neodymium:yttrium-aluminum-garnet laser.

PMID- 8364858
TI  - Mammography screening for breast cancer.

PMID- 8364859
TI  - Prognostic value of DNA ploidy in squamous cell carcinoma of esophagus. Analyzed
      with improved flow cytometric measurement.
AB  - BACKGROUND: The prognostic value of flow cytometric DNA analysis on paraffin
      embedded tumor samples has been controversial in esophageal cancer. To clarify
      its true significance, the authors developed an improved method that excludes the
      possibility of contamination by lymphocytes in tumor sample. METHODS: Single
      nuclear suspension was prepared from paraffin-embedded samples on 103 patients
      with squamous cell carcinoma of the esophagus. Both DNA content and nuclear size
      were simultaneously measured by flow cytometry on 30,000 nuclei, and contaminated
      lymphocyte nuclei were eliminated from the data by optimal gating. Correlation
      between DNA ploidy and postoperative survival was examined. RESULTS: Analysis
      using a flow cytometric cell sorter showed that the frequency of tumor cells in
      the lymphocyte-reducing gating fraction (LGF) was significantly higher than that
      in the conventional nongating fraction (NGF). LGF analysis showed aneuploid peaks
      in 58 patients (56.3%), but NGF analysis showed aneuploid peaks in only 38
      patients. LGF analysis revealed that the aneuploid tumors had higher histologic
      grading (P < 0.05) and worse survival rate (P < 0.01) compared with diploid
      tumors. However, conventional methods could not detect this difference.
      CONCLUSIONS: Flow cytometric analysis gating by nuclear size may be helpful to
      detect aneuploid peaks, and for predicting prognosis of patients with squamous
      cell carcinoma of esophagus.

PMID- 8364860
TI  - DNA flow cytometry of stomach cancer. Prospective correlation with
      clinicopathologic findings.
AB  - BACKGROUND: DNA ploidy and S-phase fraction measured by DNA flow cytometry were
      shown to correlate with several clinicopathologic characteristics in several
      types of tumors. METHODS: DNA flow cytometry was performed on 329 samples (164
      normal mucosa, 165 tumors) obtained from 165 patients (112 men) with stomach
      cancer, and the findings were correlated with various clinicopathologic
      characteristics of the patients in a prospective manner. RESULTS: Seventy-nine of
      165 samples (48%) from the tumors gave an aneuploid histogram. None of 164
      samples from the normal mucosa showed aneuploidy. There was no significant
      difference in the frequency of DNA aneuploidy in terms of age, sex, symptom
      duration, bleeding history, gastric outlet obstruction, weight loss, performance
      status, serum hemoglobin level, albumin level, creatinine level, tumor size,
      tumor location in the stomach, and TNM stage. Moderately well differentiated
      tumors had a significantly higher frequency of aneuploidy compared to well
      differentiated or undifferentiated tumors. S-phase fraction was obtained in 162
      of 164 samples from the normal mucosa, and 123 of 165 samples from the tumors.
      The overall mean of the S-phase fraction was 4.01% (range, 0.5-23.6%) for the
      normal mucosa and 13.8% (range, 0-51.9%) for the tumors. Higher S-phase fraction
      of tumors was correlated with history of weight loss, poorer performance status,
      and histologically less differentiated tumors. CONCLUSIONS: The overall frequency
      of aneuploidy was 48% in stomach cancer. DNA aneuploidy showed significant
      correlation with histologic differentiation of tumors. S-phase fraction of the
      tumors showed significant correlation with history of weight loss, performance
      status of the patients, and histologic differentiation of tumors.

PMID- 8364861
TI  - Predictive value of preoperative serum sialyl Tn antigen levels in prognosis of
      patients with gastric cancer.
AB  - BACKGROUND: Expression of sialyl Tn antigen (STN) or serum STN levels were
      reported to be the independent prognostic factors of colon and ovarian cancers,
      respectively. The clinical significance of serum STN was evaluated as a tumor
      marker in gastric cancer. METHODS: Preoperative STN levels were examined in 350
      patients with gastric cancer, surgically treated in the Department of Surgery II,
      Kyushu University Hospital, and in the National Kyushu Cancer Center, between
      April, 1981 and April, 1986. The patients were divided into two groups: a high
      STN group (n = 304), with over 45 U/ml of STN, and a low STN group (n = 46), with
      less than or equal to 45 U/ml. RESULTS: In the high STN group, the patients were
      older and the tumors were larger, compared to the low STN group. Histologically,
      tumors in the high STN group were deeply penetrating and the rates of lymphatic
      involvement, vascular involvement, and lymph node and hepatic metastases were
      higher. Infiltrative growth patterns dominated. Thus, the tumors were in an
      advanced stage. The 5-year survival rate for patients in the high STN group was
      significantly less than that of patients in the low STN group (44.8% +/- 7.9%
      versus 75.1% +/- 2.6%, P < 0.05). CONCLUSIONS: Because a high STN level
      correlates with an advanced tumor stage and a poorer prognosis, close follow-up
      and aggressive therapy are recommended.

PMID- 8364862
TI  - The association of Helicobacter pylori with differentiated-type early gastric
      cancer.
AB  - BACKGROUND: Recent studies have indicated that infection with Helicobacter pylori
      is closely associated with increased risk for gastric cancer. Previous studies,
      however, usually have been made on cases of advanced gastric cancer. METHODS: The
      Congo red-methylene blue test was performed on 19 healthy subjects, 24 patients
      with early gastric cancer of differentiated type, and 17 patients with early
      cancer of undifferentiated type. H. pylori infection was examined by culture of
      biopsy specimens obtained from noncancerous antral mucosa. RESULTS: H. pylori was
      detected in 19 (79%) of 24 patients with differentiated-type early gastric
      cancer, but in only 5 (29%) of 17 patients with undifferentiated-type early
      gastric cancer; this difference was statistically significant. It also was
      detected significantly more frequently in patients with differentiated cancers
      than in healthy subjects. CONCLUSIONS: H. pylori infection was closely associated
      with differentiated-type gastric cancers, but not with undifferentiated types.

PMID- 8364863
TI  - An immunohistochemical study of ras oncoprotein expression in gastric carcinoma.
AB  - BACKGROUND: Previous studies have shown that ras oncoprotein is overexpressed in
      gastric carcinoma. It is unsettled whether there is differential expression of
      this oncoprotein in the two major subtypes of gastric carcinoma--intestinal type
      and diffuse type. METHODS: Forty-four cases of gastric carcinomas (24 intestinal
      type, 18 diffuse type, and 2 mixed according to the Lauren classification) were
      analyzed for ras oncoprotein expression using commercially available antibodies
      in routinely formaldehyde-fixed, paraffin-embedded tissue sections. RESULTS:
      Altogether, 13 cases stained unequivocally, and these appeared as granular
      cytoplasmic staining in tumor cells. Only five were intestinal-type carcinomas;
      the remaining eight were diffuse type and included two intramucosal carcinomas.
      When the comparison between the two subtypes was limited only to the poorly
      differentiated carcinomas, the difference was statistically significant (P <
      0.05). ras Oncoprotein also was strongly expressed in normal duodenal mucosa as
      well as areas of gastric intestinal metaplasia. CONCLUSIONS: These results
      suggest that the strong expression of ras oncoprotein in gastric intestinal
      metaplasia may be merely a reflection of metaplastic change to an intestinal
      epithelial phenotype. The differential expression of ras oncoprotein between
      diffuse-type and poorly differentiated intestinal-type gastric carcinoma implies
      that these are two distinct subtypes of gastric carcinoma.

PMID- 8364864
TI  - Parathyroid hormone-related protein in gastric cancers with heterotopic
      ossification.
AB  - BACKGROUND: Parathyroid hormone-related protein (PTHrP) has been regarded as one
      of the substances causing humoral hypercalcemia of malignancy. METHODS: The
      immunohistochemical localization of PTHrP was investigated in 33 cases of gastric
      cancer (4 with heterotopic ossification and 29 without heterotopic ossification)
      to clarify the role of PTHrP in heterotopic ossification by using the anti-PTHrP
      monoclonal antibody, 4B3. RESULTS: The four cases with heterotopic ossification
      showed positive staining at primary or metastatic sites, and in one case
      fibroblasts in the stroma surrounding the heterotopic ossifying foci also showed
      positive. On the other hand, of the 29 cases without heterotopic ossification,
      only 5 showed positive staining. CONCLUSIONS: The presence of PTHrP in ossifying
      gastric carcinomas at a relatively high rate indicates that PTHrP also might be
      related to heterotopic ossification associated with malignancies. It is
      speculated that PTHrP would contribute to heterotopic ossification by
      facilitating the process of mineralization.

PMID- 8364866
TI  - Prognostic factors of malignant fibrous histiocytoma of bone. A clinical and
      histopathologic analysis of 34 cases.
AB  - BACKGROUND: Malignant fibrous histiocytoma (MFH) of bone is a rare bone tumor,
      and its prognosis has been controversial. METHODS: Thirty-four patients with MFH
      of bone were examined clinicopathologically for prognostic factors. RESULTS: The
      most common skeletal site of the tumor was the femur (15 cases), followed by the
      pelvic bones (6 cases), tibia (5 cases), and fibula (5 cases). Of 29 patients
      available for follow-up, the 5-year survival rate of 17 who underwent adequate
      surgical treatment was 63%. The 5-year survival rate of the remaining 12
      patients, including 5 with MFH of the pelvic bone who received inadequate or
      palliative surgery, was 17%. All six patients who received intensive chemotherapy
      combined with adequate surgical treatment were alive and well 5 years after the
      initial treatment. Histologically, the presence of desmoplasia and chronic
      inflammatory infiltration in the tumor tended to be prognostic indicators,
      although not to a statistically significant extent. Patients whose tumors
      contained wide areas of desmoplasia had a worse prognosis (5-year survival rate,
      20%). In contrast, those with a prominent chronic inflammatory infiltrate had a 5
      year survival rate of 78%. CONCLUSIONS: These histologic variables would be
      helpful for predicting the prognosis of MFH of bone. Adjuvant intensive
      chemotherapy combined with adequate initial surgery may effect a clinical cure.

PMID- 8364865
TI  - Metaplasia and precursor lesions of gallbladder carcinoma. Frequency,
      distribution, and probability of detection in routine histologic samples.
AB  - BACKGROUND: Gallbladder diseases, especially cholelithiasis, are extremely
      frequent in Chile, and an increasing frequency of gallbladder carcinoma has been
      observed during the last decades. Hyperplastic and atypical epithelial lesions of
      gallbladder epithelium have been considered potential precursors of invasive
      carcinoma. The current study was designed to study the frequency, distribution,
      extension, and probability of routine detection of potentially preneoplastic
      changes of gallbladder epithelium. METHODS: Epithelial changes were
      histologically studied by mapping gallbladders obtained at elective
      cholecystectomy for lithiasis in 162 Chilean patients. RESULTS: Antral-type
      metaplasia was found in 95.1% of the cases, intestinal metaplasia in 58.1%,
      hyperplasia in 46.9%, dysplasia in 16%, and carcinoma in situ in 2.5%. A
      significant association of intestinal metaplasia with hyperplasia, intestinal
      metaplasia with dysplasia, and hyperplasia with dysplasia was found. Hyperplasia
      and dysplasia were also present in four cases with carcinoma in situ. Mean
      extension of the lesions (percentages of the sections in which the change was
      observed) was antral-type metaplasia (62.7%), intestinal metaplasia (25.3%),
      hyperplasia (24.1%), dysplasia (15.5%), and carcinoma in situ (9.7%). Antral-type
      and intestinal metaplasia were more extensive and more severe in patients older
      than 50 years of age. Hyperplasia was more extensive in cases in which it was
      associated with dysplasia and carcinoma in situ. CONCLUSIONS: The extension of
      metaplasia seems to depend in part on the age of the patients. The association of
      intestinal metaplasia with hyperplasia and dysplasia agrees with the findings of
      other authors that relate metaplasia to gallbladder cancer. The epithelial
      lesions are focal or partially confluent, thus a single random histologic section
      will detect less than one third of the hyperplasias, dysplasias, and carcinomas
      in situ.

PMID- 8364867
TI  - Epidermotropic metastatic melanoma. Are the current histologic criteria adequate
      to differentiate primary from metastatic melanoma?
AB  - A case is reported of a patient with a lentiginous acral melanoma of the heel
      that was excised and recurred 3 years later at the margin of the previous scar.
      After another 3 years, a group of five small lesions appeared in the thigh that
      were considered to be junctional and epidermotropic metastases. The authors
      question the current histologic criteria for differentiating junctional and
      epidermotropic metastases of previous melanomas from multiple primary melanomas.
      It is concluded that the clinical history is of primary importance in reaching a
      correct diagnosis; histologic studies are not sufficient.

PMID- 8364868
TI  - Tamoxifen modulation of cisplatin resistance in patients with metastatic
      melanoma. A biologically important observation.
AB  - BACKGROUND: Treatment with the four-drug combination of dacarbazine (DTIC),
      carmustine (BCNU), cisplatin (DDP), and tamoxifen (TAM) has resulted in an
      overall response rate of more than 50% in patients with metastatic melanoma.
      Deletion of TAM from the regimen resulted in a decrease in the response rate to
      10%, suggesting an important role for TAM. The authors have subsequently
      demonstrated that TAM is highly synergistic with DDP in a human melanoma cell
      line, T-289, which supports the clinical observation that TAM is important in
      this regimen. The authors conducted a clinical trial to determine whether the
      addition of TAM can overcome established DDP resistance in patients with
      malignant melanoma. METHODS: Patients with metastatic melanoma were initially
      treated with DDP 100 mg/m2 alone until they demonstrated DDP resistance. On the
      next cycle of treatment, patients received TAM 40 mg by mouth four times a day on
      the day before DDP treatment followed by 20 mg by mouth daily for the rest of the
      3-week cycle plus the same dose of DDP. RESULTS: Among 24 patients treated with
      DDP alone there were one complete and two partial responses. Twenty patients, in
      whom single-agent DDP failed, were treated with the combination of TAM and DDP.
      Of these 20 patients, 19 were evaluable for response. Among these 19 patients,
      there were three partial responses (16%) and three mixed responses (16%), for an
      overall response rate of 32% (0% was expected) (P < 0.001). If the three mixed
      responses are eliminated, the statistical significance is of borderline
      significance (P = 0.058). CONCLUSIONS: The addition of TAM to DDP can overcome
      established DDP resistance in a subset of patients with metastatic melanoma.

PMID- 8364869
TI  - Aggressive pulmonary metastasectomy for soft tissue sarcomas.
AB  - BACKGROUND: To evaluate the efficacy of aggressive pulmonary metastasectomy for
      treating soft tissue sarcomas, the clinical data on the surgical management of 23
      patients with extensive pulmonary metastases from soft tissue sarcomas were
      reviewed. METHODS: Between January 1973 and April 1991, 9 male patients and 14
      female patients were treated. Their ages ranged from 13-68 years (median, 42
      years). Twenty-one patients (91%) had bilateral and multiple metastases, and two
      patients had solitary metastasis. The number of resected metastatic nodules
      ranged from 1-110 (mean, 30.5). As an initial surgical approach, median
      sternotomy was used on 18 patients and lateral thoracotomy on 5 patients. Eleven
      patients underwent two or more explorations for recurrent metastases using
      lateral thoracotomy. The neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was
      adopted in 10 patients since 1986. RESULTS: The actuarial 2-year and 5-year
      survival rates after the first pulmonary resection were 49.7% and 24.8%,
      respectively. Histologic type (alveolar soft part sarcoma versus synovial
      sarcoma, P < 0.025), histologic grade (G1 and G2 versus G3, P < 0.01), and
      metastatic localization (subpleural versus extrapleural, P < 0.005) were the most
      significant prognostic factors for aggressive pulmonary metastasectomy of soft
      tissue sarcomas. Application of laser surgery, absence of local recurrences, and
      absence of extrapulmonary metastases before pulmonary resection also correlated
      with better prognosis with borderline significance. CONCLUSIONS: Aggressive
      pulmonary metastasectomy for soft tissue sarcomas is a recommended procedure,
      even in the case of extensive metastases. The combination of median sternotomy
      and Nd:YAG laser-assisted surgery is a useful technique, especially in bilateral
      multiple pulmonary metastases.

PMID- 8364870
TI  - DNA flow cytometry and pathologic grading as prognostic guides in axillary lymph
      node-negative breast cancer.
AB  - BACKGROUND: The recurrence or mortality rate of axillary lymph node-negative
      invasive breast cancer has been associated with the tumor S-phase fraction, which
      is measured by DNA flow cytometry. Because many of the studies that established
      this association were performed using frozen, pulverized tumor specimens, this
      association could not be tested for independence from the established prognostic
      factors of histologic and nuclear grading. METHODS: Histologic, nuclear, and
      mitotic grades, DNA ploidy, and S-phase fraction (SPF) were determined from
      paraffin-embedded tumors obtained from 280 women with node-negative invasive
      ductal carcinomas using standard grading schemes and flow cytometric techniques.
      These variables were compared with disease-free and cancer-specific survival
      (CSS) in univariate and multivariate analyses of these patients. RESULTS: Tumor
      diameter, SPF, histologic grade, and nuclear grade were significant predictors of
      disease-free survival (DFS); diameter and SPF had significant associations with
      CSS. Cox analysis showed histologic grade to be the only independent predictor of
      relapse, whereas diameter and SPF were independent predictors of mortality. The
      patients with low nuclear or histologic grade tumors had only a 5% risk of
      recurrence at 5 years. In contrast, 36% of patients in this series with medium
      grade or high-grade high SPF tumors had a 30% risk of recurrence over the same
      interval. CONCLUSIONS: Histopathologic grading and flow cytometric determination
      of SPF appear to provide additive prognostic information for patients with early
      invasive ductal carcinomas of the breast.

PMID- 8364871
TI  - The current detectability of breast cancer in a mammographic screening program. A
      review of the previous mammograms of interval and screen-detected cancers.
AB  - BACKGROUND: The occurrence of an interval cancer in a mammographic screening
      program is indicative of a suboptimum effect on mortality, because the very aim
      of the screening is to detect as many cancers as possible and at their earliest
      possible stage. In several studies, the previous screening mammograms of patients
      with an interval cancer were reviewed and the reasons for the "missed diagnosis"
      were classified into four categories: "screening error" (20-29%), "minimal sign
      present" (30-40%), "radiographically occult" (33-58%), or "radiographically
      occult at diagnosis" (occult both at previous screening and diagnosis; 7-16%). A
      similar procedure was followed in the Nijmegen screening project with patients
      recently diagnosed as having interval cancer or screen-detected cancer. METHODS:
      The previous screening mammograms of 40 interval and 44 screen-detected cases
      from the breast cancer screening program in Nijmegen were reviewed and
      categorized as specified above. These breast cancers were diagnosed clinically
      before the patient was invited to the eighth screening round (interval cancer) or
      were detected at the eighth screening round (screen-detected cancer). All these
      patients had been screened in the seventh round (1987-88). RESULTS: Thirteen
      percent of all cases were classified as "screening error," 38% as "minimal sign
      present," 43% as "radiographically occult," and 6% as "radiographically occult at
      diagnosis." In nearly half of the screen-detected cancers, minimal signs appeared
      to be present on the previous screening mammogram 2 years before the diagnosis.
      CONCLUSIONS: Annual instead of biennial screening may advance detection in most
      of the "screening error" cases as well as in some in the categories "minimal sign
      present" and "radiographically occult" at the previous screening. Meticulous
      analysis of the radiologic characteristics of the "minimal sign present" cases
      may very well lead to results showing that earlier detection is possible without
      a significant decrease in the specificity of the screening test.

PMID- 8364872
TI  - Effect of LC9018 combined with radiation therapy on carcinoma of the uterine
      cervix. A phase III, multicenter, randomized, controlled study.
AB  - BACKGROUND: The failure rate with radiation therapy alone for Stage III cervical
      cancer is quite high, and therefore other modalities are being pursued as
      adjuvants to radiation therapy in hopes of improving the results. METHODS: A
      randomized, controlled, comparative study on the efficacy and safety of radiation
      therapy combined with LC9018 (a biologic response modifier prepared from heat
      killed Lactobacillus casei YIT9018) was conducted using 228 patients with Stage
      IIIB cervical cancer. RESULTS: LC9018 enhanced tumor regression (P < 0.1) by
      radiation after both 30 Gy of external radiation and at the completion of
      radiation therapy. The combination therapy also prolonged survival and the
      relapse-free interval (P < 0.05) compared to radiation alone. Analysis of
      survival using the Cox proportional hazard model indicated that use of LC9018 was
      a significant factor related to survival duration. Major side effects of combined
      LC9018 included fever and skin lesions at the injection site, but no severe
      symptoms were noted. Radiation-induced leukopenia was significantly less severe
      (P < 0.05) in the LC9018-combined group than in the radiation-alone group,
      suggesting that this agent might help to prevent leukopenia during radiation
      therapy. CONCLUSIONS: LC9018 was shown to be an effective agent for adjuvant
      immunotherapy when combined with radiation therapy.

PMID- 8364873
TI  - Impaired binding properties of endothelin-1 receptors in human endometrial
      carcinoma tissue.
AB  - BACKGROUND: Endothelins, potent stimulators of smooth muscle tissue activity,
      were recently shown to also function as mitogens for numerous cell types. The
      authors investigated the properties of endothelin-1 (ET-1) receptors in human
      endometrial tissue compared with human endometrial carcinoma tissue. METHODS:
      Tissue samples from 13 patients with endometrial carcinoma and from 12 women
      undergoing hysterectomy due to uterus myomatous were obtained immediately after
      surgical removal. Binding properties of the endothelin receptors were studied
      using 125I-labeled ET-1. RESULTS: A significant difference was demonstrated
      between binding properties of ET-1 receptors of these two groups. The mean
      maximal density (Bmax) value of the normal endometrial samples was 2029 +/- 341
      fmol/mg protein, whereas that of the neoplastic samples was 356 +/- 121 fmol/mg
      protein. No differences were found, however, between the mean dissociation
      constant (Kd) values of these groups. CONCLUSIONS: These results might be
      compatible with the increased blood flow that characterizes malignant endometrial
      tissue. However, they do not indicate an important mitogenic role for ET-1 in the
      development of endometrial cancer.

PMID- 8364874
TI  - Malignant lymphoma of the uterus. Report of seven cases with immunohistochemical
      study.
AB  - BACKGROUND: Uterine lymphoma is a rare disease; therefore, information regarding
      histologic type, immunophenotype of tumor cells, and etiologic factors are
      limited. METHODS: Seven patients with uterine lymphoma, three from the corpus and
      four from the cervix, were collected by a nationwide study in Japan. Selection of
      cases was preferentially made from the "Annual of Pathologic Autopsy Cases in
      Japan." RESULTS: All cases with cervical lymphoma presented with vaginal
      bleeding. Abdominal pain or backache was observed in patients with corpus
      lymphoma. The age ranges of patients with corpus and cervical lymphomas were 46
      78 years of age (mean, 63 years) and 30-71 years of age (mean, 53 years),
      respectively. Information about clinical staging was available for six patients;
      two patients with Stage I, three patients with Stage II, and one patient with
      Stage III. A definite diagnosis of uterine lymphoma was made by biopsy in all
      cases. Total hysterectomy, with or without bilateral salpingo-oophorectomy, was
      carried out in three patients, and tumor resection was carried out in one
      patient. Adjuvant therapy was given in six cases. Follow-up showed that five
      patients died due to tumor within 1 year of treatment. Histologically, all cases
      were non-Hodgkin lymphoma showing a diffuse pattern of proliferation. All but one
      were diffuse large cell type. Immunohistochemistry revealed the tumor cells in
      all cases were of B-cell nature. Expression of HLA-DR antigen was evaluable in
      four cases, of these three showed an increased expression on the vascular
      endothelium. CONCLUSIONS: Uterine lymphoma comprises exclusively B-cell type.

PMID- 8364875
TI  - A phase II study of continuous infusion 5-fluorouracil in advanced hormone
      refractory prostate cancer. An Illinois Cancer Center Study.
AB  - BACKGROUND: 5-Fluorouracil (5-FU) has been previously associated with therapeutic
      benefit in hormone refractory prostate cancer. However, no previous study has
      administered 5-FU as a prolonged continuous infusion, which may be the optimal
      schedule for this cell-cycle specific agent. METHODS: Therefore, 25 patients were
      treated with 5-FU administered as a continuous intravenous infusion at a dose of
      1000 mg/m2/day for 5 days every 28 days. Eligibility required disease defined by
      bidimensionally measurable lesions or evaluable lesions on bone scan or
      radiograph with elevated serum levels of prostate-specific antigen (PSA), no
      severe cytopenias, and an Eastern Cooperative Oncology Group performance status
      less than 3. Prior chemotherapy was not allowed. Dose modifications were
      specified for mucositis and hematologic toxicity. RESULTS: Eighteen of 22
      patients were evaluable for response and toxicity, whereas 4 were evaluable for
      toxicity alone. Toxicity was significant using this dose and schedule and
      included episodes of sudden death (one patient), paroxysmal supraventricular
      tachycardia (one patient), and congestive heart failure (one patient). Other
      Grade 3 toxicities included stomatitis (two patients) and diarrhea (one patient).
      Significant myelosuppression did not occur. Objective responses were not
      observed, but 12 patients experienced stable disease with a median duration of 4
      months. CONCLUSIONS: Infusional 5-FU can not be recommended for the treatment of
      advanced hormone refractory prostate cancer.

PMID- 8364876
TI  - Malignant lymphoma of bladder. Report of three cases and review of the
      literature.
AB  - BACKGROUND: The significance of long-standing cystitis has been postulated as a
      causal factor in malignant lymphoma of bladder. METHODS: The authors reviewed 3
      cases of primary malignant lymphoma of the urinary bladder and an additional 27
      cases described in the literature (25 from Western countries and 2 from Japan).
      Clinical and pathologic findings in the total 30 cases are summarized. RESULTS:
      The majority of patients presented with gross hematuria and were between 20 and
      85 years of age (median age, 64 years). Marked female preponderance was found
      (male to female ratio, 1:6.5). Six patients (20%), all of whom were women, out of
      30 had a history of chronic cystitis. Macroscopic findings showed a solitary mass
      (22 cases), multiple masses (6 cases), or a diffuse lesion without nodule
      formation (2 cases). The vast majority of bladder lymphoma were non-Hodgkin
      lymphoma (NHL) of B-cell type; among them, 14% were follicular lymphomas. Follow
      up indicated that NHL of bladder had a favorable prognosis. CONCLUSIONS:
      Malignant lymphoma of bladder is characterized by a preponderance in women, who
      are occasionally affected by chronic cystitis.

PMID- 8364877
TI  - Neoadjuvant M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) for
      infiltrating transitional cell carcinoma of the bladder.
AB  - BACKGROUND: Based on the excellent results with combination chemotherapy such as
      M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) in patients with
      advanced disease, neoadjuvant chemotherapy has been advocated to improve survival
      and in some cases to permit bladder conservation. METHODS: A Phase II study of
      neoadjuvant M-VAC chemotherapy was performed in patients with T2-T4N0M0 bladder
      tumors. After clinical staging, three cycles of M-VAC were given. After patients
      underwent postchemotherapy clinical restaging, pathologic restaging (partial or
      radical cystectomy) was planned. RESULTS: Forty-six patients are evaluable. A
      clinical response was attained in 78%. Six patients (13%) had stable disease, and
      four (9%) had progression. After chemotherapy, 17 patients underwent radical
      cystectomy, none of whom were pTO. In this group, 10 of the 17 (59%) are alive at
      a median follow-up of 37+ months (range, 8-62+ months). Eleven patients had a
      partial cystectomy; 7 of the 11 (64%) are alive, 6 (55%) with a preserved
      bladder. Eighteen patients had clinical restaging only, and did not have
      pathologic staging. Median follow-up for this group is 36+ months (11-65+
      months). Twenty-one of the 29 (72%) patients managed with conservative surgery or
      transurethral resection of the bladder alone are alive with a functional bladder.
      Median survival for all patients has not yet been reached. Two-year survival is
      82%, and 3-year survival is 70%. CONCLUSIONS: The current study is of interest in
      terms of bladder conservation. Assessment of the true success of any bladder
      preserving treatment will require longer follow-up.

PMID- 8364879
TI  - Estrogen receptors and cathepsin D in human thyroid tissue.
AB  - BACKGROUND: To investigate the significance of estrogen receptors (ER) in the
      pathogenesis of thyroid dysplasia, the authors analyzed, by analogy with breast
      cancers, ER and three estrogen-regulated proteins: progesterone receptor (PR),
      cathepsin D, and pS2 protein, in cytosols of 42 human thyroid tissues. METHODS:
      ER and PR were measured by an immunoenzymatic assay and cathepsin D and pS2 by an
      immunoradiometric assay. Tissue specimens included 7 normal tissues, 6 benign
      nodules, 8 toxic adenomas, 7 from patients with Graves disease, and 14
      carcinomas. RESULTS: ER was present at very low concentrations, with no
      statistical difference between neoplastic and nonneoplastic tissues. The mean
      levels of cathepsin D, expressed as pmol/mg protein minus thyroglobulin, were
      higher in the 14 carcinomas (P = 0.0003), the 7 specimens from patients with
      Graves disease (P = 0.006), and the 8 toxic adenomas (P = 0.04) than in the 7
      normal thyroid tissues. A significant difference also was observed between the
      carcinomas (P = 0.003) and six benign nodules. Compared to TNM parameters,
      cathepsin D concentrations correlated with tumor size: higher cathepsin D levels
      were found in pT4 than in pT2 and pT3 carcinomas. All the tissues tested were
      negative for PR and pS2 protein. CONCLUSIONS: The results clearly indicate a
      significant difference between neoplastic and normal thyroid tissue in terms of
      the amount of cathepsin D, but not that of ER. This suggests that cathepsin D
      probably is not regulated by estrogen but simply is a marker of protease activity
      during invasion by thyroid carcinomas.

PMID- 8364878
TI  - Increased uptake of iodine-131 in metastases of differentiated thyroid carcinoma
      associated with less severe hypothyroidism following total thyroidectomy.
AB  - BACKGROUND: In an attempt to determine possible factors affecting the efficacy of
      iodine-131 (I-131) treatment for metastatic thyroid carcinoma, the authors
      focused their efforts on thyroid functions after total thyroidectomy. METHODS:
      Between 1980 and 1991, 47 patients with lung metastases of differentiated thyroid
      carcinoma were treated with I-131. Relationships of the images on post-therapy
      scans with various clinical features were studied. RESULTS: Among them, 28
      (59.6%) showed I-131 uptake in the metastases on post-therapy scans. Younger
      patients had lesions that concentrated more radioactive iodine than did those of
      older patients. The amount of I-131 concentrated in the metastatic lesions
      correlated with serum triiodothyronine (T3), thyroxine (T4), and thyroglobulin
      levels and inversely with serum thyroid-stimulating hormone (TSH) levels
      determined at the time of therapy. Serum T3 and T4 levels were significantly
      higher in 28 patients with positive scans than in 19 patients with negative
      scans. Most patients who had metastases with markedly increased radioactivity
      were euthyroid or mildly hypothyroid, suggesting that thyroid hormones produced
      by tumor masses compensated for severe hypothyroidism after total thyroidectomy,
      and showed favorable responses to the treatment. In three patients successfully
      treated, decreases in serum thyroglobulin levels and the size of metastatic
      lesions were accompanied by the development of severe hypothyroidism.
      CONCLUSIONS: The presence of a large amount of metastatic functioning thyroid
      tissues responsive to I-131 treatment can be suspected in patients with less
      severe hypothyroidism after total thyroidectomy.

PMID- 8364880
TI  - Virilizing adrenocortical tumors in adult women. Report of 10 patients, 2 of whom
      each had a tumor secreting only testosterone.
AB  - BACKGROUND: Virilizing adrenocortical tumors are uncommon in adult women. These
      lesions generally secrete dehydroepiandrosterone (DHEA) and
      dehydroepiandrosterone sulfate (DHEAS), but not testosterone, which usually is
      produced by ovarian tumors. Exceptionally, adrenal growths may give off
      testosterone and no other assessable androgen. The detection of the site of
      excess testosterone yield is paramount for proper surgery. The true nature of the
      growth often is unpredictable, even at the time the pathologist examines the
      surgical specimen. METHODS: The workup in a virilized adult woman relies on
      biochemical tests such as 24-hour urinary 17-KS and 17-OHCS levels and plasma
      corticosteroid levels (testosterone, DHEA, DHEAS, and androstenedione), and on
      modern imaging studies such as ultrasonography, computed tomography, and digital
      angiography. RESULTS: Among a series of 190 adrenal tumors collected in the last
      30-year period, only 10 virilizing growths (5.3%) were detected. Two cases of
      virilization mixed with cushingoid features were observed. In two other cases,
      reported in detail, the tumor secreted testosterone only, without other
      assessable androgens. Seven of the 10 tumors were malignant. CONCLUSIONS: In
      cases of tumors secreting testosterone only, high-resolution imaging has
      contributed significantly in pinpointing the site of the growth, whereas dynamic
      hormone testing, using selective stimulation or suppression studies, has been
      misleading. The malignant nature of the growth may be revealed only by the
      presence of metastases, because pleomorphism and capsular and vascular invasion
      have been detected histologically in clinically benign tumors. The prognosis for
      large tumors usually is dismal.

PMID- 8364881
TI  - Elevated serum CA 125 secondary to tuberculous peritonitis.
AB  - A 33-year-old African-American woman presented with a 10-day history of abdominal
      pain, fever to 104 degrees F, and ascites. Her PPD converted to positive. A serum
      CA 125 level was 708 U/ml before therapy. Tuberculous peritonitis was diagnosed
      via peritoneal biopsy. The CA 125 level was used to follow response to treatment
      and was undetectable after 12 weeks of antituberculous treatment. This tumor
      marker may be used to follow disease activity in non-neoplastic ascitic states.

PMID- 8364882
TI  - Infantile choriocarcinoma. Re-examination of a potentially curable entity.
AB  - Choriocarcinoma presenting in an infant or neonate is a rare entity that in the
      past has been uniformly fatal. The authors present the first reported case of
      choriocarcinoma successfully treated in a 3-week-old infant. Choriocarcinoma was
      not suspected in this case until pathologic examination revealed the diagnosis.
      In retrospect, however, the case fits well into the classic "infantile
      choriocarcinoma syndrome" initially described by Witzleben in 1968. Review of
      additional cases reported since the initial description validates Witzleben's
      initial observations and also indicates that the original definition should be
      broadened to include other significant presentations of the disease not initially
      appreciated, specifically anemic infants with central nervous system symptoms as
      well as newborns and older children. The importance of making a correct and rapid
      diagnosis is emphasized by the successful outcome in this case where aggressive
      surgery and subsequent chemotherapy have been curative. Serum beta-human
      chorionic gonadotropin (beta-HCG) levels have been uniformly positive, providing
      easy confirmation of the diagnosis. Because the mother can also be affected, an
      appropriate diagnosis of the infant may also lead to more rapid diagnosis and
      treatment of the mother.

PMID- 8364883
TI  - Inflammatory myofibroblastic tumor in children.
AB  - The authors presented the cases of two children with inflammatory myofibroblastic
      (IMF) tumor and reviewed the literature to facilitate the preoperative
      recognition, delineate the clinical features, and describe the natural history of
      this entity. The first child had IMF tumor arising from the mesentery of the
      small intestine. He presented with an abdominal mass associated with severe
      inflammatory response manifested by fever, impaired growth, thrombocytosis, and
      microcytic, hypochromic anemia. After surgical resection, his fever resolved and
      his growth rate and the laboratory abnormalities normalized. Five months after
      initial diagnosis, the fever, anemia, and thrombocytosis recurred along with two
      tumors arising from the omentum and the abdominal soft tissue. After the second
      surgery, he remains free of recurrent disease for 30 months. The second child
      presented with a lung mass that was radiologically indistinguishable from
      pulmonary sequestration. After surgical resection, she remains free of recurrent
      disease for 18 months. IMF tumor should be considered in any solid tumor that
      occurs in association with a chronic inflammatory response. IMF tumor should also
      be considered in the differential diagnosis of pulmonary sequestration.

PMID- 8364884
TI  - Elective inguinal lymph node irradiation for pelvic carcinomas. The University of
      Florida experience.
AB  - BACKGROUND: There is little published information pertaining to elective inguinal
      lymph node irradiation for carcinomas originating in the pelvis that place the
      inguinal lymph nodes at risk. METHODS: Between October 1964 and October 1988, 164
      patients with primary carcinomas originating in the pelvis that placed the
      inguinal lymph nodes at risk for subclinical disease received elective inguinal
      lymph node irradiation at the University of Florida. All patients had a minimum
      follow-up of 2 years from the start of radiation therapy. Primary sites included
      the penis, urethra, vulva, anal canal, distal rectum (within 4 cm of the verge),
      and the cervix or vagina when the tumor involved the distal one-third of the
      vagina. In 148 patients, both groins were clinically negative; in 16 patients,
      one groin was positive and the other negative by clinical examination. Treatment
      techniques were individualized according to the primary site. Tumor doses to the
      inguinal lymph nodes varied, although more than 70% of patients received 4500
      5000 cGy (range, 2650-6780 cGy) over 5 weeks (range, 2-7 weeks) at 180-200 cGy
      per fraction. Patients were excluded from the analysis of disease control in the
      inguinal area if they died less than 2 years from treatment with the inguinal
      lymph nodes continuously disease free or if they experienced recurrence at the
      primary site with the inguinal lymph nodes clinically negative at the time of
      recurrence. RESULTS: The inguinal lymph node control rate was 96% (101 of 105).
      No patient in whom recurrent disease developed in the inguinal lymph nodes
      underwent salvage therapy. CONCLUSIONS: Elective irradiation of the inguinal
      lymph nodes is highly effective in controlling subclinical disease from
      carcinomas originating in the pelvis and can be accomplished with minimal acute
      or long-term complications.

PMID- 8364885
TI  - Assessment of the mutagenic activity of some acenaphtho(1,2-b)quinolines.
AB  - The mutagenic activity of four substituted acenaphtho(1,2-b)quinolines were
      evaluated using the Ames test (Salmonella assay). The compounds tested were
      acenaphtho(1,2-b)quinoline (1) and its 10-methoxy (2), 10-methyl (3) and 10-nitro
      (4) derivatives. Compounds 1 and 3 were found to be non-mutagenic, but compound 2
      was found to be mutagenic with metabolic activation only. However, compound 4 was
      found to be very active with or without activation.

PMID- 8364886
TI  - Carcinoembryonic antigen mediates in vitro cell aggregation induced by interferon
      gamma in a human colon cancer cell line: requirement for active metabolism and
      intact cytoskeleton.
AB  - The homotypic cell aggregation of a carcinoembryonic antigen (CEA) positive colon
      cancer cell line (Colo 205) was induced in vitro by interferon-gamma (IFN-gamma)
      treatment. Divalent cations were required for this aggregation, as it was
      inhibited by EDTA. The partial inhibition by cytochalasin B and the complete
      inhibition by a mixture of sodium azide and 2-deoxyglucose suggests that the
      aggregation requires the integrity of cytoskeleton and active metabolism. The
      expression of CEA was increased in the cytoplasm and on the membrane of Colo 205
      by IFN-gamma treatment. Furthermore, this aggregation was inhibited completely by
      anti-CEA monoclonal antibody (mAb) and partially by mAb against intercellular
      adhesion molecule-1. This in vitro study suggests that CEA molecule participates
      in the IFN-gamma induced homotypic adhesion of some CEA positive cancer cells and
      that IFN-gamma has an important role in the regulation of cell-cell interaction
      mediated by CEA molecule.

PMID- 8364887
TI  - Transforming growth factor beta 1-induced delay of cell cycle progression and its
      association with growth-related gene expression in mouse fibroblasts.
AB  - TGF beta-induced cell cycle progression is relatively slower than that induced by
      EGF or PDGF-BB. Further, TGF beta delays EGF or PDGF-induced 5-phase entry in C3H
      10T1/2 mouse fibroblasts. In accordance with this delay, the induction of mRNA
      level of 'immediate early genes' such as c-myc, c-fos, c-jun and junB by TGF beta
      has slower kinetics compared with those of EGF. TGF beta induces c-sis gene,
      suggesting possible involvement of secondary growth stimulation by PDGF-like
      proteins. However, anti-PDGF-AB antibody, which was inhibitory to FDGF-BB-induced
      [3H]thymidine incorporation, did not block TGF beta-induced DNA synthesis. These
      results first demonstrate that the delay of cell cycle progression by TGF beta is
      closely associated with the altered regulation of growth-related gene expression
      in fibroblasts.

PMID- 8364888
TI  - Interleukin-6 and tumour necrosis factor alpha synergistically block S-phase cell
      cycle and upregulate intercellular adhesion molecule-1 expression on MCF7 breast
      carcinoma cells.
AB  - The effect of IL-6 and TNF alpha were studied on human MCF7 breast cancer cells.
      Synergistic interaction between IL-6 and TNF alpha, on the growth inhibition (50%
      reduction in the percentage of S-phase cells) and the upregulation of ICAM-1
      expression (4 to 11-fold increase) was shown using flow cytometric methods. IL-6
      and TNF alpha alone had negligible effect on the cell cycle. The individual
      effect of IL-6 resulted in down-regulation of ICAM-1 expression (30-35%), while
      TNF alpha always upregulated ICAM-1 (1.5 to 4-fold increase). The combined effect
      of IL-6 and TNF alpha consistently caused an increased expression of ICAM-1,
      which was greater than the sum of each one alone and also sustained for 72 h
      following cytokine withdrawal.

PMID- 8364889
TI  - Increased risk of lung cancer in Japanese smokers with class mu glutathione S
      transferase gene deficiency.
AB  - Japanese lung cancer patients (n = 121) and community controls (n = 201), both
      with current smoking history and aged < or = 69, were compared for the rates of
      class mu glutathione S-transferase (GSTmu) negative genotype detected by
      polymerase chain reaction. The prevalence of the GSTmu negative genotype was
      45.3% in the community control group and 68.4%, 69.2%, 54.3% and 72.7% in the
      squamous cell carcinoma, small cell carcinoma, adenocarcinoma and other primary
      lung cancer groups, respectively. Odds ratios adjusted for age, sex composition
      and smoking index by multiple logistic regression analysis were 2.71 (1.23-5.99),
      2.72 (1.11-6.66), 1.33 (0.68-2.60), and 3.27 (0.83-12.81), respectively. These
      results suggest that smokers with a GSTmu negative genotype are at higher risk
      for bronchial carcinoma than smokers with positive genotype.

PMID- 8364890
TI  - Tri-n-butyltin chloride promotes morphological transformation and induces
      proliferin expression in C3H10T1/2 cells.
AB  - Transcripts from the murine gene family proliferin, which are increased by a wide
      assortment of chemical promoters of C3H10T1/2 cell morphological transformation,
      were shown to be induced by tri-n-butyltin chloride at concentrations above 50
      nM. Two-stage transformation assays, with 3-methylcholanthrene as inducer and tri
      n-butyltin chloride as promoter, were performed to determine if promotion of
      morphological transformation and proliferin induction were properties shared by
      this compound. Tri-n-butyltin chloride synergistically enhanced focus formation
      at concentrations ranging from 20 to 75 nM. Di-n-butyltin dichloride, n-butyltin
      trichloride and tin (II) chloride, but not tin (IV) chloride, were also effective
      inducers of proliferin. Changes in patterns of TPA-inducible, secreted proteins,
      including those likely to be proliferin, were detected following organotin
      treatment of confluent monolayers. Tri-n-butyltin chloride resembles other agents
      active as promoters in C3H10T1/2 two-stage transformation assays by possessing an
      ability to induce proliferin expression.

PMID- 8364891
TI  - Retinoic acid induces insulin-like growth factor II expression in a neuroblastoma
      cell line.
AB  - Insulin-like growth factor II (IGF-II) is implicated in the development of the
      vertebrate neural circuitry, and increases neurite growth in vitro and in vivo.
      We examined the relationship of IGF-II expression to the in vitro differentiation
      induced by retinoic acid (RA). We find that RA stimulates an increase in IGF-II
      messenger RNA (mRNA) in the SK-N-SH (SH) neuroblastoma cell line. An increase of
      IGF-II mRNA is detected within 12 h of treatment and precedes morphological
      differentiation. A RA dose response test indicates that an increase in IGF-II
      mRNA occurs within 2 days in SH cells treated with doses of RA from 1 x 10(-8) to
      1 x 10(-5) M. We suggest that IGF-II expression may be regulated either directly
      or indirectly by RA in vitro and may lead to neuroblastoma differentiation.

PMID- 8364892
TI  - Diamine oxidase activity in rat brain carcinogenesis and in gliomas.
AB  - In the early stages of brain carcinogenesis induced by transplacental
      administration of N-ethyl-N-nitrosourea to BD IX rats, a constant increase in the
      activity of cerebral diamine oxidase, the rate-limiting enzyme in terminal
      catabolism of polyamines, was observed. Gliomas, which developed between the
      fifth and eight month of extrauterine life, showed an 8-fold increase in enzyme
      activity compared with normal brain from rats of the same age. Concomitantly, an
      11-fold enhancement in putrescine, a physiological substrate of diamine oxidase,
      was also found. Such findings indicate that an increase in oxidative putrescine
      catabolism via diamine oxidase takes place in transformed cells and in gliomas
      and is probably linked to an activation of polyamine synthesis and turnover.

PMID- 8364893
TI  - Argyrophilic nucleolar organizer regions (AgNORs) in inflammatory pre-malignant
      and malignant lesions of the uterine cervix.
AB  - Nuclear organizer regions (NORs) code for ribosomal RNA and are associated with
      non-histone nucleoproteins, which can be identified by silver staining (AgNORs).
      AgNORs have been correlated to proliferative activity of tumors and hence may be
      prognosis-related. The present study evaluates AgNOR counts in inflammatory
      lesions of the uterine cervix, cervical intra-epithelial neoplasia, and invasive
      cervical squamous carcinoma. Significant variation in AgNOR counts were observed
      between the three study groups, with invasive carcinoma showing maximum counts.
      Further, a highly significant positive correlation was observed between AgNOR
      counts and tumor progression. These results therefore suggest that AgNOR counts
      may be of significance in the evaluation of cervical carcinogenesis and could
      elaborate histopathological diagnosis of cervical lesions.

PMID- 8364894
TI  - A study of tobacco carcinogenesis. LI. Relative potencies of tobacco-specific N
      nitrosamines as inducers of lung tumours in A/J mice.
AB  - Tobacco-specific N-nitrosamines (TSNA) are formed from nicotine and the minor
      Nicotiana tabacum alkaloids during tobacco processing and tobacco smoking. The
      TSNA are the most abundant strong carcinogens in smokeless tobacco and in smoke.
      In this comparative study six TSNA and two major volatile N-nitrosamines of
      cigarette smoke are assayed for their relative tumorigenicities in strain A/J
      female mice and for their potential to induce lung tumors. N-nitrosodimethylamine
      was the most potent inducer of lung adenoma in the A/J mouse model followed in
      order of decreasing potencies by 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone,
      4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, N-nitrosopyrrolidine, N'
      nitrosonornicotine and N'-nitrosoanabasine. 4-(Methylnitrosamino)-1-(3-pyridyl)-1
      butanol and 4-(methylnitrosamino)-4-(3-pyridyl)butyric acid were inactive. The
      relative tumorigenic activities of the tobacco-specific nitrosamines in strain
      A/J mice compare well with the available data for their relative tumorigenic
      activities in F344 rats and Syrian golden hamsters.

PMID- 8364895
TI  - Formation and growth of multicellular spheroids in media containing low
      concentrations of agarose.
AB  - Human melanoma HMV-1 cells formed efficiently multicellular spheroids in media
      containing low concentrations (0.001-0.01%) of agarose (LCAM). In addition, the
      spheroids were prevented from deformation without apparent delay of the growth
      rate. On the other hand, spheroid formation was inhibited markedly by LCAM in the
      case of murine melanoma B16 cells. Also, LCAM could not prevent the B16 spheroids
      from deformation. These results indicate that LCAM acts differently depending on
      the cell types used for spheroid formation.

PMID- 8364896
TI  - The effects of phenethyl isothiocyanate on benzo[a]pyrene-induced tumors and DNA
      adducts in A/J mouse lung.
AB  - The effects of phenethyl isothiocyanate (PEITC) on benzo[a]pyrene (B[a]P)-induced
      DNA adducts and pulmonary adenomas in A/J mice were investigated. Groups of 24
      male and 24 female A/J mice were administered PEITC by gavage at doses of 0.075,
      0.25, 0.50, and 0.75 mmol/kg (12, 41, 82, 122 mg/kg) for 6 consecutive days. A
      single dose of 0.40 mmol/kg (100 mg/kg) B[a]P was given by i.p. injection after
      the fourth dose of PEITC. A positive control received only a single i.p.
      injection of B[a]P, 100 mg/kg body weight. The vehicle control group was
      administered corn oil by gavage for 6 consecutive days and a single i.p.
      injection of tricaprylin following 4 doses of corn oil. In addition, 2 groups of
      24 male and 24 female mice each were administered PEITC at dose levels of 12 and
      122 mg/kg body weight to evaluate the effects of this compound alone. Body weight
      loss occurred in both males and females in the 0.25, 0.50, and 0.75 mmol/kg PEITC
      groups relative to B[a]P controls and to untreated controls during the first week
      of the study. Tumor incidence and multiplicity in the PEITC-treated groups,
      evaluated 7 months after B[a]P administration, were not significantly different
      when compared with the B[a]P group. The results of a subsequent DNA adduct
      bioassay, using similar dose levels of PEITC and B[a]P, correlated with the
      results of the tumorigenesis study, indicating that pretreatment with PEITC did
      not inhibit the formation of B[a]P-DNA adducts in the lungs of A/J mice.

PMID- 8364897
TI  - Antiproliferative action of the steroid RU486 in cultured human lymphoma cells.
AB  - The antiproliferative properties of the synthetic steroid RU486 on the human
      lymphoma cell line Daudi are described. In suspension cultures, RU486 (10 microM)
      caused a time dose and cell density dependent reduction of cell proliferation.
      This effect was reversed within 48 h of withdrawal of RU486 from the growth
      medium. High concentrations of foetal calf serum can mask the inhibitory effect.
      In semi-solid cultures RU486 also impaired cell proliferation. Thus RU486 was
      able to suppress in this tumor cell line the expression of some properties
      frequently associated with the transformed status of the cells.

PMID- 8364898
TI  - Release of intracellular calcium by prenylamine in human ovarian tumour cells.
AB  - The effects of the calcium antagonist prenylamine on intracellular calcium
      concentration were studied in a human ovarian carcinoma cell line, OVCAR-3.
      Exposure of cells to 100 microM prenylamine resulted in nearly a 10-fold increase
      in cytosolic free calcium concentration ([Ca2+]i) as measured by Fura-2
      fluorescence. In calcium-free medium, although the increase in [Ca2+]i caused by
      prenylamine was smaller, it was still substantial compared with the basal level.
      Efflux experiments with 45Ca showed that 100 microM prenylamine increased calcium
      efflux by 70% compared with control, indicating active extrusion of the elevated
      [Ca2+]i. The sluggish nature of calcium release and its independence from the
      pool activated by ionomycin suggest that the calcium was probably not released
      from endoplasmic reticulum. These results, although paradoxical, provide a new
      insight into the possible mechanism of action of prenylamine in causing cancer
      cell death.

PMID- 8364899
TI  - Formation of DNA adducts and oxidative DNA damage in rats treated with 1,6
      dinitropyrene.
AB  - In vitro metabolism studies have indicated that the tumorigenic environmental
      pollutant 1,6-dinitropyrene has the potential to bind covalently to DNA and to
      induce oxidative DNA damage. We have determined if 1,6-dinitropyrene treatment
      will cause both types of DNA damage in vivo. Female Sprague-Dawley rats were
      given a single intraperitoneal injection of 1,6-dinitropyrene, and covalent DNA
      adduct formation, as indicated by the presence of N-(deoxyguanosin-8-yl)-1-amino
      6-nitropyrene, and oxidative DNA damage, as indicated by increases in 5
      hydroxymethyl-2'-deoxyuridine and 8-hydroxy-2'-deoxyguanosine, were assessed at
      3, 12, 24 and 48 h after dosing. 32P-postlabeling analyses of DNA isolated from
      liver, mammary gland, bladder and nucleated blood cells indicated the formation
      of N-(deoxy-guanosin-8-yl)-1-amino-6-nitropyrene, with the levels being highest
      in the bladder. 5-hydroxymethyl-2'-deoxyuridine was detected in DNA from each of
      these tissues, and the levels of this oxidized nucleoside were higher in the
      mammary glands and livers of 1,6-dinitropyrene-treated rats. 1,6-Dinitropyrene
      dosing did not affect the levels of 8-hydroxy-2'-deoxyguanosine in these two
      tissues. These results indicate that exposure to 1,6-dinitropyrene can result in
      increased levels of 5-hydroxymethyl-2'-deoxyuridine in addition to covalent DNA
      adduct formation.

PMID- 8364900
TI  - Antipromoting effects of 5-lipoxygenase inhibitors, 3-nitro-2,4,6-
      trihydroxybenzamide derivatives, on TPA-promoted transformation in BALB 3T3
      cells.
AB  - In order to discover the role in the promotion process of 5-lipoxygenase (5-LO),
      a key enzyme in the arachidonate cascade, the antipromoting effects of the 5-LO
      inhibiting 3-nitro-2,4,6-trihydroxybenzamide (NTB) derivatives were studied in a
      two-stage transformation assay system using BALB 3T3 cells. All compounds
      inhibited TPA-promoted transformation in a dose-dependent manner. Most of them
      achieved a 70-80% inhibition. Good correlations were observed between the
      inhibition of TPA-promoted transformation and that of 5-LO. These results
      indicate that 5-LO plays an important role in the promotion stage of the
      transformation of BALB 3T3 cells.

PMID- 8364901
TI  - Tumor promotion in a breast cancer model by exposure to a weak alternating
      magnetic field.
AB  - In view of the methodological problems of epidemiological studies on associations
      between exposures to 50/60 Hz magnetic fields (MF) and increased incidence of
      cancers, laboratory studies are necessary to determine if 50/60 Hz MF are cancer
      promoters or can progress cancers. The objective of the present study was to
      determine if an alternating MF of low flux density exerts tumor-promoting or co
      promoting effects in a model of breast cancer in female rats. Mammary tumors were
      induced by the chemical carcinogen 7,12-dimethylbenz(a)anthracene (DMBA). A group
      of 99 rats was exposed to a homogeneous MF of 50 Hz, 100 microT (microtesla), for
      24 h/day 7 day/week for a period of 91 days; another group of 99 rats was sham
      exposed under the same environmental conditions as the MF-exposed rats. The
      exposure chambers were identical for MF-exposed and sham-exposed animals. DMBA
      was administered orally at a dose of 5 mg/kg at the first day of exposure and at
      weekly intervals thereafter up to a total dose of 20 mg per rat. The animals were
      palpated once weekly to assess the development of mammary tumors. In controls,
      DMBA induced tumors in about 40% of the animals within three months of first
      application. Eight weeks after DMBA application the MF-exposed rats exhibited
      significantly more tumors than sham-exposed animals. This difference in the rate
      of tumor development was observed throughout the period of exposure. At the end
      of the three-month period of MF exposure the tumor incidence in MF-exposed rats
      was 50% higher than in sham-exposed rats, the difference being statistically
      significant. Furthermore, the size of tumors as estimated by palpation was
      significantly larger in the MF-exposed compared to sham-exposed rats. The data
      demonstrates that long-term exposure of DMBA-treated female rats to an
      alternating MF of low flux density promotes the growth and increases the
      incidence of mammary tumors, thus strongly indicating that MF exposure exerts
      tumor-promoting and/or copromoting effects.

PMID- 8364902
TI  - Induction of hepatic nodules in the rat by aristolochic acid.
AB  - Aristolochic acid (AA), used as an anti-inflammatory agent in the past, is known
      to be mutagenic and carcinogenic to several organs of the rat, including
      forestomach, renal pelvis and urinary bladder. However, despite the induction of
      DNA adducts in the liver, no carcinogenic potential of AA has been reported in
      the latter organ. The present study was based on the rationale that the lack of
      carcinogenicity of AA to the liver could be because this chemical may not be
      necrogenic at the doses examined and liver cell proliferation has been
      established as an essential component for initiation of liver carcinogenesis in
      the rat. The results indicated that AA is non-necrogenic to the rat liver.
      However, a single non-necrogenic dose of AA (10 mg/kg b.w., i.p.) given 18 hours
      after 2/3 partial hepatectomy initiated liver cell carcinogenesis. The initiated
      cells are promotable with 1% dietary orotic acid, a liver tumor promoter, to form
      glutathione-S-transferase 7-7 positive hepatic foci and nodules.

PMID- 8364903
TI  - Alterations in populations of GST-p-immunoreactive single hepatocytes and
      hepatocellular foci after a single injection of N-nitrosodiethylamine with or
      without phenobarbital promotion in male F344/NCr rats.
AB  - The fate of placental glutathione S-transferase (GST-P)-immunoreactive
      hepatocytes, detectable in livers of rats soon after treatment with N
      nitrosodiethylamine (DEN), was examined sequentially with or without
      phenobarbital (PB) promotion. Group 1 male F344/NCr rats were administered a
      single i.p. injection of 200 mg DEN per kg body weight at 5 weeks of age. Group 2
      rats were given 500 ppm PB in the diet two weeks after the DEN treatment. Groups
      of six rats were sequentially sacrificed 16, 42, 70, 126 and 238 days after DEN
      injection. In DEN-treated rats, GST-P immunoreactive hepatocytes (single cells
      and multiple cell foci) were detectable 16 days after DEN, the total numbers
      decreasing by day 70 and thereafter rising again. In the early stages the
      proportion of single immunoreactive hepatocytes was prominent, but with time a
      gradual increase in small GST-P+ hepatocellular foci and larger foci became
      evident. Feeding of PB to rats for 16-238 days after a single DEN injection
      resulted in increases of both single cells and foci, especially foci composed of
      more than three hepatocytes. The growth response was increasingly pronounced with
      time. Adenomas or carcinomas were only observed at 126 or 238 days. Numbers of
      GST-P+ foci far exceeded the numbers of foci visible in hematoxylin-eosin (H & E)
      stained sections, and a few H & E foci were negative for GST-P. Many GST-P+ foci
      smaller than ten cells were composed of histologically normal hepatocytes. Almost
      all GST-P+ foci identifiable in H&E stained sections were larger than ten cells,
      consisted of clear cells (in both groups) or mixed (clear-eosinophilic) cells in
      PB-exposed rats, and appeared to be evenly distributed throughout the three zones
      of the liver. These results suggest that the promotive effect of PB is most
      evident as an increase in larger hepatocyte populations composed of more than
      three GST-P+ hepatocytes, rather than in increasing the populations of single GST
      P immunoreactive cells. PB may cause clonal expansion of these single GST-P
      reactive hepatocytes. This study provides evidence for the hypothesis that some
      of the GST-P reactive hepatocytes are initiated cells.

PMID- 8364904
TI  - A marine natural product, patellamide D, reverses multidrug resistance in a human
      leukemic cell line.
AB  - A cyclic octapeptide (patellamide D) isolated from the marine tunicate,
      Lissaclinum patella, acts as a resistance-modifying agent in the multidrug
      resistant CEM/VLB100 human leukemic cell line. A three-day microculture
      tetrazolium proliferation assay was used to determine the 50% inhibitory
      concentration (IC50) for vinblastine, colchicine and adriamycin and calculate the
      degree of resistance modulation. Patellamide D at 3.3 microM was compared with
      5.1 microM verapamil in modulating drug resistance in vitro. The IC50 for
      vinblastine was reduced from 100 ng/ml to 1.5 ng/ml in the presence of
      patellamide D or to 2.1 ng/ml when exposed to verapamil. Colchicine cytotoxicity
      was enhanced only 1.4-fold by verapamil, as compared with 2.8-fold using
      patellamide D (IC50 was reduced from 140 ng/ml to 100 ng/ml or 50 ng/ml).
      Adriamycin toxicity was reduced from IC50 > 1000 ng/ml to 110 ng/ml and 160 ng/ml
      when coexposed to patellamide D and verapamil, respectively. Our results indicate
      that patellamide D acts as a selective antagonist in multidrug resistance and
      stresses the importance of investigating marine-derived compounds as a potential
      new source for modulators of the drug-resistance phenotype.

PMID- 8364905
TI  - Interleukin 10 transfected into Chinese hamster ovary cells prevents tumor growth
      and macrophage infiltration.
AB  - Expression of cytokines in tumor cells provides a sensitive modality to analyze
      the consequences of local cytokines in vivo on tumor infiltrating cells and
      tumorigenicity. We have transfected Chinese hamster ovary (CHO) cells with an
      interleukin 10 (IL-10) expression vector. CHO-IL10 cells although unaltered with
      respect to their in vitro growth lost tumorigenicity, both in nude and in SCID
      mice and in an IL-10 dose dependent manner. In addition, CHO-IL10 cells
      suppressed the growth of equal numbers of coinjected but not of contralaterally
      injected CHO cells. Immunohistology with anti-CR3/Mac-1 and anti-Mac-3 monoclonal
      antibodies revealed that CHO tumors were substantially infiltrated by
      macrophages. However, in CHO-IL10 tumors macrophages were virtually absent within
      the tumor tissue. Our results suggest that IL-10 indirectly suppresses tumor
      growth of certain tumors by inhibiting infiltration of macrophages which may
      provide tumor growth promoting activity.

PMID- 8364906
TI  - Histologically benign or low-grade malignant tumors adjacent to high-grade
      ovarian carcinomas contain molecular characteristics of high-grade carcinomas.
AB  - It is presently not clear if ovarian carcinomas arise de novo or from benign
      precursors (cystadenomas) and if high-grade malignant tumors (carcinomas) develop
      from preexisting low-grade carcinomas. The presence of allelic losses on
      chromosome 11p15.5 distinguishes high-grade ovarian carcinomas from either low
      grade carcinomas or cystadenomas. We therefore examined the distribution of such
      losses in different parts of heterogeneous tumors showing mixed histological
      grades or showing adjacent large histologically benign neoplasms. The results
      showed that all neoplastic areas, including those that were histologically benign
      or compatible with low-grade carcinomas, contained allelic losses at the above
      locus. This suggests that the morphologically less aggressive portions of these
      heterogeneous tumors were not typical cystadenomas or low-grade carcinomas and
      contained molecular abnormalities indicative of at least a predisposition to the
      high-grade carcinoma phenotype.

PMID- 8364907
TI  - Multiple breakpoints within the BCL-1 locus in B-cell lymphoma: rearrangements of
      the cyclin D1 gene.
AB  - Centrocytic lymphoma (CC) and intermediately differentiated lymphocytic lymphoma
      (IDL) are B-cell non-Hodgkin's lymphomas composed of lymphocytes presumably
      derived from follicle mantle cells. In these lymphomas, a specific chromosomal
      translocation, t(11;14)(q13;q32), has been described. Previous studies suggested
      an association between t(11;14) chromosomal translocations and BCL-1
      rearrangements. To evaluate the association between BCL-1 rearrangements and
      CC/IDL, Southern blot analysis was performed on a panel of 20 cases of CC/IDL, 22
      cases of morphologically similar non-Hodgkin's lymphomas, 11 cases of chronic B
      cell leukemias, and 2 cases of myelomas. We used various probes covering a
      considerable proportion of the 120-kilobase BCL-1 locus, and rearrangements in
      50% of CC/IDL (10 of 20) were detected. In CC, all 4 breakpoints were located at
      the major translocation cluster (MTC). In contrast, in IDL, rearrangements were
      detected in 3 different cluster regions: 2 cases in the MTC, 2 cases with a
      breakpoint 24 kilobases outside the MTC, and 2 additional cases with breakpoints
      found 3 kilobases 5' of the first exon of the PRAD1/CCND1 gene, which is located
      120 kilobases outside the MTC. In addition, one leukemia showed a breakpoint 63
      kilobases outside the MTC. In all cases, there was comigration of the rearranged
      11q13 fragment and the immunoglobulin heavy chain-joining gene complex,
      indicating a t(11;14)(q13;q32) chromosomal rearrangement. Our results show that
      Southern blot analysis is helpful to identify CC/IDL, but multiple breakpoints
      are present over a large region, and therefore, many probes are necessary to
      cover all breakpoints.

PMID- 8364908
TI  - Oxidative damage of nuclear DNA in liver of rats exposed to psychological stress.
AB  - Male Sprague-Dawley rats were exposed to conditioned emotional stimuli in a
      communication box, which is much more psychologically conditioned stress than the
      commonly used restraint and water immersion, to investigate the induction of
      oxidative DNA damage by psychological stress. Significantly higher levels of 8
      hydroxy-2'-deoxyguanosine in rat liver nuclear DNA than in the controls [1.46 +/-
      0.19 (SD) 8-hydroxy-2'-deoxyguanosine/10(5) deoxyguanosine] were detected
      immediately after the second (1.90 +/- 0.27, P < 0.01), third (3.10 +/- 0.94, P <
      0.01), and fourth exposure (2.95 +/- 1.17, P < 0.01) to conditioned emotional
      stimuli. This is the first evidence that oxidative damage to nuclear DNA is
      induced by psychological stress.

PMID- 8364909
TI  - Loss of a p53-associated G1 checkpoint does not decrease cell survival following
      DNA damage.
AB  - Cell cycle checkpoints regulate progression through the cell cycle. In yeast,
      loss of the G2 checkpoint by mutation of the rad9 gene results in increased
      genetic instability as well as increased sensitivity to ionizing radiation. In
      contrast, comparing clonogenic survival of cells which are isogeneic except for
      p53 functional status, we find that loss of a G1 checkpoint in mammalian cells is
      not associated with increased sensitivity to the lethal effects of ionizing
      radiation or a topoisomerase I inhibitor, camptothecin. These results indicate
      that increased sensitivity to DNA-damaging agents is not necessarily a defining
      feature of a mammalian cell cycle checkpoint. Furthermore, in light of a recent
      link of p53 function to radiation-induced apoptosis in hematopoietic cells, these
      observations suggest that p53-dependent apoptosis is a cell type-specific
      phenomenon and thus predict that the biological consequences of loss of p53
      function will be cell type specific.

PMID- 8364910
TI  - IA-1, a new marker for neuroendocrine differentiation in human lung cancer cell
      lines.
AB  - IA-1 is a recently isolated novel complementary DNA which encodes a protein of
      510 amino acids that contains both a zinc finger DNA-binding domain and a
      putative prohormone domain. mRNA expression of IA-1 has been found thus far only
      in tumors of neuroendocrine origin. In this report we describe the expression of
      IA-1 mRNA in a panel of 64 human lung cancer cell lines. IA-1 mRNA was detected
      by Northern blot analysis in 97% (30 of 31) of small cell lung cancer cell lines.
      In contrast, IA-1 mRNA was detected in only 13% (4 of 30) of non-small cell lung
      cancer cell lines. Nine of the 30 (30%) expressed either chromogranin A mRNA or
      produced L-dopa decarboxylase. Four of these 9 (44%) had detectable levels of IA
      1 mRNA. In most of the lung cancer cell lines examined, IA-1 showed high
      concordance with the other neuroendocrine markers, L-dopa decarboxylase, and
      chromogranin A. The one exception was a variant small cell lung cancer cell line
      which expressed low or nondetectable levels of L-dopa decarboxylase. IA-1 is a
      candidate marker of neuroendocrine differentiation of human lung tumors.

PMID- 8364911
TI  - Nickel induces a signature mutation for oxygen free radical damage.
AB  - We have determined the specificity of mutations produced by nickel(II), a known
      human carcinogen, in a forward mutation assay and also used a sensitive reversion
      assay to show that Ni(II), like iron and copper, can produce tandem double CC-
      >TT mutations, a hallmark of damage to DNA by either UV irradiation or oxygen
      free radicals. A reduction in mutation frequencies by the addition of oxygen
      radical scavengers also supports the involvement of reactive oxygen species in
      DNA damage and mutagenesis by Ni(II). Mutagenesis by Ni(II) is enhanced by the
      addition of both hydrogen peroxide and a tripeptide glycyl-glycyl-L-histidine.
      The enhancement of mutagenesis of Ni(II) by the tripeptide indicates that these
      complexes could serve to localize Ni(II) in nuclei and mediate DNA damage and
      mutagenesis via the generation of short-lived oxygen free radicals. These data
      suggest that Ni(II) carcinogenesis may proceed via the generation of active
      oxygen species and furthermore provide a model for nickel carcinogenesis based on
      the binding of Ni(II) to nuclear proteins.

PMID- 8364912
TI  - Growth inhibition of human lung cancer cell lines by interleukin 6 in vitro: a
      possible role in tumor growth via an autocrine mechanism.
AB  - It has been considered that growth of human lung cancer cells, like other
      malignant cells, is positively and negatively regulated by a variety of growth
      factors via autocrine as well as paracrine mechanisms. The autocrine mechanism is
      considered to be important in the autonomy of proliferation of cancer cells.
      Recently, the role of autocrine growth-inhibiting factors such as transforming
      growth factor beta attracts special attention for better understanding of growth
      regulation of malignant cells. Here, we have demonstrated that a multifunctional
      cytokine interleukin 6 (IL-6) had an inhibitory effect on the proliferation of
      human non-small cell lung cancer cell lines, as shown by the growth accelerating
      effect of the specific anti-IL-6 antibody as well as the effect of exogenously
      added IL-6. Moreover, IL-6 can be expressed and released by human lung cancer
      cells, and these cells had specific IL-6 receptors on their cell surfaces,
      suggesting an autocrine mechanism. The growth-inhibitory effect of IL-6 was
      additive to that of transforming growth factor beta, and could not be neutralized
      by the addition of anti-transforming growth factor beta antibody. These results
      suggested that IL-6 may function as another class of autocrine growth-inhibiting
      factor in the growth regulation of human lung cancer. Relatively lower IL-6
      sensitivity of these cells than noncarcinogenic human bronchial epithelial cells
      also suggested that escape from growth regulation by inhibitory factors such as
      IL-6 could be involved in lung cancer oncogenesis.

PMID- 8364913
TI  - Inhibitory effect of caffeic acid esters on azoxymethane-induced biochemical
      changes and aberrant crypt foci formation in rat colon.
AB  - Previous work from this laboratory established that caffeic acid esters, present
      in the propolis of honey bee hives, are potent inhibitors of human colon tumor
      cell growth, suggesting that these compounds may possess antitumor activity
      against colon carcinogenesis. The present study was designed to investigate (a)
      the inhibitory effects of methyl caffeate (MC) and phenylethyl caffeate (PEC) on
      azoxymethane (AOM)-induced ornithine decarboxylase (ODC), tyrosine protein kinase
      (TPK), and arachidonic acid metabolism in liver and colonic mucosa of male F344
      rats, (b) the effects of caffeic acid, MC, PEC, phenylethyl-3-methylcaffeate
      (PEMC), and phenylethyl dimethylcaffeate (PEDMC) on in vitro arachidonic acid
      metabolism in liver and colonic mucosa, and (c) the effects of PEC, PEMC, and
      PEDMC on AOM-induced aberrant crypt foci (ACF) formation in the colon of F344
      rats. At 5 weeks of age, groups of animals were fed diets containing 600 ppm MC
      or PEC (biochemical study) or 500 ppm PEC, PEMC, or PEDMC (ACF study). Two weeks
      later, all animals except the vehicle-treated groups were given s.c. injections
      of AOM, once weekly for 2 weeks. The animals intended for the biochemical study
      were sacrificed 5 days later and colonic mucosa and liver were analyzed for ODC,
      TPK, lipoxygenase, and cyclooxygenase metabolites. The animals intended for the
      ACF study were sacrificed 9 weeks later and analyzed for ACF in the colon. The
      results indicate that the PEC diet significantly inhibited AOM-induced ODC (P <
      0.05) and TPK (P < 0.001) activities in liver and colon. The PEC diet
      significantly (P < 0.001) suppressed the AOM-induced lipoxygenase metabolites
      8(S)- and 12(S)-hydroxyeicosatetraenoic acid (HETE). The animals fed the MC diet
      exhibited a moderate inhibitory effect on ODC and 5(S)-, 8(S)-, 12(S)-, and 15(S)
      HETEs and a significant (P < 0.001) effect on colonic TPK activity. However, the
      MC and PEC diets showed no significant inhibitory effects on cyclooxygenase
      metabolism. In an in vitro study, caffeic acid and MC showed inhibitory effects
      on HETE formation only at a 100 microM concentration, whereas PEC, PEMC, and
      PEDMC suppressed in vitro HETE formation in a dose-dependent manner. AOM-induced
      colonic ACF were significantly inhibited in the animals fed PEC (55%), PEMC
      (82%), or PEDMC (81%). The results of the present study indicate that PEC, PEMC,
      and PEDMC, present in honey, inhibit AOM-induced colonic preneoplastic lesions,
      ODC, TPK, and lipoxygenase activity, which are relevant to colon carcinogenesis.

PMID- 8364915
TI  - Reduction in the expression of glucose transporter protein GLUT 2 in
      preneoplastic and neoplastic hepatic lesions and reexpression of GLUT 1 in late
      stages of hepatocarcinogenesis.
AB  - Expression of two important glucose transporter proteins, GLUT 2 (which is the
      typical glucose transporter in hepatocytes of adult liver) and the
      erythroid/brain type glucose transporter GLUT 1 (representing the typical glucose
      transporter in fetal liver parenchyma), was studied immunocytochemically during
      hepatocarcinogenesis in rats at different time points between 7 and 65 wk after
      cessation of 7-wk administration of 12 mg/kg of body weight of N
      nitrosomorpholine p.o. (stop model). Foci of altered hepatocytes excessively
      storing glycogen (GSF) and mixed cell foci (MCF) composed of both glycogenotic
      and glycogen-poor cells were present at all time points studied. Seven wk after
      withdrawal of the carcinogen, GSF were the predominant type of focus of altered
      hepatocytes. Morphometrical evaluation of the focal lesions revealed that the
      number and volume fraction of GSF increased steadily until Wk 65. MCF were rare
      at 7 wk, increased slightly in number and size until Wk 37, but showed a
      pronounced elevation in their number and volume fraction from Wk 37 to Wk 65. In
      both GSF and MCF, GLUT 2 was generally decreased or partially absent at all time
      points. Consequently, foci of decreased GLUT 2 expression showed a steady
      increase in number and volume fraction from Wk 7 to Wk 65. GLUT 1 was lacking in
      GSF but occurred in some MCF from Wk 50 onward. The liver type glucose
      transporter GLUT 2 was decreased in all adenomas and hepatocellular carcinomas
      (HCC). In three of seven adenomas and 10 of 12 carcinomas, expression of GLUT 1
      was increased compared with normal liver parenchyma. In two cases of adenoid HCC,
      cells of ductular formations coexpressed GLUT 2 and GLUT 1. In contrast, normal
      bile ducts, bile duct proliferations, and cystic cholangiomas expressed only GLUT
      1. Seven of 12 HCC contained many microvessels intensely stained for GLUT 1, a
      phenomenon never observed in normal liver. Whenever adenoid tumor formations
      occurred, GLUT 1-positive microvessels were located in the immediate vicinity of
      these formations. Only in one HCC were such microvessels found in the absence of
      adenoid formations. Our studies indicate that a reduction of GLUT 2 expression
      occurs already in early preneoplastic hepatic foci and is maintained throughout
      hepatocarcinogenesis, including benign and malignant neoplasms. Reexpression of
      GLUT 1, however, appears in a few MCF and in the majority of adenomas and
      carcinomas.

PMID- 8364916
TI  - Interaction between ultraviolet A and ultraviolet B radiations in skin cancer
      induction in hairless mice.
AB  - The rate of tumor induction by UV-A radiation rises more slowly with time and
      accumulated dose than that by UV-B radiation. It has recently been shown that
      this difference disappears when frank papillomas are excluded from the analysis.
      Thus, the rate of development of "nonpapillomas" (mainly squamous cell carcinomas
      and precursors) can be fully characterized by a typical tumor induction time,
      e.g., the time until 50% of the mice bear tumors. This has opened the possibility
      to investigate how UV-A and UV-B exposures add up in the induction of squamous
      cell carcinomas, which is an important issue in risk assessments of artificial UV
      A sources for cosmetic or medical purposes. We present the results of an
      experiment in which 6 groups of 24 albino SKH:HR1 mice were treated daily for 600
      days with either effective UV-A radiation, effective UV-B radiation, or
      combinations of both. The observed times it took for 50% of the mice to bear
      tumors in the combination groups were compared with those calculated on the basis
      of arithmetical addition of effective UV-A and effective UV-B doses. We did not
      find a statistically significant (P < 0.05) deviation from additivity.

PMID- 8364917
TI  - Induction of renal pelvic carcinoma by phenacetin in hydronephrosis-bearing rats
      of the SD/cShi strain.
AB  - Carcinogenicity of phenacetin (PH) to the urinary tract was tested with the use
      of spontaneously hydronephrosis-bearing rats. In Experiment 1, 55 SD/cShi male
      rats were fed with 2% PH-containing diet for 85 weeks, and 32 SD/cShi male rats
      fed basal diet for 85 weeks served as controls. Forty-three of 53 rats fed with
      PH had renal pelvic carcinoma with lung metastases in three. The mean induction
      time was 78 weeks. Ureteral carcinoma and urinary bladder carcinoma were observed
      in 2 and 6 of 53 rats given PH, respectively. No urinary tract carcinoma was
      found in control animals. In Experiment 2, early lesions of the kidney affected
      by PH were also evaluated with the use of SD/cShi and Sprague-Dawley (SD) rats.
      Two groups of animals containing 6 SD/cShi or 6 SD male rats per group were fed
      2% PH-containing diet for 8 weeks. Control animals containing 6 SD/cShi rats or 6
      SD rats were fed basal diet for 8 weeks. Simple hyperplasia was found in 5 of 6
      SD/cShi rats given PH and 2 of 6 SD/cShi control rats. Papillary necrosis was
      seen in 4 of 6 SD/cShi and 2 of 6 SD rats given PH. SD/cShi rats, especially
      those treated with PH, showed higher but not significant 5-bromo-2'-deoxyuridine
      labeling indices in the covering epithelium of the renal pelvis and papillae. In
      this short term experiment PH and its metabolites, N-hydroxyphenacetin and N
      acetyl-p-aminophenol, were measured in urine and plasma by using high performance
      liquid chromatography. Significantly higher PH and slightly higher metabolites
      were detected in urine and plasma of SD/cShi rats compared to SD rats. These
      results indicated that the renal pelvis of SD/cShi rats had more sensitivity to
      PH carcinogenicity. This paper provides experimental proof of PH carcinogenicity
      toward the renal pelvis in an animal model.

PMID- 8364914
TI  - Expression of mutated p53 occurs in tumor-distant epithelia of head and neck
      cancer patients: a possible molecular basis for the development of multiple
      tumors.
AB  - As in most other tumor types, expression of mutated or phenotypically altered p53
      is a common occurrence in head and neck carcinogenesis. Since the prognosis for
      many head and neck tumor patients is severely affected by the occurrence of
      multiple primary and secondary tumors, we have analyzed the phenotype and
      genotype of p53 in squamous and respiratory epithelia either adjacent to or at
      significant distance from the primary tumors. Many tumor patients showed
      multifocal overexpression of the p53 protein in a variety of these epithelia.
      Overexpression of p53 correlated with increased proliferation and
      dedifferentiation, as demonstrated by immunohistochemistry and in situ
      hybridization using histone H3 and cytokeratin-specific probes. Polymerase chain
      reaction-single-strand conformation polymorphism analysis and sequencing of p53
      DNA, amplified from these biopsies after immunostaining and microdissection,
      confirmed and extended these findings. We have identified different mutations in
      p53 in different tumor-distant epithelia from the same patients. The data
      indicate that mutation of p53 is an early event in head and neck carcinogenesis,
      preceding signs of overt neoplasia, and that different mutations in p53 in
      multiple foci may provide a molecular basis for the development of multiple
      tumors.

PMID- 8364918
TI  - Effects of steroid hormones and opioid peptides on the growth of androgen
      responsive Shionogi carcinoma (SC115) cells in primary culture.
AB  - We investigated the effects of dihydrotestosterone (DHT), hydrocortisone (HC),
      basic fibroblast growth factor (bFGF), and opioid peptides on the growth of cells
      from the androgen-responsive Shionogi mouse mammary carcinoma (SC115) in primary
      culture. Androgen-responsive SC115 tumor cells were stimulated to grow in
      response to DHT, HC, and bFGF in a dose-responsive manner in both serum
      containing and serum-free media. Moreover, anti-bFGF antibody had a marked
      inhibitory effect on DHT- and bFGF-induced growth. Three opioid agonists, beta
      endorphin (beta-EP), cyclazocine, and morphine sulfate, markedly inhibited SC115
      tumor cell growth at concentrations ranging from 10(-11) to 10(-7) M in serum
      containing medium with or without DHT, HC, or bFGF, with the greatest inhibition
      occurring in medium with DHT. In serum-free medium, beta-EP had no inhibitory
      effects on cell growth. However, beta-EP at concentrations of 10(-9) M or greater
      significantly inhibited cell growth in serum-free medium containing DHT, HC, or
      bFGF, with the greatest inhibition again occurring in medium with DHT. Naloxone
      (10(-8) and 10(-6) M), an opioid receptor antagonist, blocked the inhibitory
      effects of beta-EP and morphine sulfate. These results suggest that SC115 tumor
      cells in primary culture are stimulated to grow in a dose-responsive manner by
      DHT, HC, or bFGF in both serum-containing and serum-free media. It appears that
      bFGF may mediate, at least partially, DHT-stimulated cell growth. In addition,
      the opioid peptide system may be involved in regulating endocrine control of
      growth of the androgen-responsive SC115 carcinoma. The dose-responsive inhibitory
      effects of opioids and their reversal by naloxone suggest that these effects may
      be mediated by opioid receptors.

PMID- 8364919
TI  - Reduced risk of colon cancer with high intake of vitamin E: the Iowa Women's
      Health Study.
AB  - Antioxidant micronutrients, including vitamin E, vitamin C, the carotenoids, and
      selenium, defend the body against free radicals and reactive oxygen molecules,
      suggesting a potential for these dietary components in cancer prevention. To
      investigate whether high intakes of antioxidant micronutrients protect against
      colon cancer in humans, we analyzed data from a prospective cohort study of
      35,215 Iowa women aged 55-69 years and without a history of cancer who completed
      a dietary questionnaire in 1986. Through 1990, 212 incident cases of colon cancer
      were documented. Adjusted for age, total vitamin E intake was inversely
      associated with the risk of colon cancer (P for trend < 0.0001); the relative
      risk for the highest compared to the lowest quintile was 0.32 [95% confidence
      interval (95% CI) 0.19, 0.54]. Further adjustment for total energy intake and
      other risk factors in proportional hazards regression had little effect on these
      estimates. The association was not uniform across age groups: the multivariate
      relative risk of colon cancer for the highest compared to the lowest quintile of
      total vitamin E intake was 0.16 (95% CI 0.04, 0.70) for those 55-59 years old,
      0.37 (95% CI 0.12, 1.16) for those 60-64 years old, and 0.93 (95% CI 0.27, 3.25)
      for those 65-69 years old. Multivariate-adjusted relative risks among women with
      higher total intakes of vitamins A and C and beta-carotene, and among users of
      selenium supplements, were not significantly different from 1.0. These
      prospective data provide evidence that a high intake of vitamin E may decrease
      the risk of colon cancer, especially in persons under 65 years of age.

PMID- 8364920
TI  - Bovine serum albumin-doxorubicin conjugate overcomes multidrug resistance in a
      rat hepatoma.
AB  - A bovine serum albumin-conjugated doxorubicin via the glutaraldehyde bridge (BSA
      DXR conjugate) showed potent dose-dependent inhibition of cell growth against
      daunorubicin-resistant AH66 (AH66DR) cells as well as parental AH66 (AH66P) cells
      in vitro as compared to treatment with DXR or BSA-glutaraldehyde conjugate
      without DXR (BSA-GA). In the culture of AH66DR with BSA-DXR conjugate, drug
      accumulation in the AH66DR cells increased as a function of time up to 24 h
      reaching approximately the same drug level as AH66P cells treated with DXR. The
      intracellular accumulation of the BSA-DXR conjugate was inhibited by the addition
      of ammonium chloride, while that of DXR alone was not inhibited. Intracellular
      DXR was effluxed rapidly from AH66DR cells, but BSA-DXR conjugate or
      pharmacologically active DXR adduct remained in the cells at a relatively high
      concentration over a 36-h time period. The life-prolonging effect of the
      conjugate was assessed using rats inoculated i.p. with AH66P or AH66DR. The rats
      were treated with the BSA-DXR conjugate, DXR, a mixture of DXR with BSA, or BSA
      GA by either the i.p. or i.v. route. Treatment with DXR had no significant
      surviving effect as compared to that with saline in AH66P-bearing rats. By
      contrast, BSA-DXR conjugate showed a significant life-prolonging effect as
      compared with DXR alone in the same degree both in AH66P- and AH66DR-bearing
      rats. BSA-GA did not show any toxicity in vivo as well as in vitro. These results
      indicate that the BSA-DXR conjugate allows DXR to escape from the multidrug
      resistance mechanism.

PMID- 8364921
TI  - Locus of the interaction among 5-fluorouracil, leucovorin, and interferon-alpha
      2a in colon carcinoma cells.
AB  - Prior studies from these laboratories demonstrated 3.2-fold potentiation of 5
      fluorouracil (FUra) cytotoxicity by recombinant human interferon-alpha 2a (rIFN
      alpha 2a) in GC3/cl colon adenocarcinoma cells that was significantly enhanced to
      14-fold when FUra was combined with rIFN-alpha 2a + a mixture of the
      diasteroisomers of the biologically active (6S) and inactive (6R) leucovorin or 5
      formyl-H4PteGlu (LV), events that were reversible by thymidine (dThd). In
      GC3/clTS-c3/c3 cells, deficient in thymidylate synthase, rIFN-alpha 2a
      cytotoxicity was not influenced by the concentration of dThd, indicating no
      direct effect at the level of dThd-less stress. Direct assays of thymidylate
      synthase indicated no significant difference between FUra-induced accumulation of
      total thymidylate synthase or free or unbound thymidylate synthase in cells
      receiving FUra + modulators. In addition, the cytotoxic activity of CB3717, a
      specific quinazoline-based inhibitor of thymidylate synthase, was not potentiated
      by rIFN-alpha 2a. These studies suggested that thymidylate synthase was not the
      primary target site for rIFN-alpha 2a activity. Since data indicated that a 5
      fluoropyrimidine was required in the interaction among FUra, LV, and rIFN-alpha
      2a, attention was focused at the level of DNA. Both DNA single-strand breaks
      (SSBs) and DNA double-strand breaks (DSBs) induced by FUra were significantly
      elevated by rIFN-alpha 2a and LV administered as single modulators and were
      influenced by the concentrations of both FUra and rIFN-alpha 2a. However; when
      FUra was combined with LV, rIFN-alpha 2a further potentiated the frequency of DNA
      SSBs, and data correlated with the relative cytotoxic activity of FUra-LV-rIFN
      alpha 2a combinations. No effect on CB3717-induced DNA SSBs or DSBs by rIFN-alpha
      2a was demonstrated. Drug exposure for 48 h was required to detect measurable
      differences in DNA SSB frequency among FUra-LV-rIFN-alpha 2a treatment groups and
      correlated with decreased clonogenic survival under these conditions. Continuous
      exposure to FUra (72 h) allowed shorter exposures to LV and/or rIFN-alpha 2a (48
      h) to maintain maximal cytotoxicity. Shorter exposure times for FUra during
      continuous exposure to the modulators were less cytotoxic. Data suggest that the
      primary locus of the interaction among FUra, LV, and rIFN-alpha 2a lies at the
      level of DNA. rIFN-alpha 2a may exert its effects via enhancement of FUra base
      excision or incorporation into DNA, events that subsequently become influenced by
      thymidylate synthase inhibition and dThd-less stress and are further potentiated
      by LV.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8364922
TI  - Effects of temperature on the therapeutic efficacy and pharmacokinetics of
      ifosfamide.
AB  - The influence of tumor temperature (28, 32, 37, 39, 41, or 43 degrees C for 1 h)
      on the therapeutic efficacy of i.v. single bolus injections of ifosfamide (IFO)
      (32, 65, 125, or 250 mg/kg body weight) in human tumor xenografts (MX1 breast
      carcinoma) grown in nude mice (n = 240) was studied. Tumor temperature was
      controlled by water bath immersion. Sixty days after treatment the percentage of
      tumor-free survival was determined. For example, at 37 degrees C IFO in a dose of
      65 mg/kg body weight led to 10% tumor-free survival in the treated animals. At 43
      degrees C the same dose resulted in 60% tumor-free survival. A clear drug dose-
      and temperature-dependent increase of the therapeutic efficacy of an active
      oxazaphosphorine compound was also demonstrated in vitro. The concentrations of
      IFO and of 4-hydroxyifosfamide in blood and tumors at different body temperatures
      (controlled by water bath immersion) were determined over 120 min and WBC counts
      were obtained. The half-lives and the areas under the curve for IFO in blood were
      not significantly different at 37 degrees C and 41 degrees C. Since the half-life
      of IFO depends mainly on hepatic metabolism, the similarity of half-lives and of
      areas under the curve for IFO at 37 degrees C and 41 degrees C indicates a
      constant activation rate. However, significantly lower plasma concentrations of
      the activated drug at a liver (body) temperature of 41 degrees C, compared with
      37 degrees C, were found, indicating a higher elimination rate. The concentration
      of the activated drug in the tumors within the initial 60 min at 41 degrees C,
      however, exceeded by > 2-fold that at 37 degrees C. The bone marrow toxicity of
      the same drug dose did not significantly increase with body temperature.

PMID- 8364923
TI  - Antitumor protection from the murine T-cell leukemia/lymphoma EL4 by the
      continuous subcutaneous coadministration of recombinant macrophage-colony
      stimulating factor and interleukin-2.
AB  - Combined continuous s.c. coadministration of macrophage-colony stimulating factor
      (M-CSF) plus interleukin-2 (IL-2) by osmotic pump protected mice given i.v.
      injections of a lethal dose of EL4 T-cell leukemia/lymphoma. Antitumor protection
      was significantly greater than that afforded by treatment with either cytokine
      alone. Since neither IL-2 receptors nor M-CSF receptors were expressed on EL4,
      the antitumor effect was likely attributed to murine effector cells. To determine
      how M-CSF+IL-2 provided this effect, we performed immunophenotypic and functional
      analyses as well as in vivo depletion studies of putative antitumor effector
      cells. Splenic phenotyping experiments revealed that the highest levels of
      macrophages and natural killer cells were observed in mice given the cytokine
      combination rather than either M-CSF or IL-2 alone. In vivo depletion of natural
      killer cells ablated the antitumor protective effect of M-CSF and IL-2. T-cells
      were also important for M-CSF+IL-2 efficacy, since adult thymectomy/T-cell
      depletion significantly inhibited the ability of cytokine coadministration to
      protect against EL4. Coadministration of the 2 cytokines significantly elevated
      in vivo levels of CD3+CD4+, CD3+CD8+, CD3+NK1.1+ T-cells, and CD3+CD25+
      (activated) T-cells, and elevated anti-EL4 cytotoxic T-cell activity measured in
      vitro. Although WBC counts and fluorescence-activated cell sorter studies showed
      that M-CSF+IL-2 treatment significantly elevated neutrophils, s.c. delivery of
      granulocyte-colony stimulating factor at doses sufficient to induce neutrophilia
      was unable to confer anti-EL4 protection. These studies indicate that
      macrophages, T-cells, and natural killer cells are all important in the M-CSF+IL
      2 anti-EL4 response. The superior antitumor effect of this cytokine combination
      along with the ability of M-CSF to diminish the toxicity of IL-2 in this model
      suggests that further investigations into the clinical potential of this
      combination treatment are warranted.

PMID- 8364924
TI  - Prolonged depletion of O6-methylguanine DNA methyltransferase activity following
      exposure to O6-benzylguanine with or without streptozotocin enhances 1,3-bis(2
      chloroethyl)-1-nitrosourea sensitivity in vitro.
AB  - This study was undertaken to ascertain the importance of prolonged depletion of
      O6-methylguanine DNA methyltransferase (MGMT) activity, following O6
      benzylguanine (BG) and streptozotocin (STZ) exposure, in reversing 1,3 bis(2
      chloroethyl)-1-nitrosourea (BCNU) resistance in vitro. We evaluated BCNU-induced
      cytotoxicity and measured the temporal recovery of MGMT activity in human colon
      carcinoma HT-29 cells following treatment with BG, STZ, or the combination of BG
      and STZ. The pretreatment regimens which provided the greatest potentiation of
      BCNU cytotoxicity were those exhibiting the greatest temporal inhibition of MGMT
      activity. The combination of BG (10 microM) and STZ (1.0 mM) produced sustained
      inhibition of MGMT activity through 24 h and potentiated BCNU cytotoxicity by at
      least one log greater than either agent alone. Similarly, BG (10-100 microM)
      produced marked reductions in MGMT activity and increased BCNU cytotoxicity in a
      dose-dependent fashion. A 100-microM dose of BG inhibited MGMT activity for 48 h
      and potentiated BCNU induced cell kill by 3 logs greater than BCNU alone. In
      addition, we observed that during the period of sustained inhibition of MGMT
      activity, no changes in the steady-state MGMT mRNA levels occurred. We conclude
      that prolonged inhibition of MGMT activity is an important determinant in
      reversing BCNU resistance and that chemotherapeutic regimens targeting the
      inactivation of MGMT activity should be optimized such that MGMT activity is
      depleted for at least 24 h following BCNU administration.

PMID- 8364925
TI  - Etoposide-induced cytotoxicity in two human T-cell leukemic lines: delayed loss
      of membrane permeability rather than DNA fragmentation as an indicator of
      programmed cell death.
AB  - Features of the apoptotic response evident in glucocorticoid-treated thymocytes
      are not uniformly observed in cell lines exposed to anticancer drugs. The
      significance of such variation has been assessed by monitoring molecular and
      cellular processes induced by etoposide (VP-16) in the human lymphoblastoid T
      cell lines CCRF-CEM (CEM) and MOLT-4 contrasted, where appropriate, with those
      induced by necrotizing injury. Cytotoxic concentrations of the drug were
      determined to be 5-100 microM on the basis of tetrazolium reduction assay. The
      two lines were equally sensitive to VP-16; no difference in concentration of drug
      which inhibited cell growth by 50% with respect to control (i.e., drug free)
      cultures was apparent irrespective of exposure times from 3-72 h. DNA strand
      breaks were evident in both populations within 3 h of exposure to VP-16.
      Morphological change, assessed microscopically, involving nuclear condensation
      and cell shrinkage was qualitatively and quantitatively similar in VP-16-treated
      CEM and MOLT-4 cells. Flow cytometric analysis indicated that the G2/M fraction
      of the randomly dividing MOLT-4 population was approximately one-third that of
      CEM cells, but each line exhibited a decrease in this fraction 3-6 h after
      treatment. Despite these similarities, marked differences in the response to VP
      16 were evident in the two populations. Internucleosomal fragmentation, detected
      electrophoretically 3 h after treatment in DNA isolated from CEM cells, was not
      detected under any condition in MOLT-4 DNA. Apoptotic bodies, also evident within
      3 h of VP-16 treatment of CEM cells, were not readily apparent in MOLT-4 cells
      under the same conditions. Treatment causing necrosis resulted in trypan blue
      uptake within 1 h in a similar high proportion of cells from both lines. Exposure
      to VP-16 resulted in such a loss of membrane integrity by 6 h in CEM cells, while
      change in this parameter occurred only after 24 h in the case of MOLT-4 cells.
      The findings indicate a wide scope of difference in apoptotic response and
      suggest delayed loss of membrane permeability, rather than DNA fragmentation, as
      the clearest indicator of programmed cell death in these populations.

PMID- 8364926
TI  - Cross-reactivity of anti-CD3/IL-2 activated effector cells derived from lymph
      nodes draining heterologous clones of a murine tumor.
AB  - Cells from lymph nodes (LN) draining progressively growing tumors can
      differentiate into immune effector cells upon in vitro stimulation with anti-CD3
      monoclonal antibodies followed by interleukin-2. The adoptive transfer of these
      activated LN cells to tumor-bearing mice mediates potent tumor-specific
      therapeutic effects. In this study, we sought to further characterize the
      antitumor efficacy and specificity mediated by the anti-CD3/IL-2 activated tumor
      draining LN cells against heterologous clones derived from the murine MCA 106
      sarcoma. Ten clones of divergent characteristics with regard to morphology, in
      vivo growth rate, ability to establish pulmonary metastases, MHC class I (H-2)
      antigen expression, susceptibility to lysis by allogeneic cytotoxic T
      lymphocytes, as well as sensitivity to doxorubicin were selected and analyzed. In
      adoptive immunotherapy experiments, pulmonary metastases derived from each clone
      were found to be sensitive to the therapeutic effects of activated cells derived
      from LN draining the parental MCA 106 tumor. The antigenic cross-reactivity was
      evident from the observation that activated cells from LN draining each of the
      individual tumor clones were capable of mediating the regression of parental
      tumor metastases. The specificity of the antitumor reactivities mediated by LN
      cells draining MCA 106 clones was demonstrated by a lack of in vivo efficacy
      against metastases derived from the antigenically distinct MCA 205 sarcoma.
      Additionally, selected clones were tested for their ability to stimulate draining
      LN against other cloned tumors or used as targets for therapy with activated LN
      cells draining different clones. In all 29 adoptive immunotherapy experiments,
      there was complete cross-reactivity between different MCA 106 tumor clones. These
      findings suggest that the MCA 106 tumor-specific antigen(s) that stimulates
      draining LN in vivo and recognized by the anti-CD3/IL-2 activated cells is
      present on most if not all tumor cells. However, in the absence of a demonstrably
      resistant tumor clone, a very highly polymorphic antigen with many cross
      reactive, but distinct epitopes might be operative and attributable to these
      observations.

PMID- 8364927
TI  - Blockade of epidermal growth factor receptor function by bivalent and monovalent
      fragments of 225 anti-epidermal growth factor receptor monoclonal antibodies.
AB  - We have previously described anti-epidermal growth factor (EGF) receptor
      monoclonal antibodies (MAbs) which can block binding of transforming growth
      factor alpha (TGF-alpha) and EGF to receptors and inhibit activation of receptor
      tyrosine kinase. Studies with these MAbs involving cell cultures and nude mouse
      xenografts demonstrated their capacity to inhibit the growth of a variety of
      tumor cell lines, which express EGF receptors and TGF-alpha and appear to depend
      upon receptor activation for cell proliferation. To explore the mechanism(s) by
      which anti-EGF receptor 225 MAb inhibits cell proliferation, we have compared the
      activity of native 225 MAb with the response to bivalent 225 F(ab')2 and
      monovalent 225 Fab' fragments. Both native 225 MAb and its fragments could
      inhibit the binding of 125I-EGF to EGF receptors. Scatchard analysis revealed
      that the Kd of 225 F(ab')2 is comparable to that of 225 MAb (1 nM), whereas the
      Kd of 225 Fab' is 5 nM. Both bivalent 225 MAb and 225 F(ab')2 and monovalent 225
      Fab' were able to completely inhibit TGF-alpha-induced EGF receptor tyrosine
      kinase activation, as assayed by autophosphorylation of tyrosine residues of EGF
      receptors on MCF10A nonmalignant human mammary cells, MDA468 human breast
      adenocarcinoma cells, and A431 human vulvar squamous carcinoma cells. The
      bivalent forms of MAb could inhibit proliferation stimulated by endogenous
      (autocrine) TGF-alpha in cultures of these three cell lines. They also blocked
      growth stimulation by added exogenous TGF-alpha in cultures of MCF10A cells and
      the growth-inhibitory effect of exogenous TGF-alpha upon MDA468 and A431 cell
      cultures. Monovalent 225 Fab' had weaker inhibitory effects upon the
      proliferation of these cell lines. To determine whether the in vivo
      antiproliferative activity of anti-EGF receptor MAb can occur without the
      participation of the Fc portion of MAb, the capacities of 225 F(ab')2 and native
      225 MAb to inhibit growth of s.c. A431 cell xenografts were compared. Equimolar
      amounts of either 225 MAb or 225 F(ab')2 were administered at intervals
      equivalent to the half-lives of the molecules, to attempt to maintain comparable
      plasma levels. Both 225 MAb and 225 F(ab')2 inhibited A431 cell xenograft growth
      in a dose-dependent manner, with a more sustained response in the case of the
      intact antibody.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8364928
TI  - Collaboration between growth factors and diverse chemical carcinogens in
      hepatocarcinogenesis of transforming growth factor alpha transgenic mice.
AB  - Transforming growth factor alpha (TGF-alpha) has been shown to induce liver
      tumors within 1 year in transgenic male mice in which this potent mitogen is
      overexpressed. To determine more precisely how TGF-alpha participates in
      multistep tumorigenesis of the liver, genotoxic (diethylnitrosamine or
      dimethylnitrosamine) and nongenotoxic (phenobarbital) chemical carcinogens were
      administered independently to TGF-alpha transgenic mice [line MT42 on a Crl:CD
      1(ICR)BR background]. TGF-alpha overexpression dramatically accelerated
      carcinogen-induced hepatocarcinogenesis in MT42 males but not females.
      Interestingly, all three chemical agents were found to enhance strongly both
      hepatic tumor formation and progression in TGF-alpha transgenic male mice. In
      this study 100%, 90%, and 78% of transgenic males exposed to diethylnitrosamine,
      dimethylnitrosamine or phenobarbital, respectively, developed tumors between 24
      and 32 weeks of age. Moreover, approximately 70% of tumor-bearing transgenic mice
      from each treatment group had hepatocellular carcinomas; no malignant lesions
      were found in any carcinogen-treated or untreated nontransgenic mice or in
      untreated MT42 mice at this age. These results demonstrate that chemical agents
      as diverse as nitrosamines and phenobarbital act as cocarcinogens with TGF-alpha
      in the livers of these transgenic mice, indicating that TGF-alpha possesses the
      unique ability to complement both initiation and promotion in
      hepatocarcinogenesis. Furthermore, because carcinogen-induced malignant
      conversion was restricted to transgenic mice, constitutive TGF-alpha
      overexpression may promote liver tumor progression as well.

PMID- 8364929
TI  - Recurrent deletions of specific chromosomal sites in 1p, 3p, 6q, and 9p in human
      malignant mesothelioma.
AB  - Detailed cytogenetic analyses were carried out on primary tumor specimens and
      cell lines from 23 patients with pleural malignant mesothelioma (MM). Clonal
      abnormalities were identified in 20 of 23 MM. In 3 cases, karyotypic data were
      compiled from harvests of both short-term cultures (1-3 days), and primary
      cultures grown on murine feeder layers for several weeks. The karyotypes obtained
      with these 2 different culture methods were very similar, although polyploid
      versions of abnormal clones were found only in the long-term cultures. In
      addition, while short-term cultures from 9 tumor biopsies usually exhibited near
      diploid clones, cell lines derived from 11 tumors tended to have higher ploidies.
      Each of the cytogenetically abnormal MM displayed multiple clonal alterations.
      The 2 most frequent changes were chromosomal losses of specific regions in 1p (17
      cases) and 9p (16 cases). The shortest regions of overlap of these losses were at
      1p21-p22 and 9p21-p22, respectively. Other common abnormalities included losses
      of 3p21 (13 cases) and 6q15-q21 (9 cases), and numerical losses of chromosomes
      14, 16, 18, and 22 (each observed in 10-13 tumors). In many of the MM examined,
      most or all of these recurrent changes occurred in combination, suggesting the
      involvement of a pathogenetic cascade in this cancer. The pattern of recurrent
      chromosomal losses suggests that these regions represent the locations of tumor
      suppressor genes whose loss/inactivation may have a pivotal role in MM
      tumorigenesis.

PMID- 8364930
TI  - Loss of heterozygosity in familial breast carcinomas.
AB  - Three loci have been implicated in the etiology of familial breast cancer; the
      BRCA1 locus on 17q, the p53 gene on 17p, and the androgen receptor gene on the X
      chromosome. However, it has been estimated that in approximately 50% of all
      breast cancer families the predisposing genetic defect is not linked to any of
      these three loci. In an attempt to identify chromosomal regions harboring
      putative breast cancer genes we performed allelotyping in 82 familial breast
      carcinomas. Polymorphic markers representing 45 different loci were analyzed and
      the most frequently involved chromosomal arms were 8p, 16q, 17p, 17q, and 19p.

PMID- 8364931
TI  - A codon 248 p53 mutation retains tumor suppressor function as shown by
      enhancement of tumor growth by antisense p53.
AB  - Codon 248 in domain iv of the highly conserved region of the p53 gene is a
      frequent site of mutations associated with sporadic cancers and the familial
      cancer syndrome (Li-Fraumeni syndrome). Therefore, a characterization of the
      functional significance of a codon 248 mutation is of interest. We used antisense
      RNA methodology to study the role of the wild-type and mutated p53 gene in cell
      growth and tumorigenesis. We introduced wild-type p53 complementary DNA in sense
      or antisense orientation under control of a beta-actin promoter into human non
      small cell lung cancer cell line H322a which has a codon 248 mutation (G to T)
      and WTH226b which has wild type p53. The biological properties and p53 expression
      of stable G418-resistant clones were analyzed. We observed that in both cell
      lines antisense RNA expression significantly reduced p53 mRNA and protein
      production; it also caused increases in growth rate in cell cultures and in
      tumorigenicity in nu/nu mice for both cell types, suggesting that the mechanism
      by which p53 suppresses cell proliferation and tumorigenesis is not always
      abrogated by a codon 248 mutation.

PMID- 8364932
TI  - Monoclonal antibody FW6 defines an epitope on alpha 3/4-monofucosylated
      polylactosaminoglycans expressed by fetal and colon carcinoma-associated mucins.
AB  - A mouse IgM monoclonal antibody FW6 was established after immunization of mice
      with mucins from human amniotic fluid and was characterized with regard to its
      binding epitope. According to a series of biochemical criteria the epitope is
      located on O-linked neutral carbohydrates of M(r) 700,000 and M(r) 570,000 mucins
      in human amniotic fluid. The epitope is presumed to contain alpha 3/4-linked
      fucose and terminal beta 3/4-linked galactose that are labile to the fucosidase I
      from almond emulsion or to the galactosidase from bovine testes, respectively.
      Immunoreactive fractions of glycan alditols from human amniotic fluid mucins were
      partially characterized by fast atom bombardment-mass spectrometry and
      methylation analysis to be composed of monofucosylated polylactosamine-type deca-
      or nonasaccharides. According to antibody competition studies, inhibition assays
      with defined carbohydrates and binding assays on neoglycolipids monoclonal
      antibody FW6 are presumed to recognize a novel epitope that is distinct from
      known carbohydrate markers of the Lex/Ley family associated with colonic
      carcinomas. The selective reactivity of this monoclonal antibody to the majority
      of human colonic carcinomas and its nonreactivity to normal colonic mucosa may
      render this antibody as a valuable tool in cancer diagnosis or cancer treatment.

PMID- 8364933
TI  - Chemotaxis and haptotaxis of human malignant mesothelioma cells: effects of
      fibronectin, laminin, type IV collagen, and an autocrine motility factor-like
      substance.
AB  - A human malignant pleural mesothelioma cell line (STAV) was studied with respect
      to production of the extracellular matrix components laminin, type IV collagen,
      and fibronectin, and interactions with these proteins in vitro. We also analyzed
      STAV cell serum-free conditioned medium with respect to the possible presence of
      "autocrine motility factor-like" substance. Sodium dodecylsulfate-polyacrylamide
      gel electrophoresis of biosynthetically labeled STAV serum-free conditioned
      medium showed that STAV cells released several proteins into the medium,
      including components with molecular weights of 850,000, 540,000 and 440,000.
      Using Western blotting we identified these proteins as laminin, type IV collagen,
      and fibronectin, respectively. By immunocytochemistry laminin, type IV collagen,
      and fibronectin were detected as a matrix surrounding the cells. Plastic culture
      dishes coated with microgram quantities of laminin, type IV collagen, and
      fibronectin induced attachment and spreading of STAV cells. Laminin, type IV
      collagen, and fibronectin stimulated directional (chemotactic) migration of STAV
      cells in Boyden chambers fitted with 8 microns filters. The same cells also
      migrated to insoluble step gradients of filter-bound extracellular matrix
      components (haptotaxis). When STAV serum-free conditioned medium was separated by
      using fast protein liquid chromatography Superose 6 gel filtration, two motility
      inducing protein peaks were detected. The first peak contained proteins with
      molecular weight > 220,000 that had both chemotactic and haptotactic properties,
      while the second peak contained material with apparent molecular weights of
      approximately 67,000 that had chemotactic and chemokinetic (random motility) but
      not haptotactic properties. Analysis of the M(r) 67,000 material indicated that
      it was a heat-sensitive and trypsin-digestible protein. The production of both
      soluble and insoluble extracellular matrix components by human mesothelioma cells
      and the motile response to these molecules as well as the production of a M(r)
      67,000 autocrine motility factor-like substance may be important for the highly
      invasive motile behavior of this tumor.

PMID- 8364935
TI  - Increased transforming growth factor beta expression inhibits cell proliferation
      in vitro, yet increases tumorigenicity and tumor growth of Meth A sarcoma cells.
AB  - Several observations correlate increased expression of transforming growth factor
      (TGF) beta 1 with tumorigenesis, suggesting that expression of this
      multifunctional growth factor may provide an advantage in tumor formation.
      However, many tumor cells are inhibited in their proliferation by TGF-beta in
      vitro, thus suggesting that TGF-beta synthesis could exert an antiproliferative
      effect on tumor formation. To evaluate the physiological relevance of increased
      TGF-beta 1 synthesis in such tumor cells which are strongly inhibited in their
      proliferation by TGF-beta, we chose Meth A sarcoma cells as a model system. We
      established cell clones overexpressing TGF-beta 1 and determined its effect on
      tumor formation in mice that are not immunocompromised. Increased expression of
      biologically active TGF-beta 1 resulted in a profound growth inhibition in the
      transfected clones and increased adhesiveness in vitro. However, these cells were
      much more tumorigenic than Meth A cells that did not overexpress TGF-beta 1, as
      assessed by both tumor incidence and tumor growth. In addition, parental Meth A
      cells were inhibited in their tumor formation by neutralizing TGF-beta antibodies
      and stimulated by exogenous TGF-beta. Our results thus provide evidence that
      increased TGF-beta synthesis provides a major advantage for tumorigenesis, even
      if the cells are growth inhibited by their endogenous TGF-beta synthesis in
      culture. These results suggest that, in vivo, direct effects of TGF-beta on the
      tumor environment, such as increased extracellular matrix formation and cell
      matrix interactions, and local suppression of the immune surveillance may provide
      a growth advantage which overrules any direct antiproliferative effects of TGF
      beta, as suggested by the effects in culture.

PMID- 8364934
TI  - MAb U36, a novel monoclonal antibody successful in immunotargeting of squamous
      cell carcinoma of the head and neck.
AB  - Using viable cells of a human head and neck squamous cell carcinoma (HNSCC) cell
      line as immunogen, we developed monoclonal antibody (MAb) U36.
      Immunohistochemical examination revealed distinct surface labeling of MAb U36
      with normal human squamous epithelium and squamous cell carcinomas of distinct
      sites of origin; head and neck, lung, esophagus, cervix, and epidermis. MAb U36
      shows high affinity binding (affinity constant, 3.5 x 10(10)/M) with a cell
      surface antigen expressed by in vitro cultured HNSCC cell lines. Similarity of
      the reactivity profiles of MAb U36 and MAb E48, currently the most promising
      antibody described for specific targeting of HNSCC in patients, warranted further
      comparison of these MAbs. MAb U36 recognizes a M(r) 200,000 antigen, which is
      different from the MAb E48 defined antigen. Furthermore, comparison of
      immunohistochemical staining patterns of MAb U36 and MAb E48 on a broad panel of
      primary HNSCC sections revealed more extensive staining for MAb U36: more tumors
      showed reactivity with MAb U36 and more tumor cells per tumor showed positive
      reaction, and staining was found to be more intense. MAb U36 does not show cross
      reactivity with mouse, rat, pig, sheep, or bovine tongue epithelium. As a first
      approach to evaluate the suitability of MAb U36 for tumor targeting in vivo,
      radiolabeled MAb U36 was administered to athymic nude mice bearing human HNSCC
      xenografts on both flanks. Selective tumor accumulation of the
      radioimmunoconjugate was observed. Mean tumor uptake (in percent injected dose/g
      wet-weight of tissue) of MAb U36 at days 1, 2, 3, 5, 7, and 12 was 15.1, 17.9,
      24.0, 21.0, 25.8, and 16.0%, respectively. The tumor to blood ratio at day 1 was
      0.9 and increased up to 3.8 at day 12. The tumor uptake at day 12 was at least 10
      times higher when compared to other tissues. The corollary of these findings is
      that MAb U36 harbors high potential for specific targeting of HNSCC.

PMID- 8364936
TI  - Establishment of estrogen receptor-positive transplantable rat thyroid tumor cell
      lines in vivo.
AB  - We established 17 transplantable rat thyroid tumor cell lines from the primary
      thyroid tumor of rats induced by N-bis(2-hydroxypropyl)nitrosamine. Among the 17
      tumor cell lines established, only two of them (D1 and G1) were estrogen receptor
      (ER) positive. These two cell lines were characterized with respect to
      transplantability, histological features, ER contents and cellular localization,
      and expression of ER message. The ER contents, determined by dextran-coated
      charcoal assay, were 13.3 and 20.7 fmol/mg protein for D1 and G1 cell lines,
      respectively. Scatchard plot analysis indicates that the dissociation constants
      (Kd) were 0.17 and 0.4 nM, respectively, for D1 and G1 cell lines. Sucrose
      density centrifugation analysis detected a hormone-receptor complex which
      sedimented at the 4S region, characteristic for ER. Immunohistological staining
      revealed that the ER was localized in the nuclei. The presence of ER in D1 and G1
      cell lines was further confirmed by reverse transcriptase-polymerase chain
      reaction to detect the ER mRNA. These results demonstrated that ER is expressed
      in some thyroid tumors. The ER-positive transplantable tumor cell lines are
      useful for studying the direct effect of estrogen on thyroid tumors in vitro and
      in vivo.

PMID- 8364937
TI  - Tamoxifen-induced increase in the potential doubling time of MCF-7 xenografts as
      determined by bromodeoxyuridine labeling and flow cytometry.
AB  - The anti-estrogen tamoxifen (TAM) is widely used in the therapy of human breast
      cancer. Shown to induce a G1 transition delay in vitro, the kinetic effects of
      TAM on breast carcinoma cells growing as tumor xenografts in nude mice have been
      less well characterized. In this study, we demonstrate a significant increase in
      the tumor potential doubling time (Tpot) and decrease in the labeling index (%LI)
      of estradiol (E2)-stimulated MCF-7 xenografts following TAM treatment or E2
      deprivation. MCF-7 tumor pieces were transplanted s.c. into nude mice
      supplemented with Silastic capsules containing E2. After 2-4 weeks, animals were
      randomized to continued E2 treatment, E2 and TAM treatment, or E2 deprivation. At
      times ranging from 0 to 23 days after treatment, animals were given injections of
      bromodeoxyuridine and tumors excised for kinetic analysis. Using flow-cytometric
      techniques, the Tpot and %LI were estimated for all tumors. Seven independent
      experiments were performed and data pooled for statistical analysis. At the time
      of hormonal manipulation, E2-stimulated tumors had a volume doubling time of 5
      days, a Tpot of 2.3 days, and a %LI of 23%. Continued E2 treatment resulted in
      only minimal changes in Tpot and %LI over the remainder of the observation
      period. Treatment with TAM resulted in a slowing of tumor growth (tumor doubling
      time, 12 days), a significant (P < 0.001) increase in Tpot to 6.6 days, and a
      decrease in %LI to 8% by 23 days posttreatment. E2 deprivation resulted in a
      cessation of tumor growth and similar changes in Tpot and %LI to 5.3 days and
      10%, respectively (P < 0.001). In contrast to previous reports, these data
      demonstrate that TAM treatment and E2 deprivation both significantly decrease
      tumor cell proliferation in MCF-7 xenografts.

PMID- 8364938
TI  - A paracrine migration-stimulating factor for metastatic tumor cells secreted by
      mouse hepatic sinusoidal endothelial cells: identification as complement
      component C3b.
AB  - Selective malignant cell invasion at secondary sites mediated by organ-specific
      (paracrine) motility factors may be of importance in preferential organ
      colonization of metastatic cells. In this study we isolated and examined a
      migration-stimulating activity present in mouse hepatic sinusoidal endothelial
      cell-conditioned medium (HSE-CM). HSE-CM contains migration-stimulating activity
      for highly liver-metastatic (RAW117-H10) and highly lung- and liver-metastatic
      (RAW117-L17) mouse large cell lymphoma sublines but not for the poorly metastatic
      parental line (RAW117-P). A migration-stimulating factor for H10 cells was
      purified from HSE-CM by hydroxylapatite affinity and DEAE anion exchange
      chromatography, Sephacryl S-200 gel filtration, and preparative native gel
      electrophoresis. The activity in each of the purification fractions was measured
      in a Transwell chamber assay using 3-microns diameter pore filters. Upon sodium
      dodecyl sulfate polyacrylamide gel electrophoresis, the component migrated as a
      single component of M(r) > 200,000 (nonreducing conditions) or as two components
      or M(r) approximately 110,000 and approximately 67,000 (reducing conditions). The
      factor was bound to Concanavalin A-Sepharose but not to heparin- or gelatin
      Sepharose affinity columns, induced mainly H10 chemotactic cell activity and some
      chemokinetic activity, and preferentially stimulated the chemotaxis of liver
      colonizing RAW117 sublines (H10 > L17 > P). NH2-terminal amino acid sequence
      analysis of each subunit indicated that the HSE-CM-derived migration-stimulating
      factor was a proteolytic fragment of complement component C3. HSE-derived
      migration-stimulating factors may be important in determining the ability of
      RAW117 tumor cells to invade and colonize the liver.

PMID- 8364939
TI  - Heart transplant candidates' perception of helpfulness of health care provider
      interventions.

PMID- 8364940
TI  - Lessons learned with ambulatory blood pressure monitoring: a focus on ramipril.
AB  - Ambulatory blood pressure monitoring (ABPM) has been available since the mid
      1970s. Widespread use of ABPM in research settings has led to an appreciation of
      its advantages and disadvantages. ABPM is a valuable research tool because of its
      ability to evaluate the duration and consistency of action with new
      antihypertensive agents. It has also been used to exclude patients who have white
      coat hypertension from pharmacotherapy. Past and current clinical studies are
      reviewed to illustrate the role of this technique in the development of a new
      angiotensin converting enzyme inhibitor, ramipril. The studies involve
      administering a single daily dose of ramipril to lower blood pressure and ABPM.
      Three double-blinded, randomized studies and one placebo-controlled, crossover
      study are reviewed. In these studies of patients with essential hypertension,
      once-daily ramipril controlled blood pressure, reduced systolic/diastolic blood
      pressure throughout a 24-hour period, and did not interfere with normal circadian
      blood pressure patterns. Lessons learned from research suggest that ABPM will
      find a niche in clinical practice.

PMID- 8364941
TI  - Efficacy and tolerability of imipenem-cilastatin versus ceftazidime plus
      tobramycin as empiric therapy of presumed bacterial infection in neutropenic
      cancer patients.
AB  - The efficacy and tolerability of monotherapy with imipenem-cilastatin (I-C) were
      compared with that of ceftazidime plus full-course therapy with an aminoglycoside
      (tobramycin) (C&T) in the treatment of presumed bacterial infection in
      neutropenic cancer patients. A total of 106 adult patients diagnosed with
      presumed bacterial infection and an underlying malignancy with an absolute
      neutrophil count (ANC) < 500/mm3 were enrolled in this open-label study. A total
      of 131 febrile episodes occurred. Forty-five patients in the I-C group and 41 in
      the C&T group, who were well matched on demographic and baseline characteristics,
      were evaluable for efficacy and safety. Seventy-two hours after the start of
      therapy, no significant between-group differences in treatment outcomes,
      including withdrawals or deaths, were seen. Thirty-five (78%) of 45 patients in
      the I-C group and 29 (71%) of the 41 in the C&T group had successful outcomes at
      the final evaluation. Superinfection occurred in 8 (18%) I-C patients and 3 (7%)
      C&T patients. Within the subgroup of patients with an initial ANC < 100/mm3, the
      final evaluation showed no significant differences in treatment outcome between
      groups. Of the 131 in the safety population 30 (46%) I-C patients and 28 (42%)
      C&T patients had one or more adverse experiences; drug-related adverse events
      occurred in 25 (38%) patients in the I-C group and 11 (17%) patients in the C&T
      group. The data suggest that imipenem-cilastatin should be considered for initial
      empiric therapy of presumed bacterial infection in neutropenic cancer patients.

PMID- 8364942
TI  - Pain relief after dental impaction surgery using ketorolac, hydrocodone plus
      acetaminophen, or placebo.
AB  - In a double-blind, placebo-controlled study, 207 patients with moderate pain
      after surgical removal of impacted third molars were randomly assigned to receive
      a single oral dose of 10 mg of ketorolac tromethamine, 10 mg of hydrocodone plus
      1000 mg of acetaminophen, or placebo. Analgesic effect as assessed by summed pain
      intensity difference at 3 and 6 hours was significantly (P < or = 0.01) greater
      after ketorolac than after hydrocodone/acetaminophen. Total pain relief at 3 and
      6 hours was significantly (P < 0.026) greater after ketorolac than after
      hydrocodone/acetaminophen or placebo. Patients taking hydrocodone/acetaminophen
      remedicated significantly (P = 0.027) sooner than those taking ketorolac. In this
      single-dose study, adverse events were reported more frequently by patients
      taking hydrocodone/acetaminophen than with ketorolac or placebo. It is concluded
      that, in this pain model, 10 mg of ketorolac affords better pain relief with
      fewer side effects than hydrocodone/acetaminophen.

PMID- 8364943
TI  - A randomized vehicle-controlled trial of topical capsaicin in the treatment of
      postherpetic neuralgia.
AB  - A large double-blind, vehicle-controlled study of 143 patients with chronic
      postherpetic neuralgia (PHN) was performed to evaluate the degree of efficacy of
      topically applied capsaicin 0.075% cream. In addition, the safety and efficacy of
      long-term application of topical capsaicin in PHN was assessed by following
      patients in an open-label study for up to 2 years. In the double-blind phase, 143
      patients with PHN of 6 months' duration or longer were enrolled. Since
      epidemiologic studies of patients who receive no treatment have shown that only
      10% to 25% of those with PHN after 1 month will still have pain at 1 year, two
      separate efficacy analyses were performed: one with all evaluable patients (n =
      131) and the other with 93 patients whose PHN lasted for longer than 12 months
      prior to study startup. All efficacy variables, including the physician's global
      evaluation of reduction in PHN pain, changes in pain severity on the categoric
      scale, visual analogue scale for pain severity, visual analogue scale for pain
      relief, and functional capacity scale, showed significant improvement at nearly
      all time points throughout the study for both patient groups, based on duration
      of PHN pain. In contrast, the group receiving vehicle cream remained essentially
      unchanged. Data from the long-term, open-label phase (up to 2 years, n = 77),
      which immediately followed the 6-week blinded phase, showed that the clinical
      benefit in patients treated for a short (6-week) period with topical capsaicin
      could be maintained or amplified in most patients (86%) during prolonged therapy.
      There were no serious adverse effects observed or reported throughout the trial;
      in fact, the only side effect associated with capsaicin treatment was the burning
      or stinging at local sites of application (in 9% of patients) during exposures of
      up to 2 years (long-term phase). On the basis of these data, we conclude that
      capsaicin 0.075% cream is a safe and effective treatment for the pain of
      postherpetic neuralgia and should be considered for initial management of
      patients with this condition.

PMID- 8364944
TI  - Efficacy and tolerability of a combination of enalapril and hydrochlorothiazide
      in the treatment of hypertension measured manually and with an ambulatory blood
      pressure monitor.
AB  - The efficacy and tolerability of an enalapril maleate-hydrochlorothiazide
      combination (EM-HCTZ) were evaluated in a prospective, open-label study in 26
      patients with uncomplicated essential hypertension (mean baseline sitting
      systolic/diastolic blood pressure: 153/103 mmHg) requiring two agents to reduce
      sitting diastolic blood pressure (SDBP) below 90 mmHg. Their mean age was 52
      years. Patients received enalapril 5 mg daily, which was increased to 10 mg if
      SDBP was not reduced to < 90 mmHg during a 5-week titration period following
      washout. If blood pressure did not reach that goal, 25 mg hydrochlorothiazide was
      added. Only patients who required enalapril 10 mg and hydrochlorothiazide 25 mg
      for control (SDBP < 90 mmHg) at the end of titration received open-label EM-HCTZ
      as maintenance therapy for 6 weeks. The SDBP of 19 of the 26 patients (73%) who
      began titration was controlled at the end of titration, and they received
      maintenance therapy. During maintenance, the mean SDBP decreased from baseline
      13.2 mmHg at week 2, 13.3 mmHg at week 4, and 10.1 mmHg at week 6. All changes
      from baseline were significant. At the end of the maintenance period, SDBP was
      controlled in 8 (42%) of 19 patients enrolled. One patient was withdrawn from the
      study because blood pressure was poorly controlled. Ambulatory blood pressure
      (ABP) was monitored, average outcome was computed for each patient during the 24
      hour interval, and with a paired comparison, baseline and follow-up data were
      compared with the data measured manually. The mean baseline ABP was 9 mmHg lower
      than the baseline SDBP measured manually (r = 0.58, P = 0.01). Following
      treatment with EM-HCTZ, mean diastolic blood pressure fell 10 mmHg and mean
      systolic blood pressure fell 15 mmHg. In summary, EM-HCTZ was highly effective
      and generally well-tolerated in a substantial proportion of participants whose
      SDBP remained > 90 mmHg on enalapril 10 mg. Important differences between blood
      pressure measured manually and with a monitor were also demonstrated.

PMID- 8364946
TI  - Effect of two doses of ginkgo biloba extract (EGb 761) on the dual-coding test in
      elderly subjects.
AB  - The subjects of this double-blind study were 18 elderly men and women (mean age,
      69.3 years) with slight age-related memory impairment. In a crossover-study
      design, each subject received placebo or an extract of Ginkgo biloba (EGb 761)
      (320 mg or 600 mg) 1 hour before performing a dual-coding test that measures the
      speed of information processing; the test consists of several coding series of
      drawings and words presented at decreasing times of 1920, 960, 480, 240, and 120
      ms. The dual-coding phenomenon (a break point between coding verbal material and
      images) was demonstrated in all the tests. After placebo, the break point was
      observed at 960 ms and dual coding beginning at 1920 ms. After each dose of the
      ginkgo extract, the break point (at 480 ms) and dual coding (at 960 ms) were
      significantly shifted toward a shorter presentation time, indicating an
      improvement in the speed of information processing.

PMID- 8364945
TI  - Antihypertensive efficacy of FK906, a novel human renin inhibitor.
AB  - The antihypertensive efficacy of a newly developed orally active human renin
      inhibitor (FK906) was evaluated in 14 patients with essential hypertension aged
      40 to 83 years (mean, 64 years). After a 1-week placebo run-in period, 25 mg of
      FK906 was given twice daily; this was increased up to 100 mg twice daily until
      sufficient blood pressure reduction was obtained. No adverse effects were
      observed in any patients. Supine blood pressure was decreased from 169 +/- 3/97
      +/- 1 mmHg to 153 +/- 5/87 +/- 3 mmHg at 25 mg twice daily (n = 14), to 142 +/-
      5/78 +/- 3 mmHg at 50 mg twice daily (n = 12), P < 0.01), and to 137 +/- 10/77 +/
      8 mmHg at 100 mg twice daily (n = 6, P < 0.01). The hypotensive effect was
      sustained over 24 hours. Pulse rate did not change. Plasma renin activity and
      angiotensin I were decreased after FK906 administration only in patients with
      increased plasma renin activity. The hypotensive effects of FK906 were not
      correlated with baseline plasma renin activity. Suppression of the noncirculating
      tissue renin-angiotensin system may account for the hypotensive action of FK906.
      The results suggest that FK906 is a promising antihypertensive drug in patients
      of all ages and with different plasma renin levels.

PMID- 8364947
TI  - Proarrhythmic effects of class Ic drugs.
AB  - Three cases managed with class Ic antiarrhythmic drugs but with subsequent
      aggravation of arrhythmias are reported herein. A 58-year-old man given 300 mg of
      flecainide for atrial flutter developed sinus arrest and transient ventricular
      fibrillation. A 42-year-old man with a postoperative condition of tetralogy of
      Fallot who received 300-mg doses of flecainide for sustained ventricular
      tachycardia had spontaneous sustained ventricular tachycardia. A 74-year-old man
      given 150 mg of propafenone for atrial tachycardia developed sustained
      ventricular tachycardia. The present cases illustrate that class Ic drugs may
      exacerbate ventricular arrhythmias, and their use may reveal concealed sinus node
      dysfunction. This may be due to marked slowing of conduction and prolonged
      ventricular refractoriness, which are characteristic of the class Ic drugs; also,
      it is probable that the patients' underlying cardiac conditions served as
      contributing factors.

PMID- 8364948
TI  - The influence of volatile anesthetics on portwine stain.
AB  - To examine the relationship between volatile inhalation anesthetics and the
      fading of portwine stain (PWS), the study retrospectively investigated the
      incidence of termination of pulsed dye laser treatment vis-a-vis PWS fade during
      use of a general inhalation anesthetic in 107 infants and children with facial
      PWS. The fading of PWS is disadvantageous to the pulsed dye laser treatment. All
      patients received pulsed dye laser treatment under general anesthesia using one
      of four kinds of volatile inhalation anesthetics (halothane, enflurane,
      isoflurane, and sevoflurane). Two hours before the induction of anesthesia, all
      patients were rectally irrigated. Treatment was discontinued in none of the 44
      patients in the halothane group or the 7 patients in the enflurane group; in one
      of the 29 in the isoflurane group; and in 10 of the 27 patients in the
      sevoflurane group. The sevoflurane group showed a significantly (P < 0.01) higher
      incidence of PWS fading. Thus, when using a volatile inhalation anesthetic in
      combination with pulsed dye laser treatment for PWS, caution should be exercised
      if sevoflurane is selected, as PWS fading is harmful to the pulsed dye laser.

PMID- 8364949
TI  - Comparison of ketorolac and meperidine in patients with postoperative pain-
      impact on health care utilization.
AB  - A double-blind, randomized study was conducted to compare the effects of
      intramuscular ketorolac tromethamine and meperidine hydrochloride, and subsequent
      oral pain medication, on health care utilization and postoperative recovery.
      Following abdominal hysterectomy or cholecystectomy, 210 patients (aged 18 to 70
      years; 189 women, 21 men) were randomly assigned to therapy and evaluated for
      efficacy, safety, nursing care requirements, functional independence, recovery
      milestones, and quality of life. The patients received 30 mg of ketorolac
      intramuscularly every 3 to 6 hours as needed, followed by 10 mg of ketorolac
      every 4 to 6 hours, or 100 mg of meperidine intramuscularly every 3 to 6 hours as
      needed, followed by acetaminophen/codeine (600 mg/60 mg) orally every 4 to 6
      hours. Patients receiving ketorolac had lower nursing utilization scores and
      achieved a higher level of functioning than patients receiving meperidine during
      the first 3 postoperative days. Times to first bowel movement, walking without
      assistance, and first oral fluids were significantly shorter after ketorolac than
      meperidine. Mean pain intensity difference (from baseline) scores and pain relief
      scores when adjusted for baseline pain severity were comparable between ketorolac
      and meperidine. Most adverse events reported by the patients were mild to
      moderate; 12 patients in each group withdrew from treatment because of adverse
      events (nausea, rash, or headache). It is concluded that ketorolac is an
      effective alternative to meperidine in the management of postoperative pain.

PMID- 8364950
TI  - The financial impact of OBRA-90 on community pharmacies: an overview.
AB  - The Omnibus Budget Reconciliation Act of 1990 (OBRA-90) may be the most
      significant piece of legislation affecting the practice of pharmacy since the
      Durham-Humphrey amendments to the Food, Drug and Cosmetic Act. As part of the
      OBRA-90 legislation, the Health Care Financing Administration (HCFA) was required
      to publish estimates of the impact of the act on states, Medicaid recipients, and
      pharmacies. Numerous stakeholders and researchers have commented on the HCFA
      estimates. We have summarized the estimates available in comments and studies and
      conducted a sensitivity analysis on these estimates. Our results demonstrate
      considerable variation in the factors important in estimating the impact of OBRA
      90 on pharmacy operations. This variation indicates the scarcity of empirical
      data needed to produce reliable impact estimates. Demonstration projects are
      needed to scientifically evaluate the total impact of OBRA-90 on pharmacy
      practice. Moreover, further investigation of the impact of the legislation on
      program recipients and states is warranted.

PMID- 8364951
TI  - Medication compliance: the patient's perspective.
AB  - There has been increasing interest in using outcomes-based research to evaluate
      quality of care. Compliance with prescribed regimens is an intermediate outcome
      measure that presumes that a positive health outcome will follow, which is why
      clinicians and researchers are interested in compliance. Patients, however, use a
      variety of criteria to determine the value of medication. They may place equal or
      greater value on personal and often competing nonclinical outcomes. A small but
      growing literature explores the influence of physical, economic, psychological,
      and social factors that influence medication use behavior. This literature
      supports the notion that patients evaluate medication based not only on its
      clinical effectiveness, but also how it affects all aspects of their lives.
      Outcomes research on compliance with prescribed medicine should recognize the
      outcomes valued from the patient's perspective.

PMID- 8364952
TI  - Conversion from glipizide to glyburide: long-term follow-up of a cost-impact
      survey focusing on the elderly.
AB  - The appropriate use of second-generation oral hypoglycemic agents is limited by
      the lack of definitive guidelines for their use in elderly diabetic patients and
      controversy over relative dosing equivalence. We previously conducted a survey to
      determine the feasibility and cost of converting diabetic patients from glipizide
      to glyburide. This new survey provides an extended, 24-month follow-up in 210
      patients and focuses on findings in elderly patients. The mean final daily dose
      of glyburide (11.6 mg) was lower than the preconversion dose of glipizide (18.7
      mg) (P < or = 0.0001). One hundred forty-one (67%) patients successfully
      continued glyburide for 24 months, including 103 (73%) patients who were 65 years
      of age or older. There was no apparent correlation between age and final dose of
      glyburide, ability to continue glyburide, or risk of stopping glyburide. The
      conversion program reduced the mean daily dose after switching from glipizide to
      glyburide, which was preserved throughout the observation period. The program
      also conferred a 49% savings in the projected 2-year expenditures for second
      generation oral hypoglycemic agents.

PMID- 8364953
TI  - Neuropeptides in the insect brain: a review.

PMID- 8364955
TI  - Identification of M cells and their distribution in rabbit intestinal Peyer's
      patches and appendix.
AB  - The distribution of intestinal membranous (M) cells has been studied within the
      follicle-associated epithelium of rabbit Peyer's patches and appendix. Vimentin
      expression has been assessed as a primary criterion to identify rabbit M cells in
      tissue sections and in whole tissue preparations. This criterion has been
      compared to the use of the absence of alkaline phosphatase which, due to its
      heterogeneous distribution within the enterocyte population, is less reliable
      than vimentin expression as a marker for rabbit M cells. The pattern of vimentin
      immunostaining revealed that the majority of M cells are located in the periphery
      of the follicle-associated epithelium, the dome apex being largely free of M
      cells. This distribution was confirmed by scanning electron microscopy. Vimentin
      is also expressed by follicle-associated epithelial cells in the vicinity of
      crypts which lack the typical lymphocyte-containing pocket of M cells.
      Cytoplasmic peanut agglutinin binding coincides with vimentin-expression
      throughout the follicle-associated epithelium but is absent from vimentin
      negative enterocytes. The co-localisation of these two phenotypic markers in both
      M cells and epithelial cells adjacent to crypts, which lack the typical
      morphology of fully developed rabbit M cells, suggests that they correspond to
      immature M cells which by their location appear to derive directly from
      undifferentiated crypt stem cells and not from mature columnar enterocytes.

PMID- 8364954
TI  - Endocardial endothelium in the rat: cell shape and organization of the
      cytoskeleton.
AB  - The cytoskeleton in endocardial endothelium of rat heart was examined by en face
      confocal scanning laser microscopy. In the ventricular cavity, endocardial
      endothelial cells had a polygonal shape and F-actin staining was generally
      restricted to the peripheral junctional actin band. Central F-actin bundles, or
      stress fibers, in endocardial endothelial cells were found on the tendon end of
      papillary muscles, especially in the right ventricle, and frequently in the
      outflow tract of both ventricles; elsewhere, stress fibers were scarce. Many
      endocardial endothelial cells were elongated in areas of endothelium with stress
      fibers, but no correlation was found between cell elongation and the number of
      stress fibers. An inverse correlation was found between the number of stress
      fibers and the surface area of endocardial endothelial cells. Shear stress as
      well as mechanical deformation of the surface of the ventricular wall during the
      cardiac cycle may affect cell shape and the organization of actin filaments in
      endocardial endothelial cells. Vimentin in endocardial endothelial cells formed a
      filamentous network with some distinct cytoplasmic and juxtanuclear vimentin
      bundles. No perinuclear ring of vimentin filaments was observed in endocardial
      endothelium. Microtubules in endocardial endothelial cells were, in contrast to
      endothelial cells of rat aorta, not aligned, less closely packed and originated
      from randomly distributed centriolar regions. The cytoskeleton has been suggested
      to play an important role in cellular functions of vascular endothelial cells.
      Accordingly, differences in the cytoskeletal organization between endocardial and
      vascular endothelial cells may relate to differences in functional properties.

PMID- 8364956
TI  - Immunohistochemical colocalization of 7B2 and 5HT in the neuroepithelial bodies
      of the lung of Rana temporaria.
AB  - The neuroendocrine cell population of the lung of Rana temporaria has been
      studied by means of immunocytochemistry. Serotonin (5HT)- and polypeptide 7B2
      immunoreactive neuroepithelial bodies have been observed in the epithelial lining
      of the lung. 5HT- but not 7B2-immunoreactive isolated endocrine cells have also
      been observed.

PMID- 8364957
TI  - Survival and proliferation of rat gonocytes in vitro.
AB  - Quiescent gonocytes were isolated from fetal testes of rat 18-day post coitum and
      cultured alone or on monolayers of somatic cells from different origins. The
      gonocytes specifically adhered to Sertoli cells, isolated from 21 to 23-day-old
      rat testes; this adherence was necessary for their survival in vitro. Addition of
      follicle-stimulating hormone and testosterone to these cultures did not increase
      the viability of the gonocytes. Serum was found to be deleterious to the germ
      cells. Electron-microscopic examination of Sertoli-cell-gonocyte co-cultures
      revealed the presence of numerous adhesion plaques between these cells,
      indicating that Sertoli cells and gonocytes are able to communicate in vitro.
      Gonocytes, in co-culture with Sertoli cells, were viable for at least 9 days. The
      gonocytes did not spontaneously resume proliferation. The simple culture system
      described in the present paper should be useful in studying the nature of the
      factors that are responsible for sending the quiescent gonocytes into the cell
      cycle and for stimulating the formation of A spermatogonia, a process
      characterizing the start of spermatogenesis.

PMID- 8364958
TI  - Gap junctions in ovarian follicles of Drosophila melanogaster: inhibition and
      promotion of dye-coupling between oocyte and follicle cells.
AB  - The analysis of chimeras has shown that communication between germ-line and soma
      cells plays an important role during Drosophila oogenesis. We have therefore
      investigated the intercellular exchange of the fluorescent tracer molecule,
      Lucifer yellow, pressure-injected into the oocyte of vitellogenic follicles of
      Drosophila. The dye reached the nurse cells via cytoplasmic bridges and entered,
      via gap junctions, the somatic follicle cells covering the oocyte. The percentage
      of follicles showing dye-coupling between oocyte and follicle cells was found to
      increase with the developmental stage up to stage 11, but depended also on the
      status of oogenesis, i.e., the stage-spectrum, in the respective ovary. During
      late stage 10B and stage 11, dye-coupling was restricted to the follicle cells
      covering the anterior pole of the oocyte. No dye-coupling was observed from stage
      12 onwards. During prolonged incubation in vitro, the dye was found to move from
      the follicle cells back into the oocyte; this process was suppressable with
      dinitrophenol. Dye-coupling was inhibited when prolonged in vitro incubation
      preceded the dye-injection. Moreover, dye-coupling was inhibited with acidic pH,
      low [K+], high intracellular [Ca2+], octanol, dinitrophenol, and NaN3, but not
      with retinoic acid, basic pH, or high extracellular [Ca2+]. Dye-coupling was
      stimulated with a juvenile hormone analogue and with 20-hydroxyecdysone. Thus,
      gap junctions between oocyte and follicle cells may play an important role in
      intercellular communication during oogenesis. We discuss the significance of our
      findings with regard to the electrophysiological properties of the follicles, and
      to the coordinated activities of the different cell types during follicle
      development and during the establishment of polarity in the follicle.

PMID- 8364959
TI  - Peripheral projections of nervus terminalis LHRH-containing neurons in the tiger
      salamander, Ambystoma tigrinum.
AB  - The peripheral projections of the nervus terminalis (NT) have been difficult to
      examine due to the weak immunoreactivity of the processes to various antibodies.
      We performed two experimental manipulations in the tiger salamander in an attempt
      to increase the luteinizing hormone-releasing hormone-immunoreactive (LHRH-ir)
      labelling in the peripheral processes of the NT:1) the NT was sectioned
      centrally, or 2) a 100 mg melatonin pellet was embedded subcutaneously for 3 days
      prior to sacrifice. Following these manipulations, animals were sacrificed and
      tissue was processed with standard immunocytochemical techniques for the analysis
      of the distribution of LHRH-ir processes. In the nasal cavity, LHRH-ir fibers
      were observed projecting 1) into the rostral olfactory epithelium, 2) to Bowman's
      glands in the lamina propria of the rostromedial olfactory mucosa and
      ventrolateral mucosa between the main nasal cavity and Jacobson's organ, 3) into
      the naris constrictor muscle, and 4) along the palatine nerves and ganglia. These
      lesion and hormone manipulations have enabled the detection of peripheral
      projections of the NT not observed previously with immunocytochemical procedures
      alone. The wide distribution of LHRH-ir NT processes in the nasal cavity and
      cranium suggests that this nerve may influence many different cranial structures
      during appropriate pheromonal or neuroendocrine events.

PMID- 8364960
TI  - The basement membranes of cryofixed or aldehyde-fixed, freeze-substituted tissues
      are composed of a lamina densa and do not contain a lamina lucida.
AB  - When tissues are processed for electron microscopy by conventional methods, such
      as glutaraldehyde fixation followed by rapid dehydration in acetone, basement
      membranes show two main layers: the electron-lucent "lamina lucida". (or rara)
      and the electron-dense "lamina densa". In an attempt to determine whether this
      subdivision is real or artefactual, two approaches have been used. Firstly, rat
      and mouse seminiferous tubules, mouse epididymis and associated tissues, and
      anterior parts of mouse eyes were subjected to cryofixation by instant freezing
      followed by freeze substitution in a -80 degrees C solution of osmium tetroxide
      in dry acetone, which was gradually warmed to room temperature over a 3-day
      period. The results indicate that, in areas devoid of ice crystals, basement
      membranes consist of a lamina densa in direct contact with the plasmalemma of the
      associated cells without an intervening lamina lucida. Secondly, a series of
      tissues from mice perfused with 3% glutaraldehyde were cryoprotected in 30%
      glycerol, frozen in Freon 22 and subjected to a 3-day freeze substitution in
      osmium tetroxide-acetone as above. Under these conditions, no lamina lucida
      accompanies the lamina densa in the basement membranes of the majority of
      tissues, including kidney, thyroid gland, smooth and skeletal muscle, ciliary
      body, seminiferous tubules, epididymis and capillary endothelium. Thus, even
      though these tissues have been fixed in glutaraldehyde, no lamina lucida appears
      when they are slowly dehydrated by freeze substitution. It is concluded that the
      occurrence of this lamina in conventionally processed tissues is not due to
      fixation but to the rapid dehydration. However, in this series of experiments,
      the basement membranes of trachea and plantar epidermis include a lamina lucida
      along their entire length, while those of esophagus and vas deferens may or may
      not include a lamina lucida. To find out if the lamina lucida appearing under
      these conditions is a real structure or an artefact, the trachea and epidermis
      were fixed in paraformaldehyde and slowly dehydrated by freeze substitution.
      Under these conditions, no lamina lucida was found. Since this result is the same
      as observed in other tissues by the previous approaches, it is proposed that the
      lamina lucida is an artefact in these as in the other investigated basement
      membranes. Thus, basement membranes are simply composed of a lamina densa that
      closely follows the plasmalemma of the associated cells.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 8364961
TI  - Suramin-induced mucopolysaccharidosis in rat incisor.
AB  - Two weeks after a single injection of suramin, the secretory and post-secretory
      ameloblasts of the rat incisor were filled with large lysosome-like vacuoles. At
      the light-microscope level, these vacuoles were positively stained with Alcian
      blue when MgCl2 was used at a critical electrolyte concentration varying between
      0.1 and 0.3 M, whereas no staining appeared when MgCl2 varied between 0.7 and 0.9
      M. Hyaluronidase digestion markedly reduced but did not totally abolish the
      staining, indicating that glycosaminoglycans were accumulated inside these
      vacuoles. Examination of these cells with the electron microscope revealed a
      polymorphic population of large vesicles, filled to various degrees with
      cetylpyridinium chloride (CPC)-positive and malachite green aldehyde (MGA)
      positive material. The same pattern was observed in secretory odontoblasts but to
      a lesser extent. In the extracellular matrix, suramin-induced alterations
      appeared as large defects occurring during enamel formation. In predentin and
      dentin, the number and/or size of electron-dense aggregates resulting from CPC
      and MGA fixation, were enhanced in the suramin-injected rats. These aggregates
      were largely reduced or suppressed respectively by hyaluronidase digestion and
      chloroform/methanol treatment of the sections. The accumulation of
      glycosaminoglycans and phospholipids reported here inside ameloblasts and
      odontoblasts and in predentin and dentin supports the occurrence of suramin
      induced mucopolysaccharidosis and lipidosis in this experimental animal model.

PMID- 8364963
TI  - Insulin-like molecules in the beetle Tenebrio molitor.
AB  - Immunocytochemical staining of the nervous system of larva, pupa, and adult stage
      of Tenebrio molitor with anti-insulin serum demonstrated insulin-like peptides in
      the protocerebrum, corpora allata, and suboesophageal ganglion. During pupal
      development, marked changes in staining intensity of the protocerebral cells were
      detected. The staining pattern suggests release of insulin-like peptides early on
      day 0 and again on day 3 of the stadium. Injections of anti-insulin at these
      times caused significant delays in the timing of pupal/adult ecdysis. An
      immunoblot of haemolymph from day-3 pupae revealed a 6.5-kDa insulin-like
      molecule. These results suggest that the prothoracicotropic hormone of T. molitor
      is an insulin-like molecule.

PMID- 8364962
TI  - Architectural arrangement of stages of the spermatogenic cycle within human
      seminiferous tubules is related to efficiency of spermatogenesis.
AB  - Stages of the spermatogenic cycle in human seminiferous tubules were evaluated in
      men with varied efficiencies of spermatogenesis to determine if the architectural
      arrangement of stages or the atypical cell types contributed to variation in
      sperm production rates. Testes were selected from men with low, intermediate, and
      high daily sperm production per g parenchyma (DSP/g). Round tubular cross
      sections were photographed by bright-field microscopy. Stages were identified for
      each cross section by two observers and the number of stages represented in each
      cross section was recorded. Number of stages per cross section in men with low
      efficiency of spermatogenesis were significantly (P < 0.05) fewer than men with
      intermediate and high efficiency of spermatogenesis. Further, the percentage of
      stages with atypical cell types in men with high DSP/g was significantly (P <
      0.05) higher than men with low DSP/g. There was a significant relationship (P <
      0.01) between the percentages of stages with atypical cell types per stage and
      number of stages per cross section. The atypical cell types appear to result from
      high density of stages per cross section in men with high DSP/g. There was no
      significant difference observed between groups for tubular volume, diameter,
      length, volume density, and volume density of seminiferous epithelium. However, a
      significant (P < 0.05) positive correlation between percent seminiferous
      epithelium per testis with DSP/g or with the number of stages per cross section
      was found.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364964
TI  - Subcellular localization of immunoreactive oxytocin within thymic epithelial
      cells of the male mouse.
AB  - Immunoreactive oxytocin is expressed by thymic epithelial cells, which share
      properties with neuroendocrine cells. In order to investigate the assumed
      paracrine secretion of oxytocin, we studied the subcellular localization of
      immunoreactive oxytocin within thymic tissue and cultured thymic epithelial cells
      of the male mouse. Three types of immunoreactive cells were distinguished with
      the electron microscope. Immunoreactive oxytocin was found to be restricted to
      the cytoplasm by the use of pre- and postembedding methods. Some epithelial
      cells, especially in the cortex, showed a pronounced labelling of vesicular
      membranes and membrane tubules of the endoplasmic reticulum. In some cells,
      keratin filaments were associated with the electron-dense stain. Under culture
      conditions immunoreactive cells of different shapes were found, all displaying
      similar patterns of labelling. The contents of different types of vacuoles were
      only rarely labelled. A special class of immunoreactive exocytotic vesicles could
      not be identified. Thus, our results do not support neuroendocrine secretion of
      oxytocin via vesicles of thymic epithelial cells but offer alternative modes of
      secretion.

PMID- 8364965
TI  - The effects of gonadectomy and testosterone treatment on the Harderian gland of
      the green frog, Rana esculenta.
AB  - The effects of gonadectomy and testosterone treatment on the fine structure of
      the Harderian gland in male and female green frogs were investigated in different
      periods of the year. Gonadectomy, carried out when the glands are in the lowest
      secretory phase (September), causes degenerative changes consisting of a
      reduction of the rough endoplasmic reticulum, the appearance of autolysosomes,
      and an increase of nuclear heterochromatin. These effects can be prevented by
      testosterone treatment. No castration effects are found during the recovery
      (November) and enhancement (April-May) phases of secretory activity. The results
      suggest that the frog Harderian gland's sensitivity to testosterone changes
      during the annual cycle. The androgen dependence of the Harderian gland is
      correlated with the presence of androgen receptors in both male and female frogs.

PMID- 8364966
TI  - Cellular components of the immune barrier in the spinal meninges and dorsal root
      ganglia of the normal rat: immunohistochemical (MHC class II) and electron
      microscopic observations.
AB  - This report deals with the distribution, morphology and specific topical
      relationships of bone-marrow-derived cells (free cells) in the spinal meninges
      and dorsal root ganglia of the normal rat. The morphology of these cells has been
      studied by transmission and scanning electron microscopy. Cells expressing the
      major histocompatibility complex (MHC) class II gene product have been recognized
      by immunofluorescence. At the level of the transmission electron microscope, free
      cells are found in all layers of the meninges. Many of them display
      characteristic ultrastructural features of macrophages, whereas others show a
      highly vacuolated cytoplasm and are endowed with many processes. These elements
      lack a conspicuous lysosomal system and might represent dendritic cells. Scanning
      electron microscopy has revealed that free cells contact the cerebrospinal fluid
      via abundant cytoplasmic processes that cross the cell layers of the pia mater
      and of the arachnoid. Cells expressing the MHC class II antigen are also found in
      all layers of the meninges. They are particularly abundant in the layers
      immediately adjacent to the subarachnoid space, in the neighbourhood of dural
      vessels, along the spinal roots and in the dural funnels. In addition to the
      meninges, strong immunoreactivity for MHC class II antigen is observed in the
      dorsal root ganglia. The ultrastructural and immunohistochemical findings of this
      study suggest the existence of a well-developed system of immunological
      surveillance of the subarachnoid space and of the dorsal root ganglia.

PMID- 8364967
TI  - The suprachiasmatic nucleus of the mink (Mustela vison): apparent absence of
      vasopressin-immunoreactive neurons.
AB  - The hypothalamic suprachiasmatic nucleus is centrally involved in generation of
      several circadian rhythms. Neurons of the mammalian suprachiasmatic nucleus
      express a number of neuropeptides including vasopressin. The suprachiasmatic
      nucleus of the mink (Mustela vison) is easily distinguished from neighbouring
      hypothalamic areas and the underlying optic chiasm as a small nucleus containing
      densely packed parvocellular neurons. A dorsal and ventral subdivision were
      clearly recognized within the midportion and caudal part of the nucleus. Using
      immunohistochemistry, we have identified vasopressin-, neurophysin-, and
      vasoactive intestinal peptide-immunoreactive neuronal elements in the
      hypothalamus of the mink. Vasoactive intestinal peptide-immunoreactive neurons
      can be observed in the ventral aspect of the suprachiasmatic nucleus, but to our
      surprise, no vasopressin immunoreactive perikarya are found within the
      suprachiasmatic nucleus, this absence being independent of the experienced annual
      cycle. The hypothalamic paraventricular and supraoptic nuclei contain large
      numbers of vasopressin-, neurophysin- and vasoactive intestinal peptide
      immunoreactive magnocellular neurons with extensive projections towards the
      infundibulum and neurohypophysis. A comparative analysis of the distribution of
      vasopressin-immunoreactive elements in a number of conventional laboratory
      animals has demonstrated that, in contrast to the rat, golden hamster and
      Mongolian gerbil, neither vasopressin-containing perikarya in the suprachiasmatic
      nucleus nor fine calibered immunoreactive fibres entering the adjacent
      subparaventricular zone are present in the mink. The mink is a photodependent
      seasonal breeder, and thus vasopressin-immunoreactive neurons in the
      suprachiasmatic nuclei may not be essential for the photoperiodic regulation of
      reproduction and seasonal events experienced by this species.

PMID- 8364968
TI  - Localization of inhibin/activin subunits in the testis of adult nonhuman primates
      and men.
AB  - The localization and distribution of inhibin/activin subunits was evaluated in
      the testes of three nonhuman primate species (Macaca fascicularis, M. mulatta, M.
      arctoides), of young (31 to 43 years) and old (60 to 85 years) men, and of men
      with disturbed or arrested spermatogenesis using immunohistochemical techniques
      (peroxidase-anti-peroxidase and alkaline-phosphatase/anti-alkaline-phosphatase
      technique). Specific polyclonal (anti-porcine inhibin alpha-1-32 and anti-bovine
      activin A) and monoclonal (anti-human inhibin alpha-1-32 and anti-human activin
      beta A-82-114) antisera were employed. Among all nonhuman primate species and in
      men, inhibin/activin subunits were present in the cytoplasm of Sertoli cells and
      Leydig cells but not in germ cells. No relationship could be established between
      the staining pattern for inhibin/activin subunits and the completeness or the
      stage of the spermatogenic process. The staining for the beta A-subunit in
      Sertoli cells appeared more intense in the testes of old men compared with that
      of young men. The majority of Leydig cells contained either the alpha-subunit and
      beta A-subunit or the beta A-subunit alone. The signal for the beta A-subunit was
      remarkably intense in normal and hyperplastic human Leydig cells. These
      observations demonstrate the presence of inhibin/activin subunits in Sertoli
      cells and Leydig cells of adult primates and raise the possibility that these
      subunits or their respective dimers (inhibin A/activin A) might subserve a
      paracrine/autocrine role in the adult primate testis.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8364969
TI  - Evidence for a direct effect of growth hormone on osteoblasts.
AB  - In order to determine whether growth hormone (GH) exerts a direct effect on
      osteoblasts, in vitro and in vivo immunocytological studies were carried out on
      newborn rat calvaria and a clonal osteoblast-like cell line (MC3T3-E1) isolated
      from newborn mouse calvaria. After exposure to human growth hormone (hGH) or 1,25
      dihydroxyvitamin D3 (1,25(OH)2D3), a significant increase in alkaline phosphatase
      activity was observed in MC3T3-E1 cells. Simultaneous exposure of MC3T3-E1 cells
      to hGH and 10 nM 1,25(OH)2D3 showed a synergistic effect of the two hormones on
      this activity. The optimal dose of hGH was 0.1 nM. An immunocytological procedure
      was performed on ultrathin frozen sections from 7-day-old rat calvaria and MC3T3
      E1 cells cultured with hGH. GH-like immunoreactivity was observed in both cases.
      In calvaria, endogenous GH-like immunoreactivity was localized at the same
      ultrastructural level (plasma membrane, cytoplasmic and nuclear matrices) as
      exogenous GH-like immunoreactivity in MC3T3-E1 cells. Following the initial step
      of binding to the plasma membrane, GH may be internalized in the cytoplasmic
      matrix and nucleus. In situ hybridization revealed the presence of mRNA coding
      for GH receptor in calvaria cells. The density of these receptors seemed to be
      lower in osteoblasts than in hepatocytes. In MC3T3-E1 cells, hGH induced a dose
      dependent secretion of insulin-like growth factor 1. In conclusion, these results
      indicate that GH may act directly on osteoblasts.

PMID- 8364970
TI  - Photoperiod-dependent changes in exocytotic activity in the hypophyseal pars
      tuberalis of the Djungarian hamster, Phodopus sungorus.
AB  - The pars tuberalis of the hypophysis of the Djungarian hamster, Phodopus
      sungorus, was investigated with regard to secretory activity by applying the
      tannic acid-Ringer perfusion technique. Two groups were maintained under long
      photoperiods (16 h light: 8 h dark) or short photoperiods (8 h light: 16 h dark),
      respectively. Perfusion with tannic acid showed that specific pars tuberalis
      cells release some of their secretory granules as indicated by typical exocytotic
      figures. The percentage of cells displaying exocytotic activity was significantly
      higher in the pars tuberalis of hamsters kept under long photoperiods. The number
      of exocytotic figures per single cell was not increased. These results provide
      further evidence for a secretory activity of the pars tuberalis and support the
      hypothesis of its involvement as a mediator between photoperiodic stimuli and the
      endocrine system.

PMID- 8364971
TI  - Distribution of intracardiac neurones and nerve terminals that contain a marker
      for nitric oxide, NADPH-diaphorase, in the guinea-pig heart.
AB  - There is strong evidence that NADPH-diaphorase can be used as a marker for
      neurones that employ nitric oxide as a messenger molecule. In the present study,
      the NADPH-diaphorase activity of intracardiac neurones and nerve terminals in
      whole-mount stretch preparations and sections of the newborn and adult guinea-pig
      atria and interatrial septum has been examined histochemically. Together with
      epicardial, endothelial and endocardial cells, which displayed some NADPH
      diaphorase staining, a subpopulation of intracardiac neurones exhibited moderate
      heavy labelling for NADPH-diaphorase, while the majority of neurones were only
      lightly stained or negative. Intracardiac ganglia containing positive neuronal
      cell bodies were located between the epicardial cells and atrial myocytes in four
      main regions: in association with the superior and inferior vena cavae, the
      points of entry of the pulmonary veins, and within the interatrial septum. Nerve
      terminals exhibiting NADPH-diaphorase activity were seen throughout the atrial
      tissue, forming basket-like endings around intracardiac neuronal cell bodies;
      varicose terminals were also observed on atrial myocytes and other non-neuronal
      structures. A proportion of the nerve fibres was clearly of intrinsic origin,
      other terminals may well have originated from neuronal cell bodies present
      outside the heart.

PMID- 8364972
TI  - Stimulation-induced damage in rabbit fast-twitch skeletal muscles: a quantitative
      morphological study of the influence of pattern and frequency.
AB  - The aim of this study was to determine whether muscle fibre degeneration brought
      about by chronic low-frequency electrical stimulation was related to the pattern
      and frequency of stimulation. Rabbit fast-twitch muscles, tibialis anterior and
      extensor digitorum longus, were stimulated for 9 days with pulse trains ranging
      in frequency from 1.25 Hz to 10 Hz. Histological data from these muscles were
      analysed with multivariate statistical techniques. At the lower stimulation
      frequencies there was a significantly lower incidence of degenerating muscle
      fibres. Fibres that reacted positively with an antineonatal antibody were most
      numerous in the sections that revealed the most degeneration. The dependence on
      frequency was generally similar for the two muscles, but the extensor digitorum
      longus muscles showed more degeneration than the tibialis anterior at every
      frequency. Muscles subjected to 10 Hz intermittent stimulation showed
      significantly less degeneration than muscles stimulated with 5 Hz continuously,
      although the aggregate number of impulses delivered was the same. The incidence
      of degeneration in the extensor digitorum longus muscles stimulated at 1.25 Hz
      was indistinguishable from that in control, unstimulated muscles; for the
      tibialis anterior muscles, this was also true for stimulation at 2.5 Hz. We
      conclude that damage is not an inevitable consequence of electrical stimulation.
      The influence of pattern and frequency on damage should be taken into account
      when devising neuromuscular stimulation regimes for clinical use.

PMID- 8364973
TI  - A monoclonal antibody disrupting cell-cell adhesion of rat ascites hepatoma
      cells.
AB  - A cell surface-associated adhesive factor (AF) separated from differentiated rat
      ascites hepatoma AH136B cells (forming cell islands in vivo) has been highly
      purified by chromatography. AF is assumed to mediate the cell-cell adhesion
      essential to island formation of the hepatoma cells. A substance, immunologically
      cross-reactive with AF, is present in the ascites fluid or culture medium of the
      AH136B cells. Because the substance is almost identical to AF in molecular weight
      and aggregation-promoting activity, it has been concluded that AF is released
      into the ascites fluid where it is concentrated. Monoclonal antibodies have been
      raised against AF purified from ascites fluid of AH136B cells. We have obtained a
      monoclonal antibody, coded MoAF-6D6, that strongly abolishes the aggregation
      promoting activity of AF. When AH136B cell islands are incubated in the presence
      of Fab fragments of MoAF-6D6, cell detachment from the islands is evident within
      24 h. Cell islands following 36-h culture show a distinct dissociation and
      islands completely lose their organization 48 h after culture. The dissociating
      effect of MoAF-6D6 is neutralized by the addition of AF. These results suggest
      that AF plays a significant role in the maintenance of cell islands.

PMID- 8364974
TI  - Neurons in a variety of molluscs react to antibodies raised against the VD1/RPD2
      alpha-neuropeptide of the pond snail Lymnaea stagnalis.
AB  - The VD1 and RPD2 neurons of Lymnaea stagnalis innervate other central neurons,
      certain skin areas, the pneumostome area, and the auricle of the heart. Recently,
      a set of four (delta, epsilon, alpha, beta) neuropeptides produced by these giant
      neurons and by certain other central neurons has been characterized. Although
      alternative splicing of the preprohormone of these neurons yields at least 10
      different alpha neuropeptides, an affinity-purified antiserum directed against a
      domain common to all alpha neuropeptides has previously been shown to be highly
      selective in staining VD1, RPD2 and other neurons that produce the preprohormone.
      Since the gene encoding the neuropeptides is structurally similar to that
      expressed in R15 of the marine opisthobranch Aplysia californica, we have used
      the affinity purified antiserum as a marker for VD1/RPD2-related systems in other
      molluscs. Immunopositive neurons and fibers are observed in the central nervous
      systems of all species studied (Achatina fulica, Anodonta sp., Aplysia
      brasiliana, A. californica, Bulinus truncatus, Cepea sp., Eobania vermiculata,
      Helix aspersa, H. pomatia, Limax maximus, Mytilus edulis, Nassarius reticulatus,
      Viviparus viviparus). Several medium-sized and small neurons and 1-4 giant
      neurons are found in the pulmonates and opisthobranchs. The giant neurons in
      pulmonates have locations in the subesophageal ganglion, axonal branching
      patterns, and terminal arborizations in the auricle of the heart; all these
      characteristics are similar to those of VD1 and RPD2. Double-labelling (Lucifer
      yellow injection, immunocytochemistry) confirms that the two giant neurons in
      Helix pomatia are Br and Br'. The immunoreactive cells in A. fulica appear to
      include the VIN and PON neurons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364975
TI  - Expression of vigilin in chicken cartilage and bone.
AB  - The expression of vigilin was followed during chick embryonal development by in
      situ hybridization. Vigilin mRNA is abundantly expressed in tissues of
      mesenchymal and ectomesenchymal origin. The mesenchymal primordial cells of
      cartilage and bone did not show any significant expression of vigilin. As tissue
      differentiation proceeded, vigilin mRNA levels increased in hyaline cartilage and
      in both endochondral as well as intramembranous bone. The results suggest that
      the expression of vigilin mRNA in cartilage- and bone-forming cells, chondrocytes
      and osteoblasts, is dependent on the stage of development and cellular
      differentiation, although not a unique process of bone formation. Most striking
      is the correlation of the maximum vigilin mRNA expression in osteoblasts and
      hypertrophic chondrocytes to periods when cell-specific genes were highly
      transcribed and substantially translated, e.g., synthesis of procollagen and
      formation of extracellular matrix in bone and cartilage.

PMID- 8364976
TI  - Principles of biotechnological treatment of industrial wastes.
AB  - This review includes current information on biodegradation processes of
      pollutants, digestor biocenosis and bioadditives, sludge production, measurement
      of pollution, and advances regarding biotechnological treatment of a series of
      specific industrial effluents.

PMID- 8364977
TI  - Neurotensin-amplification of DNA synthesis stimulated by EGF or TGF alpha in
      primary cultures of adult rat hepatocytes.
AB  - Epidermal growth factor and transforming growth factor alpha stimulated DNA
      synthesis in primary cultures of adult rat hepatocytes. In the presence of
      neurotensin, the stimulatory effect of epidermal growth factor or transforming
      growth factor alpha on DNA synthesis was enhanced 3- to 5-fold. Since neurotensin
      by itself did not stimulate DNA synthesis at all concentrations tested,
      enhancement of DNA synthesis by neurotensin is due to the amplification of the
      effect of epidermal growth factor or transforming growth factor alpha. The
      amplification by neurotensin was observed in a dose-dependent manner with a
      maximal effect at 10(-8)M, although its effect was significantly observed at as
      low as 10(-10) M. This neurotensin amplification of DNA synthesis was observed
      when hepatocytes were cultured in Williams' medium E, but not in Leibovitz L-15
      medium, suggesting that minor components in the medium are required for
      hepatocytes to fully respond to neurotensin. Neurotensin-related peptides such as
      kinetensin or neuromedin-N did not have this amplifying effect on DNA synthesis
      at any concentration tested. From these results, neurotensin can be regarded as a
      new secondary mitogen.

PMID- 8364978
TI  - Information propagation by spatio-temporal pattern change of Ca2+ concentration
      throughout Physarum polycephalum with repulsive stimulation.
AB  - The development of a spatio-temporal pattern of Ca2+ concentration (Ca2+ pattern)
      in the plasmodium of Physarum polycephalum during repulsive response was studied
      using fura-2. In the migrating cell, the gradient of the Ca2+ concentration (Ca2+
      gradient) immediately showed a decrease in local concentration in the area (S
      site) stimulated by 50 mM KCl. The concentration rose and then decreased in a
      site neighboring the S-site. This transient increase of Ca2+ concentration, the
      duration of which was approx. 10 minutes, was propagated to the site most distant
      from the S-site. There, the Ca2+ concentration gradually rose and remained at a
      high level. Twenty-five minutes after stimulation, a new Ca2+ gradient was
      established throughout the plasmodium. The migratory direction of the cell as a
      whole then changed. In this process, although the period of Ca2+ oscillation
      changed at the S-site, this change was only local to the site. During the
      information processing of the local repulsive stimulus, the transient Ca2+
      increase propagated the local information about the stimulus to the non
      stimulation sites (NS-sites), leading to the generation of a new pattern and the
      start of coordinated migration of the plasmodium.

PMID- 8364979
TI  - Effect of hepatocyte growth factor on cadherin-mediated cell-cell adhesion.
AB  - Hepatocyte growth factor (HGF) is known to induce the dispersion of epithelial
      cells, as scatter factor. On the other hand, cadherins play a crucial role in
      connecting cells together. Two groups of cadherins are involved in epithelial
      cell adhesion, those locating in adherens junctions (AJ) and in desmosomes. Here,
      we examined the effect of HGF on the function of these cadherins in keratinocyte
      cell lines F and 308R, which expressed E- and P-cadherin in AJ (referred to as AJ
      cadherins) and desmoplakin in desmosomes. In the presence of HGF, these cells
      spread more extensively than in control cultures and their associations
      apparently loosened. However, they maintained cell-cell contacts where cadherins
      and desmoplakin concentrated, although the level of the concentration was reduced
      by HGF treatment. When antibodies to E- and P-cadherins were added to cultures of
      these cells without HGF, AJ cadherins were redistributed into non-junctional
      areas of the cells, but desmoplakin still localized at cell-cell boundaries. When
      HGF was added together with anti-AJ cadherin antibodies to the cultures, cell
      cell contacts were now disrupted. In these cultures, not only AJ cadherins but
      also desmoplakin were lost at cell-cell contact sites, indicating that HGF can
      disrupt desmosomal cell-cell adhesion when AJ cadherins are inactive. These
      results suggest that, although HGF cannot block cadherin-mediated cell-cell
      adhesion when the entire cadherin system is intact, it might modulate the
      activities of cadherins, especially, of desmosomal cadherins.

PMID- 8364980
TI  - The effect of cytokines on the differentiation of an eosinophilic leukemia cell
      line (EoL-1) is associated with down regulation of c-myc gene expression.
AB  - In this study, we measured hydrogen peroxide (H2O2) release as one of the
      functions of mature eosinophils, and utilized it as a quantitative index. We
      demonstrated that 1) the human eosinophilic leukemia cell line, EoL-1, did not
      release H2O2 when stimulated with phorbol myristate acetate (PMA), but after
      culturing with tumor necrosis factor (TNF) and interferon-gamma (IFN-gamma) it
      acquired the ability to release H2O2; 2) the ability to release H2O2 was time
      dependent and reached a peak after 4 days of culture; 3) administration of TGF
      beta or GM-CSF, with TNF and IFN-gamma enhanced the PMA-induced release of H2O2
      from EoL-1. To examine the potential relationship between c-myc gene expression
      and induction of the ability to release H2O2, Northern analysis of c-myc gene
      expression in EoL-1 cocultured with TNF and IFN-gamma was performed. The results
      showed that the c-myc gene was spontaneously expressed in EoL-1, and the level of
      c-myc mRNA was markedly reduced after the cells were cocultured with TNF and IFN
      gamma, suggesting that the decrease of the c-myc mRNA level is closely associated
      with induction of the ability to release H2O2.

PMID- 8364981
TI  - Characterization of a hepatocyte growth factor derived from nonparenchymal liver
      cells.
AB  - A growth factor stimulating DNA synthesis of adult rat hepatocytes in primary
      culture was found in the conditioned medium after culturing nonparenchymal liver
      cells (NPC). Adding heparin to the NPC cultured medium stimulated the growth
      factor secretion from NPC. The growth factor was secreted mainly by Kupffer
      cells. The partially purified growth factor from the NPC appeared to be related
      to the HGF isolated from platelets according to three criteria: (a) binding to
      Heparin-Sepharose and eluting at about 0.65 M NaCl, (b) having a Mr of about 70
      kDa, (c) having an immunoreactivity to antibody against rat platelet-derived HGF.
      Adding heparin to the NPC cultured medium also resulted in protection of the
      growth factor from heat- and acid-inactivation, but the direct interaction of
      heparin with the partially purified growth factor did not lead to such
      protection. Perfusion of normal adult rat livers with Hanks' solution containing
      1 M NaCl in situ led to the release of large amounts of hepatocyte growth factor
      (10). These findings suggest that the hepatocyte growth factor derived from NPC
      binds to ECM between the layer of hepatocytes and endothelial cells forming the
      sinusoids in normal adult rat liver and that this may play a role in
      stabilization and maintaining the pool of HGF, which functions to constantly
      supply HGF in the setting of liver regeneration.

PMID- 8364983
TI  - Biochemistry of the intervertebral disc.
AB  - In comparison to other tissues, understanding the disc biochemistry is only in
      the very early stage. The few facts that are known would point to strategies for
      interventions to alter disc biology and maintain disc biomechanics.

PMID- 8364982
TI  - Close correlation between cytoplasmic Ca++ levels and release of an endothelium
      derived relaxing factor from cultured endothelial cells.
AB  - We studied whether there is a quantitative relationship between free cytosolic
      Ca++ levels and the release of an endothelium-derived relaxing factor (EDRF) from
      cultured fetal bovine aortic endothelial cells (EC). EC pretreated with
      indomethacin were stimulated by the agonists adenosine triphosphate (ATP),
      bradykinin (BKN), acetylcholine (ACh) and calcium ionophore (A23187) in various
      concentrations (10(-8)-10(-5) M), and the amount of EDRF released was determined
      on the basis of endothelium-free rabbit aortic ring relaxation and cultured
      smooth muscle cell cGMP content. Changes in intracellular Ca++ concentration
      ([Ca++]i) in response to the same stimuli were determined by photometric
      fluorescence microscopy using the fluorescent calcium indicator Fura-2. EC
      stimulation by ATP and A23187 induced dose-dependent increases in both [Ca++]i
      and the amount of EDRF released. BKN increased both [Ca++]i and EDRF release upon
      initial exposure (10(-8)M), but there were no further changes at higher
      concentrations. ACh induced no significant changes in either [Ca++]i or EDRF
      release. There was a close quantitative correlation between agonist-induced
      changes in [Ca++]i and the amount of EDRF released (relaxation response in aortic
      rings and cGMP levels.) (p < 0.001) Removal of extracellular Ca++ eliminated
      continuous elevation in both [Ca++]i and the amount of EDRF induced by ATP (10(
      5)M), BKN (10(-8)M) and A23187 (10(-6)M). These findings suggest that
      intracellular Ca++ levels are directly linked to the amount of EDRF released, and
      that extracellular Ca++ is essential for EDRF release because its influx is
      involved in the continuous elevation of [Ca++]i.

PMID- 8364984
TI  - Spinal injury in sport: epidemiologic considerations.
AB  - Review of previous epidemiologic studies, involving both contact and noncontact
      sports at all levels of competition ranging from the high school level to the
      professional level, reveals that the overwhelming majority of sports injuries
      related to the spine are soft-tissue injuries and self-limiting. The spectrum of
      injury is related to the mechanism, the force involved, and the point of
      application of the force. The immediate consequence of a soft-tissue injury is
      decreased immobilization with result in deconditioning. Most athletes have a
      strong desire to compete both at the amateur and professional levels. The
      inability to compete can have both psychologic and emotional consequences. The
      professional athlete is potentially burdened with financial consequences as well.
      The mainstay of prevention and treatment is maintaining good strength and
      flexibility through conditioning. Injuries can occur at the level of the disc,
      resulting in disc herniation, disc degeneration, and ultimately developmental
      stenosis. The biochemistry and biomechanics of the disc are age related, and
      thus, the adolescent and older athlete may have different concerns with regards
      to the diagnosis, treatment, and prognosis after injury to the spine. Remember,
      not only injuries cause back pain in the athlete. Athletes, too, can have tumors,
      infection, rheumatologic disorders, and other nontraumatic etiologies of back
      pain. Rarely athletic injuries to the spine do result in significant neurologic
      compromise. These injuries have been brought to national attention with the
      tragic recent injuries of well-known professional football and hockey
      athletes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8364985
TI  - Biomechanics of the spine in sports.
AB  - An understanding of spinal mechanics is necessary for the treatment of athletic
      injuries. Recognizing and isolating the mechanism of injury through noninvasive
      techniques will lead to specific treatment for that injury. Because the
      prevention of physical injury is the goal of all health care professionals, the
      authors hope that the information will be helpful.

PMID- 8364986
TI  - The lumbar spine in the aging athlete.
AB  - The relative importance of an elderly individual's chosen athletic endeavor
      should not be underestimated. These athletes have high expectations of their
      physical abilities. A lumbar spine syndrome can be a severe physical and
      psychologic setback. The ideal goal in the treatment of this population is to
      make an accurate diagnosis and provide expeditious treatment that allows the
      athlete to return to a satisfactory level of competition. The described algorithm
      is useful in attaining this goal. In addition, patient education is particularly
      important in preventing reinjury.

PMID- 8364987
TI  - Diagnostic imaging of sports-related spinal disorders.
AB  - Diagnostic imaging is a dynamic field that has taken a quantum leap over the past
      several years with the advent of MRI. Accordingly, it is integral that the sports
      medicine clinician be well acquainted with the sundry imaging modalities at his
      or her disposal, and be able to choose the appropriate study or studies that will
      provide the most useful and accurate information. Conventional radiography should
      be the first study performed in every athlete with sports-related injury to the
      spine. If radiography reveals evidence of spondylolysis with or without
      spondylolisthesis, MRI would be an extremely helpful adjunct for evaluation of
      the disc spaces, nerve roots, and neural foramina. Osseous fragments in the
      vicinity of the pars defect are well seen on CT but not MRI. These fragments can
      migrate and become symptomatic. Therefore, in the work-up of this subset of
      patients, CT does offer important supplementary data to the MRI. When
      conventional radiographs of the cervical spine corrected for magnification render
      the diagnosis of congenital cervical spinal stenosis, MRI should invariably be
      the next procedure of choice for evaluation of the spinal cord and to assess the
      functional reserve of the spinal canal. MRI is also the modality of choice now
      for evaluation of the athlete with degenerative disc disease and for the
      identification of degenerative disc disease associated with lumbar Scheuermann's
      disease. In the athlete with an acute cervical spine injury, following
      conventional radiography, the patient should be evaluated with CT to better
      characterize and define the extent of the fracture and to search for additional
      fractures. MRI should be performed in these patients after CT as it provides
      extremely valuable information regarding the status of the spinal cord. MRI
      because of its unparalleled soft-tissue contrast, noninvasive nature, ability to
      image in three orthogonal planes, and myelographic effect with certain pulses
      sequences has become the ideal imaging modality for spinal disease, and sports
      related spinal disorders are certainly no exception.

PMID- 8364988
TI  - Spine instability and the special olympics.
AB  - There is a broad array of abnormalities of the upper cervical spine in people
      with Down syndrome, with an increased atlanto-dens interval being the best known.
      Most patients are asymptomatic. The natural history, however, is not known, and
      therefore, treatment recommendations are based on important clinical
      determinants.

PMID- 8364989
TI  - Spondylolysis and spondylolisthesis in the athlete.
AB  - Spondylolysis and spondylolisthesis are common causes of back and leg pain in the
      athletic population. Spondylolysis originates most often in children between 5
      and 10 years of age. Many types of athletic activities requiring lumbar extension
      and rotation place the immature spine at risk for developing these lesions.

PMID- 8364990
TI  - Isokinetic back testing in the athlete.
AB  - With increasing numbers of professional, collegiate, and high school athletes
      developing low back pain, isokinetic back testing could prove to be a way of
      preventing the development of severe problems and extended stays on injured
      lists. Isokinetic testing provides an advantage over other testing procedures by
      more closely simulating the way muscles perform functional activities. This type
      of testing allows comparison between patients, normals, preoperative and
      postoperative status, and pre-rehabilitation and post-rehabilitation protocols.

PMID- 8364991
TI  - Nonoperative treatment of low back injury in athletes.

PMID- 8364992
TI  - Percutaneous lumbar discectomy.
AB  - The role of percutaneous lumbar discectomy as an adjunct in the treatment of
      herniated lumbar discs has become increasingly recognized. This article discusses
      its history, indications, techniques, and results.

PMID- 8364993
TI  - Laser discectomy.
AB  - Discectomy with lasers is a technically easy procedure and permits a surgeon to
      place a predictably sized and configured defect in a predetermined position in
      the intervertebral disc. In a small series of patients, the procedure appears
      effective in controlling symptoms in a high percentage of patients. The efficacy
      of the procedure and wider acceptance will depend on the results of multicenter
      clinical trials.

PMID- 8364995
TI  - Arthroscopic microdiscectomy versus nucleotomy techniques.
AB  - Arthroscopic microdiscectomy represents an alternative method of treatment for
      herniated lumbar disc and its associated radiculopathy. In contrast to nucleotomy
      procedures that allow for only central evacuation of the nuclear mass, in
      arthroscopic microdiscectomy, the emphasis is placed on evacuation of the
      posterior collagenized fragments, which are responsible for mechanical
      compression of the nerve roots. Over a period of 10 years, 250 patients with
      unremitting sciatica due to herniated nucleus pulposus have been treated at the
      Graduate Hospital through a posterolateral approach via a 6.5-mm cannula. Our
      overall successful results have been 87.5%, and we have not encountered any
      neurovascular or other serious complications.

PMID- 8364994
TI  - Surgical disc excision.
AB  - For the athlete, whether recreational or professional, limited surgical
      discectomy has been a predictable and highly successful procedure, enabling those
      individuals to return to their preinjury status relatively quickly. With proper
      patient selection, patients will be able to return to their athletic endeavors
      with much more reliability than with any of the other currently available
      surgical alternatives to limited surgical discectomy.

PMID- 8364997
TI  - Rehabilitation of athletes following spine injury.
AB  - We feel that the described system for staging cervical and lumbar spine injuries
      in the high-performance athlete affords a basic framework for the rehabilitation
      of those individuals. With spine injuries, one has to exercise care to rule out
      those injuries and additional pathologies presenting as neck or back pain that
      could result in catastrophic sequelae. We stress due diligence in the initial and
      continued follow-up of these patients with careful evaluation to rule out
      associated fractures, dislocations, and attendant disc pathology. The treatment
      of the "stinger" or "burner" is controversial. We suggest a conservative
      approach, although the orthopedic and neurologic literature reports that these
      individuals have been returned to full contact sports activity without documented
      subsequent neurologic sequelae. The final decision remains at the discretion of
      the treating physician. This program provides a rational approach to the
      rehabilitation of the spine-injured high-performance athlete that will provide
      for the return of him or her to preinjury activity level in an expeditious manner
      with the minimal period of interruption in training.

PMID- 8364996
TI  - Spinal fusion in the athlete.
AB  - Although there are a few anecdotal descriptions of the athlete who has gone on to
      win fame and fortune following a successful spinal fusion, there has been little,
      if any, scientific data available to aid the surgeon in his treatment of these
      highly motivated patients. At present, there is no guide to patient selection or
      to the operative procedure of choice. There is no standard postoperative
      rehabilitation program, and to date, an outcome study is sadly lacking.
      Therefore, it is worthwhile to look into this subject in greater detail.

PMID- 8364998
TI  - Intracanalicular acoustic neuromas: a conservative approach.

PMID- 8364999
TI  - Remodelling of the normal incus.
AB  - Thirty normal incudes were examined using scanning electron microscopy (SEM) to
      assess the pattern and degree of bony remodelling. The body and short process
      appeared stable throughout life. By contrast, the lenticular and long processes
      demonstrated marked osteoclastic activity with a tendency to undergo progressive
      erosion with advancing age.

PMID- 8365000
TI  - The effect of histamine challenge on nasal airflow sensation.
AB  - Objective nasal airflow resistance, as measured by the rhinomanometer, and the
      subjective sensation of nasal patency are usually regarded as showing poor
      correlation. However, previous population studies comparing nasal resistance and
      subjective nasal airflow sensation have failed to take into account the great
      individual variation in resting nasal resistance. To investigate the potential
      relationship between the two parameters, 20 healthy volunteers underwent
      histamine nasal challenge tests. Nasal resistance prior to the intra-nasal
      administration of histamine ('resting' nasal resistance, NRR) was compared with
      nasal resistance when the subject reported a subjective sensation of nasal
      blockage ('obstructed' nasal resistance, NR0) and the two were found to be
      significantly correlated using the Spearman rank correlation method (rs = 0.648,
      P = 0.002). Linear regression analysis using the method of least squares
      demonstrated an association between the two variables (P = 0.029), conforming to
      the formula NR0 = 1.26NR+0.478, (resistance units kPa.s.l-1). Subjective and
      objective measurements of nasal patency may be much more closely related than has
      previously been reported.

PMID- 8365001
TI  - A model to refine the selection of children with otitis media with effusion for
      adenoidectomy.
AB  - The selection of children with otitis media with effusion for adenoidectomy has
      been criticized on a number of grounds. In spite of the widespread popularity of
      the procedure there are few objective guidelines to help the otolaryngologist
      make a decision which is therefore usually subjective. We present a
      scientifically derived model using a Generalized Linear Interactive Modelling
      (GLIM) technique from a population of 122 children who underwent either
      adenoidectomy or no pharyngeal surgery. The outcome parameter studied was
      otoscopic clearance in an unoperated ear 1 year after treatment. This was related
      principally to the operation type (P < 0.001) and to the age at which the
      operation was performed (P < 0.005). Using a probability of clearance threshold
      of 50% the model was tested on a prospective population of 166 children and
      outcome was correctly predicted in over 72%. This model enables the surgeon to
      determine the probability of clearance of effusion following adenoidectomy in an
      individual child. At a probability threshold of 50% adenoidectomy would be
      offered to children with bilateral otitis media with effusion aged between 4.33
      and 8.00 years. Over the age of 8 years the probability of clearance occurring
      spontaneously increases beyond 50%. By careful selection of the probability of
      clearance thresholds it was possible to produce otoscopic resolution in over 80%
      of those selected to undergo adenoidectomy. The model also enables the
      otolaryngologist to determine the proportion of children with established disease
      that require adenoidectomy at his own chosen probability thresholds which will
      ensure that a more effective resource allocation is achieved.

PMID- 8365002
TI  - A morphological comparison of interposed freeze-thawed skeletal muscle autografts
      and interposed nerve autografts in the repair of the rat facial nerve.
AB  - Freeze-thawed co-axially aligned skeletal muscle autografts provide a new concept
      in peripheral nerve repair, and are being investigated in the repair of mixed
      motor/sensory nerves. These grafts provide an orientated matrix of large basement
      membrane tubes through which regenerating axons can migrate and reinnervate the
      distal nerve. Using the buccal branch of the rat facial nerve as a model, we
      compared five freeze-thawed muscle autografts with five interposed nerve
      autografts. Some 300 days after grafting, the morphology of the distal nerve was
      evaluated. When the two groups were assessed morphometrically, it was found that
      nerve grafts showed a small but significant improvement over muscle grafts in
      respect of indices of the fibre maturation.

PMID- 8365003
TI  - Parental cigarette smoking and tonsillectomy in children.
AB  - The deleterious effects of parental smoking on the upper respiratory tracts of
      children are becoming increasingly recognized. This study examines the effect of
      parental smoking on the frequency of tonsillitis and incidence of tonsillectomy
      in children. A group of children being admitted for tonsillectomy and a control
      group of children from an orthoptic clinic were studied. Details recorded about
      the children included a history of tonsillectomy and the number of courses of
      antibiotics taken for sore throats in the previous 12 months. Parents were
      questioned about their smoking habits. A marked and statistically significant
      association has been found between the incidence of tonsillectomy in children and
      parental smoking in the home environment. There was a higher frequency of attacks
      of tonsillitis requiring antibiotic treatment in those children whose parents
      smoked. This effect may be mediated by altered oropharyngeal flora, mucociliary
      dysfunction, increased cross infection or a combination of these. If parents are
      encouraged to stop smoking there will be a reduction in tobacco smoke levels in
      the home environment and this should lead to a fall in both the incidence of
      tonsillitis and the need for tonsillectomy in their children.

PMID- 8365004
TI  - The assessment of alaryngeal speech.
AB  - The objective measurement of alaryngeal speech is desirable so that results
      between different centres can be compared. We examined several phonatory
      parameters of alaryngeal speech with the Visi-pitch and correlated these with the
      subjective assessment of voice quality. Amplitude, percentage voiced and
      perturbation correlated extremely well with the subjective assessment of voice
      quality.

PMID- 8365006
TI  - Conservative treatment of otitis media with effusion by autoinflation of the
      middle ear.
AB  - A total of 85 children on the waiting list for grommet insertion aged between 3
      and 10 years with bilateral chronic otitis media with effusion (OME) were
      assigned at random to an observation or treatment group. Those in the treatment
      group were given the Otovent device to use three times a day for the duration of
      the study and both groups were then seen at monthly intervals for 3 months for
      pneumatic otoscopy and tympanometry. Statistically significant improvement was
      seen in those using the treatment with a compliance of more than 70%. This was
      detected on the outcome measures of tympanometry and pneumatic otoscopy after 1,
      2 and 3 months. No side effects were demonstrated. We conclude that autoinflation
      is an effective short-term treatment for children with OME when used regularly
      under supervision.

PMID- 8365005
TI  - Blom-Singer prostheses--an 11 year experience of primary and secondary
      procedures.
AB  - Over the past 11 years, 25 primary and 29 secondary tracheo-oesophageal punctures
      have been performed in 51 laryngectomees. Pre-operative assessment is required
      for the secondary procedure. Both primary and secondary procedures require
      intensive speech therapy after fitting of the prosthesis. Fifty-four per cent of
      the primary and 37% of the secondary patients attained long-term speech, the
      latter figure rising to 58% with newer valves and increasing experience. Failures
      were commonly due to psychological or prosthesis-related problems. Complications
      were relatively minor, none being life threatening. Seventy per cent of the long
      term users were self caring. Adequate rehabilitation counselling and support is
      necessary to ensure long-term use of the prosthesis.

PMID- 8365007
TI  - Does the location of the laryngectomy stoma influence its ultimate size?
AB  - The stoma following laryngectomy may be placed either within the incision or
      separately. To determine if this variation had a bearing on its ultimate size,
      measurements of the stoma size were carried out in 61 patients who underwent
      laryngectomy by one of these methods. It was found that the stoma was nearly
      twice the size in patients in whom the stoma had been sited within the main wound
      and that there was a minimal need for the use of a tube or stoma button post
      operatively in these patients.

PMID- 8365008
TI  - Expression of the cell-cell adhesion molecule E-cadherin in squamous cell
      carcinoma of the head and neck.
AB  - The expression of the cell-cell adhesion molecule E-cadherin has previously been
      shown to be reduced in poorly differentiated squamous cell carcinoma of the head
      and neck and absent in nodal metastases. Twenty-eight patients with previously
      untreated squamous cell carcinoma of the head and neck, 22 of whom had nodal
      metastases at presentation, were investigated for E-cadherin expression using the
      monoclonal antibody 6F9, specific for human E-cadherin. Reduced expression was
      seen in the poorly differentiated primary tumours, compared with well
      differentiated tumours, but this trend was not statistically significant. E
      cadherin expression was present at a reduced level in nodal metastases. It was
      also noted that, where both the primary tumour and corresponding nodal metastasis
      were investigated, E-cadherin expression was identical for both samples. The
      degree of E-cadherin expression did not correlate with survival. These data
      confirm a reduction in E-cadherin expression in poorly differentiated tumours.
      There was no correlation between E-cadherin expression and any of the host,
      tumour and treatment factors associated with malignancies of the head and neck
      region.

PMID- 8365009
TI  - The influence of pathological and technical variables on hearing results in
      ossiculoplasty.
AB  - A prospective study of 55 ossiculoplasty operations has been carried out. Mean
      pre- and post-operative air-bone gaps and the changes in mean hearing loss were
      determined using the frequencies 500, 1000 and 2000 Hz. The influence of six
      potentially relevant variables on hearing results has been studied. Univariate
      analysis suggested that both the loss of the stapes arch and the presence of a
      mastoid cavity were associated with a significantly poorer outcome, but multi
      variate analysis confirmed this for loss of the stapes arch only (P = < 0.01).
      This is probably because the patients with open mastoid cavities more commonly
      suffered loss of the stapes arch (55%) than those with no cavity (27%) and had
      significantly larger air-bone gaps pre-operatively than those with no cavities (P
      = < 0.008). The results confirm the paramount importance of loss of the stapes
      arch as a determinant of outcome in ossiculoplasty and highlight the difficulties
      associated with trying to make valid comparisons between different patient groups
      undergoing this type of surgery.

PMID- 8365011
TI  - Laser treatment of rhinitis--1 year follow-up.
AB  - Laser cautery of the inferior turbinates for the treatment of rhinitis has been
      shown to be as effective as sub-mucosal diathermy in the short-term and to
      produce less morbidity. However, the long-term effects are unknown. A cohort of
      patients who were treated by either of these methods were reviewed 1 year after
      treatment. Subjective and objective measurements of airway obstruction were
      performed using a linear analogue scale and a nasal peak inspiratory flowmeter.
      The results obtained were compared with those recorded pre-operatively, 3 days
      post-operatively and 6 days post-operatively. In contrast to the results of sub
      mucous diathermy of the inferior turbinates for the treatment of rhinitis, the
      reduction in subjective nasal airway obstruction obtained by laser cautery to the
      inferior turbinates is maintained 1 year after surgery. Neither method of
      turbinate reduction was associated with a sustained objective improvement in
      nasal airway patency as measured by peak nasal inspiratory flow rate
      determinations.

PMID- 8365010
TI  - Adenotonsillectomy in patients with inherited bleeding disorders.
AB  - We describe the management of tonsil or tonsil and adenoid surgery in our
      hospital in 10 patients with inherited bleeding disorders, over a 10-year-period.
      The approach to the management of the haemostatic defect is outlined in detail.
      All underwent successful surgery, two patients had limited secondary haemorrhage.
      This report demonstrates that patients with inherited bleeding disorders can
      safely undergo adenotonsillectomy, providing there is close liaison between
      surgeons and haematologists throughout the peri-operative period.

PMID- 8365012
TI  - Eustachian tube function during pregnancy.
AB  - The upper respiratory mucosa has been reported to react to sex hormones in both
      physiological and pathological conditions. The present study was specifically
      aimed to determine the influence of high levels of oestrogen on Eustachian tube
      function. Fifty-three healthy, pregnant women were prospectively evaluated for
      Eustachian tube function during pregnancy. Eustachian tube function was found to
      be highly variable in different women, and in the same woman at different stages
      of pregnancy. We did not find a specific trend in Eustachian tube function with
      increasing oestrogen levels as encountered during pregnancy.

PMID- 8365013
TI  - Day case adenoidectomy.
AB  - The Audit Commission recommends that more day surgery be undertaken in the Health
      Service. In a prospective study of 62 children undergoing adenoidectomy one major
      complication commenced within 2 hours of surgery. Of 15 minor complications, 78%
      occurred within 6 hours of surgery; they did not herald later major
      complications. Day adenoidectomy can safely be performed if patients remain in
      hospital for 6-8 hours post-operatively and then fulfil the following discharge
      criteria: they are apyrexial, eating, drinking and with no signs of haemorrhage.
      This will not result in a significant increase in workload for general
      practitioners. Day adenoidectomy for medically and socially appropriate patients
      increases our day surgery figures by 74% to 43% of the routine paediatric ENT
      caseload. There are immediate benefits to patients but the potential economic
      benefits to the Health Service will not be felt unless these children are treated
      in a designated Day Case Unit.

PMID- 8365014
TI  - Validation of acoustic rhinometry by using the Cavalieri principle to estimate
      nasal cavity volume in cadavers.
AB  - The ability of acoustic rhinometry to provide valid estimates of nasal cavity
      volume has been tested using cadaveric heads. Values obtained for the cavities in
      five intact heads were compared with unbiased estimates of the volumes of the
      same specimens. An unbiased estimate is one which does not depart in a systematic
      manner from the true value. Here, unbiased estimates were made by applying the
      Cavalieri principle to uniform random samples of 4-7 macroscopic slices per
      specimen. Using acoustic rhinometry, the mean volume (left and right sides
      combined) amounted to 31.3 ml with a co-efficient of variation of 77%. On the
      same specimens, the Cavalieri estimate of mean volume (both cavities plus the
      adjacent nasopharynx) was 31.1 ml (66%). There was a significant and positive
      correlation between the two data sets (correlation co-efficient 0.97). Repeated
      acoustic measurements on the same cavities gave a measuring error of about 4%. We
      conclude that acoustic rhinometry can provide valid and efficient estimates of
      the volume of the nasal cavity plus nasopharynx.

PMID- 8365015
TI  - Sensory interaction posturography in patients with benign paroxysmal positional
      vertigo.
AB  - BPPV (benign paroxysmal positional vertigo) is a very common peripheral
      vestibular disturbance. The dysfunction becomes manifest mainly by vertigo and
      typical nystagmus. However, the vestibulospinal reflex (VSR) can also be
      disturbed. This can be shown by the SPGIII (static posturography type III), which
      is a platform technique evaluating 'sensory interaction' in a way comparable to
      that of the Equi-test. Half the patients with BPPV show disturbed posturographic
      results. By interfering with the sensory input of vision and/or proprioception,
      the separate contribution of each input can be evaluated. Different 'formulae'
      are seen, from complete normal results, through 'overall' formulae, i.e. an
      undifferentiated influence in all test-conditions, to specific formulae, where we
      find 'eye-closure' and 'head retroflexed'-effect and so-called 'vestibular
      formulae'. These formulae are an expression of the different degrees of
      compensation achieved by the centres and especially of the 'substituting'
      compensation by vision and proprioception. These results confirm that
      posturography does not provide a typical results-pattern, thus the type of
      peripheral vestibular disorder cannot be diagnosed by it alone. The results give
      functional information on how the standing position is achieved in these patients
      with a disturbed VSR-input. The several formulae prove that indeed different
      compensatory patterns are possible, as has been shown by experiments on
      vestibular compensation.

PMID- 8365016
TI  - Fish bones and other foreign bodies.
AB  - In this prospective study the types of foreign body ingested, sites of impaction,
      radiographical findings, management and outcome in 81 patients were recorded. We
      have demonstrated that foreign bodies can be conveniently divided into 'fish
      bones' and 'others', in terms of their sites of impaction (P < 0.0001), the age
      groups affected, whether dentures were worn or not (P < 0.02) and their
      respective management (P < 0.001). Statistical analysis supporting these
      observations has not been previously reported.

PMID- 8365017
TI  - Long-term effects of otitis media with effusion on language, reading and
      spelling.
AB  - The long-term effects of early OME on language and educational attainment were
      studied in 47 children of 7-8 years of age who had participated in an earlier pre
      school study on otitis media with effusion (OME) and language development. At pre
      school age OME was diagnosed by quarterly tympanometric screens (maximum nine)
      and language was assessed by a standard Reynell test. At school age the ears of
      the children were assessed by otomicroscopy, tympanometry and audiometry, and the
      development status by several language, reading and spelling tests. The
      association between early OME and language development found at pre-school age
      was no longer present at school age.

PMID- 8365018
TI  - ANCA in diseases other than systemic vasculitis.

PMID- 8365019
TI  - Treatment of autoimmune diseases with normal immunoglobulin through manipulation
      of the idiotypic network.

PMID- 8365020
TI  - Mechanisms of neutrophil-mediated injury.

PMID- 8365021
TI  - The fate of the neutrophil in vasculitis.

PMID- 8365023
TI  - The endothelial cell: active participant or innocent bystander in primary
      vasculitis?

PMID- 8365022
TI  - Lymphocyte-vascular endothelial cell interactions in the immune response.

PMID- 8365025
TI  - Bullous diseases. Introduction.
AB  - The bullous diseases have a history as old as that of medicine. Although blisters
      have drawn the attention of medical caregivers throughout written history, only
      modern times have seen the origin of a clear classification of these disorders,
      based initially upon clinical and histologic criteria. Recent work has allowed
      clear delineation between similar diseases based upon localization of immune
      reactants and, more recently, molecular targets of autoimmune response or defects
      of inherited diseases. With a clear understanding of the clinical findings,
      histologic alterations, immune deposits, and metabolic defects, a clinician can
      arrive at a correct diagnosis in almost all cases of cutaneous blistering. The
      application of molecular biology to the study of bullous diseases has led to a
      more detailed understanding of the pathogenesis of the disorders. New horizons in
      the bullous diseases include further understanding of the molecular and
      immunologic mechanisms that lead to blisters. It is hoped that this understanding
      will lead to exciting new therapies and hope for patients suffering with
      blistering diseases.

PMID- 8365024
TI  - The clinical relevance of ANCA in vasculitis.

PMID- 8365026
TI  - The humoral immune response in autoimmunity.
AB  - Only within the last 5 years have data on variable region sequences of
      autoantibodies begun to accumulate. Although it is too early to draw final
      conclusions, certain principles are beginning to emerge. It is clear that self
      recognition by the immune system is normal. This fact is supported by the anti
      idiotype network and the presence of natural autoantibody in normal sera.
      Furthermore, there appears to be a connection between these phenomena because the
      former may serve to keep the latter in check. Natural autoantibody appears to be
      primarily IgM polyreactive antibody of low affinity, quite different from the
      monospecific high-affinity IgG antibody usually associated with autoimmune
      disease. Natural autoantibodies also exhibit a high degree of cross-reactive
      idiotypes and are the products of CD5+ B cells, whereas IgG autoantibody is not.
      This is only a generalization, however, and it must be kept in mind that IgG
      autoantibody polyreactive with several autoantigens has been reported for normal
      sera of mice and humans. In Balb/c sera, a significant proportion of natural
      autoantibody is IgG, but it is apparently masked by inhibitory polyreactive IgM
      antibody that has affinity for IgG autoantibody, thereby exhibiting a regulatory
      role. A human CD5+ B-cell clone that secretes a high-affinity IgM anti-idiotype
      specific antibody has been reported. Another generalization that is beginning to
      emerge is that natural autoantibodies are the products of unmutated germline
      genes, whereas autoantibody associated with autoimmune disease has highly mutated
      VH and VL segments. Mutations exhibited by pathogenic autoantibody increase the
      antibody's affinity for autoantigen and therefore represent an antigen-selected
      or affinity maturation, resulting in more restricted heterogeneity. In contrast
      to this, polyreactive natural antibodies have variable regions that are
      essentially identical to germline gene V segments with few amino acid changes.
      However, it is important to note that pathologic autoantibodies arise from the
      same fetal genes that give rise to natural autoantibodies and antibodies against
      foreign antigens. There does not appear to be a set of genes specific for
      autoantibodies. The key question then becomes whether or not natural
      autoantibodies are precursors of pathogenic autoantibodies. If not, what is the
      function of natural autoantibodies and how do pathogenic autoantibodies arise?
      The answers to these questions are not yet clear and many theories have been
      offered, but sufficient data are not yet available to reach conclusions. One of
      the problems in reaching a definitive conclusion is the ability to identify
      pathogenic antibody.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8365027
TI  - MHC regulation of immune responses.
AB  - The major histocompatibility complex is a group of complex genes situated on the
      short arm of chromosome 6 in humans. They play an important role in the
      regulation of the immune response. Autoimmune blistering disease provides an
      ideal model for studying the role of MHC in autoimmunity. The diseases are organ
      specific, and in some of them the relevant antigen has been cloned and sequenced.
      Such information on the antigen will help further define the interactions of the
      Ag, MHC, and TCR. Use of family studies hopefully will define and localize
      susceptibility alleles, so that any genetic susceptibility can be identified at
      the molecular level. It is from these molecular perspectives that molecular
      therapies could be assigned to restore the immune system.

PMID- 8365028
TI  - Established methods in the investigation of bullous diseases.
AB  - We have discussed an approach to the diagnosis of bullous diseases based on
      available and established methods. We highlighted the clinical features that help
      distinguish the various diseases. We then outlined a histopathologic pattern
      approach to the differential diagnosis and extensively discussed the value of
      immunofluorescence in the diagnosis of bullous diseases.

PMID- 8365029
TI  - New laboratory methods in the investigation of bullous disease.
AB  - Over the last 5 to 10 years, basic research in the areas of cell biology,
      biochemistry, immunology, and molecular biology has led to quantum advances in
      our understanding of the causes of the bullous diseases. This explosion of new
      information has been made possible by corresponding technologic advances related
      to these scientific disciplines. This article does not represent a comprehensive
      review of this topic, but rather highlights important contributions primarily
      from the field of molecular biology. Much of this article describes research
      technologies aimed at identifying and characterizing the genes and gene products
      that are directly involved in the pathogenesis of the bullous disorders. Although
      many significant advances have been made, a great deal remains to be done. It is
      our hope that the next 5 to 10 years will witness the emergence of a new set of
      technologies that will facilitate the translation of this new-found molecular
      information into more accurate diagnostic tools, more effective therapeutic
      strategies, and a fuller understanding of the basic biology of the skin.

PMID- 8365030
TI  - Pemphigus vulgaris and vegetans.
AB  - Pemphigus vulgaris, which has multiple clinical variants, is an autoimmune
      blistering disorder of skin and mucous membranes, usually affecting the elderly,
      with a strong immunogenetic link. Immunologic studies of this disease have been
      productive in defining the pathophysiology of blister formation and the
      characteristics of the pemphigus antigen. New therapies resulting from the newest
      research techniques would prevent the global immunosuppression that occurs during
      drug therapy with systemic glucocorticoids, which is the cornerstone of therapy
      for patients afflicted with this potentially life-threatening disorder.

PMID- 8365031
TI  - Endemic pemphigus foliaceus. Fogo selvagem.
AB  - Fogo selvagem is a form of pemphigus foliaceus indistinguishable on clinical,
      histologic, immunofluorescence, and ultrastructural grounds from sporadic
      pemphigus foliaceus found in North America and Europe. It can, however, be
      distinguished on epidemiologic grounds by its unique geographic distribution. The
      association of FS with its environment is supported by its limited areas of
      predilection, that is, between 500 and 800 meters altitude near rivers, and the
      remission of the disease when patients are removed from this environment. Owing
      to its obvious environmental trigger, FS may serve as a model for the initiation
      of autoimmune phenomena. We need merely to find the specific trigger or triggers,
      and the search is now under way.

PMID- 8365032
TI  - Drug-induced pemphigus.
AB  - Drug-induced pemphigus is a heterogenous group of disorders in which a drug
      induces acantholysis. The majority of patients have immune features of pemphigus
      and have a course similar to idiopathic pemphigus. Few patients do not have a
      detectable autoimmune process, and their eruption usually resolves with
      discontinuation of the associated drug. The mechanism of induction of the
      autoimmune process and acantholysis is not clear.

PMID- 8365033
TI  - Paraneoplastic pemphigus.
AB  - Paraneoplastic pemphigus is a newly recognized disease that occurs in some
      patients with lymphoproliferative neoplasms and occasionally, solid tumors.
      Patients present with an acute illness of the mucosa and skin that shares
      clinical and histologic features with erythema multiforme, toxic epidermal
      necrolysis, and pemphigus vulgaris. These patients have antibodies against a
      complex of epithelial proteins that are present in desmosomes and hemidesmosomes.
      The course is usually fatal, except in some patients who undergo total resection
      of their neoplasm.

PMID- 8365034
TI  - Bullous pemphigoid.
AB  - Bullous pemphigoid is an acquired subepidermal blistering disease of the elderly
      characterized by tense blisters. Patients with bullous pemphigoid have
      circulating and tissue-bound antibodies that are directed against a normal
      component of the epidermal basement membrane. The course of bullous pemphigoid
      tends to be self-limited, and effective treatment is often affected with systemic
      glucocorticosteroids.

PMID- 8365035
TI  - Cicatricial pemphigoid.
AB  - Cicatricial pemphigoid presents with oral or ocular inflammation and blisters
      that are followed by scarring. The differential diagnosis of cicatricial
      mucositis includes other subepithelial blistering disorders. The disease is
      usually chronic and can be associated with high morbidity. Treatment of severe
      cases with immunosuppressive agents is usually helpful.

PMID- 8365037
TI  - Herpes gestationis.
AB  - HG expresses a broader clinical range than previously thought. Disease may be
      mild and nonvesicular during one pregnancy, followed by explosive vesiculobullous
      disease during another. On the other hand, patients with extensive HG during one
      pregnancy may experience mild or even subclinical disease during a subsequent
      gestation. The broad range of clinical signs and the lack of demonstrable fetal
      or maternal risk associated with HG have important ramifications for patients
      desirous of further children. There is a genetic predisposition to HG. DRB1*0301
      (HLA-DR3) is increased and 90% of patients express either DRB1*0301 (HLA-DR3) or
      DRB1*0401/040X (HLA-DR4). Ninety percent of patients also carry a C4 null allele,
      which may be due to linkage dysequilibrium with DRB1*0301 or DRB1*0401/040X. The
      disease appears to be mediated by an IgG1 specific for a 180-kD component of
      hemidesmosomes. This protein is distinct from the 240-kD hemidesmosomal antigen
      seen in BP and is coded for by a different cDNA on a different chromosome.
      Abnormal expression of class II MHC occurs in the placental villi of those with
      HG, suggesting ongoing immunologic stimulation. This has led some investigators
      to believe that the primary immunologic event is taking place within the placenta
      and that the skin is an immunologic bystander.

PMID- 8365036
TI  - Dermatitis herpetiformis and linear IgA bullous dermatosis.
AB  - DH is an uncommon vesicular disease of the skin which has attracted great
      interest because of myriad clinical and laboratory findings believed to be
      related to its immunopathogenesis. Investigations have centered on its
      relationship to gluten intake, multisystem disease associations, pathognomonic
      patterns of IgA deposition, and impressive therapeutic response to gluten
      restriction and dapsone. However, a coherent theory of pathogenesis has not yet
      been established. The circulating antibody responsible for the IgA deposition has
      not yet been identified, and indirect IF is negative. LABD has now been separated
      from DH on the basis of its unique immunopathologic finding of linear IgA along
      the cutaneous basement membrane and the presence of circulating IgA anti-basement
      membrane antibody, which binds to a 97-kD protein found in normal human skin. It
      has been suggested that CBDC and LABD are expressions of the same disease process
      in different age groups rather than two distinct disease processes. Supporting
      evidence for this theory is based on immunopathologic findings. Linear deposition
      of IgA along the basement membrane of perilesional skin is identical to LABD and,
      in addition, a circulating IgA anti-basement membrane antibody is present in the
      serum of some patients which binds to the 97-kD antigen described in LABD.

PMID- 8365038
TI  - Epidermolysis bullosa acquisita and bullous systemic lupus erythematosus.
      Diseases of autoimmunity to type VII collagen.
AB  - Autoimmunity to C7 is a genetically predisposed condition that results in the
      production of predominantly IgG class basement membrane autoantibodies that may
      cause basement membrane damage and subepidermal blisters by at least two
      pathogenic mechanisms. Autoimmunity to C7 cuts across traditional disease
      classifications (EBA versus bullous SLE), presents with heterogeneous clinical
      and pathologic features, mimics other diseases, and may be difficult to diagnose
      and treat. Autoimmunity to C7 is associated with susceptibility to SLE and
      perhaps inflammatory bowel disease.

PMID- 8365039
TI  - Inherited epidermolysis bullosa. Clinical features, molecular genetics, and
      pathoetiologic mechanisms.
AB  - Recent advances in the molecular biology of the extracellular matrix have
      resulted in a detailed understanding of the cutaneous basement membrane zone.
      Consequently, the application of this information to the study of the molecular
      genetics of the genodermatoses has resulted in spectacular success in the last
      few years. This article summarizes progress made in the molecular biology of the
      cutaneous basement membrane zone and its impact on understanding the basis of
      heritable blistering diseases of the skin, with particular emphasis on
      epidermolysis bullosa.

PMID- 8365040
TI  - Inflammatory bullous diseases in children.
AB  - Bullous disease in children can be confusing clinically and challenging to mange.
      Five groups of autoimmune bullous disease are discussed with emphasis on unique
      features in children. Pemphigus (vulgaris, foliaceus, neonatal), pemphigoid
      (bullous and cicatricial), dermatitis herpetiformis, linear IgA dermatosis, and
      epidermolysis bullosa acquisita are uncommon pediatric disorders. A high index of
      suspicion is necessary to diagnose and treat these conditions without delay.

PMID- 8365041
TI  - The porphyrias.
AB  - The vesiculobullous porphyrias are a group of blistering diseases with systemic
      as well as cutaneous manifestations ranging from mild to disabling, secondary to
      endogenous photosensitizing porphyrins. The characteristic patterns of porphyrin
      accumulation in erythrocytes, plasma, urine, and feces are invaluable for
      differentiating the vesiculobullous porphyrias from other blistering diseases and
      from one another. Most importantly, these porphyrin profiles are essential for
      distinguishing the acute vesiculobullous porphyrias, HCP and VP, from PCT, which
      is not associated with acute attacks. This distinction may prevent the
      potentially fatal administration of porphyrinogenic drugs to patients with HCP or
      VP. Histopathology is not helpful in differentiating the vesiculobullous
      porphyrias, as all typically show subepidermal bullae. Avoidance of sun exposure
      and precipitating factors are the initial steps in both the prevention and
      treatment of these entities. In addition, more specific therapy may be indicated,
      as discussed in the preceding pages.

PMID- 8365042
TI  - Bullous dermatoses associated with systemic disease.
AB  - The bullous diseases that are neither immune-mediated nor inherited form a
      heterogeneous group that may be classified according to their major
      histopathologic characteristics. Such a classification allows clear distinctions
      to be made between entities that may have clinical similarities such as
      staphylococcal scalded skin syndrome, toxic shock syndrome, erythema
      multiforme/toxic epidermal necrolysis, and acute graft-versus-host disease.
      Proper differentiation of these entities is critical for their study and for
      appropriate management.

PMID- 8365043
TI  - Topical immunotherapy in the treatment of chronic severe alopecia areata.
AB  - In the past decade, topical immunotherapy with DPCP has been shown to be a very
      important therapeutic modality in the treatment of chronic severe alopecia
      areata. At the University of British Columbia Hair Clinic, it is our treatment of
      choice in adults. This option for treatment should be offered to the appropriate
      patients.

PMID- 8365044
TI  - Topical immunotherapy of alopecia areata.
AB  - Topical immunotherapy has proven to be a highly rewarding treatment modality for
      extensive forms of AA. The method should be considered at this time to be in an
      experimental stage, and therefore hesitation to adopt it is understandable.
      However, other acceptable and effective modes of treatment are thus far lacking.
      Extensive AA is not merely a cosmetic problem. Affected individuals often
      experience a considerable subjective loss of quality of life, and in such cases
      topical immunotherapy should be considered.

PMID- 8365045
TI  - Morphology of resistance arteries and comparison of effects of vasoconstrictors
      in mild essential hypertensive patients.
AB  - We have compared the response of small subcutaneous resistance arteries from 15
      mild essential hypertensive patients and 13 normotensive controls to various
      potentially pathophysiologically important vasoconstrictors. Blood vessels
      obtained from gluteal subcutaneous biopsies from hypertensive patients exhibited
      a significantly smaller external diameter and lumen and greater media/lumen ratio
      than those of normotensive subjects, but no significant difference in media
      thickness or cross-sectional area. Vasoconstrictor peptides produced varying
      effects on resistance arteries of hypertensive patients relative to controls:
      angiotensin II and arginine vasopressin elicited normal active media stress
      responses, while the contractile effect of endothelin-1 was depressed.
      Norepinephrine media stress responses were also blunted in hypertensive patients.
      Cocaine produced a shift to the left of the norepinephrine dose-response in
      vessels from both controls and hypertensive patients. Since the lumen diameter of
      blood vessels was reduced in hypertensive patients, vasoconstrictor responses
      were amplified, resulting in calculated pressor responses to endothelin-1 similar
      to those of normotensive controls. These results demonstrate the structural and
      functional alterations present in resistance arteries of mild essential
      hypertensive patients, which may be involved in maintaining elevated blood
      pressure.

PMID- 8365046
TI  - Intestinal permeability compared in pediatric and adult patients with
      inflammatory bowel disease.
AB  - Increased urinary excretion of 51Cr-EDTA after oral administration has been
      demonstrated in adults with active inflammatory bowel disease (IBD). Pediatric
      patients with Crohn's disease (CD) and ulcerative colitis (UC) were compared to
      pediatric and adult controls and adult patients with IBD using this technique.
      Seventy-five pediatric IBD patients, 51 (mean age 13.8 y) diagnosed with active
      CD and 24 (mean age 11.9 y) with active UC, were examined. These were compared to
      26 pediatric controls with recurrent abdominal pain or chronic non-specific
      diarrhea. Further comparison was made to 80 adult controls (mean 32.0 y), 63
      adults with active CD and 31 adults with active UC. After an overnight fast, 925
      kBq of 51Cr-EDTA was given orally and urine collected for 24 h. Excretion of the
      probe by the pediatric controls and adult controls was 1.5%/24 h and 1.3%/24 h
      (median), respectively. Of the pediatric patients, 45/51 (88.2%) with active CD
      (median 3.9%/24 h) and 16/24 (66.7%) with active UC (median 4.8%/24 h) showed
      increased excretion. Pediatric patients with active IBD demonstrated increased
      probe excretion comparable to levels of adult patients. In the pediatric
      population, accuracy of the first test was 83.0%. Thus, urinary excretion of 51Cr
      EDTA is a useful non-invasive test in the investigation of pediatric patients
      with gastrointestinal symptoms.

PMID- 8365047
TI  - Plasma beta-endorphin concentration and xanthine treatment in apnea of
      prematurity.
AB  - Apnea of prematurity is a common problem in neonatal intensive care nurseries.
      Xanthines are used to treat apnea, but their mechanism of action is not clearly
      understood. To determine whether xanthines stimulated beta-endorphin (beta-ED)
      release in preterm infants, plasma beta-ED concentrations were measured in 27
      infants with apnea of prematurity. These infants had a mean (+/- SD) birthweight
      of 1560 +/- 487 g, gestational age 31 +/- 2.5 weeks, and a postnatal age of 7.3
      +/- 4.6 d. Twenty-five of the infants were treated with I.V. aminophylline 2.5
      mg/kg/dose 4 times daily and 2 were treated orally with caffeine (10 mg/kg).
      Blood samples were collected prior to and 30 min after treatment with xanthines.
      Apneic spells greater than 15 sec were recorded and reviewed every 24 h using a
      Hewlett-Packard Merlin Monitor (Waltham, MA.) system. Infants were then
      stratified into responders (Group 1, n = 14) and nonresponders (Group 2, n = 13),
      with responders defined as showing more than 50% decrease in the frequency of
      apneic spells in the first 24 h of treatment. beta-ED were measured as previously
      described using a radioimmunoassay technique. In group 1, plasma beta-ED
      concentration increased significantly, (p = 0.0496) from pre-xanthine (24.4 +/-
      12 pg/ml) to post xanthine (34.6 +/- 24 pg/ml) treatment, whereas in Group 2 the
      concentrations remained the same (23.3 +/- 5 pg/ml) and (22.6 +/- 4 pg/ml).
      Birthweight, gestational age, postnatal age, and diagnoses in both groups were
      compared and no significant differences were observed. Interestingly, xanthine
      treatment caused increased plasma beta-ED release when apneas decreased.

PMID- 8365048
TI  - Whey proteins as a food supplement in HIV-seropositive individuals.
AB  - On the basis of numerous animal experiments, a pilot study was undertaken to
      evaluate the effect of undenatured, biologically active, dietary whey protein in
      3 HIV-seropositive individuals over a period of 3 months. Whey protein
      concentrate was prepared so that the most thermosensitive proteins, such as serum
      albumin which contains 6 glutamylcysteine groups, would be in undenatured form.
      Whey protein powder dissolved in a drink of the patient's choice was drunk cold
      in quantities that were increased progressively from 8.4 to 39.2 g per day.
      Patients took whey proteins without adverse side effects. In the 3 patients whose
      body weight had been stable in the preceding 2 months, weight gain increased
      progressively between 2 and 7 kg, with 2 of the patients reaching ideal body
      weight. Serum proteins, including albumin, remained unchanged and within normal
      range, indicating that protein replenishment per se was not likely the cause of
      increased body weight. The glutathione content of the blood mononuclear cells
      was, as expected, below normal values in all patients at the beginning of the
      study. Over the 3-month period, glutathione levels increased in all 3 cases. In
      conclusion, these preliminary data indicate that, in patients who maintain an
      adequate total caloric intake, the addition of "bioactive" whey protein
      concentrate as a significant portion of total protein intake increases body
      weight and shows elevation of glutathione (GSH) content of mononuclear cells
      toward normal levels. This pilot study will serve as a basis for a much larger
      clinical trial.

PMID- 8365049
TI  - An animal model of foodborne Listeria monocytogenes virulence: effect of
      alterations in local and systemic immunity on invasive infection.
AB  - Development of foodborne listeriosis is dependent on an interplay between
      organism-specific virulence factors and host susceptibility. Gastric inoculation
      of Sprague-Dawley rats was used as a model to explore Listeria-specific virulence
      and host susceptibility. Gastric inoculation leads to invasive infection with
      "smooth" hemolytic Listeria monocytogenes but not with "rough" L. monocytogenes
      or other Listeria species. Infection is dose-dependent with an ID50 of 10(6)
      virulent Listeria monocytogenes. In these experiments, the ID50 was not altered
      by pregnancy but invasive infection led to abnormal reproductive outcomes
      including stillbirth and reabsorption of fetuses. Immunosuppression by
      cyclosporin A led to more prolonged infection but did not alter the ID50.
      Manipulation of intestinal flora with antibiotics suggested increased rates of
      infection with antibiotics that decreased anaerobic flora. Growth of virulent
      Listeria in milk at varying temperatures did not enhance virulence. No
      differences in invasive potential of flagellated vs. non-flagellated L.
      monocytogenes were found. Oral models of invasive Listeria monocytogenes
      infection provide a useful tool for studying organism virulence and host
      susceptibility.

PMID- 8365050
TI  - Effects of immunosuppressive therapy on hepatic expression of hepatitis B viral
      genome and gene products.
AB  - To determine the effect of immunosuppressive therapy on hepatic expression of
      hepatitis B virus (HBV) DNA and antigens in vivo, serial biopsies from 12
      patients with chronic active hepatitis B who had been given immunosuppressive
      therapy (prednisolone 10-15 mg +/- azathioprine 75-125 mg daily) in an earlier
      period were studied using immunohistochemistry and non-isotopic in situ
      hybridization. Four out of the 12 patients were positive for hepatic
      HBcAg/HBeAg/HBV DNA before immunosuppressive therapy. In these 4 patients
      positive for HBcAg, there was an increase in staining intensity and the
      proportion of liver cells positive for both HBcAg/HBeAg/HBV DNA and HBsAg during
      therapy. Of the 8 patients negative for hepatic HBcAg/HBeAg/HBV DNA before
      immunosuppressive therapy, hepatic HBcAg, HBeAg, and HBV DNA were detected in 2
      patients, along with stronger and more diffuse hepatic expression of HBsAg. The
      other 6 patients also had an increase in hepatic HBsAg expression but without
      HBcAg. These data provide in vivo evidence that in some patients,
      immunosuppressive therapy enhances hepatic expression of both HBV genome and gene
      products.

PMID- 8365051
TI  - Clinical research: any future?
AB  - Laboratory-based clinical research is in a severe crisis in Canada. The reasons
      are many and range from the serious inadequacy in the financial remuneration of
      research fellows going to the USA. or Europe for further training to the
      overpowering trend to seek solutions to clinical problems directly at the
      molecular and cellular levels instead of the traditional physiopathological
      approach. The language of molecular biology and genetics, with its innumerable
      acronyms, is quite foreign to clinical medicine. In addition, molecular biology
      research leaves little time for clinical care of patients. Steps should be taken
      to reinvigorate laboratory-based clinical research since it is the key transfer
      point of basic advances to clinical care. Fellowships of the order of $50 to
      $60,000 to research fellows going to the United States or abroad should be
      provided. Close collaboration between PhD scientists and clinical scientists, as
      so successfully achieved at the Clinical Research Institute of Montreal in the
      last 25 years, should be emphasized, and a greater percentage of funds from
      research agencies should be designated for the support of laboratory-based
      clinical research and for the training of clinical scientists.

PMID- 8365052
TI  - [Magnetic resonance imaging in chronic toluene abuse, and volitional
      hyperkinesia].
AB  - We described the central nervous system impairments and findings of magnetic
      resonance imaging (MRI) of the brain in three chronic toluene abusers. Patient 1
      and 2 had a history of chronic toluene inhalation for 1 or 2 years and patient 3
      has a history of it for 16 years. The patients were evaluated after an abstinence
      period of at least 4 weeks, to avoid neurologic effects of acute intoxication.
      Neurologic signs included cerebellar, cognitive and pyramidal dysfunctions in all
      3 patients and hyperkinesie volitionnelle (HV; volitional hyperkinesia) in
      patient 3 who had a long history of toluene inhalation. This HV was found to be
      tremulous by surface electromyography. Appearance of HV in chronic toluene abuse
      seems to be related to a period or quantity of inhalation of toluene. T2-weighted
      MRI in the 3 patients revealed the following abnormalities: (1) increased signal
      intensity of middle cerebellar peduncle and cerebellar white matter, deep
      cerebral white matter, and posterior limb of internal capsule; and (2) decreased
      signal intensity of thalamus and basal ganglia. Proton-weighted MRI in patient 3
      with HV showed decreased signal intensity of lateral portion of the thalamus and
      tegmentum of the brainstem. These MRI findings correlate remarkably well with the
      neurologic signs seen in the 3 patients. Cerebellar, cognitive, and pyramidal
      dysfunctions appear to be related to involvement of middle cerebellar peduncle
      (cerebellar white matter), deep cerebral white matter, and internal capsule,
      respectively, and HV seems to correlate with involvement of the thalamus or
      tegmentum of the brainstem, especially the latter.

PMID- 8365053
TI  - [Saccadic eye movement related scalp potentials--scalp distribution of
      presaccadic slow negative potential].
AB  - We studied scalp distribution of presaccadic slow negative potential (PSN) among
      saccadic eye movement related scalp potentials in 17 normal subjects performing
      self-paced voluntary saccades in light (VS). There was a widespread PSN beginning
      at 1400 msec prior to saccades, maximum at the vertex. Amplitudes of PSN were
      greater over frontocentral electrodes contralateral to the direction of the
      saccades. These findings are consistent with reflection of activation of the
      supplementary motor area, and the frontal eye field contralateral to the
      direction of the saccades. On the other hand, amplitudes of PSN were relatively
      greater over occipital electrodes ipsilateral to the direction of the saccades.
      In addition, we studied PSN in 6 normal subjects performing self-paced voluntary
      saccades in darkness (VSD). PSN with VSD did not extend to occipital electrodes
      in comparison with PSN with VS. Occipital component of PSN with VS may reflect
      activation of other cerebral cortices which relate to visual inputs.

PMID- 8365054
TI  - [Early-onset parkinsonism with diurnal fluctuation--clinical and pathological
      studies].
AB  - The literature regarding parkinsonism of early-onset indicates that it
      encompasses several diseases differing in their clinical and pathological
      features. Since 1968 we have reported cases of early-onset parkinsonism with
      diurnal fluctuation of symptoms (abbrev. as EPDF). Attention has been focused on
      its similarities to or differences from Parkinson's disease (PD), juvenile
      parkinsonism of Yokochi, and hereditary progressive dystonia (HPD) of Segawa et
      al. In this paper we report the clinical and pathological characteristics of EPDF
      to facilitate its nosological identification. We examined the pathological
      features of EPDF in two cases. Case 1 was a 52-year-old female with
      consanguineously related parents and two other affected sisters. The disease
      began at the age of 20, and she had marked diurnal fluctuation of symptoms. With
      the assistance of L-dopa and bromocriptine, she was able to enjoy relatively
      satisfactory daily life activity until the age of 50. In the last two years she
      was bed-ridden with advanced parkinsonism. Case 2 was a 56-year-old man without
      any contributing family history. His disease started at age 26 and his symptoms
      showed slight fluctuation during the earlier stages of the disease. Treatment
      with L-dopa and bromocriptine was associated with marked up-and-down phenomenon
      and choreatic dyskinesia. Pathological study in the two cases revealed marked
      cell loss in the substantia nigra zona compacta, especially in the area A9, while
      the neuronal cell population of the ventral tegmental area (A10), locus
      caeruleus, superior raphae nucleus, and substantia innominata was relatively well
      preserved. There were no Lewy bodies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365055
TI  - [An autopsied case of intravascular malignant lymphomatosis with paraparesis,
      that presented a leukoencephalopathy-like image after spinal cord biopsy].
AB  - A 54-year-old woman was hospitalized because of paraparesis, sensory disturbance
      of the lower extremities, and dysuria. Laboratory data included an erythrocyte
      sedimentation rate (ESR) of 16 mm/h and lactate dehydrogenase (LDH) level of 459
      IU/l. Myelogram showed an enlarged spinal cord at the L1 level, and spinal MRI
      revealed a high signal area on T2-weighted images. Spinal cord biopsy by thoraco
      lumbar laminectomy showed thickening of the pia mater and neovascularization, but
      no malignant cells. Immediately after the operation, the patient displayed
      progressive mental deterioration. Cranial MRI showed widespread high signal areas
      in the cerebral white matter on T2-weighted images which resembled those of
      leukoencephalopathy. Steroid therapy was tried but was ineffective. Ten months
      after the onset of symptoms, a brief period of regression of both clinical
      symptoms and MRI appearances occurred following the administration of Inosiplex,
      subsequent progressive deterioration led to death 14 months after the onset of
      symptoms. LDH, C-reactive protein (CRP), and cerebrospinal fluid (CSF) protein
      were all elevated during the deterioration of her general status. Postmortem
      examination revealed a large tumor mass of the left adrenal gland which extended
      to the Th12, L1, and L2 vertebrae and remarkable brain edema. Microscopic
      mononuclear tumor cells were widespread but confined to the lumens of small
      vessels of the brain, spinal cord, spinal root and right adrenal gland, almost as
      if they were occluded. Cerebral white matter presented widespread multiple small
      infarcts and extensive myelin thinning. In addition to the left adrenal gland,
      interstitial invasions of tumor cells were discovered in the kidneys, iliopsoas
      muscles, oviducts, myocardium, lymph nodes, and thyroid gland.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8365056
TI  - [Familial cases of spastic paraparesis, mental disturbance and thinning of the
      corpus callosum].
AB  - We reported a family in which two brothers and one sister out of five siblings
      were affected by a neurological disease showing the following clinical
      manifestations: 1) intellectual disturbance with relative preservation of memory
      and orientation probably developed on child food, 2) spastic paraparesis
      beginning at the age of about 20 years, 3) mild peripheral neuropathy and
      cerebellar sign. Their clinical courses were stereotyped, and so much the worse
      in elder patients. Two of them were investigated in detail. Laboratory findings
      including chromosomal analysis, amino acid analysis and thyroid function were
      normal. HTLV-1 antibody was negative. Several lymphocytes lysosomal enzymes
      including beta-hexosaminidase and arylsulfatase A and serum very long fatty acids
      were also within normal range. CT and MRI showed characteristic thinning of
      corpus callosum, dominant in anterior portion. However, changes in intensity of
      white matter in T2 weighted image were not so prominent. In the older patient,
      more mentally deteriorated, were demonstrated hypoperfusion in the fronto
      parietal lobes by SPECT and slow wave bursts dominant in the same region by EEG.
      Therefore, we considered that the change of corpus callosum was hypoplasia, but
      not atrophy, and it may provoke dysfunction of relevant nervous system. Family
      cases of such clinical feature were rare. We could confirm only three families in
      literatures, all of them were Japanese.

PMID- 8365057
TI  - [A case of X-linked recessive bulbospinal muscular atrophy with demyelinating
      neuropathy and hypertrophy of the calves].
AB  - We report a 53-year-old man of X-BSMA with neuropathy. The patient developed
      slowly progressive muscular weakness and wasting over a 2-year period with an
      accompanying numbness in the finger tip. He can run normally but not so fast.
      When he was aged 52-year old, difficulty in running progressed. General physical
      examination revealed nothing particular except for hypertension and gynecomastia.
      He showed muscular weakness and atrophy in the tongue, shoulder girdle, and upper
      and lower limbs. Calf muscle hypertrophies were prominent on both sides. The
      tendon reflexes were absent. Slight sensory impairment for vibration and pin
      prick was present distally in all limbs. Autonomic nerve dysfunction was not
      observed. Hyperglycemia, elevated HbA1c and elevated serum CK (1,242 IU/l) were
      seen. The computed tomographic analyses on skeletal muscle showed hypertrophic
      changes in the calf muscles with a few fatty infiltrations. Electromyography
      showed a systemic neurogenic pattern. Motor nerve conduction velocities were
      slightly delayed in the lower limits. Sensory nerve action potentials were not
      elicited in all nerves tested. Sural nerve biopsy disclosed marked reduction of
      myelinated fibres for that of large diameter with thin myelin. Teased fibre
      studies showed a definite increase in the incidence of fibres with segmental
      demyelination and remyelination. In electron microscopic examination, typical or
      atypical onion bulb formation was observed on individual fibres. Axonal changes
      were minimum. We believe that segmental demyelination observed in this patient is
      not secondary to axonal damage. We, also, investigated AR gene abnormality by
      polymerase chain reaction (PCR) in this patient.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365058
TI  - [A case of hereditary motor and sensory neuropathy type I with optic atrophy,
      neural deafness and pyramidal tract signs].
AB  - A case of hereditary motor and sensory neuropathy (HMSN) type I with optic
      atrophy, neural deafness and pyramidal tract signs was described. The patient was
      a 53-year-old man who had suffered from difficulty in walking, decreased visual
      acuity since age 16 years. These symptoms were slowly progressive. At the age of
      37, he was pointed out optic atrophy, positive pyramidal tract signs. Distal
      muscle weakness with atrophy of four limbs was prominent at the age of 50. Since
      then, he noticed progressive hearing loss with blindness. His elder sister was
      diagnosed Charcot-Marie-Tooth disease. On neurological examination, he showed to
      have optic atrophy without retinitis pigmentosa and neural deafness. Also he
      showed mild degree of muscle weakness and atrophy in four limbs, severe in the
      distal part of lower limbs. Deep tendon reflexes were absent in all limbs with
      right Babinski sign. Superficial sensation was decreased slightly in the distal
      parts of four limbs. Deep sensation was markedly decreased in the leg. There were
      no cerebellar signs. Audiometric examination revealed bilateral neural hearing
      loss. There were no findings of spinal cord compression on spinal MRI. On the
      nerve conduction studies, sensory nerve action potential was not elicited in all
      nerves tested. Motor nerve conduction velocity of the right median was 41.1
      M/sec, also ulnar nerve 44.7 M/sec, but M-wave was not elicited with the
      electrical stimulation of other tested nerves. On sural nerve biopsy, the density
      of myelinated fibers was severely decreased. Well-myelinated axon surrounded by
      onion bulb formation was observed in electron microscopic examination.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8365059
TI  - [A case of Hallervorden-Spatz syndrome with marked atrophy of the brainstem and
      cerebellum].
AB  - We report a 20-year-old female with Hallervorden-Spatz syndrome (HSS). This
      patient is the product of consanguineous parents. She developed genu valgum,
      tendency to fall and mental deterioration at the age of 6, decrease of the number
      of spoken words at the age of 14, dysarthria, unsteady gait, postural tremor of
      the upper extremities, dystonic posture of hands and double incontinence at the
      age of 16. Her disease progressed slowly. Neurological examination on admission
      revealed severe mental retardation, optic atrophy, forced grasping, hyperactive
      tendon reflexes in the upper extremities and bilateral Babinski sign. An
      extensive laboratory investigation including the leukocyte lysosomal enzymes,
      serum amino acid analyses, copper studies and ceruloplasmin were almost within
      normal limits. MRI, T2 weighted images, showed markedly decreased signal
      intensity in the globus pallidus but substantia nigra and increased signal
      intensity in diffuse cerebral white matter. T1 weighted images showed marked
      atrophy of the brainstem and cerebellum. She met the diagnostic criteria for HSS
      by Swaiman; we diagnosed her as HSS group II. HSS is characterized by the
      presence of many spheroids in the central nervous system which is similar to
      neuroaxonal dystrophy (ND). However, clinical and pathological differences exist
      between HSS and ND, the precise classification of the two conditions has remained
      controversial. Although there are many reported cases in which both conditions
      overlap, this is the first reported case that simultaneously demonstrates
      increased iron deposition in the globus pallidus, marked atrophy of the brainstem
      and cerebellum and typical clinical course compatible with HSS.

PMID- 8365060
TI  - [A case of Wernicke-Korsakoff syndrome caused by gastrojejunostomy--specific
      findings of MRI and SPECT].
AB  - A 63-year-old woman with Wernicke-Korsakoff syndrome, despite the absence of
      alcoholism and malnutrition, is reported. She had undergone gastrojejunostomy for
      ileus 30 years ago, and this operation was thought to be an important risk factor
      for her vitamin B1 deficiency. Brain MRI showed symmetrical high intensity areas
      on T2-weighted images in the periaqueductal region and bilateral dorsomedial
      nuclei of the thalamus. On single photon emission computed tomography (SPECT)
      using 99mTc-hexamethylpropyleneamine oxime, bilateral frontal perfusion was
      reduced, which was attributed to thalamo-cortical diaschisis due to injury to the
      dorsomedial nuclei of the thalamus. Presumably this phenomenon explains the
      Korsakoff psychosis. A history of gastrojejunostomy, even if normal intake is
      possible, is a risk factor for vitamin B1 deficiency, and should be considered in
      the differential diagnosis of Wernicke-Korsakoff syndrome.

PMID- 8365061
TI  - [A case of sodium bromate intoxication with cerebral lesion].
AB  - We confirmed a cerebral lesion due to sodium bromate intoxication on MRI, SPECT,
      auditory brainstem response (ABR) and sensory evoked potential (SEP). The patient
      was 34 years old, and ingested sodium bromate (14 g) to commit suicide. Vomiting,
      epigastralgia, watery diarrhea and anuria appeared after 30 minutes and he became
      deaf within 12 hours. Renal function recovered after hemodialysis. Renal biopsy
      revealed acute renal tubular necrosis. After one month, burning pain appeared in
      bilateral lower extremities. Sporadic, clear and small high intensity spots were
      observed in the deep white matter of the right occipitotemporal border zone and
      bilateral centrum semiovale on T2 and proton weighted images of brain MRI. IMP
      SPECT disclosed partial low perfusion in the left parietal gray matter. Central
      conduction time was delayed on ABR and SEP. The clinical symptoms and course
      together with laboratory studies suggest that the cerebral lesion was due to
      direct sodium bromate intoxication.

PMID- 8365062
TI  - [A case of pure trigeminal motor neuropathy].
AB  - A 38-year-old man suffering from pure trigeminal motor neuropathy was admitted
      with a complaint of occipitalgia. Neurological examination showed severe wasting
      of the left masseter muscle on chewing. The jaw deviated to the left when he
      opened his mouth. Cerebrospinal fluid analysis was normal. The CT scan
      demonstrated a low density area in the left masseter, temporalis, lateral and
      medial pterygoid muscles. On MRI, the lesion of the left masseter, temporalis,
      lateral and medial pterygoid muscles showed high intensity of T1 and T2 weighted
      images. The cervical MRI revealed the non-communicating syringomyelia. Blink
      reflex, auditory brainstem response and trigeminal sensory evoked potentials were
      normal. EMG findings from the left masseter showed a neurogenic pattern. Muscle
      biopsy of the left temporal muscle demonstrated only fibroadipose tissue.
      Therefore, the present case was diagnosed as pure trigeminal motor neuropathy. It
      was suggested that multiple sclerosis might play an important role in the
      pathogenesis of this illness.

PMID- 8365063
TI  - [Bilateral abducens nerve palsy followed by pseudoathetosis due to pontine
      hemorrhage--clinical and neuroradiological study].
AB  - Reported here are two cases with pontine hemorrhage presented with bilateral
      abducens nerve palsy and followed by pseudoathetosis, ataxia, and hemiparesis on
      the contralateral side of the lesion. The first case, a 57-year-old man, who
      suffered from bilateral abducens nerve palsy, deafness and hypoesthesia, ataxia,
      and hemiparesis of the right side of the body. MRI showed the confined lesion in
      the left side of tegmentum at the level of middle pons. When the abducens nerve
      palsy began to improve, pseudoathetosis of the right fingers appeared. About six
      months later, symptoms almost recovered, except for ataxia. The second case, a 48
      year-old man who suffered from bilateral abducens nerve palsy, deafness of the
      left ear, and ataxia, hypoesthesia, and hemiparesis of the left side of the body
      was admitted. MRI disclosed a small lesion on the right side of the tegmentum at
      the level of middle pons. When the bilateral abducens nerve palsy was beginning
      to improve, pseudoathetosis of the left hand appeared. Three months later,
      pseudoathetosis of the left hand disappeared. Both patients presented here had a
      similar lesion in the tegmentum at the level of middle pons on the side
      contralateral to the side in which the pseudoathetosis was seen. Considering the
      clinical symptoms and radiological findings of these cases, it appears that a
      lesion which causes such rare neurological symptoms may involve the medial
      lemniscus, spinothalamic tract, lateral lemniscus, spinocerebellar fiber, and
      central tegmental tract at the tegmentum of the middle pons on the side
      contralateral to the cerebellar signs and pseudoathetosis.

PMID- 8365064
TI  - [MRI of chronic toluene intoxication].
AB  - We examined MRI of 7 chronic "thinner" abusers sniffing mainly toluene for more
      than 5 years. MRI examination revealed cerebral atrophies in 5 out of 7 patients
      and hippocampal atrophies in 3 out of 7 patients. Five out of 7 patients showed
      low intensity signal in bilateral thalamus on T2 weighted images and 2 showed
      high intensity signal in internal capsule (especially posterior limb) on T2
      weighted image together with the change of thalamus. The results of intelligence
      test for 6 patients showed significant impairment (56 +/- 17, mean +/- S.D.).
      SPECT with 99mTc-HMPAO of a patient showed non-selective diffuse low perfusion in
      cerebral cortex. Reduction of cerebral blood flow would be significant for
      understanding cerebral and hippocampal atrophies or the deterioration of the
      intelligence of chronic toluene abusers.

PMID- 8365065
TI  - [A case of diagnostic dyspraxia without ideomotor apraxia by callosal lesion].
AB  - A case of diagnostic dyspraxia was reported. A 57-year-old right handed male had
      been suffering from the lack of cooperation between his right and left hands for
      six months. Except for decreased deep tendon reflexes in all extremities, there
      were no abnormal findings on neurological examination. On neuropsychological
      examination, he was attentive, well orientated and his spontaneous speech,
      comprehension, naming, repetition and reading were intact. There was peculiar
      dissociative behavior between his right and left hands. For instance, he put a
      cigarette or coin in the pocket with his right hand then his left hand took out
      and replaced them, and he buttoned his shirts with his right hand but then
      unbuttoned with his left hand. These left hand oppositional behavior to his right
      hand were triggered by voluntary activities of his right hand. Left unilateral
      agraphia was also revealed but ideomotor apraxia, compulsive manipulation of
      tools and grasp reflex were not demonstrated. T1-weighted MRI demonstrated
      irregular low signal intensity areas extending from the genu to the body of the
      corpus callosum. No definite lesion was detected in the medial aspect of the
      frontal lobe. Only small numbers of diagnostic dyspraxia have been reported and
      such cases without ideomotor apraxia or medial frontal lesion are even rare. MRI
      is very useful for detecting the lesion of the corpus callosum.

PMID- 8365066
TI  - [Ipsilateral gustatory disturbance by thalamic hemorrhage].
AB  - Animal studies have recently demonstrated that the gustatory pathway ascends in
      the brainstem ipsilaterally without crossing, and terminates in the ipsilateral
      lower caudal limit of the thalamus, i.e., the nucleus ventralis posteromedialis
      parvocellularis (VPMpc). However, little is yet known about the corresponding
      anatomical arrangement in man. Some clinical reports on cases of ipsilateral
      gustatory disturbance caused by tegmental pontine hemorrhage have suggested that
      the human gustatory pathway may also ascend ipsilaterally in the brainstem. Our
      case is a 35-year-old man, who was admitted to the hospital because of double
      vision. Computed tomography revealed a small high density area in the right
      paramedian tegmentum of the upper midbrain. On the 7th hospital day, the patient
      suddenly complained of dysesthesia on the right side of the oral cavity.
      Neurological examination demonstrated remarkable total hypogeusia on the right
      side of the tongue. MR imaging revealed upward extension of the hematoma toward
      the lower caudal portion of right thalamus. This is first report to demonstrate
      unilateral gustatory disturbance due to lesion in the ipsilateral thalamus. It is
      also worth of note that unilateral gustatory disturbance caused by thalamic
      lesion can be accompanied by sensory impairment in the ipsilateral oral cavity.

PMID- 8365067
TI  - [Hemiballism-hemichorea caused by a putaminal hemorrhage with worsening after
      smoking--a case report].
AB  - A 65-year-old hypertensive man was admitted because of abnormal involuntary
      movements which had an onset one month prior to the admission. Neurological
      examination revealed an alert and intelligent male in no acute distress. Cranial
      nerves appeared intact except for dysarthria. His gait was wide-based. He had
      hemiballism-hemichorea in his left upper and lower extremities. Cranial CT scans
      revealed a high density area confined to the right putamen. After admission, his
      involuntary movements slowly improved without medication. After near complete
      disappearance of his abnormal movements two weeks after admission, he noted that
      smoking induced choreic movement in his left side transiently. The involuntary
      movement ceased soon after upon stopping smoking. This was repeatedly observed
      not only by him but also by us. Our observation may indicate that the inhibition
      of the subthalamic nucleus as the result of the decrease of the putaminal output
      to the external segment of the globus pallidus will induce hemiballism. The
      effect of smoking on his involuntary movements can be understood as a result of
      increase in the dopamine release from the nigrostriatal terminals induced by
      nicotine.

PMID- 8365068
TI  - [A case of acute polyradiculoneuropathy following measles infection].
AB  - A 39-year-old man was admitted to our hospital because of diplopia, dysphagia,
      tetraparesis and urinary incontinence which developed six days after fever and
      general cutaneous rash had appeared. On neurological examination, total
      ophthalmoplegia, blepharoptosis, facial nerve palsy, bulbar palsy, and
      tetraparesis were observed, and the deep tendon reflexes were hypoactive or
      absent. The cerebrospinal fluid (CSF) showed albumin-cytological dissociation.
      serial complement fixation tests and enzyme-linked immunosorbent assays showed an
      elevation of antibody titers to measles virus in sera and CSF including serum IgM
      antibody. On the basis of findings, we diagnosed him as acute
      polyradiculoneuropathy following measles infection. After 3 sessions of
      immunoadsorption plasmapheresis his symptoms improved promptly. Marked
      improvement by immunoadsorption plasmapheresis suggested that immune-mediated
      mechanisms were involved in the pathogenesis of acute polyradiculoneuropathy
      following measles infection.

PMID- 8365069
TI  - [A case of B-cell type acute lymphocytic leukemia presenting ophthalmoplegia].
AB  - A 72-year-old man suddenly developed right blepharoptosis and diplopia and
      subsequently experienced motor and sensory disturbances in his upper and lower
      limbs. Soon he developed violet eruptions on his trunk and extremities.
      Approximately 2 months after the onset of his neurological symptoms, laboratory
      tests confirmed a diagnosis of B-cell type acute lymphocytic leukemia. The
      patient died 5 days later. Autopsy findings comprised prominent intrafascicular
      infiltration of leukemic cells in multiple peripheral nerves, including cranial
      and dorsal roots. However, there was no parenchymal involvement except in the
      dorsal root ganglia. In acute leukemia, infiltration of malignant cells in the
      peripheral nervous system has been reported to be uncommon compared with that in
      malignant lymphoma. This case of acute lymphocytic leukemia was considered to be
      unique with regard to the onset of neurological symptoms and autopsy findings.

PMID- 8365070
TI  - [A case of myasthenia gravis associated with multiple sclerosis and positive
      anticardiolipin antibodies].
AB  - A 42-year-old housewife with myasthenia gravis (MG) for 22 years, who was
      initially treated by radiation to the hyperplastic thymus and anti-cholinesterase
      therapy, developed bilateral ptosis, paresthesia of her right face and decreased
      taste sensation after house work at the age of 42 years. Neurological
      examinations revealed lateral and vertical gaze palsy, upward nystagmus,
      decreased taste sensation, peripheral facial palsy on the left side. She also had
      hypalgesia on the right face, arm and chest up to Th7 level, and urinary
      retention. She had hyperreflexia on the right side but no extensor toe signs. CSF
      study revealed 5 cells/microliters and protein of 23 mg/dl. Serum IgG
      anticardiolipin antibody was positive. Magnetic resonance imaging studies
      revealed high intensity areas in the brainstem tegmentum and periventricular
      white matter. Diagnosis of multiple sclerosis (MS) was made. This is the first
      case in which MG, MS and serum anticardiolipin antibody were present
      simultaneously, which may be all due to some immunological abnormality. Steroid
      therapy made anti-cardiolipin antibody negative, but new MS plaque developed in 7
      months, which favors diagnosis of MS rather than infarction, since the activities
      of ACLA were not correlating to clinical symptoms. MRI was helpful in detecting
      MS plaques in MG patients.

PMID- 8365071
TI  - [A case of flexion myelopathy presenting with reversible muscular weakness and
      atrophy of the unilateral proximal upper limb].
AB  - A 16-year-old man visited our clinic because of right-sided weakness of shoulder
      abduction and elbow flexion. He was well until about three weeks previously.
      Neurological examination revealed only that he had severe weakness together with
      mild atrophy of the muscles innervated by the C5 and C6 segments (the deltoid,
      biceps brachii, brachioradialis), slight hypesthesia on the thumb, and loss of
      deep reflexes of the biceps brachii on the right. No pyramidal signs were found
      in the lower extremities. EMG showed neurogenic changes of the atrophied muscles.
      Neuroradiological studies revealed right-sided atrophy of the spinal cord at C4-5
      disk level, anterior shift of the posterior cervical dura mater and congestion of
      the internal vertebral venous plexus mainly at C4 and C5 vertebral level with his
      neck flexed. Conservative physiotherapy provided a good recovery within a few
      months. The clinical and neuroradiological findings of this case resemble those
      of juvenile type of distal and segmental muscular atrophy of upper extremities
      excluding distribution of involved muscles because of the different level of the
      spinal cord lesion. Pathomechanism of this case is considered to be the same as
      that of juvenile type of distal and segmental muscular atrophy of upper
      extremities.

PMID- 8365072
TI  - Pediatric liver transplantation. History, recent innovations, and outlook for the
      future.
AB  - Pediatric liver transplantation has advanced remarkably over the past three
      decades. One-year survival has progressively increased to nearly 90% in patients
      transplanted for most forms of liver disease. Parallel advances in organ
      procurement, operative technique, immunosuppression, and infection control are
      responsible for improved patient survival. Among the most important advances are
      use of the University of Wisconsin (UW) organ preservation solution, the
      employment of venovenous bypass and/or "piggyback" operative technique, the
      development of cyclosporine A (CyA) and FK506, and the emergence of acyclovir,
      ganciclovir, foscarnet, and alpha interferon to combat life-threatening viral
      infections. The current organ shortage is being addressed by "cutdown" liver
      transplantation, "split liver" transplantation, and living-related donations. The
      next decade is likely to see advances in multi-visceral transplantation,
      induction of chimerism by simultaneous bone marrow-solid organ transplantation,
      and performance of cross-species xenografting.

PMID- 8365073
TI  - Financial and emotional cost of bronchopulmonary dysplasia.
AB  - Bronchopulmonary dysplasia (BPD) in infants with neonatal respiratory disease
      significantly increases the duration of hospitalization and cost of medical care.
      Early discharge on home oxygen therapy results in cost savings for third-party
      payers and the hospital, but adds financial and emotional burdens for the family.
      The median cost of initial hospitalization for 59 infants was $173,160 each. The
      median duration of home oxygen therapy was 92 days; the median cost was $5,195,
      compared with a projected cost of $46,920 for hospitalization for the same
      period. Two thirds of the 59 families experienced increased financial stress
      associated with marital status, reduced income, type of health insurance, and/or
      lack of respite or nursing help. Emotional stress was assessed in 26 (44%) of the
      families; one half coped well. Parents' perception of adequate insurance and
      stable income was significantly associated with positive coping. Providing home
      care for an infant with BPD on oxygen therapy is rewarding in many respects, but
      success requires appreciating its financial and emotional impact on families and
      providing them with social and financial support.

PMID- 8365074
TI  - Efficacy of a protocol to distinguish risk of serious bacterial infection in the
      outpatient evaluation of febrile young infants.
AB  - A study of 534 febrile infants ages 4 to 8 weeks evaluated for sepsis assessed
      the efficacy of the Milwaukee Protocol (MP) for selecting patients at low risk
      for serious bacterial infection (SBI) who might benefit from outpatient
      management. Two groups were compared: 1) Infants with uncompromised presentation
      (UP) who met all MP criteria received ceftriaxone 50 mg/kg and were discharged,
      then reevaluated within 24 hours. 2) Infants with compromised presentation (CP)
      who did not meet MP criteria were hospitalized for antibiotic therapy pending
      culture results. Of 391 CP patients, 23 (5.9%) had SBI; of 143 UP patients, 1
      (0.7%) had SBI (P < .02). The MP criteria had a sensitivity of 96% and a 99%
      negative predictive value for distinguishing SBI outcome. The only UP patient
      with SBI was afebrile and had a negative repeat blood culture after 24 hours, and
      recovered with no complications. Managing UP infants as outpatients avoided 48 to
      72 hours of hospitalization, decreasing health-care costs by an estimated total
      of $465,170.

PMID- 8365075
TI  - Catch-up head growth and motor performance in very-low-birthweight infants.
AB  - The relationship between catch-up head growth and motor performance was examined
      in 48 very-low-birthweight (< 1,500 g) infants. All infants were nonasphyxiated,
      normocephalic, and appropriately grown for gestational age at birth. Serial
      cranial ultrasonography during the first month of life revealed no intracranial
      pathology. The age of catch-up head growth, defined as the corrected age when the
      head circumference recovered to the 5th percentile, was determined for each
      infant. At 12 months corrected age, the infants were evaluated and grouped
      according to normal (n = 37) or abnormal (n = 11) motor assessments. The abnormal
      group achieved catch-up head growth by 7.7 +/- 2.1 months vs 3.7 +/- 3.1 months
      for the normal group (P < .05). Only 27% of the motor-delayed infants achieved
      catch-up head growth by 6 months corrected age, as compared with 89% of the
      normal infants (P < .05). Premature infants who have achieved catch-up head
      growth by 6 months corrected age, corresponding to the period of maximal
      postnatal brain growth, have fewer motor abnormalities than infants who attain
      catch-up head growth later. There is a significant relationship between head
      circumference at 6 months corrected age and motor development in very-low
      birthweight infants.

PMID- 8365076
TI  - Comparison of self-referred and physician-referred patients to a pediatric
      diagnostic center.
AB  - Self-referral of children by parents without the knowledge of the child's regular
      physician can lead to redundant or unnecessary testing and difficulty in
      arranging follow-up care. This study was designed to investigate reasons for self
      referral in a hospital-based pediatric diagnostic center. During the study
      period, 59 patients were referred by their regular physicians and 51 were self
      referred. In multiple-choice questionnaires completed by 85% of the parents,
      nearly half (18/39; 46%) of those who were self-referred but only 2/51 (4%) of
      physician-referred parents said the child's regular physician was unconcerned
      about the medical problem. Further study on the causes for this perception is
      needed before recommendations can be made to physicians about demonstrating their
      concern to families.

PMID- 8365077
TI  - Treatment variables and intellectual outcome in children with classic
      phenylketonuria. A single-center-based study.
AB  - Records of 46 patients with classic phenylketonuria (PKU) were used to determine
      treatment variables associated with intellectual outcome. Patients comprised
      three groups: phenylalanine-restricted diet started 1) after 3 months and loss of
      diet control at a mean age of 7 years, 2) before age 3 months and loss of diet
      control at a mean age of 5 years, and 3) before age 3 months and through a mean
      age of 11 years. All underwent IQ testing during the diet; groups 1 and 2 were
      retested at a mean of six years off the diet. On the diet, groups 2 and 3 had
      higher IQs than group 1; group 3 IQ was also higher than IQ off diet in groups 1
      and 2. After discontinuing the diet, group 2 IQs decreased significantly.
      Predictors of IQ in group 1 were age at loss of diet control and percentage of
      phenylalanine concentrations > 15 mg/dL; in group 2, mean phenylalanine
      concentrations and age at loss of diet control. Predictors of changes in group 1
      IQs were global degree of dietary control and percentage of phenylalanine
      concentrations > 15 mg/dL; in group 2, phenylalanine concentrations of < 3 mg/dL
      and age at start of diet. Group 1 patients with phenylalanine concentrations < 3
      mg/dL or > 15 mg/dL achieved no IQ gain by continuing the diet after age 7 years.
      Thus, intellectual prognosis is best for PKU patients who start a phenylalanine
      restricted diet early and continue through age 12 years.

PMID- 8365078
TI  - Evolution of height and bone age in primary congenital hypothyroidism.
AB  - Thyroid hormones are fundamental for growth and bone maturity. Retarded physical
      and osseous development signals congenital hypothyroidism. This study assessed
      the evolution of height and bone age and final height after hormone replacement
      treatment in 25 patients with primary congenital hypothyroidism. Bone ages,
      measured periodically for 12 years after treatment began, were expressed as
      standard deviation scores (SDS) corresponding to chronologic age. Heights were
      expressed as SDS and related to standardized curves and genetic height. All
      patients experienced height recovery during the first year. Of 19 patients who
      reached their final height, 16 surpassed the expected mean for genetic height.
      Bone age accelerated progressively, with total recovery toward the third year,
      and remained accelerated, reaching +1.43 +/- 1.27 in relation to chronologic age
      12 years after hormone replacement began. Thus, early diagnosis and adequate
      treatment of congenital hypothyroidism improved growth and osseous development,
      although progressive acceleration of bone age may have limited final height in
      some children.

PMID- 8365079
TI  - A comparative evaluation of whey hydrolysate and whey-predominant formulas. How
      well do infants accept and tolerate them?
AB  - Whey hydrolysate formulas are a recent and important innovation in infant
      feeding. This study compared clinical tolerance and acceptability of a whey
      hydrolysate formula (WH) with those of a whey-predominant formula (WF) in 45
      infants. Four infants (16%) who refused to drink WH formula were eliminated from
      the study. Mean volume intake was significantly lower for WH (120 mL/kg/day) than
      for WF (147 mL/kg/day; P < .001). Consequently, mean caloric intake was also
      significantly different: 80 kcal/kg/day (WF) vs 97 kcal/kg/day (WF; P < .001).
      Nevertheless, weight gain from birth to 13 weeks of age was nearly identical in
      both groups (171% for WH vs 178% for WF). No significant differences were noted
      in duration of feeding, number of pauses during feeding, number of stools per
      day, or number of regurgitations per day. The lower rate of caloric intake and
      the dropout rate of 16% for WH raise questions about the use of WH formula in
      normal infants, as has become the case in some Western European regions.

PMID- 8365080
TI  - An unusual case of relapsing myositis in a 12-year-old child.

PMID- 8365081
TI  - Hepatitis B. A disease needing a vaccine or a vaccine needing a disease?

PMID- 8365082
TI  - Footwear and orthoses for diabetic patients.

PMID- 8365083
TI  - Complications of diabetes in childhood.

PMID- 8365084
TI  - Recurrent severe hypoglycaemia and cognitive function in type 1 diabetes.

PMID- 8365085
TI  - Diet treatment of newly presenting type 2 diabetes improves insulin secretory
      capacity, but has no effect on insulin sensitivity.
AB  - Fifteen newly diagnosed obese Type 2 diabetic subjects were treated with diet
      alone for 3 months with a median 1.5 kg weight loss. Each had a Continuous
      Infusion of Glucose with Model Assessment (CIGMA) test, at diagnosis and at 3
      months, measuring insulin and C-peptide responses, and deriving mathematically
      modelled measures of beta-cell function and insulin sensitivity. Median fasting
      glucoses were 9.6 mmol l-1 at diagnosis and 8.5 mmol l-1 at 3 months (NS). Median
      fasting insulin was 9.3 mU l-1 at diagnosis and 11.7 mU l-1 at 3 months (NS).
      Median fasting C-peptide was 0.58 nmol l-1 at diagnosis and 0.64 nmol l-1 at 3
      months (p < 0.05). Median achieved plasma insulin increased from 13.8 mU l-1 at
      diagnosis to 17 mU l-1 at 3 months (p < 0.02); median achieved plasma C-peptide
      increased from 0.72 nmol l-1 at diagnosis to 0.81 nmol l-1 at 3 months (p <
      0.002). Modelled beta-cell function rose from median 26% at diagnosis to 37% at 3
      months (p < 0.02). Modelled insulin sensitivity showed no significant change
      (median 0.31 at diagnosis, 0.27 at 3 months, NS). Elevation of achieved C-peptide
      was positively correlated with weight loss (Rs = 0.53, p < 0.05), but not with
      change in fasting glucose. Diet treatment of newly diagnosed Type 2 diabetes,
      with modest weight loss, results primarily in improvement of insulin secretory
      capacity, rather than insulin sensitivity.

PMID- 8365086
TI  - The degree of day-to-day variation in food intake in diabetic patients.
AB  - A prospective study of food intake using 7 day food diaries was undertaken in 92
      diabetic men and women aged 17-81 years. The median individual day-to-day
      coefficients of variation for energy intake were: in insulin treated patients
      12.0%, in non-insulin treated patients 13.7%; for carbohydrate intake 14.5% and
      13.8% and for fat 20.7% and 20.8%, respectively. The median individual
      differences between the minimum and maximum daily intake of energy in insulin
      treated patients was 787 kcal, in non-insulin treated patients 649 kcal, for
      carbohydrate intake 89g and 77g and fat 50g and 43g, respectively. Only 39%
      patients ate within 20% of their prescribed carbohydrate diet. In non-insulin
      treated patients on prescribed calorie controlled diets, calorie consumption was
      on average 46% in excess of that prescribed. Although the variation in dietary
      intake in diabetic patients is large, it is smaller than that reported in non
      diabetic subjects in the UK. This variation is likely to make the manipulation of
      other antidiabetic therapy both difficult and somewhat arbitrary.

PMID- 8365087
TI  - Glucose profiles in children two years after the onset of type 1 diabetes.
AB  - The relationship of 24-h glucose profiles to age, haemoglobin A1c (HbA1c), and C
      peptide concentration was analysed in consecutive, unselected children who had
      developed Type 1 diabetes 2 years earlier. Seventy-seven children in four age
      groups (age 2-4 years, n = 9; 5-8 years, n = 14; 9-12 years, n = 26; and 13-17
      years, n = 28) were studied. Each child was hospitalized for 2 days for the
      investigations. Mean blood glucose concentration was 9.7 +/- 4.1 (SD) mmol l-1 in
      children aged 2-4 years; 10.7 +/- 4.0 mmol l-1 in those aged 5-8 years; 11.3 +/-
      3.4 mmol l-1 in those aged 9-12 years; and 9.8 +/- 3.3 mmol l-1 in those aged 13
      17 years. Results were > 7.0 mmol l-1 in 69% (range 56-76%) and > 10 mmol l-1 in
      49% (39-57%) of the measurements. Values decreased by 30% (21-43%) between 10 pm
      and 3 am. The nadir of the mean profiles of the groups was always at 3 am.
      Glucose concentration was mmol l-1 in 25% (14-50%), < 2.5 mmol l-1 in 9.6% (0
      21%), and < 2.0 mmol l-1 in 2.7% (0-4.2%) of the children at 3 am; hypoglycaemia
      was most common in those aged 5-8 years. Of the four profile characteristics
      used, mean blood glucose predicted HbA1c (R2 = 24.7%, p < 0.00005, multiple
      linear regression analysis), and slightly more in combination with age (R2 =
      32.0%, p < 0.00005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365088
TI  - Psychological factors and their relationship to diabetes control.
AB  - Thirty-nine Type 1 diabetic patients were asked to complete an Eysenck
      Personality Questionnaire (EPQ). A significant relationship was found between
      neuroticism scores and glycosylated haemoglobin concentrations (r = 0.43, p <
      0.01) and also fructosamine (r = 0.45, p < 0.01). Patients with glycosylated
      haemoglobin concentrations greater than or equal to 10 (n = 13) had significantly
      higher neuroticism scores than patients with glycosylated haemoglobin results
      less than or equal to 8 (n = 11) (p < 0.01).

PMID- 8365089
TI  - Action profile of the rapid acting insulin analogue: human insulin B28Asp.
AB  - The time-action profile of the human insulin analogue B28Asp, which displays
      faster absorption rates from subcutaneous tissue compared to soluble human
      insulin, was studied under euglycaemic glucose clamp conditions (blood glucose
      5.0 mmol l-1) in 14 healthy male volunteers. Subcutaneous injection of 0.15 U kg
      1 body weight (range 9.5-14.3 U) of the insulin analogue or soluble human insulin
      resulted in half-maximal glucose infusion rates (after subtraction of mean
      baseline glucose infusion rates) that were reached significantly earlier after
      injection of B28Asp (45 +/- 11 (SD) min) as compared to human insulin (58 +/- 25
      min, p < 0.05). Forty-five and 60 min after injection of human insulin, glucose
      infusion rates had increased by 3.4 +/- 1.8 and 4.8 +/- 2.3 mg min-1 kg-1 above
      baseline glucose infusion rates, reflecting 30 +/- 15 and 42 +/- 17% of maximal
      action of 10.6 +/- 2.7 mg min-1 kg-1. Following the injection of B28Asp, glucose
      infusion rates increased by 6.3 +/- 2.7 after 45 min and by 7.9 +/- 2.8 mg min-1
      kg-1 after 60 min above baseline glucose infusion rates, reflecting 64 +/- 28%
      and 81 +/- 26% of maximal action of human soluble insulin (p < 0.001). Peak
      glucose infusion rates after injection of B28Asp were significantly higher and
      were reached earlier than after subcutaneous injection of soluble human insulin
      (p < 0.05 and p < 0.001). The human insulin analogue B28Asp showed a
      significantly faster onset of action as compared to soluble human insulin.

PMID- 8365090
TI  - Pregnancy is not a risk factor for a deterioration of autonomic nervous function
      in diabetic women.
AB  - Pregnancy may have an untoward effect on diabetic retinopathy and nephropathy and
      symptoms of autonomic neuropathy may also be exacerbated during pregnancy. To
      test the hypothesis that previous pregnancies during the diabetic state are
      associated with increased risk of development of autonomic dysfunction, autonomic
      nervous function and pregnancy history were assessed in 117 women with long
      standing Type 1 diabetes mellitus. Thirty-eight women (32%) had autonomic
      dysfunction, defined as at least one abnormal cardiovascular test. The presence
      of autonomic dysfunction was not related to the number of pregnancies during the
      disease state. Thus, this cross-sectional study suggests that pregnancies do not
      represent a risk factor for a deterioration of autonomic nervous function and
      development of autonomic neuropathy in diabetic women.

PMID- 8365091
TI  - A prospective study of clinical and metabolic associates of proteinuria in
      patients with type 2 diabetes mellitus.
AB  - Urinary protein excretion rate and clinical and metabolic associates were
      investigated in a group of 108 patients with Type 2 diabetes mellitus at the time
      of diagnosis and after 5 years, and also 121 control subjects. The presence of
      coronary heart disease, neuropathy and retinopathy, cardiovascular risk factors
      and 24-h urinary excretion rate of albumin, beta-2-microglobulin, and IgG were
      examined. At the 5-year examination, urinary excretion rate of albumin was higher
      in diabetic patients than in control subjects (39 +/- 75 vs 16 +/- 28 mg 24 h-1
      for men, p < 0.05; 38 +/- 57 vs 22 +/- 42 mg 24(-1) h for women, p < 0.01).
      Furthermore, increased beta-2-microglobulin excretion rate, a marker of tubular
      impairment, was observed in diabetic men as compared to control men (0.17 +/-
      0.15 vs 0.14 +/- 0.21 mg 24 h-1, p < 0.05). Diabetic patients with increased
      albumin excretion rate (> 30 mg 24 h-1) showed poorer metabolic control than
      those with normal albumin excretion rate, but no significant differences in body
      mass index or in the frequencies of smoking, hypertension, coronary heart disease
      or retinopathy and neuropathy were observed between the groups. Baseline
      hyperinsulinaemia was closely associated with increasing albuminuria at the 5
      year examination.

PMID- 8365092
TI  - Bacteriuria, bacterial virulence and host factors in diabetic patients.
AB  - The prevalence of bacteriuria as well as bacterial virulence and host factors
      were studied in 514 diabetic outpatients and 405 nondiabetic controls. The
      prevalence of bacteriuria was not significantly higher in diabetic women (15/239,
      6.3%) than in age-matched nondiabetic women (8/236, 3.4%). In diabetic and
      nondiabetic men, the prevalence was also similar but lower than in women. E. coli
      was found in 55% of urine cultures with significant growth from diabetic
      patients, while in 91% of positive cultures from nondiabetic controls. Most E.
      coli strains lacked ability of P-fimbriae-mediated adhesion and aerobactin
      mediated iron uptake, indicating low bacterial virulence. Long-term metabolic
      control (HbA1c), prevalence of retinopathy, neuropathy and previous foot ulcers
      were similar in bacteriuric and nonbacteriuric diabetic patients, matched
      according to gender, age, and duration of diabetes. Renal function was also
      similar, though the frequency of proteinuria and elevated blood pressure tended
      to be higher in the bacteriuric than in the noninfected group. Eight-three
      percent of the bacteriuric patients reported previous urinary tract infections
      but only 61% of nonbacteriuric patients (p = 0.07). As compared to non-diabetic
      women, diabetic women reported significantly more previous urinary tract
      infections (p < 0.01). In conclusion, the prevalence of bacteriuria in diabetic
      outpatients was not significantly higher than in non-diabetic outpatients or
      healthy volunteers. No studied host factor was clearly associated with
      bacteriuria in diabetic patients, although proteinuria and hypertension tended to
      be more common. The infecting E. coli strains were of low virulence.

PMID- 8365093
TI  - The five-year incidence of blindness after introducing a screening programme for
      early detection of treatable diabetic retinopathy.
AB  - The incidence of moderate visual impairment and blindness due to diabetic
      retinopathy was studied 5 years after introducing a screening system for early
      detection of treatable retinopathy. Photocoagulation was performed in patients
      with clinically significant macular oedema, severe preproliferative, and
      proliferative retinopathy. Eighty-eight percent of 470 Type 1 and 88% of 388 Type
      2 diabetic patients were still available for follow-up. In the Type 1 group, the
      five-year incidence of blindness and moderate visual impairment were 0.5% and
      1.2%, respectively. Corresponding figures for the Type 2 diabetic patients were
      0.6% and 1.7%, respectively. The majority of patients with loss of vision had
      severe retinopathy at baseline. Among those who entered the screening programme
      with no or mild retinopathy, loss of vision occurred in only one of the Type 1
      and four of the Type 2 diabetic patients. It is concluded that the risk for
      visual impairment and blindness due to diabetes can be substantially reduced by
      using programmes for early detection of and effective treatment of diabetic
      retinopathy.

PMID- 8365094
TI  - Accurate and precise blood glucose measurement in the hypoglycaemic range.
AB  - The aim of the study was to evaluate the performance of an electrochemical blood
      glucose sensor, the satellite G, in the low-normal and hypoglycaemic range.
      Eighty-five venous blood samples with glucose concentrations below 4.0 mmol I-1
      from six patients with Type 1 diabetes undergoing induced hypoglycaemia were
      measured in duplicate on the sensor and a reference method, the Yellow Springs
      whole blood glucose analyser. The sensor values correlated well with the
      reference method (r = 0.9, p < 0.001) with a mean absolute percentage bias of
      10.7%. The 95% confidence limits of agreement between methods were +0.7 and -0.6
      mmol I-1 with a mean difference of 0.004 mmol I-1. More than 80% of the sensor
      measurements were within 20%, and 60% were within 10% of the reference method.
      Measured over all samples, the sensor had a coefficient of variation of 7.2% for
      paired measurements. The coefficients of variation of 20 measurements on each of
      two samples with glucose concentrations of 1.3 and 2.6 mmol I-1 were 9.1% and
      5.8%, respectively. We conclude that the satellite G measures blood glucose
      accurately and precisely in the low range.

PMID- 8365095
TI  - Glycated haemoglobin centiles: a basis for audit in children's clinics?
AB  - Services for children with diabetes are a good model for audit because of
      relatively well-defined and available measures of outcome. Estimation of glycated
      haemoglobin (HbA1) is accepted as one index of control, although the assay and
      normal ranges vary in different centres. Sheffield has a stable clinic population
      and we have taken blood for HbA1 on each patient two to four times per year since
      1983. HbA1 values have been aligned in 3-monthly increments from time of
      diagnosis to construct a graph showing the mean plus or minus two standard
      deviation values for the clinic population and also a rough 'centile chart' that
      describes the unfortunate but expected pattern of deteriorating control with
      duration of diabetes. There are undoubtedly methodological flaws in this novel
      approach; however, such charts constructed for each clinic may be a suitable
      basis for comparative assessment of the control of an individual and also for
      auditing the effects of changes in practice that strive for optimum glucose
      levels in the clinic population.

PMID- 8365096
TI  - An approach to the use of the DO IT Study Group guidelines for supporting the
      optimal implementation of information systems in diabetes care.
AB  - The usefulness of the 1992 DO IT Study Group guidelines for diabetes data
      information systems was assessed using two established diabetes databases
      designed for different purposes. The recommendations detailed in the guidelines,
      written in four separate but overlapping modules, were applied individually to
      each database in turn. Percentage compliance with the recommendation to collect
      the DIABCARE dataset was high, after discounting specialist areas. While on the
      whole the information systems complied with the guidelines within the purposes
      for which they were designed, areas highlighted as demanding further action in at
      least one of the two systems included password protection, data validation
      checks, screen design, and communication with those whose records were held on
      the systems. Application of the guidelines is already stimulating attention to
      some of these areas. Some of the guidelines proved rather vague in construction
      to be applied in any formal sense, while others (for example in relation to
      international accreditation of datasets) were not applicable to individual
      systems. The results suggest the importance of a structured approach to the
      design, development, and ongoing assessment of information systems in diabetes,
      but require the present guidelines to develop a more formal structure to be fully
      effective. The widespread adoption and further testing and refinement of these
      guidelines (both within and outside Europe) should promote the ultimate goal of
      improved diabetes care.

PMID- 8365097
TI  - Emphysematous pyelonephritis: a case report and review of the literature.
AB  - Emphysematous pyelonephritis is a rare and life-threatening suppurative infection
      of renal parenchymal and perirenal tissues, characterized by spontaneous gas
      production. Although uncommon (76 cases in the literature), it occurs almost
      exclusively in diabetic patients (87% of the cases). We describe a recent case of
      a diabetic woman with emphysematous pyelonephritis due to E. coli, successfully
      managed with unilateral nephrectomy. Symptoms, diagnostic approach and management
      are discussed and related to the previously reported series.

PMID- 8365098
TI  - Awareness of hypoglycaemia--problems and perspectives, London, December 1992.

PMID- 8365099
TI  - Severe lipoatrophy with human insulin: successfully treated by CSII.

PMID- 8365100
TI  - Shared antigenic determinants of immunoglobulins in phylogeny and in comparison
      with T-cell receptors.
AB  - 1. Immunoglobulins are a complex multigene family of proteins specified by genes
      encoding variable (V), sometimes diversity (D), joining (J), and constant (C)
      domains. 2. Cross-reactions involving conformational determinants related to the
      VHa system of rabbits occur on heavy chains of vertebrate species ranging from
      elasmobranchs to man. 3. Serological markers characteristic of mu chains, the
      heavy chain of the IgM macroglobulins, occur on homologous heavy chains of
      species representing all vertebrate classes. 4. Serological markers
      characteristic of gamma type heavy chains, the major isotype in man, are
      restricted to the mammals, but are found on representatives of even the most
      primitive mammals, the egg-laying monotremes. 5. Variable region markers
      characteristic of lambda light chains are shared by light chains of shark and
      man. 6. Certain idiotypic markers defined by combining site V region sequences
      are broadly distributed in evolution. 7. Use of synthetic peptides as antigens
      and in epitope mapping show that amino acid sequences from the third framework
      region of the variable domain are broadly shared among light chain in phylogeny
      and between light chains and T-cell receptor beta chains. 8. The "switch
      peptides" linking the V and C domains of light chains and T-cell receptors,
      specified by the C-terminal portion of the J segment and the N-terminus of the
      constant region, are exposed in the three-dimensional structure of immunoglobulin
      or Tcrs, show striking homology, and form broadly shared antigenic determinants
      characteristic of immunoglobulins. 9. Although the multigene nature of the
      immunoglobulins and the complexity of antigenic determinants expressed by these
      large proteins renders comparison among molecules difficult, serum
      immunoglobulins and the closely related T-cell receptors express numerous shared
      determinants defined on the basis of amino acid sequence homology and three
      dimensional conformations.

PMID- 8365101
TI  - Protein protease inhibitors in insects and comparison with mammalian inhibitors.
AB  - 1. Studies on insect protein protease inhibitors are summarized. Biochemical,
      genetic and physiological investigations of the silkworm are performed. 2. In
      addition, the properties and characteristics of fungal protease inhibitors from
      the silkworm (Bombyx mori) are described and their importance as defensive
      functions is emphasized. 3. This review also concerns comparative and
      evolutionary studies of protease inhibitors from various sources. 4. The
      biological significance of inhibitors is discussed in view of the extensive
      experimental results.

PMID- 8365102
TI  - The calf thymus superoxide dismutase: a protein active on cholesterol metabolism.
AB  - 1. Recent studies on the new aspects of thymus physiology describing the
      correlation between thymus hormones and pituitary hormone secretion, are
      illustrated. 2. Subsequently, results of a series of experiments showing the
      effect of a calf thymus protein on cholesterol synthesis in rat hepatocyte cells
      are discussed. 3. The last part of this review is focused on the biochemical
      characteristics of this calf thymus protein that revealed an amino acid sequence
      that was found to be identical with regions of bovine erythrocyte superoxide
      dismutase. New perspectives of studies, focused on the isolation of possible
      superoxide dismutase membrane receptors, are described at the end of this review.

PMID- 8365103
TI  - Biosynthesis of frog skin mucins: cysteine-rich shuffled modules,
      polydispersities and genetic polymorphism.
AB  - 1. Frog integumentary mucins (FIM-A.1, FIM-B.1 and FIM-C.1) consist of typical
      threonine-rich highly O-glycosylated (semi)repetitive domains, and cysteine-rich
      modules, i.e. the P-domain, the short consensus repeat and a region with high
      similarity to the C-terminal end of von Willebrand factor (designated here CC29
      motif). 2. These modules are thought to be involved in protein-protein
      interactions and they have been observed in a variety of extracellular proteins.
      In FIMs, these modules may be involved in oligomerization processes leading to an
      entangled mucin network. 3. Polydispersities have been detected in FIM-B.1 and
      FIM-C.1 within single individuals. Multiple transcripts are probably generated by
      alternative splicing of a huge array of different (semi)repetitive cassettes
      encoding the threonine-rich domains. 4. Furthermore, genetic polymorphism is
      observed between different individuals, probably due to allelic variations in the
      number of (semi)repetitive cassettes.

PMID- 8365104
TI  - Comparative analysis of macromolecules in mollusc shells.
AB  - 1. Proteins and polysaccharides were isolated from the shells of molluscs; blue
      mussel, Mytilus edulis, chambered nautilus, Nautilus pompilius, and red abalone,
      Haliotus rufescens. 2. N-acetyl glucosamine was detected in nautilus but not
      mussel or abalone. 3. Amino acid analysis of protein fractions was completed for
      the three molluscs and purified proteins from the mussel were partially
      sequenced. 4. Calcium binding studies were carried out with some of the protein
      fractions.

PMID- 8365105
TI  - A comparative study on liver ornithine carbamoyl transferase from a marine mammal
      Stenella and an elasmobranch Sphyrna zygaena.
AB  - 1. Ornithine carbamoyl transferases from liver of the dolphin Stenella and the
      shark Sphyrna zygaena were purified to homogenity and compared for some kinetic
      and structural properties. 2. The two enzymes showed a specific activity of 211
      and 115 respectively. 3. With respect to molecular weight, trimeric subunit
      structure and Km values, they were alike and similar to enzymes from other
      species. 4. Both enzymes were thermolable, but they were protected from thermal
      inactivation in a different way by ornithine and phosphate. 5. The two enzymes
      focused, respectively, at pH 8.6 and between pH 6.4 and 8.0, the former value
      being appreciably higher than those of enzymes from other species.

PMID- 8365106
TI  - Comparative oxidative rates of methionine hydroxy analogue in rat and chicken
      kidney.
AB  - 1. L-2-HAOX A and L-2-HAOX B were purified from chicken and rat kidney with
      purification factors of 550 and 45, respectively. 2. It was established that both
      enzymes were tetrameric (M(r) = 169,000) and consisted of 40 kDa monomers. 3.
      While chicken kidney L-2-HAOX A is N-terminally blocked like spinach glycolate
      oxidase and chicken liver L-2-HAOX A, L-2-HOAX B begins with a Pro residue. 4.
      The kinetic parameters of L-HMB oxidation by L-2-HAOX A and B were determined. 5.
      The results are particularly interesting as regards L-HMB oxidation by L-2-HAOX
      B.

PMID- 8365107
TI  - Metabolic alterations in organs of Meriones unguiculatus infected with
      Echinococcus multilocularis.
AB  - 1. 1H-NMR spectra of liver, spleen and kidney extracts from Meriones unguiculatus
      infected with Echinococcus multilocularis showed decreased levels of glucose. In
      addition, the liver extracts were severely glycogen-depleted. 2. Both livers and
      spleens contained less glycine, taurine and acetate. Spleens also had fewer
      cholines and less lactate but more betaine and alanine. 3. In the kidneys,
      elevated concentrations of succinate, acetate and lactate were found.

PMID- 8365108
TI  - Rodent tissue alpha-L-fucosidases: analysis of brain and spleen isoforms and
      characterization of the purified hamster liver enzyme.
AB  - 1. Isoelectric focusing of brain and spleen alpha-L-fucosidases from four rodents
      (rat, mouse, guinea-pig, hamster) indicated that only mouse and hamster tissues
      contained isoforms with significant amounts of activity above pI 7.0. 2. Hamster
      liver alpha-L-fucosidase was purified approximately 57,000-fold in 80% yield (to
      a final specific activity of 24,700 nmol/min/mg protein) by affinity
      chromatography on agarose-epsilon-aminocaproyl-fucosamine. 3. SDS-PAGE analysis
      of hamster liver alpha-L-fucosidase indicated the presence of one to two closely
      spaced subunits at 56 and 60 kDa. Western blotting analysis indicated the hamster
      enzyme was recognized by polyclonal antibodies but not by a monoclonal antibody
      (both antibodies prepared against human liver alpha-L-fucosidase). 4. The pH
      activity curve of hamster liver alpha-L-fucosidase is broad with an optimum
      centered around pH 6.8 and with high activity between pH 5.5 and 7.5.

PMID- 8365109
TI  - Functional and structural identification of a new lectin activity of Borrelia
      recurrentis spirochetes.
AB  - 1. Haemagglutinating activity (HA) was found and characterized in lysate of the
      spirochete Borrelia recurrentis. 2. The highest HA was observed using native
      rabbit red blood cells (RBC), especially oxidized rabbit RBC. 3. In a
      haemagglutination inhibition test the HA showed an affinity with monosaccharides
      D-glucosamine, D-galactosamine and N-acetyl-D-mannosamine and several
      glycoproteins and polysaccharides. 4. An inhibitory effect was also achieved by
      mouse monoclonal antibody H 9724, polyclonal antibodies from B. recurrentis
      infected mice and with rabbit polyclonal antibodies directed against B.
      recurrentis HA. 5. B. recurrentis proteins components of 29, 33, 41 and 55 kDa
      were identified by immunoblotting as structural subunits of complex binding
      activity of a new agglutinin.

PMID- 8365110
TI  - Fatty acid composition of fats around the mystacial and superciliary vibrissae
      differs from that of blubber in the Saimaa ringed seal (Phoca hispida saimensis).
AB  - 1. Adipose tissues associated with the mystacial and superciliary vibrissae of
      the Saimaa seal (Phoca hispida saimensis) contained 31% of hexadecenoic acid
      (16:1 omega 7), which was almost twice the already high amount in blubber. The
      amount of tetradecenoic acid (14:1 omega 5) was also double that in blubber. 2.
      At the same time the levels of long-chain highly unsaturated docosapentaenoic
      (22:5 omega 3) and docosahexaenoic acids (22:6 omega 3) were only two-thirds of
      those found in blubber. 3. It is suggested that the excess of low-melting
      monoenoic fatty acids (14:1 and 16:1) in adipose tissues near the vibrissae might
      not be compensation for the low supply of dietary polyunsaturated fatty acids in
      these tissues, but that the self-induced excess of monoenoic fatty acids ensured
      the proper functioning of these well-developed sense organs.

PMID- 8365111
TI  - Fatty acid composition in liver and blubber of the Saimaa ringed seal (Phoca
      hispida saimensis) compared with that of the ringed seal (Phoca hispida botnica)
      and grey seal (Halichoerus grypus from the Baltic.
AB  - 1. The main differences in fatty acid composition of blubber between the Saimaa
      seal (Phoca hispida saimensis) and the Baltic seals (Phoca hispida botnica and
      Halichoerus grypus) were, that in fresh water the proportions of polyunsaturated
      C18 acids and arachidonic acid (20:4 omega 6) were high. 2. The trend became more
      evident when data on ringed seals from northern oceans were compared with the
      present data. 3. The proportions of exogenous 20:1 and 22:1 were extremely low in
      ringed seals from Lake Saimaa and in Baltic seals compared with seals living in
      oceans.

PMID- 8365112
TI  - Butyrylcholinesterase from intestinal epithelial cells of quail, chick and duck:
      a comparative study during development.
AB  - 1. Epithelial cells of avian intestine express non-specific cholinesterase
      (butyrylcholinesterase, BuChE) activity both in the embryo and adult animal. 2.
      Quail, duck and chick exhibit increased BuChE activity during the late embryonic
      period followed by decreased activity. The minimum value is reached after
      hatching at day 1 in quail, day 4 in chick and day 6 in duck. 3. The three
      species display marked sex-related differences mainly during the peri-hatching
      period. BuChE activity is higher in females than in males. 4. The three globular
      forms, G1, G2 and G4, are detected during the last days of embryonic development.
      After hatching, changes in the relative amounts of these forms are related to the
      disappearance of G2 and the gradual decrease of G4. In adult quail and duck, G4
      is not detected and BuChE activity corresponds only to the G1 form. 5. The
      changes in BuChE activity and distribution of the molecular forms occur in a
      similar manner in all three species although the embryonic periods differ
      notably, suggesting that hormonal factors secreted during this period and
      involved in the preparation of hatching may regulate BuChE activity.

PMID- 8365113
TI  - Electrospray mass spectrometric analysis of river buffalo (Bubalus bubalis)
      hemoglobins. Re-examination of alpha 1 and alpha 3 globin chain sequences.
AB  - 1. The accurate molecular weight of the globin chains from river buffalo
      hemoglobin components has been determined by means of electrospray mass
      spectrometry. 2. The ES/MS analysis demonstrated that all the buffalo Hb
      components share a common beta chain whose mass value coincides with that
      expected on the basis of the reported sequence. 3. The AA phenotype alpha 1 and
      alpha 3 globin chains exhibited a 30 Da mass difference as compared to their
      predicted molecular weights. Careful re-examination of the two alpha globin
      sequences by FAB/MS revealed the occurrence of sequence errors and hence the
      correct primary structure of both alpha chains was established.

PMID- 8365114
TI  - Enzyme properties of monoamine oxidase in the frontal cortex and liver of the
      gerbil (Meriones unguiculatus).
AB  - 1. Enzyme properties of monoamine oxidase (MAO) in the frontal cortex and liver
      of the gerbil were investigated using 5-hydroxytryptamine (5-HT), benzylamine
      (Bz) and tyramine (Tyr) as substrates. 2. The Km values of MAO towards the three
      substrates were almost similar to the values in other species. The Vmax value of
      MAO towards Bz was much lower than the value towards 5-HT. 3. In the inhibition
      studies with selective MAO-A and MAO-B inhibitors, clorgyline and deprenyl,
      deamination of 5-HT, Bz and Tyr in both tissues was induced by MAO-A alone, MAO-B
      alone and both forms of the enzyme, respectively, indicating the same substrate
      specificity as that in rats. 4. The apparent proportion of MAO-A to MAO-B
      activities in the gerbil liver was approximately 6:4, whereas MAO-A in the
      frontal cortex of the gerbil was exclusively predominant, consistent with the
      previous data in the golden hamster which belongs to the same family as the
      gerbil.

PMID- 8365115
TI  - Clinical biochemical reference ranges for female alpacas (Lama pacos).
AB  - 1. Serum samples were collected from 352 healthy female alpacas and tested for 17
      clinical biochemical analytes. 2. From the total population of alpacas tested,
      205 were pregnant, 68 were not pregnant and 79 had an unknown pregnancy status.
      3. Reference ranges for the female alpacas were determined for all the
      biochemical analytes, and compared to ranges reported for llamas, cattle, sheep
      and goats. 4. The mean values for pregnant and non-pregnant females were compared
      and any statistically significant differences identified. 5. The biochemical
      values reported here are suitable as reference ranges for pregnant and non
      pregnant female alpacas.

PMID- 8365116
TI  - Comparative studies of effects of dehydroepiandrosterone on rat and chicken
      liver.
AB  - 1. An attempt to identify the cause of decrease of gain in body weight during
      dehydroepiandrosterone (DHEA) treatment was made comparing the effects of hormone
      treatment on chickens and rats. 2. Chickens treated with DHEA for 7-10 days do
      not change their weight gain with respect to controls although their
      mitochondrial respiration and peroxisomal catalase (index of peroxisomal mass)
      were increased. 3. Liver cytosolic malic enzyme and sn-glycerol-3-phosphate
      dehydrogenase were depressed in chickens treated with DHEA in comparison with
      activities in untreated controls. DHEA treatment did not increase the activity of
      mitochondrial sn-glycerol 3-phosphate dehydrogenase. 4. In contrast to rat liver
      cytosolic sn-glycerol-3-phosphate dehydrogenase this enzyme in chicken liver was
      inactive with NADPH.

PMID- 8365117
TI  - Fecal bile acids and neutral sterols in the cotton-top tamarin (Saguinus
      oedipus).
AB  - 1. The cotton-top tamarin (Saguinus oedipus), a small New World primate
      susceptible to spontaneous development of colon cancer, was studied for its fecal
      neutral sterol and bile salt composition. 2. Standardization procedures to
      establish the effect of exposure of the stool to room temperature air for various
      time-periods showed no significant effects on the neutral sterol and bile salt
      composition of the samples. 3. Microbial degradation of cholesterol and bile
      acids to secondary metabolites showed a progressive rise during the first year of
      life after which some degree of homeostasis was observed. 4. The proportion of
      cholesterol that remained unmetabolized by colonic microflora was in excess of
      50%, an amount that was significantly higher than in man and other higher
      primates. 5. Ursodeoxycholic acid was identified as a significant (12%) component
      of fecal bile acids in this species. 6. Secondary bile acids formed by the action
      of enteric microflora were also significantly lower than levels found in man and
      other animals.

PMID- 8365118
TI  - Isolation and characterization of cock brain coated vesicles in comparison with
      porcine brain coated vesicles.
AB  - 1. Cock brain coated vesicles (CBCVs) were isolated and compared with porcine
      brain coated vesicles (PBCVs). 2. The fine structure of CBCVs was quite similar
      to that of PBCVs. 3. Size distribution of CBCVs showed a rather single
      population, whereas that of PBCVs seemed to consist at least two subpopulations.
      4. CBCVs possessed proteins quite characteristic of coated vesicles (CVs). 5. The
      protein composition of CBCVs was very like that of PBCVs with the exception of
      clathrin light chain b. 6. A small difference in the electrophoretic mobility
      existed between CBCVs and PBCVs. 7. The density of CBCVs was slightly greater
      than that of PBCVs.

PMID- 8365119
TI  - The role of subfractions of high density lipoprotein in the in vivo transport of
      cholesterol from cholesterol-loaded hepatic and peripheral endothelial cells in
      the New Zealand white rabbit.
AB  - 1. High density lipoprotein (HDL) of the New Zealand White rabbit was separated
      by heparin-Sepharose affinity chromatography into six distinct subfractions of
      different composition and particle size. 2. When human acetyl LDL containing
      [3H]cholesteryl linoleate was injected intravenously into rabbits to prime the
      endothelial cells with labelled cholesterol, only 1-2% of the radioactivity
      remained in the plasma after 2 hr. 3. After 4 hr, 60.1% of the plasma
      radioactivity was present in HDL and 25% of this was recovered in the largest
      particles of HDL (fraction VI, mean particle diameter 11.6-11.8 nm). 4. The
      concentration of these largest particles of HDL, rich in apolipoprotein E, were
      also relatively increased in acetyl-LDL-treated rabbits when compared to controls
      (P < 0.01). 5. In control in vitro experiments, 62.2% of the radioactivity
      recovered in HDL was associated with subfractions IV and V (mean particle
      diameter 10.2-10.8 nm) while only 5% was present in fraction VI. 6. The results
      show that large HDL particles enriched with apo E contain a large proportion of
      cholesterol previously supplied to hepatic and peripheral endothelial cells. 7.
      This study demonstrated that the rabbit provides a useful animal model for the
      study of the metabolism of subfractions of HDL in relation to reverse cholesterol
      transport.

PMID- 8365120
TI  - A comparative study of free radicals in vertebrates--II. Non-enzymatic
      antioxidants and oxidative stress.
AB  - 1. The three main non-enzymatic endogenous soluble antioxidants and three
      estimators of oxidative stress were measured in the liver, lung and brain of
      seven animal species of different vertebrate classes. 2. The more concentrated
      antioxidant was GSH, followed by ascorbate and finally by uric acid. Liver showed
      higher levels of GSH and uric acid than the other two organs in the majority of
      the species. 3. GSSG/GSH ratio was highest in lung, probably due to the high pO2
      prevalent in the tissue. Nevertheless, this did not result in higher tissue
      peroxidation, suggesting that the lung antioxidants are capable of coping with a
      high tissue pO2. 4. Tissue peroxidation was maximal in the brain when assayed by
      the TBA test, but this was not confirmed by HPLC of malondialdehyde (MDA). HPLC
      resulted in much lower MDA values than TBA.

PMID- 8365121
TI  - Multiple types and forms of odorant-binding proteins in the Old-World porcupine
      Hystrix cristata.
AB  - 1. Eight new proteins have been identified and purified from the nasal tissue of
      the old-world porcupine. 2. All of them show good binding activity to tritiated 2
      isobutyl-3-methoxypyrazine. 3. They show values of molecular mass, in denaturing
      conditions, between 18 and 23 kDa, and of isoelectric points between 4.2 and 4.6.
      4. This represents the first example of more than two odorant-binding proteins
      (OBPs) found in the same animal species and could support a discriminating
      function of these proteins in the process of odour perception.

PMID- 8365122
TI  - Nickel sensitivity and the implantation of orthopaedic prostheses.
AB  - There is no evidence that nickel-sensitive patients, when given a modern plastic
      to-stainless-steel hip replacement, develop cutaneous reactions or loosening of
      their prostheses. However, eczema is occasionally seen with static metal
      prostheses and eruptions sometimes accompanied the use of the older types of
      joint prosthesis. Modern plastic-to-metal joint replacements rarely cause
      sensitization to the composite metals. In the rare instances when this has been
      detected by patch testing, the affected patients have not developed eczema or
      loosening of their prostheses.

PMID- 8365123
TI  - Footwear dermatitis.
AB  - We conducted a study to determine the prevalence and clinical patterns of
      footwear dermatitis, patch testing 50 patients with suspected footwear dermatitis
      and 30 controls with 22 allergens of a shoe series (Chemotechnique Diagnostics
      AB, Malmo, Sweden). The overall prevalence among contact dermatitis cases was
      11.7%. The dorsa of the feet and toes were the commonest sites involved. 70% of
      patients showed sensitivity to footwear allergen(s), as opposed to 6.67% of
      controls. Potassium dichromate and colophony were the commonest sensitizers.
      Other sensitizers were the rubber accelerators 2-mercaptobenzothiazole (MBT) and
      diphenylguanidine (DPG) and a dye p-aminoazobenzene. Of the 23 patients patch
      tested with pieces or scrapings of footwear, only 3 showed positive reactions. We
      recommend that there should be primary and secondary footwear screening series to
      detect the responsible allergens, with the ultimate objective of providing
      correct nonallergenic footwear for our patients, with the help of manufacturers
      and research institutes.

PMID- 8365124
TI  - Contact allergy to a fatty acid ester component of cutting fluids.
AB  - 6 patients employed in the metalworking industry developed a hand dermatitis
      after exposure to a vegetable-oil-based cutting fluid. After thorough
      investigation, including patch testing with components in the cutting fluid as
      well as an oil and cutting fluid series, contact allergy was demonstrated to a
      fatty acid ester EM-550 in the cutting fluid.

PMID- 8365125
TI  - Occupational allergic contact dermatitis caused by exposure to acrylates during
      work with dental prostheses.
AB  - Between 1974 and 1992, we were consulted by 4 patients (an orthodontist, 2 dental
      technicians and a dental worker trained in-house) who had developed occupational
      allergic contact dermatitis from working with dental prostheses. All patients had
      positive allergic patch test reactions to methyl methacrylate (MMA), the acrylate
      which is the most widely used in work with prostheses. All but the orthodontist
      also reacted to dimethacrylates, which are used in cross-linked dental
      prostheses. The last patient, investigated in 1992, had been exposed mainly to
      light-cured acrylics, which are similar in composition to dental composite
      resins. These acrylics, only recently introduced into prosthetic work, contain
      more potent acrylic sensitizers than MMA. Accordingly, dental personnel working
      with prostheses may face a higher risk of sensitization than previously. To
      detect cases of occupational allergic contact dermatitis, we suggest that
      patients working with dental prostheses should be patch tested with MMA, 2
      hydroxyethyl methacrylate, dimethacrylates, epoxy acrylates and urethane
      acrylates.

PMID- 8365126
TI  - Long-lasting allergic patch test reaction caused by gold.
AB  - Allergic contact dermatitis caused by gold is rare, and only isolated cases have
      been reported. Patch testing with gold may cause a long-lasting reaction. The
      purpose of this study is to describe a well-studied case of gold allergy caused
      by dental gold crowns. A gold-sensitized patient and a non-sensitized control
      subject were examined using patch tests, immunohistochemistry, electron
      microscopy and blast transformation reactions. Sodium thiosulfate, auranofin and
      sodium thiomalate gave positive patch test reactions. Immunohistochemistry and
      electron microscopy were performed from biopsies taken from allergic patch test
      reactions caused by gold sodium thiosulfate 1 day and 17 days after applying the
      patches, from normal skin and from a 17-day-old allergic patch test reaction
      caused by ammonium persulfate. Down-regulation had taken place by 17 days in the
      allergic ammonium persulfate reaction, but not in the 17-day allergic gold test
      reaction. The patient reacted to all but one of the gold-induced blast
      transformation tests, sodium chloroaurate being non-inductive. The non-sensitized
      control subject did not exhibit any reactions. In conclusion, gold sodium
      thiosulfate, gold sodium thiomalate and auranofin can be used as patch test
      substances for gold allergy, though long-lasting allergic patch test reactions
      may develop. In vitro gold salt induced blast transformation is an alternative
      test for gold allergy. The slow down-regulation of the allergic patch test
      reactions needs to be studied further.

PMID- 8365127
TI  - Fixed drug eruption due to allylisopropylacetylurea.
AB  - We report a case of fixed drug eruption due to allylisopropylacetylurea. A 21
      year-old female developed purplish-red round eruptions on her neck and left thigh
      after taking an analgesic containing isopropylantipyrine,
      allylisopropylacetylurea, phenacetin and anhydrous caffeine. Patch testing with
      the analgesic and its ingredients on the eruptive area showed positive reactions
      to the analgesic and allylisopropylacetylurea, while patch testing on the non
      eruptive area showed negative reactions. We diagnosed her condition as a fixed
      drug eruption due to allylisopropylacetylurea in an analgesic.

PMID- 8365128
TI  - A standard protocol for phototoxicity testing. Results from an interlaboratory
      study.
AB  - Based on experience accumulated in a number of laboratories, a standardized
      protocol for phototoxicity testing in experimental animals by the dermal route is
      presented. By conducting a limited interlaboratory study, demonstrating a high
      degree of consistency using 8-methoxypsoralen (8-MOP) and acridine, the
      sensitivity and reproducibility of the proposed methodology is demonstrated.
      Important aspects of performing phototoxicity testing are discussed.

PMID- 8365129
TI  - Allergic contact dermatitis from picric acid.

PMID- 8365130
TI  - A new source of sensitivity to epoxy resin.

PMID- 8365131
TI  - Sensitization to nickel from stainless steel ear-piercing kits.

PMID- 8365132
TI  - Contact urticaria from sodium fluoride.

PMID- 8365133
TI  - HLA-A, -B and -DR antigens in hydrocortisone contact hypersensitivity.

PMID- 8365134
TI  - Occupational allergic contact dermatitis from epoxy varnishes.

PMID- 8365135
TI  - Size of the test area does not affect the result of the repeated open application
      test.

PMID- 8365137
TI  - The influence of climatic factors on patch test results in Athens.

PMID- 8365136
TI  - Contact dermatitis from UV-A and UV-B filters in a patient with erythropoietic
      protoporphyria.

PMID- 8365138
TI  - Gold-stimulated production of granulocyte/macrophage colony-stimulating factor by
      peripheral blood mononuclear cells from a patient with gold contact dermatitis.

PMID- 8365140
TI  - Pigmented contact dermatitis from deodorant.

PMID- 8365139
TI  - Contact allergy due to 4-N,N-dimethylaminobenzene diazonium chloride and thiourea
      in diazo copy paper.

PMID- 8365141
TI  - A study of attenders at an occupational dermatology clinic.

PMID- 8365142
TI  - Contact dermatitis from tioconazole mimicking "one hand two feet syndrome".

PMID- 8365143
TI  - Contact allergy to tea tree oil.

PMID- 8365144
TI  - Influence of area of application of allergen on sensitization in contact
      dermatitis.

PMID- 8365145
TI  - Intradermal testing in the diagnosis of allergic contact dermatitis. A
      reappraisal.
AB  - Contact hypersensitivity may be diagnosed with patch testing or intradermal
      testing. Although these methods have been used earlier in parallel, patch testing
      has gradually become the only method in routine diagnosis of contact allergy.
      Recent findings in corticosteroid contact hypersensitivity have shown that patch
      testing is not always an optimal method, especially when poor penetrants are
      used. Therefore, a reappraisal of intradermal testing is presented, based on the
      literature. Studies employing both patch and intradermal testing are reviewed and
      the advantages and disadvantages of intradermal tests as compared to patch tests
      in contact allergy diagnostics are discussed. We find that it might be worthwhile
      to evaluate whether contact allergy to compounds other than corticosteroids may
      be easier to detect with intradermal than patch test.

PMID- 8365146
TI  - Dermatitis in bulb growers.
AB  - A damaged skin forms a health hazard in flower-bulb growers as it enables higher
      permeation rates for pesticides than normal skin. Therefore, an investigation was
      performed into the skin condition of 103 bulb growers and 49 controls. Contact
      dermatitis of the hands was of the same order (11 and 10%) in both groups.
      However, minor signs of dermatitis were seen more often in bulb growers (30
      versus 8%, p < 0.05). Most growers had contact with narcissus sap during the
      investigation. This irritant sap, as well as many other skin contacts with
      irritants such as hyacinth dust and pesticides, seemed to be responsible for many
      skin complaints. Contact sensitization was suspected in 19 growers and 3
      controls. Patch tests showed that contact sensitization existed to pesticides in
      probably 10, and to flower-bulb extracts in 4 growers. Reactions to propachlor
      were not regarded as very reliable as the test concentration seemed to be
      marginally irritant. There were only a few allergic reactions to narcissus (3)
      and tulip (2) and none to hyacinth. This investigation showed that minor irritant
      contact dermatitis was frequent in bulb growers, and indicated that contact
      sensitization to pesticides and bulbs seemed to be a less frequent but important
      cause of dermatitis.

PMID- 8365147
TI  - Nickel sensitization and ear piercing in an unselected Danish population.
      Glostrup Allergy Study.
AB  - The study aimed at evaluating nickel sensitization and ear piercing in an
      unselected population. A questionnaire and ready-to-apply patch tests (TRUE-Test)
      were mailed to 793 subjects, aged 15 to 69 years. A total of 567 (71.5% out of
      the 793) were patch tested. The tests were read 2 days after application. Nickel
      sensitization was diagnosed in 11.1% of the females and in 2.2% of the males.
      Independent of sex, old age was associated with a lower risk of nickel
      sensitization (p < 0.01). The risk of nickel sensitization was independent of a
      history of flexural eczema (p > 0.5). Ear piercing was more common in the young
      than in the older age groups, ranging from 30.5% to 0.0% in men, and from 91.5%
      to 42.9% in women. Sensitization to nickel was found in 14.8% of those with
      pierced ears as compared to 1.8% among those without pierced ears. When adjusted
      for the effects of sex and age, the risk of nickel sensitization among those with
      pierced ears remained significantly increased and the odds ratio value was 4.5;
      the 95% confidence interval of the odds ratio value was 1.5 to 13.0. The study
      confirmed that nickel sensitization in the general population is common,
      particularly among women. Ear piercing is probably an important risk factor for
      nickel sensitization.

PMID- 8365148
TI  - Alcohol vehicles in tests for non-immunological immediate contact reactions.
AB  - In a search for vehicles that might enhance the sensitivity of human skin tests
      for nonimmunological immediate contact reactions, benzoic acid was tested in 17
      liquid vehicles on 16 medical students using the open application test method on
      the upper back. The results were read visually and the change in blood flow was
      measured using a laser-Doppler flowmeter 20, 40 and 60 min after application of
      the test substances. 2-propyl alcohol (isopropanol), ethyl alcohol (ethanol), 1,2
      propylene glycol and water were mixed to form alcohol, alcohol/water,
      alcohol/alcohol, alcohol/propylene glycol and propylene glycol/water vehicles.
      The reactions were stronger in the alcohol/water vehicles than in the alcohols as
      such. The addition of 25% propylene glycol to isopropanol and ethanol had the
      greatest enhancing effect on the reactions. Ethanol has been the most popular
      liquid vehicle in tests for non-immunological immediate contact reactions, but at
      least with benzoic acid, stronger reactions can be elicited if alcohol/propylene
      glycol or alcohol/water mixture are used.

PMID- 8365149
TI  - Studies of new short-period method for delayed contact hypersensitivity assay in
      the guinea pig. (2). Studies of the enhancement effect of cyclophosphamide.
AB  - The enhancement effect of cyclophosphamide on the delayed contact
      hypersensitivity reaction of chemical compounds was studied in Hartley albino
      guinea pigs. A series of assay procedures, combining the AP2 test (adjuvant and
      24-h occlusive patch 2x test, as previously reported) with intraperitoneal
      cyclophosphamide administration, were examined. The newly developed method was as
      follows; cyclophosphamide 200 mg/kg intraperitoneal administration 3 days before
      the 1st sensitization of the AP2 test (cyclophosphamide, adjuvant and 24-h
      occlusive patch 2x test: CAP2 test). Comparing the CAP2 test with the AP2 test,
      the cumulative contact enhancement test (CCET) and the guinea pig maximization
      test (GPMT), the CAP2 test equally and/or better enabled the detection of
      allergenicities not only of strong allergens such as bromostyrol, citronellal, p
      phenylenediamine and formaldehyde, but also of weak allergens such as benzyl
      salicylate and p-aminobenzoic acid ethyl ester. Acanthosis and spongiosis in the
      epidermis and mononuclear cell infiltration into the dermis at the skin reaction
      site were histopathologically observed. Cyclophosphamide effectively enhanced the
      delayed contact hypersensitivity reaction of weak allergens.

PMID- 8365150
TI  - Guinea pig maximization test of the bark extract from pawpaw, Asimina triloba
      (Annonaceae).
AB  - Several acetogenins, characteristic of the Annonaceae, have been found to exhibit
      pesticidal and feeding-deterrent activities against a variety of pests and are
      undergoing commercial development as pesticides. The sensitizing potential of one
      of these plants, pawpaw, Asimina triloba Dunal, was examined in the current
      study. The potential of Fraction F020 (a pesticidal crude extract of pawpaw stem
      bark) to sensitize and elicit an allergic contact dermatitis response was
      determined by using a modified guinea pig maximization test (GPMT). Fraction F020
      is a weak sensitizer and the active compound, asimicin, a trihydroxy
      bistetrahydrofuran fatty acid gamma-lactone, is a weak irritant.

PMID- 8365151
TI  - Contact allergy to aluminium in 2 brothers.
AB  - A 10-year-old boy reacted to aluminium Finn Chambers during routine patch
      testing. Further patch tests with aqueous aluminium chloride confirmed contact
      allergy to aluminium. The boy's 8-year-old brother also reacted to aluminium Finn
      Chambers. Both boys had suffered from a scaling eruption on their face and limbs
      since infancy.

PMID- 8365152
TI  - Occupational contact sensitization to ethylenediamine in a wire-drawing factory.

PMID- 8365153
TI  - Topical NSAID allergic contact dermatitis. Italian experience.

PMID- 8365154
TI  - Contact dermatitis due to Metasol D3T in a Jay cushion.

PMID- 8365155
TI  - Contact dermatitis from glyceryl di-isostearate.

PMID- 8365156
TI  - Allergic contact dermatitis following subconjunctival injection of framycetin.

PMID- 8365157
TI  - Achromic patch test from hydroquinone monobenzyl ether.

PMID- 8365158
TI  - Generalized cutaneous reaction to diltiazem.

PMID- 8365159
TI  - Isolated cobalt sensitivity in an etcher.

PMID- 8365160
TI  - Contact and photocontact allergy to dibenzoylmethanes and contact allergy to
      methylbenzylidene camphor.

PMID- 8365161
TI  - Allergic contact dermatitis in caterers.

PMID- 8365162
TI  - Contact dermatitis of the eyelids from resorcinol in an ophthalmic ointment.

PMID- 8365163
TI  - Contact dermatitis due to sensitization to lactic acid and castor oil in a wart
      remover solution.

PMID- 8365165
TI  - 'Hydrocortisone alcohol'.

PMID- 8365164
TI  - Etiologic agents in allergic contact dermatitis caused by eyedrops.

PMID- 8365166
TI  - Patch testing with glyceryl monothioglycolate.

PMID- 8365167
TI  - Compositae dermatitis in a Danish dermatology department in one year (I). Results
      of routine patch testing with the sesquiterpene lactone mix supplemented with
      aimed patch testing with extracts and sesquiterpene lactones of Compositae
      plants.
AB  - To investigate the frequency of Compositae sensitivity, the recently-developed
      sesquiterpene lactone mix (SL mix) was included in the standard patch test
      series. Patients with positive reactions to this or patients suspected of having
      a Compositae allergy were supplementarily tested with a Compositae mix,
      consisting of ether extracts of 5 European Compositae plants. In the first year,
      686 patients were tested with the SL mix and 79 with the Compositae mix. A total
      of 31 Compositae-sensitive patients (4.5%) were found. The frequency of positive
      reactions to either of the mixes was equal, but only 17 of 30 patients tested
      were positive to both mixes. Testing with the individual ingredients of the
      Compositae mix showed frequent positive patch test reactions to feverfew,
      followed in order by chamomile, tansy, yarrow and arnica. The reason for this
      distribution is discussed and the results of standard, photo- and other plant
      patch tests are presented. The only partial overlap between positive reactions to
      the mixes emphasizes the necessity of supplementary testing in patients suspected
      of Compositae allergy, as well as the lack of a reliable single screening agent.
      Since no cases of active sensitization or irritant reactions were seen, both the
      SL mix and the Compositae mix may be considered suitable for routine screening of
      Compositae allergy.

PMID- 8365168
TI  - Allergic contact dermatitis from phenylephrine in a rectal ointment.

PMID- 8365169
TI  - A polysensitized HIV-positive patient.

PMID- 8365170
TI  - Allergic contact cheilitis and stomatitis from hydroquinone in an acrylic dental
      prosthesis.

PMID- 8365171
TI  - Allergic contact dermatitis from transdermal nicotine systems.

PMID- 8365173
TI  - Captan, a rare contact sensitizer in hairdressing.

PMID- 8365172
TI  - Systemic contact dermatitis from hydrocortisone.

PMID- 8365174
TI  - Prevention of phytophotodermatitis from celery.

PMID- 8365175
TI  - Occupational protein contact dermatitis from lettuce.

PMID- 8365176
TI  - Skin reactivity to tin chloride and metallic tin.

PMID- 8365177
TI  - Topical nonsteroidal antiinflammatory drugs: allergic and photoallergic contact
      dermatitis and phototoxicity.

PMID- 8365178
TI  - Nickel sensitivity in atopics, psoriatics and healthy subjects.
AB  - A prospective study of 552 persons was performed to study nickel allergy in
      atopics, with and without dermatitis, psoriatics and healthy adults. We found no
      statistically-significant difference in the frequency of nickel allergy between
      persons with atopic dermatitis, atopics without dermatitis and healthy controls.
      More females than men gave a history of metal intolerance and gave allergic patch
      test reactions. A poor correlation between history and patch test reaction was
      not specific for atopics. Psoriatics had a significantly lower frequency of
      allergic patch test reactions to nickel than healthy controls or atopics with and
      without dermatitis. Psoriatics should not be used as controls for atopics in
      studies of contact dermatitis.

PMID- 8365179
TI  - Contact allergy to sunscreen chemicals in photosensitivity dermatitis/actinic
      reticuloid syndrome (PD/AR) and polymorphic light eruption (PLE).
AB  - From 1989-1991, 214 patients (45 PD/AR, 54 PLE, 115 controls) were patch tested
      to a sunscreen series containing 9 constituents. 16/214 (7.5%) patients reacted
      to one or more sunscreens, with allergy being significantly more common in PD/AR
      patients (10/45 versus 2/54 PLE and 4/115 contact dermatitis clinic controls).
      The benzophenone group of sunscreens (mexenone, oxybenzone) were the most
      frequent sensitizers, accounting for 8 of the 27 positive patch tests observed.
      Clinicians should consider contact allergy to sunscreens in PD/AR patients as an
      explanation for exposed-site dermatitis episodes.

PMID- 8365180
TI  - Efficacy of skin barrier creams (II). Ineffectiveness of a popular "skin
      protector" against various irritants in the repetitive irritation test in the
      guinea pig.
AB  - A popular "skin protector" consisting of an emulsion-like foam of lipophilic and
      hydrophilic substances (Marly skin) was evaluated in a previously described
      repetitive irritation guinea pig model. The product failed to inhibit the
      irritation due to sodium lauryl sulphate and toluene. In striking contrast to the
      recommended use, the irritant response of sodium hydroxide was aggravated, as
      demonstrated by significant differences for all test parameters (clinical score
      for erythema and scaling, transepidermal water loss, blood flow volume). The
      results show that protection against chemical irritants may be quite specific and
      that some formulations may actually be harmful.

PMID- 8365181
TI  - Quantitative structure-activity relationships for skin sensitization potential of
      urushiol analogues.
AB  - The relative alkylation index (RAI), a theoretically derived parameter intended
      to quantify the relative extent of carrier haptenation resulting from a given
      dose of a given sensitizer, has previously been successfully applied to the
      analysis of relative sensitization potential and dose-response data for a variety
      of contact allergens which are directly electrophilic. Here the RAI concept is
      applied to analysis of data on compounds related to urushiol (i.e., 3-substituted
      catechols), the naturally occurring mixture of allergens responsible for contact
      allergy to poison ivy and poison oak. These allergens are believed to act as pro
      electrophiles, being oxidized to electrophilic orthoquinones in vivo. It is found
      that the various types of urushiol derivatives fit the same sort of RAI
      sensitization relationships as expected theoretically and as found previously
      with direct acting electrophiles. There is evidence that in many cases, the test
      conditions were such that overload effects, whereby the degree of sensitization
      induced decreases with increasing carrier haptenation, applied. It is also
      concluded that the question as to the relative sensitization potencies of the
      naturally occurring urushiols remains open. The commonly held view that with
      these materials, sensitization potential increases with increasing unsaturation
      in the 3-hydrocarbyl chain of the 3-hydrocarbyl catechols, is based on evidence
      that is capable of alternative interpretation.

PMID- 8365183
TI  - Prognosis of occupational contact dermatitis in New South Wales, Australia.
AB  - 570 patients with occupational contact dermatitis (OCD) were seen between 1984
      and 1990 at the Skin and Cancer Foundation in Sydney. 336 (59%) were followed up
      1 to 5 years later. Roughly 1/3 were healed, 1/3 were improved without complete
      healing, 1/4 had no change and 1/12 of the patients had deteriorated. The overall
      improvement rate was in excess of 70%. Data derived from these patients
      demonstrated that changing the work duties of patients with OCD improved their
      outcome (p < 0.01), whilst leaving the industry altogether resulted in a greater
      overall healing rate (p < 0.01). No difference existed between the outcome of
      irritant contact dermatitis compared with allergic contact dermatitis. Atopics as
      expected had a worse prognosis. The outcome in the construction industry was
      significantly poorer than other industries. Patients suffering from allergic
      contact dermatitis from chromate also had a dismal prognosis.

PMID- 8365182
TI  - Sesquiterpene lactone contact sensitivity: clinical patterns of Compositae
      dermatitis and relationship to chronic actinic dermatitis.
AB  - A mix of 3 sesquiterpene lactones (SL) (SL mix 0.1%) was evaluated over a 4-year
      period. Of 7420 patients with eczema investigated by patch testing, 135 (68 male,
      67 female) (1.8%) demonstrated positive reactions, 114 (84%) considered
      clinically relevant. Females outnumbered males until the age of 60, after which
      men were more commonly affected. The clinical patterns varied from patients
      presenting with generalized eczema (20%) or eczema of the hands and face (24%),
      to patients with hand (36%) or facial eczema (11%) alone. 48 patients were
      investigated for suspected photosensitivity and 29 (21 male, mean age 69 years,
      and 8 female, mean age 66 years) had abnormal cutaneous monochromatic irradiation
      tests. These results highlight the varied clinical presentation of SL contact
      dermatitis and its association with chronic actinic dermatitis. The SL mix proved
      reliable and safe, supporting its inclusion in the European standard series of
      contact allergens.

PMID- 8365184
TI  - Allergic contact dermatitis from di-isodecyl phthalate in a polyvinyl chloride
      identity band.

PMID- 8365185
TI  - Stability of patch test allergens.

PMID- 8365186
TI  - Contact dermatitis from thioxolone.

PMID- 8365187
TI  - Contact allergy to sodium sulfite contained in an antifungal preparation.

PMID- 8365188
TI  - Allergic contact dermatitis from Biobans in Spanish metalworkers.

PMID- 8365189
TI  - Contact dermatitis from pilocarpine.

PMID- 8365190
TI  - Contact dermatitis due to dibromodicyanobutane in cucumber eye gel.

PMID- 8365191
TI  - In defense of the corporate author for multicenter trials.

PMID- 8365192
TI  - Instituting a research ethic.

PMID- 8365193
TI  - Tightening the clinical trial.
AB  - Randomized clinical trials adhere more closely to pre-agreed-on protocols than
      almost any other type of experiment, yet we can tighten up their analysis if we
      desire. If we convert the analysis into a randomization analysis--where the one
      set of data is analyzed many times--once as though each acceptable assignment has
      been employed, we can eliminate any dependence of the analysis on statistical or
      probabilistic assumptions. To do this effectively when many assignments could be
      acceptable, we can go to double randomization, in which a subset, usefully kept
      balanced, of acceptable assignments is selected (perhaps randomly) before data
      acquisition. If we have one covariate, adjustment for which answers a question
      that is at least as appropriate, we can easily build on this. Imperfect
      covariance adjustments can help almost as much as perfect ones. If it is
      appropriate to work with many covariate(s), it is often desirable to first
      construct a (few) compound covariate(s) and then work with it (them). Often we
      can base the coefficients in our compound covariate on the univariate regressions
      of response on single covariates. Doing this within each arm of the trial and
      pooling keeps the fitting of the final adjustment unbiased. Since we can
      prespecify how the compounds are to be calculated and fitted, we can do all this
      while retaining rigid prespecification. Prespecification, randomization, and
      intelligent use of covariates combined to make the resulting significance
      analysis of platinum standard quality. (If we want confidence statements, as we
      ordinarily should, it may make sense, for technical reasons, to plan for somewhat
      less than platinum standard quality).

PMID- 8365194
TI  - "Within patient"-dependent outcomes in graft occlusion after coronary artery
      bypass. SINBA Group.
AB  - In clinical trials aimed at assessing the efficacy of drugs after coronary artery
      grafting, statistical analysis is usually carried out on a per-patient basis and
      on a per-graft basis. Owing to the independence of responses among patients, the
      former outcome is analyzed by assuming a binomial model. However, this model
      cannot be directly adopted in analyzing the latter outcome because multiple vein
      grafts in the same patient do not act independently. It has been suggested that
      patients be considered as clusters of distal anastomoses, subsequently comparing
      the frequencies of occlusion under different treatments after adjusting the
      variance of each frequency for the size of the cluster. Alternatively, one can
      measure the intraclass (intrapatient) correlation coefficient and adopt
      distribution functions that include this quantity as one of the parameters. This
      approach has been adopted by many authors although the studies differed in the
      statistical model used to represent this kind of data. Two probability functions,
      Altham's and beta-binomial, have found wide application in different biomedical
      fields. Both are able to model the extrabinomial variability since their tails
      tend to zero more slowly than those of the binomial distribution. An alternative
      to adopting a specific probabilistic model consists of specifying a mixed model
      or a Markov-like susceptibility model. These models follow the same rationale
      since they assume the existence of two processes, one that causes an individual
      to become susceptible to occlusion, the other that determines the subsequent
      probability of occlusion in the individual. After presenting these models in a
      unified framework, this paper compares the estimates obtained by fitting the
      models to data gathered at coronary angiography 1 year after surgery by the SINBA
      group on a total of 847 saphenous vein anastomoses in 349 patients. Finally, the
      issue concerning the contribution of each patient to the effective sample size is
      discussed.

PMID- 8365195
TI  - Statistical design and monitoring of the Carotene and Retinol Efficacy Trial
      (CARET).
AB  - CARET is a chemoprevention trial of beta-carotene and vitamin A with lung cancer
      as the primary outcome. Participants at high risk for lung cancer are drawn from
      two populations: asbestos-exposed workers and heavy smokers. The intervention is
      a daily combination of 30 mg beta-carotene and 25,000 IU vitamin A as retinyl
      palmitate. Nearly 18,000 participants will be followed for a mean 6 years,
      yielding over 100,000 person-years of follow-up. We project that this sample size
      will have 80% power to detect a 23% decrease in the incidence of lung cancer
      cases. The purpose of this paper is to present the values of the key sample size
      parameters of CARET; our schemes for monitoring CARET for sample size adequacy,
      incidence of side effects, and efficacy of the study vitamins; an overview of the
      data collected; and plans for the primary, secondary, and ancillary analyses to
      be performed at the end of the trial. These approaches to the design, monitoring,
      and analysis of CARET are applicable for many other prevention trials.

PMID- 8365196
TI  - Research cost analyses to aid in decision making in the conduct of a large
      prevention trial, CARET. Carotene and Retinol Efficacy Trial.
AB  - Because of their larger study populations and longer durations, prevention trials
      typically are more costly than treatment trials. Thus it is important to analyze
      costs systematically to aid in making cost-effective decisions during the conduct
      of prevention trials as well as in the original design. Cost analysis must be
      tied to sample size estimation because costs depend on such factors as the total
      number of person-years of follow-up and the number of trial outcomes, which are
      not basic design parameters but are derived quantities resulting from sample size
      estimation. We illustrate the use of cost analysis to decide among options for
      future conduct of an ongoing prevention trial with three issues that have arisen
      during the Carotene and Retinol Efficacy Trial (CARET): the trade-off between
      extending the duration of the trial or increasing the number of participants, the
      effect on costs of delay in accrual, and the cost effectiveness of particular
      retention activities.

PMID- 8365197
TI  - Impact of clinical trials on medical practices.

PMID- 8365198
TI  - Simulating the electrical behavior of cardiac tissue using the bidomain model.
AB  - The complex microstructure of cardiac muscle comprised of coupled cells,
      enveloped by an interstitium made up of blood vessels, connective tissue, and
      fluid, presents some obvious problems to those interested in understanding the
      tissue as an electrical medium. One approach that has gained considerable favor
      in recent years views the tissue not as a discrete structure, but rather as two
      coupled, continuous domains: one for the intracellular space and the other for
      the interstitial space. For convenience, the averaged potentials and currents in
      both domains are defined at every point in space. The structure is partially
      preserved by assigning a conductivity tensor at each point. One advantage of
      using this space-averaged model is that the governing equations for the electric
      fields can be described by partial differential equations that on occasion lead
      to analytical solutions. This formal treatment of cardiac tissue as two coupled
      continua is referred to as the bidomain model. This article presents a
      mathematical description of the bidomain model and reviews the use of the model
      for simulating the electrical behavior of cardiac tissue.

PMID- 8365199
TI  - The critically ill child: a status report.

PMID- 8365200
TI  - The future of pediatric critical care medicine.

PMID- 8365202
TI  - Severe group A streptococcal infections.

PMID- 8365201
TI  - New treatments for sepsis.

PMID- 8365203
TI  - Nosocomial infections in the pediatric intensive care unit: etiology and
      prevention.

PMID- 8365204
TI  - Update: meningitis.

PMID- 8365205
TI  - Pediatric AIDS and critical care.

PMID- 8365206
TI  - Physiology of cardiopulmonary resuscitation in children.

PMID- 8365207
TI  - Acid-base balance during cardiopulmonary resuscitation.

PMID- 8365208
TI  - Outcome of pediatric cardiopulmonary resuscitation.

PMID- 8365209
TI  - Advances in pediatric cardiac surgery.

PMID- 8365210
TI  - Cardiac surgery and postoperative management.

PMID- 8365211
TI  - Management of low cardiac output after cardiac surgery.

PMID- 8365212
TI  - Tools for predicting outcome in the neurologically injured child.

PMID- 8365214
TI  - Cranial imaging and Doppler sonography in the critically ill infant.

PMID- 8365213
TI  - Neurologic intensive care: status epilepticus.

PMID- 8365215
TI  - A pragmatic approach to the treatment of the child with hypoxic-ischemic
      encephalopathy.

PMID- 8365216
TI  - Brain death in the pediatric patient: historical, sociological, medical,
      religious, cultural, legal, and ethical considerations.

PMID- 8365217
TI  - The intensivist's system.

PMID- 8365218
TI  - Vascular endothelium as a target and effector organ.

PMID- 8365220
TI  - New immunosuppressive agents and infection in solid organ transplantation.

PMID- 8365219
TI  - Management of fulminant hepatic failure in children--an analysis of 56 cases.

PMID- 8365221
TI  - Lung transplantation in children.

PMID- 8365222
TI  - Postoperative liver transplant care.

PMID- 8365223
TI  - Update on cardiac transplantation in infants and children.

PMID- 8365224
TI  - Life, death, and solid organ transplantation without brain death.

PMID- 8365225
TI  - Relationships between stress responses and clinical outcome in newborns, infants,
      and children.

PMID- 8365226
TI  - Patterns of the metabolic and endocrine stress response to surgery and medical
      illness in infancy and childhood.

PMID- 8365227
TI  - Hemodynamic responses to perioperative pain and stress in infants.

PMID- 8365228
TI  - Adult respiratory distress syndrome in newborn infants.

PMID- 8365229
TI  - Respiratory management for low-birth-weight infants.

PMID- 8365230
TI  - Airway management during transport.

PMID- 8365231
TI  - New modes of mechanical ventilation for severe respiratory failure.

PMID- 8365232
TI  - Newer modes of mechanical ventilation for patients with adult respiratory
      distress syndrome.

PMID- 8365233
TI  - Lung mechanics and mechanical ventilation.

PMID- 8365234
TI  - High-frequency ventilation.

PMID- 8365235
TI  - Pulmonary hypertension: physiologic or pathologic disease?

PMID- 8365236
TI  - Inhaled nitric oxide for treatment of pulmonary artery hypertension in the
      newborn and infant.

PMID- 8365237
TI  - Use of extracorporeal membrane oxygenation for preoperative stabilization of
      congenital diaphragmatic hernia.

PMID- 8365238
TI  - Congenital diaphragmatic hernia: are there reliable clinical predictors?

PMID- 8365240
TI  - Extracorporeal respiratory assistance for pediatric acute respiratory failure.

PMID- 8365239
TI  - Extracorporeal circulatory support in children in intensive care.

PMID- 8365241
TI  - Communication between physician, patient, and family in the pediatric intensive
      care unit.

PMID- 8365242
TI  - Caring for parents of critically ill children.

PMID- 8365243
TI  - Child/family advocacy: ethical issues, practical strategies.

PMID- 8365244
TI  - Managing the intensive care unit: nurse/physician collaboration.

PMID- 8365245
TI  - Collaboration between nurses and physicians in Europe.

PMID- 8365246
TI  - Managing the intensive care unit: physician-nurse collaboration.

PMID- 8365247
TI  - Bereavement: role of the nurse in the care of terminally ill and dying children
      in the pediatric intensive care unit.

PMID- 8365248
TI  - Initial assessment and stabilization of the pediatric trauma patient.

PMID- 8365249
TI  - Pediatric intensive care nursing.

PMID- 8365250
TI  - Prehospital care of the injured child: an analysis of selected premises.

PMID- 8365251
TI  - Retention of critical care staff.

PMID- 8365252
TI  - Outcome assessment.

PMID- 8365253
TI  - Withdrawing mechanical ventilation.

PMID- 8365254
TI  - Present trends in fluid therapy, metabolic care, and prevention of infection in
      burned children.

PMID- 8365255
TI  - Ecological impact of pediatric intensive care.

PMID- 8365256
TI  - Molecular pathophysiology in critical care illness.

PMID- 8365257
TI  - Clinical research in the critical care environment.

PMID- 8365258
TI  - Outcome and quality assurance standards.

PMID- 8365259
TI  - Pediatric intensive care in Argentina.

PMID- 8365260
TI  - Pediatric intensive care around the world: Australia.

PMID- 8365261
TI  - Impact of national health system financing on quality of care in the intensive
      care unit: the German experience.

PMID- 8365262
TI  - Overview of pediatric intensive care from around the world: Germany.

PMID- 8365263
TI  - Developing pediatric emergency services in Israel: goals and state of the art.

PMID- 8365264
TI  - International standard of quality in the pediatric intensive care unit: a model
      for pediatric intensive care units in South America.

PMID- 8365265
TI  - Overview of pediatric intensive care in Thailand.

PMID- 8365266
TI  - A new role for the pulmonologist. Bringing bioethics back to the bedside.

PMID- 8365267
TI  - Preflight medical screening of patients.

PMID- 8365268
TI  - Bronchoalveolar lavage fluid in HIV-infected patients. "Cytokine soup".

PMID- 8365269
TI  - Preoperative evaluation of cardiovascular reserve in the elderly.

PMID- 8365270
TI  - Pressure-controlled inverse ratio ventilation. What have we learned?

PMID- 8365271
TI  - Excessive daytime sleepiness, upper airway resistance, and nocturnal arousals.

PMID- 8365272
TI  - Chronic Pneumocystis carinii pneumonia in AIDS.
AB  - The clinical and radiologic presentation as well as the macroscopic and
      histologic characteristics of lung parenchyma in three HIV-infected patients with
      Pneumocystis carinii pneumonia (PCP) are detailed. The distinguishing clinical
      feature in these patients was a prolonged stable clinical course of the disease
      over at least 4 to approximately 24 months. Serial chest radiographs in two
      patients demonstrated persistent focal radiographic lesions. In one patient blebs
      in both upper lobes were not recognized until thoracoscopy/thoracotomy was
      performed. Biopsy specimens of affected areas revealed extensive interstitial
      fibrosis, occasional giant cell reactions, and honeycombing. In view of the
      combined clinical, radiologic, macroscopic, and histologic patterns, it is
      suggested that these patients had a chronic productive form of PCP rather than
      the well-known acute presentation of the disease. Data from the literature
      confirm the impression that atypical histologic lesions of PCP, either of a
      productive or destructive nature, are frequently related to a prolonged clinical
      course. It is unlikely that prophylactic pentamidine contributes to this entity.
      Coinfection with other pathogens may have a role. Given the recent evidence on
      augmented release of tumor necrosis factor a (TNFa) in HIV-associated pulmonary
      complications, it is speculated that TNFa may be of importance in producing focal
      fibrosis in Pneumocystis infection of the lung.

PMID- 8365273
TI  - Concentric tracheal and subglottic stenosis. Management using the Nd-YAG laser
      for mucosal sparing followed by gentle dilatation.
AB  - Treatment of tracheal stenosis varies with the type and extent of the disease.
      Tracheostomy with stents, end-to-end anastomosis, or extensive reconstructive
      procedures often is required, especially when tracheomalacia is present. High
      recurrence rate is associated with relatively less invasive endotracheal
      treatments, such as bougie dilatation or total laser ablation. Mucosal sparing
      technique using Nd:YAG laser photodissection (LPD) and gentle dilatation (GD) can
      provide durable successful results in selected patients with benign concentric
      tracheal stenosis (CTS). In our study of 18 patients with CTS, 12 were
      successfully treated with Nd:YAG LPD and GD. Of these patients, eight required a
      single treatment while four required two or more treatments. No patients required
      new tracheostomy to carry out the procedure. Follow-up periods ranging from 2 to
      85 months (mean: 32.6 +/- 1.5 months) for 12 successfully treated patients have
      revealed no recurrence of their stenosis. Lengthy scars (> 1 cm) and
      tracheomalacia were the clinical features common to those patients who failed the
      treatment. We advocate the use of Nd:YAG LPD in conjunction with "gentle" rigid
      bronchoscopic dilatation as the initial treatment of CTS.

PMID- 8365274
TI  - Three cases of paradoxical vocal cord adduction followed up over a 10-year
      period.
AB  - Paradoxical vocal cord adduction (PVCA) is a rare disorder that may present with
      symptoms similar to asthma. Incorrect diagnosis may result in patients being
      unwittingly treated with prolonged high doses of antiasthma medication. PVCA
      probably forms part of a spectrum of uncommon and complex breathing disorders
      related to laryngeal dysfunction. Herein, we describe three cases of PVCA that
      illustrate the spectrum of clinical and physiologic presentation and the long
      term natural history over a 10-year follow-up period. We conclude that PVCA,
      contrary to previous reports, is not always a benign condition; it may feature
      marked hypoxemia, fail to respond to previously advocated therapeutic strategies,
      and can persist on a long-term basis.

PMID- 8365275
TI  - Infection in the transplanted and native lung after single lung transplantation.
AB  - OBJECTIVE: To analyze a single-center experience with infectious complications of
      single lung transplantation (SLT) with special emphasis on risk factors for
      infection in the transplanted and native lung. DESIGN: Consecutive case series.
      SETTING: University teaching hospital. PATIENTS: Fifteen consecutive SLT
      recipients (mean age, 43 years; 9 men and 6 women). Mean follow-up was 337 days.
      RESULTS: Fifteen patients had 24 infectious episodes (1.6 per patient) of which
      83 percent were life-threatening, 79 percent involved the lung, airway, or
      pleural space, and 79 percent occurred in the first 4 months after
      transplantation. Despite this high infectious morbidity, there were no infectious
      deaths. The most important infections were bacterial pneumonia (n = 10),
      cytomegalovirus (CMV) pneumonia (n = 5), and bronchial anastomotic infections (n
      = 3). Significant risk factors for bacterial pneumonia were a diagnosis of
      primary or secondary pulmonary hypertension (p < 0.05) and the presence of airway
      complications of stenosis or dehiscence (p < 0.05). No risk factors for overall
      lung infections were identified. The native lung was involved in 6 of 16 lung
      infections and was the exclusive site of infection in 4 cases. Underlying disease
      in the native lung may have predisposed to infection at that site by a mechanism
      of inadequate blood flow or impaired ventilation. Three bronchial anastomotic
      infections (Pseudomonas, Candida, Aspergillus) occurred, all with dehiscence of
      the anastomosis. These were highly morbid but resolved with antibiotics, stent
      placement, and surgical retention in two of the three cases. The five episodes of
      CMV pneumonia caused mild (four patients) or moderate (one patient) dysfunction
      and responded to antiviral agents without relapse. CONCLUSION: The frequency,
      complexity, and morbidity of infections after SLT were great, but most infections
      were manageable and good outcomes were achieved. A pretransplant diagnosis of
      pulmonary hypertension or posttransplant occurrence of bronchial stenosis or
      dehiscence were associated with a higher rate of bacterial pneumonia. The
      underlying disease in the native lung may predispose to infection at that site.

PMID- 8365277
TI  - Left main coronary flow velocity associated with stenosis. Evaluation by
      transesophageal color-guided pulsed Doppler technique.
AB  - To quantitatively estimate the extent of left main coronary artery (LMCA)
      stenosis, flow velocity of the LMCA in 33 patients was analyzed by a
      transesophageal color-guided pulsed Doppler technique. In 11 of 20 patients with
      LMCA stenosis, coronary flow velocity could be measured. The peak diastolic flow
      velocity at the stenotic segments was 90 +/- 32 (SD) cm/s which was significantly
      greater than that at the nonstenotic segments (n = 13; 34 +/- 8 cm/s; p < 0.01),
      and was correlated with the angiographically determined percentage of diameter
      stenosis of the vessel which ranged from 52 to 90 percent (r = 0.77; y = 6.34
      square root of x + 10.4; p < 0.01). These results suggest that acceleration of
      flow velocity at the point of stenosis may be correlated with the severity of the
      stenosis. Measurement of flow at the point of stenosis by transesophageal color
      guided pulsed Doppler technique may facilitate the quantitative assessment of
      LMCA stenosis, although its sensitivity requires improvement.

PMID- 8365276
TI  - The impact of intraoperative autotransfusion on cardiac surgery. A prospective
      randomized double-blind study.
AB  - The effect of intraoperative autotransfusion during coronary artery bypass
      grafting was studied in a randomized double-blind trial involving 38 patients.
      Nineteen patients had the collected RBCs washed and autotransfused
      (autotransfusion group), while the remaining patients had their washed cells
      discarded (control group). Postoperative hemoglobin and hematocrit values were
      similar. Exposure to banked blood was markedly decreased in the autotransfusion
      group compared with the control group. In addition, the mean volume of banked
      packed RBCs transfused per patient was significantly less in the autotransfusion
      group compared with the control group. Platelet utilization also was markedly
      decreased in the autotransfusion group. Cryoprecipitate and fresh frozen plasma
      utilization also was less in the autotransfusion group than in the control group,
      but this did not reach statistical significance. We conclude that the
      intraoperative use of autotransfusion decreases the volume of homologous blood
      products transfused, which results in reduced exposure of the patients to banked
      blood products.

PMID- 8365278
TI  - Predicting complications after pulmonary resection. Preoperative exercise testing
      vs a multifactorial cardiopulmonary risk index.
AB  - Recent studies have used preoperative cardiopulmonary exercise testing to improve
      risk assessment of pulmonary resection for lung cancer. These studies have
      demonstrated inconsistent correlation between peak oxygen uptake (VO2) and
      postoperative complications but have not systematically examined other methods of
      risk stratification. We analyzed the findings in 42 patients who had
      cardiopulmonary exercise testing prior to lung cancer resection. Preoperative
      clinical data combining pulmonary factors (obesity, productive cough, wheezing,
      tobacco use, ratio of the forced expiratory volume in 1 s over the forced vital
      capacity [FEV1/FVC] < 70 percent, and PaCO2 > 45 mm Hg), and an established
      cardiac risk index were used to generate a cardiopulmonary risk index (CPRI).
      When analyzed using the risk index, the incidence of postoperative complications
      increased with higher CPRI scores. Those with a CPRI of 4 or greater were 22
      times more likely to develop a complication, compared to a CPRI of less than 4 (p
      < 0.0001). We found that patients with a peak VO2 less than 500 ml/m2/min (body
      surface area) were 6 times more likely to experience a cardiopulmonary
      complication (p < 0.05). With multiple logistic regression analysis, peak VO2 was
      not an independent predictor of postoperative complications. Analysis also
      demonstrated that a CPRI of 4 or greater was associated with significant
      reductions in peak VO2. We conclude that both the peak VO2 during cardiopulmonary
      exercise testing and a multifactorial CPRI are highly predictive of complications
      after lung resection. Adding the peak VO2 did not enhance the risk estimation
      generated by the CPRI. The association between postoperative complications and
      peak VO2 may be explained by the correlation between identifiable cardiopulmonary
      disease (CPRI) and reduced oxygen uptake with exercise.

PMID- 8365279
TI  - Preoperative evaluation of cardiac failure and ischemia in elderly patients by
      cardiopulmonary exercise testing.
AB  - Major surgery in the elderly continues to have a high mortality rate.
      Preoperative myocardial ischemia is a known risk factor. Cardiac failure is also
      a risk factor, but is difficult to quantify objectively. One hundred eighty-seven
      elderly surgical patients were evaluated for cardiac failure by cardiopulmonary
      exercise testing (CPX). The overall mortality in these patients was 7.5 percent.
      If three deaths secondary to surgical causes are excluded, mortality was 5.9
      percent. There were 55 patients in whom the anaerobic threshold (AT) was less
      than 11 ml/min/kg; of these, 10 died, a mortality rate of 18 percent. There were
      132 patients with an AT of greater than 11 ml/min/kg and of these, 1 patient
      died, giving a mortality rate of 0.8 percent (p < 0.001). A low AT associated
      with preoperative ischemia resulted in the death of 8 of 19 patients, a mortality
      rate of 42 percent. When the ischemia was associated with the higher AT, then 1
      patient out of 25 died, a mortality rate of 4 percent (p < 0.01). Both
      preoperative ischemia and preoperative cardiac failure are independent risk
      factors for perioperative mortality in the elderly.

PMID- 8365280
TI  - Relationship of resting lung mechanics and exercise pattern of breathing in
      patients with chronic obstructive lung disease.
AB  - To investigate the influence of resting pulmonary mechanics on the pattern of
      breathing during exercise in chronic obstructive pulmonary disease (COPD), we
      studied 29 patients with moderate to severe COPD (FEV1 50 +/- 20 percent
      predicted), and 10 normal subjects. Lung mechanics were studied using esophageal
      balloon technique and body-box. Incremental exercise testing was performed to
      exhaustion. As minute ventilation (VE) increases, COPD patients with the highest
      pulmonary resistance (RI) or lowest elastic recoil pressure (PL), used a greater
      tidal volume/vital capacity ratio (VT/VC) than the COPD patients with more normal
      RL or lowest PL. To describe the breathing pattern during exercise, an
      exponential constant (K) describes the rates of increase in VT/VC ratio with
      increasing VE, calculated according to the equation VT = VC(1-e-KVE). The K
      values achieved by COPD patients were higher than in normal subjects. In
      addition, K value correlated negatively with the resting FEV1 and FVC of COPD
      patients. When COPD patients were grouped according to their K values, it was
      revealed that patients with high K values generated greater VT/VC ratio and also
      have the most abnormal resting lung mechanics. These results suggest that the
      exercise breathing pattern in COPD patients is significantly influenced by the
      degree of impairment of resting lung mechanics.

PMID- 8365281
TI  - Rapid resolution of hyperkinesis after exercise. Two-dimensional
      echocardiographic studies in normal subjects.
AB  - Abnormal wall motion detected with exercise echocardiography identifies ischemic
      myocardium, while normal myocardium exhibits hyperkinetic motion. The normal,
      hyperkinetic response to exercise is transient and is predictive of an excellent
      prognosis. However, there are few data on the duration of the hyperkinesis after
      peak exercise. Our purpose was to determine the time course of wall thickening
      after exercise in eight normal subjects with two-dimensional echocardiography.
      Percentage of wall thickening increased from 53 +/- 24 percent at baseline to 82
      +/- 24 percent at 0 to 2 min postexercise (p < 0.001 vs baseline) and then
      decreased to 64 +/- 27 percent at 2 to 4 min, and 54 +/- 20 percent at 5 to 7 min
      (both NS vs baseline). We conclude that (1) systolic wall thickening is maximal
      within the initial 2 min following peak exercise, and (2) accurate identification
      of hyperkinetic, normal myocardium with exercise echocardiography requires
      immediate postexercise imaging.

PMID- 8365282
TI  - Complications of anticoagulation for pulmonary embolism in low risk trauma
      patients.
AB  - Trauma patients are at significant risk for deep venous thrombosis (DVT) and
      pulmonary embolism (PE). Anticoagulation is standard therapy for DVT/PE, but may
      cause severe complications. We reviewed the course of 70 trauma ICU patients
      treated over a 28-month period. Thirty-six patients (51.4 percent) were treated
      by continuous IV heparin and/or oral warfarin. Of these, 13 patients (36 percent)
      developed complications requiring termination of anticoagulation. These included
      recurrent PE (four), subdural hematomas (three), hemothorax (two), heparin
      induced thrombocytopenia (one), hemorrhagic pericardial effusion (one),
      retroperitoneal hematoma (one), and sudden unexplained drop in hemoglobin and
      shock (one). All patients with subdural hematomas had no prior evidence of head
      injury on brain computed tomography. All patients with recurrent PE received
      adequate anticoagulation therapy. Age > 55 was associated with increased risk of
      complications (8 of 13; p = .02:chi 2). Thirty-four other patients (48.6 percent)
      received inferior vena caval filters with no related complications or deaths.
      Anticoagulation for DVT/PE should be used selectively in trauma patients and
      avoided in elderly patients. Such patients should undergo early caval filter
      placement.

PMID- 8365283
TI  - Anti-CEA immunoscintigraphy might be more useful than computed tomography in the
      preoperative thoracic evaluation of lung cancer. A comparison between planar
      immunoscintigraphy, single photon emission computed tomography (SPECT), and
      computed tomography.
AB  - While a clinical, plain radiographic, and bronchoscopic assessment yields most of
      the essential information needed in lung cancer, computed tomography (CT) of the
      thorax provides diagnostic information previously unobtainable, potentially
      capable of reducing the number of explorative thoracotomies. In a few recent
      studies, immunoscintigraphy with anti-carcinoembryonic antigen (anti-CEA)
      monoclonal antibodies (MA) has shown remarkable staging potential. To compare the
      diagnostic accuracy of the two techniques, we photoscanned with indium-111
      (111In)-labeled-F(ab')2 fragments of the murine anti-CEA MA FO23C5 45 patients,
      who were pathologically assessed for possible loco-regional extension of lung
      cancer. Both planar and single photo emission computed tomography (SPECT) images
      were obtained. Additionally, CT of the thorax (contiguous CT slices, 10 mm thick,
      from the lung apices to the upper abdomen), and other routine tests of
      preoperative evaluation were obtained. On the basis of 37 (N1, T3, and T4), 38
      (N2), and 12 (N3) pathologically documented sites, an accuracy of 65, 76, 92, 78,
      and 86 percent (SPECT images), and 62, 68, 42, 78, and 84 percent (CT images) was
      calculated (figures are relevant to N1, N2, N3, T3, and T4 disease,
      respectively). Thus, both techniques shared a significant margin of error in
      almost all the categories of evaluation; however, immunoscintigraphy showed
      equivalent, and, in the lymph node assessment, superior results to CT. A marginal
      improvement of diagnostic accuracy was recorded combining the three techniques in
      one case (SPECT plus planar immunoscintigraphic images), while there was no
      benefit in any possible integration of CT and immunoscintigraphic images. In
      patients with peripheral nonsquamous cell cancers, the accuracy of anti-CEA
      immunoscintigraphy was of 90 percent or higher. Variations in the modality of
      performing immunoscintigraphy, such as changes in the dose of antibody fragments
      to be injected, in the percentage of radiolabeling, or in the time of imaging,
      affected the quality of immunoscintigraphic series, and the consequent
      interpretation of findings. At the present time, there are very few reliable
      tests capable of selecting patients to proceed directly to thoracotomy or to
      receive some intermediate surgical test, such as a prior mediastinoscopy.
      Traditionally, CT has been this type of "filter-test." If current findings will
      be confirmed in future studies, anti-CEA immunoscintigraphy might replace CT in
      the evaluation of particular subgroups of patients, such as patients with
      peripheral nonsquamous cell bronchogenic carcinoma.

PMID- 8365285
TI  - Effect of corticosteroids on IL1 beta and TNF alpha release by alveolar
      macrophages from patients with AIDS and Pneumocystis carinii pneumonia.
AB  - The mechanisms by which corticosteroids (CCs) improve the outcome of AIDS
      patients with severe Pneumocystis carinii pneumonia (PCP) are unclear. We studied
      IL1 beta and TNF alpha release from alveolar macrophages (AMs) of patients
      receiving CCs for the treatment of PCP and also the effect of in vitro
      hydrocortisone on this release. Cytokine release from AMs of AIDS patients with
      pulmonary complications not receiving CCs (group 1) was compared with that from
      AM of those receiving CCs for PCP (group 2). The AMs of HIV-negative normal
      subjects (group 3) served as controls. All participants were nonsmokers or
      exsmokers. We found that lipopolysaccharide-stimulated AM from group 2 released
      significantly less interleukin-1 beta (IL1 beta) and tumor necrosis factor alpha
      (TNF alpha) than AM from group 1 and was similar to that from group 3. There was
      a significant positive correlation between the amount of TNF alpha and IL1 beta
      released. The presence of HC in the culture medium reduced in vitro IL1 beta and
      TNF alpha release from stimulated AM of the three groups. Thus, stimulated AMs
      from AIDS patients who receive CCs for treatment of PCP release significantly
      less IL1 beta and TNF alpha than AM from patients not receiving CCs. These
      findings suggest a mechanism by which CCs improve the outcome of AIDS patients
      with PCP.

PMID- 8365284
TI  - A randomized comparison of once-monthly or twice-monthly high-dose aerosolized
      pentamidine prophylaxis.
AB  - RESULTS: Ten of the 146 (7 percent) evaluable subjects developed PCP during the
      year study period, and there was no difference in the efficacy of the two
      regimens. Among patients receiving secondary prophylaxis, the attack rate of PCP
      at 1 year was 11 percent. This compares favorably with a 1-year attack rate of 19
      percent in similar patients receiving standard dose (300 mg) prophylaxis and
      suggests, but does not prove, a dose-response effect. Concentrations of
      pentamidine in BAL fluid were not significantly different among the three lobes
      of the lung. Intrapulmonary pentamidine did not accumulate during the year of
      study. Aerosolized pentamidine was associated with a marginal but statistically
      significant increase in the residual volume, decreased flow rates, and increased
      airway reactivity. OBJECTIVE: The optimal regimen of aerosolized pentamidine in
      unknown. Published data suggest that there is a dose-response effect and that the
      occurrence of Pneumocystis carinii pneumonia (PCP) has been associated with
      prolongation of the interval between doses. The purpose of this study was to
      compare the efficacy, pharmacokinetics, and physiologic effects of two high-dose
      regimens of aerosolized pentamidine prophylaxis. DESIGN: Prospective, randomized
      study of 300 mg twice monthly vs 600 mg once monthly during a 1-year observation
      period. Pentamidine concentrations in plasma and bronchoalveolar lavage (BAL)
      fluid were measured and serial pulmonary function was measured. SETTING: A large
      teaching hospital in San Francisco. PATIENTS: One hundred fifty-one adult (age >
      18 years) men with human immunodeficiency virus infection. Of 146 evaluable
      patients, prophylaxis was primary (no prior PCP) in 108 (75 percent) and
      secondary (one prior episode of PCP) in 38 (25 percent). MEASUREMENTS: Date and
      diagnosis of PCP, occurrence of drug toxicity, pulmonary function testing, and
      concentrations of pentamidine in BAL and plasma. CONCLUSIONS: The data suggest,
      but do not prove, that a dose-response effect has been demonstrated, and that
      high-dose aerosolized pentamidine may further reduce the attack rate of PCP.
      These preliminary observations should be confirmed in a double-blind trial
      comparing 300 mg with 600 mg administered once monthly. The clinical relevance of
      the adverse pulmonary effects is unclear and requires further investigation.

PMID- 8365286
TI  - Mechanical ventilation for Pneumocystis carinii pneumonia in patients with the
      acquired immunodeficiency syndrome. Is the prognosis really improved?
AB  - The mortality rate among patients with human immunodeficiency virus (HIV)
      requiring mechanical ventilation (MV) for acute respiratory failure (ARF)
      secondary to Pneumocystis carinii pneumonia (PCP) is still a matter of
      discussion. For some authors, it is in the 50 percent range, while for others the
      prognosis is grim, with virtually no survivors. The aim of this retrospective
      study conducted between January 1987 and January 1992 was to analyze the outcome
      of such patients. We studied 33 patients, 29 men and 4 women (38.6 +/- 9.9 years,
      21 homosexuals, 8 intravenous drug users, 3 transfusion related, 1 heterosexual)
      infected by HIV for at least 19.7 +/- 21.6 months. It was the first PCP episode
      in all but 2 patients and the diagnosis was made by bronchoalveolar lavage (n =
      32) or lung biopsy specimen (n = 1). Only three patients were receiving primary
      prophylaxis for PCP (trimethoprim-sulfamethoxazole [TMP-SMZ], n = 2; pentamidine,
      n = 1). Pneumocystis carinii pneumonia was the first manifestation of AIDS in
      nine patients. The duration of symptoms prior to treatment was 19.6 +/- 11.3
      days. At the time of hospital admission, laboratory findings were as follows:
      PaO2 = 40.7 +/- 7.8 mm Hg on room air; serum LDH = 1,172 +/- 792 IU/L; T4 cell
      count = 60.2 +/- 67/mm3. Mechanical ventilation was always required for ARF,
      which was never induced by bronchoscopy. The interval between treatment and MV
      was 8.1 +/- 6.5 days and the duration of MV was 11.4 +/- 9.9 days. The patients
      were classified into 3 groups on the basis of the duration and type of treatment
      before MV, as follows: group 1, n = 10: TMP-SMZ (20-100 mg/kg) IV and
      methylprednisolone (MP) < 5 days before MV; group 2, n = 4: TMP-SMZ > or = 5 days
      and MP < 5 days; group 3, n = 19: TMP-SMZ and MP > or = 5 days before MV. (The MP
      dose was as follows: 240 mg/d once a day from day 1 to day 3; 120 mg/d from day 4
      to day 6; and 60 mg/d from day 7 to day 9.) Despite MV, TMP-SMZ, and MP, death
      secondary to PCP-related ARF occurred in 81.9 percent of patients, 20 +/- 4.8
      days after the beginning of treatment and 11.4 +/- 9.9 days after the beginning
      of MV. Six patients survived, five in group 1 and one in group 3.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8365287
TI  - Nasal continuous positive airway pressure in decompensated hypercapnic
      respiratory failure as a complication of sleep apnea.
AB  - Cardiopulmonary failure resulting from progression of obstructive sleep apnea
      (OSA) is treated with endotracheal intubation and mechanical ventilation. This
      study was conducted to determine whether the use of nasal continuous positive
      airway pressure (CPAP) would rapidly reverse changes in mental status and
      hypercapnic acidosis in such patients with decompensated hypercapnic respiratory
      failure resulting from OSA. Six morbidly obese patients (mean weight, 159 +/- 19
      kg) were treated with nasal CPAP and supplemental oxygen. Within 24 h of this
      treatment, there was a significant increase in pH, from a baseline mean of 7.23
      +/- 0.03 to 7.35 +/- 0.01 (p < 0.01), and the mean PaCO2 fell from 80 +/- 4 mm Hg
      to 64 +/- 4 mm Hg (p < 0.01). In addition, there was a dramatic improvement in
      mental status within 24 h of therapy with nasal CPAP. None of the patients
      required intubation and mechanical ventilation. There were no complications
      attributable to the CPAP delivered by nasal mask. We conclude that CPAP delivered
      by nasal mask can be safe and effective in rapidly reversing changes in mental
      status and hypercapnic acidosis in this group of patients with severe respiratory
      failure, and nasal CPAP obviates the need for endotracheal intubation and
      mechanical ventilation.

PMID- 8365288
TI  - The association between hypertension and sleep apnea in obese patients.
AB  - Strong associations have been demonstrated between hypertension (HTN) and
      obesity, and obesity and sleep apnea (SA). However, it is unclear whether
      previously suggested relationships between HTN and SA were based on causal
      mechanisms, or rather, were confounded by obesity. To investigate whether SA may
      be an independent predictor of HTN, we measured respiration during sleep and BP
      in 19 participants in a hospital-based weight control program. Additionally,
      subjects underwent cephalometry, measurement of weight and hip circumferences,
      and pulmonary function tests. Studies were repeated in 14 subjects following
      weight loss. Subjects consisted of 9 men and 10 women, ages 43 +/- 11 years (mean
      +/- SD), and weight of 114 +/- 20 kg. Hypertension (diastolic BP > 95 mm Hg,
      systolic BP > 160 mm Hg, or a report of current use of an antihypertensive
      medication) was present in 6 (32 percent) subjects. Sleep apnea was more
      prevalent among the hypertensive (5/6; 83 percent) than normotensive (2/13; 15
      percent) subjects (p < 0.01); respiratory disturbance index (RDI) was 42.4 +/-
      16.0 vs 6.2 +/- 2.3 (p < 0.01) in these groups. Compared with normotensive
      subjects, hypertensive subjects were of similar weight, but had greater central
      obesity and had lower levels of vital capacity. Regression analyses demonstrated
      that RDI was the strongest independent predictor of BP level, accounting for
      approximately 60 percent of the variability in this measurement. Following weight
      loss, BP and RDI both significantly declined, soft palate width decreased, and
      vital capacity increased. Thus, in this group of obese subjects, BP level was
      associated most significantly with the magnitude of sleep-related respiratory
      disturbances. The obese subjects who are most likely to have SA and HTN are male
      and/or subjects with greater central obesity and lower vital capacity.

PMID- 8365289
TI  - A cause of excessive daytime sleepiness. The upper airway resistance syndrome.
AB  - Subjects with isolated complaints of chronic daytime sleepiness are usually
      classified as "idiopathic hypersomniacs" and treated symptomatically. A group of
      these subjects was investigated during nocturnal sleep and daytime naps. In a
      subgroup of them, sleep was fragmented by very short alpha EEG arousals
      throughout the sleeping period. These short arousals are usually ignored in sleep
      analyses, but their impact is significant (in the 15 subjects identified with the
      syndrome, the mean sleep latency in multiple sleep latency tests was 5.1 +/- 1
      min). These arousals are directly related to an abnormal increase in respiratory
      efforts during sleep (the mean peak inspiratory esophageal pressure measured in
      our subjects in the respiratory cycle just preceding a transient arousal was -33
      +/- 7 cm H2O). Typically, an arousal occurs within one to three breaths of flow
      limitation associated with abrupt but limited reduction in tidal volume (ie,
      abnormal increase in upper airway resistance during sleep). The arousal restores
      normal breathing. Snoring was noted in association with these transient arousals
      in 10 of the 15 subjects; however, snoring was neither sufficient nor necessary
      for the identification of the clinical syndrome. Both sexes were equally
      represented in the affected group. All studied subjects had upper airway anatomy
      that was mildly abnormal. Nasal continuous positive airway pressure, used as an
      experimental tool, eliminated the daytime sleepiness (multiple sleep latency mean
      score = 13.5 min), the transient arousals (mean alpha EEG arousal index decreased
      from 31.3 +/- 12.4 to 8 +/- 2 per hour of sleep), and the abnormal upper airway
      resistance. Chronic daytime sleepiness is a major cause of social, economic, and
      medical impairment. Recognition of this syndrome and its cause is important, as
      specific treatments can be developed to eliminate the problem.

PMID- 8365290
TI  - Preflight medical screenings of patients. Analysis of health and flight
      characteristics.
AB  - We evaluated the demographic, medical, and flight characteristics of 1,115
      passengers who were routinely referred for preflight medical screening by a major
      domestic air carrier. The largest category consisted of 892 patients who
      requested in-flight oxygen therapy for cardiopulmonary conditions, of which COPD
      and cardiac disorders were the most frequent indications; 561 of these patients
      were 60 years or older. Overall, 386 passengers were recently hospitalized, 911
      were using medications, 657 were receiving oxygen therapy, and 761 had flown
      previously. In the group using in-flight oxygen therapy, the average flight
      duration was 236 min and layover time, 87 min. These findings indicate that large
      numbers of patients undergoing preflight screening are receiving medication and
      have a wide range of medical diagnoses and variable health status. We conclude
      that preflight medical screening and counselling can be important and helpful in
      assuring safe and comfortable air travel in this patient population.

PMID- 8365291
TI  - Relationship between presentation of sarcoidosis and T lymphocyte profile. A
      study in bronchoalveolar lavage fluid.
AB  - One hundred patients with histologically verified sarcoidosis were studied. They
      were divided into three groups, based on their clinical presentation and smoking
      status. Group A consisted of patients whose disease was detected by routine chest
      x-ray film, without symptoms; group B included those with respiratory and general
      constitutional symptoms; and group C included patients with erythema nodosum
      and/or arthralgia and hilar lymphadenopathy. Group A showed an increased CD4/CD8
      ratio of 4.7 +/- 1.1; group B, 8.0 +/- 1.2; and group C counted for the highest
      ratio of 10.7 +/- 1.5. Cigarette smoking modifies the immunologic bronchoalveolar
      lavage (BAL) fluid sample profile, since alveolitis was less pronounced in
      smokers. In addition, BAL fluid samples obtained from sarcoidosis patients with
      hilar lymphadenopathy showed the most characteristic features of alveolitis,
      suggesting a disseminated instead of a local immune response. Therefore, the
      clinical presentation of sarcoidosis and the smoking status of a sarcoidosis
      patient are crucial for interpreting individual lavage analysis results.

PMID- 8365292
TI  - Circadian variation of bronchial caliber and antigen-induced late asthmatic
      response.
AB  - To study whether circadian variation of bronchial caliber participates in causing
      late asthmatic response (LAR), house-dust inhalation was made at 10 AM and 6 PM
      on separate days in 6 house-dust-sensitive asthmatic children aged 8 to 13 years.
      Bronchial obstruction was assessed through measurements of FEV1 at 4-h intervals
      from 24 h before to 24 h after the inhalation. The LAR, which is a 15 percent or
      greater decrease in FEV1 from the value at the same hour of the previous day,
      occurred 4 h or later after the inhalation in all challenges. The mean (+/- SD)
      time to the occurrence of the lowest FEV1 (maximum LAR) following the morning
      inhalation was 14.7 +/- 2.1 h versus 10.0 +/- 2.2 h following the evening
      inhalation (p < 0.05). Regardless of the hour of inhalation, FEV1 after the
      inhalation was lowest or near-lowest at 2 AM in all. Therefore, the maximum LAR
      was indistinguishable from the trough of further amplified circadian variation in
      FEV1 following the inhalation. These findings suggest that the downward arm of
      circadian variation may partially participate in causing the LAR.

PMID- 8365293
TI  - No increase in plasma histamine during PAF-induced airway obstruction in allergic
      asthmatics.
AB  - To investigate the possible role of mast cell or basophil histamine release in
      mediating platelet-activating factor (PAF) airway obstruction, we studied the
      effect of inhaled PAF (30 micrograms, single dose) on plasma histamine, bronchial
      caliber, and leukocyte and platelet counts in six patients with mild or moderate
      allergic asthma (mean age, 27 +/- 1.3 years; mean FEV1, 95 +/- 5 percent of
      predicted; mean PC20 methacholine, 1.46 +/- 0.36 mg/ml). Specific conductance
      (SGaw) FEV1, FEF25-75 percent, differential leukocyte and platelet counts, and
      plasma histamine (radioimmunoassay) were measured before and 5, 10, 15, and 20
      min after PAF inhalation. Mean basal plasma histamine level was 0.28 +/- 0.04
      ng/ml. Inhalation of PAF caused a fall in SGaw peaking at 5 min (43 +/- 9
      percent) and a fall in FEV1 and FEF25-75 peaking at 10 min (19 +/- 10 percent and
      30 +/- 13 percent, respectively). There was also a rapid and transient fall in
      circulating neutrophils at 5 min (from 3,096 +/- 204/mm3 to 2,551 +/- 158/mm3, p
      < 0.05) followed by a rebound neutrophilia. In contrast, plasma histamine level
      did not change significantly at any time measured. Conversely in the same
      asthmatics, a rapid rise in plasma histamine level (from 0.29 +/- 0.03 ng/ml at
      baseline to 0.53 +/- 0.06 ng/ml at 5 min; p < 0.01) was observed after an
      allergenic challenge (Dermatophagoides pteronyssinus) causing a fall in FEV1
      peaking at 10 min (22 +/- 4 percent). Thus, inhaled PAF may induce airway
      obstruction and neutropenia in asthmatics without any significant change of
      plasma histamine level. These results indicate that it is unlikely that lung mast
      cells or basophils degranulate during PAF-induced bronchoconstriction.

PMID- 8365294
TI  - Occurrence of occupational asthma.
AB  - To estimate the percentage of adult asthmatics with occupational asthma in
      Michigan, a sample of 94 patients, aged 20 to 65 years, who were discharged from
      one of three Michigan hospitals in 1990 with the primary diagnosis of asthma were
      interviewed. The patients were classified using the National Institute for
      Occupational Safety and Health (NIOSH) criteria as having either probable
      occupational asthma, possible occupational asthma, or not having occupational
      asthma. Three percent of the adult asthmatics interviewed met the criteria for
      having probable occupational asthma. One patient from each hospital had probable
      occupational asthma. Fifteen of 60 patients (25 percent) from hospital A, 3 of 25
      patients (12 percent) from hospital B, and 2 of the 9 patients (22 percent) from
      hospital C had probable or possible occupational asthma. After adjusting for the
      difference in response rate among patients from the three hospitals, the
      percentage of adult asthmatics in Michigan whose asthma is caused by work
      exposure is estimated to be between 3 percent and 20.2 percent. In contrast, 25.5
      percent of the patients stated their asthma was caused by bad working conditions.
      If these percentages were generalizable to the whole state, then according to our
      survey 330 to 2,222 or by self-reports of the patients, 2,800 of the 11,000
      hospital discharges per year in Michigan for asthma among adults could be
      attributed to a work exposure.

PMID- 8365295
TI  - Clinical and socioeconomic features of subjects with red cedar asthma. A follow
      up study.
AB  - A follow-up study of 128 subjects with red cedar asthma was conducted to evaluate
      the clinical and socioeconomic impact of the disease in determining the working
      status of the subjects after the diagnosis was made. The results suggest that the
      severity of asthma is not the main determinant of working status. Comparing the
      data at diagnosis and at follow-up examination, we found that the persistence of
      exposure resulted in a deterioration in the asthma despite the use of more
      medications. Subjects who were working were younger and had a larger number of
      dependents than the subjects who were not working at the time of the follow-up
      examination. We conclude that the socioeconomic factors are important in
      determining the working status of subjects with red cedar asthma. To prevent
      severe impairment and disability, there should be more economic incentives for
      these subjects to choose other jobs.

PMID- 8365296
TI  - The effects of inhalation of grain dust extract and endotoxin on upper and lower
      airways.
AB  - To characterize the short-term effects of grain dusts on pulmonary function,
      mucosal inflammation, and systemic responses, four women and three men inhaled
      nebulized corn and soybean dust extracts, endotoxin diluted with Hanks' balanced
      salt solution (HBSS), and HBSS. Subjects were volunteers recruited via newspaper
      advertisement and were required to be healthy, nonasthmatic, nonatopic never
      smokers. The mean age was 26.9 years (range, 19 to 36 years). Using a randomized,
      double-blind, crossover design, each subject was challenged with each of the 4
      substances with at least 10 days between challenges. Serial spirometry,
      peripheral blood leukocyte and differential cell counts, and 24-h postchallenge
      nasal lavages were performed. Extracts were produced by mixing 3 g of the corn or
      soybean dust with 30 ml HBSS followed by shaking for 60 min, centrifugation, then
      filter sterilization. The endotoxin solution was produced by mixing lyophilized
      Escherichia coli endotoxin (serotype 0111:B4) with HBSS to attain a final
      concentration of 7 mg/L, which was the same as the concentration of endotoxin in
      both grain dust solutions. The pH of all solutions and unmixed HBSS was adjusted
      to 5.8, which was the native pH of the soybean dust extract. Subjects were
      challenged with 0.08 ml/kg of each substance, resulting in a range of endotoxin
      doses of 30 to 60 micrograms, similar to that which a worker might inhale over
      the course of one workshift. The lowest mean percentage baseline FEV1 (+/- SD)
      after inhalation challenge was 99.2 +/- 2.1 for HBSS, and it was significantly
      lower for endotoxin (90.1 +/- 8.5, p = 0.03), corn dust extract (93.1 +/- 4.3, p
      = 0.02), and soybean dust extract (96.2 +/- 3.7, p = 0.03). In addition, a
      peripheral blood leukocytosis developed after exposure to all three endotoxin
      containing solutions (p < 0.05), yet a lower peripheral blood lymphocyte count
      was found only after inhalation of corn dust extract (p = 0.02). Interestingly,
      this was associated with a higher nasal lavage lymphocyte count after inhalation
      of corn dust extract (p = 0.03). Neither the decrease in peripheral blood
      lymphocytes nor the increase in nasal lymphocytes were found after inhalation of
      soybean dust extract or endotoxin. Our results indicate that extracts of grain
      dusts have physiologic effects similar to endotoxin. However, in spite of the
      same endotoxin levels, the effects of corn dust extract appear to have different
      biologic activity than either soybean dust extract or endotoxin.

PMID- 8365297
TI  - Magnesium bolus or infusion fails to improve expiratory flow in acute asthma
      exacerbations.
AB  - HYPOTHESIS: Intravenous magnesium sulfate improves objective measures of
      expiratory flow in patients with acute severe exacerbations of asthma. DESIGN:
      Randomized, double-blind, placebo-controlled trial. SETTING: Urban emergency
      department. PARTICIPANTS: Forty-eight asthmatic patients aged 18 to 60 years with
      initial peak expiratory flow rate (PEFR) < 200 L/min who failed to double their
      initial PEFR after two standardized albuterol treatments. INTERVENTIONS: Subjects
      were randomized to three groups: a loading dose of magnesium sulfate, 2 g IV over
      20 min followed by 2 g/h over 4 h (infusion), magnesium sulfate, 2 g over 20 min
      followed by placebo infusion (bolus), or placebo loading dose and infusion
      (placebo). All subjects received standardized aminophylline and steroid therapy.
      MEASUREMENTS: The PEFR and FEV1 were measured at the start of the loading dose,
      and 20, 50, 80, 140, 200, and 260 min later using a water-displacement
      spirometer. Changes from baseline were compared by one-way analysis of variance
      for repeated measures. RESULTS: Magnesium sulfate administration did not at any
      time significantly improve either FEV1 (F = 0.036, p = 0.96) or PEFR (F = 0.51, p
      = 0.61). This study had the power to detect a PEFR difference of 26 L/min and a
      FEV1 difference of 0.19 L between groups (beta = 0.20, alpha = 0.05 two-tailed
      significance). CONCLUSION: Use of IV magnesium sulfate in addition to standard
      therapy does not provide clinically meaningful improvement of objective measures
      of expiratory flow in patients with moderate to severe asthma exacerbations.

PMID- 8365298
TI  - A comparison of albuterol administered by metered dose inhaler (and holding
      chamber) or wet nebulizer in acute asthma.
AB  - BACKGROUND: Comparative studies of albuterol by wet nebulizer or metered dose
      inhaler have tested fixed doses of medications. We compared the dose-response
      relationship to albuterol by wet nebulization or metered dose inhaler in acute
      asthma. METHODS: Randomized, double-blind, placebo-controlled trial. Patients
      with acute asthma received either albuterol, 0.4 mg, by metered dose inhaler (and
      holding chamber) or albuterol, 2.5 mg, by wet nebulizer every 30 min until
      maximal bronchodilation. Forty patients (forced expiratory volume in 1 s [FEV1]:
      1.15 +/- 0.43 L; 36 +/- 12 percent predicted) received metered dose inhaler and
      40 others (FEV1: 1.08 +/- 0.52 L; 35 +/- 16 percent predicted) received wet
      nebulization. RESULTS: Twenty-six patients (65 percent) receiving metered dose
      inhaler and 30 (75 percent) receiving wet nebulization achieved maximal
      bronchodilation after two doses. Almost all reached maximal bronchodilation by
      four doses. The FEV1 improved by 0.72 +/- 0.49 L for metered dose inhaler and
      0.68 +/- 0.61 L for wet nebulizer (p = 0.71). A significant linear relationship
      was seen in both groups (metered dose inhaler r = 0.94; wet nebulizer r = 0.98)
      between the log dose of albuterol and change in FEV1. About 1/6 the wet nebulizer
      dose of albuterol was needed to achieve similar response to the metered dose
      inhaler. CONCLUSIONS: Albuterol by metered dose inhaler provided similar
      bronchodilation to that achieved by wet nebulization in patients with acute
      asthma. The cumulative dose-response technique is applicable in the emergency
      department setting and is helpful in comparing the relative utility of various
      bronchodilator regimens.

PMID- 8365299
TI  - The effect of high doses of inhaled salbutamol and ipratropium bromide in
      patients with stable cystic fibrosis.
AB  - The effect of large doses of salbutamol (S) and ipratropium bromide (IB) were
      tested in a double-blind, randomized, crossover study. Nine patients with cystic
      fibrosis (CF), aged 12.8 +/- 2 years (mean +/- SE), were studied for 8 h on 2
      separate days. Pulmonary function tests (PFTs) included spirometry (FEV1), lung
      volumes (FRC), and airway resistance (Raw) measured by body plethysmography.
      Heart rate (HR) and oxygen saturation (SaO2) were measured before each test. On 1
      day patients received S 200 micrograms, S 400 micrograms, and IB 80 micrograms,
      by inhalation at 45-min interval (sequence A). On the other day, the sequence was
      IB 80 micrograms, S 200 micrograms, and S 400 micrograms (sequence B). The PFTs
      were obtained at baseline, 45 min after each inhalation, and 4 and 8 h after
      baseline measurements. Baseline PFTs (mean +/- SE) were not significantly
      different on the 2 study days (FEV1, 1.48 +/- 0.1 vs 1.42 +/- 0.1 L; FRC, 2.77 +/
      0.6 vs 2.87 +/- 0.6 L; Raw, 4.04 +/- 0.2 vs 4.00 +/- 0.3 cm H2O/L/s). The FEV1
      and Raw improved from baseline after each inhalation, and at 4 and 8 h during
      both days (p < 0.05). Forty-five minutes after S 200 micrograms, plus S 400
      micrograms, FEV1, FRC, and Raw were not significantly different compared with the
      values 45 min after IB 80 micrograms, plus S 200 micrograms (1.67 +/- 0.1 vs 1.63
      +/- 0.1 L; 2.81 +/- 0.6 vs 2.65 +/- 0.5 L; and 2.98 +/- 0.2 vs 2.66 +/- 0.1 cm
      H2O/L/s, respectively). The PFTs were not significantly different after maximal
      doses of IB (80 micrograms) compared with S (600 micrograms). The HR and SaO2
      were not significantly different from baseline throughout the study period. These
      results indicate that both single and sequential therapy have a similar acute
      bronchodilator effect provided that large doses are used. We speculate that
      adrenergic and muscarinic pathways are equally important in airflow obstruction
      in patients with CF.

PMID- 8365300
TI  - Severe COPD and acute respiratory failure. Correlates for survival at the time of
      tracheal intubation.
AB  - The recognition of a reversible cause for acute respiratory failure (ARF) is
      frequently difficult in patients with severe chronic obstructive pulmonary
      disease (COPD). We sought to identify clinical findings present at the time of
      tracheal intubation that were associated with successful weaning and short-term
      survival among a population of male veterans with severe COPD. Over a 5-year
      period (1987 to 1991), 39 episodes of ARF requiring mechanical ventilation (MV)
      were identified in 33 men with severe COPD. All the patients had a baseline FEV1
      < 1 L. Univariate analysis suggested a higher serum albumin level and absence of
      pulmonary infiltrates on chest radiography distinguished survivors (weaned from
      MV for 72 h) from nonsurvivors (died while undergoing MV or within 72 h of
      weaning). Multivariate analysis revealed the absence of pulmonary infiltrates on
      initial chest radiography was the strongest correlate for survival. To examine
      the significance of these correlates in ARF complicating milder COPD, 19 patients
      with lesser degrees of chronic airways obstruction and ARF were also studied.
      Unlike patients with severe COPD, the presence or absence of pulmonary
      infiltrates on chest radiography was not correlated with survival in patients
      with milder chronic airways obstruction. Analyzing all COPD patients with ARF,
      the mortality risk associated with the presence of pulmonary infiltrates on chest
      radiography increased dramatically with declining baseline lung function.
      Mortality risk ratio analysis revealed the greatest likelihood for survival was
      predicted by a higher baseline FEV1 and the absence of pulmonary infiltrates on
      chest radiography. The extent of baseline airways obstruction alone was not
      correlated with short-term survival in either group. These observations suggest
      that in the subset of patients with severe COPD and ARF, the presence of
      pulmonary infiltrates on chest radiography at the time of tracheal intubation may
      be associated with less likelihood for survival. An exacerbation of COPD may
      infrequently be the terminal illness in these patients.

PMID- 8365301
TI  - Usefulness of transesophageal echocardiography in the treatment of critically ill
      patients.
AB  - To evaluate the usefulness of transesophageal echocardiography (TEE) in the
      treatment of critically ill patients, 80 patients (51 male and 29 female; mean
      age, 53 years) undergoing both transthoracic echocardiography (TTE) and TEE were
      studied in a 2-year period. Of these, 48 patients were studied in the ICU, while
      the other 32 patients were directly referred from the emergency departments.
      Indications for the study included suspected aortic dissection (34 patients),
      hemodynamic instability (22 patients), suspected cardiac source of embolism (11
      patients), evaluation of the severity of mitral regurgitation (7 patients), and
      suspected infective endocarditis (6 patients). The probe was passed successfully
      in 78 of 80 attempts (98 percent). No significant complications were recorded
      during the transesophageal echocardiographic study. Transesophageal
      echocardiography provided critical information that was not obtained by TTE in 39
      of 78 studies (50 percent, p < 0.005). Cardiac surgery was prompted by TEE
      findings in 14 patients (18 percent) and these findings were all confirmed at
      operation. Transesophageal echocardiography was a safe, well-tolerated, and
      valuable diagnostic approach for the rapid detection of specific cardiac
      abnormalities in patients with critical illness; TEE should be considered in the
      treatment of critically ill patients especially when TTE provided inadequate
      information.

PMID- 8365302
TI  - The addition of sighs during pressure support ventilation. Is there a benefit?
AB  - The purpose of this study was to determine if sigh breaths delivered during
      pressure support ventilation (PSV) were beneficial in maintaining arterial
      oxygenation (PaO2) and pulmonary mechanics. Ten patients being weaned from
      mechanical ventilation in the PSV mode were studied. All patients were ventilated
      for 4 h without sighs, 4 h with sighs, and again for 4 h without sighs. During
      each 4-h period, continuous measurements of ventilatory volumes and airway
      pressures were accomplished. At the end of each 4-h period, an arterial blood gas
      determination was obtained. There were no statistically significant differences
      in any of the measured variables during the different periods of ventilation. We
      conclude that the sigh breath is of no benefit during PSV.

PMID- 8365304
TI  - Closure of an intermediate care unit. Impact on critical care utilization.
AB  - We studied the effect of closing a six-bed intermediate care area (ICA) on
      utilization of a multidisciplinary critical care unit (CCU). Data were collected
      on all admissions to the 7-bed CCU for 9 months prior to ICA closure (n = 217)
      and compared with 9 months after CCU expansion (7 to 9 beds) and ICA closure (n =
      407). Nonemergency CCU admissions increased from 41 to 112 after ICA closure (p <
      0.03). Mean APACHE II score within 24 h of admission decreased from 21.9 +/- 7.4
      to 18.6 +/- 7.4 (p < 0.0001). The proportion of patients with APACHE II score <
      15, increased from 30/217 to 136/407 accounting for an increase from 5.4 percent
      to 12.7 percent of CCU days (p < 0.0001). Nursing workload at the time of
      discharge from CCU decreased (p < 0.0001). The ICA closure altered CCU admission
      and discharge decision-making. "Low-risk" admissions increased and patients
      remained in the CCU until they required less nursing care. One factor determining
      utilization of a CCU is the facilities available outside the unit. A CCU
      management system is especially important when a wide range of illness severity
      is present.

PMID- 8365303
TI  - Cardiorespiratory effects of pressure-controlled ventilation with and without
      inverse ratio in the adult respiratory distress syndrome.
AB  - To assess the cardiorespiratory effects of pressure-controlled ventilation (PCV)
      and pressure-controlled inverse ratio ventilation (PC-IRV), we compared pressure
      controlled ventilation with an inspiratory-to-expiratory time ratio (I/E) of 1/2
      (PCV) and of 2/1 (PC-IRV) to volume-controlled ventilation (VCV) with an I/E of
      1/2 in 10 patients suffering from the adult respiratory distress syndrome. In all
      modes, the inspiratory oxygen fraction, tidal volume, respiratory rate, and total
      positive end-expiratory pressure (PEEPt = applied PEEP + intrinsic PEEP) were
      kept constant. Each ventilatory mode was applied for 1 h in a randomized order.
      No significant differences in PaO2 were observed among the three modes. The PaCO2
      was lower (p < 0.05) in PC-IRV (39 +/- 4 mm Hg) than in PCV (43 +/- 5 mm Hg) and
      in VCV (45 +/- 5 mm Hg). The peak airway pressure was significantly lower in PC
      IRV than in PCV (p < 0.05) and in PCV than in VCV (p < 0.05), but plateau
      pressure was not different in the 3 modes. The mean airway pressure (mPaw) was
      significantly higher (p < 0.05) in PC-IRV (21.4 +/- 0.7 cm H2O) than in PCV (17.1
      +/- 0.7 cm H2O) and VCV (16.4 +/- 0.5 cm H2O). As a consequence of this increased
      mPaw, PC-IRV induced a decrease in cardiac index (CI) (3.3 +/- 0.2 vs 3.7 +/- 0.2
      L/min/m2 in VCV; p < 0.05) and hence in oxygen delivery (DO2) (424 +/- 28 vs 469
      +/- 38 ml/min/m2 in VCV; p < 0.05). Our results suggest that neither PCV nor PC
      IRV bring any benefit over VCV in terms of arterial oxygenation. Moreover, the
      increase in mPaw induced by PC-IRV may be deleterious to the CI and DO2.

PMID- 8365305
TI  - Double-blind, placebo-controlled trial of antithrombin III concentrates in septic
      shock with disseminated intravascular coagulation.
AB  - BACKGROUND: Septic shock is frequently complicated by a syndrome of disseminated
      intravascular coagulation (DIC). Numerous uncontrolled clinical studies have
      reported that antithrombin III (ATIII) substitution might prevent DIC and death
      in septic shock. METHODS: We conducted a randomized double-blind placebo
      controlled trial in patients with a documented septic shock and DIC. The patients
      received either a placebo or ATIII (90 to 120 IU/kg in loading dose, then 90 to
      120 IU/kg/d during 4 days). Administration of fresh frozen plasma, platelets, and
      fibrinogen concentrates was restricted to patients with hemorrhages and severe
      decreases in prothrombin time, platelet count, and fibrinogen levels. RESULTS:
      Thirty-five patients entered the study (18 placebo, 17 ATIII). Both groups were
      well balanced for all demographic, hemodynamic, and biologic data. Three patients
      were excluded before the treatment allocation code was broken. In the ATIII
      group, ATIII levels were rapidly corrected and remained over normal levels until
      day 10; sequential protein C and protein S levels were not modified. The duration
      of DIC was significantly reduced: in the ATIII group, 64 percent of patients were
      cured of DIC at day 2, and 71 percent were cured at the end of treatment vs in
      the placebo group, 11 percent (p < 0.01) and 33 percent (p < 0.05), respectively.
      In the 32 included patients, the mortality in ICU was reduced by 44 percent in
      the ATIII group (p = 0.22, NS). Care loads and transfusion requirements were not
      different. No side effect was observed. CONCLUSIONS: Mortality was reduced by 44
      percent in this trial, but the difference did not reach the statistical
      significance. Circulating protein C and protein S levels were not modified by
      ATIII supplementation. High doses of ATIII concentrates significantly improved
      sepsis-induced DIC during septic shock. The trend toward improved survival
      suggests further randomized studies.

PMID- 8365306
TI  - Extracorporeal carbon dioxide removal and low-frequency positive-pressure
      ventilation. Improvement in arterial oxygenation with reduction of risk of
      pulmonary barotrauma in patients with adult respiratory distress syndrome.
AB  - Mortality of the adult respiratory distress syndrome (ARDS) remains high and
      could be increased by pulmonary barotrauma induced by positive-pressure
      mechanical ventilation. Extracorporeal CO2 removal combined with low-frequency
      positive-pressure ventilation (ECCO2R-LFPPV) has been proposed to reduce lung
      injury while supporting respiratory failure. Use of this technique in 23 patients
      resulted in the following: a dramatic and highly significant increase of PaO2
      obtained rapidly with ECCO2R-LFPPV, allowing subsequent reduction in inspired
      oxygen fraction; a reduction of the risk of barotrauma evidenced by a significant
      decrease in pressures and insufflated volumes; a survival rate of 50 percent.
      Bleeding was the only complication related to the technique and was the cause of
      death in four patients. This method allowed improvement in gas exchange along
      with reduction of the risk of barotrauma caused by the ventilator.

PMID- 8365307
TI  - Hypoxemic episodes of patients in a postanesthesia care unit.
AB  - The incidence, degree, and duration of acute hypoxemia were evaluated with
      continuous arterial hemoglobin oxygen saturation monitoring by pulse oximetry in
      100 postoperative patients during 40 percent oxygen administration by aerosol
      face tent from postanesthetic recovery room admission to discharge. Saturations
      were recorded by pulse oximeters (Nellcor-N 200) with desaturations of < or = 92
      percent for > or = 30 s considered significant. On recovery room admission, 15
      percent of patients were experiencing episodes of desaturation. Low admission
      saturations correlated positively with patient age and body weight, American
      Society of Anesthesiologists class, patients having received general anesthesia,
      and with greater volumes of intraoperative intravenous fluids, particularly >
      1,500 ml. Later desaturations to 86.7 +/- 4.6 percent (72 to 91 percent) at 32 +/
      54 min after admission for 5.2 +/- 12.6 min occurred in 25 percent of patients
      and correlated positively with peripheral surgical procedures, low oxygen
      saturation on admission, duration of anesthesia, and volume of intraoperative
      intravenous fluids. Desaturation durations were longer for female subjects and
      correlated positively with body weight and intravenous fluid volume. Significant
      arterial hemoglobin oxygen desaturations occurred despite prophylactic oxygen
      administration by aerosol face tent during short-term postoperative recovery room
      care.

PMID- 8365308
TI  - Pressure-preset ventilation. Part 2: Mechanics and safety.

PMID- 8365309
TI  - The pathophysiologic changes following bile aspiration in a porcine lung model.
AB  - Aspiration of bile is an underpublicized aspiration syndrome. Using a porcine
      lung model, the physiologic response and the histopathology of lung tissue were
      evaluated after the intratracheal instillation of sublethal doses of bile. Twenty
      one domestic swine (11 to 19 kg) were the studied population. Three groups of
      five swine were evaluated: a control group received intratracheal physiologic
      saline (pH 7.45); study group 1 received strained gastric contents (pH 2.24); and
      study group 2 received strained bile (pH 7.19). All animals received the
      solutions at 0.5 ml/kg intratracheally. Lungs of six additional animals were
      studied (two gastric, two bile, and two physiologic saline) after aspiration by
      scanning electron microscopy (SEM). A seventh untreated animal was used as the
      SEM control. The physiologic data were analyzed using analysis of variance for
      repeated measures. The SEM and histopathologic results were graded by an observer
      blinded to the groups and were analyzed using the analysis of variance (ANOVA)
      and Scheffe tests. The group with bile aspiration was consistently characterized
      by significant deterioration of PaO2, the alveolar-arterial (A-a) gradient, shunt
      fraction, and static compliance (p < 0.01); and the light histopathologic and SEM
      findings demonstrated pathologic changes in the bile-exposed lung (p < 0.05)
      greater than the gastric- or saline-exposed lungs. It is concluded that bile
      aspiration produces a severe chemical pneumonitis leading to noncardiac pulmonary
      edema.

PMID- 8365310
TI  - Increasing back pain in a young man.

PMID- 8365311
TI  - Diffuse pulmonary infiltrates and respiratory failure following 2 weeks of
      dyspnea in a 45-year-old woman.

PMID- 8365312
TI  - Measurement of oxygen consumption after uncomplicated acute myocardial
      infarction.
AB  - BACKGROUND: Oxygen consumption (VO2) has been shown to be decreased after acute
      myocardial infarction (AMI) complicated by cardiogenic shock. STUDY OBJECTIVE: To
      evaluate early measurement of VO2 by indirect calorimetry after an uncomplicated
      AMI (UAMI). STUDY DESIGN: Prospective nonrandomized case study. SETTING:
      Emergency department of a large urban hospital. PARTICIPANTS AND INTERVENTIONS:
      Twenty-six consecutive patients presenting with confirmed UAMI. VO2 was measured
      by indirect calorimetry (Deletrac, Datex Ins,) which is noninvasive. All patients
      received buccal or intravenous nitroglycerin and thrombolytic therapy, and none
      received opiates before VO2 measurement. RESULTS: Two groups of patients were
      identified by subsequent development of cardiogenic shock. Group 1 did not
      develop cardiogenic shock, and group 2 developed shock within 24 h of admission.
      Group 1 (n = 22) had a significantly higher VO2 compared to group 2 (n = 4), mean
      154(SD 25) vs mean 100(SD 13) ml/min.m2, p < 0.002. Group 1 had a significantly
      higher increase in basal metabolic rate than group 2, mean 30 percent (SD 11) vs
      mean 10(SD 15) percent, p < 0.007. There was no significant difference in age,
      heart rate (HR), shock index (SI), or rate-pressure product (RPP) between groups
      1 and 2. All patients in group 2 developed cardiogenic shock despite thrombolytic
      therapy, and two died within 24 h of admission. CONCLUSION: VO2 is increased in
      UAMI and represents increased metabolic demands of peripheral tissues and not
      cardiac oxygen uptake. A reduction in VO2 (< 100 ml/min.m2) after AMI may be an
      early predictor of subsequent development of cardiogenic shock. Measurement of
      VO2 in UAMI by indirect calorimetry in the emergency department may be of value
      to identify patients at high risk and could influence their management.

PMID- 8365313
TI  - Cardiac profiles of national-class race walkers.

PMID- 8365314
TI  - Redefinition of normal sinus heart rate.

PMID- 8365315
TI  - Thoracoscopy in the subacute management of patients with thoracoabdominal trauma.

PMID- 8365316
TI  - Disappearance of a left ventricular aneurysm on radionuclide ventriculography due
      to formation of a mural thrombus.
AB  - Radionuclide ventriculography is an accepted method for diagnosing left
      ventricular aneurysms, but false-negative studies have been associated with a
      mural thrombus filling the left ventricular cavity. We describe a patient with a
      left ventricular aneurysm due to myocardial infarction whose aneurysm
      scintigraphically "disappeared" from serial radionuclide ventriculograms. This
      was documented echocardiographically and pathologically to be due to the
      formation of a large mural thrombus. Review of the literature suggests that
      radionuclide ventriculography and echocardiography may be complementary
      techniques in the diagnosis of left ventricular aneurysm. Echocardiography may
      remain diagnostic when a mural thrombus has caused the loss of the characteristic
      scintigraphic findings on radionuclide ventriculography.

PMID- 8365317
TI  - Association of miliary lung metastases and bone metastases in bronchogenic
      carcinoma.
AB  - Five cases of miliary lung metastasis among 630 patients with bronchogenic
      carcinoma were investigated. Bone metastases from the bronchogenic carcinoma were
      observed in 246 (39 percent) of these 630 patients, and the five were all
      patients in this latter group. These results suggest that bronchogenic carcinoma
      may produce miliary lung metastasis through its bone metastasis.

PMID- 8365318
TI  - Toxic shock syndrome as the AIDS-defining diagnosis.
AB  - Toxic shock syndrome (TSS) has been infrequently reported as a complication of
      AIDS. We present the case of a 24-year-old man, previously unknown to be positive
      for the human immunodeficiency virus, presenting in septic shock. The literature
      on TSS in AIDS is reviewed and the association between the two diseases is
      presented.

PMID- 8365319
TI  - Needle/wire lung nodule localization for thoracoscopic resection.
AB  - Small lung nodules undiagnosed by percutaneous needle biopsy have traditionally
      gone to thoracotomy for diagnosis. We describe a technique using computed
      tomographic needle/wire lung localization of these nodules, to be resected using
      video-assisted thoracoscopy. This is less invasive and less painful than
      thoracotomy and provides for cost-effective definitive diagnosis.

PMID- 8365320
TI  - Localized Wegener's granulomatosis relapsing as diffuse massive intra-alveolar
      hemorrhage.
AB  - In a 75-year-old patient presenting with a solitary pulmonary mass, a localized
      form of Wegener's granulomatosis was diagnosed after lobectomy. In the absence of
      extrapulmonary manifestations and after a benign postoperative course, the
      patients was discharged without medical treatment. Three months later, diffuse
      alveolar hemorrhage developed abruptly, necessitating mechanical ventilation, and
      was followed by cardiac complications and a fatal outcome. This case and another
      previously reported strongly suggest the need for medical treatment in patients
      with a localized form of pulmonary Wegener's granulomatosis, even when complete
      remission after surgical resection of the lung lesion seems to have been
      achieved.

PMID- 8365321
TI  - Combined median sternotomy and video-assisted thoracoscopic resection of
      pulmonary metastases.
AB  - Median sternotomy has been a common approach for resection of bilateral pulmonary
      metastases. It provides good exposure and quick accessibility to most lesions in
      the lung. The retrocardiac left lower lobe may at times be a problematic area for
      resection of metastases. We have used a simultaneous median sternotomy and left
      video-assisted thoracoscopic approach to remove three such lesions in two
      patients, with satisfactory results.

PMID- 8365322
TI  - Use of Nd:YAG laser in endobronchial granular cell myoblastoma.
AB  - Granular cell myoblastoma is an uncommon benign tumor that causes pulmonary
      complications due to obstruction of the airways. We report the first case of
      bronchial obstruction due to granular cell tumor treated with Nd:YAG laser. The
      Nd:YAG laser appears to be an effective new tool for relieving obstruction and,
      in some cases, preventing recurrence, and can be delivered with the use of a
      flexible bronchoscope.

PMID- 8365323
TI  - Fluid bronchogram. A common finding in opacified lung requiring contrast medium
      administration for demonstration.
AB  - One example was selected to demonstrate the requirement of intravenous
      administration of contrast medium for visualization of the fluid bronchogram in
      opacified lung, as is the case in most patients. Another example was chosen to
      show that on rare occasions, a faint fluid bronchogram could be detected without
      contrast medium because of marked dilation of the bronchi. The mechanism for the
      computed tomographic demonstration of the fluid bronchogram and it significance
      were discussed.

PMID- 8365324
TI  - Fatal cerebral fat embolism associated with a patent foramen ovale.
AB  - A healthy 22-year-old woman developed respiratory failure and brain death within
      48 h of bilateral tibial fractures. Autopsy showed fat embolism in the lung and
      brain, and a large patent foramen ovale that may have contributed to massive
      cerebral fat embolism.

PMID- 8365325
TI  - Fatal respiratory arrest in adult epiglottitis in the intensive care unit.
      Implications for airway management.
AB  - A 64-year-old man with acute epiglottitis, monitored in an ICU without an
      artificial airway, suffered sudden fatal respiratory arrest 36 h after admission
      despite rapid emergency interventions. This case demonstrates the importance of
      adequate airway protection in adult epiglottitis even within an ICU setting. A
      protocol for airway management for such patients is presented.

PMID- 8365326
TI  - Acute right ventricular infarction mimicking extensive anterolateral wall injury.
AB  - A patient presented with an acute right ventricular infarction characterized by
      an electrocardiographic current of injury in both the inferior (2,3,aVF) and
      anterior precordial leads (V1-V6). Cardiac catheterization demonstrated normal
      left ventricular wall motion, a codominant circulation, and severe disease of the
      right coronary artery. We propose that this coronary anatomy explains the injury
      currents on the electrocardiogram. This case illustrates a rare presentation of
      right ventricular myocardial infarction mimicking an extensive anterolateral wall
      injury.

PMID- 8365327
TI  - Drug-induced pulmonary edema in a patient infected with human immunodeficiency
      virus.
AB  - Adverse reactions to drugs are common in patients infected with the human
      immunodeficiency virus (HIV). In these patients pulmonary reactions to drugs may
      be difficult to differentiate from opportunistic pulmonary infections. We report
      a HIV-infected patient who on two occasions developed acute pulmonary edema
      related to the administration of ibuprofen.

PMID- 8365328
TI  - Right atrial mass biopsy guided by transesophageal echocardiography.
AB  - A 69-year-old woman was found to have a right atrial mass on transthoracic
      echocardiogram. Biopsy of the mass was performed using transesophageal
      echocardiography for visual guidance. Pathologic study revealed an organizing
      thrombus. This case illustrates the clinical utility of transesophageal
      echocardiography in the biopsy of right atrial masses.

PMID- 8365329
TI  - Thionyl-chloride-induced lung injury and bronchiolitis obliterans.
AB  - Thionyl-chloride (TCl) is used in the manufacture of lithium batteries, producing
      SO2 and HCl fumes on contact with water. We report two cases of accidental TCl
      exposure resulting in lung injury that may vary from a relatively mild and
      reversible interstitial lung disease to a severe form of bronchiolitis obliterans
      causing, after a latent period, an acute/chronic respiratory failure as well as
      other complications (spontaneous pneumothorax and bronchopleural fistula),
      previously unreported in TCl fume inhalation.

PMID- 8365330
TI  - Bronchopulmonary bacillary angiomatosis.
AB  - A man with prior AIDS developed acute febrile interstitial pneumonitis, hilar and
      paratracheal adenopathy, and bronchial polyps. The polyps were histologically
      typical for bacillary angiomatosis and complete symptomatic and radiographic
      response to oral clarithromycin was seen. The clinical presentation of bacillary
      angiomatosis includes pulmonary disease and in particular bronchial polyps;
      clarithromycin is an effective oral antibiotic.

PMID- 8365331
TI  - Late cardiac strangulation due to an iatrogenic pericardial defect.
AB  - A 14-year-old boy developed broad posterolateral myocardial infarction. During
      cardiac surgery at age five, a small pericardial window had been made. Autopsy
      revealed an extensive left-sided pericardial defect and necrosis of the left
      ventricular free wall, which had herniated and strangulated through the enlarged
      pericardial defect.

PMID- 8365332
TI  - Acute ventilatory failure from massive subcutaneous emphysema.
AB  - A 66-year-old woman developed massive subcutaneous emphysema following
      intubation. Acute thoracic restriction developed resulting in life-threatening
      respiratory acidosis. The patient could not be ventilated with conventional
      means. A tracheostomy was performed to decompress the chest and mediastinum with
      rapid resolution following. Although ventilatory failure from subcutaneous
      emphysema is very unusual, decompression with tracheostomy can be life saving.

PMID- 8365333
TI  - Hemoptysis during sexual arousal. An unusual manifestation of amyloidosis.
AB  - Hemoptysis associated with sexual arousal is thought to be secondary to cardiac
      dysfunction brought on by the physiologic stress of sexual activity. A patient
      who presented with hemoptysis occurring only during episodes of sexual
      stimulation was subsequently found to have cardiac amyloidosis.

PMID- 8365334
TI  - Miliary opacities diagnosed as lung metastases of a thyroid carcinoma after 13
      years of stability.
AB  - A 29-year-old man was hospitalized for the diagnosis of clinically asymptomatic
      miliary opacities discovered 13 years earlier and unchanged since then.
      Transbronchial biopsy showed metastatic thyroid carcinoma. Thyroid surgery
      revealed massive local invasion by a papillary carcinoma. We conclude that
      thyroid carcinoma, whether clinically detectable or not, should be considered in
      the diagnostic investigation of stable miliary lesions.

PMID- 8365335
TI  - Pacemaker-induced friction rub and apical thrill.

PMID- 8365336
TI  - Pacemaker-induced friction rub and apical thrill.

PMID- 8365337
TI  - Diagnosis of acute pulmonary embolism in patients with COPD.

PMID- 8365338
TI  - Adenosine triphosphate enhancement of postischemic function in immature
      myocardium.

PMID- 8365340
TI  - Aspiration of potpourri.

PMID- 8365339
TI  - Evaluation of cardiac output by thoracic electrical bioimpedance during exercise
      in normal subjects.

PMID- 8365341
TI  - The atrial natriuretic peptide paradox. A hypothesis.

PMID- 8365342
TI  - Blunt chest trauma causing isolated single papillary muscle dysfunction and
      mitral regurgitation.

PMID- 8365343
TI  - Pulmonary barotrauma in mechanical ventilation.

PMID- 8365344
TI  - Controlled-release oral salbutamol and cardiac arrhythmias in asthmatic patients.

PMID- 8365345
TI  - Value of a Mycobacterium avium complex respiratory tract isolate as a predictor
      of disseminated infection.

PMID- 8365346
TI  - NIH's "Family Inn" lets out-of-town youngsters stay "home".

PMID- 8365347
TI  - Mismatch recognition in chromosomal interactions and speciation.
AB  - Homologous chromosomes interact during meiosis by means of proteins involved in
      recombination and in the recognition and repair of mismatched base pairs.
      Recombination proteins bring homologous chromosomes or chromosomal regions
      together by facilitating the search for DNA homology and by catalyzing strand
      exchange between homologous molecules or regions. Mismatch recognition and repair
      proteins act as editors of recombination and appear to disrupt those DNA
      associations that contain mismatched base pairs. Thus, it may be that, as
      chromosomes diverge in their primary sequence and become increasingly
      polymorphic, recombinational interactions leading to chromosome pairing and
      recombination tend to be inhibited. Decreasing homologous interactions within and
      between chromosomes will clearly contribute to maintaining the integrity of
      individual chromosomes and may ultimately lead, as a result of sterile meioses,
      to the reproductive isolation of closely related species.

PMID- 8365348
TI  - Sequence organization and evolution, in all extant whalebone whales, of a DNA
      satellite with terminal chromosome localization.
AB  - A heavy (GC rich) DNA satellite with terminal chromosomal localization is
      characteristic for all mysticete (whalebone whale) genomes. Sequences of 58
      repeats of the satellite were compared in all ten extant mysticete species. In
      three families comprising eight species, the typical repeat length was 422 (421)
      bp. In two species, the northern right whale and the bowhead, of family
      Balaenidae (right whales) the repeats were much longer, typically ca. 900 and ca.
      1200 bp. In all species the repeats were composed of a unique portion of constant
      length (212/211 bp), and a subrepeat portion, the length of which was variable.
      The evolutionary rigidity of the unique portion of the repeat is contrasted by
      the pronounced length variability of the subrepeat portion. The subrepeat portion
      consists essentially of 6 bp motifs, such that length differences are usually in
      multiples of 6 bp. The motif TTAGGG constituted 35%-50% of the subrepeats.
      Comparison between the unique portion of the 58 sequenced repeats revealed that
      the repeats divided into two primary groups, one comprising the two balaenids,
      the other including the eight remaining species. The mean difference between the
      two groups averaged 8.4%. In this sequence comparison the repeats of the pygmy
      right whale constituted a group that was separated from repeats of the other
      species. In all other cases repeats were intermingled to some extent between
      species. Comparison of individual repeats suggests that the unique portion
      evolves in concert, at a slow rate. A neighbor-joining comparison between the
      consensuses of all species suggests that the unique portion of the repeats
      evolves at a somewhat different rate in different lineages.

PMID- 8365349
TI  - Solitary and synaptonemal complex-associated recombination nodules in pro-nurse
      cells during oogenesis in Drosophila melanogaster.
AB  - An oocyte in Drosophila melanogaster originates from 1 of 16 cells comprising an
      ovarial syncytium. The two pro-oocytes proceed into the pachytene stage of
      meiosis, but only one develops further into a mature oocyte while the other
      reverts to a nurse cell. It is known that pro-nurse cells also enter meiosis, as
      they contain incomplete synaptonemal complexes (SCs). We now show that these
      cells also harbour recombination nodules (RNs). In cells that only occasionally
      contain SC segments, the RNs are typically not located close to distinct
      tripartite SC structures. Instead, these RNs are frequently associated with a
      spherical body of amorphous material and two to three, more or less parallel
      fibres, possibly representing SC material. The significance of the solitary RNs
      is discussed in relation to the present knowledge of the assembly and disassembly
      of the SC.

PMID- 8365350
TI  - Yeast pre-meiotic DNA replication utilizes mitotic origin ARS1 independently of
      CDC7 function.
AB  - In budding yeast, mitotic DNA replication initiates at sequence-specific
      replication origins, the prototype for which is ARS1. Initiation serves as the
      primary control point for mitotic DNA replication, and is catalyzed by the Cdc7
      protein kinase. In contrast, premeiotic DNA replication apparently does not
      require Cdc7, and the existence and nature of specific replication origins in the
      meiotic division cycle have not been previously reported. We have begun to
      investigate the mechanism of premeiotic DNA synthesis by determining whether or
      not ARS1 functions as a DNA replication origin in meiosis. We have taken
      advantage of the fact that transcription through ARS1 disrupts its ability to
      function as an origin to show that ARS1 is required for premeiotic DNA
      replication of a plasmid bearing this element. Further, premeiotic replication
      from ARS1 still occurs in a cdc7 mutant strain held at conditions non-permissive
      for Cdc7 protein kinase activity. These findings reveal that premeiotic DNA
      replication can initiate from origins also used in mitosis, and is not regulated
      by Cdc7. Taken together with previous findings implicating Cdc7 in meiotic DNA
      recombination and induced mutagenesis, these findings prompt us to postulate that
      the Cdc7 protein kinase regulates some step common to several DNA metabolic
      processes such as local disassembly of chromatin or activation of a key component
      of the DNA metabolic machinery.

PMID- 8365351
TI  - Chromatin condensation behaviour of the Y chromosome in the human testis. I.
      Evidence for decondensation of distal Yq in germ cells prior to puberty with a
      switch to Sertoli cells in adults.
AB  - The condensation behaviour of the human Y chromosome in germ cells and Sertoli
      cells of pre- and post-pubertal testes was followed by fluorescence in situ
      hybridisation using probes for three different regions of the Y chromosome.
      Patterns of expansion or contraction of signal are taken to reflect degrees of
      condensation of the related Y chromatin and hence its potential for genetic
      activity. For probe pHY2.1, which labels the distal non-fluorescent and
      fluorescent heterochromatin of the Y chromosome (Yq12), an expanded signal seen
      in gonocytes of the prepubertal testis is superseded by a condensed signal seen
      in adult germ cells at all but the zygotene stage of meiotic prophase when
      meiotic pairing takes place. In contrast, Sertoli cells show a condensed signal
      pre-pubertally but a greatly expanded signal in the adult testis. A totally
      condensed pHY2.1 signal is found in a chromosomally normal man with Sertoli-cell
      only syndrome. It is hypothesised that control over at least some facets of
      spermatogenesis may not, in the adult, be autonomous to the germ cells, but
      rather may emanate from the Sertoli cells. Chromatin expansion at zygotene could,
      however, be important for pairing and crossing over in the XY bivalent,
      successful synapsis ensuring survival of spermatocytes into the post-meiotic
      stages.

PMID- 8365352
TI  - Neurosteroids: 3 alpha-hydroxy-5 alpha-pregnan-20-one and its precursors in the
      brain, plasma, and steroidogenic glands of male and female rats.
AB  - A RIA procedure for measuring progesterone (PROG), 5 alpha-pregnane-3,20-dione (5
      alpha-DH PROG), and 3 alpha-hydroxy-5 alpha-pregnan-20-one (3 alpha,5 alpha-TH
      PROG) has been developed and validated by GLC/mass spectrometry. Measurements
      were made in intact and adrenalectomized (ADX) male rats, in cyclic, pregnant,
      spayed, and spayed-ADX females, and in both males and spayed females injected
      with PROG. The predominant contribution of the ovary to the concentrations of 3
      alpha,5 alpha-TH PROG in plasma and brain, was indicated by its larger levels in
      females, in particular during pregnancy, and by its presence in ovarian tissue
      and disappearance after ovariectomy. An additional adrenal origin in both males
      and females was shown. Neither PROG nor 5 alpha-DH PROG disappeared from brain,
      contrary to plasma, after combined adrenalectomy and gonadectomy, thus suggesting
      that PROG might be synthetized de novo in brain. However, the concentrations of 3
      alpha,5 alpha-TH PROG in plasma and brain of female rats were positively
      correlated with the concentrations of PROG in plasma, indicating that plasma PROG
      was the major precursor of 3 alpha,5 alpha-TH PROG. The direct formation of 3
      alpha,5 alpha-TH PROG from PROG in brain was strongly suggested by the increased
      3 alpha,5 alpha-TH PROG/PROG ratios in brain vs. plasma, when measured in control
      females, and after injection of PROG to both males and OVX females. It was
      previously reported that 3 alpha,5 alpha-TH PROG is a sedative/anxiolytic
      steroid, as a result of its binding to gamma-aminobutyric acid (GABA)A receptors
      and allosteric potentiation of GABAcergic neurotransmission. Its concentrations
      in brain reach indeed the neuroactive range in cyclic and pregnant females, and
      are compatible with a physiological role of this neurosteroid.

PMID- 8365353
TI  - Effects of female hormones and 3,5,3'-triiodothyronine or dexamethasone on
      induction of epidermal growth factor and proteinases F, D, A, and P in the
      submandibular glands of hypophysectomized male mice.
AB  - The effects of progesterone (Pro), 5 alpha-dihydrotestosterone (DHT), 17 beta
      estradiol (E2), T3, and dexamethasone (Dex), given alone or in combination, on
      induction of epidermal growth factor (EGF) and proteinase isozymes in the
      submandibular glands of hypophysectomized mice were examined. Each hormone,
      except E2, acting alone had essentially comparable inductive effects on EGF
      concentrations and on total proteinase activity. E2 alone had no inductive effect
      at all. Pro acted synergistically with T3, but its inductive effect was
      diminished when given with Dex. E2 was not synergistic with T2, and it inhibited
      the effect of Dex; it also partially blocked the action of DHT on induction of
      proteinase activity but not of EGF. Simultaneous administration of all five
      hormones restored total proteinase activity completely but EGF levels to only 50%
      of values for intact males, respectively. Submandibular proteinases were resolved
      by isoelectric focusing into four isozymes: proteinase F (pI 4.8), proteinase D
      (pI 5.8), proteinase A (pI 6.2), and proteinase P (pI 10.0). Pro alone slightly
      increased levels of proteinase F but greatly raised levels of the other three
      isozymes. This inductive action was augmented when Pro was given with T3 but
      blocked when it was given with Dex. E2 alone not only failed to induce any of the
      isozymes, but even further reduced levels of proteinase F. It also decreased the
      inductive effects of T3 on these isozymes, and with Dex completely blocked
      induction of proteinases D, A, and P. E2 plus DHT suppressed proteinase F levels
      and only induced proteinase A. All five hormones together reestablished the
      isozyme profile seen in intact males. These results show that Pro by itself is as
      capable as androgens, thyroid hormone, or glucocorticoid in regulating expression
      of these submandibular polypeptides, and that its action can be modulated by
      other pituitary-dependent hormones. In addition, they demonstrate that E2 does
      not regulate their expression, and that it has an inhibitory effect on the
      inductive action of other hormones. Last, they indicate that these various
      hormones may regulate expression of EGF and of each of the individual proteinase
      isozymes differently.

PMID- 8365354
TI  - Induction of prostaglandin endoperoxide synthase isoform-2 in ovine cotyledonary
      tissues during late gestation.
AB  - The present study was designed to characterize the developmental pattern of
      specific prostaglandin endoperoxide synthase (PGS) isoform immunoreactivity and
      activity in tissues of fetal origin during the last half of gestation in sheep.
      Fetal amnion, allantochorion, and cotyledons were collected under halothane
      general anesthesia on days 79-80, 105-108, 120-122, 128-131, and 140-145 (term)
      of pregnancy. Solubilized extracts were prepared and analyzed by immunoblots
      using anti-PGS antibodies previously shown to recognize PGS isoform-1 and -2 (PGS
      1 and PGS-2). PGS activity from cotyledon microsomes was assayed by the
      measurement of prostaglandin E2 (PGE2) production under initial velocity
      conditions. All fetal tissues contained PGS-1 at each of the stages of gestation
      examined, with minimal regulation of this isoform from 79-144 days gestation. In
      contrast, PGS-2 increased gradually in the cotyledons from 120-139 days
      gestation, with the most marked expression observed at term. PGS-2 was not
      detected in amnion or allantochorion. PGS activity in cotyledons increased (P <
      0.01) in parallel with immunoreactive PGS-2 levels; indicating that PGS-2, rather
      than PGS-1, is associated with increased PG synthesis in this tissue. Both the
      activity (n = 5/group) and the amount of PGS-2 increased significantly from 105
      108 days gestation to term (P < 0.01). We conclude that the increase in PGS that
      occurs at term in sheep is predominantly active PGS-2 localized to fetal
      cotyledons.

PMID- 8365355
TI  - Insulin stimulates endothelin binding and action on cultured vascular smooth
      muscle cells.
AB  - Hyperinsulinemia has been implicated as a separate risk factor for the
      development of accelerated cardiovascular disease, but the mechanism is unknown.
      Recently, we and several other groups have shown that insulin stimulates the
      production and secretion of the vasoconstrictor peptide endothelin-1 (ET-1) from
      vascular endothelial cells, and hyperinsulinemia results in increased plasma ET
      levels in vivo. However, the interactive effects of diabetes, insulin, and
      glucose on ET target tissues, like those on vascular smooth muscle cells (VSMC),
      are not well defined. In these studies, we examined the effects of the diabetic
      factors on ET receptors and [3H]thymidine incorporation into cultured cells
      prepared from control, streptozocin-diabetic, insulin-treated diabetic, and
      hyperinsulinemic rats. Scatchard analysis of saturation binding studies revealed
      a 2-fold increase in ET receptor number in normal VSMC treated in vitro with
      insulin, whereas glucose had no significant effect. Neither treatment affected
      receptor affinity. Similarly, aortic smooth muscle cells, brain capillary
      pericytes, and kidney afferent arteriolar smooth muscle cells from rats made
      hyperinsulinemic in vivo each showed approximately a 2-fold increase in receptor
      number. This increase in receptor density probably resulted from the stimulation
      of receptor protein production, because insulin caused a maximal 2.3 +/- 0.3 (+/-
      SEM) fold increase in the ETA receptor mRNA expressed in cultured VSMC by 4 h.
      Both insulin and ET significantly increased thymidine incorporation in aortic
      VSMC, but ET-1 was much more potent in this regard. However, the combined effects
      of insulin plus ET-1 resulted in a 10-fold increase in this index of cell
      proliferation, significantly different from the effects of either peptide alone.
      We postulate that hyperinsulinemia in vivo may potentiate ET release and receptor
      mediated action, thereby contributing to vascular disease in the setting of
      diabetes.

PMID- 8365356
TI  - Prostaglandin F2 alpha mediates platelet-activating factor-stimulated atrial
      natriuretic factor release from the isolated rat heart.
AB  - Platelet-activating factor (PAF) and the prostaglandins have recently been shown
      to stimulate atrial natriuretic factor (ANF) secretion from the heart. As PAF
      also potentiates the release of cyclooxygenase products from isolated hearts, the
      role of these substances in PAF-induced ANF secretion was investigated. Using an
      isolated perfused rat heart preparation, cyclooxygenase inhibition by
      indomethacin or meclofenamic acid (10 microM for each) significantly attenuated
      the rise in ANF associated with PAF administration (2.5 nmol). Prostaglandin F2
      alpha (PGF) produced an immediate and dose-dependent increase in ANF secretion,
      which was significant at 0.01 mumol and reached 348 +/- 66% over baseline values
      after a 1-mumol injection. Prostaglandin E2 (PGE) generated a much smaller 98 +/-
      25% increase after a 1-mumol administration. Furthermore, PGF but not PGE was
      released from isolated hearts immediately after PAF administration. PGF release
      reached a maximum of 0.06 nmol/min g Heart-1 1 min after PAF stimulation and had
      returned to undetectable baseline values by 6 min. Cyclooxygenase inhibition
      abolished the release of PGF after PAF, in addition to attenuating (by 60-70%)
      the increased secretion of ANF after PAF injection. These results demonstrate
      very clearly that PGF is the major mediator for PAF-stimulated ANF secretion.
      Such an interaction may provide an alternative mechanism to atrial distension for
      the secretion of ANF in pathologies such as myocardial infarction, where
      autacoids such as PAF and the PGs are released from damaged cardiac muscle and
      elevated plasma levels of ANF are observed.

PMID- 8365357
TI  - Growth hormone transgenes regulate the expression of sex-specific isoforms of 3
      beta-hydroxysteroid dehydrogenase/delta 5-->4-isomerase in mouse liver and
      gonads.
AB  - The sexually dimorphic pattern of GH secretion regulates the expression of
      several steroidogenic enzymes in rat liver, including a male-specific 3 beta
      hydroxysteroid dehydrogenase/delta 5-->4-isomerase (3 beta HSD). Recently, we
      identified male-specific isoforms of immunoreactive 3 beta HSD in mouse liver [42
      kilodaltons (kDa)] and gonads (47 kDa). To test whether GH can regulate the
      expression of these murine 3 beta HSDs, endogenous forms of 3 beta HSD were
      studied in transgenic mice expressing heterologous GH transgene products. Mice
      from five transgenic lines were used; two expressed GH transgenes encoding the
      phosphoenolpyruvate carboxykinase (PEPCK) promoter fused to either the human (h)
      GH (somatogenic and lactogenic) or bovine (b) GH (somatogenic) structural genes,
      and three expressed GH transgenes encoding the mouse metallothionein-1 (MT1)
      promoter fused to the hGH, hGH variant (hGHv), or bGH structural genes. Control
      mice were normal nontransgenic littermates. Expression of a male-specific (42
      kDa) isoform of hepatic 3 beta HSD is dramatically suppressed in all transgenic
      mouse lines, as detected on Western immunoblots, without affecting a 47-kDa
      isoform expressed in livers of both male and female mice. This negative
      regulation was not observed in mouse kidney, which normally expresses two 3 beta
      HSD isoforms (in both sexes) with molecular masses similar to those in liver.
      Considering that PEPCK and MT1 promoters direct expression of GH fusion genes in
      both tissues, the inhibition of hepatic, but not renal, 3 beta HSD
      immunoreactivity suggests that GH affects sex-specific, rather than tissue
      specific, expression of 3 beta HSD. As in the liver, sex-specific expression of 3
      beta HSD in the testis is also suppressed by heterologous GH, but with one
      notable difference. Only human-derived GH (MT1-hGH and MT1-hGHv) effectively
      inhibits expression of the 47-kDa sex-specific isoform of testicular 3 beta HSD,
      without affecting the 44-kDa isoform expressed in gonads of both male and female
      mice. These results suggest that the negative effects of heterologous GH on sex
      specific 3 beta HSDs may be mediated by PRL receptors in the testis and GH
      receptors in the liver. PEPCK-GH transgenes had little effect on testicular 3
      beta HSD, possibly because this promoter (unlike MT1) is relatively inactive in
      this tissue. In the liver of male transgenics (PEPCK-hGH), loss of the sex
      specific (42-kDa) 3 beta HSD has little effect on the Km for
      dehydroepiandrosterone (DHEA; 11 microM) compared with that in normal controls
      (16 microM).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8365358
TI  - Glucocorticoid suppression of human placental fibronectin expression:
      implications in uterine-placental adherence.
AB  - Increased levels of glucocorticoids are associated with human parturition whether
      occurring before or at term. In the present study we examined the effects of
      glucocorticoids on placental fibronectin (FN) expression in cytotrophoblasts,
      isolated from human term placentas, to provide a potential mechanism through
      which glucocorticoids may influence uterine-placental adherence near parturition.
      Based on immunoassays, relative to controls, media levels of placental FNs
      bearing an oncofetal epitope (onfFN) were inhibited 65-80% by treatment with 10(
      7) M dexamethasone (DEX) during experiments in which cumulative levels and daily
      release of onfFN were measured. DEX treatment increased human CG production by
      cytotrophoblasts approximately 3-fold without affecting the levels of total
      protein, suggesting that DEX treatment did not reduce placental function. DEX and
      cortisol inhibited onfFN expression with an EC50 of 2 and 16 nM, respectively.
      Other steroids were not effective in down-regulating onfFN expression, indicating
      that this was a glucocorticoid-specific response. In immunoprecipitation studies,
      treatment of cytotrophoblasts with 10(-7) M DEX for 3 days inhibited both release
      of labeled FN to the media and its incorporation into cell-associated material by
      approximately 80%. Results from Northern blotting indicated that DEX treatment
      suppressed levels of FN messenger RNA approximately 90% relative to controls.
      Levels of labeled laminin in media were inhibited approximately 80% by a 3-day
      treatment with 10(-7) M DEX, suggesting that glucocorticoids may coordinately
      suppress the synthesis of multiple extracellular matrix proteins in
      cytotrophoblasts. In our model, we propose that glucocorticoids may suppress
      placental extracellular matrix protein synthesis, which could lead to decreased
      uterine-placental adherence and be associated with parturition.

PMID- 8365359
TI  - Effects of sex and pregnancy hormones on growth hormone and prolactin receptor
      gene expression in insulin-producing cells.
AB  - During pregnancy, marked hyperplasia of the pancreatic islet cells has been
      observed. This effect may be mediated by the pregnancy-associated peptide
      hormones, placental lactogen, PRL, and GH, which were previously shown to be
      mitogenic to beta-cells in vitro. To study whether the responsiveness of islet
      cells to these hormones is regulated on the receptor level, GH and PRL receptor
      gene expression was studied in pancreata from male rats and virgin, pregnant, and
      lactating female rats and in cultured islets and insulinoma cells (RIN-5AH) in
      response to various hormones. The mRNA levels were quantitated by ribonuclease
      protection assay, using probes specific for mRNA encoding, extracellular and
      intracellular domains of the GH receptor, and short and long forms of the PRL
      receptor, respectively. Specific transcripts for the GH receptor were present in
      pancreas, islets, and RIN-5AH cells. Furthermore, as previously observed in RIN
      5AH cells, a predominant expression of the long form of PRL receptor vs. the
      short form was also found in pancreas and islet cells. Male and nonpregnant
      female pancreas did not differ significantly in their levels of GH and PRL
      receptor mRNAs. On day 14 of pregnancy, increases in both GH and PRL receptor
      mRNA levels were observed (1.7- and 2.4-fold, respectively), and a further
      increase occurred in late pregnancy (day 19), when GH and PRL receptor mRNA
      levels were 2.7- and 3.9-fold higher than those in the nonpregnant state. mRNA
      levels returned toward the basal level during lactation. In the cultured islets,
      PRL receptor mRNA levels were markedly increased by GH and PRL (3.5- and 6.5
      fold, respectively) after exposure for 24 h, whereas estradiol and testosterone
      had modest stimulating effects (1.8- and 1.5-fold increases, respectively).
      Dexamethasone induced a 2.5-fold increase in GH receptor mRNA levels, and a weak
      stimulatory effect was also observed for progesterone. In RIN-5AH cells, the
      effect of dexamethasone on GH receptor mRNA was detectable after 2 h and maximal
      after 16 h. In contrast, the effects of GH and PRL on PRL receptor mRNA required
      24-48 h of exposure. The effective doses were within the physiological ranges. In
      conclusion, these results show a differential hormonal regulation of GH and PRL
      receptor gene expression in the pancreatic islets, which may play a role in the
      adaptive beta-cell growth during pregnancy.

PMID- 8365360
TI  - Differential expression of A- and B-subtypes of cholecystokinin/gastrin receptors
      in the developing calf pancreas.
AB  - Cholecystokinin (CCK)/gastrin receptors were characterized in calf pancreatic
      plasma membranes from newborns, 28- and 119-day-old milk-fed preruminants, and
      119-day-old weaned ruminants. Scatchard analysis of [125I]Bolton-Hunter reagent
      [Thr28,Nle31]CCK-(25-33) binding indicated two classes of binding sites: high
      affinity sites exhibited significant higher affinity and binding capacity (P <
      0.05) in 119-day-old ruminants than in 119-day-old preruminants (Kd = 0.13 +/-
      0.02 vs. 0.35 +/- 0.08 nM; binding capacity (Bmax) = 53 +/- 12 vs. 18 +/- 5
      fmol/mg protein). Pharmacological analysis using selective agonists and
      antagonists indicated the expression of the CCK-A receptor at birth, whereas the
      CCK-B receptor predominated at postnatal stages. At all stages, the binding was
      inhibited by guanosine 5'-[gamma-thio]triphosphate. Binding site identification
      by photoaffinity labeling showed that at birth, the labeling occurred mainly on a
      78- to 96-kilodalton (kDa) component. In milk-fed animals, aged 28 and 119 days,
      two membrane-binding components were labeled at 78-96 and 43-52 kDa. In 119-day
      old ruminants, labeling occurred mainly on a 40- to 47-kDa protein.
      Deglycosylation by endo-beta-N-acetylglucosaminidase-F of the 40- to 47- and 43-
      to 52-kDa components resulted in the formation of a 37-kDa membrane protein.
      Consequently, this study demonstrated 1) the differential expression of CCK-A and
      -B receptors in developing calf pancreas, 2) the predominance of CCK-B receptors
      in normal pancreas, and 3) the maturation of CCK-B receptors during the weaning
      period, which includes the glycosylation level. These results suggest that CCK
      may play a predominant role during the early postnatal development, while gastrin
      and CCK-B receptors can function progressively to regulate proliferation and
      exocrine secretion in the calf pancreas, especially from the weaning period.

PMID- 8365361
TI  - Gene expression and serum thyroxine-binding globulin are regulated by adrenal
      status and corticosterone in the rat.
AB  - Supraphysiological doses of glucocorticoids reduce serum T4-binding globulin
      (TBG) concentrations when administered to human subjects. Studies were performed
      in rats to determine if glucocorticoid administration alters serum TBG in another
      species, if circulating concentrations of glucocorticoids tonically affect serum
      TBG concentrations, and if changes in TBG production are likely to be a cause of
      the glucocorticoid-induced changes in serum TBG concentrations that are observed
      in humans. The serum TBG-binding capacity was 14.9 +/- 2.3 nmol/liter in
      adrenalectomized male rats compared to 6.6 +/- 1.0 nmol/liter in intact male rats
      and 4.8 +/- 0.9 nmol/liter in adrenalectomized male rats that received
      corticosterone in a dose equal to or less than the replacement dose, as assessed
      by thymus weight (P < 0.01 for serum TBG in adrenalectomized vs. intact or
      adrenalectomized corticosterone-treated groups). Hepatic TBG mRNA content, as
      assessed by polymerase chain reaction amplification and expressed as a ratio of
      beta-actin mRNA content, was 0.10 +/- 0.03 density units in intact male rats,
      0.59 +/- 0.17 density units in adrenalectomized male rats, and 0.05 +/- 0.02
      density units in adrenalectomized corticosterone-treated male rats (P < 0.03 for
      adrenalectomized vs. intact or adrenalectomized corticosterone-treated rats).
      Adrenalectomy increased the serum TBG-binding capacity in female rats (intact
      female rats, 13.9 +/- 1.0 nmol/liter; adrenalectomized female rats, 39.0 +/- 6.4
      nmol/liter; P < 0.01). These studies indicate that serum TBG is tonically down
      regulated by adrenal glucocorticoids, because corticosterone decreases the TBG
      production rate, probably at the level of transcription. This effect is similar
      to that described for corticosterone-binding globulin, but differs from that for
      many proteins of the serine protease inhibitor family that are related to TBG.

PMID- 8365362
TI  - Stimulation of prolactin secretion in the pig: central effects of relaxin and the
      antiprogesterone RU 486.
AB  - Our previous study has shown that oral administration of a potent progesterone
      antagonist, RU 486, caused a marked elevation of plasma concentrations of both
      PRL and progesterone in hysterectomized pigs bearing aging corpora lutea.
      Hysterectomized pigs (hysterectomy performed on day 8; estrus = day 0) were
      subjected to cranial surgery for chronic placement of a head-mounted stereotaxic
      apparatus for intracerebroventricular (icv) administration of relaxin (300 U once
      daily on days 111 and 113; n = 6) and RU 486 (4 mg once daily on days 111, 113,
      and 115; n = 5) to test whether relaxin and RU 486 exert their actions within the
      central nervous system and/or pituitary gland to affect PRL and GH secretion.
      Control pigs (n = 3) received icv injection of vehicle. Intensive blood sampling
      revealed that icv injection of relaxin on day 111 markedly increased the plasma
      PRL concentration from 8 to 38 ng/ml within 10 min (P < 0.01). An identical icv
      injection of relaxin on day 113 caused only a modest increase in PRL, but the
      overall mean concentration of PRL after relaxin treatment was greater than that
      before treatment (14 vs. 8 ng/ml; P < 0.05). Intracerebroventricular injection of
      RU 486 on day 111 greatly elevated plasma PRL. The increase in PRL lasted more
      than 2 h, with several peak increases of 18-29 ng/ml (P < 0.01). The PRL response
      to subsequent icv infusion of RU 486 on days 113 and 115 was blunted, but the
      overall mean concentration of PRL (14 ng/ml) after icv injection of RU 486
      remained greater (P < 0.01) than that before treatment (9 ng/ml). In contrast,
      PRL concentrations in the control group remained unchanged after injection.
      Plasma concentrations of GH, relaxin, and progesterone were significantly altered
      in neither hormone- nor vehicle-treated groups during this brief period of
      sequential blood sampling. This study provides strong evidence that relaxin has a
      central role in modulating PRL secretion in the pig. In addition, the
      antagonistic effects on progesterone receptor by RU 486 in the central nervous
      system and/or pituitary gland caused an abrupt increase in PRL secretion in these
      hysterectomized gilts.

PMID- 8365363
TI  - Angiotensin-II induces changes in the cytosolic sodium concentration in bovine
      adrenal glomerulosa cells: involvement in the activation of aldosterone
      biosynthesis.
AB  - The homeostasis of cytosolic free calcium ([Ca2+]i) and intracellular free sodium
      ([Na+]i) are linked in many cell types. We, therefore, studied the effect on
      [Na+]i of two physiological stimulators of aldosterone synthesis that trigger the
      calcium messenger system, angiotensin-II (Ang II) and potassium ion (K+), in
      cultured bovine adrenal glomerulosa cells, using the intracellular fluorescent
      probe for sodium, sodium benzofuran isophthalate. Ang II induced a concentration
      dependent and sustained increase in [Na+]i, from a resting value of 9.2 +/- 3.5
      to a maximum of 48.5 +/- 5.5 mM (n = 14). This [Na+]i response was mediated by
      receptors of the AT1 subtype, because it was abolished by losartan (DuP 753). K+
      (15 mM) induced a weaker [Na+]i response, from 5.9 +/- 2.6 to 16.8 +/- 2.5 mM (n
      = 9). In freshly prepared cells, basal [Na+]i was significantly higher (23.9 +/-
      1.8 mM; n = 14; P < 0.01) than in cultured cells. Atrial natriuretic peptide,
      which is known to affect sodium transport in various cell types, did not alter
      the [Na+]i response elicited by Ang II. Ethylisopropylamiloride, an inhibitor of
      Na+/H+ exchange, and dichlorobenzamyl, an inhibitor of Na+/Ca2+ exchange, both
      inhibited in a concentration-dependent manner the Ang II- and K(+)-induced
      aldosterone response. Isoosmotic replacement of extracellular Na+ markedly
      reduced basal aldosterone synthesis. Under these conditions, the concentration
      response curve for Ang II-induced aldosterone synthesis was shifted to the right,
      and its maximum was strikingly diminished. These results show that Ang II and, to
      a lesser extent, K+ induce significant changes in [Na+]i in bovine glomerulosa
      cells. These [Na+]i changes probably occur through the Na+/H+ and Na+/Ca2+
      exchangers and are likely to play a role in activation of the steroidogenic
      cascade.

PMID- 8365364
TI  - Location of a glucose-dependent response region in the rat S14 promoter.
AB  - The rat S14 gene provides an excellent model to examine the DNA sequences
      associated with carbohydrate regulation of hepatic gene transcription. We
      constructed internal deletions within 5 kilobases of the 5'-up-stream region and
      ligated these to a luciferase reporter gene. The constructs were transfected into
      primary hepatocytes and pancreatic HIT cells. In hepatocytes, an increase in the
      medium glucose concentration led to a parallel increase in endogenous mRNA S14
      content and transfected luciferase reporter activity driven by 5 kilobases of the
      S14 promoter. Internal deletions of several sequences from -2706 to -285 each led
      to a decrease in glucose-stimulated activity, suggesting that multiple elements
      are necessary for the transcriptional response to glucose. Deletion from -1583 to
      -1069 nearly abolished the glucose effect in both cell types and delineated the
      carbohydrate response element (CHORE). The CHORE deletion was specific for
      glucose, because it did not alter the response to thyroid hormone, another known
      regulator of this gene. Although the CHORE sequence did not confer glucose
      activation to either a heterologous promoter or the basal S14 promoter (bases 
      285 to +19), a 5-fold enhanced response was observed when two copies of the CHORE
      were ligated to the first 2110 basepairs of the S14 promoter. The results suggest
      that the CHORE contains a carbohydrate regulatory element and operates as an
      enhancer in concert with other sequences within the S14 gene.

PMID- 8365365
TI  - Differential regulation of human progesterone receptor A and B form-mediated
      trans-activation by phosphorylation.
AB  - Hormone-dependent phosphorylation of progesterone receptors (PRs) plays a
      functional role in their transcriptional activity. However, hormone-independent
      phosphorylation has also been shown to modulate the chicken PR-mediated trans
      activation in the presence of phosphorylating agents. The present study was
      designed to investigate the effects of protein kinase A- and protein kinase C
      mediated signal transduction pathways on the regulation of the activity of the
      two forms of human PR (hPRA and hPRB). Similar to chicken PR, hPR was activated
      by 8-bromo-cAMP (8-Br-cAMP) in the absence of ligand, whereas 8-Br-cAMP
      synergized with the progestin agonist R5020 to amplify hPRA- and hPRB-mediated
      reporter activity. Interestingly, the effect of 8-Br-cAMP was much more
      pronounced on hPRA-induced trans-activation than on hPRB. This differential
      regulation by 8-Br-cAMP could also be mimicked by okadaic acid. Both mouse
      mammary tumor virus-thymidine kinase-chloramphenicol acetyl transferase and
      progesterone response element-thymidine kinase-chloramphenicol acetyl transferase
      showed a similar response to 8-Br-cAMP in the presence of R5020. Protein kinase
      C, on the other hand, did not discriminate between hPRA- and hPRB-mediated trans
      activation. Unlike 8-Br-cAMP, phorbol 12-myristate 13-acetate did not cause
      marked ligand-independent trans-activation through either of the two receptor
      forms. RU486, an antagonist of progestin, preferentially blocked R5020-induced
      trans-activation compared to R5020 + 8-Br-cAMP synergism. As expected, H-89, a
      specific inhibitor of protein kinase A was more effective in inhibiting ligand
      independent activity. Western analysis of transfected receptors suggested that 8
      Br-cAMP and 8-Br-cAMP + R5020 but not R5020 alone down-regulated the level of
      hPRB in COS-1 cells. Only marginal modulation of hPRA levels was observed with
      R5020 treatment in the presence and absence of 8-Br-cAMP. These data suggest that
      R5020 and 8-Br-cAMP mediate PR-dependent transactivation through distinct
      pathways, and that phosphorylation can differentially regulate the activity of
      hPRA and hPRB forms, an observation which may be important for selective target
      gene activation in vivo by progestins.

PMID- 8365366
TI  - Effect of a major histocompatibility complex class I peptide on insulin-like
      growth factor-I receptor internalization and biological signaling.
AB  - Previous studies have shown that a peptide derived from the murine major
      histocompatibility complex class 1 (MHC-1) antigen inhibits insulin receptor
      internalization and enhances insulin action. Consequently, we have studied the
      effect of this peptide [Dk-(62-85)] derived from the MHC-1 antigen on insulin
      like growth factor-I (IGF-I) internalization and action. When Chinese hamster
      ovary cells that overexpress human IGF-I receptors were incubated in the presence
      or absence of 30 microM Dk-(62-85), IGF-I internalization was inhibited by 43.9
      +/- 1.7% (P < 0.005). This inhibitory effect was dose responsive, with a half
      maximal effect at 8 microM and a maximal effect at 30 microM. The peptide did not
      affect IGF-I receptor autophosphorylation or ligand-induced phosphorylation of an
      endogenous substrate, pp185, in vivo. When added alone, the peptide increased
      glucose transport into Chinese hamster ovary cells by 66.3 +/- 16.0%, whereas
      when the peptide was added together with IGF-I, ligand-stimulated glucose
      transport was inhibited. In conclusion, 1) the MHC-1-derived peptide Dk-(62-85)
      inhibits IGF-I internalization in a dose-responsive fashion; 2) Dk-(62-85) does
      not affect receptor kinase activity, as IGF-I receptor autophosphorylation and
      endogenous substrate phosphorylation are unaltered; and 3) Dk-(62-85) stimulates
      glucose transport by itself, but inhibits IGF-I stimulated transport.

PMID- 8365367
TI  - Luteinizing hormone-releasing hormone (LHRH) in rat prostate: characterization of
      LHRH peptide, messenger ribonucleic acid expression, and molecular processing of
      LHRH in intact and castrated male rats.
AB  - Continuous administration of LHRH agonist suppresses the pituitary-gonadal axis,
      achieving chemical castration. Thus, LHRH agonist has been used as an alternative
      (to surgical castration) for the treatment of steroid-dependent prostate cancer.
      However, recent reports have demonstrated that LHRH agonist had a direct
      inhibiting effect on prostate cancer cell proliferation and that cancerous
      prostate tissue contained a LHRH-like peptide. In this paper we are reporting for
      the first time that the normal rat ventral prostate contained immunoactive and
      bioactive LHRH as well as its precursor molecule, pro-LHRH. Our investigation
      showed that the LHRH concentration in prostate increased 2 weeks after castration
      from 1.68 +/- 0.09 to 3 +/- 0.2 pg/mg tissue (P < 0.001). At the same time, the
      concentration of pro-LHRH decreased from 149 +/- 6.5 to 68 +/- 6.8 pg/mg tissue
      (P < 0.001). Furthermore, intact rat prostate expressed LHRH mRNA, which
      increased 13-fold 2 weeks after castration. In summary, the prostate of intact
      Sprague-Dawley rats has the capacity to produce the LHRH precursor and process it
      to the mature decapeptide, and this production/processing increases significantly
      after castration.

PMID- 8365368
TI  - Lactation alters neuropeptide-Y and proopiomelanocortin gene expression in the
      arcuate nucleus of the rat.
AB  - To identify possible factors associated with lactation that may be involved in
      the suppression of GnRH neuronal function, we have examined whether lactation
      induces changes in arcuate nucleus neuronal function, focusing on changes in
      neuropeptide-Y (NPY) and POMC neuronal activity. Animals were studied during
      diestrous day 1 of the estrous cycle or during day 10 postpartum. Lactating
      animals had their litters adjusted to eight pups on day 2 postpartum. Brain
      tissue was removed to measure NPY peptide content in the median eminence (ME) or
      the ME-arcuate nucleus (ME-ARC) and to quantify NPY or POMC mRNA by in situ
      hybridization, using 35S-labeled antisense riboprobes. The NPY peptide content
      was significantly increased in the ME (1.8-fold) and ME-ARC (1.5-fold) during
      lactation compared to those on diestrus. The NPY mRNA content throughout the ARC
      did not differ between diestrous and lactating animals. However, if specific
      subdivisions of the ARC were examined, a significant increase (1.8-fold) in NPY
      mRNA in the ARC-C region of the ARC (at the plane of the dorsal medial
      hypothalamic nucleus) was observed during lactation. Dorsal to the ARC in this
      same plane, there was also an induction of NPY expression in cells lateral to the
      dorsal medial hypothalamic nucleus. The increases in NPY mRNA in the ARC-C region
      of the arcuate nucleus persisted for at least 24 h after removal of the suckling
      stimulus. The other subdivisions of the ARC did not show any differences in NPY
      mRNA between diestrus and lactation. The POMC mRNA content was decreased by 20
      30% during lactation compared with that on diestrus. The effects of lactation to
      decrease POMC mRNA content were not specific to any subdivision of the ARC, but
      were observed throughout the entire ARC. Given that lactation is an estrogen
      deficient state, the increase in NPY neuronal activity, as indicated by increased
      gene expression in the caudal portion of the ARC and increased content in the ME,
      could play an inhibitory role in the regulation of GnRH secretion. However, the
      decrease in POMC neuronal activity, as suggested by the decrease in gene
      expression throughout the ARC, would not appear to be involved in the suppression
      of GnRH neuronal activity. These changes in ARC neuronal function could be
      related to hormonal changes or metabolic signals regulating food intake during
      lactation.

PMID- 8365369
TI  - Lactotrope differentiation in rats is modulated by a milk-borne signal
      transferred to the neonatal circulation.
AB  - We have previously reported that normal differentiation of PRL-secreting cells in
      neonatal rats requires a maternal signal specific to the first few days of
      lactation. Subsequently, we found that milk proteins from this period had a
      greater capacity than those from later in lactation to stimulate lactotrope
      differentiation in vitro, suggesting that the maternal signal was a milk-borne
      peptide. We reasoned in the present study that if this were the case, the signal
      should be present in the serum of suckling pups, and its level should reflect
      that in mothers' milk. To test this hypothesis, we first compared serum from 3
      day-old pups with that from newborn pups that had not yet suckled. Anterior
      pituitary cells from 1-day-old pups were cultured for 6 days in the presence of
      various serum samples (0.01-1.0% by volume). Lactotrope differentiation was
      assessed using a reverse hemolytic plaque assay for PRL. Serum from 3-day-old
      pups was more effective (P < 0.01; n = 4) than that from unsuckled newborns at
      stimulating lactotrope differentiation in vitro (to 3.5 +/- 0.5% and 1.5 +/- 0.5%
      of all anterior pituitary cells, respectively). Next, we tested whether this
      increase in serum bioactivity in 3-day-old pups required maternal influences
      restricted to the first few days of lactation. Newborn pups were placed with
      foster mothers that had been lactating for 0 or 7 days. When the pups were 3 days
      old, their serum was tested for lactotrope-differentiating activity. Serum from
      pups placed with day 0 foster mothers (control) increased the abundance of PRL
      cells to 2.4 +/- 0.3% of all cells (P < 0.01; n = 3), whereas serum from pups
      placed with day 7 foster mothers failed to stimulate lactotrope differentiation.
      In similar experiments, litters placed the day after birth with day 7 foster
      mothers were separated on day 3 postpartum for 3 h, after which littermates were
      allowed to suckle for 90 min on different foster mothers on day 3 or 9 of
      lactation. This brief suckling bout increased (P < 0.01; n = 3) the capacity of
      serum from pups on day 3 mothers to stimulate PRL cell differentiation (to 3.9 +/
      0.4%) above that of serum from littermates placed with day 9 foster mothers (to
      1.8 +/- 0.2%). Finally, the differentiating activities in pup serum and mothers'
      milk eluted from gel filtration chromatography in identical fractions (4-8
      kilodaltons).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8365370
TI  - Characterization of thyroid hormone binding to apolipoprotein-E: localization of
      the binding site in the exon 3-coded domain.
AB  - Apolipoprotein-E (apoE) has been shown by noncovalent binding and photoaffinity
      labeling with [125I]T4 to possess a single L-T4 binding site with a K5 of about 3
      x 10(7) M-1 and a relative affinity for analogs of L-T4 = D-T4 = rT3 =
      triiodothyroacetic acid > L-T3. T4 binding was not affected by the flavonoid EMD
      21388 or heparin, but was inhibited by diclofenac = mefenamic acid > furosemide.
      Localization of the T4 site to the N-terminal 62-amino acid region of the mature
      peptide coded by exon 3 was deduced from the following evidence. 1) The N
      terminal 15- to 26-kilodalton (kDa) fragments (within residues 1-160 to 210), but
      not the approximately 10- to 11-kDa fragments (within residues approximately 220
      299), were labeled by [125I]T4. 2) Variants apoE2 and apoE4, with nonconservative
      mutations at positions 112 and 158 (the latter unable to interact with the apoB/E
      receptor), maintained the ability to bind T4. 3) Monoclonal antibodies MAb 1D7
      and 3H1 (epitopes at positions 139-169 and 243-272, respectively) failed to
      inhibit T4 binding, but MAb 6H7 (epitope at 1-125) decreased labeling by about
      24%. 4) Polymers of apoE were specifically labeled despite the interaction
      between amphipathic alpha-helices of the exon 4-encoded region (63-299). We
      conclude that apoE, as previously observed with apoA-I and apoB, possesses a T4
      binding domain separate from the lipid-binding domain and distinct from both the
      heparin- and the cell receptor-binding sites. Thyroid hormone binding by apoE may
      facilitate uptake of the hormone by cells through apoB/E receptors, which are
      widely distributed in tissues.

PMID- 8365371
TI  - Immunological identification of the protein-producing masculine differentiation
      of the Wolffian duct in the fetal mouse: western blot analysis and determination
      of the biological activity.
AB  - Recently, we identified a protein in the developing male reproductive tract of
      the fetal mouse which induced Wolffian duct differentiation in vitro in the
      absence of testis or testosterone. In this paper, we further evaluated the
      masculinizing role of this protein using an immunological approach. Thus, we
      purified a 72K protein from the 18-day-old male fetal reproductive tracts,
      prepared an antibody against the protein, and determined the role of this protein
      in producing masculine differentiation of the Wolffian duct using the polyclonal
      antibody against the protein. We demonstrate that the antibody reacted with the
      purified 72K protein, producing only one immunoreactive band around the 72K
      region in Western blot analysis. However, it reacted with 72K and 63K proteins
      present in the 18-day-old male reproductive tract. Both of these immunoreactive
      bands disappeared when the antibody was pretreated with the purified antigen.
      Nonimmune immunoglobulin G (IgG) produced no reactive bands with the extract of
      the male reproductive tracts. The IgG preparation of the immune serum
      specifically prevented Wolffian duct differentiation when tested in organ culture
      containing 13-day-old fetal male or female reproductive tracts in the presence of
      testis or testosterone (1 micrograms/ml) in a dose-dependent manner. No effect
      was found on the development of other organs, namely testis, Mullerian duct, and
      urogenital sinus, that were included in the organ culture. Nonimmune IgG, as
      expected, produced no effect on Wolffian duct differentiation. Western blot
      analysis of male and female reproductive tracts indicated a difference in their
      reactivities with this antibody. In females, the reactivity to the proteins
      around the 72K and 63K regions was very weak compared to that found with male
      proteins in those regions. Both of the above bands of the female reproductive
      tract disappeared when the antibody was pretreated with an excess of female
      reproductive tract extract, but in males, only the 63K band disappeared, whereas
      its 72K band remained. In conclusion, it appears that a 72K protein of the male
      reproductive tract plays a role in the Wolffian duct differentiation of the fetal
      mouse.

PMID- 8365372
TI  - Brain corticotropin-releasing hormone- and interleukin-1 beta-induced suppression
      of specific antibody production.
AB  - CRH serves as a central nervous system mediator of autonomic and visceral
      responses to stress. In addition, central infusion of CRH has a role in the
      modulation of in vitro correlates of cell-mediated immune function, such as
      natural killer cell activity and T-lymphocyte proliferation. The present study
      examined the effects of central CRH on an integrated in vivo immune response,
      specific antibody production to a novel antigen. Synthetic rat CRH (1.0
      micrograms) microinjected into the lateral ventricle significantly (P < 0.001)
      slowed the induction of a specific immunoglobulin G (IgG) antibody response to
      the T-cell-dependent antigen keyhole limpet hemocyanin (KLH) after either primary
      or secondary immunization. CRH-induced suppression of the IgG response in vivo
      was found after immunization with a low threshold dose of KLH, but not when a 100
      fold increased dose of antigen was given. Administration of CRH 20 min before
      immunization reduced the antibody response, whereas CRH infusion 24 h after KLH
      exposure failed to alter antibody levels, suggesting that CRH alters initial
      antigen processing. These effects of CRH on an in vivo antibody response were due
      to the infusion of CRH into the brain, as a 1.0-micrograms dose of CRH injected
      either ip or sc had no effect. In addition, central coadministration of the CRH
      antagonist alpha-helical CRH-(9-41) significantly blocked the immunosuppressive
      action of CRH. Finally, as central interleukin-1 beta has been reported to
      modulate cellular immunity, we examined the effect of central infusion of
      interleukin-1 beta on the KLH antibody response and found that
      intracerebroventricular interleukin-1 beta (50 ng) produced a significant (P <
      0.001) suppression of the IgG response to KLH. These findings extend previous
      data on central CRH-induced suppression of in vitro measures of cellular immunity
      and demonstrate that CRH acts in the brain to reduce an in vivo antibody
      response.

PMID- 8365373
TI  - The effect of insulin and insulin-like growth factor-I on glucose transport in
      normal and small for gestational age fetal rats.
AB  - In a model of asymmetric small for gestational age (SGA) fetal growth
      retardation, we have previously found that glucose transport is decreased in lung
      (an organ whose growth is restricted) and unaffected in brain (growth is normal).
      The SGA model alters a number of physiological and metabolic factors that may
      decrease glucose transport, thereby causing growth retardation. Specifically,
      insulin and insulin-like growth factor-I (IGF-I) concentrations are diminished in
      SGA fetuses. We hypothesized that the specific modulation by these factors of
      gene expression of a glucose transporter, Glut-1, is impaired. We performed
      bilateral uterine arterial ligation in pregnant rats on day 19 of gestation (term
      = 21.5 days) and obtained fetal brain, lung, and skeletal muscle on day 20. Lung
      and muscle explants and monolayers of glial cells and type II pneumocytes were
      cultured in the presence or absence of insulin or IGF-I for 24 h. Glucose uptake
      and levels of Glut-1 protein and mRNA were similar in brains of SGA and control
      fetuses and were not affected by treatment with insulin or IGF-I. Treatment with
      insulin or IGF-I increased glucose uptake and levels of Glut-1 protein and mRNA
      in a dose-dependent manner in lung and muscle from control fetuses. However, the
      response in SGA lung was not as great as that in controls. SGA muscle
      demonstrated no significant response to either hormone. These findings suggest
      that changes in glucose transport modulation might contribute to the development
      of asymmetric growth retardation, and that maintenance of normal transporter
      function and expression in brain may play a role in sparing its growth.

PMID- 8365374
TI  - Stretch-induced atrial natriuretic factor release utilizes a rapidly depleting
      pool of newly synthesized hormone.
AB  - Atrial muscle stretch is widely believed to be the main stimulus for atrial
      natriuretic factor (ANF) release. However, a few reports have shown that although
      stretch induces an immediate increase in ANF output, this release rapidly decays
      even though hormone stores are not significantly depleted. In the present work,
      this phenomenon was studied in an isolated rat atria preparation using double
      isotope labeling. The tissue was labeled with [14C]leucine for 3 h followed by a
      1-h chase, and then with [3H]leucine for 1 h. A final 1-h chase period was
      conducted with the tissue under basal (0.2-g load) or stretched (5-g load)
      conditions. During this final chase period, the [14C]ANF represented older,
      stored ANF and the [3H]ANF represented the newly synthesized peptide. After both
      the [14C]- and [3H]leucine pulses, immunoprecipitable isotope incorporated into
      ANF appeared in the chase medium within the first 10 min and stabilized to lower
      levels after 20 min of chase. Stretch resulted in an immediate significant
      increase in immunoreactive ANF release and a decrease in the medium [14C]ANF
      specific activity (SA). However, no change was observed in the medium [3H]ANF SA
      but the tissue SA tended to decrease. It is concluded that a portion of ANF is
      immediately and preferentially released upon synthesis, while the remainder is
      taken up into tissue stores and released from them at a lower rate. The secretory
      response to stretch was demonstrated to consist of a rapid, short-lived burst of
      newly synthesized ANF, suggesting an increased translocation of newly synthesized
      hormone into a stretch-sensitive, rapidly depletable pool. Given the nature of
      this pool, additional factors yet to be characterized likely come into play to
      maintain chronically elevated circulating levels of ANF.

PMID- 8365375
TI  - Transforming growth factor beta 1-like immunoreactivity in the pituitary gland of
      the rat: effect of estrogen.
AB  - We have recently shown that transforming growth factor-beta 1 (TGF beta 1) is
      produced in the rat pituitary gland and inhibits the secretion of PRL and the
      estrogen-induced growth of lactotropes. In this study, we sought to ascertain
      whether TGF beta 1 inhibits lactotropic functions by an autocrine or paracrine
      mechanism. Our techniques consisted of localizing the pituitary distribution of
      the growth factor immunoreactivity and measuring changes in pituitary TGF beta 1
      and PRL levels in the presence and absence of estrogen in ovariectomized animals.
      With the use of standard immunohistochemical techniques, we observed that in
      cyclic females and ovariectomized rats, 60 +/- 7% of the cells exhibiting TGF
      beta 1-like immunoreactivity in the anterior pituitary were lactotropes. In
      addition, the melanotropes in the intermediate lobe appeared to be TGF beta 1
      immunopositive. Treatment with estrogen for 7 days reduced the number of TGF beta
      1-immunoreactive lactotropes. Immunoreactive TGF beta 1 was also detectable in
      anterior pituitary extracts using a specific RIA. Estrogen treatment decreased
      the level of TGF beta 1 in the anterior pituitary extracts from ovariectomized
      rats. TGF beta 1 immunoreactivity was inversely proportional to the overall size
      of the anterior pituitary and the concentrations of PRL, as measured in both the
      anterior lobe extracts and plasma. These results suggest that lactotropes may
      serve as a site of TGF beta 1 synthesis and that the production of TGF beta 1 in
      these cells can be negatively influenced by PRL stimulation through the action of
      the lactotrope-proliferating hormone, estrogen. Furthermore, these data support
      the notion that TGF beta 1 controls lactotropic function by an autocrine
      mechanism.

PMID- 8365376
TI  - Atrial stretch induces rapid increase in brain natriuretic peptide but not in
      atrial natriuretic peptide gene expression in vitro.
AB  - Pressure and volume overload in vivo is characterized by induction of the
      expression of two cardiac hormones, atrial natriuretic peptide (ANP) and brain
      natriuretic peptide (BNP), but whether stretch directly or other
      pathophysiological factors associated with cardiac overload cause the activation
      of these genes is not known. In the present study we examined the effect of short
      term (from 30 min to 2 h) direct myocardial stretch on atrial ANP and BNP
      synthesis and release in modified perfused rat heart preparation that enabled the
      stepwise distension of the right atrium by pressures approximating those found in
      vivo. The increase in right atrial pressure by 3.6 mm Hg for 2 h resulted in a
      3.3- (p < 0.001) and 1.7-fold (p < 0.02) increase in the rate of IR-ANP and IR
      BNP release, respectively, into the perfusate. The maximal increase in both ANP
      and BNP release was seen after 20 min distension. Thereafter the perfusate IR-ANP
      and IR-BNP concentration gradually decreased, reaching control values within 2
      hours. Chromatographic analysis showed that the hearts primarily release the
      active, processed 28- and 45-amino acid ANP- and BNP-like peptides, respectively,
      both before and during atrial stretch. Atrial stretch induced rapid stimulation
      of BNP gene expression: 1.9- (p < 0.001) and 4.5-fold (p < 0.001) increase in
      right auricular BNP mRNA levels after 1.0 and 2.0 hours' stretching,
      respectively, was found on Northern blot analysis, while no change was seen after
      30 min distension. In contrast, stretching for up to 2 h did not change auricular
      ANP mRNA, IR-ANP or IR-BNP levels. Our results show for the first time that
      atrial stretch induces rapid stimulation of both synthesis and secretion of BNP.
      The induction of BNP gene expression in the very early stages of cardiac overload
      mimics the induction of protooncogenes and occurred without involvement of
      humoral or neural factors. The lack of response of atrial ANP mRNA levels
      demonstrates that the regulation of BNP gene expression differs from that of ANP.

PMID- 8365377
TI  - Growth hormone receptor and growth hormone-binding protein messages in mouse
      placenta contain the exon analogous to human exon 3.
AB  - Growth hormone receptor (GHR)-encoding messages from the human placenta and other
      tissues have been recently characterized by several investigators. Of particular
      interest is the finding that exon 3 is deleted from the mRNA encoding GHR in
      human placenta, but not in maternal tissues. We have used a reverse transcriptase
      polymerase chain reaction (RT-PCR) technique to amplify the distinct mRNAs
      encoding GHR and GH-binding protein (GHBP) in the mouse placenta and liver,
      followed by restriction analysis, to determine whether an analogous deletion
      exists in these mRNAs. The restriction analysis and sequencing of the PCR
      products shows that the mRNAs encoding GHBP and GHR in the mouse placenta do not
      have a deletion analogous to that found in human placental GHR mRNA.

PMID- 8365378
TI  - alpha 1-Antitrypsin- and anchorage-independent growth of MCF-7 breast cancer
      cells.
AB  - alpha 1-Antitrypsin (alpha 1-AT) and alpha 1-antichymotrypsin (alpha 1-ACHY) are
      closely related protease inhibitors, synthesized primarily by the liver, which
      play major roles in modulation of the inflammatory response. Previously, we had
      shown that MCF-7 human breast cancer cells were able to synthesize active alpha 1
      AT and alpha 1-ACHY and that the synthesis of both inhibitors varied among
      different MCF-7 sublines. We now show that when MCF-7(ML) cells (a subline
      synthesizing low levels of alpha 1-AT) are grown in soft agar in medium depleted
      of its trypsin inhibitory capacity (i.e. alpha 1-AT-free), addition of alpha 1-AT
      (50 micrograms/ml) significantly reduces colony formation in both the presence
      and absence of estradiol (34% and 44%, respectively). Under these conditions,
      incubation with 10(-7) M estradiol alone increased colony formation 2- to 3-fold.
      Colony formation was also significantly reduced by serum leukocyte protease
      inhibitor, which, like alpha 1-AT, is a potent inhibitor of elastase-like
      enzymes. We also found that a variety of inflammatory mediators, cytokines, and
      steroid hormones are able to stimulate synthesis of alpha 1-AT and alpha 1-ACHY
      by MCF-7 cells. Stimulation by interleukin-6 (IL-6; 200 U/ml), epidermal growth
      factor (4 nM), and estradiol (10(-7) M) was 2- to 3-fold, whereas stimulations by
      tetradecanoylphorbol-13-acetate (TPA; 80 nM) and IL-1 (10 U/ml) were 2- to 5-fold
      and 5- to 10-fold, respectively. In each instance, protein synthesis, monitored
      by immunoprecipitation of 35S-labeled proteins followed by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis, and steady state mRNA levels, monitored by
      Northern blot analysis with specific cDNA probes, increased to the same extent.
      Consistent with their ability to stimulate alpha 1-AT synthesis, TPA and IL-1
      reduced colony formation in the absence of estradiol by 65% and 63%,
      respectively. In addition, the effects of both TPA and IL-1 could be reversed by
      antibody to alpha 1-AT. These results suggest that local synthesis of alpha 1-AT
      and possibly other protease inhibitors may be important in regulating the
      tumorigenic potential of MCF-7 breast cancer cells.

PMID- 8365379
TI  - The effect of very long-chain n-3 fatty acids on immune-related skin diseases.

PMID- 8365380
TI  - Predictive equations for basal metabolic rates of Indian males.
AB  - The article deals with the generation of a prediction equation for basal
      metabolic rate (BMR) of well-nourished Indian males, from prospective
      measurements on 121 males, using a single validated technique. The equation
      related BMR to simple measures such as weight (WT) and age, and was given by: BMR
      (kJ/d) = 48.7 * WT-14.1 * AGE + 3599. The equation was internally as well as
      externally validated against other Indian databases and the net differences of <
      2% (100 kJ/d), were non-significant. Interestingly, American BMRs were predicted
      to within 0.5% (28 kJ/d) by this equation, while European BMRs were significantly
      higher than predicted by 6.3% (433 kJ/d). Similar results were obtained on
      validating the American and European data against the equations of C. K. J. Henry
      & D. G. Rees (1991) Eur J. Clin. Nutr. 45, 177-185. Such results suggest that
      there are no differences in the BMR of age- and weight-matched Asian Indian
      males, other tropical populations and Americans. This has implications in the
      estimation of energy expenditure and hence energy requirements for these
      populations.

PMID- 8365381
TI  - Role of zinc supplementation in the rehabilitation of severely malnourished
      children.
AB  - A double-blind study was conducted to assess the role of zinc supplementation in
      the rehabilitation of severely malnourished children. Thirty-three children with
      severe protein-energy malnutrition received either 40 mg of zinc as zinc sulphate
      or a placebo during their rehabilitation in addition to the diet containing about
      700 kJ and 3-4 g protein per kg body weight/day. Their clinical and biochemical
      responses were examined. Clinical response and serum albumin synthesis were found
      to be similar in both the groups. The leukocyte (micrograms/10(10) cells) and
      plasma zinc levels (micrograms/dl) showed a significant (P < 0.001 and P < 0.01)
      increase from 46.9 +/- 5.490 to 107.2 +/- 13.224 and 80.4 +/- 9.972 to 107.5 +/-
      11.822, respectively, after zinc supplementation. The placebo group also showed a
      significant (P < 0.025) increase in leukocyte zinc from 45.7 +/- 4.409 to 70.9 +/
      8.414. However, the plasma zinc in the placebo group fell from 83.6 +/- 10.363
      to 68.2 +/- 7.031. Plasma copper showed a significant improvement in both zinc
      supplemented (P < 0.01) and placebo (P < 0.025) groups. The results indicate that
      zinc supplementation along with the diet would result in rapid restoration of
      zinc status, though there is no effect on the weight gain or other responses.

PMID- 8365382
TI  - Nutrient intake and biological maturation during adolescence. The Amsterdam
      growth and health longitudinal study.
AB  - The study evaluates the association of the food intake and the rate of biological
      maturation of 200 boys and girls in Amsterdam during their adolescence. The
      subjects were followed in a longitudinal survey over a period of 9 years, between
      the ages of 13 and 22 years. In the first four years (1976-1980) annual
      measurements were performed (school period). In 1985 a fifth measurement was made
      at the age of 21 years. Biological maturation was estimated from X-ray
      photographs of the left hand and wrist and rated according to the Tanner
      Whitehouse II method. On the basis of the annual measurements in the first four
      years a distinction was made between late maturers (LMs) and early maturers
      (EMs). The individual food intake was obtained with a cross-check dietary history
      method: a dietitian interviewed the entire range of foods and drinks, making
      allowance for regular meals as well as in-between meals, separately for normal
      schooldays and weekend days. Analysis of variance was used to test the effects of
      maturation (M), time of measurement (T) and interaction (M x T). The results show
      that EMs of both sexes consumed less energy and protein per kg body weight, but
      were fatter at young adult age and showed less habitual physical activity than
      LMs during the whole period of observation. The conclusion could be drawn that
      late maturation seems to coincide with an energy intake that is more appropriate
      to their higher activity pattern than early maturation during adolescence. This
      results in a significantly lower body fat mass in late maturing boys and girls
      compared to early maturers.

PMID- 8365383
TI  - 'Determination' of sugar alcohol and Polydextrose absorption in humans by the
      breath hydrogen (H2) technique: the stoichiometry of hydrogen production and the
      interaction between carbohydrates assessed in vivo and in vitro.
AB  - The production of hydrogen from substrates and substrate mixture of sugar
      alcohols and Polydextrose was determined, both in vivo using the breath hydrogen
      test, and in vitro, using human faecal microorganisms in anaerobic culture. One
      objective was to test a previous assumption that the stoichiometry of hydrogen
      production from different alternative carbohydrates is similar. Another objective
      was to discover whether hydrogen responses from mixtures of substrates were
      simply additive, or whether interactions occurred. The breath tests were
      performed in a 10 subject x 10 substrate factorial design with substrates and
      substrate mixtures (5-11 g) administered in 42 g chocolate confectionery.
      Incorporation of the alternative carbohydrates lactitol (L), Isomalt (I) and
      Polydextrose (P) into otherwise conventional confectionery increased breath
      hydrogen production by approximately 112, 73 and 11%/g respectively. There was no
      interaction between L and I or between P and I, but a combination of L and P
      approximately doubled the breath hydrogen anticipated from their individual
      contributions (P < 0.05). Anaerobic cultures showed a sixfold range in the
      efficiency of converting individual substrates and mixtures to hydrogen gas
      (0.003-0.018 kJ H2 per kJ carbohydrate). The positive interaction between L and
      P, and the lack of interaction between L and I, and between P and I, found in
      vivo were reproduced in vitro. The work showed that interpretation of the
      hydrogen breath test is confounded by differing stoichiometries for hydrogen
      production, by interaction between substrates and by an uncertain extent to which
      small intestinal hydrolysis yielding species with a fermentation stoichiometry
      that differs from the parent substrate.

PMID- 8365384
TI  - No effect of human serum and erythrocytes enriched in n-3 fatty acids by oral
      intake on Plasmodium falciparum blood stage parasites in vitro.
AB  - To examine the effect of n-3 polyunsaturated fatty acids (n-3 PUFA) on the
      erythrocytic growth of Plasmodium falciparum, serum and erythrocytes were
      separated from blood of a healthy donor before and after he had taken fish oil
      capsules for 8 days. Such intake supplied an amount of eicosapentaenoic acid
      (EPA, 20:5n-3) of 3.5 g/d and docosahexaenoic acid (DHA, 22:6n-3) of 2.5 g/d and
      24 mg/d of total tocopherol. Post-intake fish oil serum (post-s) and erythrocytes
      (post-e) were tested in vitro for inhibitory activity against blood stages of P.
      falciparum compared with pre-intake serum (pre-s) and pre-intake erythrocyte (pre
      e). Also the effect of EPA and arachidonic acid (AA, 20:4n-6) on the erythrocytic
      growth of P. falciparum was tested using in vitro assays. The results show that
      both post-s and post-e had no antimalarial activity on P. falciparum. No
      differential antimalarial effect was observed for 20:5n-3 compared with 20:4n-6,
      which at high concentrations (> 40 microM) had an anti-schizont-growth effect.

PMID- 8365385
TI  - Effects of stearic acid and trans fatty acids versus linoleic acid on blood
      pressure in normotensive women and men.
AB  - The objective of this study was to compare the effect of linoleic acid (cis,cis
      C18:2) with that of its hydrogenation products stearic acid (C18:0) and elaidic
      acid (trans-C18:1) on blood pressure levels in normotensive humans. We therefore
      measured the effects of these fatty acids on systolic and diastolic blood
      pressure in 30 women and 25 men. Three strictly controlled experimental diets
      were supplied to every subject for 3 weeks each, in different order (multiple
      cross-over). The composition of the three diets was constant, except for 8% of
      daily energy, which was provided by either linoleic acid, stearic acid, or
      monounsaturated trans fatty acids. The statistical power for detecting a true
      difference between two diets of 3 mmHg in systolic and diastolic blood pressure
      was over 90%. Mean systolic/diastolic blood pressure at the end of the dietary
      periods was 114/69 mmHg on the linoleic acid diet, 113/70 on the stearic acid
      diet, and 113/69 on the trans fatty acid diet. No significant differences were
      observed in blood pressure levels after 3 weeks on each diet. We conclude that a
      major increase in the intake of linoleic acid at the expense of stearic acid or
      trans fatty acids has no effect on blood pressure in normotensive young women and
      men.

PMID- 8365386
TI  - Computerized analysis of food records: role of coding and food composition
      database.
AB  - Reported dietary intake records of 30 subjects (26 men and 4 women) were analysed
      by three different centres using their own computerized nutrient database
      systems. The agreement between systems was evaluated by different statistical
      criteria (the correlation coefficient, the mean difference and the proportion of
      individuals placed in the same thirds of distribution). Significant differences
      between the three systems were found in the calculation of alcohol,
      polyunsaturated fatty acids, saturated fatty acids, linoleic acid, linolenic
      acid, cholesterol, magnesium, sodium and water. To ascertain the extent of mean
      differences that could be attributed to the coding process or to the database
      used, coding forms of each centre were forwarded to the other two centres.
      Analysis of variance showed that differences in the data obtained by the three
      systems were mainly due to the food composition database used.

PMID- 8365388
TI  - Visual/vestibular effects of inert gas narcosis.
AB  - Divers breathing compressed air at depths beyond 30 m experience a type of
      behavioural impairment known as inert gas narcosis. This condition degrades
      performance on a wide range of tasks and has the potential to compromise safety.
      Symptoms associated with narcosis include slowed response time, amnesia, and
      euphoria. Studies have also found disturbances to mechanisms regulating ocular
      control in response to vestibular stimulation; however, these experiments have
      been limited to very low frequency head movement (0.2 Hz). Thus, to further
      examine the effects of narcosis on visual/vestibular mechanisms, the vestibular
      ocular reflex (VOR) was assessed across a range of higher frequencies more
      representative of natural head movement (2.0-4.7 Hz). Seven subjects were tested
      prior to, during and after exposure to narcosis which was induced using 30%
      nitrous oxide. Standard room air was breathed as a control. The results indicated
      that narcosis decreased the velocity of compensatory eye movements in response to
      head rotation (decrease in VOR-gain), with more pronounced decreases occurring at
      the higher frequencies. The lag between eye and head position (phase lag) was
      also decreased by nitrous oxide; an effect that was again more pronounced at
      higher frequencies. These results indicate that narcosis disrupts ocular
      regulatory mechanisms which help to stabilize images on the retina during head
      movement.

PMID- 8365387
TI  - Work-related chronic injuries of the forearm and hand: their specific diagnosis
      and management.
AB  - Work-related chronic injuries occur in muscles, tendons, and nerves.
      Epidemiological, histological, and physiological data confirm their often
      disputed physical basis. Terms such as repetitive strain injury and cumulative
      trauma disorder, when used as a diagnosis, have obscured the issue for they are
      really statements of causation. Definitive diagnosis is required both to treat
      and prevent such injuries. Precise terminology that identifies the tissue and its
      pathology is required. A detailed assessment methodology is described that allows
      a precise diagnosis. A clear relationship to work stress is necessary both to
      establish the cause and formulate prevention strategies. Treatment must begin
      early and be appropriate to the tissue and the nature of the injury. Examples are
      presented and discussed. Early treatment begins before too much damage has been
      done and yields better results.

PMID- 8365390
TI  - The vibration characteristics of chain saws and their influence on vibration
      white finger disease.
AB  - The vibration from chain saws can cause vibration-induced white finger disease
      (VWFD). Measurements of vibration levels on the front and rear handles of
      different chain saw-types, and on the operator's middle finger were collected at
      three logging camps on Vancouver Island. Factors effecting the vibration levels
      on the finger and handles were investigated. The acceleration at the firing
      frequency was found to be the dominant factor effecting handle and finger
      vibration. Other factors which were investigated were: grip force; the presence
      of handle covers; and chain sharpening procedure. Weighted acceleration levels
      are calculated and this information is used to assess the latency period for
      fallers to develop VWF disease.

PMID- 8365389
TI  - Biomechanical comparison of carpet-stretching devices.
AB  - Peak impact forces, measured from seven male carpetlayers using a knee-kicker
      over 39 trials were 2933 N (SD 397), taking 9.5 ms (SD +/- 1.1) to reach peak.
      The knee-kicking cycle involved high knee decelerations of 880 m.s-2 (SD +/-
      271). Angles at peak force for the knee (63 degrees SD +/- 10 degrees) and hip
      (80 degrees SD +/- 35 degrees) showed considerable variation between individuals.
      Kneeling forces on the non-kicking leg during the kick cycle were 894 N:
      comparative forces were 368 N and 476 N measured during use of the power
      stretcher and crab re-stretcher, respectively. Under dynamic conditions the
      effective mechanical advantage of the knee-kicker was less than 1.0. In
      comparison, the mechanical advantage of the power stretcher was approximately 14
      times greater over the stretch action. When tested with a crab re-stretcher, the
      breaking strength of the smooth-edge to which the carpet attaches averaged 2384 N
      (SD +/- 245). Design guidelines for an improved carpet stretching device are
      provided.

PMID- 8365391
TI  - A human factors evaluation of two different machine control systems for log
      loaders.
AB  - The implement movement in today's mobile, heavy machinery does not correspond in
      a one-to-one proportion with hand control movement. This lack of correspondence
      places high perceptual and psychomotor demands on the operator. The objective of
      this study was to evaluate the human factors of two different machine control
      systems on a log loader in a controlled field setting. The traditional joint
      control system was compared with a co-ordinated control system. The two machines
      were tested on ten novice and six experienced operators. Operator performance was
      based on the time required to complete a task sequence, as well as reaction time.
      The results show that the novice operators performed significantly better in co
      ordinated mode than they did in joint mode, whereas the experienced operators
      performed better in joint mode than they did in co-ordinated mode. Results
      indicate, however, that it would not take long for experienced operators to
      transfer their skills from joint control to co-ordinated control.

PMID- 8365392
TI  - Cardiovascular and muscular strain during a tree planting season among British
      Columbia silviculture workers.
AB  - Cardiovascular and muscle strain were determined in 16 British Columbia
      reforestation workers during a period of tree planting (75 days). Serial data
      collected from each worker included pre- and post-work blood chemistry on the
      first day of the work shift; working heart rate (HR), a PWC170 fitness test, and
      a daily diary of an individual's work-rest schedule. Repeated blood samples from
      each planter were analysed for the elevated serum enzyme activities (ESEA) of
      creatine kinase (CK), lactate dehydrogenase (LDH), and aspartate transaminase
      (AST), and for the blood haematology parameters (BH) of haematocrit (Hct), red
      blood cell count (RBC), and haemoglobin (Hgb). HR and BH were used as an index of
      cardiovascular strain and ESEA was used as an index for musculoskeletal strain. A
      group mean working heart rate of 116.5 +/- 9 b.min-1 (range 100.0-139.1) was
      sustained throughout the period of an 8.0 hour day representing 39.2% of the
      delta Heart Rate ratio (ratio of elevated working Hr above resting to maximum
      HR). Grouped data were analysed by sample day for a subset of planters (n = 10)
      participating in six sample dates during the first 32 days of planting. Pre- and
      post-work ESEA were significantly higher throughout the entire planting period
      when compared with a pre-season resting control group (n = 9, p < or = 0.01). The
      post-work rise in CK and AST from pre-work values decreased during successive
      weeks of work as some adaptation to the work rate occurred. LDH continued to rise
      and was significantly elevated on day 32 compared with day 1. No significance was
      found in the BH variables between sample dates, yet a decreasing trend was
      observed. However, pooled data from all subjects for all sample dates showed a
      highly significant difference (p < or = 0.01) between pre- and post-work samples
      for both ESEA and BH. ESEA increased and BH decreased. These data present
      evidence that the work rate and rest time of a tree planter are not well ordered
      within the daily and seasonal working routine, and may compromise worker well
      being in the silviculture industry.

PMID- 8365393
TI  - Physiological effects of work stress and pesticide exposure in tree planting by
      British Columbia silviculture workers.
AB  - Tree planters in British Columbia have reported symptoms that are congruent with
      musculoskeletal stress and organophosphate or carbamate pesticide intoxication.
      The purpose of this research was to determine the existence of any physiological
      or biochemical correlate supporting the existence of these potential hazards in
      tree planting. Worker's health complaints were assessed from regularly
      distributed questionnaires. Blood samples were obtained from 14 male and three
      female Canadian subjects before and after tree planting work on 10 occasions
      throughout a tree planting season. The strenuous physical challenge of tree
      planting was confirmed by a significant elevation of serum enzyme activity (ESEA)
      at the beginning of the season, which did not return to a normal level during the
      remainder of the season. Significant (p < or = 0.05) inhibition of erythrocyte
      acetylcholinesterase activity (AChE) postwork was observed in 15.9% of
      individuals, and a significant group mean prework-postwork difference of AChE or
      plasma pseudocholinesterase (PChE) was observed on two days of testing,
      indicating a potential toxicological hazard from pesticide absorption. No
      correlation was found between the degree of ESEA or cholinesterase inhibition and
      the number of health complaints.

PMID- 8365394
TI  - Ergonomics aspects of tree-planting using 'multipot' technology.
AB  - The highlights of a descriptive study on the ergonomics and occupational health
      and safety aspects of tree-planting in Quebec are presented. The study was
      planned to consider the most representative geographical sites, planting
      technologies, and planting organizations. Semi-directed interviews were made with
      a mixed group of 48 male and female tree-planters and physiological measurements
      were made on four male planters. Tools and other equipment were also examined. An
      analysis of the work identified the main elements of the planting cycle, and the
      high cardiac rate in the working planters was related more to his manual
      transportation of seedlings and travel on rough paths than to planting per se. A
      tree-planter will typically travel 2.4 km carrying 16.8 kg of material and
      equipment in order to plant an average of 1245 seedlings daily. One out of two
      interviewed planters reported having a work-related accident or incident during
      his or her lifetime planting career. The body parts reported most frequently
      injured were the lower extremities (knee, foot, ankle), the skin, the eyes, and
      the wrist. Recommendations on the development of appropriate tools and footwear
      for tree-planters and for further research on repetitive strain injury induced by
      tree-planting have been made.

PMID- 8365395
TI  - The anatomy of a kinase and the control of phosphate transfer.

PMID- 8365396
TI  - Zinc coordination in mammalian sorbitol dehydrogenase. Replacement of putative
      zinc ligands by site-directed mutagenesis.
AB  - Rat sorbitol dehydrogenase was expressed in Escherichia coli and purified to
      homogeneity, resulting in a protein with a specific activity of 4.7 U/mg, close
      to that of the enzyme isolated from mammalian liver. A Glu residue has been
      postulated to replace the Cys of alcohol dehydrogenase as a ligand to the active
      site zinc atom of sorbitol dehydrogenase. This Glu (position 155 in the rat
      enzyme) was mutated both to Cys, in order to mimic the alcohol dehydrogenase
      relationships, and to Ala, as a control. A third mutation, Cys164 to Ala, was
      also performed since Cys has also been considered as a possible zinc ligand. With
      Ala at position 155, an inactive enzyme was obtained, showing that correct active
      site relationships have been destroyed. With Cys at position 155, the enzyme is
      still partly active, but rapidly looses activity unless stabilized by the
      addition of ZnSO4. The catalytic efficiency in the oxidation of sorbitol is 120
      fold less than that of the native form, and reduction of fructose is lost
      completely. In contrast, the activity of the Cys164Ala mutant is comparable with
      that of the native enzyme and, in fact, even increased in the oxidation of
      sorbitol. Combined, the results strongly suggest that Glu155 is a ligand to the
      active-site zinc atom. Zinc analysis of the different variants of sorbitol
      dehydrogenase establishes that all contain one atom of zinc/subunit, also when
      the catalytic function is lost. Apparently, zinc remains coordinated even after
      replacement with an amino acid residue (Ala) unable to ligand metal atoms.

PMID- 8365397
TI  - Intestinal arginine metabolism during development. Evidence for de novo synthesis
      of L-arginine in newborn pig enterocytes.
AB  - The capacity for L-arginine metabolism was studied in villus enterocytes isolated
      from pigs at birth, after 2-8 days suckling and after weaning. Immediately after
      birth, enterocytes were able to convert 1 mM L-citrulline, 2 mM L-glutamine or 1
      mM L-ornithine to L-arginine. In 2-8-day-old animals, the net production of L
      arginine from L-citrulline (2.00 +/- 0.45 nmol x 10(6) cells-1 x 30 min-1), or
      from L-ornithine (0.29 +/- 0.06 nmol x 10(6) cells-1 x 30 min-1) was similar to
      the values obtained at birth. Furthermore, 40% of L-arginine synthetized de novo
      from L-citrulline were released into the incubation medium. In 2-8-day-old
      animals, the production of L-arginine from L-glutamine represented only 5% of the
      production at birth (the latter being 0.73 +/- 0.15 nmol x 10(6) cells-1 x 30 min
      1). In enterocytes isolated from post-weaned pigs, no significant production of L
      arginine from either L-glutamine or L-ornithine was detected. In contrast,
      although the L-arginine production from L-citrulline was very low in post-weaned
      animals, it was significantly enhanced in the presence of L-glutamine,
      representing 23% of the production measured in suckling animals. The capacity of
      enterocytes to cleave L-arginine to L-ornithine and urea was very limited at
      birth, but was increased more than threefold in 2-day-old animals. This was
      concomitant with a marked increase in arginase activity. In post-weaned animals,
      the flux through arginase in intact enterocytes, and the arginase activity were
      both threefold higher than in 2-8-day-old animals. It is concluded that
      enterocytes isolated from neonatal pigs exhibit the capacity for a net production
      of L-arginine since the metabolism of this amino acid is oriented to anabolism
      rather than catabolism. The results are discussed in relation to L-arginine
      metabolism in the neonatal liver.

PMID- 8365398
TI  - The major-histocompatibility-complex-encoded beta-type proteasome subunits LMP2
      and LMP7. Evidence that LMP2 and LMP7 are synthesized as proproteins and that
      cellular levels of both mRNA and LMP-containing 20S proteasomes are
      differentially regulated.
AB  - The proteasome (high-molecular-mass multicatalytic proteinase complex) is
      composed of a large number of non-identical protein subunits of the alpha and
      beta types. The mouse beta-type subunits LMP2 and LMP7 (LMP, low-molecular-mass
      protein) are encoded within the mouse major histocompatibility complex (MHC II)
      region, and are thought to connect the proteasome to the MHC class-I antigen
      processing pathway. In the present communication, we have analysed the two
      proteasome subunits with regard to their identity within the proteasome complex,
      their protein levels, their amounts of mRNA in different mouse tissues and cell
      lines, and have investigated the intracellular localization of LMP2 and LMP7
      subunits in thymus and liver by immunocytology. Our experiments indicate that
      LMP2 and LMP7 subunits are synthesized as precursor proteins of 24 kDa and 30
      kDa, respectively, and that only the processed 21-kDa and 23-kDa subunits are
      part of the 20S proteasome complex. The proportion of LMP2-subunit-containing and
      LMP7-subunit-containing proteasome complexes, as well as LMP2 and LMP7 mRNA
      levels, vary strongly and are shown to be dependent on the tissues or cell lines
      analysed. Furthermore, high LMP2 and LMP7 mRNA levels do not always correlate
      with high protein levels, suggesting a specific translational mechanism which
      controls proteasome subunit synthesis. Generally, mRNA levels appear to be
      particularly high in those tissues which are known to be involved in MHC class-I
      antigen presentation. Immunocytological analysis shows a strong nuclear
      localization of the subunits in cells of the thymus, while in the liver they
      appear to be evenly distributed between the two cellular compartments. Our data
      support the idea that both LMP2 and LMP7 proteins are non-essential proteasome
      subunits which are probably involved in the regulation of proteasome activities.
      The function of the two subunits, however, may not be restricted to the proposed
      role of proteasomes in antigen presentation.

PMID- 8365399
TI  - Regulation of rabbit alpha 1-acid glycoprotein gene expression in acute-phase
      liver. Identification of inducible and constitutive proteins like CCAAT-enhancer
      binding protein that interact with the 5'-proximal promoter elements.
AB  - To identify the cis-acting DNA sequences responsible for inducible transcription
      of rabbit alpha 1-acid glycoprotein gene, 5'-flanking region containing 529 bp of
      this gene and its various 5'-deletions were linked to the reporter gene coding
      for the bacterial chloramphenicol acetyltransferase (CAT) and analyzed for their
      ability to confer cytokine-mediated inducibility to the reporter CAT gene in
      liver cells. Deletion analysis has identified a 151-bp region from the sequence 
      186 to -35, that contains the regulatory promoter element(s) responsible for
      stimulation mediated by cytokines present in the conditioned-medium. Using
      mobility shift assays, we have identified highly inducible nuclear factors in
      acute liver nuclear extract that interact with this regulatory promoter region.
      DNase I footprint analysis has revealed two adjacent nuclear factor binding sites
      and competition of DNA-binding activity has indicated that the distal element of
      these two sites has higher affinity for nuclear factors than the proximal one.
      Both of these two regions have been found to be capable of directing conditioned
      medium-induced transcription. Studies on the characterization of nuclear factors
      binding to these elements have shown that they belong to a class of transcription
      factors called CCAAT-enhancer binding protein (C/EBP). Our results indicate that
      binding of C/EBP-like factors to the inducible promoter elements of rabbit alpha
      1-acid glycoprotein gene is highly specific and the induction of this gene under
      acute-phase conditions may involve their participation.

PMID- 8365401
TI  - Secondary structure of the DNA-binding domain of the c-Myb oncoprotein in
      solution. A multidimensional double and triple heteronuclear NMR study.
AB  - The DNA-binding domain of the c-Myb oncoprotein contains two repeats, R2 and R3,
      both of which have been proposed to be related to the helix-turn-helix (HTH)
      motif. As a first step towards determination of the three-dimensional structure
      of this domain and of the mode of interaction with the DNA, we have undertaken
      multidimensional heteronuclear NMR studies using uniformly 15N-labeled and 13C,
      15N double-labeled R2R3 and, a selectively 15N-enriched sample on all lysine,
      histidine and leucine residues of R2R3. We present almost complete assignments of
      the backbone 1H, 15N and 13C" atoms and determine the secondary structure of R2R3
      in solution. The R3 repeat is composed of three helices (residues 62-75, 78-85
      and 91-100) while for the R2 repeat only two helices are found (residues 10-23
      and 28-34). The remaining C-terminal part of the R2 repeat, predicted to be
      helical and part of the HTH motif, undergoes intermediate conformational exchange
      processes. Stabilization of this segment might occur upon binding to DNA.

PMID- 8365400
TI  - Role of Tyr201 and Tyr385 in substrate activation by p-hydroxybenzoate
      hydroxylase from Pseudomonas fluorescens.
AB  - The crystal structure of the enzyme-substrate complex of p-hydroxybenzoate
      hydroxylase from Pseudomonas fluorescens shows that the hydroxyl group of 4
      hydroxybenzoate interacts with the side chain of Tyr201, which is in close
      contact with the side chain of Tyr385. The role of this hydrogen bonding network
      in substrate activation was studied by kinetic and spectral analysis of Tyr-->Phe
      mutant enzymes. The catalytic properties of the enzymes with Tyr201 or Tyr385
      replaced by Phe (Tyr201-->Phe and Tyr385-->Phe) with the physiological substrate
      are comparable with those of the corresponding mutant proteins of p
      hydroxybenzoate hydroxylase from P. aeruginosa [Entsch, B., Palfey, B. A.,
      Ballou, D. P. & Massey, V. (1991) J. Biol. Chem. 266, 17341-17349]. Enzyme Tyr201
      ->Phe has a high Km for NADPH and produces only 5% of 3,4
      dihydroxybenzoate/catalytic cycle. Unlike the wild-type enzyme, the Tyr201-->Phe
      mutant does not stabilize the phenolate form of 4-hydroxybenzoate. With enzyme
      Tyr385-->Phe, flavin reduction is rate-limiting and the turnover rate is only 2%
      of wild type. Despite rather efficient hydroxylation, and deviating from the
      description of the corresponding P. aeruginosa enzyme, mutant Tyr385-->Phe
      prefers the binding of the phenolic form of 4-hydroxybenzoate. Studies with
      substrate analogs show that both tyrosines are important for the fine tuning of
      the effector specificity. Binding of 4-fluorobenzoate differentially stimulates
      the stabilization of the 4 alpha-hydroperoxyflavin intermediate. Unlike wild
      type, both Tyr mutants produce 3,4,5-trihydroxybenzoate from 3,4
      dihydroxybenzoate. The affinity of enzyme Tyr201-->Phe for the dianionic
      substrate 2,3,5,6-tetrafluoro-4-hydroxybenzoate is very low, probably because of
      repulsion of the substrate phenolate in a more nonpolar microenvironment. In
      contrast to data reported for p-hydroxybenzoate hydroxylase from P. aeruginosa,
      binding of the inhibitor 4-hydroxycinnamate to wild-type and mutant proteins is
      not simply described by binary complex formation. A binding model is presented,
      including secondary binding of the inhibitor. Enzyme Tyr201-->Phe does not
      stabilize the phenolate form of the inhibitor. In enzyme Tyr385-->Phe, the
      phenolic pKa of bound 4-hydroxycinnamate is increased with respect to wild type.
      It is proposed that Tyr385-->Phe is involved in substrate activation by
      facilitating the deprotonation of Tyr201.

PMID- 8365402
TI  - Evidence for transformation-related increase in CTP synthetase activity in situ
      in human lymphoblastic leukemia.
AB  - To determine the role of the enzyme CTP synthetase (EC 6.3.4.2) in the synthesis
      in situ of CTP in normal and in malignant lymphoblastic cells, the metabolism of
      radiolabeled pyrimidine ribonucleosides was studied in proliferating normal T
      lymphocytes and was compared with that of proliferating MOLT-3 cell-line cells
      and differentiated (non-proliferating) MOLT-3 cells. Both the incorporation of
      [14C]uridine into UTP and CTP and the incorporation of [14C]cytidine in CTP, as
      well as the fluxes of these labeled nucleosides through the nucleotide pools into
      nucleic acids, were elevated in proliferating MOLT-3 cells compared to
      proliferating T lymphocytes. Furthermore, the conversion of UTP into CTP was
      enhanced in proliferating MOLT-3 cells compared to proliferating T lymphocytes,
      indicating a higher activity of CTP synthetase in the leukemic cells. In non
      proliferating MOLT-3 cells, the pyrimidine ribonucleotide fluxes were decreased
      compared to proliferating MOLT-3 cells and proliferating T lymphocytes. However,
      the decreased ratio of uracil/cytosine ribonucleotides that was found in
      proliferating T lymphocytes and proliferating MOLT-3 cells compared to non
      proliferating blood lymphocytes, was preserved in the differentiated MOLT-3
      cells. Moreover, although the fluxes had decreased, most CTP was still
      synthesized by CTP synthetase in the differentiated MOLT-3 cells. Thus, the
      elevated activity of CTP synthetase in MOLT-3 cells was independent of the cell
      growth and maturation stage. We conclude that the increased activity of CTP
      synthetase is associated with the process of malignant transformation in MOLT-3
      cells. Therefore, CTP synthetase offers an attractive target for selective
      therapy in human acute T-lymphoid leukemia.

PMID- 8365403
TI  - Secretory phospholipase A2 is not required for arachidonic acid liberation during
      platelet activation.
AB  - The subcellular localization of secretory phospholipase A2 (sPLA2) and cytosolic
      phospholipase A2 (cPLA2) in resting and activated platelets, and their
      involvement in arachidonic acid liberation during platelet activation, were
      studied. The amounts of sPLA2 and cPLA2 recovered were not modified during
      platelet activation. sPLA2 was mainly associated with the organelles of resting
      platelets (71% of total activity) and was released into the extracellular medium
      during cell activation (60% of total activity), whereas the majority of cPLA2 was
      localized in the cytosol of resting and activated platelets. The secretion of
      sPLA2 correlated with the release of ATP. sPLA2-depleted platelets aggregated as
      much as control platelets and produced similar amounts of thromboxane B2 upon
      thrombin activation. These results indicate that sPLA2 is not involved in the
      liberation of arachidonic acid during platelet activation.

PMID- 8365404
TI  - Restriction-enzyme cleavage of DNA modified by platinum(II) complexes.
AB  - The effect of binding of cis-diamminedichloroplatinum(II), its trans isomer and
      diethylenetriaminechloroplatinum(II) chloride to DNA on the splicing
      effectiveness of BamHI, EcoRI and SalI restriction endonucleases has been
      determined by means of gel electrophoresis. All three platinum complexes inhibit
      the cleavage of linearized plasmid DNA. In addition, the three platinum complexes
      bound to DNA constitute a barrier across which the linear diffusion of EcoRI on
      DNA is difficult. We interpret these findings to mean that the splicing
      effectiveness of restriction enzymes is influenced by bifunctional and
      monofunctional DNA adducts of platinum via both steric interference and DNA
      conformational distortions. Whereas the platinum adducts in the restriction sites
      or in their very close proximity inhibit the cleavage, the lesions occurring a
      greater distance from the restriction site can slow down the process of the
      localization of recognition sequences.

PMID- 8365405
TI  - VAT-1 from Torpedo electric organ forms a high-molecular-mass protein complex
      within the synaptic vesicle membrane.
AB  - VAT-1 is an abundant 41-kDa protein from Torpedo cholinergic synaptic vesicles.
      Most of VAT-1 immunoreactivity (70%) is localized to the synaptic vesicle
      membrane while the rest (30%) copurifies with larger membranous fragments. VAT-1
      forms a high-molecular-mass complex within the synaptic vesicle membrane. The
      Stokes radius of the VAT-1 complex is 4.85 nm and the sedimentation coefficient
      is 8.0 x 10(-13) S. Using these values, the calculated apparent mass of the VAT-1
      complex is 176 kDa and the friction coefficient is consistent with that for a
      globular protein. Electrophoresis of solubilized synaptic vesicle proteins
      following cross-linking resulted in a 40-kDa ladder which was detected by VAT-1
      antibodies. This is in accord with VAT-1 protein complex being composed primarily
      of VAT-1 subunits. The hydrodynamic characteristics of the VAT-1 protein complex
      suggest that it is composed of three or four VAT-1 subunits. Synaptophysin, an
      abundant component of Torpedo synaptic vesicle membranes, which has a similar
      apparent size as VAT-1, is not part of the VAT-1 protein complex. Interactions
      between the subunits within the protein complex do not depend on disulfide bonds
      or on lowering the ionic strength. However, partial dissociation of VAT-1
      subunits from the complex occurs by chelating calcium ions.

PMID- 8365406
TI  - High expression in Escherichia coli of the gene coding for dihydrofolate
      reductase of the extremely halophilic archaebacterium Haloferax volcanii.
      Reconstitution of the active enzyme and mutation studies.
AB  - The gene coding for the enzyme dihydrofolate reductase of the extremely
      halophilic archaebacterium Haloferax volcanii was recombined into the Escherichia
      coli expression vector pET11d. Following induction, the enzyme was produced in
      large quantities and accumulated in the cells in an insoluble form. The enzymic
      activity could be efficiently reconstituted by dissolving the aggregate in 6 M
      guanidine hydrochloride followed by dilution into salt solutions. Mutants were
      produced in which Lys30 was converted to Leu (K30L), Lys31 was converted to Ala
      (K31A) and a double mutant in which both lysines were converted (K30L, K31A). The
      mutated enzymes were produced in E. coli, activated and purified to homogeneity.
      The effect of the salt concentration on the steady-state kinetic parameters was
      determined. It was found that the salt concentration affects the Km but not kcat
      of the various mutants.

PMID- 8365407
TI  - The solution structure of the histidine-containing protein (HPr) from
      Staphylococcus aureus as determined by two-dimensional 1H-NMR spectroscopy.
AB  - The three-dimensional solution structure of the heat-stable phosphocarrier
      protein HPr from Staphylococcus aureus was determined from two-dimensional NMR
      data by restrained molecular dynamics. It consists of a large twisted
      antiparallel beta-pleated sheet with four strands A, B, C, and D of amino acids 2
      7, 34-37, 40-42 and 60-65. Three right-handed helices A, B, C (amino acids 18-27,
      47-53 and 71-85) are positioned on top of this sheet. The aromatic ring of His15
      is located in a cleft formed by amino acids 12-17 and 55-58, only the nitrogen (N
      delta 1) atom which can be phosphorylated by enzyme I is exposed to the water.
      The side chains of Thr12 and Arg17 are located close to the histidine ring. The
      regulatory serine residue (Ser46) is located in a hydrophobic patch, its hydroxyl
      group is water-accessible but forms hydrogen bonds with the amide groups of the
      backbone. The general features of the three-dimensional structure are similar to
      those found in HPr proteins from different microorganisms such as Escherichia
      coli, Bacillus subtilis and Streptococcus faecalis.

PMID- 8365408
TI  - Comparative study of high-mannose-type oligosaccharides in membrane glycoproteins
      of rat hepatocytes and different rat hepatoma cell lines.
AB  - A comparative study was undertaken to characterize the oligosaccharides released
      by endo-beta-N-acetylglucosaminidase H (endo H) from the membrane glycoproteins
      of rat hepatocytes and three different Morris hepatoma cell lines (NA-MH 7777,
      HTC and MH1C1). It is shown that the membrane glycoproteins of hepatocytes and
      hepatoma cells contain markedly different quantities and forms of high-mannose
      type carbohydrate chains. After radiolabelling of the cells with D-[2-3H]mannose,
      in the absence and presence of 1 mM 1,5-dideoxy-1,5-imino-D-mannitol (1
      deoxymannojirimycin), high-mannose-type oligosaccharides were released from
      delipidated membrane glycoproteins by enzymic digestion with endo H. The
      carbohydrate chains were converted to their corresponding oligosaccharide
      alditols by reduction with sodium borohydride, then further analysed by HPLC
      using an APS-2 Hypersil column. In the absence of 1-deoxymannojirimycin, up to
      10% of the radiolabelled oligosaccharides were released by endo H-treatment of
      the membrane glycoprotein fraction from rat hepatocytes. In contrast, the
      quantity of radiolabelled high-mannose-type carbohydrate chains released by endo
      H-treatment from tumour-cell membrane glycoproteins of hepatoma cell lines NA-MH
      7777 (31.5%). MH1C1-MH 7795 (37.2%) and HTC-MH 7288c (48%) was increased up to
      fivefold. The formation of higher-mannosylated structures after oligosaccharide
      analysis was observed in all hepatoma cell lines, with Man8GlcNAcOH as the major
      component, whereas in hepatocytes Man5GlcNAcOH was the predominant high-mannose
      type structure. In contrast, in the presence of the Golgi alpha-D-mannosidase I
      inhibitor, 1-deoxymannojirimycin, no significant differences were observed
      between the distribution of high-mannose-type oligosaccharides in the membrane
      glycoproteins of hepatocytes and hepatoma cells. However, in the presence of this
      inhibitor, the proportion of radiolabelled glycans sensitive to deglycosylation
      by endo H was greatly increased (> 85%) in all the cell lines investigated, the
      predominant structures being Man8-9-GlcNAcOH. This study shows that an increased
      content of high-mannose-type sugar chains is a general characteristic of membrane
      bound glycoproteins for malignant transformed hepatocytes.

PMID- 8365409
TI  - The role of the proton-pumping and alternative respiratory chain NADH:ubiquinone
      oxidoreductases in overflow catabolism of Aspergillus niger.
AB  - Mitochondria of fungi contain two respiratory chain enzymes concerned with the
      oxidation of matrix NADH. These are the proton-pumping NADH:ubiquinone
      oxidoreductase, also called complex I, which has a high affinity for NADH, and a
      non-proton-pumping NADH:ubiquinone oxidoreductase, called alternative NADH
      dehydrogenase, which has a low affinity for NADH. The role of these two enzymes
      in normal and overflow catabolism has been studied in Aspergillus niger. Three
      strains were investigated, the wild-type 732, the mutant nuo51 that was generated
      from the wild-type by disrupting the gene of the (51-kDa) NADH-binding subunit of
      complex I and the citric acid over-producing strain B60 that looses complex I
      concomitantly with the onset of the over-production. Under standard growth
      conditions, respiratory energy transduction in the mutant nuo51 was decreased by
      40% compared to the parental wild-type and the strain B60. Respiratory electron
      transfer in the mutant nuo51, however, meets standard catabolic requirements. The
      intracellular levels of citric acid cycle intermediates in the mutant nuo51 were
      the same as in the other two strains. Under growth conditions which lead to
      uncontrolled catabolic flux through glycolysis, a dramatic catabolic overflow
      occurred in the mutant nuo51. Intracellular levels of citric acid cycle
      intermediates increased to 20-fold normal levels. The strain B60, likewise
      lacking complex I under these conditions, excretes large amounts of citrate to
      moderate the intracellular catabolic overflow.

PMID- 8365410
TI  - Recombinant soluble human interleukin-6 receptor. Expression in Escherichia coli,
      renaturation and purification.
AB  - The recombinant soluble human interleukin-6 receptor (srhIL-6R) was expressed in
      Escherichia coli as a non-glycosylated protein comprising the first 339 amino
      acids after the signal peptide. The protein accumulated within the cells as
      insoluble protein aggregates (inclusion bodies). After solubilization, 10% of the
      denatured srhIL-6R could be renaturated by an in vitro folding procedure using L
      arginine and the glutathione-redox system. The native receptors were purified to
      near homogeneity by affinity chromatography on an IL-6-Sepharose column. The
      functional features of the recombinant soluble receptor were further analysed. A
      part of the extracellular domain (amino acids 145-345) of the human interleukin-6
      receptor (IL-6R) was expressed in E. coli and the purified protein was used to
      raise antibodies in rabbits. Characterization of the antiserum obtained indicated
      that an epitope of 13 amino acids close to the transmembrane region is needed for
      recognition by the antibodies. Since the antiserum obtained did not interfere
      with IL-6 binding, it could be used to establish a cell-free IL-6-binding assay,
      In this assay, the srhIL-6R bound IL-6 with an affinity of Kd = 1.5 nM as
      measured by Scatchard-plot analysis. When 125I-IL-6 was chemically cross-linked
      to the purified srhIL-6R and analyzed by SDS/PAGE, several 125I-IL-6-containing
      bands were detected, indicating the possible existence of a multimeric structure
      of the natural IL-6/IL-6R complex. The srhIL-6R was shown to exhibit biological
      activity, i.e. it stimulated acute-phase protein synthesis in the recently
      established human hepatoma cell line HepG2-IL-6 which does not express the IL-6
      binding subunit of the IL-6R complex on the cell surface.

PMID- 8365411
TI  - Rabbit and rat liver nuclei both contain proteins which bind to the regions
      controlling apolipoprotein A-I gene expression.
AB  - We have tested the 5' flanking region of the apolipoprotein A-I (apo A-I) gene,
      which controls its expression in hepatic cells, for the ability to bind protein
      factors from rat and rabbit liver nuclei. We found that nuclear extracts from
      each species contain proteins which bind to three sites in the region which have
      been shown to be important for control of apo A-I gene transcription. These
      results contrast with a previous report [Dai, P. H., Lan, S. S. F., Ding, X. H. &
      Chao, Y. S. (1990) Eur. J. Biochem. 190, 305-310] that no rabbit liver nuclear
      protein could be detected which binds to the rat apo A-I upstream region and that
      this lack of binding could explain the failure of the rabbit liver to express the
      apo A-I gene. We have also shown that the low levels of apo A-I mRNA in the
      rabbit liver correlate with decreased transcription. Our data suggest that the
      lack of apo A-I gene expression in liver is a result of transcriptional control
      but cannot be due to simple lack of protein binding to this region of DNA.

PMID- 8365412
TI  - Expression of the laminin-A chain is down-regulated by a non-canonical
      polyadenylation signal.
AB  - It is well accepted that 3' untranslated regions (UTR) are an essential part of
      mRNA. However, little is known in detail about the contribution of different
      regions of 3' UTR on synthesis, stability and translatability of their mRNA. In
      addition to the highly conserved hexanucleotide AAUAAA, some consensus sequences
      for 3'-end processing and polyadenylation have been characterized, but most of
      this work has been done with viral mRNA or beta-globin mRNA. We have studied the
      influence of the 3' UTR of the mRNA for the three chains A, B1, B2 of laminin on
      the expression of a reporter gene (galK). Laminin is a large glycoprotein of
      basement membranes and all three polypeptide chains are needed in equal amounts
      for a functional molecule. The three 3' UTR of the laminin mRNA differ widely
      with respect to length, number of polyadenylation signals and other consensus
      sequences. Nevertheless, all three 3' UTR reduce the expression of the reporter
      gene at least three-fold, when the corresponding cDNA sequences are inserted
      downstream of the reporter gene instead of the 3' UTR of simian virus 40 early
      genes. The 3' UTR of laminin-A mRNA contains the non-canonical polyadenylation
      signal AUUAAA which seems to be responsible for the limiting amounts of laminin-A
      mRNA and protein compared to those for laminin B1 and B2 [Speth and Oberbaumer
      (1993) Exp. Cell Res. 204, 302-310]. Mutation of the laminin-A polyadenylation
      signal to the canonical form AAUAAA increases expression by a factor of 2.5.

PMID- 8365413
TI  - Large-scale preparation of fully deuterated cell components. Ribosomes from
      Escherichia coli with high biological activity.
AB  - Some applications of NMR and of neutron scattering require fully deuterated
      biological material which should be highly active and available in large
      quantities. These requirements are hardly compatible since full deuteration is
      achieved easily only if cells are grown in minimal media. This condition used in
      standard batch fermentation results in both low yields and reduced activities of
      the biological mass. Here we report a method which combines the apparently
      incompatible requirements taking advantage of a recent observation according to
      which the appearance of growth inhibiting extracellular products could be
      prevented. The method was applied for growing Escherichia coli cells, strain
      MRE600rif (resistance against high doses of rifampicin is used as selection
      marker) on partially deuterated media (76% and 84% D2O) with glucose as carbon
      source and on deuterated acetate and succinate with 100% D2O when full
      deuteration was to be achieved. The essential point for preserving the log-phase
      character of the cells is that the cultivation is carried out at substrate
      limiting conditions thus keeping the growth rate at low levels (for glucose the
      growth rate, mu < or = 0.35 h-1, for acetate/succinate mu < or = 0.1 h-1) which
      avoids the accumulation of the substrate or of by-products in the medium. Our
      data suggest that acetate is a main extracellular component for accompanying or
      triggering the transition from logarithmic growth to stationary phase of E. coli
      cells cultivated on glucose as carbon source. The cells were first grown in fed
      batch to high cell densities (above 50 g wet cells/l) under conditions of
      substrate limitations. A steady-flow fermentation followed keeping the growth
      rate at about mu of 0.1 h-1. Cells were harvested in kg quantities, the extracted
      ribosomes showed a normal complement of proteins, contained intact rRNA and were
      fully active. The ribosomal protein and rRNA fractions could be efficiently
      reconstituted to highly active particles. In the case of full deuteration a
      matching point of 120% (tentative D2O scale) was achieved. The reported method
      facilitates the preparation of deuterated biological material for applications in
      NMR and neutron scattering analysis.

PMID- 8365414
TI  - Isolation and identification of two proto-oncogene products related to c-fgr and
      fyn in a tyrosine-protein-kinase fraction of rat spleen.
AB  - TPK-III, a tyrosine-protein-kinase fraction previously isolated from rat spleen
      [Brunati, A. M. & Pinna, L. A. (1988) Eur. J. Biochem. 172, 451-457] has been
      further purified and resolved by Mono-Q FPLC into two homogeneous compounds, Q1
      and Q2, with molecular mass approximately 52 kDa, exhibiting high specific
      activities for phosphate incorporation into the phosphoacceptor substrate
      poly(Glu80Tyr20) (1194 nmol.min-1 x mg-1 and 579 nmol.min-1 x mg-1,
      respectively). Both Q1 and Q2 appear to be scr-related enzymes since they are
      readily recognised by anti-SEEP serum raised against the highly conserved segment
      at positions 330-345 of p60c-scr. Q1, but not Q2, interacts with a specific
      antibody raised against the N-terminal segment of p55c-fgr. Microsequence
      analysis of tryptic fragments generated from Q1 revealed five peptides which
      exactly overlap the expected segments of p55c-fgr. Two of these peptides were not
      entirely conserved in any of the other src-related tyrosine protein kinases. A
      sixth fragment is very similar, albeit not identical, to the C-terminus of p55c
      fgr. Microsequence analysis of two tryptic fragments from the other TPK-III
      fraction, Q2, provided the sequences FQILNSSE and LTTQETGYIPSNY, which are
      identical to two segments of fyn not entirely conserved in any of the other src
      related tyrosine protein kinases. These results provide evidence that the spleen
      tyrosine-protein-kinase fraction, conventionally designated TPK-III, is composed
      of products from two proto-oncogenes, one of which corresponds to fyn, while the
      other is either identical or very closely related to c-fgr.

PMID- 8365415
TI  - Molecular cloning and expression of mouse and human cDNA encoding AES and ESG
      proteins with strong similarity to Drosophila enhancer of split groucho protein.
AB  - Mouse and human cDNA encoding AES (amino-terminal enhancer of split) and ESG
      (enhancer of split groucho) proteins with strong similarity to Drosophila
      enhancer of split groucho protein were isolated and sequenced. Mouse AES-1 and
      AES-2 proteins, probably resulting from alternative splicing, contain 202 and 196
      amino acids, respectively, while mouse ESG protein consists of 771 amino acids.
      The amino acid sequences of mouse and human AES proteins were found to exhibit
      approximately 50% identity to the amino-terminal region of Drosophila groucho,
      mouse ESG and human transducin-like enhancer of split (TLE) proteins. Mouse AES
      transcripts of 1.5 kb and 1.2 kb were abundantly expressed in muscle, heart and
      brain. Human AES transcripts of 1.6 kb and 1.4 kb were predominantly present in
      muscle, heart and placenta. Mouse ESG (homolog of human TLE 3) transcripts of 3.3
      kb and 4.0 kb were found only in testis, while human TLE 1 transcripts of 4.5 kb
      was more abundant in muscle and placenta compared to heart, brain, lung, liver,
      kidney and pancreas. Human AES, TLE 1 and TLE 3 genes were mapped to chromosomes
      19, 9 and 15, respectively, using human and Chinese hamster hybrid cell lines.

PMID- 8365416
TI  - Basic features of class-I alcohol dehydrogenase: variable and constant segments
      coordinated by inter-class and intra-class variability. Conclusions from
      characterization of the alligator enzyme.
AB  - The enzymatic and structural properties of alligator liver alcohol dehydrogenase
      have been determined. Aliphatic and alicyclic alcohols serve as substrates for
      this first reptilian form of the enzyme characterized, with Km values decreasing
      rapidly from methanol to hexanol, as for the human class I enzymes, and a Km of
      1.2 mM for ethanol at pH 9.9. The N-terminus of the 374-residue protein chain is
      acetyl-blocked. The enzyme is related in descending order to class I > III > V >
      II of the structurally characterized mammalian alcohol dehydrogenases. This
      observation is compatible with the presence of a I/III ancestral line.
      Differences of the enzyme classes exceed those of the species, suggesting an
      early origin of the classes. Within its enzyme class, the reptilian protein is
      most closely related to the avian form (82% residue identities), and is closer to
      the human than to the amphibian form (76%, versus 69%, respectively). This
      establishes class I alcohol dehydrogenase as an enzyme having fairly constant
      rate of change during much of vertebrate evolution, approximately 10% residue
      differences/100 million years of separation between pairs compared. Residues
      interacting with the substrate and coenzyme are largely conserved. In the
      alligator enzyme, there are only four replacements in the substrate pocket
      compared with the human class I gamma subunit, and those are not known to have
      functional roles. These properties account for the kinetic parameters, and
      suggest distinct metabolic functions for the class I enzyme in vertebrates.
      Comparisons of the enzymes of the different vertebrate lines reveal that segment
      patterns are characteristic features of the class I enzymes. Three segments are
      'variable', while two are 'constant', and both these types of segment are
      identical with those of the classes. There is extensive variability in close
      proximity to the active site of the enzyme and this appears to constitute a
      fundamental property of class I liver alcohol dehydrogenases in general.

PMID- 8365417
TI  - Ferredoxin binding site on ferredoxin: NADP+ reductase. Differential chemical
      modification of free and ferredoxin-bound enzyme.
AB  - The chloroplast enzyme ferredoxin: NADP+ reductase (FNR) catalyzes the reduction
      of NADP+ by ferredoxin (Fd). FNR and Fd form a 1:1 complex that is stabilized by
      electrostatic interactions between acidic residues of Fd and basic residues of
      FNR. To localize lysine residues at the Fd binding site of FNR, the FNR:Fd
      complex (both proteins from spinach) was studied by differential chemical
      modification. In a first set of experiments, free FNR and the FNR:Fd complex were
      reacted with the N-hydroxysuccinimidyl ester of biotin. Biotinylated peptides and
      non-biotinylated peptides were separated on monovalent avidin-Sepharose and
      purified by high-performance liquid chromatography. Two peptides containing Lys18
      and Lys153, respectively, were less biotinylated in complexed FNR than in free
      FNR. In a second set of experiments, free and complexed FNR were treated with 4
      N,N-dimethylaminoazobenzene-4'-isothiocyano-2'-sulfonic acid (S-DABITC) to obtain
      coloured lysine-modified FNR. Protection of Lys153 was again found by
      modification with S-DABITC. In addition, Lys33 and Lys35 were less labelled in
      the S-DABITC-modified. Fd-bound enzyme. FNR modified in the presence, but not in
      the absence, of Fd was still able to bind Fd, indicating that the Fd-protected
      residues are involved in the formation of the Fd:FNR complex. The lysine residues
      disclosed by differential modification surround the positive end of the molecular
      dipole moment (558 Debye approximately 1.85 x 10(-27) Cm) and are located in a
      domain of strong positive potential on the surface of the FNR molecule. This
      domain we had proposed to belong to the binding site of FNR for Fd [De Pascalis,
      A. R., Jelesarov, I., Ackermann, F., Koppenol, W. H., Hirasawa, M., Knaff, D. B.
      & Bosshard, H. R. (1993) Protein Science 2. 1126-1135]. The prediction was based
      on the complementarity of shape between positive and negative potential domains
      of FNR and Fd, respectively.

PMID- 8365418
TI  - An arrestin homolog of blowfly photoreceptors stimulates visual-pigment
      phosphorylation by activating a membrane-associated protein kinase.
AB  - An arrestin homolog (Arr2, 49-kDa protein) of blowfly (Calliphora erythrocephala)
      retinae undergoes light-dependent reversible binding to the photoreceptor
      membrane. In order to characterize this arrestin homolog and to study its
      function in a well-defined experimental system, we developed a purification
      scheme which used microvillar photoreceptor membranes as an affinity binding
      matrix. Additional purification steps included ammonium sulfate precipitation,
      gel filtration and binding to heparin-agarose. The molecular mass of purified
      Arr2, as judged by SDS/PAGE, is in the range 45-49 kDa. The isoelectric point, as
      judged by gel isoelectric focussing, is 8.7. Arr2 is specific to the retina,
      where it is subject to phosphorylation at multiple sites. Binding of purified
      Arr2 to isolated photoreceptor membranes efficiently activates the light-induced
      phosphorylation of visual pigment. Since the assay system used is deficient in
      rhodopsin phosphatase activity, the arrestin-stimulated phosphate incorporation
      into rhodopsin results solely from the activation of a protein kinase.
      Phosphorylation experiments with highly purified membrane preparations indicate
      that rhodopsin kinase is tightly associated with the rhabdomeric membrane or the
      microvillar cytoskeleton. Rhodopsin kinase is released from the membrane or
      inactivated upon treatment with urea. It is concluded that this arrestin is a
      regulator protein that controls visual-pigment phosphorylation by affecting the
      interaction of metarhodopsin and rhodopsin (metarhodopsin) kinase.

PMID- 8365419
TI  - Non-cytochrome mediated mitochondrial ATP production in bloodstream form
      Trypanosoma brucei brucei.
AB  - The life cycle of Trypanosoma brucei brucei involves a series of differentiation
      steps characterized by marked changes in mitochondrial development and function.
      The bloodstream forms of this parasite completely lack cytochromes and have not
      been considered to have any Krebs cycle function. It has been suggested that
      glycolysis is the sole source of ATP in all bloodstream forms. However, earlier
      results indicated that in the mitochondria of the transitional intermediate/short
      stumpy bloodstream forms, the biochemical pathways are present that could allow
      intra-mitochondrial production of ATP. Using a high mannitol buffer to enhance
      permeability, we confirm previous observations showing that transitional forms
      maintain motility and respiratory activity with 2-oxoglutarate as the sole
      substrate. Using a luminometer to measure intracellular ATP levels via the
      luciferin/luciferase chemiluminescence assay, we show that these same
      transitional forms, but not long slender forms, maintain high levels of
      intracellular ATP in the presence of 2-oxoglutarate. Further, in the presence of
      bongkrekic acid, an inhibitor of the mitochondrial adenine nucleotide
      translocase, ATP levels are reduced with subsequent death and lysis of the cells
      when 2-oxoglutarate, but not glucose, is used as sole substrate. These data are
      direct evidence of ATP production by transitional bloodstream form mitochondria.

PMID- 8365420
TI  - The proteolytic susceptibility of specific sites in myosin light chains is
      modulated by the filament conformation.
AB  - The proteolytic susceptibilities of specific sites in the LC1 and LC2 N-termini
      were modulated by ionic strength in myosin (a species able to form filaments) but
      not in S1. (a) In the presence of Ca2+ or Mg2+, the proteolytic susceptibility
      (apparent initial reaction rate) showed a sharp discontinuity at a critical ionic
      concentration similar for LC1', LC2' and LC2'' cleavages. (b) The susceptibility
      of LC1' and LC2'' was higher at low ionic concentration in the more compact
      structure of the filament than in the dissociated form at high ionic
      concentration. (c) The ionic concentration effect was no longer observed with
      species unable to form filaments. (d) This effect occurred at a critical ionic
      concentration markedly different from the critical concentration at which the
      monomer-filament equilibrium was found. These observations lead to the following
      conclusions. (a) The ionic concentration effect is an attribute of the filament
      structure. (b) In the filament the faster cleavage at sites (LC1' and LC2'') near
      the LC1 and LC2 N-termini are due to an extended configuration of the N-terminal
      segment binding to a site in the filament structure. (c) The slower rate of
      formation of LC2' in the filament indicates that the N-terminal segment of LC2
      binds more tightly to the structure than that of LC1. (d) The critical ionic
      concentration is not that of the filament-monomer equilibrium but corresponds to
      the order-disorder transition of the heads in the filament. These results suggest
      that the N-termini of the light chains (here in striated muscles) play a role in
      a secondary regulatory mechanism. The analysis of these regions may contribute to
      our understanding of the altered activity and regulation seen in such diseases as
      idiopathic dilated cardiomyopathy [Margossian, S. S., White, H. D., Caulfield, J.
      B., Norton, P., Taylor, S. & Slayter, H. S. (1992) Circulation 85, 1720-1733].

PMID- 8365421
TI  - Elastic behaviour of the carotid artery in intact spontaneously hypertensive
      rats.
AB  - Intact spontaneously hypertensive rats (SHR) were studied to assess the effect of
      prolonged antihypertensive treatment on the elastic behaviour of the external
      carotid artery. Thirty-week-old SHR received the ACE inhibitor captopril, the
      arteriolar dilator hydralazine or their vehicle for 6 weeks. These rats were
      compared to normotensive, vehicle treated WKY rats. The internal diameter of the
      carotid artery was measured continuously in halothane-anaesthetized rats using an
      echo-tracking device, and intra-arterial pressure was also monitored
      continuously, on the contralateral side. Captopril- and hydralazine-treated SHR
      as well as normotensive controls had similar blood pressure values. No
      significant shift in the distensibility-pressure curves was observed among
      vehicle-treated SHR and WKY rats or the SHR which had received captopril or
      hydralazine. Histological examination of the carotid artery fixed ex vivo with
      paraformaldehyde showed a significant increase in cross-sectional area in vehicle
      treated SHR as compared to their normotensive counterparts. These results
      therefore suggest that the elastic behaviour of elastic arteries is not
      necessarily altered by the structural changes developing in response to
      hypertension.

PMID- 8365422
TI  - Heart failure, ventricular remodelling and the renin-angiotensin system: insights
      from recently completed clinical trials.
AB  - Increased insight has been gained into the pathophysiology of heart failure,
      which is now recognized as a milieu created by specific diseases that cause
      myocardial dysfunction resulting in haemodynamic abnormalities. Subsequent
      compensatory circulatory and hormonal changes cause substantive metabolic
      derangement, and it is the haemodynamic and metabolic abnormalities that produce
      the congestive and low cardiac output symptoms and physical findings associated
      with heart failure. One of the earliest abnormalities noted in the failing heart
      is activation of the renin-angiotensin-neurohormonal axis. This is associated
      with both dilation and hypertrophy of the left ventricle. This remodelling may be
      regulated, at least in part, by myocardial tissue angiotensin-converting enzyme
      systems. Clinical drug trials in patients with heart failure have demonstrated
      that certain agents reduce mortality and interdict detrimental hormonal activity
      and remodelling. The Veterans Administration's (VHEFT-I and II) and Scandinavian
      (CONSENSUS-I) heart failure trials, as well as Studies of Left Ventricular
      Dysfunction (SOLVD) and the post myocardial infarction captopril trial (SAVE-
      Survival and Ventricular Enlargement) indicate that vasodilators and, in
      particular, angiotensin-converting enzyme inhibitors, decrease heart failure
      mortality. Furthermore, diminution in morbidity measured as a reduction in
      hospitalization for congestive heart failure or myocardial infarction was a
      dramatic beneficial effect noted even in relatively asymptomatic patients with
      left ventricular dysfunction. Importantly, in the SOLVD and SAVE trials, the
      diminution in major ischaemic events observed in the treatment groups were noted
      whether drug was started one week (SAVE) or one year (SOLVD) post
      infarct.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365424
TI  - Vascular remodelling in hypertension.
AB  - Essential hypertension is associated with alterations in the structure of the
      resistance vasculature, such that the ratio of the media thickness to the lumen
      diameter (media:lumen ratio) is increased. These abnormalities have previously
      been explained in terms of vascular growth (an encroachment of the wall into the
      lumen), but the abnormalities could also be due to a rearrangement of a normal
      amount of material around a smaller lumen, a process known as 'remodelling'. This
      paper reviews briefly some of the evidence for vascular remodelling as an
      important factor in the pathogenesis of essential hypertension.

PMID- 8365423
TI  - Influence of angiotensin converting enzyme inhibition on exercise performance and
      clinical symptoms in chronic heart failure: a multicentre, double-blind, placebo
      controlled trial.
AB  - One hundred and seven patients with chronic heart failure (NYHA class II to IV)
      stabilized on digitalis and/or diuretics, recruited from 11 centres were
      randomized into a double-blind, placebo-controlled study to assess the effect of
      12 weeks of cilazapril therapy on exercise tolerance and clinical status. Thirty
      five patients were randomized to placebo and 72 to cilazapril at a starting dose
      of 1 mg daily; titration to cilazapril 2.5 mg at week 4 and 5 mg at week 8 (or
      matching placebo) was carried out in patients who did not improve clinically.
      Demographic characteristics, including exercise test duration increased from 402
      s (+/- 17 SEM) at baseline to 462 s (+/- 19 SEM) at week 12 for the cilazapril
      group (+15%) and from 405 s (+/- 23 SEM) at baseline to 408 s (+/- 30 SEM) at
      week 12 in patients on placebo (+1%) (P < 0.001). In the placebo group, patients
      able to exercise for more than 6 min at baseline showed an increase in exercise
      duration at week 12 while those able to exercise for up to 6 min at baseline
      showed a decrease (P = ns). In contrast, cilazapril-treated patients showed an
      increase in exercise tolerance regardless of baseline exercise test duration;
      patients with the most impaired exercise tolerance at baseline showed a greater
      improvement than patients with mildly impaired baseline exercise tolerance (P <
      0.05 vs placebo). NYHA class improved by at least one grade in 51% of the
      cilazapril group vs 32% in the placebo group (P = ns). At the end of the trial,
      15% of the patients were non-responders on cilazapril vs 41% on placebo (P <
      0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365425
TI  - Ventricular remodelling: consequences and therapy.
AB  - The mammalian left ventricle can change its size and shape in response to a
      variety of stimuli including loss of tissue and external work. These changes in
      size and shape, defined as remodelling, are the sum total of a number of
      processes that involve the myocyte and the interstitial fibrous structures which
      provide the matrix in which the myocyte functions. The adapted mechanisms which
      occur are affected by humoral and cellular phenomena and can be modified by
      pharmacological agents. This paper reviews the remodelling process that occurs in
      myocardial infarction and heart failure and the effect of various pharmacological
      agents on this remodelling process.

PMID- 8365426
TI  - Effects of angiotensin converting enzyme inhibition on endothelial vasodilator
      function in primary human hypertension.
AB  - Hypertension in animal models and in humans is associated with a decreased
      vasodilator response to acetylcholine which causes vascular relaxation by release
      of endothelium-derived relaxing factor from the endothelium. Since lowering of
      blood pressure, particularly with angiotensin converting enzyme inhibitors,
      improved the response to acetylcholine we investigated the effects of brachial
      artery infusions of ascending dosages of acetylcholine on forearm blood flow
      before and after 5 months of therapy with the angiotensin converting enzyme
      inhibitor, cilazapril, in 10 patients with mild to moderate primary hypertension.
      Cilazapril decreased blood pressure from 150.8 +/- 14.4/98.9 +/- 4.3 mmHg during
      placebo to 138.8 +/- 15.6/88.6 +/- 8.9 mmHg (P < 0.01). Brachial artery
      acetylcholine infusions increased forearm blood flow from 2.95 +/- 1.5 to a
      maximum of 22.8 +/- 11.5 ml.min-1.100 ml-1 forearm tissue and decreased forearm
      vascular resistance from 48.1 +/- 34.1 to 6.9 +/- 6.9 units before cilazapril.
      This response did not change after cilazapril therapy. Our findings in patients
      with primary hypertension, therefore, do not support the concept that angiotensin
      converting enzyme inhibition influences endothelium-dependent vascular relaxation
      to acetylcholine to a significant degree. Whether this lack of effect on
      endothelial vasodilator function is specific for the vascular bed chosen for
      study or whether it represents a fundamental difference between animal models and
      human hypertension remains an important issue to be clarified.

PMID- 8365427
TI  - Outcome of patients with untreated cancer of the prostate.
AB  - A group of 74 patients among 1,663 patients with biopsy-proven prostate cancer of
      various stages who, contrary to the usual practice, received no treatment were
      followed at the outpatient clinic of the Inselspital university hospital in
      Berne, Switzerland. The aim of this study was the evaluation of the number of
      patients eventually succumbing to cancer of the prostate, the survival figures
      for these patients, and the prognostic value of minimal clinical staging.
      Thirteen patients had hormonal treatment at a later stage, but 61 of 1,663
      patients (3.7%) were never treated for prostate cancer. Overall survival for all
      61 patients was 50% at 5 years and 24% at 10 years. Overall disease-specific
      survival was 75% at 10 years. In the group with organ-confined disease (T0-2)
      actuarial 5- and 10-year survival rates were 67 and 34%, respectively, whereas in
      the group with extraprostatic disease (T3-4) the respective survival rates were
      11 and 0%. Disease-specific 5- and 10-year actuarial survival was 89% in the T0-2
      group and 51 and 0% in the T3-4 group. The cause of death in 30 patients was
      reported as disease-related in 8 patients (26.6%), unrelated to prostate cancer
      in 18 patients (60%) and unknown in 4 patients (13.3%). Despite the absence of
      treatment for a mostly clinically overt prostate cancer the majority of patients
      apparently did well and eventually died from other causes.

PMID- 8365428
TI  - Pedicled gastric tube as a catheterising conduit.
AB  - Treatment of urinary and faecal incontinence using the Mitrofanoff principle or
      the antegrade continence enema technique requires the creation of a
      catheterisable stoma. Although the appendix is by far the most satisfactory
      structure for the creation of this channel, its removal or use in previous
      surgical reconstruction may force the use of alternatives. We describe the use of
      the pedicled gastric tube for this purpose.

PMID- 8365429
TI  - Experience with one-stage repair of severe proximal hypospadias: operative
      technique and results.
AB  - Our experience with one-stage repair of severe proximal hypospadias in children
      is reported. The operative technique, which makes one-stage repair of hypospadias
      and associated bifid scrotum feasible, is described in detail. A 45% chance of
      secondary repair notwithstanding, we recommend our one-stage repair for all
      children with severe hypospadias.

PMID- 8365430
TI  - Endoscopic correction of vesico-ureteric reflux in duplex systems.
AB  - Between May 1984 and April 1990, 37 children with vesico-ureteric reflux (VUR) in
      43 duplex systems were treated by endoscopic subureteric Teflon injection
      (STING). There were 32 girls and 5 boys; the duplex systems were complete in 27
      refluxing units and incomplete in 16 refluxing units. All patients had high-grade
      reflux. In incomplete duplicated systems, VUR was corrected in 14 (87.5%) after a
      single injection of polytef paste and 2 patients required 2 injections to correct
      VUR. Of the 27 refluxing units with complete ureteral duplication, reflux was
      corrected in 16 (59%) units after a single injection of polytef paste, and 3
      (11%) units showed improvement of VUR to grade I or II after 1 injection; no
      further treatment was given. 7 units with complete ureteral duplication required
      2-4 injections for correction of VUR. STING failed to correct VUR in 1 duplex
      system which required a re-implantation. In 93% of refluxing units where VUR was
      corrected by a single injection, the quantity of polytef paste used was less than
      0.3 ml. 36 (97%) of patients were discharged home on the day of the procedure.
      All patients were followed up for 2-8 years. Of the corrected ureters, there were
      no recurrences in the incomplete duplicated ureters. 3 of the completely
      duplicated ureters showed recurrence of reflux at follow-up micturating
      cystography.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365431
TI  - Laparoscopic nephrectomy with vaginal delivery of the intact kidney.
AB  - The first case of laparoscopic nephrectomy in Italy is described. The patient was
      a 51-year-old woman with a small, nonfunctional, tuberculous left kidney. The
      organ, once detached from its lumbar site, was brought in to the pelvic cavity
      and extracted from the body via a posterior colpotomy. In this way, the integrity
      of the organ is preserved, hence, this could be the preferable route when dealing
      with a little kidney tumor in a woman.

PMID- 8365432
TI  - A modified Winter's procedure for priapism treatment with a new trocar.
AB  - A modified Winter's procedure with trocar which was used for 7 patients with
      priapism is presented. Complete detumescence was resumed in 5 of 7 patients.
      Cavernosaphenous shunt was used for only 2 patients. Two patients had
      postoperative impotence.

PMID- 8365433
TI  - Pathologic parameters and flow cytometric ploidy analysis in predicting
      recurrence in carcinoma of the prostate.
AB  - Recurrence of prostate cancer following radical prostatectomy is determined by
      the extent of local disease. Tumor volume and grade have improved our ability to
      predict extraprostatic extension, but tumors of intermediate volume and grade
      vary in their biologic behavior. To assess the prognostic significance of DNA
      ploidy, we performed flow cytometry in 85 patients with prostate cancer volumes >
      4 cm3. Post-radical prostatectomy serum prostate-specific antigen was used to
      prove recurrence of cancer. Mean follow-up was 35 months (median 31 months). 26
      patients (30%) had diploid histograms, 55 (65%) non-diploid histograms. In 4
      cases (5%) the histograms were uninterpretable. Tumor volume and percent of
      Gleason grades 4 or 5 separated the recurrent from nonrecurrent groups in a
      highly significant manner (p < 0.001). When tested alone, ploidy had no ability
      to predict recurrence (p = 0.26). However, in a subset of patients with 4-8 cm3
      of cancer with < 30% Gleason grade 4 or 5 tumor, ploidy conferred significant
      additional prognostic information (p < 0.005).

PMID- 8365434
TI  - Reappraisal of the biological role of epidermal growth factor receptor in
      transitional cell carcinoma.
AB  - Retrospective immunohistochemical and flow cytometric DNA analyses were performed
      on 56 cases of transitional cell carcinoma (TCC) to examine the biologic
      implications of epidermal growth factor receptor (EGFR) expression. A total of 28
      (50%) cases were reactive for EGFR immunostaining. The receptor expression
      increased from 41.7 to 56.3% with tumor stage. There was a significant
      association between EGFR expression and tumor stage (p < 0.0005), but not tumor
      grade. The flow DNA content and the Ki-67 proliferating index had no relation to
      the status of EGFR (p = 1, respectively). For those receptor-positive tumors (n =
      28), there was a significant association (p < 0.0001) between receptor expression
      and tumor proliferation. Interestingly, the DNA content was not correlated with
      EGFR expression (p = 0.69). We support the possible role of EGFR in cell
      proliferation and the potential significance for tumor growth in TCCs. However,
      the biology of TCC in half the cases could not be explained by this mechanism.
      The interaction between EGFR and DNA ploidy status necessitates further
      evaluation.

PMID- 8365435
TI  - Early diagnosis of prostatic carcinoma may be achieved through in vitro culture
      of tumor cells harvested by prostatic massage.
AB  - As a new method for early diagnosis of prostatic carcinoma we succeeded in
      growing in vitro the epithelial cells which can be collected from prostatic fluid
      after rectal prostatic massage. We report here the updated and statistically
      analyzed series of data (174 patients) on this new approach, which allows all the
      harvested cells to express their biological features. The method reaches a
      sensitivity of 72-86% and a specificity of 88-100%. This noninvasive test, which
      is also suitable for mass screening, may be very useful for an early diagnosis of
      the neoplasm.

PMID- 8365436
TI  - Pharmacocavernometry with prostaglandin E1.
AB  - The aim of this study was to define the normal response of cavernometry
      parameters with high-dose pharmacostimulation, to investigate repeatability of
      the method and to find out the incidence of cavernovenous leakage in impotence.
      82 consecutive impotent patients and 10 potent control subjects underwent
      pharmacocavernometry with 40 micrograms of prostaglandin E1. In control subjects,
      the maintenance flow at 150 mm Hg (MF150) was 3-22 ml/min with an average of 6
      ml/min (SD = 6 ml/min). Cavernometry was repeated in 17 patients, but the
      repeatability of quantitative parameters was disappointing. Cavernovenous leakage
      was estimated to be present in 55-67% of all impotent patients. Cavernometry with
      a high-dose prostaglandin E1 pharmacostimulation is a useful method in selected
      patients, but the consistency of the method should be improved.

PMID- 8365437
TI  - Duplex Doppler scanning with high-dose prostaglandin E1 stimulation in the
      diagnosis of arteriogenic impotence.
AB  - The aim of this study was to find out the normal range of penile duplex Doppler
      parameters with pharmacostimulation of 40 micrograms prostaglandin E1 and to
      assess the repeatability and clinical value of the method. Maximal systolic
      velocity increase (SVImax) is presented as a new flow parameter. 10 potent and 82
      impotent patients were investigated. Peak systolic velocity values were
      significantly higher when recorded at proximal than at distal penis.
      Repeatability of SVImax was fairly good (coefficient of variation = 0.18). SVImax
      ranged from 32 to 100 cm/s in 10 control subjects. The distribution of SVImax
      values in patients grouped according to the number of arteriosclerotic risk
      factors indicates that this parameter may be useful in the diagnosis of
      arteriogenic impotence.

PMID- 8365438
TI  - Is the volume injected a parameter likely to influence the erectile response
      observed after intracavernous administration of an alpha-blocking agent?
AB  - In 12 impotent patients with spinal cord injury, we assessed the erectile
      response induced by intracavernous administration of 20 mg moxisylyte dissolved
      in 4 different volumes of solvent. We tested successively in each patient 0.4,
      0.8, 1.2 ml and the volume usually injected of 2 ml, with a 7-day interval
      between 2 injections. The reduction in the volume from 2 to 0.4 ml did not thwart
      the quality of erection obtained by the intracorporeal administration of 20 mg
      moxisylyte. Indeed, for each erectile parameter (rigidity, abdominopenile angle,
      length and circumference of the penis), no statistically significant difference
      arose between the 4 tests. All patients achieved full rigidity. Neither priapism
      nor prolonged erection occurred. These results suggest that discreet and easily
      handled small-sized injection pens, containing little solution, could be
      conceived for autoinjection therapy.

PMID- 8365439
TI  - Predicting the outcome of radical radiotherapy for invasive bladder cancer.
AB  - The correlation between T stage, histological grade, the presence of squamous
      metaplasia, and nuclear morphometry scores and response to radiotherapy and
      survival was investigated in 60 patients with muscle invasive transitional cell
      carcinomas of the bladder. Patients with T2 tumours showed a complete response
      significantly more often than those with T3 lesions. Multivariate analysis showed
      that T stage and initial response to radiotherapy were very strong predictors of
      survival though they were not independent variables. Histological grade, the
      presence of squamous metaplasia, and nuclear morphometry scores were not found to
      have any predictive value.

PMID- 8365441
TI  - Pre- and post-nephrectomy kidney enlargement in patients with contralateral renal
      cancer.
AB  - Pre- and post-nephrectomy kidney growth was studied by computed tomography (CT)
      in 32 patients with contralateral renal cancer. Kidney enlargement was assessed
      by comparing the size of the unaffected kidney, in 32 pre- and 61 post
      nephrectomy CT examinations, with the corresponding normal size, determined from
      120 CT examinations of binephric individuals with no renal disease. The
      unaffected kidney was found to be 36% larger 1 month before nephrectomy and 54,
      62 and 47% in the 1st, 2nd, and 3rd postoperative year, respectively.
      Compensatory renal growth was influenced both by contralateral cancer and
      nephrectomy and did not depend on the patient's age or sex.

PMID- 8365440
TI  - Neutron therapy of bladder carcinoma: can a high rate of severe complications be
      avoided in neutron therapy?
AB  - We reviewed retrospectively a series of 58 patients with deeply invasive bladder
      cancer treated with fast neutron therapy (p(65) + Be) in order to evaluate its
      tolerance and side effects. Patients were divided into three groups according to
      treatment technique. Patients of group A received whole pelvis irradiation up to
      50 Gy photon equivalent followed by a boost to the bladder up to 57-66 Gy photon
      equivalent (40-56 days). Group B patients were treated by a split course regimen
      of 30 Gy photon equivalent on the whole pelvis at 3-4 weeks interval (66-108
      days). Group C patients, not suitable for radical treatment, received only 40-54
      Gy photon equivalent (26-70 days). The overall 5-year actuarial survival rate was
      30% (SE 8%). As expected, T stage was a statistically significant prognostic
      factor. The overall local control rate reached 21% at 4 years. Acute and late
      side effects were minimal to moderate. These results suggest that high-energy
      neutron beam treatment is at least as effective as photon beam treatment for
      bladder carcinoma, without a higher incidence of major side effects.

PMID- 8365442
TI  - One-shot intravesical instillation of the mucous adhesive anticancer agent
      hydroxypropylcellulose-doxorubicin for the treatment of superficial bladder
      carcinoma is sufficient to determine antitumor effects.
AB  - A 20 mg/20 ml dose of the membrane adhesive anticancer preparation,
      hydroxypropylcellulose-doxorubicin (HPC-doxorubicin), was instilled into urinary
      bladders through a catheter for the treatment of superficial bladder carcinomas
      (Ta-T1). After 14-30 days, the effects of the drug on tumors was examined by
      cystoscopy, and the residual tumor tissue where reduction in size was observed
      was resected by transurethral resection (TUR). Therapeutic effects were as
      follows: a complete response (CR) was found in 6 cases (37.5%), a reduction in
      size of more than 50% (partial response = PR) in 4 cases (25%), and a less than
      25% reduction (no change = NC) in 6 cases (37.5%). In no case was progression of
      the disease noted. In CR cases, cold cup punch biopsy revealed no tumor cells
      remaining at the site where the tumor was present before the instillation. Side
      effects such as bladder irritation were found in 4 cases, but they were only
      temporary in nature. The one-dose HPC-doxorubicin approach developed by ourselves
      allowed detection of antitumor effects between 14 and 30 days after the
      instillation and therefore determination of sensitivities at an earlier stage
      than with instillation of the conventional water-soluble type of doxorubicin
      hydrochloride.

PMID- 8365443
TI  - Correlation between ultrasonic appearance and histology of periprostatic tissue.
AB  - We compared preoperative echograms and postoperative histological specimens from
      16 patients who had undergone radical prostatectomy or radical cystourethrectomy
      to evaluate the correlation between the so-called capsular echogram obtained on
      transrectal ultrasonography and histology of the prostatic capsule. The capsular
      echogram corresponded to the periprostatic fatty tissue in all cases. In 10 of
      the 16 cases lateral ruptures of the capsular echogram were observed.
      Histologically, these ruptures corresponded to fibrous bundles in 6 of the 10
      cases and to neurovascular bundles located close to the prostatic tissue in the
      other 4 cases. Because the prostatic glands, prostatic capsule, blood vessels and
      nerve fibers complicated the structure on the lateral sides near the apex, the
      borders of the prostatic gland were indistinct on the echograms.

PMID- 8365444
TI  - Quality of life after radical retropubic prostatectomy for carcinoma of the
      prostate.
AB  - 131 patients treated by radical prostatectomy for localized prostatic cancer were
      studied with regard to quality of life. The patient's perception of his state of
      health before operation and 3, 6, 12 and 18 months later was assessed by
      questionnaires on 272 occasions. In the short term the patients complained of
      anxiety, voiding disorders, and loss of potency. In the long term only distress
      due to lack of erection persisted, but the overall well-being after 18 months was
      nevertheless better than before treatment.

PMID- 8365445
TI  - Urethroplasty for severe urethral strictures, using the preputial island flap
      technique: revisited.
AB  - We reviewed our experience with the pedicled island flap technique in severe
      urethral strictures, especially in regard of the long-term follow-up of
      functional parameters: micturition patterns and sexual behavior. Analysis of 59
      consecutive cases treated with this approach has proven the value of this
      technique. The results of a questionnaire and the current clinical status showed
      that, of the 59 cases, 12 patients were subjectively dissatisfied with their
      micturition, independent of the results of functional voiding measurements, and 2
      patients complained of impaired potency: 1 immediately after the original trauma,
      the other after the surgical repair. The most frequent reported micturition
      complaints were only minor: dribbling, nycturia and frequency, mostly already
      existing before the operation. The objective results, obtained postoperatively by
      uroflowmetry were good, but often did not correlate with the subjective results.
      The overall results are satisfactory. Only 3 patients replied to say that they
      regret having had the open operative procedure.

PMID- 8365446
TI  - Laser treatment of glans penis hemangioma.
AB  - We present a case of a glans penis hemangioma. These lesions are extremely rare,
      and as a consequence there is controversy concerning their treatment and outcome.
      Our patient was treated with a neodymium:YAG laser irradiation, with complete
      morphological recuperation. To our knowledge this is the first case of a glans
      penis hemangioma treated with this technique.

PMID- 8365448
TI  - Is the sensory innervation disturbed in the lower urinary tract of children with
      bed-wetting?
AB  - The sensation of bladder filling during cystometry and the sensory thresholds
      towards electrical stimulation in the bladder and urethra were determined in a
      group of 35 children and young adults with enuresis nocturna and in 28 similar
      patients with other urodynamic dysfunctions. The variables of the filling
      sensation were not different between the groups. The sensory threshold of the
      urethra in girls was significantly higher in the bed-wetting group indicating a
      diminished electrosensation in this structure. In 2 patients with absent
      electrosensation, an unsuspected neuropathy was discovered. A search for an
      eventual deficient sensation in the lower urinary tract in children with
      persistent enuresis nocturna would seem worthwhile.

PMID- 8365447
TI  - Endopyelotomy for pelvi-ureteric junction obstruction in children.
AB  - Endopyelotomy or percutaneous pyeloplasty has become an attractive alternative to
      open pyeloplasty in adult patients in recent years. However, the experience and
      reports of this procedure in the paediatric population have been limited to date.
      We report our experience in paediatric patients undergoing this procedure.
      Seventeen children with primary (14) or secondary (3) pelvi-ureteric junction
      (PUJ) obstruction were consented for endopyelotomy over a 3-year period. Patient
      age ranged from 4 months to 16 years, and the male to female ratio was 11:6.
      Percutaneous nephrostomy was established in 5 patients prior to endopyelotomy
      either for diagnosis or for drainage of an acutely obstructed upper tract. The
      remaining 12 had endopyelotomy as a one-stage procedure. The average duration of
      the procedure was 103 min (range 60-150 min) and the average hospital stay was 5
      days (range 3-9 days). Follow-up averaged 15 months (range 3-36 months).
      Endopyelotomy was successful in 10/13 patients (77%), unchanged in 1, and failed
      in the remaining 2. We believe that percutaneous pyeloplasty can be safely and
      successfully performed in children with primary and secondary PUJ obstruction.

PMID- 8365449
TI  - Comparison of urodynamic findings and response to oxybutynin in nocturnal
      enuresis.
AB  - Sixty-three children with persistent nocturnal enuresis were urodynamically
      assessed and subsequently treated with oxybutynin chloride. Urodynamic
      evaluation, including graduation of detrusor instability and comparison of
      maximum bladder capacity with the age-predicted norm, confirmed an inadequate
      storage function in 84% of the children. Treatment benefit totaling 70% was
      dependent upon urodynamic findings, with best relation to the determined bladder
      capacity. The value attributed to graduation of uninhibited contractions was
      prognostic in accordance with further subdivision of the maximum bladder
      capacity. Treatment benefit was limited in children with normal urodynamic
      findings.

PMID- 8365450
TI  - Sleep polygraphic studies using cystomanometry in twenty patients with enuresis.
AB  - Polygraphic exploration during sleep using cystomanometry was performed in 20
      patients aged 7-17 years with primary (17) or secondary (3) enuresis. In this
      group of patients, 9 presented with isolated nocturnal enuresis while 11 patients
      had associated diurnal micturition troubles. During this study we documented 24
      episodes of enuresis. There was no disturbance in sleep architecture or
      correlation between the uncontrolled micturition and any particular state or
      stage of sleep. Most episodes of enuresis occurred in a unique pattern in which a
      sudden or progressive intravesical increased pressure was associated with an
      awakening reaction. From a physiopathologic point of view, our findings are in
      favor of immaturity of the central system of inhibition of micturition reflex
      during sleep.

PMID- 8365451
TI  - Antihypertensive effect of chronic i.v. administration of 5-carboxamidotryptamine
      in spontaneously hypertensive rats.
AB  - The effects of chronic i.v. administration of the serotonin 5-HT1 receptor
      agonist, 5-carboxamidotryptamine (5-CT), on blood pressure (BP), heart rate (HR)
      and baroreflex sensitivity were studied in Wistar-Kyoto (WKY) and spontaneously
      hypertensive rats (SHR). Acute i.v. injection of increasing doses of 5-CT
      resulted in a dose-dependent reduction in mean arterial pressure (MAP) in SHR and
      WKY with concomitant tachycardia. In chronic experiments, 5-CT (15.0
      micrograms/kg per day) or vehicle (24.0 microliters/day) was infused i.v. for 7
      days, using osmotic minipumps. Systolic blood pressure (SBP) and HR were
      monitored daily before and during infusions. In SHR (n = 8) and WKY rats (n = 9)
      receiving 5-CT, a significant reduction in SBP was observed during the infusion
      period. HR was slightly increased in WKY rats on days 1 and 2. There were no HR
      changes in the SHR group. The fall in SBP was significantly larger in the SHR
      than in the WKY rats. Baroreflex sensitivity on day 7 was significantly greater
      in 5-CT-treated SHR than in control rats. There was no change in baroreflex
      sensitivity in WKY rats. Administration of a single dose of 5-CT (0.5
      microgram/kg i.v.) on day 7 of infusion resulted in attenuated responses in WKY
      rats while SHR responded as their respective controls. Our data suggest that
      chronic administration of 5-CT results in a sustained antihypertensive effect.
      This is associated with an improved BRS in the SHR either as a consequence of a
      resetting of the baroreflex due to sustained lowering of BP or a direct action of
      5-CT on baroreflex sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365452
TI  - Alteration of eicosanoid production in the sensitized guinea pig lung by CS-518.
AB  - The effects of CS-518 (sodium 2-(1-imidazolylmethyl)-4,5-dihydrobenzo
      [b]thiophene-6-carboxylate), a thromboxane A2 synthase inhibitor, on changes in
      arachidonic acid metabolism were investigated in the lung of actively sensitized
      guinea pigs. Antigen challenge enhanced the production of thromboxane A2 as well
      as histamine and peptide leukotrienes in lung fragments. Exogenous leukotriene D4
      also stimulated significant thromboxane A2 production in the non-sensitized lung
      in vitro. CS-518 was effective in preventing the thromboxane A2 production
      induced by either antigen or leukotriene D4, and the IC50 values were 90 and 7.5
      ng/ml (320 and 27 nM), respectively. CS-518 markedly potentiated the production
      of prostaglandin E2 and I2 with slight inhibition of leukotriene formation, but
      indomethacin significantly stimulated leukotriene production. When CS-518 was
      administered orally, it induced long-lasting inhibition of thromboxane A2
      production and potentiation of prostaglandin I2 production in guinea pig lung.
      Thus, CS-518 not only inhibited thromboxane production but also improved the
      change in arachidonic acid metabolism in the guinea pig bronchoalveolar tissue
      during allergic reaction in vivo as well as in vitro, which suggests amelioration
      of the asthmatic condition.

PMID- 8365453
TI  - Protective effect of fructose 1,6-bisphosphate against carrageenan-induced
      inflammation.
AB  - Administration of carrageenan (0.5 mg) to the plantar tissue of rats resulted in
      reversible inflammatory injury. This damage was monitored as changes in foot
      volume, using a plethysmometer. Administration of fructose 1,6-bisphosphate at
      different doses, orally or intraperitoneally, prevented the inflammatory action
      induced by the simultaneous injection of carrageenan in the rat paw. The effect
      was dose and time dependent. In contrast, fructose or fructose 6-phosphate
      afforded no significant protection. In order to extend the average half-life of
      the drug, we prepared liposomes of fructose 1,6-bisphosphate which, administered
      orally or intraperitoneally, showed a greater and more prolonged antiinflammatory
      action. The significance of these findings with respect to the mechanism of the
      antiinflammatory action of fructose 1,6-bisphosphate is discussed.

PMID- 8365454
TI  - Effects of treatment with myo-inositol or its 1,2,6-trisphosphate (PP56) on nerve
      conduction in streptozotocin-diabetes.
AB  - Nerve conduction abnormalities in peripheral nerves from diabetic patients may be
      early indicators for the future development of symptomatic neuropathy. In this
      study, three weeks of experimental diabetes in the rat caused a significant
      decrease in motor nerve conduction velocity measured in vivo (45.3 +/- 3.6 m/s;
      mean +/- S.D.) compared to controls (57.7 +/- 4.5 m/s). myo-Inositol
      administration to diabetic rats (500 mg/rat per day) for the duration of the
      study, partially prevented this decrease (50 +/- 4.4 m/s). An analogue of myo
      inositol, PP56 (D-myo-inositol-1,2,6-trisphosphate), at a dose of 24 mg/rat per
      day completely prevented this reduction in diabetic rats (53.4 +/- 5.8 m/s).
      Resistance to hypoxic conduction block was determined in vitro in endoneurial
      preparations and was assessed as the decline in compound action potential
      amplitude over a 40 min period of hypoxia. Compound action potential amplitude
      (as % of initial value +/- S.D.) was significantly greater in diabetic
      preparations compared with controls at 40 min of hypoxia (76.1 +/- 9.1 vs. 54.8
      +/- 14.7 respectively). Treatment to diabetic rats with myo-inositol did not
      significantly affect this value (79.9 +/- 16.6) but PP56 treatment partially
      prevented the increased resistance to hypoxic conduction block (69.4 +/- 16.0).
      This study demonstrates that these acute abnormalities of nerve function in early
      experimental diabetes may be attenuated by the administration of PP56, possibly
      acting via a vascular mechanism.

PMID- 8365455
TI  - Endothelin-1 induces vasoconstriction and prostacyclin release via the activation
      of endothelin ETA receptors in the perfused rabbit kidney.
AB  - Endothelin-1 (0.005 and 0.01 nmol) induced a dose-dependent increase in perfusion
      pressure in the perfused rabbit kidney. These pressor effects were markedly
      reduced by an endothelin ETA receptor antagonist, BQ-123 (0.1 microM). Similarly,
      the release of prostacyclin triggered by intra-arterial infusion of endothelin-1
      (10 nM) was significantly reduced in a concentration-dependent manner when the
      kidney was pretreated with BQ-123 (0.5-1 microM). In contrast, two selective ETB
      receptor agonists, BQ-3020 and IRL 1620, were found to be inactive, both as
      pressor agents and releasers of prostacyclin at doses (for the pressor effects)
      and concentrations (for the prostacyclin generation) 50-100 times higher than
      those of endothelin-1. BQ-123 (1 microM) did not modify the pressor or prostanoid
      releasing properties of angiotensin II. These results confirm our previous
      observations suggesting that pressor responses and prostanoid release induced by
      endothelin-1 are mediated via the selective activation of ETA receptors in the
      perfused rabbit kidney.

PMID- 8365457
TI  - Effects of dipyridamole in spontaneously hypertensive rabbits with diffuse
      chronic cerebral ischemia.
AB  - The effect of intravenous dipyridamole (0.7 mg/kg) on cerebral blood flow (CBF),
      mean arterial blood pressure (MABP), heart rate, respiration rate, cerebral
      electrical activity, arterial blood gases, pH, and glucose was investigated in 14
      normotensive and 14 stroke-prone spontaneously hypertensive anesthetized rabbits.
      CBF was measured by hydrogen and heat clearance. In both groups, MABP decreased
      (normotensive: -24 mm Hg, hypertensive: -47 mm Hg; ANOVA: P < 0.0001) and CBF
      increased (normotensive: +59 ml/100 g/min, hypertensive: +72 ml/100 g/min; ANOVA:
      P < 0.0002). CBF returned to the initial level 21 min later in hypertensive than
      in normotensive rabbits. Changes in other parameters were insignificant. In
      additional experiments, 30 mg/kg theophylline entirely prevented the cerebral
      vasodilator and systemic hypotensive effects of dipyridamole in both normotensive
      and hypertensive rabbits. We conclude that, in stroke-prone spontaneously
      hypertensive rabbits, the longer-lasting and larger CBF increase in response to
      dipyridamole may be attributed to reversible functional changes in the cerebral
      vasculature resulting from hypertension.

PMID- 8365456
TI  - WAY100135: a novel, selective antagonist at presynaptic and postsynaptic 5-HT1A
      receptors.
AB  - The novel phenylpiperazine derivative, (+/-)-WAY100135 (N-tert-butyl-3-(4-(2
      methoxyphenyl)piperazin-1-yl)-2-phenylpro pionamide dihydrochloride), is a
      selective antagonist at both somatodendritic and postsynaptic 5-HT1A receptors.
      The IC50 of (+/-)-WAY100135 at the rat hippocampal 5-HT1A receptor was 34 nM,
      whereas its IC50 at a range of other receptor sites was > 2 microM. Up to a dose
      of 2.5 mg/kg i.v. (+/-)-WAY100135 induced a maximum 30% inhibition of raphe
      neuronal firing and (at 0.5 mg/kg i.v.) antagonised the inhibition of firing
      induced by 8-OH-DPAT (8-hydroxy-2-(di-n-propylamino)tetralin) in anaesthetised
      rats. (+/-)-WAY100135 antagonised the action of 5-carboxamidoiodotryptamine in
      the guinea-pig ileum, with a pA2 of 7.2. (+/-)-WAY100135 had no agonist-like
      behavioural effects but antagonised the behavioural syndrome and hypothermia
      induced by 8-OH-DPAT in the rat and mouse, respectively. The interaction of (+/-)
      WAY100135 with the 5-HT1A receptor was stereoselective; the (+)-enantiomer being
      markedly more active in binding, functional and behavioural studies. These data
      indicate that (+/-)-WAY100135 is the first highly selective antagonist at both
      somatodendritic and postsynaptic 5-HT1A receptors.

PMID- 8365458
TI  - Involvement of corticotropin-releasing factor in the antinociception produced by
      interleukin-1 in mice.
AB  - Recombinant human interleukin-1 alpha (rHu-IL-1 alpha) has been indicated to
      produce central antinociception in the mouse phenylquinone writhing test, the
      antinociception being unaffected by naloxone. Because interleukin-1 has been
      demonstrated to be a potent releaser of corticotropin-releasing factor (CRF) from
      the hypothalamus, we were interested to see whether CRF is involved in the
      antinociception induced by rHu-IL-1 alpha. In the present study, we examined this
      question using the mouse phenylquinone writhing test, in which mice were injected
      with various doses of CRF and/or alpha-helical CRF-(9-41), a CRF antagonist. CRF
      inhibited writhing responses after i.v. and intracisternal (i.c.) administration.
      The antinociception elicited by i.v. administered CRF was antagonized by i.v.
      injection, but not by i.c. injection, of alpha-helical CRF-(9-41). The
      antinociception elicited by i.e. administered CRF was antagonized by i.c.
      injection of alpha-helical CRF-(9-41) and s.c. treatment of opioid antagonists.
      rHu-IL-1 alpha-induced antinociception was attenuated by i.v. injection, but not
      by i.c. injection, of alpha-helical CRF-(9-41). These findings suggest that CRF
      possesses antinociceptive efficacy by both peripheral and central mechanisms, and
      that the antinociception induced by rHu-IL-1 alpha is mediated, at least in part,
      by the peripheral action of CRF.

PMID- 8365460
TI  - Teicoplanin in home therapy of the terminally ill child.
AB  - Children discharged in the terminal phase of illness were offered the possibility
      of having central venous line infections treated with teicoplanin at home by
      their parents after suitable instruction. The decision to begin antibiotic
      treatment was subjective, based on a history of rigors and/or raised temperature
      in an otherwise "well" child. No difficulties were encountered in instructing the
      chosen parents. In all, five treatment periods of 7 days were required in the
      five children selected. The review time was 31 weeks (mean duration, 6.2
      weeks/patient; range, 4-12 weeks), ended in all cases by death. Infection
      occurred a mean of 3.2 weeks after discharge (range, 1-8 weeks), and all episodes
      were successfully treated at home without hospital admission or ward-based
      support. No deaths occurred as a result of antibiotic therapy failure, and there
      were no clinically relevant side-effects. Autopsy confirmed the absence of
      central venous line infection in one patient, but blood culture was positive for
      Staphylococcus aureus in another. This study shows that home treatment of line
      infections with teicoplanin is effective and well tolerated, and offers
      advantages in terms of quality of life and parent-child relationships.

PMID- 8365459
TI  - A prospective randomized study of prophylactic teicoplanin to prevent early
      Hickman catheter-related sepsis in patients receiving intensive chemotherapy for
      haematological malignancies.
AB  - In all, 88 patients with haematological malignancies requiring Hickman catheters
      for intensive chemotherapy were randomized to receive either one single bolus
      intravenous injection of teicoplanin, 400 mg, or no teicoplanin immediately
      before insertion of a double-lumen Hickman catheter. Lower incidences of catheter
      related Gram-positive sepsis were recorded in patients receiving prophylactic
      teicoplanin; exit site infection, tunnel infection and catheter-related Gram
      positive septicaemia were all reduced. The benefit of prophylactic teicoplanin
      was observed particularly among patients who were already neutropenic at the time
      of catheterization. All Gram-positive organisms isolated from infected skin sites
      or from blood cultures taken from Hickman catheters were susceptible to
      teicoplanin. No adverse reaction was reported in any of the patients receiving
      prophylaxis. Prophylactic teicoplanin, therefore, may be used routinely for
      patients requiring insertion of Hickman catheters for intensive chemotherapy, to
      reduce the early incidence of catheter-related sepsis, particularly during the
      period of neutropenia following chemotherapy.

PMID- 8365462
TI  - Teicoplanin in combination: role in the management of the febrile neutropenic
      patient.
AB  - The spectrum of microorganisms responsible for infection in neutropenic patients
      has changed in the last decade, with Gram-positive organisms now predominant. New
      antibiotic strategies have been required and have evolved to cope with this
      change. In particular, the optimal timing of glycopeptide antibiotic use has been
      addressed. Both teicoplanin and vancomycin are highly effective agents for
      susceptible Gram-positive organisms. Teicoplanin has advantages in terms of ease
      of administration and lower toxicity, while vancomycin has proved durable over
      many years' use. There are now firm indications for the use of glycopeptide
      antibiotics in febrile neutropenic patients, including clinically defined central
      venous catheter infection and microbiologically documented infection with
      susceptible organisms. The empirical use of the glycopeptide antibiotics in
      combination with other agents as first-line treatment, however, is less certain.
      The utility of this approach remains controversial and ultimately depends on the
      extent to which local practice favours the emergence of Gram-positive infections
      in neutropenic patients.

PMID- 8365461
TI  - Teicoplanin versus vancomycin in the empirical treatment of febrile neutropenic
      patients.
AB  - Gram-positive infections have become prevalent among neutropenic patients with
      cancer. A prospective, randomized, double-blind trial of teicoplanin, 6 mg/kg
      every 12 h for three doses then every 24 h, versus vancomycin hydrochloride, 15
      mg/kg every 12 h, in the empirical treatment of febrile neutropenic patients was
      undertaken among 50 consecutive patients with haematological malignancy. The
      patients also received piperacillin sodium, 3 g every 4 h, and tobramycin
      sulphate, 1.5-2 mg/kg every 8 h. Both groups (25 teicoplanin and 25 vancomycin)
      were comparable in age, sex, renal function, underlying disease and concurrent
      therapy. Among 22 patients (44%) with culture-proven infection, Gram-positive
      organisms were isolated in 15 (9 with bacteraemia) and Gram-negative in 11 (4
      with bacteraemia). Mixed or polymicrobial infection occurred in 8 patients. Serum
      1-h peak and trough levels at steady state were 41 +/- 15 and 12 +/- 3 mg/l for
      teicoplanin (at 14 +/- 4 days), and 40 +/- 10 and 8 +/- 5 mg/l for vancomycin (at
      0.9 +/- 0.6 days). Mean elimination half-life and apparent volume of distribution
      at steady state were 80.5 +/- 21.5 h and 1.4 +/- 0.8 l/kg for teicoplanin, and
      5.6 +/- 1.8 h and 0.6 +/- 0.2 l/kg for vancomycin. Empirical antimicrobial
      therapy was successful in 23 teicoplanin and 21 vancomycin patients, respectively
      (p = 0.67; two-tailed Fisher's exact test). Nephrotoxicity (serum creatinine >
      110 mmol/l), however, was more common among vancomycin patients (10 versus 2; p =
      0.02), while termination of treatment due to adverse effects was also more common
      among vancomycin patients (10 versus 2; p = 0.02).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8365463
TI  - Teicoplanin in gram-positive infection: microbiological aspects.
AB  - The widespread use of indwelling catheters and successful antibiotic treatment of
      Gram-negative infections has led to an increase of Gram-positive infections in
      severely neutropenic patients; Staphylococcus epidermidis is predominant in these
      infections. The problems associated with the use of vancomycin in treating such
      infections can be overcome by the glycopeptide antibiotic teicoplanin. It is as
      effective as vancomycin, but does not cause "red man" syndrome, is uncommonly
      nephrotoxic, can be given as a rapid bolus once daily, and routine serum
      monitoring is not required. Other approaches to reducing catheter-related
      infections include improved training of personnel in catheter insertion and the
      development of new materials and methods in cannula production.

PMID- 8365464
TI  - 5-Methylcytosine in genes with methylation-dependent regulation.
AB  - An asymmetric distribution of deoxy-5-methylcytidylic acid-inhibiting restriction
      sites (dcm-sites) takes place in ten human genes regulated by 5-methylcytosine.
      These genes are dcm-site enriched upstream and dcm-site poor downstream. Along
      them, there is a scattering of hypermethylatable introns and hypomethylatable
      exons with a common code: the 5mCpG dinucleotides characterize promoters; Gp5mCs
      characterize introns; Tp5mCs and Cp5mCs are in small concentrations in exons.
      Housekeeping genes contain more dcm-sites when compared with tissue-specific
      genes. This depends on the higher number of dcm-sites in their promoters and
      introns. In exons, the relatively lower number of dcm-sites is almost the same in
      both housekeeping and tissue-specific genes. Going from 5' to 3', the average
      frequency of occurrence of these sites per nucleotide units decreases in introns
      and increases in exons. This difference is highly discriminated for tissue
      specific and less discriminated for housekeeping genes.

PMID- 8365465
TI  - Detection of GTP-binding proteins in barley aleurone protoplasts.
AB  - We report the existence of several families of GTP-binding proteins in barley
      aleurone protoplasts. Partial purified plasma membrane proteins were separated by
      SDS-PAGE, transferred to a nitrocellulose filter and incubated with either
      antisera raised against a highly conserved animal G protein alpha subunit
      peptide/or Ras protein, or with [alpha-32P]GTP. Two sets of proteins of M(r) = 32
      36 kDa and 22-24 kDa were strongly recognized by the antisera. Binding of [alpha
      32P]GTP was detected on Western blots with proteins of M(r) = 22-24 kDa and 16
      kDa. Binding was inhibited by 10(-7)-10(-6) M GTP gamma S, GTP or GDP; binding
      was not affected by 10(-6)-10(-5) M ATP gamma S or ADP. The kinetics, specificity
      and the effects of phytohormones in a [35S]GTP gamma S binding assay were also
      studied in isolated plasma membranes of barley aleurone protoplasts.

PMID- 8365466
TI  - Constitutive over-production of DNA-damage recognition proteins and acquired UV
      resistance in prolonged culture of F9 teratocarcinoma stem cells.
AB  - An ultraviolet (UV)-resistant F9 variant cell line, termed F9Vc, was established
      from a prolonged culture of murine F9 embryonic stem cells. A 6-fold UV
      resistance was detected in F9V2 cells compared to the F9 parental cells, as
      determined by ID50 (36 J/m2 vs. 6 J/m2), the UV dose causing 50% growth
      inhibition. Using a DNA mobility-shift assay, a nuclear protein (termed UVDRP)
      that preferentially binds to UV-damaged DNA was detected in F9 and F9Vc cell
      extracts. The UVDRP in F9Vc cells was present at a 7-fold higher concentration
      than that of F9 cells. Interestingly, the F9 UVDRP was transiently induced
      following cellular differentiation by retinoic acid (RA)/cAMP, with optimum
      induction (15-fold) at 6 days. Although constitutively over-produced, UVDRP also
      remained inducible in F9Vc cells in response to RA/cAMP. Indirect DNA repair
      measurement by host cell reactivation of UV-damaged plasmid DNA demonstrated that
      F9Vc cells exhibited a slight increase or a similarity in repair ability compared
      to the F9 cells. Parallel experiments using the repair-defective xeroderma
      pigmentosum (XP) group A fibroblasts and the normal VA13 fibroblasts also
      indicated that over-production of UVDRP binding activity was associated with
      enhanced DNA repair and UV resistance. The findings indicate that prolonged
      culture of F9 cells can establish a condition sufficient to cause constitutive
      over-production of UVDRP binding activity and UV resistance. The results also
      suggest that the RA/cAMP-inducible UVDRP in F9 stem cells may be important for
      the sensitivity or resistance of the cells to UV damage.

PMID- 8365467
TI  - Organic acid activation of the alternative oxidase of plant mitochondria.
AB  - Alternative oxidase activity (oxygen uptake in the presence of KCN, antimycin or
      myxothiazol) in mitochondria isolated from the roots of soybean seedlings was
      very slow, even with succinate as substrate. This activity was stimulated
      substantially (100-400%) by the addition of pyruvate, with half maximal
      stimulation occurring at 0.1 mM pyruvate. Mitochondria from soybean shoots
      displayed high alternative oxidase activity with succinate and malate as
      substrates but lower activity with exogenous NADH; addition of pyruvate
      stimulated the activity with NADH up to that seen with succinate. This
      stimulation of cyanide-insensitive NADH oxidation was seen also with mitochondria
      from other species. Hydroxypyruvate and oxoglutarate could substitute for
      pyruvate, although higher concentrations were required to achieve maximum
      stimulation. Pyruvate stimulation of cyanide-insensitive oxygen uptake was
      observed with exogenous quinols as substrates, with sub-mitochondrial particles,
      and in the presence of the pyruvate transport inhibitor, cyanohydroxycinnamic
      acid, but was not observed with detergent-solubilised mitochondria. It is
      suggested that pyruvate acts allosterically on the alternative oxidase to
      stimulate its activity. The implications of these findings for respiration in
      vivo are discussed.

PMID- 8365468
TI  - Lysophosphatidic acid induces tyrosine phosphorylation and activation of MAP
      kinase and focal adhesion kinase in cultured Swiss 3T3 cells.
AB  - Lysophosphatidic acid (LPA) added to serum-starved Swiss 3T3 cells induced, in a
      time- and concentration-dependent manner, tyrosine phosphorylation of multiple
      proteins, including proteins of 43, 64, 88 kDa and a group of proteins between
      110 and 130 kDa. Among them, two proteins, p43 and p120, were identified as
      mitogen-activated protein kinase (MAP-kinase) and focal adhesion kinase (FAK),
      respectively, by immunoprecipitation and immunoblot analysis. Tyrosine
      phosphorylation of p64 peaked at 1 min and declined rapidly, whereas that of MAP
      kinase and FAK peaked at 5 and 10 min after the addition of LPA, respectively.
      The activity of MAP-kinase determined as phosphorylation of myelin basic protein
      increased transiently about 3-fold at 5 min, and correlated with tyrosine
      phosphorylation. These results indicate that tyrosine phosphorylation of these
      proteins is a part of the signal transduction by LPA and may be involved in its
      mitogenic responses.

PMID- 8365469
TI  - Cyclin E enhances P53-mediated transactivation.
AB  - Plasmids expressing G1 and G2 cyclins were introduced into the Saos-2 cell system
      monitoring p53-mediated transactivation [(1993) Oncogene 8, 543]. Cyclin E, but
      not other cyclins, enhanced the p53-mediated transactivation about 2-fold. Co
      transfection of a CDK2 expression plasmid caused a 30% increase in the extent of
      the p53-mediated transactivation. Moreover, the transfected p53 protein became
      phosphorylated coordinately with the enhanced transactivation. The close
      correlation between transactivation and p53 phosphorylation suggests that
      phosphorylation is involved in positive regulation for the transactivation by
      p53.

PMID- 8365470
TI  - The hinge region of chicken annexin I contains no site for tyrosine
      phosphorylation.
AB  - Annexin I (AnxI) is a calcium-dependent membrane binding protein which has been
      implicated in various physiological activities. The region of the chicken anxI
      cDNA encoding the first 130 amino terminal residues was cloned by reverse
      transcription PCR in order to determine the relationship of its variable amino
      terminal regulatory region with other known annexins. This nucleotide sequence
      shows 86% identity with pigeon AnxI isoforms, and 57% with its human homolog. The
      protein encoded by the chicken anxI cDNA lacks the canonical epidermal growth
      factor receptor/kinase phosphorylation site, which is present in AnxI of other
      species. In contrast, the putative protein kinase C phosphorylation site of the
      amino-terminus is present in the chicken AnxI. Whereas the pigeon genome contains
      two anxI genes, genomic Southern analysis shows that in the chicken AnxI is
      encoded by only a single gene. These data suggest that AnxI has undergone
      significant sequence variation in the avians, and clarifies the relationships of
      the avian anxI genes with their ancestral homologs.

PMID- 8365471
TI  - Rapid binding of synapsin I to F- and G-actin. A study using fluorescence
      resonance energy transfer.
AB  - Synapsin I is a nerve terminal phosphoprotein which interacts with synaptic
      vesicles and actin in a phosphorylation-dependent manner. By using fluorescence
      resonance energy transfer between purified components labeled with fluorescent
      probes, we now show that the binding of synapsin I to actin is a rapid
      phenomenon. Binding of synapsin I to actin can also be demonstrated when synaptic
      vesicles are present in the medium and appears to be modulated by ionic strength
      and synapsin I phosphorylation.

PMID- 8365472
TI  - The in situ degradation of ceramide, a potential lipid mediator, is not
      completely impaired in Farber disease.
AB  - The time course of degradation of a radiolabelled natural ceramide has been
      studied in intact, living lymphoid cells and skin fibroblasts from normal
      individuals and from patients affected with Farber disease, an inborn disorder of
      ceramide metabolism due to deficient activity of lysosomal ceramidase. The
      hydrolysis of ceramide in lysosomes was selectively followed by examining the
      turnover of an LDL-associated radioactive sphingomyelin. This permitted to
      estimate accurately the effective lysosomal ceramidase activity and to
      demonstrate: (i) a very active catabolism of ceramide in normal cells; and (ii)
      the absence of a complete block of ceramide degradation in Farber cells. The
      possible implication of ceramide as a lipid mediator of the pathogenesis of
      Farber disease is discussed.

PMID- 8365473
TI  - Phosphorylation of GDI and membrane cycling of rab proteins.
AB  - Membrane transport is known to be regulated by protein phosphorylation and by
      small GTPases of the rab family. Using specific antibodies, we have identified a
      55 kDa phosphorylated protein which co-immunoprecipitated with the cytosolic
      forms of rab5 and other rab proteins. We demonstrate, on the basis of its
      mobility in two-dimensional electrophoresis gels and its immunological
      properties, that this protein is rab GDI (p55/GDI). We also found that, a minor
      fraction of p55/GDI is membrane associated, but, whilst also complexed with rab
      proteins, it is not phosphorylated. On the basis of these data we suggest that
      the cycling of rab proteins between membranes and cytosol is regulated by
      phosphorylation of p55/GDI.

PMID- 8365474
TI  - Energy transfer processes in Rhodopseudomonas palustris grown under low-light
      conditions. Heterogeneous composition of LH 2 complexes and parallel energy flow
      pathways.
AB  - Excitation energy flow in the purple photosynthetic bacterium Rhodopseudomonas
      palustris grown under a low-light intensity was studied by time-resolved
      fluorescence spectroscopy in the ps time range. This bacterium synthesized the
      B824 component under this light condition. Time-resolved spectra at 20 degrees C
      indicated the sequential energy flow in the order of B803, B856, B882 and B900,
      long wavelength antenna. An emission from B803 was not observed. A remarkable
      feature was the emission from B824 throughout the measuring time. After the
      excitation pulse of 100 ps, the spectra did not change any further, indicating
      the establishment of an equilibrium among components. Based on the energy
      distribution after equilibrium, parallel energy transfer pathways to LH 1 were
      suggested; one including B824 integrated in the B803-824-856 complex, and the
      other, from the B803-856 complex to B882. The latter was the dominant energy flow
      pathway in this bacterium.

PMID- 8365475
TI  - Identification of a novel protein kinase C inhibitor in microsomes from
      phytohaemagglutinin activated human peripheral blood mononuclear cells.
AB  - A peptide inhibiting either corpuscolate or purified PKC has been identified from
      microsomes of PHA-activated human PBMC but it is not detectable in microsomes of
      resting PBMC. The peptide was obtained from a microsomal preparation in an
      oligomeric form that could be transformed into a monomeric form by beta-MSH. The
      active peptide (IN) was retained on a PC-11 chromatographic column and could be
      eluted with NaCl. IN is ineffective on PKC-dependent protamine phosphorylation of
      protamine and on Ca2+ and phospholipid-independent activity generated by mild
      hydrolysis with trypsin of PKC. Ca2+ binding is permissive for IN activity. IN
      inhibits particulate PKC in PHA-activated PBMC, but is ineffective after TPA
      activation. All these data indicate that IN acts at the regulatory domain of PKC.

PMID- 8365476
TI  - Identification of the gene encoding the activator of (R)-2-hydroxyglutaryl-CoA
      dehydratase from Acidaminococcus fermentans by gene expression in Escherichia
      coli.
AB  - (R)-2-Hydroxyglutaryl-CoA dehydratase (HGDA/B) from Acidaminococcus fermentans
      requires an activator protein for activity. This activator (HGDC) has not yet
      been purified from its natural source due to its low concentration combined with
      an extreme sensitivity towards oxygen. Gene expression in Escherichia coli
      identified an open reading frame (780 bp) as the gene encoding HGDC. Dehydratase
      activity was stimulated at least tenfold by cell-free extracts of E. coli cells
      transformed with a plasmid carrying hgdC. On the chromosome the hgdC gene is
      located just before hgdA and hgdB.

PMID- 8365477
TI  - Complete amino acid sequence of puroindoline, a new basic and cystine-rich
      protein with a unique tryptophan-rich domain, isolated from wheat endosperm by
      Triton X-114 phase partitioning.
AB  - A new basic protein has been isolated from wheat endosperm by Triton X-114 phase
      partitioning. It contains five disulfide bridges and is composed of equal amounts
      of a polypeptide chain of 115 amino acid residues and of the same chain with a C
      terminus dipeptide extension. The most striking sequence feature is the presence
      of a unique tryptophan-rich domain so that this protein isolated from wheat seeds
      has been named puroindoline. The similar phase partitioning behavior in Triton X
      114 of this basic cystine-rich protein and of purothionins suggests that
      puroindoline may also be a membranotoxin that might play a role in the defense
      mechanism of plants against microbial pathogens.

PMID- 8365478
TI  - Thrombospondin (TSP1) mediates in vitro proliferation of human MG-63 osteoblastic
      cells induced by alpha-thrombin.
AB  - Thrombospondin (TSP) is a 450-kDa glycoprotein synthesized and secreted by human
      MG-63 osteoblastic cells. In this study, we have first studied the effect of
      alpha-thrombin on TSP expression by human MG-63 cells. In situ hybridization
      indicated that TSP mRNA level in thrombin-treated MG-63 cells was increased when
      compared to unstimulated cells. As judged by immunofluorescence, thrombin
      treatment of MG-63 cells resulted in increased cell surface expression of TSP
      when compared to quiescent cells. Because thrombin stimulates proliferation of
      osteoblastic cells, the involvement of TSP in proliferation of thrombin
      stimulated osteoblastic cells was then investigated using a serum-free
      mitogenesis assay. Both alpha-thrombin (0.01 to 0.15 U/ml) and TSP (5 to 600
      ng/ml) caused a dose-dependent increase in [3H]thymidine incorporation by MG-63
      cells. Proliferation of osteoblastic cells induced by alpha-thrombin or TSP was
      specifically and totally inhibited by anti-TSP monoclonal antibodies (3-10
      micrograms/ml) or by indomethacin (1 microM), an inhibitor of prostaglandin
      synthesis. Anti-TSP antibodies which inhibited cell proliferation also inhibit
      TSP expression to the surface of these cells. Our experiments support the
      existence of a mechanism whereby TSP bound to the cell surface of thrombin
      treated MG-63 cells stimulates secretion of prostaglandins which, in turn, allow
      cell proliferation to proceed.

PMID- 8365479
TI  - Production of recombinant antibodies in lymphoid and non-lymphoid cells.
AB  - A recombinant tandem of 'chimeric' mouse/human immunoglobulin (Ig) genes was
      constructed and inserted into plasmid pGEM1 under the control of the T7
      bacteriophage RNA polymerase promoter. Lymphoid (Sp2/0) and non-lymphoid (CHO)
      cell lines used for transfection contained in their genomes a semisynthetic gene
      of T7 RNA polymerase and steadily expressed this enzyme. It was shown for the
      first time that a stable polycystronic transcription of the Ig gene tandem occurs
      under the control of a single T7 phage promoter, both in lymphoid and non
      lymphoid cells. Synthesis of kappa-light and epsilon-heavy Ig chains and
      functionally active antibodies was observed in the above-mentioned transfected
      cell lines.

PMID- 8365480
TI  - Staurosporine-related compounds, K252a and UCN-01, inhibit both cPKC and nPKC.
AB  - The potent inhibitors of protein kinase C (PKC), H7, staurosporine, and
      staurosporine derivatives, were examined for their inhibitory effects on novel
      PKC (nPKC) isozymes delta and epsilon. H7 and staurosporine, usually used as
      selective inhibitors of PKC, showed similar inhibitory effects on cPKC (a mixture
      of cPKC alpha, beta, and gamma) and nPKC delta and epsilon. The inhibitory
      effects of K252a, a non-selective protein kinase inhibitor, on cPKC was 3.2- and
      22-fold higher than those on nPKC epsilon and delta, respectively. The
      staurosporine derivatives UCN-01 and UCN-01-Me also showed selective inhibition
      of cPKC.

PMID- 8365481
TI  - cDNA isolation and partial gene structure of the human alpha 4(IV) collagen
      chain.
AB  - A novel collagen IV chain, alpha 4(IV), has recently been identified in basement
      membranes. We describe part of the primary structure of the human alpha 4(IV)
      polypeptide for the first time, which has been determined by cloning and
      sequencing of cDNAs encoding 241 amino acid residues of the COL domain and 231
      residues of the NC1 domain. We also characterized a genomic DNA fragment
      containing 4 exons coding for the entire NC1 domain. Among five known alpha
      chains of collagen IV, the alpha 4(IV) chain is distinct from the other four
      chains. However, it is more similar to the alpha 2(IV) chain than to the alpha
      1(IV), alpha 3(IV) and alpha 5(IV) chains in terms of amino acid sequence
      homology, domain structure of polypeptides and exon/intron structure of the
      genes, suggesting the presence of two phylogenetically distinct subclasses of
      collagen IV alpha chains; one composed of alpha 2 and alpha 4 chains and the
      other of alpha 1, alpha 3 and alpha 5 chains.

PMID- 8365482
TI  - Fluorescence quenching at interfaces and the permeation of acrylamide and iodide
      across phospholipid bilayers.
AB  - Studies of fluorescence quenching in membrane proteins are complicated by the
      fact that the barrier effect of the bilayer towards the quenchers is not known
      with precision. Our studies show that (a) both acrylamide and iodide can permeate
      the membrane at comparable rates, (b) when quenchers are added externally to a
      vesicle suspension, the apparent Stern-Volmer quenching constants for the same
      fluorophores are lower in the inner than in the outer aqueous compartments, and
      (c) at least some non-polar fluorophores embedded in the bilayer are quenched by
      iodide, but not by acrylamide.

PMID- 8365483
TI  - Modification by site-directed mutagenesis of the specificity of Erythrina
      corallodendron lectin for galactose derivatives with bulky substituents at C-2.
AB  - Examination of the three-dimensional structure of Erythrina corallodendron lectin
      (ECorL) in complex with a ligand (lactose), the first of its kind for a
      Gal/GalNAc-specific lectin [(1991) Science 254, 862-866], revealed the presence
      of a hydrophobic cavity, surrounded by Tyr108 and Pro134-Trp135, which can
      accommodate bulky substituents such as acetamido or dansylamido (NDns) at C-2 of
      the lectin-bound galactose. Comparison of the primary sequence of ECorL with that
      of soybean agglutinin, specific for galactose and its C-2 substituted
      derivatives, and of peanut agglutinin, specific for galactose only, showed that
      in soybean agglutinin, Tyr108 is retained, and Pro134-Trp135 is replaced by Ser
      Trp, whereas in peanut agglutinin, the former residue is replaced by Thr and the
      dipeptide by Ser-Glu- Tyr-Asn. Three mutants of ECorL were therefore constructed:
      L2, in which Pro134-Trp135 was replaced by Ser-Glu-Tyr-Asn; Y108T, in which
      Tyr108 was replaced by Thr and the double mutant L2; Y108T. They were expressed
      in Escherichia coli, as done for recombinant ECorL [(1992) Eur. J. Biochem. 205,
      575-581]. The mutants had the same hemagglutinating activity as native or rECorL.
      Their specificity for galactose, GalNAc and Me beta GalNDns was examined by
      inhibition of hemagglutination and of the binding of the lectin to immobilized
      asialofetuin; in addition, their association constants with Me alpha GalNDns and
      Me beta GalNDns were measured by spectrofluorimetric titration. The results
      showed that Y108T had essentially similar specificity as the native and
      recombinant lectins. The affinity of L2 and L2;Y108T for galactose was also the
      same as ECorL, but they had a lower affinity for GalNAc and markedly diminished
      affinity for the dansyl sugars (up to 43 times, or 2 kcal, less). This appears to
      be largely due to steric hindrance by the two additional amino acids present in
      the cavity region in these mutants. Our findings also provide an explanation for
      the inability of PNA to accommodate C-2-substituted galactose derivatives at its
      primary subsite.

PMID- 8365484
TI  - Cloning and expression of a novel human profilin variant, profilin II.
AB  - We have isolated a 1.7 kbp cDNA encoding a 140 amino acid protein (15.1 kDa, pI
      5.91) with a high sequence similarity (62%) to human profilin (profilin I). We
      have termed this variant profilin II. Northern blot analysis showed that profilin
      II is highly expressed in brain, skeletal muscle and kidney and less strongly in
      heart, placenta, lung and liver. In addition, three different transcript lengths
      were detected. Only one transcript of profilin I was found. The expression level
      of this was low in brain and skeletal muscle, medium in heart and high in
      placenta, lung, liver and kidney.

PMID- 8365485
TI  - Expression of mRNA for cyclooxygenase-1 and cyclooxygenase-2 in human tissues.
AB  - The rate-limiting step in the formation of prostanoids is the conversion of
      arachidonic acid to prostaglandin H2 by cyclooxygenase, also known as
      prostaglandin G/H synthase/cyclooxygenase. Two forms of cyclooxygenase have been
      characterized: a ubiquitously expressed form (COX-1) and a recently described
      second form (COX-2) inducible by various factors including mitogens, hormones,
      serum and cytokines. Here we quantitate by the reverse transcriptase-polymerase
      chain reaction (RT-PCR) the expression of COX-1 and COX-2 mRNA in human tissues
      including lung, uterus, testis, brain, pancreas, kidney, liver, thymus, prostate,
      mammary gland, stomach and small intestine. All tissues examined contained both
      COX-1 and COX-2 mRNA and could be grouped according to the level of COX mRNA
      expression. The highest levels of COX mRNAs were detected in the prostate where
      approximately equal levels of COX-1 and COX-2 transcripts were present. In the
      lung high levels of COX-2 were observed whereas COX-1 mRNA levels were about 2
      fold lower. An intermediate level of expression of both COX-1 and COX-2 mRNA was
      observed in the mammary gland, stomach, small intestine, and uterus. The lowest
      levels of COX-1 and COX-2 mRNA were observed in the testis, pancreas, kidney,
      liver, thymus, and brain.

PMID- 8365486
TI  - cDNAs sequences encoding cytochrome P450 (CYP71 family) from eggplant seedlings.
AB  - Three cytochrome P450 (P450) cDNAs were isolated from an eggplant hypocotyl cDNA
      library using eggplant CYP75 cDNA as a probe. These cDNAs have greater than 65%
      identity in their amino acid sequences, indicating that they belong to the same
      family. Comparison of these with P450 proteins from other sources showed that the
      protein with the greatest degree of homology is CYP71, isolated from avocado
      fruits (approximately 48%). We concluded that they are novel members of the CYP71
      gene family (CYP71A2, 3 and 4). We have examined the level of mRNA transcripts
      from the CYP71 family in eggplant hypocotyl tissues and petunia flower buds, and
      found that the level of transcripts is developmentally regulated in the flower
      bud.

PMID- 8365487
TI  - Prooxidant role of vitamin E in copper induced lipid peroxidation.
AB  - When exposed to Cu2+, alpha-tocopherol, in detergent dispersion, is rapidly
      oxidised. Moreover, if phospholipids and traces of their hydroperoxide
      derivatives are included in these dispersions, Cu2+ initiates lipid peroxidation,
      the rate of which is dramatically stimulated by alpha-tocopherol. The observation
      that the rate of alpha-tocopherol consumption is identical in the absence and in
      the presence of lipids undergoing peroxidation, apparently rules out any
      antioxidant effect. These results are consistent with a prooxidant effect of
      vitamin E, mediated by its capability to reduce Cu2+ to Cu+ which, in turn,
      produces, from lipid hydroperoxides, the highly reactive alkoxyl radicals.
      Present data highlight the risk of misleading results in interpreting the
      significance of lags in peroxidation of LDL challenged with Cu2+.

PMID- 8365488
TI  - The conformation of tRNA genes. Chemical modification studies.
AB  - It has been suggested that eukaryotic tRNA genes might adopt a higher order stem
      and loop structure to facilitate transcription by interaction of their variably
      spaced intragenic promoter blocks. Using sodium bisulphite, which reacts
      specifically with cytosine residues in single-stranded nucleic acids, no
      deamination of C in the TTCGAA sequence of the 3' ICR of a tRNA(Leu) gene could
      be detected under conditions which caused 60% deamination of cytosine residues
      within the loop region of a synthetic cruciform cloned in the same negatively
      supercoiled plasmid vector. We conclude that, under these conditions, such
      structures occur in tRNA genes very rarely, if at all.

PMID- 8365489
TI  - Peroxynitrite modification of low-density lipoprotein leads to recognition by the
      macrophage scavenger receptor.
AB  - Peroxynitrite is an oxidant which could be formed in the vasculature by the
      reaction of superoxide with nitric oxide. It is capable of modifying amino acid
      residues and of initiating lipid peroxidation. In the present study we have shown
      that peroxynitrite converts low density lipoprotein to a form recognized by the
      macrophage scavenger receptor and that this process is associated with
      modification of the protein and lipid, and with the oxidation of alpha-tocopherol
      to alpha-tocopherol quinone.

PMID- 8365490
TI  - Primary structure of the 5 S subunit of transcarboxylase as deduced from the
      genomic DNA sequence.
AB  - Transcarboxylase from Propionibacterium shermanii is a complex biotin-containing
      enzyme composed of 30 polypeptides of three different types. It is composed of
      six dimeric outer subunits associated with a central cylindrical hexameric
      subunit through 12 biotinyl subunits; three outer subunits on each face of the
      central hexamer. Each outer dimer is termed a 5 S subunit which associates with
      two biotinyl subunits. The enzyme catalyzes a two-step reaction in which
      methylmalonyl-CoA and pyruvate form propionyl-CoA and oxalacetate, the 5 S
      subunit specifically catalyzing one of these reactions. We report here the
      cloning, sequencing and expression of the monomer of the 5 S subunit. The gene
      was identified by matching amino acid sequences derived from isolated authentic 5
      S peptides with the deduced sequence of an open reading frame present on a cloned
      P. shermanii genomic fragment known to contain the gene encoding the 1.3 S
      biotinyl subunit. The cloned 5 S gene encodes a protein of 519 amino acids, M(r)
      57,793. The deduced sequence shows regions of extensive homology with that of
      pyruvate carboxylase and oxalacetate decarboxylase, two enzymes which catalyze
      the same or reverse reaction. A fragment was subcloned into pUC19 in an
      orientation such that the 5 S open reading frame could be expressed from the lac
      promoter of the vector. Crude extracts prepared from these cells contained an
      immunoreactive band on Western blots which co-migrated with authentic 5 S and
      were fully active in catalyzing the 5 S partial reaction. We conclude that we
      have cloned, sequenced and expressed the monomer of the 5 S subunit and that the
      expressed product is catalytically active.

PMID- 8365491
TI  - Interaction of GTP-binding protein Gq with photoactivated rhodopsin in the
      photoreceptor membranes of crayfish.
AB  - Interaction of G-protein with photoactivated rhodopsin (Rh*) in crayfish
      photoreceptor membranes was investigated by immunoprecipitation using an antibody
      against rhodopsin. Two kinds of protein were co-precipitated with rhodopsin. One
      is an alpha subunit of class-q G-protein (42 kDa, CGq alpha) which showed light
      induced, dose-dependent binding to rhodopsin, and the other is an actin-like
      protein (44 kDa) with light-independent binding. Most of the CGq alpha was
      available for binding to Rh* but was dissociated from Rh* in the presence of GTP
      gamma S. These findings demonstrate that, in the crayfish photoreceptor, a Gq
      class of G-protein is activated by Rh*.

PMID- 8365492
TI  - A novel ryanodine sensitive calcium release mechanism in cultured human
      myometrial smooth-muscle cells.
AB  - In cultured human myometrial cells application of caffeine (1-30 mM) did not
      result in an elevation of intracellular Ca2+ ([Ca2+]i). Caffeine was found to
      reversibly inhibit both spontaneous and agonist-induced repetitive rises in
      [Ca2+]i possibly as a consequence of its ability to interfere with the binding of
      inositol trisphosphate (IP3) to the receptor on the sarcoplasmic reticulum. Brief
      applications of ryanodine (1-10 microM) were observed to elevate [Ca2+]i and
      repeated exposures to ryanodine could elicit Ca2+ transients of similar
      magnitude. Ryanodine was also observed to mobilise Ca2+ in cells bathed in
      nominally Ca(2+)-free solution. These observations suggest the presence of a
      novel type of ryanodine-sensitive Ca(2+)-induced Ca2+ release (R-CICR) system in
      human myometrial cells.

PMID- 8365493
TI  - Compartmentation of inorganic phosphate in perfused rat liver. Can cytosol be
      distinguished from mitochondria by 31P NMR?
AB  - Compartmentation of inorganic phosphate was studied in intact perfused rat liver
      at 4 degrees C by 31P NMR. It was shown that decreases in cytosolic pH or
      cytosolic Pi concentration induced the appearance of an additional Pi resonance
      at low field which was assigned to Pi from an alkaline compartment. Valinomycin
      (K+ ionophore) induced a further splitting of the lines whereas nigericin (K+/H+
      antiport) or potassium cyanide (inhibitor of cytochrome oxidase) had opposite
      effects. As valinomycin acts mainly on the cytosolic/mitochondrial K+ gradient
      and KCN on the mitochondrial respiratory chain, it was deduced that the alkaline
      compartment as revealed by the second Pi resonance was probably mitochondria.
      Single Pi lines observed on perchloric extracts of livers exhibiting two
      resonances during cold perfusion confirmed that the split peaks in the intact
      liver indeed arose from the same molecular species.

PMID- 8365494
TI  - A complex of rab3A, SNAP-25, VAMP/synaptobrevin-2 and syntaxins in brain
      presynaptic terminals.
AB  - Two monoclonal antibodies (SPM-1 and SPM-2) immunoprecipitate brain N-type
      calcium channels. On immunoaffinity chromatography of digitonin extracts of
      bovine brain membranes on SPM-1- and SPM-2-Sepharose, proteins of 36 (syntaxins A
      and B), 28 and 19 kDa are specifically retained by both columns. Here we show
      that the 19 and 28 kDa bands contain VAMP/synaptobrevin-2, and rab3A/smg25A and
      SNAP-25, respectively. Since SPM-1 and SPM-2 recognize only syntaxins and the 28
      kDa band (rab3A/sm25A and SNAP-25), respectively, the results indicate that all
      these proteins form a complex. Our results suggest tight linkage between the
      components involved in neurotransmitter release.

PMID- 8365495
TI  - A comment on: 'Homology of the NifS family of proteins to a new class of
      pyridoxal phosphate-dependent enzymes', by Christos Ouzounis and Chris Sander
      (1993) FEBS Lett. 322, 159-164.

PMID- 8365496
TI  - The American Fertility Society conjointly with The Canadian Fertility and
      Andrology Society. Montreal, Quebec, Canada, October 11-14, 1993. Abstracts.

PMID- 8365497
TI  - [The renin-angiotensin system and blood pressure].
AB  - The renin-angiotensin system plays an important role in the regulation of blood
      pressure. Recent progress in molecular biology enables us to investigate the
      molecular mechanism of essential hypertension. Accumulating data suggest that the
      disorder of the renin-angiotensin system is not essentially a primary factor of
      hypertension, but it apparently plays an indispensable role in the pathogenesis
      of hypertension. Many researchers including us have shown that the renin
      angiotensin system also contributes the development of various hypertension
      related organ damages by its hypertrophic, vasculotoxic or unknown mechanisms.
      Gene diagnosis and newly developed antihypertensive drug therapy including gene
      therapeutics will open the new era of individualized and etiology-based
      hypertension treatment.

PMID- 8365498
TI  - [Parenteral replacement of 1-T4 in hypothyroid patients with esophageal stenosis
      and unconsciousness].
AB  - Hypothyroid patients are usually treated with in an oral administration of 1-T4.
      When oral administration is impossible because of esophageal stenosis or
      unconsciousness in such patients, parenteral replacement is required. We prepared
      a solution of 1-T4 50 micrograms/ml for intravenous administration in Tohoku
      University Hospital as follows: 5mg of 1-T4 (Nakarai Co.) was dissolved in 1ml of
      0.1N NaOH and diluted with 0.9% NaCl and sterilized with membrane filter. Two
      patients with esophageal stenosis due to thyroid cancer and esophageal cancer and
      one in a coma due to adrenal crisis had replacement with intravenous 1-T4.
      Initial doses of 12.5 micrograms or 25 micrograms diluted with 100ml of 0.9% NaCl
      containing 1% albumin were given by drip infusion. Every week 12.5 micrograms or
      25 micrograms of 1-T4 was increased. By replacement of low doses, 50 micrograms
      or 75 micrograms, serum T4 reached a normal level. No adverse action was observed
      during or after parenteral replacement. The preparation of 1-T4 was stable at
      least for one year and 11 months. Parenteral replacement of T4 is a useful and
      safe method for patients who are unable to take drugs orally.

PMID- 8365499
TI  - [Studies on the in vitro binding assay of androgen receptor in rat skeletal
      muscle].
AB  - It is known that some athletes use androgenic anabolic steroids to promote
      skeletal muscular strength and muscle hypertrophy in response to muscle strength
      training. However, it is not defined whether anabolic steroids are effective for
      muscle hypertrophy. In order to make this question clear, we examined the
      conditions of a binding assay of cytosolic androgen receptor on rat skeletal
      muscle as the first step. We used 3H-mibolerone as the ligand for specific
      binding to the androgen receptor. The following conditions of the assay were
      examined in this study: the incubation temperature and time, concentration of 3H
      mibolerone, the effects of monothioglycerol and triamcinolone acetonide, and the
      effect of repeated freezing and thawing of the samples on binding. It was a
      suitable condition for an androgen receptor assay that samples prepared from
      unfrozen fresh muscle were incubated with 16nM 3H-mibolerone at 4 degrees C for
      20 hrs, with monothioglycerol (20mM) and triamcinolone acetonide (25 microM)
      added. Using these assay conditions, we measured the binding capacity of androgen
      receptor in rat skeletal muscles. The values of Kd and Bmax in M. gastrocnemius
      were 3.61 +/- 0.60 x 10(-9)M and 3.18 +/- 2.23fmol/mg protein respectively.

PMID- 8365500
TI  - [Iodination and binding characteristics of 125I-d(CH2)5 [Tyr(Me)2, Tyr(NH2)9]
      AVP].
AB  - With iodinated vasopressin analogue, d(CH2)5[Tyr(Me)2, Tyr(NH2)9] AVP, at
      position 9, followed by purification by HPLC (specific activity 473-543Ci/mmol),
      a specific binding was observed in the rat liver plasma membrane fraction.
      Scatchard analysis indicated a single class of high-affinity binding sites with a
      Kd of 0.23nM and Bmax of 142fmol/mg protein. V2-agonist, DDAVP, did not displace
      125I-vasopressin analogue. These results suggest that 125I-d(CH2)5[Tyr(Me)2,
      Tyr(NH2)9] AVP with a high specific activity is a useful tool to investigate V1
      receptors.

PMID- 8365501
TI  - [Relative lymphopenia in Cushing's syndrome].
AB  - The differential white blood cell (WBC) count often reveals relative lymphopenia
      in Cushing's syndrome and may be a clue to the discovery of the ailment. However,
      the incidence of this finding has rarely been reported in the literature. We
      conducted a study on 40 patients with Cushing's syndrome due to adrenocortical
      adenoma to evaluate the diagnostic implications of relative lymphopenia. Total
      WBC count, differential WBC count, basal level of plasma cortisol, urinary
      excretion of free cortisol and thyroid function were evaluated preoperatively. We
      also investigated the differential WBC count in 40 patients with thyroid tumors
      matched for age and sex with the Cushing's syndrome patients. The proportion of
      lymphocytes among WBCs was also compared between the two groups. The proportion
      of lymphocytes among WBCs was significantly lower in the patients with Cushing's
      syndrome (19.4 +/- 10.8%) than in those with thyroid tumors (42.3 +/- 9.5%, mean
      +/- SD, p < 0.05). The incidence of relative lymphopenia was high (82.5%) as well
      as that of increased urinary excretion of free cortisol (85.3%) in Cushing's
      syndrome patients. The low T3 syndrome was frequently seen (73.9%), whereas the
      incidences of leukocytosis and an increased level of basal plasma cortisol were
      relatively low (42.5% and 47.5%, respectively). Relative lymphopenia provides
      useful information for diagnosing Cushing's syndrome since it has high
      sensitivity although it should be kept in mind that its specificity is low.

PMID- 8365502
TI  - Update on oral contraception.

PMID- 8365503
TI  - Clinical utility of CA 125 in preoperative diagnosis of patients with pelvic
      masses.
AB  - The preoperative prediction of whether a pelvic mass is benign or malignant is of
      great clinical use. Ultrasound examinations have become increasingly popular but
      despite this remains problematic. It is discussed whether or not preoperative
      serum CA 125 levels may be of value in differentiating between a benign and a
      malignant pelvic mass. When the results of the CA 125 assay are added to any
      other diagnostic test in the postmenopausal patient, predictive values approach
      100%. Utilizing CA 125 levels, a workup scheme may be developed and an operative
      intervention may be in order based on a high degree of preoperative diagnostic
      accuracy.

PMID- 8365504
TI  - CA 125 in the management of endometriosis.
AB  - CA 125 is expressed by eutopic and ectopic endometrium. In women with advanced
      endometriosis, plasma concentrations are increased towards the end of the luteal
      phase and during menstruation but not during the follicular and early luteal
      phases. In women without endometriosis, such cyclic changes of CA 125 in plasma
      are not observed. In women with cystic ovarian endometriosis, plasma CA 125
      concentrations are markedly elevated. Measurement of CA 125 in ovarian cyst fluid
      is the method of choice to differentiate a cystic corpus luteum from an ovarian
      endometriotic cyst, a frequent and difficult clinical problem. CA 125 can be used
      to diagnose deeply infiltrating endometriosis with a sensitivity of 36% and a
      specificity of 87%. These figures underestimate the clinical importance, since
      plasma CA 125 concentrations are mainly important for the diagnosis of deeply
      infiltrating endometriosis types II and III, which are the most severe forms and
      which are clinically easily missed. Because of the strong association of deep
      endometriosis and pelvic pain, the assay of CA 125 in plasma may be advocated in
      all women with unexplained pelvic pain as an aid in the diagnosis of deeply
      infiltrating endometriosis. Following surgical excision of endometriosis, CA 125
      can be used to monitor the completeness of surgery.

PMID- 8365505
TI  - CA 125 in gynecological pathology--a review.
AB  - The original CA 125 serum tumor marker test is a homologous double-determinant
      (OC 125 monoclonal antibody based) assay for the quantification of tumor
      associated mucin-like CA 125 molecules present in the serum. Commercial kits, now
      supplied by various manufacturers (and in different versions, e.g. IRMA, EIA,
      etc.) are currently widely applied in the following clinical situations: (i)
      Monitoring of disease. Doubling or halving of CA 125 serum values correlated (in
      87% of all cases) with tumor progression or regression, respectively. (ii) Early
      prediction of outcome. Deviation from the ideal CA 125 regression curve predicts
      poor outcome within 3 months of cytostatic treatment. (iii) Tumor status after
      completion of therapy. Patients with CA 125 > 35 U/ml have (in 95% of all cases)
      still tumor present (at second look surgery). However, patients with CA 125 < 35
      U/ml have in 50% (mostly minimal) residual disease. (iv) Early detection of
      recurrence. After a complete remission, a rise in CA 125 precedes tumor
      recurrence in 75% of all patients, with lead times up to more then 1 year,
      surpassing the CT-scan in cheapness and accuracy. (v) Diagnosis and differential
      diagnosis. Only when used in combination with other markers, do CA 125
      determinations have a value as a diagnostic adjunct in the discrimination of
      ovarian cancer patients from those with benign ovarian tumors and from those with
      advanced colon cancer. Today, optimal management of ovarian cancer patients can
      only be provided using the CA 125 serum test.

PMID- 8365506
TI  - The 3-keto-desogestrel/ethinylestradiol ring: a new parenteral form of hormonal
      contraception.

PMID- 8365508
TI  - Pelvic infections and infertility.

PMID- 8365507
TI  - Contraception: traditional and religious attitudes.

PMID- 8365509
TI  - HIV infection in women.

PMID- 8365510
TI  - Chlamydia trachomatis--a major threat to reproduction.

PMID- 8365511
TI  - Transvaginal color Doppler in the assessment of placental blood flow.
AB  - A cross-sectional transvaginal color and pulsed Doppler study was performed on 95
      normal singleton pregnancies to establish blood flow characteristics of maternal
      and placental components of circulation. During the pregnancy, vascular impedance
      to blood flow decreases from the main uterine artery to the spiral arteries in
      the maternal component of uteroplacental circulation. In the placental component
      of circulation, vascular impedance decreases from the umbilical artery to the
      fetal arteries within placenta-intraplacental arterioles. At the same time, in
      both components of uteroplacental circulation, an increase of blood flow velocity
      with gestational aging was observed. There was no significant drop of vascular
      impedance of blood flow or increase of blood flow velocity around the 12th or
      14th gestational week, which should prove the hypothesis of 'opening' of spiral
      arteries which have tips plugged with trophoblast tissue.

PMID- 8365513
TI  - Screening for ovarian cancer by transvaginal sonography and colour Doppler.

PMID- 8365512
TI  - Melatonin: a contraceptive for the nineties.
AB  - The hypothalamic GnRH pulse generator activates the pituitary-gonadal
      reproductive axis, and contraceptive techniques have advanced to the point where
      GnRH analogues can block this effect. However, nature has an even finer form of
      contraception, whereby the GnRH pulse generator is activated or inactivated at
      different seasons of the year. Darkness affects the retino-pineal nervous pathway
      to cause the synthesis and release of melatonin from the pineal gland at night.
      The duration of the night time release of melatonin is longer in winter than in
      summer; and it is the prolongation in the duration of the night time release of
      melatonin, with the change of season from summer to winter, which acts as the
      endocrine signal for inactivating the hypothalamic GnRH pulse generator. Humans
      are not seasonal breeders, and evidence is presented to indicate that this is due
      to an impairment of the retino-pineal pathway rather than an impairment of
      melatonin hypothalamic function. Thus the way is open for utilising melatonin as
      a human contraceptive, and a melatonin-based contraceptive is at present
      undergoing phase III clinical trials. The challenge is to develop more refined
      methods for administering (or releasing) melatonin, so that it has a night time
      amplitude and duration which mimics that seen in long day breeders.

PMID- 8365514
TI  - Replacing diagnostic curettage by vaginal ultrasound.
AB  - Dilatation and curettage has for many years been the method of choice for
      diagnosing endometrial cancer in postmenopausal women. However, less than 10% of
      women with postmenopausal bleeding have an endometrial cancer. Vaginal sonography
      for measuring endometrial thickness, has in several studies proved to be a
      sensitive diagnostic method for diagnosing endometrial pathology. Our studies as
      well as others have shown that an endometrial thickness of 4 mm or less
      (including both endometrial layers) indicates a very low risk for endometrial
      carcinoma as well as any other major endometrial pathology in women with
      postmenopausal bleeding. Since vaginal sonography is such a simple and a non
      invasive diagnostic method, it thus seems reasonable that vaginal sonographic
      assessment of the endometrium should be the primary method for excluding any
      endometrial abnormality in a woman with postmenopausal bleeding.

PMID- 8365515
TI  - Effect of antihormones on endometrial receptors and protein secretion.
AB  - The antiestrogen tamoxifen and the antiprogestin RU 486 both interact with
      respective hormones at the receptor level, RU 486 as a pure antagonist which
      inhibits endometrial development, the downregulation of estrogen and progesterone
      receptors and the production of endometrial protein, such as PP14, during the
      secretory phase of the menstrual cycle. Tamoxifen, on the other hand, has both
      agonistic and antagonistic action.

PMID- 8365516
TI  - The early detection and assessment of endometrial cancer by transvaginal colour
      Doppler ultrasonography.

PMID- 8365517
TI  - Early detection of endometrial cancer by transvaginal color Doppler.
AB  - The present study aimed at evaluating the possibility of using transvaginal color
      Doppler sonography in early detection of endometrial cancer. This method was
      performed on 276 patients with uterine tumors before hysterectomy.
      Neovascularization was detected in 167 (67%) benign masses, while all malignant
      masses (26) were vascularised. The final diagnosis was made following
      pathological examination. Tumoral arterial blood flow was detected in all (26)
      patients with endometrial cancer. The blood flow analysis showed a significantly
      lower (P < 0.05) resistance index (RI = 0.37 +/- 0.07) in the cases of
      endometrial cancer than in patients with benign uterine lesions (0.54 +/- 0.09).
      Central vessels within endometrial carcinoma tended to have lower velocity and
      impedance compared to peripheral ones. Significant difference in the impedance of
      uterine artery blood flow, represented with RI between mentioned groups occurred
      (P < 0.05). There is a downward trend in the uterine artery RI in patients with
      endometrial cancer (mean RI = 0.64, ranged from 0.53 to 0.72) regarding benign
      lesions (mean RI 0.74, ranged from 0.64 to 0.82).

PMID- 8365518
TI  - Risk-adapted therapy for cancer of the endometrium.

PMID- 8365519
TI  - Cervical intraepithelial neoplasia: to treat or not to treat!

PMID- 8365520
TI  - Mechanisms of vascular protection by hormonal replacement therapy.

PMID- 8365521
TI  - Effects of female sex steroids on breast tissue.

PMID- 8365522
TI  - Prevention of osteoporosis and reproductive history.

PMID- 8365523
TI  - Subcutaneous hormone replacement therapy.
AB  - It is estimated that 75% of women are in an acute estrogen deficiency state
      within a few years after the onset of the menopause. Every woman inevitably
      reaches this phase except for a fortunate few who have some source of endogenous
      estrogens available to them. We believe it would be prudent to offer hormone
      replacement therapy to every woman with symptoms of the menopause, and to those
      in whom symptoms are not patently manifest, if an estrogen deficit is present as
      indicated by vaginal cytology. Certainly even in the absence of symptoms, the
      presence of osteoporosis is sufficient reason to initiate small doses of
      estrogens (along with increased calcium and protein uptake, and exercise) for the
      remainder of the woman's lifetime. Crystalline pellets of 17 beta-estradiol offer
      excellent relief of symptoms for those postmenopausal women who fare poorly on
      oral estrogens or intramuscular injections. Although somewhat more expensive than
      other modes of therapy, pellet use is convenient, highly effective and associated
      with few side effects.

PMID- 8365524
TI  - Vaginal progesterone after tubal pregnancy.
AB  - We studied the effect of vaginal progesterone (P) treatment during the luteal
      phase of patients who had had a tubal pregnancy (TP) and were planning another,
      in a prospective, randomized, double-blind trial. The outpatient clinics of two
      University hospitals and three central hospitals had 135 patients treated for
      tubal pregnancy: 100 with grossly normal fallopian tubes (supposing an
      accidentally abnormal luteal phase as a possible etiology of their first TP) and
      35 with signs of earlier pelvic inflammatory disease (PID etiology). They were
      treated with vaginal P (25 mg b.i.d.) or placebo during cycle days 16-24, for 10
      months. Serum P levels after a single vaginal or oral dose were compared. The
      rates of conception, delivery, spontaneous abortion and recurrent TP were
      recorded, and fetal and placental weight measured. Both vaginal and oral formulas
      of P provoked a physiological (24-43 nmol/l) rise in serum concentrations. P and
      placebo-treated cycles resulted in a nearly equal number of pregnancies (33/37
      resp.). Of the 55 infants born 53 were to mothers without signs of earlier PID
      (53/100); only 2 (2/35) to mothers in whom signs had been present. Recurrent TP
      occurred in 9% of all pregnancies. Four out of six recurrent TPs were patients
      with signs of PID (4/35), but two were without such signs (2/100): one occurred
      during placebo and one during P-treated cycle. Prophylactic P treatment of
      patients at risk of recurrent TP does not improve fertility or prevent recurrent
      TP. This indicates, that the functional etiology of recurrent TP, as compared to
      infection, is not important.

PMID- 8365525
TI  - Conservative treatment for ectopic pregnancy by local application of
      prostaglandins.

PMID- 8365526
TI  - Laparoscopic management of tubal ectopic pregnancy.
AB  - As with laparotomy, laparoscopic treatment of ectopic pregnancy (EP) can be
      either conservative or radical. After conservative laparoscopic treatment by
      salpingotomy the risk of failure (between 4 and 6%) is comparable with that
      observed after similar treatment by laparotomy. The fertility results after
      laparoscopic treatment of EP are comparable if not better than those observed
      after similar treatment by laparotomy. These two reasons, together with the
      considerable advantages of endoscopy over laparotomy, mean that today
      laparoscopic treatment is without question the best surgical treatment for EP.
      The prognosis for post-EP fertility is unrelated to the characteristics of the EP
      (size, rupture, location). The post-EP fertility depends mainly on the patient's
      previous history. We have established the Therapeutic Scoring System for EP by
      assessing the different factors affecting future fertility and multivariable
      analysis. This score allowed us to choose the most suitable treatment to preserve
      fertility and reduce the risk of recurrence between conservative laparoscopic
      treatment, laparoscopic salpingectomy with or without contralateral tubal
      sterilization.

PMID- 8365527
TI  - Medical treatment of ectopic pregnancy.

PMID- 8365528
TI  - Expectant management of ectopic pregnancy.

PMID- 8365529
TI  - What do we know about the origin of CA 125?
AB  - The murine monoclonal antibody OC 125 recognizes an epitope on a molecule called
      Cancer Antigen 125 (CA 125). The CA 125 antigen is expressed in amnion and its
      derivatives of fetal coelomic epithelia (such as Mullerian epithelia, peritoneum,
      pleura and pericardium) and in many adult tissues (such as the epithelium of
      fallopian tubes, endometrium, endocervix, pleura and peritoneum). The normal
      endometrium produces CA 125 and this production can contribute significantly to
      the level of circulating CA 125 at the time of menstruation. During peritoneal
      irritation (hyperstimulation, salpingitis, ruptured ectopic pregnancy,
      laparotomy) peritoneally derived CA 125 significantly contributes to circulating
      CA 125 concentrations, giving elevated CA 125 values. The use of the CA 125 serum
      assay as a single diagnostic tool is restricted by the fact that the antigen CA
      125 is produced by normal epithelia (of peritoneum, endometrium and benign
      ovarian cysts) and not only by the ovarian cancer cell.

PMID- 8365530
TI  - Discordant serum CA 125 values in commercial immunoassays.
AB  - The CA 125 assay is from a clinical point of view very well suited to monitor
      ovarian cancer patients. Although most commercial assay systems include as
      standards CA 125 preparations derived from the OVCA 433 cell line, the various
      assay configurations do not produce identical results. The so called cut-off
      value of 35 U/ml obtained in the original Centocor CA 125 assay appears to be
      equivalent to CA 125 values ranging as low as 18 U/ml and as high as 53 U/ml in
      other commercial CA 125 assays now available. Because of these dissimilar
      results, obtained with different immunoassays, switching from one assay to
      another during follow-up, should not be tolerated. The newly introduced second
      generation Centocor CA 125 II IRMA was shown to retain the cut-off values of 35
      U/ml and 65 U/ml as defined with the original CA 125 IRMA.

PMID- 8365531
TI  - Rates of cesarean section and perinatal outcome: stillbirths.
AB  - Based on their yearly clinical statistics for 1983-1989, the cesarean section and
      stillbirth rates at National Maternity Hospital (Dublin), where the patients are
      generally white, and University Hospital (Newark), where the patients are
      predominantly black, were compared. After adjusting for confounding factors, such
      as unregistered mothers admitted subsequent to fetal demise, differing rates of <
      2500 g births and lethal congenital defects, the overall rates of intrauterine
      fetal demise were identical. When analyzed according to birth weights, in all
      weight groups, the stillbirth rates were significantly lower in Newark than in
      Dublin. However, for every 1000 births, more < or = 2500 g fetuses died in utero
      in Newark than in Dublin. This trend was reversed in the > 2500 g group, where
      the respective rate at National Maternity Hospital exceeded that of University
      Hospital more than twice. The latter result largely derived from an almost 7-fold
      higher rate of intrapartum deaths in the > 2500 g weight group at National
      Maternity Hospital as compared to University Hospital. When projected against
      prevailing American statistics, which reflect a stillbirth rate about twice as
      high among blacks than among whites, the results suggest that the management
      patterns favored in Newark, including a relatively liberal cesarean section rate
      (17.5% versus 5.8%), affected the rate of in utero losses favorably.

PMID- 8365532
TI  - Outcome of 328 pregnancies in 205 women with insulin-dependent diabetes mellitus
      in the county of Northern Jutland from 1976 to 1990.
AB  - STUDY OBJECTIVE: To determine the degree of centralization and to describe the
      outcome of all pregnancies among Type 1 (insulin-dependent) mothers in the county
      of Northern Jutland from 1976-90. DESIGN: Retrospective, hospital record based
      study. SETTING: Data were collected from all departments of surgery (n = 8) and
      obstetrics (n = 3) in the county covering 550,000 inhabitants (approx. 10% of the
      total Danish population). PATIENTS: Three hundred and twenty-eight consecutive,
      unselected pregnancies among 205 women with Type 1 diabetes mellitus admitted to
      the hospitals in the county from 1976-90. MAIN RESULTS: Thirty-two (11%)
      pregnancies were terminated with spontaneous abortions and ten (3.3%) abortions
      were induced for medical reasons. There were eleven (4.3%) neonatal deaths. There
      was no additional fetal loss within the first year of life. Eight (3.1%) babies
      had major and additionally six (2.4%) minor malformations. Total fetal loss was
      53/297 = 18%. Twenty-eight percent of the babies were large-for-gestational age.
      No pregnancies terminated at primary level hospitals and only 6% at the non-sub
      specialized obstetrical Departments. CONCLUSION: We have achieved an almost
      complete centralization of the management of pregnant women with diabetes
      mellitus and our outcome is comparable to the results published from other
      regional surveys taking care of these patients.

PMID- 8365533
TI  - Recurrent eclampsia. Clinical data, morbidity and pathogenic considerations.
AB  - The analysis of 24 patients with recurrent eclampsia showed that (i) the first
      attack complicated the second or later pregnancies in nine cases, (ii) there was
      one or more apparently normal gestations before the second eclampsia in one-third
      of the patients, (iii) total maternal and neonatal mortality were twice those of
      general eclampsia, (iv) four autopsies revealed chronic pyelonephritis and
      cardiac hypertrophy in addition to the characteristic glomerular and hepatic
      lesions, (v) all six deaths were due to brain damage, and (vi) chronic
      hypertension was diagnosed in half of the survivors. The results of this study
      demonstrate that (i) one or several normal pregnancies after eclampsia do not
      cancel the possibility of another attack, (ii) recurrent eclampsia is an
      extremely severe event even though most clinical data are no different from
      general eclampsia, (iii) underlying diseases seem to play a decisive role, and
      (iv) some aspects of recurrent eclampsia challenge single cause pathogenic
      mechanisms.

PMID- 8365534
TI  - Lack of associations between fetal and maternal serum-erythropoietin at birth.
AB  - Erythropoietin (EPO) is known to be the main regulator of erythropoiesis. We
      wanted to determine whether EPO production during pregnancy takes place
      independently in the mother and the fetus, and to identify the factors which set
      the EPO level. Endogenous EPO levels were determined in simultaneous samples from
      the umbilical vein, the umbilical artery and a maternal vein in 126 mother-child
      pairs and simultaneously from amniotic fluid (n = 14) in unselected births.
      Results were related to clinical and biochemical parameters of fetal well-being,
      mode of delivery, duration of labor, and infant parameters at birth. There was a
      weak correlation between maternal and fetal log EPO values (umbilical vein: r2 =
      0.11; umbilical artery: r2 = 0.08), but a highly significant correlation between
      log EPO levels in the two umbilical vessels (r2 = 0.91) and between both
      umbilical blood and amniotic fluid (r2 = 0.41). Maternal EPO levels were lower
      than fetal levels in 76 cases, higher in 47, and nearly identical in 3. Increased
      fetal EPO levels were associated with clinical and biochemical indicators of
      fetal stress. These associations help to explain why EPO concentrations in fetal
      blood are independent of maternal levels and also indicate that EPO does not
      cross the placental barrier. These findings are discussed in the light of the
      animal experimental and in vitro evidence for placental transfer of EPO. Our
      data, and the work of others, make such a transfer in humans quite unlikely. This
      observation has therapeutical consequences for the treatment of maternal anemia
      with recombinant human EPO.

PMID- 8365535
TI  - European multicentre studies in the field of obstetrics.
AB  - Within Europe a number of multinational, multicentre studies are performed in the
      field of Obstetrics and Gynaecology. Many of these are funded by the European
      Community. Unfortunately, concise information on currently ongoing European
      multicentre studies is not easily obtainable. There is no particular central
      information point. The current overview aims to provide insight in obstetrical
      EC/European multicentre studies which recently have been finished, are ongoing or
      have been planned for the near future. The various projects are described, and
      information on the number of participants, the research period, the responsible
      project leader and framework of each project is summarized in tables. A list with
      the addresses of the project leaders and/or contact persons in the EC member
      states is added. The paper hopes to facilitate researchers and institutes
      involved in Obstetrics within Europe to make easier contacts and to promote
      collaboration on the international level.

PMID- 8365537
TI  - Influence of audit and feedback on use of caesarean section in a geographically
      defined population.
AB  - The influence of audit and feedback on use of caesarean section was investigated
      in a geographically defined population. At the beginning of 1986 and throughout
      that year the three principal reasons for the increased use of caesarean section
      were drawn to the attention of the resident obstetricians in the hospital where
      85% of the women resident in the health district gave birth. A repeat survey of
      the indications for caesarean section was conducted for 1986 births. Despite an
      increase in the number of women delivered in 1986 who had previously had two or
      more sections, the caesarean section rate fell from 15.9% in 1982 to 12.7% in
      1986 (P < 0.005). Most of this decrease was due to a reduction in caesarean
      section for the three indications that were the main contributors to the
      increased rate between 1974 and 1982. The rate for the women who gave birth in
      the hospital whose resident obstetricians had been informed about the preceding
      audit was 12.2%, compared with 15.6%, for the women who gave birth in other
      hospitals. Audit and feedback of specific information, imparted in a non
      directive way to resident obstetricians responsible for performing caesarean
      section, probably accounted for a more rational use of caesarean section.

PMID- 8365536
TI  - Immune response to hepatitis B vaccine in pregnant women receiving post-exposure
      prophylaxis.
AB  - Hepatitis B immunoglobulin and vaccine were given as post-exposure prophylaxis to
      73 women after an outbreak of hepatitis B due to in vitro fertilization
      treatment. The immunization schedule consisted of 5 ml of hepatitis B
      immunoglobulin (125 IU/ml) at months 0 and 1 and recombinant hepatitis B vaccine
      (10 micrograms of HBvaxDNA) at months 0, 1, 2 and 6. The safety and
      immunogenicity of hepatitis B vaccine were studied in 16 women who became
      pregnant after in vitro fertilization; 57 non-pregnant women receiving the same
      treatment served as controls. Blood samples were drawn at 0, 1, 2, 6 and 7
      months. One patient had a clinical abortion 2 days after initial immunization;
      other side effects of vaccination were not found in vaccinees or in their
      offspring. All vaccinees exhibited antibodies against hepatitis B surface antigen
      after vaccination but relatively low peak geometric mean titers of 258 IU/l and
      684 IU/l were attained in pregnant and non-pregnant women, respectively. There
      were no significant differences in seroconversion rates and geometric mean titers
      between the two groups although the immune response to hepatitis B vaccine was
      slower and lower in pregnant women at all times. Our results suggest that when
      post-exposure prophylaxis for hepatitis B infection is indicated, passive active
      immunization can be started safely during pregnancy. The relative weak response
      to the vaccine calls for monitoring of the anti-HBs 1 month after the initial
      series of vaccinations.

PMID- 8365538
TI  - Perinatal mortality in Greece and Greek-born women in Victoria. What does a
      'natural experiment' suggest?
AB  - A comparison of perinatal outcome in the Greek perinatal mortality survey of 1983
      with the outcome of births to Greek born women who had migrated to Victoria,
      Australia found marked similarities in maternal age, parity, marital status and
      cigarette smoking. The birthweight distributions were almost identical in the two
      groups. Despite these similarities the perinatal mortality was substantially
      higher in Greece. Analysis by cause of death showed the differences to be
      marginal in all categories except deaths attributed to intrapartum asphyxia which
      were eight times as common in Greece.

PMID- 8365539
TI  - Five-year follow up of patients with cervical intra-epithelial neoplasia in the
      cone margins after conization.
AB  - Three hundred eighty-five women treated with conization due to repeated CIN I,
      CIN II or CIN III of the cervix uteri have been followed up for 5 years. All
      cones were classified according to diagnosis and status of the resection margins.
      A significantly greater recurrence rate of 16.2% was found in the group with
      neoplasia in the resection margins, in contrast to 3.9% in the group with normal
      resection margins. However, 83.8% (75.4-92.2%) of patients with neoplasia in the
      resection margins can be expected to be free of recurrence after a 5-year
      postoperative follow-up period. Whether the non-free resection margins were
      endocervical, ectocervical or both, did not influence the recurrence rate. While
      the prevalence of non-free resection margins increased significantly with
      increasing dysplasia, this could not be found with increasing age. The risk of
      recurrence could not be correlated with the grade of dysplasia. We conclude that
      neoplasia in the resection margins of the cone represents an increased risk of
      recurrence. Therefore, we changed the normal smear check-up with a cotton-swab to
      smear with cyto-brush, supplemented with colposcopy in the non-free resection
      margin group, but it remains to be proven that this procedure is safer.

PMID- 8365540
TI  - Current management of ruptured corpus luteum.
AB  - The objectives of the study are to assess current management of the rather
      frequent event of ruptured corpus luteum. Special emphasis is made on the value
      of ultrasonography, laparoscopy and culdocentesis in deciding appropriate
      treatment. A series of 70 patients with ruptured corpus luteum diagnosed and
      treated during a period of 6 years in one institution in Israel is reported.
      Eighteen patients with concurrent ruptured corpus luteum and ectopic pregnancy
      are included. Abdominal pain, the most prevalent presenting symptom, has no
      typical characteristics. The correlation between large amount of fluid as
      observed by ultrasound and the finding of > 250 ml of blood at laparotomy is very
      high. Culdocentesis was performed in only 21 patients. Surgical intervention
      (laparoscopy, laparotomy following laparoscopy or direct laparotomy) was carried
      out in 58 patients (83%). The remaining 12 cases were handled by observation
      only. Forty patients required laparotomy in whom 17 underwent wedge resection. We
      conclude that observation is sufficient treatment in hemodynamically stable
      patients, without severe abdominal pain and in the presence of a small amount of
      pelvic fluid demonstrated by ultrasound. When a large amount of fluid is observed
      and/or in the presence of severe abdominal pain laparoscopy should be performed
      on admission. Direct laparotomy is mandatory in case of circulatory collapse.

PMID- 8365542
TI  - Interaction of serum albumin with the Fe(III)-citrate complex.
AB  - 1. Fe(III)-citrate forms a red coloured complex with bovine serum albumin (lambda
      max = 500 nm). 2. Fe(III)-albumin complexes also appear, when Fe(III)-citrate is
      mixed with albumin, suggesting that albumin competes with citrate for ferric
      ions.

PMID- 8365541
TI  - Localization of steroid hormone receptors in the pelvic muscles.
AB  - After the menopause the pelvic floor becomes progressively weaker, one
      consequence of which is the increasing incidence of prolapse and urinary
      incontinence. It is plausible that the reduction in estrogen levels
      postmenopausally is an etiological factor in these problems. For the pelvic floor
      muscles to be considered as target organs for estrogen, demonstration of the
      presence of estrogen receptors is required. The present study aims to confirm
      previous findings of estrogen and progesterone receptors in the levator ani
      muscle, and to further localize them histologically. In seven women biopsies from
      the levator ani muscle were taken and analyzed immunohistologically with
      monoclonal antibodies for estrogen and progesterone receptors. The receptors were
      detected in the nuclei of connective tissue cells and striated muscle cells.
      These findings provide a scientific basis for a possible beneficial effect of
      estrogen therapy, as a complement to other therapies, in prolapse and urinary
      incontinence.

PMID- 8365544
TI  - Effects of Mg2+ and Ca2+ on Fe2+ uptake by Bifidobacterium thermophilum.
AB  - Ferrous iron uptake was investigated in Bifidobacterium thermophilum (B.
      thermophilum) in the presence of Mg2+ and Ca2+ with the following findings: 1.
      Mg2+ inhibited Fe2+ accumulation in the cells in a dose-dependent manner at 37
      degrees, but not at 0 degrees. Removal of Mg2+ from the medium resulted in a
      resumption of rapid iron uptake. 2. Mg2+ had no effect on the binding of Fe2+ by
      B. thermophilum protoplasts, its cellular particulate fraction, or distribution
      between the particulate and soluble fractions. 3. Ca2+ exerted a stimulatory
      effect on iron uptake by B. thermophilum, but was not able to reverse the
      inhibitory effects of Mg2+. 4. It was concluded that Mg2+ has no effect on the
      binding of iron on the surface or interior of B. thermophilum and that it
      affected the Fe2+ transport mechanism (permease) in a reversible manner. It is
      possible that iron and magnesium share the same permease in this microorganism.

PMID- 8365543
TI  - Identification of annexin II, annexin VI and glyceraldehyde-3-phosphate
      dehydrogenase as calcyclin-binding proteins in bovine heart.
AB  - 1. Matrix-immobilized calcyclin as affinity ligand in chromatography led to
      purification of three protein bands at 68, 36 and 35 kDa from bovine heart that
      required Ca2+ for binding. 2. Polyacrylamide-immobilized phosphatidylserine
      separated this fraction into a phospholipid-binding part (68 kDa, 35 kDa), also
      attaching to phospholipid vesicles even in the presence of calcyclin, and a flow
      through part, constituting approx 30% of the total fraction (36 kDa). 3. Enzyme
      assays and electrophoretic mobility showed an at least close relationship of the
      36 kDa band to glyceraldehyde-3-phosphate dehydrogenase. Interaction between
      enzyme and calcyclin in a solid-phase assay was inhibited by sialoglycoproteins
      and depended strongly on the integrity of carboxyl and hydrophobic groups of the
      enzyme. The interaction between the two proteins had a KD value of 110 nM. 4.
      Application of annexin-specific antibodies revealed an immunological relationship
      of the 35 and 68 kDa calcyclin-binding proteins to members of the annexin family,
      namely to annexin II (35 kDa) and annexin VI (68 kDa). The N-terminal amino acid
      sequence of a cleavage peptide of the 68 kDa protein was identical to a sequence
      stretch in human annexin VI, corroborating this evidence.

PMID- 8365545
TI  - In vitro phosphorylation of proteins tightly bound to DNA by protein kinase NII.
AB  - 1. Highly purified DNA from calf thymus was phosphorylated with protein kinase
      NII. 2. Digestion with proteinase K of this DNA demonstrates proteins as
      phosphorylated component. 3. Gel filtration chromatography on Bio-Gel A-0.5m gel
      column shows a major protein peak between 50 and 70 kDa. 4. SDS gel
      electrophoresis, after hydrolysis, to digest completely DNA, shows three major
      phosphorylated bands corresponding to polypeptides of M(r) between 31 and 21 kDa.
      5. After high voltage electrophoresis on TLC plates tryptic digested polypeptides
      show very similar phosphopeptides patterns.

PMID- 8365546
TI  - Thyroxine type II 5'-deiodinase activity in pineal and Harderian gland is
      enhanced by hypothyroidism but is independent of serum thyroxine concentrations
      during hyperthyroidism.
AB  - 1. This paper studies the effect of thyroid status on 5'-D activity in pineal
      gland, Harderian gland, brown adipose tissue (BAT), pituitary gland, brain
      frontal cortex (BFC), and cerebellum. 2. Hypothyroidism clearly increased diurnal
      5'-D activity in Harderian gland, BAT, pituitary gland, BFC, and cerebellum. In
      pineal gland, diurnal values of 5'-D activity were not affected by
      hypothyroidism. 3. Hypothyroidism in adult rats clearly enhanced nocturnal
      increase of 5'-D activity in pineal and Harderian gland. Congenital
      hypothyroidism also enhanced the nocturnal increase of 5'-D activity in pineal
      gland. 4. Hyperthyroidism inhibited 5'-D activity in pituitary gland, BFC, and
      cerebellum. A small inhibition, although significant, was found in BAT. 5. In
      pineal and Harderian gland, hyperthyroidism did not inhibit either the basal
      diurnal values of the enzyme or the nocturnal increase of its activity. 6.
      Results suggest that, in tissues where 5'D-activity is regulated by adrenergic
      mechanisms, mostly pineal gland and Harderian gland, the enzyme activity is
      independent of serum T4 concentrations during hyperthyroidism.

PMID- 8365547
TI  - Characterization of the ferredoxin gene transcripts in bovine liver and brain.
AB  - 1. To study the expression of a ferredoxin gene in extra-adrenocortical tissues,
      the amounts and structures of the ferredoxin gene transcripts in bovine liver and
      brain were studied and compared to those of that in adrenocortex. 2. The sizes
      and amounts of the ferredoxin mRNAs were analyzed by means of Northern blotting,
      RNA slot blotting and RT-PCR. 3. The nucleotide sequences were determined for 39
      ferredoxin cDNA clones from bovine liver. 4. The results indicated that the sizes
      of the ferredoxin mRNAs in liver and brain were the same as that in adrenocortex,
      however, their amounts were approx 1/30th and less than the latter, respectively.
      5. Although the multiple forms of ferredoxin cDNA, differing in the poly(A)
      addition sites, were also found in liver, a minor form of ferredoxin cDNA,
      produced through alternative promoter usage and splicing, could not be detected
      in liver. 6. The nucleotide sequences of all hepato-ferredoxin cDNA clones
      obtained were identical to that of a major type of adreno-ferredoxin. 7. These
      results showed that the expression level of the ferredoxin gene in different
      tissues was controlled by the amount of mRNA.

PMID- 8365548
TI  - Glycolytic enzymes as DNA binding proteins.
AB  - 1. Numerous studies have demonstrated the presence of at least four glycolytic
      enzymes in the nuclear compartment of several cell systems. 2. These include,
      lactate dehydrogenase, phosphoglycerate kinase, aldolase and glyceraldehyde-3
      phosphate dehydrogenase. 3. In some cases the glycolytic enzymes found in the
      nuclei were a modified form from that found in the cytoplasmic counterpart. 4. In
      all four cases, the nuclear form of these glycolytic enzymes has been reported to
      bind DNA. 5. Although none of these enzymes interact with a specific target DNA
      sequence, their association with DNA may play a role in transcription and
      replication of DNA through general stabilization of the nuclear matrix or
      chromatin structure. 6. The present review aims to summarize the current
      understanding of this phenomenon and to examine the role of the DNA-binding
      activities of the glycolytic enzymes in cell growth and differentiation.

PMID- 8365549
TI  - Post-translational chemical modifications of proteins--III. Current developments
      in analytical procedures of identification and quantitation of post-translational
      chemically modified amino acid(s) and its derivatives.
AB  - 1. The Chemical modifications of amino acids and their derivatives are mainly due
      to different post-translational enzymatic reactions. 2. The enzymatic reactions
      resulting in amino acids such as acetylation-, formylation, methylation
      phosphorylation-, sulfation-, hydroxylation, ADP ribosylation-, carboxylation-,
      amidation-, adenylylation-, glycosylation-, ubiquitination-, prenylation and
      acylation are listed and analytical methods are reported and extensively
      reviewed. 3. The post-translationally modified cross-linking molecules after
      maturations such as desmosines, allo-desmosine, hydroxy-, lysylpyridinoline, 3
      hydroxypyridinium derivatives, cyclopentenosine recently found in matured
      elastin, and in collagen, and pulcherosine a novel tyrosine-derived found in
      fertilization envelope of Sea Urchin embryo, di-tyrosine in resilin, gamma
      glutamyl-lysine isopeptide cross-linking molecule etc. are listed and both
      physico-chemical and analytical methods are extensively reviewed and discussed.
      4. Other consequences of post-translational modifications encountered in the
      analytical procedure such as N-terminal step-wise Edman degradation of
      glycosylated site(s), phosphorylated-site(s) and or sulfated-site(s) were also
      reported by us.

PMID- 8365550
TI  - Spectrofluorometric studies of nile red treated native and oxidized low density
      lipoprotein.
AB  - 1. The excitation and emission maxima of nile red in the presence of LDL were
      found to be 526 and 587 nm, respectively. Oxidation of LDL for 16 hr in the
      presence of CuSO4 resulted in significant spectral shifts to longer wavelengths
      in both the excitation and emission spectra. 2. The difference in the
      fluorescence intensity between native and oxidized LDL was most pronounced at
      wavelengths between 550 and 580 nm. At these emission wavelengths, the relative
      fluorescence intensity of nile red treated oxidized LDL was found to be decreased
      by approx 30% when compared to that observed in the presence of native LDL. 3.
      Differences in the nile red fluorescence spectra were not observed when LDL and
      acetylated LDL were compared.

PMID- 8365551
TI  - Uncoupling of mitochondrial oxidative phosphorylation abolishes the stimulatory
      action of insulin on the binding of glycolytic enzymes to muscle cytoskeleton.
AB  - 1. We show here that treatment of diaphragm muscle with 2,4-dinitrophenol (DNP),
      an uncoupler of oxidative phosphorylation, abolished the stimulatory action of
      insulin on binding of the glycolytic enzymes, phosphofructokinase (PFK) and
      aldolase, to muscle cytoskeleton. This effect was demonstrated with low
      concentration of DNP, which caused only a small decrease in ATP and did not
      affect the basic levels of cytoskeleton-bound glycolytic enzymes. 2. Higher
      concentrations of DNP, which induced a drastic decline in ATP content, caused a
      decrease in cytoskeleton-bound glycolytic enzymes and damage to myofibrils. 3.
      These results suggest that mitochondrial ATP is required for both the
      preservation of the basal levels of cytoskeleton-bound glycolytic enzymes and
      cell structure, as well as for the expression of the stimulatory action of
      insulin on glycolytic enzymes' binding to muscle cytoskeleton.

PMID- 8365552
TI  - Characterization of calcyclin fragments obtained by CNBr-cleavage.
AB  - 1. Two calcyclin fragments were obtained by CNBr-cleavage. 2. One fragment
      represented N-terminal end of a molecule (residues 1-56), and another one a C
      terminal end (residues 57-89). 3. Properties of intact calcyclin such as binding
      of calcium, binding to hydrophobic resins and interaction with calcyclin specific
      antibodies were not retained by these fragments. 4. However, both fragments were
      able to form dimers and higher forms of aggregates as seen for uncleaved
      calcyclin. 5. This indicates that both halves of the molecule contain the regions
      responsible for non-covalent interaction which might participate in dimer
      formation.

PMID- 8365553
TI  - Origins of neural crest cell diversity.
AB  - The neural crest is a population of migratory cells, arising from the ectoderm,
      that invades many sites within the embryo and differentiate into a variety of
      diverse cell types. Pigment cells, most cells of the peripheral nervous system,
      adrenal medullary cells, and some cranial cartilage are derived from the neural
      crest. Despite a wealth of knowledge concerning their pathways of migration and
      vast array of derivatives, little is known about the formation of neural crest
      cells or their acquisition of positional identity. This review focuses on the
      origin of neural crest cells from the ectoderm and the generation of differences
      in neural crest cell fates along the rostrocaudal axis. In addition, we consider
      the role of temporal restriction in the developmental potential of premigratory
      neural crest cells. While evidence for the existence of multipotent stem cells is
      strong, some experiments also suggest that there may be heterogeneity among
      neural crest cell precursors, perhaps due to differences in origin, that might
      explain commitment events occurring early in neural crest development.

PMID- 8365554
TI  - Developing rat retinal ganglion cells express the functional NGF receptor
      p140trkA.
AB  - The expression and cellular localization of NGF receptors in the developing rat
      retina were investigated immunocytochemically and biochemically. In in vitro
      preparations of retinal neurons from neonatal rats the functional NGF receptor
      p140trkA was immunocytochemically detected on retrogradely labeled retinal
      ganglion cells (RGCs). In transverse retinal sections p140trk-immunopositive
      cells were localized exclusively at the level of the RGC layer. Affinity labeling
      with 125I-NGF, chemical cross-linking, and immunoprecipitation with anti-NGF
      antibodies revealed the presence of three complexes which migrate on SDS-PAGE at
      approximately 90, 95, and 150 kDa. The bands at 90 and 95 kDa correspond to the
      so-called low affinity NGF receptor p75NGFR. Western blotting experiments using
      anti-TRK antibodies revealed that the slowest migrating band (150 kDa), which is
      not immunoprecipitated by monoclonal antibodies to p75NGFR, corresponds to
      p140trkA. The presence of the functional NGF receptor on RGCs provides the
      molecular explanation for the reported sensitivity of these cells to the
      biological action of NGF.

PMID- 8365555
TI  - Lineage diversification of the neural crest: in vitro investigations.
AB  - This review addresses the contribution of in vitro investigations to our
      understanding of neural crest development. Cell culture has been used to study
      the environmental control of cell lineage decisions in the neural crest and to
      define the developmental potentials of specific populations of neural crest and
      neural crest-derived cells. We consider the roles of environmental signals in the
      context of the development of several different neural crest-derived lineages. We
      also discuss evidence for influences of local cell-cell interactions and
      substrate molecules on neural crest development. Data bearing on the issues of
      neural crest cell multipotency, self-renewal, and lineage commitment are
      reviewed.

PMID- 8365556
TI  - Sperm, inositol trisphosphate, and thimerosal-induced intracellular Ca2+
      elevations in rabbit eggs.
AB  - Fertilization-induced calcium (Ca2+) changes were examined in in vivo fertilized
      rabbit eggs, using the fluorescent Ca2+ inducer fura-2 dextran. Twenty-four of 48
      fertilized eggs exhibited repetitive Ca2+ rises with intervals of 13 +/- 1 min
      (mean +/- SEM) during the recording period of 45 min. None of the unfertilized
      eggs showed Ca2+ rises (6/6). The mean peak Ca2+ concentration ([Ca2+]i) was 466
      +/- 30 nM and the average duration was 100 +/- 3 sec. The amplitude of the Ca2+
      rises decreased and the duration increased as the stage of fertilization
      progressed from recently fertilized to pronuclear apposition (P < 0.05). In
      unfertilized eggs, Ca2+ release was elicited by injection of inositol 1,4,5
      trisphosphate (InsP3; 5 microM in the injection pipette) with a mean peak [Ca2+]i
      of 764 +/- 88 nM and a duration of 28 +/- 1 sec (n = 9). Injection of InsP3S3
      (500 microM), a nonmetabolizable analogue of InsP3, induced repetitive Ca2+ rises
      different from sperm-induced rises in periodicity and duration. Exposure to 400
      microM thimerosal caused spontaneous Ca2+ rises (1.4 +/- 0.1 Ca2+ rises in 45 min
      of measurements) with an amplitude of 1200 +/- 54 nM and duration of 114 +/- 8
      sec. Heparin injection (100 mg/ml), an InsP3 receptor antagonist, blocked both
      InsP3 and thimerosal-induced spontaneous Ca2+ rises. Successive application of
      InsP3 and thimerosal in Ca(2+)-free medium showed that either InsP3 or thimerosal
      produced smaller Ca2+ rise(s) when preceded by Ca2+ rise(s) induced by the other
      agonist. The results of this study indicate that rabbit eggs, like other
      mammalian eggs, exhibit repetitive Ca2+ rises during fertilization. InsP3 and
      thimerosal stimulate intracellular Ca2+ release most likely from a common large
      intracellular pool by activating the InsP3 receptor.

PMID- 8365557
TI  - Isolation and characterization of Xenopus follistatin and activins.
AB  - Xenopus follistatin and activins were purified from a Xenopus laevis cell line
      (XTC-F1) by four purification steps consisting of consecutive affinity
      chromatography on dextran sulfate-Sepharose and Sulfate Cellulofine, fast protein
      liquid chromatography gel permeation, and reverse-phase high performance liquid
      chromatography (HPLC). Our results thus obtained indicated that almost equimolar
      amounts of activins A, AB, and B were found to be present as a complex with
      follistatin (activin-binding protein) in the conditioned medium of XTC-F1 cells.
      Reverse-phase HPLC of the complex gave Xenopus follistatin and activins A, AB,
      and B. The purified Xenopus follistatin showed four major bands in a molecular
      mass range from 34 to 39 kDa by SDS-polyacrylamide gel electrophoresis under
      nonreducing conditions. The ability of each form of the protein to specifically
      bind activin was determined by activin-binding assay and ligand blotting
      analysis. Each protein was found to have the same NH2-terminus and its sequence
      was very homologous to that of mammalian follistatin. Several criteria including
      immunoblotting analysis and various functional assays revealed the existence of
      three isoforms of activins A, AB, and B in Xenopus, as in mammals. Xenopus
      activins significantly induced both ventral and dorsal mesoderm in explants of
      Xenopus blastula cells that would otherwise form epidermis. In a dose-dependent
      manner of each isoform of activin, the induced explants were able to
      differentiate into blood-like cells, coelomic epithelium, mesenchyme, muscle, and
      notochord. The induction patterns of three Xenopus activins were essentially the
      same. The mesoderm induction by the purified Xenopus activins was shown to be
      inhibited stoichiometrically by the purified Xenopus follistatin. These results
      indicate that Xenopus XTC-F1 cells secrete several molecular forms of
      follistatin/activin-binding protein and three isoforms of activins AB and B in
      addition to activin A.

PMID- 8365558
TI  - Germline stem cell division and egg chamber development in transplanted
      Drosophila germaria.
AB  - Germline and somatic stem cells reside within the anterior region (or
      "germarium") of each ovariole in the Drosophila ovary. When individual germaria
      were dissected free of developing eggs and sheath tissue and transplanted into
      the abdominal cavity of a host fly, they regenerated ovariole-like structures and
      continuously supported the entire process of oogenesis, indicating that the stem
      cells remained functional. This system allowed us to measure the duration of
      several stages in oogenesis and to analyze the role of specific germarial cells
      in providing stem cell function. Laser ablation of presumptive germline stem
      cells near the apical tip prior to transplantation blocked the production of new
      germline cysts, but allowed previously initiated cysts to complete development.
      This confirmed the location of germline stem cells and showed that subsequent
      development of preexisting cysts did not require continued cyst production.
      Ablation of a distinct group of somatic cells lying close to the germline stem
      cells ("the terminal filament") increased the rate of oogenesis by approximately
      40%, suggesting that the terminal filament may negatively regulate stem cell
      division.

PMID- 8365559
TI  - Nerve-dependent and -independent patterns of mRNA expression in regenerating
      skeletal muscle.
AB  - Muscle regeneration was used to assess the roles of innervation and intrinsic
      genetic information in the acquisition of predominant slow and fast contractile
      protein mRNA profiles in adult skeletal muscle. Rat soleus (slow) and EDL (fast)
      muscles were allowed to regenerate in the presence and absence of their
      respective slow and fast nerves. Levels of mRNAs encoding fast, slow, and cardiac
      contractile protein isoforms were quantitatively determined at specific times
      during regeneration. All muscles initially expressed a heterogeneous pattern of
      fast, slow, and cardiac isoform mRNAs during myotube formation. Subsequently, the
      EDL muscle made a transition to a predominantly fast profile of mRNAs which was
      independent of innervation. The mRNA profile for the noninnervated regenerating
      soleus muscle was similar to both the innervated and the noninnervated EDL muscle
      profile. Thus, the decision to express predominantly fast isoform mRNAs is
      intrinsic to in vivo muscle regeneration with the fast nerve not appearing to be
      informative. In contrast, acquisition of a slow mRNA profile is dependent on the
      presence of a slow nerve. The mRNAs encoding slow isoforms from all of the
      contractile protein gene families are upregulated during the period of
      reestablishment of neuromuscular transmission. Additionally, there is no
      concomitant down-regulation of the fast isoform mRNAs upon reinnervation in the
      soleus regenerate. We propose that information both intrinsic to the muscle and
      supplied by the in vivo environment acts to provide potential isoform mRNA
      options to the regenerating muscle.

PMID- 8365560
TI  - Lineage analysis of early neural plate cells: cells with purely neuronal fate
      coexist with bipotential neuroglial progenitors.
AB  - To investigate the lineage relationships of neurons and astroglial cells early in
      central nervous system development, we have analyzed the progeny of neural plate
      cells in an amphibian embryo (Pleurodeles waltl). A fluorescent tracer, lysinated
      rhodamine-dextran, was iontophoretically injected into individual precursor cells
      in various areas of the early neural plate. The phenotypes of clonally related
      cells were identified in the hindbrain and spinal cord by morphological and
      immunohistochemical criteria 12 days later, at larval stages. We found that the
      large majority of clones (83%) contained both neurons and astroglial cells,
      whereas the remainder (17%) were homogeneous and were only composed of neurons.
      We never observed purely astroglial clones. These results clearly demonstrate the
      predominance of bipotential progenitors in the neural plate. Interestingly, the
      progenitors with a restricted neuronal fate were always located along the
      intermediate axes of the neural plate, while mixed progenitors were found in all
      areas examined. The analysis of migratory paths has shown that sister cells first
      migrated together along radial pathways without dispersion along the rostrocaudal
      axis. From larval stages, some neurons migrated away from the original clonal
      cohort along dorsoventral and ventrodorsal tangential routes, but only after they
      had reached the border between the intermediate and marginal zones.

PMID- 8365561
TI  - Inhibition of differentiation in P19 embryonal carcinoma cells by the expression
      of vectors encoding truncated or antisense EGF receptor.
AB  - Murine embryonal carcinoma cells do not express detectable cell-surface epidermal
      growth factor receptors (EGF-R) but after 2 days of differentiation induced by
      retinoic acid (RA) increasingly express mRNA and protein encoded by the EGF
      receptor gene (Joh et al., Cell Growth and Differentiation 3, 315, 1992). The
      effect on morphology, growth, and differentiation of the introduction of
      expression vectors that produce either a truncated, kinase-negative mouse EGF
      receptor or an antisense mRNA was studied in P19 embryonal carcinoma (EC) cells
      before and after differentiation. The presence of either construct should lead to
      the reduction of EGF-R expression by either the dominant negative effects of a
      truncated protein or the inhibition of endogenous EGF-R mRNA
      production/translation by complementary RNA, respectively. Cells were
      cotransfected with the bacterial neomycin resistance gene and constitutively
      expressing clones were selected with G418. The cytomegalovirus LTR
      promoter/enhancer was found to be very inefficiently activated in P19 EC cells.
      After RA addition, changes in gene expression included induction of both the
      exogenous truncated constructs and endogenous EGF-R. Differentiation was gauged
      by the expression of tissue-type plasminogen activator and intermediate filament
      protein markers of neural tissues, as well as EGF-R. The expression of 120-kDa
      truncated EGF-Rs was high in four clones, but all 10 clones examined had
      diminished abilities to differentiate after RA induction compared to four control
      cell lines. Similarly, the majority of antisense transfected clones was unable to
      differentiate normally. The results indicate that the reduced expression of EGF
      Rs in differentiating EC cells inhibits the rate, frequency, and extent of
      differentiation after RA induction. We conclude that the expression of EGF-Rs
      plays a role in the stimulation of differentiation and we speculate that the
      mechanism involves the tyrosine kinase activity of the receptor.

PMID- 8365562
TI  - Basic FGF maintains some characteristics of the progress zone of chick limb bud
      in cell culture.
AB  - The apical region of chick limb buds (progress zone, PZ) is known to be essential
      for limb pattern formation. In the PZ, the cells are in an uncommitted state and
      change their positional values under the influence of the apical ectodermal ridge
      (AER). Using a culture system of chick PZ cells, we have examined the factor(s)
      which helps to maintain some of the characteristics of PZ cells. It was found
      that basic FGF (bFGF) stimulated the expression of AV-1 and Msx 1 mRNA, which are
      rich in PZ cells at early stages, in the cultured PZ cells. These two molecules
      were rapidly lost in the control culture without the bFGF. Further, bFGF promoted
      growth and inhibited chondrogenesis of the cultured PZ cells. When quail PZ cells
      were cultured in FGF medium, harvested, and grafted to the apical region of chick
      limb buds, in about half of the grafts, the cells distributed to form a long band
      along the proximodistal axis and participated in normal host cartilage pattern
      formation as did intact PZ tissues. In contrast, those cultured in the medium
      without bFGF distributed as a cluster and did not participate in host cartilage
      pattern formation. The culture with conditioned medium of BRL cells increased the
      percentage of the grafts participating in normal pattern formation. These results
      indicate that bFGF helps to maintain some of the characteristics of PZ cells in
      culture and suggest that bFGF may be a PZ maintenance factor from the AER.

PMID- 8365563
TI  - Patterning of neural crest derivatives in the avian embryo: in vivo and in vitro
      studies.
AB  - In this article we review recent findings from our laboratory on the
      developmental fate of the neural crest as studied in the avian embryo using the
      quail-chick marker system in vivo. Quail-chick chimeric experiments carried out
      at the late neurula stage have revealed the contribution of the neural crest to
      the skull vault, i.e., the frontal and parietal bones, previously thought to be
      mesodermally derived. At early developmental stages, the fate of the cephalic
      mesoderm (free of neural crest cells) could be analyzed. The striking result was
      that the mesoderm does not contribute to the head and face dermis except in the
      occipital and otic areas where the skull is derived from the cephalic and somitic
      mesoderm. Thus, the neural crest forms the dermis, the membrane and cartilage
      bones of the skull vault, the skull basis, and the face. The limit of the
      mesoderm-derived skeleton in the skull basis is located in the sella turcica
      between the basipre- and the basipostsphenoid and coincides with the tip of the
      notochord. We thus define a "chordal" and an "achordal" skull, the latter being
      all derived from the neural crest. These results are discussed in the framework
      of the "New Head" concept of Gans and Northcutt (1983). The second part of this
      review deals with the role of the environment in the morphogenesis and
      diversification of neural crest derivatives. The role of the rostrocaudal
      heterogeneity of the somites in establishing the metameric pattern of the truncal
      neural crest derivatives is analyzed. The respective contributions of the "in
      embryo" and in vitro approaches to our understanding of the neural crest cell
      differentiating potentialities are reviewed. It is pointed out that the search
      for survival and proliferation factors acting locally on neural crest derivatives
      when they are wandering and/or settling in various embryonic locations
      constitutes the new challenge for further understanding their complex patterning
      and the highly diversified variety of their phenotypes.

PMID- 8365564
TI  - Brain-derived neurotrophic factor and neurotrophin-3 induce cell proliferation in
      the cochleovestibular ganglion through a glycosyl-phosphatidylinositol signaling
      system.
AB  - We have investigated the role of brain-derived neurotrophic factor (BDNF) and
      neurotrophin-3 (NT-3) in the regulation of cell proliferation in the early
      developing cochleovestibular ganglion (CVG). Ganglia were isolated from 72-hr
      chick embryos and cultured for 24 hr. Both BDNF and NT-3 had a powerful mitogenic
      effect, at doses of 1-5 ng/ml, consistent with an involvement of the high
      affinity receptor. Evidence for the participation of the glycosyl
      phosphatidylinositol (GPI)/inositol phosphoglycan (IPG) signaling system in the
      mediation of proliferative effects of BDNF and NT-3 is presented. Both of these
      neurotrophins elicited a fast and transient hydrolysis of labeled GPI,
      approximately 60% in 30 sec. The dose-response profile of GPI hydrolysis overlaps
      the neurotrophin-induced cell proliferation response profile. Anti-IPG antibodies
      were able to block the growth-promoting effects of BDNF and NT-3. Anti-IPG
      antibodies immunoprecipitated a CVG-endogenous IPG, induced upon BDNF treatment,
      which exhibited proliferative stimulating properties. Both BDNF and NT-3 are
      proposed as potential candidates for regulation of growth during CVG development,
      with this mitogenic effect being mediated by the GPI/IPG signaling system.

PMID- 8365565
TI  - Brain-derived neurotrophic factor and neurotrophin-3 support the survival and
      neuritogenesis response of developing cochleovestibular ganglion neurons.
AB  - The effects of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3)
      on the differentiation of avian cochleovestibular ganglion and their possible
      association with the hydrolysis of glycosyl-phosphatidylinositol (GPI) were
      studied. BDNF and NT-3 (2 ng/ml) promoted neurite outgrowth in explants of both
      cochlear and vestibular ganglia. This effect on neuritogenesis was stage
      dependent, reaching a maximum at E7 for NT-3 and at E9 for BDNF. The magnitude of
      the response of the vestibular ganglion to BDNF was always smaller than that of
      the cochlear ganglion of an equivalent stage. BDNF and NT-3 stimulation of
      neuronal survival and neurite extension was also demonstrated in dissociated
      neuronal cell cultures. The effect was concentration-dependent with saturation of
      the response occurring at 4 ng/ml for BDNF and at 2 ng/ml for NT-3, the half
      maximal effect occurring at 2 and 1 ng/ml, respectively, for the most sensitive
      stages of the chick cochlear ganglion. Inositol phosphoglycan (IPG) did not mimic
      the effects of BDNF or NT-3 on neuronal survival and neurite outgrowth, nor was
      it able to potentiate their responses. Antibodies raised against IPG did not
      block the effects of these neurotrophins. The results suggest that BDNF and NT-3
      may act in cooperation to establish the innervation pattern of the inner ear.
      Unlike their early proliferative effects, neurotrophic effects are uncoupled from
      the GPI/IPG signal transduction system.

PMID- 8365566
TI  - Identification of two regions from the Drosophila decapentaplegic gene required
      for embryonic midgut development and larval viability.
AB  - The Drosophila decapentaplegic (dpp) gene, a member of the transforming growth
      factor-beta family, is required for dorsal/ventral pattern formation and midgut
      and imaginal disk development. We have identified a 3-kb upstream regulatory
      region necessary for dpp expression in the visceral mesoderm of the gastric caeca
      primordia and a second 2.5-kb upstream regulatory region necessary for dpp
      expression in the midgut visceral mesoderm corresponding to a portion of
      abdominal segments 1 and 2 (parasegment 7). These regulatory regions act over a
      distance of up to 10-kb on all four of the dpp promoters examined. Absence of dpp
      expression in the gastric caeca primordia caused defective development of the
      gastric caeca and a concomitant partial reduction in larval and pupal viability.
      Absence of dpp expression in the visceral mesoderm of parasegment 7 caused a
      reduction in the length of the central portion of the larval gut and a change in
      the morphology of the midgut cells in this region but had little effect on the
      survival of the animals to the adult stage. However, a larval lethal phenotype
      was observed when both the central portion of the larval midgut and the gastric
      caeca were defective.

PMID- 8365567
TI  - DNA replication in fertilized eggs of the starfish Asterina pectinifera.
AB  - Early starfish embryos were labeled with 5-bromo-2'-deoxyuridine (BrdU; the
      thymidine analogue) for 3-4 min of pulse, and the BrdU incorporated into newly
      replicated DNA was immunocytochemically detected with anti-BrdU antibody. Series
      of optical sections of the stained embryos observed with a confocal laser
      scanning microscope (CLSM) were collected, and three-dimensional images of the
      chromatin and the incorporated BrdU were reconstructed on a computer display. The
      distribution of the DNA replication sites and the chromatin structure were
      investigated from a three-dimensional point of view. The oocytes fertilized
      during maturation and the eggs fertilized after maturation were examined for the
      timing of S phase, DNA replication pattern, and chromatin distribution in the
      nucleus. Duration of the first S phase between the two types of embryos differed
      in the first S phase, but was the same in the second and third S phases. We
      observed a successive change in the distribution of DNA replication sites from a
      "uniform" to a "condensing" pattern during a single S phase traverse, except in
      the first S phase of the eggs fertilized after maturation. These two patterns of
      DNA replication almost coincided with chromatin visualized by anti-single
      stranded DNA antiserum. The apparent change in the pattern of DNA replication
      sites thus simply reflects the change in the spatial distribution of chromatin.
      The spatial pattern of DNA replication at the first S phase of the eggs
      fertilized after maturation was unique in that the whole nucleus was a mosaic of
      two distinct regions, each supposedly derived from the female and male pronuclei.
      The putative female region had a fibrillar pattern of DNA replication sites
      confined to the periphery of the nucleus, while the male region showed condensed
      sites of DNA replication, which persisted longer than the sites in the female
      pronuclear region. We discuss such a singularity of the first S phase in starfish
      eggs on the basis of the temporal relation between the progress of maturation and
      the time of activation.

PMID- 8365568
TI  - Ectopic spindle assembly during maturation of Xenopus oocytes: evidence for
      functional polarization of the oocyte cortex.
AB  - Inversion of stage VI Xenopus oocytes, when combined with cold-induced
      microtubule depolymerization, resulted in the displacement of the germinal
      vesicle (the oocyte nucleus) from its normal position in the animal hemisphere to
      a more equatorial or vegetal position. Confocal immunofluorescence microscopy
      with anti-tubulin antibodies revealed that the breakdown of ectopic germinal
      vesicles during progesterone-induced maturation of inverted oocytes was
      accompanied by the assembly of a transient MTOC-microtubule complex (MTOC-TMA
      complex) that migrated to the region of cortex nearest the site of GV breakdown.
      Formation of ectopic meiotic spindles, including spindle rotation and polar body
      formation, was observed with nearly equal frequency throughout the animal
      hemisphere. In contrast, the frequency of spindle formation in the vegetal
      hemisphere was substantially reduced. Many spindles that did form in more vegetal
      regions of the oocyte appeared unable to rotate and did not result in polar body
      formation. The results presented suggest that the assembly of meiotic spindles at
      the animal pole during maturation of Xenopus oocytes does not result from a
      specific targeting of the MTOC-TMA complex during oocyte maturation. However, the
      oocyte cortex does exhibit A-V polarization of its ability to support spindle
      rotation and polar body formation. Finally, the observed increase in the
      incidence of monaster formation in the vegetal hemisphere suggests that
      interactions between the nascent spindle and cortex may regulate spindle assembly
      and elongation.

PMID- 8365569
TI  - Crumbs and stardust act in a genetic pathway that controls the organization of
      epithelia in Drosophila melanogaster.
AB  - We provide evidence that the genes crumbs (crb) and stardust (sdt) encode
      critical components of a pathway that acts at the apical pole of epithelial cells
      to control the cytoarchitecture of ectodermally derived epithelia of the
      Drosophila embryo. We describe the developmental defects caused by sdt mutations,
      which are very similar to those associated with mutations in crb. In both mutants
      the epithelial structure of ectodermal cells breaks down during early
      organogenesis, leading to the formation of irregular clusters of cells and cell
      death in some epithelia. Certain cells can, however, compensate for the loss of
      crb or sdt function in a tissue-specific manner, later reassuming an epithelial
      cell shape and forming small epithelial vesicles, suggesting that, besides crb
      and sdt, other tissue-specific components are involved in this process. The crb
      protein (CRB) is continuously expressed in wild-type embryos in cells of the
      ectoderm and ectodermally derived epithelia. In sdt mutant embryos CRB is present
      only during gastrulation, but becomes undetectable during germ band extension;
      the protein is again visible during early organogenesis, at the time when the sdt
      mutant phenotype becomes apparent. In sdt mutant embryos, CRB is associated with
      the apical membrane only in well-differentiated epithelial cells, but it is
      expressed diffusely in the cytoplasm of cells which have lost epithelial
      morphology. Our results suggest that time- and tissue-specific control mechanisms
      exist to establish and maintain epithelial cell structure. Mosaic experiments
      suggest that sdt is required cell autonomously, in contrast to crb, the
      requirement of which appears to be non-cell-autonomous. Double mutant
      combinations of crb and sdt suggest that these genes are part of a common genetic
      pathway (crb/sdt pathway), in which sdt acts downstream of crb and is activated
      by the latter.

PMID- 8365570
TI  - Coordinate and noncoordinate regulation of synaptic vesicle protein genes during
      embryonic development.
AB  - Because the formation of a mature nerve terminal requires the accumulation of
      large quantities of synaptic vesicles, the expression of synaptic vesicle
      proteins would be expected to correlate with synaptogenesis. However, previous
      studies have provided conflicting evidence on this point. We have examined the
      developmental pattern of expression of mRNA and protein for three RNAs derived
      from two genes coding for synaptic vesicle membrane proteins. For these
      experiments, we cloned a chick p65 (synaptotagmin) cDNA using a reduced
      stringency screen with a rat p65 cDNA probe. We examined p65 expression in chick
      forebrain in conjunction with that of synaptophysin II. RNase protection assays
      for p65 and the two isoforms of synaptophysin II (Bixby, 1992) show essentially
      coordinate increases of these three mRNAs in embryonic forebrain during the peak
      period of synaptogenesis (E17 to E20). However, each of the three mRNAs has a
      distinct temporal pattern of expression during the early stages of embryogenesis.
      In the ciliary ganglion, upregulation of synaptophysin II mRNA correlates very
      well with synaptogenesis. Our results suggest that the regulation of expression
      of vesicle membrane protein mRNA can serve as a marker for synaptogenesis,
      despite temporal differences in early expression patterns. In contrast to mRNA
      expression, assays for vesicle protein expression show a relatively steady rise
      in both p65 and synaptophysin II throughout the embryonic period, without a sharp
      increase corresponding to that seen in message levels. These results suggest that
      the expression both of the p65 and of the synaptophysin II proteins is post
      transcriptionally regulated.

PMID- 8365571
TI  - The formation of the pronephric duct in Xenopus involves recruitment of posterior
      cells by migrating pronephric duct cells.
AB  - Cell migration and cell-cell interactions play important roles in numerous
      processes during embryogenesis. One of these is the formation of the pronephric
      (Wolffian) duct (PD), which connects the pronephros to the cloaca. It is
      currently accepted that in most amphibians the pronephric duct is formed by
      active migration of the pronephric duct rudiment (PDR) cells along a
      predetermined pathway. However, there is evidence that in Xenopus, the PD may be
      formed entirely by in situ segregation of cells out of the lateral mesoderm. In
      this study, we show, using PDR ablation and Xenopus laevis-Xenopus borealis
      chimeras, that PD elongation in Xenopus requires both active cell migration and
      an induced recruitment of cells from the posterior. We also show that PDR cell
      migration is limited to only a few stages during development and that this
      temporal control is due, at least in part, to changes in the competence of the PD
      pathway to support cell migration.

PMID- 8365572
TI  - Effects of the neurotrophins and CNTF on developing statoacoustic neurons:
      comparison with an otocyst-derived factor.
AB  - During the early stages of auditory development, the inner ear (otocyst) releases
      an unidentified, diffusible factor that promotes neurite outgrowth from the
      associated statoacoustic ganglia (SAG). Using a variety of criteria, the present
      study compared the neurite- and survival-promoting properties of this otocyst
      derived factor (ODF) to the neurotrophins NGF, BDNF, NT-3, and NT-4 and ciliary
      neurotrophic factor (CNTF). Ganglia known to respond to specific growth factors
      were cultured in the presence of ODF. ODF failed to promote neurite outgrowth
      from trigeminal, ciliary, sympathetic, or dorsal root ganglia, suggesting that
      ODF may have properties different from other identified growth factors. In
      complementary experiments, SAG explants were cultured in ODF, the neurotrophins,
      and CNTF. The extent of outgrowth was greatest in the presence of ODF and CNTF,
      with the neurotrophins having little effect. In neuron-enriched, dissociated cell
      cultures, ODF promoted both survival and outgrowth of SAG neurons. However,
      neither the neurotrophins nor CNTF, alone or in combination, promoted the
      survival or outgrowth of dissociated SAG neurons. Thus, the outgrowth seen in the
      explant cultures appears to be due to indirect effects via the ganglionic
      nonneuronal cells. The addition of anti-NGF antisera failed to block the activity
      of chick, rat, or mouse ODF, further indicating that NGF is not the primary
      component of ODF. Together, the results of this study indicated that the
      properties of the ODF are not mimicked by the neurotrophins or CNTF.

PMID- 8365573
TI  - Requirements for promoter activity in mouse oocytes and embryos distinguish
      paternal pronuclei from maternal and zygotic nuclei.
AB  - Fertilization of mouse eggs produces a 1-cell embryo containing both a paternal
      and maternal pronucleus. These two nuclei combine during the first mitosis to
      form the zygotic nuclei of 2-cell embryos. This transition is accompanied by the
      onset of transcription and the decline of maternal mRNA-dependent gene
      expression. To determine how changes in nuclear composition affect gene
      expression, plasmid DNA containing a promoter and an enhancer that function
      throughout a broad host range was injected into nuclei of oocytes and embryos.
      The requirements for promoter activity in paternal pronuclei of 1-cell embryos
      were distinct from those in maternal or zygotic nuclei: (1) Paternal pronuclei
      permitted high levels of promoter activity relative to maternal or zygotic
      nuclei. (2) Butyrate, an agent that alters chromatin structure, stimulated
      promoter activity in maternal or zygotic nuclei, but not in paternal pronuclei.
      (3) The embryo-responsive polyomavirus F101 enhancer also stimulated promoter
      activity, but only after formation of a 2-cell embryo. Either butyrate or the
      F101 enhancer stimulated promoter activity in zygotic nuclei to the level
      observed in paternal pronuclei. Stimulation also was observed with 2-cell embryos
      containing nuclei of only maternal or paternal origin, but their transcriptional
      capacity was more limited. These and other results support the hypothesis that
      the need for enhancers in 2-cell embryos results from repression by chromatin
      structure, and the role of enhancers is to relieve this repression.

PMID- 8365574
TI  - Development of the neural crest in the zebrafish.
AB  - The embryonic zebrafish is rapidly becoming an important model system for studies
      of early events in vertebrate development. We review recent work describing the
      development of zebrafish neural crest and experimental studies examining the
      cellular, molecular, and genetic mechanisms of crest development.

PMID- 8365575
TI  - The role of cell-cell and cell-matrix interactions in the morphogenesis of the
      neural crest.
AB  - The neural crest is an excellent model system with which to study the molecular
      controls of morphogenesis. Neural crest cells initiate their migration from the
      dorsal portion of the neural epithelium owing to an epithelial-mesenchymal
      transformation. They then followed stereotyped pathways for long distances before
      reaching their multiple destinations, and they cease migration in defined regions
      where they undergo terminal differentiation. Recent experimental evidence, which
      is summarized in this review, suggests that these various steps in neural crest
      morphogenesis are influenced by cell-cell and cell-matrix adhesions. Future
      studies employing genetic mutants and molecular techniques should provide more
      direct evidence for the role of cell-cell and cell-matrix interactions in neural
      crest morphogenesis.

PMID- 8365576
TI  - The characterization of astrocyte cell lines that display properties of glial
      scar tissue.
AB  - The glial scar has been proposed to be a major impediment to regeneration in the
      adult CNS. Analysis of glial scars in vivo is complicated, however, by the large
      number of cell types present in such lesions. We have attempted to simplify
      analysis of the glial scar environment by deriving a series of conditionally
      immortal astrocyte cell lines that display several properties expressed by glial
      scar tissue in vitro. The astrocyte lines, which were derived from H-2KbtsA58
      transgenic mice, expressed macromolecules associated with glial scars in vivo and
      were significantly less effective than neonatal astrocytes at promoting neurite
      outgrowth from postnatal central and peripheral neurons. The astrocyte lines also
      inhibited migration of oligodendrocyte type-2 astrocyte progenitor cells in
      vitro. We propose that certain properties shown previously to be expressed by
      glial scars may be reconstituted in vitro by astrocytes alone.

PMID- 8365577
TI  - Methoxyacetaldehyde, an intermediate metabolite of 2-methoxyethanol, is
      immunosuppressive in the rat.
AB  - 2-Methoxyethanol (ME) is metabolized to 2-methoxyacetic acid (MAA) via the
      intermediate metabolite methoxyacetaldehyde (MAAD). Both ME and MAA have been
      shown in this laboratory to be immunosuppressive in rats following oral dosing.
      In this study, the plaque-forming cell (PFC) response to trinitrophenyl
      lipopolysaccharide (TNP-LPS) was used to determine if MAAD is immunosuppressive
      in rats. Rats pretreated with the aldehyde dehydrogenase inhibitors disulfiram (2
      mmol/kg) or cyanamide (0.48 mmol/kg) followed by oral dosing with ME (2.64
      mmol/kg) resulted in suppressed PFC responses equivalent to the suppressed
      responses of rats dosed with ME alone. Rats pretreated with disulfiram and then
      dosed with 2.64 mmol/kg 2-methoxyethyl acetate (MEA), also resulted in suppressed
      PFC responses similar to that of MEA alone. In contrast, coadministration of the
      alcohol dehydrogenase inhibitor 4-methylpyrazole (1.2 mmol/kg) with ME or MEA
      blocked suppression of the PFC response following exposure to ME or MEA alone.
      Oral dosing with equimolar (2.64 mmol/kg) concentrations of ME, MAA, or MAAD
      resulted in equivalent suppression of the TNP-LPS PFC response. Rats exposed to
      either disulfiram or cyanamide and MAAD also resulted in suppression of the PFC
      response. These results indicate that metabolism of ME to either MAAD or MAA is
      required for immunosuppression, and that these two metabolites are equipotent
      immunosuppressants in the rat.

PMID- 8365578
TI  - Toxicokinetics of intravenous methanol in the female rat.
AB  - The toxicokinetics of intravenously administered methanol were examined in female
      Sprague-Dawley rats. Animals received a single administration of 100, 500, or
      2500 mg methanol/kg; the two lower doses were administered as a bolus, while the
      high dose was administered over 1.5 min. A small (approximately 3%) but
      statistically insignificant (p > 0.1) degree of transpulmonary methanol
      extraction, expressed as the fractional arterial-venous difference in
      concentration, was observed after administration of 250 mg methanol/kg. The
      elimination of methanol from the systemic circulation was markedly nonlinear,
      suggestive of a significant capacity-limited route of elimination. A single set
      of kinetic parameters (apparent distributional volume of the central compartment
      [Vc], intercompartmental transfer rate constants [k12 and k21], and Vmax and Km
      for elimination) described the blood methanol concentration-time data from rats
      receiving the 100 and 500 mg/kg doses. Blood methanol concentrations declined
      much more rapidly in animals receiving the 2500 mg/kg dose than would be
      predicted from the kinetic parameters derived from the other two experimental
      groups. The data from the 2500 mg/kg group could be described adequately by a
      kinetic model incorporating parallel first-order and saturable elimination
      processes. A portion of this apparent linear elimination pathway was due to renal
      excretion of the unchanged alcohol. The presence of both linear and nonlinear
      elimination pathways for methanol may have implications regarding high-dose to
      low-dose toxicologic extrapolations.

PMID- 8365579
TI  - DMBA induces programmed cell death (apoptosis) in the A20.1 murine B cell
      lymphoma.
AB  - The mechanism by which 7,12-dimethylbenz[a]anthracene (DMBA) produces
      cytotoxicity in lymphocytes was investigated in these studies using the murine
      A20.1 B cell lymphoma. Results show that in vitro exposure of these cells to 10
      30 microM DMBA for 4 hr produced an increase in intracellular Ca2+, DNA
      fragmentation, and subsequent cell death. Elevation of Ca2+ and DNA fragmentation
      induced by DMBA were greatly pronounced when the A20.1 cells were exposed at high
      cell density (10(7) cells/ml). DMBA-induced DNA fragmentation and cell death were
      inhibited by coexposure of A20.1 cells to a calcium chelator (EDTA), a general
      nuclease and polymerase inhibitor (aurintricarboxylic acid), and a protein
      synthesis inhibitor (cycloheximide). These agents have been previously shown to
      inhibit apoptosis in lymphocytes and other cells exposed to chemical agents. We
      also found that cyclosporin A, an inhibitor of Ca(2+)-dependent pathways of T and
      B cell activation, prevented apoptosis in the A20.1 cell line. These results
      demonstrate that DMBA induces programmed cell death (apoptosis) in the A20.1
      murine B cell lymphoma by Ca(2+)-dependent pathways. The increased sensitivity of
      A20.1 at high cell density to Ca2+ elevation and DNA fragmentation suggests that
      cell to cell interactions may also be important in this process.

PMID- 8365580
TI  - Production of metallothionein and heat-shock proteins in response to metals.
AB  - Acute stress, such as heat, and some metals, such as arsenite, will induce a
      specific group of stress proteins referred to as heat-shock proteins. The heat
      shock proteins contribute to the survival of cells following a variety of
      stresses. Similarly, metals such as cadmium and zinc, will increase the levels of
      metallothionein (MT). The metal-binding protein, MT, has also been found to have
      a protective role in the cellular response to acute stresses like heavy metals.
      The purpose of the present study was to examine the production of these proteins
      in response to metals. Rat hepatocytes were maintained in monolayer culture for
      22 hr, and subsequently treated with various concentrations of metals for 4 hr,
      or incubated at 43.5 degrees C for 15-60 min. Following two washes with fresh
      media, the cells were labeled with [35S]-methionine (25 microCi/ml) in methionine
      free media for 4 hr for determination of heat-shock protein production, or
      reincubated in fresh media for 20 hr for MT determination. Heat-shock protein
      production was determined by SDS-polyacrylamide gel electrophoresis followed by
      autoradiography. The autoradiograms were quantified by densitometric scanning. MT
      was determined by the Cd/hemoglobin affinity assay. Three metals (arsenite,
      cadmium, and zinc) strongly increased the heat-shock proteins. Whereas arsenite
      was a much less effective inducer of MT than was cadmium or zinc, arsenite was as
      effective as the other metals in inducing heat-shock proteins. Nickel was a good
      inducer of MT; however, it resulted in only a slight increase in the levels of
      heat-shock proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365581
TI  - DNA-carcinogen adducts in circulating leukocytes as indicators of arylamine
      carcinogen exposure.
AB  - DNA-carcinogen adducts in leukocytes and putative target tissues (liver and
      urinary bladder) of C57BL/6J mice were measured by 32P-postlabeling and HPLC
      analysis after controlled exposure to the arylamine carcinogen 2-aminofluorene (2
      AF). After an acute exposure via ip injection, adducts were detected at 3 hr in
      leukocytes, liver, and bladder. The disappearance of DNA-carcinogen adducts in
      liver and leukocytes were parallel over the 24-hr period studied. Following a 7
      day continuous exposure to 2-AF via drinking water, adduct levels in leukocytes
      and target tissues were responsive to dose at 30, 100, and 300 ppm. Adduct levels
      at the highest dose reached 17,000 fmol/mg DNA in leukocytes, 1900 fmol/mg in
      liver, and 2300 fmol/mg in bladder. Although adduct levels after 7 days were
      highest in leukocytes, adducts were not detectable in leukocytes 7 days after
      discontinuing exposure. In contrast, liver and bladder retained approximately 50
      and 75% of their respective adduct levels 7 days after exposure was stopped. The
      results indicate that circulating leukocytes may be useful as indicators of
      current exposure to arylamine carcinogens. Circulating leukocytes may also be
      useful as biological monitors of DNA damage in arylamine target tissues during
      chronic exposure to these compounds. Some important differences in persistence of
      DNA-carcinogen adducts between leukocytes and target tissues were observed.

PMID- 8365582
TI  - Respiratory and immunological responses of guinea pigs to enzyme-containing
      detergents: a comparison of intratracheal and inhalation modes of exposure.
AB  - Guinea pigs were exposed once a week for 10 weeks by intratracheal exposure to
      solutions of 3, 1, 0.3, or 0.1 micrograms of the enzyme protein, Subtilisn
      Carlsberg (Alcalase), in 250 micrograms of a detergent base. Other groups of
      guinea pigs were exposed by inhalation (6 hr per day, 4 days a week) to 1 mg/m3
      of the aerosolized detergent base containing either 3.5, 1.1, 0.3, or 0.1%
      Alcalase protein. Evaluations of gross respiratory responses immediately
      following each intratracheal exposure revealed a significant dose response in
      respiratory symptoms measurable after the fourth exposure and continuing
      throughout the study. In the inhalation experiment, during Weeks 4 through 10,
      animals were observed to have respiratory symptoms which were dependent upon both
      the dose of enzyme and on total exposure to the enzyme/detergent atmosphere. For
      both intratracheal and inhalation routes of exposure, the initial appearance of
      respiratory symptoms coincided with the first appearance of measurable serum
      allergic antibodies specific to Alcalase. The allergic antibody levels increased
      with time and dosage by both routes of exposure, and the antibody titers
      generated by the intratracheal administration of antigen were comparable to those
      generated by the inhalation route of exposure. These results indicate that the
      intratracheal technique is appropriate for the evaluation of the respiratory
      allergic response to a protein.

PMID- 8365583
TI  - The encapsulation of squid diisopropylphosphorofluoridate-hydrolyzing enzyme
      within mouse erythrocytes.
AB  - This study describes the entrapment of squid-type diisopropylphosphorofluoridate
      hydrolyzing enzyme (DFPase) within mouse red blood cells. These erythrocytes
      thereby gain the ability to rapidly hydrolyze alkylphosphate cholinesterase (ChE)
      inhibitors such as diisopropyl fluorophosphate (DFP). DFPase rapidly hydrolyzes
      DFP to diisopropyl phosphate. Resealed erythrocytes provide a stable carrier
      system that can preserve the activity of encapsulated enzymes against otherwise
      rapid in vivo degradation; thus, ChE inhibitors can be degraded to relatively
      nontoxic metabolites by these erythrocyte carriers. Squid DFPase was purified
      from the hepatopancreas of Atlantic squid and DFPase activity was determined by
      measuring changes in fluoride ion concentration using a fluoride ion selective
      electrode. Mouse erythrocytes in suspension with excess squid DFPase were
      dialyzed against hypotonic buffer to allow the encapsulation of the enzyme to
      occur. Cells were then resealed by returning the suspension to isosmotic with
      saline. Rate of DFP hydrolysis observed with these cells was much greater than
      the rate of nonenzymatic hydrolysis and was directly proportional to the amount
      of the erythrocyte suspension added to the assay solution. The rate of hydrolysis
      was first order in substrate. Erythrocyte controls showed no endogenous DFPase
      activity. These results suggest that enzyme entrapment may be developed as a
      method to prevent and antagonize organophosphate poisoning.

PMID- 8365584
TI  - Chronic toxicity and carcinogenicity studies of 1-methylnaphthalene in B6C3F1
      mice.
AB  - The carcinogenic potential of 1-methylnaphthalene (1-MN), a compound which exists
      widely in the environment, was investigated in B6C3F1 mice. Groups of 50 male and
      50 female mice were given diets containing 0, 0.075, or 0.15% 1-MN for 81 weeks.
      Both treatment groups developed pulmonary alveolar proteinosis at high incidence,
      with 46.0 and 34.7% of females and 46.0 and 38.0% of males, respectively, being
      affected. Total lipid and phospholipid levels in sera and monocytes in peripheral
      blood were also significantly increased in 1-MN-treated female and male mice in
      contrast with control values. The incidences of bronchiolar/alveolar adenomas in
      the lungs of male mice given both 0.075 or 0.15% 1-MN were 26.0 and 24.0%,
      respectively, in both cases significantly increased in contrast with the 4.1%
      observed for control males. However, neither dose dependence nor significant
      difference in the incidences of bronchiolar/alveolar carcinomas between 1-MN
      treated and control male mice was observed. The incidences of other tumors also
      were similar in both 1-MN-treated and control groups. The results of the present
      experiment thus suggested a possible weak carcinogenic potential of 1-MN to the
      lung of male but not female B6C3F1 mice.

PMID- 8365585
TI  - Application of the tukey trend test procedure to assess developmental and
      reproductive toxicity. I. Measurement data.
AB  - Developmental and reproductive (DAR) toxicity studies typically include a series
      of increasing doses of a compound and a zero dose control. Given this framework,
      Tukey et al. (Biometrics, 41, 295-301, 1985) proposed a procedure (referred to as
      either the Tukey trend or TCH test procedure) for detecting a nonzero trend in
      response to increasing doses of the test compound. The procedure considers three
      candidate dosage scalings to ensure high power against relatively common dose
      response patterns and appreciable power against most reasonable patterns. For
      toxicologic effects with near monotonic dose-response patterns, simulation
      studies have shown the TCH test to be overall more powerful than pairwise
      comparison procedures. The TCH test can be applied sequentially, eliminating the
      highest dose each time a statistically significant trend is observed, until a no
      statistical-significance-of-trend dose is reached. This is the highest dose
      through which there is no statistically trustworthy evidence of the compound's
      impact on the response. Since DAR toxicity usually exhibits a progressive
      (monotonic) dose-response, we advocate routine use of Tukey's trend test for the
      evaluation of treatment effects in these studies. In this article, we discuss the
      procedure in detail and apply it to fetal body weight, a continuous measurement
      variable, from a developmental toxicity study.

PMID- 8365586
TI  - Nephrotoxicity of pravadoline maleate (WIN 48098-6) in dogs: evidence of maleic
      acid-induced acute tubular necrosis.
AB  - Single oral administration of pravadoline maleate (WIN 48098-6), the maleic acid
      salt of WIN 48098, induced acute tubular necrosis (ATN) in male and female beagle
      dogs at dosages > or = 40 mg/kg (WIN 48098 base (31 mg/kg) and maleic acid (9
      mg/kg)). Subsequent oral studies were conducted with equimolar dosages of maleic
      acid and WIN 48098-7, the ethanesulfonate salt of WIN 48098, to determine the
      nephrotoxic moiety of WIN 48098-6. ATN was observed for dogs given only maleic
      acid at single oral dosages > or = 9 mg/kg. This result provided evidence that
      maleic acid was responsible for the nephrotoxicity observed in dogs given single
      oral dosages of WIN 48098-6. The induction of maleic acid-related nephrotoxicity
      in dogs may confound the interpretation of toxicologic studies of maleic acid
      salts of basic pharmaceutics, if the dosage of test article results in the
      delivery of dosages of maleic acid > or = 9 mg/kg. Furthermore, the results of
      these studies underscore the importance of establishing maximum no-observed
      effect dosages and target organ toxicity profiles for acids and bases that are
      commonly used in the development of salts of pharmaceutics.

PMID- 8365587
TI  - Quaternary silsesquioxane: a developmental toxicity study in rats.
AB  - The developmental toxicity of an antimicrobial organosilicon quaternary ammonium
      chloride (Quaternary Silsesquioxane) was evaluated in rats. Groups of 25 pregnant
      CD rats were administered 100, 300, or 1000 mg/kg/day of test material by gavage
      as a single daily dose on Days 6 through 15 of gestation at a volume of 10 ml/kg.
      The control group received only corn oil as the vehicle. Cesarean examinations
      were performed on all females on Gestation Day 20 followed by evaluation of the
      fetuses for teratogenicity. Maternal effects included a slight but statistically
      significant increase in relative liver weights at the 1000 mg/kg/day dose level.
      Using these hepatic changes as an adverse effect, the maternal no observable
      adverse effect level for this study was identified at 300 mg/kg/day. The number
      of corpora lutea, implantation sites, viable fetuses, and early and late
      resorptions, the fetal body weights, the crown-rump length, and the gravid
      uterine and corrected body weights were not affected by the administration of
      Quat-Silsesquioxane. The occurrence of external and internal soft tissue
      malformations and variations and the incidences of skeletal malformations and
      variations in the treated groups were not significantly different from those in
      the control group. These results demonstrated that oral administration of Quat
      Silsesquioxane as high as 1000 mg/kg/day did not produce teratogenicity or other
      indications of developmental toxicity in the rat conceptus.

PMID- 8365588
TI  - Risk assessment in immunotoxicology. II. Relationships between immune and host
      resistance tests.
AB  - We have reported on the design and content of a screening battery using a "tier"
      approach for detecting potential immunotoxic compounds in mice (Luster et al.,
      Fundam. Appl. Toxicol., 10, 2-19, 1988). The data base generated from these
      studies, which consists of over 50 selected compounds, has been collected and
      analyzed in an attempt to improve future testing strategies and provide
      information to aid in developing future quantitative risk assessment for
      immunotoxicity. In a recent study it was shown that as few as two or three immune
      parameters were needed to predict immunotoxicants in mice (Luster et al., Fundam.
      Appl. Toxicol., 18, 200-210, 1992). In particular, enumeration of lymphocyte
      populations and quantitation of the T-dependent antibody response were
      particularly beneficial. Furthermore, commonly employed apical measures (e.g.,
      leukocyte counts, lymphoid organ weights) were fairly insensitive. The present
      analyses focus on the use of this data base to develop statistical models that
      examine the qualitative and quantitative relationship(s) between the immune
      function and host resistance tests. The conclusion derived from these analyses
      are: (1) A good correlation exists between changes in the immune tests and
      altered host resistance in that there were no instances where host resistance was
      altered without affecting an immune test(s). However, in some instances immune
      changes occurred without corresponding changes in host resistance. (2) No single
      immune test could be identified which was fully predictive for altered host
      resistance, although most assays were relatively good indicators (i.e., > 70%).
      Several others, such as proliferative response to lipopolysaccharide and
      leukocyte counts, were found to be relatively poor indicators for host resistance
      changes. (3) The ability to resist infectious agent challenge is dependent upon
      the degrees of immunosuppression and the quantity of infectious agent
      administered. (4) Logistic and standard regression modeling using one extensive
      chemical data set from the immunosuppressive agent, cyclophosphamide, indicated
      that most immune function-host resistance relationships followed linear rather
      than linear-quadratic (threshold-like) models. For most of the relationships this
      could not be confirmed using a large chemical data set and, thus, a more
      mechanistically based approach for modeling will need to be developed. (5) Using
      this limited data set, methods were developed for modeling the precise
      quantitative relationships between changes in selected immune tests and host
      resistance tests.

PMID- 8365589
TI  - Are mouse strains differentially susceptible to the reproductive toxicity of
      ethylene glycol monomethyl ether? A study of three strains.
AB  - Most rodent reproductive toxicology studies utilize strains of high fecundity.
      These studies were conducted to examine the possibility that mouse strains of
      differing fecundity would respond differently to a known reproductive toxicant.
      Thirty pairs each of Swiss CD-1, C57B1, and C3H mice were cohabited for 14 weeks
      while consuming 0, 0.03, 0.10, or 0.30% EGME in the drinking water. Litter data
      were collected during cohabitation. Body and organ weights, and various sperm
      data, were collected at necropsy, and second-generation fertility was evaluated.
      The data show that the most fecund strain (Swiss) was affected the least by
      exposure to EGME, while the least fecund strain (C3H) suffered the greatest
      declines in fertility. These differences might alter interspecies extrapolation
      factors, or the permissible exposure levels for humans.

PMID- 8365590
TI  - Bioavailability of arsenic in soil impacted by smelter activities following oral
      administration in rabbits.
AB  - This study determined the extent of arsenic (As) absorption from soil from
      Anaconda, Montana. Prepubescent male and female SPF New Zealand White rabbits
      (5/sex/group) were given a single oral (capsule) administration of soil (3900 ppm
      As) at three different dose levels (0.2, 0.5, and 1.0 g of soil/kg, corresponding
      to 0.78, 1.95, and 3.9 mg As/kg, respectively). Standard groups included
      untreated controls, an intravenous sodium arsenate group (1.95 mg As/kg), and a
      gavage sodium arsenate group (1.95 mg As/kg). Urine, cage rinse, and feces were
      collected at 24-hr intervals for 5 days and were analyzed for total As
      concentration. Clinical signs, body weights, and food consumption for treated
      animals were similar to controls. Maximum As concentrations were obtained over
      the initial 24-hr collection interval. A dose-dependent delay in urinary As
      excretion, the major elimination pathway, was observed in the oral soil group
      compared to that in the gavage group. For the animals in the soil groups,
      approximately 80% of the administered As dose was eliminated in the feces
      compared to approximately 10 and 50% for the intravenous and oral gavage groups,
      respectively. The relative oral bioavailabilities (+/- SD) of As in the gavage
      and test soil groups based on comparison with excreta data from the intravenous
      group were approximately 50 +/- 5.7 and 24 +/- 3.2%, respectively (after
      normalization of intravenous group's As recovery data to 100%). These results
      indicated that As in the soil was probably in a less soluble and therefore a less
      absorbable form than sodium arsenate.

PMID- 8365591
TI  - Metabolism of acrylic acid to carbon dioxide in mouse tissues.
AB  - Acrylic acid (AA) is acutely irritating at sites of initial contact but causes
      little systemic toxicity probably due to its rapid metabolism to CO2 and acetyl
      CoA via a secondary pathway of propionic acid catabolism. In this study, the rate
      of AA oxidation in 13 tissues of C3H mice was measured by incubating tissue
      slices with [1-14C]AA and collecting, 14CO2. Oxidation of AA followed pseudo
      Michaelis-Menten kinetics in the liver, kidney, and skin. Pseudo-Km values were
      similar among these tissues and averaged 0.67 mM. The maximal rate of AA
      oxidation in kidney, liver, and skin was 2890 +/- 436 (mean +/- SE, N = 3), 616
      +/- 62, and 47.9 +/- 5.8 nmol/hr/g, respectively. The remaining organs oxidized
      AA at rates less than 40% of the rate in liver. Rates of metabolism in tissues
      from male and female mice were similar. 3-Hydroxypropionic acid was the only
      metabolite detected by high-performance liquid chromatographic analysis following
      incubation of tissues with [1-14C]AA. Kidney and liver also oxidized [2,3-14C]AA
      and [1-14C]acetate well, thus providing for the complete metabolism of AA carbons
      to CO2. These results demonstrate that the rate of AA metabolism varies
      significantly among mouse tissues and suggest that the kidneys and liver are
      major sites of detoxification of AA.

PMID- 8365592
TI  - Are hyperplastic rectosigmoid polyps associated with an increased risk of
      proximal colonic neoplasms?
AB  - Diminutive polyps are frequent findings on screening flexible sigmoidoscopy. To
      determine the significance of distal diminutive polyps, we conducted a
      prospective study of 162 asymptomatic, average-risk subjects who were 50 years of
      age or older. Subjects were divided into four groups: 42 control subjects with no
      polyps in the rectosigmoid, 66 subjects with at least one diminutive adenoma in
      the rectosigmoid, 12 subjects with a mixed hyperplastic-adenomatous polyp in the
      rectosigmoid, and 42 subjects with only hyperplastic polyps in the rectosigmoid.
      Total colonoscopy was performed on all subjects. The prevalence of proximal
      adenomas was 42% in the adenoma group, 25% in the mixed group, 14% in the
      hyperplastic group and 12% in the control group. The prevalence of proximal
      adenomas was significantly higher (p = 0.006) in the adenoma group as compared
      with the control and hyperplastic groups. Increasing age was associated with an
      increased prevalence of proximal adenomas. Nearly two thirds of those over 65
      years of age with distal diminutive adenomas had proximal colonic neoplasms.
      These results indicate that diminutive rectosigmoid adenomas are good markers for
      proximal neoplasms. Rectosigmoid hyperplastic polyps are not associated with an
      increased prevalence of proximal neoplasms. Total colonoscopy is not indicated if
      hyperplastic polyps are the only finding on flexible sigmoidoscopy.

PMID- 8365593
TI  - Sphincter of Oddi manometry: interobserver variability.
AB  - To determine the frequency and magnitude of interobserver variability, 50
      sphincter of Oddi manometry tracings were read by three separate physicians
      experienced in reading such manometry. Ninety station pull-throughs were read,
      and attention was focused on the reference duodenal baseline pressure and two
      methods of reading the basal sphincter pressure. A high degree of correlation was
      found among the three observers with correlation coefficients of > 0.9 for
      reading baseline duodenal and basal sphincter pressures. Differences in basal
      sphincter pressure readings were greatest in patients with very high basal
      sphincter pressure. The most clinically relevant parameter was thought to be the
      mean basal sphincter pressure. All three observers agreed on normal (mean basal
      pressure < or = 40 mm Hg) versus abnormal (mean basal pressure > 40 mm Hg) in 82%
      to 90% of tracings. When the definition of agreement was broadened to include
      patients with pressures of 40 +/- 3 mm Hg (37 to 43 mm Hg), the observers agreed
      87% to 94% of the time. Overall, these findings are thought to indicate that
      interobserver variability for reading sphincter of Oddi manometry is minimal when
      the observers are experienced in reading these tracings.

PMID- 8365594
TI  - Sphincter of Oddi dysfunction in patients with intact gallbladder: therapeutic
      response to endoscopic sphincterotomy.
AB  - Increasing evidence exists of the occurrence of sphincter of Oddi dysfunction in
      patients with an intact gallbladder. Optimal therapy for such patients has not
      been defined. From 1989 to 1991, 35 patients with sphincter of Oddi dysfunction
      (abnormal basal sphincter pressure > 40 mm Hg) and an intact gallbladder were
      identified. The patients with abnormal ductography (except for duct dilation),
      pancreas divisum, or pancreato-biliary malignancy were excluded. All patients had
      disabling upper abdominal pain, which was quantified on a 0 = none to 10 = severe
      pain scale. All patients received standard endoscopic biliary sphincterotomy and
      were followed up for 4 to 26 months with a mean of 13 months. Initially, 27 of 35
      patients (77%) showed at least 50% improvement in the pain score, whereas only 15
      of the 27 remained improved throughout the follow-up interval. Patients who were
      unimproved or had relapses were offered cholecystectomy and 11 patients underwent
      the procedure. These patients were followed up after cholecystectomy for 2 to 24
      months, with a mean of 13 months. Eight of 11 were improved. In summary, the
      combination of endoscopic sphincterotomy and selective cholecystectomy and
      minimal medical treatment resulted in a good and excellent response rate of 68%.
      Better techniques are needed to select patients who will respond to these
      therapies.

PMID- 8365596
TI  - High-resolution 25-megahertz ultrasonography of the gastrointestinal wall:
      histologic correlates.
AB  - High-frequency ultrasonography (25 MHz) with histologic correlation was used to
      examine surgical specimens from the gastrointestinal tract. Although the stomach,
      colon, and rectum demonstrated the usual five-layered appearance, we found that
      the esophagus had additional layers when imaged with the high-resolution probe.
      These layers correspond to the following: (1) superficial epithelium, (2) deep
      epithelium, (3) lamina propria plus the acoustic interface echo between the
      lamina propria and muscularis mucosa, and (4) muscularis mucosa minus the
      acoustic interface echo between the lamina propria and muscularis mucosa. This
      pattern is not found in regions of the gastrointestinal tract where the
      muscularis mucosa is relatively thin compared with the axial resolution of the
      ultrasound system. These results suggest that within the esophagus additional
      structural information may be obtained when higher-resolution ultrasound systems
      are used.

PMID- 8365595
TI  - The incidence of post-sphincterotomy stenosis in group II patients with sphincter
      of Oddi dysfunction.
AB  - Patients with group II sphincter of Oddi dysfunction documented by elevated
      sphincter of Oddi pressure improve after endoscopic sphincterotomy. A large group
      II population was studied to determine the incidence of post-endoscopic
      sphincterotomy stenosis. Eighty-five patients (82 women and 3 men), ages 21 to 88
      years (mean, 50 years), fulfilled the clinical criteria for group II sphincter of
      Oddi dysfunction; each had an elevated basal sphincter of Oddi pressure (> or =
      40 mm Hg), and received endoscopic sphincterotomy. These patients were observed
      for a mean of 7 +/- 3 years. Four patients re-presented with clinical findings
      suggestive of recurrent sphincter of Oddi dysfunction; all were found to have a
      basal sphincter of Oddi pressure greater than or equal to 40 mm Hg. Symptoms re
      developed within 4 months after endoscopic sphincterotomy (mean, 3.3 months).
      Endoscopic sphincterotomy was repeated in all four patients with one
      endoscopically treated complication. On 25-month mean follow-up, none of the
      patients had further signs or symptoms of papillary stenosis. Endoscopic
      sphincterotomy in patients with group II sphincter of Oddi dysfunction is
      associated with a low incidence of restenosis (4.7%). Repeat endoscopic
      sphincterotomy was found to be effective management in patients with papillary
      restenosis.

PMID- 8365597
TI  - Delineation of the gastric muscularis mucosae and assessment of depth of invasion
      of early gastric cancer using a 20-megahertz endoscopic ultrasound probe.
AB  - Using a 20 MHz endoscopic ultrasound system, delineation of the gastric
      muscularis mucosae and estimation of the depth of malignant invasion was
      attempted by in vivo scanning during the process of routine endoscopic
      observation or in vitro scanning of excised sections of 34 early gastric cancers
      in 32 patients. The muscularis mucosae was visualized as a single hypoechoic
      layer in 16 of 32 lesions (50%) scanned in vitro. Comparison of lesions in which
      delineation of the muscularis mucosae was or was not possible revealed no
      significant differences with respect to either the thickness of the lamina
      propria and muscularis mucosae or with respect to the degree of inflammatory cell
      infiltration of the lamina propria or the conditions of the boundary between the
      lamina propria and the muscularis mucosae. This indicates that improvement of the
      operability characteristics of the ultrasonic apparatus will be needed to achieve
      improved delineation of the muscularis mucosae. The accuracy of invasion depth
      estimation of early gastric cancer was 67% (16 of 24 lesions scanned in vivo) and
      73% (8 of 11 lesions) in cases in vivo where the muscularis mucosae and the tumor
      were delineated on the same screen. The principal factors causing erroneous
      staging were the presence of dilated benign glandular ducts, ulcer scars, and
      attenuation of the ultrasound waves.

PMID- 8365598
TI  - Endoscopic Nd:YAG laser coagulation of bleeding from radiation proctopathy.
AB  - Hematochezia from mucosal vascular lesions usually confined to the rectum
      represents an uncommon but problematic late complication of pelvic radiotherapy.
      We studied 47 patients with medically refractory hematochezia resulting from
      radiation-induced rectosigmoid mucosal vascular lesions. All lesions were
      endoscopically coagulated with Nd:YAG laser. Median duration of hematochezia
      before laser therapy was 11 months, despite previous medical treatment (98%) or
      bypass colostomy (6%). Within 3 to 6 months after laser treatment, the number of
      patients with daily hematochezia fell from 40 (85%) to 5 (11%; p < 0.001), and
      the median hemoglobin level increased from 9.7 gm/dl to 11.7 gm/dl (p < 0.001).
      Complications occurred in three patients (6%); no deaths occurred. The condition
      in six patients (12.8%) was not improved by laser treatment. Two patients (4%)
      ultimately required surgical treatment for bleeding control. On the basis of
      symptomatic, hematologic, and endoscopic responses, Nd:YAG laser photocoagulation
      controlled bleeding from radiation proctopathy in most patients with an
      acceptably low morbidity. Patients with sigmoid colon involvement responded less
      favorably. Endoscopic laser photocoagulation should be considered before surgical
      intervention for treatment of hematochezia from radiation proctopathy.

PMID- 8365599
TI  - The frequency of total colonoscopy and terminal ileal intubation in the 1990s.
AB  - We examined the frequency of total colonoscopy and terminal ileal intubation in a
      training setting using modern videoendoscopic equipment and techniques with
      examinations supervised or done by the two authors. The cecum was considered
      reached if the endoscopic report included a description of the cecal landmarks
      visualized and if electronic images documenting these landmarks were obtained.
      One of us also routinely attempted terminal ileal intubation for documentation
      purposes, allotting a minute or two for the purpose. In cases of chronic diarrhea
      and possible inflammatory bowel disease, a more prolonged attempt was made to
      visualize the terminal ileum. Among 418 consecutive colonoscopies, the cecum was
      reached in 96% of cases. If cases of malignant obstruction were excluded, the
      success rate improved to 97%. When routinely attempted, the terminal ileum was
      intubated and inspected in 74% of cases (excluding cases of malignant
      obstruction). In cases in which terminal ileal intubation and inspection was
      deemed necessary, the success rate was 91%. We conclude that total colonoscopy
      can be accomplished in the 1990s in excess of 90% of cases and can be documented
      by high-quality photographs that can be attached to the procedure report. High
      rates of successful total colonoscopy should be attainable even in training
      programs. Routine intubation of the terminal ileum can be performed to provide
      further objective proof of the extent of colonoscopy and to allow the endoscopist
      to develop and maintain the skill. A skilled, practiced endoscopist can inspect
      the terminal ileum in about 90% of cases in which such examination is needed.

PMID- 8365600
TI  - Endoscopic ultrasonography in the diagnosis of colorectal cancer invasion.
AB  - Endoscopic ultrasonography was pre-operatively performed in 164 patients with
      colorectal cancer, and the resected specimens confirmed to be cancerous
      histologically. Normal colorectal wall was visualized by endoscopic
      ultrasonography as a five-layered structure. The first, third, and fifth layers
      were hyperechoic, and the second and fourth layers were hypoechoic. The first and
      second layers comprised the mucosa, the third layer the submucosa, the fourth
      layer the muscularis propria, and the fifth layer the subserosa and serosa
      (adventitia). By this technique, cancer of the colon appeared as a hypoechoic
      mass with an intermediate echo level between the third hyperechoic and fourth
      hypoechoic layers. Endoscopic ultrasonographic determination of the depth of
      tumor invasion was based on abnormal changes of these layered structures and
      adjacent organs. Overall, the accuracy rate of endoscopic ultrasonography in the
      diagnosis of the depth of colorectal cancer was 83%. A hypoechoic round mass
      adjacent to the cancer was interpreted as a metastatic lymph node. The
      sensitivity and specificity of endoscopic ultrasonography in the diagnosis of
      lymph node metastasis were 68% and 70%, respectively. The overall accuracy rate
      of tumor staging by endoscopic ultrasonography according to Dukes' classification
      was 62%. Endoscopic ultrasonography is a valuable tool in the management of
      colorectal cancer. It has a high accuracy rate in determining the depth of tumor
      invasion. The pre-operative information obtained with this tool may influence the
      choice of therapy.

PMID- 8365601
TI  - Treatment of non-extractable common bile duct stones with combination
      ursodeoxycholic acid plus endoprostheses.
AB  - Despite widely available technology for removal of bile duct stones, endoscopists
      currently encounter approximately 3% of patients with stones that defy
      extraction. After sphincterotomy and unsuccessful attempts at extraction of
      "defiant" stones, biliary stents were placed in 22 patients. Ten patients were
      treated with ursodeoxycholic acid, and 12 patients treated only with stent served
      as control subjects. Ductal strictures preventing stone extraction were present
      in eight control patients and in six patients treated with ursodeoxycholic acid.
      The number of total calculi in the ursodeoxycholic acid group was slightly higher
      (4.2 per patient) than the number in the control group (3.3 per patient). Stone
      and bile duct dimensions were similar in each group. Nine of 10 patients in the
      ursodeoxycholic acid group had complete stone clearance, and 41 of 42 stones were
      removed during a follow-up period of 9 +/- 2 months; in contrast, no patient in
      the control group had complete clearance and only 6 of 40 stones were removed
      after a follow-up period of 31 +/- 6 months. Oral ursodeoxycholic acid
      facilitates extraction of defiant bile duct stones. This treatment is an
      effective alternative to high-tech extraction methods for large biliary stones.

PMID- 8365602
TI  - Endoscopic treatment of Mirizzi's syndrome.
AB  - Electrohydraulic lithotripsy has been shown to be an effective non-surgical
      treatment for common bile duct and intrahepatic duct stones. This technique was
      applied via the endoscopic retrograde route in 14 patients (mean age, 70) with
      the Mirizzi syndrome, all of whom were at high risk for surgery. The procedure
      was performed under strict cholangioscopic guidance. Twelve patients had a single
      stone and two had multiple stones impacted in the cystic duct. Stone diameter was
      1.5 cm in one patient, 2 to 3 cm in nine patients, and greater than 3 cm in four
      patients. Insertion of the babyscope and stone fragmentation were successful in
      all patients. Complete stone clearance required one session in 12 patients and
      two sessions in two patients (both with multiple stones). In one patient post
      procedural leakage of contrast medium from the cystic duct into the peritoneal
      cavity was noted. This was attributed to pressure necrosis induced by the
      impacted stone. The patient had an uneventful course of recovery, and leakage
      resolved with conservative management. Mortality was zero. Endoscopic treatment
      of the Mirizzi syndrome with electrohydraulic lithotripsy seems to be an
      effective and relatively safe alternative to surgery.

PMID- 8365603
TI  - Feeding tubes in endoscopic and clinical practice: the longer the better?
AB  - In an attempt to combine successful distal feeding tube positioning and a more
      prolonged stay without interfering with tube patency and feeding regimens,
      commercially available 105-cm polyurethane feeding tubes were compared with
      experimental tubes 125 cm and 145 cm long. The technique for endoscopic
      positioning at the bedside of the patient was standardized. Forty-five patients
      who required intraduodenal or intrajejunal enteral feeding in the intensive care
      unit were randomly assigned to one of the three tube-length groups. Even the 105
      cm short feeding tubes were able to be introduced beyond the duodenojejunal
      junction, although insufficient tube length remained for tube fixation at the
      nose. The longer variants, however, were positioned significantly (p < 0.01)
      deeper in the intestine, with enough spare tube length for slack formation in the
      stomach and fixation at the nose. Tubes were electively removed in 29% of the
      patients. Irrespective of tube length, premature removal by the patient (in 36%)
      or by the nurse (in 11%) was rather high. Tube blockage was irremediable in 9%.
      Feeding tubes survived on average 10.6 days in all three tube-length groups,
      despite the fact that many drugs were administered by tube as well. The
      successful, easy, and fast endoscopic positioning of feeding tubes far into the
      intestine and at the patient's bedside may further expand the possibility for
      enteral feeding. Moreover, polyurethane materials are well tolerated, and
      increasing the tube length does not interfere with tube patency or feeding plans.

PMID- 8365604
TI  - Scalloped duodenal folds in childhood celiac disease.
AB  - Unlike the adult form, childhood celiac disease has not hitherto been associated
      with a particular endoscopic pattern. The upper gastrointestinal tracts of 46
      children with various stages of celiac disease and of 27 children with conditions
      other than celiac disease were examined by an endoscopist unaware of the clinical
      details of the patients. The scalloped configuration of duodenal folds was shown
      to have a sensitivity of 88% and a specificity of 87% in the diagnosis of
      subtotal villus atrophy. Attention to this finding, described here for the first
      time in childhood celiac disease, may be helpful for the diagnosis of this
      condition.

PMID- 8365605
TI  - Artery weld strength after bipolar electrocoagulation is affected by electrolyte
      solutions around the artery.
AB  - We have recently shown that artery weld strength is significantly increased by
      increasing bipolar electrocoagulation time in fresh rabbit arteries, which had
      either 2 or 20 seconds of electrocoagulation under uniform conditions. In this
      study we investigated the effect of using either distilled water or physiologic
      saline around the artery during electrocoagulation in a total of 27 experiments,
      because it is the current practice to wash clot and liquid blood off bleeding
      ulcers with water. Fresh rabbit arteries were used, with a bipolar coagulation
      time of 2 seconds, with a constant weight of 500 gm applied to the head of the
      probe to standardize conditions. The bursting pressure of the coagulum was
      determined by cannulating the artery and increasing the pressure until the
      coagulum seal fractured. The artery weld strength was significantly lower when
      distilled water was used (median, 87.5 mm Hg; range, 10 to 225 mm Hg) compared
      with results when normal saline was used (median, 150 mm Hg; range, 100 to 850 mm
      Hg); by Mann-Whitney tests U = 42.5, Z = 2.36, and p = 0.018. These data suggest
      that more effective hemostasis of bleeding arteries may be achieved by not only
      more prolonged use of the diathermy probe, but also by using physiological saline
      as the washing solution instead of water, as is currently practiced.

PMID- 8365606
TI  - Pneumatic dilation of a sigmoid esophagus in achalasia using an overtube.

PMID- 8365607
TI  - A new approach to stenting a tight, angulated post-operative biliary stricture.

PMID- 8365608
TI  - The "stent through wire mesh technique" for complicated biliary strictures.

PMID- 8365609
TI  - Safety and efficacy of a new flexible video laparoscope in diagnostic
      laparoscopy.

PMID- 8365610
TI  - Use of a new cytology balloon for diagnosis of symptomatic esophageal disease in
      acquired immunodeficiency syndrome.

PMID- 8365611
TI  - Esophageal intramural pseudo-diverticulosis: endoscopic and radiologic
      correlation.

PMID- 8365613
TI  - Intermittent positional torsion of the gallbladder demonstrated on ERCP.

PMID- 8365612
TI  - Esophageal leiomyoblastoma: the role of endoscopic procedures in the pre
      operative diagnosis.

PMID- 8365614
TI  - Bile duct drainage with lavage by nasobiliary tube in a patient with mucin
      producing cystic pancreatic tumor.

PMID- 8365616
TI  - Massive intra-hepatic and extra-hepatic bile cast formation after
      cholecystectomy.

PMID- 8365615
TI  - Failure to deflate the balloon of replacement gastrostomy tubes.

PMID- 8365617
TI  - Percutaneous endoscopic gastrostomy for treatment of gas-bloat syndrome.

PMID- 8365618
TI  - Ulcerative jejunitis in refractory celiac disease: enteroscopic visualization.

PMID- 8365619
TI  - The Japanese experience with endoscopic ultrasonography in the staging of gastric
      cancer.
AB  - The Japanese experience with endoscopic ultrasonography in the staging of gastric
      cancer is reviewed and compared with Western results. Various graphic
      classifications for prediction of the depth of transmural penetration
      characterize the Japanese approach. Differentiation of early gastric cancers from
      advanced cancers has been emphasized, with the concordance rate of the
      ultrasonographic interpretation and the pathology exceeding 90%. When pre
      operative staging by the TNM system was attempted, results were similar to the
      reports from the West, with overall concordance rate for tumor depth of greater
      than 80%. The Japanese system of classification may be useful in differentiating
      advanced cancers from early gastric cancers with co-existing ulceration and
      fibrosis. The reliability of endoscopic ultrasonography in the pre-operative
      staging of gastric cancer in Japan is similar to that in the West.

PMID- 8365620
TI  - Is the small colorectal polyp clinically diminutive?

PMID- 8365621
TI  - Sphincter of Oddi manometry: how far is the leap of faith?

PMID- 8365622
TI  - Electronic networking: pass it on.

PMID- 8365623
TI  - Esophageal intubation over a guide wire.

PMID- 8365624
TI  - Balloon dilation of corrosive esophageal strictures.

PMID- 8365625
TI  - Removal of an embedded PEG bumper.

PMID- 8365626
TI  - A screw tip for cleaning endoscopes.

PMID- 8365627
TI  - Arterial bleeding from Billroth II anastomotic scars.

PMID- 8365629
TI  - Obstructed PEG tubes.

PMID- 8365628
TI  - Diagnosis of malignant bile duct obstruction using a Dormia basket.

PMID- 8365630
TI  - Per anus enteroscopic demonstration of a non-steroidal anti-inflammatory drug
      induced ileal stricture.

PMID- 8365631
TI  - Esophageal perforation during ERCP.

PMID- 8365632
TI  - Dieulafoy's lesion of the esophagus.

PMID- 8365634
TI  - Endoscopic ultrasound staging of rectal cancer.

PMID- 8365633
TI  - Endoscopic management of phytobezoars.

PMID- 8365636
TI  - Regulation of vascular smooth muscle contraction by extracellular Na+.
AB  - 1. The effects of extracellular Na+ removal on agonist-induced contraction of
      vascular smooth muscle in vitro are reviewed. 2. The effects of extracellular Na+
      removal on contraction vary depending upon the agonist and vessel. 3. Factors
      that may influence the effects of extracellular Na+ removal on agonist-induced
      contraction include the compound substituted for Na+, time of tissue exposure to
      lowered extracellular Na+, concentration of extracellular Na+, agonist
      concentration, presence of the vascular endothelium and presence of basal tone.
      4. The potential influence of these factors needs to be determined and minimized,
      in studies that investigate the role of extracellular Na+ in agonist-induced
      contraction.

PMID- 8365635
TI  - The inhibition of neurogenic inflammation.

PMID- 8365637
TI  - Comparative electrophysiological and mechanical actions of ATP-sensitive
      potassium channel openers in canine Purkinje fibers.
AB  - 1. Electrophysiological and mechanical effects of ATP-dependent potassium channel
      openers on canine Purkinje fibers were examined. 2. Cromakalim and pinacidil (0.3
      10 microM) and nicorandil (0.3-1 mM) shortened the action potential duration
      (APD), and reduced the contractile force, in a concentration-dependent manner.
      Other action potential parameters were unaffected. The effects were reversible.
      3. Effects of the openers were antagonized by tetraethylammonium (a non-specific
      potassium channel blocker) and more potently by glibenclamide (a blocker of ATP
      sensitive K+ channel). 4. The APD shortening and the negative inotropic effect
      induced by a switch of stimulation frequency (from 0.5 to 3 Hz) were potentiated
      by the openers. At high Ca2+ (5.4 and 10.8 mM), the effects of the openers on the
      APD and contractile force were unaffected. 5. In the spontaneously beating
      preparations, the openers hyperpolarized the maximum diastolic potential, and an
      arrest occurred. 6. Under the calcium overload condition, the K+ openers
      abolished a delayed after depolarization, and enhanced the depressed post-rest
      potentiation. 7. These results suggest that the K+ channel openers increase the
      K+ conductance and might decrease the cellular Ca2+ level in calcium overloading
      cells, and that nicorandil might also act directly ATP-sensitive K+ channels.

PMID- 8365638
TI  - Propionate regulates lymphocyte proliferation and metabolism.
AB  - 1. The effect of propionate on lymphocyte proliferation and metabolism was
      investigated. Lymphocytes obtained from human blood and rat mesenteric lymph
      nodes were utilized. 2. Propionate at concentrations of 0.04 and 1.0 mmol/l
      stimulated the amount of [3H]thymidine incorporated either in cultured human T
      lymphocytes or rat T and B lymphocytes. 3. Concentrations of propionate between 2
      and 5 mmol/l caused a marked inhibition of lymphocyte proliferation. 4. This
      short-chain fatty acid was metabolized by these cells and produced succinate in
      significant amounts; however, its oxidation was low. 5. Propionate did not alter
      glucose, glutamine and pyruvate utilization and oxidation in incubated rat
      lymphocytes but increased the formation of lactate and aspartate. 6. In contrast,
      propionate inhibited by 50% the synthesis of lymphocyte lipid from [1-14C]acetate
      at concentrations of 0.5 and 1 mmol/l and reduced by half the incorporation of
      3H2O into lipids at 1 and 5 mmol/l. 7. The results suggest that inhibition of
      lipid synthesis is a possible mechanism leading to reduction of lymphocytes
      proliferation.

PMID- 8365639
TI  - Relationship between negative inotropic and chronotropic effects of tocainide and
      five class I antiarrhythmic drugs in the coronary perfused guinea-pig heart.
AB  - 1. The relationship between the negative inotropic and chronotropic effects of
      tocainide and 5 other class I antiarrhythmic drugs was evaluated in Langendorff
      perfused guinea-pig hearts. 2. All 6 drugs reduced the contractile force (Fc) and
      the heart rate (HR) of spontaneously beating guinea-pig hearts in a dose
      dependent manner. The order of crude negative inotropic potency was: quinidine
      (Qui) = aprinidine (Apr) > mexiletine (Mex) > lidocaine (Lid) > disopyramide
      (Dis) > tocainide (Toc); and the order of negative chronotropic effect was: Apr >
      Qui > Mex > Dis > Lid > Toc. 3. The order of the negative inotropic potency
      relative to chronotropic effect (expressed as a ratio: ID50 for Fc/ID50 for HR)
      was Lid > Qui > Dis > Toc > Mex > Apr (n = 6). 4. For heart electrically
      stimulated at a constant rate, the order of crude negative inotropic potency was:
      Apr > Qui > Mex > Dis > Lid > Toc, and the order of negative inotropic potency
      (determined by the ratio: ID50 for Fc in driven heart/ID50 for spontaneously
      beating HR) was: Mex > Apr > Toc > Dis > Qui > Lid (n = 6). 5. There was a
      significant influence of negative chronotropic effect on the inotropic potency
      and the order was: Lid > Qui > Dis > Toc > Apr > Mex. The potency of various
      drugs is clinically useful in the choice of drugs when considering cardiac
      function and heart rate.

PMID- 8365640
TI  - Antiplatelet effect of pentoxifylline in human whole blood.
AB  - 1. Pentoxifylline inhibits platelet aggregation in whole blood more than in
      platelet-rich plasma. 2. An inhibition of the erythrocyte uptake of adenosine
      contributes to the antiaggregatory effect of pentoxifylline.

PMID- 8365641
TI  - Effect of ebrotidine on the synthesis and secretion of gastric sulfomucin.
AB  - 1. The effect of a new antiulcer agent, ebrotidine, on the synthesis and
      secretion of sulfomucin in gastric mucosa was investigated. Rat gastric mucosal
      segments were incubated in DMEM containing [3H]proline, [3H]glucosamine and
      [35S]Na2SO4 as markers for mucin synthesis, glycosylation and sulfation, in the
      presence of 0-150 microM ebrotidine. 2. The drug, while showing no discernible
      effect on the apomucin synthesis, evoked a dose-dependent increase in mucin
      glycosylation and sulfation, which at 100 microM ebrotidine, attained its maximum
      of 2.4 and 2.7-fold stimulation, respectively. 3. The analysis of mucin secretory
      responses revealed that ebrotidine caused a concentration-dependent enhancement
      in sulfomucin secretion which attained its maximum increase of 3.3-fold at 100
      120 microM ebrotidine. Furthermore, the sulfomucin elaborated in the presence of
      ebrotidine exhibited a higher content of a large molecular-weight mucus
      glycoprotein form, the assembly of which is intimately associated with the
      sulfation event. 4. The results suggest that the ability of ebrotidine to enhance
      gastric sulfomucin synthesis and secretion may play an important role in the
      gastroprotective mechanism of action of this agent.

PMID- 8365642
TI  - Amplifying effect of serotonin on contractile responses in rat aorta and
      depletion of intracellular Ca-stores.
AB  - 1. Serotonin, 1 microM, induces a contractile response in isolated rat aorta in
      the presence or absence of extracellular Ca. 2. In Ca-free media, the fast phasic
      contraction is lower in magnitude and further addition of serotonin evokes no
      response. 3. Recovery of the contractile response in Ca-free medium is obtained
      by a 40 min incubation in Ca-containing solution. 4. In Ca, Mg-free medium, the
      response to serotonin is significantly higher than that obtained in the presence
      of Mg. 5. An amplifying effect of serotonin on the contractile responses induced
      by serotonin itself or by noradrenaline was observed in Ca-containing but not in
      Ca-free solution.

PMID- 8365643
TI  - Effect of short-term carbon tetrachloride administration on blood lactic acid
      levels.
AB  - 1. A short-term CCl4 administration was used in vivo as a model to produce a rise
      in lactic acid levels and to explain the probable interaction of CCl4 and lactic
      acid elevation with hepatic fibrogenesis. 2. A single dose of CCl4 produced an
      increase in lactic acid levels from 16.6 +/- 3.57 to 24.2 +/- 4.2 mg/dl. Three
      consecutive doses produced an elevation to 33.28 +/- 10.07 mg/dl, thus describing
      a direct relationship between lactic acid levels and CCl4 administration in a
      short-term fashion. 3. A morphological evaluation was performed to show hepatic
      changes caused by CCl4 administration. No clue of fibrogenesis was found.
      However, we conclude that an elevation in lactic acid exists, prior to cirrhosis.
      Therefore, chronic presence of lactic acid may lead to cirrhosis.

PMID- 8365644
TI  - Triphosphate, the key structure of the ATP molecule responsible for interaction
      with P2X-purinoceptors.
AB  - 1. A radioligand binding assay was carried out to explore the key structure in
      molecules of ATP and its analogues responsible for the binding to P2x
      purinoceptors. 2. It was found that adenosine, adenine and xanthine had no
      significant effect on [3H]alpha, beta-methylene ATP binding to membrane fractions
      prepared from rat urinary bladder, while pentasodium triphosphate and disodium
      pyrophosphate could effectively displace the binding. Sodium orthophosphate was
      shown to displace the binding only at much higher concentration. 3. Apart from
      ATP, several other nucleotides could also fully displace the specific binding,
      but with potencies lower than that of ATP. 4. The results indicate that the
      phosphate side chain in molecules of ATP and its analogues is the key structure
      responsible for the binding to P2x-purinoceptors.

PMID- 8365645
TI  - Elucidation of the rapid in vivo metabolism of arecoline.
AB  - 1. The metabolism of arecoline (ARE) was examined in homogenates of mouse blood,
      brain, kidney, and liver tissue. 2. Liver and kidney tissues exhibited the
      greatest rates of ARE metabolism. 3. The specific carboxylesterase inhibitor TOCP
      (tri-o-tolyl-phosphate) as well as ISO-OMPA (tetraisopropyl-pyrophosphoramide)
      completely blocked ARE metabolism in liver homogenate. 4. ISO-OMPA significantly
      inhibited ARE metabolism by purified porcine liver carboxylesterase. 5. The data
      suggest that carboxylesterase (EC 3.1.1.1) is primarily responsible for the
      metabolism of ARE in the mouse.

PMID- 8365646
TI  - Endothelial modulation of 5-hydroxytryptamine-induced contraction in goat
      cerebral arteries.
AB  - 1. In isolated goat middle cerebral artery segments, 5-hydroxytryptamine (5-HT,
      10(-8) -3 x 10(-5)M) caused concentration-dependent contractions, with EC50 = 2.1
      (1.9-2.5) x 10(-7) M and Emax = 60 +/- 2% of 50 mM KCl-induced contraction. 2.
      Mechanical removal of endothelium significantly increased the Emax (91 +/- 8%)
      and did not change the EC50 value of 5-HT-elicited contractions. 3. Incubation of
      unrubbed arteries with the irreversible inhibitor of EDRF, gossypol (10(-5) M),
      significantly increased the contractile response to 5-HT (Emax = 77 +/- 4%). 4.
      Incubation of unrubbed arteries with the competitive inhibitor of the NO
      synthesis, NG-nitro-L-arginine (L-NOARG) (10(-5) M), significantly enhanced the
      arterial response to 5-HT (Emax = 71 +/- 5%). The effects of L-NOARG were
      reversed by L-arginine (10(-4) M) but not by D-arginine (10(-4) M). 5.
      Pretreatment with the inhibitor of cyclooxygenase, indomethacin (10(-5) M),
      significantly increased the response of unrubbed arteries to 5-HT, with an Emax
      of 69 +/- 3%. 6. These results suggest that endothelium modulates the constrictor
      effect of 5-HT in goat cerebral arteries by producing both EDRF, probably NO, and
      prostacyclin.

PMID- 8365647
TI  - The ribosome-inactivating, antiproliferative and teratogenic activities and
      immunoreactivities of a protein from seeds of Luffa aegyptiaca (Cucurbitaceae).
AB  - 1. The protein isolated from Luffa aegyptiaca seeds was capable of inhibiting
      protein synthesis in a rabbit reticulocyte lysate system and [3H]thymidine uptake
      by mouse melanoma (B16) cells. 2. It also adversely affected the development of
      mouse embryos in culture. 3. In enzyme-linked immunosorbent assay it reacted with
      antisera raised against other ribosome-inactivating proteins.

PMID- 8365648
TI  - Characterization of muscarinic receptors on the isolated guinea pig ileum at
      pharmacologically low concentrations.
AB  - 1. Several selective and non-selective muscarinic agonists (McN-A-343, RS-86,
      arecoline, oxotremorine-M, pilocarpine, cis-dioxolane, and acetylcholine) were
      examined for relaxant activity in the isolated guinea-pig ileum at
      pharmacologically low concentrations. 2. The concentrations studied include: 1 x
      10(-12) M, 3 x 10(-12) M, 1 x 10(-11) M, 3 x 10(-11) M and 1 x 10(-10) M. 3. None
      of the compounds exhibited relaxant activity in both the field and non-field
      stimulated ileum. 4. All of the above compounds exert muscarinic agonist activity
      in a concentration range of 1 x 10(-9) M to 1 x 10(-6) M (Williams et al., 1992).
      5. Thus, in the isolated guinea-pig ileum, muscarinic agonists do not exert
      relaxant activity of the gastrointestinal tract at low concentrations.

PMID- 8365649
TI  - The effect of ephedrine isomers and their oxazolidines on locomotor activity in
      rats.
AB  - 1. The four stereoisomeric ephedrines and four oxazolidines formed by reaction of
      each ephedrine isomer with salicylaldehyde were tested for their ability to
      increase locomotor activity in rats. 2. All ephedrine isomers except (
      )pseudoephedrine increased locomotor activity; the order of potency was (
      )ephedrine > (+) pseudoephedrine > (+) ephedrine. 3. All oxazolidine derivatives
      increased locomotor activity except (-)pseudoephedrine oxazolidine. 4. The
      oxazolidines derived from (-) and (+) ephedrine were slightly more active than
      their parent drugs. (+) Pseudoephedrine oxazolidine was less active than its
      parent. 5. Half-lives of hydrolysis were measured for the oxazolidines in aqueous
      buffer, ephedrine oxazolidines hydrolyze faster than pseudoephedrine
      oxazolidines.

PMID- 8365650
TI  - The effects of tacrine and zacopride on the performance of adult rats in the
      working memory task.
AB  - 1. The present study investigated the effects of tacrine (an inhibitor of
      acetylcholinesterase) and zacopride (the antagonist of 5-HT3 receptors) on the
      performance of adult rats in a continuous operant delayed non-matching to
      position task assessing spatial working memory. 2. Adult rats had a decline in
      the percent correct responses at the longest delays (16 and 30 sec) in this task.
      Tacrine (1.0 mg/kg) or zacopride (0.0025, 0.05, 1.0 mg/kg) did not increase the
      percent correct responses at any time delays. The higher dose of tacrine reduced
      behavioural activity (e.g. the decreased number of trials completed and increased
      sample press latency) of rats during memory testing, and it slightly increased
      choice accuracy across all the delays. 3. The combination of zacopride (1.0
      mg/kg) and tacrine (1.0 mg/kg) increased the percent correct responses at the
      shortest delays, but not at the longest delays. 4. These results indicate a non
      mnemonic improvement in the accuracy performance of rats, and they suggest that
      the effects of acute, systemic administrations of zacopride (which is thought to
      increase the release of acetylcholine) or/and tacrine (which inhibits the
      breakdown of acetylcholine) do not improve spatial working/short-term memory in
      rats.

PMID- 8365651
TI  - Nicotinic cholinergic influences in pancreatic secretion induced by intraduodenal
      alkaline and acid solutions in the rabbit.
AB  - 1. The effect of hexamethonium on the exocrine pancreatic response to
      intraduodenal acidification and alkalinization, and the secretin and VIP release
      after these stimuli, was studied. 2. The hydroelectrolyte secretion after
      hydrochloric acid and sodium carbonate perfusion was reduced by hexamethonium
      treated (322 +/- 44% of maximum response in flow rate to sodium carbonate
      perfusion in untreated animals vs 140 +/- 12% in pretreated animals, and 252 +/-
      19% of maximum response in flow rate to HCl in untreated animals vs 166 +/- 11%
      in pretreated animals). 3. However, hexamethonium has no effect on secretin
      plasma levels after either intraduodenal acidification or alkalinization. 4. On
      the contrary, the ganglion blocker significantly (P < 0.01) reduced plasma VIP
      levels in response to intraduodenal HCl (maximum response 320 +/- 74% in
      untreated vs 184 +/- 44% in hexamethonium-treated animals). 5. Plasma VIP levels
      showed a similar increase in both untreated (maximum response: 151 +/- 12%) and
      ganglion blocked animals (170 +/- 26%) in response to sodium carbonate. 6. These
      data suggest the existence of complex neural mechanisms in the exocrine
      pancreatic response to intraduodenal stimuli, these mechanisms being different
      depending on the intraduodenal stimulus.

PMID- 8365652
TI  - Ketorolac tromethamine: an experimental study of its analgesic effects in the
      rat.
AB  - 1. The formalin test and R-III nociceptive electromyographic reflex were used to
      determine the origin of analgesia induced by ketorolac tromethamine (KT) in rats.
      2. The effects of KT and morphine were compared after i.v. administration. 3.
      Mepacrine and indomethacin were associated to KT to determine if prostaglandins
      are involved in the central action of KT. 4. In both tests KT had a poor
      analgesic effect without dose-response relationships. 5. A central component is
      involved in the analgesia produced by KT, but neither prostaglandins nor opioid
      receptors seem to mediate this effect.

PMID- 8365653
TI  - Reciprocal modulation of the binding of angiotensin agonists and antagonists to
      angiotensin receptors in smooth muscle.
AB  - 1. Direct ligand binding studies have shown that the agonist 125I-[Sar1]Ang II
      and the antagonist 125I-[Sar1Ile8]Ang II bind to bovine uterus smooth muscle
      membranes in a time-dependent, reversible and saturable manner; both ligands had
      the same number of high affinity sites. 2. [Sar1Ile8]Ang II inhibited the binding
      of 125I-[Sar1]Ang II in a non-competitive manner by decreasing the number of high
      affinity sites without changing the binding affinity of the radioligand. 3.
      [Sar1]Ang II also inhibited the binding of 125I-[Sar1Ile8]Ang II in a non
      competitive manner. 4. Dissociation of both radioligands from their receptor
      sites was fast enough that pseudo irreversible occupancy of the binding sites
      could not account for the observed non-competitive inhibition. 5. Displacement
      studies using 125I-[Sar1Ile8]Ang II as the radioligand provided evidence for the
      existence of two binding sites when the displacing ligand was [Sar1]Ang II but
      not when the displacing ligand was [Sar1Ile8]Ang II. 6. GTPS gamma S had no
      discernible effect on the binding of either 125I-[Sar1]Ang II or 125I
      [Sar1Ile8]Ang II to bovine uterine membranes. 7. The present findings are
      consistent with an allosteric mechanism of antagonism for [Sar1Ile8]Ang II. The
      data are also consistent with a mechanism wherein agonist and antagonist ligands
      occupy different binding modes at the same receptor site and induce long-term
      conformational changes in the receptor which are idiosyncratic with respect to
      the nature of the ligand. An emerging relationship between the actions of
      angiotensin peptides and non-peptide mimetics of angiotensin is presented.

PMID- 8365654
TI  - Role of calcium in mediating the biphasic contraction of the rabbit urinary
      bladder.
AB  - 1. The response of the urinary bladder to field stimulation is biphasic in nature
      consisting of an initial phasic contraction followed by a prolonged tonic phase
      which lasts for the duration of the stimulation. 2. The phasic response is
      mediated by the release of neurohumoral transmitters, primarily acetylcholine
      (via muscarinic receptor stimulation) and ATP (via purinergic receptor
      stimulation). The tonic component is mediated entirely via muscarinic receptor
      stimulation. 3. The present study investigates the dependence on extracellular
      calcium of the phasic and tonic contractile responses to field stimulation,
      bethanechol, and ATP. The results can be summarized as follows: 4. Field
      stimulation (2 and 32 Hz) and bethanechol evoke a biphasic contractile response
      whereas ATP evokes only a phasic response. 5. There were no significant effects
      of either calcium channel blockers or calcium fee EGTA medium on either
      spontaneous contraction or basal tension of muscle strips. 6. The calcium channel
      antagonists diltiazem and verapamil inhibited both the phasic and tonic responses
      induced by field stimulation (both 2 and 32 Hz) in a dose dependent manner. 7.
      For both 2 and 32 Hz stimulation, the ED50 s for the inhibition of the tonic
      phases of the responses to field stimulation were significantly lower than the
      ED50s for the inhibition of the phasic responses. 8. The tonic phase of the
      responses to field stimulation were inhibited to a significantly greater degree
      than the phasic responses by incubation in calcium-free medium containing EGTA.
      9. Both the phasic and tonic components of the response to bethanechol
      stimulation were inhibited equally, and followed a similar time course as the
      tonic component of field stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365655
TI  - The role of endothelial cells on the alterations in vascular reactivity induced
      by insulin-dependent diabetes mellitus: effects of insulin treatment.
AB  - 1. In this study, the maximal contractile responses to noradrenaline (NA) were
      significantly increased but pD2 values (sensitivity) were not significantly
      altered in aortas with endothelium from insulin-dependent (ID)-diabetic rats when
      compared to their controls. 2. Removal of the endothelium resulted in a
      significant increase in the maximum response of control and ID-diabetic aortas
      and also loss of the difference in maximum contractile response to NA between ID
      diabetic aortas and their corresponding controls. 3. Endothelium-dependent
      relaxation stimulated by acetylcholine (ACh), methacholine, histamine, ATP and
      insulin, in aortic rings precontracted with NA were significantly attenuated but
      unchanged by A23187 in ID-diabetic vessels relative to controls. 4. Relaxations
      produced by sodium nitroprusside (SNP) in ID-diabetic aortas were similar to
      those in control vessels. 5. The sensitivity of ID-diabetic aortas to relaxant
      substances were not changed when compared with controls. 6. These results
      demonstrate that ID-diabetes-induced specific changes in vascular reactivity and
      endothelial cells have an important role on the maintenance of vascular tonus.
      This feature may be responsible for the major complications of diabetes such as
      macroangiopathy, vasospasm and high blood pressure in late stage of the disease.

PMID- 8365656
TI  - Noradrenergic-GABAergic interaction in anterior hypothalamus from normotensive
      and sinoaortic denervated rats.
AB  - 1. GABA content is decreased in anterior hypothalamus and medulla oblongata of
      hypertensive rats by sinoaortic denervation (SAD) when compared to control
      animals which underwent a sham-operation (sham). 2. Lesion of noradrenergic
      pathways by 6-hydroxydopamine (6-OHDA), intracerebroventricularly administered,
      induced depletion of noradrenergic content in frontal cortex, anterior and
      posterior hypothalamus in both SAD and sham-operated rats. 3. As a consequence of
      this noradrenergic depletion there was an increase of GABA content in anterior
      hypothalamus only, from sham- and SAD-operated animals, without changes in other
      areas. 4. There is a noradrenergic-GABAergic interaction in the anterior
      hypothalamus of normotensive rats which is not impaired in hypertensive rats by
      sinoaortic denervation.

PMID- 8365657
TI  - Evolution of the mitochondrial ATPase 6 gene in Drosophila: unusually high level
      of polymorphism in D. melanogaster.
AB  - We have determined 1990 bp mitochondrial DNA sequence which extends from 3' end
      of the cytochrome oxidase subunit I (COI) gene to 5' end of the COIII gene from
      two sibling species of Drosophila, D. simulans and D. mauritiana. Analyses of the
      sequences and part of the NADH dehydrogenase subunit 2 gene and the COI gene
      together with those from D. melanogaster and D. yakuba revealed that amino-acid
      substitution rate of the ATPase 6 gene seems to be higher in some strains of D.
      melanogaster than in the other species. High level of amino-acid polymorphism in
      this gene was observed in D. melanogaster. Synonymous substitution rate is
      relatively constant in all the genes examined, suggesting that mutation rate is
      not higher in the ATPase 6 gene of D. melanogaster. The amino-acid substitutions
      found specifically in D. melanogaster are at the sites which are not conserved
      among mammals, yeast and E. coli. These sites of the ATPase 6 gene might lose the
      selective constraint in D. melanogaster, and the amino-acid substitutions can be
      explained by neutral mutations and random genetic drift.

PMID- 8365658
TI  - Directional selection and the evolution of sex and recombination.
AB  - Models of the evolutionary advantages of sex and genetic recombination due to
      directional selection on a quantitative trait are analysed. The models assume
      that the trait is controlled by many additive genes. A nor-optimal selection
      function is used, in which the optimum either moves steadily in one direction,
      follows an autocorrelated linear Markov process or a random walk, or varies
      cyclically. The consequences for population mean fitness of a reduction in
      genetic variance, due to a shift from sexual to asexual reproduction are
      examined. It is shown that a large reduction in mean fitness can result from such
      a shift in the case of a steadily moving optimum, under light conditions. The
      conditions are much more stringent with a cyclical or randomly varying
      environment, especially if the autocorrelation for a random environment is small.
      The conditions for spread of a rare modifier affecting the rate of genetic
      recombination are also examined, and the strength of selection on such a modifier
      determined. Again, the case of a steadily moving optimum is most favourable for
      the evolution of increased recombination. The selection pressure on a
      recombination modifier when a trait is subject to strong truncation selection is
      calculated, and shown to be large enough to account for observed increases in
      recombination associated with artificial selection. Theoretical and empirical
      evidence relevant to evaluating the importance of this model for the evolution of
      sex and recombination is discussed.

PMID- 8365660
TI  - Beware: the Beijing flu is coming. Immunization--with new Medicare coverage-
      provides some protection.

PMID- 8365659
TI  - The advance of Muller's ratchet in a haploid asexual population: approximate
      solutions based on diffusion theory.
AB  - Asexual populations experiencing random genetic drift can accumulate an
      increasing number of deleterious mutations, a process called Muller's ratchet. We
      present here diffusion approximations for the rate at which Muller's ratchet
      advances in asexual haploid populations. The most important parameter of this
      process is n0 = N e-U/s, where N is population size, U the genomic mutation rate
      and s the selection coefficient. In a very large population, n0 is the
      equilibrium size of the mutation-free class. We examined the case n0 > 1 and
      developed one approximation for intermediate values of N and s and one for large
      values of N and s. For intermediate values, the expected time at which the
      ratchet advances increases linearly with n0. For large values, the time increases
      in a more or less exponential fashion with n0. In addition to n0, s is also an
      important determinant of the speed of the ratchet. If N and s are intermediate
      and n0 is fixed, we find that increasing s accelerates the ratchet. In contrast,
      for a given n0, but large N and s, increasing s slows the ratchet. Except when s
      is small, results based on our approximations fit well those from computer
      simulations.

PMID- 8365661
TI  - Preparing for surgery: this practical workup pinpoints preoperative dangers.
AB  - Older patients undergo 20 to 40% of surgical procedures and account for 50% of
      surgical emergencies. Your presurgical workup can pinpoint potential cardiac,
      pulmonary, or metabolic problems that could endanger your patient in the
      operating room. Not everyone needs an extensive cardiac workup. To determine who
      does, you can use the Goldman criteria to predict the risk for postoperative
      cardiac complications. Preoperative test selection is based on these predicted
      risks and on information from the patient history and physical exam. Medication
      adjustments and discharge planning are important considerations as well.

PMID- 8365662
TI  - Adult vaccinations: protecting your patients from avoidable illness.
AB  - Influenza vaccine is recommended each year for any adult at high risk for lower
      respiratory tract complications and death. Also consider immunizing household
      members of high-risk patients. Those who are susceptible to influenza are also at
      risk for pneumococcal disease; consider revaccination more than 6 years after the
      first dose for those at the highest risk of declining antibody levels. Any adult
      patient whose tetanus immunization status is uncertain should be considered
      unvaccinated and receive a full three-dose primary series of Td. In the United
      States, hepatitis B is usually a disease of lifestyle or profession. Rabies
      vaccine is indicated for your older patients who hunt, trap, explore caves, or
      travel to endemic areas.

PMID- 8365663
TI  - Eyelid disorders: recognizing pathologic changes in the older patient.
AB  - The eyelids provide a vital function in protecting and cleansing the eye but are
      also the source of numerous disorders and complaints in your older patients.
      Clinically, the most important of these problems are suspicious lid lesions that
      may harbor malignancy, neurologic disorders, and structural malpositions that
      cause poor lid function and may damage the globe. Many of these disorders require
      prompt evaluation and often referral to an ophthalmologist for surgical
      management. Less serious problems such as blepharitis can often be treated in the
      primary care office setting.

PMID- 8365664
TI  - When your older patient can't sleep: how to put insomnia to rest.
AB  - Sleep disorders are common in midlife and older adults, coinciding with
      encephalographic changes in sleep patterns, stressful life events, and chronic
      diseases of aging. Differential diagnosis includes respiratory abnormalities
      (including obstructive sleep apnea), leg cramps, nocturia, ulcer-related pain,
      medication use, depression, and anxiety. Sedative-hypnotic agents may be
      appropriate for selected patients, with short-acting substances preferred in all
      cases. Dosage and dosing schedules should be discussed with the patient to ensure
      compliance and to avoid possible misuse of these agents.

PMID- 8365665
TI  - The biology of aging: looking to defuse the genetic time bomb.
AB  - Each cell is functionally restricted by differentiation, which determines its
      complement of active and inactive genes. Various diseases then become manifest in
      each cell, depending on these specific gene combinations. Neoplasia, for example,
      is due to a multistep series of genetic mutations. It is common in continuous
      replicators such as bronchial epithelium, colon, and marrow but rare in
      intermittent replicators such as endothelial and smooth muscle cells. In
      contrast, these latter cell types are centrally involved in degenerative
      phenomena such as atherosclerosis. However, in both continuous and intermittent
      replicators, reduction of gratuitous cell turnover will be of great benefit. The
      nonreplicating adult neuron almost never undergoes tumorigenesis compared with
      glial cells but gives rise to a variety of age-related degenerative diseases such
      as Alzheimer's or Parkinson's disease. In the nonreplicating neuron, therefore,
      it is imperative that we promote strategies to preserve cell viability by
      minimizing oxidative damage. Natural antioxidants such as vitamin C and E and
      beta carotene, as well as an optimal caloric and protein intake, should be
      cornerstones of treatment and prevention for the aging patient. A place for
      pharmacologic intervention is also likely soon. Current research should soon
      identify the precise mechanisms responsible for programmed cellular senescence
      and oxidative cellular damage so as to illuminate additional means of rational
      treatment, and perhaps more importantly, prevention.

PMID- 8365666
TI  - Close linkage of the gene for Werner's syndrome to ANK1 and D8S87 on the short
      arm of chromosome 8.
AB  - Werner's syndrome (WRN) is a rare autosomal recessive disorder characterized by
      the appearance of features of premature aging in a young adult. Skin fibroblasts
      from WRN patient demonstrate slow growth, reduced life span in vitro and mutator
      phenotype. The genetic defect in WRN is unknown. We have studied 23 WRN patients
      mainly from first or second cousin marriage and have applied homozygosity mapping
      to search for the WRN locus. A peak lod score of 5.58 at a recombination fraction
      of 0.03 was obtained with D8S87. We confirmed that the WRN locus was located on
      the short arm of chromosome 8, 8p11.2-p12.

PMID- 8365667
TI  - A seroimmunological analysis of Down syndrome.
AB  - Down syndrome (DS) was studied in terms of immunological function and serological
      aspects. It was found that antibody levels against rubella and pertussis in the
      sera from 36 institutionalized DS patients were comparable with those of healthy
      controls while low antibody levels were detected against mumps and measles. Six
      tumor markers were also assayed in the serum from DS patients and the serum
      concentration of alpha-1-acid glycoprotein (alpha 1-AGP) and immunosuppressive
      acidic protein, an analogous glycoprotein of alpha 1-AGP, were significantly
      higher than those of the control group. Multivariate discriminant function was
      constructed based on the concentration of tumor markers. The function could
      discriminate between the two groups at a sensitivity of 92.3%. Flow-cytometrical
      analysis has revealed that helper T level of DS patients' sera was lower than
      that of the control group.

PMID- 8365669
TI  - Comparison of the age- and tumor-associated changes in the c-myc gene methylation
      in mouse liver.
AB  - Study of DNA methylation of the c-myc gene in liver tumors of BCF1 mice treated
      with various agents revealed frequent alteration from that in normal liver. The
      alteration, however, was complex and showed either an increase or a decrease of
      methylation to various degrees. On the other hand, the tumors obtained from
      middle-aged C3H/He mice, which develop liver tumors spontaneously at a high
      incidence rate starting in middle age, showed predominantly increases of
      methylation in the c-myc gene, while the large tumors found in older mice
      revealed decreases. The normal part of the liver showed a slight gradual age
      dependent increase. These suggest that hypermethylation of the c-myc gene is
      common to aging and early tumor development in liver. Thus the alteration of DNA
      methylation seems to be a good clue to investigate why the tumor incidence rate
      increases rapidly as individuals grow older.

PMID- 8365668
TI  - Amyloid precursor protein is found in lysosomes.
AB  - The major component of Alzheimer's disease amyloid is a small polypeptide
      referred as the amyloid beta protein, which is derived from a larger precursor,
      amyloid precursor protein (APP). Cell fractionation and immunological studies on
      the APP molecule indicate that APP is localized either in the neuron and
      astrocyte and that the molecule is recovered from lysosomal fraction.

PMID- 8365671
TI  - [Origin of Roman medical criticism and its reception in Rome].
AB  - Our view of Cato's (234-149 B.C.) attitude towards Greek medicine and Greek
      doctors has been influenced by the elder Pliny (23-79 A.D.). Evidence is shown
      which suggests that Cato's rejection of Greek medicine did not prevent him from
      using the help of Greek physicians.

PMID- 8365670
TI  - Purification of a trypsin-type protease from human umbilical vein endothelial
      cells which is highly sensitive to the Kunitz inhibitor domain peptide of
      Alzheimer's disease amyloid protein precursor.
AB  - A trypsin-type protease was purified to enzymatic homogeneity from human
      umbilical vein endothelial cells by sequential affinity chromatographies. The
      enzyme specifically hydrolyzed dibasic substrates with leucine at the P3
      positions, but scarcely hydrolyzed the other substrates tested. The enzyme was
      strongly inhibited by the Kunitz inhibitor domain peptide of Alzheimer's disease
      amyloid protein precursor (Ki value, 0.35 nM) and by the microbial inhibitors
      leupeptin and anti-pain. These results, together with a previous finding of a
      significant increase in the expression of Alzheimer's amyloid protein precursors
      (beta APPs) with the Kunitz inhibitor domain in Alzheimer's disease, suggest that
      the activity of the trypsin-type protease is suppressed by an increase of beta
      APPs with inhibitor activity in Alzheimer's disease, resulting in aberrant
      intracellular protein catabolism including degradation of beta APPs and beta
      protein deposition.

PMID- 8365672
TI  - [Jung to Freud 1905: a report on Sabina Spielrein].
AB  - A recently discovered letter, dated September 25, 1905, proves that Jung's first
      attempt to get in contact with Freud had taken place earlier than it was assumed
      on the basis of their published correspondence. The letter contains a brief case
      history of Sabina Spielrein's disease. It was addressed to Freud and handed over
      to Sabina Spielrein's mother who intended to remove her daughter from Jung with
      whom the girl had fallen in love. However, the letter was never passed on to
      Freud.

PMID- 8365673
TI  - [Hard drugs--yesterday and today. A cultural historical essay].
AB  - This article tries to examine the current problems of drug consumption from
      different points of view. Some major historical, sociological, psychological, and
      economical aspects are dealt with in order to show the enormous complexity of the
      subject matter. An attempt is also made to make clear that all approaches
      suggesting "easy answers" to the drug problems are bound to fail and that the
      desire to build up a drug-free society has always been a complete illusion.

PMID- 8365674
TI  - [In awe of creation: "Tota substantia", "calidum innatum", "generatio spontanea"
      and atomic form teachings of Daniel Sennert].
AB  - A thorough study of the system of a philosophy of nature, elaborated by the well
      known German physician Daniel Sennert (1572-1637). At the beginning of the modern
      era, Sennert developed a new and very complex concept of the relations between
      matter and the guiding principle active in it, the Aristotelian form.

PMID- 8365675
TI  - [In memory of Paul Bert (1833-1886) and the development of high altitude
      physiology in Switzerland].
AB  - It is the merit of Paul Bert to have assigned as an important task to
      experimental physiology the investigation of mountain sickness, of immediate
      accommodation of the organism to high altitude, and of its long-term
      acclimatation. In his "Pression Barometrique" of 1878, he established the
      foundations of high-altitude physiology. In particular, he formulated the "law of
      partial pressure", the partial pressure of the atmospheric gases alone being
      responsible for their action on the organism. Paul Bert's historic role, for a
      long time nearly forgotten, has been recalled to memory by the Swiss medical
      historians E.H. Ackerknecht and N. Mani. Bert's line of investigation has been
      followed especially by Angelo Mosso of Turin and, more recently, by F. Verzar, A.
      von Muralt, A. Fleisch and other Swiss physiologists.

PMID- 8365676
TI  - The mystery of Louis Verrey (1854-1916).
AB  - In 1888, Louis Verrey, a Swiss ophthalmologist, stated emphatically that there is
      a "centre for the chromatic sense" in the human brain and that it is located in
      the lingual and fusiform gyri. He did not, however, consider the "colour centre"
      to be a separate area but a large sub-division of the primary visual cortex. His
      evidence was quickly dismissed and forgotten. It was not to be taken seriously
      again until after the experimental discovery of functional specialization in the
      monkey brain. This paper considers why it is that Verrey did not consider the
      "colour centre" to be a separate cortical area, distinct from the primary visual
      cortex, why his evidence was so quickly and effectively dismissed, and why it is
      that Verrey did not pursue the logic of his findings.

PMID- 8365677
TI  - [Effect of melatonin on the function of the pituitary-gonadal axis in food
      restriction states].
AB  - The effects of melatonin (25 micrograms s.c. daily in the late afternoon during
      ten days) on the ovarian morphometry and the gonadotropin secretion were
      investigated in food-restricted and fed ad libitum rats. It was found that in
      food-restricted rats melatonin produced the significant decrease of the surface
      area of the whole ovary and of zona granulosa. Moreover melatonin treatment of
      food-restricted rats resulted in significant decrease of the relative areas of
      graafian follicles and zona granulosa estimated in relation to the whole ovary
      cross-section surface area. On the other hand melatonin did not produced
      significant alterations of the morphometric indices of the ovary in fed ad
      libitum rats. Melatonin administration was found to inhibit the effects of
      gonadotropin release in food-restricted but not in normally fed rats. These
      findings suggest that food restriction sensitizes the pituitary ovarian axis to
      antigonadotropic melatonin action.

PMID- 8365678
TI  - [The course of sexual development in girls with diabetes type I in view of
      ultrasonographic examinations].
AB  - The gynecologic a ultrasonographic examinations in 34 insulin--dependent diabetic
      girls aged from 1-9 y, were performed. Diabetes duration oscillated between 1-9
      y. The obtained results showed that the dynamics of sexual maturation of this
      girls was independent of theirs calendar age, but was conditioned by the time of
      obtained sexual development. The right metabolic balance of diabetes stipulates
      regular course of sexual maturation.

PMID- 8365679
TI  - [Significance of assay of FSH and LH in anovulatory cycles of girls primary and
      secondary amenorrhea].

PMID- 8365680
TI  - [Analysis of cause and test treatment of amenorrhea in teenagers].
AB  - The population of 49 young, secondary amenorrheic women aged 17 to 20 was divided
      according to reaction on i.m. injection of progesterone in oil. The positive
      category was subdivided into I--polycystic ovarian disease with elevated serum LH
      and II--hypothalamic-pituitary dysfunction (HPD) with normal (or decreased) level
      of LH. The negative category consists of subgroup, III--hypothalamic-pituitary
      failure (HPF) with normal or low serum FSH and IV--ovarian failure with elevated
      level of FSH (two patients were noted). The bleeding response was obtain in two
      third of the patients, and also two third of them ovulated after clomiphene
      citrate treatment, including all six women with POC. The ovulatory response in
      patients with hypothalamic pituitary failure was noted in more than 40%. The low
      concentration of serum FSH (below 5 mU/ml) was more frequent in HPF (57%) in
      comparison with HPD (48%). The resistance to clomiphene citrate treatment was
      correspondingly 62.5% and 70%. When the ovulation occurred no difference in the
      regular function of corpus luteum in POC, HPD and HPF patients was noted.

PMID- 8365681
TI  - [Primary dysmenorrhea in teenagers].
AB  - Authors demonstrate 21 cases with primary dysmenorrhoea at girls aged 14-17
      years, which were observed between 1989-1992 and present way of treatment. In
      their opinion administration of nonsteroid, antiphlogistic medicaments and the
      spasmolytics is the most effective method.

PMID- 8365682
TI  - [Chromosome loss in metaphase of peripheral blood lymphocytes in patients with
      Turner's syndrome before treatment and at the time of substitution therapy].
AB  - Chromosome loss in metaphases of 72 hours human peripheral blood lymphocyte
      cultures, at the Turner syndrome (45,X, and 46,X,izo(Xq),) patients is three
      times higher than in lymphocyte cultures of healthy women. Hormonal therapy
      decreases frequency of chromosome loss.

PMID- 8365683
TI  - [Clinical examinations, chromosomal and molecular DNA in patients with Swyer
      syndrome].
AB  - Two girls with Swyer syndrome (SS) were described. Diagnosis was established
      according to clinical data and ultrasound, laparoscope, histopathological,
      hormonal and cytogenetical examinations. One presents diagnostic possibilities
      followed advanced methods in genetics. The GTG and RBG high resolution bounding
      technique and replication analysis of short arms (Xp and Yp) were employed.
      Normal structure of end segments of X and Y chromosomes was mentioned. Molecular
      DNA analysis by polymerase chain reaction (PCR) did not find any mutation in SRY
      gene. Normal structure of this gene does not exclude possibility of SS existence.
      Our data implicates on the other mechanism of these disturbances.

PMID- 8365684
TI  - [Diagnosis of sex differential disorders treatment in teenagers].
AB  - Inter-sexuality is diagnosed in the age between 8-19 years in 58.5% among all 253
      individuals with the signs of hermaphrodite. The diagnosis requires clinical,
      hormonal, cytogenetic and sometimes histopathological investigations. At the
      youthful patients with signs of hermaphrodite there are confirmed in 66.3%
      different kinds of gonadal dysgenesis, in 15.5% androgen insensitivity syndrome,
      in 12.2% congenital adrenal hyperplasia, in 3.4% transsexualism and in 1.3%
      adrenal virilizing tumours. To call attention to the specific and different
      treatment of every kind of hermaphrodite it is necessary a very early proper
      diagnosis of the disease.

PMID- 8365685
TI  - [Differential diagnosis of hirsutism in girls between 15-19 years old].
AB  - On the basis of clinical and hormonal investigations of 58 girls with hirsutism
      aged between 15-19 years there were confirmed congenital adrenal hyperplasia in
      3.4%, late onset adrenal hyperplasia in 24.1% and polycystic ovary syndrome in
      72.4%. The proper diagnosis were established above all on endocrinological
      investigations especially on determinations of 17- ketosteroids, of DHEA, of 17
      OH-corticoids in urine and RIA of total and free testosterone in blood.

PMID- 8365686
TI  - [Activity of b-endorphin in patients with premature ovarian failure].
AB  - Examination of B-endorphin blood serum levels of 27 girls and young women with
      premature ovarian function depression was performed Patients were not pregnant
      before. The 54 young, regularly menstruating, healthy women composed the control
      group, who were divided into two groups according to the menstrual phase. Levels
      of B-endorphin were lower in examined group than in control one. High levels of B
      endorphin were found at the patients with secondary diagnosed insensitive ovary
      syndrome. This fact suggest that examination of B-endorphin levels can be useful
      for clinical differentiation of insensitive ovary syndrome and premature ovarian
      function depression.

PMID- 8365687
TI  - Antithrombotic effect of argatroban on the pial vessels of the rat: a study with
      He-Ne laser-induced thrombus formation.
AB  - The antithrombotic effect of the synthetic thrombin inhibitor (2R,4R)-4-methyl-1
      [N2-(3-methyl-1,2,3,4-tetrahydro-8-quinolinesulfon yl)-L-arginyl]-2
      piperidinecarboxylic acid monohydrate (argatroban) was investigated in cerebral
      vessels of the rat. An occlusive thrombus was formed in pial vessels using a He
      Ne laser in a closed cranial window technique. Argatroban retarded the formation
      of thrombi in a dose-dependent manner. The antithrombotic effect of a single
      intravenous dose of argatroban at 0.5 mg/kg was diminished after 30 min in
      arterioles and after 50 min in venules, respectively. The antithrombotic activity
      was maintained, however, by continuous intravenous infusion (2 mg/kg/h).

PMID- 8365688
TI  - Characterization of a novel activation-specific antiplatelet monoclonal antibody.
AB  - We developed a murine monoclonal antibody (KmT-50) which binds to a protein
      expressed on the surface of human platelets after activation. KmT-50 is an
      immunoglobulin G1 monoclonal antibody that recognizes a 50-kD antigen localized
      in intracellular organelles and the open canalicular system of unstimulated
      platelets. After platelets were stimulated, the antigen was secreted via the
      surface-connected canalicular system and exposed on the platelet membrane. KmT-50
      bound not only to human platelets, but also to rabbit and monkey platelets. This
      new antibody may be useful for experimental studies on thrombosis and hemostasis.

PMID- 8365689
TI  - Controlled vitamin K content diet for improving the management of poorly
      controlled anticoagulated patients: a clinical practice proposal.
AB  - The aim of our study was to investigate the effect of a diet with a known vitamin
      K content on the monitor test for oral anticoagulant therapy. We studied 10
      poorly controlled patients (7 women and 3 men, mean age 48 +/- 15 years) in
      therapy with acenocoumarol for at least 1 year. Another group of 10 poorly
      controlled patients was considered as a control group. After a baseline period,
      during which a free diet was allowed, patients were administered a diet with a
      controlled vitamin K content; in the same period, control subjects were not
      subjected to any dietary restriction. Thrombotest (Nyegaard, Oslo) was employed
      for monitoring oral anticoagulant therapy, with a therapeutic range between 2.3
      and 4.8 INR. We found a significant difference by thrombotest between the
      percentages within the therapeutic range obtained before and during dietary
      treatment (p = 0.0001). The difference in percentages was -0.31 and the 95% CI,
      of the difference ranged from -0.45 to -0.17. No significant difference was shown
      in the control group in the same periods. Our data suggest that a diet with a
      controlled vitamin K content is effective in increasing the percentage of tests
      within the therapeutic range in patients with poorly controlled anticoagulation.

PMID- 8365690
TI  - Concentrations of phenprocoumon in serum and serum water determined by high
      performance liquid chromatography in patients on oral anticoagulant therapy.
AB  - Two convenient high-performance liquid chromatography procedures are proposed for
      the determination of phenprocoumon (Marcumar) in serum (S-PPC) and its unbound
      fraction in serum water (SW-PPC). S-PPC and SW-PPC were determined in samples
      from 53 patients undergoing oral anticoagulant therapy who were within the
      therapeutic interval of the thrombotest. S-PPC concentrations ranged from 0.6 to
      5.0 mg/l, SW-PPC from 1.4 to 21.1 micrograms/l. A linear correlation (r = 0.714)
      was found between S-PPC and SW-PPC concentrations in the patient samples, the
      mean free fraction being 0.30%. S-PPC and SW-PPC concentrations were intra
      individually stable during therapy. A linear correlation (r = 0.710) was observed
      between S-PPC concentrations and dosage.

PMID- 8365691
TI  - Fibrinogen and fibrin derivatives in traumatized patients: relation to injury
      severity and posttraumatic pulmonary dysfunction.
AB  - In a prospective study including 30 traumatized patients, levels of fibrinogen,
      fibrinopeptide A (FpA), fibrin monomers (FM) and fibrin degradation products
      (FbDP) were measured on admission and on days 1, 2, 3 and 7 after the incident.
      High levels of FpA, FM and FbDP were observed immediately after the trauma.
      Fibrinogen levels increased during the first 7 posttraumatic days whereas FpA and
      FM decreased. FbDP was significantly higher on day 7 than on day 3. All variables
      were to some extent correlated to the injury severity score. FbDP were
      significantly lower on the day after admission in 4 patients who developed
      pulmonary dysfunction compared with patients without this complication.

PMID- 8365692
TI  - Cathepsin G inactivates human protein S in vitro.
AB  - Human polymorphonuclear leukocyte cathepsin G was used in vitro to digest human
      protein S. While clotting assays indicated that the proteinase induced a rapid
      decrease in activity, polyacrylamide gel electrophoresis-sodium dodecyl sulphate
      indicated the removal of a peptide of low molecular mass product protein S (des 1
      40). The loss in activity was the result of cathepsin G cleaving position Phe40
      Tyr41 and removing the calcium-binding region. Calcium ions almost totally
      protected the cofactor from the action of cathepsin G in vitro.

PMID- 8365694
TI  - Elimination of plasmid pKM101 from Salmonella typhimurium by monoammonium salts.
AB  - The frequency of elimination of plasmid pKM101 from Salmonella typhimurium TA92
      exposed to the action of 1-alkyl-1-ethylpiperidinium bromides and N-alkyl-N-[5
      (benzoyloxy)-3-oxapentyl]-N,N-dimethylammonium bromides was non-linear in the
      homologous series. Change in the length of the alkyl chain markedly affected the
      elimination properties of the piperidine derivatives but had no effect on the
      elimination of benzoyl derivatives. Piperidines exhibited a weaker elimination
      capacity than the benzoyl derivatives. The most potent eliminator was the
      octylbenzoyl derivative, which causes the elimination of the plasmid in 80-85%
      cells.

PMID- 8365695
TI  - Synthesis and fungitoxicity of some pyrimidine derivatives.
AB  - A series of 12 pyrimidine derivatives were prepared and tested in vitro against
      growth, sporulation and nucleic acid content of Fusarium oxysporum f. sp.
      lycopersici and Helminthosporium oryzae. Introduction of a thiazole ring together
      with two aryl groups into 2-aminopyrimidine brought about drastic toxicity for
      both fungi. Pyrimidine derivatives with aryl groups alone were less toxic. Nitro
      groups were found to enhance the toxicity of the pyrimidine derivatives
      especially when substituted in the ortho-position of the aryl groups. Inhibition
      of nucleic acid synthesis of both fungi was attributed mainly to the presence of
      the thiazole ring.

PMID- 8365693
TI  - Characterization of two "Metabacterium" sp. from the gut of rodents. 2.
      Heteroxenic cultivation and proof of dipicolinic acid in "M. polyspora".
AB  - The vegetative cell of "Metabacterium polyspora" is "cucumber-shaped", about 21 x
      5.7 microns, Gram-negative. Cylindrical endospores are best stained by Rakette
      and Ziehl-Neelsen staining. The bacterium reproduces by sporulation (2 to 8
      endospores per cell) and by binary fission. Lateral, bow-like "hatching" of the
      endospores was seen. About 52% of guinea pigs harbor 5 x 10(6), 36% below 2 x
      10(6) and 1% more than 1 x 10(8) "M. polyspora" in 1 g of caecal content.
      Dipicolinic acid was demonstrated using HPLC in the caecum homogenate from a
      guinea pig. The amount of it was proportional to the number of spores.
      Cultivation under strict anaerobic conditions did not succeed. It was possible to
      cultivate this giant endosymbiont in vitro in a heteroxenic culture incubated in
      a 5% CO2 atmosphere using liquid medium supplemented with cell-free filtrate of
      the caecum. The caecum filtrate containing undefined growth factor(s) is
      necessary for long-term culture. The replication rate was low. These findings
      suggest that the giant endosymbiont "M. polyspora" is a spore-forming prokaryote
      without the attributes of a strict anaerobe.

PMID- 8365696
TI  - Effect of alkyldimethylamine oxides on anaerobic sporulating bacteria of genus
      Clostridium.
AB  - Antibacterial activity of alkyldimethylamine oxides and Iodaminox was determined
      in vitro in 11 strains of clostridia. The most efficient was (1
      methyldodecyl)dimethylamine oxide (MIC = 7.8-78 mumol/L). Iodaminox was about
      twice as efficient (MIC = 3.9-31 mumol/L). The bactericidal activity of both
      compounds was tested at different periods of exposure, ambient pH and cultivation
      temperature on three species of clostridia. The activity of both compounds was
      the highest at pH 6 and 40 degrees C.

PMID- 8365697
TI  - Glucomannan from Candida utilis. Structural investigation.
AB  - Structure of the glucomannan isolated from the cell walls of Candida utilis has
      been investigated using acetolysis fragmentation, methylation analysis and NMR
      spectroscopy. The structure of the glucomannan resembles that of the cellular
      mannans of other Candida species, except that the longer tetra- and
      pentassacharide side-chains are terminated with a glucosyl residue. Presence of
      the nonreducing glucosyl groups at the ends of the side-chains caused the C.
      utilis not to cross-react in a double immunodiffusion test with other Candida
      species that possess mannan antigens and cross-react with Hansenula species with
      glucomannan antigens.

PMID- 8365698
TI  - Turnover of canavanine-containing proteins in Saccharomyces cerevisiae.
AB  - Saccharomyces cerevisiae grown for 2 h in the presence of 0.5 mmol/L canavanine
      in a synthetic medium with ethanol as the sole carbon source (OEC) exhibited a
      slowing down of protein synthesis for 3-4 h after a shift to fresh ethanol-based
      medium containing 1.0 mmol/L arginine (OEA) in comparison with untreated cells
      grown on OEA. The change of carbon source from ethanol to glucose (OGA) after
      growth in the OEC medium resulted in an even deeper decline of protein synthesis.
      The degradation of canavanine-containing proteins in cells pregrown and labelled
      in an OEC medium after transfer to OEA was more rapid than in the OGA medium. The
      initial rate of protein degradation during the first hour in the OGA medium was
      less than 1%/h whereas in the OEA medium it reached almost 10%/h. The fraction of
      proteins with high turnover (half-life 0.46 h) constituted 8.3% on OEA, while
      during subsequent growth on OGA it was only 0.75% with a half-life of 0.12 h.

PMID- 8365699
TI  - Prenatal expression of the 65-kDa heat-shock protein homologue in pig tissues.
AB  - A monoclonal antibody (ML30) recognizing the 65-kDa heat-shock protein of
      mycobacteria and reacting with homologous human protein was found to stain
      various porcine tissues. Development of this reactivity was studied. The first
      ML30-positive cells were embryonic hepatocytes. The protein reacting with the
      ML30 antibody was localized predominantly in the Golgi area and mitochondria of
      hepatocytes. Cell membranes of some peripheral blood lymphocytes were also found
      to bind ML30.

PMID- 8365700
TI  - Modified simplified method for isolation of lysostaphin from the culture filtrate
      of Staphylococcus staphylolyticus.
AB  - The present paper reports a modified method for isolation of lysostaphin--a
      bacteriolytic agent with specific affinity for staphylococcal cell wall. The
      proposed purification scheme includes three steps. The first procedure is
      ultrafiltration through a membrane filter giving a yield of 75.6%. The result of
      ultrafiltration is a concentrated, 10-times purified preparation of lysostaphin
      with specific activity 0.62 U/mg which can be used for digestion of S. aureus
      cells. Further step, performed by ion-exchange chromatography on DEAE-cellulose,
      yields a 60-times purified preparation containing a mixture of enzyme components
      of lysostaphin. The yield of this step is 47.2%, the preparation contains 3.54
      U/mg protein. Using gel filtration on Sephadex G-50 a component with
      hexosaminidase activity was separated from the endopeptidase component on the
      basis of molar mass difference. A 270-times purified preparation of lysostaphin
      endopeptidase with minimum of contaminating substances was obtained in this step.
      The yield of gel filtration was 22.1%, specific activity increased up to 16.3
      U/mg protein.

PMID- 8365702
TI  - The secondary antibody response induced in tissue cultures.
AB  - The conditions for induction of memory cells (B-MC) and evocation of the
      secondary antibody (Ab) response in tissue cultures (TC) were estimated. (1) In
      vivo primed B-MC cells were isolated 6-150 d after priming and stimulated in TC
      with different doses of sheep red blood cell (SRBC) antigen. The Ab response has
      a strict time and dose dependence: only small doses (10(5)) evoke a secondary
      response, high doses (10(8), 10(9)) a state of immediate tolerance. (2) Antigen
      added to TC directly with B-MC rescued their Ab production for a long period.
      Addition of the antigen 1 or 2 d after setting the TC, follows the Ab-response
      decay, comparable with virgin cells (B-ICC). (3) Primed B-MC stimulated in TC
      responded preferentially with an IgM secondary response; the same cell suspension
      adoptively transferred into isologous recipients switched into IgG cells. (4)
      Virgin, immunocompetent, B-ICC were primarily stimulated in TC with a small dose
      of antigen (10(5) SRBC); after 7 d of cultivation the cells were transferred into
      isologous recipients, SCID mice and into TC. In all cases, the secondary response
      of IgM was determined, 10 times higher than in the primary controls.

PMID- 8365701
TI  - Comparison of the in vitro effects of several cephalosporins on the oxidative
      burst of human phagocytes.
AB  - The metabolic activity (oxygen radical formation) of human phagocytes was not
      substantially affected by the tested cephalosporins. Therapeutic concentrations
      caused only a mild suppression or immunopotentiation in some cases or there were
      no effects altogether.

PMID- 8365703
TI  - [Neuropathologic, immunologic and psychobiological aspects of Alzheimer's
      dementia].
AB  - This review attempts a consolidated overview of the results of molecular
      biological research on amyloid pathology in Alzheimer's disease crosslinked with
      other aspects of the disease that have not been so much in focus in recent years.
      The spotlight will be on many pointers to an immunological process as part of the
      Alzheimer pathology. The problem of the specificity of plaques and of
      neurofibrillary tangles that both are considered to be classical
      neuropathological markers of Alzheimer's disease is critically reviewed on the
      basis of existing findings in neuropathology in non-demented and demented elderly
      persons. The traditional unidirectional concept that interprets the
      neuropsychological functions inhibited in Alzheimer's dementia merely as sequels
      to damaged morphological structures, is questioned. Earlier and more recent
      experimental findings indicating that dysfunctional and deficient use of
      neuropsychological functions can inhibit neuronal plasticity and can be the
      origin of morphological changes, are placed in relation to numerous pointers to
      non-cognitive mental anomalies prior to the outbreak of Alzheimer's disease. In
      Alzheimer's dementia, pathology of synapses is preferably correlated with
      neuropsychological deficits. Findings on this pathology are discussed as a
      possible expression of a neuronal plasticity decrease that is partly conditioned
      by psychobiological mechanisms.

PMID- 8365704
TI  - Human ovarian aging and mitochondrial DNA deletion.
AB  - The functions of human ovary change dynamically around the menopausal period. A
      decrease of the number of primordial follicles and an increase of fibrous tissues
      are observed histologically in the aged ovary. As endocrinological aspects at
      menopause, the synthesis and secretion of ovarian steroid hormones such as
      estrogens and progesterone decrease, followed with the resultant increases of
      pituitary gonadotropins. However, the mechanism of menopause and ovarian aging is
      not well understood. Thus, to study the regulatory mechanism of ovarian
      dysfunction by aging, we analyzed the accumulation of mitochondrial DNA (mtDNA)
      mutation in the human ovary in women of various ages. The amplification of a 5.5
      kb region in mtDNA with polymerase chain reaction revealed a 0.5-kb band in
      ovarian samples obtained from menopausal and postmenopausal women, which means
      that the 5.0-kb deletion of mtDNA in ovarian tissue starts at the menopausal
      period. The close relationship between the occurrence of ovarian mtDNA deletion
      and the menstrual irregularity was also observed. These observations suggest that
      the accumulation of the deleted mtDNA may be a regulating factor of dysfunction
      of the ovary by aging.

PMID- 8365705
TI  - Role of the free radical-scavenger system in aromatase activity of the human
      ovary.
AB  - The present study was undertaken to clarify the physiological role of the free
      radical-scavenger system in the control of estrogen production in the human ovary
      with age. Both superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px)
      activities in the homogenate of the ovary significantly decreased from the
      premenopausal period to the menopausal period. The lipid peroxide content,
      however, showed a small and gradual decrease from the premenopausal to the
      postmenopausal period. In the premenopausal women, aromatase (Ar) activity in the
      microsomal fraction of the ovary showed a sharp decline and a significant
      negative correlation with age. Significant positive correlations were found
      between SOD and Ar activity, and between GSH-Px and Ar activity. Treatments of
      homogenate of the ovary with 10, 50 and 100 microM of H2O2 resulted in a decrease
      in Ar activity in a dose-dependent manner. Moreover, treatment with 10 and 50
      microM of H2O2 produced a more significant decrease in the Ar activity in the
      premenopausal women than that in the postmenopausal women. Treatments with 0.01,
      0.1, 1.0 and 10.0 U of GSH-Px before administration of 50 microM of H2O2, on the
      other hand, induced a recovery of the Ar activity in a dose-dependent manner. The
      present study showed the inhibitory effect of peroxide on Ar activity, which was
      attenuated by GSH-Px. These results seem to suggest that these age-related,
      relatively free radical predominant environments in the human ovary may have an
      important role in the decrease of estrogen production through the effects on the
      Ar activity.

PMID- 8365706
TI  - Aging changes in the alignment of chromosomes after human chorionic gonadotropin
      stimulation may be a possible cause of decreased fertility in mice.
AB  - The relation between the alignment of chromosomes in the aged oocyte and its
      capacities of fertilization and development of oocytes was examined. More embryos
      in the condition of insemination at 12 and 16 h after human chorionic
      gonadotropin (hCG) however grew into two and more cell stages than those in the
      insemination of 20, 24 and 28 h. Some embryos in the group of insemination at 12,
      16 and 20 h after hCG injection had grown into the blastocyst stage. The embryos
      inseminated 24 h after hCG and later had shown no further development. Twelve
      hours after hCG injection, 67% of oocytes have chromosomes on a straight line
      (A), and 29% have chromosomes scattered in one group (B). Three percent of
      oocytes have them separated toward both spindle ends (C) and 2% of oocytes have
      no chromosomes (D). At 16 h after hCG, the alignments of chromosomes are almost
      the same as that of 12 h after hCG injection. At 20 h after hCG, the most common
      alignment of chromosomes was scattered in a small group. The alignment of
      chromosomes of most oocytes was splitting at 24 and 28 h after hCG injection.
      Thus the oocytes with the chromosome alignment of A or B can be fertilized and
      developed into the blastocyst stage. The alignment of A and B lasts only about 8
      h after ovulation, and the time was extremely restricted for oocytes to develop
      normally.

PMID- 8365707
TI  - The aging process of the reproductive organs: an overview.

PMID- 8365708
TI  - Evidence for the involvement of epidermal growth factor in fertility decline in
      aging female mice.
AB  - A decline in fertility, defined as the number of implantation sites, was observed
      in mice as they aged; the decline started at 30 weeks of age and reached a nadir
      by 60 weeks when no implantation was detected. Epidermal growth factor (EGF)
      levels in the submandibular gland and plasma increased as the female mice aged,
      and sialoadenectomy (surgical removal of the submandibular glands) attenuated the
      rise in the plasma EGF level without affecting the overall health or survival of
      the animals. Uterine weight at 10-20 weeks of age was about 70 mg, and it
      significantly increased with age. This weight has increased more than 2-fold by
      60 weeks. These changes closely followed the increase in the concentrations of
      EGF in the submandibular gland and the plasma. After sialoadenectomy, uterine
      weight decreased immediately and remained at about 50-60 mg throughout the
      experimental period. Interestingly, sialoadenectomized mice became pregnant at an
      older age than the controls. These findings suggest that elevated levels of EGF
      may have a physiological role in fertility decline in aging mice perhaps via
      uterine hypertrophy.

PMID- 8365709
TI  - Origin of senescence: a review.
AB  - The aging process is controlled by dual mechanisms. One is the mechanism which
      programs ultimate cell death and therefore determines the life-span at birth. The
      other is the mechanism which causes aging stochastically by damaging certain
      substances with time in life. Now, these mechanisms have been investigated on
      genetical bases. Whatever the mechanisms involved in aging, increasing evidence
      suggests the important roles of oxygen free radicals in the process of aging.

PMID- 8365710
TI  - Morphological changes in spiral artery of the mammalian ovary with age.
AB  - Morphological changes which take place in ovarian arteries at different ages in
      human and monkey, were investigated by light microscopy, transmission electron
      microscopy and scanning electron microscopy. The ovarian arteries in both species
      were characterized by a spiral configuration throughout their course. The hilar
      and medullar arteries were especially convoluted. In the pubertal monkey, the
      hilar and medullary arteries exhibited some intimal thickenings in which smooth
      muscle cells of a synthetic phenotype were longitudinally arranged. These
      arteries in adult monkeys had considerable intimal thickening. In a 30-year-old
      woman, arteries with intimal thickenings were detected in the hilus and medulla.
      Around 40 years of age, the intima of the arteries were considerably thickened
      with a diameter usually equal to half of the wall. In women after menopause, the
      tunica intima of these arteries was approximately two-thirds or more of the total
      artery wall thickness. Spiral arteries of the ovary were also thickened with
      advancing age.

PMID- 8365711
TI  - Reactive human bile ductules express parathyroid hormone-related peptide.
AB  - Various cholestatic liver diseases as well as regeneration after submassive
      necrosis are accompanied by a striking increase in the number of bile ductules.
      These reactive bile ductules are thought to arise either from proliferation of
      pre-existing bile ductules or bile ductule-related facultative stem cells, or
      from ductular metaplasia of hepatocytes. Recently, we found that reactive bile
      ductules display neuro-endocrine features, and speculated that the substance(s),
      produced in the neuro-endocrine granules, might play a role in their growth
      and/or differentiation through an autocrine or paracrine pathway. Parathyroid
      hormone-related peptide has been shown to be encoded by a growth factor-regulated
      gene that may play a role in cell growth and differentiation. We studied the
      immunohistochemical expression of this peptide in human liver, including three
      normal biopsies, 11 cases of cholestatic liver disease, six cases of focal
      nodular hyperplasia and three cases of regenerating liver. In regenerating liver,
      primary biliary cirrhosis, primary sclerosing cholangitis and partial or
      intermittent obstruction, the majority of reactive ductular cells expressing
      neuro-endocrine markers also expressed parathyroid hormone-related peptide. In
      focal nodular hyperplasia, a smaller number of bile ductular cells expressed the
      peptide. These findings suggest that parathyroid hormone-related peptide is
      localized in bile ductular cells and may indicate a role for this hormone in the
      growth and/or differentiation of human reactive bile ductules.

PMID- 8365712
TI  - Recurrent hepatitis B in liver allografts: a distinctive form of rapidly
      developing cirrhosis.
AB  - Recurrent hepatitis B virus (HBV) infection in the liver allograft is a
      significant cause of morbidity and mortality in those transplanted for chronic
      HBV disease. A detailed histological and immunohistochemical study of recurrent
      HBV disease in liver allografts was carried out using archival paraffin-embedded
      tissue. A total of 34 follow-up liver biopsies from 14 patients transplanted for
      HBV were available for study. In addition to routine stains, sections were
      stained with antibodies to a range of HBV antigens. Two patients transplanted for
      acute HBV remained free of re-infection. Five of seven patients transplanted for
      chronic HBV disease who were followed-up, developed HBV-associated cirrhosis 12
      23 months later. Hepatocyte ballooning, high nucleocapsid antigen load, ductular
      proliferation and immature fibrous tissue characterized this unusual cirrhosis,
      which developed rapidly from fibrosing cholestatic hepatitis in at least three
      cases. Death from liver failure supervened quickly in three of the five patients.
      These findings support the concept that HBV infection in the liver allograft can
      be a different disease from that occurring in the non-transplant setting, and may
      be related to high antigen load.

PMID- 8365713
TI  - Expression of epidermal and nerve growth factor receptors in human thymus and
      thymomas.
AB  - The expression of epidermal growth factor (EGF) and nerve growth factor (NGF)
      receptors has been investigated by immunohistochemical analysis in eight normal
      human thymuses and in 15 thymomas. Thymomas were classified into five different
      histological types--medullary, mixed, predominantly cortical, cortical thymoma
      and well-differentiated thymic carcinoma. In fetal and paediatric normal thymus,
      EGF-receptor was expressed by subcapsular, cortical and medullary epithelial
      cells, whereas immunoreactivity for NGF-receptor was detected on only subcapsular
      and medullary epithelial cells. In thymomas, independent of their histological
      type, EGF-receptor was expressed by a large majority of epithelial cells. In
      contrast, the pattern of expression of NGF-receptor in thymomas was different for
      the various histological types. These findings indicate that the expression of
      both EGF and NGF receptors in human thymomas substantially reflects their
      expression in normal thymus, and suggest that EGF and NGF may play a role in the
      ontogenesis of the human thymus as well as in the histogenesis of thymomas.

PMID- 8365714
TI  - Granulomatous gastritis: a morphological and diagnostic approach.
AB  - The final diagnosis of granulomatous gastritis is based on morphological findings
      and clinical and laboratory data. Detailed analysis of the morphological features
      of the granulomas together with associated mucosal changes could generate more
      information on aetiology and pathogenesis. Biopsies from 71 patients diagnosed as
      having granulomatous gastritis were reviewed. Thirty-seven of these patients
      (52%) had Crohn's disease. In 18 patients (25%) an isolated granulomatous
      gastritis was diagnosed. In seven patients (10%) the final diagnosis was a
      foreign body reaction. Of the remaining cases, four (7%) corresponded to tumour
      associated granulomas and one case each of sarcoidosis (1%), Whipple's disease
      (1%) and vasculitis-associated disease (1%). Two cases (3%) were unclassifiable.
      The granulomas were mainly found in the antrum (64% antrum only, 11% antrum and
      corpus, 6% transitional mucosa corpus-antrum). Granulomas were usually small.
      This was particularly true for those found in patients with Crohn's disease.
      Multiple granulomas were observed in the sarcoidosis, the Whipple's disease and
      vasculitis-associated cases. A pattern of chronic gastritis with atrophy was
      present in 95% of the biopsies (68/71 patients). Helicobacter pylori was detected
      in 92% of the biopsies (64/71 patients).

PMID- 8365715
TI  - Prolapse-induced inflammatory polyps of the colorectum and anal transitional
      zone.
AB  - A clinicopathological study of polypoid lesions of the lower gastrointestinal
      tract from 12 patients was undertaken. Clinically, the majority had signs and
      symptoms of rectal prolapse despite having a variety of other primary diagnoses
      (e.g. carcinoma of the bowel or diverticular disease). Three patients were
      asymptomatic. The polyps were more common in females and were usually solitary.
      Histologically, fibrin 'caps', fibromuscular hypertrophy and obliteration of the
      lamina propria, goblet cell hypertrophy and serrated tubules were consistently
      noted. The fibromuscular tissue often extended into the lamina propria in a
      radial fashion. This study shows that mucosal prolapse underpins a variety of
      lesions that are part of a histological spectrum of changes. Inflammatory
      cloacogenic polyps, inflammatory 'cap' polyps, polypoid prolapsing mucosal folds
      of diverticular disease and inflammatory myoglandular polyps are all due to
      mucosal prolapse.

PMID- 8365716
TI  - Primary stromal sarcoma of the thymus with areas of liposarcoma.

PMID- 8365717
TI  - Uterine tumour resembling ovarian sex cord tumour: evidence for smooth muscle
      differentiation.

PMID- 8365718
TI  - Malignant mesenchymoma of the kidney.

PMID- 8365719
TI  - Intratubular germ cell neoplasia in an infantile testis.

PMID- 8365720
TI  - The origin of cytologically unidentifiable chromosome abnormalities: six cases
      ascertained by targeted chromosome-band painting.
AB  - De novo chromosome structural abnormalities cannot always be diagnosed by the use
      of standard cytogenetic techniques. We applied a previously developed chromosome
      band-specific painting method to the diagnosis of such rearrangements. The
      diagnostic procedures consisted of microdissection of an aberrant chromosomal
      region of a given patient, polymerase chain reaction (PCR) amplification of the
      dissected chromosomal DNA, and subsequent competitive fluorescence in situ
      hybridization (FISH) using the PCR products as a probe pool on metaphase
      chromosomes from the patient and/or a karyotypically normal person. With this
      strategy, we studied 6 de novo rearrangements (6p+, 6q+, 9p+, 17p+, +mar, and
      +mar) in 6 patients. These rearrangements had been seen by conventional banding
      but their origin could not be identified. In all 6 patients, we successfully
      ascertained the origin. Using an aberrant region-specific probe pool, FISH
      signals appeared on both the aberrant region and a region of another specific
      chromosome pair. A reverse probe pool that was generated through the
      microdissection of normal chromosomes at a candidate region for the origin of the
      aberration hybridized with both the aberrant and the candidate regions. We thus
      diagnosed one patient with 17p+ as having trisomy for 14q32-qter, one with 9p+ as
      having trisomy for 12pter-p12, one with 6q+ as having a tandem duplication
      (trisomy) of a 6q23-q25 segment, one with 6p+ as having a tandem duplication
      (trisomy) of a 6p23-q21.3 segment, one with a supernumerary metacentric marker
      chromosome as having tetrasomy for 18pter-cen, and the last with an additional
      small marker chromosome as having trisomy for 18p11.1 (or p11.2)-q11.2. The
      present targeted chromosome-band-painting method provides the simple and rapid
      preparation of a probe pool for region-specific FISH, and is useful for the
      diagnosis of chromosome abnormalities of unknown origin.

PMID- 8365722
TI  - Physical mapping of chromosome 3p25-p26 by fluorescence in situ hybridisation
      (FISH).
AB  - As part of our effort to isolate and characterise the von Hippel-Lindau (VHL)
      disease gene, we constructed a physical map of chromosome 3p25-26 by fluorescence
      in situ hybridisation (FISH) studies on a panel of cytogenetic rearrangements
      involving this region. Biotinylated cosmid and lambda probes were hybridised to
      metaphase chromosome spreads and positioned with respect to each cytogenetic
      breakpoint. These studies unequivocally established the order of five loci linked
      to the VHL disease gene: cen-(RAF1,312)-D3S732-D3S1250-D3S601-D3S18 -pter and
      determined the position of three other probes within this map. These results
      ordered RAF1 and D3S732 for the first time, confirmed the localisation of D3S1250
      between RAF1 and D3S601 and determined the position of D3S651 with respect to
      other chromosome 3p25-p26 loci. The establishment of an ordered set of
      cytogenetic aberrations will enable the rapid assignment of polymorphic and
      nonpolymorphic cloned sequences within the chromosome region 3p25-p26.

PMID- 8365721
TI  - Rearrangements between irradiated chromosomes in three-species radiation hybrid
      cell lines revealed by two-color in situ hybridization.
AB  - A human-hamster hybrid cell line containing only the human X chromosome
      (GM06318B) was exposed to 6,000-7,000 rad of X-rays and fused with a mouse cell
      line (CL1D,TK-). Three radiation hybrids, LXKC40, LXKC50, and LXKC56, were
      selected among 39 independent clones containing human material. Two-color in situ
      hybridization with total genomic DNA probes (cot1 human DNA and hamster total
      genomic DNA) was used to analyse the irradiated chromosome rearrangements. With
      this three-species model system (human-hamster-mouse) and the chromosome painting
      process it was possible to determine the origin of each chromosomal fragment in
      metaphase and interphase. The results obtained indicate preferential
      rearrangement between irradiated human and hamster chromosomes. Whole, apparently
      intact hamster chromosomes were observed in all the mitoses. We suggest that
      these chromosomes could be neoformated from random fragments after irradiation.
      Hamster and human "minichromosomes" were also detected. While the integration of
      human material into the mouse genome was exceptional, the integration of hamster
      material into mouse chromosomes was more frequent. During interphase the
      irradiated chromosome domains were often at the periphery of the nucleus.
      Irradiated material protruded at the periphery of the nuclei. Micronuclei
      containing hamster material were detected in the vicinity of these protrusions.

PMID- 8365723
TI  - Presence of telomeric and subtelomeric sequences at the fusion points of ring
      chromosomes indicates that the ring syndrome is caused by ring instability.
AB  - In situ hybridization of a telomeric (TTA-GGG)n sequence to metaphases from three
      cases of ring chromosome, involving respectively chromosomes 4, 16, and 20,
      showed the presence of the cognate sequences in all three rings. To investigate
      whether these ring chromosomes originated by telomere-telomere fusion, we
      determined, by in situ hybridization, whether telomere-associated sequences
      and/or specific distal sequences were still present in the ring chromosomes. The
      finding that these sequences were preserved in all the ring chromosomes strongly
      indicates that they originated by telomere-telomere fusion. All three subjects
      carrying the ring chromosomes are affected by the so-called ring syndrome, with
      failure to thrive, minor dysmorphic signs and no major anomalies. The r(4)
      patient has the ring in mosaic form with a normal cell line and has normal
      intelligence. The r(16) and the r(20) patients have moderate mental retardation
      and suffer from seizures. We conclude that the ring syndrome, even in its more
      severe manifestation, is caused by ring chromosome instability.

PMID- 8365724
TI  - Altered CYP21 genes in HLA-haplotypes associated with congenital adrenal
      hyperplasia (CAH): a family study.
AB  - Disorders of the CYP21 gene, which is located within the major histocompatibility
      complex on the short arm of chromosome 6, are the leading causes of congenital
      adrenal hyperplasia (CAH). The coding gene and a highly homologous pseudogene are
      tandemly arranged with the two genes for the fourth component of complement (C4A
      and C4B). To analyse the prevalence rates of mutations of the CYP21 genes and the
      segregation of the CYP21 genes with their corresponding human leucocyte antigen
      (HLA)-haplotypes, 21 families with one or two children with the severe form of 21
      hydroxylase deficiency were studied. Mutations of the CYP21 gene on their
      corresponding HLA-haplotype were detected by hybridisation of polymerase chain
      reaction (PCR)-amplified genomic DNA with sequence-specific oligonucleotides and
      solid phase direct sequencing. Our study has shown the following. (1) A single
      basepair mutation (A-->G or C-->G) within the second intron is the most frequent
      mutation leading to impaired 21-hydroxylase activity. This mutation is only
      detected in HLA-haplotypes associated with the salt-wasting form of CAH. (2) A
      large deletion of part or all of the CYP21 gene is associated with the HLA
      haplotype A3, BW47, C6, DR7, DR53, DQ2 but is also observed in other HLA
      haplotypes and can be detected by a simple rapid PCR restriction fragment length
      polymorphism method. (3) Two alleles of the coding CYP21 gene differing in a
      leucine codon within the first exon, (formerly described as a mutation associated
      with 21-hydroxylase deficiency) have been found with an equal distribution in
      patients with 21-hydroxylase deficiency, non-disease HLA-haplotypes and the local
      healthy controls.

PMID- 8365725
TI  - Recurrent mutations in the factor IX gene: founder effect or repeat de novo
      events. Investigation of the German haemophilia B population and review of de
      novo mutations.
AB  - The investigation of 114 unrelated patients, representing about half the sample
      of the German haemophilia B population, enabled us to delineate the causative
      mutation in 103 (90.4%) haemophilic factor IX genes. Of these 103 cases 84
      (81.6%) turned out to be unique molecular events, the remainder being repeats.
      Haplotype analysis revealed that the great majority, if not all, of these
      recurrent observations occurred independently. This conclusion is supported by
      our finding that three de novo mutations could be demonstrated at two sites of
      frequent mutation. A further 20 de novo events could be established in an
      unselected sample of 37 families with sporadic haemophilia B and 37 families with
      a history of the disease. Altogether, the germ line of origin could be determined
      in 21 of these 23 cases, thereby indicating a ratio of male to female mutation
      rates close to 2. On the basis of the data available, it is becoming clear that
      rearrangements in the factor IX gene (35.4% of de novo cases) are responsible for
      haemophilia B at a higher frequency than has been observed today (12.3%). More
      than two-thirds of the de novo cases cause the severe form of the disease,
      thereby reflecting the deficit of these haemophilic genes in the actual gene pool
      because of excess mortality in the past. In addition 40% (12/30) of the de novo
      single-base mutations were transitions at CpG dinucleotides. Compared with the
      expected at-random frequency, this observation indicates an 83-fold enhancement
      of mutation at CpG.

PMID- 8365726
TI  - Four novel gene mutations in five Japanese male patients with neonatal or late
      onset OTC deficiency: application of PCR-single-strand conformation polymorphisms
      for all exons and adjacent introns [corrected].
AB  - Ornithine transcarbamylase deficiency (OTC), the most common inborn error of the
      urea cycle, shows an X-linked inheritance with frequent new mutations. Southern
      blots reveal only a small percent of the mutation, but amplification of cDNA or
      genomic DNA using the polymerase chain reaction (PCR) followed by DNA sequencing,
      has contributed greatly to overcoming this difficulty. Problems remaining are the
      limited availability of fresh liver samples for preparation of intact mRNA in the
      former case, and there are primer sequences for PCR for only some exons in the
      latter case. Here, we report the structures of intron sequences which are long
      enough to analyze all exons and adjacent introns of the OTC gene using PCR and
      PCR single-strand conformation polymorphisms (PCR-SSCP). We carried out a DNA
      analysis of findings in five Japanese male patients with neonatal or late onset
      form. Five patients had mutations in the protein coding region. C to G (S192R), A
      to T (D196V), A to G (T264A), T to C (M268T), and C to T (R277W) substitutions.
      The first four of these were novel missense mutations and the presence of the
      mutation was confirmed in the corresponding families.

PMID- 8365727
TI  - No relationship between genetic instability in Bloom's syndrome and DNA
      hypomethylation of some major repetitive sequences.
AB  - Bloom's syndrome (BS) is an autosomal recessive disorder, characterized by a high
      incidence of cancer at a young age. Cytogenetically, BS cells exhibit a high
      frequency of chromosomal damage and sister chromatid exchange (SCE). Thus, BS
      provides a human model of a genetic disorder exhibiting both chromosomal
      instability and a high incidence of cancer. In addition to its involvement in
      gene regulation, CpG methylation has recently been suggested to play an important
      role in the evolution and stability of chromosome structure. We have examined DNA
      methylation profiles of total DNA and some selected repeated sequences in normal
      and BS cells. No specific DNA hypomethylation in either total blood or
      lymphoblastoid cell lines from BS patients has been detected, suggesting that the
      genomic instability observed in BS is not directly related to a major DNA
      demethylation of the total CCGG sites, or of Alu or chromosome 1 satellite 2
      repeated sequences.

PMID- 8365728
TI  - G2 phase cell cycle disturbance as a manifestation of genetic cell damage.
AB  - The predominant cell cycle change induced by X-rays and clastogens in peripheral
      blood mononuclear cells is the accumulation of cells in the G2 phase of the cell
      cycle. We show that this accumulation consists of cells that are either delayed
      or arrested within the G2 phase. Since both X-rays and DNA crosslinking chemicals
      are known to damage DNA, the G2 phase inhibition caused by these agents is
      thought to be one of the primary manifestations of (unrepaired) DNA damage. This
      interpretation is supported by two additional findings. (1) Older individuals
      have elevated baseline levels of mononuclear blood cells that are delayed and/or
      arrested in the G2 phase of the cell cycle. This coincides with the increased
      chromosomal breakage rates reported for older individuals. (2) Irrespective of
      their age, individuals with inherited genetic instability syndromes (such as
      Fanconi anemia and Bloom syndrome) exhibit elevated G2 phase cell fractions. We
      show that the method used to detect such induced or spontaneous cell cycle
      changes, viz. BrdU-Hoechst flow cytometry, is a rapid and highly sensitive
      technique for the assessment of genetic cell damage.

PMID- 8365730
TI  - Four new nucleotide sequence polymorphisms in the LDL receptor gene detected by
      SSCP analysis.
AB  - Seven nucleotide sequence polymorphisms were detected within exons of the low
      density lipoprotein (LDL) receptor gene using single-strand conformation
      polymorphism (SSCP) analysis followed by direct sequence analysis on amplified
      DNA. Four nucleotide changes at nucleotide positions 1617, 1725, 2232, and 2635
      were new nucleotide sequence polymorphisms not previously described. The
      remaining three nucleotide changes were identical with restriction fragment
      length polymorphisms and a previously reported nucleotide sequence polymorphism.
      These nucleotide sequence polymorphisms, detectable by SSCP analysis, are useful
      genetic markers for linkage analysis of the LDL receptor gene and familial
      hypercholesterolemia.

PMID- 8365729
TI  - The human complement component C8B gene: structure and phylogenetic relationship.
AB  - The eighth component of human complement (C8) is a serum protein that consists of
      three chains (alpha, beta and gamma), encoded by three separate genes, viz., C8A,
      C8B, and C8G. In serum, the beta-subunit is non-covalently bound to the disulfide
      linked alpha-gamma subunit. Using a full-length C8 beta cDNA probe, we isolated
      several clones from human genomic lambda DNA libraries. Four lambda clones
      covering the complete cDNA sequence were characterized by TaqI restriction
      mapping and were "shotgun" subcloned into M13. C8 beta-cDNA-positive clones were
      partially sequenced to characterize the 12 exons of the gene with sizes from 69
      to 347 bp. All intron-exon junctions followed the GT-AG rule. By using polymerase
      chain reaction (PCR) primers located in the adjacent intron sequences, all 12
      exons of the C8B gene could be amplified from genomic DNA. All fragments showed
      the expected sizes. The sizes of eight introns could be determined by using
      primer pairs that amplified two exons and the enclosed intron, and by restriction
      mapping. These analyses and the insert sizes of the genomic lambda clones
      indicate that the C8B gene has a total size of approximately 40 kb. The
      polymorphic TaqI site of the C8B gene localized in intron 11 could be
      demonstrated by direct restriction fragment analysis of a PCR fragment containing
      exons 11 and 12, and the enclosed intron 11. Homology comparison of the C8B gene
      with C8A and C9 on the basis of the exon structure confirmed the ancestral
      relationship known from the protein level.

PMID- 8365731
TI  - Alpha-thalassemia in the four major aboriginal groups in Taiwan.
AB  - A total of 1309 unrelated blood samples from four major Taiwan aboriginal groups,
      including 522 of the Ami, 246 of the Bunun, 227 of the Atayal, and 214 of the
      Paiwan groups, were collected. Subjects with a mean corpuscular volume below 85
      fl and Hb A2 values below 3.5% were further studied with Southern hybridization
      to determine the status of alpha-globin genes. In the Ami, 43 (4.1%) chromosomes
      had alpha-thalassemia 1 and 43 (4.1%) had alpha-thalassemia 2. Of the 43 alpha
      thalassemia 1 chromosomes, 33 were of the Thailand, one of the Philippine, and
      nine of the Southeast Asian deletion. Of the 43 alpha-thalassemia 2 chromosomes,
      42 were of the type I rightward deletion and one was of leftward deletion. In the
      Bunun group, one chromosome (0.2%) was of the Thailand deletion and two (0.4%)
      were of type I rightward deletion. In the Atayal group, only one chromosome
      (0.2%) was of the Philippine deletion. In the Paiwan group, four chromosomes
      (0.9%) were of the Southeast Asian deletion and three (0.7%) were of the Thailand
      deletion. Among the four groups, the Ami had the highest prevalence of alpha
      thalassemia, which was also higher than that of the Chinese living in Taiwan.

PMID- 8365732
TI  - Absence of linkage to the ataxia telangiectasia locus in familial breast cancer.
AB  - Heterozygotes for ataxia-telangiectasia (AT) are known to have an increased risk
      of breast cancer. The gene (or genes) responsible for almost all cases of AT has
      been localised to chromosome 11q by genetic linkage analysis. To examine the
      possibility that AT heterozygosity may account for a substantial proportion of
      familial breast cancer, we have typed five markers on chromosome 11q in 16 breast
      cancer families. We have found no evidence for linkage between breast cancer and
      chromosome 11q markers and conclude that the contribution of AT to familial
      breast cancer is likely to be minimal.

PMID- 8365733
TI  - Newer interventional devices.

PMID- 8365734
TI  - Transcatheter ablation of ventricular tachycardia arising from right ventricular
      outflow tract.
AB  - Two patients with recurrent episodes of symptomatic, sustained monomorphic
      ventricular tachycardia (VT) resistant to medical therapy underwent catheter
      ablation for the relief of VT. One patient had arrhythmogenic right ventricular
      dysplasia while the other had no structural heart disease. The VT had left bundle
      branch block morphology with normal axis in both the patients. The cycle length
      during VT was 260 msec and 270 msec respectively. Site for ablation was guided by
      pacemapping and the target site was identified in the right ventricular outflow
      tract in both the patients. Two cathodal shocks of 200 J in the first patient and
      one shock of 200 J in the second patient resulted in abolition of the arrhythmia.
      At repeat electrophysiologic testing at 7 days in the first patient and at 8
      months in the second, VT was not inducible despite three extrastimuli from two
      right ventricular sites. Over a follow up of 24 and 26 months respectively, there
      has been no recurrence without any antiarrhythmic therapy. There were no acute or
      long term complications. In conclusion, catheter ablation offers a cure in
      patients with right ventricular tachycardia resistant to antiarrhythmic drugs.

PMID- 8365735
TI  - Antihypertensive therapy and J curve.

PMID- 8365736
TI  - Sternal wound infection after myocardial revascularization with internal mammary
      artery.
AB  - The use of the bilateral mammary artery in myocardial revascularisation in
      diabetic patients has been thought to increase the risk of sternal wound
      infection. We studied unilateral IMA grafting retrospectively in 701 consecutive
      patients to determine the incidence of sternal wound infection. One hundred and
      six patients were diabetic; 595 were non-diabetic. Both groups of patients were
      comparable for age, number of bypasses, and cardiopulmonary bypass time. No
      patient in the diabetic group developed mediastinitis; two patients of 595 in the
      non-diabetic group (0.3%) developed mediastinitis. Incidence of subcutaneous
      wound infection was slightly higher in the diabetic group than in the non
      diabetic group (2% vs 0.3%) but was not statistically significant. We conclude
      that unilateral internal mammary artery grafting in diabetics is not associated
      with increased risk of sternal wound infection and should remain the conduit of
      choice for myocardial revascularization.

PMID- 8365737
TI  - Percutaneous intraaortic balloon pulsation for management of life threatening
      emergencies in an intensive coronary care unit.
AB  - The indications for the outcome of use of intraaortic balloon pulsation (IABP) in
      66 patients (65 males, 1 female), in addition to the usual conventional medical
      therapy, are reported here. IABP was used for treatment of cardiogenic shock (5
      patients), acute myocardial infarction with rupture of interventricular septum (2
      patients), acute myocardial infarction with refractory left ventricular failure
      (2 patients), resistant ventricular tachyarrhythmias (5 patients), refractory
      angina (50 patients) and for hypotension following high risk coronary angiography
      (2 patients). A Datascope 10.5 F percutaneous balloon was inserted in all, mostly
      using the left femoral artery. Either definitive treatment (coronary artery
      bypass surgery or coronary angioplasty) was offered when feasible or the balloon
      was weaned off. Twelve patients underwent coronary angiography on IABP; while 31
      patients had undergone the angiography earlier. Surgery was possible in 33
      patients with 90% survival rate. The non surgical group showed 30% survival rate.
      The complications of IABP encountered were: leg ischaemia (2 patients),
      septicemia (4 patients) and balloon rupture (2 patients). Our experience suggests
      that percutaneous IABP is a very useful management procedure for seriously sick
      high risk patients prior to definitive therapy. Patients who could have a
      definitive treatment while on IABP, especially the group with refractory angina,
      did best on a short term follow up. Vascular complications are minimal while on
      IABP.

PMID- 8365738
TI  - Does any correlation exist between a high plasma digoxin concentration and an
      electrocardiogram in younger and older patients.
AB  - In a group of 152 elderly patients (age range between 65 to 92 years) and 54
      patients (aged 35 to 64 years) plasma digoxin level measuring 2.5-6.2 nmol/1 were
      correlated with the clinical symptoms and the electrocardiogram. The conduction
      disturbances and arrhythmias as well as the P-R interval, P-T-Q index and
      corrected Q-T interval in the ECG were analyzed. The clinical symptoms of
      hypersaturation with digitalis were present in 54.6% of the elderly and 35.2% of
      the younger patients. Conduction disturbances were found in 42% of the elderly
      and 22.2% of the younger patients, while arrhythmias appeared in 40.1% of the
      elderly and 31.5% of the younger ones. 17.8% of the elderly and 46.3% of the
      younger patients were without these changes. The correlation between P-R interval
      and high plasma digoxin level in the elderly (p < 0.01) and younger patients (p <
      0.05), as well as between the P-T-Q index and high plasma digoxin level in the
      elderly (p < 0.01) was found. There was no correlation between the corrected Q-T
      interval and high plasma digoxin level in both groups. No correlation was found
      between a high plasma digoxin level and serum creatinine level in both groups,
      neither between a high plasma digoxin level and serum potassium level in both
      groups. The effect of digitalis has not been shown to be a cause of specific
      changes in an electrocardiogram neither in the elderly nor in younger patients.
      However, the association between prolonged P-R interval as well as changes in the
      P-T-Q index and high plasma digoxin level has been found more often in the
      elderly than in the younger patients.

PMID- 8365739
TI  - Mitral valve area by colour flow imaging.
AB  - Colour Doppler assessment of mitral valve area was carried out in 78 patients
      with mitral stenosis. The mitral valve area was calculated using the equation
      pi/4 (a x b), where a = color jet width at the mitral valve in the apical long
      axis view and b = width of the color jet in a 90 degree rotated view from the
      apex. The valve area obtained from the color jet was compared with the valve area
      obtained from the pressure half time. It was found that there was a good
      correlation between these two measurements (r = 0.82; p < 0.001) while 2D echo
      derived mitral valve area correlated at an r value of 0.80 (p < 0.001). It is
      concluded that the new method can be used as an adjunct to currently available
      methods to assess the severity of mitral stenosis.

PMID- 8365740
TI  - Intracardiac autonomic ganglion cells in leprosy and dilated cardiomyopathy.
AB  - Disturbances in cardiac autonomic functions are known to occur in patients of
      lepromatous leprosy and dilated cardiomyopathy. We have analyzed the number of
      cardiac autonomic ganglion cells in patients of lepromatous leprosy (2 cases),
      dilated cardiomyopathy (2 cases) and compared with those of control subjects (2
      cases). The average number of ganglion cells in cases of dilated cardiomyopathy
      (1164) and leprosy (1138) did not show any significant deviation from the average
      neuronal number of control subjects (1352).

PMID- 8365741
TI  - Endomyocardial biopsy--its evaluation in cardiac disorders.
AB  - Endomyocardial biopsies (EMBs) of 47 patients with various cardiac disorders were
      analysed. Clinically 26 patients were diagnosed as having dilated cardiomyopathy
      (DCM), 9 myocarditis, six restrictive heart disease and six as Duchenne muscular
      dystrophy. EMB showed normal histological picture in six cases of DCM and
      findings consistent with DCM in rest of the twenty cases. None of these biopsies
      showed evidence of myocarditis. Diagnosis of myocarditis could be confirmed on
      EMB only in three out of nine clinically diagnosed cases. Cases with restrictive
      heart disease showed normal biopsy in two, infarction in one, findings consistent
      with endomyocardial fibrosis in one and amyloidosis in two cases. EMB on six
      cases of Duchenne muscular dystrophy showed nonspecific histological changes. To
      conclude, in this series, cases of DCM did not show evidence of underlying
      myocarditis in endomyocardial biopsies.

PMID- 8365743
TI  - Mitral and pulmonary balloon valvotomy in pregnant patients.
AB  - Two pregnant patients, one each with mitral and pulmonary valvar stenosis,
      underwent successful balloon valvotomy during their third trimester. Single
      balloon technique was utilised in both and this resulted in a short procedure and
      fluoroscopy time (9 minutes in patient with mitral stenosis and 3.5 minutes in
      pulmonary stenosis). The procedure produced satisfactory hemodynamic and
      symptomatic benefits in both cases with no complications. The patient remained
      asymptomatic without medications and delivered healthy full term babies at term.
      Balloon valvotomy is feasible, effective, and safe during pregnancy and should be
      considered as an alternative to surgery in symptomatic patients refractory to
      medical therapy.

PMID- 8365742
TI  - A clinico-hematological study of iron deficiency anemia and its correlation with
      hyperviscosity symptoms in cyanotic congenital heart disease.
AB  - The present study was carried out in 33 cases of cyanotic congenital heart
      disease (CCHD) to determine the prevalence of iron deficiency anemia (IDA) and
      its correlation to hyperviscosity symptoms in terms of hematocrit levels.
      Furthermore, the study was aimed at assessing the response to low dose iron
      therapy (60 mg of elemental iron once daily) in relieving symptoms of
      hyperviscosity. All these cases were evaluated for presence of symptoms of
      hyperviscosity and later subjected to various hematological & biochemical
      parameters of iron deficiency anemia including hemoglobin (Hb), pack cell volume
      (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration
      (MCHC), serum iron, total iron binding capacity respectively. Results showed
      presence of IDA in 6/33 cases (18.2%) and hyperviscosity symptoms in 10/33 cases
      (30.3%). Amongst the group with symptoms of hyperviscosity, in the subset having
      IDA these symptoms were observed at PCV levels of 0.52 L/L to 0.58 L/L in
      contrast to the subset not deficient in iron where the symptoms occurred at a PCV
      0.68 L/L. Relief of symptoms of hyperviscosity was evident with a minimal rise of
      mean hemoglobin by 2.1 gm/dl. It was concluded that IDA was not an uncommon
      finding in CCHD cases and that it leads to symptoms of hyperviscosity at a level
      of PCV much lower than those known to produce these symptoms. Finally low dose
      iron therapy was found effective in relieving the symptoms of hyperviscosity.

PMID- 8365744
TI  - Two-dimensional echocardiographic diagnosis of subaortic aneurysm.
AB  - Subaortic aneurysms are uncommon and most cases have been reported among black
      Africans. The present report relates to our experience with three patients having
      subaortic annular aneurysms, two of congenital origin and one following infective
      endocarditis of the aortic valve. The role of transthoracic 2- dimensional
      echocardiography in the diagnosis is emphasized.

PMID- 8365745
TI  - Multiple hydatid cysts involving the heart, pulmonary trunk and aorta.

PMID- 8365746
TI  - Primary leiomyosarcoma of the left atrium.

PMID- 8365747
TI  - Intravenous thrombolytic therapy in unstable angina.
AB  - One hundred consecutive age and sex-matched patients of 3 different subsets of
      unstable angina (recent onset angina -65, crescendo angina -20, post-infarct
      angina-15) were randomized 1:1 after coronary angiography to receive I.V., either
      1.5 x 10(6) units of streptokinase (SK) in 200 ml of normal saline or 200 ml of
      normal saline alone (control) in 1 hour. Repeat angiography was done in those
      patients having intra-coronary thrombi (37.3%) during the initial angiography.
      Both groups received optimal doses of heparin followed by warfarin, aspirin and
      other standard drugs and were followed up for 6 months. Anginal pain subsided
      significantly in the SK group-41 (82%) vs 25 (50%) (P < 0.005), especially in
      patients with recent onset angina (92.5% vs 60%, P < 0.005). Incidence of acute
      myocardial infarction (AMI) was much less in the SKgp (4(8%) vs 17 (34%) (p <
      0.05). Four cases of fatal MI and four cases of sudden cardiac death (SCD)
      occurred in the control group against none in the SKgp. Requirements of
      mechanical revascularization was significantly less (P < 0.05) in the SK gp.
      Angiographic evidence of partial or complete clot lysis was noted in 90% of SK
      gp. vs 4.8% of control (P < 0.01). Echocardiographically assessed LV function
      improved significantly with SK-therapy in recent onset (P < 0.05) and crescendo
      angina (P < 0.001) subsets--however, the improvements in post infarct angina
      subset were not statistically significant. The beneficial outcome with SK therapy
      was observed in patients irrespective of angiographic evidence of
      thrombi.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365748
TI  - Balloon dilatation of native coarctation of aorta in infancy: immediate and
      follow up results.
AB  - We attempted balloon dilatation of native coarctation of aorta in 11 consecutive
      neonates and infants (age range 28 days-12 months, mean 4.6 +/- 4 months, all
      males) presenting with congestive heart failure. The peak to peak aorto-aortic
      systolic pressure gradient fell from 60 +/- 21 mmHg to 13 +/- 7 mmHg (range 0-30
      mmHg) (p < 0.001). The diameter of coarcted segment increased from 2.5 +/- 0.65
      mm (range 2-3.4 mm) to 5.4 +/- 0.9 mm (range 4-6.4 mm) (p < 0.001). No patient
      required surgical intervention. The peak instantaneous aorto-aortic systolic
      Doppler pressure gradient at 17.5 +/- 8.8 months (range 2-21 months) did not show
      any significant change (mean 17.5 +/- 8.89 mmHg range 0-30 mmHg). All patients
      except one showed improvement in congestive heart failure. None developed
      restenosis. On the basis of this experience we recommend that balloon dilatation
      of native coarctation of aorta in infants in congestive heart failure is a safe
      and effective procedure.

PMID- 8365749
TI  - Aortic valve replacement with concomitant open mitral valvotomy--early results
      and long term followup in 72 consecutive patients.
AB  - Experience with 72 consecutive subjects, who underwent aortic valve replacement
      with open mitral valvotomy is presented. Mean age was 30 years and history of
      rheumatic fever was forthcoming in 80%. 91.7% patients had aortic regurgitation-
      with or without aortic stenosis. 45% patients had pulmonary hypertension. Starr
      Edwards (51.4% and Bjork Shiley valves (45.8%) were commonly used. There were no
      early deaths. All patients were followed up for 1 to 19 years (mean = 9 years).
      There were 4 (5.5%) late deaths. 4.1% patients developed mild restenosis of the
      mitral valve over a mean period of 8 years and 1.04% developed mitral
      regurgitation mandating mitral valve replacement. A notable feature of this
      series is the low incidence of thromboembolism-free lives at upto 10 years
      followup despite receiving only aspirin in place of coumarin anticoagulation. We
      believe aortic valve replacement and open mitral valvotomy is a worthy
      alternative to double valve replacement in view of its zero hospital mortality,
      low late mortality, low incidence of restenosis, low thromboembolic episodes and
      the avoidance of coumarin anticoagulation.

PMID- 8365750
TI  - Limitations of using arterial conduit for myocardial revascularization in
      patients with combined coronary and other arterial lesions.
AB  - To explore the limitations of using arterial conduit for myocardial
      revascularization in patients with combined coronary and other arterial lesions,
      we evaluated 195 patients with combined lesions undergoing CABG, either alone or
      in combination with peripheral vascular reconstruction between October 1987 to
      October 1990. Doppler flow and spectral analysis revealed that 14 patients (7.1%)
      had atherosclerotic lesions of the subclavian artery, in whom ipsilateral
      internal mammary artery pedicle graft was contraindicated for myocardial
      revascularization. Out of 195 patients, 165 patients were subjected for
      aortography, 18 of whom (10.9%), revealed atherosclerotic involvement of the
      celiac trunk, thereby contraindicating the use of gastroepiploic artery for
      myocardial revascularization. Thus in our experience use of arterial conduit for
      myocardial revascularization in patients with combined coronary and other
      arterial lesions is limited.

PMID- 8365751
TI  - Pattern of hypertrophy of left ventricle--a histometric analysis of eighteen
      cases.
AB  - The pattern of myocardial hypertrophy in different sites of the left ventricular
      wall was morphometrically analysed in aortic stenosis (6 cases), hypertensive
      hypertrophy (5 cases), mitral incompetence (4 cases), and dilated cardiomyopathy
      (3 cases). The diameter of individual circumferentially oriented mid wall (or
      middle) fibre was significantly greater than those of subepicardial and
      subendocardial zones. Thus, hypertrophy does not affect the entire left
      ventricular myocardium uniformly. It seems to vary according to the spatial
      configuration of the fibrosis in relation to the cavity.

PMID- 8365752
TI  - Influence of cessation of smoking on long term mortality in patients with
      coronary heart disease.
AB  - Cessation of smoking in patients with coronary artery disease (CAD) has shown
      variable results. The long term mortality in patients of coronary heart disease
      (CHD) who quit smoking following diagnosis of their disease has been variable. We
      have analysed the long term effects of cessation of smoking on mortality in a
      cohort of 173 patients with CAD and compared the mortality of this group with 299
      nonsmokers and 52 current smokers. The baseline data were identical for major
      risk factors like age, hypertension, diabetes, cholesterol levels, and congestive
      heart failure among the three groups (p > 0.1). There were more patients with
      previous myocardial infarction in past (38.7%) and current smokers (40.4%) than
      among nonsmokers (25.4%). All patients were followed for a period extending upto
      11 years. The mean duration of follow up was 6.81 +/- 2.95 years in non-smokers,
      5.98 +/- 2.94 years in exsmokers, and 6.32 +/- 3.44 years in current smokers.
      Actuarial analysis shows that overall mortality was significantly more among
      exsmokers than nonsmokers (Logrank test = 3.72, 1p < 0.05). The exsmokers showed
      similar mortality as current smokers during the first three years of follow up
      (Logrank test = 1.10, 1p < 0.1); but afterwards the mortality was significantly
      less in exsmokers than in current smokers (Logrank test = 6.29, 1p < 0.025).
      However, the overall mortality was lowest in nonsmokers when compared to that of
      exsmokers and current smokers (Logrank test = 3.92, p < 0.05). The total
      mortality was 28.1% in nonsmokers, 32.4% in exsmokers, and 46.2% in current
      smokers. The incidence of sudden death was, however, similar in all the
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365753
TI  - Non-bacterial thrombotic vegetation mimicking a left ventricular outflow tumor.

PMID- 8365754
TI  - Ectopia cordis: report of two cases.

PMID- 8365755
TI  - Functional and histological abnormalities of the left ventricle in Ebstein's
      anomaly of the tricuspid valve.

PMID- 8365756
TI  - A case report of primary chylopericardium.

PMID- 8365757
TI  - Aspirin in ischemic heart disease--an overview.
AB  - Aspirin is one of the oldest and most commonly used nonprescription drugs in the
      world. Although commonly it is used for relief from common headache and muscular
      pain, its use in the prevention and treatment of platelet related complications
      in cardiovascular diseases (CVD) and cerebrovascular disease (CBVD) is quite
      controversial. A brief review of the major aspirin trials indicated that a full
      strength aspirin taken daily had no significant beneficial effect in reducing
      mortality of patients with CVD/CBVD. However, two major trials (ISIS-2, PHS) in
      which either low dose aspirin (160 mg) or one aspirin administered every other
      day, have demonstrated significant reduction in fatal and nonfatal cardiovascular
      events. Even a dose as low as 1 mg aspirin per day significantly lowers platelet
      thromboxane synthesis. As a result of these studies, low dose aspirin should be
      the choice of prophylactic therapy aimed at the inhibition of platelet
      cyclooxygenase activity. Controlled-release low dose aspirin may favorably reduce
      platelet thromboxane production and spare vascular prostacyclin synthesis. At
      least 100 mgs of aspirin per day are essential to completely inhibit steady state
      thromboxane formation. Low dose aspirin (160 mgs) has been shown to be as
      effective as the full strength aspirin (325 mgs) in reducing clinical
      complications related to platelet activation. The antithrombotic effect of
      aspirin is well established and improved formulations, well thought out
      therapeutic protocols, customized dosage, appropriate timing of delivery, a
      better understanding of platelet function and pathophysiology of CUD/CBUD will
      facilitate maximization of the beneficial effects of aspirin.

PMID- 8365758
TI  - Color Doppler echocardiographic assessment of Sorin mitral prosthetic valve.
AB  - Doppler echocardiographic characteristics of 57 normally functioning Sorin
      prosthetic valves (a tilting valve) in the mitral position were studied in the
      early postoperative period. The three valve sizes (in mm) studied were: 25 (n =
      15), 27 (n = 32) and 29 (n = 10). The mean gradients (mmHg) and the valve area
      (Sq cm) calculated by pressure half time method) for the three valve sizes were
      3.46 +/- 1.69 and 2.49 +/- 0.26; 3.46 +/- 1.25 and 2.57 +/- 0.44; and 3.2 +/-
      1.23 and 2.55 +/- 0.41; respectively. There was no significant difference in
      gradients and valve area between the three sizes, variations in pressure half
      time and therefore the calculated valve area was large. Color Doppler evaluation
      revealed a bifid nonturbulent jet directed anteriorly towards the
      interventricular septum. 12 patients (20%) had mild valvar and 7 (12%) had
      paravalvar mitral regurgitation (mild in 5 and moderate in 2) without any
      associated prosthetic valve dysfunction. The paravalvar regurgitation persisted
      in all the 5 patients restudied at 5-12 months postoperatively. Sorin prosthetic
      valves have similar gradients and valve area when compared to other disc valves.
      The incidence of of paravalvar regurgitation was slightly higher in our series.
      The limitations of Doppler derived gradients and area of prosthetic valve are
      discussed.

PMID- 8365759
TI  - Evaluation of prosthetic valve function: utility and limitations of echo-Doppler
      studies.

PMID- 8365760
TI  - Role of two-dimensional echocardiography in early diagnosis of suspected acute
      dissection of ascending aorta.
AB  - Seven patients with acute dissection of ascending aorta are presented and the
      role of two-dimensional echocardiography in the early diagnosis of this condition
      is emphasized. There were 5 male and 2 female patients. The mean age of the
      patients was 36.7 +/- 11.2 years. The presenting symptoms were chest pain in 7,
      associated interscapular pain in 4, dyspnoea in 4 and syncopal episodes in 2
      patients. Examination revealed hypertension in 3, pulses paradoxus in 2,
      asymetrically weak carotid and brachial pulses in 3, aortic regurgitation in 5
      and neurological deficit in 2 patients. Echocardiography showed aortic root
      diameter of 42mm and the presence of an intimal flap in all the 7 patients and
      flap oscillations in 6 patients. Echocardiographic evidence of pericardial
      effusion was present in 6, cardiac tamponade in 3, aortic regurgitation in 5 and
      regional left ventricular wall motion abnormality in 1 patient. Surgical
      correction was done in 5 patients with 60% success rate. Two patients received
      only medical treatment. Aortic root dilatation of 60 mm, presence of an
      oscillating flap, evidence of cardiac tamponade and regional wall motion
      abnormality were found to be associated with poor prognosis.

PMID- 8365761
TI  - Studies of cancer in migrant populations.

PMID- 8365762
TI  - Cancer in Italian migrant populations. Sao Paulo, Brazil.

PMID- 8365763
TI  - Italian migration: an overview.

PMID- 8365764
TI  - Cancer in Italian migrant populations. Uruguay.

PMID- 8365765
TI  - Cancer in Italian migrant populations. Australia: mortality study.

PMID- 8365766
TI  - Cancer in Italian migrant populations. New South Wales, Australia.

PMID- 8365767
TI  - Cancer in Italian migrant populations. France.

PMID- 8365768
TI  - Cancer in Italian migrant populations. Geneva, Switzerland.

PMID- 8365769
TI  - Cancer in Italian migrant populations. England and Wales: mortality.

PMID- 8365770
TI  - Cancer in Italian migrant populations. England and Wales: incidence.

PMID- 8365771
TI  - Cancer in Italian migrant populations. Scotland.

PMID- 8365772
TI  - Cancer in Italian migrant populations. Summary of the results by site.

PMID- 8365773
TI  - Cancer in Italy: incidence and mortality.

PMID- 8365774
TI  - Review of studies of cancer in Italian migrants.

PMID- 8365775
TI  - Cancer in Italian migrant populations. Study objectives and protocol.

PMID- 8365776
TI  - Cancer in Italian migrant populations. Statistical methods.

PMID- 8365777
TI  - Cancer in Italian migrant populations. Distribution of risk factors in Italy and
      in the host countries.

PMID- 8365778
TI  - Cancer in Italian migrant populations. Canada.

PMID- 8365779
TI  - Cancer in Italian migrant populations. The United States of America.

PMID- 8365780
TI  - Cancer in Italian migrant populations. Argentina.

PMID- 8365781
TI  - Nephrotic syndrome: present status. II.

PMID- 8365782
TI  - Ultrasound evaluation of kidney dimensions in neonates.
AB  - This study was done to measure normal renal dimensions of neonatal kidney at
      various gestational ages sonographically. Knowledge of these measurements may
      allow earlier diagnosis of a variety of abnormalities. Kidney dimensions (maximum
      longitudinal length, width, and anteroposterior diameter) were measured within 48
      h after birth in 100 healthy neonates with gestational ages from 26.14 to 41.28
      weeks and birth weights from 540 to 3250 g using a real time sector scanner with
      a 7.5 mHz transducer. Renal volume was calculated by volume (V) = L x W x T x
      0.5233. Total body surface area (BSA) was determined by BSA = Wt0.425 x Lt0.725 x
      71.84. Ponderal index was determined by PI = Wt (g) x 100/(Ht[cm])3. On linear
      regression analysis, a highly significant correlation was found between renal
      dimensions and body surface area, gestational age, body weight and length of the
      baby (p < 0.05). On step wise regression analysis, renal dimensions correlated
      only with body surface area and the gestational age of the neonate. Regression
      equations have been provided for rapid computation of renal length, width, and
      thickness in a given case based on body surface area and the gestational age.
      Mean (+/- 2 SD) renal volume and renal length were determined based separately on
      gestational age and body surface area. The data provided can be valuable for
      evaluating renal abnormalities in preterm neonates.

PMID- 8365783
TI  - Intramuscular injection as a provoking factor for paralysis in acute
      poliomyelitis. A case control study.
AB  - In order to identify the role of intramuscular injection (IM) as a provoking
      factor for poliomyelitis, a case control study as done at the Institute of Child
      Health, Madras from May 1988 to May 1989. The case was defined as acute
      poliomyelitis if he had acute asymmetric flaccid paralysis of lower motor neurone
      type without objective sensory disturbance following a short episode of fever.
      Controls were taken from children attending outpatient department for fever. Two
      controls matched for aged and sex were recruited for each case. Recruitment, data
      collection and clinical examination were done by a single pediatrician. IM
      injection received within 30 days prior to onset of paralysis or illness was
      considered to be the risk factor. The total number of cases and controls
      recruited were 257 and 515, respectively. Among cases, 172 (66.9%) out of 257 and
      among controls 252 (48.9%) out of 515, received IM injection within one month
      earlier to onset of paralysis or illness. The overall risk of paralysis,
      estimated for IM injection, was increased [odds ratio (OR) 2.1 (95% CI, 1.5
      3.0)]. The maximum risk for paralysis was observed to be 2 weeks preceding the
      illness; the ORs for < 7 days was 2.2 (95% CI, 1.6-3.2) and for 7-13 days 3.2
      (95% CI, 1.8 to 5.8). The risk of paralysis associated with IM injection was
      similar for unimmunized and immunized cases (OR 2.4 and 2.2). Multiple injections
      were not associated with a higher risk of developing paralysis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8365784
TI  - Dermatoglyphics in cleft lip and cleft palate anomalies.
AB  - Dermatoglyphic characteristics of sixty nine cases of cleft lip with or without
      cleft palate and twenty eight isolated cleft palate cases were evaluated for
      digital patterns, interdigital patterns, palmar simian crease and sydney line,
      and model types of C- and D-line terminations. Increased frequency of ulnar and
      radial loops than the arches and whorls was observed in cleft lip with or without
      cleft palate patients compared to controls. Interdigital patterns were less
      frequent in cleft lip and cleft palate patients. Simian crease and Sydney line
      were more common in patients than in controls. Model types of C- and D-line
      terminations showed variations in patients and controls. Wider 'atd' angle (more
      than 30 degrees) and dermatoglyphic asymmetry were noted in the patient groups.
      The findings suggest the dichotomy or heterogeneity of cleft lip and cleft palate
      anomalies. The role and utility of dermatoglyphics in genetical etiology of
      congenital defects were emphasized.

PMID- 8365785
TI  - Diagnostic and prognostic role of CRP and m-ESR in neonatal septicemia.
AB  - Serial estimation of CRP and m-ESR was done in 65 clinically suspected cases of
      septicemia and 25 healthy controls. Of these 65, 12 (18%) had a negative CRP test
      at the time of diagnosis and rest all had significantly elevated CRP and m-ESR
      compared to matched controls at the time of diagnosis. A persistently negative
      CRP test indicated bad prognosis. With treatment a declining trend of CRP was
      seen in survivors, but in deteriorating/expired babies the levels kept on
      increasing. However, m-ESR had no prognostic significance.

PMID- 8365787
TI  - Mixed bacterial meningitis.

PMID- 8365786
TI  - Utilization of maternal services in west Bengal.
AB  - A study was conducted in selected blocks of West Bengal to assess the utilization
      of available maternal health services specially immunization, antenatal care and
      other services. Coverage with two doses of tetanus toxoid levels varied between
      58.6 to 86.7% but it fell far short of Universal Immunization Programme target of
      100%. Drop out rates were slightly higher in the rural areas. It was observed
      that in 5 out of 7 blocks more than 55% of the deliveries were conducted either
      at hospital or Primary Health Centre by health personnel. However, untrained dais
      predominated over the trained dais in conducting deliveries in most of the areas.
      This indicates the poor availability or utilization of the latter.

PMID- 8365789
TI  - Neonatal herpes.

PMID- 8365788
TI  - Pendred's syndrome.

PMID- 8365790
TI  - Breast feeding in difficult situations.

PMID- 8365791
TI  - Postoperative hyponatremic convulsions in two malnourished children.

PMID- 8365792
TI  - Plasmodium vivax malaria presenting as hemolytic--uremic syndrome.

PMID- 8365793
TI  - Serum magnesium, calcium, zinc in infantile tremor syndrome.

PMID- 8365794
TI  - Diazepam intoxication in neonates.

PMID- 8365795
TI  - Oral steroids in the treatment of periorbital hemangioma.

PMID- 8365796
TI  - Radial immunodiffusion versus serum protein electrophoresis as a tool for
      diagnosis of alpha-1-antitrypsin deficiency.

PMID- 8365797
TI  - Role of prostaglandins in congenital heart disease.

PMID- 8365798
TI  - Congenital multifocal osteomyelitis.

PMID- 8365800
TI  - Intradiploic hemangioma of skull bone.

PMID- 8365799
TI  - Fetus in fetu.

PMID- 8365801
TI  - Attitudes of medical students towards IAP Pediatric Quiz.
AB  - Attitudes of medical students towards IAP Pediatrics Quiz were assessed, using a
      5 point pre-tested, standardized Likert type scale, developed in our own
      department. Students had a favorable attitude towards the Quiz and felt that it
      helps them in the study of Pediatrics, but they are not able to devote sufficient
      time for preparations because of their preoccupation with other major subjects.
      The attitudes demonstrated a decline towards unfavorableness when comparison was
      made between the scores of third year and final year medical students. The
      difference was statistically significant (p < 0.05). It is suggested that the
      timing of the Quiz should be changed, so that it doesn't coincide with final
      professional examinations. This will make it more popular besides generating
      interest of medical students in Pediatric. Giving more weightage to Pediatrics in
      university examinations is also re-emphasized as a means of making students more
      interested in pediatrics.

PMID- 8365802
TI  - Report of the sub-committee for curriculum in pediatrics for undergraduate
      medical education.

PMID- 8365803
TI  - Acute reversible cerebellar ataxia in typhoid fever.

PMID- 8365804
TI  - Chorea--a rare complication of enteric fever.

PMID- 8365806
TI  - Polioparalysis in immunized and unimmunized children.

PMID- 8365805
TI  - Treatment of inverted nipples using disposable syringe.

PMID- 8365807
TI  - Gene therapy: principles and potentials.

PMID- 8365808
TI  - Drug use in infection control--is more less?

PMID- 8365809
TI  - Topical antimicrobial prophylaxis of nosocomial pneumonia in mechanically
      ventilated patients. Microbiological observations.
AB  - Generally, reduction of colonization and infection with potentially pathogenic
      microorganisms in intensive care units (ICU) is attempted by a combination of
      antimicrobial agents administered topically in the digestive tract and
      systematically. We tested the efficacy of topical antimicrobial prophylaxis of
      the oropharynx and stomach administered in combination with sucralfate without
      systemic prophylaxis in 25 mechanically ventilated ICU patients. The regimen
      successfully reduced colonization with potentially pathogenic microorganisms in
      the oropharynx and trachea without modifying the intestinal flora. However,
      colonization and infections with gram-positive cocci and gram-negative rods other
      than Enterobacteriaceae and Pseudomonadaceae and resistant to one or both the
      antimicrobial agents used were observed.

PMID- 8365811
TI  - Aerosolized pentamidine versus i.v. pentamidine for secondary prophylaxis of
      Pneumocystis carinii pneumonia.
AB  - The efficacy and toxicity of aerosolized pentamidine was evaluated in 78 AIDS
      patients given 60 mg biweekly as secondary prophylaxis against Pneumocystis
      carinii pneumonia (PCP). Patients were monitored for clinical progression and
      mortality and were compared to 42 historical controls given 200-300 mg i.v.
      pentamidine biweekly. The relapse rates did not differ markedly between the two
      groups, and the PCP-free rates in survivors were at 12 months 0.83 and 0.77,
      respectively. Seventy-one new AIDS-defining events and 25 deaths were recorded in
      patients on aerosolized pentamidine compared to 29 AIDS events and two deaths in
      patients on intravenous pentamidine. Recurrent PCP contributed to death in only
      one case of the aerosolized pentamidine group. PCP is not a serious clinical
      problem in immunodeficient patients taking pentamidine prophylaxis by either
      route compared to the progression of clinical HIV disease and death.

PMID- 8365810
TI  - Differences in verotoxin neutralizing activity of therapeutic immunoglobulins and
      sera from healthy controls.
AB  - Intestinal infection by Escherichia coli O157 and other verotoxin (VT) producing
      E. coli has been increasingly recognized as an important factor for the causation
      of classic (enteropathic) hemolytic uremic syndrome (HUS) and hemorrhagic colitis
      (HC). Toxins most frequently involved are VT1 and VT2. As with other toxin
      mediated diseases, administration of immunoglobulin (Ig) may be beneficial.
      However, little is known about the immune response elicited by the toxin(s), and
      the prevalence of VT neutralizing antibodies in the healthy population. We
      studied the capacity of seven Igs and a commercial plasma preparation to
      neutralize four different VTs (VT1, VT2, VT2c and VT2e). The results were
      compared with the neutralization titers (NT50%) of normal human serum samples
      from various age groups. Plasma products and normal sera were separated by
      protein G affinity chromatography to investigate the factor(s) responsible for VT
      neutralization. All Igs neutralized VT1 (8 to 96 NT50%). None of them inhibited
      VT2, VT2c or VT2e effectively. In contrast, none of 40 pediatric, and only one of
      20 adult control sera (starting dilution 1:4) neutralized VT1 (25 NT50%). All 60
      samples as well as the plasma preparation blocked VT2 (22 to 446 NT50%, median
      137), but not VT2c and VT2e. The VT1 neutralizing activity was eluted with the
      IgG fraction. The VT2 neutralizing activity was not bound by protein G, but was
      recovered in the IgG-free effluent. In conclusion, therapeutic Igs significantly
      neutralize VT1, but are largely ineffective against other VTs. In contrast, all
      control sera inhibited VT2, but rarely VT1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365812
TI  - Detection of Toxoplasma gondii in AIDS patients by the polymerase chain reaction.
AB  - In recent years, toxoplasmosis has become one of the most frequent and life
      threatening opportunistic infections in AIDS patients. Despite strict clinical
      follow-up and repeated biological examinations, its diagnosis remains difficult
      to establish in the context of immunodeficiency because of the poor predictive
      value of serology. The aim of the study was to compare standard methods of
      diagnosis with the polymerase chain reaction (PCR), in an attempt to investigate
      the potential usefulness of PCR in the diagnosis of toxoplasmosis. Twelve
      biological samples (cerebrospinal fluid, bronchoalveolar lavage fluid, one brain
      biopsy and one liver biopsy) from 11 unselected AIDS patients were tested by PCR.
      The results showed good correlation (for eight out of 11 patients) between
      classical methods and PCR, and confirm the value of bronchoalveolar lavage for
      the diagnosis of toxoplasmosis in AIDS patients. The pathophysiological
      significance of the presence of Toxoplasma in samples tested is discussed.

PMID- 8365813
TI  - Immunity to measles in young adults in Israel.
AB  - The likelihood of an epidemic of measles in 1990-92 in Israel prompted us to
      study the immune status against measles in a random sample of 454 recruits aged
      18-19 years in order to obtain data that might be used in determining vaccination
      policy. This cohort had received one dose of measles vaccine at 12 months of age.
      The measles immunity status was studied by determination of antibody values that
      were measured by means of an enzyme-linked immunosorbent (ELISA) IgG antibody
      test. Of the recruits, 84.6% were found to have positive sera for anti-measles
      IgG antibodies, while 13.7% had negative sera. Eight (1.7%) subjects had
      borderline results. The results of this study indicate the need to administer a
      second dose of measles vaccine at an older age in addition to the MMR (measles,
      mumps, rubella) vaccine that is now given in Israel at 12 months of age. This
      step will help achieve the World Health Organization's target of complete
      eradication of measles.

PMID- 8365814
TI  - Disseminated intravascular coagulation associated with disseminated
      cryptococcosis in a patient with acquired immunodeficiency syndrome.
AB  - Disseminated intravascular coagulation (DIC) is uncommon in acquired
      immunodeficiency syndrome (AIDS), despite the high incidence of infectious
      diseases. We describe an HIV-infected patient presenting with disseminated
      cryptococcosis, who had clear-cut laboratory evidence of progressively worsening
      DIC (thrombocytopenia, prolonged prothrombin time and partial thromboplastin
      time, hypofibrinogenemia, increased fibrin(ogen) degradation products and D
      Dimer, reduced antithrombin III), although the clinical signs of the disease were
      rather scarce. The patient died despite intense treatment, which included heparin
      and fresh frozen plasma, and DIC was confirmed histologically. It is suggested
      that, in a patient with AIDS presenting with an opportunistic infection,
      laboratory signs of DIC should be carefully checked to early recognize this
      complication and promptly initiate the required therapy.

PMID- 8365816
TI  - Brevibacterium species as a cause of osteomyelitis in a neonate.
AB  - A case of osteomyelitis of the sternum due to Brevibacterium sp. in a neonate
      following mastitis of the mammary gland 20 days previously is described. The
      disease was successfully treated with cefazolin and oxacillin. The results of
      microbiological examinations and their significance are discussed.

PMID- 8365815
TI  - Multiple brain abscesses and bacteremia in a child due to Fusobacterium
      necrophorum.
AB  - A case of Fusobacterium necrophorum bacteremia and multiple brain abscesses in a
      6-year-old child following a Mycoplasma pneumoniae infection is described. Brain
      abscess due to this microorganism has only been described in three other cases
      since 1977. The clinical picture was consistent with postanginal septicemia, with
      septic metastatic complications normally only seen in teenagers and young adults.
      The patient was successfully treated with a 2-month course of parenteral
      penicillin G and metronidazole.

PMID- 8365817
TI  - Cross-reactivity of monoclonal antibodies and sera directed against lipid A and
      lipopolysaccharides.
AB  - The cross-reactive capacity of monoclonal and polyclonal lipid A antibodies was
      tested with rough and smooth lipopolysaccharides (LPS). The antibodies
      represented different specificities recognizing epitopes in the hydrophilic lipid
      A backbone. In none of the various assay systems applied did the antibodies react
      with complete rough or smooth-form LPS. Cross-reactions, in general, were only
      detected with the most rudimentary rough LPS tested, i.e. Re-LPS. A variety of
      reactivities with other LPS was shown not to be related to lipid A antibodies;
      such reactivities were present in rabbit sera as well as in crude ascites. These
      results underline the need for careful checks on the origin of reactivities
      observed. In addition, rabbit antisera raised with R- and S-LPS were screened for
      lipid A reactivity using synthetic lipid A and partial structures as antigens. No
      cross-reactivity of LPS antibodies with lipid A was detected in these sera.

PMID- 8365818
TI  - Ampicillin and ampicillin-sulbactam dilution tests with mixed cultures of
      Bacteroides fragilis, Escherichia coli and Enterococcus.
AB  - Bacterial interactions in mixed infections may compromise antimicrobial therapy.
      The in vitro bactericidal activity of ampicillin and ampicillin-sulbactam against
      aerobic/anaerobic mixed cultures of Bacteroides fragilis, Escherichia coli and
      Enterococcus spp. was studied by means of broth dilution tests. The MBC of
      ampicillin for Enterococcus faecalis 6 was 0.25 mg/l when tested singly; in
      association with B. fragilis 1, however, the MBC for E. faecalis 6 was 16 mg/l.
      When tested singly E. coli 9 and B. fragilis 1 were both killed by ampicillin at
      a concentration of 4 mg/l in combination with 1 mg/l sulbactam. When both strains
      were associated, the MBC for B. fragilis 1 rose to > 256 mg/l. Results obtained
      indicate that the behaviour of bacteria as determined in pure cultures is not
      necessarily identical with the antibiotic susceptibility present in mixed
      cultures. It was shown that, besides beta-lactamase production by involved
      bacteria, other factors contribute to the alteration of bacterial susceptibility
      in mixed cultures. Synergistic and antagonistic effects between associated
      organisms were observed. For example, it was found that two moderately sensitive
      bacterial strains were resistant in mixed culture.

PMID- 8365819
TI  - Haemophilus influenzae septic arthritis in a healthy adult.

PMID- 8365820
TI  - Cryptococcal pleural effusion as first indicator of AIDS: a case report.

PMID- 8365821
TI  - Significant decrease of titres of circulating IgG after oral intake of a
      preparation of Enterococcus faecalis in a group of ten healthy volunteers.

PMID- 8365822
TI  - Melatonin increases antigen presentation and amplifies specific and non specific
      signals for T-cell proliferation.
AB  - Our preceding results have shown that melatonin administration to normal and
      immunodepressed mice increases significantly the antibody response. We also found
      that melatonin is able to restore the impaired T-helper cell activity in
      immunodepressed mice. The present study shows that melatonin enhances antigen
      presentation by splenic macrophages to T-cells. This effect is concomitant with
      an increase in the expression of MHC class II molecules and production of IL-1
      and TNF-alpha. Considering the role of antigen presentation and cytokine
      production in the initiation of the immune response, the present findings provide
      evidence for relevant mechanisms that may account for the regulatory role of the
      pineal gland in immunoregulation.

PMID- 8365823
TI  - Enhanced expression of interleukin 6 in rat and murine arthritis models.
AB  - Interleukin 6 (IL-6) is a multifunctional cytokine and plays an important role in
      host defense mechanisms. Enhanced production of IL-6 has been reported in
      polyclonal B-cell abnormalities and autoimmune diseases such as rheumatoid
      arthritis (RA). To investigate the role of IL-6 inflammatory joint diseases,
      serum IL-6 levels of three animal models of RA, namely type II collagen (CII)
      induced murine, rat arthritis and adjuvant-induced rat arthritis, were monitored.
      In these models, serum IL-6 increased with the development of arthritis. Serum IL
      6 was not elevated by immunization with a non-arthritogenic immunogen such as
      bovine type I collagen (CI) and bovine serum albumin (BSA) to DBA/1J mice. The
      serum IL-6 level was correlated well with the severity of adjuvant-induced
      arthritis. The elevated IL-6 in sera may be associated with the overproduction of
      IL-6 at the arthritis paws, because higher IL-6 activity was detected in the
      homogenates of arthritic paws as compared with the control paws. Synovial
      fibroblasts were isolated from the arthritis knee joints of DBA/1J mice. These
      cells expressed type I interleukin 1 (IL-1) receptor constitutively and produced
      large amounts of IL-6 in response to IL-1 in vitro. Enhanced production of IL-1
      was also detected at the arthritis paws. These results suggest that the elevated
      IL-6 in sera may be associated with the overproduced IL-6 in response to the
      increased IL-1 at the arthritic joints. Serum IL-6 may be a useful parameter for
      monitoring disease activity.

PMID- 8365824
TI  - Involvement of central opioidergic and nonopioidergic neuroendocrine systems in
      the suppressive effect of acupuncture on delayed type hypersensitivity in mice.
AB  - The effect of a single treatment of electroacupuncture (Acu) at early or late
      stages of the efferent phase on 2, 4, 6-trinitrochlorobenzene (TNCB)-induced
      delayed type hypersensitivity (DTH) was studied in intact and hypophysectomized
      (HPX) mice. Acu (2.5 Hz, 15 min) applied to the acu-point equivalent to GV4 at 0,
      3, 18 or 21 h after TNCB challenge induced significant suppression (45-73%) of
      the maximal extent of ear swelling at 24 h after TNCB challenge. An
      immunosuppressive and antiinflammatory drug, prednisolone 10 mg/kg i.p., also
      suppressed the DTH to the same extent. Pretreatment with intracisternal injection
      of naloxone hydrochloride (2 micrograms) significantly blocked the Acu-evoked DTH
      suppression when Acu treatment was done at 0 or 3 h. On the contrary, naloxone
      did not block the effect of Acu treatment given at 21 h. In order to examine the
      potential involvement of the pituitary in the suppression of DTH by Acu, the DTH
      reaction was examined in HPX mice. Acu failed to produce suppressive response in
      the HPX mice unless given at 0 h. These findings indicate that Acu treatment at
      acu-point GV4 during the efferent phase of induced DTH can suppress the DTH
      through central opioidergic or nonopioidergic systems. The pituitary is
      apparently pivotal in this immunosuppression and it is suggested that the DTH
      suppression by Acu may be mediated via activation of the neuroendocrine system.

PMID- 8365825
TI  - Immunosuppressive action of cyclophosphamide in mice: contribution of some
      factors to determination of strain differences.
AB  - Mechanisms of strain differences in susceptibility to cyclophosphamide (CP) has
      been investigated with BALB/c, DBA/2, CC57BR, and C57BL/6 mice. It was shown that
      the final immunosuppressive effects of CP is a result of a combination of such
      factors as the level of CP alkylating metabolites in the bloodstream and the
      sensitivity of the target cells to antiproliferative action of these metabolites.
      The importance of the immune status peculiarities has been discussed.

PMID- 8365826
TI  - Effect of a novel anti-rheumatic drug, TA-383, on type II collagen-induced
      arthritis--suppressive effect of TA-383 on interleukin 6 production.
AB  - We have evaluated the effect of a novel anti-rheumatic drug, cis-2-(4
      chlorophenyl)-4,5-diphenyl-2-imidazoline hydrochloride (TA-383), on type II
      collagen (CII)-induced arthritis in DBA/1J mice. Treatment with TA-383 (0.4
      mg/kg/day) from the day of immunization with CII strongly suppressed the
      arthritic responses. Increased serum interleukin 6 (IL-6) level was lowered in
      parallel with the effect. Effect of TA-383 on IL-6 production was examined in
      vitro. TA-383 inhibited the production of IL-6 by murine synovial fibroblasts
      stimulated with recombinant interleukin 1 (IL-1) beta in a dose-dependent manner
      (0.1-10 microM). Neither the general protein synthesis nor the expression of type
      I IL-1 receptor was affected by TA-383. The results show that TA-383 possesses an
      inhibitory activity on IL-6 generation and suggest that the effect may partly
      contribute to the anti-arthritic effect of TA-383.

PMID- 8365827
TI  - Effect of immunomodulators pyrimethamine and cimetidine on immunosuppression
      induced by sulfur mustard in mice.
AB  - Despite extensive world-wide research no effective therapy has been devised for
      the treatment and cure of patients exposed to sulfur mustard (S-M). A severe
      suppression of the immune system still remains the major cause of opportunist
      infections, septicemia and death in patients injured by S-M. In this report we
      present a model of S-M contamination in mice which is suitable for
      immunomodulation studies. Results show that differing doses of S-M caused an
      overall suppression of the immune response to SRBC as indicated by agglutination
      titers, (DTH) tests, spleen histology and spleen weight indices. In the second
      stage two immunomodulating agents; pyrimethamine and cimetidine were employed and
      their effectiveness in augmenting immune responses after S-M induced
      immunosuppression was evaluated. Pyrimethamine, at all doses employed, enhanced
      antibody titers to SRBC, augmented DTH responses, and restored splenic follicles
      as compared with controls only exposed to S-M. Cimetidine augmented antibody
      titers and enhanced DTH responses at doses of 10 and 15 mg/kg as compared with
      controls. At a dose of 5 mg/kg cimetidine did not exhibit any effect on titers or
      DTH responses. Histological studies revealed that cimetidine restored splenic
      follicles and increased macrophage numbers and phagocytic activity at all three
      doses. Spleen weight indices were not augmented by either drug. These data
      provide evidence that immunomodulating drugs may prove effective in countering
      the immunosuppressive effects of S-M.

PMID- 8365828
TI  - Anti-CD3-induced T-cell activation--II. Effect of 2,3,7,8-tetrachlorodibenzo-p
      dioxin (TCDD).
AB  - An in vivo model was used to examine the effect of 2,3,7,8-tetrachlorodibenzo-p
      dioxin (TCDD) on various parameters of T-cell-activation. In this model, the
      hamster anti-mouse monoclonal antibody 145-2C11 (anti-CD3) to the CD3 portion of
      the murine T-cell receptor was injected into both rear footpads of female C57B1/6
      mice and the draining popliteal and inguinal lymph node cells (LNC) were removed
      24 h later. Cyclosporin A (CsA) was included as a known immunosuppressive
      control. As expected, CsA (50 mg/kg, i.p.) suppressed anti-CD3-induced
      proliferation, IL-2-driven 3H-TdR incorporation, and IL-2R expression. In
      contrast, TCDD unexpectedly enhanced anti-CD3-induced 3H-TdR incorporation. Flow
      cytometric analysis showed that TCDD treatment increased the percentage of both
      CD4+ and CD8+ cells cycling in S and G2M. LNC from TCDD-treated mice also had
      enhanced 3H-TdR incorporation when cultured in the presence of a saturating
      amount of exogenous mIL-2. TCDD did not significantly alter the percent positive
      or the number of IL-2 receptors (IL-2R) on either CD4+ or CD8+ cells when
      examined at several time points after anti-CD3 treatment. Both the kinetics and
      extent of anti-CD3-induced down-modulation of CD3 expression on CD4+ and CD8+
      cells was unaffected by TCDD. TCDD alone did not result in enhanced 3H-TdR
      incorporation, cell cycling or IL-2R expression. Therefore, TCDD appears to be
      targeting T-cells that are undergoing activation rather than resting cells. The
      strength of the anti-CD3 model is evidenced by the fact that two known
      immunosuppressive compounds (CsA and TCDD) have distinct and opposite effects on
      T-cell activation. These findings suggest that the mechanism(s) by which CsA and
      TCDD impair T-cell function are different.

PMID- 8365829
TI  - Effects of acute inhalation of albuterol on submaximal and maximal VO2 and blood
      lactate.
AB  - The acute effects of inhaled albuterol, a selective beta-2 adrenergic agonist, on
      measures of endurance cycling performance and pulmonary function were assessed in
      21 competitive road cyclists. A 5 step methacholine challenge revealed all
      cyclists to be non-asthmatic. Albuterol (A) total dose 360 micrograms or a saline
      placebo (P) was administered by inhaler, in 4 metered doses of 90 micrograms
      each, 15 minutes before cycle ergometry exercise. Heart rate, whole blood
      lactate, perceived exertion and VO2 were determined at the submaximal workloads
      of 150, 200, 225, 250, 275, 300 watts and at max. Pulmonary function tests
      determining forced vital capacity, forced expiratory volume during the first
      second of expiration, forced mid-expiratory flow and maximal voluntary
      ventilation were performed prior to and 10 minutes after inhalation; and 5, 10
      and 15 minutes after termination of the exercise protocol. Heart rate was
      significantly greater during the A compared to the P treatment at 200 (150.8 +/-
      2.5 vs 146.7 +/- 2.8 beats per minute), 225 (159.7 +/- 2.4 vs 154.6 +/- 2.7 beats
      per minute) and 250 watts (166.9 +/- 2.4 vs 164.4 +/- 2.6 beats per minute).
      Whole blood lactate was significantly greater during the A compared to the P
      treatment at 275 watts (4.7 +/- 0.3 vs 4.2 +/- 0.4 mmol.l-1). No other
      significant differences were found between the 2 treatments at any time point.
      These data indicate that the acute effect of albuterol inhalation at twice the
      recommended dosage has no positive effect on endurance performance measures or
      pulmonary function in athletes who are not asthmatic.

PMID- 8365830
TI  - Body composition and maximum alactic anaerobic performance during a one month
      stay at high altitude.
AB  - Prolonged altitude exposure usually leads to considerable weight loss of which a
      large part is from muscle tissue. This loss reduces maximum alactic anaerobic
      muscle power. It was hypothesized that most of the weight loss may simply be the
      result of malnutrition due to lack of palatable food in an uncomfortable
      environment. To test this hypothesis eight healthy male subjects (age 33.7 +/-
      4.6 S.C. yr), well acclimatized to prevent symptoms of acute mountain sickness,
      were exposed for 4 weeks to an altitude of 5050 m with access to a large choice
      of palatable food in comfortable conditions. Body weight (with a scale), body
      composition (from skinfolds), arm muscle plus bone cross-sectional area (Am + b)
      and muscle plus bone leg volume (Vm+b) (from skinfolds and circumferences),
      maximum voluntary contraction force of the elbow flexors (MVC, with a load cell)
      and maximum jumping height (Hmax, on a platform) were measured before departure
      (SL) and in the first (ALT1), second (ALT2) and fourth week (ALT4) of their
      altitude sojourn. Three-day dietary records were obtained at SL and at ALT4. Body
      mass had decreased significantly at ALT2 (-3.8%) and at ALT4 (-4.6%) likely
      reflecting changes in body water homeostasis. No changes were found in %fat,
      Am+b, Vm+b, MVC or Hmax. Average dietary intake at SL was 8.96 +/- 1.45 MJ and
      had increased to 13.59 +/- 3.07 MJ at ALT4. In conclusion, up to an altitude of
      5050 m loss of body mass from fat and muscle tissue, and hence impairment of
      maximum anaerobic muscle power (alactic) appears to be avoidable by food intake
      matched to energy expenditure. The latter may be achieved simply by proper
      acclimatization, sufficient comfort and availability of palatable food.

PMID- 8365831
TI  - Effect of water temperature on exercise-induced maternal hyperthermia on fetal
      development in rats.
AB  - The objective of this study was to determine if water temperature influenced
      exercise-induced hyperthermia in swim-trained pregnant rats and the resulting
      fetal development. Pregnant Sprague-Dawley rats with 6 weeks pre-pregnancy
      training were exercised daily from day 1 to day 18 of gestation in water that was
      34.6 +/- 0.4 degrees C (Cool Water Swimmers--CWS) or 37.6 +/- 0.1 degrees C (Warm
      Water Swimmers--WWS), for one hour/day. During this time period another group of
      pregnant rats was immersed to the neck in warm water (37.6 +/- 0.2 degrees C)
      (Warm Water Controls--WWC). On day 19 of gestation all animals were sacrificed
      and fetal development assessed. Maternal exercise in warm water elevated maternal
      body core temperature by 2.3 +/- 0.1 degrees C above resting values, with an
      increase in fetal abnormalities compared to the same exercise intensity in cool
      water. Fifty-eight percent of the abnormal fetuses and 60% of the resorption
      sites were found in the WWS group. Of the abnormalities determined, 65% were from
      the WWS group and 45% of these fetuses showed micrencephaly. Results suggest cool
      water may regulate maternal body temperature during swimming exercise and that
      swimming in warm water should be avoided during gestation because of potential
      teratogenic effects.

PMID- 8365832
TI  - Mechanical energy assessment with different methods during running.
AB  - In order to compare mechanical measurements obtained with force platforms, film
      analysis and a kinematic arm, a sprint runner and a long distance runner were
      asked to run at different constant velocities ranging from 2.5 m.s-1 to 5.5 m.s
      1. The external (EW) mechanical work reflected in the motion of the center of
      mass (CM) of the subject was computed using force platforms, film analysis and a
      kinematic arm. The differences observed on EW computations ranged from 12.3% +/-
      2.5% (film analysis vs kinematic arm) to 1.4% +/- 1.8% (kinematic arm vs force
      platforms). These differences could be explained by (i) film analysis inaccuracy
      and (ii) vertical kinematic arm oscillations. Furthermore, the data obtained with
      a multisegment model confirm that the large discrepancy found in the literature
      on running efficiency is not mainly due to the accuracy of the force and/or
      displacement measurements, but to the different methods of estimation of the
      mechanical power produced by the muscles. It is suggested that the kinematic arm
      principle can be applied successfully for computation of CM displacements and CM
      energy changes during running.

PMID- 8365833
TI  - Fast twitch fibres may predict anaerobic performance in both females and males.
AB  - The aim of the present study was to compare males and females with similar
      training backgrounds regarding the relationship between anaerobic performance and
      muscle characteristics and to test whether any of the analysed expressions of
      muscle characteristics could predict some of the difference in anaerobic
      performance between sexes. Subjects performed 30 s all-out sprints on a bicycle
      ergometer (Wingate test) and needle muscle biopsies were taken at rest. Peak and
      mean power were respectively 44% and 48% higher in males than in females.
      Activity of total lactate dehydrogenase (LD) was 33% higher and of M subunit of
      LD 38% higher in males. Anaerobic performance was directly related to the
      proportion of type II fibres, the relative M subunit activity or the activity of
      PFK in both males and females and the higher M subunit activity in males could
      predict some of the sex difference in anaerobic performance. It is suggested that
      anaerobic performance is directly related to fast contractile or/and anaerobic
      metabolic properties of skeletal muscle with no sex difference in this
      relationship. The difference in anaerobic performance between the sexes may
      partly be related to the sex difference in anaerobic metabolic properties of
      skeletal muscle.

PMID- 8365834
TI  - Fixed time versus fixed distance protocols for the blood lactate profile in
      athletes.
AB  - Laboratory studies of blood lactate accumulation often use a fixed time protocol
      to define the onset (4 mM) of blood lactate accumulation (OBLA) or other indices
      of blood lactate concentration. For practical reasons, field studies with
      athletes often use a fixed distance protocol to accomplish the same goal. Whether
      these variations of protocol are comparable has not been established. We studied
      10 subjects in the laboratory during fixed time (4 minute) and fixed distance (2
      km) exercise protocols on a racing bicycle attached to a wind load simulator. The
      fixed distance studies required 3-6 minutes to complete. We also studied the
      subjects during fixed distance (2 km) rides in the field. In the laboratory there
      were no systematic differences in the velocity (34.3 4.6 vs 34.2 +/- 4.6 km.hr
      1), VO2 (2.78 +/- 0.60 vs 2.84 +/- 0.62 liters.min-1), or heart rate (159 +/- 16
      vs 155 +/- 14 beats.min-1) at OBLA in the fixed time vs fixed distance protocols.
      The correlation coefficients for velocity (r = 0.97), VO2 (r = 0.97) and heart
      rate (r = 0.94) further indicate the similarity of results. In the field study
      there was a significant difference in velocity (29.9 +/- 4.8 vs 34.2 +/- 4.6
      km.hr-1) but not heart rate (155 +/- 18 vs 155 +/- 15 beats.min-1) at OBLA versus
      the fixed distance laboratory study. The correlations for velocity (r = 0.47) and
      heart rate (r = 0.93) support these data. The results suggest that the practical
      modification of the lactate profile technique of using fixed distance versus
      fixed time exercise stages does not systematically influence the outcome, at
      least for exercise stage durations approximating 4 minutes.

PMID- 8365835
TI  - Oxygen uptake, heartrate and blood lactate responses to the Chito-Ryu Seisan kata
      in skilled karate practitioners.
AB  - To evaluate the efficacy of Seisan kata as an aerobic power training mode, four
      male (28.5 +/- 4.2 y) Chito-Ryu karate black belt practitioners did kata
      continuously for 10 min. In separate sessions the kata (formal, organized
      movement sequences) were done at rates of 1 (PACE) and 2 (FAST) kata "cycles" per
      minute. Heartrate (HR) and VO2 were monitored continuously during the sessions.
      VO2 during the PACE and FAST sessions averaged 73 +/- 3 and 94 +/- 2% of leg
      cycling VO2peak, respectively. The corresponding HRs were 93 +/- 6 and 101 +/- 3%
      of HRmax (leg cycle test). PACE and FAST post-exercise blood lactates were 12 +/-
      4 and 22 +/- 6%, respectively, of the maximal leg cycle test values. These data
      indicate that karate kata can be used as an effective and specific means for
      training aerobic power in karate practitioners.

PMID- 8365836
TI  - The effect of light, moderate and severe bicycle exercise on lymphocyte subsets,
      natural and lymphokine activated killer cells, lymphocyte proliferative response
      and interleukin 2 production.
AB  - The purpose of the present study was to evaluate the effect of acute bicycle
      exercise at different exercise intensities on the immune system. Six healthy
      volunteers exercised on a bicycle ergometer for 1 h at 25%, 50% and 75% of VO2max
      with an interval of 2 to 3 weeks. Blood samples were collected in the basal
      state, at the end of exercise and 2 h later. The absolute concentrations of all
      lymphocyte subsets increased during and fell after exercise at 50% and 75% of
      VO2max, but did not change significantly at 25% of VO2max. However, at all
      exercise levels, the percentage of CD3+ blood mononuclear cells decreased due to
      a decline in the fraction of CD4+ cells. This decline was most pronounced at 75%
      of VO2max. The fraction of NK cells expressing either the CD16 or the CD56 marker
      increased during exercise and declined to prevalues 2 h later, however the
      changes were most pronounced at 75% of VO2max. The natural killer (NK) cell and
      lymphokine activated killer (LAK) cell activities (lysis per fixed number of
      mononuclear cells) were increased during all exercise intensities, but were only
      suppressed below basal levels after exercise at 75% of VO2max. Indomethacin in
      vitro abolished the post-exercise suppression of NK cell activity and the
      proportion of CD14+ monocytes increased 2 h after exercise only at 75% of VO2max.
      These findings indicate that after exercise NK cell function is inhibited by
      prostaglandins released by monocytes. During exercise at 50% and 75% of VO2max
      the proliferative response of blood mononuclear cells (BMNC) following
      stimulation with phytohaemagglutinin A (PHA) decreased, whereas that following
      stimulation with interleukin-2 (IL-2) was enhanced. The IL-2 production by BMNC
      in vitro was markedly decreased during and after exercise at 75% of VO2max and
      this inhibition could be abolished by indomethacin in vitro. In conclusion, the
      response of the immune system to exercise depends on exercise intensity. In
      essence, the response is enhanced during exercise, however, after heavy exercise
      it is suppressed due to an increased level of prostaglandins produced by the
      elevated number of monocytes.

PMID- 8365837
TI  - Functional and morphological adaptations following four weeks of knee
      immobilization.
AB  - Immobilization of the knee as part of the treatment in bone or joint lesions
      leads to atrophy and consequently loss of functionally. In patients this atrophy
      and loss of functionality is difficult to quantify because of interfering
      symptoms and missing baseline data. In the present study structural and
      functional changes in thigh muscles were examined in eight healthy volunteers of
      whom one leg was immobilized in a cast for four weeks. Quadriceps cross-sectional
      area determined with computed tomography was 21% +/- 7% diminished after four
      weeks immobilization (p < 0.05). Muscle biopsies from the musculus vastus
      lateralis revealed an 16% decreased fiber diameter (p < 0.05) and no significant
      shift in fiber types. Isokinetic strength measurements of knee extensors and
      flexors demonstrated a fall in peak torque of 53% +/- 9% and 26% +/- 13% at an
      angular velocity of 60 deg.s-1 (p < 0.01). Aerobic power in one-leg-cycling
      exercise was not significantly affected, but isokinetic quadriceps endurance work
      decreased from 9.1 kJ to 5.6 kJ (p < 0.05). Despite the fall in quadriceps
      performance the subjects had only minor functional complaints for a few days. It
      is concluded that immobilization of the knee is an important factor in the
      development of thigh muscle atrophy in patients and should therefore be
      diminished as much as possible.

PMID- 8365838
TI  - Soreness in lower extremities and back is reduced by use of shock absorbing heel
      inserts.
AB  - Soccer referees participating in large soccer tournaments may develop overuse
      injuries. In this study the effect of shock absorbing heel inserts in the
      incidence of soreness was investigated. Forty-eight referees were randomly
      selected to wear shock absorbing heel inserts (SAH) in the 5 day-tournament,
      while 43 referees were the control group. A daily questionnaire inquiring about
      complaints from the locomotive system was completed for each referee and in case
      of any soreness they were examined by doctors to document and classify the
      anatomical site. Calf, thigh, back, achilles tendon and knee were the most common
      localizations of overuse symptoms. The incidence of soreness in achilles tendon,
      calf and back were significantly reduced by the use of (SAH) inserts.

PMID- 8365839
TI  - Can experimental immobilization studies predict the clinical process after
      orthopedic surgery?

PMID- 8365840
TI  - Pyeloform-aided percutaneous litholapaxy. I. Case study.
AB  - To remove multiple calyceal stones percutaneously is not a simple task. During
      the act of dilating the pierced channel the stones are apt to drift away towards
      other parts of the renal cavitary system. For avoidance we recommend the use of
      Pyeloform, a bicomponent synthetic compound in which chemical reaction between
      the two substances produces a gel-like matter. This permits the stones partly to
      be embedded, partly to be fixed against the risk of displacement. Described is
      the effect of Pyeloform in the removal of multiple calyceal stones.

PMID- 8365841
TI  - Massive haematuria from a renal haemangioma with concomitant ureteropelvic
      junction obstruction.
AB  - A two centimeter left capillary renal haemangioma caused massive haematuria in a
      27-year-old male with left hydronephrosis and nephrolithiasis. Nephrectomy for
      life threatening haemorrhage was performed. Diagnostic algorithms for the
      evaluation of adult onset gross haematuria and "essential" haematuria with a
      review of the current literature are presented.

PMID- 8365842
TI  - The significance of cystoscopy for the diagnosis of urothelial tumour.
AB  - Authors have studied the aetiology of asymptomatic microhaematuria on the basis
      of complete urologic examinations including cystoscopy, excretory urography,
      ultrasound, urinalysis and urinary cytology. In 10 out of 422 patients
      transitional cell carcinomas of the urinary bladder were found. Bladder cancer
      was the most common malignancy among the lesions found by our evaluation of
      patients with microhaematuria. We conclude that cystoscopy should be an essential
      part in the aetiological evaluation of microscopic haematuria.

PMID- 8365843
TI  - Primary vesicoureteral reflux in children under one year of age: the case for
      conservative management?
AB  - The natural course of reflux nephropathy was evaluated in children who have been
      diagnosed for primary vesicoureteral reflux already during the first year of
      life. The retrospective study in 103 patients (163 refluxive renal units)
      revealed that 80% of all children in this age group were boys. Scarring at the
      time of diagnosis was evident in 29% of the cases, compared to a rate of 20% in
      our whole reflux population. New scarring occurred in 17 patients (18%): 63% of
      the children had high grade refluxes (IV and V). The rate of spontaneous
      resolutions was 61% and even grade V refluxes showed a spontaneous cessation in
      40% of the cases. These data indicate a high overall spontaneous cure rate in
      young children, but underline the importance of selecting those patients with
      already scarred kidneys and recurrent urinary tract infections for an early
      operation since they are not likely to show a spontaneous resolution of reflux.

PMID- 8365844
TI  - Periureteric effects of electromagnetic shock waves.
AB  - The effect of electromagnetic shock waves on the ureter and periureteric soft
      tissue was investigated in 10 patients who underwent extracorporeal shock wave
      lithotripsy (ESWL) for lower ureteric stones. Seven patients were males and 3
      females, their ages ranged between 15 and 52. The number of shock waves applied
      varied between 3000 and 6000, at a mean of 19 kV. The patients were examined
      after their first ESWL. Magnetic resonance imaging (MRI) was performed within 6
      hours of treatment by a Magnetom 1 Tesla Unit. No haematoma, fluid collection or
      abnormality was detected in the periureteric space, muscle or surrounding
      structures by MRI. Although subcapsular, intra- or perirenal haematomas can be
      observed in patients with kidney stones treated with ESWL, it appears to be safe
      for lower ureteric stones.

PMID- 8365845
TI  - Primary bladder pheochromocytoma without hypertension.
AB  - A case of urinary bladder pheochromocytoma is presented. Although urinary
      norepinephrine concentration was high, the patient was normotensive and no blood
      pressure fluctuations occurred after micturition.

PMID- 8365846
TI  - Rhabdomyosarcoma of the urinary bladder in an adult.
AB  - Primary bladder rhabdomyosarcoma is very rare in adults. We report a 76-year-old
      man who underwent partial cystectomy with postoperative radiotherapy and had a
      recurrence 6 months after the operation.

PMID- 8365847
TI  - Primary non-Hodgkin lymphoma of the prostate gland.
AB  - We present a case of non-Hodgkin lymphoma of the prostate referring to an 86-year
      old male, who was admitted with a history of urine retention of 10 days'
      duration. The symptoms and signs were compatible with a diagnosis of benign
      prostatic hypertrophy, with no preoperative evidence of malignancy. Following
      transvesical prostatectomy, immunocytochemical analysis of the specimen showed a
      highly malignant non-Hodgkin lymphoma of the large immunoblastic B-cell type,
      with a cIgM (kappa) phenotype.

PMID- 8365848
TI  - Orgotein in the treatment of plastic induration of the penis (Peyronie's
      disease).
AB  - Eighteen patients with Peyronie's disease have been treated with the anti
      inflammatory metalloprotein Orgotein, which exhibits a pronounced superoxide
      dismutase activity. Only patients with severe symptoms were selected. The drug
      was injected monthly into the indurated areas of the penis. Marked improvement
      was noted, especially regarding the loss of pain on erection. Only one adverse
      reaction has occurred.

PMID- 8365849
TI  - Use of intraoperative venography in varicocelectomy.
AB  - We performed intraoperative venography in 22 patients, of whom 8 had persistent
      varicocele. The results of the outpatient procedure were encouraging.

PMID- 8365850
TI  - Problems unique to microsurgical epididymovasostomy. Comparison of four
      techniques in a laboratory rat model with review of the literature.
AB  - The new microsurgical techniques, tubule and loop intussusception, are compared
      to end-to-end and side-to-end in an experimental rat model. Sixty adult male
      Sprague-Dawley rats were operated on bilaterally under the same conditions. The
      four microsurgical techniques differ in approach to the inner mucosal layer,
      while the outer adventitial layer was sutured similarly in all cases. Luminal
      patency was checked 3 months postoperatively. There was no statistically
      significant difference in the patency rate among these four techniques (P =
      0.3196). However, the incidence of macroscopically (P < 0.001) and
      microscopically (P < 0.01) detected spermatic granulomas was highly significant
      despite the optimum size match for each method. We found side-to-end techniques
      superior and easier to perform than end-to-end. The loop intussusception offers
      the highest patency rate (100%) with the lowest incidence of spermatic granuloma
      (10%). It was, therefore, concluded that selection of surgical technique is of
      utmost importance for durability of anastomosis.

PMID- 8365852
TI  - Nerve conduction velocities and hair concentrations of trace elements in
      haemodialysis patients.
AB  - Nerve conduction velocities and hair concentrations of trace elements were
      studied in 19 male patients with chronic renal failure undergoing haemodialysis.
      Both motor and sensory nerve conduction velocities were significantly lower in
      haemodialysis patients as compared to controls (p < 0.001). Calcium and aluminium
      concentrations were significantly higher in patients (p < 0.01), however,
      vanadium and arsenic levels were significantly lower in patients (p < 0.01). In
      concentrations of copper and zinc there was no significant difference between
      patients and controls. There were no significant correlations between hair
      concentrations of trace elements and nerve conduction velocities except between
      calcium concentration and sensory nerve conduction velocity. These facts suggest
      that nerve conduction velocities are not influenced by changes of trace element
      concentrations in hair in patients with chronic renal failure undergoing
      haemodialysis.

PMID- 8365851
TI  - Acute glomerulonephritis associated with acute pneumococcal meningitis. A case
      report.
AB  - The frequency of complications in pneumococcal infections has decreased after the
      extensive use of antibiotics. However, pneumococcal postinfectious acute
      glomerulonephritis is rarely seen. A case of acute pneumococcal meningitis with
      acute glomerulonephritis which shows signs of nephritic and nephrotic syndrome is
      presented in this report.

PMID- 8365853
TI  - Correction of anaemia in haemodialysis patients with recombinant human
      erythropoietin.
AB  - We administered recombinant human erythropoietin (r-hu EPO) to 18 anaemic
      patients with end-stage renal disease who were undergoing haemodialysis. The
      recombinant human erythropoietin was given intravenously three times weekly after
      dialysis, and transfusion requirements, haematocrit, ferrokinetic, reticulocyte
      responses and urea, creatinine and potassium kinetics were monitored. Over a
      range of doses between 50 to 90 units per kilogram of body weight, dose-dependent
      increases in effective erythropoiesis were noted. Of 18 patients receiving
      effective doses of recombinant human erythropoietin, none needed transfusion any
      longer and in 2 the haematocrit increased to 35%. Along with the rise in
      haematocrit, four patients had an increase in blood pressure, and the majority
      had increases in serum potassium, fibrinogen, leucocyte and reticulocyte counts.
      Except for transiently increased transaminase levels in one patient, no other
      organ dysfunction or toxic effect was observed. These results demonstrate that
      recombinant human erythropoietin is effective, can eliminate the need for
      transfusions with risks of immunologic sensitization, infection and iron
      overload, and can restore the haematocrit to normal levels in many patients with
      anaemia of end-stage renal disease.

PMID- 8365854
TI  - Renal failure and uraemia leading to the diagnosis of prune belly syndrome in a
      34-year-old man.
AB  - The case of a 34-year-old male is reported, who was transferred to the Regional
      Medical Center in Wels in an uraemic state and subsequently was diagnosed as
      having prune belly syndrome. Surprisingly, his past history revealed no serious
      health problems until 6 months before admission. Furthermore, some interesting
      aspects of the prune belly syndrome such as the controversial views regarding
      pathogenesis and treatment are briefly discussed.

PMID- 8365855
TI  - [Vasculitis. Nomenclature and diagnosis].

PMID- 8365856
TI  - [Coronary vasculitis].

PMID- 8365857
TI  - [Significance of vasculitis in diseases of rheumatic origin].

PMID- 8365858
TI  - [Vasculitis of the skin. Significance for internal medicine].

PMID- 8365860
TI  - [Neurologic aspects of vasculitis].

PMID- 8365859
TI  - [Vasculitis of the kidney].

PMID- 8365861
TI  - [Indurating soft tissue swelling, eosinophilia and increased blood sedimentation
      rate].

PMID- 8365863
TI  - [Comments on the contribution by X. Baur and J. Ammon. Diagnosis of allergy].

PMID- 8365862
TI  - [Occasionally patients treated with thrombocyte aggregation inhibition with
      acetylsalicylic acid also must be treated with non-steroidal antirheumatic
      drugs].

PMID- 8365865
TI  - Steer kids away from smoking.

PMID- 8365864
TI  - [Stomach ulcer and duodenal ulcer].

PMID- 8365866
TI  - Physicians must remain committed to beneficial reform.

PMID- 8365867
TI  - Health care should be subject to cost constraints.

PMID- 8365868
TI  - Clozapine shows promise in schizophrenia treatment.
AB  - Clozapine represents the first significant advance in the pharmacotherapy of
      schizophrenia since development of phenothiazine antipsychotic drugs in the 1950s
      and 60s, yet only about 10% of potential patients nationwide are taking the
      medication.

PMID- 8365870
TI  - Therefore choose life.

PMID- 8365869
TI  - Consideration, mutual respect are vital in the workplace.

PMID- 8365871
TI  - The evolution of hospital ethics committees.

PMID- 8365872
TI  - Intraoperative transesophageal echocardiography.
AB  - Intraoperative echocardiography in patients undergoing cardiac surgery was first
      described in 1972. Interest in intraoperative echocardiography has grown in
      recent years due to the extensive information provided by 2-dimensional (2-D) and
      color-flow Doppler imaging via the transesophageal approach. The value of this
      technique also has been verified in large clinical studies involving patients
      undergoing cardiac surgery. Intraoperative transesophageal echocardiography (TEE)
      is very useful in preoperative formulation of surgical plans and in immediate
      post-operative assessment of surgical results in patients undergoing valve
      surgery.

PMID- 8365873
TI  - Primary caffeine dependence: a case report.
AB  - We present a case of primary caffeine dependence based on the exclusive use of
      over-the-counter caffeine tablets. Caffeine has recently undergone scrutiny as a
      co-morbid risk factor with other substance dependencies, and in other medical and
      psychiatric conditions. Caffeine withdrawal also is briefly discussed with
      attention given to personality factors and the use of nicotine. Although caffeine
      generally is considered safe in usual doses, it is a substance potentially able
      to result in serious dependence. We cite a case which also illustrates that a
      supportive inpatient milieu may be necessary in order to interrupt a cycle of
      heavy caffeine use resulting in marked dependence.

PMID- 8365874
TI  - Testicular microlithiasis: ultra sound appearance.
AB  - Testicular microlithiasis is a diffuse, benign condition involving both testicles
      without architectural distortion. Multiple, bright echoes are present on
      ultrasound examination which rarely cause shadowing. Many associated conditions
      have been reported in patients with this entity. As this is a benign entity,
      knowledge of its appearance and associated conditions to prevent unnecessary
      surgery is important.

PMID- 8365875
TI  - Dedication of the Robert J Emrick MD Library.

PMID- 8365876
TI  - [The role of eosinophilic granulocytes for the pathogenesis of atopic dermatitis
      /neurodermatitis. Eosinophilic products as markers of disease activity].
AB  - Recent data provide increasing evidence for an immunological basis of atopic
      dermatitis (AD). Atopyspecific helper T cells (Th2-like T cells) may play a
      pathogenic role by producing and releasing cytokines that are relevant for the
      allergic inflammation, such as IL-4, IL-5 and other growth factors. It is
      suggested that eosinophils play a major role as effector cells mediating the
      pathogenetically important late-phase reaction, which is associated with
      significant destruction of the surrounding tissue. Accordingly, a significant
      preactivation of peripheral blood eosinophils was detected in AD patients,
      leading to enhanced susceptibility of these cells to distinct stimuli, such as IL
      5. Toxic proteins, such as eosinophil cationic protein (ECP), which are contained
      in the matrix and the core of secondary granules of eosinophils, may play an
      important role by propagating the allergic inflammatory process and by exerting
      their direct immunomodulatory effects. A pathogenic role of eosinophils in AD is
      further supported by the detection of these proteins in eczematous skin of the
      patients. Furthermore, recent data indicate a significant correlation between
      disease activity and deposition of eosinophil granule content: ECP serum levels
      were significantly increased in AD patients. In addition, ECP levels correlated
      with the disease activity. Moreover, clinical improvement was associated with a
      decrease both in the clinical score and in serum ECP levels. These data clearly
      indicate that activated eosinophils are involved in the allergic inflammatory
      process in AD. Therefore, modulation of eosinophil activation could be an
      important pharmacologic modality for the treatment of AD in the future.

PMID- 8365877
TI  - [Polypoid malignant melanoma. An aggressive, seldom observed variant of nodular
      malignant melanoma].
AB  - We describe a 54-year-old man with a polypoid melanoma. The tumour had developed
      within 1 year. Physical examination showed an eroded pedunculated nodule
      approximately 2.5 x 3 cm in size. Histopathology revealed a pedunculated, sharply
      demarcated tumour with an eroded surface; it was composed of atypical melanocytes
      in sheets and nests. Physical examination 11 months after excision of the tumor
      with 3-cm safety margin disclosed no evidence for enlarged lymph nodes or
      cutaneous metastases. No metastases were seen on computer tomography. To our
      knowledge, this patient represents the first case of polypoid melanoma reported
      in the German literature.

PMID- 8365878
TI  - [Adamantiades-Behcet disease. Therapeutic administration of systemic recombinant
      interferon-alpha-2a].
AB  - The effect of systemic recombinant interferon alpha-2a (rIFN-alpha-2a) on the
      mucocutaneous lesions in Adamantiades-Behcet's disease was assessed in ten
      patients with the mucocutaneous type of the disease. rIFN-alpha-2a was applied
      subcutaneously at a dose of 9 x 10(6) IU three times a week for 6 months. Five
      patients showed a significant reduction in the number, severity, duration and
      frequency of their mucocutaneous lesions during the treatment compared with the
      pretreatment phase, whereas in two patients a complete remission and in three
      patients a partial remission was achieved. In two patients, one with complete and
      one with partial remission, recurrence of the cutaneous symptoms occurred shortly
      after discontinuation of the treatment. Renewed administration of rIFN-alpha-2a
      again led to remission of the symptoms. In another patient with initial partial
      remission followed by exacerbation, interferon alpha antibodies were detected and
      the patient responded again when 15 x 10(6) IU rIFN-alpha-2a was administered
      three times a week. Three patients did not show any change in the characteristics
      of their lesions, while two patients experienced progression of their disease
      during treatment. Side-effects were generally mild and well tolerated, but the
      treatment was discontinued earlier than planned in one patient because of
      fatigue, myalgia, hypotonus and diarrhoea. Since the classical treatments are
      generally unsatisfactory, the results of the present study justify the
      administration of systemic rIFN-alpha-2a in the treatment of the mucocutaneous
      type of Adamantiades-Behcet's disease.

PMID- 8365879
TI  - [Imaging subcutaneous atrophy in circumscribed scleroderma with 20 MHz B-scan
      ultrasound].
AB  - The technique of 20-MHz B-scan sonography is non-invasive and allows
      quantification of the different compartments of the skin. Seven patients with
      atrophic linear circumscribed scleroderma and one patient with guttate
      circumscribed scleroderma were examined by ultrasound. All patients were found to
      have a total or subtotal loss of subcutaneous fatty tissue, whereas the thickness
      of the dermis remained almost unchanged. These findings should lead to further
      investigation of the pathophysiological mechanism involved in subcutaneous
      atrophy in circumscribed scleroderma.

PMID- 8365880
TI  - [Lupus erythematosus discoid-like dermatosis in a carrier of septic
      granulomatosis].
AB  - We present a clinically atypical case of discoid lupus erythematosus in the
      mother of a boy with chronic granulomatous disease. In this disorder, the
      phagocytes are unable to produce superoxide anion to degrade incorporated
      microorganisms. In addition to a discoid lupus erythematosus-like skin disease,
      recurrent stomatitis aphthosa, hidradenitis suppurativa and Raynaud phenomenon
      are markedly associated with heterozygote carriers of chronic granulomatous
      disease. Based on this conspicuous association, diverse models concerning the
      pathogenesis of lupus erythematosus are discussed.

PMID- 8365881
TI  - [Current therapeutic possibilities in cutaneous larva migrans].
AB  - The recommendations for the treatment of cutaneous larva migrans are not uniform,
      and the recommended methods are neither always available nor always effective. If
      only the skin is affected, primarily topical therapy is indicated. Topical
      thiabendazole combines efficacy with missing systemic side-effects. In Germany
      the pure substance has to be used or Mintezol tablets must be purchased from
      abroad. Topical mebendazole and freezing with liquid nitrogen are less effective
      and involve side-effects. If topical treatment fails, systemic therapy is
      required. The recognized treatment with oral thiabendazole (2 days) is associated
      with numerous side-effects. There are now two new, safer drugs that should be
      preferred: albendazole (400 mg/day for 3 days), available in Germany as Eskazole,
      or ivermectin (single dose of 200 micrograms/kg). The latter can be ordered from
      the manufacturer under the trade name of Mectizan.

PMID- 8365882
TI  - ["Baboon syndrome". A particular manifestation of hematogenous contact reaction].
AB  - We report on a 52-year-old patient with a typical manifestation of a
      haematogenous contact reaction. The characteristic distribution of light-red
      erythema predominantly located in the major flexural areas of the extremities and
      on the buttocks was consistent with the diagnosis of "baboon syndrome." The term
      derives from the skin lesions, which are compared to the red gluteal region of
      the baboon. An allergic type-IV reaction to systemically administered allergens
      probably underlies lesions of this type. In our case the baboon syndrome had been
      induced by amoxicillin. So far, mercury, nickel, ampicillin, and heparin have
      been reported as causes of baboon syndrome.

PMID- 8365883
TI  - [Chronic bullous dermatosis in childhood (linear IgA dermatosis)].
AB  - A 5-year-old boy presented with disseminated, partly grouped blisters indicative
      of chronic bullous dermatosis of childhood (CBDC) following a gastrointestinal
      infection 2 weeks earlier. CBDC has long been differentiated from adult linear
      IgA disease. Clinical and laboratory studies revealed substantial clinical and
      immunological overlap between the two blistering disorders, whereas recent
      investigations suggest heterogeneity of the target antigen involved.
      Pathohistological and immunofluorescence-microscopical characteristics of a
      subepidermal blister and linear IgA and granular C3 deposition at the basement
      membrane together with the typical history and clinical signs were decisive in
      the differential diagnosis. The disease promptly cleared up after daily
      administration of 16 mg methylprednisolone-21-acetate tapering and 25 mg dapsone.
      Immunohistological detection of collagen IV at the base of a blister made it
      possible to localize the split above the lamina densa. The demonstration of
      collagen IV stresses the importance of immunodermatopathology in the differential
      diagnosis of subepidermal blistering diseases.

PMID- 8365884
TI  - [Striped nail pigmentation with Hutchinson signs in a boxer].
AB  - We present a 68-year-old male patient, who had had longitudinal melanonychia with
      Hutchinson sign for 4 years. Melanocytic proliferation was ruled out by biopsy.
      Friction and pressure had been acting on this patient's nails during boxing for
      the past 40 years. These mechanical factors are discussed under the entity of
      "frictional longitudinal melanonychia". In addition, cellular and non-cellular
      mechanisms for longitudinal melanonychia are reviewed.

PMID- 8365885
TI  - [The Munich Society of Dermatology. Scientific meeting 6 November 1992].

PMID- 8365887
TI  - [Persistent Mongolian spot, nevus of Ota and giant blue nevus: melanoma
      precursors?].

PMID- 8365886
TI  - [Diet in neurodermatitis].

PMID- 8365889
TI  - Enter the secret service.

PMID- 8365888
TI  - [Exudative discoid and lichenoid chronic Sulzberger-Garbe dermatosis ("Oid-Oid
      disease")--reality or fiction?].

PMID- 8365890
TI  - Water. Scots verdict.

PMID- 8365891
TI  - Slow drip of dilution.

PMID- 8365892
TI  - Sickle cell. Black counsellors under pressure.

PMID- 8365893
TI  - Weaning. Any old iron.
AB  - Gabrielle Palmer takes issue with manufacturers' claims for follow on milks,
      arguing that they are often 'generous with alarm and economical with the truth'.
      A balanced weaning diet is the key to preventing iron deficiency anaemia in
      children.

PMID- 8365894
TI  - Cause and cure for iron deficiency in toddlers.
AB  - Iron deficiency is the commonest cause of anaemia in Britain. Maureen B Duggan
      asks: How does toddler iron deficiency aris? How is it reliably diagnosed? And
      how can it be prevented in the community? Is iron supplementation of foods,
      especially of breast milk substitutes and follow-on formulae important in
      communities at risk?

PMID- 8365895
TI  - Wealth and the nation's health.
AB  - Social and economic prosperity to a great extent depend on a healthy population;
      similarly good health depends on adequate income, writes Clare Blackburn. The
      government strategy for health promotion outlined most recently in The health of
      the nation, fails to acknowledge this. Nevertheless health visitors and school
      nurses cannot ignore the links between health and wealth.

PMID- 8365896
TI  - Collaboration in coronary heart disease prevention.
AB  - Health visitors are ideally placed in primary care to offer effective dietary and
      life-style advice as part of a team approach to coronary heart disease
      prevention, write Alan Jones et al. Results from a dietary and life-style
      intervention trial programme suggest that dietitians, who are limited in numbers,
      should be used as a resource to provide expert dietary advice and training to the
      more numerous health visitors. In this way CHD risk factor identification can be
      developed into effective intervention.

PMID- 8365897
TI  - Health promotion: stepping into the breach--again.
AB  - Despite government resistance to formal merger, district and family health
      service authorities (DHAs and FHSAs) are increasingly looking to make joint
      community nurse appointments to fill evident gaps in general practitioner health
      promotion services. Cath Jackson highlights two pioneering projects.

PMID- 8365898
TI  - Disability living allowance: Children can get it too.

PMID- 8365899
TI  - Recognition. When the music stops.
AB  - Trade unions can no longer expect NHS employers automatically to recognise their
      role in negotiating employment terms and conditions on behalf of their members.
      NHS self-governing trusts are now free to set their own terms and conditions of
      employment--and to choose with whom they wish to negotiate. Roger Kline outlines
      the importance of recognition agreements.

PMID- 8365900
TI  - Student fatigue.

PMID- 8365901
TI  - Milking the market.

PMID- 8365902
TI  - The plight of caregivers.
AB  - The prospect of becoming a primary caregiver is of growing concern for everyone
      because of the increase in the aging population. The demands of caregiving place
      caregivers at risk for becoming ill themselves. Nurses are vital in keeping care
      recipients and their caregivers healthy. This article examines the problems
      confronting caregivers and suggests means of coping with the additional and
      unanticipated responsibilities.

PMID- 8365903
TI  - Tuberculosis: a new threat from an old nemesis.
AB  - Mycobacterium tuberculosis (TB), which only a few years ago was thought to be
      under control and soon to be eliminated, has resurfaced as a real threat in the
      home and community setting. This article discusses TB symptoms, therapies
      (including a discussion of the drug-resistant forms of TB), prevention and
      control strategies, and the role of the home healthcare nurse in the surveillance
      for and management of TB.

PMID- 8365904
TI  - Implementation of a hepatitis B vaccine program: a how-to guide for home care
      providers.

PMID- 8365905
TI  - Love is what we need most.
AB  - Older people are subjected to increased amounts of stress and isolation as the
      losses that accompany old age occur. Love is a human need that is especially
      important for the elderly.

PMID- 8365906
TI  - Prevalence of sexual harassment among rural community care workers.
AB  - This study identified the prevalence of sexual harassment and the demographic
      characteristics of rural, midwestern community care workers (CCWs). To prevent
      premature institutionalization, community care workers provide home-based
      assistance that enables elderly persons to remain in their homes. Data were
      collected from 735 CCWs to determine their demographic characteristics and the
      prevalence of sexual harassment at the work site. The prevalence portion of the
      instrument provided data which indicated that 27.8% of the CCWs were harassed on
      the job and that 15% of the workers were harassed by their elderly client.
      Demographic characteristics were collected which showed that 94.8% of the CCWs
      were women, 60.4% were married, and 89.8% were white. Discussion and
      recommendations drawn from the results of the collected data are included in this
      article.

PMID- 8365907
TI  - The "E" word.

PMID- 8365908
TI  - Urinary incontinence: assessment, treatment, and reimbursement.
AB  - Urinary incontinence is a significant problem for elderly people. Home care
      nurses are in a unique position to identify urinary incontinence and manage it in
      the home setting. Nurses can help to decrease incontinence by assessing for
      problems, making nursing diagnoses, and implementing appropriate treatment plans.
      Well-planned and documented continence care is a reimbursable nursing service for
      home care agencies.

PMID- 8365909
TI  - Supervision of home care aides.
AB  - The supervision of home care aides is of the utmost importance, since these aides
      provide needed services in the less controlled and out-of-sight private homes of
      patients. The role of the supervisor is demanding to assure compliance with
      accreditation, certification, and agency standards. Supervision of the
      paraprofessional staff also provides the opportunity to provide positive feedback
      as well as constructive criticism to assure that high-quality in-home services
      are provided to home-bound patients. Supervision also provides the opportunity to
      interact with the aides, show respect for them as individuals, and convey to them
      that they are an important member of the home healthcare team.

PMID- 8365910
TI  - Principles of universal precautions/body substance isolation.

PMID- 8365911
TI  - Truly universal precautions.

PMID- 8365912
TI  - Cultural sensitivity: educating home healthcare nurses to be transcultural
      nurses.

PMID- 8365913
TI  - Delegation and supervision of patient care.

PMID- 8365914
TI  - [Effect of now routine staging methods on diagnosis and therapy of head-neck
      neoplasms. More reliability or a new decision dilemma?].

PMID- 8365915
TI  - [Improvement of communication behavior of laryngectomized and voice-rehabilitated
      patients by a psychological training program].
AB  - An important goal of laryngectomee rehabilitation is achieving the best possible
      result in voice restoration. In addition to good voice quality, efficient
      intelligibility in daily conversation requires specific communication skills,
      which are very often neglected in speech therapy. In this study 51 male
      laryngectomees were randomized to an intervention group or an attention control
      group. After hospital discharge the intervention group participated in a
      psychological training program aimed at improving the communication behavior of
      the laryngectomees. This training was part of a comprehensive rehabilitation
      program (lasting over six months) and consisted of four modules: Improvement of
      communication over the disability; Discrimination of factors affecting
      intelligibility; Development of behavioral strategies for improving
      intelligibility in daily conversation; Transferring the strategies to daily live.
      The effectiveness of training was evaluated by a questionnaire which covered
      three important aspects of communication behavior. As a result of the
      intervention the patients influenced more effectively their own communication
      behavior and also influenced more adequately the behavior of typical
      communication partners. Present finding with the psychological training program
      demonstrated that the communication behavior of laryngectomees can be
      significantly improved.

PMID- 8365916
TI  - [Subablative gentamycin therapy in Meniere's disease].
AB  - We have treated 20 patients suffering from unilateral Morbus Meniere (2 x 12 mg
      gentamicin for 7 days). These patients were controlled for 24 months. In 95% we
      regarded a complete or substantial control of definitive spells ("American
      Committee on Hearing and Equilibrium guidelines for reporting treatment results
      in Meniere's disease", Otolaryngol. Head and Neck Surg. 10/19-85). Only 1 patient
      with pretherapeutic equal caloric response showed a post-therapeutic destroyed
      vestibular apparatus on the treated ear. In the other 7 patients (35%), who had a
      loss of vestibular function after therapy, there was an already pretherapeutic
      more or less noticeable caloric hypoexcitability. It is possible to induce an
      only subablative damage with a clinical success in 95%.

PMID- 8365917
TI  - [Forms of monosymptomatic hereditary sensorineural hearing loss and deafness in
      the Leipzig area].
AB  - More than one third of all sensorineural hearing loss and deafness has a genetic
      basis. Syndromes are already clinically distinguishable from monosymptomatic
      forms, but even the latter represent a heterogeneous group of diseases, which
      differ in mode of transmission, audiometric features of the hearing loss and
      possible progredience of the symptoms. Till now only audiometric and genealogical
      methods have been available for diagnosis. So far serological and cytogenetical
      studies have given no results and molecular-genetic investigations have only
      given results for some very rare syndromes. To help affected families and to
      prepare molecular-genetic studies we examined all patients at our hospital who
      suffer from a sensorineural hearing impairment for the onset of a monogeneous
      mode of transmission. Altogether we could find 39 stricken kins, 15 of them with
      autosomal-dominant, 16 with autosomal-recessive and 8 with an unclear mode of
      transmission. We registered anamnestically 1548 persons, from these 171 were
      suffering from hereditary hearing impairment. We were able to examine 117 of the
      affected persons. Seven typical audiometric features could be found. Including
      mode of transmission and possible progredience even 17 forms can be found. This
      represents a higher number of monosymptomatic forms of hereditary sensorineural
      hearing loss than described in the literature. It emphasizes that the main
      obstacle hindering future genotypical diagnosis will be the extreme high
      heterogenity.

PMID- 8365918
TI  - [Minimally invasive treatment of sialolithiasis using extracorporeal shock
      waves].
AB  - BACKGROUND: In the past, management of sialolithiasis required surgical
      extirpation of the afflicted gland, in case the concrements could not be removed
      by dilatation or dissection of the glandular duct. The aim of the present study
      was to investigate the safety and efficiency of extracorporeal shockwave
      lithotripsy of salivary gland stones in men. PATIENTS AND METHODS: 51 patients
      with symptomatic solitary salivary stones which could not be removed by
      conservative measures received extracorporeal piezoelectric shockwave treatment.
      The concrements had a median diameter of 8 (4-18) mm and were located in the
      submandibular gland (69%) and in the parotid gland (31%). A total number of 72
      shockwave treatments (maximum 3 treatments per patient) were performed under
      continuous sonographic monitoring. RESULTS: In 45 patients (88%) complete
      fragmentation of the concrements was achieved. Piezoelectric shockwave therapy
      was tolerated without any need for anesthesia, nor administration of sedatives or
      analgesics. The only untoward effects resulting from therapy were individual
      localized petechial hemorrhages after 10 out of 72 treatments (13%) and transient
      swelling of the gland immediately after shockwave application (2/72, (3%)).
      Twenty weeks after initial treatment 90% of the patients (46/51) were free of
      discomfort, and 53% of the patients (27/51) were stone free. The stone clearance
      rates of patients exhibiting concrements of the parotid gland (81%) were
      significantly higher than those of patients with stones of the submandibular
      gland (40%, p < 0.01). Auxiliary measures such as dilatation or dissection of the
      salivary duct were required only in patients suffering from concrements of the
      submandibular gland (20%). No long-term damage to the treated salivary gland nor
      to adjacent tissue structures were noted during the median follow-up period of 9
      (1-24) months. CONCLUSION: Extracorporeal piezoelectric shockwave therapy
      promises to become a safe, comfortable and effective minimal-invasive, non
      surgical treatment of salivary stones.

PMID- 8365919
TI  - [Ectopic teeth in the area of the paranasal sinuses].
AB  - In contrast to dentogenious affections of the sinus maxillaris ectopic or
      supernumerary teeth in the paranasal sinuses are seldom. Ectopic teeth located at
      the ostium of the sinus maxillaris are rare, intranasal teeth are very rare and
      ectopic/supernumerary teeth in the sinus etmoidalis are a curiosity. We report
      about two patients with such ectopic teeth. A 55 year old woman had a rootless
      tooth in her right sinus ethmoidalis which had caused a "pseudopolyposis" with
      consecutive nasal airway obstruction and severe headache. A 59 year old man had
      ectopic teeth in both sinus maxillaris which obstructed the left ostium, causing
      dumbness of the left cheek and severe headache. Both patients have been cured by
      operation. However the presented patients demonstrate that even elaborated
      radiological efforts could not prove diagnosis. The etiology, diagnostical steps
      and treatment of these teeth are discussed. The surrounding soft tissue should be
      examined histologically after resection of such a tooth to prevent the
      development of a residual cyst and to notice the extremely rare development of
      malignancies deriving from the highly potential tissue of the dental follicle.

PMID- 8365920
TI  - [Differential diagnosis of dysphagia].
AB  - The symptom dysphagia is defined and an interdisciplinary team approach
      emphasized. A step like diagnostic approach in oropharyngeal dysphagia is
      described, including transnasal pharyngo-laryngo-fiber endoscopy,
      videofluoroscopy and the "modified barium swallow." First, all of the organic
      changes causing oropharyngeal dysphagia must be recognized, both "typical ENT
      diseases" and malignant tumors of the oropharynx and hypopharynx, which are
      usually diagnosed only at an advanced stage. Of particular interest is
      postoperative dysphagia with or without aspiration. If there is no evidence of an
      organic cause in the field of otorhinolaryngology, in making a differential
      diagnosis dysfunction of the upper esophageal sphincter and a "globus pharyngis"
      have to be ruled out.

PMID- 8365921
TI  - The American Society for Histocompatibility and Immunogenetics, 19th Annual
      Meeting. Phoenix, Arizona, October 2-7, 1993. Abstracts.

PMID- 8365922
TI  - Research advances in the fight against the acquired immunodeficiency syndrome
      (AIDS)

PMID- 8365923
TI  - Physicians' role in controlling diabetes requires 'detective' work.

PMID- 8365924
TI  - Fasting hyperglycemia in type I diabetes mellitus.
AB  - The differential diagnosis of fasting hyperglycemia in type I diabetes includes
      the Somogyi effect, the dawn phenomenon, and insufficient insulin administration.
      To determine the causes of fasting hyperglycemia and their effect on subsequent
      daytime blood glucose control, the authors retrospectively reviewed blood glucose
      profiles of 126 patients with type I diabetes. The Somogyi effect accounted for
      12.6% of all instances of fasting hyperglycemia, the dawn phenomenon, 24.1%, and
      poor control, 63.3%. Measurement of 3 AM and 5 AM blood glucose values is the key
      to making a correct diagnosis. Once a patient's fasting hyperglycemia is placed
      in one of these groups, appropriate treatment can be started.

PMID- 8365925
TI  - Anomalous inferior vena cava with azygos continuation.
AB  - Five patients who underwent cardiac catheterization at three separate
      institutions during a period of 6 years were found to have anomalous inferior
      vena cava with azygos continuation. Although it is not uncommon to detect this
      defect in pediatric patients with congenital heart disease, it may be an unusual
      finding for an angiographer who works primarily with adults. This article serves
      as a reminder of the existence of this potentially confusing anomaly, usually
      associated with other congenital cardiac abnormalities.

PMID- 8365927
TI  - Support groups address residents' personal development.
AB  - Graduate medical education traditionally has emphasized the teaching of
      biomedical knowledge and technical skills. However, physicians-in-training also
      need opportunities to explore their emotional reactions that occur during the
      process of patient care and medical training. The promotion of personal growth
      and self-awareness should be important components of graduate medical education.
      Easily implemented, a resident support group is one forum that addresses this
      obvious gap in medical education. This article reviews the goals and structure of
      support groups, with the hope that more training programs will implement them.

PMID- 8365926
TI  - Tennis elbow: a biomechanical and therapeutic approach.
AB  - Lateral epicondylitis, one of the most common lesions of the arm, affects some
      50% of tennis players. This condition poses a problem in clinical management
      because treatment is dependent not only on proper medical therapy but also on
      correction of the improper on-court biomechanics. The most common flaw is a late
      contact on the backhand groundstroke, forcing the player to extend the wrist with
      the extensor muscles. This action predisposes to trauma of the tendon fibers at
      the lateral epicondyle. Understanding the biomechanics will better prepare the
      physician to advise the patient and to communicate with a tennis teaching
      professional to facilitate long-term relief.

PMID- 8365928
TI  - Acute mastocytosis: a potential dermatologic emergency.
AB  - A comatose patient arrived at the emergency room with apnea and in shock after a
      grand mal seizure. A maculopapular rash, not initially observed, led to a
      diagnosis of cutaneous mastocytosis. Degranulation of the mast cells with massive
      histamine release had resulted in cardiovascular collapse. The authors follow a
      detailed report of this case history with a discussion of the diagnosis and
      treatment of the acute systemic stage of this potentially life-threatening
      illness.

PMID- 8365929
TI  - Possible association of interleukin-2 treatment with depression and suicide.
AB  - Immunomodulatory agents for the treatment of certain oncologic disorders are
      rapidly moving from the research laboratory into clinical practice. These agents
      may not be void of potential neuropsychiatric sequelae. The following clinical
      report concerns a previously nondepressed patient with no history of psychiatric
      disorders who became depressed and killed himself while being treated with
      interleukin-2. It is important that consulting psychiatrists be sensitive to
      acute emotional changes in cancer patients taking immunomodulatory agents.

PMID- 8365930
TI  - Phantom evaluation of heating of superficial tissues located above interstitial
      microwave antennas.
AB  - PURPOSE: A technique that improves heating of superficial tissues above an
      implant of microwave interstitial antennas is presented. METHODS AND MATERIALS:
      Adequate heating of tumor margins is achieved by extending an implant of
      microwave antennas beyond the tumor boundary by 1-2 cm. When the tumor
      infiltrates the superficial tissues including the skin, the implant cannot even
      reach the superficial margin of the tumor since it requires tissue to support the
      catheters. This may yield cold spots in the tissues above the implant.
      Measurements in a phantom with varying thickness of the superficial layer above
      the implant demonstrated inadequate Specific Absorption Rates of energy
      distribution in this layer. A method that improves these distributions in the
      superficial layers was developed and tested in this work. This method requires
      placing a deionized water bolus on the phantom (patient) surface. Additional
      microwave antennas are placed on top of the bolus above and parallel to the
      implanted antennas. The Specific Absorption Rates distributions were evaluated
      for the thicknesses of superficial layer ranging from 1.5 mm to 16 mm and two
      bolus thicknesses (5 and 10 mm). RESULTS: The adequate Specific Absorption Rates
      distributions were achieved for all tested thicknesses of the superficial layer
      (1.5, 4, 8, 12, and 16 mm). The use of the 5 mm bolus versus 10 mm bolus is
      discussed. The use of additional antennas did not significantly increase stray
      radiation. CONCLUSION: This method has the potential to optimize heating of
      superficial tissues located above a microwave antenna implant.

PMID- 8365931
TI  - Results of a policy of surveillance in stage I testicular seminoma.
AB  - PURPOSE: To determine what proportion of patients with Stage I testicular
      seminoma will be cured with orchidectomy alone. METHODS AND MATERIALS: From
      August 1984 to December 1991 148 patients with Stage I testicular seminoma were
      entered on a prospective study of surveillance following orchidectomy. The
      eligibility criteria included a normal chest X ray, lymphogram, computed
      tomography (CT) of the abdomen and pelvis, and normal post-orchidectomy tumor
      markers (AFP and BHCG). Patients were followed with a clinical assessment
      (markers, chest X ray and CT abdomen and pelvis) at 4 to 6 monthly intervals.
      RESULTS: With a median follow-up of 47 months (range 7-87 months), the actuarial
      relapse-free rate was 81% at 5 years. Twenty-three patients have relapsed with a
      median time to relapse of 15 months (range 2-61 months). Four patients (17%)
      relapsed at 4 or more years from diagnosis. Twenty-one of the 23 relapses
      occurred in the paraaortic lymph nodes, one patient relapsed in the mediastinum
      and ipsilateral inguinal nodes and one patient had an isolated ipsilateral
      inguinal node relapse. Nineteen patients were treated for relapse with external
      beam radiation therapy of which three developed a second relapse and were
      salvaged with chemotherapy. Four patients were treated for first relapse with
      chemotherapy and one developed a second relapse and died of disease. Age at
      diagnosis was the only prognostic factor for relapse, with patients age < or = 34
      having an actuarial relapse-free rate at 5 years of 70% in contrast to a 91%
      relapse-free rate in those > 34 years of age. CONCLUSIONS: We recommend that
      surveillance in Stage I testicular seminoma should only be performed in a study
      setting until further data regarding the risk of late relapse and the efficacy of
      salvage chemotherapy is available.

PMID- 8365932
TI  - Accelerated hyperfractionated hepatic irradiation in the management of patients
      with liver metastases: results of the RTOG dose escalating protocol.
AB  - PURPOSE: This study was prepared to address two objectives: (a) to determine
      whether progressively higher total doses of hepatic irradiation can prolong
      survival in a selected population of patients with liver metastases; (b) to
      refine existing concepts of liver tolerance for fractionated external radiation
      employing a fraction size which might be appropriate in clinical protocols
      evaluating elective or adjuvant radiation of the liver. METHODS AND MATERIALS:
      One hundred seventy-three analyzable patients with computed tomography measurable
      liver metastases from primary cancers of the gastrointestinal tract were entered
      on a dose escalating protocol of twice daily hepatic irradiation employing
      fractions of 1.5 Gy separated by 4 hr or longer. Sequential groups of patients
      received 27 Gy, 30 Gy, and 33 Gy to the entire liver and were monitored for acute
      and late toxicities, survival, and cause of death. Dose escalation was
      implemented following survival of 10 patients at each dose level for a period of
      6 months or longer without clinical or biochemical evidence of radiation
      hepatitis. RESULTS: The use of progressively larger total doses of radiation did
      not prolong median survival or decrease the frequency with which liver metastases
      were the cause of death. None of 122 patients entered at the 27 Gy and 30 Gy dose
      levels revealed clinical or biochemical evidence of radiation induced liver
      injury. Five of 51 patients entered at the 33 Gy level revealed clinical or
      biochemical evidence of late liver injury with an actuarial risk of severe (Grade
      3) radiation hepatitis of 10.0% (+/- 7.3% S.E.) at 6 months, resulting in closure
      of the study to patient entry. CONCLUSION: The study design could not credibly
      establish a safe dose for hepatic irradiation, however, it did succeed in
      determining that 33 Gy in fractions of 1.5 Gy is unsafe, carrying a substantial
      risk of delayed radiation injury. The absence of apparent late liver injury at
      the 27 Gy and 30 Gy dose levels suggests that a prior clinical trial of adjuvant
      hepatic irradiation in patients with resected colon cancer may have employed an
      insufficient radiation dose (21 Gy) to fully test the question.

PMID- 8365933
TI  - A nomograph for permanent implants of palladium-103 seeds.
AB  - 103Pd is being substituted for 125I in permanent implants for which it is desired
      to deliver a higher initial dose rate while maintaining readily achieved
      radiation protection. We have constructed a nomograph to assist in determining
      both the total seed strength required and the appropriate needle spacing for
      103Pd implants. We have calculated the "matched peripheral dose" (MPD), that is,
      the dose for which the isodose contour volume is equal to the target volume, for
      64 125I and 13 103Pd actual implants as if 103Pd had been used for all of them,
      employing a computer lookup table based on single-seed dose distribution
      measurements in solid water. The calculated data were used to obtain a least
      squares fit to a linear relationship between the logarithm of the total seed
      strength for a given MPD and the logarithm of the average dimension, da (cm). We
      found that, for a nominal MPD of 11,500 cGy, total seed strength (in mCi) is
      given by 3.2 da2.56. A 103Pd nomograph has been constructed on the basis of this
      power function relationship. Our nomographic guide for planning 103Pd implants
      calls for total seed strength to increase significantly faster as a function of
      target volume average dimension than is the case for 125I. This nomograph will
      facilitate the application of 103Pd seeds in permanent implants.

PMID- 8365934
TI  - Online repositioning during treatment of the prostate: a study of potential
      limits and gains.
AB  - PURPOSE: With on-line portal imaging devices and image registration tools, the
      verification of radiation field position prior to each treatment becomes
      technically feasible. In this paper, we analyze the impact of pre-treatment
      verification and field position adjustment on target coverage and normal tissue
      sparing. METHODS AND MATERIALS: Port films were compared with corresponding
      simulation films to determine the magnitude of setup variations in patients
      treated for prostate cancer. From these data, an analytic function was determined
      between geometric coverage of the target and field margin size. A paradigm for on
      line patient repositioning was employed to generate a new relationship between
      margin and target coverage. Margins were selected for the situations of normal
      treatment and on-line repositioning to ensure target coverage. Dose-volume
      histograms were generated for a typical prostate treatment using these margins.
      RESULTS: On-line repositioning, when setup errors exceed 1 cm, results in a 6 mm
      reduction in margin, suggesting that 10% of the volume of bladder and rectum may
      be spared of high dose. CONCLUSION: The use of on-line imaging and image
      registration to guide adjustment of patient setup may lead to a reduction in the
      volume of normal tissues irradiated, and possibly improve the probability of
      complication-free survival in future treatments.

PMID- 8365935
TI  - Digitally reconstructed fluoroscopy and other interactive volume visualizations
      in 3-D treatment planning.
AB  - PURPOSE: Add radiographic context to the beam's-eye-view used in 3-dimensional
      treatment planning. Improve methods for interactive visualization of anatomy and
      dose distributions. METHODS AND MATERIALS: Most 3-dimensional treatment planning
      systems feature a beam's-eye view that includes only graphical representations of
      patient anatomy. With input devices such as a mouse or trackball, the user
      interactively shapes the treatment field using the graphical models to provide
      geometric information. Radiographic context provides additional geometric
      information important for determining field shape. We have implemented digitally
      reconstructed fluoroscopy in the beam's-eye view by increasing the efficiency for
      computing digitally reconstructed radiographs. In addition we have improved
      algorithms for real-time surface and volume rendering for anatomy and doses using
      an experimental graphics supercomputer. RESULTS: Without radiographic context in
      the beam's-eye-view, field shapes were sometimes changed after simulation or
      portal images were obtained. Digitally reconstructed fluoroscopy has essentially
      eliminated these changes. Higher quality interactive three-dimensional displays
      improve the comprehension, confidence and efficiency of the user. Our
      improvements have already been implemented on one model of a new generation of
      commercial graphics workstations. CONCLUSION: Addition of radiographic context to
      the beam's-eye-view is recommended. Incorporation of higher quality interactive
      graphics is rapidly becoming practical and is encouraged.

PMID- 8365936
TI  - Dosimetric evaluation of total scalp irradiation using a lateral electron-photon
      technique.
AB  - PURPOSE: To evaluate the radiation dosimetry of a new technique for total scalp
      irradiation. METHODS AND MATERIALS: A treatment technique described by Akazawa
      (1989) has been studied. During each fraction, two electron and two photon fields
      are treated. While most of the lateral scalp is treated with the electron fields,
      a rind of scalp close to the midsagittal plane is irradiated by parallel-opposed
      lateral photon fields. A wax bolus is used to build up skin dose and to protect
      the brain from electron dose. The dose distribution and dose-volume histograms
      were evaluated for different field arrangements using a 3-dimensional treatment
      planning system. After modifying the technique, in-vivo thermoluminescent
      dosimetry were used to evaluate the dose distributions for the first two
      patients. RESULTS: To compensate for the lack of dose from the opposed photon
      field at the junction, the technique was modified using overlapped fields instead
      of abutting fields. A field overlap of 3 to 4 mm between the electron and photon
      fields was found optimal. When used with the field junction shift of 1 cm midway
      through the treatment, this scheme resulted in a dose uniformity of -5% to +15%
      of the prescribed dose in the region of abutment. Results of the 3-dimensional
      dose calculation were supported by in-vivo thermoluminescent dosimetry on two
      patients. CONCLUSION: On the basis of computer dose calculations and in-vivo
      dosimetry. Akazawa's technique for scalp irradiation can be improved by using a 3
      to 4 mm overlap of electron and photon fields. This modified technique is
      practical and produces clinically acceptable dosimetry.

PMID- 8365937
TI  - The combination of cis-platin based chemotherapy and radiation in the treatment
      of muscle-invading transitional cell cancer of the bladder.
AB  - Radical cystectomy is the standard of care for patients with muscle-invading
      transitional cell carcinoma of the bladder. More limited surgery is only useful
      in highly selected patients and radiation therapy alone gives overall local
      control rates under 40%. Phase II studies have shown that when radiation and
      trans-urethral surgery are combined with cis-platin based chemotherapy local
      control rates increase such that the majority of patients preserve a tumor-free
      functional bladder. Up to 85% of patients selected for bladder sparing therapy on
      the basis of their initial response to chemo-radiation may keep their bladders.
      This figure could increase further when other powerful prognostic factors such as
      the presence of hydronephrosis, the presence of carcinoma in situ, and DNA ploidy
      are also taken into account in initial patient selection. The activity of
      cisplatin combinations in metastatic disease is not in doubt with up to 50%
      response rates generally reported. The hope that this will translate into the
      eradication of micrometastatic disease (known to be present in up to 40% of
      patients at diagnosis) has yet to be borne out. Those randomized trials so far
      reported have not shown any survival advantage when combined-modality therapy is
      compared to radiation alone. The addition of combination chemotherapy to
      radiation does not increase bladder morbidity but carries a considerable systemic
      penalty. Thus, despite promising Phase II studies, until local control and
      survival benefit is proven in a randomized trial it should continue to be
      regarded as experimental.

PMID- 8365938
TI  - Prognosis of human chorionic gonadotropin-producing seminoma treated by
      postoperative radiotherapy.
AB  - PURPOSE: To clarify the controversy about the management and prognosis of human
      chorionic gonadotropin-producing seminoma, the records of 132 patients with
      abnormal human chorionic gonadotropin values treated with radiotherapy were
      analyzed. METHODS AND MATERIALS: The records of 1169 patients with pure seminoma
      treated in 10 institutions were screened for serum or urinary human chorionic
      gonadotropin. One hundred and thirty two patients with elevated human chorionic
      gonadotropin were found: 96 Stage I, 20 IIA, 7 IIB, 8 III and 1 IV. Median age
      was 34 y., mean follow-up was 5.0 years [range 1-12 y]. All received
      infradiaphragmatic radiotherapy (median dose 30 Gy), 25 (2 Stage I, 11 IIA, 5 IIB
      and 7 III) supradiaphragmatic radiotherapy (median dose: 28.5 Gy) and 10 had also
      initial chemotherapy (3 Stage IIB 6 III and 1 IV). Patients were allocated to
      three groups according to human chorionic gonadotropin values: (a) moderate
      elevation: up to 10 times (104 pts), (b) high elevation: 10 to 100 times (20
      pts), (c) very high elevation: over 100 times the upper limit of normal value (8
      pts). RESULTS: The proportion of Stage I, II and III was 76%, 19%, 5% in the ME
      group versus 50%, 35%, 15% in the high elevation group (p < 0.05). In the very
      high elevation group there were 7 Stage I and 1 Stage IV. Of 132 patients, six
      died (three dead of disease, two suicides, one acquired immunodeficiency
      syndrome). The 5 years overall survival probability was 94%. There were seven
      recurrences (initial stage: 1 Stage I, 2 IIB, 3 III and 1 IV). Of these, there
      were one in-field recurrence, 3 out of field and 3 in both sites. In 5 of 7, the
      human chorionic gonadotrophin level was again elevated at recurrence. The 5 years
      recurrence-free-survival probability was 94% (98% for Stage I, 100% for Stage IIA
      and 65% for Stage IIB and III [p < 0.001 between I and IIB + III, p < 0.05
      between IIA and IIB + III]). Four of the 7 recurrences were salvaged by
      chimiotherapy +/- radiotherapy. In the high elevation and very high elevation
      groups, the 5 years recurrence-free-survival was 88%, vs. 96% for the moderate
      elevation group (p = 0.10). CONCLUSION: Based on this series of patients, human
      chorionic gonadotropin production is not an unfavorable prognostic factor in pure
      seminoma. Even in the subgroups with high or very high human chorionic
      gonadotropin levels (who had a higher proportion of advanced stages), the
      prognosis remained excellent. In Stage I and IIA seminoma with abnormal human
      chorionic gonadotropin levels, recurrence rate after post-operative radiotherapy
      alone is extremely low.

PMID- 8365939
TI  - Anal cancer--radiation alone or with cytotoxic drugs?

PMID- 8365940
TI  - In reference to Jack F. Fowler's alpha, beta, alpha/beta and s.

PMID- 8365941
TI  - Predictive value of perfusion lung scans on post irradiation pulmonary function.

PMID- 8365942
TI  - Renal tolerance to nonhomogenous irradiation: comparison of observed effects to
      predictions of normal tissue complication probability from different biophysical
      models.
AB  - PURPOSE: A patient series was analyzed retrospectively as an example of whole
      organ kidney irradiation with an inhomogenous dose distribution to test the
      validity of biophysical models predicting normal tissue tolerance to
      radiotherapy. METHODS AND MATERIAL: From 1969 to 1984, 142 patients with seminoma
      were irradiated to the paraaortic region using predominantly rotational
      techniques which led to variable but partly substantial exposure of the kidneys.
      Median follow up was 8.2 (2.1-21) years and actuarial 10-year survival (Kaplan
      Meier estimate) 82.8%. For all patients 3-dimensional dose distributions were
      reconstructed and normal tissue complication probabilities for the kidneys were
      generated from the individual dose volume histograms. To this respect different
      published biophysical algorithms had been introduced in a 3-dimensional-treatment
      planning system. RESULTS: In seven patients clinical manifest renal impairment
      was observed (interval 10-84 months). An excellent agreement between predicted
      and observed effects was seen for two volume-oriented models, whereas
      complications were overestimated by an algorithm based on critical element
      assumptions. CONCLUSIONS: Should these observations be confirmed and extended to
      different types of organs corresponding algorithms could easily be integrated
      into 3-dimensional-treatment planning programs and be used for comparing and
      judging different plans on a more biologically oriented basis.

PMID- 8365943
TI  - Treatment of stage I testis seminoma by radiotherapy: long-term results--a 30
      year experience.
AB  - PURPOSE: From 1956 to 1986, we have retrospectively studied 184 patients with a
      Stage I testis seminoma treated by orchidectomy and radiotherapy at the Institut
      Gustave Roussy. METHODS AND MATERIALS: The 184 patients received adjuvant
      radiotherapy to the para-aortic and ipsilateral iliac nodes. Of the 184 patients,
      133 received additional mediastinal and supraclavicular irradiation, 47 received
      supraclavicular without mediastinum irradiation, 98 patients received additional
      radiotherapy given to inguino-scrotal area. The mean dose of irradiation is 21 Gy
      which is the lowest dose published. The actuarial survival rate is, respectively,
      96%, 93%, 83% and 77% at 5, 10, 15, and 20 years. RESULTS: Four patients
      relapsed, and four died of progressive disease. Four patients presented
      cardiovascular disease, all of them had mediastinal irradiation, two were heavy
      smokers. Seventeen second malignancies were observed, six tumors in the
      contralateral testis. The actuarial risk of developing a second malignancy is 10%
      at 10 years, 21% at 20 years. The cure rate and relapse rate in our patients is
      the same as that obtained by higher dosage of irradiation. CONCLUSION: We
      conclude that low dose of prophylactic irradiation in lumbo aortic and
      ipsilateral iliac lymph nodes is active and safe in the treatment of Stage I
      testis seminoma.

PMID- 8365944
TI  - Chemoradiotherapy versus radiotherapy alone for anal cancer: a retrospective
      comparison.
AB  - PURPOSE: To evaluate the effect of adding one cycle of concomitant chemotherapy
      to curative radiotherapy on tumor control and toxicity in the treatment of anal
      cancer. METHODS AND MATERIALS: One hundred twenty-five patients completed
      curative sphincter-conserving treatment, 57 with radiotherapy alone and 68 with
      concomitant chemo-radiotherapy. Compared with chemoradiotherapy patients,
      radiotherapy patients were older (median age 71 vs 63) and had less advanced
      tumors (T3-4 26% vs 51%). Radiotherapy patients were usually treated with a
      direct perineal cobalt field (mean dose 31 Gy at 5 cm/10 fractions/3 weeks),
      complemented in most cases by a sacral are field, followed (mean split 54 days)
      by Iridium-192 implantation (mean dose 23 Gy, Paris system). The large majority
      of chemoradiotherapy patients received antero-posterior opposed 10 MV photon
      fields, including pelvic and inguinal nodes (mean dose 38 Gy/19 fractions/4
      weeks), followed (mean split 42 days) by implant boost (mean dose 18 Gy). In
      addition, chemo-radiotherapy patients received starting on day 1 an IV bolus of
      Mitomycin-C, 0.4 mg/kg (maximum 20 mg) and a 5-day continuous infusion of 5
      fluorouracil 600-800 mg/m2/day. Median follow-up was 65 months for radiotherapy
      and 48 months for chemo-radiotherapy patients. RESULTS: For all 125 patients at 5
      years, overall survival was 65.5%, definitive local control 83% and local control
      with sphincter preservation 68%. Overall and stage for stage, there was no
      difference in overall, progression-free or cancer-specific survival, nor in local
      control, local-regional control, or sphincter preservation rates between patients
      treated with chemoradiotherapy vs. radiotherapy alone. There was no significant
      difference between the two groups regarding acute or late toxicity. CONCLUSION:
      This retrospective analysis does not confirm the efficacy of one course of
      simultaneous Mitomycin-C and 5-fluorouracil, at least in association with full
      dose radiotherapy incorporating Iridium-192 boost.

PMID- 8365945
TI  - Definitive postoperative irradiation of bile duct carcinoma with charged
      particles and/or photons.
AB  - PURPOSE: To determine the rates of survival and local control in patients with
      bile duct adenocarcinomas treated with post-operative photons and/or charged
      particles. METHODS AND MATERIALS: A retrospective study was performed analyzing
      all patients with bile duct adenocarcinomas who received radiotherapy through the
      University of California San Francisco and at Lawrence Berkeley Laboratory
      between 1977 and 1987, a total of 62 patients. University of California San
      Francisco patients received photon therapy (median dose 5400 cGy), and Lawrence
      Berkeley Laboratory patients were treated with the charged particles helium
      and/or neon (median dose 6000 cGyE). Forty-eight patients were treated post
      operatively with curative intent, 30 with photons and 18 with particles. Thirty
      six patients in the study had gross residual disease; none had microscopically
      negative margins. RESULTS: The overall two-year actuarial survival was 28%: 44%
      for particle-treated patients and 18% for patients treated with photons (p =
      .048). Median actuarial survival was 23 months in particle patients and 12 months
      in photon patients. Local control was also improved, though less significantly,
      in patients treated with particles (median disease-free survival 20 months vs.
      4.5 months, p = .054). A univariate and multivariate analysis was performed and
      revealed that only extent of residual disease predicted local failure and overall
      survival; no other prognostic factors were identified. CONCLUSION: Compared to
      conventional photon radiotherapy, treatment with post-operative charged particle
      irradiation at Lawrence Berkeley Laboratory appeared to offer a survival
      advantage in this non-randomized series. Additional investigation into protection
      of surrounding normal tissue with better dose localization through the use of
      charged particles is planned.

PMID- 8365946
TI  - In vitro characterization of radiotherapy-induced morphonuclear modifications on
      chemosensitive as opposed to chemoresistant neoplastic cells.
AB  - PURPOSE: We describe by means of digital cell image analysis the influence of X
      ray radiation on three in vitro cultured cell lines for which we set up
      chemosensitive and chemoresistant variants. METHODS AND MATERIALS: The three cell
      lines correspond to the MXT mouse mammary and the T24 and J82 neoplastic human
      bladder cells. The digital cell image analysis was carried out by computing
      morphometric (nuclear size), densitometric (proportion of cells in the G2 cell
      cycle phase), and textural features (chromatin pattern characteristics) on
      Feulgen-stained nuclei. RESULTS: The results show that such digital cell image
      analyses make it possible to monitor radiotherapy-induced effects on these
      morphonuclear characteristics accurately. X-ray radiotherapy induces a dose
      dependent increase in the proportion of cells in the G2 phase of the cell cycle
      along with a decrease in the overall chromatin condensation level. These two
      concomitant phenomena lead to a marked radiotherapy-induced increase in nuclear
      size. We also observed that radiotherapy-induced effects at the morphonuclear
      level are not only highly specific to the cell type analyzed, that is MXT mouse
      mammary or J82 or T24 human bladder carcinoma cells, but also to the fact that
      the cells are either chemosensitive or chemoresistant. CONCLUSION: The digital
      cell image analyses of Feulgen-stained nuclei is helpful in monitoring the
      irradiation-induced morphonuclear modifications.

PMID- 8365947
TI  - Treatment of radiation nephropathy with ACE inhibitors.
AB  - PURPOSE: A previous study showed that radiation nephritis could be treated with
      captopril, an angiotensin-converting-enzyme inhibitor. These studies were
      designed to determine whether other angiotensin-converting-enzyme inhibitors
      would be effective, whether captopril would inhibit the development of the
      histopathologic lesions typical of radiation nephritis, and whether captopril
      could be used to treat the nephropathy observed in bone marrow transplant
      recipients conditioned with total body irradiation. METHODS AND MATERIALS: In
      radiation nephritis studies, rats were given 17-27 Gy bilateral renal irradiation
      in 5 fractions. Six months after irradiation animals were stratified by blood
      urea nitrogen and assigned to no treatment, or treatment with captopril (500
      mg/l) or enalapril (50 mg/l) in the drinking water. A subset of animals was
      sacrificed for histopathology after 3 months; the remaining animals continued on
      drugs for 7 months. In the bone marrow transplant nephropathy study, rats
      received 14-17 Gy total body irradiation in 6 fractions over 3 days followed by
      syngeneic bone marrow transplant. Six months after irradiation, animals were
      stratified by blood urea nitrogen and assigned to no treatment, or treatment with
      captopril (500 mg/l). Animals remained on drugs for 6 months. In all studies
      animals were followed with periodic renal function tests. RESULTS: In the
      radiation nephritis study, survival and renal function were significantly
      enhanced by both captopril and enalapril, but there were no significant
      differences between the drugs. The histopathologic severity of the lesions of
      radiation nephritis correlated with the degree of renal dysfunction; and in
      irradiated animals with equal initial azotemia, captopril-treated rats developed
      less severe renal lesions. Finally, captopril also prolonged survival and
      preserved renal function in this rat bone marrow transplant nephropathy model.
      CONCLUSION: Angiotensin-converting-enzyme inhibitors are an effective treatment
      for both radiation nephritis and bone marrow transplant nephropathy.

PMID- 8365948
TI  - The orthodox Jungian perspective on gender differences in consciousness. A re
      examination.

PMID- 8365949
TI  - Multiple personality and the complex theory. A correction and a rejection of C.
      G. Jung's 'collective unconscious'.

PMID- 8365950
TI  - Inhibition of enterobacteria and Listeria growth by lactic, acetic and formic
      acids.
AB  - Minimum inhibitory concentrations (MIC) of undissociated lactic, acetic and
      formic acids were evaluated for 23 strains of enterobacteria and two of Listeria
      monocytogenes. The evaluation was performed aerobically and anaerobically in a
      liquid test system at pH intervals of between 4.2 and 5.4. Growth of the
      enterobacteria was inhibited at 2-11 mmol l-1, 0.5-14 mmol l-1 and 0.1-1.5 mmol l
      1 of undissociated lactic, acetic and formic acids, respectively. The MIC value
      was slightly lower with anaerobic conditions compared with aerobic conditions.
      The influence of protons on the inhibition was observed for acetic acid at the
      low pH values. Undissociated lactic acid was 2 to 5 times more efficient in
      inhibiting L. monocytogenes than enterobacteria. Acetic acid had a similar
      inhibitory action on L. monocytogenes compared with enterobacteria. Inorganic
      acid (HCl) inhibited most enterobacteria at pH 4.0; some strains, however, were
      able to initiate growth to pH 3.8. The results indicate that the values of
      undissociated acid which occur in a silage of pH 4.1-4.5 are about 10-100 times
      higher than required in order to protect the forage from the growth of
      enterobacteria and L. monocytogenes.

PMID- 8365951
TI  - Classification of the spoilage flora of raw and pasteurized bovine milk, with
      special reference to Pseudomonas and Bacillus.
AB  - Eighty-one bacterial strains isolated from refrigerated raw milk, 124 from
      pasteurized milk and cream stored at 5 degrees C and 7 degrees C, and 19 type and
      reference strains of Pseudomonas spp. and Bacillus spp. were characterized by
      numerical phenotypic analysis. Data were processed with simple matching (SSM) and
      Jaccard (SJ) coefficients, and UPGMA clustering. Fourteen clusters of Gram
      negative bacteria were formed at SJ = 79% (SSM = 90%). Raw milk was exclusively
      spoilt by Gram-negative bacteria, the majority of which were Pseudomonas
      fluorescens biovar I, Ps. fragi, Ps. lundensis and Ps. fluorescens biovar III.
      Minor groups in raw milk included Enterobacteriaceae spp. and Acinetobacter spp.
      Pasteurized milk was spoilt by essentially the same Gram-negative organisms in
      65% (5 degrees C) and 50% (7 degrees C) of the cases. The phenotypic
      characteristics of Gram-negative bacteria are given. Bacillus polymyxa (both
      temperatures) and B. cereus (only at 7 degrees C) were responsible for 77% of
      samples spoiled by the Gram-positive organisms. Minor milk spoilage groups
      included other Bacillus spp. and lactic acid bacteria. All Bacillus spp. grew
      fermentatively in milk, and most strains denitrified. It is suggested that: (i)
      industrial recontamination tests of pasteurized milk are directed against
      Pseudomonas; (ii) milk is stored at 5 degrees C or lower to avoid growth of B.
      cereus; and (iii) the significance of gas-producing and nitrate/nitrite-reducing
      Bacillus strains is recognized in cheese production.

PMID- 8365952
TI  - Some factors affecting airborne survival of Pseudomonas fluorescens indoors.
AB  - The effect of relative humidity (RH) on the airborne survival of a Pseudomonas
      fluorescens strain was studied at 20, 40, 60 and 80% RH indoors. The aero-stable
      spore of Bacillus subtilis subsp. niger, used as a tracer of physical losses was
      compared with a light scattering particle counter, as there were doubts about the
      reliability of the spore as tracer. The Rion counter was validated before use and
      found to give a good estimate of relative physical losses providing spray
      suspensions contained between 10(7) and 10(9) cfu ml-1 cells and that the
      humidity was not more than 80% RH. Pseudomonas fluorescens, strain P+S+,
      suspended in distilled water survived best at mid humidities and least at 80% RH.
      When suspended in 1% glycerol there was an apparent 'increase' in viability after
      an initial rapid reduction. This was thought to be due to delay in equilibration
      of glycerol in the cell membrane after concentration on dehydration. The cells
      were thought to be unstable and sensitive to the stress of rehydration before
      equilibration occurred. The findings are discussed in relation to Cox's theories
      of outer membrane damage on aerosolization.

PMID- 8365953
TI  - Interrelationships between strains of Salmonella enteritidis belonging to phage
      types 4, 7, 7a, 8, 13, 13a, 23, 24 and 30.
AB  - Salmonella enteritidis strain P278849 expressed long-chain lipopolysaccharide
      (LPS, termed 'smooth'), carried plasmids of 38, 34 (pDEP 44, incompatibility
      group N, R-type AS), 2.0 and 1 MDa, and belonged to phage type (PT) 23.
      Introduction of pDEP 44 into a smooth strain of Salm. enteritidis PT 4 produced a
      smooth strain of Salm. enteritidis of PT 24. Transfer of this plasmid into a
      strain of PT 8 also resulted in formation of a smooth strain of Salm. enteritidis
      of PT 24. Moving pDEP 44 into strains of Salm. enteritidis of PTs 7 or 7a which
      did not express LPS (termed 'rough') resulted in rough strains of PT 23. In
      contrast, transfer of this plasmid into a smooth strain of Salm. enteritidis PT
      7a resulted in a smooth strain of PT 23. Introduction of pDEP 44 into strains of
      Salm. enteritidis of PT 13 or PT 13a did not change the phage type, whereas
      transferring the plasmid into strains of PT 30 caused strains to become resistant
      to lysis by the typing phages and therefore untypable. The possibility of strains
      of Salm. enteritidis of PT 8 being the progenitors of strains of Salm.
      enteritidis of PT 24 must now be considered when investigating the epidemiology
      of Salm. enteritidis of PT 24 infections in areas where Salm. enteritidis PT 8 is
      common.

PMID- 8365955
TI  - In vitro susceptibility of Clostridium perfringens isolated from farm animals to
      growth-enhancing antibiotics.
AB  - Minimal inhibitory concentration (MIC) determinations were carried out with seven
      growth-enhancing antibiotics against 95 Clostridium perfringens field isolates
      obtained during 1991 and 1992 from poultry, pigs and calves. All were resistant
      to 64 micrograms ml-1 of the bambermycin antibiotic, flavomycin
      (flavophospholipol) and susceptible to avoparcin (MIC90 0.25 micrograms ml-1),
      avilamycin (MIC90 0.5 micrograms ml-1) and salinomycin (MIC90 < or = 0.12
      micrograms ml-1). Acquired resistance against bacitracin was detected in some
      isolates from poultry and bovines and resistance to tylosin and virginiamycin in
      some strains from all species investigated. Overall, the prevalence of resistance
      was comparable to the low levels recorded in 1979 in Cl. perfringens isolates
      from the same animal host species.

PMID- 8365954
TI  - Occurrence of campylobacters in small domestic and laboratory animals.
AB  - Faeces samples from 156 healthy domestic pets and laboratory animals were
      examined for campylobacters with both a selective medium (Campylobacter Blood
      Free Medium; Oxoid, CM739) and selective filtration through a 0.65 micron pore
      size filter. Campylobacter spp. were isolated from 78 of the samples; filtration
      was the most effective method. Isolates were characterized by biochemical tests
      and DNA/DNA hybridization with whole chromosomal DNA from reference strains as
      probes. Campylobacter upsaliensis was the most common species isolated from cats
      (45 from 68 samples) whilst Camp. jejuni was more often isolated from dogs (19
      from 56 samples). More attention should be paid to pets as a potential source of
      campylobacters capable of causing diarrhoea in human beings. Procedures other
      than those involving currently-used selective agents must be employed to
      efficiently detect all campylobacters.

PMID- 8365956
TI  - Development of a 24 h screen to detect viable salmonellas in faeces.
AB  - A 24 h screen to detect viable salmonellas in faeces was developed by studying
      growth dynamics of salmonellas and competing flora in combinations of enrichment
      media and artificially-inoculated pig faeces. Muller-Kauffmann tetrathionate (MK)
      broth, incubated overnight at 42 degrees C, maintained the lowest ratio of
      salmonella: competing flora and identified all inoculated samples. A 4 h
      postenrichment in M broth plus novobiocin reduced the number of false-positive
      results in subsequent ELISAs. Adjusting the negative cut-off values and
      incubation time of the chromogenic substrate from that recommended in the ELISA
      instructions reduced the rate of false-positive results further and allowed the
      detection of 10(3) salmonellas per ml in the presence of up to 10(7) ml-1 aerobic
      competing cells. Suspension of faeces diluted 1 in 2 and 1 in 5, rather than 1 in
      10 in MK broth did not necessitate further adjustments to the ELISA baseline
      values. The proposed screen protocol is an overnight incubation of faeces
      suspended 1 in 10 in MK broth, a 1 in 100 subculture into M broth plus 10
      micrograms ml-1 novobiocin (MbN) for 4 h, steam inactivation of MbN cultures and
      testing by ELISA, and can detect three salmonella cells per g faeces.

PMID- 8365957
TI  - Comparison of classical isolation protocols with a 24 h screen to detect viable
      salmonellas in faeces.
AB  - A 24 h screen which detects three viable salmonella cells per g of faeces was
      compared with classical isolation procedures for their ability to identify
      salmonella-positive samples from a pig rearing unit. The screen involved an
      overnight enrichment in Muller-Kauffmann tetrathionate (MK) broth, subculture for
      4 h in M broth containing 10 micrograms ml-1 novobiocin, followed by detection of
      the presence of salmonellas by BacTrace and Salmonella-tek ELISAs. The classical
      protocols were: (1) an overnight and 48 h incubation in MK or selenite cysteine
      broth; or (2) overnight incubation in buffered peptone water and 24 h subculture
      in Rappaport-Vassiliadis broth (BPW-RV). Salmonellas were isolated from the broth
      cultures on xylose lysine deoxycholate and brilliant green agars. Thirty four of
      100 samples were positive for salmonellas but no single isolation protocol
      identified all of them. The best of the classical isolation protocols, 48 h
      incubation in MK broth, identified 27 (79%) of the 34 positive samples whilst the
      screen identified 26 (76%) of the 34 positive samples. False-positive results
      were obtained from all isolation protocols except BPW-RV.

PMID- 8365958
TI  - A new method for the concentration of Cryptosporidium oocysts from water.
AB  - A novel method for the concentration of Cryptosporidium oocysts from water has
      been developed, based upon the precipitation of calcium carbonate. A 10 l water
      sample is treated by adding solutions of calcium chloride and sodium bicarbonate
      and raising the pH value to 10 with sodium hydroxide. Crystals of calcium
      carbonate form and enmesh particles in the Cryptosporidium oocyst size range. The
      crystals are allowed to settle, the supernatant fluid is discarded and the
      calcium carbonate precipitate dissolved in sulphamic acid. The sample can be
      concentrated further by centrifugation. Recoveries of oocysts from seeded samples
      of deionized, tap and river water were in excess of 68%.

PMID- 8365959
TI  - Routine monitoring of Cryptosporidium oocysts in water using flow cytometry.
AB  - A flow cytometric method for the routine analysis of environmental water samples
      for the presence of Cryptosporidium oocysts has been developed. It uses a Coulter
      Epics Elite flow cytometer to examine water samples and to separate oocysts from
      contaminating debris by cell sorting. The sorted particles are then rapidly
      screened by microscopy. The method has been evaluated and compared with direct
      epifluorescence microscopy on 325 river, reservoir and drinking water samples.
      The technique was found to be more sensitive, faster and easier to perform than
      conventional epifluorescent microscopy for the routine examination of water
      samples for Cryptosporidium.

PMID- 8365960
TI  - Individual airway constrictor response heterogeneity to histamine assessed by
      high-resolution computed tomography.
AB  - We directly measured the range of individual airway responses to aerosol and
      intravenous administration of histamine by using high-resolution computed
      tomography and then compared the heterogeneity in constriction responses between
      these two routes. Seven dogs were used for a total of eleven studies. Six of the
      seven dogs received intravenous histamine (100-300 micrograms/min) and five of
      the seven dogs received aerosolized histamine (0.01-3.0 mg/ml for 5 breaths).
      Data were analyzed using linear regression models calculating residual mean
      square values for each route of histamine as a measure of variability in the
      change in airway size. The residual mean square values for the absolute airway
      size after the aerosol and intravenous histamine challenges were 17.73 and 15.42,
      respectively, which were not significantly different [F(331,166) = 1.15, P =
      0.32]. Also, there were no significant differences when we compared the log or
      the percent change in airway area for the two routes of administration. We
      conclude that the route of histamine administration does not significantly affect
      the heterogeneity of airway response, suggesting that the heterogeneity observed
      after the histamine challenge is predominantly controlled by local mechanisms in
      the airways.

PMID- 8365961
TI  - Use of a new index to study relaxation in a vascular model of anaphylactic shock.
AB  - We have reported increased smooth muscle shortening ability in ragweed pollen
      sensitized saphenous vein (SSV). This may account for the vascular
      hyperreactivity of anaphylactic shock. We have now investigated relaxation in
      SSV. Because isotonic relaxation is load and initial contractile element length
      dependent, we developed an adjusted half-relaxation time index, which was
      independent of these variables. Muscle activation state was monitored by
      measuring maximum unloaded velocity. The relaxation index showed no difference
      between SSV and control saphenous vein after 2.5, 10, and 15 s of electrical
      stimulation; however, after 1 s of stimulation it was prolonged significantly in
      SSV. We concluded that the cross bridges activating early in contraction
      demonstrated prolonged relaxation. Activation state during muscle relaxation
      spontaneously increased toward the end of relaxation, coincident with a slowing
      in isotonic re-elongation rate. This was seen only in muscles relaxing from 15 s
      of stimulation. Our results indicate that 1) the relaxation properties of early
      cycling (1 s) cross bridges are altered after sensitization; and 2) toward the
      end of isotonic relaxation, cross-bridge cycling rate increases spontaneously, a
      phenomenon not previously reported. We speculate that the rapid re-elongation in
      late relaxation may reactivate muscle.

PMID- 8365962
TI  - Effect of positive end-expiratory pressure on leukocyte transit in rabbit lungs.
AB  - Previous experiments in humans and animals have shown that neutrophils (PMN) are
      delayed in the lung by the inhalation of cigarette smoke. Others have shown that
      cigarette smoking raises airway resistance, and it follows that this will
      increase the expiratory time constant of the airways. When the expiratory time
      constant of the airways exceeds that of the chest wall, alveolar pressure will
      rise and compress alveolar capillaries. To determine the effect of alveolar
      compression on PMN retention, we measured the arteriovenous (A-V) difference for
      leukocytes across the lung and determined the retention of 51Cr-labeled PMN in
      the lungs of anesthetized ventilated rabbits. The results show that the
      application of positive end-expiratory airway pressure (PEEP) produced an
      immediate difference for PMN across the lung, which disappeared in approximately
      3 min when PEEP was continuously applied. This effect was attributed to alveolar
      compression rather than reduced cardiac output, because a similar A-V difference
      for PMN was observed in separate experiments in which cardiac output was
      maintained by vascular expansion during PEEP. The results also show that, when
      PEEP was continuously applied for approximately 30 min, it failed to increase the
      percent retention of either inactivated (PEEP = 14 +/- 2% vs. non-PEEP 16 +/- 3%)
      or activated (PEEP = 62 +/- 7% vs. non-PEEP 63 +/- 6%) 51Cr-PMN. We conclude that
      the application of PEEP traps PMN in compressed alveolar capillaries, creating an
      immediate A-V difference that disappears as blood flow is redistributed to
      vessels that are not compressed by PEEP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365963
TI  - Intramuscular pressure and electromyography as indexes of force during isokinetic
      exercise.
AB  - A direct method for measuring force production of specific muscles during dynamic
      exercise is presently unavailable. Previous studies indicate that both
      intramuscular pressure (IMP) and electromyography (EMG) correlate linearly with
      muscle contraction force during isometric exercise. The objective of this study
      was to compare IMP and EMG as linear assessors of muscle contraction force during
      dynamic exercise. IMP and surface EMG activity were recorded during concentric
      and eccentric isokinetic plantarflexion and dorsiflexion of the ankle joint from
      the tibialis anterior (TA) and soleus (SOL) muscles of nine male volunteers (28
      54 yr). Ankle torque was measured using a dynamometer, and IMP was measured via
      catheterization. IMP exhibited better linear correlation than EMG with ankle
      joint torque during concentric contractions of the SOL (IMP R2 = 0.97, EMG R2 =
      0.81) and the TA (IMP R2 = 0.97, EMG R2 = 0.90), as well as during eccentric
      contractions (SOL: IMP R2 = 0.91, EMG R2 = 0.51; TA: IMP R2 = 0.94, EMG R2 =
      0.73). IMP provides a better index of muscle contraction force than EMG during
      concentric and eccentric exercise through the entire range of torque. IMP
      reflects intrinsic mechanical properties of individual muscles, such as length
      tension relationships, which EMG is unable to assess.

PMID- 8365964
TI  - Hyperoxic exposure enhances airway reactivity of newborn guinea pigs.
AB  - To determine whether altered airway smooth muscle contractility contributes to
      airway hyperreactivity resulting from hyperoxic exposure, in vitro contractile
      responses of airways to two physiological constrictors, acetylcholine (10(-9) to
      10(-4) M) and histamine (10(-8) to 10(-4) M), were examined. Extrathoracic
      trachea, intrathoracic trachea, and bronchus from 1- to 2-day-old (newborn)
      guinea pigs exposed to 85% oxygen for 84 h were compared with tissues obtained
      from newborns reared in room air. Responses in the presence and absence of
      aspirin (ASA; 10(-3) M) were compared. Hyperoxic exposure did not affect the
      histology of the airway epithelia. Contractile responses to acetylcholine and
      histamine were similar. Without ASA, maximal tensions generated were higher in
      both extrathoracic and intrathoracic trachea obtained from hyperoxia-exposed
      neonates than in trachea from newborns reared in room air. ASA caused maximal
      tensions of trachea from newborns reared in room air to increase but did not
      affect the already increased contractility of trachea from hyperoxia-exposed
      animals; the tensions achieved in hyperoxic tissues with and without ASA were
      similar to the hyperactive responses induced by ASA in tissues from animals
      reared in room air. Bronchi showed responses similar to those seen in tracheal
      segments. Thus, despite no apparent histological effect on the airway epithelium,
      hyperoxic exposure seems to increase airway smooth muscle contractility, is
      nonspecific for different constricting agents, and shows no regional differences
      in airway reactivity.

PMID- 8365965
TI  - Regulation of expiratory muscles during postnatal development in anesthetized
      piglets.
AB  - We compared maturation of the responses of the rib cage [triangularis sterni
      (TS)] and abdominal [transversus abdominis (TA)] expiratory muscles with each
      other and with the responses of the diaphragm (DIA) during hypercarbic and
      hypoxic stimulation. Studies were performed in anesthetized (urethan and
      chloralose) piglets of two age groups (< 6 days, n = 10; 14-21 days, n = 11)
      before and after bilateral cervical vagotomy. Hypercarbia (7% CO2-93% O2) was
      associated with comparable sustained increases in the minute electromyograms
      (EMGs) of both TS and TA, which were closely coupled to the DIA responses in both
      age groups. Hypoxia (12% O2-88% N2) caused a biphasic response of the minute EMG
      of both expiratory muscles and DIA; these biphasic responses were less prominent
      at 14-21 days than at < 6 days. Vagotomy caused an increase in the amplitude of
      both TS and TA (38 +/- 30 and 27 +/- 21%, respectively) as well as the DIA (45 +/
      16%) but did not affect their relative responses to chemostimulation. We
      conclude that during postnatal development 1) the rib cage and abdominal
      expiratory muscle responses to chemostimulation are coupled to each other and
      parallel those of the DIA and 2) the presence of vagal afferents attenuates the
      drive to both inspiratory and expiratory motoneurons under the current
      experimental conditions but does not influence the relative responses of
      expiratory muscles and DIA to hypercarbia or hypoxia. We speculate that
      comparable activation of inspiratory and expiratory pumping muscles serves to
      stabilize respiratory control in the face of altered chemosensory or vagal inputs
      during early postnatal life.

PMID- 8365966
TI  - Comparison of the secretory response of the nasal mucosa to methacholine and
      histamine.
AB  - To better understand the secretory response of the nasal mucosa, we must be able
      to accurately measure its physiological response. To this end, we developed a
      localized challenge technique using paper disks to stimulate the mucosa on one
      side and measure secretions from both sides to study both direct and reflex
      responses. Both methacholine and histamine induced a dose-dependent increase in
      secretion weights on the challenge side, whereas only histamine induced a
      contralateral reflex. Repeated stimulation with histamine, but not methacholine,
      resulted in tachyphylaxis. Pretreatment with atropine resulted in inhibition of
      the contralateral secretory response to histamine and the ipsilateral response to
      methacholine with only partial inhibition of the ipsilateral histamine response.
      Terfenadine pretreatment resulted in the complete inhibition of both the
      ipsilateral and contralateral responses to histamine with no effect on
      methacholine-induced secretions. Ipsilaterally applied lidocaine had no effect on
      the histamine response but, when applied contralaterally, partially inhibited
      that response. Topical diphenhydramine applied ipsilaterally led to significant
      inhibition of the ipsilateral and contralateral secretory responses to histamine
      but had no effect when applied contralaterally. We conclude that methacholine and
      histamine have different effects on the nasal mucosa. We speculate that
      methacholine stimulates glands directly, whereas histamine includes both direct
      and neurogenic stimulation.

PMID- 8365967
TI  - Importance of left atrial baroreceptors in the cardiopulmonary baroreflex of
      normal humans.
AB  - In animals, sympathetic responses to orthostasis are regulated in part by
      cardiopulmonary afferents arising from atrial and ventricular baroreceptors. To
      determine the relative importance of these baroreceptor regions in the
      cardiopulmonary baroreflex of normal humans, simultaneous measurements of left
      atrial and right and left ventricular volumes (cine computed tomography),
      invasive hemodynamics, forearm vascular resistance (plethysmography), and
      efferent sympathetic nerve activity to muscle (microneurography) were obtained
      under control conditions and with nonhypotensive lower body negative pressure (
      10 mmHg, LBNP-10) in nine normal human subjects. LBNP-10 did not alter heart rate
      or mean systemic arterial pressure, but it did produce significant decreases in
      pulmonary artery diastolic and right atrial pressures. This reduction in cardiac
      filling pressures resulted in efferent sympathoexcitation evidenced by increases
      in forearm vascular resistance and efferent sympathetic nerve activity to the
      muscle. LBNP-10 did not alter end-diastolic volume of the left or the right
      ventricle. Similarly, ventricular stroke volume was unchanged during LBNP-10, as
      assessed by cine computed tomography or thermodilution techniques. In contrast,
      LBNP-10 resulted in a significant decrease in left atrial volume. Thus, LBNP
      produced a significant decrease in cardiac filling pressures and left atrial
      volumes with resultant reflex sympathoexcitation, whereas ventricular volumes
      were unchanged. These observations suggest an important role for left atrial
      (nonventricular) baroreceptor afferents in the cardiopulmonary baroreflex of
      normal humans.

PMID- 8365968
TI  - Effects of aerosol methacholine and histamine on airways and lung parenchyma in
      healthy humans.
AB  - To investigate whether histamine (His) and methacholine (MCh) have different
      effects on airways and lung parenchyma, 11 healthy subjects were given aerosol
      MCh until a response plateau was obtained and then two doses of His. At the
      plateau, forced expiratory volume in 1 s and forced expiratory flow at 40% of
      vital capacity from partial flow-volume curves were reduced by 19 +/- 3 (SE) and
      80 +/- 4%, respectively. Aerosol His decreased forced expiratory volume in 1 s by
      an additional 12 +/- 1% but left partial forced expiratory flow unchanged. The
      bronchodilator effect of deep inhalation, as inferred from the ratio of forced
      expiratory flow from maximal to that from partial flow-volume curves, increased
      after MCh and plateaued but decreased after His. Quasi-static transpulmonary
      pressure-volume area determined in seven subjects was unchanged after MCh but was
      increased by 57 +/- 10% after His. We conclude that adding His after the response
      to MCh plateaued does not increase the maximal degree of bronchoconstriction but
      may increase parenchymal hysteresis, thus blunting the bronchodilator effect of
      deep inhalation. These results suggest that His and MCh have similar effects on
      airway smooth muscle but different effects on lung tissue properties.

PMID- 8365969
TI  - Control of segmental upper airway resistance in patients with obstructive sleep
      apnea.
AB  - We sought to determine if the upper airway response to an added inspiratory
      resistive load (IRL) during wakefulness could be used to predict the site of
      upper airway collapse in patients with obstructive sleep apnea (OSA). In 10 awake
      patients with OSA, we investigated the relationship between resistance in three
      segments of the upper airway (nasal, nasopharyngeal, and oropharyngeal) and three
      muscles known to influence these segments (alae nasi, tensor veli palatini, and
      genioglossus) while the patient breathed with or without a small IRL (2 cmH2O.l
      1.s). During IRL, patients with OSA exhibited increased nasopharyngeal resistance
      and no significant increase in either the genioglossus or tensor veli palatini
      activities. Neither nasal resistance nor alae nasi EMG activity was affected by
      IRL. We contrasted this to the response of five normal subjects, in whom we found
      no change in the resistance of either segment of the airway and no change in the
      genioglossus EMG but a significant activation of the tensor palatini. In six
      patients with OSA, we used the waking data to predict the site of upper airway
      collapse during sleep and we had limited success. The most successful index
      (correct in 4 of 6 patients) incorporated the greatest relative change in
      segmental resistance during IRL at the lowest electromyographic activity. We
      conclude, in patients with OSA, IRL narrows the more collapsible segment of the
      upper airway, in part due to inadequate activation of upper airway muscles.
      However, it is difficult to predict the site of upper airway collapse based on
      the waking measurements where upper airway muscle activity masks the passive
      airway characteristics.

PMID- 8365970
TI  - Surface electromyogram power spectrum in human quadriceps muscle during
      incremental exercise.
AB  - Spectral electromyographic (EMG) changes in human quadriceps muscles were studied
      to reinvestigate discrepant results concerning mean power frequency (MPF) changes
      during dynamic exercise. An incremental test consisting of a quasi-linear
      increase in mechanical power on a bicycle ergometer (for 20-100% of maximal
      aerobic power) was performed by forty subjects. During this test, surface EMGs
      from the quadriceps muscles showed that EMG total power (PEMG) increased with a
      curvilinear pattern for every subject, whereas MPF kinetics varied from one
      subject to another. PEMG changes had the same shape, which would lead to
      disappointing results in terms of discrimination between subjects. The ability of
      normalized MPF kinetics to define significant clusters of subjects was tested
      using a principal component analysis. This analysis led to the projection of all
      experiments onto a plane and revealed a relevant grouping of MPF profiles.
      Differences in MPF kinetics between clusters are interpreted in terms of various
      possibilities of balance between physiological events leading to an increase or a
      decrease in MPF.

PMID- 8365971
TI  - Branched-chain amino acid supplementation augments plasma ammonia responses
      during exercise in humans.
AB  - This study examined the effects of branched-chain amino acid (BCAA)
      supplementation on amino acid and ammonia (NH3) responses during prolonged
      exercise in humans. Seven men cycled for 60 min at 75% of maximal O2 uptake after
      45 min of either placebo (dextrose, 77 mg/kg) or BCAA (leucine + isoleucine +
      valine, 77 mg/kg) supplementation. Plasma samples (antecubital vein) were
      collected at rest and during exercise and analyzed for plasma NH3 and amino
      acids, whole blood glucose and lactate, and serum free fatty acids and glycerol.
      After BCAA administration, plasma BCAA levels increased from 375 +/- 22 to 760 +/
      80 microM (P < 0.05) by the onset of exercise and remained elevated throughout
      the experiment. Plasma NH3 concentrations increased continually during exercise
      for both trials and were higher (P < 0.05) after BCAA supplementation than after
      placebo administration. The mean plasma NH3 increase from rest to 60 min was 79
      +/- 10 and 53 +/- 4 microM for BCAA and placebo trials, respectively. Plasma
      alanine and glutamine concentrations were elevated (P < 0.05) during exercise for
      both treatments. However, only glutamine concentrations were greater (P < 0.05)
      for BCAA trial than for placebo trial during exercise. There were no significant
      differences between treatments for glucose, lactate, free fatty acids, and
      glycerol or any other plasma amino acid. These data suggest that increased BCAA
      availability before exercise, when initial muscle glycogen is normal, results in
      significantly greater plasma NH3 responses during exercise than does placebo
      administration.

PMID- 8365972
TI  - Change in recruitment order of motor units in human parasternal intercostal
      muscles with sleep state.
AB  - Recruitment order of individual motor units in the early part of inspiration in
      parasternal intercostal muscles was observed in normal human subjects during
      wakefulness and non-rapid-eye-movement sleep. Electromyograms from bipolar fine
      wire intramuscular electrodes were recorded while the subjects lay supine in a
      sleep laboratory, and sleep stage was determined by polysomnography. From
      wakefulness to sleep there were numerous examples of shifts in order of
      recruitment among the low threshold units of early inspiration. There were
      corresponding shifts in the order of derecruitment of these units. Analysis of
      frequency of firing of units also suggested that the levels of excitatory input
      to one unit of a pair could be altered relative to the level of input of the
      other one. The data imply that there are at least minor differences in
      distribution of excitatory inputs from various sources among motoneurons of this
      muscle pool.

PMID- 8365973
TI  - Effect of theophylline on brain tissue oxygenation during normoxia and hypoxia in
      humans.
AB  - Although theophylline, an adenosine receptor antagonist, is known to reduce
      cerebral blood flow, little clinical attention has been paid to this adverse
      effect. This study was designed to examine the effect of theophylline on brain
      tissue oxygenation for a wide range of arterial PO2 in healthy volunteers.
      Partial gas pressures and O2 saturation in an artery (SaO2) and the internal
      jugular vein (SjO2) were simultaneously measured while subjects (n = 6) were
      breathing room air and then exposed to two levels of isocapnic hypoxia (arterial
      PO2 = 60 and 45 Torr) before and after infusion of theophylline (6 mg/kg of
      aminophylline). For the same levels of arterial oxygenation, jugular vein PO2
      markedly dropped, by 3-5 Torr, after theophylline infusion, as did SjO2, by as
      much as 6-10%, under the arterial PCO2, which was slightly lower by 1-2 Torr in
      the theophylline study. By use of the linear regression lines obtained from the
      relationship between SaO2 and SjO2 in each study, it was calculated that the SjO2
      with theophylline, while SaO2 was 95, 90, and 80%, was comparable to that without
      theophylline when SaO2 was 81, 78, and 73%, respectively. On the basis of the
      assumption that partial gas pressures and SjO2 reflect brain tissue oxygenation,
      these data suggest that the effect of theophylline on brain tissue oxygenation
      should not be ignored in some clinical settings. The effects of chronic
      administration remain to be studied.

PMID- 8365974
TI  - Isolated single lung perfusion in the rat: an experimental model.
AB  - To evaluate isolated single lung perfusion with chemotherapy in a rat lung
      metastasis model, we developed a model of in vivo isolated single lung perfusion.
      Twenty male rats were anesthetized with pentobarbital sodium (50 mg/kg) and
      intubated endotracheally. A left thoracotomy was performed with an operating
      microscope (x16 magnification), the left pulmonary artery was cannulated, and a
      left pulmonary venotomy was performed. Isolated left lung perfusion was performed
      for 10 min at 0.5 ml/min with heparinized whole blood (n = 10) or 0.9% normal
      saline (n = 10). Pulmonary vein effluent was collected by suction. Nineteen of
      the 20 (95%) animals survived isolated left single lung perfusion. Twenty-one
      days after isolated left lung perfusion right pneumonectomy was performed.
      Fifteen of the 19 animals (78%) survived right pneumonectomy. Postoperatively,
      animals that survived surgery recovered preoperative body weight. In vivo
      isolated single lung perfusion in rats is feasible with low mortality and
      morbidity and may be useful in the study of isolated perfusion with chemotherapy
      and in diverse physiological and pharmacological experiments.

PMID- 8365975
TI  - Muscle-fiber pennation angles are greater in hypertrophied than in normal
      muscles.
AB  - Muscle-fiber pennation angles were measured in vivo with the use of
      ultrasonography to investigate the relationship between fiber pennation and
      muscle size for 32 male subjects (from untrained subjects to highly trained
      bodybuilders). From the image of a B-mode ultrasonogram, fiber pennation angles
      and thickness of triceps brachii were determined, the former as angles between
      echoes from the interspaces of fascicles and from the aponeurosis of long and
      medial heads of triceps and the latter as the distance between the fat-muscle and
      muscle-bone interfaces. The pennation angles were in the range of 15 and 53
      degrees for the long head and 9 to 26 degrees for the medial head, which were
      similar to or greater than the published and the present data on human cadavers.
      Significant differences were observed between normal subjects and bodybuilders in
      muscle thickness and pennation angles (P < 0.01), and there were significant
      correlations between muscle thickness and pennation angles for both long (r =
      0.884) and medial (r = 0.833) heads of triceps, suggesting that muscle
      hypertrophy involves an increase in fiber pennation angles.

PMID- 8365976
TI  - Effect of aminophylline-Ca2+ blocker interaction on membrane potential of rat
      diaphragm fibers.
AB  - We studied the antagonism between aminophylline and two calcium channel blockers,
      nifedipine and verapamil, and its effect on the resting membrane potential of rat
      diaphragm fibers in vitro at 25 degrees C. Aminophylline hyperpolarizes the
      fibers in a dose-dependent manner, and the maximum effect is reached with 1 mM of
      the drug, approximately 9 mV compared with normal values. Both nifedipine and
      verapamil (1-5 microM) decreased the amount of hyperpolarization induced by
      aminophylline, and this is partially reversed when the xanthine concentration in
      the bath is increased. From the Hill equation we obtained a value of 2 for the
      slope, suggesting that two molecules of aminophylline bind to the receptor.
      Nifedipine modifies the affinity and the intrinsic activity of aminophylline,
      whereas verapamil reduces its intrinsic activity. The effect of nifedipine and
      verapamil is explained on the basis of the changed action of aminophylline on its
      site as a result of the interaction of the calcium channel blockers with their
      interdependent receptors.

PMID- 8365977
TI  - Oxygen cost of increasing tidal volume and diaphragm flattening in obstructive
      pulmonary disease.
AB  - Hypercapnia is associated with a shallow breathing pattern in patients with
      severe chronic obstructive pulmonary disease (COPD). We sought to determine the
      oxygen cost of increasing tidal volume and to relate this to hypercapnia
      [arterial PCO2 (PaCO2) > or = 45 Torr] and diaphragm flattening. We studied 3
      normal subjects and 12 patients with stable but comparably severe COPD (forced
      expired volume in 1 s 1.01 +/- 0.09 liters) who had baseline PaCO2 ranging from
      36 to 56 Torr. Oxygen consumption was measured during the subject's native
      breathing pattern and then while tidal volume was increased by 20%; minute
      ventilation was held constant by proportionately slowing frequency. There was a
      significant oxygen cost of increasing tidal volume for hypercapnic patients (235
      +/- 23 to 260 +/- 25 ml O2/min; P = 0.002); no significant oxygen cost was
      observed in normal or eucapnic patients. This oxygen cost was positively
      correlated to baseline PaCO2 (r2 = 0.88, P < 0.001) and degree of diaphragm
      flattening assessed from chest radiographs (r2 = 0.74, P < 0.05). Although others
      have shown that force generation is preserved during chronic hyperinflation (G.
      A. Farkas and C. Roussos. J. Appl. Physiol. 54: 1635-1640, 1983; T. Similowski et
      al. N. Engl. J. Med. 325: 917-923, 1991), we conclude that diaphragm flattening
      produces mechanical inefficiency that may contribute to limiting the effective
      operating range of the respiratory muscles during tidal breathing.

PMID- 8365978
TI  - Mechanics of the parasternal intercostals in prone dogs: statics and dynamics.
AB  - It is well established that the parasternal intercostal muscles in supine dogs
      play a major role in causing the inspiratory elevation of the ribs. This posture,
      however, is not physiological in the dog. In the present study, we measured the
      electromyographic (EMG) activity and the respiratory changes in length of these
      muscles in the prone (standing) and supine postures in seven anesthetized
      spontaneously breathing dogs. With a change from the supine to the prone posture,
      the parasternal intercostals showed a 3.2% reduction in their relaxation length
      (Lr), but their mechanical behavior was essentially unchanged. Thus, the muscles
      continued to shorten below Lr during inspiration and to lengthen beyond Lr during
      expiration. With the adoption of the prone posture, the amount of parasternal
      inspiratory EMG activity and the amount of inspiratory muscle shortening each
      increased by 30-35%. Furthermore, when the parasternal intercostal in a single
      interspace was selectively denervated, the shortening of the muscle during
      inspiration in both postures was virtually eliminated. These observations
      indicate that in the dog the parasternal intercostals still play a major role in
      causing the inspiratory elevation of the ribs in the prone posture. These
      observations also suggest that these muscles in prone animals continue to operate
      on the descending limb of their length-tension curve.

PMID- 8365979
TI  - Transcapillary fluid responses to lower body negative pressure.
AB  - The effect of lower body negative pressure (LBNP) on transcapillary fluid balance
      is unknown. Therefore, our objective was to assess leg interstitial fluid
      pressures (IFP), leg circumference, plasma volume (PV), and net whole body
      transcapillary fluid transport (TFT) during and after supine LBNP and to evaluate
      the addition of oral saline ingestion on transcapillary exchange. Six healthy men
      23-41 yr old underwent 4 h of 30 mmHg LBNP, followed by 50 min of supine recovery
      on two separate occasions, once with and once without ingestion of 1 liter of
      isotonic saline. IFP was measured continuously in subcutis as well as superficial
      and deep regions of the tibialis anterior muscle by slit catheters. TFT was
      calculated by subtracting urine production and calculated insensible fluid loss
      from changes in PV. During exposure to LBNP, IFP decreased in parallel with
      chamber pressure, foot venous pressure did not change, leg circumference
      increased by 3 +/- 0.35% (SE) (P < 0.05), and PV decreased by 14 +/- 2.3%. IFP
      returned to near control levels after LBNP. At the end of minute 50 of recovery,
      PV remained decreased (by 7.5 +/- 5.2%) and leg circumference remained elevated
      (by 1 +/- 0.37%). LBNP alone produced significant movement of fluid into the
      lower body but no net TFT (-7 +/- 12 ml/h). During LBNP with saline ingestion, 72
      +/- 4% of the ingested fluid volume filtered out of the vascular space (TFT = 145
      +/- 10 ml/h), and PV decreased by 6 +/- 3%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8365980
TI  - Functional significance of increased airway smooth muscle in asthma and COPD.
AB  - Using a computational model, we investigated the effect of the morphologically
      determined increased airway smooth muscle mass, adventitial mass, and submucosal
      mass observed in patients with asthma and chronic obstructive pulmonary disease
      (COPD) on the increase in airway resistance in response to a bronchoconstricting
      stimulus. The computational model of Wiggs et al. (J. Appl. Physiol. 69: 849-860,
      1990) was modified in such a way that smooth muscle shortening was limited by the
      maximal stress that the muscle could develop at the constricted length. Increased
      adventitial thickness was found to increase constriction by reducing parenchymal
      interdependence. Increased submucosal thickness led to greater luminal occlusion
      for any degree of smooth muscle shortening. Increased muscle thickness allowed
      greater smooth muscle shortening against the elastic loads provided by
      parenchymal interdependence and airway wall stiffness. We found that for constant
      airway mechanics, as reflected by the passive area-pressure curves of the
      airways, the increased muscle mass is likely to be the most important abnormality
      responsible for the increased resistance observed in response to
      bronchoconstricting stimuli in asthma and COPD. For a given maximal muscle
      stress, greater muscle thickness allows the development of greater tension and
      thus more constriction of the lumen.

PMID- 8365981
TI  - Effects of tube thoracostomy on pleural fluid characteristics in sheep.
AB  - We studied the pleural inflammatory response to tube thoracostomy by inserting an
      Argyle 32-Fr tube in the pleural space of 10 anesthetized sheep. An experimental
      pleural effusion was created by infusion of sterile normal saline (10 ml/kg) into
      the pleural space, and the animals were allowed to recover. Systemic blood and
      experimental pleural effusion (EPE) samples were obtained at time 0, 30 min,
      hourly for 6 h, and at 6-h intervals for a total of 48 h. EPE white cell count
      rose from 125 +/- 125 to 6,323 +/- 2,268/microliters (SE) at 6 h (P < 0.05) but
      showed marked variability at 42 and 48 h (P < 0.05), with values ranging from
      8,000 to 22,000/microliters. The systemic white cell count rose from 5,195 +/-
      914 to 9,640 +/- 1,110/microliters (P < 0.01) within the first 12 h and then
      remained stable. EPE protein increased from 0 +/- 0 to 3.73 +/- 0.2 g/dl at 48 h
      (P < 0.05). EPE lactate dehydrogenase rose from 44 +/- 12 IU/l to a peak of 638
      +/- 55 IU/l at 24 h (P < 0.05). EPE glucose was significantly lower than serum
      glucose at 36, 42, and 48 h (P < 0.05). These data indicate that chest tube
      placement rapidly induces significant pleural inflammation and results in
      formation of a sterile exudate.

PMID- 8365983
TI  - Cardiovascular and renal effects of hypoxia in conscious carotid body-denervated
      rats.
AB  - The contribution of peripheral arterial chemoreceptors to cardiovascular and
      renal responses to acute hypocapnic hypoxia is currently not well understood. We
      compared the effects of normobaric hypoxia on mean arterial blood pressure
      (MABP), heart rate, glomerular filtration rate (GFR), renal blood flow (RBF), and
      renal volume and electrolyte excretion in conscious unilaterally nephrectomized
      carotid body-denervated (n = 10) and sham-operated (n = 10) control rats. Thirty
      minutes of normobaric hypoxia (12.5% O2) resulted in significant reductions in
      arterial PO2 and PCO2 as well as decreases in MABP, GFR, RBF, and renal sodium,
      potassium, and water excretion. These effects occurred more rapidly and/or were
      significantly more pronounced in carotid body-denervated than in sham-operated
      rats. These data indicate that moderate acute hypocapnic hypoxia has profound
      effects on systemic and renal hemodynamics as well as on renal excretory function
      in conscious rats. We conclude that stimulation of the peripheral arterial
      chemoreceptors can partially offset the hypoxia-induced decreases in MABP, RBF,
      GFR, urine flow, and urinary sodium and potassium excretion, thereby helping to
      maintain cardiovascular as well as fluid and electrolyte homeostasis.

PMID- 8365982
TI  - Osmolality affects ion and water fluxes and secretion in the ferret trachea.
AB  - Nonisosmolar solutions were placed in the lumen of the ferret trachea in vitro in
      an organ bath. Hyposmolar (150 mmol/kg) solutions progressively increased in
      osmolarity over 1 h. Increases in luminal concentration of impermeant blue
      dextran occurred only after 5 min, suggesting that the initial changes were due
      to ion rather than water fluxes. With hyperosmolar solutions the osmolarity
      decreased over 1 h with no change in blue dextran concentration, indicating that
      ion but not water fluxes were taking place. Cooling the preparation to 4 degrees
      C greatly reduced the osmolaity changes with hyperosmolar solutions and halved
      those with hyposmolar solutions, suggesting that active ion transport was
      involved. Hyposmolar (75-150 mmol/kg) and hyperosmolar (450-900 mmol/kg)
      solutions both increased albumin output into the lumen, but the response was
      prevented by cooling the trachea to 4 degrees C. Hyposmolar and hyperosmolar
      solutions both increased the output of lysozyme from glandular serous cells into
      the lumen. The response to hyposmolar solutions was stronger. Cooling the trachea
      abolished the lysozyme response to hyperosmolar solutions. Thus hypo- and
      hyperosmolar solutions promote ion transport in directions to restore
      isosmolarity. Both nonisosmolar solutions promote albumin movement by active
      transport across the mucosa and lysozyme secretion from submucosal glands,
      responses inhibited by tracheal cooling and therefore dependent on metabolically
      active processes.

PMID- 8365984
TI  - Pontile regulation of ventilatory activity in the adult rat.
AB  - Our purpose was to characterize the pontile components of the brain stem
      ventilatory control system in rats. This study was precipitated by reports that
      this pontile component might differ fundamentally from that of other species.
      Efferent activity of the phrenic nerve was recorded in anesthetized, vagotomized,
      paralyzed, and ventilated adult rats. As in other species, electrical
      stimulations of the rostral pons caused premature terminations and/or onsets of
      phrenic activity in eupnea. Electrolytic lesions of rostrolateral pons resulted
      in apneusis, characterized by significant prolongations of the phrenic burst.
      Some effective lesions were in the region of the nucleus parabrachialis medialis
      and the Kolliker-Fuse nucleus, the site of the pneumotaxic center. Other lesions
      resulting in apneusis were ventral to the pneumotaxic center. As in cats, lesions
      in the caudal pontile reticular formation caused the duration of the apneustic
      neural inspiration to return toward that of eupnea. Again, as in other species,
      gradual alterations from eupnea to gasping in the rat were recorded during
      hypoxia, which was induced by ventilation with carbon monoxide. We conclude that
      the brain stem respiratory control system is similarly organized in rats and
      other mammalian species. These results have implications for contemporary
      hypotheses concerning the neurogenesis of ventilatory activity.

PMID- 8365985
TI  - Depletion of alveolar macrophages by liposome-encapsulated dichloromethylene
      diphosphonate.
AB  - Alveolar macrophages (AM) play an important role in lung biology. In this study,
      we demonstrated that tracheal insufflation of liposome-encapsulated
      dichloromethylene diphosphonate (Cl2MDP-liposome) selectively depleted AMs in
      rats. Insufflation of a single dose of Cl2MDP-liposomes (80 microliters
      containing 1.34 mumol of Cl2MDP) but not liposomes containing phosphate-buffered
      saline resulted in > 70% depletion of AMs starting within 1 day and lasting for >
      5 days after insufflation. There was a slight but significant intraalveolar
      inflammatory response. Insufflation of Cl2MDP also resulted in depletion of AMs;
      however, it caused cytoplasmic edema of alveolar epithelial cells as well.
      Depletion of AMs by Cl2MDP-liposomes markedly reduced the endotoxin-induced
      neutrophil (polymorphonuclear lymphocyte) recruitment and the release of tumor
      necrosis factor into the alveolar space, suggesting that endotoxin-induced
      neutrophil recruitment and tumor necrosis factor release were dependent on AMs.
      This AM-depleted animal model will be useful for studying the in vivo functions
      of AMs and their role in various physiological and pathological conditions.

PMID- 8365986
TI  - Central and peripheral diaphragmatic fatigue in loaded normal and vagotomized
      dogs.
AB  - Severe inspiratory elastic load terminated by respiratory arrest (RA) was studied
      in 24 anesthetized dogs (group 1, normal: n = 14; group 2, vagotomized: n = 10).
      The peripheral and central components of the decrease in diaphragmatic force
      generation and the events preceding RA were studied. We measured stimulated
      tetanic transdiaphragmatic pressure (Pdi), single twitch compound action
      potentials, integrated diaphragmatic electromyographic activity (iEMGdi),
      respiratory frequency (f), inspiratory time, inspiratory drive, overall
      diaphragmatic activation, and Pdi single twitch superimposed over peak Pdi.
      Imposed target pressure was -68.8 +/- 4.37 cmH2O for group 1 and -70.9 +/- 4.19
      cmH2O for group 2, and the tension-time index of the diaphragm was the same for
      both groups (0.22 +/- 0.010). During load, 1) f increased in group 1 from 25.4 +/
      1.33 to 41.3 +/- 4.66 cycles/min, and tachypnea was prevented by vagotomy; 2)
      twitch occlusion persisted until RA and compound action potentials did not
      change; 3) iEMGdi and inspiratory drive increased and remained high until RA; 4)
      overall diaphragmatic activation increased 514 (group 1) and 260% (group 2) and
      then decreased to 228% of the basal value 10 s before RA in group 1 because of a
      fall in f; and 5) after RA, Pdi stimulated at 60 Hz fell to 39 (group 1; P <
      0.0025) and 51% (group 2; NS with group 1) of the basal value. In summary, 1)
      peripheral fatigue developed without transmission failure; 2) diaphragmatic
      activation remained maximal until RA; 3) the fall in f appeared as a preterminal
      event only in group 1; and 4) vagus nerves are necessary for load-induced
      tachypnea.

PMID- 8365987
TI  - Theory and measurements of snores.
AB  - Upper airway narrowing, collapsibility, and resistance are recognized
      predisposing factors for snoring and obstructive sleep apnea, but the mechanisms
      of their action and interaction are not known. We studied a simple theoretical
      model of the upper airways, consisting of a movable wall in a channel segment
      that connects to the airway opening via a conduit with a resistance. Inspiratory
      flow (V) through the channel segment causes local pressure changes due to viscous
      losses and the Bernoulli force that may overcome the elastic forces acting on the
      movable wall. The model predicts instability leading to upper airway closure over
      a wide range of parameter values. Increasing inspiratory V above a boundary,
      determined by values of upper airway resistance, segment compliance, length,
      width, and diameter, as well as gas density, leads to a dynamic airway closure.
      The mathematical model establishes the power relationships between parameters and
      provides physiologically realistic quantitative simulation of upper airway
      closure when values are adapted from literature and from radiographic
      measurements of upper airway motion induced by negative pressure. The rate of
      appearance of repetitive sound structures during snoring was favorably compared
      with the model's prediction of the time course of wall motion during collapse. V
      measurements during simulated snores revealed an asymmetric oscillatory pattern
      compatible with repetitive upper airway closure. We conclude that snoring may be
      modeled as a series of dynamic closure events of the upper airways. The model
      predicts that the width and length of the movable portion of the upper airways
      and the gas density are likely to affect the onset of snoring, in addition to
      other, previously recognized, parameters.

PMID- 8365988
TI  - How changes in the serial distribution of bronchoconstriction affect lung
      mechanics.
AB  - It is generally accepted that methacholine (MCh) acts predominantly on the
      central airways and histamine (H) acts on the lung periphery. We hypothesized
      therefore that lung mechanics would be affected differently by H and MCh
      aerosols. In 12 anesthetized paralyzed open-chest mongrel dogs, we obtained MCh
      (0.1-30 mg/ml, n = 6) and H (0.1-30 mg/ml, n = 6) concentration-response curves.
      The alveolar capsule technique was used to partition lung resistance (RL) into
      airway (Raw) and tissue (Rti) components. The degree of mechanical heterogeneity
      across the lung was assessed by computing the coefficient of variation for five
      alveolar pressures during relaxed expirations. RL increased 823 +/- 202% after H
      and 992 +/- 219% after MCh. Rti increased 784 +/- 192% after H and 1,014 +/- 279%
      after MCh. Raw increased 1,098 +/- 297% after H and 1,275 +/- 332% after MCh.
      Elastance increased 342 +/- 53% after H and 423 +/- 88% after MCh. The
      coefficient of variation increased 279 +/- 65% after H and 252 +/- 55% after MCh.
      The patterns of change were similar throughout the H and MCh concentration
      response curves. We conclude that H and MCh have comparable effects on lung
      mechanics and that the degree and pattern of heterogeneity inside the lung after
      constriction are the same regardless of the agent used. These data support the
      hypothesis that H and MCh have some similar direct effect on the lung parenchyma.
      Parenchymal deformation after MCh-induced central airway constriction alone would
      be unlikely to explain increases in Rti of this magnitude or changes in lung
      mechanics so similar to those induced by H.

PMID- 8365989
TI  - Responsiveness of and interactions between airways and tissue in guinea pigs
      during induced constriction.
AB  - Mechanical interdependence between airways and tissues can modify the magnitude
      of induced bronchoconstriction. We questioned whether the guinea pig, an animal
      with abundant airway smooth muscle, would differ from other species in the
      relative responsiveness of and interactions between airways and tissues.
      Therefore we induced constriction with aerosolized methacholine (MCh) and
      partitioned responses into airway and tissue components. We measured tracheal and
      alveolar pressures using alveolar capsules in open-chest guinea pigs (n = 9)
      during mechanical ventilation [frequency = 1 Hz, tidal volume = 6 ml/kg, positive
      end-expiratory pressure (PEEP) = 5 cmH2O] and calculated the resistance of lung
      (RL), tissue (Rti), and airway (Raw) before and after administration of aerosols
      of MCh in progressively doubling concentrations (0.063-16 mg/ml). In separate
      animals (n = 10), measurements were made at 3-13 cmH2O PEEP. After aerosols of
      saline and MCh (0.125-32 mg/ml), measurements were repeated at 3, 7, and 11 cmH2O
      PEEP. At submaximal levels of constriction, the airways and lung tissues
      demonstrated similar responsiveness. Increasing PEEP increased RL and Rti and
      decreased Raw under baseline conditions. At low concentrations of MCh, increasing
      PEEP increased RL but decreased RL at the highest concentration. Increases in
      PEEP significantly increased Rti at all concentrations of MCh but decreased Raw
      only at 8 mg/ml of MCh. These observations demonstrate that, in guinea pigs,
      during submaximal constriction, airways and tissues behave similarly; moreover,
      airway-parenchymal interdependence is important in determining the level of
      bronchoconstriction.

PMID- 8365990
TI  - Recovery of muscle power after high-intensity short-term exercise: comparing boys
      and men.
AB  - This study was conducted to determine whether boys differ from men in their
      ability to recover from high-intensity exercise. Two groups of volunteers, 8
      prepubertal boys (9-12 yr) and 8 young men (19-23 yr), were similar in their peak
      oxygen uptake (49.6 +/- 6.6 vs. 51.1 +/- 6.6 ml.min-1 x kg-1), adiposity, and
      activity levels. On three different occasions subjects performed two consecutive
      30-s all-out cycling tasks [Wingate anaerobic test (WAnT)], separated by a 1-, 2
      , or 10-min recovery interval. In the boys, mean power reached 89.9 +/- 3.6% of
      the initial value after 1 min of recovery, 96.4 +/- 2.3% after 2 min, and 103.5
      +/- 1.3% after 10 min. For the men, the values were 71.2 +/- 2.6, 77.1 +/- 2.4,
      and 94.0 +/- 1.3%, respectively (boys vs. men, P < 0.0001). Relative to the
      external work performed during the first WAnT, the boys had a higher net oxygen
      uptake (exercise--resting) during the test than the men (83.8 +/- 18.4 vs. 57.8
      +/- 6.1 ml/kJ). After the WAnT, the net CO2 output and the respiratory exchange
      ratio were lower in the boys, and they recovered faster. It was concluded that
      boys recover faster than men from high-intensity short-term exercise. This may
      reflect a lower reliance on glycolysis during the WAnT in the boys, leading to
      less acidosis. It is also possible that the boys had a faster postexercise
      removal of metabolites.

PMID- 8365991
TI  - Spine and total body bone mineral density in amenorrheic endurance athletes.
AB  - Lumbar spine, total body, and regional bone mineral densities (BMDs) were
      measured in eumenorrheic and amenorrheic runners and triathletes by using dual
      energy X-ray absorptiometry (Lunar DPX). Values were also compared with age- and
      weight-matched reference data from the Lunar British database. The amenorrheic
      group had significantly lower lumbar spine (P = 0.003), arm (P = 0.018), trunk (P
      = 0.014), and total spine (P < 0.0001) BMDs compared with the eumenorrheic group
      and significantly lower lumbar (P = 0.002) and total spine (P < 0.001) values
      compared with the reference controls. Leg (P = 0.009) and arm (P < 0.001)
      densities were significantly higher than controls. All regions, apart from the
      lumbar spine, were significantly higher in the eumenorrheic group compared with
      the reference group. There were no within-group differences for the runners and
      triathletes. Compared with the eumenorrheic athletes, the amenorrheic women had
      significantly later age of menarche (P = 0.0032). The type of physical activity
      undertaken by these athletes can compensate for the loss of menses at the
      majority of skeletal sites with the exception of the spine.

PMID- 8365992
TI  - Role of glucose and insulin loads to the exercising limb in increasing glucose
      uptake and metabolism.
AB  - To assess the contributions of glucose load to the working hindlimb and local
      contraction-related events (changes related to the microvasculature and/or
      intrinsic muscle metabolic properties) to the exercise-induced increases in
      muscle glucose uptake and metabolism in vivo, dogs were studied with somatostatin
      infused to suppress insulin release, and glucose and insulin were replaced 1)
      during rest and treadmill exercise at rates that recreate limb glucose and
      insulin loads evident during exercise (n = 5), 2) at rest to selectively
      normalize the limb glucose load to rates present during exercise while retaining
      basal limb insulin loads (GL, n = 5), or 3) at rest to normalize both the limb
      glucose and insulin loads to those present during exercise (IGL, n = 5). Limb
      arteriovenous difference and isotopic ([U-14C]glucose) techniques were used to
      quantify muscle glucose uptake and metabolism. Limb glucose load rose from 819 +/
      141 mumol/min in the basal state to 1,568 +/- 190 mumol/min with exercise. Limb
      glucose loads were 1,423 +/- 88 and 1,502 +/- 165 mumol/min in GL and IGL. The
      limb insulin load rose from basal rates of 12.9 +/- 2.3 to 22.9 +/- 5.9 nmol/min
      during exercise. Limb insulin loads were similar to basal loads in GL (8.8 +/-
      1.9 nmol/min) and exercise in IGL (28.2 +/- 5.5 nmol/min).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8365993
TI  - Disruption of pulmonary surfactant's ability to maintain openness of a narrow
      tube.
AB  - Pulmonary surfactant stabilizes alveoli but, by maintaining patency of peripheral
      conducting airways, will also lower resistance to airflow. A small quantity of a
      surfactant suspension (3 mg/ml) formed a blocking liquid column in a narrow
      section of a glass capillary. Pressure was raised on one side of that column,
      whereby it was forced to move out of the narrow section, and it did not return
      but left the capillary open for a free airflow. The surfactant capability to
      maintain free airflow was lost with the addition of albumin (> 10 mg/ml) or
      fibrinogen (> 0.5 mg/ml). Surfactant function was seriously affected by
      hydrolysis with phospholipase C but not with phospholipase A2. With a small
      quantity of albumin added (5 mg/ml), the ability to maintain openness was
      seriously affected at temperatures below 25 degrees C. An inflammatory reaction
      due to atopy, infection, or inhalation of irritating gases characterizes a
      variety of airway diseases, including asthma. If the in vitro studies can be
      transferred to in vivo conditions, surfactant dysfunction might contribute to
      certain types of airway disease.

PMID- 8365994
TI  - Reflex cardiovascular effects of continuous prostacyclin administration into an
      isolated in situ lung in the dog.
AB  - Bolus administration of prostacyclin (PGI2), an inflammatory product produced by
      the arachidonic acid cyclooxygenase pathway, into the pulmonary circulation is
      known to stimulate pulmonary C-fibers and to produce transient reflex
      cardiovascular depression. We used an isolated perfused in situ left lung
      preparation to examine the reflex cardiovascular effects of continuous
      administration of PGI2 into the isolated pulmonary circulation of dogs. PGI2 was
      infused for 30 min (5 micrograms.kg-1 x min-1) into the innervated isolated left
      pulmonary circulation in six dogs and into the denervated isolated circulation in
      seven dogs. Mean arterial pressure and cardiac output were significantly
      decreased from baseline values during the final 20 min of PGI2 infusion. There
      were no significant changes in maximum rate of change of left ventricular
      pressure during systole and in heart rate. All variables returned to baseline
      levels within 15 min of discontinuation of PGI2 infusion. PGI2 infusion produced
      no significant measured hemodynamic changes in the denervated group. Control
      experiments demonstrated that the observed response was not affected by duration
      of the preparation, lung denervation, or infusion vehicle. These findings suggest
      that continuous infusion of PGI2 into the isolated pulmonary circulation produces
      sustained cardiovascular depression via a vagal reflex mechanism that is probably
      mediated by pulmonary C-fibers.

PMID- 8365995
TI  - Effect of hindlimb unweighting on single soleus fiber maximal shortening velocity
      and ATPase activity.
AB  - This study characterizes the time course of change in single soleus muscle fiber
      size and function elicited by hindlimb unweighting (HU) and analyzes the extent
      to which varying durations of HU altered maximal velocity of shortening (Vo),
      myofibrillar adenosinetriphosphatase (ATPase), and relative content of slow and
      fast myosin in individual soleus fibers. After 1, 2, or 3 wk of HU, soleus muscle
      bundles were prepared and stored in skinning solution at -20 degrees C. Single
      fibers were isolated and mounted between a motor arm and a transducer, and fiber
      force, Vo, and ATPase activity were measured. Fiber myosin content was determined
      by one-dimensional sodium dodecyl sulfate- (SDS) polyacrylamide gel
      electrophoresis. After 1, 2, and 3 wk of HU, soleus fibers exhibited a
      progressive reduction in fiber diameter (16, 22, and 42%, respectively) and peak
      force (42, 48, and 72%, respectively). Peak specific tension was significantly
      reduced after 1 wk of HU (18%) and showed no further change in 2-3 wk of HU.
      During 1 and 3 wk of HU, fiber Vo and ATPase showed a significant increase. By 3
      wk, Vo had increased from 1.32 +/- 0.04 to 2.94 +/- 0.17 fiber lengths/s and
      fiber ATPase from 291 +/- 16 to 1,064 +/- 128 microM.min-1 x mm-3. The percent
      fibers expressing fast myosin heavy chain increased from 4% to 29% by 3 wk of HU,
      and Vo and ATPase activity within a fiber were highly correlated.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8365996
TI  - Neurocirculatory consequences of negative intrathoracic pressure vs. asphyxia
      during voluntary apnea.
AB  - To investigate the mechanisms responsible for fluctuations in arterial pressure
      and sympathetic nerve activity that occur during obstructive sleep apnea, we
      studied neurocirculatory responses to Mueller maneuvers and breath holds in
      conscious humans. During 20-s Mueller maneuvers at -40 mmHg, mean arterial
      pressure fell initially (-11 +/- 3 mmHg) and then rose above baseline (+8 +/- 3
      mmHg) on release of the inspiratory strain. Sympathetic outflow to skeletal
      muscle was almost completely suppressed during the initial moments of the
      maneuver and rose to more than three times the baseline level at the termination
      of the maneuver. Simple 20-s breath holds were accompanied by time-dependent
      increases in both arterial pressure (+11 +/- 3 mmHg) and sympathetic nerve
      activity (> 3 times baseline). The administration of supplemental O2 greatly
      attenuated the increases in arterial pressure and sympathetic nerve activity
      during Mueller maneuvers and breath holds. We conclude that carotid chemoreflex
      stimulation is the primary mechanism responsible for apnea-induced sympathetic
      activation during wakefulness and that it may contribute importantly to the
      sympathetic activation that accompanies sleep-disordered breathing.

PMID- 8365997
TI  - Relations between muscle soreness and biochemical and functional outcomes of
      eccentric exercise.
AB  - Correlations between functional and biochemical outcomes of eccentric exercise
      and between these outcomes and "delayed-onset muscle soreness" (DOMS) were
      studied. Maximal isotonic force, extension and flexion angle of the elbow,
      creatine kinase activity, and myoglobin concentration in serum were measured in
      27 male subjects during 5 days after 120 maximal eccentric contractions of the
      forearm flexors. Significant correlations were found between values at 1 to 96 h
      after exercise for force (r = 0.55 to 0.96), flexion (0.52 to 0.94), extension
      (0.41 to 0.95), and myoglobin (0.55 to 0.97) and at 24 to 96 h for creatine
      kinase (0.67 to 0.96) and DOMS (0.45 to 0.72). Clusters of significant
      correlations (0.32 to 0.91) were found among all functional and biochemical
      measures. DOMS, however, showed only few and lower correlations with the other
      parameters (0.34 to 0.63). These results can practically be interpreted as
      follows: 1) subjects need more time to recover completely when early deviations
      after eccentric exercise are large, 2) a large change in one measure is
      accompanied by large deviations in other measures, and 3) objective outcomes of
      eccentric exercise are more accurate parameters than a DOMS score for use in
      effect studies.

PMID- 8365998
TI  - Mucociliary clearance of inhaled particles measured at 2 h after ozone exposure
      in humans.
AB  - Acute exposure of humans to ozone is known to acutely cause pulmonary function
      decrements, inflammation, and increased permeability of pulmonary epithelium. A
      single study in humans has also shown that mucociliary transport increases during
      acute ozone exposure. Because different responses have shown a different time
      course of recovery after exposure, it was important to examine mucociliary
      transport at a different time after the cessation of ozone exposure. We exposed
      15 healthy male and female nonsmoking subjects, on different occasions, to clean
      air and 0.4 ppm ozone for 1 h while they exercised continuously. Pulmonary
      function was measured immediately before and after exposure and 90 min and 24 h
      after exposure. Between 2 and 5 h after each exposure, retention of inhaled 5
      microns mass median aerodynamic diameter 99mTc-labeled Fe2O3 particles was
      measured. Each subject returned the next day for a final particle retention
      measurement. Despite significant changes in pulmonary function, there was no
      difference in mean whole lung retention time of particles between clean air [77.9
      +/- 0.8 (SE) min] and ozone (78.0 +/- 0.8 min) exposures, indicating that
      mucociliary transport is unaffected by ozone exposure when it is measured 2 h
      after exposure.

PMID- 8365999
TI  - Carbohydrate feedings and exercise performance: effect of initial muscle glycogen
      concentration.
AB  - To determine whether the ergogenic benefits of carbohydrate (CHO) feedings are
      affected by preexercise muscle glycogen levels, eight cyclists performed four
      self-paced time trials on an isokinetic ergometer over a simulated distance of 70
      km. Trials were performed under the following preexercise muscle glycogen and
      beverage conditions: 1) high glycogen (180.2 +/- 9.7 mmol/kg wet wt) with a CHO
      beverage (HG-CHO), 2) high glycogen (170.2 +/- 10.4 mmol/kg wet wt) with a non
      CHO beverage (HG-NCHO), 3) low glycogen (99.8 +/- 6.0 mmol/kg wet wt) with a CHO
      beverage (LG-CHO), and 4) low glycogen (109.7 +/- 5.3 mmol/kg wet wt) with a non
      CHO beverage (LG-NCHO). The CHO drink (ingested at the onset of exercise and
      every 10 km thereafter) provided 116 +/- 6 g CHO/trial and prevented the decline
      in serum glucose observed during both NCHO trials. Performance times ranged from
      117.93 +/- 1.44 (HG-CHO) to 122.91 +/- 2.46 min (LG-NCHO). No intertrial
      differences (P > 0.05) were observed for O2 consumption (75% of maximal O2
      consumption), power output (237 W), or self-selected pace (8.44 min/5 km) during
      the initial 71-79% of exercise. Over the final 14% of the time trial, power
      output and pace (231 W and 8.62 min/5 km) were similar for the HG-CHO, HG-NCHO,
      and LG-CHO conditions, but both variables were significantly lower during the LG
      NCHO trial (198 W and 9.67 min/5 km, P < 0.05 vs. all other trials).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8366000
TI  - Neuroendocrine and substrate responses to altered brain 5-HT activity during
      prolonged exercise to fatigue.
AB  - Pharmacological manipulation of brain serotonergic [5-hydroxytryptamine (5-HT)]
      activity affects run time to exhaustion in the rat. These effects may be mediated
      by neurochemical, hormonal, or substrate mechanisms. Groups of rats were
      decapitated during rest, after 1 h of treadmill running (20 m/min, 5% grade), and
      at exhaustion. Immediately before exercise rats were injected intraperitoneally
      with 1 mg/kg of quipazine dimaleate (QD; a 5-HT agonist), 1.5 mg/kg of LY 53857
      (LY; a 5-HT antagonist), or the vehicle (V; 0.9% saline). LY increased and QD
      decreased time to exhaustion (approximately 28 and 32%, respectively; P < 0.05).
      At fatigue, QD animals had greater plasma glucose, liver glycogen, and muscle
      glycogen concentrations but lower plasma free fatty acid concentration than did V
      and LY animals (P < 0.05). In general, plasma corticosterone and catecholamine
      levels during exercise in QD and LY rats were similar to those in V rats. Brain 5
      HT and 5-hydroxyindole-3-acetic acid concentrations were higher at 1 h of
      exercise than at rest (P < 0.05), and the latter increased even further at
      fatigue in the midbrain and striatum (P < 0.05). Brain dopamine (DA) and 3,4
      dihydroxyphenylacetic acid (DOPAC) were higher at 1 h of exercise (P < 0.05) but
      were similar to resting levels at fatigue. QD appeared to block the increase in
      DA and DOPAC at 1 h of exercise, and LY prevented the decrease in DA and DOPAC at
      fatigue (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366001
TI  - Apnea threshold and breathing rhythmicity in newborn lambs.
AB  - This study was designed to determine the effect of the removal of chemical
      stimuli on breathing rhythmicity in awake newborn lambs; it was also designed to
      define the chemical threshold below which breathing would stop [arterial PCO2
      (PaCO2) apnea threshold]. We used a technique of graded extracorporeal CO2
      removal with apneic oxygenation in three groups of animals according to age and
      carotid body (CB) integrity: < 2 days, CB intact (n = 5); 12 days, CB intact (n =
      7); and 12 days, CB denervated (CBD; n = 5). In all animals, whatever their age
      and CB status, suppression of the chemical drive resulted in sustained apnea. The
      study, performed at four constant levels of oxygenation (hyperoxia, normoxia,
      moderate hypoxia, and severe hypoxia), allowed precise determination of the PaCO2
      apnea threshold. We found that this PaCO2 apnea threshold depended on the degree
      of postnatal maturation (it was higher in the younger lambs), the level of
      arterial oxygenation (it was lowered by hypoxia), and CB status (it was higher in
      CBD animals). Moreover, we found that the 12-day-old CBD lambs breathe at a level
      of PaCO2 set close to the point of apnea.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366002
TI  - Possible role of pulmonary blood volume in chronic hypoxic pulmonary
      hypertension.
AB  - Chronic hypoxia increases the total blood volume (TBV) and pulmonary arterial
      blood pressure (Ppa) and induces pulmonary vascular remodeling. The present study
      was undertaken to assess how the pulmonary blood volume (PBV) changes during
      hypoxia and the possible role of PBV in chronic hypoxic pulmonary hypertension. A
      novel method has been developed to measure the TBV, PBV, and Ppa in conscious
      rats. The method consists of chronic implantation of a loose ligature around the
      ascending aorta and pulmonary artery, so that when the ligature is drawn tightly,
      it traps the blood in the pulmonary vessels and left heart and simultaneously
      kills the rat. The pulmonary veins are then ligated to separate the left
      ventricular blood volume from the PBV. This surgical approach, together with
      chronic catheterization of the pulmonary artery and the use of 51Cr-labeled red
      blood cells, allows measurement of TBV, PBV, and Ppa. This method has been used
      to analyze the relationships between TBV and PBV and between Ppa or right
      ventricular hypertrophy and PBV in two rat strains with markedly different TBV
      and Ppa responses to chronic hypoxia. PBV per given lung weight did not increase
      and even decreased during hypoxia despite marked increases in TBV. There was a
      close correlation between Ppa or right ventricular hypertrophy and PBV in the two
      strains of chronically hypoxic animals, suggesting that a greater PBV plays a
      significant role in the development of severe chronic hypoxic pulmonary
      hypertension in the altitude-susceptible Hilltop rats.

PMID- 8366003
TI  - Compartmentalization of the acute cytokine response in humans after intravenous
      endotoxin administration.
AB  - Lung cytokine production was examined after the intravenous administration of
      endotoxin to 23 normal human subjects. Bronchoalveolar lavage (BAL) was performed
      7 days before and 1.5 or 5 h after endotoxin (4 ng/kg). Cytokine mRNA was
      evaluated in cell pellets (> 98% macrophages) by use of reverse transcription and
      the polymerase chain reaction. Immunoreactivity was measured by enzyme-linked
      immunosorbent assay of 20- to 40-fold concentrated BAL. Interleukin- (IL) 8 was
      detected in BAL (4-130 pg/ml) but not in the serum at baseline. Few neutrophils
      were found in BAL (< 1%) despite this IL-8 gradient. Peak serum IL-8 levels
      occurred 2 h after endotoxin (3,930 +/- 241 pg/ml), but BAL neutrophils and IL-8
      did not increase. Peak serum tumor necrosis factor (TNF) levels occurred 1.5 h
      after endotoxin (1,844 +/- 210 pg/ml), but TNF was detected in only 1 of 20 BAL
      samples. TNF and IL-8 mRNA were detected by polymerase chain reaction in > 70% of
      the BAL samples before endotoxin, whereas IL-1 alpha, IL-1 beta, and IL-6 were
      detected in < 25% of the BAL samples. After endotoxin, no change was detected in
      cytokine mRNA expression. Actinomycin D treatment of the BAL did not alter the
      pattern of cytokine mRNA expression. These data suggest that mechanisms exist to
      insulate the alveolar space from the stimulatory effects of endotoxin and high
      circulating levels of cytokines. Additional factors appear to control the
      chemotactic effects of IL-8 on neutrophils in the air spaces during acute
      systemic inflammation.

PMID- 8366004
TI  - Does baseline airway caliber affect measurements of airway responsiveness to
      histamine.
AB  - Considerable controversy exists over the influence of baseline airway caliber on
      indexes of bronchial responsiveness in asthma. To directly investigate this, we
      used inhaled methacholine to alter baseline airway caliber to determine whether
      this altered the airway response to subsequent bronchoprovocation with inhaled
      histamine. Seventeen stable asthmatic subjects were studied; their median age was
      22 yr, baseline forced expiratory volume in 1 s (FEV1) was 101.5 +/- 3.7% (SE)
      predicted, and geometric mean provocative concentration of inhaled methacholine
      causing a 20% fall in FEV1 (PC20) was 0.87 mg/ml. Initially the time course of
      bronchoconstriction to inhaled methacholine was determined. Subsequently the
      airway response to inhaled histamine administered as a single concentration was
      determined, both before and after reductions in baseline FEV1 by saline or
      methacholine of 0, 15, 25, and 35%, on 4 separate days. Altering baseline airway
      caliber had no effect on the subsequent response of the airways to inhaled
      histamine when calculated as percent fall from the new baseline. The power of the
      study to detect an effect of altering baseline FEV1 on the measured PC20
      histamine of 0.5 doubling dilutions was > 55%, and the power to detect an effect
      of 1.0 doubling dilutions was > 98%.

PMID- 8366005
TI  - Comparison of neutrophil and capillary diameters and their relation to neutrophil
      sequestration in the lung.
AB  - Neutrophils [polymorphonuclear leukocytes (PMNs)] are sequestrated in the lung
      capillary bed because PMNs are delayed with respect to red blood cells (RBCs) as
      they pass through these microvessels. The present study examines circulating PMN
      size in relation to the distribution of capillary segment diameters in human,
      dog, and rabbit lungs and compares the shape of PMNs in suspension to that found
      within the pulmonary capillaries. The data show that 61, 67, and 38% of the
      capillary segments are narrower than the mean diameter of spherical PMNs in the
      rabbit, dog, and human, respectively. They also show that PMNs deform from a
      spherical to an ellipsoid shape in the pulmonary capillaries of all three
      species. These findings are consistent with previous studies showing that the
      pulmonary circulation restricts the passage of PMNs through the lungs and suggest
      that PMNs are delayed because they must deform to pass through restrictions
      encountered in the pulmonary capillary bed. We conclude that the discrepancy
      between PMN and pulmonary capillary size and the decreased deformability of PMNs
      with respect to RBCs are major determinants of the delay that PMNs experience
      with respect to RBCs in the pulmonary circulation.

PMID- 8366006
TI  - Cerebral blood flow velocity in humans exposed to 24 h of head-down tilt.
AB  - This study investigates cerebral blood flow (CBF) velocity in humans before,
      during, and after 24 h of 6 degree head-down tilt (HDT), which is a currently
      accepted experimental model to simulate microgravity. CBF velocity was measured
      by use of the transcranial Doppler technique in the right middle cerebral artery
      of eight healthy male subjects. Mean CBF velocity increased from the pre-HDT
      upright seated baseline value of 55.5 +/- 3.7 (SE) cm/s to 61.5 +/- 3.3 cm/s at
      0.5 h of HDT (P < 0.05), reached a peak value of 63.2 +/- 4.1 cm/s at 3 h of HDT,
      and remained significantly above the pre-HDT baseline for > or = 6 h of HDT.
      During upright seated recovery (1-5 h post-HDT), mean CBF velocity decreased to
      87% of the pre-HDT baseline value (P < 0.05). Mean CBF velocity correlated well
      with calculated intracranial arterial pressure (IAP) (r = 0.54, P < 0.001). As
      analyzed by linear regression, mean CBF velocity = 29.6 + 0.32IAP. These results
      suggest that HDT increases CBF velocity by increasing IAP during several hours
      after the onset of microgravity. Importantly, the decrease in CBF velocity after
      HDT may be responsible, in part, for the increased risk of syncope observed in
      subjects after prolonged bed rest and also in astronauts returning to Earth.

PMID- 8366007
TI  - Differential modulation by extracellular ATP of carotid chemosensory responses.
AB  - The possibility that the carotid body has ATP surface receptors that mediate O2
      chemoreception was tested. To distinguish between the event(s) initiating
      chemoreception and those at the neurotransmitter level, we also tested the
      chemosensory response to nicotine before and after ATP administration. Carotid
      bodies from cats anesthetized with pentobarbital sodium were perfused and
      superfused in vitro with modified Tyrode solution (PCO2 < 1 Torr, pH 7.4, 36
      degrees C) equilibrated at PO2 > 400 or approximately 150 Torr while chemosensory
      discharge was recorded extracellularly. ATP and adenosine 5'-[gamma
      thio]triphosphate stimulated discharge with similar dose dependence, whereas
      adenosine had little effect. ATP infusion for > or = 2 min evoked an initial
      stimulation of discharge followed by a decline to baseline (desensitization).
      Desensitization did not affect the response to hypoxia (perfusate flow
      interruption) but inhibited the response to nicotine (4-nmol pulse). Therefore,
      1) the carotid body has surface ATP receptors that may mediate the chemosensory
      response to nicotine but not to hypoxia and 2) nicotinic receptors are not
      required for carotid body O2 chemoreception.

PMID- 8366008
TI  - Measurement of gastric and diaphragmatic height during slow breathing maneuvers.
AB  - Changes in height of the gastric air bubble can be inferred, in theory, from the
      difference between gastric pressures measured with water- and air-filled balloon
      catheter systems. We describe an apparatus that satisfactorily measures changes
      in height of gastric balloons in vitro. During slow breathing maneuvers in
      standing subjects, the apparatus measured changes in height of the balloons in
      the stomach that were consistent with expected changes in height of the
      diaphragmatic dome. In four subjects, balloon movements were nearly always less
      than movements of the costal margin of the diaphragmatic dome observed by
      ultrasonography; the average ratio of height changes was 0.73. We conclude that
      changes in height of the diaphragmatic dome can be measured with this method
      during slow breathing maneuvers in upright subjects.

PMID- 8366009
TI  - Construction and uses of a concentric catheter for gas sampling in lung airways.
AB  - A catheter for intra-airway sampling of gas concentrations was constructed from
      concentric polyethylene tubes. The internal tube (0.58 mm ID, 0.91 mm OD) was
      connected to a gas analyzer while the external tube (1.20 mm ID, 1.75 mm OD) was
      constantly flushed by air or a calibration gas, except during sampling. Injection
      and sampling dead spaces were 0.35 and 0.28 ml, respectively. Delay at 4-ml/min
      sampling rate was 4.0 +/- 0.2 s. The 0-90% step response to a sudden change in
      gas composition was 0.24 s when connected to a mass spectrometer. This catheter
      was used to assess tracer gas dispersion during oscillatory flow (1-20 Hz) in a
      straight long tube. Local concentrations measured through the catheter, after a
      small bolus of tracer gas was injected through the external tube, compared
      favorably with direct measurements through needles inserted via the tube wall and
      with theoretical predictions. The catheter was also used to measure intra-airway
      gas concentrations in dog airways during spontaneous breathing, conventional
      mechanical ventilation, high-frequency ventilation, high-frequency vibration
      ventilation, and constant-flow ventilation. It ws placed by a fiber-optic
      bronchoscope and used to measure local quasi-steady concentrations of CO2 and
      local dispersion with the bolus method. The occurrence of catheter clogging with
      secretions was substantially reduced with flow through the external tube.
      Transmitting a calibration gas through the external tube facilitated in situ
      recalibration of the gas analyzer without removing the catheter. The use of this
      catheter improved the efficiency and accuracy of measurements of gas
      concentrations inside lung airways.

PMID- 8366010
TI  - Effect of peak inspiratory pressure on the filtration coefficient in the isolated
      perfused rat lung.
AB  - Positive inspiratory pressure- (PIP) ventilated, isolated rat lungs become
      edematous when perfused at rates approximately the normal cardiac output. The
      study was conducted to test the hypothesis that high peak inspiratory pressures
      contribute to the edema development. Five isolated lungs were perfused at a rate
      of 24.4 +/- 2.2 ml.min-1.100 g body wt-1 with 40% whole blood (diluted with
      saline containing 4.0 g/100 ml bovine serum albumin) and ventilated with peak
      pressures ranging from 0 to 20 mmHg. The lungs exhibited edema at PIP values >
      9.3 mmHg. The stable pulmonary vascular pressure and resistance suggested that
      the edema may have resulted from a PIP-induced increase in microvascular
      permeability. In a second study, the stability of the preparation was evaluated
      during a 3-h test period. Seven lungs were ventilated at a peak inspiratory
      pressure of 8.0 mmHg and perfused at 26.8 +- 1.7 ml.min-1 x 100 g body wt-1.
      Microvascular integrity was maintained for approximately 2 h as indicated by
      filtration coefficient measurements of 0.175 +/- 0.068, 0.197 +/- 0.066, and
      0.169 +/- 0.067 g.min-1 x mmHg-1 x 100 g-1 at 25, 70, and 115 min, respectively,
      after initiation of the study. The results suggest that isolated rat lungs
      perfused at rates that parallel normal rat cardiac output and ventilated at low
      peak inspiratory pressures provide a viable mechanism for evaluation of the
      pathophysiology of microvascular injury.

PMID- 8366011
TI  - Short-term growth hormone treatment does not increase muscle protein synthesis in
      experienced weight lifters.
AB  - The purpose of this study was to determine whether recombinant human growth
      hormone (GH) administration enhances muscle protein anabolism in experienced
      weight lifters. The fractional rate of skeletal muscle protein synthesis and the
      whole body rate of protein breakdown were determined during a constant
      intravenous infusion of [13C]leucine in 7 young (23 +/- 2 yr; 86.2 +/- 4.6 kg)
      healthy experienced male weight lifters before and at the end of 14 days of
      subcutaneous GH administration (40 microgram.kg-1 x day-1). GH administration
      increased fasting serum insulin-like growth factor-I (from 224 +/- 20 to 589 +/-
      80 ng/ml, P = 0.002) but did not increase the fractional rate of muscle protein
      synthesis (from 0.034 +/- 0.004 to 0.034 +/- 0.002%/h) or reduce the rate of
      whole body protein breakdown (from 103 +/- 4 to 108 +/- 5 mumol.kg-1 x h-1).
      These findings suggest that short-term GH treatment does not increase the rate of
      muscle protein synthesis or reduce the rate of whole body protein breakdown,
      metabolic alterations that would promote muscle protein anabolism in experienced
      weight lifters attempting to further increase muscle mass.

PMID- 8366012
TI  - The detection and photography of vitamin A in fresh tissue by epi-fluorescence
      microscopy.

PMID- 8366013
TI  - Building a biomedical photography business: financial considerations.

PMID- 8366014
TI  - An inexpensive portable photographic background support system.

PMID- 8366015
TI  - The write stuff--an introduction to writing for publication.

PMID- 8366016
TI  - Environmental issues and the biophotographer.

PMID- 8366017
TI  - The use of cross-polarized illumination for patient photography.

PMID- 8366018
TI  - Primary structure of the monomer of the 12S subunit of transcarboxylase as
      deduced from DNA and characterization of the product expressed in Escherichia
      coli.
AB  - Transcarboxylase from Propionibacterium shermanii is a complex biotin-containing
      enzyme composed of 30 polypeptides of three different types: a hexameric central
      12S subunit to which 6 outer 5S subunits are attached through 12 1.3S biotinyl
      subunits. The enzyme catalyzes a two-step reaction in which methylmalonyl
      coenzyme A and pyruvate serve as substrates to form propionyl coenzyme A
      (propionyl-CoA) and oxalacetate, the 12S subunit specifically catalyzing one of
      the two reactions. We report here the cloning, sequencing, and expression of the
      12S subunit. The gene was identified by matching amino acid sequences derived
      from isolated authentic 12S peptides with the deduced sequence of an open reading
      frame present in a cloned P. shermanii genomic fragment known to contain the gene
      encoding the 1.3S biotinyl subunit. The cloned 12S gene encodes a protein of 604
      amino acids and of M(r) 65,545. The deduced sequence shows regions of extensive
      homology with the beta subunit of mammalian propionyl-CoA carboxylase as well as
      regions of homology with acetyl-CoA carboxylase from several species. Two genomic
      fragments were subcloned into pUC19 in an orientation such that the 12S open
      reading frame could be expressed from the lac promoter of the vector. Crude
      extracts prepared from these cells contained an immunoreactive band on Western
      blots (immunoblots) which comigrated with authentic 12S. The Escherichia coli
      expressed 12S was purified to apparent homogeneity by a three-step procedure and
      compared with authentic 12S from P. shermanii. Their quaternary structures were
      identical by electron microscopy, and the E. coli 12S preparation was fully
      active in the reactions catalyzed by this subunit. We conclude that we have
      cloned, sequenced, and expressed the 12S subunit which exists in a hexameric
      active form in E.coli.

PMID- 8366019
TI  - Bacteriophage Mu Mor protein requires sigma 70 to activate the Mu middle
      promoter.
AB  - Transcription during the bacteriophage Mu lytic cycle occurs in three phases:
      early, middle, and late. Middle transcription requires the early gene product Mor
      for its activation. Mor protein overproduction was accomplished by fusing the mor
      gene to an efficient phage T7 promoter and translation initiation region. A
      protein fraction highly enriched for Escherichia coli RNA polymerase (E sigma 70)
      from the Mor-overproducing strain was able to activate transcription from both
      the tac promoter (Ptac) and the Mu middle promoter (Pm) in vitro. Transcription
      initiation from Pm was Mor dependent, and the RNA 5' end was identical to that of
      in vivo RNA. Addition of anti-sigma 70 antibody to transcription reactions
      containing Ptac and Pm resulted in inhibition of transcription from both
      promoters; addition of purified sigma 70 restored transcription. These results
      indicate that Mor-dependent activation requires sigma 70 and therefore imply that
      Mor is not an alternate sigma factor. This conclusion was further substantiated
      by a reconstitution experiment with purified proteins in which all three
      components, Mor, sigma 70, and core RNA polymerase, were required for Pm
      dependent transcription in vitro. The sigma 70 dependence of Mor-specific
      transcription and the amino acid sequence similarity between Mor and C (an
      activator for Mu late transcription) both support the hypothesis that Mor
      functions mechanistically as an activator protein.

PMID- 8366020
TI  - Escherichia coli produces linoleic acid during late stationary phase.
AB  - Escherichia coli produces linoleic acid in the late stationary phase. This was
      the case whether the cultures were grown aerobically or anaerobically on a
      supplemented glucose-salts medium. The linoleic acid was detected by thin-layer
      chromatography and was measured as the methyl ester by gas chromatography. The
      linoleic acid methyl ester was identified by its mass spectrum. Lipids extracted
      from late-stationary-phase cells generated thiobarbituric acid-reactive carbonyl
      products when incubated with a free radical initiator. In contrast, extracts from
      log-phase or early-stationary-phase cells failed to do so, in accordance with the
      presence of polyunsaturated fatty acid only in the stationary-phase cells.

PMID- 8366021
TI  - Cloning and characterization of a gene whose product is a trans-activator of
      anthrax toxin synthesis.
AB  - The 184-kb Bacillus anthracis plasmid pXO1, which is required for virulence,
      contains three genes encoding the protein components of anthrax toxin, cya (edema
      factor gene), lef (lethal factor gene), and pag (protective antigen gene).
      Expression of the three proteins is induced by bicarbonate or serum. Using a pag
      lacZ transcriptional construct to measure pag promoter activity, we cloned in
      Bacillus subtilis a gene (atxA) whose product acts in trans to stimulate anthrax
      toxin expression. Deletion analysis located atxA on a 2.0-kb fragment between cya
      and pag. DNA sequencing identified one open reading frame encoding 476 amino
      acids with a predicted M(r) of 55,673, in good agreement with the value of 53 kDa
      obtained by in vitro transcription-translation analysis. The cloned atxA gene
      complemented previously characterized Tn917 insertion mutants UM23 tp29 and UM23
      tp32 (J. M. Hornung and C. B. Thorne, Abstr. 91st Gen. Meet. Am. Soc. Microbiol.
      1991, abstr. D-121, p. 98), which are deficient in synthesis of all three toxin
      proteins. These results demonstrate that the atxA product activates not only
      transcription of pag but also that of cya and lef. beta-Galactosidase synthesis
      from the pag-lacZ transcriptional fusion construct introduced into an insertion
      mutant (UM23 tp62) which does not require bicarbonate for toxin synthesis
      indicated that additional regulatory genes other than atxA play a role in the
      induction of anthrax toxin gene expression by bicarbonate.

PMID- 8366022
TI  - Subunit association in acetohydroxy acid synthase isozyme III.
AB  - Acetohydroxy acid synthase isozyme III (AHAS III) from Escherichia coli is
      composed of large and small subunits (encoded by the genes ilvI and ilvH) in an
      alpha 2 beta 2 structure. The large (61-kDa) subunit apparently contains the
      catalytic machinery of the enzyme, while the small (17-kDa) subunit is required
      for specific stabilization of the active conformation of the large subunit as
      well as for valine sensitivity. The interaction between subunits has been studied
      by using purified enzyme and extracts containing subcloned subunits. The
      association between large and small subunits is reversible, with a dissociation
      constant sufficiently high to have important experimental consequences: the
      activity of the enzyme shows a concentration dependence curve which is concave
      upward, and this dependence becomes linear upon the addition of excess large or
      small subunits. We estimate that at a concentration of 10(-7) M for each subunit
      (7 micrograms of enzyme ml-1), the large subunits are only half associated as the
      I2H2 active holoenzyme. This dissociation constant is high enough to cause
      underestimation of the activity of AHAS III in bacterial extracts. The true
      activity of this isozyme in extracts is observed in the presence of excess small
      subunits, which maintain the enzyme in its associated form. Reexamination of an
      E. coli K-12 ilvBN+ ilvIH+ strain grown in glucose indicates that AHAS III is the
      major isozyme expressed. As an excess of small subunits does not influence the
      apparent Ki for valine inhibition of the purified enzyme, it is likely that
      valine binds to and inhibits I2H2 rather than inducing dissociation. AHAS I and
      II seem to show a much lower tendency to dissociate than does AHAS III.

PMID- 8366023
TI  - Cloning, sequencing, and expression in Escherichia coli of the gene coding for
      phosphofructokinase in Lactobacillus bulgaricus.
AB  - A fragment of 1,185 bp containing the gene coding for phosphofructokinase (ATP:D
      fructose-6-phosphate-1-phosphotransferase; EC 2.7.1.11) in Lactobacillus
      bulgaricus has been cloned, sequenced, and expressed in Escherichia coli. The
      amino acid sequence of this enzyme was homologous to those of the ATP-dependent
      phosphofructokinases from E. coli, Thermus thermophilus, Spiroplasma citri, and
      Bacillus stearothermophilus, suggesting that these enzymes have closely related
      structures despite their different regulatory properties. The recombinant protein
      had the same structural and functional properties as did the original enzyme. The
      3' end of the 1,185-bp fragment showed the presence of an open reading frame
      corresponding to the N-terminal amino acid sequence of the pyruvate kinase from
      L. bulgaricus. This gene organization, the same as that in S. citri (C.
      Chevalier, C. Saillard, and J. M. Bove, J. Bacteriol. 172:2693-2703, 1990) and B.
      stearothermophilus (D. Walker, W. N. Chia, and H. Muirhead, J. Mol. Biol. 228:265
      276, 1992; H. Sakai and T. Ohta, Eur. J. Biochem. 311:851-859, 1993) but
      different from that in E. coli (H. W. Hellinga and P. R. Evans, Eur. J. Biochem.
      149:363-373, 1985), indicated that the same transcription unit apparently
      contained the genes for phosphofructokinase and pyruvate kinase, the two key
      enzymes of glycolysis. The possibility that these genes could be transcribed at
      the same time suggested that in L. bulgaricus, the coordinated regulation of
      phosphofructokinase and pyruvate kinase occurs at the levels of both biosynthesis
      and enzymatic activity.

PMID- 8366024
TI  - Cysteine biosynthesis in Saccharomyces cerevisiae occurs through the
      transsulfuration pathway which has been built up by enzyme recruitment.
AB  - The transsulfuration pathways allow the interconversion of homocysteine and
      cysteine with the intermediary formation of cystathionine. The various organisms
      studied up to now incorporate reduced sulfur into a three- or a four-carbon chain
      and use differently the transsulfuration pathways to synthesize sulfur amino
      acids. In enteric bacteria, the synthesis of cysteine is the first step of
      organic sulfur metabolism and homocysteine is derived from cysteine. Fungi are
      capable of incorporating reduced sulfur into a four-carbon chain, and they
      possess two operating transsulfuration pathways. By contrast, synthesis of
      cysteine from homocysteine is the only existing transsulfuration pathway in
      mammals. In Saccharomyces cerevisiae, genetic, phenotypic, and enzymatic study of
      mutants has allowed us to demonstrate that homocysteine is the first sulfur amino
      acid to be synthesized and cysteine is derived only from homocysteine (H. Cherest
      and Y. Surdin-Kerjan, Genetics 130:51-58, 1992). We report here the cloning of
      genes STR4 and STR1, encoding cystathionine beta-synthase and cystathionine gamma
      lyase, respectively. The only phenotypic consequence of the inactivation of STR1
      or STR4 is cysteine auxotrophy. The sequencing of gene STR4 has allowed us to
      compare all of the known sequences of transsulfuration enzymes and enzymes
      catalyzing the incorporation of reduced sulfur in carbon chains. These
      comparisons reveal a partition into two families based on sequence motifs. This
      partition mainly correlates with similarities in the catalytic mechanisms of
      these enzymes.

PMID- 8366025
TI  - Characterization of rcsB and rcsC from Escherichia coli O9:K30:H12 and
      examination of the role of the rcs regulatory system in expression of group I
      capsular polysaccharides.
AB  - In Escherichia coli K-12, RcsC and RcsB are thought to act as the sensor and
      effector components, respectively, of a two-component regulatory system which
      regulates expression of the slime polysaccharide colanic acid (V. Stout and S.
      Gottesman, J. Bacteriol. 172:659-669, 1990). Here, we report the cloning and DNA
      sequence of a 4.3-kb region containing rcsC and rcsB from E. coli O9:K30:H12.
      This strain does not produce colanic acid but does synthesize a K30 (group I)
      capsular polysaccharide. The rcsB gene from E. coli K30 (rcsBK30) is identical to
      the rcsB gene from E. coli K-12 (rcsBK-12). rcsCK30 has 16 nucleotide changes,
      resulting in six amino acid changes in the predicted protein. To examine the
      function of the rcs regulatory system in expression of the K30 capsular
      polysaccharide, chromosomal insertion mutations were constructed in E. coli
      O9:K30:H12 to independently inactivate rcsBK30 and the auxiliary positive
      regulator rcsAK30. Strains with these mutations maintained wild-type levels of
      K30 capsular polysaccharide expression and still produced a K30 capsule,
      indicating that the rcs system is not essential for expression of low levels of
      the group I capsular polysaccharide in lon+ E. coli K30. However, K30 synthesis
      is increased by introduction of a multicopy plasmid carrying rcsBK30. K30
      polysaccharide expression is also markedly elevated in an rcsBK30-dependent
      fashion by a mutation in rcsCK30, suggesting that the rcs system is involved in
      high levels of synthesis. To determine whether the involvement of the rcs system
      in E. coli K30 expression is typical of group I (K antigen) capsules, multicopy
      rcsBK30 was introduced into 22 additional strains with structurally different
      group I capsules. All showed an increase in mucoid phenotype, and the
      polysaccharides produced in the presence and absence of multicopy rcsBK30 were
      examined. It is has been suggested that E. coli strains with group I capsules can
      be subdivided based on K antigen structure. For the first time, we show that
      strains with group I capsules can also be subdivided by the ability to produce
      colanic acid. Group IA contains capsular polysaccharides (including K30) with
      repeating-unit structures lacking amino sugars, and expression of group IA
      capsular polysaccharides is increased by multicopy rcsBK30. Group IB capsular
      polysaccharides all contain amino sugars. In group IB strains, multicopy rcsBK30
      activates synthesis of colanic acid.

PMID- 8366026
TI  - Comparative analysis of flagellin sequences from Escherichia coli strains
      possessing serologically distinct flagellar filaments with a shared complex
      surface pattern.
AB  - Escherichia coli morphotype E flagellar filaments have a characteristic surface
      pattern of short-pitch loops when examined by electron microscopy. Seven of the
      50 known E. coli H (flagellar antigen) serotypes (H1, H7, H12, H23, H45, H49, and
      H51) produce morphotype E filaments. Polymerase chain reaction was used to
      amplify flagellin structural (fliC) genes from E. coli strains producing
      morphotype E flagellar filaments and from strains with flagellar filaments
      representing other morphotypes. A single DNA fragment was obtained from each
      strain, and the size of the amplified DNA correlated with the molecular mass of
      the corresponding flagellin protein. This finding and hybridization data suggest
      that these bacteria are monophasic. fliC genes from three E. coli serotypes (H1,
      H7, and H12) possessing morphotype E flagellar filaments were sequenced in order
      to assess the contribution of conserved flagellin primary sequence to the
      characteristic filament architecture. The H1 and H12 fliC sequences were
      identical in length (1,788 bp), while the H7 fliC sequence was shorter (1,755
      bp). The deduced molecular masses of the FliC proteins were 60,857 Da (H1),
      59,722 Da (H7), and 60,978 Da (H12). The H1, H7, and H12 flagellins demonstrated
      98 to 99% identity over the amino-terminal region (190 amino acid residues) and
      89% (H7) to 99% (H1 and H12) identity in the carboxy-terminal region (100 amino
      acid residues). The complete primary amino acid sequences for H1 and H12
      flagellins differed by only 10 amino acids, accounting for previously reported
      serological cross-reactions. However, the central region of H7 flagellin had only
      38% identity with H1 and H12 flagellins. The characteristic morphology of
      morphotype E flagellar filaments is therefore not dependent on a highly conserved
      primary sequence within the exposed central region. Comparison of morphotype E E.
      coli flagellins with those from E. coli K-12, Serratia marcescens, and several
      Salmonella serovars supported the established concept of highly conserved
      terminal regions flanking a variable central region.

PMID- 8366027
TI  - Melanin production by Rhizobium meliloti GR4 is linked to nonsymbiotic plasmid
      pRmeGR4b: cloning, sequencing, and expression of the tyrosinase gene mepA.
AB  - Melanin production by Rhizobium meliloti GR4 is linked to nonsymbiotic plasmid
      pRmeGR4b (140 MDa). Transfer of this plasmid to GR4-cured derivatives or to
      Agrobacterium tumefaciens enables these bacteria to produce melanin. Sequence
      analysis of a 3.5-kb PstI fragment of plasmid pRmeGR4b has revealed the presence
      of a open reading frame 1,481-bp that codes for a protein whose sequence shows
      strong homology to two conserved regions involved in copper binding in
      tyrosinases and hemocyanins. In vitro-coupled transcription-translation
      experiments showed that this open reading frame codes for a 55-kDa polypeptide.
      Melanin production in GR4 is not under the control of the RpoN-NifA regulatory
      system, unlike that in R. leguminosarum bv. phaseoli 8002. The GR4 tyrosinase
      gene could be expressed in Escherichia coli under the control of the lacZ
      promoter. For avoiding confusion with mel genes (for melibiose), a change of the
      name of the previously reported mel genes of R. leguminosarum bv. phaseoli and
      other organisms to mep genes (for melanin production) is proposed.

PMID- 8366028
TI  - A rapid method for cloning mutagenic DNA repair genes: isolation of umu
      complementing genes from multidrug resistance plasmids R391, R446b, and R471a.
AB  - Genetic and physiological experiments have demonstrated that the products of the
      umu-like operon are directly required for mutagenic DNA repair in enterobacteria.
      To date, five such operons have been cloned and studied at the molecular level.
      Given the apparent wide occurrence of these mutagenic DNA repair genes in
      enterobacteria, it seems likely that related genes will be identified in other
      bacterial species and perhaps even in higher organisms. We are interested in
      identifying such genes. However, standard methods based on either DNA or protein
      cross-hybridization are laborious and, given the overall homology between
      previously identified members of this family (41 to 83% at the protein level),
      would probably have limited success. To facilitate the rapid identification of
      more diverse umu-like genes, we have constructed two Escherichia coli strains
      that allow us to identify umu-like genes after phenotypic complementation assays.
      With these two strains, we have cloned novel umu-like genes from three R
      plasmids, the IncJ plasmid R391 and two IncL/M plasmids, R446b and R471a.

PMID- 8366029
TI  - Genetic analysis of microcin H47 antibiotic system.
AB  - The microcin H47 genetic determinants span a DNA region of ca. 10 kb and
      represent the first description of an enterobacterial antibiotic system located
      in the chromosome of the producing strain. Transcriptional and translational
      fusions to lacZ showed a complex transcriptional organization of the microcin H47
      system. Complementation tests identified six genes that are necessary for the
      production of the antibiotic; the products of two of them are involved in the
      export of microcin to the extracellular medium. The immunity determinant was
      located in an 0.8-kb DNA fragment. There is a putative "silent region" of ca. 3
      kb inside the system that could not be clearly related to any antibiotic
      function. Protein products were identified and assigned to three production genes
      and also to a gene from the silent region.

PMID- 8366030
TI  - Characteristics and osmoregulatory roles of uptake systems for proline and
      glycine betaine in Lactococcus lactis.
AB  - Lactococcus lactis subsp. lactis ML3 contains high pools of proline or betaine
      when grown under conditions of high osmotic strength. These pools are created by
      specific transport systems. A high-affinity uptake system for glycine betaine
      (betaine) with a Km of 1.5 microM is expressed constitutively. The activity of
      this system is not stimulated by high osmolarities of the growth or assay medium
      but varies strongly with the medium pH. A low-affinity proline uptake system (Km,
      > 5 mM) is expressed at high levels only in chemically defined medium (CDM) with
      high osmolarity. This transport system is also stimulated by high osmolarity. The
      expression of this proline uptake system is repressed in rich broth with low or
      high osmolarity and in CDM with low osmolarity. The accumulated proline can be
      exchanged for betaine. Proline uptake is also effectively inhibited by betaine
      (Ki of between 50 and 100 microM). The proline transport system therefore
      probably also transports betaine. The inhibition of proline transport by betaine
      results in low proline pools in cells grown in high-osmotic-strength, betaine
      containing CDM. The energy and pH dependency and the influence of ionophores on
      the activity of both transport systems suggest that these systems are not proton
      motive force driven. At low osmolarities, proline uptake is low but significant.
      This low proline uptake is also inhibited by betaine, although to a lesser extent
      than in cells grown in high-osmotic-strength CDM. These data indicate that
      proline uptake in L. lactis is enzyme mediated and is not dependent on passive
      diffusion, as was previously believed.

PMID- 8366031
TI  - Enhancer-like activity of A1gR1-binding site in alginate gene activation:
      positional, orientational, and sequence specificity.
AB  - Significant activation of promoters of alginate genes such as algD or algC occurs
      in mucoid Pseudomonas aeruginosa during its proliferation in the lungs of cystic
      fibrosis patients. These promoters have been shown to be responsive to
      environmental signals such as high osmolarity. The signaling is mediated by a so
      called two-component signal transduction system, in which a soluble protein,
      AlgR2, undergoes autophosphorylation and transfers the phosphate to a DNA-binding
      response regulator protein, AlgR1. The phosphorylated form of AlgR1 has a high
      affinity for binding at upstream sequences of both the algC and algD promoters.
      Two AlgR1-binding sites (ABS) have been reported upstream of the algC gene. One
      of the two ABSs (algC-ABS1, located at -94 to -81) is critical for the algC
      activation process, while the second ABS (algC-ABS2, located at +161 to +174) is
      only weakly active. We now report the presence of a third ABS within the
      structural gene of algC, and this ABS (algC-ABS3) is also important for algC
      promoter activation. algC-ABS1 can be replaced functionally by algC-ABS2, algD
      ABS1, or algD-ABS2 and somewhat weakly by algD-ABS3. Introduction of a half
      integral turn in the DNA helix between the algC site of transcription initiation
      and algC-ABS1 allowed only slight reduction of promoter activity, suggesting that
      the binding site could be appreciably functional even when present in the
      opposite face of the helix. Activation of the algC promoter is independent of the
      relative location (upstream or downstream of the mRNA start site), the number of
      copies, or the orientation of algC-ABS1, suggesting that it behaves like a
      eukaryotic enhancer element in promoting transcription from the algC promoter.

PMID- 8366032
TI  - Methionine-mediated lethality in yeast cells at elevated temperature.
AB  - Saccharomyces cerevisiae cells grown at 30 degrees C in minimal medium containing
      methionine lose viability upon transfer to 45 degrees C, whereas cells grown in
      the absence of methionine survive. Cellular levels of two intermediates in the
      sulfate assimilation pathway, adenosine 5'-phosphosulfate (APS) and adenosine 5'
      phosphosulfate 3'-phosphate, are increased by a posttranslational mechanism after
      sudden elevation of temperature in yeast cultures grown in the absence of
      methionine. Yeast cells unable to synthesize APS because of repression by
      methionine or mutation of the MET3 gene do not survive the temperature shift.
      Thus, methionine-mediated lethality at elevated temperature is linked to the
      inability to synthesize APS. The results demonstrate that APS plays an important
      role in thermotolerance.

PMID- 8366033
TI  - Phenotype conversion in Pseudomonas solanacearum due to spontaneous inactivation
      of PhcA, a putative LysR transcriptional regulator.
AB  - Phenotype conversion (PC) in Pseudomonas solanacearum is the coordinated change
      in production of extracellular polysaccharide and a variety of extracellular
      proteins, some of which contribute to virulence. Although PC is normally
      spontaneous, it is mimicked by transposon inactivation of the phcA locus (S. M.
      Brumbley and T. P. Denny, J. Bacteriol. 172:5677-5685, 1990). The DNA sequence of
      a 1.8-kb region from strain AW1 that contains phcA revealed one open reading
      frame that should encode a polypeptide of 38.6 kDa. The PhcA protein produced in
      Escherichia coli by using a T7 RNA polymerase expression system was of the
      predicted size. The deduced amino acid sequence of PhcA is similar to that of
      some members of the LysR transcriptional activator gene family, especially in the
      amino terminus, where a putative helix-turn-helix DNA-binding motif was
      identified. An analogous allele (phcA1) was cloned from the spontaneous PC mutant
      strain AW1-PC and found to be nonfunctional in complementation studies. When
      phcA1 was expressed in E. coli, the PhcA1 protein was 35.5 kDa, 3 kDa smaller
      than PhcA. Sequence analysis of phcA1 and chimeric constructs of phcA and phcA1
      confirmed that PhcA1 is truncated by a 2-bp insertion 147 nucleotides upstream of
      the carboxyl terminus of PhcA. Southern blot analysis of 10 additional
      independently isolated PC mutants of strain AW1 revealed that two strains have
      larger insertions (0.2 and 1.0 kb) within phcA. These results suggest that phcA
      encodes a DNA-binding protein that regulates the transcription of one or more of
      the genes involved in P. solanacearum virulence and that spontaneous PC can be
      attributed to one of several different insertions within this locus.

PMID- 8366034
TI  - High-molecular-weight protein 2 of Yersinia enterocolitica is homologous to AngR
      of Vibrio anguillarum and belongs to a family of proteins involved in
      nonribosomal peptide synthesis.
AB  - The iron-regulated irp2 gene is specific for the highly pathogenic Yersinia
      species and encodes high-molecular-weight protein 2 (HMWP2). Despite the
      established correlation between the presence of HMWP2 and virulence, the role of
      this protein is still unknown. To gain insight into the function of HMWP2, the
      entire coding sequence and the promoter of irp2 were sequenced. Two putative -35
      and -10 promoter sequences were identified upstream of a large open reading
      frame, and two potential Fur-binding sites were found overlapping the second -35
      box. The large open reading frame is composed of 6,126 nucleotides and may encode
      a protein of 2,035 amino acids (ca. 228 kDa) with a pI of 5.81. A signal sequence
      was not present at the N terminus of the protein. Despite the existence of 30
      cysteine residues, carboxymethylation prevented the formation of most if not all
      disulfide bonds that otherwise occurred when the cells were sonicated. The
      protein was composed of three main domains: a central region of ca. 850 residues,
      bordered on each side by a repeat of 550 residues. A high degree of identity
      (44.5%) was found between HMWP2 and the protein AngR of Vibrio anguillarum. The
      central part of HMWP2 (after removal of a loop of 337 residues) also displayed
      significant homology with proteins belonging to the superfamily of adenylate
      forming enzymes and, like them, possessed a putative ATP-binding motif that is
      also present in AngR. In addition, HMWP2 shared with the group of antibiotic and
      enterochelin synthetases a potential amino acid-binding site. Six consensus
      sequences defining the superfamily and four defining the family of synthetases
      were derived from the multiple alignment of the 30 sequences of proteins or
      repeated domains. A phylogenetic tree that was constructed showed that HMWP2 and
      AngR are in a family composed of Lys2, EntF, and the tyrocidine, gramicidin, and
      Beta-lactam synthetases. This finding suggests that HMWP2 may participate in the
      nonribosomal synthesis of small biologically active peptides.

PMID- 8366035
TI  - Degradation of individual chromosomes in recA mutants of Escherichia coli.
AB  - Rapidly growing wild-type Escherichia coli cells contain two, four, or eight
      fully replicated chromosomes after treatment with rifampin, reflecting that all
      replication origins are initiated simultaneously. Cells with defects in the
      timing of the initiation of replication may contain three, five, six, or seven
      fully replicated chromosomes after such treatment. This phenotype, termed the
      asynchrony phenotype, is also seen in recombination-deficient recA mutants. It is
      shown here that for recA strains, the phenotype can be explained by a selective
      and complete degradation of individual chromosomes. The selective degradation is
      largely recD dependent and is thus carried out by the RecBCD exonuclease.

PMID- 8366036
TI  - Cloning of a chromosomal gene required for phage infection of Lactococcus lactis
      subsp. lactis C2.
AB  - A phage-resistant mutant with a defect in a membrane component required for phage
      infections in Lactococcus lactis subsp. lactis C2 was transformed with a
      chromosomal library of the wild-type, phage-sensitive strain. Of the 4,200
      transformants screened for phage sensitivity, three were positively identified as
      phage sensitive. A cause-and-effect relationship between the cloned chromosomal
      fragments and the phage-sensitive phenotype was established on the basis of the
      following two criteria: (i) the frequency of loss of the cloned fragments in the
      absence of antibiotic selection pressure correlated with the frequency of loss of
      phage sensitivity; and (ii) phage sensitivity was transferred to 100% of
      recipient, phage-resistant cells transformed with the cloned fragment. The cloned
      chromosomal DNA from the three independent isolates was physically mapped with
      restriction endonucleases. The sizes of the cloned fragments were 9.6, 11.8, and
      9.5 kb. Each fragment contained an identical stretch of DNA common to all three,
      which was 9.4 kb. The gene that conferred phage sensitivity was localized by
      subcloning to a 4.5-kb region. Further subcloning indicated that a single EcoRI
      site within the 4.5-kb region must lie within the gene or its promoter. The
      required 4.5-kb region was sequenced and found to code for one partial and two
      complete open reading frames. The gene required for complementation was
      functionally mapped by Tn5 mutagenesis and localized to one of the two complete
      open reading frames, which was designated pip (an acronym for phage infection
      protein). pip is 2,703 bases in length. Potential promoters start 206 and 212
      bases upstream of the open reading frame. A ribosome binding site and a seven
      base spacer precede the GTG (Val) translation initiation codon. The amino acid
      sequence deduced from the gene has 901 residues and an M(r) of 99,426. Hydropathy
      analysis revealed four to six potential membrane-spanning regions, one near the
      amino terminus and the others at the extreme carboxyl terminus. The amino
      terminus has characteristics of a signal sequence. The putative protein would
      have a 650-residue, central polar domain.

PMID- 8366037
TI  - Glucose uptake and catabolite repression in dominant HTR1 mutants of
      Saccharomyces cerevisiae.
AB  - Growth and carbon metabolism in triosephosphate isomerase (delta tpi1) mutants of
      Saccharomyces cerevisiae are severely inhibited by glucose. By using this
      feature, we selected for secondary site revertants on glucose. We defined five
      complementation groups, some of which have previously been identified as glucose
      repression mutants. The predominant mutant type, HTR1 (hexose transport
      regulation), is dominant and causes various glucose-specific metabolic and
      regulatory defects in TPI1 wild-type cells. HTR1 mutants are deficient in high
      affinity glucose uptake and have reduced low-affinity transport. Transcription of
      various known glucose transporter genes (HXT1, HXT3, and HXT4) was defective in
      HTR1 mutants, leading us to suggest that HTR mutations affect a negative factor
      of HXT gene expression. By contrast, transcript levels for SNF3, which encodes a
      component of high-affinity glucose uptake, were unaffected. We presume that HTR1
      mutations affect a negative factor of HXT gene expression. Multicopy expression
      of HXT genes or parts of their regulatory sequences suppresses the metabolic
      defects of HTR1 mutants but not their derepressed phenotype at high glucose
      concentrations. This suggests that the glucose repression defect is not a direct
      result of the metabolically relevant defect in glucose transport. Alternatively,
      some unidentified regulatory components of the glucose transport system may be
      involved in the generation or transmission of signals for glucose repression.

PMID- 8366038
TI  - Transfer functions of the conjugative integrating element pSAM2 from Streptomyces
      ambofaciens: characterization of a kil-kor system associated with transfer.
AB  - pSAM2 is an 11-kb integrating element from Streptomyces ambofaciens. During
      matings, pSAM2 can be transferred at high frequency, forming pocks, which are
      zones of growth inhibition of the recipient strain. The nucleotide sequences of
      the regions involved in pSAM2 transfer, pock formation, and maintenance have been
      determined. Seven putative open reading frames with the codon usage typical of
      Streptomyces genes have been identified: traSA (306 amino acids [aa]), orf84 (84
      aa), spdA (224 aa), spdB (58 aa), spdC (51 aa), spdD (104 aa), and korSA (259
      aa). traSA is essential for pSAM2 intermycelial transfer and pock formation. It
      could encode a protein with similarities to the major transfer protein, Tra, of
      pIJ101. TraSA protein contains a possible nucleotide-binding sequence and a
      transmembrane segment. spdA, spdB, spdC, and spdD influence pock size and
      transfer efficiency and may be required for intramycelial transfer. A kil-kor
      system similar to that of pIJ101 is associated with pSAM2 transfer: the korSA
      (kil-override) gene product could control the expression of the traSA gene, which
      has lethal effects when unregulated (Kil phenotype). The KorSA protein resembles
      KorA of pIJ101 and repressor proteins belonging to the GntR family. Thus, the
      integrating element pSAM2 possesses for transfer general features of
      nonintegrating Streptomyces plasmids: different genes are involved in the
      different steps of the intermycelial and intramycelial transfer, and a kil-kor
      system is associated with transfer. However, some differences in the functional
      properties, organization, and sizes of the transfer genes compared with those of
      other Streptomyces plasmids have been found.

PMID- 8366039
TI  - New method for gene disruption in Salmonella typhimurium: construction and
      characterization of an ada-deletion derivative of Salmonella typhimurium TA1535.
AB  - A new method for gene disruption in Salmonella typhimurium was developed. The key
      steps of this method are to produce restriction fragments with compatible ends,
      preligate to produce concatemers, and then transform by electrotransformation. We
      developed and used this method to construct a mutant of S. typhimurium TA1535 in
      which the resident ada-like (adaST) gene was replaced with a kanamycin resistance
      gene to produce an adaST-deletion mutant derivative. The S. typhimurium adaST
      deletion strain did not exhibit a higher level of mutability upon treatment with
      N-methyl-N'-nitro-N-nitrosoguanidine than did its wild-type parent strain.
      However, it did exhibit a higher sensitivity with respect to killing by N-methyl
      N'-nitro-N-nitrosoguanidine. The ability of AdaST to function as a
      transcriptional activator is discussed.

PMID- 8366040
TI  - Cloning, primary structure, and regulation of the HIS7 gene encoding a
      bifunctional glutamine amidotransferase: cyclase from Saccharomyces cerevisiae.
AB  - The Saccharomyces cerevisiae HIS7 gene was cloned by its location immediately
      downstream of the previously isolated and characterized ARO4 gene. The two genes
      have the same orientation with a distance of only 416 bp between the two open
      reading frames. The yeast HIS7 gene represents the first isolated eukaryotic gene
      encoding the enzymatic activities which catalyze the fifth and sixth step in
      histidine biosynthesis. The open reading frame of the HIS7 gene has a length of
      1,656 bp resulting in a gene product of 552 amino acids with a calculated
      molecular weight of 61,082. Two findings implicate a bifunctional nature of the
      HIS7 gene product. First, the N-terminal and C-terminal segments of the deduced
      HIS7 amino acid sequence show significant homology to prokaryotic monofunctional
      glutamine amidotransferases and cyclases, respectively, involved in histidine
      biosynthesis. Second, the yeast HIS7 gene is able to suppress His auxotrophy of
      corresponding Escherichia coli hisH and hisF mutants. HIS7 gene expression is
      regulated by the general control system of amino acid biosynthesis. GCN4
      dependent and GCN4-independent (basal) transcription use different initiator
      elements in the HIS7 promoter.

PMID- 8366041
TI  - The Candida albicans plasma membrane and H(+)-ATPase during yeast growth and germ
      tube formation.
AB  - PMA1 expression, plasma membrane H(+)-ATPase enzyme kinetics, and the
      distribution of the ATPase have been studied in carbon-starved Candida albicans
      induced with glucose for yeast growth at pH 4.5 and for germ tube formation at pH
      6.7. PMA1 expression parallels expression of the constitutive ADE2 gene,
      increasing up to sixfold during yeast growth and twofold during germ tube
      formation. Starved cells contain about half the concentration of plasma membrane
      ATPase of growing cells. The amount of plasma membrane ATPase is normalized prior
      to either budding or germ tube emergence by the insertion of additional ATPase
      molecules, while ATPase antigen appears uniformly distributed over the entire
      plasma membrane surface during both growth phases. Glucose addition rapidly
      activates the ATPase twofold regardless of the pH of induction. The turnover of
      substrate molecules per second by the enzyme in membranes from budding cells
      quickly declines, but the enzyme from germ tube-forming cells maintains its
      turnover of substrate molecules per second and a higher affinity for Mg-ATP. The
      plasma membrane ATPase of C. albicans is therefore regulated at several levels;
      by glucose metabolism/starvation-related factors acting on gene expression, by
      signals generated through glucose metabolism/starvation which are thought to
      covalently modify the carboxyl-terminal domain of the enzyme, and possibly by
      additional signals which may be specific to germ tube formation. The extended
      period of intracellular alkalinization associated with germ tube formation may
      result from regulation of proton-pumping ATPase activity coupled with higher
      ratios of cell surface to effective cytosolic volume.

PMID- 8366042
TI  - Genetic analysis of the agrocinopine catabolic region of Agrobacterium
      tumefaciens Ti plasmid pTiC58, which encodes genes required for opine and agrocin
      84 transport.
AB  - The acc region, subcloned from pTiC58 of classical nopaline and agrocinopine A
      and B Agrobacterium tumefaciens C58, allowed agrobacteria to grow using
      agrocinopine B as the sole source of carbon and energy. acc is approximately 6 kb
      in size. It consists of at least five genes, accA through accE, as defined by
      complementation analysis using subcloned fragments and transposon insertion
      mutations of acc carried on different plasmids within the same cell. All five
      regions are required for agrocin 84 sensitivity, and at least four are required
      for agrocinopine and agrocin 84 uptake. The complementation results are
      consistent with the hypothesis that each of the five regions is separately
      transcribed. Maxicell experiments showed that the first of these genes, accA,
      encodes a 60-kDa protein. Analysis of osmotic shock fractions showed this protein
      to be located in the periplasm. The DNA sequence of the accA region revealed an
      open reading frame encoding a predicted polypeptide of 59,147 Da. The amino acid
      sequence encoded by this open reading frame is similar to the periplasmic binding
      proteins OppA and DppA of Escherichia coli and Salmonella typhimurium and OppA of
      Bacillus subtilis.

PMID- 8366043
TI  - Isoleucine synthesis in Corynebacterium glutamicum: molecular analysis of the
      ilvB-ilvN-ilvC operon.
AB  - Acetohydroxy acid synthase (AHAS) and isomeroreductase (IR) catalyze subsequent
      reactions in the flux of metabolites towards isoleucine, valine, leucine, and
      pantothenate. A 4,705-bp DNA fragment from Corynebacterium glutamicum known to
      code for AHAS and IR was sequenced and analyzed by Northern (RNA blot) analysis.
      As in other bacteria, the AHAS of this gram-positive organism is encoded by two
      genes, ilvB and ilvN. Gene disruption verified that these genes encode the single
      AHAS activity in C. glutamicum. The start of ilvB was determined by amino
      terminal sequencing of a fusion peptide. By Northern analysis of the ilvBNC
      cluster, three in vivo transcripts of 3.9, 2.3, and 1.1 kb were identified,
      corresponding to ilvBNC, ilvNC, and ilvC messages, respectively. The ilvC
      transcript (encoding IR) was by far the most abundant one. With a clone from
      which the ilvB upstream regions had been deleted, only the ilvNC and ilvC
      transcripts were synthesized, and with a clone from which the ilvN upstream
      regions had been deleted, only the smallest ilvC transcript was formed. It is
      therefore concluded that in the ilv operon of C. glutamicum, three promoters are
      active. The amounts of the ilvBNC and ilvNC transcripts increased in response to
      the addition of alpha-ketobutyrate to the growth medium. This was correlated to
      an increase in specific AHAS activity, whereas IR activity was not increased
      because of the relatively large amount of the ilvC transcript present under all
      conditions assayed. Therefore, the steady-state level of the ilvBNC and ilvNC
      messages contributes significantly to the total activity of the single AHAS. The
      ilvC transcript of this operon, however, is regulated independently and present
      in a large excess, which is in accord with the constant IR activities determined.

PMID- 8366044
TI  - Identification, isolation, and overexpression of the gene encoding the psi
      subunit of DNA polymerase III holoenzyme.
AB  - The gene encoding the psi subunit of DNA polymerase III holoenzyme, holD, was
      identified and isolated by an approach in which peptide sequence data were used
      to obtain a DNA hybridization probe. The gene, which maps to 99.3 centisomes, was
      sequenced and found to be identical to a previously uncharacterized open reading
      frame that overlaps the 5' end of rimI by 29 bases, contains 411 bp, and is
      predicted to encode a protein of 15,174 Da. When expressed in a plasmid that also
      expressed holC, holD directed expression of the psi subunit to about 3% of total
      soluble protein.

PMID- 8366045
TI  - Mutation in the plasmid pUB110 Rep protein affects termination of rolling circle
      replication.
AB  - We isolated a mutant of plasmid pUB110 that has the following properties in
      Bacillus subtilis: (i) it is toxic for recA and add cells, particularly at
      elevated temperature; (ii) it has a copy number threefold higher than that of the
      parental plasmid, and the extra copies are present as multimers; and (iii) it can
      efficiently complement replication of a cmp- satellite plasmid, despite being
      cmp+. All these properties are due to a single change in the plasmid replication
      protein, i.e., Gly at position 148 to Glu. These properties of the mutant Rep
      protein reflect a diminished ability to terminate rolling circle replication. We
      propose that the Rep protein may have a diminished affinity for the plasmid
      origin; alternatively, it may be impaired for recognition of the plasmid
      conformations which distinguish initiation and termination.

PMID- 8366047
TI  - Escherichia coli rpiA gene encoding ribose phosphate isomerase A.
AB  - The rpiA gene encoding ribose phosphate isomerase A was cloned from phage
      1A2(471) of the Kohara gene library. Subcloning, restriction, and complementation
      analyses revealed an 1,800-bp SspI-generated DNA fragment that contained the
      entire control and coding sequences. This DNA fragment was sequenced and shown to
      harbor an open reading frame of 219 codons, sufficient to encode a polypeptide
      with an M(r) of 22,845. The synthesis of the rpiA-encoded polypeptide was
      detected by analysis of minicells, which established the subunit M(r) as 27,000.
      The assignment of the correct reading frame was confirmed by amino-terminal
      analysis of partially purified ribose phosphate isomerase A. Our data indicate
      that the enzyme is composed of two identical subunits. The 5' end of the rpiA
      specified transcript was analyzed by primer extension, which revealed a well
      conserved -10 region 34 bp upstream of the presumed translation start codon.
      Analysis of the 3' end of the transcript by S1 nuclease mapping showed that
      transcription termination occurred within an adenylate-rich sequence following a
      guanylate-cytidylate-rich stem-loop structure resembling a rho factor-independent
      transcription terminator. Host strains harboring the rpiA gene in a multicopy
      plasmid contained up to 42-fold as much ribose phosphate isomerase A activity as
      the haploid strain.

PMID- 8366048
TI  - Molecular and phenotypic characterization of promoter-proximal mutations in the
      spoIIA locus of Bacillus subtilis.
AB  - Eight mutations lying within the promoter-proximal one-fifth of the spoIIA locus
      of Bacillus subtilis were studied. Two of these mutations (spoIIAA42 and
      spoIIAA69) were previously characterized at the DNA level, five more (spo-562,
      spo-565, spo-567, spo-568, and spo-569) were isolated in our laboratory several
      years ago but not fully characterized, and the eight (an in-frame deletion
      confined to spoIIAA, the first gene in the spoIIA operon) was constructed for
      this study. DNA sequencing showed that spo-569 was a transitions in the -35
      region of the spoIIA promoter; the remaining point mutations were all G:C to A:T
      transitions in spoIIAA, with spo-565 having two transitions, one of which was
      identical to that in spo-562. All the spoIIAA mutations except spo-562 led to the
      replacement of Gly residues. The incidence of sporulation, the rate of synthesis
      of sporulation-associated alkaline phosphatase, and the rate of expression of the
      forespore-specific genes gpr and spoIIIG were determined for isogenic strains
      carrying the eight mutations. All the mutations except spoIIAA42 and spo-569
      (which were slightly leaky) made the strains asporogenous, and all except spo-562
      and spo-569 abolished the synthesis of alkaline phosphatase and the expression of
      gpr and spoIIIG. spo-562 allowed alkaline phosphatase synthesis and gpr and
      spoIIIG expression to occur at about 15% of the wild-type rates but with normal
      kinetics. spo-59 allowed appreciable gpr and spoIIIG expression during
      exponential growth; we attribute this expression to transcription by RNA
      polymerase containing sigma G and suggest that a spo-569 strain makes
      insufficient SpoIIAB to inhibit sigma G in growing cells.

PMID- 8366046
TI  - Cloning, sequencing, expression, and regulation of the structural gene for the
      copper/topa quinone-containing methylamine oxidase from Arthrobacter strain P1, a
      gram-positive facultative methylotroph.
AB  - Deoxyoligonucleotides corresponding to amino acid sequences of methylamine
      oxidase and polyclonal anti-methylamine oxidase antibodies were used to probe
      Arthrobacter strain P1 plasmid and chromosomal DNA libraries. Two open reading
      frames, maoxI and maoxII, which are greater than 99% homologous, were cloned from
      the chromosomal library. The deduced amino acid sequences of the coding regions
      are identical except for two residues near the C termini. On the other hand, the
      5'- and 3'-flanking regions of maoxI and maoxII are quite different. While either
      gene could code for methylamine oxidase, the dissimilarity in the 5'-flanking
      regions indicates that the genes are differently regulated. It was determined
      that maoxII alone encodes methylamine oxidase. The tyrosyl residue which is
      converted to topa quinone in the mature enzyme was located by comparison with
      amino acid sequences at the cofactor sites in other copper/topa quinone
      containing amine oxidase. Transcriptional start sites and possible regulatory
      elements were identified in the 5' region of maoxI and maoxII, and stem-loop
      structures were found in the 3'-flanking regions. High levels of methylamine
      oxidase are produced when Arthrobacter strain P1 is grown on methylamine alone or
      on glucose plus methylamine, but growth on LB medium plus methylamine resulted in
      very low production of the enzyme. Expression of maoxII from its own promoter in
      Escherichia coli grown on glucose or LB medium with or without methylamine gave
      the same level of production of methylamine oxidase.

PMID- 8366049
TI  - Escherichia coli mutants lacking NADH dehydrogenase I have a competitive
      disadvantage in stationary phase.
AB  - We have previously characterized mutant strains of Escherichia coli that are able
      to take over stationary-phase cultures. Here we describe two insertion mutations
      that prevent such strains from expressing this phenotype. Both insertions were
      mapped to min 51, and sequence analysis revealed that both mutated genes encode
      proteins homologous to subunits of mitochondrial NADH dehydrogenase I. Crude
      extracts prepared from both mutant strains were able to oxidize NADH but lacked
      the enzymatic activity needed to oxidize deamino-NADH, a substrate specific for
      NADH dehydrogenase I. This is the first identification of genes encoding subunits
      of NADH dehydrogenase I in E. coli. The significance of the inability of these
      mutant strains to compete in stationary-phase cultures is discussed.

PMID- 8366050
TI  - A cryptic promoter in the O(R) region of bacteriophage lambda.
AB  - A cryptic promoter, designated P alpha, initiates transcription within the O(R)
      region of bacteriophage lambda. Transcription from P alpha proceeds in the
      direction of the cI repressor gene from sites 46 and 48 bp preceding the PRM
      transcription start site. P alpha is likely to compete with both PR and PRM for
      formation of open complexes, since it is only active when PR is mutated and can
      be suppressed by mutations that increase PRM activity. In addition, transcription
      initiation at P alpha is blocked by lambda repressor. Kinetic analysis of
      relative abundance of the products of in vitro transcription indicated that P
      alpha was approximately 1/3 as strong as PRM. However, a P alpha mutation had
      little effect on KBkf (the association rate constant) for PRM. These observations
      can be explained by the finding that open complexes formed at P alpha are
      relatively unstable (half-life = 20 to 25 min). Dissociation of RNA polymerase
      from P alpha allows additional open complexes to form at PR or PRM, and thus the
      apparent strength of P alpha decreases with increasing preincubation times.

PMID- 8366051
TI  - Maltose and maltotriose can be formed endogenously in Escherichia coli from
      glucose and glucose-1-phosphate independently of enzymes of the maltose system.
AB  - The maltose system in Escherichia coli consists of cell envelope-associated
      proteins and enzymes that catalyze the uptake and utilization of maltose and
      alpha,1-4-linked maltodextrins. The presence of these sugars in the growth medium
      induces the maltose system (exogenous induction), even though only maltotriose
      has been identified in vitro as an inducer (O. Raibaud and E. Richet, J.
      Bacteriol., 169:3059-3061, 1987). Induction is dependent on MalT, the positive
      regulator protein of the system. In the presence of exogenous glucose, the
      maltose system is normally repressed because of catabolite repression and inducer
      exclusion brought about by the phosphotransferase-mediated vectorial
      phosphorylation of glucose. In contrast, the increase of free, unphosphorylated
      glucose in the cell induces the maltose system. A ptsG ptsM glk mutant which
      cannot grow on glucose can accumulate [14C]glucose via galactose permeases. In
      this strain, internal glucose is polymerized to maltose, maltotriose, and
      maltodextrins in which only the reducing glucose residue is labeled. This
      polymerization does not require maltose enzymes, since it still occurs in malT
      mutants. Formation of maltodextrins from external glucose as well as induction of
      the maltose system is absent in a mutant lacking phosphoglucomutase, and
      induction by external glucose could be regained by the addition of glucose-1
      phosphate entering the cells via a constitutive glucose phosphate transport
      system. malQ mutants, which lack amylomaltase, are constitutive for the
      expression of the maltose genes. This constitutive nature is due to the formation
      of maltose and maltodextrins from the degradation of glycogen.

PMID- 8366053
TI  - Characterization of a membrane-associated ATPase from Methanococcus voltae, a
      methanogenic member of the Archaea.
AB  - A membrane-associated ATPase with an M(r) of approximately 510,000 and containing
      subunits with M(r)s of 80,000 (alpha), 55,000 (beta), and 25,000 (gamma) was
      isolated from the methanogen Methanococcus voltae. Enzymatic activity was not
      affected by vanadate or azide, inhibitors of P- and F1-ATPase, respectively, but
      was inhibited by nitrate and bafilomycin A1, inhibitors of V1-type ATPases. Since
      dicyclohexylcarbodiimide inhibited the enzyme when it was present in membranes
      but not after the ATPase was solubilized, we suggest the presence of membrane
      associated component analogous to the F0 and V0 components of both F-type and V
      type ATPases. N-terminal amino acid sequence analysis of the alpha subunit showed
      a higher similarity to ATPases of the V-type family than to those of the F-type
      family.

PMID- 8366052
TI  - The major iron-containing protein of Legionella pneumophila is an aconitase
      homologous with the human iron-responsive element-binding protein.
AB  - Legionella pneumophila has high iron requirements, and its intracellular growth
      in human monocytes is dependent on the availability of intracellular iron. To
      learn more about iron metabolism in L. pneumophila, we have undertaken an
      analysis of the iron proteins of the bacterium. We first developed an assay to
      identify proteins by 59Fe labelling and nondenaturing polyacrylamide gel
      electrophoresis. The assay revealed seven iron proteins (IPs) with apparent
      molecular weights of 500, 450, 250, 210, 150, 130, and 85. IP150 comigrates with
      superoxide dismutase activity and is probably the Fe-superoxide dismutase of L.
      pneumophila. IP210 is the major iron-containing protein (MICP). To identify and
      characterize MICP, we purified the protein and cloned and sequenced its gene.
      MICP is a monomeric protein containing 891 amino acids, and it has a calculated
      molecular mass of 98,147 Da. Analysis of the sequence revealed that MICP has two
      interesting homologies. First, MICP is highly homologous with the human iron
      responsive element-binding protein, consistent with the hypothesis that this
      critical iron-regulatory molecule of humans has a prokaryotic ancestor. Second,
      MICP is highly homologous with the Escherichia coli aconitase and to a lesser
      extent with porcine heart mitochondrial aconitase. Consistent with this, we found
      that MICP exhibits aconitase activity. In contrast to other aconitases, MICP has
      a single amino acid change of a potentially deleterious type at a site thought to
      be critical for substrate binding and enzymatic activity. However, the specific
      activity of MICP is roughly comparable to that of other aconitases, suggesting
      that the mutation has at most a mild effect on the aconitase activity of MICP.
      The abundance of MICP in L. pneumophila suggests either that L. pneumophila
      requires high aconitase and perhaps tricarboxylic acid cycle activity or that the
      bacterium requires large amounts of this protein to serve an additional role in
      bacterial physiology. A need for large amounts of MICP, which contains four Fe
      atoms per molecule when fully loaded, could at least partly explain L.
      pneumophila's high metabolic requirement for iron.

PMID- 8366054
TI  - Isolation of a Candida albicans DNA sequence conferring adhesion and aggregation
      on Saccharomyces cerevisiae.
AB  - Candida albicans is an opportunistic pathogen which may give rise to superficial
      and systemic infections. In the present study, C. albicans adhesion was studied
      by expression of C. albicans DNA sequences encoding adhesion functions in a
      nonadherent strain of Saccharomyces cerevisiae. Adherent transformant cells of S.
      cerevisiae harbouring a C. albicans genomic library cloned in a yeast-Escherichia
      coli shuttle vector were selected by using tissue culture-treated polystyrene as
      the attachment substratum. One transformant exhibited enhanced adhesion to
      treated and untreated polystyrene as well as autoaggregation, unlike control
      cells bearing the vector alone. Analysis of this clone revealed an insert of ca.
      4.5 kb from C. albicans. Curing of the plasmid resulted in loss of adhesion and
      autoaggregation properties. A subclone bearing a reduced insert of 3.3 kb
      retained the ability to autoaggregate, to bind to treated and untreated
      polystyrene, and to adhere to buccal epithelial cells, unlike appropriate
      controls. Further subcloning of the insert to 2.7- and 1.9-kb fragments resulted
      in incremental decreases in adhesion and autoaggregation, whereas smaller
      fragments did not confer these properties. Hybridization of the 2.7-kb segment
      with C. albicans and S. cerevisiae DNA confirmed its origin as a single-copy
      sequence in the C. albicans genome as well as the absence of a homologous
      sequence in the genome of S. cerevisiae. The data suggest that the adhesion and
      aggregation phenomena of the transformant cells are related to expression of a C.
      albicans surface antigen encoded by the cloned DNA fragment.

PMID- 8366055
TI  - Chloramphenicol acetyltransferase, a cytoplasmic protein is incompatible for
      export from Bacillus subtilis.
AB  - Bacillus subtilis cells expressing a hybrid protein (Lvsss-Cat) consisting of the
      B. amyloliquefaciens levansucrase signal peptide fused to B. pumilus
      chloramphenicol acetyltransferase (Cat) are unable to export Cat protein into the
      growth medium. A series of tripartite protein fusions was constructed by
      inserting various lengths of the Cat sequences between the levansucrase signal
      peptide and staphylococcal protein A or Escherichia coli alkaline phosphatase.
      Biochemical characterization of the various Cat protein fusions revealed that
      multiple regions in the Cat protein were causing the export defect.

PMID- 8366056
TI  - Plasmids from two morphologically distinct cyanobacterial strains share a novel
      replication origin.
AB  - A 2.9-kbp replication origin from a plasmid endogenous to the filamentous
      cyanobacterium Fremyella diplosiphon UTEX 481 was genetically characterized and
      sequenced. Deletion analysis of the 2.9-kbp DNA fragment delimited the minimum
      region necessary for replication in F. diplosiphon Fd33 to approximately 2.5 kbp.
      DNA sequence analysis revealed that the F. diplosiphon plasmid replication origin
      is structurally very similar to and shares significant identity with the 1.75-kbp
      replication origin reported for plasmid pDU1, isolated from the morphologically
      distinct cyanobacterium Nostoc sp. strain PCC 7524. Each cyanobacterial plasmid
      replication origin includes a large open reading frame that predicts a conserved
      protein of unknown function; the predicted proteins of the replication origins
      are of similar sizes and 30% identical in amino acid sequence. Each
      cyanobacterial plasmid replication origin also possesses a region of dyad
      symmetry approximately 300 bp upstream of the conserved open reading frame.

PMID- 8366057
TI  - The chimeric VirA-tar receptor protein is locked into a highly responsive state.
AB  - The wild-type VirA protein is known to be responsive not only to phenolic
      compounds but also to sugars via the ChvE protein (G. A. Cangelosi, R. G.
      Ankenbauer, and E. W. Nester, Proc. Natl. Acad. Sci. USA 87:6708-6712, 1990, and
      N. Shimoda, A. Toyoda-Yamamoto, J. Nagamine, S. Usami, M. Katayama, Y. Sakagami,
      and Y. Machida, Proc. Natl. Acad. Sci. USA 87:6684-6688, 1990). It is shown here
      that the mutant VirA(Ser-44, Arg-45) protein and the chimeric VirA-Tar protein
      are no longer responsive to sugars and the ChvE protein. However, whereas the
      chimeric VirA-Tar protein was found to be locked in a highly responsive state,
      the VirA(Ser-44, Arg-45) mutant protein appeared to be locked in a low responsive
      state. This difference turned out to be important for tumorigenicity of the host
      strains in virulence assays on Kalanchoe daigremontiana.

PMID- 8366058
TI  - General distribution of the nitrogen control gene ntcA in cyanobacteria.
AB  - The ntcA gene from Synechococcus sp. strain PCC 7942 encodes a regulatory protein
      which is required for the expression of all of the genes known to be subject to
      repression by ammonium in that cyanobacterium. Homologs to ntcA have now been
      cloned by hybridization from the cyanobacteria Synechocystis sp. strain PCC 6803
      and Anabaena sp. strain PCC 7120. Sequence analysis has shown that these ntcA
      genes would encode polypeptides strongly similar (77 to 79% identity) to the
      Synechococcus NtcA protein. Sequences hybridizing to ntcA have been detected in
      the genomes of nine other cyanobacteria that were tested, including strains of
      the genera Anabaena, Calothrix, Fischerella, Nostoc, Pseudoanabaena,
      Synechococcus, and Synechocystis.

PMID- 8366060
TI  - Clarification of the Escherichia coli genetic map in the 92-minute region
      containing the ubiCA operon and the plsB, dgk, lexA, and dinF genes.

PMID- 8366061
TI  - Location of the 7 alpha-hydroxysteroid dehydrogenase gene (hdhA) on the physical
      map of the Escherichia coli chromosome.

PMID- 8366059
TI  - Density fluctuation during the cell cycle in the defective vacuolar morphology
      mutants of Saccharomyces cerevisiae.
AB  - The buoyant densities of the yeast cells of defective vacuolar morphology mutants
      were examined by equilibrium sedimentation centrifugation in a Percoll density
      gradient. These vacuoleless mutants also show density fluctuation as wild-type
      cells during the cell cycle. This suggests that morphological changes of the
      vacuole are not related to cyclic density fluctuation in Saccharomyces
      cerevisiae.

PMID- 8366063
TI  - Physical and genetic mapping of the tag gene on the Escherichia coli chromosome.

PMID- 8366062
TI  - Location of the prlC (opdA) gene on the physical map of Escherichia coli.

PMID- 8366064
TI  - Location of the gltP gene on the physical map of Escherichia coli K-12.

PMID- 8366065
TI  - Physical map location of the rffC and rffA genes of Escherichia coli.

PMID- 8366066
TI  - Genetic and physical mapping of the regulatory gene csrA on the Escherichia coli
      K-12 chromosome.

PMID- 8366067
TI  - Location of the udk gene on the physical map of Escherichia coli.

PMID- 8366068
TI  - Structure and function of mammalian facilitative sugar transporters.

PMID- 8366069
TI  - Biogenesis of the mitochondrial receptor complex. Two receptors are required for
      binding of MOM38 to the outer membrane surface.
AB  - Targeting of preproteins to mitochondria is mediated by the receptor complex in
      the outer membrane that contains two import receptors and the general insertion
      pore with MOM38 (38-kDa mitochondrial outer membrane protein) as major
      constituent. As all components of the receptor complex have to be imported from
      the cytosol themselves, the specificity of their targeting is fundamental for the
      correct assembly of mitochondria. None of the receptors is involved in its own
      import; the precursor of the main receptor MOM19 is even targeted without any
      surface receptor but directly assembles with MOM38. We report that import of the
      precursor of MOM38 strictly depended on surface receptors. The import followed a
      new highly selective mechanism in that both receptors together were needed for
      the specific binding of the preprotein to the outer membrane surface, which was
      followed by its assembly into the receptor complex. These findings suggest that
      targeting of the mitochondrial targeting components involves a complex system of
      mutual specificity control, ensuring a selective assembly of the components into
      preexisting import sites.

PMID- 8366071
TI  - The catalytic mechanism of glutathione S-transferase (GST). Spectroscopic
      determination of the pKa of Tyr-9 in rat alpha 1-1 GST.
AB  - The rat alpha 1-1 glutathione S-transferase (GST) contains a single, non
      essential tryptophan and only 8 tyrosines in each subunit. One of these
      tyrosines, Tyr-9, hydrogen bonds to the substrate glutathione and stabilizes the
      nucleophilic thiolate anion. Two mutant proteins that allow for the spectrocopic
      determination of the pKa of this catalytic residue have been constructed. The
      W21F mutant provides a fully active GST with no tryptophans, and the double
      mutant W21F/Y9F lacks both tryptophan and the active site tyrosine. The intrinsic
      fluorescence and absorbance properties of these mutants are dominated by
      tyrosine. Fluorescence emission, fluorescence excitation, and absorbance spectral
      changes of samples containing the W21F mutant at several pH values in the range
      6.8-9.0 reveal a pH-dependent increase in the contribution of tyrosinate. No
      spectral changes are observed with the W21F/Y9F protein in this pH range. At pH
      12.5, both proteins exhibit complete deprotonation of all tyrosines. The pKa of
      Tyr-9 determined from these spectroscopic changes is 8.3-8.5. The changes in
      absorbance at 250 and 295 nm correspond to titration of 0.95 +/- 0.29
      tyrosines/subunit in the W21F protein between pH 6.9 and 9.3. Moreover, addition
      of the inhibitor S-hexylglutathione results in an apparent increase in the pKa of
      Tyr-9. Together, these results indicate that the catalytically active Tyr of GSTs
      has a pKa value that is 1.8-2.0 pKa units below tyrosine in solution. It is
      likely that this decrease in the pKa of Tyr-9 contributes to catalysis by
      altering the equilibrium position of the proton shared between Tyr-9 and GSH, and
      this active site residue may function as a general base catalyst in addition to a
      hydrogen bond donor.

PMID- 8366070
TI  - Molecular cloning, identification, and sequence of the hyaluronan synthase gene
      from group A Streptococcus pyogenes.
AB  - The hyaluronan (HA) synthase of Group A Streptococci has been identified by
      transposon mutagenesis and deletion analysis. The genes for the HA synthase and a
      recently identified UDP-Glc dehydrogenase (Dougherty, B. A., and van de Rijn, I.
      (1993) J. Biol. Chem. 268, 7118-7124) reside on a contiguous stretch of 3.2
      kilobase pair DNA that can direct HA biosynthesis in Enterococcus faecalis and
      Escherichia coli as well as mutant Streptococcus (DeAngelis, P. L.,
      Papaconstantinou, J., and Weigel, P. H. (1993) J. Biol. Chem. 268, 14568-14571).
      The synthase contains 395 residues (calculated Mr = 45,063) and migrates on SDS
      PAGE with a molecular mass of 42 kDa. E. coli K5, which synthesizes UDP
      glucuronic acid for production of its endogenous capsular polysaccharide, can
      make HA if it contains a plasmid encoding the intact 42-kDa protein. E. coli SURE
      or chi 1448 cells containing the same construct, however, cannot produce HA since
      these strains cannot make both required sugar nucleotide precursors. The HA
      synthase is predicted to be an integral membrane protein with four membrane
      associated helices, which is consistent with the location of the enzyme activity
      in Streptococci. There is significant homology between the HA synthase and the
      Rhizobium nodC gene product, an enzyme that synthesizes chitin-like oligomers.
      This is the first description at the molecular level of an enzyme shown to
      synthesize a glycosaminoglycan.

PMID- 8366072
TI  - Assembly of the primosome of DNA replication in Escherichia coli.
AB  - Assembly of the Escherichia coli primosome requires six proteins, PriA, PriB,
      PriC, DnaB, DnaC, and DnaT, acting at a primosome assembly site (pas) on an SSB
      coated single-stranded (ss) DNA. Assembly is initiated by interactions of PriA
      and PriB with ssDNA and the pas. PriC, DnaB, DnaC, and DnaT then act on the PriA
      PriB-DNA complex to yield the primosome. In the primosome, the dATPase (ATPase)
      of PriA becomes hyper-activated. In addition, the assembled primosome appears to
      block the pas, preventing it from activating additional PriA molecules. Either
      ATP alone or dATP in combination with GTP is sufficient for primosome assembly,
      while ATP or GTP provides for its maintenance during isolation. These nucleotide
      requirements can be reconciled with the need for ATP or dATP for DnaB-DnaC
      complex formation and hydrolysis of ATP or GTP by DnaB when it binds ssDNA. Such
      isolated primosomes contain a dATPase, the hallmark of PriA, and a GTPase
      indicative of DnaB. Further studies indicate that the isolated primosome contains
      the PriB replication activity in addition to PriA and DnaB.

PMID- 8366073
TI  - Peptide binding to protein disulfide isomerase occurs at a site distinct from the
      active sites.
AB  - Protein disulfide isomerase (PDI) is a multifunctional protein resident in the
      lumen of the rough endoplasmic reticulum that facilitates protein folding via
      disulfide bond isomerization. Previously we determined that PDI binds a variety
      of peptides that can be covalently attached to this protein via a photoreactive
      cross-linker. We have now investigated the relationship between the peptide
      binding site and the ability of PDI to catalyze disulfide bond isomerization. PDI
      has two identical sequences, -WCGHCK-, that have been demonstrated to be
      important in PDI-catalyzed disulfide isomerization. We have found that other
      proteins containing these thioredoxin-like active site sequences do not bind the
      photoreactive peptide probes. Moreover, although chemical modification of the 2
      cysteines within the thioredoxin-like active site regions completely inhibits PDI
      catalyzed disulfide isomerization, these modifications do not affect peptide
      binding by PDI. Both of these observations suggest that peptide binding occurs at
      a site other than the putative PDI active sites. To localize the site in PDI at
      which binding occurs, we used a radiolabeled peptide photoaffinity probe. Peptide
      fragments generated by cleavage of 125I-peptide-labeled PDI with cyanogen bromide
      yielded a single 8-kDa polypeptide fragment containing the 125I-labeled peptide
      site, but neither of the putative catalytic sites of PDI. An 125I-labeled tryptic
      peptide was generated from this cyanogen bromide fragment and determined by
      microsequencing to contain residues 451-476 of PDI; this 26-residue peptide is
      noteworthy because of its extremely high content of acidic amino acids. Based on
      these findings we conclude that the peptide binding site is located in the COOH
      terminal domain of the protein, and it is distinct from the two active sites for
      PDI-catalyzed disulfide isomerization and from the region of PDI that has
      estrogen receptor sequence similarity.

PMID- 8366074
TI  - Comparison of antiparallel and parallel two-stranded alpha-helical coiled-coils.
      Design, synthesis, and characterization.
AB  - An antiparallel coiled-coil has been designed and characterized as a model for
      studying protein folding and assembly. This heterostranded antiparallel coiled
      coil was formed by an interchain disulfide bond between cysteine residues at
      position 2 of one chain and at position 33 of the other chain. Each peptide chain
      has 35 residues which are composed of five heptad repeats of the sequence K-L-E-A
      L-E-G with a single Leu-->Ala substitution at position 16. Two homostranded
      parallel coiled-coils were also formed as co-products of the oxidation reaction
      to form the interchain disulfide bond. The CD spectra of the parallel and
      antiparallel peptides were very similar and their high molar ellipticities at 220
      nm did not increase in the presence of 50% trifluoroethanol. These data suggest
      that, like the parallel peptides, the antiparallel peptide also exists in a
      coiled-coil structure. Urea and guanidine hydrochloride denaturation studies, in
      conjunction with molecular modeling studies, suggest that there are no physical
      restrictions to the packing of hydrophobic residues in an antiparallel coiled
      coil. However, interchain electrostatic interactions can have positive or
      negative contributions to the overall stability of the disulfide-bridged coiled
      coil. In addition, interchain electrostatic interactions appear to play a major
      role in protein folding by controlling the parallel or antiparallel alignment of
      the alpha-helical polypeptide chains. This study is also for the first time
      providing us with a new understanding of the information that can be obtained
      from urea and guanidine hydrochloride denaturation studies of proteins concerning
      the contributions of hydrophobic and electrostatic interactions on stability.

PMID- 8366075
TI  - Comparative analysis of structurally defined heparin binding sequences reveals a
      distinct spatial distribution of basic residues.
AB  - Heparin, among the best studied glycosaminoglycans, is well known for its
      involvement in a variety of physiological processes. Many proteins, whose
      activities are modulated via heparin binding, were identified, and the
      consequences of their interaction with heparin were characterized. However, in
      the absence of solid structural information regarding heparin-protein complexes,
      the mechanism by which heparin operates at the molecular level is still obscure.
      The structure of such a complex is hereby explored via the identification of a
      common motif in heparin binding sequences. To avoid ambiguity we included in our
      data base only sequences that have been shown experimentally to be directly
      involved in heparin binding. Then, a comparison of the spatial distribution of
      basic residues was conducted among those peptides for which three-dimensional
      structures were defined. Using computer graphics techniques we were able to
      identify a unique distribution shared by all of these segments. Two basic amino
      acids (most frequently arginine) are located at about 20 A apart, facing opposite
      directions of an alpha-helix. Other basic amino acids are dispersed between these
      two residues, facing one side, while nonpolar residues face the opposite side,
      forming an amphipathic structure. The distribution of basic amino acids in other
      heparin binding sequences that preserves the same spatial arrangement seems to be
      compatible with a beta-strand structure. The 20-A interval accommodates a
      glycosaminoglycan pentasaccharide, and the spatial distribution of the basic
      residues suggests an intertwinement of the heparin-protein complex. The dynamics
      of such an interaction may provide a clue regarding the ensuing change in protein
      activity.

PMID- 8366076
TI  - Critical minimum length of the central helix in troponin C for the Ca2+ switch in
      muscular contraction.
AB  - In the troponin C (TnC) dumbbell, the NH2- and COOH-terminal lobes are well
      delineated, but the role of the central helix and especially the function of its
      long length remain doubtful. To study this, we used a cDNA construct encoding
      rabbit fast-twitch muscle TnC, comprising multiple restriction sequences to
      facilitate mutagenesis (Babu, A., Su, H., Ryu, Y. & Gulati, J. (1992) J. Biol.
      Chem. 267, 15469-15474). Systematically, we have deleted 3-12 amino acid residues
      from the central helix and examined their effects in maximally activated skinned
      muscle fibers. Limiting the deletions to 7 amino acid residues manifested little
      change in maximal force development (Sheng, Z., Francois, J. M., Hitchcock, S. E.
      & Potter, J. D. (1991) J. Biol. Chem. 266, 5711-5715). However, with further
      deletions, we now find that contractility was inhibited pari passu; by 12
      deletions, the inhibition was complete. The critical minimum length for the
      central helix is thereby estimated as 27 A. The Ca2+ binding capacity (4 mol of
      Ca2+/mol of protein) as well as the structural characteristics (alpha-helicity by
      CD measurements and the fluorescence emitted by Tyr-109) indicated a well
      preserved global conformation of the short mutant. However, surprisingly, two of
      these short mutants filled each TnC slot under highly specific superloading
      conditions: one short molecule was taken up in EGTA solution, and the second
      molecule was captured and retained with Ca2+. They also rescued the contractile
      switch, evidently in a bimolecular reaction. Another short variant (putative
      skeletal fast muscle TnC-I-II), in which the NH2-terminal Ca(2+)-binding sites
      were incapacitated, failed to respond to superloading, indicating that sites III
      and IV could not substitute for sites I and II. The results suggest that a
      critical role of the central helix linker in TnC is to keep the two lobes
      optimally apart, evidently in proximity of their respective target sites on
      troponin I in the fiber.

PMID- 8366077
TI  - Probing the role of the carboxyl-terminal region of ferredoxin-NADP+ reductase by
      site-directed mutagenesis and deletion analysis.
AB  - The carboxyl-terminal region of plant ferredoxin-NADP+ reductases is formed by an
      invariant alpha-helix/loop/beta-strand, culminating in a conserved tyrosine that
      displays extensive interaction with the prosthetic group FAD. We have
      investigated the potential role of the terminal region in reductase function, by
      introducing mutations and deletions on pea ferredoxin-NADP+ reductase
      overexpressed in Escherichia coli. Replacement of the terminal tyrosine by
      tryptophan, phenylalanine, serine, and glycine resulted in a 2.2-, 2.0-, 22-, and
      302-fold reduction, respectively, in kcat for the diaphorase reaction, whereas
      elimination of the tyrosine caused a 846-fold decrease in kcat. Km values were
      largely unaffected by the substitutions. Similar results were obtained when the
      mutants were assayed for cytochrome c reduction, indicating that aromaticity is
      the most important factor to the function of the tyrosine in catalysis. The
      presence of the phenol ring at the carboxyl-terminal position of wild-type
      reductase is important, but not an absolute requirement for enzyme function or
      FAD assembly. Deletion of the alpha-helix/beta-strand region prevented reductase
      proper folding in the bacterial host, while shortening of the terminal region by
      splicing 3 amino acids at the beginning of the alpha-helix produced a moderately
      soluble reductase, devoid of FAD and enzymatic activity.

PMID- 8366078
TI  - Structural and functional domains of apolipoprotein A-I within high density
      lipoproteins.
AB  - We prepared discoidal and spherical model high density lipoprotein (HDL) with
      apolipoprotein A-I and 1-palmitoyl-2-oleoyl phosphatidylcholine at various
      lipid:protein ratios and compared their reactivity with exo- and endopeptidases
      to that of human HDL2 and HDL3. Limited proteolysis with trypsin, Staphylococcus
      V8 protease, and elastase yielded a major stable peptide of 11,000-11,500 daltons
      under conditions which completely degraded lipid-free A-I. By Western blotting
      this protease-resistant fragment was shown to consist of the amino-terminal 90
      100 residues of the A-I protein; the residues on the carboxyl side of this
      peptide are therefore protease-sensitive and appear to correlate with the
      putative "hinge" region, which is especially reactive with antibodies. The amino
      terminus was very resistant to digestion with a variety of aminopeptidases,
      whereas carboxypeptidases could remove up to 70 residues from the lipid-free A-I
      protein or 12-24 residues from A-I in various HDL. When these truncated forms of
      A-I, in combination with lipid, were used to examine binding interactions with
      rat hepatic plasma membranes, it was found that removal of up to 20-24 residues
      from the carboxyl terminus had no significant effect on binding, whereas removal
      of 70 residues completely eliminated specific binding to the membranes. Taken
      together, our data indicate that there is a protease-resistant domain constituted
      by the first 90 residues of A-I, which, in HDL, contain little of the class of
      amphipathic helix characteristic of the rest of the molecule and most likely form
      a structure dominated by protein-protein interactions. At the carboxyl end of the
      protein, there is a functional domain constituted by residues 149-219 that
      possesses the capacity to bind to proteins on hepatic membranes.

PMID- 8366079
TI  - Alpha-lactalbumin possesses a distinct zinc binding site.
AB  - It has been proposed that the binding of Zn2+ to alpha-lactalbumin switches the
      conformation to one akin to a state intermediate in the folding of the protein.
      However, the high resolution x-ray crystal structure of human alpha-lactalbumin
      Zn2+ complex at 1.7-A resolution (pH 7.6) does not reveal any significant change
      in conformation from the native state. The Zn2+ ion binds specifically in the
      "cleft" of alpha-lactalbumin (the region which forms the active site of the
      homologous protein lysozyme). This may suggest a possible role for Zn2+ binding
      in lactose synthase complex. The coordination of the Zn2+ ion involves a symmetry
      related molecule in the crystal, the crystal contacts being stabilized by a SO4(2
      ) ion bound at the interface between three molecules.

PMID- 8366080
TI  - Two base pairs at -9 and -8 distinguish between the bacteriophage T7 and SP6
      promoters.
AB  - Bacteriophage T7 and SP6 RNA polymerases and their promoters share a high degree
      of their primary structure homology, but each polymerase exclusively recognizes
      its own promoter sequence. To reveal the molecular basis of this specificity, 4
      base pairs at positions -12, -10, -9, and -8 of the T7 promoter were substituted
      individually and multiply by SP6 promoter-specific base pairs, and 3 base pairs
      at -10, -9, and -8 of the SP6 promoter were replaced by T7 promoter-specific base
      pairs. Promoter activities of 28 sequences were measured in vitro with T7 and SP6
      polymerases separately under optimal conditions at 6 mM MgCl2. Single and double
      substitutions at -12 and -10 do not significantly affect the T7 promoter
      activity, although they are almost exclusively conserved among T7 genomic
      promoters. Changes at -10 of SP6 promoter hardly affect the activity. However,
      any T7 variants that contain either or both changes at -9 and -8 show greatly
      reduced activity. Interestingly, the double substitution at -9 and -8 yields
      significant SP6 promoter activities and virtually no T7 promoter activity.
      Furthermore, the SP6 promoter variants with both T7-specific -9C and -8T show
      good T7 promoter activities, although they still show some SP6 promoter
      activities. However, under high salt conditions (either 20 mM MgCl2 or 100 mM
      NaCl plus 6 mM MgCl2), they show only slight SP6 promoter activity. No other SP6
      variants show any T7 promoter activity. All these results indicate that the 2
      base pairs at -9 and -8 of both the T7 and SP6 promoters are the primary (if not
      the only) determinants of specificity and that the hierarchy of importance of
      positions for promoter activity is -8, -9 > > -10 > -12. Also, a phylogenic
      relationship among the T3, T7, K11, and SP6 promoters is suggested based on
      dissimilarities in their sequences from -12 to -8.

PMID- 8366081
TI  - Dihydropyrimidine dehydrogenase. Kinetic mechanism for reduction of uracil by
      NADPH.
AB  - Steady-state and pre-steady-state kinetic data were used to determine the kinetic
      mechanism for bovine liver dihydropyrimidine dehydrogenase (DPDase). Steady-state
      kinetic data suggested a random rapid-equilibrium mechanism with Km values for
      NADPH and uracil of 0.12 microM and 0.8 microM, respectively, and a kcat of 1.6 s
      1 in Tris buffer at pH 8.0 and 37 degrees C. The dissociation constant of DPDase
      for NADPH at 25 degrees C in the absence of uracil (0.09 microM) was similar to
      the Km for NADPH. DPDase also catalyzed the exchange of tritium in [4S-3H,4R
      1H]NADP3H with solvent protons in the absence of uracil. DPDase inactivated by 5
      ethynyluracil, which covalently modifies the enzyme at the uracil binding site,
      catalyzed the exchange reaction at the same rate (1 s-1) as native enzyme. Thus,
      the interaction of NADPH with DPDase was independent of the uracil binding site.
      Because DPDase catalyzed the exchange of deuterium in [4S-2H,4R-1H]NADP2H with
      solvent protons with a rate constant of 5.4 s-1, which was significantly larger
      than that for tritium, the analogous rate constant for exchange of the 4-hydrogen
      in NADPH must be significantly larger than 5 s-1. Consequently, intermediates on
      the exchange pathway were kinetically competent to participate in the reduction
      of uracil by NADPH (kcat = 1.6 s-1). Rate constants for reduction of DPDase by
      NADPH and 5,6-dihydrouracil were several orders of magnitude greater than kcat.
      The rate constants for dissociation of E.NADP+ (15 s-1) and for dissociation of
      E.5,6-dihydrouracil (> 250 s-1) were also greater than kcat. These results
      supported a random rapid-equilibrium kinetic mechanism and suggested kcat was an
      internal electron transfer between enzymic prosthetic groups.

PMID- 8366082
TI  - Functions of potA and potD proteins in spermidine-preferential uptake system in
      Escherichia coli.
AB  - Functions of potA and -D proteins in the spermidine-preferential uptake system,
      which consists of potA, -B, -C, and -D proteins, were studied. Spermidine uptake
      activity was lost when the gene for potA or potD protein was disrupted, and
      transformation of the cells with potA or potD gene recovered the uptake activity.
      PotD protein was found to bind spermidine with a 3.2 microM dissociation
      constant. Spermidine uptake by membrane vesicles prepared from Escherichia coli
      DR112 containing the genes for potA, -B, and -C proteins was strongly dependent
      on the addition of potD protein, and its optimal concentration was 5 microM when
      10 microM spermidine was used as substrate. The ATP dependence of spermidine
      uptake was examined with the atp mutant of E. coli. The uptake was completely
      dependent on ATP. When the membrane potential was extinguished by carbonyl
      cyanide m-chlorophenylhydrazone, the uptake activity was decreased by 60% even if
      ATP existed. This suggests that the membrane potential is also involved in the
      spermidine uptake. ATP was found to bind to potA protein. In the spermidine
      transport-deficient mutant E. coli NH1596, valine 135 of potA protein, which is
      located between two consensus amino acid sequences for nucleotide binding, was
      replaced by methionine. Although the amount of mutated potA protein expressed in
      E. coli cells was the same as that of normal potA protein and the mutated protein
      was membrane-associated, no significant spermidine uptake was observed. The
      results taken together indicate that potA and -D proteins are absolutely
      necessary for spermidine uptake in conjunction with the two channel forming
      proteins (potB and -C).

PMID- 8366083
TI  - Triggering of cellulase biosynthesis by cellulose in Trichoderma reesei.
      Involvement of a constitutive, sophorose-inducible, glucose-inhibited beta
      diglucoside permease.
AB  - We prepared [U-14C]cellobiose by cultivating Acetobacter pasteurianus in the
      presence of [U-14C]glucose and hydrolyzing the [U-14C]cellulose formed with beta
      glucosidase-free cellulase from Trichoderma reesei. This 14C-labeled cellobiose
      was used to investigate the presence of an uptake system for cellobiose in T.
      reesei. Evidence was obtained for the presence of a high affinity (Km for
      cellobiose 0.3 microM) but low activity (2.5 milliunits/mg fungal dry weight)
      cellobiose permease. The permease is formed constitutively, but higher levels are
      formed after addition of sophorose (glucosyl-beta-1,2-diglucoside), a reputed
      cellulase inducer. The permease appears to be specific for beta-diglucosides, as
      the uptake of [U-14C]cellobiose is inhibited by sophorose, gentiobiose (glucosyl
      beta-1,3-glucoside), and cellobiose. Under these conditions, cellooligodextrines
      (n, 4-7; final concentration, 1 mM) are not inhibitors. Glucose, but no other
      monosaccharides, inhibits the permease. The hypersecretory mutant T. reesei RUT C
      30 exhibits elevated permease activities, whereas in T. reesei QM 9979, a mutant
      strain defective in the induction of cellulases by cellulose or sophorose,
      strongly reduced permease activities were demonstrated. The results stress a
      hitherto not recognized point of control in the induction of cellulases by T.
      reesei at the level of uptake of cellulose oligosaccharides.

PMID- 8366084
TI  - Mechanism and energetics of the secondary phosphate transport system of
      Acinetobacter johnsonii 210A.
AB  - The mechanism and energetics of the secondary Pi transport system of A. johnsonii
      were studied in membrane vesicles and proteoliposomes in which the transport
      protein was functionally reconstituted. Pi uptake is strictly dependent on the
      presence of divalent cations, like Mg2+, Ca2+, Mn2+, or Co2+. These cations form
      a MeHPO4 complex with up to 87% of the Pi present in the incubation mixture,
      suggesting that divalent cations and Pi are co-transported via a metal-phosphate
      chelate. Metal-phosphate uptake is driven by the proton motive force (interior
      negative and alkaline). The metal-phosphate/proton stoichiometry was close to
      unity. The transport system mediates efflux and homologous exchange of metal
      phosphate, but not heterologous exchange of metal-phosphate and glycerol-3-P or
      glucose-6-P. Exchange and counterflow were essentially pH-independent while
      efflux and uptake increased with increasing pH. Efflux was inhibited by the
      proton motive force, whereas exchange was inhibited by the membrane potential
      only. These observations are consistent with an ordered mechanism for binding and
      dissociation of metal-phosphate and proton to and from the carrier protein and
      point to the recycling of a positively charged, protonated carrier protein during
      exchange.

PMID- 8366085
TI  - Identification of an uncleavable targeting signal in the 70-kilodalton spinach
      chloroplast outer envelope membrane protein.
AB  - A cDNA clone encoding a cognate 70-kDa heat shock protein from the spinach
      chloroplast outer envelope (SCE70) was recently characterized (Ko, K.,
      Bornemisza, O., Kourtz, L., Ko, Z. W., Plaxton, W. C., and Cashmore, A. R. (1992)
      J. Biol. Chem. 267, 2986-2993). Initial studies revealed that SCE70 is targeted
      to the chloroplast outer envelope membrane without further processing. To
      determine whether SCE70 possesses a "targeting domain," we tested the targeting
      ability of SCE70 proteins with various carboxyl- and amino-terminal deletions.
      Carboxyl-terminal deletions of up to 60% of the protein had no apparent effect on
      the targeting ability of SCE70. Amino-terminal deletions abolished targeting to
      the chloroplast except when the extreme NH2-terminal 48-amino acid sequence was
      retained. We further assessed the chloroplast-targeting ability of the NH2
      terminal 48 amino acids by fusing to the foreign protein, mouse dihydrofolate
      reductase (DHFR). The resulting fusion protein, SCE70-DHFR, was localized to the
      outer envelope membrane of isolated chloroplasts. SCE70-DHFR exhibited targeting
      characteristics similar to native SCE70. The targeting of SCE70-DHFR was
      inhibited effectively by anti-SCE70 antibodies. Immunoprecipitation and chemical
      cross-linking experiments revealed that SCE70-DHFR is targeted to the same
      complex as SCE70 in the chloroplast envelope. These results suggest that the
      extreme NH2 terminus of SCE70 is required for directing SCE70 to a destination in
      the chloroplast outer envelope membrane, possibly through assembling the
      polypeptide into a protein complex.

PMID- 8366087
TI  - Identity of Escherichia coli tRNA(Cys) determined by nucleotides in three regions
      of tRNA tertiary structure.
AB  - The in vivo aminoacylation specificity of tRNA(Cys) was studied with mutants of
      opal and amber suppressor tRNAs in Escherichia coli. This specificity depends not
      only on nucleotides in the acceptor end and anticodon of tRNA(Cys), but also on
      nucleotides in the dihydrouridine stem and loop and the variable loop that
      interact, forming the complex core of tRNA tertiary structure.

PMID- 8366086
TI  - Nonbiased identification of DNA sequences that bind thyroid hormone receptor
      alpha 1 with high affinity.
AB  - Thyroid hormone receptors are transcription factors that bind to specific DNA
      sequences and regulate gene expression in a ligand-dependent manner. Although
      thyroid hormone receptors are known to bind to the hexamer 5'-AGGTCA, it is not
      known if this represents the optimal binding site. Therefore, a nonbiased
      strategy was used to identify DNA sequences which bind thyroid hormone receptor
      alpha 1 with high affinity. Such DNA sequences were isolated from a pool of
      random sequences using a strategy combining an electrophoretic mobility shift
      assay with the polymerase chain reaction. It was found that thyroid hormone
      receptor alpha 1 binds with highest affinity to the octamer 5'-TAAGGTCA. Mutation
      of the two 5'-nucleotides decreased the affinity of thyroid hormone receptor
      alpha 1 for this DNA sequence approximately 5-fold, and the importance of those
      nucleotides in receptor binding was confirmed by DNA footprinting. A single copy
      of the octamer sequence (but not the hexamer AGGTCA) could impart T3
      responsiveness to a heterologous promoter in a transient transfection assay. The
      results indicate that the optimal binding site for thyroid hormone receptor alpha
      1 is 2 base pairs larger than previously thought, and that a single binding site
      can function as a response element. In addition, we speculate that the optimal
      binding sites for thyroid hormone, vitamin D, and retinoic acid receptors may not
      be identical, as had previously been thought.

PMID- 8366088
TI  - Bradykinin-induced cytosolic Ca2+ oscillations and inositol tetrakisphosphate
      induced Ca2+ influx in voltage-clamped ras-transformed NIH/3T3 fibroblasts.
AB  - Microspectrofluorometry (fura-2) was combined with the whole-cell patch-clamp
      technique to study bradykinin-activated calcium (Ca2+) influx in single control
      or v-Ki-ras-transformed NIH/3T3 (DT) fibroblasts. Application of bradykinin on DT
      cells, but not on control NIH/3T3 cells, evoked cytosolic Ca2+ oscillations in
      the presence of extracellular Ca2+, but not in the absence of external Ca2+. This
      effect of zero external Ca2+ concentration could be mimicked by holding at
      depolarized membrane potentials. Cytosolic Ca2+ oscillations observed at holding
      potentials of -20 to -80 mV were terminated by holding at -10 mV or more
      depolarized potentials. The frequency of Ca2+ oscillations increased with
      membrane hyperpolarization. Bradykinin significantly enhanced the
      hyperpolarization-induced increases in the intracellular free Ca2+ concentration
      ([Ca2+]i) upon membrane hyperpolarization only in DT cells but not in control
      cells. No [Ca2+]i increase upon hyperpolarization was observed in bradykinin
      stimulated DT cells in the absence of external Ca2+, suggesting that bradykinin
      activates Ca2+ influx. [Ca2+]i increased upon application of inositol 1,3,4,5
      tetrakisphosphate (Ins(1,3,4,5)P4) into control and DT cells in an extracellular
      Ca(2+)-dependent manner, indicating that NIH/3T3 fibroblasts have an
      Ins(1,3,4,5)P4-gated Ca2+ influx pathway. Ins-(1,3,4,5)P4, however, produced the
      sustained [Ca2+]i increase in DT cells, but not in control NIH/3T3 cells,
      suggesting that ras may lock the Ca2+ influx pathway at the activated state.
      Cytosolic Ca2+ oscillations, bradykinin-enhanced Ca2+ influx, and Ins(1,3,4,5)P4
      induced Ca2+ influx were all similar in that activity was increased by membrane
      hyperpolarization. The results suggest that bradykinin-induced cytosolic Ca2+
      oscillations in ras-transformed NIH/3T3 cells are maintained by bradykinin
      activated continuous Ca2+ influx which may use Ins(1,3,4,5)P4 as an intracellular
      messenger.

PMID- 8366089
TI  - Evidence for two DNA repair enzymes for 8-hydroxyguanine (7,8-dihydro-8
      oxoguanine) in human cells.
AB  - Two DNA repair enzymes for 8-hydroxyguanine (also known as 7,8-dihydro-8
      oxoguanine; OH8Gua, oxo8Gua) have been identified in human HeLa cell nuclear
      extract. One is OH8Gua-glycosylase and the other is OH8Gua-endonuclease that
      lacks OH8Gua-glycosylase activity. They were separated by heparin-Sepharose
      column chromatography and characterized by endonuclease nicking assay or by
      measuring the OH8Gua released from substrate DNA using high pressure liquid
      chromatography-electrochemical detection. Both OH8Gua repair enzymes act only on
      the OH8Gua-containing strand of the duplex substrate DNA containing OH8Gua/C,
      OH8Gua/T, or OH8Gua/G. DNA containing OH8Gua/A base pair was very poor substrate
      for either enzymes. OH8Gua-endonuclease simultaneously cleaves phosphodiester
      bonds on both sides of the OH8Gua residue, leaving 5'-hydroxy and 3'-hydroxy
      groups.

PMID- 8366090
TI  - LE-ACS4, a fruit ripening and wound-induced 1-aminocyclopropane-1-carboxylate
      synthase gene of tomato (Lycopersicon esculentum). Expression in Escherichia
      coli, structural characterization, expression characteristics, and phylogenetic
      analysis.
AB  - ACC (1-aminocyclopropane-1-carboxylic acid) synthase is the key regulatory enzyme
      in the biosynthetic pathway of the plant hormone ethylene and is encoded by a
      highly divergent multigene family in tomato (Rottmann, W. H., Peter, G. F.,
      Oeller, P. W., Keller, J. A., Shen, N. F., Nagy, B. P., Taylor, L. P., Campbell,
      A. D., and Theologis, A. (1991) J. Mol. Biol. 222, 937-961). Two members of the
      family, LE-ACS2 and LE-ACS4, are induced during fruit ripening and upon treatment
      of mature green fruits with exogenous ethylene (C2H4) in a dose-dependent manner.
      Both genes are superinduced by wounding of pericarp tissue during various stages
      of ripening. The wound-induced accumulation of LE-ACS2 mRNA is more rapid and
      greater than that of LE-ACS4. Both mRNAs accumulate in the absence of protein
      synthesis, suggesting that their induction is a primary response to the inducer.
      The LE-ACS4 gene was isolated and structurally characterized. The function of the
      LE-ACS4 protein (53,509 Da, pI 5.4) was verified by expression experiments in
      Escherichia coli. The promoters of LE-ACS2 and LE-ACS4 contain potential cis
      acting regulatory elements responsible for induction by ethylene, wounding, and
      anaerobiosis. In addition, elements for binding the transcriptional factors
      EmBP1, GBF-1, and OCSBF-1 are also present. Phylogenetic analysis of 20 ACC
      synthases from dicots and monocots indicate that the LE-ACS2 and LE-ACS4 proteins
      belong to an unique sublineage that includes an additional member of the tobacco
      family, NT-ACS1. The divergence of this sublineage is a relatively recent event
      in the evolution of ACC synthase protein.

PMID- 8366091
TI  - The Saccharomyces cerevisiae LOS1 gene involved in pre-tRNA splicing encodes a
      nuclear protein that behaves as a component of the nuclear matrix.
AB  - Mutations of the Saccharomyces cerevisiae LOS1 gene cause the accumulation of end
      matured intron-containing pre-tRNAs at elevated temperatures. In an effort to
      decipher the role of the LOS1 protein in pre-tRNA splicing, we have analyzed the
      LOS1 gene and its protein product. The LOS1 gene is located on the left arm of
      chromosome XI and the order of genes in this area of the chromosome is .... URA1
      ... SAC1 TRP3 UBA1 STE6 LOS1 .... FAS1..... The LOS1 open reading frame encodes a
      putative protein of 1100 amino acids that shows no significant homology to other
      genes. The LOS1 open reading frame was tagged with the influenza virus
      hemagglutinin epitope recognized by the 12CA5 antibody. The 12CA5 antibody
      recognizes an epitope-tagged protein of the size predicted by the LOS1 open
      reading frame. Using this antibody for indirect immunofluorescence and cell
      fractionation studies we show that the LOS1 protein is located in nuclei. Los1p
      cannot be extracted from nuclei by treatment with nucleases, salts, or Triton X
      100. This insolubility suggests that Los1p is a component of the nucleoskeleton.
      We propose that LOS1 mutations may affect pre-tRNA processing via alteration of
      the nuclear matrix.

PMID- 8366092
TI  - NGFI-A gene expression is necessary for T lymphocyte proliferation.
AB  - NGFI-A is an immediate early gene, encoding a zinc finger protein, rapidly
      activated after mitogenic stimulation. NGFI-A gene expression was found to be
      rapidly and transiently induced after interleukin-2 (IL-2) stimulation of G1
      lymphoblasts, as well as during the G0/G1 transition, when stimulated with
      concanavalin A (ConA). Activation of both Ca2+ and protein kinase C pathways,
      separately, in quiescent T lymphocytes produced a partial induction of this gene;
      however, both stimuli together are necessary to obtain a full response. ConA
      induced activation of NGFI-A in quiescent cells was inhibited by
      immunosuppressors. 8-Bromo-cAMP was able to inhibit the expression of this gene
      in G1 lymphoblasts after IL-2 stimulation, but failed to interfere with the ConA
      induced expression in quiescent T lymphocytes. Exposure of T cells to an NGFI-A
      antisense oligonucleotide blocked the ConA- and IL-2-induced proliferation of the
      cells, measured as thymidine incorporation and cell number. This inhibition
      provides direct evidence that the early gene NGFI-A plays a regulatory role in
      growth control processes of lymphocytes and that its expression is essential for
      cellular proliferation.

PMID- 8366093
TI  - Amino-terminal topology of thromboxane synthase in the endoplasmic reticulum.
AB  - The membrane topology of the NH2-terminal portion of human thromboxane synthase
      (TXS), a member of the cytochrome P450 superfamily, has been investigated. By
      sequence alignment, the first 6 residues of the mature TXS polypeptide are likely
      to form a distinctive "tail" structure not found in many other mammalian
      cytochromes P450 in the endoplasmic reticulum membrane. Peptides with either the
      ultimate 10 or 15 residues of the NH2 terminus of TXS were synthesized and used
      to produce site-directed antibodies. The resulting peptide antibodies were highly
      specific and recognized human TXS, as shown by binding assays and Western blot
      analysis. Binding of the peptide antibodies to recombinant TXS in transfected COS
      1 and to endogenous TXS in THP-1 cells was analyzed by immunocytochemistry.
      Selective permeabilization of the plasma membrane to immunoglobulin was achieved
      with streptolysin O; general permeabilization, including the endoplasmic
      reticulum membrane, was accomplished with Triton X-100. Permeabilization of the
      plasma membrane was sufficient to produce binding of both peptide antibodies to
      their epitopes, indicating that the epitopes for both of the peptide antibodies
      were exposed on the cytoplasmic side of the endoplasmic reticulum membrane. The
      results with the peptide antibodies provide direct experimental evidence
      supporting the topological model for membrane-bound cytochrome P450 proposed by
      Nelson and Strobel (Nelson, D. R., and Strobel, H. W. (1988) J. Biol. Chem. 263,
      6038-6050), in which the NH2 terminus is oriented toward the cytoplasmic side of
      the endoplasmic reticulum membrane.

PMID- 8366094
TI  - Insulin and okadaic acid induce Rab4 redistribution in adipocytes.
AB  - Insulin stimulation of glucose transport involves the translocation of vesicles
      containing the glucose transporter Glut 4 to the plasma membrane. Rab proteins,
      which have been implicated in the regulation of vesicular traffic, were studied
      in adipocytes. Rab3B, Rab3C, Rab4, and Rab8 were detected, but Rab3A was not. In
      the absence of insulin, Rab3B and Rab3C were cytosolic, while Rab4 and Rab8 were
      associated with membranes. Only Rab4 distribution was modified by insulin. In
      unstimulated adipocytes, most of Rab4 was found in a low density microsomal
      fraction, which also contained the majority of Glut 4. After insulin treatment, a
      50% decrease in Rab4 content was observed, concomitantly with a departure of
      transporters to the plasma membrane. The dose responses for the departure of Glut
      4 and Rab4 from the microsomal fractions were superimposable, half-maximal
      effects being obtained with 0.1 nM insulin. Rab4 was redistributed to the cytosol
      and its movement was reversed by insulin withdrawal. When Glut 4-containing
      vesicles were immunopurified with antibodies to Glut 4, Rab4 was found in the
      immune pellets, suggesting that Rab4 was tightly associated with the vesicles.
      Okadaic acid, an inhibitor of phosphatases 1 and 2A that is known to stimulate
      Glut 4 translocation, caused the same movement of Rab4 from low density
      microsomal fraction to the cytosol, while the phorbol ester 12-O
      tetradecanoylphorbol-13-acetate had no effect. We suggest that insulin and
      okadaic acid induce a cycling of Rab4 from a vesicular fraction containing the
      Glut 4 transporter to the cytosol and that this cycling may participate in the
      insulin stimulatory action on glucose transporter translocation.

PMID- 8366095
TI  - Myocyte-specific enhancer-binding factor (MEF-2) regulates alpha-cardiac myosin
      heavy chain gene expression in vitro and in vivo.
AB  - A myocyte-specific enhancer-binding factor (MEF-2) DNA binding site was
      identified in the rat alpha-myosin heavy chain (MHC) gene adjacent to the E-box
      binding site for alpha-MHC binding factor-2 (BF-2). Mutation of the MEF-2 site,
      within the context of the full-length promoter, reduced activity by 85 and 80% in
      neonatal cardiomyocytes and the adult heart, respectively. Mutation of the BF-2
      site reduced activity approximately 70% in both models. A MEF-2/BF-2 double
      mutant gave significantly less activity than the BF-2 mutant but not the MEF-2
      mutant, suggesting the possibility that BF-2 and MEF-2 interact. Mutations in MEF
      2, which decreased functional activity, also abolished MEF-2 DNA binding
      activity. MEF-2 DNA binding activity was present in the developing heart, reached
      a peak in the late fetal and early neonatal stages, and then declined to low
      levels in the adult heart. The adult levels were sufficient to support alpha-MHC
      gene expression. MEF-2 activity was increased 2-3-fold in the adult heart
      subjected to a pressure or volume overload. Two working models are proposed as
      possible explanations of the antithetic relationship between MEF-2 levels and
      alpha-MHC gene expression.

PMID- 8366096
TI  - Molecular cloning and expression of GRK6. A new member of the G protein-coupled
      receptor kinase family.
AB  - G protein-coupled receptor kinases (GRK), such as the beta-adrenergic receptor
      kinase (beta ARK) and rhodopsin kinase, specifically phosphorylate the activated
      form of G protein-coupled receptors. To identify additional members of the GRK
      family, we screened a human heart cDNA library by low stringency hybridization
      using the catalytic domains of two beta ARK isoforms. Here we report the
      isolation of a cDNA that encodes a 576-amino-acid protein kinase, termed GRK6,
      that has significant homology with GRK5 (70.1% amino acid identity), IT11
      (68.5%), rhodopsin kinase (47.1%), and beta ARK (37.4%). RNA blot analysis of
      GRK6 with selected human tissues reveals two distinct mRNAs of 3 and 2.4
      kilobases with a distribution very similar to that of beta ARK (i.e. brain,
      skeletal muscle > pancreas > heart, lung, kidney, placenta > liver). GRK6,
      overexpressed in Sf9 insect cells using the baculovirus system, was able to
      phosphorylate both the beta 2-adrenergic receptor and rhodopsin in a stimulus
      dependent fashion, although it was significantly less active then beta ARK on
      these substrates. These data extend the family of GRKs and suggest that GRK6 may
      have a substrate specificity quite distinct from beta ARK and rhodopsin kinase.

PMID- 8366097
TI  - Influence of 3' half-site sequence of NF-kappa B motifs on the binding of
      lipopolysaccharide-activatable macrophage NF-kappa B proteins.
AB  - Lipopolysaccharide treatment of mouse macrophage-like J774 cells was found to
      result in the activation of three different nuclear proteins which specifically
      bind to oligonucleotide containing the NF-kappa B motif of the human
      immunodeficiency virus (HIV) gene. These are designated as NF-kappa B1, -kappa
      B2, and -kappa B3, according to their electrophoretic mobilities (fast,
      intermediate, and slow, respectively). Immunological and UV cross-linking studies
      showed that NF-kappa B1 consists of only p50 subunit, whereas both NF-kappa B2
      and -kappa B3 contain NF-kappa B p65 subunit and c-Rel. In addition, NF-kappa B2
      was also found to contain p50 subunit of NF-kappa B. The binding of three types
      of NF-kappa B proteins to HIV NF-kappa B motif was effectively inhibited by other
      NF-kappa B motifs, whose 3' half-site nucleotide sequences are T/A-T-T/C-CC (HIV,
      interleukin-6, interferon (INF)-beta, H2-Kb, I-E alpha d, and TNF-alpha 2
      (nucleotide position -510)) and much less effectively by NF-kappa B motifs with
      3' half-site sequences of TGCCC (TNF-alpha 3, nucleotide position -610), ATCTC (G
      CSF), TATTC (Fc gamma R), or TCCTT (TNF-alpha 1, nucleotide position -850). Our
      data also suggested that NF-kappa B1 and -kappa B2 which contain p50 subunit of
      NF-kappa B bind with the higher preference for NF-kappa B motif of H2-Kb gene
      promoter than that of INF-beta, whereas NF-kappa B3 which does not contain p50
      subunit appears to preferentially bind to NF-kappa B sites of IFN-beta.

PMID- 8366098
TI  - Abnormal RNA processing associated with a novel tRNA mutation in mitochondrial
      DNA. A potential disease mechanism.
AB  - A patient with a mitochondrial myopathy and biochemically proven profound complex
      I deficiency has a new mutation in mtDNA. This A-to-G transition at position
      3302, involving the aminoacyl stem of tRNA(Leu(UUR)), is associated with abnormal
      mitochondrial RNA processing. Northern analysis demonstrates marked accumulation
      of a polycistronic RNA precursor containing sequence for 16 S rRNA,
      tRNA(Leu(UUR)), and ND1. Comparison of skeletal muscle and skin fibroblasts
      suggests that the processing error may be quantitatively less severe in this
      tissue, and biochemical analysis shows that fibroblasts do not express a
      biochemical defect despite containing the mutation. Important qualitative
      differences in the processing of this RNA precursor were found when comparing
      muscle and skin fibroblasts. In muscle, processing appears to occur first at the
      5'-end of the tRNA, generating 16 S rRNA plus a tRNA + ND1 intermediate. In
      fibroblasts, processing occurs at the 3'-end of the tRNA, generating a 16 S rRNA
      + tRNA intermediate. We suggest that the mutation at position 3302 induces
      abnormal mitochondrial RNA processing that is linked to the biochemical defect
      (profound loss of complex I activity), either by qualitative or quantitative
      abnormalities in the ND1 message. The restriction to skeletal muscle of both the
      processing error and the biochemical defect suggests that the observed tissue
      differences in RNA processing play a protective role in skin fibroblasts.

PMID- 8366099
TI  - Nucleosome interactions with a human Alu element. Transcriptional repression and
      effects of template methylation.
AB  - Alu interspersed repetitive elements possess internal RNA polymerase III
      promoters which are strongly transcribed in vitro, yet these elements are nearly
      silent in somatic cells. To examine whether repression by chromatin proteins
      could contribute to the low level of Alu expression, a conserved Alu element from
      the fourth intron of the human alpha-fetoprotein gene was reconstituted with
      purified octamer or tetramer particles. Analysis of reconstitutes revealed that
      this Alu element directed translational and rotational positioning of octamers as
      well as tetramers. In vitro transcription experiments with reconstituted
      templates demonstrated that RNA polymerase III-dependent transcription of the Alu
      element was profoundly repressed by positioned octamer particles. Furthermore,
      complete CpG methylation of this template enhanced the capacity of tetramers to
      repress transcription.

PMID- 8366100
TI  - Purification and characterization of recombinant Bet v I, the major birch pollen
      allergen. Immunological equivalence to natural Bet v I.
AB  - Pollen from trees of the order Fagales (e.g. birch, alder, hazel, oak, and
      hornbeam) are a major cause of Type I allergies observed in early spring.
      Previously, we reported the cloning and sequencing of Bet v I, the major birch
      pollen allergen, which showed high sequence similarities to a family of plant
      pathogen-activated genes (Breiteneder, H., Pettenburger, K., Bito, A., Valenta,
      R., Kraft, D., Rumpold, H., Scheiner, O., and Breitenbach, M. (1989) EMBO J. 8,
      1935-1938). Here, we present the results on the expression, purification, and
      characterization of recombinant Bet v I produced in Escherichia coli as fusion
      and non-fusion protein, respectively. The purified recombinant proteins were
      analyzed to verify purity and structural integrity, and their immunological
      properties were compared to those of Bet v I isolated from birch pollen (natural
      Bet v I). Immunoblot analyses showed that the recombinant proteins are
      specifically recognized by monoclonal antibodies raised against natural Bet v I
      as well as by IgE from birch pollen-allergic patients. However, enzyme-linked
      immunosorbent assays revealed a decreased IgE-binding activity of the recombinant
      fusion Bet v I compared to the non-fusion and natural Bet v I proteins, which
      probably results from conformational changes due to the fusion tail. Recombinant
      non-fusion Bet v I was equivalent to natural Bet v I with respect to IgE-binding
      properties, the ability to induce in vitro proliferation of allergen-specific T
      cell clones, and the ability to release histamine from basophils derived from
      birch pollen-allergic patients.

PMID- 8366102
TI  - Somatic mutations in c-myc intron I cluster in discrete domains that define
      protein binding sequences.
AB  - The activated c-myc allele in Burkitt's lymphoma tumor cells is associated with a
      clustering of somatic mutations within intron I near the exon I boundary. We have
      identified several discrete protein binding sites within this region of c-myc
      intron I designated as myc intron factor-1 (MIF-1), MIF-2, and MIF-3. In addition
      to our previous characterization of a 20-nucleotide binding site for MIF-1, we
      now have identified adjacent 20-nucleotide and 34-nucleotide binding sites for
      MIF-2 and MIF-3, respectively. All three elements are protected from exonuclease
      digestion by nuclear protein extracts, and each gives rise to a distinct
      migration pattern on mobility shift assays. In addition, MIF-1, 2, and 3 share a
      5-nucleotide (TTATG) internal sequence, which may account for cross-competition
      of these binding sites in the exonuclease protection experiment. Deletion mutant
      analyses showed that selective removal of the MIF-3 binding site alone was
      sufficient to enhance chloramphenicol acetyltransferase reporter activity similar
      to that observed with larger deletions of myc intron I. We have demonstrated that
      somatic mutations in activated c-myc alleles are frequently clustered in discrete
      domains that define protein recognition sequences.

PMID- 8366101
TI  - Identification of a new cAMP response element-binding factor by southwestern
      blotting.
AB  - We have identified in mammalian cells a novel cyclic AMP response element (CRE)
      binding protein of molecular mass 47 kDa. This protein was not recognized by
      either the CREB-327/341 or c-Jun antisera, and its tissue distribution did not
      overlap with those of the CREB and Jun families. For example, hepatoma and
      placental tissue did not contain the 47-kDa DNA-binding protein, but did contain
      the CREB isoforms. On the other hand, S49 lymphoma cells contained a high level
      of the 47-kDa DNA-binding protein but did not contain a 47-kDa Jun-related
      protein which was found in normal liver and hepatoma. This new 47-kDa factor
      bound to the CRE in the dephosphorylated form, and phosphorylation of the protein
      by the catalytic subunit of protein kinase A completely abolished its DNA-binding
      activity. The isoforms of the CREB-327/341 family, on the other hand, bound to
      DNA in the phosphorylated form, and alkaline phosphatase treatment reduced
      significantly their interaction with CRE sequence. This reverse effect of
      phosphorylation/dephosphorylation on the DNA-binding property of this new 47-kDa
      protein in particular distinguishes it from other known CREB factors and suggests
      that the protein might play a unique role in the regulation of cAMP-mediated
      transcription.

PMID- 8366103
TI  - Interaction between band 3 and ankyrin begins in early compartments of the
      secretory pathway and is essential for band 3 processing.
AB  - In many cell types, membrane proteins are specifically segregated to particular
      areas of the cell surface. It is known that this segregation is stabilized by
      anchorage proteins which interact with the cytoskeleton. However, the mechanism
      by which the interactions with anchorage proteins occur, as well as whether they
      may also play a role in the process of sorting, is not known. Using
      differentiated murine erythroleukemic cells, we have investigated the association
      between band 3 (a major transmembrane anion exchanger), and ankyrin (a
      cytoplasmic protein that links band 3 to the cytoskeleton). Our data demonstrate
      that the association between band 3 and ankyrin occurs in the endoplasmic
      reticulum or the first Golgi compartment. These data support a model in which the
      band 3-ankyrin complex is inserted as a "cassette" at the plasma membrane into
      the cytoskeletal network. Biosynthetic studies on cotransfected 293 cells with
      cDNAs encoding band 3 and the band 3 binding fragment of ankyrin (AnK-90),
      suggest that ankyrin is not only responsible for the anchorage of band 3 to the
      cytoskeleton but is also involved in the exit of band 3 out of the endoplasmic
      reticulum.

PMID- 8366104
TI  - A plant glutamate decarboxylase containing a calmodulin binding domain. Cloning,
      sequence, and functional analysis.
AB  - Molecular procedures have been applied to isolate plant calmodulin-binding
      proteins. A petunia cDNA expression library was screened with 35S-labeled
      recombinant calmodulin as a probe, and a cDNA coding for a Ca(2+)-dependent
      calmodulin-binding protein was isolated. The deduced amino acid sequence of the
      petunia protein (500 amino acid residues, 58 kDa) has 67% overall amino acid
      sequence similarity to glutamate decarboxylase (GAD) from Escherichia coli (466
      amino acid residues, 53 kDa). The recombinant protein expressed in E. coli cells
      displays GAD activity, i.e. catalyzes the conversion of glutamic acid to gamma
      aminobutyric acid and binds calmodulin, whereas E. coli GAD does not bind
      calmodulin. The calmodulin binding domain in the petunia GAD was mapped by
      binding truncated forms of GAD immobilized on nitrocellulose membranes to
      recombinant petunia 35S-calmodulin as well as to biotinylated bovine calmodulin
      and by binding truncated forms of GAD to calmodulin-Sepharose columns. The
      calmodulin binding domain in petunia GAD is part of a carboxyl end extension that
      is not present in E. coli GAD. Polyclonal antibodies raised against the
      recombinant petunia GAD detect a single protein band from plant extracts of gel
      mobility identical to that of the recombinant GAD. Moreover, the plant protein
      binds calmodulin in vitro. This is the first report of the isolation of a GAD
      gene from plants and of a calmodulin-binding GAD from any organism. Our results
      raise the possibility that intracellular Ca2+ signals via calmodulin are involved
      in the regulation of gamma-aminobutyric acid synthesis in plants.

PMID- 8366105
TI  - Post-translational folding of influenza hemagglutinin in isolated endoplasmic
      reticulum-derived microsomes.
AB  - The folding of influenza hemagglutinin was analyzed after in vitro translation
      and translocation into dog pancreas microsomes. Ectodomain folding of this
      membrane glycoprotein involves the formation of six intrachain disulfide bonds.
      After translation under reducing conditions, the folding process was initiated by
      the addition of oxidized glutathione or diamide. For correct folding a reduction
      oxidation potential of -310 to -210 mV had to be reached in the bulk solution. At
      lower values, or after addition of other oxidants such as NAD or NADP, no HA
      disulfides formed. At more oxidizing values interchain disulfide-cross-linked
      aggregates were generated. Judging by their electrophoretic gel mobility and
      immunoreactivity, the folding intermediates observed in microsomes were
      indistinguishable from those previously seen in the endoplasmic reticulum of live
      cells. The kinetics of folding was also similar, but the efficiency being 43% was
      somewhat lower. The folding process was dependent on lumenal factors within the
      rough endoplasmic reticulum vesicles and also on some macromolecular component(s)
      present in the reticulocyte lysate. The results showed that dog pancreas
      microsomes provide a useful system for protein folding studies.

PMID- 8366106
TI  - Ring finger motif of Arabidopsis thaliana COP1 defines a new class of zinc
      binding domain.
AB  - The COP1 gene of Arabidopsis thaliana encodes a protein mediating the switch
      between the two developmental pathways utilized in light and darkness. A cysteine
      rich motif identified the COP1 protein as a member of a group of regulatory
      proteins which share the amino acid motif Cys-X-X-Cys-loop I-Cys-X-His-X-X-Cys-X
      X-Cys-loop II-Cys-X-X-Cys (ring finger). Although this new class of cysteine-rich
      motifs has been proposed to bind metal ions, no direct evidence supporting this
      has been presented. By analyzing the COP1 protein expressed in Escherichia coli,
      we demonstrate here that each COP1 molecule can bind up to two zinc atoms. The
      two zinc ions are bound with different affinities. One is tightly bound and
      resistant to urea and EDTA, whereas the other one is labile under those
      conditions. It is further shown that deletion of the ring finger motif abolishes
      the metal-binding capacity of COP1. We conclude that the ring finger motif
      constitutes a zinc-coordinating element distinct from previously characterized
      zinc-binding domains.

PMID- 8366107
TI  - Characterization of the signal transduction pathways and cis-acting DNA sequence
      responsible for the transcriptional induction during growth and development of
      the lysosomal alpha-mannosidase gene in Dictyostelium discoideum.
AB  - The lysosomal alpha-mannosidase gene in Dictyostelium discoideum is
      representative of a small group of genes that are expressed under two different
      conditions: 1) immediately upon removal of the bacterial food source from
      exponentially growing cells at < 5 x 10(5) cells/ml (which also initiates the
      developmental cycle), and 2) when the concentration of a secreted glycoprotein
      termed the prestarvation response factor (PSF) reaches a critical threshold in
      cultures growing at densities > 5 x 10(5) cells/ml. In this report we show that
      transcription of the alpha-mannosidase gene induced by starvation did not require
      protein synthesis in axenic wild-type strains, whereas protein synthesis was
      required for the transcriptional induction observed in response to PSF. Northern
      blot analysis was also done using mRNA from G alpha 1 and G alpha 2 gene
      disruption mutants. These genes encode subunits of heterotrimeric G proteins
      found at the cell surface in growing cells and cells early in development. The
      pattern of alpha-mannosidase gene expression was normal in these mutants as well
      as in mutants unable to produce the secreted glycoprotein conditioned medium
      factor or the cAMP receptor-1 protein. These genes have been shown to regulate
      the expression of many genes during early development. Promoter analysis studies
      identified a 145-base pair sequence element containing a TTG box which was
      required for alpha-mannosidase transcriptional induction under both starvation
      conditions and in response to PSF. The TTG box identified is an important
      regulatory element in the promoter of another prestarvation response gene, the
      discoidin I gamma gene. A ts mutant was found to misregulate the expression of
      both discoidin I and alpha-mannosidase expression at restrictive temperatures.
      Taken together these results suggest that the prestarvation response genes may be
      coordinately regulated possibly through the TTG box.

PMID- 8366108
TI  - Crystals of a hammerhead ribozyme.
AB  - Hammerhead ribozyme-inhibitor complexes consisting of an RNA "enzyme" strand and
      a DNA "inhibitor" strand have been crystallized in four different crystal forms.
      The crystal form that is most attractive for structure determination diffracts to
      approximately 3.2 A resolution; it is trigonal, space group P3(1)21 or
      enantiomorph, a = 92.5 A, c = 185.0 A.

PMID- 8366109
TI  - Ribosomal protein L32 of Saccharomyces cerevisiae regulates both splicing and
      translation of its own transcript.
AB  - Ribosomal protein L32 of Saccharomyces cerevisiae regulates the splicing of its
      own transcript (1, 2) apparently by interacting with a structure composed largely
      of the 5' exon. However, even in strains overproducing L32 mRNA, e.g. from a cDNA
      copy of the gene, little accumulation of L32 is observed after a brief pulse
      label. When the 5' leader of the RPL32 mRNA is replaced by an exogenous leader,
      the amount of pulse-labeled L32 increases severalfold, suggesting that L32
      regulates the translation of its own mRNA, acting through sequences in the 5'
      region. This conclusion was confirmed by the observation that in cells carrying a
      chimeric gene in which the L32 leader is fused to LacZ coding sequences, the
      presence of a second gene that overexpresses L32 itself reduces the level of beta
      galactosidase by 50%, in spite of a doubling of L32-lacZ fusion mRNA, presumably
      due to stabilization of the message. Mutations within the 5' leader that abolish
      the regulation of splicing also abolish the regulation of translation, suggesting
      that the regulation of translation by L32 involves a structure similar to that
      proposed for the regulation of splicing. In cells overproducing L32-mRNA about
      half the excess mRNA was found in ribonucleoproteins of < 25 S, unassociated with
      ribosomal particles. Much of the rest was found in ribonucleoproteins of 80-120
      S.

PMID- 8366110
TI  - Synthesis of phosphorylated oligosaccharides in lysozyme is enhanced by fusion to
      cathepsin D.
AB  - Chinese hamster ovary cells transfected with human lysozyme cDNA encoding Asn
      instead of Gly22 synthesize a mutant lysozyme, [Asn22]lysozyme, with about 60% of
      the molecules bearing carbohydrate. This carbohydrate is predominantly of the
      complex type and contains a varied number of lactosamine repeats. In this study
      we show that the glycosylation of [Asn22] lysozyme fused to human cathepsin D is
      altered relative to [Asn22]lysozyme alone. The fusion protein is synthesized as a
      66-kDa precursor that is cleaved to enzymatically active and antigenically
      positive cathepsin D and lysozyme. As compared with [Asn22]lysozyme the lysozyme
      moiety of the fusion protein shows an increased N-glycosylation and a decreased
      synthesis of lactosamine repeats. Cleavage of the precursor with cathepsin L has
      revealed that the lysozyme portion of the secreted fusion protein bears a complex
      type carbohydrate. The intracellularly released lysozyme portion of the fusion
      protein contains trimmed oligosaccharides. In the presence of NH4Cl the lysosomal
      targeting of the fusion protein is inhibited. The secreted protein is then
      enriched in molecules bearing phosphorylated high mannose oligosaccharides in
      their lysozyme moiety. Our results indicate that carbohydrate processing in
      [Asn22]lysozyme, including the synthesis of mannose 6-phosphate residues and of
      lactosamine repeats, is altered by the attached cathepsin D. The phosphorylation
      of the carbohydrate on the lysozyme portion results in a very efficient lysosomal
      targeting of the concerned fusion protein molecules.

PMID- 8366111
TI  - Identification of enhancers in the 5'-flanking region of the rabbit surfactant
      protein A (SP-A) gene and characterization of their binding proteins.
AB  - The gene encoding surfactant protein A (SP-A) is expressed in type II
      pneumonocytes and is developmentally and hormonally regulated in fetal lung. In
      the present study, rabbit lung nuclear proteins were found to bind to two genomic
      elements within the 5'-flanking region of the rabbit SP-A gene, termed distal
      binding element (DBE; -986 to -977 base pairs) and proximal binding element (PBE;
      -87 to -70 base pairs). Binding activity was enriched in type II pneumonocytes as
      compared with whole lung tissue. Although binding activity was undetectable in
      nuclear proteins from rabbit liver and kidney, low levels of binding activity
      were detected in nuclear proteins from cardiac and skeletal muscle. DNase I
      footprinting indicated that lung nuclear proteins protected the palindromic
      sequence CCCACGTGGG in the DBE. The underlined core sequence is an E box motif; a
      similar sequence (CCCTCGTG) is present within the PBE. Both elements competed for
      binding to the same size species of nuclear proteins of M(r) approximately
      69,000, 45,000, and 22,000. In type II cells transfected with fusion genes
      containing SP-A 5'-flanking DNA linked to the human growth hormone structural
      gene, mutagenesis of the DBE or PBE resulted in a marked reduction of basal and
      cyclic AMP-stimulated fusion gene expression. These findings suggest that the DBE
      and PBE act as enhancers that interact with the same or related trans-acting
      proteins and serve an important role in type II cell-specific, cyclic AMP
      mediated regulation of SP-A gene expression.

PMID- 8366112
TI  - Expression, purification, and kinetic characterization of recombinant human
      adenylosuccinate lyase.
AB  - Adenylosuccinate adenosine 5'-monophosphate lyase (EC 4.3.2.2; ASL) catalyzes two
      distinct reactions in adenosine 5'-monophosphate (AMP) biosynthesis. A S413P
      mutation in ASL segregates with mental retardation in an affected family (Stone,
      R. L., Aimi, J., Barshop, B. A., Jaeken, J., Van den Berghe, G., Zalkin, H., and
      Dixon, J. E. (1992) Nature Genet. 1, 59-63). ASL and S413P ASL have been
      expressed, purified, and kinetically characterized. Lowering the Escherichia coli
      growth temperature to 25 degrees C and the concentration of inducer, isopropyl-1
      thio-beta,D-galactopyranoside, to 40 microM was necessary for synthesis of
      soluble, tetrameric enzymes. The recombinant enzymes were purified to homogeneity
      using anion exchange chromatography followed by chromatography on Blue 2A
      Sepharose. At pH 7.0 and 25 degrees C, the kcat for cleavage of 5-amino-4
      imidazole-N-succinocarboxamide ribotide (SAI-CAR) by ASL was 90 s-1 with a Km of
      2.35 microM. The kcat for adenylosuccinate (SAMP) cleavage was 97 s-1 with a Km
      of 1.79 microM. The catalytic mechanism involved one general base catalyst (pK
      alpha = 6.4) and one general acid catalyst (pK alpha = 7.5). ASL follows an
      ordered uni-bi reaction mechanism with fumarate released first. 5-Amino-4
      imidazolecarboxamide ribotide (AICAR) and AMP were competitive with SAICAR and
      SAMP (Ki[AICAR] = 11.3 microM; Ki[AMP] = 9.2 microM), whereas fumarate inhibited
      noncompetitively (Kii = 2.3 mM, Kis = 2.8 mM). The competitive inhibition by
      AICAR and AMP suggests a single active site that binds both SAICAR and SAMP. The
      kinetic constants at pH 7.0, 25 degrees C and the kcat/Km versus pH profiles for
      ASL and S413P ASL were very similar. These results are consistent with S413P
      being a structural rather than a catalytic defect.

PMID- 8366113
TI  - Amphoterin, the 30-kDa protein in a family of HMG1-type polypeptides. Enhanced
      expression in transformed cells, leading edge localization, and interactions with
      plasminogen activation.
AB  - Amphoterin is a heparin-binding protein that is developmentally regulated in
      brain and functionally involved in neurite outgrowth. Unexpectedly, amphoterin
      has a high mobility group 1 (HMG1)-type sequence. In the present study we have
      expressed amphoterin cDNA in a baculovirus vector and produced antibodies against
      the recombinant protein and several synthetic peptides. It was found that the
      amphoterin cDNA encodes the 30-kDa form of the protein isolated from tissues,
      whereas the co-purifying 28- and 29-kDa proteins (p28 and p29) have closely
      related but distinct primary structures. Partial amino acid sequencing shows
      several local changes in the sequences of p28 and p29 compared with amphoterin,
      suggesting the occurrence of a multigene family that encodes at least three
      different HMG1-type sequences in the rat. Studies using the probes that discern
      amphoterin from the other HMG1-type proteins indicate a high level expression in
      various transformed cell lines. Immunostaining of cells with the amphoterin
      specific antibodies indicates a cytoplasmic localization that becomes remarkably
      enriched at the leading edges in spreading and motile cells. An extracellular
      localization is suggested by immunostaining of nonpermeabilized cells and by a
      plasminogen-dependent degradation of amphoterin in the substratum-attached
      material of cells. Tissue-derived and recombinant amphoterins strongly enhance
      the rate of plasminogen activation and promote the generation of surface-bound
      plasmin both by tissue-type and urokinase-type plasminogen activators. The
      results suggest an extracellular function for amphoterin in the leading edge of
      various invasive cells.

PMID- 8366114
TI  - Proliferation of intracellular structures upon overexpression of the PMA2 ATPase
      in Saccharomyces cerevisiae.
AB  - The PMA2 gene is a presumed isogene of the PMA1 gene, encoding the major yeast
      plasma membrane H(+)-ATPase. When controlled by its own promoter, PMA2 in
      multiple copies does not complement a deficient PMA1 gene. Under the control of
      the PMA1 promoter, however, and expressed on a centromeric plasmid in yeast
      strains specially designed for stable expression, the PMA2 gene replaces the PMA1
      gene to some extent, allowing growth on standard medium but not on acidic media.
      Plasma membranes of cells expressing only the PMA2 enzyme display low ATPase
      activity correlating with low amounts of PMA2 protein. This low activity is
      maintained throughout growth and does not increase when overexpression is favored
      by increased gene dosage. Immunoelectron microscopy reveals a dramatic
      proliferation of intracellular structures (probably endoplasmic reticulum) in
      which overexpressed PMA2 protein accumulates. Overexpression of PMA1 ATPase
      causes a similar phenomenon, but quantitative effects are lower compared to PMA2.
      These results indicate that the PMA2 gene encodes a functional plasma membrane
      H(+)-ATPase and suggest a specific control of the intracellular traffic of plasma
      membrane ATPase.

PMID- 8366115
TI  - Gap junction communication modulates [Ca2+]i oscillations and enzyme secretion in
      pancreatic acini.
AB  - Global (all cells in an acinus) and focal (1-2 out of 10-15 cells) stimulation of
      pancreatic acini with bombesin or t-butyloxycarbonyl-Tyr(SO3)-Nle-Gly-Tyr-Asp-2
      phenylethyl ester (CCKJ) together with modulation of gap junction (GJ)
      permeability by octanol and NO2- was used to study the role of GJ permeability in
      controlling [Ca2+]i oscillations and enzyme secretion. GJ permeability was
      quantitated by measuring fluorescence recovery after photobleaching. Octanol at
      0.5 mM markedly reduced, whereas 15 mM NO2- increased GJ permeability. Focal
      application of bombesin caused synchronized oscillations in the entire acinus,
      whereas global stimulation resulted in asynchronous oscillations. Increasing GJ
      permeability with NO2- had no effect on bombesin-evoked [Ca2+]i oscillations.
      Octanol inhibited ongoing oscillations evoked by focal or global bombesin
      stimulation. However, when GJ were blocked prior to stimulation, subsequent
      global stimulation with bombesin induced long-lasting oscillations in all cells.
      Re-establishing GJ communication for as little as 37.5 s conferred GJ dependence
      on the order and time of [Ca2+]i spiking evoked by global bombesin stimulation.
      Focal and global stimulation with CCKJ gave different patterns of [Ca2+]i
      oscillations. However, in contrast to bombesin, inhibition of GJ with octanol had
      no effect on oscillations induced by global CCKJ stimulation. Increasing GJ
      permeability with NO2- synchronized CCKJ-stimulated oscillations by equalizing
      the amplitude and increasing the frequency in all cells within an acinus. These
      observations suggest that amplitude and frequency of [Ca2+]i oscillations can be
      regulated independently of each other, and that GJ permeable molecules modulate
      the frequency of [Ca2]i oscillation in an agonist-specific manner. Regardless of
      the agonist, increasing the frequency of oscillations by modulation of GJ
      permeability correlated with an increased enzyme secretion.

PMID- 8366116
TI  - Yeast mitochondrial RNase P. Sequence of the RPM2 gene and demonstration that its
      product is a protein subunit of the enzyme.
AB  - We report here the sequence of the RPM2 gene which codes for the 105-kDa protein
      previously purified from the mitochondria of Saccharomyces cerevisiae and shown
      by genetic techniques to be required for mitochondrial RNase P activity. The
      sequence predicts a primary translation product of 1202 residues with a molecular
      mass of 139 kDa and no obvious sequence similarity to any known protein in the
      data bases. There are 122 amino-terminal amino acids predicted by the gene that
      are not found in the purified protein, some of which may play a role in
      mitochondrial targeting of the protein. Antibodies raised against a trpE-105-kDa
      fusion protein recognize a 105-kDa protein in wild-type cells but not in cells
      carrying a disruption of the RMP2 gene. Immune, but not preimmune serum,
      immunoprecipitates the RNase P RNA and the mitochondrial RNase P activity. Thus,
      the 105-kDa protein forms a complex with RNase P RNA and is required for RNase P
      activity as predicted for a bona fide subunit of the enzyme.

PMID- 8366117
TI  - Tandem SH2 domains of ZAP-70 bind to T cell antigen receptor zeta and CD3 epsilon
      from activated Jurkat T cells.
AB  - A proximal and critical biochemical event upon T cell antigen receptor (TCR)
      stimulation is the activation of a protein tyrosine kinase (PTK) pathway. ZAP-70,
      a PTK of the p72syk family, associates with phosphorylated TCR subunits upon TCR
      stimulation. Here we report that the tandem SH2 domains of ZAP-70, expressed as a
      fusion protein, bind to tyrosine-phosphorylated CD3 epsilon and TCR zeta from
      activated Jurkat T cell lysates. The single N- and C-terminal SH2 domains of ZAP
      70, expressed separately, do not bind these TCR subunits. In comparison to fusion
      proteins containing SH2 domains from other proteins, the tandem SH2 domains of
      ZAP-70 demonstrate a remarkably restricted repertoire of protein binding, binding
      only TCR zeta and CD3 epsilon. ZAP-70 is also recovered in the binding assay, but
      this is likely to be a consequence of its interaction with multiple SH2 binding
      sites on the zeta-zeta and CD3 epsilon-containing dimers.

PMID- 8366118
TI  - The role of the carboxyl-terminal tail in human O6-methylguanine DNA
      methyltransferase substrate specificity and temperature sensitivity.
AB  - The human O6-methylguanine DNA methyltransferase (MGMT) repairs O6-methylguanine
      (O6-MG) in DNA at a much lower rate than the Escherichia coli Ada protein, and
      only MGMT repairs the altered base, O6-benzylguanine (O6-BG). The diversity in
      DNA repair properties between MGMT and Ada may be a result of divergent amino
      acid sequences outside their common proline-cysteine-histidine-arginine-valine
      (PCHRV) acceptor site. One notable sequence difference is an MGMT 28-amino acid
      carboxyl-terminal tail which is highly conserved among all mammalian
      alkyltransferases. The role of this tail sequence in substrate specificity was
      assessed by expressing full-length MGMT and Ada proteins, and mutant MGMT
      proteins lacking either 10 or 28 amino acids from the carboxyl terminus, as GST
      fusion proteins in alkyltransferase-deficient E. coli cells, and comparing rates
      of repair of O6-MG containing DNA and O6-BG by these fusion proteins at 4 degrees
      C and 37 degrees C. The MGMT carboxyl-terminal tail was not required for repair
      of O6-MG in DNA at 37 degrees C although the deletion of this tail sequence
      reversibly inhibited the ability of MGMT to repair O6-MG in DNA at 4 degrees C.
      Therefore, the absence of this region affects the ability of the protein to
      repair O6-MG in DNA at lower temperatures. Furthermore, removal of the tail
      sequence from MGMT decreased the rate of O6-BG repair 5-fold. We conclude that
      the 28-amino acid carboxyl-terminal MGMT tail, while not required for activity,
      modulates the rate of MGMT repair at reduced temperatures and plays a role in
      substrate specificity.

PMID- 8366119
TI  - Regulation of selective protein degradation in the endoplasmic reticulum by redox
      potential.
AB  - Recent studies show that the endoplasmic reticulum (ER) contains proteases, but
      it is not understood how these enzymes are regulated. In this report we study the
      selective ER degradation of the subunits (alpha beta gamma delta epsilon zeta) of
      the T-cell antigen receptor (TCR). When analyzed in vivo, unassembled subunits of
      the TCR fail to reach the Golgi apparatus and show a differential sensitivity to
      degradation after synthesis. The alpha, beta, and delta subunits are degraded
      rapidly, while gamma, epsilon, and zeta are stable. To study the regulation of
      proteolysis in more detail, beta, gamma, delta, and epsilon subunits were
      expressed alone in fibroblasts and their selective degradation analyzed in vitro.
      The beta and delta chains were degraded in the complete absence of vesicular
      transport, indicating their degradation in the ER membrane compartment.
      Proteolysis was unaffected by GTP gamma S (guanosine 5'-O-(thiotriphosphate)),
      EDTA, or depletion of ATP. The gamma and epsilon subunits were stable under the
      same in vitro conditions, indicating that the assay reconstituted selective
      protein degradation within the ER. Furthermore, the results showed that the gamma
      and epsilon subunits did not escape degradation by being transported from the ER
      to pre-Golgi, or cis-Golgi, membrane compartments. Structural determinants of ER
      degradation contained within the membrane anchor of the TCR beta subunit were
      only active in permeabilized cells when reducing agents were added to the assay.
      Surprisingly, reducing conditions disrupted the regulation of ER proteolysis and
      induced rapid ER degradation of the stable CD3 gamma subunit and of a control
      interleukin 2 receptor chimera. Taken together, the results indicated that the ER
      membrane compartment regulates the selective degradation of newly synthesized
      proteins. Importantly, the stability of proteins retained in the ER was highly
      sensitive to redox conditions. It is possible that the redox buffer within the ER
      lumen may regulate ER protein degradation in vivo.

PMID- 8366120
TI  - Identification of the cysteine residue in apolipoprotein(a) that mediates
      extracellular coupling with apolipoprotein B-100.
AB  - We have utilized a recombinant expression system in order to study the assembly
      of lipoprotein(a) (Lp(a)) particles. Using a 17-kringle recombinant form of
      apolipoprotein(a) (apo(a)) to transiently transfect human hepatoma cells, we
      could not detect recombinant Lp(a) (r-Lp(a)) particles intracellularly, by
      analysis of postnuclear lysates. However, covalent r-Lp(a) complexes were
      observed in the transfected cell supernatants. Upon addition of [35S]Cys-labeled
      human embryonic kidney cell supernatants transfected with 9-kringle or 17-kringle
      recombinant apo(a) (r-apo(a)) variants to human plasma, covalent r-Lp(a)
      complexes were observed, which could be immunoprecipitated using antibodies
      specific for either apo(a) or apolipoprotein B-100 (apoB-100); r-Lp(a) complexes
      containing the 17-kringle r-apo(a) were shown to be in the 1.063 g/ml < d < 1.20
      g/ml range by density gradient ultracentrifugation analysis. Complexes containing
      the 17-kringle r-apo(a) formed rapidly within 20 min, with a slow increase
      observed up to 90 min. Addition of increasing amounts of plasma, as well as
      increasing amounts of isolated human low density lipoprotein to cell culture
      supernatants containing [35S]Cys-labeled 17-kringle r-apo(a) led to enhanced r
      Lp(a) complex formation. Blocking of free sulfhydryls in apo(a) with N
      ethylmaleimide resulted in inhibition of r-Lp(a) complex formation in plasma,
      verifying the role of free sulfhydryls in Lp(a) particle assembly. Using site
      directed mutagenesis, we demonstrated that Cys4057 in apo(a) is involved in
      disulfide linkage with apoB-100 in Lp(a) particles.

PMID- 8366121
TI  - Activation of an S6 kinase from human placenta by autophosphorylation.
AB  - A number of protein kinases have been shown to undergo autophosphorylation, but
      few have demonstrated a coordinate increase or decrease in enzymatic activity as
      a result. Described here is a novel S6 kinase isolated from human placenta which
      autoactivates through autophosphorylation in vitro. This S6/H4 kinase, purified
      in an inactive state, exhibited a molecular mass of 60 kDa as estimated by SDS
      polyacrylamide gel electrophoresis. The 60-kDa protein underwent
      autophosphorylation, was labeled by 8-azido-[alpha-32P]ATP, and reacted with an
      antibody to the conserved APE domain of the cAMP-dependent protein kinase. The
      protein did not cochromatograph with p70 S6 kinase and did not cross-react with
      an anti-p70 kinase antibody. The synthetic peptide S6-21, histone H4, and myelin
      basic protein were phosphorylated by the purified S6/H4 kinase. Mild digestion of
      the inactive S6/H4 kinase with trypsin generated a 40-kDa fragment, as determined
      by SDS-polyacrylamide gel electrophoresis. The trypsin treatment was necessary,
      but not sufficient, to fully activate the kinase. Subsequent incubation of the
      trypsin-treated S6 kinase with MgATP resulted in the rapid autophosphorylation of
      the 40-kDa fragment along with a coordinate increase in kinase activity. The
      autophosphorylation of the 40-kDa protein was positively correlated with MgATP
      incubation time and an increase in activity toward the S6-21 peptide, histone H4,
      and myelin basic protein. Taken together, these data support the hypothesis that
      this previously uncharacterized S6 kinase belongs to a unique family of protein
      kinases which utilize autophosphorylation as part of their in vivo activation
      mechanism.

PMID- 8366122
TI  - Synthesis and stability of reaction center polypeptides and implications for
      reaction center assembly in Rhodobacter sphaeroides.
AB  - The synthesis and stability of the H and M polypeptide subunits of the
      photosynthetic reaction center of Rhodobacter sphaeroides were examined. In wild
      type cells, low levels of both M and H were found to be synthesized under aerobic
      growth conditions, with a 20-fold induction in their synthesis under anaerobic
      dark growth conditions. Neither M nor H was stable in aerobic cells, but in
      anaerobic-dark grown cells stability increased dramatically with the t1/2 going
      from 4-6 min to values estimated in excess of 4 h. In the H-deficient mutant
      PUHA1, the synthesis and membrane partitioning of the M subunit were unaffected
      by the absence of the H subunit but there was a significant decrease in M
      polypeptide stability in the membranes of PUHA1 relative to wild-type cells. The
      stability of all or part of the M population in PUHA1 could be restored by
      providing an H-encoding plasmid in trans. It was also determined that the
      presence of bacteriochlorophyll in fully aerobic cells had a direct, positive
      effect on M and H stability, utilizing the oxygen-regulatory mutant strain T1a.
      Implications for the role of the H subunit and putative assembly factors in
      reaction center assembly are discussed.

PMID- 8366123
TI  - Signaling events initiated by transforming growth factor-beta 1 that require Gi
      alpha 1.
AB  - Transforming growth factor-beta 1 (TGF-beta 1) initiates a series of signaling
      events leading to diverse cell type-specific effects on proliferation and
      morphology. The multiple effects of TGF-beta 1 are not due to selective
      expression of receptor subtypes, but rather probably reflect cell-specific
      expression of downstream components of the particular signaling system. To
      address this possibility and to identify specific signaling pathways activated by
      TGF-beta 1, we attempted to restore cell responsiveness to the cytokine by
      introducing various intracellular signal transducers in NIH-3T3 fibroblasts, a
      cell line that is minimally responsive to TGF-beta 1. In NIH-3T3 fibroblasts
      stably transfected with Gi alpha 1 cDNA, TGF-beta 1 induced a reversible
      morphological transformation that was identical to the effect of this cytokine in
      indicator cells such as AKR-2B fibroblasts. Gi alpha 1 transfectants also
      exhibited mitogenic hyperresponsiveness to TGF-beta 1. TGF-beta 1 does not elicit
      these responses in control nontransfected fibroblasts or cells transfected with
      the guanine nucleotide-binding protein Go alpha 1. The response to TGF-beta 1 in
      Gi alpha 1 transfectants is blocked by pertussis toxin and is lost in Gi alpha 1
      transfectants that have spontaneously reverted and no longer express Gi alpha 1.
      These data indicate that the expression of the guanine nucleotide-binding protein
      Gi alpha 1, normally absent in these cells, confers cell sensitivity to TGF-beta
      1.

PMID- 8366124
TI  - UDP-N-acetylglucosamine acyltransferase of Escherichia coli. The first step of
      endotoxin biosynthesis is thermodynamically unfavorable.
AB  - UDP-N-acetylglucosamine acyltransferase of Escherichia coli catalyzes the
      reaction, UDP-GlcNAc + R-3-hydroxymyristoyl-ACP--> UDP-3-O-(R-3-hydroxymyristoyl)
      GlcNAc + ACP. Using Matrex Gel Green A and heparin-agarose, we have purified the
      enzyme to near homogeneity from a strain that overproduces it 474-fold. The
      subunit molecular mass determined by SDS-gel electrophoresis is approximately 30
      kDa, consistent with results of previous radiolabeling experiments in mini-cells.
      The amino-terminal sequence (Met-Ile-Asp-Lys-Ser-Ala-Phe-Val-His-Pro) and the
      amino acid composition of the purified protein are consistent with DNA sequencing
      (Coleman, J., and Raetz, C. R. H. (1988) J. Bacteriol. 170, 1268-1274). At
      saturating concentrations of the second substrate, the apparent Km values for UDP
      GlcNAc and R-3-hydroxymyristoyl-ACP are 99 and 1.6 microM, respectively. There is
      an absolute requirement for the R-3-hydroxy moiety of the fatty acyl-ACP
      substrate; myristoyl-ACP binds effectively (IC50 = 2 microM) but is inactive (<
      0.01%) as an alternate substrate. The most remarkable feature of the reaction is
      its unfavorable equilibrium constant, Keq approximately equal to 0.01, which is
      not predicted by model S-->O acyl transfer reactions. Thus, although UDP-GlcNAc
      acyltransferase catalyzes the first unique step of lipid A biosynthesis, it is
      the second enzyme (the deacetylase) that commits the substrates to this pathway.
      The specific activity of the deacetylase is elevated approximately 5-fold when
      lipid A synthesis is inhibited.

PMID- 8366125
TI  - The firA gene of Escherichia coli encodes UDP-3-O-(R-3-hydroxymyristoyl)
      glucosamine N-acyltransferase. The third step of endotoxin biosynthesis.
AB  - The possibility that the firA gene of Escherichia coli (Dicker, I. B., and
      Seetharam, S. (1991) Mol. Microbiol. 6, 817-823) might function in lipid A
      biosynthesis was examined based on its homology to the lpxA gene, which encodes
      UDP-N-acetylglucosamine O-acyl-transferase, the first enzyme in lipid A
      formation. Extracts of a temperature-sensitive firA mutant, RL-25, were assayed
      for their ability to acylate UDP-GlcNAc, using a coupled assay. The results
      suggested that extracts of RL-25 might be defective in the third enzyme of this
      pathway, the UDP-3-O-(R-3-hydroxymyristoyl)-glucosamine N-acyltransferase. Living
      cells of RL-25 also displayed a 5-fold decreased rate of lipid A biosynthesis at
      the nonpermissive temperature as judged by a 32Pi incorporation assay. In order
      to examine N-acyltransferase activity directly, the substrate [alpha-32P]UDP-3-O
      (R-3-hydroxymyristoyl)-GlcN was synthesized enzymatically. N-Acyltransferase
      specific activity in RL-25 extracts was reduced to less than 10% of wild-type.
      When the wild-type firA gene was cloned into a T7-based expression vector, N
      acyltransferase specific activity increased almost 360-fold relative to wild-type
      extracts, demonstrating that firA is the structural gene for the enzyme. The N
      acyltransferase displays absolute specificity for the R-3-OH moiety of R-3
      hydroxymyristoyl-ACP, as does the O-acyltransferase, consistent with the
      placement of R-3-hydroxymyristate in E. coli lipid A.

PMID- 8366126
TI  - Signal transduction through a biomolecular receptor tyrosine protein kinase
      composed of a platelet-derived growth factor receptor-CD4 chimera and the
      nonreceptor tyrosine protein kinase Lck.
AB  - We have generated a novel "receptor tyrosine kinase" by fusing the extracellular
      and transmembrane domain of the mouse platelet-derived growth factor receptor
      (PDGFR) to the cytoplasmic domain of CD4 and coexpressing the construct with the
      murine cytoplasmic tyrosine protein kinase p56lck. NMuMG cells, which are mouse
      mammary gland epithelial cells that lack endogenous platelet-derived growth
      factor (PDGF) receptor expression, were stably transfected with both PDGFR-CD4
      and p56lck. The PDGFR-CD4 chimeric protein was expressed at the cell surface and
      formed a complex with p56lck. Addition of PDGF to these cells led to increased
      tyrosine phosphorylation of a 56-kDa protein likely to be p56lck and several
      unidentified cellular proteins. The enzymatic activity of p56lck was increased
      after treatment with PDGF, indicating that dimerization (or oligomerization)
      mediated by ligand binding at the cell surface is capable of inducing the
      activation not only of receptor tyrosine kinases but nonreceptor tyrosine kinases
      as well. However, the PDGFR-CD4.p56lck complex was, in contrast to the wild type
      PDGF receptor, not able to induce a PDGF-dependent mitogenic response or DNA
      synthesis in NMuMG cells. Analysis of several known substrates of the PDGFR
      signaling pathway indicates an early block in the transduction of the signal
      generated by p56lck.

PMID- 8366127
TI  - Complementation of transport-deficient mutants of Escherichia coli alpha
      hemolysin by second-site mutations in the transporter hemolysin B.
AB  - Hemolysin B (HlyB) is a membrane-bound transport protein composed of an amino
      terminal multiple membrane-spanning portion followed by a conserved ATP binding
      sequence. Together with the inner membrane protein HlyD and the outer membrane
      protein TolC, HlyB is responsible for transport of the 107-kDa toxin HlyA from
      the cytoplasm, across both membranes of the cell envelope of Escherichia coli,
      directly to the medium. We have used a mutational approach to investigate a
      postulated interaction between HlyA and HlyB. We have isolated transport
      deficient mutants of HlyA altered in the C-terminal signal sequence and used one
      of these, a deletion of 29 amino acids, to select compensatory mutants in the
      transporter protein HlyB. Fifteen mutants located at six different sites, all
      mapping within the amino-terminal multiple membrane-spanning domain of HlyB, were
      identified. All of the mutations are clustered into three groups located close to
      the predicted inner face of the cytoplasmic membrane. We propose that these
      locations are close to sites on HlyB that interact with the C-terminal signal
      sequence of HlyA. This interaction is likely to involve either binding of HlyA to
      HlyB or activation of the transport mechanism. The compensatory mutants also
      display different patterns of specificity in terms of their ability to transport
      different HlyA mutants. The fact that point mutations are able to compensate for
      drastic changes in the signal sequence of HlyA suggests that substrate
      specificity of transporters such as HlyB may shift dramatically during
      evolutionary history. This could account for the diversity of substrates observed
      for the ABC transporter superfamily in nature.

PMID- 8366129
TI  - High resolution distribution of mRNA within the cytoskeleton.
AB  - It has been well documented that mRNA is associated with the cytoskeleton, and
      that this relationship is involved in translation and mRNA sorting. The molecular
      components involved in the attachment of mRNA to the cytoskeleton are only poorly
      understood. The objective of this research was to directly visualize the
      interaction of mRNA with the cytoskeleton, with sufficient resolution to identify
      the filament systems involved. This work required the development of novel in
      situ hybridization methods for use with electron microscopy.

PMID- 8366128
TI  - Import, processing, and two-dimensional NMR structure of a linker-deleted signal
      peptide of rat liver mitochondrial aldehyde dehydrogenase.
AB  - Previous NMR studies (Karslake, C., Piotto, M. E., Pak, Y. M., Weiner, H., and
      Gorenstein, D. G. (1990) Biochemistry 29, 9872-9878) had shown that a 22-amino
      acid signal peptide of rat liver aldehyde dehydrogenase (ALDH) when bound to a
      micelle had two amphiphilic alpha-helices, one located at the N terminus and the
      other at the C terminus. It was shown that deletion of either helix caused the
      precursor protein not to be imported (Wang, Y., and Weiner, H., (1993) J. Biol.
      Chem. 268, 4759-4765). The two helices are separated by a Arg-Gly-Pro flexible
      "linker" region, and to test the role of this linker region in the import and
      processing of the precursor protein, we deleted it from the ALDH signal peptide
      and precursor protein. The 19-amino acid signal peptide of ALDH, to which has
      been added 3 residues at the C terminus and from which has been deleted the 3
      residue flexible linker region, has been studied by two-dimensional NMR in a
      dodecylphosphocholine micelle. In this membrane-like environment the peptide
      contains a single alpha-helical segment that extends almost the entire length of
      the peptide. NH exchange experiments show residues on the hydrophobic face of the
      peptide to exchange much more slowly than those of the hydrophilic face. Combined
      with the previous study, these results suggest that precursor protein import
      simply requires a sufficiently long amphiphilic helix (or helices) to bind stably
      to the membrane. The N and C helices of native ALDH are only about 6-8 residues
      long; this represents only about two turns of a helix, and either helix on its
      own does not provide enough stabilization to ensure folding and binding to the
      membrane. The linker-deleted ALDH peptide contains a single helix of 12-14
      residues that is long enough to provide a hydrophobic surface that can stably
      interact with the hydrophobic interior of the membrane. The function of the C
      helix in the native signal peptide is therefore to enhance the stability and
      binding of the N-terminal signal to the membrane. Significantly, unlike native
      ALDH precursor protein, the linker-deleted signal peptide precursor protein could
      no longer be processed after import into mitochondria. As explained by modeling
      of the alpha-helix and the NH exchange rate data, the precursor protein requires
      that the first several residues of the mature protein be part of the hydrophobic
      membrane associated face of the helix.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8366130
TI  - ABP50: an actin-binding elongation factor 1 alpha from Dictyostelium discoideum.
AB  - ABP50 is a polypeptide elongation factor 1 alpha from Dictyostelium that is
      associated with the actin cytoskeleton. Upon chemotactic stimulation, ABP50
      undergoes a dramatic cytoplasmic redistribution into newly formed surface
      projections and in vitro binds to and bundles actin filaments. Many questions are
      raised by this interaction pertaining to the spatiotemporal regulation of protein
      synthesis and cytoskeletal organization by extracellular signals.

PMID- 8366131
TI  - Effect of cytoarchitecture on the transport and localization of protein synthetic
      machinery.
AB  - The emerging picture of cytoarchitecture imposes constraints on the transport and
      localization of several components of the protein synthetic machinery. The range
      in which "free" polysomes can diffuse through the cytoplasm may be restricted to
      about 50 nm due to obstruction by cytoskeletal barriers. Individual ribosomes and
      large transcripts will diffuse at least 4-10 times slower in cytoplasm than in
      dilute aqueous solution and may be sterically excluded from some cytoplasmic
      domains. The transport of these components from the nucleus to the cell periphery
      may be restricted to microtubule-containing channels that traverse the excluding
      domains. In the peripheral cytoplasm, mitochondria, endoplasmic reticulum, and
      other membrane-bound organelles are found only in nonexcluding channels, while
      actin, nonmuscle filamin (ABP280), and fodrin are concentrated in excluding
      domains. This suggests that the cytoplasmic volume may be functionally
      compartmentalized by local differentiations of cytoarchitecture. Excluding
      compartments may play a structural role, while nonexcluding compartments are the
      site of vesicle traffic and protein synthesis.

PMID- 8366132
TI  - Spatial organization of the synthesis of cytoskeletal proteins.
AB  - The cytoskeleton of most cells is complex and spatially diverse. The mRNAs for
      some cytoskeletal proteins are localized, suggesting that synthesis of these
      proteins may occur at sites appropriate for function or assembly. mRNA
      concentrations were first observed for several oocyte and embryonic mRNAs. Some
      insight has been gained into the mechanisms that help to position these mRNAs.
      More surprising to some, many cytoskeletal mRNAs are also localized. Among them
      are mRNAs for actin, tubulin, intermediate filaments, and a variety of associated
      proteins. Different mRNAs in the same cell can be located in different places;
      the same mRNA can be located in different places; the same mRNA can be located
      differently at different times of development. For example, we observed vimentin
      mRNA in developing chicken muscle cultures by fluorescent in situ hybridization.
      We found that vimentin mRNA takes on a variety of positions during myogenesis,
      ending up located with its cognate protein at costameres. This last pattern is
      significant because it is too finely structured to have a function in the soluble
      phase and probably reflects cotranslational assembly of this particular protein.
      Analogies can be made between oocyte or embryonic positions (animal/vegetal
      poles, oocyte cortex, and interior) and somatic cell positions
      (anterior/posterior and cell cortex/cell center). These analogies may point to
      conserved mechanisms for moving and retaining mRNA. Localization of cytoskeletal
      synthesis, through the mRNA or by other means, may prove as important for
      assembling and maintaining differentiated cytoskeletal structures and somatic
      cells as mRNA location is for organizing the embryo. Mechanisms that permit mRNA
      localization are likely to be conserved.

PMID- 8366133
TI  - ADP-ribosylation of nucleolar proteins in HeLa tumor cells.
AB  - ADP-ribosylation reactions in nucleoli of exponentially growing HeLa cells were
      studied. Isolated nuclei or nucleoli were labeled with 32P-NAD; then the
      nucleolar proteins were analyzed by 1-dimensional and 2-dimensional
      polyacrylamide gel electrophoresis (PAGE) and modified proteins were detected by
      autoradiography. The labeled nucleolar proteins were also chromatographically
      fractionated on DEAE-cellulose. Electrophoretic analysis of total nucleolar and
      chromatographically purified proteins revealed that besides nuclear ADP
      ribosyltransferase and histones two characteristic nucleolar phosphoproteins
      numatrin/B23 and nucleolin/C23 were modified by ADP-ribosylation.

PMID- 8366134
TI  - 1,25-Dihydroxyvitamin D3 increases type 1 interleukin-1 receptor expression in a
      murine T cell line.
AB  - The biologically active metabolite of vitamin D3, 1,25 (OH)2 D3, exerts important
      immunoregulatory effects in addition to being a central mediator of
      calcium/phosphate metabolism. Utilizing an interleukin 1 responsive murine T cell
      line and 125I-interleukin 1 alpha, we show that 1,25 (OH)2 D3 (5,50 nM) enhanced
      125I-interleukin 1 alpha binding up to almost 2-fold over control. This 1,25
      (OH)2 D3 effect occurred in a dose-dependent manner and was detectable after 24 h
      but not before 7 h of culture. Scatchard analysis of 125I-interleukin 1 alpha
      binding data demonstrated that 1,25 (OH)2 D3 enhanced interleukin 1 receptor
      number without a significant change in affinity. The biologically less potent
      metabolite of vitamin D3, 25 (OH) D3, also augmented 125I-interleukin 1 alpha
      binding but at steroid levels 2-3 log orders greater than 1,25 (OH)2 D3. This
      observation, combined with the presence of high-affinity 3H-1,25 (OH)2 D3
      receptors (88 sites/cell, K = 0.45 nM) in cytosolic extracts, strongly suggests
      that the nuclear vitamin D receptor mediates this steroid's effect on interleukin
      1 receptor expression. Based on the capacity of an anti-type 1 interleukin 1
      receptor monoclonal antibody (35F5) to block 1,25 (OH)2 D3-enhanced 125I
      interleukin 1 alpha binding, we conclude that this steroid augments type 1
      interleukin 1 receptor expression. When combined with interleukin 1, a cytokine
      that also impacts MD10 interleukin 1 receptor expression, 1,25 (OH)2 D3 enhanced
      interleukin 1 receptor expression. Northern blots hybridized with a 32P-type 1
      interleukin 1 receptor cDNA probe show that 1,25 (OH)2 D3 enhanced type 1
      interleukin 1 receptor steady state mRNA levels. Functionally, 1,25 (OH)2 D3
      pretreatment augmented the MD10 proliferative response to suboptimal levels of
      interleukin 1 (< 100 fM interleukin 1 alpha). These findings further support 1,25
      (OH)2 D3's role as an immunoregulatory molecule and provides a possible mechanism
      by which this steroid could potentiate certain immune activities.

PMID- 8366135
TI  - Inhibition of induced endochondral bone development in caffeine-treated rats.
AB  - We have addressed questions raised by the observation in fetal rats of delayed
      ossification induced by caffeine at maternal doses above 80 mg/kg body weight per
      day. The effect of caffeine on endochondral bone development and mineralization
      has been studied in an experimental model system of bone formation which involves
      implantation of demineralized bone particles (DBP) in subcutaneous pockets of
      young growing rats. Caffeine's effects on cellular events associated with
      endochondral ossification were examined directly by quantitating cellular mRNA
      levels of chondrocyte and osteoblast growth and differentiation markers in DBP
      implants from caffeine-treated rats harvested at specific stages of development
      (day 7 through day 15). Oral caffeine administration to rats implanted with DBP
      resulted in a dose dependent inhibition of the formation of cartilage tissue in
      the implants. Histologic examination of the implants revealed a decrease in the
      number of cells which were transformed to chondrocytes compared to control
      implants. Those cartilaginous areas that did form, however, proceeded through the
      normal sequelae of calcified cartilage and bone formation. At the 100 mg/kg dose,
      cellular levels of mRNA for histone, collagen type II, and TGF beta were all
      reduced by greater than 40% of control implants consistent with the histological
      findings. Alkaline phosphatase activity in the implants and mRNA levels for
      proteins reflecting the hypertrophic chondrocyte and bone phenotype, collagen
      type I and osteocalcin were markedly decreased compared to controls. Lower doses
      of 50 and 12.5 mg/kg caffeine also resulted in decreased cellular proliferation
      and transformation to cartilage histologically and reflected by significant
      inhibition of type II collagen mRNA levels (day 7). The effects of caffeine on
      gene expression observed in vivo during the period of bone formation (day 11 to
      day 15) in the DBP model were similar to the inhibited expression of H4, alkaline
      phosphatase, osteocalcin, and osteopontin found in fetal rat calvarial derived
      osteoblast cultures following 24 hour exposure of the cultures to 0.4 mM
      caffeine. Thus the observed delayed mineralization in the fetal skeleton
      associated with caffeine appears to be related to an inhibition of endochondral
      bone formation at the early stages of proliferation of undifferentiated
      mesenchymal cells to cartilage specific cells as well as at later stages of bone
      formation.

PMID- 8366136
TI  - Biosynthesis and function of membrane bound and secreted forms of recombinant
      CD11b/CD18 (Mac-1).
AB  - Full-length (membrane bound) and truncated (secreted) forms of the beta 2
      integrin heterodimer, CD11b/CD18 (Mac-1), were expressed in a human kidney cell
      line (293) that normally does not express leukocyte adhesion molecules (Leu
      CAMs). The biosynthesis of recombinant Mac-1 in 293 cells differed from that
      reported for leukocytes in that heterodimer formation was not required for CD11b
      to be exported to the cell surface. A stable cell line was constructed that
      constitutively secreted the recombinant, truncated Mac-1 heterodimer into growth
      conditioned cell culture medium. A novel monoclonal antibody that enabled an
      immunoaffinity method for the selective purification of recombinant Mac-1
      heterodimers was identified. Sufficient protein was purified to allow the first
      measurement of the 50% inhibitory concentration (IC50) for CD11b/CD18 and for the
      direct comparison of the inhibitory activity of recombinant soluble Mac-1 with
      that of various CD18 and CD11b specific monoclonal antibodies. Purified
      recombinant soluble Mac-1 inhibited the binding of neutrophils, activated by
      opsonized zymosan or fMet-Leu-Phe peptide, to human umbilical vein endothelial
      cells. Similarly, the recombinant integrin was effective in inhibiting the
      binding of unactivated neutrophils to tumor necrosis factor (TNF-alpha) activated
      endothelial cells. The availability of an abundant source of purified,
      biologically active Mac-1 will enable direct physical and chemical investigations
      into the relationship between the structure and function of this leukocyte
      adhesion molecule.

PMID- 8366137
TI  - Induction of bone-related proteins, osteocalcin and osteopontin, and their matrix
      ultrastructural localization with development of chondrocyte hypertrophy in
      vitro.
AB  - Endochondral bone formation occurs by a series of developmentally regulated
      cellular events from initial formation of cartilage tissue to stages of calcified
      cartilage, resorption, and replacement by bone tissue. Several studies have
      raised the question of the possibility that the hypertrophic chondrocytes
      associated with the calcifying cartilage matrix can acquire properties similar to
      osteoblasts. We have addressed this possibility by measuring synthesis within
      hypertrophic chondrocytes in vitro of two bone-related proteins, osteopontin and
      osteocalcin. Chondrocytes derived from chick embryo ventral vertebral tissue were
      cultured under conditions that promoted extracellular matrix mineralization and
      differentiation towards the hypertrophic phenotype as indicated by the induction
      of Type X collagen, alkaline phosphatase, and diminished expression of Type II
      collagen and the core protein of large proteoglycan. In these cultures,
      osteopontin synthesis was detected in early cultures in the absence of a
      calcified matrix; in contrast, an absence of the bone-specific protein
      osteocalcin was observed. However, with onset of development of the hypertrophic
      phenotype an induction of protein expression for osteocalcin was observed with a
      significant (twofold) increase in osteopontin. Maximal levels of osteocalcin
      synthesis occurred with the peak of alkaline phosphatase activity and Type X
      collagen mRNA levels. The levels of osteocalcin synthesis were induced fiftyfold
      from the earliest level of detection but this level was only one one-hundredth of
      that observed for mature chick osteoblast cultures. Osteocalcin and osteopontin
      were characterized by several criteria (electrophoresis, immunoblotting,
      chromatographic characteristics, and response to 1,25(OH)2D3) which confirmed
      their molecular properties as being identical to osteoblast synthesized proteins.
      The coordinate change in the cellular phenotype to the hypertrophic chondrocyte
      was shown to be concurrent with ultrastructural maturation of the cells and the
      accumulation of osteocalcin and osteopontin in the extracellular matrix
      associated with hydroxyapatite at sites of mineralization. Since the
      ultrastructural features of the cells in vitro and the extracellular matrix
      surrounding the lacunae have features of the hypertrophic chondrocyte and
      associated matrix in vivo, the induction of the bone-specific protein osteocalcin
      suggests that at least a population of these cells may develop osteoblastic
      phenotypic markers in association with mineralizing matrix. The detection of
      osteocalcin and the high level of synthesis of osteopontin may represent an
      advanced stage of chondrocyte hypertrophy or the possibility of a trans
      differentiation of the chondrocytes to an osteoblastic-like cell.

PMID- 8366138
TI  - Characterization of atrial natriuretic peptide degradation by cell-surface
      peptidase activity on endothelial cells.
AB  - Atrial natriuretic peptide (ANP) is a fluid-regulating peptide hormone that
      promotes vasorelaxation, natriuresis, and diuresis. The mechanisms for the
      release of ANP and for its clearance from the circulation play important roles in
      modulating its biological effects. Recently, we have reported that the cell
      surface of an endothelial cell line, CPA47, could degrade 125I-ANP in the
      presence of EDTA. In this study, we have characterized this degradation of 125I
      ANP. The kinetics of ANP degradation by the surface of CPA47 cells were first
      order, with a Km of 320 +/- 60 nM and Vmax of 35 +/- 14 pmol of ANP degraded/10
      min/10(5) cells at pH 7.4. ANP is degraded by the surface of CPA47 cells over a
      broad pH range from 7.0-8.5. Potato carboxypeptidase inhibitor and bestatin
      inhibited 125I-ANP degradation, suggesting that this degradative activity on the
      surface of CPA47 cells has exopeptidase characteristics. The selectivity of CPA47
      cell-surface degradation of ANP was demonstrated when 125I-ANP degradation was
      inhibited in the presence of neuropeptide Y and angiotensin I and II but not
      bradykinin, bombesin, endothelin-1, or substance P. The C-terminal amino acids
      phe26 and tyr28 were deduced to be important for ANP interaction with the cell
      surface peptidase(s) based on comparison of the IC50 of various ANP analogues and
      other natriuretic peptides for the inhibition of ANP degradation. These data
      suggest that a newly characterized divalent cation-independent exopeptidase(s)
      that selectively recognizes ANP and some other vasoactive peptides exists on the
      surface of endothelial cells.

PMID- 8366139
TI  - Evidence for calcium mediated conformational changes in calbindin-D28K (the
      vitamin D-induced calcium binding protein) interactions with chick intestinal
      brush border membrane alkaline phosphatase as studied via photoaffinity labeling
      techniques.
AB  - The role of the vitamin D-induced calcium binding protein termed calbindin-D
      (CaBP) in the biological response to 1,25-dihydroxyvitamin D3 was assessed by
      photoaffinity labeling techniques. The heterobifunctional cross-linking reagent
      methyl-4-azidobenzoimidate was employed for studies with the 28 KD chick
      intestinal calbindin-D28K. Calcium-dependent interactions were evident with
      purified chick intestinal CaBP-immunoglobulins and bovine intestinal alkaline
      phosphatase; in the absence of Ca2+ there was a greatly diminished crosslinking
      process. There were also at least two membrane components of chick intestinal
      brush border membranes, with M(R) = 60,000 and 130,000, which were photoaffinity
      cross-linked with CaBP in a calcium-dependent manner. Similar interactions were
      demonstrated following incubations of CaBP with phosphatidylinositol-specific
      phospholipase C (PI-PLC)-treated supernatant fractions from chick intestinal
      brush borders. PI-PLC was shown to release 14% of the alkaline phosphatase from
      chick intestinal brush borders compared to greater than 80% for rabbit and chick
      kidney BBM preparations. Specific interactions between CaBP and brush border
      membrane proteins could also be demonstrated in the absence of photoaffinity
      labeling by Sephadex G-150 chromatography of Triton X-100 solubilized incubations
      between calbindin-D28K and chick intestinal BBMS, with 17% of the radiolabelled
      CaBP comigrating with alkaline phosphatase activity. These studies collectively
      demonstrate that calbindin-D28K undergoes calcium-dependent conformational
      changes which alter its subsequent interactions with cellular proteins in a way
      consistent with other calcium-binding proteins such as calmodulin or troponin C.

PMID- 8366141
TI  - Centrosome reorientation in regenerating endothelial monolayers requires bFGF.
AB  - Monolayers of endothelial cells respond to physical denudation with a
      characteristic sequence of lamellipodia extrusion, cell migration, and cell
      proliferation. Basic fibroblast growth factor (bFGF) has been implicated as a
      necessary component of this process: addition of exogenous bFGF enhances
      monolayer regeneration both in vitro and in vivo, and monolayer regeneration can
      be inhibited in vitro by treatment with neutralizing antibodies raised against
      bFGF. Centrosome reorientation from a random location to one preferentially
      situated between the nucleus and the denudation edge has been postulated as a
      mechanism essential for cell polarization and subsequent migration. This present
      study examined the effects of a polyclonal antibody to bFGF and suramin on
      monolayer regeneration, actin microfilament staining, and centrosome orientation
      at the wound edge of partially denuded bovine large vessel endothelial
      monolayers. Treatment with anti-bFGF or suramin abolished monolayer repair in
      these cultures. Cells at the denudation edge showed altered actin staining
      patterns and reduced lamellipodia extrusion, and there was complete inhibition of
      centrosome reorientation in treated cultures. Monolayer repair and centrosome
      reorientation could be restored by addition of exogenous bFGF in antibody but not
      suramin treated cultures. Recent evidence suggests that preferential centrosome
      location in migrating cells may be a consequence of lamellipodia protrusion and
      cell spreading, rather than an indication of cell polarization. However, these
      results indicate that agents which interfere with bFGF availability prevent
      endothelial monolayer regeneration via mechanisms involving cell spreading and/or
      centrosome reorientation.

PMID- 8366142
TI  - Heat-induced morphological and biochemical changes in the nuclear lamina from
      Ehrlich ascites tumor cells in vivo.
AB  - Membrane-depleted nuclei from Ehrlich ascites tumor (EAT) cells isolated at low
      ionic strength in the presence of EDTA exhibit highly decondensed chromatin
      fibers and a loss of morphologically identifiable nucleoli. Treatment of these
      nuclei with nucleases and 2 M NaCl followed by low-speed centrifugation permitted
      the facile isolation of the nuclear lamina layer. Under the same conditions, but
      after heat-shock treatment of the living cells, the chromatin appears in a more
      condensed state, the nucleoli are well-defined, and the nuclear lamina layer was
      destabilized in concert with the appearance of an internal nuclear matrix and
      nucleolar skeleton. Furthermore, we also found both an increase in the protein
      mass as well as the appearance of a relatively large number of new proteins in
      this fraction, which are phosphorylated. The major proteins of the nuclear
      lamina, the lamins, and the residual vimentin remained insoluble. These heat
      shock-induced changes were also accompanied by a dephosphorylation of lamins A
      and C but not of lamin B.

PMID- 8366140
TI  - Induction of vimentin modification and vimentin-HSP72 association by
      withangulatin A in 9L rat brain tumor cells.
AB  - Withangulatin A induced cell rounding up and the morphological alteration
      resulted from the reorganization of all of the major cytoskeletal components,
      i.e., vimentin, tubulin, and actin, as revealed by immunofluorescence techniques.
      When the withangulatin A-treated cells changed to a round-up morphology, vimentin
      intermediate filaments were found to be collapsed and clustered around the
      nucleus. The alteration was accompanied by characteristic changes of vimentin
      molecules, including augmentation of phosphorylation, retardation of
      electrophoretic mobility, and decrease in detergent extractability. The levels of
      vimentin phosphorylation were augmented by 2.5- and 1.8-fold in cells incubated
      with 50 microM withangulatin A for 1 and 3 h, respectively. The electrophoretic
      mobility of vimentin was partially retarded in cells treated with withangulatin A
      for 1 h at 10 microM and a completely upshift mobility was observed after 5 h
      treatment at 50 microM. In addition, vimentin molecules became less extractable
      by nonident P-40 after the cells were treated with withangulatin A and this
      effect was dose dependent. The decrease in solubility of vimentin was accompanied
      by the redistribution of HSP72 into the detergent nonextractable fraction and
      these two events were well correlated. Our results suggest that withangulatin A
      induced the modification of vimentin, which resulted in the alteration of cell
      morphology and redistribution of intracellular HSP72, an event that may play an
      important role in the induction of heat-shock response.

PMID- 8366143
TI  - Phorbol ester activation of functional rat protein kinase C beta-1 causes
      phenotype in yeast.
AB  - The phorbol ester receptor protein kinase C (PKC) gene family encodes essential
      mediators of various eukaryotic cellular signals. The molecular dissection of its
      mechanisms of action has been limited in part by the genetic inaccessibility and
      complexity of signaling in mammalian cells. Here we present a novel approach to
      study rat PKC beta-1 action in yeast, a simple lower eukaryotic genetic model.
      Expression of its cDNA in Saccharomyces cerevisiae introduces novel phorbol ester
      binding sites which stimulate a specific calcium- and phospholipid-dependent
      catalytic activity in vitro consistent with a fully functional protein which
      phosphorylates cellular yeast proteins in vivo. Phorbol ester activation of PKC
      beta-1 in vivo results in biological responses which include stimulation of
      extracellular calcium uptake, changes in cell morphology, and an increase in the
      cell doubling time. These PKC functions are not affected by truncation of 12
      amino terminal amino acids; however, they are completely abolished by truncation
      of 15 or more carboxyl terminal amino acids which likely result in inactivation
      of the kinase. The increase in the yeast doubling time caused by PKC beta-1
      activation provides a phenotype which can be exploited as a screen for the
      activity of random PKC cDNA mutations. Our findings indicate that rat PKC beta-1
      is functional in yeast and leads to biological responses which suggest compatible
      aspects of higher and lower eukaryotic signaling pathways and the feasibility of
      dissecting parts of the action of common signaling mediators in a simple genetic
      model.

PMID- 8366144
TI  - Effect of gallium nitrate in vitro and in normal rats.
AB  - Gallium nitrate (GN) is an inhibitor of bone resorption and thereby may result in
      a change in coupled bone formation. In the present investigation the effects of
      GN on bone formation were studied in the rat osteosarcoma (ROS) 17/2.8 cell line
      and normal diploid rat osteoblasts (ROB) in vitro and the femur of rats treated
      in vivo, measuring mRNA levels for two osteoblast parameters, type I collagen, a
      marker of matrix formation, and osteocalcin, a bone specific protein and also
      histone H4, a marker of cell proliferation. GN, at 50 microM for 3 h, increased
      type I collagen mRNA levels by 132% in ROS 17/2.8 cells and by 122% in
      proliferating ROB cells. Osteocalcin (OC) mRNA levels were decreased by 61% in
      ROS 17/2.8 cells and by 97% in differentiated ROB cells. These changes occurred
      in the absence of any effects on cell proliferation. Seventy-day-old female rats
      were then treated with GN, 0.5 mg/kg/day, for 3 weeks. As previously reported, GN
      decreased serum calcium levels, but had no effect on lumbar or femoral bone
      density. In contrast to the in vitro effects, GN had no effect on type I collagen
      steady-state mRNA levels in the femur; however, it decreased OC steady-state mRNA
      levels in the femur by 58%. These results suggest that GN has similar in vitro
      effects in transformed and normal osteoblasts, while the collagen-stimulatory
      effects observed in vitro cannot be extrapolated to in vivo models. The
      consistent inhibition of osteocalcin in vitro and in vivo suggests a more
      specific target for GN that may relate to its effects in inhibiting bone
      resorption in normal rats.

PMID- 8366146
TI  - Resistance of mitochondrial DNA to degradation characterizes the apoptotic but
      not the necrotic mode of human leukemia cell death.
AB  - Cell death can occur by two basically different processes. The original term,
      necrosis, is now reserved for the generally destructive series of events which
      include the release of lysosomal enzymes and loss of cell membrane integrity. In
      contrast, mild treatment with cell damaging agents, or withdrawal of growth
      factors, may result in a characteristic form of degradation of cellular DNA which
      is associated with cell death that has morphology known as apoptosis. In this
      study human leukemia cells were exposed to agents or conditions previously
      reported to cause necrosis or apoptosis, monitored by detection of DNA "ladders,"
      and the integrity of cellular DNA was determined on Southern blots. Nuclear DNA
      was distinguished from mitochondrial DNA by use of probes specific for nuclear
      genes or for mitochondrial DNA. When HL60, K562, MOLT4, or U937 cells were
      exposed to conditions which resulted in necrosis, mitochondrial DNA was damaged
      at approximately the same rate as nuclear DNA, but in apoptosis mtDNA was not
      degraded. Thus, the ratio of the relative (to untreated cells) abundance of
      mitochondrial DNA measured by a probe for 16S mitochondrial ribosomal RNA on
      Southern blots, to the relative abundance of DNA of any nuclear gene, was 1 or
      less in necrosis, but rose to values greater than 2 in apoptosis. It is concluded
      that the comparison of the degree of fragmentation of mitochondrial and nuclear
      DNA provides a quantitative way of distinguishing necrosis from apoptosis.

PMID- 8366145
TI  - Novel phorbol ester response region in the collagenase promoter binds Fos and
      Jun.
AB  - In rabbit fibroblasts the AP-1 sequence (5'-ATGAGTCAC-3') is necessary but not
      sufficient for induction of collagenase transcription by phorbol esters (PMA)
      (Auble and Brinckerhoff: Biochemistry 30(18):4629-4635, 1991). In this study we
      identified additional sequences involved in PMA-induced transcription. Using
      fibroblasts transiently transfected with chimeric constructs containing fragments
      of the rabbit collagenase 5'-flanking DNA linked to the chloramphenicol acetyl
      transferase (CAT) gene, we found that deletion of nucleotides -182 to -141 in a
      380 bp promoter construct resulted in about a 7-fold loss of induction by PMA.
      Mobility shift assays revealed that nuclear proteins from fibroblasts
      specifically bound to 20-bp at -182 to -161. Binding was competed completely by
      self and only partially by the AP-1 sequence, implying that proteins binding to
      the AP-1 sequence could also bind to this region. In vitro transcribed and
      translated c-Fos and c-Jun bound to both the AP-1 site and to the sequences from 
      182 to -141. DNAase I footprinting of the collagenase promoter with purified c
      Jun or c-Fos/c-Jun protected the AP-1 sequence at -77 to -69 in addition to a
      region from -189 to -178 which overlaps a putative AP-1-like site, 5'-ATTAATCAT
      3'. Finally, deletion of the -182 to -161 region in a 380-bp CAT construct
      resulted in a substantial reduction of PMA responsiveness. Thus, we have
      identified a novel phorbol-responsive region that binds c-Fos and c-Jun, and we
      suggest that these or similar proteins may regulate transcription of the
      collagenase gene by binding to sequences within and adjacent to the -182 to -161
      region.

PMID- 8366147
TI  - Chem-X and CAMBRIDGE. Comparison of computer generated chemical structures with X
      ray crystallographic data.
AB  - The structures of a number of molecules as determined by X-ray crystallography
      have been compared with the structures for the same molecules as calculated by
      the 3D structure generation program, Chem-X. In the group of molecules examined,
      ChemModel produced structures that were essentially identical to those based upon
      X-ray data in 57% of the cases. The corresponding figure for the widely used
      alternative model builder, CONCORD, was 38%. The superior performance of
      ChemModel was due entirely to that program's ability to generate multiple
      structures covering the entire conformational space.

PMID- 8366148
TI  - Hospital-acquired tuberculosis: addressing the challenge.
AB  - Treating contagious patients as outpatients is, of course, the best way to
      prevent nosocomial transmission. When hospitalized, they should be confined to
      areas with specified ventilation systems. Guidelines for monitoring exposed
      persons are presented. Immune status and drug-resistant organisms are prime
      considerations in managing both the exposed and those with active TB.

PMID- 8366149
TI  - Back to the Old Soldiers' Home?

PMID- 8366150
TI  - Heart failure: its progression and its therapy.
AB  - The complex pathology that leads to heart failure has hampered the search for
      optimal therapy. Even so, ACE inhibitors have become a cornerstone of treatment.
      After an acute MI, the goal of ACE inhibition is to limit LV remodeling and
      progression to ischemic cardiomyopathy and congestive failure. In advanced
      failure, the goal is to reverse peripheral vascular changes and ameliorate
      symptoms.

PMID- 8366151
TI  - A man who drank a breathtaking bottle of wine.

PMID- 8366152
TI  - Recurrent pulmonary infection in an infant.

PMID- 8366153
TI  - Fainting spells.

PMID- 8366154
TI  - Financial recognition.

PMID- 8366155
TI  - CEO,OOO,OOO. Oh! Oh!

PMID- 8366156
TI  - Wide QRS complexes in acute myocardial infarction.

PMID- 8366157
TI  - Aggressive drug therapy for rheumatoid arthritis.
AB  - Recent data indicate that rheumatoid arthritis is more often systemic,
      progressive, and disabling than benign, and that it reduces life expectancy. The
      new evidence argues for a dramatic alteration in pharmacologic management. If
      several months of rest, exercise, and anti-inflammatory therapy are ineffectual,
      aggressive treatment with disease-modifying antirheumatic and immunosuppressive
      agents may be in order.

PMID- 8366158
TI  - Isolated systolic hypertension in the elderly.

PMID- 8366159
TI  - Bites from pet animals.

PMID- 8366160
TI  - Enantiomeric separation of fluorescent, 6-aminoquinolyl-N-hydroxysuccinimidyl
      carbamate, tagged amino acids.
AB  - A new derivatizing reagent, 6-aminoquinolyl-N-hydroxysuccinimidyl carbamate
      (AQC), has been used successfully for chromatographic enantioseparation of 31
      amino acids on cyclodextrin bonded stationary phases. AQC reacts with both
      primary and secondary amino acids to produce stable and highly fluorescent
      derivatives suitable for efficient and sensitive chromatographic determinations.
      The derivatization reaction proceeds without detectable racemization. The
      detection limit is in the femtomole range and approximately 0.0075% of the D
      enantiomer in an excess of the L-enantiomer is detectable. High resolution values
      are needed when determining trace enantiomeric impurities.

PMID- 8366161
TI  - Comparison of flame ionization and inductively coupled plasma mass spectrometry
      for the detection of organometallics separated by capillary supercritical fluid
      chromatography.
AB  - Organotin compounds are separated by capillary supercritical fluid chromatography
      (SFC) and a comparison of the detection by flame ionization (FID) and inductively
      coupled plasma mass spectrometry (ICP-MS) is presented. Resolution, detection
      limits, linear dynamic range and reproducibility are the parameters compared
      between SFC-FID and SFC-ICP-MS, for the detection of tri- and tetraorganotin
      compounds. The resolution obtained in the SFC-FID system is not always observed
      in SFC-ICP-MS. Degradation in resolution is due to fluctuations in transfer line
      temperature. Baseline resolution for the organotins considered is achieved in
      both systems by using a longer column. Detection limits (DLs) are calculated as 3
      sigma/S, where sigma is the standard deviation of the blank signal and S is the
      slope of the calibration curve. Detection limits of 10.3, 12.5, 12.0 and 9.0 pg
      are obtained for tetrabutyltin, tributyltin chloride, triphenyltin chloride and
      tetraphenyltin, respectively, using SFC-FID. An improvement in detection limits
      of one order of magnitude is achieved by SFC-ICP-MS for the same organotins
      (0.26, 0.80, 0.57 and 0.20 pg, respectively). The relative standard deviations
      using SFC-FID for five 50-nl injections, containing 0.5 ng Sn, ranged from 3.2 to
      6.4%. Using SFC-ICP-MS, five replicate injections of 0.05 ng Sn give R.S.D.s from
      1.3 to 3.4%.

PMID- 8366162
TI  - 4-(Trifluoromethyl)-2,3,5,6-tetrafluorobenzyl bromide as a new electrophoric
      derivatizing reagent.
AB  - 4-(Trifluoromethyl)-2,3,5,6-tetrafluorobenzyl bromide (TTBB) was synthesized in a
      single step from alpha,alpha,alpha,2,3,5,6-heptafluoro-p-xylene. The purpose of
      TTBB is to function as an analogue of pentafluorobenzyl bromide (PFBB) in
      electrophoric derivatization reactions prior to detection by gas chromatography
      electron-capture negative ion mass spectrometry (GC-ECNI-MS). In more detail, it
      was anticipated that TTBB could be used along with, or as a substitute for, PFBB
      to help control some interferences and confirm results. This is because a TTBB
      product (of an analyte) would have different retention and sometimes m/z
      characteristics than a corresponding PFBB product in GC-ECNI-MS, while the two
      products should be similar in their ease of formation and yields. Results
      demonstrating these expectations were achieved by derivatizing and detecting two
      analytes with these reagents: N7-(2-hydroxyethyl)xanthine, and 2,3
      pyrenedicarboxylic acid.

PMID- 8366163
TI  - Solid-phase extraction in multi-residue pesticide analysis of water.
AB  - The determination of pesticides in water is fundamental to the solution of
      environmental problems as natural waters are usually contaminated with a large
      number of pesticides. The selection of an isolation and/or concentration
      technique depends largely on the class of pesticides to be determined. It is
      often necessary to determine simultaneously a wide variety of compounds in a
      water sample. Application of solid-phase extraction techniques offers a solution.
      The mechanisms of solid-phase extraction, types of sorbents and their application
      to multi-residue pesticide analysis are reviewed.

PMID- 8366164
TI  - Re-evaluation of solid-phase adsorption and desorption techniques for isolation
      of trace organic pollutants from chlorinated water.
AB  - Amberlite XAD resin and activated carbon columns were tested for their abilities
      to concentrate trace organic pollutants in chlorinated water. Both XAD-2 and XAD
      7 resin columns (20 ml) were capable of adsorbing about 30% of total organic
      halogen (TOX) present in 20 l of drinking water (pH 7) containing about 100
      micrograms/l of TOX, whereas the carbon column (10 ml) adsorbed over 90% of TOX.
      The adsorption capacity of XAD-7 resin was found to be strongly dependent on the
      solution pH, as compared with those of XAD-2 and carbon adsorbents. Soxhlet and
      sonication extractions were also evaluated for their abilities to recover the
      adsorbed organics from the adsorbents, by measurements of TOX, chromatographable
      compounds and mutagenicity in the eluates. Soxhlet extraction gave higher
      recoveries than sonication, as measured with the above indices, but these
      differences were generally small (ca. 20%), with exception of the carbon
      extracts. The XAD-2 and XAD-7 extracts of drinking water also showed about 3-4
      times higher mutagenic activity than the carbon extracts.

PMID- 8366165
TI  - Evaluation of a solid-phase extraction system for determining pesticide residues
      in milk.
AB  - A simple and rapid procedure based on reversed solid-phase extraction with
      octadecylsilica was developed for determining chlorinated pesticide residues in
      milk. The need for an agent that breaks the fat globules was first investigated
      and the method variables were optimized on whole homogenized milk (3.6% fat
      content). Recovery experiments performed for 26 organochlorine pesticides at
      levels of 3-40 micrograms/l gave > 80% recoveries for all the compounds. The
      method was validated and evaluated by comparison with two widely used liquid
      liquid extraction methods. The performance was checked by analysis of a certified
      standard with natural low endogenous levels (CMR 187) and different kinds of milk
      (skimmed, 2%, powdered, evaporated and condensed) spiked with the 26 pesticides.
      The procedure was used to analyse 45 commercial milks in which the presence of
      organochlorine residues had been detected. The proposed method offers advantages
      such as low cost and simplicity and the fact that the extracts obtained do not
      require a purification step.

PMID- 8366166
TI  - Chemiluminescent detection of potato and pome fruit viroids by digoxigenin
      labeled dot blot and tissue blot hybridization.
AB  - A chemiluminescent molecular hybridization protocol was compared to 32P
      autoradiography for detecting potato spindle tuber viroid (PSTVd) and apple scar
      skin group viroids (ASSVd). Labeled cRNA probes for PSTVd and ASSVd were
      synthesized by SP6 RNA polymerase transcription using digoxigenin-11-UTP or alpha
      [32P]UTP. Dot blot hybridization of purified viroids and sap extracts from
      infected plants showed that chemiluminescent detection using digoxigenin-labeled
      probes was as sensitive as autoradiography using 32P probes. A minimum of 2.0-2.5
      pg purified viroid was detected. ASSVd could be detected in as little as 0.4 ng
      of total nucleic acid extract from infected tissue or in sap extracts diluted to
      10(-3) with healthy extracts. Tissue blots of PSTVd-infected potato tubers and
      tomato roots, stems and leaves and ASSVd-infected apple fruit, stems and
      petioles, gave positive reactions when hybridized with the digoxigenin probe. No
      reaction with similar tissues from healthy plants was observed.

PMID- 8366167
TI  - Expression in baculovirus vector system of the nucleocapsid protein gene of
      rinderpest virus.
AB  - The rinderpest (RV) nucleocapsid (NP) gene segment was inserted into the genome
      of Autographa californica nuclear polyhedrosis virus (AcNPV) adjacent to the
      polyhedrin promoter. The expression of NP protein in Sf9 cells was confirmed by
      indirect immunofluorescence and by Western blotting analysis with monoclonal
      antibodies. Recombinant RV-NP protein was purified by ultracentrifugation on a
      sucrose density gradient, and used as an antigen for an enzyme linked
      immunosorbent assay to detect anti RV-NP antibody. Both IgM and IgG antibodies
      against RV-NP were detected in the sera of rabbits infected with the L strain of
      RV. The pattern of development of IgG anti RV-NP antibody closely correlated with
      that of virus neutralizing antibody. In rabbits inoculated with recombinant
      vaccinia virus expressing RV-H gene (RRV-H), anti RV-NP was not detected. The
      results indicated that the baculovirus vector system can be used for the
      preparation of the diagnostic antigen of rinderpest as well as to distinguish
      between natural infection and vaccination with RRV-H.

PMID- 8366168
TI  - Quantification of HIV-1 RNA in plasma using NASBA during HIV-1 primary infection.
AB  - Quantification of HIV-1 viral RNA in plasma was achieved by competitive co
      amplification of a dilution series of in vitro generated RNA using the nucleic
      acid sequence based amplification (NASBA) technology. This 1.5 kilobase in vitro
      RNA, comprising the gag and part of the pol region, differs only by sequence
      randomization of a 20 nt fragment from the wild-type RNA, ensuring equal
      efficiency of amplification. In model systems the accuracy of this method is
      within one log. Application of the Q-NASBA to plasma samples of a patient with a
      primary HIV-1 infection shows good concordance of the HIV-1 RNA profile with the
      p24 antigen profile. However, the HIV-1 RNA determination is more sensitive than
      the p24 antigen determination. Peak values of HIV-1 RNA are around 10(8) RNA
      molecules per ml plasma at the moment of seroconversion. Quantitative nucleic
      acid detection methods, like Q-NASBA, allow the monitoring of HIV-1 RNA during
      the course of infection which might have predictive value for disease
      development.

PMID- 8366169
TI  - Epizootic haematopoietic necrosis virus (EHNV): improved ELISA for detection in
      fish tissues and cell cultures and an efficient method for release of antigen
      from tissues.
AB  - An improved antigen capture ELISA for the detection of epizootic haematopoietic
      necrosis virus (EHNV) is described. Affinity purified rabbit anti-EHNV
      immunoglobulin was used as capture antibody, enabling the detection of EHNV at a
      concentration of 10(3.5) TCID50/ml cell culture supernatant. The sensitivity and
      specificity of the ELISA, determined by examination of clarified tissue
      homogenates from 55 infected fish and 348 uninfected fish in relation to virus
      isolation, were 81.2% and 98.9%, respectively. Specificity for redfin perch
      (Perca fluviatilis) tissue samples was 100%, however, high background optical
      density (OD) in samples from uninfected rainbow trout (Oncorhynchus [corrected]
      mykiss) resulted in lower specificity (98.5%). Specificity for rainbow trout
      tissues was increased to 100% by testing clarified tissue homogenates that had
      been diluted 1:10. Sensitivity and specificity estimates for cell culture
      supernatants were 96.2% and 99.9% based on the results obtained for 158 infected
      and 355 uninfected samples. Incubation steps in the ELISA can be shortened to
      enable its completion in less than 4 h if a rapid qualitative diagnosis is
      required. Of eight methods of releasing EHNV from infected tissue that were
      evaluated, manual grinding of tissue with a fitted pestle in a 1.5-ml plastic
      disposable tube, followed by vortexing in the same tube with 3 mm diameter glass
      beads and clarification in a microcentrifuge was the most efficient. Samples from
      150-200 individual fish could be prepared for ELISA and cell culture by a single
      operator in a day. Antigen capture ELISA can replace virus isolation as the
      method of choice for diagnosis of EHNV.

PMID- 8366170
TI  - Quantitative and sensitive detection of immune-complexed and free HIV antigen
      after boiling of serum.
AB  - 5-min boiling of 3-fold diluted serum leads to the quantitative release of immune
      complexed HIV antigen (Ag) that can be readily measured. The method is capable of
      detecting as little as 4 to 5 pg/ml Ag p24 depending on the Ag test used. Of a
      panel of 50 anti-HIV-positive sera, 30 (60%) were Ag-positive after heat
      denaturation, 17 (34%; P < or = 0.01) after acidification, and 13 (26%; P < or =
      0.001) when tested undenatured. The superiority of heat denaturation was greatest
      in sera with high-titered antibodies to p24. Occurrence and mean concentrations
      of heat-denatured Ag were reversely correlated with p24-specific antibody. It is
      suggested that heat-denatured proteins be used for raising antibodies that will
      serve as capture or trace antibodies in Ag assays. This simple change in the
      manufacturing of test reagents in combination with a short boil before testing
      may solve the problem of incomplete Ag detection due to immune complex formation.

PMID- 8366171
TI  - Evaluation of 3 nonradioactive DNA detection systems for identification of herpes
      simplex DNA amplified from cerebrospinal fluid.
AB  - The efficiencies of 4 different hybridization assays, using probes labeled with
      32P, digoxigenin (DIG) and biotin, were compared for the detection of herpes
      simplex virus (HSV) DNA amplified from cerebrospinal fluid during herpes simplex
      encephalitis (HSE). The biotinylated probe was shown to provide a clearly lower
      sensitivity than the radioactive hybridization system, regardless of whether the
      biotin-labeled probe was detected by a colorimetric or by a photobiotin assay. In
      contrast, the DIG system, which includes a luminescent detection step was shown
      to be equivalent to the 32P system, at least at lower template concentrations.
      Although generally higher background signals were observed with the DIG assay the
      analysis of 73 CSF samples yielded identical results with the 32P and the DIG
      test systems in all cases, identifying concordantly an HSE in 6 patients. Since
      the time necessary for the performance of both assays is similar the DIG system
      seems to be a powerful alternative to the radioactive detection of amplified HSV
      DNA.

PMID- 8366173
TI  - 9th Annual meeting of the European Society of Human Reproduction and Embryology.
      Thessaloniki, Greece, 27-30 June 1993. Abstracts.

PMID- 8366172
TI  - A polymerase chain reaction method adapted for selective amplification and
      cloning of 3' sequences of potyviral genomes: application to dasheen mosaic
      virus.

PMID- 8366174
TI  - What is nitric oxide and why are so many people studying it?
AB  - From social outcast to citizen of the year in less than a decade is the stuff of
      fiction. That is precisely what has happened, however, to a remarkably simple
      molecule, nitric oxide. Nitric oxide is still an environmental pollutant,
      suspected carcinogen, and precursor of acid rain, but biologists are looking past
      its dark side. They now see a molecule that is uniting neuroscience, physiology,
      and immunology. Its ubiquitous distribution in the body and its multifaceted
      roles are revising our understanding of how cells communicate and protect
      themselves. This report examines nitric oxide's role in physiology and
      pathophysiology and reviews novel therapeutic approaches which involve inhibition
      or induction of the activity of endogenous nitric oxide.

PMID- 8366175
TI  - Sotalol: a novel beta-blocker with class III anti-arrhythmic activity.
AB  - Initially synthesized in 1960, sotalol is a novel beta-adrenoreceptor blocking
      agent that also possesses class III anti-arrhythmic properties. The drug's
      ability to lengthen repolarization and prolong effective refractory periods in
      all cardiac tissues in addition to its beta-blocking effects make sotalol an
      attractive agent for use in a variety of supraventricular and ventricular
      arrhythmias.

PMID- 8366176
TI  - Pharmacokinetics of cyclosporine and steady-state aspirin during
      coadministration.
AB  - Anecdotal reports from clinical trials assessing the use of cyclosporine in the
      treatment of rheumatoid arthritis suggest an association between enhanced renal
      impairment and combined use of cyclosporine with nonsteroidal anti-inflammatory
      drugs. To explore possible pharmacokinetic contributions to this phenomenon, a
      randomized, two-period crossover investigation was performed in 24 healthy
      volunteers in which a single oral dose of 300 mg cyclosporine was administered
      alone and on day 10 of multiple oral dosing of aspirin 960 mg three times daily.
      Serial blood samples were obtained over 48 hours after each cyclosporine dose and
      over a steady-state dosing interval for aspirin on day 9 (aspirin alone) and day
      10 (coadministration of cyclosporine and aspirin). Cyclosporine whole blood
      concentrations were determined by a specific monoclonal radioimmunoassay and
      plasma concentrations of acetylsalicylic acid and metabolites by high-performance
      liquid chromatography. Lack of a pharmacokinetic interaction was conclusively
      demonstrated for the rate and extent of cyclosporine and acetylsalicylic acid
      absorption and for the rate and extent of salicylic acid formation after a single
      dose of cyclosporine was coadministered during steady-state aspirin dosing. If a
      clear association between enhanced renal impairment and the combined use of
      cyclosporine and aspirin is substantiated, the underlying mechanism appears to be
      pharmacodynamic rather than pharmacokinetic.

PMID- 8366177
TI  - Pharmacokinetics of azathioprine after repeated oral and single intravenous
      administration.
AB  - The pharmacokinetics of azathioprine (AZN) were examined in 28 renal transplant
      patients treated orally with 25 to 150 mg AZN once daily in combination with
      cyclosporin A and prednisone, and after single intravenous (IV) injection of 5
      mg/kg AZN using the rabbit as an in vivo model. The steady-state concentrations
      of AZN observed in these patients ranged from 6 to 583 micrograms/L, and the
      interday coefficients of variation of the concentration in three randomly
      selected patients were 38%, 12%, and 4.6%. The frequency distribution pattern of
      the apparent oral clearance (TCLor) of AZN separates the patients almost equally
      into poor (TCLor = 0.126 to 4 L/hour.kg) and extensive metabolizers (TCLor = 5 to
      12 L/hour.kg). The data obtained from the IV administration displayed the two
      compartment model characteristics with mean (standard error of the mean) of
      alpha, beta, Vc, and total body clearance of 15.3 (2)/hour, 2.38 (.64)/hour, 1.05
      (.3) L/kg, and 8.12 (1.26) L/hour.kg, respectively. The large variability in the
      pharmacokinetic parameters of AZN in patients and even in rabbits under carefully
      controlled conditions that may be ascribed to the complexity of its metabolism
      necessitates a careful approach to its dose selection.

PMID- 8366178
TI  - Pharmacokinetics and dialyzability of sulindac and metabolites in patients with
      end-stage renal failure.
AB  - Sulindac was administered as a single 300-mg oral dose to six patients with end
      stage renal failure and six normal subjects. Plasma concentrations of sulindac
      and its sulfide and sulfone metabolites were examined over a 48-hour period. As
      determined by ultrafiltration methods at 37 degrees C, the percentage free of
      sulindac and sulindac sulfide in plasma was greater, respectively, in the
      patients with renal failure (10.50 +/- 2.42 and 9.96 +/- 1.21) than in the normal
      subjects (6.78 +/- 0.45 and 6.01 +/- 0.37). Free sulindac plasma concentrations
      were not different between the two groups. However, sulindac sulfide, total and
      free, plasma concentrations were substantially decreased in the group with renal
      failure. Total area under the curve (AUC) of the sulfide metabolite was 18% in
      the normal subjects and the free AUC was 29%. In patients with renal failure, the
      apparent half-lives of sulindac (1.98 +/- 0.76 hours) and sulindac sulfide (15.6
      +/- 5.8 hours) were not different from those of normal subjects. Sulindac sulfone
      half-life was highly variable and longer in the patient group. Studies of
      dialysis clearance showed that sulindac and its metabolites are poorly dialyzed.
      A 4-hour dialysis period increased the plasma binding of both sulindac and
      sulindac sulfide in the patient group. Based on the decreased plasma
      concentration of the active sulindac sulfide metabolite in the patient group,
      dosage adjustments may be required in patients with end-stage renal failure.

PMID- 8366179
TI  - Echocardiograms during six hours of bedrest at head-down and head-up tilt and
      during space flight.
AB  - Left ventricular end-diastolic volume increased after 4 1/2 to 6 hours of space
      flight, but was significantly decreased after 5 to 6 days of space flight. To
      determine the role of acute gravitational effects in this phenomenon, responses
      to a 6-hour bedrest model of 0 gravity (G; 5 degrees head-down tilt) were
      compared with those of fractional gravity loads of 1/6 G, 1/3 G, and 2/3 G by
      using head-up tilts of 10 degrees, 20 degrees, and 42 degrees, respectively. On 4
      different days, six healthy male subjects were tilted at one of the four angles
      for 6 hours. Cardiac dimensions and volumes were determined from two-dimensional
      and M-mode echocardiograms in the left lateral decubitus position at control (0),
      2, 4, and 6 hours. Stroke volume decreased with time (P < .05) for all tilt
      angles when compared with control. Ejection fraction (EF) at -5 degrees was
      greater than at +20 degrees and +42 degrees (not significant); EF at +10 degrees
      was greater than at +42 degrees (not significant). For the tilt angles of -5
      degrees, +10 degrees, and +20 degrees, mean heart rate decreased during the first
      2 hours, and returned to control or was slightly elevated above control (+20
      degrees) by 6 hours (not significant). At the +42 degrees angle of tilt, heart
      rate was increased above control at hours 2, 4, and 6. There were no significant
      differences in cardiac output at any time point for any tilt angle.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8366180
TI  - Contrasting effects of pyrazinoylguanidine and hydrochlorothiazide in patients
      with renal insufficiency.
AB  - A single blind crossover study with washout phases showed that
      pyrazinoylguanidine (PZG) reduced elevated serum concentrations of urea,
      triglycerides, and cholesterol in patients with renal insufficiency.
      Pyrazinoylguanidine was saluretic, without affecting serum potassium or glucose
      concentrations. The onset of PZG's antihypertensive effect occurred within 4
      hours. In contrast, hydrochlorothiazide (HCTZ) increased serum concentrations of
      urea, triglycerides, and glucose, without affecting cholesterol.

PMID- 8366181
TI  - Determination of gentamicin pharmacokinetics by bioelectrical impedance in
      critically ill adults.
AB  - This investigation compares the accuracy of calculating gentamicin
      pharmacokinetic parameters by a noninvasive body composition technique
      (bioelectrical impedance analysis; BIA) with an empiric method, against the two
      point method as the criterion standard. A prospective concurrent open label
      design was used. The 32 medical and surgical intensive care unit beds at Henry
      Ford Hospital, a not-for-profit, university-affiliated teaching hospital, served
      as the setting. Twenty critical ill adults, Therapeutic Index Scoring System
      (TISS) = 4, who required gentamicin as part of their normal course of therapy for
      gram-negative bacillary infections, were evaluated. Gentamicin Vd and k were
      calculated by three methods. After measurement of body composition parameters by
      BIA, previously derived gentamicin dosing equations were used to predict
      gentamicin volume of distribution (Vd) and elimination rate constant (k) (BIA
      method). Empiric estimates of these parameters (Vd = 0.3L/kg and k derived from
      creatinine clearance) were compared with the BIA parameters against a criterion
      standard Vd and k determined from a two-point sampling of gentamicin serum
      concentrations. Measurements of BIA parameters and gentamicin serum
      concentrations were made in duplicate with coefficients of variation, < or = 2%
      and < or = 3%, respectively. The BIA and empiric methods produced resultant
      pharmacokinetic parameters (Vd and k) not different than those measured by the
      two-point method. There were no statistically significant differences in mean
      error (bias), or mean squared error (precision) for both Vd and k assessed by the
      empiric or BIA methods.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366182
TI  - Effect of time of food administration on the bioavailability of didanosine from a
      chewable tablet formulation.
AB  - The effect of the time of food administration on the bioavailability of
      didanosine, administered as a 300-mg dose of a chewable tablet formulation, was
      evaluated in 10 men seropositive for the human immunodeficiency virus (HIV), but
      free of any symptoms of acquired immune deficiency syndrome (AIDS). Using an
      open, randomized, balanced, incomplete block crossover study design, each patient
      received the dose of didanosine under four of the five following conditions: (1)
      after an overnight fast, (2) 30 minutes before a meal, (3) 1 hour before a meal,
      (4) 1 hour after a meal, or (5) 2 hours after a meal. The meal consisted of a
      standard high-fat, high-calorie breakfast, consumed over a 15-minute period.
      Serial blood samples and the total urinary output were collected over a 12-hour
      interval after each dose for analysis using validated high-pressure liquid
      chromatography (HPLC)/ultraviolet (UV) methods. Concentration data were used to
      calculate pharmacokinetic parameters using noncompartmental methods. There were
      no significant differences among the fasting, 30-minute before, and 1-hour before
      the meal treatments with respect to maximum peak plasma concentration (Cmax),
      area under the curve (AUC(0-infinity)), or urinary recovery (%UR). Values for
      Cmax, AUC(0-infinity), and %UR observed for the 1 and 2 hours after the meal
      treatments were significantly less than those obtained under either fasting
      conditions or before the meal. There were no significant differences among any of
      the treatments with respect to time to reach peak concentration (tmax), half-life
      (t1/2), or renal clearance (CLR).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366183
TI  - Effects of one year of treatment with pravastatin, an HMG-CoA reductase
      inhibitor, on lipoprotein a.
AB  - Lipoprotein a [Lp(a)] has emerged as a critical factor in the assessment of
      cardiovascular risk. In the study reported here, Lp(a) concentrations were
      monitored in patients taking pravastatin, a new hydrophilic, HMG-CoA reductase
      inhibitor. A cohort of patients with frozen plasma aliquots at baseline, week 12
      of the double-blind therapy, and week 48 of open-label therapy (1 years'
      treatment) was selected from 306 participants in a phase 2 dose-ranging study of
      pravastatin. The 125 men and women in the cohort had mean low-density lipoprotein
      cholesterol (LDL-C) concentrations of at least 150 mg/dL (3.88 mmol/L), and mean
      plasma triglyceride concentrations less than 250 mg/dL (2.82 mmol/L) during the
      baseline diet phase. During the double-blind phase, 46 patients received placebo,
      and 79 received pravastatin 10, 20, or 40 mg daily. Only the 79 pravastatin
      treated patients in the cohort continued in the 48-week open-label study of
      pravastatin. During the double-blind phase, Lp(a) decreased 4.6% in patients
      taking placebo, and 0.4% in patients taking pravastatin. Net change was not
      significant. At week 48, in the patients taking pravastatin, Lp(a) had increased
      2.4%, a difference that again was not statistically significant. Low-density
      lipoprotein cholesterol (-33.6%), total cholesterol (-25.6%), triglycerides (
      19.9%), high-density lipoprotein cholesterol (HDL-C) (+7.0%), apolipoprotein A-I
      (+13.3%), and apolipoprotein B (-33.0%) changed significantly (P < .01). Among 19
      patients with baseline Lp(a) levels greater than 30 mg/dL, Lp(a) decreased
      insignificantly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366185
TI  - New FDA initiatives.

PMID- 8366184
TI  - Lovastatin does not affect oral glucose tolerance in hypercholesterolemic
      patients.
AB  - In 15 non-diabetic Type II hypercholesterolemic patients, the effect of 80 mg
      lovastatin daily on oral glucose tolerance was investigated. Using a randomized,
      double-blind, two-panel, parallel design, patients on a low cholesterol diet
      received lovastatin (n = 7) or placebo (n = 8) for 6 weeks. After 6 weeks of
      treatment, patients receiving lovastatin had a significant reduction in total
      cholesterol (30%), LDL-cholesterol (36%), and triglycerides (26%). Time courses
      of plasma glucose and serum insulin changes from baseline after the oral glucose
      tolerance test were evaluated by AUC. No statistically significant differences
      were observed in the AUC of changes from baseline between treatment groups or
      within either treatment group at prestudy, 6 weeks, and poststudy. No patient had
      a clinically important laboratory or clinical drug-related adverse effect during
      the study. This study demonstrated that short-term administration of 80 mg
      lovastatin daily effectively lowers cholesterol without having adverse effects on
      oral glucose tolerance.

PMID- 8366186
TI  - A new extended-release formulation of diltiazem HCl for the treatment of mild-to
      moderate hypertension.
AB  - Calcium-channel blockers are a safe and effective treatment modality and have
      been used extensively in the treatment of angina and hypertension. Dilacor XR
      capsules, a new extended-release formulation of diltiazem, has been developed for
      the treatment of hypertension. Dilacor XR (Rhone-Poulenc Rorer Pharmaceuticals
      Inc., Collegeville, PA) uses a novel drug delivery system, the Geomatrix (JAGO
      Research AG, Zollikon, Switzerland) controlled-release system, to deliver
      diltiazem at a constant rate for 24 hours. The rate of absorption is also slower.
      As doses of Dilacor XR were increased from 120 mg to 540 mg/day, there were
      disproportionate increases observed in area under the curve, maximum peak plasma
      concentration, minimum peak plasma concentration, and average peak plasma
      concentration. The efficacy data from two clinical trials have confirmed the
      established efficacy of diltiazem and the 24-hour efficacy of Dilacor XR in the
      control of mild-to-moderate hypertension. The incidence of adverse effects with
      Dilacor XR in doses as high as 540 mg/day was generally comparable to that of
      placebo. This new extended-release formulation of diltiazem should significantly
      facilitate blood pressure control because of better patient compliance with a
      once daily regimen.

PMID- 8366187
TI  - Efficacy of class 1C antiarrhythmic agents in patients with inducible ventricular
      tachycardia refractory to therapy with class 1A antiarrhythmic drugs.
AB  - The efficacy of class 1C antiarrhythmic agents was determined in 36 patients with
      inducible sustained monomorphic ventricular tachycardia during baseline
      electrophysiology study (EPS), who continued to have inducible monomorphic
      ventricular tachycardia during EPS on class 1A antiarrhythmic therapy. Of 12
      patients who partially responded to class 1A drugs, 11 (91.7%) continued to have
      a partial response during EPS on class 1C therapy, whereas one patient did not
      respond. Of 24 nonresponders to class 1A therapy, 2 (8.3%) responded during EPS
      on class 1C therapy, 7 (29.2%) partially responded, and 15 (62.5%) did not
      respond. In the 24 nonresponders to class 1A therapy, 9 of 17 patients (53%) with
      left ventricular ejection fraction (EF) > or = 30% responded or partially
      responded to class 1C therapy, compared with none of 7 patients with EF < 30% (P
      < .05). The EPS on class 1C agents in patients who fail to respond to class 1A
      therapy may be warranted only in those with EF > or = 30%.

PMID- 8366188
TI  - Pharmacodynamics and dose-response relationship of famotidine: a double-blind
      randomized placebo-controlled trial.
AB  - The dose-response relationship of oral famotidine at doses up to 10 mg was
      evaluated in 10 healthy male subjects to assess the extent and duration of
      inhibition of meal-stimulated intragastric acid secretion. Each subject received
      single oral administrations of famotidine 0.5, 2.5, 5.0, and 10.0 mg and placebo
      in a double-blind, randomized, cross-over fashion. Intragastric pH was measured
      every 4 seconds for 24 hours and expressed as the mean pH for each 10-minute
      interval. Standard high-protein meals were provided 1 hour before each dose of
      study drug and at 3 and 9 hours postdose. The mean intragastric pH was
      significantly higher after famotidine doses 2.5, 5.0, and 10.0 mg than after
      placebo at times 2.5 to 3.0, 1.8 to 3.2, and 1.7 to 4.2 hours postdose,
      respectively. There were no significant differences in mean pH seen between
      famotidine 0.5 mg versus placebo. The range of the pH means between 1.7 and 3.2
      hours postdose was placebo (1.0 to 1.3), famotidine 0.5 mg (1.1 to 1.4), 2.5 mg
      (1.4 to 1.7), 5.0 mg (1.7 to 2.1), and 10.0 mg (2.0 to 2.3). There was a
      statistically significant linear dose-response relationship between famotidine
      dose and intragastric pH between 1.7 and 3.8 hours and from 6.3 to 8.7 hours
      after ingestion.

PMID- 8366189
TI  - Nicotine pharmacokinetics of Nicoderm (nicotine transdermal system) in women and
      obese men compared with normal-sized men.
AB  - This study examined the effect of gender and body weight on the pharmacokinetic
      properties of the Nicotine Transdermal System (NTS) (Nicoderm). This NTS was
      applied for 24 hours to 13 normal-sized men, 13 women, and 13 obese men, all of
      whom were smokers who had abstained from cigarettes for the previous 24 hours.
      Pharmacokinetic parameters were determined during a single application of the
      system. The mean nicotine maximal plasma concentration (Cmax) and area under the
      curve (AUC) values for women did not differ significantly from those for normal
      sized men. Nicotine Cmax and AUC values, however, were significantly lower in
      obese compared with normal-sized men; nicotine AUC was strongly correlated to
      body weight and body mass index. Mean apparent nicotine elimination rate constant
      values were not significantly different between normal-sized and obese men, but
      the apparent elimination rate constant value was significantly higher in women.
      The possible clinical significance of the differences in nicotine AUC values with
      body weight is discussed.

PMID- 8366190
TI  - Presystemic extraction: mechanisms and consequences.
AB  - Many drugs have incomplete systemic availability after oral dosage. This can be
      attributed to incomplete absorption from the gastrointestinal tract, or to
      presystemic extraction, in which a fraction of an orally administered dose is
      biotransformed before reaching the systemic circulation. Presystemic extraction
      can occur either via biotransformation by gastrointestinal mucosa or enteric
      flora, or via metabolism during the "first-pass" through the liver. For drugs
      with low oral bioavailability due to high presystemic extraction, impaired
      clearance leads to increased peak plasma levels and greater area under the
      concentration-time curve, but minimal change in elimination half-life.

PMID- 8366191
TI  - The hepatic first-pass metabolism of problematic drugs.
AB  - The first-pass hepatic metabolism of a number of important therapeutic agents is
      inconsistent with traditional models that assume that the hepatic extraction
      ratio of a drug is constant in each individual (independent of the concentration
      of drug in the hepatic sinusoidal blood and also independent of the history of
      exposure to the drug). In this review, the authors examine the first-pass
      metabolism of five "problematic drugs" (propranolol, lidocaine, propafenone,
      verapamil, and nitroglycerin). Each of these compounds has unique facets to its
      hepatic clearance and pharmacokinetics as well as striking similarities. Selected
      aspects of first-pass metabolism are reviewed, and a theory that may explain some
      of the unusual behavior of the four lipophilic bases (propranolol, lidocaine,
      propafenone, and verapamil) is presented. Finally, the unusual and variable
      clearance of nitroglycerin is discussed.

PMID- 8366192
TI  - The clinical implications of first-pass metabolism: treatment strategies for the
      1990s.
AB  - The first-pass effect is real. It may pose obstacles to the treatment of disease,
      and strategies need to be developed to address the problem that first pass can
      cause. First we have to look at identifying the problem, and this symposium has
      helped to further emphasize that the problem exists and awareness is increasing.
      The first-pass effect has been a basic tenant of pharmacology but an area not
      receiving active research interest and one that is often overlooked in the
      clinical arena. Avoiding drug interactions is a consideration, and that is a
      major challenge to the field of clinical pharmacology. Clinicians need to be
      aware of the problem, aware of the danger areas with drugs, and first pass.
      Another alternative is to turn to chemical modification of a drug that avoids
      needing to take first pass into consideration.

PMID- 8366193
TI  - Development of blobs in the visual cortex of macaques.
AB  - We have examined the area of the primary visual cortex and the number and size of
      blobs within it in 10 neonatal and 11 adult rhesus monkeys. The average area of
      the primary visual cortex (V1) increases from 919 mm2 in newborns to 1,069 mm2 in
      adult animals (16%). The number of blobs decreases per unit area from an average
      of 5.2/mm2 at birth to 4.3/mm2 in maturity (18%). As a consequence, the number of
      blobs remains approximately the same during maturation, at about
      4,800/hemisphere. These observations correct a preliminary report on a subset of
      the animals studied here (Purves and LaMantia: Proc Natl Acad Sci 87:5765, '90),
      in which it appeared that blob number might increase between birth and maturity.
      As in other regions of the developing postnatal brain, we found no net loss of
      modular circuitry.

PMID- 8366194
TI  - Localization of sulfated glycoprotein-2/clusterin mRNA in the rat brain by in
      situ hybridization.
AB  - Sulfated glycoprotein-2 (SGP-2) gene expression seems to be constitutively
      expressed in a variety of tissues and organs, although levels of expression vary
      widely from one tissue to the other. SGP-2, also known as clusterin, has been
      reported to be expressed in the central nervous system (CNS). Some possible roles
      for brain SGP-2 have been postulated. In order to provide a substrate for a
      better understanding of the functions of this glycoprotein in the CNS, we
      investigated the detailed anatomical and cellular distribution of SGP-2 mRNA in
      the adult rat brain as well as the variation in its cellular expression after
      excitotoxin lesion. Transcripts for SGP-2 were found to be distributed throughout
      the rat CNS, although regional differences in their prevalence were readily
      observed. The ependymal lining of the ventricles showed the highest level of
      expression followed by various gray matter areas, some of which contained very
      intensively labeled cells. These cells were mostly found among several
      hypothalamic and brainstem nuclei, the habenular complex, as well as in the
      ventral horn of the spinal cord, which displayed striking hybridization signals
      over motoneurons. Occasional cells expressing high levels of SGP-2 transcripts
      were found in fiber tracts. Highly SGP-2 mRNA-positive resting glial cells were
      mainly located near the glial limitans and blood vessels. Two areas of relatively
      low constitutive SGP-2 mRNA expression are shown to produce strong hybridization
      signals 10 days after the local administration of the excitotoxin kainic acid.
      This overexpression of SGP-2 transcripts appears to involve GFAP-positive cells.
      Taken together, these results indicate that in the intact adult rat CNS, various
      cell populations, including neurons, constitutively express SGP-2 transcripts,
      whereas in the injured brain, reactive astrocytes become the major producers.

PMID- 8366195
TI  - Neuronal morphology and efferent projections of the dorsal nucleus of the lateral
      lemniscus in the rat.
AB  - The dorsal nucleus of the lateral lemniscus (DLL) is the main source of
      inhibitory influence in the auditory brainstem of mammals. The cytoarchitecture
      and connectional properties of DLL were established in the cat in contrast to the
      rat. The goal of the present study was to establish to what extent the anatomical
      properties of the rat DLL compare to those of the cat, thus providing a basis of
      interpretation for future functional studies in the rat, an animal model used
      more and more in the auditory system. DLL of the rat contains four well
      differentiated neuronal types, as seen in Nissl-stained material. Type I neurons
      are large and multipolar with abundant cytoplasm and darkly stained Nissl
      substance. Type II neurons are large, bipolar and darkly stained in Nissl
      material. Type III neurons are medium in size and their soma is round or ovoid.
      Type IV neurons are small and round with scant cytoplasm; they seem to be also
      the least common neuronal type of the DLL. After Phaseolus vulgaris
      leucoagglutinin or biocytin injections in the DLL, fibers and terminals labeled
      by orthograde transport were observed in the corresponding region of the
      contralateral DLL and in the inferior colliculus, bilaterally. A few labeled
      fibers and terminal fields were seen in the deep layers of the superior
      colliculus bilaterally, as well as in the medial division of the medial
      geniculate body and, even more rostrally, in the posterior nucleus of the
      thalamus. Descending projections from DLL terminated in the periolivary regions
      of the ipsilateral superior olivary complex. Retrograde tracing based on
      injections of horseradish peroxidase in the various targets of the DLL confirmed
      the connections established with orthograde labeling.

PMID- 8366196
TI  - Experimentally induced visual projections to the auditory thalamus in ferrets:
      evidence for a W cell pathway.
AB  - We have previously reported that following specific neonatal brain lesions in
      ferrets, a retinal projection is induced into the auditory thalamus (Sur et al.,
      Science 242:1437, '88). In these "rewired" ferrets, a novel visual pathway is
      established through auditory thalamus [the medial geniculate nucleus (MGN)] and
      primary auditory cortex (A1); cells in both MGN and A1 are visually responsive
      and exhibit properties similar to those of visual cells in the normal visual
      pathway. In this paper, we use three approaches--physiological, anatomical, and
      developmental--to examine which of the retinal ganglion cells project to the MGN
      in these rewired ferrets. We find that: 1) physiological response properties of
      postsynaptic visual cells in the MGN are W-like; 2) retinal ganglion cells back
      filled from the MGN are small and similar to soma sizes of subsets of the normal
      retinal W cell population; and 3) subpopulations of these small cells can be
      preferentially rerouted to the MGN in response to different surgical
      manipulations at birth, consistent with differential W cell projection patterns
      in normal animals. These data suggest that retinal W cells come to project to the
      MGN in rewired animals. These findings not only provide a basis on which to
      interpret functional properties of this novel visual pathway, but also provide
      important information about the developmental capabilities of specific retinal
      ganglion cell classes and the regulation of their projections by target
      structures in the brain during development.

PMID- 8366197
TI  - Distribution of GABA-immunoreactive nerve fibers and cells in the cervical and
      thoracic paravertebral sympathetic trunk of adult rat: evidence for an ascending
      feed-forward inhibition system.
AB  - Neurochemical and immunohistochemical evidence suggests that the superior
      cervical ganglion (SCG) contains all components of a gamma-aminobutyric acid
      (GABA)ergic transmission system, which includes GABAergic axons of unknown
      origin. The number of nerve fibers with and without GABA-like immunoreactivity
      was determined in interganglionic connectives at all cervical and thoracic levels
      of the paravertebral sympathetic trunk. In addition, the distribution of GABA
      immunoreactive (IR) neurons was established within the ganglion chain and
      compared with the relative frequency of principal neurons richly innervated by
      GABA-IR axon terminals. The following results were obtained: 1) the total number
      of nerve fibers in cross sections did not significantly vary between the cervical
      levels, but it increased steadily from upper to lower thoracic segments; 2) in
      contrast, the number of GABA-IR fibers decreased from the cervical sympathetic
      trunk below the SCG (approximately 300 fibers) down to the seventh to tenth
      thoracic ganglion, below which no such fiber was seen; 3) GABA-IR nerve fibers
      originate from a subclass of GABA-IR cells; these are small, bipolar neurons with
      predominantly ascending, unmyelinated axon-like processes; 4) the number of
      principal neurons richly innervated by GABA-IR nerve fibers decreased from the
      SCG to the upper thoracic ganglia, and was very small below; and 5) apart from
      basket-like innervation, GABA-IR axons also formed diffuse networks around GABA
      negative principal neurons predominantly in cervical and upper thoracic ganglia.
      These data suggest that the GABAergic innervation of paravertebral sympathetic
      ganglia is more complex than previously suspected. What appears as preganglionic
      afferents from several spinal segments (C8-Th7) innervate GABAergic neurons in
      the sympathetic trunk which have ascending axons and focus their inhibitory
      effects on the cervical sympathetic ganglia, predominantly the SCG. These data
      suggest that GABAergic small interganglionic neurons form a feed-forward
      inhibition system, which may be driven by multisegmental spinal input in the
      paravertebral sympathetic ganglion chain.

PMID- 8366199
TI  - Qualitative and quantitative analyses of the patterns of retinal input to neurons
      in the dorsal lateral geniculate nucleus of the cat.
AB  - In the visual system of the cat the projection from the retina to the lateral
      geniculate nucleus has been studied extensively. However, the patterns of
      synaptic contacts made by individual axons onto individual cells have not been
      described. In this study these patterns have been examined for class 1 cells
      (Guillery: J Comp Neurol 128:21, '66). Retinogeniculate axons and lateral
      geniculate neurons are labeled with horseradish peroxidase (HRP) via injections
      into the optic tracts and optic radiations, respectively. Sections are then
      processed for combined light and electron microscopic analysis. They are examined
      with the light microscope to identify labeled lateral geniculate neurons that
      appear to be contacted by labeled retinal axons. These cells and axons are then
      analyzed by a computerized microscope system, and sites of apparent synaptic
      contact are recorded. This light microscopic analysis indicates that individual
      class 1 cells are contacted by many retinogeniculate axons (> 10) and that each
      of these axons contacts many lateral geniculate neurons (> 20). Some axons make
      numerous contacts that are concentrated onto a few dendrites, while others make
      only a few contacts, which are spread over several dendrites. In all cases, the
      majority of contacts are on the dendritic shafts of relatively thick secondary
      and tertiary dendrites. Electron microscopic analysis confirms that most of the
      contacts identified with the light microscope are synaptic. It also reveals that
      labeled and unlabeled retinal axons can innervate the same dendritic segment.
      Finally, one cell was studied that had its soma and most of its dendrites in
      lamina A1 but some of its dendrites extended into lamina A. This cell received
      input from retinal axons in both layers, thus suggesting that it may have been
      binocularly excitable.

PMID- 8366198
TI  - Distribution of luteinizing hormone-releasing hormones I and II (LHRH-I and -II)
      in the quail and chicken brain as demonstrated with antibodies directed against
      synthetic peptides.
AB  - Polyclonal antibodies were raised in rabbits against polypeptides corresponding
      to the N-terminal part (heptapeptides) of the two avian gonadotropin-releasing
      hormones, chicken (c) LHRH-I and -II. These peptides, which were synthesized by
      the continuous-flow technique, were selected because they contained the smallest
      number of common amino acid residues. The pGlu-His-Trp-Ser sequence at the C
      terminal was suppressed to avoid possible cross-reactions between the antisera.
      The antisera generated in this way were tested for specificity by solid and
      liquid phase absorption as well as by antigen spot tests. The antiserum raised
      against cLHRH-I recognized this peptide preferentially though not exclusively.
      Some cross-reaction with cLHRH-II was observed in the absorption test, although
      spotting tests suggested a total specificity. The anti cLHRH-II appeared to be
      completely specific in all tests. These two antibodies were then used to study
      the distribution of cLHRH-I and -II immunoreactive structures in the quail and
      chicken brain. cLHRH-I immunoreactive perikarya were observed in a fairly wide
      area covering the preoptic-anterior hypothalamic and septal region. By contrast,
      cLHRH-II cells were confined to a single group located in the dorsal aspects of
      the occulomotor nuclei, at the junction of the di- and mesencephalon. A sex
      difference in the number of cLHRH-I cells was detected in the anterior lateral
      preoptic region of the quail. Fibers immunoreactive for either cLHRH-I or cLHRH
      II were widely distributed in the telencephalon, diencephalon, and mesencephalon
      but showed a specific pattern of anatomical localization. In particular, a high
      density of cLHRH-I fibers were seen in the external layer of the median eminence,
      while cLHRH-II fibers were less prominent at this level. Contrary to previous
      reports, a significant amount of cLHRH-II fibers were however seen throughout the
      median eminence (mostly external layer). The extensive distribution of both cLHRH
      I and -II fibers in the quail and chicken brain is consistent with the potential
      role played by these peptides in the gonadotropin secretion and in the control of
      reproductive behavior. The specific role of cLHRH-II remains however elusive at
      present.

PMID- 8366200
TI  - The eosinophil.

PMID- 8366201
TI  - Different cytogenetic findings in two clinically similar leukaemic dogs.
AB  - A 4-month-old German Shepherd puppy and a 7-year-old Boxer dog, in which a
      clinical diagnosis of acute lymphoblastic leukaemia had been made, were
      investigated cytogenetically. In the puppy a diploid karyotype was found, but the
      malignant clone in the Boxer was characterized by an extra metacentric
      chromosome, apparently formed as the result of a Robertsonian translocation of
      two chromosomes 1. These findings are discussed against the background of similar
      cases reported in the literature. Possibly, different types of acute canine
      leukaemic disease, occurring at different ages, can be distinguished by
      cytogenetic evaluation.

PMID- 8366203
TI  - Laminin and type IV collagen in experimental rat oral carcinomas.
AB  - The pattern of staining and the distribution of laminin and type IV collagen in
      normal rat tongue mucosa and induced tongue carcinomas were investigated by
      immunohistochemical techniques. Both normal and neoplastic epithelial basement
      membrane revealed positive staining for laminin and type IV collagen. However,
      compared with normal tissue, carcinomas exhibited areas of increased density and
      thickness for laminin. Focal tumour basement membrane discontinuities were
      observed in some specimens stained for type IV collagen.

PMID- 8366202
TI  - Ultraviolet radiation-induced corneal tumours in the South American opossum,
      Monodelphis domestica.
AB  - Chronic exposure of the South American opossum, Monodelphis domestica, to
      ultraviolet radiation (UVR) induced 154 primary tumours of the cornea in 152
      eyes. Tumours developed gradually; frank neoplasia was preceded by non-neoplastic
      proliferation of corneal stromal fibroblasts (keratocytes) and extensive
      neovascularization. Histologically, the majority of tumours (134 of 154) appeared
      to be fibrosarcomas arising from keratocytes, but about 12 per cent of the
      tumours (18 of 154) had a highly vascular appearance, suggesting
      haemangiosarcoma. In two eyes, squamous cell carcinomas overlay mesenchymal
      tumours. Ultrastructural features of UVR-induced corneal tumours were consistent
      with tumours, and cultured skin fibroblasts expressed high content of messenger
      RNA for the intermediate filament vimentin; no cytokeratin messenger RNA was
      detected in these cells and cell lines. Based upon their light microscopic,
      ultrastructural, and intermediate filament biosynthetic characteristics, the
      majority of UVR-induced corneal tumours in M. domestica appeared to be
      fibrosarcomas. Haemangiosarcomas constituted a smaller proportion of the tumours,
      and squamous cell carcinomas were very rare.

PMID- 8366204
TI  - Ultrastructural features of normal epithelium and 4-nitroquinoline 1-oxide
      induced carcinomas of the rat tongue.
AB  - An electron microscopical examination of normal rat lingual mucosa and 4
      nitroquinoline 1-oxide (4NQO)-induced tongue carcinomas was undertaken. In normal
      rat tongue, the epithelium of papillae and interpapillary regions exhibited two
      distinct keratohyalin granule types and essentially similar ultrastructural
      cellular features in the different epithelial compartments. The interface between
      epithelium and connective tissue showed a continuous basal lamina. Compared with
      normal rat tongue epithelium, 4NQO-induced oral carcinomas revealed cellular and
      nuclear pleomorphism, atypical tonofilament aggregates, increased and swollen
      mitochondria, dilated intercellular spaces, local discontinuities and thickening
      of the basal lamina.

PMID- 8366205
TI  - Pathology and epidemiology of canine distemper in raccoon dogs (Nyctereutes
      procyonoides).
AB  - From September to December 1991, a large number of free-ranging raccoon dogs
      (Nyctereutes procyonoides) died from a highly contagious disease in the vicinity
      of Tokyo. Eighteen seriously ill or dead animals were submitted for necropsy. The
      pathological findings resembled those in a masked palm civet (Paguma larvata)
      found infected with canine distemper virus (CDV) in the same area in late August
      1991. The most striking features were pneumonia and gastroenteritis.
      Microscopical lesions consisted of cytoplasmic and intranuclear eosinophilic
      inclusion bodies in various organs and tissues, bronchiolointerstitial pneumonia,
      non-suppurative demyelinating encephalitis, lymphocytic depletion in various
      lymphoid tissues and catarrhal or necrotizing gastroenteritis. CDV-specific
      antigens, demonstrated immunohistochemically in the epithelial tissues, central
      nervous system and lymphoid tissues, corresponded with the presence of the
      eosinophilic inclusion bodies in sections of the same lesions stained with
      haematoxylin and eosin. Ultrastructurally, both cytoplasmic and intranuclear
      inclusion bodies were observed to be composed of aggregates of viral
      nucleocapsids. The study provided clear evidence that CDV was the cause of the
      disease. It is possible that the masked palm civet introduced the infection into
      the raccoon dog population.

PMID- 8366206
TI  - Two haemangioendotheliomas in a bovine brain.
AB  - The microscopical, ultrastructural and immunohistochemical features of an unusual
      type of haemangioendothelioma in the brain of a calf are described. The salient
      features of this tumour were an exuberant proliferation of vasoformative elements
      whose endothelial cells exhibited epithelioid and spindle cell features.
      Intracytoplasmic miniature lumen formation in endothelial cells was
      characteristic of this vascular neoplasm.

PMID- 8366207
TI  - Cerebral healing after craniotomy to evacuate a Coenurus cerebralis cyst.
AB  - An 11-month-old ewe developed neurological signs caused by a space-occupying
      lesion in the left cerebral hemisphere. Successful surgical evacuation of a
      Coenurus cerebralis cyst was carried out, the neurological signs regressed and
      the ewe produced twins in the following breeding season. Sixteen months after the
      surgical treatment the ewe was found dead and necropsy revealed a vegetative
      endocarditis. In the brain, at the site of cyst evacuation, there was a collapsed
      subcortical cavity lined by siderotic fibrovascular tissue and surrounded by a
      modest glial reaction. These observations confirm that the clinical signs of
      cerebral coenuriasis are related to the space-occupying effect of the parasitic
      cyst and indicate that partial replacement by gliomesodermal tissue plays a part
      in healing of the collapsed cyst.

PMID- 8366208
TI  - Argyrophil cells in gastrointestinal epithelial tumours of the dog.
AB  - Fifty-two cases of gastrointestinal mucosal tumours of the dog were examined for
      argyrophil cells by means of the Grimelius stain. Argyrophil cells were found in
      each of five cases (100 per cent) of gastric adenoma, in five (71.4 per cent) of
      seven large-intestine adenomas, in 13 (59.1 per cent) of 22 gastric carcinomas,
      in five (62.5 per cent) of eight small-intestine carcinomas and in four (40 per
      cent) of ten large-intestine carcinomas. The argyrophil cells represented a
      minority of the tumour cell population in all cases. These results demonstrate
      that a significant proportion of gastrointestinal mucosal tumours of the dog
      contain a mixture of epithelial and endocrine cells. Similar findings have been
      reported in man.

PMID- 8366209
TI  - Microscopical characteristics of uterine wall arteries in barren aged mares.
AB  - The morphology of the arteries in the uterine wall was studied in three
      multiparous aged mares that had suffered repeated pregnancy failure. The uterine
      wall arteries exhibited elastosis of the intima or adventitia, or both,
      resembling "physiological pregnancy sclerosis". In areas affected by elastosis,
      degeneration of the pre-existing elastic fibres and increased glycosaminoglycans
      were frequently observed. Newly formed elastic fibres were not evident. Delayed
      resorption due to disordered metabolic turnover of the elastin was thought to be
      an important factor in the pathogenesis of the arterial elastosis in the uterine
      wall.

PMID- 8366210
TI  - Paraneoplastic pemphigus: a subset of patients with pemphigus and neoplasia.
AB  - We reviewed the clinical, histologic, and immunofluorescence features of 20
      patients with pemphigus and neoplasia and compared them with a control group of
      17 patients with pemphigus without neoplasia. Patients with neoplasia were
      divided according to clinical, histologic, and immunofluorescence findings into
      those with paraneoplastic pemphigus syndrome (12 patients) and those with classic
      pemphigus vulgaris or pemphigus foliaceus with neoplasia (8 patients). The
      histologic findings in patients with paraneoplastic pemphigus included
      acantholysis, interface dermatitis, spongiosis, and satellite keratinocyte
      necrosis. Histologic findings in the 8 patients with classic pemphigus and
      neoplasia included acantholysis and spongiosis. Direct immunofluorescence in both
      paraneoplastic pemphigus and pemphigus with neoplasia showed IgG staining of cell
      surface proteins (intercellular substance) and deposition of immunoglobulin at
      the basement membrane zone. Indirect immunofluorescence with rat bladder
      substrate was used to differentiate paraneoplastic pemphigus from classic
      pemphigus. Circulating IgG anti-cell-surface protein antibodies were detected in
      4 patients with paraneoplastic pemphigus syndrome; they were absent in 2 patients
      with pemphigus and neoplasia. Immunoprecipitation of sera from the 4 patients
      with epithelial staining showed the complex of bands identified in studies of
      paraneoplastic pemphigus syndrome. We conclude that paraneoplastic pemphigus
      syndrome has distinct clinical, histologic, and immunologic features that
      differentiate it from classic pemphigus with underlying neoplasia.

PMID- 8366211
TI  - DNA ploidy of basal cell carcinoma determined by image cytometry of fresh smears.
AB  - Image analysis of nuclear DNA content (DNA ploidy) was performed on smears of
      basal cell carcinoma (BCC) obtained during Mohs microscopically-controlled
      surgery from 51 tumors. DNA ploidy was compared with histologic growth pattern
      and the contour of the invading edge. There was a statistically significantly
      increased frequency of DNA aneuploidy in smears from BCC exhibiting partial or
      total diffuse (infiltrative and superficial multicentric) growth patterns (80%;
      32 of 40) as compared to solely circumscribed growth patterns (0%; 0 of 11) (p <
      0.001).

PMID- 8366212
TI  - Primary cutaneous phaeohyphomycosis: report of seven cases.
AB  - We report seven cases of primary cutaneous phaeohyphomycosis. There were five
      males and two females, ranging in age from 42-65 years (mean 57.7 years). Two
      patients were otherwise healthy, but five were immunocompromised. One patient had
      rheumatoid arthritis and was on oral prednisone; two were renal transplant
      recipients, one was a heart transplant recipient, and the fifth had
      dermatomyositis. No history of trauma was elicited from any of the patients, but
      in two cases, foreign material was seen in the tissue sections. All lesions were
      on the extremities. In two cases, tissues were cultured, and these grew Exophiala
      jeanselmei. The others were not cultured because fungal infection was not
      clinically suspected. No systemic disease developed in any of the cases, and all
      were cured by the simple, complete excision of the lesions.

PMID- 8366213
TI  - Histological and ultrastructural study of a family with erythrokeratodermia
      progressiva symmetrica.
AB  - We have examined a family with 4 members in three succeeding generations
      suffering from a severe keratinization disorder. The clinical phenotype, with
      symmetric plaques on the extremities, corresponded to erythrokeratodermia
      progressiva symmetrica. It was manifested at birth, however, and in addition to
      the hyperkeratotic plaques, follicular hyperkeratosis was also observed. Electron
      microscopy revealed multiple morphological changes such as myelinated membrane
      structures, or needles, which were similar to those occurring in ichthyotic
      disorders and tyrosinemia, as well as in harlequin fetuses, all of which were
      excluded clinically or biochemically in our patients.

PMID- 8366214
TI  - CD44 expression in normal and inflamed skin.
AB  - CD44 is the principal cell surface receptor for hyaluronate. In non-inflamed
      skin, CD44 expression is limited to the cell membrane of eccrine coil cells. The
      distribution on these cells is asymmetric, with intense staining on the dermal
      side and little staining on the luminal side of the coil cell. In skin containing
      a pathologic process, either inflammatory or neoplastic, CD44 expression can be
      widespread on the membranes of keratinocytes and on infiltrating lymphocytes in
      the vicinity of the process. Diverse roles have been proposed for CD44 and
      largely involve aspects of cellular adhesion in one setting or another. CD44 may
      identify a more mobile, proliferating keratinocyte that is responding to local
      injury. In eccrine coil, the stable presence of CD44 on the non-luminal surface
      of secretory cells indicates an undefined function for CD44 in the generation of
      eccrine sweat.

PMID- 8366216
TI  - Human subcutaneous pythiosis.
AB  - Two cases of subcutaneous infection caused by the primitive aquatic hyphal
      organism Pythium are described. Pythium is an important pathogen of horses in the
      U.S.A. and Australia. Cases of human subcutaneous pythiosis have been cited in
      the literature, but clinical and histopathological features have not been
      described previously. Both cases occurred in young immunocompetent males in the
      periorbital region and showed rapid growth, clinically mimicking a tumor and
      requiring operative biopsy. In both cases there was a history of exposure to
      either swampy water or horses. The tissue reaction was distinctive, closely
      resembling that seen in equine pythiosis, comprising well-defined granular
      eosinophilic islands bordered by macrophages, multinucleate giant cells, fibrosis
      and numerous eosinophils. Hyphae were well demonstrated with the Grocott stain
      but only poorly with the PAS method. Identity of the organisms was confirmed with
      an immunoperoxidase technique employing a polyclonal antiserum to Pythium. Both
      patients responded well to amphotericin B.

PMID- 8366215
TI  - Localization of MGSA/GRO protein in cutaneous lesions.
AB  - Melanoma growth stimulatory activity (MGSA/GRO), a cytokine originally
      characterized as an autocrine growth factor for melanoma cells, is highly
      chemotactic for neutrophils and releases neutrophil elastase as well as other
      matrix-degrading enzymes. Previous work has demonstrated the presence of MGSA/GRO
      in melanocytic lesions and in the epidermal keratinocytes of non-lesional skin
      and psoriatic scale. Herein, MGSA/GRO localization was examined in a variety of
      human skin lesions exhibiting proliferative and/or differentiative disorders
      using immunohistochemical methods. Most lesions showed greater MGSA/GRO
      immunoreactivity in the more differentiated suprabasal keratinocytes of the
      stratum spinosum and stratum granulosum than in the stratum basalis, where the
      dividing basal cells are found. Hair follicles, sebaceous glands, and sweat
      glands were also frequently positive for MGSA/GRO. The highest level of
      immunoreactive MGSA/GRO in diseased epidermis was detected in verruca vulgaris,
      followed by psoriasis, keratoacanthoma, and squamous cell carcinoma. Detection of
      MGSA/GRO in basal cell carcinoma was variable, being present in the sclerosing
      variant and absent in the more common nodular variant. Melanocytic lesions
      stained less intensely for MGSA/GRO than keratinocytic lesions, where the levels
      of MGSA/GRO expression correlated with the inflammatory response and degree of
      keratinocyte differentiation.

PMID- 8366218
TI  - The American Society of Dermatopathology. The first thirty years.

PMID- 8366217
TI  - Carcinosarcoma of the skin: immunohistochemical and electron microscopic
      observations.
AB  - A rapidly growing, hemorrhagic, exophytic tumor on the upper back of a 44-year
      old male patient was investigated. Histological, immunohistochemical, and
      electron microscopic studies revealed both basal cell carcinoma-like and spindle
      cell sarcoma-like structures intermingled in the same tumor. Clinical
      consequences to this patient were mainly dependent on the sarcomatous element.

PMID- 8366219
TI  - The polymerase chain reaction. Applications in dermatology.
AB  - Within the space of the last 5 years, application of the revolutionary in vitro
      method of deoxyribonucleic acid (DNA) amplification known as the polymerase chain
      reaction (PCR), has become ubiquitous. The rapidly increasing number of clinical
      and research articles utilizing this technology, both in the dermatologic and
      general medical literature, requires one to have at least a basic understanding
      of how the PCR is conducted, what it has to offer, and the potential
      shortcomings. Such knowledge will hopefully allow a more critical appraisal of an
      increasingly complex literature. This review aims to describe the methodology and
      medical applications of this powerful technique with special consideration to the
      increasing role PCR may have on dermatologic research and practice.

PMID- 8366220
TI  - Advanced use of tissue adhesive in hair transplantation.
AB  - BACKGROUND: Cobblestoning is an unsightly result of graft elevation in the
      recipient site after hair transplantation. OBJECTIVE: To describe the use of
      tissue adhesives for the avoidance of cobblestoning. RESULTS: The long-term
      cosmetic appearance of hair transplants may be improved through the use of
      cyanoacrylate adhesives is the virtual elimination of the common problem of graft
      elevation or cobblestoning, which produces an unsightly bumpiness in the
      recipient area. The choice of type of adhesive and the method of application are
      central to successful use of this technique. CONCLUSION: The indirect benefits of
      elimination of the need for postoperative bandages and restrictions in activities
      couple with the cosmetic results to produce a high degree of patient
      satisfaction.

PMID- 8366221
TI  - The treatment of advanced Merkel cell carcinoma. A multimodality chemotherapy and
      radiation therapy treatment approach.
AB  - BACKGROUND: The optimal management of Merkel cell carcinoma has not been clearly
      defined. OBJECTIVE: To describe the treatment of eight patients who presented
      with Merkel cell carcinoma. METHODS: Eight patients with advanced locoregional
      Merkel cell carcinoma were seen in our institute over a 7-year period. Four
      patients were successfully treated by induction chemotherapy after excisional
      biopsy, followed by radiotherapy. Three patients died from widespread metastases
      and one from neutropenic sepsis induced by chemotherapy. RESULTS: These cases
      demonstrate the potential lethality and aggressive nature of this rare skin tumor
      despite its chemosensitive and radioresponsive character. In all four patients
      who are alive and disease-free, chemotherapy was given first and radiotherapy was
      given as consolidation. CONCLUSION: We suggest that a multimodality treatment
      approach--chemotherapy followed by radiotherapy--is indicated in patients with
      advanced Merkel cell carcinoma.

PMID- 8366222
TI  - Lateral rhinotomy approach for Mohs micrographic surgery of the anterior septum.
AB  - BACKGROUND: Neoplasms of the nasal septum and internal alar surface are very
      difficult to treat. This is because of the complicated surface, proximity to
      important anatomic structures, and technical difficulty--both to resection and
      follow up. Mohs micrographic surgery might be the ideal mode of treatment for
      such tumors; however, it is very difficult to accomplish through the nostril.
      OBJECTIVE: To resect the tumor on the nasal septum and internal alar surface
      using Mohs micrographic surgery. METHODS: Lateral rhinotomy was performed as a
      preparatory stage to Mohs micrographic surgery of the anterior septum and
      intranasal alar surface. RESULTS: The ala nasi was detached from the cheek, thus
      exposing the anterior nasal cavity--enabling direct access to the neoplasms and
      allowing excellent visualization. CONCLUSION: Lateral rhinotomy, as described in
      this article, is a simple office procedure and in most cases heals with no
      visible scar.

PMID- 8366223
TI  - Two new retractors for hair replacement surgery.
AB  - BACKGROUND: Two new retractors that facilitate scalp reduction and scalp-lifting
      surgery are introduced. OBJECTIVE: To improve the accuracy, visibility and speed
      of alopecia reducing procedures. METHODS: These retractors were developed through
      trial and error in cooperation with the Robbins Instrument Corporation. RESULTS:
      The suction retractor has been found to clear the field, elevate the scalp flap,
      and put the skin on stretch simultaneously. The serrated hook retractor has been
      found to greatly improve visibility for the cauterization of bleeders. The hook
      and serrated surface of this retractor prevents intraoperative slippage.
      CONCLUSION: The two new retractors introduced in this article have been found to
      improve greatly the accuracy, visibility, and speed of alopecia reducing
      procedures.

PMID- 8366224
TI  - Pulmonary edema, shunt and blood flow distribution. Problems, progress and
      perspectives.

PMID- 8366225
TI  - Dependence of shunt on cardiac output in unilobar oleic acid edema. Distribution
      of ventilation and perfusion.
AB  - OBJECTIVE: In acute respiratory failure, increased cardiac output (Qt) increases
      shunt (Qs/Qt). We have tested if this is caused by: 1) a redistribution of blood
      flow towards edematous regions, or 2) a decrease of regional ventilation in the
      edematous region. DESIGN: Oleic acid edema was induced in the left lower lobe
      (LLL) of 11 pigs. Qt was varied with bleeding and infusion of blood and dextran.
      Blood flow to the LLL was measured at low and high Qt with electromagnetic low
      probes in 6 animals and with a gamma camera in 5. In the gamma camera pigs
      regional ventilation was also measured. MEASUREMENTS AND RESULTS: Qt was
      increased by 45% (electromagnetic flow probes) and 73% (gamma camera). Qs/Qt
      increased from 24.9-31.3% (p < 0.05) and from 17.6-28.8% (p < 0.001)
      respectively. No change in fractional perfusion of LLL could be seen, neither
      with flow probes nor with gamma camera. A decrease in ventilation of LLL, 2.6%,
      was observed when Qt was increased (p < 0.05). CONCLUSION: Theoretically a small
      decrease in ventilation can explain the increase in shunt, if regions with low
      ventilation/perfusion (VA/Q) ratio are transformed to shunt. This is, however,
      unlikely since earlier studies have shown that blood flow is distributed either
      to regions with normal VA/Q ratio or to shunt regions. We conclude that the
      cardiac output dependent shunt is not caused by redistribution of blood flow
      between lobes or by decreased ventilation in the edematous region. We cannot
      exclude that blood flow is redistributed within the edematous lobe.

PMID- 8366226
TI  - Selective digestive decontamination by erythromycin-base in a polyvalent
      intensive care unit.
AB  - OBJECTIVE: To study the effect of selective digestive tract decontamination by
      erythromycin-base on the incidence of carriage and infection with MR
      Enterobacteriaceae producing an extended spectrum beta-lactamase (ESB). DESIGN:
      After a 10-week prospective survey to ascertain the baseline incidence in two
      bays (1 and 3) of the same ICU, bay 1 was compared with bay 3 during a further
      survey of 6 months. The patients in bay 1 received erythromycin-base. SETTING:
      Two non-contiguous bays, 1 and 3, of 4 beds, in the same polyvalent ICU of a
      university hospital. PATIENT: Consecutive patients with unit stay longer than 2
      days; 34 patients were included during the control period, 43 in bay 1
      (decontamination) and 46 in bay 3 (control) during the trial period.
      INTERVENTION: Erythromycin-base, 1 g t.i.d. in powder form administered by
      gastric tube to patients in bay 1 from admission to discharge. MEASUREMENTS AND
      RESULTS: Digestive tract carriage was monitored by cultures of gastric and rectal
      swab specimens, sampled twice a week. Enterobacteriaceae were isolated on
      Drigalski agar with incorporated ceftazidime (4 mg/l). In bay 1 there was a
      decrease in ESB producing Enterobacteriaceae (23% vs 10%, p = 0.0004) from rectal
      swab, especially in K. pneumoniae (15% vs 2%, p = 10(-5)), during the
      decontamination period in comparison to the control period. During the trial
      period the only differences observed between bays 1 and 3 were in the gastric
      samples: K. pneumoniae were less often isolated in bay 1 than in bay 3 (0% vs 3%,
      p = 0.03). Intestinal carriage with multiresistant Enterobacteriaceae occurred in
      28% patients in bay 1 and 30% patients in bay 3 during the trial period (p =
      0.79). Erythromycin-base did not delay the carriage by patients in bay 1 (log
      rank test p = 0.42). CONCLUSION: Erythromycin-base was not effective in
      preventing digestive tract carriage due to Enterobacteriaceae resistant to third
      generation cephalosporin by production of chromosomal cephalosporinase. The
      decrease in isolates containing K. pneumoniae in bay 1 cannot be definitively
      attributed to erythromycin-base, since the number of this species in bay 3 was
      low.

PMID- 8366228
TI  - Inspiratory pressure/maximal inspiratory pressure ratio: a predictive index of
      weaning outcome.
AB  - OBJECTIVE: To compare the accuracy of PI/PImax ratio and other commonly used
      indices in predicting weaning outcome. DESIGN: A prospective study. SETTING:
      Intensive care unit. PATIENTS: 31 stable intubated patients ready to undergo
      weaning trial. METHODS: A simple method was developed to measure the PI and PImax
      in intubated patients. The accuracy of PI/PImax ratio and other commonly used
      indices in predicting outcome were compared. All indices were measured prior to
      weaning trial using standardized methods. MEASUREMENTS AND RESULTS: Minute
      ventilation of the successful patients (13.00 +/- 0.67 (SE) l/min) was not
      significantly different from the failure patients (10.64 +/- 1.26 l/min, p =
      0.10). The PI and PImax for the successful patients (11.48 +/- 1.25 cmH2O and
      47.77 +/- 4.48 cmH2O, respectively) and the unsuccessful patients (14.32 +/- 2.31
      cmH2O and 40.16 +/- 4.55 cmH2O, respectively) were also not significantly
      different (p = 0.28 and 0.24, respectively). The PI/PImax ratio was lower for the
      weaning successes (0.26 +/- 0.03) than for the weaning failures (0.36 +/- 0.04, p
      < 0.05). The threshold value of 0.3 for PI/PImax provided the best separation
      between weaning success and failure patients. The combined usage of rapid shallow
      breathing index and PI/PImax ratio provided the highest accuracy with sensitivity
      of 0.81 and specificity of 0.93. CONCLUSION: The PI/PImax ratio provided a good
      separation between the patients who were successfully weaned and those who
      failed. It provides additional discriminative power to f/VT.

PMID- 8366227
TI  - Effects of extrinsic positive end-expiratory pressure on mechanically ventilated
      patients with chronic obstructive pulmonary disease and dynamic hyperinflation.
AB  - OBJECTIVE: To examine the circulatory and respiratory effects of extrinsic
      positive end-expiratory pressure (PEEPe) in patients with chronic obstructive
      pulmonary disease (COPD) and dynamic hyperinflation during controlled mechanical
      ventilation. DESIGN: Different levels of PEEPe were applied randomly in
      mechanically ventilated patients with COPD and dynamic hyperinflation. SETTING:
      Respiratory Intensive Care Unit of a University Hospital. PATIENTS: 9 patients
      with acute respiratory failure and dynamic hyperinflation due to acute
      exacerbation of COPD. INTERVENTIONS: PEEPe 35%, 58% and 86% of intrinsic PEEP
      (PEEPi) were applied. MEASUREMENTS AND RESULTS: Using flow-directed pulmonary
      artery catheters hemodynamic measurements were obtained, while simultaneously
      lung volumes, airflows and airway pressures were recorded. In order to estimate
      alveolar pressures (Palv), rapid airway occlusions during passive expiration were
      also performed. At no level of PEEPe were significant changes in cardiac output,
      gas exchange variables, dead space, airways inflation resistances and respiratory
      system static end-inspiratory compliance observed. At high level of PEEPe central
      venous, mean pulmonary arterial and pulmonary capillary wedge pressures were
      increased significantly. All but one patient were flow-limited during passive
      expiration. PEEPe 86% of PEEPi caused a significant increase in end-expiratory
      lung volume and total PEEP. Iso-volume pressure-flow curves showed volume
      dependence expiratory flow limitation in 2 patients, while in 8 patients volume
      dependence of critical driving pressure (Palv-mouth pressure) that decreased
      flows was also observed. CONCLUSIONS: The effects of PEEPe on iso-volume flow and
      hence on lung mechanics and hemodynamics, depend on many factors, such as airways
      resistances, lung volumes and airway characteristics, making the patient response
      to PEEPe unpredictable.

PMID- 8366229
TI  - Computerized blood gas interpretation as tool for classroom and ICU.
AB  - OBJECTIVE: To describe structure and function of a PC based blood gas
      interpretation program (ABG-consultant) developed for nurses and physicians, and
      to test educational impact and user acceptance. DESIGN: Prospective, blinded
      study SETTING: Interdisciplinary ICU of a county hospital in Switzerland
      PARTICIPANTS: Nurses specialized in intensive care INTERVENTIONS: Exposure to the
      ABG-consultant program MEASUREMENT AND RESULTS: A first group of nurses was
      subjected to a written examination, then the ABG-consultant was made available
      for them for 2 months, and finally the same examination was taken again.
      Additionally, they completed a questionnaire related to the performance of the
      ABG-consultant. A second group of nurses took the same sequence of examinations
      but had no access to the ABG-consultant. The score of the examinations increased
      by 4.8 points in the first group (p < 0.0001) and by 1.3 points (p < 0.16) in the
      second group. More than 400 consultations were conducted over a period of 2
      months and the users themselves stated that the system was of help and easy to
      use. CONCLUSION: The results have shown that exposure to the ABG-consultant has
      increased the blood gas knowledge of the ICU nurses. It therefore appears
      desirable and worthwhile to address other areas of clinical medicine by a similar
      teaching-consulting approach.

PMID- 8366231
TI  - Grading asthma severity: using the APS component of the Apache II system.
AB  - OBJECTIVE: Measurement of severity is fundamental to the description and
      comparison of case series, treatment regimens and disease outcomes. This study
      examines the Acute Physiology Score (APS) as a severity measure of an acute "life
      threatening" asthma attack. DESIGN: The APS in the emergency department (ED) and
      ICU, demographic, treatment and outcome variables were prospectively studied.
      Relationships between severity, treatment and progress were investigated. In
      addition, patients were stratified according to ED APS and differences between
      the participating hospitals were examined. SETTING: Emergency Departments and
      Intensive Care Units of two New Zealand hospitals. PATIENTS: 64 admissions to the
      ICUs following an acute episode of asthma. INTERVENTIONS: Standard management of
      acute asthma as practised at the two participating hospitals. MEASUREMENTS AND
      RESULTS: Both the treatment delivered (intravenous salbutamol, sodium bicarbonate
      and IPPV) and the rate of improvement as defined by change in APS between the ED
      and the ICU were found to be strongly related to ED APS. Similarly, the length of
      stay in the ICU correlated with the ICU APS. Stratification on the basis of ED
      APS allowed small but significant differences in patient physiologic derangement,
      dose of salbutamol, use of IPPV and incidence of complications to be detected
      between patients at the two hospitals. CONCLUSION: This prospective study
      involving two hospitals validates the APS as a method for measuring the severity
      of an acute asthma attack. It demonstrates how correction for severity can be
      used to compare treatment and outcome variables in different case series.

PMID- 8366232
TI  - Intrathecal injection of high-dose meglumine amidotrizoate with complete
      recovery.
AB  - Rarely we are faced with accidental spinal injection of potentially toxic
      substances. We present 2 cases in which amidetrizoate, water-soluble ionic
      contrast medium, was accidentally injected intrathecally. Our treatment consisted
      of vigorous hydration and barbiturate coma. This report suggests that for water
      soluble ionic contrast media increasing cerebrospinal fluid circulation by
      vigorous hydration may be as effective as spinal lavage in diminishing toxicity.

PMID- 8366233
TI  - Poor results with mechanical ventilation in AIDS patients with Pneumocysis
      carinii pneumonia (PCP)

PMID- 8366230
TI  - Studies on drug monitoring in thrice and once daily treatment with
      aminoglycosides.
AB  - OBJECTIVES: To investigate at what time the peak level should be determined under
      conventional thrice daily (t.i.d.) administration of the aminoglycoside
      netilmicin and to study its serum concentrations under once daily (od) treatment
      to define the required daily dose and to gain information about convenient drug
      monitoring. DESIGN: The design of the study was a consecutive sample trial.
      SETTING: The study took place in a university hospital. PATIENTS: 41 intubated
      patients of a surgical ICU who received netilmicin as a short-term infusion over
      30 min for life-threatening infections were included in the study. INTERVENTIONS:
      In 21 patients netilmicin was administered t.i.d. The virtual peak levels which
      had been determined by pharmacokinetic dosage calculation were compared with the
      serum concentrations obtained directly after the administration as well as after
      15, 30, 60 and 180 min. In 20 patients the netilmicin serum concentrations during
      od treatment were determined directly before and immediately after the
      application as well as 0.5, 1, 3, 7 and 12 h later. To achieve a virtual peak
      level of 25 mg/l and a trough level of 0.5 mg/l individual adjustment of the
      dosage based on pharmacokinetic calculations was performed. MEASUREMENTS AND
      RESULTS: In t.i.d. treatment the serum concentration measured after 30 min was
      closest to the virtual peak level; therefore, this is the best time to determine
      the peak level. In od treatment the required daily dose was 7.86 mg/kg body
      weight (median) in patients with normal renal function. During od dosing the
      trough level was extremely important in drug monitoring, whereas determination of
      the high peak level was of doubtful value. CONCLUSIONS: The peak level should be
      determined during t.i.d. administration at 30 min. In od treatment the initial
      daily dose should be 7 mg/kg body weight; in drug monitoring the trough level is
      very important.

PMID- 8366234
TI  - Multiorgan failure (MOF) and intestinal ischemia after cocaine intoxication.

PMID- 8366235
TI  - Foreign body aspiration mimicking asthma.

PMID- 8366236
TI  - Cardiac tamponade and hypothyroidism.

PMID- 8366237
TI  - Acoustical Society of America, 126th Meeting. Denver, Colorado, 4-8 October 1993.
      Abstracts.

PMID- 8366239
TI  - Nursing research challenges within health care reform.

PMID- 8366238
TI  - Notes on nursing today.

PMID- 8366240
TI  - Identifying the hole in holism.

PMID- 8366241
TI  - Public policy and creativity in nursing.

PMID- 8366242
TI  - Faculty improve clinical operations.

PMID- 8366243
TI  - Educating for the future: a national survey of nursing deans about need and
      demand for nurse researchers.
AB  - If nursing doctoral programs are to meet the profession's need for research, they
      must produce scholars with the specific research foci and skills capable of
      meeting the profession's unique research demands. A national survey of deans and
      directors of schools of nursing was conducted to determine their opinions about
      the differing research foci that graduates of nursing doctoral programs should
      possess. A mail survey instrument was returned by 434 deans and directors of
      baccalaureate and higher degree programs who were queried about current and
      future need, contribution, and funding capability of researchers prepared with
      five different foci: psychosocial processes, biophysical processes, health care
      delivery systems and administration, education, and methodology and
      instrumentation. Deans recommended diverse research foci for both current and
      future researchers and indicated optimism about future funding for research.
      Although deans rated current and future professional contributions of researchers
      in the psychosocial domain most highly, they indicated that they believed current
      and future funding potential was greatest for biophysical researchers. These
      deans predicted that all types of nursing research endeavors will become
      increasingly important to the profession and the development of its theory base.

PMID- 8366244
TI  - Using large data bases in nursing and health policy research.
AB  - Concern about the quality, cost, and outcomes of health care has become a driving
      force in health policy research. The growing accessibility of large clinical and
      administrative health care data bases has led to an interest in using such data
      in health policy research. Clinical data bases are created by providers of care
      and contain data about episodes and outcomes of care, usually organized as
      patient records. Administrative data bases contain data about indirect care
      processes such as insurance claims processing, vital event recording, and quality
      assurance. Clinical and administrative data bases may contain millions of
      records, consist of data from multiple sites, and often have missing data issues
      that must be considered by researchers. These and other characteristics of large
      data bases require special data manipulation and analytic techniques. Large data
      bases have been used in epidemiological studies, risk assessment, and technology
      assessment and to study variations in caregiver practice patterns. Because the
      use of large data bases by nurse researchers has been constrained by the lack of
      nursing-relevant data in them, there is a need to reach consensus on useful and
      feasible nursing data elements and to include those data in ongoing data
      collection efforts by government agencies and private organizations.

PMID- 8366245
TI  - Developing a nursing doctorate for the 21st century.
AB  - Nursing in the next century will reflect changes in the health care system, and
      although the profession has made great strides in preparing nurse researchers,
      the current system has a serious gap that must be addressed; that of preparing
      clinical leaders. The article describes the need for a practice-focused doctoral
      curriculum that will produce a new type of senior clinician or expert
      practitioner to fill this gap. The envisioned graduates will be skilled in
      clinical decision making and information processing and will effect changes at
      both the micro- and macro-levels of the system. There is a clear future need to
      expand the number of primary care providers. The faculty required for their
      education must be doctorally prepared nurses who are themselves clinically
      proficient. The research and practice doctorates should be differentiated by
      faculty, the program of studies, resources, and placement/expectation of
      graduates. The article includes a model curriculum plan.

PMID- 8366246
TI  - Access to graduate education for registered nurses with nonnursing baccalaureate
      degrees.
AB  - This article reports a study to evaluate an option for alternate access to
      graduate nursing education for 85 registered nurses with nonnursing baccalaureate
      degrees. Using the National League for Nursing Comprehensive Achievement Test
      (NLN-CAT) to assess knowledge together with successful completion of a special
      course designed by the faculty, these applicants were admitted to an accredited
      graduate program in the Lienhard School of Nursing (LSN), Pace University,
      Pleasantville, NY. The study describes 6 full years of experience using this
      option. The theoretical rationale; a content analysis for the congruency of
      content among the NLN-CAT; the terminal objectives of the LSN baccalaureate
      program; the course outlines and objectives of required upper division
      baccalaureate nursing courses; and the content of the faculty-designed course,
      Matrices of Nursing Practice (NUR 589) are presented. Evaluation of NUR 589 for
      addressing the educational gaps of these students was based on the content
      analysis described together with the content analysis of the 23 NLN-CAT items
      incorrectly answered by 50 per cent (N = 12) of successful test takers defined as
      those who scored at the 70th percentile and higher. Of the 85 successful
      candidates, 22 did not enter the program, 20 entered and did not complete the
      program, and 43 were graduated, 6 with distinction. Their grade point averages
      (GPAs) ranged from 3.37 to 4.00. Results support this method of selection of
      qualified candidates for graduate education.

PMID- 8366247
TI  - Baccalaureate educator use of environment-based strategies to teach diagnostic
      patterns.
AB  - Baccalaureate nurse educators reported that their use of 10 environment-based
      strategies in the classroom or clinical setting may foster recognition of
      diagnostic patterns likely to be encountered in clinical practice. Environment
      based strategies are verbal or print materials that draw attention to a
      particular aspect of what is being taught and that draw attention to important
      information. A national sample of 255 full-time baccalaureate educators (56 per
      cent return rate) from 28 randomly selected programs completed a questionnaire.
      The reliability estimate related to the 10 items was 0.70. Most respondents
      reported use of all 10 environment-based strategies with a minimum reported use
      of 60 per cent for each strategy on at least a "sometimes" basis. The most
      frequently reported use of a strategy on a "greater than sometimes" basis was the
      transparency (75 per cent). Color and print differences were the most
      infrequently used at 40 per cent and 37 per cent, respectively. The results of
      this study show that faculty, either consciously or unconsciously, use the
      environment-based strategies to facilitate student selection of key diagnostic
      indicators. Increasing educators' awareness of such benefits to students may
      stimulate further research in this area. Methods to help students decipher
      significant health status indicators from associated ones are clearly needed so
      that timely intervention can be used to prevent harm to patients.

PMID- 8366248
TI  - Group climate: a significant retention factor for pediatric nurse managers.
AB  - Given today's technical and demanding patient care system within the hospital
      organization, there is a need for head nurses as nurse managers to be ever more
      attuned to the climate of their staff. In a study of 34 nurse managers in seven
      pediatric hospital organizations across a midwestern portion of the United
      States, an analysis of Fiedler's Leader Match Scales showed the significance of
      group climate on retention.

PMID- 8366249
TI  - Nurse empowerment through context, structure, and process.
AB  - Empowerment is most often conceptualized and measured from an individual
      perspective. Yet, in the nursing practice environment it requires a more
      comprehensive perspective. In this article the author requires a more
      comprehensive perspective. In this article the author proposes that nurse
      empowerment most likely occurs when there is a congruent linkage among a nursing
      vision, structural components that involve nurse participation, and the use of a
      process of inquiry. An empowerment quotient for nursing could be measured on a
      continuum for each of these three components.

PMID- 8366250
TI  - Spontaneous activity, conduction velocity and segmental origin of different
      classes of thoracic preganglionic neurons projecting into the cat cervical
      sympathetic trunk.
AB  - Previously, in the anesthetized cat, thoracic preganglionic neurons projecting to
      the superior cervical ganglion were divided into four classes (groups I-IV) by
      way of their reflex pattern. Neurons of each class are probably involved in a
      distinct function, such as regulation of peripheral vascular resistance,
      regulation of blood flow through skin, regulation of pupil diameter, etc. Here it
      was tested whether the functionally different classes of thoracic preganglionic
      neurons also differ in the distribution of their segmental origin, their
      spontaneous activity and the conduction velocity of their axons. The segmental
      distribution of preganglionic neurons was almost identical to that determined
      previously with tracer methods. Distinct classes of neurons had different,
      although overlapping segmental distributions. Most group III neurons were located
      in segments T1 and T2, whereas group I, II and IV neurons showed a broader
      distribution. The subpopulations of preganglionic neurons did not differ in their
      rate of spontaneous activity. No significant difference was found in segmental
      distribution between neurons with spontaneous activity and silent neurons. No
      correlation was found between conduction velocity and spontaneous activity. The
      proportion of unmyelinated units was greater among group I (16.3%), group II
      (24.1%) and group IV (22.2%) neurons than among group III neurons (8%). The
      distributions of conduction velocity were significantly different between group I
      and group III and between group II and group III neurons. Axons of preganglionic
      neurons located in segments T1 and T2 conducted faster than axons of neurons
      located more caudally. The present study shows that distinct subpopulations of
      preganglionic neurons, as defined by their reflex patterns, differ in their
      segmental location within the spinal cord and with respect to the conduction
      velocity of their axons.

PMID- 8366251
TI  - Tracheal vascular dilatation elicited by vagal nerve stimulation in rats.
AB  - We investigated the effects of the electrical stimulation of a unilateral
      cervical vagal nerve on the blood flow in the trachea using laser Doppler
      flowmetry in urethane anesthetized Wistar King rats. Stimulation for 30 s at 1,
      2, 5, 10, 20 or 50 Hz with 10 V intensity caused an increase in tracheal blood
      flow (TBF) in a frequency-dependent manner; the effects were most dominant with
      the 10-Hz stimulation among the six frequencies used. The increased responses of
      TBF with the muscarinic receptor antagonist atropine (1.0 mg/kg, i.v.) were
      significantly reduced when compared with those without atropine at 5 Hz
      stimulation (123.3 +/- 11.9% vs. 180.1 +/- 24.5%). This shows the existence of
      vasodilation due to a cholinergic mechanism. The increased responses of TBF after
      the ganglion blocking agent hexamethonium (20 mg/kg) i.v. administration were
      significantly reduced when compared with those without hexamethonium at 1, 2 Hz
      stimulation (1 Hz: 18.9 +/- 2.7% vs. 35.4 +/- 4.7%, 2 Hz: 40.5 +/- 8.9% vs. 58.8
      +/- 6.7%); this shows the existence of vasodilation due to a non-cholinergic
      parasympathetic efferent mechanism which itself appears to be due to the release
      of neuropeptides such as VIP and PHI. The increased responses after hexamethonium
      administration were augmented probably because of the enhanced release of other
      neuropeptides like SP and CGRP especially at 10 Hz and 20 Hz stimulation. These
      findings suggest that the mechanism of vasodilation by the activity in the vagal
      fibers in the trachea of the rat has cholinergic and non-cholinergic efferent
      components and a non-cholinergic afferent component. In rats, the afferent
      component may play an important role in controlling tracheal vascular changes.

PMID- 8366252
TI  - Mechanisms of the secretory response to luminal propionate in rat descending
      colon in vitro.
AB  - Short chain fatty acids stimulate Cl secretion in rat descending colon in vitro
      via an enteric reflex involving mucosa and cholinergic nerves. We used the short
      circuit current as the measure of Cl secretion caused by Na propionate (NaP) (0.5
      mM) in luminal bath fluid and studied the mechanism of the response. The NaP
      response was decreased 81% by atropine and 76% by lidocaine. It was unaffected by
      tetrodotoxin, omega-conotoxin or by tachyphylaxis to capsaicin, CGRP, substance
      P, histamine or PGE2. It was not reduced by inhibitors of 5-HT2 or 5HT3 receptors
      or by partial tachyphylaxis to 5-HT. However, superficial mucosal injury with
      hypertonic Na sulfate (2 M) or xylose (4.5 M) reduced the NaP response by 90% and
      86%, respectively, and mucosal concanavalin A (1 mg/ml) reduced it by 73%.
      Neither piroxicam (10 microM) nor nordihydroguaretic acid (10 microM) affected
      the NaP response. We hypothesize that NaP stimulates the superficial epithelium
      to release an unidentified agonist that depolarizes predominantly cholinergic
      nerve terminals and causes colonic secretion.

PMID- 8366253
TI  - Role of nitric oxide and vasoactive intestinal polypeptide in vagally mediated
      relaxation of the gastric corpus in the anaesthetized ferret.
AB  - The roles of VIP and NO in vagally mediated relaxations of the gastric corpus
      were investigated in the anaesthetized ferret. Intracorpus pressure was recorded
      manometrically during electrical stimulation of the cervical vagus nerve in three
      groups of animals: one control group (n = 6), one group treated with an inhibitor
      of NO synthesis (NG-nitro-L-arginine methyl ester (L-NAME), 1.6 mg/kg); and a
      third group which had been immunized, prior to the experiment, with a VIP
      thyroglobulin conjugate (25 nmol equivalent) in Freund's complete adjuvant. In
      control animals, following treatment with atropine (100 micrograms/kg), vagal
      stimulation resulted in a frequency dependent fall in intracorpus pressure with
      the maximum response at 5 Hz of 2.2 +/- 0.3 cm H2O. Two components of the
      response could be observed: an initial rapid fall over the first 10 s of
      stimulation followed by a slower decline over the remainder of the stimulation
      period. In animals treated with L-NAME (n = 6) the initial rapid response was
      significantly reduced at all frequencies of stimulation (P < 0.05 - P < 0.005,
      Mann-Whitney U-test) leaving only the slower second component. In immunized
      animals (n = 6) the initial rapid response to vagal stimulation was not different
      from control but the slower second component was significantly reduced at 1 Hz (P
      < 0.005). We conclude that the response to vagal stimulation appears to consist
      of two components which can be differentiated using L-NAME and autoimmunization
      to VIP.

PMID- 8366255
TI  - Clonal attenuation: causes and consequences.

PMID- 8366254
TI  - Renal vasodilatation in response to acute volume load is attenuated following
      lesions of parvocellular neurones in the paraventricular nucleus in rats.
AB  - The effect on the cardiovascular response to volume load, of lesioning the
      paraventriculo-spinal projection to the lower thoracic cord, has been
      investigated in urethane-anaesthetised rats. In control animals volume loading
      with 4% Ficoll 70 in 165 mM NaCl at 0.6 ml/min i.v. up to 1% body weight produced
      a pressor response and tachycardia accompanied by a vasodilatation in the renal
      vascular bed. Injections of 2-4 micrograms ibotenic acid in 100-200 microliters
      solution were made into the paraventricular nucleus to lesion parvocellular
      neurones. When tested 3 days after the lesioning procedure, the renal vasodilator
      component of the response to volume load was abolished, although blood pressure
      and heart rate still rose. When the response to volume load was tested 28 days
      after the lesion, some degree of functional recovery appeared to have taken
      place. In these rats there was a weak renal vasodilation although the maximal
      increase in renal vascular conductance (20 +/- 13%) was still smaller than in the
      control animals. The efficacy of the lesioning procedure was verified by counting
      the number of fluorescent labelled neurones in PVN after injection of 1-2
      microliters of a 1.25% solution of the retrograde marker 4,6 diamidino-2-phenyl
      indole (DAPI) bilaterally into the cord at T8-10. 1005 +/- 63 neurones were
      present in each side of PVN in non-PVN-lesioned rats whilst in lesioned animals
      only 444 +/- 153 cells were present. These results suggest that the
      paraventriculo-spinal projection to the lower thoracic cord may play an important
      role in sympathetically mediated changes in renal blood flow during the early
      phase of the response to an acute volume load.

PMID- 8366256
TI  - Aged C57BL/6J mice respond to cold with increased sympathetic nervous activity in
      interscapular brown adipose tissue.
AB  - Aged, male C57BL/6J mice produce less heat than adults during cold, which may
      lead to a reduced ability to maintain core temperature, but the underlying
      mechanisms of the decreased heat production in aged mice are still unclear. We
      measured sympathetic nervous activity (SNA) to interscapular brown adipose tissue
      (IBAT) in aged mice and compared this activity with that of adults. Mice were
      anesthetized by urethane and isoflurane, and SNA was recorded from one of the
      fine nerves to IBAT. The animal's body caudal to the pelvic area was covered with
      a plastic bag containing iced-water to decrease colonic temperature 7 degrees C
      below control over 20 minutes. SNA to IBAT (IBAT-SNA) increased during cold in
      both groups, but aged mice had higher IBAT-SNA before and during cold. These
      findings indicate that neither the ability of aged mice to detect cold nor their
      ability to generate sympathetic outflow to BAT is deficient.

PMID- 8366257
TI  - Effects of aging, diet, and sex on plasma glucose, fructosamine, and lipid
      concentrations in barrier-raised Fischer 344 rats.
AB  - We studied the relationships of plasma glucose, fructosamine, triglycerides, and
      cholesterol as a function of age, gender, and diet in barrier-raised Fischer 344
      rats aged 5 to 26 months, fed a diet either ad libitum or restricted to 60% of
      the ad libitum caloric intake. The complex relationships of these plasma levels
      to age, gender, and diet led to the development of a model with age, diet, and
      sex as covariates. Overall, fasting plasma glucose concentrations were reduced by
      approximately 25% in rats on the restricted diet, compared to ad libitum-fed
      animals. There was a significant age-dependent decline in glucose levels in male
      animals, whereas in females there was an increase in plasma glucose with aging.
      Plasma fructosamine levels in calorie-restricted animals, overall, were reduced
      by 7% compared to levels in animals fed ad libitum. There was a significant
      positive correlation between plasma glucose and fructosamine levels. Mean plasma
      triglyceride content was decreased by 50% in calorie-restricted rats compared to
      ad libitum-fed animals. A significant decrease in triglyceride levels with
      increasing age was seen in male animals, and an increase with aging in females.
      There was a significant positive correlation between plasma glucose and
      triglyceride levels. Plasma cholesterol levels in calorie-restricted animals were
      reduced by 7% compared to levels in ad libitum-fed animals. An increase of
      cholesterol concentration with aging was significant in both males and females.
      Analysis of the data showed that there were significant differences between male
      and female Fischer 344 rats in the response of plasma glucose and fructosamine to
      aging and calorie restriction. Changes of plasma triglyceride and cholesterol
      with aging and dietary calorie restriction were also different in males and
      females. Studies of the effect of aging on glycemia and blood lipid content
      should take into account the contributions of animal sex.

PMID- 8366258
TI  - Beneficial effects of the oral administration of vanadyl sulphate on glucose
      metabolism in senescent rats.
AB  - We investigated the effects of the oral administration of vanadyl sulphate (0.5
      mg/ml in the drinking water) on glucose homeostasis of 3-month- and 24-month-old
      rats. Results show that aging is associated with alteration of the oral glucose
      tolerance test and impairment of the postprandial accumulation of glycogen in
      skeletal muscles and that the oral administration of vanadyl sulphate rapidly
      normalizes the inbalance of glucose metabolism in senescent rats. It is suggested
      that vanadate administration may restore the ability of skeletal muscles of
      senescent rats to respond to circulating insulin efficiently.

PMID- 8366259
TI  - Senescent decline in serum dehydroepiandrosterone sulfate concentrations in a
      population of wild baboons.
AB  - The physiologic functions of dehydroepiandrosterone sulfate (DS), a precursor of
      androgens and estrogen and the most abundant steroid in the circulation, are
      unknown. Nevertheless, numerous studies have shown that low concentrations of DS
      are correlated with a variety of metabolic and cardiovascular diseases in human
      beings, and administration of DS to experimental animals is associated with
      protection from similar diseases. Thus, the marked decline in DS concentrations
      with age in human beings may be of considerable functional significance. However,
      because of the difficulties in studying any heterogeneous human population, it
      has been difficult to assess the extent to which the DS decline with age is
      confounded by any of a number of factors (e.g., smoking, level of activity,
      genetics, diet, medication and disease). We studied the effects of age on DS
      concentrations in a well-characterized population of wild yellow baboons living
      freely in a national park in East Africa. Study of these animals circumvents many
      of the confounds just noted. In examining animals ranging in age from juvenile
      status to old age, we observed a robust decline in DS concentrations with age.
      The magnitude of the decline is approximately equal in both sexes. In addition,
      the decline is similar in comparing two baboon groups which have fully natural
      diets with one group which forages heavily on garbage from people.

PMID- 8366260
TI  - Acute delirium and functional decline in the hospitalized elderly patient.
AB  - BACKGROUND: Delirium is often considered a transient cognitive syndrome. Its
      effect on long-term physical function, however, has not been well defined.
      METHODS: In a prospective study of 325 hospitalized community and nursing home
      elderly, we analyzed the effect of in-hospital delirium on subsequent physical
      function. ADL performance was assessed prior to admission, and at 3 and 6 months
      after hospital discharge. RESULTS: There was a strong univariate (unadjusted)
      association between incident delirium and functional decline (p < .02). Delirious
      subjects lost a mean of almost one ADL, as measured 3 months after hospital
      discharge. Using multivariate linear regression analysis, with adjusted change in
      function as the dependent variable, delirium persisted as the sole predictor of
      loss of function (p = .009) at 3 months after discharge. The functional decline
      persisted at 6 months after hospital discharge. CONCLUSION: This finding of a
      nontransient, perhaps permanent consequence of delirium invites reexamination of
      the definition of delirium from that of an acute, reversible syndrome to one of
      acute onset with long-term sequelae.

PMID- 8366261
TI  - Identifying elderly patients for early discharge after hospitalization for hip
      fracture.
AB  - BACKGROUND: Some elderly patients can be successfully treated in hospitals with
      lengths of stay (LOS) shorter than the norms developed by the diagnosis-related
      groups. This study was designed to test the hypothesis that elderly patients with
      short LOS after hip fracture have characteristics that can be identified shortly
      after hospital admission. METHODS: A retrospective chart review was performed of
      216 patients over age 55 discharged alive from a university hospital after hip
      fracture. Demographic, medical, and functional data available within 48 hours of
      admission were used to develop an algorithm to identify patients eligible for
      early discharge. A prospective study of an additional 33 patients was undertaken
      to test this algorithm and to examine the predictive value of additional
      functional and psychosocial information not routinely recorded in the chart.
      RESULTS: Retrospective chart review identified 4 predictors of short LOS in
      multivariate analysis: age less than 75, admission from a nursing home, normality
      of admission laboratory results, and "no surgery or surgery by day three." These
      variables explain 25% of the total variation of LOS. In our prospective study the
      variable "day of surgery" had the greatest variance explanation (30.5%) in
      multivariate analysis. A model including day of surgery and the presence of
      dementia explained 42.5% of the variance of LOS. CONCLUSION: Short LOS can be
      predicted within 48 hours of admission utilizing data that measure severity of
      illness, functional status, and available support. The development of algorithms
      to identify patients eligible for early discharge would be beneficial to care
      managers.

PMID- 8366262
TI  - Functional performance measures: are they superior to self-assessments?
AB  - BACKGROUND: It has been suggested that performance measures of functional status
      have several advantages over self-report measures for both clinical and research
      purposes, including: greater patient acceptability, interpretability,
      reproducibility, sensitivity to change, and the focus on actual ability rather
      than presumed capability. This article challenges this assumed superiority of
      "objective," "behavioral" measures by directly comparing self-assessments and
      blindly rated performance assessments on a specific item by task basis, using an
      identical rating format. METHODS: A set of 14 performance tasks, consisting of a
      range of functional abilities (including simulations of cooking and sweeping),
      was administered to 99 community-dwelling older adults (aged 60-92) who had
      previously completed a 50-item instrumental activities of daily living (IADL)
      questionnaire. A subsample was retested 2 weeks later, and reassessed at 1 year.
      RESULTS: Of 182 subjects willing and able to complete the IADL questionnaire,
      only 99 attempted at least one of the performance tasks. Tasks that took longer
      to complete were not necessarily associated with a greater number of errors, nor
      did accuracy ratings correspond well with difficulty ratings. Good correspondence
      (greater than 80% agreement) between observed and perceived difficulty was found
      for only one-third of the item/task matchings. Generally, the rater tended to
      underestimate difficulty relative to subjective assessments. CONCLUSIONS:
      Relative to questionnaires, performance measures were not found to be
      psychometrically superior, more acceptable to respondents, easier to administer,
      or easier to interpret. Neither type of measure by itself distinguishes between
      motivation and capability, reflects adaptations made in everyday living, or
      accounts for personal preferences or reasons for difficulty.

PMID- 8366263
TI  - Cortisol production rate and the urinary excretion of 17-hydroxycorticosteroids,
      free cortisol, and 6 beta-hydroxycortisol in healthy elderly men and women.
AB  - BACKGROUND: Although many workers have tested adrenal function in the elderly,
      few have studied the effect of aging on cortisol production rate or urinary free
      cortisol or 6 beta-hydroxycortisol excretion, and none have published comparisons
      of these variables between old people of defined health status and young people.
      METHODS: We have measured cortisol production rate and the urinary excretion of
      free cortisol, 6 beta-hydroxycortisol, 17-hydroxycorticosteroids (Porter-Silber
      chromogens) and creatinine in elderly men and women screened by the SENIEUR
      protocol and in young men; 17-hydroxycorticosteroid and 6 beta-hydroxycortisol
      excretion were also measured in young women. The period of measurement was 24 h
      or, usually, 48 h. RESULTS: Only 6 beta-hydroxycortisol excretion was affected by
      aging; it was lower in the elderly men and women than in their younger
      counterparts. Urinary free cortisol excretion was lower in the elderly women than
      in the elderly men. There were no significant differences between groups in
      cortisol production rate or 17-hydroxycorticosteroid excretion. Excretion and
      (over the first 24 h) clearance of creatinine were lower in the old women than in
      the old men. The cortisol-related variables tended to be positively correlated
      with each other and with the relevant creatinine-related variables in the elderly
      subjects; over the first but not the second 24 h, most of the correlations were
      significant in the men and women combined. CONCLUSIONS: With the exception of 6
      beta-hydroxycortisol, the data agree with measurements of plasma cortisol and the
      results of adrenal function tests in showing little change in hypothalamic
      pituitary-adrenal function with aging in healthy people.

PMID- 8366264
TI  - Cross-sectional and longitudinal analyses of stimulated parotid salivary
      constituents in healthy, different-aged subjects.
AB  - BACKGROUND: Salivary gland dysfunction has traditionally been associated with old
      age, and complaints of xerostomia are common in an elderly population.
      Measurement of certain salivary constituents can provide information about the
      functional ability of discrete areas of the salivary gland. To our knowledge,
      this is the first longitudinal study to examine levels of salivary constituents
      in stimulated parotid saliva in a population of different-aged persons. METHODS:
      The levels of five salivary constituents (total protein, lactoferrin, proline
      rich proteins, sodium, and potassium) were measured in stimulated parotid saliva
      of 47 healthy, unmedicated men and women over a 10.5 year period. RESULTS: There
      were no significant age-related decreases in the presence of total protein,
      lactoferrin, proline-rich proteins, sodium, and potassium in this exocrine
      secretion. CONCLUSIONS: These data confirm and extend previous cross-sectional
      studies of salivary constituents, indicating that parotid gland function is
      maintained in healthy aging individuals.

PMID- 8366265
TI  - Dynamic stability in the elderly: identifying a possible measure.
AB  - BACKGROUND: The purpose of this research was to assess the ability of trunk
      acceleration measures to discriminate between the walking patterns of elderly
      individuals with and without stability problems. METHODS: Twenty volunteers, aged
      65 and over, and 19 younger volunteers, all of whom were free of abnormalities or
      problems that could affect their gait, were recruited for this study. A triaxial
      accelerometry system was mounted directly over the spine of the upper trunk.
      Forty seconds of walking data were collected. Using a heel contact switch to
      define the beginning of the gait cycle, harmonic analyses of each of the 3
      acceleration measures were performed on 10 strides. The ratio of summed
      amplitudes of the even and odd harmonics (index of smoothness) was calculated for
      each stride and averaged across 10 strides. One-way analyses of variance were
      used to compare harmonic ratios between groups. Relationships between variables
      were tested using a correlation analysis. RESULTS: The scores of individuals with
      stability problems were shown to be significantly different from the younger
      controls and the older individuals without stability problems for the
      anterior/posterior and vertical harmonic ratio and peak acceleration measures.
      CONCLUSION: The results from this research demonstrate that trunk acceleration
      measures offer the possibility of being able to identify unstable elderly
      individuals.

PMID- 8366267
TI  - Aging, inhibition, and verbosity.
AB  - The hypothesis that off-target verbosity, defined as extended speech that is
      lacking in focus or coherence, is mediated by an age-related decline in the
      ability to inhibit task-irrelevant thoughts, was evaluated in a sample of 205
      community-dwelling elderly volunteers aged 61-90. Results showed that performance
      on four tasks that measured the ability to suppress or remove irrelevant
      information stored in working memory accounted for a significant proportion of
      the variance in verbosity, whereas performance on other cognitive measures was
      unrelated to it. Shared effects between the measures of the ability to inhibit
      task-irrelevant information and age suggested that age declines in this
      particular ability may underlie previously observed age-related increases in
      verbosity. In contrast, the contribution of psychosocial factors to explained
      variance in verbosity scores was relatively independent of that of inhibition
      related measures and age. The results were discussed as suggesting a possible
      frontal lobe involvement in off-target speech.

PMID- 8366266
TI  - Claudication pain and hemodynamic responses to exercise in younger and older
      peripheral arterial disease patients.
AB  - BACKGROUND: Claudication patients who are candidates for exercise can frequently
      walk to maximal pain without experiencing exaggerated blood pressure and heart
      rate, as well as other clinical symptoms. However, these concomitant problems are
      more likely to become apparent as patients age. Consequently, this study compared
      the claudication and hemodynamic responses to exercise in younger and older
      peripheral arterial disease patients. METHODS: Forty younger (mean age 60.4 yr,
      range 55-62) and 51 older (mean age 75.5 yr, range 73-81) patients with stable
      claudication symptoms performed a progressive treadmill walking test to maximal
      leg pain. The times to onset and to maximal claudication pain, peripheral
      hemodynamic measurements (oximetry, ankle systolic pressure, and ankle-to
      brachial systolic pressure index), and central hemodynamic measurements (heart
      rate and brachial blood pressures) were obtained. RESULTS: Onset and maximal
      claudication pain occurred 71 sec and 126 sec sooner (p < .05) in the older
      group, respectively. Greater reductions (p < .05) in foot transcutaneous oxygen
      tension, ankle systolic pressure, and ankle-to-brachial systolic pressure index
      were obtained during and following exercise in the older group. Furthermore,
      smaller increases (p < .05) in heart rate, brachial blood pressures, mean
      arterial pressure, and rate-pressure product were noted during exercise in the
      older group. CONCLUSIONS: Greater impairment in the peripheral hemodynamic
      measurements occurs without exaggerated heart rate and blood pressure responses
      in older claudication patients who walk to maximal leg pain compared with younger
      patients.

PMID- 8366268
TI  - Long-term maintenance of gains from memory training in older adults: two 3 1/2
      year follow-up studies.
AB  - This study investigated long-term effects from memory training in healthy older
      adults, using samples from two previous studies showing maintenance of gains 6
      months after training. In both studies, a multifactorial memory training program
      (encoding operations, attentional functions, and relaxation) was compared with
      other training programs. The results from both studies showed that all groups
      performed at the same level in the 3 1/2-year follow-up as in the 6-month follow
      up. Most important, the groups receiving training in encoding operations
      performed at higher levels at the 3 1/2-year assessment compared with pretest.
      These data indicate that memory training may result in long-term effects for
      older adults in tasks that are congruent with the training activity.

PMID- 8366269
TI  - Young and old adults' ability to use different standards to evaluate
      understanding.
AB  - In Experiment 1 we examined young (mean age = 22.88 years) and old (mean age =
      70.79 years) adults' ability to evaluate their understanding of texts. We
      examined ability to detect nonsense words (a lexical standard), violations of
      prior knowledge (an external consistency standard), and inconsistent sentences
      (an internal consistency standard) that were nonadjacent in texts. Adults with
      more education detected more problems than less educated adults, and older adults
      were less able than young to use an internal consistency standard. No age
      differences were found for lexical and external consistency standards. In
      Experiment 2, older adults' (mean age = 71.02 years) ability to use an internal
      consistency standard of evaluation was affected by the amount of material
      intervening between inconsistent sentences, with hindered performance for
      nonadjacent inconsistencies. This was not true for younger adults (mean age =
      22.59 years). Results are discussed in terms of older adults' possible retrieval
      difficulty and failure to regulate comprehension.

PMID- 8366270
TI  - Influence of task-specific processing speed on age differences in memory.
AB  - Two studies were conducted to investigate the aspect(s) of processing involved in
      the hypothesized speed mediation of adult age differences in memory. Both studies
      involved a serial memory task in which information was to be recalled either in
      the original order of presentation, or in a reordered sequence. Results from both
      studies indicated that task-specific processing durations were slower among older
      adults than among young adults, but that the attenuation of the age-related
      variance in memory was nearly as great after statistical control of a task
      independent speed measure as after control of task-specific speed measures. These
      findings are consistent with the hypothesis that a substantial proportion of the
      adult age-related differences in memory is associated with a decrease with
      increased age in the speed of executing many cognitive processes, and not simply
      the speed of one or two specific processes.

PMID- 8366271
TI  - Construction and validation of the Reminiscence Functions Scale.
AB  - This research introduces the Reminiscence Functions Scale (RFS), a 43-item
      questionnaire that can be used to assess reminiscence functions over the
      lifecourse. Adults (710) ranging in age from 17 to 91 (mean age = 45.76 years)
      completed a 54-item Reminiscence Functions Scale-prototype measure, the results
      of which were submitted to a principal components analysis. Results indicated the
      viability of a 43-item, 7-factor solution with good reliability. Factors were
      labeled: Boredom Reduction, Death Preparation, Identity/Problem-Solving,
      Conversation, Intimacy Maintenance, Bitterness Revival, and Teach/Inform. A
      separate validity study demonstrated the predictive validity of the RFS.
      Directions for future research are discussed.

PMID- 8366272
TI  - Race differences in life satisfaction among aged men and women.
AB  - The purpose of this study was to attempt to explain why race differences emerge
      in examinations of life satisfaction among older adults retired from the work
      force. A conceptual model was developed and tested with data provided by 1,156
      older Black and White individuals. The findings from this nationwide survey
      reveal that older Blacks have lower levels of life satisfaction than elderly
      Whites and that these differences may be attributed to the interplay between past
      aspirations and plans (as reflected by educational attainment and economic
      retirement plans) and present financial circumstances (as assessed by current
      financial strain and economic dependence on family members).

PMID- 8366273
TI  - Social support and caregiving burden in family caregivers of frail elders.
AB  - This study assessed the relationships between six different types of social
      support and five measures of caregiving burden. Two questions were addressed: Are
      all types of social support equally associated with burden, and do the same types
      of support correlate with different types of burden? Family caregivers (N = 217)
      to frail elders composed the sample. Multiple regression analyses demonstrated
      that all types of social support for caregivers of frail elders are not equal.
      Engaging in social interaction for fun and recreation appears to be the most
      important in diminishing the burden of caregiving. These findings are instructive
      both theoretically and clinically. The theoretical import of greater social
      participation under a condition of chronic stress is discussed. Further,
      interventions that focus on caregivers regularly experiencing pleasant activity
      with friends and other family would seem to go a long way toward managing the
      burden of caregiving.

PMID- 8366274
TI  - Driving cessation and changes in mileage driven among elderly individuals.
AB  - The factors associated with driving cessation, number of miles driven, and
      changes in mileage were assessed in a community-living elderly population. A
      driving survey was administered in 1989 to surviving members of the New Haven
      EPESE cohort. Of 1,331 respondents, 456 had driven and 139 had stopped driving
      between 1983 and 1989. Independent predictors of driving cessation from a
      multiple logistic regression model included higher age, lower income, not
      working, neurologic disease, cataracts, lower physical activity level, and
      functional disability. These risk factors were combined to assess their ability
      to predict driving cessation. If no factors were present, no subjects stopped
      driving; if one or two factors were present, 17 percent stopped; if three or more
      factors were present, 49 percent stopped. Along with the expected medical
      factors, physical activity level and social and economic factors contributed to
      driving cessation. High mileage drivers tended to be younger, active males who
      still worked. Increasing age and disability were associated with mileage
      reduction compared to five years earlier.

PMID- 8366275
TI  - Psychosocial predictors of stroke outcomes in an elderly population.
AB  - The influence of premorbid psychosocial factors on physical function and
      institutionalization 6 weeks after hospital discharge was studied in elderly
      stroke patients. The predictor variables of interest were social networks,
      availability of social support, pre-stroke depression (CES-D), and religiousness.
      The data were obtained from a prospective longitudinal study based on 2,812
      noninstitutionalized individuals aged 65 years and older living in New Haven,
      Connecticut. Incident stroke cases from this study were followed for post-stroke
      outcomes. Results from 87 survivors indicated that larger social networks were
      associated with fewer limitations in physical function, controlling for relevant
      health and sociodemographic conditions. Larger networks were also associated with
      a lower risk of institutionalization (p < .05). None of the other psychosocial
      factors assessed appeared to be related to these outcomes.

PMID- 8366276
TI  - Predicting outcomes of nursing home residents: death and discharge home.
AB  - The purpose of this study was to document prevalence, identify leading
      indicators, and develop and assess prediction models for nursing home resident
      outcomes (death, discharge home). New residents (N = 647) in eight nursing homes
      were evaluated on admission and 3 and 6 months later. Predictor variables tested
      included 14 health status variables, 5 demographic variables, and 6 other
      resident and nursing home variables. A cancer diagnosis was the most important
      risk factor for death at 3 months (OR = 8.0) and 6 months (OR = 10.8). A first
      nursing home admission was the most important risk factor for discharge to home
      at 3 months (OR = 9.5) and 6 months (OR = 13.9). Not having a dementia diagnosis
      was the second most important risk factor for discharge to home at 3 months (OR =
      5.8) and 6 months (OR = 4.2). All prediction models demonstrated useful potential
      for clinical application.

PMID- 8366277
TI  - 'Shake-up' in drug industry predicted. Interview by Bob Carlson.

PMID- 8366278
TI  - Managed care and managed competition: preparing for an uncertain future.

PMID- 8366279
TI  - Hospitals buying physicians' practices.

PMID- 8366280
TI  - Physicians can help end the violence.

PMID- 8366281
TI  - Prophylactic knee braces for football: do they work?
AB  - Knee injuries in athletics are a major problem facing the sports medicine
      community. There is no compelling evidence to suggest that the likelihood of
      sustaining a knee injury is increasing; however, more knee injuries are being
      identified and treated due to improved diagnostic techniques. Successful
      prevention of knee injuries with prophylactic braces has not paralleled the
      substantial advances in diagnosis and treatment of these knee problems. This
      article summarizes the current data available and makes recommendations for
      subsequent prophylactic knee brace use.

PMID- 8366282
TI  - Common insurer creates potential conflict of interest.

PMID- 8366283
TI  - Patent ductus arteriosus in neonates.
AB  - Patency of the ductus arteriosus is one of the more common problems of the
      neonate. Although the ductus arteriosus usually closes within the first days of
      life, persistent patency can complicate the clinical status of a newborn. The
      ductus arteriosus also may play a role in the pathophysiology of persistent
      pulmonary hypertension of the newborn and in some forms of congenital heart
      disease. Diagnosis of patent ductus arteriosus can be suspected clinically but
      should be verified by echocardiography before treatment. Accurate diagnosis,
      early intervention and proper treatment are necessary to decrease the immediate
      risks and minimize the potential for long-term complications.

PMID- 8366284
TI  - Proton beam therapy using the IU Cyclotron Facility.

PMID- 8366285
TI  - Optimal circadian timing reduces the myelosuppressive activity of recombinant
      murine interferon-gamma administered to mice.
AB  - There is a marked, reproducible circadian variation in the toxicity of a number
      of antineoplastic drugs. A recent study has employed a murine model to show that
      recombinant human interferon-alpha A/D (rHuIFN-alpha A/D) exhibited a
      differential potency in its peripheral white blood cell (WBC)-suppressive and
      bone marrow-suppressive activities according to the time in the circadian cycle
      at which it was administered. It was of interest to determine whether another
      biological response modifier such as IFN-gamma would also exhibit a differential
      potency during the circadian cycle. A mouse model was used to study peripheral
      WBC suppression, a toxicity associated with IFN-gamma therapy. Recombinant murine
      (rMu)IFN-gamma was employed to induce peripheral WBC suppression and was
      evaluated for its ability to induce peripheral WBC suppression as a function of
      the time of rMuIFN-gamma administration. Mice were maintained on cycles of 12 h
      of light and 12 h of darkness. The rMuIFN-gamma was administered at various hours
      after light onset (HALO). The rMuIFN-gamma-induced peripheral WBC-suppressive
      effect varied in its intensity in a cyclical manner. Administration of rMuIFN
      gamma at 4 HALO caused the greatest suppressive effect, whereas administration of
      rMuIFN-gamma at 14 HALO caused the least suppressive effect. Mice treated at 14
      HALO were found to be about 20-fold less sensitive to the peripheral WBC
      suppressive effects of rMuIFN-gamma than mice treated at 4 HALO. This
      differential sensitivity to the peripheral WBC-suppressive effects of rMuIFN
      gamma was examined at six different times in the circadian cycle and was found to
      be a general effect, occurring throughout the circadian cycle.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8366286
TI  - Sex hormones and sex hormone-binding globulin in males with chronic viral
      hepatitis during recombinant interferon-alpha 2b therapy.
AB  - The effect of long-term treatment with recombinant interferon-alpha 2b (IFN-alpha
      2b) on luteinizing hormone (LH), testosterone, free testosterone, and sex hormone
      binding globulin (SHBG) was evaluated in 7 male patients suffering from chronic
      viral hepatitis. The drug was given three times a week for 6 months in a single
      standard dose of 3 x 10(6) units. Hormone evaluations were performed in basal
      conditions and every 2 months for 12 months. Serum testosterone values decreased
      after IFN treatment, reaching the lowest levels at the 6th month. However,
      testosterone values did not fall below the normal range. Serum SHBG
      concentrations, which were above the normal range in basal conditions, also
      decreased after IFN. Serum-free testosterone and LH concentrations did not change
      during IFN therapy. IFN-alpha 2b at the dose and schedule employed was not
      responsible for any measurable imbalance in male sex hormones.

PMID- 8366288
TI  - T-cell surface molecule expression and interferon-gamma production in human cord
      blood.
AB  - We investigated T-cell surface antigen expression and the production of
      interferon-gamma (IFN-gamma) and interleukin-2 (IL-2) by human cord and adult
      blood cells. Cord blood lymphocytes stimulated with Staphylococcus enterotoxin B
      (SEB) released only minimal titers of IFN-gamma and IL-2 in comparison with adult
      blood lymphocytes. Systematic analyses of several cell-surface molecules on
      untreated cord blood and adult blood T cells demonstrated a significant reduction
      of CD8+ subset numbers in cord blood. Furthermore, cord blood lymphocytes did not
      express the memory T-cell marker CD45RO. No differences were found in gamma/delta
      T-cell receptor (TCR), CD5, and CD25 antigen expression between untreated cord
      blood and adult blood. However, cord blood mononuclear cells showed a decreased
      CD25 antigen expression in comparison to those of adults following activation
      with SEB. These observations suggest that the decrease in the proportion of some
      T-cell subsets and the absence of CD45RO memory T cells may be responsible for
      the diminished lymphokine production of cord blood lymphocytes.

PMID- 8366287
TI  - The effect of gonadotropins on the production of human interferon-gamma by
      mononuclear cells.
AB  - Gonadotropins--follicle-stimulating hormone (FSH), luteinizing hormone (LH), and
      human chorionic gonadotropin (HCG)--and the related agent thyrotropin were shown
      to enhance yields of interferon-gamma (IFN-gamma) from human peripheral blood
      mononuclear cells (PBMC) significantly when calcium ionophores (ionomycin or
      A23187) were used as inducers. The enhancement increased the IFN yields four- to
      eight-fold. Induction with other inducers, (such as lectins, interleukin-2 (IL
      2), and anti CD3, was not associated with enhancement of the IFN yields by
      gonadotropins. Concentrations of gonadotropins associated with pregnancy (HCG) or
      menopause (FSH and LH) were able to enhance IFN-gamma yields. Addition of the
      gonadotropins to the cells after the ionophore gave the greatest degree of
      enhancement. Perturbation of the calcium messenger system or nonspecific
      stimulation of adenyl cyclase failed to influence the IFN yield enhancing effect
      of the gonadotropins. No effect of gonadotropins was observed on IFN bioactivity.

PMID- 8366289
TI  - Analysis of interferon-alpha 2 sequences in human genomic DNA.
AB  - We have analyzed the genomic DNA sequence corresponding to the human interferon
      alpha 2 (IFN-alpha 2) gene locus. In human lymphoblastoid Namalwa cells, we have
      detected sequences corresponding to IFN-alpha 2b and -2c, while in human KG-1
      cells both IFN-alpha 2a and -2b were present. However, in 100 independent IFN
      alpha 2 clones derived from 20 unrelated Caucasian volunteers, we found only
      sequences corresponding to IFN-alpha 2b. Statistical analysis of this result
      suggests that the sequences corresponding to IFN-alpha 2a and -2c are either rare
      allelic variants of this gene, occurring in only a minority of the Caucasian
      population, or are restricted to transformed cell lines.

PMID- 8366290
TI  - Is there a seasonal variation in the interferon-producing capacity of healthy
      subjects?
AB  - Induced production of interferon-alpha (IFN-alpha) and IFN-gamma was studied in
      101 blood samples from 49 healthy subjects during 1 year. The results indicate a
      seasonal variation of the IFN-producing capacity, with a decrease in summertime,
      in Finland.

PMID- 8366291
TI  - Cyclosporin A inhibits nitric oxide production by L929 cells in response to tumor
      necrosis factor and interferon-gamma.
AB  - We recently reported that tumor necrosis factor (TNF) induced the production of
      nitric oxide (NO) by TNF-sensitive, but not-resistant, tumor cells.
      Paradoxically, NO thus produced does not appear to be involved in the mechanism
      of TNF-mediated cytotoxicity as inhibitors of NO production and NO scavengers did
      not block cytotoxicity. Because the immunosuppressive drug cyclosporin A (CsA)
      inhibits several types of immune-mediated killing, we were interested in what
      effect CsA would have on TNF-mediated cytotoxicity as well as NO production.
      Treatment with CsA had no effect on the sensitivity L929 cells to TNF-mediated
      cytotoxicity, either in the presence or absence of interferon-gamma (IFN-gamma).
      In the presence of IFN-gamma alone, L929 cells were slightly less sensitive to
      the cytotoxic effects of TNF. In contrast to the effect on TNF-mediated
      cytotoxicity, CsA treatment had a profound effect on the ability of these cells
      to produce NO in response to TNF and IFN-gamma. Cells treated with CsA produced
      75% less NO than did their untreated controls. Inhibition of calmodulin-dependent
      calcineurin-like phosphatases is one mechanism by which CsA may exert its
      effects. Therefore, we tested the effect of EGTA, which inhibits calcineurin by
      chelating calcium, on NO production and found that EGTA treatment resulted in a
      15% decrease in the amount of NO produced. In addition, cells treated with the
      calmodulin antagonist W-13 produced 79% less NO than their untreated controls.
      Therefore, these results provide further evidence that NO produced by TNF
      sensitive cells is not involved in the mechanism of TNF-mediated cytotoxicity
      because reduction of NO production by CsA has no effect on TNF-mediated killing
      of these same cells.

PMID- 8366292
TI  - Tissue polypeptide antigen immunostaining in fine needle aspirates from solid
      breast nodules.
AB  - The purpose of this study was to determine the role of Tissue Polypeptide Antigen
      (TPA) immunostaining in the evaluation of aspiration smears from solid breast
      nodules and to discuss its possible clinical applications. Seventy-one cytologic
      specimens were studied; 52 were carcinomas, 15 fibroadenomas and 4 fibrocystic
      dysplasia. TPA was visualized with the peroxidase-antiperoxidase method, using 3
      3' diaminobenzidine as chromogen and hematoxylin as counterstaining. The
      incidence of TPA-positive aspiration smears was 88.5% in the carcinomas and 26.7%
      in the fibroadenomas. The four cases of fibrocystic dysplasia showed variable
      behaviour. The intensity of the TPA staining varied from - to and was most
      frequently high in the carcinomas. The results of this research show a good
      correlation between a diagnosis of carcinoma and TPA positivity in fine needle
      aspirates of solid breast nodules.

PMID- 8366293
TI  - Biochemistry and molecular biology of MCA.
AB  - The mucin-like carcinoma-associated antigen (MCA) is a mucin with a molecular
      weight of 350-500 kD. It circulates in the serum and its serum content can be
      determined with the Cobas Core MCA EIA test. Patients with breast cancer show
      elevated MCA serum levels. The molecule has a polypeptide backbone consisting of
      three parts: the C-terminus the N-terminus and the transmembrane sequences. The
      protein is heavily glucosylated with carbohydrate side chains that contain
      fucose, galactose and N-acetyl galactosamine. The antibody b-12 recognizes a
      repetitive epitope on the peptide portion of the MCA molecule. The epithelial
      mucin, which is coded by a unique gene, was cloned using PCR technology. Peptides
      corresponding to the N- and C-terminus were expressed in E. coli. Analysis of the
      purified peptides revealed molecular weights of 12 and 18 kD.

PMID- 8366294
TI  - Mucin-like carcinoma-associated antigen (MCA) in tissue and serum of patients
      with breast cancer: clinical applications in prognosis and disease monitoring.
AB  - Mucin-like Carcinoma-associated Antigen (MCA) has been associated with many
      breast cancers. The aim of this study was to evaluate MCA in tumor tissue and
      serum as a potential tumor marker for prognosis and disease monitoring. MCA
      levels were determined in the tissue of 196 patients with primary breast cancer,
      25 with metastatic disease and 25 patients with benign diseases, in pellet and/or
      cytosol. MCA levels were also determined in the serum of 50 patients with benign
      diseases, 148 with primary breast cancer (Mo), 150 with metastatic breast cancer
      (MT), and 200 with no clinical evidence of disease (NED). MCA tissue
      concentrations in pellet and cytosol were similar: 66.7 + 251 U/mg and 41.1 + 53
      U/mg, respectively. No relationship between MCA levels and tumor size or nodal
      involvement was found. Higher MCA levels were observed in patients with ER+ or
      PgR+ tumors than in those with ER- or PgR- tumors (p < 0.01). Patients with MCA
      pellet concentrations lower than 10 U/mg of protein had shorter disease-free
      intervals (DFI) than those with higher values (p < 0.05). Abnormally high serum
      levels of MCA were found in 8% of patients with benign diseases, 4% of NED
      patients, 22% of Mo patients, and in 76% of MT cases. In primary breast cancer
      MCA values were related to tumor size and nodal involvement. A trend toward a
      lower DFI in patients with elevated presurgical MCA levels was observed but was
      of no statistical significance. These differences became statistically
      significant when patients were subdivided according to nodal status, with shorter
      DFI in those without nodal invasion (p < 0.05). In metastatic patients, changes
      in serum MCA were related to the tumor's response to treatment in 82% of cases.
      The highest MCA values were found in patients with liver or bone metastasis and
      the lowest values were found in those with locoregional recurrence. In
      conclusion, although MCA is not a specific tumor marker, it can be useful as a
      prognostic factor (tissue and serum) and in monitoring metastatic patients.

PMID- 8366296
TI  - Clinical significance of the new tumor marker MCA in the follow-up of patients
      with mammary carcinoma.
AB  - MCA is a mucin-like carcinoma-associated antigen which has been found in all
      breast cancer independent of histological type and degree of differentiation. A
      two-step solid-phase EIA was developed and the serum concentration of MCA was
      measured in 176 breast cancer patients after surgery. Using a cutoff of 11.0 U/ml
      the test showed a sensitivity of 77% and a specificity of 82% when compared to
      clinical status. The predictive value of this tumor marker was 72% for a positive
      diagnosis and 93% for a negative diagnosis. Based on these observations it is
      recommended that determination of MCA values take place 2 to 3 times in the first
      postoperative week in all women with surgically treated mammary carcinoma. These
      MCA values should then serve as reference for further determinations, which
      should be performed at each check-up. A subsequent increase in the MCA value
      should be considered as a first sign of metastasis.

PMID- 8366295
TI  - Mucin-like carcinoma-associated antigen (MCA) in breast cancer: clinical
      experience at the National Cancer Institute of Milan.
AB  - Mucin-like Carcinoma-associated Antigen (MCA) is a glycoprotein belonging to the
      mucin family; it is defined by the monoclonal antibody b-12. Mucins represent an
      interesting group of tumor markers and are widely utilized in the clinical
      monitoring of neoplastic patients. These molecules show a certain degree of
      tissue specificity and MCA is preferentially associated with breast tissue.
      Several studies have demonstrated that patients with breast cancer usually have
      high MCA serum levels. In this paper the experience of the National Cancer
      Institute of Milan with the clinical use of MCA in breast cancer patients is
      reported. The observed sensitivity of the MCA test was poor in patients with
      early-stage disease, while it was acceptable in patients with advanced breast
      cancer. MCA concentrations appeared to be directly related to disease spread. A
      clear relationship was seen between MCA levels and lymph-nodal status. The
      highest MCA plasma levels were observed in patients with metastatic disease. In
      this group of patients the sensitivity of the test on the basis of a cut-off of
      11 U/mL was 52%.

PMID- 8366297
TI  - Rapid, automated enzyme immunoassay for MCA with the Cobas Core Roche
      immunochemistry analyser.
AB  - The breast cancer marker Mucin-like Carcinoma-associated Antigen (MCA) was
      evaluated in a version that has been adapted to a new enzyme immunoanalyser, the
      Cobas Core. The two-step sandwich assay has a short total assay time of less than
      60 minutes. Standard curves are stable for at least 2 weeks. The coefficients of
      variation for the inter-assay precision ranged between 3.6% and 7.8%, but were
      mainly below 5%. Single determinations of patient values from different runs
      correlated also very closely (R = 0.99). The dilution linearity for a set of 14
      sera exhibited recovery rates mostly ranging from 90% to 110%. From 165 blood
      donors investigated, more than 99% had values below the cut-off of 11 U/ml. As
      demonstrated for pathological sera, the automated and manual versions showed a
      high degree of accordance (R = 0.98). The investigation presents convincing
      evidence that the Cobas Core MCA EIA running on a Cobas Core analyser guarantees
      a high analytical reliability and reproducibility.

PMID- 8366298
TI  - Immunoscintigraphy in colorectal cancer: surgeon's perspective.
AB  - External immunoscintigraphy (IS) is a new imaging tool to diagnose, stage and
      follow-up solid malignancies. Monoclonal antibodies are raised to tumor
      associated antigens, radiolabeled and when injected in the patient localize to
      the tumor. Detection is with nuclear medicine gamma camera. In colorectal cancer,
      immunoscintigraphy can be beneficial to the surgeon. With primary colorectal
      carcinoma, IS detects synchronous primaries, identifies lymph node metastasis,
      determines extent of disease and detects occult metastasis. Postoperatively, in
      high-risk patients (Dukes B2, B3 and C lesions) IS assists in the follow-up for
      recurrence. Particular advantage with IS is seen in pelvic, mesenteric and
      retroperitoneal recurrences. Rising serum CEA and negative conventional cross
      sectional imaging can often be clarified as to site of disease with IS. IS
      contributes significantly to surgical decision making with alterations in
      management based on radiolabeled monoclonal antibody scans in 25-32% of primary
      and recurrent colorectal cancer cases.

PMID- 8366299
TI  - Usefulness of terminal deoxynucleotidyl transferase as prognosticator in leukemia
      patients.
AB  - Peripheral blood samples from 55 previously untreated leukemia patients (33
      males, 22 females) were analysed for terminal deoxynucleotidyl transferase (TdT)
      activity. TdT was significantly higher in patients with acute myelogenous
      leukemia (AML; P < 0.001), chronic myelogenous leukemia (CML; P < 0.05) and acute
      lymphoblastic leukemia (ALL; P < 0.001) when compared with controls. One patient
      with chronic lymphocytic leukemia (CLL) had undetectable TdT. Among leukemic
      patients, ALL patients had higher concentration of TdT than CML and AML patients.
      Females had higher TdT activity than males, although the difference between the
      two groups was not statistically significant. 68% TdT+ and 32% TdT- patients were
      in blastic crisis. Patients with more than 10% of blasts in the circulation had
      significantly higher TdT than blast-negative patients (P < 0.001). No difference
      in survival was observed between TdT+ and TdT- group. From these results, we
      conclude that the absolute TdT concentration is of little prognostic value in
      leukemia patients.

PMID- 8366300
TI  - Squamous cell carcinoma antigen (SCC), carcinoembryonic antigen (CEA), and tumour
      associated trypsin inhibitor (TATI) for monitoring head and neck cancer.
AB  - Eighty-eight patients with head and neck cancer were prospectively monitored,
      before and after treatment, by means of simultaneous serum SCC, CEA and TATI
      measurements. Thirty-two (36.6%) patients had early stages (I, II, III) and 56
      (63.4%) advanced (stage IV) or recurrent disease. Pre-treatment serum SCC levels
      were elevated in 20.4% of patients, CEA in 27.2% and TATI in 4.5%. There was no
      correlation between the incidence of TATI elevation and tumour burden; this
      marker did not increase with progressing disease stages. CEA and SCC had low
      sensitivity in the early stages of head and neck cancer and reached 35.7% (20/56
      patients) and 25% (14/56 patients) in stage IV or recurrent disease. Despite the
      low sensitivity of these tumour markers, there was a correlation between tumour
      marker levels and the course of the disease. This study indicates that the
      routine assessment of SCC, CEA and TATI serum levels is of no value. However, it
      can be used as a potential tool for monitoring the efficacy of individual therapy
      in both early and advanced stages of head and neck cancer.

PMID- 8366301
TI  - CEA and CA 15-3 in pleural effusion of advanced breast cancer patients: clinical
      relevance and diagnostic value.
AB  - Serum and pleural effusion fluid were tested for CEA concentration in 83 advanced
      breast cancer patients, in 43 of whom CA 15-3 was also determined. All pleural
      effusions were clinically malignant. The sensitivity of the CEA test for the
      presence of pleural metastases was closer to that of the CA 15-3 test in effusion
      (0.59 and 0.79, respectively) than the sensitivity of CEA compared to CA 15-3 in
      serum (0.43 vs. 0.79). The use of two markers combined with cytology increased
      the diagnostic rate from 48% (cytologically positive) to 88% (cytologically
      positive and/or with one or both markers increased in effusion). A high
      diagnostic rate in cytologically negative effusions (65%), and in effusions
      presented as the sole metastatic involvement (100%), points to the clinical value
      of these two markers. Our results show that markers produced by pleural
      metastases may be secreted either into the effusion fluid or into serum, or both.
      This finding, as well as some other observations, are discussed in the present
      paper.

PMID- 8366302
TI  - Combined treatments of heat, radiation, or cytokines with flavone acetic acid on
      the growth of cultured endothelial cells.
AB  - The antitumour effects of flavone acetic acid (FAA) against a broad spectrum of
      established experimental tumours has been demonstrated. Damage to the
      vasculature, which rapidly disrupts blood flow and induces haemorrhagic necrosis,
      is believed to be a major mechanism contributing to the observed antitumour
      effects. Despite these established observations, FAA has shown little effect
      against human tumours. However, other applications of FAA, for examples, for an
      extended period of treatments or in combination with other antitumour modalities,
      have not been sufficiently explored. In order to test the direct effects of FAA
      on vasculature, endothelial cells isolated from human umbilical vein (HUVEC) and
      bovine pulmonary artery (CPAEC) were used in this study. FAA at the
      concentrations of 50 to 200 micrograms/ml causes reduction in cell number (from
      20 to > 30% of the cells) of HUVEC as measured by MTT assay after 1, 3, and 5 h
      of treatment at 37 degrees C. FAA did not produce significant effects on
      similarly treated human squamous cell carcinoma, cell line UM-SCC-2. After 1 h
      treatment of FAA at 300 micrograms/ml, a large number of HUVECs failed to react
      with an actin stain, NBD-phallacidin. The growth of HUVECs and CPAEC in the
      presence of FAA for 1-3 days was progressively reduced. The number of HUVEC
      treated for 3 days at the concentrations of 100, 200, and 300 micrograms/ml were
      reduced by 75-86% in comparison with the control culture. The experiments with
      CPAEC showed similar results. The inhibition of the growth of endothelial cells
      by FAA was enhanced when it combines with tumour necrosis factor-alpha but not
      with interleukin-1, interferon-gamma, heat, or radiation. We observed that FAA
      can initiate both immediate effects and growth inhibition on cultured endothelial
      cells. These results support the notion that FAA rapidly induces vasculature
      damage. Furthermore, cytokines such as tumour necrosis factor-alpha can enhance
      the toxicity of FAA on endothelial cells.

PMID- 8366303
TI  - Kidney trace metal response to combined cisplatin (CDDP) and hyperthermia.
AB  - The effects of hyperthermia (HY) on cisplatin (CDDP) nephrotoxicity and kidney
      metal concentrations were evaluated in female F344 rats. Rats were anaesthetized
      with a xylazine/ketamine mixture, heated on a water-bed for 1 h to an
      intraperitoneal temperature of 41.1 +/- 0.2 degrees C, and maintained at
      hyperthermia for an additional 30 min (HY plateau). CDDP (5 mg/kg body weight)
      was administered at the start of the heating or at the HY plateau. Neither HY
      alone nor CDDP (5 mg/kg) at normothermia produced a significant effect on weight
      loss or nephrotoxicity. CDDP administered at the start of heating produced a
      moderate 1.5-fold increase in serum urea nitrogen (SUN) and serum creatinine
      concentrations. CDDP administered at the HY plateau produced a significant six
      fold increase in SUN and a four-fold increase in creatinine concentration. Weight
      loss increased two- to three-fold from the combined regimen, but only the rats
      given CDDP at the HY plateau continued to lose weight through day 7. A loss of
      kidney copper (50-60%) resulted from the combined regimen, similar to losses
      observed with higher doses of CDDP at normothermia. HY alone had little effect on
      concentrations of kidney copper or zinc up to 4 days post-treatment. The results
      demonstrate that systemic hyperthermia significantly increases CDDP
      nephrotoxicity in F344 rats and that kidney copper loss from CDDP exposure at
      hyperthermia is similar to the loss observed from CDDP at normothermia.

PMID- 8366304
TI  - An immunoassay for heat shock protein 73/72: use of the assay to correlate
      HSP73/72 levels in mammalian cells with heat response.
AB  - An enzyme-linked immunosorbent assay (ELISA) for measurement of levels of heat
      shock proteins 73 and 72 (HSP73/72) in cultured cells and tissues is described.
      The assay involves detection of HSP73/72 in cell homogenates in 96-well plates
      using a specific monoclonal antibody. The assay has been used to explore the
      relationship between the amount of HSP73/72 in a cell and its response to heat
      shock, both before and after the development of thermotolerance. Six mammalian
      cell lines with differing responses to heat were characterized with respect to
      their response to heat treatments at 44 degrees C and concentrations of HSP73/72.
      Contrary to the widely expressed idea that the amount of HSP73/72 dictates the
      degree of heat resistance, no positive correlation between levels of HSP73/72 and
      heat resistance was found for the six lines tested here: if one particular line,
      a mutant selected for heat resistance, was excluded from the analysis, there was
      a negative correlation between HSP73/72 levels and heat resistance. A different
      result was, however, obtained when thermotolerant (transiently resistant) cells
      were compared to control cells. Here, we found a good correlation between the
      extent of thermotolerance and the amount of HSP73/72, suggesting that an increase
      in HSP73/72 level is important for the development of thermotolerance. The
      validity of the ELISA technique was checked using a second method for quantifying
      levels of HSP73/72. This involved uniform radiolabeling of cellular proteins,
      separation on two-dimensional gels and radioscanning to quantify radioactivity in
      each protein. The second technique is more powerful in that different isoforms of
      HSP73/72 can be distinguished, but it is more difficult to perform, is more
      labour intensive and requires an expensive device for gel scanning. The results
      using the second technique agreed well with those from the immunoassay and
      indicated that the level of the highly inducible HSP72 correlated best with the
      extent of thermotolerance.

PMID- 8366305
TI  - Sensitizing for cis-diamminedichloroplatinum(II) action by hyperthermia in
      resistant cells.
AB  - cDDP-resistant Ehrlich ascites tumour (EAT) cells (ER cells) were tested for
      cellular content of total glutathione, heat sensitivity, cDDP sensitivity and
      synergistic effects of a combined treatment of heat and chemotherapy. In
      comparison with the non-resistant EAT cells (EN) the ER cells had an elevated
      level of glutathione. Treatment with D,L-buthionine-(S,R)-sulphoximine (BSO),
      resulting in almost complete depletion of cellular glutathione, did not cause
      drug sensitization. The ER cells were somewhat less heat sensitive compared with
      the EN cells. Heat chemosensitization was observed for the EN cells as well as
      for the ER cells. At 43 degrees C (but not at 42 degrees C) the thermal
      enhancement ratio (TER) for cDDP toxicity was significantly higher in the ER
      cells. The total number of cells killed by the combined treatment was less in the
      ER cells than in the EN cells. After analysing existing literature, combined with
      the current results, it is concluded that although cDDP-resistant cells can often
      considerably be chemosensitized by hyperthermia, in most cases the difference in
      cDDP sensitivity cannot be overcome totally. In those situations where cDDP
      resistant cells are more sensitive to heat and also show a high TER, especially
      at clinically relevant temperatures, hyperthermia as added modality is indicated
      for clinical treatment.

PMID- 8366307
TI  - Experimental evaluation of two simple thermal models using hyperthermia in muscle
      in vivo.
AB  - The predictions from two simple field equation models for calculating temperature
      distributions in tissue, namely, the Pennes' bioheat transfer equation (BHTE) and
      an effective thermal conductivity equation (ETCE), were compared to in vivo
      experimental temperature measurements made under hyperthermic conditions
      generated by scanned focused ultrasound. The models were kept simple (i.e.
      homogenous isotropic properties, no separate blood vessels included) in order to
      concentrate attention on the predictive abilities of these field equations using
      a minimum number of free parameters. Simulated results were fitted to the
      experimental data (multiple, linear temperature profiles in the thigh muscles of
      greyhound dogs) by minimizing a performance index using a golden section searth.
      This search determined a value for the single free parameter in each model (blood
      perfusion in the BHTE, and effective thermal conductivity in the ETCE) which
      minimized the square error difference between the experimental and simulated
      temperatures. The results showed that (a) the simple BHTE model could
      qualitatively reproduce the major features of the temperature patterns seen
      experimentally better than the ETCE model could, and (b) the simple BHTE model
      produced better quantitative fits to the experimental data than did the simple
      ETCE model. In addition, blood perfusion predictions from the BHTE model compared
      well to measurements done with coloured microspheres. Finally, the experimental
      results showed that individual, large blood vessels appeared to have a major
      influence in producing asymmetries in the experimental data in 21% of the
      measured temperature profiles.

PMID- 8366306
TI  - Performance of an adaptive MIMO controller for a multiple-element ultrasound
      hyperthermia system.
AB  - A prototype adaptive automatic control algorithm was implemented to regulate
      temperatures measured at several points in a tumour by adjusting the power
      applied to several ultrasound transducers. The goal was to control the
      temperatures under the elements of a mosaic applicator individually without any
      priori knowledge of which probes are under which elements. The control algorithm
      was devised for clinical applications where the position of each probe with
      respect to the heat sources is difficult to determine precisely. Instead, the
      program 'learns' the relationship between the inputs (power levels) and the
      outputs (temperatures) automatically. Based on the observed transfer function
      relating the power at m sources to the temperatures n probes, where n and m are
      not necessarily the same, a new method was used to implement a feedback
      controller. This method simplifies the design of the controller for a multiple
      input/multiple-output (MIMO) system, while taking into account the coupling that
      may exist between the various elements of the system. As a result of using an
      adaptive scheme, the regulator continuously tracks changes in the system, such as
      blood flow variations or patient motion, by modifying its control parameters. The
      algorithm performance has been tested in simulations as well as experiments in
      dog thigh and a perfused kidney model.

PMID- 8366308
TI  - Application of multiple modelling to hyperthermia estimation: reducing the
      effects of model mismatch.
AB  - Multiple model estimation is a viable technique for dealing with the spatial
      perfusion model mismatch associated with hyperthermia dosimetry. Using multiple
      models, spatial discrimination can be obtained without increasing the number of
      unknown perfusion zones. Two multiple model estimators based on the extended
      Kalman filter (EKF) are designed and compared with two EKFs based on single
      models having greater perfusion zone segmentation. Results given here indicate
      that multiple modelling is advantageous when the number of thermal sensors is
      insufficient for convergence of single model estimators having greater perfusion
      zone segmentation. In situations where sufficient measured outputs exist for
      greater unknown perfusion parameter estimation, the multiple model estimators and
      the single model estimators yield equivalent results.

PMID- 8366309
TI  - Guide for the protection of occupationally-exposed personnel in hyperthermia
      treatment from the potential hazards to health.

PMID- 8366310
TI  - A new respiratory rate monitor: development and initial clinical experience.
AB  - The need for continuous, noninvasive, and reliable respiratory rate monitoring
      during recovery from general anesthesia has long been recognized. Alternative
      principles can be grouped into those detecting the respiratory effort, and those
      detecting the actual result, i.e. the respiratory gas flow. The second category
      is of greatest interest for patient monitoring. In this paper, we report the
      development and initial clinical experience with a new acoustic air-flow sensor.
      By differential, multipoint detection of the air-flow in the mouth and nose
      region, the sensor can easily discriminate against different kinds of
      interference, including motion artefacts. The sensor is nonexpensive, rugged,
      simple to apply and inherently safe. An instrument with continuous display of
      respiratory rate, and an audiovisual apnea alarm has been designed and built. The
      complete system has been tested on patients during recovery after general
      anesthesia. In 16 patients, the respiratory rate displayed by the instrument has
      been correlated against that visually observed. A good correlation was obtained.
      Minor discrepancies can be explained from the fact that visual observation
      corresponds to the respiratory effort, whereas the sensor detects the actual air
      flow. In 12 patients, 24 hour simultaneous recordings were made of respiratory
      rate with the new sensor, with simultaneous recording of the oxygen saturation
      and the heart rate with a pulse oximeter. It was found that the new sensor
      reliably recorded respiratory depression and apnea. Such events may in some
      patients be as frequent as one incident per hour. One case of 'Ondine's curse'
      provided clear evidence that pulse oximetry has a low sensitivity to respiratory
      disorders.

PMID- 8366311
TI  - Anesthesia record keeping.

PMID- 8366312
TI  - A knowledge-based alarm system for monitoring cardiac operated patients-
      technical construction and evaluation.
AB  - A knowledge-based alarm system for intensive care monitoring was designed, built,
      tested on-line, and evaluated. The system is a functional prototype of a highly
      specific patient monitor providing alarms on hypovolemia, hyperdynamic state,
      left ventricular failure and hypoventilation. These intelligent alarm functions
      aim to maintain the quality of patient monitoring even if nurses' attention is
      temporarily reduced or focused elsewhere. The alarm system has an electronic
      access to data available in a multichannel patient monitor and the patient data
      management system of the intensive care unit. Median filtering, trend estimation,
      and rule-based reasoning are applied when processing the measured variables and
      estimating the patient's state.

PMID- 8366313
TI  - Bedside measurement of work of breathing.
AB  - This paper describes the technique of measuring work of breathing, presented at
      the 13th International Symposium on Computers in Clinical Medicine and
      Anaesthesiology, Rotterdam, June 1992. Measuring work of breathing has clinical
      uses in the Intensive Care Unit. Oxygen consumption does not truly reflect work
      of breathing. Mechanical work of breathing can be measured by recording
      continuous pressure and flow and integrating the resultant power. This method is
      facilitated at the bedside with the use of a PC computer and a spreadsheet
      program. It is further simplified by software to measure the area under the
      inspiratory pressure: volume loop.

PMID- 8366314
TI  - A knowledge based interpretation system for EMG abnormalities.
AB  - The conventional method of diagnosis in electromyography is complex and time
      consuming, not only due to the large number of parameters, to be considered for
      diagnosis, but also because of the usual procedure of evaluating the different
      parameters of EMG signal by visual scanning of the plotted signal. So there is a
      clear need to make use of computer aided decision support system. In the present
      work an attempt has been made in the direction of integration into one automated
      system, the qualitative knowledge of the physician, with possibly sophisticated
      signal analysis tools which must replace the visual scanning. A software program
      (in Turbo-C) on a PC-AT has been developed to evaluate the different parameters
      of MUAP's (motor unit action potential) in a EMG signal. Then an Expert system
      (in Turbo-Prolog) has been implemented for diagnostic purposes of different
      muscular abnormalities by making a knowledge base from the different parameters
      involved in the decision making procedure of clinical electromyography. A hybrid
      model of rule and frame based Expert system is implemented. An attempt has been
      made for making a complete system, i.e., for recording, analysis and decision
      making for diagnosis.

PMID- 8366315
TI  - Omar Prakash, MD PhD 1936-1993.

PMID- 8366316
TI  - Metaphor graphics to support integrated decision making with respiratory data.
AB  - Support for data integration in the intensive care unit (ICU) often includes
      efforts to improve the display of data. An electronic version of a flowsheet
      (table of numbers) with optimal line graphs is by far the most common format in
      current ICU computer workstation technology, yet there is little evidence that
      this format provides particularly good support for human integration of data. The
      present work introduces a new form of graphic representation, one that is far
      more metaphoric, far more tailored to the intensive care unit than a line graph.
      This graphic system, called volume rectangles represents mechanical ventilator
      data in such a way that is easy to keep different types of variables conceptually
      separated, yet easy to see how they relate in a truly integrated way. Volume
      rectangles are one example of a general approach to display of data called the
      metaphor graphic approach, which is being evaluated in this and other contexts.
      Metaphor graphics are custom tailored visual displays designed to look like the
      real world situation from which the data is collected but not in a literal sense
      of 'look like'. Anecdotal observation suggests that such graphics are easy to
      learn, are remembered over long period, and are good decision support tools when
      the task is finding patterns in a mass of data.

PMID- 8366317
TI  - Living with euthanasia: a futuristic scenario.
AB  - In 1991 and 1992, citizens of Washington State and California voted on whether
      "aid-in-dying" should be legalized. In both states, the proposition was defeated.
      In this article, the author, who participated in the Washington State campaign,
      imagines what might have happened in the fictitious State of Redwood, had such a
      proposal passed.

PMID- 8366318
TI  - Learning to do no harm.
AB  - The legalization of euthanasia creates a certain tension when it is compared with
      those traditional medical principles that seem to embody respect for the sanctity
      of life. It also creates a real need for us to explore what we mean by harm in
      relation to dying patients. When we consider that we must train physicians so
      that they not only understand ethical issues but also show the virtues in their
      clinical practice, it becomes important for us to strive to train them in virtue
      rather than mere knowledge. We can only do this by conveying a real sense of the
      needs of the patient and an ability to relate to patients as people not problems.
      Such attitudes take shape in a training programme in which practical situations
      are explored and discussed and the limits of scientific medical responses to
      those challenges are exposed.

PMID- 8366319
TI  - The medicalization of dying.
AB  - Physician assisted suicide or active euthanasia is analyzed as a medicalization
      of the needs of persons who are suffering interminably. As with other medicalized
      responses to personal needs, the availability of active euthanasia will likely
      divert attention and resources from difficult social and personal aspects of the
      needs of dying and suffering persons, continuing the pattern of privatization of
      the costs of caregiving for persons who are candidates for active euthanasia,
      limiting the ability of caregivers to assist suffering persons to make their
      continued suffering tolerable, and casting doubt on the voluntariness of the
      choice of active euthanasia.

PMID- 8366320
TI  - Altruism and physician assisted death.
AB  - We assume that a statute permitting physician assisted death has been passed. We
      note that the rationale for the passage of such a statute would be respect for
      individual autonomy, the avoidance of suffering and the possibility of death with
      dignity. We deal with two moral issues that will arise once such a law is passed.
      First, we argue that the rationale for passing an assistance in dying law in the
      first place provides a justification for assisting patients to die who are
      motivated by altruistic reasons as well as patients who are motivated by reasons
      of self-interest. Second, we argue that the reasons for passing a physician
      assisted death law in the first place justify extending the law to cover some
      nonterminal patients as well as terminal patients.

PMID- 8366321
TI  - Advance directives for voluntary euthanasia: a volatile combination?
AB  - Defenders of patient autonomy have successfully supported the legal adoption of
      advance directives. More recently, some defenders of patient autonomy have also
      supported the legalization of voluntary active euthanasia. This paper explores
      the wisdom of combining both practices. If euthanasia were to become legal,
      should it be permitted by advance directives? The paper juxtaposes the most
      significant doubts about advance directives, with the most significant doubts
      about euthanasia. It argues that the doubts together raise more concern about the
      combined practices than about either euthanasia or advance directives separately.
      Not all cases of voluntary euthanasia by advance directive are equally
      problematic, however. Advance directives can help in the defense of euthanasia
      for patients who make the request in advance and reaffirm it under circumstances
      of severe suffering.

PMID- 8366322
TI  - Conscience, referral, and physician assisted suicide.
AB  - Practices such as physician assisted suicide, even if legal, engender a range of
      moral conflicts to which many are oblivious. A recent proposal for physician
      assisted suicide provides an example by calling upon physicians opposed to
      suicide to refer patients to other, more sympathetic, physicians. However, the
      proposal does not address the moral concerns of those physicians for whom such
      referral would be morally objectionable.

PMID- 8366323
TI  - Physician assisted death and hard choices.
AB  - We argue that after the passage of a physician assisted death law some inequities
      in the health care system which prevent people from getting the medical care they
      need will become reasons for choosing assisted death. This raises the issue of
      whether there is compelling moral reason to change those inequities after the
      passage of an assisted death law. We argue that the passage of an assisted death
      law will not create additional moral reasons for eliminating inequities simply
      because they become motives for someone to opt for assisted death. We also argue
      that it is not feasible to eliminate these reasons for opting for assisted death
      by granting a right to health care because of an intractable scarcity of medical
      resources.

PMID- 8366324
TI  - Feature-based versus exemplar-based strategies in preschoolers' category
      learning.
AB  - Five experiments examined whether preschool children learn categories by
      formulating a categorization rule based on attention to one or two features, or
      by memorizing the category assignment for whole exemplars. Using fictitious
      animals as stimuli, children were taught a two-category discrimination at the
      basic level and were tested for their category learning using a procedure that
      required them to categorize from memory, rather than perform perceptual matching.
      Transfer stimuli manipulated the retention of features encountered in the
      training instances, and children were instructed to classify only the items about
      whose category membership they were certain. By measuring the extent of
      generalization, in addition to categorization accuracy, it was possible to assess
      whether children were applying a feature-based rule in making their
      categorization decisions. The studies found little evidence that children were
      employing rules. Analyses of the individual response patterns identified few
      children who categorized by attending to a single attribute such as shape, or
      else who used a two-feature disjunctive rule. In addition, a recognition memory
      test given after category gaining produced strong evidence that children had
      encoded the training examples as wholes, rather than focusing on individual
      features. Despite clear evidence that children had encoded the training examples,
      however, examplar information was not used successfully in categorization when
      subjects were trained on only a single instance per category. The implication of
      these results for theories of early categorization are discussed.

PMID- 8366325
TI  - Exclusion vs. selection training of auditory-visual conditional relations.
AB  - This study was conducted to assess the relative effectiveness of exclusion vs.
      selection (modified trial-and-error) training in establishing auditory-visual
      conditional relations. The study was conducted with children who had problems
      learning in school, but were otherwise normally intellectually capable. Single
      subject methodology was used. Each child was exposed to the exclusion and
      selection conditions twice each in varied order. The exclusion-training procedure
      proved significantly more effective not only in teaching new auditory-visual
      conditional relations but also in generating emergent naming of the visual
      stimuli.

PMID- 8366326
TI  - Development of phonological and orthographic skill: a 2-year longitudinal study
      of dyslexic children.
AB  - Twenty-one dyslexic children, ages 9-15, were administered a battery of tests on
      two occasions separated by 2 years to assess the development of word recognition
      and spelling. The majority of the subjects were receiving intensive small-group
      instruction and one-on-one tutoring in reading and writing. Correlational and
      regression analyses supported the assumption that phonological and orthographic
      processing are distinct but reciprocally related components of word recognition
      and spelling. However, phonological skill appeared to capture most of the unique
      variance in word identification for dyslexics and younger normal readers matched
      on word identification skill. Although the dyslexic children made significant
      gains over 2 years in overall word identification skill and in aspects of
      phonological and orthographic processing, they failed to show significant "catch
      up" in any component skills relative to age- and reading-level-matched normal
      readers. In addition, dyslexics made little or no progress on a measure of
      phonemic analysis, on a decoding task requiring processing at the level of the
      phoneme, and at spelling words with unusual and irregular orthography. The
      results are consistent with the hypothesis that dyslexic children have primary
      deficits in phonological processing of speech and print and secondary deficits in
      orthographic processing.

PMID- 8366327
TI  - Working memory in learning disability subgroups.
AB  - The purpose of this study was to investigate (a) the degree to which working
      memory differences between learning-disabled and nondisabled children reflect a
      specific or generalized deficit, and (b) whether limitations in the enhancement
      of learning-disabled student's working memory performance are attributable to
      process or storage functions. To this end, performances of reading-disabled, math
      disabled, chronological age (CA)-matched, and achievement-matched children were
      compared on verbal and visual-spatial working memory measures under initial,
      gain, and maintenance conditions. The results indicated that: (a) learning
      disabled subtypes were not differentiated by their performance on verbal and
      visual-spatial working memory measures; and (b) learning-disabled children's
      working memory performance was inferior to CA-matched and superior to achievement
      matched counterparts across initial, gain, and maintenance conditions. The
      results suggest that learning-disabled children suffer generalized working memory
      deficits, possibly due to storage constraints in the executive system.

PMID- 8366328
TI  - The fears of youth in the 1990s: contemporary normative data.
AB  - This article reports the findings of a normative fear investigation involving a
      sample of 918 Australian children and adolescents, ranging in age from 7-18
      years. The Fear Survey Schedule for Children and Adolescents-II (FSSC-II) was
      administered to determine self-reported prevalence, intensity, and content of
      fear. Consistent with past research, girls generally reported significantly
      higher levels of fearfulness than boys. Age differences also were found; younger
      children reported a higher intensity and a greater number of fears than older
      children and adolescents. Qualitative differences in normative fear were found,
      with younger children reporting more animal fears and older children reporting
      more fears relating to social evaluation or psychic stress. Significantly,
      although the specific content of children's and adolescents' normative fears in
      the 1990s (as compared with the 1960s) has changed (now including fear of AIDS
      and of nuclear war), the fears found to be most prevalent continue to relate to
      death and danger. These findings are discussed within the context of the
      prepotency and preparedness concepts of fear.

PMID- 8366329
TI  - The structural consistency of moral judgments about AIDS.
AB  - This study compared the structure (i.e., stage) of moral judgments to dilemmas
      involving AIDS to the structure of moral judgment on Kohlberg's test to determine
      whether attitudes and opinions about AIDS affect level of moral judgment.
      Subjects included 40 men, who responded to (a) two standard dilemmas from Colby
      and Kohlberg's (1987) test of moral judgment, (b) two of Kohlberg's dilemmas
      ammended to involve AIDS, (c) a set of AIDS dilemmas derived from incidents
      reported in the media, (d) a set of questions tapping attitudes toward people
      with AIDS, and (e) Rubin and Peplau's (1975) just-world scale. Moral judgment was
      structurally consistent across the three sets of dilemmas, and only weakly
      related to attitudes towards AIDS and belief in a just world. Moral choices did
      not covary with moral stage. These results are consistent with Kohlberg's
      contention that moral judgment is organized in "structures of the whole."

PMID- 8366330
TI  - Response perseveration, inhibitory control, and central dopaminergic activity in
      childhood behavior disorders.
AB  - We screened students (N = 710) in grades four through six at two public
      elementary schools for behavior problems, using the Revised Behavior Problem
      Checklist. Five groups of children were identified: conduct disorder (n = 8),
      attention deficit disorder (n = 9), conduct disorder plus attention deficit
      disorder with hyperactivity (n = 11), anxiety-withdrawal (n = 12), and normal
      control (n = 15). A response perseveration task, inhibitory control task, and a
      noninvasive measure of dopaminergic activity were administered to selected
      students, and group differences were predicted based on Quay's hypotheses as
      derived from Gray's theory of brain function. Hypothesized group differences were
      not found, although analyses revealed dimensional relationships that were
      consistent with the hypotheses. Results are discussed in terms of Quay's
      hypotheses and potential modifications to tasks for future research.

PMID- 8366331
TI  - Sex differences in reaction times, decision times, and movement times in British
      and Korean children.
AB  - In this study we compared reaction times broken down into decision times and
      movement times between 9-year-old British and Korean boys and girls. Boys tended
      to be faster on movement times, but there was no sex difference in decision
      times. These results were obtained on three reaction-time tasks of different
      levels of complexity.

PMID- 8366332
TI  - Attitudes of preschool children toward their peers with disabilities: a year-long
      investigation in integrated classrooms.
AB  - Changes in choices of preferred playmates by 3- and 4-year-old children were
      observed over the course of a school year. All of the children in this study
      participated in planned, fully mainstreamed, same-age preschool classes.
      Sociometric assessments were obtained from all children without disabilities in
      October, February, and May of the school year; peer nominations of three "best
      friends" were obtained at the beginning and end of the school year. The 3-year
      old children showed a general decline in the ratings given to all of their peers
      over the course of the school year. Four-year-old children showed significant
      preferences for same-sex peers without disabilities as playmates. The
      implications of these findings for integrated programs are discussed.

PMID- 8366333
TI  - Age differences in memory-span errors: speed or inhibitory mechanisms?
AB  - This study investigated age differences in errors on the digit-span task.
      Protocols of 119 men and women, aged 18-99 years, were scored for the occurrence
      of three types of errors derived from the speed-of-processing and inhibition
      deficit frameworks: omission errors, intrusion errors, and transposition errors.
      The types of errors made on the digit-span task varied with span size. At larger
      span sizes, participants were more likely to omit digits or introduce nonstimulus
      digits than to transpose those in storage. No age differences in intrusion errors
      were found, however, old-old women (75+ years) were significantly more likely
      than young (18-25 years) and old (60-70 years) adults of either sex to exhibit
      transposition errors. Consequently, old-old women were significantly less likely
      to exhibit omission errors. The results indicate that the digit-span task may
      involve two parallel processes: digit storage/recall and serial/position storage
      recall. Age differences in the serial-processing component, rather than in the
      digit storage/recall component, may be age sensitive. These results are discussed
      within an inhibition-deficit framework of cognitive aging.

PMID- 8366334
TI  - Children's coping styles and report of depressive symptoms following a natural
      disaster.
AB  - The present study examined the relationship between children's coping styles
      (Spirito, Stark, & Williams, 1988) and self-reported levels of depressive
      symptoms (Kovacs, 1983) following a major stressor. 257 third- to fifth-grade
      children consented to participate in the study, 5 months following a hurricane.
      The number of coping strategies employed was positively related to depression
      scores, whereas coping efficacy was negatively related to depression scores.
      Social withdrawal, self-blaming, and emotional regulation were associated with
      more severe depressive symptoms. Lower levels of symptomatology were found among
      children who sought social support and engaged in cognitive restructuring. The
      overall symptom level in the sample did not exceed that of normative samples.
      Results are discussed in terms of competing theories of childhood depression.

PMID- 8366335
TI  - Generalists in SCI medicine: good, bad or indifferent?

PMID- 8366336
TI  - Is chronic spinal cord injury associated with increased risk of venous
      thromboembolism?
AB  - To determine the incidence of symptomatic thromboembolism in patients with
      chronic spinal cord injury, a retrospective review of patients followed in a
      Veteran's Affairs Spinal Cord Injury Unit was conducted. Followed for a mean of
      13.7 years after injury, 287 patients were reviewed. Forty events were
      identified, an incidence of 10 percent. Thirty-three (83 percent) occurred in the
      first 6 months following injury. The remainder occurred at 1, 1.5, 7, 9, 10, 12,
      and 14 years after injury, an incidence of 0.17 percent per year. The incidence
      of clinically significant thromboembolism in spinal cord injury decreases
      dramatically after the first 6 months to a level similar to that in the general
      population (0.18 percent). Possible explanations for this include: 1)
      immobilization by itself may not be a risk factor for thromboembolism; 2)
      physiologic adaptations in the chronic state may protect against thromboembolism;
      and, 3) thromboembolism occurs, but remains subclinical in most patients.

PMID- 8366337
TI  - Pulmonary embolism presenting as fever in spinal cord injury patients: report of
      two cases and review of the literature.
AB  - Pulmonary embolism is a common, sometimes fatal complication of spinal cord
      injury. We describe two quadriplegic patients who developed unexplained fever as
      the sole presenting sign of multiple pulmonary emboli during the subacute phase
      following injury. These cases and a review of the literature suggest that
      ventilation-perfusion scanning should be considered in the diagnostic evaluation
      of fever in patients with recent spinal cord injury even in the absence of other
      clinical signs of thromboembolic disease.

PMID- 8366338
TI  - Urologic aspects of traumatic central cord syndrome.
AB  - Central cord syndrome (CCS) is a subset of spinal cord injury, characterized by
      more motor involvement of the upper extremities than the lower extremities and
      sacral sensory sparing. Patients with central cord syndrome have been reported to
      have a good rehabilitation and urologic outcome. Our purpose was to assess the
      urologic outcome in a group of patients with central cord syndrome. We reviewed
      23 patients with central cord syndrome who were admitted to Hines VA Hospital
      between 1983 and 1991, 20 of whom were older than 50 years of age. Urodynamic
      studies showed detrusor hyperreflexia with a synergistic EMG in 15 patients and
      detrusor hyperreflexia with external urethral sphincter dyssynergia (DSD) in five
      patients. Three patients with no urologic problems were not tested. Bladder
      sensation was preserved during filling in all patients. At follow-up (median = 2
      4 months), 16 patients (70 percent) were voiding, seven of whom required either
      occasional external or intermittent catheterization; nine were voiding
      independently. The seven other patients (30 percent) required either continuous
      external or intermittent catheterization (including the five with DSD). Urologic
      morbidity in the period after SCI included: urinary tract infections (12), renal
      (2) and bladder calculi (2), superficial bladder cancer (1), epididymitis (1) and
      none (6). Fifteen patients (65 percent) were ambulatory at follow-up while four
      patients needed wheelchairs. Data were not available for the other four patients.
      Urodynamic studies in three of the wheelchair-bound patients showed that two of
      them had DSD. Most patients with central cord syndrome have favorable urologic
      and rehabilitation outcomes and can be managed conservatively.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8366339
TI  - Sphincterotomy failure.
AB  - Our experience with transurethral sphincterotomy in the spinal cord injured
      population of the Milwaukee VA Medical Center is reviewed. The 10-year
      retrospective analysis disclosed the operative procedure had to be repeated in
      nine out of 25 patients. The original success rate of the procedure was high, but
      significant failure appeared later. Possible mechanisms of failure are outlined.
      It is suggested that the results might be improved through the use of a bladder
      neck prosthesis. The latter is under active investigation.

PMID- 8366340
TI  - Risk assessment for pressure ulcers: an adaptation of the National Pressure Ulcer
      Advisory Panel risk factors to spinal cord injured patients.
AB  - To estimate risk factors for pressure ulcers, we developed quantitative
      definitions for each of the nine general areas of risk outlined by the 1989
      National Pressure Ulcer Advisory Panel (NPUAP) and evaluated each of these
      factors in a group of spinal cord injured patients by means of a retrospective
      chart review at a spinal cord injury referral center serving the New England
      area. All patients (n = 364) admitted to the spinal cord injury service between
      January 1, 1989 and December 31, 1990 were studied. We identified a pressure
      ulcer in 81 of 364 patients (22.3 percent). In the univariate analyses, pressure
      ulcers were associated with Frankel groups A to B with an odds ratio (OR) of 5.7
      (95 percent confidence interval 2.8 to 11.9), low albumin with an OR of 4.9 (95
      percent confidence interval 2.8 to 8.6), low hemoglobin with an OR of 2.5 (95
      percent confidence interval 1.5 to 4.1), age > or = 60 years with an OR of 1.9
      (95 percent confidence interval 1.2 to 3.2) and three independent measures of co
      morbidity: Cumulative Illness Rating Scale (CIRS) with an OR of 3.7 (95 percent
      confidence interval 2.1 to 6.3), Charlson Index with an OR of 2.2 (95 percent
      confidence interval 1.3 to 3.8), and International Classification of Diseases,
      Ninth Revision, Clinical Modification count with an OR of 4.2 (95 percent
      confidence interval 2.4 to 7.2). In the logistic regression model, low albumin,
      CIRS and Frankel grade A to B and history of pressure ulcers were
      predictors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366342
TI  - The anterior cerebellar vermis: essential involvement in classically conditioned
      bradycardia in the rabbit.
AB  - The effects of lesions of the cerebellum on the acquisition and retention of
      aversive Pavlovian conditioned bradycardia were examined in rabbits. Lesions of
      the anterior cerebellar vermis severely attenuated the acquisition of simple
      conditioned bradycardia without disrupting baseline heart rate (HR), or
      unconditioned HR responses. Also, lesions of the vermis performed after the
      acquisition of conditioned bradycardia eliminated evidence of prior conditioning.
      Bilateral lesions of the cerebellar hemispheres did not affect conditioned or
      unconditioned HR responses. These results were interpreted to indicate that
      anterior vermis lesions specifically disrupted part of an essential conditioned
      response pathway without interfering with the neural circuits that mediate
      unconditioned HR responding. These lesion data, coupled with recent
      electrophysiological evidence of learning-related changes in neuronal activity
      within the anterior vermis of the fear-conditioned rabbit, suggest that the
      anterior cerebellar vermis is critically involved in the acquisition and
      retention of this rapidly learned autonomic conditioned response.

PMID- 8366341
TI  - Insulin-like receptor and insulin-like peptide are localized at neuromuscular
      junctions in Drosophila.
AB  - Insulin and insulin-like growth factor (IGF) receptors are members of the
      tyrosine kinase family of receptors, and are thought to play an important role in
      the development and differentiation of neurons. Here we report the presence of an
      insulin-like peptide and an insulin receptor (dInsR) at the body wall
      neuromuscular junction of developing Drosophila larvae. dInsR-like
      immunoreactivity was found in all body wall muscles at the motor nerve branching
      regions, where it surrounded synaptic boutons. The identity of this
      immunoreactivity as a dInsR was confirmed by two additional schemes, in vivo
      binding of labeled insulin and immunolocalization of phosphotyrosine. Both
      methods produced staining patterns markedly similar to dInsR-like
      immunoreactivity. The presence of a dInsR in whole larvae was also shown by
      receptor binding assays. This receptor was more specific for insulin (> 25-fold)
      than for IGF II, and did not appear to bind IGF I. Among the 30 muscle fibers per
      hemisegment, insulin-like immunoreactivity was found only on one fiber, and was
      localized to a subset of morphologically distinct synaptic boutons. Staining in
      the CNS was limited to several cell bodies in the brain lobes and in a segmental
      pattern throughout most of the abdominal ganglia, as well as in varicosities
      along the neuropil areas of the ventral ganglion and brain lobes. Insulin-like
      peptide and dInsR were first detected by early larval development, well after
      neuromuscular transmission begins. The developmental significance of an insulin
      like peptide and its receptor at the neuromuscular junction is discussed.

PMID- 8366343
TI  - Postmitotic expression of ankyrinR and beta R-spectrin in discrete neuronal
      populations of the rat brain.
AB  - Isoforms of ankyrin (ankyrinR) are expressed in both the erythrocyte and the
      brain. Four cDNAs representing regulatory domains of ankyrinR expressed in the
      rat spleen and brain were cloned and sequenced. These different cDNAs were found
      to result from tissue-specific alternative mRNA processing of the ankyrinR
      regulatory domain. One of the isolated cDNAs was used to develop an antibody to
      brain isoforms of ankyrinR, and this antibody was used to study the localization
      of ankyrinR in the rat brain. The protein was found to be widely expressed in
      neurons of the metencephalon but limited to a discrete subset of neurons in the
      rat forebrain. In the thalamus and areas of the basal ganglia, these neurons were
      grouped in defined nuclei, whereas in the cortex, hippocampus, and caudate
      putamen they appeared as isolated cells distributed randomly throughout these
      structures. A similar study using an antibody raised against erythrocyte spectrin
      (beta R) showed a comparable localization to that of ankyrinR. Both proteins were
      expressed late in the developing rat brain, as part of the maturation stage of
      neural development. These data suggest a specific role for these erythrocyte
      structural proteins in the postmitotic development of a subset of neurons in the
      rat brain.

PMID- 8366344
TI  - Occurrence and three-dimensional structure of multiple synapses between
      individual radiatum axons and their target pyramidal cells in hippocampal area
      CA1.
AB  - Recent physiological work has used quantal analysis to investigate the properties
      of synaptic transmission and long-term potentiation in hippocampal area CA1.
      These analyses have revealed changes in the strength of excitatory post-synaptic
      responses following long-term potentiation that could be mediated by cellular
      mechanisms in the presynaptic element, in the postsynaptic element, or in both
      elements. In these studies, either minimal stimulation, presumably involving a
      single presynaptic axon, or recordings from pairs of CA3 and CA1 cells have been
      used. Interpretation of these quantal analyses requires knowledge about whether
      single or multiple synapses occur between the presynaptic axon and its target CA1
      pyramidal cells. Here, light and serial electron microscopy was used to begin to
      examine this question and a related question concerning the ultrastructure of
      spines on multiple-synapse boutons. Light microscopic analyses of Golgi
      preparations revealed that about 20% of the axons occurring in stratum radiatum
      come into close apposition with two to four different dendrites of a target CA1
      cell. An "apposition" was defined as a point where the axons and dendrites
      crossed in the same focal plane and therefore were sufficiently close to allow a
      dendritic spine to reach the axon and possibly establish a synaptic contact. An
      additional 4% of the axons wound back and forth across individual dendrites,
      possibly forming multiple synapses closely spaced along the dendrites. Serial
      electron microscopy revealed that 24% of the individual axonal boutons in stratum
      radiatum make synapses with multiple dendritic spines arising from either the
      same or different dendritic segments. Two adjacent boutons of the same axon could
      also be found to synapse with different spines of the same dendrite. Together
      with the light microscopic analysis, these observations suggest that multiple
      synapses occur between single axons in stratum radiatum and their target CA1
      cells, and that at least some of these synapses may occur at different electronic
      distances. If these multiple synapses have different physiological strengths,
      then they may obscure or smooth peaks in the frequency histograms that are used
      for quantal analyses. A three-dimensional analysis was done to compare the
      dimensions of pairs of dendritic spines synapsing with individual axonal boutons.
      When the pairs of spines associated with a single bouton arose from different
      dendrites, at least some of which were likely to have come from different cells,
      the differences between their volumes and the areas of the postsynaptic densities
      were on average 100% and ranged up to 650%.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8366345
TI  - Contact-mediated mechanisms of motor axon segmentation.
AB  - In the chick embryo, the segmental pattern of motor outgrowth depends on guidance
      cues provided by sclerotome cells. Motor axons preferentially invade the anterior
      sclerotome but avoid the posterior sclerotome. To determine how motor growth cone
      motility is influenced by these cells, we used videomicroscopy to analyze the
      behavior of motor growth cones as they confronted identified sclerotome cells in
      vitro. After contact, motor growth cones invariably avoided posterior sclerotome
      cells by either branching or turning. Both types of avoidance behavior were
      initiated by a local inhibition of veil protrusion: veils failed to progress
      along the contacting filopodia. This inhibition was specific to veils since
      contact failed to alter the number of filopodia protruded. Moreover, motor growth
      cones turned away from posterior cells despite more persistent filopodial
      contacts with these cells than with the laminin substratum. In no case did
      contact with posterior cells cause a complete loss of growth cone motility or a
      complete collapse of growth cone structure. In contrast, motor growth cones
      exhibited a selective affinity for anterior cells, preferring the surfaces of
      these cells to the laminin substratum. Contact with anterior cells stimulated a
      generalized increase in protrusive activity: contact caused a net increase in the
      extension of veils and filopodia both locally and at sites distant from the site
      of contact. Contact also elicited a localized thickening of contacting processes,
      suggesting that contact with anterior cells promotes neurite consolidation. This
      behavior of motor growth cones in vitro suggests that both an inhibition of veil
      formation by posterior cells and an enhancement of motility and axon
      consolidation by anterior cells contribute to the preferential advance of motor
      axons into anterior sclerotome in vivo. We suggest that patterned outgrowth
      results from the juxtaposition of two contrasting environments that
      differentially influence growth cone motility.

PMID- 8366346
TI  - Spatial and behavioral correlates of striatal neurons in rats performing a self
      initiated navigation task.
AB  - To investigate the spatial and behavioral correlates of striatal neurons during
      displacement movements, the rostromedial dorsal striata (AP 1.0-2.2, ML 1.5-2.0)
      of five rats were surgically implanted with advanceable bundles of fine wire
      electrodes. After recovery, the rats were deprived of water and trained in a
      square-walled open field in a dark room. The behavioral task required alternating
      visits to water reservoirs in the center and in the four corners. A certain
      corner contained the first reward for each trial; after this reward, a cue card
      appeared in this corner for the rest of the trial. The firing rates of striatal
      units were compared as the rat moved between the center and the four corners of
      the arena. Analyses were made of 30 units. Eight of these had firing rates that
      significantly increased or decreased by 62-480% while the rat was in one or more
      quadrants of the arena. Six of these manifested such firing rate changes only as
      the rat performed certain behavioral sequences in the quadrant. Three other units
      fired as the rat's head was in a certain orientation relative to the arena walls,
      in all parts of the arena. To determine the principal controlling cues and hence
      the frame of reference of spatial selectivity of these units, the arena, while
      the rat was still inside, was rotated in total darkness. The first water reward
      was then presented at the same position relative to the outside room as before
      the rotation. The cue card was then illuminated in this corner as a visual cue
      for the extra-arena reference frame. All 11 neurons demonstrated spatial
      selectivity that rotated with the arena; thus, this activity was in the frame of
      reference of the arena and was not controlled by the visual cue. Six other units
      fired at rates up to six times their resting discharge or stopped firing
      completely in synchrony with initiation or execution of displacement movements,
      and two of these were also location selective. Four other units were silent as
      the rat performed the task, but fired tonically following arena rotations or
      other interruptions of the session, independent of the rat's location or
      movements. Nine analyzed units had very low firing rates (< 1 impulse/sec) and
      showed no discernible changes in activity as the rat performed the task. These
      patterns of unit activity indicate that fundamental informational components
      required for navigation are coded in the striatum.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8366347
TI  - Cholinergic regulation of brain-derived neurotrophic factor (BDNF) and nerve
      growth factor (NGF) but not neurotrophin-3 (NT-3) mRNA levels in the developing
      rat hippocampus.
AB  - In previous experiments it has been demonstrated that the synthesis of BDNF
      (brain-derived neurotrophic factor) and NGF in neurons of the hippocampus is
      regulated by neuronal activity. The glutamate system is predominantly responsible
      for upregulation and the GABAergic system for downregulation both in vitro and in
      vivo (Zafra et al., 1990, 1991). The aim of the present study is to examine the
      extent to which the cholinergic system is also involved in the regulation of NGF
      and BDNF mRNA and whether the regulatory contribution of the cholinergic system
      changes during development. Partial transection of the fimbria fornix bundle in
      the second postnatal week resulted in a reduction of BDNF and NGF mRNA levels in
      the hippocampus, suggesting that septal cholinergic input is involved in the
      regulation of hippocampal BDNF and NGF mRNA levels. Because the fimbria fornix
      bundle also contains fibers other than cholinergic ones, we further evaluated the
      importance of the cholinergic influence by injecting pilocarpine, a muscarinic
      agonist. Pilocarpine markedly increased hippocampal BDNF and NGF mRNA levels in
      both early postnatal and adult rats. In situ hybridization experiments
      demonstrated that pilocarpine led to an increase in BDNF expression in the CA1
      CA4 regions of the hippocampus and in the dentate gyrus. However, pilocarpine
      increased NGF mRNA only in those neurons of the dentate gyrus and CA1-CA4 regions
      that also expressed NGF mRNA in the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366348
TI  - A role for postsynaptic neurons in determining presynaptic release properties in
      the cricket CNS: evidence for retrograde control of facilitation.
AB  - Intracellular recording sin the cricket cercal system show that the synaptic
      terminals of a single sensory neuron can facilitate at one target, the medial
      giant interneuron (MGI), and simultaneously depress at another target,
      interneuron 10-3. A quantal analysis of transmission at these synapses
      demonstrates that facilitation and depression are properties of the presynaptic
      cell. For facilitating synapses contacting MGI, the mean quantal content (m),
      determined from the probability of the failures, increases for the second EPSP,
      while the quantal size (q) remains constant. Similarly, an analysis of depression
      for those synapses contacting 10-3 supports a presynaptic mechanism for
      depression. Since facilitation and depression are presynaptic and their
      expression at the synapses of a single, identified sensory neuron are correlated
      with the target interneuron, we conclude that these properties are regulated
      locally, at the synapse, possibly by an interaction with the postsynaptic cell.

PMID- 8366349
TI  - Transplanted neocortical neurons migrate selectively into regions of neuronal
      degeneration produced by chromophore-targeted laser photolysis.
AB  - Selective degeneration of neocortical callosal pyramidal neurons by noninvasive
      laser illumination was used for directed studies of neocortical transplantation,
      to test the hypothesis that transplanted embryonic neurons may seek to restore
      normal cytoarchitecture within an appropriately permissive local environment. At
      long wavelengths that penetrate through tissue without major absorption,
      photolysis can cause extremely selective degeneration to desired subpopulations
      of targeted neurons in vivo (Macklis and Madison, 1991; Madison and Macklis,
      1993). Cell death is geographically defined and slowly progressive, allowing
      control over the anatomical substrate for transplantation. Targeting occurs by
      retrograde incorporation of cytolytic chromophores that are activated by specific
      wavelength light. Intermixed neurons, glia, axons, blood vessels, and connective
      tissue remain intact. Degeneration was effected within neocortical lamina II/III
      of neonatal mouse pups following targeting in utero or early postnatally with
      photoactive nanospheres. Total neuron density was reduced typically by 25-30%
      within defined areas, with approximately 60% loss of large projection neurons and
      no change in the number of small, presumptive interneurons. Embryonic day 17
      neocortical cell suspensions, which included recently postmitotic neurons
      destined to form lamina II/III, were transplanted lateral to these regions of
      ongoing neuron degeneration in juvenile mice. Cellular injections spanned laminae
      II-V, to provide donor neurons with both lateral and laminar choice for possible
      migration and integration. Donor cells were labeled in vitro with unique
      fluorescent and electron-dense nanospheres that allowed distinct identification
      of donor cells at both light and electron microscopic levels. Control experiments
      included neocortical transplants into intact age-matched hosts, into hosts with
      kainic acid lesions to neocortex, or distant to the region of photolytic neuronal
      degeneration; embryonic cerebellar transplants to the regions of selective
      photolytic degeneration; and grafts of hypoosmotically lysed neocortical cells to
      lesioned regions. After survival times of 1 hr to 12 weeks, labeled neurons were
      identified morphologically and positions were digitized for qualitative and
      quantitative analysis of position and specificity of migration and cellular
      integration; electron microscopy was used to confirm further the donor identities
      of migrated neurons. Neurons placed near host zones of photolytic neuron
      degeneration migrated up to 780 microns specifically within these zones;
      approximately 44% of donor neurons migrated significantly beyond the injection
      site to enter these regions. Migration and integration did not occur in normal,
      unaffected deeper layers IV-VI of these experimental mice, or in the normal
      lamina II/III bordering the transplantation site on the side opposite the neuron
      deficient region. Control grafts of all five types revealed only minimal local
      spread without laminar preference.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8366350
TI  - Synaptotagmin: a membrane constituent of neuropeptide-containing large dense-core
      vesicles.
AB  - Synaptotagmin is known to be a major membrane protein of synaptic vesicles (SVs)
      in neurons. We have now used an immunoisolation procedure to demonstrate that
      synaptotagmin is also present in the membranes of peptide containing large dense
      core vesicles (LDCVs) of rat hypothalamus and bovine posterior pituitary.
      Synaptotagmin bead-immunoisolated organelles from these tissues primarily
      consisted of SVs but contained occasionally larger structures reminiscent of
      LDCVs that were absent from vesicle populations immunoisolated with a
      synaptophysin antibody. Furthermore, the vesicles immunoisolated with
      synaptotagmin beads contained significant amounts of neuropeptide Y (NPY). In
      contrast, vesicles immunoisolated with synaptophysin beads did not contain
      detectable levels of NPY. Sucrose density gradient fractionation of postnuclear
      supernatants obtained from the bovine posterior pituitary resulted in a bimodal
      distribution of synaptotagmin, corresponding to the positions of both SVs and
      neurosecretory granules. A similar distribution was found for cytochrome b561 and
      the 116 kDa subunit of the vacuolar proton pump. In contrast, the SV proteins
      synaptophysin, SV2, and p29 were restricted to the SV-containing fractions.
      Immunoisolation of small and large vesicles from the sucrose gradient confirmed
      the differential distribution of synaptotagmin and synaptophysin in the two types
      of secretory vesicles in nerve endings of the posterior pituitary. We conclude
      that synaptotagmin is a constituent of both SVs and peptide-containing secretory
      vesicles in the nervous system. Since both types of organelles undergo Ca(2+)
      dependent exocytosis, these findings support a general role of synaptotagmin as
      an exocytotic Ca2+ receptor.

PMID- 8366351
TI  - Spatial learning impairment parallels the magnitude of dorsal hippocampal
      lesions, but is hardly present following ventral lesions.
AB  - The hippocampus plays an essential role in spatial learning. To investigate
      whether the whole structure is equally important, we compared the effects of
      variously sized and localized hippocampal aspiration lesions on spatial learning
      in a Morris water maze. The volume of all hippocampal lesions was determined.
      Dorsal hippocampal lesions consistently impaired spatial learning more than
      equally large ventral lesions. The dorsal lesions had to be larger than 20% of
      the total hippocampal volume to prolong final escape latencies. The acquisition
      rate and precision on a probe test without platform were sensitive to even
      smaller dorsal lesions. The degree of impairment correlated with the lesion
      volume. In contrast, the lesions of the ventral half of the hippocampus spared
      both the rate and the precision of learning unless nearly all of the ventral half
      was removed. There was no significant effect of the location (dorsal or ventral)
      of damage to the overlying neocortex only. In conclusion, the dorsal half of the
      hippocampus appears more important for spatial learning than the ventral half.
      The spatial learning ability seems related to the amount of damaged dorsal
      hippocampal tissue, with a threshold at about 20% of the total hippocampal
      volume, under which normal learning can occur.

PMID- 8366352
TI  - Evidence for in vivo interactions between neuropeptide Y-related peptides and
      sigma receptors in the mouse hippocampal formation.
AB  - Recently, it was proposed that neuropeptide Y (NPY) and peptide YY (PYY) could
      act as endogenous ligands for sigma binding sites, as both NPY and PYY competed
      with high affinity (nanomolar) for 3H-(+)SKF 10,047 binding sites in rat brain
      membrane homogenates (Roman et al., 1989). However, various laboratories failed
      to replicate these in vitro findings. In order to clarify this apparent
      discrepancy and investigate further possible interactions between NPY and sigma
      related sites, we evaluated the effects of NPY, PYY and homologs, as well as
      nonrelated peptides, on in vivo 3H-(+)SKF 10,047 binding parameters in the mouse
      hippocampal formation. As expected, haloperidol (2 mg/kg), a prototypical sigma
      receptor ligand, competed for 90% of in vivo hippocampal labeling observed
      following a peripheral intravenous injection of 3H-(+)SKF 10,047.
      Intracerebroventricular injections of 300-3000 pmol of either NPY, PYY, NPY2-36,
      or the Y1 agonist Leu31,Pro34-NPY inhibited significant proportions (17-35%) of
      haloperidol-sensitive in vivo 3H-(+)SKF 10,047 hippocampal labeling. However, a
      Y2 receptor agonist, NPY13-36, and nonrelated peptides such as neurotensin and
      vasoactive intestinal polypeptide, as well as adrenalin, failed to alter in vivo
      3H-(+)SKF 10,047 hippocampal binding. It thus appears that NPY, PYY, and a
      selective Y1 agonist can interact in a concentration-dependent manner, with in
      vivo 3H-(+)SKF 10,047 labeling in the mouse hippocampal formation. This effect
      demonstrates selectivity as a Y2 agonist, unrelated peptides, and adrenalin
      failed to alter in vivo sigma labeling. This in vivo interaction may be relevant
      to some of the respective biological actions of NPY and sigma-related molecules.

PMID- 8366353
TI  - Topographic patterns of brain activity in response to swim stress: assessment by
      2-deoxyglucose uptake and expression of Fos-like immunoreactivity.
AB  - Alterations in brain activity patterns were assessed in response to swim stress
      by immunocytochemical detection of Fos-like immunoreactivity (Fos-LI) and high
      resolution autoradiographic imaging of 14C-2-deoxyglucose (2-DG) uptake. The
      stress paradigm investigated was a classic behavioral screen for antidepressant
      drug activity, the forced swim test. One of the most pronounced effects produced
      by swim stress was an increase in 2-DG uptake and induction of Fos-LI in a
      restricted region of the lateral septal nucleus. Specific "limbic" cortical
      regions, including the medial prefrontal, ventrolateral orbital, and cingulate
      cortices, also exhibited both increased 2-DG uptake and expression of Fos-LI in
      response to swim stress. In the hypothalamic paraventricular nucleus of swim
      stressed rats, Fos-LI was induced but no change in 2-DG uptake was apparent.
      Since the specific swim stress protocol used is a behavioral screen for
      antidepressant drugs, the effects of imipramine on stress-induced alterations in
      2-DG uptake and induction of Fos-LI were examined. The stress-induced increase in
      2-DG uptake in the lateral septum was blocked by treatment with imipramine, but
      treatment with imipramine had no effect on induction of Fos-LI in the same
      region. Neither 2-DG uptake nor Fos-LI expression was altered by imipramine
      treatment in the cortical regions influenced by swim stress. Administration of
      imipramine alone under basal conditions produced a robust induction of Fos-LI in
      the central nucleus of the amygdala and in the dorsal lateral subdivision of the
      bed nucleus of the stria terminalis. No effect of imipramine treatment on 2-DG
      uptake was apparent in these latter regions. The results provide insights into
      topographic patterns of brain activity associated with swim stress and
      neuroanatomically selective actions of imipramine. The different and
      complementary information obtained by assessment of Fos-LI and 2-DG uptake
      illustrates the utility of applying both functional mapping approaches to examine
      neuroanatomical correlates of behavioral states and drug treatment.

PMID- 8366355
TI  - Vulnerability of mossy fiber targets in the rat hippocampus to forebrain
      ischemia.
AB  - Much of the work on forebrain ischemia in the hippocampus has focused on the
      phenomenon of delayed neuronal death in CA1. It is established that dentate
      granule cells and CA3 pyramidal cells are resistant to ischemia. However, much
      less is known about interneuronal involvement in CA3 or ischemic injury in the
      dentate hilus other than the fact that somatostatin neurons in the latter lose
      their immunoreactivity. We combined two sensitive methods--heat-shock protein
      (HSP72) immunocytochemistry and a newly developed Gallyas silver stain for
      demonstrating impaired cytoskeletal elements--to investigate the extent of
      ischemic damage to CA3 and the dentate hilus using the four-vessel-occlusion
      model for inducing forebrain ischemia. HSP72-like immunoreactivity was induced in
      neuronal populations previously shown to be vulnerable to ischemia. In addition,
      a distinct subset of interneurons in CA3 was also extremely sensitive to
      ischemia, even more so than the CA1 pyramidal cells. These neurons are located in
      the stratum lucidum of CA3 and possess a very high density of dendritic spines.
      In silver preparations, they were among the first to be impregnated as "dark"
      neurons, before CA1 pyramidal cells; microglial reaction was also initiated first
      in the stratum lucidum of CA3. Whereas CA1 damage was most prominent in the
      septal half of the hippocampus, hilar and CA3 interneuronal damage had a more
      extensive dorsoventral distribution. Our results also show a far greater extent
      of damage in hilar neurons than previously reported. At least four hilar cell
      types were consistently compromised: mossy cells, spiny fusiform cells, sparsely
      spiny fusiform cells, and long-spined multipolar cells. A common denominator of
      the injured neurons in CA3 and the hilus was the presence of spines on their
      dendrites, which in large part accounted for the far greater number of mossy
      fiber terminals they receive than their non-spiny neighbors. We suggest that the
      differential vulnerability of neuronal subtypes in these two regions may be
      attributed to their extremely dense innervation by the mossy fibers and/or the
      presence of non-NMDA receptor subtypes that are highly permeable to calcium. In
      addition, early impairment of these spiny CA3 cells and hilar neurons after
      ischemia may be causal to delayed neuronal death in the CA1 pyramidal cells.

PMID- 8366354
TI  - Acetylcholine synthesis and release following continuous intracerebral
      administration of NGF in adult and aged Fischer-344 rats.
AB  - NGF promotes the survival and enhances the neurotransmitter phenotype of basal
      forebrain and striatal cholinergic neurons in brain of rat. The objective of the
      present study was to determine whether stimulations of the cholinergic neuronal
      markers ChAT and high-affinity choline uptake are reflected in enhanced synthesis
      and release of ACh. Enhancement of ACh release in brain of adult and aged rats
      could result in increased cholinergic neurotransmission, and altered animal
      behavior. NGF (1.2 micrograms/d) was administered intracerebroventricularly for 2
      weeks by osmotic minipump to male Fischer-344 rats aged 4 and 24 months.
      Cholinergic neuronal functional parameters were measured in frontal cortex,
      hippocampus, and striatum. In young adult rats, increased ChAT and choline uptake
      activities were accompanied by enhanced ACh synthesis, basal and depolarization
      induced release of both endogenous and newly synthesized transmitter, with the
      largest effect generally being observed in striatum. In aged animals, the
      responses to NGF were less uniform. Whereas the pattern for changes in ChAT
      activity was similar to that seen in younger animals, choline uptake activity was
      increased only in frontal cortex and striatum. Coincidentally, ACh synthesis was
      also increased only in these two brain regions. ACh content of synaptosomes was
      not affected by age or NGF treatment, and the ACh levels in microwaved samples of
      striatum and basal forebrain were not affected by NGF treatment. However,
      profound deficits in both basal and evoked release of newly synthesized ACh were
      observed in the aged rats. NGF treatment had no significant effect on the basal
      release of newly synthesized ACh in aged rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366356
TI  - Synaptic events that generate fast oscillations in piriform cortex.
AB  - Prominent, odor-evoked, fast (40-60 Hz) oscillations have been reported in the
      olfactory bulb and piriform (primary olfactory) cortex of both awake-behaving and
      anesthetized animals. The present study used current source-density analysis to
      examine the origin of the fast oscillations evoked by single weak shocks to
      afferent fibers. These shock-evoked oscillations closely resemble those evoked by
      odor. The results revealed that each cycle of the oscillatory field potential was
      generated by a stereotyped series of membrane currents similar to those
      previously characterized in the nonoscillatory response to strong afferent fiber
      shocks. Each cycle began with a strong inward current in layer la identified as
      an EPSC mediated by afferent fibers in distal apical dendrites of pyramidal
      cells. This afferent input was followed by a strong inward current in layer Ib
      identified as an EPSC mediated by intrinsic association fibers in middle apical
      dendritic segments. These excitatory events were followed by a smaller inward
      current at the depth of pyramidal cell somata (layers II and superficial III)
      that may be the depolarizing Cl(-)-mediated IPSC previously identified in the
      strong-shock response. Based on an analysis of the timing of the EPSCs it was
      concluded that the weak shock-evoked oscillation is generated in the olfactory
      bulb and that the resulting periodic activity in afferent fibers drives the
      oscillation in the piriform cortex.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366357
TI  - Directionally selective mnemonic properties of neurons in the lateral dorsal
      nucleus of the thalamus of rats.
AB  - The hippocampal formation has been extensively studied for its special role in
      visual spatial learning and navigation. To ascertain the nature of the
      associations made, or computations performed, by hippocampus, it is important to
      delineate the functional contributions of its afferents. Therefore, single units
      were recorded in the lateral dorsal nucleus of the thalamus (LDN) as rats
      performed multiple trials on a radial maze. Many LDN neurons selectively
      discharged when an animal's head was aligned along particular directions in
      space, irrespective of its location in the test room. These direction-sensitive
      cells were localized to the dorsal aspect of the caudal two-thirds of the LDN,
      the site of innervation by retinal recipient pretectal and intermediate/deep
      layer superior colliculus cells (Thompson and Robertson, 1987b). The directional
      specificity and preference of LDN cells were disrupted if rats were placed on the
      maze in darkness. If the room light was then turned on, the original preference
      was restored. If the light was again turned off, directional firing was
      maintained briefly. Normal directional firing lasted about 2-3 min. After this
      time, the directional preference (but not specificity) appeared to "rotate"
      systematically in either the clockwise or counterclockwise direction. The
      duration of normal directional discharge patterns in darkness could be extended
      to 30 min by varying the behavior of the animal. LDN cells required visual input
      to initialize reliable directional firing. After the rat viewed the environment,
      directional specificity was maintained in the absence of visual cues. Maximal
      directional firing was achieved only when the rat viewed the entire test room,
      and not just the scene associated with the directional preference of the cell.
      Thus, contextual information seems important. Also, a significant correlation was
      found between directional specificity and errors made on the maze during
      acquisition of the task. It was concluded that the LDN may pass on to the
      hippocampal formation directional information that is not merely a reflection of
      current sensory input. As such, the LDN may serve an important integrative
      function for limbic spatial learning systems.

PMID- 8366358
TI  - Neurotrophin receptor genes are expressed in distinct patterns in developing
      dorsal root ganglia.
AB  - All members of the neurotrophin family of neuronal growth factors promote
      survival and neurite outgrowth of dorsal root ganglion (DRG) neurons in vitro.
      The trk family of protooncogenes encodes receptors that are now thought to
      mediate the biological effects of neurotrophins. In order to learn more about the
      dependence of DRG neurons on neurotrophins in vivo, we have studied mRNA
      expression of members of the trk family in developing DRGs in embryonic and
      postnatal rats. We show here that neurotrophin receptors are expressed in
      thoracic and lumbar DRGs by embryonic day 13 (E13), which is only 24-48 hr after
      neurogenesis begins in these ganglia. Distinct patterns of expression of trkA,
      trkB, and trkC are readily apparent by E15. At this age, 40% of thoracic DRG
      neurons express trkA. In contrast, trkB and trkC are expressed by only 6% and 8%,
      respectively, of thoracic DRG neurons. These percentages change little between
      E15 and postnatal day 1. Although absolute numbers of DRG neurons expressing
      neurotrophin receptors are greater in lumbar than in thoracic ganglia, the ratios
      of DRG neurons expressing different members of the trk family are similar in the
      two regions. The different trks are expressed by distinct populations of DRG
      neurons from E15 onward. trkA is expressed predominantly by small neurons with
      darkly staining cytoplasm. trkB and trkC are expressed by large, lightly staining
      neurons. Size-frequency histograms show that trkA is expressed by neurons of
      variable sizes, but particularly by neurons at the smallest end of the spectrum.
      In contrast, trkC is expressed predominantly by large DRG neurons, including
      those with the largest soma areas. trkB is expressed by DRG neurons of
      intermediate size. Our results show that a majority of DRG neurons express mRNA
      for at least one member of the trk protooncogene family. Furthermore, trk
      expression occurs in a time frame consistent with the idea that trks mediate
      responses of DRG neurons to neurotrophins that are synthesized in both the
      periphery and spinal cord at early developmental stages. Finally, different
      populations of DRG neurons express different trks. We hypothesize that DRG
      neurons subserving different functions express different trks, and that trk
      expression of a particular class of DRG neurons determines its neurotrophin
      dependence during development.

PMID- 8366359
TI  - Rescue of axotomized immature rat facial motoneurons by R(-)-deprenyl:
      stereospecificity and independence from monoamine oxidase inhibition.
AB  - The role of monoamine oxidase B (MAO-B) in R(-)-deprenyl-mediated rescue of rat
      facial motoneurons axotomized at postnatal day 14 (P14) was investigated using
      the (+)- and (-)-enantiomers of deprenyl [S(+)-deprenyl and R(-)-deprenyl].
      Previously, doses of R(-)-deprenyl sufficient to inhibit MAO-B were shown to
      increase the survival of motoneurons following an apparent loss of target-derived
      trophic support caused by axotomy in P14 rats. In the present experiments,
      motoneuronal survival was measured 21 d after unilateral facial nerve transection
      at P14. The animals were treated with saline or doses of R(-)- or S(+)-deprenyl
      ranging from 0.001 to 10 mg/kg every 2 days (/2d). Frontal serial 10 microns
      sections were taken through the length of the facial nuclei ipsilaterally and
      contralaterally to the facial nerve transections. Every third section was
      immunoreacted for an antibody against ChAT to identify the motoneuron somata,
      while every adjacent third section was Nissl stained to assess motoneuronal
      survival. A second series of P14 rats was treated with similar doses of the two
      deprenyl enantiomers or saline and the brainstems removed for measurement of MAO
      A and MAO-B activity at 4 hr after the treatments. Averages of 24% of the facial
      motoneurons survived axotomy with either saline treatment or 0.001 mg/kg/2d doses
      of R(-)-deprenyl. Doses of R(-)-deprenyl of 0.005, 0.01, and 10.0 mg/kg/2d
      increased the surviving facial motoneuron to 38%, 51%, and 48%, respectively,
      indicating an ED50 of about 0.005 mg/kg/2d. Doses of S(+)-deprenyl as high as 10
      mg/kg/2d did not increase motoneuronal survival, revealing a stereospecificity
      for the increased survival of at least 2000-fold. The ED50 for MAO-B inhibition
      in the P14 brainstem was approximately 0.1 mg/kg for the (-)-enantiomer and 2.0
      mg/kg for the (+)-enantiomer, revealing a 20-fold higher sensitivity of the
      enzyme toward the (-)-enantiomer in the P14 rat brainstem. A dose of 10 mg/kg of
      S(+)-deprenyl inhibited about 65% of brainstem MAO-B activity without increasing
      motoneuronal survival, whereas 0.005 and 0.01 mg/kg of R(-)-deprenyl increased
      motoneuronal survival without significant inhibition of brainstem MAO-B
      activity.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8366360
TI  - Nonuniform expression of habituation in the activity of distinct classes of
      neurons in the Aplysia abdominal ganglion.
AB  - Global observations of neuronal response in the Aplysia abdominal ganglion were
      made during habituation of the gill withdrawal reflex using voltage-sensitive dye
      recording. This technique makes it possible to measure the spike activity of 30
      50% of the 1000 neurons present in the ganglion. Our experiments address the
      issue of how habituation is expressed in the activity of the population of
      neurons responding to siphon stimulation. Several classes of neurons exhibited
      characteristically distinct responses to the stimuli and to habituation training.
      One class of neurons (group I) responded to the onset and offset of the sensory
      stimulus although they are probably not primary sensory neurons. They habituate
      only partially when the behavioral reflex has already habituated completely. Two
      other classes (groups II and III) both have sustained responses to the touch, but
      habituate differently. Members of group III habituate completely while those in
      group II habituate only partially. Another class of neurons are inhibited by the
      stimulus (group IV). They become less inhibited after habituation. The response
      of both group I and group IV are new classes of response that have not been
      previously reported.

PMID- 8366361
TI  - Corticosteroid actions on amino acid-mediated transmission in rat CA1 hippocampal
      cells.
AB  - We here describe actions mediated by mineralo- and glucocorticoid receptors (MRs
      and GRs, respectively) on intracellularly recorded synaptic responses, evoked in
      rat CA1 pyramidal cells in vitro by stimulation of the Schaffer collaterals.
      Neurons in slices from adrenalectomized (ADX) rats, that is, where MRs and GRs
      are unoccupied, showed a synaptic response consisting of an EPSP, followed by a
      fast and a slow IPSP; the responses were apparently similar to those in slices
      from sham-operated rats. However, in the ADX rats, repeated electrical
      stimulation over a period of 80 min resulted in a gradual decline of the firing
      probability for synaptically driven action potentials and of the slow IPSP
      amplitude. Nonsynaptic responses (e.g., membrane potential, accommodation, and
      afterhyperpolarization) were stable during the 80 min period. Application of 3 nM
      aldosterone between 20 and 40 min after impalement of cells in slices from ADX
      rats, thus activating predominantly MRs, yielded stable synaptic and nonsynaptic
      responses for at least 1 hr after the onset of the steroid application. By
      contrast, corticosterone (30 nM), which occupies GRs in addition to MRs, reduced
      the amplitude of both the EPSP and slow IPSP, and the firing probability of
      synaptically driven action potentials, within 20 min; nonsynaptic properties
      remained stable. Similar results were obtained with the selective glucocorticoid
      RU 28362. The EPSP and fast and slow IPSPs of neurons in slices from ADX rats
      impaled with a time lag of 1-4 hr after the steroid application did not differ
      significantly from the responses of neurons impaled before steroid
      application.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366362
TI  - Unexpected presence of neurofilaments in axon-bearing horizontal cells of the
      mammalian retina.
AB  - In several mammals only one of the two types of retinal horizontal cell, the
      axonless A-type, appears to express neurofilaments. Neurofilament immunostaining
      of rodent retinas reveals a horizontal cell plexus that has previously been
      interpreted as belonging to A-type cells. Our intracellular Lucifer yellow
      injections strongly suggest that there are no A-type horizontal cells in rat and
      gerbil. Counterstaining of dye-injected cellular structures with a neurofilament
      antibody directly shows that the axon terminal systems of the axon-bearing B-type
      horizontal cells contain neurofilaments. These unexpected findings explain and
      reinterpret the neurofilament plexus in rodent retinas. In contrast, Lucifer
      yellow injections in guinea pig retina reveal both A- and B-type horizontal
      cells, showing that horizontal cell types are not uniform among rodents. In the
      guinea pig retina both A-type cells and B-type axon terminal systems contain
      neurofilaments.

PMID- 8366363
TI  - Efficacy of ampicillin/sulbactam combination in experimental shunt infections
      caused by Staphylococcus epidermidis. A light and scanning electron microscope
      study.
AB  - In this study, the efficacy of ampicillin/sulbactam combination in reactions of
      periventricular tissue of the lateral ventricle induced by the presence of
      infected (Staphylococcus epidermidis) silicone rubber shunt tubing was examined
      by using light and scanning electron microscopy. It was demonstrated that
      reactive changes to implants had occurred in periventricular tissue in the
      control group. In infected shunt tubing without given prophylactic antibiotic
      group, generalized meningitis and ventriculitis, loss of integrity of ependymal
      cells, numerous inflammatory cells, bacterial colonies, exuda and even pus were
      seen. It was also shown that rarely inflammatory reactions, minimal
      disintegration of ependymal cells, no bacterial colonies, and phagocytes were
      present in the group which was given prophylactic ampicillin/sulbactam
      combination per and postoperatively. We think that ampicillin/sulbactam
      combination is very effective in prevention and treatment of shunt infections.

PMID- 8366364
TI  - Intracranial aneurysm associated with cerebral cavernous angioma. Case report.
AB  - The very rare case of association of anterior communicating artery aneurysm and a
      right frontal cavernoma not visualized by CT-scan and angiography in a 37-year
      old man is described. The rarity and the possible pathogenesis of this
      association are discussed.

PMID- 8366365
TI  - Saccular aneurysm associated with proximal basilar artery fenestration. Case
      report.
AB  - When an aneurysm arises from a limb of an arterial fenestration at the
      vertebrobasilar junction or in the proximal third of the basilar artery, its
      surgical management can be an intriguing problem. We report here a case of such
      an aneurysm successfully clipped through a right subtemporal transtentorial
      approach.

PMID- 8366366
TI  - Spinal epidural hemangiomas.
AB  - Two patients with epidural cavernous hemangiomas located at the lumbar and
      cervical spine are reported. The first case presented clinically as progressive
      paraparesis, and the second began with sudden tetraparesis after a strong
      physical exercise. Myelography and MRI were the diagnostic tools. Surgical
      decompression improved the signs and symptoms in both cases. Spinal epidural
      cavernous hemangiomas are rare lesions that are usually regarded as vascular
      hamartomas. Symptom onset may be insidious or acute and the prognosis after
      timely surgery is better when compared with that of intrathecal cavernous
      hemangiomas. The histology and treatment of these processes are discussed.

PMID- 8366367
TI  - Intraethmoidal encephalomeningocele presenting with spontaneous cerebrospinal
      fluid rhinorrhea in an elderly man. Case report.
AB  - The case of a 63-year-old patient with spontaneous cerebrospinal fluid rhinorrhea
      from a intraethmoidal encephalomeningocele is presented. The patient was
      asymptomatic until the old age. The preoperative coronal CT-scan and the
      preoperative and postoperative MRI are shown. The rarity of this onset in an
      elderly man and the surgical indications of this disease are debated.

PMID- 8366368
TI  - Extradural haematoma of posterior cranial fossa.
AB  - Two cases of extradural haematoma of posterior fossa with an acute course are
      reported. After trauma, the two patients did not show any symptom for a time of
      16 and 18 hours respectively. Both of them showed a status of coma at the moment
      of hospitalization. The haematoma was diagnosed by CT scan. Both of them were
      immediately operated in order to evacuate the haematoma. Afterwards, one of the
      patients presented cerebellar symptoms while the other did not show any
      neurologic deficiency. The authors have analysed cases of this rare form of post
      traumatic pathology referred in the literature since 1941, examining them from a
      clinical, therapeutic and prognostic point of view. The best diagnostic and
      therapeutic procedures to follow on this subject are then stressed.

PMID- 8366369
TI  - Cervical cord compression in hereditary multiple exostoses.
AB  - A seven year old girl, known to have hereditary multiple exostoses, developed
      moderate gait disorders at the age of six years. Deterioration of myelopathy
      initiated the clinical investigation including spinal computed tomography (CT)
      and magnetic resonance imaging (MRI). These examinations demonstrated a
      coneshaped exostosis originating from the posterior arch of C2. The spinal canal
      was markedly narrowed with significant compression of the spinal cord at the C2
      level. The girl underwent laminectomy of C2 with total removal of the exostosis.
      Postoperative deterioration of neurological symptoms correlated with a
      hypointense lesion on T1 weighted imaging in the cord at the same level, but no
      further cord compression on follow-up MRI. The spastic tetraparesis has improved
      considerably within 12 months thereafter.

PMID- 8366370
TI  - CT morphology of a median nerve neurilemmoma at the arm. Case report and review.
AB  - Computed tomography was performed in a patient with a median nerve tumor at the
      arm, histologically confirmed as neurilemmoma. Neurilemmoma was a slightly
      hypodense, solid tumor with no vascular contrast enhancement. To our knowledge
      this is the first CT description of a median nerve neurilemmoma at the arm.
      According to our experience and to previous literature, CT gives useful
      information regarding extent, anatomic location, size and relationship of
      peripheral nerve neoplasm to surrounding structures and may be an useful tool for
      evaluation arm nerve mass and for appropriate planning of surgical therapy.

PMID- 8366371
TI  - Sequential measurements of cerebral blood flow in the acute phase of subarachnoid
      hemorrhage.
AB  - Cerebral blood flow (CBF) measurements were made at predetermined intervals over
      the first 20 days after a subarachnoid hemorrhage (SAH) by the method of 133Xe
      inhalation clearance in 39 patients, Hunt and Hess degrees I, II or III. Mean
      hemispheral and regional blood flow showed a similar pattern of behavior over
      time: namely an initial hypoperfusion, being more marked in patients with
      consistent or thick blood deposition at CT scanning, followed by transient
      improvement and subsequent deterioration in the second week, this being
      especially conspicuous in patients who developed vasospasm; deterioration, at any
      rate, was distributed widely regardless of the initial CBF readings or magnitude
      of bleeding. Patients developing later neurological deficit (23% of the total)
      were those who showed a statistically significant increase of hemispheric
      asymmetries and regional hypoperfusion at the time when deterioration occurred.
      Accordingly, the Author calls attention to the practical value of CBF
      measurements in SAH patients, in view of the relationships that obtain between
      certain CBF patterns and the emergence of late neurologic deficits.

PMID- 8366372
TI  - Use of a conceptual framework in planning and implementing an orientation
      program.
AB  - Staff development instructors must provide a complete and cost-effective
      orientation program for new employees. Using a conceptual framework to organize
      an orientation program ensures that essential information is covered in a
      logical, comprehensive way, allowing for the best use of time and resources. This
      article describes how a preexisting conceptual framework developed for defining
      patient-care requirements was used to plan and implement a pediatric orientation
      program.

PMID- 8366373
TI  - Role efficacy and job satisfaction of hospital nurses.
AB  - One concern of healthcare professionals today is the high turnover rate of
      hospital nursing staff. This article discusses role efficacy and its relation to
      job satisfaction of hospital nurses. It describes a role-efficacy model and
      analyzes nurses' perceptions of feedback from the job itself, nursing
      supervisors, physicians, and hospital administrators. The impact of role efficacy
      and job satisfaction on improved recruitment and retention of nurses and the role
      of staff development in the improvement process is explained.

PMID- 8366374
TI  - A reliable and valid evaluation instrument for continuing nursing education.
AB  - Practitioners in continuing nursing education must develop reliable and valid
      evaluation instruments to increase their confidence in the quality and usefulness
      of the information being gathered. In addition, they should consider the
      requirements for accreditation or approval of their continuing education
      activities. This article describes the process used by one provider to accomplish
      these goals.

PMID- 8366375
TI  - Preceptor selection and evaluation: a tool for educators and managers.
AB  - The preceptor concept has been cited extensively in the literature, although few
      measurable tools for preceptor identification, selection, and evaluation have
      been documented. This article describes a tool designed to assist in the
      selection of unit preceptors. The tool also provides an evaluation method for
      preceptors and identifies areas for future preceptor development when used on an
      annual basis.

PMID- 8366376
TI  - Proactive versus reactive recruitment and retention strategies.
AB  - With so many options available to nurses today, it is imperative to recognize the
      importance of not only recruiting but retaining nurses within the organization as
      well as the profession. This study identifies recruitment and retention
      strategies that nurses deem important. Although numerous responses were noted,
      continuing education was the most frequently cited benefit for recruitment and
      retention of nurses.

PMID- 8366377
TI  - A systematic approach to selecting and evaluating instructional materials.
AB  - This article provides an overview of the process of selecting and evaluating
      instructional materials. The reader is given specific criteria to be used in
      assessing the content, instructional design, technical production, and packaging
      of instructional materials.

PMID- 8366378
TI  - The 5-minute teaching series.

PMID- 8366379
TI  - Mandatory education: a successful, creative approach.

PMID- 8366380
TI  - Data management ... beyond the basics.

PMID- 8366382
TI  - Support needs of spouses of cardiac patients.
AB  - A focus group approach was used to determine the perceived support needs of
      cardiac patients' significant others. Data were gathered during four focus groups
      of 2-6 people for a total of 13 informants. Two open-ended questions guided the
      discussion: (a) What was it like for a person to have someone close have a sudden
      heart problem? (b) What kind of support is needed during the experience?
      Informants included spouses of cardiac patients who were newly enrolled in a
      cardiac rehabilitation program. Discussion sessions were tape recorded.
      Transcripts were analyzed by using grounded theory. Results revealed three core
      categories: perceptions, needs, and strategies. Categories differed according to
      three phases of the illness: finding out, hospitalization, and recovery. The
      model differs in perceptions, needs, and strategies for support in each phase.
      Nurses can use this model to understand the needs of significant others and plan
      support interventions.

PMID- 8366381
TI  - Drug interactions and their nursing implications.
AB  - Drug interactions occur whenever the diagnostic, preventive, therapeutic, or
      toxic action of a drug is modified by another substance (food or drug). Drug
      interactions can be harmful or beneficial. As more drugs are released, the
      possibility of drug interaction increases daily. Nurses need to be aware of the
      mechanisms for drug interactions in order to assist with prevention. The general
      concepts of drug interactions are presented as to the categories of occurrence:
      pharmacokinetic, pharmacodynamic, combined toxicities; drug-food interactions,
      and incompatibilities.

PMID- 8366384
TI  - Bibliography: nursing and technology.

PMID- 8366383
TI  - Patient adaptation to technology: an application of the Roy model to nursing
      research.
AB  - Structured interviews were used to explore 75 medical-surgical patients'
      reactions to intravenous (invasive) and telemetry (noninvasive) attachment.
      Dependent variables operationalizing constructs of comfort, self-esteem, patient
      role, and social relationships derived from Roy's four effector modes were
      organized into 19 adaptation items. It was hypothesized that patients attached to
      invasive technology would report more stimuli and need for behavioral responses
      than those attached to noninvasive technology. In keeping with the exploratory
      nature of the study and use of a new adaptation interview tool, item-by-item
      analysis was used to test the hypotheses. Most support for the hypotheses
      occurred when patients were attached to only one invasive device and for less
      than 3 days. Findings also provide new insights on how technology connections
      might put patients at risk for coping difficulties.

PMID- 8366386
TI  - What are the current recommended guidelines concerning the use of contact lenses
      in the chemical industry?

PMID- 8366385
TI  - Surrogate decision-making and ethics committees: the new role of the New York
      State nurse.
AB  - "When Others Must Choose: Deciding for Patients Without Capacity" is health care
      legislation proposed for New York state. Its intent is to remedy the absence of
      legal authority for families or other surrogates to make treatment decisions for
      their incapacitated loved ones who have neither completed an advance directive
      nor designated a health care agent. This paper provides a summary of this
      legislation and highlights nursing implications and the role of the nurse as a
      member of institutional ethics committees.

PMID- 8366387
TI  - Should an x-ray technician with ulcerative colitis be removed from his work
      because of the possible increased risk of developing colon cancer?

PMID- 8366388
TI  - Determination of disability.

PMID- 8366389
TI  - Necrosis after low-pressure injection injury of the hand.

PMID- 8366390
TI  - The Occupational Safety and Health Administration's 1990-1991 survey of
      occupational medical surveillance prevalence and type of current practices.
AB  - For all industry divisions, the likelihood that an establishment will have a
      medical surveillance program increases directly with size of establishment. Among
      establishments with 1 to 19 employees, only 4% have medical surveillance programs
      whereas 56% of establishments that employed 250 or more employees had such
      programs. The most common time to administer medical surveillance is
      preemployment. The second most common time to conduct medical surveillance is at
      periodic intervals. The most common component of medical surveillance programs is
      a general physical examination. This component of medical surveillance is also
      the most common element of preemployment surveillance, preplacement surveillance,
      periodic surveillance, preexit examinations, and surveillance for respirator
      users. Among the group of Phase II establishments, audiometric testing was the
      most common periodic test identified. Musculoskeletal testing is performed by 45%
      of firms administering preplacement examinations and by 38% of firms with
      preemployment examinations. Across all industry divisions, 14% of establishments
      that have a medical surveillance program also perform biologic monitoring of some
      employees.

PMID- 8366391
TI  - The purposes of occupational medical surveillance in US industry and related
      health findings.
AB  - The primary purpose for implementing medical surveillance is to protect the
      general health and fitness of all employees. The next most frequent purpose of
      medical surveillance programs is to determine whether employees have the physical
      capability to perform their jobs (ie, surveillance to establish "fitness for
      duty"). The most commonly reported uses of medical surveillance data for
      establishments across all industry divisions were to implement or change work
      practices, to implement or change administrative control programs, to modify
      training programs, and to change personal protective equipment. Eighteen percent
      of establishments in all size classes and industries that have medical
      surveillance programs have identified adverse health effects among employees. The
      health effects most commonly identified by the medical surveillance programs were
      repetitive trauma, hearing loss, and skin disorders. Programs designed to detect
      hearing loss and cumulative trauma disorders, are in fact, finding these adverse
      effects. Among employees actually receiving periodic medical surveillance tests
      (6 million), 5% were found to have an abnormal test result.

PMID- 8366392
TI  - Effects of occupational medical surveillance programs as perceived by respondents
      to the Occupational Safety and Health Administration's 1990-1991 survey.
AB  - Among all establishments perceiving a change as a result of their medical
      surveillance program, 43% of those employing 250 or more employees did so; for
      the smallest establishments, this figure drops to 7%. The changes most often
      perceived, regardless of size class of establishment or industry division, were
      in employee relations, injury rates, and insurance costs. Establishments with the
      most comprehensive risk reduction strategies were most likely to attribute
      benefits to their medical surveillance programs. Benefits of medical surveillance
      perceived by the Phase II respondents include reduced costs, early detection of
      medical problems, increased productivity, and a reduced injury or illness rate.
      Most firms have no systematic method or procedures for evaluating the
      effectiveness of their medical surveillance programs.

PMID- 8366393
TI  - Medical surveillance: extent and effectiveness?

PMID- 8366394
TI  - Occupational chemical exposures in an academic medical center.
AB  - Although the risks of certain chemical agents in the hospital environment are
      well known, problems associated with the entire spectrum of chemicals are not. To
      address this issue, we analyzed incident reports generated in response to
      chemical exposures in an academic medical center. We also reviewed workers'
      compensation clinic logs and the OSHA 200 log to obtain information on medical
      follow-up and severity. A total of 253 exposures occurred during the 3 years from
      1988 to 1990. The overall incidence rate was 8.0 per 1000 person-years. Exposure
      rates by job title were highest for housekeepers (60.1 per 1000 person-years),
      followed by maintenance workers (18.6), and laboratory technicians (13.1). The
      most frequently involved chemical groups were disinfectants (25.9%), solvents
      (16.8%), and cleaning compounds (12.1%). Exposure by the dermal route was most
      common (37.9%). Thirteen percent of the exposures resulted in lost time and a
      similar percentage was reported on the OSHA log. Medical treatment was obtained
      by 53%. Implications for hazard communication, recordkeeping, and prevention are
      discussed.

PMID- 8366395
TI  - Working women at risk. Results from a survey of Hispanic injury patients.
AB  - Women experience lower rates of occupational injury than do men in general, but
      subgroups are at increased risk. Based on the medical records of 2572 injury
      patients requesting treatment in a Washington, DC, emergency department during a
      1991 survey of injured Hispanics, we found that whereas women in general had a
      low risk of occupational injury. Hispanic women did not realize this protection.
      All Hispanics were at increased risk of occupational injury, but the relative
      risk attributable to ethnicity for Hispanic women (3.83; 95% confidence interval,
      2.85,5.14) was nearly twice that of the corresponding relative risk suffered by
      working Hispanic men (2.07; 95% confidence interval, 1.72,2.48). It was also
      found that whereas, overall, women had a lower risk of assault than did men,
      relative risks of assault based on sex were the same in the workplace.

PMID- 8366396
TI  - Silicosis following employment in the manufacture of silica flour and industrial
      sand.
AB  - We describe silicosis in a patient with chronic obstructive pulmonary disease who
      worked as a maintenance mechanic for less than 5 years in a plant in South
      Carolina that manufactures silica flour and industrial sand. An open lung biopsy
      showed an early stage of silicosis manifested by perivascular and peribronchial
      collections of macrophages as well as early granuloma formation. An antinuclear
      antibody profile compatible with Sjogren's syndrome or systemic lupus
      erythematosus occurred with no symptoms of either disease. Excessive occupational
      exposure levels of respirable free silica were documented.

PMID- 8366397
TI  - Heat stress and helicopter pilot errors.
AB  - Helicopter pilots are subjected to degrees of heat stress that under laboratory
      conditions result in decreased performance. However, the effect of heat stress on
      the frequency of helicopter pilot errors is uncertain. The purpose of this study
      is to determine whether there is an association between ambient heat stress and
      pilot error. The records of 500 helicopter accidents and incidents due to pilot
      error during the months May through October were selected at random. On the day
      of the event, ambient dry bulb and wet bulb temperatures were recorded and
      compared to temperature and humidity readings on 1000 days chosen at random over
      the same time period, after eliminating days where events occurred. There was a
      significant difference between the dry temperature distributions of the days with
      pilot error compared with the control group (chi 2 = 47.54, P < .0001). A dose
      response relationship was found, with a significantly lower risk when ambient dry
      bulb temperatures were 25 to 29 degrees C (odds ratio, 0.6; 95% confidence
      interval, 0.5 to 0.8, P < .0001), an increased risk of 1.6 (1.3 to 2.0, P <
      .0001) at 30 to 34 degrees C, and the highest risk at 35 degrees C or more (6.2,
      95% confidence interval, 2.1 to 21.8, P < .0002). There is a dose-response
      relationship between ambient heat stress and pilot error in Israel military
      helicopter pilots. This is the first study outside the laboratory showing a
      connection between heat stress and accidents due to human error. Further studies
      are required to substantiate our findings and to determine whether extrapolation
      to other settings is warranted.

PMID- 8366398
TI  - [Surgical approach to the nasal valve stenosis].
AB  - Nasal valve, originally defined by Mink (1903), has changed its concept and is
      now regarded as slit-like opening between the caudal end of the upper lateral
      cartilage and the septum. Contrary to Caucasians whose smallest area of the nose
      lies at the nasal valve, the narrowest part of Japanese nose situates at the area
      between the anterior portion of the inferior turbinate and the septum. Thus, we
      have fewer chance to experience patients with stenotic nasal valve. Six patients
      complaining nasal obstruction resulted from nasal valve stenosis, mainly due to
      dislocated or collapsed upper lateral cartilage, underwent surgery during the
      last 2 years and a half. Cases of septal deformity, even it it produced valve
      stenosis, were excluded in this study. Surgical intervention was directed toward
      reconstruction of normal anatomic relationships, usually by widening the nasal
      valve angle and preventing collapsibility. Three underwent open rhinoplasty with
      gull-wing columellar skin incision, whereas 3 others were operated on via
      transnostril approach. History of midfacial trauma caused us to choose open
      rhinoplasty for restoring the function and structure. Immediate postoperative
      result was excellent in the aspect of appearance and subjective data regardless
      of surgical approach. Open rhinoplasty provided a splendid long-term result
      without remarkable complications. On the other hand, 2 cases operated via
      transnostril approach complained recurrence of stuffy nose.

PMID- 8366399
TI  - [Esophageal speech and TE shunt speech--a comparison using the same subjects].
AB  - The behaviors of esophageal speech and tracheoesophageal shunt (TE shunt) speech
      were compared using two laryngectomized subjects who were able to perform both
      phonation methods. Through X-ray fluorography and fiberscopic observation of the
      PE segment, it was confirmed that the location and the shape of the vibrating PE
      segment (pseudoglottis) were consistent during esophageal speech and TE shunt
      speech in each patient. It was suggested that the mechanism of formation of the
      pseudoglottis does not differ between the two phonation methods. The aerodynamics
      were examined using one of the two subjects. There was a positive relationship
      between subpseudoglottic pressure and vocal pitch and also between
      subpseudoglottic pressure and pseudoglottic resistance. The vocal pitch and
      pseudoglottic resistance were significantly higher in esophageal speech than TE
      shunt speech, when compared within the same subpseudoglottic pressure range. It
      was suggested that the tension and the effective mass of the pseudoglottis was
      modulated differently between the two phonation methods.

PMID- 8366400
TI  - [Acute sensory deafness originating from experimental double-membrane rupture].
AB  - Combined rupture of Reissner's membrane and the round window membrane (double
      membrane rupture) as a cause of acute profound sensorineural hearing loss was
      investigated in guinea pigs. Action potentials (APs) of the cochlear nerve in
      response to tone pip stimuli (1, 2, 4, 8kHz) were recorded before and after
      rupture of Reissner's membrane at each turn of the cochlea. Then the round window
      was perforated to create leakage of the perilymph. Ninety minutes later, AP was
      again recorded. After these procedures, the animal was sacrificed for
      histological study to confirm the rupture of Reissner's membrane. The ears with
      double-membrane rupture showed a larger decrease in AP amplitude at all test
      frequencies than did control ears with round window rupture alone. The ears in
      which Reissner's membrane was ruptured at the second turn showed more a
      pronounced decrease in AP amplitude than those ruptured at the third and apical
      turns. It was concluded that double-membrane rupture could be a cause of sudden
      deafness, but that the disturbance of cochlear function depends on where
      Reissner's membrane ruptures.

PMID- 8366401
TI  - [The effect of unilateral nasal patency on the contralateral side].
AB  - This investigation was designed to verify the possible feed-back mechanism which
      works to compensate for changes in the nasal volume of one side by the other
      side. Acoustic rhinometry, with which nasal volume is easily evaluated, was used
      in this investigation. Acoustic rhinometry was performed at 4 points in time
      (immediately after, and three, six and nine minutes after, the setting of
      experimental conditions). This investigation was composed of two studies. In the
      first study, ten healthy subjects (nine males and one female, 26-49 years of age,
      mean age 30 years) were evaluated to estimate the effect of decreased unilateral
      nasal patency upon the other side. In this study, one nasal cavity was occluded
      with an acryle plug, and the nasal volume of the other side was evaluated by
      acoustic rhinometry before and after the occlusion. In the second study eight
      healthy subjects (five males and three females, 24-34 years of age, mean age 29
      years) were evaluated to estimate the effect of increased unilateral nasal
      patency upon the other side. This study covered a period of three days. A small
      piece of cotton soaked in a vasoconstrictor solution (1/1000 adrenalin or 0.05%
      naphazolin nitrate) was put in one nasal cavity (the right on the first day, the
      left on the second day) and the other side was evaluated before and after
      administration of the solution. On the third day of the control study, a similar
      piece of cotton soaked in physiological saline solution was put in one nasal
      cavity, and the other side was evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366402
TI  - [Three patients with gas gangrene of the head and neck].
AB  - Three patients with non-clostridial gas gangrene of the neck are reported.
      Patient 1 was a 57-year-old man, patient 2 a 63-year-old woman, and patient 3 a
      44-year-old man. All three were treated by thorough debridement and precise
      administration of antibiotics. We also discuss 26 cases (including our 3) of gas
      gangrene of the head and neck, reported in Japan from 1975 to 1992, from which
      the following data were obtained: 1. The 26 patients consisted of 17 males and 9
      females. 2. They ranged in age from 2 to 88 years, with a mean 56.5 years. 3.
      Causes included acute pharyngolaryngeal inflammation (46%), dental disease (27%),
      trauma (8%) and unknown etiology (19%). 4. As a result of bacteriological
      assessment, the condition was found to be attributable to Clostridium in only 2
      patients, and in the remainder the condition was non-clostridial. 5. The
      mortality rate was 15%. The patients who died were at least 80 years old, and
      their prognosis had been poor. 6. CT was useful for diagnosis and treatment.

PMID- 8366403
TI  - [Voice rehabilitation with esophageal speech in the laryngectomized].
AB  - From January 1988 to December 1990, 186 patients with laryngeal cancer or
      hypopharyngeal cancer underwent total laryngectomy in our hospital. We studied
      voice restoration in 110 of these patients by means of a direct interview method
      at the end of 1991. Seventy-six cases were excluded because of death (70) or
      being lost to follow-up (6). About 80% of the patients (89/110) attended
      esophageal speech classes, with a success rate of 78% (69/89). Seventy-four
      percent (51/69) had no problems with daily oral communication using esophageal
      speech. Neither radiation therapy nor post operative pharyngocutaneous fistula
      formation influenced the success rate. Neither did the site of the primary tumor
      in the larynx or hypopharynx exert an influence, although patients with laryngeal
      cancer were superior to those with hypopharyngeal cancer in terms of the quality
      of esophageal speech. It was found that age was the most important factor.
      Patients below 60 years old had a 90% success rate, between 60 and 75 the rate
      was 60% and above 75 it was only 10%. Unfortunately, 15% (17/110) of the
      laryngectomized patients used a pen and pad alone. Most were too old to attend
      esophageal speech classes.

PMID- 8366404
TI  - [Changes in transaminase before and after tonsillectomy].
AB  - Almost all patients who undergo palatine tonsillectomy for chronic tonsillitis
      and/or tonsillar hypertrophy manifest postoperative changes in their condition
      and laboratory data. In some patients, high preoperative transaminase levels
      decrease postoperatively. I studied 17 patients who had abnormal serum
      transaminase levels 10 days before tonsillectomy. Before tonsillectomy, serum
      glutamate oxaloacetate transaminase (GOT) levels were abnormal in half and serum
      glutamate pyruvate transaminase (GPT) were abnormal in all. Before operation,
      laboratory values of serum GPT were higher than those of serum GOT in all 17
      patients. After tonsillectomy, the abnormal GOT levels in all patients gradually
      improved to the normal range before the 11th postoperative day and GPT levels did
      so before the 25th day. Measurement of intracellular transaminase activity of the
      palatine tonsil suggested that the migration of intracellular transaminase from
      tonsillar cells to serum would not elevate the serum transaminase level.
      Postoperative changes in serum transaminase and serum cholinesterase were
      different from the recovery process observed in fatty liver. The high
      transaminase level observed in patients with tonsillectomy is suspected to be due
      to other organs, rather than continuous inflammation of the palatine tonsil.

PMID- 8366405
TI  - [Prognostic factors in primary lymphoma of the thyroid--a review of 74 cases].
AB  - Prognoses and prognostic factors in 74 patients with primary lymphoma of the
      thyroid gland were analyzed. From 1968 to 1991, 74 patients with non-Hodgkin's
      lymphoma originating in the thyroid gland were treated at Noguchi Thyroid Clinic
      Hospital. Patients consisted of 53 females and 21 males, with a median age of
      64.5 years. Survival curves were calculated by the Kaplan-Meier method and
      significance was tested by generalized Wilcoxon test. The overall 5-year and 10
      year survival rates were 81.8% and 62.5%, respectively. The survival rate in
      stage II disease was significantly (P = 0.004) lower than that in stage I. By the
      LSG classification, there was no significant difference in survival curves
      between follicular lymphoma and diffuse lymphoma. Using the Working Formulation,
      there was no significant difference in survival curves between cases with low and
      intermediate grade histology. Histologic subtype of the tumor did not appear to
      be a significant determinant of prognosis. Patients with vocal cord paralysis had
      poorer survival rates than others (P = 0.001). Extrathyroidal spread of the tumor
      by direct soft tissue invasion had a distinctly adverse effect on prognosis.

PMID- 8366407
TI  - [Clinical application of transiently evoked otoacoustic emissions in screening
      for auditory dysfunction].
AB  - Transiently evoked otoacoustic emissions (TEOAE) should be used clinically as an
      objective and noninvasive screening test for auditory dysfunction in children.
      The features of TEOAE measured by "ILO88" with non linear click stimuli are
      discussed. The following results were obtained: 1) The normal range of a power
      spectrum was determined using 42 adults with normal hearing and compared with
      data for sensorineural hearing disturbance. The power spectrum of TEOAE in adults
      with normal hearing sloped downward at high frequency and was the same for right
      and left ears in both males and females. For comparison with sensorineural
      hearing disturbance, a significant correlation between the audiogram and power
      spectrum of TEOAE was sought. 2) Patients with otitis media with effusion (109
      ears in 67 children) were examined by audiometry, tympanometry and TEOAE. The
      hearing disturbance threshold of 45 cases with TEOAE was lower than that in cases
      with no TEOAE. In tympanometry, low intratympanic pressure was noted in the
      absence of TEOAE. 3) TEOAE and spontaneous otoacoustic emission were examined in
      42 adults with normal hearing and 27 neonates using the same probe and level of
      stimuli to clarify differences in TEOAE according to age. The amplitude of TEOAE
      and the highest peak of the frequency component at 4kHz in neonates exceeded
      those of adults. The peak stimuli recorded with the intracanal probe in neonates
      was also larger than that of adults. Three out of 15 neonates had spontaneous
      otoacoustic emission and essentially the same proportion was noted in young
      adults.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366406
TI  - [Clinical studies on the furosemide VOR test].
AB  - In order to detect vestibular endolymphatic hydrops, the directional
      preponderance of the VOR gain (VOR-DP%) during sinusoidal rotation (freq. 0.1Hz;
      Amp. 120deg) was calculated and compared between pre- and post-intravenous
      injections of furosemide (20mg). Abnormal changes in VOR-DP% (> = 10%) from the
      pre-injection level were referred to as positive in this furosemide VOR test
      (FVOR). The following results were obtained from this study. (1) Positive
      responses were obtained in 31 of 61 (51%) patients with definite Meniere's
      disease, in 11 of 21 (52%) patients with delayed endolymphatic hydrops and in 7
      of 10 (70%) with syphilitic labyrinthitis. In contrast, the majority of patients
      responded negatively with sudden deafness or other peripheral vestibular
      disorders. (2) Following the endolymphatic shunt operation, in 2 out of 3
      patients (67%) in whom vertiginous attacks had been decreased or disappeared
      after the operation results changed from positive to negative. (3) The positive
      rate in Meniere's disease was dependent on the frequency of the vertiginous
      attacks before the test or the duration from the last attack to the test. (4)
      Combined with the glycerol dehydration test or electrocochleography, the FVOR
      test could detect endolymphatic hydrops of Meniere's disease at a high positive
      rate. (5) There were no side-effects of the furosemide on the inner ear, such as
      deterioration of hearing acuity or tinnitus. In conclusion, the FVOR test is
      useful for detecting and following up fluctuating vestibular endolymphatic
      hydrops, which occur in disorders such as Meniere's disease, delayed
      endolymphatic hydrops and syphilitic labyrinthitis.

PMID- 8366408
TI  - [Clinical observation of acute otitis media in children].
AB  - The efficacy of a combination of cefaclor and fosfomycin otic solution was
      investigated in 81 children with acute otitis media, who needed myringotomy for
      severe erythema and swelling of the tympanic membrane. The patients were followed
      up for one year to investigate correlations between test findings of early
      treatment and both clinical course and prognosis. These drugs were used for 10
      days, and the effects of combined use were evaluated from findings in the
      tympanic membrane after the 10-day period. Three stages were assessed; cured,
      recovered and unchanged. In cured and recovered cases, the administration was
      evaluated to be effective. Within 2 weeks after the start of treatment, views of
      the ears, nose and epipharynx were roentgenographically examined for shadows of
      mastoid pneumatization and the paranasal sinuses, and the presence or absence of
      adenoid vegetation. After the antibiotic administration, the patients were
      instructed to visit us at least once every 3 months to rule out recurrence of
      acute otitis media and otitis media with effusion (possibly occurring one year
      after treatment). The following results were obtained. 1. The two drug
      combination was effective in 99% of patients, produced no side effects, and was
      deemed extremely useful. 2. The course of acute otitis media tended to be
      significantly prolonged in patients with mastoid pneumatization and paranasal
      sinus shadows as revealed by roentgenography.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366409
TI  - Histologic observations on the topography of a human periodontal pocket viewed in
      transverse step-serial sections.
AB  - A histologic overview of a periodontal pocket at the distal of a maxillary first
      premolar is presented. The material studied is part of the Bernhard Gottlieb
      collection. This material demonstrated the topography of the periodontal pocket
      through its complete circumference as seen in transverse step serial sections.
      From these observations, it is also clear that multiple pockets had formed, each
      involving a different area of the root surface. The pockets terminated
      independently and are separated from each other by areas of tissue which progress
      from pocket epithelium to junctional epithelium to connective tissue attachment.
      The existence of independent pockets around the root surface of a single tooth
      points to the problem of access and thus the predictability of non-surgical
      therapy as well as concerns that surgical access will necessarily involve areas
      of unaffected tissues.

PMID- 8366410
TI  - Current status of lasers in soft tissue dental surgery.
AB  - The aims of this paper are to briefly describe laser physics, the types of lasers
      currently available for use on soft tissues focusing primarily on CO2 and Nd:YAG
      laser energies, the histological effects of lasers on oral tissues, laser safety,
      the clinical applications of lasers on oral soft tissues, and future directions.
      Of the two types of lasers currently available for dental applications, both the
      CO2 and Nd:YAG lasers can be used for frenectomies, ablation of lesions,
      incisional and excisional biopsies, gingivectomies, gingivoplasties, soft tissue
      tuberosity reductions, operculum removal, coagulation of graft donor sites, and
      certain crown lengthening procedures. The advantages of lasers include a
      relatively bloodless surgical and post-surgical course, minimal swelling and
      scarring, coagulation, vaporization, and cutting, minimal or no suturing,
      reduction in surgical time, and, in a majority of cases, much less or no post
      surgical pain. CO2 lasers, compared to Nd:YAG are faster for most procedures,
      with less depth of tissue penetration and a well-documented history. There have
      been recent reports on the use of the Nd:YAG laser for periodontal scaling,
      gingival curettage, and root desensitization, but further research needs to be
      conducted. Both the CO2 and the Nd:YAG laser have limited use in conventional
      flap therapy.

PMID- 8366411
TI  - Effects of antibiotic treatment on clinical conditions and bacterial growth with
      guided tissue regeneration.
AB  - Mucogingival flaps were reflected over pairs of mandibular molar teeth with Class
      II furcation invasions. The dimensions of the furcations were measured. The teeth
      were debrided and an expanded polytetrafluoroethylene (e-PTFE) membrane was
      placed and retained over one furcation of each pair (test site) for 4 weeks. The
      second site served as a control. Eight patients (group 1) with 12 e-PTFE sites
      received no antibiotic. Seven patients (group 2) with 12 e-PTFE sites were
      administered amoxicillin/clavulanate potassium for 10 days. Paper-points were
      used to collect bacterial samples and clinical indices were recorded at baseline
      and weekly for 4 weeks. Paper-point samples and the e-PTFE collected at week 4
      were sonicated and analyzed by DNA probes for seven putative pathogens. At
      baseline no parameter showed statistical differences between groups or sites. At
      week 1 significantly greater levels of Prevotella intermedia type I (P < 0.05)
      and Fusobacterium nucleatum (P < 0.01) were found in group 1. At week 4, paper
      point samples from test sites (P < 0.05) and e-PTFE materials (P < 0.001) showed
      significantly higher presence of Bacteroides forsythus in group 1. No significant
      microbial changes were found for control sites over time or between groups. The
      total bacterial load at test sites over time increased similarly for patients
      administered or not administered the antibiotic. Clinical signs of inflammation
      were significantly greater in group 1 and associated with the presence of B.
      forsythus (P < 0.01).

PMID- 8366412
TI  - Collagen membrane barrier therapy to guide regeneration in Class II furcations in
      humans.
AB  - This study was undertaken to evaluate the effectiveness of resorbable collagen
      membranes in guided tissue regeneration. The study participants were 38 adults
      with moderate to advanced periodontitis. Each patient had at least one Class II
      furcation defect which could serve as either a test or control tooth. The cases
      were randomized prior to selection, so that investigators did not known whether
      the patient would be a test case or a control case until the time of surgery.
      Sites were surgically exposed and measurements were recorded from the cemento
      enamel junction (CEJ) directly coronal to the furcation area to the alveolar
      crest, and to the base of the defect. Horizontal furcation measurements were also
      made, using a color coded furcation probe. The test patients had a trimmed and
      shaped collagen membrane barrier placed over the prepared furcation area. The
      control patients received the identical surgical management, except that no
      collagen membrane barrier was placed. All patients received normal post-surgical
      care, and at 12 weeks post-surgery, were scheduled for re-entry surgery. The re
      entry mucoperiosteal flaps were designed to expose the furcation area for
      measurements, as described above. There was clinical improvement in all
      measurements made in both the test and control patients over the 3-month period.
      The horizontal furcation measurement and the CEJ to base of alveolar defect
      measurements did yield a statistically significant improvement when comparing the
      test patients to the controls.

PMID- 8366413
TI  - Pain and discomfort levels in patients during root surface debridement with sonic
      metal or plastic inserts.
AB  - The study was designed to evaluate whether root surface debridement with a sonic
      scaler plastic insert would cause less pain and discomfort to patients than an
      ordinary, probe-shaped metal sonic insert. One quadrant in each of 23 patients
      was debrided with each insert. Blood pressure, mean arterial pressure, and heart
      rate were monitored before, during, and immediately after each treatment. Pain
      was also evaluated on a visual analogue scale (VAS) after each treatment, as well
      as 2 weeks later following pain-provoking stimuli. Blood pressure, mean arterial
      pressure, and heart rate did not reveal any differences between quadrants treated
      with plastic or metal inserts. Heart rate had a weak, positive association with
      treatment time. The VAS gave a higher pain score for the plastic (30.8) than for
      the metal insert (24.4), but this difference was not statistically significant (P
      = 0.055). Following pain-provoking stimuli at the 2-week follow-up visit,
      quadrants debrided with the metal insert (31.3) scored significantly lower (less
      pain) (P < 0.01) on the VAS than quadrants treated with the plastic insert
      (30.7). It is concluded that the sonic metal insert caused less pain and
      discomfort to the patients due to its superior accessibility and water spray
      cooling. The significant difference between metal and plastic tip debrided
      quadrants at the follow-up visit was probably caused by the smearing effect of
      the metal insert with partial closure of the dentin tubule orifices.

PMID- 8366414
TI  - Progression of periodontal disease in HIV seropositive patients.
AB  - Data from cross-sectional studies suggest that periodontitis in HIV-infected
      patients is a more destructive form of disease in contrast to the slowly
      progressing form of adult periodontitis in the general population. We studied
      prospectively over an 18-month period 30 HIV infected, but asymptomatic, patients
      and compared the rate of periodontal attachment loss with that of a healthy
      control group (n = 10) matched for age and plaque index. Every 6 months, each
      subject was assessed for their clinical status by a physician and CD4+ cell count
      determined. The proliferative response of peripheral blood lymphocytes was
      determined by in vitro cultures with PHA and Con A. The periodontal health status
      was assessed by scoring with plaque index (PI), gingival index (GI), and
      periodontal disease index (PDI). The control subjects were assessed for
      periodontal status only. Of the 30 HIV-positive patients whose data were analyzed
      14 received Zidovudine (AZT) while the remaining 16 did not. There was no
      correlation between any clinical parameter measured and periodontal status as
      determined by PI or GI. However, a significant difference in the change of
      periodontal disease index (PDI) was observed between the HIV-infected and control
      groups (P = 0.005). We concluded that HIV-infected patients with pre-existing
      periodontitis tend to experience a greater rate of attachment loss over time
      compared with controls.

PMID- 8366415
TI  - The effect of nicotine on reproduction and attachment of human gingival
      fibroblasts in vitro.
AB  - The ability of fibroblasts to reproduce and attach to teeth is of paramount
      importance in re-establishing the lost connective tissue attachment after
      periodontal therapy. This study examined the effect of nicotine, a major
      component of the particulate phase of tobacco smoke, on human gingival fibroblast
      (HGF) reproduction and attachment to tissue culture surfaces. Pooled HGF cultures
      made from explants of gingival biopsies were utilized between passages 5 and 10
      and plated in 96-well plates at 1.0 x 10(4) cells per well. Cell numbers were
      determined using 3-(4,5-dimethylthiazol-2-y)-2,5-diphenyl tetrazolium bromide
      (MTT), which is a reflection of mitochondrial dehydrogenase activity. The
      concentrations of nicotine used were 0.025, 0.05, 0.1, 0.2, and 0.4 microM, the
      average serum concentration for a smoker being approximately 0.1 microM. The
      effect of continuous nicotine exposure on HGF reproduction was determined by
      incubating cell cultures and media containing nicotine for up to 48 hours.
      Residual toxicity was determined by preincubating cells with nicotine for 1 or 6
      hours. HGF suspensions and increasing concentrations of nicotine were added
      together to determine the effect on attachment. Results showed an enhanced effect
      of nicotine on HGF attachment, with increasing numbers of cells attaching with
      increasing nicotine concentrations, compared to the control. Low concentrations
      of nicotine had a stimulatory effect on cell replication, while higher
      concentrations of nicotine appear to have no significant effect on HGF
      reproduction. The responses of cells to some concentrations of nicotine may
      persist after its removal.

PMID- 8366416
TI  - Gingival crevicular blood for assessment of blood glucose in diabetic patients.
AB  - In this study 50 patients with diabetes mellitus had gingival crevicular blood
      from periodontal probing collected in small plastic pipettes. The pipettes
      transferred the crevicular blood to a non-wipe glucose self-monitoring
      instrument. At the same time, finger-stick capillary blood measurements were
      analyzed in the same glucose self-monitoring instrument, and venous blood was
      collected for measurement in a laboratory glucose analyzer. Each laboratory
      measurement was corrected from a serum glucose value to a whole blood glucose
      value by a function of the patient's hematocrit. This corrected glucose value
      allowed direct comparison of the laboratory measurement to the intraoral and
      finger-stick whole blood measurements. The patient blood glucose concentrations
      ranged from 59 mg/dl to 366 mg/dl. The gingival crevicular blood exhibited a
      correlation of r = 0.975 (P < .0001) to the corrected laboratory standard
      measurement, with a mean prediction error (bias) of -4.11 mg/dl and a root mean
      square error (precision) of 17.43 mg/dl. The finger-stick blood had a correlation
      of r = 0.983 (P < .0001) to the corrected laboratory standard, with a mean
      prediction error of 4.65 mg/dl and a root mean square error of 14.48 mg/dl. The
      American Diabetic Association recommends that the prediction error of blood
      glucose monitoring devices fall within 15% of the laboratory standard. Using this
      criterion 92% of the gingival crevicular measurements and 90% of the finger
      puncture measurements fell within 15% of the laboratory value.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8366417
TI  - Oral-dental findings in a case of Maffucci's syndrome.
AB  - A case of Maffucci's syndrome (MS) in a 17-year-old Caucasian female is presented
      with a thorough intraoral examination. The prominent finding was recurrent
      gingival hyperplasia affecting both the free and attached gingiva with deep
      periodontal pockets, tooth mobility, pathological tooth migration, and severe
      alveolar bone loss. Furthermore, the pattern of alveolar bone destruction, in
      many ways, resembled that of localized juvenile periodontitis. Although there is
      always the possibility that these oral features may not be related with the
      syndrome, we suggest a careful dental and periodontal examination in future
      cases, which we believe will help develop a better description of oral findings
      in MS.

PMID- 8366418
TI  - You can't not believe everything you read.
AB  - Can people comprehend assertions without believing them? Descartes (1644/1984)
      suggested that people can and should, whereas Spinoza (1677/1982) suggested that
      people should but cannot. Three experiments support the hypothesis that
      comprehension includes an initial belief in the information comprehended. Ss were
      exposed to false information about a criminal defendant (Experiments 1 and 2) or
      a college student (Experiment 3). Some Ss were exposed to this information while
      under load (Experiments 1 and 2) or time pressure (Experiment 3). Ss made
      judgments about the target (sentencing decisions or liking judgments). Both load
      and time pressure caused Ss to believe the false information and to use it in
      making consequential decisions about the target. In Spinozan terms, both
      manipulations prevented Ss from "unbelieving" the false information they
      automatically believed during comprehension.

PMID- 8366419
TI  - Unemployment, distress, and coping: a panel study of autoworkers.
AB  - This study of coping with unemployment traces the distress levels of workers in 4
      closing and 12 nonclosing General Motors (GM) plants. Workers were interviewed 3
      months before plants closed, 1 year after, and 2 years after (final N = 1,136).
      Tested were (a) effects of unemployment on symptoms of depression, anxiety, and
      somatization; (b) linkages between depression and subsequent unemployment,
      controlling for workers' gender, race, marital status, age, education, prior
      income, and seniority; and (c) the relationship between workers' coping decisions
      and subsequent depression. Results showed that unemployment at Waves 2 and 3 was
      related to prior frequency of symptoms of depression. Depression, in turn, was
      alleviated for workers whose coping decisions at Wave 2 fit with their Wave 3
      outcomes: those who both wanted and found a job, lost a job they disliked, or
      remained unemployed as planned.

PMID- 8366420
TI  - Motivated augmentation and reduction of the overattribution bias.
AB  - Three experiments investigated whether the need to have (or avoid) cognitive
      closure affects observers' tendency to display attributional bias. Results of
      each experiment indicate that the overattribution bias was magnified under high
      need for cognitive closure and attenuated under high need to avoid closure. In
      Experiments 1 and 3, the relevant motivational state was manipulated
      situationally, whereas in Experiment 2 an individual-differences measure of the
      closure motivation was used. These divergent operationalizations yielded
      convergent results. Furthermore, when in Experiment 3 the task consisted of
      attributions to the situation, high need for closure augmented, and high need to
      avoid closure reduced, situational rather than dispositional overattributions.
      The results imply general motivational boundary conditions for inferential biases
      across judgmental contents.

PMID- 8366421
TI  - Adaptive significance of female physical attractiveness: role of waist-to-hip
      ratio.
AB  - Evidence is presented showing that body fat distribution as measured by waist-to
      hip ratio (WHR) is correlated with youthfulness, reproductive endocrinologic
      status, and long-term health risk in women. Three studies show that men judge
      women with low WHR as attractive. Study 1 documents that minor changes in WHRs of
      Miss America winners and Playboy playmates have occurred over the past 30-60
      years. Study 2 shows that college-age men find female figures with low WHR more
      attractive, healthier, and of greater reproductive value than figures with a
      higher WHR. In Study 3, 25- to 85-year-old men were found to prefer female
      figures with lower WHR and assign them higher ratings of attractiveness and
      reproductive potential. It is suggested that WHR represents an important bodily
      feature associated with physical attractiveness as well as with health and
      reproductive potential. A hypothesis is proposed to explain how WHR influences
      female attractiveness and its role in mate selection.

PMID- 8366422
TI  - Household crowding and social support: a quasiexperimental analysis.
AB  - People often cope with crowded living conditions by socially withdrawing from
      their housemates. This coping strategy may overgeneralize, influencing social
      interactions with others outside the home. In a stressful laboratory situation,
      Ss from crowded homes, in comparison with uncrowded counterparts, are less likely
      to seek support from a confederate and rate the confederate as less supportive.
      Moreover, Ss from crowded homes are less likely to offer support to a confederate
      in need. These differences in social interaction behaviors appear to be
      attributable to crowded residents' social withdrawal.

PMID- 8366423
TI  - Self-perpetuating properties of dysphoric rumination.
AB  - Hypotheses about the self-perpetuating properties of ruminative responses to
      depressed mood were tested in 2 laboratory studies and 2 questionnaire studies
      with dysphoric and nondysphoric Ss. Studies 1 and 2 supported the hypothesis that
      dysphorics induced to engage in self-focused rumination would report reduced
      willingness to engage in pleasant, distracting activities that could lift their
      moods, even if they believed they would enjoy such activities. Studies 3 and 4
      confirmed the hypothesis that dysphorics induced to ruminate in response to their
      moods would feel they were gaining insight into their problems and their
      emotions. Therefore, they might have avoided distraction because they believed it
      would interfere with their efforts to understand themselves. Depressed mood
      alone, in the absence of rumination, was not associated with either lower
      willingness to participate in distractions or an enhanced sense of
      insightfulness.

PMID- 8366424
TI  - Social support and undermining in close relationships: their independent effects
      on the mental health of unemployed persons.
AB  - Structural equation analyses were used to examine the impact of social support
      vs. social undermining (conflict) on mental health in longitudinal data from
      1,087 recently unemployed respondents. The results demonstrated that social
      support and social undermining were not the opposite poles of the same factor,
      each having some impact independent of the other. Social undermining had
      statistically significant and strong adverse impact at each concurrent level of
      mental health. It also predicted improvement (but not a high level) in mental
      health in subsequent time waves. In contrast, social support had a significant
      beneficial impact on mental health only at Time 1. Compared with the volatile and
      extreme effects of social undermining, those of social support appear weaker but
      more stable. These findings are consistent with literature on the impact of life
      events (S. E. Taylor, 1991) and on marital interactions and satisfaction (J. M.
      Gottman & L. J. Krokoff, 1989).

PMID- 8366425
TI  - Competence, delinquency, and attempts to attain possible selves.
AB  - The impact of impulsivity, possible selves, and social and communication skills
      on delinquent involvement in inner-city high school and incarcerated boys (aged
      13-17, N = 230) was explored. Impulsivity, perceived attempts to attain possible
      selves, and balance in possible selves were hypothesized to directly influence
      delinquency. Social and communication skills were hypothesized to influence
      delinquency directly and indirectly through their effects on impulsivity,
      balance, and attempts to attain possible selves. These factors discriminated
      moderately well between high school and incarcerated youths. Impulsivity was an
      especially powerful predictor of self-reported delinquency among high school
      youths but not among incarcerated youths. The effect of other variables differed
      somewhat for different categories of delinquency (aggression, theft, hooliganism,
      and school truancy) and between subsamples, suggesting the importance of
      examining the subjective meaning of each of these behaviors for the individual in
      his social context.

PMID- 8366426
TI  - How coping mediates the effect of optimism on distress: a study of women with
      early stage breast cancer.
AB  - At diagnosis, 59 breast cancer patients reported on their overall optimism about
      life; 1 day presurgery, 10 days postsurgery, and at 3-, 6-, and 12-month follow
      ups, they reported their recent coping responses and distress levels. Optimism
      related inversely to distress at each point, even controlling for prior distress.
      Acceptance, positive reframing, and use of religion were the most common coping
      reactions; denial and behavioral disengagement were the least common reactions.
      Acceptance and the use of humor prospectively predicted lower distress; denial
      and disengagement predicted more distress. Path analyses suggested that several
      coping reactions played mediating roles in the effect of optimism on distress.
      Discussion centers on the role of various coping reactions in the process of
      adjustment, the mechanisms by which dispositional optimism versus pessimism
      appears to operate, third variable issues, and applied implications.

PMID- 8366427
TI  - A dark side of the American dream: correlates of financial success as a central
      life aspiration.
AB  - Aspiring for financial success is an important aspect of capitalist cultures.
      Three studies examine the hypothesis that values and expectancies for wealth and
      money are negatively associated with adjustment and well-being when they are more
      central to an individual than other self-relevant values and expectancies.
      Studies 1 and 2 use 2 methods to show that the relative centrality of money
      related values and expectancies is negatively related to college students' well
      being and mental health. Study 3, using a heterogeneous noncollege sample,
      extends these findings by showing that a high centrality of aspirations for
      financial success is associated with interview ratings of lower global adjustment
      and social productivity and more behavioral disorders. Discussion is focused on
      the deleterious consequences of materialistic world views and the need to examine
      differential effects of content regarding goals and values.

PMID- 8366428
TI  - [Membrane-bound proteases involved in neuropeptide degradation in the brain].
AB  - The action of neuropeptides at the synapse is terminated through enzymatic
      degradation by membrane-bound proteases. We defined and purified membrane-bound
      proteases functioning at the initial stage of degradation of four neuropeptides.
      1. Substance P-degrading endopeptidases isolated from the rat brain and pig
      striatum showed similar properties to those of endopeptidase-24.16 (neurolysin)
      except for cleavage sites of substance P. 2. LHRH fragment (1-5)-generating
      endopeptidases isolated from the neuroblastoma cells and rat brain showed similar
      properties to those of endopeptidase-24.15 (thimet oligopeptidase). 3. One of two
      dynorphin-degrading cysteine proteases isolated from neuroblastoma cells showed
      strict specificity toward the Arg-Arg residues. 4. Endopeptidase-24.11
      (neprilysin) isolated from the rat brain was identified as a somatostatin
      degrading enzyme.

PMID- 8366429
TI  - [Stability of allantoin and identification of its degradation compounds].
AB  - The stability of allantoin was studied in pH 3.0, 6.0, and 8.0 buffer solutions
      at 50 degrees C for 55 d. Allantoin was determined by high performance liquid
      chromatography (HPLC) with a cation exchange mode and colorimetry. The known
      degradation compounds, allantoic acid and glyoxylic acid, were simultaneously
      determined by ion chromatography. Urea was determined by HPLC with an ion pair
      mode. In the stability studies on pH 6.0 and 8.0 solutions, new degradation
      compounds of allantoin were identified as two growing unknown peaks in the HPLC
      chromatogram. Isolation of these compounds by preparative HPLC and 1H, 15N and
      13C-NMR spectra revealed that they were condensates of allantoin and glyoxylic
      acid, which also reacted positively in phenylhydrazine colorimetry. The amounts
      of these compounds were calculated from the determination results of other
      allantoin related compounds in the buffer solutions and were estimated as the
      biggest amount among all other compound. As they were found to be stable in an
      alkaline solution, conditions for hydrolysis in the colorimetric determination of
      allantoin were further examined. It was found that the longer hydrolysis gave
      more than 90% recovery in the colorimetry.

PMID- 8366430
TI  - [Effects of selenium on the glycolysis and gluconeogenesis system in rat liver].
AB  - We studied the effect of selenium on the glycolysis and gluconeogenesis system in
      the rat liver. Significant decreases in glucose level in the serum were observed
      from the 4th day after daily intraperitoneal (i.p.) administration of selenite
      (173 micrograms/kg, 78.9 micrograms/kg of selenium base equivalent). Selenium was
      also effective in reducing a precursor of gluconeogenesis, lactate, alanine or
      glycerol, in the serum. Moreover, there were significant decreases in the
      activities of pyruvate carboxylase and glucose-6-phosphatase, a rate-limiting
      enzyme of gluconeogenesis, in the liver of selenium-treated rates. On the
      contrary, the activities of glycokinase and phosphofructokinase, a rate-limiting
      enzyme of glycolysis, in the liver of rat treated with selenium significantly
      increased in comparison with the control group. These data, therefore, indicated
      that the hypoglycemic effect of selenium might be due to the acceleration of
      glucose metabolism and the inhibition of glucose synthesis in the liver,
      suggesting a decrease in a source of precursor supply for the gluconeogenesis.

PMID- 8366431
TI  - Gait style as an etiology to chronic postural pain. Part I. Functional hallux
      limitus.
AB  - A common, but locally asymptomatic and therefore rarely recognized functional
      inability of the first metatarsophalangeal joint to dorsiflex strictly during
      gait is described. Normal motion is present in this joint during nonweight
      bearing examination; therefore this is referred to as functional hallux limitus.
      Since this joint forms the pivot about which the entire body advances during each
      step, this disturbance in function, when repeated thousands of times on a daily
      basis, can alter foot and postural biomechanics. It can cause and perpetuate many
      chronic postural ailments, including lower back pain. When functional hallux
      limitus is specifically addressed in an orthotic treatment plan, 77% of long-term
      chronic postural pain patients exhibit 50% to 100% improvement in their overall
      condition, in spite of failing previous therapy on their specific site of pain
      and never exhibiting any foot symptomatology.

PMID- 8366432
TI  - Acute radiodermatitis following radiotherapy for classic Kaposi's sarcoma.
AB  - There is a high incidence of radiation toxicity associated with Kaposi's sarcoma.
      The authors review acute radiodermatitis and present a case where it occurred in
      the foot following radiotherapy for classic Kaposi's sarcoma.

PMID- 8366433
TI  - Effect of extrinsic rearfoot posts on rearfoot position.
AB  - Twenty runners displaying abnormal subtalar joint pronation were selected for
      this study, the purpose of which was to investigate the effects of extrinsic
      rearfoot posted orthoses on frontal plane rearfoot and tibial position. Numerous
      temporal events were measured and compared for three different conditions:
      acrylic post, Birko post, and no post. The results suggested that rearfoot posts
      have a somewhat limited function in foot orthotic therapy and that the choice of
      posting material is of limited functional value.

PMID- 8366434
TI  - Polyunsaturated fatty acid supplementation in peripheral neuropathy.
AB  - This study is an attempt to assess the role of dietary supplementation in the
      treatment and prevention of diabetic peripheral neuropathy. The authors developed
      an animal model system to study this problem. Animals given streptozotocin to
      induce a type I diabetic state showed elevated glucose levels and decreased body
      weight. Analysis of the sciatic nerve revealed a decrease in nerve conduction
      velocity and Na(+)-K(+)-ATPase activity. The activity of protein kinase C,
      another component of the nerve transmission process, was also affected by the
      diabetic state. The dietary intervention of polyunsaturated fatty acids seemed to
      revert some of these changes toward normal.

PMID- 8366435
TI  - Epidermal culture and grafting. A brief review.
AB  - In summary, technological advances in culturing epidermis for the purpose of
      grafting allow this approach in the treatment of cutaneous wounds. Certainly,
      full- and split-thickness autografts offer immediate availability and permanent
      wound coverage, but they also involve a large, painful donor site. Cultured
      epidermal autografts can provide permanent wound coverage, but the delay required
      for cultivation of confluent sheets of keratinocytes makes them somewhat less
      desirable. Both allografts and cultured allografts, on the other hand, are
      available for immediate use, but the possibility of infectious disease
      transmission may be a concern. In any case, all types of skin grafts function as
      biological dressings that promote the proliferation of the host's epidermis and,
      thus, facilitate the ability of the patient's skin to repair itself.

PMID- 8366436
TI  - Arthrodesis of the navicular medial cuneiform joint. A case report.

PMID- 8366437
TI  - Subcutaneous alternariosis of the foot in a patient on corticosteroids.
AB  - To the authors' knowledge, this is the first reported case of alternariosis
      involving the subcutaneous tissues of the foot. Podiatrists are likely to see
      more of this condition and other unusual fungi causing deep foot infections in
      the future because of the increasing population of immunocompromised patients.

PMID- 8366438
TI  - Foot problems in the US. The 1990 National Health Interview Survey.

PMID- 8366439
TI  - Iatrogenically induced Charcot foot.

PMID- 8366440
TI  - Meeting the challenge of the 1990s: strategies to provide quality perinatal
      services in an era of decreasing reimbursement.

PMID- 8366441
TI  - Hospital policies as they affect quality in the 1990s: a case for change?

PMID- 8366443
TI  - Patient satisfaction: an outcome measure for maternity services.

PMID- 8366442
TI  - Linking perinatal standards, documentation, and quality monitoring.

PMID- 8366444
TI  - Developing a CareMap for patients with a cesarean birth: a multidisciplinary
      process.

PMID- 8366445
TI  - Nurse-midwives and the peer review process.

PMID- 8366446
TI  - Implementing a neonatal resuscitation quality improvement committee.

PMID- 8366447
TI  - Linking neonatal documentation with standards of care and quality improvement.

PMID- 8366448
TI  - Facilitating parental involvement through documentation.

PMID- 8366449
TI  - Cast titanium implants for localized ridge defects: a clinical report.
AB  - A technique that allows the correction of alveolar ridge defects with titanium
      implants and pin stabilization is described. The use of titanium pins has
      improved the intimacy of contact of the implant with the bone, which simplifies
      implant placement and enhances implant stabilization.

PMID- 8366450
TI  - Apparent intrusion of natural teeth under an implant supported prosthesis: a
      clinical report.

PMID- 8366451
TI  - Periodontal and prosthodontic treatment of amelogenesis imperfecta: a clinical
      report.

PMID- 8366452
TI  - Clinical success of cast metal posts and cores.
AB  - The topic of posts for endodontically treated teeth has received considerable
      attention in the literature, but there is sparse in vivo research and certain
      information from in vitro investigations is contradictory. A retrospective study
      of 1273 endodontically treated teeth in the practices of nine dentists in general
      practice indicated an inordinately high failure rate with cast posts and cores
      compared with alternate systems of coronoradicular stabilization. However, a
      closer evaluation of the data in this study indicated that almost half of the
      cast posts were half the desired length or less. The indications for the cast
      post and core are discussed and the specific causes of failure are reviewed.
      Additional research is needed to compare the success rate of securely seated cast
      posts and cores with alternate methods of coronoradicular stabilization.

PMID- 8366453
TI  - Effect of bone mineral density in skeleton and mandible on extraction of teeth
      and clinical alveolar height.
AB  - Residual ridge resorption of the maxillae and mandible after tooth extraction
      adversely affects many edentulous people. The jaws of 355 postmenopausal women
      were examined clinically, and the number of teeth and the clinical height of
      alveolar ridges in edentulous jaws were determined. Each subject was asked when
      the last teeth had been extracted. To study the bone mineral status of each
      woman, the bone mineral densities of the femoral neck and the lumbar spine were
      measured by dual-energy x-ray absorptiometry. For 77 edentulous or almost
      edentulous women, the bone mineral density of the mandibular cortex and the
      spongiosa were measured by quantitative computed tomography. The results were
      studied to determine whether the general status of osteoporosis or the local bone
      mineral densities in the mandible affect the time of extraction of teeth or the
      remaining height of edentulous alveolar ridges. Neither the time when the teeth
      were lost nor the number of teeth was dependent on the general bone loss, but in
      some regions, the clinical height was affected.

PMID- 8366454
TI  - Some physical properties of an improved facial elastomer: a comparative study.
AB  - An attempt was made to evaluate some properties of clinical importance of a new
      facial elastomer, Cosmesil HC2. A comparative study versus Silskin II and
      Cosmesil SM4 was also carried out and took into account the effect of weathering
      after exposure to ultraviolet radiation. The results showed that Cosmesil HC2 is
      a resilient material and yet displays good tensile characteristics. The results
      also showed that weathering does not significantly affect Cosmesil HC2
      elastomer's tear strength. The overall effect of irradiation was moderate in all
      materials tested.

PMID- 8366455
TI  - Isokinetic exercise management of temporomandibular joint clicking in young
      adults.
AB  - Temporomandibular joint clicking is frequently a sign of craniomandibular
      disorders, and the etiologic predisposing, initiating, and perpetuating factors
      must be considered in its management. The present study assesses the usefulness
      of isokinetic exercises in the treatment of temporomandibular joint clicking. At
      the end of a 6-month test period, 18 of 22 subjects (approximately 82%) with
      clicks no longer had clicking, but four subjects (approximately 18%) with
      bilateral reciprocal clicking did not lose their clicks. A number of proposals
      have been suggested in the past as an explanation of the cause of
      temporomandibular joint clicking, but the present study has shown that clicking
      in young adults is predominantly neuromuscular in origin and may be a reversible
      condition that can be treated successfully with a conservative exercise regimen.

PMID- 8366456
TI  - Comparison of muscle activity between conventional and neuromuscular splints.
AB  - The muscle relaxation appliance (MRA) has been used in the treatment of
      myofascial pain dysfunction (MPD) patients. The neuromuscular orthotic is a
      version of the MRA and is constructed from a three-dimensional mandibular
      position when muscles are in a state of minimal electromyographic (EMG) activity.
      The purpose of this study was to investigate the affect of two muscle relaxation
      appliances and a placebo (cotton rolls) on EMG activity of the functional
      masseter and anterior temporalis muscles. A centric relation mandibular MRA and a
      neuromuscular orthotic were constructed under controlled protocols for 12 women
      MPD patients with a mean age of 38 years. EMG measurements were taken during a 10
      second clench of both appliance and placebo. No statistical difference was found
      between the centric relation mandibular MRA and neuromuscular orthotic. A
      statistically significant difference was found between the mean EMG values of the
      placebo and two treatment appliances.

PMID- 8366457
TI  - Transmandibular implant system for the atrophic mandible: a case report of its
      use in the partially dentate mandible.

PMID- 8366458
TI  - Annual review of selected dental literature: report of the Committee on
      Scientific Investigation of the American Academy of Restorative Dentistry.
AB  - The annual review of selected dental literature this year cites 384 published
      papers and reports. This year's review contains more editorial comment than
      reviews of years passed. New data on the biological responses to materials is
      emphasized in several sections. Observations on new compounds able to prevent
      plaque formation are presented. Clinically relevant advances in knowledge
      concerning the etching of different tooth structures are reported along with the
      effect of etching procedures on the dental pulp. Evaluation of periodontal
      diseases in all age groups is a topic. Limitations of current diagnostic
      techniques in periodontal disease, temporomandibular disorders, and implant
      therapy are included. There are new views on the use of dental amalgam. The
      future use of dental mercury is predicted. Interest in new ceramic systems is
      indicated as the demand for esthetics continues. Clinical information is
      emphasized over scientific information throughout this year's review.

PMID- 8366459
TI  - Bond strength of composite resin to porcelain with newer generation porcelain
      repair systems.
AB  - A laboratory study was conducted to evaluate the mean shear bond strength of
      composite resin bonded to porcelain with the use of eight newer generation repair
      systems. The range of shear bond strength after 24 hours of water storage was
      23.5 +/- 5.3 MPa to 12.0 +/- 2.3 MPa. After 3 months of water storage and
      thermocycling, the bond strength range was 20.7 +/- 1.7 MPa to 4.2 +/- 1.0 MPa.
      Three of eight systems evaluated did not exhibit a significant (p > 0.05)
      decrease in bond strength when the 24-hour bond strengths were compared with the
      3-month bond strengths. Most specimens failed cohesively in the porcelain at 24
      hours, but at 3 months only four of the eight systems showed consistent failures
      in the porcelain.

PMID- 8366461
TI  - Flexural strength of provisional restorative materials.
AB  - A provisional restorative material must be strong enough to resist fracture
      during function. This study tested five autopolymerizing provisional resin
      materials under conditions that related the stresses acting on them to those
      acting on a fixed partial denture. The highest values for fracture resistance
      were displayed by Snap poly(ethyl methacrylate) material. However, two of the 11
      samples of this material displayed markedly lower values for fracture resistance.
      This finding warrants further investigation, because inconsistency had clinical
      implications. In decreasing order, the fracture resistance of the other materials
      was as follows: the poly(methyl methacrylate) materials, Caulk temporary bridge
      resin and G-C Unifast temporary resin; the composite material, Protemp; and the
      epimine material, Scutan.

PMID- 8366460
TI  - The relationship of the incisive papilla to the maxillary central incisors and
      canine teeth in southern Chinese.
AB  - A photographic technique was used to measure anatomic landmarks located on dental
      casts. The relationship of the maxillary anterior teeth to the incisive papilla
      in a Southern Chinese population living in Hong Kong was studied. The distances
      from the labial surface of the central incisors to the midpoint and the posterior
      border of the incisive papilla were measured. The area on the incisive papilla
      where the intercanine line crossed was noted. The data obtained were compared
      with those from previous studies of Caucasians. Results show that there is little
      difference between the Southern Chinese in this study and most other ethnic
      groups. The guidelines that use the incisive papilla as a reference for the
      setting of artificial teeth in denture construction recommended for Caucasians
      can be applied to Southern Chinese patients.

PMID- 8366462
TI  - Placement of retraction cord during porcelain laminate (veneer) restorative
      procedures.

PMID- 8366463
TI  - A way to quantify the occlusal factors of excursive movements.

PMID- 8366464
TI  - The relationship of depression to dissociation in patients with bulimia nervosa.
AB  - Dissociative Experiences Survey scores were compared between bulimics with and
      without depression, and among depressed patients with and without bulimia. An
      association is noted between depression and dissociation, confounding the
      previously noted relationship between bulimia nervosa and dissociation.

PMID- 8366465
TI  - An MCMI cluster typology of obsessive-compulsives: a measure of personality
      characteristics and its relationship to treatment participation, compliance and
      outcome in behavior therapy.
AB  - The two-fold purpose of this investigation was to (a) define personality subtypes
      among patients diagnosed with obsessive-compulsive disorder (OCD) and (b) examine
      the relationship between the resulting typology and treatment participation,
      compliance and outcome of OCD patients treated with behavior therapy, using
      exposure and response prevention. A hierarchical agglomerative cluster analysis
      was performed on the Millon Clinical Multiaxial Inventory (MCMI) scale scores of
      137 OCD patients seeking outpatient treatment; four cluster types emerged.
      Patients' OCD symptom severity was assessed at pretreatment, posttreatment, and 6
      month follow-up using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).
      Patients with no evident personality pathology and those with dependent qualities
      demonstrated the best overall outcome. Patients whose personalities indicated
      particular difficulties with interpersonal interaction were most likely to refuse
      behavior therapy and, among these patients who engaged in treatment, evidenced no
      reduction in OCD symptoms at posttreatment and follow-up. Patients with
      histrionic/borderline traits showed symptom reductions at posttreatment, but did
      not maintain their treatment gains at follow-up. The clinical implications of
      these findings are discussed.

PMID- 8366466
TI  - Effects of haloperidol on human plasma magnesium.
AB  - The effect of haloperidol treatment on human plasma levels of magnesium (Mg),
      calcium (Ca) and phosphorus (P) was assessed. Haloperidol treatment significantly
      reduced plasma Mg but not plasma Ca or P levels. This finding contrasts with
      studies using other neuroleptics where reductions in both Mg and Ca
      concentrations were observed. The addition of lithium to haloperidol treatment
      resulted in an elevation of plasma Mg, but not Ca or P, to levels significantly
      greater than those at baseline. The reduction of Mg levels by haloperidol may
      reflect the ion's involvement in the pathology of psychosis and/or in the
      mechanism of generating extrapyramidal side effects.

PMID- 8366467
TI  - Migraine headaches and psychopathology: future directions.

PMID- 8366468
TI  - Headache and personality: results of a community sample of young adults.
AB  - The present study investigated the association between personality, symptoms and
      headache subtypes in a prospective longitudinal epidemiologic study of a cohort
      of 19- and 20-year-olds in Zurich, Switzerland. Personality was assessed by the
      Freiburg Personality Inventory (FPI), a standardized self-report personality
      instrument, which yields nine primary factors and three secondary factors. The
      Symptom Checklist 90 (SCL-90) was employed to examine somatic and psychological
      symptoms. Subjects with migraine exhibited elevated rates of neuroticism compared
      to non-migraine subjects on FPI. Somatization was the only primary symptom factor
      on the SCL-90 which discriminated between subjects with migraine and those
      without migraine. Persons with migraine with aura exhibited greater impairment
      than any of the other headache subtypes or controls on both the FPI and SCL-90.
      Subjects with tension-type headache did not differ from controls on any of the
      personality or symptom factors.

PMID- 8366469
TI  - Headache syndromes and psychiatric disorders: association and familial
      transmission.
AB  - This paper examines the association between psychiatric disorders and headache
      syndromes in a longitudinal epidemiologic sample of young adults who were
      selected from the general population of Zurich, Switzerland. Headache syndromes
      were defined according to the newly introduced diagnostic criteria of the
      International Headache Society in 1988. The prevalence rates of psychiatric
      disorders, according to specific headache subtypes, were examined both cross
      sectionally and longitudinally. In the cross-sectional data, migraine with aura
      was associated with hypomania, recurrent brief depression, and all of the anxiety
      disorders, whereas only the phobic disorders and panic were elevated among
      subjects with migraine without aura. Similar findings emerged for the
      longitudinal data, with the exception that major depression was associated with
      both subtypes of migraine. Subjects with tension-type headaches did not differ
      from controls with respect to any of the effective or anxiety disorders in both
      the cross-sectional and longitudinal data. Prospective study data indicated that
      the age of onset of anxiety disorders generally preceded that of migraine and
      that the onset of affective disorders in the majority of comorbid subjects
      followed that of the onset of migraine. In order to investigate the mechanism for
      the associations between anxiety/depression syndromes and migraine, patterns of
      co-transmission of migraine and anxiety/depression were examined in data from a
      controlled family history study of migraine. The results were consistent with a
      syndromic relationship between migraine and anxiety/depression, rather than their
      representing discrete manifestations of shared underlying etiology. The
      implications of these data for research and clinical work are discussed.

PMID- 8366470
TI  - Migraine, physical health and psychiatric disorder: a prospective epidemiologic
      study in young adults.
AB  - In a prospective study of a random sample of 1,007 young adults, we examined the
      association between migraine and psychiatric disorder, physical complaints,
      indicators of functional impairment, and use of mental health services. A history
      of migraine was associated with increased lifetime rates of major depression,
      anxiety disorders, illicit drug use disorders, nicotine dependence, and suicide
      attempts. Compared with subjects without a history of migraine, those with such a
      history had significantly more physical symptoms and were more likely to report
      job absenteeism, assess their general health as fair or poor, and use mental
      health services. Follow-up data, gathered 14 months after the baseline interview,
      revealed that subjects with a history of migraine at the baseline had
      significantly increased rates of first incidence major depression and panic
      disorder during the interval period (odds ratio (OR) for major depression = 4.2,
      95% confidence interval (CI) 2.0-9.2; and OR for panic disorder = 12.8, 95% CI
      4.1-39.8). The risk for these psychiatric disorders in persons with prior history
      of migraine was unrelated to the recentness of their migraine attacks. These
      findings suggest that the link between migraine, major depression and anxiety
      might reflect a common predisposition.

PMID- 8366471
TI  - Migraine and depression: biological aspects.
AB  - There is a considerable overlap in migraine and depression incidence, and both
      conditions may be associated with low levels of 5-hydroxytryptamine (5-HT).
      During a migraine attack there is evidence for low levels of platelet 5-HT and
      possibly also low Vmax for 5-HT uptake; both these findings are also associated
      with the depressed state. Both conditions can be treated by tricyclic and
      monoamine oxidase inhibiting antidepressants. However, there are also clear
      differences: migraine attacks are brief and self limiting. Part of the migraine
      cascade occurs outside the blood brain barrier, presumably involving blood
      vessels and, unlike depression, migraine attacks can be ameliorated by drugs
      which only act peripherally. In addition, migraine patients, especially males,
      often have permanently low levels of platelet monoamine oxidase activity, whereas
      patients with unipolar depression tend to have raised levels of this marker. This
      low enzyme activity may reflect part of the vulnerability to migraine, often
      associated in the prodromal phase with agitation or hyperactivity. Migraine may
      form part of a family of brief recurrent self-limiting disorders, which involve
      disturbances of both mood and monoamines; during the headache phase of the
      attack, the links with depression are most apparent.

PMID- 8366472
TI  - Dead reckoning in a small mammal: the evaluation of distance.
AB  - When hoarding food under infra-red light, golden hamsters Mesocricetus auratus W.
      return fairly directly from a feeding place to their nest site by evaluating and
      updating internal signals that they have generated during the previous outward
      journey to the feeding place. To test more specifically the animals' capacity to
      evaluate the linear components of the outward journey, the subjects were led from
      their (cone-shaped) nest to a feeding place along a detour which comprised either
      2 (experiment 1) or 5 (experiment 2) segments; adjoining segments were at right
      angles to each other. In these conditions, the subjects remained significantly
      oriented towards the nest and therefore were capable of assessing translations as
      well as rotations during the outward journey. In experiment 3, the nest was
      removed after the hamsters had started the direct outward journey to the feeding
      place and the hamsters were rotated during the food uptake. The animals were no
      longer oriented towards the starting point of their journey, but nonetheless
      covered, along a fairly straight path, the correct homing distance, and then
      changed over to a circular search path. These results confirm that mammals can
      derive the linear components of an outward journey from self-generated signals
      and therefore are able to judge the homing distance without relying on cues from
      the environment. For a number of detour outward journeys, our data yield an
      unexpectedly good fit to Muller and Wehner's (1988) model of dead reckoning in
      ants. However, this is no longer the case when the outward journey contains an
      initial loop which brings the subject back to the starting point. These findings
      are discussed in terms of the biological significance and limitations of an
      approximate form of path integration.

PMID- 8366473
TI  - Acoustic response properties of single units in the torus semicircularis of the
      goldfish, Carassius auratus.
AB  - Single units of the goldfish torus semicircularis (TS) were recorded in response
      to pure tones. Response areas (RA) were obtained by recording the number of
      spikes evoked by tones in a range of frequencies and levels within the units'
      dynamic range. RAs gave estimates of best sensitivity (BS), characteristic
      frequency (CF), most excitatory frequency at each level (BF), and Q10dB. Peri
      stimulus-time histograms (PSTH), interspike interval histograms (ISIH), and
      period histograms were obtained at various frequencies and levels to describe the
      units' temporal response patterns. The distribution of CF is nonuniform with
      modes at 155, 455, and 855 Hz. The distribution of the coefficient of
      synchronization to standard tones is also nonuniform, revealing a dichotomy
      between units with little or no phase-locking and those that phase-lock strongly.
      PSTHs for units without significant phase-locking vary widely and include
      patterns resembling those of the mammalian auditory brainstem. Compared with
      saccular afferents, torus units tend to have lower spontaneous rates, greater
      sensitivity, and sharper tuning. Unlike saccular afferents, BF is independent of
      level for most torus units. Some torus units are similar to saccular afferents
      while others reveal significant transformations of information between the
      periphery and the midbrain.

PMID- 8366474
TI  - Independently evolved jamming avoidance responses employ identical computational
      algorithms: a behavioral study of the African electric fish, Gymnarchus
      niloticus.
AB  - An African electric fish, Gymnarchus, and a South American electric fish,
      Eigenmannia, are believed to have evolved their electrosensory systems
      independently. Both fishes, nevertheless, gradually shift the frequency of
      electric organ discharge away when they encounter a neighbor of a similar
      discharge frequency. Computational algorithms employed by Gymnarchus for this
      jamming avoidance response have been identified in this study for comparison with
      those of extensively studied Eigenmannia. 1. Gymnarchus determines whether it
      should raise or lower its discharge frequency based solely upon the signal
      mixture of its own reafferent and the exafferent signal from a neighbor, and does
      not internally refer to the pacemaker command signal which drives its own
      discharge. 2. The signal mixture is analyzed in terms of the time courses of
      amplitude modulation and phase modulation at each area of the body surface. 3.
      Phase of the signal mixture at each area is compared with that of another area
      for the detection of phase modulation. 4. Unambiguous information necessary for
      the jamming avoidance response is extracted by integrating information from all
      body areas each of which yields ambiguous information. 5. These computational
      features are identical to those of Eigenmannia, suggesting that the neural
      circuit for jamming avoidance responses may have evolved from preexisting
      mechanisms for electrolocation in both fishes.

PMID- 8366475
TI  - Processing a dynamic visual-spatial language: psycholinguistic studies of
      American Sign Language.
AB  - American Sign Language (ASL) has evolved within a completely different biological
      medium, using the hands and face rather than the vocal tract and perceived by eye
      rather than by ear. The research reviewed in this article addresses the
      consequences of this different modality for language processing, linguistic
      structure, and spatial cognition. Language modality appears to affect aspects of
      lexical recognition and the nature of the grammatical form used for reference.
      Select aspects of nonlinguistic spatial cognition (visual imagery and face
      discrimination) appear to be enhanced in deaf and hearing ASL signers. It is
      hypothesized that this enhancement is due to experience with a visual-spatial
      language and is tied to specific linguistic processing requirements
      (interpretation of grammatical facial expression, perspective transformations,
      and the use of topographic classifiers). In addition, adult deaf signers differ
      in the age at which they were first exposed to ASL during childhood. The effect
      of late acquisition of language on linguistic processing is investigated in
      several studies. The results show selective effects of late exposure to ASL on
      language processing, independent of grammatical knowledge.

PMID- 8366476
TI  - Processing syntactically ambiguous sentences: evidence from semantic priming.
AB  - In this paper, we report the results of a study which investigates the processing
      of syntactically ambiguous sentences. We examined the processing of sentences in
      which an embedded clause is interpretable as either a complement clause or as a
      relative clause, as in, for example, "The receptionist informed the doctor that
      the journalist had phoned about the events." The embedded clause in such
      sentences is typically analyzed as a complement to the verb informed, rather than
      as a relative clause modifying the doctor. A number of models parsing predict
      this is the only analysis ever considered, while others predict that both
      interpretations are computed in parallel. Using a cross-model semantic priming
      technique, we probed for activation of doctor just after the embedded verb. Since
      only the relative clause analysis contains a connection between the doctor and
      the embedded verb, we expected reactivation of doctor at that point only if the
      relative clause analysis were a viable option. Our results suggest that this is
      the case: Compared to priming in an ambiguous control sentence, a significant
      reactivation effect was obtained. These results are argued to support a model of
      parsing in which attachment of a clause may be delayed.

PMID- 8366477
TI  - The processing of homophonic homographs during reading: evidence from eye
      movement studies.
AB  - Research on the processing of homophonic homographs during reading is reviewed.
      The primary dependent variable considered was fixation time on target homographs.
      Both the characteristics of the homograph (whether there are two equally likely
      meanings or one dominant meaning) and the characteristics of the preceding
      context (whether it is neutral or contains disambiguating information) were
      varied. When the preceding context was neutral, readers fixated longer on
      balanced homographs (homographs having two equally likely meanings) than on
      control words matched on frequency and length, but didn't look any longer at
      biased homographs (homographs having a highly dominant meaning) than matched
      control words. However, when the preceding context disambiguated toward the
      subordinate meaning, readers fixated longer on a biased homograph than a matched
      control word (the subordinate bias effect). Attempts to eliminate the subordinate
      bias effect are described and the implications of our research for models of
      lexical ambiguity resolution are discussed.

PMID- 8366478
TI  - On the temporal course of gap-filling during comprehension of verbal passives.
AB  - The work presented in this paper examines the time course of antecedent
      reactivation following movement gaps found in passive sentences. Using a cross
      modal lexical priming technique, (re)activation of the subject noun phrase (NP)
      was examined at various critical points following the verb (near the posited gap)
      for verbal passive sentences and for active (control) sentences. Subjects made
      lexical decisions to visual targets that were presented at three locations during
      auditory sentence comprehension: immediately after the matrix verb, 500 msec
      after the verb, or 1000 msec after the verb. Responses to targets related to the
      subject NP were faster than those to controls during passive sentences (gap
      sentences), but not during active sentences (no-gap sentences), thus indicating
      that reactivation of the matrix subject did occur in the passive cases.
      Furthermore, the magnitude of the priming increased with distance and time from
      the verb, going from a nonsignificant trend at the verb to a highly significant
      effect at 1000 msec following the verb. These results are discussed in terms of
      both formal and processing models of language.

PMID- 8366479
TI  - Processing Dutch sentence structures.
AB  - This paper summarizes existing research on syntactic processing of Dutch
      sentences by adult native speakers of the language, with an eye to the
      implications of this work for a general theory of the human sentence processing
      mechanism (HSPM). The principles underlying the assignment of phrase structure
      and the binding of traces seem to be the same as those proposed for languages
      like English or Italian. For example, no delays of analysis exist in parsing the
      constituents of a phrase even if the phrase is head-final. Also, the obligatory
      topicalization of a constituent which is required in the highest clause of a
      Dutch sentence does not appear to result in trace postulation principles distinct
      from those operative in languages where topicalization is optional. The studies
      reviewed also address questions concerning the complexity of the dependency
      between a moved constituent and its trace as measured by the length of a path vs.
      the length of a chain, the processing of subject gaps following an overt
      complementizer, the complexity of interpreting an adjunct moved from an
      obligatory position, and the processing of discontinuous words. Though the
      studies do not pose a problem for pre-existing views of the HSPM, they do
      highlight certain areas of parsing theory which remain seriously underdeveloped.
      Foremost, perhaps, is the specification of the principles governing the
      architecture of the processing system, which ultimately should explain how the
      organization of the HSPM and its subcomponents results from acquiring the grammar
      of any particular language.

PMID- 8366480
TI  - Kaufman's theory of shame and identity in treating childhood sexual abuse in
      adults.
AB  - The competent nurse/therapist treats shame of the adult survivor of childhood
      sexual abuse. Shame must be identified, validated, and treated. Kaufman's
      Developmental Theory of Shame and Identity is easily applied to post-sexual-abuse
      phenomenon. Treatment principles can be incorporated in both individual and group
      therapy. Nurse/therapists are encouraged to further explore the role of shame in
      the psychopathology of the adult survivor of childhood sexual abuse.

PMID- 8366481
TI  - Depression in primary care: detection, diagnosis, and treatment. US Department of
      Health and Human Services, Public Health Service, Agency for Health Care Policy
      and Research.
AB  - 1. About 15% of the general public will suffer from major depressive disorder
      sometime in their life, but fewer than one in three will be accurately diagnosed
      and treated. 2. About 10% to 15% or more of major depressive conditions are
      caused by general medical illnesses or other conditions. Generally, treat the
      associated condition first. If the depression persists after treatment, major
      depressive disorder should be diagnosed and treated. 3. In over 50% of depressed
      outpatients, antidepressant medication caused marked improvement or complete
      remission of their depressive symptoms. Several forms of short-term psychotherapy
      are effective for mild or moderate depression; combined treatment should be
      considered in certain situations.

PMID- 8366483
TI  - Nurses as researchers and research users.

PMID- 8366482
TI  - Homosexual support groups essential.

PMID- 8366484
TI  - Are you really my nurse, or are you a snake sheriff?

PMID- 8366485
TI  - Defending homosexuality.

PMID- 8366486
TI  - Half of nurses fear contracting AIDS.

PMID- 8366487
TI  - AIDS-related neuropsych problems highlighted.

PMID- 8366488
TI  - The World Trade Center disaster. Healing the unseen wounds.
AB  - 1. After the bombing of the World Trade Center in New York on February 26, 1993,
      hospitals were flooded with individuals who manifested not only medical problems,
      but also psychological trauma. 2. Various coping mechanisms were used by the
      disaster survivors. Some people were hysterical, while others were very quiet,
      almost catatonic, with blank affect and fixated posture. Some individuals, who
      remained strong during the ordeal, collapsed when they reached the hospital. 3.
      In attending the victims, nurses talked with them about the traumatic incident,
      the fear, and the angst--a cathartic process that helps people get better sooner.
      Such therapy is the key to healing unseen wounds.

PMID- 8366489
TI  - Informed consent: the patient's right to decide.
AB  - 1. The locus of mental health treatment has moved from the psychiatric hospital
      to the community; clients have become part of the general population as they move
      in and out of the mental health system. In response to this, health care
      providers and policymakers are trying to strike a balance between the provision
      of care and the restriction of patient rights while considering individual and
      societal interests. 2. Throughout the past three decades, the legal consensus of
      thought on informed consent has emphasized the rights of the patient, rather than
      emphasizing the medical profession's expertise. 3. Informed consent remains a
      controversial issue. An openness to modification must be maintained while
      acknowledging the actual meaning of informed consent. Informed consent is not a
      process by which one forces a person to do what is mandated, but an organized
      manner of providing information that will allow a reasoned decision to be made.

PMID- 8366490
TI  - Sexual harassment of health care students by patients.
AB  - 1. Forty percent of the 158 nursing and occupational therapy students surveyed
      reported being victims of sexual harassment. 2. When confronted with sexual
      advances or assaults, students used previously learned coping strategies. Thirty
      nine percent ignored the behavior or joked about it. 3. A training program was
      designed and implemented to make students feel better able--and more empowered-
      to handle sexual harassment.

PMID- 8366491
TI  - Music: making the connection with persons who are homeless.
AB  - 1. Persons who are homeless experience isolation and loneliness; many lack social
      skills or the ability to interact comfortably with others. A music program
      designed to increase socialization and relaxation of homeless persons using a
      multiservice shelter is described. 2. The use of music provides the psychiatric
      nurse an entry into therapeutic relationships and an opportunity to establish
      relationships with persons who often do not initiate contact with others. 3.
      Music promotes relaxation and interaction with others. Listening to music
      decreases loneliness and isolation. The music program was effective in fostering
      a sense of well-being and allowing the participants to join together in a
      meaningful activity.

PMID- 8366492
TI  - Orientation intervention for parents of adolescents after psychiatric
      hospitalization.
AB  - An orientation class has been devised to address the fears, uncertainties, and
      vulnerabilities of parents admitting their children to an adolescent psychiatric
      unit. This orientation class offers support and information to parents of
      adolescents admitted to Charter Rivers Hospital, a private psychiatric inpatient
      facility in Columbia, South Carolina, and is held during the first week of the
      adolescent's hospitalization.

PMID- 8366493
TI  - Suicide in the elderly: staying in control.
AB  - Suicide remains one of the major causes of death among the fastest growing
      segment of the US population--the elderly aged 65 and over. Individuals 65 and
      over comprised 12.4% of the population in 1988, but accounted for 20.9% of all
      reported suicides (McIntosh, 1992). The purpose of this qualitative study was to
      explore the meaning of suicide to the elderly and how suicide becomes an
      alternative for them. Results indicate that elderly subjects gave considerable
      thought to the end of their lives--including planning for death. For them,
      suicide was frequently viewed as a way of maintaining control over the dying
      process. In this study, the elderly described their views on who makes the
      decision about when death will occur, when suicide is acceptable, and how they
      would like others to respond to their suicidal ideation. Risk factors and causes
      of suicide in the elderly emerged from the data.

PMID- 8366494
TI  - What's happening to clinical nurse specialists in psychiatric mental health
      nursing?

PMID- 8366496
TI  - Link found between smoking and risk of endometrial cancer.

PMID- 8366495
TI  - PTs just as valuable as RNs.

PMID- 8366498
TI  - Staff numbers increase in specialty mental health organizations.

PMID- 8366497
TI  - Primary care providers need to look for and treat major depression.

PMID- 8366499
TI  - Persons with disabilities more likely to abuse chemical substances.

PMID- 8366500
TI  - The impact of media exposure on private hospitals.

PMID- 8366501
TI  - Group psychotherapy with the elderly.
AB  - 1. Group psychotherapy is an important and valid treatment modality for the
      psychiatrically impaired elderly. 2. The group format offers a normalizing,
      reality-based, and social context in which the patients may explore their
      concerns. 3. The therapist must be sensitive to issues such as sensory loss,
      debilitating illnesses, and death when leading geriatric psychotherapy groups.

PMID- 8366502
TI  - Chicken insulin discriminates between receptors for insulin and insulin-like
      growth factor I on centrally- and peripherally-derived glial cells.
AB  - Insulin and IGF-I receptors in G26-20 cells, derived from a mouse
      oligodendroglioma, and in RN-2 cells, derived from a rat Schwannoma, were
      characterized by specific binding to [125I]insulin and [125I]IGF-I respectively.
      In both cell lines, the Kd for insulin was 1.5 nM. Insulin receptor number was
      33,000/cell for RN-2 cells and 17,000 receptors/cell for G26-20 cells. RN-2 cells
      have 700,000 IGF-I receptors/cell with a Kd of 2 nM while G26-20 cells have
      60,000 receptors/cell with an affinity of 4.9 nM. However, the independence of
      these two receptor populations in each cell type was equivocal since the subunit
      structure of these receptors appears identical by electrophoresis. In both cell
      lines, competition with insulin analogs for [125I]insulin binding demonstrated
      chicken insulin > insulin > IGF-I. Competition for [125I]IGF-I binding showed
      that IGF-I was approximately 85-fold more potent than insulin. Chicken insulin
      was ineffective at all concentrations. Thus, chicken insulin can be used as a
      specific ligand to unequivocally discriminate between IGF-I and insulin receptors
      and effects.

PMID- 8366503
TI  - Binding of doxorubicin-conjugated transferrin to U937 cells.
AB  - Binding of transferrin (Trf) and its doxorubicin-conjugated forms (Conj) to U937
      cells at 0 degrees C were compared using 125I-labelled Trf or Conj. The apparent
      binding affinity (Ka) of Conj to the surface of U937 cells was (1.9 +/-
      0.4).10(8) l/mol; it is about 40% of that of Trf [(5.0 +/- 1.2).10(8) l/mol].
      Binding of 125I-labelled ligands was blocked by the unlabelled ligands to the
      same degree, however, it was not blocked by a great excess of doxorubicin (Dox).
      N-ethylmaleimide caused about 10% inhibition while dithiothreitol was without
      effect. Dissociation of 125I-labelled ligands in the presence of different
      concentrations of unlabelled ligands (Trf and Conj in the all 4 variations)
      resulted in different R50 values (the concentration of the unlabelled ligand
      where 50% of the radiolabelled ligand was released). While Trf displaced Trf with
      an R50 value close to the binding affinity, Conj displacement by Conj occurred
      with much lower efficiency. The heterolog displacement experiments yielded R50
      values in between the two extrema. These results suggest that 1) binding of Conj
      to the surface of cells is governed by the binding of the Trf part of Conj to the
      transferrin receptor, 2) -SH groups are not involved in the binding, and 3) a
      second interaction between the Conj and some constituent(s) of the plasma
      membrane may modify the binding of Conj in comparison to that of Trf.

PMID- 8366504
TI  - A model for the effect of estrogen antagonists on cooperative estradiol binding.
AB  - Partial agonists such as estriol and estrone have been reported to diminish or
      even eliminate the upward convexity of the Scatchard plot of the binding of
      labeled estradiol to estrogen receptor. This has been interpreted as agonist
      interference with the receptor dimerization induced by estradiol. In order to
      investigate how a partial agonist or antagonist might interfere with dimerization
      we have developed a theoretical mass-action law model, where soluble receptors
      can dimerize and bind to two different ligands. Special attention was devoted to
      manifestations of positive cooperativity to determine whether they could be
      modified by competition with a second ligand. This was done using a computer
      program that evaluated a large set of combinations of affinity constants in an
      effort to explore all possible situations. The model could reproduce the effect
      of a second ligand on the cooperative binding of estradiol to the estrogen
      receptor but only if the second ligand was anticooperative, which is not the case
      of estriol, estrone and tamoxifen. Furthermore, even when the Scatchard plot was
      linear, the model still required dimerization of the receptor in most of the
      cases, showing that the addition of an antagonist may eliminate the upward
      curvature of the Scatchard without truly eliminating dimerization or
      cooperativity. We conclude that the effect of a second ligand on the binding of
      labeled estradiol to estrogen receptor is not necessarily due to interference
      with dimerization and/or cooperativity. The inability of this model to fully
      explain the published data for estriol, estrone, clomiphene, and tamoxifen
      suggests that a more complex mechanism is involved.

PMID- 8366506
TI  - Psychosocial factors related to rheumatic diseases in childhood.
AB  - This review discusses those features of psychosocial adjustment which have been
      found associated with rheumatic diseases in children. In spite of the older
      literature and widely held intuitive beliefs, children with those diseases tend
      to do well in both psychological and social development and function. Those who
      do least well have risk factors which are those which impinge on the adjustments
      of any healthy child. Those who do best are those who have a strong social
      support system, particularly maternal competence. Children may cope in part by
      positive use of denial. Thus, interventions should be tailored to just those
      children and families at risk and must take into account the individual child's
      method of coping. It is argued that generalized interventions and education are
      unnecessary and may be harmful.

PMID- 8366505
TI  - Insulin and IGE-1 receptors in a human intestinal adenocarcinoma cell line (CACO
      2): regulation of Na+ glucose transport across the brush border.
AB  - Both insulin and IGF-1 receptors are present in intestinal mucosal cells,
      although their role in this tissue is unclear. We have characterized these
      receptors in a human adenocarcinoma cell line, Caco-2, and examined their role in
      the regulation of glucose transport and absorption in these cells. The Caco-2
      cells demonstrated specific insulin and IGF-1 receptors. They also bound
      cytochalasin B, suggesting the presence of a glucose transporter-like protein.
      When grown on membranes, the Caco-2 cells formed columnar, bipolar cells with
      tight junctions. The monolayer selectively transported D-glucose and methyl-D
      glucose, with complete exclusion of L-glucose, D-mannitol and inulin. The
      absorption of glucose across the monolayer occurred via a Na+/glucose
      cotransporter, as indicated by a change in short circuit current after addition
      of glucose to the apical membrane. When examined under several conditions,
      neither insulin nor IGF-1 had an affect on the transport of glucose across the
      Caco-2 monolayer, nor the production of lactate by the cells. It is concluded
      that the insulin and IGF-1 receptors of Caco-2 cells do not regulate glucose
      transport.

PMID- 8366507
TI  - Arthropathies of cystic fibrosis: case reports and review of the literature.
AB  - Patients with cystic fibrosis (CF) have demonstrated more arthritides with their
      longer life expectancy. The most common presentations have been that of an
      episodic arthritis or a hypertrophic osteoarthropathy. However, other
      arthropathies have been associated with CF. We now describe 3 new patients with
      CF and arthritis, and review the types of arthritis that may be found in patients
      with CF. This report is to increase awareness of the arthropathies that may be
      found in patients with CF so that proper evaluation, classification, and
      treatment may be facilitated.

PMID- 8366508
TI  - Lasers in medicine--a review.
AB  - Laser systems permit very high energy radiation of a single wavelength to be
      focused on a tiny spot, and have found application in many areas of engineering.
      They are also currently used in many branches of medicine. The fields reviewed
      here are ophthalmology, gynaecology, dermatology, otolaryngology,
      gastroenterology and physiotherapy. Lasers which are in wide use for medical
      applications include argon, YAG and carbon dioxide types. In many areas, lasers
      have been found to be more effective than conventional treatment methods with
      advantages including less blood loss, more accurate removal of unwanted tissue,
      shorter operating time and less postoperative pain. It is expected that the next
      decade will see the laser as an everyday tool in many more medical applications.

PMID- 8366509
TI  - Quantitative measurement of wall shear rate by pulsed Doppler ultrasound.
AB  - A 20 MHz pulsed Doppler ultrasound system was used to obtain steady flow velocity
      profiles in cylindrical tubes. A deconvolution technique was employed to improve
      the spatial resolution and the corrected results were compared with Poiseuille's
      theory. Frequency domain windowing was used to suppress noise in the
      deconvolution procedure, using a method which reduced distortions at the window
      boundaries. Wall shear rate was calculated from the measured velocity profiles
      both before and after deconvolution, and compared with theory to quantify the
      accuracy of the technique. The results illustrate the significant improvement
      provided by deconvolution, with the average error in measured wall shear rate
      reducing from 46 to 12% after applying the technique. Some of the discrepancy is
      in part attributed to the method used to determine wall shear rate.

PMID- 8366510
TI  - Computerized measurement of ciliary beat frequency.
AB  - We describe how ciliary beat frequency (CBF) of human respiratory epithelium in
      vitro can be robustly and quickly measured. The proven photometric technique has
      been improved by using a microcomputer to calculate and display the results. The
      software, which runs on an IBM-compatible PC, was developed using Borland Turbo
      Pascal and employs a fast Fourier transform routine to derive the CBF. Results
      are displayed almost as soon as a cell is identified under the microscope, and
      are in accordance with previous work. The technique can now be used
      diagnostically and for a variety of drug trials on respiratory epithelium.

PMID- 8366511
TI  - Hepatitis B versus AIDS.

PMID- 8366512
TI  - PCR fingerprinting microbes by random amplification of polymorphic DNA.

PMID- 8366513
TI  - Cellular immunity in pertussis.

PMID- 8366514
TI  - The serotypes of Streptococcus pyogenes present in Britain during 1980-1990 and
      their association with disease.
AB  - A total of 16,909 cultures of Streptococcus pyogenes (Lancefield group A)
      isolated in Britain during 1980-90 were examined for T- and M-protein antigens.
      One or other M antigen was detected in 92.6% of the strains. The numbers of
      isolates of some serotypes, such as M3 and M12, did not show great variation from
      year-to-year, whereas there were nationwide epidemics, extending over several
      years, caused by strains of serotypes M1 and M49. Isolates of serotypes M1 and M3
      were associated particularly with invasive disease and fatal infections.
      Representatives of serotypes M80, M81 and the provisional types PT180, PT1658 and
      PT5757 were isolated most often from cases of pyoderma. Erythromycin resistance
      was detected in 30 serotypes but one half of all of the resistant isolates
      belonged to serotype M4.

PMID- 8366515
TI  - Identity of viridans streptococci isolated from cases of infective endocarditis.
AB  - The oral streptococci have undergone considerable taxonomic revision in recent
      years but there is still little information concerning associations between the
      newly defined species and disease. This study examined the identities of 47
      strains of oral streptococci collected from 42 confirmed cases of infective
      endocarditis. By means of recently described physiological schemes, the most
      common species identified were Streptococcus sanguis sensu stricto (31.9%), S.
      oralis (29.8%) and S. gordonii (12.7%). Other related species including S. mitis
      and "S. parasanguis" were less common. This indicates that attention should be
      focused on S. sanguis sensu stricto and S. oralis when considering possible
      pathogenic mechanisms involved in viridans streptococcal endocarditis.

PMID- 8366516
TI  - Effect of co-aggregation on the pathogenicity of oral bacteria.
AB  - The pathogenicity of oral bacteria was studied by measuring the development of
      subcutaneous abscesses in mice after infection with Actinomyces viscosus and
      Streptococcus mitis either singly or as co-aggregated pairs. Heat-treated cells
      were also tested. The pathogenicity of the co-aggregates was examined in various
      viable and heat-treated combinations of the two bacterial species. More abscesses
      were formed by A. viscosus than S. mitis at all the bacterial concentrations
      tested. Also, abscess formation by co-aggregates of the two strains produced a
      higher percentage of abscess formation than those caused by infection with pure
      suspensions of A. viscosus or S. mitis. Co-aggregated cells were more resistant
      to phagocytosis and killing by neutrophils in vitro and in vivo. Furthermore, A.
      viscosus in co-aggregates were resistant to killing after engulfment by
      neutrophils. These results suggest that oral bacteria that are able to co
      aggregate may resist phagocytosis, and this ability may be linked with
      pathogenicity.

PMID- 8366517
TI  - Host response to coagulase-negative staphylococci in abscesses induced within
      mice.
AB  - A model whereby a known number of coagulase-negative staphylococci were packed
      into capillary tubes and implanted into the peritoneal cavity of mice proved to
      be a satisfactory method for generating abscesses that could be easily removed
      free of extraneous host tissue, and that permitted measurement of the survival of
      the organisms and accumulation of lipid in the lesion. Strains of S. epidermidis,
      S. schleiferi and S. lugdunensis, differing in their ability to produce fatty
      acid modifying enzyme (FAME) and lipase, were packed into either glass or plastic
      capillary tubes and used to generate abscesses. Abscesses produced by S. aureus
      served as comparators. Lipids accumulated within the abscesses caused by S.
      aureus in the same manner as previously described for the organism inoculated
      without tubes. Lipids also accumulated within abscesses produced by all the
      coagulase-negative staphylococci, but the rate of accumulation was slower and the
      lipid droplets were smaller than seen with S. aureus. The mobilisation of lipid
      did not differ in response to cocci in plastic or glass tubes. Strains of S.
      epidermidis and S. schleiferi producing FAME and lipase were better able to
      survive within abscesses than strains unable to produce these enzymes. However,
      FAME and lipase production did not appear to be the sole determinants of survival
      within abscesses. Regardless of whether they produced FAME and lipase, the two S.
      epidermidis strains were significantly better able to survive within plastic
      tubes than in glass tubes. No such difference was seen with S. aureus between
      plastic and glass tubes.

PMID- 8366519
TI  - An electronmicroscope study of glycopeptide antibiotic-resistant strains of
      Staphylococcus epidermidis.
AB  - Ultra-thin section transmission electronmicroscopy revealed that two of three
      glycopeptide-resistant strains of Staphylococcus epidermidis had abnormally thick
      cell walls, a finding consistent with the view that the reduction in
      susceptibility may result from the overproduction of glycopeptide binding sites
      within the cell-wall peptidoglycan. The third resistant strain had a slightly
      thickened cell wall with an irregular, roughened outline; this strain also
      underwent autolysis on prolonged incubation on blood agar and the resistance may
      be associated with abnormal cell-wall synthesis. Sub-MIC concentrations of
      vancomycin and teicoplanin caused surface damage to a proportion of cocci able to
      grow in the presence of antibiotic. Exposure to teicoplanin was additionally
      associated with the formation of filamentous forms and variable amounts of
      extracellular material. Transmission electronmicroscopy showed that both
      antibiotics exerted effects within the bacterial cytoplasm of the resistant
      strains that were not seen in an NCTC control strain: intracellular lamellae and
      structures resembling mesosomes were observed in the former. These effects were
      more noticeable in cocci exposed to vancomycin. Bacteria exposed to teicoplanin
      often showed abnormal septation and, in some preparations, a double-layered cell
      wall.

PMID- 8366518
TI  - Chemiluminescence of human polymorphonuclear leucocytes after stimulation with
      whole cells and cell-wall components of Staphylococcus epidermidis.
AB  - The purpose of this study was to define cell-wall components of Staphylococcus
      epidermidis responsible for activation of human polymorphonuclear leucocytes
      (PMNL). Metabolic activation of PMNL was determined by chemiluminescence (CL).
      Purified peptidoglycan (PG) induced a concentration-dependent metabolic burst in
      PMNL. The minimal concentration needed for CL induction was 1 microgram/ml.
      Comparison between different S. epidermidis strains showed variation in the
      capacity to induce CL in PMNL. Purified PG induced a higher CL response in PMNL
      than its intact parent strain; this effect was found in all S. epidermidis
      strains. Lipoteichoic acid (LTA), PG stem peptide and muramyldipeptide (MDP) did
      not induce CL; teichoic acid induced a CL response only at very high
      concentrations. No differences in CL inducing capacity were found between PG,
      crude cell walls, and purified cell walls of S. epidermidis. Sonication of PG
      strongly diminished CL-inducing capacity. PG treatment with mutanolysin
      immediately resulted in decreased CL-inducing capacity. Treatment of PG with S.
      aureus lytic enzyme (SALE) 10 micrograms/ml for up to 15 min enhanced the CL
      response to PMNL; a similar increase in CL was induced by PG treated with SALE at
      1 microgram/ml for up to 120 min. Beyond these times, a continuous decrease in PG
      induced CL was observed. In conclusion, PG was found to be the major cell-wall
      component of S. epidermidis involved in CL induction. Moreover, a minimal
      fragment size or a specific tertiary structure of PG, or both, is required for
      metabolic activation of PMNL.

PMID- 8366520
TI  - Characterisation of Plesiomonas shigelloides strains that share type-specific
      antigen with Shigella flexneri 6 and common group 1 antigen with Shigella
      flexneri spp. and Shigella dysenteriae 1.
AB  - Three strains of Plesiomonas shigelloides isolated from patients with diarrhoea
      were agglutinated with Shigella flexneri 6 antiserum in slide and tube tests. All
      the strains were also agglutinated with a monoclonal antibody to the common group
      1 antigen shared between S. flexneri serotypes and S. dysenteriae type 1. Further
      studies with one strain also showed sharing of antigenicity in an enzyme-linked
      immunosorbent assay. The results suggest that the strains share type-specific
      antigen with S. flexneri 6 and the common group 1 antigen with S. flexneri
      serotypes and S. dysenteriae 1. The sharing of antigens may have implications for
      cross-protection. One strain adhered to HEp-2 cell monolayers. None of the
      strains contained high mol. wt plasmids and there was no sequence homology with
      the invasiveness plasmid of Shigella spp. in DNA probe hybridisation. They were
      susceptible to the commonly used antibiotics. However, they possessed four other
      virulence-associated properties of Shigella spp. that included Congo-red binding,
      hydrophobicity, toxicity to HeLa cells and HEp-2 cell invasiveness (although they
      gave negative results in the Sereny test for invasiveness). These data suggest
      that the three unique strains might be considered pathogenic. Studies in animal
      models and human volunteers would be necessary to establish their pathogenic
      potential.

PMID- 8366521
TI  - Transferrin-binding ability of invasive and commensal isolates of Haemophilus
      spp.
AB  - Haemophilus influenzae type b expresses an inducible siderophore-independent iron
      acquisition system that depends on a direct interaction between human transferrin
      and specific iron-regulated transferrin-binding outer-membrane proteins. To
      evaluate the importance of this iron-acquisition system amongst haemophili, 156
      isolates of Haemophilus spp. (78 commensal isolates and 78 isolates from invasive
      infections) were examined for their ability to bind transferrin. Of the 78
      invasive isolates, all of which were H. influenzae type b, 71 (91%) were capable
      of binding transferrin, with 57 (73%) binding transferrin constitutively (i.e.,
      even when grown in an iron-sufficient medium). In contrast, only 11 (14%) of the
      commensal isolates bound transferrin constitutively, with a further 16 (21%)
      binding transferrin only after growth in an iron-deficient medium. Of the 27
      commensal strains that were capable of binding transferrin, 12 were H.
      parainfluenzae biotype III, 14 were non-typable H. influenzae, and one was H.
      parahaemolyticus. None of the H. influenzae type b invasive or commensal isolates
      showed evidence of siderophore production, but 50 (66%) of the remaining 76
      commensal isolates appeared to produce an iron chelator. Thus, while not a
      universal characteristic, detectable transferrin-binding was associated strongly
      with H. influenzae type b isolates from invasive infections, and was also
      recognised for the first time in isolates of H. parainfluenzae and H.
      parahaemolyticus.

PMID- 8366523
TI  - Application of the polymerase chain reaction to the diagnosis of candidosis by
      amplification of an HSP 90 gene fragment.
AB  - A 317-base pair (bp) fragment of the Candida albicans heat shock protein 90 (HSP
      90) gene was amplified by the polymerase chain reaction (PCR) for detection of C.
      albicans DNA in clinical specimens. One hundred specimens were examined including
      swabs (39), urines (36), peritoneal fluid (9), pus (8) and blood or serum (8):
      23% gave positive results with routine culture, 31% with extended broth culture
      and 37% with PCR. The amplified product was identified by hybridisation with a
      radiolabelled internal probe and their restriction enzyme digest patterns (SspI,
      HaeIII, EcoRI, RsaI and XhoI), which could be predicted from the known sequence
      of HSP 90. C. albicans DNA gave the characteristic 317-bp band and specifically
      hybridised with restriction enzyme-digested candidal DNA. DNA from other sources
      intermittently gave multiple faint bands especially in the presence of high
      concentrations of DNA, but these could be readily distinguished. The method was
      sensitive to 50 pg of DNA (5 pg with radiolabelled probing) and 100 cfu of C.
      albicans.

PMID- 8366522
TI  - The cleavage of immunoglobulin G in vitro and in vivo by a proteinase secreted by
      the urinary tract pathogen Proteus mirabilis.
AB  - Eighteen different strains of Proteus mirabilis were all shown to produce an EDTA
      sensitive proteinase of c. 50 kDa that cleaved the heavy chain, but not the light
      chain, of IgG. Digestion of pure IgG with small amounts of pure P. mirabilis
      proteinase generated Fabc'2 and Fab'2 fragments; greater amounts generated Fab
      and Fc fragments that were comparable in size to those generated by pepsin and
      papain, respectively. Incubation of neutrophils with IgG digested with P.
      mirabilis proteinase or papain resulted in a marked decrease in the respiratory
      burst activity of the neutrophils that coincided with cleavage of the IgG into
      Fab and Fc fragments. Analysis of urine from patients with P. mirabilis urinary
      tract infection revealed in many the presence of Fab and Fc fragments of IgG
      indistinguishable in size from those generated by P. mirabilis proteinase. These
      results indicate that, in P. mirabilis urinary tract infections, the proteinase
      is secreted and cleaves IgG to fragments that have defective immune effector
      functions, thereby limiting the effectiveness of the immune response.

PMID- 8366524
TI  - The number of glomerular capillaries estimated by an unbiased and efficient
      stereological method.
AB  - A method for unbiased capillary number estimation based on the estimation of the
      Euler-Poincare characteristic or Euler number with the disector is evaluated. The
      generation of a new capillary creates a new loop in the capillary network
      corresponding to a change of exactly one unit in the Euler number of the network.
      In this way the Euler number has a one-to-one relationship to the number of
      capillaries in a network. In this report rat glomerular capillaries are counted.
      Three tissue blocks from each of 14 perfusion-fixed rat kidneys, aged between 5
      days and 18 months, were uniformly sampled and embedded in Epon. Two complete
      glomerular profiles were sampled per block. Three consecutive sections were
      studied per glomerulus using the middle one to evaluate the topological events of
      the capillaries in the sampled glomerulus. The use of complete glomerular
      profiles eliminated problems with the edges, whereas the disector ensured
      unbiased sampling in the third dimension. Estimates per animal were weighted
      averages over blocks, the weights being half the number of glomerular profiles in
      a section from a block. The number of capillaries in a glomerulus is the mean
      Euler number per disector volume multiplied by the mean volume of glomeruli
      obtained by the fractionator. The observed coefficient of variation between
      animals was 18.3% for the estimated number of capillaries per glomerulus, and the
      observed coefficient of error at the level of blocks within animals was 14.7%.
      The exact capillary number from the node-branch network of two reconstructed
      glomeruli equalled the capillary number obtained by the total Euler number from
      the same glomeruli. This shows in an applied example, as would be expected, that
      the estimation of capillary number using the Euler number is unbiased and
      independent of the direction of sectioning.

PMID- 8366525
TI  - Computed three-dimensional reconstruction of median-eminence capillary modules:
      image alignment and correlation.
AB  - Image alignment is an absolute requirement for three-dimensional (3-D)
      reconstruction from serial sections, and Fourier correlation is the most powerful
      way to compute alignments. The rotational and translational components of
      misalignment can be corrected by an iterative correlation procedure, but for
      images having significant differences, alignment can fail with a likelihood
      proportional to the extent of the differences. We found that translational
      correction was determined much more reliably when low-pass filters were applied
      to the product transforms from which the correlations were calculated. Rotational
      corrections based on polar analyses of the auto-correlations of the images
      instead of on the images directly contributed to more accurate alignments. These
      methods were used to generate 3-D reconstructions of brain capillary modules from
      serial-section mosaics of digitized transmission electron micrographs.

PMID- 8366526
TI  - Degenerative cervical disc disease.
AB  - Degenerative cervical disc disease is a very common problem with most problems
      being resolved with conservative measures. Patients can present with a wide
      variation of complaints from neck pain to myelopathy secondary to spinal cord
      compression. In those patients requiring surgery for arm pain and myelopathy, the
      results are quite favorable.

PMID- 8366527
TI  - Case records of the Department of Medicine University of Mississippi Medical
      Center. Renal cell carcinoma and amyloidosis in a menorrhagic female.

PMID- 8366528
TI  - Hospice care. Interview by Linda Edwards.

PMID- 8366529
TI  - You know the plan is in trouble when she comes to the AMA.

PMID- 8366530
TI  - Developing a response to national health-care reform.

PMID- 8366532
TI  - Sexually transmitted disease among adolescents in the juvenile justice system of
      the District of Columbia.
AB  - Disenfranchised youth are known to be at high risk for sexually transmitted
      infections. A study was conducted to validate the screening for sexually
      transmitted disease (STD) among adolescents under court jurisdiction, to
      characterize variables associated with STD among this group, and to contrast and
      compare the characteristics of STD among incarcerated youth as opposed to those
      in alternative court-sponsored facilities. Sixty teenagers referred to an
      outpatient adolescent clinic for court-ordered physical examination were tested
      for infection with syphilis. Fifty-four were tested for gonorrhea and chlamydia.
      The overall rates for gonorrhea and chlamydia among the group were an identical
      9.2%. Six percent of the study population were diagnosed with syphilis infection.
      While only 17% of the youths were female, they accounted for over half of all
      infections with gonorrhea and chlamydia. All cases of sexually transmitted
      bacterial infections were found in youth residing in alternative court-sponsored
      facilities.

PMID- 8366531
TI  - Clinical practice guidelines: a key to improving health care for all populations.

PMID- 8366533
TI  - The relationship of organism pathogenicity and route of acquisition to
      antimicrobial susceptibilities.
AB  - Three hundred forty-eight isolates of methicillin-resistant Staphylococcus aureus
      were classified as representing nosocomial or community acquired infection or
      colonization. They were then tested against 11 antimicrobials, and the percentage
      of isolates that were susceptible to each antimicrobial was compared
      statistically among the classes. There were statistically significant (P value <
      0.05, chi-square analysis) differences among isolates from several classes for
      chloramphenicol, imipenem, tetracycline, sulfamethoxazole-trimethoprim,
      ciprofloxacin, and gentamicin.

PMID- 8366534
TI  - The clinical and radiological evaluation of primary brain tumors in children,
      Part I: Clinical evaluation.
AB  - In Part I of this article, we present our data collected over the past 8 years on
      the clinical evaluations of pediatric brain tumors with an emphasis placed on the
      more common neoplasms. Our data consists of 385 children ranging in age from
      newborn to 18 years. The majority of children presented with signs of raised
      intracranial pressure (including nausea, vomiting, and headaches), seizures or
      other focal neurologic deficits. Five percent of our children presented to
      outlying hospitals with symptoms that retrospectively turned out to be due to
      brain neoplasms but were misdiagnosed as "gastroenteritis," "viral upper
      respiratory tract infection," or even viral meningitis. These delays in diagnosis
      can cause serious negative outcomes for these patients and can be avoided through
      more careful neurologic and ophthalmologic examination at the time of first
      presentation. Central nervous system neoplasms are not uncommon in children and
      any child presenting with nausea, vomiting, and headaches should raise the
      suspicion of a primary brain tumor and should receive both a thorough neurologic
      exam and screening for papilledema. If papilledema is present, these children
      should be referred for proper neuroradiologic evaluation (which will be addressed
      in Part II.

PMID- 8366535
TI  - Left ventricular mass index and coronary artery disease in hypertensive black
      males.
AB  - Thallium-201 stress scintigraphy (TSS) and echocardiography were performed on 60
      consecutive black male hypertensives and compared to 60 sex-, race-, and age
      matched controls. We found a higher prevalence of left ventricular hypertrophy
      with repolarization abnormality in the hypertensive group; 32 of 60 (53%),
      compared to 10 of 60 (17%) of the controls, P < .05. Echocardiographically
      determined left ventricular mass index revealed a significantly higher mean value
      in the hypertensive group of 147 +/- 57 compared to 124 +/- 34 in the control
      group, P < .001. Thirty-one of 60 (52%) of the hypertensive group had a normal
      TSS compared to 22 of 60 (37%) of the controls. A total of 68 (38 fixed and 30
      reversible) perfusion defects were noted in the hypertensive group compared to 74
      (55 fixed and 19 reversible) in the controls. The severity of clinical syndromes
      associated with myocardial ischemia were noted in increased incidence in the
      presence of left ventricular hypertrophy and left ventricular mass index was
      noted to be predictive of severity of coronary disease independent of the
      standard risk factors.

PMID- 8366536
TI  - Diffuse abdominal wall cellulitis in ascending omphalitis--a lethal association
      in neonatal necrotizing fasciitis.
AB  - Necrotizing fasciitis is a grave complication of ascending omphalitis in the
      neonate, but because it is rare some of the signs are not well documented.
      Rapidly progressive anterior abdominal wall edema and cellulitis were noted in 16
      patients who were clinically diagnosed with necrotizing fasciitis. Fifteen of
      these patients died soon after emergence of anterior abdominal wall edema and
      cellulitis. The appearance of anterior abdominal edema and cellulitis in a
      patient with ascending omphalitis has serious implications and demands intensive
      care if the patient is to survive.

PMID- 8366537
TI  - Management of extraperitoneal rectal injuries.
AB  - Twenty-eight consecutive extraperitoneal rectal injuries for a period of 34
      months ending in May 1990 were reviewed retrospectively. All injuries were due to
      penetrating gunshot wounds. The rectal exam was positive in 75% of patients
      versus 80.8% with proctosigmoidoscopy. All 28 patients had diversion of the fecal
      stream. Diverting colostomies were performed in 17 patients, Hartmann's
      colostomies in 7 patients, and proximal loop colostomies in 4 patients. Presacral
      drainage was used in 25 patients (89.3%). Distal irrigation was performed in 13
      patients (46.4%) and primary repair in 9 patients (32.1%). There was one
      infectious complication (3.6%) and no deaths (0%). Fecal diversion and presacral
      drainage are the mainstay of therapy for civilian rectal injuries. The importance
      of distal irrigation of the rectum has not been established. Primary repair of
      the rectum has no effect on morbidity and mortality.

PMID- 8366538
TI  - Laser excision of hypopharyngeal lesions using a transoral approach.
AB  - A transoral technique for the excision of primary hypopharyngeal, posterior
      pharyngeal, and lateral pharyngeal wall tumors using the CO(2) or KTP laser and
      an operating microscope is presented.

PMID- 8366539
TI  - Myxedema masking primary hyperparathyroidism.
AB  - This article describes a case of primary hyperparathyroidism that was unmasked in
      a 63-year-old female after the initiation of replacement therapy with L-thyroxine
      for myxedema.

PMID- 8366540
TI  - An unusual case of priapism.
AB  - A case of sickle cell disease with 63 documented episodes of priapism that were
      managed medically is presented. The case is very unusual because of the fact that
      despite so many episodes of priapism, he did not lose sexual potency. On the
      contrary, over a period of time, his penis hypertrophied. To the best of our
      knowledge, this is the first such case with so many episodes of priapism reported
      in the English literature. We present a hypothesis for such unusual occurrence.

PMID- 8366542
TI  - Grip strength: relationship to shoulder position in normal subjects.
AB  - The objective of this study was to evaluate the effect of shoulder position on
      grip strength. A Jamar dynamometer was used to measure the grip strength of 160
      subjects (80 males and 80 females), stratified on both sex and age, in the four
      testing positions. For each of the tests of grip strength, the subject stood with
      the shoulder adducted and neutrally rotated while the forearm and wrist were held
      in the neutral position. The four hand strength tests consisted of three
      positions in which the elbow was maintained in full extension combined with
      varying degrees of shoulder flexion (i.e., 0 degree, 90 degrees, and 180 degrees)
      and of one position in which the elbow was flexed at 90 degrees with the shoulder
      in 0 degree of flexion. Only the dominant hand was tested. The results showed
      that the highest mean grip strength measurement was recorded when the shoulder
      was positioned at 180 degrees of flexion with elbow in full extension; whereas
      the position of 90 degrees elbow flexion with shoulder in 0 degree of flexion had
      the lowest grip strength score. In addition, the grip strength measured with the
      elbow in extension, regardless of shoulder position (i.e., 0 degree, 90 degrees,
      and 180 degrees of flexion), was significantly higher than when the elbow was
      flexed at 90 degrees with the shoulder positioned at 0 degree of flexion.
      Finally, grip strength differed significantly for both sexes and for each age
      group. The findings are valuable in the evaluation and rehabilitation training of
      hand injured patients.

PMID- 8366541
TI  - DC General--its neuro-history in the last half century.

PMID- 8366543
TI  - Crude drug (zingiberaceae) enhancement of percutaneous absorption of
      indomethacin: in vitro and in vivo permeation.
AB  - To improve drug permeation through skin, extracts of crude drugs were evaluated
      using in vitro and in vivo penetration techniques with rabbit skin as a model
      membrane. The acetone extract of Amomum cardamomum (ae-AC) and Elettaria
      cardamomum (ae-EC) had the best effect in enhancing the penetration of
      Indomethacin (IDM). The flux of IDM for the formulation containing ae-AC from pH
      7.4 buffer-alcohol donor solution was 3.6 times higher than that from the 50%
      alcohol donor solution. In order to confirm enhancer/skin interaction, a
      microscopic study was carried out in order to determine the presence of physical
      evidence in the skin caused by enhancers. A pharmacokinetic model of percutaneous
      absorption of IDM after topical administration was employed on the assumption of
      a zero-order penetration rate through the stratum corneum followed by absorption
      into the blood by a first-order process. Good correlation was observed between
      the experimental data point and simulated plasma concentration. From the results
      of the study, the in vitro permeability coefficient correlates with the in vivo
      penetration rate through the stratum corneum.

PMID- 8366544
TI  - The effects of radiation therapy on salivary function in patients with head and
      neck cancer.
AB  - Eighty nasopharyngeal carcinoma (NPC) patients and another eighty head and neck
      cancer (HNC, non-NPC) patients were enrolled as two experimental groups to study
      their salivary function by using Tc99m sialography. Twenty healthy subjects were
      also employed as a control group. The patients received an intravenous injection
      of 4 mCi of 99mTc-pertechnetate (Tc-99mO4-). The data were collected at a rate of
      1 frame per 15 seconds for the total time of 30 minutes, and the patients
      received stimulations for salivary secretion by ingesting 0.5cc of lemon juice 15
      min after the start of data acquisition. The salivary function was measured on
      Pre-RT (radiation therapy), During-RT and Post-RT periods. The results showed no
      statistical significance for maximum uptake (%) and excretion rate (%) between
      Control and Pre-RT group on parotid or submandibular glands function. This was
      the same in the age groups (age below 40 and age above 40) and sex groups. The
      NPC group had a decreasing maximum uptake (%) 3 months after RT on both parotid
      glands and submandibular glands, whereas the HNC group showed no obvious
      difference. The excretion rate (%) of both parotid and submandibular glands
      reached its lowest mark after 3-6 months in both the NPC and HNC groups and then
      started to recover progressively. For NPC patients, the radiation damage to the
      parotid glands was greater than to the submandibular glands, whereas the effect
      was reversed on HNC patients. It is important that the radiation therapist should
      preserve salivary function whenever possible.

PMID- 8366545
TI  - The effect of shift system on sleep quality, sleep quantity, psychological
      disturbance, and family function of workers in Taiwan.
AB  - This study was designed to examine whether there were any differences in sleep
      quality and quantity between rotating shift workers and permanent day workers.
      The subjects of this study consisted of 419 rotating shift workers and 468
      permanent day workers. The Chinese Health Questionnaire (CHQ-12) and Family APGAR
      Index were used to collect information concerning psychological disturbances and
      family dysfunctions. The results showed that, compared to the permanent day
      workers, sleep quality and quantity were poorer for the rotating shift workers.
      The rotating shift workers often had more psychological disturbances and family
      dysfunctions than permanent day workers.

PMID- 8366546
TI  - [Comparison of Enterobius vermicularis infection among preschool children in Ta
      Liao District of Kaohsiung County with that in Kaohsiung City].
AB  - To compare the rate of E. vermicularis infection among preschool children in Ta
      Liao District of Kaohsiung County, with that in Kaohsiung City, a total of 532
      preschool children from 7 kindergartens in Ta-Liao District, Kaohsiung County and
      544 preschool children from Kaohsiung City kindergartens were randomly collected.
      The preschool children were examined for E. vermicularis infection with a scotch
      tape perianal swab technique (S.T.P.S.T.). After examination, the preschool
      childrens' parents were also interviewed. The interview included the following
      factors: personal data of the preschool children (age, sex and birthplace); the
      size of the living quarters (measured in "Ping") and the number of rooms in the
      living quarters; the play area floor material (e.g. carpet, wood, tile, etc.);
      the total number of family members; the distribution of family members in
      bedrooms; the frequency of finger-sucking and the frequency of hand-washing
      before eating meals and after using toilets; the preschool childrens' primary
      caregiver; the occupations of both parents; and the means and times of bathing.
      The obtained data were analyzed and E. vermicularis infection among the preschool
      children in Ta-Liao District and Kaohsiung City were compared using the Mantel
      Haenszel statistical program in Statistical Analysis System (S.A.S) software. The
      present results indicated that the rate of E. vermicularis infection among
      preschool children was higher in Ta-Liao District than in Kaohsiung City.

PMID- 8366547
TI  - [Comparison of various patterns of chopstick use and functional performance].
AB  - Three hundred and ninety-seven normal adult subjects were tested in order to
      investigate the prevalences of various patterns of chopstick-use. Manipulation
      speed was also compared. According to the movement of the fingers, finger
      positions and contact areas, we can divide the various chopstick-use patterns
      into 3 basic patterns with 13 variations. Prevalences of the 3 basic patterns
      were palmar prehension (68.5%), lateral prehension (14.2%), and dynamic palmar
      prehension (17.3%). There was a statistically significant difference in
      manipulation speed among the 3 basic patterns. The influence of sex and age on
      manipulation speed was also analyzed for each of the 3 basic chopstick-use
      patterns. The results of this study will serve as a reference for occupational
      therapists in the evaluation and training for eating activities.

PMID- 8366548
TI  - [Contralateral hearing and tympanoplasty].
AB  - The contralateral hearing level of the operated ear is closely related to its
      preoperative hearing level, and is an important index to the success of
      tympanoplasty. We analysed 146 cases of chronic otitis media who had received
      tympanoplasty by the same surgeon at Kaohsiung Medical College Hospital. From the
      results of pure tone audiometry, we divided the hearing acuity into the following
      5 categories: normal hearing, mild hearing loss, moderate hearing loss, severe
      hearing loss, and deafness. Referring to the categories of contralateral hearing,
      we discuss the preoperative hearing level of the operated ear, the occurrence of
      cholesteatoma, the type of the tympanoplasty, and the auditory gain of the
      operation. While 23.97% cases had moderate or severe loss of contralateral
      hearing, their hearing acuity of the operated ear was also poor. Most of cases
      with normal contralateral hearing received type I tympanoplasty. Compared to the
      above group, half of the cases with moderate or severe contralateral hearing loss
      received type III or type IV operations to reconstruct the ossicle chain. Though
      the type I cases had more hearing gains than the type III cases, those with
      moderate contralateral hearing loss had good results from the type III
      tympanoplasty. We also found the cases with cholesteatoma in the operated ear had
      better contralateral hearing in the contralateral ear than the cases without
      cholesteatoma. The decision to perform tympanoplasty in cases of the better
      hearing ear with poor contralateral hearing should be very carefully made so as
      to improve the postoperative social life of the patients.

PMID- 8366549
TI  - [Topics and informed consent].

PMID- 8366550
TI  - [Anesthesia and laryngeal muscle, especially intrinsic laryngeal muscles].
AB  - The intrinsic laryngeal muscles are highly specialized for phonation, respiration
      and sphincter activity. The muscles are disposed between three unpaired
      cartilages (the thyroid, cricothyroid and epiglottic) and the paired arytenoid
      cartilages. These laryngeal muscles, which are striated in character, are
      bilaterally disposed and can be grouped as adductors and abductors of the glottis
      and tensors of the vocal cords. The motor neurons for the intrinsic laryngeal
      muscles are located in the caudal half of the nucleus ambiguous. The intrinsic
      laryngeal muscles receive motor nerve supply from the external branches of the
      superior laryngeal and recurrent nerves on each side. The external branch of the
      superior laryngeal nerve serves in motor innervation of the cricothyroid muscle,
      while the other laryngeal muscles receive a motor innervation from the recurrent
      nerve. Compared with limb skeletal muscles, the intrinsic laryngeal muscle have
      unique morphologic and histochemical characteristics. In general, the intrinsic
      laryngeal muscle fibers contain greater percentages of histochemically type 1
      fibers than limb skeletal muscles. In addition, morphometrical studies of the
      subneural apparatus at the neuromuscular junctions of the intrinsic laryngeal
      muscles demonstrate the difference between the morphological features of the
      nerve endings and the distribution pattern of the motor end-plates of the
      laryngeal muscles and those of the limb skeletal muscles. Finally, the influence
      of anesthetic drugs including neuromuscular blocking agents on the intrinsic
      laryngeal muscles is discussed. The gross anatomical features such as the motor
      innervation, localization of the neurons for the motor nerve fibers, and
      arrangement and characteristics of the motor end-plates of the intrinsic
      laryngeal muscles are described based on a review of literature and our current
      investigations.

PMID- 8366551
TI  - [Anesthesia with spinal cord stimulation--II). The effects on the cardiovascular
      function and the level of the plasma catecholamines].
AB  - In 78 patients who underwent general anesthesia and surgery with nitrous oxide
      (50-60%) and SCS, SCS decreased heart rate and blood pressure. Both the skin
      temperature and the amplitude of plethysmographic wave of a left finger increased
      with SCS. Among plasma catecholamines, only epinephrine level rose significantly
      with SCS. These results suggest that in addition to the analgesic action, SCS may
      have sympathetic blocking action, but not suppressive action on release of
      epinephrine from adrenal gland.

PMID- 8366552
TI  - [Changes in respiration and hemodynamics during open heart surgery without blood
      transfusion].
AB  - The changes in respiration and hemodynamics during open heart surgery were
      studied in 25 patients undergoing coronary artery bypass grafting without blood
      transfusion. The respiratory and circulatory parameters were measured at the time
      of anesthetic induction and after cardiopulmonary bypass (CPB). The values after
      CPB were compared with those at the time of anesthetic induction. The values of
      HR, CI, SVI and mPAP increased, and the values of mAP, SVRI and PVRI decreased
      after CPB. The PaO2, BE and pH decreased but PaCO2, A-aDO2 and QS/QT increased
      after CPB. Although VO2I and DO2I increased after CPB, OER (VO2I/DO2I) was
      unchanged. Arterial lactate, pyruvate and cortisol levels increased after weaning
      from CPB. Hemodynamics during open heart surgery without blood transfusion showed
      hyperdynamic state after CPB. Hypoxia was not evident in the peripheral tissue.
      This suggests that the depression of the oxygen delivery with hemodilution is
      compensated by hyperdynamic circulation. Coronary artery bypass grafting without
      blood transfusion seems to offer no clinical problems.

PMID- 8366553
TI  - [Effect of anesthetic methods on hemodynamics and metabolic changes caused by
      hepatic ischemia and reperfusion in pigs].
AB  - The effects of halothane, isoflurane and epidural anesthesia combined with
      isoflurane on hemodynamic and metabolic changes caused by hepatic ischemia and
      reperfusion were studied in 16 pigs. Hepatic arterial and portal venous blood
      flows were measured electromagnetically. Lactate pyruvate ratio (L/P) and
      arterial ketone body ratio (AKBR) were calculated as markers of hepatic aerobic
      metabolism. Total hepatic blood flow (THBF), cardiac output (CO) and THBF/CO
      showed no significant differences among three anesthetic methods in ischemic and
      reperfusion period. In the group with epidural anesthesia combined with
      isoflurane, L/P was significantly lower and AKBR was significantly higher
      compared with the data obtained in ischemic period. However, hepatic metabolism
      was severely disturbed after the reperfusion of the liver in all three groups.
      Especially, halothane group showed the most remarkable decrease in AKBR. In
      summary, epidural anesthesia will be useful for aerobic hepatic metabolism
      because of inhibition of the release of endogenous cathecolamines, but hepatic
      metabolism will not be maintained following hepatic ischemia and reperfusion.

PMID- 8366554
TI  - [Evaluation of skin temperature of patients under spinal anesthesia during
      cesarean section].
AB  - Temperature changes of the first finger and toe were evaluated in patients under
      spinal anesthesia. One hundred and thirty female patients who were to undergo
      cesarean section were selected for this study. During spinal anesthesia the
      changes in skin temperature were classified in three patterns. The first pattern
      showed a rise of the first finger and toe temperature just after intrathecal
      injection of 0.3% dibucaine (hand and foot type, n = 77). The second pattern
      showed only a rise of the first toe temperature (foot type, n = 55), and the
      third pattern showed no change in the first finger and toe temperature (unchanged
      type, n = 3). The results of cold description tests were T5 +/- 2 (mean +/- SD)
      in hand and foot type, T8 +/- 2 in foot type and L1 +/- 6 in unchanged type. The
      skin temperature pattern was affected by the position of the patient. When the
      patients were placed in a head down position, 38 cases of foot type showed a rise
      of the first finger temperature, and 1 case of unchanged type showed a rise of
      the first finger and toe temperature. In these cases the operative procedure was
      done under spinal anesthesia. The remaining 4 cases of foot type and 2 cases of
      unchanged type needed another anesthetic method. In cesarean section under spinal
      anesthesia, skin temperature pattern of hand and foot type seems desirable.
      Simultaneous monitoring of hand and foot (first fingertip temperature) seems to
      be useful to evaluate the height of spinal anesthesia.

PMID- 8366555
TI  - [Effects of induced hypotension on perioperative renal and hepatic functions].
AB  - Hypotensive anesthesia induced by trimethaphan was maintained at 70-79 mmHg of
      the systolic radial artery pressure for two hours in 35 patients undergoing
      spherical acetabul osteotomy. The creatinine clearance, free water clearance,
      fractional sodium excretion, urine volume, urinary excretion of NAG and levels of
      gamma-GTP, serum GOT and GPT were measured perioperatively. The creatinine
      clearance, free water clearance and urine volume decreased by 50% during surgery
      but recovered to normal values on the third day after surgery. The fractional
      sodium excretion remained unchanged during and after surgery. The urinary NAG
      activity increased from 3 +/- a (SD) to 10 +/- 5 U.g-1 and gamma-GTP activity
      increased from 23 +/- 7 to 33 +/- 13 U.g-1 during surgery, and these remained at
      high levels for three days after surgery. The serum GOT and GPT levels were
      within normal ranges for 21 postoperative days. The increase in urinary enzyme
      activities during and after surgery indicates that mild damage of renal tubular
      cells has occurred during hypotensive anesthesia.

PMID- 8366556
TI  - [Effects of air injection on hemodynamics and sympathetic nerve activity in
      urethane-anesthetized rabbits].
AB  - We designed this experiment to evaluate effects of intravenous bolus injection of
      air (0.5 ml.kg-1) on systemic blood pressure (SBP), central venous pressure
      (CVP), and renal nerve activity (RNA) in urethane-anesthetized rabbits. Animals
      were divided into the following three groups: animals with neuraxis intact (I
      group, N = 5), cervical vagotomized animals (V group, N = 5) and sinoaortic
      denervated animals (SAD group, N = 4). All animals were placed on the right-side
      down position to avoid effects of the posture throughout the experiments of air
      embolism. In the I group, air caused profound hypotension (from 95 +/- 10 to 54
      +/- 15 mmHg) associated with a significant increase in CVP (from 2 +/- 2 to 7 +/-
      3 mmHg) twenty seconds after the injection of air. In spite of the significant
      hypotension, RNA response did not show any increase for twenty seconds. This
      response was followed by an augmentation in RNA thirty seconds after air
      injection. In contrast, vagotomized animals exhibited a significant RNA increase
      (147 +/- 11% of the control) in response to a decrease in SBP (from 93 +/- 6 to
      78 +/- 5 mmHg) and an increase in CVP ten seconds after the administration of
      air. In SAD group, a rapid and remarkable decline in SBP (from 85 +/- 13 to 47 +/
      12 mmHg) occurred ten seconds after the injection of air. Despite this
      hypotension, RNA decreased nearly to a noise level after administration of
      air.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366557
TI  - [Transdermal application of 10% lidocaine-gel for management of pain associated
      with herpes zoster].
AB  - We have developed transdermally applicable 10% lidocaine aqueous gel containing
      an absorption promoter and applied it for 15 patients suffering from severe pain
      in acute or subacute phase of herpes zoster. The patients, consisting of 7 males
      and 8 females with a mean age 58.5 +/- 13.0 (SD) yrs, had skin eruptions of
      herpes zoster for the past 2 months. Lidocaine-gel was applied locally to the
      diseased skin with or without an occlusive dressing. In 14 of the 15 patients
      (93%), a remarkable reduction of pain (below 10% of pretreatment level) was
      obtained after 9.9 +/- 5.6 (SD) times of lidocaine-gel treatments. There was no
      adverse systemic reactions or local skin damages. None of them developed post
      herpetic neuralgia. The lidocaine-gel treatment appears to be very useful for
      reduction of pain associated with acute or subacute phase of herpes zoster.

PMID- 8366558
TI  - [Treatment of cancer pain with the percutaneous electrocoagulation of spinal
      nerves].
AB  - To our knowledge, this is the first report of high-frequency thermocoagulation
      applied to the spinal root. We treated 34 patients suffering from cancer pain
      with this technique. Among these patients, cancer pain occurred due to
      intrapelvic metastasis in 11 patients, and 13 complained of chest pain due to
      cancer. Every patient was considered to have good or excellent response when his
      or her pain score was reduced to 6 points or less from the score before
      thermocoagulation; 10 points. Based on this criterion, 54.5% and 30.8% of the
      above-mentioned patients showed good and excellent responses respectively one
      month after treatment. This technique, therefore, was considered to be effective
      with less side effects compared with other nerve blocking techniques.

PMID- 8366559
TI  - [Postoperative pain relief by preanesthetic administration of buprenorphine
      suppository in elective mastectomy].
AB  - Seventy female patients scheduled for elective mastectomy were divided into three
      groups: Buprenorphine suppository (BPS) 0.4 mg group (n = 29); BPS 0.2 mg (n =
      23) group; and control (scopolia extract and tannic acid suppository) group (n =
      18). Suppositories were administered rectally to patients of each group one hour
      before induction of anesthesia. Plasma buprenorphine concentrations, sedation
      scores at entering the operating room, postoperative pain scores and side effects
      were evaluated. There were no significant differences in sedation effects of
      suppository among the three groups. Although there were significant differences
      in pain scores except at the time when patients left the operating room between
      BPS 0.2 mg group and the control group, postoperative pain relief in BPS 0.2 mg
      group was judged not enough. However, postoperative pain relief was more
      satisfactory in the BPS 0.4 mg group. Plasma concentrations of the BPS 0.4 mg
      group were higher than those of the BPS 0.2 mg group. Although nausea and
      vomiting were observed in 5 patients (17.2%) of the BPS 0.4 mg group and 4
      patients (17.4%) of the BPS 0.2 mg group, respiratory depression and changes in
      blood pressure and heart rate were not observed in all groups. In conclusion,
      preanesthetic administration of the BPS 0.4 mg seemed to be useful for
      postoperative pain relief after elective mastectomy.

PMID- 8366561
TI  - [EEG pattern during total intravenous anesthesia with droperidol, fentanyl and
      ketamine].
AB  - We evaluated EEG pattern during total intravenous anesthesia with droperidol,
      fentanyl and ketamine (DFK). Four surgical patients, ranged in age from 35 to 43,
      were the subjects of this study. Two male underwent oral or orthopedic surgery
      and the other two female patients underwent gynecological surgery. They were all
      free from hepato-renal dysfunction and central nervous system disorders. For the
      induction of anesthesia, droperidol 0.06-0.1 ml.kg-1, fentanyl 2-4 micrograms.kg
      1, and ketamine 1.0-1.5 mg.kg-1 were slowly administered intravenously. A total
      dose of 5-15 micrograms.kg-1 of fentanyl was given intravenously with continuous
      infusion of ketamine 2 mg.kg-1.h-1 during the surgical procedure. The total
      amounts of fentanyl and ketamine administered were 4.9-22.2 micrograms.kg-1 and
      240-340 mg.kg-1, respectively. We used HZI'Brain Function Monitoring system to
      evaluate their EEG patterns. When adequate depth of anesthesia was obtained as
      clinically evaluated by vital signs, theta wave pattern was dominant on the EEG
      tracings in any of these patients. DFK anesthesia would provide a stable
      anesthetic course, if those drugs are administered adequately considering vital
      signs including systemic blood pressure, heart rate, lacrimation and involuntary
      muscle movements of the face and extremities.

PMID- 8366560
TI  - [Immobilization of a sensitive plant, Mimosa pudica L., by volatile anesthetics].
AB  - The disappearance of thigmonastic mobility of a sensitive plant, Mimosa pudica
      L., caused by volatile anesthetic agents such as methoxyflurane, chloroform,
      halothane, enflurane or sevoflurane revealed that the response to anesthetic
      agents in plants maybe similar to that in animals. In terms of reversible
      anesthesia, animals seem to equal plants in order of potency of anesthetics, and
      the minimum immobilizing concentration (MIC; %) in the plant shows a good
      correlation with MAC in the human (MICplant = 5.8 MAChuman + 0.01, r2 = 0.946).
      These phenomena suggest the existence of a certain common mechanism in anesthesia
      between animals and plants.

PMID- 8366562
TI  - [Anesthetic management of a neonate with critical pulmonary valve stenosis for
      balloon pulmonary valvuloplasty].
AB  - We administered general anesthesia for balloon pulmonary valvuloplasty (BPV) to a
      19 day-old male infant, weighing 2,789g, with critical pulmonary stenosis. The
      patient had severe cyanosis and mild right heart failure. Atropine (0.01 mg.kg-1)
      was administered intravenously immediately before induction of anesthesia.
      Pancuronium (0.4 mg) was used to facilitate endotracheal intubation and for the
      subsequent control of ventilation. Anesthesia was maintained with oxygen and
      enflurane (0.25 approximately 0.5%) supplemented with intravenous administration
      of fentanyl (1.5 micrograms.kg-1). During catheterization for balloon pulmonary
      valvuloplasty, SpO2 and blood pressure decreased temporarily to 35% and 50 mmHg,
      respectively. Several side effects of balloon inflation have been reported, such
      as bradycardia, arrhythmia, and the decrease in systemic blood pressure and
      arterial oxygen saturation, mainly due to the occlusion of pulmonary blood flow.
      Therefore, it might be recommended that BPV should be performed under stable
      state of general anesthesia with continuous monitorings of especially ECG,
      arterial blood pressure, central temperature, SpO2, ETCO2 and urine output.

PMID- 8366563
TI  - [Anesthesia for severely burned patients--23 operations in 8 burned patients].
AB  - Severely burned patients require repeated debridement or skin grafting soon after
      the burn injury until the closure of the injury. We retrospectively examined 23
      operations in 8 severely burned patients who had undergone debridement or skin
      grafting more than twice within 30 days. We classified 23 operations into 1st to
      4th categories according to days after the burn injury and compared each group
      regarding intraoperative fluid balance, hypovolemia and perioperative
      complications. In the 3rd or 4th operation, mean blood loss and fluid
      administration were more than those of the 1st or 2nd operation. Respiratory
      dysfunctions or circulatory complications such as hypotension, oliguria occurred
      more frequently during or after the 3rd or 4th operation. Since patients are in
      hyperdynamic and hypercatabolic state at the time of the 3rd or 4th operation
      patients, they will be easily damaged in the peri-operative period. This study
      suggests that we should bear in mind, in the anesthetic management of burned
      patients, that they can be in hyperdynamic state as well as in shock state.

PMID- 8366564
TI  - [Monitoring of peripheral tissue oxygenation with near infrared spectrophotometry
      during abdominal or iliac aortic cross-clamping surgery].
AB  - Peripheral tissue oxygenation was monitored with near infrared spectrophotometry
      during abdominal or common iliac aortic cross-clamping surgery. Six patients who
      had abdominal aortic aneurysm (AAA) and eight patients who had aortic sclerotic
      occlusive disease (ASO) were studied. At the beginning of cross-clamping,
      oxyhemoglobin was decreasing and deoxyhemoglobin was increasing in all AAA
      patients. Average of 37 minutes following cross-clamping of abdominal aorta, both
      hemoglobin values were stabilized. On the other hand, changes in both hemoglobin
      values were delayed or missing in ASO patients. The results suggest that the
      duration from cross-clamping to stabilization is related to co-lateral blood
      flow. During operation, monitoring of peripheral blood flow with near infrared
      spectrophotometry is useful for detection of peripheral ischemia and for the
      estimation of postoperative local blood flow.

PMID- 8366566
TI  - [Anesthetic management of a patient with HELLP syndrome with bronchial asthma].
AB  - We gave anesthesia for cesarean section to 30 year-old female with HELLP syndrome
      with bronchial asthma. HELLP syndrome is characterized by hemolysis, liver
      dysfunction and thrombocytopenia, besides syndrome of severe toxemia of
      pregnancy. After intubation with sevoflurane, diazepam and vecuronium, anesthesia
      was maintained with nitrous oxide, oxygen, sevoflurane and vecuronium, because
      she had an attack of bronchial asthma before operation. Though she had no
      eclampsia nor hypertension during operation, her babies were intubated and were
      cared in pediatric ward. Though she had improvements of liver dysfunction and
      thrombocytopenia after operation, it took 2 days to extubated, because she had
      frequent attacks of bronchial asthma. We conclude that we should perform cesarean
      section for a patient with HELLP syndrome as soon as possible.

PMID- 8366565
TI  - [Anesthetic management of a patient with pemphigoid for prosthetic replacement
      after femoral neck fracture].
AB  - We report an 83 year-old male with pemphigoid who underwent replacement of a
      femoral neck prosthesis following femoral neck fracture. Problems associated with
      anesthetic management of patients with vesiculobullous diseases such as
      pemphigoid include fluid, electrolyte and protein loss, and secondary infection
      because of the fragility of the skin and mucous membranes. Avoidance of trauma to
      the skin and mucous membranes is therefore important. Intubation of the trachea
      may be hazardous because of the possibility of airway obstruction resulting from
      oropharyngeal and laryngeal bullae. The patient was successfully anesthetized
      with spinal anesthesia using 2.5 ml of tetracaine in a 0.4% solution of 0.45%
      NaCl. An evacutable mattress was used to protect the patient from pressure points
      in the lateral position, and to minimize the hazards from pressure by spreading
      the weight. Surgery proceeded uneventfully and the postoperative period was
      uncomplicated.

PMID- 8366567
TI  - [Anesthetic consideration of a patient with congenital insensitivity to pain with
      anhidrosis].
AB  - Congenital insensitivity to pain with anhidrosis is a rare disorder but several
      clinical anesthetic experiences have been reported in Japan. We anesthetized a
      patient with this disorder for orthopedic operation with a low concentration of
      sevoflurane under monitoring of body temperature and we measured the
      concentrations of plasma ADH, cortisol and catecholamines levels before, during
      and after the operation. There were no problems during anesthesia and the patient
      awoke rapidly. ADH, cortisol and epinephrine concentrations showed slight
      elevations during and after the operation. The management of intraoperative body
      temperature and the necessary level of anesthesia were also discussed.

PMID- 8366568
TI  - [An analysis of the status of surgical transfusion and a trial of maximum
      surgical blood order schedule (MSBOS) in Fukui Medical School Hospital].
AB  - To evaluate the present status of surgical transfusion during operations, we
      computed the amount of preoperative preparation and intraoperative use of blood.
      And we examined cross-match to transfusion ratio (C/T ratio) and maximum surgical
      blood order schedule (MSBOS) based on the statistical data in our hospital. The
      result revealed that too much blood was prepared in our hospital. The amount of
      prepared blood was 12,825 units of which 2,419 units were transfused (1 unit =
      200 ml of whole blood). The mean C/T ratio was 5.30. And a trial of MSBOS
      revealed that we could save 70% of the blood presently prepared. We are sure that
      the introduction of T & S and MSBOS will lead to more efficient transfusion in
      our hospital.

PMID- 8366569
TI  - [Development of an anesthesia ledger using relational database].
AB  - An anesthesia ledger was developed using relational database KIRI Ver3. This
      anesthesia database includes 33 items for input, for example patient's name,
      patient's I.D. number, data of operation, diagnosis, operative procedure, name of
      surgeon, name of anesthesiologists and so on. One can select data from displayed
      menu cards only by rolling down or rolling up the cursor at 19 items and can
      input numbers by keyboard at twelve items. Even a computer beginner can easily
      operate it after a minimal training. Only patient's name must be input by text
      style. We can construct this anesthesia database only by use of functions of KIRI
      Ver3 without programming. One can use this anesthesia ledger at any operative
      facilities by changing a part of database and a file of doctor's name.

PMID- 8366570
TI  - [In vitro production of gamma/delta T cell clones and their characteristics].
AB  - Human TCR gamma/delta cell clones were produced from both CD2-depleted normal
      peripheral blood mononuclear cells (PBMC) and leukemia and lymphoma cell
      predominant PBMC, effusion cells and lymph node cells in in vitro cultures with
      rIL-1 and rIL-2 and using limiting dilution techniques. These clones were then
      analyzed as to their cell morphology, phenotype and non-major histocompatibility
      restricted cytotoxicity (NMRC) to K562. The results of the cloning from CD2
      depleted PBMC showed 112 WT31+ gamma/delta-1- clones, 62 WT31- gamma/delta-1+
      clones and 101 WT31- gamma/delta-1- clones. These were produced in 17 serial
      experiments. The addition of EBV-infected B cell line cells as feeder cells
      resulted in better production of gamma/delta-1+ and non-T cell clones than that
      of WT31+ clones. One typical example of the cloning from lymphoblastic lymphoma
      cell-predominant PBMC resulted in the production of 8 gamma/delta-1+ and 3 WT31+
      clones. Most of the clones proven to be gamma/delta-1+ clones had the CD2+ CD3+
      CD4(-)-+ CD8(-)-+ TCR delta-1+ beta F1- alpha F1- and delta TCS-1- phenotype, but
      few clones displayed CD2- or delta TCS-1+ phenotype. These gamma/delta-1+ clones
      were morphologically large granular lymphocytes, but functionally they did not
      have NMRC to K562. It is possible to say that TCR gamma/delta clones were rather
      easily produced from TCR alpha/beta cell-depleted PBMC and effusion cells, and
      can be used for the study of their nature and characteristics.

PMID- 8366571
TI  - [A comparative study of VEPA and ACOMEP-BD regimen for the patients with non
      Hodgkin's lymphoma].
AB  - Between 1981 and 1990, ACOMEP-BD regimen (adriamycin, cyclophosphamide,
      vincristine, methotrexate, etoposide, prednisolone, bleomycin, dacarbazine) was
      compared with VEPA regimen (vincristine, cyclophosphamide, prednisolone,
      adriamycin) in 66 newly diagnosed patients younger than 65 of age, with non
      Hodgkin's lymphoma (NHL). The median age of the patients was 47.5 years (range 22
      64 years), 43 males and 23 females. One patients were in stage I, 6 were in II,
      27 were in III, 32 were in IV. Twenty-seven patients received VEPA and 39
      received ACOMEP-BD. The therapeutic results of 66 patients with ACOMEP-BD or VEPA
      were as follows: complete remission (CR) rate of 54% and 48%; relapse rate of 29%
      and 77%; CR duration of 2-34 months (mean: 22 months) and 2-74 months (16
      months); freedom-from-relapse survival (at 3 years) of 71% and 38%; and overall
      survival (at 4 years) of 62% and 26%, respectively. In these results, only
      relapse rate was significant and the others were not. Prognostic factors were
      performance status (PS) and lactate dehydrogenase level for ACOMEP-BD, and PS and
      marrow involvement for VEPA. Received dose intensity was 0.85 in ACOMP-BD and
      0.41 in VEPA. It was expected that outcome of patients with NHL can be improved
      by increasing dose intensity.

PMID- 8366573
TI  - [Refractory bilateral pneumothoraces complicated with interstitial pneumonitis
      after bone marrow transplantation].
AB  - We report here a case of 33 year-old-man with refractory bilateral pneumothoraces
      during the treatment for interstitial pneumonitis 6 months after bone marrow
      transplantation (BMT). He was diagnosed as having acute myelogenous leukemia
      (AML) M1. He was treated with chemotherapy, and cerebral irradiation. BMT was
      performed in August 1989 from a sibling donor whose human leukocyte antigen was
      matched, ABO blood type mismatched. Preconditioning regimen was cyclophosphamide
      and total body irradiation (TBI). BMT was successful without major graft versus
      host disease. Thereafter he complained of respiratory symptom and was admitted on
      June 14 1990. Computed tomogram (CT) scan showed interstitial and alveolar
      shadows. We started the treatment against bacterial infection, Pneumocystis
      carinii, cytomegalovirus (CMV) and against interstitial pneumonitis with bolus
      dose of steroid. The transbronchial lung biopsy specimen revealed interstitial
      pneumonitis without typical CMV nor pneumocystis carinii pneumonia. Although a CT
      scan showed improvement of pneumonitis, bilateral pneumothoraces occurred. The
      adhesion therapy became successful after the reduction of steroid dosage. A
      pneumothorax rarely occurs after BMT. In this case it is speculated that TBI
      might be responsible for interstitial pneumonitis, and the steroid might have
      inhibited the adhesion therapy of pneumothorax.

PMID- 8366572
TI  - [Treatment and prognosis after late relapse in childhood acute lymphoblastic
      leukemia].
AB  - We evaluated the clinical courses and laboratory features in 13 late-relapse
      cases of 55 children with acute lymphoblastic leukemia who had been in complete
      remission for longer than their years. In 8 of 13 cases, leukemia relapsed in
      bone marrow; 2 with testicular, 1 with central nervous system and one with
      ovarian involvement. Further, extramedullary relapse not involving bone marrow
      occurred in 5 cases (4 testicular and 1 CNS). Late-relapse was more frequently
      observed in boys (37.5%) than in girls (4.4%). Initial age and leukocyte counts
      were of no value in predicting late-relapse. The relapse rate in cases initially
      treated by the VPL regimen was twice that of those by a multi-drug regimen. A
      second prolonged remission was achieved in 5 of 10 cases by combinations of
      intensive chemotherapy (modified HEX) and irradiation to the testes or CNS. On
      the contrary, all late relapse patients initially treated by the multi-drug
      chemotherapy had a poor outcome. More intensive chemotherapy, including high-dose
      chemoradiotherapy and bone marrow transplantation, should be employed in this
      group of patients.

PMID- 8366575
TI  - [Spontaneous remission in adult T-cell leukemia].
AB  - Spontaneous remission in a 50-year-old woman with adult T-cell leukemia (ATL) is
      presented. The patient was referred to our hospital because of generalized
      lymphadenopathy and the appearance of abnormal lymphocytes with convoluted nuclei
      in the peripheral blood. She was diagnosed as ATL because of the characteristic
      morphological ATL cells, cell surface marker analysis and the presence of serum
      antibody to human T-cell lymphotropic virus type-I (HTLV-I). However during the
      following weeks before admission, her leukocyte count and ATL cells in the
      peripheral blood decreased in number even though she received no therapy. After
      admission, abnormal lymphocytes in the peripheral blood disappeared and
      lymphadenopathy decreased in size, LDH level was normalized. Spontaneous
      remission had continued ten months without chemotherapy, but she developed
      recurrence thereafter and died two years later after onset with progressive
      disease. Gene analysis study by Southern blot analysis showed monoclonal
      integration of HTLV-I proviral DNA at the same positions both before regression
      and after recurrence. In this case, the trigger of spontaneous remission was
      unclear.

PMID- 8366574
TI  - [Parapsoriasis en plaque suspected of progression to mycosis fungoides associated
      with extranodal malignant B cell lymphoma of the cheek].
AB  - A 59-year-old female, clinically diagnosed as having parapsoriasis en plaque for
      ten years, was referred on June 1991 to the Department of Oral Surgery in the
      Dental School of showa University with a complaint of painless swelling of the
      left malar area. The swelling was found to have been caused by a tumor. Since the
      excised tumor was suspected to be a malignant lymphoma, she was admitted to our
      hospital. The specimen was subsequently confirmed to be a malignant lymphoma of
      the diffuse large cell type according to the LSG classification, and was
      immunologically confirmed to be a B cell lymphoma. In addition, the excised skin
      was suspected of incipient mycosis fungoides. She was classified as having stage
      IE disease according to her bone marrow biopsy and other examinations. she was
      treated with combination of chemotherapy (CHOP) and radiation therapy. This
      subject was interesting because her tumor probably resulted from a parapsoriasis
      en plaque skin lesion.

PMID- 8366576
TI  - [Partial and complete disappearance of Ph1 chromosome in two patients with
      chronic myelogenous leukemia after conventional chemotherapy].
AB  - [Case 1] A 44-year-old female was referred to our hospital because of
      leukocytosis. The WBC count was 26400/microliters and NAP score 21. As Ph1
      chromosome was detected, she was diagnosed as CML and treated with busulfan.
      Because of the rapid decrease of WBC, we stopped busulfan. Progressive
      pancytopenia and an increase of myeloblasts and promyeloblasts in the bone marrow
      was observed. We started vincristine and prednisolone therapy. Ph1 chromosome was
      not detectable and southern blot analysis did not show rearranged bands of M-bcr
      three years after the last therapy. [Case 2] A 74-year-old female was referred to
      our hospital by reason of leukocytosis and thrombocytosis. The WBC count was
      22,500/microliters, the platelet 907,000/microliters, NAP score 53, and Ph1
      chromosome was found. The diagnosis of CML was made, and she was treated with
      busulfan. The WBC rapidly fell to 1,900/microliters, when chromosome analysis
      revealed the presence of Ph1 negative clones (4/20). She was admitted due to
      thrombocytopenia and leukocytosis with the additional chromosome change of i
      (17q). Her peripheral blood and bone marrow pictures were consistent with blast
      crisis, and she died of cardiac tamponade. These two cases show the heterogeneity
      of CML patients, and also suggest the possibility that keeping the WBC count low
      may lead to a decrease of Ph1 positive clones.

PMID- 8366577
TI  - [A case of chronic neutrophilic leukemia associated with polycythemia vera].
AB  - A 74-year-old male patient was seen on December 15, 1980 because of right
      shoulder pain and leukocytosis. The spleen and the liver were enlarged, and
      palpable, 3 and 4 fingerbreadths below the costal margin respectively. The red
      blood cell count (RBC) was 899 x 10(4)/microliters, hemoglobin (Hb) 20.6 g/dl,
      reticlocyte (Ret) 7/1000, platelets (Plt) 34.2 x 10(4)/microliters, the white
      blood cell count (WBC) 26,800/microliters with 86% neutrophils. A bone marrow
      aspiration showed the nucleated cell count (NCC) to be 16.5 x 10(4)/microliters,
      and the myeloid/erythroid ratio (M/E) 2.0. The patient was treated with
      venesection and later with carboquone. Since September 1990 he has not been
      treated with any agents because of erythrocytopenia. In July 25, 1991, the spleen
      was enlarged, and palpated 8 fingerbreadths below the costal margin. The RBC was
      456 x 10(4)/microliters, Hb 12.5 g/dl, Ret 9/1000, Plt24.2 x 10(4)/microliters,
      the WBC41,500/microliters with 90% neutrophils. Bone marrow aspiration showed the
      NCC to be 16.5 x 10(4)/microliters, M/E14.3, with no atypical cells. Chromosome
      studies of marrow cells revealed no Ph1 chromosome. Many hematologic malignancies
      have been occasionally associated with polycythemia vera (PV), but chronic
      neutrophilic leukemia associated with PV is a very rare condition.

PMID- 8366578
TI  - [Successful treatment with deferoxamine in a case of refractory anemia].
AB  - A 60-year-old female was admitted to our hospital because of macrocytic anemia
      with anisopoikilocytosis and thrombocytopenia. A bone marrow aspiration revealed
      hypolasia with nuclear deformity of neutrophils and decrease of megakaryocytic
      numbers. Karyotype analysis showed 47, XX, +8. A diagnosis of refractory anemia
      was made. The patient was treated with metenolone acetate without clinical
      response. Deferoxamine (2g/day) was given intravenously by continuous infusion.
      Ten days after deferoxamine treatment, the levels of RBC and platelet increased
      and the effect lasted 100 days after discontinuance of deferoxamine. Bone marrow
      aspiration showed normoplasia with normal megakaryocytes numbers. However,
      anisopoikilocytosis, abnormality of MCH and MCHC, and karyotype abnormality
      similar to the first medical examination remained. These data might suggest that
      deferoxamine induced differentiation of abnormal hemopoietic cells in refractory
      anemia. Retrobulbar neuritis which developed 30 days after initiation of
      treatment disappeared after halting deferoxamine treatment.

PMID- 8366579
TI  - [Detection of erythropoietic inhibitor factor in a case of acute non-lymphocytic
      leukemia after allogenic bone marrow transplantation].
AB  - A 36-year-old man was diagnosed as having acute non-lymphocytic leukemia (AML
      M5b) in 1985 and received allogenic bone marrow transplantation from an ABO
      mismatched sibling in January 1987. Recovery of erythropoiesis in this patient
      was delayed, then the hemoglobin level improved in parallel with disappearance of
      anti-A antibody in the serum on day 260 post transplantation. However, as anemia
      occurred again despite no relapse of leukemia on day 350, we tried to determine
      the presence of erythropoietic inhibitory factor in this patients. Erythroid
      colony formation was decreased when bone marrow cells were co-cultured with
      peripheral mononuclear cells from the patient. Further, erythroid colony
      inhibitory activity was found in conditioned medium of PHA-stimulated T cells
      from the patient. Sephadex gel fractionation showed that the molecular weight of
      this inhibitory factor was approximately 11,000 and addition of a high
      concentration of EPO did not eliminate the inhibitory activity. These findings
      suggest that the novel inhibitor described in this manuscript, produced by T
      cells, was differed from previously reported inhibitors such as anti-EPO
      antibody, spermine and uremic toxins.

PMID- 8366580
TI  - [Common acute lymphoblastic leukemia showing hypo-gamma-globulinemia and cerebral
      infarction due to cerebral artery obstruction].
AB  - A patient who developed hypo-gamma-globulinemia and cerebral infarction during
      the treatment for acute lymphoblastic leukemia (ALL) is reported. In this patient
      fever and rash during radio-therapy for central nervous system (CNS) prophylaxis
      and nausea and vomiting were observed during maintenance therapy. On the
      laboratory findings high level of the protein level in the cerebrospinal fluid
      and the eosinophil count of the peripheral blood were found in every examination.
      We attempted to isolate various viruses in consideration of the possibility of
      infection, but no virus could be detected. The effects of methotrexate (MTX) and
      l-asparaginase were also suspected. Since nausea and vomiting disappeared after
      discontinuation of MTX administration, the drug may had some effect, and the
      possibility of cerebral damage by MTX can not be excluded. Complication of
      irradiation are reported to occur often more than 10 years after the treatment,
      but this patient had the onset only 2 years after the treatment. Therefore,
      irradiation was unlikely to be responsible for the symptoms. The relation between
      the hypo-gamma-globulinemia and cerebral infarction was also unknown.

PMID- 8366581
TI  - [A giant esophageal ulcer in a hemophiliac with HIV infection].
AB  - A 21-year-old man with hemophilia B and human immunodeficiency virus (HIV)
      infection was admitted with hematemesis and melena. After admission, esophagogram
      and endoscopy showed a single giant ulcer with ovoid shape and slightly irregular
      margins in the middle esophagus. Biopsy specimens of the esophageal ulcer showed
      non-specific granulation and etiology was unknown. Therapeutic trails of
      famotidine, sodium alginate, acyclovir, and amphotericin B did not result in
      favorable response. With a combination therapy of dexamethasone and sucralfate,
      the swallowing pain was rapidly disappeared with gradual improvement of the
      ulcer. To our knowledge, this is the first report of a giant esophageal ulcer in
      a HIV infected patient in Japan.

PMID- 8366582
TI  - [Prostaglandin E1 bladder instillations for a patient with severe hemorrhagic
      cystitis after allogeneic bone marrow transplantation].
AB  - A 39-year-old female with AML (M2) underwent allogeneic bone marrow
      transplantation (BMT) on July 8th, 1991. The post transplantation course had been
      going well until day 85 post BMT, when severe hemorrhagic cystitis with right
      hydronephrosis and ureter stenosis developed. Adenovirus type 11 was isolated
      from the urine. She received instillations of prostaglandin E1 (PGE1) directly
      into the bladder after the appearance of clots in the urine. Complete resolution
      of hematuria was obtained by two courses of this treatment. PGE1 bladder
      instillations seem to be effective for the control of hematuria caused by severe
      hemorrhagic cystitis after BMT.

PMID- 8366583
TI  - [Definition, classification and clinical symptoms of cholelithiasis].
AB  - Generally, the cases with symptomatic biliary stone are diagnosed as
      cholelithiasis and asymptomatic cases are not defined as cholelithiasis in the
      strict sense. However, asymptomatic stones are often diagnosed and treated as
      cholelithiasis. In the diagnosis and treatment of cholelithiasis, it is important
      to study the localization and classification of biliary stones relation to
      clinical symptoms.

PMID- 8366584
TI  - [Pathogenesis and animal model of gallstone disease].
AB  - Both cholesterol and pigment gallstones are multifactorial diseases. The broad
      outlines of the mechanism and limit of cholesterol solubilization in bile are
      well-understood, whereas the physical-chemical solubilities of unconjugated
      bilirubin and other calcium salts remain unclear. The importance of
      crystallization kinetics in gallstone formation is also well-recognized and
      several protein determinants of such process have been reported in bile. The
      chances of crystal growth and stone formation are further enhanced by mucus
      hypersecretion and gallbladder hypomotility. The use of animal models will
      continue to be useful not only in promoting our understanding of the pathogenesis
      but also in developing new chemicals for dissolution and prevention of gallstone
      diseases.

PMID- 8366585
TI  - [Gallstone classification and analysis of their constituents].
AB  - Macroscopic classification of gallstones as proposed by the Japanese Society of
      Gastroenterology is based on the presence of characteristic structures on the cut
      surface. According to this classification, gallstones can be broadly divided into
      three types: cholesterol gallstones, pigment gallstones and rare gallstones. This
      classification is widely accepted in Japan because of its clinical applicability.
      A more accurate classification requires analysis of the constituents of
      gallstone. In particular, infrared absorption spectroscopy has been utilized for
      this purpose because it enables a rapid and easy analysis, requiring only small
      amounts of sample. In the selection of patients with gallstones for non-surgical
      treatment, such as ESWL and dissolution therapy, qualitative diagnosis is
      necessary. With this in mind, we have attempted to produce CT-Profile curves of
      individual gallstones, depicting changes in CT values assessed along cross
      sectional lines passing from the center of the stone to their maximum diameters.
      This method allowed qualitative diagnosis almost of all gallstones.

PMID- 8366586
TI  - [Trace metal elements in gallstones and their roles].
AB  - The concentrations of metal elements in gallstones were measured by absorption
      spectrometry. Crystallographic analysis by the powder X-ray diffraction method
      was also performed. For all stones calcium was the major component. In calcium
      carbonate stones aragonite form, one of the CaCO3 polymorphs and usually unstable
      in nature, was dominant. As a whole, black-stones contained highest proportions
      of all metal elements. But these stones were crystallographically grouped into
      three types; they are calcium carbonate-, calcium phosphate-, and other-one. In
      each type, the concentration of metal element differed greatly. It is suggested
      that in black-stones the amount of Mn is remarkable and Cu is highly correlated
      to black residue. It was true, but Mn was remarkable especially in calcium
      phosphate-type and Cu was the highest in other-type.

PMID- 8366587
TI  - [Etiology of cholelithiasis].
AB  - The incidence of gallstone has been gradually increased in the last few decades
      in Japan and the recent study revealed that approximately 15% of the autopsy
      cases had biliary stones. In the last 25 year interval, the nature of gallstones
      was greatly changed. In detail, the incidences of cholesterol gallstone and black
      stone were increased from 46.7% to 66.9% and from 0.8% to 12.1%, respectively,
      whereas that of calcium bilirubinate stone was decreased from 41.5% to 21.0% of
      the whole cholelithiasis cases. The factors influencing these changes were
      probably due to recent increase of fat diet intake and decrease of ascariasis by
      improvement of environmental hygiene. However, the factors that caused the change
      in black stone has not been defined.

PMID- 8366588
TI  - [Natural course of asymptomatic gallstone disease].
AB  - Of 1850 patients with cholelithiasis diagnosed in the past 17 years, 1116 female
      and 734 male, 598 patients (32.3%) presented with one or more of three major
      symptoms, i.e., abdominal pain, fever and jaundice, whereas the remainder (67.7%)
      had none of these symptoms. The proportion of the asymptomatic patients was
      similar in all age groups, being around 70%. Only 20 per cent of 680 asymptomatic
      patients, followed for 10 to 17 years (median 13.3 years), developed biliary
      symptoms. Older patients over 70 years of age had a higher rate of change to the
      symptomatic group, as compared with younger patients under 70, 29.5% vs. 19.3%,
      respectively. During this period, carcinoma of the gallbladder developed in one
      of the asymptomatic patients (0.1%). Oral dissolution therapy was successful in
      only 4.2 per cent of attempted cases and associated with a recurrence rate of as
      high as 20%. We conclude that asymptomatic gallstone patients should only be
      followed up by ultrasound twice a year without any treatment.

PMID- 8366589
TI  - [Diseases with high incidence of gallstone complication].
AB  - Gallstones are often complicated with diseases such as liver cirrhosis, hemolytic
      anemia, post-valvular replacement, post-gastrectomy, biliary tract cancers,
      diabetes mellitus, and during clofibrate therapy. The frequency of gallstones,
      types of stones and their pathogenesis in these situations are discussed in this
      chapter. In liver cirrhosis, hemolytic anemia and post-valvular replacement,
      black stone formation is enhanced due to bilirubin over-production, caused mainly
      by hemolysis. Bilirubin stone formation is accelerated gastrectomy and by biliary
      tract cancer, because of the decrease in gallbladder contraction, cholestasis and
      bacterial infection, etc. The incidence of cholesterol gallstone is high in
      patients with diabetes mellitus and with clofibrate therapy.

PMID- 8366590
TI  - [Diagnosis of cholelithiasis].
AB  - Evaluation of the patient with suspected cholelithiasis has been changed
      dramatically recently, to make accurate prediction of composition of the
      gallstone. That is mainly because of improvement and development of all kinds of
      diagnostic imaging modalities and development of several nonsurgical options. If
      we do the initial evaluation of the patient, it is natural to choose the
      ultrasonography first, because of its easiness and noninvasiveness. But it is
      important to choose the most appropriate modality following ultrasonography, in
      order to complete the integrated imaging diagnosis. Here we describe the gross
      feature of the each modality, and how we choose it in order to make accurate
      diagnosis and to arrive at a treatment plan best suited for each patient.

PMID- 8366591
TI  - [Diagnostic methods of gallstones--plain radiogram and contrast examination of
      biliary system].
AB  - There is a wide spectrum of diagnostic imaging modalities to evaluate the biliary
      system, such as plain radiogram, echogram (US), oral cholecystogram (OCG),
      intravenous cholangiogram (DIC), CT, MRI, and RI scintigram. Since the late
      1970's US, non-invasive and easily available, is the first choice of examination
      when gallstones are suspected because of achievement of detailed resolution. OCG
      or DIC is rarely performed for gallstones. However, it was not until the advent
      of various measures of treatment for gallstones, other than cholecystectomy, such
      as dissolution therapy or extracorporal shock wave lithotripsy of gallstones,
      that contrast examination of the biliary system has been re-utilized to evaluate
      the characteristics, number and size of gallstones, and patency of cystic duct,
      which are important data. The indications and significance of plain and contrast
      examinations for gallstone disease is discussed.

PMID- 8366592
TI  - [Diagnosis of cholelithiasis--endoscopic pancreatocholangiography].
AB  - Endoscopic cholangiography is fundamentally evaluated as X-ray anatomy of the
      biliary system as well as the principal technique for endoscopic treatments that
      is endoscopic papillotomy and endoscopic drainage, while gallstone is routinely
      diagnosed by ultrasonography in medical practice. By endoscopic cholangiography,
      stones in the cystic duct and the common bile duct are confirmedly diagnosed in
      the same quality as gallbladder stones, and the anatomical information of the
      cystic duct, the gallbladder, and the duodenal papilla are clearly demonstrated,
      which are required in many therapeutic procedures for gallstones diseases
      including laparoscopic cholecystectomy.

PMID- 8366593
TI  - [Ultrasonography in cholelithiasis].
AB  - Ultrasonography has become the first line examination in the diagnosis of
      cholelithiasis. As for the gallbladder, extracorporeal ultrasonography is the
      most useful and the safest procedure. Ultrasonic properties of gallstones even
      suggest the feasibility of dissolution therapy. The detectability of
      choledocholithiasis is, however, not satisfactory. This deficiency has been
      overcome by combining endoscopy with ultrasound. Endoscopic ultrasonography, as
      well as ERCP, is a useful tool for examining the extrahepatic bile duct and the
      pancrease. Recently, with the development of laparoscopic cholecystectomy,
      intraoperative ultrasonography during laparoscopic surgery has considerably
      improved with introduction of new probes and may replace most of the methods of
      intraoperative cholangiography in the future.

PMID- 8366594
TI  - [Diagnostic imaging of cholelithiasis--CT & MRI].
AB  - CT and MRI are inferior to ultrasound for detection of gallstones. CT and MRI
      however, might have distinctive features for diagnostic imaging of the
      cholelithiasis. The CT is sensitive, as regard with calcification of the
      gallstones, and able us to diagnose the composition of the gallstones manipulate
      the CT number. Then spiral CT, which is a new technique, is expected to improve
      the accuracy of detection of gallstones. Three-dimensional CT reconstruction
      images are useful in the sense of the anatomy of the biliary system. MRI is
      superior to evaluate bile juice concentration, so that it appears to make it
      possible to evaluate gallbladder function. Furthermore, the MRI has the potential
      advantage for acquisition the new knowledge relating to stone lysis.

PMID- 8366595
TI  - [Rationales for the selection of the therapies for gallstones].
AB  - Surgical cholecystectomy used to be the only definitive method of gallstone
      treatment. Recently, however, there have been greatly advancing in the therapies
      for gallstones, which comprise oral or topical litholysis, lithotripsies with
      shock wave or endoscopical techniques, and laparoscopical cholecystectomy. Some
      factors must be considered in selecting the method for the treatment of
      gallstones, such as; well-understanding of the physiology and the pathophysiology
      of gallbladder (stones), precise US tomography, the effects of diet, and
      especially the patient's performance status, patient's profile and informed
      consent.

PMID- 8366596
TI  - [Per oral gallstone dissolution therapy].
AB  - In this paper the author describe present status and problems of Per oral
      cholesterol gallstone dissolution therapy by bile acid. 1) Both ursodeoxycholic
      acid (UDCA) and chenodeoxycholic acid (CDCA) decrease the cholesterol output in
      bile, but their action mechanism somewhat differs. 2) Clinical results of UDCA
      treatment in our hospital during past 17 years are as follows. Complete
      dissolution rate Approx. 20% Partial dissolution rate Approx. 20% 3) In the
      attempt to increase the complete dissolution rate, bedtime administration method
      (one time administration instead of 3 times, every day), combination therapy of
      UDCA and CDCA and UDCA plus simvastatin (HMG-CoA reductase inhibitor) were tried.
      The results of these trial were not superior compared with ordinary UDCA therapy
      (3 times after each meal administration). 4) The author concluded from the
      results that small size (< 1 cm in diameter), Ia in ultrasonographic
      classification, floating by oral cholecystography, and radiolucent gallstones are
      the most suited for bile acid dissolution therapy.

PMID- 8366597
TI  - [Direct gallstone dissolution therapy with GS-100].
AB  - We have developed GS-100, a new direct dissolving drug with strong dissolution
      property for cholesterol stone by supplementing d-limonene, a dissolvent used
      since 1974, with 30% medium-chain monoglyceride (MCM). The new drug was applied
      in 23 patients with gallbladder stones and three with bile duct stone. The
      presumptive analysis of the composition of the stones was drawn from the CT
      recordings. As non-invasive therapies, methyl tert-butyl ether (MTBE) dissolution
      and extracorporeal shock wave lithotripsy (ESWL), which are commonly used in
      Europe and America, have been reported as being favourable; however, GS-100 is
      superior in respect to safety and applicative dimension, suggesting of the
      possibility of using GS-100 as an important drug in the non-invasive therapy for
      gallstone in the near future.

PMID- 8366598
TI  - [Extracorporeal shock wave lithotripsy].
AB  - Extracorporeal shock wave lithotripsy (ESWL) was performed in 84 patients with
      gallbladder stones. The gallstones completely disappeared within 12 months after
      ESWL, in 31% of the patients with one to three radiolucent stones not larger than
      3 cm in diameter and in 57% of the patients with a solitary stone up to 2 cm with
      the ultrasonographic gallstone pattern of I a or I b. There was no major
      complication. ESWL is a safe and effective treatment in selected patients with a
      solitary radiolucent stone not larger than 2 cm with I a or I b pattern.

PMID- 8366599
TI  - [Percutaneous transhepatic cholangioscopic lithotripsy].
AB  - With an advent of cholangiofiberscope in 1975, tremendous changes have been made
      in thinking way on the treatment of biliary tract stones. The technique of
      percutaneous transhepatic cholangioscopy (PTCS) was detailed and its clinical
      significance was discussed in this paper. PTCS is the technique which is
      conducted by insertion of cholangiofiberscope into the biliary tract through the
      dilated fistula produced by percutaneous transhepatic biliary drainage (PTBD).
      Advantages of this techniques are; (1) it is applicable to the cases who had had
      bilio-enteric anastomosis or gastro-jejunostomy before, (2) it can be repeatedly
      carried out if the fistula is maintained open, (3) stones visible are readily
      removable with the instruments guided by cholangiofiberscope and finally, (4) the
      informations necessary to select an adequate surgical procedure can be obtained
      by PTCS, because biliary architecture is clearly delineated. For the period of 18
      years started from 1975, 126 cases with intrahepatic stones have been encountered
      in our Hospital, endoscopic stones extraction technique was successful in 106 out
      of 121 cases excluding 5 cases converted for hepatic lobectomy. And the prognosis
      of the cases in which stones were successfully extracted were, in general, good.
      Therefore, the authors believe that the therapeutic results would be
      significantly improved with the routine use of PTCS.

PMID- 8366600
TI  - [Percutaneous transhepatic cholecystoscopic lithotomy (PTCCSL)].
AB  - We have performed percutaneous transhepatic cholecystoscopic lithotomy (PTCCSL)
      in 37 cases of cholecystolithiasis and have succeeded in the removal of the
      stones in all cases without any serious complications. The average period from
      gallbladder puncture until the completion of lithotomy was 11.8 days and PTCCSL
      was performed an average of 2.1 times. The follow-up period after lithotomy
      ranged from one to 60 months, with an average of 24.7 months. Gallbladder
      function returned to the pretreatment level. However, gallstones recurred in 7
      cases (18.9%). In comparison with both cholecystectomy by laparotomy and
      laparoscopic cholecystectomy, PTCCSL is less invasive, but recurrence may occur
      in a relatively short period with PTCCSL. Therefore PTCCSL is particularly
      indicated for high-risk patients who cannot undergo general anesthesia.

PMID- 8366601
TI  - [Endoscopic sphincterotomy for lithotripsy (EST-L) of bile duct stones].
AB  - We performed EST-L for 555 patients with choledocholithiasis between 1981 and
      1992. With the aid of conventional occlusion balloons and dormia-type baskets,
      calculi < or = 1.5 cm was extracted with relative ease. In patients with larger
      stone (> 1.5 cm), the mechanical lithotripter, extracorporeal shock wave
      lithotripsy (ESWL) and electrohydrolic lithotripsy were used for the lithotripsy.
      The overall success rate was 95%. Important early and late complications from
      these procedures occurred in 6.9% and 9.1% of all cases respectively. This result
      reveal that EST-L is safe and effective therapeutic procedures for
      choledocholithiasis. We would recommend EST-L is adopted as an initial measure to
      remove common bile duct stones.

PMID- 8366602
TI  - [Treatment of common bile duct stones by peroral cholangioscopy].
AB  - Endoscopic papillotomy (EPT) has become a popular form of treatment in managing
      common bile duct stones. But it may fail in difficult cases such as large stones
      of over 20 mm, confluence stones, and impacted stones. Over the past 5 years, our
      success rate in clearing the bile duct by conventional endoscopic techniques
      (mechanical lithotripsy) was about 90 per cent. Recently, we have performed
      electrohydraulic lithotripsy or laser lithotripsy with peroral cholangioscopy in
      these difficult cases. Complete clearance of the duct was obtained in all 23
      patients who underwent peroral cholangioscopic lithotripsy. No complication
      occurred. In conclusion, peroral endoscopic treatment of common bile duct stones
      should be safe and effective.

PMID- 8366603
TI  - [The indications and results of laparoscopic cholecystectomy].
AB  - Laparoscopic cholecystectomy was successfully achieved in 93% of the patients,
      who required removal of the gallbladder, in our institution. Other reports have
      also shown that more than 90% of patients who required cholecystectomy, were
      candidates for laparoscopic cholecystectomy. Serious complications occurred in
      2.1% of our series and in 2-4% of the literature. The complications included bile
      duct injury (around 0.5%) and visceral injury (0.2-0.4%). The incidence of
      complications resulting from technical failure seems to be higher in laparoscopic
      cholecystectomy than in conventional cholecystectomy but is acceptable for
      initial experience. Laparoscopic cholecystectomy will become the standard therapy
      of gallstone for its effectiveness and less invasiveness.

PMID- 8366604
TI  - [Cholecystectomy followed by one inch minilaparotomy].
AB  - A new surgical treatment for cholelithiasis was developed. This procedure is
      performed by a 2-3 cm subcostal skin incision in the right hypochondrium. About
      400 patients were treated by this technique. This procedure is not different in
      terms of blood loss or operation time compared to conventional methods, and no
      significant complications have occurred. Intraoperative examination is performed
      routinely because of easy insertion of a tube from the cystic duct into the bile
      duct. Minimization of the length of the incision facilitates postoperative
      recovery greatly, shortening the hospital length-of-stay within 3 days. These
      principles allowed even patients with choledocholithiasis to undergo a
      minilaparotomy and be discharged within 1 week.

PMID- 8366605
TI  - [Traditional open cholecystectomy].
AB  - During the past 5 years, traditional open cholecystectomy was performed on 344
      patients with gallbladder stones at our hospital. Using the data obtained, we
      studied the indications and results of traditional open cholecystectomy. In the
      cases of gallbladder stones with a history of cholecystitis, cholecystectomy was
      performed as a rule by laparoscopic cholecystectomy. However, traditional open
      cholecystectomy was chosen in cases which were complicated by perforation,
      pericholecystic abscess, internal biliary fistra, cirrhosis, or suspicious
      carcinoma of gallbladder. Investigation of the time of operation revealed that
      early operation tended to be performed easily. However, cases with gallbladder
      stones were often complicated with carcinoma of alimentary tracts, therefore
      before operation we must examine the alimentary tract. Cases in which gallbladder
      could not be visualized under ERCP, and those accompanied by pericholecystic
      abscess under US were difficult to operate on by laparoscopic cholecystectomy.
      Thus many cases required laparotomy. Postoperative complications of open
      cholecystectomy were rare, it was concluded that traditional cholecystectomy is
      one of the most valuable procedures for the treatment of gallbladder stones.

PMID- 8366606
TI  - [Non-surgical biliary drainage for cholelithiasis].
AB  - Non-operative methods to treat obstructive jaundice and cholangitis caused by
      cholelithiasis are endoscopic and percutaneous biliary drainage. Usually,
      endoscopic papillotomy and stone removal by basket catheter is available for
      treating choledocholithiasis. It is necessary to place a drainage catheter into
      the bile duct in patients who have severe cholangitis or remaining stones. On the
      other hand, percutaneous biliary drainage is useful in case of emergency and in
      patients reconstructed by the Billroth II method. Biliary drainage is necessary
      to treat severe cholangitis as soon as possible, for it sometimes causes
      endotoxin shock, disseminated intravascular coagulation (DIC) and multiple organ
      failure (MOF).

PMID- 8366607
TI  - [Treatment of intrahepatic gallstone].
AB  - The postoperative outcomes in patients with hepatolithiasis are greatly affected
      by the presence of residual stones. One hundred and seventeen patients with
      hepatolithiasis treated in our clinic were analysed. The indication of
      hepatectomy for hepatolithiasis was determined by the degree of stricture of
      intrahepatic bile duct. The rate of residual stones was reduced from 54.5% to
      14.5% by the introduction of choledochoscopical lithotomy. Thus, pre- and
      postoperative choledochoscopical examination and lithotomy are shown to play an
      important role in treatment of the patients with hepatolithiasis.

PMID- 8366609
TI  - [Current therapy of obstructive jaundice due to cholelithiasis].
AB  - On recent development of apparatus and techniques of ultrasonography and
      endoscopy we prefer to try the following procedures for removing jaundice instead
      of surgical operation: 1) Percutaneous Transhepatic Biliary Drainage (PTBD) 2)
      Endoscopic Retrograde Biliary Drainage (ERBD) 3) Endoscopic Naso-Biliary Drainage
      (ENBD) 4) Endoscopic Sphincterotomy (EST). After removing the jaundice and
      inflammation of bile duct, we try following procedures for elimination of
      gallstone: 1) endoscopic mechanical lithotripter (EML) 2) (Extracorporeal shock
      wave lithotripsy (ESWL) And we have got the excellent results.

PMID- 8366608
TI  - [Biliary tract infection].
AB  - Biliary tract infection is a frequently encountered clinical problem and requires
      prompt diagnosis, proper understanding of the pathologic manifestations, and
      adequate treatment. If not managed properly, it can be the cause of disseminated
      intravascular coagulation and multiple organ failure and its prognosis can be
      fatal. This paper focuses on two of its representative diseases: acute
      cholecystitis and acute cholangitis.

PMID- 8366610
TI  - [Acute biliary pancreatitis].
AB  - Pathogenesis, diagnosis, predicting severity, and treatment of acute biliary
      pancreatitis are reviewed. Clinical characteristics, treatment and outcome were
      investigated in 23 patients with severe, acute biliary pancreatitis. Conservative
      treatment is successful in most of patients with acute biliary pancreatitis.
      Surgical treatment for biliary stones should be followed by an initial
      conservative treatment. However, in patients with severe pancreatitis, who has
      poor prognosis, intensive care is necessary and surgical treatment must be
      adequately performed, in failure of active medical treatments. In these cases,
      the timing of operation is important. When biliary lesions, acute septic
      cholangitis or impacted ampullary stones, are responsible for the severe
      condition, and can't be treated by a medical procedure, such as PTCD or EST,
      surgical treatment of the biliary tract should be considered.

PMID- 8366611
TI  - [Gallstone disease in pregnancy].
AB  - The incidence of gallstone disease in Japan has increased in recent several
      decades, and this is associated with the increased fat intake, especially for
      cholesterol stones. Women are more likely to develop gallstones than men. This
      sex-related difference in incidence is thought to be related with pregnancy.
      There are several reports that suggest the lithogenicity of estrogen which
      increases the content of cholesterol in bile. And there are another reports that
      gallbladder emptying becomes poor during pregnancy because of the effect of
      progesterone. The management of gallstone disease in pregnancy is different at
      the stages of pregnancy, severity of attack, and the presence of infection. The
      gallstone attack should be treated supportively during pregnancy, especially at
      the early stage and late stage. And after delivery, cholecystectomy should be
      performed. As for recurrent attacks, severe attacks or attacks associated with
      infection, cholecystectomy should be considered even during pregnancy. In the
      middle stage of pregnancy, cholecystectomy can be performed safely. In the case
      in which cholecystectomy should be avoided, percutaneous transhepatic biliary
      drainage can be performed. The common bile duct stone, cholangitis and biliary
      pancreatitis should be diagnosed be ERCP, and after definitive diagnosis,
      treatment with endoscopic sphincterotomy should be tried.

PMID- 8366612
TI  - [Post-gastrectomy gallstone disease].
AB  - Biliary tree of gastrectomized patients was examined with ultrasonography to
      investigate the factors affecting post-gastrectomy gallstone formation. Only
      gallbladder stone was found in 57 (18.9%). In 11 (20.0%) of 55 patients, stones
      had developed within 2 years after surgery, but no difference in incidence were
      observed by sex and age. Sixty four gastrectomized gallstone patients were
      examined in respect to the kind of gallstone. Patients with cholesterol
      gallstones were 18 (28.1%), patients with black gallstones were 29 (45.3%) and
      patients with calcium bilirubinate gallstones were 17 (26.6%). The incidence rate
      of cholesterol gallstones was lower and the rate of black gallstones and calcium
      bilirubinate gallstones was higher than that of non-gastrectomized patients. In
      conclusion, the incidence of pigment gallstones is very high in gastrectomized
      patients.

PMID- 8366613
TI  - [Treatment strategy of gallstone patients under special conditions gallstone in
      the elderly].
AB  - We have treated 894 gallstone patients for these five years. The average age was
      55.47 and 163 cases (18.2%) were more than 70 year-old. One of the important
      characteristics of the aged gallstone patients that they often had bile duct
      stones causing acute obstructive cholangitis. The other was that they accompanied
      another organ disorders. Early biliary drainage was the best way to avoid
      multiple organ failure under such conditions. Principally, surgical treatment if
      it's possible, was most reliable for bile duct stones. Thirty-five patients of
      bile duct stones were treated with our new surgical procedure. That was primary
      closure technique of the common bile duct following lithotomy under pre- or intra
      operative insertion of naso-biliary drainage catheter. Especially in the elderly,
      this technique was useful to reduce post operative hospital stay by 19 days
      compared with the ordinary T-tube drainage.

PMID- 8366614
TI  - [Telomere, cellular senescence and transformation].
AB  - Telomere is the structure which is located on both ends of individual chromosomes
      in eukaryotes. The DNA sequence of the telomere consists of Guanine-rich tandem
      repeat, i.e., (TTAGGG)n in man. Telomere protects the end of the chromosome from
      fusion or deletion and maintains the stability of the chromosome and is
      synthesized by telomerase, a ribonucleoprotein. Telomere reduction is observed
      with cell senescence and immortalization, both in vivo and in vitro. Thus,
      telomere is considered to be a "clock" which measures the life span of cells, and
      its length is altered by cellular senescence and immortalization.

PMID- 8366615
TI  - [Antiviral compounds: current approaches for development].
AB  - Recent dynamic advances of molecular biology have been discovering the specific
      virus functions and replication strategies that differ greatly from their host
      cells. These studies made it possible to design the antiviral agents which block
      virus replication specifically. In this paper, we review the recent approach for
      development of anti-HIV agents and the problems of anti-herpes compounds applied
      in clinical treatment.

PMID- 8366616
TI  - [Recent trends of gene therapy of human patients].
AB  - Recent trends of gene therapy in the USA, European countries and in Japan are
      reviewed. Although only the gene treatment for ADA deficiency was shown to be
      effective, many clinical trials of gene treatment for cancer or other disorders
      have already been approved by the RAC of NIH. In Japan, the Ministry of Health
      and Welfare started to make a guide line for human somatic cell gene treatment.
      This guide line is expected to be publicized by the end of March of 1993. It is
      therefore, expected that gene treatment will start in Japan in the very near
      future.

PMID- 8366618
TI  - [Pulmonary aspergillosis with air-fluid level in a cavity].
AB  - We experienced 17 cases of pulmonary aspergillosis with air-fluid level in a
      cavity. The incidence of this phenomenon was 39% in 44 patients who were
      diagnosed as having pulmonary aspergillosis during the period from 1983 to 1991
      at Yaizu Municipal Hospital. There were two clinical patterns: primary air-fluid
      type and secondary air-fluid type. Primary air-fluid type disease began with
      cavitation with an air-fluid level. Our 14 cases of this type had severe symptoms
      and inflammatory reaction. In secondary air-fluid type, the fungus ball
      disappeared and an air-fluid level appeared in a cavity during treatment. Our 3
      cases of this type had only mild cough and sputum. The fluid disappeared later in
      two of these three cases. Some cases of primary air-fluid type changed to fungus
      ball type or productive aspergilloma on the inner wall of a cavity. Primary air
      fluid type thus seems to represent incipient pulmonary aspergilloma, and to be
      important for early diagnosis and treatment. Of the immunological tests,
      precipitins to Aspergillus fumigatus proved most useful for early diagnosis.

PMID- 8366617
TI  - [Mechanism of constriction and dilatation of pulmonary artery induced by hydrogen
      peroxide].
AB  - Hydrogen peroxide (H2O2) is known to cause transient pulmonary vasoconstriction
      in isolated lungs perfused with a solution containing no blood components, by
      inducing vasoactive arachidonate metabolites such as thromboxane A2 (TXA2).
      However, the exact site of production of the vasoactive arachidonates in the lung
      tissue is unclear. Using isolated main pulmonary arterial rings obtained from
      male Sprague-Dawley rats (B.W. 300-350 g), we attempted to examine the
      arachidonate metabolism, especially that mediated by cyclooxygenase, in the
      vascular wall of pulmonary artery without endothelium. Changes in isometric
      tension were used to measure contraction or dilatation of the ring preparation.
      H2O2 caused transient contraction of the ring, which was treated previously with
      a solution containing a high concentration of potassium (20 mM). The contractile
      response was enhanced in parallel with the concentration of H2O2 in the presence
      or absence of endothelium. Catalase (1000 U/ml), a H2O2 scavenger, completely
      inhibited the response of the isolated ring (without endothelium) to H2O2. OKY
      046 (10(-5) and 10(-4) M), a TXA2 synthetase blocker, partially attenuated the
      contractile response induced by H2O2. ONO-3708 (10(-5) M), a TXA2 and
      prostaglandin H2 receptor blocker, fully inhibited the vasoconstriction and
      caused relaxation of the ring without endothelium after addition of H2O2.
      Indomethacin (5 microM), a cyclooxygenase inactivator, completely inhibited both
      vasoconstriction and vasodilation of the denuded ring. H2O2 also induced the
      release of 6-keto-prostaglandin F1 alpha, a stable metabolite of the vasodilator,
      prostacyclin, from the pulmonary artery without endothelium.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8366619
TI  - [A clinical study of respiratory infection with methicillin-resistant
      Staphylococcus aureus (MRSA)].
AB  - We investigated patients with positive sputum for MRSA at Daido Hospital. The
      study was conducted from 1990 to 1991. The number of cases with positive sputum
      for MRSA is moderately increased. We classified 116 MRSA isolated cases into
      three groups, 67 cases of colonization with MRSA, 26 cases of suspected
      bronchopulmonary infection, and 23 cases of bronchopulmonary infection with MRSA.
      The coagulase types of MRSA were type II or type II + III. Examination of the
      susceptibility to antibiotics of MRSA showed that all MRSA strains were
      susceptible to sulfamethoxazole trimethoprim, arbekacin, and vancomycin. A few
      strains were resistant to rifampicin. There were no differences in coagulase
      types and susceptibility to antibiotics between the three groups.
      Bronchopulmonary infection with MRSA was frequently associated with underlying
      bronchopulmonary disease, whether malignant or not. Risk factors for MRSA
      bronchopulmonary infection could not be identified, but the prognosis of MRSA
      bronchopulmonary infection was poor in cases with higher grade of performance
      status. MRSA eradication rate in sputum after therapy was low, and was not
      improved by adding inhalation of antibiotics including vancomycin to systemic
      chemotherapy. This investigation demonstrates the importance of environmental
      prevention of MRSA infection in hospitals.

PMID- 8366620
TI  - [Changes in plasma electrolytes during exercise in normal subjects--with special
      reference to the concentration of potassium and inorganic phosphate (Pi)].
AB  - In 8 healthy adults, changes in plasma electrolyte levels (Na+, Cl-, Ca2+, Pi and
      lactate) and respiratory parameters (VE, VO2 and VCO2) were examined during
      incremental exercise on a treadmill. Na+, Cl- and Ca2+ increased significantly
      near the end of maximal exercise and the early phase of the recovery period.
      Considering the 14% decrease in plasma volume, the increases in Na+, Cl-, and
      Ca2+ were not significant, while the increases in K+, Pi and lactate were
      significant. During incremental exercise, the concentration of K+ significantly
      correlated with minute ventilation (r = 0.994, p < 0.0001). Two minutes after the
      completion of exercise, K+ decreased below the pre-exercise level. The inflection
      point of VE on VO2 appeared earlier than that of K+ on VO2. The results suggest
      that some other factor which may contribute to the control of ventilation during
      exercise should be considered in addition to K+. Lactate and Pi began to increase
      5 and 8 minutes, respectively, after the start of exercise. Even after the
      completion of exercise, these two parameters remained significantly higher than
      the pre-exercise level. During incremental exercise, the concentration of Pi
      increased concomitantly with time, and significantly correlated with VE. On the
      other hand, in the early stage of exercise, the concentration of lactate remained
      at the pre-exercise level. These results suggest that the increase in plasma Pi
      is responsible for the state of metabolism in the muscle in addition to lactic
      acidosis.

PMID- 8366621
TI  - [Relationship between limitation of daily life and prognosis in patients with
      sequelae of tuberculosis treated with long-term oxygen therapy].
AB  - The sequelae of tuberculosis (TBC) sometimes causes severe restrictive lung
      disorders. In Japan, lung tuberculosis was pandemic up to the 1950s, with TBC
      being a major underlying disease of chronic respiratory failure and cor
      pulmonale. Until the end of 1991, we encountered 95 cases of Home Oxygen Therapy
      (HOT) in Ogaki area, 30 of which were patients with TBC. To clarify factors
      affecting the prognosis of these patients, we examined background factors,
      directing special attention to daily activities. In this study, 10 inactive
      patients (Group A) whose daily activity was limited to indoors and 10 control
      patients (Group B) whose age, vital capacity and arterial PO2 were equal to
      inactive patients, from the 30 TBC cases were used. A comparison was made of the
      prognoses. Among the patients, activity was closely related to dyspnea grade and
      arterial PCO2. Group A patients showed more marked dyspnea and lower arterial
      PCO2 than those of group B patients. Percentage home stay and cumulative survival
      rates of Group A patients (percentage home stay, 59.2 +/- 38.7% and 3 year
      survival, 26.3%) were significantly less than those of Group B patients (91.0 +/-
      16.4% and 87.5%, p < 0.05, respectively). Among chronic pulmonary emphysema
      patients treated with HOT, no significant relation between activity and prognosis
      could be found, when factors of age, arterial PO2 and forced expiratory volume in
      1 sec were excluded. There would thus appear to be a close relation between
      activity and prognosis in TBC patients specific for underlying disease.

PMID- 8366622
TI  - [Pulmonary circulatory disturbance following endoscopic injection sclerotherapy].
AB  - We compared arterial blood gas analysis and 99mTc-MAA lung perfusion scintigraphy
      before and after endoscopic injection sclerotherapy (EIS) in 17 cases of
      esophageal varices complicating liver cirrhosis. EIS was performed by the intra
      variceal injection method with 5% ethanolamine oleate (EO) as the sclerosant
      agent. In blood gas analysis, the mean values of partial arterial oxygen tension
      (PaO2) and oxygen saturation (SaO2) were decreased, and the mean value of
      alveolar-arterial O2 difference (AaDO2) was increased, compared with before EIS
      while breathing room air. On lung perfusion scintigram, the pulmonary blood flow
      was markedly decreased, demonstrating hypoperfusion and/or perfusion defect,
      compared with before EIS in most the cases. It was suggested that pulmonary
      embolism and/or pulmonary circulatory disturbance occurred after EIS. It is
      important to note that pulmonary circulatory disturbances potentially may occur
      after EIS without any accompanying symptoms such as dyspnea, cough, or
      hemoptysis.

PMID- 8366623
TI  - [Hydraulic conductivity of visceral pleura in dogs].
AB  - We measured the hydraulic conductivity of the visceral pleura in seven mongrel
      dogs in situ. The left chest was opened at the seventh intercostal space. A
      hemispherical capsule, filled with physiological saline, was attached to the
      visceral pleura of the left lower lobe by the negative pressure in the plate,
      using a vacuum pump. Transpleural fluid flow (V) was measured at different
      intracapsular pressures (delta P). The hydraulic conductivity was calculated from
      the relation between fluid flow and intracapsular pressure, i.e., the slope of
      the linear regression line. The hydraulic conductivity was 1.49 +/- 0.68 (mean +/
      SD) nL.min-1 x cmH2O-2. Our values were smaller than those of former reports
      obtained in vivo. It is suggested that the dynamics mechanisms of plural effusion
      may be clarified by studies using our method.

PMID- 8366624
TI  - [Effect of surfactant on mouse alveolar macrophage cytotoxicity].
AB  - Surfactant has been shown to have several immunologic activities in addition to
      its property of lowering tension. To investigate the effect of surfactant on
      alveolar macrophage cytotoxicity against tumor cells, we compared the cytolytic
      activity, tumor necrosis factor (TNF) activity and L-arginine-dependent NO2-
      production of mouse alveolar macrophages in the presence of surfactant with those
      of alveolar macrophages alone. Furthermore, we measured the concentrations of
      inositol-1,4,5, triphosphate (IP3) and diacylglycerol (DG) both of which are
      second messengers of intracellular signals. Cytolysis, TNF activity and NO2-
      production were enhanced by lipopolysaccharide (LPS) and interferon-gamma (IFN
      gamma). This enhancement was further increased by addition of surfactant. The
      surfactant did not enhance the concentration of IP3, but enhanced that of DG in
      alveolar macrophages activated by LPS or IFN-gamma. These data suggest that
      surfactant upregulated the enhancement of alveolar macrophage cytotoxicity by LPS
      and IFN-gamma, and this effect was related to an increase in the concentration of
      DG in activated alveolar macrophages.

PMID- 8366625
TI  - [A case of pulmonary malignant lymphoma with macroglobulinemia and cecal cancer].
AB  - A 69-year-old female was found to have an abnormal shadow in the right middle
      lobe during examination for operation for cecal cancer. Ten months later, she was
      admitted to our hospital because of enlargement of the shadow and development of
      macroglobulinemia. Transbronchial lung biopsy and elevated IgM in BALF (IgM/Alb
      was 2.75 times that in serum evidently suggested pulmonary malignant lymphoma.
      CHOP therapy was not effective, and resection of the mass was attempted but was
      not feasible because of extension of the lesion into the upper and lower lobes.
      The biopsy specimen obtained during surgery disclosed malignant lymphoma, diffuse
      small cell type (IgM kappa type, B-cell). Radiation therapy was effective with
      complete resolution of the shadow. In this case, transbronchial lung biopsy and
      BAL were useful in the preoperative diagnosis of pulmonary malignant lymphoma.

PMID- 8366626
TI  - [A case of extraskeletal Ewing's sarcoma of the chest wall].
AB  - A 22-year-old woman was admitted to our hospital complaining of high fever,
      dyspnea and wheeze. Chest X-ray film and CT scan showed a huge mass lesion in the
      right chest. Histological findings of specimens obtained by both needle biopsy
      and surgery showed necrotic tissue. She died of rapidly progressive pulmonary
      metastasis three months after surgery, and at autopsy, the tumor was diagnosed as
      extraskeletal Ewing's sarcoma originating from the chest wall.

PMID- 8366627
TI  - [A case of pleural involvement followed by idiopathic retroperitoneal fibrosis].
AB  - We report a rare case of pleural involvement followed by idiopathic
      retroperitoneal fibrosis in a 55-year-old man. He complained of right chest pain
      and his chest radiogram showed pleural thickening and calcification. Chest X-ray
      computed tomogram (CT) also showed a mass-like pleural thickening and a soft
      tissue density lesion surrounding the thoracic aorta, suggesting fibrosis. By
      open pleural biopsy, the mass-like pleural lesion was diagnosed as chronic
      pleuritis. Three years later, the patient experienced difficulty in urination,
      and bilateral hydronephrosis which was probably due to a retroperitoneal lesion
      was detected. Abdominal X-ray CT revealed a retroperitoneal lesion of soft tissue
      density comprised of a smooth and clearly delineated mass which encased the large
      vessels and ureters, compatible with retroperitoneal fibrosis. Although it was
      not possible to biopsy the retroperitoneal lesion, the lesion was clinically and
      radiologically thought to be retroperitoneal fibrosis. We could not determine the
      etiology of these findings, but such a case of pleural involvement followed by
      idiopathic retroperitoneal fibrosis was considered to be very rare.

PMID- 8366628
TI  - [A case of alveolar microlithiasis which developed spontaneous pneumothorax due
      to progression of emphysematous bullae during 34 years after established
      diagnosis].
AB  - The patient was a 46-year-old man who was taxi driver. He had received therapy
      for miliary tuberculosis from nine years old, and the diagnosis of alveolar
      microlithiasis was made by open lung biopsy at twelve years of age in 1956. At
      that time, there were no emphysematous bullae, and slight alveolar wall
      thickening was observed histopathologically. After a 34 year interval, he
      developed spontaneous pneumothorax with sudden dyspnea. Multiple emphysematous
      bullae were found at thoracoscopy performed to treat the pneumothorax. Arterial
      blood gas analysis after resolution of the pneumothorax showed hypoxia with a PO2
      of 65.4 torr, and lung function tests revealed restrictive disorder. Thus, in
      this patient, emphysematous bullae progressed resulting in a pneumothorax, and
      lung fibrosis also developed 34 years after the diagnosis of alveolar
      microlithiasis. Alveolar microlithiasis is occasionally misdiagnosed as miliary
      tuberculosis. The authors stress that the chest roentgenographic finding of ari
      bronchogram demonstrating intra-alveolar foci is an important sign in the
      differential diagnosis.

PMID- 8366629
TI  - [Aniline-induced methemoglobinemia monitored by pulse oximetry].
AB  - A case of aniline-induced methemoglobinemia is reported. When the pulse oximeter
      reading (SpO2) was 80%, the oxygen saturation measured by a co-oximeter (SaO2)
      was 61.2%, the oxygen saturation calculated from PaO2 values was 98.9% and
      methemoglobin level was 38.8%. After methylene blue injection, methemoglobin
      level decreased gradually. With a decrease of methemoglobin level, SpO2
      approached SaO2. If disparity between SpO2 and the oxygen saturation calculated
      from PaO2 values is noted, the presence of methemoglobinemia must be suspected.
      In clinical situations, the pulse oximeter permits the continuous noninvasive
      monitoring of oxygen saturation. It is necessary, however, to consider the
      potential errors in pulse oximetry.

PMID- 8366630
TI  - [A case of so-called benign metastasizing leiomyoma responsive to progesterone].
AB  - A 47-year-old female, who had undergone hysterectomy and unilateral oophorectomy
      in 1975, was admitted to our hospital in 1989 because chest X-ray films revealed
      an increase in size and number of pulmonary nodules for two years. On admission,
      a left inguinal tumor was found and histologically it consisted of smooth muscle
      cells with nuclear atypia arranged in interlacing fascicles. An open-lung biopsy
      was performed. Pulmonary tumors revealed similar histology to the inguinal tumor.
      They were diagnosed as metastatic low-grade leiomyosarcoma, so-called benign
      metastasizing leiomyoma (BML), on the basis of location and history, reinforced
      by mild histologic atypia. The tumor contained a high progesterone receptor level
      (400 fmol/mg). Therefore, medroxyprogesterone acetate, 600 mg daily, was
      administered orally. At two years the pulmonary lesions had regressed. BML is a
      rare condition, considered to be pulmonary metastasis from low-grade
      leiomyosarcoma of the uterus. Measuring estrogen and progesterone receptors in
      lung biopy material may help determine the most appropriate therapy.

PMID- 8366631
TI  - [A case of congenital absence of the right pulmonary artery].
AB  - A 14-year-old girl was admitted to ur hospital with pneumonia of the left lung,
      and some residual abnormalities were noted on chest X-ray film after recovering,
      which showed a small right hemithorax, displacement of the heart and mediastinal
      structures toward the right, and a small right hilum. There was no radioisotope
      accumulation in the right lung on pulmonary perfusion scintigraphy, and pulmonary
      angiography showed proximal interruption of the right pulmonary artery. Contrast
      enhanced computed tomography (CT) and magnetic resonance imaging (MRI) confirmed
      the absence of the right main pulmonary artery and enabled congenital absence to
      be distinguished from acquired obstruction of the artery. The peripheral
      pulmonary arteries in the affected lung were identified on CT, and radioisotope
      angiography showed a blood supply to it from the systemic circulation. However,
      aortography and bronchial arteriography failed to show an aberrant systemic
      pulmonary artery. 133Xenon ventilation-perfusion scintigraphy showed that the
      ventilation of the affected lung was about 50% of that of the left lung, but
      there appeared to be no gas exchange by the affected lung. Her prognosis was
      expected to be good, because she had neither cardiovascular abnormalities nor had
      developed pulmonary hypertension.

PMID- 8366632
TI  - [A case of drug induced pneumonitis caused by oral etoposide].
AB  - We report a case of drug induced pneumonitis caused by oral etoposide. A 63-year
      old man was admitted to our hospital in August 1991 because of low grade fever
      and dyspnea. He underwent right upper lobectomy on Nov. 27th, 1990 for lung
      cancer (squamous cell carcinoma), and courses of adjuvant chemotherapy (CBDCA,
      IFX, etoposide) during the following admission period. He was discharged on Feb.
      14th, 1991, and as an outpatient, oral etoposide (25 mg/day) was administered for
      about 7 months (6,125 mg in total). Chest X-ray film on admission showed
      reticulonodular shadows in bilateral lung fields, and computed tomography showed
      diffuse interstitial shadows. Blood gas analysis showed marked hypoxemia (PaO2
      breathing room air was 48.4 Torr). Transbronchial lung biopsy revealed edema of
      the alveolar walls and marked proliferation of type II alveolar epithelial cells,
      suggesting cytotoxic reaction. After termination of etoposide administration and
      following steroid pulse therapy, both clinical symptoms and hypoxemia were
      ameliorated. To our knowledge, this is the first report of etoposide-induced
      pneumonitis.

PMID- 8366634
TI  - Responsibility.

PMID- 8366635
TI  - Investigating drug diversion on a hospital unit: a team approach.

PMID- 8366636
TI  - What if peer assistance weren't?

PMID- 8366633
TI  - [A case of allergic bronchopulmonary candidiasis improved with steroid
      inhalation].
AB  - A 49-year-old woman was admitted to hospital because of productive cough and
      dyspnea. She had been well two months before admission, when she developed an
      attack of asthma. Chest roentgenogram taken on admission revealed numerous
      shadows of inhomogeneous density in both lungs. Laboratory findings showed
      leukocytosis with eosinophilia (25%), high IgE level in serum and positive RAST
      score to Candida albicans. A diagnosis of allergic bronchopulmonary candidiasis
      was made by these laboratory data and clinical course. The patient was treated
      successfully by oral administration of methylprednisolone and inhalation of
      amphotericin B, but she had a relapse of the disease on cessation of steroid
      medication. Inhalation of beclomethasone dipropionate and procaterol
      hydrochloride was commenced. Thereafter, pulmonary infiltration and clinical
      symptoms improved after three weeks.

PMID- 8366637
TI  - The twelve steps: a basic understanding.

PMID- 8366638
TI  - Help for the helper.

PMID- 8366639
TI  - [Treatment of cardiogenic shock in myocardial infarction with intraaortic
      counterpulsation].
AB  - The purpose of this study was to analyse the effects of intraaortic balloon
      counterpulsation (IABP) in treatment of patients with acute myocardial infarction
      (MI) complicated by cardiogenic shock. The study group consists of 20 consecutive
      patients (13 males and 7 females, aged 38-82 years) with cardiogenic shock
      developed in the course of MI. Catecholamines were administrated in all patients
      before intraaortic balloon pumping was instituted. IABP was performed using
      Datascope device. Efficacy of the procedure was determined with invasive
      measurements of arterial blood pressure and the level of diuresis. Of 20 patients
      with cardiogenic shock, 7 were successfully treated with IABP and they were
      discharged from the hospital.

PMID- 8366640
TI  - [Spontaneous echo contrast in transesophageal echocardiographic examination:
      clinical ultrasonic analysis].
AB  - The clinical and echocardiographic variables related to spontaneous echo contrast
      were evaluated in a consecutive series of 600 patients undergoing transesophageal
      echocardiography with a 5-MHz single plane transducer. The spontaneous contrast
      was observed in 110 patients (18%). It was seen mainly in the atria; in the left
      atrium in 98, in the right atrium in 2 patients, in both atria 7, in the vena
      cava superior and right atrium in 1, in the left atrium and ventricle in 1, and
      in the false lumen of dissected aorta. Spontaneous atrial contrast was never seen
      in the absence of cardiac abnormality. There was a high incidence of atrial
      spontaneous echo contrast in cases of significant mitral stenosis, mitral valve
      prosthesis, atrial fibrillation, enlarged left atrium and absence of significant
      mitral regurgitation which were showed by univariate analysis. Multivariate
      analysis showed that atrial fibrillation, significant mitral stenosis and
      enlarged left atrium were independent factors for the presence of spontaneous
      contrast. Thus, spontaneous echocardiographic contrast detected by
      transesophageal echocardiography is a common finding in patients with mitral
      stenosis, atrial fibrillation and enlarged left atrium, in the absence of
      significant mitral regurgitation.

PMID- 8366641
TI  - [Hemodynamic effects of one administration of l-dopa in patients with left
      ventricular heart failure (introductory remarks)].
AB  - The study group consisted of 8 men with congestive heart failure. They ranged in
      age from 33 do 63 years (mean 48). Three patients were in class III NYHA, five in
      class IV. Idiopathic cardiomyopathy was diagnosed in 6 patients, one individual
      displayed ischemic heart disease and one patient was after mitral and aortic
      valve replacement despite a normally functioning prosthetic valve. L-dopa was
      given orally beginning with 250 mg every six hours until a total daily dose of
      4.0 g was achieved with no side effects (patients additionally received 50 mg of
      pyridoxine hydrochloride). Afterwards L-dopa was withheld for 24-36 hours. Having
      completed this washout period, patients underwent right heart catheterization,
      with placement of a balloon-tipped thermodilution catheter in a pulmonary artery,
      so that balloon inflation allowed recording of the pulmonary capillary wedge
      pressure. Right atrial and pulmonary arterial pressures were monitored
      continuously. Systemic arterial pressure was measured by mercury manometer.
      Cardiac output was determined by the thermodilution technique. Rest and effort
      hemodynamic measurements were repeated before and one, three hours after
      administration of 1-dopa. The base-line hemodynamic values were consistent with
      the clinical presentation of severe congestive heart failure. The average cardiac
      index (CI-1/min/m2--rest--1.93; 25 Watt-3.1) and stroke volume index (SVI-m1/m2-
      rest--22.2; 25 Watt-32.0) were markedly lowered. Left ventricular filling
      pressure and pulmonary artery pressure were elevated. The systemic vascular
      resistance was significantly increased (SVR -j.W.--rest--22.7; 25 Watt-14.2).
      Administration of 1-dopa resulted in the increase in cardiac index and stroke
      volume index accompanied by a substantial reduction in systemic vascular
      resistance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366642
TI  - [Sodium dichloroacetate decreases the size of experimental myocardial infarction
      in dogs].
AB  - The effect of sodium dichloroacetate on the size of myocardial infarction and on
      the changes of blood lactate and pyruvate levels after coronary artery occlusion
      were studies in 5 dogs. Sodium dichloroacetate administrated during coronary
      artery occlusion in dogs limited the size of myocardial necrotic area,
      simultaneous decrease of lactate and pyruvate levels in peripheral blood was
      observed. An analysis of lactate levels in blood samples from the coronary sinus
      and left atrium during coronary artery occlusion and the administration of sodium
      dichloroacetate suggests that the utilization of lactate by left ventricular
      myocardium under these conditions is increased.

PMID- 8366643
TI  - [A new multipolar transesophageal electrode for assessment of activation sequence
      in the left atrium].
AB  - A new multipolar transoesophageal electrode is described. Two patients were
      analysed. One with recurrent coronary sinus rhythm and the other with concealed
      WPW syndrome. Obtained recordings showed difference of sequence of left atrial
      depolarisation during recovery of the sinus rhythm after its overdrive
      suppression and during provoked tachycardia. Results are very promising and
      require further investigation.

PMID- 8366644
TI  - [Myocardial infarction in pregnancy].
AB  - We report two cases of pregnant women who developed an acute myocardial
      infarction. The proposed cause of massive myocardial anterior and
      interventricular wall infarction of the first patient appears to be bacterial
      intracoronary thrombus during the course of bacterial endocarditis. Acute
      insufficiency of the mitral valve caused by rupture chordae tendineae of the
      anterior mitral left was another complication. Labor contractions occurred on the
      13th day of treatment. On the next day the patient gave birth to a healthy child
      by elective cesarean section. She was also qualified for an operation because of
      increased signs of left ventricular heart failure. Preoperative coronary
      angiography revealed occlusion of the anterior descending branch and
      reconstruction of its periphery. Other vessels were not changed. The patient was
      subjected to implantation of artificial valve, an aortocoronary by-pass and
      repair of atrial septal defect. Eighteen months follow up was uneventful. The
      second case was a 29 year-old pregnant woman who had previously undergone mitral
      commissurotomy admitted because of an acute myocardial infarction in the II
      trimester. No complication of the disease was observed.

PMID- 8366645
TI  - [Intra-aortic balloon counterpulsation. Principle of action. For whom and when?
      (surgeon's point of view)].

PMID- 8366646
TI  - [Intra-aortic balloon counterpulsation--a cardiologist's point of view].

PMID- 8366647
TI  - [Intra-aortic balloon counterpulsation--point of view of the cardio-surgeon].

PMID- 8366648
TI  - [Intra-aortic balloon counterpulsation--cardio-surgeon's point of view].

PMID- 8366649
TI  - [Intra-aortic counterpulsation--cardiologist's point of view].

PMID- 8366650
TI  - [The adult with congenital heart defects].

PMID- 8366651
TI  - [Exercise echocardiography in diagnosis of ischemic heart disease].

PMID- 8366652
TI  - [Augmented activity of the adrenal medulla in young men with positive family
      history of essential hypertension].
AB  - Serum adrenaline (AD) and noradrenaline (NA) were measured by RIA method in two
      groups of young males: group S (n = 54) with positive family history of essential
      hypertension (EH) and group K (n = 9) with negative family history of EH (mean
      age: 24.6 +/- 3.3 i 23.6 +/- 3.6 years respectively). AD and NA concentrations
      were estimated in basic conditions (AD1, NA1) and after 10 min of passive
      vertical posture(AD2, NA2). In group S AD1 concentration was higher than in group
      K (54.4 +/- 24.4 i 37.8 +/- 15.6 pg/ml respectively, p < 0.05). In group S a
      positive correlation was found between mean systolic blood pressure (SBP) and
      mean heart rate (HR) estimated during 5-hours monitoring by Spacelab IGR 5300
      ambulatory blood pressure and heart rate monitoring system (r = 0.5, p < or =
      0.01). Pearson's correlation coefficient (Pcc). In this same group positive
      correlations were also found between AD2 and SBP - r = 0.31, p < 0.05 (Pcc) and
      between AD2 and HR: r = 0.33, p < 0.05 (Pcc). Results of 5-hours blood pressure
      monitoring showed that 15 of 54 males from group S had SBP > 139 mmHg (group S1).
      In group S1, AD1 and AD2 concentrations were higher than in group K (AD1: 366 +/-
      144; 206 +/- 85, p < 0.01 and AD2: 626 +/- 266; 369 +/- 156 fmol/ml, p < 0.05
      respectively). No differences were found in AD1, AD2, NA1 and NA2 concentration
      between group K and normotensive (SBB < 140 mmHg) males with positive family
      history of EH: group S2. In young males with positive family history of EH, the
      elevation of blood pressure might be caused by an augmented activity of the
      adrenal medulla.

PMID- 8366653
TI  - [Congestive heart failure and ventricular arrhythmia in relation to magnesium,
      potassium and sodium in serum and erythrocytes].
AB  - The aim of this study was to determine magnesium, potassium and sodium in plasma
      and erythrocytes in patients (14 male, 12 female; the average age 60.3) with
      congestive heart failure (CHF) (NYHA class II/III, III, IV) who were treated with
      digitalis, diuretics and vasodilators. All patients were subjected to 24 h ECG
      monitoring and ventricular arrhythmias classified according to LOWN, were
      analyzed in relation to electrolyte contents in erythrocytes and serum. Control
      group consisted of 20 persons (17 male; 3 female: the average age 58.7 years).
      Plasma and erythrocyte K and Na were determined by flame spectrophotometer; Mg
      was assayed by atomic absorption spectrophotometer. Statistical analysis was made
      by t-Student test. Results obtained suggest that patients with CHF require
      supplementation K+ with Mg2+ (tab. I). Our study has not revealed expected
      interrelationships between ventricular arrhythmias and electrolyte disturbances
      in patients with CHF. It should be stressed, however, that the small numbers of
      patients in the subgroups in our study might have blurred the possible
      relationship.

PMID- 8366654
TI  - [Complications associated with use of atrial electrodes].
AB  - The higher complication rate with atrial than ventricular leads make the
      physiological mode of pacing less popular. The aim of this study was to assess
      the complications associated with atrial leads. Between July 1985 and December
      1991 we inserted 174 atrial leads in 165 patients (pts) with sick sinus syndrome
      or/and a-v block (AAI and DDD system respectively). A variety of different types
      of unipolar leads have been used: passive fixation simple or J shaped with the
      porous tip of vitreus-carbon (n = 49) and platinum-iridium (n = 78) or polished
      tip of Elgiloy (n = 18), active fixation (n = 29). The leads were manufactured by
      Siemens-Elema, CPI, Biotronik, Medtronic and Vitatron. All leads have similar
      acute electrical characteristics. The mean follow-up period lasted 28 months (12
      83) until June 1992. We observed the following complications: displacement of
      electrode tip in 16 pts (9.7%), the disturbances of sensing in 10 pts (6%), 3rd
      degree of a-v block in 6 pts (5.4%) of 111 pts with AAI pacing, the exit-block in
      3 pts (1.8%), suppuration in 3 pts (1.8%) in pacemaker area, various in 1 pt
      (0.6%). Total complication rate, which required reoperation was 20.6%.
      Complications associated with atrial leads implantation are not dangerous, may be
      easily treated and should not limit the indication for physiological pacing.

PMID- 8366655
TI  - [Change of right ventricle performance caused by intravenous nitroglycerin
      infusion in patients with isolated mitral stenosis].
AB  - The impact of intravenous infusion of nitroglycerin (NTG) on the conditions of
      the right ventricle (RV) load was assessed in a group of 27 patients with
      isolated mitral stenosis (SM). Swan-Ganz catheter was used to assess the
      parameters influencing preload and afterload of the RV at rest and during effort
      of its performance under NTG. NTG infusion caused lowering of RV filling pressure
      at rest (from 5.1 +/- 2.8 to 3.2 +/- 1.9 mm Hg, p < 0.001), and during effort
      (from 7.6 +/- 3.6 to 4.9 +/- 2.2 mg Hg, p < 0.001), lowering of mean pulmonary
      artery pressure at rest (from 27 +/- 10.7 to 19.8 +/- 9.2 mm Hg, p < 0.001) and
      during effort (from 48.6 +/- 15.5 to 39.4 +/- 16.1 mm Hg, p < 0.001), and
      lowering of capillary wedge pressure at rest (from 17.1 +/- 6.9 to 12.7 +/- 6.2
      mm Hg, p < 0.001) and during effort (from 32.9 +/- 10.1 to 25.9 +/- 8.4 mm Hg, p
      < 0.001). NTG infusion lowers pulmonary vascular resistance at rest (from 2.5 +/-
      1.6 to 1.9 +/- 1.5 W.u., p < 0.001) and during effort (from 2.9 +/- 2.0 to 2.4 +/
      1.9 W.u., p < 0.001). NTG causes beneficial lowering of the stroke work index of
      the RV at rest (from the average of 9.9 +/- 5.3 to the average of 6.4 +/- 3.9
      pm/m2, p < 0.001) and during effort (from the average of 19.1 +/- 9.1 to the
      average of 15.7 +/- 9.0 pm/m2, p < 0.001). Beneficial hemodynamic effect of NTG
      on preload and afterload of the RV in patients with isolated SM was demonstrated.

PMID- 8366656
TI  - [Echocardiography of the fetal heart. Analysis of 350 successive examinations].
AB  - From July 1st 1990 do June 30th 1992 517 fetal echocardiography examinations were
      performed at the Department of Sonography, Polish Mother Memorial Hospital,
      (Toshiba 270 SA or Acuson 128 XP) between 20th and 41st gestation weeks. The
      medical indications for fetal heart examinations were presented. On the basis of
      echo preliminary diagnoses with 350 newborn's clinical assessment, our own
      results were reviewed. Correct heart anatomy was described in 94%. In conclusions
      we suggest that fetal heart assessment (anatomy of the 4 chambers) should be
      included in a routine screening obstetrical scan in the second half of the
      pregnancy.

PMID- 8366657
TI  - [Left ventricular outflow obstruction as a result of external cardiac compression
      by a mediastinal tumor].
AB  - A case of left ventricular outflow tract stenosis resulted from compression of
      the heart is presented. This symptomatic cardiovascular lesion was produced by
      extensive growth of mediastinal tumour. Numerous noninvasive methods were
      necessary to establish this difficult diagnosis. The patient underwent surgery
      that disclosed a benign process (of neurofibroma). After tumour's resection
      marked hemodynamic signs subsided.

PMID- 8366658
TI  - [Selective catheter ablation of the slow pathway in a patient with recurrent
      atrioventricular nodal reentrant tachycardia].
AB  - The case of a 35 year-old patient with recurrent, sustained atrioventricular
      nodal reentry tachycardia (AVNRT)--type slow/fast--refractory to group IA, IC,
      II, IV antiarrhythmic agents is presented. The maximum rate of the tachycardia
      was 280/min. During the antiarrhythmic treatment with group IA, IC and IV agents
      the tachycardia rate was 230/min. The effective refractory period (ERP) of the
      slow pathway was 200 ms in antegrade direction. ERP of the fast pathway was 260
      ms in antegrade and 210 ms in retrograde direction. Ablation of the slow pathway
      was performed with radiofrequency energy (device HAT 200 S manufactured by Osypka
      GMBH, catheter Cereblate No 6). The total ablation time was 96 s, maximal
      temperature of the effective ablation time was 51 centrigrades. Total energy
      delivered was 2316 J. The ablation caused neither atrioventricular conduction
      block nor any damage to the heart structure other than the slow conduction
      pathway. After the ablation there are no evidence of conduction through the slow
      pathway. Conduction in anterograde and retrograde direction occurs through the
      fast pathway. No AVNRT were observed. After ablation the patient has no
      antiarrhythmic treatment.

PMID- 8366659
TI  - [Is it possible to predict progress in hypertension].

PMID- 8366660
TI  - [Ischemic heart disease should have causal treatment].

PMID- 8366661
TI  - High density lipoprotein and low density lipoprotein attenuate the inhibitory
      effects of oxidized low density lipoprotein on endothelium-dependent arterial
      relaxation.
AB  - We have recently reported that oxidized low density lipoprotein (ox-LDL) inhibits
      endothelium-dependent arterial relaxation through its increased
      lysophosphatidylcholine (LPC). In this study we examined whether high density
      lipoprotein (HDL) as well as native low density lipoprotein have any effects on
      the inhibition of endothelium-dependent relaxation by ox-LDL in isolated strips
      of rabbit thoracic aorta. Both LDL and HDL were isolated from normal human plasma
      and LDL was oxidized by exposure to copper. Preincubation of arterial strips with
      ox-LDL (0.1-0.5 mg protein/ml) inhibited endothelium-dependent relaxation to
      acetylcholine (ACh) in a concentration-dependent manner. HDL (1 mg protein/ml) by
      itself had no effect on the relaxation to ACh. In the presence of HDL, the
      inhibition by ox-LDL was markedly reduced. In addition, native LDL also
      attenuated the inhibition of endothelium-dependent relaxation by ox-LDL. Thus,
      HDL and native LDL may have salutary effects against the impairment of
      endothelium-mediated vasodilation in atherosclerotic arteries.

PMID- 8366662
TI  - The stellate cells phenotypic transformation in the CCl4- injured liver fibrosis
      of ICR mice: their desmin immunoreactivity and vitamin A storage.
AB  - To elucidate the process of phenotypic transformation of stellate cells which
      were responsible in the production of collagen fibers, ICR mice were injected
      subcutaneously with CCl4 twice weekly for 5 weeks and the livers were examined by
      light and electron microscopy every week. Stellate cells were detected by desmin
      immunoreaction and vitamin A-autofluorescence. In the first week, following cell
      necrosis in the pericentral areas, granulomas were formed. Two distinct stellate
      cell phenotypes were developed i.e. desmin-negative cells in the granuloma and a
      row of intense desmin-positive cells in its boundaries. Both phenotypes seemed to
      be derived mostly from perisinusoidal stellate cells and involved in collagen
      synthesis as evidenced by the presence of reticulin meshwork within the
      granulomas. The meshwork formation was the initial stage of a new septum
      formation since in the second week the intense desmin-positive cell rows were
      closer to the central vein concomitant with the growth of several protrusions to
      form thin layer septa towards neighboring central or portal veins. The
      myofibroblast-like cells in the septa with features interposed between stellate
      cells and myofibroblasts were likely derived from the stellate cells phenotypes.
      During the transformation of stellate cells, the decline of vitamin A storage was
      accompanied by the formation of connective tissue septa. The desmin
      immunoreactivity and vitamin A storage in the stellate cell phenotypes during
      liver fibrogenesis described in this study may reveal their phenotypic
      transformation in association with the collagen synthesis.

PMID- 8366663
TI  - The osteogenic potential of fracture hematoma and its mechanism on bone formation
      -through fracture hematoma culture and transplantation of freeze-dried hematoma.
AB  - This study was conducted to provide further evidence of the inherent osteogenic
      potential of the fracture hematoma. The fracture hematoma was separated into its
      cellular and extracellular elements. The hematoma cells were cultured to study
      bone formation by the cellular elements alone. Bone formation acceleration factor
      was added to the cultured fracture hematoma cells. The cell responded to this
      stimulation by differentiation into chondrocytes. Fracture hematoma was freeze
      dried to study the presence of osteoinduction by the extracellular factors in the
      fracture hematoma. The freeze-dried fracture hematoma was packaged in
      methylmethacrylate pellets and within capsules of hydroxyapatite. These pellets
      and capsules in response to extracellular humoral factors from the freeze-dried
      fracture hematoma. The results of experimental implantation of the cultured
      fracture hematoma cells revealed that these cells had the potential to
      differentiate into chondroblasts or osteoblasts when bone induction factors and
      bone acceleration factor was added to their media. These extracellular humoral
      factors are known to be present in the fracture hematoma.

PMID- 8366664
TI  - LASA recommendations on education and training for licence holders under the UK
      Animals (Scientific Procedures) Act 1986--FELASA categories B and C. Report of a
      committee accepted by LASA Council June 1992.

PMID- 8366666
TI  - Isolation of Acinetobacter calcoaceticus from the gastrointestinal tracts of SCID
      mice.
AB  - Acinetobacter calcoaceticus colonization was observed in the gastrointestinal
      tracts of C.-B17-scid/scid (SCID) mice, while it was not observed in C.B17-scid/+
      and C.B17-+/+ mice with normal immunity housed under the same conditions. A.
      calcoaceticus and other viable enteric bacteria were not isolated from any organs
      other than gastrointestinal tract in SCID mice. The mice colonized with this
      organism were apparently healthy and no significant visceral lesion was observed.

PMID- 8366665
TI  - Allergy to laboratory mice and rats: a review of its prevention, management, and
      treatment.
AB  - Allergy to laboratory animals is reviewed from a management point of view.
      Personnel issues, medical therapy, legal aspects, animal house environments and
      work routines are discussed. Modern methods of medical treatment are presented
      but it is recommended that environmental control should be given priority over
      drugs. Several ventilation and building design systems are reviewed from an ALA
      viewpoint. New technology (including down-ventilated benches, ventilated cages)
      is reviewed and possible effectiveness analysed. These systems, though
      potentially of value, lack adequate testing under clinical conditions. We
      conclude that there are many clinically untested techniques that remain to be
      proven and whose efficacy has not been documented.

PMID- 8366667
TI  - A spontaneous outbreak of Theiler's encephalomyelitis in a colony of severe
      combined immunodeficient mice in the UK.
AB  - Severe Combined Immunodeficient (SCID) mice lack both T and B lymphocytes which
      makes them highly susceptible to infectious agents. In the present communication,
      we describe an outbreak of Theiler's encephalomyelitis in a colony of SCID mice
      which was characterized by an unusually high prevalence of clinically overt
      cases. Diagnosis was based on the clinical signs, histological lesions and
      presence of antibodies in contemporaneous immunocompetent mice. This is the first
      report of this disease in SCID mice and, to our knowledge, also the first
      reported outbreak of Theiler's encephalomyelitis in the UK.

PMID- 8366668
TI  - Handling and diet-induced atherosclerosis in rabbits.
AB  - Atherosclerosis was induced in rabbits by feeding them a 2% cholesterol diet
      (CHOL) during a 5-week period. Twelve rabbits were fed with increasing amounts of
      CHOL food until the ad libitum level was reached, whereas in 24 other rabbits the
      food was limited to the amount eaten by the lowest consumer of the group to
      reduce individual variability in total amount of food consumed. Twice a day, half
      of the rabbits were handled carefully, the other half had normal laboratory
      practice contact with their caretaker. Feed intake and amount of atherosclerosis
      were determined for all experimental animals, while for the handled animals
      behavioural parameters and changes were recorded daily and per animal. On average
      the handled and non-handled rabbits took the same amount of food per week,
      although there were large individual differences. The handled animals showed some
      behavioural adaptation to being handled. Handling had no influence on
      atherosclerosis size; this latter measure was only roughly determined by the
      amount of CHOL food eaten.

PMID- 8366669
TI  - Evaluation of the Clinitek 200 urinary test-strip reader in the analysis of dog
      and rat urines in pre-clinical toxicology studies.
AB  - The performance of a clinical urinary test-strip reader Clinitek 200 was
      evaluated for dog and rat urines, in the context of pre-clinical toxicology
      studies. No major discrepancies were found between data generated by visual
      estimation or automatic measurement. Analysis of spiked samples showed good
      agreement between actual concentrations and Clinitek 200 responses for ketone
      bodies and glucose although a lack of sensitivity was found for the latter.
      Results for proteins showed over- or underestimation in dog and rat urines
      respectively at low concentrations, and overestimation at high concentrations in
      both species. Reproducibility of responses was excellent for ketone bodies,
      glucose and proteins but was weaker for haemoglobin and bilirubin. High bilirubin
      concentrations were found to interfere with the haemoglobin reaction. The pH
      measurements were found to be accurate only around pH 7. Specific gravity
      measurements were unreliable. Overall, the Clinitek 200 as a screening tool
      proved sufficiently reliable in the measurement of all parameters tested, with
      the exception of specific gravity.

PMID- 8366670
TI  - Development of the KVL segregating inbred strain of the Syrian hamster
      (Mesocricetus auratus).
AB  - A new colony of a single segregating inbred strain of the Syrian hamster
      (Mesocricetus auratus), designated KVL, has recently been developed at the Royal
      Veterinary and Agricultural University, Copenhagen, Denmark. The segregation
      occurs with respect to coat colour (pied gray/pied brown) as a result of
      inbreeding with forced heterozygosity. After 20 generations average litter size
      was 6.7 at birth and 5.57 at weaning. Mean generation interval was 89.4 days. An
      initially significant decrease in productivity (inbreeding depression) levelled
      out with further generations and has now stabilized. The colony is being
      maintained.

PMID- 8366671
TI  - A comparison of propofol with other injectable anaesthetics in a rat model for
      measuring cardiovascular parameters.
AB  - Prolonged, stable, non-recovery anaesthesia is required for the assessment of the
      effects of novel compounds on the cardiovascular system. A comparison of
      injectable anaesthetic agents and combinations (thiobarbital, fentanyl-fluanisone
      and midazolam, propofol, fentanyl-fluanisone and propofol, and
      alphaxalone/alphadolone) was made in laboratory rats and the following parameters
      assessed over 3 h: blood pressure, heart rate and rhythm, respiration rate and
      depth, analgesia, ease of induction and maintenance of anaesthesia. It was found
      that propofol, with fentanyl-fluanisone premedication, provided stress-free
      induction, easily controlled anaesthesia, good analgesia and muscle relaxation
      for surgery, for up to 3 h duration. Heart rate, blood pressure and respiration
      remained stable and within normal limits during this time. The other
      anaesthetics/combinations assessed did not rate as highly in these respects.
      Propofol, following fentanyl-fluanisone premedication, would appear to be a
      useful and safe anaesthetic for use in rodents, which avoids significant effects
      on heart rate or blood pressure.

PMID- 8366672
TI  - Anaesthetic effects of chloral hydrate, pentobarbitone and urethane in adult male
      rats.
AB  - Chloral hydrate, pentobarbitone and urethane were evaluated and compared for
      onset, duration and depth of anaesthesia, cardiovascular and respiratory effects,
      nociception and mortality in adult male rats. Chloral hydrate (300 and 400 mg/kg)
      severely depressed the cardiovascular and respiratory systems. Duration of
      anaesthesia was linearly related to dose, and anaesthetic depth and analgesia
      were excellent. Pentobarbital (40 mg/kg) produced a short period of light
      surgical anaesthesia. Moderate to severe respiratory and cardiovascular
      depression occurred. Duration of anaesthesia was not related to dose. Urethane
      (1.2 and 1.5 g/kg) caused moderate cardiovascular depression. In addition,
      mortality was high at the 1.5 g/kg dose. Duration of anaesthesia was greater than
      24 h for most animals. Anaesthesia depth and analgesia were excellent.

PMID- 8366673
TI  - Whisker trimming behaviour in A2G mice is not prevented by offering means of
      withdrawal from it.
AB  - In group-housed laboratory mice whisker trimming (removal of vibrissae) occurs
      occasionally, but in the A2G strain it is seen almost invariably. We have tested
      the hypothesis that whisker trimming in A2G mice is not prevented by offering the
      possibility to withdraw from it. Pairs of male or female mice showing absence of
      whiskers and/or absence of nasal fur were separated by placing in their cage
      either one or two wire screens with a 10 mm mesh. Unlike the single screen, the
      two screens, which were 10 mm apart from each other, excluded nose to mouth
      contact. After five weeks, whiskers had regrown in mice separated by the double
      screen, whereas in the pairs separated by the single screen whiskers remained in
      part absent. This suggests that 2 mice involved in whisker trimming, either
      actively or passively, co-operate in this behaviour.

PMID- 8366674
TI  - Unusual patterns of susceptibility to degradation of DNA isolated from tissues in
      Peromyscus californicus.
AB  - Isolation of intact, high molecular weight genomic DNA from the livers of 2
      subspecies of Peromyscus californicus without excessive degradation was typically
      unattainable, whereas highly intact DNA from livers of other Peromyscus (field
      mice) species is invariably obtained using the same isolation methods.
      Additionally, highly intact DNA was obtained from splenic tissues of adult P.
      californicus and hepatic tissue of juvenile animals, indicating that the
      phenomenon is tissue-specific and age-related.

PMID- 8366675
TI  - Induction of oestrus in cats by photoperiodic manipulations and social stimuli.
AB  - The development of the nervous system can be studied only if the age of the
      embryo is exactly known. Since it is difficult to control reproduction in female
      cats, we tried to time fertilization very precisely to within one hour by using
      either artificial insemination, or by mating females in oestrus induced by light
      programming. In one trial, this programming was associated with male or female
      stimuli according to the work of McClintock (1971, 1978, 1984) and Preti et al.
      (1986).

PMID- 8366676
TI  - Induction of alloxan/streptozotocin diabetes in dogs: a revised experimental
      technique.
AB  - The diabetic dog represents an excellent model for use in many aspects of
      diabetic research. The present paper describes, in detail, a reproducible
      experimental protocol for the successful induction of chemical diabetes in
      beagles using a combination of the 2 pancreatic beta-cell cytoxic agents alloxan
      and streptozotocin.

PMID- 8366677
TI  - A simple gag for the intragastric dosing of guinea pigs (Cavia porcellus).
AB  - A simple gag has been designed and tested which enables the intragastric
      intubation of the guinea pig by one person without the use of sedation or light
      anaesthesia. The system described was used successfully for the daily dosing of
      materials to 7 guinea-pigs for 14 days without discomfort, aspiration or any
      injury to the upper gastro-intestinal tract.

PMID- 8366679
TI  - Determinants of children's health care use: an investigation of psychosocial
      factors.
AB  - Factors related to the amount of health care used by 5- to 11-year-old children
      in a health maintenance organization (HMO) were investigated using a
      comprehensive multivariate model that assessed the contribution of child health
      need, mental health, and social functioning; maternal mental health, social
      support and health care utilization; and family functioning and life events.
      Mothers reported on the 450 participating children. Health care visits for a two
      year retrospective period were obtained from the computerized encounter system.
      Child health need and maternal patterns of health care use were powerful
      predictors of the overall amount of health care used, and these factors
      discriminated high users from low users of care. Family conflict was associated
      with a higher volume of care, while children's depressive symptoms and non-white
      race were related to lower use. Maternal social support, mental health, and life
      events were not predictive of use in either full multivariate model. Enabling
      factors were held relatively constant by participation of all families in a
      prepaid HMO. The multiple regression model explained 33% of the variance in use,
      slightly more than in previous studies of children's health care use. When
      included in a comprehensive analysis, child and family psychosocial
      characteristics help to explain children's health care use beyond what is
      possible using simple health and illness variables. The implications of these
      findings in the development of further research and to the practice of routine
      pediatric care are discussed.

PMID- 8366680
TI  - Influencing behavior of physicians ordering laboratory tests: a literature study.
AB  - There are various reasons why physicians order laboratory tests. Earlier studies
      have shown that in many cases test-ordering behavior lacks efficiency, resulting
      in excessive laboratory utilization. Throughout the years various attempts have
      been made to improve this situation. This review, based on the literature of the
      past 20 years, gives a survey of interventions and their effectiveness. Various
      types of education are discussed: general, cost-control oriented and education by
      means of guidelines, protocols, decision support systems, and feedback (on test
      ordering or cost). The discussion addresses the quality and apparent restrictions
      of the studies, and provides possible causes of the widely varying, but mostly
      low success rates. The long-term effectiveness of interventions aiming at better
      laboratory ordering is rather unfavorable.

PMID- 8366678
TI  - Substance use among impoverished medical patients: the effect of housing status
      and other factors.
AB  - Four hundred forty-three impoverished medical patients, many of whom were
      homeless, were studied to determine whether homelessness is an independent
      predictor of current substance use. Twenty-four percent of the sample of patients
      were frequent alcohol users (i.e., daily or almost daily), and 18% had recently
      used illegal drugs (cocaine, heroin, PCP, LSD). Marijuana use was not included in
      the drug use variable. Bivariate analyses revealed that frequent alcohol was
      associated with being homeless, male, less educated, a veteran, unemployed, and
      having more children. Frequent alcohol users also were more likely to be sexually
      active, have had suicidal thoughts, a previous psychiatric hospitalization or
      felony conviction, an accident or injury, and poor physical health. Self-reported
      use of illegal drugs was associated with being younger, U.S. born, never married,
      having a poor mood, and a mental health problem or substance use by a parent. Use
      of illegal drugs was associated with being homeless, male, less educated,
      sexually active, and having a previous felony conviction or psychiatric
      hospitalization. Once demographic and family characteristics were controlled for,
      housing status was not related to either frequent alcohol or illegal drug use.
      Substance use among impoverished patients was a reflection of their historical
      social backgrounds rather than of their current housing status. Helping these
      patients to obtain stable housing may not impact the substance use of homeless
      persons.

PMID- 8366681
TI  - Influence of the doctor's gender in the satisfaction of the users.
AB  - This study was carried out in the framework of a wider research project
      concerning the degree of patient satisfaction with the various types of primary
      health care. We have studied the relationship among the gender of the doctor, the
      gender of the patient and the type of primary health care center involved. In 1
      type of primary care center (health centers) the medical staff work as a team,
      whereas in the other (ambulatory care services), the doctor works alone. The
      survey was conducted among 86 doctors and 860 patients from urban areas in
      Andalusia, Spain. The degree of patient satisfaction was tested on Likert scales.
      Both male and female patients attended by female doctors were more satisfied than
      those attended by male doctors (P < 0.005). Both male and female patients were
      attended in equal proportions by both male and female doctors (P > 0.20). Overall
      patient satisfaction values were not affected by the patient's gender (P > 0.40).
      In comparing overall satisfaction among patients according with the doctor's
      gender and type of primary health care center, there was a greater degree of
      satisfaction with female doctors working in health centers (P < 0.01) and no
      difference existed in ambulatory care services in this area.

PMID- 8366682
TI  - Comparing hospital perinatal mortality rates: a quality improvement instrument.
AB  - This article describes the development of a reliable measurement instrument for
      the quality of perinatal care. The Hospital Perinatal Mortality Comparison (HPMC)
      predicts the expected perinatal mortality for individual hospitals, based on the
      perinatal mortality experienced in a group of similar newborns in a large
      reference population. Out of the 76 hospitals analyzed in 1990, 2 performed
      significantly better and 5 performed significantly worse than expected according
      to the logistic regression model. These results may lead to the identification of
      opportunities for improving the process of medical care in these hospitals.

PMID- 8366683
TI  - When medical group and HMO part company: disenrollment decisions in Medicare
      HMOs.
AB  - Medicare beneficiaries who enroll in "risk contract" Health Maintenance
      Organizations (HMOs) are covered for services only if they are provided or
      approved by the HMO. Thus, their enrollment decisions involve selecting a health
      care delivery system and may be influenced by whether the HMO has contracts with
      particular providers. Disenrollment decisions, in turn, may be influenced by
      breaks in contracts between the HMO and its medical groups. This study examines
      decisions made by Medicare HMO enrollees when their HMO terminated its
      relationship with a major medical group; the group then signed a contract with a
      competing HMO. Beneficiaries were forced to choose between remaining with their
      HMO and switching to another provider, and switching to the competing HMO where
      they could keep their provider. Beneficiaries demonstrated considerable loyalty
      to their providers; nearly 60% switched to the competing HMO. Previous research
      on health care coverage decisions has been based on models which did not address
      consumers' knowledge, options, and information sources. In this decision context,
      we found that knowledge and information sources were the most important
      determinants of beneficiary decisions.

PMID- 8366684
TI  - Patterns of obstetrical care in single-hospital, rural counties.
AB  - This study used logistic regression to identify differences in community-level
      characteristics of small, rural hospitals that provided obstetrical services
      compared to those that did not. The hypothesis was that community
      characteristics, such as demographics, geographic location, and socioeconomic
      status influence the ability of rural hospitals to sustain obstetrical services
      locally. The sample included small (fewer than 100 beds) non-federal, general,
      acute-care hospitals that were the only hospitals in their nonmetropolitan
      counties with fewer than 50,000 people in 1989 (n = 963). Data came from the Area
      Resource File and the American Hospital Association 1989 Survey. The results
      suggest that: 1) hospitals in the South are much less likely to offer obstetrical
      services; 2) hospitals in counties with higher socioeconomic status, measured by
      unemployment rate and percentage of the population who are white, have an
      increased likelihood of providing obstetrics; 3) hospital ownership has a
      relatively strong association with the provision of obstetrical services; and 4)
      the same characteristics that predict a hospital has obstetrical services do a
      poor job at predicting which hospitals do not offer those services. These results
      encourage researchers to examine areas where hospitals do not provide obstetrical
      care, and to investigate the dynamic between community characteristics and
      provider and consumer behavior. This study suggests to policymakers that
      targeting vulnerable communities and promoting regional and alternative modes of
      delivering obstetrical services may be effective means to ensuring that rural
      women have equitable access to obstetrical care.

PMID- 8366685
TI  - A patient survey system to measure quality improvement: questionnaire reliability
      and validity.
AB  - This study describes the results of a four-year research effort to develop
      inpatient and outpatient questionnaires that have sufficient validity and
      reliability to be used to measure patient perceptions of quality. As part of this
      effort, over 50,000 inpatients, emergency room patients, and ambulatory surgery
      patients from over 300 hospitals representing every US census region were
      surveyed. Separate questionnaires, called Quality of Care Monitors, were
      developed for inpatients and outpatients. The inpatient questionnaire consisted
      of 8 scales: Physician Care, Nursing Care, Medical Outcome, Courtesy, Food
      Service, Comfort and Cleanliness, Admissions/Billing, and Religious Care. The
      outpatient questionnaire had 7 scales: Physician Care, Nursing Care, Medical
      Outcome, Facility Characteristics, Waiting Time, Testing Services and
      Registration Process. The study found strong evidence of construct validity,
      predictive validity, and internal consistency for both questionnaires. Each
      questionnaire is capable of measuring separate dimensions of patient experience.
      A data bank developed from these questionnaires is currently accessed regularly
      by participating hospitals to assess quality improvement and to make benchmark
      comparisons with similar hospitals.

PMID- 8366686
TI  - Drug information from pharmacies: desire for more spontaneous information.

PMID- 8366687
TI  - The important role of international exchange in the development of medical
      informatics in developing countries: a report from China.
AB  - China is a developing country, and so is inferior to the developed countries in
      many aspects of science and technology. It is similarly a new member in the world
      ranking of the application of computers in biomedicine. However, since
      implementing the policy of reform and opening to the outside world in 1976, China
      has achieved greater success in biomedical signal and image processing,
      biomedical data processing, computer-aided diagnosis, computerized hospital
      management, etc. China's development shows that international exchange and
      cooperation are very important for the development of medical informatics in
      developing countries, and the application of computers in biomedicine has
      progressively spread all over the world and is increasingly taking root in the
      hearts of the people.

PMID- 8366688
TI  - An algorithm for leukaemia immunophenotype pattern recognition.
AB  - Since leukaemia-specific leucocyte antigen has not been identified to date, the
      immunological diagnosis of leukaemia is achieved through the application of a
      wide set of monoclonal antibodies specific for surface markers on leukaemic
      cells. Thus, the interpretation of leukaemia immunophenotype seems to be a
      mathematically determined comparison of 'what we found' and 'what we know' about
      it. The objective of this study was to establish an algorithm for transformation
      of empirical rules into mathematical values to achieve proper decisions.
      Recognition of leukaemia phenotype was performed by comparison of phenotyping
      data with reference data, followed by scoring of such comparisons. Systematic
      scoring resulted in the formation of new numerical variables allocated to each
      state, whereas a most significant variable was described as a complex measure of
      compatibility. A system of recognized states was described by mathematical
      variables measuring the confidence of information systems, i.e. maximal, total
      and relative entropy. The entire algorithm was derived by matrix algebra and
      coded in a high-level program language. The list of the states recognized
      appeared to be especially helpful in differential diagnosis, occasionally
      pointing to states that had not been in the scientist's mind at the start of the
      analysis.

PMID- 8366689
TI  - A database manager of biomedical images.
AB  - In order to allow an efficient archiving and retrieval of biomedical images, PACS
      would include an image DBMS. As biomedical images have complex structures we
      developed a specific DBMS over a relational one. The medical image database
      manager ensures a data description that takes into account data semantics so that
      consistency or existential constraints may be verified. It provides a unique
      language to retrieve images no matter what their storage format. It encompasses
      the queries of the user which constitute a filter over associated data. The
      manager can handle changes in the environment of the image. We implemented a
      manager prototype to show the validity of logical access possibilities. The user
      need no longer know the structure of the image database to access data. The
      logical access allows retrieval of images, whatever the architecture of the base.
      An automatic query construction consists of three functional levels including the
      interfaces towards the external environment which ensure a logical independence
      from the database, a query generator which creates the correspondence between the
      user's query and physical access queries, a dictionary which contains the
      structure of the image data and consistency constraints.

PMID- 8366690
TI  - Dictionary-based medical image I/O.
AB  - A general-purpose image I/O library is presented, whose properties derive from
      externally defined data dictionaries. The library has primarily been developed
      for image I/O in a medical image processing environment. It hence addresses all
      issues found in this field such as a variety of pixel types, architecture
      independence, automatic type conversion, and an unlimited number of image
      parameters. The data access routines in the library automatically convert the
      data types when needed. By redefining the data dictionaries, the I/O library can
      be tuned for other application areas. Explicit support for image compression is
      provided. The library is written in C++, and is available for interested parties.

PMID- 8366691
TI  - Data structure and computer program for fast interactive searches of clinical
      diagnoses.
AB  - Since 1987 the IDC codes of all diagnoses of patients treated in our hospital are
      stored in a patient-oriented (upright) database. In order to facilitate
      interactive searches for specific diagnoses and their combinations this database
      has been inverted into a data structure sorted by diagnoses. The report presented
      describes the data structure and the functionality of a computer program that
      allows very fast searches for complex combinations of diagnoses.

PMID- 8366692
TI  - Comparison between manual and automatic coding of medical record statistical
      cards at a university hospital.
AB  - The coding error rate of systems for medical record statistical cards (MRSCs)
      throughout health services is about 30%. A program using automatic coding has
      been developed at the Institute of Clinical Surgery II, Padua University
      Hospital, with a view to reducing this percentage. Out of an overall sample of
      4776 MRSCs from all departments of the hospital, 54 were automatically coded at
      our institute. Categories of discrepancy between the discharge diagnosis codes of
      the 4722 manually coded MRSCs and the other 54 MRSCs were classified as follows:
      types I-III, diagnosis assigned to an erroneous under-class, class or heading
      (ICD-9) respectively; type IV, incorrect diagnosis formulation precluding code
      assignment; type V, two or more discrepancies on MRSC; and type VI, secondary
      diagnosis not coded. Discrepancy rates were as follows: 22.3% and 0.0% for type
      I; 21.3% and 0.0% for type II; 17.6% and 0.0% for type III; 1.9% and 0.0% for
      type IV; 5.8% and 0.0% for type V; 31% and 1.9% for type VI. Code discrepancy
      rates for surgical procedures, which were also compared, ranged from 7.0 to 12.5%
      for manual coding, while no discrepancy was observed in automatically-coded
      MRSCs. The results clearly demonstrate the utility of the system reported on, and
      it is suggested that it should be used in a modified form in other hospital
      departments.

PMID- 8366693
TI  - Genealogy data design appropriate for family relationship retrieving.
AB  - Data structure representing a genealogy or genealogies as a stand-alone date
      structure is presented. Genealogy is considered as a finite, connected graph with
      nodes ni representing individuals, arcs (ni, nj), ordered pairs of nodes as
      parent-offspring relationships and edges (ni, nj), unordered pairs of nodes as
      twinships. Such structure enables storage of the minimum of family relationships
      and recognition of them and others like 'ancestor-descendant', 'sibs', 'twins',
      'cousins', 'uncle/aunt-nephew/niece' or 'spouses'. Algorithms for genealogy
      retrieval are classified as vertical, lateral and parallel. In certain
      combinations, vertical and lateral algorithms become capable of finding any
      relatives, no matter if they are in a direct 'ancestor-descendant' relationship
      or if they have only the same ancestor(s). A parallel algorithm is designed in
      order to search for twins, triplets etc.

PMID- 8366694
TI  - Approaches to the construction of a medical informatics glossary and thesaurus.
AB  - In a project concerned with establishing a glossary and thesaurus for the medical
      informatics domain, various approaches to the task have been investigated. The
      developers take the view that a glossary should be a coherent system of terms,
      reflecting a coherent system of concepts that underlies a body of knowledge about
      a domain. A framework for the conceptual analysis of the concepts/terms
      underlying the domain has been developed. The emphasis of this framework is on
      how the concepts relate together. This work has given an important insight into
      how the practical task of establishing well-structured vocabularies for a field
      can be better achieved. An eclectic approach to term selection was adopted.
      Criteria for assessing what constitutes good definitions for concepts in a field
      were examined. Using all these approaches glossaries, thesauri and domain models
      of the medical informatics field are being developed. Another aspect of our work
      of particular interest is the development of attributed definitions from which
      inheritance patterns can be defined.

PMID- 8366696
TI  - [External medical audit].

PMID- 8366695
TI  - [A new Dutch analysis illuminates euthanasia without request].

PMID- 8366697
TI  - ["Fair" research funds and the other ones. How should the distribution of the
      grants be ruled?].

PMID- 8366698
TI  - [Separate accident and emergency departments!].

PMID- 8366699
TI  - [Harmony at medical meetings].

PMID- 8366700
TI  - [Better support for the Baltic countries].

PMID- 8366701
TI  - [Strong arguments against euthanasia].

PMID- 8366702
TI  - [Confusion of concepts in the report on alcoholism].

PMID- 8366704
TI  - [Violence at health services--lack of motivation].

PMID- 8366703
TI  - [Professional education of teachers].

PMID- 8366705
TI  - [Atherosclerosis--an autoimmune disease?].

PMID- 8366706
TI  - [Analgesics in acute abdominal pain. Categorical prohibition is absurd].

PMID- 8366707
TI  - [Pain relief in cases of acute abdomen. Time to reconsider?].

PMID- 8366708
TI  - [Prenatal ultrasonic diagnosis. A valuable screening with low number of false
      findings].

PMID- 8366709
TI  - [A 10-year perspective on isotretinoin therapy. Dramatic improvement in severe
      acne].

PMID- 8366710
TI  - [First cases of hepatitis E diagnosed in Sweden].

PMID- 8366711
TI  - [Oral tetracycline--treatment of acne. Rapid facial improvement, but back lesions
      are more difficult to treat].

PMID- 8366712
TI  - [Costs of stroke care. Lower costs in spite of increased incidence].

PMID- 8366713
TI  - [Mussels filtrate for circulation in the sea. Control and choice of places of
      cultivation protect against marine biotoxins].

PMID- 8366714
TI  - [Physiopathology of mitochondria. From Luft's disease to aging and diabetes].
AB  - The first disease due to disturbances in a cell organelle was discovered in 1959
      62, and its basis was loose-coupling of oxidative phosphorylation in the skeletal
      muscle mitochondria accompanied by severe alterations of their structure (Luft's
      disease). During the 1980s, functional disturbances and structural alterations in
      the mitochondria were observed in more than 100 disease entities, mainly in parts
      of the central nervous system and skeletal muscles. A second breakthrough in this
      area was the discovery in 1963-64 that mitochondria had their own DNA, mtDNA.
      Following the observation in 1988 of mutations of mtDNA in mitochondrial
      diseases, such mutations--mainly deletions and point mutations--were observed in
      almost all mitochondrial diseases. A remarkable extension of the area is the
      notion that "normal" ageing is accompanied by decreased oxidative phosphorylation
      and the appearance of mtDNA mutations. During the last two years, such changes
      have been demonstrated in diseased states in tissues and organs, which are
      especially reliant on oxygen supply: in the central nervous system (Parkinson's
      disease, some types of epilepsy and seizures, Huntington's disease, possibly also
      in Alzheimer's disease); in heart muscle (cardiomyopathies) and in skeletal
      muscle. Type 2 diabetes or NIDDM engages two tissues most reliant on oxygen
      consumption, the pancreatic islets (insulin secretion) and skeletal muscle
      (insulin sensitivity). Both these functions are genetically determined, the
      latter to a high degree also controlled by "environmental" factors. The evident
      age factor in the development of NIDDM could be on a par with the "normal" ageing
      process.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366715
TI  - [Refer emergency cases directly to the specialist! Un-economical with
      inexperienced physicians in primary health care].

PMID- 8366717
TI  - [Realistic occupational health services].

PMID- 8366716
TI  - [Control of oral anticoagulant therapy. The Quick method is one step back].

PMID- 8366718
TI  - [The law for protection against infectious diseases and HIV: differentiate
      between the law and the person].

PMID- 8366719
TI  - [The psychodynamic movement should choose its direction!].

PMID- 8366720
TI  - [Facilitate nose breathing during skiing].

PMID- 8366721
TI  - [Which health care ideology? In defense of the small hospitals].

PMID- 8366722
TI  - [Prohibition of nickel use within the EEC. Sweden directs the standardization
      work to reduce the risk of allergy].

PMID- 8366723
TI  - [Reduced blood pressure and myocardial infarction. Does therapy increase the risk
      of coronary disease?].

PMID- 8366724
TI  - [Future treatment of stroke. Brain damage in stroke can be reduced by drugs].

PMID- 8366725
TI  - [Better results for children than for adults. 10-year experience with kidney
      transplantation in children].

PMID- 8366726
TI  - [Physicians' assessments of disabilities scrutinized. Criticism does not justify
      further investigation].

PMID- 8366727
TI  - [Intraoperative determination of intact parathyroid hormone. An aid for the
      surgeon in primary hyperparathyroidism].

PMID- 8366728
TI  - [From MBD to ADHD--and then? A literature review on a controversial diagnosis].

PMID- 8366729
TI  - [Sarcoidosis from a new pulmonary perspective. Do antigenic peptides cause the
      inflammation?].

PMID- 8366730
TI  - [Caesar Boeck and Jorgen Schaumann. The men behind the sarcoidosis syndrome].

PMID- 8366731
TI  - [Enterobiasis in preschool children. Every fourth child is infected].

PMID- 8366732
TI  - [Arthroscopy of the shoulder joint. Technique, indications, surgery and
      complications].
AB  - Diagnostic and operative arthroscopy of the shoulder joint has gained
      considerable importance in traumatology and orthopedic surgery over the last
      years. Injuries of the limbus glenoidalis, in particular traumatic shoulder
      luxation, injuries of the rotator cuff, infection of the glenohumeral joint and
      unclear posttraumatic pain are indications for diagnostic and operative
      arthroscopy. Arthroscopy of the shoulder is a procedure, which offers exact
      diagnosis and the possibility of immediate surgery at the same time. The
      technique of the shoulder joint arthroscopy has to be carried out carefully and
      according to a standard protocol. The complication rate of around 5% of shoulder
      arthroscopy has not to be neglected.

PMID- 8366733
TI  - [Genesis and treatment of hand para-articular, painful tendon and tendon sheath
      changes].
AB  - Many patients suffer from wrist disorders caused by tendon- and tendon-sheath
      affections. Apart from this the successful treatment of these affections is an
      important implication concerning national economy. In Lower Saxony 2.3% of all
      RVO-insured patients have these disorders. Most tendon- and tendon-sheath
      affections are due to chronic stress which is generally treated by a non
      operative therapy. Only some need be treated by a surgical intervention. In this
      paper the most frequent painful tendon- and tendon-sheath-diseases are listed,
      their clinical appearance is shown and the different methods of treatment are
      discussed.

PMID- 8366734
TI  - [Inguinal recurrence after therapeutic lymphadenectomy in malignant melanoma].
AB  - In a retrospective study, 73 stage-II melanoma patients with 22 superficial and
      51 deep groin dissections were observed over a maximum of 9 years of follow up
      (median 67.5 months). The 5-year survival rate of 29.8% was consistent with that
      yielded by comparable analyses of other investigators. However, the probability
      of recurrence in the node dissection field was as high as 35%. All groin
      recurrences occurred in the first 29 months after lymph node clearance (median 6
      months). Patients with groin recurrence following lymph-node dissection had a
      poor prognosis (median survival 12 months). In a multifactorial analysis (Cox
      model), the only prognostic factor of probability of recurrence was the
      development of regional in-transit cutaneous metastases (p = 0.0028). Factors
      that did not affect the appearance of recurrent metastases in the node dissection
      field were: site of primary melanoma, tumor thickness, epidermal ulceration,
      degree of lymph node involvement (p = 0.2) age, sex, degree of surgery
      (superficial or deep groin dissection) and adjuvant chemotherapy. Because
      regional in-transit cutaneous metastases mostly occur synchronously with groin
      recurrence or later, they are a typical concomitant phenomenon rather than a
      prognostic factor of recurrence.

PMID- 8366735
TI  - [Measuring impedance for evaluating ischemia damage to the human liver in
      preparation for transplantation].
AB  - In 22 human donor livers the measurement of the non-invasive bioelectrical
      impedance was performed prospectively to evaluate the degree of tissue damage
      sustained during cold ischemia. The results of the measurement were correlated
      with liver function, the method of organ preservation and the period of ischemia.
      The impedance was measured in vivo as 620 ohm (at 192 Hz), the phase angle as 
      7.4 degrees (at 5 kHz). The results were compared with the data obtained from 72
      patients who underwent elective laparotomies. The 22 donor livers were studied
      further during ischemia. The method was found to be a reliable way of detecting
      severe damage to the hepatocytes during the cold ischemia.

PMID- 8366736
TI  - [Intestinal motility after jejunum interposition and Roux-Y reconstruction--an
      animal experiment study].
AB  - An experimental study in animals was conducted to evaluate the motility patterns
      after total gastrectomy. Eight male beagle dogs (22.5-27.2 kg) had total
      gastrectomy with standardized designs of gastric substitution: (1) jejunal
      interposition (JI, n = 4); (2) Roux-en-Y reconstruction (RY, n = 4). Motility
      patterns were detected with perfused manometry (eight measuring ports),
      sequential scintigraphic emptying studies of the gastric substitute (caloric and
      acaloric medium viscosity test meals), and a hydrogen breath test with lactulose.
      The preoperative studies of the same individuals served as controls (CO). To
      detect postgastrectomy adaptation processes the postoperative studies were
      conducted 6-8, 12-14, and 24-30 weeks after total gastrectomy. The emptying of
      the gastric substitutes was markedly accelerated compared with CO after 6 months
      (T50: 5.8-8.1 min). In contrast to the preoperative studies, caloric test meals
      caused a trend to increase the velocity of the evacuation. The intestinal transit
      time was accelerated too in the weeks immediately, after the operation. In JI
      dogs intestinal transit was then markedly slowed and led to a highly significant
      difference after 6 months compared to RY animals (CO: 101 +/- 26min, JI: 104 +/-
      18.2min, RY: 71.3 +/- 13.4min; p < 0.01). Pathologic motility patterns could be
      identified as the cause of this observations: RY dogs showed a marked increase of
      the intestinal motility index in the proximal jejunum (p < 0.0001) and a
      dissociation between the motility patterns of the duodenum and the gastric
      substitute. The observations gave rise for the supposition that this parts of the
      small bowel might generate two independent pacemarkers that both influence the
      lower intestinal parts after RY reconstruction. We conclude that the motility
      patterns of the entire small bowel highly influence the postoperative function of
      reconstruction procedures after total gastrectomy. The emptying velocity of the
      jejunal gastric substitute does not seem to have a major influence on the
      postoperative results. According to motility patterns jejunal interposition has a
      better outcome than Roux-en-Y reconstruction.

PMID- 8366737
TI  - [Pneumatosis cystoides intestinii].
AB  - Pneumatosis cystoides intestinalis (PCI), a condition involving submucosal or
      subserosal gas-containing cysts of the wall of the gastrointestinal tract, is a
      rare entity. It is mostly diagnosed between the third and fifth decades of life
      without a clear sexual predominance. Different aetiopathogenetic factors are
      under discussion, the most probable being a bacteriologic cause (Clostridium
      perfringens) in combination with minimal leaks in the mucosal barrier. There are
      no pathognomonic symptoms; the clinical picture ranges from incidental findings
      to haematochezia. Diagnosis is based on plain abdominal film and X-ray following
      barium enema. Methods of treatment in symptomatic cases are oxygen and antibiotic
      (metronidazole) therapies and, in severe cases, resection of the diseased part of
      the intestine.

PMID- 8366739
TI  - Effects of pulsed lasers on agar model simulation of the arterial wall.
AB  - Coronary laser angioplasty is limited by a high rate of dissection and the
      occurrence of abrupt closure and perforation. The aim of this study was to
      visualize the mechanical effects of pulsed lasers on two chamber in vitro models.
      These models consisted of 1 or 2 agar layers and calcium carbonate inclusions (1
      layer model) or lipid (2-layer model) simulating lipid or calcified tissue. The
      inclusions were irradiated with a holmium-yttrium-aluminum-garnet (Ho-YAG) laser
      or a xenon chloride excimer laser. The Ho-YAG laser demonstrated dissection-like
      expansions of the target and perforation-like cracks. The size of dissection was
      obtained using an the empirical formula of energy (E) and the maximal expansion
      distance (Dmax) of the targets, Dmax = 0.15E0,87-1,17. The excimer laser showed
      rare and short perforation-like cracks and little dissection-like expansion of
      the gaseous products originating from the ablation of material. Ho-YAG laser
      ablation is likely to induce target tissue dissections and/or perforations.
      Excimer laser-ablates targets with less traumatic effects than Ho-YAG laser.

PMID- 8366738
TI  - Beta-carotene enhances plaque detection by fluorescence attenuation in an
      atherosclerotic rabbit model.
AB  - Improved detection of plaque during cardiovascular procedures could enhance the
      outcome of diagnosis and therapy. We evaluated a new method to stain plaque using
      a special intravenous preparation of beta-carotene (beta-C) in an in vivo model.
      beta-C was used to enhance the absorption coefficient of plaque and decrease the
      laser-induced fluorescence emission. Using this approach the difference in
      fluorescence emission was accentuated between normal artery and atherosclerotic
      plaque. Twenty-nine NZW rabbits were divided into five groups, each receiving a
      different intervention. This included the administration of beta-C to rabbits on
      a normal or a high cholesterol diet, with or without endothelial debridement.
      Aortae were examined grossly, by histology, and relative total fluorescence was
      detected at 886 sites using 488 nm or 514 nm laser excitation. At 488 nm
      excitation, unstained plaque attenuated total fluorescence twice as much as
      normal controls (7.55 +/- 1.46 vs. 15.06 +/- 3.12; P < 0.0001); beta-C stained
      plaque attenuated total fluorescence 17 times more than normal controls (0.89 +/-
      0.29 vs. 15.06 +/- 3.12; P < 0.0001). Total fluorescence from unstained plaque
      was eight times greater than plaque stained with beta-C (7.55 +/- 1.46 vs. 0.89
      +/- 0.29; P < 0.0001). Results obtained using 514 nm excitation were similar. The
      attenuation effect persisted up to 8 weeks following beta-C administration. Thus,
      beta-C stained plaque displayed fluorescence attenuation, which suggests that
      pretreatment with beta-C may greatly enhance plaque detection. This may be useful
      as a guide during plaque removal procedures.

PMID- 8366740
TI  - Acute response of the arterial wall to pulsed laser irradiation.
AB  - This study was designed to examine the acute response of normal arterial wall to
      pulsed laser irradiation. Irradiation with an Excimer or a Holmium YAG laser was
      performed in 15 normal iliac sites of 8 male New Zealand white rabbits. The
      excimer laser was operated at 308 nm, 25 Hz, 50 mJ/mm2/pulse, and 135 nsec/pulse
      and the Ho:YAG laser was operated at 2.1 microns, 3.5 Hz, 400 mJ/pulse, 250
      microseconds/pulse. The excimer and Ho:YAG laser were coupled into a multifiber
      wire-guided catheter of 1.4 and 1.5 mm diameter, respectively. The mean luminal
      diameter increased similarly from 2.01 +/- 0.29 to 2.46 +/- 0.27 mm (P < 0.0005)
      and from 2.09 +/- 0.53 to 2.45 +/- 0.30 mm (P < 0.005) after excimer and Ho:YAG
      laser irradiation, respectively. Perforation occurred in 3 of 15 Ho:YAG
      irradiated sites and 0 of 15 excimer laser irradiated sites. The sites irradiated
      with excimer or Ho:YAG laser had similar histologic features, consisting of
      shedding of the endothelium, disorganization of internal elastic lamina,
      localized necrosis of vascular smooth muscle cells, and fissures in the medial
      layer. However, the sites irradiated with excimer laser had lower grading scores
      than those irradiated with the Ho:YAG laser (P < 0.05). Irradiation with excimer
      or Ho:YAG laser of normal arteries results in: (1) vasodilation of the irradiated
      artery; (2) localized mechanical vascular injury, and (3) Ho:YAG laser induces
      more severe damage to the arterial wall than excimer.

PMID- 8366742
TI  - Primary closure of choledochotomy using CO2 laser: comparison with suture
      closure.
AB  - This study was designed to compare laser welding to suture closure of the common
      bile duct (CBD). A 12 mm linear choledochotomy was closed in 12 mongrel dogs
      using tissue welding low-energy CO2 laser. Tissue welding was accomplished at 5.0
      w/cm2 for 120 sec. Twelve similar mongrel dogs (control) were treated with CBD
      closure using 5/0 Vicryl (polyglactin 910, Ethicon, Inc., Somerville, NJ)
      interrupted simple stitches. All animals were sacrificed at six weeks. Gross and
      histologic evaluation of the choledochotomy site were performed. There were no
      statistical differences in parameters of comparison in the two groups. These
      parameters were pre- and post-treatment measurements of liver function tests,
      stenosis, and dehiscence. However, it must be noted that there was a 33% (4/12)
      incidence of dehiscence and death in the CO2 laser welded choledochorrhaphy. This
      result, although not statistically significant, is clinically significant. We
      conclude that the tensile strength of CO2 laser welded CBDs must be optimized and
      that these results are preliminary and still unreliable to recommend for clinical
      adaptability.

PMID- 8366741
TI  - In vitro decalcification of aortic valve leaflets with the Er:YSGG laser, Ho:YAG
      laser, and the Cavitron ultrasound surgical aspirator.
AB  - This study was designed to compare the efficacy of the erbium:yttrium-scandium
      gallium-garnet (Er:YSGG) laser and the holmium:yttrium-aluminum-garnet (Ho:YAG)
      lasers in debriding calcium from freshly explanted aortic valve leaflets and to
      compare the Er:YSGG laser with the Cavitron ultrasonic surgical aspirator (CUSA).
      Aortic valve leaflets were freshly explanted from patients undergoing aortic
      valve replacement for aortic stenosis. Initially, 4 leaflets each were debrided
      with the Er:YSGG and the Ho:YAG lasers to attempt removal of calcium deposits
      while preserving the underlying integrity of the leaflets and minimizing thermal
      damage. The Er:YSGG laser was more effective in doing so with less thermal and
      photoacoustic damage when compared with the Ho:YAG laser. Twelve more leaflets
      each were then debrided with the Er:YSGG laser and the CUSA. The Er:YSGG laser
      again proved less injurious to the underlying leaflet. The CUSA-treated leaflets
      demonstrated shattering and disruption of adjacent tissue as well as collagen
      fiber exposure. These changes were not seen with the Er:YSGG laser. Because of
      these properties, the Er:YSGG laser merits further evaluation as a tool for
      aortic valvuloplasty procedures in selected patients with senescent calcific
      aortic stenosis.

PMID- 8366743
TI  - Tumor specific response to photodynamic therapy.
AB  - The exact mechanism by which photodynamic therapy (PDT) causes tumor destruction
      has not been elucidated. Early reports indicated that PDT causes direct cellular
      effects probably mediated by unstable oxygen species, resulting in cellular
      oxidation and death. More recently, PDT effects on tumor blood flow have been
      implicated, and there are questions as to whether the PDT response is specific to
      tumor tissue. Rats were implanted with a window chamber containing either a
      mammary adenocarcinoma or a piece of inert surgical sponge. After growth of the
      tumor was ascertained, all rats were given 5 mg/kg Photofrin intraperitoneally,
      and then were irradiated with 630 nm light 24 hours post-injection. Caliper
      thickness and reflectance measurements were performed before and after
      irradiation; all animals were sacrificed 72 hours post-PDT and the chambers
      submitted for histologic analysis. Animals implanted with tumors demonstrated
      marked edema of the chamber with an associated decrease in reflectance. No edema
      response was noted in the chambers containing inert sponge, or in any controls.
      Nonselective PDT effects (characterized by a marked foreign body response) in
      chambers containing sponge was not seen. Histologic analysis of treated specimens
      corroborate the above data.

PMID- 8366745
TI  - Slit lamp laser Doppler interferometer.
AB  - A slit lamp laser interferometer is described for clinical in vivo eye length
      measurements. The basic components are a laser Doppler interferometer, a slit
      lamp attachment, and a commercial slit lamp. First measurements of the axial
      length of the eye yielded a standard deviation of 0.04 mm and less.

PMID- 8366744
TI  - Effects of pulse width on erbium:YAG laser photothermal trabecular ablation
      (LTA).
AB  - An erbium (Er):YAG laser can remove trabecular meshwork (TM) by photothermal
      ablation with minimal contiguous thermal damage. A variable pulse width Er:YAG
      laser was used to investigate the effect of varying pulse width on ablation of
      human TM. Trabecular photothermal ablation was performed on tissue obtained from
      eye bank eyes at pulse widths of 50, 150, and 250 microseconds, with energy held
      constant at 4 mJ. At this energy, a single laser pulse was sufficient for full
      thickness ablation of TM. Laser energy was delivered through a 200-microns
      diameter optical fiber held in apposition to the tissue sample, which was
      immersed in physiologic saline. High-speed photography of the resultant steam
      bubbles also was performed. Light microscopy and scanning electron microscopy of
      TM ablated at 50 microseconds revealed the greatest variability in size (0-140
      microns) of the full-thickness ablated areas and demonstrated blast effects,
      tissue shredding and < or = 10 microns thermal damage. At 150 microseconds, the
      full-thickness ablated areas were more consistent size (115-120 microns), showed
      no blast effects and 10 to 20 microns thermal damage. At 250 microseconds, the
      largest ablations were found (180-220 microns) and showed no blast damage;
      however, a significant amount of thermal damage (< or = 50 microns) was evident.
      The steam bubbles produced by the laser energy were largest at 50 microseconds
      and did not begin to collapse until well over twice the original pulse interval.
      At 150 and 250 microseconds, the steam bubbles were successively smaller and
      dissipated at the end of the laser pulse.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366746
TI  - Changes in oxidative metabolism of murine spleen following laser and
      superluminous diode (660-950 nm) irradiation: effects of cellular composition and
      radiation parameters.
AB  - Chemiluminescence (CL) of splenocytes of A/Sn mice was recorded after irradiation
      of the cells with various individual laser an superluminous diode probes at
      wavelengths from 660 to 950 nm (pulse repetition rates varying from 4 to 5,000
      Hz) and at various doses. Laser radiation was found to increase or suppress the
      spontaneous CL of splenocytes suspension, the amplitude and the sign of the
      effect depending on the cellular composition of the samples. Direct correlations
      between the effect of laser radiation (per cent in changes of CL when irradiated
      at 820 nm, 1.1 x 10(3) J/m2, 292 Hz) and per cent of plasmacytes (r = 0.743, P <
      0.001), neutrophils (r = 0.650, P < 0.001) as well as myelocytes and
      metamyelocytes (r = 0.505, P < 0.01) were established. The correlation with per
      cent of lymphocytes (r = -0.590, P < 0.001) was found to be a reverse one.
      Dependence of the irradiation effects on dose, pulse repetition rate, and
      wavelength are presented.

PMID- 8366748
TI  - Studies of acoustical and shock waves in the pulsed laser ablation of biotissue.
AB  - Quantitative studies are conducted into the absolute pressure values of the
      acoustical and shock waves generated and propagating in a biotissue under pulsed
      (tau p = 50 ns) UV (lambda = 308 nm) laser irradiation (below and above the
      ablation threshold). Powerful (several hundreds of bars in pressure) high
      frequency (f approximately 10(7) Hz) acoustic compression and rarefaction pulses
      are found to be generated in the biotissue. The amplitudes and profiles of the
      acoustic pulses developing in atherosclerotic human aorta tissues and an aqueous
      CuCl2 solution under laser irradiation are investigated as a function of the
      laser pulse energy fluence. The results obtained point to the absence of the cold
      spallation of the objects of study by rarefaction waves. Based on experimental
      data, the rise rates, pressure gradients, and propagation velocities of shock
      waves in the biotissue are calculated. The experimental data are found to agree
      well with the theoretical estimates.

PMID- 8366747
TI  - Analgesic effect of Ga-Al-As diode laser irradiation on hyperalgesia in
      carrageenin-induced inflammation.
AB  - This study concerned the effect of Ga-Al-As diode laser irradiation (780 nm,
      continuous wave, 31.8 J/s/cm2, spot size od 0.2 mm, 3 minutes/dose) on
      hyperalgesia induced in the hind paw of rats by injecting carrageenin. The
      pressure-pain thresholds of hind paws were measured by the Randall-Selitto test
      for evaluation of hyperalgesia. Two doses of laser irradiation, given to the
      inflamed region immediately before and after the injection of carrageenin,
      partially (approximately 50%) inhibited the occurrence of hyperalgesia
      accompanied with a progression of inflammation. This analgesic effect was equal
      to that of indomethacin (4 mg/kg, i.o.). In another group, the hyperalgesia was
      removed almost completely for at least 24 hours by one dose of laser irradiation,
      which was given 3 hours after the carrageenin injection, whereas the edema was
      not inhibited. This analgesic effect, however, was partially (approximately 50%)
      antagonized with a dose of 10 mg/kg (i.p.) of naloxone and totally inhibited with
      30 mg/kg. These results suggest that low-power laser irradiation on inflamed
      regions of carrageenin-treated rats has a marked analgesic effect and that
      certain mechanisms that are not related to endogenous opioids are involved in a
      part of the mechanisms of the analgesic effects.

PMID- 8366749
TI  - [Gastroenterologic endoscopy--where does the future lie?].

PMID- 8366750
TI  - [Molecular biology: applications in hepato-gastroenterology].
AB  - Recombinant DNA technology is of increasing significance for the diagnosis,
      therapy and prevention of human diseases. The principle of recombinant DNA
      technology is illustrated and the clinical applications in hepatology and
      gastroenterology are discussed.

PMID- 8366752
TI  - [Echinococcosis--current status of diagnosis and therapy].
AB  - The most frequent parasitosis in Europe is the infection by Echinococcus spp.
      Echinococcus granulosus is identified worldwide, 60% of all human infection are
      found in the liver, where cysts (hydatides) are built. Echinococcus alveolaris is
      found in the northern hemisphere, endemic in Middle Europe in Southern Germany,
      Austria and parts of Switzerland. 98% of all human infection are localized in the
      liver, where infiltrative growth destroying the tissue is found. Diagnosis is
      based on serological techniques, ultrasound and CT-scanning. Surgery is the only
      curative therapy by resection of cystic areas followed by chemotherapy with
      Mebendazole. In studies Albendazole has shown better results. CT-guided
      percutaneous drainage followed by instillation of hypertonic saline is performed
      in case of non-resectable hydatidosis.

PMID- 8366751
TI  - [Gastroenterologic-endoscopic studies in ambulatory practice. Spectrum of
      applications, trends, quality and economic aspects].
AB  - A review on spectrum, frequency and complication rate of gastroenterological
      endoscopy in ambulant practice is given based on data of the National Association
      of Public Health Insurance Physicians of Germany. The following important aspects
      are mentioned: 1. Endoscopy has surpassed radiology in diagnostic examinations
      for gastric and colonic diseases. 2. Gastroscopy is more commonly carried out by
      physicians, coloscopy by gastroenterologists or specialists. Hospital doctors
      don't contribute significantly to ambulant endoscopic examinations of stomach and
      colon. 3. Endoscopic examinations of the pancreas, biliary tree, laparoscopy and
      other techniques play an insignificant role in ambulant practice. 4. The
      complication rate of ambulant gastroenterological endoscopy is very low. There
      have been only a few malpractice cases due to complications of
      gastroenterological endoscopic examinations. 5. The quality of coloscopy is not
      yet satisfactory as measured by the relative proportions of partial and total
      coloscopy. 6. In the past only limited attention was given to aspects of quality
      assurance and quality control in endoscopy in ambulant practice. This should be
      changed in the future. 7. The fees for gastroscopy and coloscopy allowed by the
      public insurance companies don't cover the expenses and are inadequate. As a
      result, a negative impact on the quality of medical care can be expected.

PMID- 8366753
TI  - [Ergotamine-induced rectal stenosis in a patient with long-term migraine].
AB  - A 36 year old woman was admitted to our hospital for treatment of a high-grade
      rectal stenosis of unknown origin. She had a history of migraine going back 10
      years. On intensive questioning she admitted using up to 5 ergotamine-containing
      suppositories a day. On the basis of history and clinical investigations the
      rectal stenosis must be connected with the abuse of ergotamine-containing
      suppositories. This case demonstrates that patients with an unexplained rectal
      syndrome should be asked for analgetics-containing suppositories specifically.
      Only discontinuation of treatment in time can preserve the patient from
      development of a rectal stenosis. In case of a rectal stenosis surgical treatment
      can be avoided by means of endoscopic controlled dilatation.

PMID- 8366754
TI  - [Extracorporeal shock wave lithotripsy of an impacted gallstone in cholecysto
      antral fistula].
AB  - The endoscopic examination of a patient with gastrointestinal bleeding
      unexpectedly revealed a cholecysto-antral fistula with incipient penetration of a
      gallstone into the stomach (and presumably intermittent bleeding from the fistula
      rim). As endoscopic extraction was not possible and the stone impacted in the
      fistula was visible in the ultrasound scan extracorporeal shock-wave lithotripsy
      was carried out. An electrohydraulic lithotripter was used and 1,913 shock waves
      were applied at a maximum of 26,000 volts. In a single treatment session the
      stone was disintegrated completely into fragments small enough for spontaneous
      elimination. No sedative or analgesic medication was required. There was no
      evidence of any complications or side-effects following the ESWL.

PMID- 8366755
TI  - [11C](+)McN5652 as a radiotracer for imaging serotonin uptake sites with PET.
AB  - The in vivo behavior of the stereoisomers of [11C]McN5652, a highly potent
      serotonin (5-HT) uptake blocker, was determined to evaluate their utility as
      radiotracers for imaging 5-HT uptake sites by positron emission tomography (PET).
      After intravenous injection into mice, [11C](+)McN5652 showed markedly higher
      uptake and longer retention in regions with high density of 5-HT uptake sites
      than the [11C]-labeled racemic mixture, while [11C](-)McN5652 washed out rapidly.
      With the [11C](+)-enantiomer, the ratio between hypothalamus and cerebellum
      reached 6 at 90 minutes. The binding of [11C](+)McN5652 was inhibited by 45-73%
      by pre-injection of 5 mg/kg of paroxetine, a selective 5-HT uptake blocker, in
      all regions examined except cerebellum where no significant effect of the drug
      was observed. [11C](-)McN5652 showed no specific binding in any of the regions.
      The [11C]-labeled cis isomer, [11C]McN5655, revealed surprisingly low brain
      penetration and showed no significantly higher uptake in regions of interest than
      cerebellum. These results suggest that [11C](+)McN5652 is a promising candidate
      as a PET radiotracer for studying 5-HT uptake sites in vivo.

PMID- 8366756
TI  - Effect of OP-41483.alpha-CD, a prostacyclin analog, on a clamp-induced
      endothelial injury in rats.
AB  - We studied the effect of OP-41483.alpha-CD, a stable prostacyclin analog, on
      clamp-induced endothelial injury in rats. The injury was assessed by vascular
      Evans blue leakage and using a scanning electron microscope. OP-41483.alpha-CD
      significantly reduced the Evans blue leakage at doses of 30 and 100 ng/kg/min.
      PGE1.CD was also found to show an equipotent inhibitory action on the dye
      leakage. From scanning electron microscopic observations, a moderate degree of
      intimal defects, microvillous projections and platelet adhesions at the luminal
      surface were seen in the specimens from OP-41483.alpha-CD (30 and 100 ng/kg/min)
      treated rats. Furthermore, OP-41483.alpha-CD, PGE1.CD and Dibutyryl cyclic AMP
      (DbcAMP) were found to accelerate a proliferation of cultured bovine endothelial
      cells in a dose-dependent manner in vitro. Taken together, these data indicate
      that the endothelial regenerative effect of OP-41483.alpha-CD could contribute to
      healing of clamp-induced endothelial injury and it may be an important
      therapeutic drug to protect vascular intimal injury.

PMID- 8366757
TI  - Conjugation of phenylacetic acid and m- and p-hydroxyphenylacetic acids in the
      rat striatum.
AB  - Two factors that might regulate the levels of the trace acids, phenylacetic acid
      (PAA), m-hydroxyphenylacetic acid (mHPAA) and p-hydroxyphenylacetic acid (pHPAA)
      in the rat striatum were investigated: first, formation of conjugates of these
      acids and second, transport out of the brain by a probenecid-sensitive system.
      The presence of conjugates of these acids was investigated by subjecting
      homogenates of rat striatum to hydrolysis. The concentrations of PAA were
      increased ten-fold by hydrolysis, pHPAA increased two-fold, and mHPAA was
      unaffected. These findings coupled with the failure of parglyline to decrease
      free or total PAA levels suggest that conjugation of PAA is an important factor
      regulating free PAA levels. The transport inhibitor, probenecid, increased the
      concentrations of free mHPAA, free pHPAA and the total concentrations of all
      three acids indicating that all three trace acids can be removed from the rat
      brain by a transport system.

PMID- 8366758
TI  - Possible transsynaptic cholinergic neuromodulation by ATP released from ileal
      longitudinal muscles of guinea pigs.
AB  - The effects of alpha, beta-methylene ATP (alpha, beta-mATP) and beta, gamma
      methylene ATP (beta, gamma-mATP) on endogenous acetylcholine (ACh) release evoked
      by electrical nerve stimulation were evaluated in guinea-pig ileal longitudinal
      muscles. Release of ACh was measured with an HPLC-electrochemical detector system
      and release of ATP by luciferin-luciferase assay. Electrically evoked endogenous
      ACh release was reduced by both alpha, beta-mATP and beta, gamma-mATP at
      concentrations of 3 and 30 microM. The inhibitory effect of alpha, beta-mATP (30
      microM) on ACh release was not detectable in the presence of theophylline (100
      microM), a P1-purinoceptor antagonist, that itself enhanced ATP release. When
      exogenous ATP (0.1 microM) was added to the bath in which the ileal segment was
      suspended, it was rapidly metabolized, presumably by ecto-ATPase, and disappeared
      from the medium within 15 min. At 30 microM, alpha, beta-mATP induced ATP release
      in a suramin-sensitive but Ca(2+)- and atropine-insensitive manner, suggesting P2
      receptor-mediated release of ATP from the smooth muscle. We conclude from these
      findings that alpha, beta-mATP and, probably, also beta, gamma-mATP, do not
      reduce ACh release by direct stimulation of presynaptic P1-purinoceptors, and
      that endogenous ATP released postjunctionally by these ATP analogs is decomposed
      metabolically to adenosine in the synapse and this adenosine triggers P1
      purinoceptor sensitive neuromodulation of cholinergic transmission.

PMID- 8366760
TI  - Pharmacological characterization of Abbott-81282, a novel, non-peptide
      angiotensin-II antagonist selective for type-1 receptors.
AB  - Abbott-81282 (A-81282) has been identified among a series of related compounds as
      being a highly potent and selective antagonist of angiotensin receptors. At AT1
      receptors of the rabbit aorta, A-81282 exhibited a pA2 of 9.64 (+/- 0.33) vs.
      angiotensin-II, and demonstrated characteristics consistent with competitive
      antagonism of this receptor. These results were supported in radioligand binding
      assays in which A-81282 inhibited the binding of [125I]-Sar-Il8-Angiotensin-II to
      rat liver membranes with a pKI of 8.505 (+/- 0.102). Selectivity of this agent
      for AT1 receptors was validated by its lack of activity at other receptor sites,
      such as alpha 1 receptors of isolated rabbit aorta. Moreover, A-81282 lacked
      affinity for AT2 receptors of bovine cerebellar membranes or for alpha or beta
      adrenergic receptor sites in radioligand binding assays. A-81282 lowered blood
      pressure significantly in vivo in renal artery-ligated rats at doses of 1 mg/kg
      i.v. or 5 mg/kg p.o. The compound was slowly and moderately absorbed from the
      duodenum of anesthetized rats and demonstrated low first-pass metabolism in the
      rat liver. Because of its selectivity and potency for antagonizing AT1 receptors,
      and its activity in lowering blood pressure in experimental animals, A-81282 has
      the potential to be a useful antihypertensive agent in man.

PMID- 8366759
TI  - Paroxetine binding in the blood platelets of post-traumatic stress disorder
      patients.
AB  - Platelet serotonin (5-HT) uptake, as determined by 3H-paroxetine (PA) binding,
      was studied in 20 Post-traumatic Stress Disorder (PTSD) patients and 20 normal
      controls. Kd (an inverse measure of affinity of 3H-PA binding to uptake sites)
      and Bmax (maximum number of 3H-PA binding sites) of 3H-PA binding were
      significantly decreased in PTSD patients as compared to normal controls. However,
      there was no difference in Kd or Bmax between PTSD patients with and without a
      diagnosis of major depression. The Bmax of 3H-PA binding was negatively
      correlated with state dependent anxiety score whereas Kd was positively
      correlated with the Mississippi Scale for Combat-Related PTSD score. The role of
      serotonergic processes in the psychobiology of PTSD is discussed.

PMID- 8366761
TI  - ODC activity and polyamine levels in isolated human colonocytes.
AB  - Ornithine decarboxylase (ODC) is the first and often rate-limiting enzyme in
      polyamine biosynthesis. ODC and polyamines (putrescine, spermidine, spermine, and
      cadaverine) have an essential role in cell proliferation. In this study, we
      investigated ODC activity and the polyamine levels of normal human colonocytes
      isolated from the upper and lower crypt regions. We found no significant
      differences in ODC activity between upper and lower crypt regions (mean +/- SEM:
      105 +/- 60 and 103 +/- 52 pmol CO2/mg protein/hr, respectively). This result was
      further substantiated by ODC immunoreactive antibody staining technique. Levels
      of polyamines (putrescine, spermidine, spermine, and cadaverine) were similar in
      the upper and lower crypt regions (mean +/- SEM; upper/lower: 79 +/- 29/79 +/-
      18; 189 +/- 116/ 137 +/- 38; 174 +/- 58/204 +/- 35; and 52 +/- 10/51 +/- 10
      nmol/mg protein, respectively). Acetyl-polyamines (acetyl-putrescine, acetyl
      spermidine, and acetyl-spermine) levels in human colonocytes showed no
      significant differences between upper and lower crypt regions (mean +/- SEM; U/L:
      368 +/- 109/408 +/- 89, 63 +/- 22/51 +/- 12, and 39 +/- 12/41 +/- 14 nmol/mg
      protein, respectively). Our results suggest that in isolated normal human
      colonocytes, ODC activity and polyamine levels are similar in the upper and the
      lower crypt regions.

PMID- 8366762
TI  - Glibenclamide partly reverses monesin inhibition of insulin secretion, in vivo.
AB  - Glibenclamide, a second generation sulfonylurea, is an oral hypoglycemic drug. It
      seems to act mainly on the ATP-driven K(+)- channels of the beta-cells of
      pancreas determining insulin secretion. Because monensin, a Na+/H+ antiport, is
      able when administered to rats in vivo to inhibit insulin secretion, the action
      of glibenclamide is studied on glycemia and insulinemia to verify if it can
      antagonize the action of monensin. The results show that glibenclamide is able to
      partly reverse ionophore induced hyperglycemia and the inhibition of insulin
      secretion. These results might be interpreted as if glibenclamide only reverses
      the ATP-driven K(+)- channel dependent insulin secretion. Moreover the antagonist
      action of glibenclamide is slightly delayed when both drugs are administered
      together. The role of Na+/H+ antiport in basal insulin secretion is discussed.

PMID- 8366763
TI  - Implication of ATP released from atrial, but not papillary, muscle segments of
      guinea pig by isoproterenol and forskolin.
AB  - Effects of isoproterenol and forskolin, which increases intracellular cyclic AMP,
      on contraction and ATP release in atrial and papillary muscles of guinea pig were
      evaluated. In the electrically driven-left atrial muscle segments, isoproterenol
      and forskolin at 0.1 microM produced an ATP release coupled with a positive
      inotropic effect, the values of net ATP release at 5 min after these drugs being
      5.20 +/- 0.59 and 5.37 +/- 0.55 nmoles/g wet weight, respectively. The forskolin
      evoked-ATP release was unaffected by prazosin plus propranolol or by
      guanethidine, implying that ATP is released from non-neuronal origin. In
      contrast, in papillary muscle segments, the test cardiotonics did not elicit any
      ATP release despite producing contractile response similar to that in atrial
      preparations. However, there is no difference in ectoATPase activities of both
      tissues. Adenosine added exogenously inhibited electrically evoked-contraction of
      the atrium, but not that of the papillary, although inhibitions by verapamil of
      the contractions were approximately equal in these preparations. These findings
      suggest that cardiotonics such as isoproterenol produce a liberation of ATP from
      auricle muscles, but not from ventricle muscles, and that the liberated ATP may
      mainly be catabolized to adenosine by ectoenzymes and the resultant nucleoside
      may serve as a functional modulator through stimulation of pre or postsynaptic A1
      receptors.

PMID- 8366764
TI  - Suppression of plasma endothelin-1 level by alpha-human atrial natriuretic
      peptide and angiotensin converting enzyme inhibition in normal men.
AB  - The effect of synthetic alpha-human atrial natriuretic peptide (alpha-hANP) on
      plasma endothelin-1 (ET-1) level was examined in 6 healthy subjects. Intravenous
      infusion of alpha-ANP (0.1 micrograms/kg/min) resulted in significant falls in
      plasma renin activity and aldosterone, but without effect on ET-1 level. An
      angiotensin converting enzyme inhibitor, captopril, increased plasma renin
      activity and decreased aldosterone, respectively. However, plasma ET-1 levels
      were not modified by captopril. In cases with alpha-hANP infusion after captopril
      (25 mg, p.o.,), the renin-angiotensin-aldosterone system was further inhibited
      compared with the first group, and ET-1 at 60 min was significantly suppressed
      from the baseline. These data suggest that alpha-hANP when combined with
      captopril brings about the suppression of plasma ET-1 concentrations in men.

PMID- 8366765
TI  - Inhibitory action of azelastine on cytokine production from human peripheral
      blood leukocytes in vitro.
AB  - Effects of azelastine (AZ) on human peripheral blood leukocytes (PBL) in culture
      were examined. Addition of 10.0 micrograms/ml of AZ resulted in a marked
      inhibition of PBL blastic activity, but lower concentrations (1.0 and 0.5
      microgram/ml) had no demonstrable suppressive effects on the activation.
      Interleukin (IL)-2, IL-3 and IL-4 production from PBL in response to Concanavalin
      A stimulation was also strongly suppressed when the cells were cultured in the
      presence of AZ. This suppression was observed even when lower concentrations (1.0
      and 0.5 microgram/ml) of AZ were added to cell cultures.

PMID- 8366766
TI  - Study on the suppressive effect of iodine-enriched egg on LT-C4 production in
      arachidonic acid-induced ear inflammation.
AB  - The anti-inflammatory mechanism of iodine-enriched egg was investigated in mice
      by means of arachidonic acid-induced ear inflammation. The lipid fraction of
      iodine-enriched egg was capable of suppressing the increase in ear weight induced
      by arachidonic acid in a dose-dependent manner. The lipid fraction was further
      separated into neutral and polar lipid fractions. Of these two fractions, only
      the neutral lipid fraction was capable of suppressing LT-C4 production in
      arachidonic acid inflammation. Neither the neutral nor polar lipid fractions of
      ordinary egg, however, showed any anti-inflammatory effect. These results suggest
      that the anti-inflammatory activity of iodine-enriched egg is present in the
      neutral lipid fraction, and its mechanism is assumed to be inhibition of LT-C4
      production.

PMID- 8366767
TI  - Morin hydrate is a plant-derived and antioxidant-based hepatoprotector.
AB  - Morin hydrate, or simply morin, is shown here to be an effective hepatoprotector
      in vitro and in vivo. Between 0.25-2.0 mM, morin prolongs survival of rat
      hepatocytes against free radical damage triggered by xanthine oxidase
      hypoxanthine, and substantially better than equimolar concentrations of Trolox (a
      vitamin E analogue), mannitol, and ascorbate. In a rat model of 80 min ischemia
      24 h reperfusion in the liver, infusion of morin at 2.5, 5.0 and 10 mumol/Kg body
      weight before reperfusion reduces liver necrosis in the placebo control by 51.48
      +/- 9.94%, 66.55 +/- 2.18%, and 79.37 +/- 11.03%, respectively, for n = 6 per
      group. Mechanistically, morin acts in a two-pronged manner: as a preventive
      antioxidant by partially inhibiting xanthine oxidase and partly as a curative
      antioxidant by scavenging oxyradicals. The role of morin as an effective free
      radical scavenger is further evidenced by its ability to protect human red cell
      membrane from peroxidative attack better than ascorbate, Trolox, and mannitol.
      Collectively, our data demonstrate that morin is an effective hepatoprotector,
      both in cultured cells and in hepatic ischemia-reperfusion.

PMID- 8366768
TI  - Lipid fluidity modulates platelet aggregation and agglutination in vitro.
AB  - To determine the effect of altered membrane fluidity on platelet
      aggregation/agglutination, fresh, washed human platelets were treated with A2C, a
      cyclopropyl fatty acid ester which is known to enhance mobility of intrinsic
      membrane bilayer constituents and increase membrane fluidity. Fluorescence
      polarization studies demonstrated A2C incubation time- and concentration
      dependent increases in platelet membrane fluidity (decreased fluorescence
      anisotropy). Preincubation with A2C was associated with diminished collagen,
      thrombin and ristocetin-induced platelet aggregation/agglutination.
      Aggregation/agglutination was diminished by 93 +/- 5% for collagen (0.2 mg/ml),
      53 +/- 3% for thrombin (1.0 U/ml) and 85 +/- 9% for ristocetin (1.1 mg/ml). These
      data suggest that membrane fluidity is involved in the regulation of platelet
      function.

PMID- 8366769
TI  - Activin A: its effects on rat pancreatic islets and the mechanism of action
      involved.
AB  - Activin A now used as a recombinant product was first isolated from ovarian
      fluid. Its effects on insulin and glucagon secretion, 45Ca2+ net uptake, 86Rb+
      efflux and inositol-trisphosphate (Ins-1,4,5-P3) content were investigated in rat
      pancreatic islets. Activin A increased insulin secretion at either 3.0, 8.3 or
      16.7 mM glucose. It decreased glucagon secretion at 3.0, had no effect at 8.3 and
      increased glucagon secretion at 16.7 mM glucose. The effect on insulin release
      was concentration dependent; effects were obvious at 1 and 10 nM activin A. The
      effect on insulin release was paralleled by an effect on 45Ca2+ net uptake. 10 nM
      activin A were effective in elevating Ins-1,4,5-P3 content at either glucose
      concentration used. 86Rb+ efflux as an indicator for closing K+ channels which
      leads to a depolarization of the beta-cell membrane and which is a prerequisite
      for Ca++ influx was inhibited by activin A at a low glucose concentration (3.0
      mM). The data indicate that the new peptide activin A elevates insulin release at
      various glucose concentrations: at low and high glucose concentrations 45Ca2+
      uptake is involved. At low glucose concentrations inhibition of 86Rb+ efflux is a
      prerequisite sufficient to lead to a depolarization and subsequent Ca++ uptake;
      accumulation of Ins-1,4,5-P3 probably helps mediating the insulinotropic effect
      by additionally elevating intracellular Ca++.

PMID- 8366770
TI  - Melatonin effect on serotonin uptake and release in rat platelets: diurnal
      variation in responsiveness.
AB  - The present study was conducted to examine whether melatonin impairs serotonin
      (5HT) release and uptake in rat platelets. Exposure of platelet-rich plasma
      samples (PRP) to melatonin induced a concentration-dependent inhibition of 5HT
      uptake and the value of IC50 was 1.3 x 10(-3) M. We have also investigated the
      melatonin effect on the kinetic parameters of platelet 5HT uptake. Transport
      capacity was inhibited (Vmax; CONTROL: 2.28 +/- 0.52, Melatonin: 0.74 +/- 0.13
      pmol/10(7) platelet.min; p < 0.05) while the affinity of 5HT for its uptake
      carriers remained unaltered, thus indicating a non-competitive effect. Studies
      carried out to determine the existence of a differential morning (8:00h)-evening
      (21:00h) melatonin effect showed a higher platelet uptake sensitivity at 8:00h
      (two-way ANOVA, p < 0.001). Spontaneous 5HT release was not impared by the
      hormone and no daily variation in sensitivity was detected. The possible
      mechanism of action of melatonin on platelet transport is discussed, and the
      results support the suitability of the platelet model for studying sensitivity
      changes in target cells to the hormone.

PMID- 8366771
TI  - Uptake of docosahexaenoic acid by microvessels from developing rat brain.
AB  - Uptake of polyunsaturated fatty acids by the rat brain occurs mainly during the
      three weeks before weaning. Docosahexaenoic acid [22:6], the predominant
      polyunsaturated fatty acid in the adult brain, appears to be preferentially taken
      up from the circulation by both the adult and developing rat brain. To test the
      hypothesis that this preferential incorporation was mediated by the cerebral
      microvasculature, we compared the incorporation of 22:6 to a saturated fatty
      acid, palmitic acid [16:0], in freshly isolated rat brain microvessels from the
      pooled brains of entire litters of two-week-old rats (n = 8 litters). For each
      litter duplicate incubations with 2 microCi of [1-14C]22:6 or [1-14C]16:0 were
      performed in 60% autologous rat serum for 2 hr at 37 degrees C. [3H]Sucrose was
      included in each incubation, allowing correction for non-specific uptake and
      trapping. An average of 2.7 +/- 2.0% (SD) of the radioactivity from 16:0 was
      found in the microvessels after 2 hr, vs 0.9 +/- 0.6% for 22:6. This yielded a
      three-fold enrichment of 16:0 over 22:6 (P = 0.02, paired t-test). There was
      preferential incorporation of 22:6 into phosphatidylethanolamine and of 16:0 into
      phosphatidylcholine, although most of the label from either substrate remained as
      fatty acid after the 2 hr incubation. These results do not indicate that brain
      capillaries mediate the preferential incorporation of polyunsaturated fatty acids
      into brain tissue that was seen in intact young rats.

PMID- 8366772
TI  - Reduced incidence of stress ulcer in germ-free Sprague Dawley rats.
AB  - Recent findings with respect to the role of spiral gram-negative bacteria in
      peptic ulcer disease have stimulated interest in discerning the role of these
      agents in stress ulcer disease. We tested the hypothesis that a standard
      restraint-cold ulcerogenic procedure would fail to produce ulcers in axenic rats.
      Axenic, as well as normal Sprague Dawley rats, were exposed to a cold-restraint
      procedure. The germ-free condition was maintained throughout the study in the
      axenic rats. Axenic rats had significantly fewer ulcers as compared to normal
      rats exposed to the standard cold-restraint procedure, as well as handling
      control rats. The data represent the first report suggesting a microbiologic
      component in the development of stress ulcer using the rat model.

PMID- 8366773
TI  - Interactive dietary interviewing for patients?

PMID- 8366774
TI  - Telematics in health care: trends in the European community.

PMID- 8366775
TI  - An interactive dietary interview for hospital employees.

PMID- 8366776
TI  - The tenth annual directory of medical hardware and software companies.

PMID- 8366777
TI  - ShrinkRapt: a database manager for the Macintosh.
AB  - The bad news about ShrinkRapt is that its clinical potential remains, mostly,
      potential. The good news is that ShrinkRapt works. It concentrates on the
      fundamentals, stimulates thinking, and appears to be backed up by a creative and
      dedicated company. It is versatile enough to fit many practice styles and volumes
      of record keeping. A solo practitioner with a part-time psychotherapy practice
      and a Macintosh in the office can enter data at the end of the day or the end of
      a session, typing up patients' progress notes while they are still fresh in
      memory and keeping abreast of session data and documentation requirements. At the
      end of the month, a few keystrokes generate bills and claims forms.

PMID- 8366778
TI  - Fluoridation: a lawyer looks at the issues.

PMID- 8366779
TI  - Police may underuse Section 136.
AB  - A one-year prospective study comparing Section 136 patients (39) and the severe
      Section 2 or 4 patients (29) of the Mental Health Act 1983 in a hospital with
      inner London catchment areas. The assessments were clinical, nurses' ratings and
      socio-demographic. The results showed that clinical and nursing ratings did not
      differentiate the two groups. Most social/demographic data showed similar trends
      with both groups being disadvantaged but Section 136 patients slightly more so.
      The differences were smaller than anticipated, suggesting a recent shift of
      patients admitted under Section 2 or 4 towards a more socially disadvantaged
      position. In conclusion, police did not overuse Section 136. Our comparison
      suggests: (a) police may underuse Section 136, and (b) Section 136 acts as a
      valuable 'back-up' for those patients who would otherwise fail to benefit from
      the Mental Health Act.

PMID- 8366780
TI  - Viewing human remains following disaster: helpful or harmful?
AB  - Seventy-four bereaved of the Zeebrugge Disaster completed symptom measures some
      30 months following the tragedy. The group was divided into those who viewed or
      did not view the body and according to time of recovery, i.e. the first night,
      the following weeks, at the time of righting of the ship, and subsequently. For
      the two main groups, where body recovery was made on the first night or on the
      righting of the ship, intrusive and avoidant symptomatology were lower in those
      who viewed, but general psychological symptoms and measures of bereavement were
      not affected. The implications of the findings are discussed in relation to post
      disaster management.

PMID- 8366781
TI  - Medical examination of children thought to have been sexually abused.

PMID- 8366782
TI  - Sex offenders--cure or management?
AB  - A variety of biological, psychoanalytical and behavioural treatment strategies
      have been employed to treat sex offenders. Whilst these may produce short-term
      benefits, their efficacy in reducing long-term recidivism is uncertain. It is
      possible that treatment, as generally understood, is too ambitious an aim for
      this group of people and better results could be expected by employing a
      management strategy that includes treatment as well as life-long vigilant
      supervision. This can only be achieved if psychiatric services, which are used in
      continuing care, get involved in the management of sex offenders.

PMID- 8366783
TI  - Cellular changes and time since death.
AB  - Based on a hypothesis that post-mortem cellular (chiefly nuclear) changes in the
      white blood cells could reliably be correlated with the time interval since
      death, (ti), serial observations were made on the counts (total, differential)
      and light-microscopically observable 'degenerations' of white blood cells
      obtained from 30 non-refrigerated cadavers (experimental group) and similar cells
      obtained from 200 hospital patients (control group). While neutrophils
      degenerated rapidly, lymphocytes did so slowly; the eosinophils and monocytes
      degenerated at rates between these extremes. In cadaveric blood total counts of
      identifiable leucocytes on average dropped to zero by 84 hours, identifiable
      eosinophils and monocytes were first to 'disappear' (by 60 hours), followed by
      neutrophils (by 66 hours), and finally lymphocytes: identifiable lymphocytes
      disappeared completely at or around 84 hours from the time of death. This
      'differential degeneration' was surprising but useful. Based on the use of all
      four characteristics--total and differential white cell counts, differential
      degeneration and morphology of cells--a method for a reasonably exact estimation
      of ti is presented. The method is appropriate for ti up to 84 hrs (3 1/2 days).
      Zero white cell counts (total, differential) and bizarre morphology
      (unidentifiable white blood cells) indicate a ti > 84 hrs. Avenues for further
      research are indicated.

PMID- 8366784
TI  - Eating disorders and shoplifting--a study in two settings.
AB  - Two groups of female shoplifters drawn from a specialist out-patient service (52)
      and a Magistrates' Court (50) are compared for their level of eating disorder.
      Only one person knew of a previous diagnosis of eating disorder. Their levels of
      eating disorder and general psychopathology are high in both settings but
      particularly those referred for psychiatric assessment. Those with an eating
      disorder had significantly higher levels of psychiatric disturbance, depressive
      illness and hoarding behaviour.

PMID- 8366786
TI  - Mild head injury is not always mild; implications for damage litigation.
AB  - The traditional view that mild head injury involves an essentially reversible
      physiological process is examined and is found to be largely invalid. It is
      concluded that long-term impairment following mild head injury is fairly common
      and that the degree of impairment can be assessed clinically. Such an assessment
      involves a combination of objective electrophysiological and psychometric
      investigations as well as professional interpretation. With the use of this
      approach the possibility of malingering can be ruled out in most cases and
      significant impairment, when it exists, can be demonstrated beyond reasonable
      doubt.

PMID- 8366785
TI  - An increase in violence among psychiatric inpatients: real or apparent?
AB  - Levels of violence amongst psychiatric in-patients appear to be increasing.
      Possible reasons for this are explored and include methodological differences
      between studies, increased staff awareness and perception of violence, changes in
      staff attitude, changes in psychiatric practice in recent years, staffing levels
      and increased violence in society generally.

PMID- 8366787
TI  - Paralytic shellfish poisoning in Chile.

PMID- 8366788
TI  - Season, climate and suicide in Singapore.
AB  - In Singapore, an island city state in the tropics, climatic variables like
      sunlight, windspeed, temperature, rainfall and humidity are significantly
      correlated with subgroups of suicidal subjects such as Malays, young adults and
      youths. In the young age group (0-19 years) the relationship between
      meteorological factors and suicide appear to be greater than in the other two
      groups.

PMID- 8366789
TI  - Glue sniffing deaths in Singapore--volatile aromatic hydrocarbons in post-mortem
      blood by headspace gas chromatography.
AB  - Over a period from 1983 to 1991, of a total of 19,000 post-mortems, 33 were found
      to have at least one aromatic hydrocarbon (benzene, toluene or xylenes) in the
      blood. Of the 33 deceased, 22 had a history of toluene or petrol abuse while most
      of the remaining 11 were suspected to be glue sniffers through evidence found at
      the scene. This number, which represented 0.17 per cent of all the unnatural
      deaths, is considered small for a nation having a glue sniffing epidemic. The low
      death rate, as compared to 2.1 per cent through drug and chemical poisoning
      during the same period, is attributed to the timely intervention by the
      Government who outlawed glue sniffing and the effectiveness of compulsory
      rehabilitation. The male gender predominates (81.8 per cent) among the 33
      deceased with a mean age of 20.1 years (range 15 to 33). The mean age for the
      female gender is 17.7 years (range 16 to 20). The blood toluene levels were found
      to be in the range 0.2 to 92 micrograms per ml blood. The causes of death are:
      63.6 per cent due to falling or suicide by jumping; 18.2 per cent drowning; 6.1
      per cent hanging; 6.1 per cent homicide; and 6.1 per cent acute toluene
      poisoning. The high proportion of traumatic deaths are discussed. Headspace gas
      chromatography with a suitable GC column was used for the analysis. Calibration
      blood standards were prepared in situ or in bulk stabilized by 10 per cent (v/v)
      methanol to overcome the hydrophobic and volatile nature of the aromatic
      hydrocarbons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366790
TI  - Impaling-type head injury in a road traffic incident.
AB  - A fatal impaling-type head injury is described in a young man, sustained when he
      crashed his car while intoxicated, his head being transfixed by a broken wooden
      fence post. This shattered the facial bones and damaged the brain stem. Other
      published instances of impaling head injuries are discussed.

PMID- 8366791
TI  - Failure of a feeding jejunostomy.
AB  - A healthy 16-year-old female pedestrian was hit by a motor vehicle. She sustained
      multiple injuries including severe head injury. She was admitted to hospital
      unconscious. There was no recovery of neurological function. After a short period
      of time, a jejunostomy was performed for feeding purposes. The major clinical
      problem continued to be a feeding difficulty, with profuse diarrhoea occurring.
      At no stage was it possible to adequately nourish her. Hyperperistalsis was noted
      whilst in hospital. She died just over three months after admission. Autopsy
      revealed an emaciated body weighing only 25kg. An upper jejunostomy was still
      present containing a No. 20 French catheter. The bulb had threaded down the small
      bowel so that it was situated 25cm proximal to the ileocaecal valve. The small
      bowel was empty. The cause of death was given as malnutrition due to failure of
      function of a feeding jejunostomy due to small bowel hyperperistalsis in an
      individual with diffuse brain trauma. This complication of feeding jejunostomy
      causing death from malnutrition has not previously been described in the English
      literature.

PMID- 8366793
TI  - Forensic examinations in two cases of alleged dowry deaths.
AB  - Two cases of alleged dowry deaths are presented from Haryana State, India. In
      each case a young lady died after receiving burn injuries. Forensic examination
      unveiled the mysteries of both deaths and helped in apprehending and prosecuting
      the culprits. Case 1, allegedly a dowry death, proved to be an accidental burning
      and Case 2, stated to be a suicidal death, was proved to be homicidal.

PMID- 8366792
TI  - Ring fracture of the base of the skull and atlanto-occipital avulsion due to
      anteroflexion on motorcycle riders in a head-on collision accident.
AB  - This report concerns a head-on collision accident of a motorcycle at a very high
      speed (c. 80-100 Km/h) against a bonnet-type automobile, in which both the
      motorcyclist and pillion rider were injured at the base of the skull by violent
      anteroflexion of the head due to the force of inertia. A difference in their
      injuries was: the motorcyclist sustained a 'ring' fracture and the pillion rider
      an atlanto-occipital avulsion; dural tear. Anteroflexion without impact on the
      occiput such as described above seems to be a rare causal mechanism of the 'ring'
      fracture. In addition, the mode of action of the accelerating forces to the heads
      of the victims along with their physiques may explain the mechanism which caused
      the different injuries in this accident.

PMID- 8366794
TI  - The fatal paracetamol dosage--how low can you go?

PMID- 8366795
TI  - In vivo localized proton NMR spectroscopy of silicone.
AB  - 1H NMR localized spectroscopy (STEAM) can assess unambiguously the presence of
      free chemically unchanged silicone in animal tissue after injection of silicone
      oil. Although the signal-to-noise ratio obtained in 1H imaging is sufficient to
      detect the distribution of relatively large amounts of silicone in vivo, the
      specificity of silicone detection can be improved by using 1H localized
      spectroscopy techniques. The sensitivity of the STEAM experiments is sufficient
      to detect silicone at a concentration of 0.5% in a voxel of 27 mm3. Preliminary
      results from rats with silicone gel-filled implants show no detectable amounts of
      silicone in sites such as lymph nodes, the liver or the spleen, 3 or 6 months
      after implantation.

PMID- 8366796
TI  - In vivo proton spectroscopy of meningioma after preoperative embolization.
AB  - The time course of proton spectra of meningioma after embolization has been
      followed using a localized PRESS experiment with 135 ms of echo time. The most
      conspicuous findings were the observation of transient lactate signal within 24 h
      after blocking of the capillary bed. After that time large aliphatic signals from
      necrosis were observed, whereas other metabolite signals vanished. It was
      demonstrated, that tumor necrosis as shown by proton spectroscopy is complete
      within 4 days. This finding is significant for the timing of surgery, which can
      be performed after this period.

PMID- 8366797
TI  - Processing strategies for time-course data sets in functional MRI of the human
      brain.
AB  - Image processing strategies for functional magnetic resonance imaging (FMRI) data
      sets acquired using a gradient-recalled echo-planar imaging sequence are
      considered. The analysis is carried out using the mathematics of vector spaces.
      Data sets consisting of N sequential images of the same slice of brain tissue are
      analyzed in the time-domain and also, after Fourier transformation, in the
      frequency domain. A technique for thresholding is introduced that uses the shape
      of the response in a pixel compared with the shape of a reference waveform as the
      decision criterion. A method is presented to eliminate drifts in data that arise
      from subject movement. The methods are applied to experimental FMRI data from the
      motor-cortex and compared with more conventional image-subtraction methods.
      Several finger motion paradigms are considered in the context of the various
      image processing strategies. The most effective method for image processing
      involves thresholding by shape as characterized by the correlation coefficient of
      the data with respect to a reference waveform followed by formation of a cross
      correlation image. Emphasis is placed not only on image formation, but also on
      the use of signal processing techniques to characterize the temporal response of
      the brain to the paradigm.

PMID- 8366798
TI  - MRI and MRS studies on the time course of rat brain lesions and the effect of
      drug treatment: volume quantification and characterization of tissue
      heterogeneity by parameter selection.
AB  - Magnetic resonance imaging has been used to follow the time course of lesions
      induced in the rat brain as an animal model for characterization of the volume of
      the lesion. The dispersion in spin-spin relaxation has been used to characterize
      the nature of the brain lesion. Parameter selective estimation of T2,
      quantitative determination of the lesion size and volume selective in vivo proton
      spectroscopy have been employed for the purpose. The work has been carried out on
      rats which were subject to lesioning by ibotenic acid as a model for
      excitotoxicity and also on rats which received doses of ibotenic acid and
      subsequent doses of the NMDA antagonist drug MK 801 (dizocilpine). The time
      course of the progress of the lesions in untreated animals and the effect of
      neuroprotection by MK 801 was continuously monitored in all test animals.
      Further, a relatively new inhalation anesthetic agent, isoflurane, has been
      employed. A more logical and semiquantitative T2 bandwidth demarkation useful in
      distinguishing different degrees of lesioning from the onset and up to the
      'edema' stage through penumbra (mild lesion), medium degree lesion and severe
      lesion has been proposed.

PMID- 8366799
TI  - Stabilization of echo amplitudes in FSE sequences.
AB  - The classical CPMG sequence and its extension as an imaging sequence, fast spin
      echo (FSE, based on RARE), suffer from signal magnitude variations in the early
      echoes when the refocusing pulses are not set exactly to 180 degrees. It has been
      suggested that by varying the value of the nutation angle of each refocusing
      pulse the signal magnitude could be made constant. This article describes an
      algorithm permitting the generation of sequences of nutation angles yielding
      series of echoes with constant signal magnitudes. This result is then used to
      design selective pulses for the FSE imaging technique.

PMID- 8366800
TI  - Improved myocardial tagging contrast.
AB  - Myocardial tagging is a new noninvasive MRI method that allows the study of
      myocardial motion with high accuracy. However, with conventional tagging
      techniques tagging contrast is impaired at later heart phases due to longitudinal
      relaxation. An improved method, called Complementary SPAtial Modulation of
      Magnetization (CSPAMM), which separates the component of the magnetization with
      the tagging information from the relaxed component by subtraction of two
      measurements with first a positive and then a negative tagging grid, is
      presented. This technique improves the grid contrast and greatly facilitates the
      automatic evaluation of the myocardial motion. Thus the motion assessment of the
      entire heart cycle becomes possible. The improvements are documented by numerical
      simulations and by experiments on phantoms and on human volunteers.

PMID- 8366801
TI  - Diffusion-weighted MR microscopy with fast spin-echo.
AB  - A diffusion-weighted fast spin-echo (FSE) imaging sequence for high-field MR
      microscopy was developed and experimentally validated in a phantom and in a live
      rat. Pulsed diffusion gradients were executed before and after the initial 180
      degrees pulse in the FSE pulse train. This produced diffusion-related reductions
      in image signal intensity corresponding to gradient ("b") factors between 1.80
      and 1352 s/mm2. The degree of diffusion weighting was demonstrated to be
      independent of echo train length for experiments using trains up to 16 echoes
      long. Quantitative measurements on a phantom and on a live rat produced diffusion
      coefficients consistent with literature values. Importantly, the eight- to 16
      fold increase in imaging efficiency with FSE was not accompanied by a significant
      loss of spatial resolution or contrast. This permits acquisition of in vivo three
      dimensional data in time periods that are appropriate for evolving biological
      processes. The combination of accurate diffusion weighting and high spatial
      resolution provided by FSE makes the technique particularly useful for MR
      microscopy.

PMID- 8366802
TI  - Spatially resolved and localized real-time velocity distribution.
AB  - A technique is presented for collecting the spin velocity distribution as a
      function of position and time. It uses a multidimensional excitation pulse to
      select a cylinder, giving localization in two dimensions. Resolution in the third
      spatial dimension is achieved in the readout. During readout, an oscillating
      gradient encodes the acquired data in both one spatial dimension (x) and one
      velocity dimension (v). Two acquisitions (42 ms each) are needed to get a
      complete coverage of kx--kv space, which makes this technique real-time. The data
      is interpolated from the nonuniformly sampled kx--kv space to a Cartesian frame
      with a gridding scheme to take advantage of the Fast Fourier Transform. The
      technique was successfully applied to phantoms and normal volunteers, giving
      reasonable real-time measurements of velocity.

PMID- 8366803
TI  - Novel approaches to low-cost MRI.
AB  - This paper presents a combination of speculative approaches, some related to
      earlier work and some apparently novel, which show great promise in providing a
      new class of MRI machines that would be considerably less expensive. This class
      would have advantages and disadvantages as compared to existing MRI, over and
      above that of low cost. The disadvantages include the apparent inability to
      perform classic spectroscopy, and limited flexibility in the area of selective
      excitation. The advantages include a fundamental immunity to inhomogeneity and
      susceptibility problems, the ability to create a wide class of machines that are
      designed for specific anatomy-related applications, the ability to design open
      machines for physician access, and improved capability for high speed imaging.
      Generic to all of the methods presented are a pulsed polarizing field and an
      oscillatory read-out bias field. The pulsed field initially polarizes the
      magnetic moments. Since it is not on during the readout operation it has
      negligible homogeneity requirements since changes in the field amplitude will
      merely shade the image intensity. During readout a relatively low bias field is
      used. To enable the use of a relatively inhomogeneous bias field, an oscillatory
      field is used that has a zero average value. This prevents any long-term buildup
      of phase errors due to a frequency error associated with inhomogeneity. Thus the
      average bias frequency will be determined solely by the frequency rather than the
      amplitude of the bias field. Three methods are described, all including the above
      features. The first two involve imaging in the laboratory frame, while the third
      involves imaging in the rotating frame. The second approach requires no RF
      excitation and the third approach uses RF bias and gradient signals. Some
      approaches to slice selection are described.

PMID- 8366804
TI  - 13C NMR investigation of synovial fluids.
AB  - 13C NMR spectra of synovial fluids from 20 patients suffering from rheumatic
      diseases have been recorded. Structural changes in hyaluronic acid, the main
      carrier of the viscoelastic properties of synovial fluid, could be observed in
      the NMR spectra of the native biological fluid. By comparing these spectra with
      those of purified hyaluronic acid, a rough estimation of the degree of
      depolymerization of synovial hyaluronic acid was possible. The patients with
      rheumatoid arthritis appeared to have a lower degree of polymerization compared
      to patients with osteoarthrosis. Thus, 13C NMR spectroscopy provides useful
      information about biophysical properties of synovial fluid.

PMID- 8366805
TI  - Changes in water diffusion and relaxation properties of rat cerebrum during
      status epilepticus.
AB  - Diffusion-weighted (DW) imaging has been used to record changes associated with
      status epilepticus (SE) in rat brain. It was found that the apparent diffusion
      coefficient (ADC) of water in brain decreased 14-18% during SE, and it fell a
      further 20-22% when the animals were sacrificed. The transverse decay time
      constant T2* showed corresponding reductions, but no significant changes were
      seen in relaxation times T1 or T2 values. Changes in ADC in status epilepticus
      are similar to those seen in stroke and ischemia but occur under very different
      conditions of blood flow and metabolism.

PMID- 8366806
TI  - Magnetic resonance microscopy in rat skeletal research.
AB  - Noninvasive evaluation of skeletal tissue, particularly certain sites that tend
      to be predisposed to disease, is critical in understanding the pathogenesis,
      progression, and successful treatment of various diseases like osteoporosis,
      rheumatoid arthritis, and osteoarthritis. Although several noninvasive techniques
      are currently available to evaluate skeletal tissues, they all have critical
      limitations. We report here a systematic study to compare the morphological
      changes (overall profile and tissue architecture) in the proximal tibiae and
      coccygeal vertebrae of a young growing rat and an older retired female breeder
      rat using 2- and 3-dimensional MR (magnetic resonance) microscopy and histology.
      We have obtained MR microimages of intact rat tibiae and vertebrae with
      resolution upto 24 24 250 microns and have found excellent correlations between
      MR microscopy results and histological assessment.

PMID- 8366807
TI  - Fast MRI by creating multiple spin echoes in a CPMG sequence.
AB  - A fast multislice imaging technique has been developed. RASTER (Rapid Acquisition
      with STimulated Echo Refocusing) is based on RARE (Rapid Acquisition with
      Relaxation Enhancement), and creates multiple spin echoes/each 180 degrees pulse
      utilizing stimulated echoes, and phase encode each differently. The sequence can
      be much faster than RARE while keeping the same spin echo image contrast. The
      main limitation of the technique is reduced signal-to-noise ratio.

PMID- 8366808
TI  - Self-correction of proton spectroscopic images for gradient eddy current
      distortions and static field inhomogeneities.
AB  - A postprocessing method of correcting for gradient eddy current distortions and
      inter-voxel static field inhomogeneity in spectroscopic imaging is presented.
      Data is acquired normally and all spatial processing is performed. The FID in
      each voxel is then digitally filtered to extract the signal from a single
      reference line. Phase multiplying the original FID by the phase of this reference
      signal corrects for gradient eddy currents and static field offsets. Computer
      simulations show that the method is robust with respect to noise, filter
      bandwidth and the presence of small lines close to the reference line. The method
      is demonstrated on proton spectroscopic images of phantoms.

PMID- 8366810
TI  - MRI evaluation of myocardial perfusion without a contrast agent using
      magnetization transfer.
AB  - We propose a new magnetic resonance imaging (MRI) technique that is sensitive to
      myocardial tissue perfusion that obviates the use of an extrinsic contrast agent.
      Significant advantages of such a technique are that it avoids accumulation of
      contrast agent when repeated studies are performed on the same subject and that
      it is completely noninvasive. The method makes use of a combination of
      magnetization transfer (MT) and T1sat (measured spin-lattice relaxation time in
      the presence of MT) weighting. In this Communication, we present observations
      from experiments with an isolated rat heart model that demonstrate increase of MT
      weighted signal intensity and T1sat with flow. Also included are data showing
      that these effects can be made synergistic for enhancing the sensitivity to
      perfusion. We have observed about a 3% change in MT-weighted intensity and up to
      10% change in MTT1sat-weighted intensity for a change of 1 ml/min in global flow
      rate.

PMID- 8366809
TI  - Transaminase reaction rates, transport activities and TCA cycle analysis by post
      steady state 13C NMR.
AB  - In this work, we present the post-steady state analysis of the TCA cycle and a
      closed form solution to the rate of label washout from the C4 carbon of glutamic
      acid through the transaminases and the malate-aspartate shuttle and then through
      alpha-ketoglutarate dehydrogenase. We demonstrate using a model of this problem
      that the rate of label washout depends not only on the flux through alpha
      ketoglutarate dehydrogenase, but most importantly on the activity of the malate
      aspartate shuttle as determined by the forward and reverse fluxes through the
      transaminases and by the rate of transport of glutamate and alpha-ketoglutarate
      across the mitochondrial membrane.

PMID- 8366811
TI  - Magnetization-prepared cardiac imaging using gradient echo acquisition.
AB  - Magnetization-prepared 2DFT and 3DFT gradient echo techniques are presented for
      acquisition of black blood cardiac images. Both methods incorporate RF pulses for
      blood saturation, centric or centric-like view ordering, data acquisition during
      late diastole, and breath-holding. In a series of 13 volunteer studies, these
      methods have consistently provided good visualization of intraventricular
      structures.

PMID- 8366812
TI  - Ivermectin and human lymphatic filariasis.

PMID- 8366813
TI  - The cellular immunology of bovine paratuberculosis: immunity may be regulated by
      CD4+ helper and CD8+ immunoregulatory T lymphocytes which down-regulate
      gamma/delta+ T-cell cytotoxicity.
AB  - In a previous investigation, we obtained evidence that the major
      histocompatibility complex (MHC)-restricted proliferative response of CD4+
      lymphocytes to Mycobacterium paratuberculosis antigens was depressed in naturally
      infected and immunized animals. Findings suggested that depression of the
      response was attributable to an abrogation in the ability of CD4+ cells to
      respond to specific antigens and/or the actual loss of antigen-reactive cells. In
      vitro cell experiments indicated that the depression was associated with the
      presence of gamma/delta+ T cells that modulated CD4+ cell function. Examination
      of additional animals confirmed and extended these observations and showed that
      the ability of gamma/delta+ T cells to regulate CD4+ responses were blocked by
      the presence of CD8+ cells. CD4+ T cells from some exposed animals incorporated
      [3H]-thymidine in the presence of CD8+, gamma/delta+ cells and/or antigen and
      antigen-presenting cells, but CD4+ cell proliferation was abrogated when CD8+
      were excluded from the assays. Likewise, gamma/delta+ T-cell proliferation was
      abrogated when CD8+ cells were present. The mechanism by which CD8+ cells blocked
      gamma/delta+ T-cell responses could not be determined, however, the observed
      effect resembled the veto cell phenomenon. The data suggest that the development
      of protective immunity against M. paratuberculosis may be dependent on the
      capacity of CD8+ cells to modulate the regulatory activity of gamma/delta+ T
      populations.

PMID- 8366814
TI  - Delayed (footpad) hypersensitivity and Arthus reactivity using protein-rich
      antigens and LPS in mice immunized with live attenuated aroA Salmonella vaccines.
AB  - Footpad reactions to protein-rich salmonella extracts and lipopolysaccharide
      (LPS) were studied in BALB/c mice 2 and 8 months after immunization with the
      Salmonella typhimurium SL3261 aroA live vaccine. T-cell depletion in vivo and
      adoptive serum transfer showed that protein-rich antigens induced T-cell
      dependent delayed hypersensitivity reactions, whereas LPS only elicited Arthus
      reactions. The footpad reactions to crude protein extracts were not always T-cell
      mediated, but depended on the nature and the dose of the antigen. Selective
      depletion of CD4+ T cells alone had a greater effect than depletion of CD8+ T
      cells alone, but neither was as marked as simultaneous depletion of both CD4+ and
      CD8+ T cells, which abolished the delayed type hypersensitivity (DTH) response.
      Crude protein-rich extracts subjected to alkaline hydrolysis (which removes some
      ester-linked fatty acids and causes disaggregation of LPS resulting in decreased
      toxicity while conserving O-specificity) still gave positive T-cell dependent
      reactions, but with reduced T-cell independent reactivity. Purified phenol-water
      LPS (2.5 micrograms) produced Arthus reactivity which could be confused with DTH.
      LPS induced positive reactions which still occurred in T-cell depleted mice and
      were transferable by immune serum. Arthus reactions did not occur when using
      alkali-treated LPS, which showed reduced complement fixation in vitro when using
      serum from immunized mice. The results indicate that footpad testing using
      salmonella antigens containing LPS elicit DTH but can also produce toxic
      reactions, some of which are T-cell independent and not necessarily a true
      measure of DTH. Arthus reactivity to LPS can be confused with DTH. Alkaline
      hydrolysis of the antigens can eliminate non-specific reactogenicity while
      retaining the ability of the (protein-rich) antigen to elicit a true T-cell
      dependent footpad response, which requires the participation of both CD4+ and
      CD8+ T cells.

PMID- 8366815
TI  - Non-toxigenic derivatives of the Ames strain of Bacillus anthracis are fully
      virulent for mice: role of plasmid pX02 and chromosome in strain-dependent
      virulence.
AB  - The toxin-encoding plasmid pX01 and capsule-associated plasmid pX02 are required
      for full virulence of Bacillus anthracis in some animals. However, the non
      toxigenic pX01-cured derivatives of certain anthrax strains are not completely
      attenuated for mice, and their virulence is strain-dependent. The strain-related
      differences were partially associated with plasmid pX02 as demonstrated by pX02
      transductants of the attenuated vaccine strain UM23-1 cured of pX01. To determine
      the virulence of non-toxigenic variants of virulent strains, we isolated pX01-
      derivatives of the Vollum 1B strain and the more 'vaccine-resistant' Ames strain
      which carried pX02 from either Ames or Vollum 1B. The 50% lethal dose (LD50)
      values of the derivatives of both strains which carried the Ames pX02 were not
      significantly different from the LD50s of the pX01+ pX02+ strains (and were lower
      than those of pX01+ pX02- strains). pX02+ derivatives of strain UM23-1 were less
      virulent than the comparable Ames and Vollum 1B strain derivatives, emphasizing a
      role for chromosomal loci in the virulence of the latter two strains. Non
      toxigenic isolates which carried the Ames pX02 were more virulent for CBA/J mice
      than those with Vollum 1B pX02, and the differences were mouse strain-dependent.
      The pX01- pX02+ strains multiplied and achieved high concentrations systemically.

PMID- 8366816
TI  - The interaction of primate transferrins with receptors on bacteria pathogenic to
      humans.
AB  - The binding of primate transferrins by receptors in the human pathogens Neisseria
      meningitidis, Moraxella (Branhamella) catarrhalis, and Haemophilus influenzae was
      assessed and compared with the binding of anti-human transferrin monoclonal
      antibodies by primate transferrins. In competitive binding assays the three
      pathogens showed identical specificity for primate transferrins. Only human,
      gorilla, chimpanzee and orangutan sera were capable of blocking binding of
      labelled human transferrin. Direct binding assays and affinity isolation of
      receptor proteins confirmed that chimpanzee transferrin, but not rhesus monkey
      transferrin, was capable of effectively binding to the bacterial receptors. Five
      distinct patterns of binding were seen when five anti-human transferrin
      monoclonal antibodies were reacted with the primate transferrins and these
      patterns reflected phylogenetic relatedness of these species to humans. A
      monoclonal antibody which showed transferrin-binding specificity identical to
      that seen with the bacterial receptors was found to block binding of human
      transferrin by receptors in the three bacterial species.

PMID- 8366817
TI  - Clonal relationships and variation in virulence among Escherichia coli strains of
      avian origin.
AB  - Average genetic relatedness among 44 Escherichia coli strains of serotypes O1,
      O2, and O78 isolated mainly from birds with colibacillosis or swollen-head
      syndrome from France or Saudi Arabia was estimated based on allelic variation
      detected by multilocus enzyme electrophoresis. For 20 enzyme-encoding loci, we
      resolved 2.8 alleles per locus and distinguished 17 electrophoretic types (ETs)
      that were used to mark naturally occurring cell lineages or clones. On average,
      ETs differed at 37% of their loci. Forty-eight percent of the isolates represent
      three ETs, two of which belong to previously defined complexes of clones
      identified in avian disease in North America and Europe. Virulence of strains,
      assessed in experimental infections of day-old chicks, showed little variation
      among isolates of a clone, but was significantly variable among isolates of
      different clone complexes. These findings add support to the evidence that a
      majority of avian isolates that cause colibacillosis belong to a few cosmopolitan
      pathogenic clones and indicate a substantial between-clone component of
      pathogenicity.

PMID- 8366818
TI  - Effects of the acetylcholinesterase toxin of Aeromonas hydrophila on the central
      nervous system of fish.
AB  - The purified acetylcholinesterase (AcChE) toxin, crude extracellular products
      (ECP) or viable virulent Aeromonas hydrophila were injected intraperitoneally
      into rainbow trout in different sublethal and lethal doses. When fish showed
      signs of morbidity, brain tissue was excised and assayed for acetylcholinesterase
      activity. In all cases there was a large increase in AcChE activity (about 40
      fold for purified AcChE-toxin). This was shown to be due to an accumulation of
      the fish's own AcChE and not the bacterial toxin. Nevertheless, the latter was
      detected in brain homogenates from fish in all treatment groups using a rabbit
      antiserum to the purified toxin to probe Western blots of brain homogenates,
      demonstrating that the toxin does gain access to brain tissue and is produced
      during in vivo infection. The results strongly suggest that this toxin plays a
      central role in the pathogenesis of A. hydrophila infection.

PMID- 8366819
TI  - Control of hepatitis B: evaluation of two different vaccinal schedules in
      newborns from HBsAg negative mothers.
AB  - 504 healthy infants, born to HBsAg negative mothers from May 1st to December 31st
      1991, were randomly allocated to an accelerated (group A) or traditional (group
      B) immunization schedule. The group A infants were immunized at 4 days, 1 month
      and 3 months of life with 10 micrograms of recombinant HBV vaccine (Engerix B,
      SKF) while the group B infants were immunized at 4 days, 1 month and 6 months of
      life with the same dose of vaccine. One month after the first dose of vaccine,
      9.2% of the infants in both groups had an HBsAb serum level > 10 mIU/ml. One
      month after the booster dose, at 4 months of life for group A and at 7 months for
      group B, 97.40% and 98.53% of the infants presented a serum level > 10 mIU/ml
      respectively. None in group A and only 2 patients in group B could be considered
      non-responders (serum concentration below 2 mIU/ml) and 4 infants in group A and
      4 in group B were considered hypo-responders (serum level between 2.1 and 9.9
      mIU/ml). Immunogenetic study performed on the 2 non-responders and 6 of the hypo
      responders, revealed the presence in all but two of the HLA haplotypes,
      classically involved in the lack of hyporesponsiveness to foreign peptides,
      namely: HLA-DR7; DQ2, DR4; DQ3, DR15; DQ6 and DR3; DQ2. Surprisingly, 2 hypo
      responders carried the HLA haplotypes (DR11, DQ7 and DR13, DQ6), usually
      associated with hyperresponsiveness. Both vaccinal cycles provided evidence that
      infants respond well to vaccination, started at birth, against hepatitis B virus
      with a high degree of protection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366820
TI  - Rapid methods for microbial diagnosis of mycobacterial infections.
AB  - The Authors describe their experience in rapid diagnosis of mycobacterial
      infections using a combination of a radiometric blood culture (Bactec 13 A) and a
      nucleic acid hybridization system (Gen probe, Accuprobe) to detect and identify
      Mycobacteria. They found out that a high number of septicaemias in HIV positive
      patients are due to Mycobacterium avium, while in HIV negative subjects
      Mycobacterium tuberculosis is the most frequent mycobacterium.

PMID- 8366821
TI  - Effect of intravenous immunoglobulin on opsonic activity and TNF production in
      patients at high risk for sepsis syndrome.
AB  - In a randomized double blind study, we analyzed the efficacy of IVIG in the
      infectious complications in patients at high risk of developing sepsis syndrome.
      Two groups of twenty patients were enrolled, one receiving 250 mg/Kg of IVIG on
      the first and seventh day after admission and the other receiving sterile saline
      as placebo. Serum samples were drawn before IVIG administration and 24, 48 and 72
      hours afterwards. The same schedule was used for patients treated with placebo.
      Sera pooled from healthy donors served as controls. On all the samples, opsonic
      and bactericidal activity as well as C3, total IgG and serum TNF content were
      tested. IVIG did not significantly affect total IgG and C3 content. Similarly,
      opsonic and bactericidal activity tested against E. coli 06 :K-, E. coli 0111 and
      SAC I was not modified ranging within HPS values. Furthermore, IVIG
      administration did not change the TNF level. A lower incidence of bacteremia in
      IVIG treated patients was observed.

PMID- 8366822
TI  - Culture filtrates and whole heat-killed Candida albicans stimulate human
      monocytes to release interleukin-6.
AB  - The release of interleukin-6 (IL-6) by human monocytes upon stimulation with
      culture filtrates and heat-killed Candida albicans cells was studied. Two strains
      of C. albicans (a wild strain CA3 and an agerminative mutant CA2) were cultured
      overnight at 28 degrees C in complete medium, and 10(6) cells/ml were either
      filtered at different time points (6, 12, 18, 24, 30 hours) or heat-killed. C.
      albicans preparations were then added to monolayers of monocytes isolated from
      healthy donors and incubated at 37 degrees C in 5% CO2 atmosphere. Cell culture
      supernatants were collected at different time points (every 6 hrs for 30 hrs),
      and IL-6 content was then measured by immunometric assay. Monocytes stimulated
      with heat-killed C. albicans cells released IL-6 in the supernatants with values
      ranging from 59 to 460 pg/ml, that peaked at 24 hrs of incubation. Using heat
      killed whole cells of C. albicans no major differences were observed between the
      two strains used in their capacity to induce IL-6. Culture filtrates also
      stimulated monocytes to release IL-6 and maximal cytokine levels were observed
      when the monocytes were triggered with filtrates from yeasts cultured for 24
      hours. CA2 filtrate induced IL-6 levels to an extent significantly higher than
      did CA3 filtrate. These data add further evidence to the immunomodulatory
      properties possessed by structures of C. albicans.

PMID- 8366823
TI  - Subinhibitory concentrations of antibacterial drugs and Pseudomonas aeruginosa
      virulence factors.
AB  - Pseudomonas aeruginosa is an important, opportunistic pathogen responsible for
      nosocomial infections in the immunocompromised host and resistant to
      antibacterial drugs. Its pathogenicity is related to many virulence factors such
      as proteases, alginate, exotoxin A and exoenzyme S. Our previous study showed a
      down-regulation of some P. aeruginosa virulence factors by subinhibitory
      concentrations of antibacterial drugs. This study aimed to compare the effects of
      subinhibitory concentrations of a new difluoroquinolone, PD 131,628, a
      betalactam, aztreonam and an aminoglycoside, netilmicin.

PMID- 8366825
TI  - Relationship between Candida albicans and denture stomatitis: a clinical and
      microbiological study.
AB  - A study was done on 52 upper denture wearers, randomly selected among the
      residents of two nursing-homes. The results show that the prevalence of Candida
      albicans in the denture is significantly higher than that in the mucosa. It was
      also possible to establish a significant relationship between the clinical
      patterns and the microbiological findings. A healthy mucosa does not present C.
      albicans, whereas a diffuse denture stomatitis more often presents the yeast both
      in the mucosa and in the denture. Finally, diffuse erythema is correlated to
      continuous denture-wearing, while there is not significant correlation between
      healthy mucosa and type I denture stomatitis and denture-wearing habits.

PMID- 8366824
TI  - Outer membrane proteins and lipopolysaccharide changes after exposure of
      Pseudomonas aeruginosa to antibacterial drugs.
AB  - Many studies show the low sensitivity of P. aeruginosa to antimicrobial agents,
      due to the permeability degree of the outer membrane (OM). Since the alterations
      of porins and lipopolysaccharides (LPS) are responsible for permeability to
      antibacterial drugs, the aim of this study was to evaluate the sub-M.I.C. effects
      of different antibiotics on the OM components. The M.I.C.s of five P. aeruginosa
      strains were determined and sub-M.I.C.s. versus PD-131,628, a new
      difluoroquinolone, aztreonam and netilmicin were calculated. The OM components
      were extracted before and after contact with the antibacterial drugs. We noted a
      decrease in M.I.C. values in two strains, and simultaneously an increase in the
      19 and 38 Kd bands after using aztreonam. The M.I.C.s tended to increase in three
      strains after using netilmicin. The electrophoresis profile showed a decrease in
      the 38, 41 and 45 Kd bands and in one strain also in the 19 Kd band. The use of
      the quinolone did not significantly modify the M.I.C. values, although an evident
      increase in 38 and 41 Kd bands occurred in three strains. LPS alterations were
      observed with aztreonam and netilmicin, but not when PD 131,628 was used.

PMID- 8366826
TI  - Assessment of the "Amplicor" PCR test in the diagnosis of Chlamydia trachomatis
      infection.
AB  - We compared a commercially available PCR assay (Amplicor, Roche, Switzerland) and
      tissue culture isolation for the detection of C. trachomatis in urethral and/or
      endocervical swabs. Of the 200 patients studied (130 men and 70 women) PCR and
      tissue culture gave concordant results in 199 cases; in one case PCR was positive
      and culture negative. The Amplicor PCR assay proved fast and sensitive and
      suitable for routine use in most clinical microbiology laboratories.

PMID- 8366827
TI  - Partial characterization of HCl heat extracted antigen derived from Fusobacterium
      necrophorum.
AB  - The HCl heat extracted antigen derived from Fusobacterium necrophorum was
      partially purified by CM cellulose column chromatography and treatment by freeze
      thawing. It demonstrated relatively high enzyme-linked immunosorbent assay values
      to anti-F. necrophorum sera. In sodium dodecyl sulphate polyacrylamide gel
      electrophoresis, the partially purified preparation exhibited one definite and
      two faint bands. The approximate molecular weight of the former was estimated as
      16 kD.

PMID- 8366828
TI  - The effect of an electric field on the release of hexosaminidase in Tetrahymena.
AB  - The activity of beta-D-hexosaminidase was detected by spectrofluorometry in the
      growth media of three species of Tetrahymena. The enzyme activity was about six
      times higher in T. pyriformis compared with the wild cells of T. thermophila,
      while the MS-1 mutant of T. thermophila manifested very low enzyme activity under
      the same experimental conditions. An electric field and electrical pulses
      produced significant though different increases in enzyme activity in media of
      wild and mutant T. thermophila. In contrast, T. pyriformis responded to the field
      pulses by decreasing the activity of the enzymes detected in the growth media.

PMID- 8366829
TI  - Serotype distribution, antimicrobial susceptibility, and clinical character of
      Streptococcus pneumoniae isolates.
AB  - Strains of Streptococcus pneumoniae (268 in toto) isolated from different
      infected sites in patients were serotyped, their susceptibilities to
      antimicrobial agents were determined, and the laboratory data were correlated
      with clinical information. The distribution pattern of serogroups and serotypes
      was different in paediatric patients (< 18 years old) when compared with that of
      adults. Overall, 91% of the strains were represented in a 23-valent vaccine. Only
      eight patients received pneumococcal vaccine before infection, and only 18
      strains (6.7%) were moderately susceptible or resistant to one or more of the
      antimicrobial agents tested. Five strains were moderately susceptible to
      penicillin G, and not one was fully resistant.

PMID- 8366830
TI  - Ability to assimilate nitrogenous oxides is limited to a few species of yeasts.
AB  - Several species of yeasts, Saccharomyces cerevisiae, Debaryomyces hansenii,
      Candida utilis, C. albicans, C. pelliculosa and C. tropicalis, were tested for
      their ability to utilise different inorganic nitrogen compounds as sole sources
      of nitrogen, and the results are presented as a function of their growth. All of
      them grew well on reduced nitrogenous compounds such as ammonium sulphate
      (ammonia) and L-asparagine, while only C. utilis and C. pelliculosa grew, at a
      slower rate, on oxidised nitrogenous compounds, nitrate and nitrite. The
      differences observed in the ability of various yeasts to assimilate the inorganic
      nitrogen compounds are believed to reflect their individuals abilities to
      regulate the uptake rates of potentially toxic compounds and keep them in a
      bound/transient state until reduced to less toxic and more-readily assimilable
      forms.

PMID- 8366831
TI  - Factors affecting acetic acid production by yeasts in strongly clarified grape
      musts.
AB  - High acetate content in a wine, after strong clarification of the must, is due to
      depletion in the yeast cells of important metabolites (normally present in non
      clarified musts) such as metals, amino acids, polyphenolic compounds and
      unsaturated fatty acids. These substances were added separately to a synthetic
      medium, comparable in composition to the clarified must, which was then
      inoculated with a high acetate producer strain. No effects were observed after
      the addition of various metals and amino acids. The addition of unsaturated fatty
      acids (Tween 80) caused a significant (p = 0.01) decrease in acetate content.
      Similar results have been obtained in the presence of polyphenols (catechins and
      anthocyans): their mechanism of action is probably due to direct inhibition of
      the enzyme aldehyde dehydrogenase. Control experiments were performed with a low
      acetate producer strain, and a reduction in acetate content was detected. No
      differences in the glyceropyruvic metabolism of the two strains was evident.

PMID- 8366832
TI  - [Asbestos exposure on board ships: a study of the environmental situation on 2
      classes of ferryboats].
AB  - The article describes the results of a study on contamination by airborne
      asbestos fibres on board a number of ships belonging to fleets operating from
      Civitavecchia, a port on the coast of central Italy. Asbestos was widely used
      throughout the ships as fire- and soundproofing insulation. Samples taken before,
      during and after removal of the insulation in areas of the ship outside the
      asbestos removal worksite gave concentration levels that were similar to those
      observed in other indoor environments (building), varying according to the sample
      location and the condition of the insulation material. The results are discussed
      taking into consideration the fact that a ship is also a living environment for
      crew and passengers.

PMID- 8366833
TI  - [A comparison between phase-contrast optical microscopy and scanning electron
      microscopy for the analysis of air-borne asbestos fibers in an office
      environment].
AB  - There is no general agreement on the relationship between results obtained by
      optical microscopy (PCOM) and electron scanning microscopy (SEM) or electron
      transmission microscopy (TEM) for airborne asbestos fibres. However, a
      considerable amount of data has been produced in latter years indicating that a
      general correlation factor, not differing greatly from unity, can be established
      between the two analytical techniques if counts are limited to fibres longer than
      5 microns. A study was made of the relationship between SEM and PCOM when used
      simultaneously for determination of background concentrations of asbestos in
      office buildings. Twenty-four couples of samples were collected in parallel for
      PCOM and SEM in different locations distributed over the various floors of two
      buildings containing amosite sprayed on structural parts. Asbestos and total
      fibre counts by SEM were performed following the Verein Deutscher Ingenieure
      (VDI) method 3492. For total fibre counts the European PCOM method was mainly
      used. Discrimination of asbestos from non-asbestos fibres was performed using
      criteria based on birefringence and morphological characteristics of fibres.
      Counts included only those fibres longer than 5 microns, diameter less than 3
      microns and aspect ratio greater than 3. Both total fibres and asbestos fibres
      were recorded separately by PCOM and SEM. the arithmetic and geometric means of
      the ratio between PCOM and SEM were 1.3 and 1.1 respectively for total fibres and
      1.2 and 1.1 for asbestos fibres (excluding one outlying value). The regression
      study showed a significant linear correlation (P = 0.01) with correlation
      coefficients of 0.84 for asbestos fibres and 0.52 for total fibres.

PMID- 8366834
TI  - [The cases of accident in the ceramic tile industry in relation to the age and
      job seniority of the workers].
AB  - A study was made of 3,368 workers in 36 ceramic plants in the Scandiano area
      (Reggio Emilia, Italy) during the year 1990; 403 had an accident during the
      observation period. The incidence and severity of the accident were correlated to
      age, job (low, intermediate, high accident risk), duration of employment as at
      1.1.1990 (> 24, 12-24, > 24, 12-24, < 12 months, engaged during 1990). Logistic
      regression analysis, survival analysis and RIDIT analysis were performed using
      GLIM and EGRET statistical packages. Risk: ORs for intermediate and high-risk
      jobs vs low-risk jobs were 1.3 (1.0-1.7 95% confidence limits) and 1.7 (1.3-2.3),
      respectively, adjusted for duration of employment; ORs for the 12-24, < 12
      months, engaged during 1990 categories vs the > 24 months category were 1.5 (1.1
      2.0), 1.7 (1.3-2.2), 2.1 (1.6-2.8) respectively. Severity: the mean RIDIT of the
      > 44-year-old vs < 30-year-old workers was 0.6 (0.53-0.67).

PMID- 8366835
TI  - [Work accidents in the large-scale food distribution sector].
AB  - The application of a systematic method of reading accident registers, as has
      already been experimented in various manufacturing sectors by other authors, is
      proposed for food supermarkets. The study covered 461 accidents occurring in the
      five-year period 1986-1990 in 25 food supermarkets in the Milan area. The
      proposed method is based on the identification of each accident according to the
      "process/mode of occurrence" data pairs. Subsequent elaboration of these pairs
      reveals the incidence of accidents and also enables conclusions to be drawn on
      the main causes that are then useful for the prevention programmes implemented
      both by local health units and plant management.

PMID- 8366836
TI  - [Alcohol consumption in some manufacturing activities of Venice: a public health
      problem].
AB  - A total of 1246 workers were interviewed employed in the industrial and urban
      area of Venice: 91.3% consumed alcoholic beverages, 17.4% of whom exceeded 1
      litre of wine per day. Only 15% of the interviewees thought that an acceptable
      alcohol consumption level should not exceed 1 litre, whereas more than 18%
      thought that 2 or more litres of wine per day was not harmful. A certain tendency
      to incorrect knowledge of alcohol and its effects on health was observed. A high
      consumption of alcoholic beverages was confirmed, mainly depending on the type of
      work group, a subjective assessment of individual consumption, consumption at
      work, level of education, duration of consumption, specific information about
      alcohol. In particular, jobs such as porterage, foundry work, boat piloting,
      urban refuse collection, road and machine maintenance were associated with
      alcohol abuse mainly due to the level of education and drinking for pleasure. The
      paper discusses the role of social dynamics in boosting drinking behaviour and a
      possible health education policy. The role of occupational health services in
      community care programmes involving managerial and technical staff is stressed.

PMID- 8366837
TI  - [Mucocutaneous candidiasis in exposure to biological agents: a clinical case].
AB  - Candida albicans, an ubiquity yeast, has several properties which allow it
      colonize and invade host tissues, often resisting eradication. Acid proteinase is
      the virulence factor. Bacterial proteinases are widely used in the detergent
      industry and the role of occupational exposure to enzymes in the development of
      mucocutaneous candidosis warrants investigation. A case of candidosis is reported
      in a worker employed in a detergent factory in whom there was no evidence of any
      kind of immunosuppression. The relationship between occupational exposure and
      illness is analyzed.

PMID- 8366838
TI  - A follow-up on workers with predicted individual susceptibility to silicosis.

PMID- 8366839
TI  - [What kind of health surveillance of workers?].

PMID- 8366840
TI  - [Potential for abuse of codeine and dihydrocodeine].

PMID- 8366841
TI  - [Vitamin E as a natural antioxidant. Preventive importance and requirement].

PMID- 8366842
TI  - [Psychiatric ABC for the pharmacist. Part 1].

PMID- 8366843
TI  - [Coronary heart disease. New guidelines of the European Society of
      Atherosclerosis for prevention].

PMID- 8366844
TI  - [Tuberculosis today: vaccination and chemoprophylaxis].

PMID- 8366845
TI  - [The nutritional aspects and incidence of obesity and hypertension in a groups of
      Roman adolescents].
AB  - Two-hundred-thirty teenagers of a Roman liceo (specializing in classical studies)
      have been checked with particular regard to growth, pressure and feeding. The
      diet of teenagers proved to be particularly unbalanced from the qualitative point
      of view. There is an excessive intake of fats especially to the detriment of
      carbohydrates and starches. The incidence of obesity (6.9%) and of hypertension
      (6%) is not particularly high, probably due to the fact that youngsters at this
      age "look at themselves in the mirror a lot" for the first case and the second
      one can be considered as a direct consequence of the first.

PMID- 8366846
TI  - [An epidemiological study of breast-feeding practice in the referral population
      of USSL 46 "Alto Mantovano", the Lombardy region. Unita di servizio screening
      locale].
AB  - The aim of this study is to assess the prevalence of breast feeding in the
      children population of familial advisory bureau in our territory, the reasons for
      the choice of this kind of nutrition and its duration. The authors also
      researched if there is some relationship between the choice of feeding and the
      kind of parturition, mother age, her education and job. The possible influence of
      the preparatory course of childbirth attendance, mass media and family on this
      choice was researched to complete the study.

PMID- 8366847
TI  - [A case of the cardiofacial syndrome (Cayler's syndrome)].
AB  - We report a case of cardiofacial syndrome that seems to be genetically
      transmitted as an autosomal dominant trait. It is characterized by hypoplasia of
      depressor anguli oris muscle and perimembranous ventricular septal defect. We
      emphasize the importance of performing diagnostic tests in these patients
      (cardiac assessment, spinal x-ray, renal echo) in order to rule out associated
      malformations.

PMID- 8366848
TI  - [A case of glomerulonephritis in congenital syphilis].

PMID- 8366850
TI  - [The transplacental therapy of fetal tachyarrhythmias].
AB  - The diagnosis of fetal tachyarrhythmia during a routine ultrasound scan imposes a
      continuous monitoring of fetal heart function through ECG and M-mode
      echocardiography. Since fetal dysrhythmia can lead to non-immune hydrops or to
      fetal death a correct diagnosis and an adequate intrauterine therapy are
      fundamentally important. The authors report the results obtained through a
      transplacental therapy with digoxin or with digoxin-verapamil in 8 cases with
      supraventricular tachyarrhythmia. Digoxin was very successful for conversion in
      sinus rhythm in 4 cases. The combination digoxin-verapamil led to the conversion
      in only one case resistant to the digoxin therapy.

PMID- 8366849
TI  - [The Schonlein-Henoch syndrome with severe multisystemic involvement].
AB  - A case of Henoch-Schonlein purpura (HSP) characterized by several unusual
      complications and exceedingly prolonged course is reported. A 6-year-old boy,
      hospitalized with a typical clinical picture of HSP, developed after a few days a
      severe gastrointestinal vasculitis leading to digestive hemorrhages and food
      intolerance. The treatment included continuous gastrointestinal infusion,
      parenteral nutrition, and corticosteroids during the exacerbations of symptoms.
      Intestinal ultrasonography showed diffuse submucous edema and widespread mural
      hematomas; hydrops of the gallbladder and edematous swelling of the pancreas were
      also detected. A gastro-duodenoscopy revealed diffuse and severe mucosal
      vasculitis with ulcers and petechial lesions. One week after admission the
      occurrence of weight gain, hyponatremia, and hypoprotidemia in the absence of
      proteinuria suggested a protein-losing enteropathy. The elevation of serum and
      urine amylases was consistent with pancreatic involvement. The course was
      characterized by recurrent exacerbations of gastrointestinal manifestations;
      symptoms subsided slowly to such a degree that oral feeding could be gradually
      restarted only seven weeks after admission. The use of high-frequency intestinal
      ultrasonography proved useful and sensitive in monitoring the evolution of
      intestinal involvement. During hospitalization the child complained of acute
      painful scrotal swelling. Ultrasonography showed scrotal hemorrhage and
      testicular swelling but no signs of testicular torsion, thus helping to avoid
      surgical exploration. In the recovery phase the child complained of colicky
      abdominal pain with vomiting. A plain abdominal roentgenogram showed bilateral
      staghorn pelvic urolithiasis. This finding was confirmed by an intravenous
      pyelography which also revealed a bilateral pyeloureteritis with edema of the
      ureteral wall and partial stenosis of the lumen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366851
TI  - [Clinical evaluation of the tolerance for a soy-based special milk formula in
      children with cow's milk protein intolerance/allergy (CMPI/CMPA)].
AB  - A study aiming to assess the clinical tolerance of a special follow-up soybean
      milk formula (Neo-Soyal 2) in children with cow's milk protein intolerance or
      allergy (CMPI/CMPA) has been conducted in 17 infants and children (9 girls and 8
      boys) aged from 6 months to 3 years. All the patients had a past history
      suggestive of CMPI/CMPA and were fed a restricted hypoallergenic diet with a semi
      elemental formula based on protein hydrolysates. At the time of initiation of the
      study, all the patients were asymptomatic with normal growth while on a semi
      elemental diet. The formula with protein hydrolysates was substituted by the test
      milk (Neo-Soyal 2) and blood samples were taken before and after 2 months. The
      clinical tolerance to the follow-up soybean formula was considered excellent in
      16 children who remained asymptomatic with normal growth velocity. Only one
      patient developed a severe diarrhoea within 72 hours after introduction of the
      soybean formula which was stopped. However, after one month he was able to
      tolerate a certain amount of the soybean milk (240 ml) without symptoms. For all
      the patients studied, there was no change in the nutritional parameters measured
      in the blood before and after 2 months of the trial. Likewise, the plasma amino
      acid levels determined in 2 patients remained unchanged before and after the
      experimental period. These data indicate that the soybean milk formula used here
      (Neo-Soyal 2) can be safely given as a substitute of semi-elemental diets during
      the follow-up of children with CMPI/CMPA after the age of 6 months.

PMID- 8366853
TI  - Alcohol involvement in pedestrian fatalities--United States, 1982-1992.
AB  - Pedestrian deaths constitute the second largest category of motor-vehicle-related
      fatalities (following vehicle-occupant deaths) and account for 14% of all traffic
      associated deaths and approximately 3% of all traffic-associated injuries. In
      1992, 5546 pedestrians were killed and 96,000 were injured in traffic crashes
      (1,2). Alcohol is an important determinant for both the likelihood of a motor
      vehicle colliding with a pedestrian and the outcomes for pedestrians in crashes
      (3). This report summarizes data from the Fatal Accident Reporting System of the
      National Highway Traffic Safety Administration (NHTSA) on trends in alcohol use
      in traffic fatalities involving pedestrians in the United States during 1982
      1992.

PMID- 8366852
TI  - Occupational burns among restaurant workers--Colorado and Minnesota.
AB  - Work-related burns are a leading cause of occupational injury in the United
      States (1). A substantial proportion of these burns occur among restaurant
      workers--often affecting adolescents working in fast-food establishments. This
      report summarizes investigations of restaurant-associated occupational burns by
      the state health departments in Colorado and Minnesota.

PMID- 8366854
TI  - Enumerating deaths among homeless persons: comparison of medical examiner data
      and shelter-based reports--Fulton County, Georgia, 1991.
AB  - Characteristics of causes of death and mortality patterns in homeless populations
      have been constrained by limitations in both the accuracy of estimates of the
      size of the homeless population and enumeration of the number of deaths of
      homeless persons (1,2). For example, studies of mortality among homeless persons
      in Fulton County (Atlanta), Georgia, based on medical examiner records estimated
      approximately 40 deaths of homeless persons annually (1,3); in contrast, a media
      report based on information supplied by shelters for homeless persons reported
      191 deaths of homeless persons in Atlanta during 1991 (4,5). As a basis for
      improving characterization of mortality patterns in the homeless population of
      Fulton County, Emory University and CDC assessed the differences in the estimates
      of deaths among homeless persons that were obtained from medical examiner records
      and those based on death reports from shelters that are in or adjacent to Fulton
      County (1990 population: 648,951) during 1991. This report summarizes the
      findings of that study.

PMID- 8366855
TI  - Carbon monoxide poisoning associated with a propane-powered floor burnisher-
      Vermont, 1992.
AB  - On July 28, 1992, two employees of a pharmacy in Vermont fainted within four
      hours after arriving for work; at a local hospital emergency department, carbon
      monoxide (CO) poisoning was diagnosed based on elevated carboxyhemoglobin (HbCO)
      levels. The pharmacy was evacuated, and the remaining eight employees were
      transported to the hospital for evaluation. Further investigation by the Vermont
      Department of Health (VDH) revealed that, on July 24, one of the employees had
      fainted, but CO poisoning was not suspected, and vasovagal syncope was diagnosed.
      This report summarizes the investigation of these cases by VDH.

PMID- 8366856
TI  - Quarterly table reporting alcohol involvement in fatal motor-vehicle crashes.

PMID- 8366858
TI  - Purification and immunochemical characterization of recombinant and native
      ragweed allergen Amb a II.
AB  - The complete sequence of a cDNA encoding Amb a II and its relationship to the Amb
      a I family of allergens has recently been described [Rogers et al. (1991) J.
      Immun. 147, 2547-2552; Griffith et al. (1991a), Int. Archs Allergy appl. Immun.
      96, 296-304]. In this study, we present results generated with rabbit antipeptide
      antisera that recognize Amb a II or Amb a I, but not both. The specificity of two
      anti-Amb a II antipeptide sera, anti-RAE-50.K and anti-RAE-51.K, was verified on
      Western blots of recombinant Amb a II and Amb aI.1. These two sera, directed
      against separate regions of the Amb a II molecule, detected three individual 38
      kDa Amb a II isoforms on 2D Western blots of aqueous ragweed pollen extract.
      These Amb a II isoforms have pI in the 5.5-5.85 range and can be easily
      distinguished from Amb a I isoforms with pI in the 4.5-5.2 range detected by an
      anti-Amb a I specific peptide antiserum. The Amb a II isoforms have also been
      individually purified from pollen, positively identified as Amb a II by amino
      acid sequencing, and visualized as separate bands on IEF gels. An analysis of Amb
      a II cDNA sequences generated by PCR led to the prediction of three Amb a II
      isoforms with pI of 5.74, 5.86 and 5.97 that are very similar to the pI deduced
      from 2D Western blot analysis. Recombinant Amb aI.1 and Amb a II have been
      expressed in E. coli, purified in their denatured form, and examined by ELISA for
      their capacity to bind pooled allergic human IgE. Purified native Amb a and Amb a
      II from pollen were shown to have very similar IgE-binding properties. In
      contrast, Amb a II had a markedly reduced IgE-binding capacity as compared to Amb
      a I.1. These data suggest that recombinant Amb a I.1 and Amb a II, isolated in a
      denatured form, differ significantly in their IgE-binding properties whereas the
      native molecules isolated from pollen do not.

PMID- 8366857
TI  - Structure and binding properties of monoclonal antibodies to core histones from
      autoimmune mice.
AB  - Histones are frequent targets of self-reactive antibodies during autoimmune
      syndromes. We report the specificities and V region genes of three IgG anti
      histone MAbs obtained from autoimmune mice. Each of the MAbs, named LG2-1, LG2-2
      and BWA3, is directed against a different determinant located in the basic amino
      terminal domain of core histones. LG2-1 reacts with a peptide from histone H3
      (residues 30-45), LG2-2 recognizes the amino-terminus of H2B (residues 1-13) and
      BWA3 binds an epitope corresponding to a region of high sequence similarity
      between H2A and H4 (residues 1-20 and 1-29, respectively). The analysis of their
      V region sequences indicates that the H chain CDRs of these MAbs are remarkable
      for the presence of negatively charged amino acid residues that may play a role
      in the binding to cationic histones. The H chain importance in conferring
      reactivity to histones is corroborated by the observation that each of the VH
      gene segments of these MAbs is very similar to VH genes of previously described
      murine anti-histone antibodies.

PMID- 8366859
TI  - Efficient complement-mediated lysis of cells containing the CAMPATH-1 (CDw52)
      antigen.
AB  - CAMPATH-1 antibodies recognise a unique molecule on human lymphocytes and are
      unusually efficient at causing cell lysis with homologous complement. They have
      been successfully used for lymphocyte depletion in vivo in a variety of diseases.
      The antigen is a small glycosylphosphatidylinositol (GPI)-anchored glycoprotein
      with a mature peptide comprising only 12 amino acids and one N-linked
      glycosylation site at Asn3. The antigenic epitope is found in a proteolytic
      fragment containing the C-terminal tripeptide and the GPI anchor. Both the native
      and deglycosylated antigen as well as the proteolytic fragment can be
      reincorporated into various target cells, conferring sensitivity to lysis by
      CAMPATH-1 antibodies. These results imply that the special feature of the antigen
      which makes it a good target does not reside in the N-linked sugar or the first
      nine amino acids: instead they support the hypothesis that the proximity of the
      antigenic epitope to the cell membrane is more important.

PMID- 8366860
TI  - The size, shape and stability of complement component C9.
AB  - Electron microscopy of specimens of C9 tilted through 90 degrees visualized this
      protein to be a globular ellipsoid with dimensions of 77 x 70 x 52 A. To check
      the congruence of this observation with physical properties of the molecule,
      hydrodynamic parameters for C9 were determined. From this work a frictional ratio
      of 1.32 was calculated. C9 was compared with several other proteins of similar
      frictional ratios whose tertiary structures are known. All examples found of such
      proteins whose frictional ratios were between 1.26 and 1.37 are either heart
      shaped or globular ellipsoids, but none are prolate ellipsoids. By comparison the
      size and shape of C9 determined by electron microscopy are congruent with its
      hydrodynamic parameters. Both electron microscopy and physical measurements
      suggest that the length (110-120 A) of C9 determined by neutron and X-ray
      scattering experiments is an overestimate. The source of the discrepancy was
      identified by the demonstration that the high concns of C9 employed in neutron
      and X-ray scattering work lead to aggregation of the protein. Thus,
      investigations involving neutron and X-ray scattering were measuring polydisperse
      solutions of C9. The deduced value of the radius of gyration from that work (33
      35 A) is now recognized as being statistical and significantly higher than the
      correct value of monomeric C9 (26 A), which was calculated from electron
      microscopy measurements. Also high-resolution electron microscopy clearly
      visualized poly(C9) to be a barrel-stave construct. These results suggest that
      monomeric C9 must undergo a major conformational alteration to extend by 55-70 A
      in order to self-associate laterally in order to fashion the cylindrical
      poly(C9).

PMID- 8366861
TI  - Mapping of antigenic determinants of the T. cruzi hsp70 in chagasic and healthy
      individuals.
AB  - In the present paper we describe the analysis of the immunological recognition by
      sera of healthy individuals and chagasic patients of the Trypanosoma cruzi heat
      shock 70 kDa protein. By a Falcon Assay Screening Test, using as antigen an ATP
      agarose purified T. cruzi hsp70, it has been found that the sera of infected
      patients as well as of that of healthy individuals show reactivity against the
      hsp70 protein but that the reactivity of the sera of patients is in general
      significantly higher than that of healthy individuals. The analysis of the
      reactivity of the chagasic sera against a collection of peptides covering 92% of
      the protein has shown that more than 50% of the peptides gave a positive response
      but only against a few peptides did we observe high reactivity in a wide spectrum
      of sera. Only four peptides (numbers 9, 12, 14 and 47) were recognized by all
      sera tested with high reactivity values. The sera of healthy individuals also
      showed reactivity against a large percentage of peptides but with lower values.
      It was observed that particular peptides showing high reactivity against the sera
      of healthy donors also show high reactivity against patients' sera. However, the
      general pattern of reactivity against the peptides is different in chagasic and
      healthy sera. The immunodominant peptides map in the highly conserved as well as
      in the less conserved part of the hsp70 molecule. The 1/3 C-terminal, being the
      least conserved part of the molecule, seems to be the least immunogenic. Mapping
      of the epitopes led to the identification of particular immunogenic motifs within
      individual peptides.

PMID- 8366862
TI  - Evidences that syngeneic alpha-type anti-idiotypic antibodies may non
      competitively inhibit idiotype/oligomeric antigen interactions by affecting
      idiotype avidity.
AB  - The effects of syngeneic anti-Id antibodies on the multivalent interaction
      between human TNF-alpha, a homotrimeric Ag, and an anti-TNF mAb (mAb(1)78) have
      been studied. Eight anti-mAb(1)78 Ig secreting hybridoma, able to inhibit TNF
      binding in a competitive or non-competitive mode, have been generated. Two
      representative clones (mAb(2)1G3 and mAb(2)9F1) were selected for studying the
      inhibition mechanism of TNF-mAb(1)78 interaction. Idiotype-paratope topography
      studies indicated that mAb(2)1G3 (IgG2a) and mAb(2)9F1 (IgG1) bind two sterically
      distinct idiotopes on mAb(1)78 (IgG1) V regions. In particular, mAb(2)1G3 was
      found to bind an idiotope located within (or spatially close to) the Ag combining
      site suggesting that competitive inhibition of TNF binding to mAb(1)78 by
      mAb(2)1G3 occurs through paratope blockade. On the other hand, mAb(2)9F1
      recognizes an idiotope located outside the paratope, being able to bind mAb(1)78
      even in the presence of saturating amounts of TNF. mAb(1)78-TNF molar ratio in
      complexes, at stoichiometric equivalence, was unchanged in the presence of a
      large excess of mAb(2)9F1, suggesting that the functional bivalency of mAb(1)78
      was not impaired by this anti-Id antibody. However, bivalent mAb(2)9F1 was able
      to partially inhibit the binding of bivalent mAb(1)78 to oligomeric TNF in liquid
      phase as well as in solid-phase assays, whereas no inhibition was observed with
      monovalent mAb(2)9F1-F(ab) or mAb(1)78-F(ab). This suggests that inhibition is
      based on a decrease of the avidity of bivalent mAb(1)78 and not on allosteric
      effects on antigen binding sites. The effect of mAb(2)9F1 on mAb(1)78 arm
      flexibility and paratope orientation is discussed. In conclusion, the results
      indicate that anti-Id antibodies may inhibit Ag-antibody multivalent interactions
      by paratope blockade or by affecting the antibody avidity.

PMID- 8366863
TI  - The natural autoantibodies system: between hypotheses and facts.

PMID- 8366864
TI  - Salmonella identification by the polymerase chain reaction.
AB  - Polymerase chain reaction (PCR) primers for genus specific detection of
      Salmonella have been selected from a Salmonella-specific fragment of 2.3
      kilobases (kb). Due to interserovar sequence diversity within this fragment,
      primer selection was based on DNA sequence alignment of sequences from 20
      different Salmonella serovars. The specific PCR product of 429 base pairs (bp)
      was formed from 144 of 146 salmonella strains tested (116 of 118 serovars). The
      two false-negative strains belonged to two different serovars of the rarely
      isolated subspecies IIIa (monophasic S. arizonae). No product was produced in any
      of 86 non-Salmonella Enterobacteriacea strains tested, covering 41 species from
      21 genera.

PMID- 8366865
TI  - A combined modified reverse dot-blot and nested PCR assay for the specific non
      radioactive detection of Listeria monocytogenes.
AB  - A modified reverse dot-blot assay was developed and used in combination with a
      nested PCR amplification of hly A for the specific detection of Listeria
      monocytogenes. The deoxynucleotides and digoxygenin-11-dUTP concentrations in the
      PCR were optimized for maximal sensitivity and economy. For the dot-blot
      hybridization, digoxygenin-labelled PCR products were directly spotted on nylon
      membrane-bound poly-dT tailed capture probes and the signal detection was either
      colorimetric or chemiluminescent. With crude cell lysates, the total assay could
      be completed in about 6 h with a detection limit between 2 and 25 colony forming
      units (cfu) per PCR. The assay was then tested for its applicability to
      environmental sampling of artificially contaminated aluminum surfaces. For
      environmental sampling, the assay requires an additional overnight enrichment
      step and has a sensitivity corresponding to 5 cfu per 25 cm2 of inoculated
      surface.

PMID- 8366866
TI  - Detection of mollicute contamination in cell cultures by 16S rDNA amplification.
AB  - A polymerase chain reaction (PCR) system was developed for the detection of
      mollicutes as contaminants of cell cultures. By using three oligonucleotides
      chosen in the 16S rDNA sequences, two sets of primers able to promote
      amplification of all Mycoplasma and Ureaplasma (molli1-molli2a) or all
      Acholeplasma (molli1-molli2b) species examined were determined. This PCR system,
      first applied to experimentally infected Vero cell lines, was then evaluated for
      the detection of mollicutes in 86 cell culture samples, comparatively to DNA
      staining, culture and ELISA. The results obtained by the four techniques were in
      agreement in 82 cases (36 positive, 46 negative). PCR allowed detection of
      contamination in one and two cases negative by ELISA and culture, respectively,
      and confirmed questionable results obtained by DNA staining. As described, PCR
      seems to be a very convenient tool for routine detection of cell culture
      contaminants.

PMID- 8366867
TI  - A tool for the molecular analysis of an early lethal disease: slide-PCR in spinal
      muscular atrophy patients.
AB  - DNA was recovered from sections of muscle biopsies of 20 spinal muscular atrophy
      (SMA) patients fixed on microscopic slides and stored from one to 20 years at
      room temperature. Microsatellite DNA markers tightly linked to the SMA locus were
      amplified using the polymerase chain reaction (PCR) to obtain specific amplified
      products. The procedure was successful in all cases, and allowed prenatal
      diagnosis in one at-risk pregnancy. In our hands this procedure is quick,
      sensitive and reproducible.

PMID- 8366868
TI  - Determination of N-myc gene amplification in neuroblastoma by differential
      polymerase chain reaction.
AB  - Determination of N-myc gene amplification, a powerful prognostic indicator in the
      childhood tumour, neuroblastoma, has routinely been performed by Southern
      analysis. We have developed a differential polymerase chain reaction (PCR) assay,
      in which the N-myc target gene is co-amplified with a control gene,
      glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Following electrophoresis, a
      ratio between the two PCR products within a given DNA sample is then determined
      by densitometry. This assay was applied to DNA isolated from 32 primary
      neuroblastoma tumours for which the N-myc status had previously been determined
      by Southern analysis. Following PCR, samples containing a single copy of the N
      myc oncogene were clearly distinguishable from samples with N-myc gene
      amplification, based on an N-myc/GAPDH ratio of below or above 1.0, respectively.
      Linear regression indicated a highly significant relationship (R = 0.94; P <
      0.0001) between N-myc copy number (Southern) and N-myc/GAPDH ratio (PCR). Serial
      dilution of N-myc amplified DNA with non-amplified control DNA indicated that the
      PCR assay was sufficiently sensitive to detect two-fold amplification. Moreover,
      such serial dilution allowed determination of N-myc copy number. The assay, which
      requires only small amounts of tissue and does not utilize 32P-radioactivity,
      therefore provides a rapid and sensitive alternative to Southern analysis.

PMID- 8366869
TI  - A new polymerase chain reaction (PCR) assay for the trinucleotide repeat that is
      unstable and expanded on Huntington's disease chromosomes.
AB  - The Huntington's Disease (HD) Collaborative Research Group has recently published
      the sequence of a new cDNA, IT15, containing a polymorphic trinucleotide (CAG)n
      repeat that is expanded and unstable on HD chromosomes. There is a correlation
      between the repeat size and the age of onset of symptoms. The suggested
      polymerase chain reaction (PCR) assay of the (CAG)n repeat requires unusual
      reaction components and primer concentrations and the use of 5% polyacrylamide
      sequencing gels to resolve the amplification products. We present a simple PCR
      assay that produces a smaller product using standard reaction conditions. This
      gives better resolution of the (CAG)n expansion observed on HD chromosomes by
      acrylamide gel electrophoresis and allows sufficient product to be obtained to
      perform assays using agarose gels. This will allow diagnostic labs to do rapid
      and accurate presymptomatic testing of HD in high risk families.

PMID- 8366870
TI  - Experiences on the application of the polymerase chain reaction in a diagnostic
      laboratory.
AB  - Double polymerase chain reaction (PCR) assays with nested primers have been
      applied in a routine laboratory for the diagnosis of herpes-, pesti- and
      retroviral infections of animals. Various methods and tools have been tested to
      prevent and to eliminate false positive results as well as to visualize the PCR
      products (amplicons). The u.v. and DNase treatments proved to be unsuitable for
      decontamination of PCR mixtures contaminated with amplicons shorter than 380 bp.
      By constructing special tube-holders and openers, and by applying a simple
      technique of pipetting, the false-positive PCR results were eliminated. The PCR
      products were visualized by three simple methods. The solid phase colorimetric
      method termed 'Detect Immobilized Amplified DNA' (DIANA) has been adapted to
      microplate. The other method, termed 'Colorimetric Detection Assay on Filter'
      (CODAF), proved to be very rapid. However, despite these advantages of DIANA and
      CODAF, henceforward the nucleic acid hybridization methods were found most
      reliable for safe identification of PCR amplicons. In order to simplify the
      hybridization, various non-radioactive labelling methods of oligonucleotide
      probes were compared. Biotinylation at the 5' end by means of oligonucleotide
      synthesis was the most simple and practical labelling method in this laboratory.
      The routine applicability of hybridization was further simplified by constructing
      a robot device, which automatically performs filter-hybridization and
      subsequently develops the signals derived from the biotinylated hybrids.

PMID- 8366871
TI  - Increased PCR sensitivity by using paraffin wax as a reaction mix overlay.
AB  - The use of mineral oil as a reaction mix overlay in conventional PCR may lead to
      problems. In addition to more difficult handling, traces of mineral oil in
      amplicon suspensions have been shown to decrease the efficiency of post-PCR
      manipulations. Commercial alternatives aimed at resolving the problem more than
      double the cost of an amplification. This is an important drawback when dealing
      with a large number of clinical samples. The use of inexpensive paraffin wax as a
      reaction mix overlay eliminated problems associated with the presence of mineral
      oil while being more practical and safer in handling potentially contaminated
      clinical samples. Moreover, when used in conjunction with a modified hot start
      technique, the use of paraffin wax increased the specificity and sensitivity of
      PCR amplifications over mineral oil in similar hot start conditions. Using the
      aforementioned method, the increase in specificity and sensitivity has enabled
      specific detection of viral DNA in clinical samples which the conventional PCR
      method failed to detect.

PMID- 8366872
TI  - Language comprehension in ape and child.
AB  - Previous investigations of the linguistic capacities of apes have focused on the
      ape's ability to produce words, and there has been little concern for
      comprehension. By contrast, it is increasingly recognized that comprehension
      precedes production in the language development of normal human children, and it
      may indeed guide production. It has been demonstrated that some species can
      process speech sounds categorically in a manner similar to that observed in
      humans. Consequently, it should be possible for such species to comprehend
      language if they have the cognitive capacity to understand word-referent
      relations and syntactic structure. Popular theories of human language acquisition
      suggest that the ability to process syntactic information is unique to humans and
      reflects a novel biological adaptation not seen in other animals. The current
      report addresses this issue through systematic experimental comparisons of the
      language comprehension skills of a 2-year-old child and an 8 year-old bonobo (Pan
      paniscus) who was raised in a language environment similar to that in which
      children are raised but specifically modified to be appropriate for an ape. Both
      subjects (child and bonobo) were exposed to spoken English and lexigrams from
      infancy, and neither was trained to comprehend speech. A common caretaker
      participated in the rearing of both subjects. All language acquisition was
      through observational learning. Without prior training, subjects were asked to
      respond to the same 660 novel sentences. All responses were videotaped and scored
      for accuracy of comprehension of the English language. The results indicated that
      both subjects comprehended novel requests and simple syntactic devices. The
      bonobo decoded the syntactic device of word recursion with higher accuracy than
      the child; however, the child tended to do better than the bonobo on the
      conjunctive, a structure that places a greater burden on short-term memory. Both
      subjects performed as well on sentences that required the ability to reverse work
      order as they did on sentences that did not require this capacity. These results
      are discussed in light of a model of the evolution of language that suggests that
      the potential for language comprehension preceded the appearance of speech by
      several million years at minimum. The onset of speech is linked to the appearance
      of fully adapted bipedalism, which necessitated reorientation of the laryngeal
      tract and made closure of the soft palate possible. For the first time, such
      closure permitted mammals to easily produce sounds that could be interpreted by
      the mammalian auditory system in a categorical manner. When these sounds were
      paired with the previously extant capacity to produce vowels, it became possible
      to form "bounded vowels" or sound units that could readily be discriminated as
      units by the auditory system. It is suggested that this physical adaptation
      allowed the extant cognitive capacity of the hominids to embark on a speech-like
      mode of communication.

PMID- 8366873
TI  - Comprehension and production in early language development [see comment].

PMID- 8366874
TI  - Kinetics of amorolfine in human nails.
AB  - Amorolfine penetrates rapidly into the nail after topical application. The
      kinetics of penetration follow an exponential law as expected, and the level of
      amorolfine measured in the nail (at least in the upper levels) already exceeds
      the MIC of most fungi causing onychomycosis after only 24 h of contact. After
      topical application amorolfine is detectable in the nail earlier and in higher
      concentrations than terbinafine and itraconazole after oral application.

PMID- 8366875
TI  - Susceptibility testing of Candida species for fluconazole: the role of buffering
      in the agar dilution assay.
AB  - The role of buffering in the determination of the minimal inhibitory
      concentration (MIC) of fluconazole was studied with Candida species. Agar
      dilution tests were performed on media (pH 7.25) buffered with either phosphate
      or morpholinopropane-sulfonic acid (MOPS) or endomethylene-tetrahydrophthalic
      acid (EMTA), 0.1 mol l-1 each, or on the unbuffered medium. It consisted of
      casitone and glucose supplemented with FeCl3 and MgSO4. The MICs recorded after
      24 h at 37 degrees C extended from 0.1 mg l-1 to > or = 100 mg l-1 on the
      phosphate and EMTA medium, being concordant on both media. On the MOPS medium and
      the unbuffered medium the readings were also concordant; the MICs, however, were
      mostly 25 mg l-1 or higher. This increase of the values--up to six dilution steps
      -could not be correlated with the amount of acid secreted by the single strains.
      EMTA proved to be an alternative to phosphate in this system, and because it
      allows a faster growth of the yeasts it might be superior to phosphate. The
      concordance of the MIC values in the presence of such different buffer compounds
      tends to suggest that they indeed indicate the strongest inhibition attainable in
      vitro by fluconazole. MOPS was confirmed to be of no use in this system.

PMID- 8366876
TI  - Clinical efficacy and tolerability of saperconazole for tinea of glabrous skin. A
      report on four cases.
AB  - In a randomized controlled trial three different treatment protocols with the new
      broad-spectrum peroral antifungal saperconazole were evaluated. The treatment
      regimens were as follows: 100 mg per day for 7 days, 200 mg per day for 7 days,
      100 mg per day for 14 days. Of four assessable cases of dermatophytosis of
      glabrous skin treated with one of these three therapeutic regimens, one was
      cured. In this patient, however, the dermatophytosis relapsed after the end of
      the observation period, but due to a different microorganism. While partial
      improvement was seen in the other cases definite cure was not obtained. No
      adverse events were recorded.

PMID- 8366877
TI  - Tinea corporis bullosa.
AB  - The paper reports a case of tinea corporis bullosa in a 63-year-old woman. Near
      the classical annular lesions on the anterior surface of the left leg, the
      patient presented frank bullous lesions. Serous fluid from the bulla yielded
      Microsporum canis, the first report of the association of this fungus with
      bullous lesions in tinea corporis. The patient was investigated with routine
      examinations and immunological studies which showed an intense inflammatory
      process much greater than in usual cases of tinea corporis.

PMID- 8366878
TI  - Cutaneous pythiosis in horses from Brazil.
AB  - Equine pythiosis was studied in five animals from two farms located in a swampy
      region of southern Brazil (Rio Grande do Sul State). Granulomatous lesions
      exuding necrotic material and containing a central yellow and firm tissue core,
      the 'kunker', were observed on the top of the nose of one horse, on the abdomen
      of two horses and on the hind limbs of two other animals. Direct microscopic
      preparations, histopathological examination of lesion material, and macroscopic
      and microscopic characteristics of the isolates confirmed the diagnosis of
      pythiosis. Surgical intervention of the inflammatory processes, intravenous
      potassium iodide and topical application of copper sulphate were used without
      success.

PMID- 8366879
TI  - Chrysosporium gourii Jain, Deshmukh & Agrawal sp. nov.
AB  - A new keratinophilic species, Chrysosporium gourii, an isolate of cattle farm
      soil of Sagar, India, is described and illustrated. The differences between this
      and other similar keratinophilic species of Chrysosporium are discussed.

PMID- 8366880
TI  - Diagnostic problems with imported cases of mycetoma in The Netherlands.
AB  - Eight cases of imported mycetomata in The Netherlands are reviewed. Seven of
      these were cultured; only one isolate, Actinomadura madurae, belonged to a
      species commonly known as an agent of mycetoma. The remaining strains either
      belonged to very rare species, such as Phialophora cyanescens, or could not be
      identified at all. The list of possible agents of mycetoma apparently needs to be
      expanded. In addition, the concept of endemic occurrence of aetiological agents
      of eumycetoma needs revision. Divergent saprophytes may be involved which are
      able to survive in human tissue.

PMID- 8366881
TI  - Mycetoma: a retrospective study of 41 cases seen in Sao Paulo, Brazil, from 1978
      to 1989.
AB  - Clinical and epidemiological aspects of 41 cases of mycetoma seen in Sao Paulo
      city from January 1978 to December 1989 are presented. Twenty-eight cases (68%)
      were caused by actinomycetes, while 13 (32%) were caused by true fungi. In only
      22 (78%) actinomycetoma cases was it possible to identify the agent. Nocardia
      brasiliensis, by far the commonest actinomycete isolated, was responsible for 13
      cases. Among eumycetomata, Madurella grisea was isolated from 3 cases,
      Scedosporium apiospermum from 2 cases, and Madurella mycetomatis from 1 case, and
      in 7 cases the agent was not identified. Distribution by sex and age was similar
      to that reported in the literature. Feet and legs were the commonest sites
      affected. The mean age of actinomycetoma patients was 33.2 years, while patients
      with eumycetomata were an average of 32.8 years. Mean duration of the disease was
      6.8 and 9.8 years respectively. Most patients came from rural areas in the north
      eastern region of the country and worked as field labourers. Bone involvement was
      frequent for both actinomycetomata and eumycetomata and was characterized by
      osteoporosis, periostal reaction and cavitation. The authors' elected treatment
      consists of combining sulfamethoxazole (800 mg) and trimethoprim (100 mg) with
      prednisone (10 mg) orally, daily.

PMID- 8366882
TI  - Exophiala jeanselmei keratitis.
AB  - We present the case of a 42-year-old Saudi male with a fungal corneal abscess in
      his left eye. The aetiological agent was found to be the dematiaceous fungus
      Exophiala jeanselmei. The patient was treated with topical natamycin, miconazole,
      and also amphotericin B. During the course of the infection corneal perforation
      occurred which was treated with cyanocrylate glue. Secondary glaucoma resulted
      from peripheral anterior synechia which necessitated trabeculectomy. At the end
      of the course the infection was successfully eradicated, the complications were
      cured, and vision improved from counting fingers in front of the face at
      presentation to 20/80. There was no recurrence of the infection in a follow-up
      period of 2 years.

PMID- 8366883
TI  - Sequence diversity in the intron of the calmodulin gene from Plasmodium
      falciparum.
AB  - Sequence variation in the single intron of the calmodulin gene of Plasmodium
      falciparum has been examined following amplification using the polymerase chain
      reaction (PCR). The intron has 4 repeating motifs varying in length: 3 of these
      contain a dinunucleotide repeat, dA-dT, the fourth is a pentameric repeating
      unit, dA-dT-dA-dT-dT. These DNA polymorphisms can be applied to the study of
      parasite populations in mixed infections and in strain identification. The
      function of these repeating motifs is unknown. Computer modelling of the possible
      intron structures demonstrates that each of these repeating motifs forms
      individual stem loops such that any changes in repeat number are self
      compensatory and do not change the overall intron structure. The implications of
      this sequence variation are discussed.

PMID- 8366884
TI  - Two alleles of the 175-kilodalton Plasmodium falciparum erythrocyte binding
      antigen.
AB  - EBA-175, erythrocyte binding antigen 175, is a 175-kDa antigen of Plasmodium
      falciparum which has been shown to be involved in the recognition of erythrocytes
      by merozoites and may be involved in the process of erythrocyte invasion.
      Invasion of erythrocytes by Camp strain merozoites is inhibited by pre-treatment
      of red blood cells by EBA-175 from the heterologous strain, FCR-3. The sequence
      of the Camp strain has been published and we report here the sequence of the FCR
      3 strain. The sequences are nearly identical except for a 423-bp segment in the
      FCR-3 strain, F-segment, that is not found in the Camp strain and a 342-bp
      segment, C-segment, present in the Camp strain but not in the FCR-3 strain. The
      locations of these two segments are different in Camp and FCR-3 EBA-175 genes and
      there is little DNA or amino acid sequence homology between them. The essentially
      dimorphic alleles, F-segment and C-segment, are conserved in all isolates
      examined to date. Evidence of genetic cross-over between the FCR-3 and the Camp
      EBA-175 genes was not observed in the analysis of a limited number of wild
      isolates. The continued study of the biological relevance of these sequence
      divergences in EBA-175 may further elucidate the sequence of events resulting in
      merozoite invasion of erythrocytes.

PMID- 8366885
TI  - The gene coding for the major sheath protein of Litomosoides carinii
      microfilariae, gp22, is transcribed in oocytes and embryonic cells.
AB  - The transcription and translation of the gene encoding gp22, a major constituent
      of the microfilarial sheath of the filarial parasite Litomosoides carinii were
      studied by in situ hybridisation and immunohistology. Transcription of the gp22
      gene is confined to oocytes and embryos in the reproductive organs of adult
      female worms. It starts in oocytes in the rhachis zone, is maximal in
      multicellular embryos and decreases slowly as the microfilariae develop. Blood
      microfilariae lack the gp22 transcript. The gp22 gene product is first detectable
      in parasites recovered on day 32 post infection. Expression of gp22 begins in
      multicellular embryos in the uteri of mature female worms and can be detected in
      all further developed intrauterine stages. The gp22 gene product appears to be
      exported by the embryonic cells and becomes integrated into the sheath where it
      may contribute to the flexibility of the latter structure.

PMID- 8366887
TI  - Molecular characterisation of beta-tubulin genes present in benzimidazole
      resistant populations of Haemonchus contortus.
AB  - A beta-tubulin isotype 1 gene, gru-1, from a benzimidazole (BZ)-resistant
      population of the nematode parasite, Haemonchus contortus, was cloned and
      sequenced. The predicted gene organisation showed 10 exons and 9 introns, one of
      which was H. contortus specific. Using probes and restriction sites selected from
      this sequence, restriction maps were constructed from and around beta-tubulin
      genes of 3 BZ-susceptible and 7 BZ-resistant populations. There was a reduction
      in beta-tubulin isotype 1 genes to usually one, in BZ-resistant populations. So,
      our previously reported reduction of beta-tubulin probe-reactive RFLP fragments
      in resistant populations correlated with the reduction of beta-tubulin isotype 1
      genes. The beta-tubulin isotype 1 gene present on the apparently selected
      fragment and was not always the same, and the geographical origin of the
      resistant populations indicated independent development rather than geographical
      spread of the resistant populations. The beta-tubulin genes on the apparently
      selected fragments were transcribed and processed to mRNA using the nematode
      specific trans-spliced leader (SL1). Comparison of the derived amino acid
      sequence of gru-1, with known sequences from a susceptible population, identified
      3 mutations that could be involved in BZ resistance.

PMID- 8366888
TI  - Molecular cloning, complete sequence of the small subunit ribosomal RNA coding
      region and phylogeny of Toxoplasma gondii.

PMID- 8366886
TI  - Isolate-specific parasite antigens of the Babesia bovis-infected erythrocyte
      surface.
AB  - Bovine erythrocytes taken from in vitro cultures of Babesia bovis parasites from
      Mexico and the United States were assayed for the presence of new epitopes on the
      erythrocyte surface. New surface-exposed epitopes were detected by means of a
      whole-cell antigen capture assay. These epitopes were subsequently demonstrated
      only on infected erythrocytes by immunofluorescence staining of intact, living
      cells. Parasite-synthesized antigens were identified on each isolate using a
      surface-specific immunoprecipitation technique to analyze metabolically-labeled
      infected erythrocytes. In the Mexico isolate these antigens were 120 kDa and 107
      kDa, whereas in the United States isolate polypeptides of 135, 120 and 107 kDa
      were detected. In each of these assays, reaction of immune sera with the infected
      erythrocyte surface was found to be isolate-specific.

PMID- 8366889
TI  - SA85-1 proteins of Trypanosoma cruzi lack sialidase activity.

PMID- 8366890
TI  - Inhibition of Plasmodium falciparum hypoxanthine-guanine
      phosphoribosyltransferase mRNA by antisense oligodeoxynucleotide sequence.

PMID- 8366891
TI  - Molecular cloning and characterization of an Echinococcus granulosus cDNA
      encoding malate dehydrogenase.

PMID- 8366892
TI  - Genetic exchange in Trypanosoma brucei: selection of hybrid trypanosomes by
      introduction of genes conferring drug resistance.
AB  - Genetic exchange in Trypanosoma brucei ssp. can occur when 2 different strains
      are cotransmitted through the tsetse fly vector. We have introduced heterologous
      genes for drug resistance (neo or hph) into parental trypanosome lines by
      electroporation. Drug resistant lines were then crossed in vivo in the fly or in
      vitro. Hybrids were subsequently selected by double drug resistance. Analysis of
      trypanosomes from both fly midguts and salivary glands showed the latter to be
      the probable site of genetic exchange. This is one of the first applications of
      reverse genetics to a longstanding problem in parasite biology.

PMID- 8366893
TI  - The gamma-tubulin gene of the malaria parasite Plasmodium falciparum.
AB  - By screening of cDNA and genomic libraries of Plasmodium falciparum with a DNA
      probe derived from the cognate beta-tubulin gene, gene Pf gamma tub has been
      identified that codes for gamma-tubulin, a newly discovered member of the tubulin
      superfamily that is indispensible for nuclear division and microtubule assembly
      [12]. Gene Pf gamma tub is not interrupted by introns and only present as a
      single-copy in the parasite genome. Its encoded amino acid sequence (452 amino
      acids; M(r) 50,560) has a 63% similarity to the gamma-tubulins encoded by
      Aspergillus nidulans, Schizosaccharomyces pombe, Drosophila melanogaster, Xenopus
      laevis and Homo sapiens. This figure is significantly (approx. 8%) lower than the
      average identity between the gamma-tubulins of the latter five species suggesting
      that during evolution the genes have been exposed to different selection
      pressures. The identity of gamma-tubulin to the Plasmodium falciparum encoded
      alpha- and beta-tubulins is 30 and 33%, respectively.

PMID- 8366894
TI  - Pathways of pyrimidine nucleotide biosynthesis in gravid Angiostrongylus
      cantonensis.
AB  - The incorporation of radioactive precursors into pyrimidine nucleotides via de
      novo and salvage pathways was measured in gravid Angiostrongylus cantonensis by
      HPLC and thin-layer chromatography. 14C-labelled orotate, uridine, uracil and
      deoxyuridine were traced to UMP, UDP, UTP, UDP-glucose, dTMP, CMP, CDP and CTP.
      3H-labelled cytidine was also incorporated into both uracil and cytosine
      nucleotides in a ratio of 2:1. Cytosine was a major end-product for all the
      precursors. Cytosine nucleotides were probably formed from UTP by the action of
      CTP synthetase whose activity in crude cell-free extract was 31.5 +/- 4.9 pmol
      min-1 (mg protein)-1. It was dependent on glutamine, ATP and GTP and was
      inhibited by CTP. The total amount of pyrimidine nucleotides formed from uridine
      was 3 times of that from uracil. The presence of uracil in the metabolism of
      uridine indicates that UMP is formed by uracil phosphoribosyltransferase as well
      as by uridine kinase. UMP is a key intermediate for cytidylate and thymidylate
      biosynthesis in the gravid worms.

PMID- 8366895
TI  - Phylogenetic position of the genus Perkinsus (Protista, Apicomplexa) based on
      small subunit ribosomal RNA.
AB  - Parasites of the genus Perkinsus destroy marine molluscs worldwide. Their
      phylogenetic position within the kingdom Protista is controversial. Nucleotide
      sequence data (1792 bp) from the small subunit rRNA gene of Perkinsus sp. from
      Anadara trapezia (Mollusca: Bivalvia) from Moreton Bay, Queensland, was used to
      examine the phylogenetic affinities of this enigmatic genus. These data were
      aligned with nucleotide sequences from 6 apicomplexans, 3 ciliates, 3
      flagellates, a dinoflagellate, 3 fungi, maize and human. Phylogenetic trees were
      constructed after analysis with maximum parsimony and distance matrix methods.
      Our analyses indicate that Perkinsus is phylogenetically closer to
      dinoflagellates and to coccidean and piroplasm apicomplexans than to fungi or
      flagellates.

PMID- 8366896
TI  - Random amplified polymorphic DNA analysis of Trypanosoma cruzi strains.
AB  - DNA extracted from 32 isolates of Trypanosoma cruzi was subjected to polymerase
      chain reaction amplification using 4 arbitrary primers resulting in relatively
      complex DNA profiles that include polymorphic markers known as random amplified
      polymorphic DNAs (RAPDs). The RAPD profiles of 18 strains belonging to zymodeme 1
      (Z1) collected from various regions of South America exhibited a consistant
      pattern and 59 (59%) of the bands produced were present in all Z1 strains. A
      similar level of consistency was seen in the number of bands shared between 5 Z2
      strains, 4 ZB strains and 2 ZC strains. A phenetic analysis of the 5 most
      different Z1 strains based on band sharing showed that their interrelationships
      mirrored their geographical origin. Comparison of the RAPD profiles of strains
      from different zymodemes showed that less than 7% of bands of strains in one
      zymodeme are present in strains of another zymodeme. Analysis of band sharing
      using bands present in all strains of a given zymodeme showed ZB and ZC to be
      closely related and Z1 and Z2 to form distinct groups.

PMID- 8366897
TI  - Structure of the gene encoding a putative Schistosoma mansoni tegumental antigen
      precursor.
AB  - In order to obtain the complete gene encoding the putative precursor of a 15-kDa
      Schistosoma mansoni tegumental antigen (Sm15), two cDNAs (A70 and A184) and two
      fragments of independent genomic clones were subcloned and sequenced. The
      collated sequence contains 4700 nucleotides and represents the full length open
      reading frame of the gene, encoding a protein of 1032 amino acids with a
      calculated molecular mass of 116,900. Thus, the gene encodes a much longer
      protein than that identified in the tegumental membranes, suggesting that it
      encodes a precursor that is subsequently highly processed. A 964-bp region
      composed of 5 closely related repeats was found to be present within the
      translated frame. The predicted protein is highly acidic and there is no
      indication of hydrophobic domains that may represent transmembrane regions or
      indicate attachment of a GPI anchor. The coding region has no homologies in the
      currently available data bases. In the 5' non-transcribed area a copy of the SM
      alpha repeat family is present. The coding region is preceded by putative CCAAT
      and TATA boxes that may be involved in the control of expression.

PMID- 8366898
TI  - Transport of D-fructose and its analogues by Trypanosoma brucei.
AB  - Kinetic parameters for entry of D-fructose into Trypanosoma brucei brucei have
      been determined. The net uptake of D-fructose was found to be rapid and occurred
      at a rate which was comparable with that observed for uptake of D-glucose. The Km
      and Vmax were 3.91 +/- 1.58 mM and 69.1 +/- 7.2 nmol min-1 (mg protein)-1. D
      Fructose was metabolized to pyruvate under aerobic conditions and to pyruvate and
      glycerol under anaerobic conditions in a manner similar to D-glucose. Comparisons
      of the kinetic parameters for D-fructose transport and metabolism indicated that
      uptake was rate limiting. Inhibition constants (Ki) for inhibition of 6-deoxy-D
      glucose by D-fructose and D-fructose transport by 6-deoxy-D-glucose were
      consistent with the Km values for these two substrates. These interactions
      indicate that D-fructose and 6-deoxy-D-glucose share a single common transporter.
      1,5-Anhydro-D-glucitol and 1,5 anhydro-D-mannitol (the fused pyranose ring
      analogues of D-glucose and D-mannose) have been found to interact well with the
      transporter, while L-sorbose (a D-fructose analogue with a pyranose ring) had
      only low affinity. However, 2,5-anhydro-D-mannitol (a fused furanose ring
      analogue of D-fructose) inhibited both 6-deoxy-D-glucose and D-fructose transport
      with a Ki of approx. 0.8 mM. The high affinity for 2,5-anhydro-D-mannitol (2
      deoxy-D-fructofuranose) indicates that D-fructose is transported in the furanose
      ring form.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366899
TI  - The urea reduction ratio and serum albumin concentration as predictors of
      mortality in patients undergoing hemodialysis.
AB  - BACKGROUND: Among patients with end-stage renal disease who are treated with
      hemodialysis, solute clearance during dialysis and nutritional adequacy are
      determinants of mortality. We determined the effects of reductions in blood urea
      nitrogen concentrations during dialysis and changes in serum albumin
      concentrations, as an indicator of nutritional status, on mortality in a large
      group of patients treated with hemodialysis. METHODS: We analyzed retrospectively
      the demographic characteristics, mortality rate, duration of hemodialysis, serum
      albumin concentration, and urea reduction ratio (defined as the percent reduction
      in blood urea nitrogen concentration during a single dialysis treatment) in
      13,473 patients treated from October 1, 1990, through March 31, 1991. The risk of
      death was determined as a function of the urea reduction ratio and serum albumin
      concentration. RESULTS: As compared with patients with urea reduction ratios of
      65 to 69 percent, patients with values below 60 percent had a higher risk of
      death during follow-up (odds ratio, 1.28 for urea reduction ratios of 55 to 59
      percent and 1.39 for ratios below 55 percent). Fifty-five percent of the patients
      had urea reduction ratios below 60 percent. The duration of dialysis was not
      predictive of mortality. The serum albumin concentration was a more powerful (21
      times greater) predictor of death than the urea reduction ratio, and 60 percent
      of the patients had serum albumin concentrations predictive of an increased risk
      of death (values below 4.0 g per deciliter). The odds ratio for death was 1.48
      for serum albumin concentrations of 3.5 to 3.9 g per deciliter and 3.13 for
      concentrations of 3.0 to 3.4 g per deciliter. Diabetic patients had lower serum
      albumin concentrations and urea reduction ratios than nondiabetic patients.
      CONCLUSIONS: Low urea reduction ratios during dialysis are associated with
      increased odds ratios for death. These risks are worsened by inadequate
      nutrition.

PMID- 8366900
TI  - Images in clinical medicine. Superior vena cava syndrome.

PMID- 8366901
TI  - Social and economic consequences of overweight in adolescence and young
      adulthood.
AB  - BACKGROUND AND METHODS: Overweight in adolescents may have deleterious effects on
      their subsequent self-esteem, social and economic characteristics, and physical
      health. We studied the relation between overweight and subsequent educational
      attainment, marital status, household income, and self-esteem in a nationally
      representative sample of 10,039 randomly selected young people who were 16 to 24
      years old in 1981. Follow-up data were obtained in 1988 for 65 to 79 percent of
      the original cohort, depending on the variable studied. The characteristics of
      the subjects who had been overweight in 1981 were compared with those for young
      people with asthma, musculoskeletal abnormalities, and other chronic health
      conditions. Overweight was defined as a body-mass index above the 95th percentile
      for age and sex. RESULTS: In 1981, 370 of the subjects were overweight. Seven
      years later, women who had been overweight had completed fewer years of school
      (0.3 year less; 95 percent confidence interval, 0.1 to 0.6; P = 0.009), were less
      likely to be married (20 percent less likely; 95 percent confidence interval, 13
      to 27 percent; P < 0.001), had lower household incomes ($6,710 less per year; 95
      percent confidence interval, $3,942 to $9,478; P < 0.001), and had higher rates
      of household poverty (10 percent higher; 95 percent confidence interval, 4 to 16
      percent; P < 0.001) than the women who had not been overweight, independent of
      their base-line socioeconomic status and aptitude-test scores. Men who had been
      overweight were less likely to be married (11 percent less likely; 95 percent
      confidence interval, 3 to 18 percent; P = 0.005). In contrast, people with the
      other chronic conditions we studied did not differ in these ways from the
      nonoverweight subjects. We found no evidence of an effect of overweight on self
      esteem. CONCLUSIONS: Overweight during adolescence has important social and
      economic consequences, which are greater than those of many other chronic
      physical conditions. Discrimination against overweight persons may account for
      these results.

PMID- 8366902
TI  - Acute monoarthritis.

PMID- 8366903
TI  - Treatment of Parkinson's disease.

PMID- 8366904
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 39-1993. An 83-year-old woman with hypertension, sudden severe
      back pain, and anuria.

PMID- 8366905
TI  - The diabetes control and complications trial. Implications for policy and
      practice.

PMID- 8366906
TI  - Obesity and socioeconomic status--a complex relation.

PMID- 8366907
TI  - My life at the Journal, 1961-1993.

PMID- 8366908
TI  - Hormone replacement and cardiovascular risk factors.

PMID- 8366909
TI  - Hormone replacement and cardiovascular risk factors.

PMID- 8366910
TI  - Hormone replacement and cardiovascular risk factors.

PMID- 8366911
TI  - Hormone replacement and cardiovascular risk factors.

PMID- 8366912
TI  - Single-drug therapy for hypertension in men.

PMID- 8366913
TI  - Single-drug therapy for hypertension in men.

PMID- 8366914
TI  - Single-drug therapy for hypertension in men.

PMID- 8366915
TI  - Combination chemotherapy for ITP.

PMID- 8366916
TI  - Immunization of adults.

PMID- 8366917
TI  - Immunization of adults.

PMID- 8366918
TI  - Immunization of adults.

PMID- 8366919
TI  - Physicians' autonomy.

PMID- 8366920
TI  - Physicians' autonomy.

PMID- 8366921
TI  - The American health care system. Teaching hospitals.

PMID- 8366922
TI  - The effect of intensive treatment of diabetes on the development and progression
      of long-term complications in insulin-dependent diabetes mellitus.
AB  - BACKGROUND: Long-term microvascular and neurologic complications cause major
      morbidity and mortality in patients with insulin-dependent diabetes mellitus
      (IDDM). We examined whether intensive treatment with the goal of maintaining
      blood glucose concentrations close to the normal range could decrease the
      frequency and severity of these complications. METHODS: A total of 1441 patients
      with IDDM--726 with no retinopathy at base line (the primary-prevention cohort)
      and 715 with mild retinopathy (the secondary-intervention cohort) were randomly
      assigned to intensive therapy administered either with an external insulin pump
      or by three or more daily insulin injections and guided by frequent blood glucose
      monitoring or to conventional therapy with one or two daily insulin injections.
      The patients were followed for a mean of 6.5 years, and the appearance and
      progression of retinopathy and other complications were assessed regularly.
      RESULTS: In the primary-prevention cohort, intensive therapy reduced the adjusted
      mean risk for the development of retinopathy by 76 percent (95 percent confidence
      interval, 62 to 85 percent), as compared with conventional therapy. In the
      secondary-intervention cohort, intensive therapy slowed the progression of
      retinopathy by 54 percent (95 percent confidence interval, 39 to 66 percent) and
      reduced the development of proliferative or severe nonproliferative retinopathy
      by 47 percent (95 percent confidence interval, 14 to 67 percent). In the two
      cohorts combined, intensive therapy reduced the occurrence of microalbuminuria
      (urinary albumin excretion of > or = 40 mg per 24 hours) by 39 percent (95
      percent confidence interval, 21 to 52 percent), that of albuminuria (urinary
      albumin excretion of > or = 300 mg per 24 hours) by 54 percent (95 percent
      confidence interval 19 to 74 percent), and that of clinical neuropathy by 60
      percent (95 percent confidence interval, 38 to 74 percent). The chief adverse
      event associated with intensive therapy was a two-to-threefold increase in severe
      hypoglycemia. CONCLUSIONS: Intensive therapy effectively delays the onset and
      slows the progression of diabetic retinopathy, nephropathy, and neuropathy in
      patients with IDDM.

PMID- 8366925
TI  - Our violent world.

PMID- 8366924
TI  - Nursing and health care reform.

PMID- 8366923
TI  - Toxoplasmic encephalitis in patients with the acquired immunodeficiency syndrome.
      Members of the ACTG 077p/ANRS 009 Study Team.
AB  - BACKGROUND: In patients with the acquired immunodeficiency syndrome (AIDS),
      toxoplasmic encephalitis is usually a presumptive diagnosis based on the clinical
      manifestations, a positive antitoxoplasma-antibody titer, and characteristic
      neuroradiologic abnormalities. A response to specific therapy helps to confirm
      the diagnosis, but it is unclear how rapid the response should be. We studied the
      course of patients treated for acute toxoplasmic encephalitis and evaluated
      objective clinical criteria for this empirical diagnosis. METHODS: A quantifiable
      neurologic assessment was used prospectively to evaluate the clinical outcome of
      patients with AIDS and toxoplasmic encephalitis who were treated with oral
      clindamycin (600 mg four times a day) and pyrimethamine (75 mg every day) for six
      weeks. RESULTS: Thirty-five of 49 patients (71 percent) responded to therapy, and
      30 of these (86 percent) had improvement by day 7. Thirty-two of those with a
      response (91 percent) improved with respect to at least half of their base-line
      abnormalities by day 14. Improvement in neurologic abnormalities within 7 to 14
      days after the start of therapy was strongly associated with the neurologic
      response at 6 weeks. The four patients in whom treatment failed and the two
      patients with lymphoma had progressing neurologic abnormalities or new
      abnormalities during the first 12 days of therapy. Nonlocalizing abnormalities
      (headache and seizure) improved regardless of the clinical outcome. CONCLUSIONS:
      Oral clindamycin and pyrimethamine are an effective treatment for toxoplasmic
      encephalitis. Patients who have early neurologic deterioration despite treatment
      or who do not improve neurologically after 10 to 14 days of appropriate
      antitoxoplasma therapy should be considered candidates for brain biopsy.

PMID- 8366927
TI  - Disadvantaged professionals: implications for education and practice.

PMID- 8366928
TI  - Primary care in the emergency room: a collaborative model.
AB  - Emergency rooms have become primary care centers for a large portion of the
      population. Unfortunately, most are neither designed nor appropriately staffed to
      deliver first-line, continuous, comprehensive, family-oriented, and self
      actualizing care. This paper describes a nurse-managed collaborative primary care
      practice model that has been functioning for 8 years in an inner city emergency
      department.

PMID- 8366926
TI  - Nurse manager characteristics and skills: curriculum implications.
AB  - If one accepts the premise that all nurses need knowledge of management and
      leadership, then schools of nursing need to design their curriculum to provide
      administrative content and learning experiences to adequately prepare nurses for
      leadership positions. This study assays the opinions of nurse unit managers about
      the relative importance of different characteristics and skills in effective job
      performance. A sample of 73 unit managers from six hospitals and two community
      health agencies ranked human relations and communication skills as most
      important. Nursing knowledge and clinical skills were ranked second. Experienced
      managers thought political savvy and business or management skills were more
      important than did novice managers. The results of this study are discussed in
      relation to curriculum issues in nursing management at both the baccalaureate and
      the graduate level.

PMID- 8366929
TI  - Informed consent: it's more than just a signature on paper.

PMID- 8366930
TI  - The effect of a preceptorship on nursing performance.
AB  - The purpose of this quasi-experimental study was to determine the effectiveness
      of a preceptorship program in increasing the nursing performance of the new
      graduate. Before and immediately after participating in a 5-week preceptorship
      the students completed a background data sheet and Schwirian's Six Dimension
      Scale of Nursing Performance questionnaire. The findings indicated that in all
      areas measuring frequency of experiences, the students perceived themselves as
      having performed nursing activities more frequently as a result of the
      preceptorship. There were no significant changes in the students' perception of
      their previous preparation. They were equally satisfied about their academic
      background before and after the preceptorship. Only one nursing indicator,
      teaching/collaboration, measured a decrease in the quality of performance. All
      other indicators showed that, from the students point of view, there was an
      increase in the quality of their nursing performance. The positive trend of the
      results indicates to the investigators that there was an increase in the
      effectiveness of the students nursing performance following the preceptorship
      experience.

PMID- 8366931
TI  - Continuing nursing education: why don't nurses go? Why don't they use what they
      learn?
AB  - There are barriers that block nurses from participating in continuing nursing
      education (CNE) and from using what they learn when they do participate. This
      article describes the problems nurses experience in going to, and using what they
      learn from, CNE. Possible causes for the barriers, and steps to take to surmount
      them, are discussed. This information has implications for human and financial
      resource management, staffing and scheduling, staff development, policy
      regulations, economics, and professional trends.

PMID- 8366932
TI  - Developing a tool to measure functional changes in advanced dementia.
AB  - The purpose of this study was to develop a valid and reliable tool to measure
      functional change in older persons with moderate to severe dementia. The process
      was a collaborative one, drawing on the skills of both nurse researchers and
      clinicians. In Phase I of this study, 20 nursing assistants and 3 licensed nurses
      volunteered as subjects to develop the new scale. Phase II of the study involved
      27 subjects with a known diagnosis of dementia to test the scale's interrater
      reliability and criterion validity. The results demonstrated significant
      correlation among the raters and between the instruments. The investigators
      reported promising results from both the method of using staff expertise in scale
      development and the scale itself.

PMID- 8366934
TI  - [The CBS Health Survey (Central Bureau for Statistics)].

PMID- 8366933
TI  - [Fever of unknown origin; the importance of 'vigorous' observation].

PMID- 8366935
TI  - [Digital lung angiography using a flow-directed balloon catheter in the diagnosis
      of pulmonary embolisms].

PMID- 8366936
TI  - [Vaccination against mumps successful].

PMID- 8366937
TI  - [Laparoscopy useful in the diagnosis and surgery of acute appendicitis].
AB  - The value of diagnostic laparoscopy was evaluated in 74 patients who had clinical
      signs of acute appendicitis. The average age was 27 years (5-67). The
      laparoscopically determined degree of inflammation was compared with the results
      of histologic examination, and the results of laparoscopic appendectomy were
      evaluated. In 6 patients laparoscopic appendectomy was not performed, because of
      infiltrative disease (twice), twisted ovary, ovulatory bleeding, enteritis and
      partially incarcerated inguinal hernia. In 2 patients suffering of acute
      appendicitis conversion to laparotomy was necessary because of obscured anatomy.
      On 57 out of 68 patients who underwent appendectomy, the laparoscopic findings
      were in accordance with histologic examination; i.e. 54 times acute appendicitis
      and 3 times appendix sana. In 7 patients the appendix was classified as inflamed
      during laparoscopy, histological examination revealing lymphoid hyperplasia or a
      subacute inflammation. In 4 patients with a laparoscopically normal appendix,
      inflammation was seen histologically. The average operation time was 29 minutes
      and the average postoperative hospital stay was 4 days. Three complications
      occurred: an inflammatory mass developed in 2 patients post-operatively and I
      patient had a hematoma in the trocar puncture site and a wound abscess developed.
      Laparoscopy is an aid in diagnosing appendicitis, and may prevent unnecessary
      appendectomy. If inflammation is established appendectomy can be performed safely
      and effectively.

PMID- 8366938
TI  - [Secondary cases of meningococcal disease in The Netherlands, 1989-1990; a
      reappraisal of chemoprophylaxis].
AB  - OBJECTIVE: To assess the secondary attack rate (SAR) of meningococcal disease
      among the household contacts of primary patients and to describe the use of
      chemoprophylaxis in the Netherlands. DESIGN: Descriptive, nation-wide survey.
      METHODS: Information was collected of patients with meningococcal disease,
      reported between April 1st, 1989 and April 30th, 1990, and their household
      contacts. A household contact suffering from meningococcal disease between 24
      hours and 1 month after hospital admission of the primary patient, was considered
      to be a secondary case. Chemoprophylaxis was considered appropriate if rifampicin
      or minocycline had been prescribed to all household contacts within a maximum of
      one day after admission of the primary patient. RESULTS: There were 5 secondary
      cases (SAR: 0.3%). Chemoprophylaxis was prescribed to 627 of 1130 household
      contacts (55%). Of those the prophylaxis was considered appropriate in 46%. 2
      secondary cases were not given any prophylaxis, 2 received penicillin and 1
      rifampicin. Of the primary patients, 6% were given prophylaxis during their
      hospital stay. All meningococci, isolated from pairs of secondary and primary
      patients, were rifampicin sensitive. CONCLUSIONS: The SAR of meningococcal
      disease in the Netherlands is similar to that in other countries. Although
      prescription of chemoprophylaxis is not recommended by the government, it is
      prescribed to 55% of the household contacts, and in almost half of these
      instances it was considered to be appropriate. Chemoprophylaxis is rarely
      prescribed to primary patients. Recommendations concerning chemoprophylaxis in
      the Netherlands are in need of reappraisal. Based on the results from this study
      and the literature, the prescription of chemoprophylaxis to all household
      contacts of a patient with meningococcal disease, and to the index patient, is
      recommended.

PMID- 8366939
TI  - [Blepharospasm; results of treatment with botulin].
AB  - OBJECTIVE: Discussion of clinical symptoms and differential diagnosis of
      blepharospasm and treatment with botulinum A toxin. Blepharospasm is an
      involuntary spasmodic contraction of the eyelids. Within a few years 35%-70% of
      the patients becomes severely disabled. DESIGN: Prospective, open study. SETTING:
      Academical Medical Centre, Amsterdam. METHOD: In the period 1985-1992 we have
      seen 85 patients with blepharospasm. Of these 69 were treated with botulinum
      toxin, a total of 436 treatments, with a mean dose of 25 IU for each eye.
      RESULTS: The cause of blepharospasm was unknown in 71 patients. Secondary
      blepharospasm occurred in: peripheral facial palsy (one patient), herpes zoster
      infection of the trigeminal nerve (2), brain infarct (1), use of neuroleptics
      (2), progressive supranuclear palsy (2), Shy-Drager syndrome (1), kernicterus
      (1), and morbus Sjogren (4). There were 18 patients with autoimmune diseases. 77
      (91%) patients had a (very) severe form of blepharospasm. Electromyographic
      registration revealed a dysfunction of M. levator palpebrae in 7 patients. More
      than 70% of the patients were free of symptoms for a mean period of two months
      after each treatment. Local side effects were seen in 61 (14%) of the 436
      treatments: ptosis, haematoma, dry eyes, and diplopia. CONCLUSION: Blepharospasm
      is a disabling disease and occurs sometimes in association with other
      neurological and ophthalmological diseases. Botulinum A toxin is a safe and
      effective therapy. Electrophysiological investigation is important in the
      differential diagnosis; it is unnecessary to do CT or MRI routinely.

PMID- 8366940
TI  - [Angio-immunoblastic lymphadenopathy].
AB  - Angioimmunoblastic lymphadenopathy is a rare lymphoproliferative disease with a
      poor prognosis. We saw a 24-year-old female patient with a fulminant evolution of
      an angioimmunoblastic lymphadenopathy, possibly a recurrence after a 10 years
      remission.

PMID- 8366941
TI  - [Occupational diseases in The Netherlands; time for consolidation of forces].

PMID- 8366942
TI  - [Why was the dosage of proguanil doubled in malaria prophylaxis?].

PMID- 8366943
TI  - [Post-pharyngitis sepsis caused by Fusobacterium necrophorum: Lemierre's
      syndrome].

PMID- 8366944
TI  - [Abdominal aortic aneurysm: screening and treatment].

PMID- 8366945
TI  - [Abdominal aortic aneurysm: screening and treatment].

PMID- 8366946
TI  - [Farmacotherapeutisch Kompas 1993].

PMID- 8366947
TI  - [Use of language in relation to public health research and education].

PMID- 8366948
TI  - [Pain in the upper abdomen caused by pulmonary embolism].

PMID- 8366949
TI  - [Irradiation for pain in cancer patients: the sooner the better].

PMID- 8366950
TI  - [More pain due to pain treatment].

PMID- 8366951
TI  - [Fibromyalgia in the light of current pain models].

PMID- 8366952
TI  - [Secondary prevention of chronic low back pain: a behavior-oriented approach].

PMID- 8366953
TI  - [Rabies and vaccination in The Netherlands].

PMID- 8366954
TI  - [Ascending phlebothrombosis].
AB  - Ascending phlebothrombosis of the lower extremities can have serious consequences
      if not identified at an early stage. In the Academic Hospital of the Free
      University, Amsterdam, 18 patients with this disease were seen in the period 1980
      1991. Treatment should be aimed at preventing progression of the disease to the
      deep venous system. This may necessitate ligation and dissection of the V.
      saphena magna in the groin. Usually conservative treatment will do, provided
      regular follow-up is performed to see whether progression has taken place to the
      hiatus saphenus or the popliteal fossa. As the disease has usually progressed
      further than the clinical signs indicate, duplex scanning should be used in case
      of doubt. Progression to the deep system should immediately be treated
      surgically.

PMID- 8366955
TI  - [A Dutch family with familial Mediterranean fever].
AB  - Familial mediterranean fever (or recurrent hereditary polyserositis) is a genetic
      disorder with an autosomal recessive pattern of inheritance which occurs mostly
      in patients with eastern Mediterranean origin. Two Dutch patients are described,
      a 25-year-old women and her 58-year-old father, who suffered from recurring
      abdominal complaints, fever, and increased erythrocyte sedimentation rate,
      without evidence of Middle Eastern ancestry or hyperimmunoglobulinemia D.

PMID- 8366956
TI  - [Chromosome translocation in a DES-daughter: an incidental finding?].

PMID- 8366957
TI  - [The diagnosis of spondylodiscitis].

PMID- 8366958
TI  - [Cumulative meta-analysis as ultimate truth].

PMID- 8366959
TI  - [Meta-analysis: the art of the systematic overview].

PMID- 8366960
TI  - [Treatment possibilities in basal cell carcinoma].

PMID- 8366961
TI  - [Attention in the medical curriculum for the sequelae of DES administration].
AB  - There is still a lack of knowledge among physicians with respect to epidemiology,
      diagnosis, treatment and psychology of the former use of diethylstilboestrol
      (DES). A questionnaire was sent to 24 educational representatives of eight
      departments of general practice and 8 of gynaecology asking about the DES
      education programme in their departments. Response was 100%. Three of 8 general
      practice departments had a DES education programme, and all 8 gynaecology
      departments. With respect to epidemiology, diagnosis, treatment and psychology,
      the educational effort ranged from 50% to 75%, from 25% to 50%, and from 21% to
      46% of the departments giving information regarding DES daughters, DES mothers,
      and DES sons respectively. The medical education with respect to DES depended
      much on the personal opinion and involvement of the individual teacher. Training
      of medical students with respect to the DES problem should be an integral part of
      preclinical medical education.

PMID- 8366962
TI  - [Randomized clinical trials in the Nederlands Tijdschrift voor Geneeskunde].
AB  - OBJECTIVE: To collect all randomized clinical trials (RCT) published in the
      Nederlands Tijdschrift voor Geneeskunde (Ned Tijdschr Geneeskd) in order to
      present them to the Cochrane Centre, Oxford, United Kingdom, to be included in
      the international database of RCT's, which will be used to perform meta-analyses.
      DESIGN: Retrospective bibliometric study. SETTING: Editorial office of Ned
      Tijdschr Geneeskd. METHOD: All original papers (OP), published between the May
      1st, 1948 and May 1st, 1993 were studied. Papers were selected that met the
      criteria for RCT: randomization or the similar assignment of patients to
      different treatment groups. RESULTS: Of 6820 OP 259 (3.8%) were selected. In 69
      (26.6%) randomization seemed to be performed correctly and in 20 (7.7%)
      randomization was not correct; in 170 (65.6%) there was no randomization. In the
      period May 1st, 1948 till May 1st, 1968 24 RCT's were published, in the period
      May 1st, 1973 till May 1st, 1993 60. Most RCT's (78%) describe the effects of
      pharmaceutical treatment. CONCLUSION: RCT's as such were difficult to recognize
      in Ned Tijdschr Geneeskd. Over the years there was an increase in the number of
      published RCT's. The problems we found with the design of RCT's and randomization
      are still current. An international register of published and/or planned RCT's,
      as envisaged by the Cochrane Centre, will make it easier to carry out meta
      analyses.

PMID- 8366963
TI  - [The treatment of 12 HIV-infected children with zidovudine].
AB  - 12 HIV-infected children were treated with a high dose of zidovudine
      (800/mg/m2/day) during a mean follow up period of 18 months. After starting
      treatment with zidovudine there was a subjective improvement and an increase in
      body weight, and a significant decline in serum HIV-antigenemia (p < 0.01) and
      serum IgG levels (p < 0.05). Zidovudine was generally well tolerated but there
      was serious hematological toxicity. In 9 patients (75%) dose reduction was
      necessary because of severe anemia (3 patients) or leucopenia (6 patients).
      Because of the high incidence of these side effects the starting dose of
      zidovudine was reduced to 600 mg/m2/day. These results confirm that zidovudine
      can safely be used to treat HIV-infected children. The main limitation is serious
      hematological toxicity which appears to be dose-related.

PMID- 8366965
TI  - [Cervical myelopathy as complication of manual therapy in a patient with a narrow
      cervical canal].
AB  - A 31-year-old man had manipulative therapy because of pain in the neck, the left
      shoulder and the left arm. Immediately after cervical traction he developed
      neurological symptoms. Clinical investigation led to the diagnosis of cervical
      myelopathy. The patient had a rather narrow cervical canal. Six weeks after
      treatment with external fixation and corticosteroids the situation had improved
      markedly, with remaining hypesthesia in both hands and the right leg.

PMID- 8366964
TI  - [2 children with discitis].
AB  - The childhood form of discitis was diagnosed in a 2-year-old girl and a 5-year
      old boy. They presented with an antalgic posture, muscular defense and a positive
      Gowers sign. Characteristic symptoms of this childhood discitis form the triad:
      unexplained fever, increased erythrocyte sedimentation rate and symptomatic
      narrowing of an intervertebral space.

PMID- 8366966
TI  - [Storm during the dog days; observations with an article by Dr. W. Storm van
      Leeuwen from 1932].
AB  - In 1932 Storm van Leeuwen, professor of pharmacology in Leiden, together with De
      Lind van Wijngaarden published data on an increase of common colds in the
      population in general and an increase of symptoms in asthmatic patients during
      the period August 8-10, 1931. In asthmatics treated in 'climatized rooms' this
      aggravation was not observed. In this connection the authors refer to the
      'allergen-free' nature of these rooms. After studying the meteorological data of
      August 1931, however, we conclude that the colds and the aggravation of the
      asthmatic complaints in the period of August 8-10 were probably due to a sudden
      fall of the temperature from 30 to 15 degrees C in the period August 5-10, owing
      to a change of weather with influx of cold polar air.

PMID- 8366967
TI  - [Antibiotic prophylaxis in closed fractures is cost-effective if the possibility
      of a deep infection decreases with 0.25%].

PMID- 8366968
TI  - [Antibiotic prophylaxis in closed fractures cost-effective when the possibility
      of a deep infection decreases by 0.25%].

PMID- 8366969
TI  - [Turning grey overnight, is it possible?].

PMID- 8366970
TI  - [Psychological structure as a guiding principle in forensic practice].

PMID- 8366971
TI  - [Blood circulation and energy metabolism of the brain in healthy sleep].
AB  - Studies on sleep-related changes of cerebral blood flow (CBF) and cerebral
      metabolic rate (CMR) provide important information about sleep as an active
      neurophysiological process. Decreases in global values of CBF and CMR during non
      rapid-eye-movement sleep illustrate rate role of this sleep period as a quiescent
      phase for the human brain. Increases in CBF and CMR and fast alterations in
      cerebral perfusion during rapid-eye-movement sleep are indicative of an active
      state with labile regulation. Local changes in CBF and CMR characterize the
      heterogeneity of the underlying physiological regulation. The dynamic feature of
      cerebral perfusion in relation to electroencephalographic patterns obtained by
      new recording techniques reflects quantitative uncoupling between cerebral
      electrical activity and cerebral perfusion during parts of the sleep period. A
      critical analysis of the current literature and history of sleep research on this
      topic is presented.

PMID- 8366972
TI  - [Initial experiences with implantable pump systems for intrathecal therapy of
      chronic pain conditions].
AB  - The therapeutic concept of local administration of opioids into the perimedullar
      and cerebrospinal fluid is the result of fundamental studies concerning the
      discovery and localization of specific binding sites. These studies provoked
      considerable clinical interest, because they suggested a non-destructive and
      fully reversible method. In our department we have been gathering experience with
      an implantable pump system for various indications of chronic pain on a sample of
      25 patients. The first implantation was performed in February 1987 and the latest
      included in this study in February 1991. The sample of patients consisted of two
      groups: (A) Chronic non-malignant pain (13 cases), (B) Chronic pain due to cancer
      (12 cases). We used two different pump devices: the gas-filled continuous
      infusion pump (Infusaid, Mod. 400) in 10 cases and the manually tractable micro
      pump (Cordis) in 15 cases. In 23 cases we decided in favour of an
      intraventricular drug administration, mainly because of the site of the pain; in
      each of these a ventricular catheter was placed in the frontal horn of the
      lateral ventricle. In the remaining two cases, the catheter was placed
      intraspinally, the catheter tip terminating at thoracic segments. Nine of the
      patients with cancer-related pain experienced from excellent to acceptable pain
      relief, as did also 10 patients with chronic non-malignant pain. Side effects
      were rare. Our findings also indicate that, in carefully selected patients, both
      malignant and non-malignant pain may be managed satisfactorily with this
      technique.

PMID- 8366973
TI  - [Aggressive episodes without amnesia. Differential diagnostic problems based on a
      case report].
AB  - A 21-year-old patient suffered from recurrent attacks characterized by aggression
      and a varying disturbance of consciousness. He had no amnesia for these episodes.
      Loss of activity and social withdrawal had heralded the manifestation of the
      disease. He had delusions at times. The problems of differential diagnosis:
      schizophrenic disorder, frontal lobe epilepsy, or psychogenic seizures are
      discussed.

PMID- 8366974
TI  - [Psychopathologic findings and results of treatment of pension applicants.
      Comments on the contribution by R. Sandweg, C. Sanger-Alt and G. Rudolf].

PMID- 8366975
TI  - Analgesic nephropathy--still a problem?

PMID- 8366976
TI  - Rate of production of carbon dioxide in patients with a severe degree of
      metabolic acidosis.

PMID- 8366977
TI  - Nitric oxide: an inflammatory mediator of glomerular mesangial cells.

PMID- 8366978
TI  - Dynamics of bone aluminum over one year of functioning renal graft.
AB  - The concentration of aluminum (Al) in serum, urine, and bone, as well as bone
      histomorphometry parameters were studied before and 1 year after kidney
      transplantation (Tx) in 20 dialyzed patients. One year after Tx, serum Al fell
      significantly from 50.3 +/- 8.8 to 23.9 +/- 2.7 micrograms/l, (53% fall). Bone Al
      content also decreased significantly from 62.9 +/- 9.0 to 36.5 +/- 7.0
      micrograms/kg bone weight, but urine Al excretion was still above normal. The
      repeat bone histomorphometric examination showed a good recovery of bone
      resorption which correlated well with serum parathyroid hormone levels, but
      poorer recovery of indices of bone formation and of the extent of Al deposits in
      the bone as shown by aluminum staining.

PMID- 8366979
TI  - Partial purification of a renotropic activity from plasma of uninephrectomized
      human subjects.
AB  - A renotropic factor was partially purified by sequential gel filtration and anion
      exchanger chromatography from plasma of human kidney transplantation donors and a
      renal cancer patient after uninephrectomy. This activity increased the rate of
      [3H]thymidine incorporation into DNA in rat cortical tubules, but not in rat
      liver cells, within the range of 100-200 ng/ml protein. The renotropic activity
      was detected between 7 and 12 days after uninephrectomy, and at least in 1 case
      decreased thereafter. This activity was undetected in gel-filtrated plasma of
      patients after a nonurological surgical procedure. The potency of this renotropic
      activity and its elution by gel filtration are similar to those displayed by a
      renal growth factor activity isolated from uninephrectomized rat plasma, as
      recently reported.

PMID- 8366980
TI  - Effect of hemodialysis on plasma levels of vasoactive peptides: endothelin,
      calcitonin gene-related peptide and human atrial natriuretic peptide.
AB  - To determine the role of vasoactive peptides such as endothelin (ET), calcitonin
      gene-related peptide (CGRP) and human atrial natriuretic peptide (hANP) in the
      regulation of blood pressure in uremic patients, and to determine the effect of
      various types of dialyzer membranes on hemodialysis (HD)-induced changes in
      plasma levels of such peptides, plasma ET, CGRP and hANP were measured in HD
      patients and patients on continuous ambulatory peritoneal dialysis (CAPD). Plasma
      levels of ET, CGRP, and hANP were significantly higher in HD and CAPD patients
      than in healthy subjects. There were no significant differences in plasma levels
      of ET, CGRP, and hANP between hypertensive and normotensive HD patients, and no
      significant correlation was observed between HD-induced changes in plasma levels
      and changes in blood pressure. Plasma levels of ET decreased when HD was
      performed using high-flux membranes, such as polyacrylonitrile (PAN), polymethyl
      methacrylate (PMMA) and cellulose triacetate (CTA), but did not decrease using a
      saponified cellulose (SC) membrane. Plasma levels of CGRP decreased in the case
      of PAN, but increased significantly with PMMA and showed no change with SC and
      CTA. Plasma levels of hANP decreased in all types of dialyzer membranes due to
      decreased secretion. These results indicate that the effect of HD on plasma
      levels of ET and CGRP, but not hANP, depends on the type of dialyzer membrane
      used.

PMID- 8366982
TI  - Pattern of hyperlipoproteinemia in human nephrotic syndrome: influence of renal
      failure and diabetes mellitus.
AB  - Forty-two patients with the nephrotic syndrome were grouped according to the
      absence or presence of renal failure and/or diabetes mellitus. All patients had a
      similar degree of hypoalbuminemia and urinary protein losses. A lipid and
      apoprotein pattern was generated in serum and ultracentrifugally isolated
      lipoproteins. Low-density lipoprotein composition was essentially normal in
      uremic patients while in the other patients with the nephrotic syndrome, a
      considerable lipid enrichment was noted. The very-low-density lipoprotein content
      in lipids was uniformly increased in nephrotic patients irrespective of the
      presence of complications. High-density lipoprotein cholesterol and serum
      apolipoprotein A I and E concentration was significantly reduced in uremic
      patients with respect to normal subjects and to the other groups considered.
      Serum apolipoprotein A II and B levels were also decreased in uremics. All
      patients had increased serum apoprotein C II and C III concentration. We conclude
      that diabetes mellitus does not affect the pattern of hyperlipoproteinemia of
      nephrotic syndrome while the characteristic lipoprotein and apoprotein pattern of
      uremia is present irrespective of nephrosis in uremic, nondiabetic patients.

PMID- 8366981
TI  - Lipoprotein (a) levels in end-stage renal failure and renal transplantation.
AB  - Some previous studies have documented an increase in lipoprotein (a) [Lp(a)]
      levels in renal diseases. Here, we report data in subjects with end-stage renal
      failure treated with hemodialysis (HD) or with continuous ambulatory peritoneal
      dialysis (CAPD) and in renal transplant recipients (RTR), compared with a group
      of normolipidemic controls (C). Lp(a) levels were significantly increased in HD
      and CAPD patients in comparison with C, while they were only slightly increased
      in RTR. Both HD and CAPD patients showed Lp(a) levels higher than in RTR, but no
      difference was found between the subjects of the two dialysis procedures. The
      prevalence of Lp(a) levels > 25 mg/dl was significantly higher in HD and CAPD
      patients, but not in RTR, in comparison with C. Moreover, Lp(a) levels did not
      change after HD. When patients were divided according to their fasting lipid
      levels in normolipidemics and hyperlipoproteinemics, no difference was found for
      Lp(a) levels in any group. Mechanisms underlying the increase in Lp(a) levels in
      these patients are not known. It is possible to suggest an active role of the
      kidney in the Lp(a) metabolism or that uremic plasma contains some factors
      affecting Lp(a) metabolism.

PMID- 8366983
TI  - Salt wastage, plasma volume contraction and hypokalemic paralysis in self-induced
      water intoxication.
AB  - Eleven episodes of severe hyponatremia secondary to hiccup-induced potomania were
      recorded in 3 years in a man who had essential hypertension, a low protein intake
      and a normal diluting ability. Paradoxical increase in hematocrit and plasma
      protein with acute extensive natriuresis was associated as well as urine
      potassium loss and hypokalemia producing paralysis in 1 episode. During a chronic
      water loading test, the defect in water excretion was related to a low urine
      solute delivery which was partially reverted by the natriuretic response to
      plasma volume expansion, promoting water diuresis. In acute water intoxication,
      this natriuretic response was exaggerated, producing a brisk water diuresis.
      Plasma volume was rapidly normalized but without any improvement in plasma sodium
      due to the concomitant negative sodium balance. Thus, water diuresis persisted
      until plasma volume was significantly contracted. Potassium loss appeared to be
      related to sodium excretion. Metabolic disturbances have not reoccurred despite
      persistent hiccup and potomania during 2 years of urea therapy.

PMID- 8366984
TI  - Effects of hemodialysis on body surface maps in patients with chronic renal
      failure.
AB  - To examine the effects of hemodialysis on the electrocardiogram, 87-lead body
      surface maps were performed in 38 patients with chronic renal failure, before and
      after hemodialysis. The patients were divided into two groups; 16 patients with
      coronary artery disease (CAD group), and 22 patients without ischemic heart
      disease (control group). Three maps were analyzed, QRS isopotential maps,
      isochrone maps, and QRS isointegral maps. Parameters measured were maximal R wave
      voltage (Peak R), minimal QRS wave voltage (Peak S), maximal ventricular
      activation time (VATmax) and QRS duration (QRSd). In the control group, Peak R
      and Peak S increased but VATmax decreased after hemodialysis. There were negative
      correlations between the changes of body weight and the changes in Peak R (r = 
      0.67, p < 0.01) and Peak S (r = -0.87, p < 0.001), although there were no
      correlations between changes in left ventricular diastolic dimension and the
      changes in Peak R and Peak S. In the CAD group, Peak S increased but Peak R and
      VATmax did not change significantly. There were negative correlations between the
      change of body weight and the change of Peak S (r = -0.73, p < 0.01). The most
      pronounced changes in mean QRS isointegral maps on hemodialysis were an increased
      magnitude of positivity in the control group and negativity in the CAD group on
      the anterior thorax. These findings suggested that the increase in the QRS
      amplitude after hemodialysis was influenced by the changes of the conductivity of
      extracardiac thorax and the relative heart position to the chest wall rather than
      myocardial ischemia or ventricular conduction delay.

PMID- 8366985
TI  - Dipsogenic effect of urea in rats.
AB  - Anephric rats injected subcutaneously with urea in isotonic saline drank much
      more than anephric control animals receiving isotonic saline alone. The pattern
      of water intake and urine output of normal rats, repeatedly injected with urea
      solution, was similar to that of rats injected with dipsogenic hypertonic NaCl
      and quite different from that of rats receiving furosemide. A well-evident
      dipsogenic effect (unrelated to the urine output) was observed in normal rats
      repeatedly injected with urea solution and having a rapid rise of serum urea
      concentrations. On the contrary, in rats receiving a single load of urea and
      showing first a very rapid increase, then followed by a slow decrease of serum
      urea concentrations, the dipsogenic effect was present only initially. These
      results demonstrate that urea exerts a direct dipsogenic action which may be
      interpreted as a consequence of an osmotic gradient between the extra- and the
      intracellular fluid. When this is positive, as in the case of a rapid rise of
      serum urea levels, cell dehydration ensues and thirst is stimulated. On the
      contrary, when serum urea levels are decreasing and, presumably, when the intra-
      and the extracellular concentrations of urea are in equilibrium, no cellular
      dehydration occurs and thirst does not appear.

PMID- 8366986
TI  - Effect of parathyroid-hormone-related protein on sodium-dependent phosphate
      transport in renal brush border membrane vesicles in rats. Comparison with
      parathyroid hormone.
AB  - Parathyroid-hormone-related protein (PTHrP) has significant homology with
      parathyroid hormone (PTH) in the amino-terminal region. We compared the effects
      of synthetic human PTHrP [hPTHrP(1-34)] on Na(+)-dependent phosphate transport
      with those of synthetic human PTH [hPTH(1-34)]. Intravenous administration of
      hPTHrP(1-34) in parathyroidectomized rats caused hypercalcemia, hypophosphatemia
      and phosphaturia to the same degree as hPTH(1-34). In kinetic studies using renal
      brush border membrane vesicles, the apparent Km and Vmax of phosphate transport
      were identical for the two peptides [hPTHrP(1-34): Km 27.6 +/- 0.8 microM, Vmax
      3.78 +/- 0.04 nmol/mg protein, hPTH(1-34): Km 29.6 +/- 0.9 microM, Vmax 3.04 +/-
      0.90 nmol/mg protein]. Both hPTHrP(1-34) and hPTH(1-34) at a supramaximal dose
      were equipotent in eliciting a 12-fold increase in cyclic adenosine 3',5'
      monophosphate (cAMP) production in the kidney. These results indicate that, in
      addition to the similar effect of hPTHrP(1-34) and hPTH(1-34) on serum calcium
      levels and urinary phosphorus and nephrogenous cAMP excretion in vivo, these two
      peptides have similar effects of Na(+)-dependent phosphate transport in brush
      border membrane vesicles in vitro.

PMID- 8366987
TI  - Changes of adenosine levels in the carotid artery, renal vein and inferior vena
      cava after glycerol or mercury injection in the rat.
AB  - The adenosine A1 receptor antagonist (FR113453) prevents glycerol- but not
      mercury-induced acute renal failure. To clarify this mechanism, adenosine
      concentration in the renal vein was measured serially. Plasma adenosine in the
      renal vein increased from the preinjection value of 120.6 +/- 15.4 (mean +/- SEM)
      pmol/ml to 426.9 +/- 107.5, 407.0 +/- 70.1 and 283.9 +/- 22.9 pmol/ml at 1, 5 and
      60 min after intramuscular injection of 10 mg/kg of 50% glycerol into Sprague
      Dawley rats. On the other hand, intramuscular vehicle (0.9% NaCl) injection and
      subcutaneous administration of 10 mg/kg of HgCl2 did not change or caused mild
      elevation of adenosine concentration in the renal vein. Furthermore, simultaneous
      blood collection from the carotid artery, renal vein and inferior vena cava
      revealed a greater increase in adenosine concentration in the inferior vena cava
      than in the artery or renal vein. These findings were not affected by the
      administration of FR113453 or vehicle (methylcellulose). The increase in
      adenosine in the inferior vena cava was derived from the release from the acutely
      damaged muscles due to glycerol injection. These findings suggest that the effect
      of adenosine A1 antagonist to prevent glycerol-induced acute renal failure is due
      to the inhibition of adenosine A1 receptor in the kidneys during the release of
      adenosine through the inferior vena cava. Therefore, the release of adenosine
      from the muscle and hemolysis plays an important role to induce acute renal
      failure in the glycerol-injected rat.

PMID- 8366988
TI  - Effects of endothelin and angiotensin II on renal hemodynamics in experimental
      mesangial proliferative nephritis.
AB  - The renal hemodynamic response to pressor substances in the diseased kidney has
      been suggested to be different from that in the normal kidney. The aim of this
      study was to investigate the effects of endothelin and angiotensin II on renal
      hemodynamics in experimental nephritis induced by the administration of
      antithymocyte serum in Wistar rats. This model showed mesangiolytic lesions in
      the glomeruli on day 2 and hypercellular lesions on day 8. Prior to the injection
      of either endothelin or angiotensin II, the glomerular filtration rate and renal
      plasma flow were significantly lower in model rats on day 2 or day 8 than in the
      control rats. The basal glomerular filtration rate and renal plasma flow on day 8
      were negatively correlated with the mesangium cell number. The injection of
      endothelin (0.5 ng/kg BW) led to a decrease in both renal plasma flow and
      glomerular filtration rate in rats on day 8 which was significantly greater than
      that in the control rats. Similarly, angiotensin II infusion (0.2 micrograms/kg
      BW) reduced both renal plasma flow and glomerular filtration rate in the rats on
      day 8 and the reductions were significantly greater than those in the control
      rats. In conclusion, renal hemodynamics in rats with mesangial proliferation of
      the kidney were more sensitive to both endothelin and angiotensin II than those
      in the normal kidney.

PMID- 8366989
TI  - Compensatory renal hypertrophy: tubular cell growth and transport studied in
      primary culture.
AB  - In order to define the growth and transport characteristics of renal epithelia
      during hypertrophy, primary culture of proximal tubular cells was established
      from kidneys of normal rats and those with compensatory renal hypertrophy (CRH)
      induced by unilateral nephrectomy. At confluence, enhanced growth potential was
      preserved in the cells derived from the animals with CRH (CRH cells) as compared
      with cells derived from normal animals (N cells), as evidenced by an increased
      cellular protein content (250 +/- 12 vs. 151 +/- 11 pg protein/cell; p < 0.001)
      and a somewhat lesser increase in cellular thymidine incorporation (6,820 +/- 52
      vs. 5,151 +/- 308 cpm/10(6) cells; p < 0.02). The cellular Na transport (measured
      as 22Na uptake) was increased in the CRH cells, being 733 +/- 47, 886 +/- 111,
      and 1,026 +/- 147 cpm/1,000 cells at 1, 3, and 120 min, respectively, versus 353
      +/- 36, 469 +/- 31, and 549 +/- 41 cpm/1,000 cells in N cells (p < 0.05 for each
      time point), i.e., an increase in Na transport in CRH cells of 107, 88, and 87%,
      respectively. Addition of Amiloride inhibited Na uptake in N cells by
      approximately 50% and completely suppressed the excess Na uptake in CRH cells to
      values observed in normal animals, i.e, 147 +/- 33, 224 +/- 91, and 174 +/- 86
      cpm/1,000 cells in CRH cells at 1, 3, and 120 min respectively, versus 181 +/-
      71, 164 +/- 57, and 238 +/- 85 cpm/1,000 cells in N cells (p = NS at each time
      point).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8366990
TI  - Acute renal failure from inhalation of mycotoxins.
AB  - Mysterious deaths of archeologists after opening Egyptian tombs have been
      suspected to be secondary to inhalation of mycotoxin, however, the hypothesis has
      never been verified. Recently, we observed a case of acute renal failure (ARF)
      undeniably due to inhalation of ochratoxin of Aspergillus ochraceus. After
      spending 8 h in a granary which had been closed for several months, a farmer and
      his wife suffered temporary respiratory distress; 24 h later, the woman developed
      nonoliguric ARF and biopsy revealed tubulonecrosis which healed in 24 days. Toxic
      substances were not found, but a strain of A. ochraceus producing ochratoxin was
      isolated from the wheat.

PMID- 8366991
TI  - Clinical course of late-onset bone marrow transplant nephropathy.
AB  - Late-onset renal insufficiency is an increasingly recognized complication of bone
      marrow transplantation (BMT) which occurs between 6 and 12 months after BMT. This
      syndrome, which has occurred in 25% of our 2-year survivors, is characterized by
      azotemia, hypertension, and disproportionate anemia. A minority of our subjects
      have had a presentation similar to hemolytic-uremic syndrome, with rapid decline
      in kidney function. The others have had slower declines in kidney function,
      without apparent ongoing hemolysis. Stabilization of function has occurred in
      about one third of cases. Light microscopy has shown mesangial and endothelial
      cell dropout with widening of glomerular capillary loops. Electron microscopy has
      shown a striking subendothelial expansion of the glomerular basement membrane.
      This syndrome is similar to acute radiation nephritis. Stabilization of kidney
      function has occurred in some cases, perhaps reflecting control of the blood
      pressure. Studies of the prevention of this condition are needed because of the
      frequency of its occurrence and the growing number of BMT worldwide.

PMID- 8366992
TI  - Prevalence of human immunodeficiency virus, hepatitis B virus and hepatitis C
      virus among dialysis patients. The Italian Multicentric Study on Nosocomial and
      Occupational Risk of Blood-Borne Infections in Dialysis.
AB  - In April 1991, a cross-sectional study of HIV, HBV and HCV markers among dialysis
      patients was carried out in 19 Italian units in order to evaluate the spread of
      these bloodborne infections among patients and to evaluate the potential risk for
      staff who care for them. A total of 2,180 patients were eligible and all
      consented to be tested. Of the 1,347 patients who had not been given hepatitis B
      vaccine, 67.9% had at least one marker of HBV infection; of these 9.2% were HBsAg
      carriers; conversely, the rates were 7.6 and 0.4%, respectively, among the 833
      vaccinated patients. Antibodies against HCV were found in 501 patients (23%) by
      EIA C100-3; of these, 270 were tested by RIBA-100: 246 (91%) were reactive and 11
      (4.1%) indeterminate. Five patients resulted anti-HIV positive [0.22%, 95% CI
      (Poisson distribution): 0.07-0.53] by EIA and Western blot techniques. Length of
      time on dialysis seems to correlate with higher prevalence of HBV and HCV
      infection markers, but (not) HIV. Overall, 608 (28%) patients were a potential
      source of infections for other patients and staff. This emphasizes the need for
      stricter adherence to infection control, barrier precautions and preventive
      behaviours with all patients.

PMID- 8366993
TI  - Pseudohyponatremia and pseudohyperphosphatemia in a patient with human
      immunodeficiency virus infection.

PMID- 8366994
TI  - Pentoxifylline in management of proteinuria in diabetic nephropathy.

PMID- 8366995
TI  - Antiproteinuric effect of glycosaminoglycans?

PMID- 8366996
TI  - Resistance to recombinant human erythropoietin in a child with renal failure,
      cystinosis and beta-thalassaemia minor.

PMID- 8366997
TI  - Pores in the glomerular basement membrane revealed by ultrahigh-resolution
      scanning electron microscopy.

PMID- 8366998
TI  - Unilateral reflux nephropathy with contralateral renal artery stenosis due to
      fibromuscular hyperplasia.

PMID- 8366999
TI  - Conflicting results of hepatitis C virus serological tests in haemodialysis
      patients.

PMID- 8367000
TI  - Syndrome of tubulointerstitial nephritis and uveitis: is it worth considering it
      as a proper entity?

PMID- 8367001
TI  - Anticardiolipin antibodies in patients on regular hemodialysis: an epiphenomenon?

PMID- 8367002
TI  - [Fibrillary glomerulopathies].

PMID- 8367003
TI  - [Renal effects of endothelins].
AB  - Since the discovery of endothelin in 1988, numerous studies have been undertaken
      to evaluate their physiopathologic role. There is three types of endothelin ET-1,
      ET-2 and ET-3, which probably play an essential role in renal and cardiovascular
      homeostasis. Their principal actions consist in an increase of the arterial
      pressure, a negative inotrope and chronotrope effect, a coronary
      vasoconstriction, a decrease in cardiac output and a fall in the renal blood flow
      and glomerular filtration rate. An elevation of endothelin level has been
      reported in numerous clinical conditions. However the interest of these
      descriptions remains unclear. Indeed the absence of pharmacological inhibitors of
      the synthesis or effect of endothelin prevent the understanding of the interest
      of these abnormalities. Furthermore the endothelins should not be considered as a
      hormone but as a paracrine substance.

PMID- 8367004
TI  - [Severe hypertension and renal infarct. Physiopathology and treatment. Apropos of
      1 case].
AB  - Renal infarction can be complicated by arterial hypertension, which is sometimes
      severe and may present as hypertensive encephalopathy and epilepsy. We report
      such a case in whom angiographic studies revealed a stenosis of the left renal
      artery and a post-stenotic aneurysmal dilation, containing a large thrombus with
      distal embolization. Thrombolysis associated with angioplasty resulted in the
      disappearance of the thrombus and correction of the stenosis. The pathophysiology
      of hypertension secondary to renal infarction is discussed. Therapeutic
      modalities are reviewed.

PMID- 8367005
TI  - [Peritoneal tuberculosis and continuous ambulatory peritoneal dialysis].
AB  - Depressed immunity in uremic patients increases by ten the risk of tuberculosis.
      In such patients, 40% of tuberculosis manifestations are extrapulmonary, and
      peritoneum is involved in about 6% of the cases. Seventeen cases of peritoneal
      tuberculosis have been so far reported in CAPD patients, and we add a new case.
      The prognosis of the disease is severe since 8 patients died. Three deaths out of
      8 are directly linked to tuberculosis. Indeed, peritoneal tuberculosis diagnosis
      is hard and often late, at least for two main reasons: at first, it can be
      difficult to exclude the other causes of lymphocytic peritonitis (viral, fungal,
      bacterial, etc.), secondly, growth of mycobacteria in dialysate effluent cultures
      is late and inconstant. Omental biopsy in lymphocytic peritonitis of unknown
      origin could be of great value for an early diagnosis. Despite the adaptation of
      antituberculous drugs doses, side-effects are not so rare: optical neuritis and
      liver toxicity in our case. In spite of ultrafiltration loss, stopping CAPD is
      not always necessary, as in the reported case.

PMID- 8367006
TI  - [Nephropathies and HIV virus infection. Anatamo-clinical study].
AB  - We report 16 patients with HIV1 infection with biopsy-proven renal involvement.
      Nine patients were caucasians and seven were blacks. There were 11 patients at
      stage II and 5 at stage IV of the HIV1 infection. Three patterns of histologic
      lesions were found: 6 patients, all blacks, with nephrotic syndrome and/or renal
      insufficiency had focal and segmental glomerulosclerosis (FSGS) with tubulo
      interstitial lesions. In contrast, 6 patients, all caucasians, had various types
      of glomerulonephritis characterized by immunoglobulin and complement deposits; 3
      of them were membranoproliferative glomerulonephritis (MPGN). The four remaining
      patients had predominant tubulointerstitial lesions. In three patients who had
      FSGS, treatment by AZT induced temporary improvement of renal function and
      hemodialysis could be interrupted for a few months. The cure of infectious foci
      was followed by improvement in renal signs in two out of the 3 MPGN patients. Our
      study further underlines: 1) the importance of genetic/racial factors in the
      occurrence of HIV1-associated glomerular lesions and 2) the relatively frequent
      occurrence of MPGN related to bacterial infections in caucasian patients.

PMID- 8367007
TI  - [Regional anticoagulation with sodium citrate: chronic utilization in the
      hemodialysis patient].
AB  - We used an alternative technique for regional citrate anticoagulation (citrate
      0.48 Mol; bicarbonate containing dialysate with Ca 1.75 Mmol) in three patients
      at chronic risk of bleeding and for a mean follow-up period of ten months. No
      bleeding recurrence was observed nor any complication related to citrate.
      Hemoglobin and hematocrit rose without transfusions. Serum bicarbonate increased
      during the first four months of treatment. No significant change was observed in
      serum calcium nor serum sodium concentration.

PMID- 8367008
TI  - [Severe metabolic alkalosis due to error of dialysis concentration].

PMID- 8367009
TI  - New stereological methods for counting neurons.
AB  - The issue of whether or not neurons die with age is of fundamental importance for
      understanding senescent decline in motor, sensory, and cognitive functions. Yet
      after over 100 years of attempts to quantify age-related neuron loss, this
      fundamental issue is "swirling in controversy" and the results of numerous
      studies addressing this issue "rife with confusion and seemingly contradictory
      data" (7). This is in large part due to deficiencies in the way we have thought
      about what constitutes evidence for neuron loss and deficiencies in the methods
      that have been available for counting neurons. Over the past several years, a new
      generation of stereological principles have been developed that have made it
      possible to identify and eliminate these deficiencies. Although there are now a
      number of review articles that briefly describe these and other new stereological
      principles (4,9,13,14,15,18,23), for the most part detailed descriptions of the
      new principles for counting neurons are found in specialized literature and are
      accompanied by new terms and concepts that have overwhelmed potential users and
      inhibited their adoption. In this essay, I describe the principles and concepts
      that are involved in the new stereological approach to neuron counting and
      discuss why the data obtained from their application represent improvements over
      those obtained with previously available techniques. A practical guide to the
      application of the principles to counting neurons or any other cell, organelle,
      or object present in sectioned material has been included as an appendix.

PMID- 8367010
TI  - Regionally specific loss of neurons in the aging human hippocampus.
AB  - New highly-accurate stereological methods for estimating the total numbers of
      neurons in brain structures have been used to test for age-related neuron loss in
      the human hippocampal formation. Across the age range of 13 to 85 years, there
      was a substantial loss of neurons in the subiculum (52%) and in the hilus of the
      dentate gyrus (31%); the three remaining hippocampal subdivisions showed no
      significant change. These losses qualify as potential morphological correlates of
      senescent decline in relational memory in that they can be expected to compromise
      the functional integrity of a region of the brain known to be intimately involved
      in this type of memory. The regional pattern of neuron loss is similar in certain
      respects to the patterns of cell loss seen during the initial phases of ischemia
      and epilepsy and is fundamentally different from the pattern associated with
      Alzheimer's disease.

PMID- 8367011
TI  - Morphometric image analysis of neuropil threads in Alzheimer's disease.
AB  - Neuropil threads were quantitated in the neuropil (excluding senile plaques) of
      the superior frontal gyrus of 6 late stage patients with Alzheimer's disease (AD)
      and 6 age-matched control subjects using tau immunocytochemistry and computerized
      morphometric image analysis. The mean percent of the area of the neuropil
      occupied by neuropil threads was 10.6 for AD and 0.19 for controls (p < 1 x 10(
      10)). The mean length of neuropil threads in AD was 21.9 mu compared with 19.7 mu
      for controls (p < 1 x 10(-10)). The mean area of neuropil threads was 25.3 mu 2
      for AD and 21.3 mu 2 for controls (p < 1 x 10(-10)). In AD, the threads were most
      prominent in mid cortex (lamina 2 and 3) and least prominent in the lower cortex
      (lamina 5 and 6). Neuropil threads appear to lead to severe disorganization of
      intracortical and corticocortical connectivity and probably play a role in the
      cognitive failure in AD.

PMID- 8367012
TI  - Effects of aging on spatial learning and hippocampal protein kinase C in mice.
AB  - C57BL/6Nia and F1(B6xD2)Nia mice were tested on the Morris water maze task for 5
      days followed by 12 days of testing on the place learning-set task (8 trials/day
      with each task). Mice were tested at 3, 14, and 25 months of age. C57 mice, 25
      months of age, were significantly impaired in both the Morris and place learning
      set task probe trial performance compared to mice 3 months of age (p < 0.05).
      These aged C57 mice also demonstrated a significant reduction in membrane-bound
      hippocampal protein kinase C (PKC) activity (p < 0.05) with no significant change
      in cytosolic PKC activity. F1 mice, however, showed no effect of age on probe
      trial performance on the spatial learning tasks. In addition, in a comparison of
      C57 and F1 mice within each age group, F1 mice demonstrated superior learning
      performance which was accompanied by a significant elevation in PKC activity (p <
      0.05). Spatial learning performance of both strains significantly correlated with
      membrane-bound PKC activity (p < 0.01). These data provide additional support for
      our previous hypothesis of an involvement of hippocampal PKC activity in spatial
      learning and suggest that the amount of membrane-bound PKC activity may be a
      determinant of age-related decline in spatial learning.

PMID- 8367013
TI  - Age-related decline in multiple unit action potentials of CA3 region of rat
      hippocampus: correlation with lipid peroxidation and lipofuscin concentration and
      the effect of centrophenoxine.
AB  - Changes in lipid peroxidation, lipofuscin concentration, and multiple unit
      activity (MUA recorded in conscious animals) in the CA3 region were studied in
      the hippocampus of male Wistar rats aged 4, 8, 16, and 24 months. The lipid
      peroxidation and lipofuscin concentration were increased with age. The MUA,
      however, declined with age. Correlational analyses were performed for the four
      age groups to determine the relationship between the age-associated decline in
      MUA with the age-related alterations in lipid peroxidation and lipofuscin
      concentrations. The age-related increase in lipid peroxidation correlated
      positively with the age-associated increase in lipofuscin concentration. The age
      related increases in lipid peroxidation and lipofuscin concentration correlated
      negatively with the changes in MUA. Since lipid peroxidation may affect neuronal
      electrophysiology, our data suggested that age-related increase in lipid
      peroxidation may contribute to an age-associated decline in neuronal electrical
      activity. Centrophenoxine effects were studied on the three above-mentioned age
      associated changes in the hippocampus. The drug had no effect on all three
      parameters in 4- and 8-month-old rats. In 16- and 24-month-old rats, however, the
      drug significantly increased the MUA but concomitantly decreased lipofuscin
      concentration and lipid peroxidation. Correlational analyses of the data on MUA,
      lipid peroxidation and lipofuscin concentration from the centrophenoxine-treated
      animals showed that the drug-induced diminution in both lipofuscin and lipid
      peroxidation was significantly correlated with the drug-induced increase in MUA.
      The differential effect of the drug in younger (4-8 months) and older (16-24
      months) animals indicated that the stimulation of MUA was clearly associated with
      concomitant decrease in lipid peroxidation and lipofuscin concentration.

PMID- 8367014
TI  - Effect of exercise on age-related muscle atrophy.
AB  - Fifty-five-week-old male Wistar rats exercised voluntarily in running wheels for
      10 weeks. The number and cross-sectional area of fibers in the slow-twitch soleus
      (SOL) and fast-twitch tibialis anterior (TA) muscles were recorded and compared
      with those of 20-week-old rats, and of age-matched rats not exercised. Muscle
      fibers were classified as fast-twitch oxidative glycolytic (FOG), fast-twitch
      glycolytic (FG), or slow-twitch oxidative (SO). After injection of horseradish
      peroxidase into the SOL and TA for retrograde neuronal labeling, oxidative enzyme
      activity of labeled motoneurons in the spinal cord was measured by
      microspectrophotometry. There were fewer FOG fibers in the SOL, and fewer FG
      fibers in the TA, at 65 weeks than at 20 weeks of age. The cross-sectional area
      of FOG and FG fibers in the TA was lower at 65 weeks than at 20 weeks of age.
      Exercise prevented the atrophy of FOG fibers in the TA. There were no age- or
      exercise-related differences in the number or oxidative enzyme activity of
      motoneurons in the SOL or the TA. These findings suggest that exercise can
      prevent the atrophy of FOG fibers by restoring their decreased metabolic
      capacity, and by inhibiting the degeneration of neuromuscular junctions.

PMID- 8367016
TI  - Axonal loss from the olfactory tracts in Alzheimer's disease.
AB  - Senile dementia of the Alzheimer type has been shown to be associated with
      impaired olfactory function early in the course of the disease. Neuropathology in
      the olfactory system is also a feature of Alzheimer's disease (AD) and it has
      been suggested that the disease may be caused by a pathogen entering the brain
      via olfactory pathways. To investigate this hypothesis, the effect of AD on the
      olfactory tract was investigated. There was a 40% decrease in the cross-sectional
      area of the olfactory tract and a 52% loss of myelinated axons from the tract in
      AD. These results, together with those of previous studies suggest that
      peripheral regions of the olfactory system, i.e., the olfactory bulb and primary
      sensory olfactory neurons are less affected by the pathology of AD than more
      central parts, i.e., cortical regions, the anterior olfactory nuclei, and
      olfactory tract. This less severe pathology at the periphery argues against a
      pathogen entering the brain via the peripheral olfactory apparatus and suggests a
      central pathogenesis which spreads centrifugally along olfactory pathways.

PMID- 8367015
TI  - Neuronal hypertrophy in the hypothalamus of older men.
AB  - A striking neuronal hypertrophy occurs in the infundibular nucleus of
      postmenopausal women. To determine the gender specificity of this response, we
      measured the areas of neuronal profiles in the infundibular nucleus of young (21,
      32, and 41 years) and older (60, 61, and 68 years) men and compared them to data
      reported previously from the hypothalami of pre-(28, 32, and 40 years) and
      postmenopausal women (58, 62, and 74 years). Sagittal blocks of formalin-fixed
      hypothalami were paraffin embedded, serially sectioned and stained with cresyl
      violet. The profile areas of 2,429 infundibular neurons were manually digitized
      using an image-combining computer microscope. The contralateral hypothalamus of
      each subject was cryoprotected, frozen-sectioned in the coronal plane and also
      stained with cresyl violet. The infundibular nuclear volume and the total number
      of neurons were estimated from the coronal sections using stereological methods.
      The mean profile area of infundibular neurons from older men (176.6 +/- 1.7
      microns 2) was significantly larger than that of young men (147.0 +/- 1.3 microns
      2). There was also a significant increase in the density of hypertrophied neurons
      (> 226 microns 2 profile area) in the infundibular nucleus of older men. There
      was no difference in infundibular nucleus associated with an average neurons was
      significantly increased in the older men. A comparison with previous data
      obtained from pre- and postmenopausal women revealed that the profile area of
      infundibular neurons was equal in young men and young women. However, the profile
      area of neurons in the postmenopausal women (190.4 +/- 2.1 microns 2) was
      significantly greater than that of older men.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367017
TI  - Effect of repeated stress on plasma catecholamines and taurine in young and old
      rats.
AB  - The effect of age and multiple stress responses on plasma norepinephrine (NE),
      epinephrine (EPI), and taurine (TAU) levels were determined in F344 rats. Blood
      samples obtained from catheterized young (3 months) and old (24 months) animals
      were used to examine plasma levels of NE, EPI, and TAU under baseline conditions
      and in the same animals after a 30-min immobilization stress. Rats were again
      immobilized and blood drawn (Day 3) following a 1-day rest period and, after an
      additional 4-day rest period (Day 7). Age differences seen between young and old
      rats were not the same for the three neurochemicals measured but were relatively
      unique for the specific biochemicals. In old animals baseline values of NE but
      not EPI and TAU were higher then young animals and all three values did not
      change for the baseline during the two additional stress exposures. Initial
      stress responses were similar for all three biochemicals in both age groups.
      Although no signs of adaptation were evident in the old animals, adaptation to
      immobilization was seen for EPI and TAU but not NE on the third occasion in the
      young animals. Correlations seen between NE and EPI in young and old rats on the
      first day disappeared during the second stress period but were again seen during
      the third stress exposure suggesting subtle indicators of repeated stress subject
      to adaptation. TAU values for young but not old rats correlated positively with
      EPI concentrations during the first stress exposure and negatively after the
      immobilization was terminated indicating a regulatory interaction between EPI and
      TAU present in young but lost in old animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367018
TI  - Inhibition of cytosolic human forebrain choline acetyltransferase activity by
      phospho-L-serine: a phosphomonoester that accumulates during early stages of
      Alzheimer's disease.
AB  - There is no satisfactory explanation for the cholinergic deficit characteristic
      of Alzheimer's disease. We have performed a series of experiments which
      demonstrate that (a) an inhibitor of cytosolic human brain choline
      acetyltransferase is present in the cytosol of Alzheimer brain tissue, (b) human
      brain cytosolic choline acetyltransferase activity is inhibited by phospho-L
      serine in a competitive manner. Cytosol was prepared from human forebrain or
      amygdala and the Km for choline and acetyl CoA of the choline acetyltransferase
      were 750 microM and 12.5 microM, respectively. Phospho-L-serine was found to be a
      competitive inhibitor of this enzyme with respect to choline but not with respect
      to acetyl CoA with a Ki of 750 microM for the human forebrain and 3 mM for human
      amygdala. These concentrations of phospho-L-serine are present in brain tissue at
      early stages of Alzheimer's disease. Several other phosphomonoesters and
      phosphodiesters that are increased in Alzheimer's disease were either less
      inhibitory or without effect. The addition of heat denatured and non-heat
      denatured cytosol from Alzheimers forebrain inhibited the choline
      acetyltransferase activity present in control human brain cytosol. The inhibitory
      activity of the Alzheimers cytosol was retained in TCA deproteinized samples and
      removed by dialysis or by alkaline phosphatase treatment. Dialysis of the cytosol
      increased the choline acetyltransferase activity of 5 of 8 Alzheimer's disease
      samples from 21 to 118% with p values of < 0.025 or < 0.001, respectively. These
      observations provide evidence that an endogenous non-proteinaceous, dialyzable,
      phosphomonoester, present in Alzheimers brain inhibits the choline
      acetyltransferase of both control and Alzheimers brain.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8367019
TI  - Analysis of Na+/Ca2+ exchange activity in human brain: the effect of normal
      aging.
AB  - Na+/Ca2+ exchange activity and passive permeability to Ca2+ were analyzed in
      plasma membrane vesicles (PMV) purified from whole rat brain and three regions of
      human brain: frontal cortex, temporal cortex, and cerebellum. Accumulation of
      Ca2+ due to Na+/Ca2+ exchange activity showed a characteristic pattern of an
      initial rapid rise in Ca2+ content followed by a stable plateau in both rat and
      human brain. Total Ca2+ accumulation in rat brain PMV was on average three-fold
      higher than in human brain. Passive permeability to Ca2+ was measured as the rate
      of Ca2+ release from PMV first loaded with 45Ca by Na+/Ca2+ exchange and then
      exposed to 1 mM EGTA. The Ca2+ permeabilities of human and rat brain PMV were
      similar. Ca2+ release from rat brain PMV was faster overall and was resolved into
      fast and slow components while in human brain a single slow component was found.
      Post mortem delay up to 4 h had no effect on Na+/Ca2+ exchange Km for Ca2+, Vmax,
      and peak uptake and Ca2+ release rate in rat brain PMV. Human frontal cortex was
      shown to have a greater Na+/Ca2+ exchange activity than that found in the
      cerebellum. The frontal cortex, temporal cortex and cerebellum had similar Ca2+
      permeabilities. Age-related effects on Na+/Ca2+ exchange activity and Ca2+
      permeability were determined in 15 tissues from human frontal cortex (age at
      death 21 to 93 years). No significant age related effects were seen.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8367020
TI  - 3-D reconstruction of the cholinergic basal forebrain system in young and aged
      rats.
AB  - The 3-dimensional (3-D) distribution of cholinergic neurons located throughout
      the extent of the entire basal forebrain of young (4-5 months old) and aged (24
      25 months old) Fischer-344 rats was examined using choline acetyltransferase
      immunocytochemistry (ChAT-IR). The number and 3-D position of ChAT-IR neurons
      spanning the basal forebrain were determined using serial sections and analyzed
      using computerized image analysis. The effects of aging on ChAT-IR neuron number
      were analyzed as a cohesive unit with respect to the classically-defined
      magnocellular subregions located within the basal forebrain (i.e., the medial
      septum, vertical and horizontal limbs of the diagonal band, and the nucleus
      basalis). Significant effects of age were found on ChAT-IR neuron number but no
      significant age-related interactions were noted with either the A-P, M-L, or D-V
      axes. These results suggest that a significant but diffuse age-related loss of
      ChAT-IR occurs along the entire length of the basal forebrain, and that this loss
      is not restricted to individual magnocellular nuclei (A-P axis), the M-L axis, or
      the D-V axis.

PMID- 8367021
TI  - Chronic methanesulfonyl fluoride enhances one-trial per day reward learning in
      aged rats.
AB  - Aged (24-month-old) rats were treated chronically with methanesulfonyl fluoride
      (MSF), an acetylcholinesterase (AChE) inhibitor with selectivity for central
      nervous system AChE, or with injection vehicle alone. Twelve 0.22 mg/kg IP
      injections were given over 4 weeks. MSF rats showed significantly greater speed
      and accuracy on a 1 trial/day discriminative reward learning task. The chronic
      MSF treatment resulted in a 56% decrease in brain AChE activity but no
      discernable locomotor side effects and no liver damage as indicated by aspartate
      transferase activity.

PMID- 8367022
TI  - Cold-induced increases in phenylethanolamine N-methyltransferase (PNMT) mRNA are
      mediated by non-cholinergic mechanisms in the rat adrenal gland.
AB  - Previously, we reported that cold stress induces a rapid increase in
      adrenomedullary PNMT mRNA levels, followed by concomitant increases in PNMT
      immunoreactivity (10). In the present study, the extracellular signals mediating
      this adaptive response to stress were investigated using northern analysis and
      RNA slot-blot hybridization. Although adrenal denervation significantly
      diminished cold-induced increments in adrenomedullary PNMT mRNA levels, it did
      not completely abolish the cold stress response. In contrast to these results,
      splanchnectomy completely inhibited cold-induced increments in TH mRNAs in the
      same tissue samples. These findings indicate that the effects of cold exposure on
      PNMT mRNA levels are mediated by both neural and non-neural mechanisms, and that
      adrenal PNMT and TH are differentially regulated in response to cold stress.
      Surprisingly, the neural component of the PNMT stress response could not be
      attenuated by peripheral administration of chlorisondamine, a powerful nicotinic
      ganglionic blocking agent. In contrast, chlorisondamine was effective in
      inhibiting sympathetic neural activity, as judged by the drug's ability to
      completely block increases in blood pressure, heart rate, and plasma
      catecholamines resulting from spinal cord stimulation in pithed rats. The
      administration of atropine, a muscarinic receptor antagonist, also failed to
      inhibit cold-induced alterations in adrenal PNMT mRNA. These results suggest that
      the trans-synaptic induction of adrenal PNMT mRNA involves a non-cholinergic
      component, and that cold-induced increases in PNMT mRNA are not coupled to
      acetylcholine-mediated adrenal catecholamine release.

PMID- 8367023
TI  - Sulfation of hypertensive and hypotensive drugs by monkey brain phenol
      sulfotransferase.
AB  - The substrate specificity and affinity of two forms of phenol sulfotransferase
      (PST) from Rhesus macaque brain cortex were studied. Catecholamines, their
      methylated metabolites (normetanephrine, metanephrine) and methylated precursor,
      alpha-methylDOPA, were examined as substrates for both the cationic (PST I) and
      the anionic (PST II) forms of the enzyme. Sulfation of hypertensive drugs
      (phenylephrine, octopamine, metaraminol), hypotensive drugs (alpha-methylDOPA,
      minoxidil), and related agents without a free hydroxy group on the benzene ring
      were also studied. Results indicated that both PST forms sulfated alpha
      methylDOPA and minoxidil, but only PST II transferred the sulfate group to
      catecholamines and most of the adrenergic agents examined.

PMID- 8367025
TI  - Hippocampal input to the hypothalamus inhibits thyrotrophin and thyrotrophin
      releasing hormone gene expression.
AB  - We have used in situ hybridization histochemistry to determine the effect of
      hippocampal-hypothalamic disconnection on hypothalamic thyrotrophin-releasing
      hormone (TRH) and anterior pituitary thyrotrophin beta subunit (TSH beta)
      transcripts in adult male CFY rats. Electrothermal lesions of the fornix pathway
      significantly increased TRH and TSH transcripts and increased circulating levels
      of triiodothyronine (T3). Fornix transection did not, however, prevent feedback
      regulation of TRH and TSH transcripts during exogenous T3-induced hyperthyroidism
      or propylthiouracil-induced hypothyroidism. Hippocampal inputs to the
      hypothalamus contribute to setting the basal activity of the thyroid axis, but do
      not mediate the feedback effects of T3.

PMID- 8367024
TI  - Evidence that the major physiological role of TRH in the hypothalamic
      paraventricular nuclei may be to regulate the set-point for thyroid hormone
      negative feedback on the pituitary thyrotroph.
AB  - If a primary physiologic action of TRH is to regulate the set-point for negative
      feedback, a sudden drop in plasma thyroid hormone concentration should stimulate
      the same rate of in vivo increase in TSH secretion from normal and TRH-deprived
      thyrotrophs. To test this hypothesis, 3 experiments were performed in which young
      adult female rats were divided into 3 groups of 6-10 rats each: intact controls,
      hypothalamic paraventricular nuclei ablation (PVN) and sham-ablated (Sham). Sham
      and PVN rats were thyroparathyroidectomized 2-4 weeks after brain lesions and
      serial blood samples taken in all groups at frequent intervals from 0 to 58 days
      post-thyroidectomy. Plasma TSH was significantly higher than in intact controls
      by 3 days post-thyroidectomy in both the Sham and PVN groups (p < 0.05). At 14
      days PVN plasma TSH was 4 x higher and at 30 days 8 x higher than in intact
      controls and remained consistently at 50% of that of the Sham group. There was no
      statistical difference between PVN and Sham in the rate of increase in TSH.
      Plasma T4 was 40% lower in PVN than in Sham at the time of thyroidectomy and
      became undetectable in both by day 3. The prompt parallel rate of rise of plasma
      TSH in Sham and PVN groups following thyroidectomy indicates that a primary
      physiologic action of TRH in the thyrotroph is to control the set-point for
      thyroid hormone negative feedback on TSH secretion.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8367026
TI  - Increases in neuropeptide Y content and gene expression in the hypothalamus of
      rats treated with dexamethasone are prevented by insulin.
AB  - The neurotransmitter neuropeptide Y (NPY) is abundant in the hypothalamus where
      its actions include the potent stimulation of food intake. The peripheral
      metabolic and hormonal signals involved in its regulation are not clear. The aim
      of this study was to investigate possible actions of corticosteroids and insulin
      on hypothalamic NPY synthesis and content in vivo. We measured NPY content in
      individual hypothalamic nuclei, and hypothalamic NPY mRNA by Northern blotting in
      whole hypothalamus in rats treated with dexamethasone (0.4 mg/kg/day) and
      dexamethasone plus insulin (60 U/kg/day), compared to controls. The effect of
      stopping dexamethasone treatment was also studied. Dexamethasone treatment
      produced significant increases in NPY in the paraventricular (11.0 +/- 1.3 vs.
      7.1 +/- 0.4 fmol/micrograms protein, p < 0.05) and arcuate (6.2 +/- 0.3 vs. 3.8
      +/- 0.2 fmol/microgram protein, p < 0.001) nuclei of the hypothalamus, paralleled
      by a 38% increase in total hypothalamic NPY mRNA (p < 0.05). These changes were
      not seen in the group treated with dexamethasone plus insulin. In the group in
      whom dexamethasone was stopped, NPY mRNA was unchanged compared to controls, but
      peptide content remained increased in the arcuate but not the paraventricular
      nucleus (arcuate 7.7 +/- 0.7 vs. 5.5 +/- 0.7, PVN 4.9 +/- 1.0 vs. 4.7 +/- 0.9
      fmol/microgram protein). Thus hypothalamic NPY and its mRNA were increased by
      corticosteroid administration, and this effect was prevented by systemic insulin
      treatment. This dual regulatory system for hypothalamic NPY may be important in
      the control of food intake by corticosteroids and insulin.

PMID- 8367027
TI  - Ovarian control of gonadotropin hormone-releasing hormone pulse generator
      activity in the rhesus monkey: duration of the associated hypothalamic signal.
AB  - The activity of the GnRH pulse generator in the rhesus monkey is associated with
      abrupt increases in multiunit electrical activity (MUA) volleys recorded from the
      mediobasal hypothalamus that precede each pulse of LH in the peripheral
      circulation. In long-term ovariectomized animals the duration of these MUA
      volleys is 10-25 min and consists of a brief initial 'overshoot' followed by a
      plateau phase that ends in a rapid decline to baseline activity. In intact
      monkeys, however, the MUA volley lasts only 1-3 min, a duration equivalent to the
      overshoot in ovariectomized animals. In addition, the maximal frequency of
      neuronal activity during each MUA volley is reduced in normal animals when
      compared to castrates. As shown in earlier studies, estradiol given to
      ovariectomized monkeys causes a reduction in the duration of MUA volleys to that
      characteristic of intact animals within 3-5 h. In contrast to this acute effect
      of estradiol, the increase in MUA volley duration following ovariectomy is a
      gradual phenomenon, 4-6 weeks being required to achieve the MUA volley duration
      observed in long-term ovariectomized monkeys. A similar slow time course was
      observed for the increase in maximal neuronal frequency during each MUA volley.
      This protracted effect of ovariectomy on MUA volley duration and firing rate may
      be the consequence of hypothalamic remodelling but this consideration must be
      tempered by the observation that estradiol reverses these phenomena within hours.

PMID- 8367028
TI  - Increased vasopressin secretion and release in mice transgenic for the rat
      arginine vasopressin gene.
AB  - The rat arginine vasopressin (AVP) genomic sequence has been utilized to develop
      a line of transgenic mice homozygous and heterozygous for the transgene.
      Expression of the rat AVP gene was demonstrated by Southern blotting and resulted
      in increased amounts of AVP in hypothalamus and frontotemporal brain cortex.
      Secretion of AVP from the neurohypophysial system results in an increased
      concentration of the hormone in the plasma and in an increased excretion in the
      urine in amounts three to five times those of normal mice. Extraneural ectopic
      hormone production was found only in the pancreas. Despite chronic hypersecretion
      of AVP, 24-hour urine volume and osmolality did not show evidence of increased
      antidiuretic hormone action on the kidney, so that, under basal conditions, the
      water balance in the animals is unaffected.

PMID- 8367029
TI  - Effects of single or repeated immobilization on release of norepinephrine and its
      metabolites in the central nucleus of the amygdala in conscious rats.
AB  - The release of norepinephrine (NE) and its metabolites in the central nucleus of
      the amygdala was measured using in vivo microdialysis during immobilization
      (IMMO) stress in conscious rats. Animals underwent 2-hour periods of IMMO either
      once or daily for 7 days. Extracellular fluid concentrations of NE,
      dihydroxyphenylglycol (DHPG), methoxyhydroxyphenylglycol (MHPG), and the dopamine
      metabolite dihydroxyphenylacetic acid (DOPAC) were measured before, during, and
      after IMMO. Microdialysate levels of NE and DHPG attained 2- to 3-fold increments
      during the 1 h of IMMO and declined thereafter, whereas MHPG and DOPAC levels
      attained maximal levels of about twice basal concentrations during the 2- or 3-h
      after initiation of IMMO. After the sixth IMMO basal levels of NE, DHPG, MHPG,
      and DOPAC were decreased, and NE, DHPG, and DOPAC responses during the seventh
      IMMO failed to attain levels found during the first IMMO, although the absolute
      changes during IMMO were similar between animals subjected to IMMO once or seven
      times. The results indicate that acute IMMO increases synthesis, release, and
      metabolism of NE in the central nucleus of the amygdala and that repetition of
      IMMO decreases basal catecholamine synthesis and noradrenergic turnover in this
      brain region, without inhibiting acute noradrenergic responses.

PMID- 8367030
TI  - Opioid peptidergic control of gonadotropin-releasing hormone pulse generator
      activity in the ovariectomized goat.
AB  - The role of endogenous opioid peptides in the control of gonadotropin-releasing
      hormone pulse generator activity was examined in long-term ovariectomized goats
      by recording the hypothalamic multiple-unit activity specifically associated with
      pulsatile luteinizing hormone secretion (MUA volleys). Administration of
      naloxone, an opioid receptor antagonist, at a rate of 1.0 mg/kg/h for 2 h
      resulted in shorter (p < 0.05) intervals between MUA volleys than during the
      control period (61.6 +/- 0.7 vs. 92.5 +/- 7.2 min) in animals treated with
      progesterone and estradiol that had reproduced a steroidal milieu during the
      luteal phase. Similarly, in the absence of steroidal treatment, the interval
      between MUA volleys was shortened (p < 0.01) in a dose-dependent manner from 42.3
      +/- 3.7 min (control) to 35.1 +/- 3.9, 32.6 +/- 4.1, and 27.0 +/- 1.7 min when
      infused with 0.2, 1.0, and 5.0 mg/kg/h of naloxone, respectively. On the other
      hand, the duration of each MUA volley was lengthened by naloxone. The results
      indicate that the hypothalamic gonadotropin-releasing hormone pulse generator
      activity is under a tonic suppression by endogenous opioid peptides in
      ovariectomized goats.

PMID- 8367031
TI  - Size heterogeneity of affinity-labeled estrogen receptor in the ram hypothalamo
      pituitary axis.
AB  - The presence of multiple monomeric forms of estrogen receptor (ER) has been
      described in different target tissues. Using [3H]tamoxifen aziridine (TA) to
      covalently label ER and SDS-PAGE to analyze labeled products, ER forms were
      investigated in ram pituitary and hypothalamus. A major labeled protein of M(r)
      60,000-65,000 and a minor species of 50,000-55,000 were found in the pituitary
      cytosol covalently labeled with [3H]TA. In the hypothalamic cytosol, the major TA
      labeled species was the M(r) 50,000 form while the 65,000 ER was difficult to
      detect. Comparison of ER forms after in vitro translocation of the ER complex in
      purified nuclei of ram pituitary or hypothalamus again showed major ER forms of
      M(r) 65,000 and 50,000 for the glandular and nervous tissue respectively,
      suggesting a biological significance for the M(r) 50,000 species. A similar
      heterogeneity was also observed in male rats used as controls. Moreover, covalent
      labeling of cytosol from the pars tuberalis/median eminence area showed the
      presence of ER in this part migrating with a pattern between those of the
      hypothalamus and the pituitary. The ER heterogeneity was thus demonstrated in the
      hypothalamo-pituitary axis. The source of this heterogeneity could be: (1)
      different ER mRNAs according to tissue type; (2) a specific posttranslational
      processing such as a specific proteolytic activity within the nervous tissue.

PMID- 8367032
TI  - Stimulation of H3-histamine receptors increases the release of prolactin in male
      rats.
AB  - Histamine (HA) stimulates prolactin secretion via H1 and H2 receptors. In the
      present study, we examined the role of a third subtype of receptor recently
      described in brain, the H3-HA receptor, on prolactin secretion in male rats. R(
      )alpha-methyl-HA (alpha-MHA), a selective H3 receptor agonist, was injected into
      the lateral ventricle of the brain in freely moving rats. alpha-MHA produced a
      dose-dependent (1-5 micrograms) and long-lasting increase in plasma prolactin
      levels. This increase was observed from 15 to 60 min after injection of alpha
      MHA. Its stimulatory action was prevented by thioperamide (20 micrograms i.v.t),
      a selective H3 antagonist. This compound, injected intraventricularly, lacked
      effect by itself on basal plasma prolactin levels. Neither pyrilamine (H1
      antagonist; 60 micrograms i.v.t.) nor ranitidine (H2 antagonist; 60 micrograms
      i.v.t.) affected alpha-MHA-induced prolactin release. The stimulatory effect was
      still present when brain HA was depleted by alpha-fluoromethylhistidine (30 mg/kg
      i.p.). Our findings suggest that alpha-MHA evokes prolactin release by activation
      of postsynaptic H3 receptors.

PMID- 8367033
TI  - Effects of single and repeated exposures to ethanol on hypothalamic beta
      endorphin and CRH release by the C57BL/6 and DBA/2 strains of mice.
AB  - Ethanol has been shown to enhance the in vitro release of hypothalamic beta
      endorphin (beta-EP). In the present study, the pattern of beta-EP release by the
      hypothalamus of two strains of mice, bred selectively for their preference
      (C57BL/6) or aversion (DBA/2) to ethanol, was investigated using a tissue
      perifusion system. The tissues were perifused with 20 mM ethanol for 30 min and
      the immunoreactive beta-EP content was estimated in perifusates collected every 2
      min. Ethanol induced an enhanced release of hypothalamic beta-EP characterized by
      an initial spike followed by a gradual decrease toward baseline levels in both
      strains of mice. The ethanol-induced increase in beta-EP release by the
      hypothalamus of the C57BL/6 mice was more pronounced and longer lasting than that
      by the hypothalamus of the DBA/2 mice. Similar to beta-EP, an immediate sharp
      increase of corticotropin-releasing hormone (CRH) release was induced by ethanol
      which, however, did not present a spike but was maintained significantly higher
      than spontaneous release for the duration of ethanol exposure. Both ethanol
      induced beta-EP and CRH release returned to basal levels within 10 min following
      removal of ethanol. That beta-EP levels did not remain elevated for the duration
      of ethanol exposure was not due to tissue depletion of releasable beta-EP pool,
      since exposure of the hypothalami to 10(-8) M CRH for 10 min, immediately after
      the perifusion with 20 mM ethanol, resulted in a large increase of beta-EP
      release. A second ethanol exposure 30 min after the first one did not induce an
      increase in beta-EP release. However, when the recovery period from the first
      ethanol exposure was extended to 60 min, a significant increase in the release of
      hypothalamic beta-EP was observed from the hypothalamus of the C57BL/6 but not of
      the DBA/2 mice. It is concluded that hypothalamic endorphinergic neurons present
      a fast, transient increase of beta-EP release in the presence of 20 mM ethanol,
      and become insensitive to subsequent ethanol exposures for a period of about 60
      min. In addition, genetically determined differences exist with regards to the
      magnitude and duration of the ethanol-stimulated release of beta-EP, as well as
      on the length of the ethanol nonresponsive period. These differences may explain
      in part the differences in the voluntary ethanol consumption exhibited by these
      strains of mice.

PMID- 8367034
TI  - A tissue culture model of the hypophysiotrophic CRF producing neuronal system.
AB  - To investigate functional and chemical properties of anatomically characterized
      corticotropin-releasing factor-41 (CRF-41) producing neurons in vitro,
      hypothalamic slices of 6-day-old rats were maintained in culture for up to 6
      weeks using a modified roller culture technique. This technique yields thick (100
      microns) slices that contained an average of 300-400 CRF-41-immunostained
      neurons. The majority of CRF-41-positive cells were of small size (12-15 microns
      in diameter), and contained CRF-41-labeled dense core vesicles of 100 nm diameter
      as detected by electron microscopic postembedding immunocytochemistry. These
      cells represented the only CRF-41-positive cell population in the culture. Light
      microscope double immunolabelling of colchicine-treated cultures kept in a serum
      containing media (SCM) indicated that about 60% of these CRF-41-positive neurons
      contains detectable levels of vasopressin-associated neurophysin (VP-NP).
      Culturing slices in serum-free, chemically defined media (SFM) resulted in an
      increased VP-NP immunostaining: parvicellular neurons labeled for both CRF-41 and
      VP-NP could be detected without colchicine treatment, and practically all CRF-41
      positive neurons expressed VP-NP immunoreactivity. At the electron microscopic
      level there was a significant increase in VP-NP labeling density in the dense
      core vesicle compartment of CRF-41-positive varicosities. Adding dexamethasone
      (10 nM) to the SFM restored the staining pattern originally observed in SCM.
      Hence, the increased VP-NP and CRF-41 immunostaining after culturing CRF-41
      neurons in SFM is most likely due to the absence of inhibitory glucocorticoids.
      The capacity of cultured paraventricular cells to release CRF-41 was assessed
      using an immunoassay. Unstimulated (basal) secretion of CRF-41 was not altered by
      five successive samplings at 2-hour intervals and stimulation of the same culture
      with 56 mmol K+ significantly increased (2-3 times) the CRF-41 content in the
      medium. The presence of dexamethasone (10 nM) in SFM induced a 6-fold reduction
      of K(+)-stimulated CRF-41 release and a 5 times reduction in tissue content in
      relation to cultures maintained in SFM without dexamethasone. In summary, we have
      demonstrated that cultured CRF-41 cells display morphological and biochemical
      features, as well as responsiveness to glucocorticoids, that is reminiscent to
      the situation in vivo. Thus, the model is well suited for studies of
      hypophysiotrophic CRF-41 cell functions.

PMID- 8367035
TI  - Sinoaortic denervation alters the molecular and endocrine responses to salt
      loading.
AB  - Neuroanatomical and physiological evidence indicates that baroreceptors influence
      hypothalamic vasopressin (VP) and oxytocin (OT) neurons. We evaluated the effects
      of sinoaortic denervation (SAD) on the molecular and endocrine response to salt
      loading. Sham-operated or SAD rats were given a 2% NaCl solution to drink for 72
      h. A group with limited salt water intake was included as a second control
      because the denervated rats consumed less salt than the controls. Plasma VP, OT
      and osmolality and posterior pituitary peptide content were measured. Brains were
      processed for evaluation of VP and OT mRNA expression using in situ hybridization
      with computer quantitation. Salt loading produced equivalent increases in plasma
      VP and OT in the control and SAD groups, however, there was a greater depletion
      of posterior pituitary peptides in the denervated animals. Salt loading produced
      significant decreases in pituitary VP and OT in the SAD animals, 69.8 +/- 8.4%
      and 68.3 +/- 4.0%, respectively. In the control groups, there was no decrease in
      VP content and a decrease in OT only in the control ad lib group. The peptide
      mRNA response to salt loading was also altered in the denervated rats. There was
      a significant increase in the area and intensity of the labeling for OT mRNA in
      the PVN in the SAD salt group. The control salt rats showed an increase in the
      SON and the salt-limited group showed no changes. For VP mRNA, the only change
      noted was in the SON of the salt-loaded SAD animals. These results show that
      chronic denervation of arterial baroreceptors augments the hypothalamic VP and OT
      response to salt loading.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367036
TI  - Prolactin receptors in dove brain: autoradiographic analysis of binding
      characteristics in discrete brain regions and accessibility to blood-borne
      prolactin.
AB  - Film autoradiography and densitometry were employed to obtain a detailed map of
      prolactin (PRL) receptor distribution in ring dove brain and to characterize the
      affinity, capacity, specificity, and in vivo saturability of 125I-ovine PRL
      binding in individual brain regions. Significant specific binding was detected in
      choroid plexus and in a variety of forebrain and midbrain sites, with highest
      levels observed in the preoptic area, tuberoinfundibular region, lateral
      hypothalamic area, and the suprachiasmatic, paraventricular, and ventromedial
      hypothalamic nuclei. A comparison of PRL receptors in the choroid plexus,
      preoptic area, ventromedial nucleus, suprachiasmatic nucleus, and tuberal
      hypothalamus revealed significant regional differences in binding capacity, but
      not differences in binding affinity (Kd = 0.4-0.9 nM; Bmax = 6-14 fmol/mg
      protein). Unlabelled ovine PRL proved to be an effective competitor of labelled
      ovine PRL at concentrations of 43 pM, 0.43 nM, and 4.3 nM in the choroid plexus
      and in 5 diencephalic areas. In contrast, no significant competition was observed
      in any of these brain areas in tests with unlabelled turkey GH, ovine GH, or
      ovine LH at similar concentrations. Unlabelled ovine PRL (37 nmol) significantly
      reduced the uptake of 125I-ovine PRL (37 pmol) in the preoptic area, tuberal
      hypothalamus, and bed nucleus of the pallial commissure at 2 h after intravenous
      injection. In addition, specific binding of 125I-ovine PRL in vitro was reduced
      by over 67% in these brain areas and in several other brain regions following a 7
      day period of systemic ovine PRL administration. These results indicate that PRL
      receptors in different regions of the dove brain exhibit similar binding
      characteristics. In addition, they suggest that at least some of these PRL
      sensitive brain loci are accessible to blood-borne hormone.

PMID- 8367037
TI  - Distribution of estrogen receptor-immunoreactive cells in the preoptic area of
      the ewe: co-localization with glutamic acid decarboxylase but not luteinizing
      hormone-releasing hormone.
AB  - Using immunocytochemical techniques we have examined the distribution of cells
      containing estrogen receptors (ERs) in the preoptic and anterior hypothalamic
      regions of short-term (1 week) ovariectomized ewes. Subsequent double-labelling
      experiments examined the co-localization patterns of ER and luteinizing hormone
      releasing hormone (LHRH) or glutamic acid decarboxylase (GAD) immunoreactivities.
      ER-immunoreactive (-IR) cells were identified throughout the central and medial
      aspects of the preoptic area in a continuum which begins at the level of the
      organum vasculosum of the lamina terminalis and terminates in the caudal anterior
      hypothalamic area. A conspicuous sub-population of densely clustered ER-IR cells
      was identified within this distribution extending from the central region of the
      preoptic area into the bed nucleus of the stria terminalis. ER-IR cells were also
      identified in the ventrolateral septum and supraoptic nuclei. Double-labelling
      experiments showed that although rostral LHRH neurons were surrounded by ER-IR
      cells, they did not themselves possess ER immunoreactivity. In marked contrast,
      we estimate that approximately 40% of GAD-IR cells in the central aspect of the
      medial preoptic area are immunoreactive for the ER and that these cells account
      for nearly 30% of all ER-IR cells in this region. These results indicate that, in
      common with other species, LHRH neurons in the ewe do not possess ERs and suggest
      therefore, that these neurons are unlikely to be modulated directly by
      circulating estrogens. However, large numbers of adjacent GABA neurons possess
      ERs and may comprise a major neuronal population mediating gonadal steroid input
      to LHRH neurons.

PMID- 8367038
TI  - In vivo release of neurotensin from the median eminence of ovariectomized
      estrogen-primed rats as estimated by push-pull perfusion: correlation with
      luteinizing hormone and prolactin surges.
AB  - In order to assess the physiological role of neurotensin (NT) in regulating the
      secretions of luteinizing hormone (LH) and prolactin (PRL), we examined whether
      the in vivo release of NT from the push-pull cannulated median eminence (ME) was
      altered in association with the LH and PRL surges in free-moving ovariectomized
      rats primed with estradiol. For comparison, LH-releasing hormone (LHRH) was also
      measured in the same perfusates from the ME in which NT was determined. NT and
      LHRH in the ME started to significantly increase roughly concurrently with the
      initial significant rises in LH and PRL in the plasma, and the highest levels of
      the neuropeptides clearly preceded the peak levels of LH and PRL. These in vivo
      data strongly suggest that NT, independently of or in concert with LHRH, may have
      a facilitatory role in the generation of estradiol-induced LH surge. In addition,
      these data may not disagree with a similar facilitatory role of NT in the PRL
      surge. This is the first characterization of the temporal profile of NT secretion
      in rat ME in terms of its relationship to the estradiol-induced surges of LH and
      PRL.

PMID- 8367039
TI  - Mixed vascular malformations of the brain: clinical and pathogenetic
      considerations.
AB  - The clinical relevance of any scheme for classification of vascular malformations
      of the brain remains controversial. Widely accepted pathologic classifications
      include discrete venous, arteriovenous, capillary, and cavernous malformations.
      Of 280 cases of possible vascular malformations evaluated by a single
      cerebrovascular service during a 5-year period, 14 were instances of mixed
      vascular malformations including definite features of more than one
      pathologically discrete type of malformation within the same lesion. There were
      six instances of mixed cavernous and venous malformations in the same lesion; in
      all instances, the cavernous malformation accounted for the clinical
      presentation. There were three cases of mixed venous and arteriovenous
      malformations (arterialized venous malformations), presenting with the typical
      histoarchitectural appearance of a venous malformation, but with arteriovenous
      shunting; all cases were symptomatic, two with hemorrhage and one with focal
      neurological symptoms. There were five cases of predominantly cavernous
      malformations with features of arteriovenous malformation or capillary
      telangiectasia in the same lesion. These five cases presented clinically as
      angiographically occult lesions indistinguishable from a cavernous malformation.
      Lesions including a venous malformation were recognizable preoperatively because
      of characteristic imaging features of the venous malformation. Other mixed
      vascular malformations were indistinguishable on diagnostic studies from pure
      cavernous malformations. Of the 14 mixed vascular malformations, 11 included a
      cavernous malformation that was usually responsible for the symptomatic
      presentation. In the other three cases, manifestations of clinical lesions were
      due to arteriovenous shunting within a venous malformation. We conclude that
      mixed vascular malformations of the brain are rare entities with distinct
      clinical, radiological, and pathological profiles. Their identification generates
      several hypotheses about common pathogenesis or causation-evolution among
      different types of lesions.

PMID- 8367040
TI  - Emergent aneurysm clipping without angiography in the moribund patient with
      intracerebral hemorrhage: the use of infusion computed tomography scans.
AB  - The authors report their experience with 25 patients (mean age, 44.3 +/- 12.1
      years) with an intracerebral hematoma (ICH) from a ruptured aneurysm who were
      emergently operated on without angiography. Instead, preoperative high-resolution
      infusion computed tomography (CT) scans were used to identify the aneurysm
      causing the hemorrhage. In all patients, the preoperative Glasgow Coma Scale
      score was < 5 and brain stem compression was evident. ICH was present in the
      frontal or temporal lobe and was often associated with intraventricular
      hemorrhage (n = 17) and significant (> 1 cm) midline shift (n = 18). Infusion CT
      scans correctly identified the aneurysm in all patients (middle cerebral artery,
      18; posterior communicating artery, 2; carotid bifurcation, 3; anterior
      communicating artery, 2). Partial evacuation of the hematoma guided by infusion
      CT scan was usually required first to clip the aneurysm definitively using
      standard microvascular techniques. Intraoperative rupture occurred twice, and
      temporary clips were used on four occasions. Lobectomy (n = 8), decompressive
      craniotomy (n = 15), and ventriculostomy (n = 8) were required to control
      cerebral swelling. All patients underwent postoperative angiography to confirm
      aneurysm obliteration. Eleven unruptured aneurysms were subsequently identified.
      Nine had been predicted by infusion scan. Twelve patients survived, eight of whom
      were only moderately disabled and were independent at 6-months' follow-up. Of the
      13 patients who died, all except one died within 4 days of admission. The authors
      conclude that although angiographic verification before aneurysm surgery is
      preferable, in the moribund patient with intracerebral hemorrhage, infusion CT
      scanning provides sufficient information concerning vascular anatomy to allow
      rational emergency craniotomy and aneurysm clipping.

PMID- 8367041
TI  - Tumor prostaglandin levels correlate with edema around supratentorial
      meningiomas.
AB  - The pathophysiological mechanisms to explain peritumoral edema have not been
      clarified. Multiple aspects of brain edema secondary to supratentorial
      meningiomas were prospectively investigated in a group of 29 patients who
      underwent surgery consecutively. Sixty-nine tumor samples were analyzed for
      prostanoid levels. Levels of 6-keto-PGF1 alpha, the stable metabolite of
      prostacycline, were found to correlate well with the extent of edema (r = 0.51, P
      < 0.01). The ratio, 6-keto-PGF1 alpha x PGE2/TXB2, was found to have the best
      correlation with edema index (extension/tumor volume) (r = 0.69, P < 0.005). A
      case of a hemangiopericytic meningioma with the largest edema extent within the
      study group also exhibited the highest level of 6-keto-PGF1 alpha (2420 pg/mg
      protein). Steroid treatment (dosage, duration of therapy, and their product) did
      not correlate with prostaglandin levels. These findings may explain the
      inconsistent clinical effects of steroids on meningioma-induced edema. Possible
      explanations for this phenomenon are discussed. Otherwise, histology,
      pathological features of tumor aggressiveness, or mechanical parameters, such as
      its volume, location, and insertion site, did not correlate well with edema
      parameters or with prostaglandin levels. Similarly, tumor water content, imaging
      parameters in computed tomography and magnetic resonance, and operative findings
      (including dissection plane, vascularity, and tumor firmness) did not correlate
      well with edema parameters. Although a direct cause-effect relationship between
      prostaglandins and peritumoral edema is not conclusively established, the
      circumstantial evidence of the ability of prostaglandins to induce vasogenic
      brain edema and the robust association with peritumoral edema is
      persuasive.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367042
TI  - Immunohistochemical detection of female sex hormone receptors in meningiomas:
      correlation with clinical and histological features.
AB  - Sixty-one meningiomas from 60 patients were screened for estrogen receptors and
      progesterone receptors (PgR) with monoclonal antibodies in an immunohistochemical
      assay. In addition, 43 of the cases were evaluated for tumor size and peritumoral
      edema, as seen on computed tomographic scans and magnetic resonance images. Sixty
      one percent of the tumors contained significant amounts of PgR, whereas no
      estrogen receptor-positive tumor was observed. Thirteen percent of all tumors
      were classified as nonbenign variants (atypical and anaplastic meningiomas) and
      were more frequently found in male patients (P < 0.05). Nonbenign tumors more
      frequently showed an absence of PgR (P < 0.05), and there was a tendency for PgR
      negative tumors to be larger than PgR-positive ones. No correlation was found
      between PgR status and edema. It is concluded that PgR status in meningiomas is
      related to tumor differentiation and may be of prognostic value with regard to
      biological behavior and clinical outcome.

PMID- 8367043
TI  - Intracranial hydatid cysts in children.
AB  - Brain involvement in hydatid disease occurs in 1 to 2% of all Echinococcus
      granulosus infections. Fifty to 75% of intracranial hydatid cysts are seen in
      children. This study included 19 children who underwent surgery for intracranial
      hydatid cysts between January 1979 and September 1992. There were 12 boys and 7
      girls, ages 3 to 16 years (mean, 8.1 yr). Headache and vomiting were the
      predominant symptoms. Papilledema was present in 16 patients, and 2 patients had
      secondary optic atrophy. A round, cystic lesion without perifocal edema and rim
      enhancement was detected on the computed tomographic scans of 13 patients. The
      cystic lesions with rim enhancement and perifocal edema were noted on the
      computed tomographic scans of 3 patients. Of these three patients, two
      subsequently had a recurrence. Total removal of the cyst without rupture was
      achieved in 12 patients. Only a 3-year-old boy in whom the cyst ruptured at
      surgery died. Seven patients in whom either the hydatid cyst ruptured at surgery
      or there was systemic hydatid disease received mebendazole therapy. Mebendazole
      seems to be effective in hydatid disease. Cerebral hydatid cysts should be
      removed in toto without rupture. The preoperative diagnosis is very important in
      planning surgery. When a cystic lesion is detected on computed tomographic scan,
      hydatid disease should be taken into consideration in countries where hydatid
      disease is endemic.

PMID- 8367044
TI  - Accidental head trauma and retinal hemorrhage.
AB  - Retinal hemorrhage and intracranial hemorrhage in a child with little external
      evidence of trauma and with a poorly documented history are considered
      pathognomonic child abuse. The mechanism and magnitude of force required to
      produce the injuries are seldom witnessed or known. This study was designed to
      determine the incidence of retinal hemorrhage in pediatric head injuries under
      known accidental circumstances, in association with forces sufficient to cause
      skull fracture and/or intracranial hemorrhage. Of 525 consecutive hospital
      admissions for head injuries, 200 children filled these criteria. Thirty children
      were excluded because of suspected child abuse or gunshot wounds. Of the
      remaining 170, 140 were evaluated by an ophthalmologist for retinal hemorrhage.
      Two children, who were both involved in side-impact car accidents, had retinal
      hemorrhages in associated with severe head injury. Retinal hemorrhage occurs
      rarely in accidental head injury and is associated with extraordinary force.

PMID- 8367045
TI  - Flexible endoneurosurgical therapy for aqueductal stenosis.
AB  - We successfully managed 11 patients with aqueductal stenosis of adult or
      adolescent onset, with no mortality or significant morbidity, by using a flexible
      ventriculoscope to perform either a third ventriculostomy or an aqueductal
      plasty. A flexible fiberoptic ventriculoscope and its accessories were newly
      developed, and surgical techniques were improved. For all patients, cinemagnetic
      resonance imaging was a critical part of the preoperative and postoperative
      evaluation of cerebrospinal fluid flow in the third ventricle and in the aqueduct
      of Sylvius. All of the 11 patients showed patency to cerebrospinal fluid flow at
      the aqueduct of Sylvius and the floor of the third ventricle. Only one patient
      subsequently required a lumboperitoneal shunt. Flexible endoneurosurgical
      management is simple and safe and allows in situ observation and the ability to
      perform biopsies. Therefore, flexible endoneurosurgical third ventriculostomy and
      aqueductal plasty are now considered our treatment of choice for aqueductal
      stenosis in adults and adolescents.

PMID- 8367046
TI  - The combined pterional/anterior temporal approach for aneurysms of the upper
      basilar complex: technical report.
AB  - A technique for achieving a combined pterional (subfrontal) and anterior temporal
      exposure for aneurysms of the upper basilar complex is described. The technique
      is not new, but it does involve several modifications not previously described. A
      standard pterional skin incision that extends below the zygoma just anterior to
      the tragus is used. The skin flap is separated from the temporal fascia down to
      the fat pad over the zygoma; at this point, the superficial layer of the
      temporalis fascia is incorporated and retracted with the skin flap to expose the
      zygomaticofrontal process and the zygomatic arch. The muscle is cut anteriorly
      and inferiorly and is retracted posteriorly over the ear. The bone flap includes
      the anterior temporal squama down to the temporal floor anteriorly. The pterion
      and the sphenoidal wings are drilled so as to expose completely the dura over the
      anterior temporal pole. After opening the dura on a flap centered on the sylvian
      fissure, the medial cisterns are opened widely and the fissure is opened all the
      way to the middle cerebral bifurcation. Posterolateral temporal retraction and,
      when necessary, subpial resection of the anteromedial portion of the uncus
      enhance the exposure posterolateral to the oculomotor nerve. The advantages of
      this combined approach are as follows: it combines the more anterior angle of
      vision offered by the pterional approach with the lateral line of vision offered
      by the subtemporal approach; it eliminates the need for temporal lobe elevation
      and it allows simultaneous clipping of other aneurysms of the ipsilateral
      anterior circle of Willis; and it also reduces the frequency and severity of
      oculomotor palsy, when compared with the subtemporal approach.

PMID- 8367047
TI  - Magnetic source imaging: a review of the Magnes system of biomagnetic
      technologies incorporated.
AB  - Magnetic source imaging (MSI) is a new, noninvasive technique for defining the
      relationship between brain function and structure on a patient-to-patient basis.
      It achieves this by combining detailed neurophysiological data derived from
      magnetoencephalography with high-quality neuroanatomical data derived via
      magnetic resonance imaging. By the use of mathematical models, the spatial
      locations of those neurons that generate neuromagnetic signals of interest are
      estimated and subsequently marked on spatially aligned magnetic resonance images.
      There are three prominent types of clinical MSI examinations. These are: 1)
      functional mapping examinations in which sensory and motor functions are
      localized; 2) examinations of interictal epileptiform activity; and 3)
      examinations of abnormal low-frequency magnetic activity, which has been found to
      be present in a wide range of pathophysiological conditions. Functional mapping
      provides useful information regarding the relationship between the cortical
      representation of eloquent function and the location of pathological lesions that
      may be surgically resectable. This application is of particular utility in cases
      of intracortical masses that distort and obscure the local neuroanatomy. By
      defining the primary sites of interictal epileptiform activity, MSI examinations
      are useful in the surgical planning for the implantation of depth electrodes and
      the planning of partial lobectomies. Abnormal low-frequency magnetic activity
      appears to be a neurophysiological correlate of ischemic penumbra associated with
      stroke, neoplasms, and vascular malformations. Abnormal low-frequency magnetic
      activity has also been found to be present in several other conditions, including
      head trauma and psychiatric dysfunction, although the exact pathophysiological
      mechanisms are presently unclear.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367048
TI  - Noninvasive presurgical neuromagnetic mapping of somatosensory cortex.
AB  - Rapid presurgical neuromagnetic localization of the somatosensory cortex was
      performed successfully on five patients with a large-array biomagnetometer by a
      protocol called magnetic source imaging (MSI). Determination of the location of
      the central sulcus is important in assessing operative risk and determining the
      optimal operative approach to structural lesions in the vicinity of the motor
      strip. The use of magnetic resonance imaging anatomical methods and
      intraoperative visual identification can be imprecise, whereas invasive
      localization prolongs operative time, adds cost, and entails added risk. Until
      the recent development of large-array biomagnetometer systems, neuromagnetic
      localization of the central sulcus had been demonstrated in research but was so
      time consuming and laborious as to preclude routine clinical use. In this study,
      the validity of MSI localizations was confirmed intraoperatively by direct
      cortical recording of somatosensory evoked potentials and/or direct motor
      stimulation. Complete agreement was found between MSI and intraoperative mapping
      in locating the central sulcus. Objective confirmations considered together with
      the speed and reliability of the procedure and with the presurgical availability
      of the results suggests the potential utility of MSI for routine surgical
      planning.

PMID- 8367049
TI  - Functional neurosurgical simulation with brain surface magnetic resonance images
      and magnetoencephalography.
AB  - We present a novel noninvasive technique for functional neurosurgical simulation
      combining three-dimensional magnetic resonance imaging of the brain surface with
      somatosensory evoked magnetic fields (SEFs) in a case of subcortical brain tumor.
      The preoperative analysis using this technique revealed that the central sulcus
      was located between the SEF source projected onto the brain surface and the
      tumor. At the time of surgery, the central sulcus was clearly identified by phase
      reversal of the cortical recordings of somatosensory evoked potentials. The
      actual cortical anatomy and the maximum somatosensory evoked potential location
      showed excellent agreement with the preoperative analysis of the brain surface
      magnetic resonance images and the SEF source. The subcortical tumor, which was
      barely identifiable without reliable functional cortical anatomy, was easily
      found in the motor area, just before the somatosensory evoked potential (and SEF)
      source. The potential clinical application of this technique is discussed.

PMID- 8367050
TI  - Isolated paraplegia from a remote stab wound.
AB  - A stab wound to the right flank of a 24-year-old man produced immediate paralysis
      of both legs but spared sensation. Recovery was slow but sufficient to allow
      walking with a cane. Radicular artery interruption, in combination with systemic
      hypotension, is presumed to have caused selective watershed infarction of the
      spinal cord. Strokes of the spinal cord after trauma are rare, and those at a
      thoracic level usually represent delayed infarctions after pediatric chest or
      abdominal injuries. Our patient sustained an immediate and highly selective
      infarction.

PMID- 8367051
TI  - Three-dimensional analysis of the vascular system in the rat spinal cord with
      scanning electron microscopy of vascular corrosion casts. Part 1: Normal spinal
      cord.
AB  - Vascular corrosion casts of polyester resin in the normal spinal cord at C4-C6
      and C7-T1 were inspected three-dimensionally by scanning electron microscopy in
      13 rats. Arteries and veins were easily differentiated by the impression pattern
      of endothelial nuclei on the casts. The centrifugal arterial system from the
      sulcal arteries supplied most of the gray and white matter in the ventral and
      lateral spinal cord. Each sulcal artery supplied only one side of the cord. The
      average number of sulcal arteries was 2.6 per mm. The centripetal arterial system
      from the posterior spinal arteries fed the posterior gray and white matter. In
      contrast with classical concepts, there was no pial arterial plexus on the
      ventral and ventrolateral surface except for infrequent transverse branches from
      the anterior spinal artery. In the posterior columns, two types of large veins
      were identified: the posterior medial septal veins and the posterior oblique
      veins that drained the posterior columns, medial posterior gray matter, and
      posterior gray commissure. The remainder of the gray and white matter was drained
      by the sulcal veins and the radial veins. This method clearly demonstrates the
      three-dimensional structure of both the arterial and venous system in the rat
      spinal cord.

PMID- 8367052
TI  - Three-dimensional analysis of the vascular system in the rat spinal cord with
      scanning electron microscopy of vascular corrosion casts. Part 2: Acute spinal
      cord injury.
AB  - The purpose of this study was to investigate the vascular mechanisms involved in
      the pathophysiology of acute spinal cord injury. Vascular corrosion casts of
      traumatized rat spinal cords at C7-T1 were inspected by scanning electron
      microscopy. Nineteen rats were subjected to a 51g acute clip compression at C8-T1
      and then underwent transcardial perfusion with polyester resin at 15 minutes, 4
      hours, or 24 hours after injury. The injured spinal cord appeared almost
      avascular at the compression site, although the large vessels on the surface of
      the spinal cord were all intact. The sulcal arteries at the injury site
      frequently showed constriction, and the impressions of endothelial nuclei were
      more slender and less distinct in the constricted arterial casts. Extravasation
      of the injected resin at the injury site was observed most frequently in the 15
      minute group. Poorly filled distal branches of the sulcal arteries were seen at
      the injury site in every group. Indeed, it was concluded that the disruption and
      occlusion of the sulcal arteries and their branches accounted for a considerable
      amount of the posttraumatic ischemia of the cord. Occlusion of the sulcal
      arteries in the anterior median sulcus at the injury site was more frequently
      observed in the 24-hour group than in earlier groups. This observation suggests
      that there was a progressive circulatory disturbance of the damaged sulcal
      arteries at the injury site. The 4- and 24-hour groups showed avascular areas
      extending longitudinally from the injury site in the posterior columns, probably
      the result of hemorrhage and venous obstruction.

PMID- 8367053
TI  - Appearance of a cavernous hemangioma in the cerebral cortex after a biopsy of a
      deeper lesion.
AB  - Cavernous hemangiomas are vascular malformations that can occur throughout the
      central nervous system. In certain patients, multiple lesions are known to occur.
      We present a patient with multiple cavernous hemangiomas who had a computed
      tomography-guided biopsy of a deep parieto-occipital lesion through a burr hole.
      Several passes of a biopsy needle were used. During a 5-year interval, the
      patient developed a new lesion directly under the burr hole on the cortical
      surface. The new lesion appears to have occurred from the implantation and growth
      of a cavernous hemangioma secondary to the biopsy.

PMID- 8367054
TI  - Inadvertent intraspinal placement of a Foley catheter in severe craniofacial
      injury with associated atlanto-occipital dislocation: case report.
AB  - A case of fatal, inadvertent, intraspinal placement of a Foley urinary catheter
      is presented. The patient suffered a severe craniofacial injury with life
      threatening epistaxis requiring emergent tamponade with two Foley catheters plus
      gauze packing. There was an associated atlanto-occipital dislocation. The
      mechanism of production is discussed, and guidelines to avoid this complication
      are outlined.

PMID- 8367055
TI  - Atypical meningioma of the third ventricle in a 6-year-old boy.
AB  - Pediatric meningiomas are uncommon. Those presenting in the third ventricle are
      rare; there are only 15 cases reported in the literature. We report an additional
      third ventricular meningioma in a 6-year-old boy. The tumor was resected via an
      anterior transcallosal interfornicial approach. Postoperatively, the patient
      exhibited a transient episode of mutism. Unlike previous reports, the
      pathological diagnosis of this lesion was an atypical meningioma. The
      presentation, management, pathological features, and postoperative course of our
      case are discussed and compared with previous reports.

PMID- 8367056
TI  - Meningioma in sigmoid sinus groove associated with dural arteriovenous
      malformation: case report.
AB  - A 65-year-old woman was evaluated for vertigo. Computed tomography and magnetic
      resonance imaging as well as angiography revealed the coexistence of a tumor at
      the junction of the right transverse-sigmoid sinuses, a dural arteriovenous
      malformation (AVM) of the right transverse sinus, and a right sigmoid sinus
      thrombosis. After transarterial embolization via the external carotid artery, the
      tumor was totally removed and the right transverse sinus was embolized with
      platinum coils and Surgicel. Postoperatively, the dural AVM was completely
      occluded, and the histological examination of the tumor showed it to be a
      transitional type of meningioma. It would be suggested that the right transverse
      sigmoid sinuses are involved by the meningioma to develop the sigmoid sinus
      thrombosis and the dural AVM of the transverse sinus, supporting an acquired
      origin of the dural AVM.

PMID- 8367057
TI  - Primary spinal extradural hydatid disease: report of a case with magnetic
      resonance characteristics and pathological correlation.
AB  - A rare case of hydatid disease of the lumbar extradural area and of the
      paravertebral muscles is reported. The patient underwent surgery, resulting in
      complete recovery. The limitations of computed tomography and the benefits of
      magnetic resonance imaging in forming a diagnosis are discussed. Magnetic
      resonance has been found to be an invaluable tool, not only in detecting the soft
      tissue extent of the disease but also in delineating the viability of hydatid
      cysts.

PMID- 8367058
TI  - Thecoperitoneal shunt for syringomyelia: report of three cases.
AB  - During 8 months, three consecutive cases of syringomyelia were treated by the
      placement of thecoperitoneal shunts. In the first two patients, the cord
      cavitation was idiopathic in one and thought to be related to spinal trauma in
      the other. In the third case, there was associated anomaly of the craniocervical
      junction of the Chiari I type. Surgery was followed by clinical improvement in
      all patients. Postoperative magnetic resonance images showed definite diminution
      of the syringomyelic cavity. The results of treatment seem to support the use of
      the technique as a primary treatment of syringomyelia associated with progressive
      myelopathy.

PMID- 8367059
TI  - Uterus-like mass of the conus medullaris with associated tethered cord.
AB  - A patient with a mass lesion of Mullerian origin associated with a spinal
      dysraphism is reported. The mass lesion was a genuine uterine formation, and a
      hemorrhage arose from a functional endometrium. A spinal dysraphism was
      associated, including a low-lying conus medullaris, a subcutaneous lipoma, and a
      sinus between the cul-de-sac and the lipoma. This ectopic and mature tissue may
      be differentiated from teratoma and endometriosis.

PMID- 8367060
TI  - A percutaneous epidural screw electrode for intracranial electroencephalogram
      recordings.
AB  - A new epidural electrode for monitoring brain electrical activity is described.
      The electrode is a tapered screw that is easily inserted percutaneously and
      removed without general anesthesia. The epidural screw has been used without
      complications for ictal and interictal electroencephalogram recordings in four
      patients with medically refractory complex-partial seizure disorders. The
      epidural screw electrode offers the advantages of easy insertion and removal,
      patient comfort, artifact-free electroencephalogram recordings, and minimal risk
      of intracranial infection or hemorrhage.

PMID- 8367061
TI  - Clinical predictors of abnormality disclosed by computed tomography after mild
      head trauma.

PMID- 8367062
TI  - Motor and sensory cortex in humans: topography study with chronic subdural
      stimulation.

PMID- 8367063
TI  - Bilateral carpal tunnel release at one operation: report of 228 operations.

PMID- 8367064
TI  - Clinical analysis of a series of vertebral aneurysm cases.

PMID- 8367065
TI  - [Non-palpable lesions of the breast. Analysis of 111 cases].
AB  - The authors report a series of 111 cases of non-palpable breast tumours.
      Radiological examinations showed the following mammographic patterns:
      microcalcification (63%); irregular opacity and/or denseness (26%); opacity and
      low density microcalcifications (12%), to which 3 progressive risk rates were
      assigned (high, medium, low). Histological controls of the tumours showed a
      positive predictive value of 73% for mammographic patterns defined as "high
      risk". Localisation using a metal probe proved to be a simple and efficacious
      method which was well tolerated by patients.

PMID- 8367066
TI  - [Bilateral carcinoma of the breast. Presentation of a case series and review of
      the literature].

PMID- 8367067
TI  - [Cervico-mediastinal goitre. Analysis of preoperative clinical symptoms].
AB  - During past decades, a considerable and debated speculation about the
      classification of intrathoracic goitre was more and more developing. One of the
      most reliable classifications we share is that considering the degree of the
      intrathoracic extension of the thyroid gland: i) largely intrathoracic (more than
      80%), ii) partially intrathoracic (more than 50%, but less than 80%), and iii)
      sub-sternal goitre (more than 50% holding in the neck). Consistently with the
      above mentioned classification, this report deals with ninety-seven cases of
      completely intrathoracic goitre (64 females and 33 males, aging between 29 and 78
      years). Sixty-eight patients out of these showed a goitre reaching the upper
      aortic border; the other 29 patients had a thyroid gland exceeding this degree of
      extension. Therefore the intrathoracic goitre is a not frequent thyroid disease:
      in our series, it represents the 3.67% of 2641 surgical interventions on the
      thyroid gland from January 1984 to December 1990, that is to say the 20% of the
      so-called plongeant goitres undergoing surgery during the same years. The aim of
      this survey was to study the clinical features of the intrathoracic goitre and to
      have a therapeutic and prognostic assessment in this thyroid disease, before the
      surgical intervention. To this purpose, the prodromic symptom or sign, the
      clinical course before surgery, the clinical examination (peculiarly about the
      neck) and the laboratory findings at admission, the preoperative imaging study
      (chest X-ray, ultrasound examination, scintiscan and tomoscan finding) were
      reviewed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367068
TI  - [Postoperative venous thromboembolism in bariatric surgery].
AB  - The authors discuss the problem of venous thromboembolism as a complication of
      bariatric surgery. They consider obese patients at risk for these complications,
      even if different opinions exist about this topic in the literature. They report
      their experience in bariatric surgery consisting of 53 patients submitted to
      biliopancreatic diversion. Antithrombotic prophylaxis consisted for every patient
      in elastic bandaging of the lower limbs, preoperative hemodilution, early post
      operative mobilization, and subcutaneous heparin. Complications consisted in one
      popliteo-femoral deep venous thrombosis (DVT) (1.6%), and two pulmonary embolisms
      (PE) (3.2%) of which one caused patient's death; total morbidity for venous
      thromboembolism. These results compared with literature are similar with other
      series of bariatriac surgery and slightly higher than general surgery series.
      This difference is not however significant. Even in the absence of this
      significance, thromboembolism, as desumed from more than 2900 cases considered in
      the literature, remains the main cause of morbidity and mortality in the post
      operative course of bariatric surgery patients, deserving particular attention in
      terms of prevention, also because of difficulty existing in early clinical
      diagnosis of DVT in obese people. Further studies intended to identify
      pathogenesis and risk factors of venous thromboembolism in obese people will
      allow a more correct prophylactic and therapeutic approach.

PMID- 8367069
TI  - [Acute intestinal ischemia. Diagnosis and surgical treatment].
AB  - The authors report their experience of 32 patients operated for acute intestinal
      ischemia. A massive intestinal infarction was diagnosed in 24 cases. The overall
      postoperative mortality rate was 72%. The postoperative survival rate was 20%
      after mesenteric infarction and 42% in patients with limited acute intestinal
      ischemia. The need for early specific diagnosis is stressed, because the
      therapeutic options vary widely in relation to different types of acute
      intestinal ischemia. Furthermore, the basic role of parenteral nutrition in
      postoperative treatment of short bowel syndrome is underlined.

PMID- 8367070
TI  - [Sigmoid volvulus].
AB  - The authors report a retrospective study of four patients treated for sigmoid
      volvulus at the Clinica Chirurgica II of IRCCS Policlinico S. Matteo of Pavia
      between April 1974 and June 1989. They are collected from a series of 74
      consecutive operations for colonic obstruction not related to hernias of the
      inguinal-crural region (incidence 5.4%). One patient died. The authors review the
      incidence, epidemiology, etiopathogenetic hypothesis, clinical patterns,
      nonoperative and operative therapeutic options of the affection. They emphasize
      the poor prognosis because the sigmoid volvulus usually occurs in elderly ill
      patients.

PMID- 8367071
TI  - [Congenital splenic cysts. Presentation of a clinical case].
AB  - The authors describe a rare case of congenital splenic cyst, observed in a 22
      year old female. Pathological and clinical aspects are discussed and the up-to
      date diagnostic and therapeutic approach is presented.

PMID- 8367073
TI  - [Rupture and migration of central venous catheter].
AB  - In the period 1978-1990, 100 patients (44 males, 56 females) with various
      pathology, had a catheterisation of a central vein in the Hospital of Susa (TO).
      Subclavian vein was chosen with a percutaneous infraclavicular route. In 7 cases
      (7%) there were some mechanical complications, one of them was the accidental
      breakage of the catheter and its migration to the right heart. The authors
      describe this case and the possible cure by examining the most recent literature
      data.

PMID- 8367072
TI  - [Abdominal aortic aneurysm ruptured into the inferior vena cava. Presentation of
      a clinical case. Review of the literature].
AB  - Rupture of the major veins is a rare complication of abdominal aortic aneurysms
      and is generally followed by sudden haemodynamic changes, whose importance is
      strictly dependent on the size of the fistula and rapidity of onset. The final
      result is invariably hyperdynamic congestive heart failure, oligoanuria and
      hyperazotemia, expression of renal insufficiency. Early recognition and surgical
      operation, together with appropriate postoperative intensive care, are the key
      for successful treatment of aorto-caval fistulas. Despite the improvement of
      surgical and anaesthesiology techniques, operative mortality rate still remains
      elevated (36%), but not higher than in other abdominal aortic aneurysms ruptures.
      The aim of this paper is to review the literature and to report one case of a
      seventy-year-old patient affected by an aorto-caval fistula and successfully
      treated in our Surgery Division.

PMID- 8367074
TI  - Injury: the medical and related costs in New Zealand 1990.
AB  - AIM: To describe the cost of inpatient admissions and emergency department
      attendances for injury at a major New Zealand hospital; and to extrapolate to
      indicative national costs for injury, with a view to facilitating decision
      making, in relation to injury prevention programs. METHODS: By using data from
      the patient management system database and the resource utilisation system
      operating at Dunedin Hospital to describe the utilisation spectrum for injury
      related events. RESULTS: The institutional cost of inpatient care for injury
      cases for the year ending 31 December 1990 amounted to $7,378,000, at an average
      of $3,020 a case. The costs for emergency department attendances (not resulting
      in admission) amounted to $2,585,000, at an average of $93 a case; the total of
      $9,963,000 equated to 15% of the hospitals annual operating budget. The most
      expensive causes of admission with injury were falls and motor vehicle traffic
      crashes. The commonest resulting injury was fractures of the lower limb, and the
      commonest and cumulatively most expensive injuries presenting at the emergency
      department were cuts, and sprains and strains. If these costs were extrapolated
      to New Zealand as a whole it would suggest hospital costs of approximately $457
      million per annum; when taken in conjunction with other known medical and welfare
      costs this approximates to an annual bill to the state of approximately $1.2
      billion per annum. CONCLUSION: Injuries are a significant, costly, potentially
      preventable, element of health care. The use of hospital data for the allocation
      of resources to preventive efforts to date, has been based primarily on hospital
      admission numbers. This study suggests that this is not however indicative of the
      costs to the state, and the use of financial and other utilisation data would
      assist in rationalising resource allocation to preventive programs.

PMID- 8367075
TI  - Home or hospital-based emergency care for chronic psychiatric patients?

PMID- 8367076
TI  - Medication and perception of dry mouth in a population of institutionalised
      elderly people.
AB  - AIM: (1) To estimate the prevalence of use of different medication categories;
      (2) to estimate the prevalence of xerostomia (dry mouth); and (3) to estimate the
      effects of xerostomic medication upon perceived dry mouth among institutionalised
      elderly people. SUBJECTS: A two-stage stratified random sample of three hundred
      and fifty-nine people aged 65 to 102 living in rest homes and geriatric hospitals
      in the Manawatu and Horowhenua districts. METHOD: Subjects were interviewed and
      dentally examined at their place of residence. Medication was noted from
      institutional records, and subjects' experiences of xerostomia were explored
      using the question "how often does your mouth feel dry?" RESULTS: The sample was
      found to be highly medicated, with a mean 3.6 different drugs per individual, and
      only 10% not taking any medication. Psychotherapeutics (42.3%), analgesics
      (32.9%), diuretics (31.2%) and laxatives (23.4%) were the most common drug
      categories. Of the 284 subjects who were able to answer, only those who were
      taking anticholinergic medication reported a higher prevalence of xerostomia.
      CONCLUSIONS: Institution-dwelling elderly people are a highly-medicated group.
      There is an increased risk of unwanted oral side-effects with certain drugs, and
      it is recommended that this is borne in mind when prescribing for elderly
      patients.

PMID- 8367077
TI  - Immunisation surveillance: a comparison of four methods in Canterbury.
AB  - AIMS: To evaluate four methods of immunisation surveillance by comparing the
      estimates obtained for Canterbury in the National Immunisation Coverage Survey
      with estimates calculated using data on immunisation distribution, general
      practitioner immunisation benefit claims and immunisation coverage at school
      entry. METHODS: Estimates were calculated using existing data sources on vaccine
      distribution, immunisation benefit claims, school entry immunisation coverage and
      live births in Canterbury. The survey was conducted according to a WHO protocol.
      RESULTS: The estimates based on vaccine distribution were of no use. The school
      entry data available did not allow complete evaluation of this method, which has
      some potential advantages. A number of inconsistencies were found between
      estimates from the survey and from immunisation benefit claims, between north and
      south Canterbury and between the two years for which estimates were calculated
      using benefit claims. CONCLUSIONS: It is concluded that the most practicable
      option, the immunisation benefit claim system, would require careful evaluation
      and improvement before it could be relied upon for immunisation coverage
      surveillance. The feasibility of each method as a means of immunisation
      surveillance is discussed.

PMID- 8367078
TI  - Acute myocardial infarction: experience at a rural hospital.

PMID- 8367079
TI  - The effects of user charges on the dispensing of prescription medicines: a survey
      of prescription charge payment in the Wellington region.
AB  - OBJECTIVE: The study aimed to examine the impact of user charges on the
      dispensing of prescription medicines. The effect of social class, customer type
      and number of items on the incidence of payment problems was examined. METHOD:
      The study employed a two week survey of 26 pharmacies randomly selected from
      Wellington Pharmacy Guild. Pharmacists completed a questionnaire on each occasion
      user charges led to a problem dispensing a prescribed medicine. Data collected
      included: type of problem encountered and its outcome, customer information
      (including the customer's pharmaceutical benefit category), and prescription
      information (including the number of items prescribed). RESULTS: The overall
      incidence of payment problems was 1.5% or 1 in every 66 prescription forms
      processed by the pharmacists. User charges resulted in medicine dispensing
      failure on 56% of the problem occasions. Customers incurred debt or were funded
      by a social agency on the remaining 44% of problem occasions. Fifty-three percent
      of dispensing failures resulted in non-collection of items at the end of the
      survey period. Thirty-four percent of debts were outstanding at the end of the
      survey. The incidence of all payment problems correlated with the social "need"
      score of the pharmacy area and was significantly higher for children's and
      student's prescriptions. CONCLUSION: User charges may provide a greater barrier
      to children, students and people living in areas of high social need. Ongoing
      evaluation of the impact of user charges is required to ensure improved
      prescribing is achieved equitably [corrected].

PMID- 8367080
TI  - Sexual issues in the doctor/patient relationship.

PMID- 8367081
TI  - Antibiotic prophylaxis in surgery.

PMID- 8367082
TI  - Haematuria.

PMID- 8367083
TI  - Resource constraints--what do we tell our patients?

PMID- 8367084
TI  - Emotional health and cancer.

PMID- 8367085
TI  - Fallopian tube recanalisation.

PMID- 8367086
TI  - Fallopian tube recanalisation.

PMID- 8367087
TI  - NZMA pamphlet scheme.

PMID- 8367088
TI  - Tree nettle (Urtica ferox) poisoning.

PMID- 8367090
TI  - Hepatitis C in New Zealand.

PMID- 8367089
TI  - Hospital deaths and the coroner.

PMID- 8367091
TI  - Medical journals and the popular media.

PMID- 8367092
TI  - Maternal mortality in New Zealand.
AB  - New Zealand's maternal mortality rate in the triennium 1986-8 was reviewed in
      comparison with the rates from Australia and the United Kingdom during 1985-7.
      The New Zealand rate of 9.6 obstetric deaths/100,000 total births was higher than
      that for the United Kingdom (6.2) and Australia (4.4). Six of 16 deaths in New
      Zealand during the triennium were caused by sepsis, including five cases of
      puerperal infection with group A beta-haemolytic streptococci. Careful analysis
      of maternal deaths in New Zealand remains an important priority to provide audit
      of the performance of maternity services.

PMID- 8367093
TI  - Asymptomatic low bone mineral density in otherwise healthy people: four year
      follow up.
AB  - AIM: To determine the effect of screening a normal population for low bone
      density on lifestyle, subsequent bone density and fracture risk. METHOD: A cross
      sectional study of 726 subjects screened for low bone density identified 60 with
      bone density greater than one standard deviation below an age and sex matched
      mean. Those who accepted further assessment were followed clinically and with
      repeat bone densitometry for up to four years. Those declining assessment were
      contacted four years later and questioned about lifestyle changes and fractures.
      They were offered repeat bone densitometry. RESULTS: Twenty five subjects
      accepted intervention and were advised on lifestyle modification and treated with
      calcium supplements (18) calcitriol (5) or oestrogen (1). 22 of the 35 subjects
      who initially declined intervention volunteered to have their bone density
      repeated. Bone density increased in the group accepting intervention compared to
      the 22 subjects in the group who initially declined assessment (p < 0.05).
      Several laboratory investigations had a low yield. Lifestyle modification in the
      group declining assessment did not significantly affect subsequent bone density.
      Fractures occurred infrequently in both groups. CONCLUSION: After screening the
      normal population for low bone density, significant improvements in bone density
      can be achieved in patients accepting further intervention.

PMID- 8367094
TI  - Questionable methods of cancer treatment: time to face the facts.

PMID- 8367095
TI  - Sore throat presentation and management in general practice.
AB  - AIMS: To compare the characteristics of sore throat patients with their having
      normal throat, to measure the incidence of beta-haemolytic streptococcal growth
      in both groups, and to determine the clinical outcomes of treating sore throat
      patients without the aid of a throat swab. METHOD: Patients were from a suburban
      general practice. A three phased prospective study of consecutive patients with
      sore throats as their primary complaint, or with normal throats. RESULTS:
      Patients presented with a sore throat at a rate of 45 per 1000 consultations and
      those with normal throats presented at a rate of 379 per 1000 consultations. 43%
      of normal throat patients were male compared to 34% with sore throat (chi 2 =
      4.62, p < 0.02). The incidence of beta-haemolytic streptococcal growth in sore
      throat patients was 123 per 1000 consultations per year. 23% of people 14 years
      and younger had a positive growth compared to 9% of people over 14 years of age.
      (chi 2 = 5.04, df = 1, p < 0.05). The sore throat presentation peaked over the
      late autumn to early winter months (June-July) but the beta-haemolytic
      streptococcal infection rate remained low throughout the year. A history of pain
      for less than three days and fever, and on examination large neck glands and pus
      on the tonsils were all positive clinical features for beta-haemolytic
      streptococcal infection. However use of clinical criteria alone meant 73% of
      patients with no beta-haemolytic streptococcal infection were falsely treated.
      CONCLUSION: Research is needed to develop guidelines for the management of sore
      throats in general practice.

PMID- 8367096
TI  - Comparison of Maori and European access to the Christchurch specialist diabetes
      complication screening clinic.
AB  - AIMS: To compare Maori and European utilisation of a specialist diabetes
      complication screening clinic. METHOD: All subjects attending the Christchurch
      specialist diabetes complication screening clinic over a 16 month period were
      asked to complete a questionnaire, which included data on age, ethnicity and
      diabetes treatment. The frequency of clinic attendance by age and ethnic group
      was then compared to the number of people in the general population, in the
      clinic catchment area. RESULTS: Of the 1356 subjects attending the complications
      screening clinic over the study period, 1347 completed the questionnaire. 1228 of
      the 1347 subjects (91.2%) were European and 84 (6.2%) were Maori. In the age
      range 45-64 years, Maori clinic attendance per 1000 general population was 25.6,
      compared to 7.57 per 1000 for Europeans. On a population basis, there were thus
      3.4 times more Maori than Europeans attending the clinic. This figure is
      comparable with results from recent studies, which indicate that the prevalence
      of diabetes in this age range is about 3 to 5 times higher in Maori, compared to
      Europeans. CONCLUSIONS: Although this study failed to demonstrate evidence of
      inequality of health care utilisation, quantitative measures of utilisation are
      but one dimension of access to health care. Another dimension of health care
      access discussed in this paper, is the differing health care needs of different
      ethnic groups.

PMID- 8367097
TI  - Microtympanometry, microscopy and tympanometry in evaluating middle ear effusion
      prior to myringotomy.
AB  - OBJECTIVE: To determine the accuracy of a hand-held microtympanometer (Microtymp,
      Welch Allyn) used by a general practitioner when compared with findings at
      myringotomy. METHOD: Independent preoperative assessment of children's ears using
      microtympanometry by a general practitioner, microscopy and pneumatic otoscopy by
      a specialist otologist and impedance bridge tympanometry by a specialist
      audiologist were performed and compared with findings at myringotomy. SUBJECTS:
      Fifty children (100 ears) on the waiting list for bilateral myringotomies and
      ventilation tube insertion for recurrent acute otitis media or otitis media with
      effusion. RESULTS: Microscopy with pneumatic otoscopy had a 90.9% sensitivity and
      a 92.9% specificity in detecting middle ear effusions. Impedance bridge
      tympanometry had a 94.4% sensitivity and a 71.8% specificity if type B and C2
      were combined to predict middle ear effusion. Microtympanometry had 100%
      sensitivity and 75% specificity if type B and C tympanograms were combined; if
      type B tympanograms alone were used, a sensitivity of 83.4% and specificity of
      75% in predicting middle ear effusions was obtained. CONCLUSION: The Microtypm is
      a useful instrument in general practice for assessment of middle ear effusions as
      no ears with fluid were missed in this study if type B and C tympanograms were
      considered abnormal. The Microtymp would also be useful as a screening instrument
      by suitably trained personnel.

PMID- 8367098
TI  - Acute renal failure due to low osmolar radiographic contrast medium.

PMID- 8367099
TI  - Medical profile of patients with fractured neck of femur.

PMID- 8367100
TI  - Thin end of the wedge.

PMID- 8367101
TI  - The cut off wheel.

PMID- 8367102
TI  - Dyestuffs and bladder cancer.

PMID- 8367103
TI  - Fluoridation and fractures.

PMID- 8367104
TI  - Fluoridation.

PMID- 8367105
TI  - Iron deficient children.

PMID- 8367106
TI  - AIDS.

PMID- 8367107
TI  - Successful recruitment tool: a nurse extern program.

PMID- 8367108
TI  - Ethics in the OR: DNR and patient autonomy.
AB  - Suspending Do Not Resuscitate (DNR) orders during surgery may undermine a
      patient's right to self-determination. A Nursing Ethics Committee together with a
      Clinical Ethics Committee formulate guidelines to consider when suspending or
      maintaining a patient's DNR order while in the operating room. A patient's
      autonomy must be recognized as well as the professional responsibilities of
      surgeons, anesthesiologists and nurses.

PMID- 8367109
TI  - Tying pay to performance: one critical care unit's approach.
AB  - This article describes development and testing of a tool for determining an
      appropriate reward for staff performance in a critical care area. Outlined is the
      process of identifying and quantifying appropriate merit increases based on
      bedside performance as well as participation in other unit, hospital,
      professional and community activities. Positive results are reported after one-
      and two-year use.

PMID- 8367111
TI  - No second license.

PMID- 8367110
TI  - Restraining cognitively impaired nursing home residents.
AB  - Patterns of physical restraint use were measured according to time of day,
      location on the unit, and persons in the environment on three units of one long
      term care facility. An in-depth examination clarifies aspects of temporal,
      environmental and social conditions under which restraint use typically occurs in
      cognitively impaired and agitated nursing home residents.

PMID- 8367112
TI  - Failure to assess.

PMID- 8367113
TI  - If you don't read this, you're missing out.

PMID- 8367114
TI  - When virtue becomes vice.

PMID- 8367115
TI  - The path of legislation: best opportunities for nurses' input.

PMID- 8367116
TI  - When work redesign prompts unionization activity. American Organization of Nurse
      Executives.

PMID- 8367117
TI  - Case management and caring behavior.
AB  - A conceptual framework using the 10 caring behaviors described by Watson
      clarifies an aspect of one hospital's nursing focus, means and goals. Through the
      use of this model, case managers develop transpersonal or empathetic
      relationships with patients in the hospital and in the community. The outcomes
      indicate that caring relationships promote self-healing and self-actualization.

PMID- 8367118
TI  - Clinical nurse case management: a service line approach.
AB  - Quality improvement and cost-effective outcomes are achieved through an alliance
      with clinical or "internal" and community care management. Quality and cost
      outcomes during the acute-care phase for 25 elective case managed patients were
      compared against a control group of 25 non-case managed patients. Results reveal
      improved preoperative resource utilization and patient education.

PMID- 8367119
TI  - Starting a hospital-based home health agency: Part II--Key success factors.
AB  - In Part II of a three-part series, the financial, technological and legislative
      issues of a hospital-based home health-agency are discussed. Beginning a home
      healthcare service requires intensive research to answer key environmental and
      operational questions--need, competition, financial projections, initial start-up
      costs and the impact of delayed depreciation. Assessments involving technology,
      staffing, legislative and regulatory issues can help project service volume,
      productivity and cost-control.

PMID- 8367120
TI  - Peer review for nurse managers.
AB  - One hospital's task force developed an evaluation tool specific to the nursing
      supervisor job description. This tool measures performance and enhances group
      communication.

PMID- 8367121
TI  - The "C"s in excellence: choice and change.
AB  - Today's competitive healthcare world mandates excellence. Two aspects of
      excellence, choice and change, are part of the never-ending cycle when giving
      quality patient care. Managers can enable others to initiate change when needed
      which establishes the core of management and tomorrow's realities for progress,
      performance and patient care.

PMID- 8367122
TI  - Accepting and refusing assignments.
AB  - Guidelines define the professional, ethical and legal responsibilities involved
      when challenging or delegating patient assignments. Maintaining safe nursing
      practice levels is possible through such alternatives as enabling practice
      environments and cross-training. These significant factors identify options
      available to nurse managers and their staff without compromising patient safety.

PMID- 8367123
TI  - Unsafe at any price.

PMID- 8367124
TI  - Justifying an obstetrics early discharge program.
AB  - A clinical conclusion from a research article, applied hypothetically to a
      nursing administration problem, demonstrates the importance of applying research
      to practice and sharing the results with the profession at large. This proposal
      identifies a needed service, its market and the means to implement the service-
      developing an early discharge program for mothers and their newborns.

PMID- 8367125
TI  - Patient-focused care: is it for your hospital?
AB  - Advocates of Patient-Focused Care (PFC) claim that a win-win resolution to the
      cost/quality dilemma can be achieved by placing the patient's concerns at the
      center of planning. With the patient as the central focus, a whole new paradigm
      of care emerges which links all components of systems redesign work with a
      common, defining purpose. Before embarking on such a change effort, planners
      should carefully examine PFC assumptions for relevance to their specific
      environment.

PMID- 8367126
TI  - Southern California Edison integrates management of employee disabilities.

PMID- 8367127
TI  - Industry profile: food processing. Ergonomic controls cut the shackles of meat
      packing's cumulative traumas.

PMID- 8367128
TI  - Wellness strategies help workers adopt healthy habits in lifestyles.

PMID- 8367129
TI  - Workplace statistics can't cut to the heart.

PMID- 8367130
TI  - Fertility after the age of 40.
AB  - There is approximately a 50% decrease in the fertility rate of unselected women
      attempting pregnancy at age 40 or older compared with younger women and a two to
      three fold increased rate of spontaneous abortion. Approximately 45% of older
      women achieve a term outcome, however. Proper counseling of the older patient
      should include a realistic view of the following risks: a 30% to 50% reduced
      pregnancy potential, effect of pregnancy on other maternal illnesses, an
      increased risk of pre-eclampsia, hypertension, and diabetes, and an increased
      risk of chromosomal abnormalities, abortion, and stillbirth. Knowing these risks,
      additional testing for ovarian reserve may help to identify women with favorable
      indices in whom IVF, other forms of assisted reproduction, or surgery to restore
      fertility are most appropriate. Women with decreased ovarian reserve could be
      offered oocyte donation as an alternative to surgical correction for infertility,
      because pregnancy rates are excellent when donor oocytes are transferred to the
      uteri of women older than the age of 40. In short, age alone should no longer be
      a deterrent in the treatment of infertility.

PMID- 8367131
TI  - Contraception in women older than 40 years of age.
AB  - Women older than 40 years have high rates of unwanted pregnancy and abortion and
      traditionally have had limited choices of contraception agents. In today's
      market, oral contraceptives should be considered as should IUDs in properly
      screened candidates. Sterilization is effective for the couple who knows that
      they will have no more children. Mechanical methods are effective if used when
      intercourse tends to be a planned event and infrequent. With the variety of
      agents available in today's market, there is no reason why the unwanted pregnancy
      rate and abortion rate of the women older than 40 should not be reduced
      dramatically.

PMID- 8367132
TI  - Reproductive genetics for couples older than 40 years of age.
AB  - The counseling process, which involves genetic screening and prenatal diagnosis,
      is presented. Also addressed are the recent advances in assisted reproductive
      technologies, which may prove to be particularly useful for these patients.

PMID- 8367133
TI  - Diabetes in women older than 40 years of age. Social and medical aspects.
AB  - Prevention of Congenital Anomalies. Because the first few weeks after conception
      are a critical time in terms of embryopathy, good glycemic control should be
      established before conception in the pregestational diabetic and stringently
      maintained throughout the first trimester. Encouraging the diabetic woman to
      achieve stringent glycemic control before conception would virtually eliminate
      the excess risk of spontaneous abortion and anomalies. Prenatal Diagnosis. For
      all mature gravidas with diabetes, early prenatal diagnosis of chromosome
      abnormalities (mainly trisomies) and congenital anomalies should be determined
      through detailed ultrasound examination, fetal echocardiography, and alpha
      fetoprotein determinations. Glycemic Control. Stringent metabolic control is
      mandatory throughout pregnancy to prevent the risk for macrosomia and maternal
      accompanied medical complications, such as preeclampsia. Fetal Surveillance.
      Structured fetal surveillance evaluating fetal growth and well-being must be
      pursued throughout pregnancy.

PMID- 8367134
TI  - Pregnancy in women aged 40 and older.
AB  - Counseling patients about pregnancy at advanced maternal age is a difficult
      process. This is true both because our knowledge of the attendant risks is
      incomplete and still evolving, and because of the difficulties of assigning risks
      and addressing counterbalancing benefits for individual patients. There are a
      number of social and personal considerations involved in a decision to become a
      parent after the age of 40. Generally, older parents tend to be more mature, to
      be in stable and healthy marriages, and to have more financial and family
      resources to assist with the process of child rearing. Parents in their fifth
      decade, however, may complain of having less energy to devote to young children
      or may be at a stage in their careers in which they have less time for family
      participation than when they were younger. Also, grandparents, who can play a
      critical role in early childhood development, often have become too old to
      participate in that role or have died. All of these issues must be considered by
      parents contemplating late childbearing. A great deal has been written, much of
      it positive, even enthusiastic, about the quality of pregnancy and childbirth
      among older women. Nevertheless, much of the literature is difficult to interpret
      because of problems in controlling for confounding variables. In addition, much
      of the focus on so-called older women has been on those older than 35 years. In
      fact, the great majority of the medical literature concerning late childbearing
      relates to women between the ages of 35 and 40. The data that directly concern
      women in their fifth decade suggest that risks that began to accelerate after the
      age of 35 become considerably greater and increase more rapidly after the age of
      40. Obviously, couples must decide what risks they are willing to accept and how
      these potential risks might be countervailed by the presumed advantages of
      parenthood relatively late in the reproductive years. There is convincing
      evidence to show that fecundity is decreased with advancing maternal age, and
      various forms of early pregnancy loss are increased. Thus, to delay childbearing
      results in a significant decrease in the likelihood of becoming pregnant or
      carrying a pregnancy to term. The possibility of genetic disorders is, as has
      been discussed previously, relatively easy to quantitate, and most age-related
      anomalies are amenable to prenatal diagnosis. It seems clear that women with
      underlying medical diseases, particularly hypertension and diabetes mellitus,
      contribute heavily to the excess morbidity and mortality associated with late
      childbearing.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8367135
TI  - Medical management of abnormal uterine bleeding in the patient in her 40s.
AB  - A large proportion of AUB can be controlled successfully with a variety of
      pharmacologic agents.

PMID- 8367136
TI  - Management of the symptomatic fibroid in women older than 40 years of age.
      Hysterectomy or myomectomy?
AB  - Although complications resulting from a myomectomy are infrequent, the overall
      risk is probably greater than a hysterectomy. The effect of hysterectomy on the
      specific women is difficult to quantify, however. Supracervical hysterectomy is a
      reasonable alternative in the woman with a normal cervix. Moreover, repeated
      laparotomies are not particularly advisable. In a woman who has previously
      undergone a myomectomy and has had a recurrent symptomatic myomatous uterus, the
      decision must be made either to proceed with a repeat myomectomy or to perform a
      hysterectomy. The chance of successfully achieving a pregnancy after a second
      myomectomy may be less favorable than after a primary myomectomy. A myomectomy
      can be a difficult and often time-consuming procedure. With meticulous attention
      to technique, however, the procedure can be accomplished safely and effectively
      with relatively ensured hemostasis and minimal blood loss. A myomectomy affords
      the option of preserving the uterus in those patients with symptomatic uterine
      myomata who desire to preserve their reproductive organs. However, careful
      assessment with meticulous counseling of the patient is essential. The potential
      option for a hysterectomy must always be preserved. Hysteroscopic resection of
      submucous myomata with endometrial ablation has become the technique of
      preference in many cases. At the moment, abdominal myomectomy is the preferred
      technique for the removal of intramural and subserosal myomata. For the present,
      laparoscopic myomectomy must be viewed as being of very limited acceptability.

PMID- 8367137
TI  - Management of endometriosis in women older than 40 years of age.
AB  - Endometriosis in women older than 40 years of age presents unique therapeutic
      challenges to the practicing physician. Management requires the evaluation of
      reproductive goals and a determination of the objectives of therapy, including
      symptomatic relief and avoidance or delay of recurrence of disease. Important
      considerations in this age group include diminished fertility and impending
      menopause. The diagnosis and treatment for endometriosis-associated infertility
      must be undertaken in an expedient manner. Assisted reproductive technologies may
      be effective therapies for these patients. Conservative surgery may be necessary
      to preserve reproductive potential, but definitive surgery may be indicated in
      women with long-standing pelvic pain. Estrogen replacement therapy may be used in
      menopausal women with a history of endometriosis.

PMID- 8367138
TI  - Diet, exercise, and lifestyle in preparation for menopause.
AB  - This article reviewed conservative measures in dealing with issues of
      osteoporosis and cardiovascular disease prevention. The scientific evidence for
      each singular intervention is difficult to extract because there are so many
      confounding parameters. Moreover, improvement in nutrition and diet has its
      greatest impact on premenopausal women. Needless to say, a total health care
      approach is still beneficial: exercise, a low-fat and normocalcemic diet, and
      proper use of ERT. These issues need to be a concern for both the pre- and
      postmenopausal woman. Gynecologists as primary health care providers need to
      incorporate this knowledge into their practices. They should clearly understand
      both the benefits and shortcomings of a nutritional and exercise approach in
      osteoporosis and cardiovascular disease prophylaxis. In using this knowledge
      premenopausally, they can better prepare women for the menopause.

PMID- 8367139
TI  - Sexual function in the perimenopause.
AB  - Proper medical supervision and care, especially the prescribing of appropriate
      pharmacologic therapy, combined with factual information, supportive guidance,
      and sympathetic counseling will ameliorate or enhance sexual function in most
      perimenopausal women. The preventive steps taken during the midlife years will
      help build a solid foundation to ensure continued sexual activity and enjoyment
      for couples that extends into the menopausal, postmenopausal, and geriatric
      years.

PMID- 8367140
TI  - Cancer screening for women older than 40 years of age.
AB  - As women's doctors, we have a commitment and responsibility to promote effective
      cancer screening for cervical cancer and breast cancer. At present, the screening
      tests for ovarian cancer cannot be applied to the mass population. For an
      individual patient, however, the role of sonography, tumor markers, and physical
      examination need to be individualized. Clinicians need to look to the future for
      advances in screening for this dreaded disease. This article reviews and
      discusses the available cancer screening for cervical, breast, and ovarian
      cancer.

PMID- 8367141
TI  - Development and histology of fibrous architecture of the fetal temporomandibular
      joint.
AB  - The developmental history of the temporomandibular joint (TMJ) was investigated
      in 10 fetuses of 4 to 10 months of gestational age. The S-type structure of the
      disc is formed by the following bases: 1) the flat upper and concave lower
      surfaces of the disc; 2) thinner intermediate zone and thicker anterior and
      posterior bands; 3) the projection of the articular tuberculum and
      superoposterior growth of the condyle. The posterolateral part of the disc was
      the thickest and the corresponding part of the fossa was the deepest. The condyle
      was originally positioned beneath the part of disc that was considered the main
      force-bearing area. The distribution and arrangement of elastic and collagen
      fibers in the disc was proportional to disc function. Gross elastic fibers in the
      posterolateral part of the posterior band were connected with the upper head of
      the pterygoideus lateralis muscle fibers running medioanteriorly. They were
      indicated to be antagonistic with each other. At 4 months of gestational age, a
      few elastic fibers appeared in the bilaminar region and began to form bundles as
      the fetus grew. At full-term dense elastic fibers were found in the upper stratum
      of the bilaminar region.

PMID- 8367142
TI  - Lectin-binding glycoconjugates in the tongues of the rat and guinea pig as
      revealed by lectin-gold-silver methods.
AB  - Lectin-gold-silver (LT-G-S) procedures using two lectins (RCA-I and Con A) were
      applied to appropriately prepared paraffin sections of tongues in the rat and
      guinea pig. In the lingual mucous membranes of the rat and guinea pig, positive
      RCA-I-G-S and Con A-G-S reactions were obtained in the intercellular spaces and
      the cytoplasm of epithelial cells of the basal and intermediate layers
      respectively. Likewise, the LT (RCA-I and Con A)-G-S techniques gave rise to
      varying intensities of positive reactions in the serous and mucous gland acini,
      nerve and muscle fiber bundles and connective tissue elements. The results
      obtained in the present study indicate that in the rat and guinea pig tongues the
      histologic structures mentioned contain varying amounts of beta-D-galactose and
      alpha-D-mannose or alpha-D-glucose residues of glycoconjugates, and that such
      histochemical properties of some of the lingual structures can be correlated with
      their possible histophysiological functions.

PMID- 8367143
TI  - Ectopic kidney in front of the right common iliac artery and its blood vascular
      supply--a case report.
AB  - A discoid-shaped ectopic kidney located in front of the right common iliac artery
      was observed in a 71-year-old Japanese man. The right kidney was normally
      positioned, but the left kidney was not observed in the normal position. The
      ureter of the ectopic kidney descended laterally to the left ductus deferens. The
      ectopic kidney received three arteries which arose from the anterior aspect of
      the abdominal aorta. Two of the arteries supplied the left half of the kidney.
      The other supplied the right half and gave off two branches to the adipose tissue
      around the right kidney; these branches meant that this artery belonged to the
      right side. Venous drainage from the kidney was handled by two veins. One
      collected venous radicles from the right half of the kidney and flowed into the
      inferior vena cava; this vein belonged to the right side. The other served the
      left half and joined with the left lumbar vein, which finally drained into the
      left common iliac vein; this vein was attributed to the left side. The present
      ectopic kidney had a left-side ureter, and vascular supply on both the right and
      left sides. This disunity or dissociation of laterality in the vessels and the
      ureter seemed to be strongly related to the location of this ectopic kidney in
      the median region.

PMID- 8367144
TI  - The configuration of prepubertal hymen in Turkish population and its clinical
      aspect.
AB  - The importance of the hymenal configuration lies in the fact that it is accepted
      as an important sign of the virginity in many countries and also it needs a
      clearcut definition for the forensic evaluation of child abuse and rape. To
      improve understanding of configuration of the normal hymen we studied 100
      prepubertal hymens. In addition to the most commonly seen types we found the
      fimbriated hymen at a high rate especially in adolescents. There was another
      configuration the appearance of which differed on each half of the vaginal
      orifice; one half had a labium while the other had fimbriae. The tagged type
      hymen was also encountered.

PMID- 8367145
TI  - Light- and electron-microscopic localization of basic fibroblast growth factor in
      adult rat retina.
AB  - An antiserum against basic fibroblast growth factor (bFGF) was characterized by
      immunoblot and used to localize bFGF-immunoreactivity in the adult rat retina.
      Crude homogenate of the retina, when examined with immunoblotting, exhibited a
      main band with the same molecular weight (18kDa) as bFGF. Light microscopic
      immunohistochemistry demonstrated intense bFGF staining in the photoreceptor
      outer segments and the outer plexiform layer, and weak immunostaining in some
      cells of the outer nuclear layer, inner nuclear layer and ganglion cell layer.
      The most intense bFGF-immunoreactivity was noted in glial (Muller) cells with
      vertically oriented thin processes. There were also immunoreactive pigment
      epithelial cells and mesenchymal cells in the choroid. Under electron microscopy,
      the outer plexiform layer was found to contain immunoreactive products
      exclusively in the axon terminals of photoreceptor cells which formed synapses
      with bipolar cell processes. The more widespread and uneven localization of bFGF
      immunoreactivity in the mature rat retina than previously demonstrated suggests
      that endogenous bFGF is involved in complex physiological events other than
      retinal regeneration and histogenesis.

PMID- 8367146
TI  - [Psychosomatic aspects of sterility and assisted reproduction].
AB  - The authors survey the literature of psychosomatic aspects of infertility, in
      vitro-fertilization and embryo transfer. They emphasize the most important
      thesises of psychosocial and psychodynamical approaches. The changing of sexual
      and marital relationship of infertile couples are analysed as well. They call
      readers' attention to some critical points of doctor-patient and
      psychotherapeutical relationship.

PMID- 8367148
TI  - [New therapeutic possibilities in the management of congenital pulmonary valve
      stenosis].
AB  - Data of 12 children (mean age = 3.1 yrs, range 0.4-11.1 yrs) with valvular
      pulmonary stenosis are reported. Balloon valvuloplasty was attempted for the
      treatment, first in the pediatric practice in our country. Echocardiography and
      cardiac catheterisation was used for the indication of the procedure and
      evaluation of the results. Strong correlation was found between the
      echocardiographic and haemodynamic data before (correlation coeff. = 0.9) and
      less strong after (correlation coeff. = 0.4) the procedure. As a result of the
      balloon dilatation the initial gradient of 62 mmHg (sd = +/- 17 mmHg) decreased
      to 20 mmHg (sd = +/- 10 mmHg) assessed by invasive technique. The difference is
      significant, p < 0.001. No major complication was observed. The procedure is
      recommended for widespread practice both in medical and financial sense.

PMID- 8367147
TI  - [Aspiration of barium contrast medium and its prevention].
AB  - The authors have been noted aspiration bronchograms associated with barium
      filling study of the upper gastrointestinal tract in 58 patients involving basal
      medial, anterior, lateral and posterior segments of the lower pulmonary lobes,
      mammary segment of the middle lobe, moreover inferior lingula. In 75.9% of
      patients (44 cases) the barium meal got to bilateral basal medial, anterior and
      lateral segments. The 34 men and 24 women had a mean age of 69 years (range, 29
      88 years). The aspiration was found 3.8-times more frequent after completion of
      patient's 50th year than before it observed. A transient tertiary mobility
      disorder of the esophagus, extrasystoles and tendency for collapse were on barium
      filling of bronchi. In 15 of the 18 patients the Valsalva's maneuver proved a
      pharyngomyodystonia. Carrying out of endoradiography depended on function of the
      lateral pharyngeal wall. The bronchi with physiological saline following
      aspiration of the contrast medium within 30 minutes were lavaged.

PMID- 8367149
TI  - [The use of a somatostatin analog (Sandostatin) in percutaneous drainage of
      pancreatic pseudocysts].
AB  - The inflammatory pancreatic diseases are usually hardly governable; special
      problems are arosen with the treatment of pancreatic fluid collections. The focal
      pericystic pancreatitis, the reactive inflammation developing in the course of
      the injury of the gland as well as draining pancreatic duct filling the cyst up
      may result in pitfalls. Thus subcutaneous administration of Sandostatin was added
      to the usual therapeutic regimen in 12 patients. It was applied with external and
      internal drainage of pseudocysts in 10 patients and in one of them the
      complication was reduced in an unsuccessful attempt, respectively. The pseudocyst
      of one patient disappeared by sole somatostatin administration. One cystic
      formation did not respond to this kind of treatment thus a drainage procedure had
      to be performed. Based on our initial experiences we seem to find a rather
      promising tool that may influence the basic process beneficially and makes our
      instrumental interventions safer and more successful.

PMID- 8367150
TI  - [Successful surgical management of arterio-mesenterial duodenal compression].
AB  - A 17 year old female patient developed in 6 month a gradually exacerbating
      stomach passage disturbance not responding to conservative treatment. Clinical
      and radiological examinations verified that the compression of the duodenum was
      caused by irregular position of the arteria mesenterica superior. The patient was
      operated on and a dissection and transposition of the duodenum was performed
      using an end-to-end anastomosis before the arteria mesenterica superior. This
      method has never been seen in Hungary before. The good result of the operation
      was verified by the control examinations.

PMID- 8367151
TI  - [Wound suturing at the turn of the century].

PMID- 8367152
TI  - [Psychiatric description of erotomania and its forensic psychiatric assessment in
      the last third of the 19th century].

PMID- 8367153
TI  - Oncology Nursing Society.

PMID- 8367154
TI  - Annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery
      Foundation, Inc. Minneapolis, Minnesota, October 2-6, 1993. Abstracts.

PMID- 8367156
TI  - Reevaluating Act 111's insurance requirement.

PMID- 8367155
TI  - Managing wastes in Pennsylvania.

PMID- 8367157
TI  - Burden of proof remains for KEPRO.

PMID- 8367158
TI  - Alerting patients to the risk of radon.
AB  - The potential lung cancer risk from exposure to radon gas and the development of
      appropriate public health policy have been the subject of much discussion for
      several years. The American Lung Association has taken a leading role in
      educating the public on radon and other environmental hazards. This article
      presents background on radon, including the issues of risk assessment and policy
      development; reviews the current understanding of the hazards of exposure and the
      scope of the problem; describes how to test for radon; and discusses how to
      decrease radon levels.

PMID- 8367159
TI  - Think recycled.

PMID- 8367160
TI  - Improving quality, controlling costs: the role of managed care. Pennsylvania
      Medical Society Council on Medical Economics.
AB  - Recognizing the importance of managed care concepts in the nationwide debate on
      health system reform, the State Society's Council on Medical Economics has
      compiled a discussion draft of the Society's positions on "The Role of Managed
      Care in Improving Quality and Controlling Health Expenditures," excerpted here.
      In addition to members' comments, the Society is soliciting comments from health
      caregivers, legislators, regulators, labor, business, insurers, and most
      importantly patients. Members may obtain a free copy of the complete draft by
      calling the Society's Department of Media Relations at (800) 228-7823. Direct any
      written comments to the Society's Division of Communications and Public Affairs.

PMID- 8367162
TI  - Where is that missing element?

PMID- 8367161
TI  - Secretary proposes DOH restructuring.

PMID- 8367163
TI  - Helping the medically indigent and underserved. Part III--Recruiting physicians
      for medically underserved communities.

PMID- 8367165
TI  - Helping patients improve their physical fitness. Interview by Juli C. McGreevy.

PMID- 8367164
TI  - Establishing criteria for evaluating health system reform proposals.
AB  - Effective proposals for health system reform will need to address the many
      complex issues facing medicine. Piecemeal approaches to health system reform are
      not likely to succeed. The Health System Reform Index may be a useful instrument
      for evaluating the scope and potential success of proposals that address critical
      issues in health care.

PMID- 8367166
TI  - Commentary: HIV-infected physicians--who has a right to know?

PMID- 8367167
TI  - Leaders discuss roles, future of medicine.

PMID- 8367169
TI  - Pennsylvania Medical Society Membership Directory, 1993-1994.

PMID- 8367168
TI  - The federation needs you!

PMID- 8367170
TI  - Reaching out to our nursing colleagues in the former USSR: a review of recent
      cross-cultural experiences.

PMID- 8367171
TI  - Total quality improvement (TQI).

PMID- 8367172
TI  - HIV/AIDS update. PA regional HIV planning coalitions.

PMID- 8367173
TI  - Nurse entrepreneur/intrapreneur corner.

PMID- 8367174
TI  - [HIV infection in childhood].
AB  - The increasing heterosexual transmission of HIV leads to an increase of vertical
      HIV-infection from mother to child. In Austria 19 children below 13 years with
      AIDS are registered, 16 of them had been infected by their mothers
      (osterreichische AIDS-Statistik, January 29, 1993). Clinical manifestations of
      HIV-infection in infants and children are different from those in adults. In this
      article we describe the typical signs like severe recurrent bacterial infections,
      failure to thrive, lymphoid interstitial pneumonia and neurologic symptoms as
      developmental delay, loss of previous acquired skills and progressive motor
      abnormalities. The difficulties of the diagnosis of HIV-infection in an infant
      born to a seropositive mother and problems with the integration of HIV-infected
      children in kindergarten and school are discussed.

PMID- 8367176
TI  - [Recommendations for treatment of acne vulgaris].
AB  - Acne vulgaris is by far the most prevalent of adolescent skin disease, involving
      60-80% of the teenage population. By androgen-stimulation the production of sebum
      is increased and by hyperkeratinisation the canal of the pilosebaceous follicle
      will be closed, thereby causing formation of comedones. These will get infected
      with Propionibacterium acnes. The treatment of acne vulgaris therefore consists
      in 4 steps: sebosuppression (with Benzoylperoxid), keratolysis (with Vitamin A
      acid and Azelainacid), bakteriostasis and stopping inflammation (with
      antibiotics). A mild cure of the affected skin is necessary too.

PMID- 8367175
TI  - [Psychological disorders in children and adolescents].
AB  - After some introductory remarks on definition and frequency, a classification of
      psychiatric disorders in children and adolescents is given. Due to limited space,
      the various disorders are discussed only in terms of their relation to phases of
      development in childhood and adolescence. Finally, a sketch of basic ideas of
      etiology and the most important therapeutic approaches is presented.

PMID- 8367177
TI  - [Interdisciplinary team work in the treatment of cystic fibrosis: a model of
      psychosomatic cooperation].
AB  - The "team-approach" in the care of chronically ill children is one way of
      interdisciplinary cooperation. The care of CF-patients requires the coordination
      of all treatment-measures and the integration of psychosocial counselling and
      management into medical treatment. Not only emotionally straining situations-
      "telling" the diagnosis, non-compliance, care of terminally ill patients--have to
      be managed, but both, illness and treatment, produce a lot of problems, to which
      solutions have to be offered. The task of psychological staff is on the one hand
      to contribute their specific knowledge to treatment-concepts, to enhance the
      psychosocial competence of the medical staff and, on the other hand, to offer
      counselling to the patients and their parents.

PMID- 8367178
TI  - [N-acetyl-beta-glucosaminidase (beta-NAG) in urine: a parameter for early
      detection of diabetogenic nephropathy in childhood].
AB  - N-Acetyl-beta-D-glucosaminidase (NAG) can be found in kidney in high activity. By
      determination of this enzyme activity in urine nephropathies can be recognized
      reliably. We have measured this lysosomal enzyme in the urine (Colorimetric
      method by Noto) of 206 children suffering from diabetes mellitus to find out
      whether diabetic nephropathy can be detected as soon as possible. Additional beta
      2-microglobulin (ELISA) was measured in urine, which is reabsorbed nearly
      complete in the tubulus. The several proteins in urine were identified by SDS
      PAGE. A high excretion of beta-NAG was found in children and adolescents with a
      poor metabolic control (elevated HbA1c). There was no correlation between NAG
      activity, duration of the diabetes and the age of the children. An elevated
      excretion of beta-2-microglobuline could be found only in seven children with a
      duration of the diabetes about six years; their HbA1c levels were high. The SDS
      PAGE showed a pattern of glomerular protein excretion according to the duration
      of the diabetes. However there was no significant correlation to the metabolic
      control. Only in four children we ascertained mixed proteinuria. The increasing
      levels of urinary NAG may represent the increasing severity of nephrotic damage
      by diabetes. The estimation of NAG levels in urine would seem to be reliable in
      the early detection of diabetic angiopathy also and may serve as an index of
      diabetic control independent of blood sugar levels.

PMID- 8367179
TI  - [Pediatric Research in Central Europe. Vienna, 18 June 1993. Abstracts].

PMID- 8367180
TI  - Wheelchair selection.
AB  - Selection of an appropriate wheelchair is an essential part of discharge
      planning. Although the physical therapist plays the primary role in wheelchair
      recommendations, all those involved in patient care need to have a basic
      understanding of factors that are considered. This article discusses these
      factors, which include patient diagnosis, prognosis, medical status, functional
      status, mental status, environment, and funding. It also emphasizes that the
      decision-making process is a team effort and that the patient and his/her family
      are key members of that team. Basic terminology, wheelchair components, and
      available options for wheelchairs and wheelchair cushions are addressed.

PMID- 8367181
TI  - Development of an orthopaedic case manager role.
AB  - Creation of a case manager role was one institution's strategy to improve the
      coordination and delivery of care for orthopaedic trauma patients. This article
      describes the development and implementation of the innovative role within a
      large county health system and applies Neuman's Health Care Systems Model to the
      process.

PMID- 8367183
TI  - From the president: health care reform--what you can do.

PMID- 8367182
TI  - Avascular necrosis of the bone: the causes and the cures.
AB  - Injury to bone directly or indirectly influenced by the pathophysiologic effects
      of ischemia or various disease processes can have sensitive and dramatic effects
      upon intraosseous microvascular structures. The femoral head is a common area
      affected by avascular necrosis. The causes, cures, and staging management of this
      microcirculatory phenomenon will be presented.

PMID- 8367184
TI  - An assessment of discharge planning models: communication in referrals for home
      care.
AB  - A home care referral generated upon hospital discharge communicates essential
      patient care information, links service providers, and facilitates continuity of
      patient care. The literature however, reveals that communication efforts are
      often inadequate and may even fail in this system. The purpose of this research
      was to examine whether various discharge planning models employed by hospitals
      resulted in differences in the quantity and quality of communication about
      patients referred for home health care. Kelly and McClelland's (1985) typology of
      discharge planning models provided the framework for the study. Using instruments
      designed specifically for this project, six referring hospitals' functional
      discharge planning models were labeled and 300 closed home care records of
      referrals were reviewed to ascertain the amount and type of data transmitted.
      Results indicated that only slightly more than half of the data recommended by
      the literature was actually transferred and that data was primarily background in
      nature. The hospital discharge planning model did make a significant difference
      in the amount and type of data shared, with liaison nurses sending the greatest
      amount of data. However, both conceptually and in practice, the discharge
      planning models simply describe an allocation of responsibility among various
      health personnel. They are not operational models in the traditional sense.

PMID- 8367186
TI  - Antigout medications.

PMID- 8367185
TI  - Sacred cows.

PMID- 8367187
TI  - Deep venous thrombosis.

PMID- 8367188
TI  - Respect for persons: the patient with AIDS.
AB  - Even though the Code for Nurses calls for nurses to provide nondiscriminatory
      care and to treat patients with respect, research shows that nurses (1) are
      reluctant to provide care to and (2) believe that they should have the right to
      refuse to care for patients with AIDS. This article presents two contrasting
      situations and focuses on the ethical principle of respect for persons. Nurses
      need to examine their own practice to determine if they are providing care that
      respects the uniqueness and rights of their patients.

PMID- 8367189
TI  - Clinicopathological features of xanthogranulomatous pyelonephritis in infancy.
AB  - Xanthogranulomatous pyelonephritis (XGP) is an unusual chronic inflammatory
      condition which most often affects women in their 5th to 7th decades and is rare
      in infants. Predisposing factors include infection, calculi and obstructive
      uropathy. We have reviewed the surgical files of 4 cases seen over a 28 yr period
      from 1964-91. All of the 3 partial and one total nephrectomy specimens
      demonstrated typical features of XGP with renal parenchyma effaced by a mixed
      acute and chronic inflammatory infiltrate which included prominent aggregates of
      foamy histiocytes containing eosinophilic inclusions. No Michaelis-Gutmann bodies
      were seen. This study shows the association of XGP with chronic infection,
      anatomical malformation and reflux in infancy, and raises the possibility of a
      temporary altered immune response in its pathogenesis.

PMID- 8367190
TI  - Ultrastructure of human melanosis coli with reference to its pathogenesis.
AB  - Colonic mucosal biopsies from patients with melanosis coli were examined by
      electron microscopy. They showed apoptosis of colonic surface epithelial cells
      and phagocytosis of resulting apoptotic bodies by intraepithelial macrophages.
      The latter migrated to the lamina propria where intracellular degradation of the
      apoptotic bodies resulted in formation of lipofuscin, characteristic of this
      condition. The results showed the pathogenesis of human melanosis coli was
      identical to that determined in an animal model of this disease.

PMID- 8367191
TI  - Test and teach. Number Seventy. Diagnosis: Transient myeloproliferative disorder
      in a child with Down's syndrome.

PMID- 8367192
TI  - Test and teach. Number Seventy-One. Diagnosis: Systemic lupus erythematosus (SLE)
      lymphadenitis (necrotizing lymphadenitis).

PMID- 8367193
TI  - Diagnosis of metastatic carcinoma of stomach using fine catheter aspiration
      cytology.
AB  - The value of fine catheter aspiration cytology organs of the peritoneal cavity in
      the diagnosis of a metastatic carcinoma is illustrated by this case report. The
      finding of unequivocal malignant cells was quite unexpected and led to an
      investigation of the gastrointestinal tract which demonstrated a primary
      carcinoma in the stomach. This was further confirmed on a biopsy of the tumor and
      cell block preparations of aspirated material on which immunostaining was done
      and which further substantiated the light microscopic cytohistologic diagnosis.
      The findings presented in this article further emphasize the value of fine
      catheter aspiration cytology in not only identifying tumor type or predicting the
      source of the primary but also in managing patients admitted with abdominal pain
      as an emergency who may be saved from an unnecessary laparotomy which would have
      otherwise been done for a diagnosis.

PMID- 8367194
TI  - DNA analysis and clinical outcome in pediatric adrenal cortical tumors.
AB  - Adrenal cortical neoplasms are uncommon and it is often difficult to separate
      benign tumors from those that are malignant. Histology does not provide a
      reliable guide, particularly in pediatric cases. It has been suggested that
      analysis of nuclear DNA content may complement conventional histopathologic
      methods in the diagnosis of malignancy. Six previously reported adrenal cortical
      tumors from children aged 6 mths to 6 yrs were analysed using a CAS 200 image
      analysis system which provided DNA histograms on each of the cases. In 5 cases a
      significant proportion of the tumors showed aneuploidy and in only one case did
      most of the tumor cells show a diploid pattern. All 6 cases were treated with
      surgery alone with long term survival and follow up of 2-15 yrs except in one
      child with a histologically benign aneuploid tumor who died post-operatively from
      measles pneumonia. No correlation between histological appearance, outcome and
      ploidy was seen. The aneuploid tumors included those classified by current
      histological methods as benign (1), indeterminant (2) and malignant (2). The one
      diploid tumor seen was a large tumor of indeterminant malignancy that did not
      recur. Although the series is quite small these observations suggest that
      abnormalities of DNA content may not provide an objective measure of the
      malignant potential of adrenal cortical tumors in children.

PMID- 8367195
TI  - Inhibition of the neutrophil respiratory burst by neoglycoalbumin.
AB  - Both human serum fraction V albumin subjected to enhanced glycation by incubation
      with glucose, and a highly glycated albumin fraction prepared by m-phenyl boronic
      acid agarose affinity chromatography, when compared with albumin preparations of
      lesser glycation but equal concentration, inhibited the respiratory burst of the
      human neutrophil. Native albumin also inhibited the respiratory burst in
      proportion to its concentration. It is suggested that the neoglycoalbumin impairs
      glucose utilization by the neutrophil.

PMID- 8367196
TI  - von Willebrand's disease: laboratory investigation using an improved functional
      assay for von Willebrand factor.
AB  - This report details extensive studies investigating an improved screening
      procedure for the laboratory confirmation of clinically suspected von
      Willebrand's disease (vWD). Over the past two years, over 400 plasma samples,
      comprising samples derived from both normal individuals (n = 112) and from
      patients undergoing investigation on clinical grounds, underwent analysis in this
      screening procedure, comprising three distinct assays: a standard ELISA assay for
      von Willebrand Factor (vWF) antigen levels (vWF:Ag), a standard ristocetin
      cofactor (R Cof) assay, and a functional collagen based ELISA assay for vWF
      ('CBA'). Normal individual plasma samples yielded normal reference values (mean
      +/- 2SD) approximating 50-200% (vWF:Ag, R Cof) or 50-250% (CBA). In order to
      permit comparative analysis, and based upon derived assay values, and subsequent
      multimer analysis, patient samples were either deemed to derive from persons
      unlikely to suffer vWD ('non-vWD' patient group) or those potentially suffering
      vWD. The latter group was further separated into subgroups based upon the
      likelihood, and probable subtype of vWD. In conjunction with the vWF:Ag assay,
      the CBA provides the basis by which an effective predictor system (likelihood and
      probable subtype of vWD) can be offered on the basis of preliminary screening
      procedures. To date, there has been no overlap in vWF:Ag to CBA ratios (vWF:CBA)
      between patients yielding Type II vWD like multimer patterns and those yielding
      Type I vWD, or normal, multimer patterns. Thus, high vWF:CBA (i.e. > or = 3.0)
      would suggest a Type II, or pseudo, -vWD like defect, whereas low vWF:CBA (< or =
      2.5) would likely derive from either normal individuals, or persons suffering
      from Type I vWD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367197
TI  - Immune events in lymphoid tissues during experimental glomerulonephritis.
AB  - To investigate immune events within lymphoid tissues and their role in relation
      to glomerular disease, systemic lymphoid tissues from rats with accelerated
      experimental anti-GBM glomerulonephritis or with primed serum sickness
      glomerulopathy were studied. Following disease induction, changes in leukocytic
      populations within lymphoid tissues were analysed over a 28 day time course by
      immunoperoxidase labelling with monoclonal antibodies. In anti-GBM
      glomerulonephritis there was rapid and severe renal injury and pulmonary
      hemorrhage (Good-pasture's syndrome). In these rats, antigen (rabbit IgG) was
      deposited on the GBM and within germinal centres of lymphoid tissues. From day 3
      onwards, there was a significant increase in the number of T cells, presumably
      CD4+ T helper cells, present within enlarged germinal centres of kidney draining
      lymph nodes, axillary lymph nodes and spleen (p < 0.05) which peaked at day 14
      (up to 28% of total cells) when there was intense deposition of rat IgG and C3 on
      the GBM. Similarly, increased numbers of ED1+ macrophages were evident in both
      germinal centres and T cell areas (paracortex and periarteriolar lymphoid
      sheath). Notably, the appearance of IL-2R expression in germinal centres and T
      cell areas was apparent from day 7 onwards. This was the time when widespread
      renal interstitial infiltration, cellular immune activation and severe renal
      functional and histological injury developed. In addition, antigen deposited in
      germinal centres was found to be associated with CD4+, CD5-, ED1- cells, most
      probably antigen presenting dendritic cells. In contrast, in acute serum sickness
      there was no antigen deposited in germinal centres and only mild renal injury and
      minor changes within lymphoid tissues.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367198
TI  - Dual CD45RA, CD45RO positive T-lymphocytes within rheumatoid arthritic joints.
AB  - This report documents the presence of an expanded population of dual CD45RA,
      CD45RO positive T cells (up to 91% of T cells) in the rheumatoid joint. Cells
      from peripheral blood (PB) and synovial fluid (SF) were analysed by dual
      immunofluorescence labelling. Synovium from a separate patient population was
      analysed by single and dual immunoenzyme staining of serial sections. Dual
      CD45RA, CD45RO positive T cells were found in PB (up to 74%), SF (up to 91%) and
      synovium. This was associated with a lack of early activation antigens (4F2,
      interleukin-2 receptor, transferrin receptor) but increased HLA-Class II antigens
      (HLA-DR, -DP, -DQ) in SF compared with PB. This intermediate activation phenotype
      may support the hypothesis that T cell activation or reactivation occurs within
      the rheumatoid joint.

PMID- 8367199
TI  - Susceptibility of Legionella species to antimicrobial agents.
AB  - Thirty-five clinical isolates of Legionella species were tested against 7
      antimicrobial agents using an agar dilution technique. Results obtained on
      charcoal-supplemented (BCYE) and charcoal-free agar (BSYE) were compared. On
      BCYE, the most active agent was rifampicin; the minimal inhibitory concentration
      inhibiting 90% of the strains (MIC90) was 0.008 mg/L. Imipenem was the next most
      active in vitro (MIC90 0.06 mg/L). The macrolide antibiotics and ciprofloxacin
      also inhibited the organisms at low concentrations (MIC90 < or = 2 mg/L). In
      general, MIC's obtained on BCYE agar were at least twofold higher than on BSYE
      agar except for that of imipenem. BSYE agar is a suitable alternative medium for
      susceptibility testing of most Legionella species. Erythromycin and rifampicin
      continue to demonstrate good in vitro activity against legionellae in Australia.
      On the basis of in vitro susceptibility tests, the other macrolides and
      ciprofloxacin are likely to be suitable alternatives for the treatment of
      legionellosis.

PMID- 8367200
TI  - Squamous cell carcinoma arising in an eccrine hidrocystoma.
AB  - This report describes the case of a 63 yr old male with an enlarging lesion on
      the left cheek. Excision biopsy showed a squamous cell carcinoma arising from an
      eccrine hidrocystoma. The eccrine hidrocystoma showed foci of squamous metaplasia
      and the sequence of squamous metaplasia complicated by squamous carcinoma is
      postulated. Squamous differentiation in eccrine neoplasia is discussed.

PMID- 8367201
TI  - Two fatal infections in immunocompromised patients caused by Scedosporium
      inflatum.
AB  - Two fatal infections caused by Scedosporium inflatum in immunocompromised
      patients are described. One patient developed peritonitis with this fungus 3 mths
      post renal transplantation. After a stormy course in the intensive care unit he
      eventually died. The other patient was suffering from non-Hodgkin's lymphoma and
      showed persistent neutropenia. Progressive deterioration occurred, and
      disseminated fungal infection was found at post mortem. Both isolates were
      resistant to all commonly available antifungal agents.

PMID- 8367202
TI  - Metastatic osteogenic sarcoma to the heart presenting as bacterial endocarditis.
AB  - A patient with metastatic osteogenic sarcoma involving the left atrium is
      described who presented with features of bacterial endocarditis. The source of
      infection was the adjacent esophagus into which the tumor had eroded. This case
      demonstrates that sarcomas metastasizing to the heart may result in a clinical
      condition indistinguishable from infective endocarditis. At post-mortem, careful
      dissection of cardiac metastases should be undertaken to check for possible
      esophageal involvement.

PMID- 8367203
TI  - Fibro-osseous pseudotumor of the digits: report of a case with
      immunohistochemical and ultrastructural studies.
AB  - A polypoid fibro-osseous nodule arising from the soft tissues of a toe of a 17 yr
      old man is described. Initial partial excision of the nodule led to a wrong
      diagnosis of pyogenic granuloma. The mistaken diagnosis was based on finding an
      extensively ulcerated polypoid nodule with a core of fibrovascular tissue which
      resembled granulation tissue. The fast growing lesion recurred twice within 4
      mths following incomplete excisions. Bony destruction of the distal phalanx was
      noted radiologically at the second recurrence. The rare lesion is an example of
      fibro-osseous pseudotumor of the digits, sometimes described as pseudomalignant
      osseous tumor of the soft tissues. It is curable by complete local resection. The
      importance of recognizing this lesion lies in its potential to be confused with
      parosteal or extraskeletal osteosarcoma. The fast growth rate of present case led
      to a strong clinical suspicion of malignancy. Incomplete excisions resulted in
      local recurrences rendering more extensive surgery necessary. There was no
      further recurrence 12 mths after the last excision.

PMID- 8367205
TI  - Leiomyosarcoma of the thyroid: immunohistochemical and ultrastructural study.
AB  - A primary leiomyosarcoma of the thyroid was seen in a 54 yr old female. The
      patient had a solitary, cold nodule with no abnormalities of thyroid function
      tests. Histologically it was composed of characteristic interlacing fascicles of
      spindle cells which, electron microscopically, showed thin myofilaments with
      focal dense bodies. Immunohistochemistry showed a strong reaction with vimentin,
      smooth muscle actin and desmin. No epithelial differentiation was noted
      immunohistochemically or ultrastructurally. No tumor recurrence was detected 15
      mths after surgery. It is postulated that the smooth muscle differentiation had
      arisen by metaplastic change or de-differentiation with re-differentiation of
      anaplastic thyroid carcinoma.

PMID- 8367204
TI  - Intra-abdominal desmoplastic small round cell tumor.
AB  - A rarely encountered but distinctive type of aggressive malignant tumor of
      childhood and adolescence has been recently described as occurring predominantly
      or exclusively intrabdominally. It is characterized by a generally diffuse
      pattern of growth of small cells with hyperchromatic nuclei, scanty cytoplasm,
      patchy epithelial differentiation, immunohistochemical co-expression of keratin
      and desmin intermediate filaments and a focal but pronounced desmoplastic stromal
      component. It is regarded as yet another variant in the group of small round cell
      tumors (SRCT) of infancy and childhood. This case report of a mass in the greater
      omentum of a 15 yr-old girl adds to the 33 cases already described in the English
      literature.

PMID- 8367206
TI  - Comparison of cytogenetic findings after fibroblast culture and whole tissue
      cryopreservation.

PMID- 8367207
TI  - Extrapulmonary tuberculosis--two case reports with fatal outcome.

PMID- 8367208
TI  - [Odontogenic cysts--histogenesis, histology, potential for possible neoplastic
      transformation].
AB  - Epithelial odontogenic cyst develop either in result od peridental inflammation
      radicular cyst, or in result of developmental disturbances in the course of the
      odontogenesis. The latter are divided into primordial and dentigerous cysts. Some
      odontogenic cysts are lined with squamous keratotic epithelium -ortho- or
      parakeratotic type. The latter is characterized by higher recurrence rate and
      malignant potential. Primary intraosseous carcinoma (PIOC) both keratizing and
      nonkeratizing might originate in keratocyst. Mucoepidermoid carcinoma and
      occasionally other benign and malignant sialogenic tumors might originate in
      keratocyst either. In addition in the jaw-bones with the odontogenic cyst or even
      without the cyst, squamous odontogenic tumor (SOT) can develop or so-called
      squamous odontogenic tumor-like proliferation in odontogenic cyst (SOT-LPOC).
      PIOC is a cancer of low grade malignant potential. Biology of SOT and SOT-LPOC in
      not elucidated yet as these are not frequently occurred lesion.

PMID- 8367209
TI  - Hypothalamic and neurohypophysial vasopressin and oxytocin content as influenced
      by haemorrhage in melatonin-treated male rats.
AB  - The effect of haemorrhage (1 ml per 100 g b. w.) on the vasopressin and oxytocin
      storage in the hypothalamus and neurohypophysis of melatonin-treated male rats
      was determined. Melatonin treatment (100 micrograms/100 g b. w., once daily over
      8 days) resulted in a known decrease of vasopressin as well as oxytocin content
      both in the hypothalamus and neurohypophysis. Haemorrhage decreased the
      neurohypophysial vasopressin and oxytocin storage in animals injected with
      vehicle solution or otherwise not treated. In melatonin-treated rats, however,
      bleeding did not affect the actual (i.e., decreased by melatonin) vasopressin and
      oxytocin content in the hypothalamo-neurohypophysial system. The results
      demonstrate that melatonin may be involved in mechanisms determining the rate of
      the response of vasopressinergic and oxytocinergic neurones to bleeding.

PMID- 8367210
TI  - The effect of haemorrhage and melatonin on neurohypophysial vasopressin and
      oxytocin content in pinealectomized male rats.
AB  - The effect of haemorrhage and melatonin on the vasopressin and oxytocin storage
      in the neurohypophysis of pinealectomized male rats was determined. Sham operated
      or pinealectomized rats as well as rats pinealectomized and injected with
      melatonin (100 micrograms/100 g b. w., once daily over 8 days) or with melatonin
      vehicle (2.2% ethanol in 0.9% NaCl) were subsequently subjected to haemorrhage.
      Pinealectomy was followed by known decrease of both vasopressin and oxytocin
      content in the neurohypophysis as compared to sham operated rats. Similarly,
      haemorrhage decreased the neurohypophysial vasopressin and oxytocin storage in
      both sham operated and pinealectomized animals. Melatonin, injected to
      pinealectomized animals, did not modify the diminution of neurohypophysial
      vasopressin and oxytocin content caused by bleeding. The results demonstrate that
      in pinealectomized rats melatonin does not affect the rate of the response of
      vasopressinergic and oxytocinergic neurones to bleeding.

PMID- 8367211
TI  - Immunocytochemical analysis of cellular infiltrates in primary glial and
      metastatic tumors in human brain.
AB  - Forty eight human brain tumors: 31 primary glial tumors and 17 metastasizing
      neoplasms were submitted for an immunocytochemical characterization of
      mononuclear cell infiltrates in tumor tissue and in its surroundings, with
      antibodies CD 68, CD45RO, UHCL1, EMB11, CD21 and OPD4. It was found that cells
      were mainly marked with CD68 and CD45RO, UHCL1. The counting of the marked and
      unmarked mononuclear cells proved that there is a high degree of variability in
      cell density which is tumor type and case depended. The results indicate that
      there were fewer cells which reacted to the antibody EMB11 as compared with cells
      marked with other antibodies. With CD21 and OPD4 only single cells were marked. A
      great number of cells remained unmarked. There was a significant difference
      between the primary glial and the metastatic tumors as far as the number of
      marked cells is concerned. It is suggested that the difference between primary
      and metastatic tumors in the number of mononuclear cell infiltrates can be
      connected with a possibility that the metastatic tumor will present its
      antigenicity easier as compared with primary tumors of glial origin.

PMID- 8367212
TI  - Photodynamic therapy of transplantable interstitioma testis in Wistar rats;
      histopathological examination after Evans blue injections.
AB  - The following examination was carried out confirm the effect of Photodynamic
      Therapy on tumor damage induction in Wistar rats. 20 male Wistar rats bearing
      interstitioma testis with mean diameter of 2 cm were treated with Photodynamic
      Therapy, i.e. injected intravenously with alkaline solution of meta-tetra
      hydroxyphenyl-porphyrin in dose of 5 mg/kg of body weight and after 24 hrs the
      tumors were irradiated with red light (650 nm). 2 hrs later these rats were
      injected intravenously with dye, i.e. 1% solution of Evans Blue in volume of 5 ml
      per one rat. After next 2 hrs animals were sacrificed. Necrosis areas in tumors
      were evaluated both on routine paraffin embedded sections without Evans Blue
      injections, stained with HE only and on paraffin sections from sample containing
      dye alone. There was the significant increase in necrosis size in treated tumors
      in comparison to untreated controls or tumors that were given photosensitizer,
      i.e. porphyrin or light alone. Present data indicate positive role of
      Photodynamic Therapy on interstitioma testis necrosis induction in Wistar rats.

PMID- 8367213
TI  - Studies on teratospermatogenesis occurrence in man.
AB  - In 462 left testes of males, died in the age of 17-91 years (x = 51,9 +/- 16,8
      years) the occurrence frequency and the degree of teratospermatogenesis activity
      was assessed. In the whole material, the phenomenon occurred in 84% of cases. In
      47,83% of cases the grade of intensity was low (+), in 22% high ( ), in 14%
      moderate (++). Alcoholic intoxication occurred to have the heaviest impact on
      teratospermatogenesis frequency (92,5%); in liver cirrhosis the occurrence
      frequency was significantly more rare (76%). The age of cadavers and the weight
      of the gonad did not correlate with teratospermatogenesis occurrence frequency.
      Postmortem autolysis was not connected with the phenomenon occurrence also. It
      correlated positively albeit with type II and III seminiferous tubules, i.e. with
      tubules, where spermatogenesis was stopped on the stage of spermatids and
      spermatocytes, and negatively with hyalinized tubules, and also with the V% value
      of tubular membranes.

PMID- 8367214
TI  - Ultrastructure of diffuse malignant mesothelioma of the pleura. An analysis of
      ten cases.
AB  - An electron-microscopic examination of ten cases of malignant pleural
      mesothelioma is presented. The most characteristic features for diagnosis are:
      presence of microvilli and desmosomes, abundant intermediate filaments and direct
      contact between microvilli and collagen fibres. Microvilli were present not only
      on the luminal surface of the cells, but also on the abluminal surfaces.
      Differentiation towards the cells characteristic for rhabdomyosarcoma was found
      in one case.

PMID- 8367215
TI  - Meconium aspiration syndrome: physiological and inflammatory changes in a newborn
      piglet model.
AB  - In order to evaluate further the physiological and inflammatory changes of
      meconium aspiration syndrome (MAS), 25 newborn piglets (1-2 days old, 1.5 +/- 0.4
      kg) were studied. Piglets were briefly ventilated with 100% oxygen and then
      received an intratracheal bolus of 3 mL/kg of a 20% suspension of human meconium.
      They were then further ventilated, keeping PaCO2 at approximately 40 torr and
      PaCO2 at 70 torr during 4, 12, 24, and 48 h studies. Pulmonary function studies
      and tracheal aspirates were obtained at time zero and serially throughout the
      study. Bronchoalveolar lavage was performed at the end of the study to examine
      endogenous surfactant function. Control piglets received 3 mL/kg of intratracheal
      saline and were then ventilated for 48 h at an inspired oxygen concentration and
      mean airway pressure matched to the meconium treated group (to control for the
      effects of hyperoxia and barotrauma on the lung). MAS caused acute decreases in
      gas exchange and dynamic lung compliance, which returned toward baseline by 48 h
      (P < 0.001, ANOVA). Tracheal aspirate absolute neutrophil count, neutrophil
      chemotactic activity, albumin, and total protein concentrations also increased
      significantly over time (P < 0.001). Endogenous surfactant function appeared to
      be significantly inhibited by the meconium. All variables of lung injury were
      significantly higher in the meconium group compared to the saline control group
      over the 48 h study. Newborn piglets provide a clinically relevant model of MAS,
      demonstrating physiological and inflammatory changes with apparent alterations in
      endogenous surfactant function. Effective therapies for MAS may require
      interventions directed at all of these components of lung injury.

PMID- 8367216
TI  - A simplified method for determining the frequency response of pneumotachographs
      used in infants.
AB  - In all rapidly changing systems, an appropriate response time of all sensing
      devices is essential for the accurate conversion of a physiological parameters to
      a proportional electrical signal. The frequency response of equipment is the
      ability to accurately reflect both the magnitude and temporal relationship of
      dynamic events over a defined frequency range. The phase lag expresses the
      temporal delay between the physical event being measured and the output signal.
      The attenuation expresses diminution of the amplitude ratio of the output signal
      in relation to the input signal over a range of frequencies. We have developed a
      method that specifically addresses the measurement of frequency response and
      attenuation of pneumotachographs and low pressure transducers. The system
      consists of a 81 liter rectangular box separated in the middle by a 30.5 cm
      acoustic loudspeaker, the cone sealed by latex, and driven by a signal generator
      coupled to a low frequency amplifier. This system can produce an undistorted
      sinusoidal signal between 0 and 20 Hz, and the peak flow through the
      pneumotachograph is only minimally affected by changes in frequency. Rapid
      analysis is possible using an oscilloscope to produce Lissajou loops. There is no
      measurable attenuation between the electrical signal and the pressure generated
      over frequencies from 1 to 20 Hz. The system is accurate at low frequencies and
      can generate appropriate signals over the frequency range of interest for
      respiratory applications, and it can be inexpensively constructed.

PMID- 8367217
TI  - Predictive value of measurements of respiratory mechanics in preterm infants with
      HMD.
AB  - Conventional methods for measuring respiratory mechanics model the respiratory
      system as a single compartment. The interrupter technique allows the respiratory
      system to be considered as a two compartment model with "flow resistance" of the
      conducting airways (Rinit), calculated from the initial pressure drop (Pinit),
      considered separately from Pdiff, as a measure of the viscoelastic properties of
      the lung and chest wall and any pendelluft present. The pulmonary mechanics of 50
      intubated and mechanically ventilated preterm infants (< or = 1500 g) were
      studied during the first week of life using conventional methods and the
      interrupter technique to determine whether it was possible to predict which
      infants would develop bronchopulmonary dysplasia (BPD). Pulmonary mechanics of
      preterm infants intubated and ventilated for apnea of prematurity were also
      studied. The dynamic compliance of the respiratory system (Crsdyn) was
      significantly lower on day 1 (P < 0.001) and during the first week of life in the
      infants with HMD who developed BPD (ANOVA, P < 0.0001). There was no significant
      difference in the respiratory system resistance (Rrs), Rinit, or Pdiff between
      BPD and no-BPD groups. However, Pdiff was significantly higher in infants with
      HMD, regardless of the outcome, when compared to the infants ventilated for apnea
      of prematurity. This suggests that the pathology of HMD is distal to the
      conducting airways and significantly alters the viscoelastic properties of the
      lung on day 1. Using stepwise logistic regression Crsdyn on day 1 and birth
      weight or gestational age were significant independent predictors or the
      development of BPD, correctly classifying 92% of infants.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8367218
TI  - Polysomnography in obese children with a history of sleep-associated breathing
      disorders.
AB  - We hypothesized that obese children with a history of breathing difficulty during
      sleep would demonstrate (1) evidence of complete and partial obstructive sleep
      apnea (OSA) with hypercarbia and/or hypoxemia; and (2) correlation between
      symptoms, degree of obesity, adenoid and tonsil size, and polysomnography (PSG)
      results. We evaluated 32 obese children [% ideal body weight (IBW), 196 +/- 45%]
      with a sleep history questionnaire, airway radiographs, electrocardiograms (ECG),
      and PSG. By history, we found snoring (100%), difficulty breathing (59%),
      sweating (44%), restlessness (53%), arousals (41%), apnea (50%), worsening with
      upper respiratory infection (URI) (81%), hypersomnolence (59%), and mouth
      breathing (59%). We found adenoid and/or tonsil enlargement on 75% of airway x
      ray pictures. ECGs were abnormal in 5 patients. Among all patients, mean sleep
      study oxyhemoglobin saturation (SaO2) was 85 +/- 16% and mean end-tidal CO2
      (PetCO2) was 51 +/- 7 torr; 84% had paradoxical inward movement of the chest on
      inspiration, 59% had OSA, and 66% had partial OSA. In those with > or = 200% IBW
      and adenotonsillar enlargement, elevated PetCO2 and the presence of hypoxemia
      (SaO2 < 90%) for > or = 5% of the total sleep time (TST) were correlated, unlike
      in patients of similar weight but without adenotonsillar enlargement. Individuals
      symptoms did not correlate with the severity of PSG abnormalities. By
      discriminant analysis, using three variables (IBW, presence of adenotonsillar
      tissue, and presence of > or = 5 symptoms), we could predict PSG abnormalities
      with up to 81% reliability. Our findings indicate that in obese children,
      particularly those with %IBW > or = 200 and adenotonsillar hypertrophy, with
      sleep-disordered breathing evaluation by polysomnography should be considered.

PMID- 8367219
TI  - Effect of obesity on pulmonary function in children.
AB  - The effect of obesity on pulmonary function was studied in 13 children, aged 8-15
      years, with 147-300% ideal body weight (IBW). Measurements included lung volumes,
      airflow rates pre- and post-bronchodilator nebulization, diffusing capacity
      (DLCO), maximal voluntary ventilation (MVV), minute ventilation VE), and resting
      energy expenditure (REE). When compared with predicted normal values for sex,
      height, and body surface area (BSA), decreases (mean % predicted, +/- SE) were
      observed in expiratory reserve volume (ERV, 36 +/- 5); forced expiratory volume
      in 1 second (FEV1, 73 +/- 5); forced expiratory flow between 25% and 75% of vital
      capacity (FEF25-75%, 70 +/- 6); DLCO, absolute (52 +/- 3) and corrected (DLCO/VA,
      71 +/- 5); and MVV (62 +/- 5). Residual volume (RV), RV/total lung capacity
      (TLC), VE, and REE were elevated. Other lung volumes were normal. Thus, obese
      children have altered pulmonary function, which is characterized by reductions in
      DLCO and ventilatory muscle endurance and airway narrowing. These alterations may
      reflect extrinsic mechanical compression on the lung and thorax, and/or intrinsic
      changes within the lung. The reduced DLCO may result from decreases in alveolar
      surface area relative to lung volume.

PMID- 8367220
TI  - Bronchoscopic diagnosis of an unusual presentation of pulmonary actinomycosis.

PMID- 8367221
TI  - Chronic modifications of lung and heart development in glucocorticoid-treated
      newborn rats exposed to hyperoxia or room air.
AB  - We assessed the mechanics and morphology of the lung in 165 rats treated
      neonatally with either room air (RA), O2, RA + steroids, or O2 + steroids.
      Newborn Sprague-Dawley male rats were randomly assigned to these groups. O2
      exposure (0.96-1.0 FiO2) lasted 5 days, and dexamethasone treatment consisted of
      eight daily S.C. injections of drug or buffer in successive doses of 0.5, 0.4,
      0.3, 0.2, 0.1, 0.1, 0.1, and 0.1 mg/kg. At 58 days, right ventricular systolic
      pressure (RVP) was measured. At 60 days, all rats were sacrificed for obtaining
      lung weight and DNA, saline pressure-volume (P-V) curves, and morphometry. We
      weighted right ventricles (RV) and left ventricles + septa (LV). Hyperoxia alone
      did not, but steroid decreased survival rate to 79.4% (95.3% in RA rats, P <
      0.02). Only 21 of 40 (52%) O2 + steroids rats survived, less than in both RA
      groups (P < 0.001). RV weight, RVP and muscularization of alveolar duct arteries
      were significantly increased in O2 vs. RA rats. In RA + steroids rats, weight of
      the LV was decreased but RV, RVP, and lung vasculature were not affected. These
      effects were additive in the O2 + steroid group. Wet lung weights and DNA were
      increased for RA + steroid rats over all others. O2 and steroids shifted the P-V
      curve to the left and O2 + steroids still further. Maximal lung volume increased
      significantly with RA + steroids and still further in O2 + steroids but not in O2
      alone. O2 and steroids significantly increased the mean linear intercept and O2 +
      steroids even more so.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367222
TI  - Chest wall motion before and during mechanical ventilation in children with
      neuromuscular disease.
AB  - Patients with neuromuscular disease can display paradoxic motion of the rib cage
      (RC) and abdomen (AB), which increases the work of breathing and predisposes to
      respiratory muscle fatigue. Long-term mechanical ventilation can reverse chronic
      hypercapnea and decrease the work of breathing in these patients. Changes in
      chest wall motion (CWM) that occur during mechanical ventilation have not been
      studied. We have assessed CWM using a calibrated respiratory inductive
      plethysmograph before and during mechanical ventilation in 5 children and young
      adults with neuromuscular disease and paradoxic breathing at rest. Asynchrony of
      CWM was quantitated by measuring the phase shift, theta, between RC and AB motion
      (0 degree = synchronous motion, 180 degrees = paradoxic motion). The volume
      contribution of the paradoxing compartment to tidal volume (PC/VT) was
      calculated. Before mechanical ventilation, mean +/- SEM VT was 122 +/- 17 mL,
      theta was 131 +/- 15 degrees C, and PC/VT was -27 +/- 6%. During mechanical
      ventilation, VT increased to 274 +/- 47 mL (P < 0.05), theta decreased to 41 +/-
      14 degrees (P < 0.05), and PC/VT increased to +39 +/- 9% (P < 0.02). We conclude
      that mechanical ventilation improves RC/AB asynchrony and reverses the negative
      contribution to tidal volume of the paradoxing compartment in children and young
      adults with neuromuscular disease. This implies that mechanical ventilation
      assumes most or all the role of the respiratory pump in these patients, which
      provides a rationale for the use of chronic or nighttime ventilation in the
      treatment of respiratory muscle fatigue. Assessment of CWM may be useful in the
      determination of optimal ventilator settings in this population.

PMID- 8367223
TI  - Longitudinal evaluation of pulmonary function in infants and very young children
      with cystic fibrosis.
AB  - Thirty-two infants with cystic fibrosis (CF) had pulmonary function testing and
      chest radiographs at the time of diagnosis and on average 1 year later, when they
      had no acute respiratory symptoms. At diagnosis, 14 of 32 infants had respiratory
      symptoms (RESP) and 18 did not have respiratory symptoms (NRESP). There were no
      significant differences in age, weight, or length between the RESP and NRESP
      groups. At diagnosis, the RESP group had significantly lower forced expiratory
      flows compared to the NRESP group (41 +/- 32% vs. 98 +/- 48% predicted); however,
      there were no significant differences in functional residual capacity or chest
      radiographic scores. Between diagnosis and follow-up, the NRESP group had no
      significant change in pulmonary function but a decline in chest roentgenographic
      (CXR) scores (22 +/- 2 to 21 +/- 2). For infants in the RESP group, there were no
      significant changes in FRC or CXR score. Maximal expiratory flow at functional
      residual capacity (Vmax FRC) rose from diagnosis to 1 year follow-up (41 +/- 32%
      to 74 +/- 27% predicted; P < 0.002); however, at follow-up flows for the RESP
      group remained significantly lower than flows for the NRESP group (74% vs. 113%
      predicted; P < 0.0005). For the 32 infants with CF, there was significant
      correlation between percent predicted Vmax FRC at follow-up and at diagnosis (r =
      0.47; P < 0.02). Those infants with lower percent predicted flows at diagnosis
      were more likely to have lower percent predicted flows 1 year later.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8367224
TI  - Seasonality in suicide and economic growth.

PMID- 8367225
TI  - Application of Hick's law of response speed in Alzheimer and Parkinson diseases.
AB  - Reaction time in normal subjects is known to increase in a log-linear fashion
      relative to the number of alternative choices. However, this relationship
      (formalized as "Hick's law") has received limited investigation in populations
      with neurological cognitive impairment. The present study used timed sorting of
      standard playing cards to test Hick's law for 20 young control subjects, and 20
      each of age-matched elderly subjects with Alzheimer disease, Parkinson disease,
      and no cognitive abnormalities. Although Parkinson patients were slowest in the
      simple tasks of dealing out the cards and sorting by color, Alzheimer patients
      showed the greatest slowing for the more cognitively complex conditions of
      sorting by suit and rank of the cards. The performance of all four groups
      followed Hick's law in displaying a significant linear relationship between
      response time and log2 of the number of choices. These findings suggest that,
      although limitations of information-processing speed in Alzheimer and Parkinson
      disease affected choice response time, there may be sparing of fundamental
      cognitive organization in these disorders.

PMID- 8367226
TI  - Children's understanding of facial expression of emotion: III. Adults'
      categorical and dimensional responses to children's drawings.
AB  - 49 adult subjects responded to 37 children's drawings of six emotions (happy,
      sad, angry, afraid, surprised, and disgusted) by naming the emotion depicted and
      by identifying the pleasantness and arousal status of each drawing. Various
      analyses indicated that assignment to categories could be predicted on the basis
      of ratings of pleasantness and arousal (the two key dimensions of a bipolar
      affect space). Data support the contention that emotional responses should not be
      assessed solely on the basis of literal accuracy but should rather be described
      in terms of their location in affect space.

PMID- 8367227
TI  - Mortality from suicide in follow-up studies of schizophrenics.

PMID- 8367228
TI  - Can short-range intentions predict physical activity participation.
AB  - This study examined the issue of proximity of intention in the physical activity
      domain by employing both short-range (2 and 3 days) and longer range (4 weeks)
      intentions in the prediction of participation in physical activity. Subjects were
      42 undergraduate students who completed intention and physical activity
      assessments every class (Monday, Wednesday, and Friday) for six weeks and also a
      single assessment four weeks apart. Analysis indicated that short-range intention
      is a better predictor of physical activity than is the longer range intention;
      however, even the short-range intention-physical activity correlations were only
      of modest magnitude. Interpretation of the results focused on the potential
      nonvolitional nature of physical activity and the possible role of perceived
      behavioral control and behavioral expectation.

PMID- 8367229
TI  - An anatomical analysis of Aikido's second teaching: an investigation of Nikyo.
AB  - One of the strongest subduing techniques of the Martial Art Aikido is classified
      as Nikyo (Second-teaching). This investigation focused on examining this teaching
      with the intention of describing the anatomical tissues involved in the etiology
      of pain experienced with the application of this procedure. Particular focus was
      placed on the examination of a cadaver's arm musculature affected when this
      maneuver was applied precisely.

PMID- 8367230
TI  - Perception of social support and blood pressure in young men.
AB  - This study investigated the association between perceived social support, blood
      pressure, and heart rate during rest and stress. 29 men were selected from 184
      students on the basis of having high and low perceived social support. During
      rest and two of the laboratory stressors, the low-support group had higher
      diastolic pressure than the high-support group. Systolic blood pressure and heart
      rate did not differ between the two groups during either rest or stress. The low
      support group was slightly older (24.8 yr.) than the high-support group (22.4
      yr.), but the groups did not differ with respect to parental history of
      hypertension, body mass index, smoking, anxiety, anger inhibition, or
      environmental stress.

PMID- 8367231
TI  - Depressed mood and social perception: a cross-cultural replication.

PMID- 8367232
TI  - Effects of predictable and unpredictable auditory stimuli on selective attention.
AB  - 6 normal male and 10 normal female high school students completed two versions of
      the Stroop Color-Word Task in the presence of predictable and unpredictable
      auditory stimuli. Selective attention was hypothesized to be facilitated by
      predictable auditory stimuli and unaffected or hindered by unpredictable auditory
      stimuli. A one-factor repeated-measures analysis of variance showed selective
      attention was facilitated significantly by the predictable auditory stimuli on a
      paced version of the Stroop Color-Word Task.

PMID- 8367233
TI  - Does cigarette smoking increase sleep problems.
AB  - Cigarette smoking has been associated with delayed sleep onset and diminished
      sleep duration, primarily on the bases of responses to one-shot questionnaires.
      This study used a survey format of daily diaries to observe sleep quality. 29
      smokers were matched for age, ethnicity, and gender with 29 nonsmokers. Both
      groups recorded information on cigarette, alcohol, caffeine consumption, daily
      stress, and sleep quality. While the results showed that smokers were more likely
      to experience poor sleep than nonsmokers, these data are difficult to interpret
      because smokers also used significantly greater amounts of alcohol and caffeine.

PMID- 8367234
TI  - A clock paradigm to study the relationship between expectancy and response force.
AB  - It has recently been demonstrated that the force used by subjects to press a
      response key depends on stimulation conditions such as stimulus intensity, fore
      period, etc. We performed an experiment in which response force and reaction time
      were measured as a function of expectancy. In contrast to the paradigms used so
      far, we manipulated expectancy without using warning stimuli by applying a so
      called "clock-paradigm." It enabled us to avoid the possible arousing effect of
      the warning stimulus. Both reaction time and response force depended on
      expectancy. The results suggest that response force was not affected by arousal
      or activation but was affected by preparatory state at the moment of making a
      response.

PMID- 8367235
TI  - Psychology of computer use: XXVIII: Effect of computer use on depth perception.
AB  - 30 computer users were tested first after work and then second both before and
      after periods of computer use. Subjects' depth perception ability was unaffected.

PMID- 8367236
TI  - Microgenetic process of perception of subjective contour using "self-sufficient"
      inducing pattern.
AB  - To investigate the operation of two figural cues of "alignment" and
      "incompletion" in the perception of subjective contour, the microgenetic process
      of perception of subjective contour was analyzed. Two inducing patterns were
      used, one with both "alignment" and "incompletion" cues and another with only an
      "alignment" cue. The latter was a simplified version of the "self-sufficient"
      pattern presented by Kanizsa in 1979 which induced no subjective contour under
      usual observation. These two patterns were tachistoscopically exposed for 10 to
      70 msec., and four subjects rated the clarity of subjective contour on 240
      trials. As a result, the rated clarity of subjective contour in the pattern with
      only an "alignment" cue showed a slight "inverted-U" function with a peak at 30
      to 40 msec. as the duration of exposure increased, while that in the pattern with
      both cues increased monotonically. It was shown that, even in the "self
      sufficient" pattern which induces no subjective contour under usual observation,
      the processing toward perception of subjective contour was generated at the early
      stage of the microgenetic process. The results also agree with this author's
      previous finding that "alignment" is active earlier in the processing of
      subjective contour than is "incompletion."

PMID- 8367237
TI  - The deterrent effect of the death penalty in Canada.

PMID- 8367238
TI  - Aspirin (acetylsalicylic acid) effects on behavioral thermoregulation with
      microwave radiation.
AB  - Aspirin is a widely used over-the-counter drug in our society which has wide
      therapeutic value, yet not all of the behavioral side effects have been studied.
      Different doses of aspirin solutions were administered (ip) prior to fixed
      interval 2-min. schedules of microwave reinforcement in rats tested in a cold
      environment. Four Sprague-Dawley rats were conditioned to regulate their thermal
      environment with 5-sec. exposures of MW reinforcement. Friedman's nonparametric
      test showed significant differences among aspirin and saline-control doses. Post
      hoc sign tests showed that a moderate dose of aspirin increased operant behavior
      reinforced by MW radiation, yet lower and higher doses decreased and then
      increased the rate of responding which resulted in an inverted U-shaped trend.
      Possible multiple effects of aspirin in terms of its thermoregulatory as well as
      its pain-tolerance properties, and implications for hypothalamic "set point" are
      discussed.

PMID- 8367239
TI  - Extraversion-introversion and spatial intelligence.
AB  - The purpose of this study was to assess whether extraversion-introversion is
      related to spatial intelligence. First-year psychology students (58 men, 108
      women) in an open-admission community college responded to a battery of black and
      white and color spatial ability tests, and the Eysenck Personality Inventory. As
      hypothesized, a small but significant relationship was found between scores on
      extraversion and on the SEK Test (colored spatial test). Gender differences in
      performance on the spatial tests favored males. Scores on three of the Spatial
      Dimensionality Tests correlated significantly with those on the SEK Test.
      Recommendations include investigating the effect of a variety of spatial problems
      in combination with other personality variables.

PMID- 8367240
TI  - Negative addiction in male and female runners and exercisers.
AB  - 72 male and 26 female runners and 60 male and 30 female exercisers were tested on
      the Negative Addiction Scale of Hailey and Bailey along with demographic
      questions to examine the relationships among gender, age, years of exercise
      experience, and addiction to exercise. Analysis showed no differences in
      addiction scores by age, gender, or type of activity. A trend showed longer
      involvement in physical activity was associated with higher addiction scores.

PMID- 8367241
TI  - Literacy and hemispheric specialization for language: dichotic listening in young
      functionally illiterate men.
AB  - The functional cerebral organization of young men who were defined as illiterate
      was studied by testing their dichotic listening for language stimuli. These
      functionally illiterate men showed greater right ear advantage for language
      stimuli than 50 educated subjects, a pattern already observed with completely
      illiterate persons of both sexes. This finding is consistent with the view that
      mastering written codes for language might be one of the most relevant parameters
      in hemispheric specialization when language is studied.

PMID- 8367242
TI  - Comparison of larger and smaller groups on a ward for physically handicapped
      children on interaction in the "present" game.
AB  - During a game the number of presents from 23 severely handicapped children during
      10 15-min. interactions were compared. Children in groups of 6 to 12 interacted
      more with peers than those in groups of 19 to 24. Smaller groups seemed more
      facilitative of play.

PMID- 8367243
TI  - Laboratory sleep patterns and dream content of type A and B scoring college
      students.
AB  - The suggestion that there may be a discrepancy between subjective and objective
      measures of sleep led us to explore the sleep and dreams of 7 Type A and 7 Type B
      scorers in our laboratory over a three-night period. In earlier studies, Type A
      scorers had indicated that their sleep was somewhat more disturbed and their
      dream content generally more active and negative in tone than that of Type B
      scorers. However, in this study the only differences were that Type A scorers had
      a greater number of body movements and greater dream recall than did Type B
      scorers. These results seem to indicate that the impression Type A scorers have
      of the quality of their sleep and dreams may be a function of their waking life
      style.

PMID- 8367244
TI  - A test of Magill's closed-to-open continuum for skill development.
AB  - Magill's arrangement of Gentile's 2 x 2 matrix of skills classification into a
      closed-to-open-skill learning continuum was investigated. 63 volunteer university
      students were assigned to three experimental groups who performed different
      learning sequences on the Bachman Ladder for four practice sessions, climbing the
      unsupported Bachman Ladder (Task 4) in the final scored session. Following
      practice sessions, a five-trial, scored, Task 4 "retention" session was
      performed. Analysis of variance of retention trials indicated no difference
      between the practice groups regardless of practice sequence. Comparison of five
      selected trials from the Task 4 practice session and the five Task 4 retention
      performances, using a 4 x 2 analysis of variance with repeated measures,
      indicated significant group and time effects but no interaction. While Magill's
      arrangement of related activities into closed-to-open-skill learning continuums
      is supported, the specific arrangement of the lead-up skills does not appear
      critical. The question of task specificity for any learning continuum is raised,
      and further issues for research are proposed.

PMID- 8367246
TI  - Biomedical applications of hand-held force gauges: a bibliography.
AB  - Hand-held force gauges have been used increasingly in recent years to measure
      sensory and motor performance. In an effort to identify comprehensively journal
      articles in which the biomedical use of hand-held force gauges is described, five
      bibliographic data bases were searched, reference lists of relevant articles were
      examined, and current journals were scanned. The multifaceted process resulted in
      a bibliography of 158 articles describing the use of the instruments to measure
      muscle performance, resistant to joint movement, and force or pressure
      sensitivity.

PMID- 8367245
TI  - Cortisol, biochemical, and galvanic skin responses to music stimuli of different
      preference values by college students in biology and music.
AB  - The purpose of this study was to examine biochemical and galvanic skin responses
      to music stimuli. Specifically, 30 university biology and 30 music students'
      plasma levels of norepinephrine and cortisol and their galvanic skin responses
      were measured before and after listening to two different musical selections, one
      of which was preferred (liked) by the music students and not preferred (disliked)
      by the biology students. The music-listening sessions and the controlled silent
      sessions were done in an anechoic chamber. 30 biology majors and 30 music majors
      were in the experimental groups; 14 biology and 17 music majors comprised the
      control group. Analysis indicated that the cortisol levels and galvanic skin
      responses were significantly higher for the music majors than the biology majors.
      The data indicate that music majors listen more critically and analytically to
      music than biology majors, and cortisol levels are associated with this as
      increases in music majors and decreases in biology majors after the music.

PMID- 8367247
TI  - Including neither-type in the morningness-eveningness dimension decreases the
      robustness of the model.
AB  - The present paper is a study of axillary temperature and performance during the
      waking part of the day and the relationship of these two variables to Morningness
      Eveningness preferences. A reduced scale of the Horne and Ostberg questionnaire
      was adapted and standardized for the Spanish population, and 3 groups of subjects
      were formed (Morning-types: 3 men, 2 women; Neither-type: 3 men, 6 women; Evening
      types: 1 man, 4 women). Three different tasks were tested, auditory reaction time
      (to measure alertness and speed), index finger tapping (motor skill), and verbal
      memory (information processing). The subjects were tested hourly in 13 sessions
      spread out over the day. Morningness-Eveningness preference groups did not differ
      in temperature and performance. Neither-type subjects did not present values
      intermediate between those of the Morning- and Evening-types.

PMID- 8367248
TI  - Effects of elevating blood alcohol levels on tasks related to dart throwing.
AB  - Light (0.02% BAC) and moderate (0.05% BAC) does of alcohol were administered to
      10 dart throwers while effects were monitored on tasks related to dart throwing,
      i.e., rotary pursuit and hand steadiness. Balance and accuracy of throwing
      improved with the 0.02% BAC, but performance was impaired with 0.05% BAC. The
      higher BAC levels were linked with deteriorations on rotary pursuit and hand
      steadiness.

PMID- 8367250
TI  - Priming effect in a color discrimination task.
AB  - Two experiments were run to test whether the automatic coding of colors generates
      priming effects. Subjects were tachistoscopically presented a series of prime
      target sequences. The prime stimulus could be either a red, green, or black
      circular dot, followed by a red or green annular ring (target). The role of
      automatic and conscious mechanisms was investigated in Exp. 1 by manipulating the
      predictive validity of the prime stimuli (80%, 50%, 20%), keeping constant the
      value of stimulus-onset asynchrony (350 msec.). Analysis showed priming effects
      even in the low predictive condition, where no conscious expectations could be
      activated. In Exp. 2, three different values of stimulus-onset asynchrony were
      used, 150, 350, and 2100 msec. Priming effects were obtained in the short and
      medium stimulus-onset asynchrony condition but not in the long one. Over-all, the
      data of both experiments produce converging evidence which indicates that the
      automatic elaboration of colored stimuli may produce priming effects.

PMID- 8367249
TI  - Authoritarian attitudes and aesthetic preferences: a Bulgarian replication.
AB  - This report describes a Bulgarian replication with 173 students of a German study
      concerning the effect of stimulus properties of complexity and order and
      authoritarian attitudes on the perceived pleasantness of polygons. Analyses of
      variance yielded neither significant main effects nor significant interactions
      for the different measures of authoritarianisms, but there were significant main
      effects for order and complexity.

PMID- 8367251
TI  - Self-efficacy and anxiety and their relationship to training and race
      performance.
AB  - The purpose of this study was to examine the validity of task-specific and
      general measures of physical self-efficacy in a competitive sports setting and
      how these measures relate to anxiety and actual running performance. 47 members
      of a running club and 16 members of a university track team completed measures
      assessing general and task-specific self-efficacy, anxiety, and training
      experience and were asked to run in three running events. Associations among
      these variables and running performance, examined by correlational and regression
      analyses, indicated that race finishing time was significantly related to a
      number of training variables, predicted performance, and measures of self
      efficacy; however, state and trait anxiety were not significantly related to pace
      of race. Results suggest that a task-specific measure of self-efficacy is the
      better predictor of performance in a race than a general measure of self
      efficacy.

PMID- 8367252
TI  - Using age-adjusted rates in ecological studies of suicide and homicide.

PMID- 8367253
TI  - An occluded contour becomes visible with reversal of disparity.
AB  - Suppose that there is a circle in front of a cross, the central part of which is
      occluded by the circle. One usually perceives these figures, as such, although
      the objective description of the stimulus pattern might be that there is a circle
      with four limbs attached to it. Here the occluded contours of the cross might be
      'inferred.' Until now it has not been demonstrated clearly whether this
      'inference' is based on higher cognitive processes or on perceptual processes.
      However, by manipulating binocular disparity so that the four limbs are seen in
      front of the circle, the occluded contours become visible, the color of the limbs
      spreads into the inside of the contours, and the color spreading surface appears
      transparent, suggesting that the 'inference' is on a perceptual basis.
      Interestingly, cornered subjective contours of the cross are observed.

PMID- 8367255
TI  - Topographical patterns of ERP elicited by different visual information-processing
      tasks.
AB  - Topographical patterns of event-related potentials were compared on a visual
      display terminal for a data-input task and a number-comparison task. Maximum
      negative peaks were found in the frontal and central regions for the former but
      at midline locations for the latter. Latencies were shorter in the occipital
      regions than in the frontal regions for the former and the opposite pattern was
      found for the latter. An analysis of variance indicated that hemispheric location
      significantly affected the amplitude of peaks. On the other hand, latencies were
      affected by the task, frontal and occipital regions, and their interaction. These
      results suggest that a pattern of the topographic display of event-related
      potentials can be used as an objective means for classifying visual tasks.

PMID- 8367254
TI  - Visuomotor control of the relative movement of random-dot patterns.
AB  - A series of experiments were made on human performance in controlling optical
      relative movement. The aim was to test the influence of different kinds of
      relative movement on visually controlled steering tasks. Within adjacent displays
      on a computer screen random dot patterns moved in a fixed direction at
      continually changing speeds (Exp. 1) or at constant speed and in continually
      changing directions (Exp. 2). The subject was required to compensate for the
      unpredictable modulations of the pattern movement by means of an isometric
      joystick. The task was to adjust relative movements involving pure translation,
      symmetric convergence, divergence, or shear. Analysis indicated that the task
      performance was not dependent on the special kind of relative movement. However,
      performance was significantly higher in tasks where directionally disturbed
      relative movement had to be controlled compared to those situations in which
      relative movement varied with respect to speed.

PMID- 8367256
TI  - Adults' free-form identification of emotions from children's descriptions of
      their antecedents: a quantitative analysis.
AB  - 50 adult subjects identified resultant emotions for 28 children's statements of
      antecedents to emotion in an open-ended task. Responses were scored along the
      dimensions of evaluation and activation by the Dictionary of Affect in Language,
      and a priori expectations with respect to evaluation (happy, proud, comfortable >
      sad, afraid, guilty, angry) and activation (sad, comfortable < angry, happy,
      proud, afraid, guilty) were confirmed. The importance of a dimensional approach
      to the study of emotion is highlighted in the discussion.

PMID- 8367257
TI  - Self-perceived somatotypes and clothing-related behavior of older men and women.
AB  - 507 older men and women (65 yr. or over) participated in an investigation of
      relationship between clothing-related behavior of older men and women and self
      perceived somatotypes. Analysis indicated that body-type was significantly
      related to significance of apparel, self-esteem, and chronological age. No sex
      differences were found in perception of body-types. Several implications are
      discussed and suggestions for further research are made.

PMID- 8367258
TI  - On the possibility of intermittence during fixations: a conceptual assessment.
AB  - A prevalent tacit assumption of the continuity of visual representation during
      fixations is challenged and shown to be logically tenuous. Relying upon three
      lines of suggestive evidence, it is then argued that representation must be in
      the form of static snapshots which alternate with very short dark periods wherein
      the image is omitted from vision. In view of the difficulties of a direct
      experimental verification of such a high-frequency intermittence, a conceptual
      approach to the question is defended.

PMID- 8367259
TI  - Rates of mental illness and suicide by state.

PMID- 8367260
TI  - Attention state in electrodermal activity during auditory stimulation of children
      with attention-deficit hyperactivity disorder.
AB  - Electrodermal activity during passive and active listening tasks of 18 children
      with Attention-Deficit Hyperactivity Disorder (ADHD) and 49 healthy school
      children was studied. The procedure included baseline recording, a passive
      listening task, instructions, and both simple and discriminative active-listening
      tasks. ADHD subjects tended to exhibit lower arousal as indicated by the decrease
      in amplitude of the skin conductance response. Present findings confirm classical
      observation that ADHD children have shorter attention spans.

PMID- 8367261
TI  - The horizontal-vertical illusion: transfer of illusion decrement.
AB  - Subjects first adjusted 20 vertical lines to be equal in length to the horizontal
      line in small or large inverted-T figures and were then given 10 additional
      trials on the other size figure. Vertical lines were made significantly shorter
      than the horizontal line but accuracy gradually improved and performance was not
      disrupted by the switch in figure size. By Trial 30, adjusted vertical lines did
      not differ from the length of the horizontal line. Other subjects were first
      tested on the small inverted-T figure and then asked to produce 1-in. lines in
      the vertical plane and in the horizontal plane. These subjects also improved on
      the adjustment task but, on the production task, were no more accurate than
      control subjects who were not given practice on the adjustment task. Thus, the
      magnitude of the Horizontal-Vertical Illusion decreases with practice alone and
      this practice effect readily transfers to figures of other sizes but not to an
      alternate form of the illusion. The potential factors responsible for the
      improvement and transfer are discussed.

PMID- 8367262
TI  - Repeated presentation of stimuli and production of original response by English
      speaking Indian high school students.
AB  - Sounds and Images, a measure of originality, was administered to 131 English
      speaking high school students of Orissa, India in 1987. The test has two forms,
      viz., IA and IB. Each form has four sounds which were presented three times. To
      each the students wrote their verbal images which were scored for originality and
      analyzed for effects of multiple presentation and differential sounds. The main
      effects of sounds (IA, IB), of presentation (IA), and the interaction of
      presentation by sound (IB) were nonsignificant, but presentation (IB) and the
      interaction of presentation by sound were significant.

PMID- 8367263
TI  - The stability of national suicide rates over time.

PMID- 8367264
TI  - Familial heart valve disorder is not related to autonomy, social interaction
      style, or family dynamics.

PMID- 8367266
TI  - When children talk about the causes of their emotions, how well do adults and
      other children understand which emotion they are talking about?
AB  - 100 subjects from Grade 2, Grade 5, and university levels decoded statements
      describing the antecedents of seven emotions produced by Kindergarten and Grade 8
      students. The experiment was designed to determine whether adults and different
      children could correctly identify the emotions whose causes were being described
      by the children. Accuracy in decoding increased with age of decoder, but subjects
      from Grade 2 were better at decoding statements made by Kindergarten children
      while adults were better at decoding statements produced by Grade 8 subjects.
      Even for statements generated by Kindergarten children, however, adults were
      better decoders than subjects from Grades 2 or 5. The emotions of happiness and
      comfort were decoded most accurately, those of anger and guilt least accurately.
      Several other significant effects are reported, involving the age of origin, the
      age of respondent, and sex of origin and emotion. A cognitive developmental
      theory such as Piaget's is selected as best explaining the results reported
      above.

PMID- 8367265
TI  - Blink activity and task difficulty.
AB  - This study investigated the relationship between task difficulty and blink
      activity, which includes blink rate, blink amplitude, and blink duration. Two
      kinds of tasks established two levels of difficulty. In Exp. 1, a mental
      arithmetic task was used to examine the relationship. Analysis showed that blink
      rate for a difficult task was significantly higher than that for an easier one.
      In Exp. 2, a letter-search task (hiragana Japanese alphabet) was used while the
      other conditions were the same as those in Exp. 1; however, the results of this
      experiment were not influenced by the difficulty of the task. As results indicate
      that blink rate is related to not only difficulty but also the nature of the
      task, the nature of the task is probably dependent on a mechanism in information
      processing. The results for blink amplitude and blink duration showed no
      systematic change during either experiment.

PMID- 8367267
TI  - Proprioceptive responses under rising and falling BACs: a test of the Mellanby
      effect.
AB  - This study examined proprioceptive responses under equivalent rising and falling
      blood alcohol concentrations (BAC), using a repeated-measures design. Seven
      volunteer subjects, 21 to 35 years of age, participated in the study. After
      alcohol consumption, BAC readings were obtained every 5 minutes, and the
      proprioceptive responses were measured at the following BAC levels (in %): 0
      (baseline), rising 0.05, 0.075, 0.1, falling 0.075, and 0.05. The analysis
      focused on the comparisons of these measures at the equivalent rising and falling
      0.05% and at the 0.075% BACs. Results showed that the proprioceptive response was
      less accurate during the rising than the falling BACs.

PMID- 8367269
TI  - Community nursing centers: a viable alternative.

PMID- 8367268
TI  - Foot-tapping speed in children ages 4 to 6 years.
AB  - This investigation examined the performance and measurement characteristics of
      foot-tapping speed in 155 4- to 6-year-olds. Analysis suggested that, while the
      task does not differentiate between preferred and nonpreferred limbs, performance
      does appear to be age-related, that is, subjects tapped significantly faster with
      increasing age. Considering type of task and population, reliability was judged
      as moderate.

PMID- 8367270
TI  - Evaluation in nursing continuing education.

PMID- 8367271
TI  - The recovering nurse returning to work.

PMID- 8367272
TI  - New Jersey State Nurses' Association history: what is past is prologue. The ninth
      decade--1983-1992.

PMID- 8367273
TI  - Nursing as caring: a model for transforming practice.

PMID- 8367274
TI  - State-approved schools of nursing L.P.N./L.V.N.

PMID- 8367275
TI  - RNA polymerase I catalysed transcription of insert viral cDNA.
AB  - RNA polymerase I has been used for transcription of influenza hemagglutinin (HA)
      cDNA precisely linked in the anti-sense configuration to both mouse rDNA promoter
      and terminator segments. In transcription reactions based on Ehrlich ascites cell
      nuclear extracts, specific uniform RNA products are synthesized in high rates
      that are comparable to original rDNA template transcriptions. Primer extension
      reactions show the 5' ends of these RNA transcripts to be located exactly at
      position +1, corresponding to the 5' end of negative strand HA viral RNA. RNA 3'
      ends in a first series of constructs were found extended beyond the accepted
      location of pre-rRNA 3' ends, in using both hybrid cDNA and original rDNA
      templates. But upon deletion of six basepairs from the rDNA termination region
      RNA polymerase I transcription has been adapted to yield correctly terminated
      influenza viral RNA in vitro. This result has been confirmed in an in vivo
      experiment via synthesis of an anti-sense viral RNA molecule containing the
      chloramphenicol acetyltransferase (CAT) gene, which in turn is recognized at its
      terminal sequence by viral RNA dependent RNA polymerase for plus strand mRNA
      synthesis and expression of CAT activity.

PMID- 8367276
TI  - Domains of p85cdc10 required for function of the fission yeast DSC-1 factor.
AB  - p85cdc10 is a component of the S.pombe DSC-1 complex, which is thought to mediate
      periodic transcription of genes in late G1. In order to understand the role of
      p85cdc10 in the function of this complex, we have analysed which domains of
      p85cdc10 are required for biological activity and the formation of a stable DSC-1
      complex in vitro, both in cdc10 temperature sensitive and null backgrounds. No
      DSC-1 activity is found in the absence of p85cdc10 and the activity of the
      complex is reduced or absent in all cdc10ts mutants tested. Full biological
      activity and rescue of a cdc10::ura4+ null allele requires the N-terminal domain,
      the cdc10/SWI6 repeats and the helical C-terminal region. In the absence of
      p85cdc10, both the C-terminal and cdc10/SWI6 repeat domains are required for DSC
      1 activity in vitro. In a cdc10ts background, rescue of DSC-1 activity and
      complementation of mutants, requires only expression of the C-terminal domain,
      though the presence of the cdc10/SWI6 motifs enhances its activity. The N
      terminal domain, alone, or in combination with the cdc10/SWI6 motifs, does not
      have biological activity, and does not restore DSC-1 activity. We conclude that
      both the C-terminal domain of p85cdc10 is critical for formation of the DSC-1
      complex and that the cdc10/SWI6 motifs also play a role, perhaps by stabilizing
      the complex. Our data also suggest that the S.pombe DSC-1 complex contains more
      than one molecule of p85cdc10.

PMID- 8367277
TI  - Mutagenically separated PCR (MS-PCR): a highly specific one step procedure for
      easy mutation detection.
AB  - With increasing knowledge about the causal role of genetic defects in clinical
      diseases the necessity is apparent to have procedures for rapid diagnosis of
      point mutations. We developed a PCR-based technique, whereby both normal and
      mutant alleles can be amplified in the same reaction tube, using different length
      allele-specific primers. Furthermore the allele-specific primers introduce
      additional deliberate differences into the allelic PCR-products that drastically
      reduce crossreactions in subsequent cycles. This mutagenesis separates the
      amplification reactions of the alleles performed in the same tube. Subsequent
      identification of the PCR-products is done by gel electrophoresis and shows at
      least one of the two allelic products. Therefore, in addition to simple handling,
      MS-PCR provides a within-assay quality control for the exclusion of false
      negative results. The feasibility of this technique has been tested using six
      different mutations. The high sensitivity of MS-PCR also allows screening for
      mutation carriers in pooled DNA samples.

PMID- 8367279
TI  - 'Cold SSCP': a simple, rapid and non-radioactive method for optimized single
      strand conformation polymorphism analyses.
AB  - A rapid (< 2.5 hrs) method for single-strand conformation polymorphism (SSCP)
      analysis of PCR products that allows the use of ethidium bromide staining is
      described. PCR products ranging in size from 117 to 256 bp were evaluated for
      point mutations and polymorphisms by 'cold SSCP' in commercially available pre
      cast polyacrylamide mini-gels. Several electrophoretic parameters (running
      temperature, buffers, denaturants, DNA concentration, and gel polyacrylamide
      concentration) were found to influence the degree of strand separation and
      appeared to be PCR fragment specific. Use of the 'cold' SSCP technique and the
      mini-gel format allowed us to readily optimize the electrophoretic conditions for
      each PCR fragment. This greatly increased our ability to detect polymorphisms
      compared to conventional, radioisotope-labeled 'hot' SSCP, typically run under
      two standard temperature conditions. Excellent results have been obtained in
      resolving mutant PCR fragments from human p53 exons 5 through 8, human HLA-DQA,
      human K-ras exons 1 and 2, and rat K-ras exon 3. Polymorphisms could be detected
      when mutant DNA comprised as little as 3% of the total gene copies in a PCR
      mixture. Compared to standard 'hot' SSCP, this novel non-isotopic method has
      additional advantages of dramatically increased speed, precise temperature
      control, reproducibility, and easily and inexpensively obtainable reagents and
      equipment. This new method also lacks the safety and hazardous waste management
      concerns associated with radioactive methods.

PMID- 8367278
TI  - Transcription of human 5S rRNA genes is influenced by an upstream DNA sequence.
AB  - Six human 5S rRNA genes and gene variants and one pseudogene have been sequenced.
      The six genes/variants were transcribed in a HeLa cell extract with about equal
      efficiency. Three genes contain the Sp1 binding sequence GGGCGG in position -43
      to -38 and three genes contain the Sp1 like sequence GGGCCG in this position. The
      six genes contain furthermore one Sp1 binding site in a position about -245 and
      one ATF recognition site in a position about -202. A 12 bp sequence
      (GGCTCTTGGGGC) found in position -32 to -21 strongly influenced the
      transcriptional efficiency in vitro. This 12-mer, designated the D box, has also
      been found upstream a 5S rRNA gene from hamster and mouse. Removal of the Sp1
      binding sites had no effect on the transcription in vitro whereas the
      transcriptional efficiency decreased to 10% if the D box was removed from the
      human 5S rRNA gene.

PMID- 8367281
TI  - Differential expression of principal sigma factor homologues of Streptomyces
      aureofaciens correlates with the developmental stage.
AB  - In previous experiments, Streptomyces aureofaciens has been shown to contain four
      genes hrdA, hrdB, hrdD, and hrdE, encoding polypeptides very similar to principal
      sigma factors of RNA polymerase. Two apparent tandem promoters were identified
      for each of the hrdA, hrdB and hrdD genes by S1 nuclease mapping using RNA
      prepared of S. aureofaciens in various developmental stages. Under all the
      conditions studied, tandem promoters of each gene differed significantly in their
      respective strengths. Transcription from the hrd promoters depended on
      developmental stage. While hrdB is transcribed from both promoters in all
      developmental stages, both tandem promoters of the hrdD gene are active only in
      vegetative stage and transcription of the hrdA tandem promoters temporally
      correlates with the aerial mycelium formation. In addition to a promoter, hrdB
      P2, which lies upstream of the open reading frame, the hrdB gene, proposed to
      encode functional principal factor, appeared to contain at least one internal
      promoter, hrdB-P1. Activity of all promoters was consistent with S1 mapping
      experiments after insertion of promoter-bearing DNA fragments to promoter-probe
      vectors pIJ486 and pARC1. The results implicate temporally different expression
      of the hrd genes during the differentiation of S. aureofaciens.

PMID- 8367280
TI  - The gene encoding DNA polymerase alpha from Plasmodium falciparum.
AB  - The gene encoding DNA polymerase alpha from the human malaria parasite Plasmodium
      falciparum has been sequenced and characterised. The deduced amino acid sequence
      possesses the seven sequence motifs which characterise eukaryotic replicative DNA
      polymerases (I-VII) and four of five motifs (A-E) identified in alpha DNA
      polymerases. The predicted protein also contains sequences which are reminiscent
      of Plasmodium proteins but absent from other DNA polymerases. These include four
      blocks of additional amino acids interspersed with the conserved motifs of the
      DNA polymerases, four asparagine rich sequences and a novel carboxy-terminal
      extension. Repetitive sequences similar to those found in other malarial proteins
      are also present. cDNA-directed PCR was used to establish the presence of these
      features in the approximately 7kb mRNA. The coding sequence contains a single
      intron. The gene for DNAPol alpha is located on chromosome 4 and is transcribed
      in both asexual and sexual erythrocytic stages of the parasite.

PMID- 8367282
TI  - Homologous pairing between single-stranded DNA immobilized on a nitrocellulose
      membrane and duplex DNA is specific for RecA activity in bacterial crude extract.
AB  - Reaction between a circular single stranded and a linear double stranded DNA
      molecule (ssDNA and dsDNA) provides an efficient system to study recombination
      mediated by RecA protein. However, classical assays using reaction in solution
      require highly purified enzymes. This limits biochemical studies of mutant RecA
      proteins from Escherichia coli or of RecA proteins from other organisms. We
      describe here an assay that is specific for RecA activity even in bacterial crude
      extracts. In this assay, the ssDNA is bound to a nitrocellulose membrane,
      proteins are loaded on this membrane and it is then incubated with a labeled
      homologous dsDNA. Joint molecules are visualized by autoradiography. We have
      shown that, despite the reduced mobility of the DNA due to its binding to the
      membrane, RecA protein is able to promote formation of stable plectonemic joints,
      in a homology dependent manner. Fourteen other proteins involved in DNA
      metabolism were checked and did not produce a signal in our assay. Moreover, in
      Dot blot analysis as well as after native electrophoresis and electrotransfer on
      a ssDNA coated membrane, production of a signal was strictly dependent on the
      presence of active RecA protein in the bacterial crude extracts used. We named
      this assay Pairing On Membrane blot (POM blot).

PMID- 8367283
TI  - Sigma s-dependent promoters in Escherichia coli are located in DNA regions with
      intrinsic curvature.
AB  - Expression of a number of genes during stationary phase in Escherichia coli is
      controlled by the alternative sigma factor sigma s (KatF). Promoters recognized
      by sigma s do not present a well-defined consensus sequence in their -10 and -35
      regions. By polyacrylamide gel electrophoresis of DNA fragments performed at
      different temperatures, and by computer prediction analyses, we have found that
      sigma s-regulated promoters are located in regions where DNA shows intrinsic
      curvatures. This feature does not appear in a stationary-phase-induced promoter
      which is not controlled by sigma s. We propose that DNA bending may help in
      recognition and/or binding of sigma s to stationary-phase-induced promoters.

PMID- 8367284
TI  - A quantitative assay to measure the relative DNA-binding affinity of pyrrolo[2,1
      c] [1,4]benzodiazepine (PBD) antitumour antibiotics based on the inhibition of
      restriction endonuclease BamHI.
AB  - An assay has been developed (restriction endonuclease digestion assay--RED100)
      based on inhibition of the restriction endonuclease BamHI that is capable of
      quantitative evaluation of the relative DNA-binding affinity of pyrrolo[2,1-c]
      [1,4]benzodiazepine (PBD) antitumour antibiotics. This method provides comparable
      results to those obtained from thermal denaturation and ethidium bromide
      displacement assays but is much more sensitive, discriminating between molecules
      of similar structure such as DC-81, iso-DC-81 and neothramycin. The results
      reveal a trend between relative DNA-binding affinity and in vitro cytotoxicity
      for the PBDs in two tumour cell lines studied.

PMID- 8367285
TI  - I-Sce III an intron-encoded DNA endonuclease from yeast mitochondria.
      Asymmetrical DNA binding properties and cleavage reaction.
AB  - We have previously discovered the new intron-encoded endonuclease I-Sce III by
      expressing, in E. coli, the ORF contained in the third intron of the yeast
      mitochondrial COX I gene. In this work, we analyzed the in vitro properties of
      partially purified I-Sce III and found that it is a very specific DNA
      endonuclease, tolerating relatively few base changes in its 20 base pair long
      target site. I-Sce III should be a useful molecular tool to analyze the structure
      of large genomes. Interestingly, I-Sce III is the first P1-P2 DNA endonuclease
      for which DNA binding properties could be analyzed by band-shift experiments.
      Clearly, the cleavage products corresponding to the upstream A3 exon and to the
      downstream A4 exon could compete with the substrate A3-A4 in forming a DNA
      protein complex. However, the A3 exon competes more efficiently than the
      downstream A4 product. The cleavage of the two DNA strands is also asymmetric the
      top strand (non-transcribed strand) is cleaved faster than the bottom strand, a
      property found under various experimental conditions. These findings suggest that
      this intron-encoded DNA endonuclease may have role in the RNA splicing process of
      the intron.

PMID- 8367286
TI  - Zinc fingers in sex determination: only one of the two C. elegans Tra-1 proteins
      binds DNA in vitro.
AB  - The tra-1 gene of Caenorhabditis elegans is a major developmental regulator that
      promotes female development. Two mRNAs are expressed from the tra-1 locus as a
      result of alternative mRNA processing. One mRNA encodes a protein with five zinc
      fingers and the other a protein with only the first two zinc fingers. We have
      derived a preferred in vitro DNA binding site for the five finger protein by
      selection from random oligonucleotides. The two finger protein does not bind to
      DNA in vitro. Moreover, removal of the first two fingers from the five finger
      protein does not eliminate binding and has little effect on its preferred binding
      site. We find that a protein sequence amino-terminal to the finger domain also
      appears to play a role in DNA binding.

PMID- 8367287
TI  - In vitro replication of bacteriophage PRD1 DNA. Characterization of the protein
      primed initiation site.
AB  - Bacteriophage PRD1 replicates its DNA by means of a protein-primed replication
      mechanism. Using single-stranded oligonucleotide templates carrying the sequence
      corresponding to the 25 first bases of the 3' end of PRD1 DNA, and Mg2+ as the
      activating metal ion of the phage DNA polymerase, we show that the fourth base
      from the 3' end of the template directs, by base complementarity, the dNMP to be
      linked to the phage terminal protein (TP) in the initiation reaction. This result
      suggests that phage PRD1 maintains its 3' end DNA sequences via a sliding-back
      mechanism. The single-stranded DNA templates could not be replicated by the PRD1
      DNA polymerase, much in contrast to the natural TP-DNA. Nevertheless, the
      analysis of the transition products obtained with TP-DNA and origin-containing
      oligonucleotides suggests that sliding-back occurs stepwise, the fourth base
      being the directing position during the entire process.

PMID- 8367288
TI  - Analysis of the rat hepatocyte nuclear factor (HNF) 1 gene promoter: synergistic
      activation by HNF4 and HNF1 proteins.
AB  - Hepatocyte nuclear factor (HNF) 1 is a key transcription factor involved in the
      expression of many liver-specific genes. We have isolated and characterized the
      promoter region of the rat HNF1 gene. Transfection experiments revealed that a
      short region between -118 and -8 is crucial for cell type-specific expression of
      the HNF1 gene in the hepatoma cell line, HepG2 cells. This region contains two
      positive cis-elements: site A, to which the transcription factor HNF4 protein can
      bind, and site B, to which the HNF1 protein can bind. Mutational analyses of
      these sites and cotransfection assays suggested that the HNF4 protein and HNF1
      protein can transactivate the HNF1 gene.

PMID- 8367289
TI  - Tritium labeling of antisense oligonucleotides by exchange with tritiated water.
AB  - We describe a simple, efficient, procedure for labeling oligonucleotides to high
      specific activity (< 1 x 10(8) cpm/mumol) by hydrogen exchange with tritiated
      water at the C8 positions of purines in the presence of beta-mercaptoethanol, an
      effective radical scavenger. Approximately 90% of the starting material is
      recovered as intact, labeled oligonucleotide. The radiolabeled compounds are
      stable in biological systems; greater than 90% of the specific activity is
      retained after 72 hr incubation at 37 degrees C in serum-containing media. Data
      obtained from in vitro cellular uptake experiments using oligonucleotides labeled
      by this method are similar to those obtained using 35S or 14C-labeled compounds.
      Because this protocol is solely dependent upon the existence of purine residues,
      it should be useful for radiolabeling modified as well as unmodified
      phosphodiester oligonucleotides.

PMID- 8367290
TI  - Three-step PCR mutagenesis for 'linker scanning'.
AB  - 'Linker scanning' has been used as an efficient method for systematically
      surveying a segment of DNA for functional elements by mutagenesis. A three-step
      PCR method was developed to simplify this process. In this method, a set of
      'mutation primers' was made with 6 to 8 base substitutions in the center of the
      primers. In the first PCR reaction, these 'mutation primers' are paired with an
      3' primer from the opposite end of the analyzed sequences to form a 'ladder' of
      fragments containing the base pair substitutions. These are used as templates in
      the second PCR with the 3' primer as the only primer to generate single stranded
      sequences, which are used as primers in the third PCR paired with an 5' primer to
      complete the mutagenesis. We have tested the method in a mutation screen of the
      steroid sulfatase promoter. Its application to general site specific mutagenesis
      is discussed.

PMID- 8367291
TI  - Subunits of the Schizosaccharomyces pombe RNA polymerase II: enzyme purification
      and structure of the subunit 3 gene.
AB  - To improve our understanding of the structure and function of eukaryotic RNA
      polymerase II, we purified the enzyme from the fission yeast Schizosaccharomyces
      pombe. The highly purified RNA polymerase II contained more than eleven
      polypeptides. The sizes of the largest the second-, and the third-largest
      polypeptides as measured by SDS-polyacrylamide gel electrophoresis were about
      210, 150, and 40 kilodaltons (kDa), respectively, and are similar to those of
      RPB1, 2, and 3 subunits of Saccharomyces cerevisiae RNA polymerase II. Using the
      degenerated primers designed after amino acid micro-sequencing of the 40 kDa
      third-largest polypeptide (subunit 3), we cloned the subunit 3 gene (rpb3) and
      determined its DNA sequence. Taken together with the sequence of parts of PCR
      amplified cDNA, the predicted coding sequence of rpb3, interrupted by two
      introns, was found to encode a polypeptide of 297 amino acid residues in length
      with a molecular weight of 34 kDa. The S. pombe subunit 3 contains four
      structural domains conserved for the alpha-subunit family of RNA polymerase from
      both eukaryotes and prokaryotes. A putative leucine zipper motif was found to
      exist in the C-terminal proximal conserved region (domain D). Possible functions
      of the conserved domains are discussed.

PMID- 8367293
TI  - Allelic discrimination by nick-translation PCR with fluorogenic probes.
AB  - Nick-translation PCR was performed with fluorogenic probes. Two probes were used:
      one complementary to a sequence containing the F508 codon of the normal human
      cystic fibrosis (CF) gene (wt DNA) and one complementary to a sequence containing
      the delta F508 three base pair deletion (mut DNA). Each probe contained a unique
      and spectrally resolvable fluorescent indicator dye at the 5' end and a common
      quencher dye attached to the seventh nucleotide from the 5' end. The F508/delta
      F508 site was located between the indicator and quencher. The probes were added
      at the start of a PCR containing mut DNA, wt DNA or heterozygous DNA and were
      degraded during thermal cycling. Although both probes were degraded, each probe
      generated fluorescence from its indicator dye only when the sequence between the
      indicator and quencher dyes was perfectly complementary to target. The identify
      of the target DNA could be determined from the post-PCR fluorescence emission
      spectrum.

PMID- 8367292
TI  - Site-specific mutagenesis induced by single O6-alkylguanines (O6-n-propyl, O6-n
      butyl, O6-n-octyl) in vivo.
AB  - The mutagenic activity of a series of longer chain O6-n-alkylguanine residues (O6
      n-propyl, O6-n-butyl, O6-n-octyl) has been analyzed using a plasmid molecule (pUC
      9) in which single O6-alkylguanines were positioned in the unique Pstl
      recognition site by shot gun ligation (Nucleic Acids Res. 13, 3305-3316 (1985))
      of overlapping synthetic oligonucleotides. After transfection of these vectors
      into E. coli cells having normal DNA repair systems, progeny plasmids were
      produced, of which 2.6%, 2.8% and 4.3% were mutated in their Pstl site when
      containing O6-n-propylguanine, O6-n-butylguanine, O6-n-octylguanine,
      respectively. DNA sequence analysis of mutant plasmid genomes revealed that O6-n
      propylguanine and O6-n-butylguanine induced exclusively G-->A transitions located
      specifically at the preselected site. O6-n-octylguanine induced apart from G-->A
      transitions (70%) also targeted G-->T transversions (30%). These results indicate
      that the mutation frequency of longer chain O6-alkylguanines can be substantial
      in cells with normal repair systems and that the mutation pattern depends on the
      nature of the alkyl group.

PMID- 8367295
TI  - The DAL82 protein of Saccharomyces cerevisiae binds to the DAL upstream induction
      sequence (UIS).
AB  - Expression of the DAL2, DAL4, DAL7, DUR1,2, and DUR3 genes in S. cerevisiae is
      induced by allophanate, the last intermediate in the allantoin catabolic pathway.
      Analysis of the DAL7 promoter identified a dodecanucleotide, the DAL7 UIS, which
      was required for inducer-responsiveness. Operation of the DAL7 UIS required
      functional DAL81 and DAL82 gene products. Since the DAL81 product was not an
      allantoin pathway-specific regulatory factor, the DAL82 product was considered as
      the more likely candidate to be the DAL UIS binding protein. Using an E. coli
      expression system, we showed that DAL82 protein specifically bound to wild type
      but not mutant DAL UIS sequences. DNA fragments containing DAL UIS elements
      derived from various DAL gene promoters bound DAL82 protein with different
      affinities which correlate with the degree of inducer-responsiveness the genes
      displayed.

PMID- 8367296
TI  - Tetramethylammonium does not universally neutralize sequence dependent DNA
      stability.
AB  - Effects of different concentrations of Tetramethylammonium on the thermostability
      of six DNA dumbbells with similar well defined sequences have been investigated.
      Each molecule has a 16 base pair duplex stem linked on both ends by T4 single
      strand loops. Only the sequence of the four central base pairs distinguishes one
      molecule from the next. The distinguishing central sequences are, [A-T-A-T], [T-A
      T-A], [A-A-A-A], [C-G-C-G], [G-C-G-C] and [G-G-G-G] situated between the
      sequences: 5'-G-T-A-T-C-C-[]-G-G-A-T-A-C-3' which are the same in all molecules.
      Optical melting curves collected on these molecules as a function of TMA
      concentration over the range from 0.09 M to 4.5 M revealed there is no single
      concentration of TMA where all these molecules exhibit the same melting
      temperature.

PMID- 8367294
TI  - Transcriptional repressor ZF5 identifies a new conserved domain in zinc finger
      proteins.
AB  - We have cloned a cDNA encoding a new murine C2H2 zinc finger protein, ZF5. The
      51.3 kD protein contains five GL1-Kruppel type zinc fingers at the C-terminus. At
      its N-terminus, ZF5 has a 41 amino acid region which was found to be homologous
      to the N-termini of several other zinc finger proteins. This region defines a new
      motif within zinc finger proteins which we have named the Zinc finger N-terminal
      (ZiN) domain. ZF5 binds to two sites in the c-myc promoter and to the -50 bp site
      of the herpes simplex thymidine kinase promoter. ZF5 is a transcriptional
      repressor and its repression domain is located N-terminal to the zinc finger
      domains. A single 4 kb ZF5 mRNA is expressed widely.

PMID- 8367297
TI  - Molecular characterization of the yeast meiotic regulatory gene RIM1.
AB  - In the yeast Saccharomyces cerevisiae, genetic studies suggest that the RIM1 gene
      encodes a positive regulator of meiosis. rim1 mutations cause reduced expression
      of IME1, which is required for expression of many meiotic genes, and thus lead to
      a partial defect in meiosis and spore formation. We report the sequence of RIM1
      and functional analysis of its coding region. The RIM1 gene product (RIM1)
      contains three regions similar to C2H2 zinc fingers. Serine substitutions for
      cysteine in each of the putative zinc fingers abolish RIM1 function. The carboxyl
      terminus of RIM1 is enriched in acidic amino acids and is required for full RIM1
      activity. RIM1 also contains two putative cAMP-dependent protein kinase (cAPK)
      phosphorylation sites. At one site, substitution of alanine for serine does not
      affect RIM1 activity; at the other site, this substitution impairs activity. This
      analysis of RIM1 suggests that the protein may function as a transcriptional
      activator. We have used the cloned RIM1 gene to create a complete rim1 deletion.
      This null allele, like previously isolated rim1 mutations, causes a partial
      meiotic defect. In addition to RIM1, maximum IME1 expression requires the MCK1
      and IME4 gene products. Defects associated with rim1, mck1, and ime4 mutations in
      expression of a meiotic reporter gene (ime2-lacZ) and in sporulation are
      additive. These findings suggest that RIM1 acts independently of MCK1 and IME4 to
      stimulate IME1 expression.

PMID- 8367298
TI  - p21X mRNA is expressed as a singly spliced pX transcript from defective provirus
      genomes having a partial deletion of the pol-env region in human T-cell leukemia
      virus type 1-infected cells.
AB  - In addition to the three typical transcripts such as genomic/gag-pol mRNA, env
      mRNA and tax/rex mRNA, we previously found the singly spliced pX mRNA, termed
      p21X mRNA, responsible for producing the p21X protein in human T-cell leukemia
      virus type 1 (HTLV-1)-infected cells. Our finding of the p21X mRNA being
      constitutively expressed in the fresh peripheral blood mononuclear cells (PBMCs)
      from patients with ATL has suggested that the expression mechanism is quite
      different from that of the others. In this paper, the expression mechanism of
      p21X mRNA was investigated by analyzing the organization of the proviral genomes
      present in the representative HTLV-1-infected cell lines which are positive or
      negative for the expression of p21X mRNA. Southern and PCR analyses show that
      most of the analyzed cell lines contain both one complete and one defective
      genome each. However, one cell line without the p21X mRNA expression, C91/PL,
      contains only the complete genome, suggesting that the complete HTLV-1 has no
      ability to express p21X mRNA in spite of having the ability to produce the
      infectious virus. The defective genomes of the p21X mRNA positive cell lines, MT
      2 and H582, have a large deletion of the entire pol and parts of the gag and env
      regions including the common domain of the second exon of the doubly spliced
      tax/rex mRNA, while another defective genome of the p21X mRNA negative cell line,
      MT-1, has a deletion within the gag-pol gene. We show that these defective
      genomes have the ability to express their distinct, defective genomic mRNA,
      suggesting they are active. The defective genomic mRNAs in MT-2 and H582 cells
      retain the first splice donor and the second splice acceptor sites, suggesting
      the possibility of synthesizing p21X mRNA by splicing singly with these sites.
      These findings assume that defective HTLV-1 genomes deleting the second exon
      region acquire the ability to express p21X mRNA but no ability to express tax/rex
      mRNA. Such a deletion may explain the difference between the expression
      mechanisms in the p21X mRNA transcript and those in the other viral transcripts.

PMID- 8367299
TI  - Problems related to the interpretation of autoradiographic data on gene
      expression using common constitutive transcripts as controls.
AB  - The 28S rRNA, a ribosomal RNA, and the ACTB and GAPD mRNAs, coding respectively
      for beta-actin and glyceraldehyde-3-phosphate dehydrogenase (GAPDH), are
      frequently presented as controls of modulated gene expression. These transcripts
      were quantified by replicate slot-blot autoradiography and image analysis in
      mammary epithelial cells and fibroblasts from breast tissues. Each cell-type
      group comprised strains with different pathological backgrounds, growth rates,
      antigenic phenotypes and culture histories. The effects of a differentiating
      agent (cholera toxin) and/or a tumor promoter (12-O-tetradecanoyl-phorbol-13
      acetate) were also examined. Despite the impression that visual examination of
      autoradiographs might create, image analysis suggests that 28S rRNA, ACTB and
      GAPD are substantially and independently influenced by the above biological
      factors and by the drugs. Therefore, these transcripts represent specifically
      regulated cellular activities and may not be taken as alternative indicators of
      the overall transcription rate or of the amount of material being examined.
      Instead, such nonspecific variation may be accurately measured and removed from
      quantitative data using a principal component function. A methodology that allows
      comparison of expression (or amplification) patterns between genes, between
      experiments or, even, between laboratories is presented with an example of
      quantification of transcripts related to cell-growth, differentiation, signaling
      and cancer.

PMID- 8367300
TI  - Fission yeast with DNA polymerase delta temperature-sensitive alleles exhibits
      cell division cycle phenotype.
AB  - DNA polymerases alpha and delta are essential enzymes believed to play critical
      roles in initiation and replication of chromosome DNA. In this study, we show
      that the genes for Schizosaccharomyces pombe (S.pombe) DNA polymerase alpha and
      delta (pol alpha+ and pol delta+) are essential for cell viability. Disruption of
      either the pol alpha+ or pol delta+ gene results in distinct terminal phenotypes.
      The S.pombe pol delta+ gene is able to complement the thermosensitive cdc2-2
      allele of Saccharomyces cerevisiae (S.cerevisiae) at the restrictive temperature.
      By random mutagenesis in vitro, we generated three pol delta conditional lethal
      alleles. We replaced the wild type chromosomal copy of pol delta+ gene with the
      mutagenized sequence and characterized the thermosensitive alleles in vivo. All
      three thermosensitive mutants exhibit a typical cell division cycle (cdc)
      terminal phenotype similar to that of the disrupted pol delta+ gene. Flow
      cytometric analysis showed that at the nonpermissive temperature all three
      mutants were arrested in S phase of the cell cycle. The three S.pombe conditional
      pol delta alleles were recovered and sequenced. The mutations causing the
      thermosensitive phenotype are missense mutations. The altered amino acid residues
      are uniquely conserved among the known polymerase delta sequences.

PMID- 8367301
TI  - A quality control algorithm for DNA sequencing projects.
AB  - Heterologous DNA sequences from rearrangements with the genomes of host cells,
      genomic fragments from hybrid cells, or impure tissue sources can threaten the
      purity of libraries that are derived from RNA or DNA. Hybridization methods can
      only detect contaminants from known or suspected heterologous sources, and whole
      library screening is technically very difficult. Detection of contaminating
      heterologous clones by sequence alignment is only possible when related sequences
      are present in a known database. We have developed a statistical test to identify
      heterologous sequences that is based on the differences in hexamer composition of
      DNA from different organisms. This test does not require that sequences similar
      to potential heterologous contaminants are present in the database, and can in
      principle detect contamination by previously unknown organisms. We have applied
      this test to the major public expressed sequence tag (EST) data sets to evaluate
      its utility as a quality control measure and a peer evaluation tool. There is
      detectable heterogeneity in most human and C.elegans EST data sets but it is not
      apparently associated with cross-species contamination. However, there is direct
      evidence for both yeast and bacterial sequence contamination in some public
      database sequences annotated as human. Results obtained with the hexamer test
      have been confirmed with similarity searches using sequences from the relevant
      data sets.

PMID- 8367302
TI  - RAD50 protein of S.cerevisiae exhibits ATP-dependent DNA binding.
AB  - RAD50 function of Saccharomyces cerevisiae is required during vegetative growth
      for recombinational repair of DNA double strand breaks, and during meiosis for
      initiation of meiotic recombination and formation of synaptonemal complex. RAD50
      encodes a 153 kDa polypeptide which includes an amino-terminal ATP binding domain
      essential for function and two long heptad repeat regions. We show below that
      RAD50 protein purified from yeast exhibits ATP-dependent binding to double
      stranded DNA. Physical properties of the purified protein are also described.
      Models for RAD50 function in vivo are discussed.

PMID- 8367303
TI  - Evaluation of the contingent replication assay (CRA) and its application to the
      study of the general transcription initiation factor, TFIIF.
AB  - The Contingent replication assay (CRA) is a rapid assay for the screening and
      isolation of cDNAs by protein-protein or protein-DNA interactions in mammalian
      cells. The method has been shown to enrich a plasmid containing a cDNA encoding
      the bacterial replication-related protein, R6K, from a mixture of two plasmids.
      In this report we present data illustrating the sensitivity and selectivity of
      the method. Using the small subunit of TFIIF (Rap30) as a target, we demonstrate
      the enrichment of a clone encoding the large subunit, Rap74, from a cDNA library.
      Additional cDNA clones including human Rap30 and an anonymous cDNA clone
      homologous to members of the human cdc2 kinase family were enriched and isolated
      by a modified screening approach. The structure of these additional clones
      suggest that the CRA enriches for products that interact not only directly with
      the target protein but also through bridging by endogenous proteins.

PMID- 8367304
TI  - Comparative DNA sequence features in two long Escherichia coli contigs.
AB  - The recent sequencing of two relatively long (approximately 100 kb) contigs of
      E.coli presents unique opportunities for investigating heterogeneity and genomic
      organization of the E.coli chromosome. We have evaluated a number of common and
      contrasting sequence features in the two new contigs with comparisons to all
      available E.coli sequences (> 1.6 Mb). Our analyses include assessments of: (i)
      counts and distributions of restriction sites, special oligonucleotides (e.g.,
      Chi sites, Dam and Dcm methylase targets), and other marker arrays; (ii)
      significant distant and close direct and inverted repeat sequences; (iii)
      sequence similarities between the long contigs and other E.coli sequences; (iv)
      characterization and identification of rare and frequent oligonucleotides; (v)
      compositional biases in short oligonucleotides; and (vi) position-dependent
      fluctuations in sequence composition. The two contigs reveal a number of
      distinctive features, including: a cluster of five repeat/dyad elements with very
      regular spacings resembling a transcription attenuator in one of the contigs; REP
      elements, ERICs, and other long repeats; distinction of the Chi sequence as the
      most frequent oligonucleotide; regions of clustering, overdispersion, and
      regularity of certain restriction sites and short palindromes; and comparative
      domains of inhomogeneities in the two long contigs. These and other features are
      discussed in relation to the organization of the E.coli chromosome.

PMID- 8367305
TI  - Sequence of the Rhizobium leguminosarum biovar phaseoli syrM gene.

PMID- 8367307
TI  - Nucleotide sequence of the small subunit rRNA of Ameson michaelis.

PMID- 8367306
TI  - Isolation of a murine gene encoding a nucleic acid-binding protein with homology
      to hnRNP K.

PMID- 8367308
TI  - The complete nucleotide sequence of a pathogenic swine vesicular disease virus
      isolated in Japan (J1'73) and phylogenetic analysis.

PMID- 8367309
TI  - Drosophila ribosomal protein S19 cDNA sequence.

PMID- 8367310
TI  - The nuclear 18S ribosomal RNA gene of the red alga Hildenbrandia rubra contains a
      group I intron.

PMID- 8367312
TI  - The primary sequence of the Schizosaccharomyces pombe protein homologous to
      S.cerevisiae ribosomal protein L2.

PMID- 8367311
TI  - Cloning and expression of the NspV restriction-modification genes of Nostoc sp.
      strain PCC7524.

PMID- 8367313
TI  - Nucleotide sequence of a Trypanosoma cruzi cDNA encoding a protein homologous to
      mammalian EF1 gamma.

PMID- 8367314
TI  - Electrophoretic karyotype of budding yeasts with intact cell wall.

PMID- 8367315
TI  - Analysis of oligonucleotide structure using hyperchromism measurements at long
      wavelengths.

PMID- 8367316
TI  - Excess PCR primers may dramatically affect SSCP efficiency.

PMID- 8367317
TI  - Construction of random small-insert genomic libraries highly enriched for simple
      sequence repeats.

PMID- 8367318
TI  - Sequencing of cDNA using anchored oligo dT primers.

PMID- 8367319
TI  - A novel method employing UNG to avoid carry-over contamination in RNA-PCR.

PMID- 8367320
TI  - Airway emergencies in the post anesthesia care unit.
AB  - Airway emergencies are frequently seen in the PACU. Six of the more common airway
      emergencies have been discussed. The upper-airway emergencies discussed included
      soft tissue obstruction, laryngeal edema, and laryngospasm. The lower-airway
      emergencies discussed included bronchospasm, noncardiogenic pulmonary edema, and
      aspiration. The PACU nurse must be ever vigilant. Knowing the definition,
      pathophysiology, signs and symptoms, patients at risk, and treatment modalities
      should prepare the PACU nurse for immediate response in the event of a crisis.
      Many times, the speed in which the emergency is identified and the treatment is
      begun determines the final outcome for the patient.

PMID- 8367321
TI  - Cardiovascular emergencies in the post anesthesia care unit.
AB  - Optimizing the cardiac function of the postanesthesia patient is dependent on
      identifying the possible causes of dysfunction. The causes of alterations in
      cardiac function are varied and complex. The PACU nurse must possess a knowledge
      of cardiac physiology, an intricate understanding of the cardiovascular effects
      of various anesthetic agents, and astute assessment skills.

PMID- 8367323
TI  - The pediatric patient in the post anesthesia care unit.
AB  - This article provides an overview of pediatric post anesthesia care. It
      highlights important aspects of care that are frequently encountered in practice
      or have the potential for being problematic. These include airway management,
      fluid maintenance, the treatment of seizures, thermoregulation, the management of
      malignant hyperthermia, the identification and treatment of emergence delirium,
      and the availability of appropriate emergency equipment and medications.

PMID- 8367322
TI  - The elderly patient in the post anesthesia care unit.
AB  - This article discusses the implications of providing care to the elderly patient
      in the post anesthesia care unit (PACU). Using a systems approach, physiologic
      changes along with pharmacologic and pathophysiologic alterations associated with
      aging are identified. Anesthetic options are presented; and postoperative
      priorities and nursing implications for the elderly patient are also included.

PMID- 8367324
TI  - Ambulatory surgical patient priorities.
AB  - With the increasing numbers of ambulatory surgical patients, anesthetic and post
      anesthetic care priorities have been identified with the goal of providing safe
      care and a timely discharge. This article focuses on patient selection,
      anesthetic options, pain management, nausea and vomiting, and discharge
      priorities. Collaboration between nursing, anesthesia, and surgical personnel is
      emphasized throughout.

PMID- 8367325
TI  - Local and regional anesthesia. Nursing implications.
AB  - Local and regional anesthesia offers many advantages and is relatively safe,
      resulting primarily in positive outcomes for the patient. The potential for
      complications and the need for patient education, however, dictate that the PACU
      nurse prepare the patient appropriately, remain vigilant, and initiate the
      necessary measures for monitoring and intervention when caring for such patients
      in both the preanesthesia and postanesthesia phases. Local and regional
      anesthetic agents and techniques have been discussed along with their
      implications for nursing care. Readers are also encouraged to consult the
      references and their own institutional policies for additional information.

PMID- 8367326
TI  - Assessing and improving quality in the post anesthesia care unit.
AB  - The Joint Commission on Accreditation of Healthcare Organization's 10 step
      methodology for quality assessment and improvement is a powerful tool for
      addressing and resolving complex interdisciplinary problems and issues. This
      article presents the basics of each of the 10 steps to illustrate a post
      anesthesia care unit (PACU) monitoring and evaluation process that is rigorous,
      objective, systematic, and relevant. In addition, two quality improvement tools,
      flow charts and cause-and-effect diagrams, are discussed.

PMID- 8367327
TI  - Prevention and control of tuberculosis in the 1990s.
AB  - Beginning in 1984, the long-term decline in tuberculosis (TB) cases stopped, and
      since 1985 the number of cases has actually increased by 18%, from 22,201 new
      cases in 1985 to 26,283 in 1991. The change in the morbidity trend appears to be
      primarily due to three factors: HIV coinfection, TB occurring in persons from
      countries where this disease is prevalent, and deterioration of the health care
      infrastructure with resultant outbreaks of TB. This article presents six
      interventions that address major areas where action is needed. These efforts will
      require coordinated action by health care providers, public health departments,
      and other public and private organizations. Protection of all workers and
      patients in health care settings is one important goal of these efforts.

PMID- 8367328
TI  - The influence of the Occupational Safety and Health Administration on infection
      control practice.
AB  - Beginning with the Occupational Safety and Health Administration's (OSHA)
      activities to enforce the Centers for Disease Control (CDC) and Prevention
      guidelines on Universal Precautions in 1987, this agency has had a direct and
      sustained impact on infection control programs. This article details how OSHA
      works, the OSHA inspection process, the bloodborne pathogens standard, current
      promulgation activities, other OSHA standards, OSHA reform, and the future of
      this agency.

PMID- 8367329
TI  - Methicillin-resistant Staphylococcus aureus. Past, present, and future.
AB  - The MRSA control program at UCDMC is one of many approaches used in hospitals
      today. With this less restrictive program, we have been able to maintain control
      of MRSA for approximately 5 years. By establishing a threshold for investigation
      at four new nosocomial cases per month, the ICD has been able to maintain a
      manageable endemic level of MRSA. Figure 2 shows the downward trend of new cases
      of MRSA per fiscal year. During 1991, however, we experienced clustering of cases
      in two areas of the hospital along with a major outbreak in our burn unit. This
      is reflected in the significant rise in the number of new cases for that year.
      Even with these outbreaks, however, we have been able to re-establish control.
      Figure 3 represents the number of new MRSA cases per month during fiscal year
      1991. After the peak in April, we have again seen a downward trend, with an
      average of four new cases per month during the first quarter of fiscal year 1992.
      The success of this program is attributed to the cooperation and excellent
      communication among the hospital departments who are active participants in this
      control program. It is also owing to the establishment of a very active
      antibiotic control program that discourages inappropriate use of antimicrobial
      agents. This team effort is critical to the success of any infection control
      program. Infection control protocols are constantly changing, even if they are
      directed toward the same pathogen. Hospital epidemiology provides us with a very
      systematic approach to controlling the spread of disease. During the process,
      however, we are constantly collecting new information about the pathogen,
      allowing us to re-evaluate and, we hope, improve our approach to control. This is
      one reason for the numerous approaches to control found in the vast array of MRSA
      literature. MRSA continues to be a challenge of the 1990s. It appears to be an
      increasing problem in US hospitals, regardless of hospital size. Although its
      elusive behavior evades the most comprehensive and carefully planned control
      programs of even the most skilled hospital epidemiologists, hospitals continue to
      struggle for control of this organism. The alternative to control is probable
      resistance to vancomycin, which would have devastating public health
      consequences, particularly as alternative antibiotic therapy is not yet
      available.

PMID- 8367330
TI  - Infection control in oncology patients.
AB  - In conclusion, the nurse caring for the patient with cancer must be acutely aware
      of the risk of infection. Many interventions are used in attempts to minimize or
      prevent infection. Once the patient becomes neutropenic, the risk of life
      threatening infection increases dramatically. All nursing care is focused on
      treating infection and supporting the patient until bone marrow function returns.

PMID- 8367331
TI  - Respiratory syncytial virus.
AB  - A great deal of medical research and subsequent literature has been devoted to
      understanding and defining RSV as a dangerous respiratory pathogen. Careful
      assessment and preventative measures are the hallmarks of nursing care for the
      infants or young children with RSV. Acknowledging this seasonal virus and
      recognizing its potential effects, particularly on children and their families,
      is fundamental to the provision of effective pediatric health care. This
      appreciation is imperative in creating an environment focused on the containment
      of community-acquired RSV infections and the prevention of its nosocomial
      transmission. Additional research may someday allow us a greater understanding of
      the immune response to RSV, provide effective and safe antiviral agents, and
      yield vaccines to prevent primary and subsequent RSV infections. In the interim,
      however, we must apply our current knowledge and available tools to minimize
      RSV's destructive effects. Consistent use of basic infection control disciplines,
      such as appropriate handwashing, early identification of infected patients,
      careful placement of RSV-infected patients, and protective placement of high-risk
      patients, is necessary to prevent the nosocomial spread of this disease. In
      addition, policies restricting visitors with respiratory infections and prudent
      assignment of health care workers with respiratory infections need to be
      established and fully implemented. Strict and consistent compliance with these
      procedures will significantly decrease the incidence of RSV disease and
      subsequent morbidity and mortality in the pediatric population.

PMID- 8367332
TI  - Infection control and the pregnant health care worker.
AB  - Health care workers are constantly exposed to infectious agents in the course of
      their work. The pregnant health care worker presents additional concerns because
      of the potential risk of transmission of infection to the developing fetus. This
      article addresses the aspects of infection transmission, infectious agents of
      concern to health care workers, and operational aspects of an infection control
      program that is comprehensive, scientifically based, and equitable to all
      employees.

PMID- 8367333
TI  - Sterilization processes. Meeting the demands of today's health care technology.
AB  - Universal Precautions dictate sterilization for all invasive equipment that break
      the blood barrier; however, current methods of sterilization, such as steam and
      ethylene oxide gas (ETO), are not compatible with many of the delicate, heat
      sensitive surgical instruments used in modern health care. In addition,
      traditional sterilization methods are often too time consuming for practical use
      in the operating room. Clearly, new sterilization processes need to be developed.
      In this article, the criteria modern sterilization processes must meet and how
      some manufacturers plan to meet this challenge are discussed. In addition, the
      pros and cons of using peracetic acid (the newest sterilization process currently
      available) are examined.

PMID- 8367334
TI  - Reuse of single-use devices. A program model.
AB  - There are very few products that could be considered acceptable candidates for a
      reuse program when using this criteria for reuse. In addition, the cost of the
      resources necessary to implement and maintain an effective reuse program rarely
      equate to cost savings. In today's health care environment, the focus on employee
      safety adds another variable that may make reprocessing unacceptable.

PMID- 8367335
TI  - Stemming the tide of disreputable science: implications for nursing.
AB  - Numerous cases of fraud and misconduct in scientific endeavors have been brought
      to the attention of the public in recent years. Although nursing has not yet been
      scathed by abuses, the possibility exists that similar incidents can occur. The
      author reviews the factors that potentiate unethical practices and details a
      proactive approach for nursing to take to stem the tide of disreputable science.

PMID- 8367336
TI  - The view from Scutari: a look at contemporary nursing.
AB  - Modern nursing and healthcare delivery are examined from a unique vantage point
      provided by the author's visit to Scutari, Turkey. In Selimiye Army Barracks at
      Scutari, Florence Nightingale lived while directing the care of thousands of
      wounded British soldiers during the Crimean War. What was Nightingale's legacy to
      nursing, and what have nurses done with it? If Miss Nightingale were at her desk
      reading a status report on 20th-century nursing, what reactions would she have?
      What wars are engaging contemporary nursing? The author contends that
      Nightingale's vision can inspire us to move forward as a profession.

PMID- 8367338
TI  - Loose authorship.

PMID- 8367337
TI  - A glance back in time. Nursing diagnosis: process and decision. 1966.

PMID- 8367339
TI  - Toward understanding the self.
AB  - Others may know "me" but only "I" am the knower of myself. The metaparadigm of
      nursing includes four concepts: health, environment, nurse, and person. Each
      concept is complex and can be interpreted in diverse ways. The concept analysis
      in this article focuses on one aspect of person, specifically "self:" its birth,
      development, and loss. The author makes suggestions for using the analysis in
      nursing education, theory development, and clinical practice in caring for and
      promoting the health of individuals, groups, and families.

PMID- 8367340
TI  - One step forward and two steps back.

PMID- 8367341
TI  - Reader comments on recent article.

PMID- 8367344
TI  - Return-to-work experiences of people with cancer.
AB  - Maintaining employment after a cancer diagnosis and even during therapy is
      becoming a major challenge for an increasing number of individuals. The purpose
      of this study was to further understanding of the experience of returning to work
      after a cancer diagnosis by discovering the nature and processes of the
      experience's dimensions. This exploratory, longitudinal study systematically
      analyzed the dimensions of the return-to-work experience that were evident in
      data from 19 unstructured interviews. Grounded theory methods of study design and
      constant comparative analysis guided the interviews and data analysis. The core
      social process suggested by the data is one of mobilizing social support in the
      work environment. The inceptive theory explains and delineates steps in a process
      that ultimately facilitates a person's reintegration of normal activities after a
      cancer diagnosis. The added understanding available in these results can guide
      nurses to focus not only on related dimensions of the return-to-work experience,
      such as time off for treatment, but on central concerns, such as the social
      benefits of returning to work.

PMID- 8367342
TI  - An odyssey into biologic therapy.

PMID- 8367343
TI  - Predictors of self-care: a test of Orem's model.
AB  - Despite advancements in self-care for people with cancer, a profile of
      individuals who perform self-care behaviors has not been determined. Without
      these data, interventions cannot be targeted to specific patient groups that
      demonstrate the most need. This study's investigators used Orem's model of self
      care to determine predictors of self-care behavior. The sample consisted of 127
      adults with cancer who were to receive their first dose of chemotherapy (e.g.,
      doxorubicin, methotrexate, 5-fluorouracil, cyclophosphamide, or cisplatin, given
      alone or in combination). Data were collected from the subjects prior to the
      first cycle and at drug nadir for each of the four chemotherapy cycles. Potential
      predictors of self-care included demographic variables, performance status,
      affective state, social support, ability to manage a situation, self-care
      ability, and prior health-promoting activities. Self-care was measured using a 40
      item behavior checklist. Multiple regression techniques were used to obtain four
      significant predictors of self-care, which accounted for 47% of the variance.
      Subjects with lower performance status, higher anxiety, less social support, and
      more education performed more self-care. These findings clarify Orem's model with
      this clinical population and provide a patient profile of self-care for practice.

PMID- 8367345
TI  - Managing cancer pain at home: the decisions and ethical conflicts of patients,
      family caregivers, and homecare nurses.
AB  - The purpose of this paper is to present findings from an exploratory, descriptive
      study that investigated the experience of managing pain in the home from the
      perspectives of the patient, the primary family caregiver, and the homecare
      nurse. In particular, the decisions and ethical conflicts encountered by members
      of 10 patient-caregiver-nurse triads were studied. Data were collected through in
      depth semistructured interviews, and the transcribed interviews were content
      analyzed by a multidisciplinary research team. Subjects reported that the use of
      medications prompted the majority of the decisions and provoked most of the
      conflicts; however, decisions related to assessment, the future, and how to live
      with pain were identified as well. Subjects also identified other areas that
      created conflict, such as spiritual/theological issues, when to tell the truth,
      and interpersonal relationships. Findings illustrate the importance of
      understanding the beliefs and values that influence individuals' decisions and
      conflicts, because discrepant perceptions of the pain experience among patients,
      caregivers, and nurses can interfere with satisfactory management of pain.

PMID- 8367346
TI  - Pathophysiology of hypokalemia in patients with cancer: implications for nurses.
AB  - Hypokalemia is a potentially life-threatening complication that occurs in many
      patients with cancer. Nurses need to be aware of the many common causes of this
      electrolyte disorder as well as appropriate assessment strategies that will
      enable potential problems to be detected and treated early. This article begins
      with a review of normal potassium balance and physiology, followed by a
      discussion of potential causes of hypokalemia in patients with cancer. These
      causes are grouped into four categories: inadequate dietary intake, extrarenal
      losses, redistribution abnormalities, and renal losses. Common causes of
      hypokalemia in patients with cancer are illustrated with case examples. Signs and
      symptoms associated with hypokalemia are discussed. Finally, implications for
      nursing assessment and intervention related to the administration of potassium
      are reviewed.

PMID- 8367347
TI  - Bridging the gap between research and clinical practice: a collaborative
      approach.
AB  - In nursing, a gap sometimes exists between research and practice. This paper
      discusses how a group of 11 nurses successfully bridged this gap. The group was
      composed of nurses from a large teaching hospital, a regional outpatient cancer
      center, and a university. The result of the group's work over a two-year period
      was an externally funded research proposal. This paper discusses the strategies
      that led to the group's success and provides specific recommendations for nurses
      who want to form similar groups.

PMID- 8367349
TI  - "Humor book" provides release for nurses.

PMID- 8367350
TI  - Special motto enforces the importance of humor and hugs.

PMID- 8367348
TI  - Role modeling: an educational strategy to promote effective cancer pain
      management.
AB  - Successful pain management is a crucial element in the nursing care of the
      patient with cancer. Among the many problems underlying poorly managed pain, one
      prominent concern is healthcare professionals' lack of current knowledge.
      Although educational programs are an established method of increasing knowledge,
      specific programming strategies may have a more significant impact on knowledge
      retention. This quasiexperimental study used role modeling as an educational
      method to improve knowledge retention. A purposive sample of 20 RNs participated
      in an educational program in which a lecture-only format was used for the control
      group and a lecture format plus a role-modeling component was used for the
      experimental group. An oncology pain management assessment tool was administered
      in a pretest/post-test design with repeated measures. A one-tailed t-test for
      gain scores was used to test the hypothesis. Mean change scores between groups
      were similar. Future studies are needed to further analyze the impact of role
      modeling on similarly matched, but larger, groups.

PMID- 8367351
TI  - Unit offers unique and fun approaches to therapy.

PMID- 8367352
TI  - Humor helps to "break the ice" during patient education.

PMID- 8367353
TI  - Management of children with epiglottitis during transport: analysis of a survey.
AB  - Because nationally accepted guidelines for the management of children with
      epiglottitis during transport have not been published, we surveyed physicians
      attending the 1990 Pediatric Critical Care Transport Leadership Conference in
      order to delineate current practices and to test for correlations between
      complications and methods of management. A 22-item questionnaire was distributed,
      addressing demographics, availability and composition of a designated transport
      team, methods of airway management, use of medications for sedation or paralysis,
      monitoring techniques, and complications encountered during transport. Forty
      three of the 49 attendees completed the questionnaire (87.8%). Almost all were
      attending physicians (60.9% pediatric intensivists, 29.3% pediatric emergency
      physicians) practicing in tertiary care facilities (58.5% in children's
      hospitals, 41.5% in general hospitals). Eighty-three percent of centers had
      designated transport teams. For transfer of a child with suspected epiglottitis
      from a physician's office, virtually all respondents recommended transport by
      ambulance, 64% to the nearest facility and 36% directly to a tertiary care
      center. Regarding interhospital transfers, 49% recommended intubation prior to
      transport in all cases, whereas 49% considered it on an individual basis. The
      majority of respondents preferred nasal intubation. To prevent dislocation of the
      endotracheal tube, 79.1% recommended taping it to the face only (as opposed to
      around the skull), 70.7% administered paralytic agents, but only 35.2% used
      additional mechanical restraints.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367354
TI  - Carbamazepine poisoning in children.
AB  - Carbamazepine poisoning in children remains a significant problem for the
      emergency physician. We report 16 cases of toxicity at British Columbia
      Children's Hospital and discuss presenting symptoms, treatment, and hospital
      course. Pharmacology, drug interactions, resulting in carbamazepine toxicity, and
      treatment guidelines are summarized.

PMID- 8367355
TI  - Skin disorders encountered in a pediatric emergency department.
AB  - A total of 1381 visits to a pediatric emergency department (ED) during a six-week
      period were surveyed to determine the types and frequency of skin disorders
      encountered. A primary skin complaint accounted for 431 (31%) visits. There was a
      skin complaint of secondary importance in another 35 (3%) visits, and a skin
      disorder not mentioned by the patient or parent was detected on examination in a
      further 88 (6%) visits. In total, 554 (40%) visits included a skin complaint or a
      skin finding. As expected, cutaneous trauma (including abrasions, contusions,
      lacerations, and burns) accounted for a substantial number of visits, but a wide
      range of other dermatologic conditions was also represented, including skin
      infections, contact dermatitis, and numerous other disorders. Skin diseases are
      encountered frequently in the pediatric ED setting and should be included in the
      formal teaching curriculum for training programs in pediatrics and emergency
      medicine.

PMID- 8367356
TI  - Acute urinary retention in children.
AB  - Acute urinary retention (AUR) is an uncommon diagnosis in childhood, associated
      with a variety of causes. The emergency physician is often the first to be called
      upon to evaluate and treat these children. To assist in making the diagnosis, we
      present our five-year experience with AUR presenting to the pediatric urology
      service, often through the pediatric emergency department. We present and discuss
      examples of not only the common reasons for AUR but also uncommon diagnoses and,
      in two cases, etiologies for retention we believe have not been previously
      described in the pediatric literature.

PMID- 8367357
TI  - Use of the transmitter-receiver metal detector in the evaluation of pediatric
      coin ingestions.

PMID- 8367358
TI  - Traumatic pneumomediastinum in a child secondary to corn chip perforation of the
      esophagus.
AB  - Esophageal perforations, while an infrequent form of trauma in the pediatric
      population, are of concern because of their life-threatening complications. If
      not recognized and treated promptly, esophageal injuries can result in
      mediastinitis and death. An unusual case is presented, describing traumatic
      esophageal perforation in a child resulting from laceration by an ingested corn
      chip. A study is reported investigating the rigidity of three types of these
      popular snack chips. Stress testing and statistical analysis of the resultant
      measurement data indicated that the three brands of chips were equally rigid. The
      mean force of compression required to fracture the chips was approximately three
      pounds, a force great enough to damage the fragile structures of the upper
      aerodigestive system. Physicians and parents alike should be aware of the
      possible dangers of this type of snack food to avert the possibility of
      esophageal injury with its resultant morbidity and potential mortality.

PMID- 8367359
TI  - Pseudodisaster: a case of mass hysteria involving 19 schoolchildren.
AB  - A case of mass hysteria involving 19 children has been presented. Our case
      demonstrated many of the common symptoms and vectors identified in the
      literature. No children were harmed, but significant health care dollars were
      spent ensuring their safety. Better education of child care personnel and
      preplanning by schools may reduce the frequency of this condition.

PMID- 8367360
TI  - Pertussis: the return of a bad penny.
AB  - We describe two related cases of pertussis infection ("whooping cough"). This
      disease entity was almost completely eradicated through successful mass
      immunization programs. In the past decade it has demonstrated a steady rise in
      incidence. The epidemiology, clinical manifestations, treatment, and current
      vaccines for pertussis infection are reviewed.

PMID- 8367361
TI  - Acute gastric volvulus in children: a rare disorder.
AB  - A case of acute gastric volvulus has been presented. Although this disorder can
      occur in a chronic intermittent fashion, the potentially catastrophic acute form
      should be diagnosed early and surgically corrected. Careful attention to
      presenting signs and a high index of suspicion lead to prompt recognition and
      treatment.

PMID- 8367362
TI  - Button battery ingestions in children.

PMID- 8367364
TI  - A 13 year old with desipramine ingestion.

PMID- 8367363
TI  - Coping with physician payment reform: what is it, and why should pediatric
      emergency physicians care?

PMID- 8367365
TI  - Apnea and cyanosis in an infant.

PMID- 8367366
TI  - Carbon dioxide monitors: exhaled gas (capnographs, capnometers, end-tidal CO2
      monitors).

PMID- 8367367
TI  - Laceration management.

PMID- 8367368
TI  - Case 03-1993: a 20-month-old boy with fever and neck stiffness.

PMID- 8367369
TI  - [The opening of potassium channels as a new trend of pharmacologic treatment of
      coronary disease in light of endothelial mechanisms of hemodynamic regulation].

PMID- 8367371
TI  - [The composition of fatty acids in individual classes of blood platelet
      phospholipids of patients with uremia].
AB  - The most important role in the formation of defects of the haemostasis in
      patients with uraemia is attributed to disorders of platelet activation. The
      important elements of phospholipid structure are saturated and unsaturated fatty
      acids. Five classes of phospholipids were identified in the platelets:
      phosphatidylethanolamine (PE), phosphatidylserine (PS), phosphatidylinositol
      (PI), phosphatidylcholine (PC) and sphingomyelin (Sph). This paper aimed at the
      assessment of the fatty acid composition in individual classes of phospholipids
      of blood platelets in patient with uraemia. We studied 18 uraemic patients who
      were treated conventionally and 21 patients treated with with repeated
      haemodialysis. The classes of phospholipids were isolated by thin layer
      chromatography and the contents of fatty acids in the individual classes of of
      phospholipids were assessed by gas chromatography. In patients treated
      conventionally great differences in the contents of fatty acids in the individual
      classes of phospholipids were demonstrated as compared with the control group.
      The differences can be caused by disorders of blood plasma lipids. In general-
      more unsaturated fatty acids were found in the classes of phospholipids forming
      the outer surface of the platelets as compared to the inner surface. In
      haemodialysed patients the differences in the fatty acid contents compared with
      the control group were evidently smaller (perhaps resulting from some
      normalization of biochemical changes in the plasma of dialyzed patients). In this
      group a greater content of unsaturated fatty acids in Sph and PC was also found.
      The high content of unsaturated fatty acids may increase the platelet membrane
      fluidity and intensive lipid-protein reaction, e.g. binding of coagulation
      factors, so may play a role in haemostasis disturbances observed in uraemic
      patients.

PMID- 8367370
TI  - [Level of zinc, copper, selenium and nickel in serum of patients treated for
      chronic renal failure with hemodialysis--influence of erythropoietin therapy].
AB  - 52 patients with chronic renal failure treated with haemodialysis and 21 healthy
      subjects were observed. All patients were divided in 2 groups: 1. erythropoietin
      treated patients (+EPO), 2. patients not treated with erythropoietin (-EPO). In
      all patients immediately before dialysis and after dialysis the blood samples
      were withdrawn for estimation of creatinine, haemoglobin concentration,
      haematocrit value and zinc, copper, selenium, and nickel concentration. In
      healthy subjects such measurements we made only once. In all patients serum zinc,
      selenium and nickel concentrations were significantly lower than in normals.
      Copper concentration was insignificantly higher in normals than in patients with
      CRF. No significant differences were found in serum concentration of zinc,
      copper, selenium and nickel between +EPO and -EPO. During haemodialysis a
      decrease of serum zinc, copper and selenium levels in all examined group was
      seen. No significant changes between serum, zinc, selenium, copper and nickel
      concentration between patients treated with erythropoietin and without
      erythropoietin. Conclusions 1. Serum zinc, selenium and nickel concentration were
      significantly lower in patients treated with haemodialysis than in normals. 2.
      Serum concentration of zinc, copper and selenium decreased during haemodialysis.
      3. Probably erythropoietin therapy does not influence serum zinc, selenium,
      copper and nickel levels in patients with chronic renal failure.

PMID- 8367373
TI  - [Cardiac arrhythmias during extracorporeal shock wave lithotripsy].
AB  - Holter monitoring was performed in 55 patients (24 women, 31 men), mean age 50.7
      +/- 11.3 who underwent ECG-triggered extracorporeal shock wave lithotripsy
      (ESWL). Patients were divided into two groups A--30 with history of cardiac
      disease and B--25 control. The heart rate was significantly higher before and
      after ESWL in the first group. The number of premature ventricular contractions
      was higher during ESWL in the same group. No other cardiac complication was
      observed.

PMID- 8367372
TI  - [Estimation of selected markers of bone metabolism inpatients with
      nephrolithiasis].
AB  - 19 patients with active nephrolithiasis, 14 patients with non-active
      nephrolithiasis and 17 healthy subjects were examined. After 7 days consumption
      of standardized low calcium, low phosphate, low purine and low protein diet,
      plasma parathyroid hormone (PTH) and osteocalcin concentration, activity of the
      alkaline phosphatase and its bone fraction were assessed before and after 4 hours
      i.v. infusion of calcium gluconate (15 mg/kg b.w. in 500 ml 0.9% NaCl). In
      addition, urinary excretion of oxalate, calcium, phosphate and magnesium were
      estimated in all examined groups. CONCLUSIONS: 1. In comparison to healthy
      subjects, patients with nephrolithiasis are characterized by higher plasma PTH
      and osteocalcin concentration, increased activity of bone fraction of alkaline
      phosphatase and urinary oxalate and calcium excretion. 2. Disturbances of calcium
      phosphate and oxalate metabolism, PTH secretion and bone osteoblastic activity
      found in patients with active nephrolithiasis are qualitatively similar but
      quantitatively more intensive than in patients with non-active nephrolithiasis.

PMID- 8367374
TI  - [Efficacy of hepatitis B vaccine after intramuscular or intradermal
      administration].
AB  - We compared the efficacy of intramuscular (im) and intradermal (id)
      administration of vaccine against HBV. Only one out of 25 im vaccinated subjects
      did not respond whereas all 25 id immunized persons developed anti-HBs above 10
      IU/l. The mean serum level of anti-HBs in im and id vaccinated group was 2351 +/-
      2358 IU/l and 1823 +/- 1502 IU/l, respectively (p = 0, 382; NS). It seems that
      the efficacy of both vaccine administration is very similar.

PMID- 8367375
TI  - [Acute failure of transplanted kidney after administration of angiotensin
      converting enzyme inhibitors (iACE)].
AB  - Treatment of kidney transplant recipients with inhibitors of angiotensin
      converting enzyme (iACE) is associated with increased risk of deterioration of
      renal function. Between 1988-1992 in Transplantation Institute, 71 renal
      allograft recipients were treated with iACE. 44 of them received iACE in order to
      reduce proteinuria, 18 due to secondary polycythemia and 9 recipients received
      iACE because of hypertension resistant to at least 3 hypotensive drugs. Acute
      renal failure developed in 5 patients and all of them received iACE as treatment
      of resistant hypertension. After resumption of renal function, in 3 of 5 patients
      artery stenosis of the transplanted kidney was found. In 1 recipient acute renal
      failure occurred despite normal renal arteriography and normal indexes of the
      flow through renal arteries determined by Doppler ultrasound examination. In 2
      patients acute renal failure appeared after a single minimal dose of iACE. Severe
      arterial hypertension in patients with transplanted kidney is a particular risk
      factor for development of acute renal failure after iACE. The normal
      arteriography in transplanted kidney and normal arterial blood flow measured by
      means of Doppler ultrasound do not exclude the possibility of development of
      acute renal failure after iACE.

PMID- 8367376
TI  - [Kidneys and hypertension].

PMID- 8367377
TI  - [Possibilities and perspectives of genetic engineering in management of genetic
      diseases, neoplasms and AIDS].

PMID- 8367378
TI  - [New approaches for treating skin necrosis in protein C deficiency].
AB  - A 62-year-old woman with a 8-month-history of recurrent deep and superficial vein
      thrombosis developed multiple areas of skin necrosis during warfarin treatment
      initiation. Routine coagulation tests did not revealed any abnormalities. Protein
      C plasma activity and concentration were significantly decreased (59.9% and 63.3%
      of the normal value, respectively). Antithrombin III and protein S (total and
      free) content were in the normal range. Initially, the adjusted dosage of
      standard heparin and fresh frozen plasma was administered. Thereafter, the
      treatment with low doses of oral anticoagulant (acenocoumarol) was reinstalled
      simultaneously with Protein C Concentrate (Immuno, Vienna) intravenous
      administration. After six days of the oral anticoagulation the therapeutic value
      of prothrombin time was obtained and administration of Protein C Concentrate
      could have been discontinued. No adverse reactions and post-transfusions
      complications were observed.

PMID- 8367380
TI  - Effect of DL alpha-lipoic acid on tissue lipid peroxidation and antioxidant
      systems in normal and glycollate treated rats.
AB  - The cytoprotective activity of alpha-lipoic acid against free radical toxicity,
      manifested during experimental hyperoxaluria, has been investigated. Glycollate
      was used as the inducer of oxalate hyperoxaluria in rats. The increase in lipid
      peroxidation and superoxide dismutase (SOD) activity, associated with a decrease
      in catalase activity and glutathione (GSH) level, are the salient features
      observed in tissues of hyperoxaluric rats. Free radical toxicity in the
      glycollate fed rats is effectively counteracted by lipoic acid administration.
      Lipoic acid administration brought about a significant decrease in peroxidative
      levels with an increase in catalase activity and glutathione level. These
      observations highlight the antioxidant property of alpha-lipoic acid and its
      cytoprotective action against experimental hyperoxaluria.

PMID- 8367379
TI  - Effect of the nifedipine-atenolol association on arterial myocyte migration and
      proliferation.
AB  - The in vitro effect of nifedipine and atenolol, either alone or in combination,
      on the proliferation and migration of rat aortic smooth muscle cells was
      investigated. Nifedipine inhibited the replication of arterial myocytes in
      concentrations ranging between 10 and 100 microM. The inhibition, evaluated as
      cell number, was dose- and time-dependent with an IC50 of 39 and 34 microM after
      48 and 72 h, respectively; the cell doubling time increased with drug
      concentrations up to 118 h versus 28 h for controls. Atenolol alone failed to
      reduce arterial myocyte proliferation, and did not influence the effect of
      nifedipine on cell proliferation. Nifedipine and atenolol alone inhibited in a
      dose-dependent manner rat aortic myocytes migration induced by fibrinogen as
      chemotactic agent. When the combination nifedipine-atenolol was investigated, an
      additive inhibitory effect on cell migration was observed. These results provide
      in vitro support for a potential effect of this drug association on early steps
      of atherogenesis.

PMID- 8367381
TI  - Anti-inflammatory activity of newly synthesized 2,6-bis-(1,1-dimethylethyl)phenol
      derivatives.
AB  - Four new 2,6-bis-(1,1-dimethylethyl)phenol derivatives were synthesized and
      evaluated for their anti-inflammatory activity, in comparison with indomethacin
      and vitamin E, using the carrageenan paw oedema assay in rats. Among the tested
      compounds, the 4-(6,7-dichloro-4H-1,2,4-benzothiadiazine-3-yl)-2,6-bis-(1,1-
      dimethylethyl)-phenol-S,S-dioxide (4) was the most active compound markedly
      reducing oedema formation. Moreover compound 4 potentiated, particularly in the
      early phase of carrageenan paw swelling (2-4 h), the antiphlogistic effect of
      indomethacin. This compound, on the other hand, did not show ulcerogenic activity
      at therapeutic doses and did not potentiate the gastric damage induced by high
      doses of indomethacin. In vitro, the studied compounds (1-4) showed to be
      moderately active as scavengers of 2,2-diphenyl-1-(2,4,6-trinitrophenyl)hydrazil,
      4 being the most active among them. Compound 4, on the contrary, was practically
      inactive on liposome peroxidation where compounds 1, 2, 3, which are modest anti
      inflammatory agents, exerted a good or moderate effect.

PMID- 8367382
TI  - Dexamethasone modulation of gestation length and parturition in rats.
AB  - Dexamethasone blocks aromatase and phospholipase A2 enzyme activities that are
      essentially involved in the formation of oestrogens and prostaglandins, the key
      chemicals to initiate parturition. The present study was undertaken to determine
      whether dexamethasone, a potent glucocorticoid, could prolong gestation and/or
      delay parturition in rats. Dexamethasone at 0.5 mg/rat/day from Day 19 through
      Day 21 of pregnancy consistently prolonged gestation. Only 36% of the pregnant
      rats had labour with an extended parturition time. Foetal mortality rate was also
      high. The remaining 64% pregnant rats that did not deliver showed intrauterine
      foetal death and resorption. Concomitant injection of oestradiol
      cyclopentylpropionate or prostaglandin F2 alpha on Day 19 effectively reversed
      the deleterious effects of dexamethasone. 100% of the pregnant rats had
      successful labour at term. The parturition time and foetal mortality rate were
      not different from controls. The results, therefore, indicate that an excess
      glucocorticoid that initiates parturition in sheep conversely prolongs gestation
      and delays parturition in rats.

PMID- 8367383
TI  - [Possibilities of modern toxicologic analysis for determining cause of death].

PMID- 8367385
TI  - [Individualization and identification of cadaver parts dismembered by contact
      with the ship propellor using DNA technology].

PMID- 8367384
TI  - [The number of autopsies at the Chemnitz Institute of Pathology before and after
      unification (1987-1992)].
AB  - The numbers of autopsies performed at the Institute of Pathology in Chemnitz
      before and after German unification (1990) were compared (1987-1992). In 1991 and
      1992 a decrease of up to 40% was observed. In the former GDR an autopsy was
      possible without agreement of the relatives, whereas since unification the
      relatives have the power to forbid an autopsy. This was the principal reason for
      the dramatic decline in the past 2 years. Another relevant factor is the
      difficult economic situation of most hospitals in the region, preventing the
      arrangement of more autopsies. Analysis also shows the important role of
      physicians in clinics regarding the autopsy rates.

PMID- 8367386
TI  - [Pneumatosis intestinalis--histology, immunocytochemistry and new theory of
      morphogenesis].
AB  - Based on the light microscopical and immunocytochemical findings in two cases of
      pneumatosis intestinalis, a new theory is advanced on the morphogenesis of the
      cysts that can be observed in this disease. The cavities identifiable in both
      cases in the submucosa of the small intestine and of the colon, respectively,
      were partially lined by histiocytes and foreign-body giant cells. Most of the
      lumina found in the subserosa of the stomach, small intestine and colon had an
      identical aspect. In addition, there were numerous true cysts here with a narrow,
      single-layered cells seam, showing the immunocytochemical characteristics of the
      mesothelium, but not the capillary endothelia. Thus, contrary to previous
      assumptions, pneumatosis interstinalis apparently does not develop from cystic
      dilatation of gas-filled lymph vessels that shrink and disappear in the process
      of an inflammatory foreign body reaction. Rather, the disease initially seems to
      manifest itself through gas-filled pseudocysts partially bordered by histiocytes
      and foreign-body giant cells, which become secondarily mesothelialized in the
      subserosa. Lymph vessels would thus not have significance for the morphogenesis
      of this disease.

PMID- 8367387
TI  - [Genetic-morphologic fatal syndromes. Fetal akinesia sequence (Pena-Shokeir
      syndrome I)].

PMID- 8367389
TI  - [Genetic-morphologic fatal syndromes. Bowen-Conradi syndrome].

PMID- 8367388
TI  - [Genetic-morphologic fatal syndromes. Cerebro-oculo-facioskeletal syndrome (Pena
      Shokeir syndrome II)].

PMID- 8367390
TI  - [Tungiasis--a middle European rare skin parasitosis. A case report].

PMID- 8367391
TI  - [Rupture of an echinococcus cyst in the heart septum as a cause of sudden heart
      death].

PMID- 8367393
TI  - Special issue on virus separation and purification methods.

PMID- 8367392
TI  - [Awarded the honorary chair for anatomy in Halle 100 years ago: Carl Joseph
      Eberth--discoverer of the typhus pathogen].

PMID- 8367394
TI  - Purification of viruses by electrophoresis in sucrose concentration gradients.
      1972.
AB  - Zone electrophoresis (ZE) in concentration gradients of sucrose proved to be a
      powerful technique in the purification of viruses although it is seldomly used as
      a single step for the separation of the infective agent from extraneous matter
      but usually as a final procedure. No difficulties were experienced in the
      purification of plant viruses with ZE possibly because of the resistance of the
      agents to the chloroform butanol treatment which the impure plant viruses
      received prior to the ZE. Likewise no difficulties were encountered during
      purification of human and animal picorna viruses because they also are resistant
      to chloroform or chloroform-butanol treatment prior to ZE. Purification of animal
      and possibly human reoviridae ZE as a final step is involved as they are
      associated with or even attached to the host cell membranes which are lipoidal in
      nature. Because the lipoidal material on the virus has an affinity for organic
      solvents the virus particles are caught in the emulsion when an extract of the
      crude virus material is shaken with the organic solvent. With these viruses
      polyethylene glycol M(r) 6000 (PEG) is often helpful as a means of displacing
      most of the host proteins as a step in the partial purification prior to ZE.
      Neurotropic African horse sickness virus which presented many problems to
      overcome was rendered free of extraneous proteins to the extent that electron
      micrographs could be made of it. Neurotropic Rift Valley fever virus was
      similarly difficult to purify as it was always associated with mouse brain
      components. This virus was finally purified from infected mouse blood in which
      the virus particles were not associated with host cell debris and other
      extraneous proteins. Zone electrophoresis experiments were not conducted on
      viruses with large particle sizes e.g. myxoviruses because they could be purified
      without a great deal of effort using polymer displacement, and thin layer
      centrifugation. Zone electrophoresis as a means of final purification was vividly
      displayed with the purification of five viruses of the larvae of the pine emperor
      moth, Nudaurelia cytheria cytheria.

PMID- 8367395
TI  - Tube inserts as aids in preparative ultracentrifugation. 1983.

PMID- 8367396
TI  - Bead centrifuge tube inserts--a semi-quantitative theory. 1984.

PMID- 8367397
TI  - Purification of viruses by centrifugation in gradients of inert substances.
AB  - By using a reorienting gradient centrifuge rotor cut from a block of Nylon and
      fitted with eight septae, it was possible to separate the components of the
      haemolymph of the mollusc Turbo sarmaticus into three fractions in a sucrose
      gradient held in the bowl of the rotor. The fractions were (108 and 98)S, 44S and
      16-22S. The success of the experiment was due to the large differences in the
      sedimentation coefficients of the components. When the rotor was applied to the
      natural mixture of the five viruses of the caterpillars of Nudaurelia cytheria
      only the main component could be isolated in a pure state. The viruses were
      separated by isopycnic centrifugation in "self formed" caesium chloride
      gradients, using a Beckman Model E analytical centrifuge in which a separation
      cell fitted with a centerpiece with two perforated partitions was used.

PMID- 8367398
TI  - Purification and aggregation of influenza virus by precipitation with
      polyethylene glycol. 1974.

PMID- 8367399
TI  - Isolation of a cytoplasmic polyhedrosis virus by physical and immunological
      techniques. 1975.

PMID- 8367400
TI  - Purification of filamentous plant viruses by thin layer centrifugation (applied
      to TMV, SCMV, PVX, SCV and YMC viruses). 1975.

PMID- 8367401
TI  - Electro-extraction of viruses from infected plant tissue (applied to turnip
      yellow mosaic, tobacco mosaic and maize streak viruses). 1981.

PMID- 8367402
TI  - Purification of potato leaf roll virus.

PMID- 8367403
TI  - Purification of PVYo and its soluble antigen by physico chemical means.
AB  - Potato virus Yo was purified by centrifugation of infected and minced plant
      tissue in the virus extraction rotor. As the initial seeding material was heavily
      contaminated with tobacco mosaic virus (TMV) this virus was isolated and antibody
      was elicited in chickens. The chicken antibody (IgY) against TMV was used for
      removing this extraneous virus from the original PVYo seeding material prior to
      propagating PVYo in tobacco plants, CV Glutinosa.

PMID- 8367404
TI  - Isolation of viruses by electro-extraction of infected plants. 1977.

PMID- 8367405
TI  - Preparative immunoabsorption electrophoresis. 1978.

PMID- 8367407
TI  - Concentration of solutes by freezing and centrifugation.

PMID- 8367406
TI  - An insert for the reorienting gradient rotor for virus extraction from infected
      plants. 1979.

PMID- 8367408
TI  - The sedimenting-droplet procedure for measuring fluid densities. 1980.

PMID- 8367409
TI  - Determination of the number of Fab1 pieces which react with high molecular weight
      antigens. 1982.

PMID- 8367410
TI  - Cytokine networking in the placenta.

PMID- 8367411
TI  - Differential gene expression in the amnion, chorion, and trophoblast of the human
      placenta.
AB  - Human chorionic gonadotrophin (hCG), placental alkaline phosphatase (PLAP), and
      pregnancy-specific glycoprotein (PSG) are three major proteins produced by the
      trophoblast of the human placenta. Immunocytochemical studies suggest that PSG
      and hCG are also present in the human amnion. In this study, we examined whether
      amniotic and chorionic membranes were capable of expressing trophoblastic
      specific genes. As previously reported, trophoblasts express high levels of hCG
      beta, hCG alpha, PLAP, and PSG. Both amnion and chorion were found to express
      PLAP and hCG beta mRNA. However, the hCG alpha transcript was expressed only by
      the amnion, but not by the chorion in the term placenta. Recent molecular cloning
      studies indicate that human PSGs are a group of closely related placental
      proteins that, together with the carcinoembryonic antigen family members,
      comprise a subfamily within the immunoglobulin superfamily. To demonstrate that
      amnion and chorion also express PSG transcripts, we employed ribonuclease
      protection analysis using probes specific to the 5' and 3' region of PSG mRNAs.
      Our data indicate that while amniotic as well as chorionic membrane expressed low
      levels of the PSG genes, only a certain subpopulation of PSG transcripts were
      expressed. Furthermore, the amnion and chorion demonstrated differences in PSG
      species expression from each other and from trophoblastic tissue. Thus, human
      amnion, chorion and trophoblast selectively express several placental genes.

PMID- 8367412
TI  - Differences in binding characteristics of rat and human transferrin by rat
      visceral yolk sac placenta.
AB  - Previous work has shown that human serum supplemented with rat transferrin can
      support the normal growth of cultured rat conceptuses, but that supplementation
      with human transferrin has no such effect. Such results strongly suggest an
      hypothesis of species-specificity. This potential specificity was therefore
      investigated by comparing uptake, binding, competition and vectorial transport of
      both rat and human transferrin using two well-established systems, those of 17.5
      day rat visceral yolk sacs and anembryonic yolk sacs in culture. The results of
      these investigations show that human transferrin displays a lower rate of uptake
      and lower binding affinity for the rat transferrin receptor than does rat
      transferrin. Human transferrin competes poorly with rat transferrin for receptor
      occupancy unless present in 20-fold excess. Both molecules are taken up by
      receptor-mediated endocytosis and are processed in a similar manner. Anembryonic
      yolk sac experiments show that a greater proportion of intact rat transferrin is
      transported to the exocoelomic fluid than is intact human transferrin. Binding
      analyses show a difference in binding affinities of the two molecules for the rat
      transferrin receptor and also that human transferrin exhibits negative
      cooperativity in its binding. This evidence strongly supports an hypothesis of
      species-specificity in the binding of transferrin to the transferrin receptor in
      the rat visceral yolk sac.

PMID- 8367413
TI  - Respiratory control induced by ATP in human term placental mitochondria.
AB  - Oxygen uptake in human placental mitochondria was stimulated by ATP addition. ATP
      induced respiration was supported by malate, alpha-keto glutarate, and succinate,
      and inhibited by oligomycin and carboxytractyloside. This phenomenon was not
      caused by contamination with unspecific phosphatases or alkaline phosphatase,
      since NaF, L-phenyl alanine, or P1, P5-di-(adenosine-5') pentaphosphate failed to
      inhibit oxygen uptake induced by ATP. The stimulation of respiration was caused
      by an ATPase activity tightly bound to mitochondria, which yields ADP that is
      responsible for the oxygen uptake. The stimulation was not an uncoupling effect
      because ATP addition produced a transition between state 3 and 4 of respiration,
      indicating that ATP was not released from mitochondria.

PMID- 8367415
TI  - Short report: cytokine production by human fetal membranes and uterine decidua at
      term gestation in relation to labour.

PMID- 8367416
TI  - [Screening for breast cancer. Achievements and controversies].

PMID- 8367414
TI  - Effect of exogenous arachidonic acid and enzyme inhibitors on placental
      prostanoid production.
AB  - Prostanoids play an important role throughout 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 rate-limiting steps regulating their
      biosynthesis. In these studies, the effect of exogenous arachidonic acid and of
      enzyme inhibitors on the release of placental prostanoids was investigated. Basal
      prostaglandin E (PGE), prostaglandin F (PGF), thromboxane (TxB2) and 6-keto
      prostaglandin F1 alpha (6-keto-PGF1 alpha) increased from the fifth hour in
      culture, yet the increased PGF release did not result in further 13,14-dihydro-15
      keto-PGF2 alpha (PGFM) production. Addition of varying doses of arachidonic acid
      (0.2-10 micrograms/ml) had no significant effect on PGFM, TxB2 or 6-keto-PGF1
      alpha, although the endogenous arachidonate was similar to or much less than the
      doses studied. Only at the 10 micrograms/ml dose was a delayed increase of PGE
      and PGF observed. Incubation with indomethacin resulted in an immediate
      inhibition of PGE, PGF, TxB2 and 6-keto-PGF1 alpha, with a delayed inhibition of
      PGFM. The phospholipase A2 inhibitor, quinacrine (10 microM), had no significant
      effect on PGE, PGFM, TxB2 or 6-keto-PGF1 alpha. PGF was inhibited within the
      first hour of quinacrine exposure, but no significant inhibition was observed
      thereafter. Ca2+ chelator, EDTA, effected an inhibition of only 6-keto-PGF1
      alpha. Nordihydroguaiaretic acid, a leukotriene inhibitor, reduced PGE release as
      well as 6-keto-PGF1 alpha. These data demonstrate the high biosynthetic
      competence of the human term placenta to produce prostanoids. This capacity does
      not appear to be rate-limited by arachidonic acid availability. However, the
      metabolism of PGF to PGFM appears to be saturated. In addition, the production of
      placenta prostacyclin may be affected by Ca2+ levels, as chelating agent
      inhibited the release of 6-keto-PGF1 alpha.

PMID- 8367417
TI  - [Transplantation of reduced-size livers in children].
AB  - Nowadays, liver reduction techniques make it possible to use livers obtained from
      adults or adolescents for implantation in children. These techniques have been
      evaluated by analysis of 100 liver transplantations performed between January
      1988 and October 1991 in 85 children. Forty-six full-size grafts implanted in 38
      children (group 1) were compared with 54 reduced-size grafts implanted in 47
      children (group 2). The overall actuarial survival at 4 years was 86 percent.
      There was no statistical significant difference between the two groups as regards
      the rates of death (8 versus 19 percent), reoperation (54 versus 64 percent),
      retransplantation (15 versus 16 percent), hepatic artery thrombosis (13 versus 15
      percent) and graft survival (82 versus 70 percent) respectively. Haemorrhage was
      significantly more frequent in group 1 than in group 2 (P = 0.04), irrespective
      of whether transplantation was performed urgently or electively. Using reduced
      size livers considerably increases the number of liver grafts available to
      children. Apart from a greater risk of haemorrhage, the results obtained with
      reduced-size livers were identical with those obtained with full-size livers.

PMID- 8367418
TI  - [Buerger disease, clinical and prognostic aspects. 83 cases].
AB  - A retrospective analysis of 83 records of patients with Buerger's disease is
      presented. There were 71 men and 12 (14.5 percent) women. Compared with men,
      women with Buerger's disease had a significantly more frequent vasomotor
      disorder, but they had less trophic disorders and a lower risk of amputation.
      After a 42-month follow-up, it appeared that tobacco plays a major role in the
      prognosis: patients who continued to smoke had significantly more numerous acute
      episodes than those who ceased smoking. The degree of intoxication is an element
      of prognosis, but good medical management contributes to reduction in the number
      of major amputations: only 5 patients (6 percent), all male, had a leg (4 cases)
      or a thigh (1 case) amputated.

PMID- 8367420
TI  - [Treatments by local injections of botulinum toxin in neurology. Indications and
      results].
AB  - Local injections of botulinum toxin constitute the only truly effective treatment
      of certain abnormal movements and focal dystonias. The authors describe its
      indications and report on their personal experience. One hundred and seventeen
      patients were treated: 48 for blepharospasm, 46 for hemifacial spasm and 23 for
      spasmodic torticollis. The results were evaluated by means of a score taking into
      account the effectiveness of treatment, the duration of this effectiveness, the
      side-effects, if any, observed, and the course of the neurological disorder after
      several series of injections. The results were good or excellent in 91 percent of
      patients with hemifacial spasm and 79 percent of patients with blepharospasm.
      Spasmodic torticollis was much improved in 35 percent of the cases and less, but
      satisfactorily, improved in 48 percent. In this disease, the muscles which
      antagonize those responsible for the dystonia must absolutely be re-educated.

PMID- 8367419
TI  - [Natural history of duodenal ulcer].
AB  - The authors have studied the natural history of duodenal ulcer from published
      data, in an attempt to determine precisely the evolutive potential of this
      disease both spontaneously and during its treatment. They deal successively with
      the risk of complication and the short- or long-term influence of medical and
      surgical treatment on the occurrence of exacerbations and complications. The role
      played by Helicobacter pylori in healing of the ulcer and in the long-term course
      of the ulcerous disease, as well as the problems concerning its duration and
      mortality, are discussed. The data clearly show that the medical and surgical
      treatment of duodenal ulcer can slow down, at least temporarily, the course of
      the disease. Other studies are needed before drawing firm conclusions concerning
      the relationship between H. pylori and duodenal ulcer, even though numerous
      studies seem to have demonstrated that eradication of this micro-organism is
      associated with a substantial decrease in the risk of recurrent ulcer.

PMID- 8367421
TI  - [Cystic dystrophy and aberrant pancreas treated by gastroenterostomy].

PMID- 8367423
TI  - [Diagnosis of leptospirosis, contribution of hemoculture. 11 cases].

PMID- 8367422
TI  - [Immunologic changes in Steinert disease].

PMID- 8367424
TI  - [Thrombopenia following treatment with omeprazole].

PMID- 8367425
TI  - [Partial kinetic motor seizures in a 59-year-old man. A rare manifestation of
      diabetes].

PMID- 8367426
TI  - [Cerebrovascular complications related to mitral stenosis].

PMID- 8367427
TI  - [Disseminated anguilluliasis in HIV infection. A new case].

PMID- 8367428
TI  - [Visceral leishmaniasis. Parasitological diagnosis by leukocyte concentration].

PMID- 8367429
TI  - [Diagnosis of orthostatic hypotension. Value of the head-up tilt test. 110
      cases].

PMID- 8367430
TI  - [Incidence of primary respiratory lesions in the course of severe burns].

PMID- 8367431
TI  - [Human polyvalent immunoglobulins: what is their value in thrombopenia in the
      course of leptospirosis?].

PMID- 8367432
TI  - [Pancreatic somatostatinoma. A new case].

PMID- 8367433
TI  - [Disseminated pneumocystosis. 3 cases in HIV seropositive patients].

PMID- 8367434
TI  - [Improvement of lipid parameters in patients with heart transplantation after
      withdrawal of prednisolone].

PMID- 8367435
TI  - [Munchausen syndrome: mimicking HIV infection].

PMID- 8367437
TI  - [Role of peripheral vascular angioplasty].

PMID- 8367436
TI  - [Strategy of vaccination against hepatitis A].

PMID- 8367438
TI  - [Intracranial cavernoma. 30 cases].
AB  - During the last few years, as a result of improved neurodiagnostic procedure
      there has been an increase in the number of intracranial cavernous angioma. We
      present 30 cases totalling 32 cavernous angiomas. Twenty-one received a
      successful surgical treatment. Twenty-four angiomas were supratentorial (75
      percent) and 8 subtentorial (25 percent). Cavernous angiomas are congenital
      vascular malformations, usually of small size, with multiple vascular cavities
      surrounded by fibrous walls. They are often found in young adults (mean age 35
      years in our series), most frequently located in the supratentorial white matter.
      The presenting symptoms were epilepsy, haemorrhage and an expanding mass
      syndrome. In this series, 16 patients had epilepsy (53 percent), 7 had
      haemorrhage (23.5 percent) and 7 had a mass syndrome (23.5 percent). The
      diagnosis of this lesion, usually obtained with angiography, has been
      dramatically improved by CT scan and, particularly, MRI. The natural history of
      cavernous angiomas is still poorly understood: the major complication is
      haemorrhage. Total surgical excision is the treatment of choice: it avoids a
      possible haemorrhage and is effective in relieving epileptic seizures. The
      indication for surgery depends on the clinical symptom and the location of the
      lesion. The post-operative morbidity in our 21 operated cases was fairly low due
      to minor sequelae. In only 2 of the 16 patients who had epilepsy the clinical
      seizures persisted after surgery, but they were less frequent. The literature is
      reviewed.

PMID- 8367439
TI  - [Acute aseptic arthritis in major sickle cell syndromes].
AB  - We report 9 cases of febrile aseptic arthritis which occurred in 6 adults
      presenting with major sickle cell disease. The monoarticular arthritis affected
      the knee in 8 cases and the ankle in 1 case. Body temperature ranged from 38
      degrees C to 39.5 degrees C in 7 cases, and neutrophilia (12.7 to 24 x 10(9)/l)
      was noted on six occasions. The always sterile synovial fluid contained 100 to
      1700 cells/mm3 in 6 cases and 5200 to 12,500 cell/mm3 in 3 cases. Uricacidaemia
      was normal, and a search for crystals in the synovial fluid gave negative
      results. Bone scintigraphy and magnetic resonance imaging, performed in 3
      patients, revealed the presence of a juxta-articular cortical bone infarct,
      whereas standard radiography was normal. In all patients, a brief immobilization
      and treatment with non-steroidal anti-inflammatory drugs resulted in complete
      cure in less than 10 days. These cases illustrate the characteristics of sickle
      cell arthritis, a rare complication of major sickle cell disease. Clinically, the
      condition resembles septic arthritis, being febrile and showing granulocytosis,
      but articular needle aspiration corrects the diagnosis. The mechanisms underlying
      these disorders have not yet been elucidated, but the bone scintigraphy and MRI
      performed in our patients are in favour of a reaction to a juxta-articular bone
      infarct.

PMID- 8367440
TI  - [Cardiac toxicity of anthracyclines. Clinical forms, incidence, surveillance].
AB  - Anthracyclines have greatly contributed to improvement in the prognosis of
      certain cancers, but their beneficial effect is impaired by an unquestionable
      toxicity affecting notably the heart. Changes in blood pressure or
      electrocardiograms, benign pericardial reactions and rare but severe myocarditis
      may occur at an early stage of treatment. The cumulative toxicity of
      anthracyclines limits their use. With a cumulative dose of 550 mg/m2 the mean
      incidence of toxicity varies from 5 to 10 percent. The occurrence of toxicity
      largely depends on the total dose, but other factors such as patient's age and
      general condition, and previous treatments with chemo- or radiotherapy must be
      taken into account. The best methods to monitor the cardiotoxicity of
      anthracyclines are echocardiography, radionuclide study of ejection fraction and
      myocardial biopsy for histological study. The rational use of these three types
      of examination must be adjusted to each individual patient. It should reduce the
      incidence of severe myocarditis which sometimes cancels all the beneficial
      effects of the anticancer treatment.

PMID- 8367441
TI  - YAC transgenes: bigger is probably better.

PMID- 8367442
TI  - Connections between the immune system and the nervous system.

PMID- 8367444
TI  - In vivo transcriptional pausing and cap formation on three Drosophila heat shock
      genes.
AB  - The regulation of many eukaryotic genes occurs at the level of transcriptional
      elongation. On the uninduced hsp70 gene of Drosophila melanogaster, for example,
      an RNA polymerase II complex has initiated transcription but has paused early in
      elongation. In this study, we examine pausing on hsp70 and two of the small heat
      shock genes (hsp27 and hsp26) at high resolution, using a technique that utilizes
      paramagnetic particle-mediated selection of terminated run-on transcripts. This
      technique provides precise information on the distribution of RNA polymerase
      within each transcription unit. It also details the progression of 5' cap
      formation on the elongating transcripts. For each gene, we find polymerases
      paused over a relatively narrow promoter-proximal region. The regions are
      generally around 20 nucleotides wide, with two preferred pausing positions spaced
      roughly 10 nucleotides apart or about one turn of the helix. The bulk of capping
      occurs as transcripts pass between 20 and 30 nucleotides in length.
      Interestingly, in the three genes examined here, elongational pausing and 5' cap
      formation appear largely coincident.

PMID- 8367445
TI  - Mutations of von Willebrand factor gene in families with von Willebrand disease
      in the Aland Islands.
AB  - Patients with von Willebrand disease in four families in the Aland Islands,
      including the original family that was described in 1926 by the Finnish physician
      von Willebrand, were screened for mutations in the Swedish "hot-spot" regions
      (exons 18, 28, 32, 43, and 45) of the von Willebrand factor gene. One cytosine
      deletion in exon 18 was detected in each of these families. Linkage analysis and
      genealogical studies suggest that the deletion present in these four families
      probably has an origin in common with the mutations in the Swedish patients.
      Apart from the deletion in exon 18, two close transitions (G-->A at S1263 and C-
      >T at P1266) in exon 28 on the same chromosome were identified in one individual
      who married into the original family and in his two children. The transitions
      could be due to a recombination between the von Willebrand factor gene and its
      pseudogene.

PMID- 8367443
TI  - Oxidants, antioxidants, and the degenerative diseases of aging.
AB  - Metabolism, like other aspects of life, involves tradeoffs. Oxidant by-products
      of normal metabolism cause extensive damage to DNA, protein, and lipid. We argue
      that this damage (the same as that produced by radiation) is a major contributor
      to aging and to degenerative diseases of aging such as cancer, cardiovascular
      disease, immune-system decline, brain dysfunction, and cataracts. Antioxidant
      defenses against this damage include ascorbate, tocopherol, and carotenoids.
      Dietary fruits and vegetables are the principal source of ascorbate and
      carotenoids and are one source of tocopherol. Low dietary intake of fruits and
      vegetables doubles the risk of most types of cancer as compared to high intake
      and also markedly increases the risk of heart disease and cataracts. Since only
      9% of Americans eat the recommended five servings of fruits and vegetables per
      day, the opportunity for improving health by improving diet is great.

PMID- 8367446
TI  - Apoptosis is induced by beta-amyloid in cultured central nervous system neurons.
AB  - The molecular mechanism responsible for the neurodegeneration in Alzheimer
      disease is not known; however, accumulating evidence suggests that beta-amyloid
      peptide (A beta P) contributes to this degeneration. We now report that synthetic
      A beta Ps trigger the degeneration of cultured neurons through activation of an
      apoptotic pathway. Neurons treated with A beta Ps exhibit morphological and
      biochemical characteristics of apoptosis, including membrane blebbing, compaction
      of nuclear chromatin, and internucleosomal DNA fragmentation. Aurintricarboxylic
      acid, an inhibitor of nucleases, prevents DNA fragmentation and delays cell
      death. Our in vitro results suggest that apoptosis may play a role in the
      neuronal loss associated with Alzheimer disease.

PMID- 8367447
TI  - Development of polyclonal antibodies against angiotensin type 2 receptors.
AB  - Murine neuroblastoma N1E-115 cells are a useful system in which to study neuronal
      angiotensin II (AngII) receptors. N1E-115 cells possess both type 1 (AT1) and
      type 2 (AT2) AngII receptor subtypes, as does mammalian brain. AT2 receptors in
      brain or N1E-115 cells can be solubilized in 3-[(3
      cholamidopropyl)dimethylammonio]-1-propanesulfonate. In the present study,
      heparin-Sepharose chromatography was used to partially purify solubilized N1E-115
      membranes to produce an enriched population of AT2 receptors. Subsequently, an
      eluted peak, containing the majority of AT2 binding activity, was used as an
      immunogen in the development of protein-directed polyclonal antibodies. The
      antibodies specifically detected immunoreactive proteins of approximately 110 and
      66 kDa in both solubilized N1E-115 cells, as well as the original protein
      material that eluted from the heparin-Sepharose column, whereas no such
      immunoreactivity was detected in a kidney epithelial cell line that lacks any
      specific 125I-labeled AngII (125I-AngII) binding activity. Moreover, the
      antibodies immunoreacted with affinity-purified AT2 receptors. These antibodies
      were also able to immunoprecipitate AT2 receptors from solubilized N1E-115 cells,
      as revealed by the pharmacologic profile of 125I-AngII binding to the
      precipitated protein. Similarly, the antibodies were able to immunoprecipitate a
      66-kDa protein that had been covalently crosslinked with 125I-AngII by use of the
      homobifunctional crosslinker dithiobis(succinimidyl propionate). Collectively,
      these results demonstrate the development of a specific AT2 receptor antibody
      that may be used to further characterize this receptor subtype at both the
      cellular and molecular levels.

PMID- 8367448
TI  - Nerve growth factor suppresses the transforming phenotype of human prolactinomas.
AB  - The most effective therapy of human prolactinomas is represented by dopamine D-2
      receptor agonists; there is, however, a population of nonresponder patients who
      require surgical intervention. In the present study, we report that prolactinomas
      totally resistant to pharmacological therapy have a high potential of both
      growing in soft agar and forming tumors in nude mice and lack D-2 receptors for
      dopamine. These tumors express the receptors for nerve growth factor (NGF) and
      are sensitive to its differentiating activity. After exposure to NGF for 4 days,
      prolactinoma cells decreased their proliferation rate, lost their capability to
      form colonies in soft agar, lost their tumorigenic activity in nude mice, and
      reexpressed the lactotroph-specific D-2 receptor protein inhibiting prolactin
      release. These effects were permanent after NGF withdrawal and were reproducible
      in vivo in nude mice transplanted with the tumors. NGF in fact remarkably and
      lastingly depressed tumor growth and induced expression of D-2 receptors when
      injected intravenously once a day for 5 days into prolactinoma-bearing nude mice.
      These data suggest that NGF may induce a long-lasting switch of gene expression
      in human prolactinomas, modifying their transforming phenotype and reverting them
      to more differentiated, less malignant, dopamine-sensitive lactotroph-like cells.
      The possibility thus arises that short-term treatment with NGF may restore the
      refractory patients to conventional pharmacological therapy with D-2 agonists.

PMID- 8367449
TI  - Profound decrement of mesolimbic dopaminergic neuronal activity during ethanol
      withdrawal syndrome in rats: electrophysiological and biochemical evidence.
AB  - Activity of the mesolimbic dopaminergic system was investigated in rats withdrawn
      from chronic ethanol administration by single-cell extracellular recordings from
      dopaminergic neurons of the ventrotegmental area, coupled with antidromic
      identification from the nucleus accumbens, and by microdialysis-technique
      experiments in the nucleus accumbens. Spontaneous firing rates, spikes per burst,
      and absolute burst firing but not the number of spontaneously active neurons were
      found drastically reduced; whereas absolute and relative refractory periods
      increased in rats withdrawn from chronic ethanol treatment as compared with
      chronic saline-treated controls. Consistently, dopamine outflow in the nucleus
      accumbens and its acid metabolites were reduced after abruptly stopping chronic
      ethanol administration. All these changes, as well as ethanol-withdrawal
      behavioral signs, were reversed by ethanol administration. This reversal suggests
      that the abrupt cessation of chronic ethanol administration plays a causal role
      in the reduction of mesolimbic dopaminergic activity seen in the ethanol
      withdrawal syndrome. Results indicate that during the ethanol-withdrawal syndrome
      the mesolimbic dopaminergic system is tonically reduced in activity, as indexed
      by electrophysiological and biochemical criteria. Considering the role of the
      mesolimbic dopaminergic system in the reinforcing properties of ethanol, the
      depressed activity of this system during the ethanol-withdrawal syndrome may be
      relevant to the dysphoric state associated with ethanol withdrawal in humans.

PMID- 8367450
TI  - Reaction sequence and molecular mass of a Cl(-)-translocating P-type ATPase.
AB  - The basolateral membranes of Aplysia californica foregut absorptive cells contain
      both Cl(-)-stimulated ATPase and ATP-dependent Cl- transport activities, and each
      was inhibited by orthovanadate. Both of these orthovanadate-sensitive activities
      were reconstituted into proteoliposomes. The reaction sequence kinetics were
      determined by [gamma-32P]ATP-induced phosphorylation of the reconstituted Cl-
      pump. Rapid phosphorylation and dephosphorylation kinetics of acyl phosphate
      bonding were confirmed by destabilization of the phosphoprotein by either
      hydroxylamine or high pH. Mg2+ caused phosphorylation of the enzyme; Cl- caused
      dephosphorylation. Orthovanadate almost completely inhibited the Mg(2+)-driven
      phosphorylation reaction. The molecular mass of the catalytic unit (subunit) of
      the enzyme appeared to be 110 kDa, which is in agreement with molecular masses of
      all other catalytic units (subunits) of P-type ATPases.

PMID- 8367451
TI  - Energy transduction in the thermophilic anaerobic bacterium Clostridium fervidus
      is exclusively coupled to sodium ions.
AB  - The thermophilic, peptidolytic, anaerobic bacterium Clostridium fervidus is
      unable to generate a pH gradient in the range of 5.5-8.0, which limits growth of
      the organism to a narrow pH range (6.3-7.7). A significant membrane potential
      (delta psi approximately -60 mV) and chemical gradient of Na+ (-Z delta pNa
      approximately -60 mV) are formed in the presence of metabolizable substrates.
      Energy-dependent Na+ efflux is inhibited by the Na+/H+ ionophore monensin but is
      stimulated by uncouplers, suggesting that the Na+ gradient is formed by a primary
      pumping mechanism rather than by secondary Na+/H+ antiport. This primary sodium
      pump was found to be an ATPase that has been characterized in inside-out membrane
      vesicles and in proteoliposomes in which solubilized ATPase was reconstituted.
      The enzyme is stimulated by Na+, resistant to vanadate, and sensitive to nitrate,
      which is indicative of an F/V-type Na(+)-ATPase. In the proteoliposomes Na+
      accumulation depends on the presence of ATP, is inhibited by the ATPase inhibitor
      nitrate, and is completely prevented by the ionophore monensin but is stimulated
      by protonophores and valinomycin. These and previous observations, which
      indicated that secondary amino acid transport uses solely Na+ as coupling ion,
      demonstrate that energy transduction at the membrane in C. fervidus is
      exclusively dependent on a Na+ cycle.

PMID- 8367452
TI  - RAD9-dependent G1 arrest defines a second checkpoint for damaged DNA in the cell
      cycle of Saccharomyces cerevisiae.
AB  - Exposure of the yeast Saccharomyces cerevisiae to ultraviolet (UV) light, the UV
      mimetic chemical 4-nitroquinoline-1-oxide (4NQO), or gamma radiation after
      release from G1 arrest induced by alpha factor results in delayed resumption of
      the cell cycle. As is the case with G2 arrest following ionizing radiation damage
      [Weinert, T. A. & Hartwell, L. H. (1988) Science 241, 317-322], the normal
      execution of DNA damage-induced G1 arrest depends on a functional yeast RAD9
      gene. We suggest that the RAD9 gene product may interact with cellular components
      common to the G1/S and G2/M transition points in the cell cycle of this yeast.
      These observations define a checkpoint in the eukaryotic cell cycle that may
      facilitate the repair of lesions that are otherwise processed to lethal and/or
      mutagenic damage during DNA replication. This checkpoint apparently operates
      after the mating pheromone-induced G1 arrest point but prior to replicative DNA
      synthesis, S phase-associated maximal induction of histone H2A mRNA, and bud
      emergence.

PMID- 8367454
TI  - Secretion of a single-gene-encoded immunoglobulin from myeloma cells.
AB  - We describe construction of a single gene encoding a single-chain immunoglobulin
      like molecule. This single-gene approach circumvents inefficiencies inherent in
      delivering two genes into a mammalian cell and in the assembly of a functional
      immunoglobulin molecule. It would also facilitate ex vivo transfection of cells
      for gene-therapy protocols. SP2/0 murine myeloma cells transfected with the
      single gene SG delta CLCH1 expressed a single-chain protein, SC delta CLCH1,
      comprising approximately 60 kDa of the anti-carcinoma monoclonal antibody (mAb)
      CC49. The single-chain protein consisted of the heavy- and light-chain variable
      (VH and VL) domains of the mAb covalently joined through a short linker peptide,
      while the carboxyl end of the VL domain was linked to the amino terminus of the
      human gamma 1 Fc region through the hinge region. The single-chain protein
      assembled into a dimeric molecule, termed SCA delta CLCH1, of approximately 120
      kDa and was secreted into the tissue culture fluid. SDS/PAGE analysis of the
      secreted immunoglobulin purified by protein G affinity chromatography confirmed
      the size of the molecule. The native mAb CC49 and SCA delta CLCH1 of CC49 showed
      similar binding to the tumor-associated glycoprotein TAG-72, and the chimeric mAb
      CC49 and SCA delta CLCH1 showed similar cytotoxic activity. This single-gene
      construct approach provides a way of generating an immunoglobulin-like molecule
      which retains the specificity, binding properties, and cytolytic activity of the
      chimeric mAb CC49. The immunoglobulin-like molecule SCA delta CLCH1 is
      potentially a therapeutic and diagnostic reagent against a range of human
      carcinomas.

PMID- 8367453
TI  - Myelin/oligodendrocyte glycoprotein is a member of a subset of the immunoglobulin
      superfamily encoded within the major histocompatibility complex.
AB  - Myelin/oligodendrocyte glycoprotein (MOG) is found on the surface of myelinating
      oligodendrocytes and external lamellae of myelin sheaths in the central nervous
      system, and it is a target antigen in experimental autoimmune encephalomyelitis
      and multiple sclerosis. We have isolated bovine, mouse, and rat MOG cDNA clones
      and shown that the developmental pattern of MOG expression in the rat central
      nervous system coincides with the late stages of myelination. The amino-terminal,
      extracellular domain of MOG has characteristics of an immunoglobulin variable
      domain and is 46% and 41% identical with the amino terminus of bovine
      butyrophilin (expressed in the lactating mammary gland) and B-G antigens of the
      chicken major histocompatibility complex (MHC), respectively; these proteins thus
      form a subset of the immunoglobulin superfamily. The homology between MOG and B-G
      extends beyond their structure and genetic mapping to their ability to induce
      strong antibody responses and has implications for the role of MOG in
      pathological, autoimmune conditions. We colocalized the MOG and BT genes to the
      human MHC on chromosome 6p21.3-p22. The mouse MOG gene was mapped to the
      homologous band C of chromosome 17, within the M region of the mouse MHC.

PMID- 8367456
TI  - The primary structure of a fungal chitin deacetylase reveals the function for two
      bacterial gene products.
AB  - Chitin deacetylase (EC 3.5.1.41) hydrolyzes the N-acetamido groups of N-acetyl-D
      glucosamine residues in chitin. A cDNA to the Mucor rouxii mRNA encoding chitin
      deacetylase was isolated, characterized, and sequenced. Protein sequence
      comparisons revealed significant similarities of the fungal chitin deacetylase to
      rhizobial nodB proteins and to an uncharacterized protein encoded by a Bacillus
      stearothermophilus open reading frame. These data suggest the functional homology
      of these evolutionarily distant proteins. NodB is a chitooligosaccharide
      deacetylase essential for the biosynthesis of the bacterial nodulation signals,
      termed Nod factors. The observed similarity of chitin deacetylase to the B.
      stearothermophilus gene product suggests that this gene encodes a polysaccharide
      deacetylase.

PMID- 8367455
TI  - Inhibition of human immunodeficiency virus type 1 replication by regulated
      expression of a polymeric Tat activation response RNA decoy as a strategy for
      gene therapy in AIDS.
AB  - We are investigating a strategy for somatic gene therapy to treat human
      immunodeficiency virus type 1 (HIV-1) infection by intracellular expression of an
      RNA decoy and a ribozyme. The RNA decoy, consisting of polymeric Tat activation
      response elements (TARs), is designed to compete for Tat binding in an
      equilibrium with viral TAR RNA, thereby inhibiting viral replication. The
      expression of polymeric TAR is regulated by the HIV long terminal repeat (LTR)
      and transcriptional activation is dependent on the presence of HIV Tat. Our
      initial studies indicated that plasmids expressing up to 50 tandem copies of TAR
      RNA (50TAR) inhibited tat-mediated gene expression by > 90% in a transient
      transfection assay. A HIV LTR-driven 50TAR construct was subcloned into a
      replication-defective retroviral vector to ensure high-efficiency gene transfer
      into T lymphocytes. In addition, a gag RNA-specific ribozyme gene was introduced
      into the 50TAR containing retroviral vector to enhance the inhibitory effect of
      the construct (designated TAR-Rib). A human T-cell line (Molt3) was infected
      (transduced) with the TAR-Rib recombinant retrovirus and challenged with either
      HIV-1 or simian immunodeficiency virus (SIV). HIV-1 replication was inhibited by
      99% in the TAR-Rib-transduced T cells and was maintained over a 14-month period,
      suggesting that this antiviral strategy represses the formation of escape
      mutants. Interestingly, the TAR-Rib also inhibited SIV replication in transduced
      T cells, which suggests that polymeric TAR is a general inhibitor of primate
      lentiviruses; therefore, the macaque model could be used for further in vivo
      testing of this antiviral gene therapy strategy.

PMID- 8367457
TI  - Selective proteolytic activity of the antitumor agent kedarcidin.
AB  - Kedarcidin is a potent antitumor antibiotic chromoprotein, composed of an
      enediyne-containing chromophore embedded in a highly acidic single chain
      polypeptide. The chromophore was shown to cleave duplex DNA site-specifically in
      a single-stranded manner. Herein, we report that in vitro, the kedarcidin
      apoprotein, which lacks any detectable chromophore, cleaves proteins selectively.
      Histones that are the most opposite in net charge to the apoprotein are cleaved
      most readily. Our findings imply that the potency of kedarcidin results from the
      combination of a DNA damaging-chromophore and a protease-like apoprotein.

PMID- 8367458
TI  - Yeast and mammalian metallothioneins functionally substitute for yeast copper
      zinc superoxide dismutase.
AB  - Copper-zinc superoxide dismutase catalyzes the disproportionation of superoxide
      anion to hydrogen peroxide and dioxygen and is thought to play an important role
      in protecting cells from oxygen toxicity. Saccharomyces cerevisiae strains
      lacking copper-zinc superoxide dismutase, which is encoded by the SOD1 gene, are
      sensitive to oxidative stress and exhibit a variety of growth defects including
      hypersensitivity to dioxygen and to superoxide-generating drugs such as paraquat.
      We have found that in addition to these known phenotypes, SOD1-deletion strains
      fail to grow on agar containing the respiratory carbon source lactate. We
      demonstrate here that expression of the yeast or monkey metallothionein proteins
      in the presence of copper suppresses the lactate growth defect and some other
      phenotypes associated with SOD1-deletion strains, indicating that copper
      metallothioneins substitute for copper-zinc superoxide dismutase in vivo to
      protect cells from oxygen toxicity. Consistent with these results, we show that
      yeast metallothionein mRNA levels are dramatically elevated under conditions of
      oxidative stress. Furthermore, in vitro assays demonstrate that yeast
      metallothionein, purified or from whole-cell extracts, exhibits copper-dependent
      antioxidant activity. Taken together, these data suggest that both yeast and
      mammalian metallothioneins may play a direct role in the cellular defense against
      oxidative stress by functioning as antioxidants.

PMID- 8367459
TI  - A possible role for the yeast TATA-element-binding protein in DNA replication.
AB  - The TATA-element-binding protein (TBP) is involved in the initiation of
      transcription by all three eukaryotic RNA polymerases. The following observations
      implicate TBP in the initiation of DNA replication at yeast chromosomal origins
      as well: (i) Recombinant yeast TBP binds specifically to functionally important
      regions of many yeast replication origins in vitro. (ii) TBP-binding sites from
      RNA polymerase II promoters can activate defective replication origins in vivo.
      (iii) Point mutations in TBP-binding sites that diminish their affinity for TBP
      in vitro reduce their ability to support replication in vivo.

PMID- 8367460
TI  - Sodium azide mutagenesis: preferential generation of A.T-->G.C transitions in the
      barley Ant18 gene.
AB  - The molecular basis for the absence of anthocyanins and proanthocyanidins in four
      independent sodium azide-induced ant18 mutants of barley was examined by
      sequencing the gene encoding dihydroflavonol 4-reductase in these mutants. Sodium
      azide generated 21 base substitutions, which corresponds to 0.17% of the 12,704
      nucleotides sequenced. Of the substitutions, 86% were nucleotide transitions, and
      14% were transversions. A.T-->G.C base pair transitions were about 3 times more
      frequent than G.C-->A.T transitions. No deletions or mutation hot spots were
      found. The absence of dihydroflavonol 4-reductase activity in ant18-159, ant18
      162, and ant18-164 plants is caused by missense mutations in the respective
      genes. By using microprojectile bombardment, a plasmid harboring the wild-type
      Ant18 gene was introduced into ant18-161 mutant cells and resulted in the
      development of anthocyanin pigmentation, which demonstrates that the mutation is
      corrected by expression of the introduced gene. On the other hand, a plasmid
      derivative with the two ant18-161-specific base transitions at the 5' splice site
      of intron 3 prevented complementation. It is concluded that the absence of
      detectable mRNA for dihydroflavonol 4-reductase in ant18-161 cells is due to the
      mutations in the pre-mRNA splice donor site.

PMID- 8367461
TI  - Molecular basis for the inhibition of human alpha-thrombin by the macrocyclic
      peptide cyclotheonamide A.
AB  - The macrocyclic peptide cyclotheonamide A (CtA), isolated from the marine sponge
      Theonella sp., represents an unusual class of serine protease inhibitor. A
      complex of this inhibitor with human alpha-thrombin, a protease central to the
      bioregulation of thrombosis and hemostasis, was studied by x-ray crystallography.
      This work (2.3-A resolution) confirms the structure of CtA and reveals intimate
      details about its molecular recognition within the enzyme active site.
      Interactions due to the "Pro-Arg motif" (Arg occupancy of the S1 specificity
      pocket; formation of a hydrogen-bonded two-strand antiparallel beta-sheet with
      Ser214-Gly216) and the alpha-keto amide group of CtA are primarily responsible
      for binding to thrombin, with the alpha-keto amide serving as a transition-state
      analogue. A special interaction with the "insertion loop" of thrombin (Tyr60A
      Thr60I) is manifested through engagement of the hydroxyphenyl group of CtA with
      Trp60D as part of an "aromatic stacking chain." Biochemical inhibition data (Ki
      values at 37 degrees C) were obtained for CtA with thrombin and a diverse
      collection of serine proteases. Thus, CtA is just a moderate inhibitor of human
      alpha-thrombin (Ki = 0.18 microM) but a potent inhibitor of trypsin (Ki = 0.023
      microM) and streptokinase (Ki = 0.035 microM). The relative lack of potency of
      CtA as a thrombin inhibitor is discussed with respect to certain structural
      features of the enzyme complex. We also report the total synthesis of CtA, by a
      convergent [2 + 3] fragment-condensation approach, to serve the preparation of
      cyclotheonamide analogues for structure-function studies.

PMID- 8367462
TI  - Comparison of the P2 specificity pocket in three human histocompatibility
      antigens: HLA-A*6801, HLA-A*0201, and HLA-B*2705.
AB  - Coordinates from x-ray structures of HLA-A*6801, HLA-A*0201, and HLA-B*2705 were
      analyzed to examine the basis for their selectivity in peptide binding. The
      pocket that binds the side chain of the peptide's second amino acid residue (P2
      residue) shows a preference for Val, Leu, and Arg in these three HLA subtypes,
      respectively. The Arg-specific pocket of HLA-B*2705 differs markedly from those
      of HLA-A*0201 and HLA-A*6801, as a result of numerous differences in the side
      chains that form the pocket's surface. The cause of the specificity differences
      between HLA-A*0201 and HLA-A*6801 is more subtle and depends both on a change in
      conformation of pocket residue Val-67 and on a sequence difference at residue 9.
      The Val-67 conformational change appears to be caused by a shift in the position
      of the alpha 1-domain alpha-helix relative to the beta-sheet in the cleft and
      may, in fact, depend on amino acid differences remote from the P2 pocket.
      Analysis of the stereochemistry of the P2 side chain interacting with its binding
      pocket permits an estimate to be made of its contribution to the free-energy
      change of peptide binding.

PMID- 8367463
TI  - Isoproterenol stimulates rapid extrusion of sodium from isolated smooth muscle
      cells.
AB  - beta-Agonists cause an inhibition of contractility and a transient stimulation of
      Na+/K+ pumping in smooth muscle cells of the stomach from the toad Bufo marinus.
      To determine if the stimulation of Na+/K+ pumping causes changes in intracellular
      [Na+] ([Na+]i) that might link Na+ pump stimulation to decrease Ca2+ availability
      for contraction, [Na+]i was measured in these cells with SBFI, a Na(+)-sensitive
      fluorescent indicator. Basal [Na+]i was 12.8 +/- 4.2 mM (n = 32) and was uniform
      throughout the cell. In response to isoproterenol, [Na+]i decreased an average of
      7.1 +/- 1.1 mM in 3 sec. Since this decrease in [Na+]i could be completely
      blocked by inhibition of the Na+ pump, or by blockade of the beta-receptor,
      [Na+]i reduction is the result of occupation of the beta-receptor by
      isoproterenol and subsequent stimulation of the Na+ pump. 8-Bromoadenosine 3',5'
      cyclic monophosphate and forskolin mimicked the effect of isoproterenol,
      indicating that the sequence of events linking beta-receptor occupation to Na+
      pump stimulation most likely includes activation of adenylate cyclase, production
      of cAMP, and stimulation of cAMP-dependent protein kinase. The decrease in [Na+]i
      is sufficiently large and fast that it is expected to stimulate turnover of the
      Na+/Ca2+ exchanger in the Ca2+ extrusion mode, thereby accounting for the
      observed linkage between stimulation of the Na+/K+ pump and inhibition of
      contractility in response to beta-adrenergic agonists.

PMID- 8367464
TI  - The E2A gene product contains two separable and functionally distinct
      transcription activation domains.
AB  - The E2A gene encodes transcription factors of the helix-loop-helix (HLH) family
      which are implicated in cell-specific transcriptional control in several cell
      lineages, including pancreatic beta cells. In the present work, we show by
      deletion mapping of both the E2A protein itself and the Gal4-E2A fusion protein
      that the protein contains at least two distinct activation domains. One domain
      (located between amino acids 1 and 153) functions efficiently in a variety of
      mammalian cell lines. The second domain (located between amino acids 369 and 485)
      functions preferentially in pancreatic beta cell lines. The latter domain shows a
      pattern of heptad repeats of leucine residues characteristics of "leucine zipper"
      transcription factors; site-directed mutagenesis of leucines within this repeat
      led to substantial reductions in activity. The selective properties of this
      activation domain may contribute to cell-specific transcription directed by the
      E2A gene.

PMID- 8367465
TI  - Control analysis of the dependence of Escherichia coli physiology on the H(+)
      ATPase.
AB  - The H(+)-ATPase plays a central role in Escherichia coli free-energy transduction
      and hence in E. coli physiology. We here investigate the extent to which this
      enzyme also controls the growth rate, growth yield, and respiratory rate of E.
      coli. We modulate the expression of the atp operon and determine the effect on
      said properties. When quantified in terms of control coefficients, we find that,
      in the wild-type cell growing on glucose in minimal medium, this key enzyme (H(+)
      ATPase) exerts virtually no control on growth rate (magnitude of C < 0.01), a
      minor positive control on growth yield (C = 0.15), and a small but negative
      control on respiration rate (C = -0.25). The control the enzyme exerts on the
      consumption rate of the carbon and free-energy substrate is negative (C = -0.15).
      We also studied how the control coefficients themselves vary with the expression
      of the atp operon. As the level of expression of the atp operon was reduced, the
      control exerted by the H(+)-ATPase on growth rate and growth yield increased
      slightly; the control on growth rate passed through a maximum (C = 0.1) and
      disappeared when the atp operon was not expressed at all, reflecting that with
      this substrate there are alternative routes for ATP synthesis. At elevated levels
      of the H(+)-ATPase compared to the wild type, the control exerted by the enzyme
      on growth rate became negative. The evolutionary context of the absence of
      control by the atp operon on growth rate is discussed.

PMID- 8367466
TI  - Transactivation by hepatitis B virus X protein is promiscuous and dependent on
      mitogen-activated cellular serine/threonine kinases.
AB  - The X protein of hepatitis B virus (HBV-X) can act as a transactivator of
      transcription but its mechanism of action remains obscure. We have analyzed HBV-X
      transactivation in several cell types using 13 unrelated viral and cellular
      promoters and found that transactivation is more or less apparent in most cell
      types and is promiscuous and unrelated to specific sequence motifs within the
      target promoters. In general, though, HBV-X appears to act on enhancer elements
      since HBV-X had no effect on a minimal promoter, whereas HBV-X was able to
      transactivate after insertion of an AP-1 minienhancer. Several lines of evidence
      exclude the possibility that HBV-X interacts directly with the AP-1 enhancer or
      its binding proteins and suggest that the proximal target of HBV-X is peripheral
      to the transcription complex. This hypothesis is supported by the observation
      that inhibition of serine/threonine kinases, which regulate AP-1 activity
      (phorbol ester down-regulation or staurosporine inhibition of protein kinase C
      and a dominant negative mutant of Raf-1), blocked the ability of HBV-X to
      transactivate without affecting basal promoter activity. Furthermore, basal
      transcription from the AP-1-dependent promoter was increased by overexpression of
      protein kinase C and Raf-1 but HBV-X was unable to further stimulate, indicating
      that these kinases act subsequently to HBV-X. These data suggest that
      transactivation by HBV-X is an indirect result of the activation of cellular
      serine/threonine kinases including protein kinase C and Raf-1. This mode of
      action implies that HBV-X may affect other cellular processes, besides
      transcription, that are regulated by these kinases.

PMID- 8367467
TI  - Transfer of genetic information in the rp49 region of Drosophila subobscura
      between different chromosomal gene arrangements.
AB  - Nucleotide variation in the region including the ribosomal protein 49 (rp49) gene
      was investigated by direct sequencing of 10 alleles of Drosophila subobscura from
      chromosomes differing in gene arrangements. Fifty-six nucleotide and seven length
      polymorphisms were detected over a 1.5-kb region. Of the 20 nucleotide
      polymorphisms present more than once in the sample, 13 were segregating in O[3 +
      4], 9 in O[3 + 4 + 8], and 4 in O[st] chromosomal classes. Several of these
      polymorphisms were segregating in more than one chromosomal class, a strong
      indication of genetic transfer between different chromosomal gene arrangements
      either by double crossover or gene conversion. Given the probable role played by
      gene conversion in the history of the rp49 region in D. subobscura, estimates of
      nucleotide diversity within chromosomal class indicate that the O[3 + 4]
      chromosomal gene arrangement is older than the O[st] arrangement.

PMID- 8367468
TI  - Targeting and germ-line transmission of a null mutation at the metallothionein I
      and II loci in mouse.
AB  - We report the generation of transgenic mice deficient in the metallothionein MT-I
      and MT-II genes. The mutations were introduced into embryonic stem cells by
      homologous recombination. Chimeric mice resulting from the targeted embryonic
      stem cells transmitted the disrupted alleles through their germ line. Homozygous
      animals were born alive and appeared phenotypically normal and fertile. Absence
      of MT proteins was confirmed by direct measurement in liver extracts. Challenging
      the mutant animals with moderate levels of CdSO4 indicated their greater
      susceptibility to cadmium toxicity than wild-type animals. These mice should
      provide a useful model to allow detailed study of the physiological roles of MT-I
      and MT-II.

PMID- 8367469
TI  - Probing the function of Drosophila melanogaster accessory glands by directed cell
      ablation.
AB  - The female Drosophila melanogaster fly undergoes behavioral changes after mating,
      including an increase in egg laying and an avoidance of remating. Accessory-gland
      products elicit these changes transiently when introduced into unmated female
      flies. We report here the generation and phenotype of flies that lack functional
      accessory-gland main cells as a consequence of genetically directed delivery of
      diphtheria toxin subunit A to those cells. Only main-cell secretions are
      essential for the short-term inhibition to remating; no other products of the
      genital tract can replace their function. Long-term inhibition to remating
      depends only on the storage of sperm in the female. Both sperm and main-cell
      secretions have roles in the increase of egg laying by the mated female. In
      addition to full-strength diphtheria toxin, we used low-activity toxins to kill
      only those cells that express toxin at high levels. These transgenic strains that
      express diphtheria toxins of different strengths in accessory-gland main cells
      will be useful in further defining the role of these cells.

PMID- 8367470
TI  - Binding of human apolipoprotein E to synthetic amyloid beta peptide: isoform
      specific effects and implications for late-onset Alzheimer disease.
AB  - Apolipoprotein E (apoE), a plasma apolipoprotein that plays a central role in
      lipoprotein metabolism, is localized in the senile plaques, congophilic
      angiopathy, and neurofibrillary tangles of Alzheimer disease. Late-onset familial
      and sporadic Alzheimer disease patients have an increased frequency of one of the
      three common apoE alleles, epsilon 4, suggesting apoE4 is associated with
      increased susceptibility to disease. To follow up on this suggestion, we compared
      the binding of synthetic amyloid beta (beta/A4) peptide to purified apoE4 and
      apoE3, the most common isoform. Both isoforms bound synthetic beta/A4 peptide,
      the primary constituent of the plaque and angiopathy, forming a complex that
      resisted dissociation by boiling in SDS. Oxygen-mediated complex formation was
      implicated because binding was increased in oxygenated buffer, reduced in
      nitrogen-purged buffer, and prevented by reduction with dithiothreitol or 2
      mercaptoethanol. Binding of beta/A4 peptide was saturable at 10(-4) M peptide and
      required residues 12-28. Examination of apoE fragments revealed that residues 244
      272 are critical for complex formation. Both oxidized apoE4 and apoE3 bound
      beta/A4 peptide; however, binding to apoE4 was observed in minutes, whereas
      binding to apoE3 required hours. In addition, apoE4 did not bind beta/A4 peptide
      at pH < 6.6, whereas apoE3 bound beta/A4 peptide from pH 7.6 to 4.6. Together
      these results indicate differences in the two isoforms in complexing with the
      beta/A4 peptide. Binding of beta/A4 peptide by oxidized apoE may determine the
      sequestration or targeting of either apoE or beta/A4 peptide, and isoform
      specific differences in apoE binding or oxidation may be involved in the
      pathogenesis of the intra- and extracellular lesions of Alzheimer disease.

PMID- 8367471
TI  - Production of unmodified human adult hemoglobin in Escherichia coli.
AB  - We have constructed a plasmid (pHE2) in which the synthetic human alpha- and beta
      globin genes and the methionine aminopeptidase (Met-AP) gene from Escherichia
      coli are coexpressed under the control of separate tac promoters. The Hbs were
      expressed in E. coli JM109 and purified by fast protein liquid chromatography,
      producing two major components, a and b. Electrospray mass spectrometry shows
      that at least 98% and about 90% of the expressed alpha and beta chains of
      component a, respectively, have the expected masses. The remaining 10% of the
      beta chain in component a corresponds in mass to the beta chain plus methionine.
      In component b, both alpha and beta chains have the correct masses without
      detectable N-terminal methionine (< 2%). These results have been confirmed by
      Edman degradation studies of the amino-terminal sequences of the alpha and beta
      chains of these two recombinant Hb (rHb) samples. rHbs from components a and b
      exhibit visible optical spectra identical to that of human normal adult Hb (Hb
      A). Component a and Hb A have very similar oxygen-binding properties, but
      component b shows somewhat altered oxygen binding, especially at low pH values.
      1H-NMR spectra of component a and Hb A are essentially identical, whereas those
      of component b exhibit altered ring current-shifted and hyperfine-shifted proton
      resonances, indicating altered heme conformation in the beta chain. These altered
      resonance patterns can be changed to those of Hb A by converting component b to
      the ferric state and then to the deoxy state and finally back to either the
      carbonmonoxy or oxy form. Thus, our E. coli expression system produces native,
      unmodified Hb A in high yield and can be used to produce desired mutant Hbs.

PMID- 8367472
TI  - Recombination walking: genetic selection of clones from pooled libraries of yeast
      artificial chromosomes by homologous recombination.
AB  - Recombination walking is based on the genetic selection of specific human clones
      from a yeast artificial chromosome (YAC) library by homologous recombination. The
      desired clone is selected from a pooled (unordered) YAC library, eliminating
      labor-intensive steps typically used in organizing and maintaining ordered YAC
      libraries. Recombination walking represents an efficient approach to library
      screening and is well suited for chromosome-walking approaches to the isolation
      of genes associated with common diseases.

PMID- 8367473
TI  - Radish, a Drosophila mutant deficient in consolidated memory.
AB  - We have characterized the behavior and genetics of the Drosophila mutant radish
      (rsh gene). Initial learning of radish flies in two olfactory discrimination
      tests is high, but subsequent memory decays rapidly at both early and late times
      after training. Anesthesia-resistant memory (consolidated memory) is undetectable
      in radish flies 3 hr after training. The mutant shows normal locomotor activity
      and normal sensitivity to the odor cues and electric-shock reinforcement used in
      the learning tests. The radish gene maps within a 180-kb interval in the 11D-E
      region of the X chromosome.

PMID- 8367474
TI  - Response variability in retinal ganglion cells of primates.
AB  - The signal encoded by a sensory neuron is usually characterized as the cell's
      average response to repeated presentations of a stimulus. However, each stimulus
      presentation elicits a slightly different response. This response variability may
      obscure the signal represented by neural activity, but it might also be an
      important aspect of a neuron's message and in some instances may even serve
      useful function. Here we present evidence that response variability (noise) in
      primate retinal ganglion cells at photopic light levels is (i) independent of the
      amplitude of either the stimulus or the response and is therefore additive, (ii)
      independent of receptive field size and retinal eccentricity, and (iii) similar
      for all primate ganglion cells. Our results show that the primate retina
      maintains a uniform noise level across the entire visual field and suggest that
      the noise originates within the ganglion cells themselves.

PMID- 8367476
TI  - Major histocompatibility complex monomorphism and low levels of DNA
      fingerprinting variability in a reintroduced and rapidly expanding population of
      beavers.
AB  - Loss of genetic variation due to population bottlenecks may be a severe threat
      for the survival of endangered species. Assessment and maintenance of genetic
      variability are thus crucial for conservation programs related to endangered
      populations. Scandinavian beavers went through an extensive bottleneck during the
      last century due to overhunting. In Sweden the species became extirpated but in
      Norway extinction was avoided by legal protection. Following reintroductions of
      small numbers of remaining Norwegian animals in 1922-1939, the Swedish population
      has increased tremendously, now harboring 100,000 animals. We show here that this
      viable population of beavers possesses extremely low levels of genetic
      variability at DNA fingerprinting loci and monomorphism at major
      histocompatibility complex (MHC) class I and class II loci. A similar pattern was
      also evident among Norwegian beavers but low levels of genetic variability were
      not a characteristic of the species since Russian conspecifics displayed
      substantial DNA fingerprinting polymorphism. However, the Russian animals were
      monomorphic at MHC loci, indicating that the European beaver is exceptional in
      its low level of MHC variability. The results demonstrate that a conservation
      program can be successful despite low levels of genetic variation in the founder
      population.

PMID- 8367475
TI  - A transcription inhibitor specific for unwound DNA in RNA polymerase-promoter
      open complexes.
AB  - The kinetically component open complexes formed at prokaryotic and eukaryotic
      transcription start sites are efficiently nicked by the chemical nuclease
      activity of the 2:1 1,10-phenanthroline-copper(I) complex [(OP)2Cu+] and hydrogen
      peroxide. This reaction specificity has been attributed to the creation of a
      binding site(s) for redox-active tetrahedral (OP)2Cu+ when RNA polymerase form
      productive complexes with promoters. This proposal has been confirmed for the
      Escherichia coli lac UV-5 promoter by the demonstration that the 2:1 2,9-dimethyl
      1,10-phenanthroline-copper(I) complex [(Me2OP)2Cu+], a redox-inactive isostere of
      (OP)2-Cu+, protects the transcription start site from scission by the chemical
      nuclease activity. (Me2OP)2Cu+ is also an effective inhibitor of transcription.
      The inhibition of transcription and the protection from scission of the open
      complex by (OP)2Cu+ exhibit the same dependence on the concentration of
      (Me2OP)2Cu+. This redox- and exchange-stable species is a previously undescribed
      transcription inhibitor that binds to a site generated by the interaction of RNA
      polymerase with the promoter. Unlike the intercalating agent proflavine, which is
      also an effective transcription inhibitor, it does not displace the enzyme from
      the promoter. The ability of (Me2OP)2Cu+ to inhibit transcription may be
      partially responsible for its potent cytotoxicity.

PMID- 8367477
TI  - Glyceraldehyde-3-phosphate dehydrogenase on the surface of group A streptococci
      is also an ADP-ribosylating enzyme.
AB  - We recently identified an enzymatically active glyceraldehyde-3-phosphate
      dehydrogenase (EC 1.2.1.12; GAPDH) as a major protein on the surface of group A
      streptococci (SDH), which exhibits multiple binding activity to various mammalian
      proteins. We now report that the SDH molecule also functions as an ADP
      ribosylating enzyme, which, in the presence of NAD, is auto-ADP-ribosylated. In a
      crude cell wall extract of group A streptococci, SDH is the only protein that is
      ADP-ribosylated. SDH found in the streptococcal cytoplasmic fraction could not be
      ADP-ribosylated in the presence of NAD. Treatment of ADP-ribosylated SDH with the
      cytoplasmic fraction removed the ADP-ribose from SDH, suggesting the presence of
      an ADP-ribosyl hydrolase in the cytoplasmic compartment. The covalent linkage of
      ADP-ribose to SDH was stable to neutral hydroxylamine, sensitive to HgCl2, and
      inhibitable by free cysteine, indicating that the modification was at a cysteine
      residue of SDH. In addition to its auto-ADP-ribosylation activity, purified SDH
      or streptococcal cell wall extracts were able to transfer the ADP-ribose moiety
      of NAD specifically to free cysteine, resulting in a true thioglycosidic linkage.
      Treatment of purified SDH or the crude cell wall extract with sodium
      nitroprusside, which spontaneously generates nitric oxide, was found to stimulate
      the ADP-ribosylation of SDH in a time-dependent manner. ADP-ribosylation and
      nitric oxide treatment inhibited the GAPDH activity of SDH. Since ADP
      ribosylation and nitric oxide are involved in signal transduction events, the ADP
      ribosylating activity of SDH may enable communication between host and parasite
      during infection by group A streptococci.

PMID- 8367478
TI  - PMT1, the gene for a key enzyme of protein O-glycosylation in Saccharomyces
      cerevisiae.
AB  - The integral endoplasmic reticulum membrane protein catalyzing the initial
      reaction of protein O-glycosylation in Saccharomyces cerevisiae has been purified
      to homogeneity. The 92-kDa N-glycosylated protein transfers mannose residues from
      dolichyl phosphate-D-mannose to specific serine/threonine residues of proteins
      entering the secretory pathway. This type of mannosyl transfer reaction has so
      far been observed only in fungal cells. Oligonucleotides derived from peptide
      sequences of the transferase were used to screen a genomic yeast library. A clone
      was isolated which contains an open reading frame of 2451 bp corresponding to an
      mRNA transcript of 3 kb. The predicted protein consists of 817 amino acids
      including three potential N-glycosylation sites. The hydropathy plot indicates a
      tripartite structure of the protein: an amino-terminal third and a carboxyl
      terminal third, both with multiple potential transmembrane helices, and a central
      hydrophilic part. Expression of the clone in Escherichia coli resulted in
      mannosyltransferase activity. Gene disruption led to a complete loss of in vitro
      mannosyltransferase activity from dolichyl phosphate-D-mannose to a peptide used
      as acceptor in the enzymatic assay. In vivo it was observed, however, that
      protein O-mannosylation in the disruptant had decreased only to about 40-50%,
      indicating the existence of an additional transferase which had not been measured
      by the in vitro enzyme assay.

PMID- 8367479
TI  - Targeting of the UmuD, UmuD', and MucA' mutagenesis proteins to DNA by RecA
      protein.
AB  - In addition to its critical role in genetic recombination, the Escherichia coli
      RecA protein plays a pivotal role in SOS-induced mutagenesis. This role can be
      separated genetically into three steps: (i) depression of the SOS regulon by
      mediating the posttranslational cleavage of the LexA repressor, (ii) activation
      of UmuD'-like proteins by mediating cleavage of the UmuD-like proteins, and (iii)
      a direct step, possibly to interact with and to target the Umu-like mutagenesis
      proteins to lesions in DNA. We have analyzed RecA's third role biochemically
      using protein affinity chromatography and an agarose-based DNA mobility-shift
      assay. RecA730 protein from a crude cell extract was specifically retained on
      UmuD and UmuD' protein affinity columns, suggesting that these proteins
      physically interact. Normally, neither UmuD nor UmuD' shows any affinity for DNA.
      In the presence of RecA protein, however, UmuD and UmuD' were targeted to DNA.
      RecA1730 protein, which is defective for UmuD' but proficient for MucA'-promoted
      mutagenesis, showed a dramatically reduced capacity to target UmuD' to DNA but
      was able to target a significant portion of MucA' to DNA. These data support the
      suggestion that the direct role of RecA protein in SOS-induced mutagenesis is to
      interact with and target the Umu-like mutagenesis proteins to DNA.

PMID- 8367480
TI  - Crystal structure of yeast TATA-binding protein and model for interaction with
      DNA.
AB  - The C-terminal 179-aa region of yeast (Saccharomyces cerevisiae) TATA-binding
      protein (TBP), phylogenetically conserved and sufficient for many functions,
      formed crystals diffracting to 1.7-A resolution. The structure of the protein,
      determined by molecular replacement with coordinates from Arabidopsis TBP and
      refined to 2.6 A, differed from that in Arabidopsis slightly by an angle of about
      12 degrees between two structurally nearly identical subdomains, indicative of a
      degree of conformational flexibility. A model for TBP-DNA interaction is proposed
      with the following important features: the long dimension of the protein follows
      the trajectory of the minor groove; two rows of basic residues conserved between
      the subdomains lie along the edges of the protein in proximity to the DNA
      phosphates; a band of hydrophobic residues runs down the middle of the groove;
      and amino acid residues whose mutation alters specificity for the second base of
      the TATA sequence are juxtaposed to that base.

PMID- 8367481
TI  - Identification of a gene required for membrane protein retention in the early
      secretory pathway.
AB  - The yeast SEC12 gene product (Sec12p) is an integral membrane protein required
      for the protein transport from the endoplasmic reticulum (ER) to the Golgi
      apparatus. Although this protein is almost exclusively localized in the ER, a
      significant fraction of Sec12p is modified by an enzyme that resides in the early
      compartment of the Golgi apparatus, suggesting that Sec12p is cycling between the
      ER and the early Golgi. We have taken a genetic approach to investigate the
      retention mechanism of Sec12p. Analysis of mutants that are defective in the
      retention of the Sec12-Mf alpha 1 fusion protein in the early secretory
      compartments has identified a gene, RER1. A recessive mutation in RER1 causes
      mislocalization of the authentic Sec12p as well as two different Sec12 fusion
      proteins to the late Golgi apparatus and even to the cell surface. However, the
      rer1 mutant is not defective in the retention of an ER-resident soluble protein,
      BiP, suggesting that soluble and membrane proteins are retained in the ER by
      distinct mechanisms.

PMID- 8367482
TI  - Hypersensitivity to diphtheria toxin by mouse cells expressing both diphtheria
      toxin receptor and CD9 antigen.
AB  - DTS-II is a highly diphtheria toxin (DT)-sensitive cell line previously isolated
      by transfection of wild-type DT-resistant mouse L-M(TK-) cells with the cDNA
      encoding a monkey Vero cell DT receptor. DTS-II cells are as toxin-sensitive as
      Vero cells, have approximately 3-fold more receptors than Vero cells, and have
      approximately 10-fold lower affinity for DT than Vero cells. We now cotransfected
      DTS-II cells with a plasmid containing the Vero cell cDNA coding for CD9 antigen
      (pCD9) and with a plasmid containing the gene for hygromycin resistance (pHyg).
      The stably transfected hygromycin-resistant colonies were screened for DT
      hypersensitivity employing a replica plate system. A DT-hypersensitive colony was
      isolated and purified. The purified DT-hypersensitive cells, DTS-III, (i) are
      approximately 10-fold more toxin-sensitive than DTS-II and Vero cells and (ii)
      bear approximately 10(6) DT receptors per cell (i.e., approximately 20-fold and
      approximately 60-fold more receptors than DTS-II and Vero cells, respectively),
      but their receptor affinity is still approximately 10-fold lower than that of
      Vero cells. Cross-linking experiments employing 125I-labeled DT demonstrated that
      DTS-II and DTS-III cells have essentially the same profile of DT-binding cell
      surface protein(s), suggesting that CD9 antigen, although expressed on the cell
      surface of DTS-III cells, may not be in close proximity to the DT-binding domain
      of the receptor. CD9 may affect DT receptor expression by increasing receptor
      density at the cell surface. By employing DTS-III cells it should be possible to
      purify and characterize the DT cell-surface receptor protein(s).

PMID- 8367483
TI  - Cytotoxic and interferon gamma-producing activities of gamma delta T cells in the
      mouse intestinal epithelium are strain dependent.
AB  - We have analyzed the cytolytic activity of freshly isolated intraepithelial T
      cells (i-IEL) from the intestines of several different mouse strains in an anti-T
      cell receptor monoclonal antibody-mediated redirected lysis assay. The cytolytic
      activity of gamma delta i-IEL but not that of alpha beta i-IEL was strain
      dependent. Mouse strains could be divided into high (H), marginal (M), and null
      (N) strains. The anti-gamma delta T-cell receptor monoclonal antibody-induced
      interferon gamma production showed the same strain-dependent variability, but the
      proliferative responses to gamma delta T-cell receptor crosslinking did not show
      this variability. The N phenotype of gamma delta i-IEL was found to be dominant
      in (H x N)F1 mice. In radiation bone-marrow chimeras the H/N phenotype was
      determined by the genotype of the reconstituting bone-marrow-derived cells but
      was not determined by the genotype of the radioresistant host cells. Analysis of
      (H x N)F1 backcross animals indicated that at least two genes are involved in
      determination of the H/N phenotype. One of these genes is major
      histocompatibility-complex linked. No difference in the use of the variable
      region segment of the gamma-chain or delta-chain was seen between the gamma delta
      i-IEL from H and N strains. Various models that might explain the strain
      dependent gamma delta i-IEL phenotypes are discussed.

PMID- 8367484
TI  - Potassium channel dysfunction in fibroblasts identifies patients with Alzheimer
      disease.
AB  - Since memory loss is characteristic of Alzheimer disease (AD), and since K+
      channels change during acquisition of memory in both molluscs and mammals, we
      investigated K+ channel function as a possible site of AD pathology and,
      therefore, as a possible diagnostic index as well. A 113-pS tetraethylammonium
      (TEA)-sensitive K+ channel was consistently absent from AD fibroblasts, while it
      was often present in young and aged control fibroblasts. A second (166-pS) K+
      channel was present in all three groups. Elevated external potassium raised
      intracellular Ca2+ in all cases. TEA depolarized and caused intracellular Ca2+
      elevation in young and aged control fibroblasts but not AD fibroblasts. The
      invariable absence of a 113-pS TEA-sensitive K+ channel and TEA-induced Ca2+
      signal indicate K+ channel dysfunction in AD fibroblasts. These results suggest
      the possibility of a laboratory method that would diagnostically distinguish AD
      patients, with or without a family history of AD, from normal age-matched
      controls and also from patients with non-AD neurological and psychiatric
      disorders.

PMID- 8367486
TI  - CCAAT/enhancer-binding protein mRNA is translated into multiple proteins with
      different transcription activation potentials.
AB  - The CCAAT/enhancer-binding protein (C/EBP) alpha is a leucine zipper protein that
      is preferentially expressed in certain cell types, such as adipocytes and
      hepatocytes. Here we show that C/EBP alpha mRNA is translated into two major
      proteins, C/EBP-42 and C/EBP-30, that differ in their content of N-terminal amino
      acid sequences. These results are best explained by a ribosome-scanning mechanism
      in which a fraction of ribosomes ignore the first two AUGs and initiate
      translation at an AUG located 351 nt downstream of the first one. Because C/EBP
      30, the translation product initiated at the third AUG, is devoid of the potent
      transcription-activation domain contained in C/EBP-42, the former protein
      stimulates transcription from the mouse albumin promoter much less efficiently
      than the latter. The gene encoding the liver-enriched transcriptional-activator
      protein LAP (C/EBP-beta) has also been shown to issue two proteins, LAP and the
      liver-enriched transcriptional-inhibitory protein LIP, with different
      transcription-activation potentials. The production of multiple proteins from a
      single mRNA is not only shared between different C/EBP family members but also
      appears to be conserved in vertebrate evolution.

PMID- 8367485
TI  - In vivo clonal dominance and limited T-cell receptor usage in human CD4+ T-cell
      recognition of house dust mite allergens.
AB  - Sensitivity to house dust mite antigens in atopic individuals is a major cause of
      allergic diseases, ranging from asthma to rhinitis and dermatitis. We have
      studied the T-cell receptor (TCR) usage of house-dust-mite-specific CD4+ T-cell
      clones isolated from an atopic individual, by using the anchored polymerase chain
      reaction, and have analyzed the peripheral TCR repertoire of the same individual.
      Several T-cell clones had identified TCRs at the sequence level, despite the fact
      that they had been independently isolated, in some cases, in different years.
      These data suggest the presence in vivo of long-lived T-cell clones. We have also
      shown that junctional sequences identical to these clones are present in
      peripheral blood T cells taken 6 years after the isolation of the T-cell clones.
      The analysis of TCR genes used by the panel of clones reveals oligoclonality,
      with the variable (V) region gene segments V alpha 8 and V beta 3 being dominant,
      although there is minimal conservation of junctional sequences. The results have
      implications for understanding the TCR recognition of an environmental
      aeroallergen and the life span of T-cell clones in vivo during a chronic immune
      response.

PMID- 8367487
TI  - Evidence that the 60-kDa protein of 17S U2 small nuclear ribonucleoprotein is
      immunologically and functionally related to the yeast PRP9 splicing factor and is
      required for the efficient formation of prespliceosomes.
AB  - Small nuclear ribonucleoprotein (snRNP) U2 functions in the splicing of mRNA by
      recognizing the branch site of unspliced mRNA. The binding of U2 snRNP and other
      components to pre-mRNA leads to the formation of a stable prespliceosome. In HeLa
      nuclear extracts, U2 snRNP exists either as a 17S form (under low salt
      conditions) or a 12S form (at higher salt concentrations). We have recently shown
      that the purified 17S U2 snRNP contains nine proteins with apparent molecular
      masses of 35, 53, 60, 66, 92, 110, 120, 150, and 160 kDa in addition to the
      common snRNP proteins and the U2 proteins A' and B" that are found in the 12S U2
      snRNP form. By using antibodies against the PRP9 protein from Saccharomyces
      cerevisiae (a protein required for the addition of U2 to prespliceosomes in
      yeast), we have shown that the 60-kDa protein specific to human U2 snRNP
      particles is structurally related to the yeast PRP9 protein. Interestingly, anti
      PRP9 antibodies strongly inhibit prespliceosome formation in HeLa nuclear
      splicing extracts, resulting in a complete inhibition of the mRNA splicing
      reaction in vitro. This indicates that the U2 60-kDa protein may also be
      functionally related to its yeast counterpart PRP9. Most importantly, the
      addition of purified 17S U2 snRNPs, but not of 12S U2 snRNPs, to HeLa splicing
      extracts in which the endogeneous U2 snRNPs have been functionally neutralized
      with anti-PRP9 antibodies fully restores the mRNA-splicing activity of the
      extracts. These data suggest further that the 17S form is the functionally active
      form of U2 snRNP in the spliceosome.

PMID- 8367488
TI  - Abundant mitochondrial DNA variation and world-wide population structure in
      humpback whales.
AB  - Hunting during the last 200 years reduced many populations of mysticete whales to
      near extinction. To evaluate potential genetic bottlenecks in these exploited
      populations, we examined mitochondrial DNA control region sequences from 90
      individual humpback whales (Megaptera novaeangliae) representing six
      subpopulations in three ocean basins. Comparisons of relative nucleotide and
      nucleotype diversity reveal an abundance of genetic variation in all but one of
      the oceanic subpopulations. Phylogenetic reconstruction of nucleotypes and
      analysis of maternal gene flow show that current genetic variation is not due to
      postexploitation migration between oceans but is a relic of past population
      variability. Calibration of the rate of control region evolution across three
      families of whales suggests that existing humpback whale lineages are of ancient
      origin. Preservation of preexploitation variation in humpback whales may be
      attributed to their long life-span and overlapping generations and to an
      effective, though perhaps not timely, international prohibition against hunting.

PMID- 8367489
TI  - An upstream open reading frame represses expression of Lc, a member of the R/B
      family of maize transcriptional activators.
AB  - The R/B genes of maize encode a family of basic helix-loop-helix proteins that
      determine where and when the anthocyanin-pigment pathway will be expressed in the
      plant. Previous studies showed that allelic diversity among family members
      reflects differences in gene expression, specifically in transcription
      initiation. We present evidence that the R gene Lc is under translational
      control. We demonstrate that the 235-nt transcript leader of Lc represses
      expression 25- to 30-fold in an in vivo assay. Repression is mediated by the
      presence in cis of a 38-codon upstream open reading frame. Furthermore, the
      coding capacity of the upstream open reading frame influences the magnitude of
      repression. It is proposed that translational control does not contribute to
      tissue specificity but prevents overexpression of the Lc protein. The diversity
      of promoter and 5' untranslated leader sequences among the R/B genes provides an
      opportunity to study the coevolution of transcriptional and translational
      mechanisms of gene regulation.

PMID- 8367490
TI  - Day/night and circadian rhythm control of con gene expression in Neurospora.
AB  - In the filamentous fungus Neurospora crassa, several events in the process of
      conidiation are influenced by light. Two genes, con-6 and con-10, which were
      previously shown to be transcriptionally activated during conidiation and by
      exposure to light, were found to be unexpressed in mycelium maintained in
      constant darkness or in constant light. However, when mycelium was shifted from
      darkness to light, transcripts of both genes appeared and were abundant. Upon
      further illumination both transcripts disappeared--i.e., their continued
      production was light repressed. When dark-grown mycelium was exposed to a light
      pulse and reincubated in the dark, expression of con-6 and con-10 exhibited a 20
      hr circadian periodicity. Both genes were photoinducible throughout the stages of
      the circadian cycle. In the mutant strains bd and bd;frq9, con-6 and con-10 were
      light inducible but were not normally light repressible. Mutant genes such as
      acon-2, acon-3, and fl that block developmental expression of con-6 and/or con-10
      did not prevent their photoinduction.

PMID- 8367491
TI  - Delineation of an extended surface contact area on human CD4 involved in class II
      major histocompatibility complex binding.
AB  - We describe a detailed mapping of the class II major histocompatibility complex
      (MHC) binding site using site-directed mutagenesis in conjunction with high
      resolution CD4 structural data. Residues on all lateral surfaces of domain 1 and
      the neighboring portions of domain 2 participate in contacting class II MHC.
      Thus, in addition to the C'C" ridge that forms the human immunodeficiency virus
      type 1 gp120 binding site, apparent MHC contacts extend over the BED face of
      domain 1 and across the interdomain groove onto the FG loop of domain 2. Several
      models of the CD4/class II MHC interaction accounting for the extent of the CD4
      surface involved are discussed, including the possibility that CD4 may contact
      more than one class II MHC molecule using different surfaces.

PMID- 8367493
TI  - A correlational model for the development of disparity selectivity in visual
      cortex that depends on prenatal and postnatal phases.
AB  - Neurons in the visual cortex require correlated binocular activity during a
      critical period early in life to develop normal response properties. We present a
      model for how the disparity selectivity of cortical neurons might arise during
      development. The model is based on Hebbian mechanisms for plasticity at synapses
      between geniculocortical neurons and cortical cells. The model is driven by
      correlated activity in retinal ganglion cells within each eye before birth and
      additionally between eyes after birth. With no correlations present between the
      eyes, the cortical model developed only monocular cells. Adding a small amount of
      correlation between eyes at the beginning of development produced cortical
      neurons that were entirely binocular and tuned to zero disparity. However, if an
      initial phase of purely same-eye correlations was followed by a second phase of
      development that included correlations between eyes, the cortical model became
      populated with both monocular and binocular cells. Moreover, in the two-phase
      model, binocular cells tended to be selective for zero disparity, whereas the
      more monocular cells tended to have nonzero disparity. This relationship between
      ocular dominance and disparity has been observed in the visual cortex of the cat
      by other workers. Differences in the relative timing of the two developmental
      phases could account for the higher proportion of monocular cells found in the
      visual cortices of other animals.

PMID- 8367492
TI  - Ectopic neural expression of a floor plate marker in frog embryos injected with
      the midline transcription factor Pintallavis.
AB  - The floor plate, a cell group that develops at the midline of the neural plate in
      response to inductive signals from the notochord, has been implicated in the
      control of dorsoventral neural pattern. The frog Pintallavis gene, encoding a
      member of the HNF-3/fork head transcription factor family, is expressed in the
      notochord and in midline neural plate cells that give rise to the floor plate. To
      examine whether Pintallavis might be involved in regulating the differentiation
      of the floor plate, we ectopically expressed Pintallavis by injection of
      synthetic mRNA into two-cell frog embryos. Injection of Pintallavis mRNA resulted
      in the ectopic expression of F-spondin, a gene encoding a floor plate-specific
      adhesion molecule, at the dorsal midline of the neural tube. The expression of
      Pintallavis in midline cells may therefore contribute to the establishment of the
      floor plate fate.

PMID- 8367494
TI  - Design of peptide enzymes (pepzymes): surface-simulation synthetic peptides that
      mimic the chymotrypsin and trypsin active sites exhibit the activity and
      specificity of the respective enzyme.
AB  - Two 29-residue peptides were prepared, one of which (ChPepz) was designed by
      surface-simulation synthesis to mimic the active site of alpha-chymotrypsin, and
      the other (TrPepz), which contained four substitutions relative to ChPepz, was
      fashioned after the active site of trypsin. Each peptide was cyclized by a
      disulfide bond. The ChPepz monomer effected hydrolysis of the ester group in N
      benzoyl-L-tyrosine ethyl ester, an alpha-chymotrypsin substrate, with Km and kcat
      values that were comparable to those of alpha-chymotrypsin. ChPepz was completely
      inactivated by diisopropyl fluorophosphate (DIFP), L-1-p-tosylamino-2-phenylethyl
      chloromethyl ketone (TPCK), or reduction of the disulfide bond. It had no
      catalytic activity on N-tosyl-L-arginine methyl ester, a trypsin substrate. On
      the other hand, TrPepz, which had no effect on N-benzoyl-L-tyrosine ethyl ester,
      hydrolyzed N-tosyl-L-arginine methyl ester with a Km value that was essentially
      identical to that of trypsin, but its kcat value was almost half that of trypsin.
      TrPepz was fully inactivated by reduction of the disulfide bond, by DIFP, or by
      phenylmethylsulfonyl fluoride but not by TPCK. It was also completely inhibited
      by soybean trypsin inhibitor, bovine pancreatic trypsin inhibitor, and human
      alpha 1-antitrypsin. ChPepz and TrPepz hydrolyzed proteins (myoglobin and casein)
      to give panels of peptides that were similar to those of the same protein
      obtained with the respective enzyme. However, TrPepz was more efficient than
      trypsin at hydrolyzing the C bonds of two or more consecutive lysine and/or
      arginine residues. Like its esterase activity, the proteolytic activity of ChPepz
      was inhibited by either DIFP or TPCK whereas that of TrPepz was inhibited by
      either DIFP or phenylmethylsulfonyl fluoride but not by TPCK. Finally, ChPepz and
      TrPepz were each more active at low temperature than the respective enzyme. This
      ability to construct fully functional peptide enzymes (pepzymes) of chosen
      specificities should find many practical applications.

PMID- 8367495
TI  - Alterations in phenotypic biochemical markers in bladder epithelium during
      tumorigenesis.
AB  - Phenotypic biochemical markers of oncogenesis and differentiation were mapped in
      bladder biopsies to investigate changes that occur in bladder tumorigenesis and
      to identify markers for increased bladder cancer risk. Touch preparations from
      biopsy specimens from 30 patients were obtained from tumors, the adjacent bladder
      epithelium, and random distant bladder epithelium. Markers, including DNA ploidy,
      epidermal growth factor receptor (EGFR), and oncoproteins, were quantified in
      individual cells by using quantitative fluorescence image analysis. Cluster
      analysis revealed the markers fell into three independent groups: (i) G-actin and
      EGFR; (ii) ploidy, cytology, and p185 (HER-2/neu oncoprotein) (ERBB2); and (iii)
      p300, a low-grade tumor antigen. Each marker displayed a gradient of abnormality
      from distant field to adjacent field to tumor. Different patterns for each marker
      suggested a developmental sequence of bladder cancer oncogenesis; G-actin was
      altered in 58% of distant biopsies (vs. 0/6 normals, P < 0.001), ploidy and
      cytology were altered in < 20% of distant fields and approximately 80% of tumors,
      and the other markers were intermediate. Patterns of EGFR and p185 suggest low
      and high-grade tracks diverge early (P < 0.05 by Mann-Whitney U test for EGFR and
      ANOVA for p185). In conclusion, this study shows that a sequence of phenotypic
      changes accompanies development and progression of bladder cancers. Biochemical
      alterations in cells of the bladder field are often detectable before abnormal
      pathology, and markers previously thought to be limited to tumors were found in
      the field. The hierarchy of expression may be useful in identifying high-risk
      patients, assessing completeness of response to therapy, and monitoring and
      predicting recurrence.

PMID- 8367496
TI  - Genes necessary for expression of a virulence determinant and for transmission of
      Plasmodium falciparum are located on a 0.3-megabase region of chromosome 9.
AB  - Virulence of the human malaria parasite Plasmodium falciparum is believed to
      relate to adhesion of parasitized erythrocytes to postcapillary venular
      endothelium (asexual cytoadherence). Transmission of malaria to the mosquito
      vector involves a switch from asexual to sexual development (gametocytogenesis).
      Continuous in vitro culture of P. falciparum frequently results in irreversible
      loss of asexual cytoadherence and gametocytogenesis. Field isolates and cloned
      lines differing in expression of these phenotypes were karyotyped by pulse-field
      gel electrophoresis. This analysis showed that expression of both phenotypes
      mapped to a 0.3-Mb subtelomeric deletion of chromosome 9. This deletion
      frequently occurs during adaptation of parasite isolates to in vitro culture.
      Parasites with this deletion did not express the variant surface agglutination
      phenotype and the putative asexual cytoadherence ligand designated P. falciparum
      erythrocyte membrane protein 1, which has recently been shown to undergo
      antigenic variation. The syntenic relationship between asexual cytoadherence and
      gametocytogenesis suggests that expression of these phenotypes is genetically
      linked. One explanation for this linkage is that both developmental pathways
      share a common cytoadherence mechanism. This proposed biological and genetic
      linkage between a virulence factor (asexual cytoadherence) and transmissibility
      (gametocytogenesis) would help explain why a high degree of virulence has evolved
      and been maintained in falciparum malaria.

PMID- 8367498
TI  - Heterogeneity of the principal sigma factor in Escherichia coli: the rpoS gene
      product, sigma 38, is a second principal sigma factor of RNA polymerase in
      stationary-phase Escherichia coli.

PMID- 8367497
TI  - Phospholipase A2 activity can protect renal tubules from oxygen deprivation
      injury.
AB  - During hypoxic or ischemic renal tubular injury, phospholipase A2 (PLA2) induces
      membrane deacylation, causing fatty acid accumulation and phospholipid breakdown.
      Because these changes can compromise cellular integrity, PLA2 activity has been
      widely proposed as a critical mediator of hypoxic renal tubular injury and,
      hence, of ischemic acute renal failure. To explore this hypothesis, isolated rat
      proximal tubules were subjected to continuous oxygenation or to hypoxic injury
      with or without exogenous PLA2 addition (porcine or bovine pancreatic PLA2; bee
      or snake venom PLA2). Cell death was quantified by lactic dehydrogenase (LDH)
      release. Pancreatic PLA2 (0.4 unit/ml) caused no LDH release under oxygenated
      conditions, and it dramatically attenuated hypoxic cell death (e.g., no PLA2, 55
      +/- 3% LDH release; porcine pancreatic PLA2, 22 +/- 1% LDH release; P < 0.001).
      Bee and snake venom PLA2 (0.4 unit/ml) were directly toxic to tubules under
      oxygenated conditions, and this injury was additive with that induced by hypoxia.
      However, when these venoms were serially diluted (removing their overt toxicity),
      they, too, mitigated hypoxic cell death (LDH release with PLA2, 33 +/- 2%;
      without PLA2, 60 +/- 1% LDH release; P < 0.001). PLA2-mediated cytoprotection was
      Ca2+ dependent (negated by Ca2+ chelation), and it was expressed despite
      worsening hypoxia-associated membrane deacylation/fatty acid accumulation (12
      times) and ATP depletion. These results indicate that PLA2 activity can exert
      both beneficial and deleterious effects on O2-deprived renal tubules, the net
      result of which can be a salvaging of cells from hypoxic cell death.

PMID- 8367499
TI  - [The importance of information for professionals. A study of Italian nursing
      journals].

PMID- 8367500
TI  - [The prevention of urinary infections associated with bladder catheterization:
      the use of the preconstituted kit and of the sterile closed-circuit bag. The role
      of the nurse epidemiologist].

PMID- 8367502
TI  - [The file for "personalized delivery": a presentation of experience. The S. Maria
      della Misericordia Hospital--the Nursing Service. A nursing guide to data
      collection].

PMID- 8367501
TI  - [The living conditions of the elderly in the reality of San Daniele del Friuli].

PMID- 8367503
TI  - Is this commercialism gone mad?

PMID- 8367504
TI  - A one-to-one relationship with lasting benefits. Implementing primary nursing in
      a coronary care unit.
AB  - It is essential that people who have suffered a myocardial infarction are
      counselled on how to avoid repeated attacks. By implementing primary nursing in a
      coronary care unit, the one-to-one relationship involved can be used to enhance
      the counselling process.

PMID- 8367505
TI  - Simply a case of good practice. Avoiding catheter-related sepsis in total
      parenteral nutrition.
AB  - Catheter-related sepsis is a well-known complication associated with the
      administration of total parenteral nutrition. A strict aseptic approach,
      supplemented with a knowledge of how the infection occurs, will do much to avoid
      this problem.

PMID- 8367506
TI  - Gene therapy: the dawn of a revolution.
AB  - Gene therapy offers the hope of effective treatment for thousands of people with
      genetic diseases, such as diabetes and muscular dystrophy. Early research looks
      promising, but doubts about its safety remain.

PMID- 8367507
TI  - How antibiotics work: protein synthesis.
AB  - 1. Antibiotics are important agents for the treatment of infections. 2. They are
      special chemicals produced by a few species of microorganisms which inhibit the
      growth of other micro-organisms. 3. They inhibit growth by attacking one of five
      sensitive sites. 4. A selection of antibiotics attacking the protein synthesis
      mechanism are identified and their modes of action described.

PMID- 8367508
TI  - Waterlow card.

PMID- 8367509
TI  - Paracetamol overdose.

PMID- 8367510
TI  - A concept for all the family. Family centred care: a concept analysis.
AB  - Family centred care is now perceived as fundamental to meeting hospitalised
      children's physical and emotional needs. It is important, however, that nurses
      fully understand the concept or it may be implemented more with the intention of
      meeting ward goals than family needs.

PMID- 8367511
TI  - Evaluation of a semipermeable polyurethane absorptive dressing.
AB  - While semipermeable film dressings are well established for treatment of moist
      wounds, they lose moisture to the atmosphere at a fixed rate. This article
      reports an evaluation of a semipermeable dressing recently made available in the
      UK which claims to vary the rate of moisture vapour loss.

PMID- 8367512
TI  - Steps to develop a working relationship. An evaluation of the community-based
      clinical nurse specialist.
AB  - To establish an effective working relationship between community nurses and
      clinical nurse specialists (CNSs) working in the community, the role of the CNS
      must be clearly defined. A survey was undertaken to identify CNSs' and district
      nurses' attitudes to the role and its requirements. The ensuing recommendations
      were implemented with positive results.

PMID- 8367513
TI  - A heady mixture of freedom and responsibility. Rural community nursing in New
      Zealand.
AB  - Working as a community nurse in a rural setting has its obvious attractions. A
      community health nurse based in New Zealand describes the pleasures and
      challenges involved.

PMID- 8367514
TI  - Provision to reflect real needs. Meeting the needs of disabled people in general
      practice.
AB  - Implementation of the Community Care Act makes it essential that clients' needs
      for services are accurately assessed. A study was undertaken by a general
      practice to identify whether clients with physical disabilities were satisfied
      with the service they received.

PMID- 8367515
TI  - Is caring a myth?

PMID- 8367516
TI  - [The biochemical basis of toxic actions of drugs and other xenobiotics].

PMID- 8367517
TI  - Effect of frequency and conductivity on field penetration of electromagnetic
      hyperthermia applicators.
AB  - The field penetration of electromagnetic hyperthermia applicators in 2.5-29 g l-1
      saline (NaCl) solutions over a range of frequencies is investigated. Calculated
      field penetration based on the current-element method agrees well with
      measurement at frequencies above about 100 MHz, but at lower frequencies measured
      field penetration becomes progressively less than calculated as conductivity is
      reduced. Experimental results and finite-difference time-domain (FDTD) method
      modelling show that the electromagnetic field produces circulating currents. The
      effect of these circulating currents on the heating pattern of the applicators
      should be considered when planning hyperthermia treatment.

PMID- 8367519
TI  - A statistical model for the determination of the optimal metric in factor
      analysis of medical image sequences (FAMIS).
AB  - A statistical model is added to the conventional physical model underlying factor
      analysis of medical image sequences (FAMIS). It allows a derivation of the
      optimal metric to be used for the orthogonal decomposition involved in FAMIS. The
      oblique analysis of FAMIS is extended to take this optimal metric into account.
      The case of scintigraphic image sequences is used. We derive in this case that
      the optimal decomposition is obtained by correspondence analysis. A scintigraphic
      dynamic study illustrates the practical consequences of the use of the optimal
      metric in FAMIS.

PMID- 8367518
TI  - Constrained least-squares restoration and renogram deconvolution: a comparison
      with other techniques.
AB  - It has previously been shown that an iterative constrained least-squares (CLSR)
      technique using a noise-based constraint may be superior to other methods of
      renogram deconvolution analysis. To test this hypothesis on real data, renography
      was performed on 70 patients with established diagnoses of normal, insufficient
      or acutely obstructed kidneys. Standard renography parameters were obtained from
      the time activity curves which were then deconvolved using three techniques. One
      kidney per patient was chosen at random for analysis resulting in a total of 43
      normal and 27 diseased kidneys. The ability of each of the analytical techniques
      to discriminate between normal and diseased kidneys was assessed using logistic
      regression. CLSR proved to be robust and provide the best discrimination of the
      deconvolution techniques. However, the best overall discrimination was provided
      by a model based on the renography parameters excretion ratio, rate of uptake and
      time to peak activity which correctly classified 86% of the kidneys. It is
      possible that the renogram parameters could be used to produce notional
      probabilities of renal dysfunction which the physician could use as an aid in the
      interpretation of gamma-camera renography.

PMID- 8367520
TI  - A facility for biomedical experiments with thermal neutrons.
AB  - The Studsvik thermal-neutron facility was originally designed for neutron capture
      radiography (NCR) at high thermal-neutron fluence and low fast-neutron
      contamination. It has now been modified to permit irradiation of living cells and
      animals without the need for stopping and restarting the R2-0 reactor. Previous
      calculations of the thermal-neutron intensity at the NCR position were performed
      using the two-dimensional diffusion theory code DIXY. In this report the Monte
      Carlo program MCNP 3B is used to calculate the neutron fluence at the radiography
      position, and neutron and photon fluences at the positions of the cell specimens.
      The normalized neutron fluences from the calculations agree well with measured
      values and show that the contamination with high-energy neutrons is low. The
      agreement between measured and calculated photon doses was reasonable. The
      thermal-neutron fluence rate is (2.3 +/- 0.1) x 10(9) cm-2 s-1 at 100 kW at the
      NCR position and (0.96 +/- 0.03 x 10(9) cm-2 s-1 at 100 kW at the front plate of
      the loading tube. The photon dose is about (1.6 +/- 0.2) x 10(-12) Gy per
      neutron. Survival curves of V79 cells grown as monolayers and irradiated in the
      thermal neutron beam, with and without boron, are presented.

PMID- 8367521
TI  - Quantitative neutron capture radiography for boron in biological specimens.
AB  - Track-etch detectors made of cellulose nitrate (LR 115, Kodak Pathe) and
      polycarbonate (CR 39, Pershore Mouldings Ltd) were compared regarding sensitivity
      and background when used as detectors for boron determination in biological
      samples. Measurements were made on two kinds of sample, cryosectioned biological
      tissue, and liquid samples deposited directly on the detector surface as
      microdroplets. The CR 39 films were pretreated or washed before irradiation. When
      cryosectioned tissue was used, measurements were made with and without the
      inclusion of Mylar foils between the samples and the detectors. Foil thicknesses
      used were 2 microns in the case of LR 115 and 2, 4, and 6 microns in the case of
      CR 39. All samples were irradiated with a thermal-neutron fluence of 5 x 10(12)
      neutrons cm-2 at the thermal-neutron facility in Studsvik, Sweden. The use of a
      Mylar foil generally suppressed the background tracks relative to the tracks from
      the 10B disintegration. No difference in resolution between CR 39 and LR 115 was
      observed. Pretreatment of the CR 39 resulted in an improved sensitivity of
      detection but the detector became saturated at 0.25 parts per million of 10B. The
      background was found to be lower in the pretreated detector.

PMID- 8367522
TI  - In vivo measurement of the low-frequency dielectric spectra of frog skeletal
      muscle.
AB  - Capacitance, conductance and dielectric loss spectra are obtained, in vivo, for a
      number of electrode separations in the gastrocnemius muscle of a frog. At each
      frequency the reciprocals of these parameters are plotted versus electrode
      separation. From the slopes of the resulting lines the complex permittivity and
      the conductivity of the muscle can be determined, with electrode effects
      eliminated. The sequence of power-law responses which is found is consistent with
      the fractal model proposed by Dissado. The electrical properties measured in vivo
      with needle electrodes are similar to those measured with surface electrodes for
      frequencies between 1 kHz and 1 MHz.

PMID- 8367523
TI  - Measuring astatine-211 distributions with SPECT.
AB  - We have investigated standard SPECT techniques (rotating gamma cameras, multi
      hole collimators, and filtered backprojection reconstruction) for imaging
      astatine-211 distributions. Since 211At emits alpha particles, this nuclide has
      potential for use in radiotherapy. The capability of imaging this nuclide would
      allow in vivo evaluation of the distribution and stability of potential 211At
      labelled radiotherapeutic agents. 211At decay yields x-rays in the 77-92 keV
      range in addition to 500-900 keV gamma rays. This study evaluates the feasibility
      of SPECT imaging using the x-ray emissions of 211At. We have evaluated several
      collimators, with the determination that the medium-energy collimators we used
      are suitable, with 7% penetration (uncollimated counts versus collimated counts).
      Several phantoms were imaged and attenuation coefficients were measured (narrow
      beam mu = 0.182 cm-1 for 77-80 keV x-rays in water). Reconstructed images
      demonstrate qualitative capabilities and a simple quantitative study demonstrates
      good correction for attenuation and scatter (approximately 10% error), at low
      count densities, at least for the phantom geometries used in this study.

PMID- 8367524
TI  - Normalized organ dose data measured as a function of field size for abdominal
      examinations.
AB  - Doses to 14 radiosensitive organs were measured as a function of field size for
      both antero-posterior (AP) and postero-anterior (PA) projections of the abdomen.
      The organ doses were measured using thermoluminescent dosemeters (TLD) placed
      within a Rando anthropomorphic phantom. Circular field sizes 14 cm, 26 cm and 36
      cm in diameter (measured at the image intensifier input plane) were set for the
      PA irradiations. For the AP projections, the circular field sizes measured 14 cm,
      20 cm, 27 cm and 40 cm in diameter, again specified at the input plane of the
      image intensifier. Organ doses were also measured for the conventional 35 x 35 cm
      film/screen technique, for both AP and PA views. The dose measurements were made
      at a tube potential of 81 kV, which is commonly used in radiological examinations
      of the abdomen. TLD were also used to measure the entrance surface dose (with
      backscatter) for each field size and projection. The organ doses are presented
      normalized to this entrance surface dose. A brief comparison is made between the
      data measured in the current study and normalized organ dose data published by
      other authors.

PMID- 8367525
TI  - Design of a californium-based epithermal neutron beam for neutron capture
      therapy.
AB  - The potential of the spontaneously fissioning isotope, 252Cf, to provide
      epithermal neutrons for use in boron neutron capture therapy (BNCT) has been
      investigated using Monte Carlo simulation. The Monte Carlo code MCNP was used to
      design an assembly composed of a 26 cm long, 11 cm radius cylindrical D2O
      moderator followed by a 64 cm long Al filter. Lithium filters are placed between
      the moderator and the filter and between the Al and the patient. A reflector
      surrounding the moderator/filter assembly is required in order to maintain
      adequate therapy flux at the patient position. An ellipsoidal phantom composed of
      skull- and brain-equivalent material was used to determine the dosimetric effect
      of this beam. It was found that both advantage depths and advantage ratios
      compare very favourably with reactor and accelerator epithermal neutron sources.
      The dose rate obtainable, on the other hand, is 4.1 RBE cGy min-1, based on a
      very large (1.0 g) source of 252Cf. This dose rate is two to five times lower
      than those provided by existing reactor beams and can be viewed as a drawback of
      using 252Cf as a neutron source. Radioisotope sources, however, do offer the
      advantage of in-hospital installation.

PMID- 8367526
TI  - Calibration of the NPL secondary standard radionuclide calibrator for 192Ir
      brachytherapy sources.
AB  - Safe and effective treatment with brachytherapy sources requires an accurate
      knowledge of the local tissue absorbed dose rate derived from the source
      reference air kerma rate. It is desirable that these air kerma rate measurements
      be traceable to national standards. The NPL has embarked on a programme that will
      enable the user to assay brachytherapy sources in a convenient manner prior to
      treatment. Calibration figures have been derived for the NPL secondary standard
      radionuclide calibrator for 192Ir brachytherapy sources manufactured by Amersham
      International plc. The calibration figures enable the user to accurately estimate
      the reference air kerma rate and activity of such sources by measuring the
      ionization chamber response. Calibration figures for other brachytherapy sources
      are also being derived.

PMID- 8367527
TI  - Radiation dosimetry using junction field-effect transistor detectors.
AB  - The use of junction field effect transistors (JFET) has been studied by
      connecting them in a bridge circuit. With a suitable back-up circuit, it was
      possible to measure doses as well as dose-rates. It was possible to alter the
      sensitivity of the JFET bridge by varying the biasing components of the JFET.
      Easy temperature compensation was also possible. However, response of the JFET to
      radiation showed energy dependency similar to that of semiconductor diodes.

PMID- 8367528
TI  - Liposomal delivery of a photosensitizer, benzoporphyrin derivative monoacid ring
      A (BPD), to tumor tissue in a mouse tumor model.
AB  - Biodistribution studies were carried out on 14C-labeled benzoporphyrin derivative
      monoacid ring A (BPD), which had been formulated as a unilamellar liposome or
      taken from a stock solution in dimethyl sulfoxide diluted into phosphate-buffered
      saline immediately before intravenous injection into DBA/2 mice. By and large the
      general distribution of BPD to various organs and tissues was comparable for both
      formulations. It was noted, however, that liposomal material appeared to enter
      tissues more rapidly and to be cleared more rapidly, as demonstrated by shorter
      half-lives for a number of tissues including skin, lung and fat, and generally
      lower levels in most tissues 24 h following administration. Accumulation in tumor
      tissue was slightly higher with liposomal BPD, and clearance rates for this
      tissue were equivalent (half-lives 16.1 h for liposomal BPD and 16.9 h for
      aqueous BPD). When the two preparations were tested in a bioassay in tumor
      bearing mice, photodynamic therapy (PDT) with liposomal BPD proved to be superior
      to the aqueous preparation when PDT was administered 3 h following intravenous
      administration of BPD. Plasma distribution studies in vitro demonstrated that
      91.1 +/- 0.3% of the liposomal BPD distributed to the lipoprotein fraction within
      the first hour of mixing, whereas only 49.1 +/- 2.6% of nonliposomal BPD was
      associated with lipoprotein under the same conditions. Furthermore, while
      lipoprotein-associated liposomal BPD distributed evenly between all three types
      of lipoprotein (high, low and very low density), a majority of nonliposomal BPD
      associated with the high-density lipoprotein fraction.

PMID- 8367529
TI  - The excitation of 8-methoxypsoralen with visible light: reversed phase HPLC
      quantitation of monoadducts and cross-links.
AB  - The formation of 8-methoxypsoralen-DNA monoadducts and cross-links is presumed to
      be responsible for the efficacy of photochemotherapies that employ 8
      methoxypsoralen activated with long-wavelength ultraviolet radiation (UVA, 320
      400 nm). In this report it is shown that 8-methoxypsoralen can also be activated
      with visible light (419 nm). Bovine aorta smooth muscle cells were treated with 8
      methoxypsoralen (1,000 ng/mL) and 419 nm light (up to 12 J/cm2). Cellular DNA was
      isolated, hydrolyzed using nucleolytic enzymes and then analyzed by reversed
      phase high-performance liquid chromatography. The primary effect of using visible
      light instead of long-wavelength ultraviolet radiation is a more than 10-fold
      reduction in the extent of cross-link formation. Because the extent of monoadduct
      and cross-link formation has not been routinely measured in experiments in which
      cellular assays have been performed, it is difficult to correlate cell response
      to the presence of a particular type of 8-methoxypsoralen photoadduct (monoadduct
      or cross-link). Thus, the use of visible light allows the study of cells
      containing nearly 100% monoadducts. In addition, the reduction in cross-link
      formation when visible light is used to activate the compound may also reduce the
      mutagenicity of 8-methoxypsoralen and hence enhance its therapeutic efficacy.

PMID- 8367530
TI  - Cu(II) sensitizes pBR322 plasmid DNA to inactivation by UV-B (280-315 nm).
AB  - Copper(II), in the presence of UV-B radiation (280-315 nm), can generate single
      strand breaks in the sugar-phosphate backbone of pBR322 plasmid DNA. A low level
      of single-strand backbone breaks occurs in the presence of Cu(II) alone, but UV-B
      irradiation increases the rate by the more than 100-fold. Concomitant with the
      damage to the DNA backbone is a loss of transforming activity. Oxygen is required
      for generation of the single-strand breaks but not for the loss of transforming
      activity. A DNA glycosylase (Fpg), which participates in the repair of certain
      DNA nitrogenous base damage, does not repair plasmid DNA damaged by Cu(II). The
      hydroxyl radical scavenging compound DMSO is only somewhat effective at
      protecting the physical and biological properties of the DNA. These results with
      Cu(II) are compared to those obtained previously with pBR322 plasmid DNA in the
      presence of Fe(III) and UV-A.

PMID- 8367531
TI  - Long-wavelength UVA radiation induces oxidative stress, cytoskeletal damage and
      hemolysis.
AB  - We investigated the ability of the different wavelength regions of UV radiation,
      UVA (320-400 nm), UVB (290-320 nm) and UVC (200-290 nm), to induce hemolysis.
      Sheep erythrocytes were exposed to radiation from either a UVA1 (> 340 nm)
      sunlamp, a UVB sunlamp, or a UVC germicidal lamp. The doses used for the three
      wavelength regions were approximately equilethal to the survival of L5178Y murine
      lymphoma cells. Following exposure, negligible hemolysis was observed in the UVB-
      and UVC-irradiated erythrocytes, whereas a decrease in the relative cell number
      (RCN), indicative of hemolysis, was observed in the UVA1-exposed samples. The
      decrease in RCN was dependent on dose (0-1625 kJ/m2), time (0-78 h
      postirradiation) and cell density (10(6)-10(7) cells/mL).. Hemolysis decreased
      with increasing concentration of glutathione, hemoglobin or cell number, while
      the presence of pyruvate drastically enhanced it. Because scanning spectroscopy
      (200-700 nm) showed that hemoproteins and nicotinamide adenine dinucleotides were
      oxidized, cytoplasmic oxidative stress was implicated in the lytic mechanism.
      Further evidence of oxidation was obtained from electron micrographs, which
      revealed the formation of Heinz bodies near the plasma membrane. The data
      demonstrate that exposure of erythrocytes to UVA1, but not UVB or UVC, radiation
      causes oxidation of cytoplasmic components, which results in cytoskeletal damage
      and hemolysis.

PMID- 8367532
TI  - Effects of mutagenetic substitution of prolines on the rate of deprotonation and
      reprotonation of the Schiff base during the photocycle of bacteriorhodopsin.
AB  - Membrane-buried proline residues are found in many transport proteins. To study
      their roles in the structure and function of bacteriorhodopsin (bR), effects of
      the individual substitutions of Pro-50, Pro-91 and Pro-186 on the deprotonation
      and reprotonation kinetics of the Schiff base (SB) were determined by flash
      photolysis. The obtained rate constants and the amplitudes of the slow and fast
      components were compared with those of ebR (wild-type bR, the native protein that
      is expressed in Escherichia coli). The deprotonation rates of PSB were found to
      be 10 times faster than that of ebR for P50A, P91A and P91G mutants, and 4 times
      faster for the P50G mutant. These mutations also increased the initial
      reprotonation rate of the SB, although the overall change in the reprotonation
      rate is not as significant as that in the deprotonation rate. Our results
      indicate that Pro-50 and Pro-91, as well as Pro-186, are important for the proton
      pumping function of bR.

PMID- 8367533
TI  - Ocular light damage.

PMID- 8367534
TI  - Establishment and characterization of a monoclonal antibody recognizing the Dewar
      isomers of (6-4)photoproducts.
AB  - We established a monoclonal antibody (DEM-1) that recognizes UV-induced DNA
      damage other than cyclobutane pyrimidine dimers or (6-4)photoproducts. The
      binding of DEM-1 antibody to 254 nm UV-irradiated DNA increased with subsequent
      exposure to UV wavelengths longer than 310 nm, whereas that of the 64M-2 antibody
      specific for the (6-4)photoproduct decreased with this treatment. Furthermore,
      the increase in DEM-1 binding was inhibited by the presence of the 64M-2 antibody
      during the exposure. We concluded that the DEM-1 antibody specifically recognized
      the Dewar photoproduct, which is the isomeric form of the (6-4)photoproduct. The
      DEM-1 antibody, however, also bound to DNA irradiated with high fluences of 254
      nm UV, suggesting that 254 nm UV could induce Dewar photoproducts without
      subsequent exposure to longer wavelengths of UV. Furthermore, an action spectral
      study demonstrated that 254 nm was the most efficient wavelength for Dewar
      photoproduct induction in the region from 254 to 365 nm, as well as cyclobutane
      dimers and (6-4)photoproducts, although the action spectrum values in the UV-B
      region were significantly higher compared with those for cyclobutane dimer and (6
      4)photoproduct induction.

PMID- 8367535
TI  - Improved high-performance liquid chromatographic analysis of 8-methoxypsoralen
      monoadducts and cross-links in polynucleotide, DNA, and cellular systems:
      analysis of split-dose protocols.
AB  - The distribution of 8-methoxypsoralen-thymidine photoadducts from
      polynucleotides, calf thymus DNA and mammalian cells treated with [3H]8
      methoxypsoralen under a variety of irradiation conditions was determined using
      high-performance liquid chromatography and scintillation analysis. The split-dose
      protocol, with samples treated with 8-methoxypsoralen and low doses of long
      wavelength UV radiation to generate monoadducts, washed to remove unreacted 8
      methoxypsoralen, then irradiated further to convert the monoadducts to cross
      links, was examined. The photoadduct distribution in the first step is dependent
      upon the UVA dose and the wavelength of the radiation, but it is relatively
      independent of 8-methoxypsoralen concentration. Low fluence and longer
      wavelengths generate mainly 4',5'-monoadducts, whereas higher fluences and
      shorter wavelengths yield more cross-links. The second irradiation step converts
      the 4',5'-monoadducts to cross-links as well as to 3,4-monoadducts. The overall
      yield of cross-links after the second irradiation step is not dependent upon the
      wavelength used in the first step. Cellular studies demonstrated that the split
      dose protocol is applicable to mammalian systems. These results may affect the
      interpretation of mutagenesis studies based on the split-dose protocol, because
      the second step can convert 4',5'-monoadducts to both 3,4-monoadducts, the
      expected cross-links. Therefore, interpretations that link increases in
      mutagenicity after the second step in a split-dose study solely to cross-link
      formation may need re-examination.

PMID- 8367536
TI  - A pulsed photolysis procedure for determining oxygen equilibrium parameters of
      low-affinity noncooperative hemoglobins.
AB  - It is often very difficult to obtain precise values for oxygen equilibrium
      constants for low-affinity noncooperative hemoglobins owing to the ease with
      which they are oxidized and denatured with even the most gentle stirring or
      agitation. We have developed a procedure that eliminates this problem by
      maintaining the hemoglobin as HbCO except during the brief time it is present as
      Hb, and HbO2 forms following photolysis. Oxygen is continuously removed by an
      enzyme system. The solution is photolyzed to 100% every 2-3 min during the
      deoxygenation process to obtain maximum absorbance changes at the Hb-HbCO
      isosbestic. These maximum absorbance changes at known times during the
      deoxygenation provide the necessary data for obtaining the oxygen equilibrium
      constant. These absorbance changes are used with enzyme kinetics equations to
      obtain calculated times. The simple equations, which neglect heme concentration,
      will be satisfactory for nearly all conditions, but for generality the complete
      equations are given. The variance minimizations are with respect to observed and
      calculated photolysis times. The results for native carp Hb over a range of
      temperatures are in excellent agreement with results obtained with considerably
      more material and greater difficulty by other methods.

PMID- 8367537
TI  - Laser-induced fluorescence in malignant and normal tissue of rats injected with
      benzoporphyrin derivative.
AB  - Laser-induced fluorescence was used to characterize the localization of
      intravenously administered benzoporphyrin derivative-monoacid (BPD-MA) 3 h
      postinjection in different rat tissue types, including an induced experimental
      malignant tumor. A comparison of the fluorescence properties and demarcation
      potential between the newer sensitizer BPD-MA and four other substances,
      hematoporphyrin (HP), polyhematoporphyrin ester (PHE), tetrasulfonated
      phthalocyanine (TSPc) and the commercially available Photofrin earlier
      investigated, is included. The fluorescence light was induced with a nitrogen
      laser, emitting at 337 nm. The fluorescence spectrum in the region 380-750 nm was
      analyzed by a polychromator equipped with a diode array detector. The demarcation
      potential between tumor and surrounding tissue in terms of fluorescence signal
      for the tumor model used was 2:1 for BPD-MA. In comparison with the other drugs,
      HP shows about the same demarcation potential, whereas Photofrin and PHE exhibit
      about 3 times better and TSPc about 1.5 times better demarcation. By also
      employing the endogenous tissue fluorescence signature the contrast was enhanced
      by a factor of about 2 for each of the five drugs.

PMID- 8367538
TI  - Inhibition of phthalocyanine-sensitized photohemolysis of human erythrocytes by
      quercetin.
AB  - Photohemolysis of erythrocytes in the presence of aluminum phthalocyanine
      tetrasulfonate as a sensitizer is inhibited by quercetin. D2O (98.5%) stimulated
      photohemolysis regardless of quercetin presence, suggesting the participation of
      singlet oxygen in the process. Since it has been shown that this flavonoid reacts
      with singlet oxygen, the protective effect might be attributed, at least
      partially, to its competitive reaction with singlet oxygen. At the molecular
      level, the alterations of membrane proteins that escort the process of
      photohemolysis, such as cross-linking of spectrin monomers and of other membrane
      proteins, were selectively inhibited by quercetin. This effect was qualitatively
      similar to that induced by NaF, suggesting that quercetin may, like NaF, also
      inhibit type I photooxidations, which contribute to hemolysis. The lipophilicity
      of quercetin seems to be an essential factor in the inhibition process; rutin, a
      water-soluble 3-rutinoside of quercetin, had only a negligible protective effect
      on photohemolysis.

PMID- 8367539
TI  - Membrane potential can influence the rate of membrane photomodification.
AB  - Though cellular photomodification has been shown to change cellular resting
      membrane potential, an effect of membrane potential on the rate of
      photomodification has never been reported. Here we demonstrate that the rate of
      photomodification of potassium channels in frog atrial cells is voltage
      dependent. The rate of potassium channel photomodification using negatively
      charged Rose Bengal as the photosensitizer is about 2.5 times greater at the
      resting membrane potential of -70 mV compared to +40 mV. Similar results are
      obtained using the positively charged photosensitizer methylene blue. On the
      other hand, the rate of photomodified increase of leak current in the same cells
      does not significantly change in this voltage range with Rose Bengal as
      photosensitizer, but demonstrates a voltage dependence like that of potassium
      current when methylene blue is the photosensitizer. These observations cannot be
      explained based on voltage-dependent partitioning of the sensitizer, as similar
      effects on potassium current were obtained using either a positively charged or
      negatively charged sensitizer.

PMID- 8367540
TI  - [Endangerment by the environment--on the origin and psychopathology of
      environmental anxiety].
AB  - Characteristics of the present ecological threat concerning the mind of men are
      described. Some psychiatric cases are given describing on one hand psychotic
      patients whose concern about the endangered natural environment is more
      accidental, whereas in other patients the feeling to be threatened has been
      resulted in psychopathological reactions of clinical importance. The impact of
      these new aspects of an ecological medicine is emphasized.

PMID- 8367541
TI  - [The "anxiety" ambulatory clinic: development and outlook].
AB  - The study herewith represents the conception of the Bonn "anxiety"-ambulance,
      which was established in the University of Bonn, Department of Psychiatry, in
      January 1991. Besides we report our experiences from the first four months after
      opening of our ambulance and present first results.

PMID- 8367542
TI  - [Sexuality in acute psychiatric departments].
AB  - Sexual behavior of patients in psychiatric admission wards is still only seldom
      spoken about, despite its relatively frequent occurrence in various forms and the
      emotional impact it bears on the psychiatric staff. The sexual issues have to be
      discussed with every patient. Among other things, the patients should be provided
      with information and the communicative meaning of his or her sexual
      manifestations should be elucidated and worked through psychotherapeutically. In
      the ward, a prohibitive attitude toward genital sexuality is justified; otherwise
      a flexible attitude should be assumed, which always takes the actual condition of
      the patient into consideration.

PMID- 8367543
TI  - [Young chronic psychiatric patients. A new focus in research and practice].
AB  - This paper tries to show how stimulating the mutual effects of modeling,
      providing a network of psychiatric facilities and research can be in the care of
      young adult chronic patients. However, they do not behave all the same and
      require various strategies in therapy. Under the influence of a new model of
      Sheets et al. (1982), the young adult chronic patients are classified into three
      subgroups: the "High-Functioning, High-Aspiration"-, "Low-Energy, Low-Demand"-
      and the "High-Energy, High-Demand"-group. With the example of the situation in
      Berne it can be shown that each group needs different facilities. The own
      research allows conclusions about the efficacy of the therapeutic offers. On the
      other hand, it stresses the point that especially the group of "High-Energy, High
      Demand"-patients are a major challenge for us in psychiatry. Finally some
      reflections are presented how we professionals can deal with these patients in
      future to do more justice to them.

PMID- 8367544
TI  - [Deinstitutionalization of chronic psychiatric patients exemplified by a public
      psychiatric hospital].
AB  - Basing on the multifarious phenomena of hospitalism in chronically mentally ill
      patients the authors report on a survey of known facts and analyses to enable
      focussing of appropriate on-target measures were taken to arrive at conclusions
      for caring for these long-term patients: 1. Fixing the deadline of the study; 2.
      Determining the quality of patient care; 3. Analysing the experiences collected
      in respect of the integrated training programme to promote cognitive,
      communicative and social abilities and skills among the patients in resident
      living quarters within the confines of the hospital. An attempt is made to arrive
      at an overall evaluation of the measures taken so far in respect of de
      hospitalisation and in building up complementary settlements outside the hospital
      but close to communal institutions.

PMID- 8367545
TI  - [Lithium and hyperthyroidism].
AB  - The development of hypothyroidism and the forming of a goiter are well-known
      complications associated with lithium medications. But there are also occasional
      references to cases of hyperthyroidism in the wake of both continual and of
      discontinued lithium medication. In the case being reported on here of a lady
      patient aged 64 and suffering from a toxic adenoma not recognized at the time,
      thyrotoxicosis accompanied by above-normal FT-3 results and the characteristic
      clinical symptoms developed when lithium medication was discontinued. Medical
      literature consulted in the context discussed pharmacological mechanisms which
      may be responsible for the said complications.

PMID- 8367546
TI  - [Compulsory sterilization and euthanasia--on the origins of a development that
      lead to the Fascist management of psychiatric patients].
AB  - When discussing and dealing with the way things went with German psychiatry
      during fascism the question arises constantly as to the scientific and theoretic
      self-interpretation of a specialist discipline that allowed itself to be misused
      without offering much resistance, if at all. The article makes an attempt to
      trace a few paths of specialist ideology at the turn of the 19th to the 20th
      century. The misuse of psychiatry and by psychiatry that has been practised both
      in the past and in the present cannot be understood if the guiding concepts of
      science generally ruling at the time are ignored.

PMID- 8367547
TI  - Self-defeating personality, depression, and suicidal ideation in adolescents.

PMID- 8367548
TI  - Drinking games and problems related to drinking among moderate and heavy
      drinkers.
AB  - The playing of drinking games, the quantity-frequency of alcohol consumption, and
      various problems related to drinking were assessed among a national sample of
      3,830 alcohol consuming students from 58 American colleges and universities
      during the 1990-1991 academic year. Among Light-Moderate drinkers, a
      significantly higher proportion of students who had played a drinking game
      experienced 15 of 17 drinking-related problems. On the other hand, among Heavy
      drinkers there was little difference between game and nongame players. A higher
      percentage of game players had experienced five of the problems. Generally, for
      many problems, more than twice as many Heavy drinkers among both game and nongame
      players had exhibited the problem compared to more moderate drinkers. It was
      concluded that game playing appeared to increase problems related to alcohol
      primarily among more moderate drinkers whereas those who were heavy drinkers were
      exhibiting more problems regardless of their game-playing status. Education about
      the effect of game playing among students who are moderate drinkers should be
      addressed.

PMID- 8367549
TI  - On the validity of hypotheses derived from the Rorschach: the relationship
      between color and affect, update 1992.
AB  - A review of research since the last review in 1976 reconfirms the conclusion that
      how persons will express their emotions does not necessarily bear any
      relationship to the nature of their responses to color on the Rorschach. It is
      not only time for clinicians to give up this color-affect hypothesis with regard
      to Rorschach data but to conduct some basic, exploratory research to examine,
      empirically, whether a relationship does exist between persons' characteristic
      modes of expressing their emotions and their characteristic styles of responding
      to the Rorschach.

PMID- 8367550
TI  - Gender differences in attitudes toward science.
AB  - Analysis of nationwide surveys taken from 1972 through 1990 showed that, at all
      education levels and in all age groups from 20 to 79 years, females had less
      confidence in science than males. Greater percentages of females than males
      agreed with statements that, "science breaks down people's ideas of right and
      wrong" and "science pries into things." The relationships between gender
      differences in attitudes toward science and theories about biological differences
      in cognitive abilities between the sexes, traditional societal roles of women,
      and the impediments to participation of women in historically male-dominated
      science are discussed.

PMID- 8367551
TI  - Relation between humor and generativity.
AB  - Since humor has been found to facilitate such generative pursuits as
      psychotherapy, teaching, and nursing, and been associated with intimacy, it was
      hypothesized that high levels of humor are associated with high levels of
      generativity. The Measures of Psychosocial Development (measuring generativity),
      Situational Humor Response Questionnaire, and Coping Humor Scale were given to 56
      subjects. Those scoring high on generativity scored significantly higher on both
      measures of humor than those scoring low in generativity. It was conjectured that
      humor may facilitate generativity through such mediating variables as intimacy
      and creativity as well as through stress reduction.

PMID- 8367552
TI  - Speculation contrasting experiences of World War II and U.S. servicemen of the
      Vietnam era in Southeast Asia.
AB  - Clinical experience with veterans leads to the speculation that there was
      deliberate promotion of drug use during the Vietnam War which may account for the
      markedly greater drug addiction evident in comparing Vietnam and World War II
      veterans. Returning home within a few days of combat rather than slowly by sea
      may have removed an opportunity to discuss and reflect on war experiences.

PMID- 8367553
TI  - Sex differences in romantic love attitudes among college students.
AB  - Previous research, using factor analysis, derived seven dimensions of romantic
      love. We sought to address whether these dimensions differed in importance for
      women and men. Specifically, it was hypothesized that women would consider
      Marriage and Family, Traditional Romantic Behavior, Routine Activities, and
      Religion, and men would consider Sexual Behavior, Aberrant Sex, and Drugs as more
      romantic. These specific predictions were seen as consistent with the 'double
      standard' regarding sex, i.e., it should be more important for men, and with an
      earlier theory we developed in which it was argued that in addition to the
      'double standard' for sex, security-related stimuli should be more important for
      women. The results were entirely consistent with our predictions.

PMID- 8367554
TI  - Attitudes towards and observations of nonverbal communication in a
      psychotherapeutic greeting situation: III. An interview study of outpatients.
AB  - An interview study of 50 Swedish nonpsychotic outpatients treated by some kind of
      psychotherapy was performed to investigate their attitudes towards and
      observations of nonverbal communication in a greeting situation according to the
      Questionnaire on Nonverbal Communication (psychotherapy patients' version) in
      relation to background factors such as gender, age, education, and profession,
      interest in psychological matters, "reading articles and books in psychology,"
      duration of professional help for psychological troubles, number of occasions
      waiting for a new therapist, and number of therapeutic sessions before the
      interview. The greeting situation was the first time a patient and a therapist
      met in a waiting room. Test-retest reliability of the questionnaire was larger
      for items about observation of nonverbal communication than for those about
      attitudes. Face communication (eye contact and smile) was considered by the
      subjects to constitute the most important nonverbal communication in the greeting
      process. The importance of the face in communication was stressed when the
      patient believed that such communication corresponded to more than 50% of the
      total communication in general, was female, was elderly, or reported special
      interest in nonverbal communication in the greeting situation. Some effects of
      bias were discussed. The analyses also showed a considerable consciousness and
      observation in the greeting situation by many psychotherapeutic outpatients.

PMID- 8367555
TI  - On choosing a baby's sex: what the future generation thinks, a preliminary
      survey.
AB  - The new biomedical techniques of reproduction, such as predetermination of a
      baby's sex, are gradually being initiated into formal practice in some countries
      such as Britain. This paper surveyed the attitudes of 60 academic and 60
      nonacademic men and women between 18 and 20 years on whether they supported the
      idea of choosing a baby's sex. More than 75% of all participants rejected the
      idea of choosing a baby's sex, whilst only 20% agreed with the latter issue and a
      negligible number (4%) offered no opinion. Neither sex differences nor
      differences between academic/nonacademic population were significant. The results
      are discussed in relation to recent work on differences in attitudes between
      genders in academic and nonacademic settings.

PMID- 8367556
TI  - The adult who is an only child: achieving separation or individuation.
AB  - 60 women and 60 men between the ages of 18 and 45 years (M = 30.5, SD = 9.6) were
      categorized by sex, age, and birth order (only child, firstborn, lastborn) to
      assess the differences among the adult only-child, the youngest child, and the
      oldest child in autonomous characteristics and cohesiveness in family
      interaction. Analysis of the responses on a biographical data sheet, the
      California Psychological Inventory, and the Family Adaptability Cohesion Scales
      III showed that main effects for birth order and sex are significant in the
      process of separation-individuation and that the only child is less autonomous
      than the oldest child.

PMID- 8367558
TI  - Suicide and homicide rates and national character.

PMID- 8367557
TI  - Cognitive functioning, family history of alcoholism, and antisocial behavior in
      female polydrug abusers.
AB  - Family history of alcoholism and antisocial behaviour had both independent and
      synergic negative relationships with abstract verbal reasoning for a group of 42
      female polydrug abusers whose main drug was heroin. This finding suggests that
      the observed lower cognitive performance may reflect the family history of
      alcoholism or antisocial behaviour rather than just drug abuse and is consistent
      with theories predicting a relative deficiency in high language skill by persons
      with antisocial personality disorders.

PMID- 8367559
TI  - Validation of a Portuguese form of Templer's Death Anxiety Scale.
AB  - To translate Templer's Death Anxiety Scale into the Brazilian Portuguese Escala
      de Ansiedade de Morte, linguistic validity was first established by back
      translation and calculating bilingual split-half reliability coefficients. Even
      numbered items achieved a minimally adequate .59, while the odd-numbered items
      attained a satisfactory .91. The internal consistency of the Escala (.77) matches
      that found for the original scale. The construct validity was tested by
      replicating the interactions of the English form with (1) the State-Trait Anxiety
      Inventory, (2) the Purpose-in-Life Test, and (3) Levenson's measure of locus of
      control. The Escala performed as expected, save for some difficulty with the
      locus of control measure.

PMID- 8367560
TI  - The influence of sex guilt on mood state following exposure to sexual stimuli.
AB  - 90 male subjects with high or low sex guilt were exposed to sexual music videos,
      rock videos, or a neutral travelogue before assessment of mood states. Scores on
      Elation, Vigor, and Aggression scales were significantly affected by video
      presentations when sex guilt was considered.

PMID- 8367561
TI  - Fluctuations in mood state and learning and retrieval.
AB  - The present study investigated whether learning and retrieval are associated with
      changes in mood state. 50 college students (20 men and 30 women) were assigned to
      one of five treatment conditions: Happy-Happy, Sad-Sad, Neutral-Neutral, Happy
      Sad, and Sad-Happy. Mood was induced via the Velten procedure. During the first
      mood-induction phase, students were exposed to a serial-learning task and recall
      trial, followed by a digit-symbol task. In the next phase, students were given a
      5-min. muscle-relaxation exercise and a 5-min. distracting task. In the final
      phase, students underwent a second mood-induction phase, and a subsequent recall
      trial and digit-symbol task. Analyses indicated that recall was significantly
      greater in the Happy-Happy and Sad-Sad groups. Findings for the Neutral-Neutral
      group were mixed. Results are discussed in terms of support for the concept of
      context-related, mood-state-dependent recall.

PMID- 8367562
TI  - Contributions to the history of psychology: XCV. Possible relations between
      theories of evolution and animal learning.
AB  - It is proposed that the dominance of continuity learning theory as set against
      noncontinuity learning theory during the middle third of the 20th century rested
      importantly on its derivation from Darwin's theory of evolution. The kinship is
      shown in several ways. First, Thorndike and Hull echoed the principle of natural
      selection in their belief that behaviors underwent gradual modification because
      acts that were attended steadily by favorable consequences tended to occur with
      increasing frequency. Second, they denied both nonphysical explanations of
      behavior and a priori purposes which might guide that behavior. Third, the laws
      of learning were said to hold for all organisms. It is argued that the continuity
      approach may have enjoyed success because it was consistent with the Darwinian
      world view. Had punctualist, rather than gradualist, explanations of evolution
      come to the fore in the late 19th century, learning theories might have proceeded
      quite differently with the dominance of non-continuity approaches.

PMID- 8367563
TI  - Is smoking associated with height and weight?
AB  - The reported relationship between height and smoking was tested using data from a
      representative sample of the U.S. population (N = 41,014). Both height and weight
      were associated with smoking. A further analysis for males and females separately
      showed that the initial results were a result of confounding of the variables
      with gender.

PMID- 8367564
TI  - Assertiveness in Hispanic adolescents: relationship to alcohol use and abuse.
AB  - An investigation was carried out on the relation of assertiveness to use of
      alcohol among 3129 Hispanic junior high school students. Data were obtained
      through questionnaires administered in 47 public and parochial schools in New
      York City to 5501 students. An 18-item modified version of the Gambrill-Richey
      Assertiveness Inventory was used to assess assertiveness. Factor analysis of the
      inventory identified five assertiveness factors of substance awareness, mastery
      of cognitive skills, individual rights, dating, and social skills. Significant
      gender differences were observed. Multiple regression analysis showed that
      substance awareness was negatively associated with alcohol use while dating,
      social skills, and individual rights factors were positively associated with
      alcohol use. Acculturation with peers was also a significant predictor of alcohol
      use or abuse. The findings provide a basis for design of alcohol prevention
      programs that specifically focus on Hispanic youth.

PMID- 8367565
TI  - Personality disorders in geropsychiatric outpatients.
AB  - 36 geropsychiatric outpatients were administered a semistructured personality
      disorder interview derived from DSM-III criteria. Over half (58%) of this elderly
      sample met criteria for diagnoses of personality disorders, which have been shown
      to significantly affect treatment of Axis I symptomatology in young adults.
      Compared to a young adult outpatient sample of 298, older patients had
      significantly fewer disorders and multiple ones. The greater number of diagnoses
      yielded by the interview versus clinical evaluation approached statistical
      significance.

PMID- 8367566
TI  - Geophysical variables and behavior: LXXIII. Ubiquitous errors: a reanalysis of
      Anderson's (1987) "temperature and aggression".
AB  - Reanalysis of Anderson's 1987 data showed that correlations between number of hot
      days and violence shrank to nonsignificance when variables indicative of the
      South's subculture of violence were statistically controlled. The reanalyses also
      indicated that Anderson's results were unique to the procedures he used to select
      sociodemographic controls, operationalize temperature, and combine crime rates.
      It is concluded that relations described in a review of research on temperature
      and violence are neither ubiquitous nor effects.

PMID- 8367567
TI  - Validity issues in using the Millon-II with substance abusers.
AB  - This study addressed the use of the Millon Clinical Multiaxial Inventory-II
      (Millon-II) in assessing 73 substance abusers. The influence of
      neuropsychological functioning on personality functioning is discussed and
      evaluated. Reported history of substance abuse did not significantly relate to
      measures of neuropsychological or personality functioning. Of the sample, 16.9%
      produced invalid Million-II scores; invalidity was not significantly related to
      demographic characteristics or history of substance abuse. Millon-II profile
      validity was related to verbal and perceptual-motor functioning. Some
      neuropsychological variables significantly predicted Millon-II scale scores but
      with little consistency.

PMID- 8367568
TI  - Effects of feature variations on attributions for schematic faces.
AB  - 31 subjects classified 16 schematic faces on six dimensions. Attractiveness was
      generally associated with widely separated eyes, a short nose, and high feature
      placement. When features were considered in combination, faces with low placement
      were judged attractive, although the effect was mitigated by a narrow mouth.
      Previous findings concerning perceived age and gender were partially replicated,
      but folk wisdom linking intelligence to low placement (high forehead) was
      refuted. It is suggested that the relationship between individual features and
      attributions is nonlinear and interactive, and that researchers should
      investigate these hypotheses by exercising finer control over feature variations.

PMID- 8367569
TI  - Reports of childhood incest by adults with panic disorder or agoraphobia.
AB  - A convenience sample of 94 members of an agoraphobia self-help group responded to
      an anonymous survey on their possible histories of childhood incest. 12 (13%)
      respondents reported such a history. These results are discussed in terms of
      hypothesized etiologies of panic disorder and agoraphobia.

PMID- 8367571
TI  - The structure of Templer's Death Anxiety Scale among Egyptian students: a reply.

PMID- 8367570
TI  - Animal learning and motivation and addictive drugs.
AB  - Highlights of a systematic analysis of the abstracts of over 1700 publications
      dealing with addictive drugs (primarily alcohol) in the context of animal
      learning and motivation are summarized under two main headings. The behavioral
      effects of drugs vary with the nature of the drug, the dosage, and the behavioral
      baseline; behavioral tolerance frequently results from continued practice in the
      drug state. The paradigmatic effects show that drugs can function effectively as
      conditional stimuli, unconditional stimuli, responses, and reinforcers. As a
      result, drug habits develop their own motivational support, leading to
      conditioned tolerance and conditioned addiction. It is contended that principles
      of animal behavior can provide a basis for a theory of human drug use and abuse,
      but that voluntary control of addictive behavior requires uniquely human
      cognitive processes.

PMID- 8367572
TI  - Anomalies in covert conditioning.
AB  - The covert conditioning approach has received much empirical support. Despite the
      utility of this approach, a number of anomalies (or methodological problems) have
      been considered in the past. This study describes three anomalies in covert
      conditioning which have received little attention: (1) the difficulty in
      assessing the application of the covert conditioning technique by the client, (2)
      the difficulty in explaining client's failures during use of the technique in
      terms of either problems with the therapist's instructions regarding the use of
      the technique or problems with the client's inability to imagine the scene, and
      (3) the use of single-case experimental designs in the evaluation of the
      effectiveness of covert conditioning techniques seems to violate the experimental
      format of such designs.

PMID- 8367573
TI  - First memories are nonverbal and emotional, not necessarily talked about or part
      of a recurring pattern.
AB  - Nelson (1993) hypothesized that children must learn to verbalize their memories
      to retrieve them. Their parents talk with them about the experiences thereby
      influencing what is recalled. Further, recurrence of events indicate their
      importance and aids recall. To test these hypotheses, 83 students were asked to
      recall their first memory and indicate whether they recalled it verbally or
      nonverbally, had talked or been told about it, and whether it involved recurring
      events. They also were asked whether the memory involved emotions, because
      emotionality may enhance recall. Analysis showed that 94% of first memories were
      nonverbal and 92% involved an emotional event, but only 45% had been talked about
      and 55% were part of a recurring pattern. Research into nonverbal, first memories
      of adjusted individuals is needed to understand memory better and to have a
      comparison for what is recalled in therapy, in lawsuits involving child abuse,
      etc.

PMID- 8367574
TI  - The messiah-complex in schizophrenia.
AB  - After suggesting that religio-egocentricity and the messiah-complex may be a
      universal pattern in the psychoses, this paper briefly addresses three questions.
      First, in general, what is the relationship between religious emotions and
      schizophrenia? Second, why is it that the messiah-complex surfaces so often in
      the psychoses? Finally, what is the healthy dimension of religiosity?

PMID- 8367575
TI  - A comparison between scores on Kirton's inventory for nursing students and a
      general student population.
AB  - This study compared scores on the Kirton Adaption-Innovation Inventory of 60
      first-year nursing students with scores of 73 nonnursing majors of approximately
      the same age to test the hypothesis that, in general, individuals selecting
      nursing as a major tend to show a more adaptive style of creativity in problem
      solving than their nonnursing peers. Analysis indicated the nursing students were
      significantly more "adaptive" in problem solving and less "innovative" than the
      nonnursing control group.

PMID- 8367576
TI  - Strategies of resistance by Type-A scoring Mexican-American college students.

PMID- 8367577
TI  - Alcohol use and abuse, suicide and homicide.

PMID- 8367578
TI  - Suicide and homicide rates during presidential terms as a function of economic
      conditions.

PMID- 8367579
TI  - Assessment of three-year-olds with the Stanford-Binet Fourth Edition.
AB  - The Stanford-Binet, Fourth Edition was normed for children 30 months of age and
      older, but its usefulness with young children (e.g., 36 months) has received
      little attention. This study of 121 three-year-old children examined possible
      administration problems, provided correlations with three environmental measures,
      and compared scores with those of the Peabody Picture Vocabulary Test--Revised.
      Problems of administration did arise on some subtests, correlations with
      environmental measures were moderate, and scores on the Stanford-Binet IV and
      PPVT-R were moderately correlated. The Stanford-Binet IV is a useful test in
      assessment of a broad range of intellectual abilities.

PMID- 8367580
TI  - A test of a social deviancy theory of suicide using the foreign born.

PMID- 8367581
TI  - The nature of schizotypy.
AB  - The matrix of intercorrelations between scales of schizotypy presented by Kendler
      and Hewitt in 1992 was reanalyzed, and results rather different from those
      reported by the original authors were found. The new structure shows good
      agreement with the theory of personality disorder published by Eysenck in 1987.
      In all, the different scales seem to fall into three groups or factors,
      identified as Neuroticism (N), Extraversion (E), and Psychoticism (P). It is
      doubtful if there is a common element left over once these three groups have been
      eliminated.

PMID- 8367582
TI  - Psychotherapy for Vietnam-related Posttraumatic Stress Disorder.
AB  - There are a wide range of psychotherapeutic treatments for Vietnam-related
      Posttraumatic Stress Disorder. This paper reviews some of the more commonly used
      interventions which are the behavioral, psychodynamic, family, and group
      therapies. Commonalities among these diverse treatments are shown to involve
      reconfronting trauma stimuli and the attempt to reintegrate traumatic experiences
      into ongoing personality functioning. It is shown that there are virtually no
      methodologically sound, empirically based studies that compare two or more
      treatments within a given study. Experimentally controlled, comparative studies
      are needed to advance our knowledge of effective treatments of this disorder.

PMID- 8367583
TI  - The critical mass theory of suicide.
AB  - It was reported in 1987 that nations with higher suicide rates in 1970
      experienced greater increases by 1980. The present study did not replicate this
      phenomenon for the period of 1975 to 1985 using a sample of 32 nations with
      available data.

PMID- 8367584
TI  - Development of the ego and discomfort anxiety inventory: initial validity and
      reliability.
AB  - This article reports on four studies regarding the development, reliability, and
      validity of scales to measure two forms of anxiety, ego anxiety and discomfort
      anxiety. In the first study 140 undergraduates completed fourteen items related
      to ego anxiety and discomfort anxiety, as well as the Self-esteem Scale, the IPAT
      Anxiety Scale, and the Hopelessness Scale. Principal component analyses produced
      two factors, each with five items that showed differentiation between ego anxiety
      and discomfort anxiety. Guttman scales were developed from the items in the two
      factors. The resulting Ego Anxiety Scale had a coefficient of reproducibility of
      .94, a coefficient of scalability of .67 and estimated scale reliability of .84.
      The Discomfort Anxiety Scale had a coefficient of reproducibility of .91, a
      coefficient of scalability of .65 and estimated scale reliability of .83.
      Significant relationships were found between the scores on the two anxiety scales
      and scores on the Self-esteem Scale and the IPAT. Correlations between scores on
      the new anxiety scales and scores on the Hopelessness Scale were not significant.
      In the second study, undergraduates completed the Ego and Discomfort Anxiety
      Scales, the Self-esteem Scale, the IPAT Anxiety Scale, and the Hopelessness
      Scale. The reliability of the Ego Anxiety Scale (0.77) and the Discomfort Anxiety
      Scale (0.85) was estimated using Cronbach's alpha measure. t tests for scores of
      independent samples for students in Studies I and II were completed for scores on
      the Ego and Discomfort Anxiety Scales, Self-esteem Scale, IPAT Anxiety Scale, and
      Hopelessness Scale. None of these test comparisons were significant. The data
      from Studies I and II were pooled to provide tentative normative data for the Ego
      and Discomfort Anxiety Scales. The third study explored the reliability and
      validity of the new scales, testing 79 undergraduates who completed the Ego and
      Discomfort Anxiety Scales, the Fear of Negative Evaluation Scale, and the Problem
      Solving Inventory. The reliability coefficients of the Ego Anxiety Scale and
      Discomfort Anxiety Scale were 0.75 and 0.82, respectively. The differences
      between the combined scores of subjects in Studies I and II and the scores of
      subjects in the third study on the Ego and the Discomfort Anxiety Scale were not
      significant. A significant positive correlation, however, was found between
      scores on the Ego Anxiety Scale and scores on the Fear of Negative Evaluation
      Scale.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8367585
TI  - Protection motivation theory and alcohol use attitudes among older adults.
AB  - Responses of 17 elderly persons and 20 VA inpatients with alcohol-abuse problems
      (all 60 yr. or older) to an Alcohol Attitude Survey administered by telephone and
      interview were examined. Inpatients felt more vulnerable, perceived higher costs
      in moderating drinking, and showed lower response efficacy. Inpatients consumed
      substantially more alcohol than the community-dwelling elders. Hypotheses for
      study were generated.

PMID- 8367586
TI  - Dosimetric effects of beam size and collimation of epithermal neutrons for boron
      neutron capture therapy.
AB  - A series of studies of "ideal" beams has been carried out using Monte Carlo
      simulation with the goal of providing guidance for the design of epithermal beams
      for boron neutron capture therapy (BNCT). An "ideal" beam is defined as a
      monoenergetic, photon-free source of neutrons with user-specified size, shape and
      angular dependence of neutron current. The dosimetric behavior of monoenergetic
      neutron beams in an elliptical phantom composed of brain-equivalent material has
      been assessed as a function of beam diameter and neutron emission angle (beam
      angle), and the results are reported here. The simulation study indicates that
      substantial differences exist in the dosimetric behavior of small and large
      neutron beams (with respect to the phantom) as a function of the extent of beam
      collimation. With a small beam, dose uniformity increases as the beam becomes
      more isotropic (less collimated); the opposite is seen with large beams. The
      penetration of thermal neutrons is enhanced as the neutron emission angle is
      increased with a small beam; again the opposite trend is seen with large beams.
      When beam size is small, the dose delivered per neutron is very dependent on the
      extent of beam collimation; this does not appear to be the case with a larger
      beam. These trends in dose behavior are presented graphically and discussed in
      terms of their effect on several figures of merit, the advantage depth, the
      advantage ratio, and the advantage depth-dose rate. Tables giving quick summaries
      of these results are provided.

PMID- 8367587
TI  - Hypertonic treatment during premature chromosome condensation allows
      visualization of interphase chromosome breaks repaired with fast kinetics in
      irradiated CHO cells.
AB  - A class of interphase chromosome breaks was visualized in irradiated (10 Gy)
      plateau-phase CHO cells after treatment (2-30 min) in hypertonic (500 mM NaCl)
      growth medium during the period normally allowed for chromosome condensation, in
      the premature chromosome condensation (PCC) assay. Rejoining of this class of
      interphase chromosome breaks was fast (t1/2 = 1.5 min) compared to the rejoining
      of interphase chromosome breaks normally observed in the absence of hypertonic
      treatment (t1/2 = 76 min), suggesting that they are formed from a different
      subset of precursor DNA lesions. A fast (t1/2fast = 12 min) and a slow (t1/2slow
      = 71 min) component were also observed in the rejoining of radiation-induced (50
      Gy) DNA double-strand breaks (DSBs), as measured by pulsed-field gel
      electrophoresis. We propose that fast-repairing DSBs are the precursor lesions
      underlying the fast-repairing interphase chromosome breaks observed in these
      experiments. Slowly repairing DSBs are postulated to be the precursor lesions
      underlying the slowly repairing interphase chromosome breaks visualized using
      regular protocols for PCC. The visualization of fast-repairing interphase
      chromosome breaks achieved in these experiments is assumed to be due to a
      destabilization of chromatin by the hypertonic medium. This chromatin
      destabilization may cause either an inhibition of the rejoining of the fast
      component of DSBs during the period allowed for PCC or a transformation of a
      defined subset of fast-repairing DSBs into chromosome breaks. The latter
      hypothesis allows a more consistent interpretation of the available results.
      Transformation of a defined subset of fast-repairing DSBs to interphase
      chromosome breaks may be equivalent to damage fixation, and may correspond to the
      fixation of a form of PLD (beta-PLD) sensitive to treatment in hypertonic medium.

PMID- 8367588
TI  - Hypertonic treatment does not affect the radiation yield of interphase chromosome
      breaks in DNA double-strand break repair-deficient xrs-5 cells.
AB  - A DNA double-strand break (DSB) repair-deficient CHO cell line, xrs-5, was used
      to evaluate the effect of hypertonic treatment on the radiation yield of
      interphase chromosome breaks, as visualized by means of premature chromosome
      condensation (PCC). For this purpose, interphase chromosome breaks were measured
      in plateau-phase G1 cells after exposure to 10 Gy X rays using either the
      standard protocol for PCC induction or a revised protocol that includes a brief
      (20 min) treatment in hypertonic medium (500 mM NaCl) during chromosome
      condensation. Experiments at the chromosome level were complemented by
      experiments at the DNA and the cellular level performed under similar
      postirradiation conditions. The results obtained were compared to those reported
      previously for CHO cells. Radiation yields of interphase chromosome breaks, as
      measured using standard protocols for PCC induction, were higher in xrs-5 than in
      CHO cells. However, the yields became similar between the two cell lines when a
      20-min incubation in hypertonic medium was introduced immediately after fusion
      with mitotic cells. This equalization was due to the fact that incubation in
      hypertonic medium did not affect the radiation yield of interphase chromosome
      breaks in xrs-5 cells but increased it in CHO cells to levels similar to those
      measured in xrs-5 cells. This result suggests that xrs-5 cells constitutively
      express as interphase chromosome breaks a subset of DSBs which in repair
      proficient CHO cells requires incubation in hypertonic medium for transformation
      to interphase chromosome breaks. Rejoining of DSBs, when measured in isotonic
      medium, was incomplete in xrs-5 cells compared to CHO cells. Rejoining of DSBs
      normally repaired in xrs-5 cells was completely inhibited during treatment in
      hypertonic medium. Postirradiation treatment in hypertonic medium affected the
      survival of xrs-5 cells only modestly, suggesting that the sector of PLD (beta
      PLD) which required treatment in hypertonic medium for fixation in repair
      proficient CHO cells is fixed constitutively in xrs-5 cells. These results are in
      agreement with a model developed to interpret results obtained in similar
      experiments with CHO cells (Iliakis et al., Radiat. Res 135, 160-170, 1993). The
      model postulates that potentiation in CHO cell killing induced by hypertonic
      treatment is caused by the transformation of a subset of fast-repairing DSBs to
      irreparable interphase chromosome breaks and assumes that this transformation is
      equivalent to fixation of beta-PLD.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8367589
TI  - The low carcinogenicity of electron radiation relative to argon ions in rat skin.
AB  - The carcinogenicity of electron radiation relative to argon ions in rat skin was
      examined, specifically investigating whether the linear-quadratic model is useful
      for predicting cancer yield for one type of radiation based on yields observed
      for a different type. Three experiments were conducted to obtain information on
      the relationship between cancer yield and the dose of electron radiation: (1) a
      conventional dose-response protocol where the number of rats per group was based
      on the expected tumor yield; (2) a multiple-fraction protocol designed to take
      advantage of yield additivity as a way to estimate carcinogenicity at lower
      doses; and (3) a protocol to examine the effect of age at the time of irradiation
      on the dose-response relationship for cancer induction. Published data on the
      induction of skin cancer in rats irradiated with electrons were reanalyzed and
      combined with results of the new experiments. Skin cancer yield versus dose for
      argon ions was consistent with the linear-quadratic model, but the cancer yield
      for electrons was considerably lower (by a factor of 6.7 at 10 Gy) than the
      prediction based on the linear-quadratic model. The cancer yield for electron
      radiation was better fitted by a dose-cubed power function than a linear
      quadratic function. The results indicate a substantially lower carcinogenic
      effectiveness for electron radiation, especially at lower doses, in comparison to
      argon ions and suggest that electrons may cause cancer by a three-event pathway
      instead of the two-event pathway that is consistent with the results for argon
      ions.

PMID- 8367590
TI  - Interphase death and reproductive death in X-irradiated MOLT-4 cells.
AB  - The killing effects of ionizing radiation on MOLT-4 cells were studied using
      colony formation assays, dye exclusion tests, and cell growth analysis. When MOLT
      4 cells were exposed to X rays, the fraction of cells stained with erythrosin B
      increased markedly during the incubation after irradiation at 37 degrees C and
      reached a maximum within 24 h. In contrast, no such increase was observed for
      L5178Y cells or their derivative, radiosensitive mutant M10 cells, at a dose
      resulting in the same level of cell survival as measured by the colony formation
      assay. Detailed analysis of cell survival as measured by the dye exclusion test
      in comparison with that measured by the colony formation assay in MOLT-4 cells
      indicated that MOLT-4 cells are subject to interphase death as well as
      reproductive death. Analysis of subclones showed a wide variety of differences in
      the level of stained cells using the dye exclusion test. The results confirmed
      the population heterogeneity of MOLT-4 cells. Moreover, none of the subclones
      showed exactly the same cell survival when this was measured with the two assays.
      The present results strongly suggest that both modes of cell death may occur in
      single MOLT-4 cells. Possibly apoptosis is the mechanism accounting for both
      modes of death in these cells.

PMID- 8367591
TI  - Transgenic marrow transplantation: a new in vivo and in vitro system for
      experimental hemopoiesis and radiobiology which employs sequential molecular
      monitoring of multiple genetic markers.
AB  - Efforts to understand the in vivo regulation of hemopoiesis have been greatly
      impeded by an inability to trace and quantify the fate of multiple hemopoietic
      stem cell (HSC) cohorts within a single animal simultaneously. We report here the
      development of a molecular marker system which overcomes this deficiency and can
      be readily extended to a wide variety of applications in experimental hematology
      and radiobiology. Mixtures of HSC from multiple strains of transgenic mice,
      derived on a common genetic background, were used as donors to reconstitute
      lethally irradiated wild-type mice. Using molecular hybridization and the
      polymerase chain reaction, we documented the presence and quantified the amount
      of various transgenic markers in the blood of individual recipient mice after
      transplantation. The transgenic markers were also detected in spleen, thymus,
      peritoneal exudates, bone marrow, spleen colonies (CFU-S), and in vitro colonies.
      The transgenic transplantation marker system thus permits repeated analysis of
      multiple stem cell cohorts over the entire spectrum of hemopoiesis including HSC,
      intermediate precursors, and functionally mature cells. Therefore, the transgenic
      markers should facilitate the in vivo analysis of stem cell development, gene
      transfer, leukemogenesis, recovery from radiation or drug treatment, and the
      influence of hormones/growth factors on these processes.

PMID- 8367592
TI  - Analysis of large X-ray-induced mutant populations by denaturing gradient gel
      electrophoresis.
AB  - To increase the precision by which predominant point mutations can be observed,
      hypoxanthine guanine phosphoribosyl transferase (HPRT)-deficient mutants selected
      en masse from large X-irradiated cultures of human lymphoblastoid cells (line
      TK6) were analyzed by denaturing gradient gel electrophoresis (DGGE). Four
      independent experiments yielded approximately 7 x 10(3) and 3.2 x 10(3) initial
      surviving 6-thioguanine-resistant (6-TGr) mutants in X-ray-treated and untreated
      cultures, respectively. The hprt exon 3 fragments were amplified from DNA
      extracted from these mixed 6-TGr cell populations by employing the polymerase
      chain reaction using modified T7 DNA polymerase. DGGE was used to separate the
      mutant sequences from the wild-type as mutant/wild-type heteroduplexes. The X
      irradiated populations contained several mutant bands in the 104-bp low-melting
      region of exon 3 that were not observed in the untreated cultures. Two exon 3
      specific mutations were observed in more than one treated culture and various
      tests for potential biases suggested that these were radiation-specific
      mutational hotspots. These two recurring mutations were specific 1-bp deletions
      in either a run of four T:A's (bp 294-297) or a run of 3 A:T's (bp 247-249).
      Several other "sporadic" signals observed in X-irradiated cultures were caused by
      small deletions ranging from 2 to 25 bp in length.

PMID- 8367593
TI  - Differential effects of fractionated X irradiation on mouse spermatogonial stem
      cells.
AB  - The response of spermatogonial stem cells to fractionated X irradiation was
      studied in the various stages of the spermatogenic cycle of the CBA mouse.
      Fractionated doses of 2 + 2, 1 + 3, and 3 + 1 Gy with a 24-h interval between the
      doses were compared with a single dose of 4 Gy. The numbers of undifferentiated
      spermatogonia present 10 days after (the second) irradiation were taken as a
      measure of stem cell survival. Twenty-four hours after the first irradiation a
      sensitization was observed that was found to be stage-dependent. The greatest
      sensitization occurred in that part of the spermatogonial stem cell population
      that was in stages X-I during the first irradiation, i.e., the part that is
      stimulated to proliferate or actively proliferating at that time. In stages that
      were quiescent during the first irradiation (VI-VII), fractionation did not
      influence the response. Therefore, only the spermatogonial stem cells that are
      initially radioresistant become sensitized 24 h after irradiation. When two
      unequal doses (3 + 1 Gy or 1 + 3 Gy) are given, damage correlates with the size
      of the second dose, indicating that priming doses of 1 and 3 Gy are both capable
      of inducing the sensitizing effect.

PMID- 8367594
TI  - Exonuclease I of Escherichia coli removes phosphoglycolate 3'-end groups from
      DNA.
AB  - Exonuclease I of E. coli is a 3'-->5' exonuclease acting on single-stranded DNA.
      We further demonstrate that the enzyme can remove phosphoglycolate groups at 3'
      termini in DNA. These types of lesions are introduced into DNA by agents that
      cause oxidative damage such as ionizing radiation. An oligonucleotide substrate
      pd(T)20[32P]dA was treated with acid to remove the adenine base to generate 3'
      termini containing 2-deoxyribose-5-phosphate end groups. This substrate was then
      treated with periodate to generate 3'-phosphoglycoaldehyde groups and was further
      oxidized with I2 to generate 3'-phosphoglycolate groups. The pd(T)20[32P]PGA
      substrate was annealed to pd(A)40-60 to produce a double-stranded substrate.
      Exonuclease I was effective in the removal of the 3'-phosphoglycolate groups from
      this substrate as determined by HPLC separation. With exonuclease III and
      endonuclease IV of E. coli, exonuclease I is the third activity found in E. coli
      that is able to excise deoxyribose-phosphate fragments at 3' termini in DNA.
      These sugar fragments are blocks to DNA polymerase, and their removal is
      necessary to complete the base excision repair process.

PMID- 8367595
TI  - Oncogene- transformed NIH 3T3 cells display radiation resistance levels
      indicative of a signal transduction pathway leading to the radiation-resistant
      phenotype.
AB  - Oncogenes and their normal counterparts, proto-oncogenes, are functionally
      important cellular genes which interact with one another as components of signal
      transduction pathways leading to cell growth and differentiation. Numerous
      reports in the literature have also begun to link these genes to the phenomenon
      of cellular radiation resistance. In this report we examine the radiation
      resistance level of NIH 3T3 cells transformed by various oncogenes in an attempt
      to define the intracellular pathway to the radiation-resistant phenotype. The
      results demonstrate that an analogous signaling pathway is apparently involved in
      acquisition of radiation resistance. Serine/threonine protein kinase oncogenes
      such as raf, mos, and PKC play a central role in the pathway. Moreover, specific
      oncogenes upstream (sis, HER-2, met, trk, and ras) and downstream (ets and myc)
      of these important signaling mediators can also influence the radiation
      resistance level of the cells.

PMID- 8367596
TI  - Systemic deposits of thorium in thorotrast patients with particular reference to
      sites of minor storage.
AB  - It is well established that injected Thorotrast is deposited in the liver,
      spleen, bone marrow, and lymph nodes, but accumulations in organs with lower
      macrophage activity have previously been given little attention. In this work,
      neutron activation analysis has been used to investigate concentrations of
      thorium in autopsy samples taken at sites of major and minor deposition in 24
      Thorotrast patients. In the latter category, the highest values were found in the
      testis [40 x 10(-6) g/g(wet)], followed by those in the adrenal gland,
      gallbladder, lung, and pancreas. The resulting alpha-particle dose rates
      (mGy/year) are tentatively estimated to be 8.5 to the testis, 5.5 to the
      gallbladder, and 5.3 to the lung. These results may be relevant to the residual
      excess mortality among Thorotrast patients after diseases of the principal organs
      of deposition have been excluded; they also support previous indications that
      thorium deposited in pulmonary tissues is responsible for an important component
      of the total dose to the lung. In another context, our data may bear on the
      connection, postulated elsewhere, between exposure to alpha-particle emitters and
      elevated incidence of leukemia in the children of workers engaged in the
      reprocessing of nuclear fuel.

PMID- 8367597
TI  - Is there an adaptive response in spleen lymphocytes of C57B1/6 mice as assessed
      by chromosomal aberrations?
AB  - In previous publications we have shown that no adaptive response could be induced
      in preimplantation embryos and spleen lymphocytes of Heiligenberger mice, a
      strain inbred at our institute (Wojcik et al., Int. J. Radiat. Biol. 62, 177-186,
      1992; Muller et al., Int. J. Radiat. Biol. 62, 169-175, 1992). Because of data
      indicating that some humans may be genetically deficient in the ability to
      express an adaptive response, we have speculated that the cells of the
      Heiligenberger strain may lack an adaptive response. To check this, experiments
      have been done with spleen lymphocytes of the C57B1/6 mice. Initial results
      indicated the presence of an adaptive response in some individual C57B1/6 mice.
      However, an analysis of aberration scores of parallel lymphocyte cultures
      revealed a high intraindividual variability, indicating that the adaptive
      response observed initially was a reflection of this variability rather than of
      induced radiation resistance. This conclusion is confirmed further by the lack of
      such variability in parallel cultures of lymphocytes from Heiligenberger mice.

PMID- 8367598
TI  - Deficits in the sensitivity of striatal muscarinic receptors induced by 56Fe
      heavy-particle irradiation: further "age-radiation" parallels.
AB  - We had previously shown that there was a loss of sensitivity of muscarinic
      receptors (mAChR) to stimulation by cholinergic agonists (as assessed by
      examining oxotremorine enhancement of K(+)-evoked release of dopamine from
      neostriatal slices) in animals that had been exposed to energetic particles
      (56Fe, 600 MeV/n), an important component of cosmic rays. This loss of mAChR
      sensitivity was postulated to be the result of radiation-induced alterations in
      phosphoinositide-mediated signal transduction. The present experiments were
      undertaken as a first step toward determining the locus of these radiation
      induced deficits in signal transduction by examining K+ enhancement of release of
      dopamine in 56Fe-exposed animals (0, 0.1, and 1.0 Gy) with agents [A23187, a
      potent Ca2+ ionophore, or 1,4,5-inositol trisphosphate (IP3)] that "bypass" the
      mAChR-G protein interface and by comparing the response to oxotremorine-enhanced
      K(+)-evoked release of dopamine. Results showed that although oxotremorine
      enhanced K(+)-evoked release of dopamine was reduced significantly in the
      radiation groups, no radiation effects were seen when A23187 or IP3 was used to
      enhance K(+)-evoked release of dopamine. Since similar findings have been
      observed in aging, the results are discussed in terms of the parallels between
      aging and radiation effects in signal transduction that might exist in the
      neostriatum.

PMID- 8367599
TI  - Reduced adriamycin concentration in rat mammary tumors treated previously with
      hyperthermia.
AB  - The effect of prior hyperthermia on the concentrations of adriamycin in tumors
      was examined. Chemically induced (9,10-dimethyl-1,2-benzanthracene) rat mammary
      adenocarcinomas were not heated or were heated one or two times (43.5 degrees C,
      1 h; 24 h apart when two times) using an Nd:YAG laser. Rats were administered
      adriamycin (5 mg/kg, iv) 3 h after hyperthermia treatment. The concentrations of
      adriamycin in plasma and tissue were determined using high-performance liquid
      chromatography. Although plasma pharmacokinetics was unchanged by prior local
      hyperthermia, the concentration of adriamycin was significantly lower in tumors
      that had been heated previously compared to that in unheated tumors. Tumor blood
      flow rate was determined after an identical heating protocol using a reference
      sample technique with 113Sn microspheres. Tumor blood flow rate increased
      slightly during hyperthermia and then rapidly returned to control levels after
      hyperthermia. Decreased concentrations of adriamycin in tumors may result from
      biochemical changes induced by hyperthermia in neoplastic cells and may explain
      the adriamycin resistance in thermotolerant cells reported previously.

PMID- 8367600
TI  - [Endosonography of the esophagus and the stomach].
AB  - Endosonography of the oesophagus and stomach is important for staging of
      carcinomas, for judging the degree of thickening of the wall, and for assessment
      of submucosal and intramural lesions and of space-occupying processes in extra
      oesophageal and extragastric organs.

PMID- 8367602
TI  - [Doppler echography for the preoperative assessment of malignant processes in the
      pancreas head and liver hilus].
AB  - Ultrasound is the imaging technique of choice in obstructive jaundice for
      demonstration of dilatation of the bile ducts, and its position and cause. In
      carcinoma of the pancreatic head and in hilar tumours of the liver (Klatskin) it
      is often possible to demonstrate their inoperability, making other imaging
      techniques unnecessary. Duplex-Doppler ultrasound can be highly advantageous in
      the evaluation of compression or invasive growth of the tumour in the mesenterico
      portal venous system, making such invasive examination procedures as angiography
      unnecessary.

PMID- 8367601
TI  - [Intraductal ultrasound of the bile ducts].
AB  - Intraluminal ultrasound with 12.5 and 20 MHz transducer allows precise analysis
      of the extrahepatic bile ducts and the adjacent structures. Inflammatory and
      malignant thickening of the bile duct wall can be assessed without difficulty. It
      is not possible, however, to differentiate between benign and malignant bile duct
      thickening, and for this purpose biopsy is required in addition. In tumor staging
      intraluminal ultrasound is superior to conventional ultrasound, because tumor
      infiltration into the adjacent tissues can be assessed and lymph nodes along the
      hepaticoduodenal ligament can be detected. Owing to the ultrasound frequencies
      available, local staging is limited to a circumference of 1.5/2 cm. Intraluminal
      ultrasound provides additional information that is useful in the diagnosis and
      therapy of bile duct stones and in different types of palliative tumor therapy.
      The procedure is simple and not too time consuming, and it involves no risks to
      the patient.

PMID- 8367603
TI  - [Sonography of acute appendicitis. A 5-year prospective study of 2074 patients.
      2].
AB  - High-resolution real-time ultrasound (US) with a 5 MHz transducer has proved to
      be an important method in the diagnosis of acute appendicitis. In a prospective
      study we examined 2074 unselected patients with suspected appendicitis to assess
      the diagnostic and epidemiological value of US. According to the clinical
      diagnosis females aged 10 to 30 represented the majority of suspected cases.
      Appendicitis was most often proved in male patients aged 15-30 years. The
      prevalence of acute appendicitis in childhood is lower (7%) than in elderly
      patients (33%). US enables the diagnosis of acute appendicitis with a sensitivity
      of 91%, a specificity of 98% and an overall accuracy of 97%. For differential
      diagnosis US demonstrates other diseases that mimic acute appendicitis. Thus it
      is possible to reduce the negative appendectomy rate particularly in children by
      revealing mesenteric lymphadenitis or terminal ileitis and in young women by
      directing attention to gynecological diseases.

PMID- 8367604
TI  - [Diagnosis of colonic tumors and chronic inflammatory colonic diseases by
      hydrocolonic sonography].
AB  - Retrograde instillation of water into the colon makes it possible to visualize
      the colon sonographically from the rectosigmoid transition to the cecum in 97% of
      the patients examined. The sonographic views obtained using this technique, which
      is called hydrocolonic sonography, show the echo-free intestinal lumen, the five
      individual layers of the colon wall and the connective tissue surrounding the
      colon. Colonic polyps and carcinomas appear sonographically as echogenic
      structures projecting from the intestinal wall into the lumen. Colonic polyps
      larger than 7 mm diameter can be identified in 91% of cases, and the sensitivity
      of the technique in the detection of carcinomas of the colon is 97%. In addition,
      detailed evaluation of the structure of the bowel wall permits more precise
      staging of tumors of the colon. Aside from such localized changes, hydrocolonic
      sonography can also demonstrate typical changes in the wall structure in chronic
      inflammatory large-bowel diseases. In acute Crohn's disease the normal stratified
      appearance of the colonic wall is no longer in evidence and the wall appears
      visible thickened. In contrast, in patients with acute ulcerative colitis the
      normal sonographic stratified appearance of the colonic wall is maintained.
      Hydrocolonic sonography enables a detailed sonographic examination of the colonic
      lumen and the colon wall, thus providing additional information and allowing more
      precise diagnosis of many diseases of the colon.

PMID- 8367605
TI  - [Rectal endosonography for perirectal and non-tumor rectal changes].
AB  - The value of rectal endosonography was retrospectively evaluated in 39 patients
      with various rectal and perirectal diseases. Endosonography proved to be very
      helpful in demonstrating or excluding abscesses. In patients with aspecific minor
      inflammatory rectal diseases, endosonography was not very helpful. Endosonography
      is complementary to other imaging techniques like CT and MRI in establishing
      perirectal tumors. Endosonography shows the relationship of the rectal wall with
      an extrarectal tumor and is capable of demonstrating the extent of smaller
      tumors. It may contribute to the diagnosis of endometriosis in the rectovaginal
      space. In patients with anal pain endosonography can play an important role in
      demonstrating or excluding fistulas, abscesses and other diseases.

PMID- 8367606
TI  - [2D-time-of-flight MR angiography in the diagnosis of abdominal aorta aneurysms].
AB  - In abdominal aortic aneurysm ultrasonography, contrast-enhanced CT, and digital
      subtraction angiography (DSA) are the preoperative diagnostic methods of choice
      accepted today. It was the goal of this study to evaluate time-of-flight magnetic
      resonance angiography (MRA) in comparison with other radiographic procedures in
      different types of aneurysms. In 24 patients with proven aortic aneurysm,
      projection angiograms (MIP algorithm) of the abdominal aorta and pelvic arteries
      were performed using two-dimensional gradient echo multi slice sequence (FLASH,
      TE/TR = 10/51 ms; three slices; breathhold technique; flip angle = 30 degrees) in
      coronal orientation. In addition, renal arteries were imaged in axial slices. The
      information provided by MRA was comparable to that of DSA (perfused vascular
      lumen) and contrast-enhanced CT (alteration of vascular wall). Thus dilatation,
      thrombus, dissection, or inflammation could be analysed safely. Extension of the
      aneurysm to pelvic arteries could be evaluated in most cases by rotation of the
      projection angiograms; ostial renal artery disease could be visualized on axial
      slices. If further technical improvement of MRA is presupposed, this noninvasive
      method may completely replace the invasive procedures of contrast-enhanced CT and
      DSA in the future.

PMID- 8367607
TI  - [An unclear circulatory disorder].

PMID- 8367608
TI  - Engineering considerations in the development of the automatic implantable
      cardioverter defibrillator.
AB  - Each of the authors played a significant role in the design and development of
      one or more of the Medrad/Intec/Cardiac Pacemakers Inc defibrillators. In so
      doing, each has contributed to the realization of Dr Mirowski's dream. That tens
      of thousands of patients have now benefitted from his leadership and that many
      AICDs will soon be competing in the marketplace is testimony to his truly
      remarkable vision and persistence.

PMID- 8367609
TI  - Influence of the implantable cardioverter defibrillator on survival:
      retrospective studies and prospective trials.

PMID- 8367610
TI  - Developmental history, early use, and implementation of the Automatic Implantable
      Cardioverter Defibrillator.

PMID- 8367611
TI  - The Coronary Artery Bypass Graft (CABG) Patch Trial. The CABG Patch Trial
      Investigators and Coordinators.

PMID- 8367612
TI  - Effect of in vitro exposure to acrolein on carbachol responses in rat trachealis
      muscle.
AB  - Isolated tracheal rings obtained from male Wistar rats 10 to 15 weeks old and
      weighing 300 to 400 g were exposed to aqueous solutions of acrolein, and the
      resulting change of smooth muscle contractility was evaluated by measuring the
      cumulative carbachol concentration-response curve. Using the product of acrolein
      concentration and time as a surrogate for the acrolein dose delivered to the
      smooth muscle cells, contractility measured after a variety of exposure
      concentrations from 0.01 to 3.0 microM and times from 5 to 60 min could be
      correlated in a dose-dependent manner. In the range of doses from 0.1 to 6 microM
      min, relative contractility continuously increased from 0 to 50% above unexposed
      control values. At doses greater than 6 microM-min, the enhancement in
      contractility declined. This decline may have been due to cell damage or cell
      death which was so severe at a dose of 60 microM-min that contractility fell
      below control values. Below a threshold dose of 0.1 microM-min, acrolein had no
      effect on contractility. The role arachidonic acid metabolism in the enhancement
      of smooth muscle reactivity to carbachol was studied using indometacin to block
      the cyclo-oxygenase pathway and NDGA to block the lipoxygenase pathway. At a
      concentration of 10 microM of either indometacin or NDGA, the acrolein-induced
      enhancement in airway reactivity was completely inhibited. At lower
      concentrations, inhibition by these two chemicals was partially additive,
      suggesting that both the lipoxygenase and cyclo-oxygenase pathways play a role in
      the hyperreactive response.

PMID- 8367613
TI  - Capsaicin-induced reflex bronchoconstriction in the newborn.
AB  - Although bronchoconstriction in response to C-fibre stimulation has been reported
      to be weak or absent in the newborn, pulmonary resistance and compliance have not
      been measured. We tested the hypothesis that capsaicin reflexly activates
      pulmonary efferent outflow to airway smooth muscle in the newborn. We measured
      breath-by-breath responses of inspiratory lung resistance (RLi) and dynamic
      compliance (CLdyn) in 13 newborn dogs and 4 newborn pigs during right heart
      injections of saline, capsaicin (25-50 micrograms/kg) and acetylcholine (ACh).
      Repeat capsaicin injections at 5 min intervals were made to test for
      desensitization in the newborn dog. All newborn dogs and 2 of 4 newborn pigs
      displayed a brisk bronchoconstriction; in the dog, RLi increased maximally by 97%
      +/- 13 (SE) and CLdyn decreased maximally by 32% +/- 2. In both species, initial
      capsaicin injections (CAP1) caused a long latency (time to peak heart rate 26.8
      +/- 2 and 20 sec +/- 2.5) increase in heart rate (40% +/- 11 and 20.1% +/- 8.2
      for the newborn dog and pig respectively). In the dog, but not the pig, capsaicin
      responses after the ACh trial (CAP2 and CAP3) caused a short latency bradycardia
      while the long latency tachycardia continued to be expressed in both species. The
      maximal changes in RLi and CLdyn, and the bradycardia, were reduced (i.e.
      desensitized) by 36%, 53% and 63% respectively if capsaicin injection was
      repeated within 5 min. Muscarinic blockade with atropine abolished the
      bronchoconstrictor and bradycardia responses to capsaicin but had no effect on
      the tachycardia. We conclude that the newborn possesses the neural circuitry to
      mount a bronchoconstrictor response to C-fibre stimulation. We speculate that the
      response is designed to reduce dead space and stabilize highly compliant airways
      of the newborn during the rapid shallow breathing that is typically associated
      with C-fibre stimulation.

PMID- 8367614
TI  - Reduced voluntary drive to breathe in asthmatic subjects.
AB  - Maximal voluntary drive to the diaphragm and a non-respiratory muscle group
      (elbow flexors) was compared in 10 control subjects and 11 asthmatics who were
      studied when well. The degree of voluntary activation during repeated attempted
      maximal quasi-static efforts was determined using the twitch interpolation
      technique in the absence of contractile fatigue under both control conditions and
      following bronchial challenge with histamine. Diaphragm activation was assessed
      using bilateral phrenic stimulation at the normal resting end-expiratory lung
      volume after exhalation from TLC. Asthmatic subjects showed lower and more
      variable voluntary activation than control subjects for both diaphragm (82.0% +/-
      18.4 [SD], vs 87.8% +/- 12.0, P < 0.01) and elbow flexors (91.3% +/- 7.6 vs 95.8%
      +/- 4.1, P < 0.01). Histamine challenge decreased FEV1 in asthmatic subjects to
      50% of the initial value, but had no significant effect on voluntary activation
      in either subject group. The decreased voluntary drive to the diaphragm observed
      in some asthmatic subjects may predispose to rapid development of ventilatory
      failure during severe airway narrowing.

PMID- 8367615
TI  - The carotid body in the motorneuron response to protriptyline.
AB  - Protriptyline (PRT) has been shown to preferentially stimulate upper airway
      inspiratory motorneurons relative to phrenic activity in hyperoxic hypercapnia in
      the decerebrate cat via a carotid body-independent mechanism. Since previous
      studies indicated that carotid body stimulation results in preferential
      activation of upper airway respiratory muscles during both hypercapnia and
      hypoxemia, we hypothesized that if PRT preferentially stimulated upper airway
      motorneurons, the mechanism of action might involve the carotid body. We
      investigated the effect of PRT on carotid body function by comparing the
      electrical activity of the hypoglossal (HYP) with that of the phrenic (PHR) nerve
      in carotid sinus nerve intact (CSNI) and CSN-sectioned (CSNX) anesthetized rats,
      before and after PRT (0.5 mg/kg i.v.), during 100% O2, 15% O2 (N2 balance), and
      4% CO2 (O2 balance) administration. The moving time average (MTA) peak
      inspiratory electroneurogram activities of both the HYP and PHR nerves increased
      an equivalent amount after PRT injection during hyperoxia, in both CSNI and CSNX
      rats. During hypoxia, the HYP activity increased significantly more than the PHR
      activity only in CSNI rats after PRT injection. During hyperoxic hypercapnia, HYP
      MTAs increased a similar amount in the CSNI and CSNX rats. We conclude that the
      HYP and PHR respiratory motorneuron pool responses to PRT depend on the blood gas
      status at the time of drug administration.

PMID- 8367616
TI  - Stride length and respiratory tidal volume in exercising thoroughbred horses.
AB  - The purpose of this study was to test the hypothesis that locomotor-respiratory
      coupling in horses may provide a basis for the appropriate matching of lung
      ventilation to running speed and metabolic power. This was achieved by
      determining the effect on respiratory frequency and tidal volume in thoroughbred
      horses of changing running speed while maintaining a constant metabolic demand by
      also varying the incline of the treadmill. This procedure was performed at three
      different speeds at two different levels of metabolic rate. It appears that, in
      response to metabolic demands which are not directly related to speed, horses can
      control tidal volume independently of stride length but they do not vary
      respiratory frequency independently of stride frequency. When running at 0
      degrees incline, however, they probably do not operate an elevated tidal volume,
      because of the increased energetic costs such an elevated tidal volume would
      incur.

PMID- 8367617
TI  - Effects of inspiratory support upon breathing in humans during wakefulness and
      sleep.
AB  - We have compared the effects on breathing of inspiratory mechanical support
      during wakefulness and sleep in healthy subjects. Nine awake volunteers breathed
      through a nose mask connected to a machine supplying variable levels of
      inspiratory positive airway pressure (IPAP). Tidal volume (VT), breath duration
      (TTOT) and end-tidal PCO2 (PETCO2) were measured over 1 min steady state periods
      with IPAP set at a minimal level (approx. 2 cmH2O) and at approx. 10 cmH2O. This
      protocol was repeated in 6 of the subjects during non-REM sleep. When awake, "10
      cmH2O IPAP" caused a significant increase in mean VT from 513 to 842 ml and a
      significant fall in PETCO2 from 39.7 to 32.7 mmHg. During sleep, "10 cmH2O IPAP"
      caused no significant changes in VT (388 to 390 ml) or PETCO2 (41.8 to 39.8
      mmHg). In each state, "10 cmH2O IPAP" had no significant effect on TTOT. Three
      subjects repeated the protocol with diaphragmatic surface EMG recorded as an
      index of efferent inspiratory activity. "10 cmH2O IPAP" had no consistent effect
      on EMG when awake but caused a reduction in each subject during sleep. We
      conclude that during non-REM sleep, inspiratory mechanical support is associated
      with a compensatory decrease in efferent inspiratory activity to achieve a
      similar tidal volume with maintenance of arterial PCO2. When awake, a
      "wakefulness drive to breathe" may be associated with maintained inspiratory
      activity such that mechanical support results in an increased tidal volume
      despite a fall in arterial PCO2.

PMID- 8367618
TI  - Intramedullary sodium cyanide injection on respiratory and vasomotor responses in
      cats.
AB  - To examine the effect of hypoxia confined to the ventrolateral medulla we
      microinjected NaCN into the cat medulla (1.0 mm below the ventral surface)
      unilaterally and investigated cardio-respiratory changes. We studied anesthetized
      artificially ventilated animals and measured the electrical activity of phrenic
      and cervical sympathetic nerves and blood pressure. Histotoxic hypoxia depressed
      phrenic amplitude and elevated sympathetic tone and blood pressure. These
      responses were obtained predominantly from the region 5.0-8.0 mm caudal to the
      foramen caecum and 3.0-5.0 mm lateral to the midline (intermediate area). A study
      with 14C-cyanide showed that total and covalently bound cyanide was confined
      within a 1 mm diffusion sphere following microinjection. Isolated areas in both
      rostral and caudal medulla responded to cyanide with elevated sympathetic tone in
      the absence of phrenic nerve depression, suggesting dissociation of respiratory
      and vasomotor responses to hypoxia. Thus, the respiratory depression and
      vasomotor excitation produced by central hypoxia can be reproduced by hypoxia
      limited to discrete regions of the ventrolateral medulla.

PMID- 8367619
TI  - Histamine enhances vagal pulmonary C-fiber responses to capsaicin and lung
      inflation.
AB  - Effects of histamine on the base-line activity of vagal pulmonary C-fibers and
      their responses to chemical and mechanical stimulations were studied in
      anesthetized, open-chest dogs. Histamine aerosols (5 breaths, 1% solution)
      increased the change in tracheal pressure per breath (delta Pt) to 53 +/- 9%
      (mean +/- SE) above its base line, whereas an accompanying increase in activity
      was found in only 27% of the C-fibers studied and hence the overall afferent
      activity was not significantly different from the control. After Pt returned
      toward the base line in several minutes, the receptor activity evoked by right
      atrial injection of capsaicin (0.8-4.0 micrograms/kg) increased from a base line
      of 0.43 +/- 0.02 imp/sec to 8.12 +/- 1.16 imp/sec (averaged over 10 sec), which
      was markedly greater and longer lasting than the response triggered by the same
      dose of capsaicin after phosphate buffer aerosols (4.72 +/- 0.71 imp/sec).
      Furthermore, pretreatment with histamine aerosols also enhanced the afferent
      responses of these receptors to static lung inflation (Pt = 20 cmH2O). We
      conclude that the low dose of histamine aerosols alone did not consistently
      stimulate the vagal pulmonary C-fibers, but it potentiated the stimulatory
      effects of both capsaicin and lung inflation on these receptors.

PMID- 8367620
TI  - Sensory receptors in the first gill arch of rainbow trout.
AB  - Afferent neural activity was recorded from sensory receptors innervated by the
      glossopharyngeal nerve (cranial nerve IX) in isolated, perfused first gill arch
      preparations from rainbow trout. The present study demonstrates the presence of
      every major type of peripheral cardio-respiratory receptor described in fish in
      this preparation. Oxygen-sensitive chemoreceptors responsive to internal and/or
      external hypoxia and cyanide were present. Qualitatively these receptors behaved
      in an identical fashion which was also similar to that described for mammalian
      carotid body chemoreceptors. About 5% of the sensory receptors examined were O2
      sensitive. proprioceptors were the most numerous receptor type identified and
      were sensitive to mechanical stimulation of the arch, rakers or filaments.
      Finally, baroreceptors, the least numerous class of receptor identified, were
      also present with activity that was altered in response to changes in perfusion
      pressure. While the reflex responses elicited by the stimulation of these
      receptors were not addressed in this study, it is likely that these receptors
      contribute to the reflex cardio-respiratory responses to changes in gill
      perfusion, gill deflection and hypoxia (environmental or internal) described in
      fishes. These data thus support suggestions concerning homologies between the
      first gill arch of teleosts and the carotid bodies of mammals and the importance
      of the first gill arch in trout in cardio-respiratory control.

PMID- 8367621
TI  - Carcinosarcomas: current perspectives and an historical review of nosological
      concepts.
AB  - The origins of the concepts pertaining to the histogenesis of "carcinosarcomas"
      (CS) can be traced to theories that were advanced more than 100 years ago. Since
      that time, debate has continued over the clonality of these neoplasms and their
      corresponding lineages of differentiation. This article considers the historical
      aspects of CS and attempts to place these premises in a modern perspective. A
      review of current ultrastructural, cell-culture, and immunohistological data is
      used to support a monoclonal nature for carcinosarcoma, and to suggest that
      "sarcomatoid carcinoma" is a more apt designation for this tumor entity.

PMID- 8367622
TI  - Sarcomatoid neoplasms of the breast: proposed definitions for biphasic and
      monophasic sarcomatoid mammary carcinomas.
AB  - Biphasic sarcomatoid carcinomas (SC) of the breast are defined as tumors that are
      composed of overtly carcinomatous and sarcoma-like elements and were known in the
      past as "carcinosarcomas." On the other hand, monophasic SC show features that
      are similar to those of sarcomas, but epithelial differentiation is detected in
      the former of these lesions by immunohistochemical methods. Adequate tissue
      sampling often is required to demonstrate both components of biphasic SC; if
      properly performed, this procedure greatly reduces the diagnosis of true mammary
      "sarcoma." The carcinomatous element of biphasic tumors is characterized either
      by features of a squamous carcinoma or an invasive ductal adenocarcinoma.
      Squamous differentiation is more often associated with a spindle-cell,
      fibrosarcoma-like, or malignant fibrous histiocytoma (MFH)-like sarcomatoid
      component, whereas adenocarcinomas usually are admixed with sarcoma-like tissues
      having "heterologous" properties. The overtly epithelial elements of biphasic SC
      are always immunoreactive for keratin, but areas that simulate sarcoma express
      this protein more heterogeneously. Both components may show positivity for
      vimentin, although the sarcoma-like elements do so more consistently. Monophasic
      SC is composed solely of fusiform and pleomorphic cells that are keratin-positive
      despite their mimicry of sarcomatous differentiation. This tumor variant commonly
      assumes a myxoid, angiomatoid, or storiform growth pattern, without recognizable
      carcinomatous foci by light microscopy. Prognosis and involvement of regional
      lymph nodes in mammary SC cases is controversial, because different tumors have
      been grouped together in the past for the analysis of these variables. However,
      SC generally has a less favorable outcome than that of ordinary invasive
      carcinomas of the breast.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367623
TI  - Sarcomatoid neoplasms of the respiratory tract.
AB  - Sarcomatoid carcinomas (SCAs) of the respiratory tract are uncommon neoplasms of
      adults, most of whom are men in late middle-age who have a long history of
      tobacco usage. These tumors may be observed in the paranasal sinuses, nose, naso
      oropharynx, larynx, trachea, central bronchi, or peripheral lung parenchyma. They
      may assume a polypoid configuration, with projection into luminal spaces, or show
      an infiltrative growth pattern like that of typical high-grade carcinoma.
      Histologically, both biphasic and monophasic variants of SCAs are recognized. The
      former include tumors with foci of overt carcinoma admixed with areas of
      divergent differentiation into "committed" mesenchymal tissues, such lesions have
      usually been termed "carcinosarcomas" in the past. On the other hand, monophasic
      SCAs lack obviously epithelial foci on light microscopy. Ultrastructural and
      immunohistological studies support the notion that SCA represents a continuum
      that embraces carcinosarcomas and spindle-cell carcinomas, all of which are
      basically epithelial neoplasms. Tumor behavior is site-dependent; SCAs of the
      nose, sinuses, pharynx, and lungs usually pursue an aggressive course, whereas
      histologically similar lesions in the larynx are usually found at an earlier
      stage and, therefore, are associated with a better prognosis.

PMID- 8367624
TI  - Anaplastic (sarcomatoid) carcinoma of the thyroid gland.
AB  - Anaplastic (sarcomatoid) carcinomas of the thyroid gland (ACT) seem to be
      decreasing in frequency. During the past 45 years, a threefold to fourfold
      diminution in the number of ACT cases has been seen internationally. Despite this
      fact, these tumors continue to pursue a lethal course in virtually all cases.
      Clinically, ACT are characterized by rapidly growing neck masses, often in
      patients who have had long-standing thyroid nodules or goiters. Microscopically,
      ACT shows a mixture of fusiform and pleomorphic tumor cells, with widespread
      permeation of surrounding cervical tissues. Osteoclast-like giant cells,
      intranuclear cytoplasmic invaginations, and divergent differentiation into
      chondro-osseous, vascular, or myogenic tissues also may be observed in ACT
      histologically. The common presence of admixed foci of differentiated thyroid
      cancer in ACT suggests that the latter neoplasm arises through the mechanism of
      "clonal evolution." Keratin is observed immunohistologically in roughly 80% of
      cases, further supporting this contention. Because the incidence of ACT has
      inversely paralleled increasing use of thyroid surgery in general, it may be
      hypothesized that early removal of hyperplastic or neoplastic thyroid tissue
      aborts the previously mentioned "dedifferentiation" phenomenon.

PMID- 8367625
TI  - Sarcomatoid carcinomas (carcinosarcomas) of the gastrointestinal tract: a review.
AB  - This review discusses sarcomatoid carcinomas of the gastrointestinal tract, rare
      malignant neoplasms that demonstrate both epithelial and mesenchymal
      differentiation. The clinical, histological, immunohistochemical, and
      ultrastructural features are described. Practical problems in the differential
      diagnosis of these tumors are also discussed.

PMID- 8367626
TI  - Sarcomatoid lesions of the urogenital tract.
AB  - Spindle-cell lesions other than sarcomas are relatively rare occurrences along
      the urogenital tract but include both benign and malignant processes.
      Inflammatory pseudotumors may occur anywhere along the urothelial tract; they may
      follow a surgical procedure or appear de novo. Malignant tumors may be classified
      as sarcomatoid carcinomas or carcinosarcomas according to their degree of
      differentiation, the latter containing obvious mesenchymal components. Generally
      both arise in a background of high-grade carcinoma and are of a high pathological
      stage at the time of initial presentation. For this reason they have a poor
      prognosis. Because the deferential diagnosis of spindle-cell neoplasms include
      both benign and malignant lesions, great care must be taken in making the correct
      diagnosis.

PMID- 8367627
TI  - Unwritten knowledge in nursing: consider the spoken as well as the written word.
AB  - Knowledge has been defined as familiarity gained by experience or a person's
      range of information and theoretical understanding (Sykes, 1982). The distinction
      is made to avoid confusion with the knowledge of scientism (Bullock, Stallybrass,
      & Trombley, 1988), where true or factual knowledge is held to be derivable only
      from the inductive methods of the natural sciences. Knowledge has its origins in
      a broader field of understanding than that of empirical measurement.

PMID- 8367629
TI  - The common sense model: an organizing framework for knowledge development in
      nursing.
AB  - The common sense model emphasizes the importance of persons' perceptions or
      beliefs about their health and illness, and has potential for guiding knowledge
      development in nursing. This paper describes the model, reviews the existing
      relevant literature, and organizes the literature within the framework of the
      model. Suggestions are made as to how the model can be used for further research
      in nursing.

PMID- 8367628
TI  - Patient advocacy--an important part of the daily work of the expert nurse.
AB  - Over the past two decades, patient advocacy has been recognized as a part of
      nursing. For the most part, the issue has been treated by means of theoretical
      reasoning and case studies. Narratives describing lived experiences of nursing by
      expert nurses from Sweden were analyzed in this study. The nurses were identified
      by their superiors as expert nurses, as having a special gift, a "green thumb"
      for nursing. One third of the narratives concerned patient advocacy situations.
      The analysis of the narratives showed that the patient advocacy situation is
      composed of the following elements: a powerless patient, a problem concerning the
      patient's own will or what is good for him or her, and an adversary. Further, it
      includes a trigger situation, and a prompt decision and action by the nurse. The
      nurse acts out of conviction, accepts an additional work load, and takes the risk
      of being punished.

PMID- 8367630
TI  - Development and validation of the Perinatal Nursing Self-Efficacy Scale.
AB  - Self-efficacy, a central construct of Bandura's social cognitive theory, provided
      the framework for developing a measure of perinatal nursing knowledge and skills.
      The 24-item Perinatal Nursing Self-efficacy Scale (PNSE) encompasses knowledge
      and skills required of nurses practicing in family-centered single room maternity
      care (SRMC) settings. Response data from 188 registered nurses were evaluated to
      assess the reliability and construct validity of the instrument. The instrument
      demonstrated strong factorial validity and subscales derived from the factor
      analysis generated high alpha reliabilities. A MANOVA produced results consistent
      with the propositions of self-efficacy theory and supported construct validity.
      Since self-efficacy expectations are situation specific and have significant
      predictive value, they provide both an important adjunct to needs assessment data
      for educational planning and helpful baseline data for outcome evaluation of
      perinatal nursing educational programs and transitions to SRMC settings.

PMID- 8367631
TI  - [Pelvic endoscopic lymphadenectomy in the assessment of early cancer of the
      uterine neck: survey of 25 French hospital centers].
AB  - Accurate staging of invasive cervical cancer is essential to its adequate
      treatment. Current clinical staging of cervical cancer is inaccurate,
      particularly for lymph-nodes evaluation. At reduced cost and risks laparoscopic
      pelvic lymphadenectomy allows accurate detection of lymph-node metastases. Its
      place in the staging of early cervical cancer is being evaluated. Our inquiry,
      multicentric and including more than 500 laparoscopic pelvic lymphadenectomies,
      leads to the conclusion that this technique is accurate and is associated with a
      reduced but variable morbidity depending on the technique and operator's ability.
      The implications of the results of laparoscopic lymphadenectomy in the type and
      modalities of subsequent treatment are discussed.

PMID- 8367632
TI  - [Principles of 3-pronged therapy of juvenile diabetes: insulin, diet, sports].

PMID- 8367633
TI  - [Treatment of rheumatoid arthritis: current and future].
AB  - Rheumatoid arthritis (RA) is a chronic articular inflammatory disease of unknown
      aetiology. The therapeutic approach can be achieved at different levels: 1)
      symptomatic treatment with nonsteroidal anti-inflammatory drugs which can relieve
      articular pain and stiffness, 2) second-line drugs (or DMARD, for Disease
      Modifying Anti-Rheumatic Drug) selected for their capacity to slow the rheumatoid
      process. During this last decade, sulfasalazine and methotrexate became an
      alternative choice to the "classical" slow-acting antirheumatic drugs such as
      gold, D-penicillamine or antimalarials. The extensive progress in basic
      immunology and especially in the immunopathology of RA has allowed the
      elaboration of a new approach to immunotherapy, aimed at molecular targets on
      cells from the "specific immunity" system or against mediators of the
      inflammatory process, such as the cytokines.

PMID- 8367634
TI  - [Fulminant hepatic failure of neoplastic origin].
AB  - The case of a 59-year-old woman, hospitalised for a degradation of her health
      status which evolved within 10 days in fatal liver failure is reported. Although
      acute yellow atrophy was diagnosed, its origin remained elusive. Post-mortem
      examination of the liver disclosed massive hepatic infiltration by a breast
      adenocarcinoma. The causes of acute hepatic failure are reviewed and,
      particularly, the neoplastic ones.

PMID- 8367635
TI  - [Mineral density measurement of the lumbar spine: expression of results].
AB  - The many ways of presenting measurements of bone mineral density of the lumbar
      spine are illustrated in the case of a 65-year-old osteoporotic female. It is
      preferred to express the actual measurement relative to the mean density value
      observed in a group of 30-45 year old normal premenopausal women, in T-score or
      in percentage of expected normal value.

PMID- 8367636
TI  - [Directional coronary atherectomy. Local experience].

PMID- 8367637
TI  - [Venous ulcer: etiopathogenesis and treatment].

PMID- 8367638
TI  - [Ophthalmological treatment of Lyell's syndrome].

PMID- 8367639
TI  - [Diagnosis of skin infections caused by simplex-type herpes virus and by
      varicella zona].

PMID- 8367640
TI  - [Disinfection and sterilization: an overview for clinical practice].
AB  - The importance of disinfection and sterilization has increased in the past decade
      with the spread of HIV and Hepatitis B and C virus. Clear written instructions
      for sterilization and disinfection must be provided for all relevant items. The
      principles of sterilization and disinfection are reviewed with emphasis on
      clinical practice. Important examples and frequent clinical problems are
      discussed in detail by using the disinfection guidelines of the University
      Hospital of Basel.

PMID- 8367641
TI  - [Body fat distribution: independent factor affecting the blood lipid profile].
AB  - The association of life style factors with profiles of blood lipids is described
      in a cohort of 75 middle aged (41.2 +/- 7.8 years) physically inactive,
      nonsmoking employees. The importance of body fat distribution in relation to
      relative body weight and the lipid profiles was also studied. The strongest
      possible predictor for an atherogenic lipid fraction was the quotient of
      abdominal and hip circumferences indicating an abdominal fat accumulation. In the
      group with the lowest quotient (< 0.84) the triglyceride and cholesterol values
      were lower by 43% and 13% respectively than in that with the highest quotient (<
      0.88). The body mass index (BMI) gave the best inverse correlation with HDL-c and
      Apo A-I: Men with a BMI < 23.7 kg/m2 had in the average a HDL-c concentration 0.2
      mmol/l higher than slightly overweighted men (BMI > 25 kg/m2). Physical
      inactivity and a reduced physical endurance were both associated with
      significantly higher total cholesterol and Apo B values. In a multivariate
      analysis the quotient of abdominal and hip circumferences, physical activity and
      endurance together with adherence to recommended nutritional behaviour explained
      approximately one third of the variations in LDL and Apo-B concentrations. This
      study thus confirms in a cohort of non smoking middle aged employees the
      predictive character of unfavorable life style for an atherogenic lipid profile.
      The assessment of body fat distribution added further information on the lipid
      profile that could not be detected by body size and weight determination
      alone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367642
TI  - [The pitfalls of cruralgia].
AB  - Crural neuralgia can initially present as an involvement of the hip joint. We
      studied some clinical factors helpful for the diagnosis, which is sometimes
      difficult.

PMID- 8367643
TI  - [Respiratory insufficiency and kidney failure 2 months following kidney
      transplantation].

PMID- 8367644
TI  - [A case from practice (273). Femur head necrosis].

PMID- 8367645
TI  - [Nutrition problems in ambulatory geriatrics].

PMID- 8367646
TI  - [The role of retrograde cholangiography in the diagnosis and treatment of common
      bile duct calculi].

PMID- 8367647
TI  - [Manometry of the small intestine: technical progress and limitations].

PMID- 8367648
TI  - [Mutants of the hepatitis B virus: description and value for a better
      understanding of this disease].

PMID- 8367649
TI  - [Acute diverticulitis of the left colon: diagnostic and therapeutic approach].

PMID- 8367650
TI  - [Clinical aspects and complications of puncture biopsy of the liver: results of a
      Swiss study and review of the literature].

PMID- 8367651
TI  - [Retrosternal pain. Clinical conference about a subject with esophagitis].

PMID- 8367652
TI  - [Do we think of celiac disease frequently enough?].

PMID- 8367653
TI  - [Acute urinary retention as a manifestation of a myeloradiculitis].

PMID- 8367654
TI  - [What do they know about nutritional equilibrium?].

PMID- 8367655
TI  - [Jaques-Louis Reverdin (1842-1929) and his cousin Auguste (1848-1908) or when
      clinical surgery precedes experimental physiology].

PMID- 8367656
TI  - Evaluation of the in vitro transformation technique to distinguish Trypanosoma
      evansi from cyclically transmitted Trypanozoon stocks.
AB  - In order to initiate transformation into procyclic forms, bloodstream
      trypanosomes, were transferred to semi-defined medium at 27 degrees C. All stocks
      previously classified as Trypanosoma brucei rhodesiense, T.b. gambiense and T.b.
      brucei transformed into procyclic forms. None of the 31 characterized T. evansi
      stocks transformed into procyclic forms, but died between day 4 and day 6 in
      culture. On the other hand, 3 out of 64 stocks of monomorphic brucei subgroup
      field isolates from camels transformed into procyclic forms, confirming the
      existence of T.b. brucei infection in camels kept close to tsetse belts.

PMID- 8367657
TI  - Evolution of chloroquine resistance in central and west Africa.
AB  - The evolution of in vitro chloroquine susceptibility of clinical isolates of
      Plasmodium falciparum obtained from travellers returning to France was studied
      between 1986 and 1991 using the isotopic semi-microtest. Based on the analysis of
      1,147 interpretable tests on isolates originating from Central and West Africa,
      the study showed that the proportion of chloroquine-resistant falciparum malaria
      remained stable between 1986 and 1988 and has diminished between 1989 and 1991.
      The diminution of chloroquine-resistant imported malaria may be associated, at
      least in part, with a better compliance of French travellers with the
      recommendation to use either mefloquine or a combination of chloroquine and
      proguanil since 1989 and an increasing proportion of African immigrants who tend
      to neglect regular chemoprophylaxis during the visit to their countries. The
      reason for the stabilisation of chloroquine resistance is unknown, and this
      phenomenon may be temporary, necessitating a continuous surveillance of drug
      susceptibility.

PMID- 8367658
TI  - Characterization of a variant tandem repeat from Sudanese Onchocerca volvulus.
AB  - Strategies for detection and control of onchocerciasis in Africa have included
      identification of DNA probes and PCR target sequences for sensitive and specific
      detection of parasites. To evaluate the applicability of published PCR and DNA
      probe based methods for the study of onchocerciasis in Sudan, we collected adult
      O. volvulus from geographically distinct regions of Sudan (700 miles apart), Abu
      Hamed (northern desert) and Raja (southwestern savannah), and we examined the
      similarities between Sudanese O. volvulus repeats and published versions of the
      repeat from West African O. volvulus. Amplification of DNA extracted from the
      Raja O. volvulus strain predictably generated a ladder of products, multiples of
      the base 150 bp repeat, as has been reported from West Africa. However,
      amplification of DNA from the Abu Hamed O. volvulus isolate resulted in a series
      of doublets. The unexpected DNA fragments thus amplified differed in size from
      the base 150 bp unit by approximately 50 base pairs and was most clearly
      visualized at 150-200 base pairs. DNA sequence analysis of the amplified repeats
      in the isolate of O. volvulus from Abu Hamed revealed a variant of the 150 bp
      tandem repeat which contained an extra 49 bp. The additional 49 bp contained two
      short repeats of 21 bp and 10 bp, corresponding to bases 99-119 and 128-137
      respectively, of the known 150 bp O. volvulus repeat. This work demonstrates a
      variant of the O. volvulus 150 bp tandem repeat, which easily distinguishes Raja
      and Abu Hamed isolates of O. volvulus, and which has potential value for
      differentiating Abu Hamed strains of O. volvulus from other strains in East
      Africa.

PMID- 8367659
TI  - Analysis of the genomic sequence encoding the 29-kDa cysteine-rich protein of
      Entamoeba histolytica.
AB  - By analyzing cDNA and genomic clones coding for the 29-kDa cysteine-rich protein
      of Entamoeba histolytica, substantial sequence differences were found to the 5'
      end of a previously described full-length cDNA coding for the same protein (Reed
      et al., 1992), which was reported to contain an untranslated 5'-sequence of at
      least 171 nucleotides, unusual for E. histolytica cDNAs. We found evidence that
      the cDNA published by Reed et al. (1992) represents a hybridclone composed of two
      unrelated sequences and that the gene coding for the 29-kDa molecule comprises
      all of the features typical for E. histolytica genes. A data base analysis
      revealed substantial sequence homology of the 29-kDa protein to a class of
      polypeptides found in prokaryotic organisms that may be involved in the
      inactivation of hydrogen peroxide.

PMID- 8367660
TI  - Second conference of the International Ethical Committee on AIDS. Introduction
      into the theme.

PMID- 8367661
TI  - AIDS in Asia.

PMID- 8367662
TI  - AIDS in Africa--the Ugandan experience. The AIDS Support Organization.

PMID- 8367663
TI  - AIDS: epidemiology and the international response.

PMID- 8367664
TI  - Special problems in the "Third World" possibilities of intervention concerning
      prevention and care of AIDS in the "Third World".

PMID- 8367665
TI  - Social and economic aspects of AIDS, the implications of AIDS and the resulting
      priorities in the field of development cooperation.

PMID- 8367666
TI  - 2nd conference of the International Ethical committee on AIDS--Resolution.

PMID- 8367667
TI  - The population dynamics of Onchocerca volvulus in the human host.
AB  - The quantitative aspects of onchocerciasis that focus on the relationship between
      the number of adult female Onchocerca volvulus in the human host, the total
      numbers of microfilariae (mfs) in the body at any one time, and the numbers of
      infective larvae (L3) to which a person is exposed over time, have received
      little attention. This paper attempts to investigate the problem from three
      starting points:--(a) using the numbers of palpable nodules to estimate the
      numbers of productive female worms in the body; (b) using the concentrations of
      mfs in skin snips to estimate the total load of mfs in the body; and (c) using
      the Annual Transmission Potential to estimate the numbers of L3 developing to
      productive female maturity. By analysing published and unpublished data relating
      to the forest and savanna zones of West Africa, these three approaches indicate
      that a relatively large proportion of adult female worms lie deep in the body and
      are impalpable from the surface. They also provide numerical results, of the same
      order to magnitude, which can be linked to provide estimates of the total numbers
      of adult female worms and mfs in the bodies of persons with infections of
      different intensities.

PMID- 8367669
TI  - Wuchereria bancrofti: identification of parasitic acetylcholinesterase in
      microfilariae infected human serum.
AB  - An antigen with cholinesterase activity was detected in the sera of patients
      infected with Wuchereria bancrofti. The asymptomatic microfilaremic sera showed 3
      to 4 times more cholinesterase activity for acetylthiocholine (ATCh) as compared
      to sera of symptomatic amicrofilaremic, hookworm infected and endemic normals,
      whereas the activities for butyrylthiocholine (BTCh) did not significantly
      differ. The enzyme activities from both sources, namely from sera of
      microfilaremic cases and from endemic normals, were partially purified and
      according to substrate specificity for ATCh and BTCh as well as inhibition of the
      former activity by excess substrate classified as acetylcholinesterase (AChE; EC
      3.1.1.7) and pseudocholinesterase (AChE; EC 3.1.1.8), respectively. The Km-value
      for ATCh of the cholinesterase from the microfilaremic sera was determined to be
      0.87 mM. Eserine competitively inhibited the AChE activity; the inhibition
      constant was found to be 1.3 microM. The BChE from the normal sera had Km-values
      of 0.15 and 0.20 mM for BTCh and ATCh, respectively, and did not show significant
      inhibition by eserine. These and other dissimilarities suggest a difference in
      nature of the cholinesterases in microfilaremic and normal sera and propose that
      the former enzyme, a true acetylcholinesterase, originates from the parasite.
      Additional evidence for the origin of the AChE-activity from the parasite was
      provided by ELISA-studies; anti-Brugia malayi AChE antibodies confirmed
      antigenecity and cross reactivity of the AChE in infected sera, whereas the
      antibodies did not show any cross reactivity with the BChE in normal sera.

PMID- 8367668
TI  - Epidemiological studies of onchocerciasis in southern Benin.
AB  - We studied the prevalence of human onchocerciasis in four geographically
      different regions of the southern part of Benin in West Africa. In a total of
      thirteen villages 1596 individuals were examined for clinical and parasitological
      signs of onchocerciasis. Prevalence of microfilariae of Onchocerca volvulus in
      skin snips was 29% in region I (lower Oueme river), 64% in region II (Mono
      river), 56% in region III (upper Oueme river) and 70% in region IV (Okpara
      river). Based on endemicity criteria of the WHO regions II and IV were found to
      be hyperendemic, region III mesoendemic and region I hypoendemic for
      onchocerciasis. The community microfilarial load ranged from 4 mf/mg skin in the
      hypoendemic region to 10.5 mf/mg skin in the hyperendemic regions. The prevalence
      of nodules was 21% in region I, 30% in region II, 17% in region III and 41% in
      region IV. The overall prevalence of chronic onchocercal dermatitis was 12%. Of
      689 individuals infected with O. volvulus 388 were treated with a single dose of
      ivermectin.

PMID- 8367670
TI  - Safety trial of single-dose treatments with a combination of ivermectin and
      diethylcarbamazine in bancroftian filariasis.
AB  - A supervised safety trial of the treatment with a combination of ivermectin 400
      micrograms.kg-1 (IVER 400) plus increasing doses of diethylcarbamazine (DEC),
      given simultaneously in single dose, was performed on five groups of Polynesian
      Wuchereria bancrofti carriers, 49 males aged 25 to 73 years, in whom
      microfilaremia ranged from 1 to 6,137 mf/ml. The trial was hospital-based, open,
      dose-escalating (1 group per week). Safety of an unchanging dose of IVER 400 and
      ascending doses of DEC were studied in the 5 following groups: group 1- IVER 400
      plus DEC 1 mg.kg-1, 12 patients; group 2- IVER 400 plus DEC 3 mg.kg-1, 17
      patients; group 3- IVER 400 plus DEC 6 mg.kg-1, 10 patients. Two control groups
      were included in the study, group 4- DEC 6 mg.kg-1 alone, 5 patients; group 5-:
      IVER 400 alone, 5 patients. Carriers were examined and questioned regarding their
      experience of adverse reactions, which were graded 0 to 3 according to severity,
      at 6, 12 and 24 hours and at 4 days after treatment. Biological examination was
      performed 4 days before and 4 days after treatment and included determination of
      microfilaremia, complete blood count, liver function tests and assessment of
      creatinine and urea levels. Adverse reactions were observed in 51% of 49 carriers
      (15 of grade 1, 8 of grade 2, 2 of grade 3). None was considered serious and they
      all disappeared in 2 days. The main symptoms were fever > or = 37.5 degrees C,
      myalgia, arthralgia, headache, asthenia, anorexia, vertigo and chills. Adverse
      reactions of patients were not significantly different between the five
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367671
TI  - Periodicity of Wuchereria bancrofti var. pacifica filariasis in French Polynesia.
AB  - In 1992, a study on microfilaremia periodicity was carried out on 12 Wuchereria
      bancrofti carriers in the Marquesas islands. Blood samples were collected
      simultaneously every 4 hours during a 48 hour period by finger-prick and
      venipuncture for determination of microfilaremia by both blood film and membrane
      filtration technique methods, and for determination of antigenemia. The membrane
      filtration results showed no significant nycthemeral variations between the
      microfilaria densities at hours 16:00, 20:00, 24:00, 04:00, 08:00 and 12:00.
      Conversely, the blood film method showed a significant difference between the
      microfilaria densities: the microfilaremia was higher during the day (12:00-20:00
      hours) than during the night (24:00-08:00 hours). As for antigenemia, using Og 4
      C3 monoclonal antibody, there was no significant fluctuation during 48 hours.
      These results confirm that W. bancrofti var. pacifica is subperiodic and diurnal
      in French Polynesia. In particular, they substantiate the validity of examining
      venous blood by the membrane filtration technique as the judgment criterion of
      choice in therapeutic trials and of examining capillary blood during peak hours
      by the blood film method for evaluating the endemic level in a population.

PMID- 8367672
TI  - Immune response against Trypanosoma cruzi antigens in Cebus apella monkeys.
AB  - The american primate Cebus apella has been used as an experimental model for the
      study of acute and chronic Chagas' disease. The antibody response elicited by 4 x
      10(6) blood trypnomastigotes injected into four monkeys was analysed. Peak titres
      of IgM and IgG of anti-Trypanosoma cruzi antibodies were found at day 22, and
      between days 20 and 40 post-infection (p.i.), respectively. The ability of a Mr
      37kDa (T37K) glycoprotein purified from T. cruzi epimastigotes to generate IgG
      anti-T. cruzi antibodies in monkeys, and protect them against a challenge with
      trypomastigotes, was also studied. Monkeys non-immunized with T37K reached peak
      values of parasitaemia between days 18 and 21 post-infection, whereas immunized
      monkeys had lower parasitaemias without important variation. Anti-T37K antibodies
      in immunized monkeys decreased from day 2 with the lowest titres between days 14
      to 22 p.i., coincident with the peak of parasitaemia in control non-immunized
      monkeys. These results suggest that anti-T37K antibodies could be responsible for
      the low parasitaemia detected in immunized monkeys.

PMID- 8367673
TI  - Trypanocidal activity and platinum plasma kinetics of cis-Pt pentamidine iodide
      in Trypanosoma brucei sheep model.
AB  - The trypanocidal properties of cis-Pt pentamidine iodide have been studied on the
      T. b. brucei sheep model. The compound was evaluated on the lymphatic-plasma
      phase of the disease and appeared to be active on the circulating parasites. Cis
      Pt pentamidine iodide was active at 5 mgl.kg-1 in one single dose both in mouse
      and sheep trypanosomiasis models. The chemotherapeutic index was about 200 in the
      mouse. As we observed previously with the chloride derivative, platinum plasma
      values for cis-Pt pentamidine iodide were rather constant between 24 and 48
      hours. The nature of the salt associated to cis-Pt pentamidine had a direct
      effect on the compound kinetics. The iodide compound was distributed quickly and
      largely within deep compartments according to a monocompartmental model. The
      theoretical volume of distribution was 6.41.kg-1 for a 100% absorbed fraction.
      The two iodide ions of the complex probably played an important role in the
      compound kinetics mainly due to the extended release effect. The iodide salt of
      cis-Pt pentamidine could therefore be used in chemoprophylaxis of African
      trypanosomiasis.

PMID- 8367674
TI  - Pathogenesis and pathology of African trypanosomosis in Baoule, N'Dama/Baoule
      cross bred and Zebu cattle in Burkina Faso. 1. Clinical performance under high
      natural tsetse challenge.
AB  - The pathogenesis and pathology of African animal trypanosomosis (AAT) in Baoule,
      N'Dama/Baoule-cross-bred and Zebu cattle was studied from 1987 to 1991 in a
      series of experiments conducted under natural and artificial conditions of
      challenge at the Centre de Recherches sur les Trypanosomoses Animales (CRTA) in
      Burkina Faso. This first paper reports on the clinical performance of 64 Baoule,
      10 N'Dama/Baoule-cross-bred and 20 Zebu cattle, which were transferred to the
      pastoral zone of Satiri, 50 km northeast of Bobo-Dioulasso, a zone infested with
      Glossina palpalis gambiensis, G. morsitans submorsitans and G. tachinoides. Prior
      to the experiment, the cattle had been raised in a fly proof stable and at the
      CRTA breeding station, an area of extremely low incidence of trypanosomosis or
      had been exposed at least once to natural trypanosome challenge in an area of
      high Glossina density. The cattle were monitored daily for clinical performance.
      Blood samples were collected twice weekly and examined on the spot for packed red
      cell volume (PCV) and parasitaemia. In the blood of 98% of the cattle
      trypanosomes (Trypanosoma vivax, T. congolense) were detected. Significant inter-
      and intrabreed differences with respect to the clinical performance were
      recorded. Regarding general health, the humpless Baoule and N'Dama/Baoule cross
      bred cattle (Bos taurus) proved to be superior to the humped Zebu cattle (B.
      indicus) under this high challenge. Previous exposure to natural challenge had a
      positive effect on survival for both Baoule and Zebu cattle. The phenotypic
      variation in response to trypanosomosis was small in Baoule previously exposed
      and large in Baoule previously not exposed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367675
TI  - Measurement of problem-oriented need for the primary health care services: need
      for exercise counseling as an example.
AB  - Based on several previous approaches, a new model for the measurement of needs
      for primary health care services is constructed and demonstrated. This fourfold
      model includes the concepts of diagnostic need, perceived need, client dependent
      demand and provider dependent demand. The empirical results concerning the need
      for exercise counseling in the primary health care indicated that the present
      approach is feasible and comprehensive enough to obtain valuable information
      about the health needs and how they are supplied. The model makes it possible to
      identify discrepancies, for example, between the experts' and clients' priority
      ratings and between the criterion-based prevalence of a problem and the practice
      of the care providers. It may also reveal barriers and inequalities in the use of
      services. For health administrators and decisionmakers the present problem
      oriented model provides a systematic approach to assess needs for health care
      services and to develop the services provided.

PMID- 8367676
TI  - Fibromyalgia--a new cause for disability pension.
AB  - Fibromyalgia is a condition under dispute. Accepted by some as a major step
      forward in understanding some of the patients with widespread muscular pain,
      looked upon as a confusing side step by others. In 1988 fibromyalgia was by far
      the most frequent single diagnosis as a reason for disability pension in Norway.
      Disability statistics however show big differences between counties. Two
      neighbouring counties had among the lowest and the highest incidence of
      disability pensioners with the diagnosis fibromyalgia. New pensioners with
      fibromyalgia and some closely related diagnoses have been studied during the year
      1988 by means of reading the insurance records. It became apparent that the
      difference between the two counties with respect to the incidence of fibromyalgia
      as a cause of disability pension could be explained by differences in diagnostic
      setting by the doctors and difference in the assessment from the insurance
      system, rather than real differences in morbidity pattern. Complaints from the
      musculoskeletal system is frequent and increasing in the population both as a
      reason for sick leave and disability pension. Whether this complicated and
      challenging situation is made more easy to handle by defining a subgroup of those
      persons as having "fibromyalgia" is questioned.

PMID- 8367677
TI  - Incontinence pads--prevalence of use and individual consumption.
AB  - The purpose was to describe the prevalence of incontinence pad use and individual
      consumption of pads. Data was collected at local Insurance Offices in a region of
      western Norway (population: 239,500). Overall prevalence was 1.6% for females and
      0.4% for males, increasing sharply with age. Median daily consumption was 1.7
      pads. Middle-aged persons (40-69 years) consumed fewer and smaller pads than the
      others.

PMID- 8367678
TI  - Physiological effects on patients following temporary closing of a geriatric day
      care unit.
AB  - Geriatric day care is an essential part of modern geriatric care providing
      rehabilitation and social support. During a 5 week summer closure of a geriatric
      day care unit, 24 long attenders (defined as patients having day care > 26
      weeks), were non-electively discharged and included in this study. Blood samples
      were drawn one week before the closure (0 week), at the reopening (7 weeks) and 7
      weeks after the reopening (14 weeks). The results show a longitudinal tendency of
      rising plasma prolactin levels during the whole study period. There was non
      significant increase in cortisol during the closure followed by a significant
      decrease 7 weeks after the reopening. All other measures were unaffected. The
      study indicates that geriatric patients submitted to longterm day care have a
      measurable psychophysiological response as a result of a non-controllable closure
      of a day care unit. The changes in plasma prolactin and cortisol levels are part
      of a general adaptation pattern. The study shows that elderly have a functional
      physiological response and chronically sick patients react selectively with
      regard to the hormone response. Thus, the results indicate that the support
      during minor life events induced by the closure of the day care ward should be
      improved.

PMID- 8367679
TI  - Abuse and neglect of the elderly--a Nordic perspective report from a Nordic
      research project.
AB  - This article describes how abuse and neglect of the elderly was made an issue for
      research in a Nordic perspective. The Council of Nordic Ministers funded a
      cooperation between Nordic researchers on the issue of abuse of the elderly,
      based on a Norwegian initiative in 1988. The aim was to establish a base of
      knowledge in order to recommend social and political measures for each country.
      The researchers were chosen from the disciplines of social work, social
      anthropology, sociology, nursing sciences and medicine. Interested researchers
      were hard to find in Iceland and Denmark. Important results are on a theoretical
      level the discussion and perspectives on the definition of "family", "violence"
      and "elderly". On the practical level the results reveal that between 8% and 17%
      of a random population sample in Denmark, Sweden and Finland knew about elderly
      people being abused in their homes. Between 1 and 8% of elderly people living in
      their homes are being abused by their close kin, according to either the old
      people themselves or as reported by home nurses. In one of the Swedish projects
      12% of close family members, being responsible for the care of a demented, mostly
      spouse or parent, admitted abuse towards the demented person. Swedish home nurses
      described the difficulties in intervening into the abusive families.

PMID- 8367680
TI  - Accident prevention activities in the Norwegian municipalities: the local
      response to a nationwide campaign.
AB  - The Norwegian "Campaign Against Home Accidents" was launched nationwide during
      1988 to 1991, with the goal of reducing the incidence of home accidents by 20%.
      The aim of the campaign was to urge primarily the municipal health services to
      form local accident prevention groups and to implement local measures for
      prevention of home accidents. On the basis of two surveys, after one year and at
      the end of the national campaign, an evaluation was carried out concerning the
      participation of the municipal health services in the campaign and the impact of
      the campaign on local accident prevention activities. The results indicate that
      the national campaign engaged the majority of the municipalities and stimulated
      local accident prevention work to some extent. Most local activities were health
      education measures, whereas environmental intervention were less commonly
      reported. Involvement in the campaign was the variable most related to level of
      accident prevention activities at the end of the campaign period. However, the
      relationship was only modest. Restricted economical resources, too little
      emphasis on environmental change, lack of political involvement and insufficient
      use of coalition partners at the community level are suggested as the major
      explanations for the limited effect of the campaign.

PMID- 8367681
TI  - Dietary knowledge and behaviour among schoolchildren in Copenhagen, Denmark.
AB  - In 1989, 674 schoolchildren aged 12-14 years in nine elementary schools in a
      municipality in Copenhagen, Denmark, answered a questionnaire about their dietary
      habits and knowledge. The majority of the pupils had fruit (87%), vegetables
      (72%), rye bread (81%), and drank fat-reduced milk (73%) every day. A diet score
      (reliability = 0.58) was calculated on the basis of the intake of 8 food items
      relevant to current dietary recommendations. There were no age and sex
      differences as to dietary habits, but immigrant children had a lower diet score
      than native children. Dietary knowledge was measured by the ability to state
      correctly whether 11 different food items had a high content or not of fat, sugar
      or dietary fibres. Dietary knowledge was highest for questions about fat and
      sugar. A knowledge score measured the number of correct answers to all 33
      questions (reliability = 0.90). Knowledge was highest among older children,
      native children, and children with the most healthy dietary habits. In the
      multivariate regression analysis, knowledge, health attitudes and ethnicity were
      the only significant predictors of dietary behaviour. It is concluded that both
      social and personal factors are important for dietary behaviour, and health
      promotion in children should include other methods than educational programmes.

PMID- 8367682
TI  - Physiological effects on patients following temporary closing of a geriatric day
      care unit.

PMID- 8367683
TI  - The meanings of social medicine and public health.
AB  - The term "social medicine" has been marked by a great deal of confusion in the
      medical literature, in medical education, and in discussion of systems of health
      care. It has occupied diverse relationships to the term "public health", which
      this article will explore.

PMID- 8367684
TI  - Nordic registers of visually impaired children.
AB  - A Nordic study group, NORDSYN, consisting of ophthalmologists from Denmark
      (Thomas Rosenberg), Finland (Sirkka-Liisa Rudanko), Iceland (Gudmundur
      Viggosson), Norway (Tor Flage, Egill Hansen, Ruth Riise) and Sweden (Kristina
      Tornqvist), has compiled data from registers in Denmark, Finland, Iceland and
      Norway of 2527 visually impaired children. The Swedish register was established
      later in 1990. Each record contains the following information: sex, year of
      birth, year of registration, classification of visual impairment, ocular
      diagnosis, systemic diagnosis, aetiology and evt. additional impairments. The
      ocular diagnoses were compiled into groups among which congenital malformations
      and neuro-ophthalmological diseases were the most dominating. A coding system for
      aetiology was developed. It was demonstrated, that prenatal factors, including
      genetic aetiologies, were involved in a large proportion (66%) of the cases. The
      sex distribution revealed a dominance of males compared to the general population
      at the same age. The age-specific national prevalences for registration of
      childhood blindness (WHO-definition: best corrected visual acuity in the best eye
      less than 3/60 or visual field less than 10 degrees around fixation for the ages
      0-15 years) were (N/100,000): Denmark 41, Finland 15, Iceland 19 and Norway 15.
      The differences were primarily presumed to be due to varying efficiency in
      registration. A coding system for additional impairments was developed. The
      proportion of visually impaired children with an additional mobility, hearing or
      mental impairment was between one third and one half of the national materials
      thus indicating the need for interdisciplinary tracing of and care for the
      visually impaired child.

PMID- 8367685
TI  - Methods for the evaluation of social effects on birth weight-- experiences with
      Swedish population registries.
AB  - All births in Sweden in 1986, registered in the Medical Birth Registry, were
      analyzed with linked data from the November 1985 census in order to identify
      variables which could be used as proxy variables for the socio-economic situation
      of the women, using birth weight as outcome variable. Two phenomena appear to be
      strong socio-economic indices of significance for birth weight: whether the woman
      co-habited or not at the census and whether she had a long education (> 14 years)
      and an "academic" work. The two variables interacted, however: when the woman had
      a long education, cohabitation status played no significant role. Maternal
      education as judged from occupation seemed to play a more important role than
      paternal education or job. To some extent, the effects of the socio-economic
      variables could be explained by different smoking habits but a residual effect
      existed which may have different explanations. Cohabitation status and education
      may be used as estimates of socio-economic level of significance for birth weight
      and perhaps other pregnancy outcome in the analysis of, for instance, the effect
      of various occupational exposures on pregnancy outcome.

PMID- 8367686
TI  - Socioeconomic differences in smoking in an urban Swedish population. The bias
      introduced by non-participation in a mailed questionnaire.
AB  - Stockholm Health of the Population Study is a cross-sectional study carried out
      from 1984-85. Postal questionnaires, telephone interviews and health interviews
      were used to get information from a sample of 5,199 persons, 18-64 years of age,
      on health status, risk exposures, healthcare consumption and social factors. Non
      participation with respect to the postal questionnaire was 36.8%. With subsequent
      telephone interviews and an invitation to a health interview, non-participation
      was reduced to 17.8%. The estimated prevalence of daily smoking increased from
      36.1% to 38.7. The non-responders had a higher prevalence of daily smoking in all
      sub-groups. This effect of the efforts to reduce non-participation differed
      socially. The prevalence of smoking for men, 40-64 years of age, who were reached
      by telephone was 60.3%. Male professionals and intermediate non-manual workers,
      40-64 years of age reached by telephone had a prevalence of smoking, which was
      twice as high as for the responders of the questionnaire (62.5 and 26.8%,
      respectively). In the younger age-group, non-responders had the same
      socioeconomic pattern in smoking as the responders. Independent of socioeconomic
      group, there was a tendency of ill or disabled smokers to respond more quickly
      than healthy smokers. Using a postal questionnaire with a high non-response rate
      might lead to an overestimation of socioeconomic differences and an
      underestimation of smoking prevalence.

PMID- 8367687
TI  - Sex differences in response style to two self-report screening tests on
      alcoholism.
AB  - The revised Malmo modification of the Michigan Alcoholism Screening Test (Mm
      MAST) of 10 items including all four CAGE (an acronym for Cut down, Annoyed,
      Guilty, Eye-opener) items and one item on total sobriety was used in a health
      screening of a total birth-year cohort in Malmo. Seventy-two percent of the
      female and 68% of the male population participated. Nine hundred and eleven women
      and 911 men were included in the study population. The revised Mm-MAST yielded a
      higher proportion of scores indicative of problem drinking than the CAGE in both
      sexes; 4% of the women and 17% of the men had positive Mm-MAST scores (> or = 3
      yes-answers). Rates of positive CAGE scores (> or = 2 yes-answers) were 1% and
      7%, respectively. Frequencies of problem drinking in the Mm-MAST and CAGE
      positive scorers, respectively were similar for both women and men. The
      reliability of the revised Mm-MAST was better in the male population producing a
      Cronbach's alpha coefficient of 0.69 compared with 0.58 in the female population.
      In men the four CAGE items had the highest item-total scale correlations, which
      was found in only one CAGE item in women. We suggest that the revised Mm-MAST is
      a better screening instrument than the CAGE in both sexes. Nevertheless the
      reliability of the total revised Mm-MAST was poorer in women and the need for a
      female oriented alcohol questionnaire is promoted.

PMID- 8367688
TI  - Social differences in reproductive health. A study on birth weight, stillbirths
      and congenital malformations in Denmark.
AB  - AIM: To describe differences in life style variables according to socioeconomic
      groupings and to analyse the association between birth weight, stillbirth and
      congenital malformation according to the socioeconomic grouping for the father as
      well as the mother. METHOD: Follow-up of 11,888 pregnant women in Odense and
      Aalborg, Denmark who were consecutively enrolled in the study from April 1984 to
      April 1987 as part of a community trial. DATA: Information on socioeconomic group
      and life-style factors were collected by means of self-administered
      questionnaires in the 36th week of gestation. Data on pregnancy outcomes were
      collected from birth certificates and medical records according to standardized
      search routines. RESULTS: Women in the lower socioeconomic groups were younger,
      smaller, had a higher prepregnancy weight, smoked more and had a higher intake of
      coffee during pregnancy than women in higher socioeconomic groups. Better off
      women, on the other hand, had a higher consumption of alcohol, fish, and
      vegetables. Low birth weight was found to be negatively correlated with
      socioeconomic grouping. The lowest birth weights were found among babies born to
      unskilled and unemployed women even after adjustment for smoking habits,
      prepregnancy height and weight and a number of other potential confounders.
      Stillbirth and the prevalence of congenital malformations was not associated with
      socioeconomic grouping, but the amount of information was very limited regarding
      these outcomes.

PMID- 8367689
TI  - Bicycle accidents often cause disability--an analysis of medical and social
      consequences of nonfatal bicycle accidents.
AB  - Social and medical consequences of 278 children and 264 adults injured in bicycle
      accidents and seen in two hospitals in Helsinki in 1985-86 were analyzed.
      Information was collected from patient records, by means of a special
      questionnaire and by telephone interview. A child outpatient required 1.7 and a
      child inpatient 3.0 physician visits on an average, while adults required 2.2 and
      4.9 visits, respectively. The average duration of hospital stay was 8 days for
      hospitalized adults and 6 days for children. Rehabilitative care outside the
      hospital was received by 6% of the adult outpatients and 25% of the inpatients,
      but none of the injured children. The mean duration of work disability was 82
      days among inpatients, 11 days among outpatients, 127 days among the inpatients
      injured in motor vehicle collisions and 65 days among inpatients injured in other
      bicycle accidents. Of inpatients 32% and of outpatients 5% reported persistent (>
      6 months) disability. Persistent disability was recorded in 11% of children, in
      47% of adults and in 67% of elderly inpatients. Most serious consequences were
      due to intracranial injuries in motor vehicle-bicycle collisions. Of the
      hospitalized bicyclists 4% suffered from severe cognitive and behavioural changes
      or sense impairment and of adult inpatients 3% suffered from permanent work
      disability. The average costs of health and social services were about FIM 1000
      per adult outpatient and FIM 13000 per adult inpatient. In prevention high
      priority should be given to motor vehicle collisions, head injuries and injuries
      among the elderly bicyclists.

PMID- 8367690
TI  - Lung cancer among butchers and slaughterhouse workers.
AB  - The following three questions are examined in this critical evaluation of the
      literature on lung cancer among butchers: (i) do butchers have an excess risk of
      lung cancer, (ii) if yes, is this excess possibly caused by exposures in the work
      environment, and (iii) if yes, what then are the possible etiologic exposures? It
      was concluded that butchers probably have an excess risk of lung cancer. This
      excess risk can be explained partly, but not entirely, by tobacco smoking. The
      following four possible etiologic exposures are introduced: human papilloma
      viruses, nitrite, incomplete combustion products, and fumes from meatpacking
      materials. Three of these possible explanatory factors (nitrite, combustion
      products and fumes from packing) are not, or only to a limited extent,
      substantiated by the empirical data. It was recommended that the hypothesis
      concerning human papilloma viruses and also the possible role of work stress be
      tested in future studies.

PMID- 8367691
TI  - Relationship between birthweight and occupational exposure to cytostatic drugs
      during or before pregnancy.
AB  - The birthweight of babies whose mothers were exposed to cytostatic drugs during
      pregnancy was compared with that of infants whose mothers were not so exposed.
      The study was conducted in four French hospitals and covered 420 singleton live
      births to 466 women. One hundred and seven of the 420 births were exposed before
      or during pregnancy; 298 were not. Information about exposure was not available
      for the other 15. The mean birthweight of the babies of exposed mothers was 85 g
      lower than that of infants of unexposed mothers, but the difference was not
      statistically significant (95% CI -192.2-22.2 g). When gestational age and
      conventional risk factors were taken into account, the adjusted difference in the
      means of the birthweights was -56 (95% CI -155.1-43.1) g.

PMID- 8367692
TI  - Blood lead concentrations of Swedish preschool children in a community with high
      lead levels from mine waste in soil and dust.
AB  - The lead concentration in capillary blood was investigated in 49 preschool
      children (0.7-7.4 years of age) visiting a day-care center in a Swedish community
      with high lead contamination from mining and milling in soil and dust in
      populated areas [up to 1400 and 14,000 micrograms.g-1 (6.76 and 67.63 mumol.g-1)
      of dry weight, respectively]. The blood lead levels were examined twice (in April
      and in September) in 33 of the children. The lead levels were low on both
      sampling occasions [arithmetic mean 31 (SD 13, median 30, range 13-79)
      micrograms.l-1, ie, arithmetic mean 0.15, (SD 0.06, median 0.14, range 0.06-0.38)
      mumol.l-1]. Whereas children up to four years of age showed significantly
      increased levels from April to September, a significant decrease was seen in
      older children. The level of lead in soil at home, gender, smoking habits at
      home, and estimated level of hand-to-mouth activity did not appear as strong
      determinants of lead in blood. The results indicate that lead from mine waste in
      soil and dust fallout does not constitute a significant health hazard for
      preschool children in Falun.

PMID- 8367693
TI  - Work-related agricultural fatalities in Australia, 1982-1984.
AB  - Work-related agricultural fatalities were examined as part of a larger population
      based study of all work-related fatalities in Australia in the period 1982-1984.
      A total of 257 farm-related fatalities were identified, of which 223 were deaths
      of persons in the employed civilian labor force (19.4 deaths per 100,000 persons
      per year) and 34 were deaths of children less than 15 years of age. The fatality
      incidence was higher among men, older age groups, and nonmanagers in general and
      in certain occupations in particular. Mobile mechanical equipment (particularly
      tractors) was the main fatal agent, roll-overs accounting for many of the
      fatalities. Better provision of information to agricultural workers, improvements
      in compliance to and enforcement of legislation, and changes in farming work
      practices are recommended to improve the safety of farms and farm work.

PMID- 8367694
TI  - Morbidity among unemployed and work-incapacitated men in The Netherlands.
AB  - As yet, the relationship between unemployment and physical health has not
      sufficiently been clarified. With a longitudinal approach a representative Dutch
      panel study and a study on a health center population were carried out. They
      involved work-incapacitated and unemployed men between 21 and 65 years of age.
      Men incapacitated for work were in poorer health than matched working men; the
      same was true in a three-year follow-up. Unemployed and working men were shown to
      be equally healthy. The physical health of the incapacitated men decreased with
      time but that of the unemployed men did not. This finding implies that
      unemployment per se does not lead to poorer health. Differences in social
      security systems seem to interfere with an international comparison of the
      consequences of unemployment on health. International research should distinguish
      more explicitly between those who are unemployed for economic reasons or
      incapacitated for work for medical reasons.

PMID- 8367695
TI  - Urinary styrene in the biological monitoring of styrene exposure.
AB  - The urinary excretion of styrene represents a promising indicator of exposure to
      this solvent. Nevertheless extensive research under field conditions is scant. In
      this investigation 214 styrene-exposed workers from 10 fiberglass-reinforced
      plastics factories were studied. Environmental monitoring was performed by
      personal passive sampling. Blood styrene and the urinary excretion of styrene and
      its main metabolites, mandelic acid (MA) and phenylglyoxylic acid (PGA), were
      measured. The correlation coefficient between the time-weighted average of
      environmental styrene and the mean urinary excretion of styrene was 0.88 (0.91
      after logarithmic transformation), compared with the 0.82 and 0.78 of the end-of
      shift MA and PGA values, respectively. A high correlation (0.86) was also found
      between styrene in the blood and urine. The results, obtained under field
      conditions with a large group of exposed workers, confirm the usefulness of the
      urinary excretion of styrene as an exposure index for the biological monitoring
      of styrene exposure.

PMID- 8367696
TI  - Toxicokinetics and biological monitoring in experimental exposure of humans to
      gaseous hexahydrophthalic anhydride.
AB  - Six healthy volunteers were exposed to gaseous hexahydrophthalic anhydride (HHPA)
      concentrations of 10, 40, or 80 micrograms.m-3 (65, 260 or 520 nmol.m-3,
      respectively) for 8 h. The respiratory uptake of the inhaled HHPA was almost
      complete. Rapid increases in plasma and urinary levels of hexahydrophthalic acid
      (HHP acid) were seen. During the first 4 h after the end of exposure, the half
      time of HHP acid in plasma was about 2 h. A corresponding decay was seen in
      urine. The correlations (r > 0.90) between the air concentrations of HHPA and the
      levels of HHP acid in plasma and urine were close. They were even closer (r >
      0.96) when the total respiratory uptake of HHPA was used. Urinary pH adjustment
      by intake of ammonium chloride or sodium hydrogen carbonate did not significantly
      alter the excretion of HHP acid. The results show that the analysis of HHP acid
      in plasma or urine is useful as a biological monitor for exposure to HHPA.

PMID- 8367697
TI  - Iterative use of a priori exposure matrices to improve the characterization of
      chemical exposures in agricultural work studies.
AB  - To assess pesticide exposures of agricultural workers, a priori exposure matrices
      based on "circumstantial determinants" of pesticide use were incorporated into
      the questionnaire of a case-referent study. Circumstantial determinants (crops
      cultivated, their surface areas and crop infestations) were recalled more
      frequently than specific chemicals. After the matrices were applied, the
      proportion of missing values fell from 44 to 9% for specific chemicals, from 97
      to 17% for the dose for each treatment, and from 80 to 16% for number of
      treatments per year in a random sample of 40 questionnaires. The number of
      workers changed from 19 to 30 for parathion use, from 4 to 10 for mancozeb use,
      and from 4 to 12 for DDT (dichlorodiphenyltrichloroethane) use when the matrix
      was applied. The matrix enabled exposure levels to be assigned in each case.
      Provided that the matrix used is valid, this approach could increase the
      efficiency of case-referent studies on agricultural exposure to chemicals.

PMID- 8367698
TI  - Effect of the reduction of skin contamination on the internal dose of creosote
      workers exposed to polycyclic aromatic hydrocarbons.
AB  - Ten creosote-exposed workers of a wood impregnation plant participated in this
      study, which took place in two consecutive weeks on a Monday, after a weekend
      off. On one of the two days each worker wore Tyvek coveralls underneath his
      normal workclothes. Dermal contamination measurements (pyrene on exposure pads)
      and biological monitoring (urinary 1-OH-pyrene) were performed to measure the
      reduction of both the skin contamination and the internal dose. The total pyrene
      skin contamination of workers not wearing coveralls ranged between 47 and 1510
      micrograms.d-1 (0.2-7.5 mumol.d-1). On the average, the coveralls reduced the
      pyrene contamination on the workers' skin by about 35 (SD 63)%. The excreted
      amount of 1-OH-pyrene in urine decreased significantly from 6.6 to 3.2 micrograms
      (30.2 to 14.7 nmol). Multiple regression analysis showed that skin contamination
      by polycyclic aromatic hydrocarbons is the main determinant of the internal
      exposure dose of creosote workers.

PMID- 8367699
TI  - Validity of self-reported exposures to work postures and manual materials
      handling. Stockholm MUSIC I Study Group.
AB  - Exposure data from self-administered questionnaires on manual materials handling
      and work postures were validated in relation to direct measurements and
      systematic observations on 39 men and 58 women representing 45 different
      occupations. The agreement was tested at a dichotomous level and, when possible,
      with quantification of duration or frequency. At the dichotomous level the
      agreement was "acceptable" for nine variables concerning work postures and the
      handling of loads weighing > 5 kg. No variable showed "acceptable" agreement when
      the duration or the frequency was quantified in more detail (4- to 6-point
      scales). Musculoskeletal complaints seemed to introduce a differential bias for
      some lifting variables. Thus some variables for postures or the handling loads of
      > 5 kg may, under certain conditions, be acceptable for use in epidemiologic
      studies when the relative risks are high. However, self-reported exposure seems
      to be too crude if more-detailed information is required.

PMID- 8367700
TI  - [Side effects of non-steroidal antirheumatic agents in the lower intestinal
      tract].
AB  - Side effects of non-steroid anti-inflammatory drugs (NSAIDs) on the lower
      intestinal tract are reviewed. NSAID use may exacerbate or reactivate quiescent
      inflammatory bowel disease. There are distinct types of NSAID-induced
      enterocolitis: ulcerative colitis, Crohn's disease, and necrotizing enterocolitis
      in premature infants. It is also suggested that NSAIDs may play an etiological
      role in collagenous colitis. Furthermore, NSAIDs may induce ulcerations,
      perforations and strictures in the small as well as large bowel. Occult and
      severe blood loss from lower intestinal tract under treatment with NSAIDs should
      be kept in mind.

PMID- 8367701
TI  - [Bronchiolitis obliterans organizing pneumonia (BOOP)--chronic organized
      pneumonia (COP). Diagnosis, therapy and course].
AB  - Cryptogenic organizing pneumonia (COP) or bronchiolitis obliterans organizing
      pneumonia (BOOP) designates a disease characterized by particular
      histopathological features. Symptoms and clinical findings are more or less
      typical and the etiology of the disease is unknown in most of the cases. We
      report on 7 patients in whom the diagnosis was established by open lung biopsy
      during a workup for persistent pulmonary infiltrates. The clinical findings, the
      radiological features and the course during treatment with corticosteroids are
      analyzed. In all patients the symptoms improved. In two cases we observed
      relapses after discontinuing the corticosteroids or diminishing the dose. These
      relapses again responded to steroids, but in one patient progressive pulmonary
      restriction was noticed despite continuous treatment.

PMID- 8367702
TI  - [Hemolytic-uremic syndrome in children: a 19-year retrospective study].
AB  - Forty-two children (22 girls and 20 boys, ranging in age between 2 months and 13
      years, median age 17 months) were admitted with acute hemolytic-uremic syndrome
      to the University Children's Hospital, Berne from 1973 to 1991. Seventeen
      patients developed hypertension and 30 renal failure. Three out of the 19 cases
      necessitating acute dialysis progressed to end stage renal failure. Four out of
      the 7 patients with signs of severe central nervous system involvement died. The
      initial clinical course was consistently more favourable in 35 patients with
      diarrheal prodrome. Increased protein excretion in association with high blood
      pressure was observed in 4 patients with initial favourable course who were
      examined one year after disease onset. This study indicates the generally
      favourable immediate prognosis of childhood hemolytic uremic syndrome and the
      possible persistence of high blood pressure and pathological proteinuria on
      follow-up.

PMID- 8367703
TI  - [Recurrent, life-threatening anaphylaxis as initial manifestation of cystic
      echinococcosis (granulosus) of the liver].
AB  - A 34-year-old, previously healthy Yugoslav developed relapsing generalized
      anaphylactic reactions associated with life-threatening laryngospasm. After
      successful life support with volume-replacement, epinephrine, antihistamines and
      steroids, clinical workup disclosed a slight tenderness in the right upper
      abdomen and sonography a polycystic tumor with coarse calcification within the
      wall. The presumptive diagnosis of cystic liver echinococcosis with spontaneous
      rupture of a hydatid cyst was confirmed surgically and serologically. This case
      history shows that liver echinococcosis should be considered in otherwise
      unexplained anaphylaxis.

PMID- 8367704
TI  - [Cerebrovascular symptoms in a patient with an aneurysm of the internal carotid
      artery, aneurysm of the inter-atrial septum, patent foramen ovale and redundant
      Eustachian valve].
AB  - We describe for the first time the combination aneurysm of the internal carotid
      artery, atrial septal aneurysm, patent foramen ovale and redundant eustachian
      valve in the right atrium. The presenting symptoms and clinical course are
      briefly outlined. The consequences of the cardiac findings are discussed.

PMID- 8367705
TI  - [Prevention of cardio-embolic cerebral infarcts: simple, but...].

PMID- 8367706
TI  - [Heterogeneity of involutional osteoporosis].
AB  - Bone tissue mineral content (BTMC) was measured on transiliac bone biopsies by a
      combined microradiographic-microdensitometric technique. The samples originated
      from 69 osteoporotic postmenopausal women aged 42-86 (mean age 63 years). The
      diagnosis of osteoporosis was based upon a previous in-hospital screening.
      Results demonstrated a clear heterogeneity of BTMC values in osteoporotic women
      as compared with an age-related decrease in 31 age- and sex-matched controls. No
      correlation with clinical parameters could be found: Therapeutic issues raised by
      this study are discussed.

PMID- 8367707
TI  - [Liver biopsy in ambulatory patients. Diagnostic value in comparison to
      conventional and quantitative liver function tests].
AB  - In this retrospective analysis we investigated the diagnostic yield of 148
      consecutive liver biopsies performed as an outpatient procedure. In 144 patients,
      adequate specimens for histologic analysis were obtained. In these patients, 226
      diagnoses were entertained. Clinical diagnosis was confirmed in 49.3%, modified
      in 43.8% and altered in 6.9%. Liver biopsy was particularly helpful in patients
      where an alcoholic etiology was suspected, since this could be confirmed in only
      59.4% while in the others different, often treatable, causes of chronic liver
      disease were found. Neither conventional nor quantitative liver tests (galactose
      elimination capacity, aminopyrine breath test) served to differentiate reliably
      between severe and mild lesions. We conclude that liver biopsy remains an
      important diagnostic tool in patients with chronic liver disease, and that it can
      be safely performed on an outpatient basis in appropriately selected patients.

PMID- 8367708
TI  - [Simultaneous occurrence of lymphocytic gastritis and lymphocytic colitis with
      transition to collagenous colitis].
AB  - Lymphocytic gastritis and lymphocytic colitis are two rare disorders of unknown
      etiology, only diagnosable by histology. Simultaneous occurrence of lymphocytic
      colitis and lymphocytic gastritis has not been described up to now. A 69-year-old
      female patient was examined because of crampy abdominal pain and watery diarrhea.
      Laboratory tests did not reveal an etiology and in colonoscopy the colon and
      terminal ileum were normal. Histology disclosed lymphocytic colitis.
      Esophagogastroduodenoscopy showed erosive bulbitis. Biopsies of the stomach
      revealed lymphocytic gastritis. A second colonoscopy one year later showed the
      development of collagenous colitis.

PMID- 8367709
TI  - [A balance assessment of the president of the commission for continuing
      education. Interview by Kurt Venner].

PMID- 8367710
TI  - [The number of patients is generally falling off due to the recession. Interview
      by Kurt Venner].

PMID- 8367711
TI  - [Those absent are really wrong!].

PMID- 8367712
TI  - [The dental filling therapy of carious deciduous molars: materials and methods. A
      review].
AB  - There is little consensus as to which restorative material or techniques are best
      suited to restore primary teeth. Techniques developed for the permanent dentition
      can seldom be applied to the primary teeth because of morphological differences
      and lack of cooperation by the children. The morphological properties of primary
      molars are discussed in this paper in relation to their therapeutic consequences.
      In addition to general guidelines for dental therapy in children, current
      restorative materials and techniques are compared regarding their suitability for
      the primary dentition. Finally the goals for the development of an ideal
      restorative material are formulated.

PMID- 8367713
TI  - [Mercury vapors from premeasured amalgam capsules].
AB  - 12 dental amalgam capsules were tested for mercury leakage during trituration,
      storage, and disposal. The pertinent measurements were taken using two different
      measuring systems, both of which were based on the principle of optical
      absorption. While the results were excellent for half of the encapsulated
      products, some were deficient with respect to impermeability or safe handling.
      Five products cannot be recommended for regular use in the dental office.
      Overall, dental amalgam capsules of the latest product generations release lower
      mercury vapors; however, there are always exceptions, which is why periodical
      checks are recommended to protect the dentist and his or her team from avoidable
      exposure to mercury vapors.

PMID- 8367714
TI  - Innervation of root dentine in human premolars.
AB  - Based on autoradiographic studies it is generally held that the mammalian root
      dentine is only sparsely innervated. Previous electron microscopic studies on
      human teeth did not reveal nerve fibres beyond radicular predentine. It is the
      purpose of this communication to provide ultrastructural evidence for the
      presence of nerve fibres in apical root dentine of human premolars. Two healthy
      mandibular second premolars, removed due to orthodontic reasons, which formed
      part of a previous study, were utilized for this investigation. Root discs of
      about 0.6 mm thickness were removed at about 2 mm cervical to the root apex and
      processed for light and electron microscopy. Transmission electron microscopic
      examination revealed numerous nerve fibres along the pulp-predentine border and
      in patches of predentine. Distinct nerve fibres were observed in the inner
      mineralized portion of the radicular dentine. The axons existed in close
      association to the odontoblastic processes, but no synaptic contacts or
      junctional complexes could be observed.

PMID- 8367715
TI  - [The marginal adaptation and wear resistance of a fine hybrid composite inlay in
      vitro].
AB  - A lab and a production batch of a new fine hybrid composite material were tested
      in adhesive MOD inlays. Using a long term in vitro test the wear resistance of
      both formulations and the marginal adaptation of the production batch were
      quantitated. The wear results were compared to the results generated with an
      amalgam control. The initial marginal adaptation in enamel was excellent totaling
      95.9% (occlusal) to 99.5% (axial) of "continuous margin" at the tooth/cement
      interface. These values slightly decreased after loading to 81.4% (occlusal) and
      93.8% (axial), respectively. In dentine however, insufficient marginal qualities
      were found (32.0% "continuous margin" initial and 18.9% after loading). The
      adhesion between inlay and composite cement was excellent and load stable. Both
      composite batches were significantly more wear resistant than the amalgam control
      and abraded the opposing enamel cusps significantly less than amalgam.

PMID- 8367716
TI  - [The interference with cardiac pacemakers from electrical devices].

PMID- 8367717
TI  - [Dental ceramic inlay fillings. Expanded indications for dental ceramic inlay
      fillings].

PMID- 8367718
TI  - A thin lifeline to genome researchers.

PMID- 8367719
TI  - New Seveso findings point to cancer.

PMID- 8367720
TI  - NSF balks at grants to entrepreneurs.

PMID- 8367721
TI  - Learning how to suppress cancer.

PMID- 8367722
TI  - Breaking the code for the tuberculosis invasion.

PMID- 8367723
TI  - Catalysis: design versus selection.

PMID- 8367724
TI  - Regioselective and enantioselective epoxidation catalyzed by metalloporphyrins.
AB  - Recent progress in regioselective and enantioselective epoxidations catalyzed by
      metalloporphyrins is discussed here, with an explanation of the biomimetic
      antecedents of this area and its relevance to synthetic applications.
      Classification of the catalysts that have been studied allows useful conclusions
      to be drawn about the development of this field. In particular, both the most
      promising biomimetic and practical catalysts have arisen from systems that can be
      systematically modified by convenient synthetic methodology.

PMID- 8367725
TI  - NF-kappa B activation by ultraviolet light not dependent on a nuclear signal.
AB  - Exposure of mammalian cells to radiation triggers the ultraviolet (UV) response,
      which includes activation of activator protein-1 (AP-1) and nuclear factor kappa
      B (NF-kappa B). This was postulated to occur by induction of a nuclear signaling
      cascade by damaged DNA. Recently, induction of AP-1 by UV was shown to be
      mediated by a pathway involving Src tyrosine kinases and the Ha-Ras small
      guanosine triphosphate-binding protein, proteins located at the plasma membrane.
      It is demonstrated here that the same pathway mediates induction of NF-kappa B by
      UV. Because inactive NF-kappa B is stored in the cytosol, analysis of its
      activation directly tests the involvement of a nuclear-initiated signaling
      cascade. Enucleated cells are fully responsive to UV both in NF-kappa B induction
      and in activation of another key signaling event. Therefore, the UV response does
      not require a signal generated in the nucleus and is likely to be initiated at or
      near the plasma membrane.

PMID- 8367726
TI  - Helper T cells without CD4: control of leishmaniasis in CD4-deficient mice.
AB  - Expression of either the CD4 or CD8 glycoproteins discriminates two functionally
      distinct lineages of T lymphocytes. A null mutation in the gene encoding CD4
      impairs the development of the helper cell lineage that is normally defined by
      CD4 expression. Infection of CD4-null mice with Leishmania has revealed a
      population of functional helper T cells that develops despite the absence of CD4.
      These CD8- alpha beta T cell receptor+ T cells are major histocompatibility
      complex class II-restricted and produce interferon-gamma when challenged with
      parasite antigens. These results indicate that T lymphocyte lineage commitment
      and peripheral function need not depend on the function of CD4.

PMID- 8367727
TI  - Cloning of an M. tuberculosis DNA fragment associated with entry and survival
      inside cells.
AB  - Mycobacterium tuberculosis infects one-third of the world's human population.
      This widespread infection depends on the organism's ability to escape host
      defenses by gaining entry and surviving inside the macrophage. DNA sequences of
      M. tuberculosis have been cloned; these confer on a nonpathogenic Escherichia
      coli strain an ability to invade HeLa cells, augment macrophage phagocytosis, and
      survive for at least 24 hours inside the human macrophage. This capacity to gain
      entry into mammalian cells and survive inside the macrophage was localized to two
      distinct loci on the cloned M. tuberculosis DNA fragment.

PMID- 8367729
TI  - [Results of treatment of polytraumatized patients. A comparative analysis of
      3,406 cases between 1972 and 1991].
AB  - The treatment data on 3,406 patients with multiple injuries were analyzed
      retrospectively from the viewpoint of quality control. The diagnosis, therapy,
      complications and course were documented and the treatment results of two decades
      (1972-1981 and 1982-1991) compared. Young people with an average age of 31 years
      were mostly affected: 86% had fractures (40% open injuries), 69% head injuries
      and 62% thoracic trauma. Head injury together with thoracic trauma was the most
      frequent injury combination and affected the duration of ventilation therapy and
      the intensive care course. The relationship between the kind and severity of
      injury [categorized according to the Hannover Polytrauma Score (PTS)] and the
      lethality rate was significant. Preclinical treatment (infusion, intubation,
      thoracic tube) has increased in the past decade, and rescue time has been
      shortened. For the initial clinical diagnosis, ultrasound and the CT scan have
      been used more frequently. In patient treatment the elimination of massive
      hemorrhage still has first priority. Primary stabilization of long tubular bones,
      mostly of the lower limb, is aspired for. Volume therapy has changed over the
      last decade, so the risk of acute renal failure has been nearly eliminated.
      Nowadays late complications, e.g., multiorgan failure, are well in the
      foreground. Today at Hannover Medical School the average intensive care time is
      13.7 days and the hospitalization time 31 days. When the two decades were
      compared, mortality was seen to have declined from 40% to 18%. In the future if
      the mortality rate is to be reduced further, this can only be done by treating
      the cause of post-traumatic organ failure.

PMID- 8367728
TI  - [Rehabilitation and reintegration of polytraumatized patients].
AB  - In this randomized study we attempt to verify treatment results, rehabilitation
      and social reintegration of multiple trauma patients. Two to 4 years after the
      accident a clinical follow-up examination was carried out on 104 multiple trauma
      patients with an average age of 29.5 years who had 7.7 single injuries. Patients
      with injuries of the central nervous system still showed neurological disorders
      in 32%. The initially determined Glasgow Coma Scale did not correlate with the
      long-term prognosis of neurological disorders. Only 4 of 38 thoracic injuries had
      functional disorders-these patients had required long-term ventilation therapy (>
      3 weeks). Former abdominal injuries showed no objective disorders in the follow
      up. Most of the injuries to the extremities (79.7%) healed without functional
      disorder. Only patients with lower limb injuries still had complaints. At the
      time of the checkup 6.7% had still not been able to work (for more than 24
      months) and 26.9% for more than 12 months. The disability rate was less than 20%
      in 64.3%, 7.2% more than 50% and 9.6% more than 80%. Most of these patients had
      severe head injuries. There was a relationship between reintegration at work and
      the age of the patients: 49.2% of patients younger than 25 years were working in
      their previous profession, 26.9% had here re-educated, and only 7.9% were
      unemployed. However, in the age group older than 25 years, only 29.2% worked in
      their previous profession and 12.2% had been re-educated. This follow-up study
      shows that in multiple trauma patients reintegration at work and in social life
      is possible.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367731
TI  - [The LS-8 lever fixator: repositioning and fixation aids for dislocations and
      dislocation fractures of the lumbar spine and the thoracolumbar transition. Part
      I. Biomechanical considerations and surgical technique].
AB  - We are reporting a lever-type internal fixateur, the LS-8 system, which can be
      used for reduction and stable fixation of fractures and fracture-dislocations of
      the thoraco-lumbar and lumbar spine. The LS-8 system is different from all
      previous systems: it combines the advantages of the spinal fixateur interne and
      conventional plate fixation, while largely avoiding their disadvantages, such as
      the fixed position of the screw hole and the mechanical overloading of the fixing
      points, as in the previous hook-type systems. In order to minimize these
      drawbacks, we have added a plate of variable length to our system, creating a
      fulcrum that prevents overloading. This means that the reinforced 8 mm diameter
      screws function as lever arms around this fulcrum, conducting and
      counterbalancing the active forces. As a result, the loading capacity of our
      system has been greatly improved. Since the LS-8 "lever fixateur" is a reinforced
      system, it is no longer necessary to use any plaster or brace fixation. We should
      like to illustrate the advantages and the capability of the LS-8 system by
      presenting one of our cases.

PMID- 8367730
TI  - [Results of dorsal pelvic ring stabilization].
AB  - Complete disruptions of the posterior pelvic ring are rotationally and vertically
      unstable [type C according to the Tile/AO (ASIF) classification (1991)]. Usually
      operative treatment is required. The data on 24 patients over a 5-year period
      were analyzed. Thirteen patients were female (54.2%) and 11 male (45.8%); the
      average age was 32.8 years. Multiple trauma was present in 20 patients (83.3%).
      In most cases operative stabilization of the posterior pelvic ring was performed
      by lag screws from the ilium into the body of the sacrum. The mortality in this
      series was 16.7% (4 patients). One patient had a thrombosis of the femoral and
      pelvic veins. In 2 patients we had to perform a second operative procedure
      because of lag screws that had not been precisely placed or had dislocated. Two
      incisions healed secondarily. On the postoperative radiographs in 3 patients a
      slight deformity of the pelvic ring was visible; in another patient the reduction
      of the injured hemipelvis was not sufficient. The 20 survivors had a clinical and
      radiological examination on average 27.5 months after their injury. Eleven
      patients were without pain, while 9 complained of low back pain. Gait
      disturbances were found in 8 patients; in 2 of them this was due to associated
      injuries. Five patients were unable to work. Eight patients had neurological
      deficits, some of them minor. Additional complications were impotence (3
      patients), urinary (2 patients) or fecal incontinence (1 patient), and dystocia
      requiring a cesarean section (1 woman) [multiple entries].(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8367732
TI  - [Development of thromboses in hip joint endoprostheses. A study with color-coded
      duplex ultrasound].
AB  - After 102 hip replacements in a surgical technique that avoids bone-marrow
      intravasation as much as possible, color-coded duplex sonography revealed thigh
      thrombi in only 4 cases without any signs of thrombosis. This rate is lower than
      that found in all other comparable studies. The investigations stress the role of
      bone-marrow intravasation in the induction of deep vein thrombosis in hip
      replacement. With an optimal surgical technique, thigh thrombi can be greatly
      reduced in hip replacements, which have a higher rate than all other operations.

PMID- 8367733
TI  - [Reliability of clinical examination of the shoulder in comparison with
      arthroscopy. A prospective study].
AB  - The results of clinical shoulder examination including 20 special tests were
      compared with subsequent arthroscopic findings in 45 patients. The sensitivity of
      the clinical diagnosis was 73%. Impingement syndrome was correctly diagnosed in
      19 of 22 cases (86%), rotator cuff tears in 7 of 9 cases (78%). The highest
      sensitivity for stage II impingement was found for the supraspinatus test (85%)
      and the lift-up test (92%); the sensitivity of these tests for rotator cuff tears
      was 100% and 89% respectively. Differentiation between impingement syndrome with
      and without rotator cuff tear by one of these tests alone was not possible
      because of their low positive predictive values (26% and 56%). In contrast, in
      90% of patients with negative rotator tests the rotator cuff was complete, while
      the negative predictive value of the supraspinatus test was 100%. Instability was
      confirmed in only 53% of cases; the Leffert test had the highest positive
      predictive value (73%). In conclusion, the clinical diagnosis of a shoulder
      lesion cannot reliably be achieved by single tests; rather overall evaluation by
      an experienced clinician is necessary.

PMID- 8367734
TI  - [Rupture of the patellar ligament of the tibial tuberosity as a complication
      after cruciate ligament-plasty].
AB  - We report a complication of a rupture of the patellar ligament at the tibial
      tuberositas following autologous cruciate ligament reconstruction. To our
      knowledge, this complication has not yet been described.

PMID- 8367735
TI  - [Blood lamination in bone cement--effect of cementing technique].
AB  - The quality of the cement layer influences the long-term survival of cemented
      endoprostheses. However, blood and fluid laminations within the cement layer,
      which can form during implantation of endoprostheses, lead to the deterioration
      of bone cement. Since the bone cement is the weakest part in the construction
      consisting of prosthesis, bone and bone cement, further weakening of the bone
      cement should be avoided if possible. By means of in vitro studies, three
      different cementing techniques were tested, measuring quantitatively the amount
      of fluid within the cement layer after implantation. The least amount of fluid
      within the cement layer was found in the cement-canal technique, and the highest
      amount in anterograde cement injection. Retrograde cement injection led to
      intermediate values.

PMID- 8367736
TI  - [Para-basal metatarsal V fracture: conservative functional treatment].
AB  - Fractures of the fifth metatarsal bone, mostly avulsion fractures that result
      from forced inversion of the plantar foot, are relatively common. There are two
      distinct types of fracture that involve the proximal portion of the fifth
      metatarsal bone. The first type is the proximal diaphyseal fracture, the so
      called Jones fracture, and the second type involves the area of the metatarsal
      tuberosity. They are usually not displaced or only slightly displaced. The
      standard treatment is a below-the-knee walking cast Osteosynthesis for fractures
      of the fifth metatarsal bone is indicated only in cases where significant
      displacement cannot be corrected by closed reduction. At the Department of
      Traumatology in the Stadtische Klinikum Braunschweig. 51 patients (32 male, 19
      female) with an avulsion fracture of the proximal diaphyseal portion or a Jones
      fracture of the fifth metatarsal bone were treated functionally with a brace
      (Caligamed II). The average displacement was 1.4 mm (range 0.8-4.0 mm). In each
      case the fracture was treated for 2-3 days in a short leg cast and additional
      antiphlogistic medication was applied. After edema had been reduced, every
      patient was fitted with a carefully adapted Caligamed II brace, and this was
      followed by intense mobilization and walking therapy. The average follow-up in
      this study was 14.2 +/- 1.8 month. In this protocol the patients were examined at
      our clinic during the first week after trauma in order to check the brace again,
      again after 5-6 weeks for X-rays and to remove the brace, and for a final check
      up after 12 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367737
TI  - Experience with prophylaxis in Germany.

PMID- 8367738
TI  - Experience with prophylaxis in Sweden.

PMID- 8367740
TI  - Prophylaxis: musculoskeletal evaluation.

PMID- 8367739
TI  - Cost-effectiveness--can it be measured?

PMID- 8367741
TI  - Radiographic scores and implications.

PMID- 8367742
TI  - Palpation of the thyroid gland.
AB  - The initial clinical clue to the existence of a disorder of the thyroid gland
      often is the detection of a physical abnormality of the gland. Adequate palpation
      of the gland is an essential component of the evaluation of a suspected disorder
      of the thyroid gland. Provided herein are guidelines that others have found
      useful in improving their skill in this aspect of physical diagnosis.

PMID- 8367743
TI  - Poor positive predictive value of low sensitive thyrotropin assay levels for
      hyperthyroidism in nursing home residents.
AB  - We assessed the positive predictive value of a low thyrotropin (TSH) level on
      sensitive TSH (STSH) assay as an indicator of hyperthyroidism. In 742
      determinations on nursing home residents who were not taking thyroid hormone, we
      identified 15 with low TSH levels. None of the residents had a completely
      suppressed (undetectable) TSH level upon initial testing or an elevated total
      triiodothyronine (T3) or thyroxine (T4) level. Half the patients in whom total T3
      was measured had low levels. Of 11 surviving residents, four subsequently had a
      normal TSH level and six others had a normal free T4 level. Only one patient had
      a slight elevation of the free T4 level. None of the residents were diagnosed as
      having hyperthyroidism.

PMID- 8367744
TI  - Assessment of nutritional status and obesity in elderly patients as seen in
      general medical practice.
AB  - Overweight and obesity are generally considered to have a negative impact on
      longevity because of their association with many diseases, including
      hypertension, diabetes, coronary artery disease, osteoarthritis, and certain
      types of cancer. Nevertheless, some authors, notably Ancel Keys, have concluded
      that being overweight improves one's chances for longevity. I studied 122
      consecutive patients who had comprehensive geriatric assessment with regard to
      their body mass index, responses to Wolinsky's Nutritional Risk Index, and serum
      albumin levels. There was a high prevalence of overweight (60% of men and 45.6%
      of women). This fact, coupled with the observed low prevalence of underweight
      subjects, tends to support Keys' statement concerning the benefit of being
      overweight. However, the relative absence of significant obesity supports the
      impression that significantly obesity reduces prospects for longevity. Although
      serum albumin measurements were obtained for only 38 subjects, the fact that the
      value was low in only one instance--in the case of a person who was seriously ill
      -suggests that obtaining routine serum albumin measurements in ambulatory,
      community-dwelling elderly people is not cost-effective.

PMID- 8367745
TI  - Evaluation of endometrial biopsy using an aspiration curet without cervical
      tenaculum.
AB  - In a study of 132 women having endometrial biopsy with either a Novak or Randall
      aspiration curet before hysterectomy, a tenaculum was not used initially if the
      curet could be passed easily through the cervix. One biopsy specimen was taken
      from the anterior endometrium and one from the posterior endometrium. Biopsy was
      successful in 80 women (61%) and unsuccessful in 52 (39%). Women who are
      premenopausal, who do not have cervical stenosis, and who have a uterus that
      sounds to 3.5 inches or less are significantly more likely to have a successful
      biopsy. Excluding six women in whom the curet could not be passed through the
      cervix, adequate tissue for histologic evaluation was obtained in 101 of 126
      women (80%). Furthermore, endometrial biopsy accurately reflected histopathologic
      features of the surgical specimen in 98% (98/101) of the women who had sufficient
      tissue obtained for evaluation. Endometrial biopsy done with an aspiration curet
      but without placing a tenaculum on the cervix should be attempted in women who
      require evaluation. Endometrial biopsy would appear to rival dilation and
      curettage for obtaining endometrial tissue that accurately reflects endometrial
      histopathology.

PMID- 8367746
TI  - Detection of fibrin D-dimer in plasma and urine of pregnant women using Dimertest
      latex assay.
AB  - Eighty-six women admitted for evaluation of preeclampsia had plasma and urine
      screened for the presence of fibrin D-dimer using the monoclonal antibody DD-3B6
      in a latex fixation assay (Dimertest). In 53 of the women screened, results were
      negative for fibrin D-dimer in both plasma and urine; in 33, results were
      positive in urine (N = 11), plasma (N = 14), or both (N = 8). D-dimer positive
      women were at increased risk for earlier delivery (mean 34 versus 36 weeks),
      lower birth weight babies (mean 2,327 versus 2,669 g), higher mean arterial
      pressures (mean 104 versus 94mm Hg), liver function test abnormalities (mean
      lactate dehydrogenase value 256 versus 142 U/L, mean serum glutamic-oxaloacetic
      transaminase 67 versus 23 U/L), and significantly elevated levels (> 40
      micrograms/mL) of fibrin(ogen) degradation products (FDPs). Interestingly, 22 of
      33 D-dimer positive women had insignificant levels of FDPs. Generally, D-dimer
      negative women had no significant abnormalities in results of coagulation tests
      and liver function tests. This study confirms previous observations on the value
      of D-dimer detection in screening for preeclampsia coagulopathy and extends this
      tool to its detection in urine.

PMID- 8367747
TI  - Prayer and health during pregnancy: findings from the Galveston Low Birthweight
      Survey.
AB  - In this study we examined the relationship between praying for one's baby during
      pregnancy and self-ratings of health. Data were collected from a biethnic (black
      and Hispanic) sample of postpartum mothers in Galveston, Tex, from 1986 to 1987.
      This sample is representative of the annual biethnic population of live births in
      Galveston. Subjective health was assessed for the periods both before and during
      pregnancy with self-ratings of global or overall health, worry over health, and
      functional health or lack of disability. Analyses controlled for the effects of
      the mother's age, marital status, gravidity, education, and self-rated
      religiosity. Findings revealed that all three prepregnancy health measures were
      associated with prayer. Subjectively unhealthier mothers prayed more for their
      baby during pregnancy regardless of their perceived health during pregnancy, and
      subjectively healthier mothers prayed less for their baby regardless of their
      self-reported religiosity. Additional analyses revealed that the effect of poor
      health on the frequency of prayer was not simply an outcome of the mother's worry
      over her own health.

PMID- 8367748
TI  - Immediate orthostatic hypotension: diagnostic value in acutely ill patients.
AB  - Hypotension (systolic blood pressure less than 90 mm Hg) was induced immediately
      in 21 acutely ill normotensive patients when they were raised from a supine to an
      upright position. Systolic blood pressure declined to 80 mm Hg or lower in all
      patients and to 65 mm Hg or lower in 10 patients when they assumed an upright
      posture. Immediate orthostatic hypotension observed in 9 patients suggested
      hypovolemia, which was promptly corrected by rapid infusion of large volumes of
      normal saline and/or albumin. Orthostatic hypotension was of diagnostic aid in 16
      patients, including 4 with infections (pelvic inflammatory disease, occult septic
      shock, legionnaires' disease, Rocky Mountain spotted fever), 3 with adrenal
      insufficiency, 2 with acute myocardial infarction, 1 with hypoglycemia, 2 with
      severe cardiac valvular obstruction, and 4 with inappropriate drug use (enalapril
      or trazodone). These findings suggest that immediate orthostatic hypotension in
      acutely ill patients is a physical sign that might have valuable diagnostic and
      therapeutic implications.

PMID- 8367749
TI  - Group psychotherapy for patients with dementia.
AB  - Some of the goals of our group psychotherapy sessions on the inpatient unit
      include (1) creation of an emotional climate of acceptance and warmth that helps
      patients learn to accept themselves and their feelings, (2) frequent intervention
      by the group facilitator/therapist to help facilitate social interaction for
      patients whose communication ability is impaired, (3) opportunity for patients to
      experience the feeling of belonging, of being part of a group, (4) opportunity
      for patients to ventilate feelings and rediscover mutual kinds of experience, (5)
      opportunity for patients to reminisce about past accomplishments and give new
      meaning to their current lives, and (6) creation of a platform for patients to
      achieve a sense of self by expressing personal opinions in an environment of
      respect and acceptance. The outcome of group therapy for demented as well as
      nondemented patients should be increased ability to cope with losses at several
      levels, promotion of new skills, increased adaptation skills, and increased
      ability to accept change. We also want patients to learn to express feelings and
      to realize that the expression of feelings can have a positive outcome (relief
      from repression, clarification of ambivalence, solutions, etc).

PMID- 8367750
TI  - Dementia: physician approaches to the caregiver's problems.
AB  - The demented patient requires medical and often psychiatric supervision, but the
      caregiver is often neglected. This article identifies special issues for
      caregivers that may need attention from the demented patient's physician. The
      physician's attention can benefit both the patient and the caregiver and save the
      physician valuable time.

PMID- 8367751
TI  - Medical shortages and Confederate medicine: a retrospective evaluation.
AB  - The Union's decision to treat medicines and medical supplies as contraband of war
      meant, for the Confederacy, the specter of medical shortages. The Confederate
      medical department significantly lessened the subsequent suffering through an
      energetic and resourceful program to supply its physicians' needs. Medicines and
      medical supplies were purchased abroad and smuggled through the Union blockade,
      obtained in an illicit trade with the North, captured from the enemy, and
      manufactured in the Confederacy. The search for home remedies, enthusiastically
      endorsed by Surgeon General Samuel P. Moore, was one of the most prominent
      features of the southern program. This paper surveys and analyzes medical
      shortages and Confederate medicine.

PMID- 8367752
TI  - Hemobilia in systemic lupus erythematosus.
AB  - Symptoms of acute cholecystitis developed in a 22-year-old woman with active SLE.
      Abdominal ultrasonography and biliary patency scan showed evidence of acalculous
      cholecystitis and common bile duct obstruction, respectively. Operation revealed
      acalculous cholecystitis and hemobilia; a liver biopsy specimen also showed
      hemobilia. Surgery relieved the patient's symptoms. This case demonstrates a new
      complication of SLE.

PMID- 8367753
TI  - Pneumonia due to Pneumocystis carinii in a transplant recipient with normal
      arterial oxygen tension and normal radiographic findings.
AB  - We have described an exogenously immunosuppressed, HIV-negative patient with a
      subacute presentation of Pneumocystis carinii pneumonia characterized by normal
      arterial oxygen tension and alveolar-arterial oxygen gradient and normal findings
      on serial chest radiographs. This case demonstrates that other studies in
      addition to chest radiograph and resting arterial blood gas measurement are
      necessary in all immunosuppressed patients with progressive respiratory symptoms,
      regardless of cause of immunosuppression, to exclude P carinii pneumonia from the
      differential diagnosis.

PMID- 8367754
TI  - Sarcoidosis: unusual cause of a rectal mass.
AB  - We have reported the case of a patient who had a rectal mass 3 years after the
      diagnosis of sarcoidosis. A malignancy was suspected, but biopsy of the rectal
      mass showed epithelioid granulomas with giant cells, consistent with sarcoidosis.
      Therefore, sarcoidosis should be considered as a rare cause of a rectal mass.

PMID- 8367755
TI  - Cogan's syndrome manifesting as sudden bilateral deafness: diagnosis and
      management.
AB  - Cogan's syndrome is an uncommon entity of nonsyphilitic interstitial keratitis
      with vestibulo-auditory disturbances. Although it is unusual, Cogan's syndrome
      should be considered in the differential diagnosis of patients with sudden
      hearing loss, even when they lack ophthalmologic symptoms. Systemic
      manifestations are not uncommon and, along with serologic and hematologic
      abnormalities, may help in making the diagnosis, which requires a high index of
      suspicion. Treatment with steroids has largely been based on symptoms. We suggest
      using the C-reactive protein level as a monitor of subclinical disease activity;
      it is therefore beneficial in the adjustment of steroid therapy. We have
      described the case of a 41-year-old woman who sought treatment for an upper
      respiratory infection syndrome and severe vertigo. Evaluation included
      hematologic and serologic studies, lumbar puncture, and CT and MRI scans.
      Abnormal findings consisted of an elevated white blood cell count and an ESR of
      112 mm/hr. Six days later, profound, bilateral sensorineural hearing loss
      developed suddenly. Intensive corticosteroid and vasodilator therapies were
      instituted, but there was no improvement in hearing levels. Ten days later eye
      pain and redness developed, and ophthalmologic evaluation revealed an
      interstitial keratitis consistent with Cogan's syndrome. Steroid eye drops and
      oral prednisone therapy promptly relieved the eye symptoms. Steroid tapering was
      associated with diffuse joint pain and swelling consistent with a systemic
      vasculitis. After rheumatologic consultation, steroid dosage was titrated to the
      CRP level and ESR, and vasculitic symptoms resolved. Hearing levels did not
      improve, and the patient had cochlear implantation. Thirteen cases of bilateral
      sudden deafness due to Cogan's syndrome have been reported previously. This is
      the first case in which there were no immediate eye symptoms.

PMID- 8367756
TI  - Pneumothorax and bronchopleural fistula during treatment of allergic
      bronchopulmonary aspergillosis.
AB  - A man with allergic bronchopulmonary aspergillosis had pneumothorax and
      bronchopleural fistula while impacted mucus was being successfully dislodged from
      bronchiectatic airways. We believe this is the first report of pneumothorax with
      bronchopleural fistula in a patient with active ABPA, and we have proposed a
      mechanism to explain the development of this complication.

PMID- 8367757
TI  - Intracerebral hemorrhage after topical administration of mydriatic agents.

PMID- 8367758
TI  - Adenocarcinoma of the small intestine: a plea for early diagnosis.
AB  - The small bowel is a difficult organ to examine clinically and study
      diagnostically. The SBFT study is an adequate screening tool for evaluation of
      the small bowel, but if there is a moderate to high index of suspicion of an
      undetected tumor, enteroclysis is better than upper GI series with SBFT for
      preoperative diagnosis of such lesions. Based on the above findings, we recommend
      that any patient with symptoms and findings highly suggestive of small bowel
      tumor, especially chronic GI blood loss with a negative work-up, be viewed with a
      high index of suspicion and his case investigated aggressively, using
      enteroclysis followed by exploration.

PMID- 8367759
TI  - Cryptococcus albidus and mucormycosis empyema in a patient receiving
      hemodialysis.
AB  - C albidus and mucormycosis were cultured simultaneously from the pleural space of
      a patient with end-stage renal disease receiving long-term hemodialysis. There
      have been only nine previous reports of infection with C albidus, with only one
      involving the lung. This organism has never before been isolated from the pleural
      space, and none of the previously reported cases included a coinfection with
      mucormycosis. We have reviewed and compared all known cases of infection with C
      albidus.

PMID- 8367760
TI  - Ruptured ovarian artery aneurysm complicating a term vaginal delivery.
AB  - Ruptured ovarian artery aneurysm is rare. Of the eight cases previously reported,
      seven were diagnosed postpartum. Our case of a ruptured right ovarian artery
      aneurysm was associated with massive retroperitoneal bleeding. The probable time
      of rupture could be traced to the second stage of labor. This case indicates the
      need for early evaluation of atypical flank pain during labor.

PMID- 8367761
TI  - Nephrogenic adenoma of the ureter.

PMID- 8367762
TI  - Terbutaline pump treatment of premature labor.

PMID- 8367763
TI  - Green tobacco sickness.
AB  - Green tobacco sickness (GTS) is an occupational illness that causes significant
      morbidity in tobacco harvesters. Physicians need to be aware of GTS and its
      differential diagnosis, especially when patients come to emergency rooms. Dermal
      absorption of nicotine is reported to be the cause of GTS. No fatalities have
      been reported, and treatment is supportive. Prevention, by covering exposed skin,
      seems to be the most effective way of dealing with GTS.

PMID- 8367764
TI  - Retrospective comparison of outcome of 100 consecutive open cholecystectomies and
      100 consecutive laparoscopic cholecystectomies.
AB  - If laparoscopic cholecystectomy is to be a viable option for community surgeons
      and their patients, it should have a safety profile similar to or better than
      that of open cholecystectomy. Morbidity and mortality from 100 consecutive open
      cholecystectomies were compared to morbidity and mortality from 100 consecutive
      laparoscopic cholecystectomies. All procedures were done at Davis Community
      Hospital (Statesville, NC, population 25,000). Open cholecystectomies were done
      by seven staff surgeons from July 1987 to March 1990. Laparoscopic
      cholecystectomies were done by three staff surgeons from February 1990 to August
      1990. Cholangiography during open cholecystectomy was selective. After an initial
      learning experience of 11 cases, cholangiography was routine during laparoscopic
      cholecystectomy. Patients having cholecystectomy coincidental to a planned common
      duct exploration for stones or neoplasia were excluded. For open cholecystectomy,
      morbidity was 13% and mortality, 2%. For laparoscopic cholecystectomy, morbidity
      was 9% and mortality, 1%. One death after open cholecystectomy was due to
      pulmonary embolus. The other two deaths in the series were due to underlying
      severe cardiopulmonary disease. Complications related directly to cholecystectomy
      were bleeding requiring transfusion (open 2, laparoscopic 1), bile leak (open 1,
      laparoscopic 1), wound infection (open 1), and prolonged back pain (laparoscopic
      2). In two patients, the laparoscopic procedure was converted to open
      cholecystectomy. There were no common bile duct injuries in either group of
      patients. Results of this study suggest that laparoscopic cholecystectomy can be
      done as safely as open cholecystectomy, even in smaller community hospitals.

PMID- 8367765
TI  - Symptoms of acid-peptic disease in children.
AB  - Esophagogastroduodenoscopy (EGD) is a useful procedure for the evaluation of
      gastrointestinal disease in pediatric patients. Indications for EGD in children
      are similar to those for adults. However, symptoms of acid-peptic disease
      reported by children may differ from those expressed by adults. Therefore, we
      sought to identify symptoms associated with acid-peptic disease in pediatric
      patients. The medical records of 114 children having EGD with biopsy were
      reviewed. The diagnosis, which included esophagitis, gastritis, duodenitis,
      ulcer, or normal, was based on histologic findings. Six symptoms correlated
      significantly with acid-peptic disease: epigastric pain, nocturnal pain,
      postprandial pain, water brash, weight loss, and a family history of peptic ulcer
      disease. Epigastric pain and nocturnal pain are the most sensitive symptoms of
      acid-peptic disease in pediatric patients. Fecal occult blood and hematemesis,
      although specific, are not sensitive indicators of acid-peptic disease in
      children.

PMID- 8367766
TI  - The relationship of facet tropism to degenerative disc disease.
AB  - The role of facet tropism (asymmetry) in the pathogenesis of degenerative disc
      disease is unknown, and several conflicting reports have been published. We
      studied this association using CT/discography performed at 324 lumbar levels (108
      patients). The stage of disc degeneration as well as the patient's pain response
      upon discographic injection were scored using a standardized protocol. The facet
      angles were measured directly from the axial CT/discographic images and defined,
      in each case, as the angle formed by the facet orientation with respect to the
      midsagittal plane. The facet tropism angle was defined as the difference between
      the left and right facet angles at each disc level. The mean and standard
      deviation (SD) of the tropism angles were calculated. From this calculation, each
      pair of facet joints was classified as symmetric (within 1 SD of the mean),
      moderately asymmetric (between 1 and 2 SD), or severely asymmetric (beyond 2 SD
      of the mean). There were no differences in degree of disc degeneration or pain
      response with respect to the facet tropism. The total facet angle was also
      studied. The total facet angle was greater at the more caudal levels. The total
      angle size was not associated, however, with disc degeneration or pain
      provocation. These findings do not support the hypothesis that there is an
      association between facet tropism and degenerative lumbar disc disease.

PMID- 8367767
TI  - The effects of depth of penetration, screw orientation, and bone density on
      sacral screw fixation.
AB  - Obtaining adequate sacral fixation is an important and challenging clinical
      problem. Bicortical screw fixation has been used to provide improved mechanical
      strength. The goal of this study was to evaluate the effects of depth of
      penetration (unicortical versus bicortical), orientation (medial versus lateral),
      and bone density on the strength of the bone-screw interface. Seven-millimeter
      Steffee screws (Acromed, Cleveland, Ohio) were placed in human cadaveric sacra.
      The screws were placed either medially into the centrum of the S1 body or
      laterally into the sacral ala. The fixation systems used, either bicortical or
      unicortical, were tested on a Universal testing machine. The specimens were
      loaded to failure and biomechanical parameters were measured. Medially oriented
      screws sustained the highest load to failure. In an older population, unicortical
      fixation sustained load to failure and initial compliance findings were similar
      to those for bicortical fixation. The regional bone density in the centrum of the
      first sacral body was denser than that in the lateral alar region, and also
      provided more rigid bone screw fixation.

PMID- 8367768
TI  - Mechanics of interbody spinal fusion. Analysis of critical bone graft area.
AB  - Bone graft subsidence is a serious complication of interbody spinal fusion. In
      this study, 66 mechanical tests were performed on 35 thoracic vertebral bodies to
      investigate the in situ mechanics of interbody spinal fusion. The relationships
      among trabecular bone density, bone strength, and size of bone graft area were
      analyzed. All vertebral bodies were scanned by quantitative computer tomography
      (QCT) to determine their bone density before mechanical testing. The decorticated
      trabecular beds of the vertebral bodies, void of all posterior elements, were
      loaded in a manner similar to that which occurs after surgical interbody fusion.
      That is, rectangular blocks of polymethylmethacrylate, representing bone grafts,
      were used to transfer controlled compressive loads to the decorticated vertebral
      trabecular surface. Both destructive and nondestructive tests were performed. The
      relationship between QCT bone density and trabecular bone strength was related by
      a power function, and, on average, the bone density and trabecular bone strength
      were 0.137 g/cm3 and 3.97 MPa, respectively. Eighty percent of the vertebral
      bodies with graft covering 25% of the total end plate area or less failed at
      loads less than 600 N, while 88% of the vertebral bodies with 30% or greater
      covered were able to carry a load greater than 600 N. The results suggest that
      the intrinsic behavior of trabecular bone loaded within the vertebral body is
      little different from the behavior of the whole body, that QCT bone density is
      indicative of bone strength, and that interbody graft area should be
      significantly greater than 30% of the total end plate area to provide a margin of
      safety.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367769
TI  - A histologic study of lumbar pseudarthrosis.
AB  - Biopsy specimens were obtained from 35 consecutive patients undergoing
      pseudarthrosis repair after failed posterior spinal fusions. Biopsy specimens
      were obtained when possible from the fusion mass, from areas of motion, and from
      the lumbar facet remnant where identifiable. Tissue found between adjacent bony
      segments was noted to contain predominantly fibrous tissue often accompanied by
      signs of local fibrocartilaginous metaplasia. In addition, small fragments of
      impacted bone, sometimes seen to be undergoing active resorption, also were noted
      frequently in these areas. The bone adjacent to the areas of motion was sclerotic
      and poorly organized, containing a mixture of woven and lamellar bone.
      Interestingly, multiple microtrabecular fracture with appositional new bone
      formation was a frequently seen feature. All facet joint biopsies were noted to
      have evidence of degenerative disease. Both cartilage fissuring and significant
      chondrocyte cloning were noted. Subchondral bony sclerosis was also a consistent
      feature.

PMID- 8367770
TI  - Clinical methodologies and incidence of appropriate statistical testing in
      orthopaedic spine literature. Are statistics misleading?
AB  - An analysis of 300 randomly drawn orthopaedic spine articles, published between
      1970 and 1990, was performed to assess the quality of biostatistical testing and
      research design reported in the literature. Of the 300 articles, 269 dealt with
      topics of an experimental nature, while 31 documented descriptive studies.
      Statistical deficiencies were identified in 54.0% of the total articles.
      Conclusions drawn as the result of misleading significance values occurred in 124
      experimental studies (46%) while 96 failed to document the form of analysis
      chosen (35.7%). Statistical testing was not documented in 34 studies (12.6%),
      while 20 (7.4%) employed analyses considered inappropriate for the specific
      design structure.

PMID- 8367771
TI  - Relationship of the dura, Hofmann's ligaments, Batson's plexus, and a
      fibrovascular membrane lying on the posterior surface of the vertebral bodies and
      attaching to the deep layer of the posterior longitudinal ligament. An
      anatomical, radiologic, and clinical study.
AB  - With the advent of computed tomography (CT) and magnetic resonance imaging (MRI),
      visualization of soft tissue structures in the spinal canal, which were
      previously undetectable, is possible. This study was undertaken to more
      accurately identify these soft tissue layers and to determine factors such as
      when is a disc contained and when is it not; in discography, when the disc leaks,
      into what layer is the contrast going; or when a nuclear fragment creeps upward
      or downward, just where is it. The works of Fick, Dommisse, Kikuchi, Schellinger,
      Hofmann, Batson, and Parke were studied. The professors of anatomy of four major
      medical schools were consulted along with several neuroradiologists and
      embryologists. Forty lumbar spines were dissected (20 fresh, 20 preserved).
      Magnetic resonance imaging scans were taken. Photographs and photomicrographs
      were made. A fibrous membrane, first mentioned by Fick, can be identified lying
      anterior to the posterior longitudinal ligament and attaching to the deep layer
      of the posterior longitudinal ligament. It has been given relatively little
      attention in the past. This membrane has about one fourth the toughness of the
      dura and is made up largely of fibrous tissue. The veins of Batson lie on its
      dorsal surface and pierce it to go ventral to this membrane and enter the
      vertebral body. Batson's plexus crosses the disc space. The peridural membrane
      extends from one side to the other, spanning the width of the vertebral body and
      encircling the bony canal around the outside of the dura. There is a potential
      space between it and the dura. It does not cross the disc space. A probe can
      easily be passed posterior or anterior to it, between it and the posterior
      longitudinal ligament or between it and the vertebral body. We also identified
      Hofmann's ligament anterior to the dura, attaching the dura to the posterior
      longitudinal ligament. Laterally, tiny attachments between this fibrovascular
      membrane and the circumneural sheaths of the spinal nerves can be observed as the
      nerves enter the foramina. The posterior longitudinal ligament (PLL) is very
      tough and strong and seldom ruptures. The annulus frequently ruptures. Fragments
      of nucleus pulposus can creep out at the vertebral rim and get under the PLL and
      the peridural membrane. Hematoma can form by the same route and have the exact
      appearance as a sequestrated disc. There is no periosteum inside the vertebral
      canal. With MRI, hematomas can be differentiated from an extruded fragment. They
      may cause symptoms similar to an extruded disc but will probably heal with
      time.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8367772
TI  - Discography causes end plate deflection.
AB  - Thoracolumbar cadaver spine segments were studied by biplane radiography
      techniques during intradiscal injection of radiographic contrast agent. In these
      radiographically nondegenerated discs, significant deformation of the end plate
      accompanied these in vitro discograms. End plate deflections averaged 0.3 mm. The
      intervertebral disc bulges averaged 0.5 mm. These results suggest that the end
      plate itself, or events within the bone, are possible pain sources during
      clinical discography.

PMID- 8367773
TI  - Lumbar spine following successful surgical discectomy. Magnetic resonance imaging
      features and implications.
AB  - In an attempt to determine the expected long-term appearance of the lumbar spine
      in patients who have undergone successful lumbar discectomy, follow-up magnetic
      resonance (MR) examinations were performed on 23 patients (26 levels). All
      patients in the study had undergone at surgery at least one year prior to the
      study. All patients met rigorous criteria for a successful outcome. In nine
      cases, the postoperative study indicated a virtually total resolution of the
      previously identified disc herniations. In 13 cases, the study noted moderate,
      persistent posterior contour defects in the disc that contributed to persistent
      mass effect on the thecal sac or corresponding nerve root. In the remaining four
      cases, the postoperative study indicated virtually no change in the apparent
      contour of the posterior disc margin. Gadolinium contrast examinations
      demonstrated enhancement of the persistent contour abnormalities in 18 of 19 disc
      levels, suggesting the common presence of fibrosis, which was at times "mass
      like," in these successful patients. These findings suggest that localized discal
      contour abnormalities morphologically simulating recurrent disc herniations and
      variably contributing to mass effect, may be commonly encountered in long-term
      follow-up imaging studies of successful discectomy patients.

PMID- 8367774
TI  - Artificial disc replacement. Preliminary report with a 3-year minimum follow-up.
AB  - Artificial disc replacement was performed in six patients with an average age of
      55 years and average follow-up of 3.4 years. Four of the six patients had
      juxtafusion degeneration, one had multilevel disc degeneration, and one patient
      had isolated disc resorption. The Acroflex disc (Acromed Corporation, Cleveland,
      OH), which was used in the replacement, is composed of a rubber core vulcanized
      to two titanium end plates. The latter have superior posts to provide for initial
      mechanical fixation and porous in-growth surfaces for long-term fixation.
      Satisfactory results occurred in four of six patients. Poor results occurred in
      the presence of deformity that resulted in prosthetic failure and isolated disc
      resorption. There was an average 8 degrees angular and 2.3-mm translational
      movement and satisfactory in-growth at all interfaces. Design objectives of
      endurance, biocompatibility, geometry, kinematics, constraint, dynamics,
      stability, and fail-safe were met; however, this study is preliminary in nature.

PMID- 8367775
TI  - Early versus late replacement of autotransfused blood in elective spinal surgery.
      A prospective randomized study.
AB  - The use of autologous blood is a well established and extremely popular technique
      to decrease the necessity for homologous transfusions and the attendant risks of
      hepatitis, HIV, and HTLV--I/II infections. The most beneficial timing for
      autologous reinfusion of predonated blood remains unknown. The present study was
      undertaken to determine the optimal timing of autologous blood reinfusion in
      elective spinal surgery. Fifty-seven patients were prospectively individually
      randomly allocated into early versus delayed reinfusion groups prior to
      undergoing elective spinal surgery by a single surgeon. Three surgical subgroups
      were entered into the study: anterior/posterior (A/P) spinal fusion patients,
      posterior thoracolumbar scoliosis fusion patients (PSF), and degenerative
      posterior lumbar fusion patients (LF). Randomization was successful in that three
      was no significant difference in male to female ratio, age, preoperative
      hemoglobin, or number of units predonated between the early and delayed
      reinfusion groups. Likewise, there was no significant difference in the details
      of the operative procedure when compared as a group for the early versus delayed
      reinfusion groups. A significant increase in the postoperative day #1, 2 and 3
      hemoglobin was seen in the early reinfusion group, while there was no significant
      difference seen in the postoperative day #7 hemoglobin between the early versus
      delayed reinfusion group. There was no effect of surgical grouping on these
      significant comparisons. Earlier patient mobilization was also seen in the early
      reinfusion groups for the A/P and PSF groups. There was no difference in
      patients' subjective evaluation of satisfaction and discomfort between the early
      or delayed reinfusion groups as determined by blinded interview on days 1, 3, 5,
      and 7 postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367776
TI  - Deep venous thrombosis following posterior lumbar spinal surgery.
AB  - Postoperative duplex scans were performed on 185 patients undergoing posterior
      lumbar spinal surgery in order to identify deep venous thrombosis (DVT). Elastic
      compression stockings were used for prophylaxis in 74 patients (Group E.S.);
      intermittent pneumatic compression was used in the remaining 111 patients (Group
      P.C.). High-risk patients were not eliminated from either group. Laminectomy was
      performed on 84 patients (40 from Group E.S. and 44 from Group P.C.), and spinal
      fusion, on 101 patients (34 from Group E.S. and 67 from Group P.C.). A total of
      four patients, all from Group E.S., developed acute postoperative DVT.
      Intermittent pneumatic compression significantly reduced the incidence of acute
      postoperative DVT (P < 0.05). No statistically significant differences were found
      in the incidence of DVT in relation to the type of spinal procedure, length of
      procedure, duration of bed rest, or age of the patient. In conclusion,
      considering the low rate of DVT (2%) following posterior lumbar surgery and the
      potential complications of prophylactic anticoagulation, we continue to use
      intermittent pneumatic compression rather than elastic stockings for prophylaxis.

PMID- 8367777
TI  - Anesthetic effects on motor evoked potentials in dogs.
AB  - The effects of the various anesthetic agents on the production of transcranial
      magnetic motor evoked potentials (tcMMEP) were studied in a canine model. Pre
      anesthetic baseline tcMMEPs demonstrated consistency in onset latency
      measurements and variability in measurement of peak-to-peak amplitudes. Changes
      in tcMMEPs were evaluated following the individual administrations of sodium
      pentothal, etomidate, halothane, fentanyl, and ketamine. For induction of
      anesthesia, etomidate was compatible with tcMMEP production, whereas sodium
      pentothal resulted in loss of hindlimb potentials for a period of 45 minutes. For
      maintenance of anesthesia, halothane was incompatible with the measurement of
      tcMMEPs. Fentanyl administration was consistent with the recording of reliable
      tcMMEPs, with consistent onset latencies but widely variable peak-to-peak
      amplitudes. Ketamine was compatible with stable and reproducible tcMMEP
      production. The results of this study suggest that anesthetic agents have a
      predictable and consistent effect on tcMMEP responses.

PMID- 8367778
TI  - The effect of nerve root lesioning on various somatosensory evoked potentials in
      the hog.
AB  - Somatosensory evoked potentials (SEPs) were recorded at the lumbar spine
      following stimulation of the tibial nerve (mixed-nerve SEP; MSEP), the sural
      nerve (specific nerve SEP; SSEP), and the skin corresponding to the L6 and S1
      dermatomes (dermatomal field SEP; DSEP-L and DSEP-S) in the hog. To determine the
      sensitivity of these three SEPs to the single nerve root (S1 root) function, the
      effects of nerve roots lesioning were investigated. Cutting S1 nerve root reduced
      the peak-to-peak amplitude of MSEP by only 28% in comparison with baseline
      values. The relative amplitudes of SSEP, DSEP-L, and DSEP-S were decreased by
      46%, 11% and 51%, respectively. When S1 nerve root was left intact and L5, L6,
      and S2 nerve roots were cut, the relative amplitudes of MSEP, SSEP, DSEP-L, and
      DSEP-S were decreased to 68%, 73%, 31%, and 74%, respectively. These results
      indicate that DSEP-S is as sensitive to the function of S1 nerve root as SSEP but
      the sensitivities of DSEP-S and SSEP are low in the hog. MSEP is shown unsuitable
      to monitor the single nerve root dysfunction.

PMID- 8367779
TI  - Paraspinal muscle evoked cerebral potentials in patients with unilateral low back
      pain.
AB  - Cerebral somatosensory evoked potentials (SEPs) were elicited by magnetic
      stimulation of paraspinal muscles unilaterally at the L2 and L5 levels in 20
      healthy subjects and 16 patients with low back pain and unilateral muscle spasm.
      A magnetic coil with a mean diameter of 4.7 cm was placed tangentially to the
      skin. The stimulus strength was sufficient to induce a visible muscle twitch
      without producing muscle contraction in the legs. The potentials recorded over
      the scalp consisted of several components (P30, N40, P55, N70, and P90) and were
      elicited in all subjects. In both healthy and patient subjects, paraspinal muscle
      evoked potentials were readily elicited. Vibration applied to paraspinal muscles,
      as well as voluntary contraction of paraspinal muscles, was associated with
      attenuation of the evoked potentials. This finding suggests that muscle spindle
      receptors provide the afferent input responsible for the early components of the
      magnetically evoked cerebral potentials. In patients with unilateral muscle
      spasm, the amplitudes of P30-N40, N40-P50, and P50-N70 were decreased
      significantly on the affected side when compared with values on stimulation of
      the unaffected side, as well as those obtained from control subjects. The
      cerebral evoked potentials returned to normal amplitude when the muscle spasm
      subsided following a period of time and after the application of spinal
      manipulative therapy. The technique has potential for quantitative evaluation of
      muscle spasm in low back pain.

PMID- 8367780
TI  - Predicting long-term disability in low back injured workers presenting to a spine
      consultant.
AB  - Low back pain (LBP) is the most common, costly, and disabling musculoskeletal
      condition. Although most LBP patients recover within two months, 2-3% eventually
      develop disabling chronic low back pain (DCLBP). Due to the prevalence of DCLBP
      problems, models have been developed to predict which acute low back pain
      patients are predisposed to the problems associated with this condition. Many see
      the development of these models as a first step that must be taken before useful
      approaches for containing and reducing the problem can be conceptualized,
      implemented, and tested. A recent publication by Cats-Baril and Frymoyer
      considered this specific problem. While the results of their study indicate
      considerable success in predicting DCLBP patients, the high prediction rates they
      obtained may be spurious because of the characteristics of their sampled patient
      population in conjunction with some of the predictors they found useful in
      identifying DCLBP patients. The purpose of the present study was to focus on the
      crucial patient population (i.e., acute LBP patients who perceive their problem
      as work-related and who have been unable to work for more than two but less than
      six weeks), and evaluate the ability of various personal, medical, occupational,
      and psychological factors to predict predisposition to DCLBP. Fifty-five patients
      referred by occupational physicians were evaluated and followed successfully for
      at least 6 months. Patients in the study were given a physical examination that
      included Spratt et al's assessment of pain behavior. They were then asked to fill
      out an extensive battery of self-report questionnaires, addressing issues
      associated with personal demographics, health history, work requirements, job
      satisfaction, injury information, and pain/function factors. At the 6-month
      follow-up, a structured telephone interview was used to obtain outcome
      information regarding patient status, including ability to return to work and
      general outcomes of treatment. Average patient age was 37.2 years (range, 22-57)
      and 67% of the patients were male. On average, patients had been unable to work
      for approximately 4 weeks when initially surveyed. Overall, 12.7% of the patients
      returned to work within 1 month of injury, 40% returned within 2 months, 54.5%
      within 3 months, 69% within 4 months, 74.5% within 5 months, 76.3% within 6
      months, 80% within 7 months, and 83.6% after 7 months. Approximately 16% never
      successfully returned to work within the follow-up period of this study. DCLBP
      was found to be correlated only with marital status, as married patients returned
      to work more quickly than single patients (P < 0.01).(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8367781
TI  - Responding to the pressures on spine.

PMID- 8367782
TI  - Interference screw fixation of cervical grafts. A combined in vitro biomechanical
      and in vivo animal study.
AB  - The dislodgement of an anterior bone graft in the cervical spine is a frequent
      complication of attempted fusion following discectomy or corpectomy. It has been
      hypothesized that fixation augmented with interference screws may increase the
      pullout strength of the construct and decrease the rate of these complications.
      In vitro mechanical tests and in vivo sheep studies were conducted to compare
      interference screw fixation methods for enhancing the fixation between the bone
      graft and the adjacent vertebra. Using human cadaver cervical spines, the
      anterior pullout strengths of cervical bone grafts were compared using fixation
      with and without the addition of interference screws for the in vitro mechanical
      testing. The mean pullout forces for a Smith-Robinson type bone graft alone was
      58.1 N (SD 11.4 N); for the graft augmented with two 3.5 mm cancellous bone
      screws, 153.9 N (58.9 N); and for the graft with four 3.5 mm screws, 217.1 N (SD
      69.9 N). The pullout strengths of the two- and four-3.5 mm screw constructs were
      significantly greater than the strength of the graft alone (P < 0.05). Similarly
      placed 2.7 mm cortical screws of the same length provided increased pullout
      strength (123.7 N 38.6 N and 142.5 N 38.2 N for two- and four-screw constructs,
      respectively); however, in comparison to the graft alone, these differences were
      not statistically significant. For both screw types, the four-screw fixations
      were stronger than the two-screw fixations, although these differences were not
      statistically significant. For the in vivo portion of the study, a single-level
      anterior cervical discectomy and fusion were performed on 20 sheep.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8367783
TI  - Thoracolumbar burst fractures. The clinical efficacy and outcome of nonoperative
      management.
AB  - There continues to be considerable controversy regarding the management of
      thoracolumbar burst fractures. Most feel that failure of the middle
      osteoligamentous complex, particularly with retropulsion of fragments into the
      spinal canal, is an indication for operative management. Others advocate postural
      reduction and prolonged bedrest for such injuries. The purpose of this study was
      to 1) review the clinical outcome and efficacy of closed management of
      thoracolumbar burst fractures; and 2) quantify what, if any, remodeling occurs in
      the bony canal as measured by serial CT. Forty-one patients who presented with a
      burst fracture of the thoracolumbar spine without neurologic deficit were
      reviewed clinically and radiographically following nonoperative management. At
      injury, canal compromise averaged 37% (range, 16-66%); 26 patients had at least
      30% canal compromise. During treatment, one patient developed neurologic
      deterioration that prompted surgery; all other patients remained neurologically
      intact. At average follow-up of 2 years, an overall outcome evaluation indicated
      that 49% of the patients had excellent outcomes relative to pain and function;
      17%, good; 22%, fair; and 12%, poor. Approximately 90% of the patients had a
      satisfactory work status relative to factors associated with their burst
      fracture. Serial roentgenograms documented significant progression in body
      collapse, which averaged 8% (P < 0.0001) from injury to follow-up. On the other
      hand, serial CTs documented significant improvement from injury to follow-up for
      canal compromise and midsagittal diameter. Average improvements in canal
      compromise and midsagittal diameter were 22% (P < 0.0001) and 11% (P < 0.0001),
      respectively. Only three patients had canal compromise greater than 30%, no
      patients had canal compromise greater than 40%, and no patients experienced canal
      area deterioration over time. On average, nearly two-thirds of the fragment
      occluding the canal resorbed, with most remodeling complete within one year. For
      patients with burst fractures presenting neurologically intact, we obtained the
      following findings: 1) nonoperative management yields acceptable results; 2)
      following nonoperative management, bony deformity (i.e., kyphosis and body
      collapse) progresses marginally relative to the rate of canal area remodeling; 3)
      incidence of subsequent neurologic deficits is quite low; and 4) initial
      radiographic severity of injury or residual deformity following closed management
      does not correlate with symptoms at follow-up. This pattern of results suggests
      nonoperative management as the preferred treatment in these circumstances.

PMID- 8367784
TI  - Nonoperative management of stable thoracolumbar burst fractures with early
      ambulation and bracing.
AB  - Eighteen neurologically intact patients with burst fractures at the thoracolumbar
      junction were treated with early ambulation in a total contact orthosis. No
      attempt was made to reduce the associated deformity. Selection criteria excluded
      patients with posterior column disruption. Hospital stay averaged 10 days. Follow
      up averaged 19 months. Mean kyphosis was 19 at time of injury and 20 at follow
      up. At follow-up, 15 patients rated their pain as little or none. Seventeen
      patients had little or no restriction of activity. Follow-up computed tomography
      (CT) scans obtained in eight patients showed significant resorption of
      retropulsed bone. No deterioration of neurologic function developed in any
      patient. In patients with intact posterior elements and thoracolumbar burst
      fractures, early mobilization in a total contact TLSO can lead to satisfactory
      functional results. Prolonged bed rest was not required in this series. The
      authors attribute the good results of nonoperative management to the exclusion of
      patients with posterior column disruption.

PMID- 8367785
TI  - Biomechanical analysis of three surgical approaches for lumbar burst fractures
      using short-segment instrumentation.
AB  - Burst fractures of the lumbar spine that are located below the thoracolumbar
      junction present a challenge when operative management is indicated. Short
      segment instrumentation offers the advantage of incorporating fewer motion
      segments in the fusion, but may not provide adequate long-term stabilization. The
      goal of this study was to assess the axial stiffness and torsional rigidity of
      several short-segment instrumentation procedures. Compressive axial stiffness and
      torsional rigidity were measured in six intact porcine lumbar spines (L1-L5). A
      corpectomy was performed to simulate a burst fracture injury and decompression.
      Posterior instrumentation, posterior instrumentation with an anterior strut (a
      wood block), and anterior instrumentation with an anterior strut one level above
      and one level below the fracture site were applied as treatment strategies. VSP
      plates (Acromed, Cleveland, OH) for posterior instrumentation and the Kaneda
      system (Acromed, Cleveland, OH) for anterior instrumentation were used. Load
      displacement and torque-angle plots were generated and used to calculate 144
      estimates of axial stiffness and 144 estimates of torsional rigidity for these
      constructs. These analyses showed that, in comparison with the intact spine,
      posterior instrumentation alone was an average of 76% less stiff axially,
      posterior instrumentation with an anterior strut was 3% more stiff (not
      significantly different from intact), and anterior instrumentation with an
      anterior strut was 15% more stiff. Posterior instrumentation alone was an average
      of 30% less rigid in torsion, posterior instrumentation with an anterior strut
      was 26% less rigid, and anterior instrumentation with an anterior strut was 24%
      less rigid than the intact spine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367786
TI  - A prospective, randomized study of lumbar fusion. Preliminary results.
AB  - One hundred, twenty-four patients undergoing lumbar or lumbosacral fusion for
      degenerative conditions were entered into a prospective study. The patients were
      randomly assigned to one of three treatment groups. Group I underwent
      posterolateral fusion using autogenous bone graft. Group II had autogenous
      posterolateral fusions supplemented by a semi-rigid pedicle screw/plate fixation
      system (Luque II; Danek Medical, Memphis, Tennessee). Group III patients
      underwent posterolateral autogenous fusion with a rigid pedicle screw/rod
      fixation system (Texas Scottish Rite Hospital [TSRH]-Danek Medical, Memphis,
      Tennessee). All the patients were operated on by the same surgeon, identical bone
      grafting technique was used in all, and all were treated in an identical fashion
      postoperatively. Fusion status was determined from the anteroposterior, oblique,
      and flexion-extension radiographs obtained at 1 year. Clinical results were rated
      as excellent if the patients were pain-free and had returned to work; good if the
      patients had mild backache requiring non-narcotic analgesics and had returned to
      work; fair if continuing back pain prevented a return to work; or poor if the
      pain was worse than that which the patient experienced preoperatively or the
      patient required revision surgery. Nine patients who were originally assigned to
      Group II or Group III were placed in Group I intraoperatively. This change was
      due to the identification of severe osteopenia and the determination that pedicle
      screw purchase was poor. One patient was lost to follow-up. Thus, 51 patients
      were in Group I, 35 in Group II, and 37 in Group III. Follow-up ranged from 9 to
      28 months, averaging 16 months.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367787
TI  - Straight leg raising. Anatomical effects on the spinal nerve root without and
      with fusion.
AB  - Straight leg raising (SLR) is a useful clinical test to demonstrate an
      inflammatory compressive process across a spinal nerve root. Several previous
      studies have attempted to evaluate the effect of SLR on nerve root motion, but
      the exact direction and amount of this motion is still unclear. Components of the
      SLR test that have not been adequately addressed include the effect of SLR on the
      intact dural-nerve root system, motion of the nerve tissues as distinct from the
      dura, and nerve root strain. Separately, spinal fusion is occasionally used as an
      adjunct to discectomy to decrease instability and subsequent "nerve root
      irritation." The effect of a one-level fusion on in situ nerve root biomechanics,
      however, has not been evaluated. Ten fresh human cadavers underwent posterior
      lumbar laminectomies. Spinal nerve root motion was studied while a SLR maneuver
      was performed. Data was recorded photographically and statistically analyzed. The
      results were as follows: 1) SLR induced both linear motion (0.5-5 mm) and strain
      (2-4%) in spinal nerves L4, L5, and S1; 2) The dura moved less than the
      intrathecal nerve root at the pedicle and experienced more strain (P < .05). 3)
      The nerve roots moved laterally toward the pedicle and thus would move into a
      posterolaterally herniated disc. 4) Rigid anterior stabilization did not decrease
      nerve root motion or strain.

PMID- 8367788
TI  - Arterial vascularisation of the extrahepatic biliary tract.
AB  - The aim of this study was to establish a plan of the arterial distribution to the
      main supraduodenal biliary tract in order to draw practical conclusions for
      biliary surgery, especially in bilio-alimentary and bilio-biliary anastomoses and
      liver transplantation. It was based on a study of 60 fresh subjects and was
      carried out using four different methods: dissection after injection of colored
      latex into the superior mesenteric a. (10 subjects), radiography and dissection
      after injection of Micropaque into the celiac trunk (10), dissection after
      injection of Indian ink into the common hepatic a. (10) and radiography and
      dissection after selective injection of the right hepatic a. or the
      gastroduodenal a. (30). Analysis of the results leads to definition of three
      types of vascularisation and two territories, superior and inferior, overlapping
      at the level of the mouth of the cystic duct. The practical implications for
      biliary surgery and liver transplantation are discussed.

PMID- 8367789
TI  - The relationship between Meckel's cartilage and the development of the human
      fetal mandible.
AB  - This work studied the development of the ventral part of Meckel's cartilage and
      its relationship to the morphogenesis of the mandible in a series of human
      fetuses. The development of the cartilage was followed up to the end of the
      embryonic period (stage 23, 8th week) when the primary ossification centre, which
      was formed from a condensation of embryonic mesenchyme, had become two bony
      plates forming a trough in which lay the neurovascular bundle. From this trough
      invagination of the bony plate formed the dental crypt. The primary ossification
      centre disappeared around the sixth month of fetal life.

PMID- 8367790
TI  - Evaluation by angiography of the lateral dominance of the drainage of the dural
      venous sinuses.
AB  - Venous drainage dominance of the dural venous sinuses may be defined as the
      drainage only or mainly into one of the transverse sinuses, as shown by bilateral
      carotid angiography. The aim of this study was to evaluate the venous drainage
      dominance in bilateral carotid angiograms of 189 cases retrospectively. Among
      these cases 41.3% showed drainage mainly to the right side, 37.6% showed equal
      drainage to each side, 18.5% showed drainage mainly to the left side, 2.1% showed
      drainage only to the right side and 0.53% showed drainage only to the left side.
      Cerebral venous drainage dominance is of great importance and should be
      considered before operations on patients for radical neck dissection, removal of
      tumors in the neck that invade the internal jugular vein or tumors of the glomus
      jugulare which may require ligation of the internal jugular vein.

PMID- 8367791
TI  - Epiphysial ossification centres in iliosacral joints: anatomy and computed
      tomography.
AB  - Bilateral apparently bony structures of different forms and sizes located in the
      inferior and superior ventral parts of the sacroiliac joints were observed on
      axial CT images of the pelvic region of juvenile patients. No other pathological
      changes were noted in the sacroiliac joints of these individuals. In one patient
      the bony structures could also be seen on a conventional plain radiograph. We
      also examined 3 juvenile autopsy specimens of this joint using radiology, CT,
      macroscopical evaluation and histology. In two of them, structures could be
      detected on the CT scans which were similar to those observed in the young
      patients. Macroscopic investigations revealed the structures to be secondary
      ossification centres located in the articular cartilage of the lateral part of
      the os sacrum at the levels of the first and third sacral segments. According to
      older anatomical literature, these epiphysial ossification centres contribute to
      the auricular surface of the lateral part of the os sacrum and the free lateral
      surface of the inferior sacral parts. They can be observed between the ages of 12
      and 25 years and begin to synostose with the lateral part around the age of 18
      years. In macerated juvenile specimens of the bony pelvis, free ossicles were not
      detectable in the region of the sacroiliac joints. Histological peculiarities of
      the ossification process observed are discussed. These physiologically occurring
      ossification centres are to be differentiated from pathological alterations
      appearing as bony or bone-like structures on CT scans.

PMID- 8367792
TI  - Sonographic quantitative analysis of the heart in the third trimester of
      gestation.
AB  - The fetal heart was studied with transabdominal sonography in 40 single normal
      pregnancies to analyze the increase of cardiac length and width (major
      longitudinal and transverse diameters of the heart) during the third trimester.
      Relationships between the cardiac data and fetal age, femur length and biparietal
      diameter (BPD) were explored by allometry and linear regression analysis. The
      length and width of the heart could be measured reproducibly in the 4-chamber
      view of the heart. This study verified that the heart grows very rapidly during
      the third trimester (positive allometry). The linear increase of the fetal heart
      shows a strong and significant correlation with the increase of both femur length
      and BPD. This suggests that non invasive analysis of cardiac data can be useful
      for prenatal detection of congenital heart disease or for the assessment of
      gestational age.

PMID- 8367794
TI  - Left superior vena cava continuing to the accessory hemiazygos without
      anastomosis with the coronary sinus.
AB  - A case of double superior vena cava lacking the left brachiocephalic vein was
      found. The left superior vena cava directly continued to the accessory hemiazygos
      vein without anastomosis with the coronary sinus. Therefore, the blood from the
      left superior vena cava drained into the right superior vena cava via the
      transverse anastomosis between the left and right azygos lines. It was thought
      that embryologically 1) the inter-precardinal vein was not formed, and 2) the
      left precardinal vein did not continue to the common cardinal vein, rather it
      drained into the left azygos line. This case may represent one of the most basic
      arrangements of the superior caval system.

PMID- 8367793
TI  - Static morphometric bases for CT identification and evaluation of the outflow
      chamber of the left ventricle. Preliminary study in formalin-fixed heart.
AB  - A static morphometric study of the outflow chamber of the left ventricle (OCLV)
      was investigated in a series of 10 formalin-fixed hearts. A spatial
      reconstruction of the shape and the volume of the OCLV was carried out by means
      of a Somaton Plus TR4 Tomodensitometer (Siemens). The technic allows evaluation
      of the surface of the aortic and the mitral orifices and visualization of the
      three-dimensional OCLV and LV morphology, as well as calculation of their
      volumes. The limits of the technic in the dynamic study of the OCLV are
      presented.

PMID- 8367795
TI  - One further case of unusual origin of three hepatic arteries.
AB  - This article describes a triple vascularization of the liver which is not a
      common vascular anomaly. Dealing with this particular kind of vascularization, we
      note the following: a main hepatic a. which enters in the right lobe of the liver
      and two accessory arteries, the right hepatic a. (a branch of the superior
      mesenteric a.) and left hepatic a. (from the left gastric a.). In the same way,
      the cystic a. has an unusual origin: the right accessory hepatic artery. The
      whole hepatic pedicle was dissected, and its branches were described, indicating
      their relations, length and diameter.

PMID- 8367796
TI  - The iceman.

PMID- 8367797
TI  - Anterolateral thoracic fascia: an anatomic and surgical entity.
AB  - This anatomic study, based on six subjects, is aimed at a better description of
      the anterolateral thoracic fascia, not previously studied in its entirety. The
      literature describes a fascia of the pectoralis major m. continuous with that of
      the serratus anterior m., starting at the lateral border of the pectoralis major
      or pre-pectoral. The upper limits have never been studied and the lower limits
      are ill-defined, the aponeurosis of the pectoralis major or the pre-pectoral
      fascia being continuous with that of the rectus abdominis m. It is shown that
      this fascia, from a retropectoral origin, extends to the base of the axilla above
      and is stretched as bridge between the pectoralis major and latissimus dorsi mm.
      and the muscles of the anterolateral wall of the abdomen. This fascia has some
      surgical importance as a plane of coverage in the protection of mammary implants.
      The lack of concordance with classical anatomic accounts, the histology and the
      vascularisation of this fascia call for complementary studies.

PMID- 8367798
TI  - A study of the orientation of the fibers of the flexor carpi radialis tendon:
      anatomy and clinical applications.
AB  - The authors report a series of 41 dissections of the forearm intended to study
      the orientation of the fibers of the flexor carpi radialis (FCR). This shows that
      there is a constant torsion of the fibers of the FCR by an average of 180
      degrees. Half of this torsion occurs in the forearm and half in the sheath of the
      FCR at wrist level. Awareness of this torsion is particularly useful surgically
      when the tendon is employed in ligamentoplasty, particularly after trapeziectomy.
      Our study of the orientation of the fibers was aimed at the ability to perform
      subcutaneous splitting of the fibers for use of part of the tendon.

PMID- 8367799
TI  - Segmentary analysis of the coronary artery distribution in the left ventricle.
AB  - In a series of 90 human hearts, from individuals aged between 4 days and 94 years
      (X = 61.09 +/- 21.96) the coronary arterial distribution of the left ventricle
      (LV) was studied using Selvester's system of segmentation[24]. Postmortem
      angiographies and microdissection techniques were used. The analysis of the 12
      segments of the LV showed that the three septal segments (basal, mesial and
      apical) present a type of irrigation which is practically constant and of a dual
      type. The superoapical, posterobasal and posteromesial segments present an
      irrigation with a high index of exclusivity for the anterior interventricular and
      circumflex arteries. In the rest of the segments the vascularization is of a
      mixed type, although the apical segments reach an important degree of arterial
      exclusivity. The analysis by segments of the LV allows us to conclude that the
      arterial vascularization of the left ventricle depends fundamentally on the
      anterior interventricular artery and the left circumflex artery, which are those
      that present the greatest extension, together with a small contribution by the
      right coronary artery, which is always minor with respect to the left coronary
      artery.

PMID- 8367801
TI  - Acute mesenteric ischemia.
AB  - Acute mesenteric ischemia resulting from specific etiologies is a treatable
      vascular emergency. It requires a high index of suspicion and prompt, aggressive
      resuscitation and diagnostic maneuvers to determine the specific underlying
      cause. This will allow specific directed surgical revascularization, optimization
      of cardiac performance, or correction of a hypercoagulable state, all directed at
      maximizing the amount of functional bowel that is salvageable. These strategies
      are the cornerstones for a successful outcome in this life-threatening vascular
      catastrophe.

PMID- 8367800
TI  - Anatomical observations of spurs of the tuber ischiadicum.
AB  - In a study of 101 human pelves, 8 pelves (only males) were found with
      ossification in the area of the ligamentum sacrotuberale. Seven of these showed a
      characteristic and similar morphology and could be considered to be periosteal
      exostoses. The term "spur of the tuber ischiadicum" is proposed for this
      manifestation. There was a single case of metaplastic ossification, possibly of
      traumatic origin. Hence, not all ossifications in the area of the ligamentum
      sacrotuberale can summarily be classified as a spur of the tuber ischiadicum;
      careful discrimination is essential in every case.

PMID- 8367802
TI  - Medullary carcinoma of the thyroid--therapeutic strategy derived from fifteen
      years of experience.
AB  - BACKGROUND: The purpose of this investigation was to analyze our experience with
      patients treated for medullary carcinoma of the thyroid to identify prognostic
      factors and to develop a stage-related treatment strategy that might improve cure
      rates. METHODS: Between 1970 and 1985 a total of 40 patients with medullary
      thyroid carcinoma were treated (21 women, 19 men; mean age +/- SEM; 40 +/- 3
      years; mean follow-up, 82 +/- 12 months). Initial operation involved total
      thyroidectomy (28 patients), subtotal resection (11 patients), and a lobectomy (1
      patient). The initial lymph node dissection generally consisted of a selective
      removal of enlarged nodes. Unilateral neck dissection was performed in six cases.
      Secondary operation for recurrent disease was necessary in 26 patients. RESULTS:
      At the end of the follow-up period 10 patients were tumor free, 12 patients were
      scheduled for further treatment, six patients suffered from persistent but
      clinically occult disease, and 12 patients had died (mean survival time, 68 +/- 7
      months). The paramount prognostic factor was the absence or presence of lymph
      node involvement at the time of primary operation (p = 0.011). Patients with
      distant metastases died within 2 years of diagnosis. Women, patients younger than
      40 years of age, and those elicited by familial screening programs exhibited
      increased survival times. CONCLUSIONS: Because of the prognostic and therapeutic
      importance we recommend the total thyroidectomy with a complete dissection of the
      central lymph node compartment as primary treatment. Patients with lymph node
      involvement or elevated serum calcitonin levels should subsequently be treated by
      a modified radical neck dissection of the lateral compartments.

PMID- 8367803
TI  - Management of obstructing lesions of the left colon by resection, on-table
      lavage, and primary anastomosis.
AB  - BACKGROUND: The purpose of this study was to assess the feasibility and safety of
      single-stage resection, on-table lavage, and primary anastomosis in patients
      presenting with obstruction of the left colon. METHODS: The outcome of surgery in
      73 consecutive patients presenting with obstruction of the left colon during a 5
      year period was assessed in terms of perioperative complications and long-term
      survival. RESULTS: Sixty-three patients (86%) underwent single-stage restorative
      procedures. In this group there were four clinical anastomotic leaks (6%).
      However, there were no deaths as a result of leakage. There were four deaths (6%)
      but these were not due to anastomotic leakage. Long-term survival rates compared
      favorably, stage for stage, with large published series of elective experience.
      CONCLUSIONS: We believe that resection, on-table lavage, and primary anastomosis
      constitute the operation of choice for most patients with acute obstruction of
      the left colon.

PMID- 8367804
TI  - Ultrasonography in the initial evaluation and follow-up of blunt abdominal
      injury.
AB  - BACKGROUND: Ultrasonography has been routinely performed in the assessment of
      blunt abdominal injury at our department of surgery since 1980. To establish its
      reliability, a retrospective study was carried out on 818 consecutive patients in
      the years 1980 to 1990. METHODS: Seven hundred twenty six patients underwent real
      time ultrasonographic examination of the abdomen. Indication for ultrasonography
      included all cases evaluated for blunt abdominal trauma. Ninety two patients
      before 1985 were excluded. RESULTS: Two hundred seventy (37.2%) patients
      underwent laparotomy, 252 patients (34.7%) because of ultrasonographic diagnosis.
      Celiotomy was nontherapeutic in 28 patients; 26 of these patients had positive
      findings from ultrasonography (false positive, 3.6%). Eighteen patients with
      negative findings from ultrasonography also underwent laparotomy, which was
      nontherapeutic in two patients (false negative, 2.2%). Four hundred fifty six
      patients (62.8%) were managed without operation, relying on initial and follow-up
      ultrasonography, which was negative in 386 (53.2%) and positive in 70 patients
      (9.6%). The accuracy of ultrasonography was 94.2%, with 91.9% sensitivity, 96.0%
      specificity, and 94.9% predictive value. The rate of delayed recognition of
      documented visceral injury was 5.1%, but no false-negative findings from
      ultrasonography were noted among these patients. CONCLUSIONS: Ultrasonography has
      proved to be a thoroughly reliable, cost efficient, and noninvasive modality in
      primary evaluation and follow-up of blunt abdominal trauma.

PMID- 8367805
TI  - Prognosis in esophageal carcinoma with cervical lymph node metastases.
AB  - BACKGROUND: The purpose of this study was to assess cervical lymph node (C-LN)
      metastases and to examine whether the site of the C-LN metastasis impacts on
      survival of the patient with thoracic esophageal cancer. METHODS: Transthoracic
      esophagectomy and three-field dissection (mediastinal, abdominal, and C-LN)
      followed by esophageal reconstruction were performed on 68 patients with squamous
      cell carcinoma of the thoracic esophagus who were seen at our institution from
      1983 to 1990. RESULTS: C-LN metastasis was seen in 20 (29.4%) patients, and the
      survival curve of the 20 patients with positive C-LN metastasis was not
      significantly different from that of the 48 patients without positive C-LN
      metastasis. The survival curve of patients (n = 7) with positive node limited to
      recurrent laryngeal nerve chain node (RLN group) was significantly better than
      that of patients (n = 13) with positive internal jugular nodes including
      supraclavicular nodes (IJN group) (p = 0.010; generalized Wilcoxon). This was
      because there were more patients in the IJN group (84.6%) than in the RLN group
      (28.6%) (p = 0.022) who had five or more positive nodes in the three fields.
      CONCLUSIONS: The results suggest that RLN should not be defined as M1 but as N1
      in thoracic esophageal cancer.

PMID- 8367806
TI  - Factors predicting chronic hepatic encephalopathy after distal splenorenal shunt:
      a multivariate analysis of clinical and hemodynamic variables.
AB  - BACKGROUND: This study was aimed at evaluating several factors that promote
      chronic hepatic encephalopathy by multivariate analysis of data for patients with
      cirrhosis with good or moderate liver function submitted to distal splenorenal
      shunts. METHODS: The study group comprised 131 patients: 55 had alcoholic and 76
      nonalcoholic cirrhosis. Seventy patients were in Child's class A and 61 in class
      B. Cerebral function was assessed by a complete neurologic examination.
      Angiography with venous phase was performed before and within 1 month after the
      shunt operation. In 84 cases the original Warren technique was used and in 20
      cases a Britton's modified procedure was used. Twenty-seven patients had distal
      splenorenal shunts with a splenopancreatic disconnection. Statistical analysis
      was performed by two multivariate analyses based on stepwise selection. RESULTS:
      Thirty-nine patients died during a follow-up period of 51 +/- 32 months. Chronic
      encephalopathy occurred in 18 patients (14%). According to the multivariate
      analysis of the preoperative prognostic factors, only age (p = 0.0001) and
      albumin values (p = 0.0002) were independent predictive risk factors for chronic
      encephalopathy. In the multivariate analysis concerning the hemodynamic
      consequences of the selective shunts, independent risk factors promoting chronic
      encephalopathy were postoperative portal perfusion (p = 0.0001), postshunt portal
      pressure (p = 0.001), and surgical disconnection (p = 0.0064). CONCLUSIONS: Our
      study has shown that chronic encephalopathy after selective shunt surgery is
      promoted by both clinical and hemodynamic factors. A better selection of the
      candidates for shunt surgery and prevention of the development of portal
      malcirculation by accurate surgical disconnection should further decrease the
      risk of chronic encephalopathy.

PMID- 8367807
TI  - Cervical vascular injuries: a trauma center experience.
AB  - BACKGROUND: We analyzed 76 patients with cervical vascular injuries from
      penetrating neck trauma (n = 528) between 1977 and 1990 at a level I trauma
      center to evaluate the role of angiography in diagnosis and management and to
      assess the course and outcome of these patients. METHODS: Patients who were
      hemodynamically unstable underwent immediate surgical exploration. Stable
      patients were subjected to diagnostic investigation. Angiography was routinely
      performed to diagnose vascular injury in zones I and III and zone II if the
      trajectory was in the vicinity of major vessels. Therapeutic embolization was
      performed when possible at angiography; all other vascular injuries were treated
      surgically. RESULTS: Thirteen patients (2.5%) died of penetrating neck trauma, in
      12 of whom hemorrhage was the contributing factor (12/76; 15.8% of patients with
      vascular injury). In nine patients who were hemodynamically stable vascular
      injury was diagnosed by angiography: 5 (6.8%) of 73 in zone I and 3 (5.4%) of 56
      in zone III, four of whom underwent therapeutic embolic occlusion of the injured
      vessel. Injuries to vertebral and subclavian arteries and subclavian and
      innominate veins were often multiple, causing exsanguination and death (6.8% in
      zone I). In three patients with no preoperative neurologic deficit, the internal
      carotid artery was ligated without complication; in all other patients injury to
      the common carotid or internal carotid artery was repaired, in six of them with
      polytetrafluoroethylene grafts. CONCLUSIONS: Selective management of penetrating
      neck trauma should include routine angiography in zones I and III. Injuries to
      the common and internal carotid arteries should be repaired. The internal carotid
      artery may be ligated in the absence of preoperative neurologic deficit. Arterial
      injuries in the neck can be repaired with polytetrafluoroethylene grafts.

PMID- 8367808
TI  - Postoperative gastroparesis and tachygastria--response to electric stimulation
      and erythromycin.
AB  - BACKGROUND: The purpose of this study was to correlate clinical course, gastric
      emptying, and gastric myoelectric activity in a patient after gastric operation
      and to determine the effect of electric stimulation and the administration of
      erythromycin on the patient's gastric rhythm. METHODS: Daily myoelectric
      recordings were obtained through implanted gastric electrodes after truncal
      vagotomy and gastroenterostomy for an obstructing duodenal ulcer. RESULTS: The
      patient had acute postoperative delayed gastric emptying, accompanied initially
      by stomal edema but subsequently associated with persistent tachygastria. The
      gastric rhythm was only transiently slowed by multiple attempts at electroversion
      but appeared to respond dramatically to intravenous erythromycin therapy.
      Although delayed gastric emptying persisted on radionuclide gastric emptying
      studies, the patient slowly improved clinically with continued erythromycin
      therapy. CONCLUSIONS: Disturbances in gastric rhythm may accompany postoperative
      gastroparesis, although in our patient the dysrhythmias appeared to occur
      secondary to gastric outlet obstruction. Although his stomach could be paced,
      pacing was not effective in restoring a normal gastric rhythm. In contrast,
      intravenous erythromycin therapy was associated with rapid restoration of a
      normal gastric rhythm and slow improvement in gastric function.

PMID- 8367809
TI  - The effect of erythromycin on motility of the duodenum, sphincter of Oddi, and
      gallbladder in the prairie dog.
AB  - BACKGROUND: Interdigestive motility of the stomach, duodenum, sphincter of Oddi,
      and gallbladder is mediated through the migrating myoelectric complex and the
      action of motilin. Erythromycin, a motilin agonist, has recently been studied as
      a gastrointestinal and biliary prokinetic agent. We hypothesized that
      erythromycin would increase interdigestive duodenal and sphincter of Oddi
      motility in a dose-dependent manner. METHODS: In 10 anesthetized prairie dogs we
      determined the motility responses of the duodenum, sphincter of Oddi, and
      gallbladder to erythromycin infusion during a three-log dosing regimen and
      correlated activity with serum concentrations of the drug. RESULTS: Erythromycin
      administered at 0.01 and 0.1 mg/kg had no effect on duodenal or sphincter
      motility. At 1.0 and 10 mg/kg, duodenal motility index increased by 451% +/- 114%
      and 1070% +/- 480%, respectively, when compared with baseline values, (p < 0.05).
      Sphincter of Oddi motility index increased by 122% +/- 38% and 323% +/- 99%,
      respectively, at these same doses of erythromycin (p < 0.05). Gallbladder
      pressure did not change significantly during erythromycin infusion. Erythromycin
      serum concentration at 1.0 mg/kg was 1.0 +/- 0.7 micrograms/ml. CONCLUSIONS:
      These data suggest that erythromycin stimulates interdigestive motility of the
      duodenum and sphincter of Oddi in a dose-dependent manner at otherwise
      subtherapeutic concentrations of the drug.

PMID- 8367810
TI  - Safe intraabdominal pressure of carbon dioxide pneumoperitoneum during
      laparoscopic surgery.
AB  - BACKGROUND: The deliberate induction of carbon dioxide pneumoperitoneum during
      laparoscopic surgery could be a possible source of cardiovascular collapse. The
      effects of elevated intraabdominal pressure (IAP) on systemic hemodynamics and
      splanchnic blood flow created by insufflation of carbon dioxide were examined in
      anesthetized dogs. METHODS: Stepwise increases in IAP of 8 (n = 7), 12 (n = 7),
      and 16 (n = 7) mm Hg were applied to determine the threshold pressure that had
      minimum influence on these hemodynamics. Hemodynamic parameters were measured at
      baseline and 1, 2, and 3 hours after the start of insufflation. RESULTS: At an
      IAP of 16 mm Hg, cardiac output was decreased significantly by 1 hour after the
      start of insufflation and became progressively lower during the procedure.
      Systemic vascular resistance was elevated significantly in parallel with the
      change in cardiac output. Although hepatic arterial blood flow was not decreased
      significantly, portal venous and superior mesenteric arterial blood flows were
      diminished significantly at 16 mm Hg, resulting in a decrease in total hepatic
      blood flow. No significant changes were observed in these parameters at 8 or 12
      mm Hg. CONCLUSIONS: Based on these results, an IAP from 8 to 12 mm Hg is
      recommended for laparoscopic surgery, to avoid complications caused by
      hemodynamic derangements.

PMID- 8367811
TI  - Role of contralateral breast biopsy in infiltrating lobular cancer.
AB  - BACKGROUND: Although infiltrating lobular carcinoma (ILC) is known to be
      associated with higher rates of bilaterality, contralateral breast biopsies are
      not routinely performed in such patients. METHODS: The pathology reports of all
      patients with ILC admitted to Memorial Sloan-Kettering Cancer Center between 1970
      and 1980 were retrospectively reviewed. The incidence of contralateral biopsies,
      random and directed, was determined. The findings on contralateral biopsy were
      evaluated with respect to age of the patient, nodal status of the ipsilateral
      cancer, and multicentricity of the primary lesion. RESULTS: Of the 275 patients
      undergoing mastectomy for ILC, 130 (47%) had contralateral biopsies. Twenty-two
      were directed biopsies and 108 were random biopsies. On random biopsy 11 (10%)
      patients were found to have infiltrating carcinomas and seven (6%) were found to
      have intraductal cancer. Multicentric invasive disease in the ipsilateral breast
      was found to be predictive of a positive contralateral biopsy (p = 0.01).
      CONCLUSIONS: Despite the current trend toward less extensive surgery for breast
      cancer, random contralateral breast biopsy is indicated in patients with ILC.

PMID- 8367812
TI  - Edwin Hartley Pratt and orificial surgery: unorthodox surgical practice in
      nineteenth century United States.
AB  - Among the more interesting yet bizarre chapters in the history of nineteenth
      century American medicine was the emergence of "orificial surgery" as a widely
      practiced specialty. This philosophy, the treatment of chronic disease through
      surgical operations on the rectum, vagina, cervix, urethra, nares, and mouth,
      evolved from the personal practice experiences of Edwin Hartley Pratt, a
      homeopathic general practitioner/surgeon. Through his salesmanship skills, Pratt
      was able to establish a field of surgery that maintained its own national
      society, in addition to publishing a widely distributed specialty journal.

PMID- 8367813
TI  - The effect of acute nonbacterial dependent peritonitis on lung and liver oxidant
      stress and antioxidant activity.
AB  - BACKGROUND: The role of oxidant release and tissue antioxidant defenses on
      inflammation-induced organ injury is not clearly defined. METHODS: We determined
      the effect of acute zymosan peritonitis in rats on lung and liver tissue oxidant
      stress and antioxidant defenses during a 5-day period. Oxidant activity was
      measured as tissue malondialdehyde and oxidized glutathione (GSSG). Antioxidant
      activity was measured as tissue-reduced glutathione (GSH) and catalase activity.
      Rats were maintained hydrated with subcutaneous crystalloid. Animals were killed
      at 4, 12, and 24 hours and 5 days. RESULTS: Acute peritonitis was evident at 12
      and 24 hours but was resolving at 5 days. Peritoneal fluid cultures were negative
      after 24 hours. A 50% mortality rate was noted between 20 and 30 hours, with no
      deaths after 30 hours. We noted a significant increase in lung GSSG and
      malondialdehyde at 4 hours that persisted for the 5 days, as did histologic
      evidence of a progressing severe lung inflammation. No increased conversion of
      lung xanthine dehydrogenase to xanthine oxidase was noted. Lung GSH and catalase
      activity were maintained at control despite negligible food intake. In contrast,
      liver GSSG was increased significantly only at the 4-hour period, corresponding
      with a transient conversion of xanthine dehydrogenase to xanthine oxidase from
      10% to 31%. Tissue malondialdehyde did not increase despite the initial oxidant
      stress. However, tissue GSH and catalase values decreased by more than 50% after
      24 hours and remained decreased at 5 days. CONCLUSIONS: We conclude that early
      lung and liver oxidant stress is initiated by acute peritonitis. Lung oxidant
      changes persist and lung dysfunction progresses, even though antioxidant activity
      is maintained and acute peritonitis is resolving. Liver lipid peroxidation did
      not develop despite oxidant release, probably because of a large antioxidant
      reserve. However, a severe and sustained decrease in liver antioxidants results,
      increasing the potential damage from a subsequent oxidant insult.

PMID- 8367814
TI  - Reduction of systemic drug exposure after hepatic arterial infusion of
      doxorubicin with complete hepatic venous isolation and extracorporeal
      chemofiltration.
AB  - BACKGROUND: Hepatic arterial infusion of doxorubicin has produced tumor response
      in hepatic malignancies; however, the limited success of these treatments is
      related in part to dose-limiting systemic toxicities. The purpose of this study
      was to determine whether a novel venous isolation-chemofiltration system could
      limit systemic exposure to doxorubicin after hepatic arterial infusion. METHODS:
      Doxorubicin (1 or 3 mg/kg) was infused in the hepatic arteries of domestic pigs
      after complete hepatic venous isolation was achieved with a dual-balloon vena
      cava catheter. The hepatic vein effluent was pumped through an extracorporeal
      carbon chemofiltration circuit. Doxorubicin levels were measured in prefilter
      (hepatic vein), postfilter, and systemic serum at intervals up to 1 hour after
      drug infusion. RESULTS: Complete hepatic venous isolation with extracorporeal
      chemofiltration significantly reduced (> 90%) the postfilter and systemic levels
      of doxorubicin compared with prefilter levels (p < 0.01). At the time animals
      were killed 7 days after infusion of doxorubicin (3 mg/kg), tissue levels of
      doxorubicin in the liver showed a 16-fold increase compared with levels in the
      heart (p < 0.01). CONCLUSIONS: For chemotherapeutic drugs like doxorubicin with a
      low first-pass extraction by the liver, the novel system described herein
      achieved significant reduction in systemic drug exposure. This system will allow
      dose intensification of doxorubicin administered by hepatic arterial infusion to
      treat hepatic malignancies.

PMID- 8367816
TI  - Thermal injury-induced changes in the rat intestine brush border cytoskeleton.
AB  - BACKGROUND: The brush border cytoskeleton maintains the selective absorptive
      surface of the intestine epithelium. Increased intestinal permeability caused by
      cutaneous thermal injury may be the result of changes in the organization of the
      brush border cytoskeleton. METHODS: In this study we used electron and laser
      confocal microscopy to examine the temporal and spatial organization of the rat
      brush border cytoskeleton after thermal injury. RESULTS: Vesiculation of
      microvilli and disruption of core actin filament bundles were observed in rats
      with burns covering 20% total body surface area (TBSA). In rats with 40% TBSA
      burns changes in the brush border cytoskeleton were more pronounced, resulting in
      increased vesiculation of microvilli and disruption of terminal web actin
      filaments. Confocal microscopy of corresponding areas of the gut epithelium after
      staining with rhodamine-phalloidin showed rearrangement of brush border actin
      filaments. Although tight junctions were intact, the apical region of the gut
      epithelium in rats with 40% TBSA burns was constricted, possibly because of
      contraction of brush border actin filaments. Changes in brush border structure
      and cytoskeletal organization were most pronounced in the ileum of rats 18 hours
      after injury. CONCLUSIONS: These findings suggest that disruption of the brush
      border cytoskeleton may, in part, be responsible for the loss of intestinal
      barrier function after thermal injury in animal models.

PMID- 8367815
TI  - Effect of a thromboxane synthetase inhibitor on protamine-induced circulatory
      changes in sheep.
AB  - BACKGROUND: Rapid intravenous administration of protamine after procedures
      requiring cardiopulmonary bypass is occasionally associated with severe pulmonary
      hypertension, systemic hypotension, cardiac dysfunction, and lung edema. We
      hypothesized that the mechanism for these hemodynamic changes after protamine
      administration is the release of thromboxane. We therefore examined the effect of
      a thromboxane synthetase inhibitor (OKY-046) on these hemodynamic changes in a
      sheep model. METHODS: Ten female sheep were prepared with lung lymph fistulas and
      balloon-tipped pulmonary artery, left atrial, arterial, and venous catheters.
      After a 5-day recovery period, 2 mg/kg protamine was infused 10 minutes after 200
      units/kg heparin, with (n = 5; OKY-046 group) and without (n = 5;
      heparin/protamine group) OKY-046 (10 mg/kg). RESULTS: In the heparin/protamine
      group, pulmonary arterial pressure and lung lymphatic flow were significantly
      increased soon after administration of protamine, from 19 +/- 1 to 51 +/- 2 mm Hg
      and 5 +/- 1 to 8 +/- 1 ml/hr, respectively. The circulating leukocyte count was
      significantly reduced, from 3304 +/- 318 to 903 +/- 898 mm3. Cardiac output was
      also reduced, from 5.8 +/- 0.3 to 3.4 +/- 0.7 L/min/m2. These changes were
      completely blocked in the OKY-046 group, except for the neutrophil depletion and
      the increase in lung lymphatic flow. CONCLUSIONS: We conclude that thromboxane
      plays a significant role in protamine-induced hemodynamic deterioration and
      pulmonary permeability changes.

PMID- 8367817
TI  - Thrombosis of the descending thoracic aorta: a case report.
AB  - A 76-year-old woman with primary polycythemia vera had emboli to both superficial
      femoral arteries and to a branch of the superior mesenteric artery. Polycythemia
      vera is a neoplastic disease of bone marrow stem cells in which increased red
      cell production leads to hyperviscosity manifested by propensity to
      thromboembolic phenomena. These problems usually occur in smaller vessels,
      sparing large vessels that have high blood flow. The patient underwent an
      extensive investigation to determine the source of the emboli. Abdominal aortic
      angiograms and cardiac echogram failed to reveal the source. An esophageal
      echogram showed free-floating thrombus in the descending thoracic aorta, which
      was confirmed by magnetic resonance imaging. A thoracic aortic thrombectomy was
      performed. Embolic phenomena ceased and postoperative esophageal echogram
      confirmed a clear thoracic aorta. Although extremely rare in the descending
      thoracic aorta, thrombus formation may occur in association with polycythemia
      vera and should be sought when usual investigations fail to reveal the source.

PMID- 8367818
TI  - Popliteal venous aneurysms.
AB  - Popliteal venous aneurysms are rarely reported but represent a potentially life
      threatening condition requiring accurate diagnosis and surgical resection. Newer
      techniques including magnetic resonance imaging, computed tomography, and color
      flow duplex imaging offer new noninvasive methods to define popliteal fossa
      venous abnormalities. Excision of the aneurysm with venous reconstruction removes
      the embolic source and maintains prograde venous flow. A posterior surgical
      approach to the popliteal fossa is recommended to facilitate exposure. Early
      control of venous outflow is needed to avoid thromboembolism. This report
      describes the diagnosis and treatment of popliteal venous aneurysms in three
      patients with a review of the English-language literature.

PMID- 8367819
TI  - Liver infarct after sigmoid resection: an unusual case of mesenteric ischemia.
AB  - Hepatic infarction is an unusual event. A patient is described who had a hepatic
      infarct after a sigmoid resection. She was found to have occluded superior
      mesenteric and celiac arteries, with visceral circulation dependent on the
      inferior mesenteric artery. Disruption of the collateral circulation was presumed
      to have caused the subsequent liver infarct. A review of the pathophysiology of
      liver infarction is presented with particular reference to the relation of
      arterial occlusion to infarction.

PMID- 8367820
TI  - Laparoscopic splenectomy in the management of immune thrombocytopenia purpura.
AB  - The role of splenectomy in the management of immune thrombocytopenia purpura is
      well known. Recent improvements in laparoscopic technology have significantly
      expanded the variety of general surgical procedures amenable to a minimally
      invasive approach. An initial experience of four cases of immune thrombocytopenic
      purpura managed by laparoscopic splenectomy is presented. The entire procedure
      was completed under laparoscopic guidance in three of four cases, and a
      counterincision was required to control bleeding in one patient. The procedure is
      performed with five operating ports including a camera port, two retraction
      ports, and two dissection ports. Dissection begins at the lower pole of the
      spleen and progresses cephalad to the hilum where major vessels are individually
      ligated and divided. The short gastric vessels are divided with a linear
      laparoscopic stapler. The lateral peritoneal attachments are divided, and the
      spleen is removed intact through a 6 cm fascial incision at the umbilicus.
      Laparoscopic splenectomy appears to be a safe and efficacious procedure that is
      useful in the management of certain hematologic diseases and may ultimately be
      performed for a variety of pathologic conditions involving the spleen.

PMID- 8367821
TI  - Peripheral arterial thrombosis in the nephrotic syndrome.
AB  - Peripheral arterial thrombosis is a rare complication of nephrotic syndrome that
      occurs in conjunction with a hypercoagulable state and results in a high rate of
      limb loss and death. We report a case of brachial artery thrombosis in a
      pediatric patient with nephrotic syndrome, antithrombin III deficiency, and
      antecedent vessel trauma. An extensive review of the literature is presented. We
      conclude that management of arterial thrombosis requires aggressive replenishment
      of antithrombin III and adequate heparinization in addition to the traditional
      surgical management. Moreover, arterial puncture should be avoided because of the
      high risk of thrombosis in these patients.

PMID- 8367822
TI  - Intravascular ultrasonography for the diagnosis of traumatic aortic disruption: a
      case report.
AB  - Thoracic aortic disruptions after blunt trauma are highly lethal injuries.
      Diagnosis of these injuries has traditionally been based on clinical suspicion,
      chest radiographs, and aortography. The roles of dynamic computed tomography and
      transesophageal echocardiography are currently under investigation. Intravascular
      ultrasonography is a new technology with potential as a diagnostic adjunct in the
      evaluation of these injuries. We present a case of traumatic aortic disruption
      identified by intravascular ultrasonography after nondiagnostic aortography and
      dynamic computed tomography studies.

PMID- 8367823
TI  - Reflections on laparoscopic surgery.

PMID- 8367824
TI  - Studying experimental fetal cardiopathies.

PMID- 8367825
TI  - Interviewer bias and maternal bias.

PMID- 8367826
TI  - Clinical teratology counseling and consultation case report: low dose
      methotrexate exposure in the early weeks of pregnancy.

PMID- 8367827
TI  - Effects of 5-fluorouracil on embryonic rat palate in vitro: fusion in the absence
      of proliferation.
AB  - 5-Fluorouracil (5-FU) inhibits the enzyme thymidylate synthetase (TS) which
      results in inhibition of DNA synthesis. 5-FU is teratogenic in many species,
      inducing cleft palate, limb, and tail defects. In the present study, gestation
      day (GD) 14 embryonic rat craniofacial explants were exposed to 5-FU in organ
      culture with increasing concentrations and durations of exposure. Palates exposed
      to 5-FU were morphologically abnormal and craniofacial shape, size, and palatal
      fusion pattern were affected with the severity of effects dependent on
      concentration and duration of exposure. Cleft palate was induced in vitro as
      opposing palates overlapped in a narrowed oral cavity. Palates exposed to higher
      levels of 5-FU were growth inhibited, but fused even though proliferation ceased
      and few cells were available to participate in elevation and fusion. This was
      demonstrated as a biphasic concentration-response profile for palatal fusion in
      which 0.05 to 0.15 micrograms 5-FU/ml produced decreasing rates of palatal
      fusion, while exposure to 0.15 to 3.0 micrograms/ml resulted in progressively
      increasing rates of fusion. The effects of 5-FU were detected biochemically as a
      reduction in TS activity which was concentration and time dependent during the
      first 12 hours, with a return to control levels by 24 hours. During the first
      day, 5-FU did not alter protein levels, but DNA levels significantly decreased at
      the high concentration, 2.0 micrograms/ml. After 5 days in culture, both DNA and
      protein decreased with increasing 5-FU concentration and duration of exposure.
      Also by the end of the culture period, 3H-TdR incorporation had decreased in a
      concentration dependent manner. It is concluded that progressive inhibition of
      proliferation and growth in organ culture results in two different morphological
      outcomes: cleft palate resulting from a narrowed oral cavity and increased
      incidence of anterior palatal fusion under conditions of strong growth reduction.
      This study demonstrates that elevation and fusion can occur in the absence of
      growth and proliferation. Based on these observations, severe inhibition of
      growth or proliferation would not necessarily be sufficient to induce cleft
      palate.

PMID- 8367828
TI  - Effects of retinoic acid on cartilage differentiation in a chondrogenic cell
      line.
AB  - Previously we have isolated the monopotential chondrogenic cell line RCJ 3.1
      C5.18 from the multipotential mesenchymal cell line RCJ 3.1 [Grigoriadis et al.:
      Endocrinology, 125:2103-2110, 1989]. When cultured for approximately 20 days
      under appropriate conditions, these cells from cartilage nodules. In the present
      investigation, we have used this cell line to study the effects of all-trans
      retinoic acid (RA) on chondroblast differentiation, cartilage formation, and
      cartilage degradation. Continuous exposure of cultures to RA (0.01-100 nM)
      inhibited chondroblast differentiation and glycosaminoglycan (GAG) accumulation
      in a dose-dependent manner, without comparable effects on cell growth. Pulse
      treatment with RA for various 4 day periods during a 17-24 day culture period
      established that RA inhibited differentiation of chondroprogenitors at all
      periods tested. These effects were reversible, except for part of the effect on
      early chondroprogenitors. Treatment with RA on days 13-17 in 17 day cultures not
      only resulted in cessation of cartilage formation, but also in disappearance of
      pre-existing cartilage nodules. We demonstrated that this was associated with RA
      induced downregulation of GAG synthesis and increased degradation of cartilage
      proteoglycans. Hence, the inhibitory effects of RA on cartilage formation consist
      of inhibition of chondroblast differentiation, inhibition of GAG synthesis by
      differentiated chondroblasts, and stimulation of cartilage proteoglycan
      degradation by differentiated chondroblasts and/or chondrocytes. These results
      indicate that the clonal monopotential chondrogenic cell line RCJ 3.1 C5.18 forms
      a good model system to study the effects of retinoids on cartilage
      differentiation, formation, and degradation.

PMID- 8367829
TI  - Risk factors for coarctation of the aorta.
AB  - To test the hypothesis that environmental factors during early pregnancy may
      cause coarctation of the aorta (CoA), 50 cases of CoA and 756 controls were
      studied. The cases represented all verified CoAs in Finland during 1982-1983 and
      controls were randomly selected from all babies born during the same period. Both
      case and control mothers were interviewed by midwives approximately 3 months
      after delivery. In these data 18 patients had pure CoA only and the remaining 32
      at least one other cardiac anomaly. Three CoA patients had a chromosomal anomaly.
      The relatives of CoA babies had more congenital anomalies than those of the
      control babies. Maternal overall exposure to chemicals at work was slightly more
      prevalent among the CoA group (32.0%) than the control group (26.2%). Maternal
      exposure to mineral oil products at work during early pregnancy was more common
      among CoA cases (8.0%) than controls (1.4%) [odds ratio (OR) = 5.9, 95%
      confidence interval (CI95) = 1.8-19.2]. The risk of CoA was also associated with
      previous miscarriages (OR = 2.3, CI95 = 1.2-4.4) and twin birth (OR = 16.3, CI95
      = 4.0-67) of the child. The risk of CoA was not associated with seasonal
      variation, maternal smoking, alcohol consumption, or use of deodorants. It is
      concluded that genetic factors explain only a small fraction of the causes of CoA
      and that many common environmental exposures during early pregnancy are unlikely
      to be real risk factors for CoA. However, the power of this study was weak for
      testing the teratogenicity of specific chemicals.

PMID- 8367830
TI  - Serotonin and cardiac morphogenesis in the mouse embryo.
AB  - The possible involvement of the neurotransmitter serotonin (5-HT) and its binding
      protein (SBP) in cardiac morphogenesis was studied using mouse whole embryo
      culture (together with immunocytochemistry or 3H-thymidine autoradiography) and a
      cell migration assay. Embryos were cultured before and during the period of
      endocardial cushion formation, embryonic (E) days 9-12, in the presence of 5-HT,
      the monoamine oxidase (MAO) inhibitor nialamide, or an uptake inhibitor
      (fluoxetine or sertraline). For the migration assay, cells from the outflow
      tracts of E12 embryos were dissociated and placed in a chemotaxis chamber
      together with different concentrations of 5-HT. E9 embryos cultured in the
      presence of 10 microM 5-HT and nialamide exhibited intense 5-HT immunoreactivity
      (5-HT IR) throughout the myocardium. This staining was greatly diminished by
      fluoxetine, sertraline, or the absence of nialamide. As morphogenesis proceeded,
      myocardial staining in embryos exposed to 5-HT became restricted to developing
      endocardial cushion forming regions and was more completely blocked by uptake
      inhibitors. No evidence for 5-HT synthesis by myocardium was found at any age
      studied using the precursor L-tryptophan. SBP was present in endocardial cushions
      in cultured and uncultured embryos. 3H-thymidine autoradiography demonstrated
      that both fluoxetine and sertraline inhibited proliferation of cardiac
      mesenchyme, endocardium, and myocardium. These effects were most pronounced when
      exposure began at E9 (prior to cushion formation). Dose-dependent effects of 5-HT
      on migration of outflow tract cells were also observed. Taken together, these
      results suggest that 5-HT may play a role in cardiac morphogenesis during
      endocardial cushion formation.

PMID- 8367831
TI  - Microsurgical study on the mechanisms determining sidedness of axial rotation in
      rat embryos.
AB  - Sidedness of left/right asymmetric body structures is strongly biased in most
      animals by mechanisms that are not well understood. In rat embryos, axial
      rotation starts at the 9-10 somite stage and is almost completed at the 17-18
      somite stage. As a result, the ventrally flexed tail (caudal part of the body)
      and chorioallantoic placenta on the yolk sac take up their position normally on
      the right side of the embryo. Because the tail and chorion become connected via
      the allantois around the time when axial rotation takes place, we hypothesized
      that the allantois and possibly its connection to the chorion is important in
      determining sidedness of the tail. In the present study, we tested this
      hypothesis by surgically removing either the allantois or chorion before axial
      rotation started. Embryos were explanted at 8 AM on Day 9 of gestation (presomite
      stage), and either the allantois or chorion was removed using microforceps.
      Embryos were then cultured in rotating bottles, and sidedness of the tail,
      chorioallantoic placenta, and bulboventricular loop (heart) was determined after
      50 hours (approximately 25-26 somite stage). Removal of the allantois (n = 55)
      resulted in absence of the umbilical cord and a 49.1% incidence of inverted tail;
      a chorioallantoic placenta-like structure developed on the yolk sac in the normal
      position.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367832
TI  - Expression of the IV (reversed and/or heterotaxic) phenotype in SWV mice.
AB  - Approximately 50% of iv/iv mice have situs inversus (mirror image reversal of
      viscera) and 40% have heterotaxia (anomalous arrangement of viscera). The
      occurrence of heterotaxia is independent of situs. Using the cross-intercross
      breeding system to put the iv gene on the SWV background, an occasional presumed
      iv/+ mouse was found that had an IV (situs inversus and/or heterotaxic)
      phenotype. Testcrosses of these reversed animals indicated an iv/+ genotype.
      Since iv is linked tightly to Igh-C on chromosome 12, we inferred the genotype
      with a polymorphism of Igh-C demonstrated using the polymerase chain reaction
      (PCR). This confirmed them to be iv/+. The expression of the IV phenotype in
      animals heterozygous for the iv gene may be due to an interaction of iv with an
      autosomal recessive gene found in SWV. We have not found the IV phenotype in
      heterozygous iv/+ mice following placement of the iv gene on six other inbred
      strains. Rarely, we also found that presumed SWV +/+ mice had the IV phenotype.
      Test matings of these phenodeviants, corroborated by PCR, have confirmed them to
      be +/+. Although the phenotypes of the affected SWV +/+ and iv/+ mice resembled
      those found in iv/iv mice, the occurrence of situs inversus and heterotaxia were
      not independent of each other, and most of the SWV mice with the IV phenotype had
      heterotaxia with situs solitus. This infrequent dominant expression of the iv
      gene has so far only been seen when iv is on the SWV background. These findings
      are consistent with the idea that this phenomenon is due to the interaction of
      the iv gene with another gene found so far only in the SWV strain.

PMID- 8367833
TI  - Penetrance and expressivity of acetazolamide-ectrodactyly provide a method to
      define a right-left teratogenic gradient that differs between the C57BL/6J and
      WB/ReJ mouse strains.
AB  - Penetrance or the frequency of embryos with any degree of forelimb ectrodactyly
      is the usual method to describe the forelimb ectrodactyly response of mouse
      embryos to acetazolamide. A digit score for number of small or absent digits for
      the separate right and left forelimb response to acetazolamide provides a measure
      of expressivity or the severity of response. We examine the relationship between
      expressivity and penetrance using right and left forelimb data from a previously
      reported dose-response analysis of the C57BL/6J and WB/ReJ strains to
      acetazolamide. The data show that expressivity and penetrance are highly
      correlated for the separate right and left forelimbs for both strains. In
      C57BL/6J, the dose-response analyses of both expressivity and penetrance of the
      separate right and left forelimbs demonstrate a teratogenic gradient, decreasing
      from right to left, that depends on the symmetrical ectrodactyly response of the
      right and left forelimbs. In WB/ReJ, the right forelimb is also more sensitive
      than the left, but the dose-response analyses of both penetrance and expressivity
      show the two forelimbs are asymmetrical in their ectrodactyly response and that
      there is not a simple teratogenic gradient in this strain. In WB/ReJ, the left
      forelimb is resistant at even the highest non-lethal doses. The high correlation
      between expressivity and penetrance for the separate forelimbs of both C57BL/6J
      and WB/ReJ suggests that this right-left difference between the two strains may
      not be a property of the limbs themselves but may be an intrinsic genetic
      difference between the two types of embryos perhaps in the amount of teratogen to
      which the embryos are exposed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367834
TI  - Characterization of adhesion of "resting" and stimulated platelets to fibrinogen
      and its fragments.
AB  - Adhesion of resting and stimulated platelets to immobilized fibrinogen (Fg) was
      characterized using various forms of Fg, receptor peptide mimics, and antibodies
      to glycoprotein (GP) IIb/IIIa and Fg. Resting platelets adhered to Fg, but to
      less than half the extent of the same platelets stimulated with epinephrine/ADP.
      The adhesion of resting and stimulated platelets to Fg was inhibited by a
      receptor peptide mimic (G13, a peptide corresponding to residues 300-312 of
      GPIIb), anti-GPIIb/IIIa antibodies, and a monoclonal antibody (4A5) against the
      carboxyl terminus of the gamma chain of Fg. The results presented here
      demonstrate that the alpha chain RGD platelet recognition sites are not required
      to mediate the adhesion of either stimulated or resting platelets to immobilized
      Fg. Although stimulated platelets can adhere extensively to monomeric Fg
      containing one functional gamma chain, resting platelets require bivalent Fg
      containing two functional gamma chains to mediate irreversible adhesion to Fg.

PMID- 8367835
TI  - Recombinant plasminogen activator inhibitor-1 protects platelets against the
      inhibitory effects of plasmin.
AB  - Plasmin-induced degradation of platelet glycoprotein Ib (GPIb), the von
      Willebrand factor (vWF) receptor, has been implicated as a mechanism contributing
      to the development of platelet dysfunction following cardiopulmonary bypass
      (CPB). The goal of this study was to assess whether biologically active
      recombinant plasminogen activator inhibitor-1 (rPAI-1), could antagonize the
      inhibitory effects of plasmin on GPIb. GPIb function, as evaluated by measuring
      vWF-dependent, ristocetin-induced platelet agglutination in human platelet rich
      plasma (PRP) was significantly impaired following incubation with plasmin (60 +/-
      14% inhibition, p < 0.01). Inclusion of rPAI-1 (10 micrograms/ml) in the PRP
      antagonized this plasmin effect, restoring agglutination to 92 +/- 8% of the
      control value (p < 0.01). The effect of rPAI-1 on the enzymatic activity of
      plasmin was further evaluated in an amidolytic assay with the plasmin substrate
      S2251 where an apparent second order rate constant of plasmin inhibition by rPAI
      1 of 9.4 x 10(4) M-1 S-1 was determined. Our results suggest that rPAI-1, by
      inhibiting both tissue plasminogen activator-induced plasmin generation and
      plasmin activity directly, may have clinical value for improving platelet
      function during and after CPB.

PMID- 8367836
TI  - Superiority of plasma 11-dehydro-TXB2 to TXB2 as an index of in vivo TX formation
      in rabbits after dosing of CS-518, a TX synthase inhibitor.
AB  - We compared plasma 11-dhTXB2 and TXB2 for their ability to reflect in vivo TX
      formation in rabbits treated with AA and CS-518, a TX synthase inhibitor. The
      average plasma level of TXB2 in rabbits was much higher than that of 11-dhTXB2,
      probably because of artificial formation of TXB2 during blood sampling. CS-518 (1
      mg/kg, p.o.) caused a long-lasting suppression of the 11-dhTXB2 level, and its
      inhibitory effect on 11-dhTXB2 was much more extensive than that on TXB2. AA
      infusion for 5 min resulted in transient and remarkable increases of both TXs,
      and prevention of such increases by CS-518 pretreatment (1 mg/kg, i.v.) was
      shown: inhibitions of 11-dhTXB2 and TXB2 were 85% and 40%, respectively. The
      inhibitory effect caused by CS-518, which was more clearly observed on plasma 11
      dhTXB2 than on TXB2, was due to not only the completely inhibited levels without
      artificial formation but also the durable high levels based on the long half-life
      of 11-dhTXB2 in AA-infused rabbits. CS-518 injection during sustained AA-infusion
      also resulted in a 2-fold faster disappearance of plasma 11-dhTXB2 than was seen
      without CS-518, despite its long half-life. Considering the absence of artificial
      formation, the long half-life, and the good response to change of TX formation,
      plasma 11-dhTXB2 is superior to TXB2 as an index for monitoring in vivo TX
      synthase activity and its pharmacological modification with AA and CS-518.

PMID- 8367837
TI  - M(r) 6,400 aurin tricarboxylic acid directly activates platelets.
AB  - ATA is a novel anticoagulant polymeric anionic aromatic compound that inhibits
      von Willebrand factor binding to platelet glycoprotein Ib and thereby prevents
      ristocetin- and shear stress-induced platelet aggregation. To investigate its
      mechanism of action, ATA fractions of homogeneous M(r) have been prepared by size
      exclusion chromatography. ATA fractions of M(r) > or = 2,500 are most effective
      at inhibiting vWF-mediated platelet aggregation, and ATA of M(r) = 2,500 also
      inhibits thrombin-induced platelet activation. Paradoxical results were observed
      in studies of ATA with M(r) = 6,400. This fraction of ATA stimulates aggregation
      of washed platelets or platelet-rich-plasma. The dose/response of aggregation
      shows a bell-shaped curve with maximal aggregation at approximately 2
      micrograms/ml. Platelet aggregation is associated with phosphoinositide turnover
      and protein kinase C- and calcium-dependent protein phosphorylation. Platelet
      signalling responses to ATA are inhibited by platelet pretreatment with PGI2 or
      dibutyryl-cyclic AMP, but are unaffected by inhibiting platelet cyclooxygenase
      with aspirin. These results suggest that M(r) 6,400 ATA directly activates
      platelet phospholipase C to initiate platelet aggregation. This effect, unique to
      M(r) 6,400 ATA, could potentially mitigate ATA's beneficial anti-thrombotic
      effect on vWF-mediated platelet responses, and should be considered when
      analyzing results of experiments that utilize unfractionated ATA.

PMID- 8367838
TI  - Effect of different sample preparation methods on the results of the impedance
      technique in the study of platelet hyper- and hypo-function in whole blood.

PMID- 8367839
TI  - Supplementation-induced changes in polyunsaturated fatty acid membrane and plasma
      composition do not modify mononuclear cell procoagulant activity.

PMID- 8367840
TI  - [Pasteurella anatipestifer: a controllable farm problem].
AB  - The performance of 13 flocks of ducks on a duck farm decreased markedly. Post
      mortem and bacteriological examinations indicated that Pasteurella anatipestifer
      was a major cause, although Salmonella spp., Escherichia coli and Treponema spp.
      were also detected. Use of an autovaccine against Pasteurella anatipestifer
      markedly reduced the signs and symptoms in the second part of fattening period.

PMID- 8367841
TI  - [Salmonellosis in the horse].
AB  - Salmonellosis is a worldwide problem of both men and animals. Equine
      salmonellosis is an increasing problem and a review of the recent knowledge is
      given. Etiology, symptomatology, diagnostic procedures, therapy and prevention
      are discussed.

PMID- 8367842
TI  - [A study of uterine adhesions following suturing of the uterus with catgut or
      Vicryl in cesarean sections in cattle].
AB  - A caesarean section was performed in 202 cows for the first time. The uterus of
      103 of these cows was sutured with Vicryl (7 metric) and the uterus of 99 cows
      was sutured with plain catgut (9 metric). The cows were randomly allotted to the
      two groups. All cows were rectally examined to diagnose adhesions between the
      uterus and the surrounding tissue five weeks post partum. Adhesions were found in
      50% of the cases. There were no differences in the number of adhesions and the
      severity of the adhesions between the catgut and the Vicryl group (Table 1).

PMID- 8367843
TI  - [Practice management with computers is increasingly more businesslike. Interview
      by Sophie Deleu].

PMID- 8367844
TI  - [Effect of nutrition on growth and skeletal development in dogs].

PMID- 8367845
TI  - [Selenium values too low].

PMID- 8367846
TI  - [Embryonal mortality in swine: conditions for a low incidence].
AB  - Embryonic mortality is an important cause of reproductive losses in the pig. The
      embryonic mortality rate, 30 per cent on average, will be reduced under optimal
      management conditions if (1) all sows are inseminated between 10 and 25 hours
      before ovulation; (2) semen of boars of proven fertility is used; and (3)
      variation in embryonic development is small. The uterine capacity of sows should
      also improved to enable the lower mortality rate to be expressed in larger
      litters.

PMID- 8367847
TI  - [A severe Aspergillus flavus infection in slaughtering chicks and the effect of
      disinfection with enilconazole: a case study].
AB  - In a flock of chicks, the number of birds dying per day from infection with
      especially Aspergillus flavus increased up to 1% during the second half of the
      fattening period. Levels of Aspergillus flavus were measured before and after
      cleaning of the chicken house with the anti-mycotic agent eniconazole (Clinafarm,
      Janssen Pharmaceutical Company, BV). The cleaning and disinfection schedule
      followed reduced levels if Aspergillus flavus to zero.

PMID- 8367848
TI  - [Arbitration].

PMID- 8367850
TI  - [Feed for parrots].

PMID- 8367849
TI  - [Study of analgesics at the time of purchase inspection].

PMID- 8367851
TI  - Surgery for tricuspid insufficiency: long-term follow-up after De Vega
      annuloplasty.
AB  - Between 1975 and 1991, 97 consecutive patients underwent De Vega tricuspid
      annuloplasty either isolated or in combination with mitral, aortic, or mitral and
      aortic valve procedures. Preoperatively 96.9% of the patients were in New York
      Heart Association functional class III or IV. Causes of tricuspid insufficiency
      were functional tricuspid ring dilatation and a combination of dilatation and
      different organic tricuspid valve lesions. There were 17 early deaths (17.5%),
      primarily due to cardiac failure, none was related to the tricuspid annuloplasty.
      80 perioperative survivors have been followed up for a mean of 4.7 +/- 4.1 years
      with a total of 462 cumulative patient-years. Actuarial 5-, 10-, and 15-year
      survival rates, including early deaths, were 64% +/- 5%, 48 +/- 6%, and 26% +/-
      10%. Recurrence of tricuspid regurgitation was rated as moderate in 15% and
      severe in 18.8%. Ten patients required reoperation (2.2%/patient-year), of whom 8
      were associated with tricuspid regurgitation (1.7%/patient-year). Although in all
      patients but one the De Vega annuloplasty was intact, the tricuspid ring was
      dilated; 4 patients had additional tricuspid organic valve lesions. 6 of the 8
      patients had concomitant mitral valve or mitral prosthesis dysfunction. 26
      patients died late (5.6%/patient-year) due to chronic cardiac failure in 50% and
      after reoperation in 7% of the patients. 4 patients had implantation of a
      permanent pacemaker (0.9%/patient-year). 54 patients (67.5%) are still alive,
      with 43% having no and 17.5% having only mild residual tricuspid regurgitation.
      De Vega annuloplasty is indicated with tricuspid insufficiency due to functional
      ring dilatation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367852
TI  - Permanent epicardial and transvenous single- and dual-chamber cardiac pacing in
      children.
AB  - Between January 1974 and November 1991 33 children received a permanent single-
      or dual-chamber pacing system, mainly because of postoperative high-degree AV
      block. The children were followed up retrospectively for pacemaker- and lead
      related complications, and for differences between epi- and endocardial
      stimulation. The overall rate of lead related complications was 35% and did not
      differ significantly between the epi- and endocardially paced groups, although it
      tended to be somewhat higher in the epicardially paced children, mainly due to a
      higher rate of exit blocks in the latter. The epicardially stimulated patients
      exhibited a significantly higher rate of pacemaker-related complications, which
      was primarily accounted for by a higher frequency of battery depletions in the
      epicardial systems. The most impressive differences between both groups, however,
      was seen with respect to subacute and chronic energy consumption. Chronic energy
      drain in the epicardially paced patients amounted to almost the sixfold of that
      seen in the endocardially stimulated children. This resulted in a significantly
      shorter cumulative pacemaker survival in the epicardial group. Therefore, it is
      concluded that, whenever possible, the transvenous approach be used in children
      and small infants too. However, as a rule, in the latter transvenous dualchamber
      pacing is usually not feasible. In these cases rate-adaptive single-chamber
      pacing has evolved as a reasonable alternative for improving hemodynamics as well
      as quality of life. In epicardial pacing the use of pulse generators allowing
      bidirectional telemetry is advisable. In this way monitoring of lead impedance
      and battery status can be performed noninvasively, thus permitting
      individualization of pulse widths and amplitude setting, which is important with
      respect to energy conservation.

PMID- 8367853
TI  - Total cavopulmonary anastomosis: selection criteria related to postoperative
      results.
AB  - In this study we review our experience with total cavopulmonary anastomosis
      (modified Fontan procedure) which was performed in 31 patients. One patient died
      from postoperative cardiac low-output syndrome, the other died from a
      neurological complication (early mortality 6.5%). During a mean follow-up period
      of 15 months there was no late mortality. Preoperative assessment showed that
      one, two, or three of the Choussat criteria (defining the ideal Fontan candidate)
      were not fulfilled by 39%, 16% and 6% of our patients. In the 2 patients who died
      2 and 3 of those criteria were not fulfilled. Poor outcome could not be predicted
      based on assessment of the pulmonary artery size (expressed as the McGoon-ratio
      or the Nakata-index) alone. In order to assess the relationship of pulmonary
      artery size and pulmonary arteriolar resistance (PVR) as a predictor of outcome,
      we introduced two new indices (McGoon-ratio/PVR and Nakata-index/PVR). The
      patient who died from poor postoperative hemodynamics had the lowest values of
      all patients. Among the 29 survivors we did not observe significant acquired
      postoperative arrhythmias. In our experience the total cavopulmonary anastomosis
      can be performed with a low mortality and good postoperative results. Patients
      who do not fulfill at least 8 of the Choussat criteria and children with a low
      ratio of pulmonary artery size to PVR are high-risk patients. In these children
      we recommend either a bidirectional Glenn anastomosis as a first-step procedure
      or a total cavopulmonary anastomosis with a fenestration of the intraatrial
      tunnel.

PMID- 8367854
TI  - Low-dose anticoagulant management of patients with St. Jude Medical mechanical
      valve prostheses.
AB  - Between February 1984 and December 1990, 622 St. Jude Medical valves were
      implanted in 548 patients. There were 382 males (69.7%) and 166 females (30.3%)
      with a mean age of 32.3 +/- 11.9 years (range 9-68 years). Sixty-eight percent of
      the patients were referred from rural areas. Three hundred and forty patients
      underwent aortic valve replacement (AVR), 134 had mitral valve replacement (MVR),
      and 74 had aortic and mitral valve replacement (DVR). The hospital mortality was
      4.7% (16/340) for AVR, 6.7% (9/134) for MVR and 10.8% (8/74) for DVR. Follow-up
      period ranged from 1.1 to 7.2 years. Total follow-up was 1317.3 patient-years
      (py). All patients received 2.5 mg warfarin, 225 mg dipyridamole, and 250 mg
      aspirin daily, regardless of prothrombin time and cardiac rhythm. Thromboembolism
      was observed in 10 patients (0.75 py); there were 3 mortalities (0.22% py). Valve
      thrombosis occurred in 4 patients (0.30% py): 3 in the MVR group (0.94% py) and 1
      in the AVR group (0.11% py). Hemorrhage occurred in 19 patients (1.44% py) with
      11 fatal outcomes (0.83% py). It is concluded that a random daily dose of 2.5 mg
      warfarin with 225 mg dipyridamole and 250 mg aspirin is sufficient for safe
      anticoagulation without the need for serial prothrombin-time adjustments.

PMID- 8367855
TI  - The influence of age and other risk factors on the results of coronary
      reoperation.
AB  - In a retrospective analysis of 115 patients who underwent a coronary reoperation
      between 1984 and 1989, we studied the influence of age and other risk factors on
      the perioperative morbidity and mortality and on the long-term results. The mean
      age of the population was 59.4 years, 55 patients were below 60, 52 between 60
      and 70 and 8 patients over 70 years, respectively. The distribution of risk
      factors was similar to other populations suffering from coronary heart disease.
      The mean time between first and second coronary operation was 7.1 years. Complete
      revascularisation at the reoperation could be achieved in only 20.9% (n = 24) of
      the patients. A mean of 1.9 vein grafts were implanted. The perioperative
      mortality (within 30 days) was 5.2% (n = 6) for the whole group, whereas the
      highest mortality rate could be observed in the patients aged over 70 with 25% (n
      = 2). The incidence of perioperative complications was also higher in the elderly
      patients, comparing them to the whole group. Mean follow-up time was 39 months.
      During follow up 14 patients (12.4%) died, most of the deaths were cardiac
      related. The cumulative survival rate was 91% after one, 90% after three, and 88%
      after five years. We found no statistically significant differences in the
      survival rates and the myocardial infarction rates regarding the different age
      groups. The exercise capacity and functional status at the time of follow up were
      quite acceptable.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367856
TI  - Multiple system organ failure after open heart surgery in infants and children.
AB  - Between January 1985 and March 1989 we retrospectively observed multiple system
      organ failure (MSOF) in 16 of 460 children (3.5%) who underwent cardiac surgery
      with cardiopulmonary bypass for congenital heart disease. MSOF was arbitrarily
      defined as a clinical entity with failure of two or more vital organ systems
      associated with high fever, thrombocytopenia, and cardiocirculatory insufficiency
      and occurring within the first postoperative week. In 13 children the first
      clinical manifestations of MSOF were evident on the first post-operative day and
      in the other 3 on the second or third post-operative day. All children showed
      acute renal failure, acute hepatic failure, high fever, and thrombocytopenia.
      Most of them showed respiratory insufficiency and neurological involvement. Seven
      of the 16 children died. Four of the 9 surviving patients had neurological
      sequelae still present 6 months after the operation, and the others recovered
      completely.

PMID- 8367857
TI  - Reproducibility of assessment of left-ventricular function using intraoperative
      transesophageal echocardiography.
AB  - Reproducibility of results is an important point in assessing the utility of
      intraoperative transesophageal echocardiography for evaluating changes in left
      ventricular function. The purpose of the present study was to define the intra-
      and interobserver reproducibility of the qualitative assessment of left
      ventricular regional wall motion and the quantitative assessment of global left
      ventricular function. In addition, the interstudy reproducibility of two
      examinations was tested when the probe was displaced and replaced in the
      esophagus. A transesophageal short-axis view at the level of the papillary
      muscles was obtained in 86 patients undergoing cardiac surgery. In the 80
      patients with adequate images, regional wall motion was visually graded and area
      ejection fraction was calculated by two observers and assessment was repeated by
      the same observer one day later. The same observer graded wall motion differently
      in only 5% (24/480) of segments. Grading by two observers differed in 9% (43/480)
      of segments. Assessment differed by one grade at the most and in not more than 2
      out of 6 segments per patient. Repeated measurements of area ejection fraction
      (AEF) by the same observer correlated well (r = 0.97 before and r = 0.97 after
      cardiopulmonary bypass) with a mean percent difference of 6%. A similarly close
      correlation was found for measurements of two observers (r = 0.90 and r = 0.93,
      respectively) with a mean percent difference of 10% for area ejection fraction.
      The correlation for the first and second examination in the same patient by one
      observer was acceptable (r = 0.78 and r = 0.80, respectively) with a mean percent
      difference of 15% for area ejection fraction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8367859
TI  - Surgical treatment of pulmonary and pleuro-pulmonary Aspergillus disease.
AB  - Between 6/87 and 3/92 22 out of 24 patients were treated (22 by surgery) for
      pulmonary and pleural Aspergillus disease. The most frequent lung disorder was
      tuberculosis (9 x), followed by bronchiectasis (5 x), congenital lung cysts (2
      x), pneumonia with abscess formation (2 x), sarcoidosis (2 x), and bronchial
      cancer (4 x). More than half the patients had further severe secondary diseases.
      4 patients with "simple aspergilloma" and 5 patients with "complex aspergilloma"
      underwent lobectomy or segmentectomy without complications or recurrence. Special
      surgical problems occurred in 13 patients with inflammation involving pleura and
      chest wall (pleuro-pulmonary aspergillosis, pleural aspergillosis) and invasive
      lung changes (invasive pulmonary aspergillosis). 7 patients developed an empyema
      after lung resection, on 4 occasions with bronchopleural fistula. In 4 cases
      myoplasty, in 2 cases thoracomyoplasty, on 2 occasions completion pneumonectomy
      with omentoplasty, in one case omentoplasty alone, and on 2 occasions
      decortication with pleurectomy and lung resection lead to a complete cure. 2 open
      window thoracostomies were constructed. In 15 cases a single operation was
      adequate. In 7 patients up to 3 further operations were necessary. 17 patients
      had haemoptysis, in 10 of these cases it was recurrent. On 7 occasions life
      threatening haemorrhage took place, causing death in 2 cases. These were the only
      deaths resulting from the lung disease. Our results show that aggressive surgical
      action can be successful. Myoplasty, thoracomyoplasty, and omentoplasty are, in
      our view, the most suitable measures for healing pleura empyemas and
      bronchopleural fistulae coincident with pleuro-pulmonary aspergillosis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8367858
TI  - Effects of trehalose in preservation of canine lung for transplants.
AB  - The effect of trehalose, a non-reducing disaccharide which stabilizes and
      protects membranes, in the preservation of canine lungs was examined when Euro
      Collins solution was basically used as a preservant. In group I, five lungs were
      perfused and preserved in an Euro-Collins solution modified by replacing the
      glucose with 35.0 g/L of trehalose. Five control lungs (group II) were perfused
      and preserved with Euro-Collins solution containing 35.0 g/L glucose. In both
      groups, no vasodilators were used. After preservation for 12 hours, left lung
      allotransplantation was performed. At 10, 40, 70, and 130 minutes after
      reperfusion, the right pulmonary artery was clamped for 10 minutes and four
      parameters were measured: arterial oxygen tension, mean pulmonary arterial
      pressure, peak inspiratory pressure, and wet/dry weight ratios. The transplanted
      lung was also examined histologically. At 10, 40, 70, and 130 minutes after
      reperfusion, oxygen-tension levels from group I were 263.2 +/- 19.2, 283.4 +/-
      14.0, 277.5 +/- 19.9 and 264.9 +/- 26.2 mmHg, respectively. In group II, the
      corresponding values were 191.2 +/- 33.9, 188.0 +/- 40.3, 153.4 +/- 40.0 and
      134.7 +/- 49.4 mmHg, respectively. At 70 and 130 minutes the difference were
      significant (p < 0.05). All transplanted lungs from group I showed normal
      histology, whereas four dogs in group II developed severe pulmonary edema and one
      had a partially edematous lung. These findings suggest that simple substitution
      of trehalose for glucose has a beneficial effect on preservation of canine lung
      for 12 hours.

PMID- 8367860
TI  - Retrieval of broken left-atrial catheter using a rigid bronchoscope.
AB  - Left-atrial pressure monitoring continues to be of value in cardiac surgery of
      the high-risk patient. Complications are fortunately low and include haemorrhage
      following catheter removal and retained catheter fragments. A simple and safe
      technique is presented to retrieve retained catheters using a rigid bronchoscope
      and avoiding the need for resternotomy.

PMID- 8367861
TI  - Fractured strut of Bjork-Shiley 70 degrees convexo-concave mitral valve
      prosthesis found in left coronary artery. Use of a portable transcutaneous
      cardiopulmonary bypass system for successful valve replacement.
AB  - Strut fractures followed by disk escape of Bjork-Shiley convexo-concave valve
      prostheses are a well-known problem. This article discusses the case of a
      successfully treated patient who was admitted to our institution with extreme and
      prolonged cardiogenic shock. The strut was dislodged into the main stem of the
      left coronary artery and the disk into the iuxtarenal abdominal aorta. The intent
      of this report is, in particular, to illustrate the management problems.
      Immediately after diagnosis, circulation and oxygenation were ensured by use of a
      portable cardiopulmonary bypass support (CPS) system whose circulation lines were
      introduced subcutaneously. Thus the transfer to the operating room and the
      surgical intervention were able to start under controlled conditions. The disk
      was removed by Fogarty catheter manoevre without any problems during the same
      operation, using a transpericardial access to the descending thoracic aorta. In
      our opinion, the primary insertion of the CPS and the avoidance of an additional
      laparotomy in disk removal help promote the survival of such critically ill
      patients.

PMID- 8367862
TI  - Aortobronchial fistula: a late complication of coarctation repair by patch
      aortoplasty.
AB  - A case of aortobronchial fistula occurring 13 years after coarctation repair by
      patch aortoplasty is presented. Correct diagnosis was established by computed
      tomographic scanning and magnetic resonance imaging. Surgical treatment consisted
      of simple closure of the bronchial defect and interposition of a Dacron graft
      under partial extracorporeal bypass.

PMID- 8367863
TI  - Minimally invasive surgery in the thorax.

PMID- 8367864
TI  - Statement of the Commission for Minimally Invasive Surgery of the German Society
      of Thoracic Surgery.

PMID- 8367865
TI  - Prerequisites, indications, and techniques of video-assisted thoracoscopic
      surgery.
AB  - During the last two years video-assisted operative thoracoscopy has introduced
      new impetus into thoracic surgery. Today it is viewed as a sparing and safe
      alternative to thoracotomy for a wide spectrum of indications. The prerequisites,
      instruments, and operative techniques are discussed. In oncological thoracic
      surgery it still remains to be verified whether the criteria of radicality are
      fulfilled by this new technique. Using video-assisted operative thoracoscopy, we
      have successfully operated on 209 patients with the following indications:
      recurrent pneumothorax (n = 94), interstitial lung disease (n = 25), coin lesion
      (n = 20), pleural effusion (n = 17), hyperhidrosis (n = 14), mediastinal tumor or
      lymphoma (n = 10), thoracic empyema (n = 9), bullous emphysema (n = 8), pleural
      tumor (n = 5), hematothorax (n = 3), malignant pericardial effusion (n = 3), and
      chylothorax (n = 1). The advantages of this minimally traumatizing operating
      technique lie in a better view of the operative site, the objectively measurable
      reduction in postoperative restriction, less pain, earlier postoperative
      mobilization, and shorter hospital stay. This operating technique, in addition to
      being sparing, requires markedly less time than a thoracotomy. The disadvantages
      are the two-dimensional monitor picture and, especially, the loss of palpation.

PMID- 8367866
TI  - Clinical experience with minimally invasive thoracic surgery.
AB  - From October 1991 to June 1992 video-endoscopic lung surgery was applied in a
      total of 109 patients. In the first case a pulmonary cyst measuring 15 x 18 cm
      was resected. In 21 patients lung nodules were exstirpated by means of wedge
      resection. Moreover, metastasectomies, open lung biopsies, parietal
      pleurectomies, resections of bullae, and decortications, as well as 3 lower-lobe
      lobectomies were performed using video-endoscopic procedures. Closure of lung
      parenchyma was carried out using the 3 cm Endo-GIA stapler (Autosuture). In none
      of the patients were we forced to enlarge the intervention to a thoracotomy
      because of technical problems. Indications, operative technique and results are
      presented. This new technique offers all the known advantages of minimally
      invasive surgery to patients requiring thoracic surgery.

PMID- 8367867
TI  - Long-term myocardial function after heart transplantation.
AB  - With an increasing number of heart transplantations and an improved survival rate
      a characterization of the long-term hemodynamic profile of the transplanted heart
      is necessary. 222 cardiac catheterizations were performed in 71 heart recipients
      under cyclosporine A immunosuppression during a 7-year follow-up after
      transplantation. Hemodynamic evaluation revealed a non-progressive arterial
      hypertension due to an increased systemic vascular resistance, leading to a mild
      increase of left-ventricular chamber stiffness. Parameters of systolic myocardial
      function were found to be normal and did not deteriorate during the 7 year
      period. The prevalence of allograft coronary angiopathy increased from 13% one
      year to 54% five years after transplantation. Myocardial function was neither
      adversely influenced by the presence of coronary angiopathy nor by the number or
      severity of former rejection episodes. Unchanged annual pressure-volume loops
      excluded the development of a dilated or restrictive posttransplantation
      cardiomyopathy. Thus, not the myocardial function, but the coronary angiopathy
      represents the most critical cardiac long-term problem after transplantation.

PMID- 8367868
TI  - Third-time coronary artery revascularization.
AB  - Eighteen patients underwent a third coronary artery revascularization (rere-CABG)
      between 1983 and 1991. The factors necessitating rere-CABG were graft failure in
      83% of the patients and progression of native coronary atherosclerosis in 17%.
      Mean interval between the second and third operation was 49.1 months. Median
      sternotomy and cardiopulmonary bypass (CPB) were used in 12 patients, a left
      thoracotomy approach was used in 6 (with CPB in 3 patients and without CPB in 3).
      The mean revascularization rate was 2.2 (grafts/patient). The internal thoracic
      artery was employed in 12 patients and the right gastroepiploic artery was used
      in one. Operative mortality was 11.1% (2 deaths). Non-fatal perioperative
      myocardial infarction, reexploration for bleeding, and respiratory failure
      occurred in one patient each. There were no other serious complications. Long
      term follow-up was obtained in 15 of the 16 survivors. Four patients had
      recurrence of angina pectoris, and one late death due to myocardial infarction
      occurred. The myocardial event-free rate was 75% at 3.4 years. This experience
      indicates that a third coronary revascularization can be justified: operative
      approach and choice of graft material have to be individualized, but adequate
      long-term results can be obtained.

PMID- 8367869
TI  - A reconsideration of surgery for mitral stenosis based on the extent of valvular
      distortion shown by two-dimensional echocardiography preoperatively.
AB  - A twelve-year follow-up study was carried out with 98 consecutive patients
      operated on for pure mitral stenosis with open mitral commissurotomy (OMC) or
      valve replacement with porcine valves (MVR). Each patient had the extent of valve
      distortion diagnosed preoperatively by two-dimensional echocardiography as either
      grade I of the dome-formation type, grade II of the intermediate type, or grade
      III of the mass-formation type. Thirty grade I patients and 24 grade II patients
      underwent OMC and 44 grade III patients received MVR. The long-term survival and
      reoperation rates were significantly poorer with grade II than grade I patients
      and there was no statistical significance between grades II and III. However, the
      clinical conditions set by NYHA are significantly worse in grade II than in grade
      III. This can be clearly explained by the fact that the left atrial volume
      decreasing ratio (LAVDR) in the latest period, which was measured in patients
      with more than 7 years survival, remained nearly at the early postoperative value
      in grade III, while the LAVDR of grade II at the latest period grew worse and
      became insignificantly different from the preoperative values. This study clearly
      shows that when OMC is applied to grade II patients, frequent reoperations might
      be necessary because of poor hemodynamic conditions. Thus, it might be better to
      adopt MVR rather than OMC with grade II patients with moderately distorted mitral
      valves.

PMID- 8367870
TI  - Combined perioperative infusion of nifedipine and metoprolol provides
      antiischemic and antiarrhythmic protection in patients undergoing elective
      aortocoronary bypass surgery.
AB  - A randomized study was performed on 70 patients undergoing elective coronary
      bypass surgery to examine whether the combined, perioperative, 24-hour infusion
      of the calcium-channel blocker nifedipine (10 micrograms/kg/h) and the beta 1
      blocker metoprolol (12 micrograms/kg/h) reduces the incidence of perioperative
      myocardial ischemia and arrhythmias (group NM, n = 34). The control group
      received nifedipine only (n = 36). Repeated assessment of serum enzyme levels
      (CK, CK-MB) and 12-lead ECG, together with 3-channel Holter monitoring over 48 h
      were used to define perioperative myocardial ischemia (transient ischemic event,
      myocardial infarction) and supraventricular and ventricular arrhythmias. The two
      groups did not significantly differ with respect to preoperative anamnestic and
      surgical data. No perioperative myocardial infarction was detected in either
      group. However, a significantly lower incidence of transient ischemic events was
      observed in the NM group as compared to the nifedipine group (3% versus 11%; p <
      0.05). In addition, there was a tendency towards lower CK-MB levels and peak
      values of CK- and CK-MB in the NM group. With regard to perioperative
      dysrhythmias, there was a significantly lower incidence of sinus tachycardia (9%)
      and atrial flutter/fibrillation (6%) in the NM group as compared to the
      nifedipine group (33 and 27%, p < 0.05). In addition, postoperative heart rate
      was lower in the NM group starting from the 6th hour after opening of 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- 8367871
TI  - A technique for internal mammary artery to coronary artery anastomoses.
AB  - A "no-touch" technique for anastomosing the internal mammary artery to the
      anterior descending artery is described. This technique has been used in more
      than 3000 patients, and enables one to construct a long, patulous anastomosis in
      which all suturing is forehand.

PMID- 8367872
TI  - Three-dimensional vascular imaging--an additional diagnostic tool.
AB  - Angiography is still the standard for imaging of vascular structures. However,
      since the number of projections is limited, complex pathoanatomy may not be
      sufficiently visible. This study presents two patients in whom 3D reconstruction
      from Spiral CT data revealed combined vascular lesions undisclosed by
      angiography. In one case the combination of coarctation and chronic dissection
      type B, in another the combination of two aneurysms of the celiac trunk in series
      was disclosed. We conclude that 3D reconstruction can be a valuable asset in the
      diagnosis of complex vascular pathoanatomy.

PMID- 8367873
TI  - Effects of pulsatile and nonpulsatile perfusion mode during extracorporeal
      circulation--a comparative clinical study.

PMID- 8367874
TI  - Multiple pulmonary-artery aneurysms due to mucoid vasculopathy--angiographic and
      histological observations.
AB  - Multiple peripheral pulmonary artery aneurysms were diagnosed by computed
      tomography and confirmed angiographically in a 7-year-old boy. On histological
      examination unusual mucoid vasculopathic changes were noted in the pulmonary
      artery aneurysms and pulmonary vasculature as a part of systemic vascular
      involvement. This case demonstrates a new association between mucoid
      vasculopathic changes and pulmonary aneurysms. Mucoid vasculopathy could
      represent one more disorder having a causative role in the etiology of
      intrapulmonary arterial aneurysms.

PMID- 8367875
TI  - Combined transection of the trachea and esophagus following cervical blunt
      trauma.
AB  - The successful management of a patient with combined transection of the cervical
      trachea and esophagus following blunt trauma is reported. This type of injury was
      rare in the past, but is gradually increasing at the present time because of the
      increased use of motorcycles. Immediate primary closure of the transected trachea
      and esophagus offers the best chance for a good result.

PMID- 8367876
TI  - Closure of acute bronchial stump insufficiency with a musculus latissimus dorsi
      flap.
AB  - We describe a successful closure of an acute bronchial stump insufficiency after
      pneumonectomy by intrathoracic transposition of the pedunculated latissimus dorsi
      muscle: A 56-year-old patient with a necrotizing bronchial carcinoma developed a
      stump insufficiency after right pneumonectomy. Repeated resection and renewed
      closure of the completely dehiscent stump was not possible, as the stem bronchus
      had been separated close to the tracheal bifurcation in the preceding operation.
      Therefore we transposed the pedunculated musculus latissimus dorsi into the
      thoracic cavity. The closure of the bronchial stump insufficiency was achieved by
      fixation of the muscle on to the open stump and surrounding tissue of the
      mediastinal pleura with fibrin glue. The postoperative course was without
      complications, no further insufficiency or empyema developed.

PMID- 8367877
TI  - Complete prosthetic valve thrombosis despite several thrombolytic treatments
      after tricuspid valve replacement.
AB  - We discuss the case of a 50-year-old man who underwent tricuspid valve
      replacement with a mechanical prosthesis (Duromedics) due to traumatic tricuspid
      insufficiency following a blunt chest trauma fifteen years previously. Despite
      correct anticoagulation therapy several events of prosthetic valve thrombosis
      occurred in the following years. The patient was treated four times by
      thrombolytic therapy. Finally, seven years after the initial operation the
      mechanical valve was replaced by a Carpentier-Edwards bioprosthesis because of
      complete blockage.

PMID- 8367878
TI  - Cardiac surgery in Germany during 1992. A report by the German Society for
      Thoracic and Cardiovascular Surgery.

PMID- 8367879
TI  - Exposure to 2,3,7,8-tetrachlorodibenzo-para-dioxin leads to defective dentin
      formation and pulpal perforation in rat incisor tooth.
AB  - A single dose of 1000 micrograms 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)/kg
      body weight was given to TCDD-resistant (Han/Wistar) young adult male rats.
      Changes in the skulls and the continuously erupting incisor teeth were evaluated
      16 weeks after the administration of TCDD. The skulls of the experimental rats (N
      = 11) were significantly smaller than those of the control rats (N = 11), and the
      upper and lower incisor teeth of all experimental rats were significantly thinner
      than the control rat teeth. The pulps of the lower incisors of all experimental
      rats were lingually exposed to the oral cavity at their incisal ends. Also in 3
      cases the pulps of the upper incisors were exposed, but never in the control
      rats. Whereas the labial surfaces of the incisors of the control rats were brown,
      those of the experimental rat teeth appeared greyish and mottled. Histological
      examination revealed that the pulp chambers in the incisal halves of the affected
      teeth were larger than normal, at the expense of the thickness of dentin. Towards
      the incisal tooth ends, odontoblasts gradually lost their polarity and the pulp
      tissue became necrotic. A dentin zone next to the pulp chambers was irregular.
      Lingual tapering of the teeth was pronounced, which gave them a mesiodistally
      flattened appearance. The superficial zone of the otherwise regular enamel was
      poorly pigmented. In conclusion, a single injection of TCDD was shown to impair
      normal growth of the skull and incisor tooth formation in rats. The small size of
      the incisors, their aberrant shape and the defective dentin (and enamel)
      formation could be mediated by vitamin A metabolism, known to be interfered with
      by TCDD.

PMID- 8367880
TI  - Developmental patterns of aluminum in mouse brain and effects of dietary aluminum
      excess on manganese deficiency.
AB  - Previous studies have shown that excess dietary Al during development can affect
      neurobehavioral measures and decrease tissue Mn of 21-day-old weanling mice
      without a corresponding increase in tissue Al concentrations. Al and Mn have
      similar tissue concentrations and similar affinities for transferrin, which is
      the major plasma transport protein for Al and Mn as well as Fe. In the present
      study, brain Al, Mn and Fe were studied at 6, 12, 18 and 24 days of age in
      offspring of Swiss Webster mice fed a semipurified diet containing excess Al
      (Al[+], 1000 micrograms Al/g diet, Al as Al lactate), marginal Mn (Mn[-], 3
      micrograms Mn/g diet) or both excess Al and marginal Mn (Al[+]Mn[-]) from
      conception to day 24 postnatal (weaning on day 18). Brain Al concentrations were
      higher at 6 days of age than at later ages and were significantly elevated by the
      excess Al diet (P = 0.017) but returned to control levels by weaning. Brain Mn
      concentrations increased from day 6 to day 24 and were lower in the Mn deficient
      groups (P < 0.001) and also in the excess Al group (P = 0.024) than in controls.
      Brain Fe concentrations were not influenced by diet. Similar patterns were seen
      in liver as in brain. The marginal Mn diet led to postnatal growth retardation
      which was more severe in litters of dams fed Al[+]Mn[-] diets than in litters fed
      Mn[-] diet. These data suggest that excess Al in diet can interact specifically
      with Mn metabolism during development.

PMID- 8367881
TI  - Effect of different renal glutathione levels on renal mercury disposition and
      excretion in the rat.
AB  - Mercury renal disposition has been studied following HgCl2 injection (5.0 mg/kg
      body wt., s.c.) in controls, diethylmaleate and N-acetylcysteine-treated rats.
      The different treatments were used to generate statistically different degrees of
      non-protein sulfhydryls concentration in kidneys. Diethylmaleate (4 mmol/kg body
      wt., i.p.) diminished kidney glutathione levels to 25% and N-acetylcysteine (2
      mmol/kg body wt., i.p.) increased kidney non-protein sulfhydryls levels up to 75%
      compared with new controls. The amount of mercury in the kidneys, the mercury
      excretion rate in urine and the mercury plasma disappearance curves were
      calculated during 3 h post HgCl2 injection. BUN was measured in plasma at the
      same time period to determine the onset of kidney damage. The results indicate a
      higher HgCl2 renal clearance in N-acetylcysteine-treated rats compared to
      controls and less renal mercury accumulation. The data agree with diminished
      renal toxicity. On the other hand, renal mercury accumulation was higher and
      mercury renal clearance lower in diethylmaleate-treated animals, associated with
      higher renal toxicity. The results suggest that non-protein sulfhydryl levels
      (principally glutathione) might determine renal accumulation of mercury as well
      as its elimination rate and hence might enhance or mitigate the nephrotoxicity
      induced by the metal.

PMID- 8367882
TI  - Effects on neurobehavioral performance of chronic exposure to chemically
      contaminated well water.
AB  - Occupational exposure to trichloroethylene (TCE) and other solvents impairs
      neurobehavioral performance. Use of well water contaminated with TCE and solvents
      has been associated with excessive symptoms, cancers, birth defects and impaired
      blink reflex. We extended these observations by measuring the neurophysiological
      (NPH) and neuropsychological (NPS) status of subjects who used water contaminated
      with 6 to 500 ppb of TCE for 1 to 25 years. The 170 well-water exposed subjects
      who resided in southwest Tucson, Arizona overlying the Santa Cruz River aquifer,
      were compared to 68 referent subjects for NPH and NPS tests. Also, 113 histology
      technicians (HT) were referents for blink reflex latency only. Affective status
      was assayed by a Profile of Mood States (POMS). Exposed subjects were
      statistically significantly impaired when compared to referents for NPH tests.
      These impairments included sway speed with eyes open and closed, blink reflex
      latency (R-1), eye closure speed, and two choice visual reaction time. NPS status
      was statistically significant impaired for Culture Fair (intelligence) scores,
      recall of stories, visual recall, digit span, block design, recognition of
      fingertip numbers, grooved pegboard and Trail making A and B. POMS scores were
      elevated. Prolonged residential exposure to well-water containing TCE at lower
      levels than occupational exposures, but without time away from exposure for
      metabolism and excretion of toxins, was associated with neurobehavioral
      impairment.

PMID- 8367883
TI  - Primary aromatic amines from side-stream cigarette smoke are common contaminants
      of indoor air.
AB  - A very sensitive mass-spectrometry method has been developed for the analysis of
      aromatic amines in tobacco smoke and in indoor air. Cigarettes were smoked with a
      smoking machine; the amines from the smoke were trapped in a 5% HCl water
      solution containing internal standards and detected by gas chromatography/mass
      spectrometry in the selected-ion-monitoring (SIM) mode. The amines measured were
      the following: aniline, 2-toluidine, 3-toluidine, 4-toluidine, 2-ethylaniline, 3
      ethylaniline, 4-ethylaniline, 2,3-dimethylaniline, 2,4-dimethylaniline, 2,5
      dimethylaniline, 2,6-dimethylaniline, 1-naphthylamine, 2-naphthylamine, 2-methyl
      1-naphthylamine, 2-aminobiphenyl, 3-aminobiphenyl and 4-aminobiphenyl. We
      analyzed nine brands of cigarettes sold commercially in Italy (Gauloise,
      Nazionali, Marlboro, Camel, MS, MS mild and MS lights), with and without filter.
      Main-stream smoke contained a lower amount of aromatic amines than side-stream
      smoke: the total level of these amines in main-stream smoke ranged from 200 to
      1300 ng/cigarette, whereas the level of aromatic amines in side-stream smoke
      varied from 20,000 to 30,000 ng/cigarette. The smoke of black-tobacco cigarettes
      had higher levels of aromatic amines compared to light-tobacco cigarettes and the
      filters significantly reduced aromatic amines in main-stream smoke. We also
      determined the levels of aromatic amines in ambient air, offices and houses. Some
      aromatic amines (aniline and toluidine) were detected in ambient air, as well as
      in rooms of non-smokers. Most measurements showed a considerable contamination of
      aromatic amines derived from side-stream smoke, which was detected also in parts
      of the buildings in which smoking was not allowed.

PMID- 8367884
TI  - Liver carcinogenesis is not a predicted outcome of chemically induced hepatocyte
      proliferation.
AB  - Cell proliferation has long been recognized as a basic component of multistage
      carcinogenesis. Based largely on the finding that certain nongenotoxic chemical
      carcinogens induce cell proliferation in the same organ that develops tumors
      after long-term exposure, some suggest that the increased rates of cell division
      account for the carcinogenicity of these chemicals. This paper examines
      relationships between chemically induced liver toxicity, cell proliferation, and
      liver carcinogenesis; major factors include consistency, transient vs. sustained
      dose-response correspondence, and scientific plausibility. For a presumed
      mechanism to be valid, a sustained proliferative response is critical, largely
      because transient increases in hepatocyte proliferation are not sufficient to
      induce cancer or promote liver tumor development. A consistent association
      between liver toxicity and carcinogenicity has not been established. Our
      evaluation of studies on purported relationships between chemically induced cell
      proliferation and liver carcinogenesis shows: 1) that inconsistencies in sex and
      species specificity exist, 2) that a large percentage of proliferative responses
      are transient, 3) that inconsistencies in response to various hepatic peroxisome
      proliferators are common, and 4) that dose-response and duration relationships
      have not been sufficiently examined. Studies of proliferative responses of
      putative preneoplastic cells in the liver indicate that these cells divide faster
      than normal hepatocytes and also have higher death rates. Chemicals that induce
      cell proliferation in preneoplastic foci do not always provide a persistent
      increase in replication rates, even with continuous exposure. A selective growth
      advantage to preneoplastic cells in the liver may be provided either by an
      enhancement of the replication rates of these cells compared to the surrounding
      normal hepatocytes, by inhibition of cell loss, or by inhibition of the growth
      rate of normal cells. More work is needed to understand how chemical carcinogens
      and noncarcinogens affect cell division and cell loss of normal hepatocytes and
      of preneoplastic cells; measurements of hepatocyte proliferation alone are not
      sufficient to elucidate mechanisms of liver tumor development or to predict liver
      carcinogenesis. Because of our limited knowledge of the complex molecular changes
      occurring during liver cancer, it would be inappropriate and far too premature to
      amend scientific risk assessment procedures for nongenotoxic chemical carcinogens
      based on oversimplified or incompletely tested speculations.

PMID- 8367885
TI  - Chlorine gas exposure and the lung: a review.
AB  - We conducted a review of the literature detailing the respiratory effects of
      chlorine, an extremely important but toxic halogen. Historically, the heaviest
      mass inhalational exposures to chlorine resulted from World War I gassing.
      Currently potential human exposure to chlorine inhalation occurs in a variety of
      settings in the workplace, as a result of inadvertent environmental releases, and
      even in the home due to household cleaning mishaps. Chlorine species are highly
      reactive; tissue injury results from exposure to chlorine, hydrochloric acid,
      hypochlorous acid, or chloramines. Acute, high level exposure to chlorine gas in
      occupational or environmental settings results in a variety of dose-related lung
      effects ranging from respiratory mucus membrane irritation to pulmonary edema.
      Pulmonary function testing can reveal either obstructive or restrictive deficits
      immediately following exposure, with resolution over time in the majority of
      cases. However, some of those exposed may demonstrate long-term persistent
      obstructive or restrictive pulmonary deficits or increased nonspecific airway
      reactivity after high level exposure to chlorine gas. Symptoms and signs
      following inhalation of mixtures of chlorine-containing cleaners in the home are
      similar to those after occupational exposures and environmental releases.
      Although generally less severe, these events may be extremely common. Controlled
      human exposure data suggest that some subjects may be more responsive to the
      effects of chlorine gas; epidemiologic data also indicate that certain
      subpopulations (e.g., smokers) may be at greater risk of adverse outcome after
      chlorine inhalation. Although these findings are intriguing, additional study is
      needed to better delineate the risk factors that predispose toward the
      development of long-term pulmonary sequelae following chlorine gas exposure.

PMID- 8367886
TI  - N-methyl-N'-nitroguanidine: irritation, sensitization, and acute oral toxicity,
      genotoxicity, and methods for analysis in biological samples.
AB  - Currently, N-methyl-N'-nitroguanidine (MNG) is being considered by the U.S. Air
      Force Armament Laboratory for use in explosive formulations. A mammalian toxicity
      profile has been performed which includes the analysis of chemical impurities and
      an assessment of the potential for the metabolism of MNG to 1-methyl-3-nitro-1
      nitrosoguanidine (MNNG). Potential in situ gastric conversion of MNG to MNNG is a
      toxicological concern because MNNG is both mutagenic and carcinogenic. The
      compound was also evaluated in several bioassays to assess its potential
      genotoxic activity. The acute oral toxicity was determined in male and female
      Fischer 344 rats administered a single dose of MNG in corn oil. The maximum
      suspension of MNG that could be delivered, 1 mg MNG/kg body weight, produced no
      signs of toxic stress during the 14-day observation period. The primary eye and
      skin irritation potential of MNG was determined in female New Zealand white
      rabbits using the Draize technique. MNG produced no irritation to intact skin but
      did produce mild conjunctival irritation. The response of a single guinea pig to
      the dermal sensitization evaluation indicated that MNG is a weak sensitizer. The
      results of three genetic tests indicated that MNG does not interact with genetic
      material. Gastric contents and feces from treated animals showed no evidence of
      conversion of MNG to MNNG.

PMID- 8367887
TI  - Liver function in rats treated individually and with a combination of xylene,
      toluene and methanol.
AB  - The individual and combined influences of three industrial solvents (namely
      xylene, toluene, and methanol) on certain parameters of liver function in
      laboratory rats have been studied. Although individual treatments with all three
      solvents elevated activities of serum enzymes (i.e., GOT, GTP, and alkaline
      phosphatase), and did manifest hyperbilirubinemia, nevertheless metabolic
      interaction occurring after their combined treatment suggested a weak
      antagonistic mechanism. This assumption has been supported by the fact that the
      detoxification ability of the liver, as indicated by the formation of hippuric
      acid, improved after the combined treatment.

PMID- 8367888
TI  - Occupational skin hazards from synthetic plastics.
AB  - Epoxy and acrylic resins have numerous industrial applications but are also
      widely used in the household environment. These compounds are presently one of
      the most important sources of occupational contact dermatitis. Contact
      sensitization to epoxy resins is usually caused by the resin itself but hardeners
      or other additives, such as reactive diluents, plasticizers, fillers and
      pigments, can occasionally be responsible. Since completely cured epoxy resins
      are not sensitizers, epoxy resin sensitization is always due to the presence, in
      the final polymer, of uncured allergenic low molecular weight oligomers.
      Acrylates are now considered the fourth most common cause of contact
      sensitization due to resins. Unpolymerized monomers of acrylic compounds are
      known to be responsible for the contact allergy. Accelerators, inhibitors and
      catalysts, which are usually added to the acrylates to promote the polymerization
      process, can also sensitize. Both allergic and irritant contact dermatitis may be
      caused by exposure to epoxy or acrylic resins and their additives. Contact
      urticaria, allergic or irritant airborne contact dermatitis caused by volatile
      compounds, onychia and paronychia can also occur. From January of 1984 to May of
      1992 we detected 39 cases of occupational allergic contact dermatitis to epoxy
      resin system substances and 11 cases of occupational contact sensitization to
      acrylic compounds. In our experience, the electronics industry as well as paint
      and glue related activities were the most important sources of epoxy
      sensitization. Dental materials and anaerobic sealants were found to be the most
      frequent acrylate sensitizers.

PMID- 8367889
TI  - Characterization of highly polar DNA adducts derived from dibenz[A,H]anthracene
      (DBA), 3,4-dihydroxy-3,4-dihydro-DBA, and 3,4,10,11-tetrahydroxy-3,4,10,11
      tetrahydro-DBA.
AB  - Two highly polar DNA adducts were found after metabolic activation of 3,4,10,11
      tetrahydroxy-3,4,10,11-tetrahydrodibenz[a,h]anthracene (DBA-3,4,10,11-bisdiol) by
      liver microsomes isolated from male Sprague-Dawley rats pretreated with Aroclor
      1254 in presence of calf thymus DNA. These DNA adducts could be assigned to the
      metabolites of dibenz[a,h]anthracene (DBA), of 3R,4R,10R,11R-tetrahydroxy
      3,4,10,11-tetrahydro-DBA and of 3R,4R,10S,11S-tetrahydroxy-3,4,10,11-tetrahydro
      DBA. DNA adducts derived from metabolites of 3S,4S,10S,11S-tetrahydroxy-3,4,10,11
      tetrahydro-DBA were not found. These highly polar adducts also could be detected
      by reversed phase HPLC after incubation of dibenz[a,h]anthracene, 3R,4R-dihydroxy
      3,4-dihydro-DBA ((-)-DBA-3,4-diol) and 3S,4S-dihydroxy-3,4-dihydro-DBA ((+)-DBA
      3,4-diol) with DNA in presence of the activating system. After incubation of 14C
      labelled DBA DNA adducts derived from DBA-3,4,10,11-bisdiol were found in a
      fraction of 38% and bay region 3,4-dihydroxy-1,2-epoxy-1,2,3,4-tetrahydro-DBA-DNA
      adducts at a level of 25%. DBA-3,4,10,11-bisdiol exhibited a higher DNA binding
      yield (38 +/- 12 pmol/mg DNA) than (-)-DBA-3,4-diol (23 +/- 6 pmol/mg DNA), the
      most mutagenic 3,4-diol enantiomer. For (+)-DBA-3,4-diol the highly polar DNA
      adducts derived from DBA-3,4,10,11-bisdiol were by far the most predominant
      adducts in vitro.

PMID- 8367891
TI  - Oxisterol determination in selected coffees.
AB  - The main aim of green-coffee processing techniques, such as decaffeination and
      roasting, is always to maintain a very high level of quality in taste and flavor,
      the beverage's most important characteristics to consumers. Oxidative alterations
      of coffee lipids, which can occur in roasting, exert a very marked influence on
      these quality traits. Determining the extent of oxidation thus can provide an
      indication of the product's potential shelf-life and reveal traces of any newly
      formed oxidative products that might prove nutritionally unsafe. Yet, while much
      attention has recently been focused on certain by-products induced by cholesterol
      oxidation and their proven toxicity as risk factors in atherosclerosis and
      cancer, oxidated phytosterols have largely gone unnoticed, being considered along
      with beta-sitosterol as not very dangerous in that neither is absorbed by the
      intestinal tract. The present study investigates the substances derived from
      phytosterol oxidation (oxisterols) in samples of regular and decaffeinated
      commercial coffees. The findings show that oxisterols were absent in some samples
      and that the traces of oxidate phytosterols detected in others were well below
      the threshold considered as toxicologically active.

PMID- 8367890
TI  - Lys- and Leu-aminopeptidase activity after acute toluene exposure in the rat
      brain.
AB  - Changes in Lys- and Leu-aminopeptidase activities in several brain regions of the
      rat, after acute toluene administration, are described in this research.
      Aminopeptidase activity has been suggested as a candidate regulator of the
      degradation of several neuroactive peptides. Lys-aminopeptidase activity was
      significantly decreased in the thalamus, amygdala, and medulla oblongata. Leu
      aminopeptidase activity was significantly decreased in the thalamus and
      cerebellum. It is suggested that these aminopeptidase activities could play a
      part in the mechanism of toluene neurotoxicity.

PMID- 8367892
TI  - Possible role of free radical intermediates in hepatotoxicity of hydrazine
      derivatives.
AB  - Hydrazine derivatives constitute a wide group of compounds and have found
      application in industry, agriculture, and (as therapeutical agents) medicine. In
      spite of their widely spread use, several hydrazine derivatives are known to
      exert hepatotoxic effects and are carcinogenic. Free radical species are produced
      during the hepatic biotransformation of alkylhydrazines by both rat and humans
      liver microsomes. Cytochrome P-450 dependent monoxygenase system is responsible
      for the production of these reactive species and specific cytochrome P-450
      isoenzymes appear to catalyze the formation of free radical intermediates. Free
      radicals generated during the metabolism of alkylhydrazines are capable of
      inducing oxidative stress in isolated hepatocytes and might contribute to the
      development of cell injury.

PMID- 8367893
TI  - Purification and characterization of hepatic P-450IIE1 from acetone-treated mice.
AB  - A new cytochrome P-450 isozyme (Mr = 52,000) was purified to apparent
      electrophoretic homogeneity from hepatic microsomes of mice treated with acetone
      and its biochemical, spectral, and immunological properties characterized.
      Several criteria indicated that the purified cytochrome was distinct from the
      known mouse P-450 isozymes. The absolute spectrum of its oxidized form indicated
      that it was in the high spin state. In a reconstituted system, it showed low
      catalytic activities towards 7-ethoxycoumarin, aminopyrine, and coumarin, whereas
      it catalyzed the oxidation of aniline, acetone, dimethylnitrosamine with high
      turnover number. The mouse enzyme was immunoreactive with polyclonal antibodies
      against rat P-450IIE1 and exhibited an NH2-terminal aminoacid sequence with a
      high homology to that of rat-P-450IIE1. Based upon the above catalytic, spectral,
      immunological and structural properties, the purified mouse P-450 appears to be
      the ortholog of previously described P-450IIE1(s) of other species.

PMID- 8367894
TI  - On the origin of the "six non-natural things" in Galen.

PMID- 8367895
TI  - Galen and Egypt.

PMID- 8367896
TI  - Apollonius and Galen on "joints".

PMID- 8367897
TI  - Galen on Hellenistics and Hippocrateans: contemporary battles and past
      authorities.

PMID- 8367898
TI  - [Galen as mental healer].

PMID- 8367899
TI  - [Hellenistic science in the newly discovered Galen comment on Hippocratic
      writings "On the environment"].

PMID- 8367900
TI  - [Comments on editing revisions of Galen's manuscript "On autopsy of cadavers"].

PMID- 8367902
TI  - [Galen and medieval Armenian medicine].

PMID- 8367901
TI  - [Theoretical, empirical and semantic aspects of water in Galen].

PMID- 8367903
TI  - Galen and the utility of logic.

PMID- 8367904
TI  - Galen and Stoicism.

PMID- 8367905
TI  - [The nerves of the soul].

PMID- 8367906
TI  - [Stoicism and stoics in Galen's manuscript De foetuum formatione].

PMID- 8367907
TI  - [Galen on the topic of creation].

PMID- 8367908
TI  - Water distributions of hydrated biological specimens by valence electron energy
      loss spectroscopy.
AB  - A technique has been developed for measuring the water distribution in thin
      frozen hydrated biological specimens by means of electron energy loss
      spectroscopy (EELS). The method depends on the quantification of subtle changes
      in the valence electron excitation spectrum as a function of composition. It
      involves determining the single-scattering intensities, calculating oscillator
      strengths and applying a multiple-least-squares fitting procedure to reference
      spectra for water and the organic constituents. The direct EELS approach has an
      important advantage over other indirect methods that are based on X-ray
      generation or elastic scattering measurements since these are applied to freeze
      dried specimens where differential shrinkage between compartments may produce
      errors. Precision and accuracy of the EELS method have been tested on
      cryosectioned solution of bovine serum albumin; data have also been obtained from
      cryosections of rapidly frozen erythrocytes. Results suggest that a precision of
      better than +/- 5% (s.d.) is attainable from a single measurement and the
      accuracy may be as high as +/- 2% if repeated measurements are made. The lateral
      spatial resolution of the water determinations is limited by radiation damage to
      approximately 100 nm which is of the same order as the specimen thickness.

PMID- 8367909
TI  - Effect of probe force on the resolution of atomic force microscopy of DNA.
AB  - Experimental results are presented to show that the adhesion force is the single
      most important limiting factor in high-resolution atomic force microscopy of DNA
      in air, prepared by the cytochrome-C-assisted spreading method. It is also shown
      that humidity plays a minor role in the control of probe force. Using a pure
      carbon film as the substrate to clean the AFM tip prior to imaging, it is
      demonstrated that 4-6 nm resolution on DNA can be routinely obtained by the
      atomic force microscope with commercial Si3N4 pyramid cantilevers. We also show
      that in organic solvents a resolution of up to 3 nm can be obtained under optimal
      conditions.

PMID- 8367910
TI  - [A low dosage pile, until menopause, will facilitate medical practice.. Interview
      by Robert Henry].

PMID- 8367911
TI  - [Back pain: a disabling disease, costly and demoralizing. Interview by Robert
      Henry].

PMID- 8367912
TI  - [A patient presenting with severe thrombocytopenia].

PMID- 8367913
TI  - [Acquired hyperostosis syndrome].

PMID- 8367914
TI  - [The limits of medicine and a life without limits].

PMID- 8367915
TI  - [Periodic medical examination. Update 1992. 2. Systematic screening using
      prenatal ultrasonography. The Canadian Study Group for Periodic Medical
      Examination].

PMID- 8367916
TI  - [Is extracorporeal membrane oxygenation necessary?].
AB  - In order to evaluate our hospital center needs for extracorporeal membrane
      oxygenation (ECMO), a retrospective study was carried out over a two-year-period
      to determine the mortality rates of infants < or = 35 weeks of gestation and > or
      = 2000 grams with severe respiratory failure. The data was obtained from a
      perinatal center that serves a population that has 50,000 newborn deliveries per
      year. During the period of the study there were 75 infants meeting the above
      criteria admitted to the NICU with severe respiratory failure (defined as need
      for mechanical ventilation and 100% O2). Forty-four patients were excluded
      because of improvement of their respiratory status on conventional therapy, and
      16 were ineligible for ECMO because of their primary diagnosis. Of the 15 infants
      considered ECMO candidates, there were 2 deaths as a result of streptococcal beta
      hemolytic septicemia. The result of this study showed that few infants in the
      population served by this perinatal center would have benefited from ECMO.

PMID- 8367918
TI  - [The possible relation between hepatitis B vaccination and chronic fatigue
      syndrome].

PMID- 8367917
TI  - [Hypothalamic astrocytoma presenting as obesity with hypogonadism].
AB  - We report herein a case of a 30 year old male patient who consulted for a long
      standing obesity since childhood. Clinical examination reveals the presence of
      hypogonadism and gynecomastia without galactorrhea. Endocrine assessment showed
      an hypogonadotrophic hypogonadism with a moderate insufficiency of the
      adrenocortical axis. Neuro-ophthalmological examination disclosed an inferior
      bitemporal quadranopsia. MRI showed an extra-axial suprasellar mass, lightly
      hypointense in T1 and hyperintense in T2. After craniotomy and conservative
      biopsy, pathological examination of the tumor showed regular cells surrounded
      with collagen and reticulin marked with immunoperoxidase against S100 protein and
      GFAP (glial fibrinolytic acidic protein) strongly suggesting the diagnosis of
      juvenile pilocytic astrocytoma.

PMID- 8367919
TI  - Questioning the value of screening for prostate cancer in asymptomatic men.

PMID- 8367920
TI  - Goserelin acetate and flutamide versus bilateral orchiectomy: a phase III EORTC
      trial (30853). EORTC GU Group and EORTC Data Center.
AB  - Maximal androgen blockade (MAB), the eradication of the effects of adrenal
      androgens on prostate cancer cells after castration, has been used with differing
      success in the treatment of prostatic carcinoma. The aim of this randomized phase
      III study was to compare the efficacy and side effects of bilateral orchiectomy
      versus a combination of a luteinizing hormone-releasing hormone agonist (LHRH-A)
      depot formulation, goserelin acetate (3.6 mg s.c. once every four weeks), and
      flutamide (250 mg three times daily), in patients with metastatic cancer.
      Treatment usually continued until disease progression (or for a minimum of three
      months). Efficacy was assessed by response, time to disease progression, and
      duration of survival. Clinical evaluations, standard laboratory tests, and
      imaging examinations were carried out regularly. A total of 327 patients were
      entered in this study. There was a difference in response only for prostatic acid
      phosphatase (PAP) with a more frequent decrease of the serum values to normal in
      the serum in patients assigned to MAB treatment. The MAB treatment, however,
      proved significantly better for time to subjective progression, time to objective
      progression, time to first (subjective and objective) progression, and duration
      of survival. The most frequent side effects for both treatments included hot
      flushes and gynecomastia. In conclusion, significant time to progression and
      survival benefits are achieved by adding flutamide to an LHRH-A regimen, probably
      improving the quality of life of patients with metastatic cancer.

PMID- 8367921
TI  - Anatomy of cavernous nerves distal to prostate: microdissection study in adult
      male cadavers.
AB  - Retrograde and antegrade dissections from the penile hilum to the prostatic area
      and the glans penis were performed in 4 formalin-preserved adult male cadavers.
      In addition to the medial branches accompanying the urethra, the lateral branches
      of the cavernous nerves pierced the urogenital diaphragm 4 to 7 mm from the
      striated muscles of the external sphincter. At the penile region, multiple
      communications between the cavernous and dorsal nerves were noted that suggest
      that either the cavernous nerves use the dorsal nerve as a carrier to the distal
      portion of the penis or the dorsal nerve may itself contain autonomic fibers.
      These findings will improve our ability to preserve erectile function during
      pelvic, urethral, and penile surgery.

PMID- 8367922
TI  - Silicone gel-filled testicular prosthesis and systemic disease.
AB  - Concerns exist regarding a possible link between the presence of silicone
      implants and the development of systemic disease. A retrospective review was
      carried out to determine whether or not a pattern of diseases could be found
      after the implantation of a testicular prosthesis. A specific pattern of diseases
      did not emerge in a group of 34 men harboring a scrotal silicone gel implant for
      a mean period of over five years. The findings, with a limited population and
      period of follow-up, are not conclusive but provide basis for reassurance to men
      about the health implications of their implants.

PMID- 8367924
TI  - Laparoscopic seromyotomy (auto-augmentation) for non-neurogenic neurogenic
      bladder in a child: initial case report.
AB  - An eight-year-old boy with lifelong urinary incontinence secondary to non
      neurogenic neurogenic bladder underwent successful laparoscopic seromyotomy (auto
      augmentation) with resultant cure of his incontinence. The ability to perform
      this laparoscopically with its seventy-minute operating time, decreased hospital
      stay, and improved cosmesis militates for its consideration before a standard
      augmentation is performed.

PMID- 8367923
TI  - Effect of obesity and fertility status on sex steroid levels in men.
AB  - Endocrine studies were performed on fertile and infertile obese men and compared
      with fertile and infertile nonobese men in order to determine the independent and
      codependent effects of obesity and fertility status on the male hypothalamic
      pituitary gonadal axis. The obese infertile group exhibited significant
      endocrinologic changes as compared with fertile nonobese control group which was
      not observed in any of the other three groups. Serum testosterone was
      significantly lower. The testosterone/estradiol ratio was significantly lower
      despite a lack of significant change in serum estradiol levels. Serum steroid
      hormone binding globulin (SHBG) was significantly lower which correlated with
      elevated bioavailability of both testosterone and estradiol in the obese
      infertile group. Serum luteinizing hormone levels were no different, suggesting
      that free testosterone levels were unchanged. Obese infertile men exhibit
      endocrinologic changes that are not observed in men with either obesity or
      infertility alone. Reduction of serum SHBG, total testosterone, and
      testosterone/estradiol ratio appear to be a marker of infertility among obese
      men.

PMID- 8367925
TI  - Pituitary gonadal dysfunction in adolescents with varicocele.
AB  - Gonadotropin-releasing hormone stimulation testing was performed on 104
      adolescent males with a unilateral left varicocele to determine the frequency of
      testicular dysfunction in this group of patients. An abnormal test result was
      noted in approximately 30 percent of varicocele patients. We believe that an
      abnormal test result indicates a higher risk for future fertility problems, and
      early treatment may reduce this risk.

PMID- 8367926
TI  - Formation of ileal conduit utilizing ileal patch from augmentation cystoplasty.

PMID- 8367927
TI  - Long-term follow-up of ventriculoureteral shunts for treatment of hydrocephalus.
AB  - Surgical relief of hydrocephalus is achieved mainly with ventriculoperitoneal or
      ventriculoatrial shunting. In some patients, frequent reoperations are required
      because of infection, obstruction, or other complications, thus subjecting them
      to excessive operative morbidity and risk of neurological damage. One option that
      has been rarely addressed in recent years is drainage of cerebral spinal fluid
      into the urinary tract by way of a ventriculoureteral shunt. Patients who have
      endured multiple revisions of standard cerebral spinal fluid shunts may benefit
      from a relatively lower frequency of reoperation following ventriculoureteral
      shunting. There are several complications peculiar to this procedure, however,
      including ascending infection from the bladder, proximal shunt migration out of
      the ureter or distal migration into the bladder, failed urinary diversion, and
      electrolyte disturbances associated with volume depletion. Long-term follow-up of
      patients with ventriculoureteral shunts has not been reported. We describe the
      course of 4 patients successfully treated with ventriculoureteral shunts for an
      average of more than five years per patient. Although all eventually required
      reoperation, the frequency of reoperation with the ventriculoureteral shunts was
      markedly lower than with the standard shunts in these patients.
      Ventriculoureteral shunting should be considered for cerebral spinal fluid
      drainage in selected patients with multiple failures of standard shunts, provided
      the bladder is a low pressure reservoir with no urine infection.

PMID- 8367928
TI  - Obturator neuropathy after laparoscopic pelvic lymphadenectomy.
AB  - A case of obturator nerve injury with delayed manifestation following
      laparoscopic pelvic lymphadenectomy is presented. While the incidence of
      obturator nerve injury does not appear to differ between open surgical and
      laparoscopic approaches, the laparoscopic approach demands unequivocal
      visualization of the nerve when utilizing electrocautery because of the risk of
      nerve injury from thermal conduction through apposed tissues.

PMID- 8367929
TI  - Laparoscopic gonadectomy in a case of testicular feminization.
AB  - Laparoscopy provides a minimally invasive technique for the accurate diagnosis of
      intersex problems and may also provide the opportunity for therapeutic management
      of these patients. Herein, we report our management of a patient with complete
      testicular feminization, by laparoscopic bilateral gonadectomy of fully developed
      intra-abdominal testes.

PMID- 8367930
TI  - Hemangioma of penis and scrotum.
AB  - Hemangiomas of the genitalia are extremely rare. A hemangioma is self-limited and
      usually resolves spontaneously, therefore conservative treatment is generally
      recommended. However, genital hemangiomas may require surgical treatment if they
      become symptomatic. Herein we report a case of hemangioma of the penis and
      scrotum requiring surgical excision. The natural history and alternative
      treatments of hemangiomas are described.

PMID- 8367931
TI  - Labial fusion causing upper urinary tract obstruction.
AB  - An infant with dense and nearly complete labial fusion had marked
      hydroureteronephrosis which resolved after incision of the adherent labia.
      Although this is an unusual consequence of labial fusion, it argues for upper
      urinary tract screening in these children.

PMID- 8367932
TI  - Ultrasound characteristics of renal cryosurgery.
AB  - The ability to visualize renal cryosurgery using ultrasound was tested in an
      animal model. Five dogs underwent open laparotomy and ultrasound-monitored
      cryosurgery of both kidneys. On each kidney two cryolesions were made. The
      borders of the frozen region were identified on ultrasound as a hyperechoic rim
      created by the interface between frozen and unfrozen tissue. The thawed
      cryolesion appeared hyperechoic compared with the unfrozen kidney. Excellent
      correlation between the ultrasound and autopsy measurements of the cryolesions
      was obtained. Knowing this, renal cryosurgery under ultrasound monitoring may be
      possible.

PMID- 8367933
TI  - Automated evaluation of urethral obstruction.
AB  - The measurement of detrusor pressure and flow rate during voiding is the only way
      to objectively measure or grade infravesical obstruction. The resulting data
      cannot be interpreted easily. Manual as well as automatic methods have been
      introduced to derive one or several factors or parameters to quantify urethral
      resistance. A number of these methods are described in this overview. Since
      automatic methods involving computers guarantee uniform, unbiased, and objective
      processing of data, besides enabling the use of (statistical) methods that take
      into account more than one or two of the measured pressure and flow rate values,
      emphasis is on these methods. Some clinical results obtained with such automatic
      methods are discussed to illustrate the clinical value and possible impact on
      diagnosis and evaluation of treatment of lower urinary tract disorders.

PMID- 8367934
TI  - Detrusor instability in primary enuresis.

PMID- 8367935
TI  - Various protein and albumin corrections of the serum fructosamine concentration
      in the diagnosis of canine diabetes mellitus.
AB  - Fructosamines are formed when glucose reacts non-enzymatically with amino groups
      on proteins, and previous studies have indicated that the serum fructosamine
      concentration could be of importance in the diagnosis of canine diabetes
      mellitus. Owing to the connection between the protein/albumin concentration and
      serum fructosamine concentration, it has been suggested that the serum
      fructosamine concentration should be corrected for the protein/albumin
      concentration. Thus, the purpose of the present study was to evaluate the
      uncorrected serum fructosamine concentration and various protein and albumin
      corrections of the serum fructosamine concentration in the separation of dogs
      with diabetes mellitus from dogs with other diseases that presented with clinical
      signs suggestive of diabetes mellitus. The evaluation was assisted by relative
      operating characteristic curves (ROC curves), which may be used to compare
      various diagnostic tests under equivalent conditions (equal true positive ratios
      or false positive ratios) and over the entire range of cutoff values. A total of
      58 dogs (15 dogs with diabetes mellitus and 43 dogs with other diseases) were
      included in the study. Serum fructosamine concentration, serum total protein
      concentration and serum albumin concentration were measured in each dog, and
      various corrections of the serum fructosamine concentration for protein or
      albumin concentration were made. Comparing the ROC curves of the uncorrected and
      each corrected serum fructosamine concentration indicated that there was no
      decisive difference between the uncorrected and the corrected serum fructosamine
      concentrations in discriminating between dogs with and without diabetes mellitus.
      Hence, correcting the serum fructosamine concentration as a routine procedure
      cannot be advocated from the results of the study. Moreover, the sensitivity and
      specificity of the uncorrected serum fructosamine concentration were very high,
      0.93 and 0.95, respectively, further evidence of the value of the uncorrected
      serum fructosamine concentration in the diagnosis of canine diabetes mellitus.

PMID- 8367936
TI  - Systemic responses to challenge infection with Haemonchus contortus in immune
      Merino sheep.
AB  - Some systemic responses to single-dose infection with 10,000 Haemonchus contortus
      infective larvae were examined in sheep already shown to have protective immunity
      against the parasite. The major haematological finding was a neutrophil
      leukocytosis that occurred after the infections became patent but not during the
      pre-patent period. There was no definitive eosinophilia and no discernible change
      in the erythrocyte parameters. Systemic hyperthermia was not conclusively evident
      during the pre-patent period. Enzyme-linked-immunosorbent assays (ELISA) were
      used to measure the secondary anti-helminth antibody response in serum during the
      pre-patent period when the establishment of patent infection is resisted. These
      ELISAs employed preparations from adult worms to represent the parasitic stages
      of the worm, preparations from infective larvae to represent the pre-parasitic
      stages of the worm, and exsheathing fluid, which is the soluble material obtained
      when H. contortus larvae undergo ecdysis and transform from the pre-parasitic to
      the parasitic phase. Antibody responses to the three preparations differed
      qualitatively, indicating the presence of three different but perhaps overlapping
      sets of antigens. The three peaks in antibody against exsheathing fluid may
      reflect the pulses of antigen delivered to sheep as the parasite undergoes its
      three moults within the host.

PMID- 8367937
TI  - A standardized oral zinc tolerance test for assessment of zinc absorption in
      dogs.
AB  - Three oral zinc tolerance tests using increasing doses of elemental zinc (0.5,
      0.75 and 1.0 mg/kg) given as zinc sulphate (ZnSO4.7H2O) were carried out in eight
      normal beagles. The zinc tolerance curves obtained were similar to those
      described in man, with the peak plasma zinc concentration occurring 2 h after
      dosing. There was a considerable variation between individual animals in the peak
      plasma zinc concentration achieved with each dose. This would appear to limit the
      value of a zinc tolerance test in assessing the efficiency of zinc absorption in
      individuals, although it may be of value in making comparisons between groups of
      dogs.

PMID- 8367938
TI  - The effect of storage at low temperature on the haemolytic complement activity of
      chicken serum.

PMID- 8367939
TI  - Transient stray voltage: is it detrimental to growth performance, health status
      and welfare of market pigs?
AB  - The effects of transient stray voltage associated with an alternating current
      were evaluated in growing-finishing pigs from 9 to 22 weeks of age. Seventy-two
      pigs were assigned to 9 blocks of 8 animals each. In each block, the following
      treatments were randomly distributed: a constant voltage differential created
      between the feeder or drinker and the metallic floor (woven wire), at a level of
      0 volt plus 2-volt pulses (0 V-2 V), 2 volts plus 3-volt pulses (2 V-5 V), 5
      volts plus 3-volt pulses (5 V-8 V), and a control treatment without any voltage
      differential (0 V-0 V). The constant voltage was applied 24 h per day. The pulses
      of 3 s duration were in the form of an increase in the amplitude of the constant
      60-Hz signal. One pulse appeared every 20, 40 and 100 s during the hour following
      feed distribution and every 60, 120 and 300 s during the rest of the day. The
      animals were fed ad libitum and received fresh feed twice per day. Once during
      the 2-week periods at 9-10, 13-14, 17-18 and 21-22 weeks of age, the behaviour of
      the pigs was recorded during the hour following the two daily feed distributions.
      Animal weights and blood samples were taken every 2 weeks, from 9 to 21 weeks of
      age. No significant effect of transient stray voltage on any of the variables
      measured for the feeding, drinking, sitting or lying activities was found (p >
      0.05). At 9-10 weeks of age, the number of rooting bouts was higher for the 5 V-8
      V treatment (p = 0.03) and the number of events of butting the penmate was higher
      for the 2 V-5 V treatment (p = 0.05). Although the water and feed intake did not
      differ between treatments (p > or = 0.39), the average daily gain of the control
      group was lower than that of treated groups (p = 0.04) at 9 and 10 weeks of age,
      while the pigs submitted to a 2 V-5 V treatment had a higher daily gain than the
      pigs in the other treatment groups (p = 0.05) at 17 and 18 weeks of age.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8367940
TI  - Molecular cloning and sequencing of coat protein-encoding cDNA of rice tungro
      spherical virus--a plant picornavirus.
AB  - Rice tungro spherical virus (RTSV) was shown to have three coat protein (CP)
      species by high resolution NaDodSO4-PAGE and Western blot analyses. The sequence
      of a coat protein-expressing cDNA clone that was identified and selected from a
      RTSV cDNA library showed that the insert was composed of 2823 bp with only one
      large open reading frame (ORF) coding for 941 amino acids. The positions of the
      three coat proteins were located in the putative polyprotein by N-terminal
      microsequencing and were shown to start at amino acids 287, 495, and 698 for CP
      1, CP-2, and CP-3, respectively. The coat proteins are expressed as a polyprotein
      at the 5' region of the viral RNA genome, and all are cleaved at glutamine
      carboxy termini, presumably by picornavirus 3C-type of protease(s). Sequence
      comparisons of coat proteins revealed that there are high amino acid homologies
      between CP-2 of RTSV and VP3s of encephalomyocarditis virus (EMCV) and Theiler's
      murine encephalomyelitis virus (TMEV). These results indicate that RTSV is a
      plant picornavirus.

PMID- 8367941
TI  - Nucleotide sequence of the envelope protein gene of the tick-borne flavivirus,
      Kumlinge A52.
AB  - The envelope protein gene of the tick-borne flavivirus, Kumlinge A52, the proto
      type Finnish strain, has been amplified and sequenced.* The nucleotide and
      deduced amino acid sequence has been analyzed and compared with the closely
      related tick-borne encephalitis (TBE) virus, Western subtype, strain Neudoerfl,
      isolated in Austria. Although these two virus strains were isolated 12 years
      apart from different hosts and in different countries, the envelope proteins only
      differed by a single amino acid. It is likely, therefore, that strong selection
      pressures against antigenic variation exist. The possible reasons for this are
      discussed.

PMID- 8367942
TI  - Expression of the "helper component" protein of potato virus Y (PVY) in E. coli:
      possible involvement of a third protease.
AB  - Transmission of potyviruses by aphids depends on the presence of a virus encoded
      helper-component protein (HC) that also exhibits protease activity. HC was
      expressed in E. coli from two types of clones: a full-length cDNA clone of PVY
      and two 5' end clones containing the first three cistrons (3.6-3.7 kbp). The
      clones derived from the 5' end of PVY expressed HC of the size of the mature
      component. Other proteins reacting with antibodies to HC were also observed, and
      their sizes corresponded with those of expected intermediates resulting from
      partial protease cleavage of the three-cistron polyprotein. On the other hand,
      the only detectable HC-related product of the full-length clone was a mature-size
      HC. The presence of a third PVY protease among the first three cistrons is
      therefore suggested.

PMID- 8367943
TI  - [Reconstructive-restorative operations on the trachea].

PMID- 8367944
TI  - [Reconstructive operations on the coronary arteries in ischemic heart disease].
AB  - Direct reparative operations on coronary arteries were carried out in 18 patients
      with ischemic heart disease in order to revascularize the myocardium: auto
      pericardium plastics of right coronary artery; autogenous vein plastics of the
      opening and the trunk of left coronary artery; instrumental delactation of
      opening and the trunk of the left coronary artery; right coronary artery
      prosthesis and shunt-plastics of the front interventricular branch of the left
      and right coronary artery. The observation period was from 1 month to 5 years.
      The article shows the efficiency of direct reparative operations for prophylaxis
      of myocardial infarctions or sudden deaths. The operated patients also got rid of
      stenocardia and have acquired a more high tolerance for physical loads.

PMID- 8367945
TI  - [Angiography in a general military hospital].

PMID- 8367946
TI  - [The selection of patients in a therapeutic hospital for the surgical treatment
      of ischemic heart disease].

PMID- 8367947
TI  - [The clinico-functional results of aortocoronary bypass in patients with ischemic
      heart disease and their medical rehabilitation].
AB  - Using the materials of foreign researches the article provides data concerning
      the modern methods of rehabilitation of cardiological patients taking into
      account its efficiency for various age groups. Operation on heart itself is a
      psychological shock to the patient. It needs adequate psychological adaptation
      and corresponding medical care. 300 patients with ischemic heart disease were
      under the authors' observation after aortocoronary shunting (age 31-69). Clinical
      and functional results were studied after operation. The results of early and
      late loading tests were analysed. Indication for hypolipidemic therapy were
      determined. The article reports on the errors in determining the proof loads and
      limitations in the correction of myocardial insufficiency. The authors
      substantiate the possibilities towards prognostication of the course of ischemic
      heart disease after operation.

PMID- 8367948
TI  - [Changes in the central and peripheral hemodynamics of patients with acute
      peritonitis in the immediate postoperative period].
AB  - The article examines hemodynamic indices in patients with acute peritonitis in
      proximate preoperative period, taking into account etiology of the disease, a
      period passed from the appearance of illness and up to the performance of
      operation, and the scope of infusion-transfusion therapy. An algorithm of
      preoperative volemic preparation was worked out which made it possible to
      normalize hemodynamic homeostasis in patients and assure the performance of
      operation in more favourable physiologic conditions.

PMID- 8367949
TI  - [The use of echocardiography in examining patients with unstable stenocardia].
AB  - The report presents the results of EchoCG study in 81 patients with unstable
      stenocardia admitted in 6-24 hours from the onslaught pain. With the help of
      EchoCG the myocardial contractile function was defined and the segmental kinetics
      of left ventricular wall was registered with respect to four variants of unstable
      stenocardia courses: stenocardia occurred for the first time, progressive
      stenocardia, variational stenocardia and postmyocardial infarction stenocardia.
      During the EchoCG examination at the moment of anginal attack the significant
      increase in left ventricular end-diastolic volume and end-systolic volume and
      decrease of total ejection fraction were noted. Also, not infrequently the zones
      of dyskinesia are recorded indicative of ischemia of these segments, which
      commonly have transient character. With the progress of myocardial ischemia the
      abnormalities of left ventricular diastolic fraction appear which are determined
      with the help of Doppler-EchoCG. Thus, the use of EchoCG in diagnostics of
      patients with unstable stenocardia allows more reliably to define the degree of
      myocardial changes.

PMID- 8367950
TI  - [The potentials and outlook for rendering specialized medical care at the N. N.
      Burdenko Main Military Clinical Hospital. Interview by G. G. Piskunov].

PMID- 8367951
TI  - [Newly occurring stenocardia: the clinical picture, diagnosis, treatment and
      prognosis].
AB  - The article analyses the results of treatment of 77 patients with primarily
      emerged stenocardia. Three variants of clinical course of illness were
      distinguished: primarily emerged stenocardia at the state of exertion, primarily
      emerged progressive stenocardia at the state of exertion, primarily emerged
      stenocardia at rest state. As for primarily emerged stenocardia at the state of
      exertion, the changes at the final part of QRS complex were disclosed in 56% of
      patients, and abnormalities in the mobility of the left ventricle walls in 32%.
      The contractive function of left ventricle was unchanged. The myocardial
      infarction developed in 8% of patients in the course of one month, and in 4% in
      the course of one year. Stenocardia attacks disappeared in 16% of patients. As
      for primarily emerged progressive stenocardia, the ECG changes were marked in 74%
      of cases. The whole sphygmic fraction in 65% of patients was 55% lower. The
      myocardial infarction developed in 12% of patients in the course of one month and
      in 10.7% in more remote period. 52% of patients with the primarily emerged
      stenocardia at rest had ECG changes. In ECG daily monitoring 33% of patients had
      characteristic changes of coronary artery spasm. Myocardial infarction occurred
      in 8% of patients in the course of the first year. Stenocardia attacks
      disappeared in 25% of patients.

PMID- 8367952
TI  - [Thrombolytic therapy in acute myocardial infarct and pulmonary artery
      thromboembolism].

PMID- 8367953
TI  - [The efficacy of nitrate solutions in emergency states].

PMID- 8367955
TI  - [The clinical picture and treatment of local radiation lesions].
AB  - The article gathers a long-term experience in diagnosis and treatment of local
      radiation injuries in 205 patients, including patients with irradiations caused
      by accident situation. Relatively good results were obtained during the treatment
      of severe injuries.

PMID- 8367954
TI  - [The possibilities of using gastrotsepin in treating digestive organ diseases].

PMID- 8367956
TI  - [The early diagnosis of hypoglycemic states with an automatic electronic system].

PMID- 8367957
TI  - [The clinical aspects of the early convalescence period in patients who have had
      viral hepatitis].

PMID- 8367958
TI  - [A quarter of a century guarding the health of servicemen].

PMID- 8367959
TI  - [The 25th anniversary of the Podmoskov'e Central Military Rest Home].

PMID- 8367960
TI  - [The prognosis of the late results of vagotomy and dispensary care in patients
      with duodenal peptic ulcer].
AB  - The article studies the remote results of vagotomy in treatment of 212 servicemen
      with ulcer of duodenum. Laboratory, endoscopic, roentgenological, pH-metric,
      manometric, radioimmunological and morphological researches were used before and
      after operations. From the point of view of prognostication 30 important criteria
      were selected to forecast the results of vagometry, and also to determine the
      groups for control examination. These data made it possible to prognosticate the
      right outcomes of treatment in 84.7% of cases, and thus individualize the
      treatment and prophylaxis of the prior disease and postvagotomy syndromes
      reducing their frequency. In the results of these measures the cases of
      invalidity and disability retirement of servicemen were diminished.

PMID- 8367961
TI  - The medical assessment of impairment for legal purposes.

PMID- 8367962
TI  - Recent developments in low-cost screening and assessment of childhood
      disabilities in Jamaica. Part 2: Assessment.
AB  - This paper summarises the requirements and criteria for assessment of childhood
      disabilities. It reviews recent research carried out in Jamaica and outlines
      procedures for medical and psychological assessment used in the International
      Epidemiological Study of Childhood Disability as well as local experience in
      community-based rehabilitation. While the medical assessment procedures were
      considered to be validated, there is an urgent need for local research and
      development in psychological assessment. These approaches, while not perfect as
      yet, bring the possibility of local community capability closer. They will
      require changes in professional attitudes, training of health and educational
      personnel, and changes in the service systems, so that screening and assessment
      can be integrated into existing services. However, although this will obviate the
      need for new, specialised administrations, improved linkages and lines of
      referral will be necessary.

PMID- 8367963
TI  - The nature of interpersonal violence in Jamaica and its strain on the national
      health system.
AB  - A random prospective study of 640 victims (76.6% in the 15-39-year-old age group)
      of interpersonal violence (IPV) at the Kingston Public Hospital was conducted
      over three months. About 87.5% of the aggression on males and 74.5% on females
      was committed by males. However, there was more female/female than female/male
      violence. Weapons used ranged from guns to a variety of cooking wares, though
      knives were used most frequently (34.8%) for stabbing 48% of the victims. Head,
      neck and upper limb were the main sites of injury; only 13.4% of all the injured
      had complications, and 63% of these required hospitalization. Family members and
      acquaintances contributed to about 84% of the violence. Instinctive spontaneous
      aggression aimed at maiming the victim characterizes IPV in Jamaica. The Jamaican
      taxpayer bears 90-94% of the cost of managing trauma injuries. These costs should
      be recovered from the assailants, even in the form of blood donations and
      community service.

PMID- 8367965
TI  - Large loop excision of the transformation zone (LLETZ)--an alternative treatment
      for cervical intraepithelial neoplasia.
AB  - The technique of large loop excision of the transformation zone (LLETZ) as an
      alternative to destructive/ablative methods of treatment of cervical
      intraepithelial neoplasia (CIN) such as cryotherapy, laser vaporization and cone
      biopsy of uterine cervix is assessed. Forty-five patients underwent this
      procedure for either diagnostic or therapeutic reasons. It was well-tolerated,
      and minor bleeding occurred in 4.4% of patients. The quality of the histological
      specimen was excellent in all cases, only two showing evidence of charring
      artefacts. In 11 patients (24.4%), a more serious lesion was detected than that
      found at punch biopsy of the cervix. This method offers a cheaper and more
      effective alternative to laser vaporization and combines the benefits of the gold
      standard cone biopsy of the cervix with that of local ablative techniques.

PMID- 8367964
TI  - Changes in material resource levels in Jamaica's primary health care services
      between 1984 and 1991/1992.
AB  - Jamaica's primary health-care services have been in a process of development
      since the 1970s. In 1984, a large management study collected data on levels of
      material resources (basic facilities, utilities, furniture, equipment and
      supplies items). Since 1984, serious staff shortages have affected the services,
      and there have been economic constraints, as well as a major hurricane. In order
      to measure changes over subsequent years, data on material resources were again
      collected in 1991/1992, using the same sample of 65 types 2 and 3 health centres
      as in 1984. Data were collected by interview with health centre staff. Results,
      whilst showing various changes item-by-item, showed constancy or minor
      improvements overall in levels of resources. Type 2 health centres continued to
      have lower resource levels than type 3s, even though the methodology allowed for
      their different needs where appropriate. Staff members' opinions of condition and
      adequacy of resources had become more positive than before. It was concluded
      that, in terms of material resources, activities within the primary health-care
      sector have offset the adverse effects of the macro-environmental conditions
      affecting the health centres. This method of material resource monitoring has
      implications for quality assessment of health facilities in primary health-care.

PMID- 8367966
TI  - Surgery for post-hysterectomy vaginal prolapse.
AB  - Nine cases treated by surgery for post-hysterectomy vaginal prolapse are
      reviewed. The mean time between presentation and the antecedent hysterectomy was
      12.8 years. Two patients who had abdominal sacral colpopexy alone developed
      recurrence of prolapse. Additional culdoplasty and colposuspension improved the
      cure rate but prolonged the mean operating time. Restoration of vaginal anatomy
      and function is best achieved with the combined operation.

PMID- 8367967
TI  - Resistance to third-generation cephalosporins in Barbados.
AB  - Resistance to third-generation, or extended-spectrum, cephalosporins caused by
      induction of class I beta-lactamases has been reported rarely from developing
      countries. Seven isolates of cephalosporin-resistant Gram-negative rods were
      recovered recently from urine, burns and ulcers in the Queen Elizabeth Hospital,
      Barbados. The isolates were identified as Acinetobacter calcoaceticus (2),
      Citrobacter freundii (1), Enterobacter cloacae (1), Morganella morganii (1),
      Providencia stuartii (1) and Proteus sp. (1). Induction of beta-lactamase by
      cefoxitin was demonstrated, and minimal inhibitory concentrations (MIC) were
      determined by agar dilution. beta-lactamases were demonstrated by isoelectric
      focusing; the presence of chromosomal beta-lactamases was confirmed in at least
      three of the resistant isolates. The only antibiotics which were uniformly active
      against these resistant strains were imipenem and ciprofloxacin. These data
      confirm the existence of resistance to the third-generation cephalosporins in
      Barbados, and emphasise the necessity for continuous surveillance of resistance
      patterns in the Caribbean region.

PMID- 8367968
TI  - Analysis of pathogens isolated from urinary tract infections in Barbados.
AB  - The isolation of pathogens from urine specimens was surveyed during a six-month
      period when 1611 urine specimens were examined in the Public Health Laboratory,
      and 8769 were examined in the Microbiology Laboratory of the Queen Elizabeth
      Hospital. Significant growth (defined as > 10(4) organisms/ml urine) was detected
      in 393 (24.4%) of the urines cultured in the Public Health Laboratory and in 1218
      (13.9%) of urines cultured in the Queen Elizabeth Hospital. The overall isolation
      rate was 15.5%; Gram-negative bacilli comprised 72.8% of the isolates, Gram
      positive cocci 24.3% and yeasts 2.9%. Gram-negative bacilli were more commonly
      isolated from hospital patients, whereas Gram-positive cocci were relatively more
      common in community patients. The most common pathogens detected were coliforms
      (1233 isolates), streptococci (197) and coagulase-negative staphylococci (182);
      50% of all isolates were sensitive to amoxycillin, 68% to cephradine, 61% to co
      trimoxazole, 62% to nalidixic acid and 79% to nitrofurantoin. Anti-bacterial
      activity was detected in 130 (8%) of the urine specimens received in the Public
      Health Laboratory.

PMID- 8367970
TI  - Wiskott-Aldrich syndrome in a Jamaican.
AB  - A 3-week-old boy presented with severe thrombocytopenia and recurrent infections.
      He was subsequently found to have Wiskott-Aldrich Syndrome, a rare X-linked
      disorder. Splenectomy was performed and he died of post-splenectomy sepsis
      despite prophylactic antibiotic therapy. This is the first recorded case in the
      English-speaking Caribbean.

PMID- 8367969
TI  - Cushing's syndrome from topical glucocorticoids.
AB  - A case of Cushing's syndrome is described in a woman who self-treated psoriasis
      with a variety of potent topical glucocorticoids over 15 years. She was
      successfully weaned off corticosteroids and was treated with alternative anti
      psoriatic drugs. The disappearance, nine months later, of most features of
      Cushing's syndrome, and the normal suppression of cortisol in response to
      dexamethasone, excluded endogenous hypercorticolism. The apparent widespread
      availability across the counter of potent corticosteroids is a cause for concern.

PMID- 8367971
TI  - Co-existing leiomyoma and benign cystic teratoma of the ovary.
AB  - A case of benign cystic teratoma and a leiomyoma in the same ovary is described.
      The leiomyoma was confirmed by immunohistochemical methods. The occurrence of
      leiomyoma and a teratoma within the same ovary is very rare.

PMID- 8367973
TI  - Reversal of benzodiazepine sedation with flumazenil in a patient with tetanus.
AB  - A 54-year-old female patient admitted with a diagnosis of tetanus had her
      sedation reversed with an infusion of flumazenil. Flumazenil appears to be of use
      in reversal of sedation in patients with accumulation of benzodiazepine after
      prolonged administration.

PMID- 8367972
TI  - Necrotizing haemorrhagic colitis caused by resistant Shigella flexneri. Report of
      a case.
AB  - A case of fatal infection with Shigella flexneri is reported. The 19-year-old
      male patient who presented with fulminating haemorrhagic colitis died nine days
      after the onset of symptoms. The infecting strain of Shigella flexneri was
      resistant to multiple antimicrobial agents, including amoxycillin, co-trimoxazole
      and chloramphenicol.

PMID- 8367974
TI  - Tuberculosis occurrence in CAREC member-countries 1983-1992.

PMID- 8367975
TI  - Cerebrovascular risk factors in an elderly Austrian population: first year
      results of the Austrian Stroke Prevention Study (ASPS).
AB  - During the first year the Austrian Stroke Prevention Study enrolled 599
      volunteers without clinical signs or symptoms of cerebrovascular disease aged 50
      to 70 years. Study participants were randomly selected from the official register
      of the city of Graz. The rate of positive response was 26.9 percent. All subjects
      underwent an extensive risk factor screening with Duplex scanning of the carotid
      arteries obtained from a subset of 176 individuals. The prevalence of well
      documented cerebrovascular risk factors was 40.6% for arterial hypertension,
      35.4% for cardiac disease, 8.5% for diabetes mellitus und 3% for elevated
      haematocrit. The less well-documented cerebrovascular risk factors dyslipidemia,
      overweight, physical inactivity, hyperfibrinogenemia and smoking were noted in
      75%, 33.7%, 27.2%, 14.9% and 12.2% of subjects, respectively. Multiple well
      documented risk factors were noted in 23.7% of the examined volunteers. Multiple
      linear regression analysis revealed body mass index (p < 0.0001) and age (p <
      0.0001) as independent predictors of the frequency of well-documented risk
      factors observed in any individual. Atherosclerotic carotid disease occurred in
      61.9% of study participants investigated by Doppler sonography and was
      significantly associated with age (p < 0.00001), life-time tobacco consumption (p
      < 0.0001) and the concentration of apolipoprotein B (p < 0.05). This study
      demonstrates high prevalence rates of vascular risk factors in an elderly
      Austrian community. Implications for stroke prevention result from the
      conjunction of overweight and frequency of risk factors noted in any study
      participant, as well as from the relationship of carotid atherosclerosis to
      smoking and dyslipidemia.

PMID- 8367976
TI  - [Association between fibrinogen and blood sedimentation rate in combined
      extracorporal and fibrinogen reducing drug therapy].
AB  - Fibrinogen appears to play an important role in atherogenesis, whereby high
      levels of fibrinogen can lead to a disturbance of the haemorheologic pattern. To
      evaluate the association between fibrinogen and blood sedimentation rate (BSR) 40
      patients suffering from cerebral multi-infarct disease underwent a single heparin
      induced extracorporeal LDL < fibrinogen > precipitation (HELP). Subsequently they
      were randomly assigned to two groups, either receiving sustained-release
      bezafibrate 400 mg daily (n = 21) or placebo (n = 19) over a period of eight
      weeks. HELP led to a statistically significant reduction of fibrinogen (p <
      0.0001). At the end of the trial the difference between the bezafibrate group and
      the controls became significant (p < 0.05). The BSR strictly followed the course
      of fibrinogen, indicating a significant reduction after HELP (p < 0.0001 for both
      BSR values) and a difference between both groups at the end of the study (p <
      0.05 and p < 0.03, respectively). The correlation between fibrinogen and BSR
      remained significant during the whole trial.

PMID- 8367977
TI  - [Serologic detection of Helicobacter pylori antibodies after surgery for stomach
      and duodenal ulcer].
AB  - The occurrence of IgG antibodies to Helicobacter pylori was measured by means of
      ELISA in 175 patients who had undergone surgery for duodenal or gastric ulcer.
      There was a significant correlation between surgery with resection and the
      absence of IgG to Helicobacter pylori in about 80% of cases. In patients
      undergoing surgery without resection there was no influence of the surgical
      technique on the presence of Helicobacter pylori antibodies.

PMID- 8367978
TI  - [Epidemiologic development of AIDS in Austria].
AB  - AIDS statistics as released by the Austrian Health Authorities refer to the
      notification date of the disease, but not the time of diagnosis which is
      essential for descriptive analysis. We present for the first time data on the
      exact time of diagnosis of, and death from AIDS. Between 1981 and 1992 altogether
      899 AIDS cases were registered (747 men, 152 women), of whom 547 persons have
      already died (462 men, 85 women). At present there are 352 patients with AIDS in
      Austria (285 men, 67 women). The incidence, prevalence, and mortality rates of
      AIDS in Austria, both in absolute and relative (per 100,000 men/women 1990)
      figures are presented in a table.

PMID- 8367979
TI  - Evaluation of certain veterinary drug residues in food. Fortieth report of the
      Joint FAO/WHO Expert Committee on Food Additives.

PMID- 8367980
TI  - Health promotion in the workplace: alcohol and drug abuse. Report of a WHO Expert
      Committee.

PMID- 8367981
TI  - Calcium intake and osteoporosis.

PMID- 8367982
TI  - Monitoring calcium intake and absorption.

PMID- 8367983
TI  - Alcohol-induced bone disease.

PMID- 8367984
TI  - Fluoride and osteoporosis.

PMID- 8367985
TI  - [Brain sparing autoregulation of fetal circulation in HELLP syndrome-
      demonstrated by Doppler ultrasound findings].
AB  - In a case report of severe placental insufficiency in the HELLP-Syndrome with
      diastolic reverse flow in aorta and umbilical artery, the changes of flow in the
      renal artery and middle cerebral artery were demonstrated. A preferential
      perfusion of fetal brain at the expense of fetal kidneys was shown during fetal
      hypoxia.

PMID- 8367986
TI  - [Obstetric management of patients with HELLP syndrome].
AB  - The syndrome of haemolysis, elevated liver enzymes and low platelet count (HELLP
      Syndrome) is a severe form of preeclampsia and eclampsia. The clinical course is
      characterized by right upper quadrant and epigastric pain, hypertension,
      proteinuria and edema. Maternal and neonatal morbidity are high. The underlying
      cause for this pregnancy-related syndrome is still unclear. As soon as a reliable
      diagnosis is established handling of patients suffering from HELLP-Syndrome is
      ambivalent: Immediate termination of pregnancy, however, poses a problem at early
      gestational age. Therefore some authors have advocated a conservative management.
      At our department active management and delivery by Caesarean section as soon as
      possible has gained acceptance in the past 5 years. We report our experience with
      23 patients over a 12 year period, and with 4 patients from the intensive care
      unit (N = 27). Mean gestational age was 33.5 weeks (+/- 4.8) and the mean
      birthweight was 1922.5 g (+/- 971.5). 19 patients were delivered by Caesarean
      section. Most complications were based on a delayed delivery and subsequent
      deterioration of maternal condition. Reduction of the time interval between
      establishment of diagnosis and termination of pregnancy (1980-1985-3 days; 1986
      1992-12 hours) resulted in a better outcome. We recommend intensive laboratory
      screening and exact clinical examination since missed or delayed diagnosis as
      well as delayed delivery are life threatening for mother and child. Only prompt
      delivery yields an improvement of prognosis.

PMID- 8367987
TI  - [Detection of fetal urinary obstructions requiring therapy in routine prenatal
      ultrasound].
AB  - Routine ultrasound during pregnancy is also performed for the detection of fetal
      malformations. This retrospective study comprises 31 children treated for urinary
      tract infection within 19 months postnatally. The charts of the young patients
      were evaluated how often a dilatation of the upper urinary tract (more than 3 cm
      in diameter) was observed already during pregnancy. In 18 patients (58%) the
      dilatation was detected antenatally and was missed in 13 (42%). Reasons of the
      low sensitivity may include low technical standard of the sonographic equipment
      and limited skill of the investigators.

PMID- 8367988
TI  - [Uroflowmetry and ultrasound residual urine determination in pregnancy and post
      partum].
AB  - In order to estimate the influence of adaptational processes during pregnancy and
      post partum on micturition, uroflow-parameters (3) and residual urine were
      examined in 119 healthy women. Comparisons were made between women in the 1st,
      2nd and 3rd trimester of pregnancy, women who were between 1 and 5 days post
      partum and nonpregnant, fertile women. Compared with the control group the mean
      flow was significantly lower during the 2. and 3. trimester. Time taken to
      achieve maximum flow was significantly higher after spontaneous delivery compared
      with the control group. During pregnancy and after delivery an increase in flow
      time could be shown. During the 3rd trimester time taken to achieve maximum flow
      was noticeably higher than in the other groups. Both mean and maximum flow were
      lower during pregnancy and after spontaneous delivery than in the control group.
      Residual urine increased mainly during the 1. trimester and showed the highest
      value after delivery. As all the investigated differences stayed within the
      standardized values, uroflowmetric investigations and ultrasonic residual urine
      estimation during pregnancy and after delivery are only necessary if suspicious
      symptoms on the part of the urinary tract exist.

PMID- 8367989
TI  - [Histology of chorioamnionitis: relations to maternal and fetal infection
      parameters].
AB  - With regard to clinical diagnosis and prognosis, intrauterine infection continues
      to pose major problems for obstetricians. In recent years serum assay of CRP, an
      acute phase protein, has become firmly established in the obstetric management of
      premature rupture. We investigated the relationship between histologically
      confirmed chorioamnionitis and maternal and fetal inflammation parameters in 69
      patients on the basis of inflammation of the membranes, placenta and cord
      occurring in histomorphologic stages. Our results show the C-reactive protein to
      be a sensitive and specific indicator of chorioamnionitis and closely correlated
      with both the histologic stage and the severity of the chorioamnionitis. We
      therefore advocate adoption of the histologic result as the "gold standard" for
      evaluating subclinical and clinically manifest forms of intrauterine infection.

PMID- 8367990
TI  - [Reference values for plasma amino acids in the course of pregnancy].
AB  - Reference values for 26 plasma amino acids were determined by ion exchange
      chromatography in 29 healthy pregnant women (1st to 3rd trimenon). The results
      are given as P50 (P7-P93). In the course of pregnancy the concentrations of amino
      acids generally decrease. Threonine, however, shows a distinct, statistically
      significant increase. The interindividual concentration ranges are low and they
      show little change in the course of pregnancy. The data presented here are
      relevant for dietary treatment of metabolic disorders, e.g. maternal
      phenylketonuria in pregnants.

PMID- 8367991
TI  - [pH-metry in vivo--use in obstetrics].
AB  - A new equipment and technique in order to analyse the pH in vivo will be
      presented. The special rod-shaped probe contains an ISFET pH sensor. There is
      pointed out a wide field of applications in the obstetrics.

PMID- 8367992
TI  - [Health diagnosis and health counseling. Traditional risk factors are not in the
      foreground!].
AB  - This article reviews the bio-psycho-social factors of health stabilization and
      health rehabilitation. It is our aim to improve psychology's and general
      medicine's cooperation in these fields of research and practice. We, therefore,
      firstly concentrate on the psychosocial factors which improve health diagnosing
      and health education; we illustrate health education by selectively reviewing
      illness-related health trainings. Secondly, we discuss health counseling. Again,
      we concentrate on the improvement of general practitioner's health counseling. On
      the one hand, this improvement seems possible on the basis of individual bio
      psycho-social risk models. Individual bio-psycho-social risk models, on the other
      hand, only can serve as a basis for individual-centered interventions, but not
      for population-centered interventions. After reporting various case histories
      from different doctor-patient-interactions, we demonstrate the application of bio
      psycho-social risk models in the individual case. These applications in the
      general practitioner's office promise to be useful. Nevertheless, general
      medicine as well as psychology seem to have only minor interest in intensifying
      their cooperation.

PMID- 8367993
TI  - [Suicidality in thinking and experience of children and adolescents].
AB  - In researching the tendency to suicide among children and adolescents it is
      important to know what they think about the attitude towards suicide. The present
      article covers a survey taken of 465 male and female pupils on this subject. On
      the one hand it reveals some interesting differences in the results according to
      age groups and sex, but on the other hand thoughts of suicide expressed by the
      younger pupils questioned are not significantly lower than those expressed by
      older pupils. This result seems noteworthy because the rate of suicide in youths
      increases with age.

PMID- 8367994
TI  - [Legal discussion on euthanasia of severely ill patients from the medical
      viewpoint].
AB  - Demographic factors lead to rising numbers of old and very old people in our
      society. In connection with this development the numbers of the seriously ill and
      handicapped needing comprehensive care are growing. Society is not sufficiently
      prepared to meet these ethical and economical problems. In this situation
      consequentialistic utilitarism may contribute to the social acceptance of direct,
      active euthanasia. Three paradigmatic judicial cases are described. Medical
      aspects of recent discussions in the field of criminal law are given. The danger
      of the "bursting of the dam", i.e. the tolerance of killing incurably ill and old
      patients is stressed. Compassion, self-determination, and economical
      considerations can not be accepted as reasons for the killing of human beings.

PMID- 8367996
TI  - [Detection of meta-syndromes in configuration frequency analysis].
AB  - Metasyndromes are defined as combinations of two or more single syndromes. A
      statistical method for ascertaining their existence on the basis of observational
      data is given. This is an improvement over another technique previously presented
      in this journal.

PMID- 8367995
TI  - [What is therapeutic in psychotherapy? An empirical evaluation of assumptions of
      the "Generic model of psychotherapy"].
AB  - What is effectively therapeutic about psychotherapy? The generic of psychotherapy
      provides an empirically valid conceptual representation of psychotherapy process
      and outcome relationships that begins to answer this question. The aim of this
      study is an empirical investigation of patterns of process and outcome
      relationships. The data come from 18 single therapies (9 very successful and 9
      less successful therapies) of the Bernese Comparative Treatment Study (Grawe,
      Caspar & Ambuhl, 1990). First the variables of the generic model of psychotherapy
      are operationalized by different process and outcome measures. The statistical
      method of stepwise multiple hierarchical regression serves to prove a number of
      assumed relationships of the generic model. The findings reported here
      demonstrate the utility of the generic model for guiding exploratory
      psychotherapy research that aims to identify emerging patterns of relationships
      between process and outcome.

PMID- 8367997
TI  - [The architecture of the brain and the individuality of personality (formulating
      the problem)].
AB  - The article is concerned the problem of comparison of the individual
      psychophysiological characteristics (human personality) with structural
      peculiarities of human brain. The importance of such analysis of personal
      individuality is underlined. The author undertakes an attempt to consider some
      personal individuality in the light of the his postulated systemic principles of
      the brain structure-functional organization. The examples of possible comparison
      of the some human abilities with the structural signs of their brain have been
      done. These abilities can be obviously reflected in the different variations of
      the cortex and subcortical structures construction. The author premises his ideas
      to the following publication of the article-essay "The study of Lenin's brain".

PMID- 8367998
TI  - [Academician Aleksandr Mikhailovich Ugolev. The development of his scientific
      ideas].
AB  - The science suffered a severe loss with the sudden death in November 2, 1991, of
      and outstanding physiologist Academician Alexander Mikhailovich Ugolev at the age
      of 66. All life of this man was devoted to the development of the national
      science. It was the aim and meaning of his life, he has contributed to scientific
      progress in every possible way. The major scientific interests of A. M. Ugolev
      were focused on the basic and applied areas of food assimilation, including the
      physiology of nutrition and digestion. The works of the scientist in this field
      of knowledge were world-wide recognized. During his scientific activity Dr.
      Ugolev conducted a number of brilliant studies which remained unforgettable trace
      in physiology and for ever will be a part of golden fund of science. This was
      promoted by a unique combination of his illustrious abilities of physiologist and
      general biologist as well as evolutionist with the gift of experimenter and
      excellent surgeon. His experimental skill can serve and example of an elegant
      combination of bold intentions and their masterly realizations. But the most
      remarkable and world-wide recognized discovery of the scientist was that of
      membrane digestion--previously unknown mechanism of food assimilation. Just this
      basic discovery is emphasized in the review devoted to the memory of
      unforgettable master. The fragmentariness of material depends on a desire to
      present concisely the major characteristics of membrane digestion.

PMID- 8367999
TI  - [The study of V. I. Lenin's brain].
AB  - The investigation of V. I. Lenin's brain was carried out on the basis of study of
      1108 cytoarchitectonical slices (thickness of 20 mu), stained by Kresil-Violett
      (Nissl's method) and 558 slices of fibres stained by Geidenhain's method. This is
      the first in the history of science detailed microscopical study of the man
      brain, initiated to creation of russian architectonics (as a science of the brain
      architecture); this study was served for a foundation of structural basis of
      science on the brain individual variability of different people including
      prominent persons. The results of this study is compared with a data of the later
      macroscopic and microscopic investigation of many persons brain with different
      professions and abilities. The next peculiarities of the Lenin's brain have been
      written: 1. The relief complexity and peculiarities of sulci and gyri
      configuration, especially in frontal lobe. 2. The big percentage of the cortex in
      a deep of the sulci (so called intrasulcal component), and as a result of the
      increasing of the summarised size of the cortex cerebri. 3. The riches and
      pronunciation of s.c. limitrophic adaptation's zones between different areas,
      especially in the frontal lobe and in the other associative cortical structures.
      4. The originality in relation in size between area in one region and regarding
      to the whole cortex surface. The prevail of the size and variability of
      phylogenetically new (associative) regions, especially of frontal one (which
      takes part in the function of situation estimation, prognostication,
      generalization) and also of parietal and temporal cortex; the phylogenetically
      old zone are more stable. 5. The large number of the especially big pyramidal
      neurons in sublayer III (III(3)), that can be supposedly looked as a structural
      basis of the rich associative connections between different cortical regions. The
      above mentioned peculiarities have been done as a result of the study chiefly of
      the right brain hemisphere because the left one was seriously suffered as a
      result of the vessels damage of atherosclerosis origin.

PMID- 8368000
TI  - [The systems organization of behavior: novelty as the leading factor in the
      expression of early genes in the brain during learning].
AB  - The paper deals with the analysis of the systemic mechanisms underlying
      behavioral activation of the family of "Immediate Early Genes" in the animal
      brain. These genes are the first element of genetic mechanism that starts in the
      cells the long-term rearrangements of transcription in response to different
      extracellular effects. Previously it was shown that this mechanism is involved in
      the processes of initiation of the cell growth and differentiation. The
      experimental findings of this paper demonstrated that the induction of "Immediate
      Early Genes" genes c-fos, c-jun and zif/286 occurs in the nervous system of
      various animal species in the situations of learning and environmental novelty.
      Activation of "Immediate Early Genes" expression is noted in the nerve cells of
      the numerous structures of the brain and is of systemic character. Housing of the
      animals in usual living conditions and using by them previously acquired habits
      do not result in an increased expression of these genes. On the basis of the
      analysis of behavioral conditions of the activation of "Immediate Early Genes" it
      is supposed that the critical factor of firing this genetic mechanism is a
      subjective "novelty" of behavioral situations for animal, i. e., initiation of
      mismatch of the behaviour with the acceptors of the results of an effect of the
      early formed functional systems.

PMID- 8368001
TI  - [Peptidergic mechanisms in the parasympathetic regulation of the heart rate].
AB  - Besides the classic cholinergic and adrenergic mechanisms, the regulatory
      peptides involve in regulating the cardiac rhythm. The localization of the latter
      in neurons of intracardiac nervous system as well as the possibility of releasing
      the regulatory peptides, individually or in combination with the classic
      mediators, during extracardiac nerves is found. The regulatory peptides are
      capable of affecting the heart autonomy directly or in a mediated way via
      modulation of the vegetative effects. The paper contains data on the cardiotropic
      activity of various peptides and direction of their effects relating to
      parasympathetic control a cardiac rhythm. There is a suggestion concerning an
      existence of different ways of realization of peptidergic vagotropic effect that
      presupposes not only variation of severity of parasympathetic chronotropic effect
      but also a change in its functional organization.

PMID- 8368002
TI  - [The current problems of studying the systems morphophysiological mechanisms of
      animal growth].
AB  - The study of general physiological mechanisms of the growth in highly important
      for the substantiation of the general strategy and the choice of practical
      methods of animal growth regulation. A shortcoming of many phenomenological
      growth theories lie in the fact that they don't take into consideration the key
      role of the processes of cellular proliferation and of histo and organogenesis.
      On the basis of bibliographic and original experimental data a morphofunctional
      conception of growth is considered. It is supposed that the main links in body
      growth are the processes of cartilaginous cells division in zones of longitudinal
      bone growth and of muscle fibers nuclei reproduction. The use of simulation
      models for study of dynamics of correlation in the system of organs and tissues
      development is argued.

PMID- 8368003
TI  - How many yeast genes code for membrane-spanning proteins?

PMID- 8368004
TI  - Molecular characterization of the SEC1 gene of Saccharomyces cerevisiae:
      subcellular distribution of a protein required for yeast protein secretion.
AB  - Strains of Saccharomyces cerevisiae harbouring temperature-sensitive mutations in
      the SEC1 and SEC5 genes exhibit an accumulation of post-Golgi secretory vesicles
      at 37 degrees C. We have cloned a fragment of yeast DNA which carries two
      distinct genes, one of which complements a sec1 mutation, and the other a sec5
      mutation. Genetic test confirm that the sec1-complementing gene is indeed SEC1,
      and is essential for cell growth. Nucleotide sequence analysis reveals that the
      cloned SEC1 gene is the same as a previously sequenced sec1-complementing gene.
      The SEC1 sequence encodes a protein of 724 amino acids with a predicted molecular
      mass of 83 kDa. Antibodies purified from a polyclonal antiserum raised against
      the protein product of the cloned gene recognize a yeast protein of apparent
      molecular mass 78 kDa which is found in a detergent-resistant association with a
      rapidly sedimenting yeast subcellular fraction, behaviour which is suggestive of
      an interaction with a component of the yeast cytoskeleton.

PMID- 8368005
TI  - Vectors for the inducible overexpression of glutathione S-transferase fusion
      proteins in yeast.
AB  - A rapid and convenient method of protein purification involves creating a fusion
      protein with glutathione S-transferase (GST) (Smith and Johnson, Gene 67, 31-40,
      1988). In this report, we describe two vectors for the conditional expression of
      GST fusions in Saccharomyces cerevisiae. The parent plasmid is based on a high
      copy, galactose-inducible shuttle vector previously described (Baldari et al.,
      EMBO J. 6, 229-243, 1987). We have demonstrated the use of this system by
      creating fusions between GST and the yeast RAS2 gene. GST-Ras2 fusion proteins
      undergo the post-translational modifications required for Ras2p to become
      membrane localized. These vectors provide a useful system for the expression and
      purification of eukaryotic proteins requiring post-translational modification.

PMID- 8368006
TI  - Isolation of single yeast cells by optical trapping.
AB  - Individual yeast cells can be successfully isolated and recultured on plates with
      a new isolation method making use of optical trapping with infrared laser light.
      The cells can be selected on morphological criteria by high resolution
      microscopy. The isolation device is constructed from two coverslips separated by
      spacers, in which selected cells are transferred to a plastic capillary, using
      the optical trap. To test the procedure, selection experiments were done with a
      mixture of two Saccharomyces cerevisiae strains, distinguishable both in
      fluorescence microscopy and on agar plates. These experiments showed that only
      selected cells were isolated, and close to 100% of the isolated stationary-phase
      cells formed colonies on agar plates, indicating a high recovery. A lower
      recovery was obtained with exponential-phase cells, possibly because of a higher
      sensitivity to laser irradiation. Applications for this method may include the
      isolation of mutants with altered morphology and the isolation of subpopulations
      of yeast cultures, for their separate investigation or for the initiation of pure
      cultures.

PMID- 8368007
TI  - The in vitro permeability of yeast peroxisomal membranes is caused by a 31 kDa
      integral membrane protein.
AB  - A major 31 kDa integral peroxisomal membrane protein (PMP31) of Hansenula
      polymorpha was purified to homogeneity from isolated peroxisomal membranes by
      FPLC after solubilization by Triton X-100. Biochemical analysis indicated that
      this protein, which showed cross-reactivity with antibodies against the 31 kDa
      porin of the mitochondrial outer membrane of Saccharomyces cerevisiae, had pore
      forming properties. Firstly, proteoliposomes composed of asolectin and purified
      PMP31 showed selective permeability, determined as the [14C]sucrose/[3H]dextran
      leakage ratios. Furthermore, the generation of a delta psi by potassium diffusion
      gradients was negatively affected by the presence of PMP31 in asolectin
      liposomes. A similar effect was observed in proteoliposomes containing purified
      cytochrome c oxidase as a delta psi generating system. Control experiments
      confirmed that the observed leakage is significant and introduced by the
      incorporation of PMP31 protein. Selective sucrose leakage was abolished in
      samples pretreated with glutaraldehyde; an identical effect of glutaraldehyde
      was, however, not observed for the membrane potential measurements.

PMID- 8368008
TI  - A comparative study on the transport of L(-)malic acid and other short-chain
      carboxylic acids in the yeast Candida utilis: evidence for a general organic acid
      permease.
AB  - Cells of the yeast Candida utilis grown in medium with short-chain mono-, di- or
      tricarboxylic acids transported L(-)malic acid by two transport systems at pH
      3.0. Results indicate that probably a proton symport for the ionized form of the
      acid and a facilitated diffusion for the undissociated form were present.
      Dicarboxylic acids such as succinic, fumaric, oxaloacetic and alpha-ketoglutaric
      acids were competitive inhibitors of the malic acid for the high-affinity system,
      suggesting that these acids used the same transport system. In turn, competitive
      inhibition uptake studies of labelled carboxylic acid in the low-affinity range
      indicated that this system was non-specific and able to accept not only
      carboxylic (mono-, di- or tri-) acids but also some amino acids. Additionally,
      under the same growth conditions, C. utilis produced two mediated transport
      systems for lactic acid: a proton symport for the anionic form which appeared to
      be a common monocarboxylate carrier and a facilitated diffusion system for the
      undissociated acid displaying a substrate specificity similar to that observed
      for the low-affinity dicarboxylic acid transport. The mediated carboxylic acid
      transport systems were inducible and subjected to repression by glucose. In
      glucose-grown cells the undissociated dicarboxylic acids entered the cells slowly
      by simple diffusion. Repressed glucose-grown cells were only able to produce both
      transport systems if an inducer, at low concentration (0.5%, w/v), was present
      during starvation in buffer. This process was inhibited by the presence of
      cycloheximide indicating that induction requires de novo protein synthesis. If a
      higher acid concentration was used, only the low-affinity transport system was
      detectable, showing that the high-affinity system was also repressed by high
      concentrations of the inducer.

PMID- 8368009
TI  - TA-repeat microsatellites are closely associated with ARS consensus sequences in
      yeast chromosome III.
AB  - Microsatellites are repeats of very short sequences of DNA, interspersed in the
      genome. In this paper, the occurrence of the two-base repeat microsatellites has
      been investigated in the DNA sequence of yeast chromosome III. Only AT-repeats
      were found at a significantly high frequency. Some of the regions with the
      highest concentration of AT-repeats were located and further analysed, showing a
      close association with the core consensus of autonomously replicating sequences.

PMID- 8368010
TI  - Different signals control the activation of glycolysis in the yeast Saccharomyces
      cerevisiae.
AB  - The glycolytic pathway in Saccharomyces cerevisiae is activated by fermentable
      sugars at several steps. Mutants with deletions of genes coding for enzymes of
      the upper part of glycolysis were used to characterize the triggering mechanisms.
      Synthesis of fructose-2,6-bisphophate is catalysed by two 6-phosphofructo-2
      kinase isoenzymes, one of which is activated by fermentable sugars while
      synthesis of the second enzyme is induced (Kretschmer and Fraenkel, 1991).
      Increase in the level of fructose-2,6-bisphosphate is demonstrated to depend on
      an internal metabolite upstream of the phosphoglucose isomerase reaction. The
      signalling process correlates with distinct temporal changes in the concentration
      of glucose-6-phosphate but not with its absolute level, indicating an
      adaptational mechanism. It is independent of the uptake and phosphorylation
      systems used by different sugars. Interestingly, this increase, although delayed,
      could also be observed in strains lacking the rapid cAMP increase after sugar
      addition which is thought to be responsible for the activating process. Synthesis
      of glucose-6-P and fructose-6-P is needed for the complete induction of pyruvate
      kinase and inactivation of fructose-1,6-bisphosphatase. On the other hand,
      induction of pyruvate decarboxylase depends mainly on a signal in the lower part
      of glycolysis.

PMID- 8368011
TI  - Cloning and sequencing of the Saccharomyces cerevisiae gene LYP1 coding for a
      lysine-specific permease.
AB  - The LYP1 gene of Saccharomyces cerevisiae was cloned by complementation in lysine
      permease-deficient recipient yeast cells, and its nucleotide sequence was
      determined. An open reading frame of 1833 nucleotides was found encoding a
      polypeptide of 611 amino acids, with a calculated molecular weight of 68 118.
      Analysis of the deduced primary structure of the protein revealed ten membrane
      spanning regions and three potential N-glycosylation sites. Analysis of the
      deduced sequence of protein LYP1 indicates homology with other yeast amino-acid
      permeases, in particular with CAN1, and also the lysine-specific permease of
      Escherichia coli. The strain transformed by a multi-copy plasmid harbouring the
      LYP1 gene, showed a 20-fold increase in the maximum velocity of lysine uptake
      over that in the wild type, with no changes in the affinity of the permease for
      its substrate.

PMID- 8368012
TI  - Vector YFRp1 allows transformant selection in Saccharomyces cerevisiae via
      resistance to formaldehyde.
AB  - Formaldehyde (FA), a chemical with low toxic potential, is used as sole selective
      agent for transformation in the yeast Saccharomyces cerevisiae. Neither stable
      auxotrophic markers in recipient cells nor defined synthetic media are needed
      when multicopy vector YFRp1, containing the yeast SFA gene, is employed for yeast
      transformation. The SFA gene gives stability to the vector and its yeast (and
      other) passenger genes when transformants are propagated in complex media
      supplemented with 3-5 mM-FA. Use of inexpensive FA and non-synthetic, undefined
      media will lower the cost of yeast transformant propagation considerably and thus
      make feasible large-volume industrial application of transformants containing
      YFRp1 derivatives.

PMID- 8368013
TI  - Regulation of glycolytic enzymes and the Crabtree effect in galactose-limited
      continuous cultures of Saccharomyces cerevisiae.
AB  - In order to determine whether the changes in the activities and mRNA levels of
      enzymes involved in intermediary carbon metabolism previously observed in glucose
      limited continuous cultures (Sierkstra et al., 1992a) were glucose specific, we
      have analysed their regulation in a galactose-limited continuous culture of
      Saccharomyces cerevisiae. The Vmax of the galactose uptake system was shown to be
      dilution rate (D) dependent, comparable with the high-affinity glucose uptake.
      The maximum uptake was observed at D 0.2 h-1 (0.25 mmol min-1 per g) and the
      minimum uptake (0.1 mmol min-1 per g) at D 0.05 h-1 and 0.3 h-1. The aerobic
      fermentation of galactose occurred at D 0.275-0.3 h-1 which is identical to the
      results obtained in glucose-limited continuous cultures of this strain. Because
      galactose is not a repressing carbon source, this demonstrates that the Crabtree
      effect is not mediated by, or in any way related to glucose repression. Moreover,
      invertase and hexokinase I mRNA levels (both subject to glucose repression at the
      transcriptional level) were present when the yeast produced ethanol in galactose-
      and glucose-limited continuous cultures. In glucose-limited continuous cultures a
      decrease in alcohol dehydrogenase (I and II) mRNA levels and activity and
      phosphoglucomutase activity was observed with increasing dilution rates. In
      addition, at D 0.3 h-1, when the yeast produced ethanol, glucose-6-phosphate
      dehydrogenase and pyruvate decarboxylase were induced and a decrease in
      respiration was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368015
TI  - Current awareness on yeast.

PMID- 8368014
TI  - A 12.8 kb segment, on the right arm of chromosome II from Saccharomyces
      cerevisiae including part of the DUR1,2 gene, contains five putative new genes.
AB  - A 12,820 bp fragment from the right arm of chromosome II of Saccharomyces
      cerevisiae was sequenced and analysed. This fragment contains six non-overlapping
      long open reading frames (ORFs) designated from the centromere- to the telomere
      proximal ends as: YBR1441, 1443, 1444, 1445, 1446 and 1448. YBR1441 encodes a
      polypeptide of 845 amino acids which shares a long consensus domain with products
      of S. cerevisiae MCM2, MCM3, CDC46 and Schizosaccharomyces pombe cdc21+ genes.
      These genes are involved in DNA replication. YBR1445 encodes a polypeptide of 404
      amino acids which has strong similarity with the S. cerevisiae KRE2/MNT1, YUR1,
      KTR1 gene products. The KRE2/MNT1 protein is an alpha-1,2- mannosyltransferase.
      The product of YBR1444, which encodes a protein of 375 amino acids, presents a
      lipase signature sequence and a peroxisomal targeting signal. YBR1448, whose
      sequence extends further on the telomere-proximal end of the fragment, is
      identical to the 3' end of the DUR1,2 gene encoding urea amidolyase. The two
      ORFs, YBR1443 and YBR1446, exhibit no significant similarity with any known gene.

PMID- 8368016
TI  - [Therapy of rheumatoid arthritis with azathioprine--results of an open long-term
      study of at least 4 years with 528 patients].
AB  - In an open study 528 patients affected with rheumatoid-arthritis were treated
      with azathioprine, then observed for a period of at least 4 years and assessed
      according to Steinbrocker's therapeutic criteria. In 178 of them (33.7%) the
      therapy was still effective even after that time, which corresponds to grade I
      and II according to Steinbrocker. The therapy was cancelled in 211 patients due
      to ineffectiveness and in 85 patients due to side-effects. The side-effects are
      represented in detail. Owing to the favorable relationship between benefit and
      risk, azathioprine proves to be a means of first choice in all cases with a high
      process activity and an unfavorable prognosis.

PMID- 8368017
TI  - [Follow-up of rheumatoid arthritis beginning in advanced age].
AB  - Two cohorts of 125 patients each, with different onset of disease (group A =
      before the age of 55, group B = after the age of 54) were selected from a total
      of 1000 patients with definite rheumatoid arthritis (RA). Both groups were
      identical with regard to gender (women = 71%) and duration of disease (mean = 7
      years). Mean age was in group A = 47, in group B = 68 years, respectively. When
      compared, in both samples no significant differences were found with regard to
      acuity of onset, to occurrence and duration of a period with nonspecific
      complaints prior to synovitis and to incidence of remissions and fever. However,
      in the elderly onset group progression of disease was significantly higher, the
      functional status poorer, dynamometer values lower, and the frequency of systemic
      signs higher. Furthermore, in the late onset group were more rarely reported
      regular exercise programs, other rehabilitative measures, treatment with gold
      preparations, and joint surgery. These features seem to indicate that age at
      onset has a modifying effect on disease expression in RA. One factor of
      influence, among others, is likely to be the generally decreased functional level
      in higher age. Late onset RA is not thought to be a separate entity of the
      disease.

PMID- 8368019
TI  - [Disorders of proprioception of the arthrotic knee joint].
AB  - We measured proprioception of the knee joint by an active and a passive method in
      40 subjects under 30 years of age and in 80 subjects older than 50 years with no
      evidence of knee joint disease. Joint position sense was also determined in an
      additional 59 patients with osteoarthrosis of the knee. Proprioception was found
      to decline with increasing age. In the osteoarthritic knee the measured values
      were significantly higher than in both groups without knee-joint involvement. An
      elastic bandage had a positive effect. There was a positive correlation between
      proprioception and clinical parameters. Walking ability and range of motion did
      not significantly influence the proprioception. Patients receiving physical
      therapy showed an improved joint position sense.

PMID- 8368018
TI  - [Chronic recurrent polychondritis].
AB  - Relapsing polychondritis (RP) is a recurrent, chronic und rare disease of unknown
      etiology, characterized by inflammation of cartilaginous structures of the ears,
      nose, respiratory tract and joints. The association with HLA-DR4 and the
      occurrence of antibodies to type-II collagen and other autoantibodies suggest
      that an immunologic mechanism is involved in its pathogenesis. In about 30% of
      occurrences RP is associated with other rheumatic or autoimmune diseases. Ocular
      inflammation, involvement of the cardiovascular system, skin, central nervous
      system and audiovestibular organ are most probably caused by vasculitis. The
      course of RP is variable. Severity and outcome primarily depend on the occurrence
      of associated autoimmune diseases and vasculitis. According to the activity and
      systemic manifestations, medical treatment includes nonsteroidal antiinflammatory
      drugs, corticosteroids and cytotoxic agents.

PMID- 8368020
TI  - [Ultrasound study of the elbow joint in patients with chronic inflammatory joint
      diseases--an enrichment of diagnosis?].
AB  - After clinical and radiological examination, the elbows of 74 patients with
      rheumatoid arthritis were examined by ultrasound. Clinical examination gives a
      good impression of the inflammatory changes of the elbow joint. Sonography was
      very useful in detecting synovitis and joint effusion and their distribution in
      the different parts of the joint. It is a good method to document the therapeutic
      effects; therefore, beside the clinical and radiological findings ultrasound may
      be helpful in planning further therapeutic measures for the patient.

PMID- 8368021
TI  - [Clinical use of magnification radiography in rheumatologic differential
      diagnosis].
AB  - Rheumatologic joint disorders were examined with high-definition microfocal
      magnification radiography. The magnification technique was compared to
      conventional radiographs (mammographic film-screen combinations). The microfocal
      x-ray unit had a spot size of 20-130 microns. Fourty patients with early
      arthritis (history of less than 18 months) were examined; x5 magnification was
      used. Digital luminescence radiography was employed to minimize radiation dose.
      Digital image processing included simulation of conventional technique and edge
      enhancement. Magnification radiographs and conventional technique were evaluated.
      In 20/40 patients articular lesions were detected. Magnification radiography gave
      additional information in 14/20 patients: in 5/14 patients lesions were seen only
      with magnification radiography (erosions n = 3, loss of the cortical white line n
      = 2), in 9/14 patients the extent of the lesions could be evaluated better.
      Hence, magnification radiography proved a valuable mean in early diagnosing and
      evaluating rheumatic disease.

PMID- 8368022
TI  - [Possibilities and relevance of three-dimensional reconstruction of the
      sacroiliac joint].
AB  - The sacroiliacal joint is difficult to evaluate clinically due to its complex
      form and its topographical position, deep in the body and surrounded by other
      skeletal structures. We evaluated the potential role of three-dimensional
      reconstruction and segmentation of CT data of this joint. A total of five
      patients were examined (age range 24-60 years). In three of these only surface
      reconstructions were obtained; in the other two, segmentation was obtained as
      well in order to directly visualize the joints surfaces of the sacroiliacal
      joint. Compared to conventional radiographs and standard CT, three-dimensional
      reconstruction and segmentation of the sacroiliac joint did not add significant
      information. The subtle skeletal findings occurring in inflammatory and
      degenerative disease were obscured by the process of segmentation. Therefore,
      radiographs and, in selected cases, CT remain the imaging methods of choice for
      the evaluation of sacroiliac pathology.

PMID- 8368023
TI  - [Potential effects of nutrition including additives on healthy and arthrotic
      joints. I. Basic dietary constituents].
AB  - Owing to the methodological difficulties involved, none of the studies so far
      published on the influence of diet on human osteo-arthritis has been fully
      comprehensive. We have therefore compiled a series of experimental observations-
      including some of our own--in the mouse and other species that have a bearing on
      this subject. Fats with a high content of saturated fatty acids, such as pork
      fat, greatly favored the development of spontaneous osteo-arthritis in the mouse,
      as also did cholesterol. Cottonseed oil and olive oil showed less tendency to do
      so. The highly unsaturated linoleic acid antagonized the effect of pork fat.
      Other vegetable oils and also fish oil exerted an anti-inflammatory and
      antinociceptive action in experimental animals. Foodstuffs rich in carbohydrates
      only promoted the development of degenerative joint disease in predisposed mice.
      Hyperglycemia (diabetes mellitus) constitutes a risk factor for the development
      of osteo-arthritis in humans as well as in mice and rats. A low-protein diet led
      to dysplasia of the hip joint in the dog; a high-protein diet inhibited the
      development of osteo-arthritis in the mouse, but promoted inflammation in
      volunteers. Disturbances of protein metabolism such as alkaptonuria can initiate
      degenerative processes in the joints of humans and animals.

PMID- 8368024
TI  - Study of the photochemical immobilization of alkaline proteinase and chymotrypsin
      on the solid phase of O-hydroxyethylcellulose.
AB  - Stability of the photochemically immobilized alkaline proteinase (E.C. 3.4.21.14)
      and chymotrypsin (E.C. 3.4.21.1.) onto the gel of O-hydroxyethylcellulose has
      been studied. For the purpose of immobilization the photochemical generation of
      nitrene radicals caused by the photolysis of an azido group of bifunctional 4,4'
      bis-azidostilbene-2,2'-disodium-sulphate and the newly synthetized O-(3
      azidophthaloyl)-O-hydroxyethylcellulose have been employed. The immobilized
      alkaline proteinase demonstrated a decreased ability of denaturation and an
      increased laboratory stability.

PMID- 8368025
TI  - Mycoflora and natural occurrence of mycotoxins in tobacco from cigarettes in
      Egypt.
AB  - Forty-two species and 4 varieties belonging to 21 genera were collected from 40
      tobacco samples on glucose- and cellulose-Czapek's agar at 28 degrees C and 45
      degrees C. The most common mesophiles (at 28 degrees C) in tobacco on the two
      types of media were: Aspergillus flavus, A. flavus var. columnaris, A. fumigatus,
      A. niger, Penicillium chrysogenum and P. funiculosum. Two samples were heavily
      contaminated with members of Fusarium (F. moniliforme, F. oxysporum, F. solani).
      Some fungi were encountered only on plates of cellulose agar as Chaetomium
      globosum, Stachybotrys atra var. microspora and S. chartarum. At 45 degrees C the
      most prevalent fungus was A. fumigatus. Truely thermophiles were also collected:
      Humicola grisea var. thermoidae, Rhizomucor pusillus and Thermoascus aurantiacus.
      Based on biological assays (brine shrimp larvae (Artemia salina L.) and Bacillus
      megatherium test) and chemical analysis of chloroform extraction of tobacco (TLC
      and UV spectrophotometric), four samples (out of 40) had toxicity and four
      compounds of mycotoxins were detected namely; aflatoxins B1 & B2 (2 samples; 15.5
      and 20.7 micrograms/kg), zearalenone (1 sample, 5.5 micrograms) and T-2 toxin (1
      sample, 2.8 micrograms). For studying the tracing of aflatoxins in smoking
      cigarettes, three doses (10, 20 and 50 micrograms) of aflatoxins B1 and B2 (w/w,
      1:1) were injected each in ten cigarettes. All extracts of cigarettes smoke
      proved to be non-toxic and mycotoxins not detected. However, aflatoxins were
      detected in topping filter (2.8, 3.5 and 8.8 micrograms/the three doses,
      respectively).

PMID- 8368026
TI  - Cellulase production on high levels of cellulose and corn steep liquor.
AB  - Several enhanced cellulase mutants of Trichoderma reesei have been used for
      cellulase production using corn steep liquor and microcrystalline cellulose as
      substrates. Under the optimum fermentation conditions on 6% cellulose and 3.6%
      corn steep liquor Trichoderma reesei Rut C 30 produced high levels of cellulase
      enzymes 6MC-ase 54 IU/ml, filter paper activity 3.2 IU/ml after 10 days
      incubation at 28-30 degrees C.

PMID- 8368027
TI  - Terrestrial fungi inhabiting certain species of Nile fishes in Egypt.
AB  - Twenty specimens of six species of Nile fishes were examined for the presence of
      fungi. Of which 2 were from Alestes nurse; 3 from Bagrus docmac; 4 from Barbus
      bynni; 6 from Chrysichthys auratus; 4 from Lates niloticus and 1 from
      Malapterurus electricus. Forty-three fungal species in addition to 1 variety
      appertaining to fifteen genera were recovered from skin (15 genera and 34 species
      + 1 variety); gills, kidney (12 genera and 30 species + 1 variety, each); liver
      (11 genera and 30 species + 1 variety) and intestine (13 genera and 30 species +
      1 variety) of all specimens, using glucose Czapek-Dox medium at 28 degrees C. The
      most common genera were Aspergillus, Penicillium and Trichoderma.

PMID- 8368028
TI  - Physiological studies on xylanase production by Penicillium funiculosum on some
      agricultural wastes.
AB  - Studies were carried out on production of Xylanase enzyme from P. funiculosum
      NRCE-629 using a number of alkali-treated lignocellulosic wastes as carbon and
      energy sources as compared to pure xylan polymer. Sugar cane bagasse, rice straw
      and wheat straw yielded enzyme levels higher than that obtained on pure xylan.
      Physiological studies on enzyme formation using those three agricultural wastes
      revealed that optimum enzyme yields are obtained in media containing 2% substrate
      concentration. The enzyme synthesis was favored in agitated cultures with an
      air:medium ratio corresponding to 3:2 respectively with inoculum size of 10%
      (v/v). Further studies using rice straw medium yielded highest enzyme level after
      five days of aerobic growth at 30 degrees C with initial pH of medium adjusted to
      5.0. Results are discussed in the light of possible application.

PMID- 8368029
TI  - [Do drugs in pregnancy modify neonatal jaundice?].
AB  - An increased incidence of neonatal jaundice has been observed in babies born to
      mothers who were treated with different drugs before or during delivery. In this
      review literature data on such drugs are collected which are under suspicion to
      produce increased levels of bilirubin in the newborn infant. Despite numerous
      attempts to show significant effects of these drugs on neonatal
      hyperbilirubinaemia most of them give contradictory results. Nevertheless, agents
      that stimulate uterine motility (oxytocin) as well as drugs that inhibit uterine
      motility (ritodrine) may have an icterogenic effect. Possible mechanisms of their
      actions are described. Thus, even if there is some association between drugs
      given prenatally and jaundice developing postnatally, no practical consequences
      arise except in such cases where additional risk factors may increase the danger
      of bilirubin encephalopathies in jaundiced infants.

PMID- 8368030
TI  - Semiquantitative determination of IL-1 alpha, TNF-alpha, PDGF-A, PDGF-B, and PDGF
      receptor in term human placenta using polymerase chain reaction (PCR).
AB  - Eight placenta samples derived from normal term human placenta were examined for
      the expression levels of Il-1 alpha+, TNF-alpha+, PDGF-A+, PDGF-B+, and PDGF
      receptor+ using a semiquantitative PCR protocol. The expressional level of beta
      actin was proven to be constant, therefore beta-actin could serve to equilibrate
      sample size in our procedure. Differences were found in the mRNA levels of IL-1
      alpha and TNF-alpha. The expression of PDGF-A, BDGF-B and PDGF-R seemed to be
      relatively constant in our group of samples. Further investigation and improved
      quantitative PCR protocols are needed to correlate clinical outcome of pregnancy
      with cytokine expression at the placental level. +Il-1 alpha (interleukin-1
      alpha) +TNF-alpha (tumor necrosis factor-alpha) +PDGF-A (platelet derived growth
      factor A) +PDGF-B (platelet derived growth factor B) +PDGF-Rezeptor (platelet
      derived growth factor-rezeptor).

PMID- 8368031
TI  - [Proteolytic enzymes in meconium--studies of healthy newborn infants and
      premature infants].
AB  - Peptidatic activity of meconium of 200 newborns and 100 preterm babies. Protein
      content of meconium is higher in preterm babies than in healthy newborns referred
      to fresh weight. Enzymatic activity opposite to Gly-D-Leu is higher in term than
      in preterm newborns. It is on the contrary in the case of alanine-aminopeptidase,
      dipeptidyl-peptidase IV and the activities opposite to Leu-NA and Arg-NA. The
      good correlated enzymatic activities opposite the different substances give a
      hint to the presence of alanine-amino-peptidase (EC 3.4.11.2.)

PMID- 8368032
TI  - [Development of a magnetic urethral closure device--an animal experiment study].
AB  - The new magnetic closure device consists of a retropubically implanted magnet and
      another removable intravaginal magnet, which gently closes the urethra. This
      system has shown its proper function in Merino sheep during a period of
      observation up to 33 weeks. The pressure on the tissue can be adjusted by the
      size and strength of the removable magnet. By using smooth-edged magnets, no
      necrosis of the vaginal wall and urethra could be observed.

PMID- 8368033
TI  - [The psychological status of the female with urinary incontinence].
AB  - In the former western part of Germany, in 1989 about three million people claimed
      social costs because of urinary incontinence. 80 percent of them were women. The
      psychic situation of these women is mainly determined by social consequences of
      their incontinence. Behavioural changes to avoid incontinence lead to social
      isolation. A coherence between incontinence or urgency and agony or depression is
      acknowledged. Especially in elderly people, who have to change their well-known
      environment due to nursing problems, incontinence is a major problem, which often
      deteriorates with the new situation. Incontinence also leads to avoidance of
      sexuality. Women are mostly more irritated than their partners. On the other hand
      incontinence is used to avoid sexuality and thus may be a sign of a sexual
      conflict.

PMID- 8368034
TI  - [Fetal cyclopia with deletion 46,XX,del (7) (q32-->qter), prenatal diagnosis and
      genetic counseling].
AB  - A pregnancy at 19./20. weeks of gestation with signs of cyclopia by
      ultrasonography is described. A long arm deletion of chromosome 7 was found by
      prenatal cytogenetic investigation. Prenatal diagnosis and genetic counseling are
      discussed.

PMID- 8368035
TI  - [Our gynecologic heritage. The activities of scientific gynecologic societies in
      Northeast Germany after the World War II].
AB  - During the Second World War and especially since 1943 the activities of medical
      societies decreased more and more. The first gynecological meeting in the of
      Soviets occupied part of Germany happened October 5th till 6th 1946 in Jena. The
      Chairman was Gustav Doderlein. In May 1947 the Soviet Military Administration
      commanded the order Nr. 124 about foundation of medical societies. The Society of
      Gynecology at the University of Rostock was founded November 1947. In year 1948
      was the unification with the Gynecological Society of Greifswald. The unified
      society organized till 1989 more than 40 meetings in the Northern towns of East
      Germany. 1991 the unification with the Northwestern Society of Gynecology and
      Obstetrics took place. The Society has now the name "North-German Society of
      Obstetrics and Gynecology".

PMID- 8368036
TI  - [Radicular paralysis with reference to lumbar root compression syndromes.
      Incidence, extent and follow-up in a neurosurgical patient sample].
AB  - This is a retrospective study of 170 patients which were operated on for lumbar
      intervertebral disc herniation. The mean follow-up was 8 weeks. All patients
      showed muscular weakness before operation. Incidence, severity, and natural
      history of motor deficit following lumbar discectomy are reported. Moreover it
      was of special interest to analyze the effect of sex, age, severity and duration
      of muscular weakness, and timing of surgery on changes in radicular function.

PMID- 8368037
TI  - [Incidence of biopsy-detectable amyloid deposits in the retinaculum flexorum and
      in the tenosynovial tissue in carpal tunnel syndrome].
AB  - Histological examination of surgical specimens from 98 patients with carpal
      tunnel syndrome revealed amyloid deposits in 12% of the cases. Amyloid was
      located in the flexor retinaculum and to the same extent in the tenosynovium.
      Serial sections of the material containing amyloid deposits demonstrated that
      examination of only one level would detect solely 90% of the amyloid-positive
      cases. In one single case amyloid deposits were considered extensive enough to
      cause compression of the median nerve and thus could have played a role in the
      pathogenesis of the carpal tunnel syndrome. In 8 of the 12 cases the patients'
      histories proved no correlation to preexisting diseases. In our opinion, an
      individual disposition may promote amyloid deposits as a response to local and
      chronic irritation. It is noteworthy that the mean age in the amyloid-positive
      group (70 years) is significantly higher than in the amyloid-negative cases (55
      years).

PMID- 8368038
TI  - [Sacral anterior root stimulation to promote micturition in transverse spinal
      cord lesions].

PMID- 8368039
TI  - The recurrent carpal tunnel syndrome.
AB  - Sixteen out of 720 patients with carpal tunnel syndrome who had undergone surgery
      since 1979 were reoperated for a "recurrence" (2.2%). Twelve of these patients
      had been originally operated on in our department. Thus, our own recurrence rate
      is 1.7%. Three patients deteriorated following surgery, 6 had an unsatisfactory
      improvement, and in 7 the symptoms recurred after initial improvement. Eight of
      the reoperated patients had a predisposing disease (terminal renal insufficiency,
      insulin-dependent diabetes mellitus, acromegaly). In 10 of the 16 cases the
      initial operation had been carried out by surgeons in the first three years of
      training. Reoperation revealed incomplete splitting of the transverse carpal
      ligament in 10 cases, compression of the median nerve by the scar in 4, injury of
      the muscular branch in 1, and an anatomical variant as cause of incomplete
      decompression in 1 patient. "Recurrences" after carpal tunnel surgery are
      predominantly due to inadequacies of the first procedure. A remarkable number of
      patients (50%) has predisposing diseases. Interfascicular or epineural neurolysis
      and complete exposure and neurolysis of the median nerve and its branches is
      necessary only in cases of recurrence. Their omission at the first surgery does
      not result in an increased recurrence rate. Our observations indicate that the
      number of operations for recurrent carpal tunnel syndrome can probably be reduced
      when the first operation is performed with care and experience. Patients with
      carpal tunnel syndrome secondary to a systemic disease are particularly at risk.

PMID- 8368040
TI  - [An innovative surgical glove: Manex extra strong--added safety in all
      operations].

PMID- 8368041
TI  - Mucosal lesions of the digestive tract in cirrhosis.
AB  - Mucosal lesions of the digestive tract in cases of cirrhosis are described. The
      lesions include congestive gastropathy, antral vascular ectasia, erosions, brown
      macules and angiodysplasia in the stomach. Lesions are also observed in the
      duodenum and in the colon.

PMID- 8368042
TI  - Endoscopic varix ligation: a promising new technique?
AB  - Endoscopic varix ligation is a new promising endoscopic method which compete with
      endoscopic sclerotherapy both during acute bleeding and the chronic setting where
      the aim is to obliterate varices as soon as possible with minimal side effects.

PMID- 8368043
TI  - Photodynamic therapy and cancer of the esophagus.
AB  - Esophageal cancer is a tumor that, at diagnosis, is often advanced and not
      curable. In patients with good operative risk, surgery is still considered the
      ideal treatment. As many patients are elderly and have complicating serious
      medical conditions which preclude major resective surgery, endoscopic treatment
      (endoscopic oncology) has become a recent alternative. The endoscopic approach
      includes dilation, thermal destruction with Bicap probes, Nd. Yag laser,
      injection therapy, photodynamic therapy (PDT) and prostheses. This work is
      focused on photodynamic therapy which is safe but continues to be an experimental
      treatment. Its role in gastrointestinal malignancies is evolving. Currently the
      best results are to be expected in early lesions where the treatment could be
      curative.

PMID- 8368045
TI  - Endoscopic diagnosis and treatment of malignant biliary strictures: review of 505
      patients.
AB  - The role of ERCP and endoscopic drainage in the diagnosis and treatment of
      patients with malignant biliary obstruction is well established. Endoscopic
      drainage is an effective therapy for palliation of malignant obstructive jaundice
      and does not preclude definitive treatment in appropriate candidate. We report
      our experience, in a retrospective review, of 505 patients with malignant biliary
      obstruction. In this series, endoscopic biliary drainage is shown to be safe and
      effective management for these patients. Relief of obstruction was obtained in a
      large majority of patients with a low, procedure related, morbidity and
      mortality. We conclude that ERCP, to diagnose and localize obstructive lesions,
      followed by endoscopic biliary drainage can be strongly considered in all
      patients with suspected malignant obstructive jaundice.

PMID- 8368044
TI  - Endoscopic management of chronic pancreatitis.
AB  - The indications of endoscopic management for chronic pancreatitis are strictly
      related to the classification of severe types and to the particular anatomy of
      the ducts: 1. Impacted or distal calculi: endoscopic pancreatic sphincterotomy
      (EPS) alone followed by ESWL when extraction fails. 2. Stone(s) and stricture:
      EPS, ESWL, NPC, and then 10F plastic stenting. 3. Relapsing strictures (with
      upwards dilatation) after 6 to 12 months stenting: silicone covered self
      expanding stent in a trial, versus surgical pancreaticojejunostomy. 4.
      Paraduodenal cyst bulging into the duodenum: ECD. 5. Jaundice and/or cholestasis
      due to stricture of the intrapancreatic CBD: 10F single or multiple plastic stent
      for calibration during 3 months. For relapsing cholestasis and stricture, 30F
      metal mesh stent versus surgical hepaticojejunostomy. The indications of
      endoscopic management for chronic pancreatitis are specific and require complete
      imaging and functional check up (ERCP, CT scanner, endosonography, pancreatic
      function tests). The technique is quite difficult and requires definition
      fluoroscopy, appropriate devices and experienced team. On this condition, the
      complication rate is very low and usually medically controlled. Treatment does
      not compromise any further surgery. Endoscopy allows to avoid or to postpone
      surgery which indication will become better defined and selected in the future.

PMID- 8368046
TI  - Endoscopic lithotripsy for bile duct stones.
AB  - Endoscopic sphincterotomy and common duct stone extraction is successful in 85
      90% of patients using conventional balloons and baskets. However, most patients
      with biliary stones > 2 cm will require mechanical, electrohydraulic, or laser
      lithotripsy prior to stone extraction. Mechanical lithotripsy is inexpensive,
      easy to perform, and effective in 80-90% of cases. Most failures result from
      inability to entrap the stone in the lithotripsy basket. These cases may be
      successfully treated using either electrohydraulic or laser lithotripsy
      (intraductal shockwave lithotripsy). In most cases, intraductal shockwave
      lithotripsy requires direct visual control. Due to difficulty with peroral
      cholangioscopy, these techniques will not be widely used until a smaller, more
      maneuverable "mother and baby scope" system is developed. We recommend mechanical
      lithotripsy as the initial treatment for large biliary stones. Failed cases
      should be referred to specialized centers for a repeat attempt with intraductal
      shockwave lithotripsy. With this approach, an experienced endoscopist is
      successful in removing biliary stones in over 95% of patients. Long term biliary
      stenting remains a viable option for the high risk patients with large common
      bile duct stones.

PMID- 8368048
TI  - [Value of interferon-alpha in treatment of chronic myeloid leukemia].
AB  - In 1983 Talpaz et al. (43) for the first time demonstrated the efficacy of
      interferon-alpha (IFN-alpha) for the treatment of patients with chronic
      myelogenous leukemia (CML). This observation has been confirmed by several study
      groups in the consecutive years. An overview over the 7 largest trials including
      more than 400 patients reveals response rates (partial and complete hematological
      remissions) of 55 to 91%. In contrast to conventional chemotherapy IFN-alpha
      treatment resulted in a decrease of Philadelphia-chromosome positive metaphases
      (cytogenetic remissions) in 19 to 47% of these patients. A complete disappearance
      of the Philadelphia chromosome was found in 5 to 10% of patients. The following
      factors influence the response to IFN-alpha in patients with CML: phase and
      duration of the disease, several well defined risk factors, and IFN-dose.
      Currently available data are strongly suggestive for a survival benefit of
      patients with cytogenetic remissions, although definitive prove by phase-III
      trials is lacking. Actual studies focus on combinations of IFN-alpha and
      cytostatics, e.g. low-dose cytosine arabinoside.

PMID- 8368047
TI  - Biochemical and histopathological aspects in duodenogastric reflux gastritis
      patients with or without prior cholecystectomy.
AB  - The aim of this study was to evaluate some biochemical and histopathological
      aspects in a group of patients with a view to identifying any differences
      depending on whether the pathology was associated with previous cholecystectomy
      or idiopathic. The study involved 23 patients (8 post-cholecystectomy cases and
      15 ulcer-free dyspeptic patients) with the diagnosis of duodenogastric reflux
      gastritis confirmed by endoscopic histopathological evaluation. The following
      parameters were considered: 1. pH and bile salt concentration in gastric juice;
      2. histological classification of antral biopsies (Niemela's criteria); 3.
      dyspeptic symptoms (dyspepsia, pyrosis and epigastric pain, sense of repletion,
      foul-tasting mouth) graded on a scale from 0 to 4. All parameters were considered
      in relation to whether or not Helicobacter Pylori was found in the histological
      specimens. No significant differences were found between the two groups for pH
      and bile salt values or for Helicobacter Pylori positivity. No relationship was
      observed between the Helicobacter Pylori and either the severity of the
      histological picture, the features of the biochemical parameters or the severity
      of the clinical symptoms. Such findings confirm the common pathophysiological
      pattern of reflux gastritis regardless of any permanent biliary tract alterations
      and the low importance of Helicobacter Pylori infection in determining this
      syndrome.

PMID- 8368049
TI  - [Highly malignant non-Hodgkin's lymphomas].
AB  - High malignant non-Hodgkin's lymphomas are rare diseases, with a rising
      incidence. A qualified histological classification and a thorough staging are the
      most important points in the further management. The treatment is primarily
      chemotherapeutic; radiation is only used in selected situations. The success of
      the very first therapy is most important for the outcome. To date no one of the
      modern intensive treatment regimens could show an advantage over conventional
      CHOP. For treatment failures autologous or allogenic bone-marrow-transplantation
      is the best option. Whether bone-marrow-transplantation in first remission can
      improve the treatment results waits to be answered. HIV-associated lymphomas are
      an increasing problem. For selected patients intensive chemotherapy with growth
      factors seems to improve the results. Conflicting are the therapy data in elderly
      patients. Most centers accept a higher lymphoma mortality with reduced doses.
      With special designed treatment regimens it is probably possible to come to an
      acceptable outcome even in elderly patients.

PMID- 8368050
TI  - [Successful intubation with the Combitube of two patients with bull neck].
AB  - Endotracheal intubation is without doubt the optimal method for emergency airway
      management. Rapid intubation and effective ventilation are the major aims during
      cardiopulmonary resuscitation. As an alternative, the Combitube can be used
      whenever endotracheal intubation is not immediately possible. We report the
      successful use of the Combitube during cardiopulmonary resuscitation in two
      patients with bull-neck. The patients could be oxygenated and ventilated
      adequately with the Combitube. This case report shows that the Combitube may be a
      valuable tool for emergency intubation in difficult situations.

PMID- 8368051
TI  - Managed care: its impact upon CRNA practice.

PMID- 8368052
TI  - Mivacurium: a replacement for succinylcholine?

PMID- 8368053
TI  - Accreditation of regionalized and comprehensive nurse anesthesia programs.
AB  - Regionalized educational systems are becoming more common among nurse anesthesia
      programs and represented 41 out of 86 programs in a 1992 survey. Surveys were
      mailed to program directors of all nurse anesthesia programs accredited by the
      Council on Accreditation of Nurse Anesthesia Educational Programs to determine if
      the directors perceived a need for three separate categories of accreditation.
      Responses indicated that, although most directors saw no benefit in applying for
      separate academic and clinical accreditations for their own programs, they did
      believe the additional accreditation options should be available to all programs.
      Most directors also indicated that they preferred the Council to continue
      offering only one category of accreditation while 33 (38%) indicated they were
      interested in separate accreditation categories.

PMID- 8368054
TI  - Captain of the ship.

PMID- 8368055
TI  - Writing the grant proposal.
AB  - This article provides AANA members who are interested in seeking external funding
      with information that will assist them in writing a grant application. Avenues of
      initial contact with the funding agency are discussed, as are suggestions for
      drafting the appointment letter and the letter of inquiry. The development of a
      narrative for a grant application depends on the guidelines set forth by the
      funding agency and varies from agency to agency. A list of information that might
      be included in a narrative is provided.

PMID- 8368056
TI  - Anesthesia quality plus: the quantification of competence.

PMID- 8368057
TI  - An anesthesia quality improvement program utilizing a computer database to effect
      change.
AB  - This article describes the perceived benefits of a quality improvement program,
      briefly discusses the steps involved in the establishment of such a program, and
      describes the implementation of a computer database for data collection and
      retrieval. The outcome of 4,500 anesthesia cases, representing 30 months of
      casework, is included. This article concludes with a discussion of the strengths
      and weaknesses of the program as well as a suggestion for future quality
      improvement endeavors.

PMID- 8368058
TI  - The attrition rate of students in master's level nurse anesthesia programs.
AB  - This survey was conducted in October 1990. Survey forms were sent to all nurse
      anesthesia programs offering master's degrees. The purpose of the study was to
      determine the dropout rate of students who did not complete their programs during
      the period from 1985 to 1990. Directors were asked to rate their satisfaction to
      determine if students were more likely to leave because of clinical or academic
      difficulties or for personal reasons. The time frame and the circumstances
      surrounding the students' departures were also examined. The attrition rate of
      programs ranged from 0-25% (mean = 8.2%). More than half the students left for
      personal reasons. The remainder were almost equally divided between clinical and
      academic reasons. In fact, many directors had difficulty distinguishing between
      these two causes. Most students left during the first 12 months of their program,
      and more than half of them were not encouraged to resign. A large majority (78%)
      of directors found their program's attrition rate to be very acceptable.

PMID- 8368059
TI  - AANA journal course: update for nurse anesthetists--beyond the laryngoscope:
      advanced techniques for difficult airway management.
AB  - Airway catastrophes have been identified as the leading cause of injury and death
      during anesthesia. Proper management of a patient with a technically difficult
      airway commences with problem recognition. Physical limitations to mask
      ventilation and endotracheal intubation may be accurately identified by thorough
      observation. All patients should be examined for oral structure visibility, size
      of mandibular space, and ability to assume "sniffing" position. Patients with
      compromised airways should have patency secured while remaining awake by direct
      laryngoscopy, nasotracheal intubation, fiberoptic endoscopy, retrograde
      intubation, or possibly tracheostomy. Partial or complete airway obstruction
      requires immediate recognition and intervention. Repeated, unsuccessful attempts
      at endotracheal intubation should be avoided, as these may lead to laryngeal
      edema or hemorrhage which may critically compromise airway maintenance. Prudent
      options may include awakening the patient, proceeding with mask ventilation, or
      performing semi-elective tracheostomy. Emergency airway access may be achieved
      with a tracheoesophageal airway, esophageal tracheal combitube, laryngeal mask
      airway, digital intubation, or obtained surgically by transtracheal jet
      ventilation or tracheostomy. Reduction of airway-related morbidity and mortality
      is best achieved with an understanding of airway anatomy, common causes and
      prompt recognition of compromise, and alternative techniques of establishing
      patency and ventilation.

PMID- 8368060
TI  - HCFA issues 1993 CRNA Medicare conversion factors.

PMID- 8368061
TI  - Epidural and intrathecal analgesia in a rural setting.
AB  - Epidural anesthesia--alone or in combination with general anesthetic agents--is
      beneficial to physiological and cardiovascular stability during surgery. The
      placement of an epidural catheter at the time of surgery also provides access for
      the administration of epidural narcotics for postoperative analgesia. This
      article describes how a rural acute care facility initiated a program of epidural
      analgesia administered by the nursing staff under the direction of the anesthesia
      department utilizing AANA protocol.* In such a setting, an educated nursing staff
      can serve as an extension of the anesthetist in overseeing patient response to
      epidural and intrathecal narcotics.

PMID- 8368062
TI  - A case report: the use of ketamine and midazolam intravenous sedation for a child
      undergoing radiotherapy.
AB  - The combination of ketamine hydrochloride and midazolam was used to successfully
      provide intravenous sedation for a child requiring daily radiation treatments.
      During the radiation therapy treatments, the anesthesia provider was not in
      direct contact with the patient. Traditional monitoring was complemented by the
      addition of closed-circuit television monitoring. The drug combination provided
      consistent cardiac and respiratory stability, as well as patient immobility, for
      each radiation treatment.

PMID- 8368063
TI  - Bacteremia in children with acute lymphoblastic leukemia.
AB  - Bacteremia is one of the important complications of the treatment of
      hematological malignancy. In this report, we analyze bacteremias in 72 children
      with acute lymphoblastic leukemia who were admitted to our hospital from July 1,
      1988 to October 31, 1991. Positive blood cultures were found in 26% (19/72) of
      the patients. There were 24 episodes of bacteremia; Gram-negative, Gram-positive
      and mixed bacteremia comprised 62.5% (15/24), 33.3% (8/24) and 4.2% (1/24),
      respectively. E. coli, klebsiella pneumoniae and Pseudomonas aeruginosa were the
      three most common pathogens. Eighty-three percent of the bacteremic episodes
      occurred during neutropenia (absolute neutrophil count below 500/mm3). Our data
      suggest that a Pseudomonas etiology, associated pneumonia, and shock accounted
      for a poor outcome. The over-all mortality for bacteremic events was 26.3%
      (5/19). Intensive supportive treatment and effective antibiotics are the most
      important factors in improving the outcome of bacteremia. The success in recent
      ALL treatment can be attributed in part to the improved outcome of bacteremia.

PMID- 8368064
TI  - Risk factors of coronary arterial aneurysm in Kawasaki disease.
AB  - From April 1983 to August 1991, 70 cases of Kawasaki disease were admitted to
      Taiwan Provincial Tao-Yuan General Hospital. Fifty-seven patients treated with
      aspirin 80-100 mg/kg/day alone during the acute phase were followed by two
      dimensional echocardiography for two weeks to two years. Twelve cases (21%)
      complicated with coronary arterial aneurysm (CAA) were referred as high risk
      group. Those who had no CAA were a low risk group. Stepwise discriminant analysis
      was performed to obtain risk factors of CAA based on clinical and early
      laboratory data. This yielded a classification accuracy of 75.4%. The combination
      of two parameters, white blood cell count and C-reactive protein, can be applied
      to early identify Kawasaki patients at high or low risk of CAA.

PMID- 8368065
TI  - [Heavy metals in traditional Chinese medicine: ba-pao-neu-hwang-san].
AB  - Heavy metal intoxication of newborn infants fed with "Ba-Pao-Neu-Hwang-San" has
      been reported every year by many hospitals in Taiwan. About nine years ago, the
      National Laboratories of Foods and Drugs of the Department of Health, Executive
      Yuan, received one case report of a five month old female infant who died as a
      result of long term feeding with "Ba-Pao-Neu-Hwang-San". The drug was found to
      have contained lead 44,000 ppm. Although this unfortunate incident was propagated
      by most newspapers, the prescription of this ancient Chinese medicinal
      preparation is still widely accepted by ordinary people. Herbal medicine doctors
      prefer complex mineral drugs as did their ancestors thousands of years ago. In
      the last two years, we have collected 5 samples of "Ba-Pao-Neu-Hwang-San" from
      different manufacturers and measured the concentration of 16 heavy metals
      (including Cadmium, Mercury, Arsenic, Lead, Chromium, Manganese, Selenium,
      Germanium, Nickel, Calcium, Magnesium, Aluminum, Iron, Copper, Zinc, and
      Vanadium) in these drugs with Inductively-Coupled Plasma Atomic Emission
      Spectrometry and Graphite Furnace Atomic Absorption Spectrometry. The result of
      our survey revealed that the first sample (from Tainan) contained mercury 52,800
      ppm, the fourth (from Ping-tung) contained mercury 34,500 ppm, and the fifth
      (from Sin-chu) contained mercury 65,700 ppm. The mercurial contents of these
      samples were apparently too high to be a safe drug.

PMID- 8368066
TI  - Congenital syphilis: report of twelve cases.
AB  - Between 1983 and 1992 at the Taichung Veterans General Hospital, twelve
      congenital syphilis patients were diagnosed, according to the Centers for Disease
      Control (CDC) criteria. For the five boys and seven girls, ages at diagnosis
      ranged from 1 day to 8 months, with an average of 23 days. Among these 12
      patients, four (33%) were premature. Seven patients (58%) were diagnosed in the
      past three years. These 12 patients were divided into inborn and outborn patient
      groups. Serological tests for syphilis were done in all inborn patients, but none
      in the outborns. All five outborn patients were symptomatic. In comparison, only
      one of seven inborn infants showed clinical evidence of congenital syphilis. The
      mean age at diagnosis was obviously older in the outborn patient group (53 days
      vs. 1 day). Six of ten patients (60%) had cerebrospinal fluid (CSF)
      abnormalities, while four of nine (44%) showed radiological abnormalities of
      bones. The hematologic and biochemical abnormalities compatible with congenital
      syphilis were also described. Penicillin was the drug of choice in ten patients.
      Despite adequate treatment, one patient died of respiratory failure. There has
      been no evidence of any signs of late congenital syphilis in those patients who
      survive. Congenital syphilis, a serious but preventable disease, is best treated
      adequately and early for minimal sequelae.

PMID- 8368068
TI  - Persistent truncus arteriosus associated with interrupted aortic arch: report of
      two cases.
AB  - Two neonates with a combination of truncus arteriosus and interruption of the
      aortic arch, so-called type A4 of the Van Praagh classification, are reported.
      Both presented as tachypnea, poor appetite and increasing cyanosis during the
      first week of life. The combination of these defects significantly increases the
      surgical risk. Di-George syndrome was noted in one patient, who presented with
      hypocalcemia and T cell dysfunction. Autopsy confirmed this diagnosis.

PMID- 8368067
TI  - Rhabdomyolysis syndrome in children: report of three cases.
AB  - Three cases with distinct clinical manifestations associated with rhabdomyolysis
      syndrome were encountered in this hospital's pediatric intensive care unit.
      Elevation of serum creatine phosphokinase, uric acid, potassium, inorganic
      phosphate and hypocalcemia with seizure were noted. The three patients all had
      signs of acute renal failure. One died of respiratory failure, and autopsy
      revealed multiple intrathoracic anomalies. The remaining two recovered completely
      from rhabdomyolysis. It is of importance to early recognize any acutely ill
      patient as having rhabdomyolysis syndrome when there is elevation of muscle
      enzymes, hypocalcemic seizure, positive orthotolidine reaction of urine strip
      while negative finding of red blood cell. The syndrome may damage the kidneys.
      Appropriate management to induce diuresis usually can salvage this potentially
      life-threatening condition.

PMID- 8368069
TI  - Congenital chylothorax managed by partial pleurodesis: report of one case.
AB  - Congenital chylothorax, a rare cause of respiratory distress in neonate,
      presented here with respiratory distress from two days of age. Thoracocentesis
      was performed at six days, revealing a clear fluid with high protein content.
      Thoracotomy was performed at the age of 33 days because of a profuse amount of
      chest tube drainage. A leak of chyle was found near the esophageal hiatus of the
      costophrenic angle. Partial pleurodesis was performed because of difficulty in
      identifying the exact leakage point. Respiratory status improved very quickly
      after the operation, and oral intake was well-tolerated during follow-up.

PMID- 8368070
TI  - Rigid spine syndrome presenting with respiratory failure--report of one case.
AB  - A case of rigid spine syndrome presenting with respiratory failure was reported.
      A seven-year-old girl had had dyspnea and orthopnea for one month. Symptoms had
      aggravated gradually and she was in a state of respiratory failure on arrival at
      our hospital. There was no evidence of active lung lesions and response to
      mechanical ventilation was good. Physical examination revealed an extremely thin
      girl with marked flexion limitation of neck and severe wasting of
      sternocleidomastoid and intercostal muscles. Serum creatine phosphokinase was
      moderately elevated (801 IU/L). Muscle biopsy specimen obtained from the right
      quadriceps femoris revealed increased perimyseal connective tissue and marked
      Type II fiber atrophy. Electromyography of left paraspinal muscles demonstrated
      small amplitude, short duration motor unit potentials. She received tracheostomy
      and a home-care ventilator use during sleep. Ventilatory insufficiency, though
      rare, should be anticipated in patients with rigid spine syndrome, and timely
      ventilatory support should be given.

PMID- 8368071
TI  - [Bronchopleural fistula in a newborn: report of one case].
AB  - Persistent pneumothorax is infrequently seen in the neonate. Persistent
      pneumothorax with a large air leak and empyema may indicate the presence of a
      bronchopleural fistula which often results in mortality in infants requiring
      ventilator support. A ten-day-old female neonate with meconium aspiration
      syndrome was found to have respiratory distress after birth. During ventilator
      therapy, persistent pneumothorax with a large air leak from the chest tube was
      found. Empyema occurred three days later. Despite insertion of multiple chest
      tubes and use of bronchial balloon occlusion, a large air leak and empyema still
      were noted. Following thoracotomy and suture of the bronchopleural fistula, the
      air leak stopped. The patient was smoothly weaned from the ventilator. She was
      able to be discharged in good condition six weeks later. In management of the
      bronchopleural fistula, bronchial balloon occlusion enabled the patient to be
      maintained until more specific therapy could be attempted. Thoracotomy is
      definite therapy for selected infants requiring ventilator support who
      demonstrate a large air leak, persistent pneumothorax, and progressive hypoxia
      which is unresponsive to chest tube insertion.

PMID- 8368073
TI  - [Scavenging effects of cyproheptadine on oxygen free radicals].
AB  - The scavenging effects of cyprohepdadine (Cyp), an antiserotonin-antihistaminic
      agent with significant calcium channel blocker activity, on oxygen free radicals
      were studied. Cyp was found to significantly scavenge the hydroxyl radical (.OH)
      produced by Fenton reaction (Fe(2+)+H2O2) (EC50 = 54 mumol/L) and inhibit the
      rate of .OH generation (IC50 = 22 mumol/L). The inhibitory effects of Cyp were
      significantly more potent than those of mannitol, a specific .OH scavenger, with
      EC50 of 22.7 mmol/L and 10.7 mmol/L respectively. Cyp was also shown to have
      certain scavenging effect on superoxide anion (O2-.) produced by peritoneal
      polymorphonuclear leukocytes (PMNs) in rats (IC50 = 179 mumol/L). These results
      suggest that the anti-myocardial injury activity of Cyp may be, at least
      partially, related to its scavenging effects on oxygen free radicals.

PMID- 8368072
TI  - [Absent pulmonary valve syndrome in tetralogy of Fallot: report of two cases].
AB  - A combination of absence of the pulmonary valve with ventricular septal defect,
      annular pulmonary stenosis and aneurysm of the pulmonary artery is called "absent
      pulmonary valve syndrome". Most patients with this condition suffered from severe
      respiratory symptoms in early infancy. Respiratory failure which is the leading
      cause of mortality in infants with this syndrome, results from pulmonary
      emphysema, pulmonary atelectasis or pulmonary infection as a consequence of
      compression of the bronchus by the pulmonary aneurysm. If these patients can be
      treated medically to survive beyond one year old, gradual decrease in severity of
      symptoms is expected. A definite correction in childhood is recommended.
      Otherwise, palliative operation in infancy has a high mortality rate. This paper
      reported two cases with severe symptoms in infancy; one patient expired at nine
      months of age, and the other lived beyond one year to receive surgical correction
      at the age of three. The etiology, clinical features and treatment of absent
      pulmonary valve syndrome are also discussed.

PMID- 8368075
TI  - [Antagonistic effects of cholinergic drugs on xylazine induced sedation].
AB  - Xylazine induced sedation in mice was observed as a kind of inhibition of
      exploratory activity. The reversible cholinesterase inhibitor cui xing ning (0.25
      1.0 m.kg-1), the precursor of acetylcholine, choline bromide (100-300 mg.kg-1),
      and the M-receptor agonist arecoline (1.0-5.0 mg.kg-1) were shown to
      significantly antagonize xylazine (5.0 mg.kg-1) induced sedation. While cui xing
      ning (0.25 mg.kg-1) shifted the dose-response curve of xylazine induced sedation
      to the right, hemicholinum-3 (3 micrograms icv), which inhibits the synthesis of
      acetylcholine, shifted the dose-response curve to the left. These results suggest
      that the xylazine induced sedation may be partly due to a reduced central
      cholinergic function. Cui xing ning may have some value in the treatment of
      xylazine overdose and antagonize the anesthesia induced by anesthetics combined
      with xylazine.

PMID- 8368074
TI  - [The permissive action of glucocorticoid on the analgesic effect of kyotorphin
      and its analogue].
AB  - Kyotorphin (KTP) is an endogenous analgesic dipeptide which does not act on
      opiate receptors but may induce the release of endogenous opioid met-enkephalin.
      In order to investigate whether or not glucocorticoids have "permissive action"
      on KTP, hydrocortisone has been used to examine its action on the analgesic
      activities of KTP and its retro-isomer (riKTP) by employing thermal irradiation
      tail flick method after intracerebroventricular injection. KTP and riKTP showed
      dose-dependent analgesic activity. Dose of KTP in the range of 6-24 mmol/L were
      effective, while the dose of riKTP at 6 mmol/L was shown to be ineffective. The
      analgesia of KTP was higher than that of riKTP. Hydrocortisone alone showed no
      significant analgesic effect. Linkers by connecting hydrocortisone with KTP or
      riKTP showed significantly higher analgesic effect compared with the
      corresponding dipeptides, not only in the duration of analgesia but also in
      potency. Solutions containing hydrocortisone and any one of the dipeptides
      exhibited the same effect as the linker. Pretreatment with sc naloxone (10 mg/kg)
      15 min before icv of KTP or riKTP (24 mmol/L) could not block the analgesia.
      These findings implicate that: (1) Glucocorticoids have a permissive action on
      the analgesia of KTP and its retro-isomer. The glucocorticoids may exert its
      effects by acting on receptors in the membrane, and thus cause fast membrane
      effect. (2) KTP may also induce release of substances other than met-enkephalin
      to participate in the analgesia.

PMID- 8368076
TI  - [Pharmacokinetics of muscone in rats, rabbits and dogs].
AB  - The plasma concentration--time course of muscone in rats after a single i.v.
      administration fitted well to a two-compartment open model, and those in rabbits
      and dogs were all conformed to a three- compartment open model. Significant
      species differences were observed in the pharmacokinetic parameters among rats,
      rabbits and dogs, while no significant differences were found among the three
      dosages of 12, 18 and 24 mg/kg after i.v. administration to rats. In rats, the
      T1/2 beta was found to be 118.1-131.2 min. In rabbits and dogs, the T1/2 beta
      were 24.9 and 30.0 min, respectively and the T1/2 gamma were 331.9 and 366.4 min,
      respectively. In rats, rabbits and dogs, the Vss were 23.0, 51.7 and 7.3 L/kg,
      respectively, and the Vc were 2.33, 2.13 and 0.38 L/kg, respectively.

PMID- 8368077
TI  - [Diterpenoid alkaloids from Aconitum gymnandrum].
AB  - Aconitum gymnandrum maxim. (ranunculaceae) is used as an herbal medicine in Tibet
      area. A new diterpenoid alkaloid, gymnandine (I) along with known alkaloids 14
      acetyl-8-O-methyltalatisamine (II), acoforine (III), columbidine (IV), aconitine
      (V), ranaconitine (VI), talatizidine (VII), isotalatizidine (VIII),
      gymnanconitine (IX), talatisamine (X), and atisine HCI (XI) have been isolated
      from this unique species. The structure of I is determined on the basis of
      spectral evidences and comparison of the 13CNMR spectrum with that of denudatine.
      II has not been previously reported as a natural product and III-VII were
      isolated from this plant for the first time.

PMID- 8368078
TI  - [Isolation and identification of yibeinoside B].
AB  - A new C-nor-D-homosteroidal alkaloid named Yibeinoside B was isolated from the
      bulb of Fritillaria pallidiflora Schrenk by column chromatographic techniques.
      The structure has been determined based on spectral and chemical data.

PMID- 8368079
TI  - [Studies on the chemical constituents of Desmodium styracifolium (Osbeck) Merr].
AB  - A new alkaloid, named desmodimine, C12H15NO4, gum, and a new natural product,
      named desmodilactone, C8H13NO3, mp 84-85 degrees C have been isolated from the
      aerial parts of Desmodium styracifolium (Osbeck) Merr. belonging Leguminosae. On
      the basis of spectral analysis their structures were deduced as formula I and II.
      In addition, lupenone (III), lupeol (IV), tritriacontane (V), stearic acid (VI),
      eicosanoic acid eicosyl ester (VIII) and beta-sitosterol (VII) were isolated for
      the first time from this plant.

PMID- 8368080
TI  - [Studies on the chemical constituents of Croomia japonica Miq].
AB  - A new steroid alkaloid, namely croomionidine (II), together with four known
      compounds pachysamine A(I), croomine (III), didehydrocroomine (IV) and beta
      sitosterol were isolated from the roots of Croomia japonica Miq. Their structures
      were identified by IR, MS, 1H NMR, 13C NMR and chemical conversion.

PMID- 8368081
TI  - [Studies on PAF antagonistic bicyclo(3,2,1) octanoid neolignans from Piper
      kadsura].
AB  - As a continuation of our previous report dealing with the structures of novel
      neolignans from Piper kadsura (Choisy) Ohwi, two other new bicyclo(3,2,1)
      octanoid neolignans, named kadsurenin K and kadsurenin L, were isolated. On the
      basis of spectral analysis and chemical derivatization, their structures were
      established as 7R,8R,3'R,5'R-delta 8'-3,5'-dimethoxy-4-hydroxy-2',3',4',5'
      tetrahydro-2', 4'-oxo-7.3',8.5'-neolignan and 7R, 8R, 3'S, 4'R, 5'R-delta 8'
      3,4,5'- trimethoxy-4'-acetoxy-2',3',4',5'-tetrahydro-2'-oxo-7.3', 8.5'-neolignan
      respectively. Kadsurenin B and kadsurenin C were known compounds. In 3H-PAF
      receptor binding assay, kadsurenin B, C, K and L demonstrated significant PAF
      antagonistic activity.

PMID- 8368082
TI  - [The structure identification of zhepiresionol].
AB  - A new 3,7-dioxabicyclo[3, 3, O] octan-6-one named zhepeiresinol was isolated from
      Fritillaria thumbergii Miq. The spectroscopic and X-ray diffraction analysis
      established the structure as 2-(3',5'-dimethoxy-4'-hjydroxyphenyl)-3,7
      dioxabicyclo[3, 3, O]octan-6-one.

PMID- 8368083
TI  - [Determination of cefixime in human plasma and urine using high performance
      liquid chromatography column switching technique].
AB  - A double column and double pump HPLC switching system is described for the
      analysis of cefixime in human plasma and urine. The system used muBondapak C18
      short pretreatment column for on-line sample clean-up and a Hitachi GEL 3056
      (ODS) analytical column for separation. A mixed solution of 0.01 mol/L H3PO4-0.1
      mol/L KH2PO4-H2O (20:1:79) was used as the pretreatment mobile phase and CH2CH
      0.01 mol/L H3PO4-0.1 mol/L KH2PO4-H2O (13:20:1:66) was used as analytical mobile
      phase. The compound in plasma and urine is detected by ultraviolet absorption at
      286 nm and 314 nm, respectively. The absolute recoveries of the method in plasma
      and urine were 99.1% and 98.6% respectively. The relative standard deviations of
      the method are 0.70-3.82% and 0.80-3.73% in plasma, 1.53-3.08% and 1.31-2.67% in
      urine between days and day-to-day. Linear calibration curve for cefixime was
      measured over the range of 0.1-3.2 micrograms/ml in plasma and 1.0-32.0
      micrograms/ml in urine, and the correlation coefficients were all 0.9999. The
      detection limit was 0.05 micrograms/ml in plasma and 0.2 micrograms/ml in urine.
      The plasma and urine samples were diluted with water and injected directly onto
      the HPLC system. The operation is simple and the relative sensitivity is markedly
      increased because of higher recoveries and larger loading capacity of the sample.

PMID- 8368084
TI  - [Studies on electrochemical behaviour of antiepilepsirine and its adsorptive
      voltammetry].
AB  - Antiepilepsirine is a kind of new antiepileptic drug. In this paper, a new
      method, adsorptive voltammetry (ADV) has been established for the determination
      of antiepilepsirine. In 0.20 mol/L H2SO4 solution, a sensitive reduction wave of
      antiepilepsirine was obtained by ADV after preconcentration on the surface of
      hanging mercury drop electrode (HMDE) (Ei = 0.7V, v = 100 mV/s), the peak
      potential was -0.94V (vs Ag/AgCl). The linear range between the peak current and
      the concentration of antiepilepsirine was 3.0 x 10(-9)-3.0 x 10(-6) mol/L with a
      detection limit of 1.0 x 10(-9) mol/L. Antiepilepsirine in tablet and urine
      samples was determined by using this method. The electrochemical behaviour of the
      system and its electrode reaction mechanism were studied by means of linear sweep
      and cyclic voltammetry, constant potential coulometry, normal pulse polarography
      (NPP), etc. The diffusion coefficient D was 7.7 x 10(-6) cm2/s. The electrode
      reaction rate constant was 1.5 x 10(-3) cm/s. The number of reduction electron n
      was 2. The electron transfer coefficient was 0.52. The electrode reduction
      process was shown to be irreversible with the adsorptive characteristics.

PMID- 8368085
TI  - [Study of quality control on herbal drugs and preparations of daqingye and
      banlangen].
AB  - This paper first suggests that 2,4 (1H,3H) quinazolinedione (QZL) may be used as
      a quality control standard for the Chinese herbal drugs Daqingye (Folium
      Strobilanthis et Polygoni) and Banlangen (Radix Strobilanthis) as well as its
      preparations. QZL was found for the first time from the above mentioned two
      Chinese herbal drugs which has a representative property. Its content is stable.
      This made it possible to solve the difficulty of quality control for the
      preparations "antipyretic and common cold granules" and "Banlangan granules" and
      provide a reliable assay method to evaluate the quality of the herbal
      preparations. By changing the wavelength and using gradient elution in HPLC, 3
      constituents can be determined through one injection by the present method, thus
      the time of determination may be shortened and the efficiency of assay increased.
      The method showed good linearity (r = 0.99998, n = 4) in the range of 0.2-3.2
      micrograms/ml of QZL, the average recovery was above 95% with RSD < 1.5% (n = 3).
      HPLC condition: Column: LiChrosorb RP 18; elution gradient: methanol from 35% to
      90% in water solution; determination wavelength: 226 nm and 288 nm.

PMID- 8368086
TI  - [Synthesis of N-substituted polymethylene dicarboxamides as inducers of
      differentiation].
AB  - N-Alkyl polymethylene dicarboxamides are known potent inducers of erythroid
      differentiation in murine erythroleukemia cells. The most active inducer
      N,N,N',N'-tetramethyl-1, 6-hexane-dicarboxamide has the same effectiveness as
      HMBA which has entered clinical trials as a differentiating agent. These
      compounds also have inducing activity in HL-60 human promyelocytic leukemia
      cells. In this paper, the synthesis of a series of N,N'-bis[2-(2-thiazolinyl)],
      N,N'-bis[5-(1-methyl-2-pyridonyl)], N,N'-bis[3-(1-phenyl-5-pyrazolonyl)]
      polymethylene dicarboxamides and 3,3'-(polymethylene dicarbonyl)bis(1-methyl-2
      imidazolidine-thiones) is reported. The inducing activities of the compounds were
      evaluated in vitro with HL-60 human promyelocytic leukemia cell line. Among them,
      N,N'-bis[2-(2-thiazolinyl)]-1,8-octamethylene- dicarboxamide (I4) and N,N'-bis[5
      (1-methyl-2-pyridonyl)]-1,6-hexamethylenedicarboxami de (II3) were shown to be
      relatively effective inducers of differentiation.

PMID- 8368088
TI  - [The plan. Change. Homage].

PMID- 8368087
TI  - [Chemical studies of Strobilanthes cusia].
AB  - Seven compounds have been isolated from the whole plant of Strobilanthes cusia
      (Nees) O. Ktze. Three of them are triterpenes (I-III), two are indole alkaloids
      (IV, V), two are quinazolinone alkaloids (VI, VII). On the basis of spectral
      analysis and physicochemical properties, their structures were established as
      lupeol (I), betulin (II), lupenone (III), indigo (IV), indirubin (V), 4(3H)
      quinazolinone (VI), 2,4(1H,3H)-quinazolinedione (VII). VI and VII were found from
      natural plant for the first time. The results of the pharmacological tests
      demonstrate that compound V has anticancer activity and compound VI has
      hypotensive action. Compound VII can be quantitatively determined by HPLC, which
      may serve as a quality control standard for materia medica and its preparations.
      Compounds VI and VII have been confirmed by means of synthesis.

PMID- 8368090
TI  - [Functional assessment of the autonomic nervous system in rheumatoid arthritis].
AB  - Sympathetic and parasympathetic nervous system evaluation was performed in 21
      patients with rheumatoid arthritis. Every patient had autonomic nervous system
      (ANS) dysfunction, the parasympathetic involvement being the most frequent. ANS
      dysfunction may explain some manifestations and may well be the expression of a
      larger neuropathic involvement with pathogenic implications.

PMID- 8368089
TI  - [Chronic hepatitis: the etiological spectrum. The implications for treatment].
AB  - The prevalence of chronic hepatitis and its different aetiologies was studied in
      all patients above 10 years of age seen in the specialised outpatient clinic of
      our hospital over a 3 year period. Defining chronic hepatitis as a persistent
      elevation of the transaminases, 988 patients (62% of all the patients observed)
      were classified as follows: viral aetiology in 82%, metabolic in 2%, biliary in
      2%, alcoholic in 11%, autoimmune in 1.5% and idiopathic in 2%. Among the viral
      group, hepatitis B virus infection was predominant (65%), followed by hepatitis C
      virus (26%) and delta hepatitis (8%). While the hepatitis C and delta patients
      presented high transaminases, in the HBsAg carriers this occurred in 94% and 20%
      of the HBeAg and anti-HBe-positive patients, respectively. Thirty per cent of the
      patients with chronic hepatitis B, 35% of those with chronic hepatitis C and 18%
      with delta hepatitis were selected for alpha interferon therapy. This
      demonstrated that in a significant proportion of patients with chronic viral
      hepatitis, therapy with interferon is not indicated. Corroborating other studies,
      with even stronger data, our study shows that viral aetiology is the most
      frequent type of chronic hepatitis.

PMID- 8368091
TI  - [Cervical discectomies by the anterior approach].
AB  - A retrospective study was made of sixty patients who underwent anterior cervical
      surgery, between January, 1980 and May, 1989. The standard anterior approach
      devised by Cloward (DEC) was used for 28 patients, and discectomy alone (DS),
      without bone graft, for the other 32. The postoperative stay was 2.4 times longer
      after DEC than after DS. Surgical complications had an incidence of 11.6%, 14.3%
      with DEC and 9.3% with DS. There was no mortality. A total of 57 patients were
      available for transversal clinical evaluation, 26 of the DEC group and 31 of the
      DS group. There was no difference in the success rate between the two groups.
      Considering the over-all results, 77.2% had good or excellent results, 10.5% had
      fair results and 12.3% had poor results. Patients with radicular symptoms alone
      had better results. Evolution of the spine stability at the level of the
      intervention was of no major difference between the two groups. The authors
      conclude that there are identical results, whatever the technique used. Still,
      morbidity and postoperative hospitalization are higher with Cloward's approach,
      which seems a good reason to restrict its use to cervical instability situations,
      namely traumatic cervical pathology.

PMID- 8368092
TI  - [Neurophysiological methods for the diagnosis of genitourinary dysfunctions].
AB  - Genito-urinary function is a watershed field interesting several areas of medical
      concern. Neurophysiological studies allow objective assessment of central,
      peripheral and autonomic pathways in the nervous system contributing to
      topographical localisation of lesions. The authors describe different methods
      used, namely somatosensory evoked potentials by pudendal nerve stimulation, bulbo
      cavernous reflex, cutaneous sympathetic reflex, transcranial cortical or spinal
      magnetic stimulation and single fiber EMG. Abnormalities in neurological diseases
      are presented.

PMID- 8368093
TI  - [Miller Guerra. Physician, professor, master].

PMID- 8368094
TI  - [Echo Doppler in abdominal aortic dissection].
AB  - The authors present a case of abdominal aorta dissection--type B. The diagnosis
      was made by Doppler ultrasound and computerized tomography (CT). The use of
      Doppler ultrasound in the diagnosis and assessment of abdominal aorta dissection
      and visceral arterial involvement is discussed. Doppler ultrasound is also a
      useful imaging technique in follow-up evaluation if conservative treatment is
      employed.

PMID- 8368095
TI  - [Emphysematous pyelonephritis].
AB  - A case of emphysematous pyelonephritis to E. coli, in a 63-year-old female
      diabetic patient is presented herein. Imaging techniques (plain abdomen X-Ray,
      ultra-sonography and computed tomography) allowed the authors to make the
      diagnosis. Percutaneous nephrostomy, combined with medical therapeutics,
      contributed to a favourable clinical evolution of the patient.

PMID- 8368096
TI  - [Resistance to the action of insulin].
AB  - The author analyses the insulin and glucagon effect on glycaemia regulation. The
      structure of glucose transporters and insulin receptors is described in some
      detail. Finally the author attempts to explain the insulin resistance mechanism
      based on a post receptor alteration that would be advantageous in traditional
      nutrition, but is noxious in a western type society, due to excessive caloric
      intake.

PMID- 8368097
TI  - [Combined therapy in non-insulin-dependent diabetes mellitus].
AB  - In recent years an improved understanding of potential complications associated
      with hyperinsulinemia has led to a growing interest in alternatives to insulin
      monotherapy for patients with non-insulin-dependent diabetes mellitus, who have
      failed on a regimen of diet and sulphonylureas. These patients typically present
      normal or elevated levels of insulin. This problem which has been attributed to
      insulin resistance, is superimposed on the peripheral hyperinsulinemia resulting
      from subcutaneous insulin delivery. A plethora of clinical trials have reported
      on the efficacy of combining therapy in limiting insulin requirements while
      achieving better glycemic control. This paper attempts a critical review of the
      pros and cons with respect to combining therapy and provides guidelines for its
      practical use.

PMID- 8368099
TI  - [Critical analysis of the bibliography of Actas Urologicas Espanolas].
AB  - In the absence of Spanish journals and publications with a high impact factor and
      since one of the primary reasons to obtain such an impact is the frequency with
      which the publication is referenced, we wanted to check the general belief by
      which even in the Spanish journals the proportion of national articles that get
      referenced is very small. We reviewed all articles published by Actas Urologicas
      Espanolas during 1989 and 1990 (12 issues, 246 articles with 4,549 references),
      and found that only 14.42% of references were from publications or books edited
      in Spain or at congresses held within Spain. After excluding books and
      communications originates in congresses, the figure is 10.9%. On the other hand,
      we noticed that over 25% articles do not include one single Spanish reference.
      Finally, the publication most often consulted is the USA Journal of Urology,
      which approaches some 20% of all mentions.

PMID- 8368098
TI  - [Ethical dilemmas in the field of genetics].
AB  - After a brief introduction, the role of medical genetics in modern ethical
      conflicts is emphasized. International working approaches are discussed in an
      attempt to solve medical conflicts. The studies proposed by Wertz and Fletcher
      are reviewed in order to assess the strength of consensus on various working
      approaches. A brief discussion evaluates working approaches to ethical problems
      in genetics. This discussion also focuses on genetic counselling and screening
      questions regarding pertinent hereditary diseases. Final considerations point out
      the demanding role played by the modern geneticist in medical ethics perspectives
      now broadened by new insights, namely the challenge of human genome mapping.

PMID- 8368100
TI  - [Clinical course of primary non-obstructive megaureter: analysis of our series].
AB  - Due to the widespread use of obstetrical ultrasonography with concomitant fetal
      screening, congenital uropathies are usually diagnosed in asymptomatic neonates.
      The main issue is to distinguish those cases of dilatation which are clearly
      obstructive and need surgical treatment from those which are within the normal
      anatomical range. Out of 47 patients with primary megaureter, 23 were
      nonobstructive, these are the aim of our study. There were 16 males and 7
      females; 13 were located on the left side, 7 on the right side and 3 were
      bilateral, adding up to 26 reno-ureteral units. Prenatal diagnosis was performed
      in 16 cases, the eldest patient diagnosed was nine. All infants were evaluated
      with ultrasonography, voiding cystourethrography, excretory urography and
      diuresis renography. The latter has been the most important test inducing us to
      adopt a conservative attitude. Differential renal function was more than 40% in
      24 units and in 2 was more than 35%. Diuretic renograms were type IIIa (Dilated
      non obstructed) in 19 cases and IIIb (Dilated partially obstructed) in 7. There
      were 2 cases with vesicoureteral reflux in the contralateral system. We have
      performed ultrasonography and diuresis renography during the follow-up. There
      were 8 cases with type I (Normal) renograms and 17 cases with type IIIa. Only one
      patient developed an obstruction and was operated on. In every case differential
      renal function did not deteriorate. In 9 cases urography was performed in order
      to see the anatomical changes. They have remained asymptomatic during the follow
      up except for two cases which presented urinary tract infection. BUN, creatinine
      and other biochemical figures remained within normal ranges.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8368101
TI  - [Lymphatic staging by laparoscopic surgery].
AB  - Lymphadenectomy is mandatory in vesical and prostatic tumours for a precise
      staging of candidates to radical surgery. Presentation of our series of 18
      ilioobturative lymphadenectomies between May 1992 and February 1993, performed in
      14 prostate carcinoma and 4 vesical tumours. As most interesting results, the
      average number of nodes removed, which was 8, and the discovery of nodular
      affectation in 5 cases, understaged by the non-invasive procedures, are
      highlighted; likewise, the reduction in surgery duration up to the current frame
      of 80 to 120 minutes must be emphasized. Mortality due to the procedure was null.
      We believe that laparoscopic lymphadenectomy should be the choice technique in
      the staging of tumoral dissemination in the ilioobturative domain.

PMID- 8368102
TI  - [Giant liposarcoma of the spermatic cord].
AB  - Liposarcomas (LS) are malignant mesenchymal tumours which develop in fatty
      tissues. They are basically found at the retroperitoneum where they are
      relatively frequent in adults. The most common type is myxoid LS which, although
      less malignant, has like any other LS a high incidence of local relapses. Primary
      myxoid liposarcoma of the spermatic cord is an unusual, low-aggressiveness
      tumour. Under natural development, it can reach large dimensions with only local
      symptomatology. Pre-operative diagnosis of the paratesticular tumour is often
      difficult to establish, cuenca the teste suenate be differentiated from the
      tumoral mass by physical examination. A diagnostic approach of paratesticular
      tumours, scarcely reported in the literature, can be made by means of a vascular
      study with radionuclides. The choice therapy is surgical, through orchiectomy and
      extensive local removal. Considering the frequency of local relapse of myxoid
      liposarcoma, long-term follow-up is recommended. This paper reports the unusual
      presentation of one case of primary myxoid LS of the spermatic cord with an
      intrascrotal mass of 38 x 24 cm weighing 4,950 gr which is exceptional not only
      because of the site's infrequency but also for its size.

PMID- 8368103
TI  - [Acute urinary retention of psychogenic cause in a girl].
AB  - Psychogenic acute urine retention is not as common as once was thought to be, but
      even more infrequent is its presentation in children. Explanation of one case of
      psychogenic acute urine retention (A.U.R.) in a female child, including analysis
      of diagnosis and treatment.

PMID- 8368104
TI  - [Testicular seminoma manifested by carcinomatous neuropathy: an unusual
      presentation. Review of the literature].
AB  - Contribution of one patient with tetraparesic picture originated by a major
      sensory-motor neuropathy, due to paraneoplastic syndrome produced by a testicular
      seminoma. The patient underwent inguinal orchiectomy and radiotherapy, with
      favourable evolution of his neurological symptomatology. Review of the literature
      and confirmation of the extraordinary rarity of such clinical picture.

PMID- 8368105
TI  - [Renal abscess in patients diagnosed with AIDS and disseminated tuberculosis].
AB  - Presentation of two cases of renal abscess formation in patients with stage IV C
      1 AIDS and active associated tuberculosis. The microorganism isolated in the
      first case was S. aureus. Culture of the second cases was artefacted since
      antibiotic administration had already been started. Also, both patients showed
      abdominal abscesses, at spleen and liver level in the first case, and prostatic
      level in the second case, both compatible with Mycobacterium tuberculosis
      dissemination. Both cases showed a lethal evolution. The role played by the
      immunodeficiency as a precipitating agent in the extrapulmonary tuberculosis and
      in the formation of renal abscesses is analyzed.

PMID- 8368106
TI  - [Ureteral endometriosis. Review of the literature].
AB  - Ureteral endometriosis is an uncommon process. It should be suspected, however,
      in patients with known pelvian disease presenting urological sings and symptoms.
      It is important to establish early diagnosis which does not delay a conservative
      therapeutical approach, so as to avoid the progressive decline of renal function
      and, eventually, nephrectomy. Contribution of one case of extraluminar ureteral
      endometriosis fitting this hypothesis and review of the most appropriate
      etiology, sings and symptoms, diagnosis and therapeutical approach.

PMID- 8368108
TI  - [Laparoscopic exeresis of a completely duplicated kidney].
AB  - During the '80s, laparoscopy in general has undergone an enormous boom as
      representative of minimally invasive surgery, urology standing out in that
      progression as the specialty leading the endoscopic approach both for the
      tradition and profusion of techniques developed. In Spain, major scope
      laparoscopic surgery started with lymphadenectomy in which we are the second
      Spanish and first Andalusian group to perform it. The experience accumulated by
      our group has allowed us to perform and present one case of laparoscopic
      nephrectomy, this being the first time in Andalusia and second in Spain that an
      Urology Unit develops this technique, the distinct feature being the presence of
      complete duplicity of the kidney. The procedure had no peri or post-operative
      complications and the patient was discharged four days later. We conclude that
      although presently the indications of renal exeresis for this procedure are
      limited, these will soon be expanded thanks to the urologists' concern, the
      accumulation of experience and the improvement of the instrumentarium.

PMID- 8368107
TI  - [Retrovesical hemangiopericytoma].
AB  - The hemangiopericytoma is an uncommon variety of the mesenchymal tumour derived
      from pericapillary structures, most frequently located in limbs and exceptionally
      at the retroperitoneum level. Although macroscopically the aspect is benign, this
      tumour has a recognised ability for local invasion and distant dissemination.

PMID- 8368109
TI  - [Paratesticular tumor. Liposarcoma of the spermatic cord].
AB  - Liposarcoma of the spermatic cord is a rare tumour typically presenting in
      elderly people. It tends to grow around blood vessels. Most of them have a low
      level of malignancy and relapses tend to be localized. Metastasis, when present,
      occur through the haematological route, lymph spread being very unusual. Pre
      operative diagnosis is infrequent and overall prognosis is good. The choice
      treatment is radical orchidectomy, while long-term follow-up of these patients is
      mandatory. When local relapses become evident, the choice treatment is extensive
      local excision, followed by optional adjuvant radiotherapy. Chemotherapy has not
      proven to be effective. This paper reviews the current literature and contributes
      one case of mixed liposarcoma of the spermatic cord.

PMID- 8368110
TI  - [Cytogenetic characteristics and of primary culture in multiple renal tumors].
AB  - The incidence of multiple tumours in renal cancer ranges between 1 and 30%. In
      these cases, it becomes very difficult to differentiate between adenoma and
      carcinoma just by using conventional methods, particularly in borderline cases.
      We carried out primary cultures and subsequent cytogenetic studies in 2 patients
      with multiple renal cancer. Clonal numerical changes in the first case were: 3,
      7, 16 and 17 trisomies, chromosome loss; and structural changes, del(1) (p34),
      del(2) (p16, p22). In the second case, clonal numerical changes were 7 trisomy
      and tetrasomy and loss of the Y chromosome. Both tumours were cytogenetically
      characterized as papillary renal tumours. The diagnostic approaches are discussed
      and the prognosis possibilities evaluated, using this method to evaluate them in
      multiple renal tumours.

PMID- 8368111
TI  - [Endometrioid carcinoma of the prostate. Report of a case].

PMID- 8368113
TI  - [Shockwave cytotoxicity on neoplastic and non-neoplastic cells].
AB  - Since initial application of high-energy shockwaves to treat renal lithiasis,
      their usefulness has been extended within both the clinical and experimental
      fields. Shockwaves cytotoxic action is determined by means of cell viability
      methods of vital staining exclusion and nucleoside uptake. Application of
      shockwaves on cell cultures is carried out by means of an electromagnetic
      lithotripter. High-energy shockwaves have had cytotoxic action both on non
      tumoral and tumoral cells, during "in vitro" experiments. The cytotoxicity
      produced by the shockwaves, however, is different in tumoral and non-tumoral
      cells, the viability inhibition being higher in tumoral cells.

PMID- 8368112
TI  - [Adrenal gland surgery. Review of 34 cases].
AB  - Over the last few years, a better anatomical and functional knowledge of the
      adrenal glands has allowed us to diagnose and treat optimally most of these
      gland's conditions. A variety of medical (endocrinology, anaesthesiology) and
      surgical specialties have been used to this aim. This paper reviews the adrenal
      gland's diseases treated in our unit over the last 9 years. Pre-operative
      management, ways of approach, morbidity and mortality as well as results are
      analyzed and compared with those obtained by other authors.

PMID- 8368114
TI  - [Immunoprophylaxis of recurrence of T1 G2 bladder tumors with interferon alpha
      2b].
AB  - Assessment of results with -2b Interferon used as prophylaxis in 20 patients who
      underwent surgery for T1,G2 urothelial vesical tumours. Dosage was weekly
      intravesical instillation of 50 x 10(6) IU for three months and then monthly up
      to one year treatment. Mean follow-up was 17.20 months (4-41 months). Relapse
      rate over this time was 50%, all before 15 months, a relapsing ratio of 2.82%
      patients/month and a disease-free interval of 27.5 months. Chances of being
      disease-free at 30 months is 48.21%. Progression of disease, whether in grade or
      stage, was observed in 25% cases. No patient showed relevant changes or side
      effects during treatment, except for 5 patients who reported mictional symptoms
      mainly during the first 3 months, none of which required discontinuation of
      treatment. From the data obtained, it can be deduced that for the time being no
      reason justifies the use of -2b Interferon versus other conventional
      chemotherapeutical or immunotherapeutical (BCG) agents in the prophylaxis of this
      type of tumours.

PMID- 8368115
TI  - [Extracorporeal lithofragmentation and of direct contact. Development of
      mathematical models for calculating the energy and predicting the fragmentation].
AB  - The present experimental 'in vitro' study pursues the development of mathematical
      equations which, prior to lithofragmentation, would allow to estimate the amount
      of energy required and to predict the degree of fragmentation for each of the
      different sources of energy. A total of 114 calculi with 6 different compositions
      were analyzed by conventional X-rays (Rx), computerized axial tomography (CT) and
      dual X-ray densitometry (DO). Calculi were then fragmented using 4 different
      types of energy: electrohydraulic (LEH), piezoelectric (LEP), ultrasounds (US)
      and pulse laser (LAS). The correlation between imaging techniques parameters on
      the one side, and the amount of energy used and degree of fragmentation obtained
      on the other one, allow with a multiple linear regression analysis, both to
      develop mathematical equations to estimate the amount of energy required, and to
      predict the fragmentation rate.

PMID- 8368116
TI  - [Renal retransplantation. Study of 91 cases].
AB  - Review of 91 retransplantations performed at our hospital between 1975 and 1991.
      There were 82 second transplants and 9 third transplants. Survival of patients to
      undergo retransplantations continues to increase. Over the last year, 19.1% of
      our transplants were the 2nd or 3rd ones for some patients. Analysis of causes
      for graft loss, which essentially are of immunological and surgical nature.

PMID- 8368117
TI  - [Diagnostic effectiveness of CT and MR in local staging of renal tumors].
AB  - The aim of this paper is to study the pre-operative staging of renal tumours,
      comparing CT and MR, and the imaging criteria used, examining the diagnostic
      efficacy for each of them. Thirty-four tumours were obtained from 29 patients.
      All cases were studied with CT and MR. To measure diagnostic efficacy, both for
      each technique and the criteria used in 2 different readings, a diagnostic
      performance curve (DPC) is calculated. Neither CT nor MR show infiltration of
      renal capsule. With regard to perinephritic fat, fascia and adjacent organ
      invasion, both techniques lead to overstaging, mainly CT. When applying more
      conservative reading criteria, the results are much improved, specially in
      relation to CT, although results with MR continue to be more favourable. MR is
      better to study vascular invasion, providing no false results. Of 22 tumours
      undergoing surgery, first option was the correct staging in 14 tumour with CT and
      in 16 with MR. When selecting the best imaging technique to stage renal tumours,
      MR allows a better and simpler radiologic reading. Nevertheless, considering the
      high correlation between CT and MR, CT can be used more reliably in institutions
      where no easy access to a MR unit is available. Both CT and MR overstage renal
      tumours.

PMID- 8368118
TI  - [Incidental renal adenocarcinoma: study on 54 cases].
AB  - Between 1974 and 1992, both inclusive, 204 renal adenocarcinomas were treated in
      the Urology Unit of the '12 de Octubre' Hospital, of which 54 (26.4%) were
      diagnosed by chance. The relative frequency of these renal tumours has
      experienced a highly significant progressive increase, from 0 in the 1974-1978
      interval, to 13.04% in 1978-1980, 14.7% between 1981-1983, 20.68% in 1984-1986,
      37.84% in 1987-1990, to reach over the last three-year period of 1990-1992 the
      remarkable figure of 41.93%. There has been no differences regarding incidence by
      sex (50% males and 50% females). Mean age at presentation is 61.5 years, ranging
      from 23 to 78 years. The suspected pathological cause most frequently leading to
      carry out the study where renal carcinoma is accidentally diagnosed are
      gastrointestinal disorders (50% of cases). The most frequently used imaging
      diagnostic technique is ultrasound (50% cases), emphasising the gradual increase
      in the number of cases diagnosed by ultrasound or CAT during the course of the
      study. Carcinomas accidentally diagnosed by CAT are those with less volume in our
      series. Regarding tumour characteristics, it should be pointed out a higher
      occurrence in the right kidney (64.8%) and a most frequent location in the upper
      renal pole (48%). Mean tumoral volume was 126 cc, although that value has
      gradually dropped, so that now the mean volume of accidental tumours treated over
      the last 5 is being 91 cc. Most cases present low staging at the time of
      diagnosis, 81% being pT2 N0 M0. Current overall survival is 89% of all cases
      followed-up.

PMID- 8368119
TI  - [Spontaneous perirenal hematoma secondary to hydronephrosis in pelvic kidney].
AB  - Contribution of one case of Spontaneous Perirenal Haematoma (SPH) secondary to
      hydronephrosis accompanied by lithiasis in pelvic kidney. SPH can result from
      multiple causes, the most frequent ones being renal tumours, most particularly
      angiomyolipoma and hypernephroma. Hydronephrosis is an uncommon cause of SPH, and
      very few cases are described in the literature. The present paper addresses the
      diagnostic usefulness of the various radiological tests as well as the
      therapeutical approach to be followed.

PMID- 8368120
TI  - [Ultrastructural study of the stromal component in urethral caruncle].
AB  - The stromal component of the urethral caruncle (UC) comprises a mixture of
      inflammatory, vascular, and fibrotic phenomena. Although mastocytes are cell
      elements known to appear in relation with chronic inflammation, there is no data
      in the literature explaining their significance in UCs or their ultrastructure
      relation with fibroblasts. We postulate that this special form of intercellular
      attachment could play a role in this condition's pathogenesis.

PMID- 8368121
TI  - [Systemic lupus erythematosus (S.L.E.) and (lupoid) interstitial cystitis].

PMID- 8368122
TI  - [Metastatic disease of the penis. Report of 3 cases].
AB  - Metastatic lesions of the penis are uncommon, only some 200 cases having been
      reported in the literature. Priapism is the most frequent symptom, although
      increased penis size, ulceration and nodes formation have also been described;
      metastasis happens simultaneously in 20% cases while in 50% of cases they appear
      2 years after initial diagnosis. Survival of untreated patients has not exceed 24
      weeks, whereas treated patients have survived 47 weeks.

PMID- 8368123
TI  - [Leiomyosarcoma of the spermatic cord].
AB  - Presentation of an uncommon paratesticular tumour, located in the spermatic cord
      and originated in the smooth muscle of the cremaster, deferent, or the cord's
      vascular structures. In 1966, KYLE in Canada reviewed 22 cases of paratesticular
      leiomyosarcoma from the English literature, and in 1984 PUTS in the Netherlands
      extended this catalogue to 39. TAKAHA in 1991 presented 18 cases found in the
      Japanese literature. The theory of malignant degeneration from a previously
      existing leiomyomatous tumour is generally accepted. This entity is clinically
      associated with a clear tendency to local relapse, which does not imply a worse
      prognosis, and with a high percentage of blood metastasis three years after
      exeresis. The choice therapy is oncologic inguinal orchiectomy. Radiotherapy and
      chemotherapy, as coadjuvant therapies, appeared to be more effective in
      children's than in adult's sarcoma. Prognosis of these neoplasias in the reviewed
      literature is highly variable, ranging between 10% and 62% survival at 5 years,
      possibly due to the diversity of therapies and the patient's stage at the time of
      diagnosis.

PMID- 8368124
TI  - Protein purification by dye-ligand chromatography.
AB  - Dye-ligand chromatography has developed into an important method for large-scale
      purification of proteins. The utility of the reactive dyes as affinity ligands
      results from their unique chemistry, which confers both the ability to interact
      with a large number of proteins as well as easy immobilization on typical
      adsorbent matrices. Reactive dyes can bind proteins either by specific
      interactions at the protein's active site or by a range of non-specific
      interactions. Divalent metals participate in yet another type of protein-reactive
      dye interactions which involve the formation of a ternary complex. All of these
      types of interactions have been exploited in schemes for protein purification.
      Many factors contribute to the successful operation of a dye-ligand
      chromatography process. These include adsorbent properties, such as matrix type
      and ligand concentration, the buffer conditions employed in the adsorption and
      elution stages, and contacting parameters like flowrate and column geometry. Dye
      ligand chromatography has been demonstrated to be suitable for large-scale
      protein purification due to their high selectivity, stability, and economy. Also,
      the issue of dye leakage and process validation of large-scale dye-ligand
      chromatography has been discussed. Reactive dyes have also been applied in high
      performance liquid affinity chromatographic techniques for protein purification,
      as well as non-chromatographic techniques including affinity partition, affinity
      membrane separations, affinity cross-flow filtration, and affinity precipitation.

PMID- 8368125
TI  - The role of enantioselective liquid chromatographic separations using chiral
      stationary phases in pharmaceutical analysis.

PMID- 8368126
TI  - Molecular biochromatography: an approach to the liquid chromatographic
      determination of ligand-biopolymer interactions.

PMID- 8368127
TI  - Aging, comorbidity, and breast cancer survival: an epidemiologic view.
AB  - This is a review of epidemiologic studies, which suggest that comorbidity (e.g.,
      diabetes and heart disease) has an adverse effect on survival among women with
      incident, invasive breast cancer, adjusting for chronological age and stage of
      breast cancer at diagnosis. As part of this review, recent results are presented
      from a series of 463 breast cancer cases, identified through the Metropolitan
      Detroit Cancer Surveillance System. Women with two or more concurrent health
      conditions were 2.2 times more likely than breast cancer cases without
      comorbidity to die from their breast cancer over a four-year period (95% CI:
      1.13, 4.18). Limiting heart disease was especially problematic. Recommendations
      are made for future research in this area.

PMID- 8368128
TI  - Cytogenetics and clinical correlations in breast cancer.
AB  - We describe an ongoing study examining the relevance of cytogenetic changes in
      primary and metastatic breast cancer. Tumors samples from breast cancer patients
      are karyotype using G-banding techniques, and all chromosomal findings, including
      the presence of structural and numeric clonal abnormalities, are documented in a
      dynamic patient data base. Information on essential clinical characteristics is
      collected, and patients are followed longitudinally for disease recurrence,
      progression, and survival. Statistical analyses will examine potential
      correlations between specific abnormalities and clinical features of the disease,
      and survival differences between patients will be examined as a function of
      karyotypic differences. We anticipate that this research will provide insights on
      the natural history of breast cancer and help direct the search for the
      underlying molecular mechanisms of tumor genesis and progression.

PMID- 8368129
TI  - Breast cancer: influence of endocrine hormones, growth factors and genetic
      alterations.

PMID- 8368130
TI  - Regulation of estrogen receptor expression in breast cancer.
AB  - One of the most prevalent of cancers, breast cancer, is characterized by hormonal
      control of its growth. Expression of the estrogen receptor (ER) in MCF-7 breast
      cancer cells appears to be a complex process involving multiple steps subject to
      hormonal regulation by estrogen. Treatment of MCF-7 cells with estradiol results
      in the suppression of estrogen receptor protein. By 6 hours, the receptor protein
      declined by about 60% from a level of approximately 3.6 to 1.2 fmol/micrograms
      DNA and remained suppressed for 24-48 hours. Similar results were obtained with
      an estrogen receptor binding assay. Estrogen treatment also resulted in a
      decrease of receptor mRNA to approximately 10% of control values by 6 hours.
      Estrogen receptor remained at the suppressed level for up to 48 hours.
      Transcription run-on experiments demonstrated a transient decrease of about 90%
      in receptor gene transcription after 1 hour. By 3-6 hours transcription increased
      approximately 2-fold and remained elevated for at least 48 hours. These data
      suggest that estrogen suppresses ER mRNA by inhibition of ER gene transcription
      at early times and by a post-transcriptional effect on receptor mRNA at later
      times. To determine whether post-transcriptional regulation of ER gene expression
      is mediated by an ER-dependent mechanism independent of protein synthesis, we
      used the competitive estrogen antagonist, 4-hydroxytamoxifen, and the inhibitor
      of protein synthesis, cycloheximide, to study the regulation of ER mRNA by
      estradiol. 4-Hydroxytamoxifen had no effect on the steady-state level of receptor
      mRNA and effectively blocked the suppression of ER mRNA by estradiol. The
      metabolic inhibitor, cycloheximide, was unable to prevent the estrogen induced
      decrease in ER mRNA. These data provide evidence that the post-transcriptional
      suppression of ER expression through estradiol is mediated through the ER
      independent of protein synthesis.

PMID- 8368131
TI  - Aging and development of ovarian epithelial carcinoma: the relevance of changes
      in ovarian stromal androgen production.
AB  - There are three types of ovarian neoplasms: (1) Those which arise from the
      surface epithelium covering the ovary. (2) Those which are derived from the
      cortical mesenchymal stroma. (3) Those which develop from germ cells. Our
      laboratory has concentrated its effort on solid tumors in women of the first
      type, epithelial, which has the highest incidence and is the most lethal.
      Development of these tumors is correlated with aging in the ovary. They form
      primarily during the perimenopause. Among women, 64% of the total ovarian cancer
      cases are diagnosed between ages 41 and 60 years. Our approach has been to
      establish stable tumor cell lines from patient specimens for use as in vitro
      models. We have investigated the response of these cells to steroid hormones
      because we hypothesized that these tumors retain some metabolic characteristics
      which are specific to the ovary. Our data demonstrate that testosterone and
      androstenedione, but not cortisol, inhibited proliferation of ovarian tumor cells
      in vitro by a mechanism which was independent of steroid receptors. These
      androgens are routinely synthesized and secreted by human ovary, and in the
      menopausal ovary the primary source of androgen is the stromal cell compartment.
      Because a relatively high local concentration of ovarian androgen exists in vivo,
      it is possible that androgen may suppress ovarian epithelial carcinoma in women
      as well. If it does, then development of this carcinoma may be facilitated when
      the postmenopausal ovary fails to produce adequate androgen during
      postreproductive years.

PMID- 8368132
TI  - Prostatic cancer: an age-old problem.

PMID- 8368133
TI  - Stromal-epithelial paracrine interactions in the neoplastic rat and human
      prostate.
AB  - Homotypic paracrine interactions in the rat and human prostate have been
      investigated using prostatic stromal cells and neoplastic epithelial cells (PA
      III, rat; TSU-pr1, human). Secretory proteins prepared from each cell type were
      used to determine the dose dependent regulation of growth (DNA synthesis) of the
      corresponding homotypic responder cell, as determined by 3H-thymidine
      incorporation. PA-III secretory protein stimulated rat stromal cell proliferation
      by 1.8-fold. This stimulatory activity of PA-III protein on stromal cell
      proliferation was partially reduced (approximately 35%) by treatment with nerve
      growth factor (NGF) antibody, whereas neither acidic fibroblast growth factor
      (aFGF) antibody nor basic fibroblast growth factor (bFGF) antibody
      immunoneutralized the stimulatory activity of PA-III cell protein. In the
      corresponding opposite interaction, rat stromal cell protein modulated PA-III
      growth in a biphasic manner. At lower concentrations of stromal cell protein
      (1.25 micrograms/ml) PA-III cell growth was stimulated by 1.6-fold, whereas at
      higher concentrations of protein (100 micrograms/ml) PA-III cell growth was
      inhibited to 60%. Treatment of the stromal cell protein (1.25 micrograms/ml and
      100 micrograms/ml) with NGF antibody reduced PA-III cell relative growth to
      approximately 30% and 5%, respectively. bFGF antibody treatment of stromal cell
      protein at 1.25 micrograms/ml did not influence relative growth, whereas bFGF
      antibody treatment of 100 micrograms/ml stromal cell protein reduced relative
      growth by an additional 40%. Treatment of the stromal cell protein (1.25
      micrograms/ml and 100 micrograms/ml) with aFGF antibodies reduced relative growth
      from that observed at these two protein concentrations by approximately 50% in
      both cases. Human epithelial TSU-pr1 protein stimulated human stromal cell
      proliferation approximately 1.7-fold. Treatment of TSU-pr1 protein with NGF
      antibody resulted in stimulation of human stromal cell proliferation (4-fold). In
      the corresponding opposite interaction, human stromal cell secretory protein
      stimulated TSU-pr1 epithelial cell proliferation in a dose-dependent manner up to
      a maximum of 2.6-fold. This stimulation of TSU-pr1 proliferation by stromal cell
      secretory protein was reduced to 20% of maximal levels by treatment with antibody
      against NGF, whereas antibodies against bFGF and aFGF did not significantly
      influence the stimulatory effect of stromal cell secretory protein mediated
      proliferation of TSU-pr1 cells. These results suggest that prostatic stromal
      cells and neoplastic epithelial cells secrete several paracrine factors. One of
      these factors is nerve growth factor-like, and appears to have a major non
      neurotrophic influence on the paracrine regulation of prostatic growth.

PMID- 8368134
TI  - Age related changes in adults with acute leukemia.

PMID- 8368135
TI  - Significance of chromosomal changes in patients of different age groups with
      acute leukemia.
AB  - Chromosome abnormalities have been observed in about 50% of patients with acute
      leukemia. There have been several published reports which emphasized the
      chromosomal changes in relation to the age of the patient and the morphologic
      type of acute leukemia. All observations suggest that there are both age related
      similarities and differences. The karyotype is an important independent
      prognostic factor in acute leukemia; however, age alone (especially above age 70)
      is the single most important factor for a poor prognosis.

PMID- 8368136
TI  - Glucocorticoid receptors in leukemias, lymphomas and myelomas of young and old.
AB  - In this paper we have briefly reviewed the nature of leukemias and lymphomas in
      the old and the young. We surveyed in general the ways in which lymphoid cells
      and other hematologic elements respond to glucocorticoids, mentioning that there
      may be direct or indirect effects on their growth by these ligands. We have
      reviewed the current general model for the action of glucocorticoids in all
      cells, namely the fact that the actions of these steroids are mediated to a large
      extent through binding with ligand-activated transcription factors, their
      receptors. The growing wealth of detail about the nature of the interaction of
      these receptors with regulatory sites in the genome is discussed. Finally, we
      have described our results with lines of tissue culture cells representing clones
      from a typical leukemia of the young, and of myeloma, a typical hematologic
      malignancy of the elderly. Several features of the effects of glucocorticoids on
      these cells point up areas that would be pertinent to explore in aging and in the
      relationship of hematologic diseases to survival and response to therapy in the
      older versus the younger patient.

PMID- 8368138
TI  - General aspects of cancer chemotherapy in the aged.

PMID- 8368139
TI  - Summation and synthesis: from the cancer cell biology point of view.

PMID- 8368137
TI  - Genetic and molecular basis for cellular senescence.
AB  - Normal human and rodent cells in culture exhibit a finite life span at the end of
      which they exhibit morphological changes and cease proliferating, a process
      termed cellular senescence or cellular aging. Many cancer cells differ from
      normal cells in that they do not senesce and have an indefinite life span in
      culture, suggesting that alterations relating to cellular senescence are involved
      in the neoplastic evolution of tumor cells. Recent experimental results strongly
      support a genetic basis for cellular senescence. Defects in the senescence
      program in transformed cells can be corrected by introduction of a specific
      chromosome from normal cells into the abnormal cells. Using this approach,
      possible senescence genes have been mapped to specific chromosomes. Cell cycle
      control genes that regulate entry into the DNA synthetic phase of the cell cycle
      must be altered in senescent cells. Recent findings suggest that phosphorylation
      of the retinoblastoma gene is altered in senescent cells. It is possible, but not
      yet proven, that aging at the cellular level contributes to the aging of the
      individual. Therefore, an understanding of cellular senescence at the genetic and
      molecular levels may provide new insights into both the cancer and aging
      processes.

PMID- 8368140
TI  - Summation and synthesis: from the immunology point of view.

PMID- 8368141
TI  - Summation and synthesis: from the aging point of view.

PMID- 8368142
TI  - A single gene change can extend yeast life span: the role of Ras in cellular
      senescence.
AB  - The budding yeast Saccharomyces cerevisiae has a limited life span (reproductive
      capacity), which is measured by the number of times an individual cell divides.
      There is evidence for the involvement of a senescence factor that affects cell
      cycle traversal in older yeast cells. Distinct alterations in the abundance of a
      handful of transcripts have been identified during the life span of this
      organism, and the genes that specify these mRNAs have been cloned. This raises
      the question whether the activity of one or more genes can alter the yeast life
      span. Indeed, the controlled expression of the transforming gene of Harvey murine
      sarcoma virus (v-Ha-ras) was found to extend the life span nearly two-fold. The
      normal homologs of this oncogene, RAS1 and RAS2, play a central role in the
      integration of cell growth and the cell cycle in yeast. Expression of v-Ha-ras
      appears to impinge on this integration. We suggest that it is the relative levels
      of the senescence factor and the Ras protein that determine whether a cell ceases
      to divide and senesces. We liken the senescence factor to the product of an anti
      oncogene or tumor suppressor gene that neutralizes Ras.

PMID- 8368144
TI  - Tumors and aging: the influence of age-associated immune changes upon tumor
      growth and spread.

PMID- 8368143
TI  - A comparison of the properties of human p53 mutant alleles.

PMID- 8368146
TI  - Introduction: sphingolipids and their metabolites in cell regulation.

PMID- 8368145
TI  - T cell differentiation and functional maturation in aging mice.

PMID- 8368147
TI  - The role of sphingosine in cell growth regulation and transmembrane signaling.

PMID- 8368148
TI  - Verotoxins and their glycolipid receptors.

PMID- 8368149
TI  - Glycosphingolipid tumor antigens.
AB  - Tumor-associated glycosphingolipids are a common finding in human tumors, and
      monoclonal antibodies directed to defined carbohydrate epitopes of these
      structures have been developed. A majority of the glycosphingolipid antigens are
      of the lacto series, types 1 and 2, and these epitopes are often also found on
      glycoproteins. The tumor-associated gangliosides of the ganglio series,
      preferentially found in tumors of neuroectodermal origin, have binding epitopes
      that have not been detected in glycoproteins. A large number of monoclonal
      antibodies, mainly murine but some human, have been produced, and their epitope
      specificity defined. These antibodies have been used for investigation of the
      role of tumor-associated glycosphingolipids in tumor cells. Some antibodies have
      been shown to inhibit the growth of tumor cell lines in vitro and in vivo and to
      influence the adhesion properties of tumor cells, and some antibodies have been
      shown to give a clinical response. Tumor cell lines are commonly used in tumor
      biology studies, but the expression of tumor-associated glycosphingolipids in
      tumor cell lines does not always reflect their expression in the tumor tissue
      from which the cell line originates. The expression of tumor-associated
      glycosphingolipids has also been shown to be different in cells grown in vitro or
      as solid tumors in nude mice or rats. In conclusion, monoclonal antibodies
      specific for tumor-associated glycosphingolipids may be valuable tools in
      diagnosis and, in addition, in therapy, glycosphingolipids may also be used in
      active immunotherapy. The availability of these antibodies also opens the
      possibility of studying the biological function of glycosphingolipids and may
      then lead to new approaches for the improved diagnosis and therapy of human
      tumors.

PMID- 8368150
TI  - Gangliosides and modulation of the function of neural cells.

PMID- 8368151
TI  - The sphingomyelin cycle: a prototypic sphingolipid signaling pathway.

PMID- 8368152
TI  - The role of glycosphingolipids in hypoxic cell injury.
AB  - Recent advances in the understanding of the molecular mechanism of cell injury
      have led to the realization that cell injury is a gradual process, which
      involves, in its early stages, specific biochemical responses of cells to the
      injury process. In this review, we have shown that the pursuit of the mechanisms
      by which inhibition of a specific GSL (GalCer) in hypoxic OLG occurs can lead to
      (1) an understanding of how the synthesis and transport of GalCer are regulated
      in the cell, and (2) evidence that the injury causes a potentially devastating
      (yet reversible) block in the production of this important lipid. This review has
      also discussed evidence that GSL, in their roles as regulators of the cell's
      interaction with its environment, can play important roles in determining the
      outcome of injurious processes.

PMID- 8368153
TI  - Bioactive gangliosides: differentiation inducers for hematopoietic cells and
      their mechanism(s) of actions.

PMID- 8368154
TI  - Ceramide: a novel second messenger.
AB  - The data discussed in the preceding sections suggest that information may be
      transmitted both through synthesis and through degradation of sphingomyelin.
      Although the sphingomyelin pathway holds promise as a new signaling system
      coupling TNF receptor activation to cellular stimulation (Fig. 5), the work is
      still at a preliminary stage. A physical association of receptors with neutral
      sphingomyelinase has yet to be established and the ceramide-activated protein
      kinase has yet to be isolated. Endogenous substrates for the kinase have also to
      be identified. Furthermore, the exact role of this pathway has not been defined.
      It is unclear whether this pathway is specific to monocyte differentiation or
      cytokine action. It also seems unlikely that a single signal transduction
      mechanism can account for all the diverse effects of TNF-alpha in different
      systems (Vilcek and Lee, 1991). Interactions with other signaling systems are
      sure to complicate elucidation of the exact role(s) of this pathway.
      Nevertheless, availability of cell-permeable analogs of ceramide, localization of
      many components of the system at the cell surface, and recent development of anti
      TNF receptor antibodies to receptor isotypes may allow for greater definition of
      the sphingomyelin pathway in the near future.

PMID- 8368155
TI  - Occupational asthma--a model to study the natural history and pathogenic
      mechanisms in asthma.
AB  - Occupational agents can give rise to asthma either through producing specific IgE
      antibodies or through some as yet unidentified immunological mechanism. Study of
      pathogenic mechanisms of occupational asthma can generate very useful information
      on the pathogenesis of nonoccupational asthma. Occupational asthma also provides
      an ideal model to study the natural history of asthma. As the agent responsible
      for asthma is known, it is possible to design a study to investigate predisposing
      host factors and level of exposure and their interaction in determining the
      onset, the severity, and the outcome of the disease.

PMID- 8368156
TI  - Isocyanate induced lung disease.
AB  - A review of the pathogenesis of isocyanate induced lung disease is given with an
      emphasis on immunologic mechanisms of disease.

PMID- 8368157
TI  - Recombinant Aspergillus fumigatus allergen I/a (rAsp f I/a) in the diagnosis of
      Aspergillus related diseases.
AB  - A. fumigatus allergen I/a (rAsp f I/a) was produced in Escherichia coli, affinity
      purified by Ni(2+)-chelate chromatography and refolded. rAsp f I/a binds IgE of
      A. fumigatus-allergic individuals as shown by ELISA, dot blots and Western blots.
      In addition, rAsp I/a elicited positive immediate type I skin reactions in
      individuals allergic to A. fumigatus but not in control individuals. Hence, rAsp
      f I/a can be used as a standardized antigen/allergen for an improved serological
      and clinical diagnosis of A. fumigatus-associated diseases.

PMID- 8368158
TI  - The role of cell adhesion molecules in asthma--an overview.

PMID- 8368159
TI  - Efficacy of monoclonal antibodies against adhesion molecules in animal models of
      asthma.
AB  - Cell surface adhesive glycoproteins are principal regulators of nearly all
      aspects of immune/inflammatory responses. Using monoclonal antibodies to
      individual adhesion molecules, the expression and contribution of specific
      molecules in the pathogenesis of allergen-induced airway hyperresponsiveness in
      monkeys has been deciphered. Results confirm the importance of cell adhesion and
      demonstrate that antagonism of a single adhesion molecule may provide a novel
      therapeutic approach.

PMID- 8368160
TI  - Adhesion proteins on airway eosinophils in allergy and asthma.
AB  - Adhesion to, and interaction with, airway endothelium, interstitial matrix and
      epithelium during migration to the allergen-challenged airways of allergic
      rhinitis and asthma patients may account for the observed functional upregulation
      (priming) of airway eosinophils compared with corresponding blood eosinophils.

PMID- 8368161
TI  - Strategies for in vivo blocking of adhesion molecules.

PMID- 8368162
TI  - Cytokines in allergic inflammation.

PMID- 8368163
TI  - Eosinophils and cytokines.
AB  - Cytokines act on eosinophils to regulate eosinophil function, with IL-5
      recognised to be especially important in control of eosinopoiesis, eosinophil
      survival and eosinophil priming. In addition, eosinophils have the capacity to
      produce cytokines involved in acute and chronic inflammatory and repair
      processes, as well as to produce cytokines that stimulate eosinophils within an
      autocrine loop. This paper describes (A) an immunomagnetic selection technique
      for the purification of human blood eosinophils, and (B) a method that employs
      immunofluorescence with flow cytometry for measurement of blood and sputum
      eosinophil surface markers. Having demonstrated that sputum eosinophils express
      HLA-DR, highly purified blood eosinophils were used to analyse (C) the induction
      and function of eosinophil HLA-DR. Cytokines have the capacity to induce
      eosinophil HLA-DR, and are produced by eosinophils as an accessory function
      during antigen presentation. Finally, preliminary data on (D) eosinophil
      production of IL-8 is presented. Hence, eosinophils have the capacity to act as
      immunomodulatory cells within cells networks in allergic and asthmatic
      inflammation.

PMID- 8368164
TI  - Mast cell cytokines in allergy and inflammation.
AB  - Recent findings indicate that mast cells can influence biological responses
      through the production of cytokines and suggest that many allergic reactions and
      other biological processes may be regulated by a "mast cell-leukocyte cytokine
      cascade". This hypothesis proposes that certain biological responses are
      initiated by mast cell activation, resulting in the mast cell-dependent release
      of TNF-alpha and other cytokines which can promote the recruitment of
      eosinophils, neutrophils, and other effector cells. The recruited effectors then
      influence the progression of the response by providing additional sources of some
      cytokines which also can be elaborated by mast cells, as well as by producing
      other cytokines not known to be of mast cell origin.

PMID- 8368165
TI  - Bronchial hyperreactivity and eosinophil granule proteins.
AB  - Five lines of evidence support the hypothesis that the eosinophil, possibly
      through its granule proteins, mediates bronchial hyperreactivity. First,
      bronchial hyperreactivity and blood eosinophilia are associated in patients with
      asthma. Second, bronchial hyperreactivity is associated with the number of
      eosinophils and the levels of eosinophil granule MBP in BAL fluids. Third, direct
      instillation of MBP into the lungs of monkeys caused bronchospasm and increased
      reactivity to methacholine. Fourth, direct application of MBP to respiratory
      epithelium caused increased smooth muscle reactivity to acetylcholine, suggesting
      that MBP stimulates respiratory epithelium to produce factors active on smooth
      muscle. Fifth, MBP causes allosteric inhibition of lung M2 muscarinic receptors.

PMID- 8368166
TI  - Is airways hyperreactivity selective or non-selective?
AB  - Airways hyperresponsiveness has often been termed "nonspecific" on account of
      close correlations between responses to histamine and methacholine. This
      relationship, however, does not apply to stimuli, such as exercise,
      hyperventilation, sulphur dioxide, and distilled water. We have shown that
      allergen causes a greater and more prolonged increase in responses to bradykinin
      than to methacholine adding support to the notion that airways
      hyperresponsiveness is a selective pathophysiologic abnormality.

PMID- 8368167
TI  - Muscarinic receptor subtypes: implications for therapy.
AB  - At least three subtypes of muscarinic receptor have been localised to human
      airways. M1-receptors facilitate ganglionic transmission and therefore enhance
      cholinergic reflexes, M2-receptors are localised to post-ganglionic cholinergic
      nerve terminals and inhibit the release of acetylcholine and M3-receptors on
      airway smooth muscle mediate constriction and on submucosal glands mediate
      increased mucus secretion. M3 or mixed M1/M3-receptor antagonists should be
      preferable to the non-selective anticholinergic drugs in current use, since they
      would not increase acetylcholine release from cholinergic nerves.

PMID- 8368168
TI  - (+/-) isoprenaline revisited: adverse effects of sympathomimetics in asthma.
AB  - It is a matter of concern that regular, excessive use of contemporary
      sympathomimetics has been associated with morbidity and mortality from asthma. As
      a consequence, restrictions on sympathomimetic usage have recently been advocated
      in asthma management guidelines. he association between excessive use of inhaled
      (+/-)isoprenaline and an epidemic of asthma deaths in the 1960s provides a
      precedent; hence, we have reviewed the numerous clinical and experimental reports
      concerning (+/-) isoprenaline to provide insight into the present controversy.

PMID- 8368169
TI  - Anomalous bronchospasm following inhalation of (+) isoprenaline by asthmatics.
AB  - Sympathomimetics (beta-adrenergic agonists) presently used in asthma therapy
      comprise racemic mixtures of bronchodilator and non-bronchodilator enantiomers.
      In a randomized, double-blind placebo-controlled study, asthmatic subjects
      inhaled a nebulized solution of the non-bronchodilator (+) enantiomer of
      isoprenaline. Substantial decreased forced expiratory volume (FEV1) was detected
      in 2 patients and of the remaining 8, a single subject had increased reactivity
      to histamine 7 h after inhalation of (+) isoprenaline. These effects of (+)
      isoprenaline may contribute to anomalous effects of (+/-) isoprenaline in asthma.

PMID- 8368170
TI  - Noninvasive methods to examine the anti-inflammatory effects of drugs.
AB  - The anti-inflammatory effects of drugs can be studied non invasively using sputum
      which has either been produced spontaneously or induced with hypertonic saline.
      We have developed an efficient semi-automated method to examine sputum which
      should be widely applicable. This approach is recommended to provide a direct
      sampling of the airway secretions to study the inflammatory process and to
      demonstrate drug effects. We have validated a method to prospectively induce a
      mild exacerbation of airway inflammation by controlled reduction of inhaled
      steroid in steroid-dependent asthmatics. This can be used to examine the ability
      of drugs to prevent or reverse airway inflammation.

PMID- 8368172
TI  - Atopy and the environment.

PMID- 8368171
TI  - Methods for evaluation of anti-asthma drugs in the primate.
AB  - Use of the primate is gaining popularity in the definition of anti-asthma drugs.
      The present report describes three novel tests of (1) bronchodilatation, (2)
      hyperreactivity and (3) anti-inflammatory activity in the rhesus monkey. All
      tests are based on standard clinical techniques and the relevance and application
      of the tests to subsequent clinical evaluation is addressed.

PMID- 8368173
TI  - Air pollution and airway epithelial cells.
AB  - Recent epidemiological evidence suggests that air pollution, resulting from
      vehicle exhaust emissions and burning of liquid petroleum gas or kerosene, may
      play an important role in the development of allergic airways disease. Further,
      agents such as O3 and NO2 are thought to be major proponents of disease and act
      by damaging the airway epithelium. It is hypothesised that this pollution-induced
      damage results in the generation of mediators which lead to inflammation and
      possibly airway hyperreactivity.

PMID- 8368174
TI  - The immunology of extrinsic and intrinsic asthma.
AB  - It is now widely accepted that chronic mucosal inflammation plays an important
      role in the pathogenesis of asthma. This response involves the interaction of
      various cell types and is not the result of a single inflammatory cell acting in
      isolation. The present review describes the possible role of T lymphocytes in the
      inflammatory response of extrinsic (allergic) and intrinsic (nonallergic) asthma,
      focusing mainly on analysis of lymphocyte subpopulations, their activation state
      and cytokines produced in peripheral blood and bronchoalveolar lavages. Recent
      research suggests that there may be fundamental immunological differences between
      intrinsic and extrinsic asthma. In particular, intrinsic asthmatics have
      different patterns of T cell activation and cytokine production.

PMID- 8368175
TI  - [A case of Duane's syndrome with ocular melanosis].
AB  - Duane's syndrome has various ocular and systemic abnormalities. We report a
      Duane's syndrome patient with ocular melanosis. Duane's syndrome has many
      complications, but ocular melanosis has never been reported previously. It is
      possible that there is a similar mechanism between the ocular melanosis and
      misdirection of the oculomotor nerve to the external rectus in this case, but it
      is more probable that it is simply coincidental.

PMID- 8368176
TI  - [Corneal epithelium].

PMID- 8368177
TI  - [Transforming growth factor-beta (TGF-beta) inhibits epithelial wound healing of
      organ-cultured rabbit cornea].
AB  - Transforming growth factor-beta (TGF-beta) is a unique polypeptide growth factor
      which has been found to stimulate mesenchymal cell proliferation and inhibit
      epithelial cell growth. Whether or not TGF-beta inhibits corneal epithelial wound
      closure remains controversial. This study evaluated the effects of TGF-beta on
      corneal epithelial wound healing in vitro. Rabbit corneas with an artificial 8 mm
      epithelial defect were organ-cultured for 48 hr in TC-199 supplemented with TGF
      beta (100 pg/ml, 1 ng/ml, or 10 ng/ml). The contralateral eye served as control.
      TGF-beta at 1 ng/ml and 10 ng/ml concentrations showed significant decrease in
      wound-healing rate compared with the control. 5-bromo-2'-deoxyuridine
      immunohistochemistry showed a significant decrease in S-phase cell count in the 1
      ng/ml group compared with the control. These results strongly suggest that TGF
      beta inhibits corneal epithelial wound healing.

PMID- 8368178
TI  - [Corneal epithelial wound healing in the denervated eye].
AB  - We investigated the rate of corneal epithelial wound healing in rabbits which had
      undergone surgical trigeminal denervation. Seven New Zealand albino rabbits
      underwent unilateral neurotomy of postganglionic trigeminal nerves via
      intracranial route. At 14 days after operation, 10 mm diameter central corneal
      epithelial defects were created in both eyes by n-heptanol. The area of
      epithelial defect was then photographed at 12-hour intervals and the epithelial
      healing rate was calculated (1st experiment). At 14 days after epithelial wound
      closure, the corneal epithelium was again denuded in a similar fashion (2nd
      experiment). The epithelial healing rate of the denervated and control eyes
      respectively were 1.28 +/- 0.25 and 1.39 +/- 0.31 (mm2/hr) in the first
      experiment, and 1.05 +/- 0.20 and 1.44 +/- 0.22 (mm2/hr) in the second. There was
      a statistically significant difference in the epithelial healing rate between the
      two groups in experiment 2 (p < 0.05), These results indicate that corneal
      epithelial wound healing is impaired in the denervated eye.

PMID- 8368179
TI  - [Experimental retinal branch vein occlusion. 4. Pathological changes in the
      middle and late stage].
AB  - Retinal branch vein occlusion in macaca monkeys (Macaca irus) was produced by dye
      laser photocoagulation, and observed histopathologically from five days to one
      year after photocoagulation. Ten days later, retinal edema and hemorrhage
      observed at an early stage gradually decreased. Two weeks later, capillary bed
      closure areas were observed in fluorescein angiography. The capillary closure was
      not reversible when disturbance of the retinal circulation continued for more
      than three or four days after photocoagulation. Three months later, dry retina
      was observed in the capillary bed closure areas. One year later, the retina was
      severely degenerated and thinned. In these retinal areas, capillary lumens
      observed microscopically were occluded by cellular components. Sheathing of large
      veins was observed in these retinal areas. The walls of these large veins were
      thick and fell into hyaline degeneration. Their lumens were narrowed or
      obstructed. During the period of observation, retinal neovascularization was not
      observed.

PMID- 8368181
TI  - [Equivalent ultrasonic velocity for intraocular lens implanted eyes in A-mode
      biometry].
AB  - With the standard ultrasonic velocity in commercially available instruments,
      there is a large difference of the ultrasonic velocity between the ocular medium
      and the implanted intraocular lens (IOL). If the PMMA or silicon IOL-implanted
      eye is assessed by using the ultrasonic velocity of the phakic or aphakic eye
      (1,550 m/s or 1,532 m/s), the error induced by the mismatch of the velocity is
      considerable. Therefore, we estimated the axial length error of pseudophakic eyes
      in ultrasonic biometry, and also derived theoretically the overall average sound
      speed (equivalent ultrasonic velocity, EUV) in IOL-implanted eyes. We found that
      the EUV (VE) can be estimated from the equation, VE = LV1V2/ T(V1-V2)+LV2], where
      L is the axial length of the eye, V1 the ultrasonic velocity of aqueous and
      vitreous body, V2 the ultrasonic velocity of the IOL, and T the central thickness
      of the IOL. The EUV for a PMMA IOL-implanted eye is approximately 1,560 m/s, and
      the EUV for a silicon IOL-implanted eye is approximately 1,500 m/s in an eye of
      standard length (24 mm) and an IOL of standard central thickness (1 mm). However,
      the EUV is a function of the axial length of the eye (L), the central thickness
      of the IOL (T), and the sound velocity in the implanted IOL (V2), and thus the
      EUV can not be applied for all cases. To perform more accurate ultrasonic
      biometry in pseudophakic eyes, we should rectify the apparent axial length
      assessed by the aphakic sound speed (1,532 m/s) with the central thickness of the
      implanted IOL.

PMID- 8368180
TI  - [Evaluation of the effect of the sodium hyaluronate ophthalmic solution on tear
      film stability--non-contact specular microscopic evaluation].
AB  - Sodium hyaluronate solution is known to relieve various dry eye symptoms by
      suppressing the breakup of the preocular tear film. Using tear film stability as
      a parameter, we examined in 12 volunteers the time and concentration-dependent
      effects of sodium hyaluronate on their short precorneal tear film breakup time
      (BUT, 10 sec. or less) at a low tear volume (15 mm or less by using the phenol
      red thread test). Each subject underwent four separate study periods, receiving
      one of the following four ophthalmic solutions during each period: 0.05, 0.1,
      0.3% w/v sodium hyaluronate (molecular weight, about 1,000,000) or the vehicle
      alone. BUT was measured non-invasively using a non-contact specular microscope
      before and 5, 15, 30, 60, 120, and 180 minutes after drug application. While BUT
      was not significantly prolonged after instilling either the vehicle or 0.05%
      solution, it was significantly increased at all times after applying either 0.1%
      or 0.3% solution, as compared to preinstillation. These results indicate that
      sodium hyaluronate solutions at concentrations of at least 0.1% can be effective
      in alleviating symptoms of dry eye.

PMID- 8368182
TI  - [Risk factors for occurrence and progression of diabetic retinopathy].
AB  - The risk factors for the occurrence and progression of diabetic retinopathy were
      estimated in 1084 diabetic subjects (4358 person-years) by logistic regression
      analysis. The diabetic duration, the average of HbA1C for every year of
      observation, the range of HbA1C, the difference of HbA1C between the first visit
      to our clinic and the average of one year of HbA1C were statistically significant
      covariates for the risk of the occurrence of retinopathy. The relative risks of
      the occurrence of retinopathy as compared with the diet were estimated as 2.02 in
      oral administration of medicine and 1.86 in insulin therapy. The interaction
      between the difference of HbA1C and the average of HbA1C was statistically
      significant for the progression of retinopathy. When the response surface was
      estimated, the risk of progression of retinopathy differed greatly according to
      the blood glucose control level.

PMID- 8368183
TI  - [Prevalence of diabetic ocular complications and systemic factors].
AB  - The prevalence of diabetic ocular complications and the correlation between
      diabetic retinopathy and systemic factors were examined in 2,300 cases (4,600
      eyes) with non-insulin-dependent diabetes mellitus. The prevalence of cataract
      was 66.7%, of retinopathy 37.0%, of refractive and accommodative change 6.2%, of
      glaucoma 1.9% (rubeotic glaucoma was 1.0%), of rubeosis iridis 1.5%, of
      iridocyclitis 0.8%, of extraocular muscle palsy 0.2%, and of ischemic optic
      neuropathy 0.1%. Duration of diabetes mellitus, HbA1C value, methods of diabetic
      control, age, diabetic nephropathy, diabetic neuropathy, hypertension, systolic
      blood pressure, diastolic blood pressure, and arteriosclerosis obliterans were
      related with diabetic retinopathy. We suggest that the management of diabetic
      patients needs sufficient attention in the cases with oral administration of
      medication, insulin therapy, and diabetic nephropathy.

PMID- 8368184
TI  - [Evaluation of tissue plasminogen activator and plasminogen activator inhibitor-1
      in blood obtained from patients of idiopathic central serous chorioretinopathy].
AB  - It is postulated that idiopathic central serous chorioretinopathy (ICSC) may be
      induced by a variety of underlying choroidal diseases capable of producing
      initially alterations in the permeability of the choriocapillaries. A history of
      unusual emotional stress frequently accompanies the onset of visual complaints.
      We have reported that alterations of serum lipids may exert a powerful effect on
      tissue plasminogen activator (t-PA) levels acting as a risk factor of variable
      cardioangiopathies. In this study, we evaluated the levels of t-PA activity, t-PA
      antigen and plasminogen activator inhibitor-1 (PAI-1) in blood from the patients
      with central serous chorioretinopathy, and compared them with the levels of total
      cholesterols (TCH), triglycerides (TG), and high-density lipoprotein cholesterol
      (HDL). t-PA activity levels and HDL were lower than in standard controls but t-PA
      antigen, PAI-1 antigen, and TG were higher. These facts may be associated with
      the pathogenesis or pathophysiological features of ICSC.

PMID- 8368185
TI  - [Analysis of blood flow velocity in the ophthalmic artery by color Doppler
      imaging. 2. Studies on diabetic eyes].
AB  - Color Doppler imaging was used to investigate the changes in Pourcelot index
      (RI), which is an index for vascular resistance calculated from the blood flow
      velocity of the ophthalmic artery, related to the complications of diabetes
      mellitus (diabetic retinopathy, diabetic nephropathy) and systemic background
      (duration of diabetes mellitus, value of hemoglobin A1C (HbA1c)) in 46 diabetic
      patients and in 20 normal subjects. RI was significantly higher in diabetic
      patients than in normal subjects (p < 0.05). RI increased in patients without
      retinopathy (p < 0.05), in patients with background retinopathy (p < 0.05), and
      in patients with preproliferative or proliferative retinopathy (p < 0.05), but it
      did not change in patients after panretinal photocoagulation, compared with the
      normal subjects. In diabetic patients, RI was higher (p < 0.05) in patients with
      nephropathy than in those without nephropathy. The time from onset of diabetes
      mellitus and the value of HbA1c had no correlation with RI. Our results indicate
      that choroidal circulation was changed in diabetic patients compared with normal
      subjects and that the changes were related to diabetic nephropathy.

PMID- 8368186
TI  - [Lipoprotein (a) and sclerotic changes in retinal arterioles].
AB  - Lipoprotein (a) (Lp(a)) has been considered an independent risk factor for
      arteriosclerotic disease and its role in retinal vascular changes was studied in
      this report. The study was made on 160 patients of age 54 and above. They were
      divided into four groups depending upon their clinical background with or without
      the presence of diabetes mellitus (DM) and cerebral infarction (CI). The retinal
      vascular status of the patients was studied by ophthalmoscopic examination and
      the findings were graded according to Scheie's classification. We found that all
      the patients with retinal arterial hypertension and arteriosclerosis had a
      significant by high level of serum Lp (a). Similarly, serum Lp (a) level was
      higher in the patients with DM and CI than in the control subjects. These
      findings suggested that Lp (a) might influence the pathological changes of senile
      retinal arterioles. Moreover, we found a positive linear correlation between Lp
      (a) and plasminogen in patients with CI.

PMID- 8368187
TI  - [Inferior oblique underaction].
AB  - We investigated the etiology and incidence of 100 cases of inferior oblique
      underaction. The difference between congenital and acquired underaction was
      discussed using Awaya's New Cyclo Tests (NCT) to examine cyclodeviation
      qualitatively and quantitatively. Inferior oblique underaction had been
      considered more frequently congenital than acquired. However, 63.0% of our cases
      were proved to be acquired. The congenital cases were Brown's syndrome and cases
      of unknown causes and the acquired cases were mainly of myasthenic or traumatic
      origin. The results of the NCT examination were as follows: incyclodeviation or
      no cyclodeviation was encountered in all cases of congenital underaction except
      for one postoperative case, but excyclodeviation rather than incyclodeviation
      occurred in cases of acquired underaction, which showed ocular torticollis to the
      side of the paretic eye. This result suggested that some other muscles were
      involved in acquired cases of seemingly isolated inferior oblique underaction,
      especially in myasthenia gravis. A diagnosis of myasthenia gravis should be
      considered first when an acquired inferior oblique underaction occurs with
      association of excyclodeviation demonstrated by the NCT as well as Cogan's lid
      twitch sign.

PMID- 8368188
TI  - [Study of retinal correspondence in esotropia with phase difference haploscope].
AB  - There is some concern regarding the evaluated depth of anomalous correspondence,
      because we often experience paradoxical results. We have already reported that,
      in intermittent exotropia, we sometimes found dual correspondence with a phase
      difference haploscope (PDH) reducing the stimulus intensity of either image with
      a series of neutral density filters. In this study, we analyzed the retinal
      correspondence in esotropes with the same procedure. 27 esotropes were examined.
      11 cases had normal correspondence and 16 cases anomalous correspondence in PDH.
      All of the 11 normal correspondence cases retained normal correspondence when we
      reduced the stimulus intensity of either image of fixating eyes or squinting
      eyes. In the 16 anomalous correspondence cases in PDH, 2 cases showed normal
      correspondence when the stimulus intensity of the fixating eyes was reduced. On
      the other hand, 3 cases showed normal correspondence when the stimulus intensity
      of the squinting eyes was reduced. In fixed heterotropia, both the fovea and the
      part of the retina of the squinting eye which received the same images as the
      fovea of the fixating eye (fixating point), were suppressed by the fixating eye.
      We consider that, in some cases with anomalous retinal correspondence in PDH,
      when the stimulus intensity of the fixating eyes or the squinting eyes is
      reduced, the balance of the sensitivity of the foveas and the fixating points of
      the squinting eyes change, and show normal correspondence.

PMID- 8368189
TI  - [The assessment of blue mechanism by measuring the threshold versus intensity
      curve under flashed background].
AB  - The threshold versus intensity curve with brief blue stimuli with a flashing
      background of the same wavelength was measured in normal subjects and subjects
      with several kinds of optic nerve and retinal diseases. In young normal subjects
      the threshold curve rose sharply away from the line measured under the same
      conditions but without flashing blue background, as has been reported in
      measurements with light of long wavelengths. In the convalescent stage of optic
      neuritis, diabetic retinopathy, and central serous chorioretinopathy, the
      threshold curves presented two patterns; one pattern was shifted upward and the
      other shifted upward and to the right. We suggest that this method with short
      wavelength light is useful in differentiating retinal diseases from the change of
      optic media, and for layer-by-layer diagnosis of retinal diseases.

PMID- 8368190
TI  - [The influence of target blurring and simulated opacity of the ocular media on
      automated perimetric thresholds].
AB  - The influence of target blurring and simulated opacity of the ocular media on the
      sensitivity of the central visual field in quantitative static perimetry was
      studied using a SARGON program of the automated perimeter Octopus 201. Ten eyes
      of 10 normal subjects aged from 21 to 35 were examined with target sizes 1, 3,
      and 5; 4 spherical plus lenses of +1.0D, +2.0D, +3.0D, and +5.0D; 5 kinds of
      occlusion diffusers which corresponded to the visual acuities of 1.0, 0.8, 0.6,
      0.4, and 0.1; and 4 neutral density filters of 0.1, 0.3, 0.6, and 1.0 log units.
      The studies suggested that there was little difference between the sensitivity
      for target size 1 and that for target size 3 in spite of slight blurring of the
      target and simulated opacity of the ocular media. We concluded that target size 1
      was as useful as target size 3 in quantitative static perimetry.

PMID- 8368191
TI  - Early journals in hypnosis: an update.
AB  - To date, 139 journals concerned primarily with hypnosis have been identified.
      This article lists another 20 periodicals, including the first American journal,
      the Magnet, which was briefly published in 1835 in Hanover, New Hampshire.

PMID- 8368192
TI  - Hypnotic susceptibility, mood state, and cardiovascular reactivity.
AB  - In this study we explored the relationship between hypnotic susceptibility
      measured with the Harvard Group Scale of Hypnotic Susceptibility (HGSHS) and
      cardiovascular parameters. After assessing their degree of hypnotic
      susceptibility, we induced 21 female students into happy mood states and into sad
      mood states. During the mood state induction we monitored blood pressure, heart
      rate, and cardiac vagal tone continuously. The study demonstrated a strong
      relationship between hypnotic susceptibility and both cardiac vagal tone and
      heart rate reactivity. Subjects with lower heart rate and greater vagal tone
      during baseline and greater heart rate increases during mood induction were more
      susceptible to hypnosis. Multiple regression analyses indicated that
      approximately 40% of the individual difference variance of hypnotic
      susceptibility was accounted for by baseline cardiac vagal tone and heart rate
      reactivity during mood state. The data demonstrate that autonomic tone, assessed
      by cardiac vagal tone and heart rate reactivity, are related to hypnotic
      susceptibility as measured by the HGSHS.

PMID- 8368193
TI  - The effect of preventive measures in reducing aftereffects to hypnosis.
AB  - In the present study we assessed the efficacy of several procedures in minimizing
      the occurrence of aftereffects of a hypnotic induction. We gave experimental
      subjects (n = 347) a brief lecture dispelling some myths about hypnosis, told
      them no psychological treatment would be undertaken, and then administered the
      Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) in which all
      references to aftereffects had been removed. We gave the standard version of the
      HGSHS:A to control subjects (n = 340). Although the treatment condition did not
      reduce the overall incidence of effects, long-term effects were significantly
      reduced. Medical and psychosocial histories were obtained from subjects prior to
      the induction, but they proved to be of limited value in predicting sequelae.
      Contrary to the results of Coe & Ryken (1979), hypnosis produced more frequent
      sequelae than a nonhypnotic classroom experience (watching a film followed by an
      introductory psychology lecture) for subjects in an ad hoc control group.

PMID- 8368194
TI  - Satanic agency and mesmerism reviewed--James Braid.
AB  - Satanic Agency and Mesmerism Reviewed, In A Letter To The Reverend H. Mc. Neile
      of Liverpool, is a 12-page book in which James Braid laid the foundation stone of
      medical hypnotism. The present copy of this book is said to be unique. No other
      copy of this book has been found in the United States or England. The book, which
      is in the Rare Book Collection at the Wichita State University Ablah Library,
      came from the library of Albert Moll. The age of mesmerism or animal magnetism
      was brought to a close by James Braid, and in this book, his first work on
      mesmerism. Braid used the word hypnotism to replace mesmerism. His first use of
      the word occurred in this work and not, as is generally believed, in his later
      work, Neurypnology.

PMID- 8368195
TI  - Risk management in hypnotic recall of near-death experiences.
AB  - A substantial number of people facing physical and/or psychological crisis report
      having a near-death experience (NDE) involving a subjectively real experience of
      an alternate reality. Where NDE content is associated with positive emotions,
      benefit might be gained by hypnotic recall of the NDE, yet such recall might
      involve possible risk in the form of reactivation of the original crisis. In this
      article we describe a study involving hypnotic recall of positive NDEs by one
      male and five female subjects. We describe in detail some procedures to minimize
      risk, including a hypnosis protocol.

PMID- 8368196
TI  - Resistance to health: when the mind interferes with the desire to become well.
AB  - Secondary gain has long been viewed as a variable that can significantly affect a
      patient's recovery from such conditions as chronic pain disorders, factitious and
      somatoform disorders, and other psychological disorders. Secondary gain has not
      been evaluated in terms of its impact on major illnesses such as cancer or
      autoimmune disorders. In this paper I discuss how secondary gain can be present
      in such illnesses and how it results in a resistance to health. This resistance
      to health can lead not only to medical noncompliance, but can also ultimately
      affect the progression and recovery from the illness. I describe how hypnosis can
      be used to ferret out this resistance to health and how patients in a hypnotic
      state will indicate or express their resistance to becoming healthy. The
      advantage of this approach is that it enables the clinician to deal directly with
      the patient's unconscious resistance to health.

PMID- 8368197
TI  - Etienne Felix d'Henin de Cuvillers: a founder of hypnosis.
AB  - Etienne Felix d'Henin de Cuvillers (1755-1841) was one of the few followers of
      Mesmer who continued to study, practice, and refine animal magnetism after its
      eclipse resulting from the 1784 publication of the essentially negative
      investigatory reports of the French commissions. He differed from Mesmer in that
      he denied the existence of a magnetic fluid, emphasized the role of mental
      processes in mesmerism and in general behavior, and anticipated the much later
      psychodynamic constructs of transference and countertransference. In addition, he
      used and publicized a system of scientific nomenclature based upon the "hypn-"
      prefix for which Braid has usually, but inaccurately, been given credit for
      originating.

PMID- 8368198
TI  - Foreword: health care reform in the United States--the Presidential Task Force.

PMID- 8368199
TI  - Regulation and federalism: legal impediments to state health care reform.
AB  - In recent years, many states have attempted to address the cost and access
      problems that face their health care systems. Such efforts, however, are
      significantly impeded by a variety of federalism doctrines that limit the ability
      of states to regulate the health care market. This Article surveys some of those
      federalism barriers, including the constitutional restraints imposed by the
      Commerce Clause, the Privileges and Immunities Clause, and the Fourteenth
      Amendment, and the statutory hurdles created by ERISA, the Social Security Act,
      and the Americans with Disabilities Act of 1990. This Article concludes that the
      restraints that these doctrines and statutes place on states reflect not only
      federalism concerns, but also deeper ambivalence about governmental regulation of
      the health care market. Only when that ambivalence is resolved can a proper
      division of labor between the states and federal government be determined.

PMID- 8368200
TI  - Community care, competition and coercion: a legal perspective on privatized
      mental health care.
AB  - Even as the Clinton administration considers an increased federal commitment to
      mental health care, delivery of such care remains fixed at the state level. In
      Massachusetts, state officials are privatizing mental health care on an
      unprecedented scale, an experiment that promises to provide better care at lower
      cost. This Note explores whether privatization can achieve that lofty goal, given
      a legal system that has made individual patient autonomy its preeminent value.
      The author concludes that wide-scale privatization and modern notions of self
      determination can only coexist with a significant investment in the support
      services that are critical to the community tenure of former state hospital
      patients.

PMID- 8368201
TI  - Reforming the health care system: the universal dilemma.
AB  - This Article surveys alternative approaches by which the advanced industrialized
      nations seek to cope with the twin problems that health care poses everywhere:
      the provision of universal access to health care and the control of national
      spending on health care. Although approaches to these twin problems vary
      considerably among nations at this time, there may well be a convergence toward a
      common approach in the next century. Under that approach, all health care systems
      will be subject to top-down global budgets and will put their health care
      providers into "statistical fishbowls" that reveal just how effectively these
      providers allocate the global budgets at their disposal.

PMID- 8368202
TI  - An ethical perspective on health care insurance reform.
AB  - Much recent analysis of health care insurance reform emphasizes economic and
      policy issues. In contrast, this Article examines health policy issues from the
      viewpoint of medical ethics. The critical ethical "problem" in health care today
      is that ability to pay determines the availability and quality of care. This
      Article discusses three types of proposed solutions: health care insurance
      reform, health care financing reform, and health care cost reform. It sketches an
      ethical framework for evaluating health policy and presents seven specific
      propositions that an ethical analysis of health care reform proposals raises.
      This Article concludes that remedying the unethical treatment of certain classes
      of patients requires both health care financing reform and health care cost
      reform; health care insurance reform will not suffice.

PMID- 8368203
TI  - Canadian Medicare: can it work in the United States? Will it survive in Canada?
AB  - Any discussion of health care reform in the United States inevitably draws
      comparisons from the Canadian model. This Article frames the debate over the
      merits of the Canadian system by introducing its basic features, exploring its
      advantages, and discussing its limitations. In evaluating the prospects for a
      Canadian-type system in the United States, the author focuses on the need to
      rethink--as Canada has--the viability of market-based approaches to health care.

PMID- 8368204
TI  - Selling cost containment.
AB  - Health care expenditures in the United States have continued to grow despite
      efforts to control them. This Article discusses the need for health care reform,
      outlines the model that reform should follow, and considers why the United States
      has not progressed toward a workable solution. It introduces a single-payer
      approach to cost containment and explains how such an approach could be "sold" in
      the United States. Finally, the Article examines various ways to mobilize support
      for such health care reform.

PMID- 8368205
TI  - Projects study pharmaceutical care outcomes in ambulatory patients.

PMID- 8368206
TI  - Technician status, therapeutic interchange are subjects of resolutions by
      National Association of Boards of Pharmacy.

PMID- 8368207
TI  - Filtration of ampul contents.

PMID- 8368208
TI  - Career ladder for pharmacy interns.

PMID- 8368209
TI  - Protecting yourself from antimicrobial exposure.

PMID- 8368210
TI  - Cocaine hydrochloride topical solution prepared for ophthalmic use.

PMID- 8368211
TI  - Needleless i.v. administration systems.

PMID- 8368212
TI  - Pharmacists must receive all incident reports involving medications.

PMID- 8368213
TI  - Value of investigational drugs.

PMID- 8368214
TI  - X-rays and i.v. pump performance.

PMID- 8368215
TI  - Pharmacist deployment in support of Operation Restore Hope.

PMID- 8368217
TI  - Tap water should not be used.

PMID- 8368216
TI  - Community service at Utah.

PMID- 8368218
TI  - Pharmaceutical care and professional maturation.

PMID- 8368219
TI  - Computerized relational database for monitoring clozapine therapy.
AB  - The use of a computerized relational database to satisfy the patient-monitoring
      requirements of clozapine's manufacturer at an Oregon state psychiatric facility
      is described. The pharmacy department designed a computerized system to
      efficiently manage the patient-monitoring requirements of clozapine's
      manufacturer. A relational database program allows information in database files
      to be readily retrieved and organized into standardized or customized reports.
      These reports provide white blood cell (WBC) counts to the drug's manufacturer,
      patient discharge information to other clozapine providers, psychiatric test
      results to treating physicians, financial data to hospital administration, and
      other key data related to the facility's clozapine treatment system. The
      computerized system minimized the additional workload required to dispense
      clozapine, decreased the cost of clozapine by $234,441 compared with the cost
      under the closed distribution system, and provided for comprehensive clinical
      monitoring. Between May 1991 and October 1992, 168 clozapine recipients were
      monitored; pharmacists notified physicians about 86 patients not meeting WBC
      count criteria. The use of a computerized relational database enabled a state
      psychiatric hospital to efficiently manage the burden of monitoring clozapine
      recipients.

PMID- 8368220
TI  - Use of clozapine in Texas state mental health facilities.
AB  - Clozapine-use patterns in facilities operated by the Texas Department of Mental
      Health and Mental Retardation are reported. Data collected by manual and
      automated tracking systems from January 1990 through July 1992 were analyzed to
      determine patient demographics, the number of patients started on clozapine and
      the number who stopped taking the drug, the reasons for discontinuation, and
      other variables. Of 852 clozapine recipients still in the departmental system by
      the end of the study period, 134 (16%) had discontinued the drug by that date.
      There were no significant differences in gender, age, or race between the
      patients who discontinued the therapy and those who did not. Almost one fourth of
      the patients who discontinued clozapine therapy did so within the first month,
      and more than 90% did so within the first year. The most common reasons for
      discontinuing the medication were lack of clinical response, patient refusal or
      request, and adverse effects, including agranulocytosis. More women than men
      discontinued the drug because of adverse effects. Although relatively few
      patients discontinued clozapine during the study period, many had only recently
      begun taking the drug, and some of these may discontinue it in the near future.
      Of 852 clozapine-treated patients served by the Texas Department of Mental Health
      and Mental Retardation between January 1990 and July 1992, 16% discontinued the
      therapy. One fourth of these did so within the first month of treatment.

PMID- 8368221
TI  - Adding an expensive drug to the formulary.

PMID- 8368222
TI  - Eosinophilic meningitis.

PMID- 8368223
TI  - Eosinophilic pleocytosis in coccidioidal meningitis: frequency and significance.
AB  - PURPOSE: Coccidioidal meningitis (CM) is a major source of morbidity and
      mortality in endemic regions. The diagnosis of CM is a clinical challenge.
      Eosinophilic pleocytosis (EP) is an uncommon finding and present in a relatively
      limited number of conditions. In order to determine the frequency and the
      prognostic significance of EP in CM, we conducted the present study. PATIENTS AND
      METHODS: Retrospective chart review of all patients diagnosed as having CM
      between 1986 and 1991 at Kern Medical Center. All patients had clinical and
      cerebrospinal fluid (CSF) findings confirmatory of CM. RESULTS: Nineteen patients
      (70%) in the study group had EP, and of these, 8 patients (30%) met the criteria
      for eosinophilic meningitis (greater than or equal to 10 eosinophils/mm3). No
      correlation was found between EP and age, sex, race, results of complement
      fixation test for coccidioidal antigen in CSF or serum, peripheral eosinophilia,
      or outcome. CONCLUSION: The presence of EP is a frequent observation in CM.
      Although we did not demonstrate any prognostic correlation with EP, this finding
      is of major diagnostic significance and its presence should bring attention to
      the diagnosis of CM.

PMID- 8368224
TI  - Recovery of the hypothalamic-pituitary-adrenal (HPA) axis in patients with
      rheumatic diseases receiving low-dose prednisone.
AB  - PURPOSE: To assess the status of the hypothalamic-pituitary-adrenal (HPA) axis in
      cortico-steroid-treated patients whose prednisone dose had been tapered to
      physiologic doses. PATIENTS AND METHODS: The design of the study was a
      retrospective chart review of 50 consecutive patients receiving 10 mg or less of
      prednisone daily at a university teaching hospital rheumatology clinic. Patients
      were given a rapid adrenocorticotropic hormone stimulation test, with cortisol
      levels obtained at baseline and after intravenous administration of cosyntropin.
      Charts were reviewed for duration of therapy, highest, current, and total
      cumulative steroid dose, and average daily steroid dose in each month of the
      preceding 2 years. RESULTS: Current steroid dose was the only significant
      indicator of HPA axis function. Patients receiving less than 5 mg of prednisone
      daily had a normal HPA axis response, whereas those receiving 5 mg or more had
      widely varied responses. Neither the total, the highest prednisone dose, nor the
      duration of therapy was a significant indicator of HPA axis recovery.
      CONCLUSIONS: Spontaneous recovery of the HPA axis is usual for patients who are
      taking prednisone at daily doses of 5 mg or less. Return of normal HPA axis
      function can be achieved without alternate-day therapy in patients whose disease
      allows tapering to daily prednisone doses of 5 mg or less.

PMID- 8368225
TI  - Determinants of near fatality in acute severe asthma.
AB  - PURPOSE: The data extrapolated from cases of acute severe asthma that narrowly
      miss being fatal may prove valuable in the identification of the factors
      implicated in mortality. The purpose of this study was, therefore, to identify
      determinants of near fatality in patients with acute severe asthma. PATIENTS AND
      METHODS: We studied 81 patients with acute severe asthma in whom mechanical
      ventilation was required. Near fatality was defined as the occurrence of
      respiratory arrest and/or coma necessitating emergency tracheal intubation and
      resuscitation. In the cases that were not regarded as near fatal, tracheal
      intubation was performed electively because of deteriorating arterial blood gas
      values and/or the anticipation of exhaustion. Various continuous and categorical
      variables were compared in these two groups of patients. Patients with a
      hyperacute attack (period from onset of attack to mechanical ventilation less
      than 3 hours) were specifically sought and studied to determine the impact of
      such a course on near fatality. RESULTS: The "attack duration" (period from onset
      of attack to mechanical ventilation) was an important determinant of near
      fatality and of the subsequent clinical course. It was shorter in the group with
      a near-fatal episode (p < 0.03), and hyperacute attacks were uniformly near
      fatal. The attack duration correlated positively with the duration of the
      requirement for mechanical ventilation (p < 0.01). A longer attack duration was
      associated with an increased likelihood of the occurrence of major atelectasis (p
      < 0.01). There was no evidence of a relationship between near fatality and the
      side effects of bronchodilators as regards hypokalemia, arrhythmias, or
      cardiotoxicity. There was evidence of considerable under-treatment in the patient
      population as a whole, particularly in regard to the use of corticosteroids.
      CONCLUSIONS: A short attack duration is associated with an increased risk of near
      fatality in acute severe asthma. This is particularly evident in hyperacute
      attacks. Hyperacute attacks resolve rapidly once bronchodilator therapy has been
      instituted, suggesting that smooth muscle spasm is the predominant pathogenetic
      mechanism. The importance of routine anti-inflammatory therapy in mild to
      moderate asthma requires re-emphasis but, in addition, all patients should be
      provided with, and educated in the use of, bronchodilator rescue therapy, which
      should be available at all times. Despite current trends, the use of regular,
      prophylactic bronchodilator therapy in strict conjunction with anti-inflammatory
      agents may still be indicated. There is little evidence in the present data
      obtained from near-fatal cases to support the concept that cardiotoxicity related
      to bronchodilators contributes significantly to mortality from asthma.

PMID- 8368227
TI  - Single-dose intravenous therapy with pamidronate for the treatment of
      hypercalcemia of malignancy: comparison of 30-, 60-, and 90-mg dosages.
AB  - PURPOSE: To determine the efficacy, dose-response relationship, and safety of 30,
      60, and 90 mg of a single intravenous dose of an aminobisphosphonate, pamidronate
      (APD), for the treatment of moderate to severe hypercalcemia of malignancy.
      PATIENTS AND METHODS: Patients with histologically proven cancer and a corrected
      serum calcium level of at least 12.0 mg/dL after 48 hours of normal saline
      hydration were enrolled in a double-blind, multicenter, randomized clinical
      trial. Pamidronate in 30-, 60-, or 90-mg doses was administered as a single 24
      hour infusion. Serum calcium corrected for albumin, urine hydroxyproline, and
      calcium excretion, and serum parathyroid hormone (PTH) (1-84) were determined
      before and after pamidronate therapy. RESULTS: Thirty-two men and 18 women
      entered the study. A dose-response relationship for normalization of corrected
      serum calcium was seen after pamidronate administration. Corrected serum calcium
      normalized in 40% of patients who received 30 mg, in 61% of patients who received
      60 mg, and in 100% of patients who received 90 mg of pamidronate. The decline in
      the serum calcium level was associated with decreased osteoclastic skeletal
      resorption evidenced by a decrease in urine calcium and hydroxyproline excretion.
      Among those with a normalized corrected serum calcium level, the mean (median)
      duration of normalization of the corrected serum calcium value was 9.2 (4), 13.3
      (5), and 10.8 (6) days in the 30-, 60-, and 90-mg treatment groups, respectively.
      The response of hypercalcemia to pamidronate was not significantly influenced by
      the presence of skeletal metastases. PTH 1-84, suppressed in patients on entry
      into this study, increased to a greater extent in those patients with osteolytic
      skeletal metastases compared with those with humoral hypercalcemia of malignancy.
      Clinical improvement, including improved mental status and decreased anorexia,
      accompanied the decline in the corrected serum calcium level in all three
      treatment groups. Side effects included low-grade fever, asymptomatic
      hypocalcemia, hypomagnesemia, and hypophosphatemia. CONCLUSIONS: A single-dose
      infusion of 60 to 90 mg of pamidronate was highly effective and well tolerated
      and normalized corrected serum calcium in nearly all patients (61% to 100%) with
      hypercalcemia of malignancy.

PMID- 8368226
TI  - Arterial underfilling does not cause sodium retention in cirrhosis.
AB  - PURPOSE: To test the peripheral arterial vasodilation hypothesis of sodium
      retention in cirrhosis. This states that sodium retention is triggered by
      arterial underfilling and predicts that development of sodium retention will be
      associated with significant and related declines in indices of arterial filling
      that reverse when sodium retention resolves. DESIGN: Longitudinal evaluation of a
      cohort of patients with alcoholic liver disease. PATIENTS AND METHODS: Eighteen
      men, 8 of whom were studied twice, 3 three times, 2 four times, and 5 five times
      (40 between-study comparisons). Between 23 studies, the patients were ascites
      free (Group NN). Ascites spontaneously disappeared between seven studies (Group
      YN), appeared between six studies (Group NY), and remained present between four
      studies (Group YY). Between-study changes in blood volume, arterial blood
      pressure, cardiac output, systemic vascular resistance, left atrial volume, left
      ventricular diastolic diameter, aortic root diameter, aortic blood velocity,
      plasma norepinephrine and atrial natriuretic factor concentrations, plasma renin
      activity, and urinary sodium excretion were evaluated by paired t-tests. These
      changes were also compared among groups by analysis of variance. In addition,
      correlations among the changes were sought. RESULTS: Systolic, diastolic, and
      mean arterial pressures, left ventricular diastolic diameter, aortic root
      diameter, stroke volume, cardiac output, plasma norepinephrine concentration, and
      systemic vascular resistance were unchanged between studies. Left atrial volume
      increased between studies in Group NY. Pulse pressure fell more in Group NY than
      in Groups NN and YN, principally as a result of a decline in systolic blood
      pressure. Plasma norepinephrine concentration, plasma renin activity, and blood
      volume rose more in Group NY than in Groups NN, YN, and YY. Changes in both
      systolic and pulse pressures were directly correlated with the change in sodium
      excretion but unrelated to the change in plasma norepinephrine concentration.
      Changes in plasma norepinephrine concentration and plasma renin activity were
      unrelated to changes in blood pressure, systemic vascular resistance, and urinary
      sodium excretion. CONCLUSIONS: None of the indices of arterial filling tested
      except pulse pressure were related to sodium retention. Reduced pulse pressure is
      inconsistent with arterial underfilling, as peripheral vasodilation instead
      increases pulse pressure by increasing diastolic run-off. These data do not
      support the hypothesis that arterial underfilling is the stimulus for sodium
      retention in alcoholic cirrhosis.

PMID- 8368228
TI  - Abdominal wall fat index, estimated by ultrasonography, for assessment of the
      ratio of visceral fat to subcutaneous fat in the abdomen.
AB  - PURPOSE: To establish a new index of regional fat distribution using
      ultrasonography for assessment of the ratio of the visceral fat area (V) to the
      subcutaneous fat area (S) (V/S ratio). SUBJECTS AND METHODS: The subjects
      examined were 62 patients (23 males and 39 females); 51 patients had
      hyperlipidemia and 11 patients had glucose intolerance. The mean body mass
      indices ranged from 20.3 to 42.9. The mean age of the patients was 44 +/- 13
      years. The thicknesses of the preperitoneal fat layer (P) and subcutaneous fat
      layer (S) in the abdomen were measured by ultrasonography and the P/S ratio was
      calculated. The V/S ratio was obtained with radiographic computed tomography.
      RESULTS: Of the various P/S ratios examined, the ratio of the maximum thickness
      of preperitoneal fat to the minimum thickness of subcutaneous fat was most
      closely correlated with the V/S ratio (r = 0.746, p < 0.0001). This ratio was
      termed the abdominal wall fat index (AFI). AFI was positively correlated with
      serum triglyceride levels and negatively correlated with high-density lipoprotein
      cholesterol (r = -0.312, p < 0.05), whereas the V/S ratio was correlated with
      triglyceride levels. AFI was positively correlated with basal insulin levels in
      both men and women. CONCLUSION: These results suggest that AFI measured by
      ultrasonography may be a new indicator of visceral fat deposition, and may
      reflect metabolic disorders such as lipid metabolism and glucose metabolism
      disorders.

PMID- 8368229
TI  - Anticoagulant-related bleeding: clinical epidemiology, prediction, and
      prevention.
AB  - OBJECTIVE: To review (1) the clinical epidemiology of bleeding during
      anticoagulant therapy with heparin or warfarin, (2) data useful in estimating the
      risk for bleeding in individual patients, and (3) the efficacy of methods for its
      prevention. METHODS: Relevant literature was identified by a computerized search
      of the Medline database and by review of the bibliographies of original and
      review articles. Studies were classified according to their design. Estimates of
      the risk for bleeding during anticoagulant therapy, compared with the risk
      without therapy, were obtained from randomized trials. Estimates of the frequency
      of bleeding during the course of anticoagulant therapy and information about risk
      factors for bleeding were obtained primarily from longitudinal studies of
      inception cohorts of patients followed from the start of therapy. MAIN RESULTS:
      The average daily frequencies of fatal, major, and major or minor bleeding during
      heparin therapy were 0.05%, 0.8%, and 2.0%, respectively; these frequencies are
      approximately twice those expected without heparin therapy. The average annual
      frequencies of fatal, major, and major or minor bleeding during warfarin therapy
      were 0.6%, 3.0%, and 9.6%, respectively; these frequencies are approximately five
      times those expected without warfarin therapy. The risk for anticoagulant-related
      bleeding is highest at the start of therapy: during warfarin therapy, the risk
      for major bleeding during the first month of therapy is approximately 10 times
      the risk after the first year of therapy. An individual patient's risk for major
      anticoagulant-related bleeding can be estimated on the basis of specific risk
      factors such as the intensity of the anticoagulant effect achieved and the
      presence of serious comorbid diseases, especially cerebrovascular, kidney, heart,
      and liver disease; older age and concurrent medicines may also be independent
      risk factors. Major bleeding most often affects the gastrointestinal tract, soft
      tissues, and urinary tract. Diagnostic evaluation of gastrointestinal bleeding
      and gross hematuria leads to identification of previously unknown lesions in
      approximately one-third of cases, even when the prothrombin time is elevated.
      Intracranial bleeding is rare, but it is frequently fatal. The frequency of
      bleeding during warfarin therapy is reduced by less intense therapy achieving a
      prothrombin time with an International Normalized Ratio of 2.0 to 3.0, which is
      efficacious for most indications. CONCLUSION: Anticoagulant-related bleeding is
      common and often serious. The risk for bleeding can be estimated in an individual
      patient, giving the primary physician a quantitative basis for weighing the risks
      and benefits of therapy and for optimizing patient management. The frequency of
      anticoagulant-related bleeding is reduced by less intense warfarin therapy.
      Future studies should evaluate new approaches to management that may further
      reduce complications while maintaining efficacy.

PMID- 8368230
TI  - International hero.

PMID- 8368231
TI  - Headaches, diabetes insipidus, and hyperprolactinemia in a woman with an enlarged
      pituitary gland.

PMID- 8368232
TI  - Sympathetic dysautonomia as a remote effect of Hodgkin's lymphoma.

PMID- 8368233
TI  - Exacerbation of celiac disease after cure of Cushing's disease.

PMID- 8368234
TI  - Acetaminophen hepatotoxicity augmented by zidovudine.

PMID- 8368235
TI  - Warfarin and azathioprine: a drug interaction does exist.

PMID- 8368236
TI  - Water loading test in the reset osmostat variant of SIADH.

PMID- 8368237
TI  - True telomeric translocation in a baby with the Prader-Willi phenotype.
AB  - We report on a baby with a nonreciprocal de novo unbalanced translocation between
      chromosomes 12 and 15. Her karyotype was 45,XX, -12, -15, +der(12)t(12;15)(pter-
      >qter::q13-->qter). The paternal origin of the 15q11-13 region was shown by DNA
      marker studies and, consistent with this, the baby had the Prader-Willi (PWS)
      phenotype. The breakpoint on 12q was distal to D12S11 (lambda MS43) which maps to
      12q24.3-qter. Fluorescent in situ hybridization using the oligonucleotides
      (TTAGGG)7 and (AATCCC)7 showed that the 12q telomere was still present within the
      translocated chromosome. Thus, the translocation was within or onto the end of
      the telomere of 12q. This unusual translocation is further evidence of an
      unexplained instability of the 15q11-13 region.

PMID- 8368238
TI  - Mosaic tetrasomy 8p: molecular cytogenetic confirmation and measurement of
      glutathione reductase and tissue plasminogen activator levels.
AB  - We report the case of a 5-year-old girl with severe developmental disabilities,
      skeletal anomalies, hypotonia, rectal atresia, malrotation of the intestine,
      horseshoe kidney, vesicoureteric reflux, and minor facial anomalies. Conventional
      cytogenetic techniques suggested that she had a mosaic 46,XX/47,XX,+i(8p)
      constitution, and the identity of the isochromosome was confirmed by in situ
      hybridization and chromosome painting. Polymorphic DNA markers are consistent
      with the i(8p) having arisen as the result of a segregation error and centromere
      misdivision at the second maternal meiotic division. The i(8p) was seen in 17/25
      (68%) lymphocytes at the age of one month but had declined to 31/100 (31%) cells
      by the age of 5 years. At this time the i(8p) was seen in 30/68 (44%) cultured
      skin fibroblasts. The proposita had an approximately twofold increase in red cell
      glutathione reductase activity but a normal level of tissue-plasminogen
      activator. These enzyme results are consistent with the known localisation of the
      glutathione reductase gene on the short arm of chromosome 8 but suggest that the
      tissue-plasminogen activator gene may map outside this region.

PMID- 8368239
TI  - Multiple pterygium syndrome with body asymmetry.
AB  - We report on a fetus with multiple pterygia in the popliteal, antecubital,
      intercrural, axillary, and nuchal region, arthrogryposis, camptodactyly, anal
      atresia, hypospadias, ambiguous genitalia, and neonatal death. Arthrogryposis was
      much more pronounced at the left than at the right side. Moreover, there was
      gross body asymmetry with hypoplasia of the left arm, leg, pelvis, and kidney. As
      this spectrum of anomalies does not fit any of the known multiple pterygium
      syndromes, this patient adds another clinical entity to the already wide spectrum
      of multiple pterygium syndromes.

PMID- 8368240
TI  - VACTERL with hydrocephalus: spontaneous chromosome breakage and rearrangement in
      a family showing apparent sex-linked recessive inheritance.
AB  - The rate of spontaneous and mitomycin C induced chromosome breakage and sister
      chromatid exchange (SCE) was studied in three related cases diagnosed with
      VACTERL-H syndrome. There have been recent reports of sporadic patients with
      VACTERL-H in whom high rates of chromosome breakage were observed. This has led
      to the suggestion that some of these patients may represent the severe expression
      of Fanconi anemia. The pattern of inheritance in our family is highly suggestive
      of X-linked recessive inheritance supporting the hypothesis that VACTERL-H is, at
      least in some cases, a syndrome and not an association.

PMID- 8368241
TI  - Second family with "apple peel" syndrome affecting four siblings: autosomal
      recessive inheritance confirmed.

PMID- 8368242
TI  - Prenatal diagnosis of nail-patella syndrome by intrauterine kidney biopsy.

PMID- 8368243
TI  - Peters' plus syndrome.

PMID- 8368244
TI  - Waardenburg syndrome and meningomyelocele.

PMID- 8368245
TI  - The joining circles.

PMID- 8368246
TI  - Hypertrichosis, atrophic skin, ectropion, and macrostomia (Barber-Say syndrome):
      report of a new case.
AB  - We report on a child, born to a consanguineous parents, who presented with a
      multiple congenital anomalies (MCA) pattern consisting of severe hypertrichosis,
      macrostomia, ectropion, and atrophic skin. To our knowledge this is the third
      case with this combination of defects. The two previous cases were reported by
      Barber et al. [Syndrome Identification VIII(1):6-9, 1982], and David et al. [Am J
      Med Genet 41:192-195, 1991].

PMID- 8368247
TI  - Further delineation of the epidermal nevus syndrome: two cases with new findings
      and literature review.
AB  - "Epidermal nevus syndrome" ("ENS") is a neurocutaneous disorder in which
      epidermal nevi are associated with other abnormalities, most commonly of the
      skeletal and central nervous systems. We present two cases of epidermal nevus
      syndrome (ENS) with very different clinical findings. The first case is a newborn
      with multiple linear epidermal nevi of the trunk and limbs, and several other
      anomalies, including bony duplications of the lower limbs and hypoplastic left
      heart syndrome. The second patient, a 6-year-old boy, has a linear nevus
      sebaceous of the scalp with severe CNS involvement, including generalized
      seizures, moderate mental retardation, microcephaly, and a left hemiparesis. He
      also has genitourinary, cardiac, and skeletal defects. These two patients exhibit
      several abnormalities not previously recognized and illustrate the wide clinical
      spectrum of "epidermal nevus syndrome." We present a review of the clinical
      findings in 74 cases of "ENS." Correlation was noted between the presence of skin
      lesions located on the head and CNS involvement. The wide clinical spectrum of
      "ENS" as illustrated by these two patients suggests that "ENS" is a causally
      heterogeneous group of disorders.

PMID- 8368248
TI  - Alpers progressive infantile neuronal poliodystrophy: an acute neonatal form with
      findings of the fetal akinesia syndrome.
AB  - We report on 8 patients from two families with Alpers syndrome. The onset in one
      family was prenatal and in the 4 patients who were examined, severe microcephaly,
      intrauterine growth retardation, and typical manifestations of fetal akinesia,
      including retrognathia, joint limitations, and chest deformity were found. The
      second family presented with an early infantile form. All the affected offspring
      had micrognathia and one had findings of fetal akinesia, comparable to those seen
      in the other family. Microcephaly was mild at birth and progressed with age.
      Refractory neonatal convulsions, swallowing difficulties, and pneumonia
      complicated the clinical course of patients in both families, and all the
      patients died before age 20 months. Results of comprehensive biochemical and
      metabolic studies in both families were normal and the diagnosis was supported by
      demonstration of extensive progressive brain atrophy on CT and typical
      histological findings. Patients without a detectable defect in energy metabolism
      and normal liver histology comprise a distinct subset of Alpers syndrome. Until
      the metabolic defect(s) is defined, we suggest naming the acute neonatal form of
      this subset of Alpers syndrome "type 1."

PMID- 8368249
TI  - Congenital muscular dystrophy with neurological abnormalities: association with
      Hirschsprung disease.
AB  - We report on a baby girl with congenital muscular dystrophy (CMD) with
      neurological abnormalities ("CMD Plus" condition), who also had Hirschsprung
      disease. This association may indicate a category of congenital muscular
      dystrophy with involvement of the visceral nervous system. We propose that
      Hirschsprung disease be added to the list of anomalies pertaining to the "CMD
      Plus" array, and that CMD should be considered when Hirschsprung disease occurs
      with central nervous system anomalies.

PMID- 8368250
TI  - Lack of X inactivation: loss of one X inactivation center in a case with mos45,X,
      21, +der(21)t(X;21) (p21.3;p11.2)/46,X,t(X;21) (p21.3;p11.2).
AB  - We present a girl with a mos45,X,-21, +der(21)t(X;21) (p21.3;p11.2)/46,X,t(X;21)
      (p21.3;p11.2) chromosome constitution. The ratio of these cells was 59/26 in
      phytohemagglutinin (PHA)-stimulated lymphocytes. The 45,X,der(21)t(Xp-;21p+)
      cells lacked an X inactivation center located at Xq13 on the derivative X
      chromosome; in these cells, the whole normal X chromosome and the distal part of
      Xp translocated onto the derivative chromosome 21 were early replicating. She had
      moderate mental retardation and other findings different from those that occur in
      the Ullrich-Turner syndrome. Her phenotype may be due to the functional excess of
      the distal part of Xp on the derivative 21 in 45,X,der(21)t(Xp-;21p+) cells;
      thus, this might be another type of the "lack of X-inactivation" syndrome.

PMID- 8368251
TI  - Lethal multiple pterygium syndrome: report of a case with neurological anomalies.
AB  - We report on a 22-week female fetus with multiple pterygia, congenital joint
      contractures, muscle hypoplasia, cystic hygroma, hydrops, pulmonary and cardiac
      hypoplasia, facial anomalies, and growth retardation. Examination also documented
      microcephaly, brain immaturity, and severe cerebellar and pontine hypoplasia with
      absence of the pyramidal tracts. The spinal cord showed a marked decrease in size
      of all white matter tracts. The muscles were markedly hypoplastic. The relation
      of the neurological findings to the development of the syndrome is discussed.

PMID- 8368252
TI  - Cerebro-reno-digital (Meckel-like) syndrome with Dandy-Walker malformation,
      cystic kidneys, hepatic fibrosis, and polydactyly.
AB  - We report on a boy with several findings of the Meckel syndrome, such as hepatic
      fibrosis, polycystic kidneys, post-axial hexadactyly, and genital abnormalities,
      but a Dandy-Walker malformation rather an occipital meningocele. Progressive
      deterioration of renal function beginning at 37 months led to death at 43 months.
      Both Dandy-Walker malformation and survival to the fourth year are unusual
      findings in Meckel syndrome. This uncommon combination represents a further
      demonstration of the pleiotropy/heterogeneity of the cerebro-reno-digital
      syndromes.

PMID- 8368253
TI  - Congenital pulmonary lymphangiectasis with chylothorax: a heterogeneous lymphatic
      vessel abnormality.
AB  - We report on 7 perinatal autopsy cases of primary congenital pulmonary
      lymphangiectasis (CPL) with bilateral chylothorax. This study demonstrates that
      primary CPL is often complicated by chylous pleural effusions with ensuing
      pulmonary hypoplasia. Conversely, CPL appears to be a constant pathological
      finding in spontaneous congenital chylothorax. These observations indicate a
      common pathogenesis for both disorders. The basic defect is not an intrinsic lung
      abnormality, but a developmental error of the lymphatic system resulting in a
      pulmonary lymphatic obstruction sequence. The cause of CPL is heterogeneous.
      Apparently, most cases are sporadic occurrences. We report the second instance of
      CPL in sibs. This indicates that some cases are genetically determined with
      autosomal recessive inheritance. CPL may also be part of a multiple congenital
      anomalies (MCA) syndrome such as Noonan, Ullrich-Turner, and Down syndrome.

PMID- 8368254
TI  - Limb deficiency with or without Mobius sequence in seven Brazilian children
      associated with misoprostol use in the first trimester of pregnancy.
AB  - Misoprostol, a synthetic analog of prostaglandin, has been widely used in Brazil
      as an abortifacient. Abortion is illegal in Brazil. An uncertain number of these
      abortion attempts are unsuccessful and the pregnancy continues. We report on 7
      patients whose mothers attempted to abort using this drug in the first trimester
      of gestation without success. The 7 patients presented with limb defects and in 4
      of them a diagnosis of Mobius sequence was made.

PMID- 8368255
TI  - Chorioretinal dysplasia-microcephaly-mental retardation syndrome: report of an
      American family.
AB  - Recently we evaluated an American family with the chorioretinal dysplasia
      microcephaly-mental retardation syndrome (CDMMS, McKusick #156590). The male-to
      male transmission observed for the first time in the family of this report
      confirms autosomal dominant inheritance. Analysis of our cases and review of the
      literature illustrates the variable expressivity of this disorder and
      demonstrates the need for careful ophthalmologic evaluations of at-risk relatives
      in order to provide accurate recurrence risks.

PMID- 8368256
TI  - Severe axial anomalies in the oculo-auriculo-vertebral (Goldenhar) complex.
AB  - We have studied 4 infants with oculo-auriculo-vertebral (OAV) complex or
      Goldenhar "syndrome" who also had severe axial anomalies, including multiple
      vertebral segmentation errors affecting the thoracic and the lumbar spine. One of
      them presented a previously unreported pattern of vertebral and rib anomalies
      similar to spondylocostal dysostosis. Three patients had twins, and all 4
      patients had other associated non-skeletal malformations which affected the
      midline, i.e., cleft lip and palate, esophageal atresia with tracheoesophageal
      fistula, and ventricular septal defect. The broad extent of the axial anomalies,
      the association with midline defects and twinning, and the combination in the
      same patient of two distinct conditions support the concept that OAV complex is a
      polytopic developmental field defect arising during blastogenesis.

PMID- 8368257
TI  - Of monsters and prodigies: the interpretation of birth defects in the sixteenth
      century.
AB  - In the sixteenth century, a time of religious and social upheaval, naturalistic
      theories of generation were joined to ideas that monstrous births were divine
      signs. In this paper, we explore how medicine and theology were combined to
      explain the almost cataclysmic religious, social, and political events of the
      century.

PMID- 8368258
TI  - Interrelationships of the hemifacial microsomia-VATER, VATER, and sirenomelia
      phenotypes.
AB  - The phenotypes of hemifacial microsomia-VATER, VATER, and sirenomelia patients
      suggest a sequence of overlapping developmental abnormalities. The malformations
      of 247 hemifacial microsomia (HFM) patients with one or more anomalies in other
      body regions were analyzed and compared with those of 255 VATER and 101
      sirenomelia patients studied in the same fashion. The HFM patients were analyzed
      in four subgroups delineated by the number of their concomitant VATER
      ascertainment abnormalities (VAA). Three or more VAA occurred in 33 HFM patients
      who were designated to have the HFM-VATER phenotype and while no significant
      alteration of the HFM phenotype was found, there were notable differences in the
      analyses of the 20 malformation categories studied. Analyzed in separate heart
      and blood vessel (BV) categories, occurrences of BV defects in HFM patients with
      0-1 VAA were low (4-6%) and due to anomalies other than single umbilical arteries
      (SUA). The BV abnormalities increased to 20% in the HFM with two VAA, HFM-VATER,
      and VATER phenotypes with equal occurrences of SUA and other BV anomalies. The
      incidence of SUA was markedly increased (64%) in the sirenomelia. Heart defects
      rose from 22% to 40% with the increasing VAA in individual HFM patients but were
      less in VATER (29%) and sirenomelia (21%) patients and were attributed to
      complex, conotruncal, and other early embryonic anomalies. Unilateral agenesis of
      paired organs systems occurred frequently and, possibly, can be attributed to an
      absent blood supply. Each phenotype of the sequence also had increased VAA,
      rib/vertebrae hypersegmentation, and monozygotic twinning. The variation in the
      incidences of malformations in the three phenotypes can be attributed to their
      relative location in the craniocranial organogenesis sequence of normal human
      embryologic development.

PMID- 8368260
TI  - Jancar syndrome: mental retardation, spasticity, and distal transverse limbs
      defects.
AB  - We report on a child with mental retardation, spasticity, and distal transverse
      defects of the limbs born to healthy parents related as first cousin. This is the
      third child reported to be affected with the syndrome described by Jancar. We
      confirm the existence of the syndrome as a separate entity and raise possibility
      that it may be inherited as an autosomal recessive trait.

PMID- 8368259
TI  - Isochromosome 18q in a girl with holoprosencephaly, DiGeorge anomaly, and streak
      ovaries.
AB  - We report on the clinical and pathologic findings in a girl with isochromosome
      18q (46, XX,i(18q)) who had combined manifestations of monosomy 18p and trisomy
      18q. Major congenital anomalies included premaxillary agenesis, alobar
      holoprosenphaly, double outlet right ventricle, DiGeorge anomaly and streak
      ovaries. The clinical spectrum in i(18q) is very broad.

PMID- 8368261
TI  - Norman-Roberts syndrome: clinical and molecular studies.
AB  - We report on a 7-year-old boy with microcephaly, bitemporal hollowing, low
      sloping forehead, slightly prominent occiput, widely set eyes, broad and
      prominent nasal bridge, and severe postnatal growth deficiency. Hypertonia,
      hyperreflexia, seizures, and profound mental retardation were also present. Brain
      MRI documented partial agyric cortex with patchy pachygyria, colpocephaly, and
      hypoplasia of corpus callosum and brain stem, which is consistent with the
      diagnosis of lissencephaly type I grade 2. On the basis of his phenotypic
      appearance the patient is considered to have the Norman-Roberts syndrome.
      Molecular studies, performed by means of in situ hybridization and DNA probe
      analysis, did not demonstrate deletion in the Miller-Dieker/isolated
      Lissencephaly critical region on the short arm of chromosome 17.

PMID- 8368262
TI  - Change in K+ current of HeLa cells with progression of the cell cycle studied by
      patch-clamp technique.
AB  - The K+ channel of HeLa S3 cells in metaphase was analyzed by inside-out and whole
      cell patch-clamp techniques. The channel had the characteristics of strong inward
      rectification, small conductance (22 pS at -100 mV), and dependence on
      intracellular Ca2+. We investigated the cell cycle dependency of the channel,
      using cells synchronized by harvesting them at the mitotic stage. The cell
      capacitance increased gradually with increases in the cell volume toward the S
      phase. The inward K+ currents through the channel at fixed membrane potentials
      were highest in early G1 and then decreased with time to a minimum in the S
      phase, increasing again in the M phase. The permeabilities at fixed membrane
      potentials were also highest in early G1, decreased to minima in the S phase, and
      increased again toward the next mitosis. In contrast, mean amplitude and the open
      probability of the single channel at a fixed membrane potential (-60 mV) did not
      change significantly during the cell cycle. Therefore the capacitance increases
      with progression of the cell cycle, whereas the permeability decreases from early
      G1 to an apparent minimum in the S phase. These changes may be caused by cell
      cycle-dependent changes in the number of channels.

PMID- 8368263
TI  - Disopyramide blocks pancreatic ATP-sensitive K+ channels and enhances insulin
      release.
AB  - An antiarrhythmic agent, disopyramide, was found to enhance the insulin secretory
      capacity of Wistar rat pancreatic islets with a half-maximal concentration of
      23.3 microM. Employing a patch-clamp technique, disopyramide was found to inhibit
      ATP-sensitive K+ (KATP) channel activity in rat pancreatic beta-cells in primary
      culture without altering the unitary conductance. Half-maximal inhibition was
      achieved by the addition of 3.6 microM disopyramide to the intracellular bathing
      solution in the inside-out mode, 11.0 microM to the extracellular bathing
      solution in the outside-out mode, and 87.4 microM in the cell-attached mode. The
      binding of [3H]glibenclamide to pancreatic islets was inhibited by unlabeled
      glibenclamide but not by unlabeled disopyramide. Based on these observations, it
      is concluded that disopyramide blocks pancreatic KATP channels via binding to a
      site(s) distinct from the sulfonylurea receptor. This effect may be causatively
      involved in disopyramide-induced hypoglycemia.

PMID- 8368264
TI  - Endothelin increases [Ca2+]i in M-1 mouse cortical collecting duct cells by a
      dual mechanism.
AB  - We tested the effects of endothelin-1 (ET-1) on intracellular calcium
      concentration ([Ca2+]i) of cultured M-1 mouse cortical collecting duct cells.
      [Ca2+]i was measured using fura 2 and a fluorescent imaging system. At a
      concentration of extracellular calcium ([Ca2+]o) of 1 mM, ET-1 (10(-12) to 10(-7)
      M) increased [Ca2+]i. A second application of ET-1 had no effect on Ca2+. In
      contrast, application of arginine vasopressin after an initial exposure to ET-1
      induced a second Ca2+ response. In the absence of extracellular Ca2+ (1 mM EGTA)
      ET-1 also elicited a Ca2+ peak, indicating participation of Ca2+ release from
      intracellular stores in the initial Ca2+ peak. At [Ca2+]o of 10 mM, ET-1 also
      induced an intracellular Ca2+ peak but [Ca2+]i remained significantly elevated.
      The Ca2+ plateau phase was abolished by nickel (10 or 100 microM) and nifedipine
      (0.1 or 1 microM). We conclude that ET-1 mediates an increase in [Ca2+]i by Ca2+
      release from intracellular stores and activation of a nickel- and nifedipine
      sensitive Ca2+ entry mechanism.

PMID- 8368265
TI  - B-cell size influences glucose-stimulated insulin secretion.
AB  - To determine whether the heterogeneous B-cell response to glucose is related to a
      different metabolic handling of this sugar, we have compared rat B-cells
      differing in their redox response to glucose stimulation. To this end, a
      population of B-cells showing increased NAD(P)H autofluorescence after a 15-min
      exposure to 16.7 mM glucose was sorted from a population of B-cells that, under
      the very same conditions, failed to show detectable changes in basal NADP(H)
      autofluorescence. Insulin secretion was evaluated by a reverse hemolytic plaque
      assay in these two populations, referred to as high and low NAD(P)H,
      respectively. After a 30-min stimulation by 16.7 mM glucose, both populations
      comprised secreting B-cells and B-cells that did not release detectable amounts
      of insulin. However, the percentage of secreting B-cells and total insulin output
      were larger (P < 0.01-0.02) in the high- (77.9 +/- 6.5% and 141.7 +/- 27.4
      microns2 x 10(3)) than in the low-NAD(P)H population (58.7 +/- 6% and 92.7 +/-
      20.5 microns2 x 10(3)). The high-NAD(P)H population also comprised B-cells that,
      on average, had a larger (P < 0.001) profile area (142.9 +/- 2.3 microns2) than
      the B-cells of the low-NAD(P)H population (118.6 +/- 1.5 microns2). Glucose
      induced insulin secretion was similar in the high- and low-NAD(P)H group when
      cells of similar sizes were compared and increased similarly in the two
      populations as a function of B-cell size. Analysis of variance revealed that
      insulin secretion was influenced (P < 0.005) by the size of B-cells and not by
      their NAD(P)H level.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368266
TI  - Evaluation of antitumor effect of tumor necrosis factor in terms of protein
      metabolism and cell cycle kinetics.
AB  - To determine the significance of protein breakdown in regulating tumor growth and
      to better understand the antitumor mechanism of tumor necrosis factor in vivo, we
      measured the effects of a 6-h constant intravenous infusion of human recombinant
      tumor necrosis factor-alpha (rHuTNF) on tumor protein metabolism and cell cycle
      kinetics in rats bearing the Walker-256 carcinosarcoma. Protein metabolism was
      investigated with the use of [14C]leucine infusion; estimates of tumor cell cycle
      kinetics were obtained in vivo by use of 5-bromo-2'-deoxyuridine (BrdUrd) pulse
      labeling and bivariate BrdUrd/DNA analysis by flow cytometry. Reduction in tumor
      growth by rHuTNF was associated with a dose-dependent increase in tumor
      proteolysis but no change in tumor protein synthesis. At the cellular level,
      rHuTNF had a significant cytostatic effect on G2/M cells and caused a marked
      decrease in the fraction of cells capable of BrdUrd uptake. Release of BrdUrd, an
      indicator of cell death, was noted in only 7.5% of tumor cells labeled at the
      beginning of rHuTNF infusion. These results suggest that either tumor protein
      breakdown may influence cell cycle activity by regulating cytoplasmic protein
      mass or that tumor proteolysis may be a compensatory mechanism for limiting
      cytoplasmic size when cellular division is interrupted suddenly.

PMID- 8368267
TI  - Perinatal enhancement of cardiac myofibrillar creatine kinase activity without
      change in enzyme Km.
AB  - Myofibrillar creatine kinase (CK) serves as one microcompartment of the
      phosphorylcreatine shuttle by providing ATP as substrate for
      adenosinetriphosphatase (ATPase). During perinatal heart development,
      augmentations of myofibrillar ATPase and CK occur in concert with increased
      contractile performance. The maximal reaction velocity (Vmax) for CK doubles
      during development in both intact native myofibril and enzyme extracted from
      myofibril. The absence of alterations in ADP and creatine phosphate substrate
      Michaelis constants (Km), isoenzyme composition, or total number of -SH groups
      suggests active site function (Vmax) is influenced indirectly via a subunit
      domain effect on enzyme conformation.

PMID- 8368268
TI  - Polylysine activates smooth muscle myosin ATPase activity via induction of a 10S
      to 6S transition.
AB  - Polylysine (10-13 kDa) stimulates contraction in smooth muscle skinned fibers and
      activates actomyosin adenosinetriphosphatase (ATPase) activity in the absence of
      myosin light chain phosphorylation [P. T. Szymanski and R. J. Paul. Adv. Exp.
      Med. 304: 363-368, 1991; P. T. Szymanski, J. D. Strauss, G. Doerman, J. DiSalvo,
      and R. J. Paul. Am J. Physiol. 262 (Cell Physiol. 31): C1445-C1455, 1992]. To
      provide further information on the mechanism of polylysine action on
      contractility in smooth muscle, we investigated its effect on ATPase activity and
      conformation of purified gizzard myosin. We report here that polylysine directly
      stimulates myosin ATPase activity in a concentration-dependent manner. This
      stimulation could be completely abolished with the addition of heparin, a
      negatively charged heteropolysaccharide. Polylysine (10 microM) increases myosin
      ATPase activity to a level similar to that of myosin phosphorylation. Addition of
      10 microM polylysine to phosphorylated myosin [with myosin light chain kinase and
      adenosine 5'-O-(3-thiotriphosphate) (ATP gamma S), to approximately 1.9 mol P/mol
      myosin], however, did not further stimulate ATPase activity. At 0.2 M KCl (the
      salt concentration at which myosin exists primary in the 10S form), the addition
      of polylysine increases myosin ATPase activity to a level comparable to that of
      untreated myosin in 0.3 M KCl. These changes parallel the increase in solution
      viscosity elicited by polylysine. These results suggest that polylysine induces a
      transition in myosin conformation from the 10S to the 6S form, and this was
      confirmed by electron microscopy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368269
TI  - Hyperosmotic stress stimulates tissue plasminogen activator expression by a PKC
      independent pathway.
AB  - Shear, stretch, and the generation of oxygen radicals stimulate increases in
      tissue plasminogen activator (t-PA) mRNA levels and antigen production,
      suggesting that environmental stress may regulate t-PA gene expression. We have
      examined whether t-PA production is also responsive to a hyperosmotic
      environment. Endothelial and HeLa cells were treated with hyperosmotic medium,
      and t-PA mRNA and antigen secretion were measured. Endothelial cells incubated in
      hyperosmotic medium showed a dose-dependent decrease in cell volume and a 1.9 +/-
      0.3- and 3.7 +/- 0.9-fold increase in t-PA secretion at 425 and 485 mosmol/kgH2O,
      respectively. HeLa cells showed a 3.3 +/- 0.6- and 5.1 +/- 1.2-fold increase at
      the same osmolalities. Increased secretion began between 8 and 16 h and continued
      through 24 h. Cultures returned to isosmotic medium after 8 h of treatment
      continued to release 98.1 +/- 7% of the maximum levels of t-PA for the next 16 h,
      despite the reversal of other responses to hyperosmotic environment. t-PA mRNA
      levels also increased between 8 and 16 h to five times control levels but
      returned to baseline by 24 h. No change in intracellular Ca2+ concentration,
      inositol 1,4,5-trisphosphate, or diacylglycerol content was detected, suggesting
      that a different intracellular signal pathway may be involved in the response to
      hyperosmolar stimulus. Thus environmental stress may be a general stimulatory
      signal through which t-PA production can be induced.

PMID- 8368270
TI  - PKC-mediated redistribution of mitogen-activated protein kinase during smooth
      muscle cell activation.
AB  - Protein kinase C (PKC) translocates from the cytosol to the surface membrane at
      the time it mediates agonist-induced contraction of ferret vascular smooth muscle
      cells (R. A. Khalil and K. G. Morgan. J. Physiol. Lond. 455: 585-599, 1992).
      However, no direct communication between membrane-associated PKC and the
      contractile filaments has been identified. Mitogen-activated protein (MAP) kinase
      is a substrate for PKC and is also capable of phosphorylating the actin-binding
      protein caldesmon at sites phosphorylated during smooth muscle contraction in
      vivo (L. P. Adam, C. J. Gapinski, and D. R. Hathaway. FEBS Lett. 302: 223-226,
      1992). In the present study, the hypothesis that PKC and MAP kinase are involved
      in a signal-transduction cascade leading to smooth muscle contraction was tested.
      Immunofluorescence and digital-imaging microscopy were used to localize the
      epsilon-PKC isoform and MAP kinase during phenylephrine-induced Ca(2+)
      independent activation of ferret aorta cells. We report that maintained
      phenylephrine-induced translocation of cytosolic PKC to the surface membrane is
      associated with transient redistribution of cytosolic MAP kinase to the surface
      membrane before cell contraction. Coincident with cell contraction, MAP kinase
      undergoes a second redistribution away from the plasmalemma and toward the
      vicinity of contractile filaments. Redistribution of MAP kinase is not stimulated
      by Ca2+ but is completely prevented by PKC inhibitors. The transient Ca(2+)
      independent but PKC-dependent redistribution of MAP kinase points to MAP kinase
      as a missing link in the signal-transduction cascade between membrane-bound PKC
      and smooth muscle activation.

PMID- 8368272
TI  - Interrelationship between cell pH and cell calcium in rat inner medullary
      collecting duct cells.
AB  - In this study we investigated the interrelationship between cell pH (pHi) and
      cell calcium (Cai) in cultured inner medullary collecting duct cells of the rat.
      Confluent monolayers were made quiescent by incubation for 24 h in Dulbecco's
      modified Eagle's medium supplemented with 0.1% serum before study. Changes in pHi
      and Cai were measured with the fluorescent probes 2',7'-bis(carboxyethyl)-5,6
      carboxyfluorescein and fura 2. In nominally bicarbonate-free media containing 110
      mM Na+ and 1 mM Cai, cell acidification to pH 6.70 increased Cai from 122 +/- 24
      to 243 +/- 33 nM. In the absence of bath calcium, acidification increased Cai
      from 90 +/- 7 to 144 +/- 13 nM. An increase of pHi to 7.6 reduced Cai almost to
      baseline. Cell acidification increased inositol trisphosphate (IP3) production,
      and 3,4,5-trimethoxybenzoic acid 8-(diethylamino)octyl ester, an IP3 antagonist,
      partially inhibited the rise in Cai. Elevation of Cai resulted in a sustained
      cell alkalinization from 7.32 +/- 0.02 to 7.58 +/- 0.04. When Cai was reduced,
      pHi fell to 7.25 +/- 0.01. We conclude that Cai and pHi participate in a feedback
      loop that modulates changes in each respective parameter.

PMID- 8368271
TI  - Mechanism of diltiazem's immunomodulatory effects after hemorrhage and
      resuscitation.
AB  - Although diltiazem improves immune responses after hemorrhage and resuscitation,
      its mechanism remains unknown. To study this, C3H/HeN mice were bled to a mean
      blood pressure of 35 mmHg, maintained at that level for 1 h, and then adequately
      resuscitated and treated with diltiazem (400 micrograms/kg body wt) or saline
      (vehicle). One hour after hemorrhage and resuscitation, splenic microvascular
      blood flow was determined by laser Doppler flowmetry. Splenocytes were also
      harvested and ATP levels and cytoplasmic free Ca2+ concentration ([Ca2+]i) were
      determined by 31P nuclear magnetic resonance and fluo 3 flow cytometry,
      respectively. Splenocyte functions were determined by measuring interleukin (IL)
      1, IL-2, IL-3, IL-6, and tumor necrosis factor concentrations in concanavalin A
      stimulated supernatant with cytokine-specific cellular assays. Hemorrhage and
      resuscitation caused a significant decrease in the splenocyte's ability to
      release cytokines, which was correlated with significant reductions in splenocyte
      ATP levels and splenic microvascular blood flow as well as a significant increase
      in splenocyte [Ca2+]i. Diltiazem significantly decreased splenocyte [Ca2+]i while
      improving splenocyte ATP levels, cytokine production, and splenic microvascular
      blood flow. Nitroglycerin (71 micrograms/kg body wt) administration improved
      splenic microvascular blood flow to diltiazem-treated levels but failed to
      concomitantly improve splenocyte ATP levels or cytokine production. Thus
      diltiazem's immunoprotective effects appear to be the result of decreased Ca(2+)
      induced splenocyte injury.

PMID- 8368273
TI  - Albumin and Ricinus communis agglutinin decrease endothelial permeability via
      interactions with matrix.
AB  - We studied the effects of albumin and the lectin Ricinus communis agglutinin
      (RCA) on hydraulic conductivity (Lp) of bovine pulmonary microvascular
      endothelial cell monolayers (BPMVEC) because of the evidence that albumin and RCA
      can interfere with transendothelial albumin permeability (Siflinger-Birnboim, A.,
      J. Schnitzer, H. Lum, F. Blumenstock, C. Shen, P. Del Vecchio, and A. Malik. J.
      Cell. Physiol. 149: 575-584, 1991). BPMVEC were seeded on microporous
      polycarbonate filters, and the liquid flux was measured by collecting effluent
      into a tubing of known inner diameter at transendothelial hydrostatic pressures
      (P) ranging from 5 to 20 cmH2O. Lp was calculated as the slope of the
      relationship of liquid flux per unit surface area (Jv) vs. P. Addition of RCA (50
      micrograms/ml) or albumin (5 mg/ml) to the endothelial cell medium containing
      albumin-free Hanks' balanced saline solution (HBSS) decreased total Lp (expressed
      x 10(-6) cm.s-1 x cmH2O-1) from 17.2 +/- 3.6 during HBSS to 4.7 +/- 0.9 during
      albumin and 5.7 +/- 1.6 during RCA (P < 0.01 for both). The RCA effect, but not
      that of albumin, was prevented by the addition of D-galactose (0.1 M) (the
      cognate hapten monosaccharide of RCA). We determined the contribution of the
      extracellular matrix (ECM) in decreasing the Lp by obtaining ECM after treatment
      of the monolayers with 0.025 M NH4OH to detach endothelial cells from the ECM.
      Basal ECM Lp (expressed x 10(-6) cm.s-1 x cmH2O-1) was 57.0 +/- 15.3, and it
      decreased to 19.7 +/- 4.3 and 17.5 +/- 2.9 during RCA and albumin, respectively
      (P < 0.01 for both). In contrast, RCA and albumin did not alter the filter Lp
      values. Another lectin, Ulex europaeus agglutinin, and the protein immunoglobulin
      G had no effect on Lp values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368274
TI  - Insulin uptake and processing by cultured mouse glomerular endothelial cells.
AB  - Endothelial cells isolated from a variety of vascular beds bind and transport
      insulin but exhibit relatively low insulin degrading activity. Because
      endothelial cells exhibit heterogeneity and since kidney is a major site of
      insulin degradation, we studied the processing of insulin by glomerular
      endothelial cells (GEC). When exposed to 2 x 10(-10) M 125I-labeled insulin, GEC
      associated with the hormone in a specific manner. This interaction was inhibited
      by insulin but not by a number of unrelated peptide hormones. Over a 90-min
      period, GEC degraded 42 +/- 3% of the 125I-insulin, as measured by solubility in
      trichloroacetic acid (TCA). Degradation was inhibited 90% by an excess of insulin
      or adrenocorticotropic hormone (10(-6) M) and 57% by glucagon, whereas growth
      hormone and calcitonin were without effect. Separation of plasma membrane bound
      from internalized insulin was achieved by decreasing extracellular pH. In the
      steady state, 43% of cell-associated insulin was membrane bound and 57%
      internalized. The fate of the internalized 125I-insulin was examined by
      incubating acid-washed cells at 37 degrees C for 60 min. Over this time 18% of
      the radioactivity was released as TCA insoluble- and 72% as TCA-soluble
      radioactivity. Release was increased by insulin (10(-6) M) but not by unrelated
      peptide hormones. In the presence of chloroquine, 125I-insulin release increased
      by one third while degradation fell. High-performance liquid chromatography
      revealed that GEC released both intact insulin and large intermediates and that
      chloroquine inhibited intermediate formation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368275
TI  - Transtrophoblast and microvillus membrane potential difference in mature
      intermediate human placental villi.
AB  - Single mature intermediate villi from term placentas after normal gestation and
      vaginal or cesarian delivery were identified microscopically and mounted in a
      bath for conventional micro-electrode studies. With the application of strict
      selection criteria, the following observations on electrical potential difference
      (PD) were made. 1) With the tissue bathed in Earle's medium (37 degrees C) the PD
      across the syncytiotrophoblast microvillus membrane with respect to the bath was
      not normally distributed. The median PD was -22 mV (range -12 to -60 mV, n =
      200). This fell to -6 mV after prior incubation for 4 h with cyanide (3 mM) or
      iodoacetate (2 mM) but was not altered by short-term application of these agents
      or by 0.1 mM ouabain. Substituting Na+ in Earle's medium with choline had no
      effect on PD, but replacing Cl- with gluconate caused a depolarization of 6 mV (P
      < 0.002). Increasing KCl in the bath fluid revealed an apparently low microvillus
      membrane K+ conductance. The low microvillus membrane PD may reflect a low Na(+)
      K(+)-ATPase activity and/or a low membrane permeability to K+. 2) The
      transtrophoblast PD measured by insertion and withdrawal of the electrode was
      significantly different from zero [P < 0.003, median -3 mV (range 0 to -15 mV), n
      = 11]; and PD measured by insertion of the electrode into the villus core and
      beyond was -6 mV (significantly different from zero P < 0.003, range -2.5 to -10
      mV, n = 6). If a similar PD were to exist in vivo, it could have a significant
      influence on ion transport across the placenta at term.

PMID- 8368276
TI  - Contraction history modulates isotonic shortening velocity in smooth muscle.
AB  - The effect of contraction history on the isotonic shortening velocity of canine
      tracheal smooth muscle was investigated. Muscles were contracted isometrically
      for 20 s at initial lengths of L(o) (length of maximal active force), 85% L(o),
      or 70% L(o) using electrical field stimulation. Muscles were then allowed to
      shorten isotonically under different afterloads either with or without first
      being subjected to a step decrease in length to 70% L(o). Instantaneous
      velocities were plotted against instantaneous muscle length during isotonic
      shortening. Regardless of protocol, the velocity at any muscle length during
      shortening was lower when the muscle was initially activated at a longer length.
      The isotonic shortening velocity decreased progressively during shortening at a
      nearly linear rate with respect to instantaneous muscle length under all
      conditions. Results suggest that a longer muscle length at the time of activation
      leads to the development of higher loads on the contractile element during
      subsequent shortening, resulting in a slower shortening velocity. This plasticity
      of the force-velocity relationship may result from cytostructural reorganization
      of the smooth muscle cells in response to contractile activation at different
      muscle lengths.

PMID- 8368277
TI  - Computer modeling of the oxygen supply and demand of cells of the avian growth
      cartilage.
AB  - We have used computer modeling studies to investigate the oxygen supply to the
      prehypertrophic and hypertrophic regions of avian growth plate. We measured
      experimentally the characteristics of the oxygen consumption of chondrocytes at
      different oxygen tensions. The oxygen consumption decreases at low oxygen
      tensions. This relation between oxygen tension and oxygen consumption serves as a
      protective mechanism that prevents the cells in the prehypertrophic zone from
      becoming anoxic in the regions farthest from the blood vessels. The results of
      the calculations, when combined with redox measurements of the cells in the
      growth plate, indicate that the metabolism of the chondrocytes is not controlled
      simply by the available oxygen supply.

PMID- 8368278
TI  - WW-781, a potent reversible inhibitor of red cell Cl- flux, binds to band 3 by a
      two-step mechanism.
AB  - WW-781 ([3-methyl-1-p-sulfophenyl-5-pyrazolone-(4)]-[1,3-dibutylbarbit uric acid]
      pentamethine oxonol), a fluorescent dye that has been used for measuring membrane
      potentials by optical methods, inhibits human red blood cell Cl- exchange, which
      is mediated by the membrane protein known as band 3 or capnophorin. The
      inhibition is slowly reversible upon removal of WW-781 from the medium, with a
      half time of approximately 4.7 min in 150 mM Cl- medium at 0 degrees C. The
      mechanism of inhibition by WW-781 involves a two-step binding reaction. WW-781
      binds rapidly to band 3 to form an initial complex, which can also rapidly
      dissociate. Formation of this initial complex is followed by the much slower
      formation of a second complex (with a rate constant of approximately 1.1 min-1),
      probably involving a protein conformational change, through which WW-781 is more
      tightly bound to band 3. At low concentrations, WW-781 inhibits Cl- exchange with
      a stoichiometry of 1 WW-781 molecule per band 3 monomer, suggesting that under
      these conditions the binding of WW-781 is highly selective for the band 3
      protein.

PMID- 8368279
TI  - Twitch-dependent SR Ca accumulation and release in rabbit ventricular myocytes.
AB  - Using caffeine-induced contractures (Ccaf) and thapsigargin (TG), we estimated
      the fraction of sarcoplasmic reticulum (SR) Ca released at one twitch and also
      the number of twitches required to reload a Ca-depleted SR. Similar results were
      obtained for twitches or intracellular Ca (Cai) transient with the fluorescent
      indicator, indo 1. Sustained exposure to 10 mM caffeine completely depletes the
      SR of Ca in < 5 s (as assessed by a second Ccaf). After such Ca depletion, four
      to five twitches are necessary to reload the SR to the steady-state level (with a
      twitch constant, tau = 1.6 twitches). We also determined the time required for
      complete inhibition of the SR Ca-adenosinetriphosphatase (ATPase) by TG. After SR
      Ca depletion, 5 microM TG was applied for different periods of time before a
      train of "reloading" twitches. A TG exposure period of 90 s was sufficient to
      completely prevent Ccaf after these reloading twitches. When SR is Ca depleted,
      the twitch is larger in the presence of TG, indicating that the SR Ca-ATPase can
      limit the ability of Ca influx to activate contraction. To assess SR Ca released
      at one twitch in cells with normally Ca-loaded SR, 5 microM TG was applied for 90
      s to prevent SR Ca reuptake. Then one or several twitches were activated (causing
      SR Ca release, but with reuptake completely blocked). After the twitch (or
      train), a Ccaf was used to assess remaining SR Ca.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8368280
TI  - Effects of a Shaker K+ channel peptide and trypsin on a K+ channel in Necturus
      enterocytes.
AB  - We have previously demonstrated that a synthetic peptide composed of the first 22
      amino acids from the NH2-terminus of the Shaker B K+ channel protein deactivates
      a voltage-dependent K+ channel present in basolateral membrane of Necturus small
      intestinal epithelial cells reconstituted into planar lipid bilayers (Dubinsky et
      al. Proc. Natl. Acad. Sci. USA 89: 1770-1774, 1992). We now demonstrate that this
      peptide interacts with the inner surface of the Necturus channel only when it is
      in the open or conducting configuration and that this interaction is hindered by
      tetraethylammonium ion, a well-established blocker of this and other K+ channels.
      We conclude that this peptide is an open-pore blocker of the Necturus K+ channel
      as it appears to be in the case of the Shaker B K+ channel. We further
      demonstrate that trypsin, which abolishes the ability of this peptide to block
      both the Necturus and the Shaker K+ channels and inhibits spontaneous
      inactivation of the Shaker K+ channel, also impairs the voltage-gate of the
      Necturus K+ channel. These findings, and others to be reported in a companion
      paper, suggest structural homologies between the "inactivation peptide" of the
      Shaker B K+ channel and the voltage-gate of the Necturus K+ channel.

PMID- 8368282
TI  - Further characterization of the Na-Ca exchange-dependent Ca compartment in rat
      ventricular cells.
AB  - A discrete subcellular Ca compartment, absolutely dependent upon Na-Ca exchange
      for its exchange, has been previously identified in ventricular cells from both
      adult rat and from neonatal rat cultures. The present study further characterizes
      this compartment in the adult ventricular myocyte. The compartment's exchange is
      significantly decreased by 20 microM 3,4-dichlorobenzamil. Its content responds
      significantly to variation of the extracellular Ca concentration ([Ca]o) and to
      reversal of the Na-Ca exchanger by reduction of extracellular Na concentration to
      zero. Its content decreases to 155 +/- 24 mumol/kg dry cell wt in 0.2 mM [Ca]o
      and increases to 623 +/- 48 mumol/kg at 6.5 mM [Ca]o, where it appears to be near
      saturation. The compartment is significantly reduced by 45Ca labeling in the
      presence of 10 mM caffeine (23%) and 1 mM ryanodine (22%). This compartment is
      not significantly affected by 1 microM thapsigargin. 45Ca activity is retained in
      the compartment when 45Ca washout is conducted without Na or Ca in the washout
      solution, i.e., Na-Ca exchange is not operative. Under these conditions, addition
      of 1 mM Cd to the washout produces a significant release of 45Ca from the
      compartment. The results are interpreted to indicate that the compartment in the
      adult cell has two components that are in equilibrium: a relatively small
      sarcoplasmic reticulum (SR) component and a larger "non-SR" component. This is in
      contrast to the compartment in the cultured cell in which the compartment is 2.6
      times larger and has a larger SR component. The possibility that the non-SR
      component represents Ca bound to the cytoplasmic leaflet of the sarcolemma at SR
      junction regions is discussed.

PMID- 8368281
TI  - Immunoisolation of a K+ channel from basolateral membranes of Necturus
      enterocytes.
AB  - We have reported that a peptide composed of the NH2-terminal 22 amino acids of
      the Drosophila Shaker B K+ channel protein, which is responsible for the
      inactivation of this A-type channel, blocks the inner, open mouth of a voltage
      gated K+ channel present in the basolateral membrane of Necturus maculosa small
      intestinal enterocytes. We now demonstrate that antibodies to this "inactivating"
      peptide interact with proteins in solubilized and intact basolateral membranes
      from Necturus enterocytes. Asolectin vesicles reconstituted with the full
      complement of solubilized basolateral membrane proteins display 86Rb+ uptake that
      is inhibited by tetraethylammonium ion and abolished by immunoprecipitation with
      these antibodies. Furthermore, asolectin vesicles containing protein eluted from
      an antibody-affinity column display 86Rb+ uptake that is abolished by boiling.
      Finally, reconstitution of the immunoisolated protein into planar phospholipid
      bilayers disclosed a K+ channel whose single-channel properties are identical to
      those of the voltage-gated channel in the native basolateral membranes. Our data
      are consistent with the notion that a 150-kDa protein present in basolateral
      membranes of Necturus enterocytes possesses inwardly rectifying K+ channel
      activity and that this protein is antigenically similar to the type A K+ channel
      present in the flight muscles of Drosophila melanogaster and encoded by the
      Shaker B locus.

PMID- 8368283
TI  - Laser light-scattering system for studying cell volume regulation and membrane
      transport processes.
AB  - A simple and relatively inexpensive device utilizing laser light scattering for
      the study of volume regulatory behavior and membrane transport phenomena in cells
      cultured on or affixed to a rigid substrate is described in detail. Validation of
      the method is provided by study of cell types with known volume regulatory
      responses. The method we describe has numerous advantages over currently
      available techniques used to monitor cell volume changes. These advantages
      include 1) the ability to rapidly detect and quantify small cell volume changes
      on-line, 2) the ability to maintain natural cell morphology, cell surface
      contacts, and cell-to-cell interactions, 3) the ability to easily control
      solution temperature and gas and solute composition, and 4) the ability to
      perform multiple perturbations in a single experiment. The light-scattering
      system we describe can be modified to allow for simultaneous measurement of light
      scattering signals and fluorescence emission from intracellular ion-sensitive
      probes and membrane potential dyes. In addition, our method may be useful for the
      study of apical and basolateral membrane transport processes in epithelial
      monolayer cell cultures.

PMID- 8368284
TI  - Adult human aortic smooth muscle cells in culture produce active TGF-beta.
AB  - Vascular smooth muscle cells (VSMC) from adult human aortas proliferated in
      culture in response to fetal calf serum (FCS) with a population doubling time of
      70-85 h compared with 35 +/- 5 h for VSMC derived from adult rat aortas. Medium
      conditioned on cultures prepared from aortas from three different donors and
      mixed 1:1 with fresh Dulbecco's modified Eagle's medium plus 20% FCS [human
      conditioned medium (HCM)] reduced the rate of proliferation of rat VSMC by 46 +/-
      6% (n = 3) after 48 h compared with cells in fresh medium. HCM did not reduce the
      proportion (> 65%) of rat VSMC that entered DNA synthesis but delayed entry into
      mitosis by at least 18 h. This effect was similar to previous observations of the
      action of transforming growth factor-beta (TGF-beta) on rat VSMC (G. K. Owens, A.
      A. Geisterfer, Y. W. Yang, and A. Komoriya. J. Cell Biol. 107: 771-780, 1988). A
      TGF-beta assay using DNA synthesis in mink lung epithelial cells confirmed that
      human, but not rat, VSMC in culture secrete active TGF-beta. Addition of a
      neutralizing antibody to TGF-beta to human VSMC in the presence of 20% FCS
      decreased the population doubling time from 74 +/- 3 to 46 +/- 6 h (n = 3). These
      observations demonstrate that the long population doubling time of human VSMC is
      due to the production of active TGF-beta and to an inhibitory autocrine loop.

PMID- 8368285
TI  - Mechanisms of ET-1 potentiation of angiotensin II stimulation of aldosterone
      production.
AB  - Endothelin-1 (ET-1) exerts the following two types of aldosterone-stimulating
      actions on glomerulosa cells: ET-1-mediated direct stimulation of aldosterone
      secretion (per se effect) and potentiation of the aldosterone secretion to
      angiotensin II (ANG II; potentiation effect). The role of Ca2+ and protein kinase
      C (PKC) systems in these two effects was investigated. Incubations of calf
      cultured adrenal zona glomerulosa cells in low-Ca2+ media or in the presence of
      the Ca2+ channel antagonist verapamil reduced the aldosterone secretion to ET-1.
      When cells were preincubated with ET-1 in a low-Ca2+ media or in the presence of
      the Ca2+ channel antagonist verapamil, washed, and incubated in media with normal
      Ca2+, ANG II showed potentiation of ANG II-stimulated aldosterone secretion. The
      PKC inhibitors H-7 and staurosporine did not decrease ET-1-stimulated aldosterone
      secretion, but they inhibited the potentiation effect of ET-1 on ANG II-mediated
      aldosterone secretion. Adrenocorticotropic hormone desensitization or prolonged
      phorbol ester stimulation of PKC resulting in desensitization also resulted in
      the abolition of the ET-1-mediated ANG II potentiation of aldosterone secretion.
      The PKC inhibitors did not affect ANG II-stimulated aldosterone secretion. We
      conclude that ET-1 exerts a direct stimulation of aldosterone secretion through a
      mechanism dependent on Ca2+ and potentiates ANG II-mediated aldosterone
      stimulation through a mechanism involving PKC.

PMID- 8368286
TI  - Free and conjugated catecholamines and serotonin in canine thoracic duct lymph:
      effects of feeding.
AB  - The source and fate of sulfoconjugated catecholamines present in plasma are not
      known. Sulfated norepinephrine has been shown to overflow together with free
      norepinephrine from a typical peripheral neuroeffector junction. Some released
      free norepinephrine is removed via the lymphatic system, but it is not known
      whether sulfated catecholamines are removed similarly. Serotonin, another
      biogenic amine, is released from the enterochromaffin cells into portal blood.
      The aims of the present study were to determine whether conjugated catecholamines
      and serotonin could be detected in thoracic duct lymph of dogs and to compare
      concentrations in lymph with those in samples of portal blood collected before
      and after the dogs were fed. A method is described for the extraction and
      purification of free and conjugated catecholamines and serotonin from lymph. In
      lymph and in plasma, there were similar concentrations of free (0.2-0.4 ng/ml)
      and conjugated (0.1-0.2 ng/ml) norepinephrine and of conjugated dopamine (0.2-1.0
      ng/ml). The concentrations of free serotonin were much lower in lymph (0.1-0.2
      ng/ml) than in portal blood (100-200 ng/ml). Small amounts of conjugated
      serotonin (0.1-0.4 ng/ml) were detected in lymph but were not detected in plasma.
      Feeding caused increases in concentration of conjugated dopamine in lymph and in
      plasma and small increases in the output of free norepinephrine and free and
      conjugated serotonin in lymph.

PMID- 8368287
TI  - A compartmental model of acute stimulation of aldosterone secretion in vivo by
      potassium and ANG II.
AB  - Conscious sheep with an adrenal autotransplant were used to study the
      relationship between acute change in K+ concentration and acute change in
      aldosterone secretion rate (ASR). The kinetics of K+ within the adrenal
      circulation were shown to be consistent with distribution within a single
      compartment. In contrast, change in ASR during and after KCl infusion was
      consistent with a two-compartment model, where ASR was a sigmoidal function of
      concentration of K+ (or other unidentified agent) in the second, or "effect,"
      compartment. Prior work on the relationship between acute change in angiotensin
      II (ANG II) concentration and acute change in ASR was extended by investigating
      the interaction of K+ and ANG II in the control of ASR. The results of this study
      indicate that acute change in ANG II concentration may cause an inhibition of the
      usual response of the adrenal to acute change in K+ concentration.

PMID- 8368288
TI  - Ethanol inhibits insulin action on lipolysis and on insulin release in elderly
      men.
AB  - We have studied effects of ethanol on insulin's ability to suppress its own
      release and on its antilipolytic action in 12 healthy elderly men during
      euglycemic hyperinsulinemia. Insulin secretion was estimated from plasma C
      peptide concentrations. Lipolysis was determined with the two stable isotopes
      [2H5]glycerol and [1-13C]palmitate. Hyperinsulinemia (approximately 350 pM)
      decreased plasma C-peptide by approximately 60% (from 325 to 122 pM, P < 0.05).
      Ethanol (approximately 10 mM) completely prevented the fall in C-peptide
      concentration. Ethanol decreased the antilipolytic action of insulin by
      approximately 40% [with insulin alone, glycerol rate of appearance (Ra) decreased
      from 1.8 to 0.6 mumol.kg-1 x min-1; with insulin + ethanol, it only decreased
      from 1.8 to 1.1 mumol.kg-1 x min-1]. Ethanol did not affect palmitate Ra, which
      fell from 1.4 to 0.6 mumol.kg-1 x min-1 with insulin and from 1.4 to 0.3 mumol.kg
      1 x min-1 with insulin plus ethanol. Fatty acid reesterification was not affected
      by insulin but tripled (from 0.6 to 1.9 mumol.kg-1 x min-1) in response to
      insulin plus ethanol. Our data showed that modest concentrations of ethanol
      suppressed the inhibitory actions of insulin on its own release and on lipolysis.
      The inhibition by ethanol of various insulin actions, including glucose disposal,
      lipolysis, and insulin release, in diverse tissues such as muscle, adipose
      tissue, and pancreas raises the possibility that ethanol may produce a state of
      generalized insulin resistance.

PMID- 8368289
TI  - Effect of hypophysectomy on plasma catecholamines and enkephalins in fetal sheep.
AB  - The aim of this study was to determine the effect of fetal hypophysectomy on the
      plasma concentrations of catecholamines and enkephalins in the fetal sheep
      between 120 and 140 days gestation under basal and hypoxic conditions. During
      basal conditions, there was no difference in the plasma concentrations of
      norepinephrine and epinephrine between intact and hypophysectomized groups. Fetal
      plasma norepinephrine concentrations were significantly increased during hypoxia
      in intact fetal sheep (7.2 +/- 2.2 pmol/ml, -15 min; 20.2 +/- 7.7 pmol/ml, 30
      min) between 130 and 140 days, but after fetal hypophysectomy there was no
      significant norepinephrine response to hypoxia at this gestational age (4.7 +/-
      1.3 pmol/ml, -15 min; 8.8 +/- 2.8 pmol/ml, 30 min). In contrast, fetal plasma
      epinephrine concentrations were significantly increased during hypoxia in both
      the intact (1.5 +/- 0.5 pmol/ml, -15 min; 3.3 +/- 1.7 pmol/ml, 30 min) and
      hypophysectomized groups (1.8 +/- 0.6 pmol/ml, -15 min; 6.8 +/- 4.1 pmol/ml, 30
      min) between 130 and 140 days. During basal conditions, plasma concentrations of
      free Met-Enk were significantly less in hypophysectomized fetal sheep (170.8 +/-
      34.3 pg/ml; 120-140 days) than in intact fetal sheep (305.6 +/- 47.3 pg/ml).
      There were no differences, however, in the fetal plasma concentrations of total
      Met-Enk between the intact (18.0 +/- 1.9 ng/ml) and hypophysectomized (16.9 +/-
      2.6 ng/ml) groups. During hypoxia, there were no changes in the fetal plasma
      concentrations of either free or total Met-Enk in the intact or hypophysectomized
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368290
TI  - Acute effects of resistance exercise on muscle protein synthesis rate in young
      and elderly men and women.
AB  - Muscle mass and function are improved in the elderly during resistance exercise
      training. These improvements must result from alterations in the rates of muscle
      protein synthesis and breakdown. We determined the rate of quadriceps muscle
      protein synthesis using the in vivo rate of incorporation of intravenously
      infused [13C]leucine into mixed-muscle protein in both young (24 yr) and elderly
      (63-66 yr) men and women before and at the end of 2 wk of resistance exercise
      training. Before training, the fractional rate of muscle protein synthesis was
      lower in the elderly than in the young (0.030 +/- 0.003 vs. 0.049 +/- 0.004%/h; P
      = 0.004) but increased (P < 0.03) to a comparable rate of muscle protein
      synthesis in both young (0.075 +/- 0.009%/h) and elderly subjects (0.076 +/-
      0.011%/h) after 2 wk of exercise. In the elderly, muscle mass, 24-h urinary 3
      methylhistidine and creatinine excretion, and whole body protein breakdown rate
      determined during the [13C]leucine infusion were not changed after 2 wk of
      exercise. These findings demonstrate that, during the initial phase of a
      resistance exercise training program, a marked increase in quadriceps muscle
      protein synthesis rate occurs in elderly and young adults without an increase in
      the rate of whole body protein breakdown. In the elderly, this was not
      accompanied by an increase in urinary 3-methylhistidine excretion, an index of
      myofibrillar protein breakdown.

PMID- 8368291
TI  - Increased clearance of 1,25(OH)2D3 and tissue-specific responsiveness to
      1,25(OH)2D3 in diabetic rats.
AB  - The kinetics of 1,25-dihydroxyvitamin D3 [1,25(OH)2-D3] and the in vivo response
      to 1,25(OH)2D3 (7.5, 15, and 30 ng/100 g body wt), infused or injected
      subcutaneously for 12-14 days, were studied in male spontaneously diabetic and
      control BB rats. In control rats, increasing doses of 1,25(OH)2D3 produced
      parallel increases in plasma 1,25(OH)2D3 and calcium, urinary calcium, duodenal
      CaBP9K, and renal CaBP28K. 1,25-(OH)2D3 at 30 ng/100 g markedly raised plasma
      osteocalcin and osteoblast/osteoid surfaces in the tibial metaphysis, but
      inhibited bone mineralization rate. In diabetic rats, plasma 1,25-(OH)2D3
      concentrations were decreased, and the rise of plasma 1,25(OH)2D3 during
      1,25(OH)2D3 infusion was blunted, but the free 1,25(OH)2D3 index remained normal
      or above normal. Diabetic rats had an increased metabolic clearance rate of 1,25
      (OH)2D3 (0.38 +/- 0.015 vs. 0.24 +/- 0.007 ml.min-1.kg-1), with no further
      increase in 1,25(OH)2D3-infused diabetic rats; their relative production rate of
      1,25(OH)2D3 was unchanged. The responses of plasma and urinary calcium, duodenal
      CaBP9K, and renal CaBP28K to infused 1,25(OH)2D3 were normal, as was duodenal
      calcium absorption in 1,25(OH)2D3-injected diabetic rats. However, the virtual
      absence of osteoblasts/osteoid in trabecular bone was unaltered in diabetic rats
      infused with 30 ng/100 g 1,25(OH)2D3, with only minimal increase of their low
      plasma osteocalcin levels. 1,25(OH)2D3 treatment therefore cannot be expected to
      reverse diabetic osteopenia.

PMID- 8368292
TI  - Direct measurement of change in muscle glycogen concentration after a mixed meal
      in normal subjects.
AB  - Postprandial storage of carbohydrate as glycogen in muscle was quantitated in
      normal subjects (n = 8) by natural abundance 13C-nuclear magnetic resonance
      spectroscopy with proton decoupling in a 4.7-tesla magnet. After an overnight
      fast three basal measurements of gastrocnemius muscle glycogen were made and a
      mixed meal was given. Muscle glycogen concentration rose from 83.3 +/- 5.2 to a
      maximum of 100.2 +/- 6.7 mmol/l muscle at 4.9 h (P < 0.01) and fell thereafter to
      90.6 +/- 5.9 mmol/l muscle at 7 h postprandially (P < 0.006). The meal brought
      about an increase in plasma glucose from 5.4 +/- 0.2 to 7.3 +/- 0.4 mmol/l at 30
      min but this was followed by a rapid fall to 6.2 +/- 0.4 mmol/l at 75 min. Plasma
      insulin rose from 62.4 +/- 11.4 to 900 +/- 216 pmol/l at 30 min and declined
      steadily thereafter. It was calculated from total muscle mass measurements and
      estimation of carbohydrate absorption rates that at peak muscle glycogen
      concentrations between 26 and 35% of the absorbed carbohydrate was stored as
      muscle glycogen. These data quantitate the role of skeletal muscle glycogen
      synthesis in postprandial carbohydrate storage and demonstrate that this tissue
      acts as a dynamic buffer to maintain glucose homeostasis during postprandial
      substrate storage.

PMID- 8368293
TI  - Ontogeny of GH mRNA and GH secretion in male and female rats: regulation by GH
      releasing hormone.
AB  - Growth hormone-releasing hormone (GHRH) has been shown in vitro to increase
      proliferation of pituitary somatotrophs, to increase transcription of the GH
      gene, to promote accumulation of GH mRNA, and to stimulate GH release. The in
      vivo involvement of hypothalamic GHRH in regulating GH mRNA content had never
      been clearly documented. We studied pituitary GH mRNA and GH contents and serum
      concentrations of GH and insulin-like growth factor I (IGF-I) in rats of both
      sexes during pubertal growth spurt and investigated the effects of GHRH
      deficiency (brought about by neonatal administration of monosodium glutamate,
      MSG) and exogenous GHRH administration on these parameters. In both sexes, GH
      mRNA content increased three- to fourfold between 4 and 12 wk of life and
      declined thereafter toward 33 wk of life. This was accompanied by virtually
      parallel changes in pituitary GH content and in serum IGF-I. Neonatal MSG
      abolished the pubertal increases in GH mRNA, pituitary GH, and serum IGF-I and
      severely impaired growth rate. Exogenous GHRH (25 micrograms/kg sc every 8 h for
      7 days) given to intact animals between 6 and 7 wk of life significantly
      augmented pituitary GH mRNA content but was less effective in MSG-treated rats.
      We conclude that 1) pubertal growth spurt in both sexes is associated with rising
      pituitary GH mRNA content; 2) GHRH deficiency abolishes the puberty-associated
      increase in GH synthesis and secretion and attenuates somatic growth rate; and 3)
      exogenous GHRH augments GH mRNA content. Thus puberty-associated augmentation of
      GHRH secretion is an important mechanism of somatic growth.

PMID- 8368294
TI  - Regulation of brown adipose tissue lipogenesis by thyroid hormone and the
      sympathetic nervous system.
AB  - Thyroid hormone regulates lipogenesis differently in rat liver and brown adipose
      tissue (BAT). In the hypothyroid state, lipogenesis is suppressed in liver but
      enhanced in BAT. Here we investigated the mechanisms underlying increased
      lipogenesis in hypothyroid BAT. Housing the animals at 28 degrees C decreased
      lipogenesis in hypothyroid BAT to euthyroid levels. Denervation resulted in a 90%
      reduction in lipogenesis in hypothyroid BAT such that levels were lower than in
      euthyroid tissue. Thyroid hormone treatment of hypothyroid rats stimulated fatty
      acid synthesis in denervated BAT, as in liver, but decreased it in intact BAT.
      Steady-state levels of mRNA encoding acetyl-CoA carboxylase, fatty-acid synthase,
      and spor 14 were measured in similar animals by Northern analysis. The expression
      of these mRNAs mirrored the lipogenic data, showing that both thyroid hormone and
      the sympathetic nervous system work at a pretranslational level in this tissue.
      These data suggest that the increased BAT lipogenesis found with hypothyroidism
      is mediated by the sympathetic nervous system to counter the reduction in
      metabolic rate in these animals.

PMID- 8368295
TI  - Hypoglycemia but not hyperglycemia induces rapid changes in pancreatic beta-cell
      gene transcription.
AB  - The purpose of these studies was to quantify several mRNAs expressed specifically
      in pancreatic islet cells and known or postulated to be important for insulin
      release after acute well defined alterations in levels of plasma glucose. Glucose
      levels were maintained at 50, 120, or 180 mg/dl (2.8, 6.7, or 10 mM) for 3 h in
      conscious unrestrained rats. Hypoglycemia (for 3 h) caused significant decreases
      in pancreatic content of mRNAs for insulin 2 and GLUT-2 to 55 and 34% of control
      values, respectively. There were no significant changes in insulin 1, amylin,
      glucokinase, or glucagon mRNAs. Unprocessed insulin 1 and 2 mRNA precursors were
      decreased to 17 and 10% of levels in controls, consistent with effects of short
      term hypoglycemia on new mRNA synthesis. Hyperglycemia (for 3 h) caused no
      increase in pancreatic content of any mRNA measured. To discriminate between
      effects of hypoglycemia and hyperinsulinemia in the hypoglycemic animals, rats
      were made hypoglycemic by infusion with etomoxir, a carnitine
      palmitoyltransferase I inhibitor that lowers glucose in the fasted (glycogen
      depleted) state by inhibiting hepatic gluconeogenesis. A single dose of this
      agent caused a decrease in glucose from 120 mg/dl (6.7 mM) to 80 mg/dl (4.4 mM)
      and significantly decreased insulin mRNA and pre-mRNA. These results are
      consistent with the hypothesis that glucose modulates islet cell gene
      transcription directly. They indicate that the range of glucose concentrations
      that modulate gene transcription differs from the levels of glucose that alter
      both insulin biosynthetic and secretion rates.

PMID- 8368296
TI  - Endothelin-1: a new autocrine/paracrine factor in rat testis.
AB  - Cultured Sertoli cells of 20-day-old rats were found to produce and release
      endothelin-1-like immunoreactivity (ET-1-LI) under follicle-stimulating hormone
      control. The elution profile of ET-1-LI from extracts of spent Sertoli cell
      culture medium corresponds to that of synthetic ET-1, suggesting a testicular
      production of authentic ET-1. In contrast, the conditioned medium from rat Leydig
      cells did not contain ET-1-LI. Immunohistochemical studies confirmed that, in 20
      day-old rats, the positive staining was confined to some Sertoli cells, whereas
      interstitial cells were negative. In the adult rat testis the positivity was not
      limited to the tubular compartment (Sertoli cells) but was also present in the
      interstitium. A high concentration (13 pmol/mg protein) of high-affinity
      (dissociation constant = 0.6 nM) 125I-labeled ET-1 binding sites was present in
      Leydig cells. These sites bind ET-1 and ET-2 with 1,000-fold higher affinity than
      ET-3, suggesting that they correspond to the subtype ETA of the ET receptors.
      Specific 125I-ET-1 binding sites are present also in Sertoli cells but are 50
      fold less concentrated than in Leydig cells. Our results suggest an
      autocrine/paracrine role for ET-1 in rat testis.

PMID- 8368297
TI  - Regulation of hepatic glucose production during exercise in humans: role of
      sympathoadrenergic activity.
AB  - To investigate the role of sympathoadrenergic activity on glucose production (Ra)
      during exercise, eight healthy males bicycled 20 min at 41 +/- 2 and 74 +/- 4%
      maximal O2 uptake (VO2max; mean +/- SE) either without (control; Co) or with
      blockade of sympathetic nerve activity to liver and adrenal medulla by local
      anesthesia of the celiac ganglion (Bl). Epinephrine (Epi) was in some experiments
      infused during blockade to match (normal Epi) or exceed (high Epi) Epi levels
      during Co. A constant infusion of somatostatin and glucagon was given before and
      during exercise. At rest, insulin was infused at a rate maintaining euglycemia.
      During intense exercise, insulin infusion was halved to mimic physiological
      conditions. During exercise, Ra increased in Co from 14.4 +/- 1.0 to 27.8 +/- 3.0
      mumol.min-1.kg-1 (41% VO2max) and to 42.3 +/- 5.2 (74% VO2max; P < 0.05). At 41%
      VO2max, plasma glucose decreased, whereas it increased during 74% VO2max. Ra was
      not influenced by Bl. In high Epi, Ra rose more markedly compared with control (P
      < 0.05), and plasma glucose did not fall during mild exercise and increased more
      during intense exercise (P < 0.05). Free fatty acid and glycerol concentrations
      were always lower during exercise with than without celiac blockade. We conclude
      that high physiological concentrations of Epi can enhance Ra in exercising
      humans, but normally Epi is not a major stimulus. The study suggests that neither
      sympathetic liver nerve activity is a major stimulus for Ra during exercise. The
      Ra response is enhanced by a decrease in insulin and probably by unknown
      stimuli.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368298
TI  - Plasma NE concentrations do not accurately reflect sympathetic nervous system
      activity in human sepsis.
AB  - Plasma norepinephrine concentrations ([NE]) when raised in patients with sepsis
      are thought to indicate increased activity of the sympathetic nervous system
      (SNS). However, increased SNS activity may occur without a concomitant rise in
      plasma [NE]. Measurement of NE kinetics (clearance and spillover) is a more
      accurate and direct assessment of SNS activity. In the present study plasma [NE]
      and NE kinetics were measured in six patients with intra-abdominal sepsis
      (septic) using tritiated NE infused to achieve a plateau plasma concentration.
      The measurements were repeated in the same patients after they had recovered
      (nonseptic). NE clearance and spillover were both significantly higher (P < 0.05)
      in the septic compared with the nonseptic state. However, there was no
      statistically significant difference in plasma [NE] between the two conditions.
      Plasma [NE] indicates no alteration in SNS activity during the septic state,
      whereas NE kinetics indicate increased activity of the SNS during sepsis. The
      results suggest that plasma [NE] is a poor indicator of SNS activity during
      septic illness.

PMID- 8368299
TI  - Impaired febrile responses of aging mice are mediated by endogenous lipocortin-1
      (annexin-1).
AB  - The mechanisms underlying age-related impairments in febrile responses were
      investigated in female C57Bl/lcrf-a(t) mice. Injection of norepinephrine, to
      assess total thermogenic capacity, significantly increased oxygen consumption
      (VO2) in all age groups, although the responses of the aged mice were
      significantly reduced. Injection of lipopolysaccharide or murine interleukin-1
      beta (mIL-1 beta) significantly increased body temperature and VO2 in the young
      and adult mice but not in the aged mice. The impaired responses to mIL-1 beta in
      the aged mice were normalized by either injection of the glucocorticoid receptor
      antagonist RU-38486 or by injection of an antiserum to lipocortin-1 or its
      purified immunoglobulin G fraction. Injection of prostaglandin E2 significantly
      increased VO2 and body temperature in all age groups. Resting plasma
      corticosterone concentrations were significantly elevated in the aged and adult
      mice, whereas injection of mIL-1 beta significantly raised plasma corticosterone
      concentrations in all animals. These findings indicate that the impaired febrile
      response of aged female C57Bl/lcrf-a(t) mice may be caused by increased
      concentrations and/or sensitivity to endogenous glucocorticoids. The impaired
      febrile responses of aged mice appear to be mediated by endogenous lipocortin-1.

PMID- 8368300
TI  - Intravenous glucose tolerance test-derived glucose effectiveness in physically
      trained humans.
AB  - Glucose effectiveness (SG) and insulin sensitivity of sedentary and physically
      trained males were estimated by the minimal model approach. Trained subjects, who
      ran 86 +/- 10 km/wk and had 37% higher maximal oxygen consumption than that of
      sedentary subjects (56.2 +/- 1.2 vs. 40.9 +/- 1.4 ml.kg-1 x min-1, P < 0.01),
      were studied 16 h and 1 wk after their last training session. After overnight
      fasting, glucose was administered intravenously (300 mg/kg body wt) within 2 min,
      and insulin was infused (approximately 13-20 mU/kg given over 5 min) from 20 to
      25 min after administration of glucose. Glucose disappearance constant values as
      an estimate of glucose tolerance were significantly higher in trained subjects
      after 16 h and 1 wk of their training session (3.29 +/- 0.48 and 3.60 +/-
      0.64%/min) than in sedentary subjects (1.92 +/- 0.30%/min, P < 0.05). Insulin
      sensitivity in trained subjects measured after 16 h and 1 wk of their last
      training session (26.2 +/- 4.4 and 24.3 +/- 6.0 x 10(-5) min-1 x pM-1) was also
      higher than that of sedentary subjects (10.3 +/- 1.2 x 10(-5) min-1 x pM-1, P <
      0.05). SG, the ability of glucose itself to increase peripheral glucose uptake
      and suppress hepatic glucose output, was significantly higher in trained subjects
      after 16 h and 1 wk of their last training session (0.028 +/- 0.003 and 0.030 +/-
      0.004/min) than in sedentary subjects (0.017 +/- 0.002/min, P < 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368301
TI  - LH pulsatility, biopotency, and clearance during undernutrition in
      orchidectomized mature rats.
AB  - The effect of food restriction on circulating luteinizing hormone (LH) levels in
      orchidectomized rats is controversial. The present study demonstrates that
      decreasing food intake by 50% for 3-10 days in orchidectomized rats increases LH
      pulse amplitude, length, area under pulse curve, and mean levels but decreases LH
      pulse frequency compared with ad-lib fed, orchidectomized controls. The effects
      on pulsatile LH secretion of food reduction by 50% with or without dilution by
      cellulose to maintain food volume in orchidectomized rats were also examined.
      Food volume influences pulsatile LH secretion independent of macronutrient effect
      after 3 days of food restriction, but subsequently macronutrient deprivation
      predominates. The exaggerated increase in LH levels in orchidectomized rats
      subject to food restriction for 7 days was not due to immunochemical or
      chromatographic heterogeneity or alteration in biopotency of circulating LH
      molecules. Intravenously injected 125I-labeled rat LH analyzed by
      noncompartmental modeling revealed that neither LH clearance nor mean residence
      time was reduced by food restriction. We conclude that during food restriction in
      orchidectomized rats, increases in LH pulse amplitude exceed and precede the
      decreases in LH pulse frequency, although the early changes in pulse amplitude
      are predominantly due to reduced food volume rather than macronutrient
      deprivation.

PMID- 8368302
TI  - Impact of chronic stress hormone infusion on hepatic carbohydrate metabolism in
      the conscious dog.
AB  - The effects of chronic administration of counterregulatory hormones on hepatic
      glycogenolysis and gluconeogenesis were investigated. We studied 14 20-h fasted
      conscious dogs prior to (day 0) and after a 70-h stress hormone (SHI, n = 7) or
      saline (n = 7) infusion (day 3). Glucose production and gluconeogenesis were
      assessed using tracer and arteriovenous difference techniques. SHI increased
      plasma glucagon, cortisol, epinephrine, and norepinephrine levels approximately
      fivefold. SHI increased the arterial plasma glucose and insulin concentrations
      (110 +/- 2 to 204 +/- 19 mg/dl and 13 +/- 2 to 36 +/- 3 microU/ml on day 3).
      Tracer-determined glucose appearance and net hepatic glucose output were
      increased 80 and 60%, respectively. Net hepatic lactate uptake and fractional
      extraction were increased by 11.2 +/- 3.8 and 0.51 +/- 0.18 mumol.kg-1 x min-1,
      respectively, as was net hepatic glycerol uptake (1.0 +/- 0.6 mumol.kg-1 x min
      1). Net hepatic fractional alanine extraction was also increased by 0.37 +/- 0.03
      mumol.kg-1 x min-1; however, net hepatic alanine uptake was not altered. The
      efficiency of alanine conversion to glucose almost doubled (0.33 +/- 0.05 to 0.59
      +/- 0.09). Renal glucose production was also increased, accounting for 33% of the
      increase in glucose turnover. This increase was paralleled by an increase in
      renal gluconeogenic precursor uptake. In conclusion, SHI created marked
      hyperglycemia and hyperinsulinemia and elevated glucose production from both the
      liver and the kidney, with gluconeogenesis accounting for approximately 70% of
      the response.

PMID- 8368303
TI  - Stimulation of the renin-angiotensin system by growth hormone in Lewis dwarf
      rats.
AB  - A genetically growth hormone (GH)-deficient strain of Lewis rats was used to test
      the hypothesis that the actions of GH on electrolyte and fluid homeostasis are
      mediated by the renin-angiotensin-aldosterone system (RAAS). Dwarf rats injected
      with recombinant bGH (2 mg.kg-1 x day-1) for 7 days (group GH1+) and 28 days
      (group GH4+), respectively, were compared with saline-injected dwarf (group GH-)
      and normal (group N) Lewis rats. GH decreased Na+ excretion and increased renal
      glomerular filtration rate in dwarf rats. The dietary intake and plasma
      concentrations of Na+ and K+ remained unchanged. GH increased plasma insulin-like
      growth factor I (IGF-I) concentrations in dwarf rats (GH - = 109 +/- 9, GH1+ =
      184 +/- 5, GH4+ = 189 +/- 28, N = 477 +/- 29 ng/ml plasma). Plasma
      angiotensinogen increased towards the levels found in normal Lewis rats (GH- =
      859 +/- 38, GH1+ = 906 +/- 18, GH4+ = 1,027 +/- 19, N = 1497 +/- 80 ng
      angiotensin I/ml plasma); plasma renin activity increased above that of the
      normal Lewis (GH- = 10.2 +/- 0.6, GH1+ = 11.7 +/- 0.7, GH4+ = 16.7 +/- 2.4, N =
      10.6 +/- 0.8 ng angiotensin I.ml plasma-1 x h-1). Plasma aldosterone,
      corticosterone, and triodothyronine concentrations were unchanged by GH
      treatment. Angiotensin II receptor densities in GH- rats (liver = 356 +/- 23,
      kidney = 228 +/- 28, adrenal = 478 +/- 58 fmol/mg protein) were upregulated by GH
      (GH4+ rats; liver = 573 +/- 27, kidney = 360 +/- 86, adrenal = 721 +/- 78 fmol/mg
      protein).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368305
TI  - On the measurement of turnover in vivo.

PMID- 8368304
TI  - Characterization of osteogenic response to mechanical stimulation in cancellous
      bone of rat caudal vertebrae.
AB  - We have recently developed an experimental model in which pins, inserted into the
      7th and 9th caudal vertebrae of 13-wk-old rats, are used to load the 8th caudal
      vertebra in compression. We have now applied this model to assess the
      responsiveness of rat cancellous bone to mechanical stimulation. We found that
      daily exposure to loads that induce strains similar to those observed in bone
      during relatively gentle physical activity, for 30 cycles/day, increased the rate
      of lamellar bone formation on cancellous surfaces by up to 140-fold. Bone
      formation rate showed a highly significant (P < 0.0001) correlation with the
      number of days for which the bones were loaded and with the size of the load. A
      single loading episode of 300 cycles, representing a 10-min period of loading,
      increased bone formation to 24 times that in nonloaded controls. Indexes of bone
      resorption were essentially the inverse of the bone formation parameters. These
      experiments show that rat cancellous bone is exquisitely sensitive to mechanical
      stimulation and suggest that the mechanical environment is a major determinant of
      the physiological behavior of mammalian cancellous bone.

PMID- 8368307
TI  - Central and peripheral effects of CCK receptor antagonists on satiety in dogs.
AB  - The role of cholecystokinin (CCK) as a central and peripheral satiety factor was
      studied using the CCK-B (L-365,260) and CCK-A (MK-329) receptor antagonists in
      esophageal-fistula dogs. Suppression of feeding was induced by either balloon
      gastric distension or small bowel nutrient infusion and was measured as the
      volume sham fed. Intracerebroventricular L-365,260 abolished satiety behavior
      from gastric distension (volume sham fed 2,667 +/- 211 ml vs. vehicle alone 1,217
      +/- 446 ml, P < 0.05) but not small bowel infusion. Intravenous MK-329 abolished
      satiety behavior from small bowel infusion (volume sham fed 1,900 +/- 521 ml vs.
      vehicle alone 210 +/- 198 ml, P < 0.05) but not from gastric distension. The
      volume sham fed after intracerebroventricular MK-329 with balloon gastric
      distension or small bowel infusion did not differ from control. These results
      suggest that, in the brain, CCK is a physiological mediator of satiety behavior
      from gastric distension but not small bowel nutrients and, in the periphery, CCK
      is a physiological mediator of satiety behavior from small bowel nutrients but
      not gastric distension.

PMID- 8368306
TI  - Trefoil peptides: a newly recognized family of epithelial mucin-associated
      molecules.
AB  - Members of the trefoil family of peptides are generally small stable secreted
      molecules, structurally related by the presence of one, or up to six, compact 6
      cysteine motifs. Several trefoil peptides are expressed in mammalian gut and
      Xenopus gut and skin, often in association with mucins. Chronic ulcerative
      conditions of the gut, such as Crohn's disease, result in the growth of glandular
      structures of the ulcer-associated cell lineage (UACL) that secrete epidermal
      growth factor/urogastrone, transforming growth factor-alpha, and at least three
      trefoil peptides [pS2, human spasmolytic polypeptide (hSP), and intestinal
      trefoil factor (hITF/hP1.B)]. Neuroendocrine and goblet cells near the UACL are
      "recruited" into expressing pS2 and hSP, but the purpose of this concerted
      expression is unclear. A role in mucosal healing has been proposed. Biological
      functions of trefoil peptides have been difficult to establish. Pancreatic
      spasmolytic polypeptide of porcine origin inhibits gastric acid secretion and
      smooth muscle contraction and is a growth factor for some cultured cells, but
      pS2, once thought to be breast cancer specific, is not a mitogen. Recombinant
      trefoil peptides have allowed localization of binding sites and will allow
      structure-activity relationships to be studied, once the functions are clear.

PMID- 8368308
TI  - Interaction between cholephilic anions and bile acid transport across basal
      membrane of human trophoblast.
AB  - The sensitivity of radiolabeled bile acid (BA) binding and transport by basal
      plasma membrane (BPM) vesicles of human trophoblast to cholephilic organic anions
      (COAs) was studied by a rapid filtration technique. Glycocholate (GC) efflux from
      preloaded (15 microM GC) vesicles was investigated in the presence of 300 microM
      COAs at the trans-side of the membrane. Bilirubin (BR) diglucuronide and rose
      bengal induced a very strong transstimulating effect, whereas phalloidin and
      phenol red showed a negligible effect. This effect was from strong to moderate
      for indocyanine green > bromosulfophthalein (BSP) > or = fusidic acid > or =
      phenolphthalein > or = BR ditaurate > or = rifamycin SV > or = rifampicin. BSP
      induced transstimulation was not additive to the "velocity effect" previously
      reported for bicarbonate. At the cis-side, BSP reduced the saturable component of
      taurocholate (TC) binding to BPM vesicles. BSP also induced a partial and mixed
      type of inhibition both in TC uptake [inhibitor constant (Ki) 227 microM] and
      efflux (Ki 209 microM). Two binding sites with overlapping specificity for BAs
      and other COAs are proposed in this carrier, the site for non-BA COA presumably
      corresponding to that for bicarbonate. In summary, the results indicate that
      several COAs can act as potential substrates for the BA carrier located at the
      BPM of human trophoblast. This stresses the "biliary-like" role of the placenta
      and suggests the possibility of developing new functional tests for this organ on
      the basis of fetal-maternal transfer of nontoxic cholephilic dyes.

PMID- 8368309
TI  - Physiological and morphological properties of neurons in sphincter of Oddi region
      of the guinea pig.
AB  - Intracellular recordings and dye injections were used to investigate neurons
      located in ganglia of the sphincter of Oddi (SO) region in guinea pigs. Four
      types of neurons were encountered based on physiological properties. The two most
      abundant types, tonic and phasic, had similar membrane characteristics and
      morphologies but yet could be differentiated by their spiking characteristics.
      Tonic cells spiked throughout a depolarizing current pulse and were sometimes
      spontaneously active. Phasic cells fired only a single action potential at the
      onset of a current pulse regardless of stimulus amplitude or duration. Both tonic
      and phasic cells had Dogiel type I morphologies. They typically had a single long
      process and several very short processes emanating from the soma. NADPH
      diaphorase activity was demonstrated in cells with similar morphologies,
      indicating that nitric oxide may be an intrinsic transmitter in some of these
      cells. Cells with a prolonged afterhyperpolarization (AH cells), similar to the
      type 1/AH cells of the gut, were rarely encountered. This finding was consistent
      with the observation that very few calbindin D-immunoreactive neurons exist in
      this region. Action potentials could not be generated in the fourth type of
      neuron, called nonspiking neurons, even though they did receive synaptic input.
      Most tonic and phasic cells received at least one nicotinic fast excitatory
      postsynaptic potential (EPSP). In addition, both slow EPSPs and inhibitory
      postsynaptic potentials were observed. Most AH cells received only slow
      excitatory synaptic input.

PMID- 8368310
TI  - Cholinergic regulation of guinea pig duodenal bicarbonate secretion.
AB  - Although it is well known that vagal stimulation induces duodenal HCO3-
      secretion, there is presently no information about the nature of the
      cholinoceptor and the intracellular signals involved. In a series of experiments
      performed in a guinea pig duodenal loop model in situ, intravenous carbachol,
      atropine, pirenzepine, and hexamethonium were used to determine the extent of
      cholinergic stimulation and the types of cholinoceptors. Carbachol (2
      micrograms.kg-1.5 min-1) stimulated HCO3- secretion threefold, and atropine (0.1
      mg.kg-1.5 min-1) and pirenzepine (1 mg.kg-1.5 min-1) both abolished this effect.
      In addition, hexamethonium (0.3 mg.kg-1.5 min-1) inhibited carbachol-stimulated
      duodenal HCO3- secretion. Vasoactive intestinal peptide (VIP, 5 micrograms.kg-1.5
      min-1) stimulated duodenal HCO3- secretion, and this action was partly inhibited
      by atropine (0.1 mg.kg-1.5 min-1) but not by pirenzepine (1 mg.kg-1.5 min-1).
      [4Cl-D-Phe6,Leu17]VIP (3.3 mg/kg), an antagonist to VIP, reduced basal, VIP
      stimulated, and carbachol-stimulated HCO3- secretion. To examine the role of Ca2+
      in this process, Ca2+ ionophore A23187, verapamil, and nifedipine were employed.
      A23187 (5, 50, 500 micrograms.kg-1.5 min-1) stimulated duodenal HCO3- secretion,
      an effect blocked by the VIP antagonist, and modestly augmented the effect of
      carbachol. Verapamil (0.2 mg.kg-1.5 min-1) and nifedipine (1.7 mg.kg-1.5 min-1)
      stopped the effect of carbachol on duodenal HCO3- secretion. These results
      suggest, that in cholinergic regulation of duodenal HCO3- secretion, the M
      cholinoceptor pathway, Ca2+, and VIP are involved.

PMID- 8368311
TI  - Effects of ammonium ion and ammonia on function and morphology of in vitro frog
      gastric mucosa.
AB  - The effects of ammonium ion (NH+4) and ammonia (NH3) on function and morphology
      of gastric epithelial cells were studied in intact sheets of in vitro frog (Rana
      catesbeiana) gastric mucosa. Luminal 115 mM NH4Cl at luminal pH 8.0 (calculated
      [NH3] 2.7 mM), but not at 5.0 (calculated [NH3] 3 microM) induced 1) an increase
      in intracellular pH (pHi) in oxynticopeptic cells (OPC) and decreases in
      transmucosal potential difference (PD) and electrical resistance (R) in resting
      tissues, 2) a decrease in histamine-stimulated H+ secretion and an increase in H+
      backdiffusion after removal of luminal NH4Cl, and 3) augmented acidification of
      OPC during luminal acidification. Serosal 30 mM NH4Cl at serosal pH 7.2
      (calculated [NH3] 0.47 mM) induced 1) an increase in pHi in OPC and inhibition of
      the alkalinization of OPC after removal of ambient Cl-, 2) a decrease in PD
      associated with the increase in R and decrease in short-circuit current, effects
      attenuated by serosal 15 mM K+, accentuated by 0.2 mM Ba2+, and abolished by
      removal of ambient Cl-, 3) a sudden drop of PD in resting, but not in stimulated
      tissues, effects prevented by high serosal pH (7.8), serosal HCO3-, or removal of
      luminal Cl-, 4) a decrease in histamine-stimulated H+ secretion and an increase
      in H+ backdiffusion after removal of NH4Cl, and 5) augmented acidification of OPC
      during luminal acidification. These results suggest that 1) luminal NH3, but not
      NH+4, increases backdiffusion of H+ from the lumen to the mucosa, 2) serosal NH3
      and/or NH+4 induces depolarization of OPC and decreases electrogenic Cl-
      transport, thereby attenuating the activity of the basolateral Cl(-)-HCO3-
      exchanger in OPC, and 3) both of these effects contribute to the augmented
      acidification of OPC during exposure to high luminal [H+].

PMID- 8368312
TI  - PACAP is a stimulator of neurogenic contraction in guinea pig ileum.
AB  - The myotropic effect of pituitary adenylate cyclase-activating polypeptide
      (PACAP), a novel brain-gut peptide with high sequence homology to vasoactive
      intestinal polypeptide (VIP), was studied in the isolated guinea pig ileum in
      vitro. PACAP contracts the guinea pig ileum significantly more potently and
      efficiently compared with VIP. PACAP-induced contraction was abolished by
      tetrodotoxin, dynorphin, and somatostatin, partially reduced by atropine, and not
      affected by ganglionic and adrenergic blockade. The atropine-resistant component
      was sensitive to spantide, to the induction of tachyphylaxis with substance P,
      and to omega-conotoxin. Ileal strips desensitized to PACAP did not respond to
      VIP, although they maintained their sensitivity to PACAP after desensitization to
      VIP. COOH-terminal-truncated derivatives of PACAP exhibited full biological
      activity, although some of them showed substantially reduced potency. Deletion of
      NH2-terminal amino acids abolished biological activity. PACAP produced a
      concentration-dependent increase in the release of [3H]acetylcholine from
      longitudinal muscle-myenteric plexus preparations preloaded with [3H]choline.
      This effect was Ca2+ dependent, tetrodotoxin sensitive, and resistant to
      hexamethonium and scopolamine. In contrast, PACAP inhibited release of
      acetylcholine evoked by field stimulation. In summary, PACAP-induced contraction
      of the guinea pig ileum is mediated via release of acetylcholine and substance P
      through interaction with PACAP-1 and VIP/PACAP-2 receptors. PACAP has to be added
      to the list of myotropic neuropeptides of the gastrointestinal tract.

PMID- 8368313
TI  - Mechanoreceptors sensitive to flow at the gastroduodenal junction of the cat.
AB  - Vagal afferent activity was recorded from the cervical vagus simultaneously with
      intraluminal pressure and flow rate at the proximal duodenum, in cats
      anesthetized with pentobarbital sodium. Thirty-seven mechanoreceptors that
      adapted slowly to maintained pressure changes were found to be sensitive to the
      flow of saline through the pylorus. The passage of liquid was associated with an
      increase of pressure equal to one-tenth of that necessary to trigger a response
      of the receptors during the distension of a small balloon. The frequency of
      discharge was increased by the passage of liquid for positive back pressures < or
      = 1.5 kPa but not when back pressure was negative. The relationship between the
      discharge of the receptor and the flow rate was complex and showed an hysteresis.
      We conclude that there exist slowly adapting mechanoreceptors sensitive to
      distension of the duodenum that can also sense the passage of liquid.

PMID- 8368314
TI  - Decreased expression of protooncogenes c-fos, c-myc, and c-jun following
      polyamine depletion in IEC-6 cells.
AB  - Direct exposure of small intestinal mucosal cells to luminal polyamines
      stimulates proliferation. This study tests the hypothesis that the protooncogenes
      c-fos, c-myc, c-jun, and junB are involved in the mechanism by which polyamines
      modulate mucosal growth. Studies were conducted in the IEC-6 cell line, derived
      from rat small intestinal crypt cells. Cells were grown in Dulbecco's minimal
      essential medium containing 5% dialyzed fetal bovine serum (dFBS) in the presence
      of absence of alpha-difluoromethylornithine (DFMO), a specific inhibitor of
      ornithine decarboxylase, which is the rate-limiting enzyme for polyamine
      synthesis. Cellular polyamine levels, cell growth, and relative abundance of c
      fos, c-myc, c-jun, and junB mRNAs, were measured at 1, 2, 4, 6, 8, and 12 days
      after initial plating. The intracellular polyamines, spermidine and spermine, and
      their precursor, putrescine, in DFMO-treated cells decreased significantly at 2
      days and remained depleted thereafter. Although DFMO profoundly decreased growth
      and final cell number, both control and DFMO-treated cells entered a plateau
      phase by 6 days. In control cells, c-myc and c-jun mRNA levels significantly
      increased on days 4-6 and then returned to a basal level of expression, which was
      maintained thereafter. c-fos mRNA in quiescent cells after 24 h serum deprivation
      was significantly stimulated by 5% dFBS, although a steady-state level of c-fos
      mRNA was undetectable in control cells. Treatment with DFMO not only prevented
      increased expression of c-myc and c-jun protooncogenes at 4 days, but also
      significantly reduced steady-state levels of c-myc and c-jun mRNA between 6 and
      12 days.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368315
TI  - Identification of a 5-hydroxytryptamine (5-HT2) receptor on guinea pig small
      intestinal crypt cells.
AB  - Radioligand labeling of [3H]ketanserin was examined in suspensions of dispersed
      guinea pig small intestinal mucosal cells prepared by modification of the EDTA
      chelation method described by M. M. Weiser (J. Biol. Chem. 248: 2536-2541, 1973).
      Preferential incorporation of [3H]thymidine was used to confirm that suspensions
      were enriched in crypt cells. At 25 degrees C, binding of [3H]ketanserin to
      dispersed enterocytes was rapid, maximal by 5 min, saturable (dissociation
      constant = 1.5 nM), 65 +/- 5% specific, stable, and reversible. The maximal
      number of binding sites per cell was 92,000 (range 86,000-105,500). Binding was
      temperature dependent, with maximal binding at 37 degrees C, and was inhibited by
      5-hydroxytryptamine (5-HT) (half-maximal inhibition of [3H]ketanserin binding
      observed in response to 1 microM 5-HT) and ketanserin (half-maximal inhibition of
      [3H]ketanserin binding observed in response to 1 nM ketanserin) but not by the 5
      HT1P antagonist N-acetyl-5-hydroxytryptophyl 5-hydroxytryptophan amide (5-HTP-DP)
      or the 5-HT3 antagonist 3-tropanyl-indole-3-carboxylate methiodide (ICS-205-930).
      The second messenger system coupled to the putative mucosal 5-HT2 receptor was
      examined. 5-HT stimulated a concentration-dependent production of inositol 1,4,5
      trisphosphate (IP3) in the dispersed enterocytes. This was maximal at 1 min and
      was inhibited in a concentration-dependent manner by ketanserin. 5-HTP-DP and ICS
      205-930 had no effect on 5-HT-stimulated production of IP3. These data provide
      evidence for the existence of a mucosal 5-HT2 receptor located on guinea pig
      small intestinal crypt cells.

PMID- 8368316
TI  - Intracellular alkalinization stimulates bile flow and vesicular-mediated
      exocytosis in IPRL.
AB  - Intracellular pH recovery from an acute alkaline load in rat hepatocytes is
      mediated by a Cl(-)-HCO3- exchanger, which is electroneutral, Na+ independent,
      and 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS) sensitive.
      Stimulation of this Cl(-)-HCO3- exchanger requires intact microtubules,
      suggesting that vesicular transport may be required to activate this exchanger.
      To determine if intracellular alkalinization stimulates biliary HCO3- excretion
      and bile flow in the intact liver by vesicle-mediated exocytosis, isolated
      perfused rat livers (IPRL) were alkalinized by two protocols. Isohydric changes
      in CO2 and HCO3- concentrations induced transient increases in bile flow by 36%
      (P < 0.01), which were abolished by DIDS (0.01 mM), inhibited by pretreatment
      with colchicine (P = 0.01), but not affected by membrane depolarization with the
      K(+)-channel blocker BaCl2 (1 mM). Similarly, perfusion with 20 mM NH4Cl produced
      a 42% increase in bile flow (P < 0.01) and a 26% increase in biliary HCO3-
      excretion. Both the increases in bile flow and HCO3- excretion were almost
      completely blocked by DIDS and inhibited by pretreatment with colchicine (P <
      0.01). Biliary excretion of horseradish peroxidase was also increased during
      intracellular alkalinization with either protocol (P < 0.01). These findings
      suggest that intracellular alkalinization stimulates bile flow and biliary HCO3-
      excretion. Microtubule-dependent vesicular-mediated exocytosis is involved in
      this response.

PMID- 8368317
TI  - Effect of maternal sialoadenectomy on ontogenic response of rat gastric mucosa to
      luminal H+.
AB  - Epidermal growth factor (EGF) originating from salivary glands has been shown to
      affect the development and integrity of rodent gastrointestinal mucosa. Because
      newborn rats receive EGF from maternal milk, we have examined the effect of
      sialoadenectomy as a method of depleting EGF in milk on the resistance of
      neonatal rat mucosa to luminal H+. Rat dams were sialoadenectomized (SALX) or
      sham operated 5 days after parturition. Experiments were performed on newborns 10
      22 days old. Mucosal permeability responses to intraluminal HCl (300 mM) were
      examined in terms of luminal appearances of Na+, K+, and protein and H+ loss. EGF
      levels in maternal milk were determined by immunoassay. In rat pups from control
      litters, luminal HCl resulted in an age-associated increase in cation and protein
      flux across the gastric mucosa. Luminal cation and protein fluxes observed in 10-
      to 18-day-old rat pups from SALX dams were not significantly different from
      similarly aged rats from control dams. However, in 19- to 22-day-old rats from
      SALX dams, the permeability responses to luminal HCl were exacerbated compared
      with similarly aged neonates from control dams. These responses were reduced by
      treatment with EGF. EGF levels in milk from sham-operated and SALX dams were not
      significantly different in the 10- to 16-day lactational period. However, in SALX
      dams EGF was significantly reduced at 19 and 22 days. Chromatographic elution
      pattern of milk EGF was dissimilar to the pattern exhibited by submandibular
      gland EGF.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368318
TI  - TGF-alpha is a potent mitogen for primary cultures of guinea pig gastric mucous
      epithelial cells.
AB  - Transforming growth factor-alpha (TGF-alpha) and epidermal growth factor (EGF)
      are thought to be important in gastric epithelial proliferation and repair. It
      was therefore of interest to determine if TGF-alpha and EGF promoted the growth
      of an in vitro primary culture system of guinea pig gastric mucous epithelial
      cells (MEC). MEC were isolated from guinea pig stomachs and cultured in 24-well
      Primaria plates with DMEM with or without 10% fetal calf serum (FCS). Growth of
      MEC was determined by changes in [3H]thymidine uptake, cell counts, protein, and
      DNA. The sources of peptides were human recombinant TGF-alpha (recTGF-alpha) and
      human recombinant EGF (recEGF). Both recTGF-alpha and recEGF were used at
      equipotent doses as determined by competing activity in a 125I-labeled TGF-alpha
      radioreceptor binding assay using A-431 cells. Basal growth (no peptides) of MEC
      in 10% FCS was dependent on the initial plating density. Under serum-free
      conditions, [3H]thymidine uptake increased up to 17-fold at 24 h with recTGF
      alpha (0.1-10.0 nM) compared with only a 4-fold increase using rec-EGF (0.1-10.0
      nM) at this same time period. Under serum-free conditions, recTGF-alpha (0.01
      10.0 nM) increased cell counts up to 4.9-fold over control cultures, whereas
      similar does of recEGF produced a 2.5-fold increase in cell counts.
      Administration of recEGF 1 ng/ml) resulted in a 1.9-fold increase in the 4.8-kb
      TGF-alpha mRNA transcript, and TGF-alpha protein immunoreactivity was found in
      both 24-h conditioned media and cell lysates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368319
TI  - Cell survival in rabbit gastric glands: effect of extracellular pH, osmolarity,
      and anoxia.
AB  - Although backdiffusion of luminal acid is regarded as a common mechanism of
      gastric injury, the extracellular pH (pHo) at which cells are irreversibly
      injured is not well defined. Exclusion of the fluorescent dye propidium iodide
      was used to estimate cell survival in rabbit gastric glands incubated in buffers
      of pHo 8.0-2.0. Mean survival (+/- SE) for n = 6 experiments at 2 h in a HEPES
      buffer of 300 mosM at pHo 8.0, 7.0, 6.0, 4.0, and 2.0 was 80 +/- 3, 91 +/- 2, 90
      +/- 2, 71 +/- 2, and 17 +/- 4%, respectively. Survival at acidic pHo was improved
      in a high KCl buffer: 78 +/- 3 and 38 +/- 7% at pHo 4.0 and 2.0, respectively.
      Survival in HCO3- buffers was 73 +/- 3, 88 +/- 2, and 92 +/- 3% at pHo 8.0, 7.4,
      and 6.0. Brief (5 min) exposure to pHo 4.0 followed by reexposure to pHo 7.4 had
      no effect on acid secretion as estimated by [14C]aminopyrine uptake or cellular
      viability over 4 h. The influence on cell survival of changes in pHo under
      conditions of chemical anoxia and in buffers of different osmolarity was
      investigated. Chemical anoxia was induced using 2.5 mM KCN and 2.0 mM iodoacetic
      acid (IAA) to inhibit oxidative phosphorylation and anaerobic glycolysis.
      Survival in glands exposed to KCN and IAA in HEPES buffer was 54 +/- 5, 82 +/- 3,
      and 87 +/- 2% at pHo 8.0, 7.0, and 6.0.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368320
TI  - Altered jejunal potassium (Rb+) transport in piglet rotavirus enteritis.
AB  - To determine the mechanisms of K+ loss in viral diarrhea, K+ fluxes (estimated by
      tracer Rb+ flows) across piglet jejunum in Ussing chambers were determined.
      Normal jejunum was characterized by an indomethacin-sensitive short-circuit
      current and a small K+ secretory flow. Rotavirus-infected gut secreted K+ at high
      rates, probably resulting from increased prostaglandin generation because
      secretion was abolished by indomethacin. Tissues pretreated with indomethacin
      responded to 8-bromoadenosine 3',5'-cyclic monophosphate acid and 16,16-dimethyl
      prostaglandin E2 with K+ secretion. The secretory response in rotavirus-infected
      jejunum was no greater than that in normal tissue. Serosal addition of Ca2+
      ionophore A23187 caused K+ secretion in normal but not rotavirus-infected
      jejunum. To inhibit the basolateral uptake of K+ and reduce the driving force for
      secretion, ouabain was added to the bath. Ouabain unmasked a K+ absorptive
      process in normal intestine, which was not seen in rotavirus-infected tissue. K+
      absorption was inhibited by 3-(cyanomethyl)-2-methyl-8-(phenyl-methoxy)imidazo
      (1,2 alpha)pyridine (Sch-28080) and omeprazole. We speculate that the high fecal
      K+ losses observed in human rotavirus enteritis might be caused by an imbalance
      between K+ secretion and an impaired apical K+ absorptive mechanism in the crypt
      type epithelium.

PMID- 8368321
TI  - Age-related changes in pulmonary muscarinic receptor binding properties.
AB  - The goal of this study was to elucidate mechanisms responsible for age-related
      reductions in responsiveness to cholinergic muscarinic stimulation in guinea
      pigs, by examining the binding properties of muscarinic receptors and their
      coupling to guanine nucleotide regulatory proteins as a function of animal age.
      In addition, the binding constants of three selective muscarinic receptor
      antagonists pirenzepine, [11-((2-[(diethylamino)methyl]-1-piperidinyl)-acetyl)-5,
      11-dihydro-6H-pyrido(2,3)(1,4)benzodiazepine-6-on], and 4-diphenylacetoxy-N
      methylpiperidine methobromide were examined. We found that there were no changes
      in either the receptor density or the affinity of the muscarinic receptor with
      age. There was a significant reduction in the affinity constant for the high
      affinity agonist binding site in the old tissues (7.63 +/- 0.08) compared with
      the young tissues (8.31 +/- 0.10). Guanine nucleotides lowered agonist affinity
      for the receptor in young lungs, however, they had no effect on agonist binding
      in old tissues. Antagonist competition binding curves in young tissues revealed
      that 73% of the receptors are of the M2 type, with 27% being of the M3 subtype.
      In contrast, antagonist competition binding curves in the old tissues revealed
      that 37% of the receptors were of the M2 subtype, 30% were M3, and 33% were of
      the M1 subtype. Our studies provide evidence that the loss of sensitivity to
      cholinergic muscarinic stimulation in the senescent lung may be due to changes in
      both muscarinic receptor subtypes and receptor coupling to G proteins.

PMID- 8368322
TI  - Nitric oxide synthesis by rat pleural mesothelial cells: induction by cytokines
      and lipopolysaccharide.
AB  - The close proximity of pleural mesothelial cells (PMC) and mononuclear cells
      during pleural inflammation suggests that leukocyte-derived products (e.g.,
      cytokines) may play an important role in modulating PMC function. The purpose of
      this study was to determine whether certain cytokines and bacterial products
      induce PMC to produce nitric oxide (NO). Confluent monolayers of rat PMC were
      exposed to tumor necrosis factor (TNF), interleukin-1 beta (IL-1), gamma
      interferon (IFN), or lipopolysaccharide (LPS) individually and in various double
      and triple combinations for 6-72 h. Concentrations of nitrite and nitrate were
      quantified and used as indirect indices of NO production. Nitrite/nitrate
      accumulation was maximal at 72 h, with most of the increase occurring from 48 to
      72 h. Maximal nitrite/nitrate production was observed with triple combinations
      with the combination of LPS, IL-1, and TNF giving the highest concentration
      (137.4 +/- 2.8 microM). Nitrite/nitrate production was significantly inhibited by
      NG-nitro-L-arginine methyl ester, suggesting that nitrite and nitrate were
      derived from the L-arginine-dependent formation of NO. These data indicate that
      PMC can be induced to produce large amounts of NO in response to specific
      combinations of proinflammatory cytokines and LPS.

PMID- 8368323
TI  - Glucocorticoid elevation of mRNA encoding epinephrine-forming enzyme in lung.
AB  - The epinephrine-forming enzyme phenylethanolamine N-methyltransferase (PNMT) is
      present in lung and its activity is increased by the glucocorticoid
      dexamethasone. Chronic administration of dexamethasone (0.5 mg/kg twice daily)
      doubled levels of mRNA coding for PNMT in rat lung. Administration of the
      glucocorticoid antagonist RU 486 after 7 days of dexamethasone treated reduced
      PNMT mRNA by about two-thirds within 24 h. Lung epinephrine (E) levels correlated
      with lung PNMT activity in these dexamethasone-treated and control rats. In a
      separate experiment, lung PNMT mRNA levels were nearly tripled 6 h after
      dexamethasone (1 mg/kg sc). In a third experiment chronic administration of the
      PNMT inhibitor SKF 64139 (50 mg/kg twice daily) reduced in vitro lung PNMT
      activity in chronically dexamethasone-treated adrenalectomized rats by
      approximately 96% and reduced lung E levels by approximately 75%. We conclude
      that glucocorticoids increase lung PNMT activity by increasing levels of mRNA
      coding for this enzyme. The data also suggest that a substantial fraction of lung
      E is locally synthesized. We speculate that enhanced lung E synthesis may
      participate in glucocorticoid-induced dilation of the bronchioles.

PMID- 8368324
TI  - Hyperoxic stress elevates p52(PAI-1) mRNA abundance in cultured cells and adult
      rat pulmonary tissue.
AB  - Hyperoxic stress alters expression of genes involved in extracellular matrix
      (ECM) remodeling. To identify novel ECM-associated gene products positively
      regulated by hyperoxia, rat kidney cells were exposed to 95% O2, and the
      complement of [35S]methionine-labeled, saponin-resistant, ECM-associated proteins
      was compared with normoxic controls. O2-stressed cells accumulated significantly
      greater ECM levels (approximately 3- to 4-fold that of control cells) of a 52-kDa
      glycoprotein (p52), recently identified as the matrix form of plasminogen
      activator inhibitor type 1 (PAI-1) (P.J. Higgins, P. Chaudhari, and M.P. Ryan.
      Biochem. J. 273: 651-658, 1991; P. J. Higgins, M. P. Ryan, R. Zeheb, T. D.
      Gelehrter, P. Chaudhari. J. Cell. Physiol. 143:321-329, 1990), which peaked at 48
      h of exposure. Hyperoxia-associated increases in ECM p52(PAI-1) content reflected
      parallel elevations in p52(PAI-1) mRNA abundance. Similar results were obtained
      using secondary cultures of rat pulmonary fibroblasts. This 48-h period of
      maximal hyperoxia-induced p52(PAI-1) expression in vitro was used to design
      subsequent in vivo studies. Adult rats were exposed to 99% O2 for 24-50 h, and
      RNA was extracted from the pulmonary tissue of stressed and control animals. A 5-
      to 8-fold and 6- to 15-fold increase in lung p52(PAI-1) mRNA content was evident
      in hyperoxia-treated rats at 24 and 50 h, respectively. All of this increase
      occurred in the defined 3.2-kb species of rat p52(PAI-1) mRNA. Actin mRNA levels
      increased three- to sevenfold as a function of hyperoxic stress, whereas catalase
      and glyceraldehyde-3-phosphate dehydrogenase mRNA abundance was
      unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368325
TI  - Smooth muscle myosin regulation by serum and cell density in cultured rat lung
      connective tissue cells.
AB  - RNA and protein analyses were used to detect expression of SM1 and SM2 smooth
      muscle myosin heavy chain (MHC) in cultured adult rat lung connective tissue
      cells (RL-90). Smooth muscle MHC mRNA expression in confluent cells grown in 10%
      serum was approximately 50% of the level in adult stomach. Similar results were
      obtained in cells cultured at low density (25% confluency) in 1% serum. However,
      in low-density cultures transferred to 10% serum for 24 h, the level of MHC mRNA
      decreased to approximately 20% of that in adult stomach. Smooth muscle alpha
      actin showed a pattern of expression similar to that for smooth muscle MHC.
      Expression of nonmuscle MHC-A mRNA was higher in all culture conditions compared
      to stomach. MHC-A mRNA expression was less in low-density cultures in low serum
      and increased when low-density cultures were transferred to 10% serum for 24 h.
      MHC-B mRNA expression was less in low- vs. high-density cultures. In contrast to
      MHC-A, however, MHC-B mRNA expression in low-density cultures was higher in low
      serum. Immunofluorescence and immunoblotting with SM1-specific antibody
      demonstrated the presence of the SM1 protein isoform as well as reactivity to a
      protein band migrating slightly faster than SM2. These results demonstrate that
      cultured rat lung connective tissue cells express smooth muscle MHC and that
      expression is modulated by culture conditions.

PMID- 8368326
TI  - Type II pneumocytes secrete vitamin E together with surfactant lipids.
AB  - Lung surfactant is exposed to strongly oxidizing conditions. We examined the
      hypothesis that in lung, lipophilic antioxidants are secreted together with
      surfactant to counteract the peroxidation of surfactant constituents. Lung lavage
      and the subfractions of the alveolar surfactant contain the lipophilic
      antioxidants vitamin E, vitamin A, and plasmalogens. The specific radioactivity
      of vitamin E isolated from serum, lung homogenate, lamellar bodies, and lung
      lavage increased linearly up to 3 h after intraperitoneal application of
      [3H]tocopherol. [3H]tocopherol was secreted in situ together with [14C]palmitic
      acid-labeled phospholipid in response to isoproterenol. Type II cells cultured in
      presence of [3H]tocopherol or of [3H]cholecalciferol and [14C]palmitic acid
      responded to isoproterenol by a time-dependent increase in secretion of
      [3H]tocopherol and of 14C-labeled phospholipids but not of [3H]cholecalciferol.
      The isoproterenol-stimulated secretion of [3H]tocopherol and of 14C-labeled
      phospholipids by type II cells is inhibited by surfactant protein A. We conclude
      that the alveolar surfactant contains lipophilic antioxidants as integral
      constituents. [3H]tocopherol seems to be secreted together with surfactant.

PMID- 8368327
TI  - Glucocorticoid regulation of fatty acid synthase gene expression in fetal rat
      lung.
AB  - There are developmental and glucocorticoid-induced increases in the rate of fatty
      acid biosynthesis and in the activity of fatty acid synthase in late gestation
      fetal lung. We have now measured mRNA levels of fatty acid synthase and of two
      other enzymes of fatty acid biosynthesis, ATP citrate lyase and acetyl-CoA
      carboxylase, in developing fetal and postnatal rat lung and in fetal lung
      explants cultured with and without dexamethasone. There was a developmental
      increase in the mRNA for fatty acid synthase with the maximum level being reached
      on fetal day 21 (term is fetal day 22). This profile was similar to that reported
      for de novo fatty acid synthesis and fatty acid synthase activity. There was a
      similar but less pronounced developmental increase in the mRNA for ATP citrate
      lyase and a corresponding increase in its activity. There was no developmental
      change in the mRNA for acetyl-CoA carboxylase. Dexamethasone increased the level
      of fatty acid synthase mRNA approximately threefold but had no effect on those
      for ATP citrate lyase and acetyl-CoA carboxylase. The effect of dexamethasone on
      fatty acid synthase mRNA was rapid, biphasic, and partly inhibited by actinomycin
      D and cycloheximide. We conclude that glucocorticoids increase expression of the
      gene for fatty acid synthase in fetal lung. The effect of the hormone appears to
      be due to increased transcription and post-transcriptional events and is
      dependent on protein synthesis.

PMID- 8368328
TI  - Apoprotein-based synthetic surfactants inhibit plasmic cleavage of fibrinogen in
      vitro.
AB  - Fibrinogen (Fbg) leakage and intra-alveolar fibrin accumulation are commonly
      noticed in adult respiratory distress syndrome and interstitial lung diseases.
      Activation of the extrinsic coagulation pathway and elevation of antiplasmin- and
      plasminogen-activator inhibitor levels are assumed to favor alveolar clot
      formation and to inhibit fibrinolysis under these conditions. We investigated the
      influence of synthetic surfactants on the plasmic cleavage of fibrinogen in
      vitro. Fibrinogenolysis was quantified by sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis with densitometric evaluation and fragment E enzyme-linked
      immunosorbent assay. A synthetic phospholipid mixture (PLM) (dipalmitoyl-DL-alpha
      phosphatidylcholine:L-alpha-phosphatidyl-DL-gly cer ol: palmitic acid
      68.5:22.5:9) caused a dose-dependent inhibition of fibrinogenolysis in a
      concentration range between 0.1 and 2 mg/ml. This inhibitory capacity was
      markedly amplified upon reconstitution of PLM with natural and recombinant
      surfactant protein (SP)-C as well as natural SP-B. Natural SP-A and recombinant
      SP-A were far less effective in this respect. In the absence of phospholipids,
      the hydrophobic apoproteins revealed only moderate plasmin inhibitory capacity
      (recombinant SP-C > natural SP-C and SP-B). Natural calf lung surfactant extract
      displayed comparable inhibitory capacity on plasmic Fbg cleavage as PLM. We
      conclude that hydrophobic surfactant material may suppress plasmin activity and
      thus may contribute to the finding of delayed alveolar fibrin clearance in
      inflammatory lung diseases with Fbg leakage.

PMID- 8368329
TI  - Pulmonary surfactant protein A-mediated uptake of phosphatidylcholine by alveolar
      type II cells.
AB  - Pulmonary surfactant protein A (SP-A)-mediated uptake of phosphatidylcholine (PC)
      by alveolar type II cells was investigated. SP-A enhanced the uptake of liposomes
      containing dipalmitoylphosphatidylcholine (DPPC), 1-palmitoyl-2-linoleoyl
      phosphatidylcholine (PLPC), or 1,2-dihexadecyl-sn-glycero-3-phosphocholine (DPPC
      ether), a diether analogue of DPPC, but about twice as much DPPC was taken up by
      type II cells as PLPC or DPPC-ether. When subcellular distribution was analyzed,
      51.3 +/- 2.9% (mean +/- SD, n = 3) of cell-associated radiolabeled DPPC was
      recovered in the lamellar body-rich fraction in the presence of SP-A, whereas
      only 19.3 +/- 1.9% (mean +/- SD, n = 3) was found to this fraction in the absence
      of SP-A. When type II cells were incubated either with DPPC at 0 degree C or with
      DPPC-ether at 37 degrees C, or no cells were included, low proportions of the
      cell-associated lipids were present in the fractions corresponding to lamellar
      bodies even in the presence of SP-A. Anti-SP-A antibody significantly reduced the
      radioactivity incorporated into the lamellar body fraction. Phosphatidylcholine
      that had been incorporated into lamellar bodies remained largely intact when SP-A
      was present. Subcellular fractionations of type II cells with radiolabeled SP-A
      and DPPC revealed that the sedimentation characteristics of cell-associated SP-A
      are different from those of DPPC, although a small broad peak of radiolabeled SP
      A was found in the lamellar body fraction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368330
TI  - Hormonal regulation of inner medullary collecting duct sodium transport.
AB  - The inner medullary collecting duct (IMCD) is the final arbiter of renal Na+
      excretion, and Na+ transport in this segment is controlled by a wide variety of
      hormones and renal autacoids. This review examines the mechanisms of IMCD Na+
      transport and its regulation using results obtained from micropuncture and
      microcatheterization studies in the intact animal, as well as data from isolated
      perfused tubules, freshly prepared cell suspensions, and cultured IMCD cells.
      Where appropriate, results from closely related tissues such as the cortical
      collecting duct and model urinary epithelia are examined. Na+ reabsorption in
      this segment occurs predominantly via apical amiloride-sensitive Na+ channels and
      basolateral Na(+)-K(+)-adenosinetriphosphatase (Na(+)-K(+)-ATPase). Although
      there is some evidence for the activities of other transporters such as Na(+)
      K(+)-2Cl- and Na-Cl cotransporters and Na+/H+ exchanger, their role in Na+
      homeostasis remains undefined. Mineralocorticoids augment the activities of both
      apical Na+ channels and basolateral Na(+)-K(+)-ATPase by a variety of complex
      mechanisms. Prostaglandin E2 inhibits Na(+)-K(+)-ATPase and appears to mediate
      the actions of several peptide hormones, including endothelin, interleukin-1, and
      atrial natriuretic peptide [ANP-(31-67)]. Several peptides in the ANP family [ANP
      (99-126), urodilatin, and brain natriuretic peptide] bind to guanylate cyclase
      linked receptors, leading to inhibition of apical Na+ channel function. These
      mechanisms of regulation of IMCD Na+ transport likely play important roles in
      total body Na+ balance in health and disease.

PMID- 8368331
TI  - Sch-28080 inhibits bafilomycin-sensitive H+ secretion in turtle bladder
      independently of luminal [K+].
AB  - To explore the possible contribution of an H-K-adenosine-triphosphatase (H-K
      ATPase) to H+ secretion (JH) in the isolated turtle bladder, we measured
      electrogenic JH (JeH) as short-circuit current and total JH (JTH) by pH stat
      titration in the presence of ouabain at different ambient K+ concentration ([K+])
      and during luminal addition of a known gastric H-K-ATPase inhibitor, Schering
      (Sch)-28080. JH was not reduced by decreasing ambient [K+] to undetectable or
      very low levels (< 0.05 mM by atomic absorption) and luminal BaCl2 addition to
      further reduce local [K+] at the apical membrane. These K(+)-removal studies
      indicate that H+ transport is not coupled to countertransport of K+. JTH did not
      exceed JeH at any point: in K(+)-free solutions JTH was 0.73 +/- 0.05, and JeH
      was 0.95 +/- 0.08 mumol/h; in standard (3.5 mM) K+ solutions JTH was 0.72 +/-
      0.05 and JeH 0.98 +/- 0.06 mumol/h; in high (118 mM) K+ solutions JTH was 0.65 +/
      0.07 and JeH 0.94 +/- 0.08 mumol/h. Sch-28080 caused a rapid inhibition of JH,
      with similar half-maximal inhibitory concentrations (IC50) in K(+)-free, standard
      [K+], and high [K+] solutions. Bafilomycin inhibited JeH and JTH with an IC50 of
      approximately 100 nM. The observed non-potassium-competitive inhibition of JH by
      Sch-28080 and the bafilomycin sensitivity distinguish the H-ATPase of the turtle
      bladder from the gastric H-K-ATPase. The rapidity of the inhibition by Sch-28080
      suggests that it acts at an accessible luminal site of the ATPase.

PMID- 8368332
TI  - Effects of adenosine and angiotensin on macula densa-stimulated renin secretion.
AB  - The present studies were performed to assess, in the isolated perfused
      juxtaglomerular apparatus of the rabbit kidney, the effect of exogenous adenosine
      on renin secretion stimulated by a low NaCl concentration at the macula densa.
      Addition of adenosine to the bath resulted in a change of renin secretion from
      30.4 to 23.9 nGU/min at an adenosine concentration of 10(-6) M (n = 7; P = NS),
      from 38.6 to 17.9 nGU/min at a concentration of 10(-4) M (n = 7; P = 0.038), and
      from 18.4 to 5.8 nGU/min at 10(-2) M (P = 0.0053). Addition of the A1 receptor
      antagonist 8-cyclopentyl-1,3-dipropylxanthine at 10(-5) M fully reversed the
      effect of adenosine at 10(-4) M, but not at 10(-2) M. Inhibition of adenosine
      breakdown by the adenosine deaminase inhibitor pentostatin (10(-6) M) enhanced
      the inhibitory effect of adenosine with renin secretion falling from 61.7 to 19.5
      nGU/min at 10(-6) M adenosine (P = 0.035) and from 44.7 to 13.5 nGU/min at 10(-4)
      M adenosine (n = 0.027). A marked inhibition of NaCl-dependent renin secretion
      was caused by both angiotensin II (P = 0.011) and angiotensin III (P = 0.006),
      both at 10(-8) M. These results show that adenosine is capable of reducing macula
      densa-mediated renin secretion, but that this effect, even at very high
      concentrations or during adenosine deaminase blockade, does not fully mimic the
      inhibitory potency of increasing luminal NaCl concentration. Because the marked
      effect caused by angiotensins establishes the potential of this preparation to
      demonstrate inhibitory hormonal influences, it is concluded that adenosine does
      not appear to be the sole paracrine factor responsible for the NaCl-induced
      reduction of renin secretion.

PMID- 8368333
TI  - Proliferative synergy of ANG II and EGF in porcine aortic vascular smooth muscle
      cells.
AB  - To test growth effects of angiotensin II (ANG II) in porcine vascular smooth
      muscle cells (VSMC) and potential ANG II synergy with epidermal growth factor
      (EGF), we exposed subconfluent, near-quiescent porcine aortic VSMC to ANG II,
      EGF, or ANG II + EGF (each 10(-9) M) in Dulbecco's modified Eagle's-Ham's F-12
      medium with insulin + 0.4% fetal calf serum (FCS) selected for minimal ANG II
      degrading capacity. Cell number and DNA and protein synthesis (by [3H]-thymidine
      and [35S]methionine incorporation, respectively) were determined serially over 1
      6 days. ANG II alone induced an early 20% increase and then a plateau in cell
      number over the 0.4% FCS control (P < 0.01; n = 8), thus without sustained
      increase in proliferation rate. Yet ANG II alone did not increase fractional DNA
      or protein synthesis (each as cpm/10(3) cells) and, by flow cytometry, reduced S
      phase fraction without increase in cell size. EGF alone induced brisk DNA
      synthesis yet minimal cell division over days 0-4, thus late-cycle arrest. ANG II
      + EGF, despite no increase in fractional DNA or protein synthesis rates over EGF
      alone, induced significant indomethacin-resistant dose-dependent (P < 0.001)
      increase in cell proliferation rate over EGF alone with a median effective dose
      of 5 x 10(-10) M ANG II, thus proliferative synergy. We propose that 1) ANG II
      induces a subpopulation of cells arrested in or beyond S phase to proceed through
      mitosis but does not influence G1 traversal or S phase entry and 2) ANG II + EGF
      achieve proliferative synergy by complementary actions at sequential cell cycle
      loci, with EGF supporting progression from G0/G1 to S phase and ANG II inducing
      completion of mitosis by cells already in or beyond S phase ("late-cycle
      completion").

PMID- 8368334
TI  - Mechanisms of adaptation to proteinuria in adriamycin nephrosis.
AB  - To evaluate the impact of urinary protein losses on whole body protein turnover
      (WBPT) independent of acidosis or uremia, we utilized a model of unilateral
      adriamycin nephrosis. Control rats were matched by weight to nephrotic rats and
      pair fed 22% protein chow for 14-18 days; urinary urea nitrogen (UUN) was
      measured on day 12, and leucine turnover measurement was performed on the final
      day. Growth rates of nephrotic and pair-fed control rats did not differ during
      the first 2 wk of pair feeding; thereafter, a small difference in growth could be
      detected. Despite an identical intake of dietary protein, UUN excretion was 29%
      less in the nephrotic rats (P < or = 0.02). Fasting whole body protein synthesis
      and degradation did not differ between nephrotic and control rats; in contrast,
      leucine oxidation decreased by 21% in nephrosis (P < 0.05). On the basis of near
      normal growth and normal rates of WBPT, we conclude that nephrotic rats fed ad
      libitum can adapt to the stress of continuous protein losses. A reduction in
      amino acid oxidation and UUN excretion were the primary mechanisms responsible
      for protein conservation in experimental nephrosis.

PMID- 8368335
TI  - Glomerular angiotensin II receptor subtypes during development of rat kidney.
AB  - We used quantitative autoradiography to investigate distribution of angiotensin
      II (ANG II) receptor subtypes during development of the kidney in the rat. In
      fetal, newborn, and 3-day-old rats, immature glomeruli in the form of comma and S
      shaped bodies, located in the nephrogenic zone of the renal cortex, expressed
      only the angiotensin AT2 receptor subtype. Conversely, the juxtamedullary
      glomeruli, in more advanced developmental stages, expressed only the AT1 subtype.
      Similarly, maturing and fully developed glomeruli, present in 1-, 2-, and 8-wk
      old rats, expressed only AT1 receptors. In the kidney medulla, there was a
      similar change in ANG II receptor subtype expression, with the AT2 subtype
      expressed earlier and the AT1 subtype later during development. Our results
      demonstrate a selective expression of ANG II receptor subtypes during kidney
      development. We have found glomerular and medullary AT1 receptors only at
      developmental stages when kidney function has matured. Conversely, AT2 receptors
      are expressed only in immature structures, suggesting that they may have a role
      during kidney organogenesis.

PMID- 8368336
TI  - Tubular handling of fluid and electrolytes during ovine pregnancy.
AB  - Pregnancy is characterized by progressive water and sodium accumulation and
      increases in renal blood flow (RBF) and glomerular filtration rate (GFR).
      However, the influence of the different nephron segments on the increased tubular
      reabsorption is controversial. Consequently, four nonpregnant and five pregnant
      sheep were studied, after chronic instrumentation, to assess salt and water
      reabsorption in the proximal and distal tubules under basal and volume-loaded
      conditions. Lithium clearance was used as a marker for proximal tubular
      reabsorption. Volume loading was achieved by the rapid administration of 1,000 ml
      isotonic saline followed by 250 ml/h for 2 h. Under basal conditions with
      reference to the nonpregnant state, pregnant sheep had higher (P < 0.05) levels
      of right RBF (427 +/- 34 vs. 313 +/- 8 ml/min), GFR (133 +/- 7 vs. 94 +/- 9
      ml/min), proximal tubular reabsorption (102 +/- 7 vs. 73 +/- 6 ml/min), distal
      nephron fluid delivery (31 +/- 2 vs. 20 +/- 2 ml/min), and fractional distal
      nephron reabsorption of fluid (92 +/- 2 vs. 87 +/- 1%) and sodium (98.8 +/- 0.3
      vs. 97.0 +/- 0.7%). However, pregnant animals had significantly (P < 0.05)
      reduced fractional excretions of fluid (1.6 +/- 0.3 vs. 2.6 +/- 0.2%) and sodium
      (0.24 +/- 0.06 vs. 0.63 +/- 0.19%), but similar levels of filtration fraction,
      fractional proximal tubular reabsorption, urine flow, urinary sodium excretion,
      and osmolar and free water clearance. After saline loading, pregnant sheep
      excreted significantly (P < 0.05) less sodium (9.2 vs. 28.6%) and water (39.8 vs.
      56.5%). Decreases in fractional proximal and distal nephron reabsorption of
      sodium and water after saline loading were attenuated in pregnant
      animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368337
TI  - Influence of endothelium-derived relaxing factor on renal microvessels and
      pressure-dependent vasodilation.
AB  - The influence of endothelium-derived relaxing factor (EDRF) on renal microvessels
      and autoregulation was visualized in vivo, in the split hydronephrotic kidney of
      rats. EDRF synthesis was inhibited by local administration of 10(-5) M NG-nitro-L
      arginine methyl ester (L-NAME). Diameters of arcuate arteries decreased by 17%.
      In cortical vessels efferent arterioles constricted more (13-16%) than
      interlobular arteries and afferent arterioles (7-12%). Cortical glomerular blood
      flow (GBF) decreased by 46% after L-NAME. A similar behavior of blood flow and
      vascular diameters was also observed in juxtamedullary (JM) arterioles. The
      responses to acetylcholine but not to sodium nitroprusside were attenuated after
      L-NAME. After local administration of L-arginine (10(-3) M) diameters of all
      vessels and GBF increased, vascular responses to L-NAME were blunted. Stepwise
      reduction of renal perfusion pressure revealed that autoregulation was preserved
      in cortical vessels after L-NAME. In JM arterioles, which do not autoregulate in
      female Wistar rats, autoregulation of GBF was enhanced after L-NAME. These data
      suggest that tonic formation of EDRF influences basal renal hemodynamics to a
      considerable extent. EDRF may also impair autoregulation of JM glomeruli without
      disturbing autoregulation of cortical glomeruli.

PMID- 8368338
TI  - Quantitation and localization of laminin A, B1, and B2 chain RNA transcripts in
      developing kidney.
AB  - To quantitate expression of laminin A, B1, and B2 chains during kidney
      development, we prepared riboprobes of similar size (318-365 nucleotides) and
      carried out scanning densitometry of Northern blots from newborn mouse and rat
      kidneys. Much higher expression of B1 than A or B2 mRNAs was observed with an A
      to-B1-to-B2 ratio of approximately 1:8:4 in mice and approximately 1:12:1 in
      rats. In addition to the 9.5-kb laminin A chain transcript, we also observed
      specific hybridization of the A chain probe to approximately 6-kb band in both
      newborn mice and rats. To localize these mRNAs, newborn rat kidneys were sieved
      to obtain separate glomerular and tubule fractions. Northern blots from these
      samples showed that most of the B1, B2, and 9.5-kb laminin A chain mRNAs were in
      glomerular fractions, whereas tubules contained more of the 6-kb A chain band.
      Analyses of poly(A)+ mRNA from newborn and adult kidneys showed severalfold
      decreases in adult RNA encoding the three laminin chains and the alpha 1-chain
      type IV collagen. However, only a 20% decline from newborn levels was seen for
      heparan sulfate proteoglycan (HSPG) core protein message. These quantitative
      results provide additional evidence that different laminin isoforms are present
      in separate kidney basement membranes and that HSPG core protein synthesis
      remains at relatively high levels in adult kidneys.

PMID- 8368339
TI  - Vitamin D3 accelerates PTH-dependent calcium transport in distal convoluted
      tubule cells.
AB  - This study examined the interaction of 1 alpha,25-dihydroxyvitamin D3
      [1,25(OH)2D3] and parathyroid hormone (PTH) on Ca2+ uptake, intracellular Ca2+
      ([Ca2+]i) and membrane voltage in transformed mouse distal convoluted tubule
      (DCT) cells. 1,25(OH)2D3 increased PTH-dependent 45Ca2+ uptake by 2 h and was
      maximally stimulated at 5 h over the range of 10(-11) to 10(-9) M 1,25(OH)2D3.
      [Ca2+]i was measured in single cells grown on cover slips and loaded with fura-2.
      In control cells [Ca2+]i averaged 109 nM and was not changed by acute addition of
      1,25(OH)2D3 (10(-7) M) alone or by pretreatment with 1,25(OH)2D3 for 5 h. The
      magnitude of the bPTH-(1-34)-stimulated increase of [Ca2+]i was similar in
      control cells and in cells pretreated with 1,25(OH)2D3. In cells pretreated with
      1,25(OH)2D3 the latency before [Ca2+]i increased, following addition of PTH, was
      reduced from 8.6 min to 3.5 +/- 0.9 min (P < 0.01). 1,25(OH)2D3 alone had no
      effect on 45Ca2+ uptake but shortened the time course of PTH-dependent 45Ca2+
      uptake. The inactive vitamin D analogue, 25-hydroxyvitamin D3 (10(-7) M) (with or
      without PTH), did not affect 45Ca2+ uptake. Inhibition of transcription with 5-6
      dichloro-1-beta-D- ribofuranosylbenzimidazole abolished the effect of
      1,25(OH)2D3, but not that of PTH. Treatment with 1,25(OH)2D3 also decreased the
      latency but not the magnitude of membrane hyperpolarization induced by PTH.
      Nifedipine abolished PTH-induced increases of [Ca2+]i and 45Ca2+ entry in cells
      pretreated with 1,25(OH)2D3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368341
TI  - Subcellular distribution and guanine nucleotide dependency of COOH-terminal
      methylation in kidney cortex.
AB  - The subcellular distribution of COOH-terminal carboxyl methyltransferase and
      methylated substrates was studied in purified brush-border and basolateral plasma
      membranes, as well as in crude intracellular membranes and the cytosolic fraction
      isolated from rat kidney cortex. The three membrane fractions showed intrinsic
      carboxyl methylation of 21- to 23-kDa proteins, whereas 18- and 41-kDa methylated
      proteins were observed in the cytosol. In contrast, methylation activities toward
      N-acetyl-S-trans,trans-farnesyl-L-cysteine (AFC), a synthetic farnesylated
      substrate, were found to be strictly associated with membranes, with no
      detectable level of activity in the cytosol. Methylation of all membrane
      associated substrates was inhibited by AFC but remained unaffected by TS-isoD
      YSKY, a synthetic isopeptide recognized by L-isoaspartyl methyltransferase,
      suggesting that the membrane-associated substrates were methylated on a COOH
      terminal isoprenylated cysteine residue. The membrane-associated methylated
      proteins were tightly bound to the membranes as reflected by their extraction
      with 3-[(3-cholamidopropyl)-dimethylammonio]-1-propanesulfonate but not with 1 M
      NaCl or 2 M urea. The nonhydrolyzable analogues of GTP and GDP, guanosine 5'-O-(3
      thiotriphosphate) (GTP gamma S) and guanosine 5'-O-(2-thiodiphosphate) (GDP beta
      S), markedly increased the methylation of the 21- to 23-kDa substrates, whereas
      ATP gamma S and ADP beta S were without effect. This effect of guanine
      nucleotides was restricted to endogenous 21- to 23-kDa substrates with no
      stimulation of methylation of the exogenous substrate, AFC. Our results show a
      wide distribution of both COOH-terminal protein carboxyl methyltransferase
      activities and associated methylated substrates in the kidney cortex.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368340
TI  - Endothelial modulation of renal interlobar arteries from pregnant rats.
AB  - The purpose of this study was to determine whether there are gestational effects
      on 1) the response of resistance arteries from the renal vasculature to
      phenylephrine and 2) the endothelial modulation of these arteries. Interlobar
      arteries (200-300 microns ID) were isolated from the kidneys of virgin and
      pregnant rats at 18-20 days of gestation (term, 22 +/- 1 days) and studied in a
      pressurized arteriograph system. Intact arteries from virgin and pregnant rats
      did not differ in sensitivity to phenylephrine. Arteries without endothelium from
      both groups were more sensitive to phenylephrine than arteries with endothelium.
      Sensitivity was increased 3.4-fold by endothelial removal in arteries from virgin
      rats and 1.5-fold in the pregnant group. Concentration-response relationships to
      phenylephrine were determined in arteries with endothelium and then repeated in
      the presence of 2.5 x 10(-4) M N omega-nitro-L-arginine (L-NNA), an inhibitor of
      nitric oxide synthase. All arteries were more sensitive to phenylephrine in the
      presence of L-NNA, with an average increase of 3.2-fold for the arteries from
      virgin rats and 1.6-fold from pregnant rats. These results indicate that the
      increased sensitivity to phenylephrine is primarily due to elimination of
      endothelium-derived relaxing factor (EDRF) and that basal EDRF activity is
      decreased during late gestation. To determine whether stimulated endothelium
      dependent relaxation is enhanced in pregnancy, arteries with endothelium were
      constricted with phenylephrine to 50% of their maximum and relaxed to increasing
      concentrations of methacholine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368342
TI  - Thyroid hormone stimulates the Na(+)-PO4 symporter but not the Na(+)-SO4
      symporter in renal brush border.
AB  - In our previous studies we established that thyroid hormones [L-thyroxine (T4) or
      3,5,3'-triiodothyronine (T3)] elicit an increase in Na(+)-Pi symport in rat and
      mouse renal brush-border membrane (BBM) vesicles (BBMV), but the Na(+)-coupled
      symports of other solutes were not influenced. However, a recent report [H. S.
      Tenenhouse, J. Lee, and N. Harvey. Am. J. Physiol. 261 (Renal Fluid Electrolyte
      Physiol. 30): F420-F426, 1991]claimed that T3 increases to a similar degree both
      Na(+)-Pi symport and Na(+)-SO4 symport in murine renal BBM. Adult male rats were
      fed either normal (0.7% Pi; NPD) or high-phosphate (1.4% Pi; HPD) diet and
      received T3 (0.2 mg/100 g body wt ip) for 3 days before the kidneys were removed,
      BBMV were prepared, and the transport rates were determined. Although the Na(+)
      Pi symport significantly increased (delta = +35%) in both NPD and HPD rats
      treated with T3, the Na(+)-35SO4 symport and Na(+)-D-[3H]glucose symports were
      not influenced by T3. Furthermore, treatment of NPD-fed mice with T3 using a
      similar protocol as rats resulted in a significant increase (delta = +26%) of
      Na(+)-(Pi)4 symport, but did not alter Na(+)-SO4 symport or Na(+)-glucose
      symport. Our findings thus document that T3 regulates selectively the Na(+)-Pi
      symporter in BBM without having any effect on other major divalent anions, such
      as SO4.

PMID- 8368343
TI  - Immunolocalization of the Na+/Ca2+ exchanger in rabbit kidney.
AB  - We recently isolated a cDNA encoding a Na+/Ca2+ exchanger from rabbit kidney that
      was highly similar to the canine cardiac sarcolemmal Na+/Ca2+ exchanger. In the
      present study, we used two different antibodies to the exchanger to identify the
      protein and establish its cellular and subcellular localization in the kidney.
      The first antibody was prepared against a fusion protein consisting of 190 amino
      acids of the large, presumably intracellular loop of the rabbit renal exchanger
      fused to the maltose-binding protein. The second was a monoclonal antibody
      generated against the isolated purified canine cardiac sarcolemmal exchanger. To
      identify the Na+/Ca2+ exchanger protein, we performed immunoblot analysis against
      a membrane vesicle preparation from rabbit kidney cortex. Both antibodies
      immunoblotted proteins of 120 and 70 kDa that are known to be associated with the
      exchanger. Indirect immunofluorescence revealed that both antisera labeled the
      basolateral surface of the majority of cells in the connecting tubule (CNT).
      Since the phase-dense (intercalated) cells in the CNT were not stained, this
      suggested that the labeled cells were CNT cells. No labeling was detected in
      other nephron segments with the exception of occasional faint staining of the
      majority cell population of the cortical collecting duct. The fact that we did
      not detect labeling in other nephron segments is consistent with either 1) the
      absence of expression of the Na+/Ca2+ exchanger in these segments, 2) the
      expression of the exchanger in levels below the threshold of detection of the two
      antibodies used in this study, or 3) the exchanger in these segments is
      represented by a different isoform.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368344
TI  - Glucose use in neonatal rabbit hearts reperfused after global ischemia.
AB  - In this study, we measured both glycolysis and glucose oxidation during
      reperfusion of previously ischemic hearts obtained from 7-day and 6-wk-old
      rabbits. Isolated working hearts perfused with 11 mM [3H/14C]glucose, 0.4 mM
      palmitate, 0.5 mM lactate, and 100 microU/ml insulin were subjected to either 30
      or 40 min of global ischemia followed by a 60-min period of reperfusion. Recovery
      of mechanical function was 58% in 7-day-old hearts subjected to 40 min of
      ischemia. In 6-wk-old rabbits, a 45% recovery of function was seen after only 30
      min of ischemia. Addition of 1 mM dichloroacetate (DCA) to the perfusate at
      reperfusion increased glucose oxidation rates during reperfusion in both 7-day
      and 6-wk-old hearts (from 102 +/- 22 to 262 +/- 27 and from 280 +/- 63 to 523 +/-
      97 nmol.min-1.g dry wt-1, respectively). Addition of DCA, however, resulted in a
      significant improvement in recovery of mechanical function only in 6-wk-old
      hearts (from 45 to 67% of preischemic function). These results demonstrate that
      fatty acid-perfused neonatal rabbit hearts are more able to tolerate ischemia
      than the matured rabbit hearts. However, our data suggest that there may be less
      potential to improve mechanical recovery in neonatal hearts during the actual
      reperfusion period by stimulating glucose oxidation.

PMID- 8368345
TI  - Collagen characterization in volume-overload- and pressure-overload-induced
      cardiac hypertrophy in minipigs.
AB  - Previous studies in several different species have shown reduced extractability
      of collagens in some types of cardiac hypertrophy (volume overload) but not
      others (pressure overload). The objective of the present study was to examine
      collagen proteins from the same species (minipigs) with both pressure-overload-
      and volume-overload-induced cardiac hypertrophy. Hypertrophy was induced by two
      methods: thoracic banding of the aorta to create pressure overload and
      arteriovenous shunt to cause volume overload in a porcine model. Collagen types
      I, III, IV, and V were isolated by pepsin digestion from normal and hypertrophied
      pig left ventricle tissues. Types I and III collagens from normal and
      hypertrophied samples, when separated from types IV and V, were digested with
      cyanogen bromide (CB), and the peptides were examined. Collagen concentration was
      increased in myocardium removed from hearts subjected to volume overload and
      unchanged in hearts subjected to pressure overload. The extractability of total
      collagen was unaffected in pressure-overloaded left ventricles but lower in
      samples from volume-overloaded hearts. CB digestion cleaved all of the types I
      and III collagens into similar smaller CB peptides with the exception of a 100
      kDa peptide that was observed in both control and hypertrophied hearts. This
      peptide corresponds to one of the high-molecular-weight peptides found in canine
      heart tissue. The mature collagen cross-link hydroxylysylpyridinoline (HP) was
      identified in normal and hypertrophied types I and III collagen from porcine
      sources. Pressure-overload- and volume-overload-induced cardiac hypertrophy in
      the pig produced different alterations in the extracellular matrix.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368346
TI  - Spatial features of calcium transients during early and delayed
      afterdepolarizations.
AB  - Although changes in intracellular Ca2+ concentration ([Ca2+]i) are spatially
      heterogeneous during spontaneous contraction in mammalian cardiac muscle, it has
      not yet been observed how [Ca2+]i changes spatially within cardiac myocytes
      during delayed (DADs) and early (EADs) afterdepolarizations. The aim of this
      study is to characterize the spatial features of the increase in [Ca2+]i during
      such afterdepolarizations and to understand the ionic mechanisms responsible for
      them. Myocytes were enzymatically isolated from guinea pig ventricles and loaded
      with fura 2-acetoxymethylester, the Ca2+ fluorescence indicator dye. Membrane
      potential was recorded with a conventional microelectrode technique, and
      spatiotemporal changes in fura 2 fluorescence and cell length were recorded using
      a digital television system. After superfusion with potassium-free Tyrode
      solution, DADs and EADs were induced. During DADs, fluorescence transients were
      heterogeneous within myocytes (n = 11). Furthermore, they often propagated within
      myocytes as if they were "waves." In contrast, during EADs, fluorescence
      transients showed no waves within myocytes but rather showed synchronous changes
      throughout the myocytes (n = 15). The results of this study suggest that the
      spatial features of the increase in [Ca2+]i differ between the DADs and EADs. We
      concluded from these differing features that the ionic mechanisms responsible for
      the two triggered activities are different.

PMID- 8368347
TI  - A method of determining electrical potential gradient across mitochondrial
      membrane in perfused rat hearts.
AB  - The electrical potential gradient across the mitochondrial membrane (delta psi m)
      in perfused rat hearts was estimated by calculating the equilibrium distribution
      of the lipophilic cation tetraphenylphosphonium (TPP+), using measured kinetic
      constants of uptake and release of TPP+. First-order rate constants of TPP+
      uptake were measured during 30-min perfusions of intact rat hearts with tracer
      amounts (5.0 nM) of tritium-labeled TPP+ ([3H]TPP+) in the perfusate. This was
      followed by a 30-min washout, during which the first-order rate constant of
      efflux was estimated. Values of [3H]TPP+ outside the heart and total [3H]TPP+
      inside the heart at equilibrium were calculated. From this information and
      separately estimated time-averaged plasma membrane potentials (delta psi c) it
      was possible to calculate free cytosolic [3H]TPP+ at equilibrium. It was also
      possible to calculate free intramitochondrial [3H]TPP+ at equilibrium as the
      difference between total tissue [3H]TPP+ minus free cytosolic TPP+ and the sum of
      all the bound [3H]TPP+. Bound [3H]TPP+ was determined from [3H]TPP+ binding
      constants measured in separate experiments, using both isolated mitochondria and
      isolated cardiac myocytes under conditions where both delta psi m and delta psi c
      were zero. Delta psi m was calculated from the intramitochondrial and cytosolic
      free TPP+ concentrations using the Nernst equation. Values of delta psi m were
      144.9 +/- 2.0 mV in hearts perfused with 5 mM pyruvate and 118.2 +/- 1.4 mV in
      hearts perfused with 11 mM glucose, in good agreement with delta psi m obtained
      from isolated rat heart mitochondria.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368348
TI  - Effects of cardiac work on electrical potential gradient across mitochondrial
      membrane in perfused rat hearts.
AB  - The myocardium responds to alterations in cardiac work by changing its rate of O2
      consumption. This reflects an increase in the oxidative synthesis of ATP to meet
      the contractile demand for ATP. However, the biochemical mechanisms responsible
      for increased ATP synthesis are not fully understood. To localize the flux
      controlling reaction(s) in the pathway of ATP synthesis, the effects of
      substrates and cardiac work on mitochondrial membrane potential (delta psi m),
      total tissue NADH-to-NAD+ ratio, and high-energy phosphate metabolites were
      examined in perfused rat hearts. Delta psi m was measured using the equilibrium
      distribution of tetraphenylphosphonium (33). Cytosolic phosphorylation potential,
      total tissue NADH-to-NAD+ ratio, and delta psi m were higher in hearts perfused
      with pyruvate than in those perfused with glucose. Increasing cardiac work
      induced a four-fold increase in O2 consumption, which was accompanied by 1)
      decreased or unaltered cytosolic ADP concentration, 2) increased tissue NADH-to
      NAD+ ratio, and 3) decreased delta psi m. The results indicate that both NADH
      generating reactions and the ATP synthase-catalyzed reaction are important in
      causing the increase in respiration that accompanies increased work. Because the
      activation of ATP synthase by cardiac work occurred in the absence of increases
      in delta psi m, ADP, and Pi, it is possible that the work-related acceleration in
      ATP synthesis may be due to modification of the kinetic properties of the ATP
      synthase.

PMID- 8368349
TI  - Sarcolemmal phospholipid asymmetry and Ca fluxes on metabolic inhibition of
      neonatal rat heart cells.
AB  - The present study examines the hypothesis that during depletion of high-energy
      phosphates a change will occur in the phospholipid topology and in Ca fluxes in
      cultured neonatal cells and that these two events may be causally related. A
      combination of 2-deoxyglucose and iodoacetic acid was used to produce graded
      changes in the adenine nucleotides in the cells. An on-line technique for 45Ca
      measurement was used to follow Ca uptake and compartmentation by the cells, and
      chemical and enzymatic probes were used to study sarcolemmal phospholipid
      topology. After 15 min of metabolic inhibition (ATP = 10% of control) an increase
      in cellular Ca occurs, which progresses with time. Over 70% of this Ca
      accumulates in the mitochondria. After 30 min of metabolic inhibition (ATP < 10%
      of control) a change in the phospholipid topology is observed, and an increased
      amount (two times control) of sarcolemmal phosphatidylethanolamine is present in
      the outer monolayer of the sarcolemma. This change in phospholipid topology was
      independent of the extracellular Ca concentration. The sequence of altered Ca
      fluxes and distribution followed by the altered phospholipid topology is
      discussed in terms of its possible role in the pathogenesis of sarcolemmal
      disruption.

PMID- 8368350
TI  - Biaxial mechanical properties of passive and tetanized canine diaphragm.
AB  - The architecture, vascular supply, and ease of tetanization make the diaphragm an
      ideal structure in which to assess multidimensional mechanical properties of
      active and passive striated muscle. We developed an isolated, perfused canine
      diaphragm preparation suitable for the assessment of biaxial stress-strain
      relations in both the resting state and during tetanization. Each of 33 specimens
      had a wide, flat region (approximately 3 x 3 cm) wherein there was a single
      predominant fiber direction. Simultaneous, equal stretchings were imposed in the
      fiber and perpendicular cross-fiber directions over the same strain ranges in
      both the passive state and during tetanic contraction. Highly nonlinear behavior
      was seen in the passive state with a limit of extensibility in both directions.
      The specimens were also markedly anisotropic, with the cross-fiber direction
      being stiffer than the fiber direction (slopes of the regression line for the
      stresses in each direction averaged 3.97). Moreover, 31 of the 33 specimens were
      stiffer in the cross-fiber direction, one was isotropic, and one was stiffer in
      the fiber direction. During tetanization, the extent and distribution of
      anisotropy were significantly altered (regression slope averaged 1.08, and 18
      specimens were now either isotropic or stiffer in the fiber direction).
      Disrupting the membranes covering each surface increased extensibility and
      decreased the anisotropy, thereby suggesting that these membranes bear most of
      the passive load and contribute greatly to the cross-fiber stiffness and
      anisotropy of the intact diaphragm. Both before and after disruption of the
      surface membranes, there was still a consistent increase in cross-fiber stress
      during tetanization, implying active force generation perpendicular to the fiber
      direction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368351
TI  - Stimulated leukocyte adhesion in coronary microcirculation is reduced by a
      calcium antagonist.
AB  - The first step in the acute myocardial inflammatory response is leukocyte
      sequestration in the coronary microcirculation. To determine the location(s) of
      stimulated leukocyte deposition in the coronary microcirculation and the effects
      of the calcium antagonist, nisoldipine, on leukocyte adhesion, leukocytes were
      stimulated with the chemotactic peptide, N-formylmethionyl-leucyl-phenylalanine
      (FMLP) and blood cell adherence was evaluated using two methods. In vitro
      leukostasis was evaluated by measuring the extraction of white cells in nylon
      fiber columns. We found that diluted whole blood (DWB) demonstrated 30%
      granulocyte adherence. The chemotactic peptide FMLP (1 microM) significantly
      increased adherence to 69%. Pretreatment of the blood with nisoldipine (1 microM)
      immediately before FMLP significantly reduced the FMLP-induced adhesion to 47%.
      In the coronary microcirculation, FMLP caused a marked increase in leukocyte
      sequestration, primarily in coronary capillaries. The FMLP effect was somewhat
      transient because the washout of trapped white cells was similar in the vehicle
      and FMLP groups. Nisoldipine significantly reduced the FMLP-induced leukostasis
      in coronary capillaries (P < 0.05). The magnitude of the attenuation of
      leukostasis with nisoldipine was remarkably similar in both models, suggesting a
      direct effect of this agent on the blood rather than on the blood vessels. These
      findings offer another possible mechanism by which dihydropyridine calcium
      antagonists may be cardioprotective under pathophysiological conditions.

PMID- 8368352
TI  - Increase in endogenous antioxidant enzymes protects hearts against reperfusion
      injury.
AB  - Coarctation of the abdominal aorta in rats for 10 wk increased the heart weight
      to-body weight ratio by 36% and peak left ventricular systolic pressure by 75%;
      there was no apparent change in the end-diastolic pressure, and animals did not
      show any clinical signs of heart failure. These hypertrophied (H) hearts showed
      increased activities of superoxide dismutase (SOD) and glutathione peroxidase
      (GSHPx) with no change in catalase. Lipid peroxide content as indicated by the
      malondialdehyde (MDA) level was lower in H hearts. There was no apparent
      difference in either Na+ and Ca2+ content or high-energy phosphates between sham
      (S) and H hearts. Control and H hearts were subjected to 10 min of ischemia (I)
      and 15 min of reperfusion (R). Contractile failure and rise in resting tension
      due to I, in both S and H hearts, were comparable. On reperfusion, H hearts
      showed better recovery of the developed force and resting tension as well as
      reduced incidence of arrhythmias when compared with corresponding S hearts. Both
      SOD and GSHPx activities were depressed due to I-R, but these activities were
      significantly higher in reperfused H hearts. Reperfused H hearts also showed a
      better maintenance of the ultrastructure and Na+ and Ca2+ contents, recovery of
      high-energy phosphates, and reduced MDA levels compared with S hearts.
      Supplementation of the perfusion medium with SOD (120 U/ml) and catalase (80
      U/ml) significantly attenuated the I-R injury in S hearts, and the response in
      many ways was comparable to H hearts. The study documents the therapeutic
      potential of increased myocardial endogenous antioxidants against oxidative
      stress.

PMID- 8368353
TI  - Effect of adenosine receptor blockade: preventing protective preconditioning
      depends on time of initiation.
AB  - Ischemic preconditioning protects the rabbit myocardium from infarction from a
      subsequent ischemia, and adenosine receptors appear to be involved in this
      protection. The present study attempts to determine when adenosine receptors must
      be occupied to achieve protection by infusing the adenosine receptor antagonist
      PD-115,199 at various time points during the study. Open-chest rabbits were
      subjected to 30 min of regional ischemia followed by 3 h of reperfusion and had
      38 +/- 4% infarction of the risk zone. When hearts were preconditioned by 5 min
      of ischemia and 10 min reperfusion before the 30-min period of ischemia, only 9
      +/- 2% infarction occurred. PD-115,199 given 5 min before the ischemic
      preconditioning episode blocked the protective effect of preconditioning (39 +/-
      5% infarction). PD-115,199 also blocked the protection when given between the
      ischemic preconditioning episode and the 30-min period of ischemia (30 +/- 4%
      infarction). PD-115,199 given at the end of 30 min of ischemia did not block
      protection in preconditioned (PC) hearts (17 +/- 5% infarction) and had no effect
      on non-PC hearts (44 +/- 6% infarction). In prior studies we found that exogenous
      adenosine could substitute for ischemia to precondition the heart, indicating
      that adenosine is an initiator of preconditioning. These results, however,
      indicate that adenosine receptors must also be occupied during the long ischemic
      period for preconditioning to be protective and suggest that adenosine is a
      mediator of preconditioning as well.

PMID- 8368354
TI  - Age-related changes in endothelium-dependent hyperpolarization in the rat
      mesenteric artery.
AB  - This study was designed to determine the age-related changes in the endothelium
      dependent hyperpolarization to acetylcholine (ACh) and its contribution to
      relaxation in the isolated mesenteric artery from normotensive and hypertensive
      rats. Membrane potentials and contractions were recorded in arteries from male
      Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR) that were 5-6
      wk old (young), 6-8 mo old (adult), and 20-26 mo old (aged). Endothelium
      dependent hyperpolarizations produced by ACh, applied both at the resting state
      of the membrane and under conditions of depolarization with norepinephrine (10(
      5) M), were markedly impaired in aged WKY rats, adult SHR, and aged SHR.
      Endothelium-dependent relaxations to ACh in arterial rings precontracted with 10(
      5) M norepinephrine were also impaired in aged WKY rats, adult SHR, and aged SHR
      even in the presence of indomethacin. Furthermore, in these rats, N omega-nitro-L
      arginine, an inhibitor of nitric oxide formation, showed potent inhibitory
      effects on the relaxations, whereas the 20 mM high K+ solution that reduces
      hyperpolarization had less pronounced effects. Hyperpolarizations and relaxations
      to cromakalim (10(-5) M), a K(+)-channel opener, were on the whole preserved in
      aged rats. It would thus appear that the endothelium-dependent hyperpolarization
      to ACh is reduced with aging as well as by hypertension, and this would, in part,
      account for the impaired relaxation to ACh in arteries of both aged rats and
      hypertensive rats.

PMID- 8368355
TI  - Thapsigargin inhibits Ca2+ uptake, and Ca2+ depletes sarcoplasmic reticulum in
      intact cardiac myocytes.
AB  - We examined the effects of thapsigargin on Ca2+ accumulation by the sarcoplasmic
      reticulum (SR) and on electrically stimulated beats in single adult rat
      ventricular myocytes loaded with indo 1 and bathed in N-2-hydroxyethylpiperazine
      N'-2-ethanesulfonic acid buffer containing 1 mM Ca2+ at 23 degrees C. The SR Ca2+
      content was assessed from the magnitude of intracellular Ca2+ (Ca2+i) transients
      and contractions elicited by rapid, brief applications of caffeine. After 20-30
      min of exposure to 200 nM thapsigargin, the caffeine-dependent Ca2+i transients
      were abolished or markedly diminished (by 89 +/- 4%). The postrest potentiation
      of the Ca2+i transient and contraction, typical for rat myocardium, was
      abolished. Thapsigargin did not significantly change resting Ca2+i but diminished
      the amplitude of the steady-state Ca2+i transients by 73%, prolonged the time to
      peak by 24%, and prolonged the half-time (t1/2) of the Ca2+i transient decline by
      42%. Progressive SR Ca2+ depletion by thapsigargin was strongly related (r = 
      0.78) to the prolongation of the t1/2 of relaxation of the steady-state Ca2+i
      transients, suggesting that the thapsigargin-dependent SR Ca2+ depletion results
      from an inhibition of the SR Ca2+ uptake. This interpretation was corroborated by
      comparison of the effects of thapsigargin with those of ryanodine (100 nM), which
      depletes SR of Ca2+ by accelerating the SR Ca2+ efflux but does not inhibit the
      SR Ca2+ pump. During rapid pacing (5 Hz), which raises Ca2+i and thus Ca2+
      available for SR uptake, the caffeine-dependent SR Ca2+ release was restored in
      ryanodine-treated cells but not in the presence of thapsigargin.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368356
TI  - Influence of endothelial surface on flow velocity in vitro.
AB  - The influence of the endothelial surface and its interaction with various plasma
      components on flow velocity was investigated in vitro. The falling velocity of
      microcarrier beads with and without cultured porcine aortic endothelial cells in
      a vertical tube containing different media was recorded with a video system
      attached to a light microscope. The falling velocity of the beads was in
      agreement with values predicted from Stokes's law. Endothelium did not affect the
      falling velocity in various media, except in plasma, where it was slower than
      expected. Fibrinogen was found to have a strong surface tension effect,
      disturbing viscosity measurements, and to bind to endothelial cells and collagen
      coated surfaces. We conclude that the endothelial surface may interact with
      plasma and plasma constituents such as fibrinogen in a way that affects blood
      flow.

PMID- 8368357
TI  - Relationship between capillary and systemic venous PO2 during nonhypoxic and
      hypoxic ventilation.
AB  - We evaluated the relationship between end-capillary and systemic venous PO2
      values in the retractor muscle of 14 anesthetized hamsters during both nonhypoxic
      and hypoxic ventilation to ascertain whether the level of tissue oxygenation
      could be reliably estimated from the systemic parameter. End-capillary PO2 was
      estimated from measurements of oxygen saturation in capillaries at the venular
      end of the network obtained using in vivo video microscopy and computer-aided
      image-analysis techniques at three different levels of inspired oxygen (0.3,
      0.21, and 0.1). Measurements of systemic arterial and venous blood gases were
      made in conjunction with these capillary determinations. In addition, in a
      portion of the study we utilized an oxygen microelectrode to determine the PO2 in
      the first-order venule draining the portion of the muscle containing the
      capillaries under study. We found that only when the animals were made acutely
      hypoxic was there any correspondence between the systemic venous and end
      capillary PO2 values. In addition, these data provide support for the presence of
      arteriovenous shunting of oxygen during nonhypoxic ventilation.

PMID- 8368358
TI  - Permeability to albumin in isolated coronary venules.
AB  - This study reports measurements of albumin permeability in isolated coronary
      venules. The isolated microvessel technique allows the quantification of
      transmural exchange of macromolecules under tightly controlled physical and
      chemical conditions. Transvenular exchange of albumin was studied in isolated
      coronary venules during alterations in filtration rate caused by changes in
      intravascular pressure. The apparent permeability coefficient of albumin (Pa) at
      an intraluminal pressure of 11 cmH2O was 3.92 +/- 0.43 x 10(-6) cm/s. Elevating
      intraluminal pressure to 16 and 21 cmH2O increased Pa to 5.13 +/- 0.57 x 10(-6)
      and 6.78 +/- 0.66 x 10(-6) cm/s, respectively. Calculation of the true diffusive
      permeability coefficient of albumin (Pd) at zero filtration rate was 1.54 x 10(
      6) cm/s. The product of hydraulic conductance (Lp) and (1 - sigma), where sigma
      is the solute reflection coefficient, was 3.25 x 10(-7) cm.s-1 x cmH2O-1. At a
      net filtration pressure of 4-5 cmH2O, diffusion accounts for > 60% of total
      albumin transport across the venular wall. Transmural albumin flux is very
      sensitive to filtration rate, rising 6.7% for each cmH2O elevation of net
      filtration pressure. At 11 cmH2O net filtration pressure, convection accounts for
      nearly 70% of net albumin extravasation from the venular lumen. We suggest that
      the isolated coronary venule is a suitable preparation for the study of solute
      exchange in the heart.

PMID- 8368359
TI  - Time-dependent rheological behavior of blood at low shear in narrow vertical
      tubes.
AB  - The time-dependent flow behavior of normal human blood after a sudden reduction
      of wall shear stress from 5,000 mPa to a low level (2-100 mPa) was studied during
      perfusion of vertical tubes (internal diam 28-101 microns) at constant driving
      pressures. Immediately after the implementation of low-shear flow conditions the
      concentration of red blood cells (RBCs) near the tube wall started to decrease,
      and marginal plasma spaces developed as a result of the assembly of RBC
      aggregates. This was associated with a time-dependent increase of flow velocity
      by up to 200% within 300 s, reflecting a reduction of apparent viscosity. These
      time-dependent changes of flow behavior increased strongly with decreasing wall
      shear stress and with increasing tube diameter. A correlation between the width
      of the marginal plasma layer and relative apparent viscosity was obtained for
      every condition of tube diameter, wall shear stress, and time. Time-dependent
      changes of blood rheological properties could be relevant in the circulation,
      where the blood is exposed to rapid and repeated transitions from high-shear flow
      conditions in the arterial and capillary system to low-shear conditions in the
      venous system.

PMID- 8368360
TI  - Mechanisms of control of skin blood flow during prolonged exercise in humans.
AB  - Exercise in a warm environment raises internal temperature and leads to a rapid
      increase in skin blood flow (SkBF). As exercise continues, and internal
      temperature approaches 38 degrees C, the rate of rise of SkBF is markedly
      attenuated despite further significant increases in internal temperature. To find
      whether this attenuation is mediated by increased cutaneous active
      vasoconstrictor activity or by a reduced rate of rise of active vasodilator
      activity, each of 12 male subjects had 0.64 cm2 forearm skin sites
      iontophoretically treated with bretylium tosylate for selective local blockade of
      noradrenergic vasoconstrictor nerves. SkBF was monitored there and at adjacent
      untreated control sites by laser-Doppler blood flowmetry (LDF). Whole body skin
      temperature (Tsk) was controlled by water-perfused suits, and esophageal
      temperature (Tes) was monitored as an index of internal temperature. Mean
      arterial pressure (MAP) was monitored and cutaneous vascular conductance was
      calculated as LDF/MAP. Sweat rate was also monitored by dew point hygrometry in
      11 subjects. Tsk was raised to 38 degrees C, after which subjects began 20-30 min
      of exercise on a bicycle ergometer. The rate of the initial rapid increase in
      SkBF with increasing Tes was not altered by bretylium treatment (P > 0.05 between
      sites). The attenuation of the rate of rise during the latter phase of exercise
      was not abolished by bretylium treatment (P > 0.05 between sites); instead, there
      was a trend for the attenuation to be enhanced at those sites. We conclude that
      the attenuated rate of rise of SkBF is due to limitation of active vasodilator
      activity and not due to increased vasoconstrictor tone.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8368362
TI  - Vascular endothelial growth factor induces EDRF-dependent relaxation in coronary
      arteries.
AB  - Vascular endothelial growth factor (VEGF), also known as vascular permeability
      factor (VPF), has recently been shown to increase cytosolic free calcium in
      endothelial cells. In the present study, we investigated the coronary vascular
      effects of recombinant human and native guinea pig VEGF/VPF in isolated canine
      coronary arteries in the presence and absence of intimal endothelium,
      indomethacin, and NG-monomethyl-L-arginine, a competitive nitric oxide synthase
      inhibitor. Addition of recombinant VEGF/VPF (1-660 pM) in coronary arteries that
      had been previously contracted with prostaglandin F2 alpha induced a slow, dose
      dependent relaxation, reaching a maximum of -59.1 +/- 6.7% (mean +/- SE, n = 19).
      Mechanical disruption of the intimal endothelium completely abolished the
      observed relaxation. No direct vascular effect of recombinant VEGF/VPF on the
      endothelium-disrupted coronary arteries was noted. Pretreatment of endothelium
      intact coronary arteries with 5 microM of indomethacin did not alter the observed
      relaxation (-57.3 +/- 7.0%, n = 18), whereas pretreatment with either NG
      monomethyl-L-arginine or 10 microM of genistein, a known inhibitor of tyrosine
      kinase, significantly inhibited the relaxation. Addition of native VEGF/VPF (1
      100 pM) also induced an endothelium-dependent relaxation in the isolated coronary
      arteries. Heating of recombinant VEGF/VPF (70 degrees C, 25 min) or prior
      incubation with a specific antibody raised against a VEGF/VPF peptide completely
      abolished the relaxation. Finally, recombinant VEGF/VPF stimulated a slow rise in
      cytosolic free calcium in cultured human endothelial cells that was qualitatively
      similar to that of native VEGF/VPF.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368361
TI  - Role of ATP-sensitive K+ channels in CGRP-induced dilatation of basilar artery in
      vivo.
AB  - Stimulation of adenylate cyclase appears to activate ATP-sensitive K+ channels in
      the basilar artery. We tested the hypothesis that calcitonin gene-related peptide
      (CGRP), which increases intracellular adenosine 3',5'-cyclic monophosphate (cAMP)
      levels, activates ATP-sensitive K+ channels and thereby causes vasodilatation.
      Using a cranial window in anesthetized rats, we examined responses of the basilar
      artery to CGRP in vivo. We also examined responses of the artery to another
      vasoactive peptide, vasoactive intestinal peptide (VIP). Topical application of
      CGRP (10(-11) to 10(-8) M) increased diameter of the basilar artery. Responses of
      the basilar artery to CGRP were almost abolished by a CGRP1 receptor antagonist,
      CGRP-(8-37). Vasodilatation in response to VIP was much smaller than that
      produced by CGRP. Dilator responses of the basilar artery to 10(-9) and 10(-8) M
      CGRP were inhibited by glibenclamide (10(-6) M), a selective inhibitor of ATP
      sensitive K+ channels, by 69 +/- 19 and 41 +/- 9%, respectively. NG-nitro-L
      arginine methyl ester (10(-5) M), an inhibitor of nitric oxide synthase, did not
      attenuate dilator response to 10(-8) M CGRP but inhibited responses to 10(-9) M
      CGRP by 34 +/- 12%. Indomethacin did not alter dilator responses to CGRP. These
      findings suggest that a minor component of CGRP-induced dilatation of the basilar
      artery is mediated by endothelium-derived relaxing factor. Vasodilatation in
      response to CGRP appears to be mediated primarily by direct activation of CGRP1
      receptors on vascular muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368363
TI  - Repletion of sarcoplasmic reticulum Ca after ryanodine in rat ventricular
      myocytes.
AB  - The ryanodine (R)-induced loss of sarcoplasmic reticulum (SR) Ca2+ and the
      abilities of the SR to accumulate Ca2+ and participate in contractile activation
      after R were studied in rat ventricular myocytes. Indo 1 fluorescence (IF)
      indexed cytosolic Ca2+, and caffeine assayed SR Ca2+. Before R, there was a
      negative staircase, and the SR accumulated Ca2+ at rest. During stimulation (0.5
      Hz), R decreased IF and contraction, converting the negative staircase to
      positive. When R was pulsed onto resting cells, IF increased and cells shortened,
      subsequently behaving as if stimulated in R. After R, there was no caffeine
      releasable Ca2+ at rest, and little accumulated during 0.5-Hz stimulation. At
      high rates, caffeine-releasable Ca2+ and diastolic IF increased. In isoproterenol
      and R, IF transients and contractions recovered at 0.5 Hz with a marked positive
      staircase and little diastolic IF increase. Within 10 beats, SR Ca2+ accumulated
      to pre-R levels. R eliminated the positive inotropic effect of paired-pulse
      stimulation, but isoproterenol temporarily restored it. Twitch contractions in
      thapsigargin, an SR Ca2+ pump blocker, and isoproterenol were slow compared with
      control or R + isoproterenol. R leaks SR Ca2+ into the cytosol. SR Ca2+ can be
      repleted in R by high-rate stimulation or by low-rate stimulation with a beta
      adrenergic agonist. SR Ca2+ release in R can be temporarily restored if Ca2+
      influx and SR Ca2+ pumping are increased enough to overcome the SR Ca2+ leak.

PMID- 8368364
TI  - Arterial compliance and its control by the baroreflex in hypertensive dogs.
AB  - The effect of the carotid baroreflex on systemic arterial compliance was tested
      in normotensive and Goldblatt hypertensive dogs. After the development of
      experimental hypertension, dogs were acutely anesthetized with pentobarbital
      sodium and vagotomized. The carotid sinuses were then isolated and held at
      controlled carotid sinus pressures (CSP) of 50, 125, and 200 mmHg. The dogs were
      placed on constant flow, constant venous pressure, cardiopulmonary bypass.
      Arterial compliance was determined from the time constant of the exponential fall
      in arterial pressure, which occurred when the flow was stopped at three different
      levels of CSP. The reflex characteristic curve (mean arterial pressure vs. CSP)
      was shifted upward and to the right in the hypertensive group. Arterial
      compliance significantly decreased with decreasing CSP, but at any given level of
      CSP, arterial compliance was not different in the normotensive and hypertensive
      groups. A nonlinear analysis revealed that the arterial compliance-arterial
      pressure relationship was not altered by Goldblatt experimental hypertension. The
      results of this study indicate that the arterial compliance is primarily a
      function of the absolute level of arterial pressure. Baroreflex control of
      arterial compliance is important at lower levels of arterial pressure.

PMID- 8368365
TI  - Regional blood flow in canine atria during exercise.
AB  - Global and regional atrial blood flow was measured with radioisotope-labeled
      microspheres in eight dogs during rest and two levels of exercise. Both mean
      right and left atrial blood flow increased significantly (P < 0.05) to a similar
      degree with each level of exercise (right atria: 0.27 +/- 0.04, 0.89 +/- 0.11,
      and 1.57 +/- 0.21 ml.min-1 x g-1; left atria: 0.35 +/- 0.04, 0.90 +/- 0.09, and
      1.61 +/- 0.17 ml.min-1 x g-1). Atrial blood flow during exercise is greater than
      anticipated if increased heart rate was the sole cause. In both right and left
      atria the ratio of appendage to nonappendage flow was significantly (P < 0.005)
      less than one during resting conditions (0.42 +/- 0.04 and 0.81 +/- 0.05,
      respectively), not different from unity during mild exercise, and significantly
      (P < 0.02) greater than one during moderate exercise (1.10 +/- 0.03 and 1.16 +/-
      0.05, respectively). This disparity in the blood flow to the appendage and
      nonappendage regions suggests that the appendage plays an augmented hemodynamic
      role during exercise, thus requiring a larger proportion of the nutrient flow.

PMID- 8368366
TI  - Cardiac effects of injections of epinephrine into the spinal intermediolateral
      column.
AB  - Small doses of epinephrine (0.008, 0.05, and 0.1 pmol, i.e., 20-nl volumes of
      0.40, 2.5, and 5 microM solutions) produced a dose-dependent increase in heart
      rate when micro-injected into the right intermediolateral column (IML) at T2
      spinal level. These effects were mediated via alpha 1-adrenergic receptors
      because prazosin blocked them. The presence of alpha 1-adrenergic receptors at
      this site was confirmed by microinjections of phenylephrine (a specific agonist
      for these receptors); phenylephrine elicited tachycardia. Larger doses of
      epinephrine (320, 2,000, and 3,200 pmol, i.e., 20-nl volumes of 16, 100, and 160
      mM solutions) caused bradycardia when microinjected into the IML. These effects
      were mediated via alpha 2-adrenergic receptors because idazoxan blocked them. The
      presence of alpha 2-adrenergic receptors at this site was confirmed by
      microinjections of clonidine (a specific agonist for these receptors); clonidine
      elicited bradycardia. Injections of the vehicle (20 nl of normal saline
      containing 0.3% ascorbic acid, pH 7.4) did not evoke a response. Epinephrine,
      prazosin, or idazoxan did not alter the responses to L-glutamate. None of the
      doses of epinephrine elicited any response when injected intravenously. The
      aforementioned results provide pharmacological evidence for the presence of alpha
      1- and alpha 2-adrenergic receptors in the IML at T2. Thus a basis is provided
      for investigating the role, if any, of alpha-adrenergic receptors in the IML in
      mediating cardiovascular responses elicited by the stimulation of different brain
      stem areas.

PMID- 8368367
TI  - Control of resting bronchial hemodynamics in the awake dog.
AB  - In the resting awake dog a continuous-wave Doppler flow transducer on the right
      bronchoesophageal artery inscribes a sharp early systolic spike and low flow in
      late systole and throughout diastole, indicating a highly resistive bed. An
      analysis of autonomic factors using intravenous, cumulative, and randomly applied
      cholinoceptor, beta 1- and beta 2-adrenoceptor, and alpha 1- and alpha 2
      adrenoceptor antagonists indicates that the low vascular conductance is due to
      cholinoceptor and alpha 1- and alpha 2-adrenoceptor effects in a ratio 3.6:1. No
      beta-adrenoceptor tone is present. Sighing behavior invokes a transient (< 2 s)
      fall in intrapleural pressure (and thus rise in bronchovascular transmural
      pressure) of 10-30 mmHg, which is followed by a two- to threefold increase over
      30 s in bronchial flow and conductance, an effect simulated in 50% of dogs when
      bronchovascular transmural pressure is acutely raised and maintained over 40-60 s
      by inflating an intra-aortic balloon distal to the origin of the bronchial
      artery. Autonomic blockade has no effect on bronchovascular dilatation evoked
      either by sighing or by balloon inflation. It is concluded that, in the resting
      bronchial circulation, there exists strong cholinoceptor and alpha-adrenoceptor
      based vasoconstrictor activity which can be overpowered by strong nonadrenergic
      noncholinergic local vasodilator reflexes evoked by sudden changes in
      intrathoracic transmural pressure possibly acting on stretch-sensitive sensory
      nerve endings containing substance P, calcitonin gene-related peptide, and
      neurokinins. The tonic vasoconstrictor but not the sigh-evoked vasodilator
      effects are sensitive to pentobarbital sodium anesthesia.

PMID- 8368368
TI  - Neuropeptide Y potentiates contractile response to norepinephrine in skate
      coronary artery.
AB  - The skate is an extant representative of the first vertebrate group with a
      coronary circulation, the elasmobranch fish. Histochemical studies have revealed
      that skate coronary arteries are innervated by adrenergic nerves as well as by
      nerves showing neuropeptide Y (NPY)-like immunoreactivity. This study
      investigates the effect of NPY in the coronary system of an elasmobranch fish, a
      vertebrate that first evolved 450 million years before mammals and the mammalian
      coronary circulation. The responses of vascular ring preparations of the coronary
      artery from the longnose skate (Raja rhina) were measured using isometric force
      transducers. The main effect of NPY was a potentiation of the amplitude of the
      norepinephrine-induced contraction, leaving the pD2 value (-log 50% effective
      concentration) for norepinephrine unaffected. NPY per se occasionally contracted
      the coronary rings in higher concentrations. The potentiation response may not
      involve the endothelium and was abolished by pretreatment with tetrodotoxin. We
      conclude from this study that NPY potentiates norepinephrine-induced contraction
      in skate coronary artery via an indirect pathway.

PMID- 8368369
TI  - Electrically stimulated contraction accelerates protein synthesis rates in adult
      feline cardiocytes.
AB  - Cardiocytes were induced to contract via electrical field stimulation with an 8
      V/cm electrical square-wave pulse of 5 ms at 0.125-2.0 Hz for up to 6 h. Protein
      synthesis rates were measured as rate of incorporation of [3H]-phenylalanine into
      total cell protein. Rates of protein synthesis were accelerated 43 +/- 4%, P <
      0.001, by 4 h. The acceleration of total protein synthesis showed a frequency
      dependence between 0.125 and 0.5 Hz. In addition to accelerating rates of total
      protein synthesis, electrical stimulation of contraction accelerated fractional
      rates of synthesis of myosin heavy chain by 42 +/- 8%, P < 0.05. Protein
      synthesis rates were not accelerated upon electrical stimulation using
      subthreshold voltages. Addition of 100 ng/ml of actinomycin D had no effect on
      the ability of electrical stimulation of contraction to accelerate protein
      synthesis. To uncouple excitation-contraction coupling, 2,3-butanedione monoxime
      (BDM) was used to block actin-myosin cross-bridge interactions. BDM significantly
      decreased the ability of electrical stimulation to accelerate protein synthesis
      rates.

PMID- 8368370
TI  - Electrophysiological-anatomic correlates of ATP-triggered vagal reflex in dogs.
AB  - To test the hypothesis that afferent traffic of the ATP-triggered vagal reflex
      travels mainly in the right vagus nerve, we quantitated the response of the sinus
      node pacemaker activity and atrioventricular (AV) nodal conduction to increasing
      doses of intra-atrial ATP under baseline conditions, in the presence of
      aminophylline, and subsequently after either right followed by left cervical
      vagotomy or vice versa. In addition, the effect of right vagal C-fiber afferent
      blockade on the action of ATP in the sinus node was also determined. Because
      vagal efferent traffic to the sinus and AV nodes travels mainly via the right and
      left vagus nerves, respectively, the working hypothesis predicted that left
      vagotomy would have a much smaller effect than right vagotomy on the negative
      chronotropic action of ATP in the sinus node and predicted similar effects of
      left vs. right vagotomy on the negative dromotropic action of ATP on AV nodal
      conduction. ATP suppressed sinus node automaticity and AV nodal conduction in a
      dose-dependent manner. The attenuation of the action of ATP on the sinus node by
      right vagotomy was much more pronounced than that caused by left vagotomy, while
      the negative dromotropic action of ATP in the AV node was similarly attenuated by
      right vs. left vagotomy. In addition, sinus node automaticity, which was only
      mildly attenuated by left vagotomy, was markedly suppressed by right vagal C
      fiber afferent blockade. It was concluded that in the dog, afferent vagal traffic
      triggered by intra-right atrial ATP travels under these experimental conditions
      mainly via the right vagus nerve.

PMID- 8368371
TI  - Preconditioning protects coronary arteriolar endothelium from ischemia
      reperfusion injury.
AB  - The objectives of this study were to test the hypotheses that 1) endothelium
      dependent regulation of coronary arteriolar reactivity is impaired after ischemia
      and reperfusion, and 2) preconditioning protects the arteriolar endothelium from
      reperfusion injury. In anesthetized open-chest dogs, coronary arteriolar
      diameters (30-110 microns) were measured in the beating heart using intravital
      microscopy during fluorescent stroboscopic epi-illumination in three groups: 1)
      control, 2) ischemia and reperfusion: 60-min occlusion and 120-min reperfusion of
      the left circumflex coronary artery, and 3) preconditioning: 10-min occlusion and
      reperfusion preceding ischemia-reperfusion. To evaluate endothelial reactivity,
      the diameter responses of coronary arterioles to the endothelium-dependent
      vasodilators, acetylcholine and serotonin, were assessed. Ischemia and
      reperfusion significantly reduced the increase in diameter by serotonin (0 +/- 2
      vs. 11 +/- 3% change in controls; P < 0.05) and acetylcholine (7 +/- 2 vs. 20 +/-
      2% in controls; P < 0.05). In contrast, preconditioning preserved the dilation to
      both serotonin (6 +/- 1%) and acetylcholine (24 +/- 3%; both NS vs. control; P <
      0.05 vs. ischemia and reperfusion). Dilation by the endothelium-independent
      vasodilator, papaverine, was similar in the three groups, indicating similar
      levels of vasodilatory reserve and suggesting that the impaired dilation to
      acetylcholine and serotonin after ischemia and reperfusion was not due to
      nonspecific damage to vascular smooth muscle. These data demonstrate that
      ischemia-reperfusion significantly attenuates endothelium-dependent vasodilation
      of coronary arterioles in the intact beating heart. Furthermore, preconditioning
      reduces the endothelial dysfunction of coronary arterioles after ischemia
      reperfusion.

PMID- 8368372
TI  - Effects of hypertension and coronary constriction on cardiac function,
      morphology, and contractile proteins in rats.
AB  - In an attempt to elucidate the effects of two major risk factors of heart failure
      in humans, high blood pressure and coronary artery disease, renal hypertension
      and coronary artery constriction were induced singularly and in combination in
      rats, and the functional, structural, and biochemical alterations of the
      myocardium were examined 12-13 wk later. Renal hypertension (RH), coronary
      narrowing (CN), and their association (NH) resulted in left ventricular failure
      demonstrated by a significant increase in left ventricular end-diastolic
      pressure, a decrease in +dP/dt and -dP/dt, and a reduction in stroke volume and
      cardiac output. Measurements of ventricular loading documented that RH was
      characterized by elevations in systolic and diastolic wall stress of 42 and 160%,
      respectively. Corresponding changes with NH were 80 and 315%. CN was accompanied
      by an augmentation of diastolic wall stress only (280%). The abnormalities in
      mural stress were coupled with reductions in systolic and diastolic wall
      thickness-to-chamber radius ratios of 39 and 29% after CN. These anatomic
      parameters were preserved with RH, whereas the systolic wall thickness-to-chamber
      radius ratio was reduced 31% with NH. Structurally, multiple foci of replacement
      fibrosis were found with each intervention. The sites of tissue injury and their
      volume percent in the myocardium were comparable with CN and RH but were
      significantly more numerous and occupied a larger fraction of the ventricular
      wall in the presence of NH. Biochemically, the calcium dose-response curve of
      myofibrillar Mg2+ adenosinetriphosphatase (ATPase) activity did not vary with CN,
      RH, and NH. In contrast, a marked decrease in Ca2+ myosin ATPase activity was
      found in NH rats in association with a shift in myosin isoenzymes from V1 to V3.
      In conclusion, multiple physiological, morphological, and biochemical factors may
      participate in the generation of the abnormalities in ventricular loading with
      hypertension and/or coronary artery stenosis.

PMID- 8368373
TI  - Plasmalemmal vesicles represent the large pore system of continuous microvascular
      endothelium.
AB  - In the capillary physiology literature, molecules and particles larger than 10 nm
      are assumed to leave the plasma mostly through large pores located at the level
      of intercellular junctions in microvessels lined with a continuous endothelium.
      In morphological studies of similar microvessels, outgoing particles > 10 nm were
      detected in endothelial plasmalemmal vesicles not in intercellular junctions.
      Because the probes may not be found in transit through the junctions because they
      may be swept away by strong currents generated by Starling forces, we have
      examined a large number of junctions in arteriolar, capillary, and venular
      segments of bipolar vascular fields of mouse diaphragms collected after perfusion
      with large pore probes. The results presented in this study indicate that 1) the
      perfused probes accumulate in the luminal introits of the junctions as filtration
      residues that decrease in size and frequency from arterioles to venules, and 2)
      large pore probes move across the endothelium exclusively through plasmalemmal
      vesicles.

PMID- 8368374
TI  - Pertussis toxin-induced ADP ribosylation of inhibitor G proteins alters vagal
      control of heart rate in vivo.
AB  - Prior studies have shown that in vivo systemic administration of pertussis toxin
      in conscious dogs catalyzes ADP ribosylation of Gi and G(o) proteins, which
      attenuates intracellular transduction of muscarinic receptor activation. We
      tested the hypothesis that this impairment may result in the alteration of the
      following indexes of cardiac vagal activity: baroreflex sensitivity and heart
      rate variability. Heart rates during submaximal exercise were also determined.
      These variables were measured in eight conscious dogs before and 72 hr after
      pertussis toxin administration. Pertussis toxin significantly reduced (P < 0.001)
      baroreflex sensitivity (from 18.7 +/- 2.6 to 6.8 +/- 1.4 ms/mmHg), the SD of the
      mean R-R intervals (from 176 +/- 17 to 61 +/- 7 ms), the mean R-R interval (from
      742 +/- 32 to 527 +/- 29 ms), and the coefficient of variance [from 235 +/- 15 to
      114 +/- 1 (x 1,000)]. The heart rate response to graded submaximal exercise after
      pertussis toxin was higher (P < 0.001) at each exercise level. In in vitro assay,
      cardiac tissue samples from pertussis toxin-treated dogs incorporated 10-fold
      less ADP ribose than what has been described previously. These data prove that
      the in vivo action of pertussis toxin on cardiac inhibitory G proteins has direct
      consequences on end-organ cardiac responses to vagal activity. This study
      quantifies the physiological consequences of pertussis toxin-induced impairment
      of inhibitory G proteins in conscious animals.

PMID- 8368375
TI  - Free cytosolic Ca2+ measured with Ca(2+)-selective electrodes and fura 2 in rat
      mesenteric resistance arteries.
AB  - Free cytosolic Ca2+ was measured with sub-micrometer-tip, double-barrelled,
      Ca(2+)-selective electrodes and fura 2 in rat mesenteric resistance arteries. The
      purpose was to establish intracellular free Ca2+ concentration ([Ca2+]i) values
      in resting and stimulated vessels. Isolated vessels were mounted for isometric
      force measurements. Measured with electrodes, mean [Ca2+]i was 115 and 708 nM
      under resting and norepinephrine-activated conditions, respectively. Fura 2 was
      calibrated intracellularly including determination of the intracellular
      dissociation constant (Kd) of the fura 2:Ca2+ complex. The intracellular Kd was
      342 nM. With this value of Kd, fura 2 measurements of mean [Ca2+]i were 129 and
      537 nM under resting and norepinephrine-activated conditions, respectively. The
      values measured with the two techniques were thus in good accordance.

PMID- 8368376
TI  - Adult rat ventricular myocytes cultured in defined medium: phenotype and
      electromechanical function.
AB  - We studied primary short-term cultures of adult rat ventricular myocytes in
      defined medium to determine whether phenotype and electromechanical function are
      maintained in rod-shaped, quiescent cells. Although > 80% of the myocytes
      retained their rod-shaped in vivo morphology for up to 72 h, contractile function
      as measured by cell edge motion declined 30-50% from 6 to 24 h, paralleling a 68%
      shortening of action potential duration. From 24 to 72 h, contractility remained
      unchanged. Ca2+ channel current density increased 55% after 24-48 h and then
      returned to the level of freshly isolated cells (9 +/- 1 pA/pF, mean +/- SE).
      Resting membrane potential (-71 +/- 1 mV) and action potential overshoot (34 +/-
      3 mV) did not change. The ratio of alpha- to beta-myosin heavy chain mRNA and the
      level of cardiac alpha-actin mRNA were maintained for 8 days. Thus quiescent
      adult rat ventricular myocytes in defined medium undergo extensive phenotypic
      adaptation within 72 h of isolation, despite maintenance of a rod-shaped
      morphology and stable levels of contractile protein mRNA, which may limit their
      suitability for electrophysiological and contractile function studies.

PMID- 8368377
TI  - A method for isolating rabbit atrioventricular node myocytes which retain normal
      morphology and function.
AB  - This report describes a method for isolating single rabbit atrioventricular (AV)
      node myocytes which retain their normal morphology when exposed to millimolar
      levels of calcium. Previous attempts to isolate cells from the AV node have
      produced myocytes that "round up" (i.e., go into contracture) when exposed to
      calcium. We show that the cells isolated with our technique possess properties
      similar to those described for intact AV nodal tissue. We find that single AV
      node myocytes are shorter and thinner (mean dimension = 103.5 +/- 2.3 by 7.8 +/-
      0.2 microns; mean +/- SE, n = 90) than atrial or ventricular cells. Many of the
      cells produced by this isolation procedure generate spontaneous action potentials
      (188 +/- 9 beats/min; n = 6), which resemble action potentials recorded
      previously from the intact AV node. Voltage-clamp recordings from spontaneously
      active cells revealed similar membrane currents to those seen in intact tissue:
      fast sodium current and a L-type calcium current, followed by a delayed outward
      current. However, we found little evidence for the hyperpolarization-activated
      current (I(f)). Because the cells responded normally to concentrations of
      acetylcholine and isoproterenol within the physiological range, their cholinergic
      and adrenergic receptors appear to be well preserved by the isolation procedure.
      The ability to isolate morphologically and functionally normal AV myocytes may
      represent a significant advance for the investigation of nodal physiology at the
      cellular level.

PMID- 8368378
TI  - Calcitonin gene-related peptide mediates hypotension and tachycardia in endotoxic
      rats.
AB  - Circulating calcitonin gene-related peptide (CGRP) concentrations are elevated in
      experimental and clinical sepsis. CGRP causes hypotension and tachycardia,
      suggesting that the peptide might mediate the acute circulatory changes in
      sepsis. To test this hypothesis we administered Escherichia coli endotoxin (8
      mg/kg iv) to Nembutal- (pentobarbital sodium; 50 mg/kg) anesthetized rats.
      Endotoxin caused hypotension and tachycardia within 60 min that stabilized for 90
      min. After 2 h more severe hypotension developed, and 80% of rats died
      spontaneously after 3 h. In other endotoxic rats we administered 20 nmol of the
      CGRP receptor antagonist hCGRP (8-37) intravenously at 60 min. hCGRP (8-37)
      transiently reversed tachycardia (from 469 +/- 11 to 407 +/- 7 beats/min, P <
      0.05) and increased mean blood pressure (from 63 +/- 4 to 93 +/- 11 mmHg, P <
      0.05) over 30 min, after which hemodynamics and survival rates were no different
      from untreated animals. The results suggest that CGRP plays an important role in
      the acute circulatory changes of endotoxemia. More detailed work is necessary to
      determine the effects of CGRP antagonism on cardiac function, regional blood
      flow, and overall survival rates in sepsis.

PMID- 8368379
TI  - Excitatory amino acid receptors within NTS mediate arterial chemoreceptor
      reflexes in rats.
AB  - The nucleus tractus solitarius (NTS) is the primary site of termination of
      arterial baroreceptor and chemoreceptor afferent fibers. Excitatory amino acid
      (EAA) receptors within NTS have been shown to play an important role in the
      mediation of arterial baroreceptor reflexes; however, the importance of EAA
      receptors within NTS in the mediation of arterial chemoreceptor reflexes remains
      controversial. Therefore, in chloralose-urethan-anesthetized, mechanically
      ventilated, paralyzed rats, 4 nmol of the broad-spectrum EAA receptor antagonist
      kynurenic acid (Kyn) was injected into the NTS to observe the effects of EAA
      receptor blockade on the pressor responses evoked by either activation of
      ipsilateral carotid body chemoreceptors (by close arterial injection of CO2
      saturated bicarbonate) or electrical stimulation of ipsilateral carotid sinus
      nerve (CSN). Under control conditions, activation of carotid body chemoreceptors
      and CSN stimulation evoked increases in arterial pressure of 27 +/- 2 (n = 24
      sites) and 28 +/- 3% (n = 8), respectively. Kyn microinjection into NTS
      significantly reduced the pressor responses evoked by activation of carotid body
      chemoreceptors and electrical stimulation of the CSN for 20 and 25 min,
      respectively. Attenuation of pressor responses evoked by chemoreceptor activation
      were maximal at 20 min post-Kyn injection (13 +/- 2%), whereas CSN-evoked pressor
      responses were maximally attenuated at 15 min (6 +/- 4%). Microinjection into NTS
      of 4 nmol of xanthurenic acid, a structural analogue of Kyn with no EAA receptor
      antagonist properties, had no effect on chemoreceptor reflexes. We conclude that
      EAA receptors within NTS play an important role in the mediation of arterial
      chemoreceptor reflexes.

PMID- 8368380
TI  - Stress and cocaine elicit similar cardiac output responses in individual rats.
AB  - Cocaine use and behavioral stress elicit variable cardiovascular responses in
      individuals. In the present study, we examined the effects of cocaine or stress
      on arterial pressure, heart rate, and cardiac output in conscious rats. Rats were
      instrumented for determination of ascending aortic blood flow as an index of
      cardiac output using pulsed Doppler flow-metry. Cocaine administration elicited
      consistent decreases in cardiac output in some rats, whereas others had
      increases. In contrast, the pressor and heart rate responses were similar in
      these two groups of animals. Air jet stress also elicited a decrease in cardiac
      output only in a subset of conscious rats, yet produced equivalent pressor
      responses in all rats. Cardiac output responses to cocaine and air jet stress
      were closely correlated in individual rats, indicating that these stimuli evoke
      similar hemodynamic responses in individual rats. These observations suggest that
      the rat may provide a model for understanding differential cardiovascular
      sensitivity to cocaine and/or stress in humans.

PMID- 8368382
TI  - Carrier-mediated transport of lactic acid in cultured neurons and astrocytes.
AB  - The glycolytic end product lactic acid induced a rapid transient decrease in
      cytosolic pH in cultured neurons and astrocytes, as measured by
      microspectrofluorometry using the fluorescent indicator dye 2',7'-bis-(2
      carboxyethyl)-5-(and-6) carboxyfluorescein acetoxymethyl ester. Over a
      physiological range of pH, the initial rate of cellular acidification was a
      saturable function of the extracellular lactate concentration, suggesting that a
      saturable transport system mediated lactic acid permeation across the plasma
      membrane. This transport process displayed stereoselectivity, with a threefold
      higher rate of intracellular acidification by L-lactic acid than by its D-isomer.
      Lactic acid-induced acidification occurred in the absence of intracellular ATP,
      suggesting that transport proceeded independently of the cellular energy charge.
      These data suggest the existence of a lactic acid carrier in mammalian neuronal
      and astrocytic plasma membranes, which might serve an acid-scavenging function
      under conditions of altered pH homeostasis. In the setting of in vivo cerebral
      ischemia, this carrier may promote the efflux of lactic acid from astrocytes,
      redistributing it among less metabolically active neurons.

PMID- 8368381
TI  - Laryngeal afferent inputs to the nucleus of the solitary tract.
AB  - The following study was undertaken to examine the integration of laryngeal
      afferent inputs within the nucleus of the solitary tract (NTS), the primary site
      of termination of laryngeal afferent fibers. Intracellular recordings were
      obtained from 63 cells that responded to electrical stimulation of the superior
      laryngeal nerve (SLN) with an excitatory postsynaptic potential (EPSP; n = 49),
      an excitatory-inhibitory postsynaptic potential (EPSP-IPSP) sequence (n = 13), or
      an IPSP (n = 1). Mechanical stimulation of laryngeal mechanoreceptors revealed a
      variety of response patterns (e.g., slowly and rapidly adapting depolarizations
      or hyperpolarizations). Two types of response to increasing SLN stimulus
      frequency were observed. In 11 cells SLN-evoked EPSP amplitude at 10 Hz was only
      47 +/- 4% of the amplitude at 1 Hz, while in 6 cells EPSP amplitude at 10 Hz was
      virtually identical (93 +/- 3%) to that at 1 Hz. Time-dependent inhibitory
      interactions occurred between SLN inputs to NTS neurons at intervals between 50
      and 400 ms and in the absence of any change in membrane potential. NTS neuronal
      responses to brief activation of laryngeal mechanoreceptors correspond well to
      discharge patterns described for individual laryngeal mechanoreceptors. Frequency
      dependent filtering and time-dependent inhibitory interactions might modify NTS
      neuronal responses during more intense stimulation of laryngeal afferents.

PMID- 8368383
TI  - Effects of renal receptor stimulation on neurons within the ventrolateral medulla
      of the cat.
AB  - Experiments were performed to determine if activation of renal receptors by
      occlusion of the renal artery, renal vein, or ureter would alter activity of
      cells within the ventrolateral medulla of the cat. Extracellular unit recordings
      were obtained from 195 cells located within the rostral ventrolateral medulla of
      90 alpha-chloralose-anesthetized cats. Fifty-five of 195 cells (28.2%) tested for
      responses to renal receptor activation responded to at least one of the
      occlusions. Occlusion of the ureter increased the activity of 25 cells from 9.7
      +/- 3.7 to 23.0 +/- 6.5 impulses/s and decreased the activity of 5 cells from
      11.9 +/- 3.6 to 3.5 +/- 1.2 impulses/s. Occlusion of the renal vein increased the
      activity of seven cells from 7.5 +/- 3.3 to 22.3 +/- 7.3 impulses/s and decreased
      the activity of six cells from 13.8 +/- 3.8 to 4.1 +/- 2.0 impulses/s. Renal
      artery occlusion elicited solely excitatory responses from 43 cells. Thirty-one
      of the 43 cells increased their activity within 0-3 s of the onset of renal
      artery occlusion from 4.1 +/- 0.8 to 12.6 +/- 1.2 impulses/s. Renal artery
      occlusion increased the activity of 10 out of 43 cells with a mean latency of
      26.1 +/- 6.5 s from 8.3 +/- 2.5 to 29.6 +/- 9.3 impulses/s. Twenty-four of the 55
      (43.6%) responders were responsive to two or more forms of renal receptor
      activation. These results demonstrate that activation of renal mechanoreceptors
      and chemoreceptors affects cells within the ventrolateral medulla of the
      cat.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368384
TI  - Influence of extent of muscle shortening and heart rate on work from frog heart
      trabeculae.
AB  - Shortening, lengthening, and net work done by frog (Rana pipiens) heart
      trabeculae were measured over a range of strain amplitudes (length change) and
      cycle frequencies. Net work, the product of muscle strain and force over a full
      lengthening/shortening cycle, increased with strain to strains well over 25% of
      the muscle's rest length, a value greater than optimum strains reported for most
      skeletal muscles. A distinct optimum strain for net work was not found. Maximum
      net work per cycle averaged 7.5 J/kg for ventricular muscle and 2.0 J/kg for
      atrial muscle. Isometric twitch stress was maximal at 0.4-0.6 Hz twitch frequency
      in ventricular trabeculae (average 51 kN/m2) and 0.6-1.4 Hz in the atrium
      (average 14 kN/m2). The twitch duration decreased with increasing twitch
      frequency. Shortening and net work were maximal at 0.7-Hz cycle frequency in
      ventricular trabeculae and 0.9 to 1.4 Hz in the atrium. The decline in work per
      cycle at slower frequencies was due in part to a decline in twitch force. Maximum
      power for the ventricle was approximately 5 W/kg and occurred at 0.8 Hz and 26%
      strain, and was 1/3 to 1/4 the power of most skeletal muscles studied at similar
      temperatures.

PMID- 8368385
TI  - Intragastric glucose but not fructose conditions robust flavor preferences in
      rats.
AB  - Prior work indicates that glucose and fructose differ in their postingestive
      reinforcing effects. The present study investigated this phenomenon by training
      rats to associate the intake of flavored water with intragastric (IG) infusions
      of 16% sugar solutions. In experiment 1, rats had one flavor [conditional
      stimulus (CS)] paired with IG sugar infusions (CS+; e.g., cherry) and another
      flavor paired with IG water (CS-; e.g., grape) 23 h/day; Chow was available ad
      libitum. In subsequent choice tests, rats infused with glucose displayed a strong
      preference (89%) for the CS+ flavor, whereas rats infused with fructose showed
      only a small and nonreliable CS+ flavor preference (62%). When next trained to
      associate one flavor (e.g., orange) with IG glucose and another flavor (e.g.,
      strawberry) with IG fructose, rats in both groups developed a significant
      preference (81%) for the glucose-paired flavor. In experiment 2, food-deprived
      rats were trained 2 h/day to associate a CS+ flavor with IG sugar and a CS-
      flavor with IG water infusions. The glucose-reinforced rats displayed a near
      total preference (95%) for the CS+ flavor, whereas fructose-reinforced rats
      showed a much smaller CS+ preference (67%). The preference findings indicate that
      the postingestive consequences of glucose are much more reinforcing than those of
      fructose. It appears that food conditioning is mediated by chemospecific actions
      of nutrients rather than their general satiating or energy repleting effects.

PMID- 8368387
TI  - Enhanced response of muscle protein synthesis and plasma insulin to food intake
      in suckled rats.
AB  - To compare the sensitivity of muscle protein synthesis to food intake in neonatal
      and weaned rats, 5- and 16-day-old suckled rats and 28-day-old weaned rats were
      either fed, fasted for 8-10 h, or refed for 1-4 h after an 8-h fast. Protein
      synthesis was measured in vivo in soleus and plantaris muscles with a large dose
      of L-[4-3H]phenylalanine. In fed rats, fractional rates of protein synthesis (KS)
      decreased with age. Fasting decreased KS, and refeeding increased KS most in 5
      day-old animals, less in 16-day-old rats, and least in 28-day-old rats. In 5-day
      old rats, there were no differences in KS between soleus and plantaris muscles in
      the fed state and after fasting and refeeding; at 28 days, KS was higher in
      soleus than in plantaris in fed rats, and the soleus did not respond to fasting
      and refeeding. In rats at all three ages, the concentration of most plasma amino
      acids decreased during fasting; when 5-day-old rats were refed, plasma amino acid
      concentrations increased, but not to the levels in the fed state. Plasma insulin
      concentrations increased with age. Plasma insulin concentrations decreased more
      rapidly with fasting and increased more extensively with refeeding in 5-day-old
      rats than in older rats. These results suggest that muscle protein synthesis is
      more responsive to food intake in young suckled rats than in older suckled or
      weaned rats; this increased responsiveness is accompanied by greater changes in
      circulating insulin concentrations.

PMID- 8368386
TI  - Induction of c-fos expression in spinal neurons by nociceptive and nonnociceptive
      stimulation of LUT.
AB  - Expression of c-fos gene in spinal neurons was detected with an
      immunocytochemical technique to study the spinal processing of nociceptive and
      nonnociceptive input from the lower urinary tract (LUT) of the urethan
      anesthetized rat. Two preparations were used to activate afferent pathways in the
      LUT: 1) the urinary bladder was exposed through an abdominal incision, and saline
      or 1% acetic acid solution was infused directly into the bladder lumen and
      expelled through the urethra; and 2) the bladder was catheterized through the
      urethra, and the urethral outlet was ligated to allow distension and reflex
      contractions to occur under isovolumetric conditions. The first preparation
      mimicked the physiological changes occurring during normal voiding, whereas the
      second preparation generated high (presumably nociceptive) pressures when the
      bladder contracted against a closed outlet. The results indicate that distension
      induced voiding increased c-fos expression largely in the region of the sacral
      parasympathetic nucleus (52% of the total number of cells/L6 section) and the
      dorsal commissure (25% of the total number of cells), whereas nociceptive stimuli
      markedly increased the number of c-fos-positive cells in the dorsal commissure
      (3.5 x increase above the number induced by distension, representing 50% of the
      total number of cells/L6 section). Bladder contractions against a closed outlet
      elicited a distribution of c-fos-positive cells similar to that induced by
      chemical irritation. Drugs that suppressed bladder reflexes did not reduce c-fos
      induced by distension, indicating that voiding reflexes do not contribute to c
      fos expression.

PMID- 8368388
TI  - Mechanisms of potassium transfer across the dually perfused rat placenta.
AB  - The purpose of this study was to directly investigate the mechanisms of K+
      transfer across the rat placenta, which was isolated and perfused through both
      its maternal and fetal circulations. Unidirectional maternofetal (Kmf) and
      fetomaternal (Kfm) clearances for 42K, 51Cr-labeled EDTA (used as a diffusion
      limited paracellular marker), and 3H2O (used as a flow-limited marker) were
      respectively 232 +/- 36, 12 +/- 4, and 1,020 +/- 260 (mf) and 96 +/- 26, 18 +/-
      6, and 737 +/- 176 (fm) microliters.min-1 x g placenta-1. Calculated K+ fluxes
      were asymmetric, being 0.75 +/- 0.12 and 0.41 +/- 0.12 mumol.min-1 x g placenta-1
      for maternofetal and fetomaternal, respectively (mean +/- SE, n = 6; P < 0.01,
      paired t test). Although Kmf for 3H2O was 28% higher than Kfm, this could not
      completely account for the asymmetry in K+ fluxes. Kmf for 42K was 12-70 times
      higher than that for 51Cr-EDTA (presumed to be a paracellular marker), although
      its diffusion coefficient is only 2.5 times higher. An apparent Michaelis
      constant (Km) of 11.0 +/- 2.4 mM and maximum velocity (Vmax) of 3.8 +/- 0.33
      mumol.min-1 x g placenta-1 was calculated by Michaelis-Menten analysis of the
      transcellular component of maternofetal flux (Jmf) for K+. Ouabain or barium (1
      mM in maternal and fetal perfusate) reduced Kmf for 42K from 250 +/- 38 to 76 +/-
      13 microliters.min-1 x g placenta-1 (n = 4; P < 0.01) and from 358 +/- 31 to 106
      +/- 18 microliters.min-1 x g placenta-1 (n = 5; P < 0.001). Neither drug had any
      effect on Kmf for 51Cr-EDTA or 3H2O.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368389
TI  - Impairment of insulin action on peripheral glucose uptake and hepatic glucose
      production in tumor-bearing rats.
AB  - The present study was performed to determine the time-course for the development
      of peripheral and hepatic insulin resistance in rats as a result of an increasing
      tumor burden. Animals were inoculated with Yoshida ascites hepatoma, and studies
      were conducted during the early phase of tumor growth (day 4) at which time there
      was no change in food intake and at a later time point (day 8) when the tumor
      burden was increased and rats demonstrated anorexia. In vivo insulin action was
      accessed under euglycemic hyperinsulinemic conditions, in which insulin was
      infused at rates sufficient to produce arterial insulin levels that represent
      high physiological (3.5 ng/ml) or maximally stimulating values (180 ng/ml). On
      day 4, tumor-bearing (TB) rats were euglycemic, and whole body glucose turnover
      was elevated 32%. Insulin-mediated glucose uptake (IMGU) in TB rats was similar
      to control values at the low insulin infusion rate but reduced by 53% under
      maximally stimulating conditions. The insulin-induced suppression of glucose
      production was similar in TB and control animals at this time point. In contrast,
      on day 8, TB rats were hypoglycemic and glucose turnover was reduced 35%. The
      impairment in IMGU was more severe than seen earlier, with glucose uptake being
      reduced 39 and 61% at both levels of hyperinsulinemia. At this time point, the
      ability of insulin to inhibit glucose production was also impaired. These results
      indicate that the insulin resistance induced by the Yoshida hepatoma was
      manifested initially by a reduction in IMGU by peripheral tissues. As the tumor
      burden increased peripheral insulin resistance became more severe and an
      impairment in hepatic insulin action was observed.

PMID- 8368390
TI  - Effect of exercise training on RSNA, baroreflex control, and blood pressure
      responsiveness.
AB  - The effect of exercise training (ET) on renal sympathetic nerve activity (RSNA),
      baroreflex control of RSNA and heart rate (HR), and arterial pressure (AP)
      responsiveness to phenylephrine and angiotensin II (ANG II) was studied in six
      trained (T) and six sedentary (S) male Wistar rats. ET was performed on a motor
      treadmill for 13 wk. The RSNA signals of unanesthetized rats were processed by an
      analog-to-digital converter to quantify the nerve discharges associated with
      changes in AP and HR. The reflex control of RSNA and HR were evaluated during
      progressive injections of phenylephrine and sodium nitroprusside. Mean arterial
      pressure (MAP) was similar in both groups. RSNA was significantly lower in T rats
      (28 +/- 2 vs. 36 +/- 3%). T rats had an impairment of baroreflex control of RSNA
      in response to nitroprusside (4.9 +/- 0.89 vs. 12.3 +/- 1.2 bars.cycle-1.mmHg-1).
      ET decreased AP responsiveness for phenylephrine and ANG II. Therefore ET
      produces 1) no change in resting MAP but a significant decrease in RSNA and AP
      responsiveness and 2) partial impairment of baroreflexes, i.e., bradycardic
      responses and RSNA during MAP decrease.

PMID- 8368391
TI  - Endogenous cholecystokinin in the control of gastric emptying of liquid nutrient
      loads in rhesus monkeys.
AB  - A role for the brain/gut peptide cholecystokinin (CCK) in the control of gastric
      emptying has been proposed. In the present studies, we have used a potent type A
      CCK-receptor antagonist (devazepide) to examine the quantitative contribution of
      endogenously released CCK in the control of liquid gastric emptying of 100 ml
      lipid, protein, and carbohydrate test loads in rhesus monkeys. Emptying was
      studied in conscious monkeys equipped with chronic indwelling gastric cannulas.
      Prior intragastric administration of devazepide (1.0-320 micrograms/kg)
      differentially affected the 10-min emptying of glucose (0.125/ml), peptone
      (4.5%), and Intralipid (4.5%). Glucose emptying was not affected by any dose of
      the CCK antagonist. The emptying of peptone was accelerated by doses of 10
      micrograms/kg or higher. This effect, however, was only partial and plateaued at
      a dose of 100 micrograms/kg. The gastric emptying of Intralipid was accelerated
      at a dose of 32 micrograms/kg, and the inhibitory effect of the Intralipid was
      completely eliminated at a dose of 320 micrograms/kg. At this dose of devazepide,
      the Intralipid test meal emptied from the stomach at the same rate as
      physiological saline. These data demonstrate that in rhesus monkeys endogenously
      released CCK 1) does not play a role in the control of glucose emptying, 2) is a
      partial mediator of the inhibitory action of peptone on gastric emptying, and 3)
      is the primary inhibitory mediator in the control of the gastric emptying of
      Intralipid.

PMID- 8368392
TI  - Experimental cachexia: effects of MCA sarcoma in the Fischer rat.
AB  - Temporal patterns of the cachectic effects of tumor growth and their relation to
      systemic levels of tumor necrosis factor (TNF) and IL-6 (interleukin-6) were
      examined in a rat model of experimental cancer cachexia employing the
      methylcholanthrene (MCA) sarcoma. Fischer 344 rats, implanted with biotelemeters
      for measuring temperature and activity, were implanted subdermally with tumor
      tissue fragments. Ad libitum-fed and pair-fed controls were sham incised.
      Bioassays for TNF and IL-6 were performed on serial plasma samples, obtained via
      jugular vein at 3- to 6-day intervals throughout the experimental period. Tumor
      growth induced significant anorexia, weight loss, and a decline in motor activity
      corresponding to an increase in mean plasma IL-6 levels, independent of reduced
      food intake or weight loss alone as shown in pair-fed controls. A significant
      lowering of body temperature then developed, followed by a two- to threefold
      increase in water consumption. The patterns of weight loss and temperature
      reduction differed in rate and degree from those seen with pair feeding.

PMID- 8368393
TI  - Role of intrarenal ANG II in reflex neural stimulation of plasma renin activity
      and renal sodium reabsorption.
AB  - Renal sympathetic stimulation of plasma renin activity (PRA) and sodium
      reabsorption was examined in conscious dogs before and during intrarenal
      angiotensin II (ANG II)-type 1 receptor blockade with losartan (Dup-753) and
      converting enzyme inhibition. In uninephrectomized dogs, renal function and PRA
      responses to 14% blood volume depletion (BVD) were measured. BVD was utilized to
      activate renal sympathetic outflow in the absence of hypotension. In eight
      vehicle-treated dogs, 14% BVD increased PRA from 1.38 +/- 0.32 to 2.79 +/- 0.66
      ng ANG I.ml-1 x h-1 and decreased urinary sodium excretion (UNaV) from 85.1 +/-
      11.3 to 45.4 +/- 7.5 mueq/min. During losartan (n = 6) and captopril (n = 5)
      infusion, plasma renin responses were enhanced in response to 14% BVD (1.93 +/-
      0.48 to 5.74 +/- 2.25 and 3.03 +/- 0.73 to 9.19 +/- 1.94 ng ANG I.ml-1 x h-1,
      respectively), whereas antinatriuretic responses were similar to vehicle-infused
      dogs. Thus, neurogenic antinatriuresis is not mediated by secondary generation of
      ANG II, since UNaV decreased similarly to control in all conditions of ANG II
      blockade. Tonic intrarenal and/or circulating ANG II synthesis of dogs on a
      normal sodium diet inhibit neurogenic stimulation of renin release, since PRA
      responses were enhanced after blockade of ANG II.

PMID- 8368394
TI  - Serum immunoreactive erythropoietin and red blood cell mass during pregnancy in
      conscious rats.
AB  - Serum erythropoietin concentration increases during human pregnancy and
      presumably accounts for expansion of red blood cell mass. The mechanism(s)
      underlying gestational changes of serum erythropoietin are unknown. Moreover, if
      erythropoietin synthesis increases, then the organ(s) questions about
      erythropoietin in pregnancy, we first set out to establish an animal model.
      Chronically instrumented, conscious unrestrained rats were studied. 51Cr-labeled
      red blood cells and radioimmunoassay were used to assess red blood cell mass and
      serum erythropoietin, respectively. Except for a lower hematocrit (P < 0.05 vs.
      virgin rats) and a slightly higher plasma volume (P value not significant) for
      gravid rats on gestational day 6, all other variables measured in early pregnancy
      rats were comparable to those measured in virgin control animals. Significant
      increases in total blood volume, plasma volume, and red blood cell mass were
      observed by gestational day 13 (midpregnancy) when compared with virgin control
      rats. These changes were even more pronounced on gestational day 20. Serum
      immunoreactive erythropoietin was also significantly increased at both of these
      stages of pregnancy. We conclude that the gravid rat is a reliable animal model
      of human gestation in which to further investigate erythropoietin in pregnancy.

PMID- 8368395
TI  - Role of decreased plasma volume in hematocrit alterations during incremental
      treadmill exercise in horses.
AB  - Six intact (IN) and six splenectomized (SP) mares were subjected to an
      incremental exercise test to examine the role of decreases in plasma volume (PV)
      in the changes in hematocrit (Hct) normally seen with exercise. Each horse
      underwent an incremental exercise test in which it ran on a treadmill up a fixed
      incline of 6 degrees. The test started at a speed of 4 m/s, and speed was
      increased 1 m/s each min until heart rate reached a plateau. Blood samples were
      obtained at rest and at the end of the 4, 5, 6, and 7 m/s steps of the exercise
      test. Resting PV was greater (P < 0.05) in the IN group (28.6 +/- 0.5 liters)
      compared with SP horses (22.7 +/- 2.2 liters). Exercise produced a significant
      increase in Hct in both groups of horses; however, the increases were greater (P
      < 0.05) at all exercise intensities in IN compared with SP horses. Hct increased
      rapidly during the first step (4 m/s) in the exercise test in the IN animals.
      After this, Hct increased slowly in IN horses, and values for the 5, 6, and 7 m/s
      steps paralleled the changes observed in the SP horses. Corrected Hct values were
      then used to calculate the relative change in PV. Exercise produced a significant
      decrease in PV in both groups of horses; however, there were no differences (P >
      0.05) between the groups when IN horses (-13 +/- 3 and -18 +/- 2%) were compared
      with SP horses (-14 +/- 4 and -17 +/- 4%) at the 6 and 7 m/s steps of the
      exercise test.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368396
TI  - Splenectomy alters blood pressure response to incremental treadmill exercise in
      horses.
AB  - Six intact (IN) and five splenectomized (SP) mares were subjected to an
      incremental exercise test to examine the effects of splenectomy on blood pressure
      responses during exercise. During the test the horses ran up a 6 degree grade on
      a treadmill set at an initial speed of 4 m/s. Speed was increased 1 m/s every 1
      min until heart rate (HR) reached a plateau. Hemodynamic data were collected
      continuously and analyzed for the last 18 s of the 4, 5, 6, and 7 m/s steps of
      the exercise test. There were no differences (P > 0.05) between the groups for
      resting means for any parameter measured in the study. HR increased (P < 0.05) in
      both groups of horses during exercise with significantly greater HR in the SP
      horses during the first two steps of the test. There were no differences (P >
      0.05) in maximal HR between the groups. Right atrial pressure (RAP) did not
      change during exercise in the SP horses; however, it did increase 20 mmHg (493%,
      P < 0.05) in the IN horses. Right ventricular pressure (RVP) increased (P < 0.05)
      during exercise with no differences (P > 0.05) between the groups. Right
      ventricular maximum change in pressure over time increased (P < 0.05) in a
      similar fashion in both groups of animals. Mean arterial pressure (MAP) increased
      29 mmHg (30%, P < 0.05) in SP horses, reaching a plateau by the 5 m/s step of the
      test.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368398
TI  - Rapid alterations of hypothalamic and hippocampal bombesin-like peptide levels
      with feeding status.
AB  - It has been suggested that bombesin (BN)-like peptides may play a physiological
      role in the control of food intake. We studied the time course of changes in the
      levels of central BN-like peptides during a meal. Four groups of animals were
      used: rats that were food (but not water) deprived for 12-h period (preprandial
      group) and then given access to food for either 10 min (partially satiated group)
      or 35 min (postprandial group). The fourth group constituted nondeprived controls
      (ad libitum fed group). BN-like immunoreactivity (BLI) of the hypothalamus,
      hippocampus, and medulla was determined using a radioimmunoassay. Our data
      revealed that at the hypothalamus, the BLI content dropped significantly after
      food deprivation (preprandially), and returned to the ad libitum fed control
      levels after the meal (postprandially). At the hippocampus, food deprivation did
      not affect the BLI levels; however, food ingestion significantly elevated the BLI
      content within 35 min. The medullary BLI levels failed to alter in relation to
      the feeding status. The observed rapid alterations suggest that the hypothalamic
      response to food intake is satiety linked and hence lend support to the
      contention that BN-like peptides play a physiological role in the central
      regulation of ingestive behavior. The alterations noted at the hippocampus
      implicate physiological role of BN-like peptides in other meal-associated
      processes (such as memory).

PMID- 8368397
TI  - Selective retention of essential fatty acids: the role of hepatic
      monoacylglycerol acyltransferase.
AB  - In the suckling rat, chick embryo, and hibernating marmot, fatty acids provide
      the major source of energy, and despite the high rate of hepatic beta-oxidation,
      these animals selectively retain long-chain polyunsaturated derivatives of C18:2n
      6 and C18:3n-3. To determine whether the hepatic microsomal activity
      monoacylglycerol acyltransferase (MGAT) (EC 2.3.1.22) could provide a mechanism
      to selectively acylate monoacylglycerols that contain essential fatty acids, we
      tested the ability of MGAT activity from each of the three species to acylate sn
      2-monoC18:1-, sn-2-monoC18:2-, sn-2-monoC18:3-, and sn-2-monoC20:4-glycerols.
      Hepatic MGAT activity acylated sn-2-monoC18:3-glycerol and sn-2-monoC18:2
      glycerol in preference to sn-2-monoC18:1-glycerol in each of the three different
      lipolytic animals. MGAT's acyl group specificity could not be explained by
      invoking differences in membrane fluidity because the apparent affinity for sn-2
      monoC20:4-glycerol was not increased. Further, sn-2-monoC18:3-glycerol remained a
      preferred substrate under assay conditions when both the C18:3 and C18:1 species
      were present in equal amounts. As would be predicted in the presence of high
      activity of a selective MGAT, the hepatic glycerolipids from neonatal rats showed
      increases in dienoic, trienoic, and C22:6 fatty acids and relative decreases in
      monoenoic, saturated, and C20:4 fatty acids. We hypothesize that, during
      lipolysis, the reacylation of sn-2-monoacylglycerols by MGAT may provide a
      mechanism by which essential fatty acids are retained within specific tissues.

PMID- 8368399
TI  - Vascular effects of arginine vasotocin in toad skin.
AB  - Fluid balance in amphibians is regulated, in large part, by arginine vasotocin
      (AVT). One important action of this hormone is to facilitate water uptake by
      increasing the water permeability of the skin. Cutaneous blood flow also affects
      water uptake, but the effects of AVT on skin perfusion are unknown. This study
      tested the hypothesis that AVT facilitates water uptake, not only by increasing
      cutaneous water permeability, but also by promoting cutaneous blood flow. The
      effects of AVT on blood flow through the ventral pelvic skin, a region
      specialized for water uptake, were assessed in Bufo marinus by determining the
      conductance of the skin to acetylene (GsAc), an index of cutaneous blood flow. A
      pump-perfused skin preparation was used to study the effects of AVT on the
      cutaneous vascular resistance (CVR) of the ventral pelvic skin and the dorsal
      skin (a region not normally involved in water uptake). Bolus AVT injections (iv)
      of 10 pmol/kg and below had no significant effect on GsAc (P > 0.45). However,
      100 and 300 pmol/kg of AVT decreased GsAc by 39 +/- 7 (P < 0.001) and 63 +/- 6%
      (P < 0.001), respectively. The higher AVT doses increased mean arterial pressure.
      AVT increased CVR in both pump-perfused preparations. The lowest concentration of
      AVT tested that significantly raised CVR was 1 x 10(-10) M for the dorsal skin (P
      = 0.006) and 3 x 10(-10) M for the ventral pelvic skin (P = 0.038).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368400
TI  - Exercise, unlike insulin, promotes glucose transporter translocation in obese
      Zucker rat muscle.
AB  - Insulin or exercise stimulates skeletal muscle glucose transport, most likely by
      increasing both the number and activity of glucose transporters in the plasma
      membrane. Skeletal muscle glucose transport of genetically obese Zucker rats
      (fa/fa) displays a severe insulin resistance that results, at least in part, from
      a failure of net transporter translocation to the cell membrane (King, P., E. D.
      Horton, M. Hirshman, and E. S. Horton. J. Clin, Invest. 90: 1568-1575, 1992). The
      purpose of the present study was to determine if the obese rat muscle was also
      resistant to the action of acute exercise to increase glucose transport and, if
      so, to determine if the defect involved transporter translocation as seen in the
      resistance to insulin. The muscle glucose transport system was investigated in
      plasma membranes isolated from postprandial, sedentary or acutely exercised, lean
      and obese Zucker rats. Measurements of D- and L-glucose uptake by membrane
      vesicles under equilibrium exchange conditions indicated that an acute bout of
      exercise resulted in a threefold increase in the maximum velocity (Vmax) for lean
      animals (5.7 vs. 17.6 nmol.mg protein-1.min-1) and a 4.5-fold increase in the
      Vmax for obese rats (4.1 vs. 18.6 nmol.mg protein-1.min-1). For both lean and
      obese animals, this increase in transport was associated with an increase in
      transporter number measured by cytochalasin B binding (1.6- and 2.2-fold,
      respectively) and with an increase in the average carrier turnover number (1.9-
      and 2.0-fold, respectively). The results indicate that, unlike a maximal insulin
      stimulus, acute exercise of the obese Zucker rat promotes both transporter
      translocation and transporter activation in skeletal muscle.

PMID- 8368401
TI  - Central interferon-alpha inhibits natural killer cytotoxicity through sympathetic
      innervation.
AB  - The brain has been known to produce high levels of interferon-alpha (IFN-alpha)
      during viral infections. We investigated the central and peripheral mechanisms of
      the brain IFN-alpha-induced suppression of natural killer (NK) cytotoxicity in
      the rat. The activity of NK cells in the spleen and the peripheral blood
      decreased 30-120 min after intracerebroventricular (icv) injection of recombinant
      human IFN-alpha of > 1,000 U but not after its intraperitoneal injection. This
      effect was antagonized by pretreatment with icv naltrexone (NLTX). Splenic
      denervation was observed to completely abolish the IFN-alpha-induced suppression
      of NK activity, whereas bilateral adrenalectomy did not. Furthermore, this
      immunosuppression was blocked by an icv injection of an antagonist of
      corticotropin-releasing factor (CRF), alpha-helical CRF-(9-41). The icv injection
      of CRF resulted in reduced NK activity, which was not affected by NLTX. The
      results suggest that brain IFN-alpha activates the CRF system through central
      opioid receptors and thereby suppresses the NK cytotoxicity predominantly through
      splenic sympathetic innervation.

PMID- 8368402
TI  - Vasopressin-independent alterations in renal water excretion in quadriplegia.
AB  - Postural effects on water excretion are known to be increased in patients with
      cervical spinal cord injury and may result in marked impairment of the ability to
      excrete a water load, especially in erect posture. Both vasopressin-dependent and
      vasopressin-independent mechanisms have been implicated. To assess the roles of
      these mechanisms and further identify the factors involved in the renal response
      to erect posture, sustained water loading studies were performed on 11
      quadriplegic subjects and 9 healthy control subjects, supine and erect (sitting).
      Renal blood flow was assessed by p-aminohippurate clearance (CPAH) measurements
      in 7 quadriplegic and 5 control subjects. During maximal water diuresis, plasma
      vasopressin concentrations were reduced to unquantifiable levels in all subjects.
      Osmolar clearance, free water clearance (CH2O), and distal delivery of filtrate
      (DDF) were all lower in quadriplegic than in control subjects, supine and erect.
      The relationship between CH2O and DDF was the same in quadriplegic as in control
      subjects and was not altered by change in posture in either group. Creatinine
      clearance and CPAH were lower in erect than in supine posture in quadriplegic
      subjects but not in control subjects. We conclude that impairment of water
      excretion in stable normonatremic quadriplegic subjects can be attributed
      primarily to vasopressin-independent mechanisms involving reduced filtrate
      delivery to diluting segments of the renal tubules rather than to resistance to
      normal suppression of vasopressin release.

PMID- 8368403
TI  - Effects of long-term restricted feeding on motor activity rhythm in the rat.
AB  - The motor activity circadian rhythm of the rat is driven by at least two
      different pacemakers, one entrained by light-dark cycles and the other by
      periodic food access. The interaction between these two pacemakers generates the
      overt rhythm in many variables in the rat. In this paper we study the effects of
      restricted feeding (RF) for > 300 days on the motor activity of two groups of
      eight rats each (4 males and 4 females) that were kept under different light
      patterns. The first group was kept under dim red light, and the second group was
      kept initially for 70 days under bright light and afterward under dim red light.
      Rats had access to food for only 2 h/day. Results show that strong alterations in
      the motor activity pattern, such as relative coordination, bouncing, and several
      cases of entrainment, are shown in the first group. When these animals return to
      ad libitum feeding conditions the presence of the food component is clear, in
      some cases for > 20 days. In contrast, the rats that were previously subjected to
      bright light did not entrain to RF. In this group, there was a masking effect
      when lights were on, but a free-running component appeared when lights were off.
      The endogenous period (tau) of this component was not modified during the course
      of the experiment. After RF these rats showed a longer tau than the former
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368404
TI  - High-density localization of ANP receptors in chondrocytes of eel gill cartilage.
AB  - Very high levels of atrial natriuretic peptide (ANP) receptor were found in a
      quite unexpected tissue, i.e., the chondrocyte of the eel gill cartilage. 125I
      labeled ANP binding assay indicated that the eel gill contains large amounts of
      the receptor and its levels are much higher (> 10-fold) than those in the other
      tissues examined, including the brain, kidney, head kidney including
      steroidogenic interrenal cells, and gut. Autoradiography using gill sections
      revealed dense localization of ANP receptors in the chondrocytes of the cartilage
      as well as moderate localization in the parenchymal cells. Biochemical and
      pharmacological characterization of the chondrocyte receptor indicated that most
      of the receptors are type C receptors, having a broad ligand specificity and a
      reduced M(r) of 68,000. Because a hyaline cartilage in which chondrocytes reside
      lacks blood vessels, and all metabolic exchange is by slow diffusion through the
      matrix, the chondrocyte localization of the type C ANP receptor is notable and
      may stimulate not only chondrocyte research but also studies on physiological
      significance of the type C receptor, which is generally considered to be merely a
      clearance (silent) receptor.

PMID- 8368405
TI  - Storm warnings.

PMID- 8368406
TI  - Isolated posterior cruciate ligament reconstruction. Long-term results.
AB  - From 1973 to 1987, 28 patients seen at our institution sustained isolated
      posterior cruciate ligament tears. Of these 28 patients, 25 were reevaluated at
      an average followup of 7 years and 1 month after secondary reconstruction of the
      posterior cruciate ligament using the semitendinosus and gracilis tendons alone
      or with an extraarticular procedure. Subjectively, 22 of 25 patients related no
      restrictions regarding activities of daily living, with 14 of 25 patients being
      able to return to their previous competitive level in sports. Objective
      evaluation after reconstruction revealed no change in the preoperative and
      postoperative posterior drawer examination in 13 of 25 patients, a finding
      confirmed by KT-1000 arthrometer measurements. Radiographic evaluation revealed
      degenerative changes predominantly involving the medial and patellofemoral
      compartments in 15 of 25 patients. Despite optimistic subjective reporting, this
      long-term retrospective study reveals that this procedure inconsistently limits
      posterior instability and therefore cannot be recommended.

PMID- 8368407
TI  - Tarsometatarsal joint injuries in the athlete.
AB  - This is a retrospective review of the presentation, diagnosis, treatment, and
      outcome of 19 patients who injured the tarsometatarsal joint of the foot during
      athletic activity. Diagnosis by clinical and radiographic examination was
      supplemented by stress fluoroscopy of the articulation under anesthesia. Injuries
      were classified as either a first- or second-degree sprain of the tarsometatarsal
      joint, a third-degree sprain (with diastasis between the metatarsals or
      cuneiforms), a fracture, or frank dislocation. Poor functional results were seen
      in those for whom diagnosis was delayed and for whom the injury was not treated
      adequately. Three patients were unable to return to sports, one of whom
      eventually required fusion of the tarsometatarsal joint. The third-degree sprains
      were indistinguishable from fracture and fracture-dislocations in that good
      results were not reliably obtained by nonoperative treatment, and both classes of
      injury seem to require open reduction and internal fixation for optimal return to
      function. The delay in return to full activity is a marker of the severity of
      this injury despite an often benign appearance on radiograph.

PMID- 8368408
TI  - Arthroscopy of the knee. Ten-day pain profiles and corticosteroids.
AB  - A prospective study was conducted to determine 10-day pain and analgesic use
      profiles of outpatients after arthroscopic surgery of the knee and to examine the
      effects of oral corticosteroid use on analgesic intake, perceived pain, and
      functional outcomes. Sixty-two patients who underwent a variety of arthroscopic
      procedures of the knee were matched on level of injury and surgical repair, and
      were assigned to two groups. The experimental group received a standard dosage of
      oral postoperative corticosteroids. The placebo group received the same dosage of
      a placebo (sugar pill). Both groups received the same prescription of an
      analgesic for pain relief after surgery. Results indicated that there were no
      significant differences for any dependent variables between the experimental and
      placebo groups. There were significant (P < 0.001) decreases in analgesic use and
      perceived pain throughout the 10 days. Conclusions were that most patients who
      have undergone arthroscopic surgery of the knee perceive pain at low levels, use
      limited amounts of analgesics, and return to work within a week. The addition of
      oral corticosteroids does not influence this profile.

PMID- 8368409
TI  - Postoperative pain after anterior cruciate ligament reconstruction using a
      transligamentous approach.
AB  - Anterior cruciate ligament reconstruction by free patellar tendon graft was
      performed using 2 different surgical approaches to the intercondylar notch in 67
      consecutive patients with chronic anterior cruciate ligament insufficiency. In
      the first 30 patients (Group A), the traditional medial parapatellar arthrotomy
      with lateral luxation of the patella was done, whereas in the last 37 patients
      (Group B) a transpatellar tendon approach was used. Postoperative pain was
      managed by analgesics and, in patients who had epidural anesthesia, by
      administration of bupivacaine in indwelling catheters. Generally, the analgesics
      and bupivacaine were given immediately on request to establish comfort at rest
      and to permit range of motion exercises without severe pain. Compared with those
      in Group A, the patients of Group B had a significantly longer period from the
      first dose of analgesic or bupivacaine to the second, and the total number of
      doses of analgesic or bupivacaine was significantly lower. In the subgroup of
      patients with epidural anesthesia (21 in Group A and 32 in Group B), the Group B
      patients required significantly less analgesics, as doses equivalent to 10 mg of
      morphine, compared with that of Group A.

PMID- 8368410
TI  - An evaluation of pre- and postoperative nonsteroidal antiinflammatory drugs in
      patients undergoing knee arthroscopy. A prospective, randomized, double-blinded
      study.
AB  - The potential benefits of a nonsteroidal antiinflammatory drug to 67 patients
      undergoing knee arthroscopy were evaluated in a prospective, randomized, placebo
      controlled, double-blinded study. Group A received the drug (diclofenac, 75 mg
      twice daily) for 3 to 5 days before and for 7 days after surgery. Group B
      received a placebo preoperatively and the drug postoperatively. Group C received
      a placebo at both times. Codeine was available postoperatively for all patients
      if needed. Outcomes reported by the subjects included pain, crutch use, and
      return to activities. Outcomes assessed by physicians included knee effusion,
      range of motion, and gait. Knee flexion and extension strengths were measured
      isokinetically pre- and postoperatively. Pain scores on the 1st postoperative day
      were higher in Group C than in Group A. Pain scores at all other time points were
      not significantly different in the three treatment groups. Groups A and B
      required less codeine during the first 72 hours after surgery than Group C (mean,
      2.9 +/- 1.0 versus 6.8 +/- 1.0 pills). Recovery of function, recovery of
      strength, and physical examination parameters were not significantly different in
      the three treatment groups. Diclofenac was an effective analgesic in the
      immediate postoperative period. Recovery from arthroscopy, however, was not
      enhanced by taking the drug.

PMID- 8368411
TI  - Thermal effects on skeletal muscle tensile behavior.
AB  - The effect of temperature on the mechanical failure properties of rabbit skeletal
      muscle (tibialis anterior and extensor digitorum longus) was examined. For all
      tests, one leg was maintained at 25 degrees C and the contralateral leg at 40
      degrees C. Muscles were pulled to failure according to assignment into one of
      three groups: 1) passive failure at 10 cm/sec, 2) passive failure at 1 cm/sec, or
      3) active (muscle is stimulated to contract as it is pulled) failure at 10
      cm/sec. Load to failure was higher in the cold muscle for all groups tested.
      Total deformation was the same except in Group 1, when the warm muscle had a
      greater deformation. Energy absorbed before failure was greater in the cold
      muscle in Groups 2 and 3. Stiffness was higher in cold muscles for all muscles
      except the extensor digitorum longus in Group 1. In this study, temperature had a
      significant effect on the tensile properties; these thermal effects were
      dependent on both loading rate and contractile state. Comparing loading rates,
      warm muscle tested at 10 cm/sec had higher failure loads than that tested at 1
      cm/sec. Comparing stimulated versus unstimulated muscle (Group 1 versus Group 3),
      the stimulated tibialis anterior muscle absorbed more energy than unstimulated
      ones. Stimulated extensor digitorum longus muscles had higher failure loads,
      absorbed more energy, and were stiffer than nonstimulated muscles. This study
      offers experimental data to support the theory that warming muscles can aid in
      injury prevention and improvement in athletic performance.

PMID- 8368412
TI  - Evaluation of arthroscopic anterior cruciate ligament reconstruction using
      magnetic resonance imaging.
AB  - Thirty-two patients who had arthroscopic anterior cruciate ligament
      reconstruction using a bone-patellar tendon-bone autograft underwent subsequent
      magnetic resonance imaging of the knee. A total of 32 magnetic resonance imaging
      examinations were performed from 10 days to 39 months postoperatively. The
      anatomic plane of the autograft was determined by obtaining a coronal pilot scan
      of the graft fixation screws or screw and staple. T1-weighted, T2-weighted,
      proton density, and gradient-echo imaging sequences were then obtained in the
      anatomic plane, as well as T1-weighted coronal images. The autograft was defined
      on the basis of visualization of fiber continuity on T2-weighted images as
      follows: 1) intact; 2) having a partial tear; or 3) having a complete tear. These
      results were then correlated with clinical examination and, in 10 cases,
      subsequent arthroscopy. Magnetic resonance imaging correlated with clinical
      findings in 31 of 32 patients. In addition, of the 10 patients who underwent
      subsequent arthroscopy, magnetic resonance scanning correlated in all cases with
      arthroscopic findings. T2-weighted and, in some cases, proton density images were
      most useful in visualizing the autograft. T2-weighted magnetic resonance imaging
      in the anatomic plane of the anterior cruciate ligament autograft can be a useful
      diagnostic tool in the evaluation of patients with patellar tendon anterior
      cruciate ligament reconstructions when graft integrity is in question.

PMID- 8368413
TI  - Magnetic resonance imaging of injury to the lateral ankle ligaments.
AB  - To establish the value of magnetic resonance imaging in determining which
      patients with ankle sprains will benefit from surgical treatment, 1 uninjured
      volunteer and 15 patients with acute, subacute, and chronic injuries of the
      lateral ankle ligaments were imaged at 1.0 tesla using a fast imaging with steady
      state precision three-dimensional technique and 1.5-mm slice thickness. A
      dedicated knee coil was used to hold the foot in a neutral or plantar-flexed
      position. In cases of acute, low-grade injuries, fraying of the anterior
      talofibular ligaments with intact calcaneofibular ligaments was observed in the
      presence of edema and hemorrhagic fluid. In cases of acute, high-grade sprains,
      the calcaneofibular ligament appeared wavy or was visualized only partially or
      not at all. Subacute injuries showed ligament disruption; chronic lesions, on
      occasion, showed atrophy of the calcaneofibular ligament but no edema or
      hemorrhagic fluid. These findings showed a good qualitative correlation with the
      results of graded stress radiography. Magnetic resonance imaging can definitely
      determine the ligaments involved in lateral ankle sprains and provide useful
      anatomic information in cases in which acute or reconstructive surgery is
      contemplated. However, the magnetic resonance imaging findings do not directly
      correlate with degree of instability and do not replace those of physical
      examination or routine radiographic studies.

PMID- 8368414
TI  - Intercondylar notch size and anterior cruciate ligament injuries in athletes. A
      prospective study.
AB  - Published reports agree that there is a strong association between intercondylar
      notch stenosis and anterior cruciate ligament injuries. In a previously published
      retrospective study on bilateral anterior cruciate ligament injuries and
      associated intercondylar notch stenosis, we formulated the notch width index to
      measure and compare intercondylar notch width. The purpose of this prospective
      study was to establish a normal range for the notch width index and to correlate
      intercondylar notch size and anterior cruciate ligament injuries. We gathered
      data on 902 high school athletes, including range of motion, thigh girth,
      ligament stability and intercondylar notch width using the notch width index. The
      population was then followed prospectively and anterior cruciate ligament
      injuries were recorded and correlated with notch width index in a blind manner.
      Two-year results showed that the overall anterior cruciate ligament injury rate
      was 3%. The normal intercondylar notch ratio was 0.231 +/- 0.044. Intercondylar
      notch width index for men was larger than that for women. Athletes sustaining
      noncontact anterior cruciate ligament tears have statistically significant
      intercondylar notch stenosis (notch width index, 0.189). Ten of 14 athletes with
      noncontact anterior cruciate ligament injuries had a notch width index that was
      at least 1 SD below the mean. Athletes with contact anterior cruciate ligament
      injuries had a mean of 0.233. We conclude that athletes with a stenotic
      intercondylar notch are at significantly greater risk for sustaining noncontact
      anterior cruciate ligament injury.

PMID- 8368415
TI  - Cell survival after transplantation of fresh meniscal allografts. DNA probe
      analysis in a goat model.
AB  - Fibrochondrocytes synthesize and maintain the extracellular matrix responsible
      for the distinctive material and structural properties of a normal meniscus.
      Viable meniscal cells are believed to be necessary for the long-term maintenance
      of these properties in meniscal allografts. The purpose of this study was to
      determine if the donor cells (fibrochondrocytes) survive after a fresh meniscal
      allograft transplantation. A DNA probe technique was used to clearly distinguish
      the DNA patterns in donor cells from the host cells in the Spanish goat. No
      remaining donor DNA could be demonstrated at 4 weeks in transplanted meniscal
      tissue; it was all of host origin. The host DNA content at 4 weeks approached or
      exceeded the amount present in the contralateral control meniscus. CLINICAL
      SIGNIFICANCE: The results of this study demonstrate that viable cells in medial
      meniscal allografts transplanted from one animal to another do not survive. Host
      cells rapidly repopulate the transplanted meniscus. There is no evidence these
      new cells will maintain on a long-term basis the extracellular matrix of the
      meniscus. The evidence in this paper, that the fibrochondrocytes do not survive
      transplantation, suggests further justification is necessary for using grafts
      with living cells. Allografts with living cells have an increased expense, more
      complicated surgical logistics, and have a higher potential risk of disease
      transmission.

PMID- 8368416
TI  - Prospective study of osseous, articular, and meniscal lesions in recent anterior
      cruciate ligament tears by magnetic resonance imaging and arthroscopy.
AB  - Fifty-four patients with anterior cruciate ligament tears that were
      arthroscopically reconstructed within 3 months of initial injury were
      prospectively evaluated. Patients with grade 3 medial collateral ligament,
      lateral collateral ligament, or posterior cruciate ligament tears were excluded.
      Eighty percent of our patients had a bone bruise present on the magnetic
      resonance image, with 68% in the lateral femoral condyle. Two of the latter
      findings--an abnormal articular cartilage signal (P = 0.02) and a thin and
      impacted subchondral bone (P = 0.03)--had a significant relationship with injury
      to the overlying articular cartilage. Meniscal tears were found in 56% of the
      lateral menisci and 37% of the medial menisci. A significant association was
      present between bone bruising on the lateral femoral condyle and the lateral
      tibial plateau (P = 0.02). Results of our study support the concept that the
      common mechanism of injury to the anterior cruciate ligament involves severe
      anterior subluxation with impaction of the posterior tibia on the anterior femur.
      Determination of the significance of bone bruising, articular cartilage injury,
      or meniscal tears will require a long-term followup that includes evaluation for
      arthritis, stability, and function. These 54 patients represent the first cohort
      evaluated in this ongoing prospective clinical study.

PMID- 8368417
TI  - Arthroscopic treatment of symptomatic extension block complicating anterior
      cruciate ligament reconstruction.
AB  - Arthrofibrosis resulting in loss of knee extension compromises the results of
      anterior cruciate ligament reconstructions. We designed a study to clarify the
      symptoms and to evaluate the results of arthroscopic treatment of this
      complication. Forty-two patients in a series of 959 consecutive open anterior
      cruciate ligament reconstructions required further surgical treatment for relief
      of symptoms related to loss of extension. Arthroscopic examination of these knees
      confirmed the presence of an extension block caused by hypertrophy of the
      ligament or abundant tissue formation in the anterior tibiofemoral joint an
      average of 9 months after anterior cruciate ligament reconstruction. The
      offending tissues were excised arthroscopically and the patients were followed
      with an aggressive rehabilitation program. Thirty-five patients were available
      for followup an average of 28 months after excision of the tissue. Subjective
      functional status and symptomatic status were scored numerically using identical,
      patient-completed questionnaires before and after the excision procedure. Range
      of motion, Cybex, and KT-1000 arthrometer results were also recorded. The results
      were statistically compared with results from a control group demographically
      matched and selected at random from the 959 patients. Before excision of the
      offending tissue, the knee scores of the study group differed significantly from
      those of the control group. However, after the excision procedure, the knee
      scores of the 2 groups were nearly identical. Marked improvements in function and
      symptoms (most notably, activity-related anterior knee pain, crepitus at terminal
      extension, and knee stiffness) were noted in all patients in the study group
      after removal of the extension block and resumption of an accelerated
      rehabilitation program.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368418
TI  - Anatomic considerations in harvesting the semitendinosus and gracilis tendons and
      a technique of harvest.
AB  - Although the semitendinosus and gracilis tendons have long been used in
      ligamentous reconstruction procedures of the knee, their anatomic relationships
      have not been explicitly detailed. Therefore, cadaveric dissections were
      performed on fresh-frozen adult knees to examine these relationships. Several key
      anatomic points are useful in the harvest of these tendons. Their conjoined
      insertion site is medial and distal to the tibial tubercle. They become distinct
      structures at a point that is farther medial and slightly proximal. Tendon
      harvest is facilitated by identifying the tendons proximal to this point. The
      superficial medial collateral ligament lies deep to the tendons in this area and
      should not be disturbed. The tendons are ensheathed in a dense fascial layer that
      may impede tendon stripping. The accessory insertion of the semitendinosus tendon
      (which was present in 77% of the knees dissected) should be identified and
      transected to avoid tendon damage at harvest. Knee flexion may reduce the risk of
      injury to the saphenous nerve as it crosses the gracilis tendon. Variation in
      tendon diameter affects graft strength.

PMID- 8368419
TI  - Effect of anterior cruciate ligament graft tensioning direction, magnitude, and
      flexion angle on knee biomechanics.
AB  - The objective of this study was to determine the biomechanical effect of graft
      tensioning during reconstruction of the anterior cruciate ligament. We evaluated
      the magnitude of the tensioning force (22 or 67 N), the flexion angle at which
      the tension was applied (extension or 30 degrees of flexion), and the direction
      of application of the tensioning force (proximal, distal, or distal with a
      posterior force simultaneously applied to the tibia) on 10 fresh cadaveric knees.
      The anterior cruciate ligament was reconstructed using a bone-patellar tendon
      bone graft. The graft was then temporarily fixed during the application of each
      of 12 combinations of tensioning variables listed above. After each fixation,
      graft force and joint motion were measured during anterior tibial loads.
      Tensioning direction and the flexion angle significantly affected graft force and
      joint motion, while the magnitude of the graft tensioning did not. Graft forces
      were greater when the tensioning was applied at 30 degrees of flexion. Compared
      with distal tensioning with and without posterior tibial force, graft forces with
      proximal tensioning were greater in extension and lower in flexion. The position
      of the tibia relative to the femur was posterior and externally rotated, compared
      with normal, for all combinations of tensioning variables in both unloaded and
      anterior load states.

PMID- 8368421
TI  - Ballet injuries. An analysis of epidemiology and financial outcome.
AB  - The financial outcome and epidemiology of ballet dancers' injuries were studied
      by examining workers' compensation insurance records covering 3 seasons (3 years)
      of activity for a large professional ballet company. One hundred four dancers
      sustained 309 injuries that resulted in insurance payouts for medical costs of
      $398,396. The average cost per injury was $1289. Although only 4.2% of the
      injuries resulted in medical costs exceeding $5000, these represented 60.0% of
      the total medical costs. Nine injuries resulted in medical costs in excess of
      $10,000 each. Overall, there were 2.97 injuries per injured dancer. Twenty-four
      dancers (23.0% of the injured) sustained 5 or more injuries each and thus were
      responsible for 51.9% (161) of all injuries. The foot (74 injuries, 23.9%),
      lumbar spine (71, 23.0%), and ankle (41, 13.3%) were the most frequently injured
      anatomic regions. The experience of this ballet company is similar to that of a
      college athletic department or a professional sports team. All could employ
      similar strategies to reduce injuries and associated costs.

PMID- 8368420
TI  - High- versus low-top shoes for the prevention of ankle sprains in basketball
      players. A prospective randomized study.
AB  - Using a prospective, randomized experimental design, 622 college intramural
      basketball players were stratified by a previous history of ankle sprains to wear
      a new pair of either high-top, high-top with inflatable air chambers, or low-top
      basketball shoes during all games for a complete season. Subjects were asked to
      complete a history questionnaire and were given a complete ankle examination.
      They were allowed to wear these shoes only during basketball competition.
      Followed over the course of a 2-month intramural season, 15 ankle injuries
      occurred during 39,302 minutes of player-time: 7 in high-top shoes, 4 in low-top
      shoes, and 4 in high-top shoes with inflatable air chambers. The injury rates
      (injuries per player-minute) were 4.80 x 10(-4) in high-top shoes, 4.06 x 10(-4)
      in low-top shoes, and 2.69 x 10(-4) in high-top shoes with inflatable air
      chambers. There was no significant difference among these 3 groups, leading to
      the conclusion that there is no strong relationship between shoe type and ankle
      sprains.

PMID- 8368422
TI  - Overuse ballet injury of the base of the second metatarsal. A diagnostic problem.
AB  - Performing classical ballet may cause major stress to the feet of the dancer. A
      variety of foot injuries have been described, with one such injury being an
      overuse syndrome involving the base of the second metatarsal and adjacent
      Lisfranc's joint. The diagnosis for this syndrome usually requires
      differentiating synovitis of Lisfranc's joint from a stress reaction of the base
      of the second metatarsal. Prompt diagnosis is important since the treatment for
      these two conditions differs significantly and, in the case of bone stress
      reaction, delay can cause progression of the lesion. We report good clinical
      results in a group of eight ballerinas for whom we obtained early diagnosis and
      treatment of their injuries. This is in contrast to poor results reported in the
      literature if the diagnosis and management of these types of injuries are
      delayed. We developed a simple diagnostic protocol to enable diagnosis at
      presentation. When a bone stress reaction had progressed to a fracture line, a
      characteristic appearance was found on magnetic resonance imaging, suggesting a
      specific mechanism of injury. A possible mechanism for this injury is discussed.

PMID- 8368423
TI  - Anterior shoulder instability in weight lifters.
AB  - Occult instability is recognized as a major cause of shoulder dysfunction in
      throwing athletes. Few studies have characterized the findings of occult
      instability in nonthrowers. The purpose of this study was to examine shoulder
      instability in a group of weight lifters. The symptoms, physical findings, and
      results of treatment for 23 shoulders in 20 athletes are presented. All athletes
      presented with a complaint of progressive inability to perform exercises with the
      upper extremity in the abducted, externally rotated position (the "at-risk"
      position) because of pain. One hundred percent of the athletes experienced
      posterior shoulder pain when the shoulder was placed in forced abduction and
      external rotation. Thirteen shoulders in 10 patients responded to conservative
      management including aggressive rehabilitation and modification of technique to
      avoid the at-risk position. The other 10 shoulders, which did not respond to
      conservative treatment, required surgical treatment to alleviate the symptoms.
      All 20 patients have successfully returned to their previous weight lifting
      activities.

PMID- 8368424
TI  - Prospective evaluation of the McMurray test.
AB  - The accuracy and interexaminer reliability of the McMurray test for the diagnosis
      of meniscal tears were compared with arthroscopic findings in a prospective study
      of 104 consecutive patients awaiting elective arthroscopy. The only significant
      McMurray sign found to correlate with meniscal injury was a "thud" elicited on
      the medial joint line with a medial meniscal tear (P = 0.05) that had a fair
      interexaminer reliability (kappa = 0.35). The sensitivity of a medial thud was
      16%, and the specificity was 98% with a positive predictive value of 83%.
      Examiner experience had little effect on the accuracy of diagnosis of medial
      meniscal tears. This study supports the continued but limited emphasis on the
      McMurray test in the clinical diagnosis of meniscal tears.

PMID- 8368425
TI  - Quantitative evaluation after arthroscopic anterior cruciate ligament
      reconstruction. Allograft versus autograft.
AB  - We measured the anteroposterior ligamentous laxity and thigh muscle power in 92
      subjects who were rated as successes after they had undergone arthroscopic
      anterior cruciate ligament reconstruction for unilateral anterior cruciate
      ligament insufficiency 18 to 36 months previously. The subjects were divided into
      2 groups according to the type of graft: fresh-frozen allogenic tendon (N = 47)
      or central one third of the ipsilateral patellar tendon (N = 45). Instrumented
      drawer tests in the Lachman position were performed to measure anterior tibial
      displacement at 200 N (anterior laxity). Thigh muscle power was isokinetically
      measured with a Cybex II dynamometer. Significantly more anterior laxity was
      found in the reconstructed knees than in the contralateral normal knees
      regardless of graft material (paired t-test, P < 0.01), except for the male
      allograft patients. Although the mean anterior laxity difference between sides
      for the allograft patients was less than that for the autogenous ones, analysis
      of variance failed to demonstrate a statistically significant difference between
      the 2 groups if the comparison was strictly made within the same sex. Thigh
      muscle tests revealed that extension torque in the reconstructed knees was
      significantly less than that in the contralateral knees and analysis of variance
      showed that knee extension torque at 60 deg/sec for the allograft patients was
      significantly better than that of the autograft ones (P < 0.05). We concluded
      that the allograft procedure is advantageous over the patellar tendon autograft
      in terms of better restoration of anterior stability.

PMID- 8368426
TI  - Tibiofibular synostosis in professional basketball players.

PMID- 8368427
TI  - Pneumoperitoneum as a complication of carbon dioxide knee arthroscopy. A case
      report.

PMID- 8368428
TI  - Unrecognized Achilles tendon rupture associated with ipsilateral medial malleolar
      fracture.

PMID- 8368429
TI  - Comparison of closed and open kinetic chain exercise in the anterior cruciate
      ligament-deficient knee.

PMID- 8368430
TI  - Comparison of closed and open kinetic chain exercise in the anterior cruciate
      ligament-deficient knee.

PMID- 8368431
TI  - Thoracic spine fracture in a football player.

PMID- 8368432
TI  - Does needle-exchange save lives?

PMID- 8368433
TI  - Identification of multiple proliferative growth factors in breast cyst fluid.
AB  - Gross cystic disease is a common benign breast disease that is associated with a
      twofold to fourfold increase in breast cancer risk. Both diseases are hormonally
      induced and may share a common biochemical environment conducive to abnormal
      proliferative responses. A large collection of breast cyst fluid samples was
      analyzed for growth factors associated with cell proliferation: epidermal growth
      factor (EGF), insulin-like growth factor I (IGF-I), insulin-like growth factor II
      (IGF-II), platelet-derived growth factor (PDGF), transforming growth factor-alpha
      (TGF-alpha), and transforming growth factor-beta (TGF-beta). The data demonstrate
      that significant amounts of proliferative growth factors are present in breast
      cyst fluid of all cyst subtypes. The presence of IGF-II, PDGF, and TGF-beta in
      breast cyst fluid was confirmed for the first time. EGF, PDGF, and TGF-beta
      concentrations in breast cyst fluid were several times greater than reported for
      serum; IGF-I and IGF-II concentrations were several times lower. In the first 100
      samples tested, no TGF-alpha was detected. Only EGF and IGF-II levels
      demonstrated a consistent correlation with apocrine type 1 cysts. These results
      demonstrated that effective concentrations of proliferative growth factors are in
      breast cyst fluid and suggest that adjacent breast tissue may be a probable
      source of synthesis. Growth factor profiles of breast cyst fluid may indicate the
      presence in breast tissue of a hormonal and proliferative environment permissive
      to subsequent cancer growth.

PMID- 8368434
TI  - Comparison of APACHE II, Trauma Score, and Injury Severity Score as predictors of
      outcome in critically injured trauma patients.
AB  - Trauma Score (TS), APACHE II score, and Injury Severity Score (ISS) have been
      utilized to quantitate severity of illness in various groups of patients. The
      purpose of this study was to compare the relationship of the APACHE II score, TS,
      and "computer-derived" ISS with outcome in critically injured trauma patients.
      Data were recorded prospectively in a computer database for 428 consecutive
      trauma admissions. Stepwise discriminate analysis was utilized to determine the
      best predictor of both intensive care unit (ICU) and hospital outcome. Forty-two
      patients died in the ICU (10%), and another 18 patients died after leaving the
      ICU (4%), for a total mortality rate of 14%. The mean p value and partial R2
      value obtained from stepwise discriminant analysis of the relationships between
      APACHE II score, TS, and ISS to ICU and hospital survival are shown. APACHE II
      score was the best predictor of both ICU and hospital outcome in these critically
      ill trauma patients. However, when combining all three measures (APACHE II score,
      TS, and ISS), only a portion of the variance in outcome is explained by the
      scores (R2 < 0.05). We conclude that scoring systems for outcome prediction
      should be utilized only as an adjunct to clinical assessment in the evaluation of
      the severity of illness and mortality risk in critically ill trauma patients.

PMID- 8368435
TI  - Portal endotoxin and cytokine responses during abdominal aortic surgery.
AB  - Interleukin-6 (IL-6) is a major marker of tissue injury. Surgery induces a
      systemic IL-6 response related to the magnitude of the operation. An exaggerated
      IL-6 response is associated with the development of major complications after
      aortic aneurysm repair. Endotoxemia is a potent stimulus for cytokine release and
      may occur during aortic surgery. This study attempted to examine whether the
      observed IL-6 response during abdominal aortic surgery is related to the
      development of portal endotoxemia. Serial samples of inferior mesenteric and
      systemic venous blood were obtained before, during, and after aortic cross
      clamping in eight patients undergoing elective aortic aneurysm surgery. Portal
      endotoxemia was detected in only five of the eight patients during the surgery,
      and there was no correlation with the IL-6 response. Both portal and systemic IL
      6 levels rose during the course of surgery, but, by the time of abdominal wound
      closure, the mean portal IL-6 levels were eight times higher than the systemic IL
      6 levels. These results suggest that the portal circulation draining the colon is
      a major source of the previously observed systemic IL-6 response to aortic
      surgery. The IL-6 response is not clearly related to portal endotoxemia but may
      reflect occult cellular injury in the colon occurring during surgery.

PMID- 8368436
TI  - Prediction of the severity of acute pancreatitis.
AB  - We conducted a prospective study to validate our previous finding that serum urea
      and plasma glucose levels on admission could predict the outcome of acute
      pancreatitis. Forty-two (24%) of 176 patients developed complications related to
      the attack of acute pancreatitis and were classified as having severe disease. By
      logistic regression analysis of 17 admission parameters, serum urea and plasma
      glucose levels were again the factors with independent significance in defining
      the outcome. By adopting the same cutoff levels as in our previous study (serum
      urea level greater than 7.4 mmol/L and plasma glucose level greater than 11.0
      mmol/L), and the presence of either factor above the cutoff level as indicative
      of severe disease, the sensitivity of prediction was 79%, specificity 67%, and
      overall accuracy 70%. All the deaths were correctly predicted by this
      urea/glucose criteria. The overall accuracy was also found to be comparable with
      those of the APACHE II (cutoff level greater than 11) and Ranson's scoring
      systems. We conclude that the simple prognostic criteria for acute pancreatitis
      were validated; these criteria have the potential to stratify risk rapidly at the
      time of admission for patients who might benefit from an aggressive
      interventional protocol.

PMID- 8368437
TI  - Selective shunts in selected older cirrhotic patients with variceal hemorrhage.
AB  - Whereas portal systemic shunts pose significant problems in many patients, they
      have long been thought to have particular risks when undertaken in older
      cirrhotic patients, with devastating encephalopathy reportedly common in older
      patients undergoing nonselective shunt surgery. With advances in anesthesia
      management and perioperative monitoring and the advent of selective shunting, we
      postulated that both the operative and long-term outcomes might be improved. In
      this context, we reviewed our recent experience with selective shunts [distal
      splenorenal (DSRS) and small-diameter interposition portacaval grafts (IPCG)] in
      patients over the age of 60 years with variceal bleeding. Nineteen consecutive
      cirrhotic patients over 60 years of age undergoing elective or urgent selective
      shunt surgery for variceal hemorrhage since 1986 were identified. Sixteen
      patients underwent DSRS, and 3 underwent IPCG. The etiologies of the cirrhosis
      were multiple, with 12 of 19 classified as Child's B or C disease. There were no
      operative deaths, and all but one patient returned home following the surgery. No
      patient has had recurrent bleeding or required further surgery for portal
      hypertension-related problems. Three of 19 developed encephalopathy, and 4 of 19
      died of liver failure within 1 year of surgery. Of the 14 patients still alive
      and well (mean postoperative survival: 44 months, range: 4 to 74 months), all
      remain free of encephalopathy and live independently. Based on this experience,
      it would appear that one can anticipate satisfactory short- and long-term
      outcomes after selective shunt surgery in selected patients with variceal
      bleeding over the age of 60 years. These patients with portal hypertension should
      not, therefore, be rejected for shunt surgery based on age alone.

PMID- 8368438
TI  - Mastectomy with and without immediate breast reconstruction using a
      musculocutaneous flap.
AB  - We compared surgical cosmetic results in 83 patients who underwent mastectomy
      with immediate breast reconstruction (MIBR) using a myocutaneous flap with those
      of 153 patients with breast cancer who underwent mastectomy without breast
      reconstruction. Cosmetic results were significantly better in patients who
      underwent MIBR than radical mastectomy or extended MIBR, although no intergroup
      difference existed in the reconstructive technique. Neither did any difference
      exist in the incidence of complications between patients undergoing MIBR and
      mastectomy without breast reconstruction, or between patients undergoing modified
      mastectomy and radical or extended mastectomy. Finally, MIBR did not appear to
      adversely effect recurrence or overall survival. We conclude that MIBR using a
      myocutaneous flap is an acceptable treatment option for patients with breast
      cancer.

PMID- 8368439
TI  - Immunotoxins and recombinant toxins in the treatment of solid carcinomas.
AB  - Cancer remains the second most common cause of death in our society, and advanced
      disease is often refractory to surgical, chemotherapeutic, and radiologic
      interventions. One novel approach to cancer treatment involves targeting a
      cytotoxic agent to a cancer cell. Immunotoxins have been developed that contain a
      potent toxin (either Pseudomonas exotoxin, ricin toxin, or diphtheria toxin)
      coupled to a targeting moiety that directs the molecule to cells expressing a
      certain antigen. Chemically coupled immunotoxins have been developed over the
      past 12 years. These bind to and kill cells expressing many tumor-associated
      antigens. Initial clinical results were disappointing, but recent results have
      been more promising. Furthermore, newer immunotoxins have been developed that
      will soon be in clinical trials. Some of these are recombinant toxins that have
      been developed using techniques of genetic engineering. Transforming growth
      factor-alpha, acidic fibroblast growth factor, insulin-like growth factor-1,
      interleukin-2, interleukin-4, interleukin-6, the binding portions of monoclonal
      antibodies, and CD4 have been used to direct toxins to cancer cells or cells
      infected with the human immunodeficiency virus type 1. Efforts are under way to
      circumvent problems such as immunogenicity that may limit the clinical usefulness
      of immunotoxins.

PMID- 8368440
TI  - Parathyroid localization prior to primary exploration.
AB  - The success of parathyroid surgery is based on accurate localization of normal
      and abnormal parathyroid glands, knowledge of the pathologic conditions, and
      meticulous dissection during removal of the abnormal glands. Although parathyroid
      localization is essential in cases requiring re-exploration, there is
      considerable controversy regarding the indications for localization studies prior
      to primary exploration, since the success rate for surgery exceeds 90% to 95%.
      However, in specific circumstances, including diagnostic problems, technical
      considerations, and high-risk patient factors, preoperative parathyroid
      localization assists the operating surgeon even during the primary cervical
      exploration. The purpose of this paper is to define these specific circumstances
      and discuss the appropriate studies.

PMID- 8368441
TI  - Clinical skills acquired during third-year surgical clerkships.
AB  - An instrument was developed to survey third-year medical students about their
      experience with 18 clinical skills that are generally recognized as required
      learning for the third-year surgical clerkship. The same instrument was adapted
      to ascertain which surgical skills 25 fourth-year medical students, 25 surgical
      residents, and 25 practicing surgeons thought should be acquired during the third
      year surgical clerkship. None of these evaluators had completed medical school or
      residency at our institution. A remarkable degree of conformity was found in the
      rankings of the 18 clinical skills by senior students, surgical residents, and
      practicing surgeons; fourth-year students rated only central venous line
      placement and simple operative procedures as significantly more important than
      did more senior evaluators. The third-year medical students' actual surgical
      clerkship experience with 10 out of the 18 skills was significantly below the
      overall competency levels desired by the graduate groups. Our survey demonstrates
      that both students and graduates attach similar importance to the acquisition of
      clinical skills in the third-year surgical curriculum. The instrument utilized in
      this study to measure students' experience and satisfaction with this phase of
      their education was reliable, the measurements were consistent, and this
      information was useful in the evaluation and modification of the curriculum.

PMID- 8368442
TI  - Laparoscopic cholecystectomy in patients admitted with acute biliary symptoms.
AB  - Laparoscopic cholecystectomy has become the standard of care for the elective
      management of cholelithiasis. Little information exists, however, regarding the
      appropriateness of this procedure in the setting of acute symptomatology. We
      retrospectively reviewed our experience with 516 laparoscopic cholecystectomies
      performed at a single institution from May 1990 to May 1991. Seventy-five (14.5%)
      of these patients were admitted from the emergency department with acute
      abdominal pain (100%), fever (4 of 75, 5%), and/or an elevated white blood cell
      count (22 of 75, 29%). There were 54 females and 21 males, with a mean age of
      50.0 +/- 2.4 years (range: 17 to 89 years). Laparoscopic cholecystectomy was
      attempted in all patients, and was successful in 68 of 75 patients (91%). Seven
      procedures were converted to open cholecystectomy because of the difficulty in
      dissection precluding safe laparoscopic cholecystectomy. The time from admission
      to surgery (mean: 3.4 +/- 0.3 days), as well as the total hospital stay (mean:
      5.5 +/- 0.6 days), was much longer than in the elective circumstance. Mean
      laboratory values for the group as a whole were as follows: white blood cell
      count (mean: 9.6 IU/L +/- 0.4 IU/L, range: 4.1 IU/L to 19.5 IU/L), alkaline
      phosphatase (mean: 97.0 IU/L +/- 13.7 IU/L, range: 27 IU/L to 375 IU/L), and
      alanine aminotransferase (mean: 78.3 IU/L +/- 13.7 IU/L, range: 15 IU/L to 701
      IU/L). Patients requiring open cholecystectomy were older (mean: 61.4 +/- 4.4
      versus 48.8 +/- 2.6), were more likely to be febrile (3 of 7, 42%, versus 1 of
      68, 1%), and were more likely to have a significant leukocytosis (mean: white
      blood cell count 12.9 +/- 1.8 x 10(3) cells/mm3 versus 9.2 +/- 0.4 x 10(3)
      cells/mm3) than were those undergoing successful laparoscopic cholecystectomy.
      Laparoscopic cholecystectomy can be performed safely in the majority of patients
      presenting with acute biliary symptoms. Patients with a triad of acute abdominal
      pain, fever, and elevated white blood cell count, particularly elderly patients,
      are more likely to require conversion to open cholecystectomy, however.

PMID- 8368443
TI  - A new technique of prosthetic arteriovenous fistula construction that eliminates
      the need for temporary access.
AB  - The use of polytetrafluoroethylene (PTFE) for hemodialysis requires a maturation
      period to allow for tissue ingrowth around the graft. If hemodialysis is
      necessary during this waiting period, then temporary access is used.
      Unfortunately, temporary access is difficult, if not impossible, to establish in
      many patients undergoing chronic hemodialysis. We describe a technique for the
      construction of a prosthetic arteriovenous fistula that eliminates the waiting
      period and the need for temporary access in selected patients who require PTFE
      fistulas for hemodialysis.

PMID- 8368444
TI  - Rescue of failed forearm arteriovenous access grafts using an externally
      supported polytetrafluoroethylene graft.
AB  - Thrombosis of the forearm arteriovenous access graft is common. Graft failure
      usually occurs at the venous anastomosis. Thrombectomy with jump extension to a
      more proximal unobstructed vein is recommended. A polytetrafluoroethylene graft
      with externally supported rings across the elbow joint has been used as the
      extension conduit in eight patients over the past 18 months. Satisfactory
      prolongation of graft patency for 6 months or more was achieved in seven of these
      eight patients.

PMID- 8368445
TI  - Impaired bacterial killing in early obstructive jaundice.
AB  - Sprague-Dawley rats were challenged with intraperitoneal injection of 10(7)
      Streptococcus pneumoniae 10 days after common duct ligation (BDL) or sham
      celiotomy (SC). Quantitative bacterial cultures were performed on liver, spleen,
      lung, kidney, and heart blood samples obtained 4 hours after injection. All 13
      (100%) BDL animals had positive heart blood cultures, but only 6 of 12 (50%) SC
      animals remained bacteremic (p < 0.05). Significantly more viable organisms were
      recovered from lung, liver, spleen, and kidney of BDL animals compared with SC
      controls. BDL impaired the host's ability to kill this encapsulated gram-positive
      organism. Viable bacteria remained in all organs studied, which was associated
      with continuing bacteremia.

PMID- 8368446
TI  - Carcinoembryonic antigen assay of intra-abdominal fine-needle aspirates.
AB  - Differentiating abscesses from necrotic tumors has important therapeutic
      implications. Currently, cytologic examination is the "gold standard," but it has
      a low sensitivity for cystic/necrotic tumors. To address this problem, a
      prospective study was conducted comparing the results of cytologic examination
      with those of carcinoembryonic antigen (CEA) immunoassay of fine-needle aspirates
      in 24 patients undergoing radiologically or surgically guided fine-needle
      aspiration. Of 26 fine-needle aspirates, 20 were malignant and 6 benign. Final
      results were correlated with pathologic examination (when available), clinical
      review, and follow-up. Three patients had an abscess associated with perforated,
      recurrent carcinoma, of whom only one had cytologic assessment prior to drainage.
      The sensitivity of fine-needle aspiration was 85%, and for adenocarcinoma alone,
      80%. CEA sensitivity (greater than 5 ng/mL) was 50%, and for adenocarcinoma, 90%;
      the specificity of the assay was 64%. A high CEA level alone was diagnostic of
      metastatic carcinoma of the colon in two fine-needle aspirates. Cytologic
      assessment and CEA assay of fine-needle aspirates and cyst/abscess drainage
      facilitate the diagnosis of unsuspected adenocarcinoma.

PMID- 8368447
TI  - EDTA chelation therapy.

PMID- 8368448
TI  - Morbidity after abdomino-perineal resection.

PMID- 8368449
TI  - Dialysis access.

PMID- 8368450
TI  - Injuries to the portal triad.

PMID- 8368451
TI  - Salvaging the functioning graft.

PMID- 8368452
TI  - Budd-Chiari syndrome.

PMID- 8368453
TI  - Guanine--an adequate index of mite exposure?

PMID- 8368454
TI  - Does guanine concentration in house-dust samples reflect house-dust mite
      exposure?
AB  - Using specific ELISA extracts, we analyzed samples of pure mite cultures and
      house dust for group I allergens from Dermatophagoides pteronyssinus, D. farinae,
      and D. microceras. Correspondingly, we measured the concentration of guanine and
      xanthine by rigorous chemical methods. The pure mite cultures were used to
      correlate allergen levels with guanine levels. The house-dust samples one-sidedly
      contained more guanine than expected. This suggests that considerable amounts of
      guanine originate from non-house-dust mite sources and implies that guanine
      quantifications are of limited clinical value.

PMID- 8368455
TI  - Prediction of mite allergen levels by guanine measurements in house-dust samples.
AB  - We studied the sensitivity and specificity of guanine environmental tests in the
      evaluation of the two mite allergen levels, i.e. 2 micrograms/g and 10
      micrograms/g of Der p I and Der f I, considered to be risk factors for
      sensitization or for the development of acute asthma. We examined 239 house-dust
      samples for Der p I and Der f I levels (ELISA) and guanine contents
      (semiquantitative guanine test and quantitative assays). All house-dust samples
      with class 2 or 3 guanine tests contained more than 2 micrograms/g of Der p I and
      Der f I. The probability that house-dust samples of class 2 contained more than
      10 micrograms/g of mite allergens was 88%; it was 100% for house-dust samples of
      class 3. The probability that a house-dust sample of class 0 contained less than
      2 micrograms/g of mite allergen was 87%. For each level of mite allergen, a ROC
      curve was constructed with the true positive rates and the false positive rates
      calculated by different cutoffs of guanine concentration. The cutoff point which
      gave the best compromise between sensitivity (76%) and specificity (89%) was 2100
      micrograms/g for the threshold of 2 micrograms/g of Der p I and Der f I. For
      detection of a mite allergen > 10 micrograms, a guanine content of 3000
      micrograms/g gave the best compromise between sensitivity (86%) and specificity
      (93%). In conclusion, the guanine test represents a satisfactory environmental
      test, inexpensive and simple, for predicting mite allergen levels.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368456
TI  - The effect of oral drugs on the cytologic picture of nasal mucosa in hay fever.
AB  - The aim of the present study was to assess the influence of H1-antihistamine and
      sympathomimetic drugs given orally on cytologic smears of the nasal mucosa.
      Thirty-five patients with hay fever evaluated cytologic smears of the nasal
      mucosa before and after a 2-week treatment. Fourteen patients received
      chlorpheniramine with phenylephrine, 10 patients dexchlorpheniramine, and 11
      patients pseudoephedrine. The investigated drugs significantly changed nasal
      cytograms. The number of eosinophils increased after chlorpheniramine with
      phenylephrine and after pseudoephedrine but decreased after dexchlorpheniramine.
      Thus, the sympathetic nervous system stimulation seems to produce local
      eosinophilia on the nasal mucosa. In view of such a significant correlation
      between hay fever symptoms and the number of eosinophils in the cytograms, it can
      be concluded that the combination of antihistamine and sympathomimetic drugs may
      adversely affect the course of the disease. Although, at the initial stage of the
      treatment, sympathomimetics reduce swelling and improve the patency of the nose
      through decongestion of the blood vessels, their negative effect can influence
      the immunologic mechanisms.

PMID- 8368457
TI  - Facial thermography during nasal provocation tests with histamine and allergen.
AB  - Changes of skin temperature (T degree) of the nose area during nasal provocation
      tests with histamine and allergen were followed by means of an infrared
      thermography camera. By a colimator system in which temperatures measured on a
      given surface can be integrated and averaged, thermography allows the continuous
      and quantitative recording of the temperature during the whole procedure in a
      completely noninvasive way. In 10 normal subjects, increasing doses of histamine
      induced a dose-dependent rise of the nose external temperature. No significant
      change was observed with the vehicle solution. In six subjects allergic to grass
      pollen, the nebulization of increasing concentrations of a pollen extract induced
      a dose-dependent rise in T degree. The T degree rise observed after histamine or
      allergen corresponded to a marked nasal obstruction. The nebulization of the
      highest dose of the pollen extract did not induce any T degree rise in six
      nonallergic subjects. The continuous recording of the skin temperature by a
      noninvasive method might yield additional information on the vascular changes
      rapidly occurring during nasal challenges.

PMID- 8368458
TI  - Can subjects with a positive allergen skin test be selected by a short
      questionnaire? The Glostrup Allergy Study, Denmark.
AB  - The objective was to evaluate a postal questionnaire screening procedure for
      selection of subjects with positive reactions to skin prick tests with common
      allergens. The project consisted of a screening, with subsequent skin prick test
      of two selected groups. The setting was the Glostrup Population Studies institute
      in Copenhagen, Denmark. Participants in the screening included 8000 subjects,
      aged 15-69 years. The subjects were randomly selected from the population of
      western Copenhagen County, Denmark. From the 6998 respondents (87.5%), 793
      subjects were randomly selected (Random Group), and 788 subjects were chosen on
      the basis of their answers to the questionnaire (Symptom Group). Both groups were
      invited to take skin prick tests. Attendance rates were 75.5% (Random Group) and
      80.6% (Symptom Group). The main outcome measures were responses (yes or no) to
      the specific questions and the subjects' skin reaction (positive or negative).
      The association between symptoms and skin reactivity, adjusted for the effects of
      sex and age, was summarized by odds ratios. Symptoms on exposure to allergens
      were highly associated with positive skin reactivity. In the Symptom Group the
      percentage of subjects with at least one positive skin reaction was 57.7%, which
      was twice as much (28.4%) as in the Random Group. The results show that it was
      possible to select a group with high skin reactivity on the basis of the symptoms
      reported in the screening. Questions about exposure to allergens were the most
      appropriate for selection of this group.

PMID- 8368459
TI  - Prevention of pollen rhinitis symptoms: comparison of fluticasone propionate
      aqueous nasal spray and disodium cromoglycate aqueous nasal spray. A multicenter,
      double-blind, double-dummy, parallel-group study.
AB  - Fluticasone propionate aqueous spray, a new intranasal corticosteroid
      preparation, and disodium cromoglycate 2% aqueous nasal spray, an established
      preventive treatment for seasonal allergic rhinitis, were compared in a double
      blind, double-dummy, parallel-group, multicentric study in France. A total of 218
      patients with seasonal allergic rhinitis caused by grass pollen (verified by
      positive skin prick test) were preventively treated before the onset of the grass
      pollen season with either fluticasone propionate 200 micrograms once daily or
      disodium cromoglycate 5.2 mg four times daily. Half of these doses was given in
      each nostril. Treatment started before the onset of the pollen season in most
      patients (178/218). Diary cards, including symptoms of rhinitis and usage of
      nasal sprays, were filled in twice daily for 6 weeks. Terfenadine in 60-mg
      tablets and eye-drops could be used as rescue medications. We treated 110
      patients with fluticasone propionate and 108 patients with disodium cromoglycate.
      Patients treated with fluticasone propionate had significantly more days free of
      primary efficacy symptoms of sneezing (P < 0.001) and nasal discharge during the
      day (P = 0.002), as well as free of all the other nasal symptoms (P < 0.01), and
      significantly lower median scores (P < 0.05) for all nasal symptoms except nasal
      discharge than patients treated with disodium cromoglycate. There was no
      difference in eye symptoms or in rescue medication use between the two groups.
      Compliance with the treatment was assessed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368460
TI  - Pulmonary function changes in asthmatics associated with low-level SO2 and NO2
      air pollution, weather, and medicine intake. An 8-month prospective study
      analyzed by neural networks.
AB  - This paper presents the response in subjects with asthma to gaseous air-pollution
      levels, weather, and medicine intake as identified by principal-component
      analysis and neural network techniques. Pulmonary function measured by
      respiratory peak-flow rate in nonallergic asthmatics was associated with ambient,
      low-level, air-pollution concentrations of sulfur dioxide and nitrogen dioxide,
      temperature, relative humidity, and medicine intake. Results from 27 nonallergic
      asthmatics aged 18-60 years with well-characterized bronchial asthma and regular
      medical treatment were analyzed from two cities. During an 8-month period, each
      subject kept a diary table, which included symptoms, lung function (evening peak
      flow), medicine intake, and tobacco smoking. High intake of medicine and high
      ambient temperatures corresponded to decreased peak flow. The changes in
      temperature did not occur in situations with low medicine intake. During frost
      periods, peak-flow values decreased independently of medicine intake and levels
      of SO2. During other times, increased levels of SO2 and NO2 increased
      temperature, and increased intake of medicine, and low relative humidity
      corresponded to decreased peak flow. Increased levels of SO2 and NO2 corresponded
      synergistically to decreased peak flow at levels above 40 micrograms/m3.

PMID- 8368461
TI  - In vitro diagnosis of farmers' IgE-mediated allergy by Phadiatop and three new
      multiallergen RAST analyses.
AB  - Identification of persons with atopic allergy in a population is difficult if the
      pattern of sensitizing allergens is unique. Three new multiallergen tests,
      Professional Allergy Mixes (PAX) 1-3 (Pharmacia Diagnostics, Uppsala, Sweden),
      have recently been introduced to screen IgE-mediated allergy among farmers. PAX 1
      contains animal danders and feathers, PAX 2 mites and insects, and PAX 3 pollens
      and molds. The value of these new tests for the determination of IgE-mediated
      allergy among farmers was compared with that of Phadiatop, a test for general
      atopy. Of 440 farmers, 91 were positive to Phadiatop and 97 to any of PAX 1-3.
      None of the farmers were positive in all tests. Only 70/97 sera positive in RAST
      to PAX 1-3 had a positive Phadiatop, whereas of 91 sera positive in Phadiatop, 70
      had specific IgE antibodies to PAX 1-3. The value of using either Phadiatop or
      PAX 1-3 is limited (sensitivity 74-79%), but, together, these four tests will
      detect almost all (95.9%) farmers with IgE-mediated sensitization and all (100%)
      with symptoms. We have also shown that the grain weevil Sitophilus granarius and
      the botfly Gasterophilus intestinalis are important sources of allergens in rural
      environments.

PMID- 8368463
TI  - Regional distribution of asthma-related hospital treatment periods in Finland in
      1972-86.
AB  - We examined the use of asthma-related hospital services in geographically
      different areas of Finland in 1972-86, using data obtained from hospital
      discharge registers. A total of 254,402 cases diagnosed as asthma was identified
      (diagnosis 493, International Classification of Diseases, 8th Revision),
      information on the patient's place of residence enabling comparison of the
      southern, western, eastern, and northern parts of the country. Annual
      hospitalizations and the occurrence of new cases were calculated relative to the
      population, the former being found to increase throughout the country during the
      period studied, the most marked rise being 8.8% in Northern Finland (95%
      confidence interval 6.4-11.3%), and the smallest, 1.1%, in Western Finland (-0.2
      to +2.5). A corresponding trend was also noted in the annual occurrence of new
      cases, which increased most in Northern Finland, i.e. by 4.8% (3.0-6.6), and
      decreased in Western Finland by 2.9% (-3.6 to -2.1). The change in asthma and the
      organization of treatment and factors related to the cold environment may, in
      combination, contribute to difficulties in the treatment of asthma in Northern
      Finland.

PMID- 8368462
TI  - Occupational protein contact dermatitis from herring.
AB  - We present a case of occupational protein contact dermatitis caused by herring in
      a dolphinarium worker. The in vivo and in vitro tests results indicated a type I
      allergic mechanism. In vivo cross-reactivity among fish belonging to the
      Clupeiformes order was observed.

PMID- 8368464
TI  - A comparison of the efficacy of cetirizine and terfenadine. A double-blind,
      controlled study of chronic idiopathic urticaria.
AB  - In a 20-d, double-blind, randomized, parallel study, the efficacy of cetirizine
      and terfenadine was compared in 30 patients with chronic idiopathic urticaria.
      Subjects were randomly divided into two 15-patient groups. The first group was
      given cetirizine (10 mg once daily); the second terfenadine (60 mg twice daily).
      Cetirizine proved to be more effective than terfenadine in controlling urticaria
      symptoms. In fact, the score of the investigators' overall assessment was
      significantly lower in the cetirizine-treated group than in the terfenadine
      treated group. Moreover, patient evaluation by a visual analog scale and symptoms
      assessed on a 4-point scale showed a better improvement in the cetirizine group.
      The number and severity of side-effects were similar in both treatment groups.

PMID- 8368465
TI  - Localized periorbital edema induced by aspirin.
AB  - We documented localized periorbital edema in two patients with aspirin
      sensitivity without underlying chronic urticaria. The reaction developed 30 min
      after ingestion of 62.5 and 125 mg of aspirin, respectively. No systemic symptoms
      were observed. Other NSAIDs did not induce symptoms. These patients were able to
      tolerate doses of aspirin after pretreatment with terfenadine. These observations
      suggest that histamine plays a central role in aspirin-induced skin reaction.
      Despite the fact that terfenadine blocks the drug-induced reaction, this protocol
      should be used with caution and only where there is no feasible alternative to
      aspirin.

PMID- 8368466
TI  - The batch-to-batch variation of the potency of dog- and cat-allergen-coated
      lancets. Evaluation by skin prick testing.
AB  - In clinical work I formed the impression that the potency of Phazet lancets, for
      cat and dog allergens, was lower than earlier and too low to diagnose all
      clinically sensitive children with cat and dog allergy. Therefore, I decided to
      investigate the potency of newly produced and several years old Phazet lancets
      coated with dog and cat allergens. Twenty-six adults with case histories of cat
      and/or dog allergy and skin reactive to extracts of either dog dander or cat
      epithelium were skin prick tested in duplicate with one old batch and one newly
      produced batch of Phazet dog and/or cat lancets as well as the in-house reference
      of cat and/or dog allergen, 100,000 BU/ml. The potency of Phazet lancets in
      relation to the standard was evaluated by the median slope of the allergen dose
      response relationship. The potency of the old dog lancets (mean 48,900 BU/ml) was
      higher (NS) than that of the newly produced lancets (mean 28,000 BU/ml), and the
      potency of both types of lancets was significantly less (P < 0.001) than that of
      the dog allergen in-house standard. On the other hand, the potency of newly
      produced (123,000 BU/ml), but not old (108,000), cat-allergen-coated Phazet
      lancets was higher than that of the cat allergen in-house reference extract (P =
      0.048). There was a marked variation in potency between patients. Most of this
      variation was due to factors varying between patients, not between lancets,
      indicating that the composition of the allergen on the lancets was partly
      different from that of the standard.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368467
TI  - Human proteins in house dust.

PMID- 8368468
TI  - Anaphylactic reaction to ranitidine.
AB  - Ranitidine is a well-tolerated H2-receptor antagonist with a furan ring as
      nucleus. Anaphylactic reactions are seldom reported despite the wide use of the
      drug. We report a patient who presented an anaphylactic reaction with ranitidine
      (Zantac). The positive skin prick test and oral challenge suggest type I
      hypersensitivity. Specific IgE determination by RAST technique and histamine
      release test with ranitidine were negative. The patient did not react to other H2
      receptor antagonists or to another furan-derivative (nitrofurantoin).

PMID- 8368469
TI  - Cross-reactivity between quinolones. Report of three cases.
AB  - Cross-reactivity between quinolones is uncertain. Recently, we studied three
      patients who had developed suspected allergic reactions to a quinolone. For all
      of them we performed skin test, histamine release test, RAST, and oral
      provocation with the suspected quinolone and also with another quinolone of the
      opposite generation. Five atopic and five nonatopic subjects were used as
      controls. Neither skin test, histamine release test, nor RAST was useful in the
      diagnosis. By means of oral controlled provocation, the reactions were
      reproduced, and all the patients also reacted to another quinolone. We concluded
      that cross-reactivity between quinolones seems to be very important, and
      avoidance of any quinolone should be recommended to any patient who has suffered
      an allergic reaction to one of these drugs.

PMID- 8368470
TI  - [Routine postoperative epidural analgesia. X-ray control of epidural catheter
      position and prevention of the spread of epidural contrast media].
AB  - In the last few years epidural analgesia with bupivacaine and/or opioids has
      become an important technique in the therapy of postoperative pain. Using
      bupivacaine only 2-20% of the patients are treated without sufficient success. To
      ascertain and evaluate the underlying reasons for this, we prospectively
      investigated 51 patients routinely, and 6 patients with an insufficient analgetic
      effect from a group of 212 patients, by means of epidurography. All patients were
      treated mainly with bupivacaine. The observed and documented radiographic data
      were compared with the individual analgetic results. METHODS. All investigations
      were performed within 24 h after placing the catheters. The contrast agent was
      injected under radiographic guidance in two different positions, and the end of
      the distribution was documented in the anterior-posterior ray path. In group I (n
      = 26) the catheter position and the distribution of the contrast medium with 3.0
      ml iopamidol were documented. In group II (n = 25) the catheter position was
      documented in the same way, but the distribution was documented for the stepwise
      injected contrast medium (3.0 ml + 2.0 ml + 3.0 ml). As a result of these
      findings we changed our epidural catheter placement concept in the following
      patients (group III, n = 212), and performed radiographic examinations in
      patients with a therapy failure only (group IIIa, n = 6). Instead of placing the
      catheter postoperatively mostly lumbal in a lateral position, we now placed them
      preoperatively, in the sitting position, as near as possible to the centre of the
      segments to be treated. RESULTS. Only 27 patients demonstrated an ideal catheter
      position and a typical contrast medium distribution. Three of these patients
      still could not be treated successfully. In 12 patients the spread of the
      contrast medium was inhomogeneous, and in 5 patients the contrast medium was
      found on one side of the epidural space only. Half of these 17 patients (n = 9)
      needed supplementary therapy. Surprisingly, 4 of 8 patients with a paraepidural
      catheter position were treated with success. DISCUSSION. Effective bupivacaine
      therapy by epidural catheter injections constitutes no striking evidence for a
      correct epidural catheter position. If the catheter lies in the epidural space,
      the actual therapeutic effect of bupivacaine therapy is determined mainly by the
      distribution of the substance. The epidural position of the catheter--central or
      lateral in the epidural space--seems, however, not to be particularly important.
      If high-quality analgesia is to be achieved with bupivacaine alone, or in
      combination with an opioid, the catheter should usually be placed near to, or
      better into the centre of the segments to be treated. The results demonstrate
      that in the case of failure of epidural catheter therapy, epidurographic
      examinations are very helpful in ascertaining and evaluating the underlying
      reasons for this failure and in coming to a logical decision for changing the
      concept.

PMID- 8368471
TI  - [The effect of different autotransfusion procedures on the antibiotic picture. A
      study on cephalosporin cefamandole].
AB  - Infection after open heart surgery is a serious complication since eradication of
      infection in these cases is difficult even with appropriate antibiotic therapy.
      In the attempt to avoid this problem, prophylactic administration of antibiotics
      is common. Their relative safety and their broad spectrum of activity make
      cephalosporin antibiotics popular choices for prophylaxis prior to and during
      operations, including cardiovascular procedures. METHODS. Preoperative antibiotic
      prophylaxis with 2 g cefamandole was performed in a prospective randomized study
      including 62 male patients divided into three groups. All patients gave informed
      consent, and the study was approved by the ethics committee of the hospital.
      Patients in group 1 (n = 21) and group 2 (n = 21) underwent aortocoronary bypass
      (ACVB) with extracorporeal circulation (ECC), while patients in group 3 (n = 20)
      had carotid surgery. Anaesthesia, coronary-bypass procedures and infusion regime
      were standardized. The flow rate during ECC was maintained at 2.41/min/m2 and the
      rectal temperature between 33 degrees and 34 degrees C. Arterial and urine
      specimens for the determination of plasma and urine levels of cefamandole were
      taken at definite times. Autologous blood salvage during operation was performed
      with haemofiltration techniques (HF) in group 1 (HF 80, Fresenius, Bad Homburg,
      Germany) and with cell separation techniques (CS) in group 2 (Hemonetics III,
      Hemonetics). Plasma and urine cefamandole levels were measured by high-pressure
      liquid chromatography (HPLC). RESULTS. After administration of 2 g cefamandole
      mean peak levels of 404.6 +/- 141.7 micrograms/ml were seen. Because of
      haemodilution at the beginning of extracorporeal circulation, group 1 and 2
      showed much lower cefamandole plasma levels, 22.1 +/- 11.6 micrograms/ml and 24.3
      +/- 14.4 micrograms/ml, than group 3 (after the same time course), with 47.4 +/-
      19.1 micrograms/ml. For all patients in group 1 and 2 prebypass time (70.3 +/-
      22.4 min) and the duration of the ECC (72.3 +/- 17.7 min) were comparable. There
      was a significant correlation between prebypass time and cefamandole plasma
      levels at the beginning of extracorporeal circulation (P < 0.001). No correlation
      could be seen for the plasma concentration after discontinuation of the
      extracorporeal circulation and the duration of extracorporeal circulation. The
      volume of autologous red packed cells and the enclosed amount of cefamandole
      showed a significant difference (P < 0.001) between group 1 (1120.0 +/- 296.8 ml,
      27.5 +/- 17.1 mg) and group 2 (734.3 +/- 186.6 ml, 2.9 +/- 3.2 mg). The plasma
      cefamandole level after transfusion of autologous blood displayed a significant
      correlation (p < 0.01) with cefamandole concentration in the autologous red
      packed cells. Transfusion of the autologous blood produced no significant
      increase in plasma cefamandole levels. With an operation time of more than 2.5 h
      during ECC the cefamandole plasma level decreased below the necessary minimal
      inhibitory concentration (MIC90), particularly for gram-negative bacteria.
      CONCLUSION. Additional administration of 1 g cefamandole shortly before the
      beginning of cardiopulmonary bypass is recommended, particularly for surgical
      procedures with ECC of more than 2.5 h. Adjustment of drug dosage prior to or
      during surgery may be required to optimize therapy, but before this can be
      achieved precisely, more information on drug disposition during the operative
      procedures is needed.

PMID- 8368472
TI  - [The potential dependence of the effect of bupivacaine and ropivacaine on the
      heart. In-vitro studies on the effect of local anesthetics on the force of
      contraction and the action potential in left guinea pig atria].
AB  - The cardiotoxicity of long acting local anaesthetics is still a matter of
      controversy. Therefore, the effects of bupivacaine and ropivacaine on cardiac
      contractility and electrophysiologic parameters were evaluated in the presence of
      different extracellular potassium concentrations. METHODS. In strips from left
      atria of guinea pigs action potentials were induced to obtain cumulative dose
      response curves for bupivacaine (racemic mixture) and ropivacaine (S-enantiomer).
      Effects on force of contraction and parameters of the action potential
      (especially maximum upstroke velocity, dV/dtmax, as an indirect measure of fast
      sodium channel function) were compared for low (2.7 mM) and high (8.7 mM)
      extracellular K+ concentrations (n = 7-8). RESULTS. At low K+ concentration,
      bupivacaine and ropivacaine depressed force of contraction and dV/dtmax in a dose
      dependent manner. At higher local anaesthetic concentrations, action potential
      amplitude decreased and action potential duration was prolonged. There was no
      influence on the resting membrane potential (Tables 2, 3). At high K+
      concentration, both local anaesthetics induced effects similar to those observed
      with low K+, but the dose-response curves for contractility and dV/dtmax were
      shifted leftward. The EC50 of bupivacaine for the negative inotropic effect and,
      analogously, for dV/dtmax was approximately 10 times lower. Similar results were
      observed for ropivacaine (Figs. 1, 2). CONCLUSION. This study confirms the
      dependence of the cardiodepressive effects of bupivacaine on the extracellular K+
      concentration (i.e. membrane potential). The present investigation shows a
      similar dependence for the effects of ropivacaine, a new long-lasting local
      anaesthetic. Our results concerning the potential dependency of dV/dtmax
      depression are compatible with the binding of bupivacaine to the inactivated
      state of the sodium channel protein preferentially (modulated receptor
      hypothesis). Thus accumulation of block will occur if stimulation frequency is in
      an appropriate range. Though we found striking analogies between potential
      dependency of dV/dtmax depression and negative inotropic effect, there is no firm
      evidence that the sodium channel block by bupivacaine or ropivacaine
      substantially participates in the latter effect. An influence on other ionic
      channels such as the calcium channel remains to be evaluated.

PMID- 8368473
TI  - [The neuropathy of the autonomic nervous system. An additional anesthetic risk in
      diabetes mellitus].
AB  - Some 20-40% of diabetics suffer from an autonomic neuropathy. This complication
      of diabetes mellitus impairs the regulation and the reflexes of the
      cardiovascular system. This study compares the cardiovascular characteristics of
      diabetics and nondiabetic control patients. METHODS. 21 patients (11 diabetics,
      10 nondiabetics) undergoing ophthalmic surgery were investigated. They were
      tested preoperatively for autonomic cardiovascular dysfunction by application of
      four established tests. These were: heart rate responses to the Valsalva
      maneuver, deep breathing and standing up (30/15 test) and the Schellong test. The
      anaesthesia was induced with fentanyl (0.1 mg), etomidate (2.5 mg/kg) and
      succinyl choline (1.5 mg) and maintained with oxygen/nitrous oxide (1.4:3 l/min)
      and isoflurane (0.2-0.8 vol%). Blood pressure and heart rate were automatically
      measured every minute during induction of anaesthesia and every 3 min during
      anaesthesia. Additionally the heart rate response to 0.5 mg atropine i.v. was
      evaluated. RESULTS. The autonomic function tests revealed pathologic reactions in
      all diabetics (two early, six definitive, three severe) and none in controls.
      Remarkable cardiovascular events occurred exclusively in the diabetic group,
      especially during induction of anaesthesia. The systolic blood pressure (SAP)
      increased in diabetics from a preinduction value of 150 mmHg (median, range 105
      205 mmHg) to a maximum of 200 mmHg (160-250 mmHg) after intubation, in controls
      from 130 (100-150 mmHg) to 170 (110-190 mmHg). Following this peak, SAP fell in
      diabetics to 120 mmHg (80-160 mmHg), in controls to 110 (100-140 mmHg). Two
      diabetics had to be treated because of an SAP exceeding 220 mmHg, two other
      diabetics because of an SAP below 80 mmHg. After atropine administration the
      heart rate of diabetics showed a median increase of 15% (range 0-40%). In four
      diabetics, however, the increase was less than 10%. In control patients the
      increase was 50% (40-80%). All patients with severe cardiovascular reactions
      during induction of anaesthesia and with heart rate elevation following atropine
      of less than 10% had a definite or severe neuropathy of the autonomic nervous
      system revealed by the tests. DISCUSSION. In the only slightly stressful
      ophthalmic surgery, remarkable events were noted particularly during the
      induction of anaesthesia. The critical decreases and increases of SAP might be
      related to the autonomic dysfunction, because of the hypersensitivity of a partly
      damaged autonomic nervous system or its impaired function. This led to a loss of
      heart rate variation and adequate blood vessel tone. The severe cardiovascular
      reactions always went along with clearly pathologic findings in the tests
      performed. Normal test results in diabetics implied normal cardiovascular
      reactions, as could be observed in nondiabetics. CONCLUSION. Abnormal
      cardiovascular reactions in diabetics must be kept in mind. The simple tests
      specified here can identify such predisposed patients.

PMID- 8368474
TI  - [Computer-aided anesthesia monitoring. Experiences with the use of three systems
      in heart surgery].
AB  - Basic monitoring in cardiac anaesthesia embraces at least 19 different parameters
      of haemodynamics and blood gas analysis. In special cases additional measurements
      may be desirable, providing a total of up to 44 variables displayed on various
      monitors, as depicted in Fig. 2. The recording of such an amount of data is only
      feasible with automated recording systems. Therefore, in the past 6 years we have
      introduced three different computer systems to our cardiac anaesthesia
      workplaces. The experiences in their handling are reported. MATERIAL AND METHOD.
      Three systems were investigated: (1) System S 4000 (Siemens, Germany), based on a
      central processor unit (PDP 11, DEC, Japan) connected with 20 bedside
      input/output terminals and Sirecust 404a monitors (Siemens). The system collected
      the data in a ring buffer with a capacity for about 24-48 h. (2) Patient Care
      Manager (PCM; Siemens, Germany), a single workplace system based on an IBM
      compatible personal computer (PC) with the operating system environment DOS
      5.0/Windows 3.0. In our test configuration it was connected with a Sirecust 1281
      monitor (Siemens). (3) Monitor-Data-Manager (MDM) (our own development). This
      single workplace system is also based on an IBM-compatible PC running under DOS
      and was connected to four different monitors used in our cardiac surgery
      operating theatre (Fig. 2). A second computer (Sirecust S 425, Siemens) served as
      an interface between the two 404 monitors (not featuring a serial output like RS
      232) and the PC. The self-developed program for that interface was memory
      resistant and executable with three key presses when the anaesthetic record was
      started. The three systems were compared with regard to their ease of use,
      function and practicability. RESULTS. System S 4000: Because of the older system
      architecture, the response time to key inputs was fairly long and the menu
      structure somewhat uncomfortable. A major drawback was the limited data buffer
      capacity and the lack of a long-term storage medium as well as the lack of
      compatibility with the industry standard for PCs. Software interfaces to other
      companies' monitors were not implemented, limiting the system to the Sirecust 404
      devices. Patient-Care-Manager: The user interface is a Windows 3.0 application
      representing an up-to-date graphical environment. Unfortunately some Windows
      features were not fully used, e.g. the free positioning and sizing of graphic
      windows and the color options. Drug inputs were somewhat long-winded, limiting
      the system's suitability for the operating theatre. The main disadvantage,
      however, was the lack of interfaces to monitors other than those from Siemens.
      Monitor Data Manager: The system was designed to sample data from all monitors
      operating in our hospital's heart surgery department. Each parameter was
      displayed in a digital form to get close control over the recorded data (Fig.
      1b); additionally calculated values like total peripheral resistance or oxygen
      demand could be drawn from a separate window. Furthermore, key inputs were
      reduced to minimum, making drug inputs faster than the hand-written protocol. The
      ease of performing calculations of continuous drug infusions (from
      microgram/kg/min to ml/h pump speed) was particularly appreciated by the users.
      Since the data were saved as an ASCII file, they could easily be imported by any
      spreadsheet like Lotus 1-2-3 or Excel, providing the whole variety of their
      graphical presentation or calculation features. Because of the high sampling rate
      (3 min), even short-lasting drug effects could be registered, making the system
      favourable for scientific studies. CONCLUSION. Automated monitor data record
      systems are considered to be a prerequisite not only for research in anaesthesia
      but also for quality assurance. A basic requirement for wide acceptance in
      clinical practice is a user interface that provides fast and convenient key
      inputs as well as further information about parameters not displayed on other
      monitors. In our h

PMID- 8368475
TI  - [Radiologic position control of epidural catheters (epidurography). An instrument
      of quality assurance for regional analgesia].
AB  - Epidural analgesia is a very efficient method of postoperative pain management.
      Nevertheless, problems such as unilateral analgesia, sensory loss and inadequate
      pain relief are often difficult to handle. Radiologic evaluation of the position
      of the catheter and the spread of radiopaque dye (epidurography) is an important
      advance toward a solution of these problems. METHODS. The findings of 110
      consecutive epidurographies from the acute pain service of the Department of
      Anaesthesiology of the University Hospital of Kiel, Germany, were analysed.
      Radiograms were obtained following the injection of 2 ml and an additional 8 ml
      of radiopaque dye (iopamidol) in the anterior-posterior and lateral plane. In
      addition, typical and instructive examples of epidurographies from the past 8
      years are presented. RESULTS. In 99 of 110 patients the epidurography revealed a
      proper position of the catheter. Seven cases of partial displacement (e.g.
      paravertebral spread of radiopaque dye) and two cases of complete misplacement
      were documented. Allergic reactions or other side effects were not observed. The
      radiologic criteria for a proper epidural position of the catheter are discussed
      (Fig. 2a). Furthermore, examples of the following malpositions of epidural
      catheters are presented: intravascular misplacement (Fig. 2b), paravertebral
      misplacement (Fig. 2c), paravertebral escape of radiopaque dye (Fig. 2e) and
      correct distribution after the catheter had been withdrawn 2 cm (Fig. 2f),
      intrathecal misplacement (Fig. 2g), and simultaneous spread of dye in the
      subarachnoid and epidural space in a patient with preceding dural tap (Fig. 2h).
      In some cases unexpected reasons for problems in postoperative pain management
      were revealed by epidurography (e.g. disc prolapse, (Fig. 2d). CONCLUSION. In our
      view epidurography is a valuable way of improving the quality and safety of
      postoperative epidural analgesia. It is an important tool for decision-making in
      the event of clinical problems. The benefits for the patients have to be weighed
      against the radiation exposure.

PMID- 8368476
TI  - [Morphine tablets for chronic non-tumor-induced pain. Which factors modify the
      success or failure of a long-term therapy?].
AB  - In a prospective study 60 patients receiving morphine for treatment of mostly
      neuropathic and musculoskeletal pain of non-malignant origin were investigated.
      The aim of the study was to determine the characteristics of responders to
      morphine therapy and the frequency and severity of side effects. METHODS.
      Eligible patients suffered from chronic pain that had not been relieved despite
      all current therapy. All of them received controlled-release morphine tablets.
      Dose was increased in case of insufficient pain relief. Before morphine treatment
      and at the follow-ups pain intensity was rated on a numeric analogous scale,
      analgesia and side effects on a four-stage verbal rating scale. Intake of the
      prescribed and other drugs was randomly controlled by urine analysis. The
      patients were divided in three groups retrospectively: group I, non-responders
      who ceased the morphine therapy within 1 month due to weak analgesia or severe
      side effects; group II, patients in whom the therapy was stopped within the
      following months despite persisting pain; group III, patients who continued
      therapy. STATISTICS. ANOVA, chi-squared test, non-parametric tests (Kruskal
      Wallis, Wilcoxon). Results were accepted as significant at p < 0.05. RESULTS.
      Twenty-three patients were non-responders. Fourteen other patients stopped the
      therapy after initial response because the side effects exceeded the benefit of
      analgesia (group II). Only 10 of the remaining 23 responders had good analgesia
      and minor side effects during the observation time. Constipation, despite
      prophylactic laxatives, and nausea were the most frequently reported events
      causing cessation of therapy. Analgesia and side effects in groups II and III
      were constant during the observation time of 241 (36-1486) days. In groups II and
      III, 43% of the patients needed an increase of the morphine dosage during
      therapy. The initially sufficient morphine dosage was significantly higher in
      group II than in group III; only one patient needed more than 90 mg/day in group
      III. Urine screening tests in 45 patients disclosed that 18 patients concealed
      the intake of other opioids or psychotropic drugs, mostly benzodiazepines.
      CONCLUSIONS. The study showed many problems with the patients' compliance and
      acceptance of oral morphine due to side effects and lack of analgesia. The
      discrepancy from other, positive reports might be explained by the extremely
      selected patients of this study and by the fact that not only responders were
      included for evaluation. Patients' compliance seems to have been overestimated in
      previous studies because no urinary controls were taken.

PMID- 8368477
TI  - [Epidural spinal cord stimulation in therapy-resistant angina pectoris].
AB  - Spinal cord stimulation (SCS) has routinely been used since the beginning of the
      1970s. The initial indications for stimulation were the so-called deafferentation
      or neurogenic pain. Further work has confirmed that neurostimulation is useful in
      severe peripheral vascular disease in relieving pain and increasing capillary
      blood flow and oxygen tension. The effects are similar to those of sympathectomy.
      In 1964 Apthorp et al. discovered that sympathectomy relieved angina in about 75%
      of patients. The use of SCS to treat angina follows logically from its use in
      peripheral vascular disease. METHODS. The pain-relieving effect of SCS was
      investigated in two patients, 54 and 69 years old, who were hospitalised for 8
      and 28 days. Both patients had severe angina pectoris (duration 2 and 15 years,
      New York Heart Association class III and II), related to three-vessel disease,
      and one of them had previously undergone his third bypass operation. The other
      patient was not considered suitable for surgery. The antianginal treatment (long
      acting nitrates, beta-blockers, calcium antagonists) was regarded as optimal and
      was not changed during the observation period (Table 1). SURGICAL TECHNIQUE AND
      STIMULATION EQUIPMENT. We used the commercially available Medtronic SCS system.
      The operation was performed under local anaesthesia to allow the patient to
      answer questions during the intraoperative stimulation. The epidural space was
      punctured at the level of T7-T8 in one case and T11-T12 in the other. The
      electrode tip was positioned in the midline or a few millimetres to the left at
      the T1-T2 level (Figs. 1, 2), so that the patient felt a prickling sensation in
      the precordial area and into the arms. The distal end of the electrode was
      sutured to the fascia and connected via a tunnelled extension lead to the
      external pulse generator. The pulse width was 200 microseconds, frequency 80 Hz.
      An appropriate amplitude (usually 8-10 V) was used for comfortable paraesthesia.
      The study consisted of two parts: a run-in period (1 week) to standardise the
      stimulation when mobilisation was performed. A treatment period (18 months) to
      determine the patient's working capacity after continuous stimulation (Table 2).
      After a successful run-in period a Medtronic receiver was implanted, connected to
      the electrode and stimulated by external pulse generator. Different variables
      were used to assess the effect: pulse rate, blood pressure, the product of pulse
      rate and systolic blood pressure, estimated anginal pain, and ST changes in the
      electrocardiogram (ECG) before, during and after mobilisation. RESULTS. The
      stimulation was carried out for 30 min 10-12 times a day during the run-in period
      and five to six times a day during the treatment period. Altogether there was
      slight lowering of heart rate and systolic blood pressure. Consequently the
      product of heart rate and systolic blood pressure was diminished. In one case
      (NYHA II) the distinct disorder of repolarisation reverted to the normal
      condition as shown on ECG. In the other case (NYHA III) the ECG remained
      unchanged because of a severe aneurysm of the cardiac wall. Both patients
      experienced nearly complete pain relief after a few days for 6 and 12 months
      respectively. However, an increasing effort tolerance could be demonstrated in
      both patients by reducing the extent of the heart failure (NYHA II/III to NYHA
      I/II) (Table 2). DISCUSSION. Our two hospitalised patients had clinically
      intractable angina pectoris and severe manifestations of heart disease
      corresponding to at least NYHA functional class II-III. Both were unsuitable for
      operation and showed no improvement on individually titrated maximal oral
      antianginal drug treatment. During SCS treatment significant improvement was
      obvious: chest pain, ST-segment depression, and the extent of heart failure could
      be reduced. Both patients reached a better NYHA functional class, exhibited
      increased working capacity and reported reductions in anginal attacks and pain.
      Th

PMID- 8368478
TI  - [Emergency 12-hour transesophageal stimulation in a 21-month-old infant].
AB  - In a 21-month-old child with complex cyanotic congenital heart disease an
      aortopulmonary shunt was created as preparation for a modified Fontan operation.
      During the early postoperative period low cardiac output with right atrial
      pressures of 20 mm Hg developed due to a slow ventricular tachycardia
      (ventricular rate 135 bpm). Pharmacological interventions (isoprenaline 0.01
      mg/kg hourly and lidocaine 1 mg/kg hourly were without any effect. As epicardial
      pacing leads had not been implanted during surgery, atrial pacing was performed
      via the transoesophageal route using a 9.5-F bipolar electrode catheter with an
      interelectrode distance of 15 mm. Atrial capture could be established with an
      impulse width of 9.9 ms and 10 mA output at a rate of 150 bpm. With restoration
      of atrioventricular synchronicity, right atrial pressure finally decreased to 10
      mm Hg with consecutive stabilization of the cardiovascular status. After 12.5 h
      transoesophageal pacing could be stopped without any problems due to spontaneous
      cessation of ventricular tachycardia. No clinical signs of oesophageal injury
      were noted. It is concluded that transoesophageal pacing is a practical, safe and
      effective method for emergency cardiac pacing.

PMID- 8368479
TI  - [AIDS].

PMID- 8368480
TI  - Cycled primer extension: a method for DNA amplification and labeling from
      templates of unknown sequence.
AB  - A method has been developed for simultaneous radiolabeling and amplification of
      DNA hybridization probes. The method is termed cycled primer extension (CPE). CPE
      is a series of temperature-driven reactions in which template DNA is successively
      denatured and extended by a thermostable primer-dependent DNA polymerase. The
      primers consist of semirandom nanomers of the form 5'-NNN NNN (G/C)(G/C)(G/C)-3'.
      These nanomers have the capacity to anneal to any template DNA and serve as
      initial anchors for extension at the high temperatures required for Taq DNA
      polymerase activity. CPE cycles consist of 94 degrees C denaturation, annealing
      of primers to template upon ramping to 24 degrees C, and gradual extension of the
      primer along the template as temperature is ramped back to 94 degrees C. Labeling
      efficiency with [32P]dCTP was examined and optimized as determined by the
      relation to ratios of radiolabeled to unlabeled dCTP, by number of cycles, and by
      primer composition and sequence. CPE probes can be generated without regard to
      size or sequence of template and have a high specific activity (approximately
      10(9) dpm/micrograms). With CPE, hybridization signals equivalent to those from
      random primed probes are routinely obtained with initial template amounts as low
      as 1 ng.

PMID- 8368481
TI  - Method for simultaneous detection of protein kinase A, protein kinase C, protein
      tyrosine kinase, and calmodulin-dependent protein kinase activities.
AB  - We report a simple method that permits simultaneous detection of multiple protein
      kinase activities using postnuclear supernatant of v-src transformed NIH3T3
      cells. A supernatant is incubated with activators of protein kinases and [gamma
      32P]ATP, and the phosphorylated proteins are analyzed by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis and autoradiography. The method enables
      detection of activities of at least four protein kinases (protein kinase A,
      protein kinase C, protein tyrosine kinase(s), and calmodulin-dependent protein
      kinase III) on a single gel. Experiments using various specific activators and
      inhibitors of protein kinases indicated that this method can, in crude
      preparations, reliably detect the protein kinase activities intended for
      measurement. Protein kinase C activity disappeared when membranes were
      solubilized, demonstrating the importance of membrane environment for its
      function. This method should be particularly useful for evaluating and screening
      protein kinase inhibitors.

PMID- 8368482
TI  - Activity measurement and multiplicity detection of human secretory-type
      ribonuclease based on polycytidylic acid/ethidium bromide fluorescence.
AB  - Two analytical methods for human secretory-type ribonuclease, which are based on
      polycytidylic acid/ethidium bromide fluorescence, have been developed. The first
      is a method for measurement of secretory-type ribonuclease activity utilizing the
      radial diffusion of ribonuclease in a thin agarose gel plate containing
      polycytidylic acid and ethidium bromide. Ribonuclease activity was visualized as
      a dark circle on a fluorescent background under ultraviolet light after immersing
      the gel in a cooled acidic solution. The radius of the dark circle was
      proportional to the amount of the enzyme. This method allows quantitation of
      human secretory-type ribonuclease down to at least 5 x 10(-5) unit, which
      corresponds to 60 pg. Secretory-type ribonuclease activity in 18 different human
      tissues and body fluids was measured. The second method is a zymogram technique
      for detection of secretory-type ribonuclease after isoelectric focusing, which
      includes placing a dried agarose film containing polycytidylic acid and ethidium
      bromide on the focused gel. Human secretory-type ribonuclease (less than 3 x 10(
      4) unit) was detected with a high band resolution on the same principle as that
      of the activity assay described above.

PMID- 8368483
TI  - Synthesis and characterization of N-octanoyl-beta-D-glucosylamine, a new
      surfactant for membrane studies.
AB  - The new nonionic glycosidic surfactant N-octanoyl-beta-D-glucosylamine (NOGA,
      molar mass 305.37 g) was synthesized through an easy and efficient two-step
      procedure. Specifically, beta-D-glucosylamine was obtained by the replacement of
      the anomeric hydroxyl of D-glucose by an amino group which was then selectively
      acylated. NOGA was finally purified by silica gel column chromatography and
      recrystallization. This compound is stable and soluble in water and usual buffers
      up to 80 mM at 4 degrees C and up to 0.2 M at 37 degrees C. NOGA solutions are
      also characterized by a low ultraviolet light absorbance above 250 nm (epsilon
      280 approximately 1.5 M-1 cm-1). Due to its very high critical micelle
      concentration (CMC = 80 mM, as determined by spectrofluorimetry), this surfactant
      may easily be removed from samples by dialysis or, to a lesser extent, by
      adsorption onto hydrophobic beads. Furthermore, NOGA is colorimetrically titrable
      by the ninhydrin method and its weak interference in protein determination by the
      bicinchoninic acid method is easy to overcome. This surfactant exhibits a good
      solubilizing power toward membrane proteins, with a marked selectivity for
      spiralin, a bacterial surface antigen. Protein extraction started below the CMC,
      but was much more effective above this concentration threshold. NADH oxidase
      activity, ligand binding by the glycine betaine-binding protein, and antigenicity
      of more than 20 membrane or soluble proteins were not altered by NOGA. Thus,
      owing to its extraction efficacy and mildness toward protein structure and
      activity, NOGA should prove useful for membrane studies and offers the additional
      advantage of being easy to synthesize at low cost.

PMID- 8368484
TI  - Sulfotransferase and glycosyltransferase analyses using a 96-well filtration
      plate.
AB  - Previously, we identified and characterized a sulfotransferase responsible for
      the 4-O-sulfation of Asn-linked oligosaccharides terminating with the sequence
      GalNAc beta 1,4GlcNAc beta 1,2Man alpha (GGnM). Here we present a rapid and
      sensitive method to assay for this sulfotransferase which is significantly more
      convenient than existing procedures. The acceptor substrate in this assay is
      human transferrin (Tfn) which has been enzymatically modified such that its N
      linked oligosaccharides bear the terminal sequence GGnM. GGnM-Tfn is
      biotinylated, and a fluid-phase transferase reaction is done which utilizes
      [35S]3'-phosphoadenosine 5'-phosphosulfate ([35S]PAPS) as the sulfate donor. The
      reaction product [35S]SGGnM-Tfn-biotin is separated from unreacted [35S]PAPS and
      radiolabeled endogenous acceptors by capture onto avidin immobilized onto a PVDF
      based 96-well filtration plate. Sulfate incorporation in this assay is linear
      with respect both to the donor and to the acceptor substrates and is also
      dependent upon enzyme input and time. With this assay, we can detect as little as
      0.1 pmol of sulfate transfer. In addition, by using asialo-Tfn-biotin as an
      acceptor and [3H]CMP-sialic acid as a donor substrate, we demonstrate that this
      assay can be modified for use with the alpha2,6-sialyltransferase.

PMID- 8368485
TI  - Method for sequencing synthetic oligodeoxynucleotide phosphorothioates.
AB  - Sequencing of oligodeoxynucleotide phosphorothioate by a modified Sanger method
      of sequencing is described. The procedure involves ligation of synthetic
      oligodeoxynucleotide phosphorothioate to an oligodeoxynucleotide, referred to
      here as "helper oligonucleotide." The helper oligonucleotide has a region which
      is complementary to T7 primer. By using DNA polymerase and nucleoside
      triphosphate mixture, 5'-labeled T7 primer is extended onto ligated
      oligodeoxynucleotide phosphorothioate, which is then analyzed on gel
      electrophoresis.

PMID- 8368486
TI  - Reversibility of cysteine labeling by 4-(aminosulfonyl)-7-fluoro-2,1,3
      benzoxadiazole.
AB  - The fluorescent cysteine derivative formed upon alkylation of proteins with 4
      (aminosulfonyl)-7-fluoro-2,1,3-benzoxadiazole (ABD-F) is shown to be unstable
      under certain conditions. Although previously thought to be an irreversible
      reaction, the fluorescence and absorbance associated with the ABD-cysteine can be
      released from the protein by heating at basic pH in the presence of reductants.
      Reversal of labeling is accelerated by increasing the temperature, pH, and
      concentration of reductant. Upon reversal of labeling, a free sulfhydryl is
      regenerated, since the treated protein can subsequently be realkylated (without
      reductant) to approximately the same level with only ABD-F. The findings reported
      in this work are relevant to the use of this alkylating reagent prior to any
      procedure involving heating or long incubation under reducing conditions,
      including re-electrophoresis or enzymatic deglycosylation. Investigators using
      ABD-F or structurally similar reagents should be aware that the cysteine
      derivative formed is not stable under these conditions. The reversal of cysteine
      derivatization may also be useful as a method for replacing the ABD-cysteine
      adduct with a label more suitable for subsequent specialized procedures.

PMID- 8368487
TI  - A 13C NMR study on ibuprofen metabolism in isolated rat liver mitochondria.
AB  - A 13C NMR approach was taken to study the biotransformation of (R)- and (S)-[2
      13C,2-2H]ibuprofen-CoA in isolated rat liver mitochondria. The 13C chemical shift
      induced by 2H substitution for the C-2 of [2-13C,2-2H]-ibuprofen-CoA is about 0.5
      ppm relative to the corresponding 1H-bearing thioester. The C-2 resonances for [2
      13C]- and [2-13C,2-2H]ibuprofen-CoA are 5 ppm downfield with respect to their
      acid counterparts. Consequently, this technique permits real time analyses of the
      metabolic fate of the doubly labeled substrate in a quantitative manner. The
      initial rate of the epimerization of (S)-[2-13C,2-2H]ibuprofen-CoA relative to
      the (R)-counterpart by intact mitochondria was estimated to be 1.5, which is in
      line with the equilibrium constant determined with the purified epimerase.
      Contrary to the reports by other groups, this 13C NMR study did not find
      spontaneous hydrolysis of the CoA-thioester upon being exposed to intact
      mitochondria. Current focus of this investigation is to extend this NMR
      methodology to the levels of whole cells and live animals to gain a better
      understanding of the enantioselective metabolism of ibuprofen.

PMID- 8368488
TI  - A dependable method for the synthesis of [14C]trehalose.
AB  - A new method for the preparation of [14C]trehalose was developed, based on the
      ability of yeast cells to accumulate trehalose under stress. The method is simple
      and reliable. It utilizes a yeast strain in which the gene that encodes for
      phosphoglucoisomerase has been deleted. Thus, exogenously supplied glucose is not
      metabolized, but is instead converted to trehalose. The [14C]-trehalose obtained
      is pure, it is hydrolyzed by trehalase, and it is not susceptible to the action
      of alpha-glucosidase. The yield of this method is in the order of 35% of the
      [14C]glucose supplied.

PMID- 8368489
TI  - Phase separation of nonionic detergents by salt addition and its application to
      membrane proteins.
AB  - By adding salts (sodium chloride, ammonium sulfate), it is possible to induce
      phase separation in membrane-protein solubilisates containing Triton X-100 or
      Nonidet P-40 at temperatures between 0 and 20 degrees C. Other nonionic
      detergents of the Brij, Lubrol, and Tween series can also be used for this
      procedure. The salt concentration required for induction of phase separation is
      dependent on the hydrophobicity of the detergent used. For detergents of the
      Triton series it seems that detergents with lower hydrophilic lipophilic balance
      numbers need lower salt concentrations to separate the phases than those with
      larger hydrophilic parts. Ammonium sulfate precipitation as an initial
      purification step for membrane proteins should be avoided in the presence of the
      nonionic detergents tested. Instead of this procedure, phase separation induced
      by sodium chloride or ammonium sulfate can be recommended, as was proved for
      membrane-bound proteases of Pseudomonas aeruginosa and Bacillus cereus and for
      bacteriorhodopsin.

PMID- 8368491
TI  - Voltage gradient electrophoresis of nucleic acids on agarose gels.
AB  - A very simple method is described which allows the separation of DNA molecules in
      a wide molecular weight range (from 0.6 to about 30 kb) in the same
      electrophoresis agarose gel. This is based on the achievement of a voltage
      gradient through a simple device consisting of a Plexiglas plate placed slantwise
      with respect to the gel surface plane, submerged in the electrophoretic running
      buffer. Further applications of our system are also described.

PMID- 8368490
TI  - Capillary electrophoresis for protein analysis: separation of human growth
      hormone and human insulin molecular forms.
AB  - The capillary zone electrophoresis (CZE) technique was evaluated for separation
      and quantification of human growth hormone (hGH), human insulin (hI), and
      proinsulin. Three different molecular forms of biosynthetic hGH (20K, 22K, 44K),
      methionyl-hGH, biosynthetic hI, and proinsulin, were studied. The hormones were
      separated with uncoated capillaries, and various analytical conditions were
      tested (different buffers, ionic strength, pH). The samples were introduced both
      at positive pressure and electrokinetically, and the voltage applied was varied
      in each case. Linearity, repeatibility, and limit of detection (0.8 microM for
      hGH and 1.3 microM for insulin) were determined. Different purification steps
      were tried in order to find a suitable preanalytical procedure for hGH and hI
      purification from plasma. Recovery rates from 65 to 80% were obtained.

PMID- 8368492
TI  - Preparation of a cell-free translation system with minimal loss of initiation
      factor eIF-2/eIF-2B activity.
AB  - Cell-free translation systems prepared from suspension-cultured HeLa S3 cells or
      mouse L cells by hypotonic shock followed by Dounce homogenization poorly
      initiated the translation of exogenous mRNA. In contrast, cell extracts prepared
      from cells exposed to the detergent lysolecithin translated exogenous mRNA
      readily. The block in initiation in the former lysates was localized to the
      ribosome fraction. During in vitro translation polysomes from homogenized cells
      disaggregated but the run-off ribosomes were unable to reinitiate translation.
      The block resulted from a decrease in eukaryotic initiation factor 2 (eIF-2) or
      the guanine nucleotide exchange factor (eIF-2B) activity, since the addition of
      eIF-2 or eIF-2B to these latter extracts substantially improved the capacity of
      the extract to initiate translation of exogenous mRNA. Extracts from homogenized
      cells, but not from detergent-treated cells, showed enhanced ability to
      phosphorylate the alpha subunit of exogenous eIF-2. We show that the method of
      cell extract preparation greatly influences the state of eIF-2/eIF-2B activity in
      the resulting extract and that extracts in which this activity is maintained can
      readily initiate translation on exogenous mRNA and reinitiate on endogenous mRNA.

PMID- 8368493
TI  - Electrophoretic techniques for the analysis of synthetic amyloid beta-A4-related
      peptides.
AB  - Two electrophoretic techniques have been developed for the analysis of synthetic
      beta-A4 related peptides. The first is an acetic acid--urea--polyacrylamide gel
      electrophoresis denaturing system while the second employs capillary zone
      electrophoresis at pH 7. Both methods were calibrated to identify the state
      (monomeric or aggregate) of the longer amyloid fragments beta-A4(1-40) and beta
      A4(1-43) during analysis.

PMID- 8368494
TI  - An evaluation of five commercial immunoassay data analysis software systems.
AB  - An evaluation of five commercial software systems used for immunoassay data
      analysis revealed numerous deficiencies. Often, the utility of statistical output
      was compromised by poor documentation. Several data sets were run through each
      system using a four-parameter calibration function, and the results were compared
      to those from an independent method. Comparable results between systems were
      obtained, but often several attempts at analysis were necessary. The evaluation
      process revealed that it is difficult to monitor the numerous options available
      on these types of programs, and that incorrect results could easily be obtained
      if comparison analyses were not used. Recommendations for improved software
      functionality and for using the four-parameter calibration model are presented.

PMID- 8368495
TI  - A semidry electroblotting system efficiently transfers both high- and low
      molecular-weight proteins separated by SDS-PAGE.
AB  - A general procedure is described for the simultaneous recovery by electroblotting
      on nitrocellulose or polyvinylidene difluoride (PVDF) membranes of both high- and
      low-molecular-weight proteins already separated by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. It is based on the use of an original set of
      buffers which creates a stable pH boundary between the two faces of the blotted
      membrane. The gel to be transferred is placed on the basic side (pH 8.4) of this
      boundary, which also contains sodium dodecyl sulfate. Under these conditions even
      the high-molecular-weight proteins are efficiently eluted out of the acrylamide.
      Their migration is then stopped on the membrane, due to the change of pH with the
      acid side (pH 3.8) of the boundary, and the presence of methanol in it. This
      increases the adsorption on the membrane of the low-molecular-weight polypeptides
      which have a low affinity for nitrocellulose or PVDF. The procedure permits a
      quantitative transfer of complex samples which contain poorly soluble proteins or
      with molecular masses outside the range of 20-70 kDa, like grain storage proteins
      of cereals.

PMID- 8368496
TI  - Multiple sequence analysis: pool sequencing of synthetic and natural peptide
      libraries.
AB  - Sequence analysis by automated Edman degradation has been one of the most
      powerful tools for the characterization of peptides for many years. Its
      sensitivity allows experiments in the low picomole range, and its results provide
      complete information about the primary structure of proteins and peptides. A new
      method in protein and peptide sequencing has been developed which allows for the
      direct application of automated Edman degradation to the analysis of peptide
      mixtures. With the aid of multiple sequence analysis, first, sequence motifs of
      isolated, naturally processed peptides binding to MHC molecules have been
      defined. Second, the method proved to be a valuable and reliable tool for the
      characterization of synthetic peptide libraries, and third, the specificity of
      proteases has been determined in a fast and efficient way.

PMID- 8368498
TI  - A nondenaturing preparative gel electrophoresis system for the recovery of
      functional proteins. Application to the identification of an endogenous protein
      inhibitor of fucosyl-transferase activities.
AB  - Electroelution of protein bands resolved by nondenaturing polyacrylamide gel
      electrophoresis was performed to identify an endogenous protein inhibitor of
      fucosyltransferase activities, called fuctinin, through its biological activity.
      After electrophoresis protein bands were negatively stained with zinc acetate,
      indicating that this staining technique can be also applied to nondenaturing
      polyacrylamide gels. However, even under appropriate electroelution conditions, a
      strong fucosyl-transferase inhibitory activity was eluted from the polyacrylamide
      gel itself that impeded the measure of fuctinin activity. As an alternative to
      electroelution, collection of proteins resolved by nondenaturing polyacrylamide
      gel electrophoresis as they are electrophoresed off the end of the gel was
      assayed. In the commercially available preparative electrophoretic systems, an
      elution chamber is limited by a semipermeable membrane on which proteins were
      adsorbed in the low-ionic-strength buffer used in nondenaturing electrophoresis.
      We demonstrate that the simple and inexpensive electrofractionation system
      described by Shain et al. (Anal. Biochem. 200, 47-51, 1992) can be successfully
      applied under nondenaturing conditions to purify and identify fuctinin through
      its biological activity. However, caution must be taken in the design of the
      apparatus in order to avoid local heating and thermal denaturation of proteins.
      The utility of this nondenaturing preparative electrophoresis system for the
      study of functional proteins is also demonstrated by the recovery of enzymatic
      activities of alkaline phosphatase and beta-galactosidase.

PMID- 8368497
TI  - Isoelectric focusing: pH gradients established with simple buffers and a cation
      selective membrane.
AB  - A method for isoelectric focusing is presented in which pH gradients are
      established with simple buffer systems in a thin granulated gel bed. The gel bed
      is supported by a cation-selective membrane over a buffer-filled channel with a
      sloping bottom. The component of the electric field parallel to the gel and
      membrane surfaces that results from this arrangement may be considered fixed at
      each position in the gel bed but increases with the decreasing depth of the
      buffer filled channel below. This feature, together with the ion-selective
      properties of the supporting membrane, allows the electric field to maintain a
      shallow pH gradient by adjusting the composition of the buffer at each position
      in the gel bed. Ribonuclease, myoglobin, beta-lactoglobulin, and ovalbumin,
      representing proteins with a wide distribution of isoelectric points, were
      focused in the buffers glycine, imidazole, Mes, and acetic acid, respectively.
      Focused protein fractions were rerun on conventional polyacrylamide-carrier
      ampholyte gels.

PMID- 8368499
TI  - Size-dependent separation of proteins denatured in SDS by capillary
      electrophoresis using a replaceable sieving matrix.
AB  - The determination of molecular weights by sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis (SDS-PAGE) is one of the most powerful electrophoretic
      techniques for protein characterization. A separation media has been developed
      which allows this type of analysis to be performed in the capillary format. A
      replaceable polymeric solution rather than a polymerized gel was used as the
      sieving matrix. This solution allowed for the separation of proteins denatured in
      SDS in a size-dependent manner as demonstrated by the linear correlation between
      the proteins' relative migration and the concentration of the sieving matrix
      (Ferguson plot). The logarithm of the molecular weight of protein standards
      correlated linearly with the relative mobility of the denatured proteins over the
      molecular weight range of 14,000 to 205,000. The calculated resolution at half
      peak height was such that proteins that differed by as little as 4% in molecular
      weight would be resolved. Finally, the integrated peak areas at 215 nm were
      linearly proportional to the mass of the protein injected.

PMID- 8368500
TI  - Simultaneous high-performance liquid chromatographic determination of both the
      cleavage pattern and the stereochemical outcome of the hydrolysis reactions
      catalyzed by various glycosidases.
AB  - A high-performance liquid chromatographic method for the simultaneous
      determination of both the stereochemical outcome and the cleavage pattern of
      enzymatic action on unmodified sugar substrates is described. Three different
      enzymes were investigated by this method. Human pancreatic alpha-amylase
      hydrolyzed maltopentaose with retention of anomeric configuration, with the
      cleavage position being two glucose units from the reducing end. Cellulomonas
      fimi endoglucanase D hydrolyzed cellopentaose with retention of anomeric
      configuration and predominantly two glucose units from the reducing end. beta-D
      Xylosidase from Butyrivibrio fibrisolvens hydrolyzed o-nitrophenyl beta-D
      xylopyranoside with inversion of anomeric configuration.

PMID- 8368501
TI  - Further studies on the lysozyme-like activity of alpha-lactalbumin: development
      of alternative methods of assay.
AB  - Earlier, a sensitive turbidimetric method was reported (H.A. McKenzie and F.H.
      White, Jr. Biochem. Int. 14, 347-356, 1987), with which evidence was found for
      weak lysozyme-like activity in alpha-lactalbumin (alpha-LA) against Micrococcus
      luteus. Alternative methods have been developed for the further study of trace
      cell-lytic activity, and the results are compared with those of the turbidimetric
      technique. These methods involve (1) determination of weight loss from a
      suspension of bacterial cells after exposure to the protein under investigation,
      and (2) viability studies on the exposed cells. In addition, exposed and control
      cells were subjected to microscopic examination. Results from all studies were
      consistent with lysis of cells by alpha-LA as well as by lysozyme. Activities of
      alpha-LA from the three methods of assay, expressed as ratios to those of
      lysozyme, were 2.2-5.2 x 10(-5) (mean = 3.6 x 10(-5). The methods were assessed
      with respect to sources of error characteristic of each and to protein dose
      requirements for a specified level of cell killing. The turbidimetric approach
      remains useful for measuring cell-lytic activities as described here. However,
      caution is urged in its general use.

PMID- 8368502
TI  - Electrochemical preparation of 1,1'-dimethylferricinium from a water-soluble 1,1'
      dimethylferrocene-2-hydroxypropyl-beta-cyclodextrin complex and its applications
      in enzyme assay.
AB  - Water-soluble 2-hydroxypropyl-beta-cyclodextrin (hp-beta-CyD), a cyclic and
      nonreducing oligosaccharide, was used to enclose the hydrophobic guest molecules
      ferrocene (FeCp2) and 1,1'-dimethylferrocene (DMFeCp2) to form a water-soluble
      complex. At high concentrations (300 mM), hp-beta-CyD enclosed up to 100 mM FeCp2
      or DMFeCp2. The yellow complexes were electrochemically oxidized (platinum vs
      Ag/AgCl poised at +450 mV) to form the blue dyes ferricinium (FeCp2+) and 1,1'
      dimethylferricinium (DMFeCp2+). This is a one-electron transfer process and the
      ferricinium cations formed exhibited absorption peaks at 620 and 650 nm,
      respectively. The concentrated DMFeCp2+ was much more stable (4 months) than the
      FeCp2+ (2 days) and both oxidized dyes were insensitive to a wide pH variation
      (pH 2-11). The DMFeCp2+ was reduced easily by various reducing agents such as
      ascorbic acid, uric acid, and sulfite and exhibited an absorption coefficient of
      325 cm-1 M-1. Application of the novel DMFeCp2+ complex as a colorimetric dye for
      the enzymatic oxidation of glucose, glutamate, lactate, phenylalanine, xanthine,
      and hypoxanthine was successfully demonstrated. When applied to real samples the
      results obtained agreed well with those of standard enzymatic assays. The
      DMFeCp2+ complex could also be utilized to monitor activity of oxidases under
      saturating substrate concentrations.

PMID- 8368503
TI  - Assay of the human liver citric acid cycle probe phenylacetylglutamine and of
      phenylacetate in plasma by gas chromatography-mass spectrometry.
AB  - Phenylacetate, derived from phenylalanine, is converted in human and primate
      liver to phenylacetylglutamine. The latter has been used to assess the labeling
      pattern of liver citric acid cycle intermediates. We present gas chromatographic
      mass spectrometric assays of phenylacetylglutamine, phenylacetate, and
      phenylalanine in biological fluids. The compounds are derivatized with
      dimethylformamide dimethyl acetal. Limits of detection are 0.1 nmol for
      phenylacetylglutamine and phenylacetate and 2 nmol for phenylalanine. Baseline
      plasma concentrations of phenylacetate and phenylacetylglutamine and 1 and 3
      microM, respectively. The 24-h urinary excretions of phenylacetate and
      phenylacetylglutamine are about 4 mumol and 1 mmol, respectively. Ingestion of
      phenylalanine (in the form of aspartame) by a human is followed by sequential
      increases in phenylacetate and phenylacetylglutamine concentrations in plasma and
      urine. This assay opens the way to noninvasive probing of the 13C-labeling
      pattern of liver citric acid cycle intermediates in humans.

PMID- 8368504
TI  - Methods for the quantitation of bromosulfophthalein and its glutathione conjugate
      in biological fluids.
AB  - This paper describes a solvent-gradient HPLC method which was developed for the
      quantitation of bromosulfophthalein (BSP) in erythrocyte and albumin containing
      (blood) perfusate samples, and of BSP and its glutathione conjugate (BSP-GSH) in
      bile samples obtained from rat liver perfusion experiments. Phenolphthalein was
      used as an internal standard. The cysteinyl-, N-acetylcysteinyl-, and
      cysteinylglycinyl-BSP conjugates did not interfere with the HPLC assay and
      cysteine, N-acetylcysteine, [3H]GSH, and [3H]GSSG eluted within the first 6 min
      postinjection onto the HPLC system. A spectrophotometric method was also
      developed for the rapid quantitation of BSP in blood perfusate; tracer [14C]urea
      was utilized as the internal standard. Although the spectrophotometric method was
      less sensitive than the HPLC method, good correlation was found to exist between
      the methods.

PMID- 8368505
TI  - pH modification to enhance the molecular sieving properties of sodium dodecyl
      sulfate-10% polyacrylamide gels.

PMID- 8368506
TI  - Preferential binding of the carboxylate form of camptothecin by human serum
      albumin.

PMID- 8368507
TI  - High-efficiency shotgun cloning of curved DNA segments from chromosomal DNA.

PMID- 8368508
TI  - Microanalyses of beta-cyclodextrin and glucosyl-beta-cyclodextrin in biological
      matrices by high-performance liquid chromatography with pulsed amperometric
      detection.

PMID- 8368509
TI  - A method for synthesizing genes and cDNAs by the polymerase chain reaction.

PMID- 8368510
TI  - An ultrasensitive technique for the analysis of glycoproteins using lectin
      blotting with enhanced chemiluminescence.

PMID- 8368511
TI  - Mini isoelectric focusing device to be used with the Bio-Rad Mini-Protean II
      System.

PMID- 8368512
TI  - Detection of beta-1,3-glucanase activity in gels containing alkali-soluble yeast
      glucan.

PMID- 8368514
TI  - A novel combinational pH-PCO2 microelectrode.
AB  - A novel combinational pH-PCO2 microelectrode based on a neutral carrier hydrogen
      ion exchanger is described. It is easy to fabricate and allows pH and PCO2 to be
      measured simultaneously. The microelectrode has a 5-microns tip. The PCO2
      microelectrode exhibits a linear response in the range 1.75 x 10(-5)-10(-2)
      mol/liter with a Nernstian slope of 57.0 mV/decade at 25 degrees C. The detection
      limit is 10(-5) mol/liter. The pH microelectrode exhibits a linear response in
      the range pH 4-12 with a Nernstian slope of 60.0 mV/decade at 25 degrees C. The
      95% steady-state response time of the PCO2 microelectrode is about 2 min, while
      it is about 10 s for pH microelectrode. The electromotive force drift is 4.3 mV/h
      (PCO2) and 2.6 mV/h (pH), respectively. The lifetime is 3 to 4 days. The
      microelectrode can measure pH and PCO2 in body fluids simultaneously with
      satisfactory results. It is also a good basic electrode for enzyme
      microelectrolysis.

PMID- 8368513
TI  - Separation and size distribution of red blood cells of diverse size, shape, and
      origin by flow/hyperlayer field-flow fractionation.
AB  - Red blood cells (RBCs) from human, equine, canine, feline, and bovine whole blood
      samples have been separated and characterized by high-speed flow/hyperlayer field
      flow fractionation (Fl/HyFFF). The elution-based separation of RBCs by this
      method is based mainly on the size and shape of the cell particles. The typical
      separation time for RBCs is less than 3 min. Size distributions can be derived
      from the fractograms of cell samples using a calibration plot based on retention
      data for uniform polystyrene beads. The method is shown to be effective both to
      separate and to characterize cell populations, including those with cells of
      abnormal shape and size. In order to investigate differences in cell morphology,
      shape and size changes induced by 500,000 Da Dextran were monitored. The changes
      in the Fl/HyFFF elution profiles indicate that the RBCs decrease in size but
      become partially aggregated in the presence of the dextran. These changes were
      found to depend on polymer concentration and specific blood samples. Some of the
      results from Fl/HyFFF were compared with those from the Coulter counter and from
      microscopy.

PMID- 8368515
TI  - Detection of iron binding proteins by a blotting technique.
AB  - We describe a simple method for detecting iron binding proteins based on binding
      of 59Fe to protein blots from SDS gels followed by autoradiography. This binding
      is specific and is not affected by other metal ions. The method has allowed
      identification of new iron binding proteins in intestinal mucosa and in Hela
      cells.

PMID- 8368516
TI  - A high throughput fluorogenic substrate for interstitial collagenase (MMP-1) and
      gelatinase (MMP-9).
AB  - Two members of the matrix metalloproteinase family of enzymes, interstitial
      collagenase and 92-kDa gelatinase, have been implicated in the pathogenesis of
      rheumatoid arthritis and tumor metastasis. In order to characterize the
      activities of these enzymes, we have developed a fluorogenic peptide substrate
      which is efficiently hydrolyzed by both enzymes. This substrate was developed
      based on the addition of the fluorescent tag, N-methyl-anthranilic acid (Nma), to
      several previously synthesized substrates that had been evaluated with respect to
      their turnover by interstitial collagenase. One substrate, Dnp-Pro-Cha-Gly
      Cys(Me)-His-Ala-Lys-(Nma)-NH2, had favorable solubility characteristics, was >
      98% quenched, and produced a single cleavage product, Dnp-Pro-Cha-Gly, with a
      high fluorescence yield with both interstitial collagenase and 92-kDa gelatinase.
      Since the assay depends on measurement of increases in fluorescence, the position
      of the Nma group also proved to be important for optimization of the fluorescence
      signal. The assay is free from interference by organomercurial compounds and the
      cleavage product has excitation and emission spectra compatible with filters
      commonly available on commercial plate readers. The assay has been adapted to a
      96-well format and provides a rapid screening protocol for the evaluation of
      inhibitors of these enzymes.

PMID- 8368517
TI  - A continuous fluorescence displacement assay for phospholipase A2 using albumin
      and medium chain phospholipid substrates.
AB  - A continuous fluorescence assay for phospholipase A2 is described which involves
      the displacement of the highly fluorescent fatty-acid probe 11-(dansylamino)
      undecanoic acid from albumin by decanoic acid released as a result of
      phospholipase A2-catalyzed hydrolysis of didecanoyl-phosphatidylcholine. Using
      the phospholipase A2 from Naja naja, this assay will detect activity from 1 ng of
      pure enzyme and a linear response in terms of fluorescence change with time is
      observed up to about 50 ng of enzyme. The assay is compared with the original
      fluorescence displacement assay (Wilton, D.C., 1990, Biochem. J. 266, 435-439)
      which uses rat liver fatty acid binding protein instead of albumin and is able to
      utilize any natural long chain phospholipid as substrate. The present assay will
      provide a very convenient method for detection during enzyme purification of the
      low molecular weight secreted phospholipase A2 and other phospholipases A that
      can hydrolyze medium chain phospholipids. The assay should also allow the
      identification of inhibitors of these enzymes. Other substrates including
      dioleoylphosphatidylcholine and 1-stearoyl-2-arachidonoylphosphatidylcholine were
      also evaluated in the assay.

PMID- 8368518
TI  - The application of size exclusion chromatography and computer simulation to study
      the thermodynamic and kinetic parameters for short-lived dissociable protein
      aggregates.
AB  - We describe a method to study the monomer-dimer equilibrium of human growth
      hormone (hGH) making use of a very short size exclusion high-performance liquid
      chromatographic column and rapid flow rates. By adjusting the flow rate and thus
      the retention time on the column, the dissociation of the hGH dimer can be
      observed. Using computer simulation, both the equilibrium constant for
      dissociation and the dissociation rate constant can be determined directly,
      followed by the indirect determination of the association rate constant. This
      method is potentially useful for determining the thermodynamic the kinetic
      parameters of aggregation of many protein-protein (homodimers and heterodimers)
      and protein-ligand systems whose rates of interaction are too rapid to be studied
      by conventional techniques.

PMID- 8368519
TI  - Quantitative determination of serine proteinase inhibitor activity using a radial
      diffusion assay.
AB  - An improved, time efficient, visual assay for quantitative determination of
      proteinase inhibitor activity in protein extracts is reported. Proteinase
      inhibitor activity of mammalian, bacterial, and fungal serine proteinases can be
      quantified. The method relies on radial diffusion of proteinase inhibitor
      containing extracts from a central well through an agar gel containing a serine
      proteinase. After an incubation period the agar gel is stained via the diazo
      coupling of the beta-naphthol produced by the enzymatic hydrolysis of N-acetyl-DL
      phenylalanine-beta-naphthyl-ester. Circular zones containing inhibitor-proteinase
      complexes remain colorless while the region containing only proteinase shows a
      bright pink-purple color. A reference curve relates the diameter of the colorless
      zone to the logarithm of the proteinase inhibitor concentration. The error in the
      estimation of a proteinase inhibitor quantity varying between 10 and 1000 pmol is
      4-12%. The sensitivity of the assay is approximately 2-20 pmol of inhibited
      proteinase molecules depending on the inhibitor-proteinase complex assayed. The
      sensitivity of the assay can be enhanced 10-fold or more by dilution of the
      proteinase concentration in the agar and by a reduction of the agar thickness.

PMID- 8368520
TI  - Identification of cysteine residues at the 10-pmol level by
      carboxamidomethylation of protein bound to sequencer membrane supports.
AB  - A procedure is described for the in situ carboxamidomethylation of
      cystine/cysteine residues in protein samples of as little as 10 pmol, prior to
      automated protein sequence analysis. Previous in situ methods for the
      modification of cysteines are limited to proteins available in quantities greater
      than 100 pmol due to contaminants which interfere with HPLC identification of
      phenylthiohydantoin amino acids, and cannot be performed on
      polyvinylidenedifluoride (PVDF)-bound samples. In our procedure, protein samples,
      immobilized on either PVDF- or polybrene-treated glass filters, are reduced with
      tributylphosphine followed by alkylation with iodoacetamide prior to automated
      sequence analysis. Carboxamidomethylcysteine is formed in high yield with no
      discernable side reactions in standard proteins (insulin, human transferrin,
      lysozyme) or experimental samples. Both initial and repetitive yields of
      carboxamidomethylated proteins were either comparable to or better than
      nonalkylated proteins. No apparent increase in background nor any sequence
      preview due to partial amino-terminal alkylation was observed. The
      carboxamidomethylation procedure described here successfully overcomes the
      limitations of available methods for reduction and alkylation of less than 100
      pmol of protein directly on sequencer membrane supports.

PMID- 8368521
TI  - Simultaneous kinetic-based determination of fructose and ascorbate with a
      rotating bioreactor and amperometric detection: application to the analysis of
      food samples.
AB  - A recently introduced biosensor comprising a rotating bioreactor and a stationary
      platinum ring amperometric detector (Anal. Chem. 1993, 65, 636-639) has been
      utilized for the simultaneous determination of fructose and ascorbate. The
      approach has been successfully applied to the simultaneous determination of these
      analytes in fresh food samples. Hexacyanoferrate(II) is the monitored species at
      +0.380 V vs a Ag/AgCl, 3 M NaCl reference. The determination takes advantage of a
      fast chemical oxidation of ascorbate by hexacyanoferrate(III) ions and the
      subsequent slower production of hexacyanoferrate(II) in the D-fructose 5
      dehydrogenase-catalyzed reaction between D-fructose and hexacyanoferrate(III) as
      acceptor. D-Fructose 5-dehydrogenase (EC 1.1.99.11) was incorporated into the
      rotating disk reactor in immobilized form and on controlled-pore glass via the
      glutaraldehyde attachment and cross-linking with bovine serum albumin.
      Sample/reagent processing was accomplished by programmed continuous-flow/stopped
      flow/continuous-flow operation.

PMID- 8368522
TI  - Optical measurements of pH using fluorescence lifetimes and phase-modulation
      fluorometry.
AB  - We measured the pH-dependent fluorescence decay times of the
      seminaphthofluoresceins (SNA-FL), seminaphthorhodafluors (SNARF), and BCE-CF
      using phase-modulation fluorometry. The phase and modulation values were found to
      be strongly pH-dependent in the physiological pH range, over the easily
      accessible range of light modulation frequencies from 10 to 300 MHz, making these
      probes useful as lifetime-based pH sensors. The phase and modulation values are
      dependent on excitation and emission wavelength as well as pH. This dependence
      allows the range of pH sensitivity to be chosen by selection of the wavelength(s)
      and enables increased precision of the pH measurements by use of phase and/or
      modulation measurements at several wavelengths. These probes can be excited using
      a a green He-Ne laser at 543 nm, which allows their use in low cost
      instrumentation. Phase and modulation measurements are especially suitable for
      sensing applications because they are insensitive to the changes in signal
      intensity that result from photobleaching, probe washout, and/or light losses.

PMID- 8368523
TI  - Simplification of high-energy collision spectra of peptides by amino-terminal
      derivatization.
AB  - Four-sector tandem mass spectrometry proves extremely useful for providing
      sequence information for peptides. The complexity of ion fragmentations, however,
      makes data interpretation difficult and time consuming. Attachment of a fixed
      positive charge to the peptide amino terminus forces production of only N
      terminal fragment ions to yield simplified, predictable fragmentation. Reaction
      of a peptide at pH 6 with iodoacetic anhydride selectively modifies the N
      terminus by exploiting the pK(a) differences between the alpha-amino group and
      any lysine side-chain epsilon-amino groups. The iodoacetyl peptide can react with
      many reagents to form a fixed positive charge. We find reaction with
      dimethyloctylamine forms a quaternary ammonium derivative with good surface
      activity properties and concomitant increased sensitivity. The high-energy CAD
      fragment ion spectra of the N-terminally derivatized peptides show predominantly
      a(n) and d(n) ions. The abundant d(n) ions permit ready distinction of leucine
      and isoleucine. Fewer fragment ions make data interpretation simpler and lead to
      more intense peaks since the ion intensity is spread among fewer peaks. The
      method is particularly useful for peptides which do not otherwise yield
      sufficient fragmentation to provide either the complete sequence or the locations
      of modified amino acids.

PMID- 8368524
TI  - Tryptic mapping of recombinant proteins by matrix-assisted laser
      desorption/ionization mass spectrometry.
AB  - Various matrix mixtures have been used for matrix-assisted laser
      desorption/ionization mass spectrometry to characterize the tryptic maps of
      recombinant human growth hormone (rhGH) and recombinant human tissue plasminogen
      activator (rt-PA). Carbohydrate-containing comatrices give improved results over
      single-component matrices. Of those studied, fucose plus 2,5-dihydroxybenzoic
      acid (DHB) produced a signal for 24 out of 25, or 96%, of the tryptic peptides of
      rhGH in a single spectrum. These results were obtained for analyses of as little
      as 280 fmol of unfractionated material measured in digestion buffer. Analysis of
      150 fmol showed a decrease in the relative abundance of higher molecular weight
      peptides. The incorporation of 5-methoxysalicylic acid (5MSA) as a comatrix in a
      molar ratio of analyte:fucose:DHB:5MSA = 1:5000:5000:50 gave signals for 45 out
      of 51 peptides for 4.5 pmol of a tryptic digest of rt-PA, corresponding to 88% of
      the expected fragments. Unobserved peptides were typically di- and tripeptides.
      Three glycopeptides were observed with peaks corresponding to the known major
      glycoforms. The fucose/DHB and 5MSA/DHB comatrices produced significant
      enhancements in spectral quality over DHB alone, including suppression of matrix
      peaks, increased ion signal, improved resolution, increased number of useful
      laser shots per crystal, and minimization of baseline slope. Spectra obtained
      with fucose/DHB generally surpassed DHB/5MSA in quality, though both matrix
      mixtures were clearly superior to neat DHB. Fucose/DHB demonstrated an increase
      in tolerance to ionic contaminants by producing a 10-fold reduction in the
      abundance of (M + Na)+ions. A trimatrix, DHB/5MSA/fucose, produced the highest
      quality spectra to date, although only marginally better than the fucose/DHB
      comatrix.

PMID- 8368525
TI  - Static secondary ion mass spectrometric investigation of the surface chemistry of
      organic plasma-deposited films created from oxygen-containing precursors. 3.
      Multivariate statistical modeling.
AB  - Partial least squares (PLS) multivariate statistical models were developed to
      predict the surface composition and chemistry of a set of model homopolymers
      based on their static SIMS fragmentation patterns. In the calibration or model
      building step, the positive and negative ion static SIMS spectra of different
      classes of model homopolymers were related to specific chemical attributes of the
      polymers. The models were then used to examine the surface chemistry of oxygen
      containing plasma-deposited films prepared from a variety of precursors. PLS
      models were developed to predict the surface oxygen concentration and H/C ratios.
      The results obtained from the PLS models were compared with experimental results.

PMID- 8368526
TI  - Remeasurement of ions using quadrupolar excitation Fourier transform ion
      cyclotron resonance spectrometry.
AB  - Ions formed by a single laser desorption event can be remeasured more than 500
      times in a Fourier transform ion cyclotron resonance spectrometer. Quadrupolar
      excitation and collisional axialization are used to move ions located in any
      region of the ICR cell to the center of the cell, where they can be effectively
      detected. With this method, the signal from ions formed by a single laser
      desorption event is averaged for 200 remeasurement cycles with an efficiency in
      excess of 99.5% per cycle. Collisions of ions with helium are found to give
      higher remeasurement efficiencies than collisions with methane, due to reduced
      scattering losses by the lighter collision gas. With this method, ions that are
      stored in the analyzer cell for more than 1 hour can be detected. This technique
      is shown to be compatible with high-resolution data acquisition. Ions formed by
      one laser desorption event are remeasured at eight bandwidths, demonstrating low
      resolution, wide-mass-range analysis and high-resolution, narrow-mass-range
      analysis of the same group of ions.

PMID- 8368527
TI  - Enhanced mass resolving power, sensitivity, and selectivity in laser desorption
      Fourier transform ion cyclotron resonance mass spectrometry by ion axialization
      and cooling.
AB  - Ion cooling and axialization produced by azimuthal quadrupolar excitation in the
      presence of ion-neutral collisions are applied to laser desorption Fourier
      transform ion cyclotron resonance mass spectrometry (LD/FT/ICR-MS). With this
      technique, the large kinetic and internal energies of ions generated by laser
      desorption processes can be cooled effectively by collisions of ions with neutral
      argon atoms (at > 5 x 10(-7) Torr). After sufficient cooling in the source
      compartment of a dual ion trap, the axialized ions may be transferred to the
      analyzer compartment for detection at much lower pressure (and thus much higher
      mass resolving power). Enhancements in both FT/ICR mass resolving power and
      sensitivity are observed; moreover, ion isolation with high selectivity at high
      pressure is also demonstrated.

PMID- 8368528
TI  - Electrical field-flow fractionation in particle separation. 1. Monodisperse
      standards.
AB  - In its original implementation, electrical field-flow fractionation (EFFF) was
      carried out in membrane-walled channels with the electrodes placed externally to
      the flow channel. The poor separation efficiency of this system left the
      technique largely unattended for about two decades. In the present study, we
      describe a new and simple approach to EFFF, which demonstrates the technique's
      ability to carry out rapid, high-resolution separations of colloidal samples in
      aqueous suspensions. The present channels are bounded by the smooth and rigid
      graphite electrodes which allow for the application of small voltages, typically
      less than 2 V, across the thin (178 microns) separation space defined by a Mylar
      spacer. Although this arrangement generates nominal fields of the order of 100
      V/cm, polarization of the electrodes considerably reduces the effective field
      across the bulk of the channel to less than 1% of the nominal value.
      Nevertheless, under conditions of low ionic strength the system is shown to
      retain and separate polystyrene (PS) latex standards with sizes ranging from 60
      to 10,000 nm. For small particles of comparable zeta-potential, separating in the
      "normal" mode of EFFF, the size selectivity Sd, is approximately 0.7. As with
      other FFF techniques, EFFF displays a transition from "normal" to "steric"
      behavior; the critical diameter for this transition is highly dependent on ionic
      strength, with values ranging from approximately 500 nm in deionized water to
      approximately 1200 nm in 133 microM aqueous NaCl under an applied voltage of 1.37
      V and a flow of 1 mL/min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368529
TI  - Automatic gas chromatographic determination of N-methylcarbamates in milk with
      electron capture detection.
AB  - A new analytical method that combines on-line derivatization-extraction and gas
      liquid chromatography for the determination of N-methylcarbamates is reported.
      The hydrolysis products of N-methylcarbamates (phenols) are derivatized and
      extracted in a continuous fashion using pentafluoropropionic anhydride
      (derivatizing reagent) in n-hexane as an extractant. The thermal instability of N
      methylcarbamates is overcome by forming fluoro derivatives that can be identified
      and quantified at the nanogram per milliliter level with an ECD detector.
      Application of the proposed method to six mixtures of N-methylcarbamates yielded
      detection limits between 2 and 20 ng/mL and a relative standard deviation of 2.35
      3.70%. Average recoveries of N-methylcarbamates added to cow's milk at
      concentrations between 50 ng/mL and 2 micrograms/mL ranged from 93.7 to 100.8%.

PMID- 8368530
TI  - Enzyme immunoassay using a rat prolactin-alkaline phosphatase recombinant tracer.
AB  - This paper describes a competitive enzyme immunoassay of rat prolactin (rPrl)
      using a recombinant conjugate as a colorimetric tracer. rPrl was inserted into
      the N-terminal end of Escherichia coli alkaline phosphatase (AP), using an
      expression vector which allows insertion of foreign DNA sequences between codons
      +6 and +7 of the phoA gene. The assay was performed in 96-well microtiter plates
      coated with a mouse monoclonal antibody raised against rabbit immunoglobulin G.
      Each component (recombinant tracer, rabbit antiserum against rPrl, and rPrl
      standard) was added in a volume of 50 microL. The sensitivity of the assay was
      sufficiently high to allow titration of rPrl in plasma. The detection threshold
      was 15 pg (0.3 ng/mL) and the B/B0 50% value was 150 pg (3 ng/mL). The intraassay
      coefficient of variation was less than 10% over a wide range of rPrl
      concentrations (2.9-50 ng/mL). The interassay coefficient of variation was less
      than 15% for rat plasma samples in the concentration range of 4-40 ng/mL. The
      good parallelism observed between the standard curve and sample dilution curves
      showed that the immunoreactivity in rat plasma behaves like standard rPrl.
      Together with recovery experiments, these results indicated that assay without
      extraction is possible. A single immunoreactive peak that comigrates with
      standard rPrl is observed after molecular sieve fractionation of plasma samples.
      The reliability of the assay was confirmed by good correlation with conventional
      radioimmunoassay (r = 0.996, slope 0.978).

PMID- 8368531
TI  - Line scanning system for direct digital chemiluminescence imaging of DNA
      sequencing blots.
AB  - A cryogenically cooled charge-coupled device (CCD) camera equipped with an area
      CCD array is used in a line scanning system for low-light-level imaging of
      chemiluminescent DNA sequencing blots. Operating the CCD camera in time-delayed
      integration (TDI) mode results in continuous data acquisition independent of the
      length of the CCD array. Scanning is possible with a resolution of 1.4 line
      pairs/mm at the 50% level of the modulation transfer function. High-sensitivity,
      low-light-level scanning of chemiluminescent direct-transfer electrophoresis
      (DTE) DNA sequencing blots is shown. The detection of DNA fragments on the blot
      involves DNA-DNA hybridization with oligonucleotide-alkaline phosphatase
      conjugate and 1,2-dioxetane-based chemiluminescence. The width of the scan allows
      the recording of up to four sequencing reactions (16 lanes) on one scan. The scan
      speed of 52 cm/h used for the sequencing blots corresponds to a data acquisition
      rate of 384 pixels/s. The chemiluminescence detection limit on the scanned images
      is 3.9 x 10(-18) mol of plasmid DNA. A conditional median filter is described to
      remove spikes caused by cosmic ray events from the CCD images.

PMID- 8368532
TI  - Detection of nitric oxide production from a perfused organ by a luminol-H2O2
      system.
AB  - Nitric oxide, thought to be the endothelium-derived relaxing factor (EDRF), is
      involved in intra- and intercellular signalling in various tissues. A system for
      the continuous detection of NO in the picomolar range from a perfused organ is
      described. The detection is based upon the chemiluminescence reaction between NO
      and the luminol (5-amino-2,3-dihydro-1,4-phthalazinedione)-H2O2 system. The
      chemiluminescence is due to the formation of peroxynitrite from NO and H2O2. The
      luminol-H2O2 system is specifically reactive to NO, so that other nitrogen
      containing compounds, (organic nitrite, organic nitrate, and thio-nitroso
      compounds) or endothelium-derived compounds do not interfere. The limit of
      determination was approximately 100 fM. This system has been used to measure
      continuous NO release from isolated perfused rat kidney and the simultaneous
      changes of perfusion pressure. In Wistar rats basal NO release was 85 +/- 11
      fmol/min-1 (g of kidney weight)-1 (39 pM in the perfusate), and acetylcholine
      increased NO release dose dependently with a concomitant pressure reduction. The
      changes in NO release were always associated with mirror image changes in the
      perfusion pressure. Simple pressure reduction did not interfere with the
      chemiluminescence. Precise titration data as well as results of some preliminary
      experiments using this method are presented.

PMID- 8368533
TI  - Elemental speciation with plasma mass spectrometry.

PMID- 8368534
TI  - Improved data-processing method for atomic absorption spectroscopy with
      electrothermal atomization.
AB  - A new approach is described for processing transient data from electrothermal
      atomizers used in atomic absorption spectroscopy. The transient responses are
      first integrated and then a pseudo-first-order model is fit to the time-dependent
      integrals in order to predict the response that would be measured if the
      atomization process were monitored to completion. The principal advantage
      expected and observed for the new approach is its ability to reduce effects of
      variables such as atomization temperature. For all elements studied (Cr, Mn, K,
      Yb, Fe), the new predictive approach is shown to be virtually independent of
      temperature in the range from 2200 to 2600 degrees C. The predictive approach
      exhibited lower temperature coefficients than either the peak-height or peak-area
      options for all elements examined. For the more volatile elements (Mn, K, Yb,
      Fe), the improvement ratio at 2400 degrees C of the predictive approach relative
      to the others ranged from 1.4 to 8.2. For chromium at 2400 degrees C, the
      temperature coefficient of the predictive method was approximately 10- and 30
      fold lower than those for the peak-area and peak-height options, respectively.

PMID- 8368535
TI  - Peptide mapping and evaluation of glycopeptide microheterogeneity derived from
      endoproteinase digestion of erythropoietin by affinity high-performance capillary
      electrophoresis.
AB  - High-performance capillary electrophoresis (HPCE) has been employed to
      characterize the peptide map of recombinant human erythropoietin (rHuEPO)
      expressed from Chinese hamster ovary (CHO) cells. The methodology employs an ion
      pairing agent, 100 mM heptanesulfonic acid in 40 mM sodium phosphate buffer, pH
      2.5, to increase peptide resolution, to decrease analyte wall interactions, and
      to evaluate glycopeptide microheterogeneity. The total tryptic map is segregated
      into two regions, nonglycosylated and glycosylated peptides. Reproducibility of
      the peptide map is excellent; the map results in baseline separation of 16
      tryptic peptides and one doublet peak composed of two peptides (resolution 0.22).
      The map furthermore allows for the evaluation of the microheterogeneity
      associated with the three rHuEPO glycopeptides. At least 12 glycopeptide forms
      were separated in the initial peptide map. Peptides were identified by Edman
      sequencing, and the glycopeptides were further subjected to Dionex anion-exchange
      chromatography. To simplify the level of complexity associated with the
      glycopeptides, much of the characterization employed asialoglycopeptides and
      employed several endoproteolytic diagnosis. The relative percent distribution for
      each purified asialoglycopeptide was calculated to define the level of complexity
      and to tentatively assign a known structure to the HPCE peak. The level of
      structural complexity of the asialoglycopeptides appears to increase from the
      simplest O-linked form to the more complex N83, N38, and N24 glycosylation
      positions, respectively. HPCE evaluation of glycopeptide microheterogeneity
      appears to be simpler, faster, and just as sensitive as other more frequently
      employed methods for glycopeptide characterizations.

PMID- 8368536
TI  - Amperometric monitoring of chemical secretions from individual pancreatic beta
      cells.
AB  - The goal of the work was to develop and test an amperometric method for measuring
      insulin secretion from individual pancreatic beta-cells. The electrode used was a
      carbon fiber microelectrode modified with a polynuclear ruthenium
      oxide/cyanoruthenate film. The chemically modified electrode allowed anodic
      detection of insulin in physiological buffers with a detection limit of 0.5
      microM. To measure secretion, an electrode was positioned 1 micron away from a
      beta-cell that had been stimulated with K+ or glucose. Recordings made from the
      cells consisted of a series of current spikes averaging 38 ms full width at half
      height. The spikes decreased in height and increased in width as the electrode
      was pulled away from the cell. Spikes were only observed if a modified electrode
      was used and its potential was sufficient to oxidize insulin. The area under the
      spikes correspond to approximately 600 zmol of insulin, which is within the
      expected range for vesicular insulin content. Spike area was independent of
      stimulation method. The results support the hypothesis that the electrode was
      anodically detecting a substance secreted from the cells by exocytosis. The
      results support, but do not prove, that insulin was the primary substance
      detected.

PMID- 8368537
TI  - Kinetic study of the reaction of acetoacetate with glycine and sodium
      nitroprusside.
AB  - This paper describes an extensive kinetic study of the reactions involved in the
      determination of acetoacetate in body fluids. It is concluded that acetoacetate
      reacts with glycine to produce an imine intermediate that tautomerizes to an
      enamine. It is also concluded that nitroprusside reacts with the imine
      intermediate to produce an unstable product with an absorption maximum near 540
      nm. This product decays slowly to produce a stable product with an absorption
      maximum near 393 nm. A proposed reaction pathway is used to develop kinetic
      equations, rate constants, equilibrium constants, and molar absorptivity of the
      unstable product that permit quantitative prediction of the kinetic behavior for
      a wide range of reactant concentrations.

PMID- 8368538
TI  - Ion beams and laser postionization for molecule-specific imaging.

PMID- 8368539
TI  - Anesthesiology and critical care medicine.

PMID- 8368540
TI  - Attitudes of anesthesiology residents toward critical care medicine training.
AB  - The number of anesthesiology residents pursuing critical care medicine (CCM)
      fellowship training has been decreasing in recent years. A significant number of
      training positions remain unfilled each year. Possible causes of this decline
      were evaluated by surveying residents regarding their attitudes toward practice
      and training in CCM. All 38 anesthesiology programs having accredited CCM
      fellowships were surveyed. Four of these and one program without CCM fellowships
      were used to develop the survey instrument. Four programs without CCM fellowships
      and 34 programs with CCM fellowships make up the survey group. Returned were 640
      surveys from 37 (97%) programs accounting for over 30% of the possible residents.
      Resident interest in pursuing CCM training decreased as year of residency
      increased (P < 0.0001). Residents in programs with little patient care
      responsibility during intensive care unit (ICU) rotations expressed less interest
      in CCM training (P < 0.012). The administrative role of the anesthesiology
      department in the ICU also influenced resident interest (P < 0.014). Written
      responses to open-ended questions suggested resident concerns with the following:
      stress of chronic care, financial consequences of additional year of training,
      ICU call frequency and load, ICU role ambiguity, and shared decision-making in
      the ICU. A recurring question was, "Are there jobs (outside of academics) for
      anesthesiologist intensivists?" Most residents knew a CCM anesthesiologist they
      admired and knew that there were unfilled fellowship positions available.
      Defining the job market, improving curriculum and teaching, supporting deferment
      of student loans, and introducing residents and medical students to the ICU
      earlier may increase the interest in CCM practice among anesthesiology residents.

PMID- 8368541
TI  - Effect of vasopressin on hemodynamic variables, organ blood flow, and acid-base
      status in a pig model of cardiopulmonary resuscitation.
AB  - Based upon the hypothesis that vasopressin (antidiuretic hormone) may increase
      vascular resistance during ventricular fibrillation, the effects of this potent
      vasoconstrictor were studied in a porcine model of ventricular fibrillation.
      Vasopressin therapy was compared to epinephrine by randomly allocating 14 pigs to
      receive either 0.045 mg/kg of epinephrine (n = 7) or 0.8 U/kg of vasopressin (n =
      7) after 4 min of ventricular fibrillation and 3 min of open-chest
      cardiopulmonary resuscitation. During cardiopulmonary resuscitation, myocardial
      blood flow before and 90 s and 5 min after drug administration was 57 +/- 11, 84
      +/- 11, and 59 +/- 9 mL.min-1 x 100 g-1 (mean +/- SEM) in the epinephrine group,
      and 61 +/- 5, 148 +/- 26, and 122 +/- 22 mL.min-1 x 100 g-1 in the vasopressin
      group (P < 0.05 at 90 s and 5 min). At the same times, mean cardiac index was not
      significantly different between the groups. After drug administration, coronary
      venous PCO2 was significantly higher and coronary venous pH was significantly
      lower in the epinephrine as compared to the vasopressin group. All pigs in both
      groups were resuscitated and survived the 2-h observation period. We conclude
      that vasopressin improves vital organ perfusion during ventricular fibrillation
      and cardiopulmonary resuscitation. Vasopressin seems to be at least as effective
      as epinephrine in this pig model of ventricular fibrillation.

PMID- 8368542
TI  - Selecting ventilator settings according to variables derived from the quasi
      static pressure/volume relationship in patients with acute lung injury.
AB  - Knowledge of the pressure/volume (P/V) relationship of the lung may allow
      selection of tidal volume and positive end-expiratory pressure (PEEP) to optimize
      gas exchange without adversely affecting lung function or hemodynamics. Ten
      patients with acute lung injury were stabilized on controlled mechanical
      ventilation, based on conventional practice, using criteria from arterial blood
      gas data. The P/V relationship was determined under quasi-static conditions (end
      expiratory and end-inspiratory, no flow periods > 0.8 s) during mechanical
      ventilation with an automated procedure that changed PEEP in a stepwise fashion.
      Differences in expiratory tidal volumes before and after a change in PEEP equaled
      the change in functional residual capacity (delta FRC). PEEP was set above the
      lowest point of the steepest section of the P/V curve (inflection pressure) to
      prevent end-expiratory lung collapse. Inspiratory tidal volumes (VTI) were
      adjusted to avoid an end-inspiratory lung volume reaching the flat part of the
      P/V curve. Averaged delta FRC versus PEEP curves were shifted to the left and the
      slope increased 1, 6, and 12 h after changing ventilator settings compared to
      baseline (P < 0.01). Averaged baseline delta FRC versus PEEP curves showed a
      marked inflection pressure that decreased after adjusting ventilator settings (P
      < 0.01). PEEP was increased from 7.4 +/- 1.8 cm H2O (baseline) to 11.9 +/- 1.6 cm
      H2O (1 h) (P < 0.001) according to measured baseline inflection pressures.
      Simultaneously, VTI had to be reduced from 759 +/- 161 mL (baseline) to 664 +/-
      101 mL (1 h) (P < 0.01) to avoid end-inspiratory overinflation. To maintain
      minute volume constant ventilator frequency was increased from 14 +/- 1.2
      (baseline) to 16 +/- 1.2 breaths/min (1 h) (P < 0.01). Maximum quasi-static
      compliance of 38 +/- 7 mL/cm H2O (baseline) increased to 46 +/- 9 mL/cm H2O (1 h)
      (P < 0.01). Maintaining FIO2 constant, PaO2 increased from a baseline of 90 +/-
      16 mm Hg to 122 +/- 24 mm Hg (1 h) (P < 0.001), to 130 +/- 20 mm Hg (6 h) (P <
      0.01), and to 138 +/- 19 mm Hg (12 h) (P < 0.01). Intrapulmonary shunt decreased
      from 0.28 +/- 0.08 (baseline) to 0.14 +/- 0.05 (12 h) (P < 0.001). Hemodynamic
      variables did not change. Our data suggest that using variables derived from a
      quasi-static P/V loop during mechanical ventilation under muscle paralysis is
      clinically superior compared to blood gas criteria for titration of ventilator
      settings.

PMID- 8368543
TI  - Venous air embolism during cesarean section: more common than previously thought.
AB  - To confirm the incidence of venous air embolism (VAE), we simultaneously
      monitored expired nitrogen concentration (FEN2) and precordial Doppler in 30
      patients undergoing cesarean delivery during general anesthesia. Patients were
      randomized into two groups and the effect of a 10 degrees reverse Trendelenburg
      tilt versus the horizontal position was evaluated. Forty-two episodes of VAE,
      defined by an increase in FEN2 of 0.1%, were detected in 97% (29/30) of patients.
      Doppler ultrasound failed to detect 9 of the episodes and 23 (41%) changes in
      Doppler tones were not associated with an increase in FEN2. These spurious
      Doppler signals were synchronous with compression of retroperitoneal structures,
      suggesting turbulent venous return to be the cause. The reverse Trendelenburg
      position did not reduce the incidence of VAE. Compared with the preinduction
      baseline, mean arterial blood pressure decreased by 31.5 +/- 10.1 mm Hg in this
      position and 22.6 +/- 13.4 mm Hg in the supine position after hysterotomy. We
      conclude that VAE in cesarean delivery during general anesthesia occurs very
      frequently, and that changes in Doppler tones may not be reliable indicators of
      this complication. Measures to reduce the size and effect of air emboli therefore
      should be applied routinely in all patients.

PMID- 8368544
TI  - Anesthesia for in vitro fertilization: a comparison of 1.5% and 5% spinal
      lidocaine for ultrasonically guided oocyte retrieval.
AB  - In many institutions, spinal anesthesia is used for surgery involving
      ultrasonically guided transvaginal oocyte retrieval. Because this relatively
      short procedure is performed on an outpatient basis, the optimal spinal technique
      would allow good surgical anesthesia with a short recovery time. The relative
      regression of equal doses of different concentrations of hyperbaric spinal
      lidocaine is presented. We compared 1.5% and 5% hyperbaric lidocaine (7.5%
      dextrose) as spinal drugs for use in this procedure. Fifty-six patients were
      randomized to receive 60 mg of hyperbaric solutions of either 1.5% or 5%
      lidocaine in combination with 10 micrograms of spinally administered fentanyl.
      Visual analog scale pain scores were zero throughout the procedures for all
      patients. There were no significant differences between the groups with regard to
      sensory level, maximum motor block, intravenous sedation requirements, time to
      two-segment regression, and time to full sensory recovery. The group receiving
      1.5% lidocaine had significantly shorter times to ambulation (141 +/- 21 min vs
      162 +/- 29 min; P < 0.05), voiding (147 +/- 21 min vs 174 +/- 28 min; P < 0.05),
      full motor recovery (86 +/- 21 min vs 111 +/- 22 min; P < 0.0001), and discharge
      (170 +/- 38 min vs 201 +/- 41 min; P < 0.05). The use of 1.5% hyperbaric
      lidocaine for transvaginal oocyte retrieval provides a significantly shorter
      recovery time when compared to 5% hyperbaric lidocaine and is a good choice for
      spinal anesthesia for this procedure.

PMID- 8368545
TI  - A clinical and laboratory study to compare the addition of 0.2 mg of morphine,
      0.2 mg of epinephrine, or their combination to hyperbaric bupivacaine for spinal
      anesthesia in cesarean section.
AB  - The aim of this prospective, randomized, double-blind study was to compare the
      effects of adding either preservative-free morphine, 0.2 mg (n = 20),
      epinephrine, 0.2 mg (n = 21), or a combination of both (n = 29) to hyperbaric
      bupivacaine in parturients having elective cesarean sections during spinal
      anesthesia. Ten additional patients receiving spinal bupivacaine alone were
      studied as the Control Group. High-pressure liquid chromatography with a
      sensitivity of 20 micrograms/mL was used to measure serum bupivacaine in all
      subjects. The results showed that the spread and regression of the sensory and
      motor blocks were similar among the study groups. However, the intraoperative
      analgesia was superior in patients receiving bupivacaine combined with morphine
      and epinephrine, whereas there was no difference between those given an addition
      of either morphine or epinephrine. Postoperative analgesia was the shortest and
      opioid requirement in the first 24 h the most with epinephrine alone. No
      respiratory depression occurred. The neonatal condition was excellent in all
      groups. Serum concentrations of bupivacaine at 10 min, at delivery (25 +/- 1.4
      min), and at 60 min after the intrathecal injection were similar among the groups
      including the Control Group. The concentrations of bupivacaine in umbilical
      arterial and venous sera were less than the sensitivity level of the analytical
      method. We conclude that the addition of 0.2 mg of morphine plus 0.2 mg of
      epinephrine to hyperbaric bupivacaine improves the intra- and postoperative
      analgesia without an added risk. This improvement is not due to vasoconstriction
      and a reduction in the absorption of bupivacaine from the subarachnoid space.

PMID- 8368546
TI  - Myocardial uptake of bupivacaine: I. Pharmacokinetics and pharmacodynamics of
      lidocaine and bupivacaine in the isolated perfused rabbit heart.
AB  - Bupivacaine, but not lidocaine, may cause severe cardiac dysrrhythmias in case of
      accidental intravascular injection. In an attempt to discriminate between a
      pharmacokinetic and a pharmacodynamic (or both) origin to these differences, we
      used an isolated rabbit heart model with constant coronary inflow to compare the
      myocardial uptake and disposition kinetics of lidocaine and bupivacaine. Drug
      concentration in the outflow perfusate was assayed and surface electrocardiogram
      was recorded. Drug uptake and disposition kinetics were modeled with a two
      compartment open model. An Emax model was used to describe the increase in QRS
      duration in relation with drug concentration in the central compartment.
      Lidocaine and bupivacaine exhibited similar myocardial pharmacokinetics (i.e., a
      rapid decrease in the outflow concentration upon drug administration
      discontinuation). Bupivacaine-induced maximum increase in QRS duration (Emax) was
      15 times superior to lidocaine Emax. The steady-state perfusate concentration
      producing half Emax was the same for both drugs. We conclude that bupivacaine
      induced QRS widening decreases almost at the same rate as does lidocaine-induced
      QRS widening when drug administration is terminated. Therefore, the different
      cardiac effects of lidocaine and bupivacaine are not due to differences in
      myocardial uptake and disposition kinetics.

PMID- 8368547
TI  - Myocardial uptake of bupivacaine: II. Pharmacokinetics and pharmacodynamics of
      bupivacaine enantiomers in the isolated perfused rabbit heart.
AB  - The enantiomers of a racemic drug generally differ in their pharmacokinetic
      and/or pharmacodynamic properties. Because bupivacaine is a mixture of two
      optical isomers known to exert different toxic properties on isolated nerve
      preparations, we decided to use an isolated rabbit heart model with constant
      coronary inflow to compare the myocardial uptake kinetics of the R(+)-, S(-)
      enantiomers and the racemic mixture of bupivacaine. The increase in QRS duration
      was also measured, and the inflow concentration-effect relationship was analyzed
      for the three drugs. The racemic and the two enantiomers of bupivacaine exhibited
      similar myocardial pharmacokinetics with a two-compartment profile for all hearts
      except one. All drugs showed a rapid decrease in the outflow concentration when
      drug administration was discontinued. The tissue/perfusate concentration ratio at
      steady state was similar for the three drugs. QRS widening, as well as the
      occurrence of severe arrhythmias, was much less pronounced in the hearts
      receiving the S(-) isomer than in the hearts receiving the R(+) isomer or the
      racemic mixture. Despite the occurrence of arrhythmias, QRS widening was
      adequately modelled with an Emax model. C50, the inflow perfusate concentration
      producing half Emax (maximal theoretical increase in QRS duration) was the same
      for all three drugs. The authors conclude that the S(-)-bupivacaine exerts less
      detrimental effects on the isolated heart of the rabbit perfused at a constant
      coronary flow with protein-free buffer.

PMID- 8368548
TI  - Influence of injection speed on the subarachnoid distribution of isobaric
      bupivacaine 0.5%.
AB  - The purpose of this study was to compare the anesthetic characteristics after two
      radically different speeds of intrathecal injection of isobaric 0.5% bupivacaine
      during continuous spinal anesthesia. Forty consenting patients, undergoing hip
      surgery using continuous spinal anesthesia, were allocated randomly to two groups
      of 20 each according to the rate of injection of 2 mL (10 mg) of isobaric 0.5%
      bupivacaine: FI (fast injection = 2 mL during 2 to 3 s or approximately 0.75
      mL/s) or SI (slow injection = 1 mL/min). No difference was observed between the
      two groups in terms of sensory and motor block or hemodynamic changes. However,
      the onset time to maximal sensory level was significantly shorter in the SI group
      (16 +/- 9 min vs. 24 +/- 6 min; P < 0.05). Those patients requiring reinjection
      entered the second part of the study (n = 23; 15 in the FI group and 8 in the SI
      group). Each of these remaining patients was used as his or her own proper
      control. Those in the FI group received a slow reinjection and those in the SI
      group received a fast reinjection which consisted in all cases of 10 mg (2 mL) of
      isobaric 0.5% bupivacaine. When looking at the anesthetic characteristics after
      reinjection, maximal sensory levels, as well as onset times, were very similar in
      both groups. At all times, the maximal sensory level obtained after reinjection
      was two dermatomes higher than after the initial injection. Duration of sensory
      block, which was calculated only in these 23 patients, was also comparable (126
      +/- 44 min for FI and slow reinjection group vs 146 +/- 25 min for SI and fast
      reinjection group). In conclusion, regardless of the speed of injection, there
      are no differences in anesthetic characteristics of spinal anesthesia using
      isobaric 0.5% bupivacaine.

PMID- 8368549
TI  - Preanesthetic skin-surface warming reduces redistribution hypothermia caused by
      epidural block.
AB  - Redistribution of heat from the core to the cool peripheral compartments of the
      body causes hypothermia during epidural anesthesia. Diminishing the temperature
      gradient between the core and peripheral tissues by warming the body via the skin
      before anesthesia should prevent this hypothermia. We measured core temperature,
      skin temperatures, and cutaneous heat loss in seven volunteers who received two
      lidocaine epidural injections during a single study day. One epidural injection
      was given after the volunteer had rested in a cool room (approximately 22 degrees
      C) ("no prewarming") for 2 h, and one injection was given after the volunteer had
      been covered with a forced air warming mattress (approximately 38 degrees C)
      ("prewarming") for 2 h. Skin temperatures were higher after prewarming. The
      decrease in core temperature during epidural anesthesia was smaller after
      prewarming [mean within patient difference (prewarming-no prewarming): 0.41; P =
      0.003]. However, heat loss was greater after prewarming (mean within patient
      difference: 26.4; P = 0.02). Shivering was less after prewarming. We conclude
      that prewarming decreases redistribution hypothermia caused by epidural block.
      These results support the hypothesis that redistribution of heat within the body,
      not heat loss, is the most important etiology of hypothermia from epidural
      anesthesia.

PMID- 8368550
TI  - Thoracic epidural anesthesia causes rib cage distortion in anesthetized,
      spontaneously breathing dogs.
AB  - The effects of thoracic epidural anesthesia on the performance of the parasternal
      intercostal muscles were investigated by measuring electromyographic activity and
      length changes of the parasternals (EMG activities and length, respectively, of
      the parasternals) in seven pentobarbital anesthetized, spontaneously breathing
      dogs. Epidural injection of 0.1 mL/kg of 2% lidocaine decreased tidal volume and
      minute ventilation during unstimulated breathing. These changes were accompanied
      by complete abolishment of EMG activities of the parasternals and passive
      elongation of the parasternals during inspiration. At equivalent end-tidal PCO2
      values (70 and 80 mm Hg) during CO2 rebreathing, tidal volume and minute
      ventilation were lower after epidural block compared to the corresponding values
      before the block. Thoracic epidural anesthesia impaired contraction of the
      parasternals and conceivably other respiratory muscles in the rib cage as well
      and could induce a distortion of the rib cage. The authors conclude that
      respiratory muscles in the rib cage contribute considerably to the maintenance of
      ventilation in anesthetized dogs.

PMID- 8368551
TI  - Effects of halothane and isoflurane on collateral dependent myocardium in
      chronically instrumented dogs.
AB  - The effects of moderate systemic hypotension with halothane (HALO) and isoflurane
      (ISO) on regional myocardial function and perfusion were studied in dogs with
      chronic coronary artery occlusion. Vasodilator reserve in collateral-dependent
      (CD) myocardium was quantified in conscious animals by using a dipyridamole
      challenge test. Blood flow was distributed homogeneously to the normal (Nl) and
      CD myocardium at rest, but subendocardial perfusion increased only in the Nl area
      after dipyridamole. HALO and ISO were administered at doses that reduced
      diastolic arterial pressure to 50 mm Hg. End-tidal concentrations were 1.3 +/-
      0.2 vol% for HALO (1.5 minimum alveolar anesthetic concentration) and 1.8 +/- 0.2
      vol% for ISO (1.4 minimum alveolar anesthetic concentration), respectively.
      Global and regional hemodynamic depression were more pronounced with HALO.
      Systolic wall-thickening fraction decreased both in the Nl (-37%) and CD area (
      27%). Myocardial blood flow to Nl and CD myocardium decreased to a comparable
      extent. ISO predominantly decreased systemic vascular resistance and, when
      compared to HALO, decreased systolic wall-thickening fraction less in both the Nl
      (-19%) and CD area (-18%). In addition, regional myocardial perfusion to both Nl
      and CD myocardium remained virtually unaltered from conscious control conditions.
      Despite reductions of diastolic blood pressure to 50 mm Hg, neither HALO nor ISO
      induced ischemic dysfunction in myocardium with diminished vasodilator reserve.
      Both anesthetics preserved intercoronary as well as transmural blood flow
      distribution. During HALO, myocardial perfusion was less both in Nl and CD
      myocardium due to a more pronounced metabolic depression. We conclude that
      moderate hypotensive doses of ISO and HALO preserve regional myocardial function
      of collateral-dependent myocardium in dogs with single vessel occlusion and
      enhanced collateral circulation.

PMID- 8368552
TI  - Serial intravenous doses of dezocine, morphine, and nalbuphine in the management
      of postoperative pain for outpatients.
AB  - Adult patients who had arthroscopic surgery under general anesthesia and
      requested postoperative pain relief were randomized to receive treatment in a
      double-blind protocol with 5 mg of intravenous dezocine (20 patients), morphine
      (22 patients), nalbuphine (18 patients), or saline (24 patients). At 10-min
      intervals, starting with the first dose of analgesic, patients could choose up to
      three additional doses of the primary treatment, or choose an alternative
      analgesic if the primary drug was unsatisfactory. One to four doses of morphine
      were given as the alternate treatment if the initial treatment was dezocine or
      nalbuphine, and one to four doses of dezocine were given if the initial treatment
      was saline or morphine. The proportion of patients treated successfully by the
      initial treatments (i.e., not requesting alternate treatment), with P value for
      difference from placebo treatment, were saline 25%, nalbuphine 33% (P = 0.048),
      morphine 54% (P = 0.04), and dezocine 75% (P = 0.003). Dezocine and morphine are
      more efficacious than nalbuphine in the management of early postoperative pain.
      As an alternate analgesic in this study, dezocine required fewer doses to achieve
      patient satisfaction and was thus more efficacious than morphine. The incidence
      of treatment-related, adverse effects was different from that of saline or other
      treatments only for nalbuphine-related pain or burning on injection and dezocine
      related facial itching. With respect to analgesic actions and side effects,
      dezocine seems more like morphine than nalbuphine.

PMID- 8368553
TI  - Inhaled induction and emergence from desflurane anesthesia in the ambulatory
      surgical patient: the effect of premedication.
AB  - We studied the effect of premedication (1 microgram/kg fentanyl and 0.04 mg/kg
      midazolam 5 min before induction of anesthesia) on airway reactivity and
      hemodynamic stability during inhaled induction using desflurane in 10 ambulatory
      surgical patients. Eight patients who were anesthetized without premedication
      served as the controls. Induction and emergence were rapid and unaffected by
      premedication. End-tidal and inspired concentrations of desflurane at loss of
      consciousness were significantly reduced by premedication (10.1% end-tidal/14.1%
      inspired, no premedication, vs. 5.3% end-tidal/8.9% inspired, premedication).
      Airway irritability was markedly attenuated by premedication (100% no
      premedication versus 30% premedicated), as was apnea (37.5% no premedication
      versus 0% premedicated). We observed an increase in mean arterial blood pressure
      and heart rate after loss of consciousness (mean arterial pressure 103 vs 121 mm
      Hg, heart rate 73 vs 100 bpm) in the unpremedicated patients, whereas both groups
      demonstrated a decrease in mean arterial blood pressure with no change in heart
      rate when baseline values were compared to those at incision (103 vs 74 mm Hg, no
      premedication, 99 vs 81 mm Hg premedicated). Patient acceptability was
      satisfactory and unchanged by premedication. We recommend the use of such
      premedication when desflurane is used during the induction of anesthesia.

PMID- 8368554
TI  - Propofol at a subanesthetic dose may have abuse potential in healthy volunteers.
AB  - We conducted a study in which the rewarding effects of propofol were assessed in
      humans, using a discrete-trials choice procedure. Normal healthy volunteers (n =
      12) were exposed in a blind fashion to acute bolus injections of 0.6 mg/kg of
      propofol twice and to a similar volume of Intralipid twice. Then, for the next
      three sessions, subjects chose which drug (identified by a color code) they
      wished to receive. We defined propofol choosers if individuals chose propofol two
      or three times, and nonchoosers if they chose propofol once or not at all. By
      using a chi 2 goodness-of-fit test of a random choice model, the choice
      distribution differed significantly from a random choice distribution (P <
      0.005). Six subjects were choosers: four subjects chose propofol on all three
      choice occasions and two subjects chose the drug on 2/3 occasions (referred to
      hereafter as propofol choosers). Six subjects were nonchoosers: five subjects
      chose Intralipid on all three choice occasions, and one subject chose Intralipid
      twice (referred to hereafter as propofol nonchoosers). During sampling sessions,
      propofol choosers reported pleasant acute effects and no unpleasant residual
      effects, whereas propofol nonchoosers reported either unpleasant acute subjective
      effects and/or residual effects from propofol. We conclude that 1) propofol may
      be rewarding (reinforcing) in some individuals without a history of drug abuse,
      and 2) further abuse liability testing is needed with this drug.

PMID- 8368555
TI  - Chronic alcoholism increases the induction dose of propofol in humans.
AB  - The doses of propofol that produce loss of consciousness were investigated in 26
      patients with chronic alcoholism and in 20 patients with a history of small
      alcoholic intake undergoing ear, nose, and throat surgery under general
      anesthesia. Last ethanol consumption by the alcoholics was 24 h preoperatively,
      as they had no access to alcohol when admitted to the hospital. Propofol was
      infused at a rate of 1200 mL/h (200 mg/min). The doses required to produce (a)
      loss of verbal contact and (b) loss of ability to grasp a 20-mL syringe filled
      with water were recorded. At this time a 2-mL venous blood sample was collected
      to detect propofol blood concentrations. A painful stimulus was applied to the
      abdomen, and a positive or negative response was noted. The mean +/- SD dose of
      propofol required for loss of verbal contact was 2.7 +/- 0.42 mg/kg in the
      alcoholic group and 2.2 +/- 0.43 mg/kg in the control group (P < 0.001). The dose
      of propofol required for dropping the syringe was significantly higher in the
      alcoholic group, 4.2 +/- 1.02 mg/kg versus 3.2 +/- 0.75 mg/kg in the control
      group (P < 0.01). The two groups did not differ significantly regarding the
      propofol blood concentrations at loss of consciousness, or the frequency of
      response or no response to painful stimulus. These findings suggest that the
      doses of propofol required to induce anesthesia in chronic alcoholic patients are
      more than in patients who drink socially.

PMID- 8368556
TI  - Inotropic and electrophysiologic effects of propofol and thiamylal in isolated
      papillary muscles of the guinea pig and the rat.
AB  - We compared the inotropic and electrophysiologic effects of propofol and
      thiamylal in isolated papillary muscles of the guinea pig and rat. Propofol
      applied in clinical 10% intralipid emulsion showed concentration-dependent
      negative inotropic effects, accompanied by decreased action potential duration,
      in the guinea pig. Intralipid alone had no effect. Although thiamylal showed a
      concentration-dependent depression similar to propofol in the guinea pig,
      depolarization of resting membrane potential was seen at 0.1 and 0.3 mM, and a
      slight prolongation of action potential duration at 90% repolarization at 0.1 mM,
      and then a decrease of action potential duration at 0.3 mM. In rat papillary
      muscles, propofol did not produce any depression of contractile force, whereas
      thiamylal produced a concentration-dependent negative inotropic effect. The
      important findings observed in the action potential in rat papillary muscles were
      the modest shortening of action potential duration after propofol application,
      and the significant decrease of resting membrane potential and the significant
      prolongation of action potential duration caused by thiamylal. Both propofol and
      thiamylal depressed slow action potentials and contractile force in guinea pig
      papillary muscles depolarized by 25 mM K+ solution. In conclusion, the negative
      inotropic effects of propofol and thiamylal might be caused by inhibition of
      trans-sarcolemmal Ca2+ influx accompanied by shortening of action potential
      duration in guinea pig papillary muscles. The action potential of thiamylal might
      be affected by the suppression of K+ current in guinea pig and rat papillary
      muscles that was never observed in the propofol-treated tissue.

PMID- 8368557
TI  - Trabecular outflow facility and formation rate of aqueous humor during propofol,
      nitrous oxide, and halothane anesthesia in rabbits.
AB  - Propofol decreases intraocular pressure (IOP) and the IOP response to
      laryngoscopy and intubation, but the mechanisms responsible for this effect have
      not been reported. The present study examined the effect of propofol on IOP,
      intraocular fluid formation and outflow facility, and intraocular compliance.
      Twenty-two white New Zealand rabbits were anesthetized with halothane (0.8%-1.0%
      inspired concentration) in nitrous oxide (2 L/min) and oxygen (1 L/min). Muscle
      paralysis was established with pancuronium, and the lungs were mechanically
      ventilated through a tracheal tube. Twelve rabbits examined under these
      conditions served as controls. In the treatment group (n = 10), 6 mg/kg propofol
      followed by 18 mg.kg-1 x h-1 propofol intravenously was added to
      halothane/nitrous oxide/oxygen anesthesia. In both groups, a series of
      intraocular infusions was made via a 30-gauge needle in the anterior chamber, and
      IOP, the rate of aqueous humor formation (Fa), and trabecular outflow facility
      (Ctr) were determined using conventional analysis. These same measures, as well
      as intraocular compliance, were determined using a new method of analysis adapted
      from the manometric technique for determining cerebrospinal fluid dynamics. IOP
      was 11.3 +/- 1.8 mm Hg (mean +/- SD) in halothane-anesthetized controls and
      decreased to 9.4 +/- 2.2 mm Hg when propofol was added to halothane anesthesia (P
      < 0.05). By conventional analysis, Fa was 2.82 +/- 0.94 microL/min and Ctr was
      0.121 +/- 0.044 microL.min-1 x mm Hg-1 in controls. After addition of propofol,
      Fa decreased by 24% to 2.15 +/- 0.62 microL/min (P < 0.05) and Ctr decreased by
      18% to 0.099 +/- 0.034 microL.min-1 x mm Hg-1 (P < 0.05).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8368558
TI  - Muscle paralysis by rocuronium during halothane, enflurane, isoflurane, and total
      intravenous anesthesia.
AB  - We determined the dose-response relationship, the onset time, the duration, and
      the recovery time of a rocuronium neuromuscular block under four anesthesia
      techniques. Patients were equally randomized to four different groups (n = 20)
      receiving 0.5%-1% halothane, 1.5%-2% enflurane, 1.2%-1.8% isoflurane end-tidal
      concentration in 34%/66% O2/N2O, or 6.0 mg.kg-1 x h-1 propofol without N2O for
      anesthesia and alfentanil for analgesia. Strength of thumb adduction in response
      to single and train-of-four stimulation of the ulnar nerve was quantitated.
      Rocuronium 0.15, 0.2, 0.25, and 0.3 mg/kg were given intravenously. When maximal
      depression of twitch tension occurred, supplemental doses up to a total of 0.5
      mg/kg were given. If required, additional doses of 0.15 mg/kg were given at 25%
      recovery of control twitch tension. Standard hemodynamics, end-tidal CO2, and
      anesthetic gas concentrations were monitored continuously. The mean ED50 (SD) was
      0.133 (+/- 0.009) mg/kg for the halothane group, 0.118 (+/- 0.012) mg/kg for the
      enflurane group, 0.069 (+/- 0.026) mg/kg for the isoflurane group, and 0.167 (+/-
      0.007) mg/kg for the total intravenous anesthesia (TIVA) group, respectively.
      There was a statistically significant difference between the halothane and TIVA,
      and between the enflurane and TIVA groups (P < 0.05). Rocuronium has a short
      onset time and an intermediate duration of action. The neuromuscular blocking
      potency and pharmacodynamic profile are moderately influenced by volatile
      anesthetics.

PMID- 8368559
TI  - Succinylcholine causes profound hyperkalemia in hemorrhagic, acidotic rabbits.
AB  - Two recent clinical reports suggested that succinylcholine (SCh) may cause severe
      hyperkalemia in hemorrhagic, acidotic humans. To investigate this, we
      anesthetized rabbits with halothane and N2O, and inserted venous and arterial
      catheters. Control rabbits (Group C, n = 4) remained anesthetized and
      undisturbed. Hemorrhage/profound acidosis (HPA) was accomplished by withdrawal of
      25-30 mL/kg of blood and waiting until pHa approximately 7.05 (Group HPA, n = 5).
      Hemorrhage/minimal acidosis (HMA) was accomplished by withdrawal of 25-30 mL/kg
      of blood, but acidosis was minimized by not waiting for it to occur and by
      administering NaHCO3 0-1.4 mEq/kg (Group HMA, n = 4). In a metabolic acidosis
      group (n = 4), HCl was infused until pHa approximately 7.05. Respiratory acidosis
      (n = 4) was accomplished by partial obstruction of the endotracheal tube until
      PaCO2 approximately 120 mm Hg and pHa approximately 7.05. Potassium levels were
      determined before the above interventions (baseline), immediately before (pre
      SCh), and 1, 3, 5, 7, 10, and 13 min after SCh 1 mg/kg intravenously. In Group C,
      potassium gradually increased from 3.5 +/- 0.2 mEq/L to 4.8 +/- 0.2 mEq/L 13 min
      after SCh. In Group HPA, potassium increased from 3.8 +/- 0.3 to 7.0 +/- 1.8
      mEq/L after hemorrhage/acidosis and then to 11.4 +/- 1.7 mEq/L at 13 min after
      SCh. The metabolic acidosis group was significantly different from Group C at 7,
      10, and 13 min after SCh (maximum at 13 min, 6.8 +/- 1.2 mEq/L).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368560
TI  - Evaluation of foil coverings for protecting plastic endotracheal tubes from the
      potassium-titanyl-phosphate laser.
AB  - The potassium-titanyl-phosphate laser is being used for airway surgery and could
      cause an endotracheal tube fire. To determine whether five different metallic
      foil tapes or the Laser-Guard protective wrap would protect polyvinylchloride
      (PVC) endotracheal tubes from this laser, it was set to a power of 18 W and aimed
      at the wrapped endotracheal tube under study for up to 1 min while 5 L/min of
      oxygen flowed through the endotracheal tube. A plain (unwrapped) PVC endotracheal
      tube was studied also. The plain PVC endotracheal tube was ignited by the laser
      after 14 s. Potassium-titanyl-phosphate laser radiation did not significantly
      affect the nonadhesive sides of the foil tapes tested or the Laser-Guard
      covering. However, potassium-titanyl-phosphate laser radiation caused ignition or
      melting of underlying PVC endotracheal tubes when it was applied to the
      endotracheal tubes with the adhesive side of the foil tapes facing outward. It is
      concluded that only the Laser-Guard protective coating adequately protected the
      PVC endotracheal tubes tested under the conditions of this experiment.

PMID- 8368561
TI  - Effects of midazolam on respiratory muscles in humans.
AB  - Midazolam at sedative doses alters the breathing pattern; however, its effects on
      respiratory load and respiratory muscle activity have not been established
      completely. Therefore, the effects of midazolam (0.1 mg/kg) on total pulmonary
      resistances and on diaphragmatic, intercostal, and abdominal muscle patterns were
      studied in nine volunteers. Measurements were performed during control, 5 and 10
      min after midazolam, and then 2 min after 1.0 mg of intravenous flumazenil. After
      midazolam, total pulmonary resistance increased from 6.3 +/- 0.65 to 36.6 +/- 8.1
      cm H2O-L-1 x s-1 (P < 0.01), a pattern associated with an increased intercostal
      electromyographic activity (peak and slope; P < 0.05). By contrast, the ratio of
      gastric pressure on esophageal pressure changes decreased from 65.5% +/- 6.2% to
      16.3% +/- 3.9% (P < 0.01), indicating reduced diaphragmatic activity. In 7/9
      subjects, there was expiratory abdominal muscle activity. Flumazenil reversed all
      these effects. We conclude that midazolam 0.1 mg/kg increases total pulmonary
      resistance and elicits a compensatory load response characterized by an increase
      in inspiratory intercostal and expiratory abdominal muscle activities whereas
      diaphragmatic contribution is reduced.

PMID- 8368562
TI  - Hepatic blood flow and energy metabolism during hypotension induced by
      prostaglandin E1 and nicardipine in rabbits: an in vivo magnetic resonance
      spectroscopic study.
AB  - Hepatic blood flow (HBF) and energy metabolism during moderate hypotension
      induced by prostaglandin E1 (PGE1) and nicardipine were studied by in vivo
      magnetic resonance spectroscopy. HBF was determined by the deuterated water
      clearance method by using deuterium magnetic resonance spectroscopy, and energy
      metabolism was estimated from the changes in the levels of adenosine triphosphate
      and inorganic phosphate by using phosphorus (31P) magnetic resonance
      spectroscopy. Mean arterial blood pressure was intentionally reduced to 60% of
      control with PGE1 (n = 5) or nicardipine (n = 5). The HBF decreased by 38% and by
      50% during the hypotension induced by PGE1 and nicardipine, respectively. The
      level of adenosine triphosphate decreased by 12% and that of inorganic phosphate
      increased by 80% during nicardipine-induced hypotension, whereas the
      corresponding levels showed no remarkable changes during PGE1-induced
      hypotension. After the cessation of drug administration, mean arterial blood
      pressure and HBF recovered to the control levels in the PGE1 group, but not
      completely in the nicardipine group. In the latter group, the level of inorganic
      phosphate did not recover either. These results indicate that during hypotension
      induced with PGE1 hepatic circulation and metabolism are conserved to a greater
      extent than during hypotension induced with nicardipine.

PMID- 8368563
TI  - Endotoxin in septic shock.

PMID- 8368564
TI  - Management of the parturient with a history of local anesthetic allergy.

PMID- 8368565
TI  - Is spinal anesthesia after failed epidural anesthesia contraindicated for
      cesarean section?

PMID- 8368566
TI  - Cesarean section after maternal acetaminophen overdose.

PMID- 8368567
TI  - Rhabdomyolysis, acute renal failure, and the exaggerated lithotomy position.

PMID- 8368568
TI  - Drager ventilator failure.

PMID- 8368569
TI  - Methylprednisolone, head trauma, and brain protection.

PMID- 8368570
TI  - Cost saving with reusable pulse oximeter probes.

PMID- 8368571
TI  - Venovenous bypass and liver transplantation.

PMID- 8368572
TI  - Epidural test dose with lidocaine in obstetrics: why ask questions?

PMID- 8368573
TI  - A method to assist radial artery cannulation.

PMID- 8368574
TI  - An alternative approach for administering metered dose inhalers.

PMID- 8368575
TI  - Sensory testing in a rat sciatic nerve model.

PMID- 8368576
TI  - Additional evidence against a unitary site of volatile anesthetic action.

PMID- 8368577
TI  - An infusion pump that works in MRI.

PMID- 8368578
TI  - Saline versus water for epidural injection.

PMID- 8368579
TI  - American Society of Anesthesiologists 1993 Annual Meeting. Washington, D.C.,
      October 9-13, 1993. Abstracts.

PMID- 8368581
TI  - Regulation of IgE synthesis by T cells and cytokines.
AB  - Human IgE synthesis is tightly regulated by cytokines. IgE production by normal B
      cells is specifically induced by IL-4, but requires additional, yet to be
      defined, signals that are provided by CD4+ T cells. Single surface IgM+ B cells
      can be induced to proliferate and switch to IgG4 and IgE producing cells,
      indicating that the induction of IgE synthesis by IL-4 and CD4+ T cells reflects
      direct isotype switching. Although IL-4 is the sole inducing cytokine of IgE
      synthesis known thus far, multiple cytokines modulate IL-4 induced IgE synthesis
      in vitro. IFN-alpha, IFN-gamma TGF-beta and IL-10 are inhibitory, whereas IL-5,
      IL-6 and TNF-alpha act synergistically with IL-4. Results obtained with animal
      models, as well as from clinical studies in the human have indicated that IL-4,
      IFN-alpha and IFN-gamma are operational in vitro. Cocultivation of B cells with
      allergen-specific CD4+ T cell clones producing high levels of IL-4 and IL-5, but
      normal to undetectable levels of IL-2 and IFN-gamma, following activation
      resulted in the synthesis of IgE, in the absence of exogenously added IL-4. These
      results indicate that aberrant ratio's of IL-4 and IFN-gamma production are
      sufficient for induction of IgE synthesis in vitro.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8368580
TI  - Drugs responsible for anaphylactoid reactions in anaesthesia in the United
      Kingdom.

PMID- 8368582
TI  - The histamine H3 receptor: pharmacology and potential therapeutic applications.

PMID- 8368583
TI  - Mechanisms in IgE-dependent anaphylaxis to anesthetic drugs.
AB  - The discovery of IgE antibodies to neuromuscular blocking drugs, to thiopentone
      and narcotics, particularly morphine, reinforced earlier beliefs formed from skin
      test and other clinical findings that many "anaphylactoid" reactions to drugs
      were true type 1 immediate hypersensitivity reactions. Immunochemical studies
      established the fine structural specificities of the drug-reactive IgE antibodies
      and provided an explanation in molecular terms for a number of observed clinical
      cross-reactions. Subtleties in interpreting relationships between skin tests and
      IgE radioimmunoassays are pointed out and mechanisms of drug-induced mediator
      release, persistence of IgE antibodies and the nature of the sensitizing sources
      are discussed.

PMID- 8368584
TI  - Non specific interactions in anti-agent IgE-RIA to anesthetic agents.
AB  - The sensitivity of usual IgE-RIA for detecting seric anti-neuromuscular blocking
      drug (NMBD) IgE antibodies is low. Our group and other authors have proposed
      quaternary ammonium compounds other than NMBD for the preparation of sepharose
      solid drug phase. These compounds cannot be cyclohexenyl derivatives in order to
      prevent hydrophobic interactions with seric hydrophobic IgE. Allergic reactions
      against cyclohexenyl derivatives such as propofol could be linked to a non
      specific hydrophobic binding of the drug to hydrophobic seric IgE. Such
      hydrophobic IgE are seen in 30% of atopic subjects, in 41% of patients with drug
      allergy and in 100% of those allergic to propofol. The latter had also anti
      quaternary ammonium IgE in 5 out of the 8 cases studied. These NMBD antibodies
      could bind to the quaternary-ammonium ion of the lecithins from Diprivan
      micelles.

PMID- 8368585
TI  - Improved diagnosis of anaphylactoid reactions by measurement of serum tryptase
      and urinary methylhistamine.

PMID- 8368586
TI  - Diagnosis of IgE-dependent anaphylaxis to neuromuscular blocking drugs,
      thiopentone and opioids.
AB  - Although allergenic cross-reactivity of neuromuscular blocking drugs (NMBDs) is
      recognised clinically and has been firmly established at the serological and
      immunochemical levels, interpretation of in vitro inhibition findings for
      clinical purposes is not always straightforward. Points to be taken into account
      when considering serum IgE direct binding and inhibition results and when
      determining which NMBDs a patient may be sensitive to, include the relationship
      between in vitro potencies and clinical findings and the nature of the drug solid
      phase used for testing. It should also be remembered that the stimulating
      antigenic source for the patients' NMBD-reactive IgE antibodies is almost always
      unknown. A comparison of skin and IgE radioimmunoassay (RIA) tests for NMBDs in
      29 patients is presented and difficulties involved in interpreting the results of
      both tests are discussed. Methods for increasing the detection of NMBD-reactive
      IgE antibodies are outlined. In screening sera of patients for IgE antibodies to
      thiopentone and morphine as well as NMBDs, multiple drug reactivities have been
      detected in a few subjects. Attention is drawn to defects in the existing
      thiopentone RIA although it is clear that the test is specific in patients who
      react to the drug. Addition of the serum tryptase assay to skin tests and IgE
      RIAs for NMBDs, thiopentone and morphine provides a powerful combination of
      diagnostic tests for the investigation of anaphylactoid reactions to anaesthetic
      drugs.

PMID- 8368587
TI  - Limits of interpretation of screening tests for anaphylactic shock to muscle
      relaxants.

PMID- 8368588
TI  - Concept and limitations of predictive tests in anaesthesiology.

PMID- 8368589
TI  - New concepts in the treatment of anaphylactoid reactions in anesthesia.

PMID- 8368590
TI  - [New concepts in allergo-anesthesia].

PMID- 8368591
TI  - Drugs and other agents involved in anaphylactic shock occurring during
      anaesthesia. A French multicenter epidemiological inquiry.
AB  - An epidemiological inquiry was carried out in departments of anaesthesia and
      immunology in French University and General Hospitals, as well as among those who
      were already known to have an allergo-anaesthesia outpatient clinic. This inquiry
      aimed to find out how many patients had undergone diagnostic investigations after
      as well as an anaphylactoid reaction during an anaesthetic in 1990 and 1991, as
      well as the demographic data, the kind of assessment, the accident mechanism and
      the drugs involved. Twenty-one French centres replied to the questionnaire and a
      series of 1,585 patients tested over a two-year period was thus collected. There
      were three female patients to one male. The reactions occurred mostly in the
      adult (80%), but 9% were observed in children. Allergological tests for IgE
      dependent anaphylaxis were the skin tests (21 centres), combined with
      radioimmunological assays of specific serum antibodies to muscle relaxants (10
      centres), propofol (9 centres), latex (5 centres), leukocyte histamine release (9
      centres) and human basophil degranulation test (4 centres). The criteria for a
      positive result were the same for all centres. Among these 1,585 patients, 813
      were recognized as having had a reaction of immunological origin (52%). The
      substances involved were identified in these 813 patients as being muscle
      relaxants (70%), latex (12.6%), hypnotics (3.6%), benzodiazepines (2.0%), opioids
      (1.7%), colloids (4.7%), and antibiotics (2.6%). Suxamethonium was responsible
      for 43% of the IgE-dependent reactions involving a muscle relaxant, vecuronium
      for 37%, pancuronium for 13%, alcuronium for 7.6%, atracurium for 6.8% and
      gallamine for 5.6%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368592
TI  - The incidence and clinical features of anaphylactic reactions during anesthesia
      in Australia.
AB  - The details of 826 patients referred to an Anaesthetic Allergy Clinic over a 17
      year period are described. 443 were classified as having severe immediate
      anaphylactic reactions and in the majority of these (263) a muscle relaxant was
      involved. In Australia, the most common cause of a reaction is alcuronium, which
      probably reflects usage, although it is the most commonly found to give a
      positive skin test in relaxant reactors. Suxamethonium and atracurium appear to
      have an incidence of reactions greater than predicted by market share and
      pancuronium and vecuronium appear safer both on incidence of reactions and on
      positive skin tests in reactors. The incidence of reactions is between 1:10,000
      and 1:20,000 anaesthetics. Patients who react have greater incidence of allergy,
      atopy, asthma and previous reactions than non reactors. Previous exposure is
      usually apparent in reactors to induction agents but not muscle relaxants.
      Cardiovascular collapse is the most common presenting problem and is the only
      problem in 10%. Skin changes are the next most common and then bronchospasm which
      may be transient and is the hardest feature to treat. With an investigation
      protocol based on history, skin and RIA testing subsequent anaesthesia is usually
      safe.

PMID- 8368593
TI  - Keratan sulfate as a marker of articular cartilage catabolism and joint treatment
      in ponies.
AB  - Keratan sulfate (KS) is a glycosaminoglycan, distribution of which is confined
      mostly to hyaline cartilage. As such, it is a putative marker of hyaline
      cartilage catabolism. In experiment 1, a focal osteochondral defect was made
      arthroscopically in 1 radial carpal bone of 2 ponies, and in 2 other ponies,
      chymopapain was injected into the radiocarpal joint to induce cartilage
      catabolism. Sequential and concurrent plasma and synovial fluid concentrations of
      KS were measured, up to 13 months after induction of cartilage injury, to
      determine whether changes in KS concentrations reflected cartilage catabolism. In
      experiment 2, a large, bilateral osteochondral defect was made in the radial
      carpal bones of 18 ponies, which were subsequently given postoperative exercise
      and/or injected intra-articularly with 250 mg of polysulfated glycosaminoglycan
      (PSGAG). Medication was given at surgery, then weekly for 4 weeks. Blood samples
      were collected and synovial fluid was aspirated before surgery, when medication
      was given, and at postmortem examination (postoperative week 17). The KS
      concentration was measured in these fluids to determine whether changes in KS
      concentration indicated an effect of joint treatment. In experiment 1, the
      concentration of KS in synovial fluid was highest 1 day after joint injury, and
      the concentration in plasma peaked 2 days after joint injury. For ponies
      receiving chymopapain intra-articularly (generalized cartilage catabolism), a
      fivefold increase over baseline was observed in the concentration of KS in plasma
      (peak mean, 1.2 micrograms/ml), and a tenfold increase over baseline in synovial
      fluid (peak mean, 2.0 mg/ml) was observed. On average, these maxima were
      threefold higher than values in fluids of ponies with osteochondral defects
      (focal cartilage disease). In experiment 2, nonexercised ponies had lower KS
      concentration (as a percentage of the preoperative concentration) in synovial
      fluid than did exercised ponies at all postoperative times, and at postoperative
      week 17, this effect was significant (P < 0.05). This may be related to decreased
      turnover of KS in articular cartilage attributable to stall confinement and late
      increase in turnover related to exercise. Seventeen weeks after surgery, synovial
      fluid from exercised, medicated ponies had significantly (P < 0.05) higher KS
      content than did fluid from exercised, nomedicated ponies. This indicated that
      exercise, when combined with medication, may increase KS release from articular
      cartilage. Synovial fluid from medicated joints of nonexercised ponies had
      significantly (P < 0.05) lower KS concentration than did synovial fluid from
      nonmedicated joints of nonexercised ponies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368594
TI  - Effects of sample collection and handling on concentration of osteocalcin in
      equine serum.
AB  - A commercially available radioimmunoassay kit for measurement of human
      osteocalcin was validated for use in horses. For accurate measurement of equine
      serum osteocalcin, blood samples may be collected at a temperature between 20 and
      25 C, then centrifuged within 90 minutes; serum may be stored at -20 C in plastic
      tubes for up to 26 weeks. Serum may be thawed and refrozen up to 5 times without
      significant change in measured equine serum osteocalcin concentration. Assay
      sensitivity was 0.16 ng/ml. Recovery of bovine osteocalcin standard added to
      equine serum was linear. Intra-assay coefficient of variation (x 100) for 2
      equine serum pools was 6.9 (mean +/- SD, 13.9 +/- 1.0 ng/ml) and 7.5 (10.6 +/-
      0.8 ng/ml) %. Interassay coefficient of variation for 3 equine serum pools
      measured in 12 assays was 12.5 (16.1 +/- 2.0 ng/ml), 12.7 (11.5 +/- 1.5 ng/ml),
      and 24.6 (3.0 +/- 0.7 ng/ml) %. Dilutional parallelism was documented by assaying
      pooled equine serum at 4 dilutions and correcting the mean result for dilution.
      Significant change was not observed in equine serum osteocalcin concentration for
      various time-of-day blood sample collections in horses housed under continuous
      lighting.

PMID- 8368595
TI  - Coxofemoral joint laxity from distraction radiography and its contemporaneous and
      prospective correlation with laxity, subjective score, and evidence of
      degenerative joint disease from conventional hip-extended radiography in dogs.
AB  - A 3-year prospective study of large-breed dogs (4 months to 3 years of age) was
      conducted to evaluate the influence of radiographic positioning and age on
      coxofemoral joint (hip) laxity, subjective hip score, and development of
      degenerative joint disease (DJD). The dogs (n = 142) were breeder- or client
      owned and represented 14 breeds. With dogs under heavy sedation, hips were
      radiographed in the standard hip-extended position and in the new
      compression/distraction position at 4, 6, 12, 24, and 36 months of age. The
      standard hip-extended radiographic view was evaluated by 3 methods: subjective
      evaluation by a board-certified veterinary radiologist (WHR), according to the
      standard 7-point Orthopedic Foundation for Animals (OFA) scoring scheme
      (OFA/WHR); joint laxity quantitation, using the Norberg angle (NA) method; and
      subjective scoring by a veterinary orthopedic surgeon for radiographic evidence
      of DJD. The hips in the distraction radiographic view were evaluated for passive
      hip laxity, as measured by use of a unitless distraction index (DI). Results of
      the study indicated that at a specific age (4, 6, 12, 24, or 36 months), all
      methods of hip evaluation correlated with each other at a moderate level (P <
      0.05). The strength of contemporaneous correlation tended to increase with age of
      evaluation. Longitudinally, the between-method correlations were usually
      significant (P < 0.05), but not at a sufficiently high level to permit reliable
      between-method prediction. Prospective intraclass (within-method) statistical
      analysis of the various hip-scoring methods indicated that DI was superior to NA
      and OFA/WHR in comparability of score over time. The intraclass correlation
      coefficient ranged from 0.55 to 0.91 for DI in contrast to 0.40 to 0.78 for NA,
      and 0.06 to 0.39 for OFA/WHR over the age intervals of the study. For reference,
      the highest Kappa of 0.39 for the subjective OFA/WHR scoring reflected a maximal
      level of agreement between time intervals, only slightly better than chance. The
      associated large error questions the predictive use of the 7-point, subjective
      hip-scoring scheme, particularly prior to the age of 2 years.

PMID- 8368596
TI  - Use of indirect enzyme-linked immunosorbent assay with hot saline solution
      extracts of a variant (M-) strain of Brucella canis for diagnosis of brucellosis
      in dogs.
AB  - An ELISA, using hot saline solution extracts (HSS) of a less-mucoid variant (M-)
      strain of Brucella canis as antigen, was developed for detection of antibodies
      against B canis in dogs. The test was applied to 177 field serum samples
      previously tested by use of the 2-mercaptoethanol rapid slide agglutination test,
      2-mercaptoethanol-tube agglutination test, and agar gel immunodiffusion
      containing HSS and cytoplasmic antigens of B. canis. Results indicated that this
      ELISA seems to be highly specific (95.6%) and slightly less sensitive (93.8%).
      The HSS obtained from B canis wild-type RM 6/66 also have been used, but in our
      study, it seemed to be unsuitable for use in ELISA because of the high background
      values observed for sera with negative test results.

PMID- 8368597
TI  - Prevalence of atretic corpora lutea in ovaries of bovine fetuses.
AB  - Both ovaries from 88 bovine fetuses in the fifth month or later of gestation were
      studied histologically to determine the prevalence, origin, and time of
      appearance of atretic corpora lutea (ACL). Ovaries from 36 (41%) fetuses had ACL;
      fetuses < 6 months of gestation did not have ACL. Six fetuses had more than 25
      ACL, but there was no apparent relationship between fetal age and number of ACL.
      Formation of ACL involved disintegration of the stratum granulosum of secondary
      follicles, concomitant with proliferation and invasion by vascularized elements
      of the theca. Fully developed ACL consisted of a large primary oocyte surrounded
      by a prominent zona pellucida and encased in a well-vascularized, largely thecal,
      fibrocellular wall. They measured approximately 0.5 to 1.0 mm in diameter. Empty,
      collapsed zona pellucidas were seen in many of the degenerating ACL.

PMID- 8368598
TI  - Serum immunoglobulin concentrations after feeding maternal colostrum or maternal
      colostrum plus colostral supplement to dairy calves.
AB  - Maternal colostrum or maternal colostrum plus colostral supplement, composed of a
      blend of lyophilized colostrum and dried whey, was fed to 32 Holstein calves as
      soon as possible after birth (mean +/- SEM = 2.0 +/- 0.2 hours) and, again, 12
      hours later. Mean immunoglobulin concentration in colostrum was 59.2 mg/ml; mean
      immunoglobulin fraction in supplement was 11.4%. Serum immunoglobulin
      concentrations were measured at 0, 12, 24, 48, and 72 hours, and at 28 and 56
      days. Hour/treatment interactions were significant for total immunoglobulin,
      IgG1, and IgM concentrations. Immunoglobulin concentrations were highest at 12
      hours (total immunoglobulin, IgG1, IgM) or 24 hours (IgG2) in calves fed
      colostrum plus supplement, whereas all immunoglobulin concentrations were highest
      at 24 hours in calves fed maternal colostrum only. Peak mean immunoglobulin
      concentrations did not differ between treatments. Supplementation of colostrum
      did not increase peak mean serum immunoglobulin concentration, but did alter the
      serum concentration-time profile from 12 to 72 hours after birth.

PMID- 8368599
TI  - Immunoglobulins in stimulated tears of dogs.
AB  - Immunoelectrophoresis and single radial immunodiffusion were used to identify and
      measure tear immunoglobulin concentrations in 50 healthy dogs. Immunoglobulin A
      and IgG were detected in all samples analyzed, whereas IgM was not detected in
      any sample. Mean IgA concentration was 25.28 +/- 1.9 mg/dl, adult dogs (> 18
      months) having significantly higher mean value. The IgA concentration related to
      age had significant (P < 0.006) positive correlation; mean IgG concentration was
      23.10 +/- 1.72 mg/dl. Linear correlation analysis revealed significant (P <
      0.0007) correlation coefficient between tear total protein and IgA
      concentrations. The IgA and IgG concentrations also were significantly (P <
      0.0001) correlated when expressed as milligrams per 100 mg of protein. Relation
      with sex was not established for either immunoglobulin.

PMID- 8368600
TI  - Association between the effacing (eae) gene and the Shiga-like toxin-encoding
      genes in Escherichia coli isolates from cattle.
AB  - Two hundred ninety-six Escherichia coli isolates from feces or intestines of
      calves with diarrhea were hybridized with 7 gene probes. One probe (the eae
      probe) was derived from the eae gene coding for a protein involved in the
      effacement of the enterocyte microvilli by the group of bacteria called attaching
      and effacing E coli (AEEC), and 2 probes were derived from genes coding for the
      Shiga-like toxins (SLT) 1 and 2 produced by the verocytotoxic E coli (VTEC). The
      other 4 probes were derived from DNA sequences associated with the adhesive
      properties of enteroadherent E coli (EAEC) to cultured cells (the EAF probe for
      the localized adherence pattern, probes F1845 and AIDA-1 for the diffuse
      adherence pattern, and the Agg probe for the aggregative adherence pattern).
      Hybridization results for the eae probe were in agreement, for all but 1 of the 8
      isolates, with previously published phenotypic results of microvilli effacement.
      The latter was previously reported as effacing the microvilli of calf
      enterocytes, but was eae probe-negative. Two classes of isolates hybridized with
      the eae probe. Members of a first class (60 isolates) additionally produced a
      positive signal with 1 or both of the SLT probes (VTEC-AEEC isolates). Isolates
      hybridizing with the eae and the SLT1 probes were the most frequent: 56 isolates
      (ie, 93% of all VTEC-AEEC). Members of the second class (10 isolates) failed to
      hybridize with either SLT probe (non-VTEC-AEEC isolates).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8368602
TI  - Immunologic changes in Ostertagia ostertagi-infected calves treated strategically
      with an anthelmintic.
AB  - Immunomodulation by Ostertagia ostertagi and the effects of strategic
      anthelmintic treatments were studied in 3 groups of 6 calves each: an infected
      group, inoculated with 100,000 third-stage larvae (L3)/calf at 1 and 28 days; an
      infected-treated group, similarly inoculated, but treated with ivermectin 9 days
      after each inoculation; and a noninfected control group. Calves were grazed on 2
      previously clean pastures, with the infected and infected-treated calves sharing
      1 pasture. All calves were inoculated at 12 weeks with Brucella abortus and
      infectious bovine rhinotracheitis vaccines, and at 13 weeks with a soluble O
      ostertagi L3 extract (SLE). Infected and infected-treated calves had lower blood
      lymphocyte responses to phytohemagglutinin than did control calves at 2, 4, and
      14 weeks, whereas the infected calves had higher responses at 6 and 8 weeks (P <
      0.05). Responses to pokeweed mitogen followed a similar pattern, whereas those to
      SLE were low in all calves. Infected and infected-treated calves had increased
      values of IgG1 to excretory-secretory antigens of L4 larvae, but no changes in
      the values of IgG1 to SLE. They also had lower values of IgG and IgM to B abortus
      and antibodies to infectious bovine rhinotracheitis at 13 weeks. The infected
      treated calves, however, had higher blood lymphocyte and monocyte counts and
      lower eosinophil count than did infected calves. They also had reduced abomasal
      mucosa thickness, abomasal wall weight, and abomasal lymph node weight than
      infected calves. It was concluded that O ostertagi causes nonspecific suppression
      of cellular and humoral immunity, hypersensitivity reactions coexisted with
      immunosuppression, and strategic anthelmintic treatments attenuated
      hypersensitivity reactions and initiated better immune responses.

PMID- 8368601
TI  - Serogrouping of Bacteroides nodosus isolates from 62 sources in the United
      States.
AB  - Bacteroides nodosus isolates from 62 sources in the United States were obtained
      from sheep with infectious foot diseases. Serotypic analysis of these isolates
      revealed 21 serotypes (designated I-XXI). These serotypes were compared with
      British and Australian/New Zealand B nodosus strains by use of reciprocal tube
      agglutination tests. These tests, as well as the cross-matching tube
      agglutination tests of the US serotypes, resulted in arranging the US serotypes
      into 11 serogroups, and comparing these serogroups with their Australian/New
      Zealand serogroup and British serotype counterparts. Three US serogroups and 1
      additional British serotype had little or no relationship to any of the
      Australian/New Zealand serogroups A-H (the vaccine strains). One or more of these
      unrelated serogroups were found in 29% of the sources studied. The most
      frequently found US serotype was serotype XV at 29%. The most frequently found US
      serogroups were the serogroups analogous to serogroup B (43.5%) and serogroup H
      (37%); the other serogroups were found in 22.6% or less of the sources studied.
      Evaluation of 3 sources revealed that multiple serotypes in a single flock are
      common, multiple serotypes from a single lesion are possible, B nodosus isolates
      obtained from goats (unlike those from cattle) appear identical to the isolates
      obtained from sheep, and disease can appear in vaccinated animals, even in a
      flock that appears to be harboring only a single serogroup-B serotype (the
      serogroup for which there are 3 strains in the current vaccine).

PMID- 8368603
TI  - Skeletal muscle of cattle affected with progressive degenerative
      myeloencephalopathy.
AB  - Skeletal muscle from multiple sites of 6 cattle afflicted with progressive
      degenerative myeloencephalopathy was analyzed by transmission electron microscopy
      and compared with skeletal muscle taken from 2 clinically normal cattle
      (controls) similarly studied. Major changes in the affected muscle included
      abnormal myoneural junctions with redundant junctional folds that were abnormally
      long and branching, and occasionally separated from the synaptic site; multiple
      vacuoles of variable size clustered in subsarcolemmal positions and in rows
      between myofibrils; bizarre mitochondria with thin connecting stalks, large
      electron-dense bodies, and abnormal cristae; and cone-shaped projections of the
      sarcolemma. These findings indicate that myopathy is part of the progressive
      degenerative myeloencephalopathy phenotype.

PMID- 8368604
TI  - Sequential study of pancreatic structure and function during development of
      pancreatic acinar atrophy in a German shepherd dog.
AB  - Sequential assessments of pancreatic structure and function were performed on a
      female German Shepherd Dog bred from parents with exocrine pancreatic
      insufficiency (EPI), to monitor development of pancreatic acinar atrophy in this
      breed. Determinations of serum trypsin-like immunoreactivity (TLI), results of N
      benzoyl-L-tyrosyl-P-aminobenzoic acid test, fecal soy bean stimulation test
      (SST), and gross and histologic examinations of the pancreas did not provide
      evidence of exocrine pancreatic disease up to 13 months of age. However, electron
      microscopy revealed degenerative abnormalities of acinar cells that were already
      apparent at 6 weeks and became more extensive with age. Examination of the
      pancreas at 22 months of age also indicated no gross or histologic abnormalities,
      but electron microscopy revealed widespread degenerative changes, including
      dilatation of the rough endoplasmic reticulum and extensive fusion of zymogen
      granules affecting most of the acinar cells. Serum TLI concentration was markedly
      reduced at that time, indicative of EPI, but the dog remained healthy and results
      of the SST were normal. Within 1 month, the dog had developed clinical signs of
      EPI, and not only serum TLI concentration, but also results of the N-benzoyl-L
      tyrosyl-p-aminobenzoic acid test and SST were compatible with severe loss of
      exocrine pancreatic tissue. This loss was confirmed by gross and histologic
      examination of the pancreas at 25 months, which revealed typical features of
      pancreatic acinar atrophy, including scattered and disorganized exocrine cells in
      the small remnants of pancreatic tissue. These findings indicate that in German
      Shepherd Dogs, pancreatic acinar atrophy may involve interference with normal
      intracellular processing of zymogen granules, which precedes progressive and
      eventual rapid loss of exocrine pancreatic tissue.

PMID- 8368605
TI  - Effect of ranitidine on healing of experimentally induced gastric ulcers in
      ponies.
AB  - Thirty young ponies were examined endoscopically for evidence of gastric
      ulceration. Seven ponies had noninduced gastric ulcers present at the initial
      examination and were eliminated from the study. In an attempt to induce gastric
      ulcers experimentally, flunixin meglumine (1.1 mg/kg of body weight, IM, q 8 h)
      was administered for 7 days to the 23 ponies with endoscopically normal gastric
      mucosa. During the 7 days of flunixin administration, 11 ponies developed gastric
      ulcers that were appropriate for study. The 11 ponies were randomly allotted to 2
      groups. Group-A (n = 5) and group-B (n = 6) ponies received ranitidine (4.4
      mg/kg, PO, q 8 h) and corn syrup, respectively, until ulcers healed or for a
      maximum of 40 days. General anesthesia was induced every 3 to 5 days for visual
      evaluation of ulcer healing by use of a video endoscope. The earliest complete
      healing of gastric lesions observed in a corn syrup-treated pony was at 17 days.
      At 40 days, 3 of 5 and 3 of 6 ponies of the ranitidine and corn syrup-treated
      groups, respectively, had healed ulcers. Results of this study indicate that:
      noninduced gastric ulcers may be common in young ponies, flunixin meglumine may
      be effective in inducing gastric ulcers for gastric healing studies in young
      ponies, and ranitidine (4.4 mg/kg, q 8 h) is not significantly effective in
      accelerating healing of experimentally induced gastric ulcers in ponies under
      conditions of this study.

PMID- 8368606
TI  - Pharmacokinetics of digoxin administered to horses with congestive heart failure.
AB  - Nine horses with (naturally acquired) congestive heart failure were treated with
      2.2 micrograms of digoxin/kg of body weight by the IV route, followed by 11
      micrograms/kg administered orally every 12 hours thereafter. Furosemide was
      administered IV concurrently with IV administered digoxin every 12 hours. Serum
      concentration of digoxin was measured after the first (IV) and seventh (orally
      administered) dose. After IV administration, digoxin disposition was described by
      a 2-compartment model, with a rapid distribution phase (t1/2 alpha = 0.17 hour),
      followed by a slower elimination phase (beta = 0.096 +/- 0.055 h-1, t1/2 beta =
      7.2 hours, where beta is the exponential term from the elimination phase of the
      concentration vs time curve). Bioavailability after oral administration was 21.2
      +/- 10.8%. After the seventh orally administered dose, serum concentration of
      digoxin peaked 1 to 2 hours later, and was 1.9 +/- 0.7 ng/ml (mean +/- SD). In 4
      horses, a second increase in serum digoxin concentration was observed 4 to 8
      hours after the initial peak, which possibly was evidence of enterohepatic
      recycling of the drug. Response to treatment included reduction in heart rate,
      peripheral edema, and pulmonary edema, but these could not be attributed to the
      digoxin alone because the horses were treated concurrently with furosemide.

PMID- 8368607
TI  - Effect of age on theophylline pharmacokinetics in dogs.
AB  - Differences between neonatal and adult animals in their response to drugs can
      usually be attributed to altered disposition processes. Effect of age on the
      pharmacokinetics of theophylline was determined after IV administration of the
      drug to 10 groups of dogs at 1, 2, 3, 4, 8, 12, 16, 24, 52, and 104 weeks of age.
      Plasma theophylline concentration curves for all groups were adjusted to a
      biexponential kinetic, with rapid initial distribution phase and slower
      elimination phase. It also was noticed that young dogs have a slower elimination
      half-life (1 week old, t 1/2 beta = 987 minutes) than do older animals (8 weeks
      old, t 1/2 beta = 138 minutes). The values then plateaued until 16 weeks of age,
      increasing slightly at more advanced age (104 weeks old, t 1/2 beta = 282
      minutes). A similar pattern was followed with respect to clearance (1-week-old
      pups, Cl = 1.17 ml/min/kg of body weight), which increased progressively to reach
      a value of 7.09 ml/min/kg at 16 weeks of age, then decreased to 3.5 ml/min/kg at
      104 weeks of age. Volume of distribution beta, in relation to body weight, was
      not significantly different between age groups (between 1.2 and 1.6 L/kg; P < or
      = 0.03). Theophylline biotransformation mechanisms may be mainly responsible for
      Cl and t 1/2 beta variations. This leads us to suggest that quantitative and
      qualitative modifications in the P-450 mono-oxygenase system are responsible for
      the variations observed in pharmacokinetic variables of theophylline between dogs
      of different ages. These findings may have clinical relevance with regard to
      therapeutic range of theophylline.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368608
TI  - Effect of polysulfated glycosaminoglycan on osteoarthritic equine articular
      cartilage in explant culture.
AB  - Middle carpal cartilage explants from 4 horses with mild osteoarthritis involving
      that joint were maintained in tissue culture to test the effects of a
      polysulfated glycosaminoglycan (PSGAG) on proteoglycan synthesis and degradation.
      Cultures were exposed to 0.025 or 25 mg of PSGAG/ml for 48 hours, after which the
      medium was replaced with medium containing similar doses of PSGAG and 35S.
      Subsequently, the sulfated proteoglycan content of the medium and extracts of the
      explants was measured. Gel filtration chromatography was used to estimate the
      size and to purify the principal, large proteoglycan monomer, which was further
      characterized by digestion, using glycosidic enzymes. In a second experiment,
      explants were incubated with 35S for 48 hours, and were subsequently exposed to
      the same concentrations of the PSGAG for an additional 48 hours. The amount of
      remaining labeled proteoglycan was determined for culture medium and cartilage
      extracts. Gel filtration chromatography was used to assess the hydrodynamic size
      of the large proteoglycan monomer. Aliquots of proteoglycans from the second
      experiment were incubated in high-molecular weight hyaluronate and
      chromatographed to assess reaggregation. Polysulfated glycosaminoglycan caused a
      significant (P < or = 0.04) decrease in sulfated proteoglycan synthesis by
      cartilage explants. Radioactive proteoglycan content in explants labeled prior to
      exposure to PSGAG were similar. Large proteoglycan monomer size was similar in
      both experiments (median partition coefficient [KAV] = 0.40), and was not
      influenced by PSGAG treatment. Prelabeled explants exposed to hyaluronate and
      chromatographed under associative conditions had similar proportions of the
      radiolabel eluting as proteoglycan aggregate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368609
TI  - Ibuprofen treatment of endotoxin-induced mastitis in cows.
AB  - Ibuprofen treatment was compared with saline solution treatment in an endotoxin
      induced experimental model of bovine mastitis. Acute mastitis was induced in
      healthy lactating Holstein cows (n = 12) by intramammary inoculation of 1 mg of
      Escherichia coli 026:B6 lipopolysaccharide in a single quarter per cow. Cows were
      assigned at random to ibuprofen (25 mg/kg of body weight, IV, n = 6) or 0.9%
      sodium chloride solution control (1.25 ml/kg, IV, n = 6) treatment groups.
      Ibuprofen or saline solution was administered once, 2 hours after endotoxin
      administration. The clinical course of endotoxin-induced mastitis and
      hematologic, clinical biochemical, and plasma mineral changes were monitored and
      compared between ibuprofen-treated and control cows. Clinical monitoring and
      blood sample collection were performed at 0, 2, 4, 6, 8, 12, 24, 48, 96, and 192
      hours after endotoxin challenge. Rectal temperature and heart and respiratory
      rates were significantly (P < or = 0.05) increased in saline treated cows,
      compared with cows treated with ibuprofen. Blood eosinophil count and serum
      phosphorus, sodium, and total carbon dioxide concentrations were significantly (P
      < or = 0.05) decreased in saline-treated cows, compared with cows treated with
      ibuprofen. Ibuprofen treatment did not significantly change ruminations per
      minute, electrical conductivity of milk, quarter size, or quarter inflammation.
      The remaining hematologic, serum biochemical, plasma mineral, and coagulation
      values also were not changed significantly in response to ibuprofen treatment.
      Untoward effects attributed to ibuprofen administration were not observed. These
      results indicate that ibuprofen may provide empiric relief of clinical signs of
      coliform-induced mastitis.

PMID- 8368610
TI  - Pharmacokinetics of ibuprofen in lactating dairy cows.
AB  - The pharmacokinetics of ibuprofen were studied in 6 adult lactating dairy cows
      after a single IV or oral administration of ibuprofen (25 mg/kg of body weight).
      Ibuprofen concentrations in milk and serum were analyzed by use of high
      performance liquid chromatography. The lower limit of detection of the ibuprofen
      assay was 50 ng/ml. Serum ibuprofen concentration-time curves after IV
      administration best fit an open two-compartment model. Harmonic mean volume of
      distribution at steady state was 0.14 (range, 0.12 to 0.17) L/kg, elimination
      half-life was 1.55 (range, 1.33 to 1.73) hours, and total clearance was 86.2
      (range, 68.8 to 106.2) ml/kg/h. Harmonic mean oral bioavailability was 99%
      (range, 79 to 112). Adverse effects were not observed in cows given ibuprofen.

PMID- 8368611
TI  - Effects of a 44-day administration of phenobarbital on disposition of clorazepate
      in dogs.
AB  - The disposition of clorazepate, a benzodiazepine anticonvulsant, was determined
      in dogs after administration of a single oral dose of clorazepate (2 mg/kg of
      body weight) and after oral administration of clorazepate (2 mg/kg, q 12 h)
      concurrently with phenobarbital (5 mg/kg, q 12 h) for 44 consecutive days. Serum
      concentrations of nordiazepam, the active metabolite of clorazepate, were
      measured. After a single oral dose of clorazepate, maximal nordiazepam
      concentrations ranged from 569.6 to 1,387.9 ng/ml (mean, 880.2 +/- 248.9 ng/ml)
      and were detected 16.8 to 131.4 minutes (mean, 85.2 +/- 36 minutes) after dosing.
      After administration of phenobarbital for 44 consecutive days, maximal
      nordiazepam concentrations were significantly (P < 0.01) lower, ranging from
      209.6 to 698.5 ng/ml (mean, 399.3 +/- 155.6 ng/ml) at 68.4 to 145.8 minutes
      (mean, 93 +/- 25.8 minutes) after dosing. Mean area under the curve (AUC) on day
      1 (mean, 3.37 +/- 0.598 ng.min/ml) was significantly (P < 0.001) greater than AUC
      on day 44 (1.66 +/- 0.308 ng.min/ml). Oral clearance was significantly (P < 0.01)
      greater on day 44 (12.44 +/- 2.55 ml/min/kg), compared with that on day 1 (6.16
      +/- 1.35 ml/min/kg). Values for area under the first moment curve, oral volume of
      distribution, mean residence time, and elimination half-life were not
      significantly altered by concurrent administration of phenobarbital.
      Administration of phenobarbital altered the disposition of clorazepate such that
      the amount of nordiazepam in circulation during each dose interval was
      significantly reduced. Adequate control of seizures in epileptic dogs, therefore,
      may require higher dosages of clorazepate when it is coadministered with
      phenobarbital.

PMID- 8368612
TI  - Development to blastocysts of one- to two-cell equine embryos after coculture
      with uterine tubal epithelial cells.
AB  - Development of 1- to 2-cell in vivo fertilized equine embryos cultured with or
      without uterine tubal epithelial cells (UTEC) was studied. One- to 2-cell embryos
      (n = 26) were collected surgically from the uterine tubes of pony mares 1 day
      after ovulation. Four- to 8-cell embryos (n = 9) were collected 2 days after
      ovulation. Presumptive zygotes and 2-cell embryos were cultured with (n = 17) or
      without (n = 9) UTEC, and all 4- to 8-cell embryos were cocultured with UTEC as
      positive controls. Uterine tubal epithelial cells were used as cell suspensions
      within 2 weeks after initiation of cultures. Embryos were cultured to blastocysts
      or until the embryo had morphologic degeneration. Six presumptive zygotes failed
      to cleave in vitro. Development to blastocysts of 1-cell (4 of 11) and 2-cell (2
      of 6) embryos cocultured with UTEC was similar. Coculture of 1- to 2-cell embryos
      with UTEC significantly (P = 0.05) improved development to blastocysts, compared
      with culture in medium alone (35 vs 0%, respectively); however, development to
      blastocysts of 1- to 2-cell embryos cocultured with UTEC was less (P < 0.025)
      than that of 4- to 8-cell embryos cocultured with UTEC (35 vs 89%, respectively).

PMID- 8368613
TI  - Functional variation in endogenous and exogenous immunoglobulin binding to bovine
      neutrophils relative to parturition.
AB  - Ten healthy first- and second-lactation Holstein cows were observed from 1 week
      before to 1 week after calving and at postpartum day 30 to determine
      polymorphonuclear neutrophil (PMN) functional variation and immunoglobulin
      binding profiles. Blood and mammary PMN were obtained 3 times weekly and within
      24 hours of calving. Functional traits measured included phagocytosis of
      Staphylococcus aureus and in vitro chemotaxis through micropore filters in a
      Boyden chamber. Additionally, PMN were evaluated for endogenous binding of IgG1,
      IgG2, IgA, and IgM before and after in vitro chemotaxis. Exogenous binding of the
      same isotypes was determined after incubation in pooled colostrum, purified
      immunoglobulin, and pooled sera. Phagocytosis results indicated a significant and
      transient increase in percentage of milk PMN with associated, rather than
      phagocytosed, bacteria for 1 week after calving. Blood PMN phagocytosis was not
      significantly different during this period. Though total chemotaxis was
      essentially unchanged, the percentage of PMN that were unable to complete
      migration increased substantially on the day of calving, an effect that
      disappeared by postpartum day 4. A significant (P < 0.01) positive correlation (r
      = 0.29) between percentage of PMN migrating completely through the micropore
      filter and percentage of blood PMN with associated bacteria was observed. Changes
      were not observed in endogenous immunoglobulin binding, with the exception of a
      peak in relative fluorescence intensity for IgG1 on the day of calving; this
      disappeared within 2 days after calving. Correlations between relative
      intensities of IgG2 and IgM, and percentage of mammary neutrophils phagocytosing
      were 0.37 and 0.70.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368614
TI  - Isolation and characterization of porcine milk lactoferrin.
AB  - We purified porcine whey lactoferrin by affinity chromatography on a heparin
      Sepharose column, followed by high-performance liquid chromatography. Molecular
      mass of purified lactoferrin (PLF) is 78,000 daltons. The iron-binding activity
      of PLF had a UV/visible-light absorption spectrum indistinguishable from that of
      human and bovine lactoferrins (absorbance ratio [465 nm/280 nm] approx 0.046).
      The growth ratio of WIL-2 cells in PLF-supplemented medium is 70% of that in
      serum-containing medium. The aforementioned characteristics are similar to those
      of human and bovine lactoferrins. Immunoblot analysis, using polyclonal antibody
      raised in rabbits against porcine whey lactoferrin, revealed high specificity for
      PLF, and low cross-reactivity with commercial human and bovine lactoferrins.

PMID- 8368615
TI  - Comparison of 0.9, 3.6, and 7.2% NaCl for correction of experimentally induced
      hypochloremic, hypokalemic metabolic alkalosis in sheep.
AB  - Nine adult female sheep were each surgically fitted with an Ivan and Johnston
      reentrant cannula in the cranial part of the duodenum just distal to the pylorus.
      By diversion (loss) of abomasal outflow, this model has been shown to
      consistently induce hypochloremic, hypokalemic metabolic alkalosis, accompanied
      by hyponatremia and dehydration. Each sheep was subjected to 3 treatment trials,
      each preceded by a 24-hour prediversion period, and a diversion period during
      which a syndrome of hypochloremia (68 +/- 2 mEq/L), hypokalemia, hyponatremia,
      and metabolic alkalosis was induced. Development of this syndrome was
      attributable to losses of large amounts of acid and electrolytes in the abomasal
      effluent. Mean total electrolyte contents of the effluent were: Cl-, 650 +/- 27
      mEq; Na+, 388 +/- 23 mEq; and K+, 123 +/- 12 mEq, with total volume loss ranging
      from 3.6 to 10.0 L of gastric contents and pH ranging from 3 to 5. Decreases in
      plasma electrolyte concentrations also can be attributed to decreased intake,
      because anorexia developed shortly after the onset of diversion. Electrolyte
      losses in urine during diversion were minimal for Cl- (mean +/- SEM, 12.0 +/- 5.1
      mEq), but were greater for Na+ (124.2 +/- 14.5 mEq) and K+ (185.1 +/- 31.2 mEq).
      Treatments consisted of 0.9% NaCl (300 mosm/L), 3.6% NaCl (1,200 mosm/L), and
      7.2% NaCl (2,400 mosm/L) administered over a 2-hour period, with the administered
      volume determined by the estimated total extracellular fluid Cl- deficit.
      Significant difference was not found among treatments, with all solutions
      resulting in return of clinicopathologic and physical variables to prediversion
      values within 12 hours of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368616
TI  - Normal laparoscopic anatomy of the bovine abdomen.
AB  - Three laparoscopic procedures were performed on each of 6 adult Jersey cows in
      the first trimester of gestation to describe normal laparoscopic anatomy of the
      bovine abdomen. Also, a technique for laparoscopy of the cranioventral portion of
      the abdomen was described. Right paralumbar fossa, left paralumbar fossa, and
      cranioventral midline laparoscopy were performed 72 hours apart of each cow.
      Physical examination findings, CBC, serum biochemical analysis, and peritoneal
      fluid analysis before and 72 hours after the first surgery were used to assess
      the effects of the procedures on the cows. Exploratory celiotomy was performed 2
      weeks after the last laparoscopy. The cows were then reexamined 6 weeks after the
      last procedure. The t-test for paired data was used for statistical analysis; the
      level of significance was P < 0.05. Laparoscopy was performed without
      complication in all cows. Adverse effects of laparoscopy, individually or
      serially, were not observed. Significant differences were not found between CBC,
      serum biochemical, and peritoneal fluid variables taken before and 72 hours after
      surgery.

PMID- 8368617
TI  - Evaluation of bending strength of five interdental fixation apparatuses applied
      to canine mandibles.
AB  - Strength in bending was determined for interdental fixation apparatuses applied
      to hemimandibles obtained from 24 canine cadavers. Hemimandibles were
      osteotomized perpendicular to the long axis between the third and fourth
      premolars, and segments were stabilized with 1 of 5 interdental fixation
      apparatuses: Erich arch bar (EAB, n = 6); Stout loop (SL, n = 6); acrylic (A, n =
      6); Stout loop and acrylic (SLA, n = 24); and Erich arch bar and acrylic (EABA, n
      = 6). Ultimate strengths (mean +/- SEM) of EAB, SL, A, SLA, and EABA were 395 +/-
      48; 523 +/- 57; 1,106 +/- 102; 1,306 +/- 156; and 2,707 +/- 504 N.m,
      respectively. Stiffness (mean +/- SEM) of EAB, SL, A, SLA, and EABA were 2,944 +/
      357; 6,322 +/- 2,201; 16,010 +/- 5,017; 15,777 +/- 1,026; and 27,079 +/- 5,576
      N.m/radian, respectively. Yield strengths (mean +/- SEM) of EAB, SL, A, SLA, and
      EABA were 66 +/- 6; 264 +/- 19; 911 +/- 126; 1,114 +/- 159; and 1,855 +/- 401
      N.m, respectively. There were no significant differences in acrylic weight, cross
      sectional area of the acrylic, or area moment of inertia of acrylic at the
      osteotomy site among A, SLA, and EABA; and there were no significant differences
      in osteotomy surface area and area moment of inertia at the osteotomy site among
      all apparatuses (P > 0.05). The EABA apparatus had significantly higher mean
      ultimate strength, mean stiffness, and mean yield strength compared to other
      interdental fixation apparatuses. There were no significant differences in the
      mean ultimate strength, mean stiffness, or mean yield strength between EAB and SL
      (P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368618
TI  - Scanning electron microscopy of intraocular lenses that had been implanted in
      dogs.
AB  - Scanning electron microscopy was used to evaluate changes on the surfaces of
      polymethylmethacrylate (PMMA), silicone, and polyhydroxyethylmethacrylate (HEMA)
      intraocular lenses (IOL) that had been implanted in the anterior chambers of the
      right eyes of 15 dogs. Five dogs received PMMA IOL; 5 dogs received silicone IOL;
      and 5 dogs received HEMA IOL. Twenty-eight days after surgery, the IOL were
      removed and processed for scanning electron microscopy. Nonimplanted IOL of each
      type were processed identically for comparison. Implanted PMMA IOL had
      significantly more debris and macrophages on their surfaces than did silicone IOL
      or HEMA IOL. Silicone IOL had significantly less fibrin deposition than did PMMA
      or HEMA IOL. Silicone IOL had surface defects attributable to handling by
      surgical instruments. Implanted HEMA IOL had multiple pits that appeared to be
      caused by biodegradation.

PMID- 8368619
TI  - Effect of homologous fibrin adhesive on callus formation and extracortical bone
      bridging around a porous-coated segmental endoprosthesis in dogs.
AB  - Modular, porous-coated, titanium segmental endoprostheses were implanted
      bilaterally in the femoral diaphysis of 7 adult mixed-breed dogs. Autogenous bone
      graft in particle form was placed around the implant and bone. In 1 limb,
      homologous fibrin adhesive was mixed with the graft in situ before soft tissue
      closure. The contralateral limb was grafted in identical manner, but without
      fibrin adhesive, and served as a control. Radiography was performed immediately
      after surgery and 1, 2, 3, 4, 6, 8, 10, and 12 weeks later to assess callus area
      and bone remodeling. At 12 weeks, dogs were euthanatized and bone/implant
      fixation strength was tested under torsion and compared with values for 6 in
      vitro controls. Histomorphometric and microradiographic analyses of transverse
      sections of the distal portion of the implanted femurs were performed.
      Radiographic callus area was significantly (P < 0.05) smaller in the femurs
      grafted with fibrin adhesive, compared with the contralateral control. New bone
      formation (21.4 +/- 1.8% vs 19.2 +/- 2.4%), unlabeled bone (64.8 +/- 3.0% vs 67.9
      +/- 4.2%), porosity (13.9 +/- 0.7% vs 12.9 +/- 0.8%), and bone ingrowth into the
      porous coating (10.3 +/- 0.9% vs 10.0 +/- 1.2%) were not significantly different
      between fibrin- and nonfibrin-grafted implants, respectively. There were no
      significant differences in torsional strength of implant fixation between the
      fibrin- and nonfibrin-grafted femurs or between the in vivo implanted femurs and
      the in vitro controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368620
TI  - Use of scintimetry to assess effects of exercise and polysulfated
      glycosaminoglycan on equine carpal joints with osteochondral defects.
AB  - Combined blood pool and delayed images produced by use of 99mTc-methylene
      diphosphonate (99mTcMDP) were evaluated as an objective measurement of the
      response of equine joints with osteochondral defects to postoperative exercise
      and intra-articularly administered polysulfated glycosaminoglycan (PSGAG).
      Osteochondral defects (approx 2.4 x 0.9 cm) were induced arthroscopically in the
      dorsodistal radial carpal bones of 18 ponies. These ponies were randomized (while
      balancing for age [range 2 to 15; median, 5.0; mean, 5.1 years]) to 2 treatment
      groups. Nine ponies were assigned to be exercised, and 9 were stall-rested. Six
      ponies in each group were administered PSGAG (250 mg) in 1 joint (medicated) and
      lactated Ringer's solution (LRS) in the contralateral joint. The 3 remaining
      ponies in each group were administered LRS in both joints (nonmedicated).
      Medication was given at surgery, then weekly for 4 weeks. The exercise protocol
      (begun at postoperative day 6 and conducted twice daily) started with 30 minutes
      walking (approx 0.7 m/s), and, by postoperative month 3, the ponies were being
      walked for 15 minutes and trotted (approx 1.6 m/s) for 25 minutes. Simultaneous
      dorsal images of both carpi were made 2 to 3 minutes after IV administration of
      99mTcMDP (blood pool image) and 90 to 120 minutes later (delayed image).
      Scintimetry, in counts per minute per pixel per millicurie, was done before, and
      at 1, 2, 4, 8, 10, 13, and 17 weeks after surgery, prior to euthanasia.
      Radionuclide uptake on blood pool images decreased faster than that on delayed
      images, in which uptake remained high for 17 weeks. This indicated that bone was
      metabolically active for at least 17 weeks after surgery. Exercise significantly
      (P < 0.05) decreased uptake on the blood pool images of medicated joints up to 1
      month after surgery. Thus, exercise (in the presence of PSGAG) probably had a
      transient, beneficial effect on soft tissues of the joint. Exercise, without
      PSGAG, promoted increased bone remodeling, because the highest uptake on delayed
      images was observed in exercised, nonmedicated ponies up to 3 months after
      surgery. This was consistent with development of osteoarthritis in these ponies.
      Medication alone stimulated bone remodeling, and data indicated that an identical
      effect may take place in contralateral LRS-injected joints, because of systemic
      circulation of the drug. However, the combination of exercise and medication
      appeared to moderate the independent effects of each. The combination of exercise
      and medication in individual joints resulted in notably (P < 0.05) decreased bone
      remodeling.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8368621
TI  - Death due to asthma. New insights into sudden unexpected deaths, but the focus
      remains on prevention.

PMID- 8368622
TI  - Allergen-specific treatment for asthma: III.

PMID- 8368623
TI  - Safety of bronchoalveolar lavage in patients with adult respiratory distress
      syndrome.
AB  - Although shown to be safe in many other lung disorders, the safety of fiberoptic
      bronchoscopy (FOB) with bronchoalveolar lavage (BAL) in critically ill patients
      with adult respiratory distress syndrome (ARDS) remains unproven. We conducted a
      prospective study to evaluate the safety of BAL in patients with ARDS. There were
      438 patients with ARDS at our institution during the study period. Of these, 110
      underwent FOB and BAL for either research or clinical purposes. Data were
      collected at baseline, at 5-min intervals during the procedure, and 1 h after the
      procedure. We did not detect any statistically or clinically significant changes
      in PaO2/FlO2, mean arterial pressure, heart rate, peak inspiratory pressure, or
      static thoracic compliance after the procedure. A small decrease in SaO2 occurred
      after BAL. Although this change was statistically significant, the magnitude was
      not of clinical importance. Five patients (4.5%) had transient arterial oxygen
      desaturation to < 90% during FOB and one patient (0.9%) experienced desaturation
      to < 80%. There were no prolonged episodes of severe hypoxemia. No serious
      bleeding occurred. One pneumothorax developed during the procedure. No deaths
      occurred that were related to the procedure. We conclude that FOB and BAL can be
      performed safely and are reasonably well-tolerated in patients with ARDS.

PMID- 8368624
TI  - Modes of tracheal gas insufflation. Comparison of continuous and phase-specific
      gas injection in normal dogs.
AB  - Tracheal gas insufflation (TGI) improves the efficiency of CO2 elimination
      accomplished by conventional mechanical ventilation, primarily by reducing the
      anatomic (series) dead space volume. Dead space proximal to the catheter tip can
      be reduced by two methods. Fresh gas introduced at the carinal level during
      inspiration may effectively "bypass" the upper airway. Alternatively, proximal
      dead space can be "washed out" with fresh gas during expiration to reduce CO2
      rebreathing. We examined these two modes of TGI-aided dead space reduction in
      nine paralyzed normal dogs receiving conventional mechanical ventilation and
      compared these results to those obtained with a catheter that delivered fresh gas
      continuously at the same flow rate, thereby accomplishing both bypass and
      washout. Total inspired tidal volume and cycling frequency were held constant.
      Differences in CO2 elimination efficiency among the TGI modes were flow
      dependent. Continuous catheter flow at 5 or 10 L/min reduced PaCO2 and
      physiologic dead space fraction (VD/VT) more than either proximal bypass or end
      expiratory washout (p < 0.001). At the same catheter flow settings expiratory
      washout tended to improve VD/VT more than did inspiratory bypass. Under the
      conditions tested, constant tracheal insufflation of fresh gas improves alveolar
      ventilation by mechanisms that include, but are not limited to, a functional
      reduction in the dead space proximal to the catheter tip.

PMID- 8368625
TI  - Optimizing alveolar expansion prolongs the effectiveness of exogenous surfactant
      therapy in the adult rabbit.
AB  - We evaluated four ventilator patterns after the administration of 80 mg/kg bovine
      lipid extract surfactant (LES) to anesthetized, paralyzed, saline-lavaged New
      Zealand white rabbits. Two ventilator types were compared: high frequency
      oscillatory ventilation (HFO) versus conventional mechanical ventilation (CMV),
      each at high (HI) and low (LO) end-expiratory lung volumes (EELV); n = 6, each
      group; treatment duration = 4 h. Target PaO2 ranges were > 350 mm Hg for groups
      with high EELV (i.e., HFO-HI and CMV-HI) and 70 to 100 mm Hg for those with low
      EELV (i.e., HFO-LO and CMV-LO). Ventilator pressures were limited to < or = 39/9
      cm H2O in the CMV-HI group. Five of six CMV-HI-treated animals did not maintain
      target PaO2 levels. Both ventilator type and strategy influenced outcome
      significantly. Animals managed with HFO had higher mean arterial pressures (p =
      0.004), lower mean airway pressures (Paw) (p < 0.00008) and HCO3- requirements (p
      < 0.02), larger inflation (p = 0.003) and deflation (p < 0.00001) respiratory
      system volumes at 10 cm inflation pressure, and higher lung lamellar body (p =
      0.0006) and lavage fluid (p = 0.003) phospholipid quantities than did CMV-treated
      animals. The deflation P-V curve (p = 0.0004), lamellar body (p < 0.00001) and
      lavage fluid (p = 0.0002) phospholipid levels were superior after the high EELV
      strategy. We conclude that ventilator pattern strongly influences exogenous
      surfactant efficacy. Benefits arise from keeping EELV high enough to prevent
      atelectasis and using small (approximately 2 ml/kg) tidal volumes to prevent
      overdistension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368626
TI  - Fast versus slow ventilation for neonates.
AB  - To investigate the effect of ventilation rate on respiratory mechanics, 21
      neonates ventilated in the neonatal period for various reasons were studied while
      being ventilated at 30 and 80 breaths/min. Dynamic respiratory system elasticity
      (ERS), dynamic respiratory system resistance (RRS), and alveolar pressure at end
      expiration (EEP) were calculated by using multilinear regression to fit the
      equation of motion of a linear single-compartment model. Technically satisfactory
      data were obtained from 13 neonates. With the fast ventilation rate, tidal volume
      and RRS decreased by a mean of 41.3% (p < 0.01) and 17.5% (p < 0.01),
      respectively, ERS and EEP increased by a mean of 8.3% (p < 0.05) and 22.2% (p <
      0.01), respectively. Fast ventilation produced a shorter effective time constant
      during expiration, limiting the changes in EEP and, hence, in end-expiratory lung
      volume. The same changes in respiratory mechanics were also observed in neonates
      who did not show an increase in EEP even at high frequency. These neonates had a
      high elastance and time constant short enough to ensure adequate lung emptying.
      These results suggest that the respiratory mechanics of ventilated neonates are
      frequency dependent and that neonates with higher ERS, such as those with hyaline
      membrane disease, can cope with fast rate ventilation without developing dynamic
      hyperinflation.

PMID- 8368627
TI  - Tidal volume measurements in newborns using respiratory inductive
      plethysmography.
AB  - Respiratory inductive plethysmography (RIP) is a well-accepted noninvasive
      technology for monitoring breathing patterns in adults. Prior attempts to
      calibrate this device in babies have been fraught with technical difficulties,
      thereby limiting applications in this population. Recently, a new method,
      qualitative diagnostic calibration (QDC), has been shown to provide accurate
      calibration of tidal volume in adults. The QDC method is based upon principles of
      the isovolume maneuver and carried out during natural breathing without
      specialized respiratory maneuvers or postural changes. We calibrated RIP with QDC
      in the supine posture and compared tidal volume (VT) measured with RIP to VT by a
      face mask-pneumotachograph (PNT) in 21 healthy full-term newborns in supine and
      prone postures. Eleven of the babies were calibrated during active sleep and 10
      in quiet sleep. The mean VT in the supine and prone postures were 19 and 25 ml,
      respectively. In the supine and prone postures, weighted mean difference between
      RIP (VT) and PNT (VT) and 95% confidence intervals were -0.05 ml (-0.27, 0.18)
      and -0.32 ml (-0.08, 0.55), respectively. There was no difference in the accuracy
      of RIP relative to PNT calibrated during active sleep when thoracoabdominal
      incoordination was present or quiet sleep when it was not in either the supine or
      the prone postures. Therefore, in full-term infants, RIP calibrated with QDC
      solely in the supine posture provides clinically acceptable measurements of VT in
      both supine and prone postures.

PMID- 8368628
TI  - Effect of cocaine in early gestation. Physiologic responses to hypoxia in newborn
      rabbits.
AB  - To investigate the effect of prenatal cocaine on the physiologic responses to
      hypoxia, we evaluated ventilation, oxyhemoglobin saturation, and pulse rate at
      0.21 FIO2 (baseline) and in response to 20-min exposure to either 0.15 or 0.08
      FIO2 on Days 4 to 6 of life in 31 unanesthetized New Zealand white rabbit pups
      born to cocaine-exposed (30 mg/kg/day of subcutaneous cocaine HCl injection from
      Days 7 to 15 of a 32-day gestation) or free-fed (injection of sterile water)
      does. We found that baseline ventilation (measured by dual-sidearm
      pneumotachograph from the plethysmograph), SaO2 (measured by pulse oximeter), and
      pulse rate did not differ significantly between cocaine-exposed and free-fed
      pups. At 0.15 FIO2, cocaine-exposed pups had increased VI (p < 0.0005), VT (p <
      0.0005), and VT/TI (p < 0.0005) compared with free-fed pups, but no significant
      difference in f, TI, TE, TI/TT, SaO2, or pulse rate. At 0.08 FIO2, cocaine
      exposed pups had increased VI (p = 0.001), VT/TI (p = 0.021), and TE (p = 0.023)
      compared with free-fed pups, due primarily to the effects in the first 10 min of
      hypoxic exposure. However, differences in group response were less apparent than
      at 0.15 FIO2, with a sustained ventilatory response on prolonged exposure to 0.08
      FIO2 among free-fed pups but not cocaine-exposed pups. Further, SaO2 (p < 0.0005)
      and pulse rate (p = 0.012) were significantly lower among cocaine-exposed pups
      compared with free-fed pups, particularly after 10-min exposure to 0.08 FIO2 when
      VI was equivalent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368629
TI  - Influence of sleep on genioglossus muscle activation by negative pressure in
      normal men.
AB  - An important mechanism controlling genioglossus (GG) muscle activity is the
      reflex response to negative airway pressure. We hypothesize that this reflex
      response may be lost during sleep and believe that this loss may be important in
      the pathogenesis of airway collapse during sleep. Thus, we determined the effect
      of non-rapid eye movement (NREM) sleep on the GG electromyogram (EMG) response to
      brief (0.2 to 0.6 s) episodes of negative pressure generation (NPG) in the upper
      airway of six normal subjects. Up to 100 NPGs (mean 58 +/- 12) were recorded both
      awake and during stable NREM sleep. During wakefulness, the change in GG moving
      time average EMG from basal to peak levels (during NPG) was 17.1 +/- 2.5 au (a
      154 +/- 22% increase above basal levels). This response was markedly reduced
      during NREM sleep (2.7 +/- 1.2 au; p < 0.01). The latency of the GG EMG response
      was 53.8 +/- 11.5 ms during wakefulness (n = 6), but much longer during sleep
      (132.7 +/- 24.5 ms; n = 3; p < 0.03). We conclude that in normal subjects (1) the
      GG muscle responds to negative airway pressure by reflex activation during
      wakefulness, and (2) this reflex activation is reduced or lost during NREM sleep.
      We speculate that loss of this mechanism during sleep may contribute to
      pharyngeal collapse in obstructive apnea patients.

PMID- 8368630
TI  - Pharyngeal narrowing and closing pressures in patients with obstructive sleep
      apnea.
AB  - Based on previous studies, we hypothesized that the pharynx collapses at multiple
      sites in most patients with obstructive sleep apnea (OSA). The purpose of this
      study was to document, in a population of apneic subjects, the site(s) of
      narrowing and closing pressure of the hypotonic pharynx. We endoscopically
      examined the pharynx in 45 OSA patients during sleep while they received nasal
      continuous positive airway pressure (CPAP), which produces hypotonia of
      pharyngeal muscles. Intrapharyngeal images and pressures were obtained at the end
      of expiration during single-breath tests (SBT). The fractional narrowing (FN) of
      each pharyngeal segment (nasopharynx, oropharynx, and hypopharynx) was calculated
      as the relative change in area when nasal airway pressure was reduced from a
      pressure that held the pharynx fully distended to the pressure at which the
      airway closed. The frequency distribution of FN for the nasopharynx was skewed
      toward larger values, and the frequency was relatively evenly distributed for the
      oropharynx and hypopharynx. A site having FN greater than 0.75 was defined as a
      site of primary narrowing, and a site showing FN 0.25 to 0.75 was defined as a
      site of secondary narrowing. The nasopharynx was a site of primary narrowing in
      80% of patients, and two or more sites of narrowing were commonly observed (82%).
      Four categories of combined narrowing were identified: (1) primary narrowing only
      at the nasopharynx (18%); (2) primary narrowing at the nasopharynx plus other
      sites of secondary narrowing (40%); (3) primary narrowing at the nasopharynx plus
      other sites of primary narrowing (22%); and (4) other patterns (20%).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368631
TI  - Changes in diaphragmatic EMG activity during sleep in space.
AB  - It remains unknown how increased upper airway resistance (UAR) during sleep could
      be a function of gravity. We therefore conducted quantitative evaluation of the
      gravitational influence on diaphragmatic EMG activity (EMGdi) in an astronaut to
      estimate the effect of UAR in space. EMGdi was recorded by paired surface
      electrodes on the ground (control, C) and abroad a short-term space mission
      (space, S) for 30 consecutive h. Mean EMGdi recorded during quiet breathing in
      wakefulness was assigned the value of 100. EMGdi in C was significantly enhanced
      in all sleep stages compared with that while awake in the supine position (mean
      +/- SD, 230 +/- 23.2% in non-rapid eye movement (non-REM) Stage II, 233 +/- 13.8
      in slow-wave sleep, and 233 +/- 40.0 in REM sleep versus 100 +/- 17.3 in
      wakefulness, p < 0.001). In contrast, there was no statistical difference in
      EMGdi in S between awake and any non-REM sleep stage (mean +/- SD, 100 +/- 20.5%
      in wakefulness versus 103 +/- 16.9 in non-REM Stage II and 100 +/- 14.8 in slow
      wave sleep; NS). However, EMGdi in REM sleep in S was statistically greater (132
      +/- 28.3%) than that during wakefulness or any other sleep stage in space (p <
      0.001). Therefore, gravity may play a much more significant role in the normal
      healthy human in the increased upper airway resistance during sleep than the
      relative atonia of the upper airway muscles.

PMID- 8368632
TI  - Sleep apnea and cardiac arrhythmias. Is there a relationship?
AB  - To determine if there was a relationship between cardiac arrhythmias and sleep
      apnea, we studied the prevalence of arrhythmias in a consecutive series of
      patients referred to our clinic for assessment of this disorder. Two hundred of
      263 physician-referred patients were eligible for the study and, of these, 173
      (86.5%) had complete investigations. All patients underwent a full night of
      polysomnography and Holter monitoring. Sleep apnea was diagnosed if patients had
      more than 10 apneas and hypopneas per hour (AHI). In 76 patients (43.9%) sleep
      apnea was diagnosed (median AHI = 33). The prevalence of arrhythmias in patients
      with sleep apnea versus those without was, respectively: complex ventricular
      ectopy (including ventricular tachycardia), 1.3% (95% CI, 0.4 to 6.9) versus 4.1%
      (CI, 1.6 to 10.1); frequent ventricular premature beats (> 30/h), 2.6% (CI, 0.8
      to 8.9) versus 6.2% (CI, 2.9 to 12.8); second-degree atrioventricular block, 1.3%
      (CI, 0.4 to 6.9) versus 4.1% (CI, 1.6 to 10.1); sinus arrest, 5.2% (CI, 2.2 to
      12.6) versus 1.0% (CI, 0.2 to 5.6). None of these differences was statistically
      significant. We conclude that the prevalence of cardiac arrhythmias is low in
      patients without serious cardiac or respiratory comorbidity who are referred for
      assessment of sleep apnea. Furthermore, the presence or absence of arrhythmias in
      this group is unrelated to sleep apnea severity.

PMID- 8368633
TI  - Comparison of gas exchange, lactate, and lactic acidosis thresholds in patients
      with chronic obstructive pulmonary disease.
AB  - During an incremental exercise test, three consequences of the onset of anaerobic
      metabolism can be observed: rise in blood lactate (lactate threshold, LT); fall
      in standard bicarbonate (lactic acidosis threshold, LAT); nonlinear increase in
      CO2 output (V-slope gas exchange threshold, GET). We compared these thresholds in
      31 patients with COPD. We found that the GET and LAT overestimated the LT. A
      better relationship was found between LAT and GET, even though GET was
      significantly higher than LAT (by 124 ml/min; p < 0.0001). However, since the
      bias is appreciably greater at lower LAT values (likely because VCO2 kinetics are
      slower than VO2 kinetics), we separated the studies into two groups: (A) tests
      where LAT occurred within the first 2 min of the increasing work rate period, and
      (B) tests where LAT occurred after 2 min. For Group A, there was a substantial
      bias between LAT and GET (323 ml/min, p < 0.0001), whereas the bias was much
      smaller (only 5.4%, though statistically significant) for Group B (57 ml/min, p <
      0.01). We conclude that when lactic acidosis occurs after the first 2 min of
      incremental exercise, the GET closely approximates the point at which blood
      bicarbonate begins to fall.

PMID- 8368634
TI  - KL-6, a mucin-like glycoprotein, in bronchoalveolar lavage fluid from patients
      with interstitial lung disease.
AB  - KL-6, a mucin-like high-molecular-weight glycoprotein, is a serum marker
      indicating the disease activity of pneumonitis, such as idiopathic pulmonary
      fibrosis (IPF), hypersensitivity pneumonitis, and sarcoidosis.
      Immunohistochemical studies have shown that KL-6 is strongly expressed on Type 2
      pneumocytes and also exists on epithelial cells in other organs. It has not been
      clarified whether the increased levels of KL-6 in sera from patients with
      pneumonitis are derived from the lower respiratory tract. In this study, KL-6
      levels were evaluated in bronchoalveolar lavage fluid (BALF) samples from 9
      healthy control subjects and 32 patients with interstitial pneumonitis. An
      abnormally high level of KL-6 in BALF was observed in 70% (7 of 10) of patients
      with IPF, 64% (9 of 14) of patients with sarcoidosis, and 100% (8 of 8) of
      patients with hypersensitivity pneumonitis but in none of the healthy control
      subjects. KL-6 levels in BALF were significantly correlated with numbers of total
      cells (p < 0.001), lymphocytes (p < 0.001), and neutrophils (p < 0.05) and with
      concentrations of albumin (p < 0.001) and total protein (p < 0.001) in BALF and,
      further, with serum KL-6 levels (p < 0.01). These results indicate that increased
      levels of serum KL-6 in patients with pneumonitis reflect the production levels
      of KL-6 derived from damaged or regenerating Type 2 pneumocytes in the lower
      respiratory tract.

PMID- 8368635
TI  - Cerebrospinal fluid drug concentrations and the treatment of tuberculous
      meningitis.
AB  - Tuberculous meningitis is a very serious form of tuberculosis. In the absence of
      randomized controlled trials of alternative treatment regimens, its management
      depends on employing potent drugs that penetrate well into the cerebrospinal
      fluid (CSF). The penetration of isoniazid, rifampin, and streptomycin into the
      CSF of 27 Chinese patients was studied using fluorimetric and microbiologic
      procedures. Isoniazid rapidly diffused into the CSF, peak concentrations in
      excess of 3 mg/L, or over 30 times its minimal inhibitory concentration (MIC)
      against Mycobacterium tuberculosis being attained within 4 hr. In contrast,
      rifampin and streptomycin penetrated very slowly across the meninges, and CSF
      levels only slightly in excess of their MICs against M. tuberculosis were
      achieved. The penetration of the drugs into the CSF correlated poorly with
      differences in their partitioning between octanol/water and cyclohexane/water but
      could be predicted using a simple model based on their renal clearance rates and
      plasma protein binding. It is recommended that patients with tuberculous
      meningitis should be treated for at least 9 months with a combination of
      isoniazid, rifampin, and pyrazinamide, which may be supplemented in the first 2
      mo with streptomycin.

PMID- 8368636
TI  - Evaluation of the protective efficacy of the killed Coccidioides immitis spherule
      vaccine in humans. The Valley Fever Vaccine Study Group.
AB  - A vaccine consisting of formaldehyde-killed spherules of Coccidioides immitis,
      previously shown to provide protection against development of lethal
      coccidioidomycosis in laboratory animals, was evaluated in humans. This double
      blind "Phase 3" study, conducted during the period 1980 to 1985, involved 2,867
      healthy subjects with no history of coccidioidomycosis and negative skin tests.
      Randomized into vaccine (n = 1,436) or placebo (n = 1,431) groups, the former
      received three intramuscular injections of 1.75 mg (dry weight) of spherules, the
      latter received three injections of sterile 0.85% NaCl solution. Compatible
      clinical presentation with cultural or serologic findings permitted detection of
      coccidioidomycosis. Of those receiving vaccine, nine developed coccidioidomycosis
      and nine additional were suspected of having the disease. Of the group receiving
      placebo, 12 developed coccidioidomycosis, and 13 additional were suspected of
      having the disease. All cases and suspected cases were mild. Under the conditions
      of this study, a slight but statistically insignificant reduction in the
      incidence of coccidioidomycosis was noted in the vaccinated group compared with
      that in the placebo group, and there was no discernible difference in severity of
      disease between these groups.

PMID- 8368637
TI  - Early pulmonary physiologic abnormalities in beryllium disease.
AB  - By using the beryllium-specific blood lymphocyte transformation test (BeLT) as a
      screening tool, it is possible to identify beryllium disease before clinical
      symptoms or radiographic abnormalities develop. Little is known about the early
      pulmonary physiologic abnormalities in granulomatous lung diseases. We compared
      two groups: (1) "surveillance-identified" early beryllium disease patients,
      detected using the blood BeLT in workplace screening projects (n = 21), and (2)
      "clinically identified" beryllium disease patients who presented with symptoms or
      radiographic abnormalities (n = 15). We measured spirometry, lung volumes,
      diffusing capacity for carbon monoxide, arterial blood gases, and maximal
      exercise capacity. Physiologic abnormalities occurred in 12 of 21 (57%)
      surveillance-identified patients. The most common derangement was a rise in the
      dead space to tidal volume ratio (VD/VT) during exercise, suggesting a pulmonary
      vascular abnormality. None of the surveillance-identified patients had pure
      restriction, and only one of 21 had an abnormal diffusing capacity. In
      comparison, 93% of clinically identified beryllium disease patients had one or
      more abnormalities, the most sensitive indicator being the exercise capacity. One
      third had airflow limitation. Resting arterial blood gas analysis was abnormal in
      seven of 15 (47%), whereas diffusing capacity was low in only five of 15 (33%).
      Clinically identified patients performed less work, had more severe gas exchange
      abnormalities, and had higher VD/VT at maximal exercise than did surveillance
      identified patients. We conclude that alterations in gas exchange and the
      pulmonary vascular bed occur early in beryllium disease.

PMID- 8368638
TI  - Predictors of asthma and wheezing in adults. Grain farming, sex, and smoking.
AB  - We investigated predictors for asthma and wheeze in 1,634 men and women in the
      age group 20 to 65 yr from the town of Humboldt, Saskatchewan. On the basis of
      questionnaire responses, subjects were classified into mutually exclusive groups
      as asthmatic (n = 62), wheezing (n = 444), asymptomatic (n = 908), and
      symptomatic (n = 220) groups. After excluding the symptomatic group, we used
      polytomous logistic regression models to determine predictors of asthma and
      wheezing. Significant predictors for asthma were grain farming (odds ratio [OR] =
      1.9, 95% confidence interval [Cl]: 1.1-3.5; p = 0.03) and sex (OR = 1.9, Cl: 1.1
      3.2; p = 0.03; males compared with females). Significant predictors for wheezing
      were smoking (former smoker: OR = 1.8, Cl: 1.3-2.5, p < 0.001; current smoker: OR
      = 5.0, Cl: 3.8-6.7, p < 0.001; in comparison to nonsmoker) and grain farming (OR
      = 1.7, Cl: 1.3-2.4, p < 0.001). Age, level of education, and physical activity at
      work were not significant predictors for asthma or wheezing. None of the
      interaction effects between the predictors was significant. When stratified by
      sex, grain farming was a significant predictor of asthma in men but not in women.
      Nevertheless, smoking and grain farming were significant predictors of wheezing
      in both men and women. Our study raises the possibility that grain farming might
      be a risk factor for asthma and asthma-like symptoms.

PMID- 8368639
TI  - Asthma risk and occupation as a respiratory therapist.
AB  - In the modern hospital environment, many health care workers are exposed to
      hazardous substances. Among these hazards are respiratory sensitizers, irritants,
      and infectious agents. A previous cross-sectional study of Rhode Island
      respiratory therapists reported an excess risk of asthma after entry into that
      profession. Before the results of that study were published, we conducted a
      confirmatory mailed questionnaire survey of 2,086 Massachusetts respiratory
      therapists and 2,030 physical therapists and physical therapy assistants. Neither
      the survey questionnaire nor the accompanying cover letter revealed the focus of
      our investigation. A history of physician-diagnosed asthma was reported by 16% of
      respiratory therapists and 8% of control subjects. When analysis was restricted
      to those who developed asthma after entry into their profession, respiratory
      therapists still had a significant excess, 7.4 versus 2.8%. The odds ratio for
      respiratory therapy was 2.5 (95% Cl, 1.6 to 3.3) after adjustment for age, family
      history, atopic history, smoking, and gender. These results confirm the previous
      report of excess risk of asthma among respiratory therapists. This excess risk
      develops after entry into the profession and does not appear to be explained by
      bias or confounding. Efforts should be directed to identifying potential agents
      responsible for this form of occupational asthma.

PMID- 8368640
TI  - Performance of an asthma quality of life questionnaire in an outpatient setting.
AB  - The objectives of this study were to assess the validity, reliability, and
      responsiveness of a disease-specific quality of life questionnaire (AQLQ) in
      asthma patients presenting for assessment and treatment in an emergency
      department (ED). Fifty-two patients 18 to 64 yrs of age were surveyed in three
      EDs. Admitted and discharged patients with stable and unstable asthma were
      included. Patients were interviewed prior to discharge from the ED. They
      completed a self-report asthma questionnaire, the self-administered Sickness
      Impact Profile (SIP) and AQLQ, a global assessment of asthma severity, a symptom
      questionnaire, and pulmonary function testing. Forty-three (83%) patients were
      available for follow-up at 7 to 10 days, and they completed a similar series of
      tests. Moderate correlations were found between total SIP and AQLQ measurements
      (r = 0.49; p < 0.001). Correlations were high between physical domain scores of
      the SIP and AQLQ symptoms (r = 0.58; p < 0.0001) and activity limitations (r =
      0.50; p < 0.0001). Low correlations were found between pulmonary function results
      and AQLQ domains, except activity limitations (r = 0.44; p < 0.001). High
      correlations were found between symptoms or global assessments and AQLQ (r > 0.6;
      p < 0.0001). The instrument is highly responsive to small changes in patient
      status and outperforms pulmonary function tests and symptom scores in this
      setting. Test-retest reliability in patients who were stable was substantial
      (intraclass correlation coefficients > 0.9) on all aspects of the AQLQ.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368641
TI  - Effect of leukotriene D4 and platelet-activating factor on human alveolar
      macrophage eicosanoid and PAF synthesis.
AB  - Leukotrienes (LT) and platelet-activating factor (PAF) can increase nonspecific
      airway reactivity in normal subjects, and they have been proposed as putative
      mediators of asthma. Alveolar macrophages (AM), which have receptors for and
      synthesize leukotrienes and PAF, also may play a role in the pathogenesis of
      asthma. The present study was designed to determine the effects LTD4 and PAF have
      on bronchoalveolar lavage (BAL) fluid and cells, including AM eicosanoid and PAF
      synthesis, and to relate them to changes in nonspecific airway reactivity. Airway
      reactivity to methacholine was measured in healthy, male volunteers at least 2
      days before and 6 h, 1, 3, and 7 days after inhaling either LTD4 or PAF. At least
      3 wk later subjects inhaled in random order either methacholine or the mediator
      to which they were previously exposed, and BAL was performed the next day. This
      sequence was repeated with the other chemical 3 wk or more later. LTD4 inhalation
      increased airway reactivity and stimulated AM thromboxane synthesis while it
      reduced stimulated AM LTB4 synthesis. LTD4 did not affect the number of
      percentage of BAL cells or the BAL fluid protein and histamine concentrations.
      PAF inhalation increased airway reactivity and the proportion of neutrophils and
      eosinophils recovered by BAL, but it did not alter AM eicosanoid and PAF
      synthesis or the BAL fluid protein and histamine concentrations. A relationship
      was identified between the PAF-induced increase in airway reactivity and the
      percentage of BAL neutrophils, but no correlation was found between LTD4- or PAF
      induced changes in airway reactivity and stimulated AM eicosanoid or PAF
      synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368642
TI  - Allergen-induced biphasic plasma exudation responses in guinea pig large airways.
AB  - In this study involving sensitized guinea pigs (anesthetized intramuscularly with
      a 3:2 mixture of ketamine+xylazine, 1 ml/kg), we applied allergen (ovalbumin)
      selectively to the tracheobronchial mucosa (sparing the nasal passages and the
      terminal airways) and examined the occurrence of immediate and late-phase
      inflammatory exudation of plasma and plasma-derived mediators (bradykinins) into
      the airway lumen. The experiments were terminated 10 to 480 min after challenge.
      A selective lavage that sampled the surface liquids of the extrapulmonary bronchi
      and the lower trachea was performed. The amount of plasma (microliter) was
      determined by analysis of a plasma tracer, [125I]albumin, in lavage fluid and
      blood (plasma) samples. Ovalbumin, 3 to 12 pmol, and histamine, 5 and 10 nmol,
      produced a dose-dependent immediate exudation response (p < 0.001). The effects
      were nonneurogenic because they were not affected by topical lidocaine given in a
      dose (3 nmol) that prevented the exudative effect of capsaicin. The 6- and 12
      pmol doses of ovalbumin (but not 3 pmol) produced a significant late-phase
      exudative response at 5 h (p < 0.001), and both the immediate and late phases
      were associated with increased (p < 0.01 to p < 0.001) levels of bradykinin in
      the lavage fluids. Histamine, even in doses that produced a greater early
      response than the allergen, did not produce a late-phase response. A single
      topical dose of an antiasthma steroid (budesonide, 12 mumol/kg) administered just
      before ovalbumin (6 pmol) had little effect on the immediate response but
      inhibited the late-phase response (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368643
TI  - Effect of Hoe 140 on bradykinin-induced bronchoconstriction in anesthetized
      guinea pigs.
AB  - We have investigated the efficacy of the novel, highly potent, and stable B2
      bradykinin (BK) antagonist Hoe 140 against BK-induced bronchoconstriction in
      guinea pigs via whole body plethysmography and compared different routes of
      administration. Our results clearly demonstrate that Hoe 140 is highly potent at
      inhibiting bronchoconstriction induced by either intravenous (i.v.) or inhaled
      BK. Intravenous BK was strongly inhibited by i.v. Hoe 140 (ID50 13.4 pmol/kg),
      and less by aerosolized Hoe 140 (ID50 1.34 nmol/kg). Aerosolized BK (235 nmol/kg)
      was strongly inhibited by 0.1 nmol/kg of aerosolized Hoe 140 given 30 min before.
      Hoe 140 is the first BK antagonist to effectively inhibit the bronchoconstrictor
      effect of aerosolized BK. The equieffective i.v. dose of Hoe 140, however, as
      about 100-fold higher. From the discrepancy in efficacy of Hoe 140 against i.v.
      and aerosolized BK, it was concluded that i.v. BK has no direct effect on the
      lung, in contrast to inhaled BK. Moreover, the high potency of Hoe 140 in the
      guinea pig lung does not confirm the hypothesis of a B3 BK receptor. Based on its
      high potency and good tolerability, Hoe 140 is appropriate to evaluate the role
      of BK in human airway diseases.

PMID- 8368644
TI  - Sudden-onset fatal asthma. A distinct entity with few eosinophils and relatively
      more neutrophils in the airway submucosa?
AB  - To determine the histologic differences in the airways of patients who died from
      sudden-onset asthma and the more common slow-onset asthma, we studied seven cases
      of fatal asthma. The numbers of eosinophils and neutrophils, as well as
      extracellular deposition of their respective granule contents in the airway
      mucosa and submucosa, were determined and statistically analyzed. Four of the
      seven patients had slow-onset asthma attacks in which the time interval between
      onset of asthma and death was more than 2.5 h. In contrast, three patients had
      sudden-onset asthma in which the time interval between onset of asthma attack and
      death was less than 1 h. The four patients with slow-onset fatal asthma had more
      eosinophils (34.1 +/- 6.3 in slow-onset; 9.7 +/- 3.5 in sudden-onset; p = 0.002)
      and fewer neutrophils (4.8 +/- 2.0 in slow-onset; 16.8 +/- 5.4 in sudden-onset; p
      = 0.008) in the airway submucosa than did patients with sudden-onset fatal
      asthma. In addition, within the slow-onset fatal asthma group, eosinophils
      exceeded neutrophils in the airway submucosa (eosinophils > neutrophils, p =
      0.002). By contrast, within the sudden-onset fatal asthma group, neutrophils
      exceeded eosinophils (neutrophils > eosinophils, p = 0.04). We suggest that
      sudden-onset fatal asthma is immunohistologically distinct from slow-onset fatal
      asthma and that it is characterized by a relative paucity of eosinophils in the
      face of an excess of neutrophils in the airway submucosa.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8368645
TI  - Cellular hypertrophy and hyperplasia of airway smooth muscles underlying
      bronchial asthma. A 3-D morphometric study.
AB  - In order to study whether hyperplasia or hypertrophy of cells is responsible for
      the thickening of airway muscles, 3-D morphometry of airway muscle cells was
      performed on resin-embedded semithin serial sections of autopsied lungs from 10
      asthmatics and five control subjects. There were five Type I and five Type II
      asthmatic lungs, as defined in an earlier study, thickened muscles being found
      only in the central bronchi in Type I and distributed over the whole airway tree
      in Type II. The analysis was based on "unbiased" 3-D morphometry to obtain the
      numerical density NV of muscle cells using a "disector," a spatial probe
      introduced by Sterio in 1984, which we modified into a stack of serial sections.
      The mean number NL of cells per unit airway length and the mean volume Vc of a
      single muscle cell were also determined. In Type I asthmatics, the number of
      cells increased in the larger bronchi unaccompanied by cellular hypertrophy at
      any level of the airway tree. In contrast, in Type II asthmatics, hypertrophy was
      shown to prevail over the whole airway, but it was most remarkable in the
      bronchioles, whereas hyperplasia was mild and localized only in the bronchi. The
      two types of asthmatic lungs may therefore result from different pathogeneses.

PMID- 8368646
TI  - Nitric oxide synthesis inhibitors induce airway hyperresponsiveness in the guinea
      pig in vivo and in vitro. Role of the epithelium.
AB  - The administration by aerosol of the nitric oxide (NO) synthesis inhibitors, N
      omega-nitro-L-arginine methyl ester (L-NAME) or Ng-monomethyl-L-arginine (L
      NMMA), to spontaneously breathing anesthetized guinea pigs resulted in a
      significant enhancement of lung resistance (RL) after increasing intravenous
      doses of histamine. The maximal response was increased (p < 0.01) by 126% (L
      NAME) and 282% (L-NMMA) compared with the control groups. This effect was
      inhibited by giving an aerosol of the NO precursor L-arginine (L-Arg) but not by
      its inactive enantiomer D-arginine (D-Arg). Perfusion through the lumen of guinea
      pig tracheal tubes in vitro with nitric oxide synthesis inhibitors (120 microM)
      resulted in a significant increase in basal tone, suggesting a role for NO in the
      maintenance of basal tone. In addition, the histamine concentration-response
      curve was significantly shifted upward: the maximal response was increased (p <
      0.01) by 335% (L-NAME) and 250% (L-NMMA) compared with the control group. This
      effect was concentration dependently inhibited by coincubation with L-Arg (120,
      200, and 400 microM), but not with D-Arg (200 microM). Furthermore, removal of
      the epithelium resulted in an upward shift in the histamine concentration
      response curve: the maximal response was increased by 185%. However, incubation
      with L-NAME did not further increase tracheal responsiveness to histamine, but
      addition of L-Arg (360 microM), when a plateau was reached, relaxed the tissues
      to control values. Nitric oxide synthesis inhibition did not change the
      responsiveness of intact tissues in vitro after intraluminal stimulation with
      leukotriene D4, serotonin, or the cholinergic agonist arecoline.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368647
TI  - Effect on single-breath washout and lung function of elastase-induced emphysema
      in rats.
AB  - Lung volumes, diffusing capacity (DLCO), quasi-static pressure-volume curves (P
      V), forced expiration (FE) and He-SF6 single-breath washout (SBW) were performed
      in Wistar rats with emphysema induced by different doses of pancreatic elastase
      in saline, instilled intratracheally 6 wk prior to the tests. Emphysema was
      quantitatively assessed by mean linear intercept (Lm) measurements on 5-microns
      lung sections. Lung volume, P-V curve, and FE dependence on Lm, as well as the
      nonsignificant dependence of DLCO on Lm, are generally similar to results
      reported by others. The most interesting observation concerns the SBW: N2 slopes
      of the alveolar plateau, compared for identical lung volumes, did not change with
      the degree of emphysema. By contrast, the He-SF6 slope difference did depend
      significantly on the degree of emphysema. Based on the diffusion front theory,
      the present work suggests that in rats with elastase-induced emphysema, the phase
      III slope modifications relate mainly to elastic and not to structural
      alterations.

PMID- 8368648
TI  - Changes in the structure and mechanical properties of pulmonary arteries of rats
      exposed to cigarette smoke.
AB  - The effect of cigarette smoke on the structure and mechanical properties of
      pulmonary arteries was studied in 2- and 3-month smoke-exposed rats. The animals
      were exposed to cigarette smoke in a smoke-generating system 10 times per day
      with one cigarette each time. The smoke density and the puffing duration and
      frequency of the system were regulated in accordance with reference values
      measured from human smokers. The volume fractions of the cells, including smooth
      muscle cells and fibroblasts, and extracellular matrix components, including
      collagen, elastin, and remainder (components not specified in this study), of the
      pulmonary arteries of approximately 450 microns in external diameter (at zero
      pressure) were determined in smoke-exposed and control rats by using an electron
      microscopic method. It was found that the volume fractions of the fibroblasts,
      the collagenous bundles, and the elastic laminae of the pulmonary arteries were
      increased significantly, whereas those of the smooth muscle cells and the
      remainder were decreased significantly in both the 2- and 3-month smoke-exposed
      rats in comparison with those of the corresponding control rats. The mechanical
      properties of the pulmonary arteries were determined based on the in vitro
      dimensional measurement of the vessels at various inflation pressures and zero
      stress state. An increase in the stiffness of the pulmonary arteries was found in
      both the 2- and 3-month smoke-exposed rats. We conclude that cigarette smoke can
      induce structural and mechanical remodeling in the pulmonary arteries of rats.

PMID- 8368649
TI  - Detection of nonvolatile macromolecules in breath. A possible diagnostic tool?
AB  - The analysis of parameters in bronchoalveolar extracellular lining secretions has
      come into greater use in the diagnosis of diseases of the lung and respiratory
      passages. The bronchoalveolar lavage (BAL) method is thus used for sampling
      alveolar fluids or bronchial secretions. However, this method is invasive and
      therefore cannot be routinely employed for probe sampling. Based on the
      hypothesis that aerosol particles excreted in human breath reflect the
      composition of the bronchoalveolar extracellular lining fluid, experiments were
      performed to concentrate and analyze these aerosols directly using a noninvasive
      technique. Human exhaled air was directed through a set of cool traps and the
      condensate of 200 to 400 exhalations examined for nonvolatile components, such as
      proteins. In experiments conducted with volunteers, the amount of proteins in the
      breath condensate of 8 healthy individuals (of a total of 10) amounted to between
      4 micrograms and 1.4 mg. The proteins were separated by two-dimensional
      polyacrylamide gel electrophoresis (PAGE) and compared to saliva samples of the
      respective volunteers. The results suggest that the proteins detected in breath
      originate partially from the naso-oropharyngeal tract and partially from lower
      regions of the airways. In clinical tests, the exhaled air of 13 patients
      suffering from various diseases of the respiratory tract was sampled and analyzed
      by immunoassays for inflammation parameters, such as interleukin-1 beta (IL-1
      beta), soluble interleukin-2 receptor protein, light chain (sIL-2R), interleukin
      6 (IL-6), and tumor necrosis factor alpha (TNF-alpha). In these tests, up to 370
      pg IL-1 beta, 120 pg TNF-alpha, and 2,159 U sIL-2R per ml were measured in the
      breath condensate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368650
TI  - Comparison of ventilatory support with intratracheal perfluorocarbon
      administration and conventional mechanical ventilation in animals with acute
      respiratory failure.
AB  - We investigated the efficacy of intratracheal perfluorocarbon (PFC)
      administration combined with mechanical ventilation to support gas exchange in
      adult animals with acute respiratory failure. These were compared with a similar
      group of animals treated with continuous positive-pressure ventilation (CPPV)
      with respect to respiratory parameters and postmortem lung histology. After lung
      lavage with saline, 18 adult rabbits were divided into three groups (n = 6 per
      group). All groups received conventional CPPV. Additionally, one group received
      intratracheal PFC administration at a volume of 18 ml/kg (corresponding to
      functional residual capacity) (PFC group); another received 18 ml/kg of saline
      administration (saline group), and the last had no further treatment (CPPV
      group). All groups were ventilated for 3 h using 100% oxygen, with the same
      ventilator settings of tidal volume of 12 ml/kg, respiratory frequency of 30/min,
      and positive end-expiratory pressure of 6 cm H2O. In the PFC group, PaO2
      increased from 67.2 +/- 11.4 to 424.2 +/- 14 mm Hg and remained stable for 3 h
      with well-preserved PaCO2 values. Only in the PFC group were significant
      decreases in airway pressures and increase in respiratory system compliance seen.
      In the CPPV group, PaO2 stayed around 60 mm Hg and PaCO2 gradually increased. PFC
      treatment with conventional mechanical ventilation in acute respiratory failure
      proved to be a successful supportive technique to improve gas exchange at low
      inflation pressures.

PMID- 8368651
TI  - The immunoevasive activities of Pseudomonas aeruginosa. Relevance for cystic
      fibrosis.

PMID- 8368652
TI  - The lack of distensibility of asthmatic airways.
AB  - Asthma is characterized by chronic endobronchial inflammation and the deposition
      of collagen below the epithelial basement membrane. The functional significance
      of collagen deposition is unknown, but it can lead to loss of airway
      distensibility and hence to eventual loss of bronchodilator response. In this
      study we examined the volume of airway dead space by a single-breath, nitrogen
      plateau method at a range of lung volumes during inspiration. Participants were
      10 asthmatics and 10 control subjects who were matched for lung volumes and age.
      The asthmatics increased their dead space by 27.0 ml/L compared with 37.3 ml/L in
      the control subjects (p = 0.014). The dead-space volumes at 50% TLC were no
      different (29.3 ml/L lung volume in asthma versus 26.9 ml/L in control subjects,
      p = 0.25). Loss of airway distensibility did not correlate, however, with loss of
      bronchodilator responsiveness, implying that factors other than mechanical airway
      distensibility may act to determine pharmacologic reversibility of airflow
      obstruction.

PMID- 8368653
TI  - Allergic bronchopulmonary mycosis caused by Pseudallescheria boydii.
AB  - Two cases of allergic bronchopulmonary pseudallescheriosis (ABPP) are described.
      These are the first cases of this allergic bronchopulmonary mycosis (ABPM)
      reported in which the clinical and serologic criteria are described. The first
      case was in a patient with mild asthma, and it resolved spontaneously after
      expectoration of a mucous plug. The second was in a patient with recurrent
      allergic bronchopulmonary aspergillosis with an exacerbation of ABPM caused by
      Pseudallescheria boydii. The total serum IgE, IgG, and IgE antibodies against P.
      boydii and the clinical picture well define ABPP. This diagnosis may be important
      to recognize in order to prevent a progression of the patient's lung disease.

PMID- 8368654
TI  - Management of complicated parapneumonic effusions.

PMID- 8368655
TI  - Evolution of therapy for childhood asthma.

PMID- 8368656
TI  - Estimating maximum ventilation: inclusion of maximum inspiratory and expiratory
      airflow variables.

PMID- 8368657
TI  - Increased lower airways responsiveness associated with sinusitis in a rabbit
      model.

PMID- 8368658
TI  - Neither emphysema nor Johnson's.

PMID- 8368659
TI  - Avoiding complications of long-term venous access.
AB  - Indwelling venous catheters are invaluable for long-term chemotherapy,
      antibiotics, and hyperalimentation. However, their placement and chronic use can
      cause serious complications. This study was done to develop guidelines for
      minimizing complications of long-term vascular access. Complications associated
      with 355 lines placed in 297 patients were recorded prospectively at the George
      Washington University Hospital. Single or double lumen catheters were placed via
      the infraclavicular subclavian approach (126), external jugular cutdown (133),
      internal jugular cutdown (22), and cephalic vein cutdown (42). While catheters
      were malpositioned in 15 cases (5.2%), route of placement did not influence this
      adverse outcome. Pneumothorax occurred only in the subclavian approach (5.6%).
      Axillary vein thrombosis was significantly more prevalent in catheters placed via
      the subclavian vein (10.3%) compared with the external jugular (2.3%) P < 0.05 or
      cephalic (2.3%) vein. Line sepsis occurred in 28 instances; this was
      statistically associated with an abnormal white blood count and with the use of
      double-lumen catheters (double-lumen catheter sepsis = 18.4%, single lumen =
      4.4%, P < 0.01). The morbidity of long-term venous catheters is affected
      significantly by the route of placement, the number of catheter lumens, and the
      pre-placement white blood count. As a result of our analysis, we recommend single
      lumen catheter placement using the external jugular cutdown route whenever
      possible.

PMID- 8368660
TI  - Selective monitoring in abdominal aortic surgery.
AB  - Monitoring via a pulmonary artery catheter has been advocated for all patients
      undergoing abdominal aortic surgery. This study was performed to identify a
      subgroup of patients who could be safely monitored with a central venous
      catheter. One hundred twenty-eight consecutive patients undergoing elective
      infrarenal abdominal aortic surgery were prospectively evaluated for risk of
      developing perioperative myocardial dysfunction based on criteria determined by
      the history and physical examination, chest radiography, and electrocardiography.
      Forty-five patients were identified as having no clinical evidence of coronary
      artery disease. These patients were then monitored perioperatively using a
      central venous catheter. All patients monitored via a central venous catheter
      underwent surgery for abdominal aortic aneurysmal disease (66.7%) or aortoiliac
      disease (33.3%) without intraoperative complications. There were 15 postoperative
      complications in 12 (26.7%) patients, comprised mainly of pulmonary (7) and
      gastrointestinal (3) complications. The cardiac-related morbidity was 4.4 per
      cent and consisted of congestive heart failure (1) and renal failure (1). No
      perioperative myocardial infarctions were detected. One (2.2%) postoperative
      death secondary to aspiration pneumonia occurred. The results of this data
      suggest that there exists a subgroup of patients undergoing elective infrarenal
      abdominal aortic surgery that can be monitored safely via a central venous
      catheter in the perioperative period.

PMID- 8368661
TI  - Vascular complications of the intra-aortic balloon pump: an analysis of 436
      patients.
AB  - Although the intra-aortic balloon pump can be a lifesaving device, vascular
      complications are often associated with its use. Four hundred thirty-six patients
      underwent insertion of a balloon pump over a 14-year period. Indications for the
      balloon pump were intraoperative pump failure (42%), unstable angina (24%),
      preoperative prophylaxis (22%), preoperative shock (9%), and postoperative
      support (3%). Placement of the intra-aortic balloon pump was by percutaneous
      insertion in 66 per cent of patients, the remainder were placed by direct
      exposure of the vessel. Vascular complications occurred in 46 (10.6%) patients.
      Limb ischemia was seen in 40 of 46 of these patients. Other complications
      included bleeding in three patients, dissection in two patients, and infection in
      one patient. The effects on morbidity of sex, diabetes, site of cardiac
      catheterization, duration of counterpulsation, and the presence or absence of
      pulses on admission were determined. Only the absence of pedal pulses on
      admission correlated with an increased incidence of vascular complications (P =
      0.04). Twenty four per cent of those with complications were diabetics, compared
      with 16 per cent of patients who received balloon pumps but had no complications.
      Surgical interventions in the ischemic limbs consisted of thrombectomy alone (28
      of 40) or thrombectomy and vascular bypass (5 of 40). Four femorofemoral
      crossover grafts and one saphenous vein interposition graft were used. Five limbs
      were lost to amputation, or 1 per cent of the entire group.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8368662
TI  - Percutaneously placed dual-lumen silicone catheters for long-term hemodialysis.
AB  - Dual-lumen Dacron-cuffed silicone hemodialysis catheters placed percutaneously
      under fluoroscopic control have been used by us in 200 patients since July 1986.
      A total of 246 catheters were placed in 4 years, of which 172 were for long-term
      hemodialysis in place of prosthetic tube bridge arteriovenous shunts. One-year
      catheter survival estimate by Kaplan-Meier life table was 57 per cent, and mean
      survival estimate was 16.3 months. There were a combined 76 patient years of
      catheter experience, with some catheters lasting as long as 2 1/2 years. Catheter
      thrombosis occurred in 92 catheters, but 83 per cent of cases responded to
      thrombolytic therapy. There were exit site infections with thirty-nine catheters,
      but 90 per cent resolved with antibiotic therapy. Twenty-two bacteremias occurred
      with 19 catheters, which resulted in 15 catheter removals. The remaining seven
      cases of bacteremia responded to antibiotic therapy without catheter removal.
      Subclavian vein or superior vena cava thrombosis has not been a problem. Silicone
      catheters are a practical alternative to prosthetic tube bridge arteriovenous
      shunts for long-term hemodialysis.

PMID- 8368663
TI  - Venous insufficiency: a late sequelae of four-compartment fasciotomy in the lower
      extremity?
AB  - Four-compartment fasciotomies used to relieve abnormally high compartment
      pressures necessitate interruption of the ensheathing fascial membrane. In the
      calf, this is considered an important component in maintaining a viable
      musculovenous pump and preventing venous hypertension, a leading cause of venous
      insufficiency. Through postoperative physical examination and
      photoplethysmography evaluation of 47 patients who underwent this procedure, no
      indication exists that division of the fascial component leads to calf pump
      dysfunction and chronic venous insufficiency. Of the patients studied, 92 per
      cent had unchanged musculovenous pump function upon photoplethysmography
      reevaluation at 19 weeks compared with the initial values recorded 6 weeks
      postoperatively; 6 per cent had improved venous flow, while only one of the 47
      (2%) had venous recovery measurements consistent with diminished venous flow.

PMID- 8368664
TI  - Bradycardia following carotid endarterectomy.
AB  - This study was performed to determine whether bradycardia complicates the
      postoperative course of patients undergoing carotid endarterectomy (CEA). The
      records of 216 patients undergoing 233 CEAs over a 2-year period were reviewed.
      Patients were divided into two groups based on their lowest Surgical Intensive
      Care Unit (SICU) heart rate (HR). Those with HR < 60 were in the Bradycardic
      (BRADY) group and those with HR > or = 60 were in the Non-Bradycardic (NON-BRADY)
      group. One hundred and sixteen patients developed bradycardia, with a mean (+/-
      SEM) HR of 51.1 +/- 0.5, compared with 117 NON-BRADY patients with a mean HR of
      70.6 +/- 0.9 (P < 0.0005). There were no significant differences between the
      groups in age, use of cardioactive drugs, SICU severity of illness, or length of
      SICU stay. The systolic blood pressure for BRADY patients averaged 144 +/- 2.2 on
      admission and 144 +/- 2.2 (P = NS) in the SICU, while that of NON-BRADY patients
      rose from 143 +/- 2.3 on admission to 156 +/- 2.5 (P = 0.001). Fifty-four
      patients receiving a second CEA had a SICU HR not significantly different from
      those patients undergoing a first CEA. Of 17 patients who underwent bilateral
      CEAs during the study period, SICU HRs averaged 65.1 +/- 3.7 after the first
      procedure and 64.7 +/- 3.6 after the second (P = NS). The authors conclude that
      bradycardia following CEA is a frequent but benign postoperative finding that
      does not affect outcome, cause significant hypotension, or prolong the SICU stay.

PMID- 8368665
TI  - Dysphagia lusoria: aberrant right subclavian artery with a Kommerell's
      diverticulum.
AB  - A retroesophageal right subclavian artery, the most common congenital aortic arch
      abnormality, is an unusual cause of dysphagia in adults. The embryologic
      abnormality of the aortic arch is involution of the fourth vascular arch, along
      with the right dorsal aorta, leaving the seventh intersegmental artery attached
      to the descending aorta. This persistent intersegmental artery assumes a
      retroesophageal position as it proceeds out of the thorax into the arm. Since
      compression of the esophagus by this right subclavian artery may produce
      dysphagia, the term "dysphagia lusoria" ("dysphagia by freak of nature"), has
      been used to describe the symptom complex. The presence of an aneurysm of the
      artery or Kommerell's diverticulum at its aortic origin is more likely to produce
      symptoms from esophageal compression. This case presents a middle aged adult with
      an associated Kommerell's diverticulum and dysphagia. Surgical correction was
      used to relieve his symptoms and to correct the diverticulum of the proximal
      right subclavian artery. The embryologic changes that occur are discussed in
      detail.

PMID- 8368666
TI  - Delayed pneumothorax after central venous access: a potential hazard.
AB  - Percutaneous central venous catheter access is common-place in surgical patients.
      Though several major complications of this procedure have been described,
      pneumothorax is the most common. Pneumothorax is routinely assessed by a chest X
      ray within 2 hours after catheter placement. During a recent 6-month interval,
      the authors identified five patients with delayed onset and diagnosis of
      pneumothorax following percutaneous central venous access. All immediate post
      insertion chest X-rays were normal; however, subsequent chest X-ray showed
      evidence of pneumothoraxes. The pneumothorax contributed to the death of one
      patient on positive pressure ventilation. A review of the literature revealed a
      total of 18 patients in the English literature with this complication. Although
      the incidence of delayed pneumothorax is low, it is, in some instances, life
      threatening, particularly in patients on positive pressure ventilation. A high
      index of suspicion is required to diagnosis and treat this reversible condition.

PMID- 8368668
TI  - The role of combined liver/kidney transplantation in end-stage hepato-renal
      disease.
AB  - The study describes the indications and results of combined liver/kidney
      transplantation in eight patients suffering from end-stage hepato-renal diseases.
      The causes of primary renal failure were hyperoxaluria type I (2/8), diabetic
      nephropathy (2/8), glomerulonephritis (2/8), congenital pyelonephritis (1/8), and
      polycystic kidneys (1/8). Only five of these patients were on chronic dialysis
      prior to transplantation. The indication for kidney transplantation in the other
      three patients was low GFR (< 20 mL/min) and the anticipation of further
      deterioration of the renal function after liver transplantation as a result of
      cyclosporine toxicity. The end-stage liver diseases were chronic active hepatitis
      (4/8) and alcoholic cirrhosis (2/8). There was no evidence for liver failure in
      two patients undergoing combined transplants for primary hyperoxaluria. The 1
      year patient survival rate is 75 per cent, and at that time, kidney and liver
      function were found to be within normal range. In conclusion, excellent long-term
      patient survival, as well as kidney and liver graft function, can be achieved in
      patients suffering from complex end-stage disease of both organs who undergo
      combined liver and kidney transplantation.

PMID- 8368667
TI  - Arterial injuries of the thoracic outlet: a ten-year experience.
AB  - Arterial injuries of the thoracic outlet are complex and require a precise plan
      for adequate management and prompt exposure of injured vessels. Our 10-year
      experience with 28 such injuries is reviewed. Arteriography was performed
      whenever possible in stable patients (15) and aided in planning the operative
      approach. Unstable patients with active bleeding, pulsatile or expanding
      hematoma, or pulse deficit were taken to the operating room without delay. A
      thoracic approach was required in 15 patients, and the exposure was extrathoracic
      in 12 patients. Airway was secured with liberal use of emergency endotracheal
      intubation (16 patients). Primary repair was possible in 16 patients, with
      grafting performed in eight and ligation in three. One vertebral artery injury
      was successfully controlled with embolization. Venous injuries were repaired in
      six patients and ligation was necessary in eight; there was no significant
      morbidity. Two patients died in this series from complications of severe
      hemorrhage. Significant morbidity was encountered from associated neurologic
      injuries in 15 patients. Stroke was evident in two patients, both of whom were
      moribund preoperatively. Proximal subclavian artery injuries were particularly
      more problematic and frequently required an interim anterior thoracotomy for
      early control of exsanguinating hemorrhage. Our philosophy in the management of
      these injuries and choices of exposure are discussed in detail.

PMID- 8368669
TI  - Predicting the results and outcome of patients who undergo abdominal CT scanning
      while in the surgical intensive care unit.
AB  - Postlaparotomy patients who remain in the Surgical Intensive Care Unit (SICU) are
      frequently suspected of harboring an intra-abdominal abscess (IAA). Computed
      Tomography (CT) of the abdomen has been advanced as an accurate method to
      diagnose an IAA. To determine the clinical parameters predictive of CT scan
      results, and the survival of such patients, this study reviewed a consecutive
      series of 29 postlaparotomy patients who were evaluated by abdominal CT scan
      while in the SICU. An IAA was identified significantly more frequently by CT when
      patients were explored for a GI malignancy (70% vs 30%; P < 0.05) and when
      patients were operated upon electively (11.1% vs 20.0%; P < 0.05).
      Postoperatively, alert patients were significantly more likely to have a CT scan
      positive for an IAA than were patients who were lethargic or nonresponsive (90%
      vs 10%; P < 0.05). Laboratory data, including radiographic studies, were not
      predictive of the CT scan results. A negative CT scan modified therapy in only
      10.5 per cent of patients, while a positive scan altered therapy in 70 per cent
      of patients (P < 0.05). The overall survival for this group was 48.1 per cent.
      The identification of an IAA by CT scan did not significantly improve survival
      (42% with an IAA vs 40% without an IAA). APACHY II scores were significantly
      increased in nonsurvivors (17.4 +/- 6.0 survivors vs 23.76 +/- 7.8 nonsurvivors;
      P < 0.05). Our data indicate that in critically ill postlaparotomy SICU patients
      who were evaluated by abdominal CT scanning, there are some clinical clues that
      tend to predict whether or not CT scanning will identify an IAA.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8368670
TI  - Endoscopic applications in thoracic surgery: video-assisted thoracoscopic
      surgery.
AB  - Twenty-eight cases of video-assisted thoracoscopic surgery were performed in a 10
      month period. Twenty-seven of the 28 cases were completed without a standard
      thoracotomy. In one of the 28 cases, inadequate visualization secondary to
      extensive adhesions necessitated conversion to thoracotomy. There were no
      complications secondary to the video-assisted thoracotomy or video malfunction.
      Video-assisted thoracoscopic surgery provides the thoracic surgeon with
      advantages not enjoyed with standard thoracotomy and thoracoscopic techniques.
      These advantages include: decreased patient pain and recovery time, increased
      latitude of movement for the surgeon, visualization by assistant and observers,
      adjustable magnification for close examination of pathology and still photo and
      video recording capabilities.

PMID- 8368671
TI  - Thru-knee amputation: the operation of choice for non-ambulatory patients.
AB  - Between 1983 and 1990, 32 consecutive patients had 35 thru-knee amputations for
      ischemia causing infection or gangrene of the lower leg. Twenty-seven patients
      were nonambulatory, five had limited mobility, and none were considered to be
      candidates for rehabilitation with a prosthesis after surgery. The average age
      was 73 years. Thirty-day hospital mortality was 3 per cent. The incidence of
      complications was low, and healing was achieved in 97 per cent of survivors. One
      patients required revision to an above-knee amputation. Average postoperative
      hospital stay was 8.7 days. It is concluded from this study that thru-knee
      amputation is the treatment of choice in patients with nonsalvageable ischemic
      legs and in whom ambulation is not planned after operation.

PMID- 8368672
TI  - Management of the difficult appendiceal stump: how I do it.
AB  - The appendix can usually be removed by the standard technique of stump ligation
      after transection, with or without inversion of the stump into the base of the
      cecum. When inflammation or necrosis extends into the cecum and the appendix
      cannot be ligated at its base, there are several options that can be employed.
      These include appendicocecostomy, partial cecal excision with a stapling
      instrument, and right colon resection. These techniques have been used 16 times
      in 249 patients operated upon for appendicitis. Although these techniques will be
      required infrequently, when they are necessary the risk of appendiceal stump
      breakdown with peritoneal soilage or cecal fistula can be minimized.

PMID- 8368673
TI  - Endoscopic placement of long intestinal tubes.
AB  - Partial intestinal obstruction has been successfully managed by the use of long
      intestinal tubes. For proper decompression, the long tube must pass beyond the
      pylorus; however, failure of the tube to progress by gravity alone has been
      reported to be as high as 46 per cent. A simple method of endoscopic placement of
      the long tube into the duodenum is described. If one is familiar with performing
      upper endoscopy, this technique can be learned easily.

PMID- 8368674
TI  - [Molecular advances in "non-mendelian" genetics. Implications for pediatrics].

PMID- 8368675
TI  - [Sepsis caused by coagulase-negative Staphylococcus in the newborn infant.
      Clinical and therapeutic aspects].
AB  - This study deals with sepsis caused by coagulase-negative stapylococci in a
      neonatal intensive care unit over a period of four years and eleven months. The
      global incidence was 20.7/1000 (50 cases out of a total of 2,416 admissions) and
      was higher in newborns with lower weight and with a shorter gestational age. The
      most significant clinical manifestations were fever, paleness, and
      apnea/bradycardia. In all cases the germ was sensitive to vancomycin. Evolution
      was favourable in all patients, in spite of the initial gravity of some cases.
      Sepsis due to coagulase-negative staphylococci is the most frequent cause of
      nosocomial infection in our environment.

PMID- 8368676
TI  - [Organochlorine compounds: correlation between maternal and infantile blood
      levels, maternal milk and maternal-infantile parameters. Study in the province of
      Huelva].
AB  - In our study of the levels of organochlorine compounds (OCC), several factors
      were taken into account. In the mother, age, diet, place of residency,
      profession, the number of previous breast-fed children and alcohol and tobacco
      intake. We then studied the effect of the OCC passed through the placenta. Here,
      we checked the length of gestation, the birth weight, the cephalic perimeter
      measurement, the possible neurological alterations such as hypotonie and
      hyporreflexie and the possible clinical repercussions of the OCC. The OCC studied
      were, DDT, hexachlorobenzene (HCB), hexachlorocyclohexanes (HCH) and isomers
      alpha, beta and gamma or lindane, dieldrin, heptachloro epoxide (HE) and
      polychlorobiphenyl compounds (PCB). The samples studies included, blood for the
      mother and umbilical cord during the delivery, blood from the babies at the ages
      of one and three months, and the mother's milk (n = 30) and formula milk (n = 20)
      one and three months after birth. The analytical study was made at the National
      Institute o Toxicology in Seville with the following methods, gas chromatography,
      electron capture detector and mass spectrometry. The statistical analysis was
      based on the Kruskal-Wallis, Shapiro Wilks, Levene, Pooled and Separate tests. We
      have found that older mothers and those who consumed more fatty meat and blue
      fish had statistically significant higher levels of OCC. There were also
      differences depending on the place of residency. The newborn babies with a
      greater birth-weight and cephalic perimeter measurements also had higher levels
      of OCC. In these babies, we also found clinical symptoms such as hypotonie and
      hyporreflexie.

PMID- 8368677
TI  - [Immunity against tetanus in childhood].
AB  - In order to evaluate the programs of vaccination against tetanus, we have studied
      the presence of specific antibodies in a sample of children and adolescents from
      our region. We used a passive hemagglutination test, corroborating the results by
      a biological assay based on toxin-neutralization. Among the subjects
      investigated, 93.2% (551/591) had neutralizing toxin-antibodies at a protective
      level (> or = 0.01 ui/ml). The younger children were more protected (97.5% in
      children from 1 to 5 years old, and 79.2% in children from 16 to 19 years of
      age), (X2 = 25.39, p = 0.000-). We did not find any significant differences
      between the sexes in the degree of protection. Among protected subjects, the
      higher antibody titers were observed in children from 6 to 10 years old,
      coinciding with the age of a booster vaccine. The results show an excellent
      immunization coverage among the childhood population in our region. They also
      confirm the high effectiveness of this vaccine. However, this high protection was
      not found among people above the adolescent period.

PMID- 8368678
TI  - [IgG subclasses: placental transfer in the full-term neonate and their evolution
      during the first 3 months of life].
AB  - The authors studied the placental transfer of IgG subclasses in 43 newborns (NB)
      and their mothers. All the observations included low-risk pregnancies and full
      term deliveries. The values expressed in arithmetric mean +/- standard deviation
      (means +/- SD), and referred in mg %, showed the following results: maternal Ig
      Gtotal 1,183 +/- 237 versus (vs.) NBG 1,179 +/- 187; maternal Ig G1 792 +/- 230
      vs. NB 822 +/- 124; maternal Ig G2 138 +/- 77 vs. NB 209 +/- 70; maternal Ig G3
      48 +/- 33 vs. NB 95 +/- 30, and maternal Ig G4 10 +/- 8 vs. NB 4.9 +/- 2. The
      relation between the average levels of maternal and cord serum was 1, 1.5, 1.9
      and 0.48 for Ig G1, Ig G2, Ig G3 and Ig G4, respectively. It was also proved a
      maximum decrease in the levels of the subclasses in the first three months for
      the Ig G3, a percentage being noticed in the third month, in relation to the NB
      level, of 18, 29, 1.9 and 19% for Ig G1, Ig G2, Ig G3 and Ig G4, respectively.
      After primovaccination, a response was produced and it affected the 4 subclasses:
      Ig G1 845 mg %, Ig G2 229 mg %, Ig G3 38 mg % and Ig G4 7.44 mg %, with an
      increment in relation to prevaccination values of 5.5, 3.7, 20.7 and 12.4,
      respectively. The authors concluded by showing reference patterns in the active
      placental transfer of Ig G subclasses in normal full-term newborns.

PMID- 8368680
TI  - [Prognostic value of the electroencephalogram in hypoxic ischemic
      encephalopathy].
AB  - In order to check the prognostic implications of EEG tracings in hypoxic-ischemic
      encephalopathy (HIE), we carried out prospective EEG recordings in 116 newborn
      babies (65 term and 51 premature) admitted to our neonatal intensive care unit as
      a result of perinatal asphyxia. Forty term neonates were found to have critical
      and/or intercritical epileptiform EEG alterations; the developmental results of
      23 of these cases (57.5%) were adverse and were favorable in 17 cases (42.5%).
      Given that unfavorable results occurred in only 4 of the other 25 term neonates,
      the epileptiform EEG alterations were statistically significant for adverse
      developmental results (p < 0.005). Of the premature neonates, 29 were found to
      have critical and/or intercritical epileptiform EEG alterations. The
      developmental results were adverse in 19 of these children (65.5%) and favorable
      in 10 cases (34.8%). The statistical evaluation in this case showed a barely
      significant difference (p < 0.005) between epileptiform EEG alterations and poor
      developmental outcome when uncorrected age was used, and no statistically
      significant difference when corrected age was used. Thus, we conclude that
      although epileptiform EEG anomalies may serve as markers for neurological
      development impairments, they must be considered in conjunction with the
      background EEG tracing.

PMID- 8368681
TI  - [Colloidal bismuth subcitrate and amoxicillin in the treatment of Helicobacter
      pylori infection in children].
AB  - We have analyzed the effect of treatment with colloidal bismuth subcitrate (CBS)
      and amoxicillin in a series of 60 children (age range: 2.9-18 years) infected by
      Helicobacter pylori (HP). The following results were found: clinical remission
      70%; endoscopic normalization 55%; histological normalization 61.6% and HP
      eradication 53.3%. The improvement of histological activity (100% vs 11.7%) and
      histological normalization (90.6% vs 28.5%) were significantly more frequent in
      the HP eradicated group as compared with the persistent HP group (p < 0.001). The
      present study suggests that combined therapy with CBS and amoxicillin is not the
      most adequate treatment to eradicate HP in children and supports the role played
      by HP in the development of antral histologic lesions.

PMID- 8368679
TI  - [Controlled clinical assay in Clonidine, arginine aspartate, alpha-ketoglutarate
      of Ornithine and Ciproheptadine as growth stimulants in children with short
      stature].
AB  - Eighty-one healthy prepubertal children of short stature, between two and twelve
      years of age, were divided into four homogeneous groups. Each group was treated
      with a placebo for one year and for a second year with one of the following drugs
      (double blind): clonidine (CI), arginine asprate (AA), ornithine alphaketoglutare
      (OKG), or cyproheptadine (Cp). CI and OKG did not better the standard deviation
      of height. AA and Cp did, but to no greater extent than the placebo. The growth
      rate did not change in any group. The ratio of bone age/chronological age was
      significantly higher at the end of the OKG year than at the end of the year with
      placebo, a difference that was not found in any other group. The prognosis of
      adult height (TW2) did not change in any group. The standard deviation of weight
      increased in all groups, both with the placebo and the various drugs, without
      significant differences between the groups. The CI caused frequent clinical side
      effects, including a reversible increase in transaminases in one child. The Cp
      stimulated hunger. The AA and OKG did not produce side-effects and the placebo
      increased appetite in 11% of the children. Somatomedin C was significantly higher
      after one year with Cp than after one year with the placebo, significantly higher
      after the placebo than after CI and AA and there was no difference between the
      treatment with the placebo and OKG. Growth hormone values in a 24 hour urine
      sample were so scattered that we do not consider them helpful.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8368683
TI  - [Cholelithiasis in children: apropos of 14 cases].
AB  - Between 1980 and 1990, we have diagnosed fourteen cases of cholelithiasis in
      children at our hospital. Abdominal pain was the most common symptom. Diagnosis
      was made by abdominal ultrasonography in all of the cases. Risk factors were
      found in 4 children. Family history was present in four patients. The treatments
      performed included cholecystectomy in five cases, extracorporeal lithotripsy in
      one case and a dietary regimen with regular clinical reviews in eight patients.

PMID- 8368682
TI  - [Predisposition of Down syndrome to chronic infection with the hepatitis B
      virus].
AB  - In order to know in Down's Syndrome (DS) the age of infection by hepatitis B
      virus (HBV), the incidence of evolution to a chronic carrier status and the
      optimal age for vaccination against this virus, a study of the prevalence of HBV
      markers was carried out in 302 mentally retarded children: Group I, 51 pre
      schoolchildren with DS (mean age 2.9 +/- 1.6 years); Group II, 72 schoolchildren
      with DS (mean age 13.8 +/- 3 years) and Group III, 179 schoolchildren with other
      types of mental retarded (OMR). Children from group II and III attended the same
      school as external day-pupils. Fifty eight percent of schoolchildren with SD
      presented at least one HBV-marker while this percentage was of 25% in
      schoolchildren with OMR (p > 0.05) or pre-schoolchildren with DS (p > 0.005); DS
      schoolchildren become also HBV chronic carrier with higher frequency than ORM
      schoolchildren (40 vs 17) (p > 0.05) and they maintained HBV replication in a
      higher proportion of cases (36 vs 4) (p > 0.05). In conclusion children with DS
      acquire easily HBV infection and this occurs when they attend the school
      independently that the school is a closed or an open institution. They also
      become more frequently HBV chronic carriers and they maintain HBV replication;
      so, they must be vaccinated before they begin to attend school and they must be
      treated with antiviral agents as soon as possible.

PMID- 8368684
TI  - [Atherogenic risk factors in children of parents with ischemic heart disease].
AB  - We have studied serum lipid levels and dietetic intake in 38 children whose
      parents had ischemic heart disease (HPCI) before 55 years of age and in a control
      group (n = 114). In the HPCI group, 25% had serum levels of total cholesterol
      higher than 200 mg/dl; only 2 children presented elevated levels of LDL and apo
      B. Dietetic intakes in both groups were similar, with a high protein (16-17% of
      calories) and fat (39-42% of calories) intake and a low carbohydrate intake
      (40.46% of calories). In both groups the percentage of monounsaturated fat was
      higher than other types of fat. The most frequent phenotype in the HPCI group was
      IIa (8 children). Only 1 child showed a IIb phenotype. This finding may be due to
      the variability of this phenotype in the same individual throughout life. In the
      families (n = 8), we have detected 2 families with polygenic hypercholesterolemia
      (HP), 2 others with familial combined hyperlipidemia (HFC) and 4 without family
      history of hyperlipidemia. Taking into account the lipid profile in children of
      the HPCI group, we have detected the presence of familial dysliproproteinemias.
      It appears that dietetic intake is not an atherogenic risk factor in these
      patients.

PMID- 8368685
TI  - [Benign recurrent paralysis of the sixth cranial nerve in childhood].

PMID- 8368686
TI  - [Acute megakaryoblastic leukemia in infancy].

PMID- 8368687
TI  - [Pulmonary arteriovenous fistula. Clinical course during a 6-year follow-up].

PMID- 8368688
TI  - [Benzodiazepine withdrawal syndrome in newborn infants. Clinical cases].

PMID- 8368689
TI  - [Type I spinal muscular atrophy in twins].

PMID- 8368690
TI  - [Is it necessary to remove all button-type batteries accidentally ingested by
      infants?].

PMID- 8368691
TI  - [Breast feeding and the infant food industry: mutual respect as a form of
      collaboration].

PMID- 8368692
TI  - [The 11q (-) syndrome. Report of a new case].

PMID- 8368693
TI  - [Congenital absence of a lumbar pedicle].

PMID- 8368694
TI  - [Accidental organochlorine insecticide poisoning].

PMID- 8368695
TI  - [Rheumatic fever associated with Schoenlein-Henoch purpura].

PMID- 8368696
TI  - The early days of the antinuclear antibody story: where and how did it all start?

PMID- 8368697
TI  - [Is the concept of somatization useful to the clinician?].

PMID- 8368698
TI  - [Somatoform disorders. Analysis of 43 patients in an unit of internal medicine.
      Diagnostic attitude and proposal of management].
AB  - The frequency of hospitalization for somatoform disorders in France has been
      difficult to evaluate owing to the lack of papers published on this subject.
      Retrospective analysis of the medical records of 43 patients hospitalized on an
      internal medicine ward for whom this diagnosis was retained enabled us to
      characterize this population according to the following criteria: socioeconomic
      professional group, family environment, probable triggering factors, and
      patient's evolution before and after hospitalization. Based on this study, we
      propose a diagnostic approach to and some guidelines for management of these
      patients, and discuss their place in internal medicine.

PMID- 8368699
TI  - [Acute attacks of hepatic porphyria: specific treatment with heme arginate].
AB  - Severe hepatic porphyrias (acute intermittent porphyria, variegate porphyria and
      hereditary coproporphyria) are hereditary diseases. Each type of porphyria is the
      result of a specific decrease in the activity of one of the enzymes of heme
      biosynthesis. Acute attacks are very serious: the abdominal pains are severe and
      the neurological manifestations can lead to death or incomplete recovery with
      irreversible sequelae (usually paralysis). Since 1985, the prognosis of acute
      attacks has been greatly improved by the introduction of heme-arginate. The 69
      acute attacks (30 patients, 4 men and 26 women) that we treated with heme
      arginate between 1988 and 1991 are described in this report. All patients were
      infused with 250 mg/d of heme-arginate for 4 days: the mean duration of abdominal
      pain was 2.5 days (SD 0.72). For 95 p. 100 of the attacks, the total
      hospitalization time was 5 days or less; side effects were very minor. In every
      case, a favorable response was dependent upon the early initiation of heme
      therapy.

PMID- 8368700
TI  - [Clinical study of 12 cases of malignant non-Hodgkin's lymphoma of the orbital
      region].
AB  - Over an 8-year period in the Departments of Hematology, Ophthalmology and
      Internal Medicine of our hospital, 12 cases of orbital and adnexal malignant non
      Hodgkin's lymphoma were reported. Diagnostic elements varied, including local
      tumefaction, watering eyes, uveitis, and unexplained, long-term fever. Nine
      patients had primary paraocular lymphomas involving either orbital structures,
      the lacrimal gland or the eyeball, but after appropriate staging, the disease was
      found to be disseminated in 5; the 3 other cases were secondary orbital
      lymphomas. Intermediate or high grade histological types were predominant (9
      patients) in our series. Radiation therapy, alone or combined (5 patients) with
      chemotherapy, was administered in 8 cases; other treatments consisted of
      chemotherapy (2 cases) or steroids (2 cases). Evolution was poor, with only 4
      patients surviving at 34-180 months of follow-up. The main prognostic factors
      were tumor stage and histological grade. The clinical characteristics of this
      group are compared to those reported in the literature.

PMID- 8368701
TI  - What does the future hold for the ANCA?

PMID- 8368702
TI  - [Value of phenotyping by cytofluorometry in hematology and clinical
      immunopathology].

PMID- 8368703
TI  - [Liposomes, in the treatment of infections].

PMID- 8368704
TI  - [Familial benign hypercalcemia or familial hypocalciuric hypercalcemia].

PMID- 8368705
TI  - [Temporal arteritis. Elements of differential diagnosis of Horton disease].

PMID- 8368706
TI  - [Sudden death in an adult and detection of a cardiac site of sarcoidosis].

PMID- 8368707
TI  - [Status epilepticus following voluntary poisoning with buflomedil].

PMID- 8368708
TI  - [Multiple paraneoplastic syndromes (limbic encephalitis, peripheral neuropathy
      and Schnitzler's syndrome) in an association of Waldenstrom's macroglobulinemia
      and pulmonary epidermoid carcinoma].

PMID- 8368709
TI  - [Bifocal spondylodiscitis simulating rhizomelic pseudo-polyarthritis].

PMID- 8368710
TI  - [Bacterial ascites caused by Salmonella enterica subsp. enterica serotype
      Indiana].

PMID- 8368711
TI  - [Herpetic esophagitis in immunocompetent patients].

PMID- 8368712
TI  - [Visceral leishmaniasis with dysimmunitary manifestations and renal involvement].

PMID- 8368713
TI  - [The Supreme Court for insulin?].

PMID- 8368714
TI  - [The future of mortality: epidemiological centering].

PMID- 8368715
TI  - [Cardiovascular risk factors in 4,215 subjects in the service and industrial
      sectors (the CESAME survey)].
AB  - A prospective transversal study was undertaken by occupational health physicians
      on more than 4,000 individuals including almost 800 women working in the same
      company with the following aims: a) to compare the prevalence of a certain number
      of classically recognized cardiovascular risk factors in 2 types of populations,
      service versus manufacturing industries, in the Paris region; and b) to
      understand these populations better so as to develop educational and information
      campaigns specifically adapted to their needs. Several elements were recorded in
      a computer data bank during the physical examination: blood pressure, blood
      cholesterol, smoking history, blood triglycerides, blood sugar, the ratio of
      measured to theoretical weight and physical activity. For each of these
      parameters, a value above a determined threshold level was defined as a risk
      factor. For men working in service industries, the percentages of heavy smokers
      (24%), hypercholesterolemia (18%), and hyperglycemia (7%) were significantly
      higher than in the manufacturing sector (19.3, 15 and 2.4%, respectively). In
      manufacturing industries, the percentages of men with hypertension (15%),
      hypertriglyceridemia (10%), who were overweight (24%) or had a low high density
      lipoprotein level (10%) were significantly higher than in the service sector
      (3.1, 7.5, 20 or 8.2%, respectively). The percentage of women smoking more than
      20 g of tobacco per day (25.5%) in the service sector was significantly higher
      than that in manufacturing industries (4.25%). In contrast, in the manufacturing
      sector, the percentages of hypertensive (6%) and obese (24%) women were
      significantly higher than those in the service industries (1.1 and 16%,
      respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368716
TI  - [Treatment of hypereosinophilic syndromes of myeloproliferative expression with
      the combination of hydroxyurea and interferon alpha. Apropos of 7 cases].
AB  - Seven patients suffering from hypereosinophilic syndrome with clinical and/or
      hematological symptoms of a myeloproliferative syndrome were treated with a
      combination of hydroxyurea and interferon-alpha. To date, 6 of them have been
      followed for more than 1 year. In all cases, this therapy decreased circulating
      hypereosinophilia to under 1,500/mm3 and obtained normal eosinophil levels in 5
      patients with a parallel regression of visceral complications. None of the
      patients experienced treatment-associated side effects, particularly
      hematological ones. Hypereosinophilic syndrome has a poor prognosis due, for the
      most part, to the development of visceral, cardiac and neurological
      complications, and, more secondarily, to the risk of progression towards acute
      leukemia. Conventional treatments, corticosteroids and hydroxyurea, have greatly
      improved the prognosis, but failure of these therapeutics remains common in the
      myeloproliferative form of the disease. Because interferon-alpha was proven to
      effectively treat chronic myeloid leukemia, it has been proposed for the
      treatment of hypereosinophilic syndromes, and encouraging results have been
      obtained despite the high daily doses required to control the disease. In the
      future, its association with hydroxyurea could represent an alternative therapy
      capable of controlling the disease at low doses thereby limiting the risk of side
      effects.

PMID- 8368717
TI  - [Anatomo-clinical conference. Hopital Bichat-Claude Bernard. Case No. 2-1993.
      Recurrent subcutaneous and peritoneal abscesses].

PMID- 8368718
TI  - Interview with Joaquim Coll. What is going to happen tomorrow as far as secondary
      Sjogren's syndrome is concerned?. Interview by P. Youinou.

PMID- 8368719
TI  - [Insulin resistance and arterial hypertension].

PMID- 8368720
TI  - [Insulin, triglycerides and atheroma. Epidemiological data and hypotheses].

PMID- 8368721
TI  - [Classification of dyslipoproteinemias of genetic origin].

PMID- 8368722
TI  - [Presentation of results of a general review].

PMID- 8368723
TI  - [Cogan's syndrome disclosed by meningitis. Corticoid therapy inducing rapid
      improvement in deafness].

PMID- 8368724
TI  - [Pseudo-periodic disease with hyper IgD].

PMID- 8368725
TI  - [Treatment of refractory causalgia with topical capsaicin].

PMID- 8368726
TI  - [Longitudinal fatigue fracture of the tibia].

PMID- 8368727
TI  - [Rheumatoid purpura in adults and mycoplasma infection].

PMID- 8368728
TI  - [Hemophilus parainfluenzae: a cause of severe infectious endocarditis in the
      healthy heart].

PMID- 8368729
TI  - [Pseudo-achalasia and cancer of the bladder].

PMID- 8368730
TI  - Genes coding for antigens recognized on human tumors by autologous cytolytic T
      lymphocytes.

PMID- 8368731
TI  - Polyvalent melanoma vaccine improves survival of patients with metastatic
      melanoma.

PMID- 8368732
TI  - Active specific immunotherapy of human colorectal carcinoma with an autologous
      tumor cell/bacillus Calmette-Guerin vaccine.

PMID- 8368733
TI  - Treatment of human melanoma with a hapten-modified autologous vaccine.

PMID- 8368734
TI  - Active specific immunotherapy of melanoma with allogeneic cell lysates.
      Rationale, results, and possible mechanisms of action.
AB  - Since 1985, we have conducted clinical trials with a therapeutic melanoma vaccine
      (melanoma theraccine). Mechanical lysates of two melanoma cell lines chosen for
      their complementary characteristics were combined with the adjuvant DETOX and
      injected subcutaneously on weeks 1, 2, 3, 4, and 6 for one or two courses and
      then monthly in patients with objective clinical responses. Of 106 patients, 20
      had objective clinical regression of tumor masses, 5 with complete responses. The
      median duration of response was 21 months. Twelve patients lived at least 2
      years, with a median survival of nearly 3 years. Two of them are free of disease
      for > 2 and > 6 years, respectively. However, it was not necessary to achieve
      complete remissions to cause an increase in survival, and most of the long
      surviving patients have one or more (stable) residual nodules. The pace of the
      disease process was clearly slowed in those individuals. A rise in the level of
      cytotoxic T-lymphocyte precursors in the blood (pTC) correlated with clinical
      response. Only those patients who had a rise in pTC had a remission. In addition
      to "classical" CD8+ Tc, CD4+ Tc were cloned from the blood of immunized patients.
      Melanoma-specific Tc of both types that killed autologous melanoma but not
      matched lymphoblastoid cells were detected. Allogeneic melanoma cell lines were
      also killed, with mainly HLA-A2/28 and HLA-B12/44/45 degenerate restriction. CD4+
      Tc were restricted by HLA Class I antigens, as judged by their killing of HLA
      Class II-negative melanomas and blocking by anti-class I antibodies. Other CD4+
      clones were blocked by both anti-HLA Class I or anti-Class II MHC monoclonal
      antibodies, and only two were blocked only by anti-HLA Class II. Immunohistory
      revealed CD4+ and CD8+ T cells in lesions under rejection, but the predominant
      cells were macrophages, suggesting delayed-type hypersensitivity as a possible
      mechanism. Clinical responses were found most often in patients with HLA-A2/28, 
      B12/44/45, and -C3, particularly when two or more of those alleles were present.
      This may have been due either to (1) similarity of MHC antigens between one of
      the immunizing melanomas and the patient's melanoma or (2) the intrinsic
      importance of these MHC molecules in presenting melanoma-associated antigens to
      Tc in vivo. IFN-alpha 2 b salvaged 8 of 18 patients who failed with the
      theraccine, regardless of MHC phenotype, perhaps through upregulation of MHC and
      tumor epitopes on the autochthonous tumor.

PMID- 8368735
TI  - Evaluation of vaccinia viral lysates as therapeutic vaccines in the treatment of
      melanoma.
AB  - Patients who develop metastases from melanoma in regional lymph nodes are known
      to be at high risk of developing further recurrences after surgical removal of
      the lymph node metastases. This study examines whether immunization over a two
      year period with a vaccine made from vaccinia viral lysates of an allogeneic
      melanoma cell (VMCL), following surgical removal of lymph node metastases, would
      help prevent the development of distant metastases and improve survival from the
      disease. Eighty patients treated with VMCL alone and followed for a minimum of
      5.5 years had improved survival compared with that of a historical control group
      of 151 patients and a concurrent nonrandomized group of 55 patients. Similarly,
      survival of 102 patients treated with VMCL plus low dose cyclophosphamide for a
      minimum of 3.5 years was superior to that of the historical control group but not
      to that of the group treated with VMCL alone. Improvement in survival measured
      from the date of removal of the primary tumor was still evident. Analysis of
      subsets of patients showed that VMCL treatment appeared to benefit patients
      irrespective of the number of lymph nodes involved and whether surgery was
      carried out near to (synchronous metastases) or some time after removal of the
      primary (delayed metastases). Analysis of two additional aspects provided further
      evidence for a biologic effect of the vaccine. One was an apparent alteration in
      distribution of metastases with a lower incidence of cutaneous metastases
      relative to visceral metastases in VMCL-treated patients. The second was a change
      in time to development of recurrences with a higher proportion of metastases
      occurring after 2 years in the treated patients. Of a projected 400 patients, 384
      were entered into a randomized control (phase III) study to further evaluate this
      treatment. An interim analysis gave no reason for premature closure of the trial.
      This next analysis is scheduled for 9 months after closure of the trial.

PMID- 8368736
TI  - Clinical trials with VMO for melanoma.

PMID- 8368737
TI  - Lessons from autoimmunity.
AB  - Autoimmunity is a common occurrence as shown by the human potential to make
      autoantibodies. New syndromes resembling clinical autoimmune diseases and arising
      from presumed immunotoxic exposure are presented. Future experimentation should
      attempt to harness this autoimmune potential to create more effective anticancer
      vaccines.

PMID- 8368738
TI  - Immunogenicity and clinical activity of a polyvalent melanoma antigen vaccine
      prepared from shed antigens.

PMID- 8368739
TI  - Approaches to augmenting the IgG antibody response to melanoma ganglioside
      vaccines.

PMID- 8368741
TI  - Tumor immunology: an overview.

PMID- 8368740
TI  - Human tumor-associated antigen mimicry by anti-idiotypic antibodies.
      Immunogenicity and clinical trials in patients with solid tumors.

PMID- 8368742
TI  - Genetically engineered vaccines. Comparison of active versus passive
      immunotherapy against solid tumors.
AB  - Late tumor bearers (LTB), that is, mice that had tumors 3 weeks or longer, can
      have a selective immune dysfunction and fail to respond to target antigens
      expressed by the cancer cells. Such mice, however, do respond to nonmalignant
      cells engineered to express the rejection antigen, and they can be vaccinated
      with such cells to reject growing tumors. In this study, we compared the efficacy
      of passive immunization with that of active immunization using the engineered
      vaccine. An allogeneic MHC class I molecule was used as model tumor antigen. We
      found that active immunotherapy was only effective for small tumors in early
      stages of growth. In a later stage of tumor growth, active immunotherapy did not
      cure any mice, whereas passive immunotherapy was successful in all animals.
      Reasons for the failure of these LTB to respond to active vaccination with the
      engineered vaccine may be related to the decreased primary or secondary response
      we observed in these mice after active immunization. It is suggested that normal
      antigen-presenting cells expressing the tumor rejection antigen can elicit, in
      the presence of IL-2, antigen-specific T-cell responses by LTB, and that such T
      cells may be curative when used in adoptive therapy. We also suggest that the
      stage of tumor growth and the immune status of LTB more closely simulate the
      conditions observed in cancer patients.

PMID- 8368743
TI  - Novel adjuvant strategies for experimental malaria and AIDS vaccines.
AB  - Adjuvant research has improved the ability of biotechnology to generate novel
      vaccines. Numerous strategies for enhancing the immunogenicity of synthetic
      peptides and proteins have been identified. This overview focuses on adjuvant
      development and vaccine delivery systems that provide new tools for amplifying
      the effectiveness of ongoing malaria and AIDS vaccine development programs. In
      addition, some of the complex challenges and issues that have become associated
      with the delivery of modern vaccines in man are outlined. As adjuvant research
      continues to open new opportunities in vaccine development, there is renewed
      expectation that further generations of safe and potent vaccines will be possible
      against a broad spectrum of infectious agents and cancer.

PMID- 8368744
TI  - Immunotherapeutic strategies for cancer using poxvirus vectors.

PMID- 8368745
TI  - Cancer vaccines: the perspective of the Cancer Immunology Branch, NCI.
AB  - The Cancer Immunology Branch, NCI, is supporting a great deal of exciting
      research relevant to cancer vaccine development. The few areas highlighted here
      are representative of ongoing research opportunities, but further progress
      depends largely on a continued infusion of investigator-initiated ideas to
      realize the potential of current research areas and open new ones.

PMID- 8368746
TI  - Active specific immunotherapy of murine colon adenocarcinoma with recombinant
      vaccinia/interleukin-2-infected tumor cell vaccines.

PMID- 8368747
TI  - Immunization with human monoclonal antiidiotypic antibody in colorectal cancer.

PMID- 8368748
TI  - Immunization effect of monoclonal antibodies against tumor-associated antigens
      during cancer treatment.

PMID- 8368749
TI  - Tolerance and ways to break it.
AB  - The overall picture as regards cellular mechanisms in immunologic tolerance is
      thus clear. Thymic negative selection is an important and dominant mechanism for
      both CD4+ and CD8+ T cells for those antigens (and they may be very many indeed),
      the peptides of which get expressed within the thymus. The induction of anergy
      among peripheral T lymphocytes may represent an ancillary mechanism in some
      cases, but this is not as clear as it appeared 2 or 3 years ago. Evidently, in
      many cases, T cells simply ignore antigens present only within specialized
      organs, and these T cells, even if only of low affinity for the antigen in
      question, could be provoked into autoimmunity if sufficient help is provided, for
      example, through localized production of IL-2 or through provision of cross
      reactive help. B-cell tolerance is also proven and involves deletional mechanisms
      (most likely maturation arrest) or functional inactivation (clonal anergy). The
      former phenomenon dominates for self-antigens that strongly cross-link the B
      cell's Ig receptors and the latter for weaker negative signals. Despite these two
      mechanisms, clonal ignorance prevails for many self-antigens. The secondary B
      cell repertoire is also largely free of anti-self B cells, lack of T-cell help
      being a major factor in preventing the development of anti-self memory B cells.
      Therefore, to have the best chance of creating an immunogenic antitumor vaccine,
      a few simple and rather obvious rules must be followed. The antigen in question
      must be presented in such a way as to be palatable to "professional" antigen
      presenting cells, particularly dendritic cells and macrophages. Immunotherapy
      protocols should avoid at all costs the widespread distribution of the antigen in
      question through the extracellular fluids. Indeed, it is possible that widespread
      circulation of a tumor-associated antigen through the serum and lymph because of
      large-scale shedding from the tumor cell may already have created a substantial
      degree of tolerance to the antigen in question in both T- and B-cell populations.
      If that has happened, it becomes particularly important to create a cancer
      vaccine capable of inducing help. This may well involve coupling of the most
      important epitopes to some highly immunogenic and foreign carrier. A wide choice
      of adjuvants is available for the designer of tumor vaccines, and in this regard
      the cancer immunotherapy community has much to learn from the rapidly developing
      field of infectious disease vaccinology using recombinant and other
      vaccines.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8368750
TI  - Assessment of immunologic competence and host reactivity against tumor antigens
      in breast cancer patients. Prognostic value and rationale of immunotherapy
      development.

PMID- 8368751
TI  - Augmentation of T-cell response with a melanoma cell vaccine expressing specific
      HLA-A antigens.

PMID- 8368752
TI  - Transfection of TGF-beta producing tumors with IL-2 elicits tumor rejection.

PMID- 8368753
TI  - Coexpression of IL-2 and gamma-IFN enhances tumor immunity.

PMID- 8368754
TI  - Pancarcinoma T/Tn antigen detects human carcinoma long before biopsy does and its
      vaccine prevents breast carcinoma recurrence.

PMID- 8368755
TI  - Phase Ib trial of a synthetic beta human chorionic gonadotropin vaccine in
      patients with metastatic cancer.

PMID- 8368756
TI  - Adjuvant vaccination in colorectal carcinoma.

PMID- 8368757
TI  - Specific immunotherapy of colorectal carcinoma with Newcastle-disease virus
      modified autologous tumor cells prepared from resected liver metastasis.

PMID- 8368758
TI  - Randomized study of adjuvant immunotherapy with autologous tumor cells and BCG in
      renal cancer.

PMID- 8368759
TI  - Specific immunotherapy using a recombinant vaccinia virus expressing human
      carcinoembryonic antigen.

PMID- 8368760
TI  - Identification and characterization of a colon tumor-associated antigen.

PMID- 8368761
TI  - Antiidiotype (Ab2) vaccine therapy for cutaneous T-cell lymphoma.

PMID- 8368762
TI  - A potential surrogate marker of efficacy for a therapeutic melanoma vaccine.

PMID- 8368763
TI  - Enhancement of a spontaneous immune response against a B-cell lymphoma by
      dendritic cells leads to protection against the tumor.

PMID- 8368764
TI  - Clinical trials of idiotype-specific vaccine in B-cell lymphomas.

PMID- 8368765
TI  - Clinical responses to intralymphatic whole-cell melanoma vaccine augmented by in
      vitro incubation with alpha-interferon.

PMID- 8368766
TI  - Adjuvant activity of QS-21 isomers.
AB  - QS-21, a reverse-phase purified triterpene glycoside from the South American tree
      Quillaja saponaria, can be further resolved into two peaks when chromatographed
      by high performance hydrophilic interaction chromatography. These two peaks
      demonstrated identical pseudomolecular ion weights and fragmentation patterns
      when analyzed by fast atom bombardment-mass spectroscopy. Carbohydrate analysis
      by monosaccharide composition and linkage analysis showed that a terminal apiose
      in the major peak was replaced by another pentose residue in the minor peak.
      Hence, the two peaks were structural isomers. Dose response curves for each
      isomer and reverse-phase purified QS-21 were similar, with a minimum effective
      dose of 5 micrograms in mice. This result indicates that the portion of QS-21
      containing this variation is not critical for adjuvant activity.

PMID- 8368767
TI  - Construction of immunogenic GD3-conjugate vaccines.

PMID- 8368768
TI  - Comparison of the binding parameters to melanoma cells of antihuman high
      molecular weight-melanoma associated antigen (HMW-MAA) monoclonal antibodies
      (mAb) and syngeneic anti-anti-idiotypic (anti-anti-id) mAb.

PMID- 8368769
TI  - Tumor escape from immune response by variation in HLA expression and other
      mechanisms.

PMID- 8368770
TI  - Tumor antigens known to be immunogenic in man.

PMID- 8368771
TI  - Recognition of autoantigens by patients with melanoma.

PMID- 8368772
TI  - The publisher's parish.

PMID- 8368773
TI  - Functional effects of alar cartilage malposition.
AB  - Nasal airway obstruction is frequently synonymous with septal deviation or
      inferior turbinate hypertrophy. Less readily appreciated is the fact that the
      mobile lateral nasal wall caudal to the bony arch can obstruct the airway,
      particularly at the internal or external nasal valves. External valvular
      incompetence can result from postsurgical or congenital causes, among the most
      common of which is alar cartilage malposition. Twenty-seven patients with alar
      cartilage malposition in a series of 61 patients (44%) treated for airway
      obstruction from external nasal valvular incompetence comprise this report.
      Rhinomanometric data demonstrate an increase in total nasal airflow from 99 +/-
      17 ml (mean +/- SEM) to 190 +/- 37 ml per 14 seconds after valvular correction.
      Patients in whom additional septal pathology was corrected nevertheless had no
      significant airflow improvement over patients with external valvular
      reconstruction alone. Treatment principles of valvular incompetence from alar
      cartilage malposition are given for primary and secondary rhinoplasty patients,
      among which is a composite conchal cartilage/skin graft that can reconstruct a
      functioning lateral crus and replace a vestibular skin deficiency. Interestingly,
      alar cartilage relocation to correct the malposition also narrows the alar base,
      even when no alar wedge resection is performed.

PMID- 8368774
TI  - Nasal osteotomy--utilizing dual plane reciprocating nasal saw blades: a 6-year
      follow-up.
AB  - Observation of the nasal bone anatomy has demonstrated a double S-curve
      configuration from the base of the pyriform aperture to the medial canthus. The
      most common method of osteotomy uses a curved osteotome or a chisel. The movement
      of either is facilitated by tapping with a mallet. With this method, frequent
      green-stick fractures, fragmentation, and other complications have been
      encountered. For the last 6 years, a dual plane, curved stainless steel blade has
      been used to accomplish low to high osteotomies. This gives a precise lateral
      transverse osteotomy without medial osteotomy being required. This technique
      allows the operator to produce a well-defined and precise lateral osteotomy with
      fewer potential complications and less postoperative swelling as well as improved
      patient comfort. In cases of secondary rhinoplasty or old nasal trauma, sites of
      previous fibrous union are able to be osteotomized with precisely controlled
      cuts, avoiding unpredictable fragmentation or fracture lines.

PMID- 8368775
TI  - Augmentation mammoplasty: results of a patient survey.
AB  - A detailed survey on aesthetic augmentation mammoplasty was sent to patients who
      had undergone this procedure at the Massachusetts General Hospital between July
      1973 and July 1991 to determine the incidence of postoperative complications
      after augmentation mammoplasty, and to qualify the factors related to patient
      satisfaction (n = 304). Surgical records of respondents were examined. After a
      mean follow-up of 8.2 years, there were no patients with known breast cancer or
      autoimmune disease after augmentation. Five implants (2.5%) were replaced due to
      leakage. Other complications were rare. Overall satisfaction was high and
      correlated inversely with capsular contracture ratings and elapsed time.
      Contracture ratings increased with time for silicone implants. Gel implants in
      the submuscular position were softer than subglandular ones after 5 years elapsed
      time. Most women are satisfied after augmentation mammoplasty, despite a
      significant incidence of capsular contracture. The incidence of other adverse
      effects after augmentation is low. Augmentation mammoplasty does not appear to be
      an inducer of autoimmune disease or of breast cancer.

PMID- 8368776
TI  - Nipple-areola reconstruction with intradermal tattoo and double-opposing pennant
      flaps.
AB  - Reconstruction of the nipple-areolar complex is an important part of
      postmastectomy breast reconstruction. Intradermal tattooing is effective for
      creating areolar pigmentation and is simpler than skin grafting. However, a
      simple method for the construction of a normal nipple using local tissues remains
      a challenge. Several techniques achieve long-term nipple projection but at the
      expense of complicated flap design, multidirectional scars, and often a need for
      skin grafting to obtain a uniform-appearing areola. Our one-stage method of
      nipple-areola reconstruction uses intradermal tattooing for pigmentation and
      double-opposing pennant flaps for nipple reconstruction. The entire procedure is
      simple and fast, routinely performed in < 30 minutes under local anaesthesia in
      the office. From September 1989 to March 1992 we performed 102 reconstructions.
      The method produces a realistic appearing nipple. We have had no flap necrosis.

PMID- 8368777
TI  - Prediction of vascular complications following free tissue transfer.
AB  - Thirty-five consecutive free tissue transfers were evaluated prospectively. A
      prediction of postoperative vascular complications was made at the time of wound
      closure. Two vascular complications occurred, each predicted intraoperatively.
      Conversely, the 33 flaps that did not develop vascular complications were
      correctly identified intraoperatively. Intraoperative findings that correlated
      with postoperative vascular complications were clinically recognizable changes in
      flap perfusion.

PMID- 8368778
TI  - Bacterial clearance capability of living skin equivalent, living dermal
      equivalent, saline dressing, and xenograft dressing in the rabbit.
AB  - Two new skin substitutes, Living Skin Equivalent (LSE) and Living Dermal
      Equivalent (DE), have recently been developed. In this experiment, the ability of
      the LSE and DE preparations to function as biological dressings in an acute wound
      model was tested. Forty full-thickness wounds were made in New Zealand White
      rabbits. Each wound was inoculated with 5 x 10(5) Staphylococcus aureus
      organisms. Twenty-four hours later, one of the following four dressings was
      applied: saline gauze, porcine-derived xenograft, LSE, or DE. Daily dressing
      changes and wound biopsies for bacterial counts were performed. At 96 hours after
      inoculation, split-thickness autograft was applied to all wounds. Skin graft take
      was assessed 5 days later. In all treatment groups, bacterial counts decreased
      over time (p = 0.02). At 72 and 96 hours after inoculation, wounds dressed with
      LSE or DE had significantly lower mean bacterial counts than wounds treated with
      xenograft dressing (p < 0.01). No significant differences were found among the
      LSE-, DE-, or saline-treated groups. Skin grafts took well in LSE- and DE-treated
      wounds. In conclusion, the LSE and DE were more effective than xenograft in
      reducing bacterial wound contamination in this model, thereby demonstrating their
      potential application as biological dressing materials.

PMID- 8368779
TI  - The effect of ibuprofen on microvascular thrombosis in an experimental rabbit
      model.
AB  - The efficacy of ibuprofen in reducing microvascular thrombosis in a well
      established experimental model was studied. Bilateral 2-mm arterial inversion
      grafts were constructed in the femoral arteries of New Zealand White rabbits. The
      experimental group (n = 40 grafts) received subcutaneous injections of ibuprofen
      15 mg/kg t.i.d. beginning 1 day preoperatively and continued for 7 days
      postoperatively. The control group (n = 42 grafts) received injections of an
      equivalent volume of saline three times per day. Patency was evaluated at 7 days
      by the distal milking test. Seventy-three percent of the ibuprofen grafts were
      patent at 7 days, whereas 57% of the control grafts remained open. This
      difference in microvascular patency was not statistically significant.
      Representative scanning electron micrographs revealed a moderate reduction in
      aggregated platelets and overall clot density in the patent ibuprofen arterial
      inversion grafts compared with the patent control specimens. Although the use of
      ibuprofen as a sole antithrombotic agent cannot be recommended as the result of
      this study, it may be efficacious when used in conjunction with other agents such
      as dextran 40.

PMID- 8368780
TI  - Investigation of a biodegradable, implantable antibiotic delivery system on rate
      of wound infection.
AB  - Biodel, a bioabsorbable polymer, may be adapted to serve as an antibiotic
      delivery system for high local concentrations of drugs. In an autocontaminated,
      irradiated wound model with a high intrinsic infection rate, implanted gentamicin
      impregnated Biodel beads prevented wound infections in the submental area of
      rats.

PMID- 8368781
TI  - The role of alloplastic skeletal modification in the reconstruction of facial
      burns.
AB  - The external appearance of the face is largely dictated by its supporting facial
      skeleton. After an extensive thermal injury, the underlying facial skeleton may
      need to be either augmented or restored to maintain the functional and aesthetic
      appearance of the face. The factors that make a structural reconstruction
      difficult are poor vascularity and compliance of the scar tissue, extreme
      contractile forces of the scar, and unstable skin coverage. The use of an
      alloplast in the setting of facial burn scars may be one of the greatest
      challenges for an implant material. We reviewed our experience with the use of
      the Medpor porous polyethylene implant in facial burn reconstruction. This
      biomaterial has structural characteristics that allow for tissue ingrowth, yet it
      resists deformation by contractile forces. A total of 57 consecutive implants
      were placed in 24 patients with facial burns. Implants were used for the chin,
      the nose, the malar region, and as an ear framework. Patient follow-up ranged
      from 6 months to 3 years. Although 4 implants became exposed and 1 was thought to
      become infected, only 1 of the implants was removed. There were no other implant
      related complications. We believe that skeletal modification is an important step
      for a successful facial burn reconstruction. Porous polyethylene offers a
      promising solution for the complex reconstructive problem of using an alloplast
      in the environment of a facial burn.

PMID- 8368782
TI  - The role of facial muscle resection in reconstruction of the paralyzed face.
AB  - The technique of resecting the levator labii superioris alaeque nasi muscle can
      help improve nasal symmetry and is a useful ancillary procedure in reconstruction
      of the paralyzed face. In 3 patients with facial paralysis, this technique
      markedly changed the nasal deviation seen at rest and also affected the
      nasolabial angle and medial nasolabial fold. A patient report is presented.

PMID- 8368783
TI  - Tubed, folded radial forearm free flap for pharyngeal reconstruction and voice
      rehabilitation.
AB  - Reconstruction after total laryngectomy ideally includes restoration of voice
      with protected swallowing. Local flaps and tracheo-esophageal puncture with a
      prosthesis are widely used to accomplish this. Persistent problems, perhaps
      inherent to this solution, have led to the recent use of a tubed, folded radial
      forearm free flap for postlaryngectomy reconstruction. This flap has produced a
      good voice with low phonation pressures and minimal aspiration in 7 patients. A
      new configuration for this flap is described and 3 patients reported. Our flap's
      advantages include a simplified pedicle path, ease of construction, remote
      microanastomosis, and safer revision. Both patients with surviving flaps rapidly
      developed a good voice after reconstruction. Mild aspiration in 1 delayed oral
      intake and forced a successful revision. Our reconfigured flap may have some
      technical advantages, survives to length, and restores a good voice without
      significant aspiration. This and its simple care make it popular with patients.
      Development of this flap holds promise of more complete reconstruction after
      total laryngectomy.

PMID- 8368784
TI  - Carpal tunnel release complicated by necrotizing fasciitis.
AB  - We report a 31-year-old diabetic woman who underwent carpal tunnel release for
      median nerve compression followed by a laparoscopic tubal ligation. The procedure
      was complicated by a severe postoperative necrotizing fasciitis infection of the
      carpal tunnel release incision. This has not been previously reported. The wound
      was poorly responsive to antibiotic therapy and serial wound debridements.
      Control of the woman's infection required total excision of the palmar skin and
      fascia. Complicating factors in this case included the woman's long history of
      insulin-dependent diabetes and a concomitant clean-contaminated procedure.

PMID- 8368786
TI  - "Off-the-shelf" techniques for continuous tissue expansion.
AB  - Since modern tissue expansion was introduced in 1976, it has proved to be a safe
      and effective technique for obtaining extra tissue where traditionally distant
      flaps and grafts had been used. However, the lengthy expansion times and
      prolonged gross deformity of conventional expansion protocols have often deterred
      both physician and patient from choosing this reconstructive option. Over the
      past decade, attempts to shorten the total expansion time have centered around
      decreasing the time intervals between injections. Recently, researchers at
      Washington University have developed the technique of continuous tissue expansion
      (CTE), using a custom-designed, computerized pump. With CTE, expansion times have
      been shortened from 2 weeks to 3 days. At our institution, we have demonstrated
      that CTE can be safely and economically performed with the use of equipment
      already existent in most medical centers. We describe the equipment and technique
      and present two cases of successful clinical application of CTE.

PMID- 8368785
TI  - Two unusual postburn reconstructions using tissue expansion: one exogenous and
      one endogenous.

PMID- 8368787
TI  - Tourniquet-related hypotension in venous stasis ulcer excision.
AB  - Extremity tourniquets are widely used to achieve bloodless dissection in the
      surgical field. Excision of venous stasis ulcers (VSU) is aided by tourniquet use
      because of large dilated veins associated with venous stasis disease. We present
      3 patients with hypotensive shock occurring 10 to 15 minutes after tourniquet
      release after excision of venous stasis ulcers. All patients had long histories
      of venous stasis changes and two-thirds had prior histories of deep vein
      thromboses and pulmonary embolism. Mean tourniquet inflation time was 34 minutes
      and there were electrocardiographic changes in two-third of the patients. All
      patients responded rapidly to standard resuscitation measures and in all 3
      postoperative testing for pulmonary embolus and myocardial infarction was
      negative. Wound cultures revealed no organisms in 1 patient, mixed Gram-positive
      cocci in another, and greater than 10(5) Serratia marcescens in the third
      patient. Although small decreases in blood pressure and blood pH, and increases
      in blood lactate, PcO2, and creatinine phosphokinase, are normally associated
      with the use of extremity tourniquets, hypotensive shock has not been reported.
      The combined effect of tourniquet ischemia and venous stasis changes may cause
      hypotensive shock by (1) an endotoxic bolus upon tourniquet release, (2)
      pulmonary microembolization of platelet, fibrin, and leukocyte aggregates causing
      vasoactive substance release, and (3) synergistic effects of platelet-activating
      factor, a known mediator of endotoxic shock. The untoward events noted in these
      patients may be prevented by (1) proximal to distal dissection of the ulcer with
      initial ligation of large veins, (2) pretreatment with steroids and/or platelet
      activating factor antagonists, and/or (3) slow release of the tourniquet.

PMID- 8368788
TI  - The cross-leg flap revisited.
AB  - Although free flaps are currently the gold standard for distal lower extremity
      reconstruction, situations occasionally arise when alternative methods are
      needed. We present three cases of cross-leg flaps, which have been modernized
      with current external fixation technology and current understanding of vascular
      anatomy. All cross-leg flaps were based on the axial blood supply of the
      posterior descending subfascial cutaneous branch of the popliteal artery. This
      axial flap afforded considerable length and well-vascularized tissue. All
      patients were placed in external fixation devices. Adjacent lower extremity
      joints were exercised during the period of attachment. There were no major
      complications or flap failures. All patients were ambulatory postoperatively. We
      conclude that the cross-leg flap, using external fixation techniques and axially
      based flaps, can be successfully and expeditiously used to cover defects of the
      lower extremities.

PMID- 8368789
TI  - Giant cell granuloma of the facial bones.
AB  - Giant cell granuloma of the facial bones is a benign, reparative metabolic lesion
      that usually presents as a painful, expansile mass of the mandible. However, 1 of
      our patients had the extremely rare findings of multiple other facial bone
      involvement. In this series of 3 patients followed for > 6 years, the combination
      of biopsy and clinical presentation provided a stereotypical pattern that enabled
      an accurate diagnosis in all cases. Our patients were treated successfully with
      aggressive, but not radical, therapy, excisional curettage, and cauterization of
      remaining bone. Satisfactory reconstruction and stabilization of the mandible and
      maxilla were achieved with split rib grafts. The rib graft reconstruction and new
      bone formation provided excellent contour at 6 years in our adult patients and
      resulted in normal mandibular growth in the child we treated and followed for 12
      years.

PMID- 8368791
TI  - Re: A newly designed minigraft to achieve angularity and projection of the nasal
      tip: the asymmetrical bipyramidal graft.

PMID- 8368790
TI  - Re: Squamous cell carcinoma following breast augmentation.

PMID- 8368792
TI  - [Percutaneous angioscopy and angioplasty in the treatment of arteriopathies of
      the lower limbs].
AB  - Since 1987, the authors have routinely combined angioscopy with angioplasty of
      peripheral arteries. In a series of 251 angioplasties carried out in 191
      patients, angioscopy was found to be more specific and more sensitive than
      arterial angiography in the etiological diagnosis of arterial stenoses and/or
      obstructions. Angioscopic findings modified the angioplasty procedure in 29% of
      cases. Using an inflatable catheter remains the most commonly used approach (230
      cases); in 10 cases, this was preceded by thromboaspiration and in 4 cases by
      dotterization. Angioscopic support was useful in carrying out difficult
      manoeuvres (monitoring of the angioplasty in 4 cases, correct orientation of the
      guide into the lumen in 14 cases, installation of an endoprosthesis in 9 cases,
      arterial biopsy in 5 cases and sampling of an atheroma in 8 cases).

PMID- 8368793
TI  - [Percutaneous endoluminal angioplasty using balloon catheter in peripheral
      arteriopathies of the lower limbs].
AB  - Dilatation using an inflatable catheter is the best and most commonly used
      percutaneous endoluminal treatments for arteriopathy of the legs. We now have
      enough follow-up to say that it has acquired a position beside surgery without
      opposing this as the two methods are often complementary. The indications have
      been extended and the results, for certain types of lesion, are similar to those
      achieved with surgery, with the advantages specific to this method. Complications
      remain limited and can often be dealt with during this procedure by means of
      other percutaneous methods (installation of endoprostheses, fibrinolysis,
      thromboaspiration).

PMID- 8368794
TI  - [Transcranial Doppler: methodology and indications in 1993].
AB  - Transcranial Doppler ultrasound is a new non-invasive method of exploration which
      through the use of low frequencies and transcranial windows is able to
      investigate the main vessels in the Willis polygon. It now has a variety of
      applications: diagnosis of stenoses and intracranial occlusions, assessment of
      the intracerebral impact of stenoses and occlusions of the internal carotid
      artery, monitoring of the middle cerebral artery in situations involving
      intensive care or carotid surgery, diagnosis of cerebral arteriovenous
      malformations, the diagnosis of brain death and the follow-up of secondary spasm
      due to meningeal hemorrhage. The combination of continuous Doppler and ultrasound
      scan with a transcranial Doppler scan is able to modify the indications for an
      arterial angiography, notably in cerebral ischemic disease. Its non-invasive
      nature and convenience will favor its future development for diagnostic purposes
      and, above all, for short-term monitoring or periodic long-term check-ups.

PMID- 8368795
TI  - [Delayed angioplasty for residual stenosis following thrombolyzed infarction:
      arterial permeability and left ventricular function after 6 months].
AB  - At medium term, the results of delayed angioplasty (DA) following intravenous
      thrombolysis (IVT) in terms of arterial permeability but particularly of left
      ventricular function (LVF) is still poorly understood and is the subject of this
      prospective study. Over 18 months, 76 patients underwent DA for the residual
      stenosis on day 8 +/- 5 with complete and partial success rates of 88.2% and
      11.8% respectively. Rapid reocclusion (< 48 hours) was documented in 9.2% of
      cases. After 6 months, there had been no deaths and no recurrence of infarction
      but a recurrence of angina in 23.7% of cases. Angiographic monitoring, carried
      out in 56 cases (73.7%) after 6 +/- 2.4 months identified 21 restenosis (37.5%)
      and 6 re-occlusions (10.7%). 12 of the restenosis were successfully re-dilated.
      The effect on LV function was investigated in 50 patients. In the absence of
      reocclusion, the ejection fraction and the kinetics of the infarcted territory
      were improved; significant restenosis (> 60% by digital densitometry) did not
      appear to offset these improvements. In addition to the maintenance of arterial
      permeability, the possibility of functional recovery appears to be conditioned by
      the degree of contractile abnormality observed during the initial
      ventriculography. Despite the absence of restenosis after 6 months, the
      occurrence on day 6 of akinesia or above all of dyskinesia reduces the chances of
      contractile improvement with as a corollary more marked LV changes.

PMID- 8368796
TI  - [Myocardial ischemia caused by the injection of dipyridamole followed by low
      level exertion on an exercise bicycle].
AB  - The purpose of this study was the feasibility, safety and analysis of the
      ischemic nature of the association of an injection of dipyridamole and an
      exercise test at low level exertion on an exercise bicycle for 4 minutes. The
      ischemic nature of this combination was assessed on the basis of three criteria:
      the onset of angina-type pain, electrical changes and scintigraphic
      abnormalities. The test could be carried out by all patients and the most common
      adverse events were headache (6.5%) and heartburn (3.5%). The 17 patients in this
      study who had one or more stenoses in excess of 70% presented with angina-type
      pain (3/17); electrical abnormalities (9/17) and scintigraphic abnormalities in
      all cases. Of the six patients who had lesions between 50 and 70%, 1 presented
      with angina symptoms, 2 with electrical abnormalities and 5 with scintigraphic
      abnormalities. Seven patients in this study showed no significant lesions when
      subjected to coronary artery angiography. However, angina-type pain and
      electrical signs were observed in 2 cases and one false positive result by
      scintigraphy. This study shows that it is possible to combine the injection of
      dipyridamole with an exercise test involving a low level of exertion on an
      exercise bicycle which gives a good diagnostic value to the CT scan. The
      frequency of clinical and electrical signs of ischemia makes it necessary to take
      the same precautions as for a peak exercise test.

PMID- 8368797
TI  - [A new cause of torsades de pointes: combination of terfenadine and
      troleandomycin].
AB  - The authors report a case of wave-burst arrhythmia which occurred during combined
      treatment with terfenadine and troleandomycin. After the treatment had been
      stopped and the QT interval returned to normal, terfenadine treatment was
      reintroduced with no major change in repolarization. However, as soon as
      troleandomycin was associated, there was a significant and progressive
      prolongation of QT. Normal repolarization was restored again with troleandomycin
      alone. These findings suggest drug interaction between terfenadine and
      troleandomycin. Although it is not possible to carry out serum assays of
      terfenadine, one possible physiopathological hypothesis would be an overdose of
      terfenadine. Terfenadine undergoes hepatic oxidative metabolism involving the
      cytochrome P450 pathway and troleandomycin inhibits cytochrome P450. In the
      literature, a case has already been described of wave-burst arrhythmia related to
      terfenadine overdose when associated with a cytochrome P450 inhibitor.

PMID- 8368798
TI  - [Late complication of blunt injuries of the thorax: acute pericarditis. Apropos
      of a case].
AB  - The authors report a case of closed trauma of the thorax, complicated after a
      symptom-free period by acute pericarditis, combined with pleural effusion. The
      clinical outcome was favorable and the pericardial effusion, which was
      considerable at the first ultrasound scan, spontaneously recovered fully. The
      incidence of this delayed complication of closed trauma of the thorax is unknown.
      Its mechanism, related to that of the Dresler syndrome and post-pericardiotomy
      syndrome differs from that of initial hemopericardium which is of mechanical
      origin. This case highlights the capital importance of ultrasound in the
      diagnosis and assessment of cardiac complications of thoracic trauma.

PMID- 8368799
TI  - [Rhabdomyolysis caused by pravastatin and type 1 macrocreatine kinase].
AB  - The authors report a case of rhabdomyolysis which occurred in a 61 year old woman
      who was receiving pravastatin and who was also found to present with type 1
      macrocreatine kinase. Drug induced rhabdomyolysis is common, particularly with
      HMG Coenzyme A reductase inhibitors. The authors describe the onset of an adverse
      effect of this type with pravastatin, a recently marketed drug, as has been
      previously described for lovastatin and simvastatin. The concomitant detection of
      macrocreatine kinase, the incidence of which is estimated to be between 2 and 5%
      in the population, raises the question of whether rhabdomyolysis of this type may
      occur preferentially in patients with this biological anomaly.

PMID- 8368800
TI  - [The cardiologist as consultant to the anesthetist].
AB  - The combination of surgery and heart disease is common. The incidence of both
      heart disease and surgery increase with the age of patients. However, the
      surgical risk in the cardiac patient and particularly in the coronary or heart
      failure patient is considerably aggravated. Surgery is a major factor in cardiac
      decompensation, which can accelerate the progress of the disease. Pre-anesthetic
      cardiological consultation is therefore an important part of the evaluation and
      preparation of the patient before surgery. This is carried out at the request of
      the anesthetist and can provide a diagnosis or adapt a treatment and above all
      define the cardiovascular competence of the patient. Diagnostic and therapeutic
      means available to the cardiologist are essential in defining and if possible
      reducing the cardiac handicap of patients before the hemodynamic challenge
      represented by the combination of anesthesia and surgery.

PMID- 8368801
TI  - [Spontaneous coronary dissection. Apropos of 2 cases].
AB  - Spontaneous coronary dissection is a rare and still poorly understood
      pathological disease entity; the authors report two cases in which the diagnosis
      was reached in the context of incipient necrosis in young patients. A review of
      the literature reveals the main characteristics of this problem: the clinical
      aspect is generally that of acute coronary failure with the constitution of an
      infarction. The subjects are young with no risk factor but some cases of
      combination with a disease affecting the elastic tissue have been described.
      Female gender and the post-partum phase are promoting factors. Diagnosis was long
      established by means of autopsy but can now be based on coronary angiography.
      Histologically, the lesion is a hematoma which dissects the arterial wall between
      the internal two thirds and external third of the media. The main etiological
      hypothesis is acquired or congenital fragility of the media, which promotes the
      formation of a dissecting hematoma, however the triggering phenomenon remains
      poorly understood.

PMID- 8368802
TI  - Optical density profile analysis of trypsin-Giemsa bands in human X-chromosomes.
AB  - Mean Optical Density (M.O.D.) determination of six G-bands on X-chromosomes was
      performed on 45 patients with Turner's syndrome and compared with X-chromosomes
      from women controls with a normal karyotype by a Chromosome Image Analysis
      System. Density profiles were constructed to obtain standard values for the
      staining intensity and frequency of occurrence of chromosome bands. Statistical
      analysis showed that the M.O.D. were significantly different for Xq12, Xq21, Xq25
      and Xq27 G-bands between the Turner and Control groups. Most within-group
      differences were small and appeared not to be statistically significant.

PMID- 8368803
TI  - Barriers to gene flow estimated by surname distribution in Italy.
AB  - Surname distributions were studied in order to reconstruct human migration
      patterns. Zones of sharp change in surname frequencies--presumably barriers to
      gene flow--were detected by the statistical technique of wombling (Barbujani et
      al. 1989), using data from consanguineous marriages (1910-64) collected from 280
      Italian dioceses which we grouped into 80 provinces. The 28 observed surname
      boundaries were compared with physical (geographical) and cultural (linguistic)
      barriers, and with boundaries detected from distributions of 57 alleles in the
      same territorial subdivisions. Genetic and surname boundaries had similar
      locations, as expected given the analogy in the inheritance mechanism of genes
      and surnames. Physical barriers seemed to be the main cause of gene flow
      reduction. However, cultural factors alone (e.g. linguistic ones) also determined
      barriers that delimited areas of homogeneous gene (and surname) frequency
      probably due to increased endogamy. The observed similarity between spatial
      patterns of surnames, genes and languages supports the hypothesis of the co
      evolution of genetic and linguistic variation.

PMID- 8368804
TI  - Inference of the strength of genotype-disease association from studies comparing
      offspring with and without parental history of disease.
AB  - The association between genetic polymorphisms and a multifactorial disease is
      generally investigated by case-control studies. However, inference about the
      genotype-disease association can also be drawn from studies comparing offspring
      having a parental history of disease with offspring having no parental history.
      In such studies, differences in genotype frequencies between the two groups of
      offspring will reflect a different transmission of alleles from affected and
      unaffected parents. We showed that in offspring studies, the odds ratios (ORs)
      associated with heterozygous and homozygous genotypes are related by the formula:
      OR(het) = (OR(hom) + 1)/2. These ORs depend only on the allele frequencies in
      affected and unaffected parents, and not on the pattern of genotype-disease
      association. Under simple patterns of association, it is possible to infer from
      the ORs observed among offspring, the expected ORs for the disease. The decrease
      of power of offspring studies by comparison with classical case-control studies
      is evaluated, and an application is given on the association between the apoE
      polymorphism and coronary heart disease.

PMID- 8368805
TI  - Power comparison of various sibship tests of association.
AB  - There are several tests available for use with family studies to test if there is
      significant evidence of association with a particular disease gene locus,
      especially of HLA. We have used large simulations to compare the powers of tests
      using criteria N, R, T, PR, WP and some new tests involving both affecteds and
      unaffecteds in a sibship. It was found that tests using both affected and
      unaffected siblings were often more powerful.

PMID- 8368806
TI  - Estimation of the intraclass correlation coefficient.
AB  - When families have different numbers of offspring, the maximum likelihood
      procedure for estimating the intraclass correlation is iterative, requiring
      considerable computation. Occasionally, the iterations do not even converge. To
      overcome this difficulty, several non-iterative estimators have been proposed by
      Smith (1956). However, to choose from among these estimators, some prior
      knowledge of the intraclass correlation is needed. In this paper, a combination
      estimator is proposed. The asymptotic variance of this estimator is given and
      compared with those of the two most commonly used estimators. The comparison
      shows that the combination estimator always performs better than the uniform
      weight estimator and the loss in efficiency is not more than 7% when it is used
      in place of Fisher's estimator.

PMID- 8368807
TI  - Description of a dinucleotide repeat polymorphism in the human elastin gene and
      its use to confirm assignment of the gene to chromosome 7.
AB  - Informative polymorphisms have been very difficult to detect in the elastin gene,
      and this has hampered the analysis of heritable connective tissue disorders,
      notably the Marfan syndrome. We have recently detected a dinucleotide repeat
      polymorphism in intron 17 of the human elastin gene consisting of 8 alleles with
      sizes between 161 and 175 bp. Analysis of 540 chromosomes from unrelated
      Caucasian individuals revealed a bimodal frequency distribution typical of (dC
      dA)n.(dG-dT)n repeat polymorphisms, with allele frequencies ranging from 0.004
      (161 bp) to 0.574 (163 bp). As the elastin gene was originally assigned to
      chromosome 2q31-ter and because more recent data have suggested an assignment to
      7q11.1-21.1, we have genotyped a sub-set of the CEPH pedigrees and carried out
      pairwise linkage analysis with markers on chromosomes 7 and 2. Lod-scores of
      between +3.70 and +13.69 were obtained with markers spanning 7p13-q22.1, whilst
      negative lod-scores were observed with the chromosome 2 markers. Analysis of type
      II human ovarian teratomas placed the elastin gene within 11 cM of the centromere
      on chromosome 7. Additionally, we detected the dinucleotide repeat in human
      rodent cell hybrids containing chromosome 7, but not those containing chromosome
      2. These data confirm the assignment of elastin to chromosome 7 and provide a
      new, highly informative marker for the analysis of heritable disorders of
      connective tissue for which elastin is a candidate gene.

PMID- 8368808
TI  - You can have my organs, but please make sure I'm dead before you take them.

PMID- 8368809
TI  - Instrument counts.

PMID- 8368810
TI  - HIV positive patients.

PMID- 8368811
TI  - Organ procurement surgery. What perioperative nurses can expect.

PMID- 8368812
TI  - Organ donation. Barriers, religious aspects.

PMID- 8368813
TI  - Living related liver transplants. A solution to donor shortage in pediatric
      patients.

PMID- 8368814
TI  - Radical ilioinguinal lymph node dissection. Treating malignant melanoma.

PMID- 8368815
TI  - Transurethral prostate resection. A frustration-free surgical method.

PMID- 8368817
TI  - Protecting the phrenic nerve during open heart surgery.

PMID- 8368816
TI  - Aseptic technique monitoring. A quality improvement tool in the OR.

PMID- 8368818
TI  - OR time delays. A time management plan that works.

PMID- 8368819
TI  - Communicating effectively with elderly surgical patients.
AB  - Effective communication promotes trusting, productive nurse/patient
      relationships. It is the perioperative nurse's responsibility to establish
      effective communication with each patient. Perioperative nurses strive to provide
      quality care to all patients, including the elderly. Communication barriers often
      do exist, however, between nurses and elderly patients. Perioperative nurses are
      challenged, therefore, to recognize potential communication barriers and to
      manage each nurse/patient relationship accordingly. Clear communication between
      nurse and patient enhances the elderly patient's ability to progress smoothly
      through surgery and recovery.

PMID- 8368820
TI  - Proposed recommended practices. Product evaluation and selection for the
      perioperative setting. Recommended Practices Committee, Association of Operating
      Room Nurses, Inc.

PMID- 8368821
TI  - Proposed recommended practices. Monitoring the patient receiving local
      anesthesia. Recommended Practices Committee, Association of Operating Room
      Nurses, Inc.

PMID- 8368822
TI  - ANA Code for Nurses with Interpretive Statements--explications for perioperative
      nursing.

PMID- 8368824
TI  - The operating room as a theater--a relevant metaphor.
AB  - Any metaphor can be stretched to absurdity. Nonetheless, the operating room as a
      theater can be a relevant and useful analogy. In the OR theater, the play is
      always a drama, sometimes a tragedy, occasionally even a comedy of errors, but
      never, never is it a Broadway musical.

PMID- 8368823
TI  - Discussion of the Joint Commission on Accreditation of Healthcare Organizations'
      Agenda for change.

PMID- 8368825
TI  - Do-not-resuscitate orders in the OR.

PMID- 8368826
TI  - Analysis of the Bradyrhizobium japonicum hemH gene and its expression in
      Escherichia coli.
AB  - Complementation analysis showed that the Bradyrhizobium japonicum hemH gene was
      both necessary and sufficient to rescue mutant strains I110ek4 and I110bk2 in
      trans with respect to hemin auxotrophy, protoporphyrin accumulation, and the
      deficiency in ferrochelatase activity. The B. japonicum hemH gene was expressed
      in an Escherichia coli T7 expression system and yielded a 39-kDa protein, which
      was consistent with the predicted size of the deduced product. The overexpressed
      protein was purified and shown to contain ferrochelatase activity, thereby
      demonstrating that the hemH gene encodes ferrochelatase. When expressed from the
      lac promoter, the B. japonicum hemH gene was able to complement the enzyme
      activity of a ferrochelatase-defective E. coli mutant, and it also conferred
      hemin prototrophy on those cells. These latter findings confirm the identity of
      the hemH gene product and demonstrate that B. japonicum ferrochelatase can
      interact with the E. coli heme synthesis enzymes for heme formation in
      complemented cells.

PMID- 8368827
TI  - Analysis of Tox5 gene expression in Gibberella pulicaris strains with different
      trichothecene production phenotypes.
AB  - The Tox5 gene encodes trichodiene synthase, the first unique enzyme in the
      trichothecene biosynthetic pathway. In Gibberella pulicaris R-6380, the level of
      Tox5 mRNA was found to increase 47-fold in early stationary phase. Sequence
      analysis of the Tox5 promoter regions from geographically distinct strains of G.
      pulicaris revealed the existence of two Tox5 alleles (Tox5-1 and Tox5-2). All G.
      pulicaris strains that produce high levels of trichothecenes in liquid culture
      carry a 42-nucleotide (nt) tandem repeat sequence (Tox5-1) in the Tox5 promoter
      region, whereas strains that produce low levels of trichothecenes carry a single
      copy of this sequence (Tox5-2). A genetic cross between high- and low-level
      trichothecene producers resulted in the cosegregation of higher-level
      trichothecene production with the Tox5-1 allele. To determine the importance of
      the 42-nt repeat sequence in the regulation of Tox5 expression, reporter gene
      constructs carrying either the Tox5-1 or the Tox5-2 promoter region fused to the
      beta-galactosidase gene of Escherichia coli were introduced into the high-level
      trichothecene-producing strain, R-6380. Expression of reporter gene activity in
      transformants was found to be regulated in a manner similar to Tox5 expression
      but appeared to be independent of the 42-nt sequence copy number. These results
      indicate that transcriptional controls play an important role in the regulation
      of Tox5 expression and that genes involved in trichothecene biosynthesis in G.
      pulicaris may be linked to Tox5.

PMID- 8368828
TI  - Survival and growth of Escherichia coli O157:H7 in ground, roasted beef as
      affected by pH, acidulants, and temperature.
AB  - A study was undertaken to determine the fate of Escherichia coli O157:H7 in
      ground, roasted beef as influenced by the combined effects of pH, acidulants,
      temperature, and time. There was essentially no change in the viable population
      of E. coli O157:H7 when beef salads (pH 5.40 to 6.07) containing up to 40%
      mayonnaise were incubated at 5 degrees C for up to 72 h. At 21 and 30 degrees C,
      significant (P < or = 0.05) increases in populations of the organism occurred in
      salads containing 16 to 32% mayonnaise (pH 5.94 to 5.55) between 10 and 24 h of
      incubation. Death was more rapid as the pH of acidified beef slurries incubated
      at 5 degrees C was decreased from 5.98 to 4.70. E. coli O157:H7 grew in control
      slurries (pH 5.98) and in slurries containing citric and lactic acids (pHs 5.00
      and 5.40) incubated at 21 degrees C for 24 h; decreases occurred in slurries
      acidified to pHs 4.70, 5.00, and 5.40 with acetic acid or pH 4.70 with citric or
      lactic acid. At 30 degrees C, populations decreased in slurries acidified to pHs
      4.70 and 5.00 with acetic acid. Citric and lactic acids failed to prevent
      significant increases in populations in slurries at pH 4.70 to 5.40 between 10
      and 24 h of incubation. The order of effectiveness of acidulants in inhibiting
      growth was acetic acid > lactic acid > or = citric acid. The same order was
      observed for inactivation of E. coli O157:H7 in acidified (pH 5.00) beef slurry
      heated at 54 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368829
TI  - Characterization of the methanotrophic bacterial community present in a
      trichloroethylene-contaminated subsurface groundwater site.
AB  - Groundwater, contaminated with trichloroethylene (TCE) and tetrachloroethylene
      (PCE), was collected from 13 monitoring wells at Area M on the U.S. Department of
      Energy Savannah River Site near Aiken, S.C. Filtered groundwater samples were
      enriched with methane, leading to the isolation of 25 methanotrophic isolates.
      The phospholipid fatty acid profiles of all the isolates were dominated by 18:1
      omega 8c (60 to 80%), a signature lipid for group II methanotrophs. Subsequent
      phenotypic testing showed that most of the strains were members of the genus
      Methylosinus and one isolate was a member of the genus Methylocystis. Most of the
      methanotroph isolates exhibited soluble methane monooxygenase (sMMO) activity.
      This was presumptively indicated by the naphthalene oxidation assay and confirmed
      by hybridization with a gene probe encoding the mmoB gene and by cell extract
      assays. TCE was degraded at various rates by most of the sMMO-producing isolates,
      whereas PCE was not degraded. Savannah River Area M and other groundwaters,
      pristine and polluted, were found to support sMMO activity when supplemented with
      nutrients and then inoculated with Methylosinus trichosporium OB3b. The maximal
      sMMO-specific activity obtained in the various groundwaters ranged from 41 to 67%
      compared with maximal rates obtained in copper-free nitrate mineral salts media.
      This study partially supports the hypothesis that stimulation of indigenous
      methanotrophic communities can be efficacious for removal of chlorinated
      aliphatic hydrocarbons from subsurface sites and that the removal can be mediated
      by sMMO.

PMID- 8368830
TI  - Purification, gene cloning, amino acid sequence analysis, and expression of an
      extracellular lipase from an Aeromonas hydrophila human isolate.
AB  - A structural gene which codes for an extracellular lipase (EC 3.1.1.3) in
      Aeromonas hydrophila H3, which was isolated from a female hospitalized patient,
      was cloned in Escherichia coli by using pBR322 as a vector. Lipase purified from
      both A. hydrophila culture supernatant and the periplasmic fluids of E. coli
      containing the lip determinant in the original clone (plasmid pLA2) showed an
      M(r) of 67,000 on sodium dodecyl sulfate-polyacrylamide gel electrophoresis,
      which agrees with the M(r) determined by Sephacryl S-200 chromatography.
      Regarding substrate specificity, the optimum chain lengths for the acyl moiety
      were C6 for ester hydrolysis and C6 and C8 for triacylglycerol hydrolysis.
      Sequence analysis showed a major open reading frame of 2,052 bp, which predicts a
      polypeptide with an M(r) of 71,804. The polypeptide was found to contain an amino
      acid sequence (V-H-F-L-G-H-S-L-G-A) which is highly preserved among lipases.

PMID- 8368831
TI  - Clostridium perfringens and somatic coliphages as indicators of the efficiency of
      drinking water treatment for viruses and protozoan cysts.
AB  - To find the most suitable indicator of viral and parasitic contamination of
      drinking water, large-volume samples were collected and analyzed for the presence
      of pathogens (cultivable human enteric viruses, Giardia lamblia cysts, and
      Cryptosporidium oocysts) and potential indicators (somatic and male-specific
      coliphages, Clostridium perfringens). The samples were obtained from three water
      treatment plants by using conventional or better treatments (ozonation,
      biological filtration). All samples of river water contained the microorganisms
      sought, and only C. perfringens counts were correlated with human enteric
      viruses, cysts, or oocysts. For settled and filtered water samples, all
      indicators were statistically correlated with human enteric viruses but not with
      cysts or oocysts. By using multiple regression, the somatic coliphage counts were
      the only explanatory variable for the human enteric virus counts in settled
      water, while in filtered water samples it was C. perfringens counts. Finished
      water samples of 1,000 liters each were free of all microorganisms, except for a
      single sample that contained low levels of cysts and oocysts of undetermined
      viability. Three of nine finished water samples of 20,000 liters each revealed
      residual levels of somatic coliphages at 0.03, 0.10, and 0.26 per 100 liters.
      Measured virus removal was more than 4 to 5 log10, and cyst removal was more than
      4 log10. Coliphage and C. perfringens counts suggested that the total removal and
      inactivation was more than 7 log10 viable microorganisms. C. perfringens counts
      appear to be the most suitable indicator for the inactivation and removal of
      viruses in drinking water treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368832
TI  - Effects of temperature and salinity on the survival of Vibrio vulnificus in
      seawater and shellfish.
AB  - Sterilized seawater was used to assess the effects of temperature and salinity on
      the survival of Vibrio vulnificus. In the temperature range of 13 to 22 degrees
      C, numbers of V. vulnificus increased during the 6-day incubation. Temperatures
      outside this range reduced the time of V. vulnificus survival in sterile 10-ppt
      seawater. At these restrictive temperatures, V. vulnificus numbers were reduced
      by 90% after 6 days of incubation. Incubation between 0.5 and 10.5 degrees C
      demonstrated that V. vulnificus survives poorly below 8.5 degrees C. At
      salinities between 5 and 25 ppt and at 14 degrees C, V. vulnificus numbers
      actually increased or remained unchanged after 6 days of incubation. At
      salinities of 30, 35, and 38 ppt, numbers of V. vulnificus decreased 58, 88, and
      83%, respectively. V. vulnificus could not be recovered from deionized water,
      indicating lysis. When a rifampin-resistant strain of V. vulnificus was used to
      inoculate sterilized and unsterilized seawater (20 ppt, 20 degrees C), numbers
      increased in sterile seawater but decreased to undetectable levels in 14 days in
      the unsterilized seawater, indicating that biological factors may play a role in
      the survival of V. vulnificus in the environment. Since our studies demonstrated
      sensitivity to low temperatures, the survival of V. vulnificus in naturally
      contaminated oysters at temperatures of 0, 2, and 4 degrees C was also
      determined. Numbers of endogenous V. vulnificus in oyster shellstock increased by
      more than 100-fold in shellstock stored at 30 degrees C but were reduced
      approximately 10- and 100-fold after 14 days at 2 to 4 degrees C and 0 degrees C,
      respectively. We conclude that both biological and physicochemical factors are
      important to the survival of V. vulnificus in the environment and that
      temperature is critical to controlling its growth in oyster shellstock.

PMID- 8368833
TI  - Effects of nutrients on exopolysaccharide production and surface properties of
      Aeromonas salmonicida.
AB  - Extracellular polysaccharide (EPS) and capsular polysaccharide (CPS) production
      by Aeromonas salmonicida A450 and the influence of the capsule on cell surface
      properties were studied. A. salmonicida did not produce CPS or EPS when glucose,
      phosphate, magnesium chloride, or trace mineral components were absent from the
      medium. The addition of yeast extract improved capsule production. Neither EPS
      nor CPS formation depended on the C/N ratio, although it appeared to be
      influenced by the level of carbon and nitrogen in the culture. Both EPS and CPS
      production started at the end of the logarithmic growth phase. The amounts of EPS
      and CPS produced were not influenced by temperature changes between 15 and 20
      degrees C and was maximal from pH 7 to 7.5. Cell surface properties were strongly
      influenced by capsule production; high CPS production was associated with
      enhanced cell hydrophilicity and autoagglutination. The effect of CPS on cell
      surface properties was independent of the presence of the surface protein array
      (A-layer).

PMID- 8368834
TI  - Structural stability of Bacillus thuringiensis delta-endotoxin homolog-scanning
      mutants determined by susceptibility to proteases.
AB  - Forty homolog-scanning (double-reciprocal-crossover) mutant proteins of two
      Bacillus thuringiensis delta-endotoxin genes (cryIAa and cryIAc) were examined
      for potential structural alterations by a series of proteolytic assays. Three
      groups of mutants could be identified. Group 1, consisting of 13 mutants, showed
      no delta-endotoxin present during overexpression conditions in Escherichia coli
      (48 h at 37 degrees C, with a ptac promoter). These mutants produced full-sized
      delta-endotoxin detectable by polyacrylamide gel electrophoresis with Coomassie
      blue staining or Western immunoanalysis after 24 h of growth but not after 48 h,
      suggesting sensitivity to intracellular proteases. Group 2 consisted of 13
      mutants that produced stable delta-endotoxins that were completely digested by 2%
      bovine trypsin. In contrast, native delta-endotoxin produces a 65,000-Da trypsin
      resistant peptide, which is the active toxin. Group 3 mutants expressed delta
      endotoxin and trypsin-stable toxins, similar to the wild type. In this study, 12
      group 3 mutant toxins were compared with wild type toxins by thermolysin
      digestion at a range of temperatures. The two wild-type toxins exhibited
      significant differences in thermolysin digestion midpoints. Among the group 3
      mutants, most possessed significantly different protein stabilities relative to
      their parental toxins. Two of the group 3 mutants were observed to have exchanged
      the thermolysin sensitivity properties of the parental toxins.

PMID- 8368835
TI  - Stoichiometric interpretation of Escherichia coli glucose catabolism under
      various oxygenation rates.
AB  - Metabolic by-product secretion is commonly observed in oxygen-limited cultures.
      Oxygen limitations occur because of limits in the capacity of the respiratory
      system or because of the oxygenation limits of the cultivation method used. The
      latter restriction is of considerable practical importance since it results in a
      critical cell concentration above which oxygenation is insufficient, leading to
      by-product secretion. In this study we used a flux balance approach to determine
      optimal metabolic performance of Escherichia coli under variable oxygen
      limitations. This method uses linear optimization to find optimal metabolic flux
      patterns with respect to cell growth. Cell growth was defined as precursor
      requirements on the basis of a composition analysis. A growth-associated
      maintenance requirement of 23 mmol of ATP per g of biomass and a non-growth
      associated maintenance value of 5.87 mmol at ATP per g (dry weight)-h were
      incorporated on the basis of a comparison with experimental data. From
      computations of optimal growth increased oxygen limitations were found to result
      in the secretion of acetate, formate, and ethanol in that order. Consistent with
      the experimental data in the literature, by-product secretion rates increased
      linearly with the growth rate. The computed optimal growth under increasing
      oxygen limitation revealed four critical growth rates at which changes in the by
      product secretion pattern were observed. Concomitant with by-product secretion
      under oxygen limitations were changes in metabolic pathway utilization. The
      shifts in metabolism were characterized by changes in the metabolic values
      (computed as shadow prices) of the various redox carriers. The redox potential
      was thus identified as a likely trigger that leads to metabolic shifts.2+ a

PMID- 8368836
TI  - Stereochemistry during aflatoxin biosynthesis: conversion of norsolorinic acid to
      averufin.
AB  - A reaction sequence, norsolorinic acid (NA)-->averantin (AVN)-->5'
      hydroxyaverantin (HAVN)-->averufin (AVR), is the early part of a biosynthetic
      pathway for aflatoxins. In this study, we determined the stereochemical
      relationship among these metabolites by using chiral high-performance liquid
      chromatography. In cell-free experiments using the cytosol fraction of
      Aspergillus parasiticus NIAH-26, (1'S)-AVN was exclusively produced from NA in
      the presence of NADPH. Also, only (1'S)-AVN, and not (1'R)-AVN, served as a
      substrate for the reverse reaction from AVN to NA. When the microsome fraction of
      NIAH-26 was incubated with (1'S)-AVN in the presence of NADPH, two HAVN
      diastereomers and one AVR enantiomer were formed, whereas these substances were
      never produced from (1'R)-AVN. Moreover, (1'S,5'R)-AVR was exclusively formed
      from both HAVN diastereomers by the cytosol fraction in the presence of NAD. The
      feeding experiments using this mutant showed that aflatoxins were produced from
      (1'S,5'R)-AVR but not from (1'R,5'S)-AVR. These results indicate that the enzymes
      involved in this pathway show strict stereospecificity to their substrates and
      that the configuration of (1'S,5'R)-AVR leading to the formation of aflatoxins is
      due to the stereospecificity of NA dehydrogenase which catalyzes the reaction
      between (1'S)-AVN and NA.

PMID- 8368837
TI  - Stereochemistry during aflatoxin biosynthesis: cyclase reaction in the conversion
      of versiconal to versicolorin B and racemization of versiconal hemiacetal
      acetate.
AB  - (1'R,2'S)-(-)-aflatoxins are produced from racemic versiconal hemiacetal acetate
      (VHA) through complicated pathways, including a metabolic grid involving VHA,
      versiconol acetate (VOAc), versiconol, and versiconal (VHOH), and a reaction
      sequence from VHOH to versicolorin A (VA) through (-)-versicolorin B (VB) [or (+/
      )-versicolorin C] (K. Yabe, Y. Ando, and Y. Hamasaki, J. Gen. Microbiol. 137:2469
      2475, 1991; K. Yabe, Y. Ando, and T. Hamasaki, Agric. Biol. Chem. 55:1907-1911,
      1991). In this study, we examined stereochemical changes of substances formed
      during the conversion of VHA to VA by using chiral high-performance liquid
      chromatography. In cell-free experiments using the cytosol of Aspergillus
      parasiticus NIAH-26, both (2'S)- and (2'R)-VOAc enantiomers were formed at about
      a 1:2 ratio from racemic VHA in the presence of NADPH and dichlorvos (dimethyl
      2,2-dichlorovinylphosphate). Also, the esterase activity catalyzing the
      conversion of VHA to VHOH or of VOAc to versiconol did not show the
      stereospecificity for the 2' carbon atom of VHA or VOAc. However, when racemic
      VHA or racemic VHOH was incubated with the cytosol, (1'R,2'S)-(-)-VB was formed
      exclusively. Furthermore, only (1'R,2'S)-(-)-VB, and not (1'S,2'R)-(+) antipode,
      served as a substrate for desaturase activity in the microsome fraction
      catalyzing the conversion of VB to VA. These results demonstrate that the
      stereoconfiguration of bis-furan moiety in aflatoxin molecules is determined by
      the cyclase enzyme catalyzing the reaction from VHOH to VB, and the (1'R,2'S)-(-)
      configuration was further confirmed by the subsequent desaturase reaction.
      Remarkably, we found nonenzymatic racemization in both the (2'R)- and (2'S)-VHA
      enantiomers, and it was dependent upon the temperature and alkaline conditions.

PMID- 8368838
TI  - Degradation of nitrobenzene by a Pseudomonas pseudoalcaligenes.
AB  - A Pseudomonas pseudoalcaligenes able to use nitrobenzene as the sole source of
      carbon, nitrogen, and energy was isolated from soil and groundwater contaminated
      with nitrobenzene. The range of aromatic substrates able to support growth was
      limited to nitrobenzene, hydroxylaminobenzene, and 2-aminophenol. Washed
      suspensions of nitrobenzene-grown cells removed nitrobenzene from culture fluids
      with the concomitant release of ammonia. Nitrobenzene, nitrosobenzene,
      hydroxylaminobenzene, and 2-aminophenol stimulated oxygen uptake in resting cells
      and in extracts of nitrobenzene-grown cells. Under aerobic and anaerobic
      conditions, crude extracts converted nitrobenzene to 2-aminophenol with oxidation
      of 2 mol of NADPH. Ring cleavage, which required ferrous iron, produced a
      transient yellow product with a maximum A380. In the presence of NAD, the product
      disappeared and NADH was produced. In the absence of NAD, the ring fission
      product was spontaneously converted to picolinic acid, which was not further
      metabolized. These results indicate that the catabolic pathway involves the
      reduction of nitrobenzene to nitrosobenzene and then to hydroxylaminobenzene;
      each of these steps requires 1 mol of NADPH. An enzyme-mediated Bamberger-like
      rearrangement converts hydroxylaminobenzene to 2-aminophenol, which then
      undergoes meta ring cleavage to 2-aminomuconic semialdehyde. The mechanism for
      release of ammonia and subsequent metabolism are under investigation.

PMID- 8368839
TI  - Fate of enterohemorrhagic Escherichia coli O157:H7 in apple cider with and
      without preservatives.
AB  - A strain of enterohemorrhagic Escherichia coli serotype O157:H7 isolated from a
      patient in an apple cider-related outbreak was used to study the fate of E. coli
      O157:H7 in six different lots of unpasteurized apple cider. In addition, the
      efficacy of two preservatives, 0.1% sodium benzoate and 0.1% potassium sorbate,
      used separately and in combination was evaluated for antimicrobial effects on the
      bacterium. Studies were done at 8 or 25 degrees C with ciders having pH values of
      3.6 to 4.0. The results revealed that E. coli O157:H7 populations increased
      slightly (ca. 1 log10 CFU/ml) and then remained stable for approximately 12 days
      in lots inoculated with an initial population of 10(5) E. coli O157:H7 organisms
      per ml and held at 8 degrees C. The bacterium survived from 10 to 31 days or 2 to
      3 days at 8 or 25 degrees C, respectively, depending on the lot. Potassium
      sorbate had minimal effect on E. coli O157:H7 populations, with survivors
      detected for 15 to 20 days or 1 to 3 days at 8 or 25 degrees C, respectively. In
      contrast, survivors in cider containing sodium benzoate were detected for only 2
      to 10 days or less than 1 to 2 days at 8 or 25 degrees C, respectively. The
      highest rates of inactivation occurred in the presence of a combination of 0.1%
      sodium benzoate and 0.1% potassium sorbate. The use of 0.1% sodium benzoate, an
      approved preservative used by some cider processors, will substantially increase
      the safety of apple cider in terms of E. coli O157:H7, in addition to suppressing
      the growth of yeasts and molds.

PMID- 8368840
TI  - Copper-resistant enteric bacteria from United Kingdom and Australian piggeries.
AB  - Thirty-three enteric isolates from Australian (Escherichia coli only) and United
      Kingdom (U.K.) (Salmonella sp., Citrobacter spp., and E. coli) piggeries were
      characterized with respect to their copper resistance. The copper resistance
      phenotypes of four new Australian E. coli isolates were comparable with that of
      the previously studied E. coli K-12 strain ED8739(pRJ1004), in that the
      resistance level in rich media was high (up to 18 mM CuSO4) and resistance was
      inducible. Copper resistance was transferable by conjugation from the new
      Australian isolates to E. coli K-12 recipients. DNA similarity between the new
      Australian isolates and the pco copper resistance determinant located on plasmid
      pRJ1004 was strong as measured by DNA-DNA hybridization; however, the copper
      resistance plasmids were nonidentical as indicated by the presence of restriction
      fragment length polymorphisms between the plasmids. DNA-DNA hybridization and
      polymerase chain reaction analysis demonstrated DNA homology between the pco
      determinant and DNA from the U.K.E. coli, Salmonella sp., and Citrobacter
      freundii isolates. However, the copper resistance level and inducibility were
      variable among the U.K. strains. Of the U.K. E. coli isolates, 1 demonstrated a
      high level of copper resistance, 4 exhibited intermediate resistance, and 16
      showed a low level of copper resistance; all of these resistances were expressed
      constitutively. A single U.K. C. freundii isolate, had a high level of copper
      resistance, inducible by subtoxic levels of copper. Transconjugants from one E.
      coli and one C. freundii donor, with E. coli K-12 strain UB1637 as a recipient,
      showed copper resistance levels and inducibility of resistance which differed
      from that expressed from plasmid pRJ1004.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368841
TI  - Effect of medium composition and sludge removal on the production, composition,
      and architecture of thermophilic (55 degrees C) acetate-utilizing granules from
      an upflow anaerobic sludge blanket reactor.
AB  - A thermophilic upflow anaerobic sludge blanket (UASB) reactor degrading acetate
      was started by applying published methods (W. M. Wiegant and A. W. A. de Man,
      Biotechnol. Bioeng. 28:718-77, 1986) for production of granules dominated by
      Methanothrix spp. The reactor was inoculated with thermophilic digested sludge.
      No granules were observed during the first 7 months of start-up of the UASB
      reactor. However, after the concentrations of potassium, phosphate, ammonium, and
      magnesium in the medium were gradually increased, granules developed, indicating
      that there was a critical concentration of one or more of the ions required for
      production of granules from the starting material. After several years of stable
      operation, the effect of removing 60% of the granular sludge was investigated.
      Immunologic qualitative and quantitative studies showed that removal of the
      granular sludge resulted in an increase in the number of the predominant
      methanogens, antigenically related to Methanosarcina thermophila TM-1 and
      Methanosarcina mazeii S-6, and Methanobacterium thermoautotrophicum delta H and
      GC1. These changes were accompanied by modifications of the microanatomy of the
      granules, as demonstrated histochemically and immunohistochemically. The results
      indicated that different catabolic pathways dominated in different regions of the
      granules, i.e., acetate oxidation in the middle of the granules, where there is a
      low acetate concentration, and an aceticlastic reaction in the outer surfaces,
      with a high acetate concentration. The results also showed that removal of
      granules from a UASB reactor which has been under steady-state operation for a
      long period can improve the reactor's performance via formation of denser and
      larger granules with improved microbial activities.

PMID- 8368842
TI  - Effects of hydrogen and formate on the degradation of propionate and butyrate in
      thermophilic granules from an upflow anaerobic sludge blanket reactor.
AB  - Degradation of propionate and butyrate in whole and disintegrated granules from a
      thermophilic (55 degrees C) upflow anaerobic sludge blanket reactor fed with
      acetate, propionate, and butyrate as substrates was examined. The propionate and
      butyrate degradation rates in whole granules were 1.16 and 4.0 mumol/min/g of
      volatile solids, respectively, and the rates decreased 35 and 25%, respectively,
      after disintegration of the granules. The effect of adding different hydrogen
      oxidizing bacteria (both sulfate reducers and methanogens), some of which used
      formate in addition to hydrogen, to disintegrated granules was tested. Addition
      of either Methanobacterium thermoautotrophicum delta H, a hydrogen-utilizing
      methanogen that does not use formate, or Methanobacterium sp. strain CB12, a
      hydrogen- and formate-utilizing methanogen, to disintegrated granules increased
      the degradation rate of both propionate and butyrate. Furthermore, addition of a
      thermophilic sulfate-reducing bacterium (a Desulfotomaculum sp. isolated in our
      laboratory) to disintegrated granules improved the degradation of both substrates
      even more than the addition of methanogens. By monitoring the hydrogen partial
      pressure in the cultures, a correlation between the hydrogen partial pressure and
      the degradation rate of propionate and butyrate was observed, showing a decrease
      in the degradation rate with increased hydrogen partial pressure. No significant
      differences in the stimulation of the degradation rates were observed when the
      disintegrated granules were supplied with methanogens that utilized hydrogen only
      or hydrogen and formate. This indicated that interspecies formate transfer was
      not important for stimulation of propionate and butyrate degradation.

PMID- 8368843
TI  - Inhibition of Listeria monocytogenes by Lactobacillus bavaricus MN in beef
      systems at refrigeration temperatures.
AB  - The ability of Lactobacillus bavaricus, a meat isolate, to inhibit the growth of
      three Listeria monocytogenes strains was examined in three beef systems: beef
      cubes, beef cubes in gravy, and beef cubes in gravy containing glucose. The beef
      was minimally heat treated, inoculated with L. bavaricus at 10(5) or 10(3) CFU/g
      and L. monocytogenes at 10(2) CFU/g, vacuum sealed, and stored at 4 or 10 degrees
      C. The meat samples were monitored for microbial growth, pH, and bacteriocin
      production. The pathogen was inhibited by L. bavaricus MN. At 4 degrees C, L.
      monocytogenes was inhibited or killed depending on the initial inoculum level of
      L. bavaricus. At 10 degrees C, at least a 10-fold reduction of the pathogen
      occurred, except in the beef without gravy. This system showed a transient
      inhibition of the pathogen during the first week of storage followed by growth to
      control levels by the end of the incubation period. Bacteriocin was detected in
      the samples, and inhibition could not be attributed to acidification. Low
      refrigeration temperatures significantly (P < or = 0.05) enhanced L.
      monocytogenes inhibition. Moreover, the addition of glucose-containing gravy and
      the higher inoculum level of L. bavaricus were significantly (P < or = 0.05) more
      effective in reducing L. monocytogenes populations in most of the systems
      studied.

PMID- 8368844
TI  - Detection of hepatitis E virus in raw and treated wastewater with the polymerase
      chain reaction.
AB  - The main objective of this study was to determine the applicability of the
      polymerase chain reaction (PCR) to detection of hepatitis E virus (HEV) in sewage
      treatment plants and establishment of the prevalence of hepatitis viral diseases
      in a population. Epidemics of HEV infection because of inadequate public
      sanitation have been reported in several developing countries. A procedure for
      concentration of HEV in sewage samples through adsorption to membrane filters,
      elution with urea-arginine phosphate buffer, and subsequent reconcentration with
      magnesium chloride enabled us to concentrate HEV to volumes in the microliter
      range. HEV-specific cDNA was prepared by reverse transcription of the total RNA
      extracted from samples. Specific DNA amplification by PCR in combination with
      slot blot hybridization was used to demonstrate the presence of HEV in sewage
      samples from the inlets and outlets of three sewage treatment plants. The assay
      was specific for HEV, and a 240-bp amplified product was visualized by ethidium
      bromide fluorescence. Sewage samples adjusted to pH 5.0 for adsorption of viruses
      to membrane filters were PCR positive, while samples adjusted to pH 3.5 were PCR
      negative.

PMID- 8368845
TI  - Partial purification and characterization of mold antigens commonly found in
      foods.
AB  - Rapid methods are needed for detection of molds in foods; therefore, an enzyme
      linked immunosorbent assay was developed. The extracellular and mycelial antigens
      for Mucor, Aspergillus, Cladosporium, and Geotrichum species were partially
      purified and characterized. The molecular masses of the mycelial and
      extracellular antigens, as determined by size exclusion chromatography, ranged
      from 4.5 x 10(5) to 6.7 x 10(5) Da. There was only one main antigenic peak
      separated by Sepharose CL-4B and concanavalin A-Sepharose columns for Mucor,
      Cladosporium, and Geotrichum mycelial and extracellular antigens, but there were
      two for Aspergillus mycelial antigens and three for Aspergillus extracellular
      antigens. These antigens contained 10 to 50% protein which was part of the active
      site since protease digestion significantly decreased antigenic activity. Neutral
      sugars, ranging from 13 to 75%, made up the rest of the active site, and < 1%
      phosphate was detected in mycelial antigens. Geotrichum, Cladosporium, and
      Aspergillus antigens contained mainly glucose, galactose, and mannose. Mucor
      antigens contained these sugars plus fucose. The percentage of sugars differed
      between the mycelia and extracellular antigens. Enzymatic digestion and
      competitive inhibition tests using different sugar derivatives showed that
      galactosyl residues with beta linkages were immunodominant for Aspergillus,
      Geotrichum, and Cladosporium antigens and mannosyl residues with alpha linkages
      were immunodominant for Mucor antigens.

PMID- 8368846
TI  - Influence of temperature and relative humidity on the survival of Chlamydia
      pneumoniae in aerosols.
AB  - The survival of Chlamydia pneumoniae in aerosols was investigated by using a
      chamber with a capacity of 114.5 liters. We injected 5 x 10(7) inclusion-forming
      units (IFU) of C. pneumoniae in aerosols with a droplet size of 3 to 5 microns.
      Samples were taken after 30 s and every 1 min thereafter. The survival of C.
      pneumoniae was measured at four temperatures (8.5, 15, 25, and 35 degrees C) and
      at three different relative humidities (RH) of 5, 50, and 95% for each
      temperature. The survival rates of Streptococcus pneumoniae, Streptococcus
      faecalis, Klebsiella pneumoniae, Chlamydia trachomatis LGV2, and cytomegalovirus
      were also determined at 25 degrees C and 95% RH and compared with that of C.
      pneumoniae. At the mentioned temperatures and RH, a rapid decrease of C.
      pneumoniae IFU was observed in the first 30 s. After this the decrease in the
      number of IFU was more gradual. The survival of C. pneumoniae in aerosols were
      optimal at 15 to 25 degrees C and 95% RH; it was good compared with those of
      other microorganisms. A lower death rate was observed only in S. faecalis. In C.
      trachomatis, the death rate during the first 30 s was higher than that in C.
      pneumoniae (85 and 53.3%, respectively). After the first 30 s, the death rates in
      the two organisms were identical. It was concluded that transmission of C.
      pneumoniae via aerosols was possible. There is probably a direct transmission
      from person to person, taking into account the relatively short survival period
      of C. pneumoniae in aerosols.

PMID- 8368847
TI  - Lysine-mannitol-glycerol agar, a medium for the isolation of Salmonella spp.,
      including S. typhi and atypical strains.
AB  - An agar medium for the isolation of Salmonella spp. is described. The medium,
      lysine-mannitol-glycerol agar, has features of both xylose-lysine-deoxycholate
      agar and mannitol-lysine-crystal violet-brilliant green agar, but glycerol is
      added for the differentiation of Salmonella and Citrobacter spp. The medium
      facilitates the detection of strains having atypical fermentation patterns, such
      as the lactose- or sucrose-positive salmonellae. The medium also detects
      Salmonella typhi after enrichment.

PMID- 8368848
TI  - Purification and characterization of a phenoloxidase (laccase) from the lignin
      degrading basidiomycete PM1 (CECT 2971).
AB  - A new lignin-degrading basidiomycete, strain PM1 (= CECT 2971), was isolated from
      the wastewater of a paper factory. The major ligninolytic activity detected in
      the basidiomycete PM1 culture supernatant was a phenoloxidase (laccase). This
      activity was produced constitutively in defined or complex media and appeared as
      two protein bands in native gel electrophoresis preparations. No enzyme induction
      was found after treatment with certain potential laccase inducers. Laccase I was
      purified to homogeneity by gel filtration chromatography, anion-exchange
      chromatography, and hydrophobicity chromatography. The enzyme is a monomeric
      glycoprotein containing 6.5% carbohydrate and having a molecular weight of
      64,000. It has an isoelectric point of 3.6, it is stable in a pH range from 3 to
      9, and its optimum pH is 4.5. The laccase optimal reaction temperature is 80
      degrees C, the laccase is stable for 1 h at 60 degrees C, and its activity
      increases with temperature. Spectroscopic analysis revealed that the enzyme has
      four bound copper atoms, a type I copper, a type II copper, and a type III
      binuclear copper. The amino-terminal sequence of the protein is very similar to
      the amino-terminal sequences of laccases from Coriolus hirsutus and Phlebia
      radiata.

PMID- 8368849
TI  - Cellobiose versus glucose utilization by the ruminal bacterium Ruminococcus
      albus.
AB  - Cellulose degradation and metabolism in the rumen can be adversely affected by
      the presence of soluble sugars, but relatively little information is available on
      substrate preferences of cellulolytic bacteria. When the ruminal bacterium
      Ruminococcus albus was incubated with a combination of cellobiose and glucose,
      the organism preferentially utilized the disaccharide. This preference appeared
      to be related to repression of glucose uptake systems in cellobiose-grown cells.
      Glucose transport kinetics exhibited low- and high-affinity uptake, and high
      affinity transport was apparently driven by ATP hydrolysis. Bacterial yield in
      continuous culture was as much as 38% greater when the organism was grown on
      cellobiose versus glucose, and the increased yield could be partially attributed
      to constitutive cellobiose phosphorylase activity. The maintenance coefficient of
      glucose-grown cells was significantly greater than that of cells provided with
      cellobiose (0.225 g of glucose per g of protein per h versus 0.042 g of
      cellobiose per g of protein per h), and this result suggested that more energy
      was devoted to glucose uptake. Substrate affinities were examined in carbon
      excess continuous culture, and affinities for glucose and cellobiose were
      relatively low (0.97 and 3.16 mM, respectively). Although R. albus maintained a
      proton motive force of approximately 60 mV from pH 6.7 to 5.5, growth ceased
      below pH 6.0, and this inhibition of growth may have been caused by a depletion
      of ATP at low pH.

PMID- 8368850
TI  - Induction of folds or sutures on the walls of Cryptosporidium parvum oocysts and
      their importance as a diagnostic feature.
AB  - The proportion of oocysts of Cryptosporidium parvum showing a fold on oocyst
      walls when incubated with either fluorescent monoclonal antibody or a surface
      reactive fluorescent dye was increased by incubating suspensions of oocysts with
      dimethyl sulfoxide, sucrose, or Hanks' balanced salt solution. Further incubation
      of sucrose-incubated oocysts with water showed this to be a reversible
      phenomenon. Oocysts demonstrating this fold after incubation in dimethyl
      sulfoxide were of the same viability as control oocysts and followed the same
      excystation dynamics. Despite this fold having been previously described as a
      suture, we were unable to find any evidence that this pattern of fluorescence
      highlighted the same suture that has been described in ultrastructural studies.
      Furthermore, oocysts were observed in which this fold was not always continuous
      with the gape in the oocyst wall through which the sporozoites had emerged. We
      propose that this fluorescently highlighted region or fold should no longer be
      described as a suture and question its validity as a diagnostic feature. When
      environmental and other samples are being examined for the presence of C. parvum
      oocysts, objects of appropriate size, shape, and fluorescence which do not
      demonstrate a surface fold should not necessarily be excluded.

PMID- 8368851
TI  - Degradation of atrazine and 2,4-dichlorophenoxyacetic acid by mycorrhizal fungi
      at three nitrogen concentrations in vitro.
AB  - Nine mycorrhizal fungi and free-living saprophytic microorganisms were tested for
      their ability to degrade two chlorinated aromatic herbicides at two herbicide
      concentrations and three nitrogen concentrations. Radiolabelled 2,4
      dichlorophenoxyacetic acid (2,4-D) and 2-chloro-4-ethylamino-6-isopropylamino-s
      triazine (atrazine) were used as substrates at concentrations of 1 and 4 mM.
      After 8 weeks, none of the cultures tested grew at 4 mM 2,4-D. However, when the
      2,4-D concentration was reduced to 1 mM, Phanerochaete chrysosporium 1767 had the
      highest level of 2,4-D mineralization and degradation under all nitrogen
      conditions. All cultures tested grew at both atrazine concentrations. In all
      cases, the ericoid mycorrhizal fungus Hymenoscyphus ericae 1318 had the highest
      level of atrazine carbon incorporated into its tissue. In general, as the
      nitrogen concentration increased, the total herbicide degradation increased. All
      of the cultures, except for Rhizopogon vinicolor 7534 and Sclerogaster pacificus
      9011, showed increased degradation at 4 mM compared with 1 mM atrazine. The
      ability to degrade these two herbicides thus appeared to be dependent on the
      fungus and the herbicide, with no correlation to fungal ecotype (mycorrhizal
      versus free living).

PMID- 8368852
TI  - Abundance of airborne Penicillium CFU in relation to urbanization in Mexico City.
AB  - Air was sampled simultaneously at three localities in Mexico City differing in
      urbanization index and air pollution level on 22 days during a period covering
      both dry and rainy seasons. An Andersen two-stage microbial sampler was used for
      15 min at 28 liters min-1 to isolate culturable fungi on malt extract agar. After
      exposure, plates were incubated at 25 degrees C for 48 to 72 h before colonies
      were counted and identified to give concentrations of total fungal spores and of
      Penicillium spp., expressed as CFU per cubic meter of air. Total fungi numbered
      91 to 602 CFU m-3 in Tlalpan Borough (southern area), 40 to 264 CFU m-3 in
      Cuauhtemoc Borough (downtown), and 26 to 495 CFU m-3 in Gustavo A. Madero Borough
      (northern area). Although Penicillium spp. were the second most frequently
      isolated fungal genus, concentrations were small, with a maximum of only 133 CFU
      m-3. Twice as many colonies were isolated in the southern area, with an
      urbanization index of 0.25 (arithmetic mean, 41 CFU m-3), as at other sampling
      stations with greater urbanization indices (arithmetic means, 19 and 20 CFU m-3).
      In the downtown area, with an urbanization index of 1.0, Penicillium spp. were
      more numerous than any other genus and formed 25% of the total fungal count
      compared with 14 and 17% in the other areas. Concentrations of airborne
      Penicillium spp. did not differ significantly between rainy and dry
      seasons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368853
TI  - Production of [14C]fumonisin B1 by Fusarium moniliforme MRC 826 in corn cultures.
AB  - Kinetics of growth and fumonisin production by Fusarium moniliforme MRC 826 in
      corn "patty" cultures were investigated, and a technique was developed for the
      production of [14C]fumonisin B1 ([14C]FB1) by using L-[methyl-14C]methionine as
      the precursor. A significant (P < 0.01) correlation exists between fungal growth
      and FB1 (r = 0.89) and FB2 (r = 0.87) production in corn patties, beginning after
      2 days and reaching the stationary phase after 14 days of incubation. [14C]FB1
      was produced by adding L-[methyl-14C]methionine daily to cultures during the
      logarithmic phase of production. Incorporation of the isotope occurred at C-21
      and C-22 of the fumonism molecule and was enhanced in the presence of unlabeled L
      methionine. Although the concentration of exogenous unlabeled methionine is
      critical for incorporation of the 14C label, optimum incorporation was achieved
      by adding 50 mg of unlabeled L-methionine and 200 mu Ci of L-[methyl
      14C]methionine to a corn patty (30 g) over a period of 9 days, yielding [14C]FB1
      with a specific activity of 36 mu Ci/mmol.

PMID- 8368854
TI  - A ribosomal DNA fragment of Listeria monocytogenes and its use as a genus
      specific probe in an aqueous-phase hybridization assay.
AB  - cDNAs were prepared from the total RNA of Listeria monocytogenes ATCC 19118 and
      used as probes to screen a genomic library of the same strain. Four clones were
      identified which contained ribosomal DNA fragments. Recombinant DNA from one of
      them was fractionated and differentially hybridized with the cDNA probes to RNA
      of L. monocytogenes and Kurthia zopfii. The resulting hybridization pattern
      revealed an HpaII fragment of 0.8 kb that was specific for the L. monocytogenes
      strain. The nucleotide sequence of this fragment showed 159 bases of the 3' end
      of the 16S rRNA gene, 243 bases of the spacer region, and 382 bases of the 5' end
      of the 23S rRNA gene. In dot blot hybridization assays, the 32P-labeled 784-bp
      fragment was specific only for Listeria species. Dot blot assays revealed that
      the 32P-labeled fragment can easily detect > or = 10 pg of total nucleic acids
      from pure cultures of L. monocytogenes, which corresponds to approximately 300
      bacteria. This fragment was also used as a probe in an assay named the
      heteroduplex nucleic acid (HNA) enzyme-linked immunosorbent assay. In this
      system, the biotinylated DNA probe is hybridized in the aqueous phase with target
      RNA molecules and then specific HNAs are captured by HNA-specific antibodies.
      Captured HNA molecules are revealed with an enzyme conjugate of streptavidin. In
      a preliminary HNA enzyme-linked immunosorbent assay, the 784-bp fragment
      maintained its specificity for Listeria spp. and could detect 5 x 10(2) cells in
      artificially contaminated meat homogenate.

PMID- 8368855
TI  - Microbial degradation of chlorinated acetophenones.
AB  - A defined mixed culture, consisting of an Arthrobacter sp. and a Micrococcus sp.
      and able to grow with 4-chloroacetophenone as a sole source of carbon and energy,
      was isolated. 4-Chlorophenyl acetate, 4-chlorophenol, and 4-chlorocatechol were
      identified as metabolites through comparison of retention times and UV spectra
      with those of standard substances. The proposed pathway was further confirmed by
      investigation of enzymes. The roles of the two collaborating strains were studied
      by growth experiments and on the level of enzymes. If transient accumulation of 4
      chlorophenol was avoided either by the use of phenol-absorbing substances or by
      careful supplement of 4-chloroacetophenone, the Arthrobacter sp. was able to grow
      as a pure culture with 4-chloroacetophenone as a sole source of carbon and
      energy. Several mono-, di-, and trichlorinated acetophenones were mineralized by
      the Arthrobacter sp.

PMID- 8368856
TI  - Monoclonal antibodies that react with live Listeria spp.
AB  - Seven monoclonal antibodies (MAbs) against Listeria spp. that were reactive with
      live Listeria spp. were developed. Two of these MAbs (55-8 and 55-37) were
      members of the immunoglobulin M class, and all other MAbs were members of the
      immunoglobulin G class. MAb 55-23 reacted with 148 of 157 strains tested. MAb 34
      51 reacted with serotype 1/2a, 1/2b, and 1/2c strains and exhibited a scattered
      reaction pattern with strains belonging to other serotypes. MAb 55-44 reacted
      with all of the strains belonging to serotype 4b tested. MAb 55-4 reacted with
      all of the serotype 1/2a isolates tested, although reactivity with other isolates
      also was observed. The other MAbs exhibited scattered reaction patterns. No
      correlation of reactivity pattern with serotype was found. Marked differences
      were observed between the reactivities of MAbs as determined by a magnetic
      immunoluminescence assay and a whole-cell enzyme-linked immunosorbent assay. Only
      MAb 55-23 exhibited minor reactivity with three Streptococcus spp. isolates,
      while no reactivity was observed with six Bacillus spp. strains, one Escherichia
      coli strain, and one Citrobacter sp. strain. In Western blots (immunoblots) MAbs
      55-23, 55-44, and 34-9 exhibited reactivity; all other MAbs were negative in this
      assay.

PMID- 8368858
TI  - Use of vaginal tampons in sewer surveys for non-O1. Vibrio cholerae.
AB  - Vaginal tampons were shown to be a practical alternative to conventional Moore
      swabs for isolating Vibrio cholerae from sewage. Associated laboratory
      investigations demonstrated improved isolation of V. cholerae by using 12- or 18
      h enrichments in alkaline peptone water, in comparison with 6-h enrichments, when
      cultures were incubated at ambient temperatures.

PMID- 8368857
TI  - Identification of a high-affinity glycine betaine transport system in
      Staphylococcus aureus.
AB  - Staphylococcus aureus accumulates proline and glycine betaine when cells are
      grown at low water activity. In the present study, we have identified a high
      affinity glycine betaine transport system in this bacterium. Optimal activity for
      this transport system was measured in the presence of high NaCl concentrations,
      but transport activity was not stimulated by high concentrations of other
      solutes.

PMID- 8368859
TI  - Detection of Listeria monocytogenes with a nonisotopic polymerase chain reaction
      coupled ligase chain reaction assay.
AB  - A polymerase chain reaction (PCR)-coupled ligase chain reaction (LCR) assay for
      the specific detection of Listeria monocytogenes (M. Wiedmann, J. Czajka, F.
      Barany, and C. A. Batt, Appl. Environ. Microbiol. 58:3443-3447, 1992) has been
      modified for detection of the LCR products with a nonisotopic readout. When a
      chemiluminescent or a colorimetric substrate for the nonisotopic detection of the
      LCR products was used, the PCR-coupled LCR gave a sensitivity of 10 CFU of L.
      monocytogenes. The detection method with the chemiluminescent substrate Lumi-Phos
      530 permitted detection of the LCR products in less than 3 h, so that the whole
      assay can be completed within 10 h.

PMID- 8368860
TI  - Evaluation of indoxyl-beta-D-glucuronide as a chromogen in media specific for
      Escherichia coli.
AB  - Indoxyl-beta-D-glucuronide (indoxyl) was evaluated as a specific chromogen for
      detection of Escherichia coli by the membrane filter method. In all, 413 colonies
      were tested from the indoxyl-supplemented media, yielding 93.3% confirmation, as
      E. coli. Compared with the indoxyl medium, other media gave either much lower
      recovery with high verification or equal recovery with poor verification.

PMID- 8368861
TI  - Starved cells of the fatty acid auxotroph Escherichia coli AK7 develop abnormal
      sensitivity to media with low osmolarity.
AB  - The unsaturated fatty acid auxotroph Escherichia coli AK7 supplied with linolenic
      acid, while appearing normal during logarithmic growth, showed a fast decline in
      CFU during starvation as a result of an osmotic downshift when transferred to
      standard agar plates unsupplemented with an osmolyte such as 300 mosM sucrose or
      salt (NaCl or KCl). The starved cells could recover their osmoresistance when an
      energy source was added to the starvation medium.

PMID- 8368862
TI  - Effect of substrate composition on intestinal flora.

PMID- 8368863
TI  - The carbamate insecticide ZZ-Aphox induced structural changes of gills, liver,
      gall-bladder, heart, and notochord of Rana perezi tadpoles.
AB  - Embryos of Rana perezi were kept under laboratory conditions and treated with
      carbamate ZZ-Aphox at chronic doses of 0.02% and 0.14% for 9 weeks. Both the
      histological study and the analysis of mortality show a direct relationship
      between the dosage and the effects of the pesticide. The histological study of
      the survivors over 56 days show damages in gills, liver, gall-bladder, heart, and
      notochord. Damages on the epithelial of gills (on their distal portion) and gall
      bladder recover over a few days, whereas those provoked on the compacting of the
      hepatic parenchyma and the hepatocytes, the auricle and the perintocohordal
      collagenic fibers alter their structure in a lasting way. Potentials of such
      alterations are discussed, with special reference to the possible interference of
      the pesticide on the successful synthesis of the supporting connective sheaths.

PMID- 8368864
TI  - Effects of 2,4-dichlorophenoxyacetic acid butyl ester on chick liver.
AB  - Fertilized hen eggs were externally treated with 3.1 mg 2,4-dichlorophenoxyacetic
      acid butyl ester (2,4-D ester) before starting incubation. Liver lipid
      composition, (14C)2,4-dichlorophenoxyacetic acid (14C-2,4-D) subcellular
      distribution and covalent binding to proteins and lipids of chicks hatched from
      these eggs were studied. Furthermore, catalase, glutathione S-transferase and
      glucose 6-phosphatase activities as well as reduced glutathione content were
      determined. The herbicide produced a significant decrease on the total lipids,
      specially on phospholipids, both in total liver and microsomes. (14C-2,4-D)
      subcellular distribution in liver demonstrated that the herbicide passed through
      the plasmatic membrane and it was present in all the studied fractions. Herbicide
      bound covalently to hepatic proteins and lipids, being the binding to proteins
      tenfold higher than to lipids. Because these results might be of potential
      relevance to the understanding of the 2,4-D toxicity, further studies on the
      mechanisms of these reactions are necessary. On the other hand, the microsomal
      and cytosolic glutathione S-transferases activities remained unchanged, even
      though in vitro studies 2,4-D ester caused a decrease of the enzyme activities
      with an I50 value of 0.2 mM. No significant change in reduced glutathione content
      between control and treated livers was observed. The catalase activity increased
      two-fold whereas glucose 6-phosphatase activity decreased 46% with respect to the
      corresponding control values. These results indicate that 2,4-D ester may have
      effects on the metabolism of xenobiotics.

PMID- 8368865
TI  - Isomer-specific analysis and toxic evaluation of polychlorinated biphenyls in
      striped dolphins affected by an epizootic in the western Mediterranean sea.
AB  - Isomer-specific concentrations of polychlorinated biphenyls (PCBs) including
      planar, mono- and di-ortho congeners and concentrations of DDT were determined in
      striped dolphins affected by a morbillivirus epizootic in the western
      Mediterranean in 1990. Extremely high concentrations of PCBs ranging from 94 to
      670 micrograms/g (wet wt) were detected in the blubber. Similarly, DDT
      concentrations were high, between 22 and 230 micrograms/g (wet wt). The
      concentrations of three non-ortho coplanar PCBs were 43 (3,3',4,4'-T4CB), 6.8
      (3,3',4,4',5-P5CB), and 7.8 (3,3',4,4',5,5'-H6CB) ng/g (wet wt), respectively,
      the highest residue levels reported to date. The estimated 2,3,7,8-TCDD toxic
      equivalents of non-, mono- and di-ortho PCB congeners in striped dolphins were
      several times higher than those observed for other marine mammals and humans.
      Mono-ortho congeners contributed greater 2,3,7,8-TCDD toxic equivalents than non
      ortho members. The higher ratio of 3,3',4,4',5,5'-H6CB/3,3',4,4',5-P5CB (IUPAC
      169/126) suggested a strong induction of mixed function oxidase enzymes and
      highlighted the possibility of using this ratio as an index for risk assessment
      of PCB contamination in marine mammals. Elevated concentrations of PCBs may have
      played a role in the immune depression in striped dolphins, ultimately leading to
      the development of morbillivirus disease.

PMID- 8368866
TI  - A comparison of microbial bioassays for the detection of metal toxicity.
AB  - Heavy metal toxicity was studied by assaying six microbiological toxicity tests,
      both in solution and wastewater. Pseudomonas fluorescens and baker's yeast
      (Saccharomyces cerevisiae) were used; growth and respirometric determinations
      were performed. In addition, the Microtox test was employed as a reference
      method. The Microtox test is the most sensitive assay for detecting toxicity of
      zinc, copper, and mercury but not for cadmium, chromium, and nickel. Wastewater
      increases the sensitivity threshold (EC20) and EC50 values of the metals in most
      of the assays, which is correlated to the presence of organic and inorganic
      compounds that can reduce the bioavailability of the metals, leading to a general
      loss of sensitivity. All the above-mentioned assays are potentially useful in the
      detection of chemical toxicity of metals. However, each test shows different
      sensitivities to each metal, which is related to different sensitivities of the
      organisms used in the assays, as well as to other factors. Therefore, it would be
      advisable to use a battery of tests for biological evaluation of metal toxicity.

PMID- 8368868
TI  - Chemically-induced histone modification as a predictor of carcinogenicity.
AB  - The interaction between carcinogens and DNA is believed to initiate neoplastic
      transformation, but evidence suggests that epigenetic mechanisms may also be of
      importance. Because the histone proteins have important roles in chromatin
      structure and cellular function, they provide a reasonably well understood
      epigenetically-based system for the detection of carcinogens. In this study,
      human foreskin fibroblastic cells were exposed to one of several mutagens and/or
      carcinogens for 3, 12, or 24 h to determine if induced histone modification may
      be a means of predicting chemical carcinogenicity. Butyric acid (5 mM), known to
      result in acetylation of histones H3 and H4, and 12-O-tetradecanoylphorbol-13
      acetate (3 microM), known to result in phosphorylated histone H1, were tested
      initially. Electrophoresis of the histone fractions was capable of resolving
      multiple forms of histones H1, H3, and H4. Propane sultone (0.1 mM) induced a
      broadening of the H2A and H2B bands after a 24 h exposure and carbon
      tetrachloride (1 mM) induced the formation of new histone forms in the H1
      fraction after 24 h and in the H3 fraction after 3 h. Experimental variability
      limited the statistically significant modifications to carbon tetrachloride and
      propane sultone, two known carcinogens, where new forms of modified histone were
      detected. Therefore, the histone modification assay, with further
      experimentation, may be an alternate method of detecting carcinogens, especially
      when conventional genotoxic tests prove unreliable.

PMID- 8368867
TI  - Effect of side-stream cigarette smoke on the hepatic cytochrome P450.
AB  - The effect of inhalation of side-stream cigarette smoke on the hepatic microsomal
      cytochrome P450 was investigated Rats were placed in a chamber of 0.1 m3 in
      volume, in which cigarettes were burned at the rate of 1, 3, or 5 cigarettes per
      h, 8 h/day for 5 days. Cytochrome P450 and NADPH-cytochrome c reductase showed no
      significant changes; however, cytochrome b5 increased significantly. On the other
      hand, the activity of aryl hydrocarbon hydroxylase (AHH) decreased in the rats
      treated with a high concentration of cigarette smoke. In order to study the
      changes of isoforms of cytochrome P450, western blot analyses were performed. The
      inductions of three kinds of isoforms, cytochromes P450IA1, IA2, and IIB1, were
      demonstrated immunochemically. However, there were disagreements between the
      results of the western blot analyses and the measurements of total cytochrome
      P450 content and AHH activity.

PMID- 8368869
TI  - Effects of patulin on postimplantation rat embryos.
AB  - Patulin (PAT), a highly toxic, carcinogenic, heterocyclic lactone is produced by
      a variety of fungal species, including Penicillium and Aspergillus. This compound
      has been isolated from various apple products and is stable in apple and grape
      juice and dry corn. It has been reported to be cytotoxic and to exert adverse
      influence on development in vivo in mice and merits further study and evaluation.
      In this study, whole rate embryo culture (WEC) was used to determine the
      teratogenic potential of PAT in vitro. Embryos were exposed to PAT-treated (0.00
      62 microM) rat serum for 45 h. The embryos that were exposed to 62 microM PAT
      were not evaluated because they did not survive beyond 40 h of incubation. The
      results indicate that PAT induced a statistically significant reduction in
      protein and DNA content, yolk sac diameter, crown rump length, and somite number
      count. Patulin treatment also resulted in an increase in the frequency of
      defective embryos. Anomalies included growth retardation, hypoplasia of the
      mesencephalon and telencephalon, and hyperplasia and/or blisters of the
      mandibular process. Thus, the data from the present study provide further
      evidence supporting the conclusion that the whole rat embryo assay is a rapid and
      sensitive in vitro method that can be employed to pre-screen developmentally
      toxic mycotoxins.

PMID- 8368870
TI  - Effects of pesticides on isolated rat hepatocytes, mitochondria, and microsomes.
AB  - Twenty-seven pesticides, with which people are concerned, especially as residues
      in food, were examined in vitro for their effects on hepatocytes, mitochondria,
      and microsomes isolated from male rats. Nineteen pesticides returned non-protein
      sulfhydryl (NPSH) contents in hepatocytes to less than 80% of control at
      concentrations from 10(-3) to 10(-5) M after 90 min incubation. Among them, only
      dichlofluanid was reactive with glutathione non-enzymatically. Lipid peroxidation
      in hepatocytes was stimulated by five pesticides at 10(-3) M, with edifenphos
      being the most potent peroxidant. Cell viability was considerably decreased by
      incubation with chlorobenzilate, edifenphos, dichlofluanid, and chinomethionat at
      10(-3) M, and in these cases, depletion of cellular adenosine 5'-triphosphate
      (ATP) contents proceeded to cell death. With respect to isolated mitochondrial
      respiration, six pesticides inhibited state 3 and/or state 4 respiration rates at
      concentrations from 10(-3) to 10(-5) M, whereas three pesticides uncoupled state
      4 respiration at 10(-3) M. With respect to isolated microsomal lipid
      peroxidation, seven pesticides, five of which were organophosphorus compounds,
      were peroxidative at concentrations from 10(-3) to 10(-5) M, whereas seven
      pesticides were antioxidative at concentrations from 10(-3) to 10(-7) M. Only
      three pesticides, aldicarb, maleic hydrazide, and chlormequat chloride had no
      effect on any parameters tested at 10(-3) M. Pesticides that affected isolated
      mitochondria or microsomes did not necessarily have any effect on isolated
      hepatocytes.

PMID- 8368872
TI  - Effect of nitrogen limitation on the biodegradability and toxicity of nitro- and
      aminophenol isomers to methanogenesis.
AB  - Monosubstituted nitro- and aminophenol isomers exhibited limited biodegradability
      under methanogenic conditions when supplied as the sole source of carbon and
      energy. This was examined by supplying to the same sediment samples, each isomer
      of nitro- and aminophenol as a sole source of added carbon under either N
      supplemented or N-deprived methanogenic conditions. The results demonstrated that
      under N-supplemented conditions, only 2-NP (NP = nitrophenol), 4-NP and 4-AP (AP
      = aminophenol) were stoichiometrically mineralized, 2-AP, 3-AP, and the 3-AP
      metabolite formed from 3-NP reduction were persistent over the 51-week incubation
      period. In addition, NP isomers inhibited initial rates of methanogenesis, while
      all AP amended cultures exhibited no significant inhibition in the rate of
      methanogenesis. Under N-deprived conditions, 2-NP, 2-AP and 4-AP were
      mineralized, while 3-NP, 4-NP and 3-AP were persistent over the 51-week
      incubation period. Although all NP isomers were still metabolized through the
      corresponding AP isomer, the deprivation of nitrogen significantly depressed both
      the rate and extent of methanogenesis. In general, nitrogen supplemented cultures
      produced 25% more methane than the nitrogen limited cultures, and the initial
      rates of methanogenesis were four times greater. While these data showed that
      under N-deprived conditions methanogenesis was inhibited to a greater extent by
      these compounds, it also suggests that N-deprived conditions may have facilitated
      the establishment of a 2-AP metabolizing consortium.

PMID- 8368873
TI  - In this year of health care reform, nurses' voices must be heard!

PMID- 8368871
TI  - Frictional transition of pesticides from protective clothing.
AB  - Frictional transition of pesticides, the transition of the dried pesticide due to
      rubbing, from protective clothing was investigated by using an AATCC standard
      crockmeter. One insecticide (carbaryl) and two herbicides (atrazine and
      metolachlor) were studied, together with three protective clothing materials
      [cotton, polyester, and polyester/cotton (65/35) blend] and three crock fabrics
      (cotton, nylon, and silk). The effects of the properties of pesticide, fabrics,
      water, and perspiration on the frictional transition are discussed. The
      experiment showed that up to 12% of the pesticide could transfer from
      contaminated protective clothing to the skin through rubbing. Choosing the right
      materials for protective clothing and underwear would greatly decrease the
      frictional transition of the pesticide.

PMID- 8368874
TI  - An open letter to Hillary Rodham-Clinton regarding health care reform.

PMID- 8368875
TI  - President's message. Keeping an eye on the Clinton health care reform plan.

PMID- 8368876
TI  - An evaluation of the nephrology nursing research literature: 1979-1989.
AB  - The purposes of this project were: to describe the research designs, areas of
      study, and major dependent variables of nephrology nursing research conducted
      between 1979 and 1989; and to evaluate the quality of this research. Of the 284
      publications included, 34.9% of the research designs were descriptive; 45.4%
      analytical observational; 4.9% methodological; 14.1% experimental; and 0.7%
      historical. Content analysis was conducted to classify the area of study and
      dependent variables. Nurse experts assessed the quality of the research studies
      using Georgopoulos' (1975) Quality Index.

PMID- 8368877
TI  - Renal physiology series: Part 5b of 8. Renal control of phosphorus and magnesium.
AB  - The kidney plays a major role in the maintenance of phosphorus and magnesium
      balance. The homeostasis of these substances is complex and also involves the
      gastrointestinal tract and the bone. This article reviews the functions,
      homeostasis, and renal handling and regulation of phosphorus and magnesium. The
      major sites of tubular reabsorption and the presumed cellular mechanisms involved
      are described.

PMID- 8368878
TI  - Quality of life in elderly renovascular hypertensive patients.
AB  - This study assessed perceived quality of life in elderly, surgically managed
      renovascular hypertension patients. Twenty-three patients, aged 55 to 90 years,
      with unilateral or bilateral aortorenal bypass grafting or transrenal or
      transaortic endarterectomy, participated in the study. The Sickness Impact
      Profile was used to measure perceived quality of life. Overall, elderly,
      renovascular hypertension patients, at least 1 year postoperatively, experienced
      quality of life comparable to persons with other serious chronic illnesses; and
      females reported significantly poorer quality of life than males.

PMID- 8368879
TI  - The influence of physical activity on fatigue in patients with ESRD on
      hemodialysis.
AB  - This study examined the relative influence of anemia, nonspecific symptoms and
      physical activity on fatigue in 43 patients with end stage renal disease on
      chronic hemodialysis. We found that low levels of physical activity and frequent
      symptoms were related to high levels of fatigue. Degree of anemia was not related
      to level of fatigue. Inactivity contributed to fatigue scores more than symptoms.

PMID- 8368880
TI  - Research series: Part 4 of 6. Annotated bibliography: instrument references,
      instrumentation, reliability and validity.

PMID- 8368881
TI  - Case management of the anemic patient: epoetin alfa--focus on compliance.
AB  - Lack of compliance with a treatment regimen is a common problem in patients with
      ESRD and can mean that a patient fails to receive the full benefit from
      therapies, including Epoetin alfa. Nurses can, through careful assessment and
      intervention, work with patients to encourage compliance. Viewing compliance as a
      partnership between nurse and patient and using strategies such as joint decision
      making can facilitate this process.

PMID- 8368882
TI  - 1993 educational resource directory.

PMID- 8368883
TI  - Pediatric case study: hemolytic uremic syndrome.
AB  - The nursing interventions necessary to care for this critically ill child were
      professionally challenging. Meeting the psychosocial, educational, and supportive
      needs of the family during this period of uncertainty, as well as, providing the
      dialysis therapy and support for this fragile child demonstrated the unique
      contributions of professional nursing. All outcomes were met, but the patient's
      extremely poor myocardial function made dialysis treatments and volume control
      difficult. The use of CVVHD was instrumental to providing dialysis in a safe,
      effective manner. The nursing care for S.B.K. and her family was physically and
      emotionally draining, but seeing her neurological status return was the great
      reward for all of our efforts.

PMID- 8368884
TI  - What is hepatitis C?

PMID- 8368885
TI  - Nursing guidelines for cyclosporine.

PMID- 8368886
TI  - Documentation using the Roy Adaptation Model.

PMID- 8368887
TI  - Karyotype polymorphism and conserved characters in the Leishmania (Viannia)
      braziliensis complex explored with chromosome-derived probes.
AB  - Molecular karyotype of 45 reference populations of Neotropical leishmanias was
      analyzed with ethidium bromide staining and with 6 chromosome-derived probes
      selected from a genomic library of Leishmania (Viannia) braziliensis. Size
      conserved patterns were identified and found to be specific to subgenus Viannia
      and to its constitutive species. An important issue for epidemiology and clinical
      investigations was the discrimination between L. (V.) peruviana and L. (V.)
      braziliensis, 2 species found very similar by other genetic techniques, but
      responsible for totally different clinical patterns. The suggested existence of
      genetically distinct demes, or karyodemes, within the group-species might also
      show to be of importance, as these populations might differ in virulence, host
      specificity and clinical manifestations.

PMID- 8368888
TI  - [Factors affecting the efficacy of 2 growth regulator compounds, OMS 3010
      (phenoxycarb) and OMS 3019 (ethoxypyridine), on larvae of the Simulium damnosum
      complex].
AB  - Two insect growth regulators (IGR'S) acting as juvenile hormone analogs (JHA'S),
      OMS 3010 (phenoxycarb) and OMS 3019 (ethoxypyridine) were selected after a
      screening of several compounds proposed by industry on black fly larvae of the
      Simulium damnosum complex (Diptera: Simuliidae) the vector of onchocerciasis in
      West Africa. Bioassays were designed to study two parameters: larval age and
      exposure time. The results showed that these compounds are more efficient on old
      larvae (6th and 7th instars) than young larvae (3rd, 4th and 5th instars).
      However, exposure time seems essential. The black fly larvae live in fast running
      water courses. Thus, it is difficult to insure a prolonged exposure time in
      natural conditions. Though being active on black fly larvae, three factors are
      limiting the prospects for operational use of these two compounds: high dosages,
      limited effectiveness on young instar larvae and exposure time.

PMID- 8368889
TI  - [Geographic distribution of HIV-1 infection in Central Africa: remarkable
      discontinuities].
AB  - The (confirmed) serological data, collected since 1985 and spread in space and in
      time, allow to draw a geographical image--distribution, dissemination--of HIV 1
      infection. These data raise some questions and hypotheses on the nature and the
      dynamics of the epidemiological factors involved. The geographical distribution
      of the infection in the global population is heterogeneous. Ever since the first
      surveys, the virus is widely spread at low level, in the rural as well as in the
      urban areas, covering a large territory, from Chad to Gabon; later it tends to
      focus on the large metropolitan and secondary towns. The endemicity is more
      pronounced in a double urban conglomerate (Kinshasa, Brazzaville) and in two
      regional foci, the southwest of the Congo and the south of Shaba; in the two
      towns the prevalence rate does not progress between 1985-86 and 1991-92. The
      Central African Republic has suffered an active epidemic outbreak, affecting the
      capital and the whole network of secondary towns. The epidemiological
      discontinuities noticeable across Central Africa, may represent different stages
      of the same process or be connected to the stake of different eco-epidemiological
      systems.

PMID- 8368890
TI  - Introduction of HIV-1 in a rural city of Zaire.
AB  - In the rural city of Inongo (Bandundu region, Zaire), the prevalence of HIV-1
      infection has been investigated during a survey on HTLV-I infection and
      associated neurological diseases, using a cluster sampling technique. Thirteen
      individuals were infected by HIV-1, 11 adults and 2 children, giving a crude
      prevalence rate in the cluster sample of 1.1%. More women were infected than men.
      After direct standardization on the age and sex structure given by the 1984
      census, the prevalence of HIV-1 in the city may be estimated at 1.0% for the
      whole population and 1.6% for the population above 15 years of age. The
      importance is stressed of protecting rural populations, particularly women of
      childbearing age from the HIV epidemic, by information campaigns focused on the
      male migrant population, including both seasonal and travelling workers.

PMID- 8368891
TI  - Further African cases of rhinosporidiosis.
AB  - Thirteen African cases of rhinosporidiosis are reported from Burundi, Rwanda,
      Tanzania, Chad and Zaire. They include the first reported cases from Burundi and
      from Rwanda and the first African case, outside nose and eye, localized on the
      urethral orifice in a Zairian male.

PMID- 8368892
TI  - [Morbidity and mortality related to obstetrical referral patients to the hospital
      of Bobo-Dioulasso, Burkina Faso].
AB  - The obstetrical referral patients admitted to the Sanon Souro hospital in Bobo
      Dioulasso (Burkina Faso) during 1991 were retrospectively reviewed. During the
      study period 741 women were admitted. The median distance between the referring
      centre and Bobo-Dioulasso was 33 km. Median age was 22 years and median parity
      was 3. Indications for referral were dominated by obstructed labour, haemorrhages
      and infections. The proportion of maternal mortality in the study was 5.4% and
      was not related to maternal age or parity. However, there was a linear trend of
      increasing mortality according to the distance between the referring centre and
      Bobo-Dioulasso (X2 for trend: 7.56; p = 0.006). The perinatal mortality rate of
      420 p. thousand was not related to maternal age, but a parity exceeding 4 was a
      risk factor for the occurrence of perinatal death (relative risk: 1.4; 95% C.I.:
      1.2-1.7). As for maternal mortality, there was a linear increase of perinatal
      mortality with the distance from the referring centre (X2: 20.8; p = 0.00001).
      There was no marked seasonal variation in the number of referrals nor in the
      mortality rates per month.

PMID- 8368893
TI  - [Risk approach in the diagnosis of malaria in high altitude regions].
AB  - Sixteen cases of malaria are reported per thousand inhabitants per year in
      Kayanza, a province in the High Plateaux of Burundi. A case control study was
      conducted between October 1990 and March 1991 to better document this phenomenon.
      The majority of confirmed cases presented in persons who had recently sojourned
      in an endemic area (relative risk = 18). All except one of the other patients
      were carriers of plasmodium species that can cause late recurrences, which is
      compatible with the absence of local transmission. The presumptive diagnosis of
      malaria, as it is routinely made in the health centres, is not very specific
      (60%) and it has a positive predictive value of only 10%. This implies that an
      anti-malaria treatment is useless for 90% of the patients who receive it. It also
      means that the true malaria incidence rate in Kayanza can be estimated at less
      than 1 per thousand per year. We propose an alternative diagnostic strategy based
      on the risk differences between population sub-groups. It should permit an
      adequate patient management and a satisfactory surveillance of malaria in non
      endemic epidemiological strata.

PMID- 8368894
TI  - [Antimalarial measures in expatriates in the Congo. Trends 1989-1992].
AB  - The modalities of prevention and treatment of malaria in expatriates residing in
      Brazzaville, capital of the Congo, have been studied in March 1989, April 1990
      and April 1992. These surveys of the type Behavior, Attitude, Practice have been
      carried out in the Ecole Francaise where the same questionnaire has been
      distributed among the primary school children to complete by their parents. Only
      the data pertaining to Europeans, Lebanese, and North-Americans are presented.
      The proportion of French expatriates is 80%. A progressive decrease is noticed in
      the regular taking of chemoprophylaxis: the percentage varies between 86 and 43%
      according ot the duration of residence in 1989, to between 57 and 16% in 1992.
      Chloroquine alone remains the most widely used product, especially in long term
      expatriates. The association chloroquine-proguanil is mentioned only by a quarter
      or respondents. Apparently efficient, it is especially taken by people exposed
      for less than 4 years. Amodiaquine, although contra-indicated for prevention
      purposes, is cited in 1992 by 9% of subjects taking regular chemoprophylaxis;
      other products are only exceptionally used. In curative treatment, which
      generally is presumptive, halofantrine is since 1990 the most widely used drug,
      especially in children. In contrast, a relative disclaimer is noted for the amino
      4-quinolines, due to resistance, but also and with no justification, for the
      association sulfadoxine-pyrimethamine and, to a lesser degree, for quinine. The
      occurrence of attacks considered to be malarial and their frequency, remained
      stable during the period of study.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368895
TI  - Factors affecting incidence and quality of autopsies.

PMID- 8368896
TI  - College of American Pathologists position statement regarding rapid detection of
      Mycobacterium tuberculosis.

PMID- 8368897
TI  - The epidemiology of latex allergy in health care workers.

PMID- 8368898
TI  - Current status of mycobacterial testing in clinical laboratories. Results of a
      questionnaire completed by participants in the College of American Pathologists
      Mycobacteriology E survey.
AB  - To learn what methods are used in clinical microbiology laboratories for
      detection, identification, and susceptibility testing of mycobacteria, questions
      addressing these issues were added to the College of American Pathologists'
      Mycobacteriology E proficiency testing survey, and participants in the survey
      were asked to complete the questionnaire. Other questions related to numbers of
      mycobacteriology tests performed and the frequency with which drug-resistant
      Mycobacterium tuberculosis is isolated. Just over half of the respondents stained
      smears for acid-fast bacilli with the fluorochrome stain. Only 26% of respondents
      processed respiratory specimens daily, potentially providing results within 24
      hours of receiving the specimen. The most rapid methods currently available for
      detection of mycobacteria and for identification of M tuberculosis, respectively,
      were used by 30% and 35% of the respondents. Half of the respondents who
      performed susceptibility testing on isolates of M tuberculosis used rapid
      methods. Approximately 26% of the respondents indicated that they usually
      provided a final identification of M tuberculosis within 21 days of receiving a
      specimen, and 11% indicated that identification and susceptibility test results
      were reported within 28 days. Participants' responses indicated that the mean
      number of specimens received for mycobacterial culture per month was higher
      during the first 5 months of 1992 than it had been in 1991. Moreover, the number
      of drug-resistant M tuberculosis isolated per month from January through May 1992
      was about double the number isolated per month in 1991.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8368899
TI  - Reference values and participant means as targets in proficiency testing.
AB  - Regulatory agencies will be placing greater reliance on the results of
      proficiency testing (PT) for determining licensing status of individual
      laboratories. This has caused a renewed interest in the process used by
      proficiency test providers for determining the correct result for each
      proficiency test challenge. Three general techniques have been proposed and would
      be allowed under the regulations: (1) participant-derived targets (means from a
      specific group of participants); (2) targets from a set of "reference"
      laboratories, from either a subset of participants or a selected group of experts
      using a rigorous experimental protocol; or (3) definitive values from a single
      source. The College of American Pathologists (CAP) has used all three techniques
      at different stages and for different purposes in the history of the CAP Surveys
      programs. This article reviews the early experiences of the CAP, the evolution of
      the current protocol, and activities to monitor the accuracy of target values.
      Participant-derived "consensus" results have been shown to be highly accurate and
      reliable. The CAP uses definitive methods at the National Institute for Standards
      and Technology and certified reference materials to monitor the validity of
      targets used in proficiency testing.

PMID- 8368901
TI  - The prevalence of atopy and hypersensitivity to latex in medical laboratory
      technologists.
AB  - Members of the Alberta Society of Medical Laboratory Technologists were invited
      to take part in a study of sensitivity to latex gloves. A total of 230 persons
      volunteered; 108 (47%) had no problems with gloves, and 122 (53%) reacted to
      latex gloves. A history was obtained regarding atopy, smoking, years in
      laboratory medicine, and the nature of the problem with latex gloves. Serum was
      assayed for the total IgE level and the presence of IgE with specificity to
      common inhalant allergens and to latex. The affected group had an increased
      population of subjects with an atopic history and a higher incidence of a raised
      IgE level and a positive screen for inhalant allergens. In the affected group,
      there was no relationship between the total IgE level and severity of skin
      reaction. However, smoking was related to severity of reaction and was more
      common in the groups with a more severe reaction. Three subjects were positive
      for IgE specific for latex; there were no other data distinguishing them from
      latex-negative subjects.

PMID- 8368900
TI  - The significance of ionized calcium in cardiac and critical care. Availability
      and critical limits at US medical centers and children's hospitals.
AB  - The clinical use of ionized calcium has increased since the recognition of its
      importance in cardiac and critical care medicine. However, more than half the
      general medical centers in the United States do not provide immediate testing of
      ionized calcium levels in patients in critical care settings, although
      indications for this test indicate that they should. The following objectives
      were used in this study: (1) to determine the availability of ionized calcium
      testing; (2) to document appropriate critical limits; and (3) to describe the
      significance of ionized hypocalcemia in cardiac and critical care. The
      participants were 100 medical centers and 40 children's hospitals in the United
      States. At medical centers, mean (+/- SD) critical limits were as follows: low,
      0.82 +/- 0.14 mmol/L (3.29 +/- 0.56 mg/dL); and high, 1.55 +/- 0.19 mmol/L (6.21
      +/- 0.76 mg/dL). At children's hospitals, mean critical limits were as follows:
      low, 0.85 +/- 0.13 mmol/L (3.41 +/- 0.52 mg/dL); and high, 1.53 +/- 0.11 mmol/L
      (6.13 +/- 0.44 mg/dL). In the past decade, the availability of ionized calcium
      testing increased dramatically. Now, 57%, 86%, 95%, and 100% of general
      hospitals, heart transplant centers, children's hospitals, and pediatric heart
      transplant centers, respectively, perform testing in house. Collective experience
      indicates that: (1) aggressive monitoring of ionized calcium prevents cardiac
      (and neurologic) catastrophes, (2) appropriate levels optimize cardiac function,
      and (3) calcium repletion is safest when based on acute trends measured directly
      in whole blood. Hospitals should provide rapid response testing needed during
      transplantation and massive transfusion and for the diagnosis and treatment of
      acute ionized hypocalcemia.

PMID- 8368902
TI  - Computers in total quality management. Statistical process control to expedite
      stats.
AB  - We developed a system of computer programs to gather and then display data on
      turnaround time for stat tests. The data were those generated by the testing
      process itself so that no additional data entry was necessary. The system
      provided daily as well as longitudinal data for statistical process control
      implemented in the laboratory. The median and 90th percentile turnaround times
      were calculated for high-volume tests (complete blood cell count and Chem6 [six
      chemical serum component concentrations, ie, sodium, potassium, chloride, carbon
      dioxide, glucose, and urea nitrogen]), and a graphic display was automatically
      generated. These parameters and visual aids permitted evaluation of stat
      processing in the laboratory. The impact of management decisions on the stat
      process could be measured. Intralaboratory processing procedures were modified,
      and phlebotomy personnel were repositioned. Our various measurements showed which
      decisions improved stat turnaround time.

PMID- 8368903
TI  - Aggressive angiomyxoma in men. A report of two cases associated with inguinal
      hernias.
AB  - Aggressive angiomyxoma is a rare, locally invasive, but nonmetastasizing soft
      tissue tumor that most commonly occurs in the pelvis or perineum of premenopausal
      women. In this article, we report two cases of aggressive angiomyxoma that
      occurred in middle-aged men. Although both patients initially presented with
      inguinal hernias, in other respects the two cases were significantly different.
      In one case, the tumor was small and found only incidentally at the time of
      surgery. In the other case, the tumor was extremely large, primarily involved the
      scrotal soft tissue, and was clinically thought to represent a testicular tumor.

PMID- 8368904
TI  - Laryngeal chondrosarcomas.
AB  - Four cases of laryngeal chondrosarcoma are presented. The patients' ages ranged
      from 60 to 75 years; one was a man and three were women. Two of the tumors arose
      in the thyroid cartilage, one in the cricoid cartilage, and one in the left
      arytenoid cartilage. A rapid fatal course with pulmonary and cerebral metastases
      was observed for the tumor arising in the arytenoid cartilage that histologically
      corresponded to a myxoid chondrosarcoma. The other three cases corresponded to
      low-grade, well-differentiated chondrosarcomas of the hyaline type, and the
      patients were alive and free of recurrence or metastases 3 to 6 years following
      total and partial laryngectomy. A review of the literature on the topic and the
      importance of assessing histologic grade, size, and location in the evaluation of
      these neoplasms is discussed.

PMID- 8368905
TI  - Intracranial lipomas with teratomatous elements.
AB  - We report two cases of patients with intracranial tumors that share features with
      lipomas and teratomas. Although rare reports of lipomas with "hypertrophic
      nerves" and "teratoid tumors" have been recorded, these two cases are unusual
      because they contain mature neuroectoderm (choroid plexus, peripheral nerve) and
      mesoderm (skeletal muscle). The findings are discussed and modern classification
      schemes are presented. We believe that the cases are examples of a transition
      between lipoma and teratoma.

PMID- 8368906
TI  - Inflammatory pseudotumor of the spleen. A clinicopathologic and immunophenotypic
      study of eight cases.
AB  - We report the clinical, pathologic, and immunophenotypic findings of inflammatory
      pseudotumors of the spleen in eight patients. The primary importance of
      recognizing these uncommonly found lesions is to distinguish them from malignant
      lymphoma, which splenic inflammatory pseudotumors may mimic clinically and
      radiologically. Grossly, the splenic inflammatory pseudotumors in this study
      ranged from 0.5 to 11.5 cm. One case was multinodular, and seven lesions were
      solitary. In general, the size of the lesion correlated with the presence of
      symptoms. The smaller lesions were usually incidental findings, discovered as
      part of the workup of idiopathic thrombocytopenic purpura (three cases), during
      staging for Hodgkin's disease (one case), or at autopsy (one case).
      Microscopically, the lesions were composed of a variable mixture of inflammatory
      cells admixed within a spindle cell proliferation. Small, cytologically normal
      lymphocytes and plasma cells were constant features, in a variable mixture, with
      neutrophilic and eosinophilic leukocytes present in some cases. Coagulative
      necrosis was located centrally in six lesions; neutrophilic leukocytes were
      correlated with the presence of necrosis. The presence of necrosis did not
      correlate with the presence of symptoms. Immunohistochemical studies revealed
      that the small lymphocytes present were predominantly T cells. Histiocytes and
      polytypic plasma cells were also numerous, whereas B cells were infrequent.
      Inflammatory pseudotumors of the spleen are benign lesions. The clinical follow
      up for the seven patients in this study who underwent splenectomy showed no
      evidence of recurrence or subsequent development of a hematopoietic neoplasm,
      with a median follow-up of 18 months (range, 3 to 135 months).

PMID- 8368907
TI  - Chordoma in childhood and adolescence. A clinicopathologic analysis of 12 cases.
AB  - Chordoma is a distinctly uncommon neoplasm in the first two decades of life. To
      characterize further its clinicopathologic features in this age group, we studied
      12 chordomas from six males and six females (age range, 1 month to 20 years at
      diagnosis), with a mean age of 6 years. Six tumors arose in the clivus, four in
      the cervical or thoracic vertebrae, and two in the lumbar and sacrococcygeal
      areas. The clinical presentations reflected the location. Histologically, six
      cases were classic chordomas; the remaining six had atypical or nonclassic
      features of a round cell or spindle cell tumor. Immunohistochemical stains for
      vimentin and cytokeratin were positive in all cases tested, whereas epithelial
      membrane antigen was detected in 11 examples, and S100 protein reactivity was
      noted in nine lesions. The tumors were uniformly nonreactive for glial fibrillary
      acidic protein and carcinoembryonic antigen. Electron microscopy in six cases
      demonstrated large primitive cells with attenuated cell junctions, whorls of
      cytoplasmic filaments, vacuoles, and glycogen aggregates. Ten children had died
      of tumor at intervals of 3 weeks to 4.5 years after diagnosis and treatment.
      Lung, lymph nodes, and other organs were the distant metastatic sites in seven
      cases. These findings imply that chordomas in children are more variable
      histologically and may pursue a more aggressive clinical course than their adult
      counterpart. Immunohistochemical studies are particularly helpful in the
      differentiation of atypical chordomas from other round and spindle cell
      neoplasms.

PMID- 8368908
TI  - Congenital hemangiopericytoma. An ultrastructural, immunocytochemical, and flow
      cytometric study.
AB  - Congenital (infantile) hemangiopericytoma is a rare soft-tissue tumor that has
      been described as a distinct subtype of the classic hemangiopericytoma. We report
      the ultrastructural, immunocytochemical, and flow cytometric features of a case
      diagnosed in a male neonate 3 days after birth. The tumor appeared structurally
      similar to its adult counterpart, meriting the designation hemangiopericytoma,
      but the improved prognosis that has been reported in young children supports
      according the infantile form the status of an entity rather than merging it with
      its adult counterpart.

PMID- 8368909
TI  - Myasthenia gravis and primary squamous cell carcinoma of the thymus.
AB  - Occurrence of primary squamous cell carcinoma of the thymus gland in a 65-year
      old man with myasthenia gravis is reported. Histologic and immunohistochemical
      studies confirmed the diagnosis of a differentiated squamous cell carcinoma.
      Extensive clinical investigations ruled out another primary site for the tumor.
      The patient made a full recovery postoperatively. Only three cases of primary
      squamous cell carcinoma of the thymus gland in association with myasthenia gravis
      have been reported in the literature.

PMID- 8368910
TI  - Solitary cavernous hemangioma of small intestine. Case report and literature
      review.
AB  - We describe a 14-year-old boy with a solitary cavernous hemangioma in the
      proximal small intestine that caused recalcitrant iron deficiency anemia
      beginning at 3 years of age. After a number of attempts to ascertain the cause of
      the anemia were unsuccessful, the vascular tumor was ultimately diagnosed in the
      jejunum, approximately 80 cm distal to the ligament of Treitz. We discuss the
      differential diagnoses of vasoformative intestinal lesions and review the
      literature on enteric cavernous hemangiomas in childhood.

PMID- 8368911
TI  - Intrahepatic and extrahepatic biliary papillomatosis.
AB  - We report a case of biliary papillomatosis that occurred 8 years after resection
      of a bile duct tumor. In 1982, a 63-year-old man underwent a cholecystectomy
      because of cholelithiasis. At operation, a solitary tumor was found in the left
      intrahepatic bile duct, and a lateral hepatic segmentectomy was performed. The
      tumor was diagnosed as a benign papillary adenoma. In 1990, mild liver
      dysfunction was revealed in a routine medical examination. Ultrasonography and
      computed tomography showed a solid tumor measuring approximately 6 cm in diameter
      in the left hepatic duct. There was no appearance of jaundice during the course.
      In 1991, a partial hepatic resection and a bile duct resection were performed. At
      operation, two tumors were found and removed. These tumors were essentially the
      same as the bile duct tumor resected 8 years ago. They were diagnosed as biliary
      papillomatosis.

PMID- 8368912
TI  - Recruitment of a pathology course director.
AB  - The process of choosing a course director rarely involves a rigorous examination
      of the duties to be assumed, primarily because the selection is from among
      existing faculty rather than as a result of formal recruitment. The selectee
      tends to be surprised (and often disheartened) by the amount of time the job
      requires. This report was developed from workshops conducted at recent meetings
      of both the Group for Research in Pathology Education and the Association of
      Pathology Chairmen. It describes the overall scope of a course director's
      activities, including the percentage of time devoted to various functions, and
      identifies issues to be addressed at the time of the course director's selection.
      Although the appointment may still be from within the department, the recruitment
      process does allow for a more full and open discussion of the job to be
      accomplished.

PMID- 8368913
TI  - Homosexuality and bisexuality in different populations.
AB  - The general public as well as the scientific community have use for accurate data
      on the size(s) of the heterosexual, homosexual, and bisexual populations. Uses
      include political, legal, medical, and social. The data upon which the typically
      used figures are dependent have come under scrutiny. This review of studies from
      the U.S. and elsewhere indicate that it is unreasonable to consider the often
      used figure of 10% of the male population as more or less regularly engaging in
      same-sex activities. The figure is closer to half that. And the figure for the
      lesbian population is even smaller. Further, routinely exclusive or predominantly
      exclusive homosexual activities are more common than bisexual activities.

PMID- 8368914
TI  - Expert psychological testimony in cases of alleged child sexual abuse.
AB  - Concurrent with the rapid rise in allegations of child sexual abuse,
      psychologists are increasingly assuming the role of experts for the courts. In
      this position, a new and more controversial role is often assumed by the expert,
      that of psychological investigator. A review of the common legal contexts for
      such a role as well as the theoretical and empirical basis for the investigatory
      role is presented. Ethical issues are also considered. A literature review
      reveals that many assessment instruments do not meet jurisprudential standards.
      Suggestions for improving the role of psychological experts in the courtroom
      include educating the legal audience regarding the limits of psychological
      testimony, providing standards for qualifications of experts, and emphasizing the
      data-based probabilistic nature of psychological expert testimony.

PMID- 8368915
TI  - Sexual preference assessment of sexual aggressors: predictors of penile response
      magnitude.
AB  - A current method used to assess the sexual preference of sexual aggressors is the
      recording of their penile responses during the presentation of erotic stimuli.
      This method is ineffective in subjects who do not obtain sufficient penile
      responses. Whether variables related either to the subjects or their crimes would
      correlate with the magnitude of penile responses during sexual preference
      assessment was studied. The penile responses of 92 subjects were recorded. Older
      and pre-sentencing subjects showed a lower maximum penile response magnitude than
      younger and sentenced subjects. Results are discussed as they relate to the
      validity of physiological assessment of sexual preference.

PMID- 8368916
TI  - Reports of female initiation of sexual contact: male and female differences.
AB  - Women's reports of initiating sexual contact and men's reports of experiencing
      female initiation were compared. 128 male and 212 female college students were
      recruited from sexuality classes at three institutions. It was hypothesized that
      there would be no significant difference between women's reports of initiating
      sexual contact and men's reports of experiencing female initiation. A chi-square
      test of significance at the p < 0.05 level with an alpha rate adjustment (p <
      0.002) using the Bonferroni technique was implemented. Of 26 questionnaire items,
      15 registered significant differences between male and female reports (p <
      0.002). Overall, males reported experiencing female initiation more frequently
      than females reported initiating. Traditional gender roles may influence male and
      female perceptions of female initiation of sexual contact in a way that
      contributes to significant differences in reporting.

PMID- 8368917
TI  - The role of body image in sexually avoidant behavior.
AB  - "Spectatoring" refers to a cognitive self-absorption, wherein individuals fixate
      on and carefully monitor personal body parts and/or the adequacy of personal
      sexual functioning. To examine this process within a university population,
      undergraduate and graduate students (108 male and 140 female) filled out
      questionnaires that assessed body image, sexual knowledge, global sexual
      attitudes (i.e., liberal-conservative), general psychological adjustment, and
      frequency of sexual behaviors. Multiple regression analyses were used to
      determine if spectatoring, operationalized by measures of body image, would
      significantly predict sexually avoidant behavior. Results indicated that body
      image scores significantly predicted frequency of sexual behaviors for both
      genders, while general sexual knowledge and psychological adjustment did not
      predict sexual behavior. Overall, sexual attitude scores were the best predictors
      of sexual approach/avoidance behaviors for both genders. Implications are drawn
      for future research using the assessment of more global sex attitudes in the
      study of spectatoring.

PMID- 8368918
TI  - Violence and sexual violence in pornography: is it really increasing?
AB  - Literature and research on the question of the increasingly violent nature of
      pornography is reviewed. In addition, the paper reports the findings of a content
      analysis of all cartoons and pictures in Hustler Magazine from 1974 through 1987.
      Results indicate that sexually violent cartoons and/or pictorials constitute a
      relatively small proportion of the total cartoons and pictorials. Moreover, no
      monotonic increase was found in such depictions over the 14-year period examined.
      In fact, a relatively small and constant proportion of violent and/or sexually
      violent depictions over this period is reported. These findings are examined in
      relation to previous research and societal concern about alleged increases in
      violent pornography as an explanation for increases in rape rates.

PMID- 8368919
TI  - Gastroesophageal reflux and laryngeal disease.
AB  - OBJECTIVE: We wanted to determine if surgical correction of gastroesophageal
      reflux disease (GERD) would affect inflammatory laryngeal lesions in a select
      group of patients with known GERD and chronic inflammatory laryngeal lesions.
      DESIGN: Patients with persistent inflammatory lesions in the larynx were referred
      for workup of GERD when these lesions were not associated with smoking or
      drinking or when cessation of smoking failed to ameliorate these lesions during a
      minimum period of 6 months. Twenty-four-hour pH monitoring was used to confirm
      GERD in 10 patients, while two patients had GERD confirmed radiologically, and
      one patient had typical symptoms of esophagitis and incompetent lower esophageal
      sphincter. Thus, 13 patients with chronic laryngeal inflammation persistent after
      cessation of smoking had concomitant GERD. These patients were all treated with
      Nissen fundoplication for GERD. SETTING: Patients with chronic laryngitis were
      referred to an otolaryngologist at a tertiary medical center. PATIENTS: Patients
      were consecutively selected as they presented with chronic persistent laryngeal
      lesions and were found to have GERD. INTERVENTIONS: Surgical correction of GERD
      with Nissen fundoplication. MAIN OUTCOME MEASURES: Status of the larynx was
      assessed at 3-month intervals with fiberoptic laryngoscopy and symptoms (ie,
      hoarseness, sore throat) were evaluated. RESULTS: Laryngeal inflammatory lesions
      and voice changes (hoarseness and sore throat) promptly resolved in eight (73%)
      of 11 patients. To date, these improvements have continued after a mean follow-up
      of 11 months. CONCLUSIONS: Correction of GERD in a selected subset of patients
      with laryngeal inflammatory lesions ameliorates these lesions.

PMID- 8368920
TI  - A retrospective comparison of transanal surgery and endocavitary radiation for
      the treatment of 'early' rectal adenocarcinoma.
AB  - OBJECTIVE: To compare two techniques for the local treatment of "early" rectal
      adenocarcinoma. DESIGN AND STUDY PARTICIPANTS: A retrospective comparison of 27
      patients who underwent transanal disk excision and fulguration (group A) and 38
      patients who underwent transanal endocavitary radiation (group B). SETTING:
      Inpatient and outpatient. INTERVENTION: Group A patients had rectal
      adenocarcinoma treated with disk excision and fulguration. Group B patients
      received 100 to 125 Gy in four to five fractions using the Phillips RT-50 unit.
      MAIN OUTCOME MEASURES: Survival and local recurrence. RESULTS: The median follow
      up for group A was 68 months; for group B, 38 months. The mean tumor diameter was
      2.5 cm, all were grade 1 or 2. The local recurrence rate was 7.4% for group A and
      21% for group B. Local recurrence was not correlated with tumor grade, location,
      or size but did correlate with tumor ulceration. CONCLUSION: For selected early
      rectal cancers, surgical excision and fulguration offers better local control
      than endocavitary radiation therapy, while survival was similar.

PMID- 8368921
TI  - The role of duplex ultrasound arterial imaging in patients with penetrating
      extremity trauma.
AB  - OBJECTIVE: To investigate the role of color-flow duplex ultrasound vascular
      imaging in screening patients for potential arterial injuries following
      penetrating trauma of the extremities. DESIGN: In this prospective study,
      patients with penetrating trauma in proximity to major peripheral vessels but
      without signs of arterial injury underwent color-flow duplex imaging. Patients
      with abnormal color-flow duplex examination results were then studied with
      angiography, and the results of the two studies were compared. In patients who
      presented with signs of arterial injury, immediate operative exploration and/or
      angiography was performed. SETTING: An urban trauma center. PATIENTS: Patients
      entering the trauma center with penetrating trauma between April 1991 and
      December 1992. RESULTS: Seventy-seven patients with 86 extremity injuries were
      initially screened with color-flow duplex imaging. Four patients had positive
      study results, and all injuries were confirmed with angiography (100% true
      positive). No missed arterial injuries were detected in clinical follow-up.
      CONCLUSIONS: Color-flow duplex imaging reliably detects occult arterial injuries
      and may also have a role in following up minor injuries treated without surgery.

PMID- 8368922
TI  - Accuracy of ultrasound in the diagnosis of acute appendicitis compared with the
      surgeon's clinical impression.
AB  - OBJECTIVE: To compare the accuracy of the surgeon's clinical diagnosis of acute
      appendicitis with that of an ultrasonographic examination of the abdomen. DESIGN:
      Prospective trial. SETTING: US Navel Hospital, San Diego, Calif. PATIENTS: One
      hundred ten patients admitted to the hospital with suspected appendicitis from
      May 1990 to June 1992. INTERVENTION: Symptoms and signs for each patient were
      recorded, along with the surgeon's clinical impression of immediate surgery or
      observation. The patient then underwent an ultrasound examination performed by a
      staff radiologist. On the basis of the ultrasound findings the patient was placed
      into one of three categories: appendicitis, normal examination results, or other
      conditions. Patients with an ultrasound-based diagnosis of appendicitis proceeded
      to the operation, regardless of the surgeon's clinical impression. Those with
      other conditions diagnosed with ultrasonography were treated as was appropriate
      for the condition. RESULTS: The ultrasound-derived diagnosis of appendicitis had
      a sensitivity of 85.5%, a specificity of 84.4%, a positive predictive value of
      88.3%, a negative predictive value of 80.1%, and an overall accuracy of 85.0%.
      The surgeon's clinical impression at the time of admission had a sensitivity of
      62.9%, a specificity of 82.2%, a positive predictive value of 82.9%, a negative
      predictive value of 61.7%, and an overall accuracy of 71.2%. CONCLUSION: The
      overall accuracy of ultrasonography in the diagnosis of appendicitis was
      statistically superior to that of the surgeon's clinical impression (P < .0001).
      However, 24% of the patients with normal ultrasound findings were ultimately
      found to have appendicitis at operation, emphasizing the point that
      ultrasonography cannot be relied on to the exclusion of the surgeon's careful and
      repeated evaluation.

PMID- 8368923
TI  - The Whipple procedure for severe complications of chronic pancreatitis.
AB  - OBJECTIVE: To analyze the clinical indications and long-term results for the
      Whipple procedure used for severe complications of chronic pancreatitis (CP).
      DESIGN: A series of 28 patients requiring the Whipple procedure for CP were
      reviewed by one surgeon between 1986 and 1993. SETTING: A multispecialty group
      practice hepatobiliary pancreatic referral center. PATIENTS: The referred
      patients with CP complications in the pancreatic head were anatomically defined
      by endoscopic retrograde cholangiopancreatographic and computed tomographic scans
      to include expanding pseudocysts, pancreatic duct disruption, arteriovenous
      fistula, or calcified obstructive fibrosis of bile duct, pancreatic duct, and/or
      duodenum. INTERVENTION: The Whipple procedure (pylorus-preserving [n = 25] or
      standard [n = 3]) was performed after preoperative assessment with a mesenteric
      arteriogram and, as necessary, percutaneous drainage or endoscopic stenting of
      pseudocyst, pancreatic duct, or bile duct were performed. MAIN OUTCOME MEASURES:
      Mortality, morbidity, length of hospital stay, and long-term results of the
      operation. RESULTS: There was no mortality. A 36% morbidity rate included adult
      respiratory distress syndrome (n = 3) secondary to a long operation time
      (average, 9.8 hours) or infected tissue and delayed gastric function (> 14 days)
      secondary to retrogastric amylase-rich fluid collections (n = 4). Long-term
      follow-up in 25 patients after 27 months (range, 3 to 84 months) showed that 88%
      were pain-free and 12% had improved. None had recurrent pancreas problems, but
      28% had resumed drinking alcohol. Inability to gain weight was noted in 4% and a
      marginal ulcer in 4%. CONCLUSIONS: The Whipple procedure for severe complications
      of CP in the pancreatic head is a safe and effective operation leaving little
      gastrointestinal sequelae. Preoperative endoscopic and radiological assessment,
      drainage, and stenting procedures are key elements to achieving positive results.

PMID- 8368924
TI  - Gallbladder cancer discovered during laparoscopic surgery. Potential for
      iatrogenic tumor dissemination.
AB  - OBJECTIVE: To examine the results of treatment of laparoscopically discovered
      gallbladder cancer. DESIGN: Retrospective review of clinical data for the 10
      patients with laparoscopically discovered gallbladder cancer who were referred to
      our institution for definitive surgical therapy. SETTING: An oncologic referral
      center. PATIENTS: All patients in the 24-month period from November 1990 to
      November 1992 with this entity who were referred for surgical therapy.
      INTERVENTION: Exploratory laparotomy was performed on all patients. Resection
      with curative intent was performed when possible. MAIN OUTCOME MEASURES:
      Resectability and outcome of cancer treatment. RESULTS: In three patients, a
      subsequent radical resection was performed and as a result, two patients are
      currently free of disease. Intraperitoneal spread, not present at the original
      laparoscopy and associated with violation of tumor at laparoscopy, precluded
      potentially curative resection for four patients. In two of these patients, there
      was obvious tumor growth within the laparoscopy tracts. CONCLUSIONS: Tumor
      dissemination is a real hazard of laparoscopic violation of gallbladder integrity
      in the presence of gallbladder cancer. Modification of management based on
      awareness of such a hazard is needed to improve resectability and outcome of
      future cases of laparoscopically discovered gallbladder cancer.

PMID- 8368925
TI  - Hepatic flow scintigraphy in evaluation of hepatic metastases in patients with
      gastrointestinal malignancy.
AB  - OBJECTIVE: To assess the value of hepatic flow scintigraphy for occult
      metastases. DESIGN: Prospective study, 2 years of follow-up. SETTING AND STUDY
      PARTICIPANTS: One hundred twenty-nine patients undergoing surgery for
      gastrointestinal cancer. INTERVENTION: Preoperative hepatic flow scintigraphy
      (3mCi of technetium-99m). MAIN OUTCOME MEASURE: Development of hepatic
      metastases. RESULTS: Hepatic flow scintigraphy had a sensitivity of 92% and a
      specificity of 34%. The positive and negative predictive values were 15% and 97%,
      respectively. CONCLUSIONS: Hepatic flow scintigraphy could therefore be useful in
      identifying patients who are at low risk of developing metachronous liver
      metastases and thus avoid unnecessary adjuvant chemotherapy following resection
      of the primary tumor.

PMID- 8368926
TI  - Total lobectomy and total thyroidectomy in the management of thyroid lesions.
AB  - OBJECTIVE: To study an unselected consecutive series of patients undergoing
      thyroidectomy for tumors to establish the complication rates of total lobectomy
      with isthmectomy and total thyroidectomy. DESIGN: Retrospective study. PATIENTS:
      Two hundred eight consecutive, unselected patients were operated on by one
      surgeon from 1980 to 1990. One hundred nineteen patients (57%) had a total
      lobectomy and isthmectomy and 85 patients (41%) had total thyroidectomy. Four
      patients (2%) had partial excision for technical reasons, two with anaplastic
      cancers and two with advanced thyroiditis. RESULTS: Forty-two malignant lesions
      (20%) were diagnosed with a mean follow-up of 5 years. Malignant lesions were
      diagnosed in 15 (31%) of 48 males and 27 (17%) of 160 women. Ten patients (5%)
      had parathyroid adenomas. Long-term follow-up revealed that there were no deaths,
      permanent hypocalcemia, or recurrent laryngeal nerve damage. One patient was
      returned to the operating room to control bleeding. CONCLUSION: This study
      suggests that total thyroid lobectomy with isthmectomy and total thyroidectomy
      are both safe procedures in the management of thyroid tumors.

PMID- 8368927
TI  - Hepatic resection for hepatolithiasis.
AB  - OBJECTIVE: To analyze the results of hepatic resection for hepatolithiasis.
      DESIGN: A retrospective study of case records of patients with hepatolithiasis
      undergoing hepatic resection. These patients had been followed up for 3 to 38
      months. They were referred to Queen Mary Hospital, a tertiary referral center in
      Hong Kong. PATIENTS: Of 172 patients with hepatolithiasis seen between January
      1984 and December 1981, 63 patients underwent hepatic resection because the
      affected liver segments were destroyed by repeated infection (n = 51), multiple
      cholangitic liver abscesses were found in the affected liver segments (n = 9), or
      concomitant intrahepatic cholangiocarcinoma was diagnosed (n = 3). INTERVENTION:
      Left lateral segmentectomy was performed in 42 patients, left hepatic lobectomy
      in 15 patients, right hepatic lobectomy in one patient, and segmentectomy in five
      patients. MAIN OUTCOME MEASURES: Postoperative morbidity and mortality analysis.
      RESULTS: Contrary to hepatic resection in a normal liver, dissection to isolate
      inflow and outflow vasculature was difficult in 52% of cases owing to severe
      inflammatory fibrosis at the liver hilum, at the umbilical fissure, or at the
      junction of hepatic vein with inferior vena cava. The operative morbidity rate
      was 32% and the mortality rate was 2%. The majority of complications were wound
      infection, subphrenic abscesses, or biliary fistulas, which could be due to the
      presence of infected bile (85%) and liver abscesses (25%) in this disease.
      Statistical analysis of the preoperative hematological and biochemical variables
      and the amount of intraoperative blood loss could not identify any factor with
      significance in correlating with the development of postoperative complications.
      Stones recurred in 16% after a median follow-up of 47 months. CONCLUSION: Hepatic
      resection is a satisfactory treatment for hepatolithiasis. The postoperative
      septic complication rate is high and is an intrinsic problem related to liver
      resection in a septic condition.

PMID- 8368928
TI  - Emergent liver transplantation to salvage a hepatic avulsion injury with a
      disrupted suprahepatic vena cava.

PMID- 8368929
TI  - Pneumonia due to stress ulcer prophylaxis with cimetidine: a necessary
      consequence?

PMID- 8368930
TI  - Frozen-section diagnosis of breast biopsy specimens. A necessary procedure?

PMID- 8368931
TI  - Pacific Coast Surgical Association. Surgeons and the evolution of vascular
      surgery.

PMID- 8368932
TI  - Preperitoneal prosthetic herniorrhaphy. One surgeon's successful technique.
AB  - OBJECTIVES: To review the senior author's experience with preperitoneal mesh
      inguinal herniorrhaphy, evaluate the recurrence rate, and compare it with
      previously published data and with the developing technique of laparoscopic
      herniorrhaphy. DESIGN: A retrospective records review of 204 herniorrhaphies,
      follow-up of patients (mean follow-up, 3.5 years), and review of the literature.
      SETTING: One general surgeon's clinical practice in an 860-bed regional referral
      hospital. PATIENTS: One hundred sixty-two men and 13 women (mean age, 63 years)
      who underwent preperitoneal prosthetic herniorrhaphy by the senior author between
      1984 and 1991 and whose medical records were available for review (175 [96%] of
      183 patients). MAIN OUTCOME MEASURES: Short- and long-term postoperative
      complications and hernia recurrence. RESULTS: One hundred fifty-two primary and
      52 recurrent inguinal hernias were repaired using a preperitoneal prosthetic
      approach and either general or regional anesthesia. Wound complications occurred
      in 12 (5.9%) of 204 operations, and one recurrence (0.5%) was detected over the
      mean long-term follow-up period of 42 months (range, 7.9 to 110 months). A 25
      year recurrence rate of 1% was predicted. CONCLUSIONS: This repair compares
      favorably with similar, previously reported repairs and is suggested as a
      standard for comparison with the developing technique of laparoscopic
      herniorrhaphy.

PMID- 8368933
TI  - Radial or ulnar artery laceration. Repair or ligate?
AB  - OBJECTIVE: To determine the relationship between patency of radial or ulnar
      artery repair and later hand symptoms. DESIGN: Call-back survey. SETTING: Urban
      trauma center. PATIENTS: Thirty-two subjects with wrist artery lacerations
      undergoing 26 arterial repairs and six artery ligations during an 8-year period.
      INTERVENTIONS: Directed history and hand examination (palpation of wrist pulses,
      Doppler Allen test, and Doppler interrogation of palmar arch and digital
      vessels). MAIN OUTCOME MEASURES: History of hand claudication, weakness, or cold
      sensitivity or paresthesias and patency of wrist arteries. RESULTS: Twelve (46%)
      of 26 wrist artery repairs were patent. There was no evident benefit of optical
      magnification or specialization in hand or vascular surgery. No subjects had hand
      claudication; there was a 50% incidence of hand weakness and a 12% incidence of
      cold sensitivity independent of patency of the damaged wrist artery and present
      only in subjects with associated nerve injury. Professional charges for wrist
      artery repair were threefold to fourfold higher than those for wrist artery
      ligation. CONCLUSION: Consonant with prior reports, patency following repair of
      radial or ulnar artery laceration does not exceed 50%. Later hand symptoms relate
      to nerve or tendon damage, not to arterial patency. In the absence of acute hand
      ischemia, simple ligation of a lacerated radial or ulnar artery is safe and cost
      effective.

PMID- 8368934
TI  - Popliteal-tibial bypass grafts in the management of limb-threatening ischemia.
AB  - OBJECTIVES: To ascertain the cumulative rates of primary graft patency and limb
      salvage and the frequency of proximal arterial disease progression in patients
      with autologous saphenous vein bypass grafts that originate from the popliteal
      artery and whose operative indication was limb-threatening ischemia. DESIGN: Five
      year retrospective study with follow-up that ranged from less than 1 month to 60
      months. SETTING: Tertiary care center. PATIENTS: Twenty-four threatened limbs in
      23 patients were reviewed. Surgical indications included gangrene in 15 limbs
      (63%), rest pain in seven limbs (29%), and a nonhealing ulcer in two limbs (8%).
      Patients with previous ipsilateral infrainguinal arterial reconstructive
      procedures were excluded. Mean patient age was 66 years, and 18 patients 78% had
      insulin-dependent diabetes mellitus. MAIN OUTCOME MEASURES: Percentages of
      primary graft patency and limb salvage were determined by the life-table method.
      Proximal arterial disease progression was assessed via follow-up arteriography or
      segmental limb pressures. RESULTS: The cumulative rates of primary graft patency
      and limb salvage at 1, 3, and 5 years were 73%, 59% and 59%, and 87%, 57%, and
      57%, respectively. No patient developed proximal arterial disease progression
      that required intervention during the study period. CONCLUSIONS: The cumulative
      rates of primary graft patency and limb salvage were essentially the same, which
      indicated poorly collateralized limbs that are solely dependent on the graft.
      There did not appear to be a critical progression of proximal arterial disease
      that would warrant a more proximal graft origin. A short autologous saphenous
      vein graft that originates from the above-knee or below-knee popliteal artery is
      a durable bypass.

PMID- 8368935
TI  - The value of sham-feeding tests in patients with postgastrectomy syndromes.
AB  - OBJECTIVE: The value of gastric secretory testing in surgical practice has been
      questioned. Sham feeding (SF) is a test of gastric secretion that determines the
      status of gastric vagal innervation or incomplete vagotomy. Our purpose was to
      show that the results of SF tests affect operative strategy and/or clinical
      management. DESIGN: The medical records of 30 consecutive patients studied with
      SF in our laboratory were reviewed to determine if patient management was
      affected by the results of SF. PATIENTS: All 30 patients had prior vagotomies.
      Sham feeding was performed in patients (1) before planned reoperation for
      postgastrectomy syndromes (n = 17), (2) with peptic ulcerations/pain of unclear
      etiology (n = 8), or (3) postoperatively in those who were at high risk for
      recurrent ulcer (n = 5). RESULTS: Sham feeding indicated complete vagotomy in 16
      patients and incomplete vagotomy in 14 patients. In 17 patients studied before
      planned reoperation, operative strategy was affected by results of SF in 15
      cases; five patients had revagotomies performed at reoperation, 11 did not, and
      one patient had her operation canceled. In patients with atypical postoperative
      ulcers/pain, management was changed in only two of eight patients. In the high
      risk patients studied postoperatively, management was affected in four of five
      patients. CONCLUSIONS: (1) We believe that our results justify the performance of
      SF before any reoperation on the stomach, since an operative plan was nearly
      always affected. (2) In patients with atypical peptic complaints after gastric
      surgery, SF usually (80%) confirmed acid hypersecretion, thereby affecting
      management less often. (3) Although unproved, we believe SF results can guide the
      use of "prophylactic" H2-blockers in treating selected high-risk postgastrectomy
      patients.

PMID- 8368936
TI  - Transplantation and reanimation of hearts removed from donors 30 minutes after
      warm, asystolic 'death'.
AB  - OBJECTIVE: To test whether hearts from "dead," pulseless, asystolic donors could
      be transplanted and reanimated successfully using reperfusion manipulations.
      DESIGN AND INTERVENTIONS: Ten infant lambs (mean [+/- SD] weight, 4 +/- 1 kg)
      were anesthetized and pretreated with 50% dextrose, methylprednisolone,
      prostaglandin E1, and sublingual nifedipine. Five of these lambs were paralyzed;
      hypoxic asystolic arrest occurred 10 +/- 2 minutes later. Thirty minutes
      following asystole (mean, 40 +/- 2 minutes after paralysis) sternotomy was
      performed and the hearts were excised. Aortic blood gases were as follows: pH,
      6.6 +/- 0.1; PCO2, 180 +/- 20 mm Hg; and PO2, 8 +/- 2 mm Hg. Donor hearts were
      given 30 mL/kg of Cardiosol (Water's Instrument Co, Danburg, Conn), a new
      cardioplegic agent, at 4 degrees C, and explanted into iced saline. The remaining
      five lambs then underwent cardiopulmonary bypass, were cooled to 20 degrees C,
      and hypothermic arrest was instituted. After excision of the recipient's heart,
      the donor heart was implanted in an orthotopic position. Total cold ischemic time
      was 1 hour 40 minutes +/- 10 minutes. The donor heart was retroperfused for 10
      minutes with low-hematocrit, low-calcium blood via a coronary sinus catheter,
      then normal aortic inflow reperfusion was continued for 50 minutes. MAIN OUTCOME
      MEASURES: Removal of the cardiopulmonary bypass and measurement of hemodynamic
      parameters. RESULTS: One half hour after the bypass, mean systolic aortic
      pressure was 71 +/- 6 mm Hg; mean right atrial pressure was 6 +/- 2 mm Hg; mean
      left atrial pressure was 7 +/- 2 mm Hg; and mean pulmonary arterial pressure was
      20 +/- 8 mm Hg. No inotropic drugs were given for postbypass blood pressure
      support. CONCLUSION: It is possible to transplant and reanimate hearts that have
      been dead for 30 minutes. When further developed, the use of donors who were not
      brain dead but allowed to die naturally could greatly increase the donor pool.

PMID- 8368937
TI  - Diagnosis and treatment of bowel perforation following pediatric orthotopic liver
      transplantation.
AB  - OBJECTIVE: Bowel perforation is a frequent cause of mortality after pediatric
      orthotopic liver transplantation. The aims of this study were to identify the
      cause of this phenomenon and to examine current methods of treatment. DESIGN:
      This is a retrospective analysis of 246 pediatric patients who underwent
      orthotopic liver transplantation at a large, urban, tertiary care medical center
      between 1984 and 1992. We examined the frequency of bowel perforations after
      transplantation and identified predisposing factors and signs. In this series,
      bowel perforations occurred in 24 of 246 recipients and were common in those who
      had previous liver-related surgery (22 patients). Clinical signs included fever
      (13 patients), leukocytosis (14 patients), and free air on abdominal
      roentgenograms (11 patients). RESULTS: Perforation occurred at the Roux-en-Y limb
      in 15 of 24 recipients as well as in the right transverse colon (five patients),
      terminal ileum (three patients), and duodenum (one patient). The repair was
      resection and/or primary closure (18 patients), or diversion (six patients).
      Recurrent perforations (nine patients) could not be attributed to the method of
      the repair. Perforation-related sepsis was the primary cause of death in 12
      patients (50%) and was more common among patients who developed recurrent
      perforation (seven [78%] of nine patients). CONCLUSIONS: The occurrence and
      location of bowel perforation after pediatric orthotopic liver transplantation
      suggests that the cause is related to bowel injury during difficult hepatectomy.
      Mortality may be reduced by early second-look operations in high-risk patients.

PMID- 8368938
TI  - Changes in peripheral nervous system activity produced in rats by prenatal
      exposure to carbon monoxide.
AB  - The present experiments were designed to investigate whether alterations of
      peripheral nervous system activity may be produced in male Wistar rats by
      prenatal exposure (from day 0 to day 20 of pregnancy) to relatively low levels of
      CO (75 and 150 ppm). The voltage clamp analysis of ionic currents recorded from
      sciatic nerve fibres showed that prenatal exposure to CO produced modifications
      of sodium current properties. In particular, in 40-day-old rats exposed to CO (75
      and 150 ppm) during gestation, the inactivation kinetics of transient sodium
      current were significantly slowed. Analysis of the potential dependence of steady
      state Na inactivation, h infinity (V), showed that the percentage of the maximum
      number of activable Na channels at the normal resting potential (-80 mV) was
      increased to approximately 85% in CO-exposed rats. Moreover, the voltage-current
      relationship showed a negative shift of sodium equilibrium potential in CO
      treated animals. In 270-day-old CO-exposed rats, parameters of sodium
      inactivation were not significantly modified; the reversal potential was still
      lower with respect to controls. The results indicate that prenatal exposure to
      mild CO concentrations produces reversible changes in sodium inactivation
      kinetics and on irreversible change in sodium equilibrium potential. These
      alterations could reflect CO influence on the rate of ion channel development.

PMID- 8368939
TI  - Biphasic action of sarin on monosynaptic reflex in the neonatal rat spinal cord
      in vitro.
AB  - The action of sarin, an organophosphorus (OP) compound, was examined in vitro for
      its effects on the spinal monosynaptic reflex (MSR) in neonatal rats. The effects
      of sarin were biphasic, i.e. facilitation at lower concentrations (2-20 nM)
      followed by depression of the MSR at concentrations above 30 nM. Facilitation of
      MSR was maximal (150% of control) at 20 nM sarin. The depression of MSR was
      maximal (70% of control) at 200 nM sarin, with half maximal inhibition occurring
      at 90 nM sarin. Atropine (200-500 nM) effectively reversed the depression caused
      by sarin, while pretreatment with low concentrations of atropine (10 nM)
      completely blocked the depression otherwise observed with sarin. Benactyzine was
      also effective in preventing sarin-induced depression, while pirenzepine was less
      effective. The nicotinic blocking agents tubocurarine and mecamylamine were,
      however, ineffective in preventing or reversing sarin-induced depression. The
      facilitation of MSR seen with lower concentrations (2-20 nM) correlated well with
      the blockade of late phase inhibition (between 30 and 50 ms conditioning-test
      interval) elicited in spinal cord by stimulating the adjacent dorsal root at
      various condition-test intervals, which has been shown elsewhere to be sensitive
      to bicuculline (Deshpande and Warnick 1988). Thus it is speculated that sarin at
      lower concentrations blocks GABA transmission, producing facilitation, and at
      higher concentrations activates the muscarinic receptors producing depression of
      MSR. The beneficial action of pretreatment with antimuscarinic agents may be
      attributed to the protection of the muscarinic receptors.

PMID- 8368940
TI  - Renal toxicity of aristolochic acid in rats as an example of nephrotoxicity
      testing in routine toxicology.
AB  - The nephrotoxic action of aristolochic acid (AA) was investigated in female
      Wistar rats given single doses of 10, 50 or 100 mg/kg by gastric tube. Renal
      lesions developed within 3 days, the effect being dose-dependent. Histologically,
      there was evidence of necrosis of the epithelium of the renal tubules, and
      functionally, there were rises in plasma creatinine and urea together with
      increases in urinary glucose, protein, N-acetyl-beta-glucosaminidase,
      gammaglutamyl transferase and malate dehydrogenase. Taking AA as an example, the
      aim of the present study was to consider the suitability of this model, based on
      a combination of histology and laboratory investigations, as a short-term test
      for the detection of nephrotoxic agents.

PMID- 8368941
TI  - Pulmonary clearance and toxicity of intratracheally instilled cupric oxide in
      rats.
AB  - Pulmonary clearance and toxicity of cupric oxide (CuO) dusts, which are probably
      formed in refining and smelting factories, were investigated. Groups of three
      rats received intratracheal (i.t.) instillation of CuO at a dose of 20 micrograms
      Cu/rat in time-course experiments (up to 7 days post-instillation). Other groups
      of three rats received i.t. instillation of CuO at doses of 2.5, 5, 10, 30, 50
      and 100 micrograms Cu/rat and were killed at 2 days post-instillation in dose
      effect experiments. Intratracheally instilled CuO particles were cleared from the
      lung with a half-time of 37 h. Copper binding metallothionein (MT) was induced in
      a dose-dependent manner and detected at 12 h to 3 days post-instillation. Rapid
      clearance of CuO from the lung and induction of MT at 12 h post-instillation
      suggest that CuO particles were solubilized and then cleared from the lung. The
      acute pulmonary toxicity of CuO was evaluated by cytological (numbers of
      macrophages and polymorphonuclear leukocytes), biochemical and elemental
      inflammatory indices (lactate dehydrogenase and beta-glucuronidase activities and
      protein, sulfur, phosphorus and calcium contents) in the bronchoalveolar lavage
      (BAL) fluid. These inflammatory indices peaked at 12 h to 3 days post
      instillation, and increased with dose over the dose range, except for phosphorus
      content. Dose-effect relationships in BAL inflammatory indicators of CuO-injected
      (i.t.) groups were compared to those of CuSO4-injected (i.t.) groups. The results
      of the comparison indicated that there was no significant difference in acute
      inflammatory potency between CuSO4 (soluble form of Cu) and CuO (insoluble form
      of Cu) in the rat lung.

PMID- 8368942
TI  - Toxicological studies with primary cultures of chick embryo cells: DNA
      fragmentation under the influence of DNase I-inhibitors.
AB  - Chicken embryo brain and liver cells in vitro exhibited spontaneous DNA
      fragmentation as determined by viscometry of alkaline cell lysates. Ca2+ and Mg2+
      enhanced, while Zn2+, the Ca2+ chelator ethylenglycol-bis(beta-aminoethyl-ether)
      N,N,N'-tetraacetic acid (EGTA), spermine and--to a lesser extent--spermidine and
      Hoechst 33,258 inhibited spontaneous DNA fragmentation. Under the same conditions
      chromatin condensation, as assessed by nucleoid sedimentation, increased.
      Exposure of chicken embryo cells to various genotoxic agents, i.e. doxorubicin,
      bleomycin, methyl methanesulfonate, thiyl radicals, H2O2, UV light, and X-rays,
      increased DNA fragmentation in a dose dependent manner. Zn2+ or EGTA diminished
      DNA fragmentation in cells exposed to bleomycin, thiyl radicals, H2O2 and UV
      light. An apparent sensitisation to X-irradiation has been observed in Zn2+ or
      EGTA-pretreated cells. It is suggested by the present investigations that, with
      agent specific peculiarities, apoptotic phenomena are implicated when
      nucleotoxicity is assessed in chicken embryo cells by physico-chemical short-term
      tests in vitro.

PMID- 8368943
TI  - Changes in the contractile responses to carbachol and in the inhibitory effects
      of verapamil and nitrendipine on isolated smooth muscle preparations from rats
      subchronically exposed to Co2+ and Ni2+.
AB  - Male Wistar rats were exposed to subtoxic doses of Co2+ or Ni2+, receiving
      Co(NO3)2 or NiSO4 with drinking water for 30 days. No significant differences in
      the body weight and no visible changes in the behaviour of the controls and
      experimental animals were established. Cumulative concentration-effect curves for
      carbachol were obtained in ileum and trachea isolated from control and Co(2+)- or
      Ni(2+)-treated rats. The effect of the Ca2+ antagonists on the carbachol-induced
      contractions was studied by adding increasing concentrations of verapamil or
      nitrendipine to the bath solution 20 min prior to carbachol. The results showed
      that exposure of rats to subtoxic doses of Co(NO3)2 or NiSO4 altered the
      contractile responses to carbachol. The changes in the pD2 values and the shift
      to the left of the concentration-effect curves suggest a higher sensitivity to
      carbachol in preparations from the ileum of Co(2+)- or Ni(2+)-exposed rats. The
      tracheal strips isolated from control and heavy metal-treated rats showed a less
      potent sensitiveness to carbachol as compared to the ileal segments. An opposite
      tendency for decreased cholinergic reactivity was observed in tracheal strips
      from Co(2+)- and Ni(2+)-treated animals. The inhibitory effect of the Ca(2+)
      antagonists on the contractility of ileal preparations from Co(2+)-treated rats
      increased at all concentrations of verapamil and at the highest concentration of
      nitrendipine, but decreased at lower concentrations of nitrendipine. The effect
      of verapamil on the preparations from Ni(2+)-exposed rats was unchanged or even
      decreased at higher verapamil concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368944
TI  - Comparative effect of cadmium on osteoblastic cells and osteoclastic cells.
AB  - Cadmium(Cd) has been thought to disturb the bone metabolism directly. The
      mechanism for the bone lesion is unknown, however. To examine the effects of
      cadmium on bone metabolism, we compared its effects on osteoblasts and
      osteoclasts in vitro. We used an established cell line, MC3T3-E1, as osteoblasts
      and tartrate resistant acid phosphatase (TRACP)-positive multi-nucleated cells
      (MNC) formed by a bone marrow culture system as osteoclasts. Alkaline phosphatase
      (ALP) activity was decreased by 10(-7) M Cd and DNA content and hydroxyproline
      content of osteoblastic cells were decreased by 10(-5) M Cd. Cadmium at 10(-7) M
      inhibited the osteoclastic cell formation from mouse bone marrow in the presence
      of 10(-8) M 1 alpha, 25(OH)2 vitamin D3. A 100-fold higher concentration of
      zinc(Zn) simultaneously added to the cadmium-containing medium prevented the
      toxicity of cadmium to osteoclastic cells as observed in the culture of
      osteoblastic cells. These results indicate that both bone formation and bone
      resorption are inhibited by cadmium. The responses of osteoclasts and osteoblasts
      to cadmium in this culture system were the same and the responses of cadmium
      damaged osteoblasts and osteoclasts to zinc were also similar. These results
      suggest that another mechanism by which cadmium could cause bone damage should be
      considered in addition to the specific induction of osteoclastic cells by Cd.

PMID- 8368945
TI  - Enhancement of myelotoxicity induced by repeated irradiation in mice exposed to a
      mixture of groundwater contaminants.
AB  - As part of a program on the toxicology of chemical mixtures at the National
      Institute of Environmental Health Sciences/National Toxicology Program
      (NIEHS/NTP), hematopoietic functions were studied in female B6C3F1 mice treated
      with 0, 1%, and 5% of a chemical mixture stock of 25 groundwater contaminants in
      drinking water for 31.5 weeks. The toxicologic interaction between continuous
      exposure to groundwater contaminants and stress induced by multiple irradiation
      on hematopoiesis was investigated. For those mice receiving both the chemical
      mixture and irradiation, the exposure to the former was continuous throughout the
      31.5-week experimental period, whereas whole body irradiations (4 times at 200
      rads/each) were carried out at 7-week intervals with the first one at 3.5 weeks.
      Myelotoxicity assessment was made by determining the number of granulocyte
      macrophage progenitor cells (CFU-GM) 1 week after each irradiation and also at 6
      weeks following irradiation as a measure of recovery from stress. Non-irradiated
      mice treated with 5% chemical mixture solution showed suppression of CFU-GM after
      15.5 weeks and became progressively more affected (only 70% of controls by 31.5
      weeks of treatment). The population of CFU-GM in mice treated with 5% chemical
      mixture for 4.5 weeks plus irradiation (1 week after first irradiation) was only
      22% of the non-irradiated vehicle control group. This combined (i.e., chemical
      mixture plus irradiation) suppression of CFU-GM intensified after repeated
      irradiation until the number of CFU-GM was only 10.7% following the fourth
      irradiation at 25.5 weeks. Thus, irradiation caused a significant reduction in
      CFU-GMs in all mice but the effects were more pronounced in mice treated with a
      chemical mixture.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368946
TI  - Degradation of methyl and ethyl mercury by singlet oxygen generated from sea
      water exposed to sunlight or ultraviolet light.
AB  - Photodegradation of methyl mercury (MeHg) and ethyl Hg (EtHg) in sea water was
      studied by sunlight or ultraviolet (UV) light exposure, and by determining
      inorganic Hg produced by degradation. Sea water containing 1 microM MeHg or EtHg
      was exposed to sunlight or UV light. N-Acetyl-L-cysteine was added to the
      solution for preventing Hg loss during the light exposure. MeHg and EtHg in sea
      water were degraded by sunlight (> 280 nm), UV light A (320-400 nm) and UV light
      B (280-320 nm), though the amounts of inorganic Hg produced from MeHg were 1/6th
      to 1/12th those from EtHg. Inorganic Hg production was greater with increasing
      concentration of sea water. Degradation of MeHg and EtHg by the UV light A
      exposure was inhibited by singlet oxygen (1O2) trappers such as NaN3, 1,4
      diazabicyclo[2,2,2]octane, histidine, methionine and 2,5-dimethylfuran. On the
      other hand, inhibitors or scavengers of superoxide anion, hydrogen peroxide or
      hydroxyl radical did not inhibit the photodegradation of alkyl Hg. These results
      suggested that 1O2 generated from sea water exposed to sunlight, UV light A or UV
      light B was the reactive oxygen species mainly responsible for the degradation of
      MeHg and EtHg.

PMID- 8368947
TI  - Has reactive oxygen a role in methylglyoxal toxicity? A study on cultured rat
      hepatocytes.
AB  - The toxicity of methylglyoxal and its ability to generate reactive oxygen species
      were investigated in cultured rat hepatocytes. Under aerobic and anaerobic
      conditions methylglyoxal increased lactate dehydrogenase (LDH) release and trypan
      blue uptake in a concentration dependent manner. Those concentrations of
      methylglyoxal causing cell injury (1 mM <) also caused the release of reactive
      oxygen species as indicated by peroxidase-catalyzed luminol chemiluminescence.
      Release of reactive oxygen was detectable only under aerobic conditions, and only
      became significant when a large portion of the cells had already lost their
      viability. It is concluded that methylglyoxal injuries cultured rat hepatocytes
      and induces the generation of reactive oxygen species. The reactive oxygen
      species, however, are essentially not involved in methylglyoxal hepatotoxicity
      but are released by already severely injured cells.

PMID- 8368948
TI  - The use of nipple shields by breastfeeding women.
AB  - The use of nipple shields when breastfeeding has given rise to concerns about
      possible harmful effects. A study was carried out to examine this issue. A
      lactation consultant's (LC) patients using nipple shields were compared with her
      other patients who were not using nipple shields, and an incidental sample of all
      postnatal breastfeeding women. The three groups were compared on discharge from
      hospital and at 3 months. Breastfeeding rates and problems (nipple trauma and
      mastitis) were studied: on discharge from hospital the LC patients who were not
      using nipple shields were significantly less likely to be breastfeeding than
      either of the other two groups. At 3 months, both LC groups were less likely to
      be breastfeeding than the postnatal group; there was no significant differences
      between the women using nipple shields and those who were not. There were no
      significant difference in reported problems in the 3 groups. It is concluded that
      women with breastfeeding problems are more likely to give up breastfeeding than
      those women who do not have major problems, and that the use of nipple shields is
      not a contributing factor and does not appear to compromise lactation.

PMID- 8368949
TI  - Refusal to consent: can it be ignored?
AB  - The common law has long recognised the right of competent adults to autonomy and
      self determination and this has been held to apply to the right to refuse medical
      and surgical treatment even when refusal could lead to severe detriment to the
      individual's life and health. Those who work with patients in a health profession
      can be faced with a refusal to consent to treatment when the best clinical
      opinion is that the treatment is appropriate and necessary, and considered to be
      in the patient's best interests. There have been no clear guidelines which health
      professionals can follow in deciding to treat or not treat in the presence of a
      patient's refusal. Where the patient continues to be competent there is an
      opportunity to take the matter up again with him or her as circumstances change.
      However, when the patient loses competence, a clinical dilemma arises. There are
      documented legal cases in which courts have authorized treatment of competent
      adults even when they have refused or are refusing treatment. Some of these cases
      involve saving the life of an unborn child. The question which arises is whether
      different principles apply when an unborn child is involved. To date most of the
      cases have been heard in North American courts. However, there have been two
      recent cases in England where courts have authorized treatment without consent
      when the subjects have apparently had the capacity to make a decision to refuse
      treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368950
TI  - Site comparisons of dentine collagen cross-links from extracted human teeth.
AB  - Covalent intermolecular cross-links in collagen provide the dentine matrix with
      stability and tensile strength. The density of collagen cross-links varies
      depending on the site within the same tissue. This variation is probably due to
      factors such as the different amounts of stress and different turnover rates at
      the respective sites. The aim was to quantify the collagen cross-links in
      different tooth groups as an adaptation to functional requirements. For this
      purpose, the types and content of major cross-links in dentine collagen of human
      teeth from three different sites were measured and compared: incisors, premolar
      canines and molars. After removal of cementum and pulp, 23 extracted teeth at
      different ages (27-69 yr) were individually pulverized and demineralized with
      EDTA. Collagen was reduced with standardized NaB3H4, hydrolysed, and subjected to
      amino acid and cross-link analyses. Each cross-link was quantified on the basis
      of mole per mole of collagen. The results indicated: (1) all teeth contained
      labile, reducible (dehydro-dihydroxylysinonorleucine and dehydro
      hydroxylysinonorleucine) and stable, non-reducible (pyridinoline and its lysyl
      analogue) cross-links, and (2) the content of both reducible and non-reducible
      cross-links was least in incisors and greatest in molars. This suggests that
      dentine collagen matrix maybe functionally adaptive.

PMID- 8368951
TI  - Survival and neurite formation of mesencephalic trigeminal neurones of the rat in
      vitro.
AB  - In order to study the development and functional properties of single, isolated,
      rat mesencephalic trigeminal neurones, a cell-culture procedure was developed for
      these specific primary sensory neurones. Mesencephalic trigeminal neurones were
      isolated from the brainstem of 16-day-old rat embryos. Various factors thought to
      promote the survival and growth of these neurones in vitro were examined.
      Outgrowth and maintenance of mesencephalic trigeminal neurones in vitro appeared
      to be stimulated by a muscle-derived factor, present in muscle-conditioned medium
      or in muscle extract. Of the neurotrophic factors examined, brain-derived
      neurotrophic factor and neurotrophin-3, but not nerve-growth factor, promoted the
      survival of rat mesencephalic trigeminal neurones. Optimal survival of these
      neurones was found to occur on a monolayer of astrocytes, an effect mediated
      through direct cell-to-cell interactions.

PMID- 8368952
TI  - Evidence for up-regulation of epidermal growth-factor receptors on rat
      periodontal ligament fibroblastic cells associated with stabilization of
      phenotype in vitro.
AB  - This study sought to understand the role of epidermal growth factor receptor (EGF
      R) in periodontal ligament (PDL) fibroblasts. Rat PDL fibroblastic cells and ROS
      17/2.8 cells (highly differentiated osteoblastic osteosarcoma cells) were
      cultured and treated with transforming growth factor-alpha (TGF-alpha), EGF,
      dexamethasone (Dex) or a combination of EGF and Dex. Alkaline phosphatase (ALP)
      activity, an early differentiation marker for mineralized tissue-forming cells,
      was measured using p-nitrophenylphosphate as a substrate. For Scatchard analysis
      of [125I]-EGF binding, cells were incubated in Dulbecco's modified Eagle's medium
      containing 0.2% bovine serum albumin and 0-64 ng/ml of [125I]-EGF for 4 h at 4
      degrees C. Also, the synthesis of EGF-R protein and the expression of mRNA for
      EGF-R were measured by immunoprecipitation and Northern blot analysis,
      respectively. Untreated PDL fibroblastic cells showed a gradual increase in
      spontaneous ALP activity from 32.4 U/10(6) cells at 2 days to 49.6 U/10(6) cells
      at 7 days of culture. ALP activity was further increased to 70.8 U/10(6) cells at
      7 days after treatment with Dex, whereas EGF treatment reduced it to 19.4 U/10(6)
      cells. Culture of PDL fibroblastic cells in the presence of a combination of Dex
      and EGF decreased the Dex-induced ALP activity from 70.8 U to 41.8 U/10(6) cells
      at 7 days. A similar inhibitory effect on ALP activity was found after treatment
      with TGF-alpha. In contrast, ROS cells maintained a high ALP activity (1748
      U/10(6) cells) throughout culture, unaffected by EGF. Scatchard analysis
      demonstrated that PDL fibroblastic cells have both high- and low-affinity forms
      of EGF-R, while ROS cells did not have any detectable EGF-R. Treatment of PDL
      cells with Dex for 2 days decreased the synthesis of EGF-R protein, the
      expression of EGF-R mRNA and the number of EGF-R. In contrast, EGF treatment
      increased the expression of EGF-R mRNA. These data suggest that PDL fibroblastic
      cells express numerous EGF-R, but the number decreases during their
      differentiation into mineralized tissue-forming cells under the influence of Dex.
      Thus, EGF-R may function in the stabilization of phenotype in PDL fibroblastic
      cells.

PMID- 8368953
TI  - Induction of reparative dentine formation in monkeys by recombinant human
      osteogenic protein-1.
AB  - Osteogenic protein-1 (OP-1, BMP-7), a member of the transforming growth factor
      beta supergene family, induces cartilage and bone formation when implanted in
      intra- and extraskeletal sites in vivo. The human OP-1 gene has been cloned and
      biologically active recombinant OP-1 homodimers (hOP-1) produced. The amount of
      bone induced by hOP-1 in vivo is related to the amount of protein implanted.
      Dentine possesses bone morphogenetic protein (BMP) activity. Impure material from
      allogenic bone with BMP activity induced reparative dentine formation in dogs.
      The objective of this study was to determine if the amount of reparative dentine
      stimulated by hOP-1 is related to the amount of protein utilized in direct pulp
      capping experiments. Freshly exposed molar and premolar pulps were treated with
      varying amounts of a complex comprising hOP-1 and a carrier matrix of purified
      bovine type-1 collagen powder (CM) moistened with sterile saline. Reparative
      dentine was present in all hOP-1/CM treated teeth (12 of 15) that remained sealed
      for the 6 weeks' healing. Substantially more new dentine was present in teeth
      treated with hOP-1/CM than in those treated with Ca(OH)2 paste and the amount of
      reparative dentine formed was proportional to the amount of hOP-1/CM (P < 0.05).
      No reparative dentine formed in collagen carrier or untreated teeth. The
      appearances of the new tissue suggested that much of the mass of the hOP-1/CM was
      replaced first by a pulp-like connective tissue, which mineralized to form
      reparative dentine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8368954
TI  - The effects of outward forced convective flow on inward diffusion in human
      dentine in vitro.
AB  - In vitro experiments were conducted to evaluate the influence of outward forced
      convective flow on the inward diffusion of radioactive iodide. When the smear
      layer was present, application of 15 cmH2O (1.47 kPa) outward-directed filtration
      pressure reduced the inward flux of iodide by about 10-20% depending upon the
      hydraulic conductance of each specimen. When the smear layer was removed by acid
      etching, the same 1.47 kPa pressure lowered the inward iodide flux by as much as
      60%, depending on the hydraulic conductance. The results demonstrate the
      importance of the balance between inward diffusion and outward bulk-fluid
      movement on the rate of permeation of exogenous solutes.

PMID- 8368955
TI  - Electromyographic turns analysis of sustained contraction in human masseter
      muscles at various isometric force levels.
AB  - The jaw-closing muscles differ from peripheral limb muscles in that the maximum
      attainable force does not decline following a sustained isometric contraction.
      Also, the averaged electromyographic (EMG)/force ratio in these muscles does not
      change with sustained contraction, whereas it increases in fatiguing limb
      muscles. The present study analysed EMG records from masseters in healthy male
      subjects. No statistically significant difference was seen between average
      rectified EMG signals at the beginning or the end of a sustained isometric
      contraction at 25-100% of maximum voluntary contraction (MVC). However, when the
      number of turns, or reversals of direction, was taken at various percentage MVC
      levels, a significant decrease was seen after 60s or at the end of the
      contraction. The turns/force ratio decreased monotonically with percentage MVC,
      but the ratio was not significantly different at the end of a contraction from
      that at the beginning. This result confirms an earlier suggestion that
      neuromuscular fatigue does not accompany sustained contractions of these muscles.

PMID- 8368956
TI  - The association between chewing efficiency and occlusal contact area in man.
AB  - Chewing is influenced by a number of factors, which include jaw and tongue
      movements, the activity of circumoral muscles, bite force and hard oral surfaces,
      but it is not clear which of these factors is most crucial to efficiency. The
      mere presence of surfaces such as the hard palate, or teeth, does not insure that
      chewing will be efficient. The purpose of this study was to explore the
      relationship between occlusal contact area, and chewing efficiency and to observe
      the influence of chewing-side preference on efficiency. These variables were
      recorded for both left- and right-hand sides, in a sample of 26 normal young
      adults. Chewing efficiency was estimated by the size of food particles collected
      after a predetermined number of chewing strokes. The particles were measured
      using image analysis and the median size calculated. Comparisons were made,
      firstly within subjects, between the left- and right-hand side, and secondly
      between subjects. Correlations were found between chewing efficiency and occlusal
      contact area which were more pronounced within, than between, subjects. It was
      concluded that while occlusal contact area influenced chewing efficiency within
      the same individual, it could not account for the differences in chewing
      efficiency found between individuals. Differences in the movement of the jaw and
      in the bite force may have a greater influence on chewing efficiency than
      occlusal contact area.

PMID- 8368957
TI  - Effect of dietary vitamin E supplementation and rotational stress on alveolar
      bone loss in rice rats.
AB  - The effect of this supplementation on bone loss (distance from the cementum
      enamel junction to the alveolar crest measured at the midline of the lingual
      aspect of each of the mandibular molar roots) was studied in rats that were
      either not stressed or stressed on a rotational device for 90 days. In the first
      study, neither vitamin E nor stress condition had statistically significant
      effects but there was substantial bone loss and bone-loss variability in all
      groups. Before the start of the second study, to reduce differences in bone loss
      that might otherwise exist before introduction of the treatments, rats received
      an antibiotic in their drinking water. In addition, rotational stress was
      introduced more abruptly than in the first study to reduce the likelihood of
      adaptation. Bone loss and bone-loss variability were substantially reduced in the
      second study. Analysis of these data indicated that vitamin E supplementation had
      a statistically significant protective effect, which was most pronounced at sites
      most susceptible to loss. Stressed subjects tended to lose more bone, but this
      effect was not significant. These findings suggest some role for vitamin E
      supplementation in the maintenance of periodontal health but also a sensitivity
      in this effect to initial periodontal status.

PMID- 8368958
TI  - An immunohistochemical study of the effects of fluoride on enamel development in
      the rat incisor.
AB  - A monoclonal antiamelogenin antibody was used to investigate the effects of
      fluoride on enamel development in the rat incisor. The results suggested that
      during secretion the enamel matrix molecules are arranged in such a way as to
      mask the epitope recognized by the monoclonal antibody. However, during the
      transition stage of development as the matrix begins to be degraded the epitope
      becomes exposed and labelling intensity increases to reach a maximum at the end
      of transition/start of maturation. The effect of fluoride is to delay the
      appearance of labelling within the enamel matrix until the end of transition.
      This suggests that the fluoride may inhibit enzymatic degradation or
      disaggregation of the matrix, the resulting residual matrix then inhibiting
      crystal growth.

PMID- 8368959
TI  - Histochemical demonstration of acid phosphatase activity in terminal Schwann
      cells associated with Ruffini endings in the periodontal ligament of rat
      incisors.
AB  - Histochemical staining for acid phosphatase, a marker for lysosomal elements,
      distinguished rounded, intensely reactive cells from less reactive fibroblasts
      and osteoblasts in the lingual periodontal ligament. The highly reactive cells
      were located exclusively in the alveolar half of the ligament. Double staining
      for acid phosphatase and S-100 protein confirmed that these reactive cells were
      identical with the terminal Schwann cells associated with periodontal Ruffini
      endings. Electron microscopically, reaction products for acid phosphatase were
      observed in the lysosomes and Golgi apparatus in the paranuclear cytoplasm of the
      terminal Schwann cells. As the terminal Schwann cells associated with the Ruffini
      endings are assumed to be capable of synthesizing exportable proteins, acid
      phosphatase in this type of cell may be involved in the processing of
      macromolecules in synthetic and/or secretory pathways.

PMID- 8368960
TI  - Histochemical evidence for a cervical plexus contribution to the cat mandibular
      dentition.
AB  - The accessory innervation of the mandibular dentition was examined by use of the
      retrograde transportation of horseradish peroxidase or wheat-germ agglutinin
      horseradish peroxidase. Nerves within the cervical plexus which contained
      transported horseradish peroxidase included the great auricular and transverse
      cervical. Examination of the upper cervical dorsal-root ganglia revealed
      occasional labelled cells within cervical levels C1, C2, and C3 in approx. 55.6%
      of the cases.

PMID- 8368961
TI  - Influence of mastication on saliva, plaque pH and masseter muscle activity in
      man.
AB  - An earlier study showed that frequent gum chewing may enhance parotid gland
      function and reduce the acidogenicity of dental plaque. The aim now was to
      determine whether these effects would be observed after a 2-week period of diet
      altered to increase masticatory effort, and secondarily to assess the effects of
      chewing gum on masseter muscle activity. Ten subjects took part in the first
      experiment. Saliva was collected before and after the diet change and the plaque
      pH response to a sucrose challenge was measured. Subjects completed 3-day diet
      histories and wore electromyographic (EMG) devices to record masseter activity.
      In the second experiment, 10 subjects wore EMG devices for 3 days to record
      masseter activity on three daily regimens: baseline (no gum chewing), hourly gum
      chewing (sugar-free gum chewed for 10 min every hour) and chewing five sticks of
      gum each for 20 min during the day. Data were analysed by paired t test or
      repeated-measures analysis of variance. For the first experiment, EMG data
      indicated significant increases in chewing activity (p < 0.05), although there
      were no changes in salivary flow rates or the plaque pH response to sucrose. The
      second experiment showed that total EMG activity increased significantly on both
      gum-chewing regimens (p < 0.01), the magnitude of the increase being greater for
      hourly chewing. Overall, masseter EMG activity was increased 41% by diet
      alteration, compared to increases of 96 and 152% on the five-stick and hourly gum
      chewing regimens, respectively.

PMID- 8368962
TI  - Fermentation of carbohydrates in different flours by Streptococcus mutans.
AB  - The ability of Streptococcus mutans to ferment carbohydrates and to produce acid
      was investigated in different flours in vitro. The amounts of acid produced
      suggest a possible ecological role of the tested flours in the occurrence of
      Strep. mutans in dental plaque.

PMID- 8368963
TI  - Interactions between denture lining material, protein pellicles and Candida
      albicans.
AB  - The interactions between pellicles derived from saliva, serum, mucin and lysozyme
      deposited on lining material (tissue conditioner) and Candida albicans were
      investigated by monitoring pH changes associated with protein-free and protein
      coated lining material and by ultrastructural observations of yeast colonization.
      No significant differences in pH reduction between culture media in contact with
      the protein-free, control lining materials and those coated with saliva, serum or
      mucin were observed after 120 h of incubation. However, scanning electron
      microscopy revealed that much greater numbers of the yeasts colonized the saliva-
      or serum-coated lining material than the lysozyme-, mucin-coated or control
      material. Hyphal invasion was observed in saliva-coated lining material. These
      results suggested that denture pellicle derived from saliva and/or serum may
      potentiate candidal colonization of denture lining materials.

PMID- 8368964
TI  - Sampling ryegrass to assess the risk of annual ryegrass toxicity.
AB  - Most stock losses caused by annual ryegrass toxicity occur because stockowners
      unknowingly allow their stock to graze annual ryegrass (Lolium rigidum) infected
      with the bacterium Clavibacter toxicus. To help stockowners avoid losses we have
      developed criteria for a testing service to determine the risk of poisoning
      before the pasture is grazed. Low, medium and high risk categories were selected
      using samples of dry, mature ryegrass seedheads collected by stockowners from
      untreated, infected pastures in South Australia. The proportion of toxic paddocks
      in each risk category over all the seasons tested was 11%, 32% and 76%,
      respectively, and these accounted for 7%, 14% and 79% of total stock losses. The
      proportion of paddocks in which stock were poisoned did not vary significantly
      between years, was not affected by variation in sample weight, and did not vary
      between South Australia and Western Australia.

PMID- 8368965
TI  - Use of a modified open patch-graft technique and valvulectomy for correction of
      severe pulmonic stenosis in dogs: eight consecutive cases.
AB  - A modified open patch-graft technique was used to correct congenital pulmonic
      stenosis in 8 dogs. Pulmonary valve dysplasia was moderate to severe in all
      cases, based upon clinical and echocardiographic criteria, and 3 dogs were in
      right-sided congestive heart failure at the time of surgery. Seven of the 8 dogs
      survived the surgery. One surviving dog displayed cerebral cortical dysfunction,
      the remaining 6 had no detectable neurological sequelae. Right ventricular
      failure was alleviated in all 7 surviving dogs, but right ventricular dilatation
      persisted post-operatively. Pulmonary valvulectomy and open patch-grafting
      provides an effective means of alleviating signs of congestive heart failure
      caused by pulmonary valve dysplasia, even in the presence of severe infundibular
      hypertrophy and dynamic outflow obstruction.

PMID- 8368967
TI  - A study of the microbial flora of the anterior vagina of normal sows during
      different stages of the reproductive cycle.
AB  - Sterile guarded swabs were used to sample the anterior vaginal and cervical area
      of 23 normal healthy sows during various stages of the reproductive cycle. The
      samples were collected one week before farrowing, within 24 hours of farrowing,
      weekly up to weaning, at mating and at 2 and 3 weeks after mating, and then
      plated and incubated aerobically and anaerobically. At least one positive sample
      was obtained from each sow and at each stage of the reproductive cycle. Most
      positive samples (78.3%) were obtained on the day of farrowing and the least 3
      weeks after mating (19.0%). The second highest number of positive samples (45.5%)
      was found immediately after mating. Although there was no significant difference
      among sows of different parities, there was a trend for older sows to have more
      positive samples after farrowing (84.6%). There was a greater decrease in
      positive samples after farrowing and after mating among younger sows compared
      with older sows. A wide range of bacteria including aerobic and anaerobic
      species, were recovered from 142 isolates. The more representative bacteria were
      Streptococcus spp (23.2%); Escherichia coli (22.5%); Staphylococcus spp (19.0%)
      and Corynebacterium spp (13.4%). Of the cultures, 54.7% were pure and 45.3% were
      mixed. Both the percentage of bacterial isolates as well as the type of culture
      (pure or mixed) were similar to those frequently reported in clinical cases of
      vulval discharge syndrome. The results indicate that sows usually develop
      infections of the reproductive tract at farrowing and mating but these infections
      do not normally persist.

PMID- 8368966
TI  - The relationship between the prevalence of uterine lesions and the use of
      medroxyprogesterone acetate for canine population control.
AB  - The prevalence of uterine disease was established during desexing of 175 bitches
      in the Torres Strait and Cape York, 42 of which had been treated with injectable
      medroxyprogesterone acetate (MPA) for oestrus postponement. The prevalence of
      uterine lesions was 45% for treated bitches, 5% for untreated bitches, and 14.9%
      for the sample population. A highly significant relationship (P < 0.01) between
      MPA treatment and uterine lesions was established. A significant association (P <
      0.05) between age (> 2 years old) and uterine lesions was found, most likely
      attributable to a significantly higher proportion (P < 0.01) of MPA-treated
      bitches in the older population. There was no significant difference in the
      effect of MPA on the prevalence of uterine lesions between older and younger
      bitches. There was no effect of parity on the prevalence of uterine lesions.

PMID- 8368969
TI  - Mycobacterium bovis infection in a goat.

PMID- 8368968
TI  - Studies on preweaning piglet diarrhoea.
AB  - The aim of this study was to determine the cause and risk factors involved in
      preweaning piglet diarrhoea. Faecal samples from 2380 diarrhoeic piglets, 5 to 30
      days of age, were examined for enteropathogens. Isospora suis oocysts were
      detected in 53.8% of samples, Escherichia coli in 18.2% and rotavirus in 16.9%. I
      suis had the widest distribution, being present on 70.9% of 151 piggeries. The
      onset of diarrhoea occurred mainly between 7 and 14 days (77.5%), peaking at 10
      days. Records of 4086 litters from two intensive piggeries were analysed and
      showed no seasonal variation or effect of sow parity on the incidence of piglet
      diarrhoea. I suis was the most common enteropathogen associated with diarrhoea in
      piglets from 5 days of age until weaning.

PMID- 8368970
TI  - Inhibitory effect of heparin on Rhabdovirus and Bunyavirus isolated from cattle.

PMID- 8368971
TI  - Comparative efficacy of moxidectin, an ivermectin/clorsulon combination and
      closantel against immature paramphistomes in cattle.

PMID- 8368972
TI  - Congenital lymphoedema in a Brahman calf.

PMID- 8368973
TI  - The camel, Camelus dromedarius, as a host of the cattle tick, Boophilus
      microplus.

PMID- 8368974
TI  - Observations on the endo- and ectoparasites affecting dogs and cats in aboriginal
      communities in the north-west of Western Australia.

PMID- 8368975
TI  - Spirurid nematodes in dogs and cats from central Australia.

PMID- 8368976
TI  - A puppy death and Amanita phalloides.

PMID- 8368977
TI  - Correlations between ultrasonography findings and hormonal profiles at oestrus in
      pure Spanish breed mares.

PMID- 8368978
TI  - A survey of Western Australian dogs for Sarcocystis spp and other intestinal
      parasites.

PMID- 8368979
TI  - Import of horses from Europe: an insect-proof container.

PMID- 8368980
TI  - Incidence of cardiac dysrhythmias occurring during centrifuge training.
AB  - High-G training has been reported to provoke dysrhythmias in many subjects. These
      reports have been based on small subject groups. Students attending aeromedical
      professional courses at the USAF School of Aerospace Medicine are offered the
      opportunity to participate in high-G centrifuge training on the Armstrong
      Laboratory centrifuge, during which ECG monitoring is routinely performed. This
      study documents the incidence of dysrhythmias in this large group of subjects.
      The pertinent information from the records of 1,180 training sessions from 1984
      91 were transcribed to a database on a personal computer. Dysrhythmias were
      recorded in 552 (47%) of the training sessions. Ventricular ectopy occurred in
      480 (41%) of the sessions, and supraventricular dysrhythmias appeared in 127
      (11%). In 53 (4.5%) of the sessions, training either was or would have been
      terminated because of the dysrhythmia. Session-terminating dysrhythmias included:
      26 ventricular tachycardias (2.2%), including 18 triplets (1.5%); 9 ventricular
      couplets (0.8%); 8 episodes of too-frequent ventricular premature beats (0.7%); 4
      of supraventricular tachycardia (0.3%), including 2 with aberrant conduction
      (0.2%); 2 of aberrantly conducted beats (0.2%); and 4 of anomalous bradycardia
      (0.3%). Centrifuge training can provoke serious dysrhythmias in ostensibly
      healthy individuals, and ECG monitoring of aircrew undergoing such training is
      recommended for their safety. Because some of these dysrhythmias are
      disqualifying for aircrew duties, the need for a more lenient aeromedical
      disposition policy must be considered.

PMID- 8368981
TI  - Degeneration of cervical intervertebral disks in fighter pilots frequently
      exposed to high +Gz forces.
AB  - This study investigated the occurrence and the degree of cervical disk
      degeneration among senior fighter pilots frequently exposed to high +Gz forces,
      compared with nonexposed controls matched for age and sex. A resistive magnetic
      resonance (MR) scanner operating at 0.1 T was used to image the cervical
      intervertebral disks. Sagittal MR images were obtained and disk degeneration was
      graded 0-6. Both the occurrence and the median degree of disk degeneration were
      greater among the pilots than among the controls. The greatest difference in the
      occurrence of disk degeneration (grades 1-6), which also reached statistical
      significance, was detected for the C3-4 disk: 88% among the fighter pilots and
      64% among the controls, respectively. With respect to the moderate degenerative
      changes (grades 3 and 4) in the C3-4 disk, the difference in the occurrence (88%
      vs. 36%) was again statistically significant. There was no difference between the
      other disks. The median disk degeneration between the groups differed (2.0 vs.
      1.0), the difference being the most remarkable (3.0 vs. 1.0) for the C3-4 disk.
      The differences in the median disk degeneration were also statistically
      significant. These findings suggest that frequent exposure to high +Gz forces may
      cause premature disk degeneration.

PMID- 8368982
TI  - The time-course of alcohol impairment of general aviation pilot performance in a
      Frasca 141 simulator.
AB  - This study examined the time-course of alcohol impairment of general aviation
      pilot simulator performance. We tested 14 young (mean age 25.8 years) and 14
      older (mean age 37.9 years) pilots in a Frasca 141 simulator during alcohol and
      placebo conditions. In the alcohol condition, pilots drank alcohol and were
      tested after reaching 0.10% BAL, and then 2, 4, 8, 24, and 48 h after they had
      stopped drinking. They were tested at the same times in the placebo condition.
      Alcohol impaired overall performance. Alcohol impairment also depended on the
      order in which subjects participated in the alcohol and placebo sessions, with
      larger decrements for the alcohol-placebo order than for the opposite order. To
      examine the influence of alcohol independent of session order effects, we
      compared performance in the first alcohol session with performance in the first
      placebo session. This analysis showed that alcohol significantly reduced mean
      performance in the alcohol condition at 0.10% BAL and at 2 h. In addition,
      alcohol increased variability in performance in the alcohol session from 0.10%
      BAL to 8 h, suggesting that some subjects were more susceptible to alcohol than
      others. Older pilots tended to perform some radio communication tasks less
      accurately than younger pilots.

PMID- 8368983
TI  - Spatial contrast sensitivity through aviator's night vision imaging system.
AB  - Visual acuity is often used to assess vision through image intensifying devices
      such as night vision goggles (NVG's). Fewer attempts have been made to measure
      contrast sensitivity through NVG's. Such information would be useful to better
      understand contrast processing through NVG's under various stimulus conditions.
      In this study, computer-generated letter charts were used to measure contrast
      sensitivity through third generation NVG's for a range of letter sizes. The red
      phosphor of a standard color monitor proved to be an effective stimulus for third
      generation devices. Different night sky conditions were simulated over a 3 log
      unit range. The results illustrate the profile of contrast sensitivity through
      third generation NVG's over a range of night sky conditions. Comparison of
      measurements through NVG's to measurements obtained without the device but at the
      same luminance and color distinguish between effects of luminance and noise on
      contrast sensitivity.

PMID- 8368984
TI  - Some personality and aptitude characteristics of air traffic control specialist
      trainees.
AB  - This study examined the interrelations of personality traits, aptitude test
      scores, and job performance self-expectations as predictors of success in the FAA
      Academy screening program of prospective air traffic controllers. Based on the
      State-Trait Personality Inventory (STPI), men and women Air Traffic Control
      Specialist (ATCS) trainees exhibited less anxiety and anger than normative groups
      of college students and Navy recruits. ATCS pass rates for 1,284 entrants were
      lower within each aptitude test score level for the subjects with anxiety or
      anger scores above the normative levels. Analyses indicated significant
      relationships between self-expectations of future job performance and both
      anxiety and aptitude test scores. Personality factors were found to affect the
      predictive validity of the primary test used for determining a student's aptitude
      for learning air traffic control principles and procedures.

PMID- 8368985
TI  - The effects of Benadryl and Hismanal on mood, physiological measures,
      antihistamine detection, and subjective symptoms.
AB  - The majority of antihistamines have sedative effects; however, it is claimed that
      Hismanal (astemizole) does not possess central nervous system side effects. A
      three-factor, repeated measures, double-blind design was used to compare the
      effects of singl oral doses of 1) Benadryl (diphenhydramine), 50 mg; 2) Hismanal,
      10 mg; and 3) placebo, on two mood scales, physiological measures, sleepiness,
      the ability to detect ingestion of an antihistamine versus placebo, and symptoms
      in 28 healthy men. Higher tension, greater fatigue, and lower activity levels
      were reported post-Benadryl (p < 0.05). Lower vigor-activity and higher confusion
      bewilderment post-Hismanal and Benadryl were noted 1 h postingestion (p < 0.05),
      with confusion being lower and activity higher for Hismanal than for Benadryl (p
      < 0.05). Low vigor-activity, high confusion, and increased sleepiness post
      Benadryl persisted for 3 h, while fatigue-inertia persisted for 7 h (p < 0.05).
      Results suggest that Hismanal is superior to Benadryl for avoidance of subjective
      effects; however, neither antihistamine was entirely devoid of subjective
      effects.

PMID- 8368986
TI  - The effects of Benadryl and Hismanal on psychomotor performance and perceived
      performance.
AB  - Classic antihistamines (H1 antagonists) have sedative effects and can impair
      psychomotor performance. It is claimed that Hismanal (astemizole) does not
      possess central nervous system side effects. A three-factor, repeated measures,
      double-blind design was used to compare the effects of single oral doses of (1)
      Benadryl (diphenhydramine)-50 mg, (2) Hismanal-10 mg, and (3) placebo on a
      battery of 11 cognitive information-processing tasks and performance ratings in
      28 healthy men. Performance decrements were seen at 1 h post-Benadryl ingestion
      on Following Directions (p < 0.05), at 1.5 h on Unstable Tracking (p < 0.05), and
      at 3 h on serial addition/subtraction (p < 0.05). No decrements in performance
      were found post-Hismanal. Subjects perceived their performance as poorer
      following Benadryl ingestion versus placebo and Hismanal for 3 h postingestion (p
      < 0.05). Results demonstrate performance effects post-Benadryl ingestion for 1 h
      longer than previously reported. Tasks which demonstrated sensitivity to
      antihistamines were those which required an element of sustained attention and
      those which required a visual-motor response.

PMID- 8368987
TI  - Prediction of maximal oxygen uptake from submaximal exercise testing in
      aerobically fit and nonfit men.
AB  - Aerobic physical fitness, as determined by the body's maximal capacity to utilize
      oxygen (VO2max) during demanding work, is an important determinant of a person's
      ability to perform many military tasks. The present 2.4 km (1.5 mi) run has not
      proven itself capable of accurately estimating this important factor on a
      periodic basis. This paper reviews prior studies of heart rate response to known
      workloads on a cycle ergometer to estimate VO2max. This submaximal test, as
      revised by scientists at the USAF Armstrong Laboratory at Brooks AFB, TX, was
      validated on 22 male subjects by comparing the test results with laboratory
      measurements of VO2max obtained by analysis of expired air during maximal
      treadmill exercise. Two groups of subjects were selected; one consisting of
      highly trained runners and the other of inactive subjects who did not perform
      regular aerobic exercise. The cycle ergometry prediction underestimated measured
      VO2max by 8.1 ml.kg-1 x min-1 (SEE = 4.25) in all subjects, but there was a
      correlation of 0.95 between the estimated and measured values. Both estimated and
      measured VO2max were significantly higher in the group of trained runners than in
      the inactive subjects.

PMID- 8368988
TI  - Risk assessment and clinical aeromedical decision-making.
AB  - This article presents a format of aeromedical decision-making used in neurology
      cases referred to a U.S. Navy Special Board of Flight Surgeons (SBFS) from 1988
      to 1990. The format consists of a series of questions addressing aeromedical
      concerns, an aeromedical disposition flowchart, and a decision analysis tree.
      Decision Analysis is a tool used in clinical medicine to assist decision-making
      under conditions of uncertainty. The Decision Analysis approach may be applied to
      complex aeromedical disposition questions that face flight surgeons. The concept
      of risk assessment as it applies to decision-making and aeromedical disposition
      is discussed. The outcome of 24 neurology cases referred for aeromedical
      disposition are presented.

PMID- 8368989
TI  - Mortality experience of cockpit crewmembers from Japan Airlines.
AB  - The purpose of this study was to evaluate the long-term mortality and causes of
      death among cockpit crewmembers. A total of 2,327 cockpit crewmembers registered
      at Japan Airlines between August 1, 1952, and December 31, 1988, were traced to
      assess mortality. Medical records were also reviewed. The mortality rates for the
      cockpit crewmembers were compared to those for the general Japanese population
      using standardized mortality ratios (SMR's). As of December 31, 1988, 59 (2.5%)
      of 2,327 individuals were deceased, and the leading causes of death were
      accidents, malignant neoplasms, and cardiovascular diseases. The overall
      mortality rate for the cockpit crew was significantly lower than the national
      standard (SMR = 0.66, p < 0.001; 95% C.I. 0.50-0.85). However, marked differences
      were found in cause-specific mortality, where mortality due to accidents was
      significantly increased (SMR = 2.43, p < 0.001; 95% C.I. 1.63-3.50), while deaths
      from cancer were similar, and those for cerebral vascular accidents (CVA) and
      coronary artery disease (CAD) were lower than comparable rates for the general
      population. We conclude that cockpit crewmembers had a better total mortality
      experience compared to the general Japanese population, except for deaths due to
      accidents.

PMID- 8368990
TI  - Acute hypertensive response to +Gz acceleration in mildly hypertensive pilots.
AB  - Two fighter pilots with mild hypertension and a mildly hypertensive response to
      exercise underwent ambulatory blood pressure monitoring during a routine flight
      that included a brief exposure to +4 Gz stress. They exhibited an acute elevation
      of both systolic and diastolic blood pressures during +4 Gz stress: from 140/90
      and 135/90 mm Hg to 179/139 and 180/140 mm Hg, respectively. Heart rate reached
      182 and 132 beats/min. These responses of hypertensives may reflect exaggerated
      baroreceptor and sympathetic responses which cause a pronounced over-shoot of
      blood pressure. The findings demonstrate the value of 24-h ambulatory blood
      pressure monitoring for documenting episodic elevations of blood pressure that do
      not influence the "normal" average blood pressure, but may nevertheless have
      important clinical implications.

PMID- 8368991
TI  - Fatal mishap report: first SPH-4B flight helmet recovered from a U.S. Army
      helicopter mishap.
AB  - The most common cause of death in helicopter accidents is head injury. Flight
      helmets can be designed to distribute and attenuate crash forces to the head.
      Experience derived from crashes using the U.S. Army SPH-4 flight helmet has led
      to modifications to improve protection. Within the past year, the Army has
      introduced the SPH-4B flight helmet which includes several new features to reduce
      injury in future mishaps. The first SPH-4B flight helmet recovered from a fatal
      mishap is described and correlated with the injuries to the wearer. The new shell
      and liner reduced the impact forces to the head. There were no side impacts to
      determine the performance of the crushable earcups in the helmet. The new SPH-4B
      flight helmet has several new and distinctive features that should improve
      survival in future helicopter crashes. Careful study of life support equipment
      retrieved from crashes is important to understand how the equipment performs in
      the crash environment.

PMID- 8368992
TI  - Monitoring core temperature during exercise: ingestible sensor vs. rectal
      thermistor.
AB  - A telemetry monitoring system using an ingestible temperature sensor has recently
      become available commercially, but to our knowledge no published data on exercise
      applications have been reported. Consequently, core temperature was measured by
      both ingestible capsule sensors and standard rectal thermistors in six trained
      subjects (three cyclists, three runners) during 30 to 90 min of progressive
      cycling or treadmill exercise. Testing was conducted 3-9 h after ingestion of the
      capsule. The telemetered temperature was lower than the rectal temperature both
      at rest and during exercise in every subject, with resulting significant (p <
      0.005) mean differences (+/- S.D.) of 36.91 (+/- 0.41) vs. 37.50 (+/- 0.21) and
      38.01 (+/- 0.33) vs. 38.94 degrees C (+/- 0.24), respectively. The mean
      temperature difference increased by 58% from rest (0.59 degrees C) to peak
      exercise (0.93 degrees C). These preliminary findings demonstrate a consistently
      lower temperature from the capsule sensor located within the GI tract compared to
      rectal thermistors. Replication of these results and investigation into this
      disparity are necessary before these ingestible capsules should be used for
      routine monitoring of core temperature.

PMID- 8368993
TI  - Aerospace Medical Association, Directory issue.

PMID- 8368994
TI  - [Clinical laboratory diagnosis in swine practice].
AB  - Necessity and facilities of clinical laboratory diagnostics in veterinary swine
      practice are discussed. The selection of suitable tests with regard to diagnostic
      relevance and reliability is pointed out. Typical test features (sensitivity and
      specificity) as well as disease dependent parameters (prevalence, positive or
      negative predictive value) are presented and illustrated by means of urinary
      tract infections in sows. It is concluded that a specific selection of tests and
      probands closely related to diagnosis is more successful than the use of
      unspecific multi-analysing procedures (profile tests).

PMID- 8368995
TI  - [The treatment of Eubacterium suis infections in boars].
AB  - The main habitat of Eubacterium suis (E. suis) is the preputial diverticulum of
      male pigs. E. suis can be transmitted from boars to sows at the time of mating,
      and ascending urinary tract infections (cystitis and pyelonephritis) in sows may
      develop. In this paper different methods of treatment were investigated to
      eliminate E. suis from the diverticulum of carrier boars (n = 33). Local therapy
      and feed medication were administered separately or in combination. For local
      instillation into the preputial sac penicillin, penicillin/streptomycin or
      enrofloxacin were used, while medicated feed contained enrofloxacin. None of the
      treatments resulted in boars, which were persistently free from E. suis. Also
      additional hygiene measures as washing of boars and disinfection of pens could
      not improve the results. At the latest 18 days after treatment E. suis could be
      detected again in the preputial diverticulum of all boars. Short duration of
      action of antibiotics in the preputial sac as well as re-colonisation of the
      diverticulum by contaminated pens are discussed. In herds in which urinary tract
      infections are troublesome it is worthwhile using artificial insemination to
      prevent transmission of E. suis to the sow. Treatment of unspecific urinary tract
      infections in sows may be also important, because alterations of bladder mucosa
      due to other bacteria may support the colonisation of E. suis.

PMID- 8368996
TI  - [Prevention of myopathies and cardiomyopathies in swine using magnesium aspartate
      hydrochloride].
AB  - The efficiency of magnesium-aspartate-hydrochloride (MAH) in prophylaxis of
      porcine stress-induced myopathy was investigated. For the examination a conveyor
      belt was used. MAH was administered orally or intramuscularly. Clinical
      investigations, blood specimen collections and ECG were carried out before and
      after running. Stress-induced tachypnoea and tachycardia and hyperthermia were
      reduced after both forms of administration of MAH. The enzyme activity of CK, LDH
      and alpha-HBDH increased slighter after oral and i. m. application. The increase
      of serum glucose concentration as well as serum lactate level were reduced after
      oral and i. m. substitution with MAH. In the ECG apart from the relative
      diastolic period all time values were significantly prolonged after MAH
      substitution. The results indicate that several stress-induced changes of
      clinical and metabolic parameters can be reduced by administration of MAH.

PMID- 8368997
TI  - [New methods of veterinary care for swine herds].
AB  - In hybrid breeding schemes it is important to make sure that no diseases are
      transferred from the multiplier farms to the piglet producers. In the German
      Federal Hybrid Scheme (BHZP) are 280 multiplier farms working with Personal
      Computers with the same software. The software helps the veterinarians in
      analysing health problems in the herds. Some data-evaluations of piglet losses,
      herd performance-traits and causes of sow-losses are shown. Because of the
      identical software in all farms is it possible to work with the same vaccine
      strategy in the whole breeding scheme. The results of the data-evaluations are
      the main basis for the farmer, veterinarian and adviser.

PMID- 8368998
TI  - [Clinical indications of an auxiliary effect of antihistamines (parenteral
      benadryl) in the treatment of RSV infections of cattle].
AB  - The BRSV-infection belongs to the Bovine Respiratory Disease (BRD) complex.
      Because of its clinical features as well as pathomorphological and
      histopathological lesions it can be considered an independent disease. Therefore,
      concepts of treatment deviating from conventional BRD have to be applied. In
      addition to antibiotic therapy, therefore, the effect of treatment with the
      antihistamine Diphenylhydramin (Benadryl-parenteral, Parke Davis) was checked.
      For the evaluation the internal body temperature was used as measure. With the
      additional daily application of the antihistamine to the antibiotic therapy the
      animals were faster without fever. The difference was significant.

PMID- 8368999
TI  - [Hemorrhagic enteropathies in fattening swine].
AB  - It is reported on 34 fattening pigs with hemorrhagic enteropathy or blood in the
      intestine, which were submitted for necropsy to the Veterinary Ambulance
      Schwarzenbek. Only those animals were included in this study, which had lesions
      in the small intestine or small and large intestine. Cases of swine dysentery
      with the lesions being restricted to the large intestine were not considered
      here. No common cause of hemorrhagic enteropathy was found. In four cases there
      was an intestinal torsion. In one animal the blood in the intestine originated
      from a gastric ulcer. On 25 of the 34 pigs further examinations could be done. Of
      those, enteropathogenic E. coli were isolated in 13 cases, with two of the
      animals having a mixed infection of two serotypes each. Cl. perfringens was found
      in two cases and S. hyodysenteriae in four cases. In one pig S. typhimurium was
      isolated from the mesenteric lymph nodes and in one animal the proliferative
      hemorrhagic form of the adenomatosis-complex was diagnosed. Histopathologically
      Campylobacter-like organisms were found in epithelial cells of crypts in the
      small intestine.

PMID- 8369000
TI  - Enantiomeric aspects of the metabolism of mianserin in rats.
AB  - After separate administration of mianserin (CAS 24219-97-4) enantiomers to rats,
      the hydroxy-metabolites of S-mianserin were excreted mainly as conjugates whereas
      the amount of free phenolic metabolites was greater after administration of the R
      enantiomer. The sulphate-conjugate of 8-hydroxy-mianserin was stereoselectively
      found in faeces only after administration of S-mianserin. Based on in vitro
      experiments with sulphatase, the stability of this conjugate towards enzymic
      hydrolysis appears a likely explanation. In vitro experiments with liver
      homogenates of rats revealed little enantioselectivity with respect to oxidative
      metabolism. After prior enzyme induction with phenobarbital, however,
      enantioselectivity with regard to N-oxidation was found. The 3-oxo-mianserin
      metabolite, found in vitro, is most likely the product of a rearrangement of
      mianserin-N-oxide. N-formyl-demethyl-mianserin, identified in vitro, is
      considered to be an artefact.

PMID- 8369001
TI  - Effect of the rice bran-derived phytosterol cycloartenol ferulic acid ester on
      the central nervous system.
AB  - In order to investigate the effect of cycloartenol ferulic acid ester (CFE, CAS
      21238-33-5), a component of gamma-oryzanol which is a phytosterol derived from
      rice bran, on the central nervous system, a variety of pharmacological tests were
      performed. It was shown that CFE had a suppressant effect on the central nervous
      system, but its properties were different from those of existing major and minor
      tranquilizers. In addition, its efficacy in several models of cerebral
      dysfunction was demonstrated. Since any clear effects could not be obtained under
      the treatments with gamma-oryzanol, CFE seems to be more useful than gamma
      oryzanol. Thus the results of this study suggest that CFE may serve as a new
      plant-derived cerebral activator possessing a wide range of pharmacological
      actions.

PMID- 8369002
TI  - In vitro and in vivo electrocardiographic evaluation of the novel calcium
      antagonist monatepil on cardiac conduction system.
AB  - Effects of monatepil ([(+/-)-N-(6,11-dihydrodibenzo[b, e]thiepin-11-yl)-4-(p
      fluorophenyl)-1-piperazinebutyramide]m aleate, AJ-2615, CAS 103377-41-9), a novel
      calcium antagonist, on the cardiac conduction system were compared by
      electrocardiography with those of the existing calcium antagonists (diltiazem,
      verapamil and nifedipine) in isolated rabbit heart preparations in vitro and in
      anesthetized and conscious dogs in vivo. Monatepil (10(-7) mol/l) prolonged the
      atrio-His bundle conduction time (AH interval) in the Langendorff perfused rabbit
      heart, like diltiazem, verapamil and nifedipine. This prolongation was decreased
      to 1/10 in the presence of 3.6% bovine serum albumin. In anesthetized dogs,
      monatepil (0.1-1.0 mg/kg i.v.), unlike diltiazem and verapamil, did not prolong
      AH interval. In conscious dogs, monatepil even at 100 mg/kg p.o. did not affect
      electrocardiograms. At the high dose of 300 mg/kg p.o., only a slight
      prolongation of the QT interval was found, but the QTc interval was not affected.
      Diltiazem at 10 mg/kg p.o. caused a prolongation of the PR interval and a
      disappearance of QRS waves. In conscious renal hypertensive dogs, repeated
      administration of monatepil (10 mg/kg/d p.o. for 29 days) had little effect on
      the conduction system of the heart examined by electrocardiograms, albeit a
      persistent fall in blood pressure continued throughout the administration period.
      The above results suggest that monatepil is a highly safe drug in the treatment
      of hypertension.

PMID- 8369003
TI  - General toxicity of the new calcium antagonist felodipine in dogs.
AB  - Felodipine 4-(2,3-dichlorophenyl)-1,4-dihydropyridine-2,6-dimethyl-3,5-
      dicarboxylic 3-ethyl ester and 5-methyl ester, CAS 72509-76-3) is a new selective
      calcium antagonist for use in the management of hypertension or other
      cardiovascular disease, which requires reduction of peripheral vascular
      resistance. A combined 6- and 12-month study in dogs has been performed as a part
      of the preclinical safety program. 30 dogs, 5 males and 5 females per group, were
      treated with felodipine for 12 months. Additional 18 dogs, 3 males and 3 females
      per group, were interim-sacrificed after 6-month treatment. The dose levels were
      2 x 0.38, 2 x 1.2 and 2 x 2.3 mg/kg daily. Initially, 2 x 3.8 mg/kg/d was used as
      a high dose. At this dose level 2 animals died preterminally after 4 days of
      dosing. They were replaced and the high dose level was reduced. Two similar
      control groups were given a placebo formulation for 12 and 6 months,
      respectively. All animals were treated b.i.d. using a 4-h time interval. Mucosal
      hyperemia and tachycardia, as an expression of the vasodilating properties of
      felodipine, were observed in a somewhat variable but dose-related manner.
      Noninflammatory gingival hyperplasia, similar to that after treatment with
      phenytoin and the calcium antagonist nifedipine, occurred with a propensity for
      the males after 12 months of treatment. Slight-degree gingival hyperplasia was
      also noted after 6 months of treatment. This change occurred dose- and time
      related in the medium and high dose groups but was absent in the low dose
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369004
TI  - Steady state kinetics of a fatty alcohol-based slow-release nifedipine for once a
      day application.
AB  - The linearity of the relationship between dose and plasma concentration of
      nifedipine has been investigated in healthy male and female subjects under steady
      state conditions following application of a fatty alcohol matrix slow release
      nifedipine (Aprical long, CAS 21829-25-4) formulation at a dose rate of 60, 90
      and 120 mg once daily. Plasma concentrations showed a broad plateau associated
      with mean residence times exceeding 20 h. On Day 4 mean pre-dose nifedipine
      concentrations were 20.5, 24.9, 31.8 ng/ml and Cmax values were 42.3, 51.7 and
      93.9 ng/ml for the 60, 90 and 120 mg dose, respectively (n = 15). After dose
      normalisation there was no significant difference (Wilcoxon matched pair test) in
      the mean AUCs. Adverse reactions, mainly headache and flushes, were observed at
      all dose levels but the frequency was not dose-dependent. In view of the
      demonstrated proportionality between dose and AUC and the long duration of the
      plateau plasma concentrations it is concluded that this slow release formulation
      is suitable for once daily administration at dose rates up to 120 mg daily.

PMID- 8369005
TI  - Evaluation of pharmacokinetics, bioavailability and dose linearity of diltiazem
      in healthy volunteers.
AB  - The objective of this randomized five-way cross-over study with healthy male
      volunteers was to determine, one the one hand, the bioavailability and main
      pharmacokinetic parameters of 4 sustained release diltiazem (Surecaps, CAS 42399
      41-7) test preparations with ascending doses (180, 240, 300, 360 mg),
      administered as single application, versus an immediate release 60 mg diltiazem
      reference preparation, which was given thrice a day at 8-h intervals. On the
      other hand, the study also allowed the evaluation of a possible dose linearity of
      the test substance diltiazem. Plasma concentrations of diltiazem and its major
      metabolite desacetyl-diltiazem were measured by high pressure liquid
      chromatography (HPLC) up to 48 h after single dosing of the sustained release
      preparations as well as after repeated doses of the immediate release
      formulation. The undesired side effects/concomitant symptoms observed are known
      to occur after diltiazem administration. For the area under the curve, e.g.
      calculated from time 0 to the last quantifiable sample (AUC0-Tlast), the study
      revealed for the parent compound diltiazem mean values of 926.2, 1602.4, 1873.2
      and 2415.7 h.ng/ml after administration of the 4 sustained release test
      preparations, respectively; for the immediate release reference preparation the
      value was 1007.2 h.ng/ml. Concerning the main metabolite desacetyl-diltiazem the
      corresponding values for the 4 sustained release formulations were 138.6, 236.9,
      280.2 and 345.6 h.ng/ml, respectively. The corresponding value for the
      immediately release formulation was 127.5 h.ng/ml. Concerning a possible dose
      linearity of diltiazem, statistical analysis revealed a convincing linear
      relationship between at least 3 of the 4 sustained release preparations,
      therefore linearity may be assumed between 240 and 360 mg.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8369006
TI  - Pharmacokinetics of glycerol administered orally in healthy volunteers.
AB  - Of the three standard osmotherapeutics glycerol, mannitol and sorbitol, glycerol
      (CAS 56-81-5) alone can be applied orally. As only limited pharmacokinetic data
      after oral administration are available, studies were performed in 10 healthy
      subjects (2 female, 8 male, body weight 58-90 kg, age 23-47 years). After 12 h of
      fasting the subjects drank a single dose of 1.2 g/kg glycerol (Glycerol 85% DAB
      9, flavoured with lemon juice). For the first 90 min venous blood was sampled
      every 15 min, for the following 6.5 h every 30 min. Glycerol serum concentrations
      were determined by an enzymatic procedure. Intestinal absorption was rapid.
      Maximum glycerol serum levels ranging from 1285-2238 mg/l (median = 1770 mg/l)
      were observed 1-2 h after ingestion. On the assumption of full intestinal
      absorption total body clearance was 0.18-0.26 l/h.kg, and the apparent volume of
      distribution 0.18-0.34 l/kg. The terminal elimination half-life ranged from 0.61
      1.18 h. The concentration-time curves were not adequately described by linear
      pharmacokinetic models. In all subjects glycerol serum concentrations were high
      enough to induce increases of serum osmolality of at least 10 mosmol/kg. No signs
      of haemolysis or haemodilution were observed.

PMID- 8369007
TI  - Effect of a protein-free dialysate from calf blood on human monocyte
      differentiation in vitro.
AB  - Solcoseryl is a protein-free, standardized dialysate/ultrafiltrate derived from
      calf blood, which has been shown to improve situations of impaired healing in
      both experimental animals and man. Its activity seems to be multifactorial
      although the precise cellular and molecular mechanisms contributing to its effect
      have not been fully elucidated. Since monocyte-derived macrophages play a central
      role in inflammation and particularly in wound healing and tissue remodelling,
      the effect of the dialysate on human monocytes cultured in vitro for 10 days in
      the presence of human serum was studied. The results show that the drug, at
      concentrations ranging from 0.2 to 2%, increases the cell density of the cultures
      and the cell protein content, and favours the differentiation of monocytes into
      macrophages when 1% serum concentration is used in the culture medium. These
      effects are no more apparent when the serum concentration was raised to 10%.
      These data suggest that the drug may substitute, at least in part, for serum in
      monocyte-macrophage cultures. The observed effects give a sound basis for at
      least a partial explanation of the therapeutic effects of the drug, particularly
      at sites where the supply of serum-derived factors is limited.

PMID- 8369008
TI  - [Vitex agnus castus extract in the treatment of luteal phase defects due to
      latent hyperprolactinemia. Results of a randomized placebo-controlled double
      blind study].
AB  - The efficacy of a Vitex agnus castus preparation (Strotan capsules) was
      investigated in a randomized double blind study vs. placebo. This clinical study
      involved 52 women with luteal phase defects due to latent hyperprolactinaemia.
      The daily dose was one capsule (20 mg) Vitex agnus castus preparation and
      placebo, respectively. Aim of the study was to prove whether the elevated
      pituitary prolactin reserve can be reduced and deficits in luteal phase length
      and luteal phase progesterone synthesis be normalized. Blood for hormonal
      analysis was taken at days 5-8 and day 20 of the menstrual cycle before and after
      three month of therapy. Latent hyperprolactinaemia was analysed by monitoring the
      prolactin release 15 and 30 min after i.v. injection of 200 micrograms TRH. 37
      complete case reports (placebo: n = 20, verum: n = 17) after 3 month of therapy
      were statistically evaluated. The prolactin release was reduced after 3 months,
      shortened luteal phases were normalised and deficits in the luteal progesterone
      synthesis were eliminated. These changes were significant and occurred only in
      the verum group. All other hormonal parameters did not change with the exception
      of 17 beta-estradiol which rouse up in the luteal phase in patients receiving
      verum. Side effects were not seen, two women treated with the Vitex agnus castus
      preparation got pregnant. The tested preparation is thought to be an efficient
      medication in the treatment of luteal phase defects due to latent
      hyperprolactinaemia.

PMID- 8369009
TI  - Synthesis and pharmacological evaluation of a novel series of alpha-picolinium
      hydrazone analogues with anticipated antidiabetic activity.
AB  - A new series of substituted alpha-picolinium p-dimethylaminobenzalhydrazine
      derivatives and their o-hydroxy analogues has been prepared for evaluation of
      their efficacy as potential hypoglycemic agents. The synthesis was achieved by
      condensation of N-amino-alpha-picolinium perchlorate derivatives with the
      corresponding aromatic aldehydes. The structure of the synthesized products was
      inferred from elemental and spectral data. The hypoglycemic effect, antimicrobial
      activity and toxicity of the hitherto and possibly new chemotherapeutic agents
      were evaluated. Based on screening data, a possible structure-activity
      relationship has been discussed.

PMID- 8369010
TI  - [Pharmacokinetics and relative bioavailability of iron and folic acid in healthy
      volunteers].
AB  - The pharmacokinetics and the relative bioavailability of iron and of folic acid
      was investigated in a randomized, balanced 2-way cross-over study with 14 healthy
      male participants. The drugs were given in a combined preparation dragee (Ferro
      Folsan) containing 100 mg of ferrous-II-sulfate x 1.5 H2O (CAS 13463-43-9) and
      0.85 mg of folic acid (CAS 59-30-3). Other established preparations were used as
      reference drugs. All subjects had a normal iron body level and were brought to a
      saturated folic acid level prior to the investigation. After administration of 2
      dragees of the test medication and determination of serum iron level until 9 h
      p.a., a relative bioavailability of 64%, compared to an equal dose of a ferrous
      II-sulfate-ascorbic acid reference solution, was calculated. From the serum
      folate AUC (0-9 h) the relative bioavailability was evaluated with 97% for the
      oral formulation compared to the i.m. administration. The ratio of the cumulative
      renal folate excretion in the 0-9 h interval amounted to 76% for the oral
      compared to the i.m. administration. However, in order to understand this
      differing result it should be kept in mind that during the first hours following
      parenteral administration a greater amount of the unchanged compound is renally
      excreted than after oral dosing. This is presumably based upon the different rate
      of absorption following both administrations with a steeper absorption phase
      following the parenteral dose.

PMID- 8369011
TI  - Investigations of indomethacin-induced gastric ulcer in rats.
AB  - The pathogenesis of non-steroidal anti-inflammatory drugs (NSAIDs)-induced
      ulceration is still not completely understood, but it is possible that these
      effects are associated with a cytoprotective prostaglandin deficiency. Visible
      marks of gastric mucosa erosions induced by 25 mg/kg indomethacin in rats were
      determined parallel with the changes of PGE2, PGI2, TxA2 and leukotrienes content
      in gastric mucosa at various intervals. Beside the decreased level of the so
      called cytoprotective prostaglandins caused by the inhibition of cyclooxygenase
      enzyme an overproduction of 5-lipoxygenase products (leukotrienes) was also
      found. To investigate the hypothesis that the gastric damage caused by NSAIDs is
      due not only to the decreased level of cyclooxygenase products but to the
      increased level of lipoxygenase products as well, different lipoxygenase
      inhibitors and leukotriene antagonists were tested. A lipoxygenase inhibitor and
      the structurally similar phenidone inhibited the ulcerogenic effect of
      indomethacin at the same high dose range. The selective lipoxygenase inhibitor
      nordihydroquaiaretic acid and dual inhibitors can reduce the severity of ulcer
      formation in lower concentrations as well. The first specific antagonist of SRS-A
      and a potent and selective antagonist of LTD4 produced a significant
      gastroprotective effect at i.p. treatment only at high doses. All of these
      results suggest that an overproduction of leukotrienes and other lipoxygenase
      products, following cyclooxygenase blockade induced by NSAIDs, may play a role in
      the development of gastric mucosal damage.

PMID- 8369012
TI  - Influence of ofloxacin on chloroplasts and mitochondria in Euglena gracilis.
AB  - Ofloxacin (CAS 83380-47-6), a representative of new quinolones, which exerts
      inhibitory activity against DNA gyrase in bacteria, damages both semiautonomous
      organelles in Euglena gracilis: chloroplasts and partly mitochondria. The action
      of ofloxacin on these organelles was analysed by transmission electron
      microscopy. The first symptoms of ofloxacin treatment were mass aberrations of
      chloroplasts with subsequent diluting out of these pathological organelles from
      the cells, so giving rise to the heterotrophic mutants. The loss of chloroplasts
      is hereditary. Changes in ultrastructure of mitochondria were observed too. Cup
      like (in sections ring-like) mitochondria represented the most frequent
      abnormalities of these organelles induced by the drug. After repeated
      subcultivations on ofloxacin-free media the number of damaged mitochondria
      gradually decreased to the normal.

PMID- 8369013
TI  - Effects of the combination of ketoconazole and calcium channel antagonists
      against Candida albicans in vitro.
AB  - Susceptibility of 66 strains of Candida albicans from patients were tested
      against ketoconazole (Ktz, CAS 65277-42-1), cinnarizine (Cin), verapamil (Ver),
      nifedipine (Nif), nimodipine (Nim) and the combination of Ktz with these calcium
      channel antagonists, using Sabouraud's broth. Minimal inhibitory concentrations
      (MICs) determined on diagnostic plates gave values of Ktz: 34.5 +/- 3.9
      micrograms/ml, Cin 413 +/- 11.3 micrograms/ml, Ver 334 +/- 11.4 micrograms/ml,
      Nif 374 +/- 19.3 micrograms/ml and Nim 486 +/- 20 micrograms/ml. The combination
      of Ktz and calcium channel antagonists in various ratios (1 : 1, 1 : 2, 2 : 1)
      was found to exert synergistic effect and the mean values of the combinations
      were: Ktz+Cin 6.52 +/- 1.67, 6.4 +/- 1.71, 6.06 +/- 1.7 micrograms/ml: Ktz+Ver
      11.13 +/- 2.13, 11.63 +/- 2.22, 10.6 +/- 2.1 micrograms/ml: Ktz+Nif 7.37 +/- 1.6,
      7.7 +/- 1.57, 7.4 +/- 1.75 micrograms/ml: Ktz+Nim 10.1 +/- 2.28, 10.6 +/- 2.31,
      9.91 +/- 2.21 micrograms/ml. These results were significantly different (p <
      0.001) compared with ketoconazole. Our findings indicate that some calcium
      channel antagonists increase the antifungal activity of Ktz against C. albicans
      in vitro.

PMID- 8369014
TI  - Permeation mechanisms through artificial lipoidal membranes and effects of
      synthetic surfactants on xenobiotic permeability.
AB  - Through the use of permeation/lipophilicity correlations, the mechanisms of
      permeation of selected test compounds across artificial lipoidal membranes of the
      polysiloxane type, in the absence and in the presence of a nonionic surfactant
      (Polysorbate 80), are investigated, in order to design "in vitro" conditions and
      features suitable for reproducing "in vivo" intestinal absorption tests, as well
      as to validate some conclusions arising from "in situ" rat gut experiments about
      the effects of the synthetic surfactants on drug and xenobiotic absorption
      processes. Six 4-alkylanilines showing a perfect homology were used as test
      compounds. The reported results clearly show that the in situ biophysical
      absorption (diffusion) models are completely reproduced by in vitro tests,
      provided that perfect sink conditions are achieved. Further selection of
      artificial membrane polarity should be necessary, however, in order to exactly
      equalize in vitro and in situ permeation rates. As far as the synthetic
      surfactant action on permeability is concerned, our conclusions are similar to
      those drawn from in situ studies, except that the effect of the surfactant on
      membrane polarity is much smaller and the micelle-solubilizing effect somewhat
      larger. The disruption of the aqueous stagnant diffusion layers adjacent to the
      membranes by the surfactant has been conclusively demonstrated. A clear first
      element deviation for aniline, which prevents its inclusion as a term of the
      tested series, has been observed; this feature should be borne in mind whenever
      any in vivo/in vitro correlation has to be established.

PMID- 8369015
TI  - [The effect of mistletoe lectins on the limulus amebocyte lysate test].
AB  - Former reports about too high and from batch to batch changing endotoxin contents
      in mistletoe preparations and phytopharmaceuticals for parenteral administration
      correlated with clinically observed side effects led to investigations of the
      endotoxin content of ABNOBA-viscum. For that purpose the endotoxin levels of the
      raw materials, the equipment and the production steps were observed by using the
      limulus amebocyte lysate (LAL) test. The mean value found in the preparation
      containing the highest available concentration (dilution level 2 containing 15 mg
      of plant extract from 20 mg of fresh mistletoe in 1 ml) came to 66.7 endotoxin
      units (EU) per ml, corresponding to about one fifth of the commonly accepted
      limit value of 350 EU/ml, the human pyrogenic dose. Depending on their dilution
      level, lower concentrated preparations led also to lower LAL test results. It
      could be proved that lectins contained in mistletoe preparations cause false
      positive LAL tests. Such results implicate false too high contents of endotoxin.
      Different lysates, i.e. Limusate, Pyrogel, Pyrogent, and Pyroquant showed
      approximately the same results. Microbiological and LAL test results indicate
      that only 10% of the total amount of the LAL test result was caused by
      endotoxins. So it is necessary to form a new estimation of the former results of
      determination of the endotoxin content of mistletoe preparations.

PMID- 8369017
TI  - Patient mix and utilization of resources.

PMID- 8369016
TI  - Effects of macrophage colony-stimulating factor on the proliferation and the
      function of Kupffer cells.
AB  - Using flow cytometric methods, the influence of recombinant human macrophage
      colony-stimulating factor (rhM-CSF) on DNA synthesis, the phagocytosis of
      microspheres and the uptake of lipopolysaccharide (LPS) in cultured rat Kupffer
      cells was investigated. Incubation with 10(3) U/ml of rhM-CSF did not increase
      the S-phase population of Kupffer cells, however, 10(5) U/ml of M-CSF
      significantly increased that population from 6.26 +/- 0.68% to 8.31 +/- 0.99%.
      Significantly increased rate of cells phagocytosing microspheres was provoked by
      rhM-CSF at concentration higher than 10(3) U/ml. Uptake indexes at concentrations
      of 10(3), 10(4), 10(5), and 10(6) U/ml of rhM-CSF were 114.2 +/- 7.7, 116.5 +/-
      8.7, 117.5 +/- 9.1, and 120.0 +/- 11.5, respectively. Significantly increased
      rate of cells stained with fluorescent LPS was provoked by rhM-CSF at
      concentrations higher than 10(5) U/ml. Uptake indexes at concentrations of 10(5)
      and 10(6) U/ml were 115.2 +/- 6.4 and 118.0 +/- 4.3, respectively. These results
      indicate that M-CSF has a potency to stimulate DNA synthesis, phagocytic
      activity, and LPS uptake of mature Kupffer cells in vitro. This potency may be
      helpful to the enhancement or the recovery of the role of Kupffer cells, which is
      a part of the host defense mechanism, in diseased states.

PMID- 8369018
TI  - Autologous pericardial flap for prevention of reentry injury in cardiac
      reoperations.
AB  - Cardiac injury during sternal reentry to the heart is a rare but dangerous
      complication of cardiac reoperations. Positioning a pericardial flap between the
      heart and sternum at the time of the initial operation may consistently
      facilitate cardiac reoperation by providing a reliable plane of dissection and by
      reducing adhesion formation.

PMID- 8369019
TI  - Diagnosis of pathogenic Entamoeba histolytica infection using a stool ELISA based
      on monoclonal antibodies to the galactose-specific adhesin.
AB  - Monoclonal antibodies (MAbs) directed against pathogen-specific epitopes of the
      galactose adhesin of Entamoeba histolytica were used in an ELISA to detect
      antigen from pathogenic E. histolytica. Single stool specimens from 74 patients
      in Bangladesh were used. The ELISA for pathogenic E. histolytica was positive in
      all 12 stool specimens with pathogenic amebae subsequently cultured, in no stool
      specimens with nonpathogenic E. histolytica and in 2 of 40 stools with other or
      no intestinal parasites detected. Specificity and sensitivity of the assay for
      pathogenic E. histolytica were 97% and 100%, respectively. These preliminary data
      offer promise for an ELISA using MAbs to the galactose adhesin as a rapid and
      sensitive means to detect the presence of pathogenic E. histolytica infection in
      stool specimens.

PMID- 8369020
TI  - Limits of technology.

PMID- 8369021
TI  - Transverse carpal ligament reconstruction for carpal tunnel syndrome.

PMID- 8369022
TI  - Dental enamel growth.

PMID- 8369023
TI  - The supply of rural physicians.

PMID- 8369024
TI  - The supply of rural physicians.

PMID- 8369025
TI  - Re: 'The role of nursing research committees'.

PMID- 8369026
TI  - Renal function during infrarenal aortic surgery.

PMID- 8369027
TI  - What do electrocardiographic and echocardiographic changes during cesarean
      delivery mean?

PMID- 8369028
TI  - Searching for inaccuracy in clinical laboratory testing using Medicare data.
      Evidence for prothrombin time.
AB  - OBJECTIVE: To determine if the occurrence of health outcomes following clinical
      laboratory testing can be used to identify types of laboratories that may be
      having higher than expected error rates. DESIGN: Retrospective analysis of
      Medicare Part B outpatient claims, Part A hospitalization bills, and death
      records using a case-control study. SETTING: Medicare records from six carrier
      territories were sampled during the period 1985 through 1987. PATIENTS: A total
      of 14,755 Medicare patients receiving a prothrombin time test in either a
      physician office laboratory or a commercial laboratory. OUTCOME MEASURES:
      Occurrence of a hospitalization for stroke or acute myocardial infarction, death,
      or no adverse outcome within 6 days of a prothrombin time. RESULTS: In physician
      office laboratories where prothrombin time test volume is below 40 per month, the
      odds that a tested patient will experience a stroke or an acute myocardial
      infarction are up to 1.96 and 3.43 times greater, respectively, than for a
      similar patient tested in a commercial laboratory. Switching from one laboratory
      to another between successive prothrombin time tests increased the odds of a
      stroke or an acute myocardial infarction by 1.57 and 1.32, respectively. Patients
      in two states with strong laboratory regulatory programs had fewer adverse
      outcomes. CONCLUSION: Examining patient outcomes subsequent to clinical
      laboratory testing may be a useful tool for clinical laboratory quality
      assurance.

PMID- 8369029
TI  - Magnetic resonance imaging (2)

PMID- 8369030
TI  - Stretcher's scrotum.

PMID- 8369031
TI  - Caesarean section for the pre-eclamptic.

PMID- 8369032
TI  - Pesticides and food.

PMID- 8369034
TI  - The cardiac risks of noncardiac surgery.

PMID- 8369033
TI  - Hypoxaemia in young Kenyan children with acute lower respiratory infection.
AB  - OBJECTIVES: To determine the prevalence, clinical correlates, and outcome of
      hypoxaemia in acutely ill children with respiratory symptoms. DESIGN: Prospective
      observational study. SETTING: Paediatric casualty ward of a referral hospital at
      1670 m altitude in Nairobi, Kenya. SUBJECTS: 256 Infants and children under 3
      years of age with symptoms of respiratory infection. MAIN OUTCOME MEASURES:
      Prevalence of hypoxaemia, defined as arterial oxygen saturation < 90% determined
      by pulse oximetry, and condition of patient on the fifth day after admission.
      RESULTS: Over half (151) of the children were hypoxaemic, and short term
      mortality was 4.3 times greater in these children. In contrast, the relative risk
      of a fatal outcome in children with radiographic pneumonia was only 1.03 times
      that of children without radiographic pneumonia. A logistic regression model
      showed that in 3-11 month old infants a respiratory rate > or = 70/min, grunting,
      and retractions were the best independent clinical signs for the prediction of
      hypoxaemia. In the older children a respiratory rate of > or = 60/min was the
      single best clinical predictor of hypoxaemia. The presence of hypoxaemia
      predicted radiographic pneumonia with a sensitivity of 71% and specificity of
      55%. CONCLUSIONS: Over half the children presenting to this referral hospital
      with respiratory symptoms were hypoxaemic. A group of specific clinical signs
      seem useful in predicting hypoxaemia. The clear association of hypoxaemia with
      mortality suggests that the detection and effective treatment of hypoxaemia are
      important aspects of the clinical management of acute infections of the lower
      respiratory tract in children in hospital in developing regions.

PMID- 8369035
TI  - Central nervous system toxoplasmosis in AIDS.

PMID- 8369036
TI  - Dropped head syndrome.

PMID- 8369037
TI  - Air reduction of an intussusception caused by a pathologic leadpoint in an
      infant.

PMID- 8369038
TI  - Cost-effective treatment of Candida esophagitis.

PMID- 8369039
TI  - Primary structure of the elongation factor 1 alpha in Sulfolobus solfataricus.

PMID- 8369040
TI  - Chelation treatment of neurological Wilson's disease.
AB  - The results of chelation treatment of 137 patients presenting with neurological
      Wilson's disease are described, together with the more commonly observed toxic
      reactions to the various drugs employed. Fifty-seven patients made an excellent
      response to treatment and became symptom free. Thirty-six patients made a good
      recovery, but were left with some minor neurological deficit. Twenty-four
      patients had a poor response: although the disease process was arrested they were
      left more or less disabled. Twenty patients died: nine had little or no
      treatment, but 11 died despite apparently adequate chelation therapy. There was
      no obvious reason for this failure. The liver copper level was estimated in six
      of these patients: it was still significantly elevated in only one, but in all
      four in whom it was possible to make the determination, the concentration of
      copper in the basal ganglia was in excess of 45 micrograms/g wet weight. It was
      not apparent why adequate therapy failed to remove copper from the brains of
      these patients. There was no obvious clinical, histological or biochemical
      indicator of failure to respond to treatment. Initial deterioration before
      improvement was seen in 30 patients: the prognosis for a useful recovery was not
      necessarily worse than that in patients who did not show this phenomenon.

PMID- 8369041
TI  - Six authors in search of a citation: villains or victims of the Vancouver
      convention?
AB  - OBJECTIVES: To analyse trends in the number of authors per article over the past
      10 years. DESIGN: Analysis of articles from random volumes of eight biomedical
      journals. SUBJECTS: Cell, Nature, Proceedings of the National Academy of Sciences
      USA (PNAS), Journal of Clinical Investigation (JCI), Biochemical and Biophysical
      Research Communications (BBRC), Journal of Clinical Oncology (JCO), New England
      Journal of Medicine (NEJM), Lancet. MAIN OUTCOME MEASURES: Median and modal
      numbers of authors. RESULTS: All journals except Cell and Nature showed a trend
      towards increasing authorship numbers over the study period. The trend was most
      noticeable in journals such as JCO which feature clinical research. General
      medical journals (Lancet, NEJM) with a median of six to seven authors per article
      published far fewer seven author than six author studies, which suggests that
      author number may be influenced by the Vancouver convention which precludes
      citation of more than six authors. CONCLUSIONS: The phenomenon of expanding
      authorship in biomedical journal articles is not explained by the hypothesis that
      newer research technologies have necessitated more extensive collaboration.
      Rather, the data suggest that conferral of authorship may sometimes have a
      volitional component which contributes to rising author numbers. It is proposed
      that replacement of the Vancouver convention with a "first author, last author"
      citation system may help stem this rise in author numbers.

PMID- 8369042
TI  - Screening for ovarian cancer.

PMID- 8369043
TI  - Positional asphyxia during law enforcement transport.

PMID- 8369044
TI  - [Dementia in the elderly. Will we think in AIDS].

PMID- 8369045
TI  - Is it necessary to perform appendicectomy in the middle of the night in children?

PMID- 8369046
TI  - Mycobacteria and sarcoidosis. Mycobacterium tuberculosis an unlikely culprit.

PMID- 8369047
TI  - Power and gender.

PMID- 8369048
TI  - Choosing an index for abdominal obesity: an opportunity for epidemiologic
      clarification.
AB  - Despite numerous reports that abdominal obesity is related to disease risk, the
      study of body-fat distribution remains a largely empirical science. Elucidation
      of the pathophysiologic linkage between abdominal obesity and disease would be
      better served by generating hypotheses and testing them--the process of deductive
      science. Physiologists have proposed that adipose tissue of the intra-abdominal
      compartment (that drained by the portal vein) contributes strongly to
      atherosclerosis. If this is so, then the volume of the intra-abdominal fat depot
      might be better correlated with disease states than a less specific
      anthropometric index such as the waist-to-hip girth ratio. Alternative abdominal
      obesity indices (e.g. sagittal abdominal diameter divided by thigh girth) could
      be tested in epidemiologic studies to improve our pathophysiologic understanding
      of how body-fat distribution is related to atherosclerosis and other diseases.

PMID- 8369049
TI  - Gauging the accuracy of laboratory testing from Medicare data.

PMID- 8369050
TI  - Vitiligo, autoimmune disease and melanoma.

PMID- 8369051
TI  - Cyanocobalamin--a case for withdrawal.

PMID- 8369052
TI  - Diagnosis of cough variant asthma.

PMID- 8369053
TI  - Carbamazepine for paroxysmal dystonia due to spinal cord lesions.

PMID- 8369054
TI  - Directly observed treatment of tuberculosis.

PMID- 8369055
TI  - Superfund and public health policies: an ATSDR response.

PMID- 8369056
TI  - The need for asylum.

PMID- 8369057
TI  - Systematic serologic screening for toxoplasmosis in pregnancy.

PMID- 8369058
TI  - Long term care of elderly people. Different balance of provision in Scotland.

PMID- 8369059
TI  - Dural puncture. Elective forceps delivery not indicated.

PMID- 8369060
TI  - Asthma guidelines. Guidelines ignore psychology of asthma.

PMID- 8369061
TI  - Urinary incontinence. Social and financial costs high.

PMID- 8369062
TI  - Epirubicin and the risk of leukemia: not substantiated? International
      Collaborative Cancer Group Steering Committee.

PMID- 8369063
TI  - Percutaneous ultrasound guided uterine needle biopsy.

PMID- 8369064
TI  - Reforming health care.

PMID- 8369065
TI  - Effect of dietary advice on cholesterol levels.

PMID- 8369066
TI  - Screening for ovarian cancer. Other chronic diseases affect serum marker.

PMID- 8369067
TI  - Limiting the drugs list. The trouble with generic prescribing.

PMID- 8369068
TI  - Skin self-examination.

PMID- 8369069
TI  - Canadian National Breast Screening Study.

PMID- 8369070
TI  - Blood lead levels in children.

PMID- 8369071
TI  - Pulmonary manifestations of multidrug-resistant typhoid fever.

PMID- 8369072
TI  - Asthma prevention.

PMID- 8369073
TI  - Cardiac uptake of MIBG in patients with aortic stenosis.

PMID- 8369074
TI  - Magnetic resonance imaging.

PMID- 8369075
TI  - IL-2 and MS.

PMID- 8369076
TI  - Re: "TLVs for asbestos".

PMID- 8369077
TI  - Exhibitionism treated with clomipramine.

PMID- 8369078
TI  - Cross-cultural psychiatry and children with deviant behaviors.

PMID- 8369079
TI  - Warm heart operation for acute ischemia.

PMID- 8369080
TI  - Normothermic cardiopulmonary bypass.

PMID- 8369081
TI  - The management of malaria in a district hospital: what drugs?

PMID- 8369082
TI  - [Autocrine growth mechanisms of cholesteatoma epithelium].
AB  - Transforming growth factor alpha (TGF alpha) and interleukin 1 alpha (IL-1 alpha)
      are known to be produced by normal human keratinocytes stimulating their
      proliferation. The distribution and expression of TGF alpha and IL-1 alpha were
      examined in specimens of middle ear cholesteatoma by means of immunohistochemical
      methods using a monoclonal antibody against TGF alpha and a polyclonal one
      against IL-1 alpha. Normal retroauricular skin was stained for comparison.
      Staining for TGF alpha was consistently stronger in cholesteatoma epithelium than
      in normal epidermis, and encompassed all epithelial cell layers. Immune cells
      occurring in the stroma of cholesteatoma also reacted positively for TGF alpha.
      The intensity of staining for IL-1 alpha was markedly stronger in cholesteatoma
      tissue than in normal epidermis. All cellular layers of the squamous epithelium
      of cholesteatoma stained strongly and uniformly for IL-1 alpha, whereas the
      keratin layer was negative for IL-1 alpha. In the connective tissue beneath the
      cholesteatoma epithelium intensely positive cells were scattered between negative
      stromal cells. These data are consistent with autocrine stimulation of the
      squamous epithelium of cholesteatoma by TGF alpha and IL-1 alpha as well as with
      a paracrine stimulation by immune cells. Both factors contribute to the
      unrestrained growth of cholesteatoma in the middle ear cavity.

PMID- 8369083
TI  - [Expression of 4F2-activation antigen in middle ear cholesteatoma].
AB  - Cholesteatoma consists of a keratinising squamous epithelium in the middle ear
      cavity. The human 4F2 antigen appears at the end of the phase G0 and at the
      beginning of the phase G1, remaining detectable throughout mitosis. This antigen
      is therefore considered to be an activation marker. In this study the presence
      and distribution of 4F2 in the cholesteatoma epithelium was investigated using
      monoclonal antibodies and the alkaline-phosphatase-anti-alkaline-phosphatase
      method. Normal skin showed positive immunostaining exclusively in the basal
      keratinocytes. In contrast, all cholesteatomas showed a suprabasal expression of
      the 4F2 antigen. The results confirm the hyperproliferative character of
      cholesteatoma epithelium.

PMID- 8369084
TI  - [Clinical aspects and histopathology of middle ear tuberculosis].
AB  - During the past few decades the clinical features of middle ear tuberculosis have
      changed. Hence, clinical differentiation between tuberculous and non-specific
      proliferative otitis media and mastoiditis is now difficult. Between 1986 and
      1992 five cases of tuberculous otitis media were treated surgically in the ENT
      Dept. of the University of Hamburg, representing 0.2% of all performed middle ear
      operations. According to our experience the therapy of choice is the open mastoid
      cavity with subsequent chemotherapy to avoid recurrent infections. The advantages
      of this procedure are proven by actual histopathological findings as well as by
      the analysis of historical microsections of the Wittmaack temporal bone
      collection: according to these findings, two different types of histopathological
      alterations can be differentiated.

PMID- 8369085
TI  - [Effect of adaptation and compensation mechanisms on postoperative function of
      patients with tumors of the oral cavity].
AB  - To examine adaptation and compensation mechanisms on oral function, the tongue
      and the floor of the mouth of five healthy volunteers were immobilised with a
      plastic plate. The functional results of this group were compared with the
      postoperative results of patients with tumours in the area of the anterior floor
      of the mouth and the edge of the tongue. Swallowing, sucking, and speech
      functions were used to assess oral function. Unhandicaped swallow and sucking
      functions were determined as average value (reference value 100%) in a control
      group with 20 healthy adults. The results of the study demonstrate the adaptive
      ability of the tongue and underline the importance of keeping the remaining
      structures free to move. In cases of resection in the area of the anterior floor
      of the mouth, however, careful soft tissue reconstruction plays a far greater
      role, since the remaining structures do not adapt as easily.

PMID- 8369086
TI  - [Importance of increased interstitial fluid pressure in therapy of malignant
      tumors of the head-neck area].
AB  - Animal experiments showed that elevated interstitial fluid pressure (IFP) is
      associated with poor blood supply and inadequate supply of drugs to solid
      tumours. IFP is approximately 0 mmHg in most normal tissues. Up to now there have
      been only few studies showing elevated interstitial pressure in human tumours in
      situ: Mammary carcinomas, cervical carcinomas and colorectal cancers have an
      elevated IFP. We measured IFP in squamous cell carcinomas of the head and neck
      region in humans using the "wick-in-needle" technique. In all lesions (n = 25),
      the IFP was elevated (4-39 mmHg). The IFP increased with tumour size. The highest
      IFP was 39 mmHg in a 26 ml tumour. These results show that squamous cell
      carcinomas of the head and neck region in humans have an elevated interstitial
      fluid pressure. The elevation of IFP associated with inadequate delivery of drugs
      to the interstitium of malign tumours may reduce the response to therapy.

PMID- 8369088
TI  - [Langerhans cell histiocytosis of the tonsil].
AB  - Langerhans cell histiocytosis (histiocytosis X) of the tonsil is a rare disorder
      of histiocytic proliferation with a broad spectrum of clinical symptoms. We
      report on a case of a solitary histiocytosis of a unilateral tonsillar palatine.
      To exclude a mesenchymal tumour a 32-year old male with a hyperplasia of the left
      tonsil underwent surgery. The histopathological examination revealed a solitary
      infiltration of Langerhans cells. We found a morphologically remarkable
      intraepithelial hyperplasia of Langerhans cells (S-100 protein positive) on
      contrast to the opposite side. The CT scans of the neck, thorax, abdomen and
      pelvis and the bone marrow puncture could not detect any further manifestation of
      the disease. Therefore, we refrained from systemic therapy. Up to now the patient
      is without any relapse of the disease for a period of 16 months.

PMID- 8369087
TI  - [Leiomyosarcoma of the tongue].
AB  - We report on a 48-year old female patient presenting with a spherical firm tumour
      that developed within a period of about three weeks. No causative trauma could be
      assessed. The tumour was surgically removed and turned out to be a leiomyosarcoma
      of the tongue. Probably the tumour originated from the vascular smooth muscle
      cells. Clinically this very rare tumour of the tongue must be differentiated from
      various benign and malignant mesenchymal neoplasms. Therapeutic considerations
      and differential diagnosis are discussed in reviewing the literature.

PMID- 8369089
TI  - [Oropharyngeal anthrax].
AB  - We report on a 46-year old man suffering from the oropharyngeal form of human
      anthrax. The patient presented with a sore throat and extensive swelling of the
      right neck, the oropharynx and especially the right tonsil. The skin of the
      mandibular and submandibular region showed vesicular lesions followed by
      ulcerations resulting in a blackish eschar. The diagnosis was verified by
      bacteriological culture. Thus, in cases of known exposure, in areas where anthrax
      is endemic or in immigrant workers coming from such areas, infection with
      bacillus anthracis should be included in the differential diagnosis of
      inflammatory oedematous lesions of the oropharynx.

PMID- 8369090
TI  - [Plasmacytoma of the nose and paranasal sinuses with intracranial and orbital
      extension].
AB  - A rare case of a solitary extramedullary plasmocytoma of the nasal cavity and the
      paranasal sinuses with orbital and intracranial extension of a 61-year old male
      patient was examined clinically, histologically and immunohistologically. The
      interrelationship of the generalised disease (multiple myeloma = MM) and the
      solitary extramedullary form (extramedullary plasmocytoma = EMP) is discussed as
      well as the importance of the magnetic resonance imaging in the diagnosis of
      tumours of the facial part of the skull.

PMID- 8369091
TI  - [Chronic lipogranuloma (paraffin granuloma) of the eyelids and orbits after
      endonasal paranasal sinus operation].
AB  - During the last five years 10 patients received surgical treatment in our eye
      clinic for tumours of the eyelids and the orbit that had developed after
      endonasal sinus surgery. In most patients the first signs of lid or orbital
      involvement had occurred 4 weeks after ENT surgery and after a unilateral or
      bilateral postoperative haematoma had subsided. The histological examination of
      the surgical specimens showed chronic sclerosing lipogranuloma containing large
      vacuoles surrounded by epithelioid and giant cells, typical of a so-called
      paraffin granuloma. MR-spectroscopy detected high concentrations of paraffin in
      the specimens of 3 patients. Since paraffin is a constituent of many ointments,
      we assume that the granulomatous reaction was elicited by the ointment tampons
      routinely applied to the wound area following sinus surgery. The bleeding acted
      as a vehicle to distribute the paraffin into the surrounding tissues.

PMID- 8369092
TI  - [Spiral CT: differential diagnosis of cervical swelling. Initial clinical
      results].
AB  - Spiral CT examinations were performed pretherapeutically in 27 patients in whom
      cervical lymph node enlargement had been suspected. The M/Q quotient known from
      sonography and MR can also be employed in CT by means of coronary and sagittal
      reconstruction. This improves CT differentiation between reactively changed and
      metastatically infiltrated lymph nodes in tumour patients. Hence, CT diagnosis
      can now make use of a highly sensitive and highly specific criterion for
      diagnosing lymph nodes. Another diagnostic improvement is that vascular
      infiltrations by lymph node metastases can now be visualised or excluded more
      readily. Spiral CT is also suitable in tumorous and non-tumorous processes for an
      accurate assessment of the extension of e.g. retropharyngeal abscesses or
      laryngoceles.

PMID- 8369093
TI  - [Suture of tympanic membrane transplants in tympanoplasty to the ventral wall of
      the auditory canal].

PMID- 8369095
TI  - A general method to calculate dose to spine in opposing anterior posterior
      treatment setup without CT.
AB  - The spinal cord is usually part of the treatment volume in the treatment of the
      thorax and abdomen areas using antero-posterior (AP) and postero-anterior (PA)
      ports. Thus it is necessary to know the dose the spinal cord would receive. One
      needs to locate the spine to calculate the dose at that location. In the absence
      of CT, a set of orthogonal films is taken at simulation to aid in locating the
      spine. The relative point dose then is calculated using irregular field point
      dose calculation mode of the treatment planning system. The data needed for the
      calculation are the x and y coordinates of the spine in the coronal plane, air
      gap, and depth in tissue. Correct entry of these is thus important to obtain the
      dose accurately. Planning systems assume that the spine is close to the beam
      axis. There could be possible mislocation of the spine when this assumption is
      not valid. This presentation describes a procedure to obtain the needed numbers
      for a general location without any assumptions. To obtain x and y coordinates the
      suggestion is made to solve numerically using successive approximation series for
      the coordinates, the series continued until mutually consistent values are
      obtained. The other parameters, g and d, are obtained from the source to skin
      distance (SSD) above the spine point, with the use of multiple transaxial
      contours in association with the principle of linear interpolation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8369094
TI  - Derivation of angular separation to obtain beam edge coincidence in tangential
      fields.
AB  - The separation of the two gantry angles in a pair of tangential fields required
      to obtain posterior beam edge coincidence is derived. This derivation enables one
      to calculate the second gantry angle at the time of simulation. Experience has
      shown that the setup angle is within 1 degree of the calculated value.

PMID- 8369096
TI  - Target to skin distance determination of oblique beams through a solid simulation
      table.
AB  - Oblique beams are commonly used to treat target volumes after cord tolerance is
      reached. At this institution we rely on the use of the Beams Eye View software to
      shape boost fields at oblique angles. Before the boost fields begin the patient
      is taken into the simulator room and set up according to the computerized plan.
      An integral part in the checking of the boost fields is the verification of the
      target to skin distances (TSD). Since many simulator couches have a solid top,
      the posterior oblique TSD cannot be read. With the use of simple geometrical
      relationships we have found an easy method to check the TSD's, thus aiding in the
      verification of the computer plan.

PMID- 8369097
TI  - A new gel using super absorbent polymer for mapping the spatial dose
      distributions of electron beams by MR imager.
AB  - A technique for mapping the spatial dose distribution with a magnetic resonance
      imager is presented. A ferrous sulphate solution with sulfuric acid was used as
      the detecting medium for radiation dose. To make a gel of the solution for
      filling up a cubic phantom, we developed a new gel component that is combined
      with a super absorbent polymer (Sumikagel N-100) and a cross-linked dextran gel
      (Sephadex G-200). In order to make the application for radiation treatment
      planning, mapping of the dose distribution was carried out using a Unix computer.

PMID- 8369098
TI  - An arms-up positioning device for treatment of malignancies of the intrathoracic
      region.

PMID- 8369099
TI  - High affinity hippocampal [3H]-glibenclamide binding sites are preserved in
      Alzheimer's disease.
AB  - ATP-sensitive K+ channels were examined in sections of the hippocampus from
      patients with Alzheimer's disease and age-matched control subjects by means of
      quantitative autoradiography. ATP-sensitive K+ channels were labelled with the
      sulfonylurea, [3H]-glibenclamide, which is a potent blocker of these channels.
      The density of cells in the subiculum and the activity of choline
      acetyltransferase were determined in the same hippocampal tissue samples. In the
      hippocampal formation of control subjects, the density of high affinity [3H]
      glibenclamide binding sites ranged from 17.6 +/- 0.9 pmoles/g in the presubiculum
      to 11.6 +/- 0.6 pmoles/g in the parvo-pyramidal layer of the presubiculum. There
      was no difference between Alzheimer patients and controls in the level of high
      affinity [3H]-glibenclamide binding in any hippocampal region although there was
      a marked loss of subicular cells (reduced by 29% compared to controls) and a
      reduction in choline acetyltransferase activity (reduced by 60% compared to
      controls). The results suggest that ATP-sensitive K+ channels are associated with
      elements in the hippocampus which are preserved in Alzheimer's disease.

PMID- 8369100
TI  - Effects of monoamine oxidase inhibition by selegiline on concentrations of
      noradrenaline and monoamine metabolites in CSF of patients with Alzheimer's
      disease.
AB  - A double-blind, cross-over trial with 12 patients with Alzheimer's disease (AD)
      was carried out primarily to test the suitability of this design in the
      investigation of the clinical effects of selegiline (10 mg/day) in AD.
      Cerebrospinal fluid (CSF) samples for the determination of concentrations of
      noradrenaline (NA) and several monoamine metabolites were collected at baseline
      and at the end of both four-week treatment periods (placebo and selegiline). The
      severity of dementia was assessed using Ferm's and Gottfries-Brane-Steen (GBS)
      dementia scales. The concentrations of the dopamine metabolite, 3,4
      dihydroxyphenylacetic acid (DOPAC) and the NA metabolites, 3,4
      dihydroxyphenylglycol (DHPG), and 3-methoxy-4-hydroxyphenyl glycol (MHPG)
      decreased significantly during selegiline treatment. There was a clear trend of
      reduction in concentrations of homovanillic acid (HVA) during selegiline
      treatment, whereas the concentrations of NA, 5-hydroxyindoleacetic acid (5-HIAA),
      and tryptophan did not differ significantly. The study design was not suitable
      for the analysis of the clinical results as there was a significant carry-over
      effect in both scales. As only the first period data could be used in the
      analysis, there were no significant differences in the scores of Ferm's or GBS
      scales, but clear positive trends could be detected in favour of selegiline.

PMID- 8369101
TI  - The effect of age on concentrations of monoamines, amino acids, and their related
      substances in the cerebrospinal fluid.
AB  - We studied age-related changes in the concentrations of monoamines, amino acids,
      and their related substances in the cerebrospinal fluid on 144 neurologically
      normal subjects. The concentrations of tyrosine, 3-O-methyldopa, dopamine
      (total), norepinephrine (total), homovanillic acid, p-hydroxyphenylacetic acid,
      and 5-hydroxytryptophan increased significantly with age (p < 0.05), and the
      concentration of 3.4-dihydroxyphenylacetic acid displayed a non-significant trend
      to decrease, whereas concentrations of other monoamine precursors and metabolites
      were unchanged. We found the significant positive correlations between the
      concentrations of HVA and 5-HIAA (p < 0.001), between tyrosine and tryptophan (p
      < 0.001), and between tyrosine and 3-O-methyldopa (p < 0.001). The concentrations
      of asparagine, glycine, taurine, and alanine increased significantly with age (p
      < 0.05), while glutamine, arginine, and threonine concentrations did not change
      with age. The aspartate, glutamate, and GABA concentrations displayed the non
      significant trends to decrease in the elderly subjects. The concentrations of
      aspartate, glutamate, and GABA had mutually significant positive correlations (p
      < 0.05), but had significant negative correlations with the concentrations of
      some neutral amino acids. The urate and xanthine concentrations increased
      significantly with age (p < 0.01). These findings suggest that the concentrations
      of monoamine and amino acid transmitters and their related compounds in the
      cerebrospinal fluid reflect age-related changes in the synthesis, release, and
      reuptake mechanisms of the transmitters and their transport mechanisms across the
      blood-brain barrier.

PMID- 8369102
TI  - Circadian secretion pattern of melatonin in de novo parkinsonian patients:
      evidence for phase-shifting properties of l-dopa.
AB  - Aim of this study was the characterization of the circadian melatonin profile in
      de novo Parkinson patients (N = 9, age 60.0 +/- 3.2 years, mean +/- SEM) and the
      comparison of these profiles with those of controls and Parkinson patients
      treated with l-dopa/decarboxylase inhibitor (l-dopa/DCI). We collected 14 venous
      blood samples during a period of 24 hours and measured the serum melatonin levels
      by a radioimmuno assay. De novo Parkinson patients displayed the nocturnal
      melatonin peak (acrophase) at the same time as controls and significantly later
      than l-dopa/DCI treated patients (1:54 +/- 15.6 min [average clock time +/- SEM
      in minutes] vs. 1:45 +/- 15.6 min vs. 0:13 +/- 40.8 min). The amount of secreted
      melatonin did not differ among the three groups. Stage and duration of
      Parkinson's disease did not correlate with the amount of secreted melatonin.
      Patients of the tremor subgroup, however, secreted more melatonin than patients
      presenting only with rigidity and akinesia. The phase advance in Parkinson
      patients treated with l-dopa/DCI is possibly due to a central nervous
      dopaminergic effect elicited by l-dopa administration and not inherent to
      Parkinson's disease per se.

PMID- 8369103
TI  - Sleep, excessive daytime sleepiness and fatigue in Parkinson's disease.
AB  - The objective of this questionnaire-based survey was to evaluate the prevalence
      and causes of sleep disturbances in 90 nondepressive patients with Parkinson's
      disease (PD) and 71 age-matched healthy subjects. We also assessed the prevalence
      and characteristics of excessive daytime sleepiness (both groups) and excessive
      fatigue (PD patients). A high prevalence of sleep disturbances in PD patients was
      found; this is to a large extent probably the result of aging. As compared with
      controls, patients had a more severely disturbed sleep maintenance because of
      nycturia, pain, stiffness, and problems with turning in bed. The prevalence of
      excessive dreaming is similar in both groups, but altered dream experiences
      almost exclusively occurred in PD. Patients rated themselves more often to be
      morning-types than controls. This finding may account for the reported adaptation
      effects in experimental settings and the reduced REM latency in PD patients. The
      prevalence of daytime sleepiness was similar in both groups. Excessive daytime
      sleepiness showed a clear diurnal pattern with a peak in the early afternoon. As
      for excessive fatigue, the majority of the patients did not report a preferential
      time for this symptom. Our findings further argue against an association of
      fatigue with any circadian factor, and instead suggest a relationship with the
      motor deficits of PD.

PMID- 8369104
TI  - Alteration of protein kinase C activity in the postischemic rat brain areas using
      in vitro [3H]phorbol 12,13-dibutyrate autoradiography.
AB  - Chronological changes of protein kinase C (PKC) activity were measured using in
      vitro [3H]phorbol 12,13-dibutyrate (PDBu) autoradiography to investigate the
      postischemic alteration of this second messenger system in the rat brain.
      Transient ischemia was induced by the occlusion of the middle cerebral artery
      (MCA) for 90 min and such occlusion followed by various recirculation periods of
      up to 4 weeks. After 90 min of ischemia followed by 3 hours of recirculation,
      [3H]PDBu binding sites were found to be significantly decreased in the cerebral
      cortex and lateral segment of the caudate putamen, both supplied by the occluded
      MCA; thereafter, the binding sites decreased progressively in those ischemic
      foci. On the contrary, there was no alteration on day 1, but 3 days after
      ischemic insult, a significant decrease of [3H]PDBu binding sites was first
      detected in the ipsilateral thalamus and the substantia nigra, which both areas
      had not been directly affected by the original ischemic insult. This postischemic
      delayed phenomenon observed in the thalamus and the substantia nigra developed
      concurrently with 45Ca accumulation, which was detected there in our previous
      study. These results suggest that alteration of second messenger (PKC) pathways
      may be involved not only in the ischemic foci, but also in neuronal degeneration
      of the exo-focal remote areas in relation to the disruption of intracellular
      calcium homeostasis which plays a key role in the pathogenesis of postischemic
      neuronal damage and that marked alteration of intracellular signal transduction
      may precede the neuronal damage in the exo-focal postischemic brain areas.

PMID- 8369105
TI  - Circadian variations of superoxide dismutase activity in the rat pineal gland.
AB  - The 24 h profile of the activity of the antioxidant enzyme superoxide dismutase
      (SOD) in the pineal gland of rats was studied. Rhythmic analysis showed a
      significant 24 h rhythm with an amplitude of oscillation of 25% of the 24 h mean
      value, that was 100.34 +/- 1.6 U SOD (nitrite). An ultradian rhythm of 9 h was
      also detected. The diurnal profile of superoxide dismutase activity is discussed
      in relation to the oxidative metabolism of the pineal gland.

PMID- 8369106
TI  - Inhibition of type A and B monoamine oxidase by 6,7-dihydroxy-1,2,3,4
      tetrahydroisoquinolines and their N-methylated derivatives.
AB  - 6,7-Dihydroxy-1,2,3,4-tetrahydroisoquinoline (norsalsolinol) and 1-methyl-6,7
      dihydroxy-1,2,3,4-tetrahydroisoquinoline (salsolinol), and their N-methylated
      derivatives were found to inhibit type A and B monoamine oxidase isolated from
      human brain synaptosomal mitochondria. N-Methyl-norsalsolinol, (R) and (S)
      enantiomer of salsolinol, and N-methyl-salsolinols inhibited type A monoamine
      oxidase competitively to the substrate, kynuramine, and R enantiomers were more
      potent inhibitors than S enantiomers. The inhibition was reversible.
      Norsalsolinol induced positive cooperativity toward kynuramine. Both
      norsalsolinol and N-methyl-norsalsolinol inhibited type B oxidase non
      competitively to the substrate, and their Ki values were much higher than those
      to type A. Types of inhibition of type A monoamine oxidase depended on the enzyme
      sources. Inhibition of monoamine oxidase by 6,7-dihydroxy-1,2,3,4
      tetrahydroisoquinolines is discussed in relation to their chemical structures.

PMID- 8369107
TI  - Modulation of serotonin binding sites in the brain of the Djungarian hamster,
      Phodopus sungorus, during adaptation to a short photoperiod.
AB  - During the physiological adaptation of the Djungarian hamster, Phodopus sungorus,
      to a short photoperiod in autumn the modulation of specific serotonin (5-HT)
      binding sites of synaptic membranes was investigated in two brain regions, i.e.
      cerebral cortex and basal brain (CNS without cerebral cortex, cerebellum, pineal
      gland, and spinal cord). The radioligands [3H]5-HT and [3H]ketanserin were used
      to characterize total 5-HT1 and 5-HT2 binding sites, respectively. An increase of
      5-HT1 and 5-HT2 binding sites was observed in both brain regions within 14 days
      after reduction of the photoperiod from a 14:10 h light/dark (l/d) cycle to an
      8:16 h l/d cycle. The increase was still present after 56 days of the short
      photoperiod. Binding kinetics assayed after 4 days of the short photoperiod show
      that maximal specific binding of [3H]5-HT and [3H]ketanserin was increased, while
      dissociation constants (KD) were not changed. The membrane anisotropy of synaptic
      membranes, measured by fluorescence polarization, was reduced transiently during
      the early part of the adaptation. Neither the phospholipids nor the mole ratio of
      cholesterol to phospholipids were significantly affected by adaptation to short
      photoperiod. The results suggest an important role of the central nervous 5-HT
      system in the physiological adaptation of the Djungarian hamster to a short
      photoperiod.

PMID- 8369108
TI  - Therapy with central active catechol-O-methyltransferase (COMT)-inhibitors: is
      addition of monoamine oxidase (MAO)-inhibitors necessary to slow progress of
      neurodegenerative disorders?
AB  - Neurotrophic factors, like e.g. nerve growth factor (NGF), neurotrophin 3 (NT-3)
      or brain-derived neurotrophic factor (BDNF) promote the survival and function of
      neurones in the peripheral and central nervous system. Dopamine or other biogenic
      amines induce the biosynthesis of neurotrophic factors in glial and neuronal
      cells. Therefore inhibition of enzymes, like the extraneuronal and neuronal
      located MAO or the predominantly glial situated COMT, which both metabolize
      catecholamines, may induce an increased biosynthesis of neurotrophic factors. Due
      to clinical studies especially MAO-B-inhibitors appear to slow the progression of
      neurological deficits in Parkinson's disease and the cognitive decline in
      Alzheimer's disease. On the one hand inhibition of COMT alone may also slow the
      metabolisation of biogenic amines in glial cells and may consequently induce
      synthesis of neurotrophic factors in glial cells. But on the other hand in vivo
      and in vitro studies show, that COMT-inhibitors may intensify the metabolisation
      of catecholamines in neurones by MAO, what may cause an enhanced generation of
      free radicals. This increase of free radicals may induce lipid peroxidation of
      membranes and therefore cause accelerated neuronal and glial cell death. For that
      reason we conclude, that centrally active COMT-inhibitors may only be used
      together with MAO-inhibitors in the neuroprotective treatment of
      neurodegenerative disorders. Medical treatment with both inhibitors will have to
      be performed very carefully due to cytotoxic effects of high catecholamine levels
      on neuronal and glial cells and due to possible prolongation or potentiation of
      the activity of several noradrenergic drugs in the periphery.

PMID- 8369109
TI  - Vitamin E attenuates the development of haloperidol-induced dopaminergic
      hypersensitivity in rats: possible implications for tardive dyskinesia.
AB  - Chronic haloperidol treatment in rats results in behavioural supersensitivity to
      dopamine agonists. This mechanism has been suggested as a possible animal model
      for tardive dyskinesia. In the present study the simultaneous administration of
      vitamin E to chronic haloperidol treatment in rats prevented the development of
      behavioural supersensitivity to apomorphine. This finding suggest that the
      concomitant administration of vitamin E to neuroleptics might prevent the
      development of tardive dyskinesia in humans.

PMID- 8369110
TI  - U.S. Environmental Protection Agency's Ozone Epidemiology Research Program: a
      strategy for assessing the effects of ambient ozone exposure upon morbidity in
      exposed populations.
AB  - The Clean Air Act Amendments of 1990 mandate a future reduction of ambient ozone
      levels in many areas of the country, the cost of which will be great. In order to
      assess the current public health burden of ambient ozone exposure and to provide
      information for assessment of potential health benefits of improved air quality,
      the Health Effects Research Laboratory of the U.S. EPA has undertaken an Ozone
      Epidemiology Research Program. The research strategy which will guide this
      scientific program is described in this paper. Criteria for selection of
      important research questions as well as issues which cut across all questions and
      study designs are discussed. In particular, this program emphasizes the study of
      effects which reflect morbidity in the population. The three questions identified
      as being of most immediate importance involve the relationship of short-term
      ambient ozone exposure to acute respiratory illness, the relationship of
      recurrent exposure to chronic respiratory disease, and the relationship of
      recurrent exposure to development of acute respiratory illness. Specific research
      approaches and initial projects to address these three questions are described.

PMID- 8369111
TI  - Reducing the risks from radon.
AB  - The U.S. Environmental Protection Agency estimates that residential radon levels
      in the United States lead to approximately 13,600 lung cancer deaths per year. To
      address this problem, the Agency has identified three program initiatives that
      can provide substantial reductions in the public's risks: (1) public information
      activities that urge the public to test for radon and reduce elevated
      concentrations in existing homes, (2) new construction standards to reduce radon
      entry, and (3) radon testing and mitigation during real estate transactions. This
      paper analyzes the costs and risk reductions that could result from the
      implementation of these major initiatives, showing how all three elements cost
      effectively protect the public's health.

PMID- 8369112
TI  - Assessment of carcinogenic risk from personal exposure to benzo(a)pyrene in the
      Total Human Environmental Exposure Study (THEES).
AB  - The Total Human Environmental Exposure Study (THEES) was an investigation of
      multimedia exposure to the ubiquitous environmental carcinogen, benzo(a)pyrene
      (BaP). The three-phase study was conducted in Phillipsburg, New Jersey and
      involved the participation of 14-15 individuals (8-10 homes) during each 14-day
      monitoring period. Microenvironmental sampling of air, food, water and soil
      indicated that environmental exposure to BaP was primarily through air and food.
      Exposure and risk estimates were, therefore, based on the results of personal
      monitoring of breathing zone air and prepared food samples. Based on a comparison
      of the range and magnitude of inhalation and dietary BaP exposures, food
      ingestion was clearly the predominant exposure to pathway. The relative
      contributions of other potential sources of community exposure to BaP (e.g., soil
      and drinking water ingestion) were also assessed. The excess cancer risk
      estimates for food ingestion were consistently greater than those for personal
      air, reflecting both the predominantly higher BaP exposures through the diet and
      the higher carcinogenic potency value for oral exposure. Overall, the total
      lifetime risk from personal exposure to BaP for nonsmokers in the community was
      estimated at 10(-5). In identifying risk reduction options, it is important to
      account for the observation that personal activities, lifestyle, and diet
      strongly influenced individual exposures to BaP.

PMID- 8369113
TI  - Treatment of cholesteatoma and retraction pockets.
AB  - Treatment of retraction pockets (RP) and cholesteatomas depends on their nature
      and evolvement and the size of mastoid pneumatization. RP are secondary to
      vacillating middle ear negative pressure. Treatment when necessary consists of
      placing a ventilating tube, excision of the RP or both. In most children and
      adults, cholesteatoma is derived from RP (or "atelectasis") of the tympanic
      membrane, where it can be termed "retraction pocket" cholesteatoma or "secondary"
      cholesteatoma. This type of cholesteatoma is associated with a non-pneumatized
      mastoid coupled by negative pressure. Approximately one-third of children's
      cholesteatomas present clinically behind an intact drum despite a pneumatized
      mastoid. Pathogenetically this type may be "congenital" or "metaplastic" and
      should be best termed "primary" cholesteatoma. Central perforations associated
      with cholesteatoma are probably derived from continuous tympanic membrane
      destruction by infection in cases of RP cholesteatomas or due to a primary
      cholesteatoma bursting out from the tympanic cavity. Canal-up surgery of
      cholesteatoma fails in 60% of cases at Tel Aviv University because of the
      inherent tendency of the tympanic membrane to retract once again. Residual
      disease was found in our cases to be a lesser cause for failure. Treatment
      depends on the type of cholesteatoma, emphasizing small "radicals" in sclerotic
      mastoids. When a pneumatized mastoid is encountered, a posterior tympanotomy
      should be considered.

PMID- 8369115
TI  - Variations of the ethmoid labyrinth and sphenoid sinus and CT imaging.
AB  - Three hundred macerated and partly isolated postmortem mid-facial bones were
      studied for the development, variations and dimensions of the structures of the
      nasal cavity. On 184 axial CT scans of bones (102 male, 82 female) from patients
      ranging in age from 1 to 90 years old, the dimensions of the ethmoid labyrinth
      and sphenoid sinus were studied in detail in order to determine which anatomic
      situation might be unsafe during clinical endoscopic interventions. Six anatomic
      variations were identified. Most unsafe for surgery seemed to be the following
      types: type III, in which the anterior diameter of the ethmoid labyrinth was
      large and the posterior ethmoid and sphenoid diameters were relatively narrow;
      type V, in which both ethmoid dimensions were large and the sphenoid diameter was
      narrow: type VI, in which the ethmoid labyrinth had an "hour-glass" shape.
      Present findings indicate that CT orientation before any endoscopic intervention
      might help to avoid serious complications.

PMID- 8369116
TI  - Specific activities of antioxidative enzymes in the cochlea of guinea pigs at
      different stages of development.
AB  - Significant activities of superoxide dismutase (SOD) and glutathione peroxidase
      (GSH-Px) were found in the cochleas of guinea pigs of different ages. The
      specific activities of SOD and GSH-Px (expressed as units/mg protein) increased
      significantly from fetal animals to animals 2 days old and then to 6-month-old
      animals.

PMID- 8369114
TI  - Chemotherapeutic drug resistance in the management of head and neck cancer.
AB  - Considerable progress has been made in the development of more effective
      chemotherapy regimens for squamous cell head and neck carcinomas. Unfortunately,
      increased response rates have not been translated into marked improvements in
      survival since durations of response have been brief, and the natural history of
      the disease has ultimately remained unaltered. Since the development of drug
      resistance is a major obstacle to successful antineoplastic chemotherapy,
      comprehensive efforts have been focused on understanding the underlying
      mechanisms. In this review, general and specific aspects of drug resistance
      related to head and neck cancer are addressed. In particular, mechanisms of
      resistance towards the most widely used antineoplastic drugs in head and neck
      malignancies--methotrexate, cisplatin, 5-fluorouracil, bleomycin, and vincristine
      -are discussed.

PMID- 8369117
TI  - Arachidonic acid metabolism by isolated and cultured middle ear epithelial cells
      from the chinchilla.
AB  - Thin-layer chromatography was used to examine the metabolism of arachidonic acid
      and prostaglandins (PGs) in freshly isolated and cultured middle ear epithelial
      cells from the chinchilla. The freshly isolated cells converted arachidonic acid
      predominantly to PGE2, while those cells grown in culture for 10 days acquired
      the ability to convert arachidonic acid to 6-keto-PGF1 alpha, PGD2, and PGE2.
      Incubation of the isolated cells and primary cultures with acetylsalicylic acid
      and indomethacin inhibited the formation of these PGs. These findings suggest
      that studies on the factors regulating arachidonic acid metabolism in middle ear
      epithelium may help to explain the role of eicosanoids in middle ear secretions,
      particularly in relation to the pathophysiology of otitis media.

PMID- 8369118
TI  - Influence of LAK cells on expression of HLA-DR antigen on laryngeal carcinoma
      cell line in new culture systems.
AB  - We demonstrated the enhancement of HLA-DR antigen expression on cultured
      laryngeal carcinoma cells (Hep 2) by in vitro cultivation with LAK cells using
      flow cytometric and immunohistological analysis. For in vitro cultivation of
      tumor cells with LAK cells, we used newly developed experimental systems (the
      Transwell double-dish system and experimental three-dimensional tumors). In flow
      cytometric analysis, expression of HLA-DR antigen on tumor cells was compared
      before and after co-cultivation with LAK cells. When tumor cells were cultured
      separately with LAK cells in a Transwell Petri dish and the expression of HLA-DR
      antigen on tumor cells was analyzed by flow cytometry, the expression of HLA-DR
      antigen on tumor cells was increased in a dose-dependent manner related to the
      number of LAK cells used. Furthermore, when anti-interferon-gamma monoclonal
      antibody was added to the experimental system, enhancement of HLA-DR antigen
      expression was blocked. These findings were consistent with immunohistological
      studies, in which experimental three-dimensional Hep 2 cell tumors were
      established in double-layered agar with/without being co-cultivated with LAK
      cells. The expression of HLA-DR antigen in this system was significantly
      increased when compared to such expression before cultivation with LAK cells.
      These findings suggested that the culture systems employed in this study could be
      a possible model for examining solid tumor in vivo biological responses. This
      enhanced expression of HLA-DR antigen may also represent one of the multi
      factorial responses seen with adoptive LAK cell immunotherapy for solid tumors.

PMID- 8369119
TI  - Gait analysis in patients with vertigo.
AB  - Gait analysis utilizing foot switches and electromyography of antigravity muscles
      was performed on 31 patients with vertigo. Twenty-one cases had peripheral
      vestibular lesions (such as vestibular neuronitis, Meniere's disease, traumatic
      labyrinthitis, small acoustic neuroma), and 10 cases had central lesions (such as
      spinocerebellar degeneration, pontine glioma, cerebellar tumor and giant acoustic
      neuroma). Parameters employed for analysis included time from heel strike to
      forefoot strike (HA-I), time from heel off to forefoot off (HA-II) as well as
      durations of stance, swing and (initial) double supports (DS). Fourteen healthy
      adults served as controls. The overall incidence of abnormality was highest in HA
      I, followed by stance and swing. The occurrence of abnormalities in stance, swing
      and DS was higher in the central lesion when compared with the group having
      peripheral lesions. The significance and usefulness of gait analysis for dizzy
      patients are discussed.

PMID- 8369120
TI  - Mycobacterial species causing cervicofacial infection in Turkey.
AB  - The aim of the study was to determine the mycobacterial species causing cervical
      lymphadenitis at Cukurova University Hospital, Adana, Turkey. To this end,
      culture and differential tests were performed on excisional or incisional biopsy
      specimens from patients with mycobacterial cervical disease (MCD). The diagnosis
      was confirmed by skin tests, histopathological examination and positive cultures.
      In 15 of 40 cases diagnosed as MCD, mycobacteria were isolated in Lowenstein
      Jensen medium. The etiological agents were tuberculous mycobacteria
      (Mycobacterium tuberculosis in 9 cases and M. bovis in 3 cases). Of the 3 non
      tuberculous cases, 2 were due to M. kansasii and the other to M. fortuitum.
      Antituberculous chemotherapy was given in all cases over an average period of 18
      months. A combination of three of four drugs was used including isoniazid,
      ethambutol, rifampin and/or streptomycin. At the end a follow-up period of at
      least 3 years, there were no recurrences or persistences of infection and no
      surgical treatment was necessary to remove residual lymph nodes.

PMID- 8369121
TI  - Effects of cocaine on human nasal mucosa.
AB  - The effects of cocaine on the contractile response of isolated human nasal
      mucosal blood vessels to field stimulation and methoxamine were investigated.
      Results showed that cocaine antagonized methoxamine and inhibited field
      stimulation. The drug increased resting tension in human nasal mucosa in vitro
      through direct actions and potentiated mucosal contractions by norepinephrine and
      epinephrine. The study indicated that high concentrations of cocaine may actually
      antagonize alpha-adrenoceptors, but these concentrations are not necessary in
      eliciting desired degrees of vasoconstriction in nasal blood vessels while being
      applied as a local anesthetic.

PMID- 8369122
TI  - A comparison of current expressions of nasal patency.
AB  - Rhinomanometry is well established as a useful clinical method for objective
      assessment of nasal patency, although several expressions of nasal patency have
      been reported and universal standardization has not been achieved. In this
      communication, nasal resistances were calculated from the equation R = delta P/V
      (R; resistance; delta P; transnasal differential pressure; V; nasal airflow) at
      delta P 100 Pa and at peak flow. Time-averaged nasal resistances and integrated
      nasal patencies were measured in 350 adult patients by Rhinorheograph MPR-1100
      and processed by a NI-101 computer program. The values from the equation R =
      delta P/V at delta P 100 Pa were slightly lower than those from the same equation
      at peak flow or those from the time-averaging method. Correlations between the
      values of nasal resistance at peak flow and the time averaging method were very
      close to the line of identity. No significant correlations were demonstrated
      between integrated nasal patency and the values from the other three expressions.
      The differences of the results from these expression are discussed.

PMID- 8369123
TI  - Melanoma and pregnancy. A review.
AB  - In the last half-century the incidence of cutaneous malignant melanoma has
      increased all over the world according to available reports. No association
      between risk of melanoma and age at menarche, first birth, menopause or duration
      of reproductive period has been proven so far. Studies on the effect of parity on
      relative risk and survival have given divergent results with multiparous women
      possibly having a better prognosis than nullipara. Women with melanoma diagnosed
      during pregnancy tend to have thicker tumours, shorter disease-free interval and,
      maybe, lower 10-year survival rate than non-pregnant matched controls. There is
      no conclusive evidence that therapeutic abortion improves the cure rate.
      Multivariate analysis has failed to unveil impaired prognosis in women who become
      pregnant subsequent to diagnosis.

PMID- 8369124
TI  - Decision analysis--a helpful tool for clinicians to establish diagnostic
      therapeutic guidelines?
AB  - In this paper we focus on the question: Does decision analysis provide a
      framework to assess the value of diagnostic tests in clinical practice and how
      can it be used by clinicians in establishing diagnostic-therapeutic guidelines.
      To study this question we performed two analyses concerning the use of pelvic
      lymphadenectomy and pedal lymphography for staging prostate cancer. Both analyses
      yielded similar results as far as the preferred strategy was concerned, yet the
      approach and set up of the two analyses were different. The first analysis was
      performed in accordance with the textbooks on decision analysis. However, using
      this traditional approach we encountered some difficulties: in structuring the
      decision tree, in eliciting values for the quality of life parameters, and in
      interpreting the results. These difficulties urged us to modify the approach,
      presented in the second analysis. In this second analysis, the decision problem
      was split into several consecutive decision problems which corresponded to the
      questions posed by the clinicians. Longevity and quality of life were considered
      separately and the consequences of treatment and testing, which affect the
      quality of life of the patients, were indicated by just two parameters. Finally,
      the result of the analysis was expressed in clinically meaningful terms. The
      second analysis is compared with different approaches presented in the literature
      for analyzing decision problems involving diagnostic tests. Despite some
      unresolved methodological problems it is concluded that decision analysis
      provides a good framework for clinicians to structure and analyze complex
      decision problems.

PMID- 8369125
TI  - Non-Hodgkin's lymphoma in northern Sweden. A retrospective analysis of
      morphologic diagnosis and stage in a material from the Swedish Cancer Registry.
AB  - Morphologic diagnosis and clinical stage were studied in a retrospective material
      of non-Hodgkin's lymphomas comprising 352 patients diagnosed 1978 until 1982 and
      reported to a regional cancer registry. Classification was made according to the
      original Kiel classification. Patients who could be classified as belonging to
      low- (46%) or high-grade (47%) malignancy groups (n = 337) were further studied.
      The median age was high, 65 years, which probably reflects the low degree of
      selection in a regional register material compared to most hospital register
      based materials. The proportion of stage I cases was rather high, in low-grade
      lymphomas 24%, and in high-grade 39%, which can be attributed to incomplete
      staging procedures in old patients. The aim of the study was to illustrate the
      distribution according to morphologic subclasses and clinical features in a
      material with a low degree of patient selection.

PMID- 8369126
TI  - Esthesioneuroblastoma. A report of seven cases.
AB  - The biologic behavior of esthesioneuroblastoma in seven patients, treated from
      1978 to 1989, is reviewed. The patients were initially treated with surgical
      resection (2 cases), radiation alone (1 case) or a combination of radiation and
      surgery (4 cases). The radiation dose ranged from 30 to 62 Gy. Operations were
      performed via a transmaxillary approach (2 cases), lateral rhinotomy approach (3
      cases) and craniofacial approach (1 case). Four of the seven patients experienced
      local recurrence, occurring after disease-free intervals as long as 6 years. The
      other three patients died of distant metastasis within one year after initial
      treatment. The effectiveness of radiation therapy varied, and in some patients a
      dose of 60 Gy was not enough to control microscopic disease. One patient
      developed bone marrow metastases which was fatal due to the ensuing pancytopenia.
      One patient developed a brain metastasis. Hyams' histopathologic staging of the
      tumor appeared to be related to prognosis.

PMID- 8369127
TI  - Therapeutic use of granulocyte-macrophage colony-stimulating factor (GM-CSF). A
      review of recent experience.
AB  - Recombinant cytokines are now available for clinical use. Several colony
      stimulating factors (CFS) have been identified which induce activation,
      proliferation and maturation of myeloid lineage cells. Recent therapeutic trials
      with granulocyte-macrophage colony-stimulating factors (GM-CSF) in association
      with chemotherapy, bone marrow transplantation and leukemia treatment are
      reviewed. GM-CSF as primary treatment for myelodysplasia and other types of bone
      marrow failure is also of interest. Colony-stimulating factor therapy in AIDS may
      be useful in order to reduce myelodepression caused by antiviral treatment and
      chemotherapy for associated malignancies like Kaposi's sarcoma. However, the
      effect of neutrophil count increase on infection is far from clear, and the real
      benefit of GM-CSF in cancer therapy has yet to be demonstrated.

PMID- 8369128
TI  - Estimation of creatinine clearance without 24-hour urine collection--a useful
      guide during cisplatin therapy.
AB  - The validity of the Cockroft and Gault formula in monitoring renal function
      during cisplatin therapy was examined in 110 consecutive cancer patients. A good
      correlation between estimated creatinine clearance (ECC) and the standard
      measured creatinine clearance (MCC) was found both before and after the onset of
      cisplatin. The correlation was better in males (r = 0.78 prior to cisplatin and r
      = 0.79 after the initiation of cisplatin) than in females (r = 0.69 and r = 0.63
      respectively). Obesity (> 125% of ideal body weight) had no major effect on the
      correlation between ECC and MCC. The presence of third-space body fluids, on the
      other hand, had an influence on the relations between ECC and MCC, particularly
      in females (r = 0.49). It is concluded that estimation of creatinine clearance,
      without the cumbersome collection of 24-h urine specimens, is accurate enough for
      the purpose of adjusting cisplatin dose. It should not be used in females with
      third-space body fluids.

PMID- 8369129
TI  - Comparison of ondansetron with customary treatment in the prophylaxis of nausea
      and emesis induced by non-cisplatin containing chemotherapy.
AB  - One hundred cancer patients receiving non-cisplatin containing chemotherapy were
      entered in a prospective study in which the efficacy of ondansetron was compared
      with standard antiemetic treatments in the prophylaxis of nausea and emesis.
      During the first 24 h, 77% of patients on ondansetron reported complete control
      of emesis compared with 56% of those on customary treatments (p = 0.03). However,
      no statistically significant difference was observed between ondansetron and
      customary treatments in control of delayed emesis on days 2-5. Nor was any
      statistically significant difference seen between ondansetron and customary
      treatments in preventing acute or delayed nausea.

PMID- 8369130
TI  - Quantification of apoptosis and necrosis by flow cytometry.
AB  - Apoptosis and necrosis are two important mechanisms of cell death. Several
      methods have recently been described for quantifying apoptotic cells by flow
      cytometry. We report a novel method for the quantification and separation of
      viable normal and apoptotic cells. We have applied this method both to immature
      rat thymocytes treated with a variety of agents and to a murine haemopoetic cell
      line after withdrawal of a growth factor. The cells were incubated with two dyes
      which give fluorescent complexes when bound to DNA, the bis-benzimidazole,
      Hoechst 33342, and propidium iodide. Three populations were identified and
      characterized. On excitation with UV radiation, dead cells fluoresced red due to
      the uptake of propidium iodide whereas apoptotic cells fluoresced bright blue;
      normal cells showed low blue, low red fluorescence. In this paper, we demonstrate
      how this method may be used to help to distinguish between cell death by
      apoptosis and necrosis.

PMID- 8369131
TI  - A method for dose calculation for high energy photon beams based on measurements
      performed at reference depth.
AB  - An algorithm is proposed to calculate the dose per monitor unit at any point
      along the beam axis for blocked or unblocked fields. The proposed formalism takes
      into consideration the beam measurements performed at the reference depth as
      recommended by most dosimetry protocols (5 cm or 10 cm depending on the beam
      quality). The only parameters which cannot be measured at the reference depth are
      the peak scatter factors, but they appear only as a ratio of two peak scatter
      factors for two slightly different field sizes. A correction factor is proposed
      when the distance of one shielding block to the beam axis is smaller than 5 cm.
      An agreement better than 1% has been obtained between calculations and
      measurements in the range of beam qualities, distances to the source and field
      sizes defined by typical collimators or shielding blocks, usually encountered in
      clinical practice.

PMID- 8369132
TI  - In vivo dosimetry with TLD in conservative treatment of breast cancer patients
      treated with the EORTC protocol 22881.
AB  - Two anthropomorphic phantom breasts and six patients with breast carcinoma were
      irradiated according the prescriptions of the EORTC protocol 22881 on the
      conservative management of breast carcinoma by tumorectomy and radiotherapy.
      During the implantation procedure for an iridium-192 boost, three tubes were
      implanted, enabling the measurement with TLD rods of the dose within the breasts
      of the phantom and the patients during one fraction of the external x-ray therapy
      and during the interstitial therapy. Measured doses were compared with calculated
      values from a 2-D dose planning system. In general a fair agreement was found
      between the measured and calculated doses in points within the breast for the
      external beam therapy as well as for the interstitial treatment.

PMID- 8369133
TI  - External beam treatment planning. Can we deliver what we plan?
AB  - Many sources of uncertainty exist in the delivery of the prescribed dose to the
      specified target volume in external beam radiotherapy. Their magnitudes are
      compared with recommendations for the overall accuracy of dose delivery (+/- 5%).
      Five dose intercomparisons are reviewed, including a recent UK survey undertaken
      by the Institute of Physical Sciences in Medicine (IPSM). For phantom doses,
      standard deviations in the ratio of stated to delivered doses range from 1-3.5%,
      with larger uncertainties when irradiation of volumes within anthropomorphic
      phantoms is considered. In addition, uncertainties arise from geometrical
      discrepancies, and the role of portal films in their assessment is also
      considered. Imaging during radiotherapy will be increasingly important in the
      development of complex conformal treatments, where the shape of the target volume
      may be irregular.

PMID- 8369134
TI  - Target dose versus extratarget dose in stereotactic radiosurgery.
AB  - In radiosurgery the dose in the periphery of the target is generally about 50-70%
      of the maximum dose. This type of dose distribution may be expected to be
      beneficial when tumours containing anoxic, more radioresistant, cells are
      treated. However, the impact of a high maximum dose in the target on the dose
      outside the target is of importance for the risk of complications. Dose
      distributions have been calculated for different beam geometries applicable to
      radiosurgery by integration of the dose from a continuum of beams. The dose
      distributions were calculated for beams of different diameters, and the
      distributions were weighted to give the same dose in the periphery of the target.
      With a 4 pi beam geometry it is shown that the maximum dose in the central parts
      of the target can be increased by a factor of 2, by using beams with smaller
      diameters, at the cost of a marginal increase of the dose outside the target. The
      average dose in the normal tissue outside increases from 29.8% with 18 mm beams
      to 34.1% with 14 mm beams, while the average dose within the target increases
      from 100 to 158%. In radiosurgery of tumours a high maximum dose in the target
      may give a therapeutic gain.

PMID- 8369135
TI  - Lymphoma and type I membrano-proliferative glomerulonephritis--a case report.

PMID- 8369136
TI  - Reconstructive surgery for metastatic destruction of the acetabulum.

PMID- 8369137
TI  - Temperature-dependent selection in the transmission of mitochondrial DNA in
      Drosophila.
AB  - We previously reported a selective mode of mitochondrial DNA (mtDNA) transmission
      in mtDNA heteroplasmy that was induced artificially in Drosophila melanogaster;
      the transmission bias appeared to depend on the particular temperature at which
      heteroplasmic lines were maintained. Here we report investigations of the
      temperature-dependent mode of mtDNA transmission in heteroplasmic lines for intra
      and interspecific combinations maintained separately at 22.5 degrees C, 25
      degrees C and 29 degrees C for 20 generations. We have examined a selection model
      for mitochondrial transmission, similar to genetic selection in haploid
      organisms. Changes in the relative proportions of two types of mtDNA fit the
      expectations from the model well. The intensity of selection estimated as a
      selection coefficient depends on temperature. Temperature-sensitive processes
      thus appear to be involved in the transmission and maintenance of mitochondria.

PMID- 8369138
TI  - Synthesis of free X duplications carrying a specific region of the centromeric
      heterochromatin in Drosophila melanogaster.
AB  - Free X duplication chromosomes of Drosophila melanogaster were synthesized by X
      ray irradiating the In(1)scL8Lsc8R chromosome which has a deletion in the distal
      half of hA and the proximal half of hB of the centromeric heterochromatin. Fifty
      nine duplications have been isolated and cytogenetically analyzed. They all carry
      wild-type allele of the yellow gene, y+, which should come from the distal tip of
      In(1)scL8Lsc8R. They appear to be telocentric and predominantly heterochromatic.
      Majority of the duplications, especially in the classes MEDIUM and LARGE, can
      pair with XYL.YS in the male meiosis, indicating that they carry male meiotic
      pairing site(s) that is known to be located exclusively in the X heterochromatin.
      Complementation test in the males, Df(1)svr, v/Dp, y+, demonstrates that most of
      the duplications in the classes MEDIUM and LARGE carry euchromatin enough to
      cover the deletion. The portion of the euchromatin should be of the very proximal
      region close to the irradiated X chromosome centromere.

PMID- 8369139
TI  - A theoretical approach to chromosome banding pattern analysis.
AB  - Based on a schematic model of karyotype evolution, a new methodology for G-, R-,
      or Q-banding pattern analysis was investigated. Banding pattern analysis
      essentially depends on the unidirectional alteration and the randomness of the
      exchange sites of the AM-inversion. In karyotypes that evolved by AM-inversion
      and Robertsonian rearrangement, two matching patterns appear; (1) tandem and (2)
      complementary matching patterns. The former is characteristic of a single lineage
      sharing the same AM-inversions, and the latter appears in different lineages
      sharing different AM-inversions, by which it is theoretically possible to detect
      the ancestral karyotype and to reconstruct the karyotype phylogeny (cladogram).
      In contrast, the evolutionary pathway cannot always be perceived if karyotypes
      evolve only by Robertsonian rearrangement. The tandem matching pattern does not
      always mean tandem fusion, but can be interpreted as 'tandem fission' by a
      combination of AM-inversion and centric fission. Tandem fusion and MM-inversion
      often cause entangled matching patterns, and thus they interfere with banding
      pattern analysis. Some methodological problems inherent in the conventional
      banding pattern analysis are highlighted, and suggested that such problems can be
      minimized by using the karyograph method. The methodology of banding pattern
      analysis proposed in the present paper will be applicable for matching the
      chromosome map of genetic markers among different species.

PMID- 8369140
TI  - Sliding toward nutrition malpractice: time to reconsider and redeploy.

PMID- 8369141
TI  - Nutritional management of cystic fibrosis.

PMID- 8369142
TI  - Recent advances in mammalian amino acid transport.
AB  - During the last four decades, mammalian amino acid transport systems have been
      described at the cellular level through general properties such as ion
      dependence, kinetics, substrate specificity, regulation of activity, and numerous
      other characteristics. These studies have allowed the definition of multiple
      transport systems for neutral, anionic, and cationic amino acids. Each system is
      distinct but exhibits overlapping substrate specificity. Direct measurement of
      transport has permitted a wealth of information to be accumulated regarding the
      regulation of overall activity, but the underlying molecular mechanisms have not
      been investigated because of a lack of the appropriate tools. Recent research
      designed to obtain these tools has proven fruitful, and the field of amino acid
      transport clearly is entering a new era. In the immediate future, transporter
      properties such as hormonal regulation, adaptive control, ion-dependence, and
      trans-effects will be studied at the molecular level by assaying mRNA or protein
      content and by analyzing results obtained with altered protein structures
      following site-directed mutagenesis. Identification of specific proteins
      associated with activities already well described will provide answers to
      heretofore untestable questions. For example, is Na(+)-independent transport
      mediated by the same proteins that mediate Na(+)-dependent uptake except that
      their function in this mode does not require sodium binding? What is the protein
      composition of amino acid transporters? As discussed above, emerging evidence
      suggests that transporter proteins have different molecular structure, 12 versus
      1 transmembrane domains, or that they exist as heterodimers or heterotetramers.
      Identification of certain transporter proteins and cloning of the respective
      genes also will provide valuable information about a number of inheritable
      diseases that are thought to be caused by defects in transporter synthesis or
      function. The opportunity to ask these questions will certainly generate renewed
      interest in the field of amino acid transport and lead to exciting advances in
      our knowledge.

PMID- 8369143
TI  - Fungal toxins in foods: recent concerns.

PMID- 8369144
TI  - Biosynthesis and function of enzymes with covalently bound flavin.

PMID- 8369145
TI  - Impact of plant genetic engineering on foods and nutrition.

PMID- 8369146
TI  - Biological effects of short-chain fatty acids in nonruminant mammals.

PMID- 8369147
TI  - Effects of polyunsaturated fats on blood pressure.

PMID- 8369148
TI  - Nutritional factors in osteoporosis.

PMID- 8369149
TI  - Biological nitrogen fixation.

PMID- 8369150
TI  - Genetics of obesity.

PMID- 8369151
TI  - Regulation of plasma LDL-cholesterol levels by dietary cholesterol and fatty
      acids.
AB  - Extensive data obtained in both experimental animals and humans demonstrate that
      steady-state plasma LDL-C concentrations are determined largely by the rate of
      LDL-C formation, Jt, and the level of LDL-R activity, Jm, located primarily in
      the liver. An increase in net cholesterol delivery to the liver suppresses Jm,
      slightly elevates Jt, and modestly raises the LDL-C level. Feeding lipids such as
      the 12:0, 14:0, and 16:0 saturated fatty acids further suppresses Jm, increases
      Jt, and markedly elevates the plasma LDL-C concentration. Feeding
      triacylglycerols containing the 18:1(c9) fatty acid restores hepatic receptor
      activity, decreases Jt, and modestly reduces the concentration of LDL-C in the
      plasma. The 18:2(c9, c12) compound has similar effects, although it is
      quantitatively less active than the monounsaturated fatty acid in restoring Jm.
      In contrast to these fatty acids that actively raise or lower hepatic receptor
      activity, a large group of compounds including the 4:0, 6:0, 8:0, 10:0, 18:0, and
      18:1(t9) fatty acids have no demonstrable effect on any parameter of LDL-C
      metabolism. These fatty acids, therefore, can be added to animal and human diets
      with relative impunity. They will alter plasma LDL-C levels only to the extent
      that they replace the active saturated fatty acids (in which case they lower the
      LDL-C concentration) or unsaturated compounds (in which case they raise the
      plasma cholesterol level). All of these effects of cholesterol and the various
      fatty acids can be explained by the effects of these lipids in altering the size
      of the regulatory pool of cholesterol in the hepatocyte. However, many aspects of
      the cellular and molecular biology of these regulatory processes require
      additional investigation. In particular, new studies should focus on how the
      genetic background of an individual animal or human alters the quantitative
      response of its plasma LDL-C concentration to the dietary challenge of each of
      these types of lipids.

PMID- 8369152
TI  - Clinical physiology of taste and smell.

PMID- 8369153
TI  - Aluminum metabolism.

PMID- 8369154
TI  - Effects of exogenous bovine somatotropin on lactation.

PMID- 8369155
TI  - Mammalian glucokinase.

PMID- 8369156
TI  - Regulation of the pyruvate dehydrogenase multienzyme complex.

PMID- 8369157
TI  - Iron deficiency and cognitive function.

PMID- 8369158
TI  - Lipid modulation of cell function.

PMID- 8369159
TI  - Actions of carotenoids in biological systems.

PMID- 8369160
TI  - Regulation of selenoproteins.
AB  - Selenium exerts its biological activity largely through selenoproteins, which
      contain the element in the form of selenocysteine. Five selenoproteins have been
      characterized in animal tissues and there is evidence that a number of others
      exist. Selenoprotein synthesis is a complex process that has been well
      characterized in prokaryotic systems but incompletely characterized in eukaryotic
      systems. Selenium deficiency causes a decrease in selenoproteins, but the
      decrease is not uniform and some selenoproteins are maintained better than
      others. The selenoprotein most sensitive to selenium deficiency is liver cGSH-Px.
      It contains a significant fraction of the selenium in the body, and decreased
      synthesis of it under deficiency conditions might serve to increase the selenium
      available for synthesis of selenoproteins that are more important to the survival
      of the animal than is cGSH-Px. The regulation of individual selenoproteins in
      selenium deficiency appears to be at the mRNA level. Factors that affect mRNA
      levels have not been completely characterized, but the fall in cGSH-Px mRNA in
      rat liver is not accompanied by decreased transcription, which suggests that it
      is regulated through changes in degradation.

PMID- 8369161
TI  - Nutritional management of glycogen storage disease.

PMID- 8369162
TI  - Synergistic inhibition of HIV-1 envelope-mediated cell fusion by CD4-based
      molecules in combination with antibodies to gp120 or gp41.
AB  - CD4-based molecules were tested in combination with HIV-1-neutralizing antibodies
      directed against the V3 loop of gp120 or against gp41, for inhibition of HIV-1
      envelope-mediated cell fusion. A virus-free cell fusion assay was developed,
      using Chinese hamster ovary cells that stably express HIV-1 gp120/gp41. These
      cells were incubated with dilutions of CD4-based molecules, antibodies, or
      mixtures of both, then overlaid with C8166 CD4+ T cells. Syncytia were counted
      and the degree of inhibition of cell fusion was determined. Synergy, additivity,
      or antagonism was calculated by the combination index (CI) method. The CD4-based
      molecules included soluble human CD4 as well as fusion proteins composed of CD4
      linked to human immunoglobulin gamma 1 or gamma 2 heavy chains. Combinations of
      CD4-based molecules and monoclonal or polyclonal anti-V3 loop antibodies were
      synergistic in blocking HIV-1 envelope-mediated cell fusion (CI = 0.21-0.91 at
      95% inhibition). Synergy was also observed with combinations of the CD4-based
      molecules and a broadly neutralizing anti-gp41 monoclonal antibody (2F5) (CI =
      0.29-0.65 at 95% inhibition). These results demonstrate that molecules inhibiting
      HIV attachment act synergistically with molecules inhibiting HIV-1 fusion. The
      results suggest that CD4-based therapeutics would be more effective in patients
      with naturally occurring anti-V3 loop or anti-gp41 antibodies. In addition, there
      may be an advantage in coadministering CD4-based molecules and antibodies that
      block fusion, especially broadly neutralizing anti-gp41 antibodies, as a
      combination therapy for HIV-1 infections.

PMID- 8369163
TI  - Mutational analysis of the assembly domain of the HIV-1 envelope glycoprotein.
AB  - The amino-terminal 129 amino acids of gp41 of the human immunodeficiency virus
      type 1 (HIV-1) envelope (Env) glycoprotein constitute the assembly domain
      required for efficient oligomer formation and stability. Point mutations in
      highly conserved structural features including cysteine residues, potential N
      linked glycosylation sites, and a leucine zipper motif have been made in a
      soluble secreted form of Env (Envsec). No single point mutation had adverse
      effects on Env protein oligomerization. However, truncation of the C terminus of
      gp41 from 129 amino acids to 68 amino acids drastically reduced oligomerization
      efficiency, indicating that amino acids 68-129 are essential for assembly.

PMID- 8369164
TI  - Soluble CD4 and CD4 immunoglobulin-selected HIV-1 variants: a phenotypic
      characterization.
AB  - The selection of HIV-1 resistance to neutralization by both monovalent and
      bivalent forms of soluble CD4 was demonstrated under various conditions.
      Phenotypic traits of the neutralization-resistant variants were systematically
      explored in order to gain insight into which aspects of the interactions with CD4
      are most expendable to HIV-1 replication. The size of the nonneutralized fraction
      after treatment of preparations of the HIV-1 isolate IIIB and a molecular clone
      derived from it (HX10), with either monovalent soluble CD4 (sCD4) or bivalent CD4
      Ig, was determined. These fractions were greater for the polyclonal IIIB than for
      the viral clone, and greater after treatment with sCD4 than with CD4-Ig. The
      virus in the nonneutralized fractions exhibited 2- to 20-fold lower sensitivity
      to the neutralizing agents than did unselected virus. In addition, clonal HIV-1
      (HX10) was cultured in the presence of sCD4 or CD4-Ig for 12 weeks, so as to
      allow for accumulation of mutations that would confer stronger resistance to the
      selecting agent. Variants were obtained with up to 100-fold increased resistance
      to sCD4 or CD4-Ig. Detergent-solubilized gp120 from sCD4- and CD4-Ig-selected
      virus showed decreases in affinity for sCD4 and CD4-Ig. The monoclonal antibodies
      6H10, to the gp120-binding site in domain 1 of CD4, and 5A8, to domain 2 of CD4,
      inhibited the induction by the viral escape variants of syncytium formation of
      C8166 cells. In general, the concentration of antibody 6H10 that inhibited the
      escape variants was lower than the concentration that inhibited the wild type,
      whereas there was no significant difference for the domain 2 antibody 5A8. We
      interpret this as a weaker attachment of the escape variants than of the wild
      type virus to cellular CD4, but as an intact dependence of the variants on CD4
      interactions for gaining entry into cells.

PMID- 8369165
TI  - A hidden region in the third variable domain of HIV-1 IIIB gp120 identified by a
      monoclonal antibody.
AB  - The third variable domain (V3 domain) of HIV-1 gp120 is involved in virus
      neutralization by antibody, in determination of cell tropism, and in syncytium
      inducing/non-syncytium-inducing capacity. Antibodies are highly specific tools to
      delineate the role of different V3 amino acid sequences in these processes, and
      to dissect events occurring during synthesis of gp120/160, gp120-CD4 interaction,
      cellular infection, and syncytium formation. We describe here an IgG1 murine
      monoclonal antibody (MAb), coded IIIB-V3-01, that was raised with a synthetic
      peptide (FVTIGKIGNMRQAHC) derived from the carboxy-terminal flank of the HIV-1
      IIIB V3 domain. The binding site of this antibody was mapped to the sequence
      IGKIGNMRQ, using Pepscan analysis. In ELISA, this antibody binds to E. coli
      derived gp120 from HIV-1 IIIB, which is denatured and not glycosylated. The
      antibody showed no neutralizing activity against HIV-1 IIIB, MN, SF2, or RF in a
      virus neutralization assay and in a syncytium formation inhibition assay. In
      addition, this antibody did not react with gp120 expressed on the surface of IIIB
      infected MOLT-3 cells in FACS analysis. To assess whether the epitope defined by
      MAb IIIB-V3-01 is hidden on native gp120, reactivity of the antibody with SDS-DTT
      denatured or DTT-denatured glycosylated gp120 (CHO cell produced) was tested.
      Both these treatments exposed the epitope for binding. From these data we
      conclude that the epitope defined by MAB IIIB-V3-01 is hidden on glycosylated
      recombinant gp120, and is not accessible on gp120 expressed on the membrane of
      HIV-1, IIIB-infected cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369166
TI  - Genetic diversity of human immunodeficiency virus type 1 strains in Kinshasa,
      Zaire.
AB  - The envelope (env) gene of human immunodeficiency virus type 1 (HIV-1) was
      amplified by polymerase chain reaction (PCR) from the peripheral blood
      mononuclear cells (PBMCs) of 14 HIV-1-infected women from Kinshasa, Zaire.
      Amplified DNA was directly sequenced with a primer specific for the HIV-1 env C2
      region. The predicted amino acid sequences for the C2-V3 region for the 14
      specimens are presented. The tetrapeptide sequence, GPGQ, located at the crown of
      the V3 loop, is conserved in all specimens. The same tetrapeptide sequence is
      present in the Zairian isolate MAL, but not in other published Zairian isolates
      (Z6, ELI, Z321, JY1, and NDK). Sequence comparison of the env C2-V3 region among
      the 14 specimens from Kinshasa revealed a 9-25% range of nucleotide divergence,
      with an average of 16%. Divergence between the 14 specimens and the Zairian
      isolates MAL, Z6, ELI, Z321, JY1, and NDK ranged from 13 to 31%. A range of 18
      28% nucleotide sequence divergence was demonstrated between the 14 Kinshasa
      specimens and the North American isolate MN. These results demonstrate the
      importance of examining HIV-1 samples from diverse geographic origins in the
      development of effective HIV-1 vaccines.

PMID- 8369167
TI  - Complement-dependent virolysis of HIV-1 with monoclonal antibody NM-01.
AB  - Previous studies have described the isolation of monoclonal antibodies that
      neutralize human immunodeficiency virus type 1 (HIV-1). However, although certain
      antibodies are capable of blocking infection of CD4+ cells, the antibody-HIV-1
      complex could potentially remain infectious and enter cells by an Fc receptor
      mediated mechanism. Indeed, one goal of HIV-1 therapy with antibodies is the
      development of reagents capable of killing virus. The present studies with murine
      monoclonal antibody (MoAb) NM-01 demonstrate complement-mediated lysis of HIV-1.
      NM-01-dependent virolysis has been visualized by electron microscopy. Virus
      particles treated with NM-01 and rabbit or human complement undergo a process of
      outer envelope rupture and loss of the electron-dense core. The involvement of
      human complement in this process was confirmed by the presence of C9 in
      association with MoAb NM-01 immune complexes. In contrast, virolysis was not
      detectable with antibody or complement alone. Moreover, although MoAb NM-01 alone
      is capable of neutralizing HIV-1, the presence of rabbit complement was
      associated with over a 10-fold decrease in infectivity. Similar but less
      pronounced effects were observed with human complement. These findings support a
      potential role for antibody-dependent complement-mediated virolysis in HIV-1
      therapy.

PMID- 8369168
TI  - Antibodies to recombinant gp160 in mucosal secretions and sera of persons
      infected with HIV-1 and seronegative vaccine recipients.
AB  - An enzyme immunoassay (EIA) was developed to detect secretory IgA (sIgA)
      antibodies to HIV-1 envelope glycoprotein, using a mouse monoclonal antibody and
      a highly purified, baculovirus-expressed recombinant gp160 (rgp160) as antigen.
      Detection of sIgA was enhanced by prior immunoprecipitation of IgG. IgG and sIgA
      rgp160 antibodies were measured in parotid saliva and nasal wash samples of 18
      HIV-1-seropositive volunteers and 14 HIV-1-seronegative adult volunteers
      immunized 3 times with HIV-1 IIIB rgp160 vaccine at 1 of 4 dosage levels: 40
      micrograms (N = 3), 80 micrograms (N = 3), 160 micrograms (N = 4), and 640
      micrograms (N = 4). We detected rgp160-specific IgG antibody in the nasal wash
      samples of all HIV-1-seropositive volunteers and 4/8 vaccinees (50%) immunized
      with the two highest doses of rgp160 vaccine. All infected volunteers tested had
      rgp160-specific sIgA in their nasal wash samples. None of the vaccinees and very
      few of infected volunteer specimens had detectable antibody in the parotid saliva
      samples (5/8 had IgG and 1/8 had sIgA). We also detected IgG antibody to rgp160
      in the sera of all infected volunteers and 13/14 vaccinees (93%). With this EIA,
      sIgA antibody can be measured in mucosal secretions of recipients of appropriate
      candidate HIV-1 vaccines.

PMID- 8369169
TI  - The impact of HIV-1 infection on phenotypic and functional parameters of cellular
      immunity in chimpanzees.
AB  - As a means of assessing the immunological impact of HIV infection in the
      chimpanzee, as well as the participation of the cellular components in the
      control of HIV infection in these animals, various aspects of cellular immunity
      were investigated in chronically HIV-infected chimpanzees. Eight HIV-1-infected
      chimpanzees were included in this study; two of them were infected for more than
      5 years and six for nearly 3 years at the time of study. All of the chimpanzees
      received either 40 or 100 TCID50 of HTLV-IIIB. Circulating peripheral blood
      lymphocytes were studied by flow cytofluorimetric analysis in order to reveal
      possible alterations in the CD4:CD8 ratio, as well as in specific CD4+ and CD8+
      cell subpopulations. Chronically infected chimpanzees did not present significant
      alterations in the percentage of CD4+ or CD8+ lymphocyte subsets. Interestingly,
      the CD8+/CD57+ cell subset was not detectable. The expression of markers for
      activation on circulating lymphocytes, usually higher in the HIV-infected
      patients, was not altered in infected animals. The functional aspects of specific
      anti-HIV-1 non-MHC and MHC-restricted cellular cytotoxic reactivities were also
      investigated. The results were compared with the findings in normal uninfected
      chimpanzees and in HIV-infected humans. Only one chimpanzee (881) developed a
      detectable, specific non-MHC-restricted anti-HIV-1- reactivity. Compared to that
      seen in humans, the ontogeny of this activity is delayed. Among the other
      infected chimpanzees, no specific anti-HIV cellular reactivities were detectable
      in the peripheral blood. In chimpanzees, HIV-1 infection evidently does not
      elicit the same strong cellular reactivity as that detected in infected patients.
      The absence of chronic cellular activation, despite continued viral replication,
      may highlight a key determinant in HIV-1-induced pathogenesis that is likewise
      absent in infected chimpanzees.

PMID- 8369170
TI  - Progressive impairment of monocytic function in HIV-1-infected human macrophage
      hybridomas.
AB  - Using human macrophage hybridomas infected with HIV-1, we investigated monocyte
      function over a 5-week period after HIV-1 infection. Two clones, 63 and 30, were
      infected with HIV-1IIIB. Infection was documented by RT activity (15 x 10(6)
      cpm/ml), intracytoplasmic staining with an anti-p24 antibody, in situ
      hybridization with an HIV-1-specific riboprobe, and electron microscopy showing
      intracytoplasmic virus. Two weeks after infection, clones 63 and 30 lost
      expression of all class II antigens (DR, 81.7 vs. 0%; DQ, 15.6 vs. 0%; and DP,
      76.9 vs. 0%) while retaining expression of class I (87.4 vs. 84.1%), LFA-1 (82.4
      vs. 83.1%), and LFA-3 (79.1 vs. 74.7%) antigens when compared to uninfected
      cells. When tested for functional integrity, infected but not uninfected clone 63
      cells failed to stimulate a tetanus-specific MHC-restricted T cell proliferative
      response 2 weeks after infection. Cytokine secretion and antigen processing were
      also perturbed as production of IL-1 was abolished 2 weeks after infection
      (although IL-6 secretion was augmented) and infected clone 63 cells failed to
      process exogenous antigen. Last, the viability of T cells cocultured with
      infected clone 63 was dramatically decreased 35 days after infection (85 vs.
      15%). There was no evidence of transmission of HIV-1 to T cells, suggesting a
      toxic effect of infected clone 63. Taken together, these data suggest that
      altered macrophage function in our system occurs at multiple levels, which may
      account for the early immunological defects described in HIV-1 infection.

PMID- 8369171
TI  - Early replication steps but not cell type-specific signalling of the viral long
      terminal repeat determine HIV-1 monocytotropism.
AB  - The expression of human immunodeficiency virus type 1 (HIV-1) is enhanced after
      cell activation because of the interaction of cell-encoded nuclear factors that
      interact with binding sites in the long terminal repeats (LTRs). Here we studied
      the contribution of cell type-specific activation signals to differences in
      cytotropism of HIV-1 variants. Four closely related molecular HIV-1 clones with
      distinct biological phenotypes and different capacities to replicate in primary
      monocyte-derived macrophages (MDMs) or T cell lines were used. Sequence analysis
      of these LTRs revealed variation in functionally important regions. Adaptation of
      virus variants to particular host cells by differences in LTR responsiveness was
      analyzed. LTR-CAT constructs were transiently transfected in T cells that were
      stimulated with T cell-specific activation signals such as combinations of anti
      CD3 or anti-CD28 MoAB or in primary monocytes that were stimulated with IL-3, IL
      4, or GM-CSF. No differences in responsiveness to cell type-specific signals were
      demonstrated. To further elucidate the level of restriction in cell tropism,
      transfection of four full-length infectious molecular HIV-1 clones into 5-day
      cultured MDMs was performed. From all clones, competent virus could be rescued
      from MDMs by coculture with PHA-stimulated PBLs. However, following cell-free
      inoculation, proviral DNA could be detected by PCR analysis only in monocytes
      exposed to HIV-1 clones that previously were shown to establish productive
      infection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369172
TI  - HIV-1 Tat alters normal organization of neurons and astrocytes in primary rodent
      brain cell cultures: RGD sequence dependence.
AB  - The HIV-1 trans-activator protein Tat has been implicated as a mediator of
      neuronal dysfunction in several model systems. To explore the possibility that
      Tat can affect primary brain cells, we examined the effect of recombinant Tat
      protein on rat cortical brain cell cultures. Tat induced marked aggregation of
      neurons and astrocytes in developing cultures and caused the neuritic processes
      to coalesce into fascicles. Cell death was not seen and brain macrophages were
      not affected. These effects mapped to a different region from the trans
      activation domain of Tat, as mutating the RGD (arginine-glycine-aspartic acid)
      sequence within the second exon abrogated aggregation and fascicle formation
      without affecting trans-activation capacity. Such effects on primary neurons and
      astrocytes may reflect specific interactions of Tat with uninfected cells within
      the CNS in vivo.

PMID- 8369173
TI  - Monoclonal antibodies to HIV-1 gp120: a request.

PMID- 8369174
TI  - Assimilating HIV sequences.

PMID- 8369175
TI  - Genetic typing of HIV-2 from a Senegalese/German heterosexual transmission.

PMID- 8369176
TI  - V3 loops of HIV-1 specimens from pregnant women in Malawi uniformly lack a
      potential N-linked glycosylation site.

PMID- 8369177
TI  - Digital radiography. A useful clinical tool for computer-aided diagnosis by
      quantitative analysis of radiographic images.

PMID- 8369178
TI  - Digital luminescence radiography using a chest phantom. Comparison between
      radiographs displayed on monitor at a workstation and at a personal.
AB  - With the introduction of picture and archiving communicating systems an
      alternative image display for the wards might be a personal computer (PC). The
      intention with this study was to evaluate the diagnostic image quality of the
      monitor of a PC compared to that of a workstation. Eighty-five digital
      radiographs of a chest phantom with simulated tumors in the mediastinum and right
      lung were saved on optical discs. The examination were reviewed by 4 radiologists
      on a monitor at a workstation and at a PC, and receiver operating characteristic
      (ROC) curves were constructed. No significant difference was found between
      performance of the PC and the workstation.

PMID- 8369179
TI  - Advanced multiple beam equalization radiography (AMBER) combined with computed
      radiography. Preliminary evaluation.
AB  - The combined use of AMBER (Advanced Multiple Beam Equalization Radiography) and a
      digital storage phosphor (SP) radiography system was evaluated for chest
      radiography in a pilot study with 4 patients. Four image modes with different
      dose levels were compared: the SP in combination with an AMBER equalized exposure
      (SP/AMBER) and 3 nonequalized exposures with dose levels corresponding to the
      respective calculated AMBER lung dose (SP/lung field dose), the calculated AMBER
      mediastinal dose (SP/mediastinal dose) and the calculated AMBER average dose
      (SP/average dose). All image modes were matched for Hurter and Driffield
      characteristics and subjectively rated according to visibility of details. The
      improved signal-to-noise (S/N) ratio of SP/AMBER resulted in a better
      visualization of structures in the mediastinum and the basal lung where SP/lung
      field dose scored lowest. For the central lung no quality differences were seen
      between techniques. The compressed dynamic range of the SP/AMBER images was more
      easily displayed on the hard-copy film. The combination of AMBER with SP
      radiography promises to overcome the dynamic range limitations of digital
      displays while, at moderate doses, giving better S/N and image quality than
      standard SP technique.

PMID- 8369180
TI  - Normal left ventricular wall motion measured with two-dimensional myocardial
      tagging.
AB  - Using a myocardial tagging technique, normal left ventricular wall motion was
      studied in 3 true short axis views and a double oblique 4-chamber view in 14 and
      11 volunteers, respectively. Three orthogonal directions of left ventricular
      motion were observed throughout the systole; a concentric contraction towards the
      center of the left ventricle, a motion of the base of the heart towards the apex,
      and a rotation of the left ventricle around its long axis. The direction of left
      ventricular rotation changed from early systole to late systole. The base and
      middle levels of the left ventricle rotated counterclockwise (CCW) at early
      systole and clockwise (CW) at late systole, whereas the apex of the heart rotated
      CW at early systole and CCW at late systole. The different directions of the
      rotation of base and apex resulted in a myocardial twisting that changed
      direction from early to late systole. We conclude that MR imaging with myocardial
      tagging is a method that can be used to study normal left ventricular wall
      motion, and that is promising for future use in patient groups.

PMID- 8369181
TI  - Target delineation in radiosurgery for cerebral arteriovenous malformations.
      Assessment of the value of stereotaxic MR imaging and MR angiography.
AB  - A study of 6 selected arteriovenous malformation (AVM) patients was performed to
      investigate the feasibility of delineating an AVM on MR images and to compare the
      AVM volume outlined on different images. Conventional stereotaxic angiograms,
      stereotaxic MR images and MR angiograms using several different pulse sequences
      were obtained prior to radiosurgery. Treatment plans were made from the
      conventional stereotaxic angiograms. These plans were then transferred to a
      separate dose planning computer which displayed the MR images with the
      superimposed isodose lines. The radiated volumes of AVM and brain tissue were
      measured from these MR images. Last, an assessment was made of the radiation
      volume needed for an appropriate treatment of the AVM if the treatment plan was
      made from the MR images rather than from the conventional stereotaxic angiogram.
      It was possible to delineate medium and large size AVM nidi on stereotaxic MR
      images based on an integration of information obtained from various pulse
      sequences. The estimated volumes of the AVM nidi were found to be larger on the
      conventional stereotaxic angiograms than on the stereotaxic MR images.
      Consequently, a dose plan based on a conventional stereotaxic angiogram would
      result in a higher integral dose to the brain with the same target dose. By using
      reliable MR information it is expected that the volume of brain exposed to
      radiation could be decreased and the adverse effects of stereotactic radiosurgery
      for AVM thereby minimized.

PMID- 8369182
TI  - Intramedullary nailing and cortical bone mineral content. Photon absorptiometry
      measurements in vitro.
AB  - A transverse diaphyseal osteotomy of the tibia was stabilized using rigid
      intramedullary nailing in rabbits. In a 2nd group, nailing was performed without
      osteotomy. The rabbits were sacrificed 3 to 24 weeks postoperatively, and the
      nails were removed. The mineral content (BMC) was measured by dual photon
      absorptiometry and the mineral density (BMD) was calculated. At 24 weeks the
      osteotomized bones had significantly lower BMC values than did the respective
      nonosteotomized bones or the intact bones. The BMC of the nonosteotomized bones
      remained above the control level throughout the experiment. The minimum BMD
      values of the osteotomized bones were detected at 3 weeks, whereafter they
      gradually approached the control level over time. The results suggest that rigid
      intramedullary nailing in connection with osteotomy causes a significant decrease
      in cortical bone mineral mass, seen at 24 weeks postoperatively. The photon
      absorption method used seemed sensitive enough to detect changes in cortical bone
      mineral quantity in these experimental conditions.

PMID- 8369183
TI  - Ultrasound-guided biopsies of neuroendocrine metastases. Comparison of 0.9 and
      1.2 mm biopsy-gun needle biopsies.
AB  - Twenty-five patients with known neuroendocrine tumour disease were biopsied with
      1.2 mm and 0.9 mm biopsy-gun needles to evaluate the respective diagnostic
      accuracy of the 2 needle sizes. The influence of treatment-related fibrosis on
      the histopathological diagnosis was also evaluated. The overall diagnostic
      accuracy with the 0.9 mm needle was 69% as compared to 92% with the 1.2 mm
      needle. This difference, however, seems more related to needle guiding
      difficulties with the 0.9 mm needle than to insufficient tissue yield. When the
      tumour was hit with both the 0.9 and the 1.2 mm needle the tissue yield was
      inferior with the 0.9 mm needle in only one of 16 cases. The increased amount of
      fibrous tissue due to interferon treatment did not seem to negatively influence
      the diagnostic accuracy.

PMID- 8369184
TI  - Duplex ultrasonographic evaluation of liver transplants.
AB  - Two hundred and twenty-two duplex ultrasonographic examinations were performed on
      36 liver transplants in 30 patients over a period of 5 years and 9 months.
      Positive sonographic findings were correlated with 13 angiographic examinations.
      Arterial complications included 4 thromboses, 5 stenoses, and one mycotic
      aneurysm. A false-negative result was obtained in 2 cases of stenosis and a false
      positive result in one case of thrombosis. One portal vein thrombosis, 2
      stenoses, and 2 cases of portal hypertension were diagnosed correctly.
      Sensitivity was 87%, specificity 95%, and accuracy 93%. Duplex Doppler was least
      effective in the diagnosis of hepatic artery stenosis. Five cases showed biliary
      complications of ischemic origin. Angiography is indicated when duplex Doppler is
      positive or doubtful, but also when the clinical condition is unclear.

PMID- 8369185
TI  - Sonographic evaluation of renal appearance in 665 adult volunteers. Correlation
      with age and obesity.
AB  - The purpose of this study was to investigate the sonographic appearance of the
      normal adult kidney. Parenchymal echogenicity, pyramid visibility, and transverse
      pelvis diameter of the kidneys were prospectively determined in an age- and sex
      stratified random sample of 665 volunteers 30, 40, 50, 60, and 70 years old.
      Furthermore, incidences of kidney stones and split sinus echo were determined.
      The relation between obesity and above-mentioned parameters was evaluated. In the
      30-year-old age group the right kidney was isoechoic as compared to the liver in
      1/3, and had clearly or faintly visible pyramids in 2/3 of the cases. These rates
      decreased gradually with increasing age. Transverse diameter of renal pelvis > or
      = 10 mm was observed in 13% of participants. Renal stones were observed in 2.1%.
      The incidence of split sinus echo was 3.6%. Obese participants showed lower
      incidences of isoechogenicity, pyramid visibility, pelvic ectasia, and split
      sinus echo. Isoechoic parenchyma, clearly visible pyramids, and transverse pelvis
      diameter > or = 10 mm are not uncommon sonographic findings in normal adult
      kidneys and should not be used as indicators of renal pathology.

PMID- 8369186
TI  - The kissing balloons technique. Simultaneous dilatation of stenoses of branch
      arteries at the bifurcation of the renal artery.
AB  - Whereas dilatation of a single stenosis of the main renal artery is a routine
      intervention, a narrowing of the renal artery at its bifurcation extending into
      the branch arteries poses a more complex problem. The procedural risks of renal
      artery dilatation are compounded by the danger of occlusion of one of the branch
      arteries during maneuvers to dilate the other. Long-term results of surgical
      vascular reconstruction at a renal artery bifurcation are not satisfactory.
      Untreated, these stenoses lead to intractable hypertension and impairment or loss
      of renal function. We present a patient with hypertension and impaired function
      of the right kidney on account of a renal arterial bifurcation stenosis. Using a
      bilateral transfemoral arterial approach 2 balloon catheters were simultaneously
      placed into the origins of the renal artery branches and both arteries were
      successfully dilated by the kissing balloons technique. This method provides an
      elegant alternative to difficult surgery to save an endangered kidney.

PMID- 8369187
TI  - Reactive mediastinal lymphadenopathy in bronchiectasis assessed by CT.
AB  - Mediastinal lymphadenopathy is commonly detected on CT. It is a non-specific
      finding, but because of its significance in the treatment in lung carcinoma it is
      important to know with which other disease states it is associated. We present a
      series of 42 patients in whom CT of the chest was used to confirm a clinical
      diagnosis of bronchiectasis. The size, number and distribution of mediastinal
      lymph nodes is documented. Lymph nodes were visible in 81% of patients. Nodes
      larger than 10 mm, the recognised maximum size for normal nodes in the U. K.,
      were detected in 29%. In the absence of other recognised causes of
      lymphadenopathy in these patients, these findings confirm "reactive" mediastinal
      lymph node enlargement in bronchiectasis.

PMID- 8369188
TI  - Carpet-layer's knee. An ultrasonographic study.
AB  - In order to reveal abnormalities in the soft tissue of the anterior part of the
      knee, caused by protracted mechanical stress, we performed ultrasound studies of
      both knees of 95 male workers in the carpet-laying and parquet floor trade (group
      1). Seventy-three painters (group 2) served as controls. In group 1, an anechoic
      fluid collection was detected in 10 knees, localized in the superficial
      infrapatellar bursa and in one patient in the prepatellar bursa, whereas there
      were no cases of fluid accumulation in the controls. A hypoechoic, oval
      subcutaneous thickening in the anterior wall of the superficial infrapatellar
      bursa was detected in 35 (18.4%) and 4 (2.7%) knees, respectively. Prepatellar
      subcutaneous thickening was detected in 45 knees (23.7%) in group 1, but in only
      2 knees (1.4%) in group 2. Two knees in group 1 had thickened and inhomogeneous
      patellar tendons, while one in group 2 had a thickened and 2 both thickened and
      hypoechoic patellar tendons. We conclude that ultrasonography is a useful method
      for the detection of bursitis and soft tissue changes in carpet-layers. Detection
      of a fluid collection in a bursa does not necessarily denote bursitis of clinical
      importance, but does signify irritation due to work stress. Patellar tendon
      pathology is rare among carpet-layers and is probably unrelated to the
      occupation.

PMID- 8369189
TI  - In vivo fluorescence microscopy of microcirculation in the renal cortex of mice.
      Part III. Effects of mannitol and iohexol infusions after pretreatment with
      cyclosporin A.
AB  - In vivo fluorescence microscopy was used for experimental studies of the renal
      cortical microcirculation in normal mice and in mice pretreated with the
      nephrotoxic drug cyclosporin A. The cortical circulation was studied after i.v.
      infusions of a nonionic low osmolar contrast medium (iohexol) and after infusions
      of mannitol. All infusions produced marked effects on the distribution and
      velocity of cortical blood flow with no differences between iohexol and mannitol.
      The renal cortical blood flow was inhomogeneous regarding different capillaries
      and there was an initial rise in the number of capillaries with increased blood
      flow after infusions of both mannitol and iohexol. There was simultaneously an
      increased number of capillaries with decreased blood flow following all
      infusions. The decreased blood flow after infusion of iohexol was more pronounced
      when the animals had been pretreated with cyclosporin A. The difference was only
      significant (p < 0.05) during a short part of the observation period of 30 min,
      but it may indicate that kidneys previously exposed to cyclosporin A are more
      susceptible to infusions of iohexol.

PMID- 8369190
TI  - In vivo fluorescence microscopy of microcirculation in the renal cortex of mice.
      Part IV. Effects of mannitol and iohexol infusions after temporary renal
      ischemia.
AB  - In vivo fluorescence microscopy was used for experimental studies of the renal
      cortical microcirculation in mice. The effects of i.v. infusions of mannitol and
      iohexol were studied in untreated mice as well as in mice after temporary renal
      ischemia. All infusions produced marked effects on the distribution and velocity
      of cortical blood flow with no differences between iohexol and mannitol. The
      renal cortical blood flow was inhomogeneous with respect to different capillaries
      and there was an initial rise in the number of capillaries with increased blood
      flow after infusions of both mannitol and iohexol. There was an initial increase
      in the number of capillaries with a decreased blood flow following 30 min of
      ischemia. This increase was reduced by both types of infusions, suggesting a
      beneficial effect on renal cortical blood flow. Neither mannitol nor contrast
      medium exhibited any adverse effects in ischemic kidneys that would be likely to
      affect renal function. However, 5 min after the infusions there was an increasing
      number of capillaries with decreased blood flow in all groups.

PMID- 8369191
TI  - Hemodynamic effects of gadodiamide injection and gadopentetate dimeglumine in
      anesthetized dogs.
AB  - A nonionic (gadodiamide injection) and an ionic (gadopentetate dimeglumine)
      contrast medium were compared for their effect on hemodynamics in the
      anesthetized, open-chest dog. Both agents were administered i.v. over 15 s at
      dosages of 1.0 and 1.5 mmol/kg, in randomized order. Both contrast agents
      resulted in transient but statistically significant decreases in aortic pressure,
      left ventricular pressure, indices of left ventricular contractility and
      relaxation, and systemic and pulmonary vascular resistance, and increases in
      aortic blood flow. At each dosage investigated, the changes associated with the
      administration of gadodiamide injection were of significantly smaller magnitude
      than those seen after gadopentetate dimeglumine and returned to preadministration
      levels sooner. The results from this study confirm that gadodiamide injection
      produces less severe alterations in hemodynamics than gadopentetate dimeglumine.

PMID- 8369193
TI  - MR appearance of central neurocytoma.
AB  - To provide a detailed description of the MR appearances of central neurocytoma,
      MR images of 13 patients with central neurocytoma were retrospectively reviewed
      and compared with CT examinations. The histology was confirmed by ultrastructural
      and immunohistochemical studies. In 12 patients the tumors were histologically
      benign and located in the anterior part of the lateral ventricle, 6 of which
      extended to the 3rd ventricle. There was one case of a histologically malignant
      variant involving the thalamus and lateral ventricle. The tumors were primarily
      solid, but contained cysts (85%, 11/13), calcifications (69%, 9/13), and signal
      void from tumor vessels (62%, 8/13), frequently producing heterogeneous signal
      intensity on both T1- and T2-weighted images. Most of the solid portion appeared
      isointense or slightly hyperintense relative to the cerebral cortex on all MR
      pulse sequences. Calcifications were iso- or hypointense on MR, making them
      difficult to characterize with MR alone. Intratumoral hemorrhage was seen in 2
      patients on MR but not on CT. Contrast enhancement was variable in degree and
      pattern. Coronal and sagittal MR images were valuable in evaluating the tumor
      extent and origin site, and in planning the surgical approach. It is concluded
      that MR imaging appears to be more useful than CT in the overall evaluation of
      central neurocytoma, even though calcification is better characterized with CT.

PMID- 8369192
TI  - Oral contrast media in CT of the abdomen. A double-blind randomized study
      comparing an aqueous solution of amidotrizoate, an aqueous solution of iohexol
      and a viscous solution of iohexol.
AB  - In a double-blind randomized study 3 different preparations of oral contrast
      media for bowel opacification at CT of the abdomen have been compared. Plain
      aqueous solutions of amidotrizoate (9 mg I/ml) and iohexol (9 mg I/ml) were used
      as well as a preparation of iohexol (9 mg I/ml) to which a viscosity-increasing
      agent had been added. The distribution of the contrast media in the intestine,
      transit time and patient tolerance were evaluated. No significant differences
      were found regarding the distribution between the 3 preparations of contrast
      media, while there was a tendency for the transit time to be increased when the
      viscous preparation of iohexol was used. The aqueous solution of iohexol had the
      best taste, while the viscous preparation was markedly more difficult to drink.
      Aqueous solutions of iohexol and amidotrizoate were equal for bowel opacification
      and the addition of the viscosity-increasing agent did not improve the
      distribution of the contrast medium in the intestine.

PMID- 8369194
TI  - MR imaging of monostotic fibrous dysplasia of the clivus. A case report.
AB  - We describe the MR appearance of a case of monostotic fibrous dysplasia confined
      to the clivus. The lesion showed intermediate signal intensity on T2-weighted
      images which is uncommon among clival diseases.

PMID- 8369195
TI  - Audiogenic seizures in magnesium-deficient mice: effects of magnesium pyrrolidone
      2-carboxylate, magnesium acetyltaurinate, magnesium chloride and vitamin B-6.
AB  - Magnesium deficiency in mice causes and increases audiogenic seizures. This
      effect was reversed by oral administration of magnesium acetyltaurinate (ATaMg),
      magnesium pyrrolidone-2-carboxylate (PCMH), MgCl2. When treatment was
      discontinued, audiogenic seizures recurred only in the groups treated with PCMH
      or MgCl2. Following intraperitoneal administration of AtaMg, the mice were
      protected against audiogenic seizures after 4 h and this protection persisted for
      up to 72 h after the treatment. With the other magnesium salts (PCMH and MgCl2)
      maximum protection occurred by 6 h after the injection, but after that time the
      number of seizures increased sharply. Intraperitoneal taurine alone only reduced
      the severity of the audiogenic seizures. The length of treatment needed to
      inhibit audiogenic seizures was reduced by treatment with a combination of
      vitamin B-6 (a magnesium fixing agent) and PCMH or MgCl2. However this
      combination of vitamin B-6 and magnesium salts did not prevent the recurrence of
      audiogenic seizures, which was only achieved by ATaMg. The results suggest that
      audiogenic seizures in magnesium-deficient mice form a model of magnesium
      depletion. This depletion is completely inhibited by the combination of an
      inhibitory neurotransmitter (taurine) and magnesium, in the form of magnesium
      acetyltaurinate.

PMID- 8369196
TI  - Brain weight and noradrenaline content in mice selected for low (MGL) and high
      (MGH) blood magnesium.
AB  - Brain noradrenaline content was determined by high performance liquid
      chromatography in adult male mice from three different strains: 40 mice with
      genetically low (MGL) or high (MGH) blood magnesium levels, obtained by selective
      breeding and 20 outbred Swiss albino mice. Brain wet weight and noradrenaline
      levels were significantly higher in MGL than in MGH and Swiss mice. Few or no
      differences were found between MGH and Swiss mice. MGL and MGH animals had a
      similar mean body weight, were raised in identical conditions, and were fed with
      a normal diet, rich in magnesium. These results together with the higher urinary
      noradrenaline excretion previously observed in the MGL line, indicate that the
      mere selection for genetic traits inducing low blood magnesium levels entails an
      increased catecholamine production. This phenomenon most probably accounts for
      the higher sensitivity and/or reactivity of MGL animals to stress. The possible
      role of magnesium-controlling genetic factors in the regulation of brain growth
      is also suggested.

PMID- 8369197
TI  - Hypothesis: possible links between the respiratory distress syndrome of the
      premature neonate, the sudden infant death syndrome, and magnesium deficiency
      shock.
AB  - This hypothesis notes the similarities in the respiratory distress syndrome (RDS)
      of premature neonates, sudden infant death syndrome (SIDS) of postneonates, and
      the seizure-shock syndrome of acute magnesium (Mg) deficiency in stressed
      weanling animals, and suggests a common pathogenic link between the three. In
      each of these syndromes the lung is the major target organ, with haemorrhage,
      oedema, and microvascular congestion. It is suggested that platelet aggregation,
      leading to the transient release of mediators of shock, causes an acute, self
      limited arachidonic acid cascade. The result of the shock is early death or
      spontaneous recovery with a propensity for recurrence; premature neonates who
      have had RDS are at particularly high risk for SIDS. Cases linking RDS and SIDS
      are cited.

PMID- 8369198
TI  - Blood magnesium, potassium, sodium, calcium and cortisol in drug-free depressed
      patients.
AB  - Many biochemical variables, including plasma and erythrocyte magnesium, were
      simultaneously measured in drug-free depressed patients (n = 34), compared to
      healthy controls (n = 35). Higher plasma and erythrocyte magnesium concentrations
      were observed in patients than in controls (+12 per cent, P < 0.0001 and 14 per
      cent, P < 0.0001, respectively). In contrast, patients showed a lower plasma
      potassium level (-10 per cent; P < 0.007). Cortisol secretion was much higher in
      patients (+35 per cent; P < 0.02), particularly in females, showing overactivity
      of the hypothalamo-hypophyseo-adrenal axis in the patients. Except in a few
      cases, plasma sodium and calcium in patients did not differ from control values.
      Significant differences in magnesium and cortisol levels were observed between
      patients classified in diagnostic groups and by sex, whereas little variation in
      the other biochemical indices was noted. The increase in blood magnesaemia and
      its possible association with central hypocatecholaminergic deficiency in
      affective disorders are discussed.

PMID- 8369199
TI  - Potassium replacement associated with the development of tetany in a patient with
      hypomagnesaemia.
AB  - A case of hypomagnesaemia secondary to cisplatin therapy and diarrhoea had
      concomitant hypokalaemia. Increasing the serum potassium level from 2.8 to 3.4
      mmol/litre by potassium supplementation induced tetany. Hypokalaemia in the face
      of hypomagnesaemia may have a membrane-stabilizing effect and preserve
      excitability.

PMID- 8369200
TI  - Magnesium content of human myometrium and placenta during various stages of
      gestation, and of different body fluids at term.
AB  - Pregnancy is marked by a state of hypomagnesaemia but not much is known about the
      effects of maternal magnesium deprivation on the fetus. The aim of this study was
      therefore to measure magnesium concentrations in human myometrial and placental
      tissues and in different body fluids during pregnancy and at term, using atomic
      absorption spectrophotometry. The magnesium concentration in umbilical cord blood
      was higher than in the maternal blood, supporting the existence of an active
      magnesium transport system. There was also a difference between the magnesium
      concentration in the amniotic fluid and that in the umbilical cord blood. The
      magnesium content of myometrium increased from the 32nd week of pregnancy,
      reaching its maximum level at the 37th week of gestation. Later there was
      significant decrease in magnesium level until the end of pregnancy. The magnesium
      content of placental tissue did not change up to the 30th week of pregnancy;
      however, it then decreased continuously during the last trimester. The
      significant improvement experienced in certain pathological conditions of
      pregnancy treatment with magnesium supports the existence of a magnesium deficit
      induced by pregnancy and the need for magnesium supplementation.

PMID- 8369201
TI  - Control of a cerebrospinal meningitis epidemic.

PMID- 8369202
TI  - Diarrhoeal Diseases Control Programme. Evaluation of training and performance.

PMID- 8369203
TI  - Measles in 1992.

PMID- 8369204
TI  - Lasers in dermatology.
AB  - Lasers have many applications in dermatology. Recent developments in laser
      technology have produced significant therapeutic advances in several areas. The
      introduction of pulsed tunable dye lasers has considerably improved the treatment
      of vascular lesions, particularly port wine stain malformations in children. A
      wider range of continuous-wave and quasi-continuous-wave lasers have also become
      available for treating vascular lesions, and their use in conjunction with
      automated delivery systems has improved results whilst reducing adverse effects.
      Increasing interest in treatment of pigmented lesions and tattoos has led to
      investigation of a range of high-power short-pulse lasers, and early results look
      very promising. However, further work is needed in all these areas to determine
      which lesions respond best to each laser system, and which treatment techniques
      are optimal.

PMID- 8369205
TI  - The effect of oral activated charcoal on the course of congenital erythropoietic
      porphyria.
AB  - The administration of oral activated charcoal to two patients with congenital
      erythropoietic porphyria has previously been reported to result in a marked
      reduction in plasma and urinary porphyrin concentrations and in one case,
      clinical remission. We describe an additional case in which the use of charcoal
      was associated with an apparent exacerbation of the biochemical activity of the
      disease following an initial period of remission. This result is unexpected, and
      currently unexplained. We conclude that charcoal therapy in porphyria may not be
      without risk, and should be used with caution.

PMID- 8369206
TI  - The effect of hormonal changes on cutaneous disease in lupus erythematosus.
AB  - The behaviour of cutaneous disease in systemic lupus erythematosus (SLE) and
      discoid lupus erythematosus (DLE), under the influence of various hormonal
      states, was studied in 68 patients. In 28 pregnancies, cutaneous disease was
      essentially unchanged. In a total of 57 patients whose lupus erythematosus (LE)
      had been diagnosed prior to the menopause, 20% described a premenstrual cutaneous
      exacerbation. Only three patients had taken an oestrogen-containing
      contraceptive. The duration of oral contraceptive treatment before the onset of
      lupus varied: 1 month in a patient presenting with the acute malar rash of SLE, 2
      months in a patient who presented with annular weals and later developed systemic
      features, and 12 months in a patient who developed generalized DLE. Thirty-three
      patients were menopausal at the time of the study; 4% had noticed a
      perimenopausal cutaneous flare. There was no deterioration in the skin of the
      five patients on hormone replacement therapy.

PMID- 8369207
TI  - The vellus hair follicle in acne: hair growth and sebum excretion.
AB  - In this study we investigated the activity of the vellus hair follicle in acne.
      Hair growth and sebum excretion in vellus hair follicles were measured on the
      forehead and back of men, and on the forehead, cheek, and back of women with
      acne. Hair growth was assessed by computerized image analysis (phototrichogram),
      and sebum excretion by computer analysis using Sebutape. In patients with acne,
      marked differences were revealed when results were compared with recent data from
      healthy persons. In particular, the mean growth rate of vellus hairs was higher,
      whereas the percentage of anagen hairs was lower, and the duration of the anagen
      phase shorter in patients with acne than in healthy individuals. Hair growth and
      sebum excretion depended significantly (P < 0.01) on the anatomical site
      (forehead 414 hairs/cm2, 0.053 mm/day, 34%; back 93 hairs/cm2, 0.16 mm/day, 21%).
      In addition, analysis of hair growth revealed significantly higher values in
      females than in males for (i) percentage of anagen hairs (P > 0.01), (ii) for
      vellus hair length (P < 0.05), and (iii) for the duration of the anagen phase (P
      < 0.01). The present study demonstrates that the activity of the vellus hair
      follicle is influenced by acne, and vice versa, and therefore its role in the
      aetiopathogenesis of acne should be reconsidered.

PMID- 8369209
TI  - PUVA treatment for alopecia areata--does it work? A retrospective review of 102
      cases.
AB  - The results of PUVA treatment for severe alopecia areata (AA) were reviewed in
      102 patients. Fifty-three per cent had greater than 90% regrowth of hair.
      Although these results appear to be encouraging, they differ little from what
      would be expected with no treatment. We consider that PUVA is not an effective
      treatment for AA.

PMID- 8369208
TI  - PUVA and cancer: a case-control study.
AB  - A detailed case-control study was carried out on 24 PUVA-treated patients with
      squamous cell cancer of the skin, and on an accurately matched control population
      of 96 PUVA-treated patients. Possible co-carcinogens, such as prior therapy with
      tar, ultraviolet-B, ionizing radiation, methotrexate and arsenic, were
      investigated. The only statistically significant association to emerge was that
      of prior therapy with methotrexate: relative risk 3.5; 95% confidence interval
      1.2-9.9. Our data suggest that prior therapy with methotrexate might be a risk
      factor for skin cancer in PUVA-treated patients.

PMID- 8369210
TI  - Increased adherence to keratinocytes of peripheral blood mononuclear leucocytes
      of a patient with drug-induced erythema multiforme.
AB  - The pathogenetic mechanisms involved in the development of drug-induced erythema
      multiforme (EM) are still largely unknown. The observation that epidermal
      keratinocytes (KC) in EM express intercellular adhesion molecule-1 (ICAM-1)
      points to a putative role for T-cell/KC adhesion in the pathogenesis of EM. In
      this study, the binding of peripheral blood mononuclear leucocytes (PBML) from a
      patient with carbamazepine-induced EM and of normal control PBML to autologous
      and heterologous KC was investigated, using two different binding assays. Patient
      PBML obtained at the time of disease (t0) showed an increased binding to ICAM-1
      positive heterologous KC, which could be inhibited completely by anti-LFA-1.
      Adhesion of patient PBML-t0 to autologous KC, and to carbamazepine-pretreated
      heterologous KC in sections of skin biopsies, was also increased, but was found
      to be only partially LFA-1-dependent. These findings support the view that
      PBML/KC adherence plays an important role in the pathogenesis of this drug
      induced EM.

PMID- 8369211
TI  - Dose-response testing with nickel sulphate using the TRUE test in nickel
      sensitive individuals. Multiple nickel sulphate patch-test reactions do not cause
      an 'angry back'.
AB  - The aim of this study was to employ the TRUE test assay to confirm the presence
      or absence of the 'angry back' phenomenon, i.e. that a strong positive patch-test
      reaction heightens adjacent patch-test response. In addition, we wished to
      establish the dose-response relationship for nickel sulphate patch tests among
      nickel-sensitive patients. Seventy-two nickel-sensitive patients, 36 in Odense
      and 36 in Stockholm, were tested with a 10-step nickel sulphate dilution series
      (TRUE test) and two placebo patches. The position of the patches was rotated, to
      provide a balanced spatial distribution of the different concentrations. Readings
      were performed blind. The results were analysed by means of polynomial multiple
      regression methods and a logistic dose-response model. Half the patients (38/72)
      had a threshold patch-test concentration for nickel sulphate in the range of 3
      0.3 microgram/cm2. The 'angry back' phenomenon was not apparent in this study, as
      the spill-over effect was not statistically significant. Strong reactions to high
      concentrations of nickel sulphate did not enhance the response to adjacent lower
      concentrations of nickel sulphate.

PMID- 8369212
TI  - Dermatomyofibroma: additional observations on a distinctive cutaneous
      myofibroblastic tumour with emphasis on differential diagnosis.
AB  - Following the very recent description of a benign plaque-like myofibroblastic
      tumour of the skin, known as dermatomyofibroma, we present four further cases,
      emphasizing its clinical features and its histological differential diagnosis.
      Three patients were adult females and one was a boy. Two of the lesions arose on
      the anterior abdominal wall, one on the shoulder, and one on the neck.
      Clinically, there was often close resemblance to a keloid. Follow-up revealed no
      evidence of recurrence after simple excision. Histologically, these were non
      encapsulated but well-circumscribed, plaque-like lesions located in the reticular
      dermis, and composed of fascicles of monomorphic myofibroblasts, orientated
      parallel to the skin surface. Immunohistochemically, most of the tumour cells
      expressed alpha-smooth-muscle actin. The principal differential diagnosis is
      plaque-stage dermatofibrosarcoma protuberans. Other differential diagnoses
      include diffuse neurofibroma, dermatofibroma and other myofibroblastic skin
      tumours.

PMID- 8369213
TI  - High-dose topical calcipotriol in the treatment of extensive psoriasis vulgaris.
AB  - Ten patients with extensive plaque psoriasis were treated with calcipotriol
      ointment (50 micrograms/g) for 2 weeks (200 g for 1 week, followed by 300 g
      during the second week). Mean improvement in psoriasis area and severity index
      (PASI) was 71%. Mean 24 h urine calcium rose from 4.79 mmol/24 h to 7.27 mmol/24
      h (P < 0.0001). Urine calcium returned towards baseline after stopping
      calcipotriol. Mean serum calcium also rose slightly, but significantly, from 2.26
      mmol/l to 2.32 mmol/l (P < 0.005), and fell again in the washout phase.
      Individual serum calcium values remained within the normal range throughout the
      study. Topical calcipotriol is an effective, rapidly acting and safe in-patient
      treatment for extensive plaque psoriasis.

PMID- 8369214
TI  - Hydralazine predisposes to acute cutaneous vasculitis following urography with
      iopamidol.
AB  - We report a 60-year-old woman with renovascular hypertension who developed a
      severe cutaneous vasculitis 24 h after the injection of iopamidol during
      urography. A review of the literature suggests that her concomitant hydralazine
      therapy probably predisposed her to this reaction, as similar reactions have
      occurred in systemic lupus erythematosus, and hydralazine can induce a LE-like
      syndrome. We recommend that urography should be avoided in patients receiving
      hydralazine.

PMID- 8369215
TI  - Collodion baby dehydration: the danger of high transepidermal water loss.
AB  - We describe transepidermal water loss (TEWL) measurements in a collodion baby
      suffering from severe hypernatraemic dehydration and hypothermia, who required
      intravenous fluid therapy in a special incubator. The TEWL values 4 days after
      birth were abnormally high compared with normal infants of the same age. The TEWL
      measurements returned towards normal within the first month, in parallel with the
      improvement of both the skin signs and the electrolyte and fluid balance.

PMID- 8369216
TI  - An unusual case of transient papular mucinosis associated with carpal tunnel
      syndrome.
AB  - A 67-year-old man presented with discrete mucinous papules on the scalp and
      fingers, and bilateral carpal tunnel syndrome. Both features remitted
      spontaneously within several months. The acral distribution, and
      histopathological features, were in keeping with the recently described acral
      persistent papular mucinosis. Involvement of the scalp, however, has not
      previously been described, and transient mucin deposition is unusual. The history
      of bilateral carpal tunnel compression raises the possibility of extracutaneous
      involvement, not previously reported in this group of patients.

PMID- 8369217
TI  - Detection of latent variegate porphyria by fluorescence emission spectroscopy of
      plasma.
AB  - The plasma of patients with overt variegate porphyria contains porphyrin with a
      fluorescence emission maximum at about 626 nm, which is diagnostic for the
      condition. We have evaluated qualitative fluorescence emission scanning of saline
      diluted plasma as a method for the identification of asymptomatic carriers of the
      gene for variegate porphyria. Plasma from 36 unrelated patients with variegate
      porphyria, 136 of their asymptomatic first- and second-degree relatives aged 15
      years or over, and 322 normal subjects was scanned. An emission maximum between
      621 and 627 nm was observed in the 36 patients with variegate porphyria and 54 of
      their relatives, but not in any normal subject, nor in 56 patients with other
      types of porphyria. For the detection of asymptomatic adult carriers of the gene
      for variegate porphyria, fluorescence emission scanning of plasma appears to be
      100% specific, with a sensitivity of 86% (95% confidence interval 71-98%). In
      contrast, the sensitivity of faecal porphyrin analysis as a test for adult gene
      carriers was 36%. These results suggest that fluorescence emission scanning of
      plasma should replace faecal porphyrin analysis as the test of first choice for
      this purpose.

PMID- 8369218
TI  - Vulvitis chronica plasmacellularis (Zoon's vulvitis).
AB  - Vulvitis chronica plasmacellularis (Zoon's vulvitis) is rare. We describe a case
      in whom all the typical features, as delineated by Zoon, are demonstrated.

PMID- 8369219
TI  - Diagnostic accuracy for basal cell papillomas.

PMID- 8369220
TI  - Cutaneous abscess: a rare complication of Streptobacillus moniliformis infection.

PMID- 8369221
TI  - Unusual onset of lupus erythematosus profundus.

PMID- 8369222
TI  - Tissue-specific regulatory elements of the Drosophila Gld gene.
AB  - Putative cis-acting regulatory elements immediately upstream of the Gld promoter
      were identified by comparative analysis of three Drosophila species. A 509 bp
      region containing these elements and the Gld promoter region was shown to confer
      tissue-specific regulation to a reporter gene similar to the pattern observed for
      Gld mRNA and protein. A dispersed repeat with a core motif of TTAGA was also
      capable of directing the expression of a reporter gene to several epidermally
      derived tissues in which GLD is normally expressed. These tissues include male
      and female somatic reproductive organs. The TTAGA elements and a palindromic
      element act antagonistically to block expression of reporter gene in some
      tissues. Previously reported mutations of the heat shock response element
      resulted in the creation of three TTAGA elements. This mutated hsp70 promoter
      directs expression of a reporter gene to many of the same tissues as does the Gld
      TTAGA elements. We have found TTAGA elements near the promoter of two other genes
      which show an identical expression pattern in the male ejaculatory duct as Gld
      and the mutant hsp70.

PMID- 8369223
TI  - Changes in protooncogene expression correlated with general and sex-specific
      differentiation in murine primordial germ cells.
AB  - Primordial germ cells (PGCs) of the mouse undergo key developmental transitions
      during embryonic days 12-15. On day 12 they complete migration into the gonads.
      They cease mitotic proliferation on day 13 and subsequently enter sex-specific
      pathways of development. The molecular mechanisms controlling these transitions
      are poorly understood, yet they are crucial to production of normal gametes later
      in life. We have used the polymerase chain reaction (PCR) to directly compare
      levels of expression of several protooncogenes proposed to be involved in control
      of cell proliferation and differentiation in proliferating and differentiating
      PCGs of both sexes over a 4 day time course. We report here that mRNA levels for
      nuclear protooncogenes c-myc, c-fos, and c-jun increase dramatically in both
      sexes from little or no detectable expression on day 12 to high expression on
      days 13-15. We observe c-kit message on day 12 in combined PGCs of both sexes, in
      female but not male PGCs on day 13, and in both sexes on day 14, c-kit mRNA is
      undetectable on day 15 in either sex, c-mos is not expressed at detectable levels
      on day 12 in either sex, but increases gradually in female PGCs to very high
      levels on day 15. In male PGCs, c-mos is expressed at high levels on days 13-15.
      Our results are consistent with a role for protooncogenes c-myc, c-fos and c-jun
      in mediating the initial differentiation of PGCs of both sexes that occurs upon
      colonization of the gonad. Because c-kit and c-mos are expressed differentially
      in male and female day 13-15 germ cells, they may play roles in initiating or
      mediating progress along the sex-specific pathways of development that PGCs
      embark upon at this time.

PMID- 8369224
TI  - Cloning and developmental expression of Grg, a mouse gene related to the groucho
      transcript of the Drosophila Enhancer of split complex.
AB  - Genes of the Enhancer of split complex are involved in neural-epidermal cell fate
      decisions during early embryogenesis in Drosophila. One of these genes, the
      product of the Enhancer of split m9/10 or groucho transcript, encodes a
      ubiquitous nuclear protein with homology at the carboxy-terminus to G-protein
      beta-subunits. Here we describe the cloning and RNA expression analysis of a
      mouse gene, designated Grg, that is homologous to just the amino-terminal region
      of the groucho product. Grg encodes a 197 amino acid protein that shares 53%
      amino acid identity with the corresponding region of the product of the
      Drosophila groucho gene. However, the mouse Grg protein does not contain the
      region homologous to G-protein beta-subunits. An analysis by in situ
      hybridization of the spatial and temporal localization of Grg RNA expression
      revealed that, while the initial pattern of Grg expression was quite restricted,
      by midgestation Grg RNA was ubiquitously expressed in the developing embryo.
      Widespread Grg RNA expression was maintained in adult mice. The implications of
      these results for the existence of separable functional domains of the Drosophila
      groucho product, and possible roles of the Grg gene during mouse development, are
      discussed.

PMID- 8369225
TI  - Contrasting distributions of patched and hedgehog proteins in the Drosophila
      embryo.
AB  - The segment polarity genes patched (ptc) and hedgehog (hh) are thought to encode
      a receptor and signal molecule respectively, components of a signal transduction
      pathway that regulates the transcription of the wingless gene in the Drosophila
      embryo. Here we describe the production of antibodies specific for the products
      of these two genes and the patterns of protein distribution that they reveal in
      the developing embryo. The results are consistent with the hh protein being
      secreted by cells in which it is expressed and support a role for ptc in the
      reception of the putative hh encoded signal.

PMID- 8369226
TI  - Egg ligation alters the Bcd protein gradient and segmentation gene expression in
      embryos of Drosophila.
AB  - A concentration gradient of the anterior morphogen Bicoid (Bcd) plays a key role
      in the specification of cell fates in the early Drosophila embryo. We found that
      introduction of a membrane barrier across the embryo results in increased levels
      of Bcd protein on the anterior side of the barrier and decreased levels on the
      posterior side, consistent with a blockage in the postulated anterior-to
      posterior translocation of Bcd protein. The expression patterns of downstream
      segmentation genes were in large part consistent with their regulation by the Bcd
      morphogen. However, some aspects of the patterns did not correlate with the
      altered Bcd distribution, suggesting that other morphogens also regulate the
      anteroposterior pattern. Our results suggest that axial translocation of
      morphogens is critical for establishing a well-proportioned body plan.

PMID- 8369227
TI  - Prenatal cerebral development in individuals at genetic risk for psychosis: head
      size at birth in offspring of women with schizophrenia.
AB  - Previous investigation has shown preschizophrenics to have disproportionately
      small head circumferences (HC) (in relation to body length) at birth, providing
      further evidence of disturbed prenatal cerebral development among
      preschizophrenics. This reduced HC at birth appeared to have resulted from some
      factor(s) other than genetic risk for schizophrenia, as reduced HC was
      significantly related to an absence of family history of psychosis. A re-test of
      the finding that genetic risk for schizophrenia is not associated with reduced HC
      at birth was performed in the current high-risk study, which compared HC: body
      length ratios at birth in 31 offspring born to women with a history of
      schizophrenia vs. 38 demographically comparable control offspring. The
      genetically high-risk offspring were highly similar to control offspring of HC:
      body length ratios, supporting the previous findings that disturbed prenatal
      cerebral development, as measured by disproportionately small HC, is not a
      function of genetic risk for schizophrenia.

PMID- 8369228
TI  - Ultrastructural features of biopsied temporopolar cortex (area 38) in a case of
      schizophrenia.
AB  - An electron microscopic study of tissue from area 38 of the temporopolar cortex
      obtained at surgery from a schizophrenic patient has established that, although
      the ultrastructure of this area was in general similar to that found in normal
      human cerebral cortex, the neuropil contained many unusual asymmetrical synapses.
      Their synaptic vesicles were clumped, often away from the synaptic thickenings,
      and the thickenings themselves were short, compared to the total length of
      apposed pre- and postsynaptic membranes. Some preterminals were unusual in that
      they were myelinated. The affected terminals were always of the asymmetrical
      variety, and therefore probably excitatory. Glutamate is likely to be the
      transmitter at, at least, some of these synapses. The clumped, but numerous,
      synaptic vesicles, together with short synaptic active zones, is consistent with
      previous observations of normal glutamate levels in schizophrenic brain, but
      reduced numbers of glutamate receptors in some cortical areas.

PMID- 8369229
TI  - The use of clozapine in treatment-refractory schizophrenia.
AB  - The effects of clozapine on positive and negative symptoms were studied in 103
      patients with treatment-refractory schizophrenia. The evaluation of symptom
      profile was made before and after clozapine treatment. Overt psychopathology did
      not vary significantly before clozapine treatment. Significant decreases in
      positive and negative symptoms were noted by the third month on clozapine. No
      further significant progress could be observed after 6 months of treatment. No
      fatal cases were observed, although two patients developed agranulocytosis during
      clozapine treatment.

PMID- 8369230
TI  - Haloperidol response and plasma catecholamines and their metabolites.
AB  - Eleven acutely psychotic patients with schizophrenia or schizoaffective disorder
      underwent a 5-7 day drug-washout period (with lorazepam allowed) prior to
      participating in a 6-week controlled dose haloperidol trial. Patients were
      evaluated longitudinally with clinical ratings and with plasma measures of the
      catecholamines dopamine (pDA) and norepinephrine (pNE) and their metabolites,
      homovanillic acid (pHVA) and 3-methoxy-4-hydroxyphenylglycol (pMHPG). All
      patients exhibited clinical improvement with haloperidol; the decrease in their
      Brief Psychiatric Rating Scale (BPRS) scores ranged from 32 to 89%. Measures of
      pHVA increased within the first week of treatment and returned to baseline by
      week 5. The pattern of change of pDA resembled that of pHVA. The pattern of
      change of pNE and pMHPG revealed a decrease over the course of treatment. The
      early increase and the subsequent decrease in pHVA were strongly correlated with
      improvement in positive symptoms on the BPRS. These data are consistent with
      previous reports on the change in pHVA and pMHPG during clinical response to
      haloperidol. The data on change of pDA and pNE further describe the nature of the
      biochemical response to this drug.

PMID- 8369231
TI  - The clinical relevance of an auditory attention task (PAT) in a longitudinal
      study of chronic schizophrenia, with placebo substitution for chlorpromazine.
AB  - A new auditory attention task (PAT) is described. The test comprises four
      different subtest combinations (diotic/dichotic, slow/fast) each of 5 min
      duration. Omission and commission errors are combined by an index of errors (IE).
      The PAT was given fortnightly to 20 chronic schizophrenic inpatients for more
      than one year. Independent psychiatrists rated the patients according to the
      Brief Psychiatric Rating Scale and a Global Rating Scale. All measures yielded
      significant test-retest reliabilities. The patients were stabilized on
      individualized doses of chlorpromazine (CPZ) and randomized to two groups.
      Placebo was substituted for CPZ during 10 weeks, according to a double-blind
      cross-over design. Significant deterioration under placebo was detected by all
      three methods, but the PAT was the most sensitive to change. The PAT mean score
      (M IE) was correlated with both rating scales. Unlike the rating scales, it also
      correctly ordered the twenty patients along a dimension which measured the
      severity of illness and 'predicted' hospital discharge.

PMID- 8369232
TI  - Effects of placebo, orphenadrine, and rising doses of chlorpromazine, on PAT
      performance in chronic schizophrenia. A two year longitudinal study.
AB  - An earlier study (Study 1: 14 months duration) showed that the PAT (an auditory
      attention task) is sensitive to changes of clinical state in chronic
      schizophrenia and is able to predict hospital discharge. The newly presented
      study (Study 2: 12 months duration) investigated the effects of increasing the
      dose of chlorpromazine (CPZ) stepwise (double-blind) to between 900 mg and 1800
      mg per day, in 10 of the original 20 patients. Measurements were made fortnightly
      throughout both studies and the data were depicted continuously for each patient.
      Study 2 showed that a 300% increase of CPZ dose neither improved nor impaired PAT
      performance. Also, the addition of orphenadrine 300 mg per day had no significant
      effect on performance. Four types of relapse were detected. The first was induced
      by placebo substitution for CPZ and recovered when the drug was reinstated. The
      remaining types of relapse were all resistant to CPZ and comprised: a long-period
      pattern with a spontaneous reversal; unremitting deterioration; and a short
      period pattern of labile relapse and recovery.

PMID- 8369233
TI  - Factor analysis of schizophrenic symptoms and comparison of different rating
      scales.
AB  - This study examines the factor structure of persistent schizophrenic symptoms and
      compares factors derived from different rating scales. Forty stable chronic
      schizophrenic patients were assessed for positive and negative symptoms. In
      factor analysis, 3 factors could be detected: a negative factor which correlated
      with low drug dose and increased involuntary movements, a thought
      disturbance/paranoid factor which correlated negatively with extrapyramidal side
      effects and a delusion/hallucination factor which correlated negatively with
      involuntary movements. These findings support the existence of a negative factor
      but only partly the trichotomous division of schizophrenic symptoms. Positive
      symptom organisation is heterogeneous but thought disorder marks one clear
      dimension and non-paranoid delusions and hallucinations may mark another. The
      type of scale used has very significant effects on the findings.

PMID- 8369235
TI  - Cognitive functioning and anhedonia in subjects at risk for schizophrenia.
AB  - This study investigated the performance of individuals with familiar loading of
      schizophrenia (healthy siblings of schizophrenic inpatients) on three
      neuropsychological tasks assumed to require frontal lobe functions: Trail Making
      Test (TMT), verbal fluency and Wisconsin Card Sorting Test (WCST). Healthy
      siblings of schizophrenics differed in performance from healthy controls not only
      on the WCST, but also on the Trail Making Test and the verbal fluency task.
      Furthermore, scores of physical anhedonia, assessed in a self-report rating scale
      (Chapman et al., 1976) were also significantly higher in the high risk group than
      in the control sample. However, healthy siblings of schizophrenics did not differ
      from controls with regard to experiences of perceptual aberrations, measured by
      the same method (Chapman et al., 1978). Neuropsychological performance and
      elevated anhedonia scores in the high risk group were interpreted under the
      conceptual framework of vulnerability markers: they were supposed to represent a
      trait shared by family members of schizophrenic probands. Amongst the
      neuropsychological tests, there were significant correlations between the
      physical anhedonia score and WCST and Trail Making test performance in the group
      of healthy siblings of schizophrenics, but not in the control group.

PMID- 8369234
TI  - Puberty and the onset of psychosis.
AB  - According to the neurodevelopmental hypothesis of schizophrenia, maturational
      events in the brain at puberty interact with congenital defects to produce
      psychotic symptoms. As girls reach puberty at a younger age than boys, we
      predicted that (i) females would show earlier onset of psychotic illness arising
      around puberty, and (ii) onset of psychosis in females would be related to
      menarche. Analysis of epidemiological data regarding admission to psychiatric
      units in (a) England over the period 1973-1986, (b) France over the period 1975
      1980, as well as examination of 97 psychotic adolescents referred to an
      adolescent unit over a 14 year period, supported both these propositions.

PMID- 8369236
TI  - Memory functioning in chronic and non-chronic schizophrenics, affectively
      disturbed patients and normal controls.
AB  - Memory impairment has been reported among schizophrenics in several studies.
      There are a number of uncertainties in interpreting such deficits. The present
      study examined short- and long-term verbal memory in schizophrenic patients (n =
      30), affectively distributed patients (n = 18) and normal controls (n = 18).
      Schizophrenics showed a significant decrease in memory test performance, compared
      with both normal controls and other psychiatric patients. Chronic schizophrenics
      seem to be characterized by qualitatively different memory functioning compared
      with non-chronic subjects. In a free recall task chronic subjects showed
      significantly decreased performance for the initial (primacy) and final (recency)
      items. Memory functioning was not correlated with performance on the Wisconsin
      Card Sorting Test. This could indicate a selective cognitive dysfunction of an
      amnesic nature in chronic schizophrenics.

PMID- 8369237
TI  - Stimulation of murine intestinal intraepithelial lymphocytes by the bacterial
      superantigen staphylococcal enterotoxin B.
AB  - To gain insight into the specificity and function of intestinal intraepithelial
      lymphocytes (IEL), we have examined their response to staphylococcal enterotoxin
      B (SEB), a significant cause of food poisoning and a potent T cell mitogen. IEL
      include two populations of TCR alpha beta+ T cells. One of these resembles the T
      cells found in the Peyer's patch and is thymus dependent. The other subset is
      characterized by both TCR alpha beta and gamma delta+ IEL bearing a unique form
      of the CD8 molecule, expressed as an alpha alpha homodimer. CD8 alpha+ beta- IEL
      are thymus independent and appear to mature extrathymically in the gut
      epithelium. Two-color flow cytometric analysis showed that in vitro stimulation
      of IEL with SEB resulted in the expansion of the thymus dependent but not the
      thymus independent IEL; the CD8 alpha+ beta- IEL were functionally non-responsive
      to stimulation with SEB. 'Forbidden' self-superantigen reactive T cells present
      among IEL were also non-responsive to stimulation with SEB. The presence or
      absence of class II MHC molecules does not appear to play a role in the non
      responsiveness to SEB, since CD8 alpha+ beta- IEL from class II deficient mice
      also failed to respond to stimulation with SEB. Depletion of CD8 beta+ and CD4+ T
      cells from total IEL decreased IL-2 production by IEL in response to cross
      linking with anti-CD3, suggesting that the non-responsiveness of CD8 alpha+ beta-
      IEL extends to antigens other than SEB.

PMID- 8369238
TI  - Functional inactivation of the CD3 zeta chain in a T cell hybridoma by in vitro
      gene targeting.
AB  - Specific inactivation of the CD3 zeta or CD3 eta gene was introduced into a
      murine T cell hybridoma cell line by homologous recombination to elucidate the
      role of the CD3 zeta chain in the assembly of and signal transduction through the
      TCR complex. Since CD3 zeta and CD3 eta are alternatively spliced forms from a
      common gene with the only difference occurring in the last exon, we constructed
      targeting vectors by introducing a neomycin phosphotransferase gene into the CD3
      zeta- or CD3 eta-specific exon to selectively inactivate zeta or eta.
      Subsequently, clones bearing a mutated allele were established. In spite of the
      disruption of only a single allele of the CD3 zeta gene in the CD3 zeta-targeted
      clone, most of the authentic zeta transcripts and zeta proteins disappeared from
      the cells, resulting in an extreme decrease in cell surface expression of the TCR
      complex. Consequently, these cells exhibited no antigen response. These defects
      were compensated by transfecting the CD3 eta gene. These results confirm previous
      studies on a somatic mutant showing that CD3 zeta has crucial roles in antigen
      recognition by and signaling through, as well as the expression of, the TCR-CD3
      complex. Our results suggest that there is a major transcriptionally active
      allele for the expression of these genes in this cell line which seems to be
      susceptible to homologous recombination. In vitro gene targeting, therefore,
      provides a powerful approach for studying the roles of intracellular molecules.

PMID- 8369239
TI  - Emergency contraception: time for de-regulation?

PMID- 8369240
TI  - Male infertility.

PMID- 8369241
TI  - Endometriosis: still an enigma.

PMID- 8369242
TI  - A paramedic based emergency domiciliary obstetric service: the South Glamorgan
      experience.
AB  - OBJECTIVE: To assess the potential benefits of using extended trained ambulance
      personnel (paramedics) as primary responders for domiciliary obstetric and
      gynecological emergencies. DESIGN: An observational study of performance and
      analysis of operational data in a newly established service. SETTING: A mixed
      urban and rural population served by South Glamorgan Health Authority. MAIN
      OUTCOME MEASURES: Work load, response times, management and transfer of patients,
      efficiency of communications and appropriateness of training. RESULTS: There was
      an initial increase in requests above that when a hospital-based service
      operated. Targets for response times were met. The mean response time for
      providing appropriate skilled help was halved compared with the previous
      arrangements and a safe and efficient service was provided. Prompt transport and
      advance notice and preparation for reception in the delivery unit contributed to
      optimal management. Medical staff depletion in the delivery unit was minimised.
      CONCLUSION: An Emergency Domiciliary Obstetric Service based on primary response
      by specially trained ambulance service paramedics can beneficially replace
      traditional hospital-based Obstetric Flying Squads.

PMID- 8369243
TI  - Phenytoin prophylaxis in severe pre-eclampsia and eclampsia.
AB  - OBJECTIVE: To determine plasma phenytoin levels and seizure outcome in women
      given phenytoin for seizure prophylaxis in severe pre-eclampsia and eclampsia.
      DESIGN: Prospective observational study comparing two phenytoin loading regimens.
      SETTING: Two UK teaching hospitals. SUBJECTS: Sixty-seven consecutive women with
      severe pre-eclampsia and five with eclampsia. INTERVENTIONS: The first 29 women
      were given a 15 mg/kg intravenous loading dose of phenytoin. The next 43 received
      17.5 mg/kg. All were given 500 mg phenytoin 12 h after completion of the loading
      dose and then 250 mg every 12 h for four doses. MAIN OUTCOME MEASURES: Total
      plasma phenytoin levels at 30 min, 6 h and 12 h after loading dose, 6 h after
      first maintenance dose and on days 2 and 3 of maintenance therapy; eclamptic
      seizures after starting phenytoin. RESULTS: Mean plasma phenytoin levels were
      higher at 30 min and 6 h after the 17.5 mg/kg loading dose. Nine of 29 (31%)
      phenytoin levels 30 min after the loading dose were above the therapeutic range
      in the 15 mg/kg group compared with 26/38 (68%) in the 17.5 mg/kg group (P <
      0.01). Six of 27 (22%) phenytoin levels 12 h after the loading dose were
      subtherapeutic in the 15 mg/kg group compared with 2/38 (5%) in the 17.5 mg/kg
      group (P < 0.05). Three women, two in the 17.5 mg/kg group, developed seizures
      after starting phenytoin. All three had plasma levels within the therapeutic
      range. CONCLUSIONS: Compared with a loading dose of 17.5 mg/kg, loading with 15
      mg/kg phenytoin was associated with a lower incidence of high plasma levels at 30
      min but a higher incidence of subtherapeutic levels at 12 h. Seizures occur in 2
      to 3% of pre-eclamptics despite apparently therapeutic phenytoin levels.

PMID- 8369244
TI  - The effect of anxiety and depression during pregnancy on obstetric complications.
AB  - OBJECTIVE: To investigate the effects of anxiety and depression during pregnancy
      on obstetric complications using the data collected from the St George's
      Birthweight Study. DESIGN: Prospective population study. SETTING: District
      general hospital in inner London. SUBJECTS: A consecutive series of 1860 white
      women booking for delivery were approached. Of these, 136 refused and 209 failed
      to complete the study for other reasons, leaving a sample of 1515. MAIN OUTCOME
      MEASURE: Data were obtained by research interviewers at booking, 17, 28, and 36
      weeks gestation and from the structured antenatal and obstetric record. The
      predictor variables were the anxiety and depression scores measured using the
      General Health Questionnaire. The outcome variables were five obstetric
      complications: preterm delivery; nonspontaneous onset of labour; major analgesia
      in the first and second stages of labour; and nonspontaneous vaginal deliveries.
      The possible confounding effects of 35 socio-economic, psychological and personal
      variables were investigated using logistic regression. RESULTS: The factors that
      had the strongest relation with the outcomes were parity and maternal age.
      Depression during pregnancy was unrelated to the obstetric complications. Anxiety
      was weakly related to analgesia/anaesthesia in the second stage of labour (P =
      0.04). However, anxiety accounted for only 0.1% of the variance in use of major
      analgesia/anaesthesia. The most effective model, that for analgesia/anaesthesia
      in the first stage of labour, accounted for only 7.3% of the variance.
      CONCLUSIONS: In the general population of pregnant women, anxiety and depression
      during pregnancy, while undesirable in themselves, are of little importance in
      the evolution of obstetric complications.

PMID- 8369245
TI  - Cervical contractions: the response of the cervix to oxytocic stimulation in the
      latent phase of labour.
AB  - OBJECTIVE: To assess the cervical response to myometrial activity in early
      labour. DESIGN: Prospective observational study. SUBJECTS: Women requiring
      oxytocin stimulation in induced and spontaneous labours. SETTING: A teaching
      hospital in Birmingham. MAIN OUTCOME MEASURES: Simultaneous comparison of the
      cervical response to myometrial contractions was made on a cycle by cycle basis
      to deduce the properties of the cervix in early labour. RESULTS: Sixty-seven
      patients have been monitored, of whom 63 had satisfactory cervimetry data. Thirty
      (47.6%) women exhibited cervical contractions in response to myometrial activity.
      This response was only observed at dilatations up to 4 cm. The change in
      behaviour coincides with the transition from latent to active phases of
      dilatation. The length of the latent phase of labour was significantly longer in
      those women who exhibited cervical contractions (P < 0.001), although the active
      phase was similar in the two groups (P > 0.1). The group without cervical
      contractions exhibited a greater degree of effacement (P < 0.05) and tended to
      have more dilated cervices (P < 0.01) than those who showed cervical
      contractions. CONCLUSIONS: It is possible for the cervix to contract in early
      labour. This response may be the result of incomplete preparation of the cervix
      for the process of dilatation, and is seen during what is recognised as the
      latent phase in those women in whom the cervix is unaffected and undilated. These
      properties of the cervix may explain the poor results obtained from oxytocin
      stimulation of labour in the latent phase.

PMID- 8369246
TI  - Intravaginal misoprostol as a cervical ripening agent.
AB  - OBJECTIVE: To determine if misoprostol (exogenous prostaglandin E1 PGE1) used
      vaginally was of value in improving the Bishop score, leading to an early safe
      vaginal delivery in women in whom the cervix is unripe and delivery is indicated.
      DESIGN: A double-blind clinical trial. SETTING: Antenatal and labour wards of the
      University Hospital of the West Indies, Jamaica. SUBJECTS: Forty-five women in
      the third trimester with various obstetric indications for induction of labour
      and with no contra-indications to prostaglandins. INTERVENTIONS: The women were
      randomly assigned to receive treatment or a placebo. The treated group had 100
      micrograms misoprostol inserted vaginally while the placebo was similarly
      inserted. MAIN OUTCOME MEASURES: Efficacy of the misoprostol was measured by the
      increase in the Bishop score 12 h after giving the treatment, the time between
      insertion and delivery, the need for oxytocin, and the outcome of the pregnancy.
      RESULTS: The prostaglandin was superior to the placebo in ripening the cervix and
      inducing labour. The change in Bishop score was 5.3 in the misoprostol group
      compared with 1.5 in the placebo group (P < 0.001). The mean time from insertion
      to delivery was 15.6 h in the former while it was 43.2 h in the placebo group (P
      < or = 0.001). The need for oxytocin was also significantly less in the women
      receiving the prostaglandin compared with those who received the placebo (29% vs
      62%, P < 0.02). There was no difference in the two groups in the delivery outcome
      in terms of complications, Apgar scores and mode of delivery. CONCLUSIONS:
      Intravaginal misoprostol is an effective and cheap method of inducing labour in
      the third trimester.

PMID- 8369247
TI  - Are the WHO (1980) criteria for the 75 g oral glucose tolerance test appropriate
      for pregnant women?
AB  - OBJECTIVE: To determine the normal response to a 75 g glucose challenge in the
      context of an oral glucose tolerance test in the third trimester of pregnancy.
      DESIGN: Prospective observational study. SETTING: Antenatal clinic, Kandang
      Kerbau Hospital, Singapore. SUBJECTS: Sixty-four normal pregnant women with a low
      risk for diabetes. INTERVENTIONS: Glucose (75 g) challenge following an overnight
      fast after 28 weeks of gestation. MAIN OUTCOME MEASURE: Venous plasma glucose
      levels taken before and 2 h after the glucose challenge. RESULTS: Upper limits of
      normality were found to be fasting glucose 4.9 mmol/l and 2 h glucose 9.2 mmol/l.
      CONCLUSION: The WHO (1980) criteria should not be used in pregnancy.

PMID- 8369248
TI  - A nonpenetrating fetal scalp electrode.
AB  - OBJECTIVE: To develop a nonpenetrating scalp electrode for intrapartum fetal
      monitoring. DESIGN: Preliminary observational evaluation of the device. SETTING:
      An urban academic hospital in Johannesburg, South Africa. SUBJECTS: Fifteen women
      in labour. INTERVENTION: Application of the electrode for intrapartum monitoring.
      OUTCOME MEASURES: Quality of tracings, duration of application, disconnection of
      the electrode, marking of the scalp. RESULTS: Application was successful in 13 of
      15 women, and high quality tracings obtained in 12. CONCLUSIONS: The design of
      scalp electrode tested is effective and produces high quality tracings in most
      cases.

PMID- 8369249
TI  - Prediction of fetal acidaemia in intrauterine growth retardation: comparison of
      quantified fetal activity with biophysical profile score.
AB  - OBJECTIVE: To study the relation between quantified fetal movements and fetal
      activity assessed by the biophysical profile score and the pH in umbilical
      arterial blood at elective caesarean section. DESIGN: Fetal activity was assessed
      within 24 h prior to caesarean section for decelerative fetal heart rate patterns
      both by quantification (% of time spent moving) and by applying the biophysical
      profile score (BPS) criteria. SETTING: Department of Obstetrics, University
      Hospital. SUBJECTS: Nineteen growth retarded fetuses. MAIN OUTCOME MEASURES:
      Fetal generalised movements (FGM%), fetal breathing movements (FBM%), total fetal
      activity (TFA% = FGM% + FBM%); FGM, FBM and tone as assessed according the
      biophysical profile score (BPS); umbilical arterial pH. RESULTS: In all 11
      acidaemic fetuses (pH < 7.20) TFA% was below the 10th centile for normal fetuses;
      nine had decreased FGM% and eight decreased FBM%. Absence of FGM or tone
      according to the biophysical profile score was only seen in two acidaemic
      fetuses. CONCLUSION: TFA% < 11.7% was a better predictor of acidaemia at birth
      than either reduced FGM%, FBM%, or absence of FGM, FBM and tone as defined in the
      biophysical profile score. The two methods of assessing FBM were identical in
      predicting acidaemia, suggesting that in presence of acidaemia the decrease of
      FBM may be an all-or-none phenomenon. Furthermore, the data indicate that
      reduction in body movements may precede reduction in breathing movements.

PMID- 8369250
TI  - Invasive carcinoma of the cervix following local destructive treatment for
      cervical intraepithelial neoplasia.
AB  - OBJECTIVE: To investigate the occurrence of invasive carcinomas following local
      destructive treatment for cervical intraepithelial neoplasia (CIN) and to
      evaluate the factors responsible. DESIGN: A multicentre retrospective study.
      SUBJECTS: Forty-nine women registered with the British Society for Colposcopy and
      Cervical Pathology from 24 centres throughout Great Britain between 1985 and
      1992, who had been treated by local destructive methods for CIN and who
      subsequently developed invasive carcinoma of the cervix. RESULTS: Of the 49 women
      whose details were submitted, 42 had squamous cell carcinoma, six adenosquamous
      carcinoma and one adenocarcinoma. Eight had microinvasive carcinomas (Stage Ia)
      at the time of diagnosis, 24 had Stage Ib tumours and eight Stages II to IV.
      Thirteen women have died. Thirty-five women had been treated by laser
      vaporization, ten by cold coagulator, two by diathermy and two by cryosurgery. In
      19 women (39%) the diagnosis of invasive carcinoma was made on the first follow
      up visit or within one year of treatment. Five patients did not present with
      invasive disease until more than five years after treatment. CONCLUSIONS: The
      data presented suggest that many, but not all, of the invasive carcinomas
      presenting after local destructive treatment for CIN resulted from failure to
      recognise early invasive disease at the time of the initial assessment. The
      importance of thorough evaluation before undertaking these forms of treatment is
      emphasised. The use of excisional procedures should further reduce the small risk
      of invasive carcinoma developing after treatment for CIN.

PMID- 8369251
TI  - The Royal College of Obstetricians and Gynaecologists micro-invasive carcinoma of
      the cervix study: preliminary results.
AB  - OBJECTIVES: To determine how micro-invasive carcinoma of the cervix is diagnosed
      and treated in the United Kingdom. To record the frequency of the various
      pathological features which comprise the histological diagnosis of micro
      invasion, and to assess their relevance to outcome. DESIGN: Prospective
      observational study. SETTING: Hospitals throughout the United Kingdom. SUBJECTS:
      Two hundred and eighty-six cases were submitted for entry into the study.
      Following independent review of the histological material 116 cases were
      excluded: 41 were not accompanied by histological slides for review, 55 had no
      evidence of invasive disease, 17 had invasive disease greater than FIGO Stage 1a,
      and three were adenocarcinomas. The remaining 170 cases were registered for the
      study but follow up was incomplete in 18. This report concerns the 152 women with
      complete follow up to 1991. RESULTS: The age of the 152 women ranged from 22 to
      65 years (median 36 years). In 116 women (76%) the diagnosis was made by cone
      biopsy (cold knife, loop diathermy, or laser) or wedge biopsy, in 9 women (6%)
      the diagnosis was made by hysterectomy, and in 27 women (18%) punch biopsy
      suggested an invasive lesion and subsequent excisional treatment (including
      radical hysterectomy with node dissection in three) demonstrated micro-invasion.
      The depth of invasion was up to 3 mm in 142 women (93%) and 3.1 to 5 mm in 10
      women (7%). Capillary-like space involvement was present in 12 women (8%).
      Treatment methods used were local cervical surgery in 79 women (52%), simple
      hysterectomy in 63 (41%), and radical hysterectomy in 10 (7%). There was only one
      known recurrence and death due to cervical carcinoma. CONCLUSION: There is no
      uniformity in the management of micro-invasive carcinoma of the cervix. The
      frequency of recurrence, lymph metastases, and death is low. Nonradical surgery
      appears to give satisfactory results.

PMID- 8369252
TI  - Antithyroid antibodies underlying thyroid abnormalities and miscarriage or
      pregnancy induced hypertension.
AB  - OBJECTIVE: To assess whether asymptomatic abnormalities, including thyroid auto
      antibodies, were associated with an abnormal miscarriage rate or a poor obstetric
      outcome. DESIGN: Prospective study of thyroid auto-antibodies and thyroid
      function in an unselected obstetric population. SETTING: Saint-Pierrie Hospital,
      Brussels, Belgium. SUBJECTS: Seven hundred and thirty consecutive pregnant women
      attending the antenatal clinic. MAIN OUTCOME MEASURES: Miscarriage and pregnancy
      induced hypertension. RESULTS: Elevated antithyroperoxidase (TPO-Ab) and
      antithyroglobulin (TG-Ab) antibody titres are associated with an increased
      miscarriage rate. Also, asymptomatic thyroid abnormalities, mainly abnormal echo
      structure but not antithyroid antibodies, are associated with pregnancy induced
      hypertension. CONCLUSION: The presence of thyroid auto-antibodies during
      pregnancy constitutes a marker of increased risk of miscarriage and poor
      obstetric prognosis.

PMID- 8369253
TI  - Erythrocyte sodium lithium countertransport in normal and hypertensive pregnancy:
      relation to haemodynamic changes.
AB  - OBJECTIVE: To establish the changes in erythrocyte sodium lithium
      countertransport (SLC) with advancing normal pregnancy and to determine if these
      changes were different in pregnancy induced hypertension (PIH). The changes in
      both groups were assessed in relation to haemodynamic changes. DESIGN: SLC, mean
      arterial pressure (MAP), cardiac output (CO) and total peripheral vascular
      resistance (TPVR) were determined serially during normal pregnancy and cross
      sectionally in PIH. Women were studied again 20 weeks after delivery where
      possible. SETTING: Routine antenatal clinic and antenatal ward of a regional
      reference centre. SUBJECTS: Fifty-one normal primigravid women were studied
      serially and 41 primigravid women with PIH were studied at time of diagnosis.
      RESULTS: During normal pregnancy SLC (mmol Li/h/l cells) increased from a
      nonpregnant value of 0.24 +/- 0.02 (mean +/- SEM) to 0.32 +/- 0.02 at 14 weeks,
      and 0.37 +/- 0.02 at 20 weeks gestation. This was maintained until 38 weeks (0.40
      +/- 0.02). The increase until 20 weeks occurred at the time of greatest change in
      CO (5.10 +/- 0.18 to 6.79 +/- 0.20 l/min) and TPVR (1327 +/- 58 to 969 +/- 33
      dyn/s/cm-5). The decrease in TPVR with a rise in SLC is opposite to the relation
      reported in essential hypertension so that a functional relation is unlikely.
      However, the changes within pregnancy were positively correlated (r = 0.43, P <
      0.01). In hypertensive pregnancies TPVR was elevated compared with normotensive
      pregnancies (1543 +/- 100 vs 1090 +/- 37) but the SLC was not different from that
      found in normotensive pregnancies (0.43 +/- 0.02 vs 0.40 +/- 0.02). CONCLUSIONS:
      The changes in SLC activity suggest dynamic effects on erythrocyte membrane
      function during pregnancy. However, no differences could be found between normal
      and hypertensive pregnancy and SLC is unlikely to be of value as a marker of
      hypertensive risk during pregnancy.

PMID- 8369254
TI  - Alterations in erythrocyte chloride content accompanying the changes in
      erythrocyte hydration and potassium content in normal human pregnancy: a
      comparison with pregnancy induced hypertension.
AB  - OBJECTIVES: To determine whether the change in erythrocyte potassium content in
      normal human pregnancy is accompanied by a similar change in erythrocyte chloride
      content. To assess erythrocyte hydration and potassium and chloride content in
      pregnancies complicated by proteinuric pregnancy induced hypertension. DESIGN: A
      serial study during and after normal pregnancy. A comparative study during and
      after pregnancies complicated by proteinuric pregnancy induced hypertension
      (PIH). Erythrocyte hydration, total osmoles, potassium and chloride and plasma
      osmolality were determined. SETTING: University teaching hospital, UK. SUBJECTS:
      Twenty-eight women studied at 14, 28 and 36 weeks of normal pregnancy and ten
      women with PIH studied during the third trimester of pregnancy. All women were
      reinvestigated 20 weeks after delivery. RESULTS: The fall of erythrocyte
      potassium early in normal pregnancy (277.4 vs 265.2 mmol/kg; P < 0.02) and its
      rise between 28 and 36 weeks (272.3 vs 288.0 mmol/kg; P < 0.005) were accompanied
      by similar changes in erythrocyte chloride content (151.9 vs 131.1 mmol/kg; P <
      0.001 and 129.4 vs 141.3 mmol/kg; P < 0.001, respectively). Plasma osmolality in
      PIH was raised above that normal in pregnancy (287.2 vs 283.0 mosm/kg; P <
      0.005). In PIH, compared to normal pregnancy, erythrocyte hydration (2.00 vs 1.89
      l/kg dry weight cells), total osmoles (573.0 vs 534.2 mosm/kg), potassium (303.0
      vs 288.0 mmol/kg) and chloride (154.9 vs 141.3 mmol/kg) were greater.
      CONCLUSIONS: These findings further support the hypothesis that changes in plasma
      osmolality in pregnancy are secondary to alterations in cell osmoles and serve to
      limit changes in cell hydration. Erythrocyte composition and plasma osmolality
      are altered in PIH.

PMID- 8369255
TI  - Whole blood platelet aggregation in moderate and severe pre-eclampsia.
AB  - OBJECTIVE: To compare whole blood platelet aggregation in moderate and severe pre
      eclampsia with normal pregnancy. DESIGN: Whole blood platelet aggregation in
      response to collagen, ADP, PAF, adrenalin and arachidonic acid was measured in
      the pre-eclampsia group at 36 weeks gestation and at 1, 24 and 48 h and at five
      days and six weeks post delivery. The normal pregnancy group were studied
      serially at 12, 20, 28, 32, and 36 weeks gestation and at 1, 24, 48 h and six
      weeks post delivery. SETTING: Trinity College Medical School, St James's
      Hospital, Dublin. SUBJECTS: Thirty women with diagnosed pre-eclampsia were
      recruited for the study. Fifteen of these women had severe pre-eclampsia and the
      remaining 15 had moderate disease. The pre-eclampsia group were compared with 20
      healthy primigravid women with uncomplicated pregnancies and deliveries. RESULTS:
      In women with severe pre-eclampsia, platelet aggregation in response to collagen,
      ADP, adrenalin and arachidonic acid was significantly lower at 36 weeks gestation
      compared with normal pregnancy. Lower levels of collagen induced aggregation were
      also found at 1 h post delivery when compared with normal pregnancy. Women with
      moderate pre-eclampsia showed a decreased response to aggregating agents at 36
      weeks gestation but this was not significant. ADP, collagen and PAF induced
      aggregation was higher in women with moderate pre-eclampsia at 36 weeks gestation
      and during the early puerperium compared with severe pre-eclampsia. CONCLUSIONS:
      The clinical signs of pre-eclampsia are accompanied by a reduction in platelet
      responsiveness, the extent of which is related to the severity of the disease.
      This suggests that an abnormal platelet activation occurs early in pregnancies
      destined to be complicated by pre-eclampsia. This activation may be involved in
      the pathogenesis of pre-eclampsia since its inhibition using low dose aspirin has
      been shown to modify the disease in high risk pregnancies.

PMID- 8369256
TI  - The use of gemeprost pessaries to arrest postpartum haemorrhage.

PMID- 8369257
TI  - Pregnancy and ACE inhibitors.

PMID- 8369258
TI  - Cervical cancer: the diagnostic value of rectosonography for the judgement of
      parametrial invasion in regard of inflammatory stromal reaction.

PMID- 8369259
TI  - Sex hormone binding globulin concentrations in premenstrual syndrome.

PMID- 8369260
TI  - Epidemic of conjoined twins in Cardiff.

PMID- 8369261
TI  - Computerised and visual assessment of the cardiotocograph.

PMID- 8369262
TI  - Prevalence of hepatitis B and C viruses and human immunodeficiency virus
      infections in women of reproductive age.

PMID- 8369263
TI  - Long term follow up of women after hysterectomy with a history of pre-invasive
      cancer of the cervix.

PMID- 8369264
TI  - Long term follow up of women after hysterectomy with a history of pre-invasive
      cancer of the cervix.

PMID- 8369265
TI  - Antibiotic prophylaxis and caesarean section.

PMID- 8369266
TI  - Endometrial changes and lesions in postmenopausal women treated with tamoxifen.

PMID- 8369267
TI  - Neuroendocrine neoplasms of the lung. A 10 year perspective of their
      classification.
AB  - Based on clinical and pathologic data, neuroendocrine neoplasms of the
      bronchopulmonary tract may be classified into 3 groups: bronchial carcinoid; well
      differentiated neuroendocrine carcinoma (WDNC); poorly differentiated
      neuroendocrine carcinoma. The criteria of classification and the problems of
      multidirectional differentiation are discussed in detail.

PMID- 8369268
TI  - [Medullary thyroid carcinoma. Immunohistochemical markers in histopathology and
      research].
AB  - Medullary thyroid carcinoma, a tumour derived from the calcitonin-producing C
      cells, is a rare tumour. Nevertheless it has evoked considerable interest in the
      past two decades amongst pathologists, clinicians, and human geneticists.
      Medullary thyroid carcinoma occurs either sporadically or as part of the
      inherited MEN II syndromes. The introduction of sensitive biochemical screening
      tests for the detection of early, clinically occult disease, and the advent of
      specific immunohistochemical staining methods have proved ideally for the study
      of this tumour. Immunohistochemical confirmation of the diagnosis of medullary
      thyroid carcinoma and the demonstration or exclusion of concomitant C cell
      hyperplasia (which precedes medullary thyroid carcinoma) are regarded as
      mandatory. Immunohistochemical markers used in routine histopathology and/or
      research of medullary thyroid carcinoma are reviewed and briefly discussed in the
      present paper.

PMID- 8369269
TI  - Functional-morphological effect of the synthetic atrial natriuretic factor (ANF
      101-126) on the zona glomerulosa cells of adrenal cortex.
AB  - The effects of atrial natriuretic factor (ANF) on the adrenal steroidogenesis
      were examined in the zona glomerulosa of rats in vivo. ANF administration
      provoked a significant decrease in the width of zona glomerulosa (P < 0.01) and a
      significant enlargement of nuclei of zona glomerulosa cells (P < 0.01).
      Ultrastructurally conspicuous change was observed in mitochondria of the cells of
      the zona glomerulosa treated with ANF, representing elongated mitochondria with
      "parallel arrays" of tubules with pipe-like structure. In vitro autoradiography
      125I-labelled ANF binding displayed a significant decrease of a specific receptor
      site in the zona glomerulosa treated with ANF. A significant lowering in plasma
      levels of aldosterone was observed in ANF-treated rats. These findings could be
      interpreted as an inhibitory effect of ANF on adrenal steroidogenesis of the
      glomerular zone by action through a specific ANF-receptor.

PMID- 8369270
TI  - [Neuroendocrine system and neuroendocrine tumors].

PMID- 8369272
TI  - Mutational replacements of the amino acid residues forming the hydrophobic S4
      binding pocket of subtilisin 309 from Bacillus lentus.
AB  - The amino acid side chains of Ile107, Leu126, and Leu135 participate in the
      formation of the important hydrophobic S4 binding pocket of the subtilisin
      Savinase. Ile107 and Leu126, located on each side of the pocket, point toward
      each other, and Leu135 is situated at the bottom of the pocket. These amino acid
      residues have been substituted for other hydrophobic amino acid residues by site
      directed mutagenesis, and the resulting enzymes have been characterized with
      respect to their P4 substrate preferences. The Leu126-->Ala or Phe substitutions
      reduce kcat/KM for the hydrolysis of all substrates to around 5% without altering
      the substrate preference. It is concluded that Leu126 is an essential structural
      part of the pocket which cannot be replaced without seriously affecting
      catalysis, consistent with the fact that Leu126 is conserved among all
      subtilisins. In contrast, the Ile107-->Gly, Ala, Val, Leu, or Phe and Leu135-
      >Ala, Val, or Phe substitutions strongly influence the P4 substrate preference,
      and some of the mutants exhibit large specificity changes for particular
      substrates when compared to wild-type Savinase. The results can be rationalized
      on the basis of Ile107 and Leu135 being responsible for steric repulsion of
      branched aliphatic and aromatic P4 side chains, respectively. Leu135 exclusively
      interacts with aromatic P4 side chains, and its replacement with less bulky amino
      acid residues alleviates steric repulsion such that the activity toward this type
      of substrates is enhanced. Conversely, the introduction of a more bulky amino
      acid residue at position 135 produces more steric repulsion and reduces the
      activity toward substrates with aromatic P4 side chains.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8369271
TI  - 2'-Hydroxyl groups important for exon polymerization and reverse exon ligation
      reactions catalyzed by a group I ribozyme.
AB  - The functional importance of ribose moieties in both exons and in intron
      sequences proximal to the 3' splice site of a group I intron has been analyzed
      using a novel exon polymerization reaction. The ribozyme is a modified version of
      a self-splicing bacterial tRNA intron (I) that attacks a 20-nucleotide synthetic
      ligated exon substrate (E1.E2), yielding E1 and I.E2 by reverse exon ligation. A
      series of repetitive reactions then polymerize E2 on the 3' end of the intron;
      attack by E1 subsequently generates E1.(E2)n. Systematic deoxyribonucleotide
      substitution within E1.E2 was used to probe the function of 2'-hydroxyl groups in
      each exon and the 3'-terminal nucleotides of the intron. We find that ribose at
      the splice junction (U-1) and at the two adjacent positions with E1 (A-2, C-3) is
      important for reverse exon ligation. Within E2, deletion of 2'-hydroxyl groups of
      the nucleotides that form P10 does not affect reactivity. In contrast, ribose at
      the 3' end of the intron is essential for reverse exon ligation, and the presence
      of a 2'-OH group in each of the nucleotides comprising P9.0[3'] contributes to
      reaction efficiency. These results support a model in which specific 2'-hydroxyl
      groups at and adjacent to the reaction sites form tertiary contacts that serve to
      stabilize interactions with the catalytic core of the ribozyme. Furthermore, they
      suggest that the mechanism by which guanosine at the 3' end of the intron is
      activated for reverse exon ligation is the same as that by which guanosine
      mononucleotide is activated in the first step of splicing.

PMID- 8369273
TI  - Elucidation of anti-ssDNA autoantibody BV 04-01 binding interactions with
      homooligonucleotides.
AB  - Binding interactions of various synthetic oligohomonucleotides with anti-ssDNA
      autoantibody BV 04-01 (IgG2b, kappa) and the corresponding single-chain antibody
      (SCA) 04-01/212 were studied. Oligonucleotide binding to IgG or SCA resulted in
      quenching of the protein's tryptophan fluorescence permitting direct assessment
      of ligand binding under equilibrium conditions. The effect of oligothymidylate
      length, (dT)n, on tryptophan quenching was evaluated. The equilibrium
      dissociation constants (Kd) for the binding of (dT)6 and (dT)8 were the same
      [(1.3 +/- 0.02) x 10(-7) M], while decreasing the length of the oligothymidylate
      to (dT)3 increased the Kd an order of magnitude. To assess base specificity, the
      comparative binding of other hexahomonucleotides was examined. Neither (dA)6 nor
      (dC)6 showed measurable binding, while the dissociation constant for (dG)6 was
      (7.1 +/- 0.3) x 10(-7) M. Fluorescence lifetime quenching data correlated with
      the steady-state binding results and indicated that the quenching process
      contains both dynamic and static components. The ability of BV 04-01 to bind
      (dT)6 and (dG)6 nucleotides was further supported by fluorescence anisotrophy
      studies with fluorescein-labeled hexadeoxynucleotides. Various levels of
      tryptophan fluorescence quenching upon titration with oligothymidylates of
      different length, as well as the similar affinities for (dT)6 and (dG)6,
      supported the concept that the groove-type binding pocket in BV 04-01 consists of
      binding subsites that cooperatively adapt for efficient binding of
      oligonucleotides.

PMID- 8369274
TI  - A role for the epsilon-amino group of lysine-334 of ribulose-1,5-bisphosphate
      carboxylase in the addition of carbon dioxide to the 2,3-enediol(ate) of ribulose
      1,5-bisphosphate.
AB  - Earlier structural and functional studies of ribulose-1,5-bisphosphate
      carboxylase/oxygenase imply that K334 facilitates the addition of gaseous
      substrate to the 2,3-enediol(ate) derived from ribulose 1,5-bisphosphate.
      Crystallographic analysis of the activated spinach enzyme [Knight et al. (1990)
      J. Mol. Biol. 215, 113-160] shows that the lysyl side chain is appropriately
      positioned to stabilize the transition state for the addition of CO2 to the
      enediol(ate). Furthermore, despite total impairment of carboxylase and oxygenase
      activities, site-directed mutants of the Rhodospirillum rubrum enzyme with
      replacements for lysine K334 (formerly designated K329) retain the capacity to
      enolize ribulose bisphosphate, demonstrating that the primary catalytic lesion
      lies beyond this initial step [Soper et al. (1988) Protein Eng. 2, 39-44; Hartman
      & Lee (1989) J. Biol. Chem. 264, 11784-11789]. We now show that the K334C mutant
      is also competent in the latter stages of catalysis, whereby 2'-carboxy-3-keto-D
      arabinitol 1,5-bisphosphate, the six-carbon intermediate of the carboxylation
      pathway, is correctly processed to 3-phosphoglycerate. Thus, the impairment of
      the mutant in overall catalysis can be attributed to preferential disruption of
      the reaction of CO2 or O2 with the enzyme-bound enediol(ate). Chemical rescue of
      the K334C mutant by aminoethylation and aminopropylation shows that this
      disruption reflects, at least in part, a failure to adequately stabilize the
      relevant transition state. With several simplifying assumptions, the CO2/O2
      specificity factor tau can be reduced to the ratio of the fundamental second
      order rate constants for the interaction of the gaseous substrates with the
      enzyme-bound 2,3-enediol(ate) of ribulose bisphosphate.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8369275
TI  - Oxidation of tetrahydrostilbazole by monoamine oxidase A demonstrates the effect
      of alternate pathways in the kinetic mechanism.
AB  - The steady-state kinetics for the oxidation of 1-methyl-1,2,3,6
      tetrahydrostilbazole (MTHS) by purified human liver monoamine oxidase A yielded
      biphasic double-reciprocal plots. Rate constants from stopped-flow studies were
      determined to show that the apparent stimulation at high substrate concentrations
      can be explained in terms of the alternate oxidative pathways available to
      monoamine oxidase A [Ramsay, R. R. (1991) Biochemistry 30, 4624-4629]. At low
      substrate concentrations, the slower reoxidation of the free enzyme (second-order
      rate constant was 4000 M-1 s-1) predominates, but at higher concentrations the
      faster reoxidation of the reduced enzyme-substrate complex (38,300 M-1 s-1)
      becomes significant. Computer simulation using this model predicts that similar
      biphasic curves could be obtained for the oxidation of the neurotoxin, 1-methyl-4
      phenyl-1,2,3,6-tetrahydropyridine, but that nonlinearity would be obvious only at
      concentrations above 200 Km.

PMID- 8369276
TI  - Crystallographic and fluorescence studies of the interaction of haloalkane
      dehalogenase with halide ions. Studies with halide compounds reveal a halide
      binding site in the active site.
AB  - Haloalkane dehalogenase from Xanthobacter autotrophicus GJ10 catalyzes the
      conversion of 1,2-dichloroethane to 2-chloroethanol and chloride without use of
      oxygen or cofactors. The active site is situated in an internal cavity, which is
      accessible from the solvent, even in the crystal. Crystal structures of the
      dehalogenase enzyme complexed with iodoacetamide, chloroacetamide, iodide, and
      chloride at pH 6.2 and 8.2 revealed a halide binding site between the ring NH's
      of two tryptophan residues, Trp-125 and Trp-175, located in the active site. The
      halide ion lies on the intersection of the planes of the rings of the
      tryptophans. The binding of iodide and chloride to haloalkane dehalogenase caused
      a strong decrease in protein fluorescence. The decrease could be fitted to a
      modified form of the Stern-Volmer equation, indicating the presence of
      fluorophors of different accessibilities. Halide binding was much stronger at pH
      6.0 than at pH 8.2. Assuming ligand binding to Trp-125 and Trp-175 as the sole
      cause of fluorescence quenching, dissociation constants at pH 6.0 with chloride
      and iodide were calculated to be 0.49 +/- 0.04 and 0.074 +/- 0.007 mM,
      respectively. Detailed structural investigation showed that the halide binding
      site probably stabilizes the halide product as well as the negatively charged
      transition state occurring during the formation of the covalent intermediate.

PMID- 8369277
TI  - Molecular organization and motions of cholesteryl esters in crystalline and
      liquid crystalline phases: a 13C and 1H magic angle spinning NMR study.
AB  - Cholesteryl esters are a major lipid constituent of plasma lipoproteins and
      atherosclerotic lesions. Crystalline and liquid crystalline phases of several
      cholesteryl esters [oleate (C18:1, omega-9), erucate (C22:1, omega-9), hexanoate
      (C6:0), decanoate (C10:0), undecanoate (C11:0), myristate (C14:0), palmitate
      (C16:0), and stearate (C18:0)] have been studied by natural abundance 13C NMR
      with magic angle spinning (MASNMR) at 75 MHz (7.05 T). Spectra obtained with
      magic angle spinning, high-power proton decoupling, and cross-polarization
      transfer were highly resolved for crystalline cholesteryl esters. Acyl chain
      carbons had narrower lines than protonated steroid ring carbons, reflecting
      differential motions in the crystal (specifically, more rapid motions in the acyl
      chain than in the steroid ring). Esters which crystallize into the monolayer type
      II structure, in which all molecules are equivalent, gave rise to a single
      resonance for each carbon; esters of the monolayer type I and bilayer structures,
      in which there are two types of nonequivalent molecules in the unit cell, had two
      resonances (equal intensity and line width) for several carbons, such as the
      carbonyl and the steroid ring C5 and C6. Spectra for liquid crystalline phases
      did not show inequivalence of signals for the same carbon and were not enhanced
      by cross-polarization transfer. These changes are a result of increased molecular
      motions in the liquid crystals, which average the nonequivalent environments and
      reduce the dipolar interactions. Cholesteric and smectic liquid crystalline
      phases were distinguished by the broader C = O, C5, and C6 signals for the
      cholesteric compared with the smectic phase. In the smectic phase, chemical
      shifts of corresponding carbons of all cholesteryl esters are similar and are
      close to those for crystalline esters with a monolayer II structure, which
      suggests that the smectic phase has structural features resembling the monolayer
      II crystal structure. 13C MASNMR is thus a powerful approach for examining
      structure and motions of crystalline and liquid-crystalline cholesteryl esters.
      1H MASNMR spectra did not give as detailed information on the molecular level but
      were unique for each phase and provided a simple and quick method for
      distinguishing the solid, smectic, cholesteric, and isotropic phases.

PMID- 8369278
TI  - Solution structure of GCCAAT recognition motif by 2D NMR, spectral simulation,
      molecular modeling, and distance geometry calculations.
AB  - Solution conformation of a self-complementary 14-mer DNA duplex (d
      GGATTGGCCAATCC) containing the GCCAAT recognition motif of several transcription
      factors has been investigated by NMR spectroscopy. Complete resonance assignment
      of all the protons (except H5',H5'' protons) has been obtained following standard
      procedures based on two-dimensional NMR techniques. Three-bond coupling constants
      have been determined by spectral simulation procedures. New strategies have been
      described and employed for quantifying NOE intensities from the structural point
      of view. Approximate ranges of gamma torsion angles have been obtained from a
      selective NOESY experiment, by estimating the J(4'-5'), J(4'-5''), or their sum
      in the H1'-H4' cross peaks of the spectrum. Likewise, ranges of epsilon torsion
      angles have been obtained by monitoring the H3' multiplicities in the H8/H6-H3'
      cross peaks in selective NOESY spectra. With the help of such a total of 73
      coupling constraints, 79 NOE intensity constraints, and 108 H-bond constraints,
      model building has been carried out to obtain a structure which satisfies the
      constraints. Starting from such a structure, an expanded distance constraint set
      has been created which has been used for the distance geometry calculations using
      the program TANDY. In the best structure thus derived, interesting irregularities
      similar to a BI-BII transition have been observed in the center. The molecule
      exhibits a bend. The overall base stacking is different from that in either B- or
      A-DNA models. The base pairs are tilted with respect to the local helix axes. The
      observed structural features are likely to have important implications for the
      recognition mechanism of the GCCAAT motif.

PMID- 8369279
TI  - Isolation of lambda repressor mutants with defects in cooperative operator
      binding.
AB  - A hybrid operator-promoter region was designed to aid in a screen for
      cooperativity mutants of the lambda repressor. In this system, lambda repressor
      mutants with defects in pairwise cooperative binding are unable to act as
      efficient transcriptional repressors. Four single amino acid substitutions in the
      C-terminal domain of the repressor were isolated. Studies of the DNA binding
      properties of the purified mutant proteins show that a repressor bearing the
      Gly147-->Asp mutation binds with normal affinity to single operator sites but is
      defective in pairwise cooperative site binding. Quantitative footprinting studies
      show that the free energy of interaction between repressor dimers bound at
      operator sites OR1 and OR2 is reduced from -2.4 kcal/mol for the wild-type
      repressor to 0 kcal/mol for the GD147 mutant.

PMID- 8369280
TI  - Factors participating in the liver-specific expression of the human
      apolipoprotein A-II gene and their significance for transcription.
AB  - We have shown previously that the hepatic and intestinal transcription of the
      human apolipoprotein A-II (apoA-II) gene in cell cultures is controlled by a
      complex set of regulatory elements A-N [Chambaz, et al. (1991) J. Biol. Chem.
      266, 11676-11685; Cardot, et al. (1991) J. Biol. Chem. 266, 24460-24470]. In the
      present communication, we have assessed the functional importance of each of the
      regulatory elements. In addition, we have used DNA binding and competition assays
      and protein fractionation to identify the hepatic nuclear activities which are
      involved in the regulation of the human apoA-II gene. Such activities may be of
      general importance for the regulation of liver-specific genes. The DNA binding
      and competition analysis showed that the regulatory elements M, D, and F bind new
      activities which have not been identified in apolipoprotein or other liver
      specific promoters. These activities have been designated AIIM1 and AIIM2 for
      element M, AIID1 and AIID2 for element D, and AIIF2 for element F. The activity
      AIIM2 is present in liver, but absent in CaCo-2 cells. A set of regulatory
      elements binds activities which resemble liver-enriched or ubiquitous factors
      previously shown to play important roles in the regulation of their target genes.
      Thus, element I binds to activities related to NF1, and elements L, C, D, G, AB,
      and F bind to C/EBP alpha as well as other heat-stable activities. The affinity
      of the bacterially expressed C/EBP alpha for the various apoA-II regulatory
      regions follows the order: AIIL approximately AIIC > AIID > AIIF > AIIG > AIIAB.
      Protein fractionation showed that element J binds at least three hepatic nuclear
      activities and is also recognized by members of the nuclear receptor family,
      HNF4, EAR2, EAR3, and ARP1. Another liver-enriched factor, HNF1, was shown
      previously to bind to element H. Despite the importance of HNF1, HNF4, NF1, and
      C/EBP alpha in the regulation of numerous other target genes, deletion of the
      HNF1, NF1, and HNF4 and several C/EBP binding sites did not drastically affect
      the hepatic transcription of the apoA-II gene. Rather, the hepatic and intestinal
      transcription is affected severely by deletion of elements A, B, K, L, and N. In
      addition, the intestinal transcription is affected by deletion of elements C, J,
      and M. The in vivo physiological importance of these elements will require
      analysis of their function in transgenic animals. This analysis establishes the
      organization of several nuclear activities on the human apoA-II
      promoter.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8369281
TI  - Footprinting titration studies on the binding of echinomycin to DNA incapable of
      forming Hoogsteen base pairs.
AB  - In order to investigate the possible importance of Hoogsteen base pairing to the
      DNA-binding ability of echinomycin, quantitative DNase I footprinting has been
      performed. The substrate was the tyrT DNA restriction fragment, either "native"
      or substituted with one of the purine analogs 2'-deoxy-7-deazaadenosine and 2'
      deoxy-7-deazaguanosine in both strands. The modified DNA species were prepared by
      PCR and selectively labeled at the 5' terminus of one strand (usually the upper
      "Watson" strand) with [32P]ATP and polynucleotide kinase. Proper incorporation of
      the analog nucleotides was verified by Maxam-Gilbert G- and C-sequencing
      reactions as well as exposure to osmium tetroxide and diethyl pyrocarbonate. OsO4
      was found to react strongly with the 7-deaza nucleotides, providing a good check
      of faithful incorporation. The previously observed echinomycin-induced
      hyperreactivity of purines toward diethyl pyrocarbonate was eliminated by
      incorporating the appropriate 7-deazapurine. The DNase I footprinting titration
      studies greatly refined the existing knowledge of the DNA-binding characteristics
      of echinomycin, as they revealed five general types of concentration-dependent
      behavior at single-bond resolution. Estimates of microscopic binding constants at
      individual DNA binding sites were obtained by measuring the antibiotic
      concentration which produced a half-maximal effect on the concentration of a
      given DNase I cleavage product. All binding sites contained one or more CpG
      steps, and all CpG steps analyzed formed part of a binding site for echinomycin.
      No consistent differences in the estimated binding constants for these sites were
      observed by comparing normal and modified DNAs, indicating that the abolition of
      formal Hoogsteen pairs did not significantly alter the thermodynamics of
      echinomycin-DNA interaction. The lack of any detectable decrease in binding
      constants for critical sites in the 7-deazapurine-substituted DNAs argues against
      any anti-syn conformational transition of purine nucleosides occurring in
      association with the bis-intercalative complex formation.

PMID- 8369282
TI  - DNA interstrand cross-links induced by the cyclopropylpyrroloindole antitumor
      agent bizelesin are reversible upon exposure to alkali.
AB  - Bizelesin, a cyclopropylpyrroloindole (CPI) antitumor agent, has been shown to
      alkylate and cross-link DNA within A/T-rich tracts. Previous studies have shown
      that covalent reaction of the CPI adozelesin with DNA was reversible [Warpehoski,
      M. A., Harper, D. E., Mitchell, M. A., & Monroe, T. J. (1992) Biochemistry 31,
      2502-2508]. That is, the monofunctional adduct could be lost from DNA, thus
      restoring the fidelity of DNA. In this study, we demonstrate that covalent DNA
      adducts induced by bizelesin at the adenine N3 position undergo two subsequent
      competing reactions: one which causes DNA strand cleavage, via depurination, and
      one which proceeds through loss of the DNA adduct (adduct reversal with
      restoration of DNA integrity). Our results were obtained by studying the chemical
      stability of synthetic DNA oligonucleotides which contained either a distinct DNA
      monofunctional adduct or DNA interstrand cross-links. Quantification of adduct
      reversal was performed on the basis that drug-modified DNA, upon exposure to heat
      followed by hot piperidine treatment, was resistant to strand cleavage at the
      site of alkylation. The rate of adduct reversal was found to increase with
      increasing temperature and was found to be maximum at 70-80 degrees C. The rate
      of adduct reversal was also found to increase with increasing pH and ionic
      strength. In contrast, the rate of depurination and subsequent DNA strand
      cleavage decreased as pH and ionic strength were increased. Adduct reversal was
      favored in DNA containing interstrand cross-links, whereas rapid depurination
      occurred preferentially within monofunctionally alkylated DNA.

PMID- 8369284
TI  - Hypersensitivity of an enzyme reaction to solvent water.
AB  - The hydrolytic activity of calf intestinal adenosine deaminase is reduced
      sharply, but reversibly, in the presence of added methanol, ethanol,
      acetonitrile, or dioxane. This decrease in kcat/Km appears to be related to
      diminished water content in the presence of each of these cosolvents. No
      agreement between cosolvents is observed if enzyme activity is plotted as a
      function of viscosity or dielectric constant; nor do these cosolvents act as
      conventional reversible inhibitors. The Km value of adenosine and the Ki values
      of a substrate analogue (6-dimethylaminopurine ribonucleoside) and a powerful
      competitive inhibitor (6-hydroxy-1,6-dihydropurine ribonucleoside) increase with
      decreasing solvent water content, but kcat is unaffected. Values of 1/Km and 1/Ki
      increase with roughly the 9th power of the concentration of water and show no
      sign of approaching a maximum value as the concentration of water approaches 55
      M. These results are consistent with an equilibrium between an abundant,
      inactive, relatively dehydrated form of the enzyme and a rare, relatively
      hydrated form of the enzyme. Only the hydrated form of the enzyme, containing at
      least nine more water molecules than the dehydrated form, appears to be capable
      of binding substrates or competitive inhibitors. Possible physiological
      consequences of this behavior, in a tissue in which water is transported in large
      quantities, are considered.

PMID- 8369283
TI  - Selection and characterization of a mutant T7 RNA polymerase that recognizes an
      expanded range of T7 promoter-like sequences.
AB  - The compatible plasmids pKGP1-1 and pCM-X# will confer chloramphenicol resistance
      to Escherichia coli harboring the two plasmids if the T7 RNA polymerase produced
      from pKGP1-1 can recognize the T7 promoter carried on pCM-X# and transcribe the
      CAT gene that is cloned behind the promoter [Ikeda et al. (1992) Biochemistry 31,
      9073-9080]. When E. coli harbor pKGP1-1 and a pCM-X# plasmid that carries a point
      mutation in the T7 promoter that destroys promoter activity (an inactive pCM-X#),
      the T7 RNA polymerase will not utilize the T7 promoter point mutant, will not
      produce CAT, and will not induce chloramphenicol resistance. The selection of
      mutants of T7 RNA polymerase that exhibit altered promoter recognition was
      pursued by randomly mutagenizing pKGP1-1 with aqueous hydroxylamine,
      cotransforming E. coli with the mutagenized pKGP1-1 and a mixture of seven
      different inactive pCM-X# plasmids, and isolating and characterizing the RNA
      polymerase that was present in those colonies that exhibited chloramphenicol
      resistance. It was established that E. coli harboring the mutant plasmid pKGP
      HA1mut4 and an inactive pCM-X# are chloramphenicol-resistant and that the
      mutation responsible for the expression of CAT from the inactive pCM-X# plasmid
      is a G to A transition at nucleotide 664 of T7 gene 1 that converts glutamic acid
      (222) to lysine. Apparently this mutation expands the range of T7 promoter
      sequences that can be utilized by the enzyme. The mutant T7 RNA polymerase,
      GP1(Lys222), utilizes all seven inactive T7 promoter point mutants more
      efficiently than wild-type T7 RNA polymerase both in vivo and in vitro.
      Furthermore, the correlation of in vivo and in vitro promoter utilization
      suggests that the restoration of chloramphenicol resistance in the cotransformed
      E. coli results from the ability of GP1(Lys222) to initiate transcription from T7
      promoter point mutants that are normally inactive.

PMID- 8369285
TI  - Simple centrifugation method for efficient pelleting of both small and large
      unilamellar vesicles that allows convenient measurement of protein binding.
AB  - Separation of unilamellar model membrane vesicles from external solution is often
      an important step in quantitation of vesicle bound or entrapped materials. An
      efficient method that allows pelleting of both small and large model membrane
      vesicles by centrifugation is described in this report. In this method
      streptavidin is added to vesicles containing a trace amount of biotinylated
      lipid. The resulting aggregation allows pelleting of the vesicles using an
      ordinary high-speed centrifuge. Control experiments show that the addition of
      streptavidin does not induce substantial vesicle fusion or leakage of substances
      trapped in the internal aqueous compartment of the vesicles. The method can
      accommodate different phospholipid compositions and lipid concentrations.
      Experiments with proteins that switch between hydrophilic and hydrophobic states
      show that the method can readily be used to monitor protein binding to vesicles.

PMID- 8369286
TI  - Luminescence studies with trp repressor and its single-tryptophan mutants.
AB  - Time-resolved and steady-state fluorescence, low-temperature phosphorescence, and
      optically detected magnetic resonance (ODMR) measurements have been made to
      resolve the luminescence contributions of the two intrinsic tryptophan residues
      in the subunits of trp aporepressor from Escherichia coli. Assignments of
      spectral information have been confirmed by use of the single-tryptophan mutants
      W19F and W99F. Solute fluorescence quenching studies show that both Trp19 and
      Trp99 are exposed to acrylamide and iodide, with Trp99 being the more exposed.
      Time-resolved and steady-state fluorescence measurements show Trp19 to have a
      bluer emission, a longer mean fluorescence decay time, a higher quantum yield,
      and essentially no independent rotational motion with respect to the protein.
      Trp99 is found to have a redder emission, a shorter mean fluorescence decay time,
      a lower quantum yield, and a significant degree of rotational freedom.
      Phosphorescence studies show a clear resolution of 0-0 vibronic transitions for
      each type of residue, with maxima at 407 and 415 nm that are assigned to Trp19
      and Trp99, respectively. ODMR measurements show the zero-field splitting
      parameters to be quite characteristically different for each tryptophan residue.
      The existence of resonance energy transfer from Trp19 to Trp99, in the wild-type
      protein, is indicated by three types of data: comparison of the long-lived decay
      time (attributed to Trp19) in the absence (W99F) and presence (wild type) of the
      acceptor Trp99, comparison of the fluorescence quantum yield of the wild-type and
      mutant proteins, and deviations from the expected phosphorescence intensities for
      Trp19 and Trp99 in the absence of energy transfer.

PMID- 8369287
TI  - Cytochrome P450 hydroxylation of hydrocarbons: variation in the rate of oxygen
      rebound using cyclopropyl radical clocks including two new ultrafast probes.
AB  - The oxidation of eight methyl-substituted and three alkyl-substituted
      cyclopropanes by rat liver microsomal cytochrome P450 and pure reconstituted
      rabbit P450 2B4 was studied. Alkane hydroxylation catalyzed by P450 is generally
      believed to proceed by hydrogen abstraction followed by reaction of the carbon
      centered radical with an iron-bound hydroxyl radical, a process called oxygen
      rebound. Hydrogen abstraction from methylcyclopropanes generates
      cyclopropylcarbinyl radicals whose solution rate constants for ring opening are
      known [Bowry, V.W., et al. (1991) J. Am. Chem. Soc. 113, 5687-5698]. Rearranged
      products were only observed with the five substrates which, upon hydrogen
      abstraction, would generate a cyclopropylcarbinyl radical that undergoes ring
      opening with a rate constant > or = 2.0 x 10(9) s-1 in solution. Values of the
      rate constants for oxygen rebound (kOH) were calculated by determining the ratio
      of unrearranged products (cyclopropylmethanols) to rearranged products
      (alkenols). For each substrate this ratio was generally about the same for the
      oxidations catalyzed by microsomal P450 and by P450 2B4. It is concluded that all
      of the substrates are oxidized via an intermediate cyclopropylcarbinyl radical.
      Two ultrafast probes, trans-1-methyl-2-phenylcyclopropane and 1,1-diphenyl-2
      methylcyclopropane, gave alcohol product ratios which yielded unreasonably high
      values for kOH, viz., ca. 1.5 x 10(12) and ca. 7 x 10(12) s-1,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369288
TI  - Acrylodan can label amino as well as sulfhydryl groups: results with low-density
      lipoprotein, lipoprotein[a], and lipid-free proteins.
AB  - Human plasma lipoprotein[a] and autologous low-density lipoprotein were reacted
      with the fluorescent probe 6-acryloyl-2-(dimethylamino)naphthalene (acrylodan)
      previously reported to be specific for sulfhydryl groups. Reaction kinetics were
      biphasic in both cases. The reaction of bovine serum albumin with acrylodan was
      also biphasic. Monophasic kinetics were observed when protein free sulfhydryl
      groups were blocked by carboxamidomethylation prior to acrylodan reaction. A
      significant increase in total fluorescence was observed in the reaction of
      acrylodan with proteins containing no free sulfhydryl groups and with polylysine.
      The rates of these reactions were highly sensitive to pH. Fluorescence changes
      due to dissolution of probe into hydrophobic protein or lipid domains were
      minimal as was reaction of probe with phospholipid head groups. When isolated
      from acrylodan-labeled Lp[a], apo[a], which contains no free sulfhydryl groups,
      contained covalently bound acrylodan. These results suggest that acrylodan can
      modify the lysine residues of lipid-free proteins and may modify not only the
      free sulfhydryl groups of low-density lipoprotein and lipoprotein[a] but also
      reactive amino groups. We conclude that under these conditions, the use of this
      probe to quantify free sulfhydryl groups in these lipoproteins is infeasible.

PMID- 8369289
TI  - Structure of novel gangliosides, deaminated neuraminic acid (KDN)-containing
      glycosphingolipids, isolated from rainbow trout ovarian fluid.
AB  - Two acidic glycosphingolipids were isolated and purified from rainbow trout
      ovarian fluid. They were designated as ovarian fluid gangliosides ofg-2a and ofg
      2b. Both of these glycolipids were found to contain glucose, galactose, and N
      acetylgalactosamine in a molar ratio of 1:2:1, but they differ by the presence of
      2 mol of deaminated neuraminic acid (KDN; 2-keto-3-deoxy-D-glycero-D-galacto
      nononic acid) in ofg-2a and 1 mol each of KDN and 9-O-acetyl-KDN in ofg-2b. On
      the basis of composition analysis, methylation analysis, mild acid hydrolysis,
      fast atom bombardment mass spectrometry (FABMS), 400-MHz 1H nuclear magnetic
      resonance spectroscopy, and immunochemical analysis using a monoclonal antibody
      (mAb.kdn3G), the complete structures of these gangliosides were determined to be
      KDN alpha 2-->3Gal beta 1-->3GalNAc beta 1-->4(KDN alpha 2-->3)Gal beta 1-->4Glc
      beta 1-->Cer for ofg-2a [(KDN)GD1a] and 9-O-AcKDN alpha 2-->3Gal beta 1-->3GalNAc
      beta 1-->4(KDN alpha 2-->3)Gal beta 1-->4Glc beta 1-->Cer for ofg-2b
      [(KDN)GD1a(OAc+)]. The ceramide moieties (Cer) in both ofg-2a [(KDN)GD1a] and ofg
      2b [(KDN)GD1a(OAc+)] were found by combining of the results from fatty acid
      analysis and FABMS measurements to be made up of 4-sphingenine and mainly a C24:1
      fatty acyl chain (nervonate). The structures of ofg-2a and ofg-2b are novel, and
      they represent the second example of naturally occurring KDN-gangliosides. Mild
      acid hydrolysis of both ofg-2a and ofg-2b resulted in formation of (KDN)GM1a.

PMID- 8369290
TI  - Demonstration of a two-step reaction mechanism for the inhibition of heparin
      bound neutrophil elastase by alpha 1-proteinase inhibitor.
AB  - Heparin decreases the rate of inhibition of neutrophil elastase by alpha 1
      proteinase inhibitor as a result of its strong binding to the enzyme. Here, we
      used the slow-binding kinetic approach to decide whether the enzyme-inhibitor
      interaction proceeds via a two-step mechanism and to identify the step that is
      affected by heparin. The inhibition kinetics was assessed under pseudo-first
      order conditions using conventional or stopped-flow spectrophotometry. In the
      absence of heparin, the pseudo-first-order rate constant of inhibition increased
      linearly with the inhibitor concentration indicating that within the experimental
      concentration range (< or = 6 microM) the enzyme-inhibitor association conforms
      either to a simple bimolecular reaction (E+I kass-->EI with kass = 10(7) M-1 s-1)
      or to a two-step reaction (E+I Ki*<==>EI* k2-->EI with Ki* > 0.4 microM and k2 >
      4 s-1). In the presence of heparin, the rate constant of inhibition varied
      hyperbolically with the inhibitor concentration, indicating that the inhibition
      is a two-step process with Ki* = 80 nM and K2 = 0.15 s-1. Thus, heparin has two
      opposite effects on the elastase + alpha 1-proteinase inhibitor interaction: it
      favors the association by decreasing Ki* but impairs it by decreasing k2. This
      rationalizes the previously demonstrated rate-depressing effect of the sulfated
      polymer. Heparin does not significantly alter the stability of the irreversible
      elastase-alpha 1-proteinase inhibitor complex.

PMID- 8369291
TI  - Identification of a second rat pancreatitis-associated protein. Messenger RNA
      cloning, gene structure, and expression during acute pancreatitis.
AB  - The pancreatitis-associated protein (PAP) is a lectin-related secretory protein
      present in small amounts in the rat pancreas and overexpressed during the acute
      phase of pancreatitis. On the other hand, PAP is constitutively expressed in the
      intestinal tract but not in other tissues. We cloned from a pancreatic cDNA
      library two overlapping cDNAs encoding a protein structurally related to PAP.
      This second PAP, which was called PAP II, was the same size as the original PAP
      (PAP I) and showed 74.3% amino acid homology. Studies on gene expression
      demonstrated that PAP II mRNA concentration increased within 6 h following
      induction of pancreatitis, reached maximal levels (> 200 times control values) at
      24-48 h, and decreased thereafter, similar to PAP I. However, PAP II mRNA could
      not be detected in the intestinal tract or in other tissues. We also isolated a
      PAP II genomic DNA fragment which was characterized over 2.7 kb of gene sequence
      and 1.9 kb of 5' flanking sequence. The 5' end of the coding sequence was
      determined by primer extension of the PAP II mRNA. The PAP II coding sequence
      spanned six exons separated by five introns. Several potential regulatory
      elements were identified in the promoter region, including two glucocorticoid
      response elements and one IL-6-response element. Antibodies raised to a synthetic
      peptide of PAP II detected a single band in Western blot analysis of the
      pancreatic secretory proteins from rats with pancreatitis, with a M(r) compatible
      with the theoretical M(r) of PAP II.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369292
TI  - Tissue- and development-specific expression in transgenic mice of a type I
      procollagen (COL1A1) minigene construct with 2.3 kb of the promoter region and 2
      kb of the 3'-flanking region. Specificity is independent of the putative
      regulatory sequences in the first intron.
AB  - Previous reports have provided inconsistent data as to the cis-regulatory
      elements that are essential for correct expression of the gene for the pro alpha
      1 (I) chain of type I procollagen (COL1A1) in the many tissues in which the
      protein is synthesized. Here, two internally deleted minigene versions of the
      human COL1A1 gene were used to prepare transgenic mice. The constructs made it
      possible to test regulatory sequences in the normal context of the gene. Also, in
      contrast to the reporter genes used in previous experiments, the constructs made
      it possible to assay quantitatively expression of the exogenous genes relative to
      expression of the endogenous COL1A1 gene, both as mRNA and as protein. The
      average level of expression of the minigenes varied among three transgenic lines,
      but the ratio of expression of the minigenes to expression of the endogenous gene
      was the same in all transgenic mice of a given line. Within the same line, the
      ratio of expression was essentially the same in nine or more tissues in which
      expression of the endogenous gene varied widely. Also, the ratio of expression
      within a given line was the same in 15-day-old embryos and in mice ranging in age
      from 4 days to 4 months. In addition, the ratio remained constant during repair
      of a surgical wound. The results demonstrated, therefore, that the minigene
      constructs with about 2.3 kb of the promoter region and about 2 kb of the 3'
      flanking region contained all of the sequences necessary for correct expression
      of the genes in a tissue-specific and development-specific manner.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8369293
TI  - Purification and characterization of Bacillus subtilis CheY.
AB  - Amino acid sequence comparison suggests that numerous proteins are common to the
      signal transduction pathways controlling chemotaxis in Bacillus subtilis and
      Escherichia coli. However, previous work has indicated several differences
      between the two systems. We have undertaken a comparative study of the roles of
      the CheY protein in chemotaxis by B. subtilis and E. coli. Although CheY from the
      two species share only 36% amino acid sequence identity, purified B. subtilis
      CheY was phosphorylated in vitro by E. coli CheA, and dephosphorylation of CheY-P
      was enhanced by E. coli CheZ. Alteration of the putative site of phosphorylation
      in B. subtilis CheY, Asp54, eliminated chemotaxis in vivo, further confirming
      that phosphorylation is important for B. subtilis chemotaxis. Loss of CheY
      function resulted in tumbling behavior in B. subtilis. Introduction of positively
      charged residues in place of Asp10 of B. subtilis CheY abolished function,
      whereas the corresponding changes in E. coli CheY apparently result in
      constitutive activation. The B. subtilis CheY Asp10 mutant proteins also failed
      to cause tumbling in E. coli, consistent with a different interaction between
      CheY and the flagellar switch in the two species. Finally, B. subtilis adapted
      more rapidly to positive stimuli than negative stimuli, whereas the opposite is
      true of E. coli. We conclude that B. subtilis regulates its response to positive
      chemotactic stimuli by enhancing phosphorylation of chemotaxis proteins, whereas
      E. coli reduces phosphorylation in the same circumstance.

PMID- 8369294
TI  - Exclusion of 2'-deoxycytidine 5'-monophosphate by asparagine 229 of thymidylate
      synthase.
AB  - In thymidylate synthase (TS, EC 2.1.1.45), the only side chain in direct hydrogen
      bonding with the pyrimidine ring of the substrate dUMP is asparagine 229 (N229).
      In binary and ternary complexes, the carboxamide moiety of the side chain of N229
      forms a cyclic hydrogen bond network bridging N-3 and O-4 of the uracil
      heterocycle. Most of the N229 mutants of TS bind dUMP and catalyze dTMP formation
      as well as the wild-type enzyme; thus, N229 does not contribute to binding of
      dUMP. Wild-type TS binds dCMP weakly and does not accept dCMP as a substrate.
      Mutations at N229 of TS modify the interaction of TS with dCMP. TS N229D and TS
      N229E catalyze the methylation of dCMP [Liu, L., & Santi, D. V. (1992)
      Biochemistry 31, 5010-5014]. With the exception of the TS N229Q, most of the N229
      mutants bind dCMP as well as or tighter than dUMP and bind dCMP 300-3000-fold
      tighter than wild-type TS. We conclude that TS discriminates binding of dUMP
      versus dCMP by a 3-4 kcal mol-1 difference in binding energy by exclusion of dCMP
      from the active site. We propose that this exclusion is a consequence of untoward
      interactions between dCMP and the side-chain carboxamide group of the Asn or Gln
      at position 229 of TS. We speculate that exclusion of cytosine versus uracil by
      Asn or Gln may account for specificity observed in other protein-pyrimidine
      interactions.

PMID- 8369295
TI  - A fluorescence spectroscopic study of substrate-induced conformational changes in
      glutaminyl-tRNA synthetase.
AB  - Glutaminyl-tRNA synthetase from Escherichia coli is a member of a subgroup of
      aminoacyl-tRNA synthetases that do not catalyze ATP-PPi exchange in the absence
      of the cognate tRNA. Such behavior suggests conformational changes upon substrate
      binding. Two different fluorescent probes, pyrenylmaleimide and acrylodan, were
      used to specifically label a nonessential sulfhydryl group of GlnRS.
      Conformational changes induced by substrates were studied using glutaminyl-tRNA
      synthetase labeled with these two environment-sensitive probes. ATP was shown to
      cause a significant conformational change that alters the mode of binding to
      tRNA(Gln) to GlnRS. The alteration of the salt sensitivity pattern of tRNA(Gln)
      binding to GlnRS by ATP supports this. Binding of tRNA(Gln) causes a
      conformational change that may be different in nature for the ATP/GlnRS complex
      and free GlnRS. Hydrodynamic parameters deduced from fluorescence polarization
      studies and the use of a noncovalent probe indicate that the ATP-induced
      conformational change may not be global in character.

PMID- 8369297
TI  - Assignment of enzymatic function to specific protein regions of cobalamin
      dependent methionine synthase from Escherichia coli.
AB  - Cobalamin-dependent methionine synthase catalyzes methyl group transfer from
      methyltetrahydrofolate to homocysteine to form tetrahydrofolate and methionine,
      and the cobalamin prosthetic group serves as an intermediate methyl carrier.
      Enzyme possessing cobalamin in the cobalt(II) oxidation state is inactive, and
      this form is activated by one-electron reduction coupled to methylation by S
      adenosylmethionine (AdoMet). The enzyme from Escherichia coli has been divided
      into separable fragments by limited proteolysis with trypsin, and the
      contribution of each of these fragments to substrate binding and catalysis has
      been evaluated. The 37.7-kDa carboxyl-terminal domain binds AdoMet, and this was
      demonstrated through covalent modification with radiolabeled AdoMet during
      ultraviolet irradiation. Following reductive activation with AdoMet, the enzyme
      was digested with trypsin and a 98.4-kDa amino-terminal fragment was isolated. It
      retained at least 70% of the activity of the intact enzyme and must therefore
      possess determinants sufficient for the binding of methyltetrahydrofolate and
      homocysteine, as well as residues required for catalysis. However, when the
      cobalamin was oxidized to the cob(II) alamin state, the 98.4-kDa fragment could
      not be reductively remethylated with AdoMet. A purified, 28-kDa domain within the
      98.4-kDa fragment retained bound cobalamin and therefore must play a central role
      in catalysis, but the isolated 28-kDa domain retained no catalytic activity.
      Because AdoMet binds to a different domain of the protein than
      methyltetrahydrofolate and homocysteine, the enzyme probably uses conformational
      flexibility to allow the cobalamin access to the required methyl donor or
      acceptor at the appropriate time in catalysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369296
TI  - Electrospray mass spectrometric analysis of the domains of a large enzyme:
      observation of the occupied cobalamin-binding domain and redefinition of the
      carboxyl terminus of methionine synthase.
AB  - Cobalamin-dependent methionine synthase from Escherichia coli catalyzes the
      methylation of homocysteine to form methionine, using methyltetrahydrofolate as
      the primary methyl donor. We have used electrospray mass spectrometry as a
      powerful tool for characterizing separable fragments obtained by proteolysis of
      this monomeric 136.1-kDa enzyme. A central 28.0-kDa domain, reported to bind the
      cobalamin, has been purified to homogeneity in 30% yield. We were able to detect
      the domain with bound cobalamin by electrospray mass spectrometry at neutral pH.
      Mass analysis of a 37.2-kDa carboxyl-terminal domain was grossly inconsistent
      with either of the two amino acid sequences from previously published DNA
      sequences. We then used electrospray mass spectrometry to analyze peptides
      generated by a lysyl endoproteolytic digest of a C-terminal fragment, and we have
      constructed a peptide map that accounts for > 95% of the peptide mass derived
      from this domain. The correct translational end of this protein (27 residues
      downstream from the previously predicted ultimate residue) has been established,
      and sequence conflicts within the two published DNA sequences have been resolved
      (GenBank Accession Number J04975). Resequencing the DNA near the carboxyl
      terminus ruled out a frameshifted reading of the DNA and suggested that a
      cytosine had twice been incorrectly inserted late in the reading frame. The
      strategies reported here for sequence confirmation, localization of coenzyme
      binding regions, and identification of chemically modified peptides within a
      large protein are potentially applicable to the characterization of many other
      proteins.

PMID- 8369298
TI  - Isolation of bovine kidney leucine aminopeptidase cDNA: comparison with the lens
      enzyme and tissue-specific expression of two mRNAs.
AB  - Aminopeptidases catalyze the hydrolysis of amino acid residues from the amino
      terminus of peptide substrates. Leucine aminopeptidase (LAP) from bovine lens is
      the best characterized aminopeptidase and the only LAP for which the amino acid
      sequence was determined by protein sequencing. Using this sequence information,
      we isolated a bovine kidney LAP cDNA and compared its deduced amino acid sequence
      to the published amino acid sequence for bovine lens LAP. Overall, the sequences
      are highly conserved. However, several differences are observed. The kidney LAP
      cDNA indicates a 26 amino acid extension at the amino terminus which is not found
      in the mature purified lens LAP. The cDNA also indicates an additional
      octapeptide in the C-terminal region which was not indicated in the published
      lens LAP amino acid sequence but which was required for best fit of
      crystallographic data regarding bovine lens LAP. Several other single amino acid
      changes were also noted. Levels of LAP transcripts were examined in bovine lens
      and kidney tissue as well as in cultured lens cells. Lens epithelial tissue
      showed only one LAP transcript (2.4 kb) whereas two transcripts (2.0 and 2.4 kb)
      were observed in cultured lens cells derived from epithelial tissue and in kidney
      tissue. Using Northern blot analysis, we correlated LAP mRNA levels with
      previously determined changes of LAP activity in aging lens tissue and in
      progressively passaged lens epithelial cells which were used to simulate aging in
      vitro. No differences were found in LAP mRNA levels in epithelial tissue from old
      and young lenses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369299
TI  - Kinetic mechanism of Escherichia coli isocitrate dehydrogenase.
AB  - The kinetic mechanism of the NADP-dependent isocitrate dehydrogenase of
      Escherichia coli was investigated using initial steady-state kinetic analyses.
      Kinetic coefficients, obtained using natural and alternative substrates with the
      wild-type and two mutant enzymes (S113L and S113N), suggest that the forward
      reaction [the oxidative decarboxylation of (2R,3S)-isocitrate by NADP] of the
      wild-type enzyme is a steady-state random mechanism, with catalysis more rapid
      than product release. The mechanism of the wild-type enzyme becomes rapid
      equilibrium random when an alternative substrate [(2R)-malate or NAD] is used.
      The mutant enzymes always display rapid-equilibrium random kinetics, and for each
      enzyme the apparent dissociation constant of each substrate from the binary
      complex [Kia = E.A/(EA)] is similar to its apparent dissociation constant from
      the Michaelis complex [Ka = (EB).A/(EAB)], which suggests that the binding of one
      substrate is independent of the binding of the second. When the wild-type enzyme
      catalyzes the forward reaction, the apparent dissociation constant, KiIso, is
      equal to its equilibrium dissociation constant, KdIso, determined from
      equilibrium binding studies. However, the apparent dissociation constant of the
      cofactor, KiNADP, is far smaller than its equilibrium dissociation constant,
      KdNADP. This is consistent with the proposed mechanism, because simulations show
      that when catalysis is steady-state and product release is rate-limiting, KiNADP
      and KNADP will be far smaller than KdNADP, while KiIso and KIso remain similar to
      KdIso. Product inhibition studies support the steady-state random mechanism of
      the wild-type enzyme.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369300
TI  - Structure of isocitrate dehydrogenase with isocitrate, nicotinamide adenine
      dinucleotide phosphate, and calcium at 2.5-A resolution: a pseudo-Michaelis
      ternary complex.
AB  - The structure of isocitrate dehydrogenase (IDH) with a bound complex of
      isocitrate, NADP+, and Ca2+ was solved at 2.5-A resolution and compared by
      difference mapping against previously determined enzymatic complexes. Calcium
      replaces magnesium in the binding of metal-substrate chelate complex, resulting
      in a substantially reduced turnover rate. The structure shows the following: (i)
      A complete, structurally ordered ternary complex (enzyme, isocitrate, NADP+, and
      Ca2+) is observed in the active site, with the nicotinamide ring of NADP+
      exhibiting a specific salt bridge with isocitrate. The binding of the cofactor
      nicotinamide ring is dependent on this interaction. (ii) Isocitrate is bound by
      the enzyme with the same interactions as those found for the magnesium/substrate
      binary complex, but the entire molecule is shifted in the active site by
      approximately 1 A in order to accommodate the larger metal species and to
      interact with the nicotinamide ring. The distances from isocitrate to the bound
      calcium are substantially longer than those previously found with magnesium.
      (iii) NADP in the Escherichia coli IDH has a novel binding site and conformation
      as compared to previously solved dehydrogenases. (iv) The orientation and
      interactions of the nicotinamide ring with the substrate are consistent with the
      stereospecificity of the enzyme-catalyzed reaction.

PMID- 8369301
TI  - Structure of isocitrate dehydrogenase with alpha-ketoglutarate at 2.7-A
      resolution: conformational changes induced by decarboxylation of isocitrate.
AB  - The structure of the isocitrate dehydrogenase (IDH) complex with bound alpha
      ketoglutarate, Ca2+, and NADPH was solved at 2.7-A resolution. The alpha
      ketoglutarate binds in the active site at the same position and orientation as
      isocitrate, with a difference between the two bound molecules of about 0.8 A. The
      Ca2+ metal is coordinated by alpha-ketoglutarate, three conserved aspartate
      residues, and a pair of water molecules. The largest motion in the active site
      relative to the isocitrate enzyme complex is observed for tyrosine 160, which
      originally forms a hydrogen bond to the labile carboxyl group of isocitrate and
      moves to form a new hydrogen bond to Asp 307 in the complex with alpha
      ketoglutarate. This triggers a number of significant movements among several
      short loops and adjoining secondary structural elements in the enzyme, most of
      which participate in dimer stabilization and formation of the active-site cleft.
      These rearrangements are similar to the ligand-binding-induced movements observed
      in globins and insulin and serve as a model for an enzymatic mechanism which
      involves local shifts of secondary structural elements during turnover, rather
      than large-scale domain closures or loop transitions induced by substrate binding
      such as those observed in hexokinase or triosephosphate isomerase.

PMID- 8369302
TI  - Kinetic analysis of NAD(+)-isocitrate dehydrogenase with altered isocitrate
      binding sites: contribution of IDH1 and IDH2 subunits to regulation and
      catalysis.
AB  - NAD(+)-dependent isocitrate dehydrogenase from Saccharomyces cerevisiae is an
      allosterically regulated enzyme that exists as an octamer composed of two
      nonidentical subunits, designated IDH1 and IDH2. To determine the contribution of
      each subunit to regulation and catalysis, a conserved serine residue at the
      proposed active site of each subunit was mutated to alanine. This mutation in
      IDH1 resulted in a 6-fold decrease in Vmax and a decrease in cooperativity, but
      little change in S0.5 for isocitrate. The mutant IDH2, in contrast, exhibited a
      60-fold decrease in maximal velocity and a 2-fold reduction in S0.5 for
      isocitrate, but the cooperativity was unaffected. Responses to the allosteric
      modifier AMP also differed for the two mutant enzymes. The IDH1 mutant enzyme was
      not activated by AMP, whereas the IDH2 mutant enzyme exhibited an increase in
      isocitrate affinity in the presence of AMP similar to that observed with the wild
      type enzyme. On the basis of these kinetic results, a model is presented which
      proposes that IDH1 functions as a regulatory subunit while IDH2 functions in
      catalysis. To determine if IDH1 or IDH2 alone is catalytically active, we also
      expressed the individual subunits in yeast strains in which the gene encoding the
      other subunit had been disrupted. Mitochondrial extracts from strains
      overexpressing solely IDH1 or IDH2 contained no detectable activity in the
      presence or absence of AMP. Gel filtration of these extracts showed that both
      IDH1 and IDH2 behaved as monomers, suggesting that the major subunit interactions
      within the octamer are between IDH1 and IDH2.

PMID- 8369303
TI  - Covalent bond changes as a driving force in enzyme catalysis.
AB  - A procedure is developed for assessing covalent and noncovalent aspects of the
      acylation of alpha-chymotrypsin (alpha-Ct) by the substrate trifluoroethyl
      furoate (S) to form furoyl-chymotrypsin (F-Ct) and trifluoroethanol (P1). The
      free energy change (-4.31 kcal/mol) for the acylation at pH 7, alpha-Ct+S <--> F
      Ct+P1, contains contributions from covalent bond changes as well as noncovalent
      changes. The noncovalent changes are considered to be manifested in the
      structures of alpha-Ct and F-Ct, and a noncovalent free energy difference between
      alpha-Ct and F-Ct has been evaluated from the difference in unfolding free energy
      changes for these proteins. The unfolding free energy changes demonstrate that F
      Ct is 1.6 kcal/mol less stable than alpha-Ct at pH7. Thus, despite an overall
      favorable free energy change for acyl-enzyme formation (-4.31 kcal/mol), covalent
      linkage of the furoyl moiety to the active site is thermodynamically
      destabilizing to the enzyme. The consequence of this unfavorable effect of the
      furoyl moiety on the noncovalent free energy is that "binding" of the covalently
      linked furoyl moiety cannot be the driving force for acylation. The source of
      free energy driving acylation is the covalent bond-breaking and bond-making
      involved in transesterification of the furoyl group to the enzyme. Since the
      (noncovalent) Michaelis complex between alpha-Ct and substrate is significantly
      more stable (thermodynamically) than F-Ct, a substantial amount of noncovalent
      free energy must be given up on forming F-Ct. The destabilization residing in F
      Ct is consistent with the possibility that energy transduction occurs when the
      Michaelis complex is converted to F-Ct and that destabilization is relieved on
      reaching the next activated complex.

PMID- 8369304
TI  - Active site labeling of the Yersinia protein tyrosine phosphatase: the
      determination of the pKa of the active site cysteine and the function of the
      conserved histidine 402.
AB  - In this report, we demonstrated that the Yersinia protein tyrosine phosphatase
      (PTPase) could be inactivated by the alkylating agent iodoacetate. The enzyme
      modification was selective, and the covalent attachment was stoichiometric. The
      residue that was labeled by iodoacetate was shown to be Cys403, which was the
      same catalytically essential residue identified by site-directed mutagenesis
      [Guan, K. L., & Dixon, J.E. (1990) Science 249, 553-556]. The rate of iodoacetate
      modification decreased as the ionic strength of the media increased. There was no
      significant D2O solvent isotope effect associated with the inactivation of the
      enzyme, suggesting that thiol anion of Cys403 reacted as a nucleophile. The
      Yersinia PTPase also displayed differential reactivity (940-fold) toward
      iodoacetate over iodoacetamide. This indicates that residues within the active
      site of the enzyme are positively charged. The pKa of the active site thiol group
      was determined to be 4.67. The low pKa value suggests that ionic interactions are
      important in stabilizing the thiolate anion. One candidate residue for this
      stabilization is the invariant histidine (His402) found in all PTPases.
      Substitutions of His402 with Asn or Ala altered the active site thiol pKa to 5.99
      and 7.35, respectively. Interestingly, the active site thiol in the mutants also
      showed enhanced reactivity toward iodoacetate. The second-order rate constants
      for the inactivation of the wild-type enzyme, H402N, and H402A were 59.7, 3305,
      and 1763 M-1 min-1, respectively.

PMID- 8369305
TI  - Amino acid residues in Anabaena ferredoxin crucial to interaction with ferredoxin
      NADP+ reductase: site-directed mutagenesis and laser flash photolysis.
AB  - Ferredoxin (Fd) functions in photosynthesis to transfer electrons from
      photosystem I to ferredoxin-NADP+ reductase (FNR). We have made several site
      directed mutants of Anabaena 7120 Fd and have used laser flash photolysis to
      investigate the effects of these mutations on the kinetics of reduction of
      oxidized Fd by deazariboflavin semiquinone (dRfH.) and the reduction of oxidized
      Anabaena FNR by reduced Fd. None of the mutations influenced the second-order
      rate constant for dRfH. reduction by more than a factor of 2, suggesting that the
      ability of the [2Fe-2S] cluster to participate in electron transfer was not
      seriously affected. In contrast, a surface charge reversal mutation, E94K,
      resulted in a 20,000-fold decrease in the second-order rate constant for electron
      transfer from Fd to FNR, whereas a similar mutation at an adjacent site, E95K,
      produced little or no change in reaction rate constant compared to wild-type Fd.
      Such a dramatic difference between contiguous surface mutations suggests a very
      precise surface complementarity at the protein-protein interface. Mutations
      introduced at F65 (F65I and F65A) also decreased the rate constant for the Fd/FNR
      electron transfer reaction by more than 3 orders of magnitude. Spectroscopic and
      thermodynamic measurements with both the E94 and F65 mutants indicated that the
      kinetic differences cannot be ascribed to changes in gross conformation, redox
      potential, or FNR binding constant but rather reflect the protein-protein
      interactions that control electron transfer. Several mutations at other sites in
      the vicinity of E94 and F65 (R42, T48, D68, and D69) resulted in little or no
      perturbation of the Fd/FNR interaction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369306
TI  - Reductive dehalogenation by cytochrome P450CAM: substrate binding and catalysis.
AB  - Biological reductive dehalogenation reactions are important in environmental
      detoxification of organohalides. Only scarce information is available on the
      enzymology underlying these reactions. Cytochrome P450CAM with a known X-ray
      structure and well-studied oxygenase reaction cycle, has been studied for its
      ability to reduce carbon-halogen bonds under anaerobic conditions. The reductive
      reactions functioned with NADH and the physiological electron-transfer proteins
      or by using artificial electron donors to reduce cytochrome P450CAM. Halogenated
      methane and ethane substrates were transformed by a two-electron reduction and
      subsequent protonation, beta-elimination, or alpha-elimination to yield alkanes,
      alkene, or carbene-derived products, respectively. Halogenated substrates bound
      to the camphor binding site as indicated by saturable changes in the Fe(III)-heme
      spin state upon substrate addition. Hexachloromethane was bound with a
      dissociation constant (KD) of 0.7 microM and caused > 95% shift from low- to high
      spin iron. Ethanes bearing fewer chlorine substituents were bound with increasing
      dissociation constants and gave lesser degrees of iron spin-state change. Camphor
      competitively inhibited hexachloroethane reduction with an inhibitor constant
      (KI) similar to the dissociation constant for camphor (KI = KD = 0.9 microM).
      Rate determinations with pentachloroethane indicated a 100-fold higher enzyme V/K
      compared to the second-order rate constant for hematin free in solution. These
      studies on substrate binding and catalysis will help reveal how biological
      systems enzymatically reduce carbon-halogen bonds in the environment.

PMID- 8369307
TI  - Ferroxidase kinetics of human liver apoferritin, recombinant H-chain apoferritin,
      and site-directed mutants.
AB  - A detailed study of the kinetics of iron(II) oxidation by molecular oxygen in
      natural and recombinant human apoferritins has been carried out using electrode
      oximetry to better understand the ferroxidase activity of the protein shell. A
      comparative study of recombinant L-chain ferritin (rLF), recombinant H-chain
      ferritin (rHF), and variants has shown that (1) rLF lacks a ferroxidase activity,
      confirming the results of previous studies; (2) the ferroxidase site of rHF
      involves Glu-62 and His-65, presumably as Fe2+ ligands, since mutation of these
      residues abolishes most of the oxidase activity, in agreement with previous
      studies; and (3) mutation of both the putative ferroxidase and nucleation site
      ligands in rHF renders the protein totally incapable of catalyzing the oxidation
      of Fe2+ whereas mutation of nucleation site ligands alone (Glu-61, Glu-64, and
      Glu-67) decreases the activity only slightly. Analysis of the kinetics of rHF and
      natural human liver ferritin (HLF) (4% H-chain, 96% L-chain) gave the following
      apparent parameters at pH 7: Km,O2 = 6 +/- 2 microM, Km,Fe = 80 +/- 10 microM,
      and kcat = 201 +/- 14 min-1 for rHF and Km,O2 = 60 +/- 12 microM, Km,Fe = 50 +/-
      10 microM, and kcat = 31.2 +/- 0.6 min-1 for HLF. Furthermore, Zn2+ was shown to
      be a noncompetitive inhibitor of Fe2+ oxidation in rHF but a mixed inhibitor in
      HLF. These different forms of Zn2+ inhibition in the two proteins and the higher
      activity of HLF than expected, based on its H-chain composition as well as
      differences in their enzyme kinetic parameters, suggest that H- and L-chains
      cooperate in modulating the ferroxidase activity of the apoferritin even though
      the L-subunit lacks a ferroxidase site itself.

PMID- 8369309
TI  - Generation, oxidation by the oxidized form of the tyrosine of polypeptide D2, and
      possible electronic configuration of the redox states S0, S-1, and S-2 of the
      water oxidase in isolated spinach thylakoids.
AB  - Suitable treatment of thylakoids with hydrazine permits a high population of the
      redox states S0, S-1, and S-2 in the water oxidase. Experiments performed with
      dark-adapted samples enriched either in the oxidized or reduced form of the redox
      active tyrosine, YD, of polypeptide D2 reveal that YoxD is a unique endogenous
      oxidant within the PS II complex which causes a one-electron abstraction from the
      water oxidase in states S0, S-1, and S-2, respectively. A kinetic analysis of the
      period four oscillation of oxygen yield induced by a train of short flashes in
      dark-adapted samples permits the determination of the rate constants of electron
      abstraction from the reduced water oxidase by YoxD. A value of 9 x 10(-4) s-1 was
      found for the oxidation of S0 and S-2, while S-1 becomes oxidized with a rate
      constant of 4 x 10(-4) s-1 at 20 degrees C and pH 7.2. The redox state S0
      generated either from S1 via the three-flash-induced oxidative pathway through S4
      or from a one-flash oxidation of the S-1 state obtained by S1 reduction with
      NH2NH2 exhibits the same kinetics as S0 oxidation by YoxD. On the basis of these
      findings and data taken from the literature, the electronic configuration of the
      manganese atoms in the tetranuclear cluster is discussed. It is assumed that the
      dimer model of two binuclear manganese groups within the tetranuclear cluster is
      discussed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369308
TI  - Evidence for the structure of the active site heme P460 in hydroxylamine
      oxidoreductase of Nitrosomonas.
AB  - Hydroxylamine oxidoreductase (HAO) is responsible for the oxidation of
      hydroxylamine to nitrite in nitrification by Nitrosomonas europaea. It has an
      alpha n subunit structure and eight covalently bound hemes per subunit. Seven of
      these have visible spectra indistinguishable from heme c. The eighth, designated
      as P460, has unusual visible spectroscopic features in the enzyme and in a heme
      containing proteolytic fragment. Its structure has not been previously
      determined. Enzymatic digestions of HAO were performed, and various proteolytic
      fragments were purified. Mass spectrometry confirmed the presence of authentic
      heme c in some fragments, that is, iron protoporphyrin IX cross-linked by two
      thioether bonds to cysteine residues. It was possible to detect the presence of
      the P460 pigment in some fragments, based upon the sensitivity of this pigment to
      treatment of the holoenzyme with hydrogen peroxide. A proteolytic fragment
      produced by sequential digestion with trypsin and pronase was shown to contain
      heme c and a hydrogen peroxide-sensitive heme with an unusual visible spectrum.
      This fragment contained two covalently cross-linked peptides. Mass spectrometry
      and NMR indicated that the P460 heme was iron protoporphyrin IX covalently bonded
      by two thioether bridges to peptide, but in addition there was a new, third
      covalent bond between a meso heme carbon and an aromatic ring carbon on a tyrosyl
      residue. The new covalent bond has been tentatively assigned to the C2 carbon of
      the tyrosyl ring and the 5-meso heme carbon (IUPAC-IUB tetrapyrrole
      nomenclature), although this location requires further proof.

PMID- 8369310
TI  - Calorimetric studies of the binding of ferric ions to human serum transferrin.
AB  - The binding of ferric ions, chelated with nitrilotriacetate, to human serum
      transferrin (hTF) has been studied using ultrasensitive titration calorimetry.
      Studies were done in both the presence and the absence of the synergistic
      bicarbonate anion. It was found that the C-site of hTF is capable of weakly
      binding bicarbonate (K of 250 M-1, delta H of -8 kcal) at the binding site even
      before ferric ion is added, although this does not happen to the same extent at
      the N-site. When preinsertion of the bicarbonate ion occurs, then ferric ion can
      subsequently bind very quickly to the C-site. Although the chelated ferric ion
      can bind weakly to the N-site in a fast reaction, the insertion of the
      bicarbonate ion occurs subsequently in a slow endothermic reaction. Binding of
      ferric ion to both sites is quickly reversible in the absence of bicarbonate but
      becomes kinetically controlled for long periods of time once bicarbonate has
      inserted into the metal-binding site due to the long time required for release of
      ferric ion. Estimates of the heats of binding to each site, apparent binding
      constants, and heat capacities of binding are made for different sets of solution
      conditions. Results from this study are compared to earlier results with
      ovotransferrin (Lin, L.-N., Mason, A. B., Woodworth, R. C., & Brandts, J. F.
      (1991) Biochemistry 30, 11660-11669), with major differences and some
      similarities noted.

PMID- 8369311
TI  - Nuclear magnetic resonance relaxation of glycogen H1 in solution.
AB  - The NMR relaxation properties of the H1 proton of oyster glycogen in D2O and H2O
      solutions have been studied using nonselective, semiselective, and selective
      inversion recovery and Hahn spin-echo pulse sequences. The data were analyzed in
      terms of an isotropic, rigid-rotor dipole-dipole model including cross
      relaxation. At 8.4 T in D2O, p = 5.4 +/- 0.4 s-1 and sigma = -4.5 +/- 0.4 s-1.
      The large, negative sigma value is consistent with strong cross-relaxation and a
      long correlation time. The relaxation data can be explained by a single
      correlation time, tau c = 2.7 x 10(-9) s, indicating significant internal
      mobility. With this value of tau c, and assuming that the structure of the
      glucose moieties was the same as in alpha-D-glucose crystals, the dipole sum
      contributing to T1 relaxation was calculated. The intra-ring relaxation was
      dominated by dipole fields from the H2 proton, but these only accounted for
      approximately 18% of the total relaxation. Most of the relaxation comes from
      inter-glucose relaxation. From modeling, this is dominated by the H4' across the
      alpha-1,4-glycosidic bond. The H1 longitudinal relaxation rates were
      significantly enhanced in H2O compared with D2O. This enhancement is not due to
      direct dipolar interaction between H1 and bulk water. Transverse relaxation rates
      were not significantly enhanced in H2O.

PMID- 8369312
TI  - Transfer nuclear Overhauser effect study of the conformation of oxytocin bound to
      bovine neurophysin I.
AB  - This study reports the structure of the peptide hormone oxytocin bound to its
      carrier protein, neurophysin I, obtained by nuclear magnetic resonance
      techniques. At the pH value of 2.1 in our experiments, the ligand is in fast
      exchange with its carrier protein, allowing the use of transfer-NOE methods. The
      number of distance constraints for the peptide being limited, considerable
      attention has been paid to an accurate distance determination. The resulting
      accurate distance limits were used as input for a distance geometry calculation
      followed by a restrained molecular dynamics run. Convergence to a well-defined
      family of structures for oxytocin in its bound state was reached. Both the
      backbone and the side-chain conformations differ between the bound form and the
      crystal structure of free oxytocin [Wood, S. P., et al. (1986) Science 232, 633].
      These differences, as well as other structural features of the bound form, are
      discussed in terms of interactions made with the carrier protein. Transfer-NOE
      experiments at low peptide protein ratios provide direct experimental evidence
      for contacts between the oxytocin Tyr2 residue and an aromatic residue of
      neurophysin. The resonance assignments of the aromatic groups [Whittaker, B. A.,
      et al. (1985) Biochemistry 24, 2782] together with the recently published X-ray
      structure of the neurophysin II protein complexed with a dipeptide [Chen et al.
      (1991) Proc. Natl. Acad. Sci. U.S.A. 88, 4240] allow us to assign the aromatic
      signal on the protein to the neurophysin Phe22 residue.

PMID- 8369313
TI  - Efficiency of N-linked core glycosylation at asparagine-319 of rabies virus
      glycoprotein is altered by deletions C-terminal to the glycosylation sequon.
AB  - In N-linked core glycosylation, the oligosaccharide Glc3Man9GlcNAc2 is
      transferred to the tripeptide sequon Asn-X-Ser/Thr. However, this process must be
      regulated by additional protein signals, since many sequons are either poorly
      glycosylated or not glycosylated at all. Since N-linked glycosylation can
      influence protein structure and function, understanding these signals is
      essential for the design and expression of recombinant glycoproteins. Core
      glycosylation usually occurs cotranslationally in the rough endoplasmic reticulum
      (RER) during translocation of nascent proteins. Since only regions of a protein
      immediately near to a sequon or N-terminal to it are thought to be in the RER
      when core glycosylation occurs, most models predict that regions C-terminal to
      the sequon do not influence this process. We tested whether regions C-terminal to
      a sequon can influence its core glycosylation. Full-length (505 amino acid)
      rabies virus glycoprotein (RGP) mutants, each containing only one of the three
      sequons normally present in RGP, were used for these studies. Using a cell-free
      system, the core glycosylation efficiency at each sequon was determined.
      Termination codons were then introduced into these mutants at defined sites to
      produce C-terminal truncations, and the effect of each of these truncations on
      the core glycosylation efficiency at each sequon was assessed. While deletion of
      the C-terminal transmembrane and cytoplasmic domains did not affect core
      glycosylation, more extensive C-terminal deletions did result in altered core
      glycosylation in a site-specific fashion. Specifically, C-terminal truncations
      resulting in proteins containing 386 or 344 amino acids decreased the efficiency
      of core glycosylation at Asn319. This demonstrates that core glycosylation
      efficiency can be influenced by the presence or absence of regions in a protein
      more than 68 amino acids C-terminal to a specific glycosylation site.

PMID- 8369314
TI  - Expression and identification of p90 as the murine mitochondrial glycerol-3
      phosphate acyltransferase.
AB  - Glycerol-3-phosphate acyltransferase (GPAT) catalyzes the initial and committed
      step in glycerolipid biosynthesis. Mitochondrial GPAT, unlike the microsomal
      isozyme, prefers saturated fatty acids as a substrate. We have recently reported
      cloning of a cDNA to an unidentified 6.8-kb mRNA by a differential hybridization.
      The mRNA contains an open reading frame of 827 amino acids (p90) with 30%
      sequence homology in a 300 amino acid stretch to Escherichia coli GPAT. The 6.8
      kb mRNA was induced dramatically when fasted mice were refed a high-carbohydrate
      diet. Here, we have expressed the open reading frame as trpE fusion proteins and
      used them to generate antibodies. The antibodies recognized a polypeptide of 90
      kDa (p90) when the 6.8-kb cDNA sequence was used for in vitro transcription and
      translation. By Western blot analysis using these antibodies, we detected p90 in
      mitochondrial fractions of liver, and the p90 level was increased by refeeding.
      The increase in the p90 level correlated with the increase in mitochondrial GPAT
      activity. Moreover, p90 was not detectable in 3T3-L1 preadipocytes but markedly
      increased during adipose conversion. This increase was consistent with the 11
      fold increase we observed in N-ethylmaleimide (NEM)-resistant mitochondrial GPAT
      activity during adipocyte differentiation. In addition, we have expressed p90 in
      CHO cells by stable transfection. The transfected genes in both correct and
      reverse orientations produced distinct 3.9-kb transcripts owing to the truncation
      of a part of the noncoding regions of the endogenous 6.8-kb mRNA before insertion
      into the pMSXND vector. The transfected CHO cells were treated with 2
      aminopurine, an agent that increases expression of exogenous genes.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8369316
TI  - Hepatic lipase acylates dolichol in the presence of a plasma cofactor in vitro.
AB  - Phosphatidylethanolamine:dolichol acyltransferase (PEDAT), an enzyme previously
      partially purified and characterized in rat liver [Sindelar, P., Chojnacki, T., &
      Valtersson, C. (1992) J. Biol. Chem. 267, 20594-20599], is here purified to
      homogeneity from a heparin perfusate of rat liver and is shown to be identical to
      hepatic lipase. However, in contrast to triglyceride hydrolysis by hepatic
      lipase, the PEDAT activity is strongly dependent on a heat-stable plasma
      cofactor. This cofactor stimulates the activity up to 15-fold and shifts the pH
      optimum for the reaction from 8.5 to 7.5. Upon gel filtration on Bio-Gel A-1.5,
      the factor is heterogeneously distributed, with a major peak at 220 kDa. The
      dolichol-acylating activity can also be detected in rat adrenals and ovaries, and
      evidence is presented that the PEDAT assay shows a higher degree of specificity
      for hepatic lipase than the standard assay with triolein-gum arabic emulsion in 1
      M NaCl.

PMID- 8369315
TI  - A prenylated protein-specific endoprotease in rat liver microsomes that produces
      a carboxyl-terminal tripeptide.
AB  - The maturation of proteins that contain the C-terminal sequence Cys-Ali-Ali-Xaa
      (where Ali is usually an aliphatic amino acid and Xaa is a number of different
      amino acids) involves the attachment of a farnesyl or geranylgeranyl group to the
      cysteine residue, proteolytic removal of the C-terminal three amino acids, and
      methylation of the prenylated cysteine alpha-carboxyl group. Two prenylated and
      radiolabeled peptides were prepared in order to detect the proteolysis step(s) in
      a cell-free system and to determine the reaction products. These peptides are ECB
      NPFRQRRFFC(S-geranylgeranyl)AI[3H]L and ECB-C(S-farnesyl)VI[3H]S (ECB is an
      extended-chain biotin group) which are patterned after the C-termini of
      geranylgeranylated and farnesylated G protein gamma-subunits. Incubation of these
      peptides with rat liver microsomes, but not cytosol, results in the production of
      radiolabeled dipeptides (I[3H]L and I[3H]S) and tripeptides (AI[3H]L and VI[3H]S)
      as the major products and smaller amounts of amino acids ([3H]L and [3H]S). A
      multitude of independent experiments shows that the dipeptides are produced from
      the tripeptides by secondary proteolysis. Although a portion of the [3H]S
      produced comes directly from ECB-C(S-farnesyl)VI[3H]S, the KM of > 30 microM for
      this reaction is significantly higher than the KM of 1.1 microM for the
      production of VI[3H]S from the farnesylated peptide. This suggests that the
      carboxypeptidase is not part of the pathway for the maturation of prenylated
      proteins. Nonprenylated peptides at concentrations of 10-100-fold higher than
      those of the prenylated substrates did not reduce the amount of tripeptide
      produced.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369317
TI  - The Registry of the International Society for Heart and Lung Transplantation:
      tenth official report--1993.

PMID- 8369318
TI  - Pretransplantation risk factors for death after heart transplantation: a
      multiinstitutional study. The Transplant Cardiologists Research Database Group.
AB  - Risk factors for death after heart transplantation were identified by analyzing
      the total primary heart transplantation experience (n = 911) among 25
      institutions from January 1, 1990, through June 30, 1991. Overall actuarial
      survival was 93% at 1 month and 84% at 12 months. The hazard function for death
      was highest early after heart transplantation and fell rapidly over the first 6
      months, with a gradually declining hazard thereafter. The two most common causes
      of death were infection (n = 29) and early graft failure (n = 28), accounting for
      45% of the overall deaths. By multivariable analysis, risk factors for death
      during the study period included very young recipient age (p = 0.004), advanced
      age (p = 0.009), ventilator support at time of transplantation (p = 0.09),
      abnormal renal function (p = 0.1), lower pretransplantation cardiac output (p =
      0.009), higher pulmonary vascular resistance in children (p = 0.006), longer
      donor ischemic time (p = 0.001), older donor age (p = 0.001), and donor and
      recipient not both blood type O (p = 0.009). The recipient age effect was
      greatest in patients under 5 years of age (1-year survival rate 68% versus 85%
      for all others, p = 0.002). Patients aged 60 years and older had a 1-year
      survival rate of 81%. Patients who were ventilator dependent at transplantation
      fared especially poorly, with a 3-month survival rate of 65%. Transplantation of
      a blood group O heart into a non-O recipient had a somewhat lower 1-year survival
      rate than did blood group O into an O recipient (82% versus 88%, p = 0.06). The
      adverse effect of a longer ischemic time was most notable after 4 hours (1-month
      survival rate 71% for more than 4 hours versus 85% for less than 4 hours, p =
      0.0003). Inference: These multiinstitutional-derived risk factors for early-term
      death after heart transplantation may help improve patient and donor selection
      and focus further scientific investigations to increase the safety of heart
      transplantation.

PMID- 8369319
TI  - Spectrum of humoral rejection after pediatric heart transplantation.
AB  - The deposition of immunoglobulin and complement 3 in the coronary
      microvasculature (humoral rejection) has been associated with poor outcome after
      heart transplantation. The purpose of this study is to relate the incidence of
      immunoglobulin and complement 3 myocardial deposition to the clinical course of
      pediatric heart transplant patients. One hundred thirty-one biopsy specimens from
      30 patients, whose mean age at transplantation was 4.9 years (range, 2 days to 17
      years), were processed for light microscopy and immunofluorescence. The mean
      follow-up was 25 months (range, 6 to 63 months). All patients underwent annual
      selective coronary artery angiography. No cellular or humoral rejection was seen
      in 97 biopsy specimens. Humoral rejection without cellular infiltrate was found
      in eight biopsy specimens from four patients (13%). Of 19 grade 1A, B (mild)
      biopsy specimens, 17 showed only cellular rejection, and two showed a mixed
      pattern of cellular and humoral rejection. Of six grade 2,3 (moderate) biopsy
      specimens, four showed only cellular rejection, and two showed a mixed pattern.
      The only grade 4 (severe) biopsy specimen revealed a mixed pattern. Three
      patients have had persistent immunoglobulin M and complement 3 deposits. One of
      these had angiographic evidence of accelerated graft coronary artery disease 2
      years after transplantation, which was later confirmed at autopsy. Coronary
      artery disease has not been detected by serial angiography at 1 year (28
      patients), 2 years (18 patients), 3 years (15 patients), 4 years (five patients),
      and 5 years (one patient). Humorally mediated rejection occurs with and without
      cellular rejection after pediatric heart transplantation. Humoral rejection may
      persist after treatment and resolution of severe cellular rejection
      episodes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369320
TI  - The impact of steroid withdrawal on the development of lipid abnormalities and
      obesity in heart transplant recipients.
AB  - Hyperlipidemia and obesity are common problems after heart transplantation, which
      may increase the risk of chronic graft atherosclerosis. The intent of this study
      was to (1) determine the impact of a history of hyperlipidemia on the occurrence
      of lipid abnormalities after transplantation, (2) compare lipid profiles of those
      patients being treated with triple-drug immunosuppression versus those patients
      weaned from prednisone therapy, and (3) identify any factors that would predict
      which patients are at highest risk for the development of hyperlipidemia after
      transplantation. Of 89 patients who lived for more than 12 months, 35 patients
      had a history of hyperlipidemia before heart transplantation (cholesterol level
      of more than 240 mg/dl; low-density lipoprotein cholesterol level of more than
      160 mg/dl). The most dramatic rise in cholesterol level was observed in patients
      with no history of hyperlipidemia who were treated with triple-drug
      immunosuppression, in whom a 64% increase occurred versus a 24% increase in
      patients receiving steroid-free immunosuppression (p < 0.001). In patients with a
      history of hyperlipidemia, cholesterol level increased by 20% with triple-drug
      immunosuppression versus 14% with steroid-free immunosuppression (p = 0.613);
      however, 83% of the patients in the triple-drug group and 92% in the steroid-free
      group had elevated cholesterol levels. Multiple regression analysis revealed that
      significant independent and additive (p < 0.00001) contributions with respect to
      percent change in cholesterol level were evident for (1) a negative history of
      hyperlipidemia (p = 0.005), (2) triple-drug immunosuppression (p = 0.0021), and
      (3) female sex (p = 0.0113). A negative history of hyperlipidemia was predictive
      of the percent change in low-density lipoprotein cholesterol level (p = 0.0049),
      and triple-drug immunosuppression administration predicted the percent change in
      high-density lipoprotein cholesterol (p = 0.0119). Patients with a positive
      history of hyperlipidemia had higher lipid values at 12 and 24 months after
      transplantation; however, patients with no previous history of hyperlipidemia
      experienced the greatest percent change in both cholesterol and low-density
      lipoprotein levels. Patients receiving prednisone therapy gained more weight (9.0
      +/- 7.0 kg) as compared with those patients tapered from prednisone therapy (5.9
      +/- 8.6 kg); however, neither the increase in actual weight (p = 0.120) nor the
      increase in percent ideal body weight (14% +/- 11% versus 9% +/- 13%,
      respectively) were significant (p = 0.133). This study identified that
      postoperative weight gain is best predicted by premorbid habitus, rather than the
      type of immunosuppression used.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8369321
TI  - OKT3 treatment of cardiac allograft rejection.
AB  - Since the initial report of the murine monoclonal antibody OKT3 for acute kidney
      rejection, a significant body of information has been collected regarding the
      efficacy of OKT3 in reversing acute allograft rejections in kidney, liver, and
      heart transplant recipients. The use of OKT3 therapy for the reversal of cardiac
      allograft rejection in patients in whom other therapeutic alternatives have
      failed or are contraindicated is described. Treatment with OKT3 reversed acute
      heart rejection in 102 of 113 patients (90%). Complete reversal was achieved in
      63 patients, and partial reversal in 39 patients. At 2 years, graft and patient
      survival rate was 77% and 65%, respectively. No significant differences were
      noted in reversal rate and in 12-month graft and patient survival rates between
      those patients experiencing one rejection episode and those patients experiencing
      two or more rejection episodes. Comparable reversal rates and graft and patient
      survival rates were achieved in patients whether OKT3 was administered as the
      primary rejection therapy or as rescue therapy. Adverse events were common in the
      first 2 days of therapy, but they were well tolerated in most patients.
      Infectious complications occurred in 49% of patients in whom most infections were
      not serious. On the basis of this experience, OKT3 appears highly effective in
      reversing acute cardiac allograft rejection.

PMID- 8369322
TI  - Aspergillosis with Aspergillus osteomyelitis and diskitis after heart
      transplantation: surgical and medical management.
AB  - This is the report of a 49-year-old man, who could be cured of aspergillosis with
      Aspergillus osteomyelitis and diskitis of the lumbar spine by medical and
      surgical therapy after heart retransplantation. Aspergillus osteomyelitis and
      diskitis is a rare complication of invasive aspergillosis. Lumbar involvement is
      the main manifestation, followed by rare locations in the tibia, ribs, wrist,
      sternum, pelvis, and knee. It is nearly always secondary to pulmonary
      aspergillosis, which occurs in about 6% to 14% of patients after heart
      transplantation. For treatment, a combined surgical and medical approach is
      recommended, which enables quick pain relief for the patient and histologic and
      microbiologic diagnosis and stabilization of the spine. Because of definitive
      cure of osteomyelitis cannot be guaranteed by removal of the abscess, medical
      therapy after surgery is necessary for years.

PMID- 8369323
TI  - Noninvasive assessment of the pulmonary artery pressure response to exercise
      after uncomplicated heart transplantation.
AB  - The pulmonary artery pressure response to exercise has been used as an index of
      cardiac reserve and frequently mirrors diastolic conditions. To define this
      response after orthotopic heart transplantation, we exercised 27 subjects on
      supine bicycle ergonometers. Stroke volume and pulmonary artery pressure were
      monitored with contrast-enhanced Doppler imaging. Study patients had undergone
      orthotopic heart transplantation. Seventeen patients were screened, and eight
      were subsequently determined by endomyocardial biopsy to be histologically free
      of acute cardiac allograft rejection. A control population of nonconditioned
      normal volunteers was also evaluated (heart transplant patients: n = 8, age =
      45.7 +/- 7.3 years, seven men; normals volunteers: n = 10, age = 49.4 +/- 12.8
      years, nine men; P = NS). Total exercise time and peak heart rate were reduced in
      heart transplant patients: 7.6 +/- 2.5 minutes, 123 +/- 4 beats/min versus normal
      volunteers: 16.2 +/- 4.5 minutes, 134 +/- 4 beats/min (P < 0.05). Change in
      stroke volume from baseline to peak exercise was greater in heart transplant
      patients: 29.9 +/- 4.6 ml versus normal volunteers: 3.9 +/- 5.7 ml (P < 0.01). No
      difference was observed in the pulmonary artery pressure response to exercise. In
      patients with uncomplicated heart transplantation a reduction in exercise
      capacity is shown; however, the pulmonary artery pressure response to exercise is
      comparable to normal subjects. A blunted heart rate response is observed, which
      is partially compensated by increases in stroke volume. These findings suggest
      that cardiac diastolic function is preserved and that denervation of the heart
      accounts for impaired exercise tolerance.

PMID- 8369324
TI  - Importance of substrate enhancement for long-term heart preservation.
AB  - These experiments tested the hypothesis that addition of pyruvate to a
      preservation medium would improve postpreservation cardiac function as quantified
      in an isolated working heart model after heterotopic transplantation. Four groups
      of rabbit hearts were studied (n = 5 per group): fresh controls, fresh hearts
      perfused as isolated working hearts; surgical controls, fresh hearts transplanted
      heterotopically and reperfused with blood for 75 minutes before being studied as
      isolated hearts; preserved without pyruvate, hearts perfusion-preserved with
      oxygenated extracellular-type crystalloid medium; preserved with pyruvate, same
      same as the group without pyruvate, but medium contained 20 mmol/L pyruvate.
      After preservation, the hearts in the two preserved groups were transplanted and
      studied as isolated hearts. Total ex vivo time for the preserved hearts was 24.5
      +/- 0.2 hours. During preservation, glucose was not consumed by hearts in either
      preserved group. Pyruvate was used by the hearts to which it was provided (22.9
      +/- 2.7 mumol pyruvate x hour-1 x gm dry weight-1). Performance of transplanted
      surgical control hearts was not significantly different from that of fresh
      controls. Function of the pyruvate-preserved hearts was similar to that of the
      fresh and surgical controls except that left ventricular peak systolic pressure
      and peak rate of pressure development were lower and that left ventricular end
      diastolic pressure was higher for the pyruvate-preserved hearts. The hearts
      preserved without pyruvate had significantly lower compliance and function
      compared to the other three groups, which was evident in all indexes of
      contractility and output. We conclude that hearts preserved with pyruvate
      containing crystalloid medium had better postpreservation, posttransplantation
      function than hearts preserved without pyruvate, although there was slight loss
      of compliance and decreased contractile function in the pyruvate-preserved hearts
      compared to controls.

PMID- 8369325
TI  - One-hour exposure to University of Wisconsin solution does not impair endothelium
      dependent relaxation or damage vascular smooth muscle of epicardial coronary
      arteries.
AB  - To determine whether University of Wisconsin solution impairs production of
      endothelium-derived relaxing factor or damages vascular smooth muscle function of
      epicardial coronary arteries, isolated segments of canine left circumflex
      coronary artery were exposed to either cold (7 degrees C) or normothermic (37
      degrees C) University of Wisconsin solution or to cold (30 degrees C) or
      normothermic (37 degrees C) physiologic salt solution in vitro for 60 minutes.
      After incubation with the solutions, the vascular segments were studied in vitro
      in organ chambers. Exposure to cold or to normothermic University of Wisconsin
      solution did not alter endothelium-dependent relaxation (either maximal
      relaxation or ED50) of the segments in response to adenosine diphosphate or
      acetylcholine (10(-9) to 10(-4) mol/L). Also, contraction of the segments in
      response to potassium ions (voltage-dependent) or prostaglandin F2 alpha
      (receptor-dependent) and relaxation in response to isoproterenol (cyclic AMP
      mediated) or sodium nitroprusside (cyclic GMP-mediated) were unaltered after
      exposure to cold University of Wisconsin solution. Direct exposure to
      normothermic University of Wisconsin solution induced transient vasoconstriction
      in segments with or without endothelium. Thus University of Wisconsin solution
      does not irreversibly impair release of endothelium-derived relaxing factor or
      alter function of vascular smooth muscle in epicardial coronary arteries.

PMID- 8369326
TI  - Cyclosporine increases the intracellular free calcium concentration in
      electrically paced isolated rat cardiomyocytes.
AB  - The effect of cyclosporine on the mean cytoplasmic free calcium concentration in
      electrically paced single cardiomyocytes from adult rats was studied. Cardiac
      myocytes were paced by electrical field stimulation with either 2 or 3 Hz in the
      presence of 5 micrograms/ml cyclosporine or the solvent cremophor. Exposure to
      cyclosporine during 40 minutes of electrical pacing caused irreversible
      hypercontracture in most cells, only 22.1% +/- 1.2% (mean +/- SEM) remained rod
      shaped versus 64.1% +/- 3.2% in the solvent (p = 0.01). The cytoplasmic free
      calcium concentration was measured by means of digital image processing of fura-2
      fluorescence. Electrical field stimulation increased the cytoplasmic free calcium
      from 69.7 +/- 5.4 to 124.9 +/- 24.5 nmol/L Ca2+ in the presence of the solvent
      and from 84.2 +/- 25.4 to 250.1 +/- 55.9 nmol/L in the presence of cyclosporine
      (p = 0.036 versus solvent). The data provide direct evidence that cyclosporine
      enhances the cytoplasmic free calcium concentration in single paced rat
      cardiomyocytes. These findings may be of importance in the consideration of a
      possible cardiotoxicity of cyclosporine.

PMID- 8369327
TI  - Chylothorax: report of a case complicating orthotopic heart transplantation.
AB  - We describe a case of a chylothorax that occurred in a 62-year-old man after
      orthotopic heart transplantation. Injury to collateral lymphatics in the anterior
      mediastinal or thymic areas was the probable cause of the chylous fistula.
      Excessive chyle drainage causes loss of large amounts of fat, protein,
      electrolytes, and lymphocytes. These losses further compromise the nutritional
      and immunologic status of the transplant patient. Conservative therapy with chest
      tube drainage and a strict medium-chain triglyceride diet allowed the chylous
      fistula to spontaneously close without the need for surgical intervention.

PMID- 8369328
TI  - Prognosis of patients with cystic fibrosis awaiting heart and lung
      transplantation.
AB  - Heart-lung transplantation is a successful treatment for patients with cystic
      fibrosis and chronic respiratory failure. Patients are assessed for surgery when
      life expectancy is deemed short. This study assesses the ability of measurements
      of pulmonary function, blood gas levels, and nutritional status to predict
      survival of patients awaiting heart-lung transplantation and to assess the effect
      of heart-lung transplantation on survival. Sixty-seven patients with cystic
      fibrosis were accepted for heart-lung transplantation from 1985 through 1990.
      Each patient underwent tests of pulmonary function, exercise tolerance, blood-gas
      levels, and nutritional status. Cox regression was used to analyze the prognostic
      value of these data. Of the 67 patients accepted for heart-lung transplantation,
      organs became available for 30; 24 patients died waiting, and 13 patients were on
      the list December 31, 1990. Eight patients died after transplantation. Patients
      with above-average forced expiratory volume in 1 second (FEV1) (median, 17%
      predicted) at assessment were half as likely to die waiting (relative risk, 0.47;
      95% confidence interval, 0.23 to 0.97) as patients with below-average FEV1. The
      relative risk of death for patients on the waiting list was 1.44 (95% confidence
      interval, 1.17 to 1.77) for each increment in PCO2 of 1 kPa. No effect of
      nutritional status on waiting list death was found, but seven of eight patients
      who died after heart-lung transplantation were below 80% predicted weight for
      height. Using a time-dependent analysis, heart-lung transplantation almost halved
      the risk of death (relative risk, 0.57; 95% confidence interval, 0.22 to 1.48).
      Postoperative actuarial survival was 79% (95% confidence interval, 63% to
      95%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369329
TI  - The diagnosis of obliterative bronchiolitis after heart-lung and lung
      transplantation: low yield of transbronchial lung biopsy.
AB  - Obliterative bronchiolitis is the most significant long-term complication of lung
      and heart-lung transplantation characterized by the rapid development of
      obstructive airway disease. It is thought to be a manifestation of chronic
      rejection and has been treated, with limited success, with augmentation of
      immunosuppression. Early detection of obliterative bronchiolitis and prompt
      initiation of therapy may result in an improved outcome. The role of
      transbronchial biopsy has been reported in the diagnosis of acute rejection and
      infection but not for obliterative bronchiolitis. To study this problem we
      retrospectively reviewed the transbronchial biopsy results of patients with
      advanced clinical obliterative bronchiolitis, as defined physiologically. Between
      January 1, 1988, and December 31, 1991, 46 "sets" of adequate transbronchial
      biopsy specimens were obtained from 16 patients (15 heart-lung recipients and one
      double lung recipient). Seven sets of transbronchial biopsy specimens (15.2%)
      showed obliterative bronchiolitis by pathologic study. In four patients with
      severe clinical obliterative bronchiolitis, only one transbronchial biopsy
      specimen of seven (14.3%) showed obliterative bronchiolitis. The pathologic
      diagnosis of obliterative bronchiolitis was confirmed in three of these patients
      at the time of autopsy or retransplantation. Twelve patients were still alive at
      the end of the study period, and all experienced further deterioration of lung
      function typical for obliterative bronchiolitis. We conclude that the sensitivity
      of transbronchial biopsy for obliterative bronchiolitis is poor. Possible
      explanations for these results are explored.

PMID- 8369330
TI  - Use of a Doppler pulmonary artery catheter for continuous measurement of right
      ventricular pump function and contractility during single lung transplantation.
AB  - Despite numerous technologic advances in intraoperative monitoring, the only
      methods routinely available for assessment of right ventricular function in lung
      transplant recipients are continuous measurement of right heart pressures and
      intermittent thermodilution determination of cardiac output and ejection
      fraction. Additional data may now be obtained with transesophageal
      echocardiography, although this technology is expensive and not widely available
      and requires diverting attention from a potentially unstable patient for data
      acquisition and analysis. Recently, a Doppler pulmonary artery catheter was
      introduced that measures beat-to-beat pulmonary artery blood flow-velocity, cross
      sectional area, and volume flow. Because of data indicating that acceleration of
      blood in the pulmonary artery (measured as the first derivative of either the
      velocity or flow waveform) is a sensitive indicator of right ventricular
      contractility, we have used waveforms obtained with the catheter for assessment
      of right ventricular pump function (stroke volume and peak pulmonary artery flow
      rate) and contractility in heart surgery patients. We report here our experience
      with this method in two patients undergoing left single lung transplantation.

PMID- 8369331
TI  - Transesophageal echocardiographic assessment of pulmonary venous flow after
      single lung transplantation.
AB  - Transesophageal echocardiography was used to evaluate pulmonary venous flow
      velocity and pulmonary venous diameter of both the transplanted and native lungs
      in six single lung transplant recipients. Mean pulmonary venous velocity (50 +/-
      10 versus 27 +/- 8 cm/sec) and pulmonary venous diameter (1.39 +/- 0.16 versus
      0.98 +/- 0.18 cm) were significantly greater in the transplanted lung than in the
      native contralateral lung. An index of allograft perfusion, QD-transesophageal
      echocardiography (pulmonary venous velocity x pulmonary venous diameter),
      correlated highly with previously measured technetium 99m-labeled macroaggregated
      albumin quantitative lung perfusion studies (r = 0.94). A pressure gradient in
      pulmonary venous flow velocity across the left atrial anastomosis was detected in
      two patients (8 and 12 mm Hg). Analysis of previous resting supine and upright
      incremental hemodynamic exercise testing showed no significant differences in
      these two patients with respect to maximum oxygen uptake, mean pulmonary arterial
      pressure, pulmonary capillary wedge pressure, cardiac index, or pressure-flow
      relationships. Therefore these left atrial anastomotic gradients did not appear
      to adversely affect the pulmonary vascular response to incremental exercise.
      Transesophageal echocardiography may be an invaluable technique in the expedient
      evaluation of cardiac function and allograft perfusion after lung
      transplantation.

PMID- 8369332
TI  - Should alpha 1-antitrypsin-deficient patients with emphysema continue to receive
      alpha 1-antitrypsin after lung transplantation?

PMID- 8369333
TI  - Ventilatory problems observed after single lung transplantation in emphysema.

PMID- 8369334
TI  - Picosecond energy transfer and trapping kinetics in living cells of the green
      bacterium Chloroflexus aurantiacus.
AB  - The excitation energy transfer and trapping processes in intact cells of
      Chloroflexus aurantiacus were studied by picosecond time-resolved fluorescence
      spectroscopy. The fluorescence decay kinetics is investigated over the near
      infrared emission range between 730 nm and 920 nm using various excitation
      wavelengths and excitation intensities. The data were analyzed by global decay
      analysis and are presented as decay-associated spectra (DAS). The specific
      dependence of the decay kinetics on the excitation wavelength and on the
      photochemical redox state of the reaction center (RC) allows the identification
      of the energy transfer and trapping components. The DAS provide evidence for two
      chlorosomal energy transfer processes. The first one occurs between the
      chlorosomal bacteriochlorophyll (BChl)-c and the BChl-a792 complex (B792) in the
      chlorosomal baseplate with an equilibration time constant of 15-16 ps, while the
      second one occurs from the B792 pigments to the BChl-a806 pigments in the B806
      866 complex with a time constant of 35-40 ps. The overall energy trapping process
      in whole cells is mainly determined by the kinetics of the primary charge
      separation process in the RCs. With open RCs (QA oxidized) the trapping time
      constant is 70-90 ps, while the trapping process with closed RCs (QA reduced)
      takes as long as 180-200 ps. The results on whole cells reported here are
      interpreted in conjunction with those reported earlier for the various isolated
      complexes, i.e., two different chlorosome preparations (Holzwarth, A.R., Muller,
      M.G. and Griebenow, K. (1990) J. Photochem. Photobiol. B 5, 457-465), the B806
      866 complex (Griebenow, K., Muller, M.G. and Holzwarth, A.R. (1991) Biochim.
      Biophys. Acta 1059, 226-232) and isolated reaction centers (Muller, M.G.,
      Griebenow, K. and Holzwarth, A.R. (1991) Biochim. Biophys. Acta 1098, 1-12).
      Based on these data, a unified and self-consistent scheme for the primary
      processes in the whole photosynthetic system of C. aurantiacus is presented. The
      BChl antenna pigment groups are arranged to form a linear energy transfer cascade
      with four energy transfer steps from shorter-wavelength- to longer-wavelength
      absorbing antenna pools. The overall fluorescence decay kinetics of the
      photosynthetic system of C. aurantiacus turns out to be 'trap-limited' by the
      reaction center rather than 'diffusion-limited' by the energy transfer processes.

PMID- 8369335
TI  - From uni-site to multi-site ATP synthesis in thylakoid membranes.
AB  - The membrane-bound H(+)-ATPase from chloroplasts, CF0F1, was brought into the
      active, reduced state by illumination in the presence of thioredoxin and
      dithiothreitol. The endogenous nucleotides were removed by a washing procedure so
      that the active, reduced enzyme contained one tightly bound ATP per CF0F1. When
      [14C]ADP was added in substoichiometric amounts during continuous illumination,
      ADP was bound to the enzyme, phosphorylated and released as [14C]ATP, i.e., the
      tightly bound ATP was not involved in the catalytic turnover ('uni-site ATP
      synthesis'). The rate constant for ADP binding was k = (2.0 +/- 0.5) x 10(6) M-1
      s-1. The rate of ATP synthesis was measured as a function of the ADP
      concentration from 8 nM up to 1 mM in the presence of 2 mM phosphate during
      continuous illumination. A linear increase of the rate was observed up to 100 nM.
      Above this concentration a supralinear increase was found, indicating the
      occupation of a second ADP-binding site. A plateau was reached between 1.5 microM
      and 2.3 microM ADP with a rate of vpl = 3.7 s-1. The half-maximal rate from this
      plateau was observed at 780 nM. Above 2.3 microM ADP up to 1 mM ADP the data were
      described by Michaelis-Menten kinetics (vmax = 80 s-1; apparent KM = 32 microM).
      These results indicated the participation of at least two different ADP binding
      sites in ATP synthesis catalyzed by the membrane-bound CF0F1.

PMID- 8369336
TI  - Is cellobiose oxidase from Phanerochaete chrysosporium a one-electron reductase?
AB  - The heme domain of cellobiose oxidase (CBO) from Phanerochaete chrysosporium
      increases the rate of electron transfer to one-electron acceptors. This
      conclusion was drawn from comparisons of the rates of reduction of 3,5-t-butyl-o
      benzoquinone, triiodide ion, cytochrome c and ferricyanide by intact CBO, FAD
      fragment and CBO with the heme inactivated by cyanide. The oxidation of
      cellobiose produced hydrogen peroxide, but the enzyme disturbs peroxidase-based
      assays by reduction of the product or by direct interaction with the peroxidase.
      CBO can also degrade hydrogen peroxide in the presence of cellobiose. The 1,2,4,5
      tetramethoxybenzene cation radical was rapidly reduced by CBO.

PMID- 8369337
TI  - Electrochromic responses of carotenoid absorbance bands in purified light
      harvesting complexes from Rhodobacter capsulatus reconstituted into liposomes.
AB  - Light-Harvesting Complexes I and II (LHI and LHII) were extracted from
      chromatophores of Rhodobacter capsulatus, purified in Triton X-100 and
      reconstituted into phospholipid vesicles. Application of membrane potentials (K+
      diffusion potentials) to LHII proteoliposomes led to absorbance changes in the
      carotenoid bands which were spectrally similar to those in chromatophores. These
      (electrochromic) absorbance changes were linear with the applied membrane
      potential between -107 mV and +105 mV. The data were consistent with the
      existence of two forms of carotenoid in LHII. One form, comprising 2/3 of the
      total and with a long wavelength absorbance maximum at 510 nm, was not
      significantly affected by membrane potential. The other component, comprising 1/3
      of the total and with a long wavelength absorbance maximum at 516.5 nm, was
      shifted by approx. 1.6 nm to the red by a membrane potential of 105 mV. Reduction
      of the B800 bacteriochlorophyll in LHII with NaBH4 before reconstitution did not
      affect the absorbance spectrum of the carotenoids and it did not affect their
      response to applied membrane potentials in proteoliposomes. Although the
      electrochromically-sensitive carotenoids might be associated with B800,
      interactions with the bacteriochlorophyll are perhaps not the cause of the
      polarisation of the carotenoid that is responsible for the linearity of the
      response. The carotenoids in reconstituted LHI complexes were not detectably
      electrochromic. The electrochromic absorbance changes of carotenoids in LHII
      could be useful for membrane potential measurement in liposomes containing ion
      translocating proteins.

PMID- 8369338
TI  - Electrochromic responses of bacteriochlorophyll absorbance bands in purified
      light-harvesting complexes of Rhodobacter capsulatus reconstituted into
      liposomes.
AB  - Purified light harvesting complexes I and II (LHI and LHII) from Rhodobacter
      capsulatus were purified and separately incorporated into liposomes.
      Electrochromic absorbance changes of bacteriochlorophyll bands in the
      proteoliposomes in response to K(+)-diffusion potentials were recorded. In LHII
      proteoliposomes the application of positive-inside potentials led to red shifts
      in the bacteriochlorophyll absorbance bands centered at 377, 801 and 858 nm.
      Negative-inside potentials caused blue shifts of these bands. Electrochromism of
      the 590 nm band was too small to detect. The band at 858 nm was considerably more
      electrochromic than that at 801 nm. Electrochromic absorbance changes measured at
      865-850 nm were linear with the applied diffusion potential. In LHI
      proteoliposomes positive-inside diffusion potentials caused red shifts of the
      bands centred at 374 nm and 880 nm. At 880 nm the response was linear with the
      applied diffusion potential and was equivalent in amplitude to that of the 858 nm
      band in LHII proteoliposomes. If it is assumed that the permanent dipole moment
      differences between the ground state and excited state of B800, B850 and B870 are
      similar and that polarisability effects are negligible, it follows that (a) the
      plane of the bacteriochlorin ring of B850 is more perpendicular to the membrane
      plane than that of B800 and (b) the orientations of B850 and B870 relative to the
      membrane plane are similar.

PMID- 8369339
TI  - Analysis of chimeric spinach/cyanobacterial CP43 mutants of Synechocystis sp. PCC
      6803: the chlorophyll-protein CP43 affects the water-splitting system of
      Photosystem II.
AB  - Mutants of the cyanobacterium Synechocystis sp. PCC 6803 have been generated in
      which parts of psbC (the gene encoding the Photosystem II chlorophyll-protein
      CP43) have been replaced with the homologous gene fragment from spinach. Upon the
      replacement of all but the 3' 84 bp of the cyanobacterial psbC gene with the
      homologous fragment from spinach, an obligate photoheterotrophic mutant was
      generated. Two photoautotrophic derivatives of this mutant were made
      reincorporating 3' cyanobacterial sequences back into the spinach psbC gene of
      the mutant. These two mutants are similar to each other, carrying a chimeric CP43
      with the N-terminal half from spinach. These mutants are photosynthetically
      active at a rate of about half that of wild type, which correlates with a
      decreased Photosystem II/chlorophyll ratio in these mutants. Thylakoids from the
      chimeric mutants contain a CP43 protein which migrates slightly more slowly on
      SDS-polyacrylmide gels than the native Synechocystis CP43. Interestingly, these
      mutants show significant shifts in thermoluminescence peaks, reflecting altered
      thermodynamic properties of the back reaction between the acceptor side and the
      water-splitting system. On the basis of the oscillations of these shifts with
      number of flashes, we conclude that S2 is stabilized and S3 is destabilized in
      these mutants. This represents evidence for an involvement of CP43 in events
      associated with water splitting.

PMID- 8369340
TI  - Intimate relationships of the large and the small subunits of all nickel
      hydrogenases with two nuclear-encoded subunits of mitochondrial NADH: ubiquinone
      oxidoreductase.
AB  - The sequence pattern CxxCxnGxCxxxGxmGCPP, thus far found in the small subunits
      from 21 different nickel hydrogenases, appears also to be present in the PSST
      polypeptide from NADH:ubiquinone oxidoreductase (Complex I) of beef-heart
      mitochondria. There is only one difference: the first cysteine residue is a
      leucine in the PSST subunit. The large nickel-binding subunit of nickel
      hydrogenases shows a surprising homology with the 49 kDa subunit of mitochondrial
      Complex I.

PMID- 8369341
TI  - Activation and inhibition of mitochondrial transhydrogenase by metal ions.
AB  - Mitochondrial transhydrogenase has been reported previously to be inhibited by
      high, rather non-physiological concentrations (in the range of 2-20 mM) of
      divalent cations. We show that the enzyme could be activated by low (from about 1
      microM to 1 mM) concentrations of Ca2+ and Mg2+, which are within physiological
      range. These results bring in line the effects observed with mitochondrial enzyme
      to the findings with bacterial transhydrogenases. The activation of
      transhydrogenase by divalent cations is interpreted as an increase in affinity of
      the NADP(H)-binding site of the enzyme-NAD(H) complex. Reported effects of the
      metal ions could be important for the enzyme function in vivo.

PMID- 8369342
TI  - Cloning and sequence of the Rhizobium leguminosarum biovar phaseoli fixA gene.
AB  - We report the identification and cloning of Rhizobium leguminosarum biovar
      phaseoli fixABCX homologous genes and the complete nucleotide sequence of the
      fixA gene. The corresponding gene product is highly homologous to the Rhizobium
      meliloti and Azorhizobium caulinodans FixA proteins. Putative NtrA- and NifA
      binding sites are identified in the fixA promoter region.

PMID- 8369343
TI  - Dependence of normalized protein catabolic rate on Kt/V in continuous ambulatory
      peritoneal dialysis: not a mathematical artifact.

PMID- 8369344
TI  - The role of vaccination in the prevention of staphylococcal peritonitis in
      continuous ambulatory peritoneal dialysis.

PMID- 8369345
TI  - Cross sectional assessment of weekly urea and creatinine clearances and indices
      of nutrition in continuous ambulatory peritoneal dialysis patients.
AB  - OBJECTIVE: To perform a cross sectional analysis in 71 patients on continuous
      ambulatory peritoneal dialysis (CAPD) to identify significant correlations of
      weekly small solute clearances and indices of nutritional status with each other
      and with patient demographics and other commonly monitored clinical and
      laboratory parameters. DESIGN: This was a retrospective, cross sectional analysis
      in 71 patients on CAPD from less than 1 to 105 patient-months (average, 20
      months). SETTING: An outpatient CAPD program. PATIENTS: All patients on CAPD in
      our program at the time of the study willing to undergo the clearance and
      nutritional status measurements. INTERVENTIONS: No interventions other than the
      monitoring of their status. MAIN OUTCOME MEASURES: Weekly small solute
      clearances, dietary protein intake, serum albumin, lean body mass, net protein
      catabolic rate, and urinary and dialysate nitrogen. RESULTS: Weekly Kt/V urea
      (weekly urea clearance normalized to total body water) of at least 1.7 and weekly
      total creatinine clearances (liter/week/1.7 m2) of at least 50 are associated
      with net protein catabolic rates (PCR) greater than 0.9 g/kg of normalized body
      weight in average CAPD patients. Kt/V urea and net PCR correlate significantly
      with serum albumin. High transporters identified by the peritoneal equilibration
      test have greater albumin losses and lower serum albumin concentrations.
      Estimates of lean body mass correlate significantly with serum albumin and net
      PCR; lean body mass correlates significantly and inversely with age. CONCLUSIONS:
      Greater small solute clearances are associated with better nutritional status.

PMID- 8369346
TI  - Assessment of dialysis dose by measured clearance versus extrapolated data.
AB  - OBJECTIVE: To determine whether estimates of daily dialysis clearance of
      creatinine and urea, based on data from the 4-hour peritoneal equilibration test,
      correlate well with daily dialysis clearance measured by 24-hour dialysate
      collection in chronic ambulatory peritoneal dialysis patients. DESIGN:
      Prospective study in which each subject collected all dialysate from a 24-hour
      period and then immediately thereafter underwent a standard peritoneal
      equilibration test (PET). Daily clearances of creatinine and urea were calculated
      from 24-hour dialysate collections by standard methods and then were compared
      with several estimates of 24-hour clearance based on PET data. SETTING: Single
      peritoneal dialysis unit of a university teaching hospital. PATIENTS: Thirty-six
      stable patients on continuous ambulatory peritoneal dialysis (CAPD). MAIN
      OUTCOME: The estimated values for daily dialysis clearance both overestimated and
      underestimated the measured 24-hour clearance. The correlation coefficient
      between the extrapolations and the actual 24-hour clearances ranged from 0.63
      0.68. The range of discordance for daily creatinine clearance was from -2530
      mL/day to +2199 mL/day. For daily urea clearance, the range of discordance was
      from -2103 mL/day to +1940 mL/day. The peritoneal membrane transport
      characteristics of the individual patient did not predict whether the
      extrapolation overestimated or underestimated the measured daily clearance.
      CONCLUSION: Extrapolation of PET data is not a reliable method to estimate the
      dose of dialysis delivered to the patient. A 24-hour collection of dialysis is
      necessary for this determination.

PMID- 8369347
TI  - Determining peritoneal dialysis prescriptions by employing a patient-specific
      protocol.
AB  - OBJECTIVE: To develop a formula that would permit a rapid and simple calculation
      of required dialysate volume needed to provide a predetermined daily creatinine
      clearance. DESIGN: Prospective study of peritoneal dialysis patients followed for
      6 months. SETTING: A primary care teaching hospital in New York. PATIENTS: Twenty
      six patients beginning peritoneal dialysis entered and completed the study.
      INTERVENTION: By employing each patient's measured peritoneal equilibration test
      (PET) and a standard clearance formula, a patient-specific treatment protocol
      (PSP) was calculated. The PET 2-hour D/Pcreat was used for continuous cycling
      peritoneal dialysis (CCPD) and the 4-hour D/Pcreat was used for patients on
      continuous ambulatory peritoneal dialysis (CAPD) to determine a PSP that would
      provide a minimum of 6 L of creatinine clearance daily. MAIN OUTCOME MEASURES:
      Patients were followed for 6 months to assess the ability of this approach of
      maintaining acceptable levels of blood urea nitrogen, creatinine, albumin, and
      hematocrit over the 6-month period of observation. RESULTS: Our study of 26
      patients revealed that only 6 patients (23%) could be treated with the standard
      prescription of 8 L/day on CAPD. The remaining 77% of our patients required 9-13
      L/day for CAPD and 12-21 L/day for CCPD. All patients were free of uremic
      symptoms and demonstrated acceptable biochemical parameters over a 3-6 month
      period of observation. CONCLUSIONS: A patient-specific protocol utilizing
      individually derived PET data provides an acceptable and easy to calculate
      initial treatment prescription for each patient that avoids the necessity for
      trial and error that has heretofore been employed.

PMID- 8369348
TI  - A comparison of peritoneal dialysis-related infections in short- and long-term
      peritoneal dialysis patients.
AB  - OBJECTIVE: We hypothesized that the infection rates and organisms would differ in
      long-term peritoneal dialysis (PD) patients versus those who died or transferred
      to hemodialysis during the first 4 years on PD. DESIGN: Data on PD-related
      infections and outcome were collected from 1979 to 1991 (prospectively since
      1982). SETTING: The patients were followed at University and Veterans
      Administration dialysis centers. PATIENTS: All patients on continuous ambulatory
      peritoneal dialysis (CAPD) or continuous cycling peritoneal dialysis (CCPD) for 4
      years or more (n = 43) were compared to those patients who died or transferred to
      hemodialysis prior to 4 years on PD (n = 213). MAIN OUTCOME MEASURES: Infection
      rates due to various microorganisms and reasons for transfer to hemodialysis were
      examined. RESULTS: Peritonitis rates were 1.2/year versus 0.8/year (p < 0.001) in
      patients on peritoneal dialysis less than 4 years compared to those on 4 years or
      more, respectively, a difference due to S. epidermidis (0.32/year vs 0.20/year, p
      = 0.0001) and gram-negative rods other than P. aeruginosa (0.15/year versus
      0.06/year, p < 0.001). Exit-site infection rates were 1.2/year versus 0.7/y (p <
      0.0001) in the patients on less than 4 years compared to those on 4 years or
      more, respectively, a difference in part due to S. aureus (0.45/year vs 0.3/year,
      p < 0.001) and other gram-positive organisms (0.28/year vs 0.10/year, p < 0.001).
      The rates of infections that were similar in the two groups were tunnel
      infections (0.2/year), P. aeruginosa infections, and S. aureus peritonitis
      (0.18/year vs 0.14/year, p = 0.09). S. aureus was the most common cause of exist
      site and tunnel infections in both groups. Forty-two percent of the patients on
      PD 4 years or more subsequently transferred to hemodialysis, most often due to
      infections, especially S. aureus. CONCLUSIONS: Although infection rates are lower
      in patients on peritoneal dialysis 4 years or more, S. aureus and P. aeruginosa
      continue to account for a high proportion of the infections. Improvement in
      technique survival will require prevention of these infections.

PMID- 8369349
TI  - Chronic tunnel infections in children: removal and replacement of the continuous
      ambulatory peritoneal dialysis catheter in a single operation.
AB  - OBJECTIVE: Chronic tunnel infections often necessitate the removal of the
      continuous ambulatory peritoneal dialysis (CAPD) catheter. Most published studies
      advocate postponing the insertion of a new catheter for several weeks. For young
      children it will be particularly difficult to wait this length of time, since
      vascular access may be cumbersome, and hemodialysis may not be well tolerated.
      The present study describes the results of the simultaneous removal and
      replacement of the CAPD catheter. DESIGN: Twenty-three Toronto Western Hospital
      II catheters were inserted in 17 children because of infectious complications (21
      chronic tunnel infections; 2 recurrent peritonitis) in a single operation under
      appropriate antibiotic prophylaxis. The new catheter was inserted at the
      contralateral side of the abdomen with the deep cuff in the midline, using the
      same entrance to the peritoneal cavity. Dialysis was resumed immediately after
      the operation. SETTING: A university pediatric dialysis unit. PATIENTS: Seventeen
      children (mean age 3.7 years; range 1.0-8.5 years) were studied. In this group 23
      catheters were replaced. RESULTS: In four cases a relapse of the tunnel infection
      was observed within 3 months. All other cases remained free of infection for a
      period of at least 6 months. The main causative microorganism was Staphylococcus
      aureus (15 occurrences). CONCLUSION: It is not necessary to interrupt peritoneal
      dialysis for the replacement of a CAPD catheter because of infectious
      complications.

PMID- 8369350
TI  - In vitro study of the mechanism of potassium transport into human mesothelial
      cells. I: Effect of hyperosmolality.
AB  - OBJECTIVE: To study the mechanism(s) of potassium transport into human
      mesothelial cells (HMC) exposed to osmotic solutes. DESIGN: Using potassium
      analog 86Rb, we evaluated its intracellular transport through three pathways: 1.
      blocked by ouabain; 2. blocked by furosemide but not by ouabain; 3. blocked by
      neither furosemide nor ouabain. Experiments were performed in a normotonic medium
      (control) or in a medium supplemented with osmotic solutes (glucose, glycerol,
      mannitol). Both the acute and chronic effects of osmotic solutes on potassium
      transport were studied. RESULTS: The acute exposure of mesothelial cells to
      osmotic solutes modifies the intracellular transport of potassium through all
      studied channels, and the effect is specific for every solute. In mesothelial
      cells exposed over 7 days to glucose (90 mM), the intracellular transport via
      ouabain- and furosemide-blocked channels is decreased, whereas it is increased
      through the third pathway. Total intracellular accumulation of 86Rb (potassium)
      ions in mesothelial cells cultured in a medium supplemented with various
      concentrations of glucose is decreased, and this effect is proportional to the
      concentration of glucose in the medium. CONCLUSIONS: The intracellular transport
      of potassium in mesothelial cells is regulated through at least three independent
      mechanisms. Acute or chronic exposure of mesothelial cells to a hypertonic medium
      affects the intracellular accumulation of potassium, and this effect is specific
      for the various osmotic solutes.

PMID- 8369351
TI  - Heat sterilization of fluids for peritoneal dialysis gives rise to aldehydes.
AB  - OBJECTIVE: To chemically identify and quantify glucose degradation products in
      heat sterilized fluids for peritoneal dialysis. DESIGN: Three different brands of
      commercial PD-fluids and one laboratory made fluid, sterilized either by heat or
      filtration, were investigated for the presence of aldehydes. MEASUREMENTS:
      Aldehydes were identified and quantified using high performance liquid
      chromatography and gas chromatography. RESULTS: The tested brands of heat
      sterilized PD-fluids were found to contain several different aldehydes while the
      sterile filtered PD-fluid contained none. The highest concentrations in
      commercial PD-fluids of these aldehydes were: acetaldehyde (420 microns), glyoxal
      (14 microns), methylglyoxal (12 microns) and formaldehyde (11 microns).
      Valeraldehyde was also identified but not quantified. The presence of 5-HMF (15
      microns) and 2-furaldehyde (2 microns), which has been identified by others, was
      confirmed. CONCLUSIONS: The heat sterilization of commercial PD-fluids gives rise
      to several aldehydes which may contribute to adverse effects of PD-fluids on
      patients.

PMID- 8369352
TI  - The serum complement system in children on continuous ambulatory peritoneal
      dialysis.
AB  - OBJECTIVE: During continuous ambulatory peritoneal dialysis (CAPD), the loss of
      complement factors via the dialysate may cause complement deficiencies. This
      hypothesis was tested in a group of children treated with CAPD. DESIGN: Classical
      (CH50) and alternative (AP50) complement activity and serum levels of factors
      C1q, C3, C4, C3d, B, D, and P in CAPD patients were compared to normal controls
      and to children with preterminal renal failure. SETTING: Patients were seen in a
      university hospital; normal controls were seen in an outpatient clinic of a
      general hospital. PATIENTS: A group of 22 children on CAPD was compared to a
      normal control group of 44 children and to a group of 12 children with
      preterminal renal failure with a creatinine clearance below 25 mL/min/1.73 m2.
      RESULTS: CH50, AP50, C3, and B were not significantly different from the control
      group in both the CAPD and preterminal groups. Factors C1q (p = 0.01) and C4,
      C3d, D, and P (p < 0.001) were higher in the CAPD group in comparison to the
      normal control group. The factors D (p < 0.001) and P (p = 0.02) were also
      elevated in the preterminal group. For the measured factors there was no
      significant difference between the CAPD group and the preterminal group.
      CONCLUSIONS: There is no deficiency of complement in children treated with CAPD.
      High levels of C3d and D can be explained by the reduction of their elimination
      by the kidney. The increased levels of the other factors are presumably due to
      increased synthesis in renal failure. This does not seem to be caused by CAPD.

PMID- 8369353
TI  - Calcium and magnesium mass transfer in peritoneal dialysis patients using 1.25
      mmol/L calcium, 0.25 mmol/L magnesium dialysis fluid.
AB  - OBJECTIVE: To examine the effect of a reduced calcium/magnesium dialysis fluid
      (1.25/0.25 mmol/L, respectively) on calcium and magnesium mass transfer in both
      1.36% and 3.86% glucose solutions. DESIGN: Each patient underwent four test
      exchanges, two with a standard dialysis fluid containing 1.36% and 3.86% glucose,
      and two with a reduced calcium/magnesium fluid containing 1.36% and 3.86%
      glucose. Calcium and magnesium were measured in dialysate and serum at 0 and 240
      minutes. SETTING: Single renal unit of a university teaching hospital. PATIENTS:
      Sixteen patients established on CAPD, and peritonitis-free, for at least 3
      months. RESULTS: A lower dialysate calcium results in negative mass transfer when
      serum-ionized calcium exceeds dialysate calcium (mean -0.21 +/- 0.15
      mmol/exchange), and positive mass transfer when serum-ionized calcium is less
      than dialysate calcium in 1.36% glucose solutions (mean 0.57 +/- 0.18
      mmol/exchange). A negative correlation was found between serum-ionized calcium
      level and calcium mass transfer. With a 3.86% reduced calcium/magnesium solution,
      calcium mass transfer is always negative (-0.88 +/- 0.18 mmol/exchange) due to
      ultrafiltration and solute drag. Fifteen patients were found to be
      hypermagnesemic at the time of the study. Magnesium mass transfer was neutral
      with the standard 1.36% glucose fluid (mean -0.01 mmol/exchange), but negative
      with the reduced calcium/magnesium 1.36% glucose fluid (mean -0.58 +/- 0.13
      mmol/exchange). With the 3.86% glucose solution, both fluids produced negative
      magnesium mass transfer (mean -0.32 +/- 0.11 and -1.07 +/- 0.11 mmol/exchange for
      standard and reduced calcium/magnesium fluids, respectively). CONCLUSIONS: We
      conclude that this fluid formulation should reduce hypercalcemia and
      hypermagnesemia in CAPD patients.

PMID- 8369354
TI  - Survival of 138 surgically placed straight double-cuff Tenckhoff catheters in
      patients on continuous ambulatory peritoneal dialysis.
AB  - OBJECTIVE: To determine the natural history of a surgically placed Tenckhoff
      catheter in patients on continuous ambulatory peritoneal dialysis (CAPD). DESIGN:
      Prospective 7-year study analyzing catheter survival of all catheters using the
      Kaplan-Meier life table methodology. SETTING: Teaching hospital, department of
      nephrology. PATIENTS: One hundred and fifteen unselected patients beginning CAPD.
      INTERVENTIONS: Removal of the catheter required for the following complications:
      exit-site or tunnel infections or relapsing peritonitis, outflow obstruction,
      pericatheter leak, and development of hernias. MAIN OUTCOME MEASURES: Period
      between insertion and removal of the catheter. RESULTS: The cumulative survival
      of all catheters after 1, 2, and 3 years of CAPD was 87%, 69% and 65%. Catheter
      survival of the first versus the second catheter after 1 year was significantly
      longer (p = 0.03). The difference was not significant in relation to diabetes,
      age, and sex. Infectious complications caused 61% (n = 19) of all 31 catheter
      failures, mainly due to tunnel infections caused by Staphylococcus aureus (n =
      12). "Mechanical" complications accounted for 49% (n = 12) of catheter failures.
      Eight of 12 mechanical complications were outflow failures. Seven patients had to
      be transferred to hemodialysis. CONCLUSIONS: The straight Tenckhoff catheter is a
      reliable peritoneal access device for CAPD in an unselected patient population.

PMID- 8369355
TI  - Destructive spondyloarthropathy in a patient on continuous ambulatory peritoneal
      dialysis for 13 years.
AB  - Since 1984 there have been reports of a destructive spondyloarthropathy occurring
      in patients on long-term hemodialysis. The primary abnormality appears to be an
      accumulation of beta 2-microglobulin, which is not adequately removed by
      dialysis, and forms amyloid deposits in articular and periarticular tissues. We
      report a case of this disease in a patient treated only by peritoneal dialysis.
      While this form of treatment may delay the development of arthropathy, as
      compared to hemodialysis, it does not prevent it. An increasing incidence of this
      disorder may be expected, since increasing numbers of patients have been on long
      term peritoneal dialysis.

PMID- 8369356
TI  - Influence of mothers on school adjustment of continuous ambulatory peritoneal
      dialysis children.
AB  - In school children on continuous ambulatory peritoneal dialysis (CAPD), school
      adjustment is regarded as an important indicator for comprehensive medical care.
      The aim of the present study was to examine the influence of mothers on school
      adjustment of CAPD children. The children tended to indicate school maladjustment
      with school absenteeism and poor relationships with friends. The mothers were
      characterized by poor independence, poor achievement orientation, strong
      emotional reliance, and lack of social self-confidence, indicating emotional
      instability. The family environment, including the mother's psychological
      condition, was strongly associated with the children's maladjustment to school.
      The results suggested the necessity of comprehensive medical care for these
      children and their mothers.

PMID- 8369357
TI  - Assessing the adequacy of peritoneal dialysis.

PMID- 8369358
TI  - Serial changes of serum beta-2-microglobulin in CAPD.

PMID- 8369359
TI  - Group B Streptococcus (agalactiae) peritonitis and bacteremia associated with
      CAPD.

PMID- 8369360
TI  - Death associated with Pseudomonas peritonitis in malnourished elderly diabetics
      on CAPD.

PMID- 8369361
TI  - Literature. July-September 1993.

PMID- 8369362
TI  - Potential clinical use of the EDTA-infusion test.
AB  - The introduction of assays for the intact parathyrin (parathyroid hormone) has
      dramatically improved the diagnosis and follow-up of patients with primary
      hyperparathyroidism. However, in some patients with mild or intermittent
      hypercalcaemia, when plasma concentrations of intact parathyrin may be within the
      normal reference concentrations, the diagnosis of primary hyperparathyroidism may
      still be problematic. In these patients, the EDTA-infusion test is of potential
      value, as it also might be in patients with equivocal operative findings.

PMID- 8369363
TI  - Evaluation of the creatinine assay on the Reflotron analyser under centralized
      and non-centralized conditions.
AB  - The creatinine assay, performed on Reflotron "dry chemistry" analysers in six
      offices of general practitioners, was evaluated as part of a project on the
      quality of laboratory determinations in decentralized situations. The method
      itself was evaluated before this investigation was started. Differences were
      noticed between Reflotron machines, batches of strips, and various types of
      sample, viz. heparin-treated blood or plasma gave higher results than serum of
      EDTA-treated samples. All Reflotron results were lower in comparison with wet
      chemistry methods. The "dry chemistry" technique was not influenced by the
      presence of glucose or bilirubin (below 170 mumol/l); haemoglobin interfered. By
      simultaneous sampling, all creatinine determinations performed on whole EDTA
      blood in the general practitioners offices were repeated on serum in centralized
      laboratories using "wet chemistry" techniques. In this comparison 3% of all
      creatinine determinations in general practitioners offices were outside the 95%
      confidence interval. We conclude that the creatinine determination on the
      Reflotron may be used in general practitioners office testing as long as the
      general practitioner is aware of its limitations and can rely on a "reference"
      laboratory for training, quality control and repetition of unexpected results.

PMID- 8369364
TI  - Calibrators and control samples for bilirubinometers.
AB  - The different matrix properties of neonatal serum and commercial control samples
      can lead to considerable errors in the calibration and control of
      bilirubinometers. These difficulties can be avoided by calibration with serum
      from healthy adults which is supplemented with unconjugated bilirubin. But this
      procedure is impracticable for most routine laboratories. Under certain
      preconditions, control samples, with bilirubin concentrations determined with
      correctly calibrated bilirubinometers or spectrophotometers, are also suitable as
      calibrators. This was established by determination of the bilirubin concentration
      of 16 different control samples, using both the reference method and correctly
      calibrated bilirubinometers or spectrophotometers in three or four specialist
      laboratories. This was also confirmed in several interlaboratory surveys, some
      involving up to 72 laboratories. The results of these investigations show that a
      control sample should be used for the calibration of a bilirubinometer only if it
      meets the following preconditions: 1. There should be no significant difference
      between the bilirubin values determined with the reference method and with a
      correctly calibrated spectrophotometer or bilirubinometer. 2. The bilirubin
      concentration should lie in the range 230-300 mumol/l. The photometric response
      of bilirubinometers has a limited linear range, so that analytical results
      greater than 300 mumol/l must be rated as basically unreliable.

PMID- 8369365
TI  - Determination of nerve growth factor concentrations in human samples by two-site
      immunoenzymometric assay and bioassay.
AB  - Nerve growth factor is a neurotrophic protein which is known to act on
      sympathetic and sensory neurons and on the magnocellular cholinergic neurons of
      the basal forebrain. We quantified nerve growth factor in human tissue and body
      fluids by two methods, a rapid and sensitive two-site immunoenzymometric assay
      and a bioassay using dissociated chick dorsal root ganglion neurons. The two-site
      immunoenzymometric assay detects nerve growth factor in concentrations as low as
      0.5-2.5 ng/l. Using a monoclonal antibody to mouse nerve growth factor, we found
      that the signal of the antibody for recombinant human nerve growth factor is
      about 60-90% of the signal for mouse nerve growth factor. As a control for the
      specificity of our data, a bioassay for nerve growth factor was performed and the
      results showed a good correlation. The highest nerve growth factor concentrations
      were found in sciatic nerve (2.5 ng/g wet weight), cardiac atrium muscle (1.5
      ng/g wet weight) and in the central nervous system in the hippocampus (1.9 ng/g
      wet weight). Lower nerve growth factor concentrations were measured in human sera
      (0.2 ng/g wet weight). No nerve growth factor was detectable in cerebrospinal
      fluid. The distribution of human nerve growth factor-rich tissues is similar to
      that reported for rat tissues.

PMID- 8369366
TI  - Monitoring cyclosporin A (ciclosporin, INN) concentrations in whole blood:
      evaluation of the EMIT assay in comparison with HPLC and RIA.
AB  - We report here on an evaluation of the enzyme-multiplied immunoassay technique
      (EMIT) from Syva for cyclosporin A (ciclosporin, INN) concentration measurements
      in whole blood. The assay incorporates a monoclonal antibody for specific
      determination of ciclosporin. Measurements by EMIT were performed on the Cobas
      Mira-S from Roche. A total of 197 blood specimens from heart-(n = 74), kidney-(n
      = 62) and liver-(n = 61) transplant recipients were analyzed. EMIT values
      correlated well with those obtained by HPLC, as well as with those obtained by a
      selective radioimmunoassay (INCStar). Ciclosporin concentrations determined by
      EMIT (y) agreed very well with those by RIA, and averaged 8% higher than those by
      HPLC (x) [n = 197, mean = 143 micrograms/l, y = 155 micrograms/l, y = 1.09x -
      0.6, r = 0.969]. Within-series and between-days CVs ranged from 4.6% to 7.3% for
      ciclosporin concentrations > 100 micrograms/l, and from 5.5% to 10.5% for
      ciclosporin concentrations between 69.5 micrograms/l and 100 micrograms/l. The
      within-series CV for a concentration of 45.5 micrograms/l was 14.8%. Calibration
      employing a 2-point mode instead of a continuous mode of UV-signal evaluation
      improved the precision of the EMIT assay at low ciclosporin concentrations.
      Sample pretreatment required thorough and skillful performance to avoid false
      positive ciclosporin measurements. We conclude that the EMIT assay is specific,
      and rapid to perform. It can be effectively used in the monitoring of ciclosporin
      concentrations in whole blood.

PMID- 8369367
TI  - Development and evaluation of a time-resolved immunofluorimetric assay for
      thyrotropin.
AB  - The assay described in this article is based on microtitre plate technology; it
      employs an europium label. The streptavidin-biotin system has been used and all
      components are commercially available. The lower detection limit of the assay is
      below 0.003 mU/l; the standards are made up in newborn calf serum. Correlation
      with a commercially available immunoluminometric assay (Berilux--Behringwerke)
      was excellent (r = 0.92, n = 201 data pairs, range covered 0-10 mU/l). The
      regression line using a double logarithmic transformation was: (log y) = 0.91
      (log x)-0.08. The assay precision at the clinical limits of decision--i.e.
      between hyper- and euthyroidism (0.2 mU/l) and eu- and hypothyroidism (4 mU/l)-
      was acceptable. The median coefficient of variation was 1.93% in the range 0.02-1
      mU/l and 2.11% in the range 1.0-3.5 mU/l, with both values being determined from
      precision profiles using 214 and 188 data pairs respectively. Inter-assay
      coefficients of variation determined in over 30 consecutive assays were under 6%
      in the range 1.3-20 mU/l. From 201 sera measured in both assays, 194 sera gave
      clinically identical values; 8 sera gave clinically discrepant values. The assay
      has a large dynamic range covering a concentration range of above 5 decades, with
      the count ratio between the 100 mU/l standard and the zero standard being in
      excess of 4150:1. A high dose hook effect was first seen in excess of 500 mU/l.
      The maximum signal was achieved around 150 mU/l, which registered around 8 x
      10(6) counts per second, a figure more than 8000 times higher than that in the
      zero standard.

PMID- 8369368
TI  - Establishment of reference ranges for follitropin and lutropin in neonates,
      infants, children and adolescents.
AB  - Follitropin was determined in the sera of 645 probands, and lutropin in the sera
      of 649 probands between the ages of 5 days and 18 years (neonates, infants,
      children and adolescents), using microparticle-enzyme-immunoassays (MEIA) on the
      IMx from Abbott Laboratories. The proband collective was divided into 9 age
      groups and each group into males and females. In accordance with the
      recommendations of the International Federation of Clinical Chemistry, the 95%
      scatter range was taken as the reference range. In some age groups, the ranges
      for individual hormones showed a significant sex difference. Age groups without
      significant sex differences were combined and evaluated statistically as a single
      group. Only a few reference groups showed a normal Gaussian distribution. In
      addition to the 50th percentile, the 2.5th and 97.5th, or the zero and 95th
      percentiles were determined for all reference groups. Minimal and maximal values
      were also determined. The U-test of Mann & Whitney was used to test for
      significant differences between the individual reference groups. Groups showing
      no significant differences were combined, and reference ranges were finally
      calculated for follitropin and lutropin in the serum of healthy neonates,
      infants, children and adolescents.

PMID- 8369369
TI  - Measuring Bence Jones proteins with antibodies against bound immunoglobulin light
      chains: how reliable are the results?
AB  - Protein mass concentrations of nine individual urinary Bence Jones proteins were
      determined via protein dry weight and compared (i) to immuno-nephelometric
      measurements using two different antisera against bound light-chains and (ii) to
      total protein concentrations determined by trichloroacetic acid nephelometry and
      the Biuret method. In each case, these four measurements differed significantly
      from each other and from the expected value (as determined by protein dry
      weight). The extent and direction of deviation were different for each
      measurement and varied between cases, but similar patterns were observed in
      different samples from the same patient. Apparently, these measurements can not
      be quantitatively compared between different individual Bence Jones proteins, but
      can be interpreted in terms of disease activity and therapeutic success for each
      patient. Accordingly, the quantitative expression of Bence Jones proteins should
      be restricted to relative terms, e.g. "arbitrary units" or "serum light-chain
      equivalents". This avoids the (potentially incorrect) statement of protein mass
      concentrations.

PMID- 8369370
TI  - Optimum experimental designs for properties of a compartmental model.
AB  - Three properties of interest in bioavailability studies using compartmental
      models are the area under the concentration curve, the maximum concentration, and
      the time to maximum concentration. Methods are described for finding designs that
      minimize the variance of the estimates of these quantities in such a model. These
      methods use prior information. Both prior estimates and prior distributions are
      used. The designs for an open one-compartment model are compared with the
      corresponding D theta-optimum design for all parameters and also with designs
      that minimize the sum of the scaled variances of the individual properties.

PMID- 8369371
TI  - t-REML for robust heteroscedastic regression analysis of mitochondrial power.
AB  - The paper reports a long series of observations on two statistically independent
      variates which have different nonlinear regressions on the same parameter vector.
      In our analysis of the data, heteroscedasticity is handled by residual maximum
      likelihood, REML, but to cope with outliers as well, REML based on a t
      specification, called t-REML, is introduced. The data are the results of
      factorial experiments designed to model the quantitative performance of
      mitochondria generating aerobic power. The response variates are flux, measured
      as respiration, and ATP potential as log(ATP/ADP). The background of metabolism
      and oxidative phosphorylation is briefly sketched.

PMID- 8369372
TI  - An index of tumorigenic potency.
AB  - A new index of tumorigenic potency is derived using a survival-adjusted quantal
      response estimator given by Bailer and Portier (1988, Biometrics 44, 417-431).
      The small-sample bias and mean squared error properties of this estimator are
      explored using computer simulations of animal carcinogenicity experiments and are
      compared to the characteristics of the TD50, an estimator proposed by Sawyer et
      al. (1984, Biometrics 40, 27-40). It is observed that this new index tends to
      have smaller bias and mean squared error relative to the TD50 over varying shapes
      of the tumor onset distribution, levels of tumor lethality, and levels of
      treatment lethality.

PMID- 8369373
TI  - A Weibull model for the estimation of tumorigenic potency.
AB  - In this paper, a new method of estimating tumorigenic potency is proposed that
      takes into account information on survival and, when available, the underlying
      cause of death. Specifically, Weibull distributions are used to describe the time
      to tumor occurrence (X), the time to death as a result of tumor occurrence (Y),
      and the time of death from causes other than tumor occurrence (Z). The
      distributions of X and Y are related via a lethality parameter p lying between 0
      (incidental tumors) and 1 (rapidly fatal tumors). The index of tumorigenic
      potency is defined as the dose inducing a specified excess tumor response rate
      (in the range of 25%-50%) following exposure for an extended period encompassing
      most of the expected lifespan. Application of the proposed method is illustrated
      using several data sets taken from the literature.

PMID- 8369374
TI  - Regression analysis of grouped survival data: informative censoring and double
      sampling.
AB  - To analyze grouped survival data subject to informative censoring, we propose the
      following two-part model: a logistic regression model for the hazard for failure,
      given covariates and a logistic regression model for the hazard for informative
      censoring, given time of failure and covariates. We fit the model to survival
      data arising from a double sampling design: In a full follow-up (FF) sample
      subjects are followed after censoring, and in a partial follow-up (PF) sample
      subjects are not followed after censoring. We illustrate the methodology using
      data from a study of wound infection in which patients in the PF sample are
      censored by release from the hospital, whereas patients in the FF sample are
      followed after hospital release. We discuss identifiability when there is only a
      PF sample. We also consider how the allocation between the PF and FF samples
      affects the precision of estimates.

PMID- 8369375
TI  - Selection designs for pilot studies based on survival.
AB  - In cancer clinical trials new regimens are typically tested for antitumor
      activities in patients with advanced disease. The promising ones are then
      compared to the standard treatment in a randomized study, sometimes performed on
      patients with earlier-stage disease. When there are multiple promising regimens,
      it may not be possible to compare all of them to the control group because of the
      prohibitive sample size and study length requirements. We propose a design that
      uses the Cox regression model to select a best treatment based on survival before
      the randomized comparison. Sample sizes for an asymptotically correct selection
      probability of .90 are presented for Weibull survival distributions with
      parameters in a range we consider to be of practical interest. Simulations verify
      that the asymptotic approximations to the correct selection probabilities are
      quite satisfactory. Simulations also indicate that the procedure is reasonably
      robust to the proportional hazards assumption. In contrast to the two-stage
      screening design recommended by Schaid, Wieand, and Therneau (1990, Biometrika
      77, 507-513), our design has the advantage of fitting naturally to a progression
      of cancer trials where the selection and comparison phases are carried out on
      different populations of patients. When the population of interest stays the
      same, our design can be more conservative on the average but offers the
      opportunity to base the comparative trial on the experience gained during the
      selection phase.

PMID- 8369376
TI  - Evaluating constraints that allow survival-adjusted incidence analyses in single
      sacrifice studies.
AB  - Ideally, analyses of tumor incidence data from long-term animal experiments
      should allow the incidence rates to vary with age, without restricting tumor
      lethality, without requiring data on cause of death, and without assuming
      independence of competing risks. This article focuses on nonparametric methods
      that not only satisfy these conditions, but also accommodate studies having just
      one sacrifice time, by constraining the effects of age on one of the three
      functions used to characterize the likelihood. Several constrained analyses were
      evaluated using data on over 18,000 mice from the ED01 study. Of the five
      constraints considered, only the assumption of constant differences between the
      death rates for animals with and without the tumor of interest produced
      reasonable results across a wide range of tumor lethalities.

PMID- 8369377
TI  - Estimation of two ordered mean residual lifetime functions.
AB  - In many statistical studies involving failure data, biometric mortality data, and
      actuarial data, mean residual lifetime (MRL) function is of prime importance. In
      this paper we introduce the problem of nonparametric estimation of a MRL function
      on an interval when this function is bounded from below by another such function
      (known or unknown) on that interval, and derive the corresponding two functional
      estimators. The first is to be used when there is a known bound, and the second
      when the bound is another MRL function to be estimated independently. Both
      estimators are obtained by truncating the empirical estimator discussed by Yang
      (1978, Annals of Statistics 6, 112-117). In the first case, it is truncated at a
      known bound; in the second, at a point somewhere between the two empirical
      estimates. Consistency of both estimators is proved, and a pointwise large-sample
      distribution theory of the first estimator is derived.

PMID- 8369378
TI  - Epidemiologic assessment of risks of adverse reactions associated with
      intermittent exposure.
AB  - Measures of risk of adverse reactions, such as the absolute risk, the relative
      risk, and the excess risk, are analyzed for individuals who are exposed
      occasionally for periods of varying duration. This type of exposure is of
      particular importance for the epidemiologic assessment of drug safety. A Poisson
      point process model that allows for the simultaneous consideration of concomitant
      factors is derived for the estimation of the hazard rates. The model can judge
      acute adverse reactions and is applicable not only for rare risks since an
      undesired effect may occur repeatedly for an individual. Hazard estimation is
      achieved with the aid of the maximum likelihood method for several sampling
      designs, such as cohort studies, case-cohort studies, and case studies. In the
      latter design only those individuals who have had an adverse reaction during the
      time of observation are considered for hazard estimation. An application to the
      analysis of wound-healing impairments is given.

PMID- 8369379
TI  - Conditional regression analysis of the exposure-disease odds ratio using known
      probability-of-exposure values.
AB  - Conditional inference methods are proposed for the odds ratio between binary
      exposure and disease variables when only the probability of exposure is known for
      each study subject. We develop a conditional likelihood approach that removes
      nuisance parameters and permits inferences to be made about important parameters
      in log odds ratio regression models. We also discuss a heuristic procedure based
      on estimating the (unknown) number of truly exposed individuals; this procedure
      provides a simple framework for interpreting our likelihood-based statistics, and
      leads to a Mantel-Haenszel-type estimator and a goodness-of-fit test. As an
      example of the use of this methodology, we present an analysis of some genetic
      data of Swift et al. (1976, Cancer Research 36, 209-215).

PMID- 8369380
TI  - Random-effects models, for longitudinal data using Gibbs sampling.
AB  - Analysis of longitudinal studies is often complicated through differences amongst
      individuals in the number and spacing of observations. Laird and Ware (1982,
      Biometrics 38, 963-974) proposed a linear random-effects model to deal with this
      problem. We propose a generalisation of this model to accommodate multiple random
      effects, and show how Gibbs sampling can be used to estimate it. We illustrate
      the methodology with an analysis of long-term response to hepatitis B
      vaccination, and demonstrate that the methodology can be easily and effectively
      extended to deal with censoring in the dependent variable.

PMID- 8369381
TI  - Nonparametric procedures for comparing umbrella pattern treatment effects with a
      control in a one-way layout.
AB  - In this paper we are concerned with comparing umbrella pattern treatment effects
      with a control in a one-way layout. The problem of testing whether there is at
      least one treatment that is better than the control is considered. Distribution
      free tests are proposed for both cases where the peak of the umbrella is known or
      unknown. Approximate small-sample critical values are presented and the results
      of a Monte Carlo power study are discussed.

PMID- 8369382
TI  - Qualitative interactions in multifactor studies.
AB  - In clinical trials qualitative interaction or crossover interaction is said to
      occur when one treatment is superior for some sets of patients and the
      alternative treatment is superior for other subsets. Here we propose a definition
      of no qualitative interaction with respect to a single continuous covariate which
      implies that one treatment is superior to the other treatment over a prespecified
      range of the covariate. Further, in studies involving patients cross-classified
      by two or more prognostic factors, we define a marginal qualitative interaction
      with respect to a treatment factor and a prognostic factor by averaging in some
      sense over the remaining prognostic factors. In some situations, the methodology
      of Gail and Simon (1985, Biometrics 41, 361-372) is shown to be appropriate.
      Their procedure assumes independent estimates of treatment effect for each subset
      of patients and this may not be appropriate for the generalizations we propose.
      Therefore, we generalize the procedure of Gail and Simon to the case of two
      correlated estimates of treatment effect, providing a table of critical values.
      Results for one-sided tests for the case of J correlated estimates are also
      obtained. We also present an example illustrating our procedure.

PMID- 8369383
TI  - The contribution of individual variables to Hotelling's T2, Wilks' lambda, and
      R2.
AB  - We examine the effect of each variable on the following statistics: the one
      sample and two-sample Hotelling's T2, Wilks' lambda for multivariate analysis of
      variance, and R2 in multiple regression. For T2, the net effect of each variable
      is an increase in the multivariate statistic, and the particular factors
      determining the amount of increase are (i) the multiple correlation of the
      variable with all other variables, and (ii) how well the variable's contribution
      to falsifying the hypothesis can be linearly predicted from the other variables.
      The effect of each predictor variable on R2 is similar to the effect of each
      variable on T2. For Wilks' lambda, each variable induces a decrease, due to (i)
      the F for that variable alone, and (ii) the change in multiple correlation from
      within-sample to total-sample.

PMID- 8369384
TI  - Modeling the Ames Salmonella/microsome assay.
AB  - Of the many short-term tests for mutagenicity that have been proposed in recent
      years, the Ames Salmonella/microsome assay is the single most widely used and
      most thoroughly validated in vitro test system. This assay uses cells cultured in
      a soft agar containing a trace amount of histidine to allow growth of auxotrophic
      bacteria, and is designed to detect reverse mutations from auxotrophic cells to
      histidine-independent prototrophic cells. In this paper, statistical models that
      have been proposed for the analysis of Ames test data are reviewed, including
      those of a mechanistic and empirical nature. An extension to the class of
      biologically based models derived by Margolin, Kaplan, and Zeiger (1981,
      Proceedings of the National Academy of Sciences 78, 3779-3783) is proposed by
      allowing for diffusion of histidine within the plate agar. Quasi-likelihood
      methods for estimating the model parameters are presented, and applied to 1,120
      data sets from a recent collaborative trial sponsored by the International
      Programme on Chemical Safety.

PMID- 8369385
TI  - Fixed-distance latent class models for the analysis of sets of two-way
      contingency tables.
AB  - This paper develops and describes the application of modified latent class models
      for analyzing sets of two-way contingency tables. The proposed fixed-distance
      models differ from traditional latent class models in that the assumption of
      local stochastic independence is superseded by allowing interactions of the
      manifest variables within each class, which can be represented by a single
      association parameter. As an example, two data sets on eye color by hair color
      [collected in Caithness (N1 = 5,387) and Aberdeen (N2 = 22,361)] and fixed
      distance models with up to six classes (three classes per data set) are
      considered, finally leading to satisfactory fit and rather simple interpretation.

PMID- 8369386
TI  - Interval estimation under two study designs for kappa with binary
      classifications.
AB  - Cornfield's test-based method of setting a confidence interval on a parameter
      associated with a two-by-two contingency table is adapted for use with the
      measure of agreement kappa. One-sided confidence intervals derived in this way
      are compared to other intervals proposed for kappa under two study designs. Both
      designs involve two ratings per subject on a dichotomous scale. In one design the
      same two raters make all evaluations; in the other, possibly different pairs of
      raters evaluate different subjects, or the same rater carries out a pair of
      independent assessments for each subject. It is shown through simulation that
      lower bounds based on Cornfield's test-based method attain the nominal coverage
      probability more often than other intervals proposed in the literature.

PMID- 8369387
TI  - Higher-order kappa-type statistics for a dichotomous attribute in multiple
      ratings.
AB  - We introduce a sequence of parameters called canonical moments to characterize
      the predictive value of the pattern of consensus among (kappa-1) ratings to an
      additional rating. The usual kappa coefficient of agreement among ratings (two or
      more) is just the second canonical moment. By using the higher canonical moments,
      we can evaluate the consensus of multiple binary ratings.

PMID- 8369389
TI  - A test of hypothesis on familial correlations.
AB  - When familial data are analysed, the model usually employed assumes independence
      of family observations and constancy of interclass and intraclass correlations. A
      statistic for testing the validity of the assumptions of family independence and
      constant interclass and intraclass correlations is developed. The test statistic
      is for constant family size; it has an asymptotic chi-square distribution. An
      example to illustrate the theory is given using Frets's data on head lengths. A
      recommendation is made on how to apply the test to the general case of varying
      sizes. Another recommendation is made on models to be tried once the null
      hypothesis is rejected.

PMID- 8369390
TI  - Nonparametric estimation of relative mortality from nested case-control studies.
AB  - Andersen et al. (1985, Biometrics 41, 921-932) gave an estimator of the
      cumulative relative mortality comparing rates of death in an epidemiologic cohort
      to an external population as a function of time when covariate information is
      available on all cohort members. We present an analogous estimator when covariate
      information is known only on a nested case-control sample. Counting process
      techniques are used to show that this estimator is almost unbiased and an
      estimator of its variance is derived. Estimators of the relative mortality
      function, using kernel smoothing methods, and the average relative mortality over
      grouped time intervals are also presented. The methods are illustrated by
      comparing rates of lung cancer mortality in a cohort of Montana smelter workers
      to that in the United States population.

PMID- 8369388
TI  - On the covariance between parameter estimates in models of twin data.
AB  - We study the covariance between estimates of additive genetic variance and either
      dominance genetic variance or common environmental variance in likelihood-based
      twin analyses. The central tools used in these investigations are the asymptotic
      covariances of variance component estimates, which we present for several
      commonly used twin models. We first illustrate the use of the asymptotic
      covariance terms for determining the optimal ratio of monozygotic to dizygotic
      group sample sizes for a twin study. We then focus attention on the asymptotic
      correlations between estimates of additive genetic variance, and either dominance
      genetic variance or common environmental variance, and their use in understanding
      when parameters are efficiently estimable from twin data. The results of this
      investigation are confirmed by simulation studies, and highlight inherent
      limitations of the twin model, in the sense that having only twin data limits the
      ability to detect individual variance components. Finally, remarks on possible
      alternative statistical methods are given, and results are presented to
      illustrate the improvements in efficiency that are possible with additional
      family data. In particular, the results provide insight into the limitations of
      inference from twin data.

PMID- 8369391
TI  - Nonparametric estimation for the difference or ratio of median failure times.
AB  - A simple and purely nonparametric confidence interval procedure for the
      difference or ratio of two median failure times is proposed with censored
      observations. The new proposal does not involve unstable and complicated
      nonparametric density estimates and is valid asymptotically even when the two
      underlying distribution functions differ in shape. Extensive numerical studies
      are carried out to examine the appropriateness of the new procedure for practical
      sample sizes.

PMID- 8369392
TI  - Power and sample size calculations for exact conditional tests with ordered
      categorical data.
AB  - We develop an algorithm for computing sample sizes, equal or unequal, for
      categorical data. We illustrate its use in the two-sample setting using the
      Wilcoxon rank-sum statistic, but the algorithm accommodates the entire class of
      linear rank statistics and can be extended to include nonlinear rank statistics
      as well. The sample size determinations can be based on either exact power or on
      a very precise Monte Carlo estimate of it. To reduce the computations further,
      power can be computed as a function of asymptotic critical values when the number
      of categories is not too small. For the Wilcoxon statistic we show that this
      approximation works well if there are more than five response categories.

PMID- 8369393
TI  - An application of the truncated Poisson distribution to immunogold assay.
AB  - An example of the use of the truncated Poisson distribution in an immunogold
      assay of dystrophin, a gene product of importance in the study of muscular
      dystrophies, is presented. The practical benefit of using minimum variance
      unbiased estimators of relevant functions of the parameter of the distribution is
      considered.

PMID- 8369394
TI  - Case studies in binary dispersion.
AB  - It is common in biomedical studies with binary responses that variability in the
      observed number of events exceeds binomial variability, a phenomenon known as
      overdispersion. Failure to make an adjustment to the nominal standard errors can
      lead to seriously misleading inference for regression analysis. In this note, we
      examine a series of examples drawn from the literature to see which of two
      commonly used variance formulas is more adequate for describing overdispersion in
      applications. Two methods, residual analysis and formal comparison, are
      introduced. We recommend that both methods be employed in seeking an appropriate
      variance expression for binary responses. Each of the five data sets exhibits
      substantial overdispersion, one favoring the beta-binomial form, another favoring
      a constant overdispersion factor. The remaining three examples exhibit no
      preference.

PMID- 8369395
TI  - A test of the missing data mechanism for repeated categorical data.
AB  - Due to the occurrence of missing observations, longitudinal data are rarely
      balanced and complete. Weighted least squares analyses described by Grizzle,
      Starmer, and Koch (1969, Biometrics 25, 489-504) have been developed for the
      analysis of incomplete longitudinal categorical data [Stanish, Gillings, and Koch
      (1978, Biometrics 34, 305-317); Woolson and Clarke (1984, Journal of the Royal
      Statistical Society, Series A 147, 87-99)]. However, all these analyses have
      assumed that missing observations are missing completely at random in the sense
      of Rubin (1976, Biometrika 63, 581-592). When the occurrence of missing
      observations is related to the unobserved response values, these analyses may
      result in biased results. In this paper, we develop a simple and practical test
      of the missing mechanism in incomplete repeated categorical data. The proposed
      test is an extension of the test of Little (1988, Journal of the American
      Statistical Association 83, 1198-1202) and uses a test criterion given in general
      form by Wald. The test is illustrated using data from a longitudinal
      investigation of obesity in school-age children.

PMID- 8369396
TI  - Comparing proportions in the presence of false positive and false negative
      instrument sorting errors.

PMID- 8369397
TI  - Mixture estimation and the neurophysiological quantal hypothesis.
AB  - Quantal release models provide a mechanistic description of the process by which
      neurotransmitter is released from the nerve cell. The usual such model assumes
      that the quantity of transmitter released after nerve depolarization follows a
      finite mixture distribution with an unknown number of components, and with
      constraints on component means and variances. General procedures for estimating
      the dimension of a finite mixture model are discussed, and applied to the
      analysis of a quantal release data set.

PMID- 8369398
TI  - How to detect nonrandom motion of proteins in membranes.

PMID- 8369399
TI  - Calcium on the level.

PMID- 8369400
TI  - Why pancreatic islets burst but single beta cells do not. The heterogeneity
      hypothesis.
AB  - Previous mathematical modeling of beta cell electrical activity has involved
      single cells or, recently, clusters of identical cells. Here we model clusters of
      heterogeneous cells that differ in size, channel density, and other parameters.
      We use gap-junctional electrical coupling, with conductances determined by an
      experimental histogram. We find that, for reasonable parameter distributions,
      only a small proportion of isolated beta cells will burst when uncoupled, at any
      given value of a glucose-sensing parameter. However, a coupled, heterogeneous
      cluster of such cells, if sufficiently large (approximately 125 cells), will
      burst synchronously. Small clusters of such cells will burst only with low
      probability. In large clusters, the dynamics of intracellular calcium compare
      well with experiments. Also, these clusters possess a dose-response curve of
      increasing average electrical activity with respect to a glucose-sensing
      parameter that is sharp when the cluster is coupled, but shallow when the cluster
      is decoupled into individual cells. This is in agreement with comparative
      experiments on cells in suspension and islets.

PMID- 8369401
TI  - Molecular dynamics in lipid bilayers. Anisotropic diffusion in an odd restoring
      potential.
AB  - Recent 2H nuclear magnetic resonance spin relaxation studies have questioned the
      influence of restoring potential parity on the description of lipid or molecular
      reorientational dynamics. In biomembranes the polar head groups of lipid and
      sterol constituents are expected to associate with the aqueous interface;
      therefore, realistic descriptions of molecular reorientation in bilayer systems
      should use an odd restoring potential. The multiexponential correlation functions
      and related spectral density functions for small-step anisotropic diffusion in a
      pseudo-restoring potential of the form U(beta) = -lambda cos beta are evaluated
      as a function of molecular ordering <P2(cos beta)>. From analysis of these
      results the single exponential approximation used in previous investigations is
      found to overestimate the decay rate at lower order, but is reliable for <P2(cos
      beta)> > 0.6. The exception to this trend is the decay constant for the G11
      (omega; t) correlation function, which is not accurately portrayed by the first
      order approximations. A second-order single exponential approximation is
      presented, and is shown to be equivalent to the weighted sum of the multidecay
      constants. In general, the potential parity is found to have only minor effects
      on the spin relaxation rates obtained to describe molecular reorientation in
      lipid bilayers.

PMID- 8369403
TI  - Weak acid transport across bilayer lipid membrane in the presence of buffers.
      Theoretical and experimental pH profiles in the unstirred layers.
AB  - This paper presents a simple model to describe experimental data on weak acid
      transport across planar bilayer lipid membrane separating two buffered solutions.
      The model takes into account multiple proton-transfer reactions occurring in the
      unstirred layers (ULs) adjacent to the membrane. Differential equations of the
      model are shown to be reduced to a set of nonlinear algebraic equations. Since
      the latter equations depend monotonically on unknown variables, they can be
      easily solved numerically, using bisection method. For the particular system
      studied experimentally (with acetate as the weak acid and TRIS+MES as the buffer
      mixture) pH profiles in the ULs are calculated from the model. These results are
      compared with experimental data obtained using pH microelectrode. The agreement
      between theoretical and experimental pH profiles is found to be satisfactory. The
      most pronounced deviations are observed at the UL/bulk solution boundary. To
      obtain a better correlation between the theoretical and experimental results, two
      other, less idealized models are considered. They take into account,
      respectively, (a) the electric field arising in the ULs from ion diffusion and
      (b) finiteness of the rates of proton-transfer reactions. However, both acetate
      membrane fluxes and pH profiles in the ULs computed from these models are found
      to be close to those of the simple model. One can thus conclude that the
      difference between experimental and theoretical pH profiles is due to the
      inconsistency of the generally accepted model of the "unstirred layer", assuming
      the existence of a strict boundary between the regions of "pure diffusion" and
      "ideal stirring".

PMID- 8369402
TI  - Deformations in the cytoplasmic membrane of Escherichia coli direct the synthesis
      of peptidoglycan. The hernia model.
AB  - To explain the growth of the Gram-negative envelope and in particular how it
      could be strengthened where it is weakest, we propose in the hernia model that
      local weakening of the peptidoglycan sacculus allows turgor pressure to cause the
      envelope to bulge outwards in a hernia; the consequent local alteration in the
      radius of curvature of the cytoplasmic membrane causes local alterations in
      phospholipid structure and composition that determine both the synthesis and
      hydrolysis of peptidoglycan. This proposal is supported by evidence that
      phospholipid composition determines the activity of phospho-N-acetylmuramic acid
      pentapeptide translocase, UDP-N-acetylglucosamine:N-acetylmuramic acid
      (pentapeptide)-P-P-bactoprenyl-N-acetylglucosamine transferase, bactoprenyl
      phosphate phosphokinase, and N-acetylmuramyl-L-alanine amidase. We also propose
      that the shape of Escherichia coli is maintained by contractile proteins acting
      at the hernia. Given the universal importance of membranes, these proposals have
      implications for the determination of shape in eukaryotic cells.

PMID- 8369404
TI  - Explaining glomerular pores with fiber matrices. A visualization study based on
      computer modeling.
AB  - The extracellular space of the glomerular capillary wall is occupied by a complex
      meshwork of fibrous molecules. Little is understood about how the size, shape,
      and charge recognition properties of glomerular ultrafiltration arise from this
      space-filling fiber matrix. We studied the problem of size recognition by
      visualizing the void volume accessible to hard spheres in computer-generated
      three-dimensional homogeneous random fiber matrices. The spatial organization of
      the void volume followed a complex "blob-and-throat" pattern in which
      circumscribed cavities of free space within the matrix ("blobs") were joined to
      adjacent cavities by narrower throats of void space. For sufficiently small
      solutes, chains of blobs and throats traversed the matrix, providing pathways for
      trans-matrix permeation. The matrices showed threshold or gating properties with
      respect to permeation: solutes whose radius exceeded a critical value, at which a
      throat on the last connected trans-matrix pathway pinched off, could not cross,
      whereas smaller solutes had nonzero permeability. The thresholds may give the
      glomerular fiber matrix porelike response properties and explain why pore models
      have been such a useful means of treating permselectivity.

PMID- 8369405
TI  - Effect of Ca2+ binding on the profile structure of the sarcoplasmic reticulum
      membrane using time-resolved x-ray diffraction.
AB  - A number of studies have indicated that Ca(2+)-ATPase, the integral membrane
      protein of the sarcoplasmic reticulum (SR) membrane, undergoes some structural
      change upon Ca2+ binding to its high affinity binding sites (i.e., upon
      conversion of the E1 to the CaxE1 form of the enzyme). We have used x-ray
      diffraction to study the changes in the electron density profile of the SR
      membrane upon high-affinity Ca2+ binding to the enzyme in the absence of enzyme
      phosphorylation. The photolabile Ca2+ chelator DM-nitrophen was used to rapidly
      release Ca2+ into the extravesicular spaces throughout an oriented SR membrane
      multilayer and thereby synchronously in the vicinity of the high affinity binding
      sites of each enzyme molecule in the multilayer. A critical control was developed
      to exclude possible artifacts arising from heating and non-Ca2+ photolysis
      products in the membrane multilayer specimens upon photolysis of the DM
      nitrophen. Upon photolysis, changes in the membrane electron density profile
      arising from high-affinity Ca2+ binding to the enzyme are found to be localized
      to three different regions within the profile. These changes can be attributed to
      the added electron density of the Ca2+ bound at three discrete sites centered at
      5, approximately 30, and approximately 67 A in the membrane profile, but they
      also require decreased electron density within the cylindrically averaged profile
      structure of the Ca(2+)-ATPase immediately adjacent (< 15 A) to these sites. The
      locations of these three Ca2+ binding sites in the SR membrane profile span most
      of the membrane profile in the absence of enzyme phosphorylation,in agreement
      with the locations of lanthanide (Tb3+ and La3+) binding sites in the membrane
      profile determined independently by using resonance x-ray diffraction.

PMID- 8369406
TI  - Eutectic mixed monolayers in equilibrium with phospholipid-bilayers and triolein
      liquid phase.
AB  - Triolein (TO) and phospholipids (egg yolk phosphatidylcholine, egg yolk
      phosphatidylethanolamine, and bovine brain phosphatidylserine) had low mutual
      solubilities and separated into the TO-liquid phase and phospholipid-bilayers.
      Spreading pressures of the TO-phospholipid mixture (i.e., surface pressures of
      the mixed monolayer in equilibrium with the phase-separating lipid mixture) at
      the air/saline interface were independent of the lipid composition. On the other
      hand, collapse pressures of the mixed monolayer of TO and phospholipid (i.e.,
      surface pressures of the mixed monolayer in equilibrium with the TO-liquid phase)
      at the interface changed with the monolayer composition and were lower than the
      spreading pressure. The experimental data indicated the spreading and collapse
      pressures as offering a phase diagram for the presence of equilibrium between the
      mixed monolayer, the phospholipid-bilayers and the TO-liquid phase. The diagram
      showed that TO and the phospholipids were miscible in the mixed monolayer,
      forming an eutectic mixed monolayer. When the mixed monolayer initially had the
      eutectic composition, no collapse of the monolayer was detected until the surface
      pressure reached the value of the spreading pressure. No specific complex between
      TO and the phospholipid is required to explain the stability and collapse of the
      mixed monolayers. The bulk immiscibility of the lipids elucidated by the
      spreading pressure-measurements, immediately leads to the phase behaviors
      observed.

PMID- 8369407
TI  - Lateral diffusion in an archipelago. Single-particle diffusion.
AB  - Several laboratories have measured lateral diffusion of single particles on the
      cell surface, and these measurements may reveal an otherwise inaccessible level
      of submicroscopic organization of cell membranes. Pitfalls in the interpretation
      of these experiments are analyzed. Random walks in unobstructed systems show
      structure that could be interpreted as free diffusion, obstructed diffusion,
      directed motion, or trapping in finite domains. To interpret observed
      trajectories correctly, one must consider not only the trajectories themselves
      but also the probabilities of occurrence of various trajectories. Measures of the
      asymmetry of obstructed and unobstructed random walks are calculated, and
      probabilities are evaluated for random trajectories that resemble either directed
      motion or diffusion in a bounded region.

PMID- 8369408
TI  - Time courses of cell electroporation as revealed by submicrosecond imaging of
      transmembrane potential.
AB  - Changes in the membrane conductance of sea urchin eggs, during the course of
      electroporation, were investigated over the time range of 0.5 microsecond to 1 ms
      by imaging the transmembrane potential at a submicrosecond resolution with the
      voltage-sensitive fluorescent dye RH292. When a rectangular electric pulse of
      moderate intensity was applied across an egg, a position-dependent potential
      developed synchronously with the pulse, as theory predicts for a cell with an
      insulating membrane. From the rise and fall times, the membrane capacitance of
      unfertilized eggs was estimated to be 0.95 microF/cm2 and the intracellular
      conductance 220 omega.cm. Under an electric pulse of much higher intensity, the
      rise of the induced potential stopped at a certain level and then slowly
      decreased on the microsecond time scale. This saturation and subsequent reversal
      of the potential development was ascribed to the introduction of finite membrane
      conductance, or permeabilization of the membrane, by the action of the intense
      pulse (electroporation). Detailed analysis indicated the following: already at
      0.5 microsecond in the rectangular electric pulse, the two sides of the egg
      facing the positive and negative electrodes were porated and gave a high membrane
      conductance in the order of 1 S/cm2; the conductance on the positive side
      appeared higher. Thereafter, the conductance increased steadily, reaching the
      order of 10 S/cm2 by 1 ms. This increase was faster on the negative-electrode
      side; by 1 ms the conductance on the negative side was more than twice that on
      the positive side. The recovery of the porated membrane after the pulse treatment
      was assessed from the membrane conductance estimated in a second electric pulse
      of a small amplitude. At least two recovery processes were distinguished, one
      with a time constant of 7 microseconds and the other 0.5 ms, at the end of which
      the membrane conductance was already < 0.1 S/cm2.

PMID- 8369409
TI  - A mathematically defined motif for the radial distribution of charged residues on
      apolipoprotein amphipathic alpha helixes.
AB  - Multiple amphipathic alpha-helical candidate domains have been identified in
      exchangeable apolipoproteins by sequence analysis and indirect experimental
      evidence. The distribution of charged residues can differ within and between
      these apolipoproteins. Segrest et al. (Segrest, J. P., H. DeLoof, J. G. Dohlman,
      C. G. Brouillette, and G. M. Anantharamaiah. 1990. Proteins. 8:103-117.) argued
      that these differences are correlated with lipid affinity. A mathematically
      defined motif for the particular charge distribution associated with high lipid
      affinity (class A) is proposed. Primary sequence data from protein segments
      proposed previously to have an amphipathic alpha-helical structure are scanned.
      Counting formulas are presented for determining the conditional probability that
      the match between an observed charge distribution and the proposed motif would
      occur by chance. Because the preselected helical segments are short (the modal
      length is 22) and the motif definition imposes multiple constraints on the
      acceptable distributions, the computer-based algorithm is quite feasible
      computationally. 19 of the 20 segments previously assigned to class A match the
      motif sufficiently well (the remaining one is borderline), while very few others
      "erroneously" pass the screening test. These results confirm the original
      assignments of the candidate domains and, thus, support the hypothesis that there
      is a distinguishable subset of helixes having high lipid affinity. This counting
      approach is applicable to a growing subset of protein sequence analysis problems
      in which the segment lengths are short and the motif is complex.

PMID- 8369410
TI  - Structural relaxation and nonexponential kinetics of CO-binding to horse
      myoglobin. Multiple flash photolysis experiments.
AB  - The geminate recombination kinetics of CO-myoglobin strongly deviates from single
      exponential behavior in contrast to what is expected for unimolecular reactions
      (1). At low temperatures, this result was attributed to slowly exchanging
      conformational states which differ substantially in barrier height for ligand
      binding. Above 160 K the kinetics apparently slow down with temperature increase.
      Agmon and Hopfield (2) explain this result in terms of structural relaxation
      perpendicular to the reaction coordinate, which enhances the activation energy.
      In their model, structural relaxation homogenizes the kinetic response. Recently,
      Steinbach et al. (3) proposed a relaxation model which conserves the kinetic
      inhomogeneity. Below we test these conjectures by single and multiple excitation
      experiments. This method allows for discrimination between parallel
      (inhomogeneous) and sequential (homogeneous) kinetic schemes. The kinetic anomaly
      above 160 K is shown to result from a homogeneous, structurally relaxed
      intermediate. However a second anomaly is found above 210 K concerning the
      inhomogeneous phase which may indicate either a shift in activation energy or
      entropy.

PMID- 8369411
TI  - A theoretical study of rotational diffusion models for rod-shaped viruses. The
      influence of motion on 31P nuclear magnetic resonance lineshapes and transversal
      relaxation.
AB  - Information about the interaction between nucleic acids and coat proteins in
      intact virus particles may be obtained by studying the restricted backbone
      dynamics of the incapsulated nucleic acids using 31P nuclear magnetic resonance
      (NMR) spectroscopy. In this article, simulations are carried out to investigate
      how reorientation of a rod-shaped virus particle as a whole and isolated nucleic
      acid motions within the virion influence the 31P NMR lineshape and transversal
      relaxation dominated by the phosphorus chemical shift anisotropy. Two opposite
      cases are considered on a theoretical level. First, isotropic rotational
      diffusion is used as a model for mobile nucleic acids that are loosely or
      partially bound to the protein coat. The effect of this type of diffusion on
      lineshape and transversal relaxation is calculated by solving the stochastic
      Liouville equation by an expansion in spherical functions. Next, uniaxial
      rotational diffusion is assumed to represent the mobility of phosphorus in a
      virion that rotates as a rigid rod about its length axis. This type of diffusion
      is approximated by an exchange process among discrete sites. As turns out from
      these simulations, the amplitude and the frequency of the motion can only be
      unequivocally determined from experimental data by a combined analysis of the
      lineshape and the transversal relaxation. In the fast motional region both the
      isotropic and the uniaxial diffusion model predict the same transversal
      relaxation as the Redfield theory. For very slow motion, transversal relaxation
      resembles the nonexponential relaxation as observed for water molecules
      undergoing translational diffusion in a magnetic field gradient. In this
      frequency region T2e is inversely proportional to the cube root of the diffusion
      coefficient. In addition to the isotropic and uniaxial diffusion models, a third
      model is presented, in which fast restricted nucleic acid backbone motions
      dominating the lineshape are superimposed on a slow rotation of the virion about
      its length axis, dominating transversal relaxation. In an accompanying article
      the models are applied to the 31P NMR results obtained for bacteriophage M13 and
      tobacco mosaic virus.

PMID- 8369412
TI  - Analysis of 31P nuclear magnetic resonance lineshapes and transversal relaxation
      of bacteriophage M13 and tobacco mosaic virus.
AB  - The experimentally observed 31P lineshapes and transversal relaxation of 15%
      (wt/wt) M13, 30% M13, and 30% tobacco mosaic virus (TMV) are compared with
      lineshapes and relaxation curves that are simulated for various types of
      rotational diffusion using the models discussed previously (Magusin, P. C. M. M.,
      and M. A. Hemminga. 1993. Biophys. J. 64:1851-1860). It is found that isotropic
      diffusion cannot explain the observed lineshape effects. A rigid rod diffusion
      model is only successful in describing the experimental data obtained for 15%
      M13. For 30% M13 the experimental lineshape and relaxation curve cannot be
      interpreted consistently and the TMV lineshape cannot even be simulated alone,
      indicating that the rigid rod diffusion model does not generally apply. A
      combined diffusion model with fast isolated motions of the encapsulated nucleic
      acid dominating the lineshape and a slow overall rotation of the virion as a
      whole, which mainly is reflected in the transversal relaxation, is able to
      provide a consistent picture for the 15 and 30% M13 samples, but not for TMV.
      Strongly improved lineshape fits for TMV are obtained assuming that there are
      three binding sites with different mobilities. The presence of three binding
      sites is consistent with previous models of TMV. The best lineshapes are
      simulated for a combination of one mobile and two static sites. Although less
      markedly, the assumption that two fractions of DNA with different mobilities
      exist within M13 also improves the simulated lineshapes. The possible existence
      of two 31P fractions in M13 sheds new light on the nonintegral ratio 2.4:1
      between the number of nucleotides and protein coat subunits in the phage: 83% of
      the viral DNA is less mobile, suggesting that the binding of the DNA molecule to
      the protein coat actually occurs at the integral ratio of two nucleotides per
      protein subunit.

PMID- 8369413
TI  - Temperature dependence of the phosphorescence quantum yield of various alpha
      lactalbumins and of hen egg-white lysozyme.
AB  - The radiative quantum yield, phi op, of the triplet state of human alpha
      lactalbumin (HLA) has been measured in the temperature range between 6 K and the
      softening point of the aqueous glass (approximately 150 K). phi op has little
      temperature dependence below approximately 30 K, but above this it decreases
      sharply with increasing temperature. The unusual temperature dependence is fitted
      by a phenomenological two-state model in which the phosphorescence originates
      primarily from a donor, tryptophan (Trp) 104, and an acceptor, Trp 60, the
      populations of which are coupled by a thermally activated triplet-triplet energy
      transfer process. The model assumes that the acceptor (Trp 60) triplet state
      undergoes radiationless deactivation by a proximal disulfide residue, while the
      donor (Trp 104) has no such extrinsic quencher. The decrease of phi op with
      increasing temperature is accounted for by the thermally activated triplet
      triplet energy transfer process. The disulfide quenching rate constant itself is
      assumed to be temperature independent, in accord with recent measurements of
      simple disulfide quenching in long chain snake venom neurotoxins (Schlyer, B. D.,
      E. Lau, and A. H. Maki. 1992. Biochemistry. 31:4375-4383; Li, Z., A. Bruce, and
      W. C. Galley. 1992. Biophys. J. 61:1364-1371). We find that the phosphorescence
      quenching in HLA occurs with an activation energy of 97 cm-1, which we associate
      with a barrier to the energy transfer process. The data are fit well by the model
      if we assume a value for the temperature-independent disulfide quenching constant
      of kQ > 3 s-1 that is consistent with recent measurements on indole-disulfide
      model systems (Li, Z., A. Bruce, and W. C. Galley. 1992. Biophys. J. 61:1364
      1371). Similar results are reported for bovine alpha-lactalbumin (BLA) and for
      hen egg-white lysozyme (HEWL) that contains the structural equivalents of Trp 104
      and Trp 60 of HLA. HLA provides the best agreement with calculations since it is
      the simplest, lacking Trp 26, a residue not considered in the model, that
      probably contributes significantly to the phosphorescence of BLA, guinea pig
      alpha-lactalbumin (GPLA), and HEWL. GPLA, which contains Trp 104 but lacks Trp
      60, shows qualitatively less thermally induced phosphorescence quenching than
      HLA, BLA, and HEWL, thus supporting the postulated quenching model.

PMID- 8369414
TI  - Nonequilibrium freezing of one-cell mouse embryos. Membrane integrity and
      developmental potential.
AB  - A thermodynamic model was used to evaluate and optimize a rapid three-step
      nonequilibrium freezing protocol for one-cell mouse embryos in the absence of
      cryoprotectants (CPAs) that avoided lethal intracellular ice formation (IIF).
      Biophysical parameters of one-cell mouse embryos were determined at subzero
      temperatures using cryomicroscopic investigations (i.e., the water permeability
      of the plasma membrane, its temperature dependence, and the parameters for
      heterogeneous IIF). The parameters were then incorporated into the thermodynamic
      model, which predicted the likelihood of IIF. Model predictions showed that IIF
      could be prevented at a cooling rate of 120 degrees C/min when a 5-min holding
      period was inserted at -10 degrees C to assure cellular dehydration. This
      predicted freezing protocol, which avoided IIF in the absence of CPAs, was two
      orders of magnitude faster than conventional embryo cryopreservation cooling
      rates of between 0.5 and 1 degree C/min. At slow cooling rates, embryos
      predominantly follow the equilibrium phase diagram and do not undergo IIF, but
      mechanisms other than IIF (e.g., high electrolyte concentrations, mechanical
      effects, and others) cause cellular damage. We tested the predictions of our
      thermodynamic model using a programmable freezer and confirmed the theoretical
      predictions. The membrane integrity of one-cell mouse embryos, as assessed by
      fluorescein diacetate retention, was approximately 80% after freezing down to -45
      degrees C by the rapid nonequilibrium protocol derived from our model. The fact
      that embryos could be rapidly frozen in the absence of CPAs without damage to the
      plasma membrane as assessed by fluorescein diacetate retention is a new and
      exciting finding. Further refinements of this protocol is necessary to retain the
      developmental competence of the embryos.

PMID- 8369415
TI  - Use of fura red as an intracellular calcium indicator in frog skeletal muscle
      fibers.
AB  - Fura red, a fluorescent Ca2+ indicator with absorbance bands at visible
      wavelengths, was injected into intact single muscle fibers that had been
      stretched to a long sarcomere length (approximately 3.8 microns) and bathed in a
      'high-Ca2+' Ringer ([Ca2+] = 11.8 mM). From fura red's slow diffusion coefficient
      in myoplasm, 0.16 (+/- 0.01, SEM) x 10(-6) cm2 s-1 (N = 5; 16 degrees C), it is
      estimated that approximately 85% of the indicator molecules are bound to muscle
      constituents of large molecular weight. Binding appears to elevate, by 3- to 4
      fold, the indicator's apparent dissociation constant for Ca2+ (KD), which is
      estimated to be 1.1-1.6 microM in myoplasm. Fura red's myoplasmic absorbance
      spectrum was used to estimate fr, the fraction of fura red molecules in the Ca2+
      bound form at rest. In 3 fibers thought to be minimally damaged by the micro
      injection, fr was estimated to be 0.15 (+/- 0.01). Thus, resting myoplasmic free
      [Ca2+] ([Ca2+]r) is estimated to be 0.19-0.28 microM. For fibers in normal Ringer
      solution ([Ca2+] = 1.8 mM), at shorter sarcomere length (approximately 2.7
      microns), and containing a nonperturbing concentration of indicator (< or = 0.2
      mM), [Ca2+]r is estimated to be 0.18-0.27 microM. This range is higher than
      estimated previously in frog fibers with other techniques. In 6 fibers, R, the
      indicator's fluorescence ratio signal (equal to the emission intensity measured
      with 420 nm excitation divided by that measured with 480 nm excitation), was
      measured at rest and following electrical stimulation and compared with
      absorbance measurements made from the same fiber region. The analysis implies
      that RMIN and RMAX (the values of R that would be measured if all indicator
      molecules were in the Ca(2+)-free and Ca(2+)-bound states, respectively) were
      substantially smaller in myoplasm than in calibration solutions lacking muscle
      proteins. Several methods for estimation of [Ca2+]r from R are analyzed and
      discussed.

PMID- 8369417
TI  - Bending rigidity of SOPC membranes containing cholesterol.
AB  - Bilayer membranes in the fluid state exhibit a large resistance to changes in
      surface area, negligible resistance to surface shear deformation, and a small but
      finite resistance to bending. The presence of cholesterol in the membrane is
      known to increase its resistance to area dilation. In this report, a new method
      for measuring bilayer membrane bending stiffness has been used to investigate the
      effect of cholesterol on the bending rigidity of SOPC (1,stearoyl-2,oleoyl
      phosphatidylcholine) membranes. The curvature elasticity (kc) for membranes
      saturated with cholesterol was measured to be 3.3 x 10(-19) J, approximately 3
      fold larger than that the modulus for cholesterol-free SOPC membrane. These
      findings are consistent with previous measurements of bending stiffness based on
      thermal fluctuations, which showed a similar approximately 3-fold increase in the
      modulus with cholesterol addition (Evans and Rawicz, 1990, Phys. Rev. Lett.
      64:2094) and provide further substantiation of the important contribution that
      cholesterol makes to membrane cohesion and stability.

PMID- 8369416
TI  - Human olfactory neurons respond to odor stimuli with an increase in cytoplasmic
      Ca2+.
AB  - The sense of smell allows terrestrial animals to collect information about the
      chemical nature of their environment through the detection of airborne molecules.
      In humans smell is believed to play an important role in protecting the organism
      from environmental hazards such as fire, gas leaks and spoiled food, in
      determining the flavor of foods, and perhaps in infant-parent bonding. In
      addition, the study of human olfaction is relevant to a number of medical
      problems that result in olfactory dysfunction, which can affect nutritional
      state, and to the study of the etiology of neurodegenerative diseases which
      manifest themselves in the olfactory epithelium. Although much is known about
      behavioral aspects of human olfaction, little is understood about the underlying
      cellular mechanisms in humans. Here we report that viable human olfactory neurons
      (HON) can be isolated from olfactory tissue biopsies, and we find that HON
      respond to odorants with an increase in intracellular calcium concentration
      ([Cai]).

PMID- 8369418
TI  - The effects of bilirubin on the thermal properties of phosphatidylcholine
      bilayers.
AB  - The thermotropic properties of multilamellar vesicles of
      dimyristoylphosphatidylcholine (DMPC), dipalmitoylphosphatidylcholine (DPPC), and
      distearoylphosphatidylcholine (DSPC), as a function of the concentration of
      bilirubin in the range of 0.1 to 1 mol%, were measured. The exact effects of
      bilirubin depended on the chain length of the polymethylene chains. But the
      general effects of bilirubin were the same in all systems. At the lowest
      concentrations tested (0.1 mol bilirubin/100 mol phospholipid (0.1 mol%)),
      bilirubin broadened and shifted to higher temperatures the main phase transitions
      of all bilayers. For DPPC and DSPC, but not DMPC, this concentration of bilirubin
      was associated with a new transition at 25 degrees C (DPPC) or 34 degrees C
      (DSPC). Bilirubin at 0.2 mol% was required for the detection of a similar
      transition (at 13.7 degrees C) in DMPC. Higher concentrations of bilirubin (> 0.2
      mol%) suppressed completely the main phase transitions in all bilayers but
      increased the enthalpy of the new transition. Maximal values of delta H for these
      transitions were reached at 0.5, 0.25, and 0.2 mol% bilirubin in DMPC, DPPC, and
      DSPC, respectively. Values of delta H and delta S for these transitions were far
      larger than for the corresponding gel-to-liquid crystal transitions in pure lipid
      bilayers but were equal to those expected for a transition between crystalline
      and liquid crystalline phases.

PMID- 8369419
TI  - Tracing charge separation events in photosynthesis: anomalous photovoltage
      polarity events explained.

PMID- 8369421
TI  - Estimated acid dissociation constants of the Schiff base, Asp-85, and Arg-82
      during the bacteriorhodopsin photocycle.
AB  - The pK(a) values of D85 in the wild-type and R82Q, as well as R82A recombinant
      bacteriorhodopsins, and the Schiff base in the D85N, D85T, and D85N/R82Q
      proteins, have been determined by spectroscopic titrations in the dark. They are
      used to estimate the coulombic interaction energies and the pK(a) values of the
      Schiff base, D85, and R82 during proton transfer from the Schiff base to D85, and
      the subsequent proton release to the bulk in the initial part of the photocycle.
      The pK(a) of the Schiff base before photoexcitation is calculated to be in effect
      only 5.3-5.7 pH units higher than that of D85; overcoming this to allow proton
      transfer to D85 requires about two thirds of the estimated excess free energy
      retained after absorption of a photon. The proton release on the extracellular
      surface is from an unidentified residue whose pK(a) is lowered to about 6 after
      deprotonation of the Schiff base (Zimanyi, L., G. Varo, M. Chang, B. Ni, R.
      Needleman, and J.K. Lanyi, 1992. Biochemistry. 31:8535-8543). We calculate that
      the pK(a) of the R82 is 13.8 before photoexcitation, and it is lowered after
      proton exchange between the Schiff base and D85 only by 1.5-2.3 pH units.
      Therefore, coulombic interactions alone do not appear to change the pK(a) of R82
      as much and D85 only by 1.5-2.3 pH units. Therefore, coulombic interactions alone
      do not appear to change the pK(a) of R82 as much as required if it were the
      proton release group.

PMID- 8369420
TI  - Cooperativity in F-actin: chemical modifications of actin monomers affect the
      functional interactions of myosin with unmodified monomers in the same actin
      filament.
AB  - We have chemically modified a fraction of the monomers in actin filaments, and
      then measured the effects on the functional interaction of myosin with unmodified
      monomers within the same filament. Two modifications were used: (a) covalent
      attachment of various amounts of myosin subfragment-1 (S1) with the bifunctional
      reagent disuccinimidyl suberate and (b) copolymerization of unmodified actin
      monomers with monomers cross-linked internally with 1-ethyl-3
      (dimethylaminopropyl)-carbodiimide. Each of these modifications abolished the
      interaction of the modified monomers with myosin, so the remaining interactions
      were exclusively with unmodified monomers. The two modifications had similar
      effects on the interaction of actin with myosin in solution: decreased affinity
      of myosin heads for unmodified actin monomers, without a change in the Vmax of
      actin-activated myosin ATPase activity. However, modification (b) produced much
      greater inhibition of actin sliding on a myosin-coated surface, as measured by an
      in vitro motility assay. These results provide insight into the functional
      consequences of cooperative interactions within the actin filament.

PMID- 8369422
TI  - Glycerol effects on protein flexibility: a tryptophan phosphorescence study.
AB  - In exploring the dynamic properties of protein structure, numerous studies have
      focussed on the dependence of structural fluctuations on solvent viscosity, but
      the emerging picture is still not well defined. Exploiting the sensitivity of the
      phosphorescence lifetime of tryptophan to the viscosity of its environment we
      have used the delayed emission as an intrinsic probe of protein flexibility and
      investigated the effects of glycerol as a viscogenic cosolvent. The
      phosphorescence lifetime of alcohol dehydrogenase, alkaline phosphatase,
      apoazurin and RNase T1, as a function of glycerol concentration was studied at
      various temperatures. Flexibility data, which refer to rather rigid sites of the
      globular structures, point out that, for some concentration ranges glycerol,
      effects on the rate of structural fluctuations of alcohol dehydrogenase and RNase
      T1 do not obey Kramers' a power law on solvent viscosity and emphasize that
      cosolvent-induced structural changes can be important, even for inner cores of
      the macromolecule. When the data is analyzed in terms of Kramers' model, for the
      temperature range 0-30 degrees C one derives frictional coefficients that are
      relatively large (0.6-0.7) for RNase T1, where the probe is in a flexible region
      near the surface of the macromolecule and much smaller, less than 0.2, for the
      rigid sites of the other proteins. For the latter sites the frictional
      coefficient rises sharply between 40 and 60 degrees C, and its value correlates
      weakly with molecular parameters such as the depth of burial or the rigidity of a
      particular site. For RNase T1, coupling to solvent viscosity increases at subzero
      temperatures, with the coefficient becoming as large as 1 at -20 degrees C.
      Temperature effects were interpreted by proposing that solvent damping of
      internal protein motions is particularly effective for low frequency, large
      amplitude, structural fluctuations yielding highly flexible conformers of the
      macromolecule.

PMID- 8369423
TI  - The relationship of agarose gel structure to the sieving of spheres during
      agarose gel electrophoresis.
AB  - To understand the organization of fibers in an agarose gel, digitized electron
      micrographs are used here to determine the frequency distribution of interfiber
      distance (2Pc) in thin sections of agarose gels. For a preparation of
      underivatized agarose, a 1.5% gel has a Pc distribution that is indistinguishable
      from the Pc distribution of a computer-generated, random-fiber gel; the log of
      the occurrence frequency (F) decreases linearly as a function of Pc. As the
      agarose concentration decreases below 1.5%, the semilogarithmic F versus Pc plot
      becomes progressively less linear. Two straight lines represent the data; the
      plot is steeper at the lower Pc values. As the percentage of agarose increases
      above 1.5%, the semilogarithmic F versus Pc plot becomes steeper at the higher Pc
      values. This change in the shape of semilogarithmic F versus Pc plots is possibly
      explained by the existence in agarose gels of two zones, one whose Pc
      distribution is more sensitive to the average agarose concentration than the
      other. To compare the structure of agarose gels to their sieving during
      electrophoresis, the root mean square value of Pc (Pc) is compared to the sieving
      based radius of the effective pore (PE; Griess et. al. (16)) for both
      underivatized agarose and a derivatized agarose that has a smaller PE at any
      given agarose percentage. For 0.8-2.0% gels of either underivatized or
      derivatized agarose, PE/Pc is a constant within experimental error. Deviations
      from this constant are observed at lower gel percentages. This relationship of PE
      to Pc constrains theoretical descriptions of the motion of spheres in fibrous
      networks.

PMID- 8369424
TI  - Transients in neuron with arbitrary dendritic branching and shunted soma.

PMID- 8369425
TI  - The binding capacity is a probability density function.
AB  - The binding capacity of a system, or equivalently, the fluctuations of the number
      of ligands bound around the average value defined by the binding isotherm, can be
      regarded as a probability density function for the chemical potential of the
      ligand. The first moment of this density function is the mean ligand activity as
      defined by Wyman and gives the average free energy (in kT units) of binding per
      site. The second moment is directly related to the cooperativity of the system.
      These and higher moments can be obtained from numerical integration of
      experimental data in a direct way. An analytical expression for the moment
      generating function shows that the N independent coefficients of the partition
      function of a system containing N sites are uniquely defined by the first N
      moments of the binding capacity.

PMID- 8369427
TI  - Zippier zaps: faster electrostatics calculations.

PMID- 8369426
TI  - Single event recording shows that docking onto receptor alters the kinetics of
      membrane fusion mediated by influenza hemagglutinin.
AB  - The initial steps of membrane fusion, receptor binding and membrane
      destabilization, are mediated by the envelope glycoprotein hemagglutinin of
      influenza virus. Interaction between these functions was determined from the time
      course of individual virion fusions to a planar membrane with and without
      receptor. With receptor, fusion was described by a Poisson process. In the
      absence of receptor, the time course was more complicated and could not be
      described with exponential rate constants. The conversion of a non-Markovian
      process into a simple Markov chain is direct evidence that receptor binding
      fundamentally alters the route of fusion.

PMID- 8369428
TI  - NADH fluorescence of isolated ventricular myocytes: effects of pacing, myoglobin,
      and oxygen supply.
AB  - Endogenous fluorescence was used to measure the extent of reduction of
      mitochondrial NAD in individual, isolated rat cardiac myocytes. NAD reduction was
      determined from emitted fluorescence at 415 and 470 nm during brief epi
      illumination at 365 nm. NAD reduction of resting myocytes, superfused with medium
      equilibrated with 95% O2/5% CO2, was 27 +/- 3% (SE) (n = 78), comparable to that
      in beating whole heart. Increasing intracellular Ca2+ did not significantly
      change NAD reduction. NAD reduction decreased reversibly to 11 +/- 1% (n = 78) in
      contracting myocytes electrically paced at 5 Hz for 10 min. Oxygen uptake was
      stimulated fivefold. There was minimal change in sarcoplasmic pH measured by
      fluorescence of carboxy-seminaphthorhodafluor-1. However, NAD reduction increased
      reversibly in response to electrically paced contractions when: (a) myoglobin was
      inactivated with sodium nitrite (37 +/- 7%; n = 48); or (b) cells were more
      densely layered and gassed with 20% O2/5% CO2 (48 +/- 3%; n = 30). We conclude
      that (a) the ratio NADH/NAD is decreased in well-oxygenated cells with increased
      work; (b) steady-state NAD reduction is increased with increased work when oxygen
      delivery is limited; and (c) functional myoglobin ensures an oxygen supply to the
      mitochondria of working cells.

PMID- 8369429
TI  - The changing faces of research.

PMID- 8369430
TI  - Affinity of alpha-actinin for actin determines the structure and mechanical
      properties of actin filament gels.
AB  - Proteins that cross-link actin filaments can either form bundles of parallel
      filaments or isotropic networks of individual filaments. We have found that
      mixtures of actin filaments with alpha-actinin purified from either Acanthamoeba
      castellanii or chicken smooth muscle can form bundles or isotropic networks
      depending on their concentration. Low concentrations of alpha-actinin and actin
      filaments form networks indistinguishable in electron micrographs from gels of
      actin alone. Higher concentrations of alpha-actinin and actin filaments form
      bundles. The threshold for bundling depends on the affinity of the alpha-actinin
      for actin. The complex of Acanthamoeba alpha-actinin with actin filaments has a
      Kd of 4.7 microM and a bundling threshold of 0.1 microM; chicken smooth muscle
      has a Kd of 0.6 microM and a bundling threshold of 1 microM. The physical
      properties of isotropic networks of cross-linked actin filaments are very
      different from a gel of bundles: the network behaves like a solid because each
      actin filament is part of a single structure that encompasses all the filaments.
      Bundles of filaments behave more like a very viscous fluid because each bundle,
      while very long and stiff, can slip past other bundles. We have developed a
      computer model that predicts the bundling threshold based on four variables: the
      length of the actin filaments, the affinity of the alpha-actinin for actin, and
      the concentrations of actin and alpha-actinin.

PMID- 8369431
TI  - Blitz and blizzard: crossbridges and chaos.

PMID- 8369432
TI  - Time-resolved fluorescence of the single tryptophan of Bacillus
      stearothermophilus phosphofructokinase.
AB  - The fluorescence of the single tryptophan in Bacillus stearothermophilus
      phosphofructokinase was characterized by steady-state and time-resolved
      techniques. The enzyme is a tetramer of identical subunits, which undergo a
      concerted allosteric transition. Time-resolved emission spectral data were fitted
      to discrete and distributed lifetime models. The fluorescence decay is a double
      exponential with lifetimes of 1.6 and 4.4 ns and relative amplitudes of 40 and
      60%. The emission spectra of both components are identical with maxima at 327 nm.
      The quantum yield is 0.31 +/- 0.01. The shorter lifetime is independent of
      temperature; the longer lifetime has weak temperature dependence with activation
      energy of 1 kcal/mol. The fluorescence intensity and decay are the same in H2O
      and D2O solutions, indicating that the indole ring is not accessible to bulk
      aqueous solution. The fluorescence is not quenched significantly by iodide, but
      it is quenched by acrylamide with bimolecular rate constant of 5 x 10(8) M-1 s-1.
      Static and dynamic light scattering measurements show that the enzyme is a
      tetramer in solution with hydrodynamic radius of 40 A. Steady-state and time
      resolved fluorescence anisotropies indicate that the tryptophan is immobile. The
      allosteric transition has little effect on the fluorescence properties. The
      fluorescence results are related to the x-ray structure.

PMID- 8369433
TI  - Conformational transformations in the protein lattice of phage P22 procapsids.
AB  - During the packaging of double-stranded DNA by bacterial viruses, the precursor
      procapsid loses its internal core of scaffolding protein and undergoes a
      substantial expansion to form the mature virion. Here we show that upon heating,
      purified P22 procapsids release their scaffolding protein subunits, and the coat
      protein lattice expands in the absence of any other cellular or viral components.
      Following these processes by differential scanning calorimetry revealed four
      different transitions that correlated with structural transitions in the coat
      protein shells. Exit of scaffolding protein from the procapsid occurred
      reversibly and just above physiological temperature. Expansion of the procapsid
      lattice, which was exothermic, occurred after the release of scaffolding protein.
      Partial denaturation of coat subunits within the intact shell structure was
      detected prior to the major endothermic event. This major endotherm occurred
      above 80 degrees C and represents particle breakage and irreversible coat protein
      denaturation. The results indicate that the coat subunits are designed to form a
      metastable precursor lattice, which appears to be separated from the mature
      lattice by a kinetic barrier.

PMID- 8369434
TI  - Probability of alamethicin conductance states varies with nonlamellar tendency of
      bilayer phospholipids.
AB  - With few exceptions, membrane lipids are usually regarded as a kind of filler or
      passive solvent for membrane proteins. Yet, cells exquisitely control membrane
      composition. Many phospholipids found in plasma membrane bilayers favor packing
      into inverted hexagonal bulk phases. It was suggested that the strain of forcing
      such lipids into a bilayer may affect membrane protein function, such as the
      operation of transmembrane channels. To investigate this, we have inserted the
      peptide alamethicin into bilayer membranes composed of lipids of empirically
      determined inverted hexagonal phase "spontaneous radii" Ro, which will have
      expectably different degrees of strain when forced into bilayer form. We observe
      a correlation between measured Ro and the relative probabilities of different
      conductance states. States of higher conductance are more probable in
      dioleoylphosphatidylethanolamine, the lipid of highest curvature, 1/Ro, than in
      dioleoylphosphatidylcholine, the lipid of lowest curvature.

PMID- 8369435
TI  - A novel fluorescence ratiometric method confirms the low solvent viscosity of the
      cytoplasm.
AB  - Two homologous indocyanine dyes, Cy3.18 and Cy5.18, can be used as a ratio pair
      for fluorometric determination of solvent viscosity. Succinimidyl ester
      derivatives of these dyes can be attached to inert carrier macromolecules, such
      as Ficoll 70, for measurement of intracellular or intravesicular solvent
      viscosity. When the viscosity of the solvent was varied by various methods, the
      fluorescence intensity ratio (Cy3/Cy5) in a mixture of Cy3.18-Ficoll 70 (Cy3F70)
      and Cy5.18-Ficoll 70 (Cy5F70) in solution was found to be solely a function of
      solvent viscosity and was insensitive to other solvent parameters such as
      dielectric constant, temperature, and the ability of the solvent to form hydrogen
      bonds. Most important, it was insensitive to the presence of large
      macromolecules, such as proteins, which increase the shear viscosity but have
      little effect on solvent viscosity. Following microinjection into the cytoplasm
      of living tissue culture cells, no binding of Cy3F70 or Cy5F70 to intracellular
      components was detected by fluorescence recovery after photobleaching.
      Fluorescence intensity ratio imaging of Cy3F70 and Cy5F70 in non-motile
      interphase CV1 and PtK1 cells showed that the solvent viscosity of cytoplasm was
      not significantly different from water and showed no spatial variation.

PMID- 8369436
TI  - Transition modes in Ising networks: an approximate theory for macromolecular
      recognition.
AB  - For a statistical lattice, or Ising network, composed of N identical units
      existing in two possible states, 0 and 1, and interacting according to a given
      geometry, a set of values can be found for the mean free energy of the 0-->1
      transition of a single unit. Each value defines a transition mode in an ensemble
      of nu N = 3N - 2N possible values and reflects the role played by intermediate
      states in shaping the energetics of the system as a whole. The distribution of
      transition modes has a number of intriguing properties. Some of them apply quite
      generally to any Ising network, regardless of its dimension, while others are
      specific for each interaction geometry and dimensional embedding and bear on
      fundamental aspects of analytical number theory. The landscape of transition
      modes encapsulates all of the important thermodynamic properties of the network.
      The free energy terms defining the partition function of the system can be
      derived from the modes by simple transformations. Classical mean-field
      expressions can be obtained from consideration of the properties of transition
      modes in a rather straightforward way. The results obtained in the analysis of
      the transition mode distributions have been used to develop an approximate
      treatment of the problem of macromolecular recognition. This phenomenon is
      modeled as a cooperative process that involves a number of recognition subsites
      across an interface generated by the binding of two macromolecular components.
      The distribution of allowed binding free energies for the system is shown to be a
      superposition of Gaussian terms with mean and variance determined a priori by the
      theory. Application to the analysis of the biologically interaction of thrombin
      with hirudin has provided some useful information on basic aspects of the
      interaction, such as the number of recognition subsites involved and the energy
      balance for binding and cooperative coupling among them. Our results agree quite
      well with information derived independently from analysis of the crystal
      structure of the thrombin-hirudin complex.

PMID- 8369437
TI  - Measuring orientation of actin filaments within a cell: orientation of actin in
      intestinal microvilli.
AB  - Orientational distribution of actin filaments within a cell is an important
      determinant of cellular shape and motility. To map this distribution we developed
      a method of measuring local orientation of actin filaments. In this method actin
      filaments within cells are labeled with fluorescent phalloidin and are viewed at
      high magnification in a fluorescent microscope. Emitted fluorescence is split by
      a birefringent crystal giving rise to two images created by light rays polarized
      orthogonally with respect to each other. The two images are recorded by a high
      sensitivity video camera, and polarization of fluorescence at any point is
      calculated from the relative intensity of both images at this point. From the
      value of polarization, the orientation of the absorption dipole of the dye, and
      thus orientation of F-actin, can be calculated. To illustrate the utility of the
      method, we measured orientation of actin cores in microvilli of chicken
      intestinal epithelial cells. F-actin in microvillar cores was labeled with
      rhodamine-phalloidin; measurements showed that the orientation was the same when
      microvillus formed a part of a brush border and when it was separated from it
      suggesting that "shaving" of brush borders did not distort microvillar structure.
      In the absence of nucleotide, polarization of fluorescence of actin cores in
      isolated microvilli was best fitted by assuming that a majority of fluorophores
      were arranged with a perfect helical symmetry along the axis of microvillus and
      that the absorption dipoles of fluorophores were inclined at 52 degrees with
      respect to the axis. When ATP was added, the shape of isolated microvilli did not
      change but polarization of fluorescence decreased, indicating statistically
      significant increase in disorder and a change of average angle to 54 degrees. We
      argue that these changes were due to mechanochemical interactions between actin
      and myosin-I.

PMID- 8369438
TI  - Solid state NMR study of [epsilon-13C]Lys-bacteriorhodopsin: Schiff base
      photoisomerization.
AB  - Previous solid state 13C-NMR studies of bacteriorhodopsin (bR) have inferred the
      C = N configuration of the retinal-lysine Schiff base linkage from the [14
      13C]retinal chemical shift (1-3). Here we verify the interpretation of the [14
      13C]-retinal data using the [epsilon-13C]lysine 216 resonance. The epsilon-Lys
      216 chemical shifts in bR555 (48 ppm) and bR568 (53 ppm) are consistent with a C
      = N isomerization from syn in bR555 to anti in bR568. The M photointermediate was
      trapped at pH 10.0 and low temperatures by illumination of samples containing
      either 0.5 M guanidine-HCl or 0.1 M NaCl. In both preparations, the [epsilon
      13C]Lys-216 resonance of M is 6 ppm downfield from that of bR568. This shift is
      attributed to deprotonation of the Schiff base nitrogen and is consistent with
      the idea that the M intermediate contains a C = N anti chromophore. M is the only
      intermediate trapped in the presence of 0.5 M guanidine-HCl, whereas a second
      species, X, is trapped in the presence of 0.1 M NaCl. The [epsilon-13C]Lys-216
      resonance of X is coincident with the signal for bR568, indicating that X is
      either C = N anti and protonated or C = N syn and deprotonated.

PMID- 8369439
TI  - Cellular motions and thermal fluctuations: the Brownian ratchet.
AB  - We present here a model for how chemical reactions generate protrusive forces by
      rectifying Brownian motion. This sort of energy transduction drives a number of
      intracellular processes, including filopodial protrusion, propulsion of the
      bacterium Listeria, and protein translocation.

PMID- 8369440
TI  - Fluorescence dequenching kinetics of single cell-cell fusion complexes.
AB  - In an earlier paper which models the cell-cell (or virus-cell) fusion complex as
      two partial spherical vesicles joined at a narrow neck (Rubin, R. J., and Yi-der
      Chen. 1990. Biophys. J. 58:1157-1167), the redistribution by diffusion of lipid
      like molecules through the neck between the two fused cell surfaces was studied.
      In this paper, we extend the study to the calculation of the kinetics of
      fluorescence increase in a single fusion complex when the lipid-like molecules
      are fluorescent and self-quenching. The formalism developed in this paper is
      useful in deducing fusion activation mechanisms from cuvette fluorescence
      measurements in cell-cell fusion systems. Two different procedures are presented:
      1) an exact one which is based on the exact local density functions obtained from
      diffusion equations in our earlier study; and 2) an approximate one which is
      based on treating the kinetics of transfer of probes between the two fused cells
      as a two-state chemical reaction. For typical cell-cell fusion complexes, the
      fluorescence dequencing curves calculated from the exact and approximate
      procedures are very similar. Due to its simplicity, the approximate method should
      be very useful in future applications. The formalism is applied to a typical cell
      cell fusion complex to study the sensitivity of dequenching curves to changes in
      various fusion parameters, such as the radii of the cells, the radius of the pore
      at the fusion junction, and the number of probes initially loaded to the complex.

PMID- 8369441
TI  - Aggregation and disaggregation kinetics of human blood platelets: Part I.
      Development and validation of a population balance method.
AB  - Hydrodynamic shear stress of sufficient intensity is known to cause platelet
      activation and aggregation and to alter the effects of biochemical platelet
      agonists and antagonists. In this work, a population balance equation (PBE) model
      is developed for analysis of platelet aggregation and disaggregation kinetics
      under the influence of a shear field. The model incorporates both aggregation and
      disaggregation by splitting and/or erosion mechanisms. This paper, the first of a
      series of three, deals with the formulation, simplification, and validation of
      the PBE and with the estimation of parameters involved in the PBE. These
      population parameters include collision efficiency, void fraction (related to the
      particle collision diameter), and the breakage rate coefficient. The platelet
      particle size distribution is determined experimentally, both initially and at
      some later times. The PBE can then be used to match satisfactorily the observed
      particle histograms, by appropriate choice of parameters of the model as
      functions of time, platelet size, and magnitude of physical or chemical stimuli.
      Besides providing information on adhesive forces and on the rates of aggregation
      and disaggregation, these parameters infer the physical properties of platelets
      and platelet aggregates. These properties are of potential value in increasing
      our understanding of the processes involved in thrombotic disease and/or therapy.
      A numerical procedure for solving the PBE is validated by application to simple
      cases for which analytical solutions are available. The model is applied to
      analysis of experiments, and parameter sensitivity studies are used to order the
      importance of the parameters and to reduce the complexity of the model. The
      simplified model is shown to give good agreement with experimental observations.

PMID- 8369442
TI  - Aggregation and disaggregation kinetics of human blood platelets: Part II. Shear
      induced platelet aggregation.
AB  - A population balance equation (PBE) mathematical model for analyzing platelet
      aggregation kinetics was developed in Part I (Huang, P. Y., and J. D. Hellums.
      1993. Biophys. J. 65: 334-343) of a set of three papers. In this paper, Part II,
      platelet aggregation and related reactions are studied in the uniform, known
      shear stress field of a rotational viscometer, and interpreted by means of the
      model. Experimental determinations are made of the platelet-aggregate particle
      size distributions as they evolve in time under the aggregating influence of
      shear stress. The PBE model is shown to give good agreement with experimental
      determinations when either a reversible (aggregation and disaggregation) or an
      irreversible (no disaggregation) form of the model is used. This finding suggests
      that for the experimental conditions studied disaggregation processes are of only
      secondary importance. During shear-induced platelet aggregation, only a small
      fraction of platelet collisions result in the binding together of the involved
      platelets. The modified collision efficiency is approximately zero for shear
      rates below 3000 s-1. It increases with shear rates above 3000 s-1 to about 0.01
      for a shear rate of 8000 s-1. Addition of platelet chemical agonists yields order
      of magnitude increases in collision efficiency. The collision efficiency for
      shear-induced platelet aggregation is about an order of magnitude less at 37
      degrees C than at 24 degrees C. The PBE model gives a much more accurate
      representation of aggregation kinetics than an earlier model based on a
      monodispersed particle size distribution.

PMID- 8369443
TI  - Aggregation and disaggregation kinetics of human blood platelets: Part III. The
      disaggregation under shear stress of platelet aggregates.
AB  - In the preceding two papers (1, 2), a population balance equation (PBE)
      mathematical model was developed, validated, and applied to the analysis of
      platelet aggregation kinetics under the influence of hydrodynamic shear stress.
      The present work involves the application of the model to the analysis of
      platelet reactions under shear stress in circumstances where disaggregation
      processes are of dominant importance: the disaggregation of aggregates formed in
      response to added agonists. Aggregation-disaggregation experiments were performed
      in the constant shear field of a rotational viscometer, and the evolution of the
      particle size distribution was determined by use of an electronic particle
      counter. The PBE model was used to simulate the experimental results. Exploratory
      calculations made it possible to reduce a rather complete, complex model to a
      more tractable form which retains the capability of simulating the experimental
      observations. For the experimental conditions studied, disaggregation by a
      splitting mechanism was found to be of dominant importance. The surface erosion
      mechanism can be neglected without significant impact on results. Physical
      reasoning confirmed by exploratory calculations showed that a discontinuous form
      of the breakage rate expression which incorporates a minimum friable particle
      size, gives significantly better results than a continuous expression. A simple
      step function void fraction parameter was found to be at least as successful as a
      more complicated, continuous function. The resulting simplified model has the
      potential of increasing our understanding of kinetics and mechanisms of platelet
      reactions, and of characterizing the state of platelet activity. Hence, it may be
      useful in efforts to understand thrombotic and hemostatic processes.

PMID- 8369444
TI  - Why does the light-gradient photovoltage from photosynthetic organelles show a
      wavelength-dependent polarity?
AB  - The light-gradient photovoltage from photosynthetic organisms and organelles is
      thought to arise from the primary charge separation in the reaction centers. The
      current explanation of the effect is the stronger excitation of the membrane side
      of a vesicle facing the light source than the one on the opposite side. Together
      with the known orientation of reaction centers, this explanation predicts
      unequivocally the polarity of the photovoltage. However, a polarity opposite to
      the one expected has often been reported. A dependence of the polarity on the
      wavelength has been published but no explanation was given (Graber, P., and H.-W.
      Trissl. 1981. FEBS Lett. 123:95-99). Here we report on a theoretical treatment of
      light propagation and interference in pigmented and nonpigmented multilayers. A
      model calculation is carried out for a pair of membranes, demonstrating the
      wavelength-dependent light distribution as well as the relative photovoltage and
      its polarity. When the membranes contain no chromophores or when the absorption
      coefficient is low, the predicted polarity to that expected from a simple
      macroscopic absorption behavior. The model is tested by comparing new
      photovoltage data obtained at 532 nm as well as in the blue and red absorption
      bands of chlorophyll in chloroplasts. It is concluded that outside the main
      absorption bands the amplitude and polarity of the photovoltage is determined by
      the ratio of the refractive indices of the membrane and the medium.

PMID- 8369445
TI  - Flash and smash: rapid freezing of muscle fibers activated by photolysis of caged
      ATP.
AB  - A new approach was used to study transient structural states of cross-bridges
      during activation of muscle fibers. Rabbit skinned muscle fibers were rapidly and
      synchronously activated from the rigor state by photolysis of caged ATP in the
      presence of Ca2+. At several different times during the switch from rigor to
      fully active tension development, the fibers were rapidly frozen on a liquid
      helium-cooled metal block, freeze-substituted, and examined in an electron
      microscope. The limits of structural preservation and resolution with this
      technique were analyzed. We demonstrate that the resolution of our images is
      sufficient to draw the following conclusions about cross-bridge structure. Rigor
      cross-bridges point away from the Z-line and most of them are wider near the thin
      filaments than near the backbone of the thick filaments. In contrast, cross
      bridges in actively contracting fibers stretch between the thick and thin
      filaments at a variable angle, and are uniformly thin. Diffraction patterns
      computed from contracting muscle show layer lines both at 38 and 43 nm indicating
      that active cross-bridges contribute mass to both the actin- and myosin-based
      helical periodicities. The images obtained from fibers frozen 20 ms after release
      of ATP show a mixture of rigor and active type cross-bridge configurations. There
      is little evidence of cross-bridges with the rigor shape by 50 ms, and the
      difference in configurations between 50 and 300 ms after photolysis is
      surprisingly subtle.

PMID- 8369446
TI  - An experimental evaluation of the critical potential difference inducing cell
      membrane electropermeabilization.
AB  - When applied on intact cell suspension, electric field pulses are known to induce
      membrane permeabilization (electropermeabilization) and fusion (electrofusion).
      These effects are triggered through a modulation of the membrane potential
      difference. Due to the vectorial character of the electric field effects, this
      modulation, which is superimposed on the resting membrane potential difference,
      is position-dependent on the cell surface. This explains the difference between
      the experimentally observed critical field strengths requested to trigger the
      processes of permeabilization and fusion. The critical membrane potential
      difference which induces membrane permeabilization can be calculated from these
      experimental observations. It is observed that its value is always about 200 mV
      for many different cell systems as we previously reported in the case of pure
      lipid vesicles. This is much less than assumed in most previous studies.

PMID- 8369447
TI  - Solutions for transients in arbitrarily branching cables: I. Voltage recording
      with a somatic shunt.
AB  - An analytical solution is derived for voltage transients in an arbitrarily
      branching passive cable neurone model with a soma and somatic shunt. The response
      to injected currents can be represented as an infinite series of exponentially
      decaying components with different time constants and amplitudes. The time
      constants of a given model, obtained from the roots of a recursive transcendental
      equation, are independent of the stimulating and recording positions. Each
      amplitude is the product of three factors dependent on the corresponding root:
      one constant over the cell, one varying with the input site, and one with the
      recording site. The amplitudes are not altered by interchanging these sites. The
      solution reveals explicitly some of the parameter dependencies of the responses.
      An efficient recursive root-finding algorithm is described. Certain regular
      geometries lead to "lost" roots; difficulties associated with these can be
      avoided by making small changes to the lengths of affected segments. Complicated
      cells, such as a CA1 pyramid, produce many closely spaced time constants in the
      range of interest. Models with large somatic shunts and dendrites of unequal
      electrotonic lengths can produce large amplitude waveform components with
      surprisingly slow time constants. This analytic solution should complement
      existing passive neurone modeling techniques.

PMID- 8369448
TI  - The nature of cation-pi binding: interactions between tetramethylammonium ion and
      benzene in aqueous solution.
AB  - A combined quantum mechanical and molecular mechanical Monte Carlo simulation
      method was used to determine the free energy of binding between
      tetramethylammonium ion (TMA+) and benzene in water. The computed free energy as
      a function of distance (the potential of mean force) has two minima that
      represent contact and solvent-separated complexes. These species are separated by
      a broad barrier of about 3 kJ/mol. The results are in good accord with
      experimental data and suggest that TMA+ binds to benzene more favorably than to
      chloride ion, with an association constant of about 0.8 M-1.

PMID- 8369449
TI  - Solutions for transients in arbitrarily branching cables: II. Voltage clamp
      theory.
AB  - Analytical solutions are derived for arbitrarily branching passive neurone models
      with a soma and somatic shunt, for synaptic inputs and somatic voltage commands,
      for both perfect and imperfect somatic voltage clamp. The solutions are infinite
      exponential series. Perfect clamp decouples different dendritic trees at the
      soma: each exponential component exists only in one tree; its time constant is
      independent of stimulating and recording position within the tree; its amplitude
      is the product of a factor constant over that entire tree and factors dependent
      on stimulating and recording positions. Imperfect clamp to zero is mathematically
      equivalent to voltage recording with a shunt. As the series resistance increases,
      different dendritic trees become more strongly coupled. A number of interesting
      response symmetries are evident. The solutions reveal parameter dependencies,
      including an insensitivity of the early parts of the responses to specific
      membrane resistivity and somatic shunt, and an approximately linear dependence of
      the slower time constants on series resistance, for small series resistances. The
      solutions are illustrated using a "cartoon" representation of a CA1 pyramidal
      cell and a two-cylinder + soma model.

PMID- 8369450
TI  - Solutions for transients in arbitrarily branching cables: III. Voltage clamp
      problems.
AB  - Branched cable voltage recording and voltage clamp analytical solutions derived
      in two previous papers are used to explore practical issues concerning voltage
      clamp. Single exponentials can be fitted reasonably well to the decay phase of
      clamped synaptic currents, although they contain many underlying components. The
      effective time constant depends on the fit interval. The smoothing effects on
      synaptic clamp currents of dendritic cables and series resistance are explored
      with a single cylinder + soma model, for inputs with different time courses.
      "Soma" and "cable" charging currents cannot be separated easily when the soma is
      much smaller than the dendrites. Subtractive soma capacitance compensation and
      series resistance compensation are discussed. In a hippocampal CA1 pyramidal
      neurone model, voltage control at most dendritic sites is extremely poor.
      Parameter dependencies are illustrated. The effects of series resistance compound
      those of dendritic cables and depend on the "effective capacitance" of the cell.
      Plausible combinations of parameters can cause order-of-magnitude distortions to
      clamp current waveform measures of simulated Schaeffer collateral inputs. These
      voltage clamp problems are unlikely to be solved by the use of switch clamp
      methods.

PMID- 8369451
TI  - Multigrid solution of the nonlinear Poisson-Boltzmann equation and calculation of
      titration curves.
AB  - Although knowledge of the pKa values and charge states of individual residues is
      critical to understanding the role of electrostatic effects in protein structure
      and function, calculating these quantities is challenging because of the
      sensitivity of these parameters to the position and distribution of charges.
      Values for many different proteins which agree well with experimental results
      have been obtained with modified Tanford-Kirkwood theory in which the protein is
      modeled as a sphere (reviewed in Ref. 1); however, convergence is more difficult
      to achieve with finite difference methods, in which the protein is mapped onto a
      grid and derivatives of the potential function are calculated as differences
      between the values of the function at grid points (reviewed in Ref. 6). Multigrid
      methods, in which the size of the grid is varied from fine to coarse in several
      cycles, decrease computational time, increase rates of convergence, and improve
      agreement with experiment. Both the accuracy and computational advantage of the
      multigrid approach increase with grid size, because the time required to achieve
      a solution increases slowly with grid size. We have implemented a multigrid
      procedure for solving the nonlinear Poisson-Boltzmann equation, and, using
      lysozyme as a test case, compared calculations for several crystal forms,
      different refinement procedures, and different charge assignment schemes. The
      root mean square difference between calculated and experimental pKa values for
      the crystal structure which yields best agreement with experiment (1LZT) is 1.1
      pH units, with the differences in calculated and experimental pK values being
      less than 0.6 pH units for 16 out of 21 residues. The calculated titration curves
      of several residues are biphasic.

PMID- 8369452
TI  - Effect of stress on the membrane capacitance of the auditory outer hair cell.
AB  - The membrane capacitance of the outer hair cell, which has unique membrane
      potential-dependent motility, was monitored during application of membrane
      tension. It was found that the membrane capacitance of the cell decreased when
      stress was applied to the membrane. This result is the opposite of stretching the
      lipid bilayer in the plasma membrane. It thus indicates the importance of some
      other capacitance component that decreases on stretching. It has been known that
      charge movement across the membrane can appear to be a nonlinear capacitance. If
      membrane stress at the resting potential restricts the movement of the charge
      associated with force generation, the nonlinear capacitance will decrease.
      Furthermore, less capacitance reduction by membrane stretching is expected when
      the membrane is already extended by the (hyperpolarizing) membrane potential.
      Indeed, it was found that at hyperpolarized potentials, the reduction of the
      membrane capacitance due to stretching is less. The capacitance change can be
      described by a two state model of a force-producing unit in which the free energy
      difference between the contracted and stretched states has both electrical and
      mechanical components. From the measured change in capacitance, the estimated
      difference in the membrane area of the unit between the two states is about 2
      nm2.

PMID- 8369453
TI  - Simulations of three-dimensional ciliary beats and cilia interactions.
AB  - A new set of equations describing the time evolution of torsion and curvature for
      an inextensible curve is developed. Combined with our recently developed Slender
      Body Theory approach to such problems, these equations were applied to simulate
      three-dimensional ciliary beats, while allowing for cilia interactions. The
      computer animation technique, which was originally designed to display two
      dimensional beats, has been enhanced to accommodate the new three-dimensional
      results.

PMID- 8369454
TI  - Conformational change--an alternative energy source? Exothermic phase transition
      in phage capsid maturation.

PMID- 8369455
TI  - Comparative study of phototactic and photophobic receptor chromophore properties
      in Chlamydomonas reinhardtii.
AB  - The motile, unicellular, eukaryotic alga Chlamydomonas reinhardtii exhibits two
      distinct behavioral reactions to light stimuli, phototaxis and the photophobic
      response. Both are mediated by retinal-containing receptors. This paper focuses
      on a direct comparison of the two photoresponses and the chromophore requirements
      for their photoreceptor(s). Using computerized motion analysis assays for
      phototaxis and photophobic responses by the same populations of cells, we
      measured the ability of various isomers and analogues of retinal to reconstitute
      photobehavior in the pigment-deficient mutant FN68. The results indicate that
      photophobic and phototaxis responses each require chromophores with an all-trans
      polyene chain configuration, planar ionone ring/polyene chain conformation, and
      the ability to isomerize around the retinal C13-C14 double bond. One difference
      between the two behaviors is that the photophobic response becomes highly
      desensitized after light stimuli to which the phototaxis response does not become
      desensitized, indicating the existence of at least one distinct step in the
      photophobic response pathway. A second difference is that the retinal
      regeneration of the photophobic response but not of phototaxis is inhibited by a
      5-membered ring 13-trans-locked analogue. While showing close similarity in the
      chromophore structural requirements of the two behaviors, the results indicate
      that differences exist between the two responses at the level of their
      photoreceptor proteins and/or in their transduction processes.

PMID- 8369456
TI  - Reconstruction of ionic currents in a molluscan photoreceptor.
AB  - Two-microelectrode voltage-clamp measurements were made to determine the kinetics
      and voltage dependence of ionic currents across the soma membrane of the
      Hermissenda type B photoreceptor. The voltage-dependent outward potassium
      currents, IA and ICa(2+)-K+, the inward voltage-dependent calcium current, ICa2+
      and the light-induced current, IIgt, were then described with Hodgkin-Huxley-type
      equations. The fast-activating and inactivating potassium current, IA, was
      described by the equation; IA(t) = gA(max)(ma infinity[1-exp(-t/tau ma)])3 x (ha
      infinity [1-exp(-t/tau ha)] + exp(-t/tau ha)) (Vm-EK), where the parameters ma
      infinity, ha infinity, tau ma, and tau ha are functions of membrane potential,
      Vm, and ma infinity and ha infinity are steady-state activation and inactivation
      parameters. Similarly, the calcium-dependent outward potassium current, ICa(2+)
      K+, was described by the equation, ICa(2+)-K+ (t) = gc(max)(mc infinity(VC)(1
      exp[-t/tau mc (VC)]))pc (hc infinity(VC) [1-exp(-t/tau hc)] + exp(-t/tau
      hc(VC)])pc(VC-EK). In high external potassium, ICa(2+)-K+ could be measured in
      approximate isolation from other currents as a voltage-dependent inward tail
      current following a depolarizing command pulse from a holding potential of -60
      mV. A voltage-dependent inward calcium current across the type B soma membrane,
      ICa2+, activated rapidly, showed little inactivation, and was described by the
      equation: ICa2+ = gCa(max) [1 + exp](-Vm-5)/7]-1 (Vm-ECa), where gCa(max) was 0.5
      microS. The light-induced current with both fast and slow phases was described
      by: IIgt(t) = IIgt1 + IIgt2 + IIgt3, IIgti = gIgti [1-exp(- ton/tau mi)] exp(
      ton/tau hi)(Vm-EIgti) (i = 1, 2). For i = 3, /Igt(t) = gigt3m33h3(Vm - Eigt3)exp(
      ton/Ton) x exp(-tfoff/t Off). Based on these reconstructions of ionic currents,
      learning-induced enhancement of the long lasting depolarization (LLD) of the
      photoreceptor'slight response was shown to arise from progressive inactivation of
      /A, lca2+ -K+, and lCa2+.

PMID- 8369457
TI  - Bioelectrorheological model of the cell. 4. Analysis of the extensil deformation
      of cellular membrane in alternating electric field.
AB  - Analysis of the angular distribution of extensil mechanical stress, sigma e,
      generated in cytoplasmic membranes by an external oscillating electric field, is
      presented. Theoretical considerations show that sigma e is directly proportional
      to the local relative increase in membrane area and/or to the local relative
      decrease in its thickness. The magnitude of this stress depends on the position
      of the analyzed point of the membrane in relation to field direction. The maximal
      value, sigma eo, is reached at the cell "poles." The magnitude of sigma eo
      depends on electric and geometric parameters (in particular on field frequency)
      of the system studied. The foregoing analysis can be applied to quantitatively
      describe the destabilizing effects of the electric field on the cellular
      membrane, leading to its poration, fusion, and destruction.

PMID- 8369458
TI  - Bioelectrorheological model of the cell. 5. Electrodestruction of cellular
      membrane in alternating electric field.
AB  - Recently proposed analysis of the extensil stress developed in a cellular
      membrane subjected to an alternating electric field (Pawlowski, P., and M. Fikus,
      1993. Bioelectrorheological model of the cell. 4. Analysis of the extensil
      deformation of the membrane in an alternating field. Biophys. J. 65:535-540) was
      applied in calculations of extensil stress threshold values, sigma eo[d],
      producing experimentally observed electrodestruction of cells within the
      frequency range of 7 x 10(1) - 3 x 10(5) Hz. It was shown that the susceptibility
      (s[d] = 1/sigma eo[d]), of the membrane to this process varies with field
      frequency and depends on the type of cells. Electrodestruction is facilitated in
      the 10(5)-Hz field. A rheological hypothesis explaining the experimentally
      observed dependence of membrane stability on electric field frequency was
      proposed and successfully tested for two other phenomena: electroporation and
      electrofusion.

PMID- 8369459
TI  - Mesophase transition temperatures as measured by fluorescence and calorimetry.

PMID- 8369460
TI  - Teaching biophysics. Strategies for recruiting and retaining minorities in
      physics and biophysics.
AB  - Several strategies directed toward increasing the participation of minority
      students in physics and biophysics are presented. Since the number of minority
      students entering college with an interest in science and mathematics must be
      increased if we expect to see more students graduating in science, several
      programs aimed at increasing the level of instruction of physics and biology in
      urban middle schools and high schools are outlined. We also describe approaches
      designed to increase the retention of science major during the freshman core
      physics course where many potential science majors are lost. Increasing the
      number of minority students at the PhD level will rely increasingly on
      partnerships between research universities and historically black colleges and
      universities (HBCUs) and several programs already in effect are given as examples
      of such linkages.

PMID- 8369462
TI  - Fusion flashes illuminate kinetics.

PMID- 8369461
TI  - Supramolecular ordering of DNA in the cholesteric liquid crystalline phase: an
      ultrastructural study.
AB  - Aqueous solutions of 146-base pair DNA fragments form a cholesteric liquid
      crystalline phase in the range of about 160-290 mg/ml. We present a structural
      analysis of this phase by comparing the data obtained from polarizing and
      electron microscopy. This phase shows multiple aspects or "textures" which are
      presented and interpreted. They mainly depend on the orientation of the structure
      relative to the observation plane and on the nature, distribution, and amount of
      defects present in the phase. These defects are then analyzed with the two
      methods, and the molecular orientations can be defined precisely in their core.
      The biological interest of such structural analyses is discussed in relation with
      the understanding of chromatin structure and function.

PMID- 8369463
TI  - How does a virus bud?
AB  - How does a virus bud from the plasma membrane of its host? Here we investigate
      several possible rate-limiting processes, including thermal fluctuations of the
      plasma membrane, hydrodynamic interactions, and diffusion of the glycoprotein
      spikes. We find that for bending moduli greater than 3 x 10(-13) ergs, membrane
      thermal fluctuations are insufficient to wrap the viral capsid, and the
      mechanical force driving the budding process must arise from some other process.
      If budding is limited by the rate at which glycoprotein spikes can diffuse to the
      budding site, we compute that the budding time is 10-20 min, in accord with the
      experimentally determined upper limit of 20 min. In light of this, we suggest
      some alternative mechanisms for budding and provide a rationale for the
      observation that budding frequently occurs in regions of high membrane curvature.

PMID- 8369464
TI  - Understanding fluorescence decay in proteins.

PMID- 8369465
TI  - Myocardial dysfunction following cardiopulmonary bypass: recovery patterns,
      predictors of inotropic need, theoretical concepts of inotropic administration.
AB  - Clinical myocardial dysfunction following cardiopulmonary bypass commonly occurs
      in patients with good preoperative ventricular function. Following separation
      from cardiopulmonary bypass, ventricular function improves initially, but then
      begins to worsen and reaches a nadir between 4 and 6 hours after surgery with
      full recovery occurring around 24 hours postoperatively. However, in patients
      with preoperative ventricular dysfunction, the depression of ventricular function
      is more severe and recovery is longer. Despite this high frequency of myocardial
      dysfunction, many patients do well without requiring pharmacologic intervention
      after cardiopulmonary bypass to augment contractility and peripheral perfusion.
      Factors that may predict the need for inotropic support in patients following
      cardiopulmonary bypass include low ejection fraction, older age, cardiac
      enlargement, female sex, the length of cardiopulmonary bypass and the duration of
      aortic cross-clamping. The patient with preoperative ventricular dysfunction has
      many of these preoperative and intraoperative predictors for inotropic support.
      The pharmacologic regimen to support the myocardium during the recovery period
      following cardiopulmonary bypass must take into consideration the
      pathophysiologic processes of chronic congestive heart failure and reperfusion
      injury. Reduction of cyclic adenosine monophosphate (cAMP) levels is a
      fundamental problem in congestive heart failure and results from either down
      regulation of beta-receptors or a defect in the G-regulatory proteins controlling
      adenylyl cyclase production. This diminishes the effectiveness of agents
      dependent on cAMP to produce an inotropic response. However, amplification of the
      reduced cAMP produced by beta-agonists may occur in association with the
      inhibition of cAMP breakdown resulting from phosphodiesterase inhibitors. All
      inotropic agents are usually effective in reversing the reperfusion-induced
      stunned myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369466
TI  - Congestive heart failure: systolic and diastolic function.
AB  - There is increasing recognition that disorders of both left ventricular systolic
      and diastolic function can result in congestive heart failure. As such,
      consideration of both the filling and emptying characteristics of the left heart
      is needed to evaluate the hemodynamic abnormalities present in this syndrome.
      Considerations of the systolic (emptying) and diastolic (filling) pumping
      characteristics of the left heart also provides a conceptual basis to classify
      and understand the pathophysiology of congestive heart failure. In this context,
      systolic dysfunction can be defined as impaired emptying of the LV, apparent as a
      decreased (< 50%) effective ejection fraction (forward stroke volume divided by
      end-diastolic volume). Systolic dysfunction may result from impaired myocardial
      contractile function, increased left ventricular afterload, and/or structural
      abnormalities of the left heart. Diastolic dysfunction can be defined as a
      condition in which filling of the LV sufficient to produce an adequate cardiac
      output requires an elevated pulmonary venous pressure. Thus, diastolic
      dysfunction is clinically manifested as pulmonary congestion. Defined in this
      manner, the most common cause of diastolic dysfunction is systolic dysfunction.
      In fact, the most common symptom of patients with systolic dysfunction is dyspnea
      from the resulting diastolic dysfunction. Diastolic dysfunction in the setting of
      normal systolic function may be due to obstruction of left ventricular filling,
      impaired left ventricular distensibility, or extensive external compression of
      the LV. Treatment of diastolic dysfunction can be accomplished by relieving
      myocardial ischemia, improving systolic function, lowering arterial systolic
      pressure, and decreasing cardiac distention.

PMID- 8369467
TI  - Early intervention of inotropic support in facilitating weaning from
      cardiopulmonary bypass: the New England Deaconess Hospital experience.
AB  - The current article reviews the therapeutic advantages and disadvantages of early
      inotropic intervention prior to separation from cardiopulmonary bypass (CPB).
      Background information is provided on predictors of failure to wean as well as
      the multiple etiologies and consequences of the "failed wean" from CPB.
      Advantages of early inotropic intervention include (1) increased contractility,
      (2) resolution/prevention of ischemia, (3) attainment of therapeutic levels of
      drug, (4) minimization of inotropic side effects while on CPB, (5) avoidance of
      mechanical intervention (intra-aortic balloon pump), (6) dilatation of the
      internal mammary artery, and (7) prevention of the "failed wean". Disadvantages
      of early inotropic intervention include (1) unnecessary drug usage, (2)
      tachycardia/arrhythmias, (3) hyper/hypotension, (4) metabolic disturbances
      (hyperglycemia), (5) coagulation disorders, (6) need for additional drugs to
      treat side effects, (7) possible myocardial damage, and (8) additional costs. A
      brief review of this institution's preference for amrinone follows, including its
      pharmacology, side effects, and dosing prior to separation from CPB. Due to the
      large percentage of patients with diabetes mellitus undergoing cardiac surgery at
      our institution (approximately 30% to 40%) a synopsis of special inotropic
      considerations for this patient population is included.

PMID- 8369468
TI  - Support of the perioperative failing heart with preexisting ventricular
      dysfunction: currently available options.
AB  - Perioperative support of the patient with preexisting biventricular failure
      requires simultaneous optimal manipulation of heart rate and rhythm, loading
      conditions, and contractility. Patients with preexisting ventricular dysfunction
      will have alterations in beta-adrenergic receptors, resulting in decreased
      responsiveness to catecholamines. Even patients with previously normal
      ventricular function can develop ventricular dysfunction caused by reperfusion
      injury and other potentially damaging effects of extracorporeal circulation. The
      mainstay of therapeutic agents used to allow separation from cardiopulmonary
      bypass are catecholamines, which stimulate alpha- and beta-adrenergic receptors.
      Submaximal responses to beta 1-adrenergic stimulation can occur in the down
      regulated heart. The phosphodiesterase inhibitors provide both inotropic support
      and vasodilatation, which improves both systolic and diastolic function and
      bypasses beta-adrenergic receptors. When administered in combination,
      catecholamine and cyclic-AMP-specific phosphodiesterase inhibitors can have
      additive effects to restore beta 1-adrenergic responsiveness. Combination therapy
      provides an important therapeutic option to facilitate separation from
      cardiopulmonary bypass. Pharmacologic intervention for right ventricular
      dysfunction focuses on reversal of pulmonary vasoconstriction with nitrates, beta
      2-adrenergic agents, phosphodiesterase inhibitors and prostaglandin E1.

PMID- 8369469
TI  - Postcardioplegia acute cardiac dysfunction and reperfusion injury.
AB  - In cardiac surgery, an obligatory period of ischemia is imposed in order to
      provide a convenient operative field. Brief periods of ischemia produce systolic
      and diastolic abnormalities related to pathology occurring during ischemia per se
      (ischemic injury) or expressed after the onset of reperfusion (reperfusion
      injury). In the surgical setting, ischemia may be encountered preoperatively with
      preexisting coronary disease, hypotension, or ventricular fibrillation, between
      intermittent infusions of cardioplegia solutions, or as a result of
      maldistribution of cardioplegia solution. The potential for reperfusion injury
      exists not only at the time of cross-clamp removal, but also with each infusion
      of cardioplegia solution. Infusion of cardioplegic solution is, in fact, a form
      of reperfusion to previously ischemic myocardium. Ischemic injury and reperfusion
      injury are intimately linked in that the severity of ischemia sets the stage for
      and determines, in part, the extent of reperfusion injury. Mild-to-moderate
      systolic dysfunction, which may be called "postcardioplegia stunning," remains a
      significant complication after cardiac surgery. More significant postoperative
      functional depression may occur in hearts with severe preoperative dysfunction,
      and in operations requiring long cross-clamp times. In addition, the failure to
      adequately distribute cardioplegic solution to all areas of the myocardium
      because of coronary stenoses, high coronary resistance or inadequate delivery
      pressure-flow relations, contributes to postcardioplegia dysfunction. However,
      the cardioplegic solution itself may also contribute to postcardioplegic
      dysfunction by creating temporary ionic and metabolic abnormalities. In addition,
      systemic hypocalcemia or hyperkalemia resulting from using large doses of
      cardioplegic solution may temporarily aggravate postcardioplegic mechanical
      dysfunction. Current formulations and strategies for delivery of cardioplegia
      solutions are designed to address the various contributors to both ischemic and
      reperfusion injury that may impact on postoperative mechanical performance.
      Ischemic injury is avoided by reducing myocardial oxygen demand by engaging
      immediate arrest and cooling the heart to approximately 10 degrees centigrade,
      and intermittently infusing solution to reoxygenate the myocardium, maintain
      hypothermia, and wash out accumulated metabolites. Reperfusion injury may be
      avoided by infusing hyperosmotic solutions at moderate pressures, and by
      incorporating oxygen radical scavengers or inhibitors to reduce membrane lipid
      peroxidation, myocellular and microcirculatory (endothelium) damage.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 8369470
TI  - Alzheimer's disease and spirochetes; a questionable relationship.

PMID- 8369471
TI  - Alzheimer's disease--a spirochetosis?
AB  - The aetiology of Alzheimer's disease (AD), which affects a large proportion of
      the aged population is unknown and the treatment unresolved. The role of beta
      amyloid protein (beta A4), derived from a larger amyloid precursor protein (APP)
      in AD is the subject of intense research. Here I report observations that in 14
      autopsy cases with histopathologically confirmed AD, spirochetes were found in
      blood and cerebrospinal fluid and, moreover, could be isolated from brain tissue.
      Thirteen age-matched control cases were without spirochetes. Reference strains of
      spirochetes and those isolated from brains of AD patients, showed positive
      immunoreaction with monoclonal antibody against the beta amyloid precursor
      protein. These observations suggest that spirochetes may be one of the causes of
      AD and that they may be the source of the beta amyloid deposited in the AD brain.

PMID- 8369472
TI  - The peptidergic motoneurone.
AB  - Acetylcholine is the classic transmitter in the spinal cord motoneurone. Recent
      studies have shown that motoneurones also contain calcitonin-gene related peptide
      (CGRP) and other peptides. In addition to transmitter-like effects, CGRP may also
      exert trophic actions, as suggested by changes in CGRP expression in motoneurones
      during development and following experimental perturbations.

PMID- 8369474
TI  - Lesions of the hippocampus enhance or depress humoral immunity in rats.
AB  - The effect on the humoral immune response in rats by bilaterally destroying cell
      bodies in the hippocampus with kainic acid or by electrolytic lesion was studied.
      After 3 days a humoral immune response was evoked by injecting 1 ml of 10% sheep
      red blood cells. Five days later, the haemolysin content (MC50) was measured.
      Chemical destruction of pyramidal cell bodies in CA2 and CA3 significantly
      increased humoral immunity as measured by HC50, but larger chemical lesions that
      also included CA1 did not. Electrical destruction of cell bodies and axonal
      pathways in CA2 and CA3 did not significantly affect HC50. These results suggest
      that different areas of the hippocampus can stimulate or inhibit humoral
      immunity.

PMID- 8369473
TI  - Second messenger-induced modulation of the excitability of respiratory neurones.
AB  - The phospholipase inhibitor quinacrine and the protein kinase C activator phorbol
      12,13-dibutyrate were injected intracellularly into expiratory neurones of the
      ventral respiratory group within the brain stem of anaesthetized cats. Neurones
      were identified by their on-going spontaneous respiratory activity and by
      antidromic excitation from the spinal cord at the C2-C3 level. Phorbol-12,13
      dibutyrate and quinacrine, increased the amplitude of respiratory drive
      potentials reproducing an effect which is also obtained by potassium blockers. We
      conclude that modulation accounts for approximately a 40% reduction of the
      excitatory respiratory drive potentials provided by the respiratory rhythm
      generator. This modulation appears to be mediated by potassium currents that are
      controlled by intracellular messengers in brain stem respiratory neurones.

PMID- 8369475
TI  - Sensory receptor-like cells in the human foetal vomeronasal organ.
AB  - The vomeronasal organ (VNO) was studied in ten human foetuses, 12 to 36 weeks
      old. At 12 to 23 weeks, it was lined by a smooth pseudostratified epithelium,
      with neurone-specific enolase (NSE) positive cells looking like olfactory
      receptors. Clusters of NSE-positive cells were seen in relation with the
      posterosuperior end of the organ and along nerve fascicles in the nasal septum.
      At 36 weeks, the organ was lined by a respiratory epithelium and did not show any
      receptor-like cells; some pear-shaped NSE-positive cells of unknown significance
      were seen at the upper part of the respiratory epithelium. Our results suggest
      that during the early foetal period, the VNO could have some, as yet unknown,
      sensory function.

PMID- 8369476
TI  - Pheromones induce c-fos in limbic areas regulating male hamster mating behavior.
AB  - Hamsters rely on chemosensory cues from females of the same species for the
      initiation of copulatory behavior. While these cues are detected by both the main
      and accessory olfactory systems it is the central nuclei in the accessory system
      that regulate mating behavior. The results of the present study indicate that
      exposure to vaginal secretions from a female Syrian hamster (FHVS) stimulates c
      fos production in the medial nucleus of the amygdala (Me), the bed nucleus of the
      stria terminalis (BNST) and the medial preoptic area (MPOA). Exposure to vaginal
      secretions from Djungarian hamsters do not stimulate neurons in these areas. Thus
      the present results suggest that FHVS stimulates mating behavior by activating
      neurons within the vomeronasal pathway.

PMID- 8369477
TI  - Hip stabilization and lateral balance control in toddlers during the first four
      months of autonomous walking.
AB  - The main purpose of the present paper was to investigate the inter-segmental
      coordinations between hip, shoulder and head, in toddlers, during the first four
      months of autonomous walking. The efficiency of locomotor balance control was
      examined in the frontal plane. The main result to emerge from this study is that
      the hip stabilization in space appears as soon as the first week of autonomous
      walking, while shoulder stabilization in space appears to be effective only at
      the second month. Finally, no preferred head stabilization, either in space or on
      shoulders, has appeared by the end of the fourth month. These results seem to
      indicate, from an early hip stabilization, an ascending progression with age of
      the ability to control lateral balance during locomotion.

PMID- 8369478
TI  - Lesion of the suprasylvian cortex impairs depth perception of cats.
AB  - Using a 2-alternative-forced-choice-procedure on a jumping stand, four adult cats
      were trained to make simple depth discriminations. They were tested binocularly
      and monocularly before and after bilateral lesions of different parts of the
      lateral suprasylvian cortex. Our results give support to a functional segregation
      between the lateral suprasylvian visual areas (LSA) and area 7. Lesion of any of
      these areas impairs the ability to use binocular depth cues. However, lesion of
      LSA more severely impairs the ability to use monocular depth cues whereas
      binocular ones can still be used. After lesion of area 7, binocular depth cues
      can no longer be used. Additional undercutting of areas 17/18/19 leads to a
      performance similar to that of area 17/18 lesioned cats.

PMID- 8369479
TI  - Is water diffusion restricted in human brain white matter? An echo-planar NMR
      imaging study.
AB  - Water diffusion is extremely anisotropic in brain white matter, depending on
      myelin fiber orientation. A suggested, but unproven cause of anisotropy is that,
      in the direction transverse to the myelin fibers, axonal water diffusion is
      prevented by the presence of the myelin sheath. We found, however, using an ultra
      fast nuclear magnetic resonance imaging technique, that the dependence of the
      diffusion coefficient on the diffusion time does not support the model of water
      restriction by impenetrable barriers. These results, which were obtained non
      invasively in vivo in the human brain, imply that water diffuses with a
      measurable rate across myelin fibers.

PMID- 8369480
TI  - Transient expression of PKC gamma mRNA in cerebellar granule cells during rat
      brain development.
AB  - The localization of PKC gamma mRNA expression during the maturation of rat
      cerebellum has been studied by in situ hybridization. We found a transient
      expression over the granule cell layer and persistent high expression in the
      Purkinje cells during postnatal development. Expression in granule cells appeared
      as early as postnatal day 5 over the external granule cell layer, when Purkinje
      cells are multiply innervated by climbing fibres in contrast to their mono
      innervation in the adult. As the regression of the poly-innervation during the
      following weeks is known to require granule cell input, our findings suggest that
      the PKC gamma expression over the migrating granule cell layer is linked to the
      process of selective stabilization of synapses during the maturation of the
      cerebellum.

PMID- 8369481
TI  - Oral stimulations induce apnoea in newborn kittens.
AB  - The aim of the present work was to study oral trigeminal mechanisms which might
      induce apnoeic reflexes in adult cats and kittens at different postnatal ages.
      Various oral stimulations and electrical stimulations of the lingual nerve
      produced apnoeas whose duration decreased with age until three weeks of life. In
      addition, swallowing was only rarely observed before 5 days and then occurred
      with apnoea until the third week. Responses became similar to those observed in
      adults between weeks 3 and 4. Thus, in kittens, the nervous control which
      regulates coordination between breathing and swallowing appears to be immature at
      birth.

PMID- 8369482
TI  - Cell migration and subplate loss in explant cultures of murine cerebral cortex.
AB  - We studied whether cortical cells migrate and subplate cells are lost in explants
      of murine cortex cultured for up to 14 days in defined serum-free medium. We gave
      bromodeoxyuridine (BrdU) to mice on embryonic days 12-13 (E12-13), to label
      subplate cells, or E17, to label cells destined for superficial cortical layers.
      We started culturing on E18-20. We left some mice to develop and provide in vivo
      data. At E18-20, most cells born on E17 lay below the cortical plate. During the
      following days in vitro, many of them moved to the cortical plate's superficial
      edge, although an abnormally high number remained in the ventricular zone. There
      was a selective loss of BrdU labelled cells from the subplate in culture; this
      occurred more rapidly than in vivo. Factors absent from our cultures may normally
      enhance migration and prolong the survival of subplate cells.

PMID- 8369483
TI  - Activation of PKC reverses apparent NMDA receptor reduction in ALS.
AB  - The binding of [3H]MK-801 to NMDA receptors was reduced by 40-45% in the dorsal
      and ventral horns of spinal cords from patients who died with amyotrophic lateral
      sclerosis (ALS) compared with controls. These results reflect either neurone
      death with concomitant receptor loss or regulation-related receptor decreases
      independent of motoneurone degeneration. To distinguish between these
      possibilities we explored aspects of NMDA receptor regulation using phorbol ester
      to activate protein kinase C (PKC). Spinal cord sections were exposed to phorbol
      ester before incubation with [3H]MK-801 to determine levels of NMDA binding.
      Phorbol ester treatment increased [3H]MK-801 binding in both ALS and control
      tissue to almost identical levels of specific binding for both groups. The
      increased [3H]MK-801 binding could be completely blocked by concurrent exposure
      of spinal cord sections to H-7, a general protein kinase inhibitor. These results
      suggest that NMDA receptors in ALS spinal cord are decreased as a result of
      abnormal enzyme activity independent of motoneurone degeneration.

PMID- 8369484
TI  - Endothelin-1-like immunoreactivity is expressed in human reactive astrocytes.
AB  - The expression of endothelin-1-like immunoreactivity in astrocytes of the human
      brain was investigated by the avidin-biotin-peroxidase complex method in post
      mortem material. A marked immunoreaction was present in reactive astrocytes
      around infarcts, lacunes, traumatic injuries, the lesions of progressive
      multifocal leuco-encephalopathy and in the cerebral cortex and white matter of
      Alzheimer's disease. The brains of patients who had neither history nor signs of
      cerebral disease exhibited only occasional immunoreactive astrocytes. A
      hypothesis is presented that endothelin-1 may be released from reactive
      astrocytes in many organic diseases of the human brain with considerable
      pathogenic consequences. It is known from experimental investigations that
      endothelin-1 may for instance cause severe vasoconstriction resulting in cell
      injury and that it may act as a growth factor for glial cells.

PMID- 8369485
TI  - N-methyl-D-aspartate (NMDA)-mediated muscle relaxant action of dextromethorphan
      in rats.
AB  - The present study examined whether the antitussive agent dextromethorphan, which
      is an antagonist at the N-methyl-D-aspartate (NMDA) receptor, depresses spinal
      reflexes in rats. Injection of both the specific NMDA antagonist (-)-2-amino-7
      phosphonoheptanoate and of dextromethorphan dose-dependently reduced the
      magnitude of the polysynaptic flexor reflex without affecting the monosynaptic H
      reflex. In contrast, the non-NMDA antagonist 6,7-dinitroquinoxaline-2,3-dione
      depressed the H-reflex in a dose-dependent manner without affecting the flexor
      reflex. The depressant effect of dextromethorphan on the flexor reflex was
      prevented by co-administration with NMDA but not with the non-NMDA agonist alpha
      amino-3-hydroxy-5-terthyl-4-isoxazole-propionic acid. These data suggest that
      dextromethorphan exerts a muscle relaxant action via the NMDA receptor.

PMID- 8369486
TI  - Analgesic effect of morphine, clonidine and serotonin microinjected into the PTN
      of rats.
AB  - The study was aimed to delineate the neurotransmitter receptors involved in
      pretectal analgesic mechanisms by direct microinjection of neurotransmitter
      agonists and antagonists through chronically implanted cannulae in the pretectal
      nucleus of rats. Morphine, clonidine and serotonin, at doses of 2.5 and 5.0
      micrograms microinjected into the pretectal nucleus, produced a significant and
      prolonged analgesia as measured by the tail-flick test. The analgesia produced by
      morphine, clonidine and serotonin is significantly attenuated by pretreatment of
      the animals with naloxone (1 micrograms), yohimbine (5 micrograms) and
      methysergide (5-10 micrograms) respectively. The results indicate the possible
      involvement of opioid, adrenergic and serotonergic mechanisms in pretectal
      analgesia.

PMID- 8369487
TI  - Association of the peptidase inhibitor RB 101 and a CCK-B antagonist strongly
      enhances antinociceptive responses.
AB  - The brain peptide cholecystokinin (CCK) has been shown to counteract the
      analgesic effects of morphine suggesting a physiological antagonism between
      opioid and CCK neural systems. This has been definitely demonstrated in this
      study by co-administration of the CCK-B selective antagonist L-365,260 with RB
      101, a systemically active inhibitor of peptidases, which fully protects the
      endogenous opioids, the enkephalins, from their inactivation. The naloxone
      reversible analgesic effects induced by RB 101 in the mouse hot-plate and rat
      tail-flick tests were strongly increased by low doses of L-365,260. These results
      could have important clinical applications by reducing the efficient dose of RB
      101, which has recently been shown to be practically devoid of morphine-like side
      effects.

PMID- 8369488
TI  - L-deprenyl increases GFAP immunoreactivity selectively in activated astrocytes in
      rat brain.
AB  - L-deprenyl is a selective inhibitor of monoamine oxidase (MAO) B, an enzyme
      predominantly localized in astrocytes. We have investigated the effect of
      treatment with L-deprenyl (0.25 mg kg-1 day-1) on glial fibrillary acidic protein
      (GFAP) immunoreactivity (IR) after lesioning the rat striatum with an injection
      cannula. No effect of drug treatment on GFAP IR was found in unlesioned striata.
      A significant increase (p < 0.01 vs saline treated rats) in GFAP IR was found in
      the tissue surrounding the lesion in striata of rats treated with L-deprenyl for
      4 days after the lesion. When post-treated for 42 days, however, L-deprenyl no
      longer increased GFAP IR although reactive astrocytes were still present in the
      lesioned area. These results suggest that L-deprenyl can enhance the activation
      of astrocytes during a critical time-period following a striatal injury.

PMID- 8369489
TI  - TrkA NGF receptor expression by non-cholinergic thalamic neurons.
AB  - Expression of the trkA receptor for nerve growth factor was analyzed by mRNA in
      situ hybridization in the telencephalon and diencephalon in adult rats. Two
      densely packed populations expressing trkA mRNA were detected in the thalamus, in
      the paraventricular thalamic nucleus anterior and reuniens thalamic nucleus.
      These neurons did not express mRNA coding for choline acetyltransferase. In basal
      forebrain and striatum, trkA and choline acetyltransferase mRNAs showed identical
      patterns of expression, supporting the view that trkA expression is confined to
      cholinergic population in these areas. In contrast, cholinergic neurons of the
      medial habenula did not express trkA mRNA. Our findings suggest the existence of
      previously undiscovered populations of non-cholinergic, NGF responsive
      populations in the thalamis.

PMID- 8369490
TI  - Theta-like activity in hippocampal formation slices: cholinergic-GABAergic
      interaction.
AB  - Brain slice preparations obtained from the rat were used to study cholinergic
      GABAergic interaction in mechanisms responsible for production of theta-like
      activity in hippocampal slices maintained in vitro. Bicuculline, a GABA-A
      antagonist, applied at 25 microM facilitated the effect of low concentration
      carbachol (25 microM) in inducing theta-like oscillations. At 100 microM,
      bicuculline increased the amplitude of carbachol-induced theta-like slow waves.
      This carbachol-bicuculline induced field potential was antagonized by a
      muscarinic blocker, atropine sulphate, and a GABA-A agonist, muscimol. These
      results provide in vitro evidence for cholinergic-GABAergic interaction in the
      production of hippocampal theta-like slow waves.

PMID- 8369491
TI  - Trans-azetidine-2,4-dicarboxylic acid activates neuronal metabotropic receptors.
AB  - The expression of metabotropic glutamate receptors (mGluRs) in primary cultures
      of cerebellar granule neurones can be: (i) modulated by the degree of
      depolarization during the culture period, rendering neurones differently
      sensitive to agonist-stimulated inositol phosphate (IP) hydrolysis; (ii) down
      regulated by specific mGluR agonists. In this culture the new rigid glutamate
      analogue, (+/-)-trans-azetidine-2,4-dicarboxylic acid (t-ADA) and the known mGluR
      agonist 1S,3R-aminocyclopentane-1,3-dicarboxylic acid (1S,3R-ACPD) stimulated IP
      formation in line with the depolarization-modified expression of mGluR1. However,
      the two compounds caused different patterns of mGluR down-regulation. The effects
      of t-ADA and 1S,3R-ACPD were also tested on transformed human embryonic kidney
      293 cells transfected with mGluR1. Only 1S,3R-ACPD, but not t-ADA, stimulated IP
      hydrolysis, suggesting that t-ADA acts on a subtype of metabotropic receptors
      different from mGluR1. Hence, t-ADA might prove useful in differentiating the
      function of various mGluR subtypes.

PMID- 8369492
TI  - Effects of coencapsulated NGF and GM1 in rats with cortical lesions.
AB  - Nerve growth factor (NGF) and monosialoganglioside GM1 were microencapsulated in
      biodegradable co-polymer poly(L-lactide):co-glycolide and administered locally to
      rats with unilateral cortical devascularizing lesions. Microcapsules were placed
      directly onto the lesioned cortical surface and rats were sacrificed 30 days post
      operatively. Biochemical and quantitative immunocytochemical analyses revealed
      effective protection from degenerative changes of nucleus basalis magnocellularis
      (NBM) cholinergic neurones on the lesioned side as well as a significant increase
      in choline acetyltransferase activity in the frontoparietal cortex surrounding
      the lesion. Results of this study strongly suggest that the topical application
      of microcapsules of a biodegradable polymer containing a mixture of two
      neuroprotective factors is a viable alternative to the use of osmotic minipumps
      for delivery of these agents into the CNS. Indeed, this approach might find
      clinical applications.

PMID- 8369493
TI  - Purkinje cell responses in the anterior cerebellar vermis during Pavlovian fear
      conditioning in the rabbit.
AB  - Extracellular single-unit recordings of Purkinje cells in the anterior cerebellar
      vermis (ACV) of the rabbit found evidence of short-latency (20-30 ms)
      differential responses to discriminatively-conditioned auditory stimuli during
      Pavlovian fear conditioning procedures. These differential unit responses
      appeared to be a function of learning as differential ACV Purkinje cell responses
      were not observed in naive (untrained) animals. Some of these evoked
      neurophysiological responses were also correlated with the behavioral conditioned
      autonomic response. (CAR); a conditioned bradycardiac response. These
      electrophysiological data, coupled with previous lesion results, suggest that the
      ACV is part of an important neural circuit for Pavlovian conditioned bradycardia.

PMID- 8369494
TI  - Hypothalamic modulation of Purkinje cell activity in the anterior cerebellar
      vermis.
AB  - Intricate anatomical connections exist between the cerebellar vermis and the
      hypothalamus. This study examined the effects of electrical microstimulation of
      the hypothalamus on Purkinje cell activity in the anterior cerebellar vermis
      (ACV) in the awake rabbit. Single-pulse stimulation of the hypothalamus evoked
      robust, short-latency modifications of Purkinje cell discharge. Heterogeneous
      response profiles were observed with cells demonstrating patterns of either
      unimodal excitation, biphasic excitation/inhibition or complex triphasic
      responses. These results support the hypothesis that the hypothalamus and ACV are
      functionally interactive, and may promote further understanding of the role of
      the ACV in emotional behavior and autonomic responses.

PMID- 8369495
TI  - A new brain stem pathway for vocal control in the zebra finch song system.
AB  - Projections from the telecephalic vocal control nucleus robustus archistriatalis
      (RA) to the brain stem were studied with anterograde and retrograde tracers in
      adult male Zebra finches. A previously undescribed projection to the
      ventrolateral medulla that originates in a dorsal subregion of the RA was found,
      in addition to the known projections to the tracheosyringeal portion of the
      hypoglossal nucleus (nXIIts) and to the dorsomedial nucleus of the
      intercollicular complex (DM), a mesencephalic vocal area. The DM was also found
      to project to the same area of the lateral medulla, which in turn projects to the
      nXIIts. This area in the lateral medulla includes the nucleus ambiguus, and may
      be of a pathway that links the telencephalic vocal pathway with respiratory
      control areas.

PMID- 8369496
TI  - Stimulation of glycolytic key enzymes in cerebral cortex by insulin.
AB  - In adult male Wistar rats, a test was conducted to find whether or not insulin,
      administered intracerebroventricularly, would stimulate the activities of the
      glycolytic key enzymes hexokinase and phosphofructokinase in brain tissue as in
      non-neuronal tissue. The data clearly demonstrated an increase in these enzyme
      activities in cerebral cortex by approximately 20% after 80 mU insulin, whereas
      the increase in the hippocampus was just short of statistical significance. It is
      concluded that insulin controls glycolytic flux in the brain, and the suggestion
      that any perturbation in insulin signal transduction has severe impacts on brain
      glucose metabolism seems justified.

PMID- 8369497
TI  - Laboratory methods for diagnosing and monitoring HIV infection.
AB  - The authors provide a brief review of laboratory methods used to diagnose
      infection, monitor HIV disease progression, and monitor response to treatment in
      the HIV-infected person. Included are descriptions of the characteristics of the
      HIV virus, and the immune damage that results from HIV infection. The authors
      describe the antibody tests, tests of the virus, "surrogate markers" of disease
      progression, and immune parameters. Nurses' understanding of these tests will
      facilitate effective patient monitoring and education.

PMID- 8369499
TI  - Evaluation of community-based nurse case management activities for symptomatic
      HIV/AIDS clients.
AB  - The purpose of this study was to evaluate case management activities performed by
      nurse case managers in the California Pilot Care and Waiver Projects for HIV/AIDS
      patients. Nurse case managers, social workers, and site directors completed a 62
      item survey. Significant differences appeared in ratings among the groups on five
      items. The nurse case managers responding to the survey indicated that a wide
      variety of nursing skills are used to provide case management services to persons
      living with AIDS and AIDS-related complex. This survey validates the
      interdisciplinary case management model in a community-based HIV population.

PMID- 8369498
TI  - Stage of illness, level of HIV symptoms, sense of coherence and psychological
      functioning in clients of community-based AIDS counseling centers.
AB  - The psychological functioning of HIV-infected individuals in community
      populations has taken on new meaning and urgency for healthcare policymakers
      responding to the special challenges of the AIDS epidemic. The authors' objective
      is to test several hypotheses that predict depression and anxiety in adults
      infected with HIV. Data were obtained from 156 HIV-infected adults (age > or =
      18) who sought support, counseling, and maintenance services from one of three
      HIV care and referral centers in the Mid-South. The results of the study
      emphasize the relative importance of perceived physical symptoms over stage of
      illness for psychological functioning among adults with HIV.

PMID- 8369500
TI  - A call for help: collaborative nursing research.
AB  - Key issues related to HIV nursing research are the focus of this literature
      review. Results of two prior literature reviews are combined with the author's
      current review to serve as a basis for discussion. Findings indicate that further
      research is needed, particularly in the area of physiological responses to
      nursing care. Collaboration between clinicians and researchers is viewed as the
      most effective way to conduct HIV nursing research. Suggestions related to ways
      of facilitating collaborative research are discussed.

PMID- 8369501
TI  - Pain characteristics and their management in persons with AIDS.
AB  - Discussion of pain problems in persons with AIDS has been limited in medical and
      nursing literature, yet pain is a major source of suffering and concern for
      patients. Common pain characteristics are described in 100 persons with CDC
      defined AIDS, using the 1987 definition. The two most frequently cited types of
      pain for both drugs users and nondrug users with AIDS were abdominal pain and
      neuropathic pain. Drug users experienced pain due to esophagitis and headaches
      more frequently than nondrug users, while nondrug users experienced Kaposi's
      sarcoma-related pain more often. Treatment responses were individualized, with
      drug users requiring more frequent use of opiates. General treatment strategies
      are suggested with special emphasis on the unique needs of PWAs.

PMID- 8369502
TI  - Atovaquone.

PMID- 8369503
TI  - Addressing the concerns of HIV-infected individuals.

PMID- 8369504
TI  - Don't forget the invisibles.

PMID- 8369505
TI  - Building bridges.

PMID- 8369506
TI  - Drugs are not enough. Failure of short-course chemotherapy in a district in
      India.

PMID- 8369507
TI  - Imaging and lung disease: uses and interpretation.
AB  - Diagnostic imaging has undergone a profound revolution since the first computed
      tomography (CT) unit was conceived in 1971; CT is now an integral part of daily
      practice in thoracic radiology, and has reached a relative technological
      maturity. Magnetic Resonance Imaging (MRI) has been introduced more recently.
      Technical difficulties still exist and are related to cardiac and respiratory
      motion. The storage-phosphor-based computed radiography system provides several
      advantages, including compensation for variations in exposure, but is still under
      evaluation especially in bedside radiography. Nevertheless careful plain film
      analysis still remains an important examination, and should be done before
      special procedures are taken to answer specific questions. Routine chest
      radiography is still the most frequent method of imaging employed today.
      Radiographic studies can suggest airway pathology such as atelectasis,
      endobronchial neoplasia or bronchiectasis, but CT provides a unique strategy for
      the localization and characterization of bronchial and pulmonary parenchymal
      disease. The most important role of CT is to determine, localize and characterize
      patterns within the pulmonary parenchyma, and correctly identify bronchiectasis
      even when bronchography is equivocal. In lung cancer, imaging has an important
      role in accurate staging with regard to the correct selection of patients and
      evaluation of prognosis. CT is one of the major tests used for staging. The
      staging system now adopted worldwide is based upon AJCC and ATS classification,
      and has two major components: anatomic extent of the disease (TNM) and cell
      types. The role of MRI with regard to lung cancer is not precisely determined.
      MRI can play a complementary role in the staging of lung cancer in cases of
      superior sulcus tumour; pericardial involvement, tumoral extension in subcarinal
      region and invasion of the superior vena cava. The radiologic detection of the
      solitary nodule is a difficult charge for the radiologist; CT provides the
      precise localization of the nodule and is reliable for analysing radiologic
      features such as calcification, cavitation, and spiculated borders. The problem
      remains of the discovery of an incidental benign pulmonary nodule in the patient
      with an extrathoracic malignancy, and often necessitates percutaneous biopsy
      under CT guidance. The evaluation of diffuse lung disease lies on pattern
      recognition. Chest radiography is the initial tool for diagnosis, high resolution
      CT (HRCT) can provide routine visualization of structures of less than 500 mu.
      HRCT can be useful in formulating a differential diagnosis with recognition of
      pattern and distribution of the disease.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8369508
TI  - The HIV epidemic and its effect on the tuberculosis situation in The Netherlands.
AB  - To determine the influence of the HIV (human immunodeficiency virus) epidemic on
      the tuberculosis situation in the Netherlands, we made a retrospective analysis
      of all reported tuberculosis cases from 1984 through 1990. We studied the course
      of the tuberculosis incidence in the Netherlands among the group at highest risk
      for HIV infection (Dutch males, 25-49 years of age, in Amsterdam). This was
      compared with the course among same-age Dutch males in areas with lower risk for
      HIV infection and among other-age Dutch males in Amsterdam. The tuberculosis
      incidence among Dutch males aged 25-49 years in Amsterdam increased from 16.1 in
      1984 to 34.7 per 100,000 in 1990 (chi 2 for trend, P < 0.01). The incidences
      among Dutch males in other places of residence in this age group and among other
      age Dutch males in Amsterdam remained stable or decreased during the same period.
      As this increase could not be ascribed to tuberculosis among other risk groups,
      it appears to be related to the HIV epidemic among male homosexuals. Our results
      indicate that, even in a country where the prevalence of tuberculous infection is
      low, an increase of tuberculosis among certain subgroups can be observed as the
      result of the HIV epidemic.

PMID- 8369509
TI  - Bacteriology and drug susceptibility of tuberculosis at St Vincent's Hospital,
      Melbourne 1962-1991.
AB  - 39,000 specimens were examined for the growth of Mycobacterium tuberculosis over
      a 27-year period (1962-1989) at St Vincent's Hospital, Melbourne. The culture
      positive rate was 2.0% overall but was as high as 3.5% for tissue specimens and
      less than 1% for specimens of pleural fluid. There were 329 culture positive
      patients over a 29-year period (1962-1991) of whom 34 (10.5%) yielded an isolate
      resistant to at least one anti-tuberculosis drug and 19 (5.8%) were resistant to
      isoniazid. An overall increase in the rate of drug resistance together with
      important ethnic group differences were noted.

PMID- 8369510
TI  - Six years' experience with the discontinuation of BCG vaccination. 1. Risk of
      tuberculosis infection and disease.
AB  - BCG vaccination programmes were introduced into Czechoslovakia 40 years ago under
      a quite different epidemiological situation than that of today. Compulsory mass
      BCG vaccination of infants born in a selected area was discounted in 1986, except
      for those having a high risk of contracting tuberculosis or those whose parents
      expressly asked for it. The aim of this study was to ascertain the risk of
      tuberculosis infection and breakdown rate from infection to disease in 165,854
      newborns following a period of 6 years. The average risk of infection in children
      aged 0-6 years was low (0.046%). No identifiable factors increasing the risk of
      infection were found. Primary tuberculosis was diagnosed in 31 children
      (7/100,000 persons/year); this corresponds to a 15.5% breakdown rate from
      infection to disease. The majority of patients were symptom-free with minimal
      disease and detected in the course of regular check-ups. These findings indicate
      that the change from mass BCG vaccination to selective vaccination of high risk
      newborns can be recommended. Nevertheless social and economic aspects which
      involve migration, living conditions and the attitudes of the population, as well
      as of medical staff, to vaccination should also be taken into consideration.

PMID- 8369511
TI  - Oral corticosteroids in patients with mild Pneumocystis carinii pneumonia and the
      acquired immune deficiency syndrome (AIDS).
AB  - OBJECTIVE: To assess the effect of oral corticosteroids in patients with mild
      Pneumocystis carinii pneumonia and the acquired immune deficiency syndrome
      (AIDS). DESIGN: Prospective, double blind, placebo controlled, randomized trial.
      METHODS: Included were AIDS patients having their first episode of P. carinii
      pneumonia, who had no other known active pulmonary pathology, who had no
      contraindications for corticosteroids and who had received no other anti-P.
      carinii medications for more than 48 h. Subjects received either prednisone, 60
      mg/day for 7 days, followed by a progressive tapering over 14 days, or identical
      placebo. The present analysis pertains to patients with mild P. carinii pneumonia
      as defined by a baseline resting oxygen saturation greater than 90% and a
      decrease in oxygen saturation during exercise while breathing room air of not
      less than 5 percentage points. Early deterioration, the end-point of the trial,
      was defined as a 10% decrease from baseline oxygen saturation on day 3 or
      thereafter. RESULTS: At study termination, there were 12 subjects in the placebo
      group and 11 in the corticosteroid group. Baseline characteristics were not
      statistically different between the treatment groups. Early deterioration
      developed in 7 and 1 patients in the placebo and corticosteroid groups
      respectively (P = 0.027). In addition, by day 3, a number of parameters were less
      favorable in the placebo group relative to the corticosteroid group including
      median oxygen saturation (85% vs 97%; P = 0.003), lactic dehydrogenase (1514 vs
      763; P = 0.013), median respiratory rate (30 vs 22; P = 0.003), median heart rate
      (100 vs 81; P = 0.002), and median temperature (39 vs 37; P = 0.024). Even though
      patients suffering early deterioration in the placebo group were switched to
      corticosteroids, significant differences between the groups remained at day 30
      with regard to exercise tolerance. More than half of patients assigned to the
      corticosteroid group exercised for a median of 6.5 min on day 30 (P = 0.017).
      CONCLUSION: Oral corticosteroids prevent early deterioration and increase
      exercise tolerance in patients with mild AIDS-related P. carinii pneumonia as
      defined on the basis of pulse oximetry.

PMID- 8369512
TI  - Critical assessment of smear-positive pulmonary tuberculosis patients after
      chemotherapy under the district tuberculosis programme.
AB  - This is a status report of a retrospectively assembled cohort of 3357 smear
      positive patients initiated on anti-tuberculosis chemotherapy in the North Arcot
      district between April 1986 and March 1988. The patients were contacted once at
      their homes between November 1988 and June 1989 (6 and 36 months after start of
      treatment), and information on their status, including death, could be obtained
      from 76% of them. Regimens were selected by the patients. 2306 (69%) had accepted
      short course regimens (SCC) and 1051 (31%) had been started on standard
      chemotherapy (non-SCC), 43% and 35% in SCC and non-SCC respectively had completed
      80% or more of their treatment. Overall mortality was 28%. Of those remaining,
      31% had active disease and were excreting bacilli, among which 65% of the
      cultures were resistant to isoniazid and 12% to rifampicin. Combined resistance
      to isoniazid and rifampicin was seen in 4% and to isoniazid and streptomycin was
      seen in 19%. A significant finding was that even among those who had taken less
      than 50% of their treatment, 56% were bacteriologically negative. However,
      inadequate or irregular chemotherapy resulted in over four times the mortality
      and about twice the rate of smear positivity as compared with those taking
      adequate chemotherapy. No comparisons are made between patients on short-course
      and standard regimens as the patients selected their treatment and the groups are
      not comparable.

PMID- 8369513
TI  - The role of bacterial super infection in extensive pulmonary tuberculosis. Data
      from protected brush cultures in untreated patients from the University of South
      Alabama Medical Center, Mobile, Alabama, USA.
AB  - Pulmonary tuberculosis (TB) and bacterial pneumonia are both characterized by
      fever, cough, and purulent sputum production. Although TB alone can cause these
      symptoms, the possibility of a concomitant bacterial pneumonia has led some
      clinicians to treat these patients empirically with antibacterial agents. Neither
      the benefit of such empiric antibiotic therapy nor transtracheal aspirate
      cultures from patients with pulmonary TB have yielded consistent results.
      Consequently, we performed a prospective study to obtain lower airway secretions
      via a bronchoscopic protected specimen brush (PSB) technique for quantitative
      aerobic and anaerobic cultures from untreated patients with extensive pulmonary
      TB (defined as cavitary disease or involvement of > or = 3 segments). We obtained
      bronchoscopic samples from 3 untreated men aged 21, 61, and 60 years with
      extensive pulmonary TB. There was no significant bacterial growth (aerobic or
      anaerobic) from the specimens obtained. These results, therefore, do not support
      the hypothesis that bacterial pneumonia is a common concomitant of extensive
      pulmonary TB.

PMID- 8369514
TI  - Negative sputum smear results in HIV-positive patients with pulmonary
      tuberculosis in Lusaka, Zambia.
AB  - During recruitment to a prospective study of tuberculosis patients in Lusaka,
      Zambia, 109 had pulmonary disease proven by sputum culture for Mycobacterium
      tuberculosis, of whom 72 were HIV-1 antibody-positive and 37 were HIV-negative.
      Among these culture-proven cases, 43% of the HIV-positive patients had a negative
      sputum smear, compared with 24% of the HIV-negative cases. There was a strong
      trend towards lower grade or negative sputum smear in the HIV-positive group (P =
      0.003). HIV-positive cases also had lower colony counts on culture and colonies
      took longer to appear. The findings imply that cases of HIV-associated pulmonary
      tuberculosis may frequently be missed and emphasise the need for new diagnostic
      methods.

PMID- 8369515
TI  - The use of monoclonal antibodies to identify mycobacteria grown in culture in
      Zimbabwe.
AB  - Monoclonal antibodies (Mabs) were used in an ELISA system to identify 462
      mycobacterial isolates from clinical specimens in Zimbabwe. Cultures of
      mycobacteria were either sonicated or mechanically homogenised and used to coat
      the wells of microtitre plates. The mouse Mabs used reacted to lipoarabinomannan,
      an antigen common to all species of mycobacteria, to a 16 kDa protein specific to
      members of the Mycobacterium tuberculosis complex, to a glycolipid found in the
      cell wall of M. kansasii and to a glycolipid found in the cell wall of members of
      the M. avium-intracellulare complex. On the basis of serologic reactivity 443/462
      (94%) isolates were identified as M. tuberculosis, 6/462 (1%) were identified as
      M. avium-intracellulare and 7/462 (2%) were identified as M. kansasii. The
      remaining 16 isolates gave negative reactions with each of the monoclonals,
      except that reactive with lipoarabinomannan. On the basis of biological tests on
      the 13 of the isolates that were available, 6 were identified as M. tuberculosis
      and 3 as M. bovis. In each of these the optical densities in the ELISA with at
      least one of the Mabs directed against the 16 kDa protein, was within 0.2 units
      of the cut off value. 4 isolates were not identifiable using biological tests in
      our laboratory. Each of the available isolates identified serologically as M.
      avium-intracellulare or M. kansasii gave biological reactions consistent with
      this identification. This study has shown Mab-ELISA to be a reliable means of
      rapidly identifying large numbers of mycobacterial isolates in a reference
      laboratory in Zimbabwe.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369516
TI  - Detection of antigens of Mycobacterium tuberculosis in patients of infertility by
      monoclonal antibody based sandwiched enzyme linked immunosorbent assay (ELISA).
AB  - A sandwich ELISA to detect specific protein antigens of Mycobacterium
      tuberculosis was developed by using polyclonal anti-BCG rabbit antibodies as the
      primary capture antibodies. The mycobacterial antigens were detected with
      horseradish peroxidase conjugated monoclonal antibodies (P 6) as secondary
      antibodies. The enzyme was detected by using 1,2 Phenylenediamine dihydrochloride
      (OPD) and Hydrogen peroxide as substrate. The antigen could be quantitated
      through linear regression analysis with lower detection limit of 1.25
      micrograms/ml. 50 consecutive cases of infertility were examined by laparoscopy
      and tested for the presence of the antigen in the serum. Mycobacterial antigen
      could be detected in 9 of the 12 cases with definitive diagnosis of tuberculosis,
      5 of the 23 where the diagnosis of tuberculosis was probable and in only 1 of 15
      patients who had no laparoscopic abnormalities indicative of tuberculosis.

PMID- 8369517
TI  - Pancytopaenia associated with disseminated tuberculosis, reactive histiocytic
      haemophagocytic syndrome and tuberculous hypersplenism.
AB  - A 38-year-old black male is reported with a rare combination of disseminated
      tuberculosis together with a reactive histiocytic haemophagocytic syndrome and
      tuberculosis hypersplenism. Tuberculosis and histiocytic haemophagocytosis were
      diagnosed on bone marrow examination. The pancytopaenia and splenomegaly which
      were present on admission did not resolve despite adequate anti-tuberculosis
      chemotherapy. Prior to splenectomy the patient continued to have a marked
      thrombocytopenia which resulted in recurrent bouts of epistaxis; splenectomy
      together with tuberculostatic therapy was curative for the condition. The patient
      remains well with normal blood counts 1 year later.

PMID- 8369518
TI  - Disseminated skeletal tuberculosis with skull involvement.
AB  - We report a patient with widespread osteolytic lesions, including extensive
      involvement of the skull, due to Mycobacterium tuberculosis. Response to
      treatment with antituberculosis drugs was slow with appearance of new lesions
      while on therapy despite a sensitive organism. Excision of diseased skull bone
      was eventually done, after which no new lesions appeared in the ensuing 14
      months.

PMID- 8369519
TI  - Antituberculosis drug-induced hepatitis and HBsAg carriers.

PMID- 8369520
TI  - Larger axillary metastases in obese women and smokers with breast cancer--an
      influence by host factors on early tumor behavior.
AB  - To better define the influence by host factors on very early breast cancer
      behavior, we retrospectively analyzed nodal status, diameter of the largest
      axillary metastasis (M), diameter of the primary tumor (P), the M/P ratio, tumor
      estrogen receptor status, age, obesity, and smoking habits in 176 women with node
      positive breast cancer. Both M/P ratios and M were larger in the 72 obese women
      and in the 40 nonobese smokers than in the 64 nonobese nonsmokers after control
      for other factors. Step-wise regression analysis demonstrated independent
      associations between M/P ratios and obesity (p = 0.0002), larger primary tumors
      (p < 0.0001), more positive nodes (p < 0.0001), and smoking (p = 0.0268), as well
      as between M and obesity (p = 0.0201), larger primary tumors (p = 0.0093), and
      more positive nodes (p = 0.0001). Among the 104 nonobese women, smoking was
      associated both with larger M (p = 0.0257) and larger M/P (p = 0.0055). Our
      observations suggest more rapid growth by metastases in obese women and smokers
      with breast cancer, as well as earlier metastasis from their primary tumors.

PMID- 8369521
TI  - Epidermal growth factor receptor in breast cancer: correlation of quantitative
      immunocytochemical assays to prognostic factors.
AB  - Immunocytochemical assays for EGFR were performed on frozen sections from breast
      carcinomas (n = 209). Results were evaluated by computer assisted image analysis
      to accurately define the percentage of immunostained surface and the mean optical
      densities. Thirty seven percent (n = 77/209) of the tumors were EGFR positive,
      but about one third of them were faintly reactive (35%). No significant
      relationship was observed between EGFR tumor content and patient age, tumor size,
      histological type, histoprognostic grade, or axillary lymph node status. A
      negative correlation was observed with the results of estrogen receptor
      immunocytochemical assays and a positive correlation with immunodetectable
      cathepsin D and Ki 67 antigen evaluated according the same method. No correlation
      was found with HER-2/neu protein, aneuploidy, nucleolar organizor region
      distribution, and nuclear morphometry, also assessed by image analysis. These
      results suggest that immunocytochemical assays assessed on frozen sections and
      evaluated by image analysis are suitable for current and standardized evaluation
      of EGFR which has been previously documented as a prognostic indicator in breast
      carcinomas.

PMID- 8369522
TI  - The pattern of diagnosis of a second primary tumor in the breast.
AB  - One hundred and sixty-seven patients with metachronous bilateral breast cancer
      were diagnosed at the Northern Israel Oncology Center during the years 1950-1989.
      The group at high risk to develop a second breast tumor included Jewish women
      born in Europe whose first tumor was diagnosed when the patient was under the age
      of 55. The mean time interval between tumors was 88 months. Seventy percent of
      the patients were diagnosed within nine years of the diagnosis of the first
      tumor. The characteristics of the 27% of patients with single breast cancers who
      did not comply with follow-up recommendations were compared to those who did
      comply. Patients who were under follow-up had smaller tumor and less lymph node
      involvement. Nevertheless, their survival rate did not differ from those who did
      not keep their follow-up appointments. This was ascribed to the fact that follow
      up procedures for many years used mainly clinical examination and this was not
      enough to decrease mortality. The diagnosis of non-palpable breast cancer by
      routine yearly mammography has proved to reduce mortality in patients over the
      age of 50 with single breast cancers. Therefore, yearly mammography of the
      contralateral breast in patients with single breast tumors must be done in order
      to increase the cure rate of contralateral breast cancer. Less patient delay in
      diagnosis was found before the diagnosis of the second tumor than in patients
      with a single tumor.

PMID- 8369523
TI  - Medroxyprogesterone acetate inhibits the proliferation of estrogen- and
      progesterone-receptor negative MFM-223 human mammary cancer cells via the
      androgen receptor.
AB  - This study demonstrates for the first time, that medroxyprogesterone acetate
      (MPA) inhibits the proliferation of the estrogen and progesterone receptor
      negative mammary cancer cell line MFM-223 via the androgen receptor. MPA is a
      progestin, which is used in the hormonal treatment of disseminated breast cancer.
      It binds to the progesterone, androgen, and glucocorticoid receptor and may exert
      its antiproliferative effects via different receptors. MFM-223 human mammary
      cancer cells contain a very high level of androgen receptors (160 fmol/mg
      protein) and low levels of estrogen, progesterone, and glucocorticoid receptors
      (< 20 fmol/mg protein). This cell line provides therefore a good model system to
      analyze the possible role of the androgen receptor in the action of MPA avoiding
      interference with other steroid hormone receptors. Effective inhibition of
      proliferation is achieved by 10 nM MPA or 1 nM of the androgen
      dihydrotestosterone, corresponding well to the binding affinities of both
      compounds (3.6 and 0.18 nM, respectively). The involvement of the androgen
      receptor was confirmed by competition experiments with antiandrogens.
      Furthermore, MFM-DHT cells, which are an androgen resistant subline of MFM-223
      cells, are also resistant to MPA. This data supports the involvement of the
      androgen receptor in the action of MPA and additionally rules out direct hormone
      independent cytotoxic effects of MPA.

PMID- 8369524
TI  - The influence of a novel cyclopropyl antiestrogen (compound 7a) on human breast
      cancer cells in culture.
AB  - Compound 7a ([Z]-1,1,-dichloro-2,3-diphenyl-2-(4-(2- dimethylamino)ethoxy)phenyl)
      cyclopropane, dihydrogen citrate salt) is a novel cyclopropyl antiestrogen which
      was shown to be an estrogen antagonist without estrogen agonist activity. The
      antiproliferative activity of 7a was examined on estrogen receptor (ER) positive
      MCF-7 and ER-negative MDA-MB-231 human breast cancer cells and A-549 human lung
      cancer cells. Compound 7a inhibited the growth of MCF-7 cells in a dose-related
      manner over a concentration range of 10(-9) to 10(-5) M, but did not alter the
      growth of MDA-MB-231 or A-549 cells. The antiproliferative activity of 7a (10(-7)
      M) on MCF-7 cells was reversed by co-administration of estradiol (10(-8) M). An
      ER-dependent mechanism of action is also supported by the specific ER binding of
      7a in MCF-7 cells observed in this study. A study of cell surface morphology
      using scanning electron microscopy (SEM) revealed that compound 7a at 10(-6) M
      reduced the length and density of microvilli (MV) on MCF-7 cells, which was
      reversed by co-administration of estradiol (10(-8) M). Compound 7a did not alter
      the cell surface morphology of ER-negative MDA-MB-231 cells. In conclusion, 7a
      inhibited the growth of ER-positive MCF-7 cells in an estradiol-reversible
      manner, and had no effect on ER-negative MDA-MB-231 cells or A-549 lung cancer
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369525
TI  - The prognostic effect of histological tumor grade in node-negative breast cancer
      patients.
AB  - The prognostic effect of histological tumor grade was evaluated in 1036 patients
      with early breast cancer (pT1 pN0 M0) entered into a trial comparing mastectomy
      and breast preserving treatment. All analyses were adjusted for the factors
      treatment, patients' age, and tumor size. Tumor grade was defined according to
      Bloom and Richardson based on the sum of scores assigned to each of three
      histological features: 1) degree of differentiation, 2) pleomorphism, and 3)
      mitotic index. The relative importance of these factors with regard to disease
      free survival was evaluated. In univariate as well as in multivariate analyses
      the pleomorphism was the only factor showing a significant effect (univariate: p
      = 0.0024, multivariate: p = 0.015). It was investigated how the factors should be
      combined to define a histological grading score which yields the best possible
      classification of the patients with respect to prognosis. A new grading system
      was defined splitting the patients into three groups: 1) pleomorphism 1; 2)
      pleomorphism 2 or pleomorphism 3 and mitotic index 1; 3) pleomorphism 3 and
      mitotic index 2 or 3. This yields a good classification of the patients with
      respect to prognosis (p = 0.0004). The prognostic effect of this score was
      compared with the effects of the grading systems proposed in the literature.
      According to Bloom and Richardson and in the modified version by Schauer and
      Weiss, grading is based on the sum of scores of the various histological factors.
      Therefore, the strong effect of the pleomorphism was diluted in these grading
      definitions (Bloom and Richardson: p = 0.03, Schauer and Weiss: p = 0.028). The
      grading system proposed by Le Doussal et al. consists only of the scores of
      pleomorphism and mitotic index (p = 0.014). In summary, the factor pleomorphism
      showed a stronger effect on disease-free survival by itself than the grading
      systems proposed in the literature.

PMID- 8369526
TI  - Markers of prognosis in breast cancer--the relationship between binding of the
      lectin HPA and histological grade, SPF, and ploidy.
AB  - Abnormal cellular glycosylation as demonstrated by the binding of a lectin from
      Helix pomatia (HPA) to paraffin-embedded sections has been shown in several
      studies to be associated with aggressive biological behaviour and poor long-term
      patient prognosis in breast cancer. This study aims to address the possibility
      that expression of the HPA binding ligand may be of prognostic significance
      through an association with increased cellular proliferation (as measured by S
      phase fraction and histological grade), anaplasia (reflected in histological
      grade), or ploidy (DNA index). In a 24 year retrospective study, paraffin
      embedded sections of 366 primary breast cancers were stained for binding of HPA.
      All tumours were assessed for histological grade. Flow cytometry was performed on
      all cases for which sufficient tumour tissue was available (358/366 cases) and S
      phase fraction (SPF) and ploidy calculated. Data regarding patient age at
      diagnosis, nodal status, and tumour size were also recorded. Life table analyses
      revealed survival advantage for HPA 'non stainers' in comparison to 'stainers' (p
      < 0.001); for patients with tumours of low grade vs. high grade (p < 0.001); and
      for those with tumours of low SPF vs. high SPF (p < 0.001). No survival advantage
      was shown for those with diploid vs. aneuploid tumours (p = 0.17). No association
      was apparent between HPA binding and grade, SPF, or ploidy (Chi squared values
      not significant). This was confirmed by multivariate analysis in which nodal
      status, tumour size, and SPF were independently predictive of survival. There was
      no confounding effect of grade, SPF, or ploidy upon the correlation between
      survival and HPA binding. HPA was, however, not independently predictive owing to
      its strong association with nodal status. The results of this study suggest that
      the prognostic significance of altered glycosylation, as detected by HPA binding,
      is unlikely to be through an association with proliferative rate, degree of
      anaplasia, or cellular ploidy, but may rather be through a direct association
      with the presence of nodal metastases.

PMID- 8369528
TI  - Long-term follow up of breast cancer patients treated for hypercalcaemia with
      aminohydroxypropylidene bisphosphate (APD).
AB  - No systematic data are available about the long-term follow up of breast cancer
      patients treated with amino-hydroxypropylidene bisphosphate (APD) for
      hypercalcaemia and about the results of APD treatment of recurrent hypercalcaemia
      in these patients. Treatment with intravenous APD (10-15 mg daily until
      normalization of the serum calcium level) normalized serum calcium in 29 of 31
      patients with hypercalcaemia due to advanced breast cancer. Survival in these 29
      patients varied between 8 and 693 days (median 140 days) and 7 patients achieved
      a partial remission or stabilisation of disease during subsequent anti-tumor
      therapy. In 16 of the 29 patients in whom APD treatment was initially successful,
      hypercalcaemia recurred after a median period of 65 days. Eleven of these
      patients received a second course of APD, which was equally successful as the
      first in terms of percentage of patients with normalization of serum calcium,
      total dose of APD needed, and duration to normalization of serum calcium.
      Recurrent hypercalcaemia occurred significantly faster after the second
      successful APD course (median 17 days) than after the first (median 65 days).
      When only patients with progressive disease were taken into account, recurrence
      of hypercalcaemia usually occurred early, both after a first (median 23 days) and
      after a second successful APD course (median 17 days). Normalization of serum
      calcium occurred in 4 of 6 patients receiving a third APD course, in all 3
      patients receiving a fourth, and in 1 of 2 patients receiving a fifth
      course.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369529
TI  - [HIV testing with the informed consent].

PMID- 8369527
TI  - The use of natural interferon alpha conjugated to a monoclonal antibody anti
      mammary epithelial mucin (Mc5) for the treatment of human breast cancer
      xenografts.
AB  - An immunoconjugate composed of natural interferon alpha (nIFN alpha) bound in a
      noncleavable fashion to a monoclonal antibody (MoAb) recognizing a breast
      epithelial membrane mucin (Mc5) was used to to treat xenografts of a human
      mammary carcinoma cell line (MCF-7) growing in nude mice. The immunoconjugate
      (nIFN alpha/Mc5) was administered as 20 intralesional (i.l.) injections to 1 of 2
      xenografts in each animal. It was found that nIFN alpha/Mc5 produced a
      significant enhancement of the growth inhibitory actions of nIFN alpha on the
      injected tumors. Further enhancement was obtained when nIFN gamma or nIFN gamma
      together with Mc5 (at a dose 10 times larger than that present in nIFN alpha/Mc5)
      were added to the immunoconjugate. Biodistribution experiments showed that the
      uptake of 125I-nIFN alpha/Mc5 by the tumors was greater and its elimination
      slower than for 125I-nIFN alpha alone or conjugated to irrelevant mouse IgG1. In
      addition, the immunoconjugate up-regulated the antigenic expression of a breast
      epithelial membrane mucin by the carcinoma cells, an up-regulation which was not
      significantly different from that produced by nIFN alpha alone. The contralateral
      noninjected tumors exposed to systemic levels of the immunoconjugate showed an
      enhancement of antitumor effects, but to a lesser extent than the injected
      tumors. These findings suggest that the enhancement of the growth inhibitory
      action of the immunoconjugate was related to the specific binding of Mc5 which
      targeted the IFN to the carcinoma cells and impeded its elimination. It is likely
      that the targeting was favored by the IFN-mediated up-regulation of antigenic
      expression by the carcinoma cells, thereby producing a cascade of interrelated
      effects. The results of this study point out the feasibility and potential
      usefulness of IFN treatment by means of immunoconjugates as well as the worth of
      pursuing and improving this form of therapy.

PMID- 8369530
TI  - [Prevalence of anti C100-3 and HBsAg in blood donors--comparative study of total
      collected blood units, total collection adjusted to exclude repeat blood
      donations, and in first time blood donors].
AB  - Prevalence of anti C100-3 and HBsAg in donor blood collected at the Hiroshima Red
      Cross Blood Center during the period of Aug., 1990 to July, 1991 was studied in
      three groups--total received blood units (187,532 units) without any adjustment,
      blood units after adjustment by excluding repeat donations of blood units by the
      same donors (142,160 units), and blood units of first time donors (28,596 units).
      The results of the study is summarized as follows. 1) There was no significant
      difference in the prevalence of anti C100-3 between the group comprising the
      total collected units, and the group after the adjustment. This result suggests
      that repeat donors do not necessarily belong to any fixed age group. 2) The
      prevalence of HBsAg is significantly higher in the first time donor group than in
      the other two groups. In both the total blood units group and the group after the
      adjustment, prevalence of HBsAg among older age groups was as low as that of
      younger age groups. This is presumably because of the introduction of selective
      exclusion of HBsAg positive subjects from donors since 1980. When data from blood
      donors are used for the epidemiological studies of viral infection among healthy
      subjects, it is important to know the characteristics of such donor subjects and
      whether or not they are pre-screened for the viral markers in question.

PMID- 8369531
TI  - [Efficacy of influenza vaccination and its relationship to daily absentee rate].
AB  - To determine the efficacy of influenza vaccination and it's relationship to
      "daily physical condition", an investigation was carried out in two elementary
      schools and one junior high school. Since children who had many absences during
      the first and second trimesters, tend to have many absentee days in the third
      trimester and during the last year, also, absentee rate during the first and
      second trimesters was considered to be an indicator of "daily physical
      condition". Vaccinated children tended to have lower absentee rates than
      nonvaccinated children during the first and second trimesters. This indicates
      that there is a definite difference between vaccinated and nonvaccinated children
      in terms of "daily physical condition". Children who had many absences during the
      first and second trimesters, also tended to have many absentee days during the
      influenza season, introducing a confounding factor, "daily physical condition",
      when comparisons are made in the absentee rate between vaccinated and
      nonvaccinated children during the influenza season. Careful analysis of these
      data, taking into account their "daily physical condition", showed that
      vaccinated children tended to have lower absentee rates than the nonvaccinated
      during the influenza season. However there was no definite difference between
      vaccinated and nonvaccinated children in length of absentee days during the
      influenza season.

PMID- 8369532
TI  - [Relationships among blood pressure, 24-hour urinary electrolyte excretion, and
      alcohol consumption].
AB  - Relationships among blood pressure (BP), 24-hour urinary electrolyte excretion,
      and alcohol consumption were studied in 104 men and 229 women aged over 30 years
      living in a rural village in Kyoto, Japan. Twenty four hour urine was collected
      for two consecutive days to measure Na, K, Ca, Mg, and creatinine (Cr). In men,
      age, obesity index (OI), Ca/Mg ratio, and (Na.Ca)/(K.Mg) ratio were significantly
      related to BP. In women, diastolic blood pressure adjusted for age and OI, but
      not systolic blood pressure correlated with Na/K. Among male daily drinkers, the
      Ca/Mg ratio and (Na.Ca)/(K.Mg) ratio were significantly increased and K/Cr was
      significantly decreased. Results of path analysis confirmed the relation of BP to
      alcohol consumption and suggests that urinary electrolytes change in hypertensive
      drinkers.

PMID- 8369533
TI  - [Visual acuity testing of three- and four-year old nursery school and
      kindergarten children].
AB  - Visual acuity testing was conducted on 1,531 children in nursery schools and
      kindergartens in Chita district, for the purpose of determining the rate of
      successfully performing the test, as well as the visual acuity of those shown to
      be normal by various ophthalmologic examinations. The rate of successful
      performance of the visual acuity test increased monthly with increasing age, with
      maximum changes seen at 4-5 months after the third birthday. The rate of
      successful performance of the test at the third birthday was 73%, progressively
      increasing up to 95% in the successive 6 months. The rate at the fourth birthday
      became almost 100%. Average of visual acuity of 3.0-year old children was 0.55,
      and for 3.5-year olds was 0.82. The average visual acuity reached 0.88 at 4.0
      years of age, and at 4.5 years of age became 0.97. In view of the results
      obtained, it is concluded that children who could not successfully perform a
      visual acuity test at 3.0-years of age should be tested again at 3.5-years of
      age. Preferably the vision screening should be performed during the period
      between 3.5- and 4.0-years of age, for reliability and efficiency. Accordingly,
      the screening standards should also be changed with consideration given to visual
      development of children of this age.

PMID- 8369534
TI  - [Relationship of proportion of DCO cases in cancer registration to gastric cancer
      screening participation rate and proportion of all referred inpatients diagnosed
      with neoplasm].
AB  - Of all cancer cases registered the proportion where identification is solely from
      death certificates, (DCO-Death Certificate Only), is one of the important indices
      for assessing the accuracy of the cancer registration system. Regional
      differences exist in the proportion comprised of DCO cases. These differences
      were analyzed in terms of the regional differences that also exist in gastric
      cancer screening participation rates, proportion of all referred inpatients with
      diagnoses of neoplasm by place of residence, and proportion of all referred
      inpatients with diagnoses of neoplasm by place of treatment. Up to 65% of the
      regional differences in DCO proportion can be explained by these three factors.

PMID- 8369535
TI  - [Repellent effect of wood odors on mites].
AB  - Since mites are known to react to odor, the repellent effect of wood odors on
      mites was measured with a simple indicative method of mite evasion behavior. This
      experiment confirmed that the odors of three types of trees including Hinoki
      (Chamaecyparis obtusa), Pine (Pinusdensiflora) and Cedar (Cryptomeria japonica),
      had repellent effects on Tyrophagus putrescentiae, Dermatophagoides farinae and
      D. pteronyssinus, mite specics which are comminly found in houses. The effects of
      Lauan (Shorea spp.) and Spruce (Picea sitchensis) were less than those of Hinoki,
      Pine and Cedar in stimulating evasion response. In comparing the evasion
      behaviors of three species of mites to wood odors, the responses of D. farinae
      and D. pteronyssinus seemed to be stronger than those of T. putrescentiae. Very
      little differences in responses between males and females of these mites were
      seen.

PMID- 8369536
TI  - [Assessment of malocclusion among Japanese junior high school pupils of Matsuo,
      Iwate Prefecture using dental aesthetic index (DAI)].

PMID- 8369537
TI  - [Evaluation of personal computer program for measuring energy expenditure in a
      day among college students].

PMID- 8369538
TI  - [Method to confirm the efficacy of health education for hypertensive patients].

PMID- 8369539
TI  - Comparison of sound quality and clarity with asymmetrical peak clipping and
      output limiting compression.
AB  - This study compared the preferences of 12 subjects with mild-to-moderate hearing
      losses for a linear circuit when the type of output limitation could be changed
      between asymmetrical peak clipping and output limiting compression. Through a
      paired-comparison paradigm, subjects rated the sound quality and clarity of
      speech in quiet, speech in noise, and music when the output levels were well
      below saturation and when slight saturation and high saturation occurred. A
      significant preference was found for the output limiting compression for each of
      the three stimuli for both sound quality and clarity. The preference became
      stronger with increases in saturation. The results suggest that if linear hearing
      aids are being used, the output should be limited with compression rather than
      peak clipping.

PMID- 8369540
TI  - Rate, frequency, and intensity effects on early auditory evoked potentials and
      binaural interaction component in humans.
AB  - The binaural interaction component (BIC) of the auditory brainstem response (ABR)
      and BIC of the frequency-following response (FFR) to tonal stimuli were studied
      in normal-hearing adults. The ABR and BIC latencies from all subjects were
      consistently shorter to the click-like sound than to the 2.0 kHz tone burst.
      Increasing stimulus presentation rate produced longer latencies and diminished
      amplitudes of ABR and BIC waveforms. The consequences of rate changes were
      independent of sound level. The FFR and BIC latencies to low-frequency tone
      bursts (0.5 and 1.0 kHz) were minimally affected by rate, but their amplitudes
      were modified. The results are consistent with and reflective of the functional
      characteristics of lower brainstem auditory neurons. The results provide evidence
      that the BIC to tones is differentially sensitive to the rate, frequency, and
      intensity of sounds other than clicks.

PMID- 8369541
TI  - Speech-evoked cortical potentials in children.
AB  - Event-related potentials (ERPs) were obtained to synthesized speech stimuli in 16
      school-aged children (7-11 years) and compared to responses in 10 adults. P1, N1,
      and P2 event-related potentials were elicited by the phoneme /ga/. The mismatch
      negativity (MMN) was elicited by variants of /da/ and /ga/, which differ in the
      onset frequency of the second and third formant transitions. In general, the well
      defined N1/P2 complex characteristic of the adult response, was not found in
      children. Waves P1 and N1 had longer peak latencies in children than in adults.
      Wave P2 amplitude was smaller in children than in adults. In contrast to the
      often poorly delineated earlier cortical potentials, the MMN was well defined in
      children. Significant MMNs were obtained in all subjects tested. MMN magnitude
      (peak amplitude and area) was significantly larger in the children. No
      significant differences were found in peak latency and duration of the MMN in
      children compared to the adult response. Another negative wave occurring at 400
      msec was also observed in response to the deviant stimuli. This negative wave
      occurred at a similar latency in adults and children and was significantly larger
      and more robust in children. Results support the view that development of ERPs
      does not involve a hierarchical process with respect to latency. That is, earlier
      occurring waves do not necessarily mature before later occurring waves. The
      latencies of P1, N1, and P2 and overall morphology of these waves may provide a
      measure of maturation of central pathways. The early development of the MMN, its
      apparent robustness in school-aged children, and its reflection of the processing
      of acoustic differences in speech stimuli suggest its possible use in the
      assessment of central auditory function.

PMID- 8369542
TI  - Some factors affecting assessment of hearing handicap in the elderly.
AB  - In 42 elderly hearing-impaired persons we compared the patient's self-assessment
      of hearing handicap with the assessment made by the patient's significant other.
      In general, patients tended to rate themselves as less handicapped than did their
      significant others. The difference was not affected by degree of loss but was
      affected by slope of loss and by the presence of central auditory processing
      deficit. Results support the value of the handicap assessment by the significant
      other in understanding the communication problems of the elderly patient.

PMID- 8369543
TI  - Effects of audiometric threshold step size on proposed ANSI S12.13 outcomes for
      characterizing hearing conservation program effectiveness.
AB  - Audiometric records of 213 employees with low noise exposure were selected from
      the public domain data base underpinning Draft American National Standards
      Institute (ANSI) S12.13-1991 Standard Evaluating the Effectiveness of Hearing
      Conservation Programs. Records were selected from an ANSI S12.13 "control" group
      demonstrating raw audiometric thresholds in 1-dB steps, presumably resulting from
      self-recording audiometry. Raw audiometric data were rounded to the nearest 5-dB
      step, and ANSI S12.13 analysis protocols were applied to both raw and rounded
      data sets. The magnitude of all proposed ANSI test statistics increased with
      audiometric step size. Percent worse sequential and percent better or worse
      sequential protocols were markedly more sensitive to threshold step size than
      standard deviation of difference thresholds. The direction and magnitude of
      change in these outcomes supports the assumption that criterion ranges in the
      draft standard hold artifactual bias against hearing conservation programs (HCPs)
      collecting audiometric data in 5-dB steps.

PMID- 8369544
TI  - Detecting and remediating external meatal collapse during audiologic assessment.
AB  - We present a case study in which the jaw/mouth-open procedure during air
      conduction testing is employed to both detect and remediate external auditory
      meatal collapse. A prospective investigation was also conducted to compare the
      efficacy of the proposed jaw/mouth-open procedure with that of the traditional
      insert receivers in remediating meatal collapse during audiologic assessment.
      Meatal collapse was present in 6 of the 136 subjects evaluated. In these 6
      subjects, the air-conduction thresholds under supra-aural headphones in the
      jaw/mouth-open condition were similar to those under insert receivers. We discuss
      the implications of this finding in clinical settings where insert receivers are
      not available.

PMID- 8369545
TI  - Prolonged I-III interwave interval in cerebellar astrocytoma.
AB  - We are reporting the case of a 41-year-old female diagnosed with a cerebellar
      astrocytoma. The tumor was detected after the patient was referred for MRI scan
      because of an abnormal ABR. The ABR was unusual as the I-V interwave intervals
      (IWIs) were within normal limits bilaterally, but the I-III IWI was prolonged by
      .40 msec on the left ear in comparison to the right ear. This case report
      illustrates the importance of the I-III IWI in the detection of retrocochlear
      pathology and the nonsequential generation of the components of the ABR.

PMID- 8369546
TI  - Aided masked thresholds: case of deception.
AB  - A case of contaminated functional gain measures from internal hearing aid noise
      is presented and clinical implications addressed. The contaminated functional
      gain measures underestimated real ear insertion gain. Recognition of this source
      of functional gain measurement error is essential for accurate hearing aid
      fitting.

PMID- 8369547
TI  - Confounding binaural interactions.

PMID- 8369549
TI  - The role of extracellular calcium in generating and in phase-shifting the Bulla
      ocular circadian rhythm.
AB  - Since extracellular calcium is known to be involved in the entrainment of the
      circadian pacemaker in the retina of Bulla gouldiana, we have assessed the
      requirement for extracellular calcium in the generation of the circadian rhythm.
      To enable us to assay the state of the pacemaker during low-calcium treatment,
      which often obscures rhythmicity, long-duration pulses of low-calcium artificial
      seawater (no added calcium, 10 mM EGTA, calculated calcium concentration = 4.5 x
      10(-10) M) were applied, and the phase of the subsequent rhythm was measured.
      Pulse treatments started at zeitgeber time (ZT) 6, and durations ranged from 4 to
      72 hr. Although no phase shifts followed pulses ending before the next projected
      dawn (ZT 24), phase delays of up to 4 hr followed pulses ending after projected
      dawn, and delays of up to 8 hr followed pulses spanning two dawns. Some activity
      records exhibited unequivocal circadian rhythmicity during the long low-calcium
      treatments, with phases and periods similar to untreated control eye records;
      this finding suggests that the phase delays observed following long low-calcium
      pulses are attributable to the pulsatile nature of the treatment. These data
      suggest that extracellular calcium is not an essential requirement for the
      pacemaker in generating the circadian rhythm.

PMID- 8369548
TI  - Circadian rhythm in the visual system of the lizard Anolis carolinensis.
AB  - The electroretinogram (ERG) was recorded from free-moving Anolis lizards once per
      hour for 5 days. As in our previous work, the b-wave, but not the a-wave, showed
      a reliable circadian rhythm (CR) in amplitude, with an acrophase near projected
      noon. Both the a- and b-waves showed a CR in peak time (implicit time, or IT),
      with the a-wave IT being longest near midnight, and the b-wave IT at midday.
      Acrophases were shifted when animals were housed on a phase-shifted light-dark
      cycle. The ERG CR was unaffected by removal of the parietal organ, but it was
      virtually abolished by removal of the pineal gland, thus suggesting that pineal
      output (probably melatonin) modulates retinal responses. In addition to the ERG,
      the tectal light-evoked potential exhibited a CR--a finding compatible with a
      circadian variation in retinal output. Lastly, the amplitude of the ERG component
      waveforms showed a seasonal variation, but the ERG CR was constant across the
      year.

PMID- 8369550
TI  - Circannual rhythms in starlings: response of castrated birds to 12-hr days
      depends on photoperiodic history.
AB  - The annual cycle of reproductive function in starlings (Sturnus vulgaris) is
      driven by seasonal changes in daylength and consists of a 6-month period of
      photosensitivity, culminating in maximal gonadal development, followed by a 6
      month period of photorefractoriness. If male starlings are held under a constant
      photoperiod of 12 hr of light per day (LD 12:12), some individuals show
      circannual rhythms of testicular size. Do these rhythms consist of alternating
      periods of photosensitivity and photorefractoriness, and does the response depend
      on whether daylength is increased or decreased to 12 hr? Castrated starlings were
      transferred from natural short days in January (LD 9.5:14.5) to LD 12:12. Plasma
      LH decreased and then remained low for 2.5 years. Most birds molted, some twice.
      Other castrated birds were transferred from long days in August (LD 16:8) to LD
      12:12. Plasma LH increased and then remained high for 15 months. None of these
      birds molted. Young starlings were exposed to LD 12:12 throughout incubation and
      thereafter. Plasma LH remained low until birds were 13 months old. All of these
      birds molted. These results demonstrate, first, that castrated starlings show no
      evidence of alternating periods of photosensitivity and photorefractoriness under
      LD 12:12; and second, that LD 12:12 can be perceived as a long day or a short day
      depending on photoperiodic history, and that young birds with no experience of
      any other daylength perceive LD 12:12 as a long day.

PMID- 8369552
TI  - Animal issues statement of the society for research on biological rhythms.

PMID- 8369551
TI  - Phase control of ultradian feeding rhythms in the common vole (Microtus arvalis):
      the roles of light and the circadian system.
AB  - In their ultradian (2- to 3-hr) feeding rhythm, common voles show intraindividual
      synchrony from day to day, as well as interindividual synchrony between members
      of the population, even at remote distances. This study addresses the question of
      how resetting of the ultradian rhythm, a prerequisite for such synchronization,
      is achieved. Common voles were subjected to short light-dark cycles (1 hr
      darkness with light varying between 0.7 and 2.5 hr); to T cycles (long light-dark
      cycles in the circadian range--16 hr darkness and 3-13 hr light); to light pulses
      (15 min) during different circadian and ultradian phases; and to addition of D2O
      to the drinking water (25%). Short light-dark cycles and D2O were also applied to
      voles without circadian rhythmicity, after lesions of the suprachiasmatic nuclei.
      In these experiments, four hypotheses on synchronization of ultradian rhythmicity
      were tested: (I) synchronization by a direct response to light; (II)
      synchronization via the circadian system with multiple triggers, here called
      "cogs," each controlling a single ultradian feeding bout; and (III and IV)
      synchronization via the circadian system with a single "cog," which resets an
      ultradian oscillator and either (III) originates directly from the circadian
      pacemaker, or (IV) is mediated via the overt circadian activity rhythm. Short
      light-dark cycles failed to entrain ultradian rhythms, either in circadian
      rhythmic or in non-circadian-rhythmic voles; light pulses did not cause phase
      shifts; and in extreme T cycles no stable phase relationship with light could be
      demonstrated. Thus, Hypothesis I was rejected. Changes in the circadian period
      (tau) were generated as aftereffects of light pulses, by entrainment in various T
      cycles, and by the addition of D2O to the drinking water. These changes in tau
      did not lead to parallel, let alone proportional, changes in the ultradian
      period. This excluded Hypothesis II. Both in T-cycle experiments and in the D2O
      experiments with circadian-rhythmic voles, the phase of ultradian feeding bouts
      was locked to the end of circadian activity rather than to the most prominent
      marker of the pacemaker, the onset of circadian activity. This was not expected
      under Hypothesis III, but was consistent with entrainment via activity
      (Hypothesis IV). On the basis of these experiments, we conclude that the most
      likely mechanism of ultradian entrainment is that of a light-insensitive
      ultradian oscillator, reset every dawn by the termination of the activity phase
      controlled by the circadian pacemaker, which is itself entrained by the light
      dark cycle. Neither in circadian-rhythmic nor in non-circadian-rhythmic voles was
      the period of the feeding rhythm lengthened by administration of D2O. This
      insensitivity to deuterium is exceptional among biological rhythms.

PMID- 8369553
TI  - The application of random amplified polymorphic DNA for sandfly species
      identification.
AB  - We have applied the recently developed Random Amplified Polymorphic DNA (RAPD)
      method to produce species-specific, DNA profiles for two sympatric, Venezuelan
      sandfly species, thought to be the vectors responsible for recent outbreaks of
      cutaneous and mucocutaneous leishmaniasis in the Andean State of Tachira.
      Moreover, within the profile, it was possible to identify a diagnostic DNA band
      for Lu. youngi of 0.32 kb. Results showed that the size of this diagnostic DNA
      band remained constant and did not vary with sex or geographical distribution.

PMID- 8369554
TI  - Analysis of mosquito bloodmeals by DNA profiling.
AB  - Human specific genetic markers have been used to profile the human DNA found
      within a mosquito bloodmeal. In this technique, variable numbers of tandem repeat
      (VNTR) sequences are employed to prime amplification of human DNA in the
      polymerase chain reaction (PCR) and the radiolabelled products are analysed by
      high resolution denaturing gel electrophoresis. Matching of DNA profiles allows
      identification of the individual human host. Bloodmeals of 125 female Anopheles
      gambiae Giles mosquitoes, caught dead or alive in verandah-trap huts wherein two
      people had slept overnight protected by intact insecticide-impregnated bednets,
      were analysed: thirty-five out of thirty-nine profiles generated were identical
      to those of the sleepers under the nets. Thus the blood-fed mosquitoes found
      after impregnated nets have been used cannot, in most cases, be explained away by
      entry of already fed mosquitoes into the huts.

PMID- 8369555
TI  - Host feeding preference of Phlebotomus guggisbergi, a vector of Leishmania
      tropica in Kenya.
AB  - Recently the sandfly Phlebotomus guggisbergi was found to be a vector of
      Leishmania tropica causing cutaneous leishmaniasis in the Laikipia focus, Kenya,
      but extensive searches have shed no light on the identity of the rural reservoir
      host(s). In order to discover more about the biology of the vector, a host
      feeding preference study was conducted on wild sandflies in their natural cave
      environment over a 6-month period. Solid state Army miniature (SSAM) traps,
      without light bulb, were suspended over cages with potential hosts or an empty
      cage control. The animals tested included sheep, goat, dog, cat, hamster, rabbit,
      giant rat (Cricetomys gambianus), crested rat (Lophiomys imhausi) and rock hyrax
      (Procavia capensis), all of which (except hamsters) are normally found in the
      vicinity of the study site. Sandfly collections from traps baited with goat,
      sheep, cat, dog, rabbit, or wild rodent species were significantly higher than
      the control, whereas trap collections with hamster and rock hyrax were not
      significantly different from the control. Numbers of sandflies collected from the
      goat, sheep and cat were significantly greater than from the rabbit and rodents.
      The sex ratio also varied between collections: larger animals attracted a higher
      proportion of female P. guggisbergi than did the smaller animals (P > 0.05).
      Therefore greater emphasis should be placed on surveying larger animals to assess
      their status as reservoir hosts for L. tropica in Kenya.

PMID- 8369556
TI  - Semiochemical mediation of oviposition by the phlebotomine sandfly Lutzomyia
      longipalpis.
AB  - Extracts of rabbit food, hay and rabbit faeces elicited a positive oviposition
      response from gravid female Lutzomyia longipalpis sandflies (Diptera:
      Phlebotominae). Combined extract of rabbit food and oviposition pheromone had a
      synergistic effect on sandfly egg-laying, greatly increasing the number of eggs
      laid and resulting in a highly targeted response. Individually tubed flies,
      exposed to the combined extract, were shown to be 3.5 times more likely to
      survive oviposition and laid 2.5 times more eggs than control flies. A laboratory
      oviposition trap baited with the combined extract was tested in a cage and caught
      31 (62%) of 50 gravid L. longipalpis over a 72h period.

PMID- 8369557
TI  - Bloodmeal digestion in the midgut of Phlebotomus papatasi and Phlebotomus
      langeroni.
AB  - Bloodmeal digestion in midguts of the sandflies Phlebotomus papatasi and
      Phlebotomus langeroni (Diptera: Psychodidae) was investigated in optimized assays
      to detect general protease, trypsin and aminopeptidase activities using synthetic
      substrates. Optimal activity occurred at pH 8-9 for all enzymes examined in both
      species. Protease activity peaked at 24-34 h post human bloodmeal in midguts of
      P. papatasi and 34-48 h in P. langeroni; all endo- and exoprotease activities
      were completed by 50 h in P. papatasi compared to 72 h in P. langeroni.
      Hydrolysis of two chymotrypsin substrates was < 2% of trypsin activity in both
      species. Aminopeptidase activity was associated mainly with the midgut wall,
      whereas trypsin activity was confined to the midgut lumen. A feature of digestion
      in P. langeroni was the high level of aminopeptidase recorded within 10 h of the
      bloodmeal.

PMID- 8369558
TI  - Comparison of five tests for the serologic diagnosis of myiasis by Gasterophilus
      spp. larvae (Diptera: Gasterophilidae) in horses and donkeys: a preliminary
      study.
AB  - Sera from 41 horses and 159 donkeys, from twelve States of Mexico, were tested to
      ascertain anti-Gasterophilus circulating antibodies by double immunodiffusion
      (DD), counterimmunoelectrophoresis (CIE), indirect haemagglutination (IH), thin
      layer immunoassay (TIA) and diffusion-in-gel ELISA (DIG-ELISA) methods using
      crude somatic antigen from third instar larvae of G. intestinalis (DeGeer). At
      necropsy, 33/41 horses and 24/159 donkeys were found to be parasitized by G.
      intestinalis and/or G. nasalis (L.). Gasterophilus intestinalis was the species
      most commonly found in the equines. Analysis of the sera from the infected
      animals by DD showed positive results of 21.2% in horses and of 8% in donkeys.
      Screening the sera with CIE gave sensitivities of 69.7% in horses and of 32% in
      donkeys. Examination of the sera by IH showed positive results of 87.9% and of
      48% in horses and donkeys, respectively. Testing the sera with TIA gave
      sensitivities of 93.9% in horses and of 96% in donkeys. Analysis of horses' sera
      by DIG-ELISA showed a sensitivity of 93.9%.

PMID- 8369559
TI  - Climate, satellite imagery and the seasonal abundance of the tick Rhipicephalus
      appendiculatus in southern Africa: a new perspective.
AB  - Recent predictive models for the distribution of the African tick Rhipicephalus
      appendiculatus Neumann, based on the computer packages CLIMEX and BIOCLIM and
      data derived from meteorological satellites, and for the seasonal dynamics of the
      same tick using the computer simulation models ECFXPERT and T3HOST, all have
      their limitations. Statistical analysis of the relationships between the seasonal
      abundance of all three life stages of this tick and climatic and satellite
      derived data from five sites in southern Africa, taken from the literature,
      supports a new perspective that it is the timing of the questing activity of the
      desiccation-vulnerable larvae that determines the pattern of the tick's seasonal
      dynamics. The timing of the activity of nymphs and adults is determined by
      temperature-dependent development rates plus the delaying phenomenon of
      photoperiod-sensitive diapause, the timing and duration of which have evolved to
      achieve maximum generation survival by ensuring the occurrence of eggs and larvae
      during periods of optimal climatic conditions. The most important environmental
      factor appears to be night-time minimum temperature, determining condensation and
      saturation deficit and thus the tick's ability to replenish moisture lost during
      the daytime and so to survive while questing for hosts. It is the larvae whose
      numbers are correlated most closely with these factors, consistent with earlier
      experimental results showing larvae to be most susceptible to desiccating
      conditions. There is a statistical linkage between larval tick numbers and
      satellite imagery, arising from the correlation between larval numbers and
      minimum temperature and saturation deficit conditions, and in turn the
      relationship between these climatic conditions and the subsequent vegetational
      changes monitored by the satellites. Moisture availability to larvae is likely to
      be the critical factor throughout the geographical range of R. appendiculatus,
      but the precise combination of climatic conditions that optimize moisture
      availability and questing tick survival can be expected to vary geographically.
      The relationships between ticks, temperatures and satellite data in parts of
      equatorial Africa have yet to be established. These correlative patterns
      highlight both the critical life stage and environmental factors when trying to
      understand temporal, and ultimately spatial, variations in tick abundance.

PMID- 8369561
TI  - Scanning electron microscopy of the larval instars of Cochliomyia hominivorax.
AB  - Descriptions are given of the morphological features of laboratory-reared first
      to third larval stages of Cochliomyia hominivorax. The pseudocephalon, spines and
      papillae of the segments, and the anterior and posterior spiracles of all three
      larval stages were studied by scanning electron microscope microscope.

PMID- 8369560
TI  - Diethylphenylacetamide: a new insect repellent against stable fly, Stomoxys
      calcitrans.
AB  - This paper reports the results of a laboratory study showing effectiveness of a
      new insect repellent N,N-diethylphenylacetamide (DEPA) against stable fly,
      Stomoxys calcitrans, and compared to N,N-diethyl-m-toluamide (DEET) and dimethyl
      phthalate (DMP). DEPA gave maximum protection time of more than 6 h at 3%
      concentration followed by DEET and DMP.

PMID- 8369562
TI  - Effects of the fungus Aspergillus penicillioides on the house dust mite
      Dermatophagoides pteronyssinus: an experimental re-evaluation.
AB  - In this report the widely-held view that house dust mites benefit from fungal
      contamination of the dietary substratum is re-examined. The performance of
      Dermatophagoides pteronyssinus (Acari: Pyroglyphidae) is documented over two
      successive generations in the presence or absence of the xerophilic fungus
      Aspergillus penicillioides (Hyphomycetales: Moniliaceae). This fungus reduced
      survival, development rate, adult length and fecundity of D. pteronyssinus.
      Detrimental effects of A. penicillioides were proportional to the fungal density.
      Despite the antagonistic effects of A. penicillioides, a requirement for the
      fungus was indicated by the poor performance of fungus-free mites in the second
      generation; sustained culture of D. pteronyssinus in the absence of fungi is
      probably not possible. It is suggested that fungi may alter the particulate
      nature of the substratum to the detriment of house dust mites, but also provide
      micronutrients deficient in the diet.

PMID- 8369563
TI  - Characterization and description of a virus causing salivary gland hyperplasia in
      the housefly, Musca domestica.
AB  - A double-stranded DNA virus was isolated from hyperplasic salivary glands of male
      and female houseflies, Musca domestica L. (Diptera: Muscidae), collected from a
      dairy in Alachua County, Florida, U.S.A. Sodium dodecyl sulphate (SDS)
      polyacrylamide gel electrophoresis (PAGE) of this housefly salivary gland
      hyperplasia (SGH) virus revealed the presence of two major and eight minor
      structural polypeptides. Restriction endonuclease analysis indicated that the c.
      137 kilobase pair DNA was double-stranded. Weekly, sweep-net sampling of the fly
      population throughout the season (May-October, 1991) showed that 1.5-18.5% of the
      dissected flies possessed hyperplasic salivary glands. The virus replicated
      within the nuclei of the salivary gland cells and was transmitted per os to newly
      emerged healthy adult flies.

PMID- 8369564
TI  - Vertical transmission of Toscana virus in the sandfly, Phlebotomus perniciosus,
      via the second gonotrophic cycle.

PMID- 8369565
TI  - Temperature-related activity loss and mobility changes of esterases associated
      with insecticide resistance in Culex pipiens mosquitoes.

PMID- 8369566
TI  - Gonotrophic status of female phlebotomine sandflies collected by three different
      methods in Kenya.

PMID- 8369567
TI  - Leishmania donovani infections in phlebotomine sandflies from the kala-azar focus
      at Aba Roba in Ethiopia: DNA probe compared with conventional detection methods.

PMID- 8369568
TI  - Temperature-induced refractoriness of Aedes aegypti mosquitoes to infection with
      the filaria Brugia pahangi.

PMID- 8369569
TI  - Distribution and taxonomic status of chromosomal forms of the onchocerciasis
      vector Simulium exiguum in central Ecuador.

PMID- 8369570
TI  - Malaria sporozoite rates in Anopheles mosquitoes: theoretical comparability of
      salivary gland dissection with the ELISA detection method.

PMID- 8369571
TI  - Thermal behavior of a human glioma cell line and its response to combinations of
      hyperthermia and lonidamine.
AB  - The effect of hyperthermia and lonidamine, alone and in combination, on the
      clonogenic activity of a human glioma cell line was investigated. The time
      temperature relationship of asynchronous, exponentially growing cells was defined
      in the range of 40-45 degrees C. All survival curves were exponential and an
      Arrhenius plot for heat killing was linear over the temperature range tested,
      with an activation energy of 192 Kcal/mol. The survival curve of lonidamine
      treated cells was also exponential after an initial shoulder. The analysis of the
      interaction between lonidamine and hyperthermia, performed by the isobolar
      method, demonstrated an additivity of response so that the effectiveness of the
      combined treatment was the result of two independent effects. Lonidamine inhibits
      the neoplastic growth mainly through an ATP depletion, but the thermal killing
      was not mediated by the drug-induced changes in the energy status of the cell.
      The effectiveness of the combined treatment was strongly influenced by the
      schedule of administration. In fact, the sequence lonidamine-->hyperthermia made
      the cells less sensitive to heat so that the pre-established end-point, i.e. 30%
      survival, was never achieved whichever combination was used. This "drug-induced
      heat resistance" was not associated with the induction of heat shock proteins,
      but rather with modification of cell cycle. On the contrary, showing a purely
      additive effect, the sequence hyperthermia-->lonidamine allowed achievement of
      the pre-established cell killing (70%), with exposure times (1-2 hr) and with a
      temperature (42 degrees C) generally accepted as clinically achievable.
      Therefore, also considering its low systemic toxicity, lonidamine may be useful
      in reducing the side effects of hyperthermia.

PMID- 8369572
TI  - Patterns of expression of metalloproteinases and their inhibitors in human
      malignant lymphomas.
AB  - Forty-two cases of malignant lymphomas were studied for the expression of matrix
      metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) by Northern blot
      and in situ hybridization. The lymphomas were classified according to Working
      Formulation classification (25 high grade, 15 low grade, and 2 intermediate
      grade). The MMPs studied included: 72-kDa and 92-kDa gelatinases (type IV
      collagenases), interstitial collagenase, PUMP-1 (MMP-7), and stromelysins 1 and
      3. TIMPs included TIMP-1 and TIMP-2. All but one case expressed TIMP-1, and TIMP
      2 transcripts were detected in 35 cases. Among the MMPs, 92-kDa gelatinase was
      expressed most consistently (35 cases), whereas mRNA transcripts of 72-kDa
      gelatinase, interstitial collagenase, and PUMP-1 were detected in only a few
      cases. Stromelysins 1 and 3 mRNAs were not detected in any of the tumors studied.
      However, marked differences in the level of expression of certain MMPs and TIMPs
      were found among different grades of malignant lymphomas. The low grade tumors
      expressed low and relatively constant levels of TIMP-1, TIMP-2, and 92-kDa
      gelatinase transcripts, whereas high grade lymphomas displayed variable amounts
      of mRNAs for TIMPs and MMPs, with a trend toward elevated TIMP-1 and 92-kDa
      gelatinase mRNA levels. In situ hybridization localized TIMP-1 transcripts to
      stromal cells, while 92-kDa gelatinase transcripts were most abundant in "starry
      sky" macrophages and large lymphoma cells. Zymography showed that active 92-kDa
      gelatinase is present in tumor protein extracts and differences in the level of
      the enzymatic activity were seen between low and high grade lymphomas. Our data
      indicate that 92-kDa gelatinase and TIMP-1 expression by human malignant
      lymphomas may play an important role in controlling their biologic
      aggressiveness.

PMID- 8369573
TI  - 2-Alkylsulfonyloxy-3-hydroxy-1,4-naphthoquinones: a novel class of radio- and
      chemosensitizers of V79 cells.
AB  - Four 2-alkysulfonyloxy-3-hydroxy-1,4-naphthoquinone derivatives, VH(1-4), have
      been synthesized as a novel class of bioreductive alkylating agents and tested as
      hypoxic cytotoxins, radiosensitizers, and chemosensitizers of V79 cells. In this
      series, the naphthoquinone is the bioreductive moiety while the sulfonyloxy
      group, as a good leaving group, could lead to alkylations of nucleophilic
      substrates in the cells. All VH-compounds are moderately selective cytotoxins of
      V79 cells with a differential aerobic-hypoxic toxicity of approximately 2, i.e.
      ratio of drug concentrations to give 50% killing for aerobic versus hypoxic
      cells. All derivatives are radiosensitizers of hypoxic V79 cells but only VH-3
      can give a sensitization enhancement ratio of 2.05 at a nontoxic concentration.
      Finally, all VH-derivatives are good chemosensitizers of V79 cells to the aerobic
      toxicity of melphalan, either under hypoxic preincubation without melphalan or
      under aerobic coincubation with melphalan. The dose modification factors were
      approximately 2, at low, non-toxic concentrations.

PMID- 8369575
TI  - Reference listings in cancer research.

PMID- 8369574
TI  - Apoptosis (programmed cell death) and the evaluation of chemosensitivity in
      chronic lymphocytic leukemia and lymphoma.
AB  - Chronic lymphocytic leukemia and lymphoma cells were treated with antitumor drugs
      in vitro and analyzed by flow cytometry to measure the number of apoptotic (AP)
      cells and DNA damage in the cells that escaped apoptotic death. AP cells were
      identified by a high sensitivity of DNA to thermal denaturation, which induced
      binding of antibody to single-stranded DNA, and by decreased stainability of
      cells with the intercalating DNA dye propidium iodide. The appearance of AP cells
      was prevented by Zn++ and inhibited by phorbol ester. AP cells were induced by
      alkylating agents, antimetabolites, and anthracyclines. A linear relationship
      between L-phenylalanine mustard dose and the number of AP cells was observed. A
      synergistic interaction between drugs was detected by an increased number of AP
      cells and by the intensity of DNA damage in non-apoptotic cells. A most
      interesting example of synergism was the combination of alkylating agents with
      fludarabine. Linearity of dose-response curves, and the capability to detect drug
      synergism and to evaluate variable response of cells from different patients to
      single agents and combinations suggest that flow cytometry of apoptosis will
      provide a basis for chemosensitivity tests in leukemia and lymphoma.

PMID- 8369576
TI  - Short- and long-term considerations concerning the management of plaque psoriasis
      with low-dose cyclosporin. Studio Italiano Multicentrico nella Psoriasi (SIMPSO).
AB  - In an open multicenter study, cyclosporin (CsA) at low doses (3 mg/kg/day
      adjusted during the course of treatment on the basis of clinical response and
      tolerability up to a maximum of 5 mg/kg/day) was given to 293 evaluable patients
      with severe plaque-form psoriasis (M/F 215/78, aged 19-80 years, 2-53 years from
      diagnosis) in order to evaluate its safety and efficacy over a median follow-up
      of 7 months of treatment and 3 months after treatment. All patients were
      unsatisfactory responders to conventional topical therapy and had indications for
      systemic treatment. Patients entered the study only if they were within the
      normal range for renal and hepatic function and blood pressure, and were free of
      any clinically obvious immunodeficiencies, malignancies or blood dyscrasia. All
      gave their informed consent. After remission (defined as reduction > or = 75% of
      the body area involved and an improvement of at least 2 points on a 4-point scale
      for desquamation, erythema and infiltration) CsA was slowly tapered off (0.5
      mg/kg/day every 2 weeks) until total discontinuation or the reappearance of signs
      of the disease; the dose of CsA was also varied in the case of any important
      modification in renal and hepatic function of blood pressure. As concomitant
      treatment, white petrolatum was allowed, as well as specific local therapy after
      CsA discontinuation. Considerable improvement (> 50% reduction in the skin area
      affected) was observed in 98%, and only 2% (5 patients) did not respond. Clinical
      remission was achieved in 225 patients (77%): of these, 73% after a median of 2
      months at CsA doses of 2.5-3.49 mg/kg/day, 8% after 4 months at doses < or = 2.49
      mg/kg/day and 19% after 3 months at doses > or = 3.5 mg/kg/day. After remission,
      the gradual withdrawal of the drug over a period of 3 months (0.5 mg/kg/day every
      2 weeks) allowed control over the disease (the absence of relapse) to be
      maintained for a median of 8 months in 133 patients (59%). The topical therapies
      permitted after remission and during the maintenance phase (steroids, inert
      topical agents and exposure to UVB radiation) were used in less than 50% of
      cases. Disease relapse (the reappearance of skin involvement over more than 50%
      of the area affected at baseline) occurred in 92 of the 225 patients achieving
      remission, 24 of whom relapsed a median of 6 months after remission, when CsA had
      been completely withdrawn; the remaining relapses occurred about 4 months after
      remission, during the gradual withdrawal of the drug.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 8369577
TI  - Management of erythrodermic psoriasis with low-dose cyclosporin. Studio Italiano
      Multicentrico nella Psoriasi (SIMPSO).
AB  - Thirty-three patients (M/F 25/8, aged 19-71 years) with severe erythrodermic
      psoriasis entered an open multicenter study to evaluate the efficacy (induction
      and maintenance of clinical remission) and toleratility of long-term treatment
      with cyclosporin. It was given at a maximum initial dose of 5 mg/kg/day (initial
      mean dose 4.2 mg/kg/day), subsequently adjusted during the course of treatment
      according to clinical response, patient tolerability and any modification in
      laboratory parameters or blood pressure, carefully monitored each month. All of
      the patients were unsatisfactory responders to conventional systemic therapy
      (PUVA therapy, retinoids, corticosteroids), free of any clinically obvious
      immunodeficiencies, malignancies or blood dyscrasia and within the normal range
      for renal and hepatic function and blood pressure. At remission (defined as
      complete resolution of erythema in the body area involved), cyclosporin was
      slowly tapered off (0.5 mg/kg every 2 weeks) until total discontinuation or the
      reappearance of signs of disease. As concomitant therapy, white petrolatum in
      association with cyclosporin as well as specific local therapy between
      cyclosporin cycles was allowed. After 6.3 +/- 3.4 months (mean +/- SD),
      cyclosporin doses of 3-5 mg/kg/day had led to complete remission in 67% of
      patients (22/33) in a median time of 2-4 months; in a further 27% of cases,
      considerable improvement in skin involvement was observed, with a reduction of
      more than 70% in comparison with baseline.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369578
TI  - Cyclosporin therapy in psoriasis: recommendations for treatment. Italian
      Multicenter Study Group on Cyclosporin in Psoriasis.

PMID- 8369579
TI  - Cyclosporin versus etretinate: Italian multicenter comparative trial in severe
      plaque-form psoriasis. Italian Multicenter Study Group on Cyclosporin in
      Psoriasis.
AB  - Seventy-six patients with severe diffuse plaque-form psoriasis and a baseline
      PASI score > or = 18 were enrolled in a randomized open study comparing
      cyclosporin 5 mg/kg/day (36 patients) with etretinate 0.75 reduced to 0.5
      mg/kg/day (40 patients) over a period of 3 months (phase 1). The rate, severity
      and time to relapse after the withdrawal of therapy in the 54 patients achieving
      remission were evaluated over the following 6 months (phase 2). Twelve of these
      patients entered an open, uncontrolled phase aimed at defining the safety and the
      strategy of cyclosporin 2.5-5 mg/kg/day maintenance therapy over a further period
      of 9 months (phase 3). Patient tolerability, laboratory parameters and blood
      pressure were carefully monitored every week for the first 3 months and then
      monthly. The only concomitant therapy allowed was white petrolatum. Not only the
      number (35/36 vs. 29/40) but also the speed of remission (20/36 vs. 1/40 at the
      fourth week of treatment) was higher in the cyclosporin than in the etretinate
      group. Both the tolerability and safety of cyclosporin proved to be adequate for
      short-term treatment, all altered clinical or laboratory parameters being
      completely reversible after the withdrawal of therapy. Only 1 of the 36 patients
      in the cyclosporin group prematurely stopped taking the medication because of an
      adverse reaction, as against 7/40 in the etretinate group (1 case of inefficacy,
      1 case of adverse reaction and 5 cases of non-compliance). Six months after the
      discontinuation of the trial drugs, relapses occurred in 13/29 patients in the
      cyclosporin group and in 3/25 in the etretinate group; no 'rebound' was observed
      in any of the relapsing patients. Long-term cyclosporin treatment was both
      efficacious and well tolerated. In conclusion, cyclosporin at doses of 2.5-5
      mg/kg/day administered to reliable, carefully selected patients closely monitored
      in terms of both clinical and laboratory parameters currently produces the
      quickest and more constantly favourable results in patients with severe
      psoriasis.

PMID- 8369580
TI  - Characterization of the family Pasteurellaceae on the basis of cellular lipids
      and carbohydrates.
AB  - Selected strains representing established and newly described taxa in the family
      Pasteurellaceae were investigated for their cellular lipid and carbohydrate
      composition to clarify the taxonomic significance of such features. Methylated
      cellular fatty acids and acetylated derivatives of the cellular carbohydrates
      were determined by capillary gas chromatography using a flame ionization
      detector. In part the carbohydrates were identified by mass spectrometry.
      Phospholipids were determined by thin layer chromatography, the lipoquinones by
      high pressure liquid chromatography. The cellular fatty acid patterns proved to
      be uniform with minor variations, but the separation from the Neisseriaceae and
      from Moraxella was possible. Also the distribution of the phospholipids was
      uniform within the family. The lipoquinone contents were useful for the
      discrimination of groups within the family not necessarily reflecting the degree
      of genomic relatedness. The analysis of the cellular carbohydrates resulted in a
      common sugar pattern with all members of the family and characteristic
      carbohydrate profiles discriminating groups, often to the species level. All of
      the cytochemical features considered were useful for the characterization of the
      family Pasteurellaceae.

PMID- 8369582
TI  - Classification of Pasteurella field strains isolated from farms in Germany using
      traditional methods and DNA-DNA hybridization.
AB  - 410 Pasteurella (P.) field strains isolated from calves and piglets were
      classified according to Bisgaard et al. (1). 376 strains were assigned to P.
      multocida ssp. multocida, 34 of them were ornithine- and trehalose+, and 61 of
      them ornithine- and trehalose-. 4 strains belonged to P. multocida ssp. septica,
      4 to P. multocida ssp. gallicida, 6 to P. avium biovar 2 and 20 to P. canis
      biovar 2. There was no difference in the prevalence of the species in calves and
      pigs. The fact that strains belonging to P. multocida ssp. septica were isolated
      only from calves and P. multocida ssp. multocida ornithine- and trehalose- were
      mostly isolated from piglets could indicate a certain host specificity of these
      isolates. In genotypic investigations 20 field isolates of P. multocida belonging
      to different Carter serotypes, as well as serologically negative strains were
      compared to reference strains in terms of deoxyribonucleic acid (DNA)
      relatedness. The data obtained by filter hybridization revealed a considerable
      degree of genotypic intraspecies heterogeneity within P. multocida. No
      correlations to the respective serotypic classification could be detected.

PMID- 8369581
TI  - Prevalence and biochemical properties of V factor-dependent Pasteurellaceae from
      rodents.
AB  - Organs of 1436 rats and 2839 mice were monitored for V-factor dependent
      Pasteurellaceae. Such bacteria were isolated from 21.2% of rats and from 2.4% of
      mice, respectively. They were most frequently cultured from the deep respiratory
      tract (lungs and trachea). In addition, they were found in the nasal cavity and
      on mucous membranes of the genital and the intestinal tract. 35 phenotypical
      criteria were determined for 429 isolates. Based on these data, groups of
      bacteria showing similar biochemical properties were formed using exploratory
      statistical methods (principal qualitative analysis). The majority of 333
      isolates is represented in a rather homogenous group which has some
      characteristics in common with the Haemophilus parainfluenzae complex. The
      remaining isolates consist of several groups. It was shown by others that some of
      these bacteria are closely related to the yet unnamed Taxon B which forms a genus
      like cluster together with Pasteurella pneumotropica type Jawetz.

PMID- 8369583
TI  - Epidemiology of human infections by Pasteurella and related groups in France.
AB  - A retrospective study of infections due to Pasteurella (P.) and related groups
      was performed between the Pasteurella National Center and Nancy's hospital from
      1985 to 1991. Among the 958 cases recorded, wound infections (bites, scratches
      and punctures) were the common forms of pasteurellosis (66%) caused by P.
      multocida (48%), P. canis (11%), P. dagmatis (5%), P. stomatis (4%), and in few
      cases by groups EF-4 and M-5 (14 and 13%, respectively). In human infections
      unrelated to animal wounds, respiratory tract diseases and bacteremia-septicemia
      were the predominant infections with respectively 19 and 11%, and caused by P.
      multocida. Next in importance were urogenital (2.5%), abdominal (1%) and central
      nervous system (< 1%) infections. The majority of animal bite wound infections
      was treated with penicillins or tetracyclines; with other forms, penicillins and
      cephalosporins were more likely.

PMID- 8369584
TI  - Isolation and characterization of group EF-4 bacteria from various lesions in
      cat, dog and badger.
AB  - Bacteria of Group EF-4 were isolated from local purulent lesions in 7 dogs and in
      5 cats, from pneumonic lungs in 2 additional cats and from internal organs in a
      badger. Results of characterization were compared with those of a human strain of
      Group EF-4a isolated from an infected dog-bite wound. Lungs of 2 necropsied cats
      showed a severe focal necrotizing pneumonia in the various lobes. Organs of the
      badger were typical for a case of septicemia. The organisms were isolated mostly
      in pure culture. Colonies were up to 1.5 mm in size, round, entire, more or less
      yellowish pigmented and non hemolytic. Culture smelled slightly like popcorn. In
      conventional biochemical tests, 12 isolates as well as the human strain were
      shown to belong to Group EF-4a and the 3 remaining strains to EF-4b. Belonging to
      Group EF-4 was confirmed by assimilation tests with the gallery ATB 32 GN of
      BioMerieux. However some differences to other reports were observed when compared
      with results obtained with similar methods. Results of this study seem to
      indicate that bacteria of Group EF-4 are important in veterinary medicine not
      only from an epidemiological but also from an etiological point of view.

PMID- 8369585
TI  - Ecology and significance of Pasteurellaceae in man--an update.
AB  - Within the last decade new knowledge has emerged concerning the significance of
      Pasteurellaceae in man; the classification has undergone some changes, and new
      taxa were described. Haemophilus influenzae serotype b was shown to have a clonal
      distribution that is related to demographic patterns of the human host. Brazilian
      purpuric fever is caused by a special clone of Haemophilus aegyptius. H.
      influenzae biotype IV seems to be a genital pathogen, and may deserve species
      rank. New Pasteurella species have been described, that occur in well known
      pathological foci in man, e.g. bite wounds. Toxigenic P. multocida may occur in
      man also; the significance of toxigenicity in man is not known. The real
      actinobacilli of man, A. ureae and A. hominis are still very rarely reported. In
      order to avoid wrong epidemiological conclusions, correct diagnosis is
      emphasized.

PMID- 8369586
TI  - Detection of an adenylate cyclase gene in Pasteurella species.
AB  - A Pasteurella multocida adenylate cyclase gene has been previously cloned in
      Escherichia coli and sequenced. A 1200 bp HpaI fragment from the coding region
      was used as a probe to analyse the presence of the gene in different Pasteurella
      species and subspecies, Actinobacillus ureae (formerly P. ureae) and group EF-4
      bacteria. Thirty-seven strains were checked for the presence of the gene. It was
      shown that the adenylate cyclase gene was detected only in the species
      Pasteurella multocida.

PMID- 8369587
TI  - Ecology and significance of Pasteurellaceae in animals.
AB  - The reservoir of eighty-one taxa/groups classified with the family
      Pasteurellaceae Pohl 1981 is reviewed based upon published data and own
      investigations. With the exception of certain strains of P. multocida, A.
      pleuropneumoniae and [H.] paragallinarum organisms belonging to this family are
      usually regarded as opportunistic, secondary invaders which under normal
      conditions coexist peacefully with the animal host on mucosal membranes of the
      upper respiratory- and lower genital tracts. Very little is known about factors
      that govern the ecological preferences that certain members of this family show
      for specific surfaces and hosts. Mechanisms of colonization, survival and
      multiplication, invasion and pathogenic action are incompletely understood. The
      significance of Pasteurellaceae in animals and man has recently been reviewed.
      Subsequent publications have underlined the significance of biovars 2 of P. canis
      and P. avium and ornithine negative P. multocida in pneumonia in cattle. In
      addition, differences in pathogenicity have been demonstrated for different
      serovars of [H.] parasuis. The disease potential of many taxa/groups is only
      incompletely known.

PMID- 8369588
TI  - Genetic analysis of Actinobacillus pleuropneumoniae, and comparison with
      Haemophilus spp. Taxon "minor group" and Taxon C.
AB  - The genetic diversity among 52 field isolates, mainly from Australia, and 15
      reference strains of Actinobacillus pleuropneumoniae was examined using
      multilocus enzyme electrophoresis. Thirty three electrophoretic types (ETs) were
      recognised, with a mean genetic diversity per locus of 0.312. Australian strains
      of serovars 1, 2, 5 and 7 belonged to the same clonal lines as strains of these
      serovars in other countries, but distinct clones of serovars 3, 7, 11 and 12 were
      also identified. The type strains of serovars 1, 9 and 11 were placed in the same
      ET. Strains of A. pleuropneumoniae biovar 2 were closely related to biovar 1
      strains. Twenty three isolates which did not react with the typing sera or could
      not be assigned to a single serovar were divided into seven clonal groups. Five
      strains of Haemophilus sp. Taxon "minor group" which were included in the study
      were distinct from A. pleuropneumoniae, and were diverse, being divided into at
      least two major genetic groupings. Two strains of Haemophilus sp. Taxon C were
      placed in another distinct ET.

PMID- 8369589
TI  - Whole cell protein profiling of actinobacillus-like strains classified as taxon 2
      and taxon 3 according to Bisgaard.
AB  - Thirty-nine strains representing all biovars established within the taxa 2 and 3
      complex of Bisgaard and two strains belonging to the avian [P.] haemolytical[A.]
      salpingitidis complex were characterized by one-dimensional SDS-PAGE of cellular
      proteins. The protein patterns, which contained 40 to 45 discrete protein bands,
      were highly reproducible. Numerical analysis of the background protein patterns
      obtained resulted in six major and twelve minor groups (phena). Comparison of the
      phena defined by protein profiling with species/groups previously established by
      DNA: DNA hybridization, chemotyping and "biotyping" showed that the best
      correlation existed between DNA:DNA hybridization and "biotyping". A correlation
      between results obtained from DNA:DNA hybridization and protein profiling was not
      obtained. With a few exceptions, a connection was demonstrated between protein
      profiles and hosts from which the strains belonging to the respective phena
      originated.

PMID- 8369590
TI  - Aspirin and the elderly. Current status.

PMID- 8369591
TI  - Prescribing policy for antiulcer treatment in the elderly.
AB  - In the short and long term treatment of peptic ulcer in the elderly some problems
      have yet to be resolved, mainly concerning the physiology and pathophysiology of
      the aging stomach, the pharmacokinetic and pharmacodynamic properties of
      antiulcer drugs, and the presence of different risk factors compared with young
      patients. The available data from controlled trials of peptic ulcer in the
      general population and from the limited experience in geriatrics, show that the
      clinical efficacy and tolerability of the anti-secretory drugs (e.g. cimetidine,
      ranitidine and famotidine) and of cytoprotective compounds are similar to that
      observed in younger patients. However, more data are necessary concerning the
      optimal dosage in relation to physiological age-related changes of liver and
      kidney function, the duration of prophylactic treatment, and importantly, the
      assurance of adequate patient compliance.

PMID- 8369592
TI  - Physiological changes due to age. Implications for drug therapy of congestive
      heart failure.
AB  - The segment of the population considered to be 'elderly' is consistently growing.
      At the same time, the number of patients with congestive heart failure continues
      to grow. Therefore, it is important to consider whether older patients with
      congestive heart failure have characteristics that identify an aging effect in
      addition to the obvious abnormalities produced by heart failure. Furthermore, it
      is important to determine the relevance of these abnormalities to the use of
      pharmacological therapy. Within a population of 128 consecutive heart failure
      patients, age-related increases of systemic vascular resistance, changes in
      baroreceptor responses, and increases of plasma noradrenaline (norepinephrine)
      levels were identified. In addition, an age-related reduction of renal function
      was clearly evident in patients > 65 years of age. These changes affect the use
      of digoxin, diuretics and angiotensin converting enzyme (ACE) inhibitors. Most
      notably, marked reduction of renal function in such patients must be considered
      in the drug treatment of heart failure.

PMID- 8369593
TI  - The problems of anticholinergic adverse effects in older patients.
AB  - The old saying 'red as a beet, dry as a bone, blind as a bat, hot as a hare, mad
      as a hatter' is often quoted when describing the autonomic effects of drugs that
      block the muscarinic cholinergic system. These effects may be subtle or dramatic,
      yet can be overlooked or discounted as a natural consequence of old age. Elderly
      patients can be particularly sensitive to the anticholinergic action of drugs
      because of physiological and pathophysiological changes that often accompany the
      aging process. The use of multiple drugs, a common finding in older patients, may
      result in pharmacodynamic and pharmacokinetic drug interactions that heighten
      anticholinergic effects. While the classic anticholinergic problems of decreased
      secretions, slowed gastrointestinal motility, blurred vision, increased heart
      rate, heat intolerance, sedation and possibly mild confusion, may be
      uncomfortable for a younger patient in relatively good health, these effects can
      be disastrous for older patients. Even the most common peripheral anticholinergic
      complaint of dry mouth can reduce the ability to communicate, predispose to
      malnutrition, promote mucosal damage, denture misfit or dental caries, and
      increase the risk of serious respiratory infection secondary to loss of
      antimicrobial activity of saliva. Mydriasis and the inability to accommodate will
      impair near vision and may precipitate narrow angle glaucoma in predisposed
      patients, but less obviously could lead to an increased risk of accidents,
      including falls. Somatic complaints of constipation and urinary hesitancy, could,
      in the presence of anticholinergic challenge, result in faecal impaction or
      urinary retention. Cardiac effects may be poorly tolerated. Increases in heart
      rate may precipitate or worsen angina. Finally, thermoregulatory impairment
      induced by anticholinergics, which block the ability to sweat, may lead to life
      threatening hyperthermia. Central anticholinergic effects range from sedation,
      mild confusion and inability to concentration to frank delirium. Even mild
      effects can reduce function and increase dependency. At any level of care, the
      loss of independence increases the caregiver burden, costs, and most importantly,
      can negatively affect quality of life. Many age-related and disease-related
      conditions may predispose elderly patients to anticholinergic drug toxicity.
      Careful attention to anticholinergic effects when prescribing drugs, patient
      education, regular review of the entire drug regimen, and familiarity with the
      signs and symptoms of anticholinergic toxicity will help to reduce the risk of
      drug-induced problems.

PMID- 8369595
TI  - A critical review of admission and discharge medications in an elderly Australian
      population.
AB  - Medications were examined on admission to and discharge from hospital in an
      elderly population. Polypharmacy was documented. Patients were discharged on more
      medications (4:7) than they were taking prior to admission (4.1). This was
      statistically significant in men (p < 0.001) but not women. Multiple medication
      changes were undertaken. Admission drug regimens perceived by patient, admitting
      hospital doctor and general practitioner were also compared. Of 64 patients who
      were able to name their medications, only 64% described the same list as
      admitting doctors and only 43% described the same list as general practitioners.
      Hospital doctor and general practitioner lists were the same in only 37% of
      cases. Communication between these 3 groups needs to be optimised.

PMID- 8369594
TI  - Drug-induced cognitive impairment. Defining the problem and finding solutions.
AB  - Drug-induced cognitive impairment is a common cause of delirium and is frequently
      a confounding factor in dementia. Predisposing conditions for delirium include
      age, brain disease and addiction to alcohol and/or drugs. The elderly are at
      particular risk because of multiple diseases, multiple drug use and alterations
      of drug metabolism associated with age. Sedatives such as benzodiazepines have a
      particularly high risk of cognitive impairment. Centrally acting sympathetic
      antihypertensive agents, sedating antipsychotic drugs, opioids, digitalis, anti
      Parkinsonian drugs, antidepressants and corticosteroids are also associated with
      greater risk relative to other classes of medications. Cognitive impairment due
      to medication may be reduced by recognition of the problem. The risk of drug
      induced impairment may be minimised by strategies which optimise overall health,
      avoidance of unnecessary medications, and selection of medications least likely
      to cause delirium.

PMID- 8369597
TI  - Simulations of passive properties and action potential conduction in an idealized
      bullfrog atrial trabeculum.
AB  - This study investigates the properties of a distributed parameter model of an
      idealized trabeculum of cardiac muscle surrounded by a resistive-capacitive
      trabecular sheath. A mathematical approach is developed that permits the direct
      solution for the absolute potential in each medium [i.e., the intracellular (Vi),
      interstitial (Ve), and external (Vo) potentials), as opposed to obtaining
      solutions for the transmembrane potential V (where V identical to Vi-Ve). The
      mathematical description of the underlying individual cell is based upon
      quantitative whole-cell voltage-clamp measurements in bullfrog atrial myocytes.
      "Reduced" or "simplified" cell membrane models that lack the complete complement
      of transmembrane currents are compared with regard to their accuracy in
      representing the root, upstroke, and plateau regions of the propagated action
      potential in the complete model. The results show that a reduced cell membrane
      model must contain the sodium current INa, calcium current ICa, and background
      rectifying K+ current IK1. A cell membrane model that contains a linear
      background K+ current IL instead of IK1 results in much poorer approximation to
      the upstroke, plateau, and conduction velocities of an action potential. The
      effects of varying the resistive-capacitive parameters of the trabecular sheath
      on both the passive properties (the time and space constants and the input
      resistance) and conduction parameters (time and space constants of the foot and
      conduction velocity of the action potential) of the trabeculum are also
      investigated. These simulations show that electrical activity within the
      trabeculum is much more sensitive to variations in the resistive component than
      in the capacitive component of the sheath. The trabecular sheath reduces the
      extracellular resistance seen by the cell by shunting current away from highly
      resistive interstitial medium into the volume conductor medium, which is of low
      resistance, and thereby increases conduction velocity. Finally, the addition of
      the cholinergic neurotransmitter acetylcholine to the extracellular medium
      reduces both the space constant of the trabeculum and the conduction velocity of
      propagated electrical activity.

PMID- 8369598
TI  - Distributed solute and water reabsorption in a central core model of the renal
      medulla.
AB  - In this model study we investigate the dependence of urine concentrating
      capability on the spatial distribution of solute and water reabsorption from
      Henle's loops. Within the context of model assumptions, urine concentrating
      capability is increased by exponential decline in loop population as a function
      of medullary depth and by solute efflux localized near loop bends, in accordance
      with earlier, but less comprehensive, studies. Further, we find that water
      impermeable prebend enlargements of the descending limb may release urine
      concentrating capacity that would otherwise be needed to concentrate the fluid
      flowing in the prebend enlargements. Calculations reported here suggest that
      without some distributed features, even vigorous net active transport of solute
      from the ascending limbs of the inner medulla would not be sufficient to explain
      the large concentration gradients generated by some mammals. We consider the
      significance of distributed reabsorption for the operation of the concentrating
      mechanisms of the mammalian inner medulla, the mammalian outer medulla, and the
      avian medullary cone.

PMID- 8369599
TI  - A stochastic model of hormesis.
AB  - In order to describe the life-prolonging effect of some agents that are harmful
      at higher doses, ionizing radiations in particular, a stochastic model is
      developed in terms of accumulation and progression of intracellular lesions
      caused by the environment and by the agent itself. The processes of lesion
      repair, operating at the molecular and cellular level, are assumed to be
      responsible for this hormesis effect within the framework of the proposed model.
      Properties of lifetime distributions, derived for analysis of animal experiments
      with prolonged and acute irradiation, are given special attention. The model
      provides efficient means of interpreting experimental findings, as evidenced by
      its application to analysis of some published data on the hormetic effects of
      prolonged irradiation and of procaine on animal longevity.

PMID- 8369600
TI  - Waves of extinction from sterile insect release.
AB  - Employing theoretical models, we show that the sterile insect release method
      (SIRM) can give rise to traveling waves of fertile insects. The velocity of these
      waves depends critically upon the density of sterile insects (and thus upon the
      rate at which sterile individuals are being released into the environment). When
      the sterile density is sufficiently low, the traveling wave advances, giving rise
      to an invasion. However, when the sterile density exceeds a critical threshold,
      the wave reverses direction, thereby retreating and giving rise to local
      extinction. Both analytical (regular perturbation) methods and numerical methods
      are used to determine wave velocities and wave profiles. This is the first time
      traveling wave solutions have been shown for the SIRM.

PMID- 8369601
TI  - [Assessment of the degree of disability in narcolepsy].
AB  - This article sums up the scientific results of the past 10 years on narcolepsy
      reflecting its impact on socio-medical impairment of narcoleptic patients.
      Extensive epidemiological studies showed that major restrictions for narcolepsy
      patients are caused by daytime sleepiness and sleep attacks with consecutive
      cognitive and memory deficits high accident rates, personality, mood and sexual
      disorders. We suggest the minimum degree of impairment as a rule should be at
      least 50%, in case of drug-resistant cataplexy or permanent sleep attacks around
      80%.

PMID- 8369596
TI  - Diltiazem. A review of its pharmacology and therapeutic use in older patients.
AB  - Diltiazem is a benzothiazepine derivative calcium antagonist available in several
      formulations, some of which enable once daily administration. The drug as
      monotherapy has demonstrated similar efficacy to diuretics in older patients with
      hypertension. Data comparing diltiazem with beta-blockers and angiotensin
      converting enzyme inhibitors are more limited, but available studies suggest at
      least comparable antihypertensive efficacy. Diltiazem as monotherapy or in
      combination with a beta-adrenoceptor-antagonist, isosorbide dinitrate, or another
      calcium antagonist, has demonstrated efficacy in patients with effort angina. The
      drug has also been used intravenously to terminate supraventricular tachycardias
      and to control the ventricular response to atrial fibrillation or flutter; it
      also appears to reduce the rate of early reinfarction in patients with non-Q-wave
      myocardial infarction. The most common adverse events during diltiazem therapy
      include headache, flushing, peripheral oedema and hypotension. Atrioventricular
      block although rare, is the most frequent serious adverse event related to
      diltiazem therapy and may be exacerbated by coadministration of beta-adrenoceptor
      antagonists, especially in the elderly. Thus, diltiazem appears to be an
      effective and well tolerated treatment for hypertension and angina in older
      patients and has shown promise as therapy for supraventricular tachycardias and
      as prophylaxis against early reinfarction in patients with non-Q-wave myocardial
      infarction.

PMID- 8369602
TI  - [Development, organization and evaluation of a public health surveillance
      system].
AB  - Health professionals who set health policies and manage prevention and disease
      control programs are committed to the goals of reducing disease and injury
      related morbidity and mortality and improving the public's health and quality of
      life. To determine what health policies are needed and what specific actions
      should be taken and which epidemiological investigations should be carried out in
      order to identify lack of coverage of public health programs, decision makers
      need continuous information in order to tackle upcoming technical questions and
      to identify the most serious existing and emerging health problems of today's
      society. Both, political decision makers and health professionals have to ask
      themselves how those health problems can be prevented and which are the most cost
      effective prevention and control strategies for this purpose. Other important
      issues for the implementation of public health surveillance is the feasibility of
      available control strategies and their possible impact on different health
      outcomes. Alternative prevention and control activities have to be evaluated as
      how they meet the proposed objectives. Finally, remains the question, how scarce
      economic, material and human recourses should be allocated and targeted in order
      to achieve maximum impact for health goals. Only a sophisticated public health
      surveillance system can give answers to all those issues. Surveillance is defined
      as the ongoing systematic collection, analysis and interpretation of date on
      specific health events for use in planning, implementation and evaluation of
      public health programs. Timely dissemination of these data to persons who need to
      know is essential to effective prevention and control.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8369603
TI  - [Effect of change in the occupational structure on extending life expectancy in
      Germany--a cohort analysis].
AB  - Life expectancy in Germany has increased considerably during the 20th century.
      Simultaneously a considerable change in occupational structure has occurred.
      Keeping the occupational impact on mortality in mind, the question arises as to
      what extent the mortality decrease can be contributed to changes in occupation.
      Based on cohort data this question is analysed with the result that a
      considerable impact on life expectancy is confirmed. The impact of changes in
      occupational structure on life expectancy is greater for men than for women. This
      can be explained by the fact that men benefit from the improvements of general
      living conditions associated with occupational status, as well as from improved
      working conditions.

PMID- 8369604
TI  - [The status of maternally acquired tetanus immunity in newborn infants].
AB  - In newborn and their mothers a considerable lack of immunity to tetanus was
      found. Values of corresponding serum pairs differed in part; some children were
      unprotected in spite of maternal immunity. Pregnant women without protection
      should therefore be vaccinated twice before delivery. Over and above this, good
      hygienic standards in obstetrics must be maintained.

PMID- 8369605
TI  - [Changes in suicide mortality in Germany].
AB  - OBJECTIVE: About one third of the total number of life lost in the period between
      1 and 65 years in consequence of "external causes" (E-classification by WHO) in
      East and in West Germany account alone for "suicide" as a cause of death. Suicide
      alone produces, e.g. among the male population, a loss in years of life which
      corresponds to 53% (in East Germany) and to 40% (in West Germany), respectively,
      of the total number of years of life lost due to cancer of all organic
      localizations. METHODS: The analysis is based on the official mortality data from
      1961 to 1989. The data are analysed by age and sex. SMR, average age of death and
      PYLL are calculated. RESULTS: A comparative survey of suicide mortality over the
      period from 1961 to 1989 has shown that there are differences in suicide
      frequencies between East and West Germany. If related to the whole period, the
      lowest suicide rates both in the East and in the West have been observed at the
      end of that period. The suicide mortality rate in the East, however, remained
      higher than in the West, by 79.9% (male population) and by 70.2% (female
      population), respectively. The long-term trend is characterised by a slight
      increase of the suicide gap between East and West among the male population,
      whereas the difference has diminished in respect of the female population. Sex
      related differences are even more distinct than differences between East and West
      in suicide mortality. Thus, in 1989, the standardized suicide rates among the
      male population amounted to 2.7 times (West Germany) and 2.8 times (East Germany)
      of that of the female population, these differences having increased continually
      during the period from 1961 to 1989. CONCLUSIONS: The results cast justifiable
      doubts on whether the actual distribution of research capacities and of financial
      and personnel resources are adequate to cope with the problems raised by the
      phenomenon of "suicide".

PMID- 8369606
TI  - [Assessment of health effects of CS gas].
AB  - O-chlorobenzylidene malononitrile (CS) gas or aerosol is by no means a harmless
      tear-gas, as often is described; in particular, CS is a very effective irritating
      war gas. The effects of CS on humans are relatively unknown because publications
      in this respect are mostly on military medical research, partly classified as
      secret, and brought to the knowledge of a small number of experts only. CS is
      highly soluble in water, and hence the effects in police water jets are very low.
      The efficacy of CS-containing water-jetting consists only in the pressure of the
      jet stream. Medically, in police use, CS is therefore considered to be harmless.
      Military medical research results, however, show that persons older than 30
      years, those under physical strain, and those with hitherto undetected aneurysm
      are especially at risk.

PMID- 8369607
TI  - [The medical service of compulsory health insurance--quo vadis? The law,
      responsibility and interests of those involved].
AB  - In contrast to all predictions and expectations the Medical Advisor of Health
      Insurance (MDK) still has to cope with an enormous quantity of medical
      examinations and reports. As long as the capacities of the MDK are completely
      absorbed by this task it cannot fulfill its legal commission as a medical
      consultant of the health insurance in an economical and highly qualified way. The
      present economical crisis of the health insurance can also be regarded as a
      challenge to overcome this situation.

PMID- 8369608
TI  - Preoperative diagnosis of malignant melanoma using the touch-fluorescence method.
AB  - We have developed a touch-fluorescence method using preparations from the outer
      surface of elevated and ulcerative malignant melanoma lesions. This method allows
      the demonstration of the melanogenic activity of melanoma cells within 30 min and
      has made it possible to definitively diagnose a lesion as malignant melanoma at
      the initial examination. In 21 cases clinically diagnosed as typical melanoma, 17
      were definitively diagnosed as melanoma from the touch-fluorescence microscopic
      findings. Of the four cases in which no fluorescent tumor cells were found, two
      proved not to be melanoma. There was some correlation between the morbid types of
      primary melanoma and the configuration of fluorescent melanoma cells, the main
      cellular configuration of superficial spreading melanoma being round whereas that
      of nodular melanoma and acral lentigenous melanoma was pleomorphic. Based on the
      above results, this method was concluded to be extremely reliable for the
      preoperative diagnosis of elevated and ulcerative lesions of malignant melanomas,
      which are sometimes difficult to diagnose.

PMID- 8369610
TI  - Pulmonary oxygen transfer deficits of diabetic origin in patients undergoing
      coronary artery bypass grafting.
AB  - The objective of this study was to determine the effects of a diabetic
      disposition on pulmonary gas exchange by examining 72 patients who underwent
      coronary artery bypass grafting (CABG), using the arterial/alveolar oxygen
      tension ratio [(a/A)PO2] as a criterion. Patients were divided into a diabetic
      (DM) group and a nondiabetic (non-DM) group. The postoperative blood gases and
      hemodynamic data measured when the blood glucose level was at a maximum on the
      day of CABG were used as the postoperative pulmonary gas exchange indices, and
      the physicians who managed these patients were unaware of this study. The
      preoperative (a/A)PO2 ratio was 0.66 +/- 0.03 (SE) in the DM group and 0.78 +/-
      0.02 in the non-DM group (P < 0.01), while the postoperative ratios were 0.42 +/-
      0.03 and 0.52 +/- 0.03, respectively (P = 0.01). The correlation coefficient (r)
      for regression analysis of the relation between the postoperative PaO2/FIO2 ratio
      and the postoperative (a/A)PO2 ratio was 0.99 in the DM group (P < 0.01) and 0.88
      in the non-DM group (P < 0.01). The r values of the relation between (a/A)PO2 and
      (A-a)PO2 were -0.68 (P < 0.00) and -0.84 (P < 0.01), while those for the
      respiratory index were -0.87 (P < 0.01), and -0.93 (P < 0.01), respectively.
      Thus, pulmonary oxygen transfer was compromised before and after CABG in the DM
      group compared to the non-DM group. Moreover, the PaO2/FIO2, being the simplest
      pulmonary gas exchange index to calculate, was a reliable substitute for the
      (a/A)PO2 ratio during the early postoperative management of CABG patients.

PMID- 8369609
TI  - Changes in plasma dopamine-beta-hydroxylase activity during the perioperative
      period of cardiac surgery: an index of sympathetic nerve activity.
AB  - To evaluate the usefulness of plasma dopamine-beta-hydroxylase (DBH) activity as
      an index of sympathetic nerve activity during cardiac operations, we examined the
      serial changes in plasma DBH activity, in relation to the plasma noradrenaline
      (NA) level and hemodynamic parameters, in patients who underwent cardiac surgery.
      The plasma DBH activity decreased significantly after cardiopulmonary bypass, and
      remained low during dopamine (DA) infusion until 72 h after the operation.
      However, recovery of the hemodynamic parameters, being the mean arterial
      pressure, heart rate and cardiac index, was seen as early as 1-3 h
      postoperatively. It was therefore assumed that the plasma DBH activity takes a
      long time to recover after an operation. The time-course changes in the plasma NA
      level were quite different from the changes in DBH activity, with an apparent
      negative correlation being observed between them. Thus, there is a possibility
      that exogenously administered DA, as well as increased plasma NA, might inhibit
      DBH activity during cardiac surgery. Moreover, since catecholamines are often
      administered upon completion of cardiac surgery, measurement of the plasma
      catecholamine level would be inappropriate for evaluating real sympathetic nerve
      activity. From the results of this study, it is surmised that measurement of the
      plasma DBH activity could be useful for estimating the intrinsic sympathetic
      nerve activity of patients who have undergone cardiac surgery.

PMID- 8369611
TI  - The psychological and cosmetic aspects of breast conserving therapy compared with
      radical mastectomy.
AB  - An evaluation of the psychological and cosmetic morbidity of 31 patients who had
      undergone breast conserving treatment (BCT group) and 71 patients who had
      undergone radical mastectomy (RM group) revealed that 85% and 73%, respectively,
      were satisfied with their operative results. BCT appeared superior to RM in
      relation to body image, with 93% of the BCT group indicating BCT as a future
      choice of treatment, whereas only 35% of the RM group indicated RM as a future
      choice of treatment. For 59% of the BCT patients, the results were considered
      excellent or good by a physician, but fear of recurrence was frequently expressed
      by both groups even though an early stage of breast cancer had been significantly
      more common in the BCT group than the RM group. Sexual adjustment was the same in
      both groups. Body image was thus concluded to have been improved by BCT rather
      than RM, but psychological morbidity was essentially the same in both groups.

PMID- 8369612
TI  - A new animal model for split liver transplantation using an infrahepatic IVC
      graft.
AB  - An animal model of split liver transplantation using pigs is described herein.
      The donor liver was divided into two grafts, the right graft consisting of the
      right medial and lateral segments with the caudate lobe, and the left graft
      consisting of the left lateral and medial segments. To make implantation easier,
      a distal part of the donor's inferior vena cava (IVC) was isolated and attached
      to the left graft with an anastomosis between the orifice of the renal vein and
      the graft's hepatic vein. The left graft thereby contained a newly constructed
      retrohepatic IVC for anastomosis to the recipient. During the anhepatic phase, no
      conventional bypass procedure was used, but an abdominal aortic clamp in
      combination with general hypothermia was employed. Ten pigs were used as donors
      and a total 20 liver transplantations performed. No immunosuppressive drugs were
      given in this series. Ten of the 20 recipients survived for more than 2 days, the
      mean survival time being 4.7 days, with a range of 2-14 days. The mean survival
      time of the left grafts was much longer than that of the right grafts, although
      no technical problems such as kinking of the graft or occlusion of the hepatic
      vein were encountered in either. This model is the first report of split liver
      transplantation in animals. The advantages of using the infrahepatic IVC graft
      include stability of the graft and safe hepatectomy. This model will therefore be
      useful for the experimental study of split liver transplantation and may also be
      employed for clinical use in the future.

PMID- 8369613
TI  - The modulation by L-leucovorin of 5-fluorouracil antitumor activity on human
      colon carcinoma cells in vitro and in vivo.
AB  - We investigated the modulating effect of L-leucovorin (LV) on the antitumor
      effect of 5-fluorouracil (5-FU) against human colon carcinoma cells (C-1) in
      vitro and human colon carcinoma xenografts (Co-4) in nude mice. The modulating
      effect of LV on 5-FU reached an optimal concentration of 40-80 micrograms/ml in
      vitro which was detected by a colorimetric MTT assay. An optimal dose of 200
      mg/kg was also observed in the nude mouse system. The modulating effect of LV
      increased according to the increment of thymidylate synthetase inhibition in
      vivo. Since the pharmacokinetic pattern of LV in the nude mice administered LV at
      200 mg/kg was similar to that in patients treated with LV at a dose of 100 mg/m2,
      this clinical method of administration was thought to be adequate for modulating
      the antitumor activity of 5-FU against clinical colon carcinomas.

PMID- 8369615
TI  - Thymic metastasis from prostatic carcinoma: report of a case.
AB  - The thymus is an important organ involved in cell-mediated immunological
      function, and to our knowledge, there has never been a case of thymic metastasis
      reported. We recently examined a 65-year-old man who presented at our department
      with a cough and shortness of breath on exertion. He had a history of prostatic
      carcinoma for which he had undergone an orchiectomy 11 years previously.
      Investigations disclosed a mediastinal tumor, 14 x 9 cm in size, and histological
      examination of the resected tumor confirmed a diagnosis of thymic metastasis from
      prostatic carcinoma.

PMID- 8369614
TI  - The effects of a biological response modifier, OK-432, on tumor-induced
      alterations in the host metabolism.
AB  - The effects of multicytokine inducer, OK-432, on tumor-induced metabolic
      alterations were studied by assessing three key regulatory enzymes of
      gluconeogenesis, de novo fatty acid synthesis and the triglyceride clearance
      pathways. Two Klinish Einheit (KE) of OK-432 was subcutaneously injected on
      alternate days, for 10 days, into Fischer 344 rats with or without
      methylcholanthrene-induced sarcoma. At the time of sacrifice, the tumors
      accounted for approximately 23% of their total body weight. The injections of OK
      432 did not affect the amount of food intake in either the tumor bearers or the
      controls. The tissue lipoprotein lipase activities in the epididymal fat pads of
      the tumor bearers were significantly decreased compared with the controls (P <
      0.01). Phosphoenolpyruvate carboxykinase activity in the liver was significantly
      increased (P < 0.01), while malic enzyme activity tended to be decreased in the
      tumor bearers compared with the controls. However, there were no significant
      differences in those activities depending on the OK-432 injections, even though
      OK-432 induced tumor necrosis factor (TNF) and increased cytotoxic activities in
      the mesenteric lymph nodes as well as in the spleen. Thus, although the role of
      monokines in inducing cancer cachexia is not yet clearly understood, OK-432 was
      not able to revert the tumor-induced metabolic alterations which lead to tissue
      wasting and cancer cachexia.

PMID- 8369616
TI  - Lumbar artery pseudoaneurysm: an unusual cause of a retroperitoneal hematoma:
      report of a case.
AB  - Pseudoaneurysm of the lumbar artery is a rare complication of penetrating trauma.
      We present herein a case thought to have been caused by a blow to the left flank
      without any evidence of a stab wound. In this patient, the diagnosis of a first
      lumbar artery pseudoaneurysm with a retroperitoneal hematoma was confirmed by
      computed tomography (CT) findings, after which transcatheter embolization was
      successfully performed.

PMID- 8369617
TI  - The neurosurgical management of brain metastasis from colorectal cancer: a report
      of three cases.
AB  - We report herein three cases of brain metastasis from primary colorectal cancer
      in which the metastatic lesion was resected to effectively relieve neurological
      symptoms. Case 1 was a 61-year-old woman with a solitary brain metastasis from
      colorectal cancer and no other metastases; case 2 was a 59-year-old woman who
      died from liver metastasis 11 months after resection of the metastatic brain
      tumor; and case 3 was a 68-year-old woman with multiple metastases to the lungs
      and bones detected before the brain metastasis. According to 16 cases previously
      reported in the Japanese literature and our 3 cases, the interval between
      diagnosis of the primary cancer and discovery of brain metastasis was 23 months
      on average, while the median survival after the discovery of brain metastasis was
      7 months. Brain metastases with liver and lung metastases were seen more
      frequently than brain metastases alone. In these three cases, chemotherapy
      appears to have been of no use in preventing recurrence. Thus, we believe
      neurosurgical management to be appropriate for a solitary lesion and that it
      should be actively pursued to prolong survival and improve quality of life.

PMID- 8369618
TI  - Hemangiopericytomatous meningioma metastasized to the liver: report of a case and
      review of the literature.
AB  - A 54-year-old male was admitted to our hospital for treatment of a liver tumor
      which was pointed out by screening ultrasonography. Computed tomography revealed
      a tumor in the right lobe of the liver measuring 7 cm in diameter. Angiography
      revealed a hypervascular tumor. A hepatocellular carcinoma or hypervascular
      metastatic tumor was suspected. A right hepatic lobectomy was performed. The
      patient had previously undergone operations for a hemangiopericytomatous
      meningioma in the occipital fossa in 1972 and 1977. The histological findings of
      the liver tumor were identical to those for hemangiopericytomatous meningioma, so
      the etiology was considered to be liver metastasis from the previous meningioma.
      Nineteen cases of extracranial metastasis of hemangiopericytomatous meningioma
      have been reported in the literature, but hepatic resections of this
      metastasizing tumor have been very rare.

PMID- 8369619
TI  - Extended right lobectomy for Caroli's disease: report of a case and review of
      hepatectomized cases in Japan.
AB  - A 27-year-old man was admitted to Nagasaki University Hospital complaining of
      fever. Percutaneous transhepatic cholangiography revealed multiple cystic
      dilatations of the intrahepatic bile ducts of the right lobe, as well as three
      obvious cystic dilatations and several small dilatations of the intrahepatic bile
      ducts of the left lobe. An extended right lobectomy was performed. However, the
      patient later suffered from repeated cholangitis and required the administration
      of antibiotics as a result of remnant cystic dilatations and stricture of the
      extrahepatic bile duct following hepatectomy. A slight enlargement of the remnant
      cystic dilatations, but no new cystic dilatations, were also recognized in the
      regenerating liver. We reviewed nine cases of hepatectomy for Caroli's disease
      reported in the Japanese literature, as well as our own case. Among these, four
      of the seven patients subjected to hepatic resection involving unilateral lobe
      demonstrated a good recovery. On the other hand, it is difficult to successfully
      treat Caroli's disease involving both lobes of the liver by hepatic resection.

PMID- 8369620
TI  - Curricular changes and improved performance by high-risk students on the National
      Boards Part I.
AB  - The present study was undertaken to identify the components of an introduction to
      clinical medicine (ICM) course at Morehouse School of Medicine that were most
      helpful in improving performance on the National Board of Medical Examiners
      (NBME) part I examination by an academically high-risk population. After
      completing a revised ICM course that incorporated problem-based learning-style
      innovations, students performed significantly better on the NBME part I. The
      students did not differ from their predecessors demographically or academically.
      A modified Likert scale questionnaire revealed subjects' agreement with the
      helpfulness of each ICM component. Open-ended questions elicited other helpful
      factors. Case-based learning, small discussion groups, quiz discussions,
      immediate quiz feedback, basic scientist involvement, and faculty role models
      were found most helpful. Non-ICM-related factors of value included support of
      family and friends and diligent studying.

PMID- 8369621
TI  - Interstitial cystitis in minority women.
AB  - A bladder disorder of unknown etiology, interstitial cystitis affects mainly
      women, and its prevalence may be increasing. Little information is available on
      the demographic, clinical, diagnostic, and treatment aspects of interstitial
      cystitis in the minority population. This retrospective review of the patient
      database at the Interstitial Cystitis Center, New England Medical Center,
      identified 17 minority women among a total of 201 patients who satisfied the
      criteria of the National Institutes of Health's National Institute of Diabetes
      and Digestive and Kidney Diseases for diagnosis of interstitial cystitis.
      Minority women accounted for 8.5% of the patients, with 3% being African
      American; 3.5%, Hispanic American; and 2.0%, Asian American. The clinical and
      endoscopic findings as well as responses to treatment were similar in both the
      minority and nonminority populations. However, the average duration of symptoms
      prior to diagnosis was 2.9 years in the minority group, compared with an average
      of 13 months in the nonminority group. Minority women with interstitial cystitis
      appear to be symptomatic for longer periods before a definitive diagnosis is
      made. Their response to treatment parallels that of the nonminority population.
      Further studies are needed to address the natural history, urologic referral
      patterns, and treatment outcomes in minority women who have interstitial
      cystitis.

PMID- 8369622
TI  - The history of African-American physicians and medicine in the United States.

PMID- 8369623
TI  - Recent advances in the understanding of potassium channel function.

PMID- 8369624
TI  - Structure of nicotinic acetylcholine receptors.
AB  - Nicotinic acetylcholine (ACh) receptors convert the binding of ACh into the
      opening of a cation-conducting channel. New information about the regions of the
      receptor most immediately involved in its function, namely the ACh-binding sites,
      the gate and the channel, has come from two approaches. One is the identification
      by labelling and by mutagenesis of residues contributing to these regions.
      Another is the determination of the three-dimensional structure of the receptor
      by electron microscopy. Although the identification of functionally relevant
      residues is incomplete and residues cannot yet be resolved in the three
      dimensional structure, the two approaches are converging. There is still room in
      the gap for speculation.

PMID- 8369625
TI  - A new wave of serotonin receptors.
AB  - The neurotransmitter serotonin mediates diverse effects through multiple receptor
      subtypes. Recently, many of these receptor subtypes have been identified,
      molecularly cloned and characterized, advancing our understanding of their
      functional roles in the central and peripheral nervous systems.

PMID- 8369626
TI  - Synaptic vesicle proteins in exocytosis: what do we know?
AB  - Synaptic release of neurotransmitters is a fast process that is mediated by
      Ca(2+)-dependent exocytosis of synaptic vesicles. Several abundant membrane
      proteins of synaptic vesicles have been characterized at the molecular level but
      their function in synaptic vesicle traffic is poorly understood. Recent evidence
      suggests that some of these proteins are involved in exocytotic membrane fusion.

PMID- 8369627
TI  - Signal recognition and integration by Gs-stimulated adenylyl cyclases.
AB  - Six Gs-stimulated adenylyl cyclases have been cloned. Two additional forms have
      been identified as partial cDNAs. These adenylyl cyclases have distinct
      functional properties and are differentially regulated by protein kinases. The
      adenylyl cyclases have distinct patterns of distribution in peripheral tissues
      and various brain regions. The unique functional characteristics of the members
      of this effector family may allow each cell type and/or brain region to customize
      the signal-recognition and integrative properties of its cAMP-generation system
      by varying the ratios of the various adenylyl cyclases.

PMID- 8369628
TI  - Pleiotropic signaling from receptor tyrosine kinases.
AB  - The molecular cloning of genes encoding new neuroactive growth factors and their
      receptors has greatly enhanced our understanding of important interactions
      between receptors and signaling molecules. These studies have begun to illuminate
      some of the mechanisms that allow for specificity in neuronal signaling.

PMID- 8369629
TI  - Novel inositol containing phospholipids and phosphates: their synthesis and
      possible new roles in cellular signalling.
AB  - Details of the widely employed PtdIns(4,5)P2 hydrolysis receptor-stimulated
      signalling pathway continue to be elucidated rapidly. However, it has recently
      become apparent that numerous other inositol lipids and phosphates are widespread
      and are likely to have important cellular functions. In this review, we focus
      particularly on three rapidly progressing areas: the synthesis and possible
      functions of 3-phosphorylated inositol lipids, particularly phosphatidylinositol
      3,4,5-trisphosphate; the roles of inositol 1,4,5-trisphosphate and inositol
      1,3,4,5-tetrakisphosphate in coordinating intracellular Ca2+ mobilization and
      Ca2+ influx in stimulated cells; and the metabolism and possible functions of
      other inositol polyphosphates and of inositol polyphosphate pyrophosphates.

PMID- 8369630
TI  - Cellular mechanisms of long-term depression in the cerebellum.
AB  - Cerebellar long-term depression is a persistent, input-specific attenuation of
      the parallel fiber-Purkinje neuron synapse induced by co-activation of parallel
      fibers and climbing fibers. This phenomenon endows the Purkinje neuron with a
      powerful associative computational ability. Recent investigations have provided
      strong evidence that two mechanisms, Ca2+ influx via voltage-gated channels, and
      stimulation of protein kinase C via metabotropic receptor activation, are
      required for induction of long-term depression. In addition, two other
      mechanisms, Na+ influx via AMPA receptors, and stimulation of a nitric oxide/cGMP
      cascade may also be involved in this process.

PMID- 8369631
TI  - Signalling mechanisms.

PMID- 8369632
TI  - A connectionist approach to the prefrontal cortex.
AB  - Recent data from studies of the prefrontal cortex (PFC) in humans and laboratory
      animals are reviewed with particular reference to the anatomical substrates of
      prefrontal neuropsychological function in health and disease. The PFC has been
      shown to have a unique pattern of supramodal connectivity with intracortical and
      subcortical circuits that place the PFC in an anatomical position to subserve
      "executive" cognitive functions and modulate limbic information to relate to
      basal ganglia circuits in a highly specific manner and to uniquely control the
      neurochemical elements of attention and reward. PFC connectivity is also
      consistent with current hypotheses about prefrontal neuropsychology, which
      emphasize conscious, goal-directed behavior guided by past experience. PFC
      connectivity explains the frequency with which prefrontal dysfunction is seen in
      disease states, which, on the basis of neuroimaging and neuropathology data, can
      be categorized as either intrinsic or dysconnection disorders.

PMID- 8369634
TI  - Regional syndromes.

PMID- 8369633
TI  - Drug and alcohol use and neuropsychological performance in asymptomatic HIV
      infection.
AB  - The effect of drug and alcohol abuse on neuropsychological performance was
      examined in 132 human immunodeficiency virus-seropositive gay or bisexual men.
      Syndromal (diagnostic) criteria of alcohol/drug abuse based on DSM-III-R were
      used, and quantitative estimates of alcohol consumption were obtained. Very few
      differences appeared between substance abuse subgroups formed on the basis of
      recency or severity of drug use. There were some correlations with the
      quantitative estimate of alcohol use, but not on the measures previously found to
      differentiate seronegative and asymptomatic seropositive gay men. These data
      indicate that alcohol use does affect neuropsychological performance but does not
      account for the differences observed in studies of seronegative and seropositive
      subjects.

PMID- 8369635
TI  - Dementia.

PMID- 8369636
TI  - Similarities and differences in memory deficits in patients with primary dementia
      and depression-related cognitive dysfunction.
AB  - The authors examined differences between the verbal memory performance of older
      patients with major depression (MD) alone; major depression with reversible
      depression-related cognitive dysfunction (MD/DRCD); and primary dementia and
      major depression (DEM/MD). Patients were evaluated before antidepressant
      treatment and 6 and 15 months after treatment. Of the three groups, patients with
      MD alone acquired significantly more information on the California Verbal
      Learning Test and showed a more pronounced primacy effect. Patients with DEM/MD
      were more likely to commit errors of intrusion. Although older depressed patients
      with MD/DRCD may resemble patients with DEM/MD on some aspects of verbal memory
      performance, differences may be observed in the types of learning errors they
      commit. Diagnostic implications are discussed.

PMID- 8369637
TI  - Relationship of seizure variables to personality disorders in epilepsy.
AB  - Among epileptic patients, personality disorders may be associated with specific
      seizure manifestations. In an epilepsy clinic, we identified 42 idiopathic
      epilepsy patients diagnosed with various DSM-III-R personality disorders,
      including borderline, atypical or mixed, explosive, and dependent. When compared
      with 42 age- and sex-matched epileptic control subjects on six seizure variables,
      the personality disorder group had more patients with epileptic auras (P =
      0.001), particularly "cephalic" auras, and fewer with secondarily generalized
      tonic-clonic seizures (P < 0.05). These findings suggest that the experience of
      epileptic auras contributes to the development of personality disorders,
      especially when auras are not masked by secondarily generalized seizures.

PMID- 8369638
TI  - Midline cerebral malformations and schizophrenia.
AB  - To investigate a possible association of midline cerebral malformations with
      psychotic disorders, MRI and CT scans were blindly evaluated for 52 patients with
      schizophrenia, 9 with schizoaffective disease, and 79 consecutive nonpsychotic
      control subjects. Midline abnormalities were present in 10 of 61 patients (16.4%)
      versus 4 of 79 control subjects (5.1%; P < 0.05, chi-square). Of 52 schizophrenic
      patients, 8 had abnormalities of the septum pellucidum (SP): 5 had cavum vergae
      (CaV), 2 had cavum septum pellucidum (CaSP), and 1 had agenesis of the corpus
      callosum and SP. Of 9 schizoaffective patients, 2 had SP abnormalities: 1 CaV and
      1 CaSP. Abnormalities of the SP, especially CaV, were significantly more frequent
      in women than in men (P < 0.02, chi-square).

PMID- 8369639
TI  - Patterns of neuropsychological deficits that discriminate schizophrenic
      individuals from siblings and control subjects.
AB  - Previous research on persons with schizophrenia and their relatives suggests two
      independent etiologic factors may combine to produce schizophrenia, and these
      factors may be indexed respectively by independent neuropsychological tests. Two
      neurocognitive measures, the Trail Making and Wisconsin Card Sorting (WCST)
      tests, were administered to 28 schizophrenic subjects, 15 nonschizophrenic
      siblings, and 35 control subjects by investigators blind to DSM-III-R diagnoses.
      Results support key predictions of a two-factor model: 1) having poor scores on
      both tests discriminated schizophrenic individuals from both siblings and control
      subjects, and 2) poor Trail Making and WCST performance were inversely associated
      among schizophrenic individuals' non-schizophrenic siblings.

PMID- 8369640
TI  - Early childhood abuse and limbic system ratings in adult psychiatric outpatients.
AB  - The authors investigated the hypothesis that early abuse might affect the
      development of the limbic system. During initial psychiatric evaluation, 253
      outpatients completed a self-report scale, the Limbic System Checklist-33 (LSCL
      33), designed to measure somatic, sensory, behavioral, and memory symptoms
      suggestive of temporal lobe epilepsy, along with a questionnaire about physical
      or sexual abuse. Physical abuse was associated with a 38% increase in LSCL-33
      scores (P < 0.01), sexual abuse with a 49% increase (P < 0.02), and combined
      abuse with a 113% increase (P < 0.0001). Physical or sexual abuse alone was
      associated with elevated LSCL-33 scores only if the abuse occurred before age 18.

PMID- 8369641
TI  - Clinical and neurochemical effects of fenfluramine in children with autism.
AB  - Fifteen children with autism were treated with 60 mg d,l-fenfluramine (FEN) or
      placebo in a double-blind A-B-A protocol followed immediately by double-blind
      placebo-controlled crossover administration of FEN (total duration 62 weeks).
      Both biochemical and clinical outcomes were examined. Biochemically, FEN led to
      an increase in dihydroxyphenylacetic acid (DOPAC) and decreases in whole-blood
      serotonin (5-HT), plasma norepinephrine (NE), and plasma 3-methoxy-4
      hydroxyphenylglycol (MHPG). The decrease in whole-blood 5-HT was seen only during
      treatment with FEN. However, NE levels did not return to baseline as long as 8
      weeks after the first FEN treatment period. Increases in DOPAC were greater
      during the second FEN treatment period than the first. Persistent changes in
      catecholamine regulation may be related to previously reported long-term effects
      on central nervous system 5-HT after FEN. Clinically, FEN led to a modest
      decrease in parent, but not teacher, ratings of hyperactivity and to a small
      reduction in sensorimotor abnormalities. Abnormal social and affectual responses
      also decreased, but this was not directly related to FEN treatment. Effects on
      cognition were equivocal. Hyperserotonemic subjects did not differ from
      normoserotonemic subjects in clinical response. Overall, no significant advantage
      for the use of FEN could be established.

PMID- 8369642
TI  - EEG coherence in men with AIDS: association with subcortical metabolic activity.
AB  - The authors studied the relationship between cerebral metabolism and brain
      electrical activity in patients with acquired immunodeficiency syndrome (AIDS),
      using positron-emission tomography and quantitative electroencephalography.
      Electroencephalographic coherence in the 6-to 10-Hz band correlated positively
      with thalamic metabolic activity. Coherence adjusted for background activity
      correlated strongly and positively with basal ganglia metabolic activity.
      Posterior interhemispheric coherence showed the highest correlations with
      measures of metabolic activity. These results suggest that changes in coherence
      may reflect AIDS-related subcortical disease. The high correlations between the
      two different measures of cerebral activity support the validity of
      electroencephalographic coherence measures in studies of AIDS-related
      neuropsychiatric dysfunction.

PMID- 8369643
TI  - Human brain fluoxetine concentrations.
AB  - Data on 22 subjects treated with fluoxetine suggest that magnetic resonance
      spectroscopy (MRS) of fluorine-19 can measure brain concentrations of
      fluoxetine/norfluoxetine in vivo. Fluoxetine accumulates in the human brain
      relative to plasma, with brain concentrations of fluoxetine/norfluoxetine ranging
      up to 10.7 micrograms/ml. Brain concentrations may reach a plateau between 6 and
      8 months of treatment. The apparent concentration in brain relative to plasma is
      20:1, roughly parallel to brain antidepressant concentration ratios in animal
      studies.

PMID- 8369644
TI  - Separation of affective disorder into seasonal and nonseasonal types using motion
      sickness susceptibility as a marker.
AB  - A sample of 133 candidates for antidepressant or mood-stabilizing medication
      treatment, with acute onset or a new phase of illness between the autumnal and
      vernal equinoxes, was gathered over a 3-year period from a private outpatient
      practice. All patients were diagnosed using DSM-III-R criteria, rated on a
      standard motion sickness (MS) questionnaire, and asked whether they had
      experienced cardinal symptoms of seasonal affective disorder (SAD). There was a
      positive relationship between greater MS and SAD in the entire patient sample.
      When a subsample of 23 patients was given a 2-week trial of phototherapy and
      rated for improvement, MS-susceptible patients responded better than MS-resistant
      patients.

PMID- 8369645
TI  - Cerebrospinal fluid thyrotropin-releasing hormone concentrations in patients with
      anxiety disorders.
AB  - In a study of 45 patients with anxiety disorders and 11 control subjects, mean
      cerebrospinal fluid (CSF) concentrations of thyrotropin-releasing hormone (TRH)
      were not significantly different between nonpsychiatric control subjects and
      those with panic disorder, generalized anxiety disorder, or obsessive-compulsive
      disorder. Male subjects, regardless of diagnosis, had significantly higher mean
      CSF concentrations of TRH than females.

PMID- 8369646
TI  - In vivo quantitation of basal ganglia and thalamic degenerative changes in two
      temporal lobectomy patients with affective disorder.
AB  - The authors examined the brain magnetic resonance imaging scans of two epilepsy
      patients who had temporal lobectomies, one on the right and one on the left, with
      postoperative symptoms of affective disorders. Degenerative changes of
      ipsilateral thalamus and putamen after surgery, with coincident affective
      disorder, were noted. The authors discuss a possible relationship between
      postlobectomy degeneration and depression.

PMID- 8369647
TI  - Automobile driving fitness and neurological impairment.

PMID- 8369648
TI  - Thyrotropin-releasing hormone in a patient with bipolar disorder.

PMID- 8369650
TI  - Two simple methods for measuring iodine in urine.
AB  - Urinary iodine excretion is currently the most convenient laboratory marker of
      iodine deficiency. Accelerating international interest in correcting this
      condition demands rapid, simple methods for assessment and monitoring. We
      describe two adaptations of the Sandell-Kolthoff reaction, in which urine is
      first digested with chloric acid and iodine then determined from its catalytic
      reduction of ceric ammonium sulfate in the presence of arsenious acid. Both
      methods use gentle digestion by chloric acid in a heating block. Method A detects
      iodine in a colorimeter, method B by the indicator ferroin and a stopwatch.
      Results with 12 samples ranging from 1.8 to 19.0 micrograms/dL (0.14-1.48
      mumol/L) differed from those in a reference laboratory by a mean of 9.1% for
      method A and 15.7% for method B. One technician can perform at least 150 tests
      per day at a total cost of less than $0.50 each. The speed, low cost, and simple
      instrumentation make these methods well suited to epidemiological assessment of
      iodine deficiency in developing countries.

PMID- 8369649
TI  - The measurement of fecal thyroxine in the diagnosis of thyrotoxicosis factitia.
AB  - Two patients with prolonged thyrotoxicosis are presented with low radioiodide
      uptake, low-normal serum thyroglobulin concentrations, and low iodide content of
      the neck on x-ray fluorescence studies. The surreptitious intake of thyroid
      hormone was directly proven by a high fecal concentration of T4 (12.38 and 23.99
      nmol/g) compared with low concentrations in healthy subjects (1.03 +/- 0.64
      nmol/g; mean +/- SD, n = 6) and in patients with hyperthyroidism due to Graves'
      disease (1.93 +/- 1.86; n = 8). Fecal thyroid hormone measurement may help to
      provide formal proof of factitious thyrotoxicosis.

PMID- 8369651
TI  - Hashimoto's thyroiditis in association with Tolosa Hunt syndrome: a case report.
AB  - Tolosa Hunt syndrome (THS) is a painful ophthalmoplegia due to a nonspecific
      inflammatory process in the cavernous sinus or to parasellar neoplasms. Although
      the cause of the disease is unknown, previous observations support the hypothesis
      that THS may be only one manifestation of a generalized vasculitis. The diagnosis
      is based on findings of painful ophthalmoplegia, excellent response to
      corticosteroids, and exclusion of other causes including aneurysm, diabetes
      mellitus, paranasal mucocele, and carotid cavernous fistula. We report the case
      of a 24-year-old woman with THS who had undergone thyroidectomy 4 years before
      admission for goiter with histologic diagnosis of Hashimoto's thyroiditis. This
      case shows the unusual association between Hashimoto's thyroiditis and THS and
      supports the autoimmune origin of both diseases.

PMID- 8369652
TI  - Glucose transport stimulation by thyroid hormone in ARL 15 cells: partial role of
      increased GLUT1 glucose transporter gene transcription.
AB  - We have previously reported that the stimulation of glucose transport by thyroid
      hormone in the rat liver-derived ARL 15 cell line is attributable, at least in
      part, to increased abundance of cellular glucose transporters with a
      corresponding increase in the mRNA coding for the GLUT1 glucose transporter
      isoform. To elucidate further the mechanism by which thyroid hormone increases
      glucose transport, we examined the time-course of the effect of L
      triiodothyronine (T3) on 3H-2-deoxyglucose uptake, GLUT1 protein abundance, and
      GLUT1 mRNA abundance in ARL 15 cells. At 6 h of T3 treatment, 3H-2-deoxyglucose
      uptake was increased by 40 +/- 11%, whereas the abundance of GLUT1 protein in
      cell extracts had not yet changed at this time. At 48 h, GLUT1 protein was
      increased by 58 +/- 10%, whereas 3H-2-deoxyglucose uptake at this time was
      increased by 116 +/- 14%. GLUT1 mRNA levels rose within 4 h of T3 treatment,
      preceding the increase in GLUT1 protein, and more than doubled by 24 h. In
      additional experiments to determine the mechanism by which T3 increases GLUT1
      mRNA, T3 treatment for 48 h increased the rate of transcription of the GLUT1
      gene, determined by nuclear run-on analysis, by 55 +/- 11%. T3 treatment did not
      significantly alter the half-life of GLUT1 mRNA. In the presence of inhibitors of
      protein synthesis, GLUT1 mRNA increased at 6 h (5-7-fold), but there was no
      further induction of this mRNA by T3 in the presence of these
      inhibitors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369653
TI  - Defective organification of iodide causing hereditary goitrous hypothyroidism.
AB  - We present a survey of the current state of knowledge about the prevalence of the
      syndrome involved in defective organification of iodide, and the mechanism of
      iodination and coupling catalyzed by the thyroid peroxidase (TPO) enzyme. A brief
      summary of the recent developments in molecular cloning of TPO and regulation of
      TPO gene expression is also included. Methods for purification of the enzyme and
      details about the assessment of TPO activity in tissue are briefly explained. The
      classification of defective organification of iodide is primarily based on the
      site of the biochemical defect, being quantitative (TPO absent) or qualitative
      (TPO structure, localization or apoenzyme are defectives). The presence of TPO
      inhibitors is also briefly described. The rare possibility of an absent source of
      peroxide (H2O2) causing defective iodide organification is discussed. Analysis of
      the 118 reported cases shows that the biochemical classification covers a
      spectrum of abnormalities and it is likely that further molecular biology studies
      will increase this heterogeneity as well as refining it. Genetic studies have
      suggested linkage between the TPO gene polymorphisms and the iodide
      organification defect and can be of importance for carrier detection and prenatal
      diagnosis. Neonatal screening for hypothyroidism is likely to expand the number
      of cases available for DNA analysis and possibly the molecular diagnosis. The
      importance of the mutations that would affect the histidine (His) residues in the
      translated protein was recently documented by the finding of a deletion removing
      part of exon 9 and thus also deleting a proximal His residue. The resulting TPO
      enzyme was inactive for iodide organification and coupling reaction. It is hoped
      that in time we will be able to expand our knowledge of the molecular diagnosis
      of the inborn errors of iodide organification.

PMID- 8369655
TI  - Classification of Graves' ophthalmopathy.

PMID- 8369654
TI  - The finding of 3'-3,5 triiodothyronine: personal account.

PMID- 8369656
TI  - Thyroid hormone levels affected by time of blood sampling in thyroxine-treated
      patients.
AB  - Patients receiving exogenous levothyroxine are reported to have higher total and
      free serum thyroxine levels than euthyroid controls. This may be an artifact of
      the serum collection time. We explored the effect of collection time on serum
      levels of thyroid hormones in outpatients receiving levothyroxine for replacement
      therapy (26 patients) or suppression of thyrotropin (25 patients). Blood samples,
      obtained during regular clinic visits (random samples) and at more than 22 h from
      ingestion of levothyroxine (trough samples), were assayed for total and free
      thyroxine, triiodothyronine, and thyrotropin. Four athyreotic patients on
      levothyroxine therapy had serial blood sampling over 24 h. Compared to
      corresponding trough samples, random samples had elevated total thyroxine levels
      in patients receiving replacement (8.1 +/- 1.2%, mean +/- SE, p = 0.0001) and in
      patients undergoing suppression (8.8 +/- 1.6%, p = 0.0001). Free thyroxine was
      increased by 12.7 +/- 2.6% (p = 0.0003) and 14.5 +/- 2.3% (p = 0.0001),
      respectively, compared with trough samples. Thyrotropin levels were 18.9 +/- 6.8%
      (p = 0.003) lower in patients receiving replacement and triiodothyronine levels
      showed small or no changes. Time-course analysis showed that free and total
      thyroxine levels remained significantly elevated above baseline for 9 and 5 h,
      respectively, after a levothyroxine dose. In conclusion, there is a transient
      increase in thyroid hormone levels for 9 h after an oral levothyroxine dose.
      Accurate assessment of thyroid hormone levels in patients receiving levothyroxine
      therapy should take this into account. This has greatest significance in
      selecting minimal levothyroxine dosages for suppression of thyrotropin.

PMID- 8369657
TI  - Surgery for solitary thyroid nodules: assessment of methods to select patients at
      low risk for unsuspected malignancy in the unaffected lobe and the possible
      utility of preoperative thyroid ultrasound.
AB  - One hundred and twelve bilateral thyroidectomies for solitary thyroid nodules
      with suspected malignancy were performed. The incidence of malignancy in the 112
      primary nodules was 42%. Twenty-nine of the 112 contralateral lobes (26%)
      contained malignancy, which was unsuspected in 80%. Of these 29, 20 were foci of
      papillary cancer < or = 5 mm and 9 were larger papillary tumors or follicular
      carcinoma. We analyzed these 112 patients to determine whether there was a simple
      method to identify those patients at risk for contralateral, unsuspected
      malignancy. With use of the AMES clinical staging retrospectively, 70 of the 112
      patients were classified as having low-stage disease. Fifty percent (35) had
      cancers on the primary side and 27% (19) on the contralateral side. Of these 19
      contralateral cancers, 14 were papillary cancers < or = 5 mm, 4 were papillary
      cancer > 5 mm and one was a 1.5 cm follicular carcinoma, a similar distribution
      as in the whole group of 112. When the AMES analysis then excluded those thought
      to be at risk for multicentricity or papillary carcinoma and examined female
      patients only with nonpapillary frozen sections, nonpapillary aspiration
      cytological results, and no history of radiation exposure, no further reduction
      in the proportion of contralateral cancers (7 of 26, 27%) was found. Fifty-five
      of the 112 patients underwent preoperative ultrasound scans. In those cases in
      whom the contralateral lobe had no intraoperative palpable or preoperative
      sonographic mass, 5 of 20 still had contralateral cancers, but all were papillary
      < or = 5 mm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369658
TI  - Clinical aspects of primary thyroid lymphoma: diagnosis and treatment based on
      our experience of 119 cases.
AB  - We describe the clinical aspects of primary thyroid lymphoma, particularly
      diagnostic procedures and successful therapy based on our observation of 119
      patients with primary thyroid lymphoma. Thyroid lymphoma occurred exclusively in
      the thyroid gland of patients with Hashimoto's thyroiditis as a rapidly growing
      mass in the thyroid gland. Therefore, progressively enlarging goiter and
      compression symptoms were the most common clinical manifestations. A significant
      number of patients in our series had subclinical hypothyroidism (14%) or overt
      hypothyroidism (27%) because of the coexistence of Hashimoto's thyroiditis.
      Whenever thyroid lymphoma is suspected, we recommend an ultrasound scan of the
      thyroid gland and fine needle aspiration biopsy as initial diagnostic procedures.
      Thyroid ultrasound showed characteristic asymmetrical pseudocystic pattern in 43
      of the 46 patients (93%), and thyroid cytologic examination showed abundant
      monomorphic infiltration of lymphoid cells. Among 83 patients who underwent fine
      needle aspiration biopsy, 65 patients (78.3%) were diagnosed correctly and 10
      patients (12%) had borderline cytologic results. Thus, 90% of patients with
      thyroid lymphoma were diagnosed or the diagnosis suspected based on fine needle
      aspiration biopsy. To confirm the diagnosis of lymphoma histologically and to
      determine the degree of malignancy, open biopsy taking 2-3 g tissue should be
      done for all cases. Treatment of thyroid lymphoma does not require resection of
      all lymphoma tissue or total thyroidectomy. Our successful treatment is radiation
      therapy combined with six courses of CHOP chemotherapy (cyclophosphamide,
      adriamycin, vincristine, prednisolone). This mode of therapy improved the 8-year
      survival rate to nearly 100% regardless of the histological type of malignancy.

PMID- 8369659
TI  - Platelet volume: laboratory measurement and clinical application.
AB  - Modern cell analyzers routinely produce platelet indices, but many clinicians do
      not utilize them in clinical decision-making. In part this can be attributed to
      difficulties with their laboratory measurement. The mean platelet volume is
      dependent on a number of variables, including time of analysis after
      venepuncture, method of analysis, anticoagulant used and specimen storage
      temperature. The influence of these laboratory variables is significant and
      reproducible mean platelet volumes are dependent on standardized laboratory
      methodology. When pre-analysis factors are controlled, alterations in platelet
      volume can be demonstrated in a number of disease states and assessment of
      platelet volume can be useful in the monitoring and diagnosis of patients. An
      understanding of the pathophysiology of alterations in platelet volume and of the
      inverse relationship between platelet volume and count is a prerequisite for the
      successful clinical application of platelet volume measurements.

PMID- 8369660
TI  - Management of the hematologic manifestations of HIV disease.

PMID- 8369661
TI  - Fluorescence in situ hybridization.
AB  - Spectacular advances in the use of fluorescence in situ hybridization (FISH) for
      the visualisation of specific DNA sequences in metaphase chromosomes and
      interphase cells have been made over the last few years making the technique a
      useful tool in clinical research. One of the biggest impacts has been in the
      field of detection and diagnosis of human malignancies. Chromosomal
      translocations, deletions, amplification of specific genes and changes in
      chromosome number can all be detected in the non-dividing interphase nucleus
      using probes ranging from whole chromosome 'paints' to individual gene specific
      probes. Gene mapping has also benefited from advances in FISH technology. Target
      sequences ranging from one to several hundred kilobases can be visualised on
      metaphase chromosomes and spatial resolution in interphase cells permits the
      ordering of two probes over a distance as small as 1000 base pairs. The potential
      uses of FISH continue to increase with each new technical innovation.

PMID- 8369662
TI  - Membrane proteins in paroxysmal nocturnal haemoglobinuria.
AB  - A review of recent information on the abnormalities of the blood cell membrane in
      paroxysmal nocturnal haemoglobinuria (PNH) is presented, with a detailed analysis
      of biochemical and flow cytometry findings. The complex patterns observed in the
      various cell lineages of which the PNH clone consists are described, and a
      simplified monoclonal antibody panel is defined for diagnostic purposes.
      Available data on in vitro culture of progenitor cells and on the recent
      establishment of PNH cell lines are summarized. Finally, we discuss speculative
      hypotheses on the growth advantage of the PNH clone.

PMID- 8369663
TI  - The changing course of thrombotic thrombocytopenic purpura and modern therapy.
AB  - Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder of unknown
      etiology. Pathologically, there appears to be an abnormal interaction between the
      vascular endothelium and platelets, but the primary event remains uncertain.
      While historically, TTP was a fatal disease, dramatic improvement in its outcome
      has occurred over the past two decades with the development of effective therapy.
      Plasma infusion or exchange remains the cornerstone of the treatment of TTP,
      along with corticosteroids, platelet inhibitor drugs, vincristine and
      splenectomy. This review summarizes the clinical findings, what is known of the
      pathogenesis and the available therapeutic modalities for TTP. In most cases,
      remissions can be attained and cures are now common. However, approximately half
      the patients will relapse. The clinical course at relapse is usually milder than
      the disease at presentation and less aggressive therapy may be needed. However,
      relapsing TTP still carries a significant mortality and preventive therapies are
      not always effective. Further progress may have to await an understanding of the
      fundamental etiology of this disease.

PMID- 8369664
TI  - A health care revolution.

PMID- 8369665
TI  - Nurse practitioners: primary providers at Lehigh County Visiting Nurse
      Association Family Health Clinic.

PMID- 8369666
TI  - Legal issues relating to access to medical records.

PMID- 8369667
TI  - Nurse-managed health care: an ongoing tradition.
AB  - Nurse-managed health care is a concept that has received much attention lately;
      however, it is not a new idea. Nurse-managed health care has been delivered
      through nursing centers since the beginning of the 20th century. This article
      examines the history of nursing centers and reports on the current diversity that
      exists in these centers today. Characteristics of academic and nonacademic
      nursing centers are examined through a review of the few studies currently
      available in the literature.

PMID- 8369668
TI  - Establishing a nurse-managed health center: getting started.
AB  - Many nurses are deciding that the best way to meet health care needs of clients
      and ensure high quality care is to establish a nurse-managed health center. This
      article provides practical information on assessing the need for such a center,
      determining the scope of services to be provided, obtaining the financial
      resources needed, and determining the staff and facilities required. The
      application of this information can make the center a reality.

PMID- 8369669
TI  - Establishing a nurse-managed health center: interacting with regulatory,
      professional, and fiscal environments.
AB  - In establishing a nurse-managed health center, one must be cognizant of legal and
      regulatory issues that could impact on the practice. The ability to negotiate
      outside services, such as laboratory and medical consultation, is important.
      Additionally, as an integral component of financial viability, attainment of
      third-party reimbursement should be considered.

PMID- 8369670
TI  - Establishing a nurse-managed health center: assuring excellence.
AB  - The roles of accreditation, clinical protocols, and quality assurance in
      maintaining high standards of quality in the nurse-managed health center are
      discussed. The components of a quality assurance program for the nurse-managed
      center are presented, including peer chart review, diagnosis-related review, and
      review of high-risk client encounters. Various methods of generating practice
      protocols for the nurse-managed center are outlined.

PMID- 8369671
TI  - The solo nurse practitioner: a private practice model.
AB  - This article discusses the experience of one NP through 4 years of an independent
      private practice. Suggestions are offered for those considering the option.
      Personal, practical, and financial factors should be carefully considered.
      Business training and a business plan are essential. Expected and unexpected
      outcomes are shared with the reader.

PMID- 8369672
TI  - Establishing a nurse-managed center: a community approach.
AB  - Documentation of need, designing and implementing services to meet the need,
      networking with and referral to other community providers, practice agreements,
      and mechanisms for reimbursement and billing are just a few issues that must be
      addressed when establishing a community-based health care unit. This article will
      discuss essentials of establishing a nurse-managed, community-based health care
      center, based on the author's experience in developing and managing the Outreach
      Health Care Unit.

PMID- 8369673
TI  - Combating blinding trachoma.

PMID- 8369674
TI  - Reflex anoxic seizures.

PMID- 8369675
TI  - Who needs dual chamber pacing?

PMID- 8369676
TI  - Doctors and markets.

PMID- 8369677
TI  - The new information management and technology strategy of the NHS.

PMID- 8369678
TI  - Wanted: guidelines that doctors will follow.

PMID- 8369679
TI  - France's Court of Appeal sentences blood officials.

PMID- 8369680
TI  - Squabbles over AIDS vaccine trials nearly over.

PMID- 8369681
TI  - Outcome of childhood status epilepticus and lengthy febrile convulsions: findings
      of national cohort study.
AB  - OBJECTIVE: To study outcome after lengthy febrile convulsions and status
      epilepticus in children. DESIGN: Population based birth cohort study. SETTING:
      The child health and education study (16,004 neonatal survivors born in one week
      in April 1970). SUBJECTS: Information available for 14,676 children. OUTCOME
      MEASURES: Clinical information and tests of intellectual performance at five and
      10 years after birth. RESULTS: 19 children had lengthy febrile convulsions and 18
      had status epilepticus. Two children with status epilepticus died (one at 5 years
      old); neither death was directly due to the status epilepticus. Four of the 19
      (21%) developed afebrile seizures after lengthy febrile convulsions compared with
      14 of the 17 (82%) survivors after status epilepticus. Measures of intellectual
      performance were available for 33 of the 35 survivors: 23 were normal and 10 were
      not normal but eight of them had preceding developmental delay or neurological
      abnormality. CONCLUSION: The outcome in children after lengthy febrile
      convulsions and status epilepticus is better than reported from studies of
      selected groups and seems determined more by the underlying cause than by the
      seizures themselves.

PMID- 8369682
TI  - Study of infection with HIV and related risk factors in young offenders'
      institution.
AB  - OBJECTIVES: To estimate the prevalence of infection with HIV in young offenders
      in Scotland and to obtain information about related risk factors and previous
      tests for HIV. DESIGN: Voluntary anonymous study with subjects giving saliva
      samples for testing for HIV and completing questionnaires about risk factors.
      SETTING: Polmont Young Offenders' Institution near Falkirk, Scotland. SUBJECTS:
      421 of 424 available male prisoners in Polmont. The questionnaires of 17 of the
      prisoners were excluded because of inaccuracies. MAIN OUTCOME MEASURES:
      Prevalence of infection with HIV and related risk behaviour. RESULTS: 68 (17%) of
      prisoners admitted misuse of intravenous drugs, of whom 17 (25%) admitted having
      injected drugs while in prison. Three subjects admitted having anal intercourse
      while in prison. Prevalence of misuse of intravenous drugs varied geographically:
      28% (33/120) of prisoners from Glasgow compared with 9% (7/81) of those from
      Edinburgh and Fife. A high level of heterosexual activity was reported, with 36%
      (142/397) of prisoners claiming to have had six or more female sexual partners in
      the year before they were imprisoned. Altogether 8% (32/389) of prisoners had
      previously taken a personal test for HIV: 50% (9/18) of those who had started
      misusing intravenous drugs before 1989, 18% (9/49) of those who started misuse
      later, and only 4% (14/322) of those who had not misused intravenous drugs. No
      saliva sample tested positive for antibodies to HIV, but 96 prisoners requested a
      confidential personal test for HIV as a result of heightened awareness generated
      by the study. CONCLUSIONS: Voluntary, anonymous HIV surveys can achieve excellent
      compliance in prisons, and the interest generated by the study suggests that
      prisons may be suitable sites for providing education and drug rehabilitation for
      a young male population at high risk of future infection with HIV.

PMID- 8369683
TI  - Lifelong exercise and stroke.
AB  - OBJECTIVES: To examine the potential of lifelong patterns of increased physical
      activity to prevent stroke. DESIGN: Case-control study. SETTING: 11 general
      practices in west Birmingham. SUBJECTS: 125 men and women who had just had their
      first stroke and were aged 35-74 and 198 controls frequency matched for age and
      sex recruited over 24 months during 1988-90. Exclusion criteria were a previous
      history of stroke, mitral valvular heart disease combined with atrial
      fibrillation, primary or metastatic cerebral neoplasm, or coagulation disorder or
      myeloproliferative disease. MAIN OUTCOME MEASURES: Odds ratios for stroke related
      to lifetime history of exercise after 15 years of age. RESULTS: A history of
      vigorous exercise during the ages 15-25 appeared to protect from stroke: odds
      ratio adjusted for age and sex 0.33 (95% confidence interval 0.2 to 0.6). This
      effect was independent of other potential risk factors. Increasing years of
      participation in vigorous exercise between the ages of 15 and 55 produced an
      increasing protection from stroke (p < 0.001). In the 65 cases and 169 controls
      who were free of cardiac ischaemia, peripheral vascular disease, and poor health
      recent vigorous exercise and walking were protective against stroke: odds ratios
      of 0.41 (0.2 to 1.0) for recent vigorous exercise and 0.30 (0.1 to 0.7) for
      recent walking. CONCLUSIONS: Appreciable protection from stroke in later life is
      conferred by vigorous exercise in early adulthood. This increased level of
      physical activity should, if possible, be continued lifelong.

PMID- 8369685
TI  - Microalbuminuria in chronic obstructive lung disease.

PMID- 8369684
TI  - Psychological distress in pregnancy and preterm delivery.
AB  - OBJECTIVE: To investigate if psychological distress during pregnancy is
      associated with increased risk of preterm delivery. DESIGN: Prospective,
      population based, follow up study with repeated measures of psychological
      distress (general health questionnaire), based on the use of questionnaires.
      SETTING: Antenatal care clinic and delivery ward, Aarhus University Hospital,
      Denmark. SUBJECTS: 8719 women with singleton pregnancies attending antenatal care
      for the initial visit between 1 August 1989 and 30 September 1991; 5872 women
      (67%) completed all questionnaires. MAIN OUTCOME MEASURE: Preterm delivery.
      Estimation of gestational age at delivery was mainly based on early ultrasound
      measurements. RESULTS: In 197 cases (3.6%) the woman delivered prematurely (less
      than 259 days). A dose-response relation between psychological distress in the
      30th week of pregnancy and risk of preterm delivery was found, but distress
      measured in the 16th week was not related to preterm delivery. Control of
      confounding was secured by the use of multivariate logistic regression models.
      Relative risk for preterm delivery was 1.22 (95% confidence interval 0.84 to
      1.79) for moderate distress and 1.75 (1.20 to 2.54) for high distress in
      comparison to low distress. CONCLUSIONS: Psychological distress later in
      pregnancy is associated with an increased risk of preterm delivery. Future
      interventional studies should focus on ways of lowering psychological distress in
      late pregnancy.

PMID- 8369686
TI  - Fine needle aspiration cytology in diffuse or multinodular goitre compared with
      solitary thyroid nodules.

PMID- 8369687
TI  - Erythema multiforme following substitution of amlopidine for nifedipine.

PMID- 8369688
TI  - Fluoxetine-warfarin interaction.

PMID- 8369689
TI  - Generalised seizure due to terfenadine.

PMID- 8369690
TI  - Opiate related collapse in an octogenarian.

PMID- 8369691
TI  - Is the cold chain for vaccines maintained in general practice?
AB  - OBJECTIVE: To investigate the cold chain for vaccines and compliance with the
      local code of practice for storage. DESIGN: In a random sample of general
      practices orders for live vaccines (oral polio and measles, mumps, and rubella)
      were accompanied by a cold chain monitor which was activated on leaving the
      supplying pharmacy. The monitors were read at specified intervals and when all
      vaccines in the order had been used. Structured interview was used to check
      compliance with the local code of practice on storage. SETTING: West Berkshire
      and Aylesbury Vale district health authorities. SUBJECTS: 16 (25%) general
      practices in West Berkshire, and 13 (50%) in Aylesbury Vale. MAIN OUTCOME
      MEASURES: Compliance with code of practice. Changes in the cold chain monitor.
      RESULTS: For six key requirements within the code of practice compliance varied
      from 70% to 0%. Only 16 of 29 practices had a named person responsible for
      vaccine storage and only four were aware of the local code of practice. Vaccine
      was stored for longer and more breaks in the cold chain occurred in West
      Berkshire than in Aylesbury Vale. The potency of some vaccines in 10 of 26 orders
      became suspect before use. CONCLUSIONS: Knowledge of appropriate management of
      the cold chain in two districts was poor. Breaks in the chain were more frequent
      and compromised potency more likely when vaccine had been stored for more than
      eight weeks. Problems in maintaining the cold chain indicate the need for
      continuing audit, which should become a prerequisite for payments to general
      practitioners for immunisation.

PMID- 8369692
TI  - Therapeutic aerosols in children.
AB  - The use and variety of drugs administered to children as inhaled aerosols is
      increasing, but little is known about how much drug reaches the lung and how it
      is distributed there in different age groups. In this article the reasons for
      measuring aerosol deposition in children are discussed and the potential methods
      for doing this described. Of the methods available, only the use of radiolabelled
      aerosols gives accurate information on total lung deposition and distribution.
      The potential risk of the radiation exposure required for these measurements
      varies with the age of the child but seems to be small. Properly designed studies
      are expected to clarify the factors affecting lung deposition in children and
      identify methods of inhalation associated with efficient and predictable delivery
      of the drug. Measurements of radioaerosol deposition may therefore be justified
      in children when this information is expected to lead to improvements in the
      effectiveness or safety of their treatment.

PMID- 8369693
TI  - Legal landmark for community care of former psychiatric patients.
AB  - A recent judgment of the Lands Tribunal has set an important precedent which
      should decrease the potential for restrictive covenants to thwart the development
      of the government's care in the community programme. In 1989 a Worthing couple
      were permitted to convert their own house into a residential care home for former
      psychiatric patients. Judge B Marder, QC, ruled on 12 January 1993 that the
      "public interest" outweighed a contractual stipulation that the property should
      be used only for residential, non-business purposes. This is a radical change in
      the Lands Tribunal's view of mental illness.

PMID- 8369694
TI  - Global regulations on diabetic treated with insulin and their operation of
      commercial motor vehicles. DiaMond Project Group on Social Issues.
AB  - Governments often regulate who may and may not drive vocationally for public
      safety purposes. Recent arguments, however, imply that employment opportunities
      may be limited unnecessarily for people with medical impairments. Drivers with
      diabetes treated with insulin are commonly perceived to pose an increased risk of
      accidents because of their susceptibility to hypoglycaemia. Much uncertainty,
      though, surrounds the data on the risks of these drivers. An international survey
      studied the licensing policies applied to professional lorry drivers with
      diabetes treated with insulin. Responses from 24 countries indicated that
      regulations differ considerably; ranging from a complete ban on professional
      driving to no restrictions at all. Many reasons may explain this difference,
      including the lack of data on the effects of hypoglycaemia on the incidence of
      traffic accidents. A proper account of the risks of diabetic drivers is necessary
      to balance fairly the rights of employment against the risks.

PMID- 8369695
TI  - Secondary adrenocortical insufficiency.

PMID- 8369696
TI  - NSAIDS in the postoperative period. Many factors threaten renal function.

PMID- 8369697
TI  - NSAIDS in the postoperative period...and after major surgery.

PMID- 8369699
TI  - The hazards of asbestos. Detailed occupational history is vital.

PMID- 8369698
TI  - NSAIDS in the postoperative period. Clinical experience confirms risk.

PMID- 8369700
TI  - The hazards of asbestos. Inaccurate diagnoses distort results.

PMID- 8369701
TI  - Management of uncomplicated miscarriage. Patients' safe with expectant
      management.

PMID- 8369702
TI  - Management of uncomplicated miscarriage. Randomized trials are possible.

PMID- 8369703
TI  - The hazards of asbestos. Access to vital data is denied.

PMID- 8369704
TI  - Delaying appendicectomy overnight.

PMID- 8369705
TI  - Bleeding complications after thrombolysis.

PMID- 8369706
TI  - Children's consent to treatment. Legal advice often unnecessary.

PMID- 8369707
TI  - Children's consent to treatment. Abstract debate is unhelpful.

PMID- 8369708
TI  - Analgesia for children in intensive care.

PMID- 8369709
TI  - Citizens' advice in general practice. Patients benefit from advice.

PMID- 8369710
TI  - Health care for prisoners ... by sympathetic medical staff.

PMID- 8369711
TI  - Health care for prisoners. Prison environment encourages conflict.

PMID- 8369712
TI  - Health care for prisoners. Whitemoor's inmates well cared for.

PMID- 8369713
TI  - Children are being denied intensive care.

PMID- 8369714
TI  - Diabetic services must match the patients.

PMID- 8369715
TI  - Screening for cystic fibrosis. Specialists get on with it.

PMID- 8369716
TI  - Insomnia in the chronic fatigue syndrome.

PMID- 8369717
TI  - Management of medical research. Room for improvement.

PMID- 8369718
TI  - Misrepresentation of epidural analgesia in labor.

PMID- 8369720
TI  - Management of medical research. Experience confirms directors' dissatisfaction.

PMID- 8369719
TI  - Management of medical research. Don't confuse management with administration.

PMID- 8369721
TI  - Management of medical research. Who exactly is in charge?

PMID- 8369722
TI  - Management of medical research. Management at MRC is modern and flexible.

PMID- 8369723
TI  - Management of medical research. Change requires a rational approach.

PMID- 8369724
TI  - Management of medical research. Judgement of science needs constant review.

PMID- 8369725
TI  - Management of medical research. Open up the evaluation process.

PMID- 8369726
TI  - Prevention of mural thrombus in porous inner tube of double-layered tube by
      saline perfusion.
AB  - An in vitro experiment under laminar nonpulsatile blood flow and an acute canine
      ex vivo femoral A-V series shunt experiment were undertaken to investigate the
      effectiveness of saline perfusion through pores of porous tubes to prevent
      formation of mural thrombus. PS/SBR porous tubes were used for the in vitro
      experiment. Commercially obtained ePTFE porous tubes were etched by sodium
      naphthalenide, and the etched tubes were used for the ex vivo experiment.
      According to the results of the in vitro experiment, mural thrombus on the
      surface of the porous tube could be prevented by the saline perfusion. Adhered
      blood cells decreased semi-logarithmically with increased perfusion rate (up to
      0.022 ml/min-cm2) of isotonic saline solution. According to results of the ex
      vivo experiment, mural thrombus decreased with increased perfusion rate (up to
      0.060 ml/min-cm2).

PMID- 8369727
TI  - Comparative study of the mechanical behaviour of Castaman external fixator in
      different mounting configurations.
AB  - The mechanical behaviour of the Castaman external fixator was determined using
      different mounting configurations in a system that simulated a long bone fracture
      during the formation of the bone callus. The first stage of the study was the
      determination of the stress-strain characteristics of the system with monolateral
      mounting. The second stage, the object of this study, is the analysis of the
      system with bilateral mounting and a comparison between the two configurations of
      the external fixator examined. Strain gauge analysis was used to determine the
      strains and stresses in the various elements of the system (fiches and external
      unit). Numerical techniques (FEM) were also used in order to confirm the results
      obtained using the simulation system. The results obtained show clearly the
      greater stiffness of the bilateral system. Combined bending and compressive
      stresses are present on both the screws and the external units, and reveal a
      little asymmetrical behaviour due to the conicity of the screws.

PMID- 8369728
TI  - Viscoelastic properties of stiff joints: a new approach in analyzing joint
      contracture.
AB  - The purpose of this study was to analyze the joint stiffness after immobilization
      in a rat's lower extremity model. Rat knee joints were surgically immobilized in
      a full flexed position for periods of up to 7 weeks with or without intra
      articular intervention. The biomechanical analysis was assessed by measuring the
      bone-joint-bone sample as a cantilever. Measurement was performed with (a) knee
      flexion angle with gravity, (b) fast Fourier transform analysis of time-dependent
      mechanical noise with random frequencies, and (c) dynamic stiffness and loss
      tangent with sinusoidal vibration at a certain frequency. The results showed that
      the conventional static mechanical test could not detect the intraarticular
      changes of the whole knee joint. The measurement of the viscoelastic properties
      covering wide frequencies revealed that an accurate change occurred.

PMID- 8369729
TI  - The role of ions and mineral-organic interfacial bonding on the compressive
      properties of cortical bone.
AB  - Bone tissue is a composite material composed of an inorganic stiff mineral phase
      embedded in a compliant organic matrix. Similar to other composites, the
      mechanical properties of bone depend upon the properties, volume fraction, and
      orientation of its constituents as well as the bonding interactions. Interfacial
      bonding between the mineral and organic constituents are based, in part, on
      electrostatic interactions between negatively charged organic domains and
      positively charged mineral surface. Phosphate and fluoride ions can alter mineral
      organic interfacial causing a permutation in the mechanical properties. Partial
      debonding between the mineral and organic constituents of bone may play an
      important role in the mechanical properties of aged and diseased bone. The
      present study examines the effects of phosphate and fluoride ion treatment on the
      compression properties of cortical bone and the reversibility of the effect.

PMID- 8369730
TI  - Prevention of blood cell adhesion in porous inner wall of double-layered tube by
      saline perfusion.
AB  - A double-layered tube consisting of a porous inner tube and a solid outer tube
      was used to perfuse isotonic saline solution into blood to prevent blood cell
      adhesion. Polystyrene/poly(styrene-co-butadiene) (PS-SBR) porous tubes were made
      using a dipping method. Citrated canine blood was circulated for 30 min with the
      flow rate of 100 ml/min using an in vitro blood circulation setup which makes
      nonpulsatile blood flow. Blood cell adhesion in the PS/SBR porous tubes decreased
      with increased saline perfusion rate regardless of changes in variables such as
      tube porosities, tube materials, and perfusion materials. The relationship
      between blood cell adhesion and perfusion rate was semi-logarithmic. Blood cell
      adhesion was relatively high in the more porous tube (65% sugar tube), compared
      to the less porous tube (55% sugar tube) for an identical saline perfusion rate.
      The blood cell adhesion in the sulfonated PS/SBR porous tube was less than that
      in the nonsulfonated (control) PS/SBR porous tube. The blood cell adhesion was
      also decreased by citrate perfusion. The results of this study indicates that the
      saline perfusion method can be used to prevent blood cell adhesion in the blood
      lines of extracorporeal circulation systems (such as hemodialysis and heart-lung
      machines) if certain technical problems involving the surface roughness can be
      resolved.

PMID- 8369731
TI  - Protein phosphorylation in the nerve terminal.

PMID- 8369732
TI  - Evidence of free radical damage in the central nervous system of guinea-pigs at
      the prolonged acute and early relapse stages of chronic relapsing experimental
      allergic encephalomyelitis.
AB  - Central nervous system tissue from guinea-pigs in various stages of chronic
      relapsing experimental allergic encephalomyelitis (CR-EAE) has been analysed for
      evidence of free radical damage using the thiobarbituric acid test as an
      indicator of oxidative changes. Levels of thiobarbituric acid-reactive materials
      in brain and spinal cord regions from prolonged acute and early relapse phases of
      CR-EAE were significantly higher than in central nervous system tissue from
      Freund's adjuvant control and normal uninoculated animals. In the late relapse
      phase of CR-EAE, levels of thiobarbituric acid-reactive materials in CNS samples
      were at control values. Fluorescence analysis of central nervous system tissue
      confirmed evidence of increased free radical damage in prolonged acute and early
      relapse stages of CR-EAE. The increased oxidative damage observed in the central
      nervous system in CR-EAE is discussed in relation to the role of macrophages and
      their oxidative burst.

PMID- 8369733
TI  - Cocaine-sensitive and -insensitive dopamine uptake in prefrontal cortex, nucleus
      accumbens and striatum.
AB  - Behavioral studies have indicated that the reinforcing effects of cocaine are
      dependent on inhibition of dopamine uptake in nucleus accumbens and prefrontal
      cortex. As it has been suggested that dopamine uptake and cocaine-inhibition of
      dopamine uptake may differ in nucleus accumbens, prefrontal cortex and striatum,
      we have further characterized dopamine uptake and its susceptibility to
      inhibition in these three regions. Dopamine uptake was resolved into two
      processes, which accounts for some of the apparent reported regional differences
      in sensitivity of dopamine to inhibition by cocaine. One, which is probably
      associated with uptake into dopaminergic terminals, was sensitive to 6
      hydroxydopamine lesions, cocaine, GBR 12909 or ouabain and was dependent on
      temperature and sodium ion concentration; this was responsible for most of the
      observed uptake in tissue from striatum and nucleus accumbens, but not from
      prefrontal cortex. There appeared to be no regional difference in susceptibility
      of this mode of dopamine uptake to either cocaine or GBR 12909. The other type of
      dopamine uptake, which represented a significant proportion of the total in
      prefrontal cortex, but not in striatum or nucleus accumbens, was relatively
      insensitive to cocaine, GBR 12909 and ouabain and was dependent on temperature,
      but not sodium ion concentration. In addition, the cocaine-insensitive dopamine
      uptake was more sensitive to inhibition by dopamine than serotonin, but did not
      distinguish between dopamine and norepinephrine. The occurrence of cocaine
      sensitive dopamine uptake in all examined regions and its equal sensitivity to
      cocaine and GBR 12909 is consistent with the involvement of nucleus accumbens
      and/or prefrontal cortex in the reinforcing effects of cocaine.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8369734
TI  - Antiserum against neuropeptide Y enhances the nicotine-mediated release of
      catecholamines from cultured rat adrenal chromaffin cells.
AB  - A primary culture of chromaffin cells was prepared from adult rats and the
      stability of cell contents, NPY and catecholamines (CAs), during the culture was
      studied. The responsiveness of cultured chromaffin cells to NGF or secretagogues
      and the possible role of NPY on the CA secretion from cultured chromaffin cells
      were investigated. After plating of isolated cells, there was marked decrease in
      the cell content of CAs but a significant increase in the cell content of NPY.
      Though both NPY and CAs in the cultured cells were positively regulated by NGF,
      the results of this study seemed to suggest a differential regulation for NPY and
      CAs in the chromaffin cell. The cultured chromaffin cells secreted NPY and CAs in
      response to stimulation by nicotine. The nicotine stimulated secretion of CA was
      enhanced by the presence of IgG fraction, prepared from NPY antiserum, in the
      secretion medium. The results suggested that NPY was co-released with CAs from
      chromaffin cells and then acted as a modulator on CA secretion.

PMID- 8369736
TI  - The superoxide dismutase activities of cerebral tissues, assayed by the
      chemiluminescence method, in the gerbil focal ischemia/reperfusion and global
      ischemia models.
AB  - Superoxide dismutase is well known to act as an effective antioxidant enzyme
      against cellular damage caused by oxidative stresses including
      ischemia/reperfusion-induced cerebral injury. However, it is still controversial
      whether or not the activity of endogenous superoxide dismutase changes during
      cerebral ischemia and reperfusion. In order to elucidate this phenomenon, we
      assayed the superoxide dismutase activity in the cerebral tissues of gerbils
      using the chemiluminescence method with a Cypridina luciferin analog. This method
      was demonstrated to be a sensitive and specific assay for the enzymatic activity
      of superoxide dismutase in cerebral tissues, which was not subject to
      interference from proteins or ascorbate. After 3 h of focal and global ischemia,
      there were no changes in the cerebral tissue superoxide dismutase activities.
      After 24 h of reperfusion following 1 h of ischemia, the superoxide dismutase
      activity decreased only approx 20%, whereas the adenylate kinase activities,
      measured in the same cerebral tissues as those used for superoxide dismutase
      assay, started to decline 1 h after reperfusion commenced and were approx 50% of
      the control levels after 24 h. These results show that almost all the activity of
      endogenous superoxide dismutase is maintained and does not decrease significantly
      as a result of ischemia/reperfusion-induced cerebral injury.

PMID- 8369735
TI  - Selective masking of M1-receptors in calf retina membranes by the venom of the
      marine snail Conus tessulatus.
AB  - The non discriminatory antagonist [3H]QNB labels M1- and M2-muscarinic receptors
      in calf retina membranes. Crude venom from the marine gastropod Conus tessulatus
      produces a partial decrease in [3H]QNB binding. The total number of sites (560 +/
      13 fmol/mg protein in control experiments) decreases to 370 +/- 10 fmol/mg
      protein whereas the affinity of the radioligand is unaffected (KD = 0.42 +/- 0.01
      nM and 0.46 +/- 0.02 nM, respectively). This process is venom concentration
      dependent, quasi-irreversible, and calcium-dependent. Proteolytic activity can
      not be detected. The partial effect of the venom is related to preferential
      masking of the M1-receptors. Competition curves of the M1-selective antagonist
      pirenzepine are shallow in control experiments: 45% of the receptors are of the
      M1-type (Ki = 45 +/- 6 nM) while the remaining are of the M2-type (Ki = 1.0 +/-
      0.2 microM). In venom-treated membranes, only a low affinity site (M2-receptors,
      Ki = 1.5 +/- 0.4 microM) is detected by pirenzepine competition binding.
      Saturation binding experiments reveal that the venom causes a substantial
      decrease in the number of high affinity sites for [3H]pirenzepine without
      affecting its KD (23 +/- 4 nM and 20 +/- 6 nM in control- and venom-treated
      membranes respectively). The venom produces a leftward shift of the
      carbachol/[3H]QNB competition binding curve, but the ability of 0.1 mM GTP to
      confer a rightward shift of the competition curve is not affected.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8369737
TI  - The subcellular distribution of [3H]-CGS 21680 binding sites in the rat striatum:
      copurification with cholinergic nerve terminals.
AB  - The subcellular distribution of the adenosine A2a receptor in rat striatum has
      been investigated using specific binding of the A2a-selective ligand [3H]-CGS
      21680. After subcellular fractionation, the distribution of [3H]-CGS 21680
      binding was similar to that of the cholinergic nerve terminal marker
      acetylcholinesterase rather than the more general membrane marker 5'
      nucleotidase, with 42% of binding associated with the synaptosomal sub-fraction
      and 19% with a light membrane fraction. Binding of [3H]-CGS 21680 was also found
      to co-purify with the cholinergic nerve terminal marker choline acetyltransferase
      during immunoaffinity purification of striatal cholinergic nerve terminals. These
      results demonstrate that some adenosine A2a receptors are present on cholinergic
      nerve terminals in rat striatum.

PMID- 8369738
TI  - Indole-pyruvic acid treatment reduces damage in striatum but not in hippocampus
      after transient forebrain ischemia in the rat.
AB  - The effects of treatment with indole-pyruvic acid, an endogenous metabolite of
      tryptophan converted into kynurenic acid in the brain, were studied in rats after
      transient forebrain ischemia induced by the 4-vessel occlusion procedure. The
      histological analysis showed a significant protective effect of indole-pyruvic
      acid treatment on striatal ischemic lesions assessed by the extent of regional
      atrophy and the area of neuronal disappearance 14 days after ischemia. Striatal
      neurons were labelled by dopamine and adenosine 3':5' monophosphate regulated
      phosphoprotein-32 immunoreactivity. Conversely, increased neuronal loss, regional
      atrophy and glial fibrillary acidic protein immunoreactivity, an index of post
      injury astroglial activation, were observed in the hippocampal formation,
      especially the CA3 field, of indole-pyruvic acid-treated rats when compared with
      vehicle-treated ischemic rats. The treatment with indole-pyruvic acid did not
      produce any improving effects in a test assessing short-term impairments after
      transient ischemia (motor test score at 24 h and 48 h post-ischemia).
      Furthermore, no significant effects of indole-pyruvic acid treatment were found
      on performance in water T-maze studied at 7 and 14 days post-ischemia. The
      opposite effects of indole-pyruvic acid on ischemic lesion in different brain
      regions may be related to its multiple neurochemical actions in the brain. The
      protective effect of indole-pyruvic acid on ischemic damage in striatum may be
      due to its conversion into kynurenic acid, a broad spectrum glutamate receptor
      antagonist. At hippocampal level, where glutamate receptor antagonists have been
      proved ineffective in the present lesion model, indole-pyruvic acid-induced
      changes in monamine availability may lead to a worsening of neuronal damage.

PMID- 8369740
TI  - Monosialoganglioside (GM1) restores membrane fatty acid levels in ischemic tissue
      after cortical focal ischemia in rat.
AB  - Using a consistent, reproducible and reliable cortical focal ischemia in rat
      (permanent unilateral occlusion of the left middle cerebral artery & the
      ipsilateral common carotid artery [MCAo + CCAo] with a 1 h temporary occlusion of
      the contralateral CCA), the levels of four major membrane fatty acids (palmitic,
      C16:0; stearic, C18:0; Oleic, C18:1 and arachidonic, C20:4) were analyzed at 3,
      36 and 72 h, and 2 and 4 wk following ischemia to determine the critical point of
      irreversibility of the cellular plasma membrane disorganization in primary
      ischemic (Area 1, parietal cortex) and peri-ischemic (Area 2, tempero-occipital
      cortex) areas. The cortical focal ischemia resulted in time dependent
      differential loss in four of these major membrane fatty acids. The quantitative
      differences among primary and peri-ischemic areas reflected the different degree
      of ischemic injury inflicted to these regions. Acute treatment with ganglioside
      GM1 protected the further losses of all of these fatty acids and differentially
      restored their levels in these various injury sites over periods of time. The
      changes in levels of these membrane fatty acids indicate that the primary
      ischemic area suffers an irreversible injury and peri-ischemic area suffers
      reversible injury. After acute treatment (< 2 h) with ganglioside GM1, a partial
      recovery was observed in primary ischemic area and complete recovery was observed
      in peri-ischemic areas. These studies support the hypothesis that, ischemia leads
      to a irreversible plasma membrane disorganization which underlies the eventual
      cell death, and protection and restoration of these membrane changes by drugs,
      such as ganglioside GM1 leads to neuroprotection against ischemic injury.

PMID- 8369739
TI  - Aging does not affect the susceptibility to lipid peroxidation and lysosomal
      enzyme release of rat visual system structures and sciatic nerve.
AB  - The aim of the present study was to clarify the issue of lipid peroxidation
      operating in visual system structures and sciatic nerve of the rat as a
      contributing factor to senescence. In 4-, 14- and 28-month-old male rats, the
      amount of endogenous malondialdehyde, conjugated dienes and extractable
      phospholipids were all taken as indices of lipid peroxidation. In addition, the
      total free and released enzyme activities of four lysosomal hydrolases were
      evaluated. The susceptibility of all these parameters to in vitro iron-induced
      peroxidation was also taken as an age-related indicator of the endogenous
      peroxidative potential of the nervous tissues examined. Our data show that the
      content of malondialdehyde and phospholipids did not change in an age-related
      fashion. Furthermore, the susceptibility of rat visual system structures to lipid
      peroxidation, together with the release of lysosomal enzymes were unchanged as a
      function of aging. The results do not lend support to the hypothesis that an
      increase in overall lipid peroxidation is peculiar to the aging phenomenon of the
      central nervous system areas which delimit the rat visual pathway.

PMID- 8369741
TI  - Intracellular formation and release of adenosine from rat hippocampal slices
      evoked by electrical stimulation or energy depletion.
AB  - In this study, the basal and evoked release of [3H]- and endogenous adenosine,
      inosine and hypoxanthine from rat hippocampal slices, labelled with [3H]adenine,
      was investigated. Evoked release was brought about by either electrical
      stimulation or energy depletion. The aim was to determine whether adenosine is
      formed intracellularly, and released as adenosine or extracellularly, from
      sequential extracellular hydrolysis of released ATP. All measurements were made
      in the presence of 5 microM erythro-9-(2-hydroxy-3-nonyl) adenosine (EHNA) to
      inhibit the enzyme adenosine deaminase. It was found that electrical field
      stimulation (5 min) increased the release of endogenous adenosine from
      hippocampal slices 10-fold and increased the proportion of [3H]-label associated
      with adenosine from approx 7% of the total released to 13% after the first
      stimulation and 20% after the second stimulation. Removal of oxygen and glucose
      from the superfusion medium (energy depletion) increased the release rate of
      endogenous adenosine 16-fold and increased the proportion of [3H]-label
      associated with [3H]adenosine from approx 10% of the total released to 50%. In
      order to prevent extracellular formation of adenosine, experiments were carried
      out in the presence of 50 microM alpha, beta-methylene ADP (AOPCP), an inhibitor
      of ecto-5'-nucleotidase. AOPCP was found to be without effect on either the basal
      or evoked release of adenosine. In contrast, L-homocysteine thiolactone (0.1-1.0
      mM) which was used to "trap" intracellular adenosine reduced both the basal and
      evoked release of adenosine by 70-85%. This effect of L-homocysteine thiolactone
      also occurred in the presence of adenosine uptake inhibitors. It is concluded
      from these results that adenosine is formed predominantly intracellularly in
      hippocampal slices and is released as adenosine as a result of either tissue
      depolarisation or energy depletion. Furthermore, the finding that during energy
      depletion there is a proportionally greater release of adenosine than other ATP
      breakdown products, such as inosine and hypoxanthine, indicates that energy
      depletion is both a potent and selective stimulus for adenosine formation and
      release.

PMID- 8369742
TI  - Action of myenteric GABAergic neurons in the guinea pig stomach.
AB  - GABAergic neurons in the guinea pig stomach were localized immunocytochemically
      using antibodies against its synthesizing enzyme, L-glutamate decarboxylase
      (GAD). Numerous ganglion cells and nerve bundles in the myenteric plexus were
      found to be GAD-positive, while the longitudinal muscle, submucosa and mucosa
      were largely devoid of GABAergic innervation. The distribution of GABAergic
      neurons and their processes in both myenteric ganglia and circular muscle is
      rather uneven throughout the stomach. GABA elicited contraction of the
      longitudinal fashion (LF) strips of the body and antrum of guinea pig stomach in
      a concentration-dependent fashion with a maximal response at 10(-7) M and 10(-5)
      M, respectively. GABA-induced contraction appears to be mediated by the GABAA
      receptor and not the GABAB receptor, since the action is blocked by bicuculline,
      a GABAA receptor antagonist. Furthermore, GABAA agonists e.g. muscimol produced
      even stronger responses than GABA itself while GABAB agonist, (-)baclofen had no
      effect in eliciting muscle contraction. The GABAA receptor is desensitized by
      prolonged exposure to its agonists such as GABA and muscimol. However, no such
      desensitization was observed for the muscarinic cholinergic receptor. The GABA
      action in eliciting smooth muscle contraction seems to involve two components,
      one is scopolamine and tetrodotoxin (TTX) sensitive, and the other one is
      insensitive to scopolamine and TTX. It is proposed that the scopolamine- and TTX
      sensitive component acts through a direct or indirect interaction between
      GABAergic and cholinergic neurons whereas the scopolamine- and TTX-insensitive
      component acts directly upon the smooth muscle.

PMID- 8369743
TI  - Purification and characterization of Silurus asotus (catfish) roe lectin.
AB  - A rhamnose-binding lectin isolated from Silurus asotus (catfish) roe by DEAE
      cellulose ion exchange and galactose-Sepharose affinity chromatographies
      predominantly agglutinated human type B and rabbit erythrocytes. S. asotus lectin
      (SAL) also agglutinated sarcoma 180 ascites carcinoma cells, but not AH109A
      cells. The most effective saccharide in hemagglutination inhibition assay was L
      rhamnose. The monosaccharides possessing steric similarity to the hydroxyl group
      orientation at C2 and C4 of the pyranose ring structure of L-rhamnose, such as L
      mannose and L-lyxose, were also effective. The molecular weight of SAL was
      determined to be 38000 by size exclusion chromatography on TSK gel G3000SW and
      33000 by SDS-polyacrylamide gel electrophoresis under reducing conditions. SAL
      did not require a Ca2+ ion or free thiol group for its agglutination activity.
      The N-terminal 29 amino acid sequence was determined by a gas-phase sequencer as
      follows, ANMITCYGDVQKLHXETGLIIVKSXLYGR (X: not determined). It has no homology to
      the sequences of well known vertebrate lectins.

PMID- 8369744
TI  - Site-specific inactivation of papain by ascorbic acid in the presence of cupric
      ions.
AB  - The mechanism of inactivation of papain (EC 3.4.22.2) by ascorbic acid (AsA) in
      the presence of cupric ions (Cu2+) was investigated. The aerobic combination of
      Cu2+ and AsA resulted in an irreversible loss of enzyme activity. The
      inactivation was found to be an apparent first order reaction. The prior mixing
      of Cu2+ and AsA caused the complete disappearance of the inactivation. The
      addition of iron ions led to significant suppression against the inactivation.
      Cu2+ was bound to the enzyme in a molar ratio of 1:1. At lower concentrations of
      Cu2+ (molar ratio of enzyme to Cu2+ of 1: < 1), the extent of inactivation showed
      the same dependence against the extent of oxidation of AsA. The rate of
      inactivation increased as the concentration of AsA was increased. Saturation
      kinetics were observed with respect to the concentration of AsA. Changes in the
      concentration of Cu2+ had no effect on the dissociation constant of the enzyme
      AsA complex (KI), though the rate constant of inactivation (k2) showed a linear
      relationship with the concentration of Cu2+. At various pH values tested, no
      change of k2 was found, whereas the value of KI increased when the pH bacame
      lower. At higher concentrations of Cu2+, the rate of inactivation fell beyond a
      certain concentration of AsA. The present results suggest that both Cu2+ and AsA
      bind to the enzyme to form a ternary complex and that free radicals are site
      specifically formed and react preferentially with the enzyme, at the site of
      their formation, impairing its activity.

PMID- 8369745
TI  - Effects of lipid peroxidation on surface charge density of the porcine intestinal
      brush-border membranes.
AB  - The effects of lipid peroxidation on the surface charge density of the porcine
      intestinal brush-border membranes were studied using an oxygen-radical-generating
      system consisting of ascorbic acid, ferrous ion and tert-butyl hydroperoxide
      (tert-BuOOH). Changes in the membrane surface charge density were monitored using
      a fluorescent dye, 8-anilino-1-naphthalenesulfonate (ANS). The incubation of the
      membranes with ascorbic acid/Fe2+/tert-BuOOH resulted in a decrease of the
      fluorescence intensity of the ANS-membrane complex with a red-shift in the
      emission maximum, depending on the hydroperoxide concentration and the incubation
      time. The kinetic studies on ANS-binding showed that the apparent dissociation
      constant of ANS-membrane complex decreased by treatment with ascorbic
      acid/Fe2+/tert-BuOOH. Similar results were also obtained by treatment of the
      membranes with other oxidizing systems, hematin/tert-BuOOH and
      dipyridyl/Fe2+/tert-BuOOH. These results proposed the possibility that lipid
      peroxidation of the membranes causes an increase of the positive charge on the
      membrane surface. The results of the dependence of the ionic strength with
      increasing KCl concentrations in the medium upon the ANS-binding affinity for the
      membranes further supported this interpretation.

PMID- 8369746
TI  - Characterization of two acidic polysaccharides having immunological activities
      from the root of Panax ginseng.
AB  - Two acidic polysaccharides, named ginsenan PA and ginsenan PB, were isolated from
      the root of Panax ginseng C. A. Meyer. They were homogeneous on electrophoresis
      and gel chromatography, and their molecular masses were estimated to be 1.6 x
      10(5) and 5.5 x 10(4), respectively. They are composed of L-arabinose: D
      galactose: L-rhamnose: D-galacturonic acid: D-glucuronic acid in the molar ratios
      of 11:22:1:6:1 (ginsenan PA) and 3:7:2:8:1 (ginsenan PB), in addition to small
      amounts of O-acetyl groups. Almost all (ginsenan PA) and part (ginsenan PB) of
      the hexuronic acid residues exist as methyl esters. Reduction of carboxyl groups,
      methylation analysis, nuclear magnetic resonance and periodate oxidation studies
      indicated that their structural features include mainly both alpha-arabino-beta
      3,6-galactan type and rhamnogalacturonan type structural units. Both
      polysaccharides showed remarkable reticuloendothelial system-potentiating
      activity in a carbon clearance test, pronounced anti-complementary activity and
      alkaline phosphatase-inducing activity in a dose dependent manner.

PMID- 8369747
TI  - The amino acid sequence of neocarzinostatin apoprotein deduced from the base
      sequence of the gene.
AB  - A segment of the neocarzinostatin apoprotein gene corresponding to T30 to A91 of
      the protein was amplified using a polymerase chain reaction (PCR) with total DNA
      from Streptomyces carzinostaticus subsp. neocarzinostaticus E-793 (ATCC 15944) as
      the template and with 5'- and 3'-primers synthesized in consideration of the
      codon usage of streptomyces. The PCR product was cloned, sequenced and confirmed
      to direct an amino acid sequence reasonably well matching that reported. Using
      the PCR product as a probe, we cloned a DNA segment (2580 bp) spanning an open
      reading frame (ORF) for preapoprotein (leader peptide plus apoprotein) and its
      upstream and downstream flanking regions. The amino acid sequence deduced from
      the base sequence of the DNA clearly identified those amino acid residues which
      had remained inconsistent among different research groups. The base sequence
      homology with other apoprotein genes of related antibiotics was analyzed and was
      found to be limited within the structural gene.

PMID- 8369748
TI  - Local cerebral glucose utilization in rats with decerebrate rigidity and effects
      of centrally acting muscle relaxants, diazepam and tizanidine.
AB  - Local cerebral glucose utilization (LCGU) was investigated in rats with
      decerebrate rigidity using the [14C]2-deoxyglucose (2DG) method in order to
      identify the site responsible for the rigidity. LCGU was increased in the medial
      vestibular nucleus, the fastigial nucleus, the interpositus nucleus and the
      dentate nucleus during decerebrate rigidity. Diazepam and tizanidine, centrally
      acting muscle relaxants, reduced the increase of LCGU in the vestibular and
      cerebellar nuclei. These results suggest that the vestibular and cerebellar
      nuclei are the possible sites responsible for the development of decerebrate
      rigidity and the action of some centrally acting muscle relaxants.

PMID- 8369749
TI  - Possible antifertility agents belonging to substituted indoles.
AB  - Of the 21 compounds evaluated for antiimplantation and abortifacient activities,
      compounds (A1, A2, A4 and B1) and compounds (C1, C2, D1 and D3) were found to
      exhibit 40% and 30% antiimplantation activity, respectively, in female rats when
      given orally on days 1-5 postcoitum. The remaining 13 compounds were found to be
      inactive. All of the 21 compounds were also tested for the abortifacient
      activity, but all were found to be inactive.

PMID- 8369750
TI  - Lack of stereoselectivity in rat liver peroxisomal enzyme induction by optically
      active phenoxyacetic acids.
AB  - To ascertain if there is stereoselectivity in peroxisomal proliferation induced
      by chiral peroxisome proliferators, induction by stereoisomers of 2-methyl-4'
      chlorophenoxyacetic acid and 2-methyl-2-(2'-4'-dichlorophenoxy)acetic acid were
      studied in rat in vivo and in vitro with isolated rat hepatocytes. No significant
      differences in the inducing potencies of the stereoisomers of the above two
      phenoxyacetic acid derivatives were found for cyanide-insensitive fatty acyl-CoA
      oxidizing system, fatty acyl-CoA oxidase, carnitine acetyltransferase or
      carnitine palmitoyltransferase. There was also no significant difference in the
      degree of hepatomegaly or lipid-lowering effect between the isomers. The findings
      with cultured rat hepatocytes agreed with those of the studies in vivo.

PMID- 8369751
TI  - Pharmacokinetics of novel hexapeptides with neurotensin activity in rats.
AB  - A high-performance liquid chromatographic method to determine (Me)Arg-Lys-Pro-Trp
      tert-Leu-Leu (NT-2) with neurotensin (NT) activity in rat plasma was developed
      and a pharmacokinetic study was performed in rats. Quantitative analysis with
      high reproducibility was achieved for NT-2 over the concentration range of 1.14
      500 ng/ml. (Me)Arg-Lys-Pro-Trp-tert-Leu-Leu-OEt (NT-1) was rapidly hydrolyzed to
      NT-2 in rat plasma at 37 degrees C. This degradation of NT-1 was observed as a
      pseudo first-order reaction, and the pseudo first-order rate constant was
      calculated to be 7.26 min-1 (t1/2 = 0.095 min). The pharmacokinetic profiles of
      NT-2 after intravenous administration of NT-1 at doses of 0.1 and 0.3 mg/kg were
      compatible with that of NT-2 after intravenous administration of NT-2 at 0.5
      mg/kg. Range of the half-life of the terminal phase (t1/2 beta) of NT-2 was 0.36
      0.53 h. The absolute bioavailabilities after oral administrations of NT-1 and NT
      2 at a dose of 20 mg/kg were 0.61 +/- 0.17 (mean +/- S.E.) and 0.19 +/- 0.08%,
      respectively. It was found that NT-1 was more suitable for oral administration
      than NT-2.

PMID- 8369752
TI  - Pharmacokinetic characteristics and antitumor activity of the N-succinyl-chitosan
      mitomycin C conjugate and the carboxymethyl-chitin-mitomycin C conjugate.
AB  - The conjugate between N-succinyl-chitosan (Suc-chitosan) and mitomycin C (MMC),
      named Suc-chitosan-MMC, and that between carboxymethyl-chitin (CM-chitin) and
      MMC, named CM-chitin-MMC, were investigated in vivo. As for the intraperitoneal
      drug administration using rats, the order of the maximum blood concentration of
      MMC was unconjugated MMC > CM-chitin-MMC > Suc-chitosan-MMC. The plasma
      concentration of MMC for Suc-chitosan-MMC was maintained at an almost constant
      level over 24 h. Pharmacokinetic analysis of each plasma concentration indicated
      that for each conjugate, the in vitro drug release reported previously was useful
      for the approximate estimation of the in vivo regeneration of MMC. The
      chemotherapeutic effect of MMC and the conjugates was investigated using mice
      bearing L1210 leukemia or B16 melanoma. Concerning antitumor activity against
      L1210 leukemia, the conjugates exhibited a marked effect at higher doses, and
      their effect increased even in the dose range where the effect of MMC decreased.
      MMC and the conjugates exhibited a good growth-inhibitory effect against B16
      melanoma. Complete inhibition of growth of B16 melanoma was observed at the dose
      of 10 mg eq MMC/kg for CM-chitin-MMC.

PMID- 8369753
TI  - A study of cis-diamminedichloroplatinum(II) suppositories for the treatment of
      rabbit uterine endometrial carcinoma.
AB  - cis-Diamminedichloroplatinum (II) (cisplatin: CDDP) suppositories containing NaCl
      at different concentrations were prepared as a local chemotherapeutic agent for
      the treatment of uterine endometrial carcinoma and were administered to rabbits
      implanted with uterine VX2 tumor. The intrauterine CDDP histological level, as
      well as the antitumor effects and side effects of the suppositories to the liver
      and kidney were studied. The results showed high intrauterine tissue CDDP level
      in all suppository administrations. In particular, the NaCl-added suppositories
      enhanced the intrauterine CDDP level. As for antitumor effects, while the tumor
      growth rate of the NaCl-added suppository group was likely to be suppressed, the
      suppositories could not suppress tumor growth completely. The plasma platinum
      (Pt) level was 1.5 micrograms/ml or less and that of the liver and kidney was as
      low as 0.31 to 0.48 micrograms/g. No difference in levels depending on NaCl
      concentration was observed, nor was any abnormality found in the biochemical
      analysis including glutamate oxaloacetate transaminase (GOT) and blood urea
      nitrogen (BUN). Histopathological study revealed the degeneration of tumor cells
      in the NaCl-added suppository group. Minimal congestion and hemorrhage were
      observed in the endometria, possibly resulting from CDDP. By adding NaCl to CDDP
      suppositories, the uterine CDDP level and antitumor effects increased while no
      serious renal dysfunction was noted. Therefore, we conclude that NaCl-added CDDP
      suppositories are a useful local chemotherapy for endometrial carcinoma.

PMID- 8369754
TI  - Population pharmacokinetics of theophylline. I: Intravenous infusion to children
      in the acute episode of asthma.
AB  - The population pharmacokinetics of theophylline during constant-rate intravenous
      infusion has been studied in 66 children (8.7 +/- 4.7 year of age; 26.0 +/- 12.8
      kg, mean +/- S.D.) with an episode of acute asthma. One hundred and twelve
      theophylline serum concentrations (13.9 +/- 4.8 micrograms/ml) collected
      retrospectively were analyzed using a nonlinear mixed-effect model. The influence
      of hepatic dysfunction, age, gender, days after admission, blood gas measurements
      (PaO2, PaCO2, blood pH) and clinical analyses data (total serum protein, albumin
      concentration, haemoglobin concentration, haematocrit) on theophylline clearance
      was examined by the likelihood ratio test. A final estimate of population mean
      clearance was 58.6 ml/kg/h, which was decreased by 36% in patients with hepatic
      dysfunction. Other factors tested displayed no statistically significant effect
      on theophylline clearance. The inter-individual variability in clearance was 26%
      while the intra-individual variability in theophylline concentrations was 2.6
      micrograms/ml as a standard deviation, which was almost double that observed for
      stable patients. Taking into account that the therapeutic window of this drug is
      10-20 micrograms/ml, this value indicates a relatively large intra-individual
      variability and suggests that frequent (daily) monitoring of serum concentrations
      is necessary for patients with an episode of acute asthma.

PMID- 8369755
TI  - The influence of increased plasma protein binding on the disposition of quinidine
      in turpentine-treated rats.
AB  - The effect of the increased plasma protein binding of quinidine on its
      disposition was investigated in turpentine-treated rats, since turpentine
      treatment is known to increase the plasma concentration of alpha 1-acid
      glycoprotein which preferentially binds basic drugs. The plasma free fraction of
      quinidine 16 and 48 h after turpentine treatment was decreased by 30 and 76%,
      respectively, compared to the control value. The treatment did not cause liver
      injury nor alter the hepatic blood flow. The disappearance of quinidine in plasma
      after an intravenous injection (3.0, 7.0, 12.5 mg/kg) was analyzed by a two
      compartment open model in both control and turpentine-treated rats. The blood
      total body clearance (CLb) of quinidine at 48 h after the treatment was decreased
      by 30 to 65% in a dose-dependent manner, compared to that in control rats. The
      distribution volume (Vdss) of quinidine (12.5 mg/kg) at 16 and 48 h after
      turpentine treatment was decreased by 30 and 79%, respectively. Hepatic
      extraction ratio (HER) of quinidine, which was determined at steady state blood
      concentrations from 0.5 to 2.3 micrograms/ml, was decreased from 0.8 to 0.35 with
      an increase in the quinidine concentration in control rats. The HER value 48 h
      after turpentine treatment was consistently reduced by 15 to 40% in a
      concentration-dependent manner compared to the corresponding control value. These
      findings indicate that the increased plasma binding of quinidine caused a
      reduction of HER of the drug, and the reduced HER resulted in the decrease in CLb
      in turpentine-treated rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369756
TI  - Systemic effects of epidermal growth factor (EGF) ointment containing protease
      inhibitor or gelatin in rats with burns or open wounds.
AB  - The systemic effects of epidermal growth factor (EGF) ointment containing
      nafamostat (NM), gabexate, or gelatin was studied in rats with burns or open
      wounds. At 1 d after burn, plasma epinephrine, cortisol, and glutamic-oxalacetic
      transaminase (GOT) levels were elevated, but treatment with EGF plus NM (EGF+NM)
      ointment significantly suppressed the increase in these levels. Further, there
      was no loss of body weight in the open wound model following treatment with
      EGF+NM ointment, while loss of body weight occurred in animals in which EGF
      ointments without NM were applied. Increases in plasma epinephrine 1 d after open
      wound formation were also suppressed by the application of EGF+NM ointment.
      Treatment with EGF ointment containing gabexate (GX) or gelatin (GL) ameliorated
      changes in body weight that occurred after open wound formation, while loss of
      body weight in animals with open wounds occurred following the application of
      ointment base, EGF ointment, GX ointment, or GL ointment. The present study thus
      indicates that the topical application of EGF ointment containing a protease
      inhibitor has ameliorative systemic effects.

PMID- 8369757
TI  - Detection of tetracycline resistance protein encoded by Bacillus subtilis plasmid
      pNS1.
AB  - Tetracycline resistance protein (TET) of Bacillus subtilis plasmid pNS1 was
      detected by immunoblot analysis using a specific antibody to TET-chloramphenicol
      acetyltransferase (CAT) fusion protein. In two-dimensional electrophoresis, one
      major spot which seemed to be the pNS1-encoded TET (pNS1-TET), was detected by
      immunostaining. Its molecular weight and isoelectric point were approximately 52
      kDa and 6.2, respectively. Judging from the nucleotide sequence, the pNS1-TET is
      a very hydrophobic, 50 kDa protein. Therefore, the 52 kDa protein is thought to
      be an intact form of the pNS1-TET produced by B. subtilis cells.

PMID- 8369758
TI  - Accumulation of (E)-4-hydroxy-2-nonenal and n-hexanal, degradation products of
      lipid peroxides, in mouse lung and liver.
AB  - Effects of lipid peroxide breakdown products, (E)-4-hydroxy-2-nonenal (4-HN) and
      n-hexanal, on mouse lung lesion were examined. When 4-HN was injected i.v., the
      plasma level of 4-HN increased just after the injection and then decreased
      immediately. The amounts of 4-HN increased in the liver and lung were ca. 0.085
      and 0.43% to the dose administered, respectively, 5 min after the injection.
      Reduced glutathione (GSH) content and both GSH peroxidase (GSH-Px) and GSH
      reductase (GSSGR) activities in the lung were decreased significantly by 4-HN
      treatment. On the other hand, in the case of i.v. injection of n-hexanal into
      mice, the amount of n-hexanal detected in the lung was 5.0% to that of 4-HN, and
      no effect on the activities of GSH-Px and GSSGR and the content of GSH was
      observed. These results suggest that 4-HN generated from lipid peroxides would be
      transferred into the lung and cause the lung lesion through the inhibition of GSH
      dependent antioxidative defense systems.

PMID- 8369759
TI  - Recognition of a palindromic DNA sequence by ESF-1, a factor stimulating
      transcription of the adenovirus type 12 E1A gene.
AB  - We previously identified a factor, designated E1A-stimulating factor 1 (ESF-1),
      that stimulates transcription of the adenovirus type 12 E1A gene in vitro by
      binding to a region next to a TATA box. We report here on the partial
      characterization of the mode of ESF-1 action. Point mutations within the
      nucleotide sequence 5'-TCAGCTGA-3' abolished the binding of ESF-1. Stimulation of
      transcription of the adenovirus type 12 E1A gene in vitro was lost when a 7 base
      pair insertion was introduced between the ESF-1-binding site and a TATA box.
      These results suggest that ESF-1 stimulates adenovirus type 12 E1A gene
      transcription by interacting with a palindromic DNA sequence present in a region
      immediately upstream from a TATA box.

PMID- 8369760
TI  - Further differentiation of 2'- and 4'-chloroflavones as inducers of hepatic
      microsomal monooxygenases in rats.
AB  - 2'-Chloroflavone (CF) and 4'-CF were studied as inducers of cytochrome P-450
      mediated monooxygenases in rat hepatic microsomes by comparison with
      phenobarbital (PB) and 3-methylcholanthrene (MC). As a result of interaction with
      the substrate 7-ethoxycoumarin (7-EC), 2'-CF-induced microsomes showed a
      difference spectrum different from usual type I, whereas 4'-CF-induced microsomes
      showed a typical type I spectrum. 2'-CF-induced microsomes increased the Vmax of
      aminopyrine (AM) N-demethylase activity about 1.6-fold while not affecting the
      apparent Km value. In contrast, 4'-CF-induced microsomes decreased the Km of 7-EC
      O-deethylase activity to about one fourth while significantly increasing the Vmax
      value. All the activities of AM N-demethylase, 7-EC O-deethylase and 6,7
      dimethoxycoumarin O-demethylase in 2'-CF-induced microsomes were inhibited
      strongly by metyrapone and SKF 525-A, and significantly by diphenhydramine. The
      three enzyme activities in 4'-CF-induced microsomes were inhibited markedly by
      alpha-naphthoflavone and significantly by 2-bromo-4'-nitroacetophenone. These
      results further support the previous proposal that 2'-CF is a PB-type inducer of
      cytochrome P-450 while 4'-CF is a MC-type inducer.

PMID- 8369761
TI  - Autooxidation of alkylhydrazones and mutagenicity of the resulting
      hydroperoxides.
AB  - Acetone alkylhydrazones were readily autooxidized to 2-alkylazo-2-propyl
      hydroperoxides, which were directly mutagenic in Salmonella typhimurium TA1535,
      TA100, TA102 and Escherichia coli WP2hcr. The mechanism of this mutagenicity
      presumes that the hydroperoxides in aqueous solution decompose to alkyl diazonium
      ions which were observed in the alkylation of 4-(p-nitrobenzyl)pyridine, and also
      to hydroxyl radical which was detected by ESR.

PMID- 8369762
TI  - Why battering during pregnancy?
AB  - This exploratory study was designed to determine the reasons men might beat their
      female partners during pregnancy from the perspectives of women who had
      experienced this form of violence. Seventy-nine battered women were recruited by
      newspaper advertisement and bulletin board postings to take part in a larger
      study of women's responses to relationship problems. Women battered in their
      relationships were asked if they had ever been beaten during pregnancy. The 27
      (34%) women who had a pregnancy with the abusive partner as the father and had
      experienced physical abuse during the pregnancy were compared with 24 (30%) women
      who also had been pregnant by the abuser but had not been abused during
      pregnancy. The only significant difference between the two groups was that the
      women battered during pregnancy were more frequently and severely beaten
      throughout the course of the relationship. Those abused during pregnancy were
      asked why they thought that had happened. Their answers were thematically
      analyzed into the categories: (1) jealousy of the unborn child; (2) anger toward
      the unborn child; (3) pregnancy-specific violence not directed toward the unborn
      child; and (d) "business as usual." Implications for nursing assessment and
      interventions for abuse during pregnancy are derived from this analysis.

PMID- 8369763
TI  - Abuse during pregnancy: the horror and the hope.
AB  - Physical violence against women is pervasive; and such abuse may begin during
      pregnancy. This article chronicles the clinical research on battering during
      pregnancy and focuses on a prospective study of 691 pregnant women; the study
      documented that one in six women are abused during pregnancy. Ethnic differences
      in the patterns of abuse are discussed, as are related findings of entry into
      prenatal care and characteristics of the abuser. Clinical implications are
      presented, with an emphasis on the usefulness of straightforward assessment with
      a three-question abuse assessment screen to identify abused women and intervene
      to prevent abuse during pregnancy.

PMID- 8369764
TI  - Abuse of adolescents: what can we learn from pregnant teen-agers?
AB  - One of the most perplexing issues for nurses working with abused women is the
      extent of violence experienced by teen-agers. This article presents research
      findings from a study of pregnant women and teen-agers in Baltimore and Houston
      that found 32% of pregnant teen-agers reported having been physically or sexually
      abused in the prior year. The rate of abuse during pregnancy was 22% for teen
      agers. Teen-age violence is discussed in terms of possible reasons for teen-agers
      to be reluctant to report abuse and nursing considerations in the assessment and
      intervention of adolescents experiencing abuse.

PMID- 8369765
TI  - Nursing interventions for abused women on obstetrical units.
AB  - Battering is a public health problem that traditionally has been ignored by
      nurses, which has conveyed acceptance and approval of violence. Using the Betty
      Neuman Health Care System Model, nurses on obstetrical units can understand the
      health effects battering has on the mother and infant. Battering puts the woman
      at serious risk. By systematically addressing this stressor, nurses can improve
      the health and quality of life of the mother and newborn.

PMID- 8369766
TI  - Exploration of women's identity: clinical approaches with abused women.
AB  - This article outlines clinical approaches with women in abusive relationships or
      those who recently have left such situations. A model, the process of entrapment
      in and recovering from an abusive relationship, describes the experience of women
      in abusive relationships with a male partner and the cumulative influence of
      these experiences on women's views of self. This model has served as the basis
      for the development of specific interventions designed to assist women at
      different points in time while they experience abuse in a relationship or are
      recovering from the experience of being abused.

PMID- 8369767
TI  - What helped most in leaving spouse abuse: implications for interventions.
AB  - Women who are leaving abusive relationships rely on social support. However,
      their descriptions of the process of leaving, their reasons for leaving, and what
      helped them most in leaving relate to issues about the self as much as the
      availability of support. Clinicians who consider both of these resources can
      better support the decision making of women who are living in and leaving abusive
      male partners.

PMID- 8369769
TI  - Screening for abuse in the clinical setting.
AB  - Physical examinations can be positive patient experiences, providing reassurance,
      education, and case finding. However, examinations also can be extremely anxiety
      provoking because of feelings of shame and embarrassment about visible injuries
      from an abuser. They also may provoke flashbacks related to incest, child sexual
      abuse, and rape. Nurses involved in clinical assessment of any kind need to be
      aware that a patient's history often affects her response to clinical evaluation.
      Asking a patient about abuse before evaluation is respectful and empowering and
      often establishes a valuable opportunity for intervention.

PMID- 8369768
TI  - Sexual abuse within adult intimate relationships.
AB  - An intimate partner's initiation of forced sex may signal the escalation of
      tyranny in physically abusive relationships and failed plans to obtain mutual
      consent for sexual intercourse in dating relationships. Providers of obstetric
      and gynecologic care are in strategic positions for primary detection of and
      intervention in physical and sexual abuse. To assist nurses with the
      understanding of women's responses to abuse and to enhance implementation of
      interventions, this article describes the dynamics of and a process for
      intervening in such abuses. The dynamics include brief explanations of its
      insidious development, why women stay, and women's empowerment for coping with
      physical, emotional, and sexual abuse. Beginning with asking about the abuse, the
      process progresses through short-term goals, safety issues, and intervention
      techniques.

PMID- 8369770
TI  - Nursing care of African-American battered women: Afrocentric perspectives.
AB  - The focus of this article is on prominent Eurocentric beliefs, attitudes, and
      behaviors that may prevent African-American battered women from receiving
      effective intervention by health care professionals and other providers.
      Afrocentric perspectives are presented to provide an alternative context for
      understanding the traditions, beliefs, and behaviors that should be considered
      when providing care for African-American battered women. These perspectives are
      integrated into discussions of suspected contributions to the incidence of
      violence in the lives of African-American women. They also are incorporated into
      suggested interventions and a case study exploring nursing considerations that
      may be unique to providing effective care for African-American battered women.

PMID- 8369771
TI  - Nursing care of low-income battered Hispanic pregnant women.
AB  - Nurses working with pregnant Hispanic women can create barriers in the health
      care system by not understanding or accepting the variety of ways in which the
      Hispanic culture perceives and treats pregnancy. This article describes nursing
      care of low-income, battered Hispanic pregnant women within the context of the
      Hispanic culture and discusses clinical and nursing implications for
      interventions. To deliver effective culturally competent care to battered
      Hispanic pregnant women, nurses need to have a thorough understanding of the
      variables that influence the health care of Hispanics in the United States, such
      as the scope of wife abuse in the Hispanic population, sociodemographic
      characteristics of the Hispanic population in the United States, Hispanic women's
      access to health care, pregnancy in the Hispanic population, and health care
      practices of Hispanics in the United States. This will facilitate screening,
      education, and guidance without upsetting the often precarious security of this
      period.

PMID- 8369772
TI  - Nursing care of Native American battered women.
AB  - Native American nations and peoples have experienced hundreds of years of
      oppression, prejudice, poverty, and the lack of self-determination. This has
      resulted in a disintegration of self-esteem and traditional values that are
      manifested in high rates of self-inflicted injury and other violence, including
      suicide, homicide, alcoholism, and domestic violence. Nurses have a key role to
      play in addressing violence in Native American communities. Cultural sensitivity
      is central to effective intervention.

PMID- 8369773
TI  - Violence in transience: nursing care of battered migrant women.
AB  - Nurses working with migrant farm worker women face serious challenges. Poverty,
      language, and cultural differences between farm worker women and health care
      providers present substantial barriers to women obtaining access to the health
      care system. These differences are especially important in instances of domestic
      violence. The transient life style of migrant farm workers, combined with
      geographic and social isolation, make it especially difficult for health care
      providers to meet the needs of migrant battered women. Strategies for working
      with migrant battered women are offered.

PMID- 8369774
TI  - Nursing care of rural battered women.
AB  - Rural battered women face enormous challenges when they attempt to end the abuse
      in their lives. Success depends on overcoming difficulties such as geographic
      isolation from sources of help; lack of accessible services for battered women
      and their children; limited opportunities for higher education, employment, and
      affordable housing for women; and strong allegiance to the land, kinship ties,
      and traditional gender roles. Through community education, routine assessment for
      abuse, responding in a helpful manner to women who disclose abuse, and forming
      links with existing programs for battered women and their children, nurses in
      rural areas can positively influence the health and safety of rural battered
      women.

PMID- 8369775
TI  - Changing women's lives: the primary prevention of violence against women.
AB  - Significant numbers of women in the United States experience violence and abuse
      in their intimate relationships that compromise the health and safety of the
      women and their children. This article discusses the problem of violence against
      women and outlines strategies for responding to violence and abuse in the primary
      care setting. Nurses can play a vital role in the primary prevention of abuse by
      implementing abuse screening and education on the issue of violence against
      women. This article presents strategies for the primary prevention of abuse and
      guidelines for mobilizing support for women. Collective prevention strategies
      aimed at eliminating violence against women at the institutional, community,
      professional, and political level are highlighted.

PMID- 8369776
TI  - Helping battered women take care of their children.
AB  - Children of battered women are at risk for a variety of emotional, cognitive, and
      behavioral difficulties. However, a growing body of research has described the
      important mediating effects on children of even one positive relationship with a
      significant person. Nurses need to be aware of family violence and to assess
      every client and family for this problem. Early identification and interventions
      can stem detrimental effects and help mothers and children recover.

PMID- 8369777
TI  - Developing hospital-based domestic violence programs, protocols, policies, and
      procedures.
AB  - Interest in developing hospital-based domestic violence programs, protocols,
      policies, and procedures is growing secondary to efforts by national nursing,
      medical, and hospital accreditation organizations. Creating specialized health
      services for domestic violence survivors can be expedited by reviewing existing
      protocols, policies, and procedures. A reference list of sample domestic violence
      protocols and a sample domestic violence policy and procedure are provided. The
      authors share their experiences in developing two of the nation's eight hospital
      based domestic violence programs. Domestic violence is a nursing concern, and
      nurses have been the leaders in providing perinatal and women's health services
      to battered women. Implementing the suggestions contained in this article will
      enhance hospitals' successful compliance with the 1992 Joint Commission on
      Accreditation of Healthcare Organizations guidelines for emergency and ambulatory
      services departments. The need for preprogram data collection, multidisciplinary
      support, patient and staff safety, specific program services, and staff
      supervision is addressed.

PMID- 8369778
TI  - Woman abuse: educational strategies to change nursing practice.
AB  - Nurses and other health care providers are ideal persons to intervene with women
      who are experiencing violence and abuse in their intimate relationships. All
      women are not assessed for this health care problem because of lack of education
      on the part of their health care providers. This article presents principles and
      methods for the provision of education about women abuse to practicing nurses and
      students in graduate and undergraduate nursing programs. By redressing this lack
      of knowledge and skills, nurses will be empowered to provide clinical
      intervention and leadership in addressing this major health and social problems.
      Sample outlines and objectives are provided.

PMID- 8369779
TI  - Domestic violence: ethical issues in the health care system.
AB  - Domestic violence is a highly prevalent event in the United States. Health
      providers frequently treat abused patients; however, many do not routinely assess
      for family violence or suspect it when the injuries seem fairly obvious. Because
      abused women feel stigmatized by the violence, they are hesitant to volunteer the
      abuse. In 1990, the Joint Commission on the Accreditation of Healthcare
      Organizations added requirements for emergency and ambulatory care services to
      develop and use protocols for the identification of violence among patients. This
      article addresses the ethical and legal dilemmas facing nurses that influence
      their assessment and intervention in family violence.

PMID- 8369780
TI  - Woman abuse and public policy: potential for nursing action.
AB  - Woman abuse is the number one cause of trauma to women in the United States and a
      leading cause of women's mortality and morbidity. Nursing has been in the
      forefront in conducting research, identifying survivors, and intervening with
      women abuse in a variety of health care settings. Several initiatives are being
      taken by the American health care system with regard to this problem. Nurses,
      especially those in maternal, child, and women's health care arenas, need to
      continue their leadership in and support for these policy measures.

PMID- 8369781
TI  - TB control in the 21st century.

PMID- 8369782
TI  - The impact of education on treatment compliance.

PMID- 8369783
TI  - Respiratory function in precapillary pulmonary hypertension.
AB  - Since dyspnoea on exertion is very often the first symptom of precapillary
      pulmonary hypertension (PPH), either from chronic thromboembolic pulmonary
      hypertension (CTEPH) or from idiopathic pulmonary hypertension (IPH), these
      patients are often first examined in a pulmonary function laboratory. We carried
      out a retrospective study (1987-1992) on pulmonary function in 34 patients
      diagnosed to have PPH by means of specific diagnostic tools, out of 5,467
      patients first attending our laboratory. Nine suffered from IPH, 10 from CTEPH
      and 15 from Eisenmenger physiology. This last group differed from the others,
      since its diagnosis had been known for a long time and the stage of the disease
      was more advanced, when pulmonary function tests were performed in our laboratory
      (with a view to transplantation). Respiratory function, blood gases and arterial
      oxyhaemoglobin saturation (HbSaO2) during exercise (Bruce protocol), diffusing
      capacity of the lungs for carbon monoxide (DLCO), shunt fraction (QS%)
      (approximation obtained from arterial oxygen tension (PaO2) after 100% oxygen
      breathing) had been evaluated. In the first two groups, in contrast to other
      reports, we could observe no obstructive defect. Only 20% of the subjects had
      restrictive defects, however mild. The typical functional picture of these
      patients revealed normal lung volumes, normal or slightly reduced DLCO, mild
      hypoxaemia with hypocapnia, severe HbSaO2 drops during exercise, and pathological
      QS%. We conclude that every time a patient presents with breathlessness at rest
      or on exercise, a normal chest X-ray and respiratory function tests, pulmonary
      hypertension must be suspected and subject to specific and invasive tests. More
      severe functional impairment was observed in the PPH from the Eisenmenger
      disorder. This might be due to a more advanced stage of this type of hypertension
      at the time of our observation and/or to the different mechanisms of the diseases
      themselves.

PMID- 8369784
TI  - Bioavailability of isoniazid, rifampicin and pyrazinamide (in free combination or
      fixed-triple formulation) in intermittent antituberculous chemotherapy.
AB  - A study was carried out in six human volunteers, to assess the blood kinetics of
      isoniazid, rifampicin and pyrazinamide, administered in a fixed-triple
      combination intended for use in intermittent chemotherapy of tuberculosis. The
      formulation employed contained 125 mg of isoniazid (H), 100 mg of rifampicin (R)
      and 375 mg of pyrazinamide (Z) per tablet; six tablets were administered to every
      subject, giving a total dosage of 750 mg of isoniazid, 600 mg of rifampicin and
      2,250 mg of pyrazinamide. In each subject, the same dose of each drug was
      administered individually in separate sessions and the results compared. The
      results indicated that, at the level of dose of the intermittent tablet, no
      negative interactions between the drugs were observed.

PMID- 8369785
TI  - Tracheobronchopathia osteochondroplastica.
AB  - A 65 year old man presented with exacerbation of the chronic bronchitis from
      which he had been suffering for several years. A chest X-ray revealed
      disatelectatic pulmonary zones. Bronchoscopy showed numerous nodules, beginning
      at the mid-trachea and extending into the major bronchi. Histological examination
      of the biopsy specimens demonstrated well-differentiated cartilaginous tissue,
      consistent with tracheobronchopathia osteochondroplastica.

PMID- 8369786
TI  - The assessment of respiratory function in a patient with dyspnoea and severe
      hypoxaemia.
AB  - In the investigation of dyspnoea and severe hypoxaemia the clinical relevance of
      multiple diagnostic techniques was studied. The patient was sequentially studied
      utilizing several techniques. The degree of lung impairment by spirometry,
      diffusing capacity for carbon monoxide, haemodynamics, pulmonary gas exchange,
      ventilation-perfusion relationships assessed by the multiple inert gases
      elimination techniques, ventilation and perfusion lung scans, gallium 67
      scintigraphy, bronchoalveolar lavage and high resolution computerized tomography,
      twice over a period of 12 months during recovery under treatment. A marked
      impairment of pulmonary gas exchange was first explained by diffusion impairment
      and ventilation-perfusion mismatch. The multiple inert gas elimination technique
      allowed determination of the cause of hypoxaemia by ventilation-perfusion
      inequality. A pathological correlate of the ventilation-perfusion inequality was
      the appearance of honeycomb lungs detected by high resolution computed tomograph
      and active alveolitis by bronchoalveolar lavage. All results were consistent with
      a diagnosis of fibrosing alveolitis. The patient was evaluated again during
      treatment. Some functional improvement occurred despite persistence of the same
      pathological findings. In conclusion, this study demonstrates the value of
      information derived from different tests. Physiological correlations complemented
      by pathological observations expand understanding of the pathogenesis of disease.
      These procedures contribute to understanding mechanisms responsible for
      functional impairment.

PMID- 8369787
TI  - Diagnosis of pulmonary problems in HIV-infected patients.
AB  - During the past 13 yrs it has become evident that pulmonary complications occur
      frequently and are often life-threatening in patients infected with the human
      immunodeficiency virus (HIV). Moreover, the spectrum of HIV-related pulmonary
      diseases has enlarged considerably and it now includes numerous infectious and
      non-infectious conditions. Because clinical and radiological presentation is
      generally nonspecific and often altered by diminished signs of inflammation or
      prophylactic measures, and multiple simultaneous complications frequently occur,
      an early aetiological diagnosis is essential. The diagnostic work-up of these
      patients must be straightforward. Examination of (induced) sputum and
      bronchoalveolar lavage fluid are the most important procedures. If they are not
      diagnostic, transbronchial biopsy, transbronchial needle aspiration, computed
      tomography and echocardiography are most often revealing. However, we must be
      continuously prepared to face new complications in the course of this devastating
      disease.

PMID- 8369788
TI  - Pulmonary lymphangioleiomyomatosis.
AB  - Lymphangioleiomyomatosis (LAM) is an interstitial lung disease seen virtually
      only in women of childbearing age. The diagnosis, symptoms, paraclinical
      investigations including the use of CT and spirometry are reviewed. A hormonal
      dependency of LAM seems obvious, but the exact mechanism has never been
      understood. Oestrogen and Progesterone receptors may or may not be present in the
      myoma tissue in LAM. The receptor status seems to have no influence on the
      results of treatment with medroxyprogesterone or oophorectomy. In spite of the
      uncertain results of hormonal treatment a therapeutic trial with
      medroxyprogesterone 200 mg i.m. weekly is warranted. If no improvement is
      observed bilateral oophorectomy is recommended. Death due to respiratory
      insufficiency is common, but prognosis seems better than previously though,
      survivors for more than 20 years after diagnosis being described.

PMID- 8369789
TI  - Current issues in the assessment of interstitial lung disease.
AB  - Interstitial lung diseases (ILDs) are chronic disorders of the lower respiratory
      tract, characterized by inflammation and derangement of the alveolar walls. The
      major functional consequence is the loss of alveolar capillary units and, thus, a
      limitation of oxygen transfer from air to blood. In recent years, new insights
      into many aspects of alveolitis as the basic pathological substrate of these
      diseases, the different inflammatory and immune competent effector cells and
      their role in the mechanisms of injury and repair have changed our concepts about
      the pathogenesis of ILD. New techniques, such as bronchoalveolar lavage and
      computed tomography, allow a better assessment of disease activity and extent of
      the underlying process. This review also discusses the problems of classification
      of ILD, and concentrates on issues of assessment and markers of disease activity.
      Treatment is not a topic of this review but better assessment of these disorders
      is probably a prerequisite of further progress in treatment and prognosis.

PMID- 8369790
TI  - Bronchoalveolar lavage and the study of proteinases and antiproteinases in the
      pathogenesis of chronic obstructive lung disease.
AB  - Bronchoalveolar lavage has been used for 15 yrs to investigate the role of
      proteinases and antiproteinases in the pathogenesis of emphysema, but the results
      are confused by numerous technical factors, many of which may prove
      insurmountable. Even if the problems can be overcome, the technique will probably
      not prove sensitive enough to provide a true insight into the pathogenesis of
      emphysema in man. Nevertheless, the studies with this technique have provided
      important information and methodologies that have advanced our scientific, if not
      pathological, knowledge. Perhaps further applications of the knowledge obtained,
      to cellular and genetic studies, will eventually establish the true mechanisms
      involved in determining whether a smoker remains "healthy" or develops disabling
      disease. Lavage may have played a major role in the study of emphysema, if for no
      other reasons than to establish the fact that the pathogenesis of the disease is
      far from clear.

PMID- 8369791
TI  - Treatment of nocturnal asthma.
AB  - Cough, wheeze and breathlessness at night are common problems for many asthmatics
      and result from airway narrowing. Therapy should consist of improving management
      of their asthma over the full 24 h day by use of inhaled steroids and
      conventional inhaled bronchodilators. Such therapy should be introduced before
      treatment specifically improving nocturnal airway calibre is introduced. Inhaled
      long acting beta 2-agonists are the current long acting bronchodilator of choice
      in such patients.

PMID- 8369792
TI  - The fundamentals of cardiopulmonary exercise testing.

PMID- 8369793
TI  - A primer in cardiopulmonary exercise testing.
AB  - Cardiopulmonary exercise testing is useful in diagnosing the cause of exercise
      intolerance, in evaluating disability, and in defining the response to therapy.
      This testing modality is firmly founded on physiological principles. An efficient
      interaction of the body's systems is required to transport oxygen to the
      exercising muscles; failure of any system will yield characteristic changes in
      the ventilatory and gas exchange responses to exercise. An important measurement
      to make during exercise testing is the work rate at which oxygen transport begins
      to be inadequate. This work rate, known as the anaerobic threshold, is marked by
      a rise in blood lactate, and can be estimated noninvasively by examination of gas
      exchange responses during incremental exercise. In recent years, computerized
      systems and improved transducers have been introduced to facilitate breath-by
      breath measurements during exercise testing. These systems also facilitate
      calibration, data presentation and report generation, making cardiopulmonary
      exercise testing a practical testing modality.

PMID- 8369794
TI  - Considerations on 200 cases of percutaneous cricothyroidotomy (minitracheotomy).
AB  - More than 10 yrs ago, minitracheotomy was suggested as an elective method in the
      treatment of sputum retention, resulting from impaired ability to cough, in many
      medical and surgical diseases. We report our experience of 200 cases of
      percutaneous cricothyroidotomy in our Intensive Care Unit (145 patients), and in
      other wards (55 patients). The results confirm that minitracheotomy is easy and
      quick to perform, well-accepted by patients, and free of relevant complications
      when the technique is performed correctly and sufficient care is adopted. About
      60-70% of treated patients benefited by minitracheotomy and did not require more
      invasive interventions. A better control of technique, moreover, allowed other
      possible applications to be discovered.

PMID- 8369795
TI  - Passive smoking and children.

PMID- 8369796
TI  - Fine structural characterization of the olfactory epithelium and its response to
      divalent cations Cd2+ in the fish Alburnus alburnus (Teleostei, Cyprinidae): a
      scanning and transmission electron microscopic study.
AB  - The olfactory organ of the fish Alburnus alburnus consists of 22 lamellae
      arranged into rosette like structure and are built up by supporting, gland,
      basal, ciliated and unspecialized epithelial cells, as well as receptor cells
      with microvillous, ciliated or rod shape dendritic endings. The spatial
      distribution of the supporting and gland cells can be considered homogeneous
      while the ciliated epithelial cells are dominant on the latero-marginal areas of
      the lamellae with a 10 +/- 3/1000 microns 2 average density. The occurrence
      frequency of the ciliated receptor cells is the highest in the medial area with a
      30 +/- 6/1000 microns 2 average density while the microvillous receptor cells
      have the highest occurrence frequency in the dorso-marginal area of the olfactory
      lamellae with a 25 +/- 15/1000 microns 2 average density. Rod shape sensory
      dendrites were detected with a negligible density. The presence of divalent
      cations Cd2+ in the environment significantly increased the density of rod shape
      sensory dendrite 19.8 +/- 7.7/1000 microns 2. These results demonstrate that the
      appearance and composition of the population of sensory dendrites on the
      olfactory lamellae are affected by environmental factors.

PMID- 8369797
TI  - Minireview: regulation by second messengers of permeability in the cerebral
      microvessels.
AB  - The view that the cerebral endothelial cells represent the cellular analogue of
      the blood-brain barrier has been generally accepted. The regulation of transport
      processes operating in the cerebral endothelial cells is of great current
      interest. Different elements of the intracellular signaling messenger systems
      have been detected in the course of our studies in the cerebral endothelial
      cells. Our knowledge of these regulatory mechanisms is briefly reviewed here with
      special emphasis on the importance of second messenger molecules and
      phosphorylation of certain proteins of microvascular origin.

PMID- 8369798
TI  - Spatial selectivity in the anterior ectosylvian visual area of the cat.
AB  - Pattern reversal visually evoked potentials (PR-VEPs) were recorded in the
      anterior ectosylvian visual area (AEV) of the cat, and the dependence of the PR
      VEPs on the spatial frequency (SF) and the mean luminance of the stimulation was
      studied. Six SFs between 0.025 and 1 cycles per degree (c/d) and four light
      density levels between 2 x 10(-2) and 117 cd/m2 (candela per square meter) were
      tested. The latency of the first positive component (P1) and the amplitude
      measured between P1 and the first negative (N1) component were analyzed. The
      dependence of the PR-VEP latencies on the SF displayed a significant
      relationship, with a minimum at around 0.05 c/d. This relationship was consistent
      at all luminance levels tested. The dependence of the amplitudes on the SF gave a
      "low-pass" tuning curve at every luminance level. The higher the luminance level,
      the steeper was the curve. The cut-off SF of these curves was at around 1 c/d
      under photopic conditions and around 0.6 c/d under scotopic conditions. The
      contrast dependence of the PR-VEP amplitudes exhibited saturation at 0.5, which
      was much higher than that of either the striate cortex or other extrastriate
      visual cortical areas, but similar to that of the superior colliculus. These
      results provide further evidence in support of the notion of a tecto
      extrageniculo-extrastriate visual pathway functioning separately from the
      geniculo-striate mechanisms.

PMID- 8369799
TI  - Vimentin persists in the mature glia of fish brain.
AB  - Adult carp brains were processed for immunohistochemical staining against
      vimentin and glial fibrillary acidic protein. The shape, density and distribution
      of immunopositive structures were found to be very similar with both types of
      antibody. Thus, it appears that vimentin, the cytoskeletal protein typical for
      immature glia in the early phase of ontogenesis in mammals can also be
      demonstrated in the adult glia of the phylogenetically older fish brain.

PMID- 8369800
TI  - The astrocytic localization of protein kinase C in the neocortex, hippocampus and
      in vitro hippocampal slices of the guinea pig.
AB  - Immunohistochemical studies prove the most of the neurons of the central nervous
      system express one or more protein kinase C isoenzymes. However, there are only a
      few descriptions of the glial localization. In the present study, we detected
      protein kinase C immunohistochemically in guinea pig sensory neocortex,
      hippocampus and hippocampal slices following in vitro maintenance. Monoclonal
      antibodies against types II and III of protein kinase C were used. Consecutive
      sections were stained with polyclonal anti-glial-fibrillary-acidic protein serum.
      Scattered astrocytes contained protein kinase C in layers I and VI of the
      cerebral cortex, in the subcortical white matter, the subiculum, alveus and
      molecular layer of Ammon's horn, in the hilus and molecular layer of the dentate
      fascia. Ultrastructurally, immunostaining of glial processes in the neuropil and
      around blood vessels was observed. Strong staining of the endoplasmic reticulum
      and nuclear envelope was noted in glial cell bodies. The ultrastructural
      localization of protein kinase C suggests its participation in receptor-mediated
      processes, which may influence the shape and function of astrocytes.

PMID- 8369801
TI  - The effects of in vivo selenium supplementation on the amplitude of the
      spontaneous contractions and the responses to acetylcholine in isolated rabbit
      ileum.
AB  - This study was carried out to investigate the effect of selenium supplementation
      at a therapeutic level on the isolated ileum contractions and the acetylcholine
      responses in New Zealand rabbits. While no difference with respect to the
      controls was found in the spontaneous ileum contraction frequencies a significant
      increase in the contraction amplitude was noted after 15 days of supplementation.
      Increasing concentrations of acetylcholine in the perfusion solution resulted in
      a significant increase of the contraction amplitudes in the supplemented animals
      as compared to controls. The tissue selenium levels and the gluthathione
      peroxidase activities were also found significantly higher than the controls. No
      difference was observed between the contraction numbers in the two groups. These
      findings indicate that selenium supplementation does not influence the smooth
      muscle resting potential.

PMID- 8369802
TI  - Appearance of diaminobenzidine-staining glial cells in the rat CNS: an
      ontogenetic histochemical study.
AB  - The postnatal appearance of diaminobenzidine (DAB)-staining glial cells was
      studied in certain regions of the rat central nervous system. DAB-positive cells
      appeared in the hypothalamus, the nucleus of the solitary tract and the most
      superficial laminae of the spinal dorsal horn on the 7th, 8th and 14th postnatal
      day, respectively. The number and staining intensity of these DAB-positive cells
      progressively increased and reached the adult levels at the end of the third
      postnatal week. Glial staining is likely to result from a non-enzymatic oxidation
      of DAB, since it was resistant to heat pretreatment, but was abolished if
      hydrogen peroxide was omitted from the incubation medium. The present results
      reveal that a particular population of glial cells exhibit a characteristic
      developmental change which can be detected by means of peroxidase histochemistry.
      The close topographical relationship is suggestive of a functional association
      between capsaicin-sensitive primary afferents and DAB-positive glial cells.

PMID- 8369803
TI  - Drug-induced systemic lupus erythematosus in childhood.

PMID- 8369804
TI  - Plasmapheresis in lupus.

PMID- 8369805
TI  - A review of serological abnormalities in relatives of SLE patients.

PMID- 8369806
TI  - Antiphosphatidylethanolamine antibodies in systemic lupus erythematosus.
AB  - Antiphosphatidylethanolamine antibodies (aPEA) were investigated in a population
      of 78 systemic lupus erythematosus (SLE) patients, by means of an enzyme-linked
      immunosorbent assay method. These antibodies are specifically directed against
      phosphatidylethanolamine, one of the zwitterionic phospholipids present in cell
      membranes. Antiphosphatidylethanolamine antibodies were found in 13 patients
      (16.6%). They were generally associated with lupus anticoagulant (two patients),
      antiphospholipid antibodies directed against anionic phospholipids (six
      patients), or both (four patients). In only one case, aPEA were the sole
      detectable antiphospholipid antibodies. Thrombosis, recurrent fetal loss,
      valvular disease or neurological involvement was present in most (11 of 13) of
      the patients with aPEA. It seems valuable to carry on further searches for these
      antibodies in SLE, since patients with aPEA are at higher risk of thrombosis
      and/or recurrent fetal losses than are patients with antiphospholipid antibodies
      (anticardiolipin, anti-anionic phospholipid and/or lupus anticoagulant) other
      than aPEA. Moreover, since aPEA can be the sole detectable antiphospholipid
      antibodies, they should be investigated in SLE with thrombosis when neither lupus
      anticoagulant nor anticardiolipin antibodies can be demonstrated.

PMID- 8369807
TI  - Reciprocal changes in complement activity and immune-complex levels during plasma
      infusion in a C2-deficient SLE patient.
AB  - Although systemic lupus erythematosus (SLE) is abnormally common in individuals
      with complement deficiency, conclusive evidence has been lacking for a direct
      causal relationship between disease manifestations and a missing complement
      component. A patient with C2 deficiency and SLE has been treated with 56 courses
      of fresh frozen plasma (FFP) infusions over a period of 8 years. Each infusion,
      involving a total of 12 units of FFP administered in equal doses over 4
      consecutive days, has consistently resulted in a transient restoration of the
      classical pathway of complement, and a full clinical remission lasting 6-8 weeks.
      This report is concerned with changes in the levels of immune complexes, C2 and
      C3d during an infusion cycle. Four progressively rising peaks in C2 and C3d were
      observed during the 4 days of the plasma infusion, and these peaks coincided with
      four reciprocally descending troughs in the levels of immune complexes. Identical
      fluctuations have been consistent in all the plasma-infusion cycles that have so
      far been monitored, and their consistent association with clinical remissions
      indicates a causal relationship between the C2 restoration and clinical
      remissions in this C2-deficient SLE patient.

PMID- 8369808
TI  - Clinical renal involvement in Afro-Caribbean lupus patients.
AB  - This study reports the severity of clinical lupus nephritis (LN), defined as the
      sustained presence of proteinuria and/or cellular casts, in a group of 68 newly
      diagnosed patients with systemic lupus erythematosus (SLE) in Curacao. Fifty-four
      patients (78%) developed clinical signs of LN, of whom 31 (54%) had clinical LN
      at the time of SLE diagnosis. The probability of developing clinical LN reached
      80% in the first 3 years after SLE diagnosis and hardly increased later. No
      clinical or serological differences existed at the time of SLE diagnosis or at
      onset of LN between patients with early-or late-onset LN. Survival in patients
      without LN was 100% at 5 years, while for patients with clinical LN these rates
      at 1 and 5 years were 91% and 59%, respectively (P = 0.0001); male LN patients
      had a worse prognosis than females (P = 0.012), while time of LN onset did not
      influence survival. Six patients (11%) developed end-stage renal failure; all
      were female, five had early LN and one had late-onset LN (P = 0.17). Renal
      survival was 97% and 80% at 1 and 5 years, with decreased rates for patients with
      nephrotic-range proteinuria (P = 0.02). Hypertension was present in 13% of LN
      patients, but had no influence on patient or renal survival. Thus, clinical LN
      was a frequent complication, which carried a poor prognosis in these Afro
      Caribbean lupus patients.

PMID- 8369809
TI  - Clinical diversity of Raynaud's phenomenon in childhood: report of six cases.
AB  - Six pediatric patients with Raynaud's phenomenon are reported. Three patients had
      clinical and immunological evidence for a connective tissue disease; one had
      primary Raynaud's phenomenon associated with antinuclear antibodies and two had
      Raynaud's phenomenon secondary to exposure to lead and to a vibrating instrument,
      respectively. The diagnostic and therapeutic implications of these observations
      will be discussed.

PMID- 8369810
TI  - Allergic disorders in systemic lupus erythematosus.
AB  - Allergic disorders commonly occur in patients with systemic lupus erythematosus
      (SLE) and allergies to some drugs may occasionally be related to disease flares.
      We evaluated the prevalence of several types of allergy in 132 patients with SLE
      and their families and compared the SLE patients with a control group of 66
      patients with non-lupus disorders. Total IgE levels were tested in 117 SLE
      patients and 61 controls. Eighty-three of the 132 SLE patients (63%) had a
      history of at least one type of allergic disorder. This prevalence was
      significantly higher (P < 0.0001) than that of the control group (20 of 66
      controls). The prevalence of drug allergy (38% vs. 17%; P < 0.005), skin allergy
      (36% vs. 17%; P < 0.01) and insect allergy (14% vs. 2%; P < 0.02) were
      significantly higher in SLE patients when compared with controls. Family members
      of SLE patients had an increased prevalence of at least one type of allergy (55%
      vs. 24%; P < 0.0001), allergic rhinitis (30% vs. 14%; P < 0.02), asthma (25% vs.
      9% P < 0.02), and both rhinitis or asthma (44% vs. 20%; P < or = 0.002). The
      presence of allergy both in the patient and in the family was more frequent in
      SLE patients than controls (42% vs. 15%; P < 0.001). We found no differences in
      total IgE levels between the two groups. Drug, skin and insect allergies were
      particularly frequent in SLE patients. We also found a high prevalence of
      rhinitis and asthma in their families.

PMID- 8369811
TI  - Drug-induced systemic lupus erythematosus in a nine-year-old boy.
AB  - After a series of intercurrent infections, a 9-year-old boy on ethosuximide for
      pefit mal developed typical drug-induced systemic lupus erythematosus. After
      ethosuximide was stopped, he continued to deteriorate and was treated with
      corticosteroid therapy, which could be only gradually tapered off over many
      months. Follow-up 4 years later showed him to be completely well.

PMID- 8369812
TI  - Factitious systemic lupus erythematosus.
AB  - We report the case of a 15-year-old girl who simulated a complex clinical picture
      including cutaneous lesions, fever, arthralgia, asthenia and oliguria. A
      diagnosis of probable systemic lupus erythematosus (SLE) was assumed by numerous
      specialists and steroid therapy instituted. Factitious SLE should be considered
      for differential diagnosis of SLE, especially when laboratory evidence for
      autoimmunity is not demonstrated.

PMID- 8369813
TI  - Parkinson-like symptoms as a manifestation of systemic lupus erythematosus.
AB  - A 42-year-old Japanese woman with systemic lupus erythematosus (SLE) developed
      Parkinsonian-like movements. Steroid pulse therapy was most effective and
      additional anti-Parkinsonian drugs were not required. Although psychosis,
      seizures and meningitis are common central nervous system (CNS) manifestations in
      SLE patients, Parkinsonian-like symptoms are extremely rare. The putative genesis
      and treatment of CNS lupus are discussed.

PMID- 8369814
TI  - Blood transfusion related HBV and HIV infection in a patient with SLE.
AB  - We described the course of a young man with SLE who developed hepatitis B virus
      and human immunodeficiency virus infections through contaminated blood
      transfusion. He presented with severe SLE, improved on treatment and then
      developed hepatic failure which responded to conservative treatment. He now has
      AIDS and the SLE and HBV infection are quiescent.

PMID- 8369815
TI  - Histiocytic necrotizing lymphadenitis in a sibling of a patient with systemic
      lupus erythematosus.

PMID- 8369816
TI  - [Chromosomal analysis of bladder tumors. Technical aspects, anatomoclinical
      correlations and perspectives. Report of 18 cases].
AB  - The course of bladder tumours is difficult to predict. The most reliable
      prognostic factor at the present time is histological grade. Cytogenetic
      subclasses of bladder tumours can be distinguished on the basis of the
      demonstration of karyotype anomalies in bladder tumour cells. Eighteen patients
      underwent cytogenetic examination of their bladder tumour and were followed for
      an average of 35 months. Multivariate analysis of the clinical and laboratory
      parameters studied revealed the importance of age and the absence of trisomy 7 in
      the tumour on patient survival. The presence of trisomy 7 in a bladder tumour may
      therefore constitute a factor of poor prognosis. This hypothesis needs to be
      confirmed by further studies in larger populations. The search for this anomaly
      can be performed by fluorescent in situ chromosomal hybridisation, a technique
      which transforms cytogenetics from an experimental procedure into a routine
      complementary investigation. These techniques can be performed on urine samples,
      suggesting the possibility of their application to screening or follow-up of
      bladder tumours.

PMID- 8369818
TI  - [Hypospadias in the adult: report of 15 cases].
AB  - This paper is based on the analysis of 15 cases of adults between the ages of 17
      and 72 years with hypospadias, previously untreated in 2 cases and unsuccessfully
      treated in the other 13 cases. The author demonstrates the severe sexual,
      psychological and urinary implications of this malformation when it is not
      correctly treated during childhood. The difficulties accumulate with age and the
      problems become more and more difficult to treat, especially as these patients
      are frequently from poor socioeconomic groups. The conclusion of this study is
      not original, but once again emphasises the need to correct this malformation as
      early as possible, at least before puberty and with a minimum of operations (one
      operation whenever possible).

PMID- 8369817
TI  - [Duckett's+ simple surface or double surface? Comparison of 2 urethroplasty
      procedures. Report of 91 hypospadias].
AB  - The results and complications of the treatment of hypospadias were studied in
      relation to the two pedicle foreskin mucosal flap techniques described
      successively by Duckett, "single surface" and "double surface". 91
      urethroplasties were performed: 58 "single surface" and 33 "double surface"
      Duckett urethroplasties. The children were operated between the ages of 18 months
      and 16 years with a mean age of 4 years. 75% of children had a good result on
      long-term follow-up. In the case of major complications, essentially fistula,
      distal necrosis af the urethra or stricture, a single reoperation increased the
      percentage of good results to almost 98% for the entire series. However, when the
      two procedures were compared, a good result was obtained immediately in 81% of
      cases for the "single surface" operation versus 66% for the "double surface"
      operation. The fistula rate was 27.2% with the "double surface" flap versus 13.7%
      with the "single surface" flap and the distal stricture rate was 15.1% with the
      "double surface" flap versus 3.4% with the "single surface" flap. In the light of
      these results, Duckett's "double surface" procedure has been abandoned in favour
      of the "single surface" flap.

PMID- 8369819
TI  - [Posterior vertical lumbar approach in the treatment of pyelo-ureteral junction
      syndromes in the adult].
AB  - Posterior vertical lumbar incision is an alternative incision for the treatment
      of hydronephrosis due to ureteropelvic junction anomaly in adults. The authors
      have performed 18 pyeloplasties via this incision in adults between the ages of
      19 and 72 years (mean 36 years). The results of pyeloplasty (88% success rate)
      were comparable to those obtained via other incisions. The operating time varied
      between 50 and 110 minutes (mean: 75 minutes) and the mean hospital stay was of
      the order of one week. The morbidity was low and essentially consisted of
      parietal complications such as hypoaesthesia or hypotonia. The technique is
      simple to perform provided the contraindications, especially those related to
      patient anatomy, are respected.

PMID- 8369820
TI  - [Posterior vertical lumbar incision in the treatment of pyelo-ureteral junction
      anomaly: report of 71 cases].
AB  - Posterior vertical lumbar incision, described for the first time in 1869 by
      Simon, provides a simple access to the kidney and offers excellent exposure of
      the ureteropelvic junction. The technical modifications proposed by Gil Vernet
      facilitate access to the kidney and reduce the morbidity. The operative technique
      is described in detail and the authors report their retrospective experience of
      71 cases of correction of ureteropelvic junction anomalies (stage 2, 3 and 4).
      The morbidity was low (19%). Patients returned to work by the 3rd week. 88% of
      good results were observed at 3 months (84% in initial stage and 4 lesions). This
      approach should be preferred to the lateral incision or the percutaneous approach
      due to the simplicity of the technique and the low complication rate.

PMID- 8369821
TI  - [Calculi of the ilio-pelvic ureter: therapeutic approach and importance of
      ureteroscopy regarding 200 cases].
AB  - The authors report their experience of 200 consecutive emergency admissions for
      iliopelvic uteric stones. 82 patients (41%) eliminated their stones with medical
      treatment. 118 patients (59%) required ureteroscopic treatment either by
      immediate basket extraction (n = 58) or by contact fragmentation (pulsed laser =
      57, ultrasound = 1, electrohydraulic catheter = 2). 6 failures were observed and
      one case of distant ureteric stenosis was successfully treated by balloon
      dilatation. This therapeutic approach cured 187 (93.5%) of the patients of their
      stones within an average of 8 days (82 "spontaneous", 105 "endourological") with
      a mean hospital stay of 2.3 days and 2.7 days, respectively. Ureteroscopy had a
      success rate of 95% and appears to be the most effective treatment, but the
      medical option remains the basic treatment for stones of the lower ureter.

PMID- 8369822
TI  - [Ballistic (Lithoclast) and hydro-electric (Riwolith) endo-ureteral lithotripsy.
      Report of 60 cases].
AB  - 25 hydroelectric endoureteric lithotripsies (Group 1, Riwolith) and 35 ballistic
      endoureteric lithotripsies (Group 2, Lithoclast) were analysed. 60 stones were
      treated, including 18 pelvic stones (Group 1 : 10, Group 2 : 8), 39 iliolumbar
      stones (Group 1 : 14, Group 2 : 25), and 3 stones of the ureteropelvic junction
      (Group 1 : 1, Group 2 : 2). The mean maximal diameter was 9.9 mm (Group 1 : 8.2,
      Group 2 : 11). Complementary Dormia extraction was performed in 24 cases (Group 1
      : 8, Group 2 : 16), 55 double J stents were implanted (Group 1 : 24, Group 2 :
      31) and 23 immediate ECL sessions were performed (Group 1 : 8, Group 2 : 15).
      Overall, 57 good results were recorded, but 3 complete failures of fragmentation
      and 2 severe ureteric lesions were attributed to hydroelectric lithotripsy. The
      Lithoclast, much less traumatic, had a greater stone fragmentation potential, but
      its efficacy on very mobile stones is limited due to its more intense stone
      propulsion effect.

PMID- 8369824
TI  - [Atypical renal cysts: report of 31 cases].
AB  - In a series of 205 patients operated for renal cyst, 31 cases had a persistent
      preoperative doubt concerning the benign nature of the cyst after IVU and/or
      first-line renal ultrasonography or even computed tomography (80% of cases).
      Histological confirmation based on analysis of the entire cyst wall or the
      partial nephrectomy specimen revealed cancer in 45% of cases. Computed tomography
      must therefore be performed routinely in patients with atypical renal cysts. The
      authors recommend surgical exploration and partial nephrectomy with frozen
      section examination at slightest doubt.

PMID- 8369823
TI  - [Scrotal temperature in 258 healthy men, randomly selected from a population of
      men aged 18 to 23 years old. Statistical analysis, epidemiologic observations,
      and measurement of the testicular diameters].
AB  - Scrotal hyperthermia can induce certain alterations in spermatogenesis. The basal
      scrotal temperature used to define hyperthermia is usually 33 degrees C. However,
      no study, conducted according to a strict methodology has validated this mean
      measurement. We therefore randomly selected 258 men between the ages of 18 and 23
      years from a population of 2,000 young French men seen at the National Service
      Selection Centre in order to measure the scrotal temperature over each testis and
      in the median raphe in order to determine the mean and median values for these
      temperatures. For a mean room temperature of 23 +/- 0.5 degrees C with a range of
      18 to 31 degrees C, the mean right and left scrotal temperature was 34.2 +/- 0.1
      degree C and the mean medioscrotal temperature was 34.4 +/- 0.1 degree C. Scrotal
      temperature was very significantly correlated to room temperature and its
      variations. It was therefore impossible to define a normal value for scrotal
      temperature. Only measurement of scrotal temperature at neutral room temperature,
      between 21 and 25 degrees C, is able to provide a reference value for scrotal
      temperature. In this study, the mean scrotal temperature under these conditions
      was 34.4 +/- 0.2 degree C, i.e. 2.5 degrees C less than body temperature. In the
      12.9% of cases with left varicocele, left scrotal temperature was significantly
      higher than in the absence of varicocele and was also higher than right Scrotal
      temperature. The authors also determined the dimensions of the testes.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8369825
TI  - [Is the urodynamic assessment of enuresis in young adults justified?].
AB  - Primary or secondary nocturnal enuresis in adults (over the age of 15 years) is
      rare, but is associated with considerable psychosocial repercussions. The aim of
      this retrospective study was to determine whether urodynamic studies have any
      predictive value for the efficacy of the treatments proposed in these patients.
      This study was based on 20 patients (8 females and 12 males) between the ages of
      15 and 33 years (mean: 23.75 years), studied between 1982 and 1990 with a mean
      follow-up of 13.35 months. Enuresis was primary in 12 patients and secondary in 8
      patients. 11 patients had already received one or more treatments without
      success. Patients with clinically obvious neurological disease were excluded from
      the study. The urodynamic assessment included water cystomanometry, water
      urethromanometry with a perfused catheter and uroflowmetry. In addition to the
      investigation of other associated disturbances of micturition, the following
      complementary investigations were performed: urine culture in every case, IVU
      and/or cystography (n = 18), cystoscopy (n = 3), renal and vesical
      ultrasonography (n = 1). The urodynamic assessment was abnormal in 16 out of 20
      cases: marked detrusor hyperactivity (n = 15), impaired compliance (n = 6),
      significant urethral instability (n = 7), isolated premature urge (n = 1). 15
      patients presented with diurnal disorders dominated by frequency (n = 13),
      urgency (n = 9) and urge incontinence (n = 4); detrusor hyperactivity was
      detected in every case. The abnormalities observed on the urodynamic assessment
      guided treatment, allowing correction of enuresis in 3/4 of cases.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8369826
TI  - [Ectopic ureteral orifice into the seminal duct with homolateral renal agenesis:
      contribution of ultrasonography].
AB  - Based on an incidental case of ectopic ureteric orifice in the seminal tract
      associated with homolateral renal agenesis, the authors demonstrate the value of
      ultrasonography, particular transrectal, both for diagnosis and follow-up.
      Digital rectal examination is the key to the diagnosis, combined with
      ultrasonography and urography. The indications for surgery depend on the clinical
      symptoms and signs.

PMID- 8369827
TI  - [Ultrasonographic study of adrenal gland tumors (report of 5 cases)].
AB  - The authors study the ultrasound signs of the adrenal gland based on 5 different
      types of operated adrenal tumours (a lipoma, an adrenal cortical adenoma, a cyst,
      a corticoadrenaloma, an adrenal metastasis from a renal cell carcinoma). The
      ultrasonographic morphological criteria of the normal adrenal gland and each type
      of tumour are recalled and are illustrated by clinical cases. The value of
      ultrasonography in the investigation of this organ was evaluated in comparison
      with other imaging techniques. It constitutes a good first-line diagnostic
      guiding examination, but needs to be completed by other investigations (computed
      tomography, magnetic resonance imaging, etc.). Ultrasonography can also reveal
      asymptomatic adrenal tumours ("adrenal incidentalomas") in which the therapeutic
      decision (surveillance or surgery) must be based on criteria of size and
      appearance after a complete laboratory and morphological assessment.

PMID- 8369828
TI  - [Lymphangiomyomatosis: an exceptional cause of chyluria. Report of a case].
AB  - A rare case of lymphangiomatosis without pulmonary involvement is reported. The
      diagnosis was based on the presence of multifocal lesions and histological
      examination. Retroperitoneal lesions were responsible for chyluria, which was
      treated surgically. Chyluria is an exceptional complication of this disease, as
      only 3 such cases have been reported in the literature. The presence of cutaneous
      signs raises the question of the relations between lymphangiomatosis and
      Bourneville's tuberous sclerosis.

PMID- 8369829
TI  - [Transitional tumor of the right kidney with vena cava thrombus. Report of a
      case].
AB  - Transitional cell carcinoma of the kidney with vena caval tumor thrombus is a
      rarity with 12 cases reported in the literature. We review in this article the
      elements of the diagnosis and possible treatment modalities.

PMID- 8369830
TI  - [Antibiotic prophylaxis in surgery. Consensus conference. December 10-11, 1992].

PMID- 8369831
TI  - Elizabeth Shire's helping hands. Interview by Jill L. Sherer.

PMID- 8369832
TI  - Baby boomers grow up.
AB  - "The baby boom generation has different expectations and a far different
      background than older generations" when it comes to their health care, says one
      expert on the subject. Indeed, providers can expect the demands of the emerging
      consumer generation to be radically different: The new health care consumers will
      actively participate in their own care, and will help shape the debate over
      comprehensive health care reform. Are you ready?

PMID- 8369833
TI  - Consumers and health reform. Survey highlights awareness gap.

PMID- 8369834
TI  - Keeping pace. Academic medical centers begin retooling for the future.

PMID- 8369835
TI  - The long march toward progress.

PMID- 8369836
TI  - Chain reaction. Will reform hurt hospital-dominated local economies?

PMID- 8369837
TI  - Birmingham, Alabama. Hospitals, employers forge cost/quality partnerships.

PMID- 8369838
TI  - Data watch. Study: rural elders living alone at greater risk for health problems.

PMID- 8369839
TI  - Iowa study helps consumers, employers evaluate health plans.

PMID- 8369840
TI  - Nine New Jersey hospitals charge Blue Cross with antitrust. Beth Israel Hospital
      et al. v. Blue Cross and Blue Shield of New Jersey, Inc.

PMID- 8369841
TI  - LINC (Ladders In Nursing Careers) program helps valued employees pursue nursing
      careers.

PMID- 8369842
TI  - 10 steps to protecting your tax-exempt status now.

PMID- 8369843
TI  - Burnout.

PMID- 8369844
TI  - Safe motherhood.

PMID- 8369846
TI  - The healing art of listening.

PMID- 8369845
TI  - One intact son.

PMID- 8369847
TI  - A homeopathic primer for midwives.

PMID- 8369848
TI  - Wise use, best use.

PMID- 8369849
TI  - The "art" of midwifery.

PMID- 8369850
TI  - More thoughts on breech.

PMID- 8369851
TI  - This is Babylon, Part 2.

PMID- 8369853
TI  - Midwifery and herbs.

PMID- 8369852
TI  - An American birth.

PMID- 8369855
TI  - A Japanese birth.

PMID- 8369854
TI  - Faith or fear?

PMID- 8369856
TI  - Natural remedies.

PMID- 8369857
TI  - A matter of choice.

PMID- 8369858
TI  - Red flags.

PMID- 8369859
TI  - Java jive.

PMID- 8369860
TI  - Purslane.

PMID- 8369861
TI  - Reportability of incidents.

PMID- 8369863
TI  - Strategic planning in clinical engineering.

PMID- 8369862
TI  - Medical technology in perspective.

PMID- 8369864
TI  - Evolution of a successful quality management program for biomedical engineering.

PMID- 8369865
TI  - An equipment systems laboratory for the biomedical equipment technology
      curriculum.

PMID- 8369866
TI  - Three-dimensional visualization of air flow in infant incubators using
      computational fluid mechanics.
AB  - An application of three-dimensional (3D) computational fluid mechanics to the air
      flow in infant incubators is presented. The air flows in two numerical models
      were simulated by directly solving the Navier-Stokes equations for incompressible
      gases. The method used was a finite-volume method incorporating a body-fitted
      coordinate system. The basic model was based on a real infant incubator, which
      was slightly simplified and included a model of a baby. The number of computation
      grids was 56 (width) x 21 (depth) x 21 (height) = 24,696. There were several very
      large-scale eddies in the incubator free space. In addition to the global
      structure, small-scale eddies were shown to be produced at many locations
      scattered in the free space. From these results, it is evident that the
      conventional assumption of steady and uniform flows in incubators is not always
      justified when considering heat loss from the body of a baby in an incubator.

PMID- 8369868
TI  - Long-term performance of a rechargeable glucose electrode in vitro.
AB  - A rechargeable glucose sensor now under development performed satisfactorily for
      over eight months at 25 degrees C and over 90 days at 37 degrees C without
      recharging. A prototype sensor was operated through three recharge cycles, which
      increased the life of the sensor more than two months. This demonstrates the
      potential for reducing the frequency of surgical replacements. Earlier work
      utilized three forms of carbon upon which glucose oxidase was immobilized. Recent
      work reported herein demonstrates that the longer-performing sensor is realized
      with ultra-low-temperature isotropic (ULTI) carbon powder. Due to its fine
      particle size, the ULTI carbon with immobilized enzyme acts as a liquid
      suspension. The sensor is stable and there is no detectable degradation of the
      sensor components from one recharge cycle to the next.

PMID- 8369867
TI  - Electrohysterography during pregnancy: preliminary report.
AB  - The purpose of this study was to test the ability of uterine electrical activity
      recorded by electrohysterography (EHG) from abdominal electrodes during pregnancy
      to provide reliable information about uterine contractions. In this preliminary
      study, abdominal EHG was used to monitor the uterine contractions of eight women,
      three of whom were having spontaneous contractions related to preterm labor and
      five of whom were having medical abortions after intrauterine fetal death. The
      EHG signal consisting of one electrical burst (EB) correlated with a single
      episode of mechanical activity (MA) in more than 66% of the recorded
      contractions. When mechanical or electrical activity identified as artifactual
      was excluded, the temporal correlation of EBs with MA was found in 89% of the
      recorded contractions. Furthermore, the electrical bursts detected had temporal
      and spectral characteristics similar to those described previously. Reliable
      detection of mechanical activity during early pregnancy remains problematic.
      Nevertheless, abdominal EHG appears suitable for noninvasive monitoring of
      pregnancies at risk. Further studies are needed to elucidate the significance of
      the EHG signal in both normal and abnormal pregnancies. It may eventually be
      possible to use EHG as an ambulatory monitoring tool for the early diagnosis of
      preterm labor.

PMID- 8369869
TI  - FDA's international standards policy.

PMID- 8369870
TI  - Kidney anatomy and physiology.

PMID- 8369871
TI  - Upper airway obstruction in the syndromal craniosynostoses.
AB  - This series of consecutive cases details the prevalence and management of upper
      airway obstruction in the syndromal craniosynostoses (Crouzon, Apert and Pfeiffer
      syndromes). Upper airway obstruction presents more frequently in Crouzon and
      Pfeiffer syndrome when presenting early and during the intermediate years. Those
      patients with Apert syndrome appear relatively free of this problem. Management
      has been directed toward increasing the size of the nasopharyngeal space by soft
      tissue alterations (uvulopalatopharyngoplasty, soft palatal split and
      adenotonsillectomy) with success. Le Fort III advancement osteotomy has been
      reserved for those more extreme cases, again with objective airway improvement.
      These techniques have removed the necessity for the progression to tracheostomy
      in these cases.

PMID- 8369872
TI  - A preliminary report on open tip rhinoplasty at the time of lip repair in
      unilateral cleft lip and palate: the Alor Setar experience.
AB  - A method of open-tip rhinoplasty using nostril and columella rim incisions at the
      time of unilateral cleft lip repair is described. This preliminary report details
      experience gained using this technique in the Malaysian centre of Alor Setar
      following its introduction in September, 1991.

PMID- 8369873
TI  - Refinements in the axial frontonasal flap.
AB  - The frontonasal flap is a useful flap for medial and lateral tip defects of the
      nose. It can be used as a random rotation flap or as an axial flap. This paper
      describes modifications to the original designs of these flaps, with improvements
      in the final scar.

PMID- 8369874
TI  - The cervicopectoral rotation flap--a valuable technique for facial
      reconstruction.
AB  - Four cases of lower cheek reconstruction using the cervicopectoral rotation
      advancement flap are reported. This fasciocutaneous flap can be raised quickly,
      provides excellent colour and texture match for the tissues of the face, and
      donor site morbidity is minimal. It is an especially useful method for lower
      cheek reconstruction following wide excision of melanomas of the cheek and for
      advanced parotid tumours where skin replacement is required following resection.

PMID- 8369875
TI  - Observations on experimental flow-through venous flaps.
AB  - The aim of this work was to compare the survival of an arteriovenous island flap
      with the survival of an island flap with a flow-through venous supply. Our
      experimental studies were performed on 95 Wistar rats randomised into six groups:
      Group 1: Indian ink injection of flow-through venous flaps with capillary
      network; Group 2: control group deprived of vascularisation; Group 3: control
      group with arteriovenous supply; Group 4: flow-through venous flaps of group 1;
      Group 5: epigastric flow-through venous flaps with a main venous trunk; Group 6:
      histological examination of flow-through venous flaps. The survival of flaps was
      monitored by direct examination, histological examination, capillaroscopy, and
      laser Doppler. Three out of 50 flow-through venous flaps survived. There was a
      statistically significant difference in the delay of clinical necrosis between
      the composite non vascularised free grafts (2.8 +/- 1.2 days) and the flow
      through venous flaps (4.1 +/- 1.3 to 4.9 +/- 1.1 days depending on the type of
      flap). A 20% decreased venous blood flow was observed in the flow-through venous
      flaps.

PMID- 8369876
TI  - Restoration of basement membrane structure in pigs following keratinocyte
      autografting.
AB  - The attachment of grafts of keratinocyte sheets is mediated in part by the
      presence and organisation of basement membrane components. The reappearance of
      basement membrane following keratinocyte autografting was examined in pigs. These
      studies showed that there was rapid expression of anchoring fibrils and
      hemidesmosomes, which reached normal numbers at 10 days. However, the length of
      hemidesmosomes did not reach normal size during the period of study. Weakness of
      attachment of keratinocyte autografted epidermis was found to lie between the
      basement membrane and the granulation tissue. This suggests that reported
      clinical problems with keratinocyte graft attachment may be mediated not only by
      delay in maturation of the basement membrane but also by its poor integration
      with collagen of the wound bed.

PMID- 8369877
TI  - A porcine model using skin graft chambers for studies on cultured keratinocytes.
AB  - In wound healing research, animal models permit an extensive tissue analysis
      which is not normally possible in clinical studies. A morphological comparison of
      human and porcine skin was made in order to identify those aspects of the wound
      healing process where a porcine model may help our understanding of clinical
      problems. We describe a porcine model for evaluating the growth of cultured
      keratinocytes on a variety of wound beds. Polytetrafluoroethylene skin graft
      chambers were used to isolate wounds and prevent epidermal healing from the skin
      edge. The chambers remained in situ for 5-7 weeks. We detail the surgical
      technique, the method of porcine keratinocyte culture and highlight some
      practical measures that were taken to optimise the "take" of the cultured
      keratinocyte grafts.

PMID- 8369878
TI  - Kerato-dermal grafts: the importance of dermis for the in vivo growth of cultured
      keratinocytes.
AB  - In a porcine model, we studied the benefit of dermis for the growth of cultured
      autologous keratinocytes (CAK) on full-thickness wounds isolated within skin
      graft chambers. Kerato-dermal grafts were prepared in a two stage process using
      autologous de-epidermalised dermis (DED) and CAK (Group 1). Control wounds were
      prepared by grafting either CAK only (Group 2) or DED only (Group 3). The median
      epidermal cover of 34 wounds in Group 1 was 47% and was significantly greater (p
      < 0.001) than the epidermal cover of 12 wounds in Group 2 (4%) and 14 wounds in
      Group 3 (12%). The epidermis in Group 1 was durable whereas it was fragile in the
      control wounds. Histologically rete ridges were present at 2 weeks in Group 1,
      but not in the control wounds. These data indicate that a dermal wound bed
      significantly improves the in vivo growth of cultured keratinocytes.

PMID- 8369879
TI  - Experimental study on growth of epiphysial plate: free graft in rabbits.
AB  - The growth potential of a free graft of an epiphysial plate was investigated in
      rabbits. Two epiphysial plate grafts were harvested from each iliac crest. One
      was grafted to the head (onto bone) and the other to the ear (onto cartilage).
      Both of the epiphysial plates enlarged to a maximum height of 1.4 cm and became
      similar to iliac crests. Enchondral ossification was observed up till
      approximately 28 weeks of age. We conclude that an epiphysial plate has growth
      potential after free heterotopic transplantation.

PMID- 8369880
TI  - Histologic examination of peripheral nerves elongated by tissue expanders.
AB  - Histological changes induced by the slow stretch of peripheral nerves using a
      tissue expander were studied using a rat sciatic model. Tissue expanders were
      adapted to elongate the sciatic nerve in vivo. Nerves elongated over an eight
      week period using this method achieved an average increase in length of 88%.
      Light microscopic examination revealed that individual axons were separated but
      each axon and the myelin sheaths were stained well. Electron microscopic
      examination showed that the convoluted contour of the axons appeared and some
      loss of myelin was also observed, but the intraneural cytoskeleton elements were
      kept intact.

PMID- 8369881
TI  - The effect of omental wrapping on nerve graft regeneration.
AB  - We have performed 1 cm long nerve grafts in the sciatic nerves of 60 Wistar rats.
      In 30 cases (n = 30) the grafts were wrapped in omentum. We have studied the
      nerve regeneration accomplished after 30 and 90 postoperative days from the
      histological and neurophysiological points of views. Survival of the omentum has
      been excellent. The histological assessment showed a higher blood vessel
      population as well as a higher count of axons in the cases where the nerve graft
      was wrapped in omentum. Areas with neural fibrosis, which are a sign of poor
      vascularisation, were smaller in the cases with omentum. The amplitude of the
      contraction in the gastrocnemius muscle was higher in the cases where omentum was
      used. The endothelial cells of the omentum synthesis fibroblast growth factors
      (acid and basic) which, due to their angiogenic and neuronotrophic properties,
      may be the cause of the beneficial effects of omentum on peripheral nerve
      regeneration.

PMID- 8369882
TI  - The results of pharyngoplasty by muscle transplantation in "failed cleft palate"
      cases, with special reference to the influence of the pharynx on voice
      production. 1953.

PMID- 8369883
TI  - The results of pharyngoplasty by muscle transplantation by Wilfred Hynes.

PMID- 8369884
TI  - A severe case of Beare-Stevenson syndrome and associated congenital deformities.
AB  - A severe case of congenital anomalies is described, with several characteristics
      of Beare-Stevenson syndrome, such as cutis gyrata, acanthosis nigricans,
      craniofacial anomalies, ear defects, enlarged umbilical stump and anogenital
      anomalies. He does not have craniosynostosis or clover leaf skull, which has also
      been described in this syndrome. This patient also shows hands and feet
      anomalies, absence of skin adnexa in several locations and dental anomalies,
      which could suggest an associated ectodermal dysplasia.

PMID- 8369885
TI  - TB or not TB?: That is the question.

PMID- 8369886
TI  - The way forward for hydrotherapy.

PMID- 8369887
TI  - Viscosity of plasma and blood in rheumatoid arthritis.
AB  - Blood rheology was studied in 130 consecutive RA outpatients, 33 with and 97
      without extra-articular disease (EAD), and compared with that in 88 blood donors.
      All rheological variables were significantly elevated in the RA patients compared
      with the controls. Painful joint count (PJC), morning stiffness (MS) and
      radiographic changes (RC) correlated significantly with plasma viscosity (PV),
      CRP, ESR and fibrinogen concentration (FC), but only in the group without EAD.
      Corrected blood viscosity (CBV) at a shear rate of 92/s correlated significantly
      only with MS. Multiple regression with PJC, MS and RC as dependent variables
      showed significant associations of PJC with PV, MS and CRP and RC with PV.
      Multiple regression with PV as the dependent variable showed significant
      associations with FC and IgG. RA patients with EAD had higher PV (P < 0.01), CBV
      at 92/s (P < 0.05) and ESR (P < 0.05) than the RA patients without EAD.
      Differences in profiles of viscosity variables between subgroups of EAD in RA
      patients were observed.

PMID- 8369888
TI  - Transient decrease in osteocalcin and markers of type 1 collagen turnover during
      high-dose corticosteroid pulse therapy in rheumatoid arthritis.
AB  - The effect of corticosteroid pulse therapy on bone metabolism was studied in 10
      patients with active RA. We measured alkaline phosphatase, osteocalcin and two
      recently introduced markers of collagen type 1 metabolism, reflecting synthesis
      (PICP) and degradation (ICTP). The day after the pulse therapy, there was a
      statistically significant (P < 0.05) decrease in osteocalcin, PICP and ICTP from
      the value at start. Three weeks after pulse therapy, these values had returned to
      baseline. During pulse treatment there is a transient decrease in bone formation,
      as shown by the changes in osteocalcin and PICP. Because of the changes in ICTP,
      we conclude that bone resorption is transiently reduced as well, but whether
      these changes result from a direct or an indirect effect on bone is not clear.
      ICTP has to be investigated further as a (serum) marker of bone resorption.

PMID- 8369889
TI  - Tendon calcifications of the hip adductors in chondrocalcinosis: a radiological
      study of 75 patients.
AB  - Studies on tendon involvement in articular chondrocalcinosis (ACC) are scarce,
      with little data focusing on its prevalence and characteristics. We carried out a
      radiological survey on 75 patients with ACC in order to establish the frequency
      and radiological appearance of calcific deposits at the origin of the adductor
      tendons on the ischium. In 19 of these patients, radiological visible linear
      calcifications compatible with chondrocalcinosis were observed at this site.
      There is a high correlation between the existence of pelvic tendon calcifications
      and the extension and intensity of calcific deposits in other articular areas.
      Calcifications of the adductor tendons are not uncommon in ACC, the amount of
      calcium pyrophosphate deposits may be the most important factor leading to tendon
      involvement in this disorder.

PMID- 8369890
TI  - HLA associations in subjects with rheumatoid arthritis and bronchiectasis but not
      with other pulmonary complications of rheumatoid disease.
AB  - We have examined HLA-DR, DQA and DQB variants in 72 controls, 153 subjects with
      RA without extra-articular features and in subjects with the rheumatoid pulmonary
      complications of interstitial fibrosis (23) peripheral airways disease (13) and
      in 41 subjects with RA and bronchiectasis. Subjects with RA alone showed the
      expected association with HLA-DR4 (79%) but those with RA and co-existent
      pulmonary fibrosis were less likely to be DR4 positive (61%). No other HLA-DR
      variants were significantly increased in the different disease groups. HLA
      DQB1*0501 which types serologically as DQw1 was increased in subjects with RA and
      peripheral airways disease as compared to rheumatoid subjects with normal lung
      function, but these differences were not statistically significant. DQB1*0601 was
      increased in subjects with bronchiectasis with or without RA (but only
      significantly so in RA-BR subjects) DQB1*0301, DQB1*0201 and DQA1*0501
      frequencies were also increased in subjects with RA and bronchiectasis as
      compared to those with RA alone.

PMID- 8369892
TI  - Home exercises are as effective as outpatient hydrotherapy for osteoarthritis of
      the hip.
AB  - Hydrotherapy for OA of the hip has rarely been evaluated in controlled studies.
      Forty-seven patients with OA of the hip were followed for 18 weeks. Patients were
      randomly allocated either to a regimen of home exercises or to twice weekly
      hydrotherapy for 6 weeks in addition to home exercises. There was an improvement
      seen in both subjective and objective measures in both groups with treatment.
      There was no significant difference between the two groups. Response to treatment
      appeared independent of age, sex and radiological severity. We conclude that for
      most patients, a carefully graded and supervised regimen of home exercises is
      beneficial and there is little benefit in adding hydrotherapy to this regimen.

PMID- 8369891
TI  - Transition questions to assess outcomes in rheumatoid arthritis.
AB  - The importance of patient-based assessments of outcomes of care in RA is
      increasingly recognized. There are a number of methods of gaining such data. One
      method is to request patients to assess change in health status by means of
      transition questions. This is considered advantageous to other methods because is
      directly addresses perceptions of change over time and is short and simple. One
      hundred patients with RA completed a range of clinical, laboratory and health
      status assessments on two occasions 3 months apart. On the second occasion they
      also completed a transition question. Results show the question to be valid and
      to correlate with a number of different changes obtained from assessments.
      Psychological mood did not appear to influence transition judgements. A small
      minority of patients experienced changes for specific dimensions of health status
      in the opposite direction of the transition item. Transition judgements may have
      an important role in evaluation studies and audit.

PMID- 8369893
TI  - Glucocorticoids in rheumatoid arthritis--mediators and mechanisms.

PMID- 8369894
TI  - Benign synovitis of the hip in adults.
AB  - Hip synovitis plays a part in many rheumatic diseases. In the young adult acute
      arthritis may be due to reaction to trauma, infection or gout. Although transient
      synovitis of the hip is a well-known phenomena in children the condition is not
      well-documented in adults. We present 10 young adults with idiopathic transient
      synovitis of hip who had attended the Soroka Medical Centre between 1986 and
      1990.

PMID- 8369895
TI  - Letter from Hungary.

PMID- 8369896
TI  - The diagnosis of Poncet's disease.
AB  - Two cases of polyarthritis in young people with extra-articular tuberculosis are
      described. The clinical features were consistent with the concept of Poncet's
      disease. After synovial biopsy one patient proved to have tuberculous peripheral
      arthritis. This observation raised doubts about the diagnosis in the other
      patient. Multiple joints may be simultaneously infected with Mycobacterium
      tuberculosis and Poncet's disease, if it exists, should not be entertained in the
      absence of synovial biopsy.

PMID- 8369897
TI  - Remission of severe rheumatoid arthritis following liver transplantation.
AB  - We present the case of a 32-year-old male who suffered from severe RA from the
      age of 21 years. After 9 years of active disease and poor response to therapy the
      patient developed severe hepatitis induced by the NSAID pirprofen. He went into
      fulminant hepatic failure necessitating emergency liver transplantation. Liver
      transplantation was followed by clinical and laboratory remission of his RA and
      he has remained virtually asymptomatic for more than 3.5 years. The possibility
      that this favourable clinical course was due to the immunosuppressive effect of
      the liver transplant rather than the ensuing immunosuppressive therapy is
      discussed.

PMID- 8369898
TI  - A case of steroid-responsive organizing pneumonia in a patient with rheumatoid
      arthritis showing migratory infiltration and normal glucose levels in pleural
      effusions.
AB  - A 59-year-old Japanese man with RA was referred to us with arthralgia and
      pulmonary infiltration. Chest roentgenogram showed migratory infiltration and
      pleural effusion, the glucose levels of the pleural fluid were not reduced.
      Transbronchial lung biopsy showed granulation tissue plugging the alveolar ducts,
      indicating organizing pneumonia and interstitial inflammation. These pathological
      findings were identical with those for cryptogenic organizing pneumonitis (COP).
      There was a good clinical and roentgenographic response and the pleural effusion
      responded well to corticosteroids. The characteristic migratory infiltration in
      rheumatoid lung disease responds well to corticosteroids.

PMID- 8369899
TI  - Iliopsoas bursa presenting as deep vein thrombosis in rheumatoid arthritis.
AB  - The case of a woman with longstanding rheumatoid arthritis presenting with a deep
      vein thrombosis of the leg secondary to an enlarged iliopsoas bursa is described.
      The anatomy, presentation and disease associations are described, and the optimum
      techniques of imaging and management are discussed.

PMID- 8369900
TI  - HLA and juvenile psoriatic arthritis.

PMID- 8369901
TI  - The role of infection in juvenile chronic arthritis.
AB  - Juvenile chronic arthritis covers a heterogeneous group of arthritides for which
      there appears to be a genetically determined susceptibility. The exact events
      which trigger or perpetuate an arthritic disease have yet to be defined. There is
      circumstantial clinical evidence that JCA can be initiated by environmental
      factors such as infection, and indirect laboratory evidence that immune responses
      to infectious agents are associated with ongoing JCA; such immune responses seem
      particularly vigorous within the joint space. Although the weight of evidence
      favours the hypothesis that the intra-articular inflammatory process is antigen
      driven, none of the critical antigens have been identified, and it is still
      unclear whether they are derived from infectious agents or are true auto
      antigens. We can however expect progress to be made, since techniques are now
      available for defining the antigenic specificity and TCR usage of synovial T cell
      populations, while PCR allows exquisitely sensitive detection of infectious
      agents deposited in the synovial space. Application of these techniques should
      lead to an enhanced understanding of whether (or in what circumstances)
      infectious agents are involved in the pathogenesis of arthritis in children.

PMID- 8369902
TI  - Evolution of synovial fluid mononuclear cell responses in a HLA B27-positive
      patient with Yersinia-associated juvenile arthritis.
AB  - A 15-year-old boy who developed acute arthritis following an episode of
      urethritis, was found to have agglutinating antibodies (titre 1:320) against
      Yersinia enterocolitica 0:3. Synovial fluid mononuclear cell (SFMC) proliferative
      responses to this agent and other antigens were examined on four occasions over
      the subsequent 40 months. Responses to Yersinia were predominant during the first
      year, but after 29 months responses to purified protein derivative of
      Mycobacterium tuberculosis and Salmonella were greater than to Yersinia. Moderate
      responses to a mycobacterial heat shock protein (HSP65) were present throughout
      the illness. These results suggest that maximal mononuclear cell proliferative
      responses may change over time, and raise the possibility that responses which
      are initially specific for the inciting arthritogenic agent may eventually become
      more generalized.

PMID- 8369903
TI  - Infantile myofibromatosis: a cause of severe bone pain in a neonate.
AB  - A 3-week-old, female infant, developed severe bilateral shoulder pain in
      association with large, symmetrical, lytic lesions in the proximal humeri. The
      radiological appearance was suggestive of infantile myofibromatosis and bone
      biopsy confirmed the diagnosis. She subsequently made a complete recovery. This
      uncommon condition is infrequently confined to bone and except in the presence of
      obvious pathological fracture, severe pain has not previously been reported.

PMID- 8369904
TI  - Abnormal fibrinolysis in chronic low back pain.

PMID- 8369905
TI  - Hospital treatment for low back pain.

PMID- 8369906
TI  - Charcot arthropathy as an unusual initial manifestation of diabetes mellitus.

PMID- 8369907
TI  - The British Journal of Surgery 80th anniversary.

PMID- 8369908
TI  - Carotid endarterectomy: confidence restored.

PMID- 8369909
TI  - Recurrent varicose veins: a national problem.

PMID- 8369910
TI  - Infrainguinal vein graft stenosis.
AB  - Although knowledge of the biological processes involved in the development of
      intimal hyperplasia has increased markedly in recent years, the precise aetiology
      of infrainguinal vein graft stenosis remains undetermined. Current therapy is
      therefore directed at treatment of the established lesion rather than its
      prevention. There seems little doubt, however, that recent advances in
      understanding of the vascular biology of normal and pathological saphenous vein
      will eventually lead to specific targeted therapy that will allow the prevention
      of vein graft stenosis.

PMID- 8369911
TI  - Foot volumetry and duplex ultrasonography after saphenous and subfascial
      perforating vein ligation for recurrent venous ulceration.
AB  - Forty-three patients undergoing superficial and perforating vein ligation for
      recurrent venous ulceration underwent preoperative and postoperative foot
      volumetry and postoperative duplex ultrasonography. Patients were followed for a
      median of 66 (range 18-144) months. Of nine patients who developed recurrent
      ulceration, six had femoral vein incompetence and all had popliteal vein
      incompetence demonstrated by duplex ultrasonography. Of the 34 patients who
      remained ulcer-free, five had femoral vein incompetence and a single patient had
      popliteal vein incompetence on duplex scanning, giving positive predictive values
      for recurrent ulceration of 55 per cent (femoral vein incompetence) and 90 per
      cent (popliteal vein incompetence). Patients with saphenofemoral incompetence on
      late follow-up were also more likely to suffer recurrence. Preoperative foot
      volumetry with tourniquet occlusion of superficial veins showed that the median
      expulsion fraction of patients who developed recurrent ulcer during follow-up was
      0.8 (range 0.6-2.3) per cent compared with 1.5 (range 0.4-2.9) per cent for those
      who remained ulcer-free (P = 0.025); the median half-refilling time of patients
      with recurrent ulcer was 1.5 (range 0.5-5.5) s compared with 5.0 (range 0.5-23.0)
      s for those without recurrence (P < 0.01). Postoperative foot volumetry showed
      similar differences. Deep venous incompetence, particularly of the popliteal
      segment, as demonstrated by duplex ultrasonography and foot volumetry, is a
      useful predictor of recurrent ulceration after subfascial perforator and
      superficial venous ligation.

PMID- 8369912
TI  - Recurrent varicose veins: correlation between preoperative clinical and hand-held
      Doppler ultrasonographic examination, and anatomical findings at surgery.
AB  - A consecutive series of 118 patients (148 legs) presenting with recurrent
      varicose veins underwent preoperative clinical and hand-held Doppler
      ultrasonographic examination by a single observer. The presence of
      saphenofemoral, mid-thigh perforator and saphenopopliteal reflux was noted.
      Ultrasonography markedly improved the accuracy of clinical assessment at all
      three potential sites of reflux compared with operative findings. Of 71 patients
      undergoing repeat groin dissection, only 20 (28 per cent) had a tied
      saphenofemoral junction, 31 (44 per cent) had intact major tributaries and 52 (73
      per cent) had an intact long saphenous vein (LSV) in the thigh. There was a
      positive association between mid-thigh perforator reflux giving rise to recurrent
      varices and the presence of an intact LSV in the thigh. Of 45 legs with
      saphenopopliteal reflux, only four had previously undergone saphenopopliteal
      ligation, suggesting that most short saphenous varicosities had either appeared
      after or had not been recognized at the time of primary surgery. This study
      indicates that even an experienced vascular surgeon can have difficulty in
      assessing the presence or absence of recurrent deep to superficial reflux by
      means of clinical examination alone and that Doppler ultrasonographic examination
      is mandatory. Recurrence continues to be associated with persistent or recurrent
      incompetence at the site of previous inadequate surgery.

PMID- 8369913
TI  - Intraoperative measurement of vascular graft resistance as a predictor of early
      outcome.
AB  - The quality of distal run-off is one of the most important factors influencing
      the early outcome of femorodistal vein grafting. During femoropopliteal and
      infrapopliteal bypass, assessment of graft resistance and flow were made using a
      combination of Doppler flowmeter recordings and measurements of arterial
      pressure. In a series of 100 reconstructions there were 12 early failures. The
      mean (95 per cent confidence interval (c.i.)) maximal flow measurement in the
      group of grafts that failed when anastomosed to the popliteal artery or
      tibioperoneal trunk was 125 (74-176) ml/min compared with 256 (223-289) ml/min in
      successful grafts (P = 0.006). The corresponding figures for grafts inserted into
      a single crural vessel were 99 (72-126) and 165 (137-193) ml/min (P < 0.02). In
      the group that failed the mean (95 per cent c.i.) resistance after papaverine
      injection was 1.02 (0.82-1.22) peripheral resistance units (p.r.u.) compared with
      0.47 (0.44-0.51) p.r.u. in the successful group (P < 0.001). Using a combination
      of resistance > 0.9 p.r.u. and capacity loss ratio after papaverine injection <
      10 per cent to identify grafts that subsequently failed, the sensitivity,
      specificity, positive predictive value, negative predictive value and accuracy
      were 92, 97, 85, 99 and 97 per cent respectively. These results confirm that
      haemodynamic measurements can be used at operation to identify a group of
      patients in whom bypass is likely to fail.

PMID- 8369914
TI  - Intraoperative thrombolysis in the management of thrombosed popliteal aneurysm.

PMID- 8369915
TI  - Sutureless circumcision.

PMID- 8369916
TI  - Non-therapeutic operations for penetrating trauma: early morbidity and mortality.
AB  - A prospective study was carried out to assess the incidence and type of
      complications after non-therapeutic operations for penetrating trauma. A total of
      372 operations were performed on 368 patients with penetrating injuries to the
      abdomen (240 procedures), chest (49), neck (48) and extremities (35). There were
      46 negative or non-therapeutic operations. The incidence of major complications
      directly related to anaesthesia or operation in this group of patients was 4
      percent (two patients). The operation might have contributed to a further three
      major complications. The mean hospital stay for patients undergoing uncomplicated
      non-therapeutic operation was 4.1 days; for those with complications it was 21.2
      days. It is concluded that non-therapeutic operations for penetrating trauma
      carry a significant morbidity rate. A policy of selective conservatism is
      advocated.

PMID- 8369917
TI  - Electrocautery of the upper thoracic sympathetic chain: a simplified technique.

PMID- 8369918
TI  - Screening for breast cancer detects tumours at an earlier biological stage.
AB  - Between August 1988 and July 1990, 17,678 women in the Gateshead, Sunderland,
      South Tyneside and Durham districts attended the national breast screening
      programme. A total of 131 cancers were detected. The morphology of cancers
      detected by screening was compared with that of tumours in 71 patients presenting
      clinically in the same period. Screen-detected cancers included a higher
      proportion of tumours of more favourable histological grade and type, were
      smaller in size and had less axillary lymph node involvement than those detected
      clinically. Survival was predicted from the Nottingham Prognostic Index. Patients
      with screen-detected cancer had an expected survival advantage (95 per cent
      confidence interval) of 26.5 (12.3-40.6) per cent at 5 years, 26.5 (11.8-41.2)
      per cent at 10 years and 29.1 (14.5-43.7) per cent at 15 years. This survival
      advantage in screened patients expected at 5, 10 and 15 years is consistent with
      the 30 per cent reduction in mortality rate demonstrated in the Health Insurance
      Plan study and the Swedish two counties trial.

PMID- 8369919
TI  - Cytodiagnosis of breast disease using a liquid suspension medium.
AB  - Fine-needle aspiration cytology specimens from 187 breast lesions were processed
      using conventional slide cytology. Results were compared with those from 201
      lesions prepared using a liquid suspension medium (Cytospin) for specimen
      collection, to assess the clinical utility of each technique. The frequency of
      diagnostic groups was similar for each method. No significant difference was
      found in sensitivity (conventional slide cytology 86 per cent versus Cytospin 82
      per cent), specificity (72 versus 82 per cent) or diagnostic accuracy (88 versus
      91 per cent). The Cytospin technique compares favourably with conventional slide
      cytology and can be recommended for ease of use in breast cytodiagnosis.

PMID- 8369920
TI  - Use of silicone implants after wide local excision of the breast.
AB  - The appearance of the breast after wide local excision for carcinoma may be
      unsatisfactory. In 59 patients undergoing wide local excision a silicone
      prosthesis was inserted into the cavity at the time of primary surgery.
      Assessment of the cosmetic result was performed after 12 months by questionnaire
      and clinical examination. Four prostheses were removed within 1 year because of
      infection (two patients), wound breakdown (one) and pain  (one). Seven prostheses
      were subsequently removed because of severe capsular contraction. Capsular
      contraction was more common in patients who had received radiotherapy. Only 23
      patients found the results of the implant acceptable or satisfactory. The
      immediate use of intramammary implants after wide local excision is currently
      associated with a poor cosmetic result, and the problem of the distorted breast
      after such excision requires continued attention.

PMID- 8369921
TI  - New adjustable knot for securing subcuticular running sutures.

PMID- 8369922
TI  - Laparoscopic removal of an adrenocortical adenoma.

PMID- 8369923
TI  - Prospective randomized comparison of teres cardiopexy and Nissen fundoplication
      in the surgical therapy of gastro-oesophageal reflux disease.
AB  - Teres cardiopexy was compared with Nissen fundoplication in a prospective
      randomized study of surgery for gastro-oesophageal reflux disease refractory to
      medical treatment. Follow-up at 3 months of ten patients undergoing each
      procedure showed good clinical results and improvement of the mean symptom score
      in both groups, for cardiopexy from 7.8 to 1.1 (P < 0.01) and for fundoplication
      from 5.7 to 0.2 (P < 0.01). After 1 year, six of the ten patients undergoing
      cardiopexy required a second antireflux procedure because of recurrent disease,
      whereas one reoperation was performed after fundoplication. The mean symptom
      score after 1 year was higher in patients submitted to cardiopexy than in those
      receiving fundoplication (3.9 versus 0.3, P < 0.01). The mean endoscopic
      oesophagitis score after 1 year was no different from preoperative values after
      cardiopexy (1.9 versus 1.9) but was significantly lower after fundoplication (1.5
      versus 0.3, P = 0.01). Ambulatory 24-h pH monitoring showed a significantly
      higher proportion of total time at pH < 4 after cardiopexy than fundoplication
      (24.0 versus 3.8 per cent, P < 0.05). Cardiopexy is significantly less effective
      than fundoplication for the treatment of gastro-oesophageal reflux disease
      assessed at 1-year follow-up. This study does not support the use of cardiopexy
      either in conventional or laparoscopic antireflux surgery.

PMID- 8369925
TI  - Oesophagomyotomy for achalasia: a 22-year experience.
AB  - To determine the clinical results in achalasia, particularly as regards
      postoperative gastro-oesophageal reflux, a 22-year personal experience with
      transthoracic short oesophagomyotomy without an antireflux procedure was
      analysed. A total of 185 such procedures were performed, of which 179 (97 per
      cent) were available for analysis. There was an overall improvement rate of 89
      per cent over a mean postoperative interval of 9 years. Primary procedures were
      followed by a 93 per cent rate of improvement. Twenty patients, nine of whom had
      previously undergone one or more oesophageal operations, were considered as
      having a poor result. Marked gastro-oesophageal reflux accounted for a poor
      outcome in nine patients. Although the overall rate of postoperative improvement
      did not deteriorate significantly with time, the level of improvement did, the
      proportion of excellent results declining from 54 to 32 per cent (P = 0.02) at 10
      20 years after operation. These findings substantiate the view that a short
      transthoracic oesophagomyotomy without an antireflux procedure provides excellent
      long-term relief of dysphagia for the patient with oesophageal achalasia and is
      accompanied by an extremely low risk of serious postoperative gastro-oesophageal
      reflux.

PMID- 8369924
TI  - Erythromycin improves emptying of the denervated stomach after oesophagectomy.
AB  - Oesophagectomy, necessitating vagotomy, is associated with delayed gastric
      emptying. Cisapride and erythromycin have prokinetic effects and improve emptying
      of the innervated stomach. Their effect on the denervated stomach following
      oesophagectomy is unknown. The effect of pyloroplasty, cisapride and erythromycin
      on the rate of gastric emptying after oesophagectomy was studied using a
      radiolabelled meal. Oesophagectomy was associated with a marked delay in gastric
      emptying (56 per cent of the test meal remaining after 4 h) compared with age-
      and sex-matched normal controls (16 per cent; P < 0.001). Erythromycin improved
      the rate of gastric emptying to preoperative control values (18 per cent).
      Cisapride had no significant effect on gastric emptying. After pyloroplasty, 32
      per cent of the label remained at 4 h (P = 0.065). The mean(s.e.m.) half-emptying
      time in patients receiving erythromycin was 94(29) min, which was similar to
      control values, 55(3) min (P = 0.26). Erythromycin may have a role in the
      treatment of gastric stasis following oesophagectomy or truncal vagotomy.

PMID- 8369926
TI  - Pattern and surgical treatment of gastric cancer in Singapore.
AB  - A personal series of 150 patients with gastric cancer operated on over an 11-year
      period in Singapore is reviewed. Cancer occurred in the antrum and/or body of the
      stomach in 117 patients and in the cardia in 33. Gastric tumours were well or
      moderately differentiated adenocarcinoma in 50 patients and poorly differentiated
      or signet ring cell carcinoma in 100. Surgical resection was performed on 115
      patients, in whom it was palliative in 47. Attempted cure by R2 radical resection
      was performed in 68 patients: 14 with stage I, 12 with stage II and 42 with stage
      III disease. There was no operative death in these 68 patients. In 82 patients
      operated on more than 5 years ago, five patients with carcinoma of the cardia and
      28 with cancer of the gastric antrum and/or body underwent curative resection.
      There were 12 known 5-year survivors among the latter 28 patients; 16 of the 28
      had stage III disease, six of whom survived 5 years. These results compare
      favourably with those of an earlier report from Singapore in which there were no
      5-year survivors. The improved results probably accrue from earlier diagnosis and
      the current policy of radical resection.

PMID- 8369927
TI  - Prognostic significance of histological type in gastric carcinoma with invasion
      confined to the stomach wall.
AB  - Survival was determined after resection for the two main histological types of
      gastric carcinoma, intestinal (n = 223) and diffuse (n = 170), in 393 patients
      with pT1 or pT2 tumours. Lymph node metastases were present in 94 patients. The
      10-year survival rate was significantly lower for patients with intestinal-type
      than for those with diffuse-type carcinoma (72 versus 91 per cent, P < 0.005). In
      patients without nodal involvement, the 10-year survival rate was still lower for
      those with intestinal-type cancer (70 versus 94 per cent, P < 0.01). Recurrence
      of carcinoma was more often by haematogenous dissemination in patients with
      intestinal-type cancer. Although the results of resection for pT1 or pT2 gastric
      carcinoma can be acceptable, the introduction of adjuvant therapy based on
      histological findings may be necessary for patients with the intestinal type of
      cancer to prevent haematogenous spread of carcinoma to the liver.

PMID- 8369928
TI  - Spontaneous rupture of a normal portal vein causing severe retroperitoneal and
      intraperitoneal bleeding.

PMID- 8369929
TI  - Kinetic changes and experimental carcinogenesis after Billroth I and II
      gastrectomy.
AB  - To determine the risk of gastric remnant cancer according to the type of surgical
      reconstruction, the distal two-thirds of the glandular stomach was resected in
      male Wistar rats, followed by gastroduodenostomy (Billroth I anastomosis) or
      gastrojejunostomy (Billroth II anastomosis). No carcinogens were given and the
      animals were killed 50 weeks after operation. No cancers developed in 22 rats
      undergoing Billroth I gastrectomy, but five of 24 with Billroth II anastomosis
      had adenocarcinoma (P < 0.05). All carcinomas were confined to the stoma. Animals
      with Billroth II anastomosis had a more advanced grade of mucosal atrophy at the
      stoma, with a higher incidence of cystic dilatation, submucosal adenocystic
      proliferation and pseudopyloric metaplasia (P < 0.05). Cell kinetics in the
      stomal mucosa after Billroth II gastrectomy showed an increased cell count in the
      proliferative zone, longer duration of S phase and increased cell cycle time (P <
      0.05). These results suggest that Billroth II gastrectomy carries a greater risk
      of cancer than the Billroth I procedure.

PMID- 8369931
TI  - Translocation of enteric bacteria in humans.

PMID- 8369930
TI  - Intraoperative enteroscopy in Crohn's disease.
AB  - Intraoperative small bowel endoscopy was performed on 33 occasions in 31 patients
      with Crohn's disease. The extent of mucosal inflammation was compared with that
      of changes in the external bowel wall: serositis, fat-wrapping and mural
      thickening. The influence of endoscopic findings on surgical management was
      evaluated. Mucosal inflammation was generally more extensive than serositis (P <
      0.01), but less so than mural thickening (P < 0.001). The extent of fat-wrapping
      did not differ from that of mucositis. Of 23 patients undergoing reoperation or
      with fistula or abscess, however, eight had serositis and/or fat-wrapping in
      bowel segments without mucosal inflammation. Endoscopic findings influenced
      surgical decisions on 20 of the 33 occasions, limiting planned resection in 14,
      identifying strictures for repair in one, and deciding against resection in two
      cases and for extended resection in three. These results suggest that external
      inflammatory changes are unreliable guides to the extent of intestinal mucositis
      and requirements for resection in Crohn's disease. By visualizing the mucosa,
      intraoperative enteroscopy can provide information for more precise surgery,
      thereby limiting resection.

PMID- 8369932
TI  - Extended left hepatectomy: technical aspects of an evolving procedure.
AB  - Lessons learned in an operative experience of 14 patients submitted to extended
      left hepatectomy for the management of liver tumours are presented. There were no
      deaths within 30 days of operation. Essential preoperative studies, indications
      and technical details of the operation are described. The importance of the
      morphology of the tumour and the influence of the tumour on the technique to be
      adopted are emphasized. Modifications of technique that allow selection of
      patients for the procedure, control of venous bleeding, accurate identification
      of the sectorial portal pedicles within the right liver and definition of the
      plane of parenchymal transection are addressed.

PMID- 8369933
TI  - Laparoscopic treatment of a liver hydatid cyst.

PMID- 8369934
TI  - Biliary stent failure after 42 years.

PMID- 8369935
TI  - Orthotopic liver transplantation for hepatic complications of Wilson's disease.
AB  - Thirteen orthotopic liver transplantations were performed in 12 patients for
      hepatic complications of Wilson's disease between May 1988 and July 1992. Ten
      patients had fulminant hepatic failure and two chronic liver disease. One patient
      underwent retransplantation for liver abscess secondary to hepatic artery
      thrombosis. Nine patients survive at a median follow-up of 18 (range 6-31)
      months. Three patients have died: two from multiple organ failure and sepsis, one
      from B cell lymphoma. Postoperative complications included bleeding requiring
      laparotomy in two patients, renal impairment in five, bacterial septicaemia in
      three, fungal sepsis in two and acute cellular rejection in six. The nine
      surviving patients are well with normal liver function test results.

PMID- 8369936
TI  - Superselective intra-arterial chemotherapy with mitomycin for gallbladder cancer.
AB  - A group of 27 patients with carcinoma of the gallbladder was treated by
      superselective intra-arterial chemotherapy with mitomycin between 1981 and 1990.
      Results were compared with those in 22 historical controls. The overall response
      rate to intra-arterial chemotherapy was 48 per cent. The median survival time for
      responders was 34 months and for non-responders 8 months. Survival was
      significantly related to tumour stage in patients treated by chemotherapy (P <
      0.001) and controls (P < 0.01); all patients with tumour extending beyond the
      serosa died within 4 years. The median survival period after intra-arterial
      chemotherapy was 14 months, compared with 4 months in controls. The cumulative 5
      year survival rates for patients treated by chemotherapy and controls were not
      significantly different. Cessation of chemotherapy was required in 16 of the 27
      patients: in eight because of tumour progression, in seven after toxicity to
      chemotherapy and in one because of patient refusal. Superselective intra-arterial
      chemotherapy can be useful for patients with cancer restricted to the gallbladder
      wall but cannot prevent tumour growth once this has extended beyond the
      gallbladder serosa.

PMID- 8369937
TI  - Herniation at the site of cannula insertion after laparoscopic cholecystectomy.

PMID- 8369938
TI  - Sclerotherapy of the human gallbladder using ethanol and tetracycline
      hydrochloride.

PMID- 8369939
TI  - Prophylactic use of cefuroxime in biliary tract surgery: randomized controlled
      trial of single versus multiple dose in high-risk patients. Galant Trial Study
      Group.
AB  - To assess the efficacy of a single-dose short-acting antibiotic in the prevention
      of septic complications after biliary surgery, a randomized controlled double
      blind multicentre trial was conducted. One dose of cefuroxime before operation
      (1.5 g intravenously) was compared with a three-dose regimen of the drug as
      control (1.5 g before and two doses of 0.75 g after operation). The study group
      comprised 1004 patients with risk factors for infection, who were followed for 4
      6 weeks after surgery. The characteristics of both treatment groups were
      comparable. No significant difference was found between the one- and three-dose
      antibiotic regimens in preventing postoperative wound infection: 6.6 versus 6.2
      per cent for minor wound infection (P = 0.78) and 4.6 versus 3.8 per cent for
      major wound infection (P = 0.52). The estimated difference in major wound
      infection rate between the two groups was 0.8 per cent (95 per cent confidence
      interval -1.7 to 3.3 per cent).

PMID- 8369940
TI  - Randomized study of the value of laparoscopy before appendicectomy.
AB  - Two groups of 30 women with clinical signs of appendicitis were randomized to
      immediate appendicectomy or diagnostic laparoscopy. In the latter group,
      appendicectomy was performed if a diagnosis of acute appendicitis was established
      or if the appendix could not be visualized. Eleven patients undergoing immediate
      operation had unnecessary appendicectomy, compared with two having laparoscopy.
      This difference of 30 per cent (95 per cent confidence interval 11-49 per cent)
      was significant (P = 0.01). There was no significant difference in postoperative
      morbidity rate in the two groups. Diagnostic laparoscopy is a useful preliminary
      investigation in women with clinical signs of acute appendicitis.

PMID- 8369941
TI  - Safety of double-stapled anastomosis in low anterior resection.
AB  - Clinical leakage of the anastomosis follows low anterior resection for rectal
      carcinoma in 5-10 per cent of patients despite standard stapling techniques. A
      modification of this method has obviated the need for a distal purse string. A
      flexible transverse stapling instrument (Roticulator 55) is applied across the
      rectum below the tumour, and a double-staggered row of staples is inserted as a
      substitute for the distal purse string. End-to-end stapled anastomosis is then
      performed with peranal insertion of a Premium CEEA stapling instrument. In 111
      patients the indications for operation were colorectal carcinoma (96 patients),
      diverticulosis (ten), megarectum (four) and ulcerative proctocolitis (one). Three
      patients had clinical evidence of anastomotic leakage; all survived. The
      incidence of radiological leakage on Gastrografin enema 10-12 days after
      operation was 9 per cent. The perioperative mortality rate was 2 per cent; all
      deaths were from cardiovascular causes. Local recurrence of tumour occurred in
      eight patients (7 per cent) after a mean follow-up of 40 months. In conclusion,
      double-stapled end-to-end anastomosis has made low anterior resection for rectal
      carcinoma a safe procedure with a low mortality rate, an acceptable local
      recurrence rate and minimal (clinical) anastomotic leakage.

PMID- 8369942
TI  - Reappraisal of radical local excision for carcinoma of the rectum.
AB  - Outcome in all 167 patients treated by radical local excision for rectal
      carcinoma between 1948 and 1984 at St Mark's Hospital was assessed in terms of
      the original tumour differentiation except for 15 patients with incomplete follow
      up or ungraded tumours. Fifty-six of the 152 patients had low-grade tumours, with
      one death from carcinoma in this group. Of 81 patients with average-grade
      tumours, ten died from carcinoma of the rectum: two after early reoperation and
      eight following recurrence. Six of 15 patients with high-grade tumours underwent
      early reoperation and three of these died from carcinoma. Among the nine patients
      who did not undergo early reoperation there were three related deaths (two from
      carcinoma, one after rectal excision for recurrence). Local excision remains a
      valid therapy for suitable patients with low-grade tumours but is not recommended
      for those with average-grade lesions. The necessity for early reoperation in
      patients with high-grade tumours is questioned.

PMID- 8369943
TI  - Multicentre study of a continent colostomy plug.
AB  - A multicentre clinical study was carried out to assess the performance of a new
      disposable device, the Conseal 1-Piece, for colostomy control and continence.
      Forty-three patients were studied; none had any complication at the stoma. The
      time elapsed since surgery and the condition of the stoma and surrounding skin
      were recorded. The new product was compared with the patients' usual colostomy
      bag, studying the following parameters: ease of application, reliability,
      leakage, confidence, ease of removal, adhesion and comfort. Thirty-seven patients
      completed the study. No complications arose, and complete faecal continence was
      obtained with 71.1 per cent of applications. The plug was kept in position for a
      mean of 11.5 h and a normal stoma bag was used for the remainder of the day. Of
      the 37 patients who completed the trial, 26 preferred the Conseal 1-Piece to a
      colostomy bag. In this preliminary study the device was easy to apply, involved
      no major complications and provided a high degree of continence. This product
      deserves further study because of its simplicity of use. However, research to
      improve the level of continence should continue.

PMID- 8369944
TI  - Anorectal function after preoperative intraluminal brachytherapy and colonic J
      pouch-anal anastomosis for rectal carcinoma.
AB  - The effects of preoperative intraluminal brachytherapy on bowel function after
      anoabdominal rectal resection and colonic J pouch-anal anastomosis were studied.
      The patients included eight not receiving irradiation (group 1), eight who
      received 30 Gy (group 2) and eight who received 80 Gy (group 3). Stool frequency
      and the incidence of soiling were significantly greater in group 3 than in the
      other groups. Anal resting pressure was lower in group 3 during the study period
      but J pouch distensibility was not reduced. The maximum tolerated volume,
      threshold volume and squeeze pressure were significantly lower in group 3 than in
      the other groups in the early postoperative period. These results suggest that
      high-dose brachytherapy affects the anal sphincters and colonic J pouch. A
      moderate dose of 30 Gy may be more suitable before restorative anorectal surgery.

PMID- 8369945
TI  - Pouch-vaginal fistula.
AB  - Between January 1976 and June 1991, 161 women underwent restorative
      proctocolectomy. Seventeen (10.6 per cent) developed pouch-vaginal fistula. There
      was no difference in the incidence of inflammatory (15 of 141; 10.6 per cent) and
      non-inflammatory (two of 20; 10 per cent) disease, the severity of colitis or the
      number of stages in the operation. In 15 patients the fistula involved the
      ileoanal anastomosis; in two it had possibly occurred at the dentate line. There
      was no significant difference in the proportion of hand-sewn (ten of 120; 8.3 per
      cent) and stapled (seven of 41; 17 per cent) ileoanal anastomosis. Of the 17
      women, six had pelvic sepsis in the immediate postoperative period and five had
      an anastomotic complication. There was no case of Crohn's disease. Three patients
      developed a pouch-vaginal fistula before closure of the ileostomy. The remaining
      14 fistulas occurred a median of 7 (range 1-144) months after closure. Five
      further patients were referred from elsewhere to give a total of 22 for analysis
      of treatment and outcome. The fistula developed before ileostomy closure in five
      patients (group 1) and after closure in 17 (group 2). Following treatment, six
      fistulas had healed with five patients still undergoing treatment. In group 1,
      three of the five fistulas healed, whereas in group 2 only three of the 17
      healed. Eight patients required excision of the pouch. The prognosis appears to
      be worse when pouch-vaginal fistula occurs after ileostomy closure. The optimal
      management is not yet established.

PMID- 8369946
TI  - The future of vascular surgery.

PMID- 8369947
TI  - Choice of agent for peripheral thrombolysis.

PMID- 8369948
TI  - Selective cholangiography in laparoscopic cholecystectomy.

PMID- 8369949
TI  - Adjuvant herbal treatment for gallstones.

PMID- 8369950
TI  - Easy technique for cholangiography during laparoscopic cholecystectomy.

PMID- 8369951
TI  - Autotransplantation of splenic tissue in an isolated segment of small intestine.

PMID- 8369952
TI  - Benign parotid cysts associated with human immunodeficiency virus infection.

PMID- 8369953
TI  - Ankle fracture is associated with prolonged venous dysfunction.

PMID- 8369954
TI  - Steroid priming promotes oxytocin-induced norepinephrine release in the
      ventromedial hypothalamus of female rats.
AB  - In vivo microdialysis was used to detect norepinephrine (NE) release in the
      ventromedial hypothalamus of estradiol (E2)- or E2 plus progesterone (P)-treated
      female rats injected with 1.0 IU of oxytocin (OXY). Dialysates were collected
      before and after OXY administration on 3 consecutive days and analyzed for NE
      content by high performance liquid chromatography with electrochemical detection.
      After the last sample was collected on day 1, animals were injected with 3
      micrograms E2 benzoate or oil. On day 3, E2-primed animals received 200
      micrograms of P and control females received oil prior to OXY administration. OXY
      administration did not induce NE release on day 1. When OXY was administered to
      animals that received E2 approximately 20 h earlier, increased release of NE was
      not consistently seen. In contrast, E2-primed animals that received P on day 3
      displayed significant increases in the release of NE after OXY administration
      compared to their own basal levels and to NE levels in control animals. To
      distinguish whether E2 priming is sufficient to promote OXY-induced release of NE
      without the addition of P, NE content of VMH dialysates in a second group of
      animals was examined following exposure to vehicle or E2 alone. When OXY was
      administered 24 or 48 h after estrogen priming, only 1 of 4 E2-primed females had
      modestly elevated dialysate NE levels. To evaluate the interactions between OXY
      and NE in the regulation of reproductive behavior, lordosis responses were
      observed in hormone-primed female rats receiving systemic injections of OXY, the
      alpha 1-adrenoceptor antagonist prazosin, or both OXY and prazosin.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8369955
TI  - Chronic corticosterone administration enhances behavioral sensitization to
      amphetamine in mice.
AB  - The role of corticosterone (CCS) in regulating sensitization to amphetamine's
      locomotor activating effects was measured in female DBA/2 mice that had been sham
      operated or adrenalectomized and implanted with CCS-containing or cholesterol
      pellets. Three days following surgery, the mice were injected with saline and
      circular open field locomotor activity was measured for a 5-min time period
      starting 15 min after injection. Over the next 4 days, amphetamine (1.0-10.0
      mg/kg) was injected and locomotor response measured. Control animals (sham
      operated, cholesterol pellet) showed increased locomotor activity following their
      first injection of 5.0 mg/kg and 10.0 mg/kg amphetamine, while ADX animals showed
      increased activity only after treatment with the 10 mg/kg dose. Chronic CCS
      treatment did not significantly alter initial responsiveness to amphetamine in
      either sham-operated or ADX animals, but it did alter the dose-dependent
      sensitization to amphetamine. Both sham-operated and ADX animals implanted with
      cholesterol pellets showed increased locomotor response to amphetamine
      (sensitization) following injection with 2.5, 5.0 and 10.0 mg/kg doses of
      amphetamine. However, the enhancement of locomotor activity was greater in the
      sham-operated control animals. CCS-treated sham-operated animals exhibited
      sensitization to the locomotor-activating effects of amphetamine at the lowest
      dose used (1.0 mg/kg) and increased stereotype following treatment with the
      higher doses. ADX/CCS animals developed sensitization to the locomotor-activating
      effects of amphetamine following chronic injection with the 2.5 mg/kg dose, and
      showed sensitization to amphetamine-induced stereotypy at higher doses.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8369956
TI  - Acute anoxia-induced alterations in MAP2 immunoreactivity and neuronal morphology
      in rat hippocampus.
AB  - Cerebral ischemia induces major neuronal morphological alterations. It is not
      clear, however, whether this is directly caused by O2 deprivation. To determine
      the effect of hypoxia on cytoskeletal structures and neuronal morphology, we
      performed experiments and examined anoxia-induced changes in microtubule
      associated protein 2 (MAP2) and cell morphology in hippocampal slices in vitro.
      Anoxia (measured PO2 = 0 Torr) induced a marked loss in dendritic MAP2
      immunoreactivity and cell swelling of hippocampal neurons by 2 h after O2
      reinstitution. These changes were severe in CA1 and CA3 neurons and comparatively
      mild in dentate gyrus neurons. Quantitative analysis showed that 10 min of anoxia
      induced a 30% loss of MAP2-positive dendrites but this increased to 70% after 30
      min of anoxia. A concurrent major increase in somata area of about 100% and 200%
      was observed in CA1 and CA3 neurons respectively. Somata area in the lower
      dentate gyrus, however, increased either insignificantly or by only 30% for the
      respective periods of anoxia. These results suggest that deprivation of O2 can by
      itself induce a major loss in dendritic MAP2 immunoreactivity and changes in cell
      morphology in hippocampal neurons. These alterations occur rapidly after hypoxia,
      and the severity of these changes is directly related to the duration of anoxia
      and brain region in the hippocampus.

PMID- 8369957
TI  - A comparative study of age-related changes in inhibitory processes and long-term
      potentiation in the lateral septum of mice.
AB  - Anaesthetized C57 BL/6 mice of different ages (young: 5 months; middle-aged: 15
      months; and old: 21 months) were used to determine whether aging alters the
      efficiency of synaptic inhibition and long-term potentiation (LTP) in the lateral
      septum (LS). Electrical stimulation of the fimbria induced field potentials in
      the ipsilateral LS comprising two initial negative components (N2 and N3)
      followed by a positive wave of low amplitude. Paired-pulse experiments showed a
      facilitation of the N2 component and a concomitant depression of the N3
      components. Facilitation of the N2 component was stronger in both middle-aged and
      old mice as compared to young mice, whereas an inverse pattern of changes was
      observed for inhibition of the N3 component. High-frequency stimulation of the
      fimbria produced a persistent increase in the N3 amplitude. This LTP was of
      significantly higher amplitude in both young and middle-aged mice as compared to
      old mice. These results suggest that aging impairs both inhibitory processes and
      synaptic plasticity in the mouse LS, but that inhibitory processes appear to be
      affected earlier.

PMID- 8369958
TI  - Distribution of ryanodine receptors in the chicken central nervous system.
AB  - The ryanodine receptor (RR), an intracellular calcium release channel, has been
      identified in the nervous system but its contributions to neuronal function are
      unknown. We have utilized immunohistochemical techniques to establish the
      distribution of RRs in the central nervous system (CNS) of the chick as a step
      toward elucidating the function of RRs in this system. RR immunoreactivity is
      observed throughout the brain, most prominently in large neurons. The strongest
      immunoreactivity is found in cerebellar Purkinje neurons, but nuclei in the
      motor, visual and vestibular systems are also intensely labeled, and
      immunoreactive neurons are observed the olfactory bulb and the hippocampus. In
      these neurons, labeling is prominent in cell bodies, dendrites and axons, but is
      not observed in the dendritic spines or in plasma membranes. The neuronal RRs
      bind [3H]ryanodine with high affinity and this activity is regulated by calcium,
      caffeine, MgCl2/ATP and ionic strength. Multiple forms of the RRs are found in
      the chicken CNS. Immunoprecipitation and localization studies using RR isoform
      specific monoclonal antibodies reveal major differences in their distribution.
      The predominant species in the cerebellum is similar to the skeletal muscle
      isoform while there is a lower level of expression of either the cardiac or beta
      skeletal isoforms. In the remainder of the brain, the predominant isoform is
      similar to the cardiac or beta skeletal muscle isoforms. The broad distribution
      of RRs in the CNS suggests that calcium release events mediated by these proteins
      may have a functional role in a diverse array of neurons. Moreover within the
      populations of neurons expressing RR's, the presence of specific RR isoforms may
      correlate with specialization in the calcium release events mediated by these
      proteins.

PMID- 8369959
TI  - Suprachiasmatic circadian pacemaker of rat shows two windows of sensitivity to
      neuropeptide Y in vitro.
AB  - The geniculohypothalamic tract carries visual information from the
      intergeniculate leaflet to the suprachiasmatic circadian pacemaker. NPY, found in
      this projection, has been shown to affect the phase of behavioral rhythms and
      influence photic entrainment. We now demonstrate that NPY, when briefly applied
      to the geniculate projection sites of rat SCN in vitro, induces permanent phase
      shifts in the rhythm of neuronal electrical activity at two separate phases of
      the circadian cycle.

PMID- 8369960
TI  - GABA decreases in the spinal cord dorsal horn after peripheral neurectomy.
AB  - A significant fall in the number of GABA-immunoreactive cells in laminae I-III of
      the rat spinal cord occurred in the somatotopic area of projection of the sciatic
      nerve after nerve transection. The decrease started at 2 weeks post-neurectomy,
      and at 4 weeks ipsilateral mean cell numbers were approximately 72% of
      contralateral control values. Similarly, the concentration of GABA in spinal
      homogenates was significantly reduced 4 weeks post-neurectomy. These data,
      together with our recent finding of an increase in spinal GABA during chronic
      inflammation of the hindlimb, suggest that the level of GABA in the dorsal horn
      is regulated by the amount of primary afferent input.

PMID- 8369961
TI  - Nerve growth factor does not influence the expression of beta amyloid precursor
      protein mRNA in rat brain: in vivo and in vitro studies.
AB  - We investigated the effect of NGF on amyloid precursor protein (APP) mRNA levels
      in the rat septal/nucleus basalis system. Total APP mRNA and APP 695 mRNA were
      determined in basal forebrain primary cell cultures exposed acutely and
      chronically to NGF (150-300 ng/ml) and, in vivo, in the septal area and striatum
      of rat pups after multiple intracerebroventricular injections of NGF. The trophic
      factor was able to affect cholinergic neurons in both paradigms, as evidenced by
      the significant increase of choline acetyltransferase (ChAT) activity induced by
      NGF in cell cultures (+80%) and in the striatum (+240%) of rat pups. In spite of
      this effect, no significant change of APP mRNA expression was observed in
      neuronal cultures and brain tissues. These data indicate that the neurotrophic
      effect of NGF on forebrain cholinergic neurons is not always associated with an
      alteration of APP expression.

PMID- 8369962
TI  - Melatonin release from pineal cells of diurnal and nocturnal birds.
AB  - Melatonin release from the pineal cells of chicks, pigeons and crows (diurnal
      birds) in vitro was compared with that from owls (a nocturnal bird). The pineal
      cells of diurnal birds secreted large amounts of melatonin during the dark
      period, whereas owl pineal cells released virtually no melatonin over 24 h and
      did not respond to exogenous stimulant agents. Histological examination revealed
      that the owl pineal gland is very small and has a poor vascular network. These
      results suggest that the pineal gland of owls may have degenerated and is not
      involved in the circadian clock mechanism in this species.

PMID- 8369963
TI  - Effect of transient forebrain ischemia on superoxide dismutases in gerbil
      hippocampus.
AB  - Substantial generation of oxygen-derived free radicals has been implicated in
      pathophysiology of ischemic brain damage. Immunoreactive mitochondrial manganese
      and cytosolic copper-zinc superoxide dismutases, initial and essential enzymes to
      scavenge superoxide radical anions, increased in the gerbil hippocampal neurons
      after transient forebrain ischemia. Neuronal cells responded to oxidative stress
      in ischemia and induced the protective mechanism to increase superoxide
      dismutases.

PMID- 8369964
TI  - The wind-elicited escape response of cockroaches (Periplaneta americana) is
      influenced by lesions rostral to the escape circuit.
AB  - When the escape response of the cockroach (Periplaneta americana) is triggered by
      wind, it is mediated by the cercal-to-giant interneuron pathway and leg motor
      circuitry, within the abdominal and thoracic portions of the ventral nerve cord.
      We have found that a lesion rostral to the thorax (transection of a cervical
      connective) produces specific changes in wind-evoked escape. Lesioned animals
      reliably displayed short-latency responses to wind. However, the orientation of
      the initial turning component of escape was altered and the duration of
      subsequent running was reduced. Preliminary physiological study suggests that
      changes in the orientation of escape reflect changes in the integration of wind
      sensory signals by thoracic circuitry. These findings imply that rostral centers
      influence sensorimotor integration underlying wind-evoked escape.

PMID- 8369965
TI  - Acute effects of reserpine on tryptophan hydroxylase activity and mRNA in rat
      brain.
AB  - The present study examined changes in tryptophan hydroxylase (TPH) activity in
      the rat brainstem 1-4 days after i.p. reserpine administration. TPH enzyme
      activity was significantly decreased day 1 posttreatment and followed by a small
      but significant increase on days 2-4. Maximal TPH activity on day 4 was elevated
      only 42% above control level. This small increase in TPH activity was not
      preceded by any change of in situ hybridization signal of TPH message on day 1.
      In contrast, adrenal tyrosine hydroxylase (TH) activity in these same
      reserpinized animals was 2.5-fold higher than control on 4 day posttreatment. In
      addition, TH message was correspondingly increased day 1 posttreatment. Taken
      together, these results indicate a trend of small increase in TPH activity and no
      alteration in message after reserpine treatment unlike catecholaminergic systems.

PMID- 8369966
TI  - Characterization of neurons born and incorporated into a vocal control nucleus
      during avian song learning.
AB  - In male zebra finches, song learning is accompanied by the addition of new
      neurons to Area X, a nucleus necessary for normal song development. We examined
      whether Area X neurons born after 15 days post-hatch are recruited into the
      efferent pathway from Area X to the dorsolateral nucleus of the medial anterior
      thalamus (DLM). Our data suggest that the majority of these new Area X neurons
      are interneurons and that DLM-projecting neurons are incorporated into Area X
      prior to song learning.

PMID- 8369967
TI  - Morphine-induced potentiation of brain stimulation reward is enhanced by MK-801.
AB  - Morphine (2.5 mg/kg, i.p.) and MK-801 (0.05 mg/kg, i.p.) each enhanced the
      rewarding impact of electrical stimulation of the medial forebrain bundle,
      causing small but reliable parallel leftward shifts of the functions relating
      response rate to stimulation frequency. Administration of MK-801 and morphine
      together caused a profound leftward shift in the functions. This effect was not
      due to sensitization to either drug, and suggests that disruption of
      glutamatergic function can potentiate the rewarding impact of opiates.

PMID- 8369968
TI  - Reciprocal synaptic relations between CRF-immunoreactive- and TRH-immunoreactive
      neurons in the paraventricular nucleus of the rat hypothalamus.
AB  - By double immunoelectron microscopy, we studied synaptic relations between
      corticotropin-releasing factor (CRF)-immunoreactive (ir) and thyrotropin
      releasing hormone (TRH)-ir neurons in the paraventricular nucleus (PVN) of the
      rat hypothalamus. CRF-ir and TRH-ir neurons made reciprocal synaptic connections
      in the medial and periventricular parvocellular regions. These results may
      suggest that both the parvocellular neurons interplay on their hypophysiotropic
      functions within the PVN.

PMID- 8369969
TI  - Hypothalamic but not cortical grafts induce recovery of sexual behavior and
      connectivity in medial preoptic area-lesioned rats.
AB  - We have previously shown that hypothalamic fetal brain grafts induced recovery of
      sexual behavior in medial preoptic area (MPOA)-lesioned male rats. In the present
      series of experiments, male rats with completely abolished sexual behavior by
      MPOA lesions received either hypothalamic or frontal cortical fetal grafts. The
      animals that received hypothalamic grafts showed a gradual recovery of sexual
      behavior. In contrast, those animals who received cortical grafts did not recover
      sexual behavior during the 15 weeks after the graft. In addition, to evaluate the
      connectivity of the grafted tissue with the host brain, a retrograde tracer,
      fluorogold, was injected in the dorsal tegmental area. Fluorogold-labeled cells
      were found in the hypothalamic, but not in the cortical grafts. These results
      suggest that specificity of the grafted tissue and connectivity between brain
      grafts and host tissue are necessary for the recovery of male sexual behavior in
      MPOA-lesioned rats.

PMID- 8369970
TI  - Thymopoietin, a thymic polypeptide, prevents nicotinic agonist-induced
      morphological changes in neonatal muscle cells in culture.

PMID- 8369971
TI  - Dissecting cockroach allergens.

PMID- 8369972
TI  - Pre- and post-natal events leading to allergen sensitization.

PMID- 8369973
TI  - The role of CD8+ T cells in the regulation of IgE.

PMID- 8369974
TI  - Food allergy in childhood. Hypersensitivity to cows' milk allergens.

PMID- 8369975
TI  - Evidence for an increase in atopic disease and possible causes.

PMID- 8369976
TI  - Isolation and in vitro translation of messenger RNA from the American cockroach.
AB  - Total RNA was extracted from the whole body of American cockroach (Periplaneta
      americana) using chaotropic salt guanidine isothiocyanate in the presence of 2
      mercaptoethanol (2-ME). Polyadenylated mRNA was isolated by oligothymidylic acid
      cellulose chromatography and mRNA was translated using a rabbit reticulocyte
      lysate system. The translation, as judged by the incorporation of 35S-methionine,
      was obtained with poly(A)+ RNA, where an approximately 9.5-fold increase in label
      incorporation over control was achieved. Analysis of translation products by
      sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) in
      combination with autoradiography showed that many proteins with apparent
      molecular weights ranging from 12 to 200 kD were synthesized, and no labelled
      proteins were found with negative RNA control and poly(A)- RNA.
      Immunoprecipitation studies performed using polyclonal and monoclonal antibodies
      revealed that synthesized proteins of MW 90, 78, 72, 49, 45, and 26 kD
      corresponded with previously identified principal and major allergens of American
      cockroach from our laboratory. In addition, the allergenicity of the translation
      mixtures was also confirmed by fluoroallergosorbent test (FAST) inhibition
      studies with IgE antibodies of human reaginic serum pool.

PMID- 8369977
TI  - Seasonal enhancement of IL-4 induced IgE synthesis by peripheral blood
      mononuclear cells of atopic patients.
AB  - The role of IL-4 on IgE synthesis has been well established. IL-4 has been shown
      to promote IgE production by B cells from atopic and non-atopic donors. In this
      study, the effects of natural exposure to pollens on IL-4-induced IgE synthesis
      by peripheral blood mononuclear cells of atopic and non-atopic donors were
      examined. The results confirm production of IgE in an IL-4 dose-dependent manner
      by PBMC cultures of these two groups. When cultures were performed out of the
      pollen season, following stimulation by IL-4, no significant differences was
      observed between the levels of IgE produced by PBMC of atopic and non-atopic
      donors. In contrast, upon natural exposure to pollens, significant higher levels
      of IgE were measured in the atopic group than in the non-atopic one. These
      results show that the pollen season influences the IL-4-induced IgE synthesis by
      PBMC of allergic patients and are in keeping with seasonal rise of specific IgE
      antibodies.

PMID- 8369978
TI  - The effect of genetic and environmental factors on the prevalence of allergic
      disorders at the age of two years.
AB  - The effect of genetic and environmental factors on the prevalence of allergic
      disorders in early childhood was determined in a prospective follow-up study.
      Information was available on 1174 children at the age of 2 years. Two-hundred and
      seventy-five were considered to have an allergic disorder. The prevalence varied
      from 3.2% for rhinitis to 10.9% for asthma. At 2 years 60 children reacted
      positively on skin-prick test (SPT). Multivariate logistic regression analysis
      was used to obtain adjusted odds ratios (95% confidence interval) for each
      factor. For asthma, positive family history, male sex, low birth-weight, maternal
      smoking and season of birth were significant risk factors. For eczema, positive
      family history was the only significant risk factor. For rhinitis, lower socio
      economic group and autumn birth were significant. Male sex and low birth-weight
      were significant for skin test positivity. Positive family history and low birth
      weight were significant risk factors for any allergy. Low birth-weight was also a
      significant risk for skin test reactivity to house dust mite. Genetic and
      environmental factors have a profound effect on the development of allergic
      disorders in the first two years of life.

PMID- 8369979
TI  - The effect of zardaverine, an inhibitor of phosphodiesterase isoenzymes III and
      IV, on endotoxin-induced airway changes in rats.
AB  - Zardaverine is a novel phosphodiesterase III/IV inhibitor, developed as a
      potential therapeutic agent for asthma. In this study we evaluated the effect of
      zardaverine in an in vivo animal model of airway inflammation and
      hyperresponsiveness. Endotoxin exposure in rats causes a transient increase in
      airway responsiveness and a neutrophilic inflammation of the bronchi, which are
      both at least partly mediated through the secondary release of tumour necrosis
      factor alpha (TNF alpha). Groups of 10 animals each were pretreated with placebo
      or zardaverine (1, 10, 30 mumol/kg) i.p., 30 min prior to exposure to aerosolized
      endotoxin (LPS) or saline. Ninety minutes later, airway responsiveness to 5-HT
      was assessed and bronchoalveolar lavage (BAL) performed. Zardaverine did not
      influence baseline lung resistance (RL), but inhibited dose dependently the 5-HT
      induced increase in RL in control animals. In placebo pretreated animals LPS
      exposure caused a significant decrease in PC50RL5-HT (provocative concentration
      of 5-HT causing a 50% increase in RL), compared to the saline exposed control
      group (1.1 +/- 0.1 vs 2.7 +/- 0.4 micrograms/kg) (P < 0.01). This decrease in
      PC50RL5-HT was significantly inhibited by zardaverine 30 mumol/kg (5.4 +/- 1.8 vs
      1.1 +/- 0.1 micrograms/kg) (P < 0.05). Compared to placebo pre-treated, LPS
      exposed animals, zardaverine 30 mumol/kg also significantly inhibited to LPS
      induced neutrophil increase (193.0 +/- 50.0 vs 915.6 +/- 181.3 x 10(3)) (P <
      0.01), increase in elastase activity (23 +/- 11 vs 54 +/- 9 nmol substrate/h/ml)
      (P < 0.05) and TNF alpha release in BAL fluid (93.1 +/- 19.5 vs 229.5 +/- 24.8
      U/ml BAL fluid) (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8369980
TI  - Effect of oral and inhaled cetirizine in allergen induced bronchoconstriction.
AB  - Cetirizine is a potent, selective H1 histamine receptor antagonist. The effect of
      oral and inhaled cetirizine was assessed on the early bronchoconstrictor response
      to inhaled allergen in 10 mild atopic asthmatic patients in a double-blind,
      randomized, placebo controlled trial. All were sensitive to Dermatophagoides
      pteronyssinus and this was used as the provoking allergen. The geometric mean
      PD20 FEV1 values obtained at allergen challenge were measured as cumulative
      breath units (c.b.u.) and following oral cetirizine, inhaled cetirizine and
      placebo were 124.5, 75.7 and 76.7 c.b.u. respectively. These did not differ
      significantly. We conclude that neither oral nor inhaled cetirizine significantly
      attenuates the early response to inhaled allergen in atopic asthmatic subjects.
      However, the method of repeated allergen challenge is likely to be relatively
      insensitive.

PMID- 8369981
TI  - House dust mite exposure as a cause of asthma.

PMID- 8369982
TI  - Risks of infantile atopic dermatitis from parental atopy.

PMID- 8369983
TI  - Paracetamol anaphylaxis.

PMID- 8369984
TI  - Extracellular and intracellular action of clodronate in osteolytic bone diseases?
      A hypothesis.

PMID- 8369985
TI  - The effects of walking at the anaerobic threshold level on vertebral bone loss in
      postmenopausal women.
AB  - The purpose of this study was to determine the optimal intensity of exercise
      necessary to prevent the postmenopausal bone loss on the basis of anaerobic
      threshold (AT). Thirty-three postmenopausal women were randomized to control
      (group C: n = 12) or two exercise groups (group H and group M). All women
      performed a treadmill exercise test, and the AT was measured by expired gas
      analysis. The exercise regimen consisted mainly of walking at a speed that kept
      the exercise heart rate above the AT (group H: n = 12) or below the AT (group M:
      n = 9). Exercise was performed for 30 minutes, three times a week for 7 months.
      The bone mineral density (BMD) of the lumbar vertebrae was measured using dual
      energy X-ray absorptiometry. The BMD level in group C decreased by 1.7 +/- 2.7%,
      but there was a significant increase of 1.1 +/- 2.9% in group H. In group M there
      was a decrease of 1.0 +/- 3.1% which did not differ from group C. In group C,
      serum osteocalcin and urinary hydroxyproline excretion were significantly
      increased, but no changes were seen in either of the exercise groups. Urinary
      calcium significantly decreased in the exercise groups. We conclude that short
      term (7 months) exercise with intensity above the AT is safe and effective in
      preventing postmenopausal bone loss.

PMID- 8369986
TI  - Neutrophil functions in patients with fractures of the upper end of the femur.
AB  - In the present study, neutrophil functions were examined in vitro in 40 patients
      suffering from fractures of the upper end of the femur (trochanteric and
      subcapital). Adherence to nylon, serum chemotaxis, and phagocytosis-bactericidal
      function were assayed. Three microbial strains, namely, Staphylococcus aureus, S.
      epidermidis, and Pseudomonas aeruginosa, were used for the experiments. Adherence
      of the patients' neutrophils was found normal. On the contrary, the chemotactic
      ability of the patients' sera was inferior to that of healthy controls;
      phagocytosis and bactericidal function were also significantly impaired for all
      three bacterial strains. The results were independent of fracture site
      (intracapsular or extracapsular), sex, and age. The observed host defense
      disorders provide additional information that helps to explain the increased
      susceptibility of these patients to bacterial infections.

PMID- 8369987
TI  - Serum bone Gla protein as a marker of bone turnover in acromegaly.
AB  - Serum bone Gla protein, a sensitive and specific marker of bone turnover, was
      measured in 35 acromegalic patients (14 untreated, 8 clinically active, and 13
      cured) and 21 controls. We also examined 10 acromegalic patients before and after
      transsphenoidal surgery. Untreated and clinically active acromegalic patients had
      significantly higher serum bone Gla protein concentrations than the control
      subjects. Other nonspecific biochemical markers of bone metabolism, such as
      urinary hydroxyproline and urinary calcium, were also present in significantly
      greater amounts in active acromegalic patients. After treatment, a significant
      decrease in levels was observed, with return to control levels. In acromegalic
      patients, positive correlations were found among serum bone Gla protein and serum
      growth hormone and serum insulin-like growth factor I levels, as well as among
      levels of insulin-like growth factor I and serum phosphorus, serum alkaline
      phosphatase, and urinary hydroxyproline. These results suggest that serum bone
      Gla protein is a sensitive marker of the action of growth hormone in bone
      metabolism in acromegaly, a role that is probably mediated by insulin-like growth
      factor I.

PMID- 8369988
TI  - Bone mineral density in hyperandrogenic amenorrhoea.
AB  - The authors assessed bone mineral density in androgenized amenorrheic (group A; n
      = 9) and androgenized nonamenorrheic patients (group B; n = 30) and compared it
      with controls (n = 22). Bone mineral density of group A patients (1.023 +/- 0.045
      g/cm2) did not differ from controls (1.047 +/- 0.83 g/cm2); both groups had
      significantly lower values than group B women (1.099 +/- 0.085 g/cm2). Of the
      hormonal variables explaining bone mineral density in androgenized women, only
      dehydroepiandrosterone sulfate had a significant negative correlation (r = 
      0.45). In contrast to other forms of amenorrhea, women with hyperandrogenic
      amenorrhea seem to be spared from osteopenia.

PMID- 8369989
TI  - Life-style and different fracture prevalence: a cross-sectional comparative
      population-based study.
AB  - In order to explain the higher prevalence of fractures in urban compared with
      rural areas, 782 residents in the city of Malmo, Sweden and 486 inhabitants from
      the nearby rural municipality of Sjobo were invited to participate in a sex- and
      age-matched cross-sectional study on life-style differences; 73 and 80%
      respectively responded. Responders answered a questionnaire on medical and social
      background and were interviewed on past and present physical activity. The men
      and women of the rural area were found to be significantly more active physically
      at work and during spare time. Housing was larger in the rural area. For women,
      these differences are decreasing in the younger age groups. Bone mass was found
      to be correlated to heavier work load for men. Other life-style variable such as
      dairy calcium intake, coffee drinking, estrogen medication, and morbidity, could
      not explain this difference. Higher prevalence of fractures in the city could
      therefore be explained by physically less active life-style.

PMID- 8369990
TI  - Misoprostol, a prostaglandin E1 analogue, inhibits basic calcium phosphate
      crystal-induced mitogenesis and collagenase accumulation in human fibroblasts.
AB  - Synovial fluid basic calcium phosphate (BCP) crystals are associated with severe
      destructive arthropathy. BCP crystals induce the secretion of matrix-degrading
      enzymes such as collagenase. No prophylactic or therapeutic agents are recognized
      to ameliorate the cartilage damage associated with BCP deposits in joints. As a
      chondroprotective effect of prostaglandins (PG) has been suggested, we studied
      the effect of misoprostol, a PGE1 analogue, on BCP crystal-induced mitogenesis
      and collagenase messenger RNA (mRNA) accumulation in human fibroblasts (HF).
      Mitogenesis was determined by 3H-thymidine incorporation assays and collagenase
      mRNA accumulation by Northern blot analysis, in HF stimulated with BCP crystals
      in the presence or absence of misoprostol. Misoprostol caused concentration
      dependent inhibition of BCP crystal-induced mitogenesis. The inhibition of BCP
      stimulated mitogenesis was not specific as misoprostol also inhibited the
      mitogenic response to 10% serum. There was only 50 (+/-5)% inhibition of serum
      induced mitogenesis by misoprostol at 500 ng/ml, the concentration that
      completely inhibited BCP crystal-induced mitogenesis. Misoprostol also inhibited
      the accumulation of collagenase mRNA in BCP-stimulated HF by 63%. These data
      suggest that misoprostol may inhibit the synovial proliferation and cartilage
      degradation that accompany BCP crystal deposition.

PMID- 8369991
TI  - Evidence that interleukin-1 mediates its effects on bone resorption via the 80
      kilodalton interleukin-1 receptor.
AB  - Interleukin-1 (IL-1) mediates its effects through two distinct receptors, one of
      80 kilodaltons (80 kD) present in athymic lymphocytes and fibroblasts, and one of
      60 kD present in cells of the monocyte-macrophage lineage. A novel monocyte
      cytokine in the IL-1 family which binds to both the 80 and the 60 kD receptors
      has been purified, cloned, and expressed. As the interleukin-1 receptor
      antagonist (IL-1ra) has been shown to inhibit bone resorption in organ culture,
      it is not clear whether these effects are mediated through the 80 or the 60 kD
      receptor. Recently, neutralizing antibodies (35F5) have been developed to the 80
      kD receptor which inhibit IL-1 effects mediated through this receptor. To
      determine the importance of the 80 kD receptor to IL-1-mediated bone resorption,
      we used the neutralizing antibodies (35F5) to the 80 kD receptor to determine if
      they inhibited bone resorption stimulated by IL-1 in bone organ cultures. The
      35F5 antibody blocked bone-resorbing activity due to IL-1 completely, and also
      blocked control or "endogenous" bone-resorbing activity present in murine bone
      organ cultures incubated in control media. The 35F5 antibody had no effect on
      bone resorption mediated by tumor necrosis factor (TNF), or parathyroid hormone
      (PTH). These data suggest that the availability of the 80 kD IL-1 receptor is
      required for osteoclastic bone resorption mediated by IL-1.

PMID- 8369992
TI  - Effect of prostaglandin D2 on the femoral bone mineral density in ovariectomized
      rats.
AB  - We studied the effects of prostaglandin D2 (PGD2) on the femoral bone mineral
      density (BMD) and other related parameters in ovariectomized (OVx) and sham
      operated rats. BMD was measured in vivo by dual energy X-ray absorptiometry (DXA)
      for the period of 36 days or 112 days after operation. When 9- or 10-week-old
      rats were used at the time of operation, the femoral BMD increased during these
      periods. Ovariectomy resulted in a marked suppression of this steady increase in
      BMD at both proximal and distal ends of the femur. Subcutaneous administration of
      a slow-release preparation of PGD2 on days 1 and 21 not only prevented the
      ovariectomy-induced suppression of BMD, but also augmented the steady increase in
      BMD of the sham-operated rats. When medication was started on day 70, the
      depressed rate of increase in BMD was restored to the control level. Serum
      calcitonin (CT) and parathyroid hormone (PTH) levels were not affected by either
      ovariectomy or by PGD2 administration. Body weight and bone length were
      increased, but uterine weight was decreased by ovariectomy. PGD2 administration
      showed no effects on these parameters. There was a significant increase in the
      fasting level of urinary hydroxyproline excretion after ovariectomy, and PGD2
      administration had no significant effect on this parameter either. These results
      indicate that the prevention of osteopenia in OVx rats and the increase in BMD in
      sham-operated and post-OVx rats by PGD2 administration are due to its stimulatory
      effect on bone formation.

PMID- 8369993
TI  - Histomorphometry of iliac crest trabecular bone in adult male baboons in
      captivity.
AB  - Data in the literature on bone histomorphometry in the baboon are scant. This
      study provides data from analysis of trabecular bone of the iliac crest of 16
      adult male chacma baboons (Papio ursinus) in captivity. Five animals were young
      adults judging by the presence of growth cartilage in the iliac crest biopsy.
      Bone volume resembled that in humans, but trabeculae were thinner and more
      closely spaced. Bone turnover appeared somewhat lower than in humans. Coupling of
      resorption and formation was excellent as judged by cellular and kinetic
      variables; erosion surface was an unreliable indicator of ongoing coupling. The
      similarities between human and baboon trabecular bone make the baboon suited for
      the study of microstructure and bone turnover of trabecular bone with relevance
      to humans.

PMID- 8369994
TI  - Purified Pasteurella multocida protein toxin reduces acid phosphatase-positive
      osteoclasts in the ventral nasal concha of gnotobiotic pigs.
AB  - To study the in vivo response of conchal (turbinate) osteoclasts to Pasteurella
      multocida toxin, four gnotobiotic pigs (7 days of age) were inoculated
      subcutaneously with 0.2 microgram/kg of purified toxin. One toxin-treated pig
      along with one control pig were necropsied at 2, 5, 9, and 14 days
      postinoculation. The entire length of nasal concha from the nasal planum toi
      ethmoid region was removed, blocked by transverse cuts into five areas,
      decalcified, sectioned, and then stained with tartrate-resistant acid phosphatase
      (TRAP) to identify osteoclasts. In each section, total area of concha, total
      osteoclast cytoplasmic area, and number of osteoclasts were determined using an
      image analysis morphometric unit. Also collected from pigs were blood and serum
      for complete blood counts, electrolyte levels, liver enzymes, and TRAP levels.
      Conchal atrophy increased in severity with time after 2 days postinoculation. In
      general, the ventral conchae from toxin-treated pigs at 9 and 14 days
      postinoculation had decreased surface area, osteoclast cytoplasmic area, and
      numbers of osteoclasts. Serum levels of TRAP were mildly elevated when compared
      with age-matched controls. No other significant alterations in blood cells or
      chemistries occurred and no lesions were present histologically in tissues
      (liver, kidney, lung, heart, and spleen) other than concha. This study shows that
      the P. multocida toxin induces rapid bone resorption and increases serum levels
      of acid phosphatase but leads to diminished acid phosphatase expression and
      presumably, numbers of osteoclasts.

PMID- 8369995
TI  - The effect of high or low dietary calcium on bone and calcium homeostasis in
      young male rats.
AB  - Young male rats (100 g body weight) were fed diets containing varying amounts of
      calcium. Body weight and bone development were studied together with various
      endocrine parameters, including blood levels of Ca2+, calcitonin, parathyroid
      hormone, vitamin D, and gastrin, and the enterochromaffin-like (ECL) cell-related
      parameters gastric mucosal histidine decarboxylase activity and histamine
      concentration. A diet containing 0.5% calcium resulted in optimum body weight
      gain and bone development. A lower calcium intake impaired body weight gain and
      bone development. The impairment was manifested in reduced bone calcium content
      whereas the size of the bones was unaffected. The net absorption of calcium
      seemed to be proportional to the calcium intake. A low calcium diet (0.03%)
      raised the circulating levels of 1,25(OH)2D and parathyroid hormone and lowered
      25(OH)D3 and Ca2+, whereas a high calcium diet (5.46%) raised calcitonin, Ca2+,
      25(OH)D3, and 1,25(OH)2D. In addition, the low calcium diet lowered the
      circulating gastrin concentration and the histidine decarboxylase activity and
      histamine content of the ECL cells in the gastric mucosa. A high calcium diet
      raised the circulating gastrin concentration, but the rise was not associated
      with an increase in the histidine decarboxylase activity and histamine content.

PMID- 8369996
TI  - Type II collagen expression in the mandibular condyle during growth adaptation:
      an experimental study in the rabbit.
AB  - An experiment was designed to mimic orthopedic functional appliances in order to
      investigate the spatial and temporal characteristics of type II collagen
      secretion as a marker of cartilage maturation in the mandibular condyle of young
      rabbits. The position of the glenoid fossa in relation to the condyle was altered
      so that articulation now took place more posteriorly. Histological sections of
      the condyles of 15-, 20- and 30-day-old experimental and control animals were
      stained with toluidine blue and with an anti-type II collagen antibody. A widened
      progenitor cell layer was found posteriorly in the experimental condyles and a
      narrow layer was found anteriorly to the articulating region. The chondroblast
      layer was also widened posteriorly, whereas the hypertrophic cell zone was
      narrower; the opposite was seen anteriorly. The effect was marked in 15- and 20
      day-old animals and weak in 30-day-old animals. Type II collagen stain and strong
      toluidine blue metachromasia were not observed in the progenitor cell zone until
      the chondroblasts had acquired a flattened, slightly hypertrophic morphology,
      which was found deeper in the experimental condyles than in the controls. This is
      interpreted as a slowing down of the differentiation of chondroblasts as a result
      of the force applied. The effect of masticatory function may also be explained in
      terms of delayed differentiation of chondroblasts and increased growth.

PMID- 8369997
TI  - Correlation between densitometric and hystomorphometric values in isolated
      vertebrae of Sprague-Dawley rats.
AB  - The study of bone mass in experimental animals usually requires invasive
      techniques. Dual energy X-ray absorptiometry (DEXA) may be an alternative as a
      non-invasive method (1). Bone mineral density (BMD) and bone mineral content
      (BMC) of 62 vertebrae of Sprague Dawley rats (SDr) measured by DEXA densitometry
      were compared with histomorphometric bone volume measurements, and a
      statistically significant correlation was found (r = 0.79 and 0.75, respectively,
      p < 0.001). In conclusion, DEXA is an accurate and feasible technique for the
      study of trabecular bone mass in SDr.

PMID- 8369998
TI  - Computer-based training: training approach of choice.

PMID- 8370000
TI  - Bedside terminals and quality of nursing documentation.
AB  - In this article, the authors report on part one of a three-part investigation
      studying the impact of bedside terminals at New York University Medical Center,
      New York, NY. Using a before-after parallel control-group design, the quality of
      computerized nursing documentation was studied before and after adding computers
      to patient rooms. The quality of documentation was defined by timeliness and
      completeness of data. The study hypothesis, which predicted a positive
      relationship between the presence of bedside terminals and the quality of nursing
      documentation, was not supported. Study results showed a minimal use of the
      computer terminals located in patient rooms. A surprising result was the use of
      terminals located in rooms other than that of the patient for which documentation
      was made.

PMID- 8369999
TI  - A computer assisted tutorial for applications of computer spreadsheets in nursing
      financial management.
AB  - A computer-based tutorial for teaching nursing financial management concepts was
      developed using the macro function of a commercially available spreadsheet
      program. The goals of the tutorial were to provide students with an experience
      with spreadsheets as a computer tool and to teach selected financial management
      concepts. Preliminary results show the tutorial was well received by students.
      Suggestions are made for overcoming the general lack of computer sophistication
      among students.

PMID- 8370001
TI  - Hybrid expert-system approach to nurse scheduling.
AB  - The objective of this research was to develop a hybrid expert system entitled
      NURSE-HELP to achieve flexible and effective scheduling for nurses. NURSE-HELP
      was developed with the emphasis on following the ergonomics guidelines, which
      will improve the performance of nurses. Moreover, the combination of linear zero
      one goal programming and an expert system program reduces the program run time
      while maintaining the quality of the schedule. The system was evaluated by
      comparing 18 sets of 4-week schedules generated by the head nurses manually and
      by NURSE-HELP. Concerning the amount of time required to generate the schedules,
      NURSE-HELP averaged less than 20 minutes, whereas head nurses spent from 2 to 4
      hours. The quality of the schedules was measured using the following four
      criteria: 1) minimum staff level not satisfied, 2) day off request not granted,
      3) backward rotation, and 4) maximum consecutive work periods on the night shift.
      NURSE-HELP was superior in all these aspects.

PMID- 8370003
TI  - Optimizing computer-based system use in health professions' education programs.
AB  - The use of computer-based systems to support training in health profession
      education programs has been discussed and analyzed for more than 10 years. The
      literature is rich with examples of how using these systems can benefit programs
      by more effectively distributing human resources, by making the delivery of
      instruction more individual and more flexible, by expanding the professional and
      technical competence of trainees, and by improving the monitoring of trainee
      performance. Obstacles to and conventional recommendations for the broadened use
      of computer-based systems are discussed, and an additional set of system design
      characteristics are described that health care educators can use in their preview
      and specifications for procurement of more effective computer-based systems in
      their training settings.

PMID- 8370002
TI  - Evaluation of a labor and delivery videodisc simulation.
AB  - The purpose of this project was to determine the impact of an interactive
      videodisc (IVD) simulation in labor and delivery on the learning and clinical
      confidence of junior-level nursing students. Two clinical groups of students were
      created from the total 39 and both groups were pretested on knowledge and
      clinical confidence. Group 1 (n = 18) completed the IVD program before the first
      clinical experience in the labor and delivery setting. Group 2 (n = 21) received
      a traditional clinical experience first and then completed the IVD program.
      Students completing the IVD program plus the clinical experience had
      significantly greater clinical confidence and learning than those students
      completing only the clinical experience. Evaluation comments provided suggestions
      for improvements and were filled with positive comments about the program.

PMID- 8370004
TI  - Bedside/point-of-care technology: the 'window' into the integrated clinical
      database, Part 4.

PMID- 8370005
TI  - Effect of dynamization of a static interlocking nail in promoting fracture
      healing.

PMID- 8370006
TI  - Evaluation of new surgical procedures.

PMID- 8370007
TI  - Stenosis of stapled colorectal anastomosis.

PMID- 8370009
TI  - Effect of dynamization of a static interlocking nail on fracture healing.
AB  - A retrospective study was done of 22 patients with complex femoral (11) and
      tibial (11) shaft fractures treated with static interlocking nailing followed by
      dynamization, which was carried out on average 7.8 months later. The success rate
      was 54% with no significant difference between the healing of femoral and tibial
      fractures. The follow-up was at least 2 years. The interval from nailing to
      dynamization did not correlate with the success rate; the longest interval
      associated with successful healing was 20 months. The authors found that static
      interlocking nailing without dynamization can still produce a high union rate,
      and if there is sparse callus formation during the healing process, indicating
      low osteogenesis, dynamization will result in fracture union in only half the
      cases. To improve the union rate, cancellous bone grafting may be necessary.

PMID- 8370008
TI  - Consensus conference on well-differentiated thyroid cancer: a summary.
AB  - OBJECTIVE: To update recommendations for the surgical treatment of well
      differentiated thyroid cancer. DATA SOURCES: Literature reviews and personal
      files. STUDY SELECTION: Panelists selected relevant articles to make arguments
      for and against current recommendations for the surgical treatment of well
      differentiated thyroid cancer. OUTCOMES: Four aspects of surgical treatment were
      considered: (a) the extent of surgical resection, (b) the definition and
      utilization of high- and low-risk patient groups, (c) who should perform thyroid
      surgery and (d) the use of radioactive iodine. RECOMMENDATIONS: Total
      thyroidectomy is not the treatment of choice for all well-differentiated thyroid
      cancers. The use of risk factors help select those patients in whom a total
      thyroidectomy would be of benefit. High-risk patients are those who are
      considered at high risk according to the AGES and AMES classifications or who
      have lymph-node metastases, aggressive variants of their disease, multifocal
      cancer or disease in the contralateral thyroid lobe and a history of radiation to
      the neck. Those at low-risk are those previously described as being at low risk
      according to the AGES and AMES classifications. General surgery training programs
      across Canada need to ensure that their residents obtain enough experience in
      thyroid surgery that as general surgeons they can perform this type of surgery
      with low morbidity. CONCLUSIONS: The findings of this consensus conference were
      supported by those of several review articles and by the arguments put forward by
      the panelists. These findings are only guidelines as to the surgical approach to
      well-differentiated thyroid cancer.

PMID- 8370010
TI  - Double stress fracture of the tibia in the presence of arthritis of the knee.
AB  - Two cases of double stress fracture of the tibia are described. Both patients had
      severe medial compartment arthritis of the knee and some varus bowing of the
      tibia prior to the stress fractures. The deformities were corrected by tibial
      osteotomies. Total knee replacement was not required.

PMID- 8370011
TI  - Osteomyelitis of the spine due to Salmonella: case report, review of clinical
      aspects, pathogenesis and treatment.
AB  - Osteomyelitis of the spine caused by Salmonella is rare. The authors describe a
      case in which the patient had fusion of the L1 and L2 vertebrae, which were
      affected by osteomyelitis. The infecting organism was Salmonella typhimurium. The
      authors describe the relationship of the vascular anatomy to the development of
      osteomyelitis of the spine. They discuss the clinical features, diagnosis,
      pathogenesis and treatment of the disease. Although the association of
      osteomyelitis due to Salmonella and sickle cell disease has long been known, this
      patient did not have sickle cell disease or any other condition that would
      compromise the immune system.

PMID- 8370012
TI  - Arm problems and psychological distress after surgery for breast cancer.
AB  - The frequency of problems in the arm affected by surgery for breast cancer and
      the association of these problems with psychological distress were assessed among
      223 women with newly diagnosed breast cancer 3 months after operation and again
      15 months later among 201 of these same women. At 3 months after operation, 182
      (82%) of the 223 patients reported at least one arm problem. Specific problems
      reported were swelling (24%), weakness (26%), some limitation in range of
      movement (32%), stiffness (40%), pain (55%) and numbness (58%), and these
      percentages had changed little 15 months later. Regardless of the type of
      mastectomy, women who underwent axillary dissection had more arm problems.
      Compared with women reporting no arm problems, the adjusted odds ratios of having
      psychological distress at 3 months for women reporting one to two, three to four
      and five to six arm problems were 1.2, 2.3 and 3.1 respectively (chi 2 for trend
      = 9.5, p = 0.002). Arm problems are frequent after operation for breast cancer,
      and these problems appear to increase the likelihood of psychological distress.
      Women should be informed that arm problems are expected but non-threatening
      sequelae of initial surgical treatment for breast cancer.

PMID- 8370013
TI  - Laparoscopic inguinal herniorrhaphy.
AB  - Between September 1991 and April 1992, 30 patients were admitted for repair of an
      inguinal hernia. Four elderly patients were excluded because of other medical
      conditions. Of the remaining 26 patients laparoscopic hernia repair was carried
      out successfully in 24; the procedure was abandoned in 2 because of dense
      adhesions in the pelvis from inflammatory disease. Nineteen of the 24 patients
      were discharged within 24 hours of operation; the other 5 were treated as
      outpatients. All patients returned to their normal employment within 7 days of
      operation. There were no wound infections and no evidence of recurrence at follow
      up of up to 10 months. The authors believe that laparoscopic repair may usher in
      a new era of hernia management.

PMID- 8370014
TI  - Surgical and postoperative management of two neonates with necrotizing fasciitis.
AB  - Two neonates who presented with necrotizing fasciitis (NF) secondary to
      omphalitis were treated by radical excision of the anterior abdominal wall.
      Postoperatively, renal failure in both children was managed by continuous
      arteriovenous hemofiltration (CAVH). One child survived; the other died of
      sepsis. Serum lactate levels, which were 10 to 15 times the normal levels in both
      infants postoperatively, decreased rapidly in the survivor, but never approached
      normal levels in the infant who died. Although the best prospect for survival in
      neonatal NF remains prompt, radical, surgical excision and is associated with a
      low threshold for repeat debridement, modern supportive measures (including CAVH)
      may enhance survival.

PMID- 8370015
TI  - Thrombolytic therapy in peripheral arterial occlusive disease: mechanisms of
      action and drugs available.
AB  - Catheter-directed thrombolytic therapy has become an important part of the
      treatment of patients with acute arterial and graft occlusion. The underlying
      pharmacologic principle is the activation of plasminogen, bound to fibrin within
      the thrombus. Guide-wire passage reliably predicts success of catheter-directed
      thrombolysis. The underlying disease process leading to thrombosis should be
      accurately identified and promptly corrected to reduce the probability of
      recurrent occlusion. Streptokinase (SK), urokinase (UK) and recombinant tissue
      plasminogen activator (rt-PA) are the three agents used to treat peripheral
      arterial occlusive disease. The evolution from SK to UK and rt-PA and
      improvements in techniques and delivery systems have led to improved success
      rates and lower complication rates. Patient selection, basic technical
      considerations and overall results are discussed here. The currently available
      thrombolytic agents, as well as those being developed, are reviewed to provide
      background information for current and future applications.

PMID- 8370016
TI  - Arterial diagnosis and management of acute thrombosis of the lower extremity.
AB  - Acute ischemia of the lower extremity is associated with reduced blood flow to
      muscle, nerve, subcutaneous tissue and skin. This condition may be caused by
      thrombosis on an atherosclerotic plaque or embolus or by the occlusion of a
      previously placed arterial bypass graft. The difficulties in differentiating
      embolic arterial occlusion from acute thrombotic arterial occlusion are
      discussed. Although balloon catheter thrombectomy has been the traditional
      approach to treatment of patients with acute ischemia, this method has several
      disadvantages: it may not remove all of the thrombus, the thrombus may be
      inaccessible, it may damage vessels and atherosclerotic plaque and it does not
      identify or correct the underlying cause of the thrombosis. The advantages of
      catheter-directed thrombolysis are discussed, including its use as a diagnostic
      tool. Detailed techniques are presented along with data from extensive studies.

PMID- 8370017
TI  - Intraoperative thrombolysis in peripheral arterial occlusion.
AB  - Thromboembolic occlusion of peripheral arteries continues to be associated with
      significant morbidity, mortality and loss of limbs. Surgical intervention with
      prompt revascularization by clot extraction, alone or in combination with
      arterial bypass, remains the standard therapy for critical ischemia with imminent
      tissue loss. Mechanical thrombectomy using a balloon catheter has been the
      preferred technique for distal embolus or thrombus extraction. Unfortunately,
      complete thrombectomy is rare, and the procedure is associated with arterial wall
      injury. Intraoperative thrombolytic therapy is an attractive adjunct to catheter
      thrombectomy alone and is appropriate in the care of a significant number of
      patients with acute limb ischemia. Its safety and efficacy have been confirmed in
      the laboratory and in a limited number of patients. The authors review
      experimental and clinical data and report their experience with 19 patients.

PMID- 8370018
TI  - Thrombolytic therapy for deep venous thrombosis: a clinical review.
AB  - Although anticoagulation is the treatment most commonly chosen for patients
      suffering from deep venous thrombosis (DVT), thrombolytic therapy offers the
      promise of dissolving the thrombus within the deep venous system, restoring
      patency and preserving valve function. If this is achieved, the incidence and
      severity of post-thrombotic syndrome can be reduced. Data from 13 studies
      comparing anticoagulant therapy with thrombolytic therapy for DVT in 591 patients
      have shown that, among those treated with heparin, 4% had significant or complete
      lysis, 14% had partial lysis and 82% failed to improve or worsened. Of those
      receiving lytic therapy, 45% had significant or complete lysis, 18% had partial
      lysis and 37% failed to improve or worsened. Long-term follow-up of randomized
      patients has shown that those with successful lysis had a lower incidence of post
      thrombotic syndrome and improved long-term venous function. The failure rate of
      systemic lytic therapy among patients suffering iliofemoral venous thrombosis is
      high; therefore, catheter-directed thrombolysis has been adopted with increasing
      success. Thrombolytic therapy, delivered systemically using catheter-directed
      techniques, should be considered as an important alternative in the treatment of
      patients with DVT.

PMID- 8370019
TI  - Long-term results of treatment for axillary subclavian vein thrombosis.
AB  - Thrombolytic therapy is an effective method for reopening an occluded venous
      segment, but little is known about the long-term results of thrombolysis via
      direct intravenous route for axillary subclavian vein thrombosis (ASVT). Our
      experience with 13 cases of primary ASVT illustrates the possible advantages of a
      protocol consisting of lytic therapy, surgical decompression and percutaneous
      balloon angioplasty if a high-grade stenosis persists. If accompanied by
      adjunctive therapy to correct the underlying cause, thrombolytic therapy for ASVT
      results in acceptable long-term symptom relief and vein patency.

PMID- 8370020
TI  - Thrombolysis in peripheral arterial graft occlusion.
AB  - Acute thrombosis of arterial bypass grafts in the lower extremities poses a
      significant risk for limb loss. Graft salvage in patients affected by this
      complication remains a challenge. The vascular surgeon must consider the spectrum
      of treatment options (thrombolysis, thrombectomy, graft replacement) in managing
      acute graft thrombosis. Oral anticoagulants should be considered in patients with
      low-flow polytetrafluoroethylene (PTFE) grafts and after successful thrombolysis,
      with or without revision. The role of thrombolytic therapy for occluded vein
      grafts is less clear, but successful lysis is likely in patients who present
      within 48 hours of graft thrombosis and the etiology includes a correctable graft
      stenosis.

PMID- 8370021
TI  - Synthesis of multivalent beta-lactosyl clusters as potential tumor metastasis
      inhibitors.
AB  - A beta-lactosyl residue was linked to the amino groups of L-lysyl-L-lysine
      through spacer arms of three different lengths (C2, C4, and C9) to give trivalent
      beta-lactosyl clusters in order to increase the inhibitory activity of the beta
      lactosyl group against tumor cell colonization. Thus, O-(2,3,4,6-tetra-O-acetyl
      beta-D-galactopyranosyl)-(1-->4)-2,3, 6-tri-O-acetyl-glucopyranosyl
      trichloroacetimidate was treated with methyl or benzyl hydroxyethanoate, methyl
      or benzyl 4-hydroxybutanoate, and methyl 9-hydroxynonanoate, respectively, in the
      presence of trimethylsilyl trifluoromethanesulfonate to give the corresponding
      beta-lactosides. These were coupled to L-lysyl-L-lysine, after conversion to the
      N-hydroxysuccinimide esters, to yield the corresponding trivalent beta-lactosyl-L
      lysyl-L-lysine conjugates in good yields. The beta-lactosyl group with a C4
      spacer arm was also coupled similarly to poly(L-lysine) (M(r) 3800) to form a
      polyvalent beta-lactosyl cluster. Coinjection of the trivalent (with C2 and C4
      spacer arms) and polyvalent beta-lactosyl clusters with the highly metastatic B16
      murine melanoma cells inhibited the formation of lung colonies in C57/BL mice,
      whereas the trivalent cluster with a C9 spacer arm displayed no activity.

PMID- 8370022
TI  - [Carbohydrate building blocks for the construction of tumor-associated antigens.
      Synthesis of Lewis Y determinants].
AB  - The synthesis of the ethoxycarbonyloctanyl glycoside of the Lewis-Y (Ley)
      tetrasaccharide, a part of complex glycosphingolipids, was based on the
      trichloroacetimidate method for glycoside synthesis. The regioselective
      introduction of protective groups and the high yield of epimers of the
      azidonitration reaction applied to O-[2,3,4-tri-O-acetyl-6-O-[dimethyl-(2,3
      dimethyl-2-butyl)silyl]-beta-D- galactopyranosyl]-(1-->4)-3-O-acetyl-1,5-anhydro
      6-O-[dimet hyl-(2,3- dimethyl-2-butyl)silyl]-D-arabino-hex-1-enitol led to a
      lactosamine acceptor molecule. The double specific introduction of an alpha-L
      fucosyl group in high yield gave a protected Ley-tetrasaccharide. After
      activation to give the alpha-trichloroacetimidate, specific beta-glycosylation
      with 8-ethoxycarbonyl octanol under SN 2 condition, followed by cleavage of all
      protective groups led to the tetrasaccharide, alpha-L-Fucp-(1-->2)-beta-D-galp-(1
      ->4)-[alpha-L-fucp-(1--> 3)]-beta-D- GlcpNAcO(CH2)8CO2Et in high yield.

PMID- 8370024
TI  - Convergent synthesis of an elusive hexasaccharide corresponding to the cell-wall
      polysaccharide of the beta-hemolytic Streptococcus group A.
AB  - A convergent synthesis of a hexasaccharide corresponding to the cell-wall
      polysaccharide of the beta-hemolytic Streptococcus Group A is described. The
      strategy relies on the preparation of a key linear trisaccharide unit beta-D
      GlcpNAc-(1-->3)-alpha-L-Rhap-(1-->2)-alpha-L-Rhap which has previously resisted
      our efforts. The trisaccharide functions both as a glycosyl acceptor and donor to
      give an elusive hexasaccharide. This fully functionalized unit can serve, in
      turn, as a glycosyl acceptor or donor for the synthesis of higher-order
      structures. Deprotection gives a hitherto unknown hexasaccharide for use as a
      hapten in immunochemical studies. The characterization of all compounds by high
      resolution 1H and 13C NMR spectroscopy is also described.

PMID- 8370023
TI  - Preparation of 4,6-cyclo-hexopyranoses by palladium-mediated intramolecular
      cyclodehalogenation.
AB  - 4,6-Cyclo-4,6-dideoxy-hexapyronoses were obtained by palladium-mediated
      intramolecular cyclodehalogenation. Thus, methyl 2,3-di-O-acetyl-4,6-dideoxy-4,6
      diiodo-beta-D-galactopyranoside (3) afforded methyl 2,3-di-O-acetyl-4,5-cyclo-4,6
      dideoxy-beta-D-galactopyranoside (5) in 56% yield upon treatment with hydrogen in
      the presence of palladium-on-charcoal and diethylamine. The structure of 5 was
      proven by MS, NMR including NOE measurements, and by independent conversion of 4
      to 5 by zinc-mediated Wurtz synthesis. Similarly, methyl 2,3-di-O-acetyl-4,6
      cyclo-4,6-dideoxy-alpha-D-galactopyranoside (6) and O-(2,3,-di-O-acetyl-4,6-cyclo
      4,6-dideoxy-alpha-D-galactopyranosyl)-(1-- >4)-1,2,3,6-tetra-O-acetyl-beta-D
      glucopyranose (17) were obtained along with the respective 4,6-dideoxy analogues.
      Also methyl 2,3-di-O-acetyl-4,6-dideoxy-4,6-diiodo-beta-D-glucopyranoside (19)
      gave galacto-configured 5 stereoselectively.

PMID- 8370025
TI  - On the structure of calonyctin A, a plant growth regulator.
AB  - The plant growth regulator calonyctin A, isolated from the dried leaves of
      Calonyction aculeatum L. House (Yue-Guang-Hua), was separated into two pure
      components by high performance liquid chromatography. By use of mass spectrometry
      based on various ionization techniques, one- and two-dimensional NMR
      spectroscopy, IR spectrometry, and chemical methods the molecular structures of
      the two homologous glycosides were determined. Each molecule contains two hydroxy
      fatty acid residues and four 6-deoxyhexose units. The fatty acids are 3-hydroxy-2
      methylbutanoic acid and 11-hydroxytetradecanoic acid or 11-hydroxyhexadecanoic
      acid. The 6-deoxyhexose residues (three of quinovose and one of rhamnose)
      comprise a tetrasaccharide having the following structure: [formula: see text]
      The long-chain hydroxy acid is linked glycosidically through its O-11 to Qui D
      and esterified to O-2 of Qui C, forming a macrocyclic lactone. The 3-hydroxy-2
      methylbutanoic acid is ester-linked to O-3 of Qui C.

PMID- 8370026
TI  - Structure of an extracellular polysaccharide produced by Erwinia chrysanthemi.
AB  - Erwinia chrysanthemi pv zeae strain SR260, a phytopathogen of corn, produced from
      lactose an acidic extracellular polysaccharide which was purified and found to
      consist of L-rhamnose, D-mannose, D-glucose, and D-glucuronic acid in the ratio
      of 3:1:1:1. A combination of chemical (carboxyl-group reduction, methylation
      analysis, periodate oxidation, Smith degradation, and lithium-ethylenediamine
      degradation) and physical (1 and 2D NMR spectroscopy) methods revealed that the
      polysaccharide is composed of a hexasaccharide repeating unit 1: [formula: see
      text]

PMID- 8370027
TI  - Structural studies of acetan, an exopolysaccharide elaborated by Acetobacter
      xylinum.
AB  - The exopolysaccharide acetan, elaborated by Acetobacter xylinum, has been
      investigated. The polysaccharide and a heptasaccharide, obtained on enzymic
      hydrolysis, corresponding to the repeating unit were characterised by sugar and
      methylation analysis and by NMR spectroscopy and MS. It is concluded that the
      polysaccharide is composed of repeating units with the following structure.
      [formula: see text] The polysaccharide further contains approximately two O
      acetyl groups per repeating unit, which have not been assigned, but it appears
      that they are on primary locations.

PMID- 8370028
TI  - Structural studies of the capsular polysaccharide (S-21) from Klebsiella
      pneumoniae ATCC 31314.
AB  - The structure of the polysaccharide (S-21) elaborated by Klebsiella pneumoniae
      ATCC 31314 has been investigated. NMR spectroscopy, sugar and methylation
      analysis, uronic acid degradation, and partial hydrolysis to oligosaccharides
      were the main methods used. In order to obtain good NMR spectra, the polymer was
      subjected to non-specific degradation by treatment with fuming hydrochoric acid.
      It is concluded that S-21 is composed of pentasaccharide repeating units with the
      following structure. [formula: see text] Approximately 0.7 equivalent of O-acetyl
      group, distributed over at least three positions, was also present but not
      located. The carbohydrate backbone in S-21 is identical to that of Klebsiella K30
      and K33 capsular polysaccharides.

PMID- 8370029
TI  - Recognition of the acceptor beta-D-GlcpNAc-(1-->2)-alpha-D-Manp- (1-->6)-beta-D
      Glcp-OR by N-acetyl-glucosaminyltransferase-V: none of the hydroxyl groups on the
      Glc-residue are important.
AB  - The enzyme, N-acetylglucosaminyltransferase-V (GlcNAcT-V, E.C. 2.4.1.155),
      transfer a beta-D-GlcpNAc residue, from UDP-GlcNAc, to the OH-6 group of the Man
      residue in the synthetic acceptor beta-D-GlcpNAc-(1-->2)-alpha-D-Manp-(1-->6)
      beta-D-Glcp-O(CH2)7 CH3 (3). Trisaccharide 3 is an excellent substrate for the
      enzyme from hamster kidney with a Km value of 26 microM. In this paper we examine
      the contribution of the Glc residue in 3 to acceptor recognition by this enzyme.
      beta-D-GlcpNAc-(1-->2)-alpha-D-Manp-O(CH2)7CH3 where the Glc residue in 3 has
      been deleted, was synthesized and found to be a very poor substrate with a Km
      value elevated to almost 2 mM. Two other analogues of 3, where the Glc residue
      was O-trimethylated (6) or O-tribenzylated (7), respectively, possessed Km values
      very near to those of 3. The Glc residue in 3 is thereby shown to present an
      important recognition element for GlcNAcT-V, but none of the free hydroxyl groups
      are required. This observation should facilitate the design of more hydrophobic
      and membrane-permeable analogues of 3 that are expected to function as specific
      glycosylation inhibitors.

PMID- 8370030
TI  - Complete assignment of the 1H NMR spectra of phytoalexin elicitor-active
      oligoglucosides.

PMID- 8370031
TI  - Identification of oligosaccharides consisting of D-glucuronic acid and L-glycero
      D-manno- and D-glycero-D-manno-heptose isolated from Vibrio parahaemolyticus O2
      lipopolysaccharide.

PMID- 8370032
TI  - Occurrence of 2-O-sulphated D-glucuronic acid in rat liver heparan sulphate.

PMID- 8370033
TI  - Authentic standards for the reductive-cleavage method. The positional isomers of
      partially methylated and acetylated or benzoylated 1,5-anhydro-D-fucitol.
AB  - Described herein is an efficient method for the synthesis of the eight positional
      isomers of methylated and acetylated or benzoylated 1,5-anhydro-D-fucitol. The
      compounds are generated simultaneously by partial methylation of 1,5-anhydro-D
      fucitol and subsequent benzoylation, and the individual isomers are obtained in
      pure form by high-performance liquid chromatography. Debenzoylation of the latter
      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 tri-O-methyl derivative. Also reported for the acetates and the tri-O
      methyl derivative are their linear temperature programmed gas-liquid
      chromatography retention indices on three different capillary columns.

PMID- 8370034
TI  - Synthesis of 3-deoxyaldulosonic acid esters by one-carbon chain extension of
      glycal-derived lactone precursors.
AB  - A convenient preparative route is described for 3-deoxyaldulosonic acids. Glycal
      precursors are oxidatively converted into 2-deoxyaldonolactones, which react with
      1,3-dithian-2-yl anion to afford 1,3-propanediyl dithioacetals of higher 3
      deoxyaldosuloses. Deprotection with mercuric salts in wet or dry alcohols gave
      high yields of the corresponding alkyl aldulosonates. Preparative reaction
      conditions were optimized and the anomeric configurations of the ketopyranose
      products were established by 13C NMR.

PMID- 8370035
TI  - Synthesis of the monodeoxy derivatives of 2-(trimethylsilyl)ethyl beta-lactoside.
AB  - Monodeoxy derivatives of 2-(trimethylsilyl)ethyl (Me3SiEt) beta-lactoside were
      synthesized, by deoxygenation at the disaccharide level, for the 2'-, 3'-, 4'-,
      and 6'-monodeoxylactosides. The 2-, 3-, and 6-deoxy derivatives were synthesized
      by beta-D-galactosylation of suitably protected monodeoxygenated Me3SiEt
      glucosides. Silver silicate was shown to be an efficient glycosylation promoter
      in the preparation of the 2- and 3-deoxylactosides.

PMID- 8370036
TI  - Synthesis of Kdo-alpha-glycosides of lipid A derivatives.
AB  - The synthesis of the lipopolysaccharide fragment O-(4,5,7,8-tetra-O-acetyl-3
      deoxy-N-methyl-alpha-D-manno-2- octulopyranosylonamide)-(2-->6)-O-(2-deoxy-2
      [(3R)-3- dodecanoyloxytetradecanamido]-4-O- phosphono-3-O-tetradecanoyl-beta-D
      glucopyranosyl)-(1-->6)-1-O-acetyl-2- deoxy-2 - [(3R)-3
      dodecanoyloxytetradecanamido]-3-O-tetradecanoyl-alpha-D- glucopyranose (35 alpha)
      is performed via anomeric O-alkylation. With this objective, the 2-azido-3-O
      benzyl-2-deoxy-6-O-trifluoromethanesulfonyl-beta-D-glu copyranosides 5, 7, and 19
      alpha, beta were synthesized from D-glucal and employed as alkylating agents.
      Reaction of 5 with the O-cyclohexylidene-protected Kdo-derivative 10 afforded the
      desired alpha-linked disaccharide, tert-butyldimethylsilyl 4-O-allyl-2-azido-3-O
      benzyl-2-deoxy-6- O-(4,5:7,8-di-O-cyclohexylidene-3-deoxy-N-methyl-alpha-D-manno
      2- octulopyranosylonamide)-beta-D-glucopyranoside (11); even better yields of the
      structurally related disaccharide 12 were obtained with the 4-O-unprotected 7 as
      alkylating agent. 1-O-Desilylation of 12 furnished the lactol 20, which could be
      alkylated at the anomeric position with 1-O-allyl protected alkylating agents 19
      alpha and 19 beta, both of which furnished exclusively the desired beta-(1-->6)
      linked trisaccharides allyl O-(4,5:7,8-di-O-cyclohexylidene-3- deoxy-N-methyl
      alpha-D-manno-2-octulopyranosylonamide)-(2-->6)-O-( 2-azido-3- O-benzyl-2-deoxy
      beta-D-glucopyranosyl)-(1-->6)-2-azido-3, 4-di-O-benzyl-2-deoxy-alpha- (21 alpha)
      and -beta-D-glucopyranoside (21 beta), respectively. Phosphorylation with
      diphenyl phosphorochloridate, replacement of the O-cyclohexylidene protective
      group by O-triethylsilyl (TES) protective groups, removal of the 1-O-allyl group,
      azido group reduction, subsequent N-acylation, and then O-acetylation provided
      the key 1-O-acetyl protected intermediate 30 alpha. Removal of the O-TES groups,
      subsequent O-acetylation, and hydrogenolytic O-debenzylation furnished O-[4,5:7,8
      tetra-O-acetyl-3-deoxy-N-methyl-alpha-D-manno-2- octulopyranosylonamide]-(2-->6)
      O-(2-deoxy-4-O-diphenoxyphospho ryl-2-[(3R)- 3-dodecanoyloxytetradecanamido]-beta
      D-glucopyranosyl)-(1-->6)-1-O -acetyl-2- deoxy-2[(3R)
      dodecanoyloxytetradecanamido]-alpha-D-glucopyranose (33 alpha), which underwent
      the required selective O-tetradecanoylation at the 3-O- and 3'-O-position, thus
      furnishing, after hydrogenolytic O-dephenylation of the diphenoxyphosphoryl
      group, the target molecule 35 alpha.

PMID- 8370037
TI  - Synthesis of the methyl glycosides of a tri- and a tetra-saccharide related to
      heparin and heparan sulphate.
AB  - The methyl glycoside of a tetrasaccharide isolated from heparin, methyl O-(alpha
      L-idopyranosyluronic acid)-(1-->4)-O-(2-acetamido-2-deoxy-alpha-D-
      glucopyranosyl)-(1-->4)-O-(beta-D-glucopyranosyluronic acid)-(1-->3)-O-beta-D
      galactopyranoside disodium salt and a trisaccharide derivative thereof, methyl O
      (alpha-L-idopyranosyluronic acid)-(1-->4)-O-(2-acetamido-2- deoxy-alpha-D
      glucopyranosyl)-(1-->4)-O-beta-D-glucopyranosyluronic acid disodium salt, were
      synthesized using a block-type strategy. A suitable protected disaccharide block
      of iduronic acid and glucosamine (IdoA-GlcN) was used as a key intermediate for
      the syntheses and was glycosidated with a protected galactose derivative and a
      disaccharide block of glucuronic acid and galactose (GlcA-Gal) to give tri- and
      tetra-saccharide derivatives, respectively. Deprotection gave the target
      compounds.

PMID- 8370038
TI  - Synthetic approaches to 2-deoxyglycosyl phosphates.
AB  - By the use of the N-iodosuccinimide (NIS)-procedure, various glycals could be
      converted into 2-deoxy-2-iodoglycosyl phosphates. Treatment of glycals 1 and 7
      with NIS and dibenzyl phosphate gave the corresponding alpha-1,2-trans-diaxial 2
      deoxy-2-iodoglycosyl phosphates 2 and 8 as the main products. The beta-1,2-trans
      diequatorial compounds 3 and 9 were isolated as by-products. Analogous reaction
      of glycals 4 and 10 gave the corresponding 2-deoxy-2-iodoglycosyl phosphates 5,
      6, 11, and 12 as crude products, which were characterized by 1H NMR spectroscopy.
      Classical phosphorylation of 2-deoxy-glycosyl chlorides 14 and 16 with silver
      dibenzyl phosphate gave the corresponding dibenzyl 2-deoxy-alpha-glycosyl
      phosphates 15 and 17. Alternatively, glycosylation of tri-O-acetyl-D-glucal using
      dibenzyl phosphate and triphenylphosphine hydrobromide afforded 15 in lower
      yield. The application of S-(2-deoxyglycosyl) phosphorodithioates as glycosyl
      donors provided the most convenient way to dibenzyl 2-deoxyglycosyl phosphates.
      The alpha-glycosyl phosphates 15, 20, and 22 could be synthesized by reaction of
      the 2-deoxyglycosyl dithiophosphates 18, 19, and 21 with dibenzyl phosphate and
      activation by iodonium di-sym-collidine perchlorate. Similarly, the 2,6
      dideoxyglycosyl dithiophosphates 23 and 25 gave the 2,6-dideoxy phosphates 24 and
      26; however, the isolation of these labile compounds could not be effected.

PMID- 8370039
TI  - "Chitin Leash": a polysaccharide heterobifunctional cross-linking agent which can
      be cleaved by lysozyme.
AB  - 6-O-[(2-Hydroxyethyl)poly(2-oxyethyl)]chitosan ("glycolchitosan") was oxidatively
      cleaved with nitrous acid and then partly acetylated with acetic anhydride,
      reacted with bromoacetyl-N-hydroxysuccinimide, and reacted further with acetic
      anhydride. Conditions were selected, including fractionation by size-exclusion
      chromatography, so that the resulting "Chitin Leash" had an estimated, average
      molecular weight of 10,000 (dextran standards), corresponding to a length of
      approximately 40 sugar residues. It possessed 0.9 terminal aldehyde and 2.6
      random (presumably) side-chain bromoacetyl reactive groups per chain (average
      values). As a model system, the Chitin Leash was used to crosslink staphylococcal
      nuclease (SNase) to ribonuclease A (RNase) with retention of 75 and 78%,
      respectively, of the starting enzyme activities. For this coupling, the Nase was
      first converted to a sulfhydryl SNase derivative which retained 74% of the
      activity of starting enzyme. The yields in this synthesis were: 13% Chitin Leash
      from glycolchitosan, 24% Chitin Leash-RNase from Chitin Leash and 45% SNase
      Chitin Leash-RNase from the latter conjugate. The ratio of SNase to RNase in this
      conjugate was 1.0:0.94. In a second preparation, in which [14C]acetic anhydride
      was used, a longer reaction time was employed for the coupling of Chitin Leash to
      RNase. This gave a 1.0:1.8:0.95 molar ratio of Nase: [14C]Chitin Leash: RNase,
      revealing multiple attachment of the [14C]Chitin Leash to RNase. The activity of
      the RNase in the final conjugate was 20%. The latter conjugate was approximately
      70% hydrolyzed by diaminooctyl-succinyl-lysozyme, disconnecting the two enzymes
      while not affecting their activities.

PMID- 8370040
TI  - Structure of the K10 capsular antigen from Escherichia coli O11:K10:H10, a
      polysaccharide containing 4,6-dideoxy-4-malonylamino-D-glucose.
AB  - The K10 antigen from Escherichia coli O11:K10:H10 consists of equimolar amounts
      of rhamnose and 4,6-dideoxy-4-malonylaminoglucose [Qui4NMal; 4-(2
      carboxyacetamido)-4,6-dideoxyglucose]. Methylation analysis and 1 and 2D NMR
      spectroscopy showed that the K10 capsular polysaccharide has the structure
      [formula: see text]

PMID- 8370041
TI  - Structural elucidation of the capsular polysaccharide of Escherichia coli
      serotype K101 by high resolution NMR spectroscopy.

PMID- 8370042
TI  - Structural studies of the extracellular polysaccharide from Butyrivibrio
      fibrisolvens strain X6C61.
AB  - The capsular polysaccharide from Butyrivibrio fibrisolvens strain X6C61 has been
      investigated using NMR spectroscopy, mass spectrometry, methylation analysis, and
      partial acid hydrolysis as the main methods. The polysaccharide is composed of
      hexasaccharide repeating units having the following structure. [formula: see
      text] The polysaccharide also contains O-acetyl groups, of which approximately
      70% are substituted to O-3 of the beta-D-Glc pA residue.

PMID- 8370043
TI  - Structural studies of the saccharide part of the cell envelope lipopolysaccharide
      from Haemophilus influenzae strain AH1-3 (lic3+).
AB  - The structure of the saccharide part of the lipopolysaccharide from Haemophilus
      influenzae strain AH1-3 (lic3+) has been investigated. The saccharide was
      obtained from the lipopolysaccharide by mild acid hydrolysis followed by high
      performance anion-exchange chromatography, and isolated fractions were studied by
      methylation analysis, NMR spectroscopy, and FAB mass spectrometry. The major
      saccharide is a heptasaccharide with the following structure, [formula: see text]
      in which Kdo is 3-deoxy-D-manno-oct-2-ulosonic acid and PEA is 2-aminoethyl
      phosphate. Hep is identified as L-glycero-D-manno-heptose. The absolute
      configuration of the phosphorylated heptose is tentative only.

PMID- 8370044
TI  - Short synthesis of allyl 2-acetamido-2-deoxy-3,6-di-O-(alpha-L-fucopyranosyl)
      beta-D-glucopyrano side.

PMID- 8370046
TI  - A synthetic approach to polysialogangliosides containing alpha-sialyl-(2-->8)
      sialic acid: total synthesis of ganglioside GD3.
AB  - A stereocontrolled, facile total synthesis of ganglioside GD3 is described as an
      example of a proposed systematic approach to the preparation of gangliosides
      containing an alpha-sialyl-(2-->8)-sialic acid unit alpha-glycosidically linked
      to O-3 of a D-galactose residue in their oligosaccharide chains. Glycosylation of
      2-(trimethylsilyl)ethyl 6-O-benzoyl-, 3-O-benzoyl-, or 3-O-benzyl-beta-D
      galactopyrano-sides, or 2-(trimethylsilyl)ethyl 2,3,6,2',6'-penta-O-benzyl-beta
      lactoside (7), with methyl [phenyl 5- acetamido-8-O-(5-acetamido-4,7,8,9-tetra-O
      acetyl-3,5-dideoxy-D- glycero-alpha-D-galacto-2-nonulopyranosylono-1',9 lactone)-
      4,7-di-O-acetyl-3,5-dideoxy-2-thio-D-glycero-D-galacto-2-nonulopyrano sid] onate
      (3), using N-iodosuccinimide-trifluoromethanesulfonic acid as a promoter, gave
      the corresponding alpha glycosides 8 (32%), 13 (33%), 14 (48%), and 17 (31%),
      respectively. The glycosyl donor 3 was prepared from O-(5-acetamido-3,5-dideoxy-D
      glycero-alpha-D-galacto-2-nonulopyranosy lonic acid)-(2-->8)-5-acetamido-3,5-
      dideoxy-D-glycero-D-galacto-2-nonulopyranosonic acid by treatment with Amberlite
      IR-120 (H+) in methanol, O-acetylation, and subsequent replacement of the
      anomeric acetoxy group with phenylthio. Compound 8 was converted into the methyl
      beta-thioglycoside via O-benzoylation, replacement of the 2-(trimethylsilyl)ethyl
      group by acetyl, and introduction of the methylthio group by reaction with
      methylthiotrimethylsilane. Compound 17 was converted, via O-acetylation,
      selective removal of the 2-(trimethylsilyl)ethyl group, and reaction with
      trichloroacetonitrile, into the alpha-trichloroacetimidate, which was coupled
      with (2S,3R,4E)-2-azido-3-O-benzoyl-4-octadecene-1,3-diol to give the beta
      glycoside. This glycoside was easily transformed, via selective reduction of the
      azido group, condensation with octadecanoic acid, O-deacylation, and hydrolysis
      of the methyl ester and lactone functions, into ganglioside GD3.

PMID- 8370045
TI  - Chemical behavior of benzylidene acetal groups bridging the contiguous glucose
      residues in malto-oligosaccharide derivatives.
AB  - Treatment of phenyl alpha-maltoside with an excess of alpha, alpha
      dimethoxytoluene in the presence of (+)-10-camphorsulfonic acid, followed by
      partial hydrolysis to remove unstable acyclic acetal substituents, gave phenyl
      3,2':4',6'-di-O-benzylidene-alpha-maltoside. Thus, one of the benzylidene groups
      formed an eight-membered cyclic acetal ring bridging the two monosaccharide
      components. This acetal function was stable under conventional acylation and
      alkylation conditions, but was selectively hydrolyzed by 80% acetic acid at room
      temperature. Treatment of a per-O-benzoyl derivative of 1 with N-bromosuccinimide
      barium carbonate afforded phenyl 2,6,3', 4'-tetra-O-benzoyl-6'-bromo-6'-deoxy
      alpha-maltoside in 80% yield. Reductive ring opening of the tri-O-benzyl
      derivative of 1 with lithium aluminum hydride-aluminum chloride gave a
      2,3,6,3',4'-penta-O-benzyl derivative, while reduction with sodium
      cyanoborohydride-hydrogen chloride or borane trimethylamine complex-aluminum
      chloride afforded a 2,3,6,3',6'-penta-O-benzyl derivative in good yield. Similar
      regioselectivity was observed in the reductive cleavage of a 1,6-anhydro
      3',2'':4'',6''-di-O-benzylidene-beta- maltotriose derivative.

PMID- 8370047
TI  - Solid-phase synthesis and conformational studies of glycosylated derivatives of
      helper-T-cell immunogenic peptides from hen-egg lysozyme.
AB  - 3-Mercaptopropionic acid and N alpha-Fmoc serine, both with unprotected carboxyl
      groups, were stereospecifically glycosylated in 62-82% yields, using saccharide
      1,2-trans peracetates and Lewis acid catalysis. The resulting glycosylated
      building blocks were used in the synthesis of derivatives of helper-T-cell
      stimulating peptides, with the carbohydrate moiety located at the amino terminus,
      or internally in the peptide chain. 1H NMR spectroscopy in Me2SO-d6 showed that
      the glycopeptides assumed random conformations, which were not influenced by the
      glycosylation or by single substitutions of amino acids in the peptide moiety.

PMID- 8370048
TI  - [The genetics of sex].
AB  - A stepwise resolution of the role of individual genes known to play role in sex
      determination is presented. Cytogenetic abnormalities e.g. male phenotype with XX
      and female phenotype with XY gonosomal complements helped substantially to
      ascertain SRY (Sex region of Y) gene activity to be essential for sex phenotype
      development control. This control seems to be rather suppressive than activating.

PMID- 8370049
TI  - [Maladaptation and the circumstances of its development].
AB  - In the submitted review the author discusses contemporary views on the
      maladaptation syndrome. He characterizes mental stress and conditions under which
      it develops and ways in which individuals can react, as well as differences in
      the reaction of children, adolescents and adults. The author characterizes
      maladaptation, explains causes of its development and manifestations in relation
      to age (child, adolescent, adult) and its possible sequelae. Finally the paper
      contains reflections on the possible prevention of influences which may lead to
      maladaptation behaviour.

PMID- 8370050
TI  - [Candida sepsis. I. Risk factors, pathogenesis and the clinical picture].
AB  - Candida sepsis is a serious and ever increasing complication in patients with a
      reduced defense capacity. At the intensive care unit of the infectious department
      in 1978-1990 from a total of 430 patients with the diagnosis of sepsis 20 (4.7%)
      had a Candida aetiology. Candida sepsis is suspected in particular in leukaemic
      patients with neutropenia, in organ transplantations and in patients given
      intensive care on account of a serious primary disease, bacterial infection or
      after surgery. The risk of deep candidosis is increased by venous catheters,
      hyperalimentation, antibiotic treatment, invasive operations. Diagnosis is
      supported by endophthalmitis and skin lesions; signs of affection of the liver,
      lungs, kidneys and cardiac valves are sought. Analysis of risk factors,
      pathogenesis and the clinical picture of invasive Candida infections is based on
      ample data in the literature.

PMID- 8370051
TI  - [Candida sepsis. II. Laboratory methods and their clinical importance].
AB  - The authors present experience assembled at the septic station of the infectious
      department and mycological laboratory as regards interpretation of results of
      laboratory examinations in invasive Candida infections and they summarize the
      most important data from the literature on the correct collection of material,
      evaluation of microscopic and cultivation findings, the importance of
      examinations and haemocultures, venous catheters, urine, faeces and sputum. They
      analyze problems of serological examination and direct detection of antigen, they
      recommend mycological monitoring of patients at risk. In the conclusion they
      summarize the most frequent mistakes as regards the evaluation of laboratory
      results and indications of treatment.

PMID- 8370052
TI  - [Surveillance of tuberculosis in the Czech Republic in 1991].
AB  - They authors present an interim report on the epidemiological situation of
      tuberculosis and the effectiveness of control measures as regards tuberculosis in
      the Czech Republic in 1991. The data are compared with previous years. The
      incidence of tuberculosis of all forms was 19.9/100,000 population, TB of the
      respiratory organs 16.2/100,000 and the incidence of bacteriologically confirmed
      respiratory TB 11.5/100,000 population. As compared with previous years, no
      statistically significant differences were found. Extrapulmonary TB accounted for
      less than 10% of the incidence, the position was similar also as regards
      mycobacterioses other than TB. The incidence of TB in children was 1.3/100,000
      children under 15 years, after a transient increase in 1990 (microepidemic in
      gypsy children), a marked decline was recorded. The TB mortality rate was low
      (1.1/100,000 population), the prevalence to the date of Dec. 31 1991 was
      21.7/100,000 population. On account of complaints 76% new cases were detected,
      the majority within 1 month, antituberculous treatment was effective, the mean
      period of treatment was reduced to less than 8 months. However, long in-patient
      treatment persists usually at the beginning of antituberculous treatment (3
      months).

PMID- 8370053
TI  - [Naftifin--laboratory and clinical experience with a new antimycotic from the
      allylamine group].
AB  - The authors evaluated the effectiveness of naftifin on a broad spectrum of 42
      types of agents causing mycoses. Using the microdilution method, the authors
      assessed minimal inhibiting concentrations (MIC) of this antimycotic agent in 107
      clinical isolates. Naftifin displayed a selective antifungal activity: excellent
      sensitivity was found in dermatophytes (MIC 90% = 0.39 mg.l-1), Aspergillae were
      medium sensitive (MIC = 0.09-12.5 mg.l-1). The majority of yeasts and filamentous
      fungi from the group of Zygomycetes was resistant to naftifin. The therapeutic
      results in 57 subjects with dermatomycoses corresponded to the results of in
      vitro tests of the antimycotic agent. Most successful as treatment of
      dermatophytoses at extra-intertriginous sites and treatment of pityriasis
      versicolor; manifestation of candidoses were not affected. The commercial
      preparation used--Fetimin cream--is considered by the authors a suitable
      alternative of hitherto used local antimycotics, in particular preparations from
      the azole series.

PMID- 8370054
TI  - [A review of mushrooms containing amanitins and phalloidines].
AB  - The toxic peptides amanitins and phalloidins were found in 22 species of gilled
      fungi in Europe: 3 species of the Amanita genus, 8 species of the Galerina genus
      and 11 of the Lepiota genus. Galerina sulcipes in the most toxic one, followed by
      Amanita phalloides, A. virosa, Galerina marginata and Lepiota brunneoincarnata.

PMID- 8370055
TI  - [Review of present knowledge on the pathogenesis and pathophysiology of Amanita
      phalloides poisoning].
AB  - The mushroom poisoning of phalloid type is caused by amatoxins, mainly by alpha
      amanitine. It is a cytotoxin which acts through an indirect mechanism. It binds
      irreversibly the nucleolar enzyme, RNA-polymerase II in cells with intensive
      proteosynthesis (enterocytes in the digestive tract, hepatocytes in the liver and
      epithelial cells of proximal renal tubules). A tight binding of the toxin with
      the enzyme blocks the transcription from DNA to m-RNA and thus makes the
      proteosynthesis impossible. This results in the cell necrosis. Pathophysiology of
      the phalloid type poisoning is rather complicated, as the disorders of primarily
      affected organs (gastrointestinal tract, liver and kidney) produce a derangement
      of other remote organs and systems. After a relatively long period of latency
      (average 8-10 hours) the symptoms of the initial phase of the symptomatologic
      course of intoxication--excessive vomiting and diarrhea (during one or two days)-
      are observed, leading to dehydration which culminates in the hypovolemic shock. A
      short subsequent phase of an apparent improvement (in the 3rd day) is followed,
      beginning with the fourth day, by an acute failure of the liver and kidney. The
      cause of the failure of both the organs is the same--the toxic noxa. Therefore it
      is not possible to classify the coexistence of acute hepatal and renal failure as
      a so-called hepatorenal syndrome. The true hepatorenal syndrome is namely a
      potentially reversible prerenal failure accompanying a variety of serious liver
      diseases, namely in their terminal phase. The phalloid nephropathy, however, has
      two constituents.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370056
TI  - [Methods in laboratory diagnosis of Amanita phalloides poisoning].
AB  - Methods for laboratory diagnostics that can be used in Amanita phalloides
      intoxication examinations are described and discussed. These methods (microscopic
      examination, chemical methods as TLC, HPTLC, HPLC, RIA, and clinico-biochemical
      examinations) are characterized, their use and limits, and the possibility of
      using during the treatment is emphasised.

PMID- 8370057
TI  - [Isolation of toxic peptides from Amanita phalloides and their analysis using
      high-performance liquid chromatography].
AB  - The objective of the work is isolation of toxic peptides from Amanita phalloides-
      amatoxins (alfa-, beta-, gamma-amanitin) and phallotoxins (phalloidin,
      phallacidin, phallisin, phallisacin) by liquid chromatography on Sephadex LH-20
      according to Yocum modification. Seven main toxins were isolated in centigram
      amounts. The purity of the toxins isolated was verified by the characteristics of
      their absorbance spectra, by thin layer chromatography (TLC) and high-performance
      liquid chromatography on reversed phase (RP-HPLC). The fraction of acid
      phallotoxins which appears homogenous in TLC and Sephadex LH-20 was separated
      into 5 substances (four of which are phallotoxins) by preparative RP-HPLC
      technique. The toxins isolated are sufficiently pure to be used as standards in
      HPLC.

PMID- 8370058
TI  - [Hemoperfusion in mushroom poisoning. Clinical analysis of 58 patients].
AB  - Fifty-eight patients with acute mushroom poisoning--Amanita phalloides were
      treated. Among them were 28 children and 2 adolescents. From all the patients
      mean age was 30.5 years, 31 patients were in hepatic coma. All patients undergone
      conservative treatment and haemoperfusion. The mean time from beginning of acute
      poisoning to the first haemoperfusion was 61 hours. Ninety-eight haemoperfusions
      were performed, from this number 26 using Amberlite XAD-2. Seventeen simultaneous
      or subsequent haemodialyses and 12 plasmaphereses were performed. Mortality
      occurred in 20 patients (34.5%). Survival of patients depended on the amount of
      ingested mushroom, on the early admission of patients to dialysis centre and on
      the beginning of extracorporeal treatment until the period of 24 hours after
      acute poisoning.

PMID- 8370059
TI  - [Amanita phalloides toxins in dried mushrooms].
AB  - The content of toxins from Amanita phalloides in dried carpophores is decreasing
      in the dependence on time. The content of alpha-amanitin found after 20 years was
      about one half. A mere trace of alpha-amanitin which is the most stable of all
      toxins was detected in a carpophore 50 years old. Degradation of amatoxins and
      phallotoxins by light (mainly the UV part) and high temperatures was observed.

PMID- 8370060
TI  - [Amanita phalloides poisoning queries recorded at the Toxicology Information
      Center in Prague].
AB  - The Poison Information Centre answered in 1990 and 1991 in the mean 6000
      inquiries year. Inquiries concerning mushrooms belong to the most severe ones,
      their number may be substantially different. In 1990 there were 38 inquiries
      regarding mushrooms, only 8 inquiries concerning Amanita phalloides, but in 1991
      146 inquiries including 65 demanding symptoms and treatment of Amanita phalloides
      intoxication. In the same year 27 Amanita phalloides intoxications were confirmed
      on the basis of discharging reports from the hospitals, in seven cases fatal. As
      important prognostic factors seem the early visit of a physician and the
      treatment without delay. The influence of negative prognostic factors by
      Floersheim--short latency period, massive founding of spores and the lowering of
      the Quick test under 10% were not confirmed by the data of the Poison Information
      Centre.

PMID- 8370061
TI  - [Contempo '92].

PMID- 8370062
TI  - Current bibliography of cell calcium prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 8370063
TI  - The calcium signal in human neutrophils and its relation to exocytosis
      investigated by patch-clamp capacitance and Fura-2 measurements.
AB  - Intracellular calcium ([Ca2+]i) and exocytosis of human neutrophils were
      investigated with patch-clamp capacitance and Fura-2 fluorescence measurements.
      Intracellular application of GTP gamma S induces a calcium transient and
      exocytosis. The onset of degranulation occurs at the time where the maximal
      [Ca2+]i is reached. Despite the close correlation in time, buffering [Ca2+]i at
      the resting level or at approximately 2 microM leaves the extent and the time
      course of degranulation unchanged. The decay of the calcium transient is due to
      diffusional equilibration between the cytosol and the pipette volume. GTP gamma S
      activates no cellular mechanisms for Ca2+ reuptake or extrusion. The endogenous
      calcium buffer capacity can be estimated to be as low as that of approximately 90
      microM Fura-2. Stimulation with fMLP also induces degranulation and a calcium
      transient. The decay of fMLP-induced calcium transients is much faster than that
      of GTP gamma S-induced transients and is independent of diffusion indicating that
      fMLP also induces rapid reuptake or extrusion of Ca2+. Degranulation but not the
      calcium transient requires the presence of intracellular GTP. Different
      signalling pathways appear to be involved in GTP gamma S- and fMLP-stimulated
      calcium signals. The intracellular calcium release is not an essential signal to
      initiate exocytosis in neutrophils.

PMID- 8370064
TI  - Calcium control on InsP3-induced discharge of calcium from permeabilised
      hepatocyte pools.
AB  - The control exerted by intralumenal and cytosolic Ca2+ on InsP3-induced release
      of Ca2+ from intracellular Ca2+ pools in suspensions of saponin-permeabilised rat
      hepatocytes was investigated by combined Quin-2 and 45Ca2+ measurements at 20
      degrees C. We failed to detect a major effect of intralumenal Ca2+ in regulating
      this release, as various manipulations in which the load of the Ca2+ pools was
      varied by a factor of two did not significantly affect the apparent relative
      efficiency of InsP3 in releasing Ca2+; these manipulations included loading the
      Ca2+ pools up to various steady state levels by preliminary equilibration at
      various external free Ca2+ concentrations, as well as emptying them progressively
      through the blockade of pump-mediated Ca2+ uptake. As regards Ca2+ on the
      cytosolic side, in contrast with recent results obtained with other systems, we
      found that, at maximal doses, InsP3-induced Ca2+ release was not stimulated by
      raising Ca2+ from very low to submicromolar or micromolar concentrations, and
      that only relatively high concentrations of free Ca2+ inhibited this release
      (half-maximal inhibition was between 3 and 15 microM). Such elevated Ca2+
      concentrations reduced the size of the InsP3-sensitive Ca2+ pool. We also noted
      that the apparent cooperativity of InsP3 activation of release at pCa 5 was
      noticeably less than that observed at pCa 7. As a result, at low InsP3
      concentrations, a rise in cytosolic Ca2+ from pCa 7 to pCa 5 stimulated InsP3
      mediated Ca2+ release. These results are discussed in the context of the current
      speculations about tissue specificity, heterogeneity, quantal release,
      oscillations, and the several different mechanisms that may control InsP3-induced
      Ca2+ release.

PMID- 8370065
TI  - Nimodipine protects cultured spinal cord neurones from depolarization-induced
      inhibition of neurite outgrowth.
AB  - In the nervous system calcium ions play a crucial role in the regulation of
      growth cone motility, cell migration and neurite outgrowth. High intracellular
      Ca2+ concentrations severely disturb Ca(2+)-regulated processes and may lead to
      neuronal death. We studied whether the Ca(2+)-antagonist nimodipine could prevent
      inhibition of neurite outgrowth which occurs in depolarized cultures of rat
      foetal spinal neurones. Spinal cord slices were depolarized in culture with 50 mM
      K+. Nimodipine (0.01-10 microM) was added before depolarization. After 5 and 7
      days the effect of treatment was determined by: (a) blind scoring of neurite
      outgrowth under phase contrast; and (b) measuring neurofilament (NF) protein with
      an ELISA. Neurite outgrowth was markedly decreased after depolarization, but was
      restored to control values by nimodipine (0.1 microM). Depolarization also led to
      a decrease in total NF content (18%). The NF content of depolarized slices
      incubated with 0.1 microM nimodipine was the same as in the controls. Thus,
      depolarization-induced Ca2+ entry into spinal neurones inhibits neurite outgrowth
      from spinal neurones. Low concentrations of nimodipine prevented this inhibition.
      As nimodipine had no effect on neurite outgrowth in control cultures, we conclude
      that nimodipine does not act as a neurotrophic factor but rather as a
      neuroprotective agent.

PMID- 8370067
TI  - One-pool model for Ca2+ oscillations involving Ca2+ and inositol 1,4,5
      trisphosphate as co-agonists for Ca2+ release.
AB  - Experimental observations indicate that Ca(2+)-induced Ca2+ release (CICR) may
      underlie Ca2+ oscillations in a variety of cells. In its original version, a
      theoretical model for signal-induced Ca2+ oscillations based on CICR assumed the
      existence of two types of pools, one sensitive to inositol 1,4,5-trisphosphate
      (IP3) and the other one sensitive to Ca2+. Recent experiments indicate that Ca2+
      channels may sometimes be sensitive to both IP3 and Ca2+. Such a regulation may
      be viewed as Ca(2+)-sensitized IP3-induced Ca2+ release or, alternatively, as a
      form of IP3-sensitized CICR. We show that sustained oscillations can still occur
      in a one-pool model, provided that the same Ca2+ channels are sensitive to both
      Ca2+ and IP3 behaving as co-agonists. This model and the two-pool model based on
      CICR both account for a number of experimental observations but differ in some
      respects. Thus, while in the two-pool model the latency and period of Ca2+
      oscillations are of the same order of magnitude and correlate in a roughly linear
      manner, latency in the one-pool model is always brief and remains much shorter
      than the period of oscillations. Moreover, the first Ca2+ spike is much larger
      than the following ones in the one-pool model. These distinctive properties might
      provide an explanation for the differences in Ca2+ oscillations observed in
      various cell types.

PMID- 8370066
TI  - The polyether Bistramide A affects the calcium sensitivity of the contractile
      proteins in frog atrial heart muscle.
AB  - The effects of Bistramide A, a new toxin isolated from the Urochordate
      Lissoclinum bistratum Sluiter have been studied on the mechanical activity of
      frog heart atrial muscle preparations. The peak tension of isolated trabeculae
      was sensitive to nanomolar concentrations of Bistramide A. Lineweaver-Burk
      relationships suggest that Bistramide A competes with Ca for a common site. In
      voltage-clamped trabeculae, the toxin inhibited both the cadmium-sensitive Ca
      current and the phasic component of the tension with a dissociation constant of
      3.3 microM and a stoichiometry of 2. Bistramide A decreased the isometric tension
      of skinned fibres in a dose-dependent manner with a dissociation constant of 400
      nM and a stoichiometry of 2. The toxin reduced the maximum Ca activated force and
      decreased the sensitivity of the contractile proteins to Ca. The data suggest
      that Bistramide A decreases the Ca-sensitivity of contractile proteins prior to
      blocking the Ca current.

PMID- 8370068
TI  - Identification of an S100 target protein: glycogen phosphorylase.
AB  - An S100 binding protein from skeletal muscle, R95 000, has been purified,
      identified as glycogen phosphorylase, and shown to be regulated in vitro by the
      S100 alpha isoform. When a soluble skeletal muscle fraction was subjected to a
      standard purification procedure for glycogen phosphorylase, R95 000 copurified
      with the 95 000 molecular weight glycogen phosphorylase protein standard on SDS
      polyacrylamide gels, as well as having glycogen phosphorylase activity. In
      addition, purified glycogen phosphorylase a and b interacted with both S100
      isoforms, S100 alpha and S100 beta, by gel overlay and affinity chromatography.
      While S100 beta had no effect on the enzymatic activity of glycogen phosphorylase
      a, S100 alpha inhibited the enzymatic activity of glycogen phosphorylase a in a
      calcium-independent manner. Altogether, these data suggest that glycogen
      phosphorylase may be an intracellular S100 alpha target in skeletal muscle
      fibers. Furthermore, these results suggest that the inhibition of glycogen
      phosphorylase a activity may be responsible for the lack of fatigability of slow
      twitch fibers, which express S100 alpha, when compared to fast-twitch fibers,
      which do not express S100 proteins.

PMID- 8370069
TI  - Intracellular calcium transients induced by different kinds of stimulus during
      myogenesis of rat skeletal muscle cells studied by laser cytofluorimetry with
      Indo-1.
AB  - Resting intracellular calcium levels and intracellular calcium transients induced
      by three types of stimulus (acetylcholine, high potassium and caffeine) were
      recorded, during in vitro myogenesis, by means of a ratiometric fluorescence
      method using the calcium probe Indo-1 under laser illumination. Resting levels
      seemed to decrease with the age of cultured cells and the depolarization-induced
      transients, through 100 mM K+ or Ach application, were progressively faster and
      larger as the muscle cells developed. An additive mechanism, likely due to
      calcium entry into the cell through nicotinic acetylcholine receptors, could
      explain the differences observed in Ach-induced responses as compared with the
      100 mM K(+)-induced ones. In myoballs (the older cells) the calcium transients
      exhibited progressively a biphasic shape. From data obtained in different
      conditions (tetrodotoxin, nifedipine, strontium and free Ca EGTA) and those
      indicating the appearance of caffeine-releasable intracellular calcium stores
      only at 2-3 days stage, and from the previously reported developmental appearance
      of calcium currents and contraction, it was proposed that, in young myotubes, the
      calcium transients were more dependent on extracellular calcium than in older
      cells. These developmental data are discussed in the light of a known model of
      the in situ biogenesis of the structures involved in excitation-contraction
      coupling (ECC) like transverse tubules and triads.

PMID- 8370070
TI  - Calbindin D28K expression in transfected mouse NIH3T3 cells.
AB  - Calbindin D28K (formerly known as vitamin D-dependent calcium binding protein and
      referred to here as calbindin) is found in a wide variety of tissues, but only in
      certain cells within those tissues. Apart from its ability to bind calcium,
      nothing is known about its function in these cells. To investigate its role we
      have transfected the chick calbindin cDNA into mouse NIH3T3 fibroblasts and
      established a new cell line where calbindin is permanently expressed.
      Immunofluorescence studies show that calbindin is distributed throughout the
      cytoplasm, and treatment of the cells with cycloheximide shows that it has a
      relatively long half-life within the cell. Measurements of intracellular calcium
      concentration using Fura-2 suggest that the presence of calbindin within the
      cells does not affect the increase in intracellular calcium levels which occurs
      in response to serum stimulation or the rate at which these return to the basal
      level, but that it may act as a buffer for the entry of extracellular calcium.

PMID- 8370071
TI  - Multiple derangements of cytokine homeostasis in mice infected with
      immunosuppressive retrovirus.
AB  - Altered production of various lymphokines is considered an important factor in
      retrovirus-induced immunosuppression. We have measured the production of
      interleukin 2 (IL-2), interleukin 6 (IL-6), transforming growth factor beta 1
      (TGF-beta 1), and tumor necrosis factor alpha (TNF-alpha) in splenocytes of
      retrovirus-infected NMRI mice. In Con A-stimulated splenocytes from mice infected
      with the acute transforming retrovirus Friend leukemia complex (FLC), TNF-alpha
      and IL-6 production was significantly suppressed. We compared cytokine production
      in infection with Friend-derived murine immunosuppressive virus (Fd-MIV), a low
      oncogenic retrovirus that induces a immunosuppression of a magnitude similar to
      that of FLC. In Fd-MIV infection, the ability of lymphoid cells to produce both
      IL-2 and TNF-alpha was suppressed. The suppression of these cytokines coincided
      with the suppression of the primary antibody response. In contrast to FLC
      infection, the production of IL-6 was elevated. Furthermore, increased production
      of TGF-beta was found in unstimulated splenocytes from Fd-MIV-infected mice.
      Infection with immunosuppressive retroviruses induces a complex derangement of T
      cell cytokine homeostasis and the relative contributions of the various factors
      to the immunosuppressed state are difficult to assess at present.

PMID- 8370072
TI  - Bidirectional modulation of human B cell stimulation by activated T cells.
AB  - Although human T cells have been shown to exert effects of both help and
      suppression on B cells, the precise sequelae for these different effects have not
      yet been delineated. The present study therefore examined in detail the functions
      of human peripheral blood T cells activated for various periods by immobilized
      anti-CD3 to modulate B cell responses. CD4+ (CD45RA+ or CD45RA-) or CD8+ (CD45RA+
      or CD45RA-) T cell subsets were cultured in wells with immobilized anti-CD3 for
      as long as 20 days. At various periods of time, these activated T cells were
      harvested and cocultured with either fresh resting B cells or preactivated B
      cells. CD4+ and CD8+ T cells, irrespective of their expression of the CD45RA
      molecule, were able to stimulate resting B cells to express transferrin receptor
      (CD71) and IL-2 receptor (CD25) up to 17 days after activation with immobilized
      anti-CD3, although CD8+ but not CD4+ T cell subsets appeared to become less
      potent in stimulating resting B cells after 17 days of activation. By contrast,
      these CD4+ and CD8+ T cell subsets activated by immobilized anti-CD3 suppressed
      the maturation of the B cells preactivated with anti-CD3-stimulated CD4+ T cells,
      at the same time as when they provided help for resting B cells. The suppression,
      but not the help, was abrogated by treatment of the T cells with mitomycin C up
      to 13 days after activation. The suppression was not abrogated by addition of
      exogenous IL-2, irrespective of the length of stimulation of suppressor-effector
      T cells. These results indicate that human activated T cells can provide help and
      suppression simultaneously, irrespective of their phenotypes. Moreover, the data
      suggest that the state of activation of B cells might be important in determining
      the functions of the activated T cells.

PMID- 8370073
TI  - Rat splenocytes inhibit antigen-specific lymphocyte proliferation through a
      reactive nitrogen intermediate (RNI)-dependent mechanism and exhibit increased
      RNI production in response to IFN-gamma.
AB  - Rat splenocytes inhibited antigen-specific proliferation of primed lymph node
      cells in vitro. This inhibition resided in the plastic-adherent splenocyte
      fraction and was radioresistant, suggesting that the effect was due to
      macrophages. While this suppression was more evident if spleen cells were derived
      from immunized rats, spleen cells from normal rats were just as suppressive when
      added to cocultures at higher numbers. Proliferative responses were greatly
      enhanced in the presence of NG-monomethyl-L-arginine, a specific inhibitor of the
      nitric oxide synthetic pathway, and significant levels of nitrite (NO2-), a
      product of this pathway, were detected in culture supernatants in association
      with suppressed responses, supporting the notion that suppression was mediated by
      the L-arginine-dependent production of reactive nitrogen intermediates (RNI).
      When the splenocytes were physically separated from the responding lymph node
      cell population, high levels of NO2- were still detected but proliferative
      responses were no longer inhibited, suggesting that cell proximity or contact is
      necessary for delivery of the suppressive signal. Adherent splenocytes cultured
      alone produced low levels of NO2-. Addition of 1 to 50 U/ml IFN-gamma induced a
      dose-dependent increase in NO2- production, with the maximal level approximating
      that found in suppressed cocultures; TNF-alpha, IL-2, or LPS did not synergize
      with IFN-gamma to enhance NO2- production. These findings suggest that by
      activating macrophages to upregulate RNI synthesis, IFN-gamma-producing T cells
      may exert a negative influence over their own proliferation.

PMID- 8370074
TI  - Adoptive transfer of experimental autoimmune dacryoadenitis in susceptible and
      resistant mice.
AB  - Strains of mice with diverse genetic backgrounds were compared for their ability
      to develop experimental autoimmune dacryoadenitis (EAD) after immunization with a
      purified lacrimal gland antigen (LG-Ag) in complete Freund's adjuvant.
      Susceptibility to the induction of EAD was linked to the murine H-2
      histocompatibility background. SJL/J mice with the H-2s haplotype were the most
      susceptible to EAD, developing extensive cellular infiltration of the lacrimal
      gland, but those with the H-2d haplotype (BALB/c mice) or H-2q haplotype (DBA/J
      mice) were resistant to EAD, having little or no infiltration of the lacrimal
      gland. There was no correlation between the development of EAD and either the
      antibody response or the in vitro lymphocyte proliferative response to LG-Ag. The
      differences in the induction of EAD observed between susceptible and resistant
      strains resided in the different capacity of their lymphocytes to transfer
      disease. Splenocytes from susceptible SJL/J mice sensitized with LG-Ag in CFA
      could be activated in vitro with LG-Ag to transfer disease to normal syngeneic
      recipients. The capacity for adoptive transfer was abrogated by treatment with
      anti-Thy 1.2 antibody plus complement, an indication that T cells are responsible
      for the transfer of EAD. However, EAD cannot be transferred with the donor cells
      from resistant mice even after they have been cultured in vitro with LG-Ag. These
      results suggest that T cells play a major role in the induction of EAD and that
      variations in susceptibility are under the control of distinct genetically
      inherited mechanisms that may include active suppression.

PMID- 8370075
TI  - Studies of the cellular immune response to heparan sulfate proteoglycan in the
      tight skin mouse.
AB  - As in human scleroderma, tight skin (TSK/+) mice develop cutaneous hyperplasia
      with over-production of extracellular matrix, including collagen and
      proteoglycans, associated with autoimmunity to a number of autoantigens. The
      present study investigated the presence of cellular autoimmunity to basement
      membrane heparan sulfate proteoglycan (HSPG) in diseased TSK/+mice and their
      nondiseased littermates, pallid mice (+/pa). Lymphocyte proliferative responses
      to specific HSPG antigens, including intact HSPG, HSPG protein core (P. Core),
      and the glycosaminoglycan heparan sulfate (HS) were studied. Splenocytes from
      young TSK and control pallid mice reacted weakly to intact HSPG and HSPG P. Core
      antigens and did not respond to HS. However, lymphocytes from old TSK mice were
      reactive with HSPG and P. Core and demonstrated a de novo response to HS. The
      proliferative response to intact HSPG and HSPG P. Core in TSK mice was T cell
      dependent, but the response to HS was T cell independent. The T cell-dependent
      response was mediated by the CD4-positive subset and required the participation
      of class II major histocompatibility complex molecules. Cellular autoimmunity to
      HSPG, a critical cell surface and extracellular matrix component, may play a role
      in the disease suffered by TSK mice. Further studies are necessary to determine
      the mechanisms which link autoimmunity to HSPG with the pathology seen in TSK
      mice, particularly the overproduction of extracellular matrix and fibrosis.

PMID- 8370076
TI  - Chromium and tritiated thymidine releases from target cells are differential
      events in human monocyte/macrophage-mediated cytotoxicity.
AB  - Cytotoxic properties of human activated macrophages were investigated by
      measuring both 51Cr and [3H]TdR releases from prelabeled target cells. The
      kinetic study of macrophage-mediated cytotoxicity indicated that 51Cr and [3H]TdR
      releases showed a distinct time course. Next, when [3H]TdR release was measured
      as a parameter for cytotoxicity, pretreatment of activated macrophages with
      either actinomycin D or emetine remarkably decreased their cytotoxicity in a dose
      dependent manner. In contrast, the pretreatment with these inhibitors had little
      effect on 51Cr release. Furthermore, the addition of Zn2+ in the assay medium
      caused the decrease in [3H]TdR release but not 51Cr release from the target
      cells. Taken together, our findings indicate that 51Cr and [3H]TdR releases from
      the target cells are induced by activated macrophages through different cytotoxic
      mechanisms; the former does not require RNA and protein syntheses in macrophages
      during coculture, whereas the latter requires them. Our findings also suggest
      that macrophage-derived nuclease may play an important role for inducing [3H]TdR
      release from the target cells.

PMID- 8370077
TI  - B cell differentiation. II. Isotype potential of a single B cell.
AB  - Clonal, functionally responsive B cells are important tools for analyzing B cell
      activation and differentiation. Previously, we developed a method to immortalize
      murine B lymphoblast cells using an oncogene-carrying retroviral vector. The
      immortalized B cells express a cell surface phenotype similar to that of normal
      splenic B cells. These cells were shown to respond to B cell polyclonal mitogens
      and IL-4. More significantly, these cells could form conjugates with TH2 cells in
      the presence of a T cell superantigen. The T-B interaction promoted by the T cell
      superantigen resulted in B cell differentiation as demonstrated by IgM secretion
      and switching to IgG1 production. In this report, we analyze Ig isotype potential
      using two retrovirus-immortalized B cell clones. The clonality of both B cell
      clones was confirmed by Southern blot analysis using JH probes. It was found that
      anti-CD3-activated TH1 and TH2 cells promoted clonal B cells to differentiate
      into IgM-secreting cells. More significantly, activated TH1 cells promoted clonal
      B cells to switch to IgG2a production, whereas activated TH2 cells promoted
      clonal B cells to switch to IgG1 production. Thus, depending on which type of T
      helper cell a given B cell interacts with, a single B cell has the potential to
      switch to more than one Ig isotype. Addition of rIL-4 and anti-IFN-gamma to
      cultures containing TH1 and B cells resulted in IgG1 production (in addition to
      IgG2a production). Similarly, addition of IFN-gamma and anti-IL-4 to cultures
      containing TH2 and B cells resulted in IgG2a production (in addition to IgG1
      production). Therefore, interaction of B cells with a given type of T helper
      cells could commit the B cells to a given Ig isotype. However, the presence of
      exogenous cytokines could divert B cells to switch to other Ig isotypes.

PMID- 8370078
TI  - Retinoids enhance IgA production by lipopolysaccharide-stimulated murine spleen
      cells.
AB  - The effect of all-trans retinoic acid (RA) and vitamin A on IgA production by LPS
      stimulated murine spleen cells was studied. Concentrations of immunoglobulins of
      six subclasses in the culture medium were determined. Only IgA level increased,
      RA dose dependently. In contrast, IgG1 level decreased and other subclasses (IgM,
      IgG2a, IgG2b, and IgG3) were not significantly affected by the treatment. IgA
      levels in LPS-stimulated spleen cells were usually between 10 and 100 ng/ml. When
      RA was added at the concentrations above 0.1 nM, the levels were increased dose
      dependently and peak response (8- to 20-fold) was observed from 0.1 to 1 microM.
      Enhancement of IgA secretion begins after 4 days culture and then increases
      linearly until Day 7. Vitamin A also showed IgA-enhancing activity, although its
      activity was about 1/170 of that of RA. TGF-beta activity in the culture medium
      was also determined, finding that RA rapidly stimulates secretion of biologically
      active TGF-beta, the elevation being evident after 1 day of culture. Specific
      neutralizing antibodies to TGF-beta 1 and TGF-beta 2 partially inhibited IgA
      enhancement caused by RA. These results suggest that retinoids at physiological
      concentrations may act as positive regulators for IgA production and the effect
      may be mediated, at least in part, via the induction of active TGF-beta.

PMID- 8370079
TI  - Suppression of local and systemic GVHR by supernatants from human choriocarcinoma
      cell lines.
AB  - Graft versus host reaction (GVHR) and host versus graft reactivity during
      pregnancy share at least some cellular pathways. Immunosuppression mediated by
      placental suppressor factors may actively contribute to the survival of the
      conceptus in the immunocompetent mother. We have previously reported that
      supernatants from human choriocarcinoma cell lines inhibit mitogen-activated and
      antigen-activated proliferation of lymphoid cells. From this perspective, we
      investigated the capacity of supernatants from human choriocarcinoma cell lines
      (HCS) to suppress in vivo graft versus host reactions in mice. HCS was tested for
      its ability to block both local as well as systemic GVHR induced by the injection
      of parental cells into F1 mice. HCS mediates profound suppression of acute and
      chronic GVHR. These results confirm that human choriocarcinoma cell lines secrete
      a potent immunosuppressive factor(s) which can efficiently modulate immune
      responses in vivo.

PMID- 8370080
TI  - Inhibitors of cytochrome P450 suppress tumor necrosis factor production.
AB  - We tested the effect of different inhibitors of cytochrome P450 on tumor necrosis
      factor (TNF) production. Metyrapone and SKF525A (100 and 50 mg/kg, ip,
      respectively) suppressed serum TNF induced by cotreatment with endotoxin (LPS),
      (2.5 micrograms/mouse). Inhibition was independent of endogenous corticosteroids
      since it was also observed in adrenalectomized mice. In vitro production of TNF
      by endotoxin-stimulated human monocytes was also inhibited by metyrapone and
      SKF525A. Since lipoxygenase (LO) inhibitors also block TNF production and
      metyrapone was reported to inhibit LO, we suggest that inhibition by metyrapone
      and SKF525A might be due to inhibition of either LO or a cytochrome P450
      implicated in the oxidation of endogenous substrates involved in the inflammatory
      response.

PMID- 8370081
TI  - Double-negative (L3T4-, Lyt2-) thymocytes of autoimmune lpr/lpr mice are
      resistant to down-regulation of DNA synthesis by a thymic stromal cell product.
AB  - The murine autosomal recessive gene, lpr, induces a progressive lymphadenopathy
      and lupus-like autoimmune syndrome characterized by the accumulation of immature,
      dull Thy 1.2+, TCR+, L3T4-/Lyt 2- (double-negative, DN) T cells in peripheral
      lymphoid organs. Previous studies demonstrated that the thymic microenvironment
      is required for the generation of the abnormal, peripheral DN T cells, while a
      more recent report linked the lpr gene defect with a failure of thymocytes to
      express a functional form of the Fas antigen, which mediates apoptosis. Thus, the
      lpr gene defect apparently prevents lpr thymocytes from responding to the ordered
      sequence of differentiation and proliferation signals involved in normal
      thymocyte maturation and selection. We compared the responses of thymocytes from
      C57BL/6 +/+ (normal) and congenic C57BL/6 lpr/lpr (lpr) mice to a thymic stromal
      cell product which down-regulates DNA synthesis in vitro. The results indicate
      that (a) thymic stromal cells from lpr mice produce a factor that can down
      regulate DNA synthesis as efficiently as that from normal mice, even at an age
      when massive lymphadenopathy is present, (b) mitogen-stimulated thymocytes of
      normal, but not lpr, mice are sensitive to the inhibitory factor, (c) normal DN
      thymocytes are the cellular target of the inhibitory factor, which acts at some
      postmembrane receptor-ligand binding event during mitogen-stimulated
      proliferation, and (d) IL-4-dependent DN thymocyte proliferation seems to be the
      main target of the inhibitory factor.

PMID- 8370082
TI  - Both human and mouse cells expressing H-2Kb and ovalbumin process the same
      peptide, SIINFEKL.
AB  - HeLa cells, derived from a human cervix carcinoma line, were transfected with a
      mouse MHC class I gene, H-2Kb, and chicken ovalbumin. H-2Kb-restricted cytotoxic
      mouse T cells specific for ovalbumin recognized the double-transfected human
      cells with similar efficiency as ovalbumin-transfected EL4 mouse thymoma cells (H
      2b). The naturally processed ovalbumin T cell epitope was eluted from H-2Kb
      molecules from double-transfected HeLa cells and was biochemically compared to a
      synthetic peptide, SIINFEKL, known to be the natural Kb ligand of ovalbumin
      transfected H-2b mouse cells. The results indicate that the ovalbumin-derived Kb
      ligand of double-transfected HeLa cells is also SIINFEKL. Thus, both human cervix
      carcinoma cells and mouse thymoma cells expressing Kb and ovalbumin process the
      same octapeptide. Together with previous data, derived by comparing Kb ligands of
      unknown sequences from both human and mouse cells expressing Kb, it can be
      concluded that both mouse and human cells are capable of processing the same
      ligands for mouse MHC class I molecules. Hence, the general specificity of the
      peptide-generating mechanism for class I ligands is apparently conserved between
      evolutionary distant species.

PMID- 8370083
TI  - Immunotargeting of thyroglobulin on antigen presenting cells abrogates natural
      tolerance in the absence of adjuvant.
AB  - Mice usually develop strong IgG responses to self-thyroglobulin (Tg) following
      immunization with mouse Tg (mTg) emulsified in complete Freund's adjuvant (CFA).
      Here we report that adjuvant-free challenge of mice with small doses of mTg
      conjugated onto a monoclonal antibody (MAb) specific for class II MHC
      determinants (anti-I-Ak) induces an mTg-specific IgG response in CBA (H-2k) but
      not in B6 (H-2b) mice. This is not a result of nonspecific uptake of
      immunoconjugate or chemical modification of mTg because mTg conjugated in a
      similar manner to a control MAb (specific for influenza nucleoprotein) of the
      same IgG subclass as the anti-I-Ak MAb did not elicit an autoimmune response.
      Despite the presence of mTg-specific IgG with titers equal to those observed
      after challenge with mTg in CFA, thyroid lesions were not detected in CBA mice
      that received mTg-(anti-I-Ak Mab) conjugate indicating a clear divergence in the
      requirements for autoantibody production and disease. The data suggest that small
      amounts of soluble autoantigen, conjugated onto MAbs specific for determinants
      expressed on antigen-presenting cells (APC), can effectively abrogate natural
      tolerance perhaps via a targeting mechanism that focuses autoantigen on APC. This
      approach may help elucidate the role of various APC subsets in autoimmunity and
      allow the study of initial events that trigger autoreactivity outside a CFA
      induced granuloma site.

PMID- 8370084
TI  - Antibodies for treating and preventing disease: the potential role of polymeric
      controlled release.
AB  - Following the identification of antibodies (Abs) as agents of immunity, it was
      hypothesized that individuals could be both (1) protected against disease by the
      transfer of unmodified Ab (passive immunization), and (2) cured of established
      disease by Ab armed with cytotoxic agents (immunotherapy). The development of
      monoclonal antibody (mAb) technology in 1975 reinvigorated these ideas. Although
      passive immunization has been practiced with great success for many years,
      successful tissue targeting by systemically delivered immunotoxins in humans has
      been documented in only a few cases. New modes of drug delivery, engineered for
      mAb-based products, may enable new applications of passive immunization and may
      provide improved tissue targeting for immunotherapy. By allowing sustained and
      tissue-localized delivery of mAb-conjugates, controlled-release polymers may play
      an important role in this effort. This article reviews the use of mAb in treating
      and preventing human disease, as well as the pharmacokinetics of Ab delivery. Two
      areas where controlled Ab release may yield new therapies are highlighted:
      sustained passive immunization of the mucus secretions and immunotherapy of brain
      tumors.

PMID- 8370085
TI  - Gastroretentive dosage forms.
AB  - This article begins with a review of gastric emptying, small intestine transit,
      and colonic transit of drug delivery systems with special attention paid to the
      different physiological processes involved in stomach emptying and to the cut-off
      size of nondigestible solids for passage through the gastroduodenal junction
      during the digestive phase. Then, the proposed means for prolonging the gastric
      residence time (GRT) of drug delivery systems are reviewed and analyzed with
      special emphasis on floating (F) dosage forms. The following means are discussed:
      the use of passage-delaying agents, large single-unit dosage forms, bioadhesive
      drug delivery systems, "heavy" pellets, and buoyant forms. In the section devoted
      to bioadhesive forms, the influence of the turnover time of the intestinal mucus
      gel layer on the performance of mucoadhesive preparations is pointed out to
      explain the poor results obtained in humans with such peroral products. The use
      of a specifically designed apparatus for measuring the total force acting
      vertically on an object immersed in a liquid is presented as a methodology for
      selecting optimized buoyant formations in vitro. Scintigraphic studies are
      described in nonfasting human volunteers either in upright or in supine posture,
      who concurrently were given one optimized F and one nonfloating (NF) hydrophilic
      matrix capsules of the same size, for three different sizes (small, medium, and
      large). In upright subjects, the F forms stayed continuously above the gastric
      contents irrespective of their size, whereas the NF ones sank rapidly after
      administration and never rose back to the surface thereafter. Consequently, the F
      forms show prolonged and more reproducible GRTs compared to the NF ones. The
      significance and extent of this prolongation are the most marked for the small
      size units (p < 0.001) but gradually lessen as the dosage form size increases (p
      < 0.05 for the medium size units), to become insignificant for the large size
      units (p > 0.05). Moreover, there is no significant difference between the mean
      GRTs of the small, medium, and large F units (p > 0.05). This indirectly confirms
      that the intragastric buoyancy of the F forms is the main process determining
      their prolonged GRT and protecting them from random gastric emptying related to
      antral peristaltism. Thus, their GRT depends mainly on the occurrence of the end
      point of digestion. To the contrary, the lasting retention of the NF forms in the
      stomach is only size dependent.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 8370087
TI  - Treatment of Jehovah's Witnesses.

PMID- 8370086
TI  - Treating epilepsy--when, with what and by whom?

PMID- 8370088
TI  - National drug quality assurance system.

PMID- 8370089
TI  - Minimally invasive therapy.

PMID- 8370090
TI  - Changing trends in maternity care in Sri Lanka.

PMID- 8370091
TI  - Fungal skin infections in a paediatric dermatology clinic.
AB  - A diagnosis of fungal infection was established in 8.6% of patients who attended
      the dermatology clinic at the Lady Ridgeway Hospital, Colombo over a one year
      period. Only 4.3% were confirmed in the laboratory. The agreement between
      clinical and laboratory diagnosis was 96.6% for patients with typical clinical
      features, but only 26.4% for patients who did not have the classical appearance.
      Both direct microscopy and culture are required to determine the causative agent,
      although the majority (92%) of patients could be diagnosed on microscopy alone.
      Microsporum gypseum was the commonest fungus isolated from children.

PMID- 8370092
TI  - Effect of treatment on maximal expiratory flow rates in tropical eosinophilia.
AB  - Maximal expiratory flow rates such as peak expiratory flow rate (PEFR), rates at
      25%, 50% and 75% of vital capacity (VE max 25%, VE max 50%, VE max 75%) and
      forced expiratory flow during the middle half of forced vital capacity (FEF 25
      75%) were recorded in 23 patients with tropical eosinophilia (TE) before and
      after treatment. The mean values of all flow rates were significantly lower (P <
      0.001) in untreated TE patients compared to predicted values. After three weeks'
      treatment with diethylcarbamazine, although there was a significant rise in the
      mean values of all expiratory flow rates (P < 0.05) except VE max 75% (P > 0.2),
      all flow rates continued to be significantly lower (P < 0.01) at one month than
      predicted values.

PMID- 8370093
TI  - Is drainage necessary after cholecystectomy?
AB  - There is controversy on the use of drains after cholecystectomy. This study was
      undertaken to test the claim that routine drainage after cholecystectomy was
      unnecessary. Results from 62 patients in whom cholecystectomy was performed
      without additional procedures on the biliary tract, demonstrated that there were
      no complications attributable to the absence of a drain. It is concluded that
      avoiding drainage does not interfere with a smooth outcome after cholecystectomy.
      On the contrary, it has distinct advantages.

PMID- 8370095
TI  - Aplastic anaemia complicating hepatitis A virus infection.
AB  - We report three patients with aplastic anaemia complicating hepatitis A virus
      infection. The pathogenesis and management of this rare complication which
      usually carries a poor prognosis, are briefly discussed.

PMID- 8370094
TI  - Management of missle injuries in a combat zone in Sri Lanka.
AB  - This series comprises 527 missile victims of armed combat managed at Base
      Hospital, Polonnaruwa (BHP) during a five year period commencing January 1984.
      The injuries were multiple and involved many regions of the body. The results are
      compared with recent reports from other countries with similar conflicts. The
      inadequacy of first aid and the lack of organised transport for the victims are
      emphasised with suggestions to improve the care of such patients.

PMID- 8370096
TI  - Acute pulmonary embolism in a patient with nephrotic syndrome.
AB  - Pulmonary embolism is a rare complication of nephrotic syndrome. We report the
      case history of a 30 year old man who presented with nephrotic syndrome and
      became acutely dyspnoeic with cyanosis and peripheral circulatory failure while
      on treatment. The clinical and ECG findings were strongly suggestive of acute
      pulmonary embolism.

PMID- 8370097
TI  - Dermoid cyst of the caecum.
AB  - Dermoid cysts of the caecum are rare and only four cases have been reported in
      the literature. They are sequestration cysts and are lined by squamous epithelium
      with skin appendages. Aetiologically these cysts may represent squamous
      metaplasia of enterogenous cysts or sequestration cysts due to epidermal
      inclusion at the time of closure of the neural groove.

PMID- 8370098
TI  - Sensible drinking? Why not a sensible smoking goal too?

PMID- 8370099
TI  - Eliminating leprosy from Sri Lanka--the launch of a social marketing campaign.

PMID- 8370100
TI  - Gait apraxia and headache.

PMID- 8370101
TI  - Effect of phosphatidylcholine and cholesterol on pH-sensitive liposomes.
AB  - We previously reported that liposomes composed of phosphatidylethanolamine (PE)
      and fatty acid exhibited pH-dependent leakage, aggregation and fusion (N.
      Hazemoto, M. Harada, N. Komatubara, M. Haga and Y. Kato, Chem. Pharm. Bull., 38,
      748 (1990)). In this study, we have examined the effects of phosphatidylcholine
      (PC) and cholesterol (Chol) on the pH-sensitivity of liposomes. Contents-leakage
      from liposomes was always accompanied by a change in light-scattering, suggesting
      that aggregation or fusion of liposomes causes the leakage. The pH-sensitivity
      was observed only when liposomes contained less than 32 mol% of PC. The leakage
      vs. pH curves shifted to the more acidic regions as the PC content of the
      liposomes increased, but the maximum leakage (%) did not change. The effect of
      cholesterol on the pH-sensitivity depended on the PC/PE ratio of the liposomes.
      Addition of cholesterol to PC/PE/oleic acid (OA) liposomes system induced two
      effects, that is, aggregation of liposomes via the reduction in PC content and
      the stabilization of the liposomal membrane. It was shown that pH-sensitivity can
      be controlled by addition of the appropriate amount of PC and/or Chol to
      liposomal lipids.

PMID- 8370102
TI  - Investigation of the dimethylsulfoxide-trifluoroacetic acid oxidation system for
      the synthesis of cystine-containing peptides.
AB  - Disulfide bonds of peptides were effectively established between S-protected
      cysteine residues as well as free cysteine residues by the action of
      dimethylsulfoxide in trifluoroacetic acid. Oxytocin and alpha-human calcitonin
      gene-related peptide were synthesized using this oxidation system. The
      feasibility of this method for the formation of two disulfide bridges of apamin
      was also examined.

PMID- 8370103
TI  - Optically active antifungal azoles. I. Synthesis and antifungal activity of
      (2R,3R)-2-(2,4-difluorophenyl)-3-mercapto-1-(1H-1,2,4-triazol-1-yl)-2-b utanol
      and its stereoisomers.
AB  - (2R,3R)-2-(2,4-Difluorophenyl)-3-mercapto-1-(1H-1,2,4-triazol-1-yl )-2-butano l
      [(2R,3R)-7] and its stereoisomers [(2S,3R)-, (2S,3S)- and (2R,3S)-7] were
      prepared from the optically active oxiranes 6 by a newly developed ring-opening
      reaction and evaluated for antifungal activity. The thiol (2R,3R)-7 showed
      extremely potent antifungal activity in vitro and in vivo. The optically active
      oxirane (2R,3S)-6, a useful intermediate for the synthesis of sulfur-containing
      antifungal azoles 5, was synthesized from methyl (R)-lactate [(R)-8] via eight
      steps in a stereocontrolled manner. The key step in the synthesis is the Grignard
      reaction of an amide derivative [(R)-12a] of (R)-lactic acid with 2,4
      difluorophenyl-magnesium bromide (13).

PMID- 8370105
TI  - Synthesis and antihypertensive activities of new 1,4-dihydropyridine derivatives
      containing nitrooxyalkylester moieties at the 3- and 5-positions.
AB  - We have synthesized new 1,4-dihydropyridine derivatives having nitrooxyalkylester
      moieties at the 3- and 5-positions in order to develop potent and long-lasting
      vasodilators. The antihypertensive activities of these compounds were compared
      with that of nifedipine. One of them, 2-nitrooxypropyl 3-nitrooxypropyl 2,6
      dimethyl-4-(3-nitrophenyl)-1,4-dihydro-3,5- pyridinedicarboxylate (CD-349) was
      selected for further development. The structure-activity relationship is
      discussed.

PMID- 8370104
TI  - Optically active antifungal azoles. II. Synthesis and antifungal activity of
      polysulfide derivatives of (2R,3R)-2-(2,4-difluorophenyl)-3-mercapto-1-(1H- 1,2,4
      triazol-1-yl)-2-butanol.
AB  - In an effort to find potent antifungal agents, a variety of optically active
      triazole derivatives with a polysulfide structure, 3, 4 and 5, were prepared and
      evaluated for antifungal activity against Candida albicans in vitro and in vivo.
      The symmetrical polysulfides 3 (m = 2-4) were obtained by an oxidative coupling
      reaction of (2R,3R)-2-(2,4-difluorophenyl)-3-mercapto-1-(1H-1,2,4-triazol-1-yl )
      2-butanol (1) or by the treatment of its thiocarbonate derivative 8 with
      potassium tert-butoxide. The unsymmetrical disulfides 5 were synthesized by the
      reaction of the thiol 1 with Bunte salts 11 or the thiosulfinate 12 or by the
      reaction of the thiocarbonate 8 with various thiols 13. All of these polysulfides
      showed potent antifungal activity against candidosis in mice.

PMID- 8370106
TI  - Structure-activity study of antihypertensive 1,4-dihydropyridine derivatives
      having nitrooxyalkyl moieties at the 3 and 5 positions.
AB  - 1,4-Dihydropyridine derivatives having two nitrooxyalkyl moieties as esters at
      the 3 and 5 positions possess antihypertensive activity. To understand how
      substituents affect the biological activity, the quantitative structure-activity
      relationship (QSAR) of 27 compounds was analyzed using the Fuzzy adaptive least
      squares (FALS 91) method. The QSAR models suggested that the hydrophobicity and
      electronic effect at the 4 position of the 1,4-dihydropyridine along with the
      special structures of the nitrooxyalkylester components are important for
      antihypertensive activity.

PMID- 8370107
TI  - Synthesis and pharmacological activities of novel cyclic disulfide and cyclic
      sulfide derivatives as hepatoprotective agents.
AB  - In order to search for anti-hepatitis drugs, we synthesized a series of eight-
      and nine-membered cyclic disulfides (1) and six- and seven-membered cyclic
      sulfides (2) and evaluated them for ability to reduce mortality in the model of
      acute hepatic failure induced by Propionibacterium acnes-lipopolysaccharide in
      mice. Compounds 1 were synthesized by oxidative cyclization of the corresponding
      dithiol derivatives (3) with diethyl bromomalonate or iodine. Compounds 2 were
      prepared from the methyl esters of 1 by desulfurization with
      tris(diethylamino)phosphine followed by deprotection. Compounds 1 were generally
      found to be more active than compounds 2. Compound 1b (SA3443) was found to
      exhibit potent protective activity. The synthesis and structure-activity
      relationships are discussed.

PMID- 8370108
TI  - Development of active center-directed plasmin and plasma kallikrein inhibitors
      and studies on the structure-inhibitory activity relationship.
AB  - The molecule of trans-4-aminomethylcyclohexanecarbonylphenylalanine 4
      carboxymethylanilide (8), which is a potent and selective inhibitor of plasma
      kallikrein, can be divided into three parts (P1, P1' and P2'), each of which
      contains one of the rings. In order to study the role of each part in the
      manifestation of potent and selective inhibitory activity and the relationship
      between the structure and inhibitory activities toward plasmin, plasma
      kallikrein, urokinase and thrombin, each part was substituted with various other
      moieties to give many kinds of analogs and their inhibitory activities against
      the above enzymes were examined. Among them, trans-4
      aminomethylcyclohexanecarbonyl-O-2-bromobenzyloxycarbon yltyrosine 4
      acetylanilide (12) inhibited plasmin and plasma kallikrein with IC50 values of
      2.3 x 10(-7) M and 3.7 x 10(-7) M, and K(i) values of 1.2 x 10(-7) M and 1.3 x
      10(-7) M, respectively.

PMID- 8370109
TI  - 1,4:3,6-Dianhydrohexitol nitrate derivatives. I. Synthesis and antianginal
      activity of alkylpiperazine derivatives.
AB  - A series of 5-deoxy-5-(4-substituted piperazin-1-yl)-1,4: 3,6-dianhydro-L-iditol
      2-nitrates was prepared and evaluated for oral anti-ischemic activities.
      Inhibition of lysine-vasopressin-induced T-wave elevation in the
      electrocardiogram (ECG) of rats (angina pectoris model) served as a primary
      assay. Optimum activity was observed for the compounds with the aryl-heteroatom
      (O,S, or N)-propyl group. Among them, the phenylthiopropyl-substituted compound
      13 exhibited the most potent activity. Furthermore, intraduodenal administration
      (i.d.) of 13 tended to decrease left ventricular end-diastolic pressure (LVEDP)
      in a propranolol-induced heart failure model (dogs) and showed a potent
      protective effect against reperfusion arrhythmia in rats. Thus, 13 (KF 14124) is
      under further study as an orally active nitrate.

PMID- 8370110
TI  - 1,4:3,6-Dianhydrohexitol nitrate derivatives. II. Synthesis and antianginal
      activity of aryl- or arylcarbonylpiperazine derivatives.
AB  - A series of 5-(4-aryl- or 4-arylcarbonylpiperazin-1-yl)-5-deoxy-1,4: 3,6
      dianhydro-L-iditol 2-nitrates was prepared in order to obtain orally active,
      nitrate-type vasodilators with reduced side effects. Our drug design was based on
      a small reduction in the lipophilicity compared to that of 5-deoxy-5-[4-(3
      phenylthiopropyl)piperazin-1-yl]-1,4: 3,6-dianhydro-L-iditol 2-nitrate (1,
      KF14124). Compounds 4h (aryl = benzimidazol-2-yl), 4i (arylcarbonyl =
      nicotinoyl), and 4w (arylcarbonyl = 3-furoyl) showed potent anti-ischemic
      activity in a lysine-vasopressin-induced angina pectoris model (rats), and their
      structure-activity relationships are discussed. Compound 4i exhibited potent
      vasodilation of the coronary artery in anesthetized dogs and also exhibited
      potent preload reduction in a heart failure model (dogs) as compared with
      isosorbide dinitrate (2), nicorandil (3), and KF14124 (1). Furthermore, 4i showed
      much weaker acute lethal toxicity and less central nervous system depression than
      1 in mice. Thus, 4i (KW-3196) is under development as a vasodilator and a drug
      for treating angina pectoris.

PMID- 8370111
TI  - A widely applicable electrode sensitive to basic drugs based on poly(vinyl
      chloride) membrane plasticized with tricresyl phosphate.
AB  - A plastic membrane ion-selective electrode applicable to many basic drugs has
      been developed. The electrode developed was constructed with tricresyl phosphate
      and a poly(vinyl chloride) matrix on a polytetrafluoroethylene film. The
      electrode showed a near-Nernstian response to chlorpromazine, trihexyphenidyl,
      imipramine, dibucaine, papaverine, propranolol, tetracaine, trazodone, quinidine
      and cinnarizine. The determination of 50 to 3000 micrograms/ml of trazodone
      hydrochloride in a pH 4.0 acetate buffer solution showed an average recovery of
      99.4% (mean standard deviation 0.7%) by direct potentiometry. Inorganic cations
      and pharmaceutical excipients did not interfere with the determination. Trazodone
      hydrochloride and trihexyphenidyl hydrochloride in tablets were determined, and
      the results compared favorably with those obtained by conventional methods.

PMID- 8370112
TI  - Senegoses A--E, oligosaccharide multi-esters from Polygala senega var. latifolia
      Torr. et Gray.
AB  - From the roots of Polygala senega var. latifolia Torr. et Gray five new
      oligosaccharides, called senegoses A--E, were isolated and their structures were
      elucidated by spectroscopic and chemical means. These oligosaccharides were
      esterified with acetic, benzoic, trans-ferulic and cis-ferulic acids.

PMID- 8370113
TI  - Design and preparation of ethyl cellulose microcapsules of gadopentetate
      dimeglumine for neutron-capture therapy using the Wurster process.
AB  - Microcapsules of hygroscopic, highly water-soluble gadopentetate dimeglumine (Gd
      DTPA-DM) for use in preliminary in vivo experiments for neutron-capture therapy
      were designed. They were prepared with such properties as a particle size small
      enough to be suspended and injected through a syringe, a negligible release of Gd
      DTPA-DM, and a high drug content by means of the Wurster process, a spray coating
      method using a spouted bed with a draft tube. They were composed of lactose cores
      of 53-63 microm, an undercoat of ethyl cellulose (EC) and polyvinylpyrrolidone
      (PVP), a drug-layer of Gd-DTPA-DM, EC and PVP, a waterproof coat and a release
      sustaining overcoat of EC and cholesterol (1:1), and a surface treated with
      hydrogenated egg lecithin. By curing at 110 degrees C for 30 min after mixing
      with 20% pulverized mannitol powder, the 20% overcoating suppressed the release
      of Gd-DTPA-DM from 75-106 microm microcapsules to less than 10% for the first 20
      min, which was the period required to prepare a suspension, inject it and
      irradiate the neutron. The microcapsules could be used to confirm that the
      intracellular presence of Gd is not critical in gadolinium neutron-capture
      therapy.

PMID- 8370114
TI  - Preparation and pharmacological evaluation of N3-substituted thymidine
      derivatives as central depressants.
AB  - Central depressant effects in mice of N3-substituted thymidines (Td) (1) were
      examined by intracerebroventricular (i.c.v.) injection. Nine derivatives
      including the methyl, ethyl, propyl, allyl, benzyl, xylyl and alpha-phenylethyl
      derivatives at the N3-position of 1 were synthesized and their pharmacological
      effects were evaluated by using hypnotic activity, pentobarbital-induced sleep
      prolongation and locomotor activity as indices for central depressant effects. At
      a dose of 2.0 mumol/mouse, the values of mean sleeping time induced by N3
      benzylthymidine (6), N3-o-xylylthymidine (7), N3-m-xylylthymidine (8), N3-p
      xylylthymidine (9) and N3-alpha-phenylethylthymidine (10) were 61, 30, 48, 45 and
      23 min, respectively. These derivatives (2.0 mumol/mouse) prolonged pentobarbital
      induced (40 mg/kg, i.p.) sleeping time. None of the alkyl (2-4) or allyl (5)
      derivatives exerted hypnotic activity, although the derivatives tested (2-10)
      significantly prolonged the pentobarbital-induced sleeping time. Compound 1 and
      its xylyl derivatives tested (0.25 mumol/mouse, i.c.v.) decreased locomotor
      activity. These results indicate that thymidine derivatives have central
      depressant activity, and the benzyl derivatives but not alkyl derivatives possess
      a hypnotic activity.

PMID- 8370115
TI  - Cytotoxic sesquiterpenes from Nardostachys chinensis.
AB  - Five cytostatic sesquiterpenes, desoxo-narchinol-A (1), nardosinone (2), debilon
      (3), nardosinonediol (4) and kanshone A (5), were isolated from the roots and
      rhizomes of Nardostachys chinensis (Valerianaceae). The steric structure of 1 was
      determined by nuclear Overhauser effects (NOEs) and the exciton chirality method.
      All five showed cytotoxic activity against P-388 cells and the structure-activity
      relationship of 1 was also discussed.

PMID- 8370116
TI  - Isolation of camelliaside C from "tea seed cake" and inhibitory effects of its
      derivatives on arachidonate 5-lipoxygenase.
AB  - A new flavonol glycoside, camelliaside C, was isolated from "tea seed cake"
      prepared from the defatted seeds of Camellia sinensis O. Kuntze. The structure
      was determined as kaempferol 3-O-beta-D-galactopyranosyl-(1-->2)-beta-D
      glucopyranoside by spectroscopic methods (FAB-MS, UV, IR, 1H- and 13C-NMR) and
      the enzymatic transformation of camelliaside C to astragalin. Camelliaside C
      showed an inhibitory effect on the arachidonate 5-lipoxygenase of RBL-1 cells
      (IC50:1.4 x 10(-4)M) as did camelliaside A and B isolated from the same product.

PMID- 8370117
TI  - Sulfoorientalols a, b, c, and d, four new biologically active sesquiterpenes from
      Alismatis rhizoma.
AB  - Four new sesquiterpenes, sulfoorientalols a, b, c, and d, having a sulfonic acid
      function were isolated from Chinese Alismatis Rhizoma. Their structures were
      determined on the basis of chemical and physicochemical evidence.
      Sulfoorientalols inhibited the contraction of isolated bladder smooth muscle
      induced by carbachol.

PMID- 8370118
TI  - Ca2+ and segment length dependence of isometric force kinetics in intact ferret
      cardiac muscle.
AB  - The influence of Ca2+ and sarcomere length on myocardial crossbridge kinetics was
      studied in ferret papillary muscle by measuring the rate of force redevelopment
      following a rapid length step that dropped the force to zero. Tetanic stimulation
      with 5 mumol/L ryanodine was used to obtain a steady-state contraction, and
      segment length was measured and controlled using a sense-coil technique that
      measures changes in the cross-sectional area of the central region of the muscle.
      The rate constant for the recovery of force (ktr) following a rapid length
      release was obtained by fitting the data with a single exponential function.
      Contrary to results from skinned skeletal fibers in which ktr increases almost 10
      fold from low to maximal activation levels, ktr was found not to increase at
      higher activation levels in this study. Similarly, although force increased with
      segment length under all conditions, ktr never increased with length. Data
      presented here are consistent with a model of myocardial Ca2+ activation in which
      Ca2+ modulates the number of crossbridges interacting with the thin filament and
      are inconsistent with a model in which Ca2+ modulates the kinetics of transitions
      to force producing states within the actomyosin cycle. Differences in the
      activation dependence of the force redevelopment rate between cardiac and
      skeletal muscle suggest that there are fundamental differences in the mechanism
      of Ca2+ activation between these two muscle types.

PMID- 8370119
TI  - Molecular structure and transcriptional function of the rat vascular AT1a
      angiotensin receptor gene.
AB  - Rat vascular angiotensin receptors (AT1a receptors) are encoded by two mRNA
      transcripts sharing an identical receptor coding sequence but differing in their
      5' and 3' untranslated sequences. We screened male Sprague-Dawley rat genomic
      libraries to clone the vascular AT1a receptor gene. Two sets of overlapping
      clones were isolated that encode over 90 kb of genomic sequence around the AT1a
      receptor gene. Four overlapping clones were identified from the 5' flanking
      portion of the gene. These contain the promoter region and two exons, 141 bp and
      89 bp in size, respectively, encoding the alternatively spliced 5' untranslated
      mRNA sequence. Six additional clones overlap each other but do not overlap the
      set of clones from the 5' flanking region of the gene. These contain a single
      1977-bp exon that encodes 900 bp of the 5' and 3' untranslated sequences in
      addition to a 1077-bp open reading frame identical to that found in vascular
      smooth muscle cell AT1a receptor cDNAs. Primer extension and RNase protection
      studies indicate that the transcription start site for this gene begins 9 bp
      upstream from the most 5' sequence found within the AT1a receptor cDNAs. Our
      mapping studies of the cloned gene, which so far includes an uncloned gap within
      the second intron, indicate that the transcription start site is no less than 67
      kb upstream from the receptor coding exon. Promoter-reporter assays were
      performed by transfection of vascular smooth muscle cells with deletions of a 3.2
      kb promoter region fused to a luciferase cDNA reporter plasmid. Relatively strong
      basal transcriptional activity is observed from the 5'-most 2 kb of the promoter
      and diminishes markedly with deletions within 1 kb of the early promoter region,
      suggesting strong promoter elements in the more upstream regions of the gene.
      Deletion of a 53-bp early promoter region containing the transcription start site
      and a putative TATA box completely abolishes the ability of upstream elements to
      drive transcription of the luciferase cDNA. These results indicate that we have
      isolated the AT1a receptor gene and its functional promoter.

PMID- 8370121
TI  - Heart-specific targeting of firefly luciferase by the myosin light chain-2
      promoter and developmental regulation in transgenic mice.
AB  - Based on hybridization studies indicating constitutive expression levels of the
      endogenous myosin light chain-2 (MLC-2) gene in embryonic, fetal, and adult
      myocardium, a model system for selective targeting of genes to the heart of
      transgenic mice has been developed. A 2.1-kb DNA fragment of the 5' flanking
      region of the rat cardiac MLC-2 gene was fused to the firefly luciferase reporter
      gene and introduced into fertilized mouse oocytes. In four independent transgenic
      mouse lines, the expression of the MLC-2-luciferase fusion gene was found
      exclusively in heart muscle. In contrast to the endogenous MLC-2 gene, no
      luciferase activity was detectable in slow-twitch skeletal muscle or any other
      tissue of transgenic mice. This result suggests that the 2.1-kb DNA fragment of
      the 5' flanking region of the cardiac MLC-2 gene contains the regulatory elements
      required for selective gene expression in cardiac myocytes in vivo. In contrast
      to the endogenous steady-state MLC-2 expression during development, transgenic
      luciferase activity was 10-fold higher during embryogenesis, when formation of
      the ventricular loop and septum takes place. The enhanced luciferase activity in
      early heart development may suggest a growth-dependent control mechanism,
      involving either transcriptional or posttranscriptional regulation. In
      conclusion, this model system with the 2.1-kb ventricle-specific MLC-2 promoter
      sequence should facilitate the overexpression of gene products in the developing
      and mature heart muscle and further elucidate molecular mechanisms of myocardial
      diseases such as cardiomyopathies.

PMID- 8370120
TI  - Characterization of promoter elements of the rabbit cardiac sarcoplasmic
      reticulum Ca(2+)-ATPase gene required for expression in cardiac muscle cells.
AB  - The sarcoplasmic reticulum Ca(2+)-ATPase (SERCA2) plays a critical role in the
      contractile performance of cardiac and slow-twitch skeletal muscle by restoring
      cytosolic calcium to low resting levels during the contractile cycle. We have
      previously shown that SERCA2 expression in the heart is altered by a number of
      pathophysiological stimuli. In an effort to define molecular mechanisms
      regulating expression of the SERCA2 gene in cardiac muscle cells, deletions of a
      1460-bp promoter fragment were generated and inserted into a luciferase reporter
      plasmid. Promoter constructs were transiently transfected into embryonic
      cardiocytes and skeletal muscle cell lines Sol 8 and C2C12 in vitro and injected
      into adult myocardium in vivo. Results demonstrate that sequences from the
      transcription start site to -284 are both necessary and sufficient for high-level
      transcription of the reporter gene in differentiating muscle cells and in fetal
      cardiocytes in culture. We further demonstrate that this promoter fragment is
      highly active in vivo when injected into rat hearts, suggesting that the same
      regulatory elements are functional in vivo as well as in vitro. The region of the
      gene from -284 to -658 exerts a modest positive effect in cardiocytes and Sol 8
      myotubes but exerts a negative effect in C2C12 fast skeletal muscle cells. This
      initial analysis of transcriptional regulation of the SERCA2 gene will serve as a
      foundation for the study of alterations of expression of the gene in pathological
      conditions.

PMID- 8370122
TI  - Malondialdehyde and glutathione production in isolated perfused human and rat
      hearts.
AB  - A number of studies show the relation between oxygen-derived free radicals and
      cardiac ischemia/reperfusion injury. However, little is known about oxidative
      stress in the human heart, which can be measured by oxidized glutathione (GSSG)
      and malondialdehyde (MDA) formation. Furthermore, data on MDA production by rat
      hearts are controversial, possibly because of the use of the aspecific
      thiobarbituric acid assay. Therefore, GSSG and MDA were measured, with
      colorimetric and high-performance liquid chromatographic assays, respectively, in
      buffer-perfused explanted human hearts and normal rat hearts made temporarily
      ischemic. Human hearts received cardioplegia; rat hearts were studied in a
      control and an ischemic group with or without cardioplegia. Baseline GSSG release
      was < 0.01 nmol.min-1.g wet wt-1 in both species. During reperfusion, GSSG
      release from human hearts and from ischemic and cardioplegic/ischemic rat hearts
      peaked at 0.24 +/- 0.12, 1.1 +/- 0.4, and 0.19 +/- 0.04 nmol.min-1.g-1,
      respectively. MDA was undetectable (< 0.02 nmol.min-1.g-1) in the effluent of
      both species and in human hearts (< 4 nmol/g protein). Rat heart reduced
      glutathione levels decreased 32% as a consequence of cardioplegia and ischemia.
      Cardioplegia induced a 41% (P = .08) decrease in rat heart MDA content, whereas
      cumene hydroperoxide increased it 3.6 times (P < .01). Thus, after ischemia human
      and rat hearts release GSSG, indicating that oxidative stress has occurred.
      Apparently, lipid peroxidation takes place in normal rat hearts, decreases after
      cardioplegia, but does not increase after ischemia/reperfusion. Human hearts lack
      MDA under normoxic and ischemic conditions. This novel finding seems to reflect a
      low MDA-forming potential in both situations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370123
TI  - Selective induction of an embryonic fibronectin isoform in the rat aorta in
      vitro.
AB  - The temporal changes in the expression of fibronectin and other extracellular
      matrix genes were studied in rat aortic rings incubated in vitro in a serum-free
      medium. Changes in all forms of fibronectin mRNA increased progressively during
      the 24-hour incubation period, although an increase in the alternatively spliced
      form of fibronectin designated EIIIA was most pronounced. Both collagen and
      elastin mRNA levels decreased markedly during the 24-hour interval, as did alpha
      actin mRNA. The increase in the relative amount of the EIIIA isoform after a 24
      hour incubation was also shown using ribonuclease protection assays. In situ
      hybridization showed the distribution of the induced fibronectin mRNA to be
      within all cell types, including endothelial cells, medial smooth muscle cells,
      and adventitial fibroblasts. Localization in the media was not uniform and was
      clearly identified mainly in clusters of cells distributed throughout the media.
      The early induction of fibronectin mRNA was inhibited by genistein, implicating
      tyrosine kinase activation as a causative factor in fibronectin expression. The
      in vitro changes reported may reflect a phenotypic change in vascular cell types
      that is both similar to and different from the changes reported in vivo under
      conditions in which vascular injury and repair occur.

PMID- 8370124
TI  - Dynamic interaction between cardiac myosin isoforms modifies velocity of
      actomyosin sliding in vitro.
AB  - To study the functional significance of cardiac isomyosin heterogeneity, active
      sliding of actin-myosin was studied using two different types of in vitro
      motility assay systems: (1) a sliding actin filament assay, in which
      fluorescently labeled actin filaments were made to slide on a myosin layer
      attached to a glass coverslip, and (2) a myosin-coated bead assay, in which
      myosin-coated latex beads were made to slide on actin cables of an alga. Two
      different isomyosins were obtained from 3-week-old (V1) and hypothyroid (V3) rat
      hearts and were mixed to form solutions with various mixing ratios [V1/(V1 +
      V3)]. For these myosin mixtures, both ATPase activity and sliding velocity of
      actin-myosin were determined. As the relative content of V1 increased, both
      ATPase activity and velocity increased. However, in contrast to the linear
      relation between the mixing ratio and ATPase activity, the relation between the
      mixing ratio and sliding velocity was sigmoid, suggesting the existence of
      mechanical interaction between different isomyosins. To clarify the nature of
      this interaction, sliding velocity was measured for mixtures of V1 and p-N,N'
      phenylene-dimaleimide-treated V1 myosin (pPDM-M). A convex relation was observed
      between the relative content of pPDM-M and velocity. Because pPDM-M is known to
      form a noncycling and weakly bound crossbridge with actin, it is expected to
      exert a constant internal load on V1, in contrast to the actively cycling V3. In
      conclusion, in actomyosin sliding, different isomyosins mechanically interact
      when they coexist. The interaction may be a dynamic one that cannot be explained
      by a simple load effect.

PMID- 8370125
TI  - Spontaneous sarcomeric oscillations at intermediate activation levels in single
      isolated cardiac myofibrils.
AB  - Spontaneous oscillations observed in various heart muscle preparations are widely
      thought to be triggered by spontaneous release of Ca2+ from the sarcoplasmic
      reticulum (SR). Here, we report undamped propagated oscillations that occur in
      the absence of SR. In single cardiac myofibrils treated with Triton X-100 to
      remove SR and held isometrically, partial activation initiated periodic
      fluctuations of sarcomere length persisting up to 1 hour. Oscillation
      characteristics could be readily quantitated by virtue of the small size of the
      preparation. In an individual sarcomere, the oscillation cycle generally
      consisted of a slow shortening phase, followed by a phase of rapid lengthening.
      Oscillations usually propagated along the myofibril--frequently along the entire
      specimen--in a wavelike fashion (average velocity, 12.3 microns/s at 10 degrees
      C; Q10, approximately 1.3). The oscillation period was 2.30 and 1.72 seconds at
      10 degrees and 20 degrees C, respectively, and was insensitive to stretch. The
      average oscillation amplitude, which was temperature independent, decreased with
      stretch from more than 20% of the mean sarcomere length at lengths below 2
      microns to zero beyond a sarcomere length of 3 microns. Stiffening of the Z line
      by labeling with anti-alpha-actinin resulted in a dose-dependent decrease of
      oscillation amplitude, while the period was not affected. Tension oscillations
      could not be detected in single myofibrils but were frequently detectable in
      myofibril doublets, where the oscillation magnitude (approximately 1 microgram)
      was above the noise floor. Addition of 10 mumol/L ryanodine to the activating
      solution did not alter oscillation characteristics, as expected, since the
      oscillations are unrelated to SR calcium release. On the basis of our results, we
      consider a mechanism for the oscillations in which a length dependence of
      myofibrillar Ca2+ sensitivity and a dynamic Z-line structure are essential.

PMID- 8370126
TI  - Glibenclamide, a putative ATP-sensitive K+ channel blocker, inhibits coronary
      autoregulation in anesthetized dogs.
AB  - We tested the hypothesis that ATP-sensitive K+ channels are involved in the
      mechanism mediating coronary autoregulation in open-chest dogs. We perfused the
      left anterior descending coronary artery with arterial blood from an
      extracorporeal circuit and measured steady-state coronary blood flow (CBF) with
      stepwise changes in coronary perfusion pressure (CPP) between 50 and 150 mm Hg
      during an intracoronary infusion of vehicle or glibenclamide (a putative blocker
      of ATP-sensitive K+ channels). CBF was relatively stable over CPP between 50 and
      110 mm Hg during vehicle infusion, indicating the presence of autoregulation at
      the CPP range. During glibenclamide infusion (10 micrograms.min-1 x kg-1), CBF
      progressively decreased with reduction in CPP below 110 mm Hg, whereas the CPP
      CBF relation at CPP above 110 mm Hg was not altered by glibenclamide. The
      autoregulation index [1-(delta F/F)/(delta P/P), where F indicates CBF and P
      indicates CPP] was greater than 0 over the CPP range between 50 and 100 mm Hg
      during vehicle infusion and was less than 0 during glibenclamide infusion.
      Glibenclamide did not alter systemic arterial pressure, heart rate, left
      ventricular pressure, and changes in regional myocardial oxygen consumption
      associated with changes in CPP. In the absence of glibenclamide, the CPP-CBF
      relation was reproducible in the repeated studies for time control. These results
      suggest that ATP-sensitive K+ channels play an important role in mediating
      coronary autoregulation at the lower range of CPP in the blood-perfused dog
      heart.

PMID- 8370127
TI  - The treatment of women with hirsutism.

PMID- 8370128
TI  - The impact of a pure anti-androgen (flutamide) on LH, FSH, androgens and clinical
      status in idiopathic hirsutism.
AB  - OBJECTIVES: We assessed in women the effects of androgen suppression on
      gonadotrophin secretion and the therapeutic efficacy of the pure anti-androgen
      flutamide (2-methyl-N-[4-nitro-3-(trifluoromethyl)phenyl]-propanamide). DESIGN
      AND SUBJECTS: Ten women, aged 28-35 years, using an intrauterine device for
      contraception, were selected for this study. All women had idiopathic hirsutism
      with or without acne and seborrhoea. Flutamide was administered orally in a dose
      of 250 mg twice daily for 1 year. Basal body temperature was recorded and pelvic
      ultrasonography performed before and every 3 months during treatment. LH pulse
      frequency and amplitude (Cluster analysis) and basal and GnRH-stimulated plasma
      LH and FSH levels were determined on day 5 of the cycle prior to flutamide
      treatment, and after 6 and 12 months of therapy. Plasma total testosterone (T),
      non-SHBG bound T, androstenedione (A), dehydroepiandrosterone sulphate (DHEAS),
      androstanediol glucuronide (3 alpha-diol G) and sex hormone binding globulin
      (SHBG) levels were measured before and every 3 months during therapy, on day 5 of
      the cycle. Plasma oestradiol and progesterone levels were determined on day 22 of
      the studied cycles. RESULTS: Disappearance of acne and seborrhoea occurred after
      2 months with a marked improvement of hirsutism at 6 months. At 12 months,
      hirsutism had disappeared with a Ferriman and Gallwey score < 7. No adverse side
      effects, apart from transient diarrhoea in two patients, were reported with this
      flutamide dose. None of the patients had any disturbance of menstrual cycles
      which remained ovulatory. The pure anti-androgen flutamide induced no significant
      change in LH pulsatile profile, nor in LH and FSH responsiveness to GnRH. Plasma
      concentrations of steroids were not altered. Plasma SHBG and 3 alpha-diol G
      levels did not change during flutamide treatment. CONCLUSION: Flutamide, which
      interacts only with the androgen receptor, is effective for hirsutism, acne and
      seborrhoea, and does not disturb menstrual cyclicity or ovulation. It may
      represent a treatment of choice for essential hirsutism in women using safe
      contraceptive methods.

PMID- 8370129
TI  - Circadian variation in serum free and non-SHBG-bound testosterone in normal men:
      measurements, and simulation using a mass action model.
AB  - OBJECTIVE: We measured the changes in testosterone fractions in serum of normal
      men over a 24-hour period, and determined whether they could be simulated on the
      basis of current understanding of the interactions between steroids and binding
      proteins in the blood. DESIGN: Starting from between 0830 and 0930 h, blood
      samples were taken every 45 minutes for 25.5 hours. PATIENTS: Five healthy males
      aged 26-45 years. All participants worked on a hospital campus and while being
      sampled carried out their normal activities during waking hours. MEASUREMENTS:
      The concentrations of testosterone (RIA) and albumin, and the percentage non-sex
      hormone binding globulin-bound testosterone (ammonium sulphate precipitation) and
      percentage free testosterone (rate dialysis), were measured on each sample.
      Cortisol (RIA) and sex hormone-binding globulin (SHBG) (IRMA) concentrations were
      measured on every second sample, and that of corticosteroid-binding globulin on
      two samples from each series. RESULTS: In all participants the levels of free and
      non-SHBG-bound testosterone in early morning samples (near 0530 h) were
      significantly different from those taken before midnight (P < 0.0005).
      Significant circadian rhythms (P < 0.05) in the concentration of testosterone and
      in the level of the free fraction were detected in all participants, and in four
      of the five participants for the non-SHBG-bound fraction. The amplitude of the
      free testosterone rhythm (34 +/- 2% of basal) was greater than that for
      testosterone itself (24 +/- 3% of basal). The 24-hour rhythm of the non-SHBG
      bound fraction was similar to the total and free fractions except for the period
      0330-0900 h when the level of this fraction declined by 15-45% over 1.5-3 hours.
      This decline was coincident with the initial rise in the concentration of
      cortisol. A decline of 10.5 +/- SEM 1.0% in the concentration of albumin, and
      12.0 +/- 1.1% in that of SHBG occurred when the mean ambulant and supine levels
      were compared; analysis indicated significant circadian rhythms in the
      concentrations of these proteins. Simulation was used to investigate possible
      causes for the circadian rhythms in free and non-SHBG-bound testosterone.
      Simulation results matched the measured data well in qualitative terms, but
      quantitatively there were differences. CONCLUSIONS: Increasing saturation of the
      binding proteins following rises in testosterone production, and the small but
      significant changes in protein concentration, probably related to postural
      changes, were implicated as the major factors in the rhythm amplitude. However,
      the early morning decline in the non-SHBG-bound fraction was not explained by
      these factors. The rise in cortisol concentration at this time is a probable
      cause. Alternatively, simulation suggests that a substance appearing in the early
      morning and competing with testosterone for albumin binding sites may be
      responsible.

PMID- 8370130
TI  - Molecular heterogeneity of serum follicle-stimulating hormone in hypogonadal
      patients before and during androgen replacement therapy and in normal men.
AB  - OBJECTIVE: The present study was performed to characterize the molecular
      heterogeneity of serum FSH in normal males and to investigate the possible
      influence of testosterone on serum FSH in androgen-deficient men before and
      during testosterone administration. DESIGN AND PATIENTS: Serum samples were taken
      at 10-minute intervals between 0730 and 0830 h from nine healthy, eugonadal men
      and from eight men with primary hypogonadism (Klinefelter's syndrome). In the
      hypogonadal patients, sampling was performed before treatment (n = 8), 4-5 days
      after the first and the third injection of 250 mg testosterone enanthate given
      intramuscularly at three-weekly intervals (n = 6), as well as 3 months after the
      onset of therapy (n = 3). Sampling was repeated 7 days apart in two of the nine
      healthy volunteers. MEASUREMENTS: Aliquots from the individual serum samples were
      pooled and fractionated by chromatofocusing in the pH range 6-3. Immunoreactive
      FSH was measured by immunofluorometric assay (IFMA) in each fraction and the
      individual serum samples. In each serum pool, bioactive FSH was determined by in
      vitro bioassay (rat Sertoli cell aromatase bioassay), testosterone by RIA and LH
      by IFMA. RESULTS: After grouping the percentage of immunoreactive FSH recovered
      in the individual fractions into intervals of 0.5 pH units, significant
      differences between controls and patients were observed in the pH regions 4-4.5,
      5.5-6 and 6-6.5. No statistically significant changes in the isoform distribution
      of FSH were detected during therapy in the Klinefelter patients. A high degree of
      variability, which did not follow a common pattern, was observed in the isoform
      distribution of FSH within the same individuals, both in the hypogonadal patients
      during treatment and in the two normal men whose blood samples were taken on two
      different occasions. CONCLUSIONS: Serum FSH is highly heterogeneous in normal and
      hypogonadal men. There is a spontaneous intra-individual variability in the
      relative abundance of the different FSH isoforms in serum that may most probably
      be related to metabolic deglycosylation of FSH. Minor but significant differences
      in the molecular heterogeneity of serum FSH could be demonstrated in Klinefelter
      patients compared to normal men. These differences are not modified by
      administration of testosterone enanthate at doses achieving normal
      androgenization, suggesting that factors different from testosterone may modulate
      FSH pleomorphism.

PMID- 8370132
TI  - Melatonin stimulates growth hormone secretion through pathways other than the
      growth hormone-releasing hormone.
AB  - OBJECTIVE: There is evidence that melatonin plays a role in the regulation of GH
      secretion. The aim of this study was to investigate the neuroendocrine mechanisms
      by which melatonin modulates GH secretion. Thus we assessed the effect of oral
      melatonin on the GH responses to GHRH administration and compared the effects of
      melatonin with those of pyridostigmine, a cholinergic agonist drug which is
      likely to suppress hypothalamic somatostatin release. DESIGN: The study consisted
      of four protocols carried out during the afternoon hours. Study 1: oral melatonin
      (10 mg) or placebo were administered 60 minutes prior to GHRH (100 micrograms
      i.v. bolus). Study 2: GHRH (100 micrograms i.v. bolus) or placebo were
      administered at 0 minutes; oral melatonin or placebo were given at 60 minutes and
      were followed by a second GHRH stimulus (100 micrograms i.v. bolus) at 120
      minutes. Study 3: placebo; oral melatonin (10 mg); oral pyridostigmine (120 mg);
      melatonin (10 mg) plus pyridostigmine (120 mg) were administered on separate
      occasions. Study 4: placebo; oral melatonin (10 mg); oral pyridostigmine (120
      mg); melatonin (10 mg) plus pyridostigmine (120 mg) were administered on separate
      occasions 60 minutes prior to a submaximal dose (3 micrograms i.v. bolus) of
      GHRH. SUBJECTS: Four groups of eight normal male subjects, ages 22-35 years, were
      randomly assigned to each protocol. MEASUREMENTS: Growth hormone was measured by
      RIA at 15-minute intervals. RESULTS: Oral melatonin administration had a weak
      stimulatory effect on GH basal levels. Prior melatonin administration
      approximately doubled the GH release induced by supramaximal (100 micrograms) or
      submaximal (3 micrograms) doses of GHRH. Melatonin administration restored the GH
      response to a second GHRH challenge, given 120 minutes after a first GHRH i.v.
      bolus. The GH releasing effects of pyridostigmine, either alone or followed by
      GHRH, were greater than those of melatonin. However, the simultaneous
      administration of melatonin and pyridostigmine was not followed by any further
      enhancement of GH release, either in the absence or in the presence of exogenous
      GHRH. CONCLUSIONS: Our data indicate that oral administration of melatonin to
      normal human males increases basal GH release and GH responsiveness to GHRH
      through the same pathways as pyridostigmine. Therefore it is likely that
      melatonin plays this facilitatory role at the hypothalamic level by inhibiting
      endogenous somatostatin release, although with a lower potency than
      pyridostigmine. The physiological role of melatonin in GH neuroregulation remains
      to be established.

PMID- 8370131
TI  - Evening administration of melatonin enhances the pulsatile secretion of prolactin
      but not of LH and TSH in normally cycling women.
AB  - OBJECTIVE: The aim of the study was to evaluate the effects of exogenous
      melatonin on the spontaneous pulsatile release of PRL, TSH and LH in normal
      women. DESIGN: A double blind placebo-controlled protocol was designed to study
      seven subjects in the mid follicular phase of two non-consecutive cycles. Two mg
      of exogenous melatonin or placebo were given at 1600 and 2000 h, and blood
      samples were collected every 10 minutes from 1800 to 2400 h for hormone
      determination. RESULTS: Melatonin treatment caused a significant upward resetting
      of the pulsatile pattern of PRL in six out of seven subjects. Average maximal
      peak height was significantly increased (median 716 mIU/l (range 198-1433) on
      melatonin vs 324 mIU/l (212-688) on placebo, P < 0.001), nadir value (572 mIU/l
      (148-1084) vs 216 mIU/l (54-580), P < 0.001) and area under the peak (26352 mIU/l
      min (5904-93672) vs 12096 mIU/l min (2340-33552), P < 0.001), whereas peak
      number, amplitude and interpeak interval did not change significantly. TSH
      pulsatility was unaffected by melatonin administration in four out of six
      subjects. Distribution of LH patterns after melatonin was inhomogeneous: level of
      pulsatility was higher in two cases and reduced in three; group analysis did not
      therefore show significant variation of pulsatility parameters. CONCLUSIONS:
      Exogenous melatonin has a stimulatory effect on PRL release without affecting the
      temporal pattern of its pulsatile secretion in normal women. Melatonin has minor,
      if any, effect on TSH secretion whereas the effect on LH may depend on individual
      sensitivity.

PMID- 8370133
TI  - Urinary growth hormone excretion in the assessment of children with disorders of
      growth.
AB  - OBJECTIVE: We wished to evaluate the use of urinary GH measurements when compared
      to conventional GH provocation tests in the assessment of short children. DESIGN:
      Children presenting for the first time to a regional growth clinic were assessed
      clinically by one observer. Investigations comprising standard GH provocation
      tests and measurement of urinary GH were undertaken to exclude GH deficiency.
      PATIENTS: Fifty-eight children aged 5.8-16 years were enrolled. Ten were
      diagnosed on clinical assessment as GH deficient, 43 had delayed growth and/or
      familial short stature, and five had idiopathic short stature; the 48 children in
      the last two groups were defined as short normal. MEASUREMENTS: GH secretion was
      evaluated by two standard provocation tests and by the measurement of GH in five
      overnight urine collections. A normal peak GH concentration was defined as > 16
      mU/l. The values for urinary GH excretion were compared to normal ranges (+/- 2
      standard deviations from the mean), established in healthy schoolchildren of
      normal stature. RESULTS: All children considered GH deficient on clinical grounds
      had low peak GH concentrations on provocation tests, while 8/10 had low values of
      urinary GH excretion. All short normal children with normal peak GH
      concentrations (n = 36) on provocation tests and 11/12 children with low peak GH
      concentrations had urinary GH excretion within the normal range. There was
      therefore a significant difference in the classification of 'normal' GH secretion
      in the two tests. If the clinical diagnosis was used as the standard by which GH
      tests were judged, the predictive value of a positive urinary GH test in the
      diagnosis of GH deficiency was 89% compared with 45% for GH provocation tests.

PMID- 8370134
TI  - In-vitro response of erythroid progenitors from children with thalassaemia major
      to human growth hormone and insulin-like growth factor I.
AB  - OBJECTIVE: Most short-statured children with beta-thalassaemia major have
      markedly reduced levels of circulating insulin-like growth factor I (IGF-I). Both
      human growth hormone (hGH) and IGF-I enhance the in-vitro growth of erythroid
      progenitors, with hGH exerting its effects via paracrine production of IGF-I. The
      aim of this study was to characterize further the hGH-IGF-I axis abnormalities in
      thalassaemia major by evaluating the erythroid potentiating effects of both
      peptides in cultures of thalassaemic and control erythroid progenitors. DESIGN:
      Ten short-statured thalassaemic children and nine age-matched healthy donors were
      evaluated for the in-vitro response of their peripheral blood erythroid
      progenitors to stimulation with hGH and IGF-I. MEASUREMENTS: The frequency of
      erythroid progenitors in serum-free cultures of thalassaemic and control
      peripheral blood mononuclear cells was enumerated following 14 days of incubation
      in the presence of hGH or IGF-I. RESULTS: Biosynthetic hGH induced a similar dose
      dependent magnitude of colony enhancement in cultures of erythroid progenitors
      from thalassaemic children, as compared to controls. Significant enhancement of
      colony growth was detected at 42 mU/l hGH, with a maximal effect detected at 83
      mU/l of this hormone (173 +/- 8 vs 153 +/- 9% of baseline erythroid progenitors
      in patients versus controls, respectively). Enhancement of both thalassaemic and
      control erythroid precursors by hGH was completely abrogated by monoclonal
      antibodies (alpha IR-3) directed against the IGF-I membrane receptor, thereby
      confirming the normal capacity of thalassaemic accessory cells to produce IGF-I
      in response to hGH. Biosynthetic IGF-I also enhanced the growth of thalassaemic
      and control erythroid precursors to 172 +/- 17 and 159 +/- 10% of baseline at 100
      and 10 U/l, respectively. CONCLUSIONS: Our detection of a normal capacity of
      thalassaemic peripheral blood target cells to response to hGH and IGF-I suggests
      that these patients do not suffer from a specific defect in receptor and/or post
      receptor mechanism(s) involving the response of these cells to both peptides. The
      normal responsiveness of thalassaemic target cells to hGH and IGF-I suggests that
      both peptides may be useful in the treatment of growth retardation in
      thalassaemia.

PMID- 8370135
TI  - Protein intake during aggressive calorie restriction in obesity determines growth
      hormone response to growth hormone-releasing hormone after weight loss.
AB  - OBJECTIVE: We evaluated the influence of two types of calorie restriction, total
      fast or very low calorie diet, on GH responsiveness to GHRH in severely obese
      patients. DESIGN: Twenty patients with massive obesity underwent one of two types
      of calorie restriction, total fast (10 patients) or very low calorie diet (10
      patients). MEASUREMENTS: Fasting GH, IGF-I, glucose, insulin and GH secretion
      after GHRH (100 ug i.v.) were assessed in all patients before and after diet
      therapy. RESULTS: Both types of diet produced similar weight reduction (total
      fast, 5.6 +/- 1.6 kg/m2 vs very low calorie diet, 5.6 +/- 1.5 kg/m2 mean +/- SD).
      A significant increase in the integrated GH secretion was observed after weight
      loss with very low calorie diet (17 +/- 9 vs 27 +/- 12 mU/l min; P < 0.05).
      However, no change was found in GH response after weight loss with total fast (13
      +/- 5 vs 15 +/- 7 mU/l min). Glucose, insulin and IGF-I levels showed a
      significant decrease with weight reduction which was similar for both groups.
      CONCLUSION: These findings suggest that the type of dietary manipulation during
      calorie restriction in obese patients may influence the changes in GH response to
      GHRH after weight loss.

PMID- 8370136
TI  - Deficient inactivation of cortisol by 11 beta-hydroxysteroid dehydrogenase in
      essential hypertension.
AB  - OBJECTIVE: 11 beta-Hydroxysteroid dehydrogenase protects renal mineralocorticoid
      receptors from cortisol by converting cortisol to inactive cortisone. 11 beta
      Dehydrogenase deficiency, either congenital or after inhibition by liquorice and
      carbenoxolone, results in cortisol-dependent mineralocorticoid excess and
      hypertension. We tested the hypothesis that the same mechanism occurs in some
      patients with essential hypertension. DESIGN/PATIENTS: Twenty patients with
      essential hypertension were compared with 19 matched healthy controls.
      MEASUREMENTS: 11 beta-Hydroxysteroid dehydrogenase activity was assessed by the
      half-life of 11 alpha-3H-cortisol, and by the ratios of cortisol to cortisone in
      plasma and of their metabolites in urine. Renal mineralocorticoid receptor
      activation was assessed by plasma potassium, renin activity and aldosterone.
      RESULTS: Half-lives of 11 alpha-3H-cortisol were prolonged in a subgroup of
      hypertensives (mean +/- SE 53.2 +/- 3.6 min in hypertensives vs 42.3 +/- 2.3 in
      controls, P < 0.05; seven of the 20 hypertensives had half-lives exceeding 2 SD
      of controls). Ratios of cortisol to cortisone in plasma and of their metabolites
      in urine were not different. 11 alpha-3H-Cortisol half-lives correlated with
      blood pressure but not with indices of renal mineralocorticoid receptor
      activation. CONCLUSIONS: 11 beta-Dehydrogenase is defective in a proportion of
      patients with essential hypertension. The normal ratios of cortisol to cortisone
      in plasma and of their metabolites in urine, also seen after carbenoxolone
      administration, suggest that 11 beta-reductase conversion of cortisone to
      cortisol is also defective. Unlike other syndromes of 11 beta-dehydrogenase
      deficiency, the defect was not associated with mineralocorticoid excess. We
      suggest that it may cause hypertension by increasing exposure of vascular steroid
      receptors to cortisol.

PMID- 8370137
TI  - A case of antibody formation against octreotide visualized with 111In-octreotide
      scintigraphy.
AB  - A case of antibody formation in a patient with carcinoid syndrome is described.
      The patient was treated with octreotide in dosages up to 1.5 mg/day. Serum
      samples were analysed for the presence of octreotide antibodies before and after
      20 months of octreotide treatment. In-vivo 111In-octreotide scintigraphy was
      performed before and during therapy, and after antibodies had developed. Before
      treatment, no serum antibodies against octreotide were detected. After 20 months
      of treatment, they were detectable up to a 1:115 serum dilution. The serum
      binding of 125I-Tyr3-octreotide was blocked by adding excess unlabelled Tyr3
      octreotide, indicating the presence of specific octreotide antibodies. Before
      treatment, a normal distribution of radioactivity in the spleen and kidneys,
      irregular uptake in the liver due to metastases, and a hot spot in the lower
      abdomen were found during 111In-octreotide scintigraphy. After antibodies had
      developed, increased radioactivity over the heart and high background
      radioactivity in the abdomen with only faint visualization of the spleen, liver,
      and kidneys were found, indicating a prolonged presence of 111In-octreotide in
      the blood resulting from its being bound to antibodies. Increased radioactivity
      was also seen at the injection sites of the drug in the upper legs. In-vitro
      incubation of biopsy tissue from this site with 125I-Tyr3-octreotide revealed
      diffuse guanosine triphosphate (GTP) independent specific binding, indicating non
      G-protein linked binding of labelled octreotide. This report describes the
      characteristic abnormalities during in-vivo 111In-octreotide scintigraphy in a
      patient with octreotide antibodies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370138
TI  - Deoxycorticosterone, 11 beta-hydroxylase and the adrenal cortex.
AB  - We report a child in whom DOC excess secondary to congenital adrenal hyperplasia
      (CAH, 11 beta-hydroxylase deficiency) caused malignant hypertension. Clinical and
      metabolic control could be achieved only by replacement of both glucocorticoid
      and mineralocorticoid, thus confirming in clinical practice the hypothesis that
      DOC is produced from both the zonae fasciculata and glomerulosa of the adrenal
      cortex under the independent control of the ACTH and renin-angiotensin systems
      respectively.

PMID- 8370139
TI  - Thyrotoxicosis increases right to left shunt in congenital cyanotic heart
      disease.
AB  - We wish to report two cases of congenital cyanotic heart disease in whom
      coexisting thyrotoxicosis increased the right to left shunt. We review the
      literature on the cardiac and respiratory effects of thyroid hormone to try to
      explain this phenomenon. Two patients, one with Fallot's tetralogy (diagnosed at
      68 years of age), the other with a ventricular septal defect, developed
      thyrotoxicosis which resulted in a dramatic but reversible deterioration in their
      cardiac condition. We conclude that thyrotoxicosis increases right to left shunt
      in congenital cyanotic heart disease. This effect is profound but reversible. We
      suggest that when an unexplained rapid deterioration occurs in patients with
      congenital cyanotic heart disease, thyrotoxicosis should be excluded.

PMID- 8370140
TI  - Factors influencing body weight regulation.
AB  - As obesity is a major health problem for both the adult and adolescent
      populations of the United States there is an increasing need to understand basic
      mechanisms that control the body weight of an individual. Body fat content in
      adults is determined by energy balance status which is influenced by both food
      intake and energy expenditure. Current evidence suggests a dominant role for
      control of intake although chronic exercise and genetic factors will influence
      body composition. The hypothalamus appears to be the brain area responsible for
      determining food selection and intake although it is not yet clear how central
      mechanisms modulate peripheral feeding and satiety responses.

PMID- 8370141
TI  - The gastrointestinal mucosal immune system.
AB  - The mucosal immune system, consisting of lymphoid tissues associated with the
      lacrimal, salivary, gastrointestinal, respiratory and urogenital tracts and
      lactating breasts, quantitatively contains the majority of the lymphoid tissue of
      the body. There are a number of important features of the gastrointestinal
      mucosal immune system: the mucosal immune system contains specialized structures,
      such as the Peyer's patches, where immune responses are thought to be initiated;
      there is a pattern of relatively specific recirculation of lymphoid cells to the
      mucosa, known as mucosal homing; subsets of lymphoid cells, particularly IgA B
      cells and memory T cells, predominate at mucosal surfaces; and the predominant
      mucosal immunoglobulin, secretory IgA, is particularly well adapted to host
      defense at mucosal surfaces. These elements of the gastrointestinal mucosal
      immune system function together to generate an immune response which on the one
      hand protects the host from harmful pathogens, but on the other hand is tolerant
      of the ubiquitous dietary antigens and normal microbial flora.

PMID- 8370142
TI  - Recent progress in senescence-associated gut mucosal immunity.
AB  - The immune response in gut-associated lymphoid tissues (GALT) is altered in the
      aging process. Senescence-induced quantitative decline and qualitative changes of
      GALT T and B cells and their subpopulations contribute largely to the impaired
      gut mucosal immune responses. Thus, not only direct cell-to-cell contact
      interactions, but also patterns of immuno-regulatory cytokine production and
      serum-soluble cytokine, such as interleukin-2 receptors are also altered, causing
      both cellular and humoral immune abnormalities in GALT. One of the characteristic
      features includes functional defects of suppressor T cells. As a consequence,
      relative hyperfunction of helper T cells ensures. The defective immune response
      of both function and control of aged GALT may help to explain the increased
      incidence of infection and neoplasia in the gastrointestinal tract with age. On
      the subcellular level, these aged T and B cells impair transmembranous signal
      transduction. Trials of immune interventions to reduce or reverse
      immunosenescence in GALT were made in animals. The results of adoptive transfer
      of in vitro educated helper T cells from aged GALT are encouraging. Further
      innovative immunologic interventions are indicated.

PMID- 8370143
TI  - Dissolution of gallstones.
AB  - Gallstones represent a major health problem in western society. For symptomatic
      gallstones, cholecystectomy is the gold standard. A considerable number of
      patients, however, cannot tolerate or are unwilling to undergo surgery and
      anaesthesia. For these patients, dissolution therapy, administered either
      systemically ('oral dissolution') or directly into the gallbladder ('contact
      dissolution'), might be preferable. In this review, the possibilities and
      limitations of dissolution therapy are discussed. It is concluded that
      dissolution is a good alternative in selected symptomatic patients and that it is
      useful as adjuvant therapy after lithotripsy (ESWL) of gall-bladder stones.

PMID- 8370144
TI  - Update on laboratory diagnosis and prognosis of acute pancreatitis.
AB  - In this review, the relative values of serum pancreatic enzyme assays and other
      laboratory tests for diagnosis and prognosis of acute pancreatitis have been
      evaluated. It is concluded that serum lipase measurement should be the preferred
      diagnostic method since it is as simple and accurate as amylase assay, all the
      while being more specific. As for prognosis, among the several biochemical tests
      now available, the most useful for clinical practice is serum C-reactive protein
      determination.

PMID- 8370145
TI  - Myotonic dystrophy: from linkage with secretor status to mutation detection.

PMID- 8370146
TI  - Direct molecular diagnosis of myotonic dystrophy.
AB  - Myotonic dystrophy (DM) arises from an unstable trinucleotide (CTGn) repeat
      sequence within the DM locus at 19q13.3. Twenty-three myotonic dystrophy families
      containing 205 persons with no symptoms, minimal manifestations, classic DM or
      congenital DM were investigated to validate the application of the pM10M6 probe
      to direct molecular diagnosis. Affected family members had been diagnosed
      clinically and the unaffected family members had been assigned carrier
      probabilities close to either zero or 100%, using closely linked flanking
      markers. Southern analysis identified all 89 DM gene carriers as having
      expansions of the unstable element. PstI detected all small expansions of the
      repeat sequence as easily seen discrete bands; but large expansions were usually
      seen as diffuse smears, sometimes difficult to distinguish from lane background.
      EcoRI concentrated these diffuse smears, associated with somatic instability,
      into discrete bands which were easy to detect; but it did not resolve the smaller
      expansions present in 9 (10%) of the DM carriers. It is essential that PstI and
      EcoRI gels are run in parallel to detect all DM gene carriers. The extent of
      expansion of CTG correlated with age of onset and disease severity. Biopsies of
      various fetal tissues from two terminated pregnancies confirmed the diagnosis
      obtained by CVS and revealed no heterogeneity between tissues at this
      developmental stage. Further expansion occurred during the culture of CVS cells,
      indicating that direct prenatal diagnosis needs to be carried out on CVS tissue
      rather than on cultured cells. The intergenerational change of the repeat
      sequence from DM parent to DM offspring showed a significant parental sex
      difference for those parents with large expansions. Contraction of the unstable
      element was observed in the three males carrying the largest expansions and could
      explain why congenital DM is exclusively of maternal origin.

PMID- 8370147
TI  - DNA analysis of distinct populations suggests multiple origins for the mutation
      causing Huntington disease.
AB  - Results of association studies can be significantly biased if the ancestry of the
      control population is not similar to that of the affected population. One
      approach to overcome such a bias is to use distinct populations where controls
      and affected individuals are likely to be of similar descent. We have examined
      homogeneous populations of French, Danish and Swedish ancestry for nonrandom
      allelic association between Huntington disease (HD) and several markers
      previously shown to be in association with HD. No evidence for nonrandom allelic
      association between HD and these markers was shown in these populations. The
      demonstration of association in a United Kingdom (UK) sample of similar size, and
      lack of significant differences in allele frequencies between the French, Danish,
      Swedish and UK populations suggested that the absence of association was not
      predominantly a consequence of allele frequencies or sample size. To investigate
      further the number of potential HD chromosomes, DNA haplotypes were constructed
      for the Danish, French, Swedish and UK populations. The minimum of two HD
      haplotypes observed in each of the French, Danish and Swedish populations,
      compared to the one haplotype in the UK population of a similar size, is an
      important factor accounting for the absence of association between HD and the DNA
      markers in these populations. Furthermore, these data are in favour of multiple
      independent origins for the mutation causing HD.

PMID- 8370148
TI  - Intrafamilial variability in the clinical expression of familial
      hypercholesterolemia: importance of risk factor determination for genetic
      counselling.
AB  - A specific mutation in the low-density lipoprotein receptor (LDLR) gene causes
      familial hypercholesterolemia (FH) in about 60% of Afrikaner FH heterozygotes.
      Molecular diagnosis of this so-called FH Afrikaner-1 mutation was performed in a
      family with the disease. One individual did not develop coronary heart disease
      (CHD) by age 84, despite having the FH Afrikaner-1 mutation, while his son who
      inherited the same gene, developed CHD before age 50 and had to undergo bypass
      surgery. All the sibs in the third generation inherited the defective LDLR gene
      allele. This variation in clinical presentation creates a counselling dilemma. It
      also raises questions about the effect of diet and life style, and the
      possibility of other genes either contributing to the severity of the disease, or
      protecting against high lipid levels in plasma. An investigation of the influence
      of selected factors on the clinical expression of the FH Afrikaner-1 mutation in
      this family indicated that it was especially the elevated apolipoprotein (a)
      levels, in addition to low levels of high density lipoprotein cholesterol and
      raised triglyceride and apolipoprotein B levels, that were associated with a
      greater risk of developing CHD. These findings are thus in accordance with the
      view that the severity of CHD in FH patients is not only determined by nature of
      the gene defect, but is also influenced by other risk factors.

PMID- 8370149
TI  - Distal arthrogryposis with autosomal dominant inheritance and reduced penetrance
      in females: the Gordon syndrome.
AB  - A family is reported in which camptodactyly, club foot, pectus excavatum and
      undescended testes are transmitted as an autosomal dominant with reduced
      penetrance and variable expressivity, affecting 13 members through five
      generations. Penetrance is more reduced in females than in males and asymptomatic
      carriers are always females. Similar findings were previously described in two
      other families reported by Gordon et al. (1962) and Halal & Fraser (1979).

PMID- 8370150
TI  - Marden-Walker syndrome: case report, literature review and nosologic discussion.
AB  - The Marden-Walker syndrome is characterized by psychomotor retardation, a mask
      like face with blepharophimosis, micrognathia and a high-arched or cleft palate,
      low-set ears, kyphoscoliosis and joint contractures. We report on a male patient
      with the clinical features of the syndrome. In addition, he had a Dandy-Walker
      malformation with hydrocephalus and vertebral abnormalities. During pregnancy,
      there were feeble fetal movements and polyhydramnios. We propose that Marden
      Walker syndrome is one of the etiologic possibilities in children with the
      heterogeneous fetal a(hypo)kinesia deformation sequence (FADS). Differential
      diagnosis is discussed. The etiology is probably heterogeneous.

PMID- 8370151
TI  - Evidence of chromosome 9 origin of the euchromatic variant band within 9qh.
AB  - Fluorescence in-situ hybridization studies using a whole chromosome 9 painting
      probe were performed on three individuals from two different families, who carry
      a chromosome 9 variant with an extra band within the elongated 9qh region. The
      results confirm the euchromatic nature of the extra band, and provide evidence
      that it is of chromosome 9 origin. This variant band, which may not be very rare,
      thus possibly results from a duplication of a segment of 9qh plus band p12 or
      part of band q21.

PMID- 8370152
TI  - Two siblings with mental retardation and progressive spasticity.

PMID- 8370153
TI  - Inheritance of intrahepatic cholestasis of pregnancy in one kindred.
AB  - We report three sisters with intrahepatic cholestasis of pregnancy (ICP) and the
      pedigree of the family, including six generations. ICP was observed in five
      successive generations; most of the patients also had cholelithiasis. The uniform
      expression, the complete penetrance of the trait and the direct parent-to-child
      transmission support the Mendelian dominant mode of inheritance. Determination of
      HLA A, B and C haplotype was made in five ICP patients, without any findings of
      HLA type common to everyone. X-linked inheritance cannot be excluded in this
      study.

PMID- 8370154
TI  - A retrospective CISS hybridization analysis of a case with de novo translocation
      t(18;22) resulting in an 18p- syndrome.
AB  - An unbalanced de novo translocation t(18;22) leading to a severely malformed
      liveborn girl with 18p- syndrome is described. Using the chromosomal in situ
      suppression (CISS) hybridization technique on 4-year-old G-banded chromosome
      preparations, it could be demonstrated that the translocation chromosome is
      composed of the long arm including the centromere of a chromosome 22 and the long
      arm of a chromosome 18. Consequently, the patient described here has lost the
      short arm including the centromere of chromosome 18. The possibility of
      restudying cytogenetically unsolved cases in clinical cytogenetics using older G
      banded chromosome preparations with the fluorescence in situ hybridization
      techniques is pointed out.

PMID- 8370155
TI  - Basilar impression and syringomyelia in a patient with tricho-rhino-phalangeal
      syndrome type I.

PMID- 8370156
TI  - Identical psychological profile and behaviour pattern in different types of
      mutation in the FMR-1 region.

PMID- 8370157
TI  - Clinical immunology: is it clinical science or medical practice?

PMID- 8370158
TI  - Immune stimulatory and anti-tumour properties of haemin.
AB  - IL-2 induces tumour regression in some patients with metastatic disease, but the
      dose of IL-2 is limited by severe toxicity. Agents that increase the expression
      of IL-2 receptors in the effector cells could be used to improve the
      effectiveness of IL-2 in mediating its anti-tumour effect. We have reported that
      haemin increased the expression of IL-2 receptors in human peripheral blood
      mononuclear cells (PBMC) and synergized with IL-2 in the induction of
      mitogenicity, cytotoxicity and cytokine production. We now report on haemin
      induced immune stimulation and tumour regression in mice. Haemin-induced
      mitogenicity in mouse splenocytes was potentiated up to two-fold by IL-2. The
      combination of haemin and IL-2 was also effective in inducing cytotoxicity for
      natural killer (NK)-resistant target cells. Maximal induction of cytotoxicity was
      attained at an optimal concentration of haemin of 10 microM. Higher
      concentrations were less effective. Splenocytes isolated from mice that had been
      treated in vivo with haemin and IL-2 incorporated twice the amount of 3H
      thymidine compared with splenocytes from mice treated with either haemin or IL-2
      alone. Cytotoxicity of splenocytes for NK-resistant target cells was not
      increased following in vivo administration of haemin and IL-2 when fresh
      splenocytes were tested. Cytotoxicity was enhanced, however, up to five-fold
      following 48 h in vitro incubation with IL-2. Administration of haemin and IL-2
      resulted in a significant decrease (40%) of established hepatic metastases in
      mice. Either IL-2 or haemin alone at the dose used were ineffective. The anti
      tumour effect of haemin and IL-2 was enhanced (63% decrease in metastases) by
      administration of the thiol compound, N-acetylcysteine. Since haemin can safely
      be administered to patients, it may represent a new class of biologic response
      modifiers that could enhance IL-2-mediated anti-tumour effects.

PMID- 8370159
TI  - Suppression of autoimmune disease in NZB/W F1 mice by treatment with the novel
      immunomodulator BTS 63155.
AB  - Autoimmune disease in NZB/W F1 mice was treated from 23 weeks of age with the
      novel immunomodulator BTS 63155 and, for comparative purposes, the established
      immunosuppressive agent cyclosporin A. Both drugs significantly improved survival
      compared with untreated controls. Lupus nephritis was also significantly reduced
      in the drug-treated groups, and this was related to reduced glomerular deposition
      of IgG. Autoantibody (ANA) levels were lowered by treatment with cyclosporin A,
      but not by BTS 63155. This latter finding may indicate a different mode of action
      for the two drugs. In a long term study, neither drug effected a complete cure,
      as autoimmune disease recurred on withdrawal of drug treatment.

PMID- 8370160
TI  - The anti-arthritic and immunosuppressive effects of cyclosporin A on collagen
      induced arthritis in the rhesus monkey.
AB  - The influence of cyclosporin A (CsA) on type II collagen-induced arthritis (CIA)
      in the rhesus monkey has been investigated. CsA was administered subcutaneously
      in a dose of 25 mg/kg per day during 9-18 days and additionally 12.5 mg/kg per
      day for 7 days. At this dosing regime no significant alterations of haematologic
      parameters were found, indicating that the toxicity of CsA was negligible.
      Administration of CsA after onset of arthritis had no beneficial effect, but when
      given between immunization and manifestation of clinical symptoms, CIA could be
      prevented completely. Moreover, these monkeys became resistant to the disease,
      because no arthritic activity could be observed upon a booster immunization with
      type II collagen (CII). The suppression of disease by CsA is reflected in reduced
      antibody levels to CII.

PMID- 8370161
TI  - Cyclosporin A increases the pulmonary eosinophilia induced by inhaled Aspergillus
      antigen in mice.
AB  - We evaluated the effects of anti-inflammatory drugs in a murine model of allergic
      bronchopulmonary aspergillosis (ABPA). Mice instilled with 100 micrograms of
      Aspergillus fumigatus antigen (intranasally, 3 days a week for 3 weeks) developed
      pulmonary lesions, characterized by a perivascular and peribronchial eosinophil
      infiltration, a bronchoalveolar lavage (BAL) eosinophilia, and elevated levels of
      total IgE, total IgG1 and A. fumigatus-specific IgG1. Under the same conditions,
      groups of mice receiving a daily dose of 2 mg/kg dexamethasone showed decreased
      numbers of eosinophils and total cells in BAL, had less numerous eosinophils in
      their pulmonary infiltrates, and had lower levels of serum and BAL fluid total
      IgE, total IgG1 and A. fumigatus-specific IgG1. Conversely, groups of mice
      pretreated with an immunosuppressive agent, cyclosporin A (CsA) at a dose of 50
      mg/kg, three times per week, developed pulmonary lesions with enhanced lung
      eosinophilic influx and increased total IgE levels, both in serum and in BAL
      fluid. These findings show that dexamethasone potently prevents the murine
      immunopathologic response to A. fumigatus. The effect of CsA on this inflammatory
      response was paradoxical, insofar as it suggests an activation of the T helper 2
      subset, which up-regulates eosinophil recruitment and IgE production.

PMID- 8370162
TI  - A longitudinal study of the IgG antibody response to HIV-1 p17 gag protein in HIV
      1+ patients with haemophilia: titre and avidity.
AB  - The IgG response to HIV-1 p17 gag protein was studied for up to 6 years in 12 HIV
      1-infected patients with haemophilia, who had seroconverted between 1982 and
      1985. To assess any prognostic value, p17 IgG titres were compared with p24 IgG
      titres, CD4 cell counts and p24 antigenaemia. p17 IgG avidity index was also
      examined. A strong similarity was found between the IgG titre to HIV-1 p17 and
      that to p24. In patients who developed AIDS the decline in p17 IgG titres could
      precede by several years the drop in CD4 cells to under 200 cells/microliters;
      whereas some long-term asymptomatic patients (CDCII) had increasing p17 IgG
      titres and stable CD4 cell counts. Declining p17 and p24 IgG titres were not
      always associated with an increase in p24 antigenaemia. IgG titres were found to
      be better predictors of disease progression than CD4 cell counts or p24
      antigenaemia. Patients who developed AIDS during the study were also
      characterized by a lower p17 IgG avidity than patients who remained asymptomatic.
      This result suggests that IgG avidity could have prognostic relevance and be of
      importance for host resistance to AIDS onset.

PMID- 8370163
TI  - Immunogenicity of the meningococcal stress protein MSP63 during natural
      infection.
AB  - Acute- and convalescent-phase sera from 40 patients with meningococcal disease
      were evaluated for immunoreactivity with the meningococcal member of the hsp60
      stress protein family. The IgG response was measured by ELISA, using bacterial
      cell lysate of the corresponding patients' strain, and purified hsp60 proteins
      from Neisseria meningitidis (MSP63), Escherichia coli (GroEL) and Mycobacterium
      bovis BCG (65K) as antigens. Analysis of the antibody responses revealed that
      24/35 patients (69%) with elevated anti-meningococcal titres, generated anti
      MSP63 antibodies during the time course of infection. Twelve of these patients
      generated antibodies specific for MSP63, in six patients anti-MSP63 levels
      exceeded anti-GroEL/65K antibodies. In the remaining six patients, equal levels
      of anti-MSP63 and anti-GroEL/65K were measured. We conclude that MSP63 is
      expressed and immunogenic during natural meningococcal infection, and that
      individual subjects have a restricted response to the antigen, resulting in the
      recognition of Neisseria-specific hsp60 epitopes and/or cross-reactive hsp60
      determinants.

PMID- 8370164
TI  - Successful primate immunization with peptides conjugated to purified protein
      derivative or mycobacterial heat shock proteins in the absence of adjuvants.
AB  - We have previously shown in mice that antibodies can be induced to synthetic
      malaria peptides conjugated to mycobacterial antigens, such as purified protein
      derivative (PPD) or heat shock proteins (hsp), and given in the absence of
      adjuvants after a previous priming with bacille Calmette-Guerin (BCG). In the
      present study we investigated this model of immunization in the non-human
      primates, Saimiri sciureus monkeys. Monkeys primed with BCG subcutaneously and
      then immunized subcutaneously with the Plasmodium falciparum sporozoite (NANP)40
      synthetic peptide conjugated to PPD or mycobacterial hsp of 65 or 70 kD, in the
      absence of adjuvants, produced antipeptide and anti-sporozoite IgG antibodies.
      Interestingly, the carrier effect of the hsp of 70 kD for the induction of anti
      (NANP)40 antibodies was also observed in the absence of a previous priming with
      BCG. These data suggest that such a vaccination strategy may be applied to
      humans.

PMID- 8370165
TI  - Contrasting levels of in vitro cytokine production by rheumatoid synovial tissues
      demonstrating different patterns of mononuclear cell infiltration.
AB  - Synovial membrane samples obtained at knee arthroplasty from 22 patients with
      rheumatoid arthritis (RA) were characterized histologically. Two groups were
      identified. Tissue samples from 15 patients demonstrated multiple focal lymphoid
      aggregates of mononuclear cells (group A). Samples from the remaining seven
      patients demonstrated diffuse mononuclear cell infiltration (group B). Samples of
      each synovial membrane (0.25 g) were cultured for cytokine production. The
      highest levels of IL-1 beta and IL-6 were produced by group A tissues: 19.1 +/-
      19.6 ng/ml IL-1 beta (mean +/- s.d.) and 264.4 +/- 301.9 ng/ml IL-6, versus 3.8
      +/- 6.6 ng/ml and 54.7 +/- 42.6 ng/ml respectively. Small quantities of IL-2 and
      IL-4 were measured in both groups: the levels of IL-2 in group A cultures were
      highest (P = 0.04). Moreover, using MoAbs, the most intense cytokine staining in
      the tissues was detected in group A. Similar total numbers of each cell
      subpopulation and similar quantities of immunoglobulin and rheumatoid factor
      synthesis were measured in both groups. It is suggested that the presence of
      multiple focal lymphoid aggregates associated with higher levels of cytokine
      production observed in group A represent a greater degree of immunological
      activation, and may represent a subgroup of patients with a greater potential for
      articular destruction.

PMID- 8370166
TI  - Antibody penetration of viable human cells. II. Anti-RNP antibodies binding to
      RNP antigen expressed on cell surface, which may mediate the antibody
      internalization.
AB  - As U1 small nuclear ribonucleoprotein (U1 snRNP2) has a crucial role in pre-mRNP
      splicing, the interaction of anti-RNP antibody with snRNP within viable
      lymphocytes may profoundly influence cell functions. We have shown that antibody
      can penetrate viable human lymphocytes, and anti-RNP antibodies enter more cells
      than other anti-nuclear antibodies or control IgG. In order to study the in vitro
      interaction of anti-RNP antibodies with viable cells, T lymphocytes were
      metabolically labelled with 35S-methionine, then incubated with the antibodies
      and washed. A set of 35S-labelled cell-associated snRNP polypeptides A, B'/B, C
      and D were found to bind to both monospecific human polyclonal anti-RNP IgG
      (human anti-RNP IgG) and a mouse monoclonal anti-RNP antibody (2.73), indicating
      that anti-RNP antibodies interacted with RNP antigen inside or/and on the surface
      of viable cells. To investigate antibody binding to RNP antigen on the cell
      surface, the cell surface proteins were either iodinated with 125I or the cells
      processed for immunoelectron microscopic studies after incubation with MoAb. At
      least seven 125I-labelled polypeptides on the cell surface were found to be
      immunoprecipitated by the anti-RNP MoAb which have similar molecular weights to U
      snRNP polypeptides 70K, A, B, D, E, F, and G. The immunoelectron microscopic
      studies showed that the gold particles formed clustered patches on the cell
      membrane. Further studies suggested that RNP antigen bound to the cell surface,
      and the RNP binding structure was probably a heterodimer receptor. This study
      provides evidence to suggest that anti-RNP antibody entry into viable cells may
      be mediated by interaction with RNP antigen expressed on the cell surface.

PMID- 8370167
TI  - Relevance of classic anti-neutrophil cytoplasmic autoantibody (C-ANCA)-mediated
      inhibition of proteinase 3-alpha 1-antitrypsin complexation to disease activity
      in Wegener's granulomatosis.
AB  - In the sera of patients with Wegener's granulomatosis (WG), C-ANCA can be
      detected that are directed against proteinase 3 (PR3). We have previously
      observed that C-ANCA interfere with PR3 proteolytic activity and with
      complexation of PR3 with its major physiologic inhibitor, alpha 1-antitrypsin
      (alpha 1AT). In the present study we investigated whether this inhibitory effect
      of C-ANCA on PR3-alpha 1AT complexation correlates with clinical activity of WG.
      Serial serum samples of eight consecutive patients with histologically proven
      relapses of WG were tested. At the moment of relapse all sera revealed inhibitory
      activity towards PR3-alpha 1AT complexation (median 22%, range 10-59%). Disease
      activity score (r = 0.87, P < 0.02) and C-reactive protein (CRP) levels (r =
      0.66, P < 0.1) correlated with C-ANCA inhibition of PR3-alpha 1AT complexation,
      while they did not correlate with the C-ANCA titre detected by indirect
      immunofluorescence (IIF) nor with IgG anti-PR3 antibody level measured by ELISA.
      The inhibitory effect of C-ANCA on PR3-alpha 1AT complexation had risen
      significantly at the moment of relapse compared with values 3 months (P < 0.05)
      and 6 months (P < 0.01) before relapse. Eight patients with established WG and
      positive for C-ANCA but without clinical evidence of relapse served as controls.
      In this group no inhibitory effect of C-ANCA on PR3-alpha 1AT complexation was
      observed in 7/8 patients sera. Sera of one control patient contained moderate C
      ANCA inhibitory activity towards PR3-alpha 1AT complexation, which remained at a
      constant level during the 6 months period of observation. Thus, disease activity
      in WG appears to be more closely related to C-ANCA inhibitory activity towards
      PR3-alpha 1AT complexation.

PMID- 8370168
TI  - C3 and C4 gene expression and interferon-gamma-mediated regulation in human
      glomerular mesangial cells.
AB  - The glomerular mesangial cell (GMC) plays a key role in the maintenance of
      glomerular structure and function and in the mediation of glomerular injury. To
      explore the potential of this cell to produce complement and react to local
      inflammatory signals, we studied the synthesis and regulation of the third and
      fourth components of complement in cultured human GMC. Using metabolic labelling
      and immunoprecipitation, we found that C3 and C4 polypeptide chains were
      synthesized and secreted by GMC. Interferon-gamma (IFN-gamma) led to an increase
      in C4 protein synthesis, but not C3 synthesis. There was a corresponding increase
      in C4 mRNA in IFN-gamma-activated cells, but no increase in C3 mRNA, as
      determined by semi-quantitative polymerase chain reaction (PCR) estimation. These
      results demonstrate that human GMC can synthesize C3 and C4 proteins, and that
      regulation of expression of the C4 gene is mediated by IFN-gamma. We hypothesize
      that GMC production of complement could influence the clearance of immune
      aggregates by the kidney and the mediation of glomerular injury.

PMID- 8370169
TI  - Serum glomerular binding activity is highly correlated with renal disease in
      MRL/lpr mice.
AB  - The pathogenesis of lupus nephritis is felt to be mediated by anti-DNA
      antibodies. However, the anti-DNA response and renal disease do not entirely
      correspond. We recently developed a new assay which detects immune elements based
      on their ability to bind glomeruli as an alternative approach to understanding
      the pathogenesis of this disorder. The glomerular binding activity (GBA) defined
      by this assay consists of immune elements containing IgG which interact
      specifically with renal tissue, the binding of which is DNase-inhibitable, but
      which do not bind to DNA directly. In the current study we assessed the
      relationship between GBA and renal disease in MRL/lpr mice (both untreated and
      cyclophosphamide-treated) and compared it with the anti-DNA assay. Both assays
      were highly correlated with renal disease in untreated mice in terms of
      proteinuria. In cyclophosphamide-treated mice, however, only a weak correlation
      between the anti-DNA assay and proteinuria was apparent. GBA, in contrast, was
      more strongly correlated with proteinuria in treated mice. This correlation
      improved substantially when the DNase-sensitive component of the GBA was used.
      GBA appeared related to, but not covariant with, the anti-DNA response. These
      results demonstrate that GBA is a better correlate of murine lupus nephritis than
      the anti-DNA assay, and suggest that the immune elements detected by this assay,
      the DNase-sensitive component in particular, may be pathogenically important.

PMID- 8370170
TI  - The paraproteins in systemic capillary leak syndrome.
AB  - Systemic capillary leak syndrome (SCLS) is a rare disease characterized by
      episodes of collapse due to rapid transfer of considerable volumes of plasma from
      the intravascular to the extravascular compartment. The pathogenesis of this
      disease is unknown. The diagnosis is made largely on clinical grounds, and
      investigations are unhelpful. The only consistent abnormality is that an IgG
      paraprotein is found in most patients, raising the possibility that the
      paraprotein may be involved in the pathogenesis of the disease. Reduction of the
      paraprotein level in our patient was associated with remission. Blood samples
      from three SCLS patients and one probable SCLS have been studied. All patients
      had monoclonal IgG paraproteins. The purified paraproteins were all of IgG1
      subclass and had kappa light chains. However, they differed in size and charge.
      Antibodies against each of the paraproteins were raised in rabbits. Affinity
      purified anti-idiotypic antibodies were tested for cross-reactivity against the
      other paraproteins using immunoblotting and Ouchterlony assay. These assays
      showed that the anti-idiotypic antibodies reacted only with the immunizing
      paraprotein and not with any of the other paraproteins, i.e. that the
      paraproteins do not share a common idiotype. Paraproteins did not bind to
      cultured endothelial cells, either unactivated or following activation with
      interferon-gamma (IFN-gamma), IL-2 or IL-6. In addition, we were unable to
      demonstrate any cytotoxicity towards cultured human endothelial cells by
      paraprotein alone, or in the presence of neutrophils (pronounced neutrophilia
      being a feature of attacks). The relationship between the paraproteins and the
      disease remains unclear. It is likely that additional, as yet unidentified,
      factors are required for the paraprotein to lead to capillary leak.

PMID- 8370171
TI  - Intrathyroidal lymphocyte subsets, including unusual CD4+ CD8+ cells and CD3loTCR
      alpha beta lo/-CD4-CD8- cells, in autoimmune thyroid disease.
AB  - Intrathyroidal lymphocyte subsets were analysed in 13 euthyroid patients with
      autoimmune thyroid disease by two-colour flow cytometry and compared with subsets
      in peripheral blood. In both Graves' and Hashimoto's diseases, proportions of
      intrathyroidal CD5- B cells were higher than in peripheral blood. The numbers of
      such cells were correlated with serum levels of anti-thyroid microsomal
      antibodies. Proportions of T cells bearing alpha beta chains of T cell receptors
      (TCR alpha beta+ T; T alpha beta) and CD16+CD57+ natural killer (NK) cells were
      lower in the thyroid, but proportions of CD3hiTCR alpha beta-TCR gamma delta+ (T
      gamma delta) cells were not different. Proportions of CD4+Leu-8- helper T cells
      and CD4+CD57+ germinal centre T cells were higher and proportions of CD4+Leu-8+
      suppressor-inducer T cells and CD8+CD57+ or CD8+CD11b+ suppressor T cells were
      lower than in the blood in both diseases. Proportions of CD5+ B cells were high
      in Graves' disease, and proportions of CD8+CD11b- cytotoxic T cells were high in
      Hashimoto's disease. Unexpectedly, CD4+CD8+ cells and CD3loTCR alpha beta lo/-CD4
      CD8- cells were present in thyroid tissues of both diseases. These findings
      suggest that: (i) an imbalance in the numbers of regulatory T cells and of NK
      cells that had appeared in the thyroid resulted in the proliferation of CD5- B
      cells, which were related to thyroid autoantibody production; (ii) CD5+ B cells
      and cytotoxic T cells are important for the different pathological features in
      Graves' and Hashimoto's diseases, respectively; and (iii) intrathyroidal CD4+CD8+
      cells and CD3loTCR alpha beta lo/-CD4-CD8- cells may be related to the
      pathogenesis of autoimmune thyroid disease.

PMID- 8370172
TI  - The presence of immunosuppressive 'p15E-like' factors in the serum and urine of
      patients suffering from malign and benign breast tumours.
AB  - Certain types of tumours are capable of producing factors inhibiting mononuclear
      phagocyte chemotaxis which may contribute to defects in immunosurveillance. In
      head and neck cancer these factors are said to be related to the retroviral
      protein p15E. This study examines the presence of p15E-like factors in serum and
      urine of patients with malign and benign breast tumours. Thirty patients with
      breast cancer, 29 patients with benign breast masses, and 28 healthy controls
      were tested blindly with the monocyte polarization assay, using N-formyl
      methionyl-leucylphenylalanine as chemo-attractant. The low molecular weight
      fractions prepared of sera of the malign tumour patients inhibited the monocyte
      polarization significantly (mean inhibition 34%, s.d. = 12) compared with those
      of benign tumour patients (15%, s.d. = 7) and of controls (14%, s.d. = 6). The
      observed inhibitory effects on the monocyte polarization could be compensated by
      MoAbs reactive to p15E-related antigens. The mean difference between the
      polarization inhibition with and without anti-p15E adsorption (the 'p15E-like
      factor-induced inhibition') was 25% (s.d. = 13) in the breast cancer group,
      compared with 7% (s.d. = 5) in the benign tumour patients and 5% (s.d. = 4) in
      the healthy control group. Surgical removal of the tumours resulted in a
      restoration of the monocyte polarization in 20/23 (87%) patients of the breast
      cancer group. Results testing preoperative urine samples correlated well with
      those of corresponding sera. These data give additional support to the concept
      that tumour-derived p15E-like factors are responsible for the inhibitory effect
      on monocyte chemotaxis in breast cancer patients, and that these factors can be
      found in serum as well as in urine.

PMID- 8370173
TI  - Functional analysis of TCR gamma delta+ T cells in tumour-infiltrating
      lymphocytes (TIL) of human pancreatic cancer.
AB  - In six patients with advanced pancreatic carcinoma, TIL and tumour-draining
      lymphocytes (TDL) were isolated from primary pancreatic tumour and regional lymph
      nodes. In comparison with TDL and peripheral blood lymphocytes (PBL), TIL
      contained a comparatively higher percentage of TCR gamma delta+ cells, although
      they were still a small fraction. By 2 weeks culture with rIL-2 and immobilized
      OKT-3 antibody, the TCR gamma delta+ cells in TIL were preferentially expanded at
      the early culture periods, although it was temporary. In four cases, the TCR
      gamma delta+ and CD8+ TCR alpha beta+ TIL were separated by negative sorting
      using flowcytometry. All the TCR gamma delta+ TIL were CD4-, CD8- (double
      negative), and one of the TIL lines was mostly composed of delta TCS1+ cells,
      while the others were delta TCS1-. In comparison with CD8+ TCR alpha beta+ TIL,
      all the TCR gamma delta+ TIL exhibited much stronger lytic activity against
      freshly isolated autologous pancreatic cancer cells. However, all the gamma
      delta+ TIL also exhibited a strong non-MHC-restricted cytotoxicity, and there was
      no correlation between the lytic pattern and the percentage of delta TCS1+ cells.
      These data suggest that the TCR gamma delta+ T cells can proliferate vigorously
      in a certain condition, and if successfully expanded in vitro they might be
      helpful material for effective adoptive immunotherapy.

PMID- 8370174
TI  - Expression of cytokine genes in human cardiac allografts: correlation of IL-6 and
      transforming growth factor-beta (TGF-beta) with histological rejection.
AB  - Cytokines may play critical roles in allograft rejection. Currently, a clear
      pattern of cytokine production that correlates with rejection has not emerged.
      Our preliminary studies suggested a trend toward increased IL-6 and TGF-beta gene
      expression in cardiac allografts during rejection. We have extended these studies
      using reverse transcriptase/polymerase chain reaction (RT/PCR) to detect the
      expression of IL-6, TGF-beta, and T cell receptor beta chain constant region (TCR
      beta) genes in 21 additional consecutive myocardial biopsies obtained from six
      heart transplant patients and from five pre-transplant donor hearts. Cytokine
      gene expression was compared with histological diagnosis of rejection. There was
      strong correlation between IL-6 as well as TGF-beta gene expression, and
      histological rejection (6/8 biopsies with versus 0/7 without rejection (P =
      0.006) and 7/9 biopsies with versus 0/7 without rejection (P = 0.003)
      respectively). Neither IL-6 nor TGF-beta transcripts were detected in any pre
      transplant donor heart. TCR-beta chain mRNA was found in all allograft biopsies
      regardless of the presence of rejection, but was absent in pre-transplant donor
      hearts. Our results indicate that expression of IL-6 and TGF-beta is highly
      correlated with allograft rejection and thus may play an important role in
      regulation of cardiac allograft rejection. T cell infiltration of allografted
      myocardium is invariably detected by PCR regardless of histological rejection.
      The long-term functional significance of these cells in transplanted hearts needs
      further investigation.

PMID- 8370175
TI  - IgG inhibits the increase of platelet-associated C3 stimulated by anti-platelet
      antibodies.
AB  - We investigated the increase of platelet-associated IgG and complement component
      3 (C3) caused by the in vitro action of anti-platelet MoAbs, and the effect of
      mouse and human IgG on these events. Anti-glycoprotein IIb/IIIa and anti
      glycoprotein Ib MoAbs caused a slight increase of C3, but not of platelet
      associated IgG. In contrast, anti-CD9 and anti-Fc gamma II receptor MoAbs caused
      an increase of both platelet-associated C3 and IgG. In particular, three MoAbs
      which activated the complement system caused a marked increase of C3. When
      platelet-rich plasma was treated with aspirin and prostaglandin E1 before
      incubation with antibodies, the increase of platelet-associated IgG was inhibited
      in all cases. In contrast, the increase of platelet-associated C3 was scarcely
      influenced. These results suggest that the binding to platelets of platelet
      activating antibodies caused the increased expression of IgG molecules on the
      platelet surface and a possible increase of platelet-associated IgG. However, the
      increase of platelet-associated C3 appeared to depend on specific characteristics
      of the antibodies tested, such as a complement-activating effect. In addition,
      intact mouse or human IgG inhibited the increase of platelet-associated C3 caused
      by complement-activating antibodies, while F(ab')2 mouse or human IgG had no such
      effect. This suggested that the Fc portion of IgG may block the increase of C3
      mediated by anti-platelet antibodies.

PMID- 8370176
TI  - Definition of unique traits of human CD4-CD8- alpha beta T cells.
AB  - We have studied the nature of human CD4-CD8- (double negative) alpha beta T cells
      to determine whether they possess unique characteristics which could further
      differentiate them from conventional CD4+ or CD8+ (single positive) T cells. We
      observed that double negative TCR alpha beta+ T cells differ from single positive
      T cells in the following respects: (i) their T cell receptor (TCR) repertoire is
      different, as revealed by the analysis of 47 clones derived from three
      individuals and by analysis of peripheral blood lymphocytes (PBL) prior to in
      vitro manipulation; (ii) their in vivo CD3:TCR expression is lower before in
      vitro manipulation and expansion; (iii) their direct proliferative response to IL
      3, which is not mediated by secondary release of other T cell growth factors.
      These characteristics have also been recently ascribed to murine double negative
      alpha beta T cells, which develop extrathymically and are considered to be a
      distinct T cell lineage. Our data suggest that, like their murine counterparts,
      human double negative alpha beta T cells may represent a distinct T cell lineage
      which might develop extrathymically.

PMID- 8370179
TI  - Clinical immunology: guidelines for its organization, training and certification;
      relationships with allergology and other medical disciplines--a WHO/IUIS/IAACI
      report.

PMID- 8370178
TI  - IL-2 receptor gene expression and IL-2 production by human preterm newborns'
      cells.
AB  - IL-2 receptor (IL-2R) gene expression in human umbilical cord blood mononuclear
      cells (CBMC) of preterm and term newborns was examined following stimulation for
      18 h with phytohaemagglutinin (PHA) and compared with that of adult peripheral
      blood mononuclear cells (PBMC; mothers and control group). mRNA for IL-2R could
      not be detected in CBMC of preterm infants, whereas the mRNA levels for IL-2R
      found in full term neonates were similar to those observed in PBMC of adults. IL
      2 activity in conditioned medium (CM) of mononuclear cells stimulated with either
      optimal or suboptimal PHA concentrations for 24 h and 48 h was also determined.
      At 24 h of stimulation, IL-2 activity found in CM obtained from CBMC of preterm
      and term newborns was significantly higher than that found in CM of adults' PBMC.
      A further enhancement of IL-2 activity (six to eight times) was observed in CM of
      preterm and term cells stimulated for 48 h, whereas no significant difference was
      found in IL-2 activity in CM from adult cells tested at the two incubation
      periods. The present findings may provide an additional explanation for the
      impaired function of the immune system, and the high susceptibility to infections
      observed in preterm newborns.

PMID- 8370177
TI  - Interaction of IL-1 beta, IL-6 and tumour necrosis factor-alpha (TNF-alpha) in
      human T cells activated by murine antigens.
AB  - We used a mixed leucocyte culture between human T cells and irradiated murine
      splenocytes which allowed us to distinguish between cytokine production from the
      responder and stimulator cells by the use of species-specific assays for mRNA up
      regulation. Using this model of T cell activation by antigen, we studied the
      effects of human antigen-presenting cell-derived cytokines IL-1 beta, IL-6 and
      TNF-alpha on the activation of human T cell subsets. We show in this system that
      exogenously added IL-1 beta, IL-6 and TNF-alpha induces IL-2 receptor (R) up
      regulation and IL-2 production, and proliferation by both CD4+ and CD8+ cells.
      The addition of IL-1 beta induces IL-6 mRNA, and anti-IL-1 antibodies or an IL-1R
      antagonist protein completely suppresses IL-6 and TNF-alpha supported
      proliferation. Similarly, addition of IL-6 or TNF-alpha induces up-regulation of
      IL-1 beta mRNA. However, anti-IL-6 and anti-IL-6R antibodies only partially block
      proliferation supported by IL-1 beta. These findings suggest that IL-6 and TNF
      alpha will induce IL-2R up-regulation/IL-2 secretion via the induction of IL-1
      beta production.

PMID- 8370180
TI  - SART stress effects on lymphocytes in the thymus and spleen of normal,
      adrenalectomized, and sympathectomized mice.
AB  - The effects of stress due to specific alteration of rhythm of temperature (SART)
      on lymphocyte subpopulations of the thymus and spleen were examined in C3H/He
      mice. Thymic and splenic involution were evident in SART-stressed mice, and
      lymphocyte subpopulations were significantly changed. In the thymus, CD4+ CD8+
      and CD3- or CD3low lymphocytes were decreased by SART stress more than other
      lymphocytes, and CD4- and CD8-single-positive lymphocytes and B lymphocytes in
      the spleen were decreased equally. Immunoregulation via the adrenal glands and
      sympathetic nervous system was studied in chemically sympathectomized and
      adrenalectomized SART-stressed mice. Neither chemical sympathectomy nor
      adrenalectomy alone influenced the thymus or spleen in nonstressed mice, but
      chemical sympathectomy enhanced SART stress-induced thymic changes and further
      decreased the number of B lymphocytes in the spleen of SART-stressed mice;
      adrenalectomy blocked SART stress-induced thymic changes and increased the number
      of B lymphocytes in the spleen. These findings indicate that the genesis of
      thymic changes induced by SART stress is in the adrenal glands, and malfunction
      of sympathetic nerves and insufficient excretion of adrenal hormones could alter
      the balance of lymphocytes in the spleen during stress. It was also clear that
      thymic changes induced by SART stress could be immediately reversed to pretest
      conditions by alleviating the stress.

PMID- 8370181
TI  - Effects of adoptive immunotherapy with autologous CD8+ T lymphocytes on
      immunologic parameters: lymphocyte subsets and cytotoxic activity.
AB  - CD8+ cytotoxic T lymphocytes (CTL) may be an important parameter of host
      resistance to HIV infection. The present study determined whether CD8+ cells
      could be purified and propagated in vitro to enhance anti-HIV CTL activity, and
      the immunologic effects of infusion of these cells into autologous, HIV-infected
      patients as a potential immunotherapy for AIDS and AIDS-related complex (ARC).
      CD8+ lymphocytes from five AIDS and ARC patients were purified from leukapheresis
      preparations in cell culture flasks coated with CD8-specific monoclonal
      antibodies and propagated in vitro for 3 weeks. The ex vivo propagated cells were
      98% (+/- 1%) CD8+ and 43% (+/- 6%) HLA-DR+. The majority of the CD8+ cell
      preparations had increased lytic activity against autologous B lymphoblastoid
      cells infected with vaccinia virus vectors expressing HIV-IIIb structural
      proteins gag, pol, or env, relative to that of fresh blood mononuclear cells
      tested prior to purification and culture. The results also show for the first
      time that CD8+ CTL from HIV-infected patients can lyse cells expressing the HIV
      regulatory protein, tat. Enhanced expression of CD56 (natural killer cell marker)
      and lytic activity against vaccinia virus control vector-infected, autologous
      targets were also noted in the CD8+ cell preparations. Infusion of the CD8+ CTL
      into autologous patients was well-tolerated and resulted in low but discernible,
      temporal increases in circulating cytotoxic activity against the HIV gene
      expressing targets.

PMID- 8370182
TI  - Induction of immune-mediated glomerulonephritis in normal mice immunized with
      bacterial DNA.
AB  - Normal mice immunized with bacterial DNA produce high titers of anti-DNA
      antibodies and represent a new model for autoantibody production in systemic
      lupus erythematosus. To determine whether DNA immunization can also provoke
      clinical manifestations of lupus, the occurrence of nephritis in immunized mice
      was assessed and correlated with levels of anti-DNA as well as antibodies to
      glomerular antigens. BALB/c mice immunized with Escherichia coli single-stranded
      DNA in complexes with methylated bovine serum albumin in adjuvant showed
      increased proteinuria compared to control mice immunized with mBSA alone.
      Furthermore, DNA immunized mice had significantly greater glomerular
      proliferative changes and immunoglobulin deposition than control mice. In an in
      vitro assay, sera from DNA immunized mice exhibited greater binding to glomerular
      antigens than sera from control mice. Compared to sera, renal eluates from DNA
      immunized mice were enriched for anti-DNA and glomerular binding activity. These
      data indicate that immunization of normal mice with E. coli DNA induces an immune
      mediated proliferative glomerulonephritis that is likely secondary to the renal
      deposition of anti-DNA antibodies.

PMID- 8370183
TI  - Modulation of MHC expression on human endothelial cells by sera from patients
      with systemic lupus erythematosus.
AB  - Major histocompatibility complex (MHC) antigen expression on cells is a
      prerequisite for immune interaction with activated T-cells. This study examined
      the ability of sera from patients with systemic lupus erythematosus (SLE) to
      modulate MHC expression on vascular endothelial cells. SLE sera were able to
      selectively upregulate MHC class I antigen expression on cultured human umbilical
      venous endothelial (HUVE) cells, without concomitant induction of MHC class II
      antigen. The stimulation index (SI) for MHC class I expression produced by SLE
      sera (1.21 +/- 0.23) was significantly higher than those for normal controls
      (1.01 +/- 0.10) (P < 0.0001) and non-SLE patients (1.12 +/- 0.14) (P < 0.05).
      Additionally, active SLE patients had higher mean SI than inactive patients (P <
      0.001). Preincubation of SLE sera with Protein A-Sepharose beads conjugated with
      antibodies against tumor necrosis factor-alpha and interferon-alpha was able to
      significantly reduce their ability to upregulate class I MHC expression by HUVE
      cells, indicating that these cytokines were responsible for the modulatory
      effect. This could be an important mechanism for the immune-mediated vascular
      injury seen in SLE.

PMID- 8370184
TI  - Decreased activity of complement-mediated immune complex clearance in
      hemodialysis patients.
AB  - Complement-mediated immune complex (IC) clearance was examined in the sera from
      regular hemodialysis patients, who accumulated excess factor D in the
      circulation. Both complement activities for the inhibition of insoluble IC
      formation and the solubilization of insoluble IC were lower in the sera from
      these patients than in the sera from normal individuals. A similar decrease in
      complement activities was observed in normal serum fortified with excess factor
      D. In addition, complement-processed IC was found to be bound less effectively to
      human erythrocytes via complement receptor type 1 in the sera from these patients
      and from normal serum fortified with excess factor D than in normal serum. Gel
      filtration HPLC analysis revealed a decrease in covalent binding of C3 fragments
      to IC solubilized in the sera from hemodialysis patients or in normal serum
      fortified with excess factor D. This supports the notion that lower complement
      mediated IC clearance is due to the paucity of complement fragments bound to IC.
      It is suggested that some detrimental alterations in the complement system,
      probably due to excess factor D, cause decreased IC clearance activity in
      hemodialysis patients with chronic renal failure.

PMID- 8370185
TI  - Immunohistochemical localization of intracellular and extracellular associated
      TGF beta in the skin of patients with systemic sclerosis (scleroderma) and
      primary Raynaud's phenomenon.
AB  - We have investigated the distribution of TGF beta using antibodies specific for
      its intracellular and extracellular forms in full-thickness biopsies of patients
      with SSc, primary Raynaud's phenomenon (PRP), systemic lupus erythematosus (SLE),
      and from normal subjects. Nine of 11 SSc biopsies demonstrated intracellular TGF
      beta in endothelial cells while only 6 exhibited extracellular TGF beta.
      Endothelial cells in skin biopsies of all PRP patients displayed both
      intracellular and extracellular TGF beta. All other control biopsies were
      negative. In patients with PRP, some positively staining fibroblasts were found
      scattered throughout the dermis. Lastly, extracellular TGF beta was localized in
      the papillary dermis of PRP and SSc biopsies and in all the dermal layers of SLE
      patients. No significant staining of TGF beta was observed in the endothelial
      cells, fibroblasts, or in the extracellular matrix of the majority of biopsies
      from normal subjects. These data suggest that TGF beta may be one of the
      cytokines involved in the early stages of pathogenesis of SSc, and that
      endothelial cells in SSc and PRP may be a source and/or a target of TGF beta.

PMID- 8370186
TI  - Characterization of antinuclear autoantibodies present in the serum from nonobese
      diabetic (NOD) mice.
AB  - The nonobese diabetic (NOD) mouse develops insulin-dependent type 1 diabetes in
      response to autoantibodies and T-cell attack directed against pancreatic islet
      cell antigens. Sera obtained from nondiabetic and diabetic female mice
      demonstrated a 1.4-fold increase in IgG levels when compared to BALB/c control
      animals. Nondiabetic and diabetic male mice had a 2.1- and 3-fold increase,
      respectively, in serum IgG levels over that of control mice. Seven of 11 non
      diabetic and 7/10 diabetic sera from female NOD mice contained antibody to
      cytoplasmic or nuclear components of HEp-2 cells. Cytoplasmic staining revealed
      reaction against cytoskeletal and midbody structures. Punctate nuclear staining
      patterns with HEp-2 cells showed antibody reaction to the centriole, mitotic
      chromosomes, and nuclear rim. On the other hand, sera from BALB/c mice were
      negative for antibody staining of HEp-2 cells. Confirmation of the autoantibody
      nature of the NOD sera was obtained by antibody staining of nuclear structures
      from the mouse 3T3 fibroblast cell line, and by staining of salivary gland tissue
      sections. The nuclear and cytoplasmic staining patterns of diabetic NOD sera were
      reminiscent of the autoantibody staining patterns observed in Sjogren's syndrome
      and other inflammatory autoimmune connective tissue diseases.

PMID- 8370187
TI  - In vivo effects of thymustimulin on hematopoiesis of mice treated with
      cyclophosphamide.
AB  - This study reports on the in vivo effects of thymustimulin (TST), a thymic
      extract, on the hematopoiesis of mice treated with cyclophosphamide (CTX).
      Peripheral blood counts and both bone marrow pluripotent (spleen colony-forming
      units, CFU-S) and committed (granulocyte-macrophage colony-forming units, CFU-GM;
      erythroid burst-forming units, BFU-E) hematopoietic progenitor cells were assayed
      by in vitro methods. Administration of CTX alone was associated with severe
      hemotoxicity, which was followed by a gradual recovery of hematopoiesis.
      Hematotoxic effect of CTX was less pronounced when TST was administered in
      association with CTX. All the studied parameters were higher in TST + CTX-treated
      animals than those in CTX-treated animals, especially after Day 5 from the
      beginning of treatment for blood leukocytes, bone marrow cell counts, and packed
      red cell volume, and at Day 10 or 15 for CFU-S, CFU-GM, and BFU-E. These findings
      suggest that, in this experimental model, the simultaneous administration of TST
      reduces the myelosuppressive activity of CTX in vivo.

PMID- 8370188
TI  - Balloon dilatation of inferior vena cava obstruction in Budd-Chiari syndrome.

PMID- 8370189
TI  - Interventional techniques for the management of coronary artery lesions: an
      update.
AB  - Coronary balloon angioplasty has become standard treatment for ischemic coronary
      artery disease. Major limitations of angioplasty are the inferior results
      obtained with unfavorable lesions, the occurrence of abrupt occlusion responsible
      for in-hospital mortality and morbidity, and the high restenosis rate at 6
      months. New techniques for stents, laser, and atherectomy have been developed to
      overcome these limitations. Until now, although the initial results are
      encouraging, these new techniques have not as yet shown to be clearly superior to
      balloon angioplasty. However, due to the limitations of balloon angioplasty,
      further development of new techniques should be stimulated so that nonsurgical
      treatment of coronary artery disease will become safer, more effective, and
      applicable to a wider spectrum of coronary artery disease.

PMID- 8370190
TI  - Transesophageal echocardiography: increased risk by repeated attempts to insert
      the transducer in patients with coronary artery disease?
AB  - The question of whether several attempts at transducer insertion increase the
      risk of performing transesophageal echocardiography (TEE) in patients with
      coronary artery disease (CAD) has not been addressed to date. In the course of
      performing TEE in 45 patients with CAD, two or more attempts to insert the
      transducer were necessary in 9 cases. During various attempts, heart rate, blood
      pressure and ST-segment depression were recorded and correlated with the findings
      of the exercise electrocardiogram (ECG) and coronary angiography. Insertion was
      successful in six patients after two attempts and in three other patients after
      three, four, and five attempts, respectively. Heart rate rose significantly (p <
      0.005) with the increase of insertion attempts. In one patient, it continued to
      rise at the fourth attempt, reaching 216% compared with the initial heart rate.
      Systolic blood pressure rose by 5%, whereas there was hardly any change in
      diastolic blood pressure. As the number of insertion attempts increased, we
      recorded a continuous ST-segment depression in eight patients with angiographic
      changes of the coronary artery system. The depression was already significant at
      the first attempt (p < 0.05). Compared with the initial reading (0.053 mV), the
      increase was 335% (p < 0.01) after the second attempt (0.231 mV). One patient
      whose angiographic findings were normal had no ST-segment depression during TEE.
      In all eight patients with CAD ST-segment depression during TEE was > 0.2 mV.
      Since none of the patients complained of angina pectoris, the ST-segment
      depressions satisfied all the criteria of silent myocardial ischemia.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8370191
TI  - Amlodipine once a day in stable angina: double-blind crossover comparison with
      placebo.
AB  - Although calcium antagonists form a mainstay of therapy in patients with angina
      pectoris, the currently available agents have significant limitations.
      Nifedipine, diltiazem, and verapamil are all high-clearance agents with
      significant hepatic extraction and rapid clearance, leading to limited and short
      lived bioavailability necessitating frequent daily administration. In contrast,
      amlodipine, a dihydropyridine calcium antagonist, has a long half-life of 35-50 h
      (compared with 3 to 4 h elimination half-life of diltiazem, verapamil, and
      nifedipine). After oral doses, the relative bioavailability of amlodipine is high
      (64%) and absorption is smooth, with peak plasma levels being achieved 6-12 h
      postdose. Bioavailability is not affected by the consumption of food. In common
      with other dihydropyridine calcium antagonists, amlodipine is eliminated mainly
      by metabolism. None of the metabolites of amlodipine has significant calcium
      antagonist effects in humans. In contrast to verapamil or diltiazem, amlodipine
      has no effect on sinus or atrioventricular node and little or no effect on the
      resting heart rate. Amlodipine does not have any appreciable negative inotropic
      effect with the relevant clinical dose. Other clinical studies have shown
      amlodipine to be effective when used once-daily in chronic stable angina and
      vasospastic angina. Comparative studies indicate that the antianginal efficacy of
      amlodipine is comparable to the beta blocker nadolol and the benzothiazepine
      calcium antagonist diltiazem. Amlodipine has also been found to provide improved
      antianginal effects when combined to treatment with beta blockers and/or long
      acting nitrates. Treatment with amlodipine either as monotherapy or combined with
      other antianginal therapy for up to 26 weeks shows that efficacy is maintained,
      with no evidence of tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370192
TI  - Interobserver variation in interpretation of electrocardiographic signs of atrial
      infarction.
AB  - The electrocardiogram (ECG) is the only means of diagnosing atrial infarction
      antemortem. Certain ECG changes (PR-segment displacements) have been taken
      earlier as signs of atrial infarction. The purpose of this study was to assess
      the interobserver variation on suggested ECG signs of atrial infarction in
      patients admitted with acute myocardial infarction. The ECGs from 290 patients
      were evaluated by three physicians with respect to the occurrence of each of the
      following seven criteria suggestive of atrial infarction: (1) PR-segment
      elevation > 0.5 mm in lead I; (2) PR-segment depressions > 0.5 mm in leads II and
      III; (3) PR-segment depressions > 1.2 mm in leads I, II, and III; (4) PR-segment
      depressions > 0.5 mm in leads V1 and V2; (5) PR-segment elevations > 0.5 mm in
      leads V5 and V6; (6) PR-segment depressions > 1.5 mm in precordial leads; and (7)
      abnormal P waves. Kappa values ranged from 0.00-0.86. Of the seven criteria
      tested only criteria 2, 4, and 7 could be detected in a reasonable number of
      patients. The interobserver variations of these criteria were considerable,
      although the strength of agreement could be designated as fair to moderate.

PMID- 8370193
TI  - Changes in pulmonary hemodynamics predict benefits in exercise capacity after ACE
      inhibition in patients with mild to moderate congestive heart failure.
AB  - Several causes may affect the efficacy of angiotensin-converting enzyme (ACE)
      inhibitors in congestive heart failure (CHF). The present study was undertaken to
      identify what factors might predict benefits in exercise capacity after ACE
      inhibition in 22 patients with mild to moderate CHF. All patients underwent
      hemodynamic evaluation before and following an oral dose of quinapril (20 mg).
      They were then treated daily with 20 mg of quinapril and underwent exercise
      stress test off-drugs 1 day and 6 months later. Patients were grouped according
      to their relative changes in vascular resistances after quinapril: Group A (n =
      15) showed a greater decrease in pulmonary vascular resistance (PVR) than in
      systemic vascular resistance (SVR) (% delta PVR/% delta SVR > 1). The opposite
      occurred in Group B (n = 7). Comparison of pretreatment baseline features
      revealed that the two groups had similar biochemical and hormonal variables,
      cardiac index, and SVR. Conversely, Group A patients had higher (p < 0.05)
      pulmonary artery pressure and PVR compared with Group B patients. Following
      quinapril, Group A patients showed a greater (p < 0.05) increase in cardiac index
      than Group B patients, despite a similar reduction in SVR. Accordingly, 1-day
      drug treatment significantly (p < 0.001) increased exercise duration in Group A
      (+29%), but not in Group B patients (+7%). Benefits in exercise capacity were
      still significant (p < 0.001) 6 months later.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370194
TI  - Structural and dynamic changes in the elastic arteries due to arterial
      hypertension and hypercholesterolemia.
AB  - Five groups of 20 patients each were studied to analyze the vascular dynamics and
      structure of the elastic arteries. Group I consisted of healthy young individuals
      (27 +/- 4 years); Group II of healthy adults (46 +/- 9 years); Group III of
      normotensive hypercholesterolemic adults (45 +/- 12 years and serum cholesterol >
      239 mg/dl); Group IV of hypertensive normocholesterolemic adults (56 +/- 13
      years); and Group V of hypertensive hypercholesterolemic adults (56 +/- 9 years).
      The differential arterial pressure was estimated and divided by the volume change
      (delta P/delta V) of the aorta and the carotid and brachial arteries. The volume
      change was calculated using the "cylinder formula", measuring the radius from the
      ultrasonographic vessel image and assigning the cylinder a height of 1 cm. The
      A/E index of the Doppler transmitral spectrum and the maximum velocity flow using
      Doppler in the above arteries were calculated. The presence of carotid
      atherosclerosis was observed and given an arbitrary scoring grade of 0, 1, or 2.
      A higher arterial and ventricular stiffness was found in the hypertensive
      patients regardless of the presence of hypercholesterolemia. A higher fall in
      Doppler velocity and an increase in atherosclerosis lesions were found in Group
      V. Based on the results of this study, it was concluded that vascular and left
      ventricular stiffness have a close relationship with arterial hypertension but
      not with hypercholesterolemia. The hypercholesterolemic patients had a higher
      prevalence of carotid atherosclerosis and a higher scoring grade of severity.

PMID- 8370195
TI  - Ventricular tachycardia due to sustained bundle branch reentry: diagnostic and
      therapeutic considerations.
AB  - We have identified bundle-branch reentry (BBR) as the mechanism of ventricular
      tachycardia (VT) during electrophysiologic studies in 48 patients at our
      institution. All but three patients had significant structural heart disease,
      that is, dilated ischemic or idiopathic cardiomyopathy, the most common of
      anatomic substrates. Syncope and sudden death were the modes of presentation in
      up to 70% of these patients. The critical prerequisite for the development of
      this arrhythmia is conduction delay in the His-Purkinje system, which was present
      in all patients and manifests as a nonspecific conduction delay or a left bundle
      branch block (LBBB) in the surface electrocardiogram (ECG) and a prolonged HV
      interval in the intracardiac recordings. VT with an LBBB morphology is the most
      common form of BBR, present in 98% of patients. Transcatheter ablation of the
      right bundle branch (RBB) with the use of radiofrequency current is the treatment
      of choice, as it effectively eliminates BBR. During long-term follow-up,
      recurrent tachycardia due to BBR was not documented in any patient; however,
      congestive heart failure was a common cause of death in this population.

PMID- 8370196
TI  - Anatomy, histology, and pathology of the cardiac conduction system--Part VI.
AB  - Various pathologic conditions producing atrioventricular block are reviewed.
      Calcific atrioventricular block (aortic stenosis, mitral valve annular calcium),
      active infective endocarditis ("ring" abscess), acute and healed myocarditis,
      various collagen-vascular diseases, amyloidosis, and tumors are reviewed as
      causes of atrioventricular block. Various diseases producing bundle-branch block
      are also discussed.

PMID- 8370198
TI  - [Electrophysiological analysis of diabetic polyneuropathy with
      microneuronography].
AB  - We recorded median nerve action potentials in 40 healthy individuals and 40
      patients with type II diabetes mellitus by means of microneurography. The latter
      group included 20 patients complicated by dysesthesia of distal extremities (mean
      diabetic history: 12.4 years), and another 20 patients without dysesthesia (mean
      diabetic history; 5.5 years). Mean age of each group was about 60 years old and
      had no significant difference among three groups. Patients and healthy controls
      gave an informed consent for participation in this study. A tungsten
      microelectrode with a tip diameter of about 1 micron was inserted percutaneously
      into the median nerve trunk at elbow without anesthesia. With supramaximal
      electric stimulation on the median nerve at wrist, the largest compound nerve
      action potential was recorded. In healthy controls the median nerve action
      potential showed a large triphasic wave (positive-negative-positive, 400 microV
      in average amplitude) followed by small multiphasic waves. In diabetics maximal
      conduction velocity (NCV) and amplitude of this triphasic wave (Amp) were
      decreased and multiphasic waves became more prominent. Reproducibility of
      potentials in the same subject was acceptable. The differences among three groups
      were most conspicuous in Amp, and the amplitude of the multiphasic wave was
      increased in diabetic patients with dysesthesia. Thus, the diminution of Amp
      appeared to be associated with temporal dispersion due to segmental
      demyelination. In diabetic polyneuropathy NCV and Amp decreased along with the
      disease progression; in patients with advanced disease and subjective symptoms,
      small Amp and prominent multiphasic waves became apparent.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 8370197
TI  - H. Newell Martin.

PMID- 8370199
TI  - [Event-related potentials in progressive supranuclear palsy].
AB  - Abnormal event-related potential (ERP) has been reported in several types of
      dementing illness including Parkinson's disease (PD) and progressive supranuclear
      palsy (PSP). In this paper we report the result of EPR recordings obtained in
      normal control subjects (14 cases) and in patients with PSP (6 cases) and PD (32
      cases). ERPs were recorded from 13 scalp electrodes, using the acoustic odd-ball
      paradigm. All PD patients were in early stage (Yahr stage 1 to 2), and all PSP
      patients were in the mild-to-moderate state. In control subjects and PD patients
      P3 was normal. In PSP patients, only one subject (17%) showed a normal P3
      component, three cases (50%) demonstrated low amplitude and normal latency P3,
      and two cases (33%) featured lack of normal P3 sequence. The P3 abnormalities in
      PSP patients were not related with dementia, but with low amplitude P3 being
      observed in 2 of 3 non-demented patients, and abolished P3 in a patient with only
      mild dementia. The result suggests that the P3 changes in PSP patients develop
      earlier than the cognitive dysfunction, and they are related to the underlying
      subcortical lesion rather than dementia.

PMID- 8370200
TI  - [A pathological study of basilar artery sclerosis resulting from vertebral artery
      asymmetry].
AB  - We conducted a pathological study of the arteries of Willis ring in 130 autopsied
      specimens to evaluate the influence of vertebral artery (VA) asymmetry on basilar
      artery (BA) sclerosis. The cases studied comprised 109 of non-brainstem
      infarction (control) and 21 of thrombotic basilar artery occlusion (BAO). The
      frequency of VA asymmetry was significantly higher (p < 0.01) in BAO cases (13
      out of 21 cases; 61.9%) than in the controls (35 out of 109; 32.1%). In the
      controls, the mean scores for stenosis of the caudal (p < 0.01) BA were
      significantly higher in VA asymmetry pattern than in VA normal pattern, but the
      mean score of the rostral BA was nearly equal in both patterns. In BAO cases with
      VA asymmetry, the score for stenosis was higher in the caudal portion than in the
      rostral portion, and occlusion was frequently found in the lower BA and
      continuing from the thicker VA to the BA. These findings suggest that
      atherosclerotic changes may occur more preferentially in the lower BA in cases of
      VA asymmetry, and that VA asymmetry is considered to be one of the risk factors
      for BA occlusion.

PMID- 8370201
TI  - [A case of migraine with aura associated with meningioma].
AB  - We reported a case of migraine with aura associated with meningioma. A 66-year
      old female visited to our department in 1985, with occipital throbbing pain
      following visual hallucination and nausea. She had been diagnosed as migraine. CT
      scan, magnetic resonance image and angiography showed a right occipital tumor,
      which was totally removed in 1990. Postoperatively, the migraine disappeared
      completely. The tumor was histologically diagnosed as fibroblastic meningioma. We
      supposed that the migraine had been associated with meningioma. Although some
      previous papers reported correlation with brain tumor and migraine, as example of
      arteriovenous malformation or angioma, migraine associated with meningioma is
      very rare. In arteriovenous malformation, pathophysiology of migraine is unclear,
      but induction of circulatory disturbance in the distribution of the posterior
      cerebral, posterior communicating and basilar artery is supposed. And then a
      space occupying lesion in the occipital lobe is possible to cause in the
      circulatory disturbance of the posterior cerebral and basilar artery. In the
      diagnosis of migraine, we should consider its relation to brain tumors, such as
      meningioma.

PMID- 8370202
TI  - [Juvenile Binswanger-type encephalopathy with alopecia and spondylosis deformans-
      a case report].
AB  - The patient is a 33-year-old male and his parents are first cousins. He noticed
      his hair loss since about the age 14. At age 29, he manifested gait disturbance
      and urinary incontinence, which gradually progressed. Neurologically, he showed
      dementia (WAIS < 64), pyramidal and extrapyramidal signs, and pseudobulbar palsy.
      His blood pressure was normal. He also had dry skin with sclerema and marked
      cervical and lumbar spondylosis. His brain CT showed enlargement of the lateral
      ventricles and the periventricular low density areas. T2 weighted image of MRI
      showed diffuse high intensity in the periventricular white matter. Yamada et al
      presented a case progressive subcortical vascular encephalopathy (Binswanger
      type) with alopecia and spondylosis as a possible new syndrome, and this patient
      has the same syndrome. The etiology of this syndrome has not been known at the
      present time. The biopsied skin from the patient showed much hyaline deposits
      like glycoprotein in perivascular area of dermis. These morphological changes are
      very similar to those of lipoid proteinosis. These findings suggested that the
      pathological mechanism of this syndrome might be related to the biochemical
      disturbance in lipoid proteinosis.

PMID- 8370203
TI  - [A case of non-Fukuyama type congenital muscular dystrophy with progression in
      early adulthood, ocular involvement, and sensorineural deafness].
AB  - Congenital muscular dystrophy (CMD) is a concept applied to infants showing
      muscular weakness and hypotonia at birth, with myopathic changes which are
      histopathologically similar to those of muscular dystrophy. Patients with
      Fukuyama-type CMD (FCMD), characterized by progressive muscular dystrophy, mental
      retardation and occasionally, convulsions, are more frequently seen in Japan than
      those with non-Fukuyama type CMD (NFCMD). FCMD has been regarded as a distinct
      clinical and pathological entity, although the nosologic status of CMD is still
      controversial. A 24-year-old man had exhibited hypotonia and weakness at birth
      and delay in early development. During childhood, his muscular weakness improved,
      and he rode a bicycle and enjoyed skiing. However, his strength began to
      deteriorate at the age of 19 years. Neurological examination on admission
      revealed prominent muscular wasting and weakness, predominantly in the proximal
      limbs. He had ocular involvement (corneal opacity and slow saccades),
      sensorineural deafness, and a high-arched palate, saddle nose and funnel chest as
      anomalous conditions. Serum CK was moderately elevated and EMG showed myogenic
      patterns. A muscle biopsy specimen of the left biceps brachii was dystrophic,
      showing increased variation in fiber size with fibrous tissue proliferation, an
      increased number of centralized nuclei, fiber splitting and
      degenerating/regenerating fibers. Those findings were compatible with those seen
      in NFCMD. In Japan, only one patient with NFCMD who was followed to adulthood has
      been reported. This patient's symptoms progressed very slowly. The present
      patient's course of illness was stable during childhood but progressive in early
      adulthood. It suggests heterogeneous clinical expression of the disease.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8370204
TI  - [A case of Crow-Fukase syndrome associated with chronic pachymeningitis].
AB  - A 34-year-old woman was admitted to our hospital in 1991, because of progressive
      headache, nausea and generalized edema. She was diagnosed as Crow-Fukase syndrome
      associated with plasma cell dyscrasia (IgA lambda type) in 1987, presenting with
      polyneuropathy, edema, and dermatologic changes. Those manifestations were
      improved with irradiation and corticosteroids, but headache, nausea and
      generalized edema gradually developed after the discontinuation of corticosteroid
      therapy in 1991. On admission, marked bilateral papilledema was noted but fever
      and meningeal irritation signs were absent. A spinal tap showed a clear
      cerebrospinal fluid (CSF) with an open pressure of more than 400 mmH2O, normal
      cell count, total protein level of 87 mg/dl, and IgG level of 12.3 mg/dl. The CSF
      culture for microorganisms was negative and the cytological study of CSF also was
      normal. De novo synthesis rate of CSF IgG was markedly elevated (35.3 mg/day).
      MRI of the head using Gd-DTPA revealed diffuse hypertrophic dura mater, which
      made the diagnosis of chronic pachymeningitis. Cerebral angiographies were
      normal. An RI cisternography demonstrated delayed absorption of the CSF without
      ventricular reflux. Gallium and bone scintigrams did not show any pathological
      accumulation of the isotopes in the head. The lack of abnormalities causing
      chronic pachymeningitis in this case suggests that the chronic pachymeningitis
      might be associated with Crow-Fukase syndrome. The development of increased
      intracranial pressure is not rare in Crow-Fukase syndrome but the etiology
      remained unknown in most cases. We therefore suggest that MRI study with contrast
      enhancement should be performed in cases of this condition with increased
      intracranial pressure.

PMID- 8370205
TI  - [Superior sagittal sinus thrombosis in paroxysmal nocturnal hemoglobinuria--an
      autopsied case].
AB  - A 43-year-old Japanese man was admitted to our hospital because of acute
      occipital headache and drowsiness. He had been diagnosed as paroxysmal nocturnal
      hemoglobinuria (PNH) with acute renal failure for 2 months prior to the
      admission. He had abdominal pain and fever of unknown origin for 2 weeks. On
      admission neurological examination revealed mild disturbance of consciousness,
      right papilledema and minimal nuchal rigidity. The urinalysis was normal and
      blood hemoglobin was 8.3 g/dl. Mild hemolysis was suspected because of decreased
      level of the serum haptoglobin. The magnetic resonance imaging (MRI) of the brain
      demonstrated the complete occlusion of the superior sagittal sinus by fresh
      thrombus and the cerebral hemorrhage in the right parieto-occipital subcortex. No
      other cause for cerebral sinus thrombosis was detected. The patient was treated
      medically using anti-edema agents, but on the twentieth hospital day he died
      because of brain herniation. The postmortem examination disclosed thrombosis in
      the superior sagittal sinus and transverse sinus on both side. There was a
      massive hematoma in the right parieto-occipital subcortex. The spleen and kidney
      also contained multiple venous thromboses. Twelve cases of cerebral sinus
      thrombosis with PNH have been reported in the literatures. Although cerebral
      sinus thrombosis is a common complication with PNH in Caucasian, but is rare in
      Asian including Japanese. This may probably depend upon a racial difference. To
      our knowledge, this is the first report of a patient with cerebral sinus
      thrombosis with PNH in Japan.

PMID- 8370206
TI  - [Isolated inferior rectus muscle paresis from midbrain infarction].
AB  - A 74-year-old woman, with hypertension and dilated cardiomyopathy, presented with
      sudden onset of diplopia without vertigo and other neurological symptom.
      Examination revealed left inferior rectus muscle paresis. Other neurological
      findings were normal. She had no cerebellar ataxia and sensori-motor dysfunction.
      Magnetic resonance imaging showed increased signal intensity on T2-weighted and
      proton density-weighted images in the right ventral midbrain, compatible with
      infarction involving the fascicular oculomotor fibers. Complete resolution of the
      diplopia and normal ocular motility were noted 3 months after the onset of the
      diplopia. Focal ischemic midbrain lesions should be considered in cases of
      isolated partial oculomotor nerve paresis.

PMID- 8370207
TI  - [A case of facial nerve neurinoma originated from cerebellopontine angle].
AB  - A 77-year-old man who had been diagnosed as the right peripheral facial palsy ten
      years ago, slowly developed progressive hearing loss and gait disturbance. He
      died of pneumonia. The autopsy revealed a tumor (4.7 x 2.6 x 2.6 cm) arising from
      the facial nerve in the region of the right cerebellopontine (C-P) angle. The
      tumor was displacing the cochlear and vestibular nerve, but did not extend
      laterally into the internal auditory meatus. Histological diagnosis of this tumor
      was neurinoma. Facial nerve neurinomas are relatively rare and most of them
      appear at the vertical portion of the facial nerve. Facial nerve neurinoma
      originated from the C-P angle is less frequently reported. The most frequent
      symptom of this neurinoma is hearing loss. We emphasize that preoperative
      diagnosis of facial nerve neurinoma in the C-P angle is difficult from
      neurological symptoms, even with CT scanning.

PMID- 8370208
TI  - [A case of multiple sclerosis manifesting piano playing movement].
AB  - We report a case of 33-year-old man with multiple sclerosis, showing piano
      playing movement in both hands. His course of multiple sclerosis was
      remittent/progressive during 2 years and the clinical manifestation suggested the
      spinal cord involvement. On July 15, 1991, he was admitted with numbness of the
      right limbs, and then developed piano playing movement in both hands, more marked
      in the right side. Neurological examination revealed mild weakness in the right
      upper extremity, and rough touch, pain, and temperature sensation were slightly
      decreased. However, there was no deep sensory abnormalities, such as vibration,
      fine touch, and position senses. Vibration sense was lost below ilium. CSF
      examination showed elevation of IgG index (1.6), three oligoclonal bands and
      myelin basic protein content of 2.4 ng/ml. There was no HTLV-I antibody in CSF.
      SSEP, elicited by median nerve stimulation at the right wrist, showed no N13 and
      low amplitude of N20. T2-weighted images of cervical MRI revealed area of high
      signal intensity at the C3-C4 level. The piano playing movement gradually
      improved and disappeared by the initiation of steroid hormone therapy. It was
      considered that involuntary movement in this patient was due to the spinal cord
      lesion caused by multiple sclerosis. These findings suggested that the
      involuntary movement like pseudoathetosis could present without deep sensory
      abnormalities.

PMID- 8370209
TI  - [Diffusion weighted magnetic resonance imaging in multiple cerebral infarction].
AB  - Serial examination of magnetic resonance images (MRI) for two months were carried
      out on two cases of multiple cerebral infarction during the acute stage. The T2
      weighted MR images at the onset of the infarction showed both acute (new) and
      chronic (old) lesions appearing as high signal area. While on the diffusion
      weighted images only an acute lesion was detected as a high signal area with good
      contrast. The diffusion coefficient of the acute lesion was lower than that of
      normal white matter. Diffusion coefficient of the chronic lesions were higher
      than that of normal white matter. Therefore, on the apparent diffusion
      coefficient mapping images (ADC images) only an acute lesion appeared as a low
      signal area. The examination of diffusion images was very useful for
      distinguishing an acute lesion from a chronic lesion during the acute stage of
      multiple infarction. The diffusion weighted images after 4 weeks from the onset
      showed the diffusion coefficient of the "acute" lesion to be the same level of
      normal white matter. And after 8 weeks from the onset, increased to a level
      higher than that of normal white matter to the same level of the "chronic"
      lesion.

PMID- 8370210
TI  - [Lesion of the bilateral MLF and unilateral paramedian pontine reticular
      formation, caused by an infarction in the midbrain tegmentum].
AB  - A 71-year-old man with bilateral medial longitudinal fasciculus (MLF) syndrome
      and paralytic pontine exotropia caused by an infarction of the midbrain tegmentum
      was reported. He suddenly noticed a diplopia and gait disturbance, and visited
      our clinic. Neurological examination revealed that this right eye was slightly
      abducted in the primary position. On horizontal gaze, outwardbeating nystagmus of
      the abducted eyes was observed, bilaterally. The adduction of the bilateral eyes
      was severely disturbed and the abduction of the left eye was slightly restricted,
      while the convergence was normal. T2-weighted magnetic resonance imaging revealed
      high signal intensity area in the medial portion of the midbrain tegmentum, which
      indicated an infarction. Several cases showing bilateral MLF syndrome with
      exotropia have been reported, but a case whose lesion was shown in the midbrain
      has not been reported so far. The present case suggests that paramedian pontine
      reticular formation (PPRF) is not confined to pons but expands to midbrain.

PMID- 8370211
TI  - [An immunopathological study during steroid-responsive and steroid-nonresponsive
      stages on a patient with neuro-Behcet's disease].
AB  - We followed up the clinical course and changes of brain magnetic resonance
      imaging (MRI) findings in a case of neuro-Behcet's disease, and performed serial
      immunological examinations of the cerebrospinal fluid (CSF). On the two episodes
      of acute exacerbation, gadolinium (Gd)-enhancement effects on brain MRIs were
      observed in the brain stem and the deep white matter of cerebral hemispheres. The
      CSF abnormality of this period was characterized by increases in proportions of
      polymorphonuclear leukocytes and intrathecal IgG synthesis in addition to the
      findings suggesting breakdown of the blood brain barrier (BBB). These findings
      disappeared in parallel with clinical improvement by corticosteroid therapy. In
      contrast, during a subsequent chronic progressive stage, steroid-resistant
      neuropsychiatric symptoms and an absence of Gd-enhancement effects on brain MRIs
      were observed despite progressive breakdown of BBB. These findings suggest that
      neuro-Behcet's disease should comprise two distinct immunopathogenetic stages,
      that is, a relatively early steroid-responsive stage with a relapsing-remitting
      clinical course and a late steroid-nonresponsive stage with a chronic progressive
      course.

PMID- 8370212
TI  - [Cerebrospinal fluid and plasma corticotropin-releasing hormone (CRH) in
      dentatorubropallidoluysian atrophy (DRPLA)--study in two cases of hereditary
      DRPLA].
AB  - The levels of corticotropin-releasing hormone (CRH) in cerebrospinal fluid (CSF)
      and plasma were examined in two cases of hereditary dentatorubropallidoluysian
      atrophy (DRPLA). Both patients were female and showed cerebellar ataxia, choreic
      movement and subcortical dementia. The onset ages of the first and second
      patients were 30 and 47 years, respectively. The first patient did not have the
      cerebral white matter damage (CWD). The second patient of late onset was
      associated with marked and diffuse CWD which was shown as high signal intensity
      by T2-weighted image on MRI. Regardless of accompaniment with CWD, the
      radioimmunoassay studies of CSF and plasma CRH revealed that both patients had
      markedly reduced levels of CRH in CSF and plasma. Together with the recent
      anatomic evidence on the distribution of CRH neurons and receptors in the central
      nervous system, the present results suggest that degeneration of the subcortical
      structures including the basal nuclei, the brain stem and the cerebellum involves
      degeneration and/or dysfunction of the CRH neuronal system which, presumably, are
      related to those of some other neurotransmitter systems, and that the reduced
      activity of the CRH system plays a pathophysiological role in such diseases as
      DRPLA with degeneration of the subcortical nuclei and the cerebellum.

PMID- 8370213
TI  - [Fungal meningitis caused by a Malassezia species masquerading as painful
      ophthalmoplegia].
AB  - The patient, an otherwise healthy 42-year-old woman, developed non-throbbing
      periorbital pain and abducens nerve palsy of the right side two weeks prior to
      the present admission. Under the diagnosis of Tolosa-Hunt syndrome, she had been
      placed on prednisolone (30 mg/day) in another hospital, leading to exacerbation
      of her neurologic manifestations. On admission, neurologic examination revealed
      bilateral abducens nerve palsy, incomplete bilateral oculomotor paresis, and
      hypalgesia in the first and the second branch of the left trigeminal nerve. On
      CSF examination there were 742/mm3 white blood cells of which about 80% of the
      cells were neutrophils. The glucose was 70 mg/dl (blood glucose was 170 mg/dl)
      and the protein 49 mg/dl. Although repeated cultures for bacteria or fungi were
      negative, PAS stains for CSF sediments showed a large number of yeasts
      morphologically consistent with a Malassezia species. Anti-fungal treatment with
      fluconazole and flucytosine resulted in dramatic improvement both in neurologic
      signs and laboratory findings. According to morphological criteria, the yeasts
      found in CSF sediments from this patient differed from those described previously
      as being pathogenetic in the CNS fungal infection. By contrast, these yeasts were
      similar to a Malassezia species in all aspects. Because some Malassezia requires
      oil for its growth in culture, it is possible that it failed to grow in the
      standard media and thus escaped recognition.

PMID- 8370214
TI  - Colour flow and spectral Doppler imaging after papaverine-induced penile erection
      in 220 impotent men: study of temporal patterns and the importance of repeated
      sampling, velocity asymmetry and vascular anomalies.
AB  - Of 220 impotent men studied, 52 demonstrated venous leakage, 85 had arterial
      insufficiency and 65 showed normal vascular response. Persistent diastolic
      velocity > 7 cm/s diagnosed venous leakage with a sensitivity of 94% and a
      specificity of 69%, using cavernosography as the reference standard. Using
      clinical response as the reference standard maximal systolic velocity of 30 cm/s
      identified normal penile arterial response with a sensitivity of 96% and
      specificity of 82%. There was a good correlation between penile arterial
      insufficiency and a strong history of arteriopathy. Time to peak systole > 0.1 s
      was a reliable predictor of arteriogenic impotence and Pulsatility Index (PI) <
      300 was discovered only in patients with either venous leakage or arteriogenic
      impotence. Peak systolic velocity (Tmax) occurred between 5.2 and 6.5 min after
      injection, and diastolic velocity was minimal at 9 min with only the normal
      responders showing reversed diastolic flow. However, 22% had a delayed response
      (Tmax range 1-18 min). Velocity asymmetry was equally common in the three groups
      and unilateral sampling would have misdiagnosed 6% of patients studied. Vascular
      anomalies were seen in 13%, particularly a single feeding artery, dorsal vein
      flow or collateral arterial flow.

PMID- 8370215
TI  - The effective use of magnetic resonance imaging in the diagnosis of acoustic
      neuromas.
AB  - The diagnostic approach to acoustic neuromas is complex but these tumours are
      infrequent in patients even with a suggestive clinical picture. Easy access to an
      efficient, reliable and cost effective investigation is desirable. Magnetic
      resonance imaging is now the imaging modality of choice and this paper shows that
      it may be used effectively as the sole investigation. T2-weighted (T2W) fast spin
      echo axial images taking 1 min 37 s to acquire were compared with T1-weighted
      (T1W) gadolinium-enhanced axial images, taking 5 min 11 s to acquire, in 157
      patients. The T2W images were satisfactory alone in 43% of patients and allowed
      confident diagnosis of seven of the nine acoustic neuromas. Partial volume
      artefact and CSF flow artefact resulted in equivocal examinations in the
      remaining patients. Using both sequences in every patient, imaging time was 7 min
      41 s and at least 40 patients could be examined in 1 day, thus ensuring efficient
      patient throughput. We suggest that T2W fast spin echo axial images be routinely
      obtained and that only when they are equivocal should T1W gadolinium-enhanced
      axial sequences be employed.

PMID- 8370216
TI  - Aortoarteritis of abdominal aorta: an angiographic profile in 110 patients.
AB  - The angiographic appearances in 110 patients (49 males, 61 females, age range 11
      46 years, mean 27.8 years) with aortoarteritis involving the abdominal aorta
      and/or its branches were analysed. There were 41 aneurysms of the abdominal aorta
      in 37 patients and eight aneurysms of its branches in as many patients. In 50
      patients, 53 obstructive lesions involved the abdominal aorta and were classified
      as stenoses of focal, segmental and diffuse types and total occlusions. Branch
      obstructions (182 lesions in 85 patients) affected in order of frequency, the
      renal, superior mesenteric, coeliac, iliac and the inferior mesenteric arteries.
      Mesenteric arterial lesions were significantly more common in males (P = 0.01).
      Collateral circulation through a prominent mesenteric arcade was a distinctive
      angiographic feature in 28 patients. Computed tomography done in four patients
      showed peri-adventitial thickening and layered thrombus within aneurysms in three
      patients, and luminal occlusion of the upper abdominal aorta in one patient.
      Angiographic appearances in aortoarteritis of the abdominal aorta are
      characteristic and sufficiently distinctive for definitive diagnosis and
      appropriate management.

PMID- 8370217
TI  - A long term follow-up of Gunther vena caval filters.
AB  - Seven patients with Gunther inferior vena caval filters were reviewed between 28
      and 60 months following insertion of the filter. Some 71% of the filters showed
      some sort of structural failure, the commonest of these being limb fracture
      (57%). Fifty-seven per cent also showed either fracture or severe distortion of
      the basket. Twenty-nine per cent of the filters had suffered loss of an anchoring
      limb. Only one patient had any clinical sequelae, this being an IVC occlusion.
      This study confirms that Gunther inferior vena caval filters have a structural
      failure rate of greater than 50%.

PMID- 8370218
TI  - Mammographic parenchymal patterns in Asian and Caucasian women attending for
      screening.
AB  - The breast parenchymal patterns were assessed and compared on the screening
      mammograms of 200 Asian and 400 Caucasian women, matched for age and between 50
      and 64 years of age. The breast patterns were allocated according to Wolfe's
      classification. The results show a significant excess of Asians in the P1 and N1
      groups and a deficit in the P2 group. Taking N1 and P1 as a low risk group and P2
      and DY as a high risk group, there is a highly significant excess of Asians in
      the low risk group. These findings are considered in relation to the low
      incidence of breast cancer in Asian women and their poor acceptance of breast
      screening.

PMID- 8370219
TI  - Ultrasound in the diagnosis of gall-bladder carcinoma in Chinese patients.
AB  - A review of the ultrasound (US) findings with clinical and pathological
      correlation in 18 Chinese patients with gall-bladder carcinoma (GBCa) showed that
      the most frequent appearance was that of diffuse infiltration and thickening of
      the GB wall (8/18 patients, 44%). Polypoid protrusion into the GB lumen (5/18
      patients, 28%) and massive replacement of the entire GB (5/18 patients, 28%)
      accounted for the remainder. The infiltrating type of tumour was poorly-detected
      by US (1/8) and was more frequently seen than has been reported in the Western
      population. Frequent associations with GB calculi (13/18) and synchronous
      presentation of biliary sepsis (6/18) also contributed to a modest overall US
      detection rate of 50% (9/18) in this series. Most tumours detected by US were
      hyperechoic in appearance (6/9). Biliary obstruction was detected by US in 5/6
      patients, but only thought to be malignant in 3/6. It most often occurred due to
      spread of tumour to peripancreatic lymph nodes. Hepatic metastases were seen by
      US in 4/5 patients. Discontinuous GB wall calcification and non-dependent stones
      due to elevation by tumour (the 'elevated stone' sign) were infrequent but
      reliable signs of GBCa, seen in 5/18 and 3/18 respectively. This study suggests
      that GBCa is as difficult to detect sonographically in Chinese patients as in the
      Western population. GBCa must be included in the differential diagnosis of causes
      of both the acutely-presenting 'hot' gall-bladder and lymph node masses in the
      peripancreatic region if the US detection rate of this important biliary
      malignancy is to be improved.

PMID- 8370220
TI  - Barium enema or computed tomography for the frail elderly patient?
AB  - In order to determine whether abdominopelvic computed tomography (CT) offers an
      alternative to barium enema (BE) for the investigation of the large bowel in
      frail elderly patients, we have assessed and compared the results of both tests
      performed in each patient. Thirty-seven patients aged 71 to 88 (mean 80) with a
      history or clinical findings suggestive of large bowel disease were studied. The
      seven colonic neoplasms in this group were demonstrated by both techniques (apart
      from one patient who did not undergo BE as CT had shown an obstructing lesion).
      CT showed useful additional data in four patients (e.g. abdominal wall
      involvement) and demonstrated numerous extracolonic lesions (e.g. ovarian
      carcinoma). However, CT did raise the possibility of a large bowel neoplasm in
      four patients where none was shown by BE and missed one case of Crohn's disease.
      CT was the preferred test amongst the 25 patients where the acceptability of the
      two techniques could be compared. Only in 16 patients were the BE studies
      adjudged to be of good quality. CT should be the initial investigation of the
      large bowel in frail elderly patients requiring inpatient bowel preparation; the
      more unpleasant BE could be reserved for those cases where CT is equivocal or
      severe symptoms are unexplained.

PMID- 8370221
TI  - Postaortic left innominate vein: radiological assessment and pathogenesis.
AB  - Postaortic left innominate vein (PALIV) is a rare venous anomaly and the findings
      on plain chest radiographs have not been well described. Plain chest radiographs,
      CT and MR of nine adults known to have PALIV were reviewed. They all showed a
      high aortic arch, including four with a right-sided aortic arch and one with a
      double aortic arch, in postero-anterior radiographs, and seven showed curved
      shadows in the left upper mediastinum. On all lateral chest radiographs (n = 5),
      the superior retrosternal region was opacified by the high aortic arch. CT or MR
      images confirmed the aortic arch and/or innominate artery to be in that part of
      the retrosternal space, normally occupied by the left innominate vein, in all
      cases. Association of a curved shadow in the superior mediastinum with a high
      aortic arch on plain chest radiographs is therefore suggestive of, though not
      diagnostic for, PALIV. This entity was well documented by CT or MR and the
      radiological findings were considered to imply that developmentally PALIV is
      secondary to a high position of the aortic arch.

PMID- 8370222
TI  - Pictorial review: benign and malignant enlargement of the pterygo-masseteric
      muscle complex.
AB  - Seven cases of unilateral enlargement of the pterygoid and/or masseter muscles
      due to haemangioma (1), benign masseteric hypertrophy (2), rhabdomyosarcoma (2),
      leukaemic infiltration (1) and non-Hodgkin's lymphoma (1) are presented. The
      differential diagnosis of pterygo-masseteric muscle enlargement is outlined and
      the usefulness of computed tomography (CT) discussed.

PMID- 8370223
TI  - Case report: mediastinal lymphadenopathy in eosinophilic pneumonia.
AB  - Chronic eosinophilic pneumonia is a relatively rare disorder characterized
      radiologically by non-segmental homogenous consolidation in the lung periphery
      [1]. We present a patient who had marked mediastinal lymphadenopathy as well as
      the more typical radiological features, which resolved rapidly with treatment.

PMID- 8370224
TI  - Case report: computed tomographic and scintigraphic appearances of
      dermatofibrosarcoma protuberans.
AB  - The computed tomographic and scintigraphic appearances of dermatofibrosarcoma
      protuberans involving the mental region are presented. The tumour was
      demonstrated as a moderately well-defined vascular mass extending from the skin
      to invade the subcutaneous tissue and strap muscles. Only one case of the imaging
      features of this rare tumour has been reported previously.

PMID- 8370225
TI  - Case report: calcification in benign cystic peritoneal mesothelioma.
AB  - Benign cystic mesothelioma of the peritoneum is a rare multicystic tumour that
      occurs predominantly in middle aged women with strong predilection for the
      surface of the pelvic viscera. Our patient was a 79-year-old woman who presented
      with weight loss and left upper abdominal mass showing calcification on CT. This
      is the first reported case of benign cystic mesothelioma with calcification.
      Differentiation from an adrenal tumour and peritoneal teratoma was not possible
      preoperatively.

PMID- 8370226
TI  - Case report: generalized arthralgia following Gd-DTPA administration.
AB  - A case of transient generalized arthralgia in a young female patient following
      the intravenous administration of Gd-DTPA (dimeglumine gadopentetate-Schering) is
      presented. We believe that this is the first report of an adverse drug reaction
      of this nature.

PMID- 8370227
TI  - Accessory navicular bone.

PMID- 8370228
TI  - Staging prostatic cancer.

PMID- 8370229
TI  - Clinico-radiological meetings.

PMID- 8370231
TI  - Re-engineering health care.

PMID- 8370230
TI  - Optimum dosage of hyoscine-N-butylbromide for biphasic barium meals.

PMID- 8370232
TI  - Understanding health care integration. 1.
AB  - The decade of the 1990s is likely to be looked upon by future social historians
      and health policy analysts as the time of greatest change in the American
      healthcare industry. They will point to this decade as the time when new
      principles of healthcare delivery were implemented.

PMID- 8370233
TI  - Middle cerebral artery velocity during head-up tilt induced hypovolaemic shock in
      humans.
AB  - Middle cerebral artery mean velocity (Vmean) and pulsatility index (PI) were
      followed during head-up tilt induced hypovolaemic shock in nine subjects. Mean
      arterial pressure (MAP), heart rate (HR), central venous pressure (CVP) and
      thoracic (TI) electrical impedance were also recorded. Vmean, PI, and CVP did not
      change during head-up tilt to 50 degrees, while MAP increased from 92 (81-106)
      (median and range) to 100 (97-112) mmHg, HR from 63 (53-74) to 84 (68-89) beats
      min-1 and TI100kHz from 30 (27-36) to 32 (30-39) Ohm (P < 0.01) (n = 8). During
      maintained tilt, Vmean decreased from 52 (32-72) to 34 (16-59) cm s-1, whereas HR
      increased to 87 (52-108) beats min-1 and TI100 kHz to 33 (31-39) Ohm (P < 0.01).
      Presyncopal symptoms appeared after 33 (3-46) min and were associated with a MAP
      of 65 (32-84) mmHg (P < 0.01) and a HR of 58 (52-71) beats min-1 (P < 0.05).
      Vmean decreased to 25 (16-36) cm s-1, and cerebral conductance index
      (Vmean/MAPbrain) and PI increased (P < 0.01). Arterial collapse was observed
      (diastolic velocity of zero) in one subject at a brain (diastolic) blood pressure
      of 21 mmHg and he developed tachycardia (131 beats min-1) during presyncope.
      PaCO2 did not change. Maintained tilt resulted in central volume depletion
      reflected by changes in MAP, HR, and thoracic electrical impedance but not in
      CVP. Transcranial Doppler derived indices of cerebral perfusion demonstrated
      critically low values despite marked increase in conductance index.

PMID- 8370234
TI  - Work capacity and metabolic and morphologic characteristics of the human
      quadriceps muscle in response to unloading.
AB  - The response of skeletal muscle to unweighting was studied in six healthy males
      who were subjected to four weeks of lowerlimb suspension. They performed three
      bouts of 30 consecutive maximal concentric knee extensions, before unloading and
      the day after (POST 1), 4 days after (POST 2) and 7 weeks after (REC) resumed
      weight-bearing. Peak torque of each contraction was recorded and work was
      calculated as the mean of the average peak torque for the three bouts and
      fatigability was measured as the decline in average peak torque over bouts.
      Needle biopsies were obtained from m. vastus lateralis of each limb before and at
      POST 1. Muscle fibre type composition and area, capillarity and the enzyme
      activities of citrate synthase (CS) and phosphofructokinase (PFK) were
      subsequently analysed. Mean average peak torque for the three bouts at POST1,
      POST2 and REC was reduced (P < 0.05) by 17, 13 and 7%, respectively. Fatigability
      was greater (P < 0.05) at POST2 than before unloading. Type I, IIA and IIB
      percentage, Type I and II area and capillaries per fibre of Type I and II did not
      change (P > 0.05) in response to unloading. The activity of CS, but not PFK,
      decreased (P < 0.05) after unloading. The weight-bearing limb showed no changes
      in the variables measured. The results of this study suggest that this human
      lowerlimb suspension model produces substantial impairments of work and oxidative
      capacity of skeletal muscle. The performance decrements are most likely induced
      by lack of weight-bearing.

PMID- 8370235
TI  - The effect of opioids on inspiratory muscle fatigue during inspiratory resistive
      loading.
AB  - The effect of opioids on inspiratory muscle function under high mechanical load
      is still unknown. Even less clear is the extent to which opioids influence the
      shift of the electromyographic power spectrum of the inspiratory muscles to lower
      frequencies during ventilatory stress. We studied seven healthy subjects
      breathing against high inspiratory threshold loads until exhaustion while keeping
      the minute ventilation constantly high. We compared runs with and without
      administration of 0.2 mg kg-1 of morphine sulphate intramuscularly; two subjects
      were given 30 mg morphine sulphate so that we could study the effect of higher
      opioid concentration. The endurance time (Tlim), the diaphragmatic electromyogram
      (EMG), the transdiaphragmatic pressures (Pdi) and the ventilatory effort
      sensation were analysed. Morphine did not have any effect on Tlim or on the
      effort sensation elicited by the inspiratory resistance in both concentrations.
      Analysing the spectral shifts of the diaphragmatic EMG, we did not find any
      significant difference in the decrease of the centroid frequency between drug and
      control runs. Furthermore, the activation pattern of the diaphragm and the
      intercostal muscles, evaluated from the percentage contribution of oesophageal
      and gastric pressures on the transdiaphragmatic pressure swings, did not change
      following the administration of morphine. Our study shows that morphine does not
      change the function of the inspiratory muscles during high-resistive breathing.
      Morphine does not affect the electromyographic power spectrum of the diaphragm
      during those resistive breathing runs, either. This points out that during
      stressful ventilatory situations, the shift of the electromyographic power
      spectrum is attributed to a peripheral (muscular) event consequent to muscle
      fatigue and not to the elaboration of endogenous opioids.

PMID- 8370236
TI  - Renal effects of i.v. adenosine infusion in humans.
AB  - The effects of systemic intravenous (i.v.) infusion of adenosine on renal blood
      flow and glomerular filtration in eight healthy, awake females have been
      examined. Renal blood flow and glomerular filtration rate were measured as the
      clearance of para-aminohippuric acid (PAH) and inulin, respectively. Following
      basal sampling adenosine was infused i.v. at successive rates of 60 and 80
      micrograms kg-1 min-1 for 30 min at each rate. Plasma clearance of PAH showed a
      minor, but non-significant, increase from 697 +/- 41 to 775 +/- 97 ml min-1.
      However, the arterial plasma concentration of PAH decreased by 17 +/- 4% (P <
      0.001), indicating that there was a small increase in renal blood flow. Inulin
      clearance was reduced from 123 +/- 14 to 88 +/- 11 ml min-1 1.73 m-2 (P < 0.01).
      The resulting filtration fraction was reduced from 18 +/- 1 to 11 +/- 1 (P <
      0.001). The K+/Na+ excretion ratio increased from a basal value of 10 +/- 1 to 42
      +/- 11 (P < 0.01) at the highest dose of adenosine, and renal oxygen consumption
      decreased from 17 +/- 2 to 9 +/- 1 ml min-1 (P < 0.001). In conclusion, i.v.
      infusion of adenosine in healthy, awake subjects causes a minor increase in total
      renal blood flow and a marked reduction in glomerular filtration. This shows that
      adenosine also exerts a vasodilatory effect in the renal circulation, primarily
      on postglomerular arterioles. In addition, adenosine may produce an aldosterone
      like effect on salt excretion, and a reduction in renal oxygen consumption.

PMID- 8370237
TI  - Variability of digitized left ventricular M-mode echocardiography: a study in
      healthy subjects and patients with repaired tetralogy of Fallot.
AB  - To assess possible factors affecting the variability of digitized left
      ventricular M-mode echocardiograms, the influence of respiration and the
      variability due to different beats and observers were analysed in 11 healthy
      subjects and 11 patients with repaired tetralogy of Fallot. Left ventricular end
      diastolic dimension (LVEDD) decreased from end-expiration to end-inspiration in
      the healthy subjects, but not in the patients. The maximal rate of dimension
      change decreased in both healthy subjects and patients from end-expiration to end
      inspiration. The beat-to-beat variability assessed by the coefficient of
      variation (CV,%) between measurements of one cardiac cycle was twice the CV for
      three cycles, whereas the CV for three and five cardiac cycles was not different.
      The CV for intraobserver variability was less than 5.0% for dimensions and less
      than 13.0% for the rates of dimension change, whereas the interobserver
      variability had CV of 17.1% for rates of dimension changes. The influence of
      respiration and different observers on the variability of LV end-systolic
      dimension and shortening fraction was larger in the patients than in the healthy
      subjects. Thus, to obtain optimal technique for analysis of digitized LV M-mode
      echocardiograms in serial patient studies, the number of observers should be kept
      at a minimum and at least 3 beats at end-expiration should be used.

PMID- 8370238
TI  - Planar 201Tl scintigraphy in ischaemic heart disease: a critical re-evaluation of
      qualitative and quantitative data analysis.
AB  - The aims of the present study were to examine the observer agreement of
      qualitative (visual) and quantitative (computer-assisted) analysis of planar
      201Tl imaging and to compare the diagnostic values of these methods in the
      detection of infarcted and exercise-induced ischaemic myocardium. The study
      population comprised of 119 patients (aged 24-77 years) referred consecutively
      for stress thallium scintigraphy for either diagnostic reasons (n = 42, 35%) or
      for further evaluation of known coronary artery disease (CAD) (n = 77, 65%). The
      interobserver agreement was low with the qualitative method and significantly
      higher with the quantitative method: Kappa-values 0.29-0.39 vs. 0.80-0.92, P <
      0.00001. Sensitivity and specificity for the detection of previous Q-wave infarct
      was significantly higher with the quantitative method (94% and 94%) compared to
      the qualitative method (77% and 74%), P < 0.01. The corresponding predictive
      values of a positive and a negative test were 96% and 92% vs. 80% and 70% (P <
      0.01). In 86 patients in whom coronary angiography was performed the two methods
      did not differ significantly regarding sensitivity, specificity and predictive
      values for the diagnosis of reversible ischaemia or rather CAD. However, when 22
      patients with a maximal exercise heart rate < 80% of the predicted target heart
      rate were excluded the sensitivity was increased with both techniques and was
      significantly higher with the quantitative method. We conclude that qualitative
      image analysis has an unacceptably low reproducibility and that quantitative
      image analysis increases the diagnostic value of 201Tl scintigraphy considerably
      in both the detection of previous infarcts and, provided a sufficient exercise
      level is achieved, in the disclosure of reversible myocardial ischaemia.

PMID- 8370239
TI  - Neuropeptide Y, noradrenaline and invasive haemodynamic data in mild to moderate
      chronic congestive heart failure.
AB  - Neuropeptide Y (NPY) is a peptide released together with noradrenaline (NA) from
      sympathetic nerve endings. Elevated plasma levels of NA and NPY-like
      immunoreactivity (LI) are found in patients with congestive heart failure. In
      order to assess any relationship found between plasma NPY-LI and haemodynamic
      data 12 patients with mild to moderate chronic congestive heart failure were
      studied during cardiac catheterization. All patients were treated with diuretics
      but not ACE inhibitors and were in New York Heart Association functional class II
      or III. Mean left ventricular ejection fraction determined by echocardiography
      was 34%. Plasma NPY-LI from mixed venous blood was elevated in five patients and
      NA in nine. Mean plasma NPY-LI was 29 +/- 3 pmoll-1 (mean +/- standard error of
      the mean) and NA 2.6 +/- 0.3 nmoll-1. Heart rate was 70 +/- 3 beats min-1,
      systolic blood pressure (SBP) 131 +/- 7 mmHg, stroke volume index (SVI) 29 +/-
      1.9 ml m-2 and cardiac index (CI) 2.0 +/- 0.13 l min-1 m-2. Elevated levels of
      plasma NPY-LI (> 30 pmol l-1) were associated with lower SVI, CI, and SBP and a
      higher pulmonary vascular resistance. Elevated plasma NA (> 2 nmol l-1) did not
      correlate with haemodynamic data. Log NPY-LI correlated inversely with SVI (P <
      0.01) and CI (P < 0.05) but not with plasma NA. It is concluded that log NPY-LI
      in mixed venous blood correlates inversely with SVI and CI in patients with mild
      to moderate chronic congestive heart failure.

PMID- 8370240
TI  - Comparison between reference values for 201thallium uptake and washout from the
      myocardium after exercise and after dipyridamole.
AB  - A slow washout of 201Thallium has a high diagnostic and prognostic value for
      coronary artery disease. The aim of the present work was to contribute with
      reference data on 201Tl uptake and washout from the myocardium. With a
      quantitative method using circumferential profiles and interpolative background
      subtraction we performed 201Tl myocardial imaging in two groups of subjects with
      a low probability of coronary artery disease. Washout in per cent is defined as
      (1-D/I).100, where D is the delayed uptake rate and I the initial uptake rate. In
      group A (n = 16) myocardial hyperaemia was induced by maximal exercise, in group
      B (n = 15) by intravenous infusion of dipyridamole. In group A, the mean washout
      was 52%, and in group B it was 34% (P < 0.001). The delayed uptake rate D was
      significantly higher after dipyridamole, 58.4 cps, than after exercise, 44.5 cps
      (P < 0.05). There was no significant differences in I between the two groups. The
      findings regarding D and I explain that the washout is slower after dipyridamole
      than after exercise, as the mean D/I ratio was 0.48 in group A and 0.66 in group
      B (P < 0.001).

PMID- 8370241
TI  - Changes in plasma volume and baroreflex function following resistance exercise.
AB  - The dynamics of change in plasma volume (PV) and baroreflex responses have been
      reported over 24 h immediately following maximal cycle exercise. The purpose of
      this study was to determine if PV and baroreflex showed similar changes for 24 h
      after resistance exercise. Eight men were studied on 2 test days, 1 week apart.
      On 1 day, per cent change (% delta) in PV was estimated at 0,3, and 6 h after
      resistance exercise using haematocrit and haemoglobin. Baseline PV was measured
      24 h after exercise using Evans blue dye. The carotid baroreceptor-cardiac reflex
      response was measured before, and 3, 6, 9, 12, and 24 h post-exercise. Each
      subject performed six sets of the bench press and leg press with 10 repetitions
      per set with a load that induced failure within each set. On a control day, the
      protocol was used without exercise. Plasma volume did not change during the
      control day. There was a 20% decrease in PV immediately post-exercise; the
      recovery of the PV was rapid and complete within 3 h. PV was 20% greater 24 h
      post-exercise than on the control day. There were no differences in any of the
      baroreflex measurements. Therefore, it is suggested that PV shifts may occur
      without altering baroreflex sensitivity.

PMID- 8370242
TI  - The stuff that dreams aren't made of: why wake-state and dream-state sensory
      experiences differ.
AB  - It is adaptive for individuals to be continuously alert and responsive to
      external stimuli (such as the sound and odor of an approaching predator or the
      cry of an infant), even during sleep. Natural selection thus has disfavored the
      occurrence during sleep of hallucinations that compromise external vigilance. In
      the great majority of mammalian species, including Homo sapiens, closed eyes and
      immobility are basic aspects of sleep. Therefore, (a) visual and movement sensory
      modalities (except kinesthesis) do not provide the sleeper with accurate
      information about the external environment or the sleeper's relationship to that
      environment; (b) the sleeper's forebrain "vigilance mechanism" does not monitor
      these modalities; hence (c) visual and movement hallucinations--similar or
      identical to percepts--can occur during sleep without compromising vigilance. In
      contrast, the other sensory modalities do provide the sleeper with a continuous
      flow of information about the external environment or the sleeper's relationship
      to that environment, and these modalities are monitored by the vigilance
      mechanism. Hallucinations of kinesthesis, pain, touch, warmth, cold, odor, and
      sound thus would compromise vigilance, and their occurrence during sleep has been
      disfavored by natural selection. This vigilance hypothesis generates novel
      predictions about dream phenomenology and REM-state neurophysiology and has
      implications for the general study of imagery.

PMID- 8370243
TI  - Processing discontinuous words: on the interface between lexical and syntactic
      processing.
AB  - How are discontinuous words processed? Are they identified in the lexicon or in
      the syntax? Schreuder (1990) proposes the existence of morphological integration
      nodes (MI nodes) to account for the representation of complex verbs with
      separable prefixes in Dutch. We tested the MI model during sentence processing in
      Dutch, using an ungrammaticality judgment task. The results supported the
      predictions of the Schreuder model, and also provide evidence for distinct
      lexical/morphological and syntactic processing subsystems, each driven by the
      information resources and tasks relevant to its own representational vocabulary.
      It is argued that no special principles are needed to govern the interaction of
      lexical/morphological and syntactic processing, even for the identification of
      discontinuous words; this follows automatically from independently required
      characterizations of the subsystems themselves. We also examine the principles
      underlying the MI model in an attempt to extend the model to a wider array of
      constructions and languages. It is hypothesized that frequently encountered
      linguistic expressions are represented in the lexicon. In the basic case, they
      are represented as access nodes, if they may stand alone, and as MI nodes, if
      their constituents are already represented by access nodes. Unlike the original
      MI model, no further stipulation is needed concerning the existence or inhibition
      properties of MI nodes, assuming that candidate lexical/morphological hypotheses
      are appended to whatever portion(s) of the input string they are hypotheses
      about.

PMID- 8370245
TI  - Physical fitness.

PMID- 8370246
TI  - Diagnosis and management of vascular disease in systemic sclerosis.
AB  - Vascular disease is seen in virtually all patients with systemic sclerosis and
      presents several challenges to physicians caring for them. Early recognition of
      isolated pulmonary hypertension and scleroderma renal crisis may be keys to
      successful outcomes. Although complete reversal of vascular disease is usually
      not possible, the availability of calcium channel blocking agents for RP and
      isolated pulmonary hypertension and ACE inhibitors for hypertensive renal disease
      has improved the morbidity and mortality of these patients. Optimal management of
      the vascular events in systemic sclerosis will ultimately depend on a clearer
      understanding of their pathogenesis. Treatment may ultimately be directed at
      preventing the development of these vascular syndromes. This may occur through
      combined therapy directed at both the abnormal immune response and disregulated
      fibroblast function seen in the disease, as well at the abnormal vascular
      responses. Such therapies have yet to be identified.

PMID- 8370244
TI  - Modality-specific and amodal aspects of object perception in infancy: the case of
      active touch.
AB  - Three experiments investigated 4.5-month-old infants' perception of the unity and
      boundaries of haptically presented objects. When infants actively explored the
      two handles of an unseen object assembly, perception of the unity of the assembly
      depended on the handles' motion. Infants perceived a single, connected object if
      the handles moved rigidly together, and they perceived two distinct objects if
      the handles underwent relative vertical or horizontal motion. When infants
      passively explored the same object assembly undergoing the same motions, object
      perception appeared to be indeterminate. The findings of the active motion
      experiments accord with the findings of studies of visual object perception and
      suggest that object perception depends on amodal processes, operating on
      representations of either seen or felt surface motions. The findings of the
      passive motion experiments nevertheless suggest a difference between visual and
      haptic perception: for infants as for adults, haptic perception is enhanced by
      the active production of surface motion.

PMID- 8370247
TI  - Diagnosis, etiology, and therapy of fibromyalgia.

PMID- 8370248
TI  - Giant cell tumor of bone.

PMID- 8370249
TI  - Anabolic-androgenic steroids: use and abuse.

PMID- 8370250
TI  - Pediatric bone tumors.
AB  - A variety of benign and malignant bone tumors can affect the metabolically active
      pediatric skeleton. A thorough investigation with pertinent imaging studies can
      establish an appropriate differential diagnosis and frequently allows distinction
      between benign and malignant tumors. By using a multidisciplinary approach to the
      treatment of malignant tumors, a number of advances have been made. Further
      research is needed to gain more understanding and improve on the remarkable
      advances of the past 20 years.

PMID- 8370251
TI  - Extent and severity of periodontal destruction based on partial clinical
      assessments.
AB  - The aim of the present study was (i) to identify the 10 approximal tooth sites
      that provide Extent and Severity estimates of clinical attachment loss which are
      maximally coherent to the full mouth scores, and (ii) to evaluate the
      applicability of such a partial recording system. Data from two subject samples,
      comprising 192 subjects aged 30-64 yr (sample A) and 175 subjects aged 35-80 yr
      (sample B), were involved in the development and the evaluation of the system,
      respectively. Approximal probing attachment loss (PAL) measurements were
      available from all subjects. A PAL value of > 1 mm was required for a tooth site
      in order to qualify for the Extent and Severity computations. A full mouth
      bivariate Extent and Severity Index (FESI) was firstly calculated for every
      subject in sample A. Multiple regression models applied on data derived from the
      same sample identified the 10 approximal tooth sites which provided the best
      correlation to the full-mouth scores (correlation coefficients between partial
      and full mouth scorings of Extent and Severity 0.85 and 0.88, respectively). All
      tooth types were found to be represented in this set of sites and the ratio of
      mesial/distal sites was 6/4. The applicability of a partial recording system
      (PESI) based on these sites was evaluated in sample B. Fully comparable estimates
      between PESI and FESI values were obtained, but the degree of correlation varied
      at different ages. Further adjustments by means of regression models failed to
      increase the validity and reliability of the PESI.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8370252
TI  - Juvenile periodontitis--pattern of progression and relationship to clinical
      periodontal parameters.
AB  - The present investigation was carried out 1) to identify subjects with juvenile
      periodontitis (JP) in a group of schoolchildren from a community with a high
      prevalence of periodontal diseases and with no access to preventive dental care,
      and 2) to study the clinical features of the disease and the progression pattern
      during a period of 1 yr, and the relationship of JP to clinical periodontal
      parameters. The periodontal condition of a group of 502 Iraqi schoolchildren (260
      girls and 242 boys) was assessed radiographically and clinically at baseline.
      Children showing > or = 3 mm arc-shaped angular radiographic bone loss at the
      proximal surfaces of two or more first molars and who showed clinical attachment
      loss at the same sites were regarded as JP patients. A second group of children
      with no signs of JP were randomly chosen from the study material. One year later,
      the JP and the non-JP groups were re-examined radiographically and clinically to
      assess plaque, gingivitis and presence of calculus. The results showed that nine
      children (1.8%) had JP. The ratio of girls to boys was 3.5:1, and of localized to
      generalized forms 2:1. Mesial surfaces of first molars were more often affected
      than distal surfaces. Clinical assessments showed a more profound loss than was
      depicted radiographically. All JP patients exhibited evidence of periodontal
      disease progression during the following year. There were no differences between
      JP and non-JP children with respect to gingival inflammation, dental plaque, or
      calculus deposits on teeth.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370253
TI  - CPITN, DMFT, and treatment requirements in a Nicaraguan population.
AB  - WHO basic methods were used to assess CPITN, DMFT, and treatment requirements in
      a population of 178 persons aged 12-64 yr living in urban and rural areas of
      Nicaragua. Two groups were examined: individuals presenting for dental treatment
      at health clinics (30%) and subjects chosen randomly at other locations (70%).
      Mean ages of both groups were similar although females were found in higher
      percentages among those presenting for dental care. With the exception of one
      young individual, all subjects had calculus in at least one sextant. About 26% of
      the subjects who presented for treatment had a > or = 6 millimeter pocket
      compared to about 14% of the remainder of subjects. The mean DMFT for health
      clinic subjects was 16.1 compared to 10.3 for subjects from other locations.
      Subjects presenting for treatment had twice as many missing teeth and a mean of
      0.5 filled teeth compared to 2.4 filled teeth for other subjects. Subjects at the
      clinics were in greater need of restorative care and extractions, while subjects
      from other locations were found to have more teeth that did not require any
      treatment. Health clinic subjects reported more visits to the dentist in the last
      year than other subjects. Only 80% of those presenting for treatment owned a
      toothbrush compared to 97% of those examined in other locations, and the latter
      group reported brushing their teeth more frequently. Attrition was a commonly
      encountered tooth disorder with 53% of all subjects exhibiting this condition.

PMID- 8370254
TI  - Caries experience in Icelandic 12-year-old urban children between 1984 and 1991.
AB  - In order to evaluate trends in caries experience, a 20% random sample of 12-yr
      old residents of Reykjavik, Iceland (252 children) was examined clinically and
      radiographically in 1991 under conditions consistent with those of the survey
      conducted in 1984. In addition to caries data, frequency of toothbrushing and use
      of fluoride dentifrice were recorded. The mean DFT and DFS were 3.0 and 4.1,
      respectively. The decrease in caries experience reached 60% with an annual fall
      in DFS of nearly 10%. During the 7-yr period between examinations the decline in
      DFT and DFS scores averaged 5.2 and 8, respectively, the annual reduction
      amounting to 0.7 DF teeth or 1.1 DF surfaces per child. The ratio of
      approximal/occlusal caries and the proportion of approximal caries were similar
      in both surveys. Fourteen percent of the children were free from manifest caries
      in 1991, but only 2% in 1984. Polarization between low and high prevalence
      individuals had intensified. Ninety-five percent of the children brushed their
      teeth regularly and 97% reported using a fluoride dentifrice.

PMID- 8370255
TI  - Dental status of 12-year-olds treated in private practice and a school dental
      service.
AB  - Different ways of service provision frequently lead to different services being
      provided. In the School Dental Service (SDS) in Western Australia, all 5-15-yr
      olds are eligible for care free of charge and most avail themselves of the
      service. The parents of some children choose to use private dentists (typically
      copaying about 50% of the cost) and their children do not attend the SDS. This
      study aimed to compare the dental status of 12-yr-olds who attended private
      dentists with that of matched children enrolled in the SDS. Non-enrolled 12-yr
      olds in Perth (F- 0.8 mg/l) were identified and asked to provide background
      information and participate in clinical examinations. Each non-enrolled
      participant was matched with a classmate of the same sex. Of 184 non-enrolled
      children, 100 actually participated. Data on caries experience (DMFT and DMFS),
      fissure sealants and gingival health (CPITN) were collected by clinical
      examination. Analyses used Wilcoxon's signed rank, categorical and t-tests and
      simple linear regression. Caries prevalence was lower in non-enrolled children
      (0.31) than in enrolled (0.47). Caries experience was also lower in non-enrolled
      children (mean DMFT 0.71 vs. 0.95, ns). Enrolled children had more FT than non
      enrolled (Wilcoxon, P = 0.059) but the mean number of DT in each group was 0.14.
      Enrolled children had somewhat fewer fissure sealants than non-enrolled children
      but in enrolled children there was an apparent (P = 0.056) inverse relationship
      between number of fissure sealants and DMFT scores; this was not the case in the
      non-enrolled group, suggesting better targeting of fissure sealants in the
      SDS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370256
TI  - Assessment of diagnostic accuracy in caries detection: an analysis of two
      methods.
AB  - The quality of a diagnostic tool for caries detection is usually evaluated by
      quantification of observer performance using sensitivity and specificity values
      calculated from data obtained from ordinal caries depth rating scales. The
      application of Receiver Operating Characteristic (ROC) analysis has been
      restricted to the use of confidence rating scales. The aim of this investigation
      was to study the appropriateness of ROC analysis using caries depth ratings by
      comparing sensitivity and specificity values to parameters of diagnostic
      performance obtained by ROC analysis. In two recent reports, sensitivity and
      specificity values were utilized to express diagnostic accuracy of observer
      performance from specified caries diagnostic systems. The raw data from these
      investigations were subjected to ROC analysis in the current study. The results
      illustrated that ROC analysis, producing estimates of sensitivities for all
      specificities, yielded more comprehensive measures of diagnostic performance than
      single values for sensitivity and specificity. In particular, the area under the
      ROC curve constituted a clearly interpretable parameter representing the quality
      of diagnostic performance.

PMID- 8370257
TI  - Ethnicity and maternal education as risk indicators for dental caries, and the
      role of dental behavior.
AB  - The aim of this study was to assess differences in dental health between
      socioeconomic and ethnic groups in a cohort of 5-yr-old children born in 1982 and
      in a cohort of 11-yr-old children born in 1976. A further aim was to evaluate the
      putative role of dental behaviors as intervening factors between ethnicity and
      maternal education on the one hand and caries experience on the other. A
      secondary analysis was performed on data collected in a study monitoring the oral
      health of youths covered by public health insurance (Ziekenfonds) in the
      Netherlands. The results showed both ethnicity and maternal education to be
      indicators of caries risk in the primary dentition. For caries in the permanent
      dentition, only maternal education could be identified as a risk indicator.
      Dental behaviors were related to caries experience as well as to ethnicity and
      maternal education, though the evidence for the role of these dental behaviors as
      intervening factors was weak. It is concluded that the validity and reliability
      of the behavioral measurements might be questionable and that the mechanism
      underlying the differences in caries experience between the various groups is
      still little understood.

PMID- 8370258
TI  - Characteristics and treatment outcome of diagnostic subgroups of CMD patients:
      retrospective study.
AB  - The records of 193 randomly chosen patients with CMD referred 2.5 yr previously
      were examined retrospectively for anamnestic, clinical and radiological findings
      and observations related to treatment. These data were supplemented with
      information from questionnaires sent to all treated patients in which their
      opinion on the treatment outcome was asked. Within the patient group, four
      diagnostic subgroups were distinguished. Three subgroups consisted of patients
      with the diagnoses CMD with a mainly myogenous component, osteoarthrosis and
      internal derangement respectively, whereas the fourth subgroup consisted of
      patients who did not fit into one of these categories. Differences between the
      four groups were found concerning mean age, the prevalence of a limited range of
      motion, headache, psychosocial factors, loss of posterior tooth support and
      objective treatment outcome. The patients with CMD with a mainly myogenous
      component showed the highest percentages of CMD associated disorders, the least
      successful treatment outcome and the highest percentage of renewed treatment. The
      patients with internal derangement showed the lowest mean age, the highest
      prevalence of a limited range of motion and the best treatment outcome. The
      patients in the osteoarthrosis group showed the highest mean age and the highest
      percentage of loss of posterior tooth support. It may be concluded that the
      evaluation of diagnostic subgroups of CMD patients has to be preferred in the
      assessment of a heterogeneous group of patients with CMD.

PMID- 8370259
TI  - What do anxious patients think? An exploratory investigation of anxious dental
      patients' thoughts.
AB  - According to BECK's cognitive model of emotional disorders (1976) anxiety is
      associated with negative and threatening thoughts concerning the likelihood of
      personal danger. In the present study the content of thoughts of 32 anxious
      dental patients was investigated. Patients' mean score for the Dental Anxiety
      Scale was 17.1 (SD = 2.0). The average time period patients had not visited a
      dentist was 9.1 yr (SD = 8.7). Using semi-structured interviews 132 thoughts were
      explored. The mean number of thoughts reported per patient was 4.1 (SD = 1.6).
      Almost all patients reported thoughts in some way related to their fear. All
      patients except one reported self-verbalizations of a negative or catastrophizing
      nature. Nine different categories of the content of the thoughts were identified.
      Nine percent of the thoughts consisted of visual images. The largest category
      (23%) consisted of catastrophic thoughts about the patient's own functioning
      during dental treatment, e.g., thoughts about losing control, panicking and
      dying. Fifty-nine percent of the patients reported thoughts of this type. The
      findings provide support for BECK's cognitive model of emotional disorders.

PMID- 8370260
TI  - Prevalence study of tongue lesions in a Hungarian population.
AB  - The aim of the study was to assess the prevalence of tongue lesions in a district
      population, in Budapest, called regularly for X-ray lung examinations. Oral
      examinations of 7820 individuals were performed, 42% were over 60 yr of age,
      42.9% were men and 57.1% women. Tongue alterations were found in 18.52% of the
      examined individuals, more frequently in women than in men. Lingua fissurata has
      been diagnosed in 8.8%, geographic tongue in 3.0% of the examined subjects.
      Atrophic lesions of the tongue were found in 6.37%, among them 5.42% central
      papillary atrophy (median rhomboid glossitis): 0.35% of the total sample.
      Manifest clinical symptoms of oral Candidiasis were found in 2.15% of the total
      sample, and in 4.28% of patients with tongue lesions. The occurrence of oral
      leukoplakia and lichen in patients with tongue lesions was respectively 0.47 and
      0.07%. The prevalence of tongue alterations was consistent with the literary
      data, the oral screening attached to the X-ray lung examinations proved to be
      useful in detecting changes of the oral mucosa.

PMID- 8370261
TI  - Oral health status of a long-term-care, veteran population.
AB  - The Department of Veterans Affairs (VA) operates the largest, integrated health
      care system in the United States of America. The projected need for long-term
      care in the VA health care system parallels an expected increase in need for care
      in the United States, but precedes the need for care in the general population by
      25-30 yr. The VA's Office of Dentistry, in an effort to estimate the resource
      requirements of this swelling group of veterans, initiated in 1986-7 an oral
      health survey of long-term care patients. The overall goals were to describe the
      oral health status of VA nursing home care units (NHCU) residents and to develop
      a methodology for estimating future dental health services utilization. This
      study describes the oral health status of the study population. Demographic and
      oral health data were collected for 650 long-term care residents of six VA NHCUs
      between October 1986 and July 1987. Data were collected on sociodemographic
      status, medical history, dental caries, periodontal diseases, oral soft tissue
      pathology, and the presence of dental prostheses. Caries and periodontal disease
      were evaluated using the United States National Institute of Dental Research
      Survey of Employed Adults and Seniors protocols. The oral health status of the
      population is described using DMF and ESI indices, the prevalence of oral
      lesions, levels of tooth loss, oral hygiene scores, and the status of existing
      dentures. Findings show moderate levels of untreated dental caries and
      periodontal disease and significant tooth loss which increased with age. A need
      for preventive therapy, restorative dentistry, conservative periodontal therapy,
      and prosthodontic care was evident.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370262
TI  - Influence of age and gender on oral health and related behaviour in an
      independent elderly population.
AB  - Previous studies have been unable to determine the influence of advanced age on
      oral health because they included relatively few subjects, particularly men, over
      75 yr of age. In this study a disproportionate and stratified random sample of
      subjects over 70 yr and living independently was selected from a list of voters
      in Vancouver, B.C. The sample of 521 elders was structured to provide similar
      numbers of men and women in three 5-yr age-groups. All of the subjects were
      interviewed, and 255 of them, representing a similar distribution of age and
      gender, were examined to investigate the influence of aging on oral health and
      related behaviour. In bivariate analyses neither age nor gender was associated
      significantly with oral health or complaints. The use of dental services during
      the preceding year was associated with female and younger subjects, while men and
      older subjects usually went to dentists only to relieve pain. Logistic regression
      in a multivariate model confirmed the importance of natural teeth in predicting
      the use of dental services (by improving the prediction from 60% to 73%). Other
      models offered less useful improvements in predicting complaints (64% to 70%) or
      oral health (56% to 60%). Overall the study demonstrates that the age and gender
      of independent elders have very little direct influence on the oral health or
      related behaviour established early in life.

PMID- 8370263
TI  - Oral health care for nursing home residents in The Netherlands--a national
      survey.
AB  - In order to be able to develop adequate oral health care programs for nursing
      home residents in The Netherlands, currently available arrangements and problems
      experienced by dentists participating in this field of dentistry were evaluated
      in a national survey. One questionnaire was mailed to the managements of all
      nursing homes and a second to all dentists known to be involved in nursing home
      dentistry. The response rates were very high. The study indicated that, in almost
      every nursing home, dental care for residents was available, at least in cases of
      dental emergency. On average the dentists were spending only limited time on
      nursing home dentistry. The majority of dentists examined or treated the
      residents only when either the patients or others experienced or discovered an
      oral health problem. In delivering this kind of care the dentists experienced a
      lot of problems. These findings suggest that the oral health care for nursing
      home residents in The Netherlands must be evolved by research, special training
      of dentists, and through development of special care programs.

PMID- 8370264
TI  - Impact of dental fluorosis on the perception of well-being in an endemic
      fluorosis area in Tanzania.

PMID- 8370265
TI  - Determining optimal levels of fluoride in drinking water for hot dry climates--a
      case study in Sri Lanka.

PMID- 8370266
TI  - Monkeys and mug shots: cues used by rhesus monkeys (Macaca mulatta) to recognize
      a human face.
AB  - We investigated the cues rhesus monkeys (Macaca mulatta) use to recognize a
      familiar human face. To manipulate facial cues, schematic faces were constructed
      with Identi-Kit materials derived from mug shots. The monkeys (N = 4)
      spontaneously classed Identi-Kit as faces on initial presentations. The monkeys
      then learned to distinguish one Identi-Kit face, the standard, from others. Panel
      presses indicated recognition of the standard face. Eye movement recordings
      revealed that the monkeys predominantly fixated on the eyes of the standard face.
      When the standard face was transformed by removing, altering, or reorienting its
      features, only alterations of eyes or brows lowered recognition; removal of eyes,
      brows, nose, or lips did not. Responses to rotated, inverted, and scrambled
      versions of the standard face varied but generally disrupted recognition. We
      concluded that features and configuration were used to recognize the human face.

PMID- 8370267
TI  - Auditory frequency generalization and a failure to find octave generalization in
      a songbird, the European starling (Sturnus vulgaris).
AB  - Many species of songbirds have absolute pitch perception. They memorize tones
      when discriminating between sequences and fail to generalize to novel frequency
      ranges. I examined frequency generalization in starlings (Sturnus vulgaris) that
      were trained to discriminate between individual frequencies. Starlings were
      tested for frequency generalization after training on 2- and 3-tone
      discriminations. There was no evidence for octave generalization, which is a
      hallmark of human absolute pitch perception. This suggests that avian absolute
      pitch perception must not be interpreted as identical with that in humans. A
      control experiment with 1-tone discriminations indicated that the presence of lit
      response keys affects the shape of the generalization gradients. Lit response
      keys are a common feature in avian auditory perception experiments, and this
      control experiment cautions that results may be affected by this seemingly minor
      procedural change.

PMID- 8370268
TI  - Imitation in free-ranging rehabilitant orangutans (Pongo pygmaeus).
AB  - We made an observational study of spontaneous imitation in orangutans (Pongo
      pygmaeus). Previous studies may have underestimated great apes' imitative
      capacities by studying subjects under inhibiting conditions. We used subjects
      living in enriched environments, namely, rehabilitation. We collected a sample of
      spontaneous imitations and analyzed the most complex incidents for the likelihood
      that true imitation, learning new actions by observing rather than by doing, was
      involved in their acquisition. From 395 hr of observation and other reports on 26
      orangutans, we identified 354 incidents of imitation. Of these, 54 complex
      incidents were difficult to explain by forms of imitation based on associative
      processes grounded in experimental learning alone; they were, however, congruent
      with acquisition processes that include true imitation. These findings suggest
      that orangutans may be capable of true imitation and point to critical eliciting
      factors.

PMID- 8370269
TI  - Posture and reaching in chimpanzees (Pan troglodytes) and orangutans (Pongo
      pygmaeus).
AB  - Hand preference in reaching was assessed under 2 postural adjustment conditions
      in 40 chimpanzees (Pan troglodytes) and 9 orangutans (Pongo pygmaeus). The
      postural conditions were quadrupedal and upright, during which reaching for food
      was scored on a minimum of 50 trials. Results indicated no population preference
      during quadrupedal reaching but a right-hand population preference was found
      during upright reaching. There were no significant effects of age or sex on
      either the direction or strength of hand preference. Early rearing history
      affected the strength of hand preference but not direction. The results suggest
      that posture is an important factor in the assessment of hand preference in great
      apes and may have important evolutionary consequences.

PMID- 8370270
TI  - Time-dependent decisions in dogs (Canis familiaris).
AB  - We investigated whether the foraging decisions of dogs (Canis familiaris) were
      time dependent and consistent with a temporal weighting rule (TWR) for maximizing
      the reliability of information. Dogs were given information about patches whose
      qualities varied over time. To simulate natural conditions, we interposed
      interruptions at selected points in foraging. Patch choices were time dependent
      and closely matched the predictions of TWR. Dogs relied on very recent
      information when available, but with increasing delays they used patch averages.
      TWR may be a general solution to problems faced by foragers in variable
      environments.

PMID- 8370271
TI  - Processes of social learning in the tool use of chimpanzees (Pan troglodytes) and
      human children (Homo sapiens).
AB  - Common chimpanzees (Pan troglodytes) and 2-year-old human children (Homo sapiens)
      were presented with a rakelike tool and a desirable but out-of-reach object. One
      group of subjects observed a human demonstrator use the tool in one way, and
      another group observed a demonstrator use the tool in another way. Children in
      both cases did what the model did. Chimpanzee subjects, however, behaved
      identically in the 2 model conditions. Both groups performed better than subjects
      who saw no demonstration. This pattern of results suggest that the chimpanzees
      were paying attention to the general functional relations in the task and to the
      results obtained by the demonstrator but not to the actual methods of tool use
      demonstrated. Human children were focused on the demonstrator's actual methods of
      tool use (her behavior). The different social learning processes used by the 2
      species have implications for their different forms of social organization.

PMID- 8370272
TI  - Caregiving in virgin mice (Mus musculus): effects of biparental care and exposure
      to a second litter during preweaning development.
AB  - I examined the effects of early family unit conditions on later parenting
      behavior in laboratory mice (Mus musculus). I challenge previous studies that
      claim to show enhancing effects of biparental care on offspring parental
      responsiveness by raising mice with a male parent either present (MPP) or absent
      (MPA) during preweaning development. The results of those studies are confounded
      because MPP mice also have a second litter present (SLP) and MPA mice do not
      (SLA). Thus, the findings may have been due to the presence of second litter and
      not to the presence of the male parent. In this experiment I show that when
      offspring raised in different family units are tested as virgins with stimulus
      pups, more SLP mice are parental than SLA mice, and fewer SLP mice bite newborn
      pups than do SLA mice. Thus, results of previous studies are due to second litter
      exposure and not biparental care.

PMID- 8370273
TI  - Development of spontaneous classificatory behavior in chimpanzees (Pan
      troglodytes).
AB  - I investigated the development of spontaneous classificatory behavior in 5
      chimpanzees (Pan troglodytes) tested at different ages and analyzed subjects'
      spontaneous constructive interactions with sets of logically structured objects.
      The results show that chimpanzees possess a natural capacity to react to
      similarities and differences among test stimuli and construct classes. The
      general progression of their classificatory development is very similar to that
      reported for human infants from 6 to 24 months. In both species, classification
      progresses from constructing single classes by different properties of objects to
      constructing single classes by similar or identical properties of objects. In
      addition, like humans, older chimpanzees spontaneously coordinate relations of
      similarities between sets and construct 2 class-consistent groupings.
      Chimpanzees' results are compared with those from a similar study with capuchins
      and macaques.

PMID- 8370274
TI  - Memory for individual scent in hamsters (Mesocricetus auratus) as assessed by
      habituation methods.
AB  - The memory of hamsters (Mesocricetus auratus) for the flank scent of other male
      hamsters was investigated in a series of habituation experiments. In 2 types of
      habituation tasks (Experiments 1 and 2), male hamsters habituated to the flank
      scent of 1 male and then increased their level of investigation to that of a
      novel male; similar results were obtained when the intervals between trials
      ranged from 1 s to 2 days. When the test trial was 10 or 21 days after
      habituation (Experiment 3), males discriminated between familiar and novel flank
      scents at 10 days but not at 21 days. The results demonstrate recognition of
      familiar and unfamiliar individual odors and excellent memory for these
      differences. Habituation techniques yield extremely robust results and may be
      useful for investigations of other aspects of individual signatures.

PMID- 8370275
TI  - Processing of ordinality and transitivity by chimpanzees (Pan troglodytes).
AB  - Three chimpanzees (Pan troglodytes) were trained to discriminate among pairs of
      boxes in an ABCDE-ordered series. The 2nd member of each pair was reinforced,
      until all 4 training pairs were learned. During novel tests the nonadjacent BD
      pair was presented, and all 3 animals reliably selected D. In Experiment 2,
      numerals 1-5 served as stimuli. One chimpanzee reliably selected the larger
      numeral 4 during testing with a nonadjacent pair (2-4), and 2 chimps showed no
      preference. In a 2nd phase, the same chimp demonstrated proficiency at reversing
      the task, reliably selecting the smaller of the 2-4 pair. In Experiment 4, after
      additional training, a 2nd test, which included novel test pairs composed of
      numbers that had not been used during training, was completed. Two of 3 animals
      were 100% correct on Trial 1 for all novel pairs. The results suggest that
      chimpanzees with experience in number concepts may recognize the ordinal
      character of numbers.

PMID- 8370276
TI  - Communal reproductive success in rats (Rattus norvegicus): effects of group
      composition and prior social experience.
AB  - We compared the reproductive success and maternal behavior of sibling pairs of
      female Long-Evans rats (Rattus norvegicus) housed together from birth (familiar)
      to that of pairs of unrelated females housed apart during development
      (unfamiliar). Sires either remained in the colonies through weaning of their pups
      or were removed before parturition. Familiar animals reared more pups to weaning,
      were more likely to share in caring for their pups, and were less likely to
      exhibit infanticide than were unfamiliar ones. The presence of males in cages
      with pups had no direct effect on the reproductive success of females, but female
      pairs housed with males spent less time than female pairs housed alone caring for
      pups together in a combined nest. Conflicting evidence for communal rearing in
      populations of wild rats may reflect differences in the genetic relatedness or
      early social experience of female rats.

PMID- 8370277
TI  - NONMEM version III implementation on a VAX 9000: a DCL procedure for single-step
      execution and the unrealized advantage of a vectorizing FORTRAN compiler.
AB  - There is great interest within the FDA, academia, and the pharmaceutical industry
      to provide more detailed information about the time course of drug concentration
      and effect in subjects receiving a drug as part of their overall therapy.
      Advocates of this effort expect the eventual goal of these endeavors to provide
      labeling which reflects the experience of drug administration to the entire
      population of potential recipients. The set of techniques which have been thus
      far applied to this task has been defined as population approach methodologies.
      While a consensus view on the usefulness of these techniques is not likely to be
      formed in the near future, most pharmaceutical companies or individuals who
      provide kinetic/dynamic support for drug development programs are investigating
      population approach methods. A major setback in this investigation has been the
      shortage of computational tools to analyze population data. One such algorithm,
      NONMEM, supplied by the NONMEM Project Group of the University of California, San
      Francisco has been widely used and remains the most accessible computational tool
      to date. The program is distributed to users as FORTRAN 77 source code with
      instructions for platform customization. Given the memory and compiler
      requirements of this algorithm and the intensive matrix manipulation required for
      run convergence and parameter estimation, this program's performance is largely
      determined by the platform and the FORTRAN compiler used to create the NONMEM
      executable. Benchmark testing on a VAX 9000 with Digital's FORTRAN (v. 1.2)
      compiler suggests that this is an acceptable platform. Due to excessive branching
      within the loops of the NONMEM source code, the vector processing capabilities of
      the KV900-AA vector processor actually decrease performance. A DCL procedure is
      given to provide single step execution of this algorithm.

PMID- 8370278
TI  - A qualitative model of the dynamics of blood glucose and its hormonal control.
AB  - A qualitative model of the short term glucose regulation system is presented. The
      model is based on the qualitative process theory, based on the concept of
      physical process defined by the property of causing changes in objects over time.
      The model has been successfully validated on inputs of several tests. It is
      intended to employ this model within a comprehensive system encompassing
      qualitative and quantitative aspects of modelling, building an environment useful
      for new treatment planning and for education.

PMID- 8370279
TI  - Knowledge-based client-server approach to structural information retrieval: the
      Digital Anatomist Browser.
AB  - Structural information can be defined as data and knowledge about biological
      objects ranging in size from molecules to the whole body. A framework is
      described for organizing structural information around a well-defined set of
      terminology and semantic relationships, and for disseminating multimedia
      structural information by means of a wide-area information server that is
      accessible over the internet. A Macintosh-based client of this server, called the
      Digital Anatomist Browser, has been used to teach neuroanatomy for the last 2
      years. The client-server approach provides each student unlimited access to a
      rapidly growing knowledge base of structural biology that, while immediately
      useful for anatomy teaching, has the potential to be an organizing framework for
      other kinds of medical knowledge as well.

PMID- 8370280
TI  - DREAM: a shell-like software system for medical data analysis and decision
      support.
AB  - A software system was designed whose aim is to support everyday scientific
      research of physicians in different fields of medicine. DREAM is a shell-like
      tool which can be customized embedding in it the desirable structure of a
      particular medical problem. Various basic statistical analyses are provided along
      with the decision support capabilities. The decision aid is proposed in two steps
      -feature selection and classifier design. Genetic algorithm is implemented as the
      feature selection procedure. The classifier design option includes crisp and
      fuzzy k-Nearest Neighbors rule and a two-level classification scheme based on
      majority rule on the votes of several first-level k-Nearest Neighbors
      classifiers. The system's performance is illustrated with a database from
      aviation medicine.

PMID- 8370281
TI  - Peak identification of auditory brainstem responses with multi-filters and
      attributed automaton.
AB  - An attributed automaton, a special case of attribute grammar, is a flexible tool
      in pattern recognition. It allows the utilization of contextual information from
      previously analyzed patterns in the analysis of the current pattern, and offers
      the possibility of describing those structural characteristics of patterns which
      cannot be described by classic methods of syntactic pattern recognition. Auditory
      brainstem responses are routinely used in audiology and otoneurology. Many
      studies on using the spectral analysis of averaged auditory brainstem responses
      have described at least two frequency bands, corresponding to the slow and fast
      components. Selective non-recursive digital filters for each frequency band in
      the spectrum of the auditory brainstem response have revealed enhancement or
      attenuation of components, depending on the band. In this study, multi-filters
      and an attributed automaton were combined for the identification of peaks.

PMID- 8370282
TI  - A software simulation of tibial fracture reduction with external fixator.
AB  - In modern orthopaedic practice, circular external fixators are frequently
      preferred to plaster cast for various reasons. The realignment of the two
      fractured bone segments is usually performed under a continuous fluoroscopy
      checking which involves a long radiation exposure time for both patients and
      surgeon. In order to overcome this problem, a computer controlled external
      fixator is under development. One relevant problem which this project faced in
      its initial stage was the difficulty to define in geometrical terms the manual
      reduction trajectory normally adopted by the surgeon. Basically it was a typical
      problem of empirical knowledge transfer from the surgeon to the engineer. Thus,
      it was necessary to create a common ground where the two experts could carry out
      the necessary analyses in order to define an empirical algorithm capable of
      suggesting a correction trajectory. The problem was solved by developing a
      simulation program called S.E.R.F. (Simulation Environment of a Robotic Fixator)
      provided with an extremely powerful graphic output, able to visualize the whole
      reduction trajectory from any viewpoint in space. The authors suggest the use of
      this kind of tool every time the techno-clinical information exchange is a
      critical issue.

PMID- 8370283
TI  - A computer program for non-parametric receiver operating characteristic analysis.
AB  - Sensitivity and specificity are key measures of the performance of a given test
      in detecting a given disorder. For tests yielding numerical scores, sensitivity
      and specificity usually vary inversely over the range of theoretically possible
      cutoff scores, complicating the task of quantifying and comparing the diagnostic
      accuracy of tests. Receiver Operating Characteristic analysis (ROC) approaches
      this problem by plotting the curve of sensitivity versus 1-specificity for all
      possible cutoff scores of the test. The area under the ROC curve (AUC) can be
      used to describe the diagnostic accuracy of the test. Parametric and non
      parametric methods exist that allow the calculation of the AUC and the comparison
      of tests. A disadvantage of parametric formulations is the assumption of a normal
      or Gaussian distribution of test scores. The present article presents a computer
      program that utilizes non-parametric formulations that do not require the normal
      distribution of test scores. The program calculates the sensitivity and
      specificity of a test at all possible cutoff scores, plots the ROC curve,
      calculates the AUC, its standard error and 95% confidence limits, and allows the
      comparison of tests on independent and correlated samples.

PMID- 8370284
TI  - A new PAGE in mechanical ventilation?

PMID- 8370285
TI  - Medical direction of emergency medical service systems: a full-time commitment
      whose time has come.

PMID- 8370286
TI  - Nitric oxide as a target for therapy in septic shock.

PMID- 8370287
TI  - Regional blood flow and oxygen transport: implications for the therapy of the
      septic patient.

PMID- 8370288
TI  - Does resuscitative hypothermia protect the ischemic brain?

PMID- 8370289
TI  - Perfluorocarbon-associated gas exchange (partial liquid ventilation) in
      respiratory distress syndrome: a prospective, randomized, controlled study.
AB  - OBJECTIVE: To determine the efficacy of perfluorocarbon-associated gas exchange
      (partial liquid ventilation) in respiratory distress syndrome. DESIGN:
      Prospective, randomized, controlled study. SETTING: State University of New York
      at Buffalo, School of Medicine and Biomedical Sciences. SUBJECTS: Eleven
      premature lambs with respiratory distress syndrome, delivered by cesarean
      section. INTERVENTIONS: Five lambs were supported by conventional mechanical
      ventilation alone. Six lambs were switched to perfluorocarbon-associated gas
      exchange after 60 to 90 mins of conventional mechanical ventilation.
      Perfluorocarbon-associated gas exchange was accomplished by instilling a volume
      of liquid perfluorocarbon equivalent to normal functional residual capacity (30
      mL/kg) into the trachea, performing 3 to 4 mins of tidal liquid ventilation, and,
      at end-expiration, with liquid functional residual capacity of 30 mL/kg remaining
      in the lung, reconnecting the animal to the volume ventilator for gas tidal
      volumes. MEASUREMENTS AND MAIN RESULTS: Serial arterial blood gases and lung
      mechanics were measured. While receiving conventional ventilation, all animals
      developed progressive hypoxemia, hypercarbia, and acidosis. However, in the
      perfluorocarbon-associated gas exchange group, within 5 mins of the initiation of
      perfluorocarbon-associated gas exchange, mean PaO2 increased four-fold, from 59
      +/- 6 torr (7.9 +/- 0.8 kPa) during conventional ventilation to 250 +/- 28 torr
      (33.3 +/- 3.7 kPa; p < .05) during perfluorocarbon-associated gas exchange, and
      this increase was sustained at 60 mins of perfluorocarbon-associated gas exchange
      (268 +/- 38 torr; 35.7 +/- 5.1 kPa; p < .05). Mean PaCO2 decreased progressively
      from 62 +/- 4 torr (8.3 +/- 0.5 kPa) during conventional ventilation to 38 +/-
      3.3 torr (5.1 +/- 0.4 kPa) at 60 mins of perfluorocarbon-associated gas exchange
      (p < .05). Mean pH concomitantly increased. Dynamic compliance increased three
      fold within 15 mins of instituting perfluorocarbon-associated gas exchange, from
      0.31 +/- 0.02 mL/cm H2O during conventional ventilation to 0.90 +/- 0.11 mL/cm
      H2O during perfluorocarbon-associated gas exchange, and this increase was
      sustained at 60 mins of perfluorocarbon-associated gas exchange (p < .05). Mean
      peak expiratory flow and mean expiratory resistance were essentially unchanged
      during perfluorocarbon-associated gas exchange as compared with conventional
      ventilation in the same group. CONCLUSIONS: We conclude that perfluorocarbon
      associated gas exchange, which employs liquid functional residual capacity and
      gas tidal volumes delivered by a conventional ventilator, can facilitate
      oxygenation and CO2 removal, and dramatically improve lung mechanics in the
      premature lamb with respiratory distress syndrome.

PMID- 8370290
TI  - Effect of full-time, specialized physician supervision on the success of a large,
      urban emergency medical services system.
AB  - OBJECTIVES: Despite the universal proliferation of emergency medical services
      programs throughout the United States since 1970, only a few have ever documented
      a valid lifesaving effect, particularly in large, urban centers. The purpose of
      this study was to demonstrate the effect of specialized physician supervision on
      the effectiveness of an emergency medical services system. DESIGN: Prospective,
      cohort study. SETTING: Large, urban municipality (population 2 million).
      PATIENTS: Evaluation of victims of out-of-hospital sudden cardiac death cases,
      before (n = 152) and after (n = 200) the introduction of specialized physician
      supervision for the emergency medical services system. INTERVENTIONS: The hiring
      of a full-time, salaried emergency medical services system physician whose
      principal duties would be to provide intensive individualized training, direct
      operational supervision, and continuous system monitoring, including frequent on
      scene oversight of emergency medical services personnel. MEASUREMENTS AND MAIN
      RESULTS: Comparison of existing hospital discharge rates for out-of-hospital
      sudden cardiac death cases to those rates achieved 5 yrs after recruitment of the
      specialized emergency medical services system physician. A dramatic increase in
      hospital discharge rates was demonstrated for sudden death patients presenting
      with ventricular fibrillation, from zero at year 0 (0 of 152 patients survived),
      to 21% (42 of 200 patients) by year 5 (p < .001). This result was achieved
      despite the fact that all other related factors (budget, paramedic numbers,
      response times) significantly worsened during the comparison periods.
      CONCLUSIONS: The introduction of the new factor into the emergency medical
      services system (specialized physician supervision) was associated with
      significantly improved patient outcome. In view of current suboptimal outcome
      statistics found in most municipal emergency medical services programs across the
      United States, future goals of medical community leaders should be directed at
      efforts to properly train, certify, and establish appropriate positions for
      physicians who specialize in emergency medical services system supervision.

PMID- 8370291
TI  - L-arginine pathway in the sepsis syndrome.
AB  - OBJECTIVE: To investigate the role of nitric oxide in the regulation of vascular
      tone in patients with the sepsis syndrome. DESIGN: Prospective, intervention
      study. SETTING: Tertiary care hospital. PATIENTS: Fifteen patients admitted to
      our medical intensive care unit with the diagnosis of sepsis syndrome by defined
      criteria. INTERVENTIONS: Eight patients received N omega-nitro-L-arginine (20
      mg/kg, iv bolus) followed by L-arginine (200 mg/kg, iv bolus). Seven patients
      received L-arginine alone (200 mg/kg). MEASUREMENTS AND MAIN RESULTS: In the
      first group, hemodynamic and oxygen transport variables were recorded at
      baseline, during 45 mins after the injection of N omega-nitro-L-arginine, and
      during 45 mins after the administration of L-arginine. In the second group,
      hemodynamic parameters were recorded at baseline and during 15 mins after the
      administration of L-arginine. Data are mean +/- SEM. The administration of N
      omega-nitro-L-arginine was followed by hypertension (mean blood pressure
      increased from 89 +/- 8 to a maximum of 140 +/- 12 mm Hg) accompanied by a
      decrease in cardiac index (from 3.51 +/- 0.39 to a minimum of 2.65 +/- 0.21
      L/min/m2) and an increase in right atrial and pulmonary artery occlusion
      pressure. Systemic vascular resistance index increased from 1871.1 +/- 302.3 to
      3825.6 +/- 244.4 dyne.sec/cm5.m2, and pulmonary vascular resistance increased
      from 533.2 +/- 125.8 to 816.0 +/- 117.3 dyne.sec/cm5.m2. These changes induced by
      N omega-nitro-L-arginine were reversed by the administration of L-arginine. The
      administration of L-arginine to another group of patients caused transient
      hypotension (from 103 +/- 6 to 81 +/- 10 mm Hg) and an increase in cardiac index
      (from 3.57 +/- 0.15 to 4.74 +/- 0.54 L/min/m2). Both systemic and pulmonary
      vascular resistance indices decreased (from 1987.6 +/- 163.9 to 1251.4 +/- 231.5
      dyne.sec/cm5.m2, and from 486.1 +/- 65.2 to 380.5 +/- 70.3 dyne.sec/cm5.m2).
      Parallel to the increase in oxygen transport due to the increase in cardiac
      output, oxygen consumption index increased significantly 1 min after L-arginine
      (from 127.0 +/- 19.0 to 182.5 +/- 37.3 mL/min/m2). All mentioned changes were
      statistically significant (p < .05). CONCLUSIONS: A continuous basal release of
      nitric oxide plays a role in the regulation of systemic and pulmonary vascular
      tone in patients with sepsis syndrome. L-arginine has systemic and pulmonary
      vasodilatory actions.

PMID- 8370292
TI  - Regional blood flow and oxygen transport in septic shock.
AB  - OBJECTIVE: To measure the blood flow distribution and regional oxygen transport
      in hyperdynamic septic shock during hypotension and after correction by
      vasopressor doses of dopamine or norepinephrine. DESIGN: Prospective, randomized,
      controlled trial. SETTING: Tertiary care center. PATIENTS: Ten patients with
      hyperdynamic septic shock (ages ranging from 45.1 +/- 16.6 yrs) and a control
      group of 11 postoperative cardiac surgery patients (ages ranging from 54.8 +/-
      7.9 yrs). INTERVENTIONS: Systemic and regional hemodynamics and oxygen transport
      were measured in ten patients with hyperdynamic septic shock during hypotension
      and after vasopressor therapy (norepinephrine or dopamine). Oxygen consumption
      (VO2) was measured by indirect calorimetry and splanchnic and leg blood flow with
      indocyanine green infusion. MEASUREMENTS AND MAIN RESULTS: Splanchnic blood flow
      and VO2 (p < .05) were increased in septic shock during hypotension and during
      vasopressor therapy. Both dopamine and norepinephrine increased systemic blood
      flow and VO2 independently of the arterial lactate level. Despite the relatively
      small changes in systemic oxygen transport, major regional changes occurred in
      oxygen delivery and VO2, and these changes were unpredictable from systemic
      changes. CONCLUSIONS: Regional changes in oxygen transport in septic shock cannot
      be predicted from the changes in the whole body. The increased oxygen demand in
      the splanchnic region is the main risk factor for splanchnic tissue hypoxia in
      septic shock.

PMID- 8370293
TI  - Regional blood flow and oxygen transport in patients with the low cardiac output
      syndrome after cardiac surgery.
AB  - OBJECTIVE: To assess systemic and regional oxygen transport after open heart
      surgery in patients with the low cardiac output syndrome who are receiving
      vasoactive drugs and in patients with normal hemodynamics during spontaneous
      rewarming. DESIGN: Prospective, nonrandomized controlled trial. SETTING: Tertiary
      care center. PATIENTS: Sixteen patients aged 53.1 +/- 8.4 yrs were studied after
      coronary artery bypass operations: ten patients with a cardiac index of < 1.75
      L/min/m2 and six control patients with a cardiac index of > 1.75 L/min/m2.
      INTERVENTIONS: The patients with a cardiac index of < 1.75 L/min/m2 received
      either dobutamine alone (n = 5) or in combination with nitroprusside (n = 5). The
      control patients with a cardiac index of > 1.75 L/min/m2 did not receive
      vasoactive treatment. The systemic oxygen consumption was measured by indirect
      calorimetry and the regional blood flow was measured by primed continuous
      infusion of indocyanine green. MEASUREMENTS AND MAIN RESULTS: Both splanchnic and
      femoral blood flows increased (p < .05) in parallel with cardiac output during
      vasoactive drug therapy. High splanchnic oxygen extraction in patients with low
      cardiac index and flow-dependent splanchnic oxygen consumption in some patients
      indicated marginal splanchnic oxygen delivery. In addition, femoral blood flow
      was low and oxygen consumption changed in parallel with oxygen delivery in
      patients with the low cardiac output syndrome. CONCLUSIONS: In low cardiac output
      syndrome after cardiac surgery, splanchnic oxygen delivery was marginal and was
      maintained at the expense of peripheral oxygen delivery. Dobutamine, both alone
      and in combination with sodium nitroprusside, improved splanchnic oxygen
      delivery.

PMID- 8370294
TI  - Effects of blood transfusion on oxygen transport variables in severe sepsis.
AB  - OBJECTIVE: To investigate whether increasing oxygen delivery (DO2) by increasing
      hematocrit results in increases in oxygen uptake (VO2) in septic patients with an
      abnormal DO2/VO2 relationship. DESIGN: Prospective, randomized, interventional
      crossover study. SETTING: Tertiary care hospital. PATIENTS: A consecutive sample
      of 16 patients admitted to the intensive care unit, who were diagnosed as having
      severe sepsis by defined criteria and who had a hemoglobin concentration of < 10
      g/dL. INTERVENTIONS: Patients received, in random order, an infusion of
      dobutamine (10 micrograms/kg/min) and a blood transfusion (800 mL of packed red
      blood cells in 90 mins). Hemodynamic and oxygen transport variables were
      determined before and after each treatment, allowing at least 20 mins during the
      infusion of dobutamine to achieve the steady state. MEASUREMENTS AND MAIN
      RESULTS: Changes in DO2 and VO2 induced by each intervention were measured.
      Dobutamine significantly increased DO2 (48.5 +/- 6.9%; p = .0001) and VO2 (21.7
      +/- 3.3%; p = .0001). Blood transfusion increased DO2 (21.4 +/- 4.3%; p = .005)
      but VO2 did not change significantly (2.2 +/- 4.1%). Correlation coefficients for
      the percent changes of DO2 and VO2 (r2 = .67, p = .001 for dobutamine; and r2 =
      21, p = .07 for blood transfusion) were significantly different for each
      treatment (p = .0001). CONCLUSIONS: In patients with an abnormal DO2-dependent
      VO2, as shown by increases in VO2 brought about by an infusion of dobutamine,
      blood transfusion does not significantly increase VO2, despite significant
      changes in DO2. The VO2, in some critically ill patients, depends more on blood
      flow than on global DO2.

PMID- 8370295
TI  - An exploratory analysis of medication utilization in a medical intensive care
      unit.
AB  - OBJECTIVES: To evaluate patterns of medication use in a medical intensive care
      unit (ICU) and to explore relationships between drug use, patient age, admitting
      diagnosis, Acute Physiology and Chronic Health Evaluation (APACHE II) scores,
      length of stay, and survival. DESIGN: Combination prospective and retrospective
      study. SETTING: Medical ICU in a large teaching institution. PATIENTS: Patient
      admissions (n = 191) to a medical ICU during a 4-month study period.
      INTERVENTIONS: The following data were collected: age, length of stay, diagnosis,
      physiologic variables necessary for APACHE II scores, medications administered,
      and survival. MEASUREMENTS AND MAIN RESULTS: The mean length of stay of the study
      patients was 5.2 +/- 9.8 days. Overall mortality rate was 33%. The mean age of
      survivors, 62.7 yrs, was significantly (p < .05) lower than that value for
      nonsurvivors (68.6 yrs). Postcardiopulmonary resuscitation (CPR) or -stroke
      patients had a mortality rate that was higher than the overall mortality rate (p
      < .05). APACHE II scores of > 19 were associated with a reduced survival rate
      when compared with the overall mortality rate. The mean daily and mean total
      number of medications administered per patient were 7.5 +/- 3.4 and 12.1 +/- 7.6,
      respectively. Antihypertensives/vasodilators and gastrointestinal prophylaxis
      medications were administered most commonly in 69% and 65% of patients,
      respectively. The median total drug use per patient was significantly greater in
      nonsurvivors vs. survivors (13 and 10, respectively, p < .02). There was a
      positive linear relationship between total medication use and log length of stay
      (r2 = .62). Patients admitted post-CPR or with seizures received the highest
      number of medications (p < .05). CONCLUSIONS: Patients admitted to the medical
      ICU receive multiple medications from a variety of pharmacologic classes.
      Prolonged length of stay, certain admitting diagnoses, and death are associated
      with increased medication administration. Age, certain admitting diagnoses, and
      APACHE II scores are significantly related to survival.

PMID- 8370296
TI  - Effect of extracorporeal membrane oxygenation on neutrophil function in neonates.
AB  - OBJECTIVE: To study the effect of long-term extracorporeal membrane oxygenation
      (ECMO) support on neutrophil function. DESIGN: A prospective, clinical
      investigation. SETTING: A pediatric intensive care unit. PATIENTS: Four groups of
      patients: ECMO group 1, newborns after 1 day of ECMO support (n = 10); ECMO group
      2, newborns after 5 days of ECMO support (n = 6); group 3, normal newborns (n =
      20); group 4, normal adults (n = 30). INTERVENTIONS: Two mL of heparinized blood
      was obtained from patients in each group. A modification of the Smith and Rommel
      technique was used to measure neutrophil phagocytosis and killing utilizing live
      Candida tropicalis as the test organism. Neutrophils were incubated for 90 mins
      in normal adult serum with live Candida. Viability of Candida after phagocytosis
      was tested by vital fluorochrome staining. Phagocytic index (the number of
      neutrophils with intracytoplasmic Candida divided by the total neutrophils) and
      candidicidal ratio (neutrophils with dead Candida divided by total neutrophils
      with Candida) were determined daily. MEASUREMENTS AND MAIN RESULTS: Neutrophils
      from ECMO group 1 (day 1) and ECMO group 2 (day 5) patients had significantly
      higher phagocytosis indices (72.8 +/- 20 and 76 +/- 18) and candidicidal ratios
      (0.15 +/- 0.1 and 0.16 +/- 0.09) compared with neutrophils from group 3 patients
      (normal neonates) (64 +/- 7 and 0.06 +/- 0.04). The phagocytosis indices were
      significantly lower in neutrophils from ECMO group 1 (day 1) and ECMO group 2
      (day 5) patients compared with group 4 (adults) patients (86 +/- 9). However, the
      candidicidal ratios in neutrophils from ECMO groups 1 and 2 (ECMO day 1 and day
      5) patients were equal to that value in group 4 (adults) (0.10 +/- 0.04). ECMO
      support for 5 days (ECMO group 2 vs. group 1) did not significantly change either
      the phagocytosis index or candidicidal ratio. CONCLUSIONS: Phagocytosis and
      intracellular killing by neutrophils of ECMO-supported neonates were
      significantly greater than those values found in normal newborns. ECMO support
      for 5 days produced no significant changes in neutrophil phagocytosis or killing.

PMID- 8370297
TI  - Inflicted versus accidental head injury in critically injured children.
AB  - OBJECTIVES: To assess the frequency of inflicted head injury in critically
      injured children; the severity of neurologic injury; the neurologic outcome; and
      the historical, socioeconomic, physical, and radiologic factors associated with
      inflicted head injury. DESIGN: Prospective clinical study. SETTING:
      Multidisciplinary pediatric intensive care unit (ICU). PATIENTS: Consecutive
      cases (n = 40) of severe head injury admitted to a pediatric ICU. INTERVENTIONS:
      None. MEASUREMENTS AND MAIN RESULTS: Fourteen (35%) of 40 cases of head injury
      were due to inflicted head injury. Eleven (79%) of 14 inflicted head injury cases
      were due to child abuse and three (21%) were due to neglect. The severity of
      neurologic injury, as measured by the admission Glasgow Coma Scale, was worse in
      cases of inflicted head injury (7.1 +/- 0.7 [SE] [inflicted] vs. 9.9 +/- 0.8
      [accidental]; p = .04). Glasgow Outcome Scores were worse after inflicted head
      injury (2 +/- 1 inflicted] vs. 4 +/- 1 [accidental]; p = .004). In victims of
      child abuse, we found the combination of any two of the following three factors
      was associated with inflicted head injury: an inconsistent history/physical
      examination; retinal hemorrhages; or parental risk factors (alcohol or drug
      abuse, previous social service intervention within the family, or a past history
      of child abuse or neglect). CONCLUSIONS: This study confirms that severity of
      neurologic injury and neurologic outcome in cases of inflicted head injury are
      worse than in any other type of childhood head injury. We believe that a
      combination of any two of the above three risk factors may prove to be a reliable
      marker of inflicted head injury in children admitted to a pediatric ICU and will
      lead to an early and definitive diagnosis.

PMID- 8370298
TI  - Decreasing imposed work of the breathing apparatus to zero using pressure-support
      ventilation.
AB  - OBJECTIVES: To apply pressure-support ventilation with the goal of decreasing the
      imposed work of the breathing apparatus (endotracheal tube, breathing circuit
      tubing, and the ventilator's demand-flow system) to zero and to evaluate a
      clinical method of measuring the imposed work of breathing. DESIGN: A prospective
      evaluation of adult and pediatric patients receiving mechanical ventilatory
      support. SETTING: A surgical and a pediatric intensive care unit in a university
      hospital. PATIENTS: Fifteen patients (11 adult and four pediatric), who were
      diagnosed with acute respiratory failure from various etiologies, and who were
      intubated and spontaneously breathing, received continuous positive airway
      pressure and pressure-support ventilation. MEASUREMENTS AND MAIN RESULTS: Imposed
      work of the breathing apparatus was calculated by integrating pressure measured
      at the tracheal end of the endotracheal tube from a narrow air-filled catheter
      and the change in volume from a miniature pneumotachograph (flow sensor)
      positioned between the "Y" piece of the breathing circuit and the endotracheal
      tube. Pressure and volume signals were directed to a computerized, portable
      respiratory monitor (Bicore Monitoring Systems) that provides real-time display
      of the pressure-volume (work) loops and calculation of the imposed work. Imposed
      work was measured at 0 cm H2O pressure-support ventilation, and then incremental
      levels of pressure-support ventilation were applied until the imposed work
      decreased to zero. Imposed work decreased in a quadratic fashion after
      incremental levels of pressure-support ventilation (r = -.83 [r2 = .69]; p <
      .001). At pressure-support ventilation level of 0 cm H2O, the imposed work was
      0.60 +/- 0.17 joule/L. At mean pressure-support ventilation levels of 13.5 +/-
      4.8 cm H2O, imposed work decreased to 0 joule/L. CONCLUSIONS: Ideally, the
      imposed work of the breathing apparatus should be zero to decrease the afterload
      on the ventilatory muscles and, thus, the patient's work of breathing.
      Eliminating the imposed work is achieved using appropriate levels of pressure
      support ventilation. We describe an easily applied, practical method of measuring
      imposed work using a commercially available, portable, bedside respiratory
      monitor. We recommend that all patients diagnosed with respiratory failure and
      compromised pulmonary mechanics and who are intubated and breathing
      spontaneously, receive at least a minimal level of pressure-support ventilation
      that results in zero breathing apparatus-imposed work of breathing.

PMID- 8370299
TI  - Delay in cooling negates the beneficial effect of mild resuscitative cerebral
      hypothermia after cardiac arrest in dogs: a prospective, randomized study.
AB  - OBJECTIVE: Previously, we documented that mild hypothermia (34 degrees C) induced
      immediately with reperfusion after ventricular fibrillation cardiac arrest in
      dogs improves functional and morphologic cerebral outcome. This study was
      designed to test the hypothesis that a 15-min delay in the initiation of cooling
      after reperfusion would offset this beneficial effect. DESIGN: Prospective,
      randomized, controlled study. SETTING: Animal intensive care unit. SUBJECTS: A
      total of 22 custom-bred coonhounds. INTERVENTIONS: Eighteen dogs underwent
      normothermic ventricular fibrillation arrest (no blood flow) of 12.5 mins,
      reperfusion with brief cardiopulmonary bypass, defibrillation within 5 mins,
      intermittent positive-pressure ventilation to 20 hrs, and intensive care to 96
      hrs. Three groups of six dogs each were studied: group 1, normothermic controls;
      group 2, core temperature 34 degrees C from reperfusion to 1 hr; and group 3,
      delayed initiation of cooling until 15 mins after normothermic reperfusion, and
      34 degrees C from 15 mins to 1 hr 15 mins after cardiac arrest. MEASUREMENTS AND
      MAIN RESULTS: Tympanic membrane temperature (which represented brain temperature)
      in group 2 reached 34 degrees C at 6 +/- 3 (SD) mins after reperfusion; and in
      group 3 at 29 +/- 1 mins after reperfusion. Best overall performance categories
      achieved (1, normal; 5, brain death) compared with group 1, were better in group
      2 (p < 0.5) but not in group 3 (NS). Similar results were found with best
      neurologic deficit scores (0%, normal; 100%, brain death), i.e., 44 +/- 4% in
      group 1, 19 +/- 15% in group 2 (p < .01), and 38 +/- 9% in group 3 (NS). Total
      brain histologic damage scores (< 30 minimal damage; > 100 severe damage),
      however, were 150 +/- 32 in group 1, 81 +/- 13 in group 2 (p < .001 vs. group 1),
      and 107 +/- 17 in group 3 (p < .05 vs. group 1). CONCLUSIONS: Mild, resuscitative
      cerebral hypothermia induced immediately with reperfusion after cardiac arrest
      improves cerebral functional and morphologic outcome, whereas a delay of 15 mins
      in initiation of cooling after reperfusion may not improve functional outcome,
      although it may slightly decrease tissue damage.

PMID- 8370301
TI  - Device to limit inflation of a pulmonary artery catheter balloon.
AB  - OBJECTIVE: The most serious complication seen with pulmonary artery catheters is
      rupture of the pulmonary artery. The effectiveness of an external safety balloon
      added to the pulmonary artery balloon inflation port was tested. DESIGN: The
      external balloon is designed to inflate and absorb excess volume from the
      inflation syringe after the internal balloon contacts the vessel wall. When the
      catheter tip is in a small pulmonary artery, expansion of the external balloon
      indicates that the catheter tip is in a noncompliant or small vessel. SETTING:
      The external balloon was tested in a bench simulation. INTERVENTIONS: None.
      MEASUREMENTS AND MAIN RESULTS: The pulmonary artery balloon was slowly inflated
      inside 2.6-, 3.0-, 4.7-, 8.6-, and 11.6-mm internal diameter polyvinyl chloride
      tubes, with and without the external safety device in place. Without the external
      balloon, the average balloon pressure was 1647 +/- 145 (SD) mm Hg in the 2.6-mm
      vessel. With the external balloon in use, the maximum pulmonary artery balloon
      pressure was 473 +/- 7.2 mm Hg in the 2.6-mm vessel. CONCLUSIONS: The external
      balloon can limit balloon pressures within the pulmonary artery and identify when
      excessive volumes are being forced into the pulmonary artery balloon.

PMID- 8370300
TI  - Sucralfate does not reduce the risk of acid aspiration pneumonitis.
AB  - OBJECTIVE: To study the pulmonary effects of aspirating a mixture of sucralfate
      in water and sucralfate in hydrochloric acid in an animal model of aspiration
      pneumonia. DESIGN: Prospective, randomized, controlled study with repeated
      measures. SETTING: University research laboratory. SUBJECTS: Thirty-two in situ,
      isolated, blood perfused porcine lung preparations. INTERVENTIONS: Five control
      preparations received no aspiration. Twenty-seven preparations received a
      standard aspiration of 1.5 mL/kg body of a) distilled water (n = 5), b)
      sucralfate in distilled water (n = 8), c) 1/10 normal hydrochloric acid (n = 6),
      and d) mixture of sucralfate in distilled water and hydrochloric acid (n = 8).
      MEASUREMENTS: The pH measurements were made of all aspirates. Lung weight, airway
      pressures, and pulmonary artery pressures were continuously monitored before and
      for 4 hrs after aspiration. Lung wet/dry weight ratio was measured at the
      completion of the study. RESULTS: The pH of sucralfate mixed with distilled water
      was 4.9, pH of 1/10 normal hydrochloric acid was 1.0, and pH of equal volumes of
      a sucralfate-water suspension mixed with hydrochloric acid was 1.5. Airway
      pressures and pulmonary arterial pressures increased in all aspirate groups over
      time compared with those values of control lungs. Control lungs gained 18 +/- 3
      (SEM) g over 4 hrs and the wet/dry ratio was 4.951 +/- 0.310. Lungs aspirating
      distilled water gained 147 +/- 49 g and the wet/dry ratio was 5.198 +/- 0.120.
      Lungs aspirating sucralfate and distilled water increased their weight by 109 +/-
      30 g and the wet/dry ratio was 5.380 +/- 0.076. Lungs aspirating a suspension of
      sucralfate and water and hydrochloric acid were similar to lungs aspirating
      hydrochloric acid alone with weight increases of 265 +/- 30 g and 346 +/- 81 g,
      and the wet/dry ratio of 7.011 +/- 0.273 and 7.230 +/- 0.390, respectively.
      CONCLUSIONS: Sucralfate has minimal acid buffering effect. Aspiration of
      sucralfate mixed with distilled water causes lung edema similar to aspiration of
      water alone. Aspiration of a sucralfate-water suspension mixed with hydrochloric
      acid causes severe lung edema. These results suggest that patients given
      sucralfate prophylaxis for stress ulceration are at risk for acid aspiration.

PMID- 8370302
TI  - Real-time gas-exchange measurement of oxygen consumption in neonates and infants
      after cardiac surgery.
AB  - OBJECTIVES: The purposes of this study were: a) to measure oxygen consumption
      (VO2) in ventilated neonates and infants after cardiac surgery, utilizing a real
      time gas exchange system; and b) to assess this new method by comparing the
      measured VO2 with calculated VO2 (using the Fick equation and simultaneously
      determined thermodilution cardiac output, measured hemoglobin, and measured mixed
      venous and arterial saturations). DESIGN: Prospective, comparison study.
      Comparison of measured VO2 and calculated VO2 using correlation coefficient,
      linear regression analysis, and bias and precision. SETTING: Cardiac intensive
      care unit in a children's hospital. PATIENTS: A total of 60 direct comparisons
      were made between measured and calculated VO2 in 15 patients (ages ranging from 4
      days to 14.1 months with median age of 2.4 months) who were receiving mechanical
      ventilation after undergoing corrective cardiac surgery. INTERVENTIONS: a) Direct
      measurement of VO2 using gas exchange method involving a pneumotachograph and a
      gas sampling system; b) determination of cardiac output by the thermodilution
      technique; c) measurement of arterial and mixed venous oxygen content by blood
      sampling. MEASUREMENTS AND RESULTS: The absolute measured VO2 ranged from 19 to
      154 mL/min with a mean of 52 +/- 32 mL/min (when indexed, the range was 81 to 367
      mL/min/m2 with mean 185 +/- 69 mL/min/m2, or range 4.7 to 18.8 mL/min/kg with
      mean 10.4 +/- 3.3 mL/min/kg). While 34 (57%) of 60 measured VO2 values were
      within 10% of their respective calculated VO2 values, 58 (97%) of 60 were within
      25%; the mean percent difference between measured and calculated VO2 values was
      10.6 +/- 7.7%. In comparing the measured VO2 and calculated VO2, the correlation
      coefficient was good (r2 = .87; p < .01) and the linear regression equation was:
      measured VO2 = 1.1 x calculated VO2 -9.0 mL/min/m2. The mean difference, or bias,
      was 0 mL/min/m2 with precision of 26 and 52 mL/min/m2 (at 1 and 2 SD). As an
      alternative means of examining the measured VO2 data, we also directly compared
      the thermodilution cardiac output with cardiac output derived by using the
      measured VO2 and the Fick equation. The range of Fick-derived cardiac output was
      between 1.69 to 8.11 L/min/m2 (mean 3.72 +/- 1.56) and the range of
      thermodilution cardiac output was between 1.75 to 7.42 L/min/m2 (mean 3.71 +/-
      1.36). The correlation coefficient between thermodilution cardiac output and Fick
      derived cardiac output was good with r2 = .88 (p < .01) and the linear regression
      equation was: thermodilution cardiac output = 0.81 x Fick-derived cardiac output
      + 0.71 L/min/m2. The bias was -0.01 L/min/m2 with a precision of 0.54 L/min/m2 at
      1 SD (or 1.08 L/min/m2 for 2 SD). CONCLUSIONS: Measured VO2 using a gas-exchange
      system compared favorably with calculated VO2 values using the Fick equation and
      simultaneously obtained thermodilution cardiac output and arterial and venous
      oxygen concentrations. By employing this breath-by-breath gas-exchange system,
      real-time VO2 measurement in ventilated neonates and infants is now feasible.

PMID- 8370304
TI  - Fellowship programs in critical care medicine: 1994.

PMID- 8370303
TI  - Reperfusion injury after intestinal ischemia.
AB  - OBJECTIVE: Review the histologic and pathophysiologic alterations seen after
      intestinal ischemia and reperfusion. DATA SOURCE: Current literature review.
      STUDY SELECTION: The most pertinent, current, and representative articles
      describing results from both animal and human investigations are utilized and
      discussed. DATA SYNTHESIS: Postischemic intestinal tissue damage appears to be
      due to the formation of oxygen radicals and the activation of phospholipase A2.
      The initial source of oxygen radicals seems to be the hypoxanthine-xanthine
      oxidase system. Oxygen radicals react directly with poly-unsaturated fatty acids,
      leading to lipid peroxidation within the cell membranes. Indirectly, the radicals
      trigger the accumulation of neutrophils within the affected tissue initiating
      inflammatory processes that lead to severe mucosal lesions. Similarly,
      phospholipase A2 also initiates postischemic mucosal lesions. Phospholipase A2 is
      a hydrolytic enzyme capable of increasing formation of cytotoxic
      lysophospholipids within the tissue. Enhanced activity of phospholipase A2 also
      stimulates the production of prostaglandins and leukotrienes. Various substances
      (superoxide dismutase, catalase, dimethyl sulfoxide, allopurinol, and
      deferoxamine, etc.) are able to detoxify oxygen radicals or inhibit the
      mechanisms leading to their enhanced generation, thus attenuating the
      postischemic lesions of the mucosa. CONCLUSIONS: Oxygen radicals and the
      activation of phospholipase A2 during reperfusion seem to be instrumental for the
      development of hemorrhagic mucosal lesions after intestinal ischemia. Radical
      scavengers and phospholipase A2 inhibitors may prevent reperfusion damage of the
      intestine, even when the treatment starts during ischemia but before reperfusion.

PMID- 8370305
TI  - Spurious hemodynamic alterations resulting from light sensitive pressure
      transducers.

PMID- 8370306
TI  - Muscle relaxants in intensive care patients.

PMID- 8370307
TI  - Routine hypertonic saline in clinical practice: is it worth it?

PMID- 8370308
TI  - Reversal of midazolam sedation.

PMID- 8370309
TI  - Omeprazole and refractory stress-induced gastric mucosal hemorrhage.

PMID- 8370310
TI  - Cytoprotective effect of glycine in cold stored canine renal tubules.
AB  - Reperfusion injury has been suggested to cause delayed graft function in renal
      transplantation. Methods to reduce reperfusion injury could lead to improved
      clinical renal transplantation. Glycine has been shown to suppress reperfusion
      injury in rabbit renal tubules and rat hepatocytes. In this study we have
      determined the effects of glycine on viability of isolated canine renal tubules.
      Renal tubules were cold stored at 4 degrees C under hypoxic conditions for up to
      96 h in the UW solution and rewarmed to 37 degrees C for up to 2 h under
      oxygenated conditions to simulate reperfusion of an organ after cold static
      storage. Short-term storage (24 to 48 h) did not cause membrane injury (leakage
      of lactate dehydrogenase (LDH)) on rewarming. However, after 72 and 96 h cold
      storage reperfusion injury was evident and LDH leakage increased from about 25%
      to 59 +/- 3% and 71 +/- 2% at 72 and 96 h cold storage, respectively. The
      presence of 3 mM glycine in the reperfusion medium suppressed injury to cold
      stored renal tubules. After cold storage for 72 and 96 h LDH leakage was reduced
      to control concentrations (31 +/- 3% and 29 +/- 1%, respectively). After cold
      storage for 72 h there was a reduction in ATP concentration in rewarmed renal
      tubules (3 nmol/mg protein at 48 h to 1.25 nmol/mg protein at 72 h). Also, there
      was a loss of mitochondrial functions including decreased stimulation of oxygen
      consumption by uncoupling of oxidative phosphorylation. Although glycine
      suppressed LDH leakage in renal tubules cold stored for 72 h it had no effect on
      the regeneration of ATP or mitochondrial functions, which remained
      depressed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370311
TI  - Cold- and cryopreservation of human liver and kidney slices.
AB  - Tissue slices may provide a rapid and economical way of determining cold ischemic
      effects on human liver and kidney cell viability and metabolism. In contrast to
      isolated hepatocyte cultures, tissue slices offer an in vitro system which more
      closely resembles the in vivo situation because of the differentiation and
      functional heterogeneity of the slice. In this study, human liver and kidney
      slices were cold stored for 10 days in Belzers University of Wisconsin (UW), Euro
      Collins, and Modified Sacks solutions. Another set of slices was cryopreserved at
      1 degree C/min for liver and 12 degrees C/min for kidney using a 10% dimethyl
      sulfoxide/fetal calf serum (FCS) cryoprotectant solution. The cold- and
      cryopreserved slices were incubated in roller culture for 4 h using FCS as the
      media. Liver slice viability was assessed by K+ content, protein synthesis,
      gluconeogenesis, and urea synthesis. Kidney slice viability was assessed using K+
      content, protein synthesis, and organic ion transport (PAH and TEA). Human kidney
      slices were cold preserved in UW for 4-6 days, while the human liver slices were
      preserved for 12-24 h depending on the viability parameter. Following
      cryopreservation, human liver slice viability was retained at between 65 and 90%
      of control values, while kidney slice viability was maintained between 70 and 90%
      of control values depending on the viability parameter. These results indicate
      that this human in vitro tissue slice system can be used to optimize preservation
      solutions and methods. The ability to cold- and cryopreserve human slices could
      facilitate the more efficient utilization of human tissue.

PMID- 8370312
TI  - Successful cryopreservation of fetal porcine proislets.
AB  - This study reports the cryopreservation of purified fetal pig proislets (FPP)
      which were isolated by a culture technique. The FPP were equilibrated with 2 M
      dimethyl sulfoxide (Me2SO), cooled at a rate of 0.25 degrees C/min to -40 degrees
      C, transferred to liquid nitrogen (-196 degrees C), stored for 2 h to 2 months at
      -196 degrees C, and thawed in a 37 degrees C water bath. The morphology of frozen
      thawed FPP was similar to that of noncryopreserved FPP. One hundred percent
      recovery of response capacity was achieved when tested with 16.7 mM glucose plus
      10 mM theophylline. We have recently shown that streptozotocin is not toxic to
      FPP. Accordingly, we transplanted a standardized dose (10-15 mg/mouse) of either
      cultured of frozen-thawed FPP beneath the renal capsule of nude mice. Three to
      four weeks later the recipients of the FPP were rendered diabetic by iv
      streptozotocin. All of the mice transplanted with cultured FPP and seven of eight
      mice receiving cryopreserved FPP achieved normoglycemia, 74.8 +/- 32.9 and 54.7
      +/- 8.1 days (P > 0.05) after transplantation. An intraperitoneal glucose
      tolerance test in the mice of both groups showed a flatter response to glucose
      compared to those of normal controls. Grafts removed from the mice with
      normoglycemia for > 3 weeks, in both groups, had the capacity to secrete insulin
      in response to 16.7 mM glucose alone and 16.7 mM glucose plus 10 mM theophylline
      during in vitro perifusion. Histological examination revealed that the extent of
      differentiation and development, in vivo of cryopreserved FPP was comparable with
      that of cultured FPP. These data indicate that cryopreservation, with the
      protocol used here, is successful in maintaining functional viability of frozen
      thawed FPP. This study is valuable for clinical islet transplantation research.

PMID- 8370313
TI  - Prostaglandin E2, interleukin-1 alpha, and potassium release from artificial
      human skin after freeze-thaw injury.
AB  - Living skin equivalent (LSE) was used to identify nonvascular aspects of freeze
      thaw injury to human skin cells. Pairs of transwell cell culture inserts,
      containing LSE, were washed twice for 30 min in maintenance media at 37 degrees C
      in a CO2 incubator and placed in two wells of a six-well assay tray (containing
      assay media). One specimen was maintained at room temperature. The other was
      cooled at 1 degrees C/min to -15 degrees C and rapidly rewarmed. Both were
      incubated for 24 h on fresh maintenance media at 37 degrees C in a CO2 incubator.
      This process was repeated producing 12 per group. Prostaglandin E2 (PGE2),
      interleukin-1 alpha (IL-1 alpha), and K+ were measured (mean +/- SE) in the assay
      medium, after the rewarming interval, and in the maintenance media after the 24-h
      incubation. Specimens were then processed for electron microscopy. After the
      rewarming interval, PGE2 (164.0 +/- 23.2 pg/0.1 ml), IL-1 alpha (24.3 +/- 2.2
      pg/0.1 ml), and K+ (6.47 +/- 0.41 mM) released from frozen LSE were significantly
      increased compared to controls (PGE2 = 22.2 +/- 4.6 pg/0.1 ml, IL-1 alpha = 5.7
      +/- 1.0 pg/0.1 ml, K+ = 4.32 +/- 0.02 mM). After the 24-h incubation, PGE2 and IL
      1 alpha released by frozen LSE (PGE2 = 1126 +/- 208 pg/0.1 ml; IL-1 alpha = 80.6
      +/- 6.8 pg/0.1 ml) remained significantly higher than controls (PGE2 = 229.0 +/-
      45 pg/0.1 ml; IL-1 alpha = 4.9 +/- 0.7 pg/0.1 ml). At this time, K+ leakage from
      frozen LSE (4.39 +/- 0.03 mM) had returned to a normal range (control = 4.65 +/-
      0.02 mM). Keratinocytes and, to a lesser extent, fibroblasts showed
      ultrastructural freeze-thaw damage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370314
TI  - Osmotic effects of dilution on erythrocytes after freezing and thawing in
      glycerol-containing buffer.
AB  - Red blood cells frozen in 1.7 M and particularly in 2.2 M of glycerol retain a
      high degree of integrity upon thawing as long as the dilution procedure of the
      cryoprotectant is slow and preferentially compensated by the addition of
      sorbitol. As the nonpenetrating cryoprotectant sorbitol induces initial cell
      shrinkage, cell swelling upon dilution of the cryoprotectants may not lead to
      hemolysis. However, rapid dilution of glycerol even with buffer containing up to
      0.50 M of sorbitol cannot be achieved without provoking considerable hemolysis.
      Due to the relative slow rate at which glycerol leaves the cells, membrane damage
      to the younger cell populations remains considerable and is even more pronounced
      in the older cell groups. The dramatic osmotic changes occurring during the
      dilution process lead to the formation of aberrant cell populations as
      demonstrated by the red cell size frequency distribution curves.

PMID- 8370315
TI  - Comparative effects of cryosolvents on tubulin association, thermal stability,
      and binding of microtubule-associated proteins.
AB  - Organic cryosolvents essential for cryopreservation of living cells have a
      colligative effect on water properties, but also affect cellular structures such
      as the membrane, actin, or tubulin cytoskeleton. The effects of cryosolvents on
      actin and its binding proteins are starting to be well investigated. In parallel,
      tubulin assembly characteristics were investigated comparatively, with 0-30% 1,2
      propanediol, dimethyl sulfoxide, or glycerol, and with or without microtubule
      associated proteins, at 37 or 4 degrees C. Tubulin association was monitored by
      spectrometry and sedimentation, providing the concentration in free protein, cold
      depolymerizable microtubules, and cold-resistant associations. At 37 degrees C,
      1,2-propanediol and dimethyl sulfoxide induce a similar association level and
      cold stability of the assemblies. Glycerol yields a lower level of tubulin
      association. Cold stability of the assemblies requires the presence of solvent,
      the amount of which is modulated by microtubule-associated proteins (MAPs): 15%
      1,2-propanediol or dimethyl sulfoxide, decreasing down to 10% with MAPs, or 10%
      glycerol with MAPs only. At 4 degrees C, some cold-stable association is promoted
      by 1,2-propanediol or dimethyl sulfoxide above 10-15%, in the presence or absence
      of MAPs, but not with glycerol. In addition, protein content of the various
      fractions obtained with MAPs and 30% solvent was examined by densitometry of
      electrophoresis gels. Cold-labile associations obtained at 37 degrees C with 1,2
      propanediol or dimethyl sulfoxide are lacking in tubulin and enriched in tau
      proteins relative to control or glycerol. Associations formed at 37 degrees C and
      stable to subsequent cold treatment, or at 4 degrees C, regardless of the
      solvent, present a large tubulin content, as well as few tau proteins and high
      molecular-weight MAPs.

PMID- 8370316
TI  - Cryoprotective effect of egg yolk in cryopreservation of porcine embryos.
AB  - The objective of the present study was to assess the effect of egg yolk
      supplementation in solutions for either cooling or freezing of porcine embryos.
      In Experiment 1, porcine embryos collected on Day 3 to 7 (Day 0 = onset of
      estrus) were allocated to 12 experimental groups according to their developmental
      stages (four-cell to compact morula, early blastocyst to blastocyst, expanded
      blastocyst, and hatched blastocyst) and the concentrations of egg yolk (0, 5, and
      10% (v/v)) for cooling to 0 degrees C. Whereas no embryos ranging from four-cell
      to blastocyst survived, the 10-min exposure to 0 degrees C despite egg yolk
      supplementation, expanded blastocysts and hatched blastocysts allocated to egg
      yolk-supplemented groups survived cooling to 0 degrees C. In Experiment 2,
      porcine expanded and hatched blastocysts collected on Day 6 or 7 were assigned to
      six experimental groups according to their developmental stages and the type of
      cryoprotectant used (10% glycerol, 11% Me2SO, and 10% propylene glycol) for
      freezing at -196 degrees C. All freezing solutions contained either 5 or 10% egg
      yolk. The embryos were equilibrated with one of the freezing solutions, cooled
      from 25 to -7 degrees C at 1 degree C/min, seeded at that temperature, then
      cooled to -36 degrees C at 0.3 degree C/min, and finally plunged into liquid
      nitrogen for storage. The frozen embryos were thawed by immersion in 37 degrees C
      water. After the cryoprotectants were removed by dilution, the embryos were
      cultured for 48 h to evaluate their viability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370317
TI  - Survival rate of frozen-thawed bovine IVF embryos in relation to exposure time
      using various cryoprotectants.
AB  - The relationship between cryoprotectant and exposure time on the development of
      IVF-derived embryos in culture after freezing and thawing was examined. Good to
      excellent quality Day 7 to 8 blastocysts and expanded blastocysts were suspended
      in 1.6 M propylene glycol (PG), 1.8 M ethylene glycol (EG), 1.1 M diethylene
      glycol, and 1.3 M ethylene glycol monomethyl ether (EME). In Experiment I, after
      30 and 120 min of exposure, embryos were placed directly into culture medium and
      washed three times. Embryos were cocultured with cumulus cells in culture medium.
      After a 48-h culture, there were no significant differences in fully expanded,
      hatching, and hatched rates between the 30- and 120-min exposure to all four
      cryoprotectants except for the fully expanded rate with PG (55 vs 83%). In
      Experiment II, to compare the cryoprotective effects of the four cryoprotectants,
      embryos were exposed to each cryoprotectant for variable times from 10 to 120
      min, seeded, and cooled to -30 degrees C at 0.3 degree C/min, plunged into liquid
      nitrogen for storage, and then thawed. Survival was measured by coculturing the
      embryos with cumulus cells in culture medium. There were no significant
      differences in development to hatched blastocysts of embryos exposed to either PG
      (27-42%) or EG (37-56%). The number of embryos developing after exposure to EME
      was similar to that in PG or EG when exposure time did not exceed 40 min (43
      49%). Our findings suggest that the toxicity of different cryoprotectants is
      related to the exposure time and that PG and EG were relatively nontoxic as is
      exposure to EME for short periods.

PMID- 8370318
TI  - Further evidence for two modes of hypothermia damage.
AB  - The Arrhenius plot of inactivation (killing) rates of V-79 Chinese hamster cells
      exposed to hypothermia contains a break at about 8 degrees C, which corresponds
      to the minimum inactivation rate, implying that there are distinct hypothermic
      damage mechanisms above (Range I = 8 to +25 degrees C) and below (Range II = 0 to
      +8 degrees C) 8 degrees C. Several membrane-permeable hydroxyl free radical
      scavengers, N-acetylhomocysteinethiolactone (citiolone), dimethylthiourea (DMTU),
      and dimethyl sulfoxide (DMSO), were tested for their ability to protect cells
      exposed to hypothermic temperatures of 10 degrees C (Range I) or 5 degrees C
      (Range II) as a function of time in a system that is uncomplicated by previous
      hypoxia. Citiolone (3 mM) protected cells in Range I, but not in Range II. To
      date, citiolone is the only agent that protects in Range I. Adenosine was of no
      benefit in Range I. Glycine (5 mM) protected cells in Range II, but not in Range
      I. DMSO (10 mM) was ineffective in Range II, while DMTU (10 mM) protected cells
      in Range II, but not in Range I. The combination of DMTU and citiolone had a
      synergistic protective effect on the cells during 10 degrees C exposure (Range
      I). However, the combination of DMTU and citiolone is neither synergistic nor
      additive at 5 degrees C (Range II).

PMID- 8370319
TI  - Freeze drying of biomaterials for the medical practice.
AB  - Experimentally determined thermophysical characteristics of the new
      antifibrinolytic bacteriostatic biomedical preparation CAPROCOL are reported.
      Experimental and theoretical temperature histories at selected locations in a
      sample of CAPROCOL undergoing freeze drying are compared. The advance of the
      moving phase interface is also predicted.

PMID- 8370320
TI  - Penetration of clarithromycin into human saliva.
AB  - The concentrations of clarithromycin after a single oral dose of 500 mg were
      determined in serum and saliva of ten healthy adult volunteers. After 2 h, the
      levels were 4.04 +/- 1.14 (SD) mg/l in serum and 2.72 +/- 0.87 mg/l in saliva.
      After 7 h these values were 1.98 +/- 0.65 and 1.21 +/- 0.34 mg/l, respectively,
      and at the end of the dosing interval of 12 h, 0.95 +/- 0.38 and 0.73 +/- 0.35
      mg/l, respectively. In comparison, amoxicillin (a 750-mg single dose) showed a
      much faster decline of serum levels and was virtually undetectable in saliva.

PMID- 8370321
TI  - Pharmacokinetic profile of fosfomycin trometamol.
AB  - The pharmacokinetics of fosfomycin trometamol has been assessed in 12 healthy
      volunteers given oral doses of 2, 3, and 4 g of fosfomycin and 3 g intravenously
      of fosfomycin as fosfomycin sodium, all in the fasting state. The assay was
      microbiological (Proteus mirabilis ATCC 21100). There was a gradual rise in both
      peak serum concentrations and total area under the curve by rising oral doses,
      from 16.0 mg/l and 106.7 mg x h/l, after 2 g to 30.9 mg/l and 189.7 mg x h/l
      after 4 g respectively. The serum half-life was 4 h after the oral doses and 2.1
      h after the intravenous dose. After the oral doses, the amounts excreted in urine
      in the active form ranged from 36 to 40% compared to 93% after the intravenous
      dose. The bioavailability was slightly below 40%. Concentrations in urine covers
      the usual urinary tract pathogens after oral doses of 2, 3, and 4 g.

PMID- 8370322
TI  - Antimicrobial activity of new antibiotics against bacterial isolates from a
      community hospital.
AB  - In this study, the antimicrobial activity of several new antibiotics was
      evaluated using microdilution antimicrobial susceptibility testing against 220
      clinically significant isolates obtained from a community hospital. The following
      antibiotics were studied: loracarbef, cefixime, cefpirome, desacetylcefotaxime,
      cefpodoxime, cefmetazole, cefepime, cefprozil and fleroxacin. The synergy of two
      particular drug combinations was evaluated using cefpirome/desacetylcefotaxime
      and cefpodoxime/desacetylcefotaxime. Cefpirome was clearly the most active
      antibiotic: 88% of the isolates tested were found to be susceptible.
      Specifically, this included 89% of enterococci, 84% of Pseudomonas aeruginosa,
      and 33% of Pseudomonas cepacia. All of the antibiotics tested demonstrated
      excellent activity against isolates of Escherichia coli and Klebsiella, Proteus
      and Salmonella species. For the other antimicrobials, 57, 50, 64, 65, 76, 74, and
      64% of the isolates were sensitive to loracarbef, cefixime, cefmetazole,
      cefprozil, fleroxacin, desacetylcefotaxime, and cefpodoxime, respectively. Among
      the gram-positive species, 88 and 92.5% of the isolates were sensitive to
      cefprozil and cefpirome, respectively. Cefepime and fleroxacin demonstrated the
      highest gram-negative activity with 85 and 89%, respectively, of the isolates
      being sensitive. The results of this study highlighted cefepime and cefpirome,
      which showed high overall in vitro activity against 79 and 88%, respectively, of
      the isolates tested.

PMID- 8370323
TI  - Taurolidine: in vitro activity against multiple-antibiotic-resistant,
      nosocomially significant clinical isolates of Staphylococcus aureus, Enterococcus
      faecium, and diverse Enterobacteriaceae.
AB  - Taurolidine at < or = 1,250 micrograms/ml killed all 37 isolates of multiple
      antibiotic-resistant Staphylococcus aureus (n = 9), Enterococcus faecium (n =
      17), and Enterobacteriaceae (n = 11). Time-kill experiments disclosed that bovine
      serum (65% v/v) only marginally retarded the bactericidal activity of 2,000 and
      1,000 micrograms/ml of taurolidine against the various strains. Taurolidine at
      2,000 micrograms/ml did not antagonize the bactericidal activity of 50% (v/v)
      fresh human serum against promptly and delayed serum-sensitive test strains of
      Escherichia coli and Serratia marcescens. In the presence of 65% (v/v) of fresh
      defibrinated human blood from two donors, however, the bactericidal activity of
      this antimicrobial compound was delayed, i.e., manifested only following extended
      (overnight) incubation, against staphylococcal and enterococcal isolates, though
      less so in the case of Enterobacteriaceae. Taurolidine at 2,000 micrograms/ml
      killed ingested, i.e., intraphagocytic bacteria of human-serum-resistant S.
      marcescens strains CDC 06:H3 and P016:H-.

PMID- 8370324
TI  - Efficacy of ceftizoxime in the treatment of incubating syphilis in rabbits.
AB  - While ceftizoxime given as a single intramuscular shot cures uncomplicated
      gonorrhoea in almost every case, its efficacy against Treponema pallidum in cases
      of concomitant incubating syphilis is less clear. To analyse this question, the
      rabbit orchitis model was used. After initial experiments defining appropriate
      inocula and doses, ceftizoxime was compared to penicillin G with its well-known
      activity against the organism in vitro and in vivo. According to the final
      experiment, ceftizoxime applied in doses corresponding to the ones used in humans
      for uncomplicated gonorrhoea cures rabbit orchitis due to T. pallidum about as
      effectively as penicillin. Hence there seems to be no need to refrain from using
      the third-generation cephalosporin ceftizoxime to cure gonorrhoea for fear of
      masking concomitant syphilis.

PMID- 8370325
TI  - In vitro experiments on catheter-related infections due to gram-negative rods.
AB  - Although many complications may arise with the use of central venous catheters,
      catheter-related bacteremia is considered to be the most serious complication.
      Microflora on the patient's skin (coagulase-negative staphylococci,
      Staphylococcus aureus) is thought to represent the major source of microorganisms
      causing catheter-related infections. Gram-negative rods are increasingly observed
      as causative agents. We therefore performed an in vitro study to elucidate the
      pathogenesis of polymer-associated infections caused by enterobacteriaceae and
      nonfermenters and to study the resistance of polymer surface-grown gram-negative
      rods against antibiotics. Using a modification of the semiquantitative method for
      culturing vascular cannulas on solid media described by Maki et al., we studied
      the adherence of various gram-negative rods to 1-cm segments of silastic
      catheters, a material used for Port-A-Cath-systems. Organisms were obtained from
      the American Type Culture Collection (Escherichia coli, Klebsiella pneumoniae,
      Serratia marcescens, Pseudomonas aeruginosa, Enterobacter cloacae). All organisms
      but Klebsiella showed extensive irreversible adherence. Production of an
      extracellular slime substance was observed only with antimicrobially treated
      Pseudomonas. After 'infection', the silastic catheter segments were treated with
      various antimicrobial agents. The following antibiotics were used either
      individually or in combination: cefotaxime, ciprofloxacin, imipenem, fosfomycin
      and gentamicin. Despite the fact that the antibiotic concentrations used were
      many times greater than the respective MICs of the various antibiotics, none of
      the antibiotics tested succeeded in eliminating the organisms. E. coli was found
      to be the most susceptible organism. These in vitro data substantiate our
      clinical impression that it is hardly possible to successfully eliminate the
      colonization of central venous catheters with gram-negative rods by using the
      antimicrobial agents employed here.

PMID- 8370326
TI  - Comparative efficacy of ceftriaxone in experimental infections involving
      Bacteroides fragilis and Escherichia coli.
AB  - The in vivo activity of ceftriaxone was examined in an experimentally induced
      subcutaneous infection involving Bacteroides fragilis and Escherichia coli. Mice
      were challenged with 1 of 10 strains of B. fragilis or E. coli, or a dual
      combination of the two species. The efficacy was measured by a reduction in the
      count of viable organisms when antimicrobial treatment was initiated 1 h after
      challenge and continued for 5 days. Ceftriaxone exhibited impressive activity
      against E. coli but showed poor in vivo activity versus B. fragilis. The
      antimicrobial activity of ceftriaxone was influenced by the microbial interaction
      in our dual-isolate model. Pharmacokinetic studies showed that ceftriaxone
      penetrated into abscesses and achieved peak levels of about 40% of the peak serum
      levels. However, in abscesses infected with B. fragilis nearly all biological
      activity of ceftriaxone was lost.

PMID- 8370327
TI  - Treatment of renal cell carcinoma with escalating doses of alpha-interferon.
AB  - Forty-one patients with advanced renal cell cancer started treatment with
      recombinant alpha-interferon intramuscularly, beginning at a dose of 5 x 10(6) U
      x 3/week, progressively increasing doses every week, from 5 x 10(6) U x 3/week to
      10 x 10(6) U x 3/week, to the highest dose of 15 x 10(6) U x 3/week. No complete
      response was achieved, partial response was achieved in 6 (13%) patients with a
      median duration of 45.2 (13-134) weeks. The majority of side effects from
      interferon treatment evaluated according to WHO classification were seen during
      the first 2 months and they were fever (after interferon administration) in 95%
      patients, chills (51%), flu like syndrome (65%), fatigue (87%), anorexia (80%),
      worsening in performance status (56%), nausea and vomiting (19%), weight loss (>
      10% during therapy) (26%), leukopenia (14%), anemia (75%), neurological symptoms
      (43%), psychological symptoms (19%) and dyspnea (9%). The results are similar to
      other studies and toxicity was only moderate.

PMID- 8370328
TI  - The world's longest user of an insulin pump?

PMID- 8370329
TI  - Institutionalization of diabetes care and education programs: a tale of two
      cities.

PMID- 8370330
TI  - Partners provide adaptive education for people who are visually impaired.

PMID- 8370331
TI  - The relationship between diabetes-related attitudes and patients' self-reported
      adherence.
AB  - This study involved 1202 patients who were placed into low adherence or high
      adherence groups based on their answers to questionnaires. The attitudes of each
      group were compared for a variety of adherence behaviors. Patients who reported
      high levels of adherence tended to have attitudes more in accord with diabetes
      experts. Members of the high adherence group strongly supported the need for
      special training for health care professionals who treat diabetes, favored team
      care, accepted the importance of patient compliance, acknowledged the seriousness
      of non-insulin-dependent diabetes mellitus (NIDDM), and recognized the
      relationship between glucose control and complications. Differences in attitudes
      between high- and low adherence groups were more prevalent for difficult
      adherence areas, eg, diet and exercise, than for easy adherence areas, eg,
      carrying sweets or diabetic identification. An understanding of patients'
      attitudes can help diabetes educators and patients develop realistic and relevant
      self-care plans.

PMID- 8370332
TI  - Diabetes and job performance: an empirical investigation.
AB  - There are approximately 11 million people in the United States with diabetes, and
      the numbers are increasing by 6% annually. Still, the relationship between
      diabetes and job performance remains unclear and marked by bias. To help clarify
      this relationship, a multicriterion job-performance rating scale was developed to
      rate task behaviors, interpersonal behaviors, down-time behaviors, and hazardous
      behaviors. A volunteer sample of 53 subjects was selected from people with
      insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes
      mellitus (NIDDM). All subjects were rated individually by a supervisor, who also
      rated the norm for the work group. The norm rating was used to determine a norm
      referenced control group. The subjects were rated better than the norm in all
      categories and on all criteria: composite job performance (P < .001), task
      behaviors (P < .01), interpersonal behaviors (P < .01), down-time behaviors (P <
      .05), and hazardous behaviors (P < .001).

PMID- 8370333
TI  - The knowledge and practices of registered nurse, certified diabetes educators:
      teaching elderly clients about exercise.
AB  - This study identified the knowledge base and practices of Registered Nurse,
      Certified Diabetes Educators (RN, CDEs) regarding their exercise teaching
      programs for elderly clients who have non-insulin-dependent diabetes mellitus
      (NIDDM). The random sample of 197 AADE members surveyed by questionnaire was a
      highly educated and experienced group. RN, CDEs who worked 30 or more hours per
      week in diabetes education or attended four or more continuing education (CE)
      programs per year had significantly more comprehensive exercise teaching program
      designs and instructional techniques to enhance elderly NIDDM clients' learning
      (P < .05). However, many CDEs do not teach their elderly clients about exercise
      due to lack of resources, lack of specific knowledge to prescribe exercise,and
      negative stereotypes of elderly clients' ability to exercise. Greater
      availability of educational programs for CDEs to explore curriculum development,
      program planning, evaluation, and exercise prescription for elderly clients with
      multisystem disease is recommended.

PMID- 8370334
TI  - A review of the effects of resistance training for individuals with diabetes
      mellitus.
AB  - Although the effectiveness of exercise as a treatment modality for the management
      of diabetes mellitus has long been recognized, a vital component of the exercise
      prescription has been overlooked. In addition to endurance training, resistance
      training may provide physiologic benefits to the individual with diabetes that,
      in some cases, may equal or exceed those gained through aerobic training. These
      benefits may include improved blood lipid profiles, increased absolute left
      ventricular wall contractility, decreased resting blood pressure, improved
      insulin sensitivity and glucose tolerance, improved glycemic control, improved
      muscular strength and endurance, and increased bone and connective tissue
      strength. By utilizing a combination of aerobic and resistance training, the
      individual with diabetes experiences a more comprehensive exercise program that
      can improve most areas of health and physical fitness. In addition, having a
      greater number of exercise modality options may enhance exercise compliance.

PMID- 8370335
TI  - Non-insulin-dependent diabetes and obesity in the black and Hispanic population:
      culturally sensitive management.
AB  - The prevalence of diabetes is considerably higher among ethnic minorities,
      particularly black and Hispanic Americans, than in the nonminority white
      population. Obesity, a significant risk factor for non-insulin-dependent diabetes
      mellitus (NIDDM), also is more common in these ethnic groups. Because the
      combined effects of obesity and NIDDM can lead to potentially serious
      complications, overweight patients with NIDDM must be treated aggressively.
      However, effective treatment of these ethnic groups requires a sensitivity to and
      recognition of their unique cultural values. Diabetes educators and health care
      providers need to take into account specific ethnic beliefs, customs, food
      patterns, and health care practices, with the goal of incorporating these
      cultural factors into a practical and beneficial treatment regimen.

PMID- 8370336
TI  - Teaching foot care creatively and successfully.

PMID- 8370337
TI  - Higher levels of nicotine in arterial than in venous blood after cigarette
      smoking.
AB  - We examined differences between arterial and venous concentrations of nicotine in
      human subjects. Shortly after smoking a cigarette, levels of nicotine in arterial
      plasma were more than double those in venous plasma. The time course of the rise
      in arterial nicotine levels and the magnitude of the arteriovenous difference
      varied considerably among subjects. For some subjects, arterial nicotine
      concentrations after one cigarette were similar to venous concentrations
      typically observed after 20 cigarettes and were nearly 10 times greater than
      venous concentrations. Our findings have implications for understanding the high
      degree of addictiveness and cardiovascular toxicity of smoked forms of drugs.

PMID- 8370338
TI  - Effects of GBR 12909 and cocaine on cocaine-maintained behavior in rhesus
      monkeys.
AB  - The reinforcing effect of the high affinity dopamine reuptake inhibitor GBR 12909
      (1-[2-[bis(4-fluorophenyl)methoxy]ethyl)-4(3- phenylpropyl)piperazine) was
      compared with that of cocaine, and the effects of both GBR 12909 and cocaine
      pretreatments were evaluated on behaviour maintained by cocaine in rhesus
      monkeys. Increasing dose per injection of intravenously-delivered GBR 12909 or
      cocaine led to increased rates of lever-press responding. Maximum cocaine
      maintained rates were higher and occurred at a smaller dose than maximum rates of
      GBR 12909-maintained responding. Presession intravenous administration of either
      GBR 12909 or cocaine (0.32, 1.0 or 3.2 mg/kg) resulted in dose-dependent
      decreases in rates of cocaine-maintained responding when high doses of cocaine,
      which engendered high response rates, were available early in the session. Under
      these conditions, the decrease in response rates was associated primarily with
      decreases in running rate rather than with a lengthening in post-reinforcement
      pause times. The decreases in running rate produced by both cocaine and GBR 12909
      probably reflect an unconditioned rate-disruptive effect of these drugs on
      cocaine-reinforced responding rather than a reduction in the reinforcing efficacy
      of cocaine.

PMID- 8370339
TI  - A case-control study of driving-while-impaired offenders.
AB  - A case control approach was used to identify variables associated with driving
      while impaired (DWI). Data utilized for this study were obtained from interviews
      with individuals in a representative sample of 9943 Canadians. Individuals
      convicted for DWI were matched with control subjects (i.e. no DWI convictions) by
      gender, age, province of residence, education, income, and recent drinking
      behaviour. During the matching process, 39 current abstainers were found among
      the DWI offenders and were treated as a separate group for statistical purposes.
      Three groups were compared: 78 DWI cases, 78 matched controls, and 39 DWI current
      abstainers. Statistical analyses were used to detect significant differences
      among these three groups for 81 variables within the following categories: (a)
      attitudes, knowledge and behaviour related to drinking and driving; (b) driving
      behaviour; (c) drinking behaviour and drug use; (d) social issues; and (e)
      attitudes towards different policy approaches to reducing drinking and driving.
      DWI cases were significantly different from control subjects for only 10
      variables. A high proportion of differences found between these two groups
      related to attitudes regarding drinking and driving behaviour. For example, DWI
      cases were more likely than controls to believe that some people drive better
      after drinking, that it takes more alcohol to be legally impaired, and that there
      is an excuse for DWI. DWI cases were more likely to drink due to sadness or
      loneliness, and reported higher cannabis use over previous years. Little evidence
      was found to support the hypothesis that DWI offenders are less likely to
      perceive deterrents to DWI. However, evidence does support the notion that many
      DWI offenders do not believe that they have a drinking problem. Implications of
      the findings are discussed.

PMID- 8370340
TI  - Injecting drug users and HIV/AIDS: risk behaviours and risk perception.
AB  - This paper reports on the incidence of risk taking behaviours, and the
      relationship between risk perception and risk behaviours in a sample of 1245
      Sydney injecting drug users (IDUs). Almost all respondents reported engaging in
      behaviours that placed them at risk of HIV infection: 32.9% through unsafe
      injecting, 84.4% because of unsafe sexual behaviour and 89.2% because of either
      injecting or sexual behaviour. Injecting and sexual behaviour were poorly
      correlated. This study also found that risk perception is unrelated to injecting
      or sexual behaviours, previous history of sexually transmitted diseases, a range
      of demographic characteristics including age and gender, and the number of times
      tested for HIV. Social policy and prevention programs should aim to change unsafe
      injecting and sexual behaviours directly, rather than attempting to achieve
      change indirectly by changing risk perception.

PMID- 8370341
TI  - The misuse of buprenorphine and a buprenorphine-naloxone combination in
      Wellington, New Zealand.
AB  - Two surveys of 12 months duration were undertaken on opioid users presenting to
      the Wellington Alcohol and Drug Centre before and after the introduction of a
      combination buprenorphine 0.2 mg-naloxone 0.17 mg tablet (Bu-Nx), which was
      launched in 1991 in the hope of reducing intravenous misuse. There was
      considerable intravenous (i.v.) misuse of buprenorphine 0.2 mg tablets (Bu) in
      1990 with self-reports of misuse in 81% of the patients over the 4 weeks prior to
      presentation, and 65% of the patients had buprenorphine in their urine. In the
      repeat survey 57% reported misuse of the Bu-Nx combination over the previous 4
      weeks, and 43% had buprenorphine +/- naloxone detected in their urine. There was
      a reduction in the street price of Bu-Nx. One-third of the patients who used Bu
      Nx i.v. reported instances of withdrawal symptoms, and subjectively the drug was
      less attractive to misusers. The combination product may have less misuse
      potential than buprenorphine alone, but it remains a preparation, in the dosages
      employed, that is intravenously misused.

PMID- 8370342
TI  - Inhibition of non-enzymatic lipid peroxidation by 'Essentiale' a drug enriched in
      phosphatidylcholine in ethanol-induced liver injury.
AB  - The effect of 'Essentiale'--a drug, now clinically listed in European countries
      in the treatment of liver diseases was examined in ethanol-induced liver injury
      in rats (free access to a 20% ethanol solution for 3 months). The antioxidant
      enzymes, SOD (superoxide dismutase), CAT (catalase), GSH-R (glutathione
      reductase), non-protein and total SH groups as well as TBA-rs contents were
      investigated. Following treatment, we found beneficial effects in SOD and CAT
      activities. The above enzyme activities were restored after a 3-month drug
      administration. Furthermore, 'Essentiale' treatment normalized TBA-rs levels in
      the liver. These effects have been briefly discussed.

PMID- 8370343
TI  - Factors affecting neutrophil transit during acute pulmonary inflammation:
      minireview.
AB  - Recent studies confirm data that for over a century have suggested that the lungs
      are an important source of noncirculating neutrophils. Many factors control how
      neutrophils pass through the normal lungs, including the unique and complex
      structure of the pulmonary capillary bed, local hemodynamic factors, neutrophil
      deformability, and neutrophil-endothelial interactions. Alterations in these
      factors are likely to influence neutrophil traffic in the lungs in disease
      processes where neutrophil-induced lung injury has been implicated. In recent
      years experimental approaches using in vitro techniques have been used to study
      neutrophil function. Such studies, together with in vivo studies in whole animals
      and to a limited extent in humans, will help to elucidate the important
      mechanisms in neutrophil sequestration in the acute and chronically inflamed
      lung. Novel avenues of therapeutic intervention in neutrophil traffic through the
      lungs may then be possible. However, whether interference with this cell, which
      forms a major defense mechanism in the lungs, is advisable, remains a matter for
      debate.

PMID- 8370344
TI  - Effect of pentamidine on cytokine (IL-1 beta, TNF alpha, IL-6) production by
      human alveolar macrophages in vitro.
AB  - Pentamidine (Pe) is an aromatic diamidine drug used clinically to treat
      Pneumocystis carinii pneumonia by aerosol inhalation. Nothing has been reported
      about the effects of this drug on human alveolar macrophage (AM) properties. In
      this study AM were exposed in vitro to various concentrations of Pe (10(-4)-10(
      6) M) alone or in combination with bacterial endotoxin (LPS). Supernatants were
      collected at 3, 6, and 24 h and assayed for secreted IL-1 beta, IL-6, and TNF
      alpha. While the drug did not induce release of these cytokines, LPS-induced
      secretion of all three cytokines was inhibited by Pe in a dose-dependent manner.
      At the most effective Pe dose, 10(-5) M, AM viability (as determined by trypan
      blue dye exclusion) was reduced by 14% at 24 h, while no effect on viability was
      seen at lower concentrations. mRNA expression of all three cytokines was examined
      by PCR and Northern analysis to establish if the decrease in cytokine secretion
      was determined on a pre- or post-translational level. Reduced steady-state mRNA
      levels were found as early as 3 h after LPS stimulation, with Pe concentrations
      corresponding to those that decreased cytokine secretion. At the later time
      points, Pe also inhibited beta-actin, ornithine decarboxylase, and GAPDH mRNA
      expression, indicating that pentamidine had a general toxic effect on mRNA
      transcription in the macrophages. It is concluded that Pe, at pharmaceutically
      relevant concentrations and with apparent low cytotoxicity as determined by dye
      uptake, nonspecifically inhibits cytokine production by a toxic effect on
      transcriptional events.

PMID- 8370345
TI  - Lung clearance in Long-Evans rats after inhalation of porous, monodisperse cobalt
      oxide particles.
AB  - Lung clearance of a well-defined uniform and respirable material was conducted to
      aid in the development of models used to relate inhalation of inorganic hazardous
      particles to organ doses and bioassay measurements, and in particular to aid in
      the extrapolation of animal data to humans. In the present study, lung clearance
      was investigated in Long-Evans rats using monodisperse, porous, 0.8- and 1.7
      microns-diameter cobalt oxide (Co3O4) test particles. An advanced inhalation
      technique for rats using endotracheal intubation yielded exclusive particle
      deposition in the pulmonary region without external pelt contamination, thus
      allowing for clearance studies starting directly after inhalation. The kinetics
      of lung clearance was distinguished between the two dominant clearance mechanisms
      of mechanical particle transport to the larynx and translocation of dissolved
      particle material to blood. A particle fraction of about 40% was cleared by short
      term particle transport to the larynx, both the long-term particle transport rate
      and the translocation rate of dissolved particle material given as fractional
      rates of the retained particle mass in the lungs were not constant with time. The
      former declined from 0.03 to 0.004 d-1 during 6 months after inhalation. The
      latter depended on the specific surface area of the porous particles and
      increased with time from 0.08 and 0.04 d-1 for 0.8- and 1.7-microns particles,
      respectively. The results obtained were compared to previously reported data
      obtained from Fischer-344 rats and HMT rats. These were part of a previously
      reported interspecies comparison of lung clearance followed in seven species,
      including humans, and using the same batches of Co3O4 test particles. Long-term
      lung retention was similar in Long-Evans rats and HMT rats but decreased faster
      for both particle sizes than in Fischer-344 rats, as a result of a significantly
      faster translocation of dissolved material from the test particles to blood.
      Mechanical particle transport to the larynx was comparable in all three species.

PMID- 8370346
TI  - Comparison of antioxidant substances in bronchoalveolar lavage cells and fluid
      from humans, guinea pigs, and rats.
AB  - Antioxidants located in the lining layer of the respiratory tract may be
      important in determining sensitivity of lung tissues to inhaled pollutants. This
      study addressed species differences in the amounts of ascorbic acid (AH2),
      glutathione (GSH), uric acid (UA), and alpha-tocopherol (AT) in bronchoalveolar
      lavage (BAL) fluid and cells of humans, guinea pigs, and rats. Protein and lipid
      phosphorus (lipid P) were used as normalizing factors. More than 90% of the
      lavageable AH2, UA, GSH, protein, and lipid P was present in the extracellular
      fraction of BAL in rats and guinea pigs, while over 95% of the lavageable AT was
      located in the BAL cells. BAL fluid AH2/protein in rats was 7- to 9-fold higher
      than in humans and guinea pigs. However, human BAL fluid had 2- to 8-fold higher
      UA/protein, GSH/protein, and AT/protein ratios than rats and guinea pigs. In BAL
      cells, rats had higher AH2/protein and AT/protein ratios than guinea pigs and
      humans, and both rats and guinea pigs had higher GSH and AT/protein ratios than
      humans. Individual variability among humans in the BAL fluid and cellular
      antioxidants was generally greater than in the laboratory animals. These data
      demonstrate that some large species differences exist in BAL fluid and cellular
      antioxidants which could affect susceptibility to oxidant pollutants.

PMID- 8370347
TI  - Conservation analysis of rat and human SP-A gene identifies 5' flanking sequences
      of rat SP-A that bind rat lung nuclear proteins.
AB  - As an initial step toward understanding regulation of tissue-specific expression
      of SP-A, 5' flanking sequences of the rat SP-A gene and human SP-A I gene were
      cloned, sequenced, and compared using dot matrix analysis. Two regions were
      identified, each with a considerable degree of homology between the two species.
      One region was proximal to the TATAA box, at position -225/-17 in rats and -226/
      36 in humans, and the other at position -1115/-1026 in rats and -938/-851 in
      humans. Studies in rats revealed the specific binding of rat lung nuclear
      proteins to each of the conserved 5' flanking regions identified in rat SP-A.
      Binding studies using the rat proximal (rPPS) or distal (rDPS) promoter segments,
      or overlapping fragments of these segments, with rat nuclear extracts detected
      the presence of a number (1-4) of lung-specific DNA/protein complexes. When
      nuclear proteins from liver, a nonexpressing tissue, were used the binding
      profile of certain nuclear proteins differed from that of the lung. These
      studies, taken together, suggest that sequences within identified conserved DNA
      segments in the 5' flanking region of the rat SP-A gene contribute to its tissue
      specific expression in rats.

PMID- 8370348
TI  - Stretch-induced growth-promoting activities stimulate fetal rat lung epithelial
      cell proliferation.
AB  - There is increasing evidence to suggest that fetal lung growth requires normal
      fetal breathing movements. To study this process in vitro, the effect of
      mechanical stretch on proliferation of fetal rat lung cells maintained in
      organotypic cultures was examined. In previous studies it has been demonstrated
      that DNA synthesis and cell division are stimulated by stretch. To determine
      whether stretched cells release soluble growth factors into their culture medium,
      conditioned media (CMs) were collected after static culture or culture while
      stretched. At a 10% dilution (v/v), CM from stretched cells (S-CM) increased
      [3H]thymidine incorporation into DNA of mixed fetal rat lung cells by 60%,
      compared to CM from nonstretched cells (C-CM) (p < .01). S-CM increased
      [3H]thymidine incorporation of fetal lung epithelial cells by 3 to 4-fold (p <
      .01) and increased cell number by 11.9% (p < .05), but had no effect on fetal
      lung fibroblast growth. Addition of either PDGF-BB (20 ng/mL), IGF-I (25 ng/mL),
      or EGF (50 ng/mL) to C-CM, did not mimic the effect of S-CM on epithelial cell
      DNA synthesis. The stimulatory activity of S-CM on epithelial cell proliferation
      was heat-, acid- and trypsin-sensitive. It is concluded that organotypic fetal
      lung cell cultures respond to stretch by elaborating growth-promoting factors
      which stimulate fetal rat lung epithelial cell, but not fibroblast,
      proliferation.

PMID- 8370349
TI  - Effects of valproate and E-2-en-valproate on functional and morphological
      parameters of rat liver. II. Influence of phenobarbital comedication.
AB  - The effect of phenobarbital on the potential hepatotoxicity of E-2-en-valproate
      (E-2-en-VPA; trans-2-en-VPA) and VPA was studied in young male Sprague-Dawley
      rats. E-2-en-VPA and VPA were administered daily at 750 mg/kg i.p. (divided into
      three doses a day) for 7 consecutive days. Phenobarbital was coadministered i.p.
      once daily at 100 mg/kg for 2 days, followed by daily injections of 50 mg/kg for
      the subsequent days of the treatment period. Additional groups of rats were
      treated with phenobarbital alone or received once daily administration of 4-en
      VPA (100 mg/kg), a potentially hepatotoxic metabolite of VPA. Clinical chemistry
      data were studied before and after the period of treatment. Furthermore, drug and
      metabolite levels were analyzed by gas chromatography-mass spectrometry.
      Treatment with VPA and phenobarbital resulted in deaths and histopathological
      liver alterations, such as marked microvesicular steatosis and degenerative
      lesions, whereas no death and hepatotoxicity occurred in rats treated with E-2-en
      VPA and phenobarbital. Furthermore, hyperammonemia was recorded in VPA- but not E
      2-en-VPA-treated rats. In comparison to treatment with VPA or E-2-en-VPA alone,
      combined treatment with phenobarbital markedly reduced plasma levels of the
      parent drugs and metabolites originating from beta-oxidation, but, in case of
      VPA, increased metabolites originating from omega-oxidation. Plasma levels of 4
      en-VPA were increased by phenobarbital in VPA-treated rats, but 4-en-VPA was not
      detectable in rats treated with E-2-en-VPA. The most severe alterations in
      functional and morphological liver parameters were found in rats treated with 4
      en-VPA. In these animals, the extent of steatosis was significantly correlated
      with plasma levels of 4-en-VPA, but not its major metabolite 2,4-dien-VPA. Plasma
      levels of 4-en-VPA or its major metabolite 2,4-dien-VPA in rats without steatosis
      were markedly higher than levels of these compounds in VPA-treated rats with
      steatosis, suggesting that 4-en-VPA and 2,4-dien-VPA are not critically involved
      in the hepatotoxic effects of VPA. The data substantiate that E-2-en-VPA is less
      hepatotoxic than VPA and may thus offer advantages for antiepileptic therapy.

PMID- 8370350
TI  - Reciprocal positive transfer between kindling of audiogenic seizures and
      electrical kindling of inferior colliculus.
AB  - The behavioral and EEG concomitants of kindling produced by daily electrical
      stimulation of the inferior colliculus have been recorded in three series of
      Wistar rats: (1) non epileptic controls (NE), (2) rats susceptible to audiogenic
      seizures (AS), (3) acoustically susceptible rats with prior kindling of
      audiogenic seizures by repeated sound exposure (KAS). Repeated collicular
      stimulation produced behavioral and EEG changes which were similar in the AS and
      the NE rats. The tonic seizure without cortical discharges elicited by the first
      stimulation progressively changed into tonic-clonic seizures with sustained
      cortical EEG discharges after more than 20 stimulations. In the KAS group, the
      electrical collicular kindling was clearly accelerated: kindled tonic-clonic
      seizures and their EEG discharges already occurred after one to five electrical
      stimulations. Similarly, after completion of electrical collicular kindling in
      AS, sound stimulations immediately induced characteristic kindled audiogenic
      seizures. The immediate reciprocal positive transfer observed between kindling of
      audiogenic seizures and kindling of seizures induced by electrical stimulation of
      the inferior colliculus suggests that kindling of these two brain-stem seizures
      involves similar structures and mechanisms.

PMID- 8370351
TI  - The anticonvulsant activity of D-cycloserine is specific for tonic convulsions.
AB  - D-Cycloserine has been shown to exert anticonvulsant activity in maximal
      electroshock seizures. The purpose of the present study was to evaluate the
      spectrum of D-cycloserine anticonvulsant activity using other experimental models
      of epilepsy. D-Cycloserine induced a dose-related decrease in the incidence of
      tonic convulsions induced by 120 mg/kg of pentylenetetrazol. The ED50 of D
      cycloserine for the inhibition of the tonic convulsions was 109 mg/kg. The
      anticonvulsant activity was specific for the D-isomer at L-cycloserine (400
      mg/kg) had no effect on the tonic convulsions. D-Cycloserine had no effect on the
      pentylenetetrazol-induced clonic convulsions induced by either 70 or 120 mg/kg
      pentylenetetrazol, electrically induced nonkindled hippocampal seizures or
      kindled amygdala seizures. D-Cycloserine had no effect on strychnine-induced
      tonic convulsions. These results indicate that D-cycloserine is inactive against
      clonic convulsions and may be active only against tonic convulsions mediated by
      brainstem sites.

PMID- 8370352
TI  - Conventional and rapid stimulation evoked potential changes in patients with
      status epilepticus.
AB  - We utilized somatosensory evoked potentials to evaluate 33 patients with status
      epilepticus who did not have focal neurological etiologies. Eighteen percent of
      the patients had conventional stimulation evoked potential abnormalities at or
      above the P14 lemniscal level. Evoked potential abnormalities in this population
      showed a statistically significant correlation with a poor outcome including
      patients that died or required dependent care following hospital discharge. Rapid
      stimulation somatosensory evoked potential testing is a new technology which may
      be useful to detect more subtle central nervous system injury and was
      successfully utilized in the acute setting. Combined conventional and rapid
      stimulation evoked potentials demonstrated that 30% of these patients had
      abnormal findings. The results demonstrate that a significant percentage of
      status epilepticus patients have somatosensory evoked potential abnormalities and
      suggest that conventional and rapid stimulation somatosensory evoked potentials
      may be useful predictive indicators for predicting outcome and mortality in this
      condition.

PMID- 8370353
TI  - Memory complaints in epilepsy: correlations with cognitive performance and
      neuroticism.
AB  - Subjective memory functioning was assessed by a questionnaire in 102 patients
      with epilepsy. Factor analysis of their responses yielded five factors: (1)
      Absentmindedness, (2) Retrieval, (3) Memory for Semantic Structures, (4)
      Childhood Memories and (5) Rote Memory. Scales representing the factors were
      constructed. On all scales, patients (n = 71) who had been specifically referred
      for an evaluation of subjective memory problems showed moderate to large
      differences from normal Controls (n = 111) in complaint scores, indicating
      adequate sensitivity of the scales to clinically significant complaint levels. By
      contrast, candidates for epilepsy surgery (n = 31) resembled the Controls in
      their perceived memory status, showing a moderately elevated complaint level on
      only one of the factor based scales. Relationships of subjective memory
      difficulties to performance on objective tests of memory and other relevant
      cognitive functions as well as neuroticism were examined. The two epilepsy groups
      were fairly similar in their test performance, but differed markedly in their
      subjective memory problems. Also, correlational analysis revealed only a single
      weak correlation between cognitive tests and subjective memory ratings. The
      present findings indicate that there is no simple relationship between subjective
      evaluations of memory and test performance. Patients' memory complaints do not
      accurately predict disturbances that can be measured on standard
      neuropsychological tests. Such complaints may be related more to neuroticism.
      Also, psychosocial difficulties which may accompany chronic disorders in general
      may have to be invoked to account for memory complaints in people with epilepsy.
      The epilepsy itself does not appear to be a critical factor in producing memory
      complaints.

PMID- 8370354
TI  - Physiological correlates of abnormal behaviors in magnesium-deficient rats.
AB  - In order to elucidate the mechanism of behavioral alterations in magnesium
      deficient rats, changes in the electroencephalogram (EEG) and electrocardiogram
      (ECG) were studied during auditory stimulation and correlated with the behavioral
      alterations. Weanling rats were fed either a Mg-deficient diet or a control
      synthetic diet for 2-3 weeks before the experiment. EEGs were recorded from the
      hippocampus and the sensorimotor and auditory cortices, and ECGs with a telemetry
      system. White noise with an intensity of 100 dB was given continuously to induce
      behavioral changes. The Mg-deficient rats developed consistent and graded
      behavioral changes in response to the stimulation, showing running-jumping
      behavior (stage 1), followed by tonic limb convulsion (stage 2) and finally by
      falling down on the floor (stage 3). The EEGs also showed consistent changes with
      spike activity, initiating in the hippocampus (stage 2) and then spreading to the
      neocortices bilaterally (stage 3). These findings indicate that the behavioral
      changes induced by auditory stimulation in the Mg-deficient rats are due to
      seizures arising in deeper brain structures, particularly in the limbic system,
      and projecting secondarily to the neocortices. The ECG changes, mainly consisting
      of marked bradyarrhythmia, occurred as early as the appearance of the EEG spikes,
      indicating that they were also related to the seizure. We conclude therefore that
      Mg deficiency in rats causes increased excitability of the central nervous
      system, resulting in seizures possibly originated in the limbic system, later
      developing secondary generalization, and also causing cardiac dysfunctions.

PMID- 8370355
TI  - Epileptogenic spikes and seizures but not high voltage spindles are induced by
      local frontal cortical application of gamma-hydroxybutyrate.
AB  - Combining the methods of microdialysis and EEG recording, we have examined the
      effect of unilaterally, intracortically applied gamma-hydroxybutyrate (GHB) on
      frontal cortical EEG activity in freely moving rats. GHB, a natural endogenous
      GABA metabolite, is known to induce rhythmic spike and wave activity, resembling
      generalized petit mal epilepsy. Without GHB, spontaneous high voltage spindles
      (HVS, 6-9 Hz) were observed during awake and immobile behavior in most of the
      animals (HVS rats), while others never had any HVS. In those both groups of
      animals intracortical application of GHB induced epileptogenic spikes (< 0.5 Hz)
      behaviorally accompanied by occasional myoclonic jerks and epileptic discharges
      (< 2 Hz) with behavioral convulsions and contraversive movements towards the left
      hindlimb (seizures) but did not induce HVS or spike and waves, as reported after
      systemic application. In the group of rats with spontaneous occurring HVS the
      amplitude of the HVS on the side of the microdialysis probe was suppressed by GHB
      and GHB-induced spikes invading the contralateral cortex frequently triggered and
      terminated local HVS. The results point to different neural mechanisms for the
      generation of HVS and spikes and epileptic discharges (seizures) induced after
      local intracortical application of GHB.

PMID- 8370356
TI  - Left ventricular dysfunction following transient ischaemia induced by
      transluminal coronary angioplasty. Beneficial effects of calcium antagonists
      against post-ischaemic myocardial stunning.
AB  - Acute and severe ischaemia is followed by depression of myocardial contractility
      during reperfusion; return to full recovery might take a long time. This
      phenomenon, termed myocardial stunning, has been extensively demonstrated in
      experimental studies and in different clinical settings. The beneficial effects
      of calcium antagonists in preventing post-ischaemic myocardial stunning have been
      tested in experimental studies, showing that when administered before or during
      ischaemia, they inhibit post-ischaemic myocardial dysfunction. The present study
      was undertaken to verify the possible occurrence of myocardial stunning following
      transient ischaemia induced by coronary angioplasty. The aim was also to evaluate
      the possible protective effects of calcium antagonists (nisoldipine) and nitrates
      against myocardial stunning in patients with coronary artery disease undergoing
      routine coronary angioplasty (PCTA) with prolonged inflation. The study included
      25 patients, aged between 40 and 69 years, with exercise-induced angina and
      single vessel disease. The stenosis was severe (80% to subtotal occlusion),
      localized on the left anterior descending artery, but without collaterals at
      coronary angiogram. All patients had normal left ventricular (LV) overall
      function and normal systolic thickening of the anterior wall supplied by the
      diseased artery. Our data suggest that post-ischaemic myocardial stunning is not
      only an experimental curiosity, but that it does occur in different clinical
      settings. Calcium antagonists (i.e. nisoldipine), when added before or during
      ischaemia, seem to prevent myocardial stunning. These findings confer a potential
      role to these agents in the treatment of post-ischaemic myocardial dysfunction.

PMID- 8370357
TI  - Effect of transient ischaemia on left ventricular function and prognosis.
AB  - Transient myocardial ischaemia is associated with a rapid reduction in ATP
      concentration, depletion of glycogen storage, and transient from aerobic to
      anaerobic metabolism. Repeated ischaemic episodes are associated with structural
      changes, some of which are transient, while others are permanent. These changes
      affect myocardial cells, collagen matrix and lead to increased amounts of fibrous
      tissue, which may impair both systolic and diastolic left ventricular function.
      Ischaemic changes, whether silent or symptomatic, during exercise testing are
      independent predictors of worse prognosis beyond the extent of coronary disease.
      Abolition of exercise-induced ischaemia, either by coronary bypass surgery or by
      medical therapy is associated with improved outcome. Ischaemic episodes during
      daily life are independent predictors of future cardiac events beyond results of
      exercise testing, extent of coronary disease or left ventricular function.
      Impairment of systolic and diastolic function persists from hours to days after
      transient ischaemia. Abolition of myocardial ischaemia, either by medical therapy
      or coronary angioplasty, has been shown to improve both systolic and diastolic
      function. It seems, therefore, that prevention of ischaemia is fully justified as
      it preserves the metabolic and functional state of the myocardium and improves
      prognosis.

PMID- 8370358
TI  - The hibernating myocardium in ischaemia and congestive heart failure.
AB  - Hibernating myocardium refers to the presence of persistent myocardial and left
      ventricular dysfunction at rest due to reduced coronary blood flow that can be
      partially or completely restored to normal by myocardial revascularization. An
      increasing amount of data show it is most likely a downgrading of cardiac
      function so that blood flow and myocardial function are once again in a state of
      equilibrium. It has been demonstrated to occur in patients with unstable angina,
      chronic stable angina, acute myocardial infarction and in left ventricular
      dysfunction and/or congestive heart failure. Salvage of this viable myocardium by
      successful revascularization improves left ventricular dysfunction and probably
      also patient survival. Therefore, diagnosis of hibernating myocardium is
      important because it does not render left ventricular dysfunction a necessary
      contraindication to revascularization, nor does it leave the patient with chronic
      heart failure a candidate only for cardiac transplantation. Instead, these
      patients should have complete revascularization by coronary bypass
      surgery/percutaneous transluminal coronary angioplasty as soon as possible.

PMID- 8370359
TI  - Post-ischaemic cardiac dilatation and remodelling: reperfusion injury of the
      interstitium.
AB  - Cardiac size and geometry have an important influence on clinical prognosis in
      heart disease. The cardiac interstitium would appear to play a major role in
      modulating muscle configuration after ischaemic insults. Ischaemic reperfusion
      injury of the heart should not be viewed as confined to the myocyte compartment.
      There are major events occurring in the interstitial compartment which could
      ultimately determine the long-term configuration and topography of the heart.
      Thus, permanent plastic changes in cardiac dimensions appear to evolve after
      initial alterations in the collagen matrix. The physiological, cellular,
      biochemical, and molecular considerations in the cardiac interstitium are quite
      different from those of the myocyte compartment. Accordingly, therapeutic
      interventions to modulate cardiac geometry and remodelling may differ.

PMID- 8370360
TI  - Cardiac dysfunction and development of heart failure.
AB  - A major consequence of chronic cardiac dysfunction is chronic overload of
      contractile myocardium. Various aetiologies, in reaction to this, may induce
      compensatory mechanisms consisting of excentric (dilatation) and concentric
      hypertrophy. Chronic left ventricular dysfunction is caused most frequently by
      myocardial infarction. Left ventricular dilatation and hypertrophy occurs in
      patients with extensive infarction. Dilatation may at first be compensatory,
      restoring stroke volume within 4 weeks of the infarct. However, as dilatation
      progresses, left ventricular ejection fraction and stroke volume deteriorate
      during exercise and at rest, and finally pulmonary capillary wedge pressure
      increases and patients become symptomatic 1.5-3 years after the infarct. Major
      determinants of progressive left ventricular dilatation and deterioration of
      haemodynamics are a depressed left ventricular ejection fraction,
      angiographically determined infarct size, stroke volume early (4 days) after
      myocardial infarction, infarct location (anterior/inferior) and the grade (TIMI)
      of perfusion of the infarct-associated coronary artery. Chronic loading and
      unloading may accelerate or decelerate this process. Efficiency and energy
      reserve (phosphocreatine) of the dilated ventricles is reduced. Further intrinsic
      changes in surviving myocardium include morphological and functional disturbance
      of coronary microcirculation.

PMID- 8370361
TI  - The role of calcium antagonists in the treatment of chronic heart failure.
AB  - Calcium antagonists have been widely used for the treatment of angina and
      hypertension. Because of vasodilator and anti-ischaemic properties, calcium
      antagonists might be expected to bring benefit to patients with heart failure,
      particularly when the heart failure is due to coronary heart disease. Eight
      trials of calcium antagonists, fulfilling specific criteria, have been reviewed.
      The evidence at present does not support the use of calcium antagonists in
      established heart failure. Some benefit may accure from the use of the newer
      calcium antagonists but further trials are awaited. Calcium antagonists appear to
      improve diastolic fraction in patients with coronary heart disease, no overt
      heart failure but a reduced ejection fraction.

PMID- 8370362
TI  - Nisoldipine in severe ischaemic left ventricular dysfunction.
AB  - The use of calcium antagonists in patients with severe dysfunction is
      controversial because agents like verapamil, diltiazem and nifedipine have been
      shown to worsen or precipitate congestive heart failure. However, successive
      improvements in our understanding of the clinical pharmacology of these drugs, of
      their pharmacokinetics and of their action on several neuro-humoral regulatory
      mechanisms have led to a continuous improvement of the molecules available.
      Promising results have been obtained with nisoldipine in patients with ischaemic
      left ventricular dysfunction (improved exercise tolerance, improved diastolic
      filling probably related to a relative improvement of chronically ischaemic
      areas) and other studies are exploring the effects of the combination of
      nisoldipine with an ACE-inhibitor. Soon, these trials should tell us if there is
      a real clinical benefit in the use of this agent not only to improve symptoms but
      also to slow down progression of the ventricular dysfunction.

PMID- 8370364
TI  - Regional wall motion abnormalities in stunned and hibernating myocardium.
AB  - The clinical recognition that chronic dysfunctioning myocardial segments may
      retain viable myocardium has important therapeutic consequences. 'Stunned
      myocardium' and 'hibernating myocardium' have been proposed to distinguish
      respectively between post-ischaemic left ventricular dysfunction, a condition
      which normalizes spontaneously, and persistent wall motion abnormalities due to
      chronic hypoperfusion. This study examines the possible link between these two
      conditions.

PMID- 8370363
TI  - Left ventricular systolic and diastolic dysfunction in the acute phases of
      myocardial ischaemia and infarction, and in the later phases of recovery.
      Function follows morphology.
AB  - Myocardial ischaemia and infarction result in major changes in myocardial
      function, due to the metabolic and structural cause. The observed morphological
      changes may be macroscopic--as in clinical myocardial infarction, microscopic--as
      in severe, prolonged ischaemia, or ultramicroscopic--in regard to the collagen
      matrix. Recognition of the vulnerability of these structures to the metabolic and
      mechanical stresses associated with severe ischaemia or infarction allows an
      understanding of the processes of acute dilatation, late adverse remodelling and
      compensatory hypertrophy, which determine both systolic and diastolic dysfunction
      and define the principal clinical complications. Morphology--'Form'--is the
      primary determinant of function, while metabolic and other factors are secondary,
      variably dependent on the integrity of structure.

PMID- 8370365
TI  - Anti-ischaemic actions of potassium channel openers in experimental myocardial
      ischaemia/reperfusion injury in dogs.
AB  - The effect of three potassium channel openers, nicorandil, aprikalim, and
      bimakalim, on experimental myocardial ischaemia/reperfusion injury was examined
      in barbital-anaesthetized dogs. In a model of reversible injury, administration
      of nicorandil at a hypotensive dose and aprikalim at a non-hypotensive dose
      resulted in a reduction in contractile dysfunction during reperfusion
      ('stunning') following brief coronary artery occlusion (15 min) when the drugs
      were administered before occlusion. Administration of aprikalim only during
      reperfusion had no beneficial effect. Pre-treatment with the adenosine
      triphosphate (ATP)-dependent potassium (KATP) channel antagonist, glibenclamide,
      blocked completely the beneficial effects of nicorandil and aprikalim, although
      glibenclamide did not block the haemodynamic effects of nicorandil. In a model of
      irreversible ischaemia/reperfusion injury (120 min of ischaemia and 30 min of
      reperfusion) pre-treatment with equihypotensive doses of nicorandil and bimakalim
      produced marked reductions in myocardial infarct size. Similarly, aprikalim at a
      non-hypotensive dose reduced myocardial infarct size in dogs subjected to 90 min
      of ischaemia and 5 h of reperfusion, and the protective effects of aprikalim were
      antagonized completely by glibenclamide. These results indicate that nicorandil,
      aprikalim, and bimakalim are protective in two experimental models of
      ischaemia/reperfusion injury. The mechanism of action of these agents is not
      completely understood, but it appears to be a result of myocardial KATP channel
      activation.

PMID- 8370366
TI  - Coronary haemodynamics and vasodilatory profile of a potassium channel opener in
      patients with coronary artery disease.
AB  - Previous studies have indicated that nicorandil reduces both preload and
      afterload, clearly distinguishing nicorandil from conventional nitrates, whose
      predominant action is that of preload reduction. In association with the decrease
      in afterload following nicorandil, the contractile responses during isovolumic
      contraction and relaxation improved significantly, indicating that nicorandil
      does not demonstrate negative inotropic actions. Furthermore, despite a marked
      decrease in mean aortic pressure after nicorandil, coronary sinus blood flow
      remains unchanged. Therefore, coronary vasodilatation must have taken place,
      while myocardial oxygen consumption decreased significantly. The vasodilatory
      action of nicorandil on the epicardial coronary artery has also been demonstrated
      in our previous study. Nicorandil, at a dose of either 20 or 40 mg, induces a
      significant increase in coronary artery diameter favourably by acting not only on
      the non-stenotic but also on the stenotic coronary segments. In our recent study,
      the effects of intracoronary nicorandil (6 mu.kg-1) and isosorbide dinitrate (2
      mg) on the epicardial coronary arteries were investigated in patients undergoing
      coronary angioplasty. In non-stenotic coronary artery segments, the mean coronary
      diameter increased significantly after either nicorandil (+12%) or isosorbide
      dinitrate (+17%). In stenotic segments, however, increase in the diameter of the
      obstructed segment by 20% after intracoronary nicorandil was much more pronounced
      when compared to that of 8% after isosorbide dinitrate. There was a significant
      additional increase of 13% in the diameter of the obstructed segment when
      nicorandil was administered following isosorbide dinitrate, while no such
      additional effect was observed when isosorbide dinitrate was given after
      nicorandil.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370367
TI  - Potassium channels as pharmacological targets in cardiovascular medicine.
AB  - Potassium channels are membrane receptor sites for various drugs in the field of
      cardiovascular diseases. These channel proteins are extremely diverse, not only
      as regards their molecular structure but also as regards their function.
      Heterogeneous expression of various K+ channel subtypes is an integral part of
      cell specialization in different tissues. K+ channels interfere with most of the
      physiological processes of the cardiac muscle, of the vascular smooth muscle and
      of the endothelial cells. K+ channel blockers are antidiabetic agents but also
      antiarrhythmic drugs. K+ channel openers are used in the treatment of
      hypertension and most recently in the treatment of coronary heart disease. In the
      experimental setting, K+ channel openers afford cytoprotection during ischaemia.
      This exciting property opens a new field in clinical research.

PMID- 8370368
TI  - Potassium channel activators in vasospastic angina.
AB  - Activation of potassium channels induces relaxation of vascular smooth muscle,
      and experimental studies have demonstrated that potassium channel activators have
      potent coronary vasodilator properties. In humans, nicorandil, a potassium
      channel blocker, causes vasodilatation not only in angiographically normal
      segments but also at sites of dynamic coronary stenosis, where coronary spasm has
      been provoked by methylergometrine as well as at sites of spontaneous spasm. The
      efficacy of nicorandil in relieving ergometrine-induced spasm is comparable to
      that of nifedipine. Oral administration of nicorandil significantly reduces the
      frequency of anginal episodes in patients with vasospastic angina, and either as
      monotherapy, or in conjunction with other agents is a novel therapeutic option in
      patients with vasospastic angina.

PMID- 8370369
TI  - A potassium channel opener as monotherapy in chronic stable angina pectoris:
      comparison with placebo.
AB  - The vasodilating agent nicorandil produces marked coronary artery dilatation by a
      number of mechanisms including an increase in cyclic guanosine monophosphate, an
      effect which is common to all organic nitrates, and a novel potassium channel
      opening effect. In four double-blind, placebo-controlled trials, nicorandil has
      been shown to produce beneficial haemodynamic effects in patients with stable
      angina pectoris without significant deleterious effects on pulse rate, the
      cardiac conducting system, myocardial contractility or myocardial oxygen
      consumption. Significant improvements in exercise time to onset of angina,
      exercise time to cardiac ischaemia and total attainable workload have been
      demonstrated. These effects have been shown to persist for 12 h, allowing it to
      be used on a twice daily basis. It appears relatively free of important side
      effects other than a dose-dependent headache, which necessitates discontinuation
      of treatment in a minority of patients.

PMID- 8370370
TI  - A double-blind comparison of the long-term efficacy of a potassium channel opener
      and a calcium antagonist in stable angina pectoris.
AB  - The efficacies and safety of nicorandil, 20 mg b.d., and diltiazem, 60 mg t.d.,
      in the treatment of stable angina pectoris were compared in a double-blind
      randomized parallel group study involving 123 patients. The duration of the study
      was 3 months. Exercise tolerance tests were performed by the patients when on
      placebo (day 0) and at the end of the study period (day 90). Both groups were
      comparable at day 0 in terms of demography and cardiovascular status. Nicorandil
      and diltiazem were both found to decrease the frequency of anginal attacks and
      the consumption of nitroglycerin tablets (P < 0.01). Maximum exercise capacity,
      the amount of work that could be performed before reaching ischaemic threshold,
      and the amount of work required to reach onset of angina were significantly
      increased for both groups of patients on day 90 compared with day 0 (increase in
      maximum exercise capacity: nicorandil--6.9 +/- 18.9 kj, diltiazem--9.6 +/- 16.2
      kj, P = 0.44 ns; increase in work to ischaemic threshold: nicorandil--9.4 +/-
      18.1 kJ, diltiazem--14.7 +/- 15.4 kJ, P = 0.10 ns; increase in work to onset of
      angina: nicorandil--10.0 +/- 20.1 kJ, diltiazem--11.4 +/- 14.9 kJ, P = 0.68 ns).
      Differences between the two groups were not significant. The double product of
      systolic blood pressure x heart rate and peak exercise for both drugs was either
      unchanged or slightly decreased at ischaemic threshold.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 8370371
TI  - A double-blind comparison of a beta-blocker and a potassium channel opener in
      exercise induced angina.
AB  - This randomized, double-blind, parallel study compared the anti-anginal effects
      of nicorandil and atenolol in 37 patients with exercise-induced angina pectoris.
      At the end of a single-blind placebo period, patients were randomized and
      received either atenolol 50 mg o.d. or nicorandil 10 mg b.d. for 3 weeks. On the
      third week, the dosage was increased (nicorandil 20 mg b.d. or atenolol 100 mg
      o.d.) for the final 3-week period. Treadmill exercise tolerance tests were
      performed immediately before and 2 h after dosing at the end of the placebo
      period, and at the end of the third and sixth week of active treatment.
      Demographic characteristics and exercise performance with placebo were comparable
      between both treatment groups, and at the end of the treatment periods a
      significant improvement in exercise time was observed: an increase in the time to
      peak exercise of 1.33 +/- 0.29 min (mean +/- standard error of the mean) in
      atenolol-treated patients (P < 0.001), and of 1.47 +/- 0.40 min (P < 0.005) in
      nicorandil-treated patients. While the anti-anginal activity of the two drugs was
      comparable, their effects on the rate-pressure product heart rate x systolic
      blood pressure were clearly different; atenolol induced a decrease at peak
      exercise, but this parameter was not changed or was slightly increased with
      nicorandil. One patient with severe three-vessel disease died suddenly after 3
      days of treatment with nicorandil 10 mg twice daily. The most frequent adverse
      effect in both groups was headache, which led to discontinuation of one patient
      in the atenolol group and of five patients in the nicorandil group.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8370372
TI  - Haemodynamic and clinical effects of an intravenous potassium channel opener--a
      review.
AB  - Intravenous nicorandil (4-12 mg) produced a significant decrease in mean arterial
      blood pressure (-5 to -15%), systemic vascular resistance (-8 to -27%), pulmonary
      capillary wedge pressure (-15 to -41%) and left ventricular end-diastolic
      pressure (-8 to -18%) in patients with coronary artery disease, myocardial
      infarction or congestive heart failure. Cardiac output was significantly
      increased (+3 to +19%) in most studies. These haemodynamic effects of intravenous
      nicorandil (4-8 mg) were comparable to those of nitroglycerin (0.3 mg), although
      a greater decrease in preload was produced by nitroglycerin. Moreover, no
      significant haemodynamic tolerance developed over a 12 to 24 h period during
      continuous infusion of nicorandil (2.4 micrograms.kg-.min-1) in patients with
      heart failure, in contrast to nitroglycerin infusion (0.65 microgram.kg-1 x min
      1). Intravenous nicorandil (4-12 mg) was also shown to produce a slightly smaller
      increase (8-27%) in the diameter of the large coronary arteries compared to that
      of sublingual nitroglycerin (0.3 mg) (16-32%) and to cause a significant decrease
      in coronary vascular resistance (-9 to -53%) and a significant increase in
      coronary sinus flow (+6 to +81%) in patients with coronary artery disease. The
      efficacy of intravenous nicorandil (2-6 mg.h-1) in unstable angina pectoris has
      been compared with that of isosorbide dinitrate (2-5 mg.h-1) in a double-blind,
      multicentre trial. Over a 3 to 9 day period, nicorandil therapy tended to be more
      effective in abolishing anginal attacks and decreasing nitroglycerin consumption.

PMID- 8370373
TI  - Safety profile of an anti-anginal agent with potassium channel opening activity:
      an overview.
AB  - Safety has been assessed in a total of 1680 subjects who were treated with
      nicorandil, with 458 patient years of exposure to treatment. Adverse events
      usually occurred early in the course of treatment. After 30 days of treatment,
      fewer than 10% of patients reported adverse events. At the recommended doses, the
      main side effects were limited to headaches. Nearly all episodes of headache were
      experienced during the first days of nicorandil treatment and were responsible
      for most of the study withdrawals because of clinical non-acceptability. The
      incidence can be diminished by a progressive titration. In comparative trials
      with anti-anginal agents, such as propranolol, diltiazem, nifedipine, ISDN and
      isosorbide 5 mononitrate, the overall incidence of adverse events was not
      significantly different between nicorandil and the reference drug. Side-effect
      distribution was comparable between nicorandil (32%) and diltiazem (30%).
      Nicorandil can be safely combined with other anti-anginal drugs. Furthermore, due
      to its favourable pharmacokinetics, nicorandil is less likely to have
      interactions when combined with another therapeutic agent. Nearly one-third of
      the patients enrolled in the nicorandil clinical programme were 65 years old or
      older. Age-specific side-effects were not identified, and overall, the incidence
      of the most frequent adverse events in the elderly was similar. There is no
      evidence that nicorandil induces proarrhythmia, exacerbation of myocardial
      ischaemia or abrupt withdrawal syndrome. With the progressive titration scheme,
      no symptomatic decrease in blood pressure was recorded when nicorandil was
      administered in the range of 10-80 mg.day-1. Heart rate was not significantly
      affected in the same dose range.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370374
TI  - Left ventricular hypertrophy: epidemiological prognosis and associated critical
      factors.
AB  - Left ventricular hypertrophy (LVH), defined as an abnormal increase in left
      ventricular mass (LVM), is detected by echocardiography in 16-19% of a general
      population. Its prevalence is strongly associated with age, systolic blood
      pressure and obesity. In addition to the assessment of LVM, echocardiography
      allows different forms of left ventricular remodelling in hypertension to be
      described: eccentric or concentric, and symmetric or asymmetric LVH. The
      significance of the different forms, however, is not yet well defined. Increased
      LVM is now recognized as a powerful, independent risk factor for all
      cardiovascular diseases. This observation is at variance with the general concept
      that LVH is a useful adaptation of the left ventricle to chronic overload. To
      explain this paradox, three hypotheses are proposed: LVH serves as a marker, a
      limited adaptative process, or a pathological process. Each hypothesis implies
      different therapeutic approaches; thus it is necessary to clarify the reasons why
      LVH is such an important risk factor.

PMID- 8370375
TI  - Therapeutic advances in the treatment of left ventricular hypertrophy.
AB  - As a consequence of persistently raised blood pressure, left ventricular
      hypertrophy (LVH) develops as a compensatory mechanism for wall stress induced by
      the increase in afterload. Recent advances in the fields of molecular biology and
      genetics are now clarifying the mechanisms involved in the development of LVH. It
      has been reported that messenger RNA of oncogenes, such as c-fos and c-myc,
      increases by stretching; these oncogenes contribute to the progression of LVH,
      the messenger RNA expression of myosin and contractile protein synthesis in the
      cardiomyocytes. Vasoactive hormones and vascular contracting factors are also
      reported to have a progressive effect on LVH. In contrast, some antihypertensive
      agents have been shown to have pharmacological effects on regression of LVH in
      animals and man. The mechanisms responsible for LVH progression have been
      extensively studied. In contrast, the mechanisms of LVH regression have not been
      defined and require elucidation. This paper outlines the basic recognition of the
      mechanisms of LVH progression and discusses the varied pharmacological actions of
      calcium antagonists and angiotensin converting enzyme inhibitors on the
      regression of LVH in man and rats. Although the role of antihypertensive therapy
      in regression of LVH remains controversial, the calcium antagonist nicardipine
      appears to have an important role to play in the treatment of LVH in hypertension
      and in congestive heart failure.

PMID- 8370376
TI  - Methods for detection of left ventricular hypertrophy: application to
      hypertensive heart disease.
AB  - Left ventricular hypertrophy (LVH) detected by electrocardiography (ECG) and,
      more recently, by echocardiography has been shown to be an extremely strong
      predictor of morbidity and mortality in patients with essential hypertension and
      in members of the general population. Increased left ventricular mass (LVM) is
      strongly related to both increased blood pressure and overweight. Indexation of
      LVM by body surface or height has advantages for the detection of LVH related to
      hypertension or obesity. Indexation of LVM for height to the power 2.7 revealed
      by analysis of growth (allometric) relations may accomplish both these goals. In
      validation studies, the sensitivity of echocardiography to detect LVH has been
      reasonably high (85-100%), whereas that of ECG has ranged from as high as 50% in
      severely diseased necropsy populations to as low as 6-17% in recent studies in
      Cornell and Framingham. ECG sensitivity can be improved by using Cornell
      multivariate regression equations or by consideration of the Cornell voltage-QRS
      duration product. Obesity dramatically decreases the sensitivity of the ECG for
      detection of LVH, and recent research suggests a lower specificity and a higher
      rate of false-positive ECG diagnoses of LVH in black than in white subjects.
      Standard criteria for ECG LVH are less useful than echocardiographic findings for
      stratifying populations into high- and low-risk subgroups because of lower
      sensitivity, but improved ECG criteria need further evaluation in this respect.

PMID- 8370377
TI  - Peroperative nuclear medicine.

PMID- 8370378
TI  - Dosimetry of iodine-123 iomazenil in humans.
AB  - The distribution of the central benzodiazepine receptor specific ligand iodine
      123 iomazenil was investigated in seven human adults from whole-body scans, blood
      samples and urine collected up to 24 h after injection. Using 12 source organs,
      the MIRD method was applied to calculate the absorbed radiation dose of the
      radioligand in various organs. The urinary bladder wall (0.15 mGy/MBq), lower
      large intestinal wall (0.071 mGy/MBq) testes (0.044 mGy/MBq) and upper large
      intestined wall (0.038 mGy/MBq) received the highest absorbed doses. The average
      effective dose equivalent of 123I-IBZM for adults was estimated to be 0.033
      mSv/MBq.

PMID- 8370379
TI  - Quantitative single-photon emission tomography for tumour blood flow measurement
      in bronchial carcinoma.
AB  - A single-photon emission tomography (SPET) technique for the absolute measurement
      of tumour perfusion is described. Phantom studies have shown that source
      background ratios are dependent upon source size and radial position within the
      phantom. A means of correcting source-background count ratios for these variables
      has been developed and used to correct tumour-lung ratios obtained in 28 patients
      with bronchial carcinomas who underwent technetium-99m hexamethylpropyleneamine
      oxime (99mTc-HMPAO) SPET. On SPET images, the normal lung appears as a relatively
      homogeneous background. The relationship between 99mTc background concentration
      (kBq/ml) and counts/pixel was determined from phantom studies and the tumour
      99mTc concentration from the background 99mTc concentration and corrected tumour
      lung ratio. The total activity of the lipophilic 99mTc-HMPAO species injected was
      measured. The activity reaching the systemic circulation (Asys) was obtained by
      subtracting the activity trapped in the pulmonary circulation (obtained from
      background 99mTc concentration and lung volume). Tumour blood flow may then be
      calculated from fraction of Asys contained in the tumour provided cardiac output
      and extraction fraction are known. Blood flow through the central region of
      tumours ranged from zero to 59.0 (mean 14.1) ml min-1 100 g-1 and through the
      whole tumour from 0.6 to 68.0 (mean 20.6) ml min-1 100 g-1.

PMID- 8370380
TI  - Influence of the menstrual cycle and of menopause on the gastric emptying rate of
      solids in female volunteers.
AB  - The aim of this study was to assess the influence of the normal menstrual cycle
      and of menopause on the gastric emptying rate of solids. Gastric emptying was
      studied in 15 premenopausal and ten postmenopausal women with an isotopic
      technique after the ingestion of a radiolabelled test meal. Premenopausal women
      were studied twice: within 1 week prior to menses and again 1 week after onset of
      menses. Postmenopausal women were studied only once. The emptying curves of the
      solid component of the meal fitted a linear model. The half-emptying time was 78
      +/- 5 min during the follicular phase, 75 +/- 7 min during the luteal phase and
      76 +/- 6 min in postmenopausal women (differences not statistically significant).
      The mean percentages of the meal retained in the stomach at different time
      intervals were also similar in the three groups. These results suggest that the
      menstrual cycle does not influence the gastric emptying rate of solids, which
      remains unchanged in relation to the follicular phase or after menopause.

PMID- 8370381
TI  - Radioisotope assessment of heart damage in hypertransfused thalassaemic patients.
AB  - Twenty-five thalassaemic patients treated with repeated blood transfusion (BT)
      and intensive iron removal therapy were studied by echocardiography and
      rest/stress equilibrium gated radionuclide angiocardiography (EGNA). Stress left
      ventricular ejection fraction (LVEF) showed an important negative correlation
      with number of BTs (r = -0.75). Abnormal values of stress LVEF were measured
      after 200 BTs: these data demonstrate the effectiveness of stress LVEF in the
      follow-up of patients who have undergone repeated BTs and the clinical importance
      of intensive chelation therapy. Peak filling rate did not show diagnostic value
      in the early detection of iron cardiotoxicity. However, its inverse correlation
      with BT (r = -60) indicates that iron overload depresses the diastolic
      parameters.

PMID- 8370382
TI  - Intraoperative, probe-guided curettage of osteoid osteoma.
AB  - The only curative approach for osteoid osteoma is operative removal of the nidus,
      but intraoperative detection of the nidus is difficult even when an X-ray
      amplifier is used. A simple probe-guided operative procedure using technetium-99m
      methylene diphosphonate is described, and the results and follow-up in 12
      patients are reported. In addition physical properties of the probe have been
      evaluated by phantom measurements.

PMID- 8370383
TI  - Radiochemical purity of iodine-131 labelled metaiodobenzylguanidine infusion
      fluids: a report from clinical practice.
AB  - Iodine-131 labelled metaiodobenzylguanidine ([131I]MIBG) has a diagnostic and
      therapeutic role in the management of neural crest tumours, particularly
      neuroblastoma, malignant phaeochromocytoma and paraganglioma. With therapeutic
      amounts of [131I]MIBG it is essential that the amount of free [131I]iodide, the
      most important impurity, is known. In clinical practice the percentage of free
      [131I]iodide seen in a [131I]MIBG infusion concentrate increased from 2.2% +/-
      0.67% to 3.6% +/- 0.39% (mean +/- SD; n = 23) 1 day after production. At the time
      of use the percentage of free [131I]iodide was always below our upper limit of
      acceptance of 5%. Since 5% of free [131I]iodide is within practical reach in our
      environment, a higher percentage at the time of preadministration quality control
      is not accepted in the Netherlands Cancer Institute.

PMID- 8370384
TI  - Captopril radionuclide test in renovascular hypertension: a European multicentre
      study. European Multicentre Study Group.
AB  - The diagnostic work-up of renovascular hypertension is still controversial. The
      efficacy of renal scintigraphy with technetium-99m diethylene triamine
      pentaacetate (DTPA) before and after captopril (scintigraphic captopril test) was
      evaluated in a multicentre study. All 380 hypertensive patients in the study
      underwent renal arteriography; 125 had renal arterial stenosis > or = 70%, and 54
      had a technically successful intervention to correct the stenosis. The post
      captopril study had a sensitivity of 93% and a specificity of 100% for predicting
      blood pressure response to intervention, if renal function was normal and a
      combination of quantitative parameters was applied (individual kidney uptake
      index < 40%, time to peak activity < 2 min or > 10 min). In the entire population
      renal artery stenosis > or = 70% was detected with a sensitivity of 83% and a
      specificity of 93% if renal function was normal. In patients with abnormal renal
      function the performance of the test was worse, owing to a lower specificity
      which could be increased by using only time parameters. The performance of the
      test was optimal when the post-captopril findings were examined; no improvement
      was achieved by evaluation of the changes induced by captopril from the baseline.
      The test can thus be simplified by performing only a post-captopril study for
      routine use: a negative test would exclude a curable form of renovascular
      hypertension in > 80% and a positive test would predict it in > 90% of the
      patients selected for suspicion of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370386
TI  - Regional cerebral blood flow in Angelman syndrome.
AB  - A patient with typical features of Angelman syndrome--a genetically inherited
      disorder involving developmental delay, ataxia, episodes of paroxysmal laughter
      and brachiocephaly--was studied with single-photon emission tomography.
      Hypoperfusion found in the left frontal and left temporoparietal regions can
      provide insights into the functional cerebral pathology, which may be due to a
      disturbance of the developmental process related to a chromosomal abnormality.

PMID- 8370385
TI  - The diagnosis of renovascular hypertension: the role of captopril renal
      scintigraphy and related issues.
AB  - This article reviews the screening and diagnostic tests used in the detection of
      significant renal artery stenosis and renovascular hypertension. After addressing
      the pathophysiological considerations necessary for correct diagnostic test
      interpretation, this review critically surveys the recent advances in, and the
      limitations of, relevant investigational procedures and in particular focuses on
      the efficacy and issues of angiotensin-converting enzyme inhibitor renal
      scintigraphy.

PMID- 8370387
TI  - A possible role of two hydrophobic amino acids in antigen recognition by synovial
      T cells in rheumatoid arthritis.
AB  - Synovial T cells play a crucial role in the pathogenesis of rheumatoid arthritis
      (RA) synovitis. We have quantitatively analyzed the T cell receptor (TcR)
      variable (V) region gene repertoire of freshly isolated synovial fluid (SF) T
      cells, comparing it with that of peripheral blood (PB) T cells in RA. The TcR V
      gene repertoire of PB and SF T cells in RA and osteoarthritis was heterogeneous.
      In contrast, V alpha 11 in SF was expressed to a greater degree in three of five
      RA patients, and increased levels of V beta 6, 1-3 were found in the SF of four
      of six RA, compared with paired PB. Of note, V beta 6, 1-3 was universally used
      in four RA patients with a disease duration of less than 10 years, irrespective
      of their HLA-DR types. This was in contrast to two other RA patients, suffering
      for more than 20 years, who showed different V alpha and V beta usages. beta
      chain sequence analysis in RA patients with a preference for V beta 6, 1-3 has
      shown that a few clones dominated in SF, whereas polyclonality was observed in
      PB. These findings suggest oligoclonal expansion of T cells in response to
      specific antigen(s) in the SF of these patients with RA of relatively short
      duration. Concomitant use of two hydrophobic amino acids, leucine and valine in
      the D beta region was noticeable among the predominant SF clones. These two amino
      acids might directly contact a peptide specific for the induction of synovitis in
      RA patients. TcR-directed therapy may, therefore, be useful for the treatment of
      early RA synovitis.

PMID- 8370388
TI  - CD23-mediated homotypic cell adhesion: the role of proteolysis.
AB  - CD23 is a multifunctional molecule expressed by cells of lymphoid, myeloid and
      hematopoietic lineages. As a cell surface molecule CD23 acts both as a low
      affinity receptor for IgE (Fc epsilon RII) and as a cell adhesion molecule. CD23
      can undergo autoproteolysis to release soluble 37-25-kDa CD23 (s-CD23) molecules
      with a range of cytokine activities. Here we show a causal link between the two
      apparently disparate functions of autoproteolysis and cell adhesion. The Epstein
      Barr virus-transformed B cell line RPMI-8866 formed macroscopic cell clusters
      solely via CD23. Cell adhesion was inhibited by mAb to CD23 and by IgE. Cell
      adhesion was also dependent on serum as cells grown in serum-free media failed to
      form clusters. In serum-free conditions cell adhesion could be induced by the
      addition of not only 10% FCS but also s-CD23. As s-CD23 is reported to possess
      proteolytic activity we screened a range of proteases to determine whether they
      also could induce cell adhesion in serum-free medium. It was found that
      chymotrypsin and elastase induced cell:cell adhesion in RPMI-8866 cells. The same
      panel of proteases were screened against a range of CD23-positive (Jijoye, AF-10,
      T2, U937, ICH-1) and CD23-negative (RPMI-8226, U266, MOLT-4, Ramos) cell lines.
      It was found that chymotrypsin and elastase induce cell adhesion only in cells
      expressing CD23. Peptide mapping studies showed that chymotrypsin and elastase
      cleaved immunoprecipitated CD23 near the same site by which 37-kDa s-CD23 is
      released (Ala 80). Serum demonstrated no proteolytic activity towards CD23.
      However, it was found that cells grown in serum-free medium released 25-kDa s
      CD23 without the need for prior cleavage at the 37-kDa cleavage site. To confirm
      the role of proteolysis in CD23-mediated cell adhesion we screened a range of
      protease inhibitors for their ability to antagonize this process. It was found
      that tosyl-lysine chloromethyl ketone inhibited CD23-mediated cell adhesion.
      Lactoperoxidase treatment, which inhibits CD23 cleavage, also inhibited cell
      adhesion. Addition of chymotrypsin and elastase to lactoperoxidase-treated cells
      induced cell adhesion. From these data we propose that intact CD23 has no
      demonstrable role in cell adhesion; instead, the portion of CD23 remaining on the
      cell surface following cleavage appears to mediate cell adhesion.

PMID- 8370389
TI  - In vitro induction of human cytotoxic T lymphocyte responses against peptides of
      mutant and wild-type p53.
AB  - The central role of the p53 tumor suppressor gene product in oncogenesis is
      gradually being clarified. Point mutations in the p53 tumor suppressor gene are
      common in most human cancers and are often associated with p53 protein
      overexpression. Overexpressed wild-type or mutant determinants of the p53 protein
      thus represent an attractive target for immunotherapy of cancer directed against
      a structure involved in malignant transformation. An important step towards this
      goal is identification of epitopes of p53 that can be recognized by human
      cytotoxic T lymphocytes. We identified peptides of (mutant) p53 capable of
      binding to HLA-A2.1 in an in vitro assay. These HLA-A2.1-binding peptides were
      utilized for in vitro induction of primary cytotoxic T lymphocyte responses using
      a human processing-defective cell line (174CEM.T2) as antigen-presenting cell.
      These cells display "empty" HLA class I surface molecules, that can efficiently
      be loaded with a single peptide. We obtained CD8+ cytotoxic T lymphocyte clones
      capable of specifically lysing target cells loaded with wild-type or tumor
      specific mutant p53 peptides. This strategy allows the in vitro initiation of
      human cytotoxic T lymphocyte responses against target molecules of choice.

PMID- 8370390
TI  - Distribution of perforin-containing cells in normal and pregnant mice.
AB  - Cytotoxic T lymphocytes (CTL) and natural killer (NK) cells elaborate a cytolytic
      protein named perforin or cytolysin. It was widely held that, in vivo, high
      quantities of perforin are not present in resting lymphocytes and are usually
      produced only by activated lymphocytes found under pathological conditions. Until
      now, only one tissue was known to synthesize abundant quantities of perforin
      under nonpathological conditions, the uterus during pregnancy. To investigate the
      possibility that perforin might also be synthesized by other tissues, several
      tissues besides the uterus from pregnant and normal mice were tested by
      immunofluorescence and immunoperoxidase for the presence of perforin. The tissues
      studied were the ears, brain, nasal epithelium, tongue, salivary gland, larynx,
      thymus, stomach, liver, spleen, small intestine, and lymph nodes; two cell
      populations with different sizes and levels of perforin expression were found.
      Large cells, displaying the NK cell phenotype and expressing high levels of
      perforin, were detected not only in the uterus but also in the salivary gland and
      lungs of pregnant mice. Small cells, expressing low levels of perforin, were
      detected mainly in the stomach and small intestine, and they were expressed in
      both pregnant and normal mice. Taken together, these results imply that perforin
      containing cells exist in vivo under nonpathological conditions, and that the
      immune system is endowed with heretofore unknown mechanisms for stimulating the
      activation of NK cells in a limited number of tissues during pregnancy.

PMID- 8370391
TI  - Selective activation of resting human gamma delta T lymphocytes by interleukin-2.
AB  - In rheumatoid arthritis and other inflammatory diseases we and others have found
      that gamma delta T cells express activation antigens, suggesting that they are
      involved in the pathogenesis of these disorders. In this study we have stimulated
      peripheral blood mononuclear cells from normal donors with recombinant
      interleukin-2 (rIL-2) to see whether such a stimulus alone could activate gamma
      delta T cells. Short-term exposure (24-96 h) to rIL-2 selectively stimulated the
      gamma delta but not the alpha beta T cells to express activation antigens (CD69,
      CD25 and HLA-DR). Long-term culture (2 weeks) in rIL-2-containing medium caused a
      selective increase in the proportion of the gamma delta T cells and a
      corresponding reduction of the fraction of alpha beta T cells. Limiting dilution
      analysis revealed that approximately 1/60 of the gamma delta T cells responded to
      IL-2 in contrast to only 1/250 of the alpha beta T cells. Comparison of the
      expression of the IL-2 receptor (IL-2R) alpha and beta chains showed that there
      was a similar expression of the alpha chain on gamma delta and alpha beta T cells
      whereas the relative density of the beta chain was more than twice as high on
      gamma delta T cells. Both the IL-2-induced proliferation of gamma delta T cells
      and the expression of activation antigens on these cells could be inhibited by an
      anti-IL-2R beta monoclonal antibody (mAb) but not by an anti-IL-2R alpha mAb.
      Expression of CD69 on gamma delta T cells was dependent neither on the presence
      of B cells, monocytes, nor alpha beta T cells. Finally, we found that the IL-2
      induced expression of CD69 was inhibited by activation of cAMP-dependent protein
      kinase and by inhibition of the Src-family of the tyrosine protein kinase, but
      not by inhibition of protein kinase C or by activation of the CD45 associated
      tyrosine phosphatase. The ability of gamma delta T cells to be activated by IL-2
      is a feature which they have in common with natural killer cells. Moreover, it
      may be possible that the expression of activation antigens on gamma delta T cells
      in inflammatory diseases is an epiphenomenon secondary to IL-2 produced by
      activated alpha beta T cells.

PMID- 8370392
TI  - DR alpha beta dimers released from complexes with invariant chain fail to
      stimulate alloreactive T cell clones.
AB  - To demonstrate that DR alpha beta dimers still complexed to invariant chain (Ii)
      have not yet acquired peptides recognized by alloreactive T cells, complexes
      between DR molecules and Ii isolated from Epstein-Barr-virus (EBV)-transformed B
      cells were analyzed by affinity chromatography and gel filtration. First, it was
      shown that DR/Ii complexes inserted into artificial planar membranes (PM) failed
      to stimulate proliferative response of five alloreactive T cell clones and a
      polyclonal alloreactive T cell line, while PM bearing mature DR alpha beta dimers
      from the same EBV-B cells were stimulatory for the T cell clones and the T cell
      line. These findings indicate that either Ii inhibits binding of peptides to DR
      molecules or Ii hinders T cells recognition of peptide/DR complexes. Second, to
      discriminate between these two possibilities, DR alpha beta dimers, which were
      artificially released from complexes between DR molecules and Ii, were inserted
      into PM. These DR alpha beta dimers were devoid of alloreactive stimulatory
      capacity while fully capable of binding and presenting a tetanus toxin synthetic
      peptide to a specific T cell clone, indicating that DR molecules released from
      complexes with Ii are empty. This study, by showing that DR molecules bound to Ii
      do not bear peptides recognized by alloreactive T cells, supports the notion that
      association of Ii with class II major histocompatibility complex (MHC) molecules
      prevents premature peptide loading and hence favors encounter with peptides
      derived from proteins of the extracellular compartment. Since allogeneic class II
      MHC molecules released from complexes with Ii were not stimulatory for five out
      of five alloreactive T cell clones and a polyclonal alloreactive T cell line,
      these data also indicate that, in most cases, alloreactive T cells recognize
      ligands constituted by complexes between allogeneic class II MHC molecules and
      specific peptides which derive from the antigen-presenting cells themselves or
      serum proteins.

PMID- 8370393
TI  - Ontogeny of fetal CD8lo4lo thymocytes: expression of CD44, CD25 and early
      expression of TcR alpha mRNA.
AB  - CD8lo4lo cells are the immediate precursors of immature CD8hi4loTcRlo,
      CD8lo4hiTcRlo and CD8hi4hiTcRlo double-positive (DP) thymocytes in the adult
      murine thymus. These cells are the first subset in the adult thymus to express
      accessory CD8 and CD4 molecules, to rearrange the T cell receptor (TcR) alpha
      chain genes and to express the TcR alpha beta heterodimer at low levels at the
      surface. Here, we investigate the fetal ontogeny of CD8lo4lo cells. We detect
      these cells on day 15 of fetal development. They dominate the thymus on day 15.5,
      to become progressively less prominent thereafter. An important characteristic of
      fetal CD8lo4lo cells is the early expression of TcR alpha mRNA (on fetal day 15,
      36-48 h earlier than reported previously). Our results also suggest, but do not
      prove, that the receptor may be expressed on the surface as early as day 15.5.
      Fetal CD8lo4lo cells, like their adult counterparts, become DP in vitro. However,
      early fetal CD8lo4lo thymocytes express both CD44 and CD25--unlike the adult
      subset--and that links them to their putative precursors, fetal CD44+CD25+ double
      negative cells. This finding underscores the difference between adult and fetal
      thymocytes in turnover of membrane molecules and/or the kinetics of progression
      through phenotypic stages.

PMID- 8370394
TI  - Leukemia inhibitory factor production by rat mast cells.
AB  - Leukemia inhibitory factor (LIF) is a pluripotent cytokine of importance in the
      regulation of immune and inflammatory responses. This cytokine may play an
      important role in neuronal development and bone metabolism. We have examined the
      ability of freshly isolated rat mast cells and mast cell lines to produce LIF at
      both the mRNA and bioactivity levels. Initial experiments demonstrated that two
      mucosal mast cell-like cell lines RBL.2H3 and RCMC9 endogenously produced low
      levels of LIF bioactivity. The production of this cytokine was examined using a
      hepatocyte-stimulating factor activity assay and confirmed by the use of
      neutralizing antibodies specific for LIF. This production was enhanced by
      treatment with the calcium ionophore A23187. No interleukin-6 production was
      observed by these cells either endogenously or following ionophore activation.
      Freshly isolated highly purified rat peritoneal mast cells also expressed mRNA
      for LIF. These results could have important implications for the role of mast
      cells in neuronal development, hematopoiesis bone metabolism and the acute-phase
      response.

PMID- 8370395
TI  - A novel immunosuppressant, IR-1116, which has a different biological mechanism
      from that of cyclosporine A.
AB  - The effects of an epifumagillol derivative, IR-1116, on human lymphocytes in
      vitro, mouse antibody production in vivo and rat renal and cardiac
      transplantation were investigated. IR-1116 suppressed the human primary mixed
      lymphocyte reaction (MLR) in a dose-dependent manner with a value of the dose
      required for 50% suppression of 0.32 microM. IR-1116 suppressed the antibody
      production by human B lymphocytes activated with pokeweed mitogen or Epstein-Barr
      virus, but did not affect the interleukin-2 production by human lymphocytes
      stimulated with phytohemagglutinin. Furthermore, IR-1116 did not have any effect
      on the proliferation of B or T lymphocytes. IR-1116 is thought to have a
      different mechanism from cyclosporine A (CsA). BALB/c mice were immunized by s.c.
      injection of bovine gamma-globulin (BGG) and then received IR-1116 or CsA by i.p.
      injection at a dose of 20 mg/kg every other day for 2 weeks. IR-1116 suppressed
      the production of serum antibodies against BGG as strongly as CsA. In this
      experiment, IR-1116 apparently showed no adverse effects, while CsA-treated mice
      suffered from diarrhea and appeared to be irritated. Histological studies showed
      that IR-1116 suppressed the formation of germinal centers in the spleen of
      immunized mice. Flow cytometric analysis showed that IR-1116 caused a reduction
      of B lymphocyte population in splenocytes. On the other hand, CsA caused a marked
      reduction of helper T lymphocyte population in splenocytes and thymocytes.
      Furthermore, the i.p. administration of IR-1116 prolonged the survival time in a
      rat renal allograft model and the vital period of grafted hearts in rats. Based
      on the above, IR-1116 seems to be a new type of immunosuppressant acting via
      novel mechanisms different from those of immunosuppressants such as CsA, a potent
      T lymphocyte suppressant.

PMID- 8370397
TI  - Cholera toxin adjuvant greatly promotes antigen priming of T cells.
AB  - Cholera toxin (CT) given perorally is a powerful mucosal immunogen and adjuvant.
      Information that explains the adjuvant effect of CT may be used for the
      development of more effective oral vaccines and might also contribute to our
      understanding of the mechanisms involved in regulating mucosal immunity. The
      present study was undertaken to investigate if CT administered together with
      keyhole limpet hemocyanin (KLH) would act to promote or inhibit priming of KLH
      specific T cells and whether the adjuvant effect of CT is restricted to mucosal
      immune responses or is a generalized phenomenon due to direct immunomodulating
      effects of CT. We found that CT adjuvant greatly augmented the effectiveness of a
      single oral priming immunization with KLH: re-challenge with KLH in vitro 1 week
      following immunization gave several-fold stronger proliferation in KLH-specific
      spleen, mesenteric lymph node, Peyer's patch and gut lamina propria T cells from
      KLH + CT adjuvant as opposed to KLH only-treated mice. Moreover, several-fold
      stronger cytokine production, i.e. interleukin (IL)-2, IL-4, IL-5, IL-6, IL-10
      and interferon-gamma accompanied the enhanced proliferative response of T cells
      from CT adjuvant-treated mice. The adjuvant effect of CT was not restricted to
      mucosal immune responses but was evident also following a single parenteral
      immunization with KLH + CT. Limiting dilution analysis revealed that CT adjuvant
      promoted a 20- to 40-fold increase in the frequency of primed KLH-specific T
      cells. Phenotypic and functional analyses clearly demonstrated that CT adjuvant
      primarily enhanced priming of CD4+ rather than CD8+ T cells and the pattern of
      lymphokine secretion disclosed that CT most probably promoted antigen priming of
      both Th1 and Th2 type of CD4+ T precursor cells.

PMID- 8370396
TI  - Activator protein-1 (AP-1) is stimulated by microbial superantigens in human
      monocytic cells.
AB  - Microbial superantigens bind to major histocompatibility complex (MHC) class II
      molecules and activate gene transcription in monocytes. In search of
      transcription factors that potentially mediate the effects of superantigens at
      the nuclear level, we examined the capacity of staphylococcal superantigens to
      stimulate the activity of the transcriptional promoter factor activator protein-1
      (AP-1). Electrophoretic mobility shift assays showed an increase in nuclear
      proteins that bound to the consensus AP-1 motif within 5 min following the
      stimulation of the monocytic cell line THP-1 with toxic shock syndrome toxin-1
      (TSST-1) or staphylococcal endotoxin A. We show that mRNA levels for the subunits
      that compose AP-1, the protooncogenes c-fos and c-jun, are upregulated by
      stimulation of THP-1 cells with TSST-1. The activated AP-1 complexes were
      functional, as evidenced by the capacity of TSST-1 to stimulate the expression of
      an AP-1-driven reporter gene construct transfected into THP-1 cells. These
      results establish that the engagement of MHC class II molecules by superantigens
      increases the activity of functional AP-1 complexes and that this may proceed in
      part by transcriptional activation of c-fos and c-jun protooncogenes.

PMID- 8370398
TI  - Somatic hypermutation in 5' flanking regions of heavy chain antibody variable
      regions.
AB  - The aim of this study has been to determine the distribution of somatic mutations
      in the 5' flanking regions of rearranged immunoglobulin heavy chain variable
      region genes (VDJ). We sequenced the 5' flanking region in 12 secondary immune
      response antibodies produced in C57BL/6j mice against the hapten (4-hydroxy-3
      nitrophenyl)acetyl (NP) coupled to chicken-gamma-globulin. In these and
      previously published sequences, almost 97% of the mutations occurred in the
      transcribed region of the gene, and only a minority of genes (5/29) contained
      mutations upstream of the transcription start (cap) site. No potential germ-line
      donor was found for a cluster of five base changes previously found in a single
      heavy chain gene, 3B62. However, the uniqueness of this mutational cluster and
      its distance from the normally mutated region suggests that the nucleotide
      changes may not be due to the normal mutator mechanism. Thus, as this was the
      only instance of somatic mutations that far upstream of the promoter/cap site
      region, the reverse transcriptase model for somatic hypermutation is still a
      possibility. The data are consistent with a mutational mechanism that requires
      transcription of the rearranged target V(D)J gene which appears to result in the
      generation of a positively skewed asymmetrical distribution of somatic mutations.
      A single mode is centered near the V(D)J and a long tail extends into the 3' non
      translated region of the J-C intron. Two classes of model could explain this
      mutation distribution pattern: those where transcription products (RNA, cDNA) are
      the direct mutational substrates, or those that postulate local unfolding of the
      chromatin around a V(D)J rearrangement directly exposing the DNA of the
      transcribed region to specific mutational enzymes.

PMID- 8370399
TI  - The evolutionary origin of the major histocompatibility complex: polymorphism of
      class II alpha chain genes in the cartilaginous fish.
AB  - T cells recognize antigen (Ag) in the form of peptides bound to the major
      histocompatibility complex (MHC) molecule. One of the important issues in
      evolutionary immunology is to identify the stage in phylogeny when this mode of
      Ag recognition emerged. At present, there is a considerable controversy as to
      whether the cartilaginous fish have the bona fide MHC. In our previous study, we
      showed that the nurse shark, a member of the cartilaginous fish, has (a) gene(s)
      capable of encoding MHC class II alpha chains. In the present study, we examined
      the polymorphism of nurse shark MHC class II alpha chain genes designated Gici
      DAA and Gici-DBA using the polymerase chain reaction. The Gici-DAA and Gici-DBA
      genes had six and five alleles, respectively, and individual alleles usually
      differed by multiple nucleotides. In addition, most of the nucleotide
      substitutions were located at the putative Ag-binding sites, where non-synonymous
      substitutions occurred more frequently than synonymous substitutions. The fact
      that the Gici-DAA and Gici-DBA genes display a polymorphism pattern essentially
      similar to that of mammalian MHC genes playing a major role in Ag presentation
      suggests that the cartilaginous fish have the bona fide MHC. Thus, the MHC
      peptide-based T cell recognition system appears to have arisen at or before the
      emergence of the cartilaginous fish.

PMID- 8370400
TI  - C1q, the collagen-like subcomponent of the first component of complement C1, is a
      membrane protein of guinea pig macrophages.
AB  - C1q, a subcomponent of C1--the first component of complement, is synthesized by
      macrophages (M phi). Immunofluorescence and immunoperoxidase studies first
      indicated the presence of C1q on the surface of guinea pig (gp) and human
      peritoneal M phi (Loos, M., Storz, R., Muller, W. and Lemmel, E. M.,
      Immunobiology 1981. 158: 213). In our study different methods for labeling of gp
      serum and gp M phi C1q were employed. The presence of C1q protein on the surface
      of gp peritoneal M phi is shown by cell surface labeling with the biotin
      derivative sulfosuccinimdyl-6-(biotinamido)-hexanoate and subsequent
      immunoprecipitation. The mechanism by which C1q is attached to the cell membrane
      was also investigated. Intact cells were treated with acid stripping-buffers or
      phosphatidylinositol-specific phospholipase C and separated membranes were
      extracted with a buffer containing 1 M KCl and 3 M urea. Regardless of which
      method was used, C1q remained attached to the membrane. When surface-labeled
      cells were cultured, they were found to release the C1q from their surface
      membrane into the culture medium. Lysates of biosynthetically labeled cells were
      used to show that, like secreted or serum C1q, cellular M phi C1q binds to
      immobilized homologous IgG. This implies that the globular regions of the
      cellular C1q are functionally active. The results reveal that (i) cellular M phi
      C1q is firmly located in the membrane throughout the biosynthetic pathway, such
      that it is comparable with an integral membrane protein, (ii) cellular M phi C1q
      is not reversibly bound to the cell surface via a receptor. We suggest that C1q,
      as a membrane protein of M phi, serves as an Fc binding factor that also is
      secreted into the environment.

PMID- 8370401
TI  - Modification of the anti-CD3-induced cytokine release syndrome by anti-interferon
      gamma or anti-interleukin-6 antibody treatment: protective effects and biphasic
      changes in blood cytokine levels.
AB  - Anti-interferon-gamma (IFN-gamma) antibodies were found to protect mice against
      pathological changes induced by injection of anti-CD3 antibody: incidence of
      diarrhea, severity of hypothermia and mortality rates were dramatically reduced.
      In anti-IFN-gamma antibody-treated mice, IFN-gamma blood levels were
      significantly reduced at 1.5 h post anti-CD3 challenge, but more elevated levels
      were found from 4 to 24 h. This rebound-like IFN-gamma response coincided with
      more profound hypoglycemia. Tumor necrosis factor and interleukin (IL)-6 levels
      were not affected by anti-IFN-gamma treatment. Exogenous IFN-gamma, administered
      within 3 h (but not later) of the anti-CD3 challenge made the syndrome worse.
      Furthermore, inter-mouse strain differences in sensitivity to the anti-CD3
      syndrome correlated with the ability of the strain to produce IFN-gamma. Anti-IL
      6 antibodies provided only marginal protection against hypothermia and mortality,
      but did markedly reduce hypoglycemia. Levels of biologically active IL-6 in serum
      were not influenced by anti-IL-6 antibody treatment during the first few hours
      after anti-CD3 challenge, but were significantly increased at later times. The
      data provide evidence that endogenous IFN-gamma is a critical element in the
      early phase of the anti-CD3 syndrome; endogenous IL-6, while possibly being
      involved in hypoglycemia, seems of lesser importance for the outcome of the
      syndrome.

PMID- 8370402
TI  - Interleukin-4 and interleukin-10 synergize to inhibit cell-mediated immunity in
      vivo.
AB  - The lack of cell-mediated (TH1-like) immunity that is often associated with
      strong humoral immune responses is thought to be due in part to the inhibition of
      Th1 effector function by the Th2-derived cytokine interleukin-10 (IL-10). This
      hypothesis, however, is based entirely on results from in vitro studies, wherein
      IL-10 has been shown to inhibit Th1 cytokine synthesis. In this study we have
      compared the regulatory effects of both IL-4 and IL-10 on the development of a
      more complex Th1 effector function in vivo, the development of delayed-type
      hypersensitivity (DTH) to Leishmania major in mice immune to Leishmania. The
      results revealed two findings unexpected from in vitro studies with Th1 clones.
      First, optimal inhibition of the DTH response (up to 70%), assessed by footpad
      swelling and leukocytic infiltration, required the combination of IL-4 and IL-10,
      indicating that these two activities synergized to inhibit DTH reactivity.
      Second, IL-4 inhibited interferon-gamma (IFN-gamma) production by lymph node
      cells draining the site of antigen challenge as well as did IL-10. The
      combination of both cytokines was no more effective than either alone. The
      mechanism by which IL-4 and IL-10 acted to inhibit DTH responses did not appear
      to be through inhibition of IFN-gamma or tumor necrosis factor production as
      treatment with antibodies which neutralized these activities failed to inhibit
      DTH responses. Inhibition of the DTH with IL-4 and IL-10 is the most effective
      specific regulator of DTH responses reported and the only one capable of
      modulating tuberculin DTH. These data establish IL-4 and IL-10 as potent
      inhibitors of Th1 effector function in vivo and suggest their utility in
      controlling deleterious Th1-mediated inflammatory responses such as occur in some
      infectious and autoimmune diseases.

PMID- 8370403
TI  - Growth requirements for avian gamma delta T cells include exogenous cytokines,
      receptor ligation and in vivo priming.
AB  - These studies analyze growth requirements for the normal gamma delta T cell
      population in peripheral lymphoid tissues. Avian gamma delta T cells can respond
      well to T cell mitogens in the presence of alpha beta T cells, but our studies
      indicate that they do not grow well alone. Exogenous growth factors were required
      in order for gamma delta T cells to proliferate in response to receptor ligation
      by anti-T cell receptor antibodies or other T cell mitogens. Interleukin-2 was
      implicated as one of the necessary growth factors that the gamma delta cells
      cannot produce adequately on their own. The response to dual stimulation
      (receptor ligation plus exogenous T cell factors) was attributable to a discrete
      subpopulation of gamma delta T cells that could be identified by their cell
      surface CD8, major histocompatibility complex class II expression and relative
      increase in cell size. Conversely, non-responsive gamma delta T cells did not
      exhibit these activation markers. These observations suggest a physiological
      basis for the relatively late appearance of gamma delta T cells in inflammatory
      responses and their failure as a population to match the growth potential of
      alpha beta T cells. More importantly, the results imply that the biological role
      of gamma delta T cells must be understood within the context of their interaction
      with alpha beta T cells.

PMID- 8370404
TI  - Natural killer cells participate in the early defense against Leishmania major
      infection in mice.
AB  - In this study the role of natural killer (NK) cells in the course of experimental
      Leishmania major infection was investigated. NK cells in genetically resistant
      C57BL/6 mice were depleted by in vivo administration of anti-asialo-GM1 or anti
      NK1.1 antibodies. A marked exacerbation of the infection was found in the NK
      depleted mice within the first two weeks of infection. Both the local tissue
      swelling and the number of parasites in the lesions were significantly higher
      than in normal animals. Lymph node cells taken from infected NK-depleted mice
      released less interferon-gamma (IFN-gamma) when cultured in vitro. As an
      alternate approach we have used poly I:C treatment in order to activate NK cell
      activity in vivo in BALB/c mice, which are genetically susceptible to L. major
      infection. Poly I:C treatment led to milder symptoms and to a significantly lower
      parasite burden in the early course of infection. Lymph node cells from infected
      and poly I:C-treated BALB/c mice released higher amount of IFN-gamma in vitro
      than cells from control mice. These data show that NK cells are active
      participants in the non-specific phase of anti-leishmanial activity in the
      control of parasite multiplication early in the course of L. major infection in
      mice.

PMID- 8370405
TI  - Plasmodium berghei-specific T cells respond to non-processed sporozoites
      presented by B cells.
AB  - The mechanism of malaria protective immunity induced by immunization with
      radiation-attenuated Plasmodium sporozoites (SPZ) is only partially understood.
      For example, B and T cell responses specific for the circumsporozoite (CS)
      protein, a 46 kDa SPZ surface protein, have been characterized; however, events
      leading to SPZ-specific T cell activation, i.e., processing and presentation of
      SPZ by antigen-presenting cells have not been investigated. In the present study
      we describe the in vitro analysis of requirements for accessory cell function in
      the presentation of SPZ to SPZ-immune T cells. The results establish that SPZ
      induced proliferative T cells are reactive to non-processed SPZ presented by
      activated B cells and, thus, imply that the non-processed form of the SPZ
      associated CS protein restricts the induction of the potential CS protein T cell
      repertoire.

PMID- 8370406
TI  - Class I-deficient resistant mice intracerebrally inoculated with Theiler's virus
      show an increased T cell response to viral antigens and susceptibility to
      demyelination.
AB  - Intracerebral inoculation of Theiler's murine encephalomyelitis virus (TMEV)
      results in immune-mediated demyelination in susceptible mouse strains. The
      histology of TMEV-induced demyelination is similar to that seen in patients
      suffering from multiple sclerosis. It was previously shown that the
      susceptibility of mice to TMEV-induced demyelination in certain strain
      combinations is closely associated with the major histocompatibility complex
      (MHC) class I locus. Here we examine disease susceptibility of beta 2
      microglobulin (beta 2M)-deficient transgenic mice lacking class I expression and
      functional CD8+ T cells. In contrast to TMEV-infected parental C57BL/6 mice, the
      transgenics develop high levels of virus-specific DTH and T cell proliferation
      accompanied by an increased frequency of central nervous system (CNS)
      demyelinating lesions. However, clinical signs of demyelination were not noted.
      Neither antibody titer nor viral persistence were significantly affected in the
      beta 2M-deficient mice. These results suggest that in the absence of functional
      class I/CD8+ cells, the class II-restricted T cell response to TMEV is enhanced
      and CNS pathogenesis is heightened, although the level is not severe enough to
      result in clinical disease. When the TMEV-infected mice were subcutaneously
      immunized with virus, however, the beta 2M-deficient mice displayed clinical
      symptoms. Therefore, our results strongly suggest that CD8+ T cells do not
      directly contribute to CNS demyelination. In contrast, such T cells appear to be
      primarily involved in down-regulation of a potentially damaging CD4+ T cell
      response in resistant animals, although some of the T cells may play a role in
      clearing viral persistence in the CNS, resulting in the protection of the host
      from viral demyelination.

PMID- 8370407
TI  - Role of transforming growth factor-beta in the preferential induction of T helper
      cells of type 1 by staphylococcal enterotoxin B.
AB  - Stimulation of murine CD4+ T cells with staphylococcal enterotoxin B (SEB)
      results in the preferential development of T helper (Th) 1 cells [i.e. high
      interferon (IFN)-gamma and low interleukin (IL)-4, IL-5 and IL-10]; whereas in
      response to plate-bound anti-CD3 or anti-T cell receptor-alpha beta, Th1 as well
      as Th2 cells develop. In the present study, we examined the mechanism which is
      responsible for the selective Th1 development in the SEB system. The addition of
      IL-4 resulted in a strong development of Th2 cells showing that SEB stimulation
      can result in Th2 differentiation. Co-stimulation with anti-CD28 was insufficient
      in this regard. Lack of Th2 development in the SEB system was in part due to the
      inhibitory effect of endogenously produced transforming growth factor-beta (TGF
      beta), because anti-TGF-beta allowed the development of Th2 cells. Similarly, TGF
      beta inhibited Th2 development and stimulated Th1 development in the anti-CD3
      system. This shift was only partially prevented by also including IL-4 in the
      cultures. The effects of TGF-beta could only partially be explained by
      stimulation of IFN-gamma or inhibition of IL-4 as intermediatory cytokines: (1)
      TGF-beta stimulated Th1 development even in the presence of anti-IL-4 and anti
      IFN-gamma, and (2) a strong inhibitory effect of anti-TGF-beta on Th1 development
      was still observed when anti-IL-4 and IFN-gamma were simultaneously added to the
      cultures. It is concluded that SEB favors Th1 development by stimulation of TGF
      beta production. Inhibition of Th2 development by TGF-beta is due, in part, to
      inhibition of IL-4 and stimulation of IFN-gamma, and, in part, to a direct effect
      of TGF-beta on the responding T cells.

PMID- 8370408
TI  - A new macrophage differentiation antigen which is a member of the scavenger
      receptor superfamily.
AB  - The antibodies Ki-M8, Ber-Mac3, GHI/61 and SM4 define a human macrophage
      associated antigen with a relative molecular mass of 130,000 which we designate
      M130. The protein was purified by immunoaffinity chromatography and an N-terminal
      and three internal amino acid sequences were obtained. A cDNA fragment was
      initially obtained by polymerase chain reaction (PCR) using reverse-translated
      primers. Several variant cDNA clones, derived from alternative spliced messages,
      were obtained from a lipopolysaccharide-stimulated human monocyte library and
      were sequenced. The relative abundance of these variants was evaluated by a
      series of overlapping PCR reactions. The size of the most representative cDNA is
      3.7 kb and closely agrees with the mRNA size of 3.8 kb determined by Northern
      blot analysis. The membrane protein encoded contains a leader peptide of 40
      residues, a putative extracellular domain of 1003 residues, followed by a
      hydrophobic segment of 24 residues and a cytoplasmic domain of 49 residues. The
      extracellular domain was found to contain nine repeating elements, of about 110
      residues, which are similar to those of the scavenger receptor superfamily.

PMID- 8370409
TI  - B cells are anergic in transgenic mice that express IgM anti-DNA antibodies.
AB  - B lymphocytes in individuals with systemic lupus erythematosus (SLE) secrete
      pathogenic autoantibodies to DNA which cause clinical nephritis. (NZB X NZW) F1
      (BW) female mice also secrete pathogenic anti-DNA autoantibodies, and therefore
      are considered to be an animal model of SLE. The rearranged immunoglobulin (Ig)
      genes that encode an anti-DNA antibody from a diseased BW mouse have been cloned,
      and transgenic (Tg) mice have been created by microinjection of these constructs
      into fertilized eggs from normal mice. As we reported previously, when the
      construct contains the C gamma 2a heavy chain constant (CH) region, the mice
      spontaneously secrete anti-DNA IgG and they develop mild nephritis. This
      demonstrated that the Ig encoded by the transgene is pathogenic. In contrast,
      here we report that when the construct contains the same anti-DNA Ig variable (V)
      regions used previously, along with the C mu region, the autoreactive B cells are
      rendered tolerant. Most B cells in the Tg mice express the mu transgene product
      on their surface, and rearrangement of endogenous light chain genes is partially
      suppressed. Furthermore, most hybridomas made from Tg B cells secrete IgM anti
      DNA. Despite this, the Tg mice have reduced levels of total serum Ig and they do
      not secrete anti-DNA IgM either spontaneously or following immunization with DNA.
      We conclude that most B cells in the Tg mice have been rendered anergic. Anergy
      is however reversible in vitro; lipopolysaccharide stimulation of Tg B cells
      leads to the production of a significant amount of IgM anti-DNA antibody. The
      studies demonstrate that in this line of Tg mice on a normal mouse genetic
      background potentially pathogenic B cells that express a high-affinity Ig
      specific for a natural autoantigen are subject to tolerance by induction of
      anergy.

PMID- 8370410
TI  - Identification and expression of two forms of the human transforming growth
      factor-beta-binding protein endoglin with distinct cytoplasmic regions.
AB  - Endoglin is an homodimeric membrane antigen with capacity to bind transforming
      growth factor-beta (TGF-beta) and whose expression is up-regulated on myeloid
      cells upon differentiation to macrophages. We have isolated full-length cDNA
      clones from a lambda gt 10 library, prepared from phorbol 12-myristate 13-acetate
      differentiated HL60 cells by screening with an endoglin-specific cDNA probe from
      endothelial cells. Sequencing of the largest clone (3073 bp), revealed that the
      leader sequence contains 25 residues and that the 586 amino acids of the
      extracellular and transmembrane domains were identical to those described for
      endothelial endoglin. However, the cytoplasmic tail encoded by this cDNA clone
      contains only 14 amino acids as opposed to the 47 residues previously reported,
      suggesting the existence of two alternative endoglin variants. The expression of
      these isoforms was demonstrated by polymerase chain reaction analyses on
      endothelial cells, myelomonocytic cell lines HL-60 and U-937, and placenta.
      Independent cDNA constructs corresponding to both forms were transfected into
      mouse fibroblasts leading to the expression of two distinct endoglin molecules.
      Both forms were shown to bind TGF-beta 1 and, when overexpressed in transfected
      mouse fibroblasts, to form disulfide-linked homodimers, indicating that the
      cysteine residues present in the extracellular domain are responsible for the
      dimerization.

PMID- 8370411
TI  - Construction, expression and functional analysis of a glycolipid-linked form of
      CR1.
AB  - By genetic engineering of human CR1 cDNA and its stable transfection into cells
      we have produced a cell line which expresses CR1 anchored to the cell surface by
      a glycolipid anchor. The glycosyl-phosphatidylinositol (GPI)-CR1 protects cells
      intrinsically from damage mediated by complement activated through the classical
      pathway. Cell surface GPI-CR1 is more efficient on a molar basis than soluble CR1
      in the assay, but extrinsic protection of other cells was not obtained. Soluble
      CR1-protected cells extrinsically in the assay but was required at nearly ten
      fold higher amounts than the intrinsic protection conferred by GPI-anchored CR1.
      Additionally, GPI-CR1 was shown to act as a co-factor to Factor I in the
      generation of C3c from iC3b. Since GPI-anchored proteins can incorporate
      spontaneously into the membranes of living cells by virtue of their lipid tails,
      the isolated GPI-CR1 will be used to introduce CR1 on to the surfaces of many
      different types of cell so that its role in immunity can be further investigated.

PMID- 8370412
TI  - Autoimmune syndrome after induction of neonatal tolerance to I-E antigens.
AB  - Neonatal injection of semiallogeneic spleen cells induces a state of specific
      tolerance to the parental alloantigens, but also the development of an autoimmune
      syndrome known as host-versus-graft disease (HVGD). The autoimmune features are a
      consequence of the allogeneic cooperation between persisting alloreactive host T
      helper type 2 (TH2) cells and donor semiallogeneic B cells. It has been
      established that I-A alloantigens play a central role in the triggering of this
      HVGD. Here it was investigated if I-E antigens, which have shown functional
      differences, regarding autoimmunity and alloreactivity, with respect to I-A
      antigens, are also able to trigger this autoimmune syndrome. The injection of
      spleen cells from [B10.A(4R) x B10.A(2R)]F1 (I-E+) hybrid mice into newborn
      B10.A(4R) (I-E-) mice was accompanied by the establishment of chimerism and also
      by the development of a characteristic, but moderated, HVGD. The weak intensity
      of this HVGD is likely due to the moderation of the alloreactive responses
      induced against I-E molecules. Moreover, the marked increase in the levels of IgE
      and in the titers of anti-DNA IgG1 antibodies strongly suggest that alloreactive
      TH2 cells play also a main role in the autoimmune syndrome following tolerization
      to I-E antigens. Therefore, it is concluded that the I-E and I-A isotypes are
      functionally similar with respect to the allogeneic cellular interactions that
      account for the HVGD.

PMID- 8370413
TI  - Cloning of a human immunoglobulin gene fragment containing both VH-D and D-JH
      rearrangements: implication for VH-D as an intermediate to VH-D-JH formation.
AB  - In an Epstein-Barr virus-transformed human B cell line we found an unusual
      immunoglobulin heavy chain gene rearrangement. Restriction mapping and sequencing
      analysis led us to conclude that VH-D and D-JH recombination took place in a
      single allele. Both VH-D and D-JH complexes still had their recombination signal
      sequences adjacent and the DNA sandwiched by these two complexes retained a germ
      line configuration, suggesting the potential for a secondary rearrangement
      resulting in a VH-D(-D)-JH formation. With this finding, we propose a novel
      pathway, in which the VH-D complex is an intermediate in the formation of a
      functional VH exon.

PMID- 8370414
TI  - Linomide, a novel immunomodulator that prevents death in four models of septic
      shock.
AB  - Intravenous injections of 50 micrograms Staphylococcus aureus enterotoxin B (SEB)
      or bacterial lipopolysaccharide (LPS) are lethal, provided that mice are
      simultaneously sensitized with either N-galactosamine (GalN) or the anti
      glucocorticoid RU-38486. Similar to the synthetic glucocorticoid (GC) receptor
      agonist dexamethasone, pharmacological doses of the immunomodulator linomide
      (quinoline-3-carboxamide) prevent death in all four models of lethal septic shock
      (LPS + GalN, LPS + RU-38486, SEB + GalN, and SEB + RU-38486) and inhibit the
      secretion of tumor necrosis factor, one of the major intermediate effector
      molecules of SEB and LPS toxicity. In this system, cyclosporine A (CsA), although
      effective in suppressing SEB toxicity, fails to counteract the lethal effect of
      LPS. This observation, together with the fact that linomide acts in the presence
      of excess amounts of GC receptor antagonist, indicates that linomide functions in
      a different way to that of known immunosuppressive agents like CsA and GC.

PMID- 8370415
TI  - Increased cytokine production in mononuclear cells of healthy elderly people.
AB  - The production of cytokines during aging, except interleukin (IL)-2, has been
      neglected in humans. We measured the in vitro production of IL-6, tumor necrosis
      factor (TNF)-alpha, interferon (IFN)-gamma and IL-1 beta by peripheral
      mononuclear cells from selected healthy young (mean age 26.8 years) and aged
      (mean age 80.2 years) subjects. Significant increases of IL-6, TNF-alpha and IL-1
      beta levels were found in mitogen-stimulated cultures from aged donors, occurring
      at 24 to 72 h after stimulation. No significant differences were observed for IFN
      gamma production. Proliferative capability of cells stimulated with PHA was not
      impaired in aged subjects. Since the amounts of all cytokines studied were
      similar in unstimulated cultures from young and aged subjects, and also serum
      levels of TNF-alpha did not differ, these data indicate that the cellular
      machinery for the production of these cytokines is well preserved in aging, and
      also that cells from old people are able to up-regulate their production in
      response to appropriate stimuli. The increases in cytokine synthesis were not
      dependent on changes in the number of monocytes, nor were they related to the
      significant rise of CD45RO+, and the concomitant decrease of CD45RA+, occurring
      in both CD4+ and CD8+ lymphocytes from aged subjects. The increased production of
      pro-inflammatory cytokines by stimulated mononuclear cells of healthy aged
      subjects may be relevant to several aspects of age-associated pathological
      events, including atherosclerosis, osteoporosis, fibrosis and dementia.

PMID- 8370416
TI  - Autoimmune gld mutation uncouples suicide and cytokine/proliferation pathways in
      activated, mature T cells.
AB  - Antigen receptor-directed suicide plays an important role in the elimination of
      potentially autoaggressive immature T cells during thymic differentiation. Here
      we demonstrated evidence for a second pathway of receptor-directed suicide in
      mature T cells that is missing in a mutant strain (gld) of mice with an
      "autoimmune" lymphoproliferative syndrome. The defect is evident within the gld
      activated T cell and does not require the presence of an antigen-presenting cell
      for its expression. Receptor-driven suicide is intact in immature T cells of
      animals with this mutation. These results support the significance of receptor
      directed suicide in the mature T cell compartment and suggest that the immune
      system may use three independent pathways for regulating programmed cell death in
      shaping and controlling the immune response.

PMID- 8370417
TI  - Hyper-reactivity of mouse CD45RA- T cells.
AB  - Mouse CD4 T cells have been partitioned into CD45RA and CD45RA- subpopulations by
      means of the monoclonal antibody 14.8. The CD45RA- subpopulation proliferated
      more actively and generated more interleukin-4 (IL-4) in response to stimulation
      with anti-CD3 antibody and phytohemagglutinin, and more IL-2 in response to anti
      CD3. This subpopulation is therefore hyper-reactive to these polyclonal
      stimulators, but does not show the bias towards T helper type 2 activity that has
      been found in studies with other related CD45 isoforms. No evidence of
      suppression was obtained by comparing proliferation of CD45RA- cells in the
      presence and absence of CD45RA cells. Thus mouse CD4 T cells behave in these
      respects similarly to those of man, as is evident in a brief review of the
      quiescence-activation-quiescence cycle in the two species.

PMID- 8370418
TI  - Increased colony growth in peripheral blood cultures from patients with ALL
      depends on immunological subtype.
AB  - The proliferative capacity of precursor cells in bone marrow and peripheral blood
      of 19 patients with acute lymphoblastic leukaemia (ALL) at diagnosis was studied
      and results were compared with the immunophenotype of the leukaemic population.
      Bone marrow proliferative capacity in these patients was strongly diminished, low
      or absent, independent of the immunophenotype, compared with control values (p <
      0.0002). In contrast, the growth pattern in peripheral blood cultures from the
      same patients varied widely according to the subtype of ALL: whereas in patients
      with undifferentiated ALL [TdT+, HLA-DR+, CD19+ or-, CD10-, (n = 4) or CD7+,
      CD5+, CD1-, CD4- and CD8- (n = 1)] PB had strongly reduced proliferative capacity
      compared with control (p < 0.05), there was excess growth of normal neutrophil
      and erythroid colonies in BP cultures from patients with a more mature
      immunophenotype of either B-[CD10+, (n = 11)] or T [CD1+, CD4+ and/or CD8+, (n =
      3)] phenotype. This phenomenon was only seen in patients who had circulating
      lymphoblasts: If their number was low, growth was so prolific that single
      colonies could not be identified. In the presence of a high blast count, colony
      growth was less prolific--probably due to a "dilution" effect--but still higher
      than normal (p < 0.05). We conclude that, in relatively mature ALL of the B- and
      the T-cell line, the presence of circulating lymphoblasts is associated with
      increased PB proliferative capacity.

PMID- 8370419
TI  - Brain perfusion in polycythaemia using 99TcmHMPAO: effect of treatment.

PMID- 8370420
TI  - Complete cytogenetic and molecular remission in a case of lymphoid blast crisis
      in chronic myeloid leukemia with intensive chemotherapy and interferon alpha.

PMID- 8370421
TI  - IFN-gamma and TNF-alpha secretion by CD4+ and CD8+ TCR alpha beta + T-cell clones
      derived early after allogeneic bone marrow transplantation.
AB  - Secretion of the potentially antileukaemic cytokines IFN-gamma and TNF-alpha was
      investigated for CD4+ and CD8+ TCR alpha beta + T-cell clones derived from 4
      leukaemia patients 3-6 weeks after allogeneic BMT. We investigated cytokine
      secretion in response to the activation signal accessory
      cells+phytohaemagglutinin+Interleukin 2. All clones derived after BMT were
      capable of IFN-gamma and TNF-alpha secretion, and both for CD4+ (n = 96) and CD8+
      (n = 8) T cells quantities of IFN-gamma and TNF-alpha were significantly
      correlated with one another. When comparing the overall results for
      posttransplant and normal T-cell clones derived from 2 bone marrow donors (n =
      65), both CD4+ and CD8+ TCR alpha beta + T-cell clones showed increased IFN-gamma
      production, and CD4+ but not CD8+ clones showed a decreased TNF-alpha secretion.
      The results suggest that noncytotoxic T cells derived after allogeneic BMT can
      produce IFN-gamma and TNF-alpha and may thus be capable of mediating
      antileukaemic effects.

PMID- 8370422
TI  - Multiple myeloma treated with mitoxantrone in combination with vincristine and
      prednisolone (NOP regimen) versus melphalan and prednisolone: a phase III study.
      Nordic Myeloma Study Group (NMSG).
AB  - One-hundred-and-fifty-one patients with previously untreated multiple myeloma
      were allocated to treatment with either NOP regimen (mitoxantrone 16 mg/m2 and
      vincristine 2 mg day 1 and prednisolone 250 mg day 1-4 and 17-20) or M+P regimen
      (melphalan 0.25 mg/kg and prednisolone 100-200 mg/day day 1-4). Both regimens
      were repeated every 4 weeks and were scheduled for 1 year. Seventy-seven patients
      were treated with NOP and 74 patients with M+P. No major clinical differences
      were recorded between the groups before treatment. Sixty percent of the patients
      responded (CR+PR) to NOP versus 64% to M+P (NS). The time to progression was 16
      months (95% C.L. 14-51) in the NOP group versus 21 months (95% C.L. 15-27) in the
      M+P group (NS). The median survival was 14 months (7-21) in the NOP group and 31
      months (21-43) in the M+P group (p = 0.02). NOP was significantly more toxic than
      M+P. Seven patients treated with NOP died due to infection and neutropenia and 1
      patient died of cardiac toxicity, in contrast to 1 death due to infection and
      neutropenia in the M+P group. Gastrointestinal toxicity was acceptable in both
      groups. In conclusion, NOP was inferior to M+P as primary treatment of multiple
      myeloma.

PMID- 8370423
TI  - Cadmium-induced changes of antioxidant and metabolic status in red blood cells of
      rats: in vivo effects.
AB  - Chronic exposure of adult rats to dietary intake of cadmium (15 mg CdCl2/day/kg
      for 30 days) leads to development of anemia and thrombocytosis. Anemia is
      characterized by significant reticulocytosis (13.1 +/- 1.0%), anysocytosis,
      poikilocytosis, iron deficiency and marked alterations of antioxidant and
      metabolic status of red blood cells. Activities of SOD, catalase, GPx and GR were
      significantly increased in red blood cells of cadmium-treated rats. In treated
      animals cadmium induced an increase of red cell reduced and oxidized glutathione
      with no changes of GSSG/GSH ratio. However, significant reduction of lipid
      peroxidation was found. Plasma levels of tocopherol and ascorbate, as well as
      activity of glutathione-S-transferase, were all significantly increased in
      cadmium-treated rats. The energy metabolism of red blood cells was deeply altered
      in cadmium-treated rats. The levels of ATP, ADP, AMP and TAN were significantly
      increased while ATP/ADP ratio and adenylate energy charge (AEC) were
      significantly reduced. The level of 2,3-BPG was somewhat lower, but 2,3-BPG/Hb
      ratio was considerably higher, in red blood cells of cadmium-treated rats.

PMID- 8370424
TI  - Fludarabine in patients with advanced and/or resistant B-chronic lymphocytic
      leukemia.
AB  - In this study, we evaluated the efficacy of fludarabine (FLU), an adenine
      nucleoside analogue, in 35 previously treated patients with advanced and
      progressed B-cell chronic lymphocytic leukemia (B-CLL) and in 6 at diagnosis. All
      patients were treated at a dose of 25 mg/m2 per day for 5 consecutive days (mean
      number of courses was 5, with a range from 4 to 6). The majority of patients
      experienced a beneficial effect on hematological parameters. In particular, a
      remarkable reduction of lymphocyte count together with an increase of neutrophils
      and platelets was observed. The overall response rate was 42% with 1 complete
      response and 16 partial responses. Ten patients achieved minor responses and the
      remaining 14 showed no benefit from treatment. An increased response rate was
      achieved in 6 untreated patients who showed an overall response rate of 67%
      (4/6). The major complications observed were neutropenia (66%) and febrile
      episodes (44%) that were generally infection-related and were fatal in 3 cases.
      Because we were dealing with patients whose disease was advanced and/or resistant
      to treatment, the overall results may be considered encouraging with acceptable
      toxic reactions not superior to those frequently observed with polychemotherapy.

PMID- 8370425
TI  - Corticosteroid is not beneficial in multiple-drug combination chemotherapy for
      multiple myeloma. Finnish Leukaemia Group.
AB  - In a randomised multicentre trial a combination of methylprednisolone,
      vincristine, lomustine, cyclophosphamide and melphalan (MOCCA) was compared with
      the same regimen omitting methylprednisolone after the first course (COLA) in
      previously untreated patients with multiple myeloma. The MOCCA arm showed a
      response rate of 72% among 79 patients and the COLA arm a response rate of 60%
      among 59 patients. This difference was not statistically significant. The median
      survival time was 56 months in the MOCCA arm and 61 months in the COLA arm. There
      was a slight increase of early deaths (within the first 6 months) in the MOCCA
      arm as compared with the COLA arm. We conclude that, in multidrug therapies, the
      continuation of corticosteroid at conventional dosage beyond the first course
      does not improve response rate or survival time in multiple myeloma.

PMID- 8370426
TI  - Factors contributing to dyspnoea during bronchoconstriction and exercise in
      asthmatic subjects.
AB  - The purpose of the present study was to identify: 1) whether dyspnoea during
      bronchoconstriction and exercise is related, in asthmatic subjects; and 2) to
      what extent baseline pulmonary function and respiratory muscle strength
      contribute to dyspnoea under both conditions. One hundred and seventy five
      consecutive subjects, referred with suspected asthma, rated the intensity of
      dyspnoea (Borg scale 0-10): 1) during the administration of doubling
      concentrations of methacholine to 32 mg.ml-1 methacholine, or until the baseline
      forced expiratory volume in one second (FEV1) was reduced by 20%; and 2) during
      incremental cycle ergometry (100 kpm.min-1 each minute) to maximal capacity.
      138/175 subjects achieved a 20% reduction in their baseline FEV1; 18 of the 138
      were excluded, 2 children and 16 with complicating pulmonary disorders (diffusing
      capacity of the lung for carbon monoxide (DLCO) and/or total lung capacity (TLC)
      < 70% predicted). The remaining 120 out of 175 constituted the study population.
      Dyspnoea following a 20% reduction in the baseline FEV1 (Dys20%) was linearly
      interpolated, using the rating of dyspnoea and the FEV1 at the two final
      concentrations of methacholine. In the 120 asthmatic subjects, the mean intensity
      of dyspnoea was "moderate" (2.9, SD 1.91; Borg 0-10) and the intensity across
      subjects was not significantly related to baseline FEV1, vital capacity (VC),
      FEV1/VC, DLCO, TLC and maximal static inspiratory pressure (MIP), alone or in
      combination.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370427
TI  - Cardiac role in exercise limitation in asthmatic subjects with special reference
      to disease severity.
AB  - We wanted to assess limitations in cardiorespiratory fitness of asthmatic
      subjects, acclimatized to 1,300 m altitude and in a clinically stable state. We
      therefore studied 16 young asthmatic and 8 normal young subjects during an
      incremental bicycle exercise test. The asthmatics were divided into two groups,
      according to the Aas classification: a moderate asthma group (degree 2 and 3, no
      pulmonary impairment during symptom-free intervals), and a severe asthma group
      (degree 4 and 5, with persistent airway obstruction). The results showed that
      cardiorespiratory fitness is limited in severe asthmatic subjects acclimatized to
      an altitude of 1,300 m, due to decreased cardiac output and stroke volume. At
      submaximal exercise, the lower stroke volume is compensated by an increased
      arteriovenous oxygen content difference, but this compensation no longer exists
      at maximal exercise, which explains the lower maximal oxygen uptake in the severe
      asthma group. The hypothesis that the high tidal volume in the severe asthma
      group could lead to a decrease in left ventricular performance is considered. In
      conclusion, with respect to cardiorespiratory response to exercise, asthmatics
      should not be considered as a homogeneous group. Furthermore, relationship
      between ventilatory requirement and its consequences upon cardiac stroke volume
      provides a strong argument for the physical rehabilitation of asthmatics. Indeed,
      aerobic training can decrease the ventilation level for a given workload, and
      thus reduce inappropriate adaptations to exercise.

PMID- 8370428
TI  - Lack of short-term effect of the thromboxane synthetase inhibitor UK-38,485 on
      airway reactivity to methacholine in asthmatic subjects.
AB  - Previous open studies have suggested that thromboxane receptor antagonists or
      synthesis inhibitors lower airway hyperresponsiveness in human subjects. This
      would indicate a role of thromboxane A2 in the development or maintenance of
      hyperresponsiveness in asthma. Ten nonsmoking asthmatics (aged 23-64 yrs, 9 male)
      were included in a randomized, double-blind, placebo-controlled, cross-over study
      of the effect of one week of treatment with a potent selective thromboxane
      synthetase inhibitor (UK-38,485, 600 mg daily) on airway responsiveness. The
      study was preceded by a two week run-in period, and two weeks were used for wash
      out between the two trial periods. Adequacy of dosage and patient compliance was
      confirmed by a reduction in the ex vivo formation of thromboxane B2 (median
      concentration 3.22 micrograms.ml-1 after placebo, 0.10 microgram.ml-1 after UK
      38,485, p < 0.05). The mean forced expiratory volume in one second (FEV1) after
      UK-38,485 was 2.55 l, compared to 2.56 l after treatment with placebo (p = 0.74).
      The geometric mean provocative dose of methacholine producing a 20% fall in FEV1
      (PD20) before and after UK-38,485 was 23.9 and 32.2 micrograms, respectively,
      compared to 25.1 and 26.3 micrograms respectively, before and after placebo (p =
      0.31). The results of this study suggest that thromboxane A2 does not play an
      important role in the maintenance of increased airway responsiveness in
      moderately severe asthmatics treated with low doses of inhaled steroids.

PMID- 8370429
TI  - Ba 679 Br, a new long-acting antimuscarinic bronchodilator: a pilot dose
      escalation study in COPD.
AB  - Preclinical studies with Ba 679 Br have demonstrated a significantly longer
      duration of action than ipratropium bromide. Following inhalation of single
      doses, no systemic antimuscarinic effects were noted at doses likely to be
      bronchodilating in man. The objective of the present pilot-study of Ba 679 Br was
      to establish the dose-range for its bronchodilatory activity in a small number of
      chronic obstructive pulmonary disease (COPD) patients, before initiating a formal
      dose- and time-response study. Employing an open cross-over design, the efficacy
      of Ba 679 Br was tested, following single inhalational administration of five
      doses of increasing magnitude on separate days in six patients with COPD. A
      piezoelectric crystal was used, in order to nebulize an aqueous solution into a
      mist suitable for inhalation. There was a mean increase in forced expiratory
      volume in one second (FEV1) of 36% 30 min after inhaling ipratropium bromide 40
      micrograms. Pulmonary function tests (FEV1, and specific airways conductance
      (sGaw)) were performed, at regular time intervals up to 24 h after test drug
      inhalation. The bronchodilatory activity of Ba 679 Br appeared to be dose-related
      in the dose-range tested (10-160 micrograms). A peak response was reached in 1.5
      2 h, and persisted for 10-15 h in the majority of patients with return to
      baseline FEV1 approximately 19 h after dosing. No changes in physical
      examination, electrocardiogram (ECG) and laboratory safety tests from predose
      values were noted, and no serious adverse events were reported by the
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370430
TI  - Pulmonary hypertension in childhood.
AB  - In the presence of pulmonary hypertension, the pulmonary vasculature fails to
      remodel after birth. Secondary changes then develop, and do so more rapidly than
      in the adult lung because the cells are exposed to the insult whilst still
      relatively undifferentiated. The commonest causes of pulmonary hypertension in
      newborn and young infants are alveolar hypoxia, and congenital heart disease
      causing a left-to-right shunt and increased pulmonary blood flow. The initial
      response of an increase in pulmonary arterial muscularity is common to both, but
      intimal proliferation can develop rapidly in those with complex congenital heart
      disease. The structural abnormalities are accompanied by abnormalities in the
      control of pulmonary vascular reactivity, a problem which is the focus of much
      current research activity.

PMID- 8370431
TI  - An evaluation of P0.1 measured in mouth and oesophagus, during carbon dioxide
      rebreathing in COPD.
AB  - The pressure generated 100 ms after the onset of an occluded inspiratory effort
      (P0.1) is advocated and used as a measure of respiratory centre drive. We have re
      examined P0.1, measured simultaneously in the mouth (Pmo0.1) and the oesophagus
      (Poes0.1), during carbon dioxide rebreathing, in eight patients with severe
      chronic obstructive pulmonary disease, to see whether either indicates central
      respiratory drive. Pmo0.1 was identical to Poes0.1 in 4 out of 61, greater than
      Poes0.1 in 18 out of 61, and less than Poes0.1 in 39 out of 61 measurements
      (overall Poes0.1-Pmo0.1, median +0.075, range -0.175 to +1.01 kPa). Within a
      rebreathing run in an individual patient, there was considerable variability in
      the relationship Pmo0.1/Poes0.1 (0.89 +/- 0.24), coefficient of variation (CoV%)
      14.4 +/- 3.7%), in the end-expiratory oesophageal pressure (0.7 +/- 0.54 kPa,
      CoV% 105 +/- 106%), and in the time delay between the onset of a fall in
      oesophageal pressure (Poes) from the end-expiratory level to the beginning of
      inspiration, defined as starting when mouth pressure (Pmo) fell below atmospheric
      pressure (129 +/- 25 ms, CoV% 22.5 +/- 5.3%). We conclude that the problem of
      determining the true onset of inspiratory muscle activity from pressure data, and
      the likelihood that breaths are taken from different lung volumes, make it
      unlikely that Poes0.1 accurately represents central respiratory drive during
      rebreathing in chronic obstructive pulmonary disease. Furthermore, Pmo0.1
      differed from Poes0.1 during rebreathing, and their relationship was not
      constant, so that Pmo0.1 is even less likely to be a useful reflection of central
      nervous system output or respiratory centre drive in such patients.

PMID- 8370432
TI  - Comparison of pressure and volume preset nasal ventilator systems in stable
      chronic respiratory failure.
AB  - Nasal intermittent positive pressure ventilation (NIPPV) has been widely used in
      the treatment of chronic respiratory disease. Ventilators may be volume or
      pressure preset; each type has theoretical advantages, but to date there has been
      no formal comparison. We wanted to assess the efficacy on blood gas changes that
      may be achieved and overall acceptability of four nasal ventilators (two pressure
      preset: Respironics bilevel positive airway pressure (BiPAP) and the Thomas
      NIPPY; and two volume preset: BromptonPac and Monnal-D) in patients with stable
      chronic respiratory failure. Median age was 59 yrs (range 48-71 yrs), mean (SD)
      arterial oxygen tension (PaO2) 7.16 (0.21) kPa, arterial carbon dioxide tension
      (PaCO2) 7.02 (0.35) kPa, forced expiratory volume in one second (FEV1) 0.76
      (0.24) l, and forced vital capacity (FVC) 1.58 (0.49) l. All had previously used
      NIPPV. There were significant changes in blood gases at 2 h with each ventilator:
      mean change (95% confidence interval); BiPAP PaO2 +1.52 (0.95-2.09) kPa, PaCO2
      1.04 (1.55-0.54) kPa; NIPPY PaO2 +1.63 (0.85-2.41) kPa, PaCO2, -1.1 (1.86-0.34)
      kPa; BromptonPac PaO2 +1.22 (0.75-1.67) kPa, PaCO2 -1.14 (1.52-0.76) kPa; Monnal
      D PaO2 +1.14 (0.42-1.84) kPa, PaCO2 -1.19 (2.14-0.23) kPa. Analysis of variance
      showed no significant differences in the efficacy of volume or pressure preset
      equipment, and all ventilators proved equally acceptable to the patients studied.
      We conclude that all four of the volume or pressure preset ventilators examined
      are suitable for the delivery of nasal intermittent positive pressure ventilation
      in patients with stable chronic respiratory failure.

PMID- 8370434
TI  - Bilateral pulmonary artery aneurysms in Behcet's disease.
AB  - A patient presented with fever, haemoptysis and large bilateral perihilar masses.
      Histology proved that these were pulmonary artery aneurysms due to pulmonary
      vasculitis, as a manifestation of Behcet's disease. It is suggested that a
      routine dynamic computed tomographic (CT) scan should be performed in the
      evaluation of such cases.

PMID- 8370433
TI  - Lesions of the arytenoid region in a patient with exertional dyspnoea.
AB  - A 63 year old woman presented with a 3 year history of exertional dyspnoea.
      Spirometry suggested extrathoracic airway obstruction (decreased inspiratory flow
      and saw-tooth pattern of flow-volume curves), and bronchoscopy revealed
      structural lesions and a trembling motion in the arytenoid region, causing upper
      airway obstruction on forced respiratory efforts. As there were no abnormal
      findings other than the lesions, the exertional dyspnoea was probably caused by
      impaired movement of the arytenoid region.

PMID- 8370435
TI  - Asymptomatic solitary papilloma of the bronchus: review of occurrence in Japan.
AB  - A case of solitary papilloma of the bronchus is described, and 15 other cases
      occurring in Japan are reviewed. A 57 year old asymptomatic male was referred to
      our hospital because many squamous metaplastic cells with moderate atypia were
      observed in sputum cytology, twice in 3 months. The chest X-ray showed no
      abnormal findings. Endoscopic examination revealed a polypoid tumour at the
      bifurcation of the right B6a and B6b. The tumour was removed completely by
      endoscopic biopsy, and histological findings showed squamous papilloma. There has
      been no evidence of recurrence for 3 yrs. We are not aware of a previously
      reported case of bronchial papilloma without symptoms or abnormal shadow on chest
      X-ray. Considering the fact that malignant change was reported in only one case
      in Japan, and that there is a possibility of cancer subsequently developing at
      another location in the lung which might also require resection, lobectomy should
      be avoided if the tumour can be removed completely through endoscopy. If the
      lesion is limited to a small area in the bronchus, conservative treatment such as
      photodynamic therapy and/or yttrium aluminium garnet (YAG) laser vaporization
      might be sufficient to obtain a complete cure.

PMID- 8370436
TI  - Changes in heart rate during obstructive sleep apnoea.

PMID- 8370437
TI  - Towards testing the Dutch hypothesis from childhood.

PMID- 8370438
TI  - Highlights on pulmonary hypertension: a commentary.

PMID- 8370439
TI  - Upper airway obstruction: the culprits are the arytenoids.

PMID- 8370440
TI  - Pulmonary involvement in Behcet's disease.

PMID- 8370441
TI  - Pulmonary involvement in human T-cell lymphotropic virus type-I uveitis: T
      lymphocytosis and high proviral DNA load in bronchoalveolar lavage fluid.
AB  - The ocular manifestation of human T-cell lymphotropic virus type I (HTLV-I)
      infection has been recognized as a new clinical entity termed HTLV-I uveitis. In
      order to determine whether HTLV-I uveitis is associated with lymphocyte
      alveolitis, bronchoalveolar lavage (BAL) was carried out in 11 patients with HTLV
      I uveitis, five asymptomatic HTLV-I carriers, 11 HTLV-I-negative patients with
      ocular sarcoidosis, and nine normal control subjects seronegative for HTLV-I. Six
      of the 11 patients with HTLV-I uveitis showed increased total cell counts, and T
      lymphocytosis in BAL fluid. CD4+/CD8+ ratios of T-lymphocytes were decreased in
      three of these patients, and normal in three other patients. Such abnormalities
      of the lung were not found in asymptomatic HTLV-I carriers, and in normal control
      subjects. BAL findings in HTLV-I uveitis differed from those of patients with
      sarcoidosis in terms of the lymphocytic component. Interestingly, it was found
      that there was an increase of HTLV-I proviral deoxyribonucleic acid (DNA) load in
      peripheral blood mononuclear cells (PBMC) from seven patients with HTLV-I
      uveitis, and in the BAL cells from four patients with pulmonary involvement.
      These results provide further evidence in terms of HTLV-I tropism for the lung,
      and suggest that a systemic and local increase of HTLV-I proviral DNA load plays
      an important role in the pathogenesis of lymphocyte alveolitis in patients with
      HTLV-I uveitis.

PMID- 8370442
TI  - IgG subclasses in the lungs of patients with interstitial pneumonitis following
      bone marrow transplantation.
AB  - Subclasses of immunoglobulin G (IgG) were measured in bronchoalveolar lavage
      (BAL) fluid and serum from five normal volunteers and 25 bone marrow transplant
      (BMT) recipients, who developed 32 episodes of pneumonitis. Evidence for local
      production of the four subclasses was sought, to assess whether any observed
      deficiency was associated with any particular group of pulmonary infections. In
      the normal volunteers, IgG1 and IgG4 could be detected in BAL fluid from all
      subjects, with evidence for local production of IgG1 in one, and IgG4 in all
      five. IgG2 could be detected in BAL fluid from one subject, but IgG3 was
      undetectable in all normal BAL fluid. The BMT recipients differed from the normal
      volunteers mainly in the presence of IgG2 and IgG3 in BAL fluid. Furthermore,
      IgG4 could not be detected in BAL from seven. Furthermore, IgG4 could not be
      detected in BAL from seven episodes of pneumonitis (six patients). Bacteria,
      protozoa or fungi alone were isolated from five of these seven lavages, whereas
      pneumonitis associated with these organisms alone only occurred in 9 of the
      remaining 25 episodes of pneumonitis (19 patients) where there was also evidence
      for local production of IgG4. Moreover, 4 out of 7 patients with no detectable
      IgG4 in lavage developed secondary infections, whilst only 5 out of 19 patients
      producing IgG4 locally developed secondary infections (p = 0.05). Although there
      was individual variation within each group, levels of local production of both
      IgG1 and IgG4 tended, however, to be higher in patients who died from pneumonitis
      than in those who recovered, suggesting that this may be a poor prognostic
      marker.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370443
TI  - Proliferating alveolar macrophages in BAL and lung function changes in
      interstitial lung disease.
AB  - In interstitial lung disease, the number of alveolar macrophages (AMs) can be
      increased. This may be caused by recruitment of precursor cells from peripheral
      blood and/or local proliferation in the lung. We therefore analysed
      proliferation, by studying both the expression of the nuclear proliferation
      antigen, Ki67, and the deoxyribonucleic acid (DNA) content, using the Feulgen
      reaction followed by cytometry. The patients had interstitial lung disease, i.e.
      sarcoidosis (n = 20), extrinsic allergic alveolitis (n = 20), idiopathic lung
      fibrosis or lung involvement in collagen-vascular disease (n = 19). In all
      patient groups there was a significant increase in proliferating AMs compared to
      healthy controls (4.2 versus 1.4% Feulgen, 2.1 versus 0.5% Ki67), with a
      significant correlation between these two parameters. A positive correlation was
      also found in bronchoalveolar lavage (BAL) between numbers of lymphocytes and
      proliferating cells in sarcoidosis and in fibrosis. In fibrosis, numbers of
      eosinophils and proliferating cells were also positively correlated. Our main
      finding was, however, a positive correlation between numbers of proliferating
      cells (Feulgen) and lung function parameters, especially vital capacity and
      oxygen tension (PO2) at rest, in patients with sarcoidosis and lung fibrosis. By
      contrast, in extrinsic allergic alveolitis, no correlation could be observed
      between proliferating cells and cell population or lung function. Our results
      suggest that local proliferation of macrophages is an important element in
      interstitial lung disease.

PMID- 8370444
TI  - Suppressive mechanisms of alveolar macrophages in interstitial lung diseases:
      role of soluble factors and cell-to-cell contact.
AB  - Alveolar macrophages (AMs) from patients with interstitial lung diseases, such as
      sarcoidosis and idiopathic pulmonary fibrosis, suppress the phytohaemagglutinin
      (PHA) stimulation of autologous peripheral lymphocytes. The aim of this study was
      to determine whether the suppressive effect of alveolar macrophages of patients
      with interstitial lung disease is due, not only to the secretion of soluble
      factors prostaglandin E2 (PGE2), interleukin-1 (IL-1) but is also correlated to a
      direct effect of AMs on the expression of IL-2 receptors (IL-2R: CD25) and on the
      induction of IL-2 activity. We studied 26 subjects, 8 with sarcoidosis, 7 with
      idiopathic pulmonary fibrosis, and 11 controls. Alveolar macrophages of sarcoid
      and idiopathic pulmonary fibrosis patients suppressed proliferation of autologous
      peripheral lymphocytes by 68 +/- 14% and 53 +/- 4.5%, respectively, compared to
      enhancement of 19 +/- 11% in three controls and suppression of 25 +/- 11% in the
      other six controls; the difference between subjects with interstitial lung
      disease and controls was significant. As already reported, the alveolar
      macrophages of sarcoid patients secreted large amounts of IL-1 (184 +/- 59 U.ml
      1) whereas the alveolar macrophages from idiopathic pulmonary fibrosis patients
      secreted large amounts of PGE2 (3.6 +/- 2 ng.ml-1 x 10(-5) cells) compared with
      23 +/- 19 U.ml-1 IL-1 and 0.34 +/- 0.15 ng.ml-1 x 10(-5) cells respectively, of
      controls. Suppression by supernatants recovered from lipopolysaccharide (LPS)
      stimulated alveolar macrophages can only partially explain the high suppressive
      effect of alveolar macrophages of interstitial lung diseases.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 8370445
TI  - The medical management of patients with cystic fibrosis following heart-lung
      transplantation.
AB  - Transplantation for end-stage respiratory failure in cystic fibrosis (CF), with
      encouraging medium-term results, is now possible. This paper details the
      postoperative medical treatment required by these patients. The management of 79
      patients who underwent heart-lung transplantation is described. Details of
      intensive care, postoperative care, long-term follow-up, and the problems
      specific for cystic fibrosis patients are reported. The duration of care in the
      Intensive Care Unit (ICU) was 1-93 days (median 5 days). Intubation was required
      for 7 h to 93 days (median 48 h), and 11 patients required haemodiafiltration.
      High doses of cyclosporin A (mean 22 mg.kg-1 q.d.) were required. Acute rejection
      was common. There were 133 episodes of infection: bacterial 115, viral 11, and
      other organisms 7. Grand mal seizures occurred in 10 patients,
      lymphoproliferative disorders in 4, and obliterative bronchiolitis in 17. The
      median duration of hospital stay was 32 days. Despite having a multi-system
      disease, patients with CF can be successfully transplanted, if detailed attention
      is paid to their complex medical management.

PMID- 8370446
TI  - Surfactant inhibition by plasma proteins: differential sensitivity of various
      surfactant preparations.
AB  - Leakage of plasma proteins into the alveolar space may inhibit surfactant
      function. We compared the surface properties and the sensitivity to inhibitory
      proteins of different organic solvent surfactant extracts and a synthetic
      surfactant. Experiments were performed in the pulsating bubble surfactometer,
      with surfactant concentrations ranging between 0.1 and 2 mg.ml-1. Inhibition
      profiles towards fibrinogen, albumin and haemoglobin were obtained from calf lung
      surfactant extracts (CLSE), Alveofact, Curosurf and Survanta (all used in
      clinical, replacement studies in respiratory distress syndrome (RDS) and of an
      apoprotein-based synthetic phospholipid mixture (PLM-C/B; DPPC:PG:PA =
      68.5:22.5:9, supplemented with 2% wt/wt non-palmitoylated human recombinant SP-C
      and 1% t/wt natural bovine SP-B). In the absence of inhibitory proteins, all
      surfactants exhibited dose-dependent rapid adsorption (rank order of relative
      efficacy PLM-C/B = CLSE > Alveofact > Curosurf > Survanta). Minimal surface
      tension was reduced to near zero values under dynamic compression (rank order PLM
      C/B > CLSE > Alveofact = Curosurf) and to approximately 4 mN.m-1 (Survanta).
      Curosurf and Survanta were dose-dependently inhibited by fibrinogen > haemoglobin
      > albumin, with far-reaching loss of surface activity at protein-surfactant
      ratios above 1:1. In contrast, CLSE and Alveofact were only moderately inhibited
      by fibrinogen, and were not affected by haemoglobin and albumin, up to protein
      surfactant ratios of 2:1. PLM-C/B exhibited resistance to fibrinogen,
      intermediate sensitivity to albumin, and was severely inhibited by haemoglobin.
      We conclude that various natural surfactant extracts and an apoprotein-based
      synthetic surfactant mixture markedly differ in their sensitivity to inhibitory
      plasma proteins.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370447
TI  - The contribution of respiratory function tests to clinical diagnosis.
AB  - The purpose of this study was to investigate the amount of diagnostic information
      contained in a set of routine lung function studies and to attempt to determine
      which tests could be omitted without significant loss of discrimination. Cluster
      analysis was performed on a set of physiological and questionnaire data,
      collected prospectively in 1,542 male patients, referred consecutively for
      measurement of forced expired volumes, static lung volumes and measurements of
      the transfer factor for carbon monoxide. A respiratory questionnaire was
      completed for each patient. A physician assigned the patients to a rigorously
      defined diagnostic category, based on supporting clinical information, as well as
      pulmonary function, apart from 241 patients with unusual diagnoses and those in
      whom the criteria did not apply satisfactorily. This diagnosis was never included
      as a classification variable. Basing the classification on three independent
      measurements, total lung capacity, the ratio of forced expiratory volume in one
      second (FEV1) to vital capacity, and the transfer factor for carbon monoxide, the
      computer generated six groups: one normal, one showing an isolated gas exchange
      defect, and four with varying degrees of restriction and obstruction. This
      classification performed well in separating the patients with the clinical
      diagnoses of chronic airflow obstruction, bronchial asthma and interstitial lung
      disease from those with ischaemic and valvular heart disease and other
      miscellaneous disorders. Omitting total lung capacity resulted in some loss of
      specificity, but valid information was still obtained. The inclusion of all the
      static and dynamic lung volumes and of carbon monoxide transfer coefficient made
      little difference.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370448
TI  - Tracheal size is a determinant of the bronchoconstrictive response to inhaled
      methacholine.
AB  - We hypothesized that the size of the large airways is a determinant of bronchial
      responsiveness to inhaled methacholine. This was investigated by measuring the
      relationship of tracheal size and branching angle to the bronchoconstrictive
      response to methacholine, in 169 male construction insulators, aged 20-50 yrs, as
      part of a workforce-based, cross-sectional survey of respiratory health.
      Bronchial responsiveness was expressed as the concentration of methacholine,
      inhaled for 2 min of tidal breathing, which provoked a 15% fall in forced
      expiratory volume in one second (FEV1). Tracheal size was assessed from tracings
      of standard posteroanterior chest radiographs, at full inspiration. After
      accounting for the effect of airway calibre (FEV1/forced vital capacity (FVC)),
      age, height, and pack-years of cigarette smoking, on airways responsiveness,
      there was a significant association (p < 0.05) between tracheal length, diameter,
      or surface area and the degree of bronchoconstriction obtained by inhaling
      methacholine. The increase in airway responsiveness with decreasing tracheal size
      may reflect increased deposition of methacholine, secondary to smaller cross
      sectional area and greater linear velocity of air in the trachea and main
      bronchi.

PMID- 8370449
TI  - Accuracy and sensitivity of the interrupter technique for measuring the response
      to bronchial challenge in normal subjects.
AB  - The interrupter technique is a non-invasive method for measuring airway calibre.
      Since the calculation of interrupter resistance (Rint) is critically dependent
      upon the analysis of the mouth pressure/time (Pmo(t)) curve obtained after flow
      interruption, we wanted to assess the relative merits of four different analyses
      of Pmo(t) curves, obtained under basal conditions and following methacholine
      induced airway narrowing, in 10 healthy adults. Four methods of analysing the
      Pmo(t) curves were used to calculate Rint values: RintC-a smooth curve fit with
      back-extrapolation; RintL-two-point linear fit with back-extrapolation; RintEO
      calculated from the pressure change after the post-interruption oscillations had
      decayed (end-oscillation); and RintEI-calculated from the pressure change at the
      end of the period of interruption. The airway response measured with the four
      Rint methods was compared with plethysmographic airway resistance (Raw). The
      sensitivity of the methods was determined by calculating a sensitivity index
      (SI), the change in resistance after challenge expressed in multiples of baseline
      standard deviation. Values of RintC were similar to Raw values under all
      conditions. Resistance values from the remaining Rint methods significantly
      exceeded Raw (mean basal difference: 0.13-0.34 kPa.l-1 x s; mean difference after
      challenge: 0.12-0.42 kPa.l-1 x s. Raw was the most sensitive method for detecting
      bronchoconstriction (doubling of Raw was equivalent to SI of 10.5). Of the Rint
      methods, RintEI gave the highest sensitivity index (SI = 3.1), with a 42% mean
      change; RintC produced the greatest proportionate change after challenge (55%),
      but with a lower SI (2.2).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 8370450
TI  - Kin recognition. A model for the retention of Golgi enzymes.
AB  - The surprising result that the spanning domain causes retention of proteins in
      the Golgi stack poses the question as to the actual mechanism. Here we present a
      simple model that might have general applicability.

PMID- 8370451
TI  - Observation of inter-subunit nuclear Overhauser effects in a dimeric protein.
      Application to the Arc repressor.
AB  - For the structure determination of symmetric protein dimers it is necessary to
      distinguish between intra- and inter-subunit NOEs. A method is presented to
      measure selectively the inter-subunit NOEs using uniform 15N and 13C isotope
      labelling. This is accomplished by double filtered 2D NOE experiments on mixtures
      of native protein with isotope-labeled protein. The method has been applied to
      the Arc repressor and allows the characterization of virtually all proton-proton
      NOEs in terms of their intra- or inter-subunit nature.

PMID- 8370452
TI  - Mammalian calponin. Identification and expression of genetic variants.
AB  - Calponin is a smooth muscle specific, actin-, tropomyosin- and calmodulin-binding
      protein thought to be involved in some way in the regulation or modulation of
      contraction. Here we describe the cloning and bacterial expression of two
      calponin species from murine and porcine smooth muscle tissues. Primary and
      secondary structural analyses of the deduced amino acid sequences revealed a high
      degree of homology to avian calponin with the exception of a short and variable C
      terminal segment. The sequence data demonstrate that the two mammalian calponin
      variants do not arise via alternative splicing but are encoded by different
      genes.

PMID- 8370453
TI  - Biosynthesis and secretion of a precursor of nisin Z by Lactococcus lactis,
      directed by the leader peptide of the homologous lantibiotic subtilin from
      Bacillus subtilis.
AB  - The DNA sequence encoding the leader peptide of the lantibiotic subtilin from
      Bacillus subtilis was fused to the sequence encoding pronisin Z, and this hybrid
      gene was expressed in a Lactococcus lactis strain that produces nisin A. This
      strain simultaneously secreted nisin A and a protein of approximately 6 kDa.
      Amino acid sequencing of the purified 6 kDa protein and structural analysis of
      its main tryptic fragment by two-dimensional 1H-NMR showed that it consists of
      the unmodified leader peptide of subtilin, without the N-terminal methionine
      residue, linked to a fully matured nisin Z part. The hybrid protein and its main
      tryptic fragment [ITPQ]-nisin Z, showed at least 200-fold lower antimicrobial
      activities than nisin Z against three different indicator strains.

PMID- 8370454
TI  - Methylglyoxal and the polyol pathway. Three-carbon compounds are substrates for
      sheep liver sorbitol dehydrogenase.
AB  - Methylglyoxal, 1,2-propanediol and glycerol are shown to be substrates for sheep
      liver sorbitol dehydrogenase. With 1,2-propanediol the enzyme-catalyzed reaction
      occurs specifically with the R(-)-enantiomer. The maximum velocities and the
      specificity constants obtained for the three-carbon substrates are considerably
      lower than those reported previously for sorbitol, and suggest that rate
      determination is imposed by catalytic steps other than the enzyme-coenzyme
      product dissociation. The present findings are discussed in terms of substrate
      specificity and stereospecificity, and may indicate novel aspects of sorbitol
      dehydrogenase function in relation to glucose metabolism and diabetic
      pathogenesis.

PMID- 8370455
TI  - Purification of an UDP-glucose:flavone, 7-O-glucosyltransferase, from Silene
      latifolia using a specific interaction between the enzyme and phenyl-Sepharose.
AB  - An UDP-glucose:flavonoid, 7-O-glucosyltransferase, from Silene latifolia was
      isolated from petals and purified 450-fold using a combination of gel-filtration,
      affinity chromatography and anion-exchange chromatography. Affinity
      chromatography on a phenyl-Sepharose CL-4B column in combination with elution
      with the substrate, isovitexin (6-C-glucosylapigenin), was an especially
      effective purification step. A purification factor between 10 and 20 could be
      reached using this column. A possible mechanism for the specific interaction of
      the enzyme with the phenyl-Sepharose will be discussed. This method of
      purification may also be applicable to other enzymes which use aromatic compounds
      as substrates. On a SDS-PAGE gel a band of 54 kDa, which co-purified with enzyme
      activity, could be detected in the purest fraction.

PMID- 8370456
TI  - Ribosomal proteins, TL4 and TL5, from Thermus thermophilus form hybrid complexes
      with 5 S ribosomal RNA from different microorganisms.
AB  - Hybrid complexes of the ribosomal proteins, TL4 and TL5, from Thermus
      thermophilus with 5 S ribosomal RNA from Escherichia coli and Bacillus
      stearothermophilus have been prepared. There was no competition between the two
      proteins for the binding sites. Stoichiometry of 5 S RNA binding for both
      proteins was 1:1 (protein/RNA). The TL4 protein competed with the E. coli
      ribosomal L5 protein, and the TL5 protein competed with the E. coli ribosomal
      proteins, L18 and L25, for binding with 5 S RNA.

PMID- 8370457
TI  - beta-Amyloid protein enhances the mitogen-induced calcium response in circulating
      human lymphocytes.
AB  - The role of beta-amyloid in Alzheimer's disease and its cellular mechanism of
      action on neurons are still unclear. There is growing evidence that beta-amyloid
      or its fragment, 25-35, influence neuronal calcium regulation. To investigate the
      effects of beta-amyloid on calcium homeostasis in man we used peripheral human
      lymphocytes as a model system for central neurons. beta-Amyloid fragment 25-35
      exposed to lymphocytes for 60 s elevates the phytohemagglutinin (PHA)-induced
      Ca2+ rise in a dose-dependent manner. Small effects were already seen at
      concentrations as low as 50 nmol/l. Similar effects were also observed with
      fragment 1-40, whereas fragments 1-28 or 12-28 did not affect the Ca2+ response
      after PHA stimulation. Our findings support the hypothesis of an enhanced calcium
      response as a general feature of beta-amyloid's neurotoxicity. The lymphocyte
      seems to be a valuable model to study this effect in man.

PMID- 8370458
TI  - Excitonic interactions in the light-harvesting antenna of photosynthetic purple
      bacteria and their influence on picosecond absorbance difference spectra.
AB  - A new model of the light-harvesting antenna (core complex) of purple
      photosynthetic bacteria is proposed based on excitonic interactions in circular
      aggregates of bacteriochlorophyll molecules. The calculated absorbance difference
      spectra of circular aggregates demonstrate all special features observed in the
      experimental spectra of purple bacteria. In particular, the absorption changes
      with high amplitude of bleaching at the long-wavelength side of the absorption
      band at different excitation energy are predicted.

PMID- 8370459
TI  - Tamoxifen and related compounds decrease membrane fluidity in liposomes.
      Mechanism for the antioxidant action of tamoxifen and relevance to its anticancer
      and cardioprotective actions?
AB  - Tamoxifen and related compounds decrease membrane fluidity in ox-brain
      phospholipid liposomes: their order of effectiveness is, 4-hydroxytamoxifen > 17
      beta-oestradiol > tamoxifen > cis-tamoxifen > N-desmethyltamoxifen > cholesterol.
      A good positive correlation was demonstrated between the decrease in membrane
      fluidity by these compounds and their antioxidant ability as inhibitors of
      liposomal and microsomal lipid peroxidation (correlation coefficient, r = 0.99, P
      < 0.001, in both cases). The ability of tamoxifen to decrease membrane fluidity
      is suggested to be the mechanism of its antioxidant action and is discussed in
      relation to its anticancer and cardioprotective actions.

PMID- 8370460
TI  - A plasma-membrane progesterone receptor in human sperm is switched on by
      increasing intracellular free calcium.
AB  - Recent studies have revealed the presence of an atypical progesterone receptor on
      the plasma membrane of a relatively small subpopulation of human sperm cells. In
      this study, we show that the receptor is present in many cells in a latent form
      and that the receptor function in these cells is switched on asynchronously by
      increasing intracellular free Ca2+ levels. Under physiological conditions, this
      process occurs during sperm capacitation, but it can be mimicked by a short sperm
      exposure to the Ca(2+)-mobilizing agent thapsigargin. These observations suggest
      a role of Ca2+ as a modulator of nongenomic steroid effects on the cell surface.

PMID- 8370461
TI  - Efficient processing and export of human growth hormone by heat labile
      enterotoxin chain B signal sequence.
AB  - The heat-labile enterotoxin chain B (LTB) signal sequence was used for the
      processing and export of human growth hormone (hGH). The protein was completely
      processed and exported across the cell membrane to accumulate in the periplasmic
      space in Escherichia coli. The human growth hormone cDNA was cloned as a PCR
      amplified fragment under the control of tac promoter and translationally fused to
      the LTB signal sequence. The rate of processing of hGH under the control of the
      LTB signal sequence was equal to or more than the rate of induction of
      expression, indicating efficient processing. The receptor binding activity of the
      processed periplasmic protein was established in a radio receptor assay.

PMID- 8370462
TI  - Identification of MIM23, a putative component of the protein import machinery of
      the mitochondrial inner membrane.
AB  - A screening for yeast mutants impaired in mitochondrial protein import led to the
      identification of two genes (MPII and MPI2) encoding the essential components
      MIM44 and MIM17 of the inner membrane import machinery. We analyzed twelve
      additional mutants obtained in the screening and found two further
      complementation groups. One group represents mutants of SSC1, the gene encoding
      mitochondrial hsp70, an essential matrix protein required for protein import
      across the inner membrane. The second complementation group represents mutants of
      a new gene (MP13) encoding a 23 kDa integral inner membrane protein (MIM23).
      MIM23 is synthesized without a presequence, and its import to the inner membrane
      requires a membrane potential. MIM23 contains a domain homologous to half of
      MIM17. We speculate that MIM23 is a new member of the protein import machinery of
      the mitochondrial inner membrane.

PMID- 8370463
TI  - Phospholipid asymmetry of the outer membrane of rat liver mitochondria. Evidence
      for the presence of cardiolipin on the outside of the outer membrane.
AB  - The phospholipid topology of the outer membrane of intact rat liver mitochondria
      and derived outer membrane vesicles was investigated by determining the
      accessible pool of the various phospholipid classes towards phospholipase A2, a
      phosphatidylcholine-specific transfer protein and by chemical labeling using
      trinitrobenzene sulfonic acid. The outer membrane vesicles are sealed and have a
      right-side-out topology with a proposed localization of 55%, 77%, 100%, and at
      least 30% of the phosphatidylcholine, phosphatidylethanolamine, cardiolipin, and
      phosphatidylinositol plus phosphatidylserine in the outer leaflet, respectively.
      The outer membrane in intact mitochondria appears to have a similar phospholipid
      distribution.

PMID- 8370464
TI  - Storage of saposins A and D in infantile neuronal ceroid-lipofuscinosis.
AB  - We have isolated storage cytosomes from brain tissue of patients with infantile
      neuronal ceroid-lipofuscinosis. The purified storage bodies were subjected to
      compositional analysis which revealed a high content of proteins, accounting for
      43% of dry weight. Saposins A and D, also known as sphingolipid activator
      proteins (SAPs), were shown to constitute a major portion of the accumulated
      protein using gel electrophoresis and sequence analysis. This is the first time
      that saposins have been found to be stored in any form of neuronal ceroid
      lipofuscinosis.

PMID- 8370465
TI  - Enhancement by retinoid of hemin-induced differentiation of human leukemia K562
      cell line.
AB  - The effect of retinoid on human leukemia K562 cell differentiation induced by
      hemin was examined. Retinoids (retinoic acid and synthetic retinoids [Am80 and
      Ch55]) dose-dependently enhanced hemin-induced erythroid differentiation of K562
      cells, though these retinoids themselves did not induce the differentiation.
      Under optimal conditions, these retinoids caused a doubling of the population of
      hemin-induced differentiated cells. In addition, co-treatment of cells with hemin
      and retinoid led to longer maintenance of the differentiated state after the
      removal of hemin, which might imply acquisition of irreversibility of hemin
      induced differentiation. These results suggest that the combination of retinoids
      with other differentiation inducers might be useful for leukemia therapy in cases
      where the leukemic cells are poorly responsive or unresponsive to retinoids,
      alone.

PMID- 8370466
TI  - Cooperative homodimeric hemoglobin from Scapharca inaequivalvis. cDNA cloning and
      expression of the fully functional protein in E. coli.
AB  - The overexpression of the fully functional, cooperative homodimeric hemoglobin of
      the bivalve mollusc, Scapharca inaequivalvis, has been accomplished in E. coli
      from its cDNA. The latter was isolated by PCR amplification of total RNA and
      sequenced. The cDNA-derived sequence differed by a single amino acid when
      compared to that previously obtained from purified protein. Interest in this
      hemoglobin resides in the unique assemblage of the two identical subunits, with
      the heme groups facing each other in the inside of the molecule, opposite to that
      occurring in vertebrate hemoglobins. The results presented here are the basis for
      future studies of structure/function relationships by site directed mutagenesis.

PMID- 8370467
TI  - Uridylylation of the PII protein in Rhizobium leguminosarum.
AB  - Permeabilization with cetyl trimethyl ammonium bromide was used to study the post
      translational modification of the PII protein in Rhizobium leguminosarum. Upon
      incubation with radioactive UTP a single band was obtained after SDS-PAGE and
      autoradiography. RNase resistance and snake venom phosphodiesterase sensitivity
      showed that radioactivity was bound through a phosphodiester bond to a protein
      which was absorbed by an antiserum specific for the PII protein. Uridylylation of
      the PII protein was shown to be dependent on the modifications of the
      glutamine/alpha-ketoglutarate ratio.

PMID- 8370468
TI  - The cyanobacterium, Synechococcus sp. PCC7942, possesses two distinct genes
      encoding cation-transporting P-type ATPases.
AB  - P-type (or E1 E2-type) ATPases comprise a large family of prokaryotic and
      eukaryotic proteins capable of transporting a variety of cations, and function in
      a wide variety of cellular processes. The present study was carried out to search
      for genes encoding P-type ATPases in the phototrophic cyanobacterium,
      Synechococcus sp. PCC7942. We succeeded in cloning two genes each encoding P-type
      ATPases from this bacterium. It was found that Synechococcus at least, two
      distinct P-type ATPases; one belongs to the family of typical prokaryotic P-type
      ATPases and the other markedly resembles eukaryotic P-type ATPases. An insertion
      mutant lacking either of these two ATPase-genes was constructed. The results
      showed that the growth of these mutants is hypersensitive to osmotic stress upon
      addition of NaCl or sorbitol to the medium.

PMID- 8370469
TI  - Intracellular parasitism of Legionella and signaling in eukaryotic cells.
AB  - In this review the phenomenon of antibacterial activity of phagocytes and its
      relationship to the general system of signal transduction in eukaryotic cells is
      examined. Data are reviewed that support the hypothesis that interference in
      transduction of regulatory signals during microbial invasion could be caused by
      specific bacterial products and lead to an inadequate bactericidal response, and
      hence multiplication of the bacteria in a host. In this connection, information
      concerning virulence factors of the facultative intracellular parasite Legionella
      is discussed.

PMID- 8370470
TI  - Bacterial bioluminescence: organization, regulation, and application of the lux
      genes.
AB  - Significant advances have been made in the characterization of luciferases and
      other lux-specific proteins as well as the lux genes from a number of different
      species of marine and terrestrial luminescent bacteria. A common lux gene
      organization (luxCDAB..E) modulated by the presence of specific genes involved in
      regulation and flavin binding and metabolism (luxF-I,L,R,Y) has been found with
      the luciferase genes (luxAB) flanked by the genes involved in synthesis of its
      fatty aldehyde substrate (luxCDE). For many species, light intensity per cell is
      highly dependent on cellular growth resulting in a spectacular autoinduction of
      luminescence at high cell density. Consequently, the bacterial lux system is of
      particular interest as it can serve as an excellent model for more general signal
      transduction systems involved in developmental processes, intercellular
      communication, and even symbioses. Identification of the lux autoinducers and
      regulatory proteins of Vibrio harveyi and Vibrio fischeri has provided the
      biochemical and genetic basis for dissection of the luminescent system. Isolation
      of the lux genes and the ability to transfer these genes into prokaryotic and
      eukaryotic organisms have greatly expanded the scope and potential uses of
      bacterial bioluminescence as a safe, rapid, and sensitive sensor for a wide
      variety of compounds and metabolic processes.

PMID- 8370471
TI  - Integral membrane heparan sulfate proteoglycans.
AB  - Heparan sulfate is a regulatory polysaccharide. It modulates specific growth
      factor-receptor interactions, accelerates the formation of specific proteinase
      proteinase inhibitor complexes, and mediates interactions of the cell surface
      with several enzymes and structural proteins. It abounds on the surfaces of
      embryonic cells, respecting or outlining morphogenetic rather than histological
      boundaries. This cell surface-associated heparan sulfate is implanted on specific
      integral membrane proteins, which together constitute two novel molecular
      families. The first family includes four syndecan-like integral membrane
      proteoglycans (SLIPS), with core proteins that span the membrane and shared
      sequence motifs in highly conserved cytoplasmic domains. The second is made up by
      two or more glypican-related integral membrane proteoglycans (GRIPS) that are
      linked to the cell surface via glycosyl phosphatidylinositol. These proteoglycans
      show differential expression and turnover patterns, prevailing in distinct cell
      types, membrane domains, and endocytotic machineries, and are subject to strict
      developmental controls. This suggests that each of these cell surface
      proteoglycans functions in a specific context, and that these functions pertain
      to the transduction of signals that emanate from the continuous interplay between
      matrix components, growth factors, and proteinases. Caution: beware of loose
      GRIPS and SLIPS on unsteady cell surfaces.

PMID- 8370472
TI  - Pericyte physiology.
AB  - Endothelial cells are the primary physical barrier between blood and tissue in
      microvessels. The other capillary and post-capillary venule wall cell is the
      pericyte. The literature on the biology of endothelium is appreciable but less is
      known about pericytes. Pericytes are morphologically, biochemically, and
      physiologically heterogeneous. Some of pericyte functional characteristics
      observed in vivo and in vitro are that they: regulate endothelial proliferation
      and differentiation; contract in manners that either exacerbate or stem
      endothelial cell junctional inflammatory leakage; function as a progenitor cell;
      synthesize and secrete a wide variety of vasoactive autoregulating agonists;
      synthesize and release structural constituents of the basement membrane and
      extracellular matrix. Pericytes are also involved in specific microvascular
      diseases. This review focuses principally on nonmesangial pericytes and specific
      activities such as the posttranslational, short-term responses that affect
      microvascular perfusion and permeability, and on pericyte-endothelial cell
      interaction.

PMID- 8370473
TI  - Regulation of the long-chain carnitine acyltransferases.
AB  - Long-chain carnitine acyltransferases are a family of enzymes found in
      mitochondria, peroxisomes, and endoplasmic reticulum that catalyze the exchange
      of carnitine for coenzyme A in the fatty acyl-CoA. Conversion of the fatty acyl
      CoA to fatty acylcarnitine renders the fatty acid more permeable to the various
      cellular membranes. The mitochondrial carnitine palmitoyltransferases are
      considered important in the regulation of mitochondrial beta-oxidation of long
      chain fatty acids. However, palmitoylcarnitine produced by peroxisomal carnitine
      octanoyltransferase or by microsomal carnitine palmitoyltransferase is not
      different from that produced by the mitochondrial enzyme. Therefore, for there to
      be control of fatty acid oxidation by the long-chain carnitine acyltransferases,
      there would have to be some mechanism to coordinately regulate these varied
      enzymes. The first system of regulation involves inhibition by malonyl-CoA, an
      intermediate in the synthesis of fatty acids. Malonyl-CoA inhibits long-chain
      carnitine acyltransferase activity by all three enzymes at similar concentrations
      in the physiological range. In addition, the mitochondrial and peroxisomal
      enzymes are known to be regulated at the level of mRNA transcription by a number
      of shared factors. Although the microsomal enzyme is less well studied, there
      does, indeed, appear to be a pattern of coordinate regulation for this system.

PMID- 8370474
TI  - Nicotine inhibition of apoptosis suggests a role in tumor promotion.
AB  - Recent evidence indicates that cell death through apoptosis may be an important
      mechanism to prevent tumor development. Therefore, agents that inhibit apoptosis
      may function as tumor promoters. The purpose of this study was to determine the
      effects of nicotine on the process of apoptosis. The results demonstrate that
      nicotine inhibits apoptosis induced by diverse stimuli including tumor necrosis
      factor (TNF), UV light, chemotherapeutic drugs, and calcium ionophore. This
      phenomenon was observed in normal and transformed cells derived from a variety of
      species and tissues, including tumor cell types related to tobacco use. The major
      nicotine metabolite, cotinine, also inhibited apoptosis, whereas N
      nitrosodiethylamine, a carcinogen found in tobacco, was without effect.
      Therefore, nicotine-mediated inhibition of apoptosis may contribute to the
      pathogenesis of tobacco-related cancer as well as decrease the efficacy of cancer
      therapies.

PMID- 8370475
TI  - Seasonal variations in antibody-dependent cellular cytotoxicity regulation by
      melatonin.
AB  - Data collected over a period of 4 years show that melatonin (two daily i.v.
      injections of 0.1 mg/kg body wt. given at 16:00 h) was able to enhance antibody
      dependent cellular cytotoxicity (ADCC) in summer, but not in winter. Dose
      response curves carried out in January, May, July, and October suggest that the
      seasonal effects reported are related to differences in the sensitivity of mice
      to melatonin during the course of the year. These results show seasonal
      variations in the immune modulatory action of melatonin.

PMID- 8370476
TI  - Somatostatin analog lanreotide inhibits myocyte replication and several growth
      factors in allograft arteriosclerosis.
AB  - Chronic rejection is the most common reason for late loss of a transplant. The
      molecular mechanism of chronic rejection is not known and there is no treatment
      for this disorder. The characteristic histological feature in chronic rejection
      is increased smooth muscle cell replication in the vascular wall, leading to
      allograft arteriosclerosis. In this study we demonstrate that nonimmunosuppressed
      rat aortic allografts undergoing chronic rejection synthesize increased
      quantities of several smooth muscle cell growth-promoting substances in the
      vascular wall including interleukin-1, eicosanoids, and several peptide growth
      factors. Administration of a stable somatostatin analog lanreotide, BIM 23014,
      strongly inhibits myocyte proliferation in the allograft in vivo. It has no
      inhibitory effect on the proliferation of smooth muscle cells in vitro.
      Concomitantly, the locally produced peptide growth factors, i.e., epidermal
      growth factor, insulin-like growth factor 1, and BB-isomer of platelet-derived
      growth factor, but not other mediators of inflammation, are significantly
      reduced. The results suggest that growth factors are the main effector molecules
      leading to myocyte proliferation in allograft arteriosclerosis and that allograft
      arteriosclerosis (chronic rejection) may be specifically inhibited by lanreotide
      administration.

PMID- 8370477
TI  - Microencapsulation of recombinant cells: a new delivery system for gene therapy.
AB  - The therapeutic potential of somatic gene therapy has been extensively
      investigated in recent years, yet its slow progression into the clinical setting
      can be attributed to problems associated with the inability to achieve efficient
      gene transfers, to obtain sustained level of expression of the transfected gene,
      and the necessity to avoid immunorejection after transplantation. Here we report
      on an alternate strategy in gene therapy that overcomes all three problems by
      immunoisolating genetically modified cells in a biocompatible membrane, thereby
      introducing a system that can provide sustained delivery of the desired gene
      product. As a model, mouse fibroblasts transformed with the human growth hormone
      gene (Ltk-GH) were encapsulated with an alginate-poly-L-lysine-alginate membrane.
      Long-term in vitro studies showed that the encapsulation of the cells was
      physiologically compatible with growth and survival of the cells. Furthermore,
      there was a unique pattern of secretion of the human protein by the encapsulated
      cells: there was a phase of steady increase in the secretion of the human growth
      hormone by each cell, followed by a plateau phase. The most convincing evidence
      of the feasibility of this strategy was provided by the in vivo study: Balb-c
      mice transplanted with encapsulated Ltk-GH cells had detectable serum levels of
      human growth hormone (hGH) for the duration of the study (115 days). Moreover,
      encapsulated cells recovered from a recipient 1 year after the transplantation
      continued to secrete high levels of hGH in culture.

PMID- 8370478
TI  - Intracellular diversion of glycoprotein GP160 of human immunodeficiency virus to
      lysosomes as a strategy of AIDS gene therapy.
AB  - A potential gene therapy strategy against human immunodeficiency virus (HIV-1) is
      to disrupt the intracellular transport of viral proteins. We report here the
      binding and transporting of HIV-1 glycoprotein gp160 to lysosomes as a result of
      the expression of fusion genes consisting of soluble CD4 and lysosome targeting
      domains. The effective lysosome targeting domain tested includes a lysosomal
      protease zymogen, procathepsin D, and the COOH-terminal domains of three lysosome
      membrane proteins: lamp-1, lamp-2, and lysosomal acid phosphatase. We
      demonstrated that cell fusion (syncytium), caused by the transport of gp160 to
      the surface of HeLa-CD4+ cells, was completely abolished by the expression of
      these fusion genes. The lysosomal localization of gp160 in HeLa cells
      coexpressing CD4-fusion genes was also established. From pulse-chase experiments,
      we observed that gp160 and the fusion proteins were degraded, as expected of
      lysosomal activities. Additionally, T lymphoblastoid cells transiently and
      permanently expressing these fusion genes strongly retarded the propagation of
      human immunodeficiency virus type 1. Thus, these fusion genes can deprive HIV of
      newly synthesized envelope protein gp160 for the assembly of new virions and are
      potentially useful in gene therapy against AIDS.

PMID- 8370479
TI  - Regulation of the phosphoenolpyruvate carboxykinase/human factor IX gene
      introduced into the livers of adult rats by receptor-mediated gene transfer.
AB  - Gene transfer systems targeting the asialoglycoprotein receptor have been
      developed to introduce functional genes into cells in culture and livers of
      intact animals. A synthetic neoglycoprotein carrier was constructed and complexed
      to a chimeric gene containing the cDNA for human factor IX ligated to the
      promoter-regulatory region of the gene for phosphoenolpyruvate carboxykinase from
      the rat. The complex was used to transfect human hepatoma cells that express the
      asialoglycoprotein receptor. Human factor IX DNA sequences were found in cells 10
      days after treatment. A 1.4 kB mRNA transcript was detected by Northern blot
      hybridization, which was inducible by treatment with dexamethasone or cAMP with
      theophylline. Western blot hybridization of proteins secreted into the culture
      medium detected human factor IX. The chimeric gene was also transferred into
      livers of rats using the neoglycoprotein carrier system after partial
      hepatectomy. Although the results were variable, the exogenous gene was
      transcribed in livers of several animals, and maximal levels of expression of the
      fully processed human factor IX were detected 30 days after introduction. The
      concentration of factor IX in the blood returned to control levels 60 days after
      transfection. Factor IX production was induced as late as 96 days after treatment
      by feeding transfected animals a diet high in protein but devoid of
      carbohydrates. This DNA carrier system can be used to introduce functional genes
      into the livers of rats, and may be a useful technique for gene therapy targeting
      the liver.

PMID- 8370480
TI  - Autoimmune diabetes results from genetic defects manifest by antigen presenting
      cells.
AB  - In most cases, insulin-dependent diabetes results from autoimmune elimination of
      pancreatic beta cells by T lymphocytes that are generated as a result of complex
      polygenic interactions between particular MHC haplotypes and non-MHC linked
      susceptibility modifiers. Immature T cells with potential autoreactivity are
      normally destroyed in the thymus when they are highly activated after ligation of
      the T cell receptor (TCR) with "self" peptides bound to MHC molecules on antigen
      presenting cells (APC) such as macrophages. Here the hypothesis is put forth that
      non-MHC linked diabetes susceptibility genes contribute to subtle defects in the
      maturation of macrophages, and in synergy with a diabetogenic MHC haplotype
      generate APC that are unable to trigger autoreactive T cells to an activation
      state high enough to induce their destruction.

PMID- 8370482
TI  - Science odyssey: bringing our schools aboard.

PMID- 8370481
TI  - Basic medical sciences and research 50 years ago.

PMID- 8370483
TI  - Extracellular matrix. 2: Role of extracellular matrix molecules and their
      receptors in the nervous system.
AB  - Extracellular matrix molecules help regulate many aspects of neural development,
      including survival, migration, axon growth, and synapse formation by neurons.
      These same molecules have been shown to modulate regeneration of neurons after
      injuries. They also regulate the development and differentiation of other neural
      cells, such as astroglia and Schwann cells. Significant progress has been made
      recently in characterizing both ECM constituents and their receptors in the
      nervous system. Extracellular matrix molecules promote cell adhesion, activate
      intracellular signaling pathways, and modulate the activities of several growth
      factors and proteins. Our current understanding of the extracellular matrix, its
      receptors, and its functions in the nervous system are discussed.

PMID- 8370484
TI  - [Legal determination of physician's professional role exemplified by the abortion
      problem].

PMID- 8370485
TI  - [D-dimer and plasminogen activator of the urokinase type: personal experiences
      with breast cancer].
AB  - Plasma values of d-dimer, a stable end product of plasmin-induced fibrinolysis,
      were ascertained in 128 female patients with mammary carcinoma. These patients
      demonstrated significantly increased d-dimers in comparison with the control
      group with benign mammary disease (p < 0.01). The sensitivity and specificity of
      d-dimer were slightly higher than those of the established tumour marker CA 15-3
      and CEA. There was no correlation between d-dimers in the plasma and increased
      expression of urokinase plasminogen activator (UPA) in the tissue. Increased d
      dimers in the plasma of female patients with mammary carcinoma reflect multi
      factoral interactions between carcinoma growth and the haemostatic-fibrinolytic
      system, and may be used as tumour markers.

PMID- 8370486
TI  - [Immunohistochemical detection of EGF-receptors in breast cancers].
AB  - We examined the possibility of a quick and easy-to-perform way to determine the
      EGF receptor status in primary breast cancer cells by immunohistochemical
      staining. For this, we used two different monoclonal antibodies on corresponding
      tissue slides (Gullick, London; Mendelsohn, New York). The staining was
      interpreted by a semiquantitative histoscore. With both antibodies, we were able
      to detect EGF-R in breast tumours. We examined 80 tumours. 15 respectively 21%
      were EGF-R rich. 25% of the tumours were classified EGF-R poor. In 64 (54%) we
      were not able to detect EGF-R. The judgement of the EGF-R status by the different
      antibodies was identical in 80%. The results were also compared with the
      oestrogen receptor status (ER). We did not find a significant accumulation of EGF
      R positive tissues in the group of ER-negative tumours (11/28 respectively
      16/32). Nevertheless most ER-positive tumours showed a negative EGF-R receptor
      score (32/52; 27/48). These results are comparable to the studies of the
      Sainsbury group. In addition we compared the EGF-R of our tumours also with other
      parameters for the prognosis of breast cancer such as lymph node status,
      histological grading and menopausal status. We found, that nearly two thirds of
      the EGF-R negative tumours were lymph node negative. Only 18% of the lymph node
      negative tumours had a positive EGF-R status in both techniques. The results of
      immunohistochemical staining were also compared with a radio-receptor assay. The
      results were identical in 85% of the cases.

PMID- 8370487
TI  - [Surgical treatment of recurrent stress incontinence: Burch versus lyodura sling
      operation--a prospective study].
AB  - This prospective randomised study involved 52 female patients suffering from
      recurrent stress urinary incontinence, objectively confirmed by means of clinical
      incontinence tests and urodynamic examinations. They alternatively underwent
      colposuspension according to Burch or suburethral sling procedure surgery.
      Urodynamic and sonographic examinations were carried out before and 2.5 years
      (i.e. within a range of 2-3) after surgery according to Burch or suburethral
      sling procedure. There was no significant difference between the two methods with
      respect to subjective and objective rate of cure, which amounted to 85% of the
      cases involving colposuspension and 88% of cases involving the suburethral sling
      procedure. Both methods resulted in a significant improvement of the depression
      quotient and a significant elevation of the internal urethral meatus (p < 0.05).
      Apart from an aggravation of urge symptoms in both groups, the patients with
      surgery according to Burch tended towards enterocele and rectocele in the medium
      range, whereas urination disorders had to be accepted in the patients operated on
      according to the sling procedure in the long term.

PMID- 8370488
TI  - [Changes in central hemodynamics and peripheral circulation in pregnancy].
AB  - Systemic blood pressure, stroke volume, systolic time intervals (measured via
      impedance cardiography), rheological properties of blood (hematocrit, plasma
      viscosity and erythrocyte aggregation) and peripheral flow conditions (measured
      via occlusive impedance plethysmography) were assessed longitudinally in 21
      nonpregnant women and in 49 patients from 5th to 41st week of gestation and 4 to
      9 days postpartum. Measurements were taken in the left lateral position. The data
      showed, that dz/dt, stroke volume and cardiac index rose until the 30th week of
      gestation and decreased throughout the rest of pregnancy. The same changes were
      observed in the data on diastolic pressure and Heather Index. Peripheral
      resistance fell during the first trimester and then increased notably throughout
      the following time of pregnancy. The systolic time intervals become longer in the
      last trimester of pregnancy, but were characterised by a markedly shortened left
      ventricular ejection time (LVET). The reduction of stroke volume in the last
      trimester is due to diminished venous return or venous outflow by obstruction of
      the inferior vena cava or by abnormalities in the left ventricular function
      and/or impaired rheological properties of the blood.

PMID- 8370489
TI  - [Correlation between reduced amniotic fluid volume and Doppler spectra of fetal
      blood vessels at term].
AB  - The aim of this study was to determine, whether foetuses with reduced amniotic
      fluid in other-wise uncomplicated pregnancies at term show signs of
      redistribution of blood flow analogous to foetuses with intrauterine growth
      retardation. In 33 pregnancies > or = 37 gestational weeks with the largest
      pocket of amniotic fluid < 2 cm, flow velocity waveforms were recorded for the
      umbilical artery, middle cerebral artery and renal artery and compared with those
      of foetuses of the same gestational age and normal amniotic fluid volume. No
      difference was found in the resistance index (umbilical artery and middle
      cerebral artery), the pulsatility index (renal artery), or for the cerebral
      placental ratio between these two collectives. We conclude, that Doppler
      examination of foetal vessels does not help to clarify the phenomenon of
      decreasing amniotic fluid volume during the final period of gestation. We
      suggest, that the decrease is not caused by renovascular changes, but has intra-
      or extrarenal causes.

PMID- 8370490
TI  - [Atypical cytologic findings in pregnancy].
AB  - The clinical significance of dysplasia and precancerous lesions of the cervix in
      pregnancy, frequency, age distribution and etiological factors is demonstrated
      based upon the clinical material of the Department of Obstetrics and Gynaecology
      of the University of Tubingen from 1970 to 1984. The diagnostic and therapeutic
      guidelines (cytology, colposcopy, histology by biopsy, conisation or
      hysterectomy) during pregnancy and associated problems are presented in detail.
      From a total of 168 patients included in the study, 128 revealed the histological
      classification Pap III/IIID, 38 Pap IVa/b and 2 cases Pap V. Histological
      carcinoma in situ was verified in 16 cases, microinvasive carcinoma in 6 cases
      and in 4 cases invasive cancer. From the data obtained, the following conclusions
      can be drawn: 1. Many of the dysplastic lesions of the cervix in pregnancy are
      found accidentally because of the limited participation of the patients in the
      routine cancer screening programme. 2. The precancerous lesions, even
      unfavourable stages, increase markedly in pregnancy. There is a shift towards
      younger women. 3. The known risk factors for cervical pre-invasive and invasive
      cervical abnormalities are confirmed. 4. For the management of cervical dysplasia
      in pregnancy it could be concluded, that observation by cytology and colposcopy
      should be done in cases with Pap III/IIID. In cases with Pap IVa/b, careful
      observation is mandatory, also by biopsy. Doubtful findings require conisation.
      Generally, this is also possible in pregnancy without complications. If invasion
      is excluded, an observant attitude may be adopted until delivery.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 8370491
TI  - [Clarithromycin, a new macrolide antibiotic. Effectiveness in puerperal
      infections and pharmacokinetics in breast milk].
AB  - The aims of this study were, to determine the pharmacokinetic parameters of
      clarithromycin and to study the passage of the drug into breast milk. Twelve
      patients (age 24 to 38; weight 44 to 83 kg), suffering from puerperal infections,
      were treated orally with 250 mg clarithromycin b.i.d. for 6 days. Samples of
      blood and breast milk were taken at timed intervals. The specimens were assayed
      for clarithromycin and its active metabolite 14-hydroxy-clarithromycin by HPLC
      and electrochemical detection. Serum concentrations of clarithromycin in the
      investigated patients were higher than those reported in healthy volunteers. The
      mean peak concentrations of clarithromycin and 14-hydroxy-clarithromycin in
      breast milk were about 25%, and 75% respectively of the corresponding serum
      concentrations. All patients recovered within 2 to 4 days and no drug-associated
      side effects (eg. gastrointestinal) were noted. Clarithromycin appears to be an
      appropriate antibiotic for the treatment of puerperal infections and (because of
      its considerable concentrations in breast milk) for puerperal mastitis as well.

PMID- 8370492
TI  - [CA-125--a tumor marker of lymphangioleiomyomatosis of diagnostic and prognostic
      importance?].
AB  - Lymphangioleiomyomatosis is a rare tumour of the lymphatic system, affecting
      mostly women of childbearing age. Due to its rare occurrence, diagnosis is mostly
      made after thorough examination therefore time for an early treatment is lost.
      Diagnostically important are, on the one hand, the histological findings with
      smooth muscle cells invading the lymphatic system, and on the other hand thin
      walled cysts in CT scanning of the lung. CA-125 seems to be a suitable screening
      parameter for LAM, which may be additionally of prognostic value. Sensitivity and
      specificity of CA-125 require further observation.

PMID- 8370493
TI  - [Choriocarcinoma of the uterine cervix and cervical pregnancy].
AB  - Case report of a 20-year-old women with a chorionic carcinoma of the uterine
      cervix. Subsequently, the aspects of the disease of chorionic carcinoma and
      cervical pregnancy are discussed, including epidemiology, aetiology, diagnosis
      and management. Finally, the conclusions of this discussion are compared with the
      case report.

PMID- 8370494
TI  - [Why are most children born from I. cephalic presentation?].
AB  - The question, why most children are delivered in I. cephalic position, is
      unsolved up to now. Most children are positioned with crossed legs in the uterus.
      Ultrasonography was employed from the 36th week of gestation onwards to find out
      whether there is a connection between crossing of the legs and the position in
      utero. From 58 pregnancies with I. position in 47 cases and from 32 pregnancies
      with II. position in 28 cases, the leg nearer to the back of the mother was
      crossed over the other one. According to the neuro-cerebral differentiation
      between both sides, the foetus prefers a crossing in such a manner, that the left
      leg is folded over the right leg. The foetus finds a more stable position, if the
      more mobile leg is directed with the foot against the yielding belly walls of the
      mother. In accordance with the preferred crossing of the left leg over the right
      leg the I. position in utero is more frequent.

PMID- 8370495
TI  - [Gestagen-estrogen combinations in gynecology. On the history, dosage and use of
      a hormone principle].
AB  - The first experimental and clinical investigations with gestagen-oestrogen
      combinations were undertaken in the late 'forties and the early' fifties of this
      century. In the course of further research and development, the dosage and
      mixture ratio of this hormonal principle were adjusted, according to the
      physiological status of the corpus luteum phase and its imitation by means of
      administration of hormonal doses. Considering the relatively large individual
      variations, an average daily production of 0.05 mg oestradiol/oestrone and 25 mg
      progesterone can be assumed, the mixture ratio being 1:50. Further indicators for
      the dosage were obtained by studying the biological valency of the semi-synthetic
      substances on the basis of the following parameters: transformation dose,
      menstruation delay test, anti-oestrogenic effectiveness and ovulation inhibition
      dose. Finally, dosage was also determined by the relevant indications; in this
      respect, depending on the intended use, preparations with the emphasis either on
      the oestrogen component or the gestagen component were deliberately produced. Up
      to the end of the 'fifties', parenteral gestagen-oestrogen combinations were the
      only preparations available for gynaecological hormonal therapy. Oral medication
      was predominant from 1957 onwards. The high ranking achieved by the combination
      preparations was due to their properties with respect to regulating menstrual
      haemorrhage and inhibiting proliferation and ovulation, as well as to their
      antiandrogenic properties. As far as methods of application were concerned,
      cyclical administration was most frequently employed (including phase variants),
      therapeutic amenorrhoea being second, whereas high-dosage application in the
      sense of hormonal pseudopregnancy was less often used. The gestagen-oestrogen
      combinations have become the most important hormonal principle in gynaecology as
      therapeutic agents and hormonal contraceptives.

PMID- 8370496
TI  - [Use of molecular genetic diagnosis of malignant hyperthermic syndrome (MHS) in
      selection of pigs].
AB  - Recently, a mutation has been discovered in the ryanodine-receptor gene causing
      malignant hyperthermic syndrome (MHS) in pigs. Taking advantage of the RCR
      analysis of tissue samples from pigs of the Deutch Landeras breed we could have
      demonstrated that the gene-diagnostics MHS analysis is a simple, reliable and
      significant way of gene-typing for the stress resistance. Employing this test
      with sufficient reliability and effectively will make it possible to create
      homozygous stress resistant lines and to produce heterozygous stress resistant
      animals having both good meat quality tending to improvement and good feeding
      characters. The advantages of this first gene--technological technique just ready
      for application in animal breeding seem to ensure its quick implementation into
      the applied pig breeding.

PMID- 8370497
TI  - [Behavior of pachytene chromosomes in male mice heterozygotic for various
      translocations (Rb(8,17), T(16,17)43H)].
AB  - The electron microscopic analysis of synaptonemal complexes of the Robertsonian
      translocation heterozygotes (Rb/T) and heterozygotes of the reciprocal
      translocation (Rb(8, 17)/T(16, 17) 43H revealed three types of translocation
      configurations (TC). The observed TC were subdivided into three types according
      to the manner of synapsis: 1) full synapsis of homologues forming trivalent with
      interstitial centromere in 15%; 2) the centromeric asynapsis (8 and 17-16
      chromosomes forming trivalent with the extension region of asynapsis and
      breakpoint of the reciprocal translocation on chromosome 17 in 70%; 3)
      centromeric asynapsis (only single chromosome 17-16 of trivalent, when the break
      point of reciprocal translocation and the absence of centromeric asynapsis of
      another chromosome 8 formed trivalent in 15%). The frequency of association
      between trivalents and the XY bivalents is 20% and close proximity is 15% for
      heterozygotes Rb/T. Which are fertile, while in the sterile heterozygotes Rb(8,
      17)/T(16, 17) 43H it is 45% for association and 15% close proximity (total 60%).
      These data show the significant differences in the contact of translocation
      configurations with the XY bivalents of fertile heterozygotes, in comparison with
      the sterile. Thus, it is shown that the chromosome pairing of fertile and sterile
      mice is clearly distinguished.

PMID- 8370498
TI  - [Molecular diagnosis of fragile X-chromosome syndrome (Martin-Bell syndrome) in
      patients of native populations].
AB  - 63 families at-rist of Fragile X-syndrome (FraX) are subjected to Southern blot
      analysis with the DNA probes Ox1.9 and Ox0.55. Molecular studies have confirmed
      an initial clinical diagnosis of FraX in 26 families earlier studied
      cytogenetically and in 11 of 27 families with only some clinical traits of FraX
      syndrome in proband. Full mutation and premutation condition of FMR-1 gene was
      ascertained in 34 and rejected in 18 close relatives of probands with the proved
      FraX syndrome in 37 and families. Four different patterns of pathological alleles
      are detected at electrophoretograms of DNA samples restricted by endonuclease
      RcoRI and hybridized to the DNA probe Ox1.9. Prenatal diagnosis of FraX was
      carried out in two cases at the 1st and 2nd trimester of pregnancy. Perspective
      of broad application of molecular methods for early diagnostics and prophylactic
      of FraX syndrome are briefly discussed.

PMID- 8370499
TI  - [Migration structure and inbreeding in the Talysh population].
AB  - The origin of genes in Talysh population (South Azerbaijan Republic) is
      considered. During 11 generations of population history more than 100 unrelated
      persons supplied the genes to the population. At present, the population is
      highly isolated: the endogamy index is 0.878, gametic index being 0.935.
      Inbreeding is estimated both ty means of genealogy and from the frequency of
      marriages between the persons of the same kin. The inbreeding coefficient is FIT
      = 0.026-0.030, its random component is FST = 0.01-0.02 and non-random component
      is FIS = 0.026-0.020.

PMID- 8370500
TI  - [Load of autosomal recessive diseases in populations of Kirov Province and its
      relationship to consanguinity].
AB  - The dependence of the load of autosomal recessive disorders on a variation of
      random inbreeding in the populations of the 9th Districts of the Kirov Province
      was investigated. The values of the Fst varied between different districts from
      0.00021 to 0.0011 and the values of load of AR--from 0.73 to 2.01 affected per
      1000. There is a close significant correlation (r = 0.90) between the parameters
      in the population studied which increased under analysis of the population
      considering the coefficients of random inbreeding.

PMID- 8370501
TI  - [Computer program of genetic map construction and database of gene localization].
AB  - Computer data base containing information about gene localization in the
      chromosomes of various organisms is composed. Computer program of genetic map
      constructing is created. The program represents graphically the information
      conserving in the data base. The data base and the program are intended for
      realization on the IBM-compatible computers.

PMID- 8370502
TI  - [Amplification of the integrated bovine growth hormone transgene using the
      polymerase chain reaction (PCR)].
AB  - Conditions of the PCR amplification of unique fragments of bovine growth hormone
      (bGH) were found that allow reliable identification of transgenic rabbits for
      this gene. An integrated construction containing a part of MT promoter of
      metallothionein gene and chromosomal bGH gene was amplified. Two of 46 newborn
      lambs were found to be transgenic for the bGH gene by using primers BG3 and BG4
      for amplification of the gene bGH fragment and its following restriction with
      pVUII. We managed to whow the possibility of successful amplification of growth
      hormones genes of pig and sheep using primers BG3 and BG8, corresponding
      respectively to the beginning and the end of the bGH gene.

PMID- 8370503
TI  - [Cloning of recA and lexA genes on the plasmid with a broad host range].
AB  - The recA gene from Escherichia coli and Propionibacterium shermanii and lexA gene
      from E. coli were cloned of the plasmid pBI101 with a broad host range. The
      correlation of induction of the SOS function and the dose of UV-light, MMS and 4
      NQO was studied in E. coli cells carrying the plasmid pJE43. The level of SOS
      response in recA cells carrying the plasmid pBI101::recA E. coli and pBI101::recA
      P. shermanii was higher than a SOS response level in EC1000 with a normal recA
      gene. However, no complete complementation of the SOS function was observed in
      recA cells when pBI101 with recA and lexA genes was incorporated and under the
      action of all mutagenic factors.

PMID- 8370505
TI  - [Genetic analysis of differences in dopamine metabolism in two Drosophila virilis
      lines under normal conditions and under heat stress].
AB  - The results of genetic analysis of the differences in dopamine (DA) content
      between two lines of Drosophila virilis in response to heat stress are presented.
      The gene(s) controlling the differences in DA content under normal conditions is
      located on the X-chromosome, and the gene(s) controlling the differences in
      responsiveness of DA system to stress was found to be autosomal. By means of
      polyacrylamide gel electrophoresis was also examined phenoloxidase activity in
      these lines under normal conditions and short-term heat stress (60 min, 38
      degrees C). Of the five phenol oxidase fractions identified, three were major,
      A1, A2 and A3 components, and two appeared occasionally. It seems likely that A1
      is monophenol oxidase and A2 is diphenol oxidase. It was shown that neither mono,
      nor diphenol oxidase activities change under heat stress. It was found that D.
      virilis lines 147 and 101 differ in diphenol oxidase activity under normal
      conditions. Genetic analysis of these differences revealed that they are
      controlled by a single gene (or a group of closely linked genes). The gene
      controlling diphenol oxidase activity in D. virilis is located on the X
      chromosome.

PMID- 8370504
TI  - [Cloning of the RIB7 gene encoding the riboflavin synthase of the yeast Pichia
      guilliermondii].
AB  - The RIB7 gene encoding the enzyme of the final stage of riboflavin biosynthesis
      in Pichia guilliermondii--riboflavin synthase was cloned on the pFL38 shuttle
      vector as the Sau3A fragment of the chromosomal DNA of about 4 kb. The HindIII
      fragment of 1.4 kb was subcloned from the hybrid plasmid pFR7 obtained onto the
      pUC18 plasmid. The plasmid pR7 thus constructed transform Escherichia coli ribB
      45 mutant cells with a blocked riboflavin synthase approximately at the same
      frequency as pFR7. High riboflavin synthase activity was discovered in the E.
      coli transformants carrying pR7 but not pFR7. Using both plasmids we also
      complemented rib17 mutant of P. guilliermondii.

PMID- 8370506
TI  - [Sex chromosome behavior in meiosis in the gray hamster (Cricetulus migratorius
      Pallas, 1770)].
AB  - The sequence of X and Y chromosomes pairing at meiotic prophase in the Armenian
      hamster Cricetulus migratorius Pall., 1770 gas been studied. The results of
      differential staining (C-, Ag-NOR) of mitotic chromosomes are presented. The rare
      case of interstitial synapsis of the sex chromosomes has been described. Earlier
      it was established only for Peromyscus sitkensis (Hale, Greenbaum, 1986). Pairing
      of the X and Y chromosomes is initiated at an interstitial position of the
      euchromatic region with subsequent synapsis towards the telomeres of the short
      arms. The latter conjugate completely and in this state do not differ outwardly
      from autosomal bivalents. The long arms remain asynaptic (heteropycnotic)
      constantly but at the meiosis undergo different morphological changes (thickness,
      bulging, clear showing filament structures, etc.) The data obtained agree with
      the hypothesis of Matthey (1961) claiming that the paired parts of X and Y
      chromosomes of the species with large Y chromosome and visible chiasma have
      autosomal origin. Therefore, X and Y chromosomes of Cricetulus migratorius could
      be originated via autosome-gonosome translocation.

PMID- 8370507
TI  - [Some developmental features of Escherichia coli Mu phage in Pseudomonas
      aeruginosa cells].
AB  - In order to determine the replication-transposition (RT) efficiency of
      Escherichia coli phage Mu in Pseudomonas aeruginosa cells, the change of Mu DNA
      copy number after transfer of P. aeruginosa (RP4::Mu) from 42 (the condition of
      RP4::Mu plasmid stability and low phage production level in P. aeruginosa) to 30
      degrees C (the condition of RP4::Mu plasmid instability and higher phage
      production level in P. aeruginosa) was analysed. It was shown that the
      temperature shift causes no increase in Mu DNA copy number, although free phage
      DNA is revealed after transfer of the cells at 30 degrees C. Considering that the
      studied cells contained also a linear RP4 DNA and the free Mu DNA hybridized with
      the RP4 DNA, we proposed that the mature Mu DNA arises as a result of Mu genome
      packaging from the original plasmid. So, the Mu genome RT is uneffective in P.
      aeruginosa and all of the phage particles released from P. aeruginosa (RP4::Mu)
      cells contain Mu DNA apparently originated from the DNA of hybrid plasmid
      RP4::Mu. Moreover, these results suggest that the Mu DNA packaging is not
      effective in P. aeruginosa (taking into account that the P. aeruginosa (RP4::Mu)
      cells release about 10(-2) p.f.u./cell and that originally the copy number of
      RP4::Mu > or = 1).

PMID- 8370508
TI  - [Number of chromosome breaks and the probability of break reunion during
      irradiation of mature Drosophila sperm].
AB  - The dose-effect curves for half and full translocations induced in mature sperm
      with the break points within the same chromosomal region were obtained.
      Probability of reunion q and the number of breaks N that could be calculated from
      these curves varies within the range 0.83-0.69 and 0.011-0.078, respectively. The
      half and full translocations were induced under maternal effect of mus 104D1. In
      this case, q = 0.86 (for normal genotype 0.79) and N = 0.114 (for normal genotype
      0.048). These figures show that the dose increase and the introduction of the mus
      104 cause increase in the breaks number and only weak change in break reunion
      occurs. The method developed can be used for the search for mutations that
      interfere with break reunion.

PMID- 8370509
TI  - [Effect of vitamin C on prostatilen mutagenicity in mice].
AB  - Frequencies of sperm head anomalies (SHA) and chromosome aberrations (CA) in bone
      marrow cells were studied after injection of drugs, prostatilen and vitamin C
      into the male mice Mus musculus. It was found that prostatilen (5, 10 and 50 mkg)
      increased the frequency of both SHA and CA. Vitamin C (14 and 140 mkg) induced no
      CA but increased SHA frequency at the dose of 140 mkg. The joint action of the
      drugs led to decrease in SHA frequency for all dose combinations. Antimutagenic
      action of vitamin C in the CA test was recorded for only 14 mkg dose.

PMID- 8370510
TI  - [Genetic effects of tritium-labeled amino acids in mice].
AB  - The frequency of dominant lethal mutations (DLM) in germ cells and the frequency
      of reciprocal translocations (RT) in spermatogonia of male mice exposed to H
      labeled amino acids at the dose of 1.45-2.30 Gy was studied. The effect from H
      glycine was equal to that from tritium oxide (THO). When D,L-lysine-3H and L
      lysine-3H were injected into the body of mice the frequency of DLM exceeded that
      from the equal dose of THO by 2.5 and 7 times, respectively. As to RT, these
      indexes for H-amino acids have no statistically significant differences from the
      similar index for THO.

PMID- 8370511
TI  - [Mutations in mouse minisatellite DNA, induced by radiation].
AB  - Male (101/HY x C3H/SnY) F1-hybrid mice were given an acute exposure to 0.5 or 1
      Gy gamma-irradiation using 60Co, and DNA fingerprints were produced from parents
      and progeny using probes 33.6 and 33.15. The frequency of mutations in the
      offspring of irradiated males was 1.72 times higher than in offspring of
      nonirradiated males. Possible implications of the DNA fingerprint technique in
      monitoring of mutations in human populations are discussed.

PMID- 8370512
TI  - Divergence of two families of repeated DNA in wood and field mice of the genus
      Apodemus (Muridae, Rodentia).
AB  - The nDNA of six species of a wood and field mice of the genus Apodemus (2n = 48):
      peninsulae, sylvaticus, flavicollis, microps, speciosus, agrarius, grey rat
      Rattus norvegicus as well, and house mouse Mus musculus were studied using EcoRI
      and HindIII restriction endonucleases with an agarose and polyacrylamide gel
      electrophoresis and a microdensitometry. It is shown for dispersed sequences that
      a quarter of 1.85 kb EcoRI genus specific family of repeated DNA is constant but
      a quarter of 1.35 kb EcoRI repeats, which are specific for more large taxon unit,
      is variable. The HindIII satDNA of the various species differs in the length of
      monomer, size of more representative multimer and digestion of the monomers by
      the same endonuclease of restriction; HindIII satDNA quantity correlates with
      1.35 kb EcoRI repeat content. Some nonidentified components are found in Apodemus
      genomes. The possible ways evaluation of the repetitive DNA are briefly
      discussed. It was supposed that the evolutionary age of the wood mice is directly
      proportional to the length of HindIII multimer and inversely proportional to the
      amount of HIndIII satDNA with a 1.35 kb EcoRI repeats.

PMID- 8370513
TI  - [Differentiation of GC-rich restriction sites in the highly repeated DNA in
      Apodemus (Muridae, Rodentia].
AB  - nDNAs of six species of wood and field mice of the genus Apodemus (peninsulae,
      flavicolis, microps, speciosus, and agrarius), grey rat Rattus norvegicus as
      well, and house mouse Mus musculus were digested with restriction endonucleases
      (MspI (CCGG), BspRI (GGCC) and MvaI (CCA/TGG). Two highly representative
      satellites are found in A.peninsulae (8%) and M.musculus (20%) genomes using
      BspRI and MvaI. The length of restriction fragments of these components are equal
      to n x 30 and n x 230 nb, respectively. Based on the results of PDRF of nDNA in
      rodent interspecies, genetic distances are estimated and phylogenetic tree
      reconstructed. Among wood mice examined A.sylvaticus and A.flavicollos are most
      closely related, A.peninsulae is more diverged. Field mouse has approx. equal
      differences from the european and asian species of wood mice. A middle value of
      genetic distances is about 7.12% in Apodemus genus, 12.69 and 13.2% between
      Apodemus with M.musculus and R.norvegicus, respectively.

PMID- 8370514
TI  - [Mapping of the dominant gene of hyperkeratosis palmaris et plantaris in man].
AB  - Analysis of linkage between the gene of autosomal dominant tylosis and some loci
      with RFLP in 1, 14 and 17 chromosomes in the pedigree with this disorder was
      performed. A positive load score (0.729 at 0-0.20) for tylosis and D17S14 locus
      (DNA probe pTHH-59) was found.

PMID- 8370515
TI  - [Structure and variability of hereditary disease in the Kirov Province].
AB  - The main purpose of this report is to present the nosological spectrum of
      hereditary diseases in 9 Districts of Kirov Province and to compare it with that
      studies earlier in other Russian populations. This comparison is undertaken in an
      attempt to define a "nucleus" of hereditary diseases in the Russian population
      studied. During this study 343 families with 546 affected were registered. The
      spectrum covered 55 different autosomal dominant, 14 autosomal recessive and 11 X
      linked recessive hereditary disorders in the population under study. Some of
      these forms could be considered as common forms for the whole Russian population,
      because they were met in all Russian populations which were analysed. This
      conclusion is proved by the cluster analysis of genetic distances calculated on
      the basis of gene frequencies for autosomal recessive hereditary disorders.

PMID- 8370516
TI  - [Role of the homologous translocation, located on the Y-chromosome, in
      mutagenesis of the double super-unstable system in Drosophila melanogaster
      males].
AB  - Main features of mutagenesis induced in the double super-unstable system in
      Drosophila melanogaster males and females was studied earlier. Very different y-
      and sc-alleles arose under the mutagenesis. These are differed one from another
      by the expression of yellow and scute loci. However, it was shown that the
      female's mutagenesis very differed from the male's one. The structure of a
      homologous chromosome has played an important role in the mutagenesis in
      Drosophila females. We found here that the homologous translocation in Y
      chromosome led to double decrease of the frequency of the mutagenesis in males.
      It is proposed that interconnections between two homologous insertions are
      essential in the recombinational processes by which alleles change. The nature
      and mechanism of the sub-lethal allele's formation in the presence of
      translocation in Y chromosome is discussed.

PMID- 8370517
TI  - Spatial restriction of cellular differentiation.
AB  - Myxococcus xanthus cells differentiate into myxospores within a fruiting body, an
      aggregate of approximately 10(5) cells. Previous work had discerned an inner and
      outer domain within the fruiting body differentiated by cell density and cell
      alignment. To test whether the two domains might play different roles in spore
      differentiation, developmentally regulated gene fusions were screened for
      expression restricted to one domain or the other. Transcriptional lacZ fusions to
      80 developmentally regulated genes were examined and eight fusions were found
      that restricted expression to the inner domain, while one fusion, omega 7621,
      showed initial expression in the outer domain. Initial omega 7621 expression
      coincided with patches of spore precursors evident in bright-field microscopy.
      Later in development, both omega 7621 expression and the patches expanded inward,
      eventually filling both the inner and outer domains. Previous work had also shown
      that high cell density and cell alignment are required for transmission of the C
      signal, which is needed to initiate spore differentiation. Evidence is presented
      for a novel morphogenetic mechanism in which C-signaling in the outer (high
      density) domain initiates spore differentiation. It is proposed that spore
      precursors are passively transported from the outer to the inner domain by the
      movements of undifferentiated rod cells. Reconstruction experiments showed that
      developing rod cells move with sufficient force to displace spores. Spore
      precursors thus accumulate in the inner domain where they express spore-specific
      genes at high levels and account for inner domain specific expression.

PMID- 8370518
TI  - Expression of a retinoblastoma transgene results in dwarf mice.
AB  - Introduction of the normal retinoblastoma gene (RB) into different tumor cells
      possessing inactivated RB genes suppresses their tumorigenicity in nude mice.
      These results suggest that RB replacement is a potential strategy for developing
      future clinical treatments of cancer. In a transgenic mouse model, we found that
      the quantity of RB protein in a given cell may play an important role in
      dictating its effect. Four founder mice containing 1-7 copies of a human RB cDNA
      transgene under the transcriptional control of the human RB promoter were
      generated. Most of the transgenic mice were smaller than nontransgenic
      littermates. This effect was found as early as embryonic day 15. The degree of
      dwarfism correlated roughly with the copy number of the transgene and the
      corresponding level of RB protein. The expression pattern of the transgene
      products was similar to that of the endogenous mouse RB gene with regard to
      tissue and temporal distribution. Transferring the transgene to RB deficient
      mice, which are nonviable, resulted in the development of normal, healthy mice,
      indicating that the human RB gene can functionally complement the mouse homolog.
      These studies demonstrate that the effect of RB on overall mouse development is
      closely dependent upon its dosage.

PMID- 8370519
TI  - Identification of a novel zinc finger protein binding a conserved element
      critical for Pit-1-dependent growth hormone gene expression.
AB  - The growth hormone (GH) and prolactin genes require the pituitary-specific POU
      domain transcription factor Pit-1 for their activation. However, additional
      factors are necessary for the effective expression of these genes. Analysis of
      evolutionarily conserved sequences in the proximal GH promoter suggests the
      critical importance of one highly conserved element located between the two Pit-1
      response elements. Mutation of this site decreases expression of a transgene in
      mice > 100-fold. We have identified a major activity binding to this site as a
      novel member of the Cys/His zinc finger superfamily, referred to as Zn-15. The Zn
      15 DNA-binding domain comprises three zinc fingers separated by unusually long
      linker sequences that would be expected to interrupt specific DNA site
      recognition. Zn-15 synergizes with Pit-1 to activate the GH promoter in
      heterologous cell lines in which this promoter is only minimally responsive to
      Pit-1 alone. Our data suggest that functional interactions between the tissue
      specific POU domain factor Pit-1 and this novel zinc finger factor binding to an
      evolutionarily conserved region in the GH promoter may constitute an important
      component of the combinatorial code that underlies the effective expression of
      the GH gene.

PMID- 8370520
TI  - A bZIP protein, sisterless-a, collaborates with bHLH transcription factors early
      in Drosophila development to determine sex.
AB  - Sexual identity in Drosophila is determined by zygotic X-chromosome dose. Two
      potent indicators of X-chromosome dose are sisterless-a (sis-a) and sisterless-b
      (sis-b). Genetic analysis has shown that a diplo-X dose of these genes activates
      their regulatory target, the feminizing switch gene Sex-lethal (Sxl), whereas a
      haplo-X dose leaves Sxl inactive. sis-b encodes a transcriptional activator of
      the bHLH family that dimerizes with several other HLH proteins required for the
      proper assessment of X dose. Here, we report that sis-a encodes a bZIP protein
      homolog that functions in all somatic nuclei to activate Sxl transcription. In
      contrast with other elements of the sex-determination signal, the functioning of
      this transcription factor in somatic cells may be specific to X-chromosome
      counting. Using in situ hybridization, we determined the time course of sis-a,
      sis-b, and Sxl transcription during the first few hours after fertilization. The
      pattern of sis-a RNA accumulation is very similar to that for sis-b, with a peak
      in nuclear cycle 12 at about the time of onset of Sxl transcription. Considered
      in the context of other studies, these results suggest that the ability to
      distinguish one X from two is attributable to combinatorial interactions between
      bZIP and bHLH proteins and their target, Sxl, as well as to positive and negative
      interactions with maternally supplied and zygotically produced proteins.

PMID- 8370521
TI  - Interactions between dorsal and helix-loop-helix proteins initiate the
      differentiation of the embryonic mesoderm and neuroectoderm in Drosophila.
AB  - The dorsal (dl) morphogen has been implicated in the establishment of the
      embryonic mesoderm, neuroectoderm, and dorsal ectoderm in Drosophila. Here we
      show that the simultaneous reduction in the levels of dl and any one of several
      helix-loop-helix (HLH) proteins results in severe disruptions in the formation of
      mesoderm and neuroectoderm. Certain triple heterozygous combinations essentially
      lack mesoderm as a result of a block in ventral furrow formation during
      gastrulation. HLH proteins that have been implicated previously in sex
      determination and neurogenesis (daughterless, achaete, and scute) are shown to be
      required for the formation of these embryonic tissues. Evidence is also presented
      that dl-HLH interactions involve the direct physical association of these
      proteins in solution mediated by the rel and HLH domains. We discuss the striking
      parallels in mesoderm formation and sex determination.

PMID- 8370522
TI  - Masking mRNA from translation in somatic cells.
AB  - We present evidence for a role for Y-box proteins in both mRNA transcription and
      translation. We have expressed an oocyte-specific RNA-binding protein (FRGY2) in
      somatic cells. This protein is normally found together with mRNA in large amounts
      within the masked maternal mRNA storage particles of Xenopus laevis oocytes.
      Masked maternal mRNA is believed to be translationally repressed during oogenesis
      and is stored within ribonucleoprotein storage particles for subsequent use
      during embryogenesis. Surprisingly, FRGY2 is not only found to direct the
      accumulation of mRNA from promoters containing binding sites for the protein but
      also to selectively repress translation of the same mRNA. Thus, the role of FRGY2
      in the transcription and storage of maternal mRNA is similar to that of the
      transcription factor TFIIIA in the transcription and storage of 5S rRNA from the
      oocyte type 5S rRNA genes.

PMID- 8370523
TI  - mRNA destabilization triggered by premature translational termination depends on
      at least three cis-acting sequence elements and one trans-acting factor.
AB  - Nonsense mutations in a gene can accelerate the decay rate of the mRNA
      transcribed from that gene, a phenomenon we describe as nonsense-mediated mRNA
      decay. Using amber (UAG) mutants of the yeast PGK1 gene as a model system, we
      find that nonsense-mediated mRNA decay is position dependent, that is, nonsense
      mutations within the initial two-thirds of the PGK1-coding region accelerate the
      decay rate of the PGK1 transcript < or = 12-fold, whereas nonsense mutations
      within the carboxy-terminal third of the coding region have no effect on mRNA
      decay. Moreover, we find that this position effect reflects (1) a requirement for
      sequences 3' to the nonsense mutation that may be necessary for translational
      reinitiation or pausing, and (2) the presence of an additional sequence that,
      when translated, inactivates the nonsense-mediated mRNA decay pathway. This
      stabilizing element is positioned within the coding region such that it
      constitutes the boundary between nonsense mutations that do or do not affect mRNA
      decay. Rapid decay of PGK1 nonsense-containing transcripts is also dependent on
      the status of the UPF1 gene. Regardless of the position of an amber codon in the
      PGK1 gene, deletion of the UPF1 gene restores wild-type decay rates to nonsense
      containing PGK1 transcripts.

PMID- 8370524
TI  - Dominant negative alleles of RAD52 reveal a DNA repair/recombination complex
      including Rad51 and Rad52.
AB  - Saccharomyces cerevisiae rad52 mutants are characterized by severe defects in
      double-strand break (DSB) repair and recombination. In this study we have
      identified several regions of RAD52 that are required for these biological
      functions. We cloned and characterized a RAD52 homolog from Kluyveromyces lactis
      that partially complemented S. cerevisiae rad52 mutants while exhibiting negative
      dominance in wild-type (RAD52) strains. The dominant negative effect was
      suppressed by overexpression of RAD51, an additional gene known to be required
      for DSB repair and recombination, indicating a genetic interaction between these
      loci. Furthermore, GAL4 two-hybrid analysis revealed a physical interaction
      between Rad51 and the carboxy-terminal one-third of Rad52. Deletion alleles of
      rad52 (with or without the Rad51 association domain) also produced dominant
      negative defects, suggesting the disruption of repair through nonfunctional
      interactions with other DSB repair and recombination proteins. RAD51 relieved the
      negative dominance of each of these alleles either by competitive titration or
      functional activation of mutant or heterologous Rad52 proteins. These results
      demonstrate the importance of Rad52-Rad51 interactions and point to the formation
      of a higher order repair/recombination complex potentially containing other yet
      unidentified components.

PMID- 8370525
TI  - Transcription-dependent recombination induced by triple-helix formation.
AB  - The homologous recombination between direct repeat sequences separated by either
      200 or 1000 bp was induced by active transcription of the downstream gene when
      poly(dG)-poly(dC) sequences exist between the two direct repeats. This dG tract
      mediated and transcription-induced recombination was RecA independent, and the
      frequency of recombination was dependent on both the length and the orientation
      of the poly(dG)-poly(dC) sequences relative to the gene. An intramolecular
      dG.dG.dC triplex formation was detected in Escherichia coli cells in a length
      dependent manner when the transcription of the downstream gene was activated. We
      suggest that the negative superhelical strain generated by active transcription
      of the downstream gene induces poly(dG)-poly(dC) sequences to adopt a triple
      helix structure in vivo and that this structure brings two remote sequences
      together to stimulate homologous recombination.

PMID- 8370526
TI  - Potentiation of RNA polymerase II transcription by Gal4-VP16 during but not after
      DNA replication and chromatin assembly.
AB  - Purified, reconstituted chromatin templates containing regular, physiological
      nucleosome spacing were transcribed in vitro by RNA polymerase II along with the
      Gal4-VP16 activator. When Gal4-VP16 was prebound to DNA before reconstitution of
      either H1-deficient or H1-containing chromatin, the resulting templates were
      transcribed with a similar efficiency. Under such conditions, we observed long
      range (1000 bp) activation of transcription in vitro with H1-containing
      chromatin, but not naked DNA templates. When Gal4-VP16 was added to preassembled
      chromatin, the H1-deficient chromatin was transcriptionally active, whereas the
      H1-containing chromatin, which possessed properties similar to native chromatin,
      was transcriptionally inert. We then mimicked DNA replication and chromatin
      assembly at a replication fork and found that Gal4-VP16 could potentiate
      transcription during, but not after, replication and assembly of histone H1
      containing chromatin. These experiments provide biochemical data that support a
      DNA replication-dependent mechanism for reconfiguration of chromatin structure
      and activation of transcription by Gal4-VP16.

PMID- 8370527
TI  - The erythroid protein cGATA-1 functions with a stage-specific factor to activate
      transcription of chromatin-assembled beta-globin genes.
AB  - The chick beta-globin gene is regulated developmentally within erythroid cells by
      the interaction of multiple proteins with the promoter and the 3' enhancer. These
      interactions are correlated with changes in chromatin structure, which are
      characteristic of the actively expressed gene. Using in vitro chromatin assembly
      and transcription with staged erythroid extracts, we have determined the critical
      proteins required to activate expression of nucleosome-reconstituted beta-globin
      genes. These genes contain a specialized TATA box at -30 (GATA) through which the
      erythroid-restricted protein cGATA-1 and TFIID both function to regulate
      different steps in beta-globin expression. We find that TBP (TATA-binding
      protein) alone can activate transcription of beta-globin chromatin templates from
      promoters mutated to a canonical TATA box but is ineffective on those containing
      the normal -30 GATA site. The occupancy of this site by cGATA-1 also fails to
      generate efficient expression of beta-globin chromatin unless combined with a
      stage-specific protein, NF-E4, that binds to an adjacent site. However, NF-E4
      does not function with TBP to derepress nucleosome-assembled beta-globin genes.
      We propose that the developmental regulation of beta-globin expression is
      achieved, in part, by the requirement of an erythroid protein and a stage
      specific factor, rather than TBP, to activate chromatin through a specialized
      TATA box.

PMID- 8370528
TI  - Functional interaction of adenovirus E1A with holo-TFIID.
AB  - The activation domains of several regulatory transcription factors have been
      shown to bind directly in vitro to the TATA box-binding protein (TBP). Yet TBP
      must also interact with multiple associated polypeptides, called TAFs, for these
      same activators to stimulate transcription. These findings raise the question of
      how TBP can interact with so many proteins, both activators and TAFs,
      simultaneously. Here, we show that the activation domain of the adenovirus large
      E1A protein can bind specifically and stably to isolated holo-TFIID, the
      multisubunit protein complex consisting of TBP plus TAFs. Consequently, the
      surface of TBP that interacts with E1A must be exposed in the holo-TFIID complex.
      To assess the functional significance of this interaction, we established an in
      vitro transcription system responsive to the E1A activation domain. The addition
      of excess E1A to this system inhibits (squelches) both E1A-dependent and E1A
      independent transcription by sequestering a target factor required for E1A
      activation. From among the component activities that collectively reconstitute
      E1A-responsive transcription in this system, holo-TFIID alone is singularly
      capable of reversing the inhibition of transcription mediated by excess E1A,
      indicating that holo-TFIID is the direct functional target of the E1A activation
      domain.

PMID- 8370529
TI  - Rapid transcriptional autoregulation of a yeast metalloregulatory transcription
      factor is essential for high-level copper detoxification.
AB  - Copper detoxification in the yeast Candida glabrata is carried out in large part
      by a family of metallothionein (MT) genes: a unique MT-I gene, a tandemly
      amplified MT-IIa gene, and a single unlinked MT-IIb gene. In response to elevated
      environmental copper levels, members of this MT gene family are transcriptionally
      activated by a copper-dependent, sequence-specific DNA-binding transcription
      factor, AMT1. AMT1 shares several structural and functional features with the
      Saccharomyces cerevisiae copper metalloregulatory transcription factor ACE1,
      which is constitutively expressed and poised for rapid transcriptional responses
      to the toxic metal copper. In this paper, we demonstrate that AMT1 is subject to
      positive transcriptional autoregulation, which is exerted through binding of
      copper-activated AMT1 to a single copper responsive element in the AMT1 promoter.
      A nonautoregulatory amt1 mutant displayed a marked decrease in both copper
      tolerance and expression of the MT-II genes, which are critical for high-level
      copper detoxification in Candida glabrata. Kinetic analysis demonstrated the
      remarkably rapid AMT1 mRNA accumulation in the presence of copper, which is
      followed by increased expression of the metallothionein gene products. These
      results demonstrate that AMT1-positive autoregulation plays a critical role in
      metal detoxification and suggest that the rapid autoactivation of the AMT1
      metalloregulatory transcription factor biosynthesis is essential for C. glabrata
      to quickly build up a cellular defense line to protect cells upon exposure to
      high environmental copper levels.